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Philips V200 Ventilation Hood User Manual

1. Description Example Resolution Range Units Comments Not used oooeee N A N A N A Outputs example value Date FEB 2301997 N A N A N A 12 character field MMM DDeYYYYe Mode setting CMVe e N A CMVe e N A Assist Control SIMVee CMV Spont Timed CPAP SIMV Spont CPAP Active Respiratory 12 0 0 lor1 1 0 9 0 BPM Outputs eese Rate setting 10 80 when mode is CPAP or Spont VCV Tidal Volume 0 50 0 01 0 05 2 50 L setting VCV Peak Flow 5eeece 1 3 140 LPM setting Oxygen Concentration 100 1 21 100 96 setting Pressure Trigger 0 5 e 0 1 0 1 20 0 cm Outputs value from setting H20 active type VCV or PCV When active type is NPPV then outputs the VCV value PEEP or EPAP setting 0 0 0 1 0 0 35 0 cm Uses PEEP setting H20 from active ventilation type VCV or PCV When active type is NPPV uses EPAP setting VCV Insp Hold 0 0ee 0 1 0 0 2 0 Sec Setting Not used oooeee N A N A N A Outputs example value Not used oooeee N A N A N A Outputs example value Not used oooeee N A N A N A Outputs example value Not used ooooee N A N A N A Outputs example value VCV Apnea Interval 10 eeee 1 10 60 sec setting VCV Apnea Tidal 0 50 0 01 0 05 2 50 L Outputs VCV Tidal Volume setting same Volume setting as Tidal Volume setting Table 13 4 Ventilation Report Sheet 2 of 10 REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 41 Chapter 13 Options and Accessories
2. Indicator Illuminates green when active Accept Function Enables you to accept selected settings on the front panel graphical display Table 8 3 Front Panel Keys Sheet 1 of 3 8 8 Respironics V200 Ventilator Operator s Manual REF 1057983 A Key Symbol Definition Alarm Silence Chapter 8 Operating Instructions Front Panel Keys Continued Description Function Disables the audio alarm for two minutes When Alarm Silence is pressed before the end of a two minute period the two minute timer is reset Alarms that cannot be silenced are listed in Table 9 1 Alarm Alert Messages on page 9 5 Indicator Illuminated yellow when the audible alarm has been disabled is active and stays on for two minutes when the ALARM SILENCE button is pressed If ALARM SILENCE is active and a new alarm condition occurs which involves exceeding an active alarm limit the visual alarm functions will be active Refer to Alarm Silence on page 9 2 ALARM RESET clears ALARM SILENCE If a medium or high priority alarm exists after ALARM RESET clears ALARM SILENCE the audible alarm will begin Alarm Reset Function Clears the visual indicator for auto reset alarms certain active alarms see Alarm Reset on page 9 3 and reset of apnea ventilation back to the active mode of ventilation see Apnea Ventilation on page 8 27 Alarm Reset also terminates ALARM SILENCE NOTE The ventilator may automatically reset certai
3. Ventilation Report Description Example Resolution Range Units Comments VCV Apnea 12 0 0 1 orl 1 0 9 0 BPM Respiratory Rate 10 80 setting Apnea Peak Flow 5eeece 1 3 140 LPM Outputs VCV Peak setting same as Peak Flow setting Flow setting VCV Apnea Oxygen 2leeoee 1 21 100 Outputs Oxygen Concentration setting Concentration same as Oxygen setting Concentration setting Pressure Support Oreeee 1 0 100 cm Outputs value from setting HO active ventilation type VCV or PCV When active type is NPPV then IPAP EPAP is used VCV Flow Pattern SQUARE N A SQUARE N A setting RAMP Not used ooooee N A N A N A Outputs example value Not used oooeee N A N A N A Outputs example value 100 Oxygen setting ON e N A ONoeee N A OFFeee Not used oooeee N A N A N A Outputs example value Not used oooree N A N A N A Outputs example value Not used oooeee N A N A N A Outputs example value Measured tota 0 0ee 0 10r1 0 0 9 9 BPM For values greater respiratory rate 10 150 than 150 output set to 150 Measured tida 1 15 0 01 0 00 9 99 L Outputs eese volume for values out of range Measured tota 0 00 0 01 or1 0 00 9 99 L For values out of minute volume 10 0 99 9 range output set to 99 9 Measured 0 00 0 01 or 0 1 0 00 9 99 L Outputs eese spontaneous minute 10 0 99 9 when ventilation volume mode is A C For values o
4. REF 1057983 A Respironics V200 Ventilator Operator s Manual 2 1 Chapter 2 Warnings Cautions and Notes ventilator power before removing the heated expiratory bacteria filter Exercise caution when handling the filter housing All oxygen connections should be carefully inspected to ensure that leaks are not present Excessive leaks can result in higher than normal ambient oxygen concentrations and create a potentially hazardous oxygen enriched environment Worn frayed oxygen hoses or oxygen hoses contaminated by hydrocarbon greases or oils should not be used since an oxygen leak or intense fire could result Care in the routing of the oxygen inlet hose should be exercised to ensure it is not exposed to mechanisms that could cause damage by cutting or heating melting The cover plate for the PCMCIA slot at the back of the ventilator must be replaced after the adapter and card are installed This is to protect the ventilator AC power is applied to the humidifier from the ventilator humidifier outlet only available on 100 120 VAC ventilators Under no circumstances does the Respironics V200 Ventilator provide control for the humidifier To ensure patient safety it is important that any humidifier used with the ventilator include an acceptable temperature control and monitoring mechanism as well as a temperature display and appropriate alarm capabilities refer to ISO 8185 To avoid electrical shock hazard connect the ventila
5. Ug gt _ lt Bottom Foam Insert Figure 4 1 Unpacking Repacking the Ventilator WARNING One person alone should not attempt to lift the ventilator or remove it from the shipping carton or the cart At least two people are required to avoid possible personal injury or damage to the equipment REF 1057983 A Respironics V200 Ventilator Operator s Manual 4 1 Chapter 4 Getting Started Inspection List of Parts and Accessories NOTE Medical electrical equipment needs special precautions regarding EMC and needs to be installed and put into service according to the EMC information provided in Chapter 12 Technical Specifications Unpacking Instructions Refer to Figure 4 1 Tools Required Box knife l Using a box knife cut a slit in packaging tape on top of shipping carton Remove accessories box and optional flex arm box not shown Remove top foam insert from inside carton Roll the plastic shipping bag not shown off the ventilator Gently lift ventilator from the bag and carton Remove patient circuit package not shown Store carton foam insert and plastic bag in safe place for possible future use OU A UN After unpacking the ventilator inspect its cabinet exterior for damage including cracks and scratches or blemishes Inspect the front panel for scratches chips abrasions or other deformities CAUTION Be sure to check all exterior parts of the ventilator Problems found dur
6. E i Figure 13 44 RS 232 Communication Ports for the Monitor and the Ventilator 4 Connect the patient circuit to the ventilator 5 Power up the ventilator if not already operating NOTE When powering on the ventilator for the first time after installing the respiratory profile monitor software the Trending Memory Card must be reformatted Press YES when asked the question Are you sure you want to erase the trended data stored in memory Yes No 6 Power up and connect the monitor according to the user s manual for your Respironics respiratory profile monitor e Inspect the monitor before powering up Press the Operate Standby key to turn the monitor on REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 89 Chapter 13 Options and Accessories e Connect the sensors to the monitor ventilator circuit and patient according to the Respiratory Monitoring section of the user s manual for your Respironics respiratory profile monitor 7 Select the NICO Esprit interface on the respiratory profile monitor Press the MENU key to activate the SELECT A SCREEN menu Figure 13 45 Select A Screen Menu screen Turn the knob to highlight SETUP and then press the knob The SETUP screen appears Turn the knob to highlight INPUT OUTPUT and then press the knob The INPUT OUTPUT screen appears Figure 13 46 Input Output Setup Screen e Turn the knob to highlight RS232 2 and then press the knob Th
7. Ventilation Report Description Example Resolution Range Units Comments PCV Inhalation Time 0 10 0 01 0 10 9 90 sec Outputs PCV Setting Inhalation Time when PCV or VCV is active NPPV Inhalation Time when NPPV is active PCV or NPPV Apnea 10 1 10 60 sec Outputs PCV Interval Setting Apnea Interval when PCV or VCV is active NPPV Apnea Interval when NPPV is active PCV Apnea Inhalation 100 1 5 100 cm Outputs PCV Pressure Setting or H20 Pressure setting NPPV Apnea IPAP when VCV or PCV setting active IPAP EPAP when NPPV active PCV Apnea 12 eeee 0 1 orl 1 0 9 9 BPM Outputs PCV Respiratory Rate 10 80 Apnea Rate setting Setting or NPPV when VCV or PCV Apnea Respiratory active NPPV Rate Setting Apnea rate when NPPV active PCV Apnea Inhalation 2 00 0 01 0 10 9 90 sec Outputs PCV Time Setting or NPPV Inhalation Time Apnea Inhalation setting when VCV Time Setting or PCV active NPPV Inhalation Time when NPPV active PCV Apnea Oxygen 100 eee 1 21 100 Concentration Setting or NPPV Apnea Oxygen Concentration PCV Apnea High 20eeee 1 10 105 cm Outputs PCV High Inhalation Pressure H20 Inhalation Setting or NPPV Pressure setting Apnea High when VCV or PCV Inhalation Pressure active IPAP 10 Setting when NPPV active Alarm Silence Status ON e N A ON eee N A OF Fees Apnea Alarm Status NORMAL N A NORMAL N A RESET ALARM Table 13 4 Ventil
8. 4 Atthe end of the maneuver whether successful or cancelled the Stop button changes to Continue While the Continue button is displayed the graph is frozen and can be rescaled Touch Continue or exit the screen to unfreeze the display 5 Touch Continue the button changes to Start and you can repeat the maneuver WARNING Perform the Vital Capacity maneuver according to instructions Because machine assisted breath delivery apnea detection and detection of certain patient alarms are temporarily disabled during a Vital Capacity maneuver close clinical supervision is recommended WARNING Because PEEP is temporarily set to 0 cmH 0 during a Vital Capacity maneuver close clinical supervision is recommended Flow Volume and Volume Time buttons Time Vital Stamp Capacity window Figure 13 29 Vital Capacity Screen REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 53 Chapter 13 Options and Accessories MIP PO 1 Maneuver Information type Description Flow Volume or Volume Flow Volume Displays a real time flow volume loop Time button Volume Time Displays a real time volume time waveform Start button Starts the maneuver Changes to Stop when the maneuver is started Changes to Continue when the maneuver is complete or when the Stop button is touched Changes to Start when Continue is touched Vital Capacity window Displays the most recently accepted VC maneuver results The date and time
9. Figure 6 9 Analog Port 6 8 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 7 Introduction System Overview Ventilator Breath Types Operating Theory This chapter describes the ventilator s breath delivery capabilities It includes a system overview and descriptions of the ventilation modes and available breath types For descriptions of button settings and general operating instructions refer to Chapter 8 Operating Instructions The ventilator is a microprocessor controlled ventilator capable of delivering a mixture of air and oxygen to a patient s lungs in a predetermined manner to augment or replace the work normally performed by the patient s respiratory system The ventilator performs breath delivery via two different patient interfaces e endotracheal tube or tracheostomy tube invasive ventilation e face mask nasal mask nasal pillows or mouthpiece with a seal non invasive ventilation The ventilator provides the following ventilation breath types e Volume Control Ventilation VCV invasive ventilation Pressure Control Ventilation PCV invasive ventilation Non Invasive Positive Pressure Ventilation NPPV non invasive ventilation During mechanical ventilation the operator selects one of the ventilation modes The selected ventilation breath type along with the selected mode the patient breathing effort and the ventilator settings determine the type of breath deliver
10. Glossary f respiratory frequency FIO fractional inspired oxygen FRC functional residual capacity f VT rate versus tidal volume ratio rapid shallow breathing index HIP high inspiratory pressure HME heat and moisture exchanger hPa unit of pressure measurement hecto Pascals E ratio inspiration exhalation ratio ICU intensive care unit ISO International Standards Organization IMV intermittent mandatory ventilation Inop inoperational IPAP inspiratory positive airway pressure I Time inspiratory time L Liter MAP mean airway pressure mL milliliter or 1 1000 L mm millimeters msec millisecond M a notation for screw threads metric NPPV noninvasive positive pressure ventilation NO nitric oxide O molecular oxygen OIM operator initiated mandatory Paw airway pressure PCV pressure controlled ventilation Pe End airway pressure at end exhalation Glossary 2 Respironics V200 Ventilator Operator s Manual REF 1057983 A Glossary PEEP positive end expiratory pressure Pi End airway pressure at the end of inhalation PIP peak inspiratory pressure Plateau inspiratory plateau pressure pressure at end exhalation and no flow from or out of the ventilator Pplat end inspiratory plateau pressure psi pounds per square inch Unit of pressure measurement psig pounds per square inch gauge above atmospheric pressure PSV pressure support ventilation SIMV synchronous intermittent mandatory ventilation Spont Rate spontan
11. an indicator is illuminated a sequence of tones sounds a screen alert window appears with a message in it The ventilator includes alarm and status indicators located on the front panel to provide a visual summary of active alarm conditions Each of these indicators is illuminated by either a red green or yellow light which will flash or remain illuminated depending on the alarm condition Normal Alarm High Alarm Med Low Figure 9 1 Alarm Status Indicators Pressing the ALARM RESET key on the front panel clears the visual indicators for active or auto reset alarms If the alarm condition reoccurs the visual indicator illuminates again Alarm messages also appear in an Alert insert that appears in any screen whenever there is a low medium or high urgency alarm active Figure 9 2 REF 1057983 A Respironics V200 Ventilator Operator s Manual 9 1 Chapter 9 Alarms Audible Alarms J 0 orto 2o BB 2 01 eo PCV Settings High Leak Rate Alarm Insert Figure 9 2 Alarm Alerts When an alarm condition exists the ventilator will generate a sequence of audible tones to alert the operator The sequence varies according to the urgency and priority level of the alarm High Urgency The ventilator emits a repeating sequence of five tones Medium Urgency The ventilator emits a repeating sequence of three tones Low Urgency No audible tone emitted Med Low indicator illuminates and alar
12. 12 Alarm 0 V active alarm 1 5 V no alarm or silenced alarm 13 36 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Respironics V200 Ventilator Analog Output Port Pinout 13 Nebulizer 0 V exhalation phase 5 V inhalation or plateau phase 14 No data 15 No data NOTE All analog outputs 0 V at power up Voltages have a linear relationship to the corresponding values For example 2 5 V on pin 9 0 LPM 2 5 Von pin 11 270 cmH 0 NOTE The resolution of the analog output is 0 to 5 V in 256 increments Table 13 3 Ventilator Analog Output Port Pinout REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 37 Chapter 13 Options and Accessories This page is intentionally blank 13 38 Respironics V200 Ventilator Operator s Manual REF 1057983 A RS 232 Configuration Chapter 13 Options and Accessories RS 232 Communications Option 2 Com2 The Respironics V200 Ventilator allows the transmission of data from the ventilator to the RS 232 communications interface The Com2 option allows the ventilator to communicate with data systems The ventilator has two communications options Com1 and Com2 which work exclusively of one another WARNING Itis the responsibility of the end user to validate the compatibility and use of information transmitted from the ventilator with the device to be connected to the ventilator WARNING The data provided v
13. A message appears on the ventilator screen that prompts the user to Verify that the patient is disconnected prior to proceeding Press OK to enter Diagnostic Mode 3 Once you ve entered Diagnostic Mode select either SST or EST Press Start SST or if in EST Start EST 5 Select Neonatal patient type and then follow the remaining on screen instructions The next time the ventilator is powered on it will be set for neonatal patients For optimum performance use a Neonatal patient circuit 10 mm I D with compliance compensation enabled These same steps apply when changing to Adult or Pediatric patient type from Neonatal 13 98 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Heated Filter Test The heated filter test in EST for adult and pediatric patient types automatically tests for pressure drop of the exhalation filter This portion of EST is not possible with neonatal circuits We recommend running this test according to the filter manufacturers recommendations The following steps can be run in diagnostics mode 1 2 Power off the ventilator Power on the ventilator while holding down the ALARM RESET and 100 O keys for approximately 5 seconds A message appears on the ventilator screen prompting the user to Verify that the patient is disconnected prior to proceeding Press OK to enter Diagnostic Mode Once you ve entered Diagnostic Mode select t
14. PCMCIA Card Chapter 13 Options and Accessories The View 1 and View 2 buttons make it possible for the user to store three trending waveforms and a time scale and recall them with a press of a button view View 2 A highlighted View button indicates that a preselected view is being displayed If neither button is highlighted the view waveform s and or time scale has been changed from the preselected view Touch the View button to revert to the preselected view To store settings to one of the View buttons select the desired waveforms and timescale Are you sure you want then press and hold the View 1 or View 2 to change the view parameters button for three 3 seconds A pop up Y N window asks you to confirm that you want L Ye L Ne to change the preselected view Press Yes to reconfigure the preselected view or No to exit the pop up window without making changes Repeat the process to store settings to the other View button Clear The Clear button allows you to clear all stored data for trending ear Press Clear between patients or to erase all of a patient s previously stored data When you press Clear a pop up window asks you to confirm that you want to erase he e you sure you want to erase the all stored data Press Yes to clear the data trended data stored in memory or No to exit the pop up window without VER No clearing data If an alarm occurs while viewing the Trending screen
15. Parameter Description Display Range Resolution Spont VE Spontaneous Minute Volume 0 00 to 99 9 L 0 01 for 0 00 to The spontaneous ventilation BTPS 9 99 normalized to one minute 0 1 for 10 0 to 99 9 Compliance compensated if enabled Total VE Exhaled Minute Volume 0 00 to 99 9L 0 01 for 0 00 to The total volume exhaled bythe BTPS 9 99 patient in one minute 0 1 for 10 0 to 99 9 Compliance compensated if enabled 96 05 Delivered O 0 0 to 11096 0 01 for 0 00 to One second average of O2 9 99 sensor reading if O5 sensor is 1 for 100 to 110 installed Spont Rate Spontaneous Respiratory Rate 0 0 to 150 0 1 for 0 0 to 9 9 The respiratory rate of Bpm 1 for 10 to 150 spontaneous breaths Total Rate Total Respiratory Rate 0 0 to 150 0 1 for 0 0 to 9 9 The respiratory rate for all Bpm 1 for 10 to 150 breaths FM Rapid Shallow Breathing Index 0 to 150 Bpm 1 The ratio of the respiratory rate L to exhaled tidal volume for spontaneous breaths I E Ratio KE Ratio 9 9 1 to 1 99 0 1 for 9 9 1 to The ratio of inspiratory time to 1 9 9 expiratory time one 1 for 1 10 to 1 99 Table 8 7 Patient Data Definitions Range Units amp Resolution Sheet 2 of 2 NOTE Pt Leak only appears on Patient Data block on Settings screen The monitor screen Figure 8 34 is the default screen and is automatically displayed if the screen has not been touched for 15 minutes The screen can also be viewed by pressing th
16. 2 Touch the Trending button to display the Trending screen Figure 13 33 Trending button Figure 13 49 Patient Data Screen The Trending screen Figure 13 34 displays three trending waveforms as well as a summary of ventilator settings and patient data You can change the waveforms and time scale at any time REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 93 Chapter 13 Options and Accessories Parameter select button Manual rescale button Begin trending time Cursor time and date End trending time View 1 View 2 buttons Figure 13 50 Trending Screen The parameter select button above each waveform shows the name of the currently displayed parameter To choose a different parameter for display press the button above the waveform The Trended Data pop up window appears showing the available data choices 3 Press the NICO button on the Trended Data pop up window to view the available parameters See Figure 13 51 4 Select a parameter button then press Accept or Cancel to return to the Trending Data screen 13 94 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Figure 13 51 Trended Data screen NOTE For more information regarding the Trending Data screen or using the Trending Option refer to Trending Option on page 13 69 REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 95 Chapter 13 Options
17. AutoPeep Time of Last 11 14 0113 11 1 minute 01 01 70 N A AutoPeep Time of Maneuver 0 00 to Last Maneuver 01 19 38 display from 3 14 Mechanics Patient Status Screen 15 character field 24 hour clock MM DD YYwwHH MM Occlusion Alarm NORMAL N A NORMAL N A Status or SM ALARM Occlusion Alarm RESET Status Safety Valve Status NORMAL N A NORMAL N A ALARM RESET Low Internal Battery NORMAL N A NORMAL N A Alarm Status ALARM RESET Nonvolatile Memory NORMAL N A NORMAL N A Failure Using ALARM Default Settings RESET Primary Alarm Failure NORMAL N A NORMAL N A ALARM RESET High Inspiratory NORMAL N A NORMAL N A Pressure Alarm Status ALARM RESET Apnea Alarm Status NORMAL N A NORMAL N A ALARM RESET Low Inspiratory NORMAL N A NORMAL N A Pressure Alarm Status ALARM or Disconnect Alarm RESET Status Air Source Fault NORMAL N A NORMAL N A Alarm Status ALARM RESET O Valve Stuck Closed NORMAL N A NORMAL N A Alarm Status ALARM RESET Table A 1 Ventilation Report Sheet 8 of 10 REF 1057983 A Respironics V200 Ventilator Operator s Manual Appendix A 9 Appendix A RS 232 Communications Protocol Ventilation Report Continued Description Example Resolution Range Units Comments Exhalation Valve NORMAL N A NORMAL N A Stuck Open Alarm ALARM Status RESET Low O5 Supply Alarm NORMAL N A NORMAL N A Low supply Status ALARM pressure RESETe Low O Alar
18. C amp R Screen 15 character field 24 hour clock MM DD YYwwHH MM AutoPeep 1 26 0 1 for 9 9 to 9 91 20 120 cmH2 AutoPeep display for 10 to 201 for 0 from the 10 to 120 Mechanics Patient Status Screen AutoPeep Time of 11 14 01 13 11 1 minute 01 01 70 N A AutoP eep Time of Last Maneuver 0 00 to 01 19 38 3 14 Last Maneuver display from Mechanics Patient Status Screen 15 character field 24 hour clock MM DD YYwwHH MM Static C amp R 8 2000 0 2 for 20 to 99 9 20 0 130 cmH 20 Pojat display from Plateau End 1 for 100 to 130 Static C amp R Pressure Screen Stop Code 0x03 N A N A N A ASCII End Transmission Character ETX Table A 5 Patient Data Report Sheet 4 of 4 When the ventilator receives ALRM followed by a carriage return it will respond by transmitting the information shown in Table A 6 Alarm Status Report The ventilator responds to the ALRM command by returning a string with a variable length Fields 2 through 4 define the length of the message The last character transmitted is a stop code indicating the end of the message The second field indicates the number of characters between the start and stop codes The third field indicates the number of fields between the start and stop codes The fourth field is the start code 0x02 The last field in the string is the stop code 0x03 REF 1057983 A Respironics V200 Ventilator Operator s Manual Appendix A 21 Ap
19. CSA C22 2 No 601 2 certified by the following 12 UL2601 1 Table 12 23 Compliance and Approvals Power Requirements Configuration Voltages amp Frequencies Ventilator Only 100 to 240VAC 50 60Hz 6 amp max or 100 to 120VAC 50 60Hz 6 amp max depending on configuration Ventilator Only 24VDC 8AH Backup Battery pack operating time approximately 30 minutes Ventilator with Humidifier 100 to 120VAC 50 60Hz 9 amp max Table 12 24 Power Requirements REF 1057983 A Respironics V200 Ventilator Operator s Manual 12 11 Chapter 12 Technical Specifications NOTE The humidifier power connection is available only on 100 120VAC ventilators Dimensions and Weights Dimensions and Weights Ventilator Cart Height 17inches 42 cm 42 inches 107 cm Width 15 inches 38 cm 23 inches 58 cm Depth 25 inches 65 cm 37 inches 95 cm 29 inches with water trap filter 74 cm Weight 66 pounds 30 kg 80 pounds 36 2 kg With backup battery 93 pounds 42 kg Table 12 25 Dimensions and Weights Electromagnetic Compatibility Guidance and Manufacturer s Declaration Electromagnetic Emissions Declaration 9 The ventilator is intended for use in the electromagnetic environment specified below The user of the ventilator should assure that it is used in such an environment Emissions Test Compliance Electromagnetic Enforcement Guidance The ventilator uses RF energy only for its
20. Chapter 12 Technical Specifications Guidance and Manufacturer s Declaration Electromagnetic Immunity NOTE 1 At 80 MHz and 800 MHz the higher frequency range applies NOTE 2 These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people a The ISM industrial scientific and medical bands between 150 kHz and 80 MHz are 6 765 MHz to 6 795 MHz 13 553 MHz to 13 567 MHz 26 957 MHz to 27 283 MHz and 40 66 MHz to 40 70 MHz b The compliance levels in the ISM frequency bands between 150 kHz and 80 MHz and in the frequency range 80 MHz to 2 5 GHz are intended to decrease the likelihood that mobile portable communications equipment could cause interference if it is inadvertently brought into patient areas For this reason an additional factor of 10 3 is used in calculating the recommended separation distance for transmitters in these frequency ranges c Field strengths from fixed transmitters such as base stations for radio cellular cordless telephones and land mobile radios amateur radio AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy To assess the electromagnetic environment due to fixed RF transmitters an electromagnetic site survey should be considered If the measured field strength in the location in which the ventilator is used exceeds the applicable RF compliance level above the ventilator
21. an Alerts window replaces the Settings window and lists up to four currently active alarms If the alarm conditions no longer exist press Alarm Reset to close the Alerts window and restore the Settings window The Trending option with the ventilator requires the use of a Respironics approved 16 MB flash memory card The card must be used in conjunction with an adaptor for the PCMCIA slot at the back of the ventilator The order number for the card and adaptor is P N 1014293 REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 77 Chapter 13 Options and Accessories WARNING The cover plate for the PCMCIA slot at the back of the ventilator must be replaced after the adaptor and card are installed This is to protect the ventilator CAUTION The PCMCIA card should only be removed by trained service personnel once power to the ventilator is off Trending Not This Trending Not Available message indicates a problem with Trending option Available data storage Trending Not Available See Operator s Manual for Details ox This message may appear if the PCMCIA card installed for the Trending option is removed the PCMCIA card includes unrecognizable or corrupted files or the PCMCIA card does not contain enough memory the internal clock setting was moved back by more than 1 25 hours and trending data was not erased Contact Respironics Technical Support for more information Specifications
22. appear at the top of the Trended Data pop up window Each button when pressed displays a different set of Parameter select buttons There are a total of 78 parameters that are displayed by the four category select buttons Below is a summary of each category select button 13 72 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories The Pt Data category includes measured and calculated patient data parameters e The Settings category includes ventilator settings The Mech category includes lung mechanics data most of the Mech parameters are available only if the Respiratory Mechanics option is installed e The NICO category includes data collected from the Respiratory Profile Monitor This category is available only if the respiratory profile monitor interface NICO Esprit option is installed NOTE If any button is grayed out that particular feature may not be enabled Contact Respironics Technical Service at 1 800 345 6443 Summary of Trended Data Information Information type Description Pt Data Settings or Mech button Selects the category of data to choose from the current selection is highlighted Changing the category causes a Pi Data different set of parameter select buttons to appear Parameter select button Selects which parameter to display as trended data the current selection is highlighted in the data category list For a complete list o
23. mandatory minimum exhalation time of 200 msec this alarm will not be activated unless this condition occurs for three consecutive breaths Low Vt Spontaneous The ventilator triggers a medium urgency alarm to indicate that the VCV or PCV spontaneous tidal volume is below the set alarm limit It is elevated to high urgency after one minute Note A Low Vt setting of zero 0 will disable this alarm O Valve Stuck Closed Alarm cannot be silenced or manually reset Call for service Occlusion SVO Safety Valve opens The ventilator triggers a high urgency alarm to indicate that an occlusion has been detected in the patient circuit Check circuit tubing for crimped hoses or blockage Check filters and humidification devices to ensure they are functioning properly Alarm cannot be manually reset Restart The ventilator has restarted If the ventilator repeatedly restarts on its own call for service Using Default Altitude Ventilator is using default altitude Using Default Ventilator is using default compliance Compliance Using Default Settings Ventilator is using default settings Table 9 1 Alarm Alert Messages Sheet 4 of 4 9 8 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 9 Alarms Alarm Indicators Normal Alarm High Alarm Med Low Safety Valve Figure 9 4 Alarm and Status Indicators Normal The Normal indicator remains lit with a steady green light as long as
24. means for external separation of the conductive earth paths must be provided All equipment used and connected to the ventilator communications ports analog parallel and serial must comply with the medical electrical equipment IEC601 1 or other applicable standards The remote alarm port is intended to connect only to SELV safety extra low voltage and ungrounded system with basic insulation to ground in accordance with IEC60601 1 To prevent damage to the remote alarm the signal input should not exceed the maximum rating of 24 VAC or 36 VDC at 500 mA with a minimum current of 1 mA Failure to protect the expiratory filter from damage by using inappropriate patient circuit configurations may cause damage to delicate ventilator components such as the expiratory flow sensor which may lead to inaccurate spirometry or a Vent Inop condition If clinical conditions do not require setting the HIP Limit above 60 cmH50 we recommend the setting normally be adjusted to 60 cmH50 or less in order to prolong the operating life of the blower and to maximize backup battery run time The ventilator alarm indicators and the Alerts insert should be monitored closely during the Alarm Silence period to ensure that unexpected alarms are noticed If an alarm persists for no apparent reason contact Respironics Customer Service at 1 800 345 6443 Care should be taken when cleaning the touch display Refer to Figure 8 2 on page page 8 3 A soft
25. mechanics results weaning parameters ventilator settings maneuver date and time stamps and other patient data It also provides access to the respiratory mechanics maneuvers via the maneuver buttons on the bottom of the screen Weaning Ventilator Parameters Settings Lung 0 00 Manai 0 0 0 8 Mechanics Stamps 462 29 32 7 dp 02 314 11 1 Other patient data Maneuver Buttons Figure 13 28 Patient Status Screen The Vital Capacity screen Figure 13 29 allows you to perform a Vital Capacity Maneuver maneuver and displays the maneuver results graphically and numerically The Vital Capacity maneuver is available only in VCV and PCV It is not available in NPPV How to perform the Vital Capacity Maneuver 1 Enter the Vital Capacity screen Touch the Mechanics icon button then the Vital Capacity button 2 Touch the Start button Instruct the patient to inhale to maximum capacity at the next inspiration then exhale completely followed by a normal inspiration Once touched the Start button changes to Stop The Stop button allows you to cancel the maneuver at any time A high priority alarm automatically cancels the maneuver 13 52 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories 3 Atthe end of a successful maneuver a pop up screen displays the result of the maneuver and asks you to accept or reject the results by touching the Accept or Reject button
26. or 20 d Ay 6 Figure 13 60 Turn Speaking Mode On First Message Box The second message box then appears with the same command Turn Speaking Mode On reminding the user to Please be sure there is NO Speaking Valve installed and the tracheostomy cuff is deflated 3 Press Accept to continue or Cancel to exit Speaking Mode Figure 13 61 Turn the Speaking Mode On Reminder Second Message Box REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 107 Chapter 13 Options and Accessories Speaking Mode is ON when the Active Mode button in the upper left hand corner of the screen is orange and the Speaking Mode button at the bottom of the screen has a white background Active Mode button is orange Speaking Mode button Figure 13 62 How the Ventilator Screen Appears When Speaking Mode Is ON 4 We recommend reviewing alarm and ventilator settings at this time Continue to monitor patient s respiratory effort and clinical status If patient s respiratory efforts deteriorate discontinue Speaking Mode See Discontinue Speaking Mode on page 115 13 108 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Alarms While in Speaking Mode the ventilator switches all volumetric alarms from exhaled to delivered alarms This means that all alarms that were triggered based on exhaled volumes will now be based on delivered volumes These alarms include Low
27. the MIP maneuver Table 13 6 Summary of MIP P0 1 Screen Information The Static C and R screen Figure 13 31 allows you to perform a static compliance and resistance maneuver and displays the maneuver results The maneuvers are carried out on machine or operator initiated breaths If the patient triggers a breath when a maneuver is scheduled the ventilator does not perform the maneuver Although the maneuver does not require patient effort patient interference can affect the accuracy of maneuver results The Static C and R maneuver is available in VCV only It is not available in PCV and NPPV NOTE Depending on the High Pressure limit setting if the pre maneuver flow pattern is ramp delivering a square waveform during the Static C and R maneuver can trigger a High Inspiratory Pressure alarm and cancel the maneuver Should this happen adjust alarm settings as needed How to perform Static C and R maneuver 1 Enter the Static C and R screen touch the Mechanics icon button then Static C and R 2 Touch the Start button If you do nothing the maneuver automatically ends at the next mandatory inspiration Once touched the Start button changes to Stop The Stop button allows you to cancel the maneuver at any time A high priority alarm automatically cancels the maneuver 13 56 Respironics V200 Ventilator Operator s Manual REF 1057983 A Scale button Start button Time Stamp Chapter 13 Options and Accessories A
28. 4 8 16 24 48 or 72 hours Table 13 12 Trending Data Specifications Sheet 4 of 4 REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 81 Chapter 13 Options and Accessories This page is intentionally blank 13 82 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Flow Trak Option Flow Trak provides additional flow to Volume Control Ventilation VCV breaths It allows the patient to draw additional flow or volume as desired Ventilators with Flow Trak installed are identified by the option label as seen in Figure 13 39 Flow Trak Figure 13 39 Flow Trak option label Once the Flow Trak option has been loaded on the ventilator it is active Follow these steps to turn Flow Trak Off and On 1 While in VCV press the Peak Flow settings button 2 Press the Ftrak OFF button 3 Press the Accept button Use these same steps pressing Ftrak On to turn Flow Trak on Figure 13 40 Turning off the Flow Trak Option Flow Trak will stay resident on the ventilator when shut down and restarted That is if Flow Trak is OFF when the ventilator is shut down then it will be OFF the next time the ventilator is started REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 83 Chapter 13 Options and Accessories NOTE If the Ftrak On button is grayed out in the settings window Figure 13 41 then the Flow Trak Option has not been installe
29. 9 0 0 100 96 The Pt Trigger of Breaths 1 for 100 display on the Triggered by the NPPV Monitor Patient NPPV screen Spont T mode only otherwise 99999 Monitored Oxygen 55 10 0 1 for 0 0 to 99 91 for 0 0 100 The O2 display Concentration 100 from the Patient Data Screen Ti Ttot 0 236 0 01 0 00 1 00 N A The Ti Ttot display Table A 5 Patient Data Report Sheet 2 of 4 from the Mechanics Patient Status Screen REF 1057983 A Respironics V200 Ventilator Operator s Manual Appendix A 19 Appendix A RS 232 Communications Protocol Patient Data Report Continued Description Example Resolution Range Units Comments Dynamic 5 43 0 01 for 0 00 to 0 00 400 cmH2 The Dynamic Resistance ANE ir T O L Resistance display RO to Sec from the Mechanics Patient Status Screen Dynamic 19 2 0 01 for 0 00 to 0 00 350 mL cm The Dynamic Compliance 9 990 1 for 10 0 to H20 Compliance display 99 91 for 100 to 350 from the Mechanics Patient Status Screen Peak Lung Flow 35 10 0 1 for 99 9 to 99 91 300 300 LPM The Peak L Flow for 100 to 3001 for display from the Teas eno Mechanics Patient Status Screen Vital Capacity 46899 1 0 9999 mL Vital Capacity display from Vital Capacity Screen Vital Capacity Time 11 14 01 13 11 1 minute 01 01 70 N A Time of Last of Last Maneuver 0 00 to Maneuver display 01 19 38 from the Vital 3 14 Capacity Screen 15 character field 24 hour clock MM DD
30. Aseptically store parts until used CAUTION DO NOT autoclave the ventilator Chemical Disinfecting The O sensor tee P N 1001736 and the O sensor coupling P N 1002505 may be chemically disinfected The PVC O sensor tee P N 8 100498 00 gray in color cannot be chemically disinfected For chemically disinfected parts reassemble after disinfecting 10 2 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 10 Care and Maintenance CAUTION Formaldehyde phenol based and quaternary ammonium compound QUATS disinfectants are not recommended because these agents can cause cracking and crazing of plastic parts Exposure of components to disinfectant concentrations stronger than required or for excessive time may shorten product life Parts should be thoroughly rinsed and dried to prevent spotting and blemishes when exposed to elevated temperatures 1 Separately immerse each part in the chemical disinfectant i e ammonia 15 solution bleach 10 solution or commercial hospital grade disinfectant etc Follow the disinfectant manufacturers directions for the solution concentration immersion times and other conditions for disinfecting The use of a laminar air flow hood during the chemical disinfecting process is recommended 2 Thoroughly rinse and dry each part 3 Aseptically reassemble as required and store the part until use Ventilator Exterior Wipe the ventilator exterior clean with a damp clo
31. Battery is designed for use with a Respironics V200 Ventilator equipped with a backup battery E External battery Figure 13 5 Ventilator with Extemal Battery Installed REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 7 Chapter 13 Options and Accessories Installation Power Consumption Sequence External Battery Backup Battery Contact Respironics Customer Service at 1 800 345 6443 to arrange installation or refer to the installation section of the Ventilator External Battery Service Instructions 1013569 WARNING Do not lift the external battery If the battery needs to be removed from the cart contact Respironics Customer Service at 1 800 345 6443 When AC power becomes unavailable the ventilator consumes power from the battery systems as follows With the external battery installed and turned ON and backup battery installed External battery power is consumed first until depleted Backup battery power is then used until depleted An audible alarm sounds when the backup battery is in use The ventilator will not operate when both batteries are depleted With backup battery installed only Backup battery power is used until depleted An audible alarm sounds when the backup battery is in use The ventilator will not operate when the battery is depleted AC power can be restored to the ventilator at any time during battery use When AC power is restored the ventilator consumes AC power only
32. Electromechanical Controls User Interface Figure 12 1 Pneumatic System REF 1057983 A Respironics V200 Ventilator Operator s Manual 12 17 Chapter 12 Technical Specifications Labels Ventilator Labels Label Description 7 i On Off Switch Label Heated Expiratory Filter Label WARNING Heated Expiratory Filter may be hot Allow to cool before removing A A Gas Return Label Gas Return Gas Outlet Label Gas Outlet Serial Port Remote Alarm Nurse Call parallel printer port Label uF o Keep Covered Label KEEP COVERED Analog port Potential Equalization Connector DC Battery Connection Label AC Power Label 100 240 V 50 60 Hz 6A MAX WITH HUMIDIFIER 9A MAX Humidifier Outlet Label HUMIDIFIER OUTLET N MAXIMUM CURRENT 3 AMPS Power Switch on Front Label POWER SWITCH ON FRONT HUMIDIFIER MAINS Circuit Breakers Label CIRCUIT BREAKER CIRCUIT BREAKER SWITCH SWITCH 12 18 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 12 Technical Specifications Ventilator Labels Continued Oxygen Inlet Label CAUTION Do not crimp kink or knot oxygen gas supply hose Oxygen inlet pressure range must be 40 90 psig 276 621 kPa 200 LPM min WARNING Emergency Air Intake Do Not Obstruct Emergency Air Intake Label Caution Do Not Block Cooling Inlet Cooling Inlet Labe
33. Filter Single 1003847 Reusable Patient Circuit Kit Adult 1003058 Kit includes 1 Reusable Inspiratory Bacteria Filter 1003847 1 Reusable Exhalation Bacteria Filter 1002970 2 Water Traps 1003648 2 Coupling Straight Silicone 500 1000 43 Reusable Patient Circuit Kit Pediatric 1003059 Kit includes 1 Reusable Inspiratory Bacteria Filter 1003847 1 Reusable Exhalation Bacteria Filter 1002970 2 Water Traps 1003648 2 Coupling Straight Silicone 500 1000 43 Reusable Vial System Water Collection 1021884 Disposable Items Disposable Exhalation Bacteria Filter pkg of 12 1002240 Disposable Inspiratory Bacteria Filter Single 1014047 Disposable Inspiratory Bacteria Filter pkg of 10 0342077 Disposable Patient Circuit Adult 1003698 Kit includes 1 Disposable Inspiratory Bacteria Filter 1014047 1 Disposable Exhalation Bacteria Filter 1002240 2 Coupling Straight Silicone 500 1000 43 Disposable Vial System Water Collection 1006241 Documentation Respironics V200 Operator s Manual CD 1062476 Respironics V200 Operator s Manual included on CD 1057983 Respironics V200 Service Manual CD 1062500 Respironics V200 Operator s Manual included on CD 580 1000 02 Table 13 1 Options and Accessories Sheet 2 of 2 a The part number varies with the country to which the ventilator is delivered b The part number varies by language WARNING The use of accessories cables and transducers other than those specified
34. Medical electrical equipment needs special precautions regarding EMC and needs to be installed and put into service according to the EMC information provided in Chapter 12 Technical Specifications Speaking Mode is available ONLY in invasive ventilation mode REF 1057983 A Respironics V200 Ventilator Operator s Manual 2 11 Chapter 2 Warnings Cautions and Notes This page is intentionally blank 2 12 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 3 Symbols The following symbols appear on the Respironics V200 Ventilator accessories documentation and packaging Additional symbols pertaining to options and accessories are included in the documentation for each option or accessory Refer to Chapter 13 Options and Accessories Symbols Symbol Description READ THE USER MANUAL OR ACCOMPANYING DOCUMENTS ATTENTION ON condition for part of the equipment When pressed the ventilator will operate from the MAINS voltage if connected or from the backup battery if the battery charge is within operating specifications OFF condition for part of the equipment PROTECTIVE EARTH ground POTENTIAL EQUALIZATION CONNECTOR used to connect the equipment to an electrical installation earth busbar TYPE B applied part which indicates equipment that provides a particular degree of protection against electric shock particularly with regards to allowable leakage current and of the
35. Midpoint Outside Range 3148 Op Step Position for Close Outside Range 3149 Exh Step Position for Open Outside Range 3150 Exh Step Position for Midpoint Outside Range 3151 Exh Step Position for Close Outside Range 3152 Patient Wye Not Unblocked 3153 Touchscreen Failure 3154 LED Indicator Failure 3155 Remote Alarm Not Sounding 3156 Inh Transducer Autozero Failure 3157 Exh Transducer Autozero Failure Table 11 1 Diagnostic Codes and Descriptions Sheet 3 of 4 11 8 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 11 Diagnostics Diagnostic Codes and Descriptions Continued Code Description 3158 Exhalation Valve initial pressure Outside Range 3159 Exhalation Valve final pressure Outside Range 3160 Exhalation Valve flow Outside Range 5XXX Safety Valve Open or Backup Battery Not connected 5000 Occlusion Safety Valve Open Alarm 5001 Gas Supplies Lost Safety Valve Open Alarm 5002 Backup Battery Not Connected 8XXX Software Diagnostic information 8003 Software Option Button Failure 8004 Insufficient Blower Current Table 11 1 Diagnostic Codes and Descriptions Sheet 4 of 4 WARNING Please contact Respironics Customer Service at 1 800 345 6443 or consult your service manual if any diagnostic codes are encountered Information The Information function is reserved for future expansion Option The Option function is reserved for future expa
36. Minute Volume Alarm 9 7 Low O2 Alarm 9 7 Low O2 Supply Alarm 9 7 Low PEEP Alarm 9 7 Low Tidal Volume Alarm 9 7 Low Vt Mandatory Alarm 9 8 Low Vt Spontaneous Alarm 9 8 M Mandatory Breaths 7 3 8 26 Manometer 8 13 Manual Breath Key 8 10 Med Low Indicator 8 5 Medium Low Urgency Alarm 12 9 Modes 8 1 12 1 Common to NPPV 7 6 Common to VCV amp PCV 7 3 Emergency 7 7 Mount Wall 5 4 Index Non Invasive Positive Pressure Ventilation NPPV 7 6 Non Invasive Ventilation 7 1 7 6 8 1 Normal Indicator 8 5 12 9 Notes 2 8 NPPV 7 6 8 23 Symbols Nurse Call Label 12 18 Remote Alarm 5 1 0 02 Cylinder Bracket 13 1 High Pressure Hose 13 1 Manifold 13 1 Sensor 4 16 13 3 Sensor Kit 13 1 02 Sensor Tee Autoclaving 10 2 Chemical Disenfecting 10 2 See also PVC O2 Sensor Tee O2 Valve Stuck Closed Alarm 9 8 Occlusion SVO Alarm 9 8 On Off Power 5 4 On Off Switch 5 2 Open 7 7 Safety Valve 7 7 7 8 9 9 9 10 Operating Conditions 9 1 Instructions 8 1 Theory 7 1 Options Communications 13 1 Flow Trak 13 1 Graphics 13 1 Neonatal 13 1 REF 1057983 A Respironics V200 Ventilator Operator s Manual Index 3 Index Respiratory Mechanics 13 1 RS 232 Communications 2 13 1 Trending 13 1 Output Analog label 3 1 Analog port 6 7 Field A 1 Port 6 1 Serial label 3 2 Oxygen Source Connection 4 21 Oxygen Sensor 13 3 P Panel Back Connections and Controls 5 1 Pa
37. N A ADULTe PEDe e NEO OO PCV Respiratory Rate 12000 1 1 150 BPM Setting PCV Pressure Setting 20000 1 5 100 cmH 0 hPa PCV Inspiratory Time 1 000 0 01 0 1 9 9 sec Setting PCV PEEP Setting 099999 1 0 35 cmH50 hPa PCV Pressure Support 099999 1 0 100 cmH50 Setting hPa Table A 3 Pressure Control Ventilation Settings Report Sheet 1 of 3 Appendix A 14 Respironics V200 Ventilator Operator s Manual REF 1057983 A Appendix A RS 232 Communications Protocol Pressure Control Ventilation Settings Report Continued Description Example Resolution Range Units Comments PCV I Trigger Type PRESS N A PRESSe N A FLOWS e AUTO PCV Pressure I Trigger 2 099 0 1 0 1 20 0 cmH 0 Setting hPa PCV Flow I Trigger 3 0000 0 1 0 3 20 0 LPM Setting PCV E Cycle Type FLOW N A FLOW N A AUTO PCV Flow Expiratory 259999 1 10 80 Cycle Setting PCV Rise Time 0 1999 0 1 0 1 0 9 Sec PCV Oxygen 210000 1 21 100 Concentration Setting PCV Apnea Rate 120000 1 1 80 BPM Setting PCV Apnea Interval 200000 1 10 60 sec Alarm Limit Setting PCV High Inspiratory 350000 1 10 105 cmH50 Pressure Alarm Limit hPa Setting PCV Low Inspiratory 399999 1 3 105 cmH50 Pressure Alarm Limit hPa Setting PCV Low PEEP Alarm 099999 1 0 35 cmH 70 Limit Setting hPa PCV Low Mandatory 099999 1 0 2500 mL Tidal Volume Alarm Limit Setting PCV Low Spontaneous 099999 1 0 2500 mL Tidal Volume Ala
38. Options Reference Communications 13 27 1010525 Flow Trak 13 83 1019026 Graphics 13 19 1003772 Neonatal 13 97 1016851 Respiratory profile monitor interface NICO Esprit Interface 13 87 1022488 Respiratory Mechanics 13 51 1006600 RS 232 Communications 2 13 39 1015725 Trending 13 69 1013446 Speaking Mode 13 103 1046805 Auto Trak 13 117 1061450 Hardware Accessories AC Power Cord 1001832 Backup Battery 1059956 External Battery 13 6 1059955 Vuelink Cable 1006912 V200 Cart 1060495 Flex Arm Assembly 1003781 Flex Arm Bracket 1002497 Humidifier Bracket Kit Hudson CONCHATHERM IV 1061390 Humidifier Mounting Adapter Hudson CONCHATHERM 1002231 Series III IV O Cylinder Holder Kit 1060815 O High Pressure Hose 1001664 O Manifold 13 13 1060785 O2 Sensor Kit 13 3 1002541 O gt Sensor Kit PVC 13 3 1032037 Respiratory Profile Monitor Mounting Kit 1060784 RS 232 serial communications 3 cable NICO Esprit 1018292 Table 13 1 Options and Accessories Sheet 1 of 2 REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 1 Chapter 13 Options and Accessories Options and Accessories Continued Remote Alarm Cable Kit Normally Open Protocol 1003741 Remote Alarm Cable Kit Normally Closed Protocol 1003742 Remote Alarm Cable Kit Respironics LifeCare 1003743 Test Lung 1001737 Reusable Items Reusable Exhalation Bacteria Filter Omni Single 1002970 Reusable Inspiratory Bacteria
39. Rate Apnea Rate Alarm High Pressure High Pressure Low Pressure Limits Low Insp Pressure Low Insp Pressure Low EPAP Low PEEP Low PEEP Low Tidal Volume Low Mandatory Tidal Volume Low Mandatory Tidal Volume High Rate High Rate High Rate Low Exhaled Minute Volume High Exhaled Minute Volume High Exhaled Minute Volume High Leak Low Exhaled Minute Volume Low Exhaled Minute Volume Table 7 2 Parameters Used in Apnea Ventilation Settings and Alarm Limits The ventilator will reset out of Apnea Ventilation if the operator presses the Alarm Reset button or if the patient triggers two successive breaths Safety Valve Open SVO Safety valve open is an emergency mode of ventilation that allows the patient to breathe through the system whenever any of the following occur 1 An occlusion is detected The ventilator resumes normal breathe delivery if the occlusion is removed 2 Loss of both the air supply and the oxygen supply occurs The ventilator resumes normal breath delivery if the gas supply is made available 3 The Ventilator Inoperative state Vent InOp is entered due to a hardware malfunction that prevents breath delivery The ventilator will not resume normal breath delivery in this case Call for service During SVO The safety valve is opened The exhalation valve is opened The air and oxygen valves remain closed A high priority alarm is activated The Safety Valve Open indicator is illuminated The Normal indic
40. Sa eae C t RP Pa EU 9 9 Care and Maintenance L eese 10 1 General Information eneee ea e ecu yw Rd sa reru we UE Na 10 1 ClEANING x bio penal as se rv rk e en b so t AE Baek 10 1 Sterilization tesan matatia gennana edu e RAG eee elige Rae ye ORE dos Ducis 10 2 Bacteria Filters RIA oe dee aN ELE EYE EE 10 4 Periodic Maintenance 0 ce s 10 7 Storage acted aman E e aed ex cr adem das Eat a dere 10 10 Repairs zs eren pein beak ahd ee eth NEED DRM eee OS 10 10 DiagnOSUCS 242245 bet Joey bi Sety chet prasad REA EET bees 11 1 Entering Diagnostic Mode aoaaa en 11 2 Diagnostic F nctions x vex Bap ead baa Wee Ped Bae ad RA wa eee es 11 3 Extended Self Test EST sid ic ud Xe Dae deba ea i E ud 11 4 Self TeSt cou mace et sts Oh feo LE rena Db v tas nid ie 11 10 Technical Speclificatlolis i ole heh ond dees 12 1 Breath Types ao aa ina daiane dede ace e dete debe doli A Senec ids ode c 12 1 Modes eanan y Ram ERARBEITEN TAE d E E NE 12 1 Volume Ventilation Settings Ranges and Resolution 005 12 1 Pressure Control Ventilation Settings Ranges and Resolution 12 2 Non Invasive Positive Pressure Ventilation Settings Ranges and Resolution 12 3 Apnea Ventilation ee die rreIqeteex eR I eb eT de eae IER VET 12 3 Value Entry Message iliis n 12 4 Respironics V200 Ventilator Operator s Manual REF 1057983 A 13 Contents Patient Data Screen llli en 12 5 Fron
41. Screen 10 Once you have reviewed all the parameters on the User Config screen the ventilator is ready for patient use Turn the ventilator off then on without holding down any front panel keys 11 Ventilator settings from the previous use are in effect at power up Select appropriate settings for the next patient as described in this chapter Alarm Testing A procedure is available if the operator wants to test the operation of alarms Procedure We recommend following the preoperational procedure Refer to C Alarm Testing Procedure Where To Go For Help For clinical or technical support contact Respironics Customer Service at 1 800 345 6443 8 34 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 9 Alarms Introduction Visual Alarms The Respironics V200 Ventilator provides an easy to use hierarchical alarm system that includes both visual and audible alarms When the ventilator detects an operating condition that requires attention it generates an alarm The alarm system communicates three levels of urgency and priority High Urgency Alerts the operator that immediate response is required red flashing indicator Medium Urgency Alerts the operator that prompt response is required yellow flashing indicator Low Urgency Alerts the operator to a change in the ventilator status yellow continuous indicator In most cases the alarm will have the following audible and visual components
42. Urgency 9 1 9 2 Low Urgency 9 1 9 2 Medium Urgency 9 1 9 2 Operator Initiated Reset of 9 3 Remote 6 2 Reset 9 3 Silence 9 2 Visual 9 1 Alert Messages 9 4 Altitude Setting 5 5 5 9 Analog Port 5 2 6 7 Apnea Alarm 9 5 Apnea Ventilation 7 7 8 27 Operation During 7 7 Respiratory Rate 8 22 Apply Date 5 8 Apply Time 5 8 Assist Control Ventilation 7 3 Assist Control Ventilation A C 7 3 Audible Alarm Failed Alarm 9 5 Auto PEEP 8 31 Calculation 8 31 Backup Battery 4 4 Power Status Indicators 8 6 Bad ADC Wrap Sensor Alarm 9 5 Bad Bat Volt Sensor Alarm 9 5 Bad Int O2 Sensor Alarm 9 5 Bad Int Temp Sensor Alarm 9 5 Battery Backup On Alarm 9 5 Baud Rate RS 232 6 2 A 1 Breath Indicator 8 13 Breath Type 12 1 Selecting 8 23 BTPS G 1 Built In Test 11 11 Bus Activity Monitor 11 10 C Cautions 2 5 Circuit Breaker Humidifier AC 5 2 Mains 5 2 Cleaning Ventilator Parts 10 1 Clock 5 7 REF 1057983 A Respironics V200 Ventilator Operator s Manual Index 1 Index Compliance G 1 G 4 Circuit 5 5 11 5 Compensation 8 33 11 1 Tubing 5 10 Compliance and Approvals 12 11 Continuous Positive Airway Pressure 7 4 CPAP 7 4 D Date of Manufacture 3 3 Date Setting 5 7 Delivered O2 9602 8 29 Diagnostic Codes 11 5 Descriptions 11 6 11 8 Mode 5 5 11 2 Diagnostics 11 1 Display Front Touch Panel 8 11 Patient Leak 7 6 End Exhalation Pressure 8 31 EPAP 7 6 8
43. V200 Ventilator Operator s Manual 12 3 Chapter 12 Technical Specifications Value Entry Message If you enter a value that is outside the operational limits of the ventilator you will be shown a message window on the screen Once you acknowledge the message the ventilator retums to the value modification display without changing the value Assist Control Ventilation Value Entry Reasonability Checks Item Limit Exceeded Message Apnea Rate I E Ratio gt 3 1 E Ratio must be less than or equal to 3 1 Check V Peak Flow or Insp Hold Peak Flow I E Ratio gt 3 1 E Ratio must be less than or equal to 3 1 Check V Apnea Rate or Insp Hold Tidal Volume I E Ratio gt 3 1 E Ratio must be less than or equal to 3 1 Check Flow Apnea Rate or Insp Hold Insp Hold I E Ratio gt 3 1 E Ratio must be less than or equal to 3 1 Check V Apnea Rate or Peak Flow Waveform I E Ratio gt 3 1 E Ratio must be less than or equal to 3 1 Check V Peak Flow or Apnea Rate I Time Time 9 sec Time must be less than or equal to 9 sec Check V Peak Flow Insp Hold or Waveform Table 12 6 Assist Control Ventilation Value Entry Reasonability Checks Pressure Control Ventilation Value Entry Reasonability Checks Item Limit Exceeded Message Changed Apnea Rate 1 E Ratio gt 4 1 I E Ratio must be less than Readjust the Apnea Rate or or equal to 4 1 Check I adjust I Time or Rate Time Time E Ratio g
44. V200 Ventilator Operator s Manual 13 43 Chapter 13 Options and Accessories Ventilation Report Description Example Resolution Range Units Comments Low Exhaled 0 00 0 01 0 00 2 50 L For VCV and PCV Mandatory Tidal types of Volume Alarm setting ventilation set to Low Exhaled Mandatory Tidal Volume alarm limit for A C and Apnea and Low Exhaled Spontaneous Tidal Volume Alarm limit for SIMV and CPAP When active type of ventilation is NPPV uses Low Exhaled Tidal Volume alarm limit Low Exhaled Minute 0 0 0 1 0 0 60 0 L Low Exhaled Volume Alarm setting Minute Volume alarm limit from active type VCV PCV or NPPV High Respiratory Rate O eeee 1 0 150 BPM High Respiratory Alarm setting Rate from active type VCV PCV or NPPY High Inhalation NORMAL N A NORMAL N A Pressure Alarm status RESET ALARM e Low Inhalation RESET N A NORMAL N A Pressure Alarm status RESET or Disconnect Alarm ALARM status Low PEEP or Low ALARM N A NORMAL N A Outputs Low PEEP EPAP Alarm status RESET in VCV and PCV ALARM Low EPAP in NPPV Table 13 4 Ventilation Report Sheet 5 of 10 13 44 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Ventilation Report Description Example Resolution Range Units Comments Low Exhaled NORMAL N A NORMAL N A Outputs ALARM Mandatory RESET wh
45. YYuuHH MM MIP 54 1 0 1 for 99 9 to 100 200 cm MIP display from 99 91 for 100 and H20 MIP P0 1 display 100 to 200 Screen MIP Time of Last 11 14 014 13 11 1 minute 01 01 7 N A MIP Time of Last Maneuver 0 0 00 to Maneuver display 01 19 38 from MIP P0 1 3 14 Screen15 character field 24 hour clock MM DD YYuuHH MM P0 1 2 300 0 1for 99 9 to 100 200 cm P0 1 display from 99 9 for 100 and H20 MIP P0 1 display 100 to 200 Screen P0 1 Time of Last 11 14 0113 11 1 minute 01 01 70 N A P0 1 Time of Last Maneuver 0 00 to Maneuver display 01 1 38 from MIP PO 1 3 14 Screen 15 character field 24 hour clock MM DD YYwwHH MM Static Resistance 5 43 0 01 for 0 00 to 0 00 400 cmH2 Static Resistance 9 990 1 for 10 0 to 0 L display from the 99 91 for 100 to Sec Static C amp R screen 400 Table A 5 Patient Data Report Sheet 3 of 4 Appendix A 20 Respironics V200 Ventilator Operator s Manual REF 1057983 A Alarm Status Report ALRM Description Static Compliance Appendix A RS 232 Communications Protocol Patient Data Report Continued Example 19 2 Resolution 0 01 for 0 00 to 9 990 1 for 10 0 to 99 91 for 100 to 350 Range Units 0 00 350 mL cmH2 0 Comments Static Compliance display from the Static C amp R Screen Static C amp R Time of Last Maneuver 11 14 01013 11 1 minute 01 01 70 N A 0 00 to 01 19 38 3 14 Static C amp R Time of Last Maneuver display from Static
46. activate new breath type Gi Rate mllej y Low VE Figure 8 28 Alarm Limits Screen PCV active REF 1057983 A Respironics V200 Ventilator Operator s Manual 8 25 Chapter 8 Operating Instructions 6 Active mode and breath type Indicates the active breath type alarms Alarm limits no longer grayed out indicating that the selected breath type is active Selecting the Mode A C SIMV CPAP or If the operator reviews alarm settings and then activates the new breath type the ventilator uses the new breath type and displays the alarm settings of the new breath type Figure 8 29 Active Mode PCV A C See C High P F 120 High Pressure Pressure Control z K Alarms Active y SETTINGS Low PEEP To LowPEEP O cmH20 rime 1 is button is Low Vt Mand 200 b PEEP 3cmH20 selected a eae Patient Data indicating the Low vis it A EEM CMS PIE COLS Mand mp alarm settings L High Rate 35 M Total ae das er shown are for L ae the active breath High VE 24 0 Pleat Beim Pm l Suppen M type EM ae 220 1 Apnea 15 B Exhale O VCV Settings PCV Settings NPPVSettings Option ghy n4 Figure 8 29 Alarm Limits Screen PCV inactive Summary Ventilation Modes and Availability Spont Spont T Ventilation Available Mode during Description AIC VCV or PCV Assist control all breaths are mandatory and are trigg
47. amp Spt Rate measured spontaneous and total rate displayed on the same waveform Pe End measured end expiratory pressure LE Ratio inspiratory to expiratory ratio Table 13 12 Trending Data Specifications Sheet 2 of 4 REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 79 Chapter 13 Options and Accessories Trended data Pt Data continued Alarm alarm occurrence 02 percentage of oxygen delivered F Vt rapid shallow breathing index Ti Ttot the ratio of inspiratory time to total respiratory cycle time for spontaneous breaths Peak L Flow peak flow of gas during the inspiratory phase Pt Trigger percentage of patient triggered breaths Pt Leak patient leak Trended data Set Tidal Vol Settings set tidal volume only available in VCV mode Set Pressure set pressure only available in PCV mode Set PEEP set PEEP level only available in VCV or PCV mode Set 02 set delivered 02 Set PSV set pressure support only available in VCV mode Set IPAP set inspiratory positive airway pressure level only available in NPPV mode Set EPAP set expiratory positive airway pressure level only available in NPPV mode Set I Time set inhalation time only available in PCV or NPPV mode Table 13 12 Trending Data Specifications Sheet 3 of 4 13 80 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Trended
48. and Accessories Troubleshooting NICO button does not appear on the Trended Data Screen Troubleshooting Probable Cause What to Do The ventilator may not have respiratory profile monitor interface software Contact Respironics Technical Service 1 800 345 6443 NICO button on the Trended Data screen is grayed out Probable Cause What to Do The respiratory profile monitor interface option is loaded but not enabled on the ventilator Contact Respironics Technical Service 1 800 345 6443 Ventilator is not capturing data sent from the respiratory profile monitor Probable Cause What to Do The bidirectional communication link is not functioning properly Check that the RS 232 serial communications cable P N 1018292 is being used Check cable connections Preform the steps listed on page 13 90 and page 13 91 for setting up the monitor with the RS 232 input output for the ventilator Cycle the power on the monitor If there is no improvement Contact Respironics Technical Service 1 800 345 6443 The monitor displays the CHECK COMMUNICATION message Probable Cause What to Do Probable Cause What to Do The bidirectional communication link is not functioning properly Check that the RS 232 serial communications cable P N 1018292 is being used Check cable connections If there is no improvement Contact Respironics Technical Service 1 800 345 6443 The
49. and both batteries begin recharging See Battery Charging on page 13 10 The external battery must be turned ON in order for the external battery to be used Make sure the ON OFF switch located on the external battery Figure 13 6 is in the ON I position When AC power becomes unavailable the Operation ventilator automatically switches to external battery operation without interruption in ventilation When the external battery is depleted the ventilator automatically switches to backup battery power 13 8 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories On Off switch Figure 13 6 External Battery On Off Switch WARNING The external battery ON OFF switch must be in the ON I position to ensure operation during a power failure When this switch is in the OFF 0 position the external battery is disabled Switch off ONLY when connecting or disconnecting cables or when the ventilator or external battery is in storage for more than 2 weeks and is not connected to AC power When the external battery is in use the External Battery indicator F is continuously illuminated If the ventilator switches to backup battery operation the In Use text version of the front panel or symbol version of the front panel indicator illuminates and the ventilator sounds an audible alarm every 60 seconds the alarm cannot be reset or silenced When approximately five minutes of backup
50. battery power and continue ventilation without interruption Whenever the ventilator is powered by the backup battery it will generate a non silenceable non resettable alarm that creates an alarm sound every 60 seconds During this state the front panel indicator labeled In Use text version of the front panel as shown in Figure 4 17 or the battery symbol q symbol version of the front panel as shown in Figure 4 18 will illuminate yellow continuously In addition Backup Battery On is displayed In Use Charging Low Mains Ext Battery Battery Figure 4 17 Backup Battery Front Panel Indicators Text Version 1 x A4 t E C C Co Co Co Figure 4 18 Backup Battery Front Panel Indicators Symbol Version Operation will continue in this state until the battery capacity is nearly expend ed When the battery has only about 5 minutes of operation left an audible nonresetable HIGH priority alarm will sound When this happens the red front panel indicator labeled Low text version of the front panel as shown in Figure 4 17 or the low battery symbol q 4 symbol version of the front pan el as shown in Figure 4 18 and the high priority alarm LED will flash continu ously In addition Low Backup Battery is displayed WARNING When the battery low indicator is flashing red operation of the ventilator from the battery power should be discontinued When power is finally depleted the ventilator will open the Safety Valv
51. button MIP window Start MIP Press amp Rescale Hold button button Start P0 1 button P0 1 window Figure 13 30 MIP P0 1 Screen REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 55 Chapter 13 Options and Accessories Static C and R Maneuver Information type Description Start MIP Press amp Hold Starts the MIP maneuver Changes to Continue when the maneuver is button complete or when finger is lifted from the button Changes to Start when Continue is touched Start P0 1 button Starts the P0 1 maneuver Changes to Stop when the maneuver is started Changes to Continue when the maneuver is complete or when the Stop button is touched Changes to Start when Continue is touched MIP window Displays the most recently accepted maneuver results The date and time of the maneuver appears below each window P0 1 window Displays the most recently accepted maneuver results The date and time of the maneuver appears below each window Scale button at left of Allows you to adjust graphic scales manually The default scale for the graphic display MIP P0 1 screen is 100 cmH50 to the High Pressure limit Default scales are in effect every time you enter the MIP P0 1 screen and the graph reverts to default scales when the maneuver is complete Rescale button Allows software to adjust the vertical scales for waveforms and vertical and horizontal scales for loops The graph cannot be rescaled during
52. button is grayed if the current time scale is 2 hours e Zoom out button returns the time scale to its previous setting Rescale button Automatically adjusts the vertical axis for all three waveforms for optimal viewing based on the maximum and minimum values for the currently displayed data t Table 13 10 Summary of Trending Screen Information REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 71 Chapter 13 Options and Accessories Selecting Parameters for Display Time scale button Displays the time scale menu to select from 2 to 72 hours The button shows the currently selected time scale View 1 and View 2 buttons Displays either of two user defined views Each view consists of three trending waveforms and a time scale The button shows the active view Clear button Clears all stored trended data Table 13 10 Summary of Trending Screen Information On the Trending screen Figure 13 35 a Parameter select button above each waveform shows the name of the currently displayed parameter To choose a different parameter for display press the button above the waveform a Trended Data pop up window allows you to select another parameter Parameter select button Trended Data pop up window Category select em es ee Touros Parameter select buttons Figure 13 35 Selecting Parameters for Display on the Trending Screen Four category select buttons PT Data Settings Mech NICO
53. by qualified biomedical technicians who have received appropriate training and authorization to provide maintenance repair and service for the ventilator WARNING Patients on life support equipment should be visually monitored by competent medical personnel since life threatening circumstances may arise that may not activate alarms Heed all appropriate alarms and follow the instructions and warnings in this operator s manual Always check life support equipment for proper operation before use WARNING Do not use in the presence of flammable anesthetics Possible explosion hazard CAUTION Federal law USA restricts this device to sale by or on the order of a physician NOTE Follow the setup instructions in this manual before placing the Respironics V200 Ventilator into service If you have questions contact Respironics Customer Service at 1 800 345 644 REF 1057983 A Respironics V200 Ventilator Operator s Manual 1 1 Chapter 1 Introduction and Intended Use This page is intentionally blank 1 2 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 2 Warnings Cautions and Notes Throughout this manual the following definitions apply WARNING CAUTION NOTE A condition that could cause injury to a patient or operator if the operating instructions in this manual are not followed correctly A condition that could cause damage to or shorten the service life of the Respironics V200 Ventilat
54. cmH5O 1 for 100 120 10 Pressure hPa 0 1 for 20 0 to 99 9 Delivered 02 0 0 to 110 E 1 for 100 110 3 vol 0 1 for 20 0 to 99 9 Total Respiratory Rate 0 0 to 150 Bpm 1 for 10 150 10 0 1 for 0 0 to 9 9 Spontaneous 0 0 to 150 Bpm 1 for 10 150 10 Respiratory Rate 0 1 for 0 0 to 9 9 End Exhalation 20 0 to 99 9 cmH 0 0 1 10 Pressure Pe End hPa Patient Leak Pt Leak 0 0 to 140 LPM 0 1 for 0 0 99 9 Not 1 for 100 140 specified Percent Patient Trigger 0 0 to 99 9 0 1 for 0 0 99 9 10 Pt Trigger 1 for 100 Table 12 10 Patient Data Range Resolution Units amp Accuracy Sheet 2 of 2 a Due to the variable nature of patient leaks this parameter is an estimate only Front Panel Keys Alarm Silence Screen Lock Alarm Reset Expiratory Hold 100 0 Accept amp amp jy amp Manual Breath Table 12 11 Front Panel Keys 12 6 Respironics V200 Ventilator Operator s Manual REF 1057983 A Level Controls Calculated Values from Expiratory Hold Maneuver Interface Ports Chapter 12 Technical Specifications Level Controls Control Adjustment Display Brightness Continuous min to max gt d underneath front panel C keys Pd N I Alarm Volume Continuous 54 to 77 db underneath front panel key Adjust Control Continuous to change values on Screen Table 12 12 Level Controls Calculated Values from Expiratory Hold Maneuver Value Range
55. condition exists yellow A low priority alarm condition exists In addition Continuous indicates auto reset conditions yellow Vent Inop Red active The ventilator is not capable of supporting mechanical ventilation and requires service During Vent Inop the ventilator opens the safety valve to enable the patient to breathe room air spontaneously The ventilator also discontinues detection of new alarm conditions during Vent Inop WARNING Vent Inop is a serious condition which is indicated by both visual and audible alarms If the ventilator is attached to a patient when Vent Inop occurs the patient must be supported with another means of life support ventilation Safety Valve Red active The safety valve is open and the ventilator is not in operation This is a high priority alarm condition When the Safety Valve indicator is illuminated the ventilator is not providing ventilatory support to the patient The safety valve opens to allow the patient to breathe spontaneously through the ventilator circuit The patient must be capable of creating a spontaneous breath in order to breathe through the safety valve Table 8 1 Alarm Status Indicators REF 1057983 A Respironics V200 Ventilator Operator s Manual 8 5 Chapter 8 Operating Instructions Power Status Indicators Power status indicators alert you to the status of the backup battery The text version of the power status indicators is shown in Figure 8 5 The symbol ve
56. data Static C Mech static compliance maneuver only available if Mechanics option is installed Static R static resistance maneuver only available if Mechanics option is installed vc vital capacity maneuver only available if Mechanics option is installed MIP maximum inspiratory pressure maneuver only available if Mechanics option is installed P0 1 P0 1 maneuver only available if Mechanics option is installed Dynamic C dynamic compliance only available if Mechanics option is installed Dynamic R dynamic resistance only available if Mechanics option is installed Auto PEEP expiratory hold Trended data CO a NICO Cardiac Output Average only available if the respiratory profile monitor interface NICO Esprit option is installed SpO O5 Saturation only available if the respiratory profile monitor interface NICO Esprit option is installed ETCO End Tidal CO only available if the respiratory profile monitor interface NICO Esprit option is installed VCO CO Elimination only available if the respiratory profile monitor interface NICO Esprit option is installed Vtalv Alveolar Tidal Volume only available if the respiratory profile monitor interface NICO Esprit option is installed Mvalv Alveolar Minute Volume only available if the respiratory profile monitor interface NICO Esprit option is installed Time scales Selected time scales apply to all displayed waveforms 2
57. depends on the connected printer For example if a printer turns itself offline when it is out of paper the error message may indicate that the printer is offline rather than out of paper 13 28 Respironics V200 Ventilator Operator s Manual REF 1057983 A Vuelink Compatibility Chapter 13 Options and Accessories Message Corrective action Print aborted Printer paper empty Load paper and retry print screen Check printer cycle power to printer retry print Print aborted Printer offline screen Check printer retry print screen if printer is busy cycle power to printer UU rint aborted Printer error Avoid touching the screen while the printer icon is dimmed unless intending to cancel the print in progress UU rint canceled Touching the screen while print is in progress will cancel the Print w None required retry print screen when current print is complete UU rint unavailable Print in progress Table 13 2 Print Screen Messages and Corrective Actions The Communications option allows the ventilator to communicate with a Philips Agilent HP Component Monitoring System CMS via the VueLink module M1032A A02 Once the ventilator and VueLink module are connected the VueLink module automatically updates the monitor s screen to display ventilator parameters provided the CMS is configured for an Open Interface device For more information on configuring see Configuring the VueLi
58. device alarms should be Accepted or Ignored Press Module Config Highlight Open Interface M1032 TU1AA by using the arrow keys or pressing Next Device Press On Off Preselect if On is not already displayed beside this item REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 31 Chapter 13 Options and Accessories NOTE If On Off Preselect is pressed a second time the preselection is switched off NOTE If there are already three devices preselected one of the preselected devices must be turned off before adding a new one Press Store Preselect then Confirm 8 Attach the adhesive label containing Open Device to the VueLink module The adhesive labels MUST be placed on the module in the same order as they appear in the Preselection Task Window 9 When the above steps have been completed change the CMS to Monitoring mode see Changing Modes For more information about the VueLink module refer to the VueLink Module Handbook Information Sent to the VueLink System Once the CMS detects that the ventilator is connected to the module the CMS automatically displays ventilator parameters The active type of ventilation determines what data the CMS displays Table Figure 13 24 defines CMS displays and equivalent Respironics V200 Ventilator information Available on one N20 Comments CareNet Message equivalent Volume control ventilation VCV
59. hoses or oxygen hoses contaminated by hydrocarbon greases or oils should not be used since an oxygen leak or intense fire could result Care in the routing of the oxygen inlet hose should be exercised to ensure it is not exposed to mechanisms that could cause damage by cutting or heating melting The ventilator oxygen filter should be replaced annually as a part of preventive maintenance The ventilator should only be connected to an appropriate medical grade 10096 O gas source capable of delivering a regulated 40 to 90 PSIG 276 620 kPa The ventilator is shipped with the appropriate gas fittings and hoses for the intended environment i e DISS U S A and Canada Ohmeda Germany NIST UK Air Liquide France SIS Australia 4 20 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 4 Getting Started Oxygen Source Connection Instructions Refer to Figure 4 21 1 Locate the O filter with water trap 1 located in the lower left corner of the rear panel Ensure that the O filter and water trap 1 are properly attached to the ventilator Inspect the bowl 1 for cracks or potential leaks Ensure all connections are tight Inspect the O5 hose 2 hose connector 3 and the hose connector mate 4 Check the oxygen gas supply Clean adjust pressure and drain condensate from any water traps filters or regulators in the O supply lines Connect O gas connector 3 to the ventilator O fil
60. moist cloth should be used that does not drip water and or soap solution when in contact with the display After cleaning and rinsing with a damp cloth remove all moisture with a dry soft cloth Never allow solutions of any kind to collect on the bottom bezel of the display Never use a brush or device that can cause abrasion to clean the touch display or its bezel they will cause irreparable damage Do not remove any screws from the cooling filter area Removing screws from this area will result in damage to internal components 2 6 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 2 Warnings Cautions and Notes e Follow the detergent manufacturer s instructions Exposure to detergent solution stronger than necessary can shorten the useful life of the product Rinse parts thoroughly to remove all detergent residues Wipe parts dry Detergent residue can cause blemishes or fine cracks especially on parts exposed to elevated temperatures during sterilization e Autoclavable parts will withstand repeated steam autoclaving at temperatures not to exceed 135 C 2759F DO NOT autoclave the ventilator Formaldehyde phenol based and quaternary ammonium compound QUATS disinfectants are not recommended because these agents can cause cracking and crazing of plastic parts Exposure of components to disinfectant concentrations stronger than required or for excessive time may shorten product life Parts should
61. myrer ext E RE ERES SEA ae EEr ed eee ea E CEXA 13 78 vi Respironics V200 Ventilator Operator s Manual REF 1057983 A Contents Flow Trak Options iix rua E EE bee ara er Ete CE b E Gl cal 13 83 On the SCEreems iex esae d ere dau WW dre ae ARI ets GEA 13 84 Breath Delivery a ni uta ye reU a ae eae a 13 85 Inisprratory Hold 244 sala be mb peek ata eek ees 13 85 Respiratory Mechanics suauu aaa en 13 85 Alartisssee stole teret oath rf users seb tatters ene cede Te eee ne epu URN 13 86 Respiratory Profile Monitor Interface NICO Esprit Option 005 13 87 System Requirements lille 13 87 Hardware Setup sue esie pc Ve eR eR PETERS 13 88 RS 232 Communications sens 13 91 Trended NICO Data iis soe Ree eR d m ER a 13 92 Troubleshooting ceu ran ebi i dx pea wa bed thee pA 13 96 Neonatal Option 00 c cece ee eee eee eee eee ees 13 97 System Requirements 20 ee 13 97 Changing Patient Types 00 cee en 13 98 Percent Leak 12 au duco RES debe dane ds Paw e ton d d dus ds 13 101 Patient Leak Values llle 13 102 Speaking Mode Option isis sr 13 103 Warnings Cautions and Notes 0 cee ee eens 13 103 Patient Preparation i repr hey aa Ra CERRO RE RETE 13 104 Settings i zo puer ve Bah a eed cae gripe te esed sc ed a E et ea 13 106 Starting Speaking Mode iliis nen 13 106 Alar MSA audeas zd e tha aw Rede bed denos p e Don diete dis a 13 109 Display
62. of duct Figure 10 6 Removing and Replacing Internal Air Source Inlet Filter Refer to Figure 10 6 Figure 10 6 shows exploded view of the duct 2 and filter 1 but it does not have to be disassembled 1 Move the ventilator so that there is easy access to the underside of the internal air source duct 2 2 The internal air source filter 1 can be removed manually The filter can be reached from under the internal air source duct 2 as indicated by the arrow 3 Wash internal air source filter 1 with mild soap and water Rinse thoroughly then pat dry 5 Reinstall internal air source filter 1 from underneath the duct 2 in the same fashion it was removed Storage If you need to store the ventilator for fifteen days or more ensure that the altitude temperature and humidity of the storage site fall within the following ranges Environmental Temperature 20 to 60 C 4 to 140 F Relative Humidity 10 to 10096 noncondensing Maximum Altitude 6 560 m 20 000 ft Repairs For technical service or repairs not included in this chapter refer to the Esprit V200 Ventilator Service Manual P N 580 1000 02 or contact Respironics Customer Service at 1 800 345 6443 10 10 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 11 Diagnostics The Diagnostic Mode allows you to Run short self test SST Run extended self test EST Run hardware diagnostics to help you troubleshoot SST or EST failu
63. of the maneuver appear below the window Scale button at left of lows you to adjust graphic scales manually The default scales for the A graphic display Vital Capacity screen are 1000 to 1500 mL for volume 100 to 100 LPM for flow Default scales are in effect every time you enter the Vital Capacity screen Rescale button Allows software to adjust the vertical scales for waveforms and vertical and horizontal scales for loops Table 13 5 Summary of Vital Capacity Screen Information The MIP PO0 1 screen Figure 13 4 allows you to perform a Maximum Inspiratory Pressure MIP or occlusion pressure at 100 ms P0 1 maneuver It displays the maneuver results graphically and numerically The MIP maneuver is available only in VCV and PCV It is not available in NPPV How to perform an MIP or P0 1 maneuver 1 Enter the MIP PO 1 screen touch the Mechanics icon button then MIP PO 1 MIP maneuver hold down the Start MIP Press amp Hold button and instruct the patient to inhale several times as forcefully as possible The maneuver automatically ends after 30 seconds or when you release the Start MIP Press amp Hold button The Start MIP Press amp Hold button can be pressed and held at any time during a breath If pressed during the inhalation phase of a breath the MIP maneuver will be executed during the exhalation phase of that breath If pressed during an exhalation the maneuver will be executed during th
64. positive airway pressure SEPAP set EPAP Set expiratory positive airway pressure X PIP PIP Measured peak inspiratory pressure MnAwP MAP Measured mean airway pressure Pplat Pi End Measured end inspiratory plateau pressure SpMV Spont VE Measured spontaneous minute volume MV VE Measured minute volume PtLeak Pt Leak Estimated patient leak X TV Vt Measured tidal volume sFIO 2 set 02 Set oxygen percentage fractional inspired oxygen X FIO 2 02 Measured oxygen percentage fractional inspired oxygen sInsTi set Time Set inspiratory time RiseTi Rise Time Set rise time SAWRR set Rate Set airway respiratory rate SpAWRR Spont Rate Measured spontaneous respiratory rate X AWRR Rate Measured airway respiratory rate F TV F Vt Ratio of frequency to tidal volume rapid shallow breathing index Alarms X OCCL Occlusion SV Occlusion safety valve open SM occlusion Disconnec Open SM disconnect Red Alarm t Occlusion Disconnect APNEA Apnea Apnea detected Red Alarm X LOWINSP Low Insp Low inspiratory pressure limit violation Red Alarm PRESS Pressure X LOW 02 Low 02 Oxygen supply below acceptable level Red Alarm SUPPLY Supply X HIGH High Pressure High pressure limit violation Yellow Alarm INSP PRESS LOW 02 Low O2 Low measured oxygen concentration Yellow Alarm X LOW EXH Low Minute Low exhaled minute volume Yellow Alarm MV Volume 13 34 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Op
65. procedure is to be performed only by a qualified service technician As required External oxygen sensor Replace and recalibrate new sensor by running Extended Self Test Backup Battery For charging and maintenance instructions see Backup Battery on page 4 4 Table 10 1 Schedule for Periodic Maintenance Removing Cooling Filter Figure 10 4 Removing Cooling Filter Refer to Figure 10 4 1 Remove black filter retaining bracket 1 Pry off if necessary 2 Wash filter 2 in soapy water 3 Dry thoroughly before reinstalling CAUTION Do not remove any screws from the cooling filter area Removing screws from this area will result in damage to internal components 10 8 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 10 Care and Maintenance Removing and Replacing O Input Filter Element Figure 10 5 Removing and Replacing O Input Filter Element Refer to Figure 10 5 1 o Ny an uu A UUN Disconnect O Hose 1 Unscrew filter housing 3 Unscrew filter element retaining screw 4 Remove and replace filter element 5 Reconnect filter element retaining screw 4 Reinstall filter housing 3 Reconnect O hose 1 Check system for leaks prior to patient use REF 1057983 A Respironics V200 Ventilator Operator s Manual 10 9 Chapter 10 Care and Maintenance Removing and Replacing Internal Air Source Inlet Filter Pull filter out from underside
66. support bracket grommet Using the Allen wrench attach the bracket to the cart using the two M6 x 10mm screws Wall O2 connection Figure 13 11 Attaching Manifold Support Bracket 4 f you will be using O5 cylinders connect either or both of the oxygen hoses from the O cylinders to the left and right inlets of the oxygen manifold assembly These inlets are marked Oz Cylinder RS o7 Y Figure 13 12 Completed Manifold Assembly 13 16 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories 5 When using oxygen from a wall supply attach a wall oxygen hose not included to the center inlet of the oxygen manifold assembly Replacement Parts The following replacement parts can be ordered from Respironics e Check Valve Assembly PN 1007190 24 inch Medical Hose Assemblies Oxygen PN 1006655 Bracket and Hardware Kit PN 1062294 Using the Manifold To Use Wall Supply Oxygen Connect the wall oxygen supply to the manifold Close the O gt cylinder valves Oxygen is delivered to the ventilator from all sources that are active Therefore if the O cylinder valves are open while oxygen is being delivered from the wall supply the cylinders can be depleted of oxygen To avoid depleting the O cylinders shut off the cylinder valves when using the wall oxygen supply WARNING If using wall oxygen supply close the 0 cylinder valves to avo
67. the alarm limits of the other ventilation breath types The ventilator is easy to use because all mode settings and alarm limits are selected using the same three step process 1 Select the parameter to be changed by pressing the associated button The screen shown in Figure 8 1 appears 1 Set O5 and patient type are exceptions that can be changed only in the active mode and applies to all modes REF 1057983 A Respironics V200 Ventilator Operator s Manual 8 1 Chapter 8 Operating Instructions Peak Flow Increase bar the farther from the middle the bar is pushed the faster the value changes Similarly for the decrease bar 140 Digital value of setting to be changed Increase A 30 LPM v Decrease Y 3 Cancel Accept Figure 8 1 Entering Settings and Alarm Parameters 2 Press the INCREASE bar or DECREASE bar until the desired value appears in the digital window or use the front panel control knob to increase or decrease the displayed value 3 Press the ACCEPT button or FRONT PANEL ACCEPT key to enter the value and return to the previous display Press the CANCEL button to leave the value unchanged NOTE All volumes entered into the ventilator are assumed to be BTPS Body Temperature atmospheric Pressure Saturated with H20 volumes unless otherwise noted All volumes reported by the ventilator are reported as BTPS volumes All pressures are assumed to be rela
68. there are no active or auto reset alarm conditions present Alarm High The Alarm High indicator visually indicates a high priority alarm When a high priority alarm condition exists this indicator flashes red and an audible five tone sequence sounds until the condition is corrected or reset WARNING A high priority visual and audible alarm indicates a potentially life threatening condition and immediate response is required Alarm Med Low The Alarm M ed Low indicator visually indicates a medium or low priority alarm When a medium priority alarm condition exists this indicator will flash yellow and an audible three tone sequence will be heard until the condition is corrected When a low priority alarm condition exists this indicator remains lit with a steady yellow light until the alarm is reset Vent Inop The Vent Inop indicator signals the operator that the ventilator is not capable of supporting ventilation and requires service During a ventilator inoperative condition the ventilator enters a safe state where the safety valve is opened and new alarm condition detection is discontinued If the ventilator is attached to a patient when this condition is detected the ventilator must be replaced immediately WARNING Vent Inop is a serious condition which is indicated by both visual and audible alarms If the ventilator is attached to a patient when Vent Inop occurs the patient must be supported with another means of life suppor
69. time stamped based on ventilator time and date Measured pressures from 100 to 200 cmH50 are displayed for the P0 1 maneuver If measured pressure exceeds these limits only a message no data is displayed Range 100 to 200 cmH50 Resolution 1 cmH50 Accuracy 0 5 cmH 20 x 1096 of true value Table 13 9 Respiratory Mechanics Maneuver Summary and Data Specifications REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 63 Chapter 13 Options and Accessories Parameter Static compliance and resistance static C and R maneuver Description Procedure Patient participation is not required and patient interference can affect the accuracy of the maneuver If the patient initiates a breath when a maneuver breath is scheduled the ventilator does not perform the maneuver Available in VCV only Not available in PCV and NPPV During the maneuver The ventilator delivers a square waveform regardless of the current setting No other settings change during the static C and R maneuver The maneuver is not performed unless a machine or operator triggered breath is delivered within 20 seconds The inspiration time must be between 200 ms and 5 seconds for the maneuver to occur and the maximum plateau duration is 2 5 seconds Results display Static compliance is displayed in mL cmH50O Static resistance is displayed in cmH Oj L s All compliance and resistance values are measured on time or operator triggered man
70. 0 Respironics V200 Ventilator Operator s Manual REF 1057983 A Maneuver Static C and R Chapter 13 Options and Accessories Error Messages Temporarily Disabled Alarms Measurement out of range Check tubing None all alarms are active during system for leaks the Static C and R maneuver Static compliance exceeds 0 to 350 mL cmH50 or static resistance exceeds 0 to 400 cmH50 L s Static C amp R unavailable due to alarm condition Alarm condition exists when maneuver requested Static C amp R only available in VCV Ventilator not in VCV mode Static C amp R unavailable I Time less than 200ms Inspiration time must be between 200 ms and 5 seconds Static C amp R unavailable I Time greater than 5 seconds Inspiration time must be between 200 ms and 5 seconds Plateau pressure stability not achieved Static C amp R unavailable Stable plateau pressure cannot be achieved Maneuver cancelled Operator presses Stop button Maneuver timed out No machine or operator initiated inspiration within 20 seconds of starting maneuver Maneuver cancelled by alarm condition Alarm condition occurs after maneuver begins Table 13 8 Respiratory Mechanics Error Messages and Alarms REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 61 Chapter 13 Options and Accessories Parameter Vital Capacity VC maneuver Description Procedure The clinician instructs the patient to inhale to maximum ca
71. 0 cmH50 we recommend the setting normally be adjusted to 60 cmH 0 or less in order to prolong the operating life of the blower and to maximize backup battery run time NOTE When the active mode is set to NPPV the HIP Limit Setting will automatically be adjusted to 10 cmH5O above the current IPAP setting Follow these steps to adjust alarm limits that are not currently active 1 Depending on the alarm limits you wish to review push the VCV SETTINGS PCV SETTINGS or NPPV SETTINGS button that has a gray background and black letters not active REF 1057983 A Respironics V200 Ventilator Operator s Manual 8 17 Chapter 8 Operating Instructions 2 NOTE ACTIVATE Activate reed tive button Figure 8 16 PCV Setting while NPPV is the active breath type From the control settings screen push the ACTIVATE button Refer to Figure 8 16 The ventilator displays a prompt insert Figure 8 17 Figure 8 17 Change Breath Type Insert Window for PCV Select the REVIEW ALARMS button to display the alarm settings for PCV Figure 8 18 Notice that all the alarm buttons Figure 8 18 are grayed out indicating that the alarm limits are not currently active The ventilator displays the current value for that set of alarm limits Push the button for the alarm limit you want to adjust The ventilator keeps a distinct set of alarm limits for each ventilation breath type VCV PCV and NPPV Press the bar or use
72. 02 is required for communication with the ventilator The VueLink Module can communicate to three different protocols for external devices VueLink Interface Analog Interface or VueLink Open Interface The ventilator uses the VueLink Open Interface Refer to the VueLink Handbook provided with the VueLink module for configuration directions for an Open Interface device For reference purposes only below are configuration directions from the Agilent M1032A VueLink Module Handbook Fourth Edition 08 2000 Configuration Overview The VueLink Module must be configured during installation Additional configuration will be required whenever a new device driver is preselected for availability in Monitoring Mode The VueLink Module can be configured for up to three preselected device drivers Changing modes The CMS must be in Configuration Mode to preselect devices To do this follow the steps below 1 Turn on the ventilator in ventilation mode and connect it to a VueLink Module as shown in Figure 13 23 13 30 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Press Monitor Setup on a Standard Control Panel or Instrument Config on a Classic Control Panel of the Component Monitoring System CMS Highlight Operating Modes on the displayed window and press Confirm The current operating mode will appear in the task window for example Operating Mode Monitoring along with a
73. 096 Settings Alarms and Data Display Type TFT liquid crystal touch screen Table 12 20 Measuring and Display Devices AC Power and Battery Indicators AC Power amp Battery Indicators Loss of Power audible only Backup Battery Low dq 4i External Battery In Use E Backup Battery In Use d 1 Backup Battery Charging Mains eL Table 12 21 AC Power amp Battery Indicators 12 10 Respironics V200 Ventilator Operator s Manual REF 1057983 A Leakage Current Compliance and Approvals Power Requirements Chapter 12 Technical Specifications Leakage Current Ventilator Earth Leakage Current 100 to 240VAC 300A maximum Enclosure Patient Leakage Current 100 to 240VAC 100A maximum Table 12 22 Leakage Current WARNING When connecting a humidifier to the humidifier outlet available only on 100 120 VAC ventilators allowable leakage current values may be exceeded Compliance and Approvals The Respironics V200 ventilator system complies with the requirements of the European Directive 93 42 EEC concerning medical devices and the requirements of Directive 0086 89 336 EEC relating to electromagnetic compatibility IEC 601 1 Classification Protection class 1 type B applied part drip proof continuous operation The ventilator system complies IEC 601 1 EN60601 1 with these international and IEC 601 1 2 EN60601 1 2 European Standards EN 794 1 The ventilator system has been CSA NRTL CSA C22 2 No 601 1
74. 1 RT125 is EU equivalent 22mm Male x Male Connector Refer to Figure 13 52 1002505 coupling Straight Silicone 500 1000 43 NOTE We recommend using approved circuits or equivalent when connecting to the ventilator Table 13 20 Neonatal Option Requirements OCOCCOC a Filter Silicone coupler Connector Circuit Figure 13 52 Circuit to Filter Connection REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 97 Chapter 13 Options and Accessories Changing Patient Types The Neonatal option is available once the software option is installed The current patient is identified by the icon found on any active ventilation type screen In Figure 13 53 the neonatal patient type has been selected which is identified by the neonatal patient type icon Neonatal patient type icon Figure 13 53 Identifying the Neonatal Patient Type Changing to or from the neonatal patient type requires that the Short Self Test SST or Extended Self Test EST must first be run Attempts to change patient types to or from the neonatal patient type while in the active ventilation type screen causes a message box to appear explaining that you must run SST or EST in order to change patient type Selecting Neonatal Patient Type To select the neonatal patient type you must enter Diagnostic Mode 1 Power off the ventilator 2 Power on the ventilator while holding down the ALARM RESET and 100 O keys for approximately 5 seconds
75. 23 12 3 G 1 EST 11 4 Exhalation Bacteria Filter 13 2 Exp Valve Stuck Open Alarm 9 5 Expiratory Bacteria Filter 4 18 Expiratory Hold Calculated Values 12 7 Expiratory Hold Key 8 10 Expiratory Positive Airway Pressure G 1 Extended Self Test EST 5 12 11 4 F FM 8 29 Filters Removal Installation Bacteria 10 4 Cooling 10 8 Heated Bacteria 4 18 Inspiratory Bacteria 4 16 Internal Air Source Inlet 10 10 O2 Input Filter 10 9 Flex Arm 4 22 Front Panel 8 3 Controls 8 10 Keys 8 8 Text Version 8 3 Touch Display 8 11 G Gas Supplies Lost SVO Alarm 9 5 Glossary G 1 H High Indicator 8 5 High Inspiratory Pressure 9 5 12 9 Alarm Test C 2 High Inspiratory Pressure Alarm 9 5 High Internal O2 Alarm 9 5 High Leak Rate Alarm 9 5 High Minute Volume Alarm 9 6 High O2 Alarm 9 6 High Respiratory Rate 9 6 12 9 High Respiratory Rate Alarm 9 6 High Temperature Alarm 9 6 High Urgency Alarm 12 9 high urgency alarm 9 1 9 5 Humidifier AC Circuit Breaker 5 2 AC Outlet 6 1 Connecting 6 3 Index 2 Respironics V200 Ventilator Operator s Manual REF 1057983 A I E Ratio 8 29 Inspiratory Bacteria Filter 4 17 13 2 13 4 Installation 4 16 Removing and Replacing 10 5 Inspiratory Trigger I Trigger 8 21 IPAP 7 6 8 23 12 3 I TIME 7 2 I Time Too Long Alarm 9 6 L Labels 12 18 Lock Screen 8 8 Low Backup Battery Alarm 9 6 Low EPAP Alarm 9 6 Low Insp Pressure Alarm 9 7 Low
76. 3 0000 0 1 0 5 20 0 LPM Setting NPPV E Cycle Type AUTO N A FLOWO N A AUTO NPPV Flow 259999 1 10 80 Expiratory Cycle Setting NPPV Oxygen 219999 1 21 100 96 Concentration Setting NPPV Apnea Rate 120000 1 1 80 BPM Setting NPPV Low Inspiratory 300000 1 3 105 cmH 30 Pressure Alarm Limit hPa Setting NPPV Low EPAP 099999 1 0 25 cmH50 Alarm Limit Setting hPa NPPV Low Tidal 099999 1 0 2500 mL Volume Alarm Limit Setting Table A 1 Ventilation Report Sheet 4 of 10 REF 1057983 A Respironics V200 Ventilator Operator s Manual Appendix A 5 Appendix A RS 232 Communications Protocol Ventilation Report Continued Description Example Resolution Range Units Comments NPPV High 15000 1 0 150 BPM Respiratory Rate Alarm Limit Setting NPPV Low Minute 1 009 0 01 for 0 00 60 0 L Volume Alarm Limit T Setting to60 0 NPPV Apnea Interval 209999 1 10 60 Sec Alarm Limit Setting NPPV High Leak 60000 1 10 60 sec Alarm Limit Setting Measured Peak 24 199 0 1for 20 0 20 0 130 cmH O The PIP value from i to 99 9 i Inspiratory Pressure To TOO hPa the Patient Data 130 Screen Measured Mean 5 60999 0 1for 20 0 20 0 120 cmH 20 The MAP value Airway Pressure i arm hPa from the Patient De 9 Data screen Measured End 2 0000 0 1 20 0 99 9 cmH 0 The End Exp value Expiratory Pressure hPa from the Patient Data screen Measured End 24 000 0 1 for 20 0 20 0 130 cmH 0 The Plateau va
77. AL ALARM RESET Comments Low O gt Supply Alarm Status NORMAL NORMAL ALARM RESETe Low supply pressure Low O Alarm Status NORMAL NORMAL ALARM RESETe Low 0 concentration Low Minute Volume Alarm Status NORMAL NORMAL ALARM RESETe Low Mandatory Tidal Volume Alarm Status NORMAL NORMAL ALARM RESET High Minute Volume Alarm Status NORMAL NORMAL ALARM RESET Low Tidal Volume Alarm Status NORMAL NORMAL ALARM RESET Low Spontaneous Tidal Volume Alarm Status NORMAL NORMAL ALARM RESET l Time Too Long Alarm Status NORMAL NORMAL ALARM RESET a igh Respiratory Rate Alarm Status NORMAL NORMAL ALARM RESET as igh O5 Alarm Status NORMAL NORMAL ALARM RESET igh Enclosure Temperature Alarm tatus VI NORMAL NORMAL ALARM RESET igh Internal Oxygen Concentration arm Status gt I NORMAL NORMAL ALARM RESET Low PEEP Alarm Status Table A 6 Alarm Status Report Sheet 2 of 3 NORMAL NORMAL ALARM RESET REF 1057983 A Respironics V200 Ventilator Operator s Manual Appendix A 23 Appendix A RS 232 Communications Protocol Unrecognized Commands Alarm Status Report Continued Description Example Range Comments Low EPAP Alarm Status NORMAL NORMAL ALARM RESETe High Leak Alarm Status NORMAL NORMAL ALARM RESETe Stop
78. Chapter 4 Getting Started Inspiratory Bacteria Filter Installation The inspiratory bacteria filter 4 in Figure 4 19 mounts on the gas outlet port 1 located in the lower right corner on the front of the ventilator If the optional O sensor 2 will be used it will be connected to the gas outlet port 1 before the inspiratory bacteria filter is connected For more information regarding the optional O sensor refer to Chapter 13 Options and Accessories 5 4 3 2 1 Figure 4 19 Inserting Disposable Inspiratory Bacteria Filter 4 16 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 4 Getting Started WARNING To reduce the chance of contamination or infection always use an inspiratory and expiratory filter when the ventilator is in operation Refer to manufacturer s instructions and follow institutional infection control guidelines when replacing the inspiratory and expiratory filter WARNING Do not use anti static or conductive hoses or conductive patient tubing NOTE Follow institutional infection control guidelines when replacing the inspiratory or expiratory bacteria filter NOTE When adding attachments or other components or subassemblies to the breathing system for example an HME or humidifier ensure that the inspiratory and expiratory resistances measured at the patient connection port do not exceed 6 cmH50 hPa at a flow of 60 L min for adults 30L min for pediatrics Inspiratory B
79. Code 0x03 N A ASCII End Transmission Character ETX Table A 6 Alarm Status Report Sheet 3 of 3 If an unrecognized command is received the ventilator will respond by transmitting the information shown in Table A 7 Unrecognized Commands Unrecognized Commands received set off in brackets Description Example Comments The unrecognized command ERROR response 7ERROR Time of request 13 45 24 hour clock hh mm Up to the first five characters VRPY Example for VRPT being sent as VRPY Non printable characters are returned as Table A 7 Unrecognized Commands Appendix A 24 Respironics V200 Ventilator Operator s Manual REF 1057983 A Appendix B Customer Service amp Warranty Customer Service Warranty For further information or assistance in operating the Respironics V200 contact Respironics Customer Service Within the United States 800 345 6443 Outside the United States 724 387 4000 Fax 724 387 5012 email service respironics com Two Year Warranty Respironics warrants the Respironics V200 to be free from defects in material and workmanship for a period of two years from the date of purchase provided that the unit is operated under conditions of normal use as described in this Operator s Manual At its discretion Respironics will make replacements repairs or issue credits for equipment or parts that are found to be defective Exclusions This warranty does not apply to any u
80. Connection source for devices capable of serial communication Refer to Chapter 6 Connecting Additional Equipment 2 Remote Alarm Nurse Call Connection source for remote alarm devices 3 Parallel Printer Port For use with the Communications Option Refer to Chapter 13 Options and Accessories 4 PCMCIA Card Slot PC Card For use with the Trending Option Refer to Chapter 13 Options and Accessories REF 1057983 A Respironics V200 Ventilator Operator s Manual 5 1 Chapter 5 Setup WARNING The cover plate for the PCMCIA slot at the back of the ventilator must be replaced after the adapter and card are installed This is to protect the ventilator CAUTION The PCMCIA card should only be removed by trained service personnel once power to the ventilator is off 5 Analog Port Pin 12 signals an unsilenced high or medium urgency alarm Other pins are used by the Communications Option Refer to Chapter 13 Options and Accessories 6 DC Battery Connector Connection source for battery power cord 7 AC Inlet Connection for AC power cord 8 Humidifier AC Circuit Breaker Circuit breaker for AC power applied to a humidifier WARNING AC power is applied to the humidifier from the ventilator humidifier outlet only available on 100 120 VAC ventilators Under no circumstances does the Respironics V200 Ventilator provide control for the humidifier To ensure patient safety it is important that any humidifier used w
81. Controlled Figure 7 7 Spont T Mode The ventilator has the following two emergency modes of ventilation that are entered in response to certain alarm conditions Apnea Ventilation e Safety Valve Open Apnea Ventilation Apnea ventilation provides an emergency mode of ventilation if the ventilator does not deliver a breath for an operator set interval of time The apnea time can be set between 10 and 60 seconds Upon entering this mode of ventilation the ventilator will alarm and immediately start using the Apnea Rate setting specified by the operator In PCV and VCV the ventilator will begin delivering breaths in Assist Control A C but with the operator set Apnea Rate In NPPV the ventilator will deliver only machine controlled breaths either at the operator set Apnea Rate or in response to patient effort In Apnea ventilation the alarms used are the ones used for machine controlled breaths for the ventilation breath type VCV PCV and NPPV the ventilator was using when Apnea occurred REF 1057983 A Respironics V200 Ventilator Operator s Manual 7 7 Chapter 7 Operating Theory Parameters Used in Apnea Ventilation Settings and Alarm Limits VCV PCV NPPV Settings Tidal Volume Inhalation Pressure IPAP Peak Flow Inhalation Time EPAP PEEP PEEP Inhalation Time Trigger pressure flow l Trigger pressure flow Rise Time Flow pattern Rise Time l Trigger flow O O E Cycle nsp Hold Apnea Rate 0596 Apnea
82. Data collection and The system collects numeric data every 20 seconds Alarms are considered display active if they occurred at any time during the previous 20 second interval If the selected time scale is 2 hours each data point on a waveform represents 20 seconds As the scale is increased each data point represents a longer interval Data is periodically refreshed if there is no user interaction Display time outs The Trending screen automatically reverts to the Monitor screen if 15 minutes elapse without user interaction Pop up windows are cleared from the display if 2 minutes elapse without user interaction and any pending changes are cancelled Table 13 12 Trending Data Specifications Sheet 1 of 4 13 78 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Trended data The Trending option simultaneously trends 32 parameters from four categories patient data settings lung mechanics Mech and NICO Parameters that are not currently displayed are stored in memory for viewing Trended data PIP Pt Data peak inspiratory pressure MAP mean airway pressure Tidal Vol exhaled tidal volume Total VE total minute volume Spont VE spontaneous minute volume Tot amp Spt VE both spontaneous and total minute volume displayed on the same waveform Total Rate measured total respiratory rate Spont Rate measured spontaneous respiratory rate Tot
83. Description The maximum measured inspiratory flow at the patient wye Available in VCV and PCV Peak L Flow is displayed in LPM Dynamic compliance and resistance An estimation of the compliance and resistance of the patient s lungs using the Least Square Estimation algorithm on the equation of motion P R Q V C where Q lung flow and V lung volume performed during each machine or operator initiated inspiration Dynamic compliance is displayed in mL cmH 0 Dynamic resistance is displayed in cmH5O L s All compliance and resistance values are estimated on time or operator triggered mandatory breaths only If there were no machine or operator initiated breaths within the last one minute is displayed These alarms interrupt dynamic compliance and resistance updates Corrupt Compliance Corrupt Altitude High Pressure Low Insp pressure Air Source Fault O2 Valve stuck closed Exh Valve stuck open Low Tidal volume Low PEEP Dynamic compliance values from 0 to 350 mL cmH50 and dynamic resistance values from 0 to 400 cmH0 L s are displayed If either value is above its limit only is displayed If either value is below its limit only is displayed Table 13 9 Respiratory Mechanics Maneuver Summary and Data Specifications Compliance C and Dynamic C and R are estimated during ventilator and operator initiated Resistance R breaths Static C and R are estimated during a Static C and R maneuver Co
84. End Expiratory Pressure 20 to 120 cmH50 hPa Expiratory Pause Pressure 20 to 120 cmH50 hPa Auto PEEP calculated range 0 to 120 cmH50 hPa Table 12 13 Calculated Values from Expiratory Hold Maneuver Interface Ports Parallel Printer Port future RS 232 output and input Analog Output 0 to 5 VDC full scale feature Remote Alarm Nurse Call and Remote Alarm Annunciation Table 12 14 Interface Ports REF 1057983 A Respironics V200 Ventilator Operator s Manual 12 7 Chapter 12 Technical Specifications Environmental Specifications Environmental Specifications Temperature Humidity Operating 109to 40 C 509 to 104 10 to 9596 R H non condensing Storage 202 to 60 42 to 1409F 10 to 100 R H non condensing Atmospheric Pressure Operating 700 to 1060 cmH50 hPa Storage 500 to 1060 cmH50 hPa Altitude Operating 0 to 3280m 0 to 10 000 ft Storage up to 6560m 20 000 ft Oxygen Inlet Supply Pressure 276 to 620 kPa 40 90 psig Flow 200 L min minimum Table 12 15 Environmental Specifications Environmental Protection Environmental Protection Batteries Do not dispose of in fire possible explosion hazard Do not dispose of in garbage recycle lead batteries Ventilator Enclosure The system plastic enclosure should not be disposed of in fire possible toxic fumes may be generated General The system and accessories bacteria filters patient tubing etc may b
85. Exhaled Minute Volume High Exhaled Minute Volume Low Exhaled Mandatory Tidal Volume Low Exhaled Spontaneous Tidal Volume Disabled Alarms The Low PEEP alarm is disabled while in Speaking Mode This alarm will be appear grayed out When the ventilator returns to PSV PCV VCV SIMV or CPAP operation the current alarm settings will remain after Speaking Mode is discontinued Volume Control Alarma Active Disabled alarms are grayed out vorsennge rovsenoge veremos 0 8 1B Figure 13 63 Alarm Settings Screen Changes can be made to these disabled alarms while in Speaking Mode but they will not take affect until Speaking Mode is discontinued REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 109 Chapter 13 Options and Accessories Mode Specific Alarms Disconnect Alarm If the tracheostomy tube becomes disconnected from the patient circuit a high urgency Disconnect Alarm will sound When the disconnect alarm is active the ventilator continues ventilation If the tracheostomy tube becomes re connected the alarm auto resets Airway Occlusion Alarm If the area surrounding the tracheostomy tube becomes obstructed during ventilation in Speaking Mode e g the tracheostomy cuff is inflated so the flow rate through the patient s airway during exhalation is less than 5 L min for the entire exhalation a high urgency airway occlusion alarm will sound The ventilator continues to ventil
86. Figure 8 26 Prompt when Activate is pressed and PCV settings selected 4 Atthis prompt the operator can Move directly into PCV by pressing the OK button or Review the PCV alarm settings or e Change nothing and return to the PCV settings screen by pressing the CANCEL button If the OK button is pressed the ventilator immediately begins operations in PCV the PCV settings become active and screen in Figure 8 27 a appears Press the OK button and go to this screen a 8 24 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 8 Operating Instructions oe m e me Press the Review Alarms button to go to this screen 40 10 o emi Harms f 407 300 4 00 s 15 Press the Cancel button and return to this screen Figure 8 27 Destination Screens after Activate Prompt If the REVIEW ALARMS button is pressed the ventilator immediately displays the screen shown in Figure 8 27 b appears If the CANCEL button is pressed the ventilator returns to the settings screen for the selected breath type as shown in Figure 8 27 c 5 f the operator elects to review alarm settings the alarm settings screen for the destination mode is shown Figure 8 28 All the alarm limits are grayed out in this screen because the selected breath type PCV is not yet active However the grayed out buttons can be used to adjust values as seems appropriate for the patient Activat Sr NN Press to
87. LOWe e N A FLOWe e N A AUTO NPPV Flow I Trigger 3 0000 0 1 0 5 20 0 LPM Setting NPPV E Cycle Type FLOW N A FLOW N A AUTO NPPV Flow 259999 1 10 80 96 Expiratory Cycle Setting NPPV Oxygen 219999 1 21 100 96 Concentration Setting NPPV Apnea Rate 120000 1 1 80 BPM Setting NPPV Low Inspiratory 30000 1 3 105 cmH 70 Pressure Alarm Limit hPa Setting NPPV Low EPAP 099999 1 0 25 cmH50 Alarm Limit Setting hPa NPPV Low Tidal 099999 1 0 2500 mL Volume Alarm Limit Setting NPPV High 150 9 9 1 0 150 BPM Respiratory Rate Alarm Limit Setting NPPV Low Minute 1 00 0 01 for 0 00 60 0 L Volume Alarm Limit 0 00 to 9 99 Setting 0 1 for 10 0 to 60 0 NPPV Apnea Interval 20 1 10 60 sec Alarm Limit Setting Table A 4 Non Invasive Positive Pressure Ventilation Settings Report Sheet 2 of 3 REF 1057983 A Respironics V200 Ventilator Operator s Manual Appendix A 17 Appendix A RS 232 Communications Protocol Patient Data Report PTDT Non Invasive Positive Pressure Ventilation Settings Report Continued Description Example Resolution Range Units Comments NPPV High Leak 609999 1 1 60 LPM Alarm Limit Stop Code 0x03 N A N A N A ASCII End Transmission Character ETX Table A 4 Non Invasive Positive Pressure Ventilation Settings Report Sheet 3 of 3 When the ventilator receives PTDT followed by a carriage return it will respond by transmitting the information shown in Table A 5 Patient Data Repor
88. LPM Resolution is 0 1 LPM Expiratory Trigger E Cycle 96 Peak Flow 10 to 80 of inspiratory peak flow Rise Time 0 1 to 0 9 seconds Resolution is 0 1 second 960 21 to 100 Insp Hold 0 to 2 0 seconds Resolution is 0 1 second Flow Waveform Descending ramp square Patient Type Adult P ediatric Table 12 3 Volume Ventilation Settings Ranges and Resolution Sheet 2 of 2 Pressure Control Resolution is one unit unless otherwise noted cmH50 is considered Ventilation Settings numerically equivalent to hPa Ranges and Resolution Pressure Control Ventilation Settings Ranges amp Resolution Setting Range Apnea Rate 1 80 Bpm Respiratory Rate 1to80 Bpm PCV Pressure 5 to 100 cmH50 hPa Relative to PEEP Inspiratory Time 0 1 to 9 9 seconds Resolution is 1 second PEEP 0 to 35 cmH50 hPa PSV Pressure 0 to 100 cmH50 hPa Relative to PEEP Inspiratory Trigger I trigger Pressure Sensitivity 20 to 0 1 cmH20 hPa Resolution is 0 1 cmH20 hPa Flow Sensitivity 0 5 to 20 LPM from base flow of 3 LPM above sensitivity Resolution is 0 1 LPM Expiratory Trigger E Cycle 96 Peak Flow 10 to 8096 of inspiratory peak flow Table 12 4 Pressure Control Ventilation Settings Ranges amp Resolution Sheet 1 of 2 12 2 Respironics V200 Ventilator Operator s Manual REF 1057983 A Non Invasive Positive Pressure Ventilation Settings Ranges and Resolution Apnea Ventilation Chapt
89. Last 11 14 014 13 11 1 minute 01 01 7 N A MIP Time of Last Maneuver 0 0 00 to Maneuver display 01 19 38 from MIP P0 1 3 14 Screen15 character field 24 hour clock MM DD YYuuHH MM P0 1 2 300 0 1for 99 9 100 200 cmH 0 P0 1 display from to 99 9 MIP PO 1 display 1 for 100 and 100 to Screen 200 P0 1 Time of Last 11 14 01 913 11 1 minute 01 01 70 N A P0 1 Time of Last Maneuver 0 00 to Maneuver display 01 1 38 from MIP PO 1 3 14 Screen 15 character field 24 hour clock MM DD YYwwHH MM Static Resistance 5 43 0 01 for 0 00 400 cmH20 Static Resistance 0 00 to 9 99 i OL Frid L Sec oe the to 99 9 tatic screen 1 for 100 to 400 Static Compliance 19 2 0 01 for 0 00 350 mL Static Compliance 0 00 to 9 99 i ET HOO cmH50 uei the to 99 9 s 1 for 100 to Screen 350 Static C amp R Time of 11 14 01 9913311 1 minute 01 01 70 N A Static C amp R Time Last Maneuver 0 00 to of Last Maneuver 01 19 38 display from Static 3 14 C amp R Screen 15 character field 24 hour clock MM DD YYwwHH MM Table A 1 Ventilation Report Sheet 7 of 10 Appendix A 8 Respironics V200 Ventilator Operator s Manual REF 1057983 A Appendix A RS 232 Communications Protocol Ventilation Report Continued Description Example Resolution Range Units Comments AutoP eep 1 2 0 1 for 9 9 20 120 cmH20 AutoPeep display are from the T dd 2S Mechanics Patient 1 for 10 to Status Screen 120
90. Module sli 13 30 Analog Output Chart Recorder 1 llle 13 36 RS 232 Communications Option 2 Com2 00 cece eee eee 13 39 RS 232 Configurations s n mph E iana a dept ts detects 13 39 Commands Transmitted to the Ventilator isle 13 40 Transmission of Data from the Ventilator llle een 13 40 SNDA CR Send Variable Length Ventilator Settings Report 13 40 Respiratory Mechanics Option isses 13 51 Accessing Respiratory Mechanics Data liess 13 51 Vital Capacity Maneuver 2 e 13 52 MIP P O T Marie ver iid torn aha ERR acm dn 13 54 Static C and R Maneuver 0 0 0 nn 13 56 Alarms and Error Messages i i nn 13 58 Compliance C and Resistance R Computations 000 13 65 Trending Option ss sarpi s eeraa da a hh rra 13 69 Accessing Trending Data lisse ee 13 69 Selecting Parameters for Display oasa ee 13 72 Using the Manual Rescale Function anaana aa 13 74 Changing the Cursor Position isses eh 13 74 Selecting the Time Scale liis 13 75 Using the 2 Hrs 2 Hrs buttons liliis 13 76 Using the Zoom Function llle 13 76 Using the Rescale Button illii 13 76 Using the View 1 View 2 buttons lisse 13 77 Using the Clear button 2 0 s 13 77 Alarms during Trending isses 13 77 PCMCIA Card i sede CIE X A eee eee ee ba ER 13 77 Trending Not Available si pdr errer ub ara enn 13 78 Specifications
91. OO N A ON OO N A Status of the Alarm OFFOoe Silence LED on the front panel Screen Lock Status OF FOO N A ON OO N A Status of the OFFeee Screen Lock LED on the front panel Tube Type ETOOO N A ET OO 8 N A Tube type as TTe 99 selected in NONEO Respiratory Mechanics Screens Not used Tube Size 7 0999 0 1 for 3 5 3 5 10 mm Tube size as m selected in 9r Respiratory Mechanics Screens Not used VCV High Minute 60 0 0 01 for 0 00 60 0 L Volume Alarm Limit 0 00 to 9 99 Setting 0 1 for 10 0 to 60 0 Static C amp R Plateau 8 200 0 1 for 20 20 0 130 cmH20 Pyi display from End Pressure to 99 9 Static C amp R 1 for 100 to S 130 creen Stop Code 0x03 N A N A N A ASCII End Transmission Character ETX Table A 1 Ventilation Report Sheet 10 of 10 When the ventilator receives VCVS followed by a carriage return it will respond by transmitting the information shown in Table A 2 Volume Control Ventilation Settings Report The ventilator responds to the VCVS command by returning a string with a variable length Fields 2 through 4 define the length of the message The last character transmitted is a stop code indicating the end of the message The second field indicates the number of characters between the start and stop codes The third field indicates the number of REF 1057983 A Respironics V200 Ventilator Operator s Manual Appendix A 11 Appendix A RS 232 Communications Protocol fields between the start and stop codes
92. Respironics V200 Ventilator Operator s Manud PHILIPS PHILIPS For Technical Support and Customer Service contact USA and Canada 1 800 345 6443 or 724 387 4000 Respironics Europe Africa Middle East 33 1 47 52 30 00 Respironics Asia Pacific 852 3194 2280 Facsimile 724 387 5012 USA Respironics California Inc 2271 Cosmos Court Carlsbad CA 92011 Email and web addresses service philips com clinical philips com www philips com healthcare Authorized European address Respironics Deutschland GmbH Ea Gewerbestrasse 17 D 82211 Herrsching Germany 49 8 15 29 30 60 2009 Respironics and its affiliates All rights reserved This work is protected under Title 17 of the United States copyright code and is the sole property of Respironics No part of this document may be copied or otherwise reproduced or stored in any electronic information retrieval system except as specifically permitted under United States copyright law without the prior written consent of Respironics Table of Contents Introduction and Intended Use 000 0020 ee 1 1 Warnings Cautions and Notes 0 cece eee eee 2 1 Summary of Warnings Cautions and Notes 0c eee eee eee 2 1 Symbols 2 o er pats d eres dub een OE ten Ob SCOPO S PER GUTER Y 3 1 Getting States 5e dire eoa te Md oe So EE ee eta 4 1 Unpacking 1 224 uiui denim Rari herb desiit deed qiie oe 4 1 Inspection usd EUER RR ET MEAS ee
93. The fourth field is the start code 0x02 The last field in the string is the stop code 0x03 Volume Control Ventilation Settings Report Description Example Resolution Range Units Comments Command Name VCVS N A N A N A Number of characters 209 N A N A N A 3 character field between the start and stop codes Number of fields 29 N A N A N A 2 character field between the start and stop codes Start Code 0x02 N A N A N A ASCII Start Transmission Character STX Time of request 13 45 N A N A N A 24 hour clock hh mm Date FEB 2301997 N A N A N A 12 character field MMM DD YYYY Current Ventilation vcveee N A vcveee N A The ventilation Type PCVeee type currently NPPVee being used by the ventilation VCV Mode Setting AICOO N A AICOO N A SIMVO CPAP VCV Waveform RAMP N A RAMP N A Setting SQUARE VCV Patient Type ADULT N A ADULTe PEDOO NEO OO VCV Respiratory Rate 129999 1 1 80 BPM Setting VCV Tidal Volume 500999 1 50 2500 mL Setting VCV Peak Flow 300000 1 3 140 LPM Setting VCV PEEP Setting 099999 1 0 35 cmH5O hPa VCV Pressure Suppot 000000 1 0 100 cmH20 Setting hPa VCV l Trigger Type PRESS N A PRESS N A FLOW e AUTOe VCV Pressure I 2 0000 0 1 0 1 20 0 cmH 0 Trigger Setting hPa Table A 2 Volume Control Ventilation Settings Report Sheet 1 of 2 Appendix A 12 Respironics V200 Ventilator Operator s Manual REF 1057983 A Appendix A RS 232 Communi
94. The ventilator is connected to an AC power source and the rear panel Mains circuit breaker e is on I Ext Battery Yellow Continuously illuminated when the external battery is in use NOTE The external battery is an optional accessory See Options and Accessories on page 13 1 for more information Table 8 2 Power Status Indicators Sheet 2 of 2 REF 1057983 A Respironics V200 Ventilator Operator s Manual 8 7 Chapter 8 Operating Instructions Front Panel Keys The front panel keys enable you to initiate ventilator functions The keys that include an indicator also provide operational status of the function that it performs The text version of the front panel keys is shown in Figure 8 7 The symbol version of the front panel keys is shown in Figure 8 8 Refer to Chapter 9 Alarms for more detailed information on the alarm keys and buttons s s NOLO gue eT Figure 8 7 Front Panel Keys Text Version 9 92 m O gag e Figure 8 8 Front Panel Keys Symbol Version V200 100 Front Panel Keys Key Symbol Definition Description Screen Function Locks and unlocks the graphic display touch screen When the Lock screen lock is activated all on screen buttons are disabled until the touch screen is unlocked This prevents inadvertent setting and display changes via the touch screen MANUAL BREATH 10096 O2 EXP HOLD ALARM RESET and ALARM SILENCE keys are still active keys
95. Waveforms screen 1 Foreach waveform press the FLOW PRESSURE or VOLUME button 2 Pressthe 7 sec 14 sec or 21 sec button to select the waveforms time scale REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 19 Chapter 13 Options and Accessories Figure 13 14 Waveform Screens Replotting and You can select one of two plotting methods for waveforms Sc rolling e Replotting selects a waveform that is drawn from left to right then clears and restarts from the left edge similar to an oscilloscope Scrolling selects a waveform that is drawn from left to right then continuously shifts to the left to display the most recent data at the right edge of the screen similar to a stripchart Rescaling the Display Press RESCALE Figure 13 15 to allow software to adjust the vertical scales for waveforms and vertical and horizontal scales for loops Rescaling is available for waveforms and loops in normal and during Freeze operation For optimum viewing press RESCALE at the end of exhalation Rescale button Figure 13 15 Rescale Button 13 20 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Figure 13 16 shows waveforms before and after rescaling a BEFORE Rescale n al E 40 3 0 bd a v b AFTER Rescale Figure 13 16 Waveforms Screen a Before and b After Rescale Follow these steps to change scales manually 1 Touch
96. a Aarm Sotinga Monier Descending ramp and square wave act as ac sim cea a Active mutually exclusive select non select buttons TM Emme y N Push this button Push this button to to select select square descending ramp waveform waveform Figure 8 19 Selecting Waveforms descending ramp selected Selecting Adult Pediatric Buttons You can configure ventilation for adult or pediatric patients Figure 8 20 from the active ventilation type screen Selecting adult or pediatric tailors the ventilator s breath delivery algorithms to the selected adult pediatric patient type Selecting adult or pediatric does not change how the screens work and does not change ventilator or alarm settings The patient type selection determines flow output at various rise time settings for PCV PSV and IPAP In addition the I Time too long alarms and time out for spontaneous breaths are set to 3 5 seconds for the adult setting and 2 5 seconds for the pediatric setting Peak flow is limited to 100 LPM in all pressure based breaths when using the pediatric setting were meme onem ab My eB Push this button to Push this button to select controls select pediatric controls Figure 8 20 Selecting Adult Pediatric Controls adult selected 8 20 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 8 Operating Instructions Selecting the Inspiratory Trigger I Trigger The I Trigger setting deter
97. a resuscitator or similar device is available while the ventilator is in use on a patient WARNING DO NOT perform the preoperational procedure when the ventilator is on a patient Follow these steps 1 Follow the setup procedures in Chapter 5 Setup to prepare the ventilator for use 2 Connect the patient circuit to be used on the next patient 3 Install any components that are to be used in line with the patient circuit for example humidifier O5 monitor or airway temperature monitors NOTE All components of the patient circuit must not have leaks in order to pass SST Ensure that the ventilator is not on a patient Hold down the ALARM RESET and 100 O keys while the ventilator is powered up The operator must confirm that the machine should be in Diagnostic Mode Figure 8 36 WARNING The Diagnostics Mode i not to be used when a patient i connected to the ventilator Verily thai the patient s disconnected prior 1o proceeding Cancel Circuit Compliance 2 13 ml em H20 WARNING Entering Diagnostics Mode Very that the paterd amp disconnected prior to proceeding OK Failure Data Failure Code Measured Tolerance Diag Codes Information Jptio Option az Figure 8 36 Entering Diagnostic Mode 6 Press OK to clear the Warning message and enter Diagnostic Mode 8 32 Respironics V200 Ventilator Operator s Manual REF 1057983 A NOTE Any failures detected during SST are listed here Chapter 8 Operating Instr
98. acteria Filter Installation Instructions Refer to Figure 4 19 l Locate the gas outlet port 1 on the front panel 2 If the optional O sensor 2 will be used connect it to the gas outlet port 1 3 Remove the inspiratory bacteria filter from the filter package and inspect for cracks or potential leaks Discard the filter if it is cracked has moisture inside or is otherwise unserviceable 4 Some bacteria filters provide an arrow or other mark to indicate the direction of flow The flow indicator should be pointed away from the ventilator toward the patient circuit connection Insert inspiratory filter inlet 4 into either the optional O sensor 2 using the 22mm connector 3 or the gas outlet port 1 if the optional O sensor 2 is not used 5 Connect inspiratory limb of patient circuit 5 to bacteria filter 4 REF 1057983 A Respironics V200 Ventilator Operator s Manual 4 17 Chapter 4 Getting Started Heated Expiratory Bacteria Filter Installation WARNING CAUTION WARNING NOTE NOTE Figure 4 20 Installing Expiratory Bacteria Filter The expiratory filter housing may be hot if removed from the ventilator immediately after use Wait 15 minutes after turning off ventilator power before removing the heated expiratory bacteria filter Exercise caution when handling the filter housing Do not operate the ventilator without a properly functioning expiratory filter and heater Doing so may
99. agraphs a space is designated as When data is unavailable the output field shall contain i e four dash characters followed by two spaces When the ventilator receives VRPT followed by a carriage return it will respond by transmitting the information shown in Table A 1 Ventilation Report The ventilator responds to the VRPT command by returning a string with a variable length Fields 2 through 4 define the length of the message The last character transmitted is a stop code indicating the end of the message The second field indicates the number of characters between the start and stop codes The third field indicates the number of fields between the start and stop codes The fourth field is the start code 0x02 The last field in the string is the stop code 0x03 REF 1057983 A Respironics V200 Ventilator Operator s Manual Appendix A 1 Appendix A RS 232 Communications Protocol Ventilation Report Description Example Resolution Range Units Comments Command Name VRPT N A N A N A Number of characters 990 N A N A N A 3 character field between the start and stop codes Number of fields 134 N A N A N A 3 character field between the start and stop codes Start Code 0x02 N A N A N A ASCII Start Transmission Character STX Time of request 13 45 N A N A N A 24 hour clock hh mme Date FEBe23 19974 N A N A N A 12 character field MMM DD YYYY Current Ventilati
100. alue Press the CANCEL button to leave the value unchanged Window insert to change the value of Altitude Figure 5 10 Setting Altitude Enabling Disabling Tubing Compliance The operator can activate or deactivate tubing compliance compensation in the User Configuration screen To enter Diagnostic Mode follow the instructions for Entering Diagnostic Mode on page 5 6 At Figure 5 5 select USER CONFIG and the screen in Figure 5 11 appears Figure 5 11 Compliance Activated 5 10 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 5 Setup You can have the ventilator compensate the volumes delivered in volume controlled mandatory breaths with the tubing compliance volume by activating the COMPLIANCE button Figure 5 11 Circuit compliance is activated when this button has a white background When the function is activated the exhaled volumes reported by the ventilator will also be tubing compliance compensated Bac kup Battery You can have the ventilator confirm the backup battery is connected each time that the machine powers on Pressing the BKUP BATTERY button Figure 5 12 allows this confirmation feature which is identified by an active button with a white background Backup Battery confirm at startup button active Aen Time Figure 5 12 Backup Battery Activated From then on when the machine powers on it searches for a backup battery If the backup battery is connected to the ve
101. ames for performing all necessary care and maintenance procedures for the ventilator are presented in this section Respironics recognizes that cleaning sterilization sanitation and disinfecting practices vary widely among health care institutions It is not possible for Respironics to specify or require specific practices that will meet all needs or to be responsible for the effectiveness of cleaning sterilization and other practices carried out in the patient care setting General procedures for cleaning and sterilizing the ventilator are described in the following sections Some ventilator parts must be disassembled before cleaning and sterilizing Refer to Removing and Replacing Internal Air Source Inlet Filter on page 10 10 When cleaning parts avoid the use of hard brushes or other instruments likely to cause surface damage CAUTION Care should be taken when cleaning the touch display Refer to Figure 8 2 on page page 8 3 A soft moist cloth should be used that does not drip water and or soap solution when in contact with the display After cleaning and rinsing with a damp cloth remove all moisture with a dry soft cloth Never allow solutions of any kind to collect on the bottom bezel of the display Never use a brush or device that can cause abrasion to clean the touch display or its bezel they will cause irreparable damage CAUTION Follow the detergent manufacturer s instructions Exposure to detergent solution stronge
102. and Accessories lisse ees B 2 Alarm Testing Procedure 00 cece eee ene C 1 GOSS ANY icone eae aia ate Reena ere Geka als aE wees Glossary 1 Index ss occa xU SX wT Ne LW X a a ee a Re viii Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 1 Introduction and Intended Use The Respironics V200 Ventilator is a microprocessor controlled electrically powered mechanical ventilator It is intended for use by qualified medical personnel to provide continuous or intermittent ventilatory support for adult pediatric and neonatal patients as prescribed by a physician The ventilator is intended for use in either invasive or non invasive applications in institutional environments The Respironics V200 Ventilator meets applicable safety requirements consensus guidelines U S A regulatory statutes and international regulatory standards for life support mechanical ventilation devices Please read this manual thoroughly and become familiar with the ventilator s operation before using it on a patient For additional information about accessories or related equipment such as humidifiers and remote alarm systems refer to the appropriate instruction manual prior to operating the accessory with the ventilator Advanced troubleshooting calibration and maintenance instructions are included in the Esprit V200 Ventilator Service Manual P N 580 1000 02 All maintenance and repair work should be performed
103. anual can only describe general guidelines It is the user s responsibility to ensure the validity and effectiveness of the methods used Because some environments cause a quicker collection of lint and dust than others inspect and clean the fan filters more often than every 250 hours if necessary The Hardware function and EST in the Diagnostics Mode should only be run by qualified personnel A restart is an infrequent event The gas return port on the ventilator is a cylindrical port which requires mating to a specified expiratory filter to seal the expiratory limb The humidifier power connection is available only on 100 120VAC ventilators Record O sensor manufacturing or warranty numbers and installation date for future reference Save manufacturers instruction about end of life replacement To ensure accurate O monitoring check O sensors periodically and replace as per manufacturer specification Sensor performance and expected operating life information is outlined in the sensor manufacturer s instructions for use Thoroughly review all O5 sensor instructions prior to installation and use with the Respironics V200 Ventilator O sensor calibration is performed during EST If recalibration of the O sensor is required follow the instructions in Extended Self Test EST on page 11 4 for running EST 2 10 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 2 Warnings Cautions and Notes
104. are not being used in the ACTIVE MODE This is because the setting is used in Apnea Ventilation or when manual inspiration is pressed The operator should always choose a value for an active button that is appropriate for the patient being ventilated Pressing the ACTIVE MODE button displays the settings screen for the currently selected ventilation breath type and mode Chapter 7 Operating Theory for more information on ventilation modes breath types and controls For example in Figure 8 13 the current breath type is VCV and the mode is A C Because A C does not allow the ventilator to deliver any spontaneous breaths any settings that apply to spontaneous breaths are not active and are grayed out In Figure 8 13 PSV is grayed out indicating that it isn t active but you can still push this button and change the PSV value The PSV value will become active only if the SIMV or CPAP mode is selected Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 8 Operating Instructions Ventilation mode A C SIMV or CPAP Spont or Spont T are available during NPPV AN Mola Tee te o Ventilation control settings VCV PCV or NPPV Figure 8 13 VCV Settings Screen VCV active Selecting Settings Follow these steps to adjust ventilator control settings 1 Push VCV SETTINGS PCV SETTINGS or NPPV SETTINGS 2 Push the button for the control settings you want to select The ventilator displays the current value
105. are not permitted during the inspiratory phase of a breath whether manual or spontaneous Pressing the MANUAL BREATH key during these times will not result in the delivery of a manual breath Enables calculations of Auto PEEP from an expiratory hold maneuver See Expiratory Q Hold Special Procedures on page 8 31 Table 8 3 Front Panel Keys Sheet 3 of 3 Front Panel Level Controls The front panel level controls enable you to adjust ventilator settings brightness and volume Front Panel Controls Control Definition Description B Adjust Used in conjunction with the front panel graphical Control display and touch screen to enter operator selected values for ventilator settings and alarms i Display Increases or decreases the brightness of the touch screen C Brightness display 4 hj I _ Audible Increases or decreases the audible alarm volume The Alarm minimum audible alarm volume is dictated by Volume international standards The audible alarm volume control will not turn the audible alarm volume lower than the minimum decibel level dictated by these standards It is not possible to turn the audible alarm volume off On Off Located near the front panel the On Off switch is O O Switch recessed to avoid inadvertent or accidental access When the switch is in off position the ventilator does not provide mechanical ventilation although AC power is active and the green Mains indicator is il
106. arms Alarm Alert Messages Description A high urgency alarm indicates the internal air source is not functioning properly patient ventilation continues using the 100 O gas source if available Call for service Cannot be silenced or manually reset Apnea The ventilator triggers a medium urgency alarm condition and enters Apnea Ventilation mode if no inspiration is started within the operator set apnea interval while in a non emergency breathing mode It is elevated to high urgency after one minute of Apnea Ventilation Audible Alarm Failed Primary audible alarm is defective Alarm cannot be manually reset Bad ADC Wrap Sensor Alarm cannot be silenced or manually reset Call for service Bad Bat Volt Sensor Alarm cannot be silenced or manually reset Call for service Bad Int O Sensor Alarm cannot be silenced or manually reset Call for service Bad Int Temp Sensor Alarm cannot be silenced or manually reset Call for service Battery Backup On Indicates the backup battery is the power source for ventilator operation Alarm cannot be silenced Exp Valve Stuck Open Alarm cannot be silenced or manually reset Call for service Gas Supplies Lost SVO A high urgency alarm indicates the oxygen and air source are no longer operable Safety valve opens Check O source and internal air source Call for service Cannot be silenced or manually reset High Inspiratory Pressur
107. arms Figure 13 58 Speaking Mode Sequence for Use 13 105 REF 1057983 A Respironics V200 Ventilator Operator s Manual Chapter 13 Options and Accessories Settings Starting Speaking Mode Speaking Mode Ventilator Settings Available in Modes Pressure Control Ventilation AC SIMV and CPAP Volume Control Ventilation AC SIMV and CPAP Pressure Support Ventilation SIMV and CPAP Apnea Ventilation Patient Type Adults amp Pediatrics PEEP Automatically reset to zero and low PEEP alarm is reset to zero Trigger type Automatically will switch from flow triggering if previously selected to a pressure triggering of 1 cm H20 Alarm Changes Exhaled volume alarms automatically change to delivered volume alarms Patient Data Trended and displayed values based on delivered volumes Mechanics Respiratory mechanics feature not available Prepare the patient and deflate the tracheostomy cuff l Press the Speaking Mode button Speaking Mode Button Figure 13 59 Speaking Mode Button The first message box appears Turn Speaking Mode On This message box explains the changes that will occur while the ventilator is operating in Speaking Mode 13 106 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories 2 Press Continue to continue or Cancel to exit Speaking Mode VEVSetinge POrSetege Nerv sening
108. ashes indicate Inspiratory are not calculated loop not frozen Figure 13 21 Loops Screen with Inspiratory Area Window 13 24 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Alarms During If an alarm occurs during Graphics an Alerts window Figure 13 22 lists the Graphics active alarms Figure 13 22 Graphics Screen with Alerts window REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 25 Chapter 13 Options and Accessories This page is intentionally blank 13 26 Respironics V200 Ventilator Operator s Manual REF 1057983 A Print Screen Chapter 13 Options and Accessories Communications Option Com1 The Communications option allows the Respironics V200 Ventilator to Print out the ventilator s screen contents e Communicate with a Philips Agilent HP VueLink module e Connect another device such as a chart recorder via the analog output port Using the Communications option does not affect ventilation or monitoring The Communications option button a printer icon is displayed in the lower right corner of the screen Figure 13 23 The printer icon is gray if the Communications option is not installed not available or a print is in progress Vo Seri Pria EXER Figure 13 23 Communications Print Option Button Printer Icon The Communications Print option allows the ventilator to print out the screen contents to an attached prin
109. ate Set Rate Apnea Rate must be Changed Increase the Apnea Rate or greater than or equal to the decrease the Rate Set Rate Table 12 9 General Value Entry Reasonability Checks Patient Data Screen Monitored patient data is displayed when Patient Data is pressed Patient data ranges resolution units and accuracy specifications are provided in the table below Minute volume data is based on an eight breath average Patient Data Range Resolution Units amp Accuracy Patient Data Display Range Units Resolution Accuracy Exhaled Minute 0 00 to 99 9 L 0 01 for 0 00 9 99 10 Volume 0 1 for 10 0 99 9 Exhaled Tidal Volume 0 to 9999 mL 1 10 Spontaneous Minute 0 00 to 99 9 L 0 01 for 0 00 9 99 10 Volume 0 1 for 10 0 99 9 Rapid Shallow Breathing 0 to 500 Bpm L 1 10 Index Table 12 10 Patient Data Range Resolution Units amp Accuracy Sheet 1 of 2 REF 1057983 A Respironics V200 Ventilator Operator s Manual 12 5 Chapter 12 Technical Specifications Front Panel Keys Patient Data Range Resolution Units amp Accuracy Continued Patient Data Display Range Units Resolution Accuracy IE 9 9 1 to 1 99 none 0 1 for 9 9 1 1 9 9 10 1 for 1 10 1 99 Peak Inspiration 20 0 to 130 cmH 20 1 for 100 130 10 Pressure hPa 0 1 for 20 0 to 99 9 End Inspiration 20 0 to 130 cmH20 1 for 100 130 10 Pressure Pi End hPa 0 1 for 20 0 to 99 9 Mean Airway 20 0 to 120
110. ate alarm capabilities refer to ISO 8185 1 The humidifier should be connected between the inspiratory bacteria filter Figure 6 5 and the inspiratory limb of the patient circuit that leads to the patient wye Figure 6 6 2 Follow steps illustrated by Figure 6 5 Figure 6 6 and Figure 6 7 Figure 6 5 Ventilator Gas Outlet Port to Humidifier Patient Circuit Connection REF 1057983 A Respironics V200 Ventilator Operator s Manual 6 5 Chapter 6 Connecting Additional Equipment Figure 6 7 Expiratory Limb of Patient Circuit to Water Trap Connection Shows Down Tube between Ventilator and Water Trap 6 6 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 6 Connecting Additional Equipment When connecting a patient circuit without a humidifier for example when using a heat and moisture exchanger refer to Figure 6 8 Figure 6 8 Patient Circuit Connections Without Humidifier Connecting the The analog output port adds a second remote alarm output Pin 12 fourth pin Analog Port from the top left is pin 12 signals an unsilenced high or medium urgency alarm 0 VDC z active alarm 1 5 VDC no alarm or silenced alarm REF 1057983 A Respironics V200 Ventilator Operator s Manual Chapter 6 Connecting Additional Equipment The Communications option provides additional signals on this port Refer to Chapter 13 Options and Accessories Analog Port Circuit breaker cover not shown
111. ate and the exhalation valve closes during inhalation only The airway occlusion alarm will auto reset when an exhalation occurs that does not meet the alarm condition The airway occlusion alarm cannot be silenced by the alarm silence key p de VCV A C SM Patient Dota Arm etinge Monitor Ac amv omes H we i e T2 Tea vaure 500 mprou OO S F YD A su oeciasor BM Disconnect ise Time 3M Occluglan BM Olaconnect Figure 13 64 Speaking Mode Alerts Disconnect and Airway Occlusion Alarms 13 110 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Displayed Data While in Speaking Mode the ventilator switches all volumetric readings from exhaled to delivered readings This means that all data displayed based on exhaled volumes will now be based on delivered volumes Some data is not available in Speaking Mode including data on Patient Leak circled below in Figure 9 Patient Leak data is not available in Speaking Mode Figure 13 65 Active Mode Displayed Data in the VCV Settings Screen The following data in the Patient Data screen displays in delivered volumes not exhaled volumes Tidal Volume Spontaneous Minute Volume Total Minute Volume The following data is not available in Speaking Mode Dashed lines appear in the data box instead of a numeric value Patient Leak e F Vt Ratio of respiratory r
112. ate to tidal volume REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 111 Chapter 13 Options and Accessories Data not available in Speaking Mode Figure 13 66 Active Mode Patient Data Screen Trended Data NOTE NICO data is not available when the Speaking Mode is active NOTE The time spent in Speaking Mode can be recorded as trended data This requires the Trending Option be loaded and active on the ventilator To access the Trending screen l Press the Patient Data button at the top of the settings screen see Figure 13 66 2 Press the Trending button at the bottom of the settings screen see Figure 13 67 3 Choose a Parameter select button light blue button above each displayed data option that shows the name of the currently displayed data option see Figure 13 67 4 Once the Trended Data pop up window has displayed click on one of the Category Select buttons at the top of the menu to view and select parameters for each option Speaking Mode Trended Data To display trended data in Speaking Mode press the Speaking Mode Parameter select button over the displayed data option if displayed Or press any Parameter select button to activate the Trended Data pop up window Figure 13 67 13 112 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories l Press the Settings button 2 Press the Speaking Mode button to show trended data options
113. ath using operator Mand Window breath period settings for mandatory breath type Restart Window timer expires breath period Mand Patient Trigger Deliver mandatory breath using operator Spont Window Operator Trigger settings for mandatory breath type Window Spont Patient Trigger Deliver a spontaneous breath using Spont Window operator settings for spontaneous breath Window type Spont Operator Trigger Deliver a mandatory breath using operator Spont Window settings for mandatory breath type Window Spont Time Trigger Restart breath period timer Mand Window breath period Window elapses Table 7 1 SIMV Logic REF 1057983 A Respironics V200 Ventilator Operator s Manual 7 3 Chapter 7 Operating Theory Continuous Positive Airway Pressure CPAP CPAP is a spontaneous mode of ventilation No mandatory breaths are delivered Throughout the breath cycle an operator set pressure is provided The level of pressure delivered during CPAP is the baseline pressure or PEEP Positive end Expiratory Pressure Refer to Figure 7 3 Pressure Baseline En du UU xU QS Pressure Spontaneous Breaths Time Figure 7 3 Continuous Positive Airway Pressure CPAP Pressure Support Ventilation PSV In Pressure Support Ventilation the patient s spontaneous efforts are assisted by the ventilator at an operator set level of inspiratory pressure Inspiration is initiated by the patient and terminated when the inspiratory flow falls be
114. ation Report Sheet 9 of 10 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Ventilation Report Description Example Resolution Range Units Comments Occlusion Alarm NORMAL N A NORMAL N A Status or SM RESET Occlusion Alarm ALARM Status or I Time Too Long Alarm Status Not used oooeee N A oooeee N A Outputs example value Not used oooeee N A oooeee N A Outputs example value Not used oooeee N A oooeee N A Outputs example value Not used oooeee N A oooeee N A Outputs example value Not used I TIME N A I TIME N A Outputs example value E Ratio 1 99 N A 9 9 1 1 99 N A measured E ratio expressed as 1 X X 1 XX X X 1 or XX 1 Stop Code 0x03 N A N A N A ASCII End Transmission Character ETX Table 13 4 Ventilation Report Sheet 10 of 10 REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 49 Chapter 13 Options and Accessories This page is intentionally blank 13 50 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Respiratory Mechanics Option The Respiratory Mechanics option allows the Respironics V200 Ventilator to perform respiratory mechanics maneuvers including e Vital Capacity VC The VC maneuver measures the patient s lung capacity It is available only in Volume Control Ventilation VCV and Pressure Contr
115. ator alarm indicators and the Alerts insert should be monitored closely during the Alarm Silence period to ensure that unexpected alarms are noticed Automatic Alarm Reset Auto Reset When the alarm conditions that have caused a medium or high level alarm clear the audible alarm will terminate automatically auto reset However after an alarm condition has been corrected you must press the ALARM RESET key to clear all visual alarm indicators Operator Initiated Alarm Reset You can clear active and auto reset alarms by pressing the ALARM RESET key This clears the alarm messages in the Alerts insert for active and auto reset alarms If the alarm condition reoccurs the alarm restarts at its initial level of urgency and elevates as described in Table 9 1 Alarm Alert Messages on page 9 5 For you to clear an apnea alarm the ALARM RESET key may be pressed Once it has been pressed the ALARM RESET will cancel an existing apnea alarm and return ventilation to the active mode If the condition that triggered the apnea alarm persists after the ALARM RESET key has been pressed the apnea alarm will re trigger If the patient triggers two successive breaths in apnea ventilation the ventilator will automatically reset out of apnea ventilation CAUTION If an alarm persists for no apparent reason contact Respironics Customer Service at 1 800 345 6443 Alarm Reset Terminates Alarm Silence If ALARM SILENCE is active when ALARM RESET is presse
116. ator are reported as BTPS volumes All pressures are assumed to be relative to atmospheric pressure unless otherwise noted NOTE The Air Inlet Filter houses a reusable foam filter that should be periodically cleaned Refer to Chapter 10 Care and Maintenance for more information on filter changes Connecting AC Power Cord e Circuit Breaker Cover not shown Figure 5 2 AC Power Cord Retaining Bracket WARNING To avoid electrical shock hazard connect the ventilator to a properly grounded AC power outlet CAUTION Before connecting the ventilator to the AC power source ensure that the total electrical load does not exceed the ampere rating of the AC branch circuit especially when using the ventilator with other electrical equipment An AC branch circuit includes all outlets serviced by a single circuit breaker If the maximum current drain through a branch circuit exceeds the circuit breaker s rating the branch circuit will open causing the ventilator to lose power For further information consult a service technician or a trained biomedical technician CAUTION The ventilator is shipped with a power cord that complies with electrical safety standards Do not use substitute power cords unless specifically instructed to do so by an authorized distributor or qualified personnel Do not modify the power cord or connect it with electrical extension cords or outlet adapters REF 1057983 A Respironics V200 Ventilator Oper
117. ator is turned off O U 25 WN np 7 8 Respironics V200 Ventilator Operator s Manual REF 1057983 A Overview Chapter 8 Operating Instructions WARNING Ensure that an alternative means of ventilation that is a resuscitator or similar device is available while the ventilator is in use on a patient WARNING The ventilator complies with the requirements of IEC 601 1 2 EMC collateral standard including the E field susceptibility requirements at a level of 10 volts per meter However even at this level of immunity certain transmitting devices cellular phones walkie talkies etc emit radio frequencies that could disrupt ventilator operation if operated in a range too close to the ventilator WARNING DO NOT operate the ventilator in a Magnetic Resonance Imaging MRI environment There are three ventilation breath types Volume Control Ventilation VCV Pressure Control Ventilation PCV Non Invasive Ventilation NPPV Each has mandatory or machine controlled breaths and each has patient controlled or spontaneous breaths Each ventilation breath type has its own settings that are mutually exclusive from the other ventilation modes e n VCV you can select either A C SIMV or CPAP mode n PCV you can select either A C SIMV or CPAP mode n NPPV you can select Spont T or Spont mode Alarms are specific to the ventilation breath type Alarm limits in one ventilation breath type are mutually exclusive from
118. ator s Manual 5 3 Chapter 5 Setup Connecting AC Power Cord Instructions Refer to Figure 5 2 e Tools Required Small Phillips screwdriver 1 Ensure that the ventilator is properly positioned on a secure table top wall mount or pedestal 2 Connect the AC Power Cord 1 to the AC inlet 3 located on the rear panel Refer to Figure 5 1 3 After cord is fully inserted tighten the retaining bracket screw 2 so that the power cord cannot be inadvertently disconnected from the ventilator Power On Off The ON OFF 65 switch is located in the lower portion of the front panel and is recessed to avoid inadvertent access When the switch is in OFF 4 position the ventilator does not provide mechanical ventilation If the AC plug is connected and the Mains circuit breaker refer to Figure 5 1 is ON AC power is active and the green Mains circuit indicator on the front panel is illuminated Power On Off Switch Figure 5 3 On Off Switch 5 4 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 5 Setup Turning the Ventilator On 1 Ensure that the Mains Circuit Breaker refer to Figure 5 1 located on the ventilator back panel is in the ON position 2 For 120V applications if a humidifier is attached to the ventilator ensure that the Humidifier AC Circuit Breaker refer to Figure 5 1 located on the ventilator back panel is in the ON position A humidifier connection is o
119. ator triggered mandatory breath Assist e Patient triggered mandatory breath Plateau e Inspiratory hold can be set at the end of the inspiratory phase of a VCV breath type Support e Patient triggered spontaneous breath with PSV gt 0 or IPAP gt EPAP Spont Q Patient triggered spontaneous breath PSV 0 or IPAP EPAP Exhale Q Indicates exhalation phase of any breath Table 8 5 Breath Indicator REF 1057983 A Respironics V200 Ventilator Operator s Manual 8 13 Chapter 8 Operating Instructions Settings Screens Pressing the HIP indicator on the screen Figure 8 12 will nip immediately allow the operator to modify the high pressure limit for VCV or PCV In NPPV the high pressure limit is automatically set to 10 cmH50 hPa above IPAP The HIP indicator does not appear near the manometer in NPPV The buttons in the middle of the settings and alarm limit screens all have two states active and inactive Active settings have a gray background with black letters Figure 8 13 An active setting is currently being used to control ventilation or as an alarm limit Inactive setting buttons have a gray background with gray letters Inactive settings are not currently being used to control ventilation or as an alarm limit In both states the button can be pressed and an insert window will appear that will allow the operator to change the value of the setting Figure 8 1 NOTE Some settings buttons appear active despite the fact they
120. available in Speaking Mode Figure 13 68 Parameter select button Trended Data pop up window Category Parameter select buttons Figure 13 67 Selecting Speaking Mode on the Trended Data Screen REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 113 Chapter 13 Options and Accessories The trended data will appear as blocks of time shown as either ON or OFF Speaking Mode trended data Figure 13 68 Speaking Mode Trended Data Screen For more information regarding Trending see the Trending Option instructions or contact Respironics Inc Customer Service at the following numbers USA and Canada 1 800 345 6443 or 724 387 4000 Europe Africa and the Middle East 33 1 47 52 30 00 Asia Pacific 852 3194 2280 In North America Respironics California Inc 2271 Cosmos Court Carlsbad California 92011 Made in USA 13 114 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Discontinue Speaking Removing a patient from Speaking Mode is very similar to starting a patient on Mode Speaking Mode 1 Press the Speaking Mode button 2 The message box appears Turn Speaking Mode Off reminding the user to Please be sure to inflate tracheostomy cuff AFTER switching SM OFF Patent Data values and alarms will be based on exhaled volumes WARNING Do not inflate the tracheostomy tube cuff until Speaking Mode has been turned off Press Yes to
121. backup battery has been installed on the ventilator and its operation has been confirmed NOTE Save the shipping container in case the backup battery has to be returned to Respironics Figure 4 3 illustrates the backup battery assembly Figure 4 3 Backup Battery 1 Before the backup battery is installed disconnect AC power and any attached equipment Disconnect the backup battery cable connector from the rear panel of the ventilator by rotating the connector s collar nut counterclockwise while pulling back on the connector REF 1057983 A Respironics V200 Ventilator Operator s Manual 4 5 Chapter 4 Getting Started Figure 4 4 Disconnecting the Battery Cable 2 Remove the rear cable channel cover from the cart by gently prying it back from the top of the center column freeing it from the column Rear cable channel cover Figure 4 5 Removing the Rear Cable Channel Cover 4 6 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 4 Getting Started 3 Loosen the ventilator mounting screws 4 from the underside of the cart and remove the ventilator from the cart WARNING One person alone should not attempt to lift the ventilator or remove it from the shipping carton or the cart At least two people are required to avoid possible personal injury or damage to the equipment Mounting screws Figure 4 6 Removing the Ventilator from the Cart REF 1057983 A Respironics V200 Ventilat
122. battery power remains the ventilator sounds a high urgency audible alarm a repeating sequence of five tones that cannot be reset and the red Low text version of the front panel or A symbol version of the front panel and Alarm High indicators flash WARNING When the ventilator Battery Low indicator flashes red less than five minutes of battery power remains Immediately connect AC power or provide an alternate source of ventilation REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 9 Chapter 13 Options and Accessories Battery Capacity The external battery is used with the backup battery Under optimal running conditions both batteries together can operate the ventilator for up to four hours However ventilator power consumption varies according to environmental conditions and ventilator settings Battery capacity varies with the age and charge level of the battery The external battery should be kept fully charged to ensure maximum capacity when needed CAUTION Battery operating life depends on battery age and number of discharges and recharges Over time the battery degenerates and provides less operating time per charge than a fully charged new battery Use a Respironics External Battery P N 1059955 only Battery Charging The external battery is designed to be recharged only as described here Do not use any other method to recharge the battery In order for the external battery to charge the system must be
123. be thoroughly rinsed and dried to prevent spotting and blemishes when exposed to elevated temperatures DO NOT allow liquid to penetrate the ventilator rear or front panel DO NOT attempt to sterilize the ventilator by exposing to ETO gas DO NOT steam autoclave e Troubleshooting and repair should be performed only by a qualified service technician e If the optional external O sensor is in line it must be calibrated during EST Diagnostic codes should only be cleared by qualified personnel e To prevent contamination of the O sensor always locate it between the ventilator gas output port and the inspiratory bacteria filter e PVC O P N 8 100498 00 and Ultem P N 1020380 Sensor Tees cannot be autoclaved or chemically disinfected When inserting the battery tray into the cart s center column make sure not to crimp cable connections between the battery tray and cart The backup battery is designed to be charged only by the Respironics V200 Ventilator Under no circumstances should an attempt be made to charge it in any other way If the ventilator will not be used for 30 days or more the backup battery should be preserved Either disconnect the backup battery from the ventilator or keep the ventilator plugged into an active electrical outlet REF 1057983 A Respironics V200 Ventilator Operator s Manual 2 7 Chapter 2 Warnings Cautions and Notes Notes Follow the setup instructions in this manual bef
124. button allows a qualified service technician to delete codes from the log Because diagnostic codes provide the primary means of fault diagnosis they should only be cleared by or under the advice of qualified personnel CAUTION Diagnostic codes should only be cleared by qualified personnel Table 11 1 Diagnostic Codes and Descriptions summarizes some diagnostic codes and their descriptions The codes and descriptions for SST and EST are identical except that SST codes are preceded by a 2 and EST codes are preceded by a 3 For example if code 106 occurred during an SST it would be logged as 2106 If it occurred during an EST it would be logged as 3106 WARNING Remove the ventilator from service and contact trained service personnel if any diagnostic codes appear with the exception of 1 3 2000 3000 5000 5002 8003 or 8004 WARNING Use of a ventilator that has not passed SST or EST is against the strongest recommendation of Respironics Diagnostic Codes and Descriptions Code Description 1 Normal mode startup 3 Diagnostic Startup 2XXX Short Self Test 2000 SST Passed 2106 Patient Circuit Leak 2107 Inh Pressure Too Low 2110 Check Valve 3 Leak 2125 Inhalation Pressure Exhalation Pressure Disagreement 2128 Circuit Compliance Out of Range 2129 Pressure Leak Out of Range 2130 Safety Valve Cannot Open 2131 Patient Wye Not Blocked Table 11 1 Diagnostic Codes and Descriptions Sheet 1 of 4 11 6 Respironics V200 Ventilator Operator s Man
125. by measuring its leak rate and compliance SST also tests critical hardware components including the safety valve flow sensors and autozero solenoids Perform SST before every patient circuit change If SST passes the ventilator and all attached components are ready for use WARNING Do not use a ventilator that has failed SST without verifying operational readiness by other means Doing so may place a patient at risk WARNING Never initiate SST while the patient is connected to the ventilator The high airway pressures generated during SST can injure a patient Equipment required to run SST Patient circuit to be used on the next patient including any devices installed in line with the circuit such as a humidifier O sensors and or temperature sensor Plug or cap for the patient wye Follow these steps to run SST 1 OU BW NY Connect the circuit to be used on the next patient to the ventilator Press the SST button Figure 11 1 on the diagnostic screen Press the Start SST button to begin the test When prompted unplug the patient wye and press the OK button When prompted plug the patient wye and press the OK button When SST completes successfully press the OK button When SST is completed the calculated circuit compliance is displayed on the screen REF 1057983 A Respironics V200 Ventilator Operator s Manual 11 3 Chapter 11 Diagnostics Extended Self Test EST EST verifies the overall fun
126. cates that the time scale is not available Figure 13 38 Selecting the Time Scale for the Trending Screen The 2 Hrs and 2 Hrs buttons shift all three p2we jo 2 Hre waveforms forward or backward by two hours without changing the time scale If you press and hold the buttons the time scale shifts every second If less than 2 hours of data exist the waveform shifts by the amount of available data The buttons are grayed if the waveform cannot shift any further A The Zoom button allows you to zoom in on trended data by switching the time scale to two hours centered around the cursor position If the current time scale is two hours the zoom button is grayed When the Zoom button shows a magnifying glass with a plus sign the zoom in function is available Once zoomed in the button changes to a magnifying glass with a minus sign to indicate that the zoom out function is available and the Time and View buttons are disabled Zooming out returns the waveforms to their previous time scale and all buttons to their previous states __Rescale The Rescale button automatically adjusts the vertical axis for Rescale i all three waveforms The software determines a scale based on the minimum and maximum values of the data to display an optimal view 13 76 Respironics V200 Ventilator Operator s Manual REF 1057983 A Using the Mew 1 View 2 buttons Using the Clear button Alarms during Trending
127. cations Protocol Volume Control Ventilation Settings Report Continued Description Example Resolution Range Units Comments VCV Flow I Trigger 3 0000 0 1 0 5 20 0 LPM Setting VCV E Cycle Type Flow N A FLOW N A AUTO VCV Flow 259999 1 10 80 96 Expiratory Cycle Setting VCV Rise Time 0 1999 0 1 0 1 0 9 Sec VCV Oxygen 210000 1 21 100 Concentration Setting VCV Plateau Setting 0 000 0 1 0 0 2 0 Sec VCV Apnea Rate 129999 1 1 80 BPM Setting VCV High Inspiratory 359999 1 10 105 cmH50 Pressure Alarm Limit hPa Setting VCV Low Inspiratory 300000 1 3 105 cmH50 Pressure Alarm Limit hPa Setting VCV Low PEEP Alarm 00000 1 0 35 cmH50 Limit Setting hPa VCV Low Mandatory 000000 1 0 2500 mL Tidal Volume Alarm Limit Setting VCV Low 099999 1 0 2500 mL Spontaneous Tidal Volume Alarm Limit Setting VCV High Respiratory 15000 1 0 150 BPM Rate Alarm Limit Setting VCV Low Minute 1 00000 0 01 for 0 00 60 0 L Volume Alarm Limit aor Setting t060 0 VCV Apnea Interval 200000 1 10 60 sec Alarm Limit Setting VCV High Minute 60 000 0 01 for 0 00 60 0 L Volume Alarm Limit 0 00 to 9 99 Settin 0 1 for 10 0 g to 60 0 Stop Code 0x03 N A N A N A ASCII End Transmission Character ETX Table A 2 Volume Control Ventilation Settings Report Sheet 2 of 2 REF 1057983 A Respironics V200 Ventilator Operator s Manual Appendix A 13 Appendix A RS 232 Communications P
128. cause damage to delicate ventilator components such as the expiratory flow sensor which may lead to inaccurate spirometry or a Vent Inop condition Vent Inop is a serious condition which is indicated by both visual and audible alarms If the ventilator is attached to a patient when Vent Inop occurs the patient must be supported with another means of life support ventilation Follow institutional infection control guidelines when replacing the inspiratory or expiratory bacteria filter When adding attachments or other components or subassemblies to the breathing system for example an HME or humidifier ensure that the inspiratory and expiratory resistances measured at the patient connection port do not exceed 6 cmH20 hPa at a flow of 60 L min for adults 30L min for pediatrics Heated Expiratory Bacteria Filter Installation Instructions Refer to Figure 4 20 4 18 Respironics V200 Ventilator Operator s Manual REF 1057983 A 10 NOTE Chapter 4 Getting Started Locate the heated expiratory bacteria filter 1 and receiving compartment 6 in the lower center of front panel Turn knob 2 counterclockwise to unlatch retaining bracket 3 Open retaining bracket 3 by pulling it out and away from the ventilator Use tabs 4 to gently pull the heater housing 5 away from the ventilator Ensure that ventilator has been turned off for 15 minutes If not allow the heater housing 5 to cool before touching it wit
129. cmH20 0 100 cmH 0 Trigger 2 0 L Min 0 3 10 0 L Min E Cycle 2596 10 8096 Rise Tlme 0 2 Sec 0 1 0 5 Sec O5 96 same as last O setting 21 100 Apnea Rate 20 BPM 1 80 BPM Alarm Settings Value Ranges High Press 30 cmH20 10 105 cmH20 Low Insp Press 5 cmH20 3 105 cmH20 Low Peep 0 cmH20 0 35 cmH20 Low Vt Mand 10 mL 0 300mL Low Vt Spont 3mL 0 300 mL High Rate 150 BPM 0 150 BPM High VE 1 2L 0 00 5 0L Low VE 0 3L 0 00 5 0 L Apnea 20 Sec 10 60 Sec l Time Too Long sounds after 1 5 Sec of spont breath Table 13 21 Initial Neonatal Patient Settings 13 100 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories NOTE Patient data ranges and accuracies can be found in Chapter 12 Technical Specifications with the exception of the Exhaled Tidal Volume The accuracy for exhaled Tidal Volume is 4ml 10 NOTE Neither Respiratory Mechanics nor Expiratory Hold are active when the neonatal patient type is selected Flow trigger is the only trigger type available All other features apply Percent Leak When the neonatal software option is loaded on the ventilator a Leak window appears on the Patient Data screen The window displays the estimated leak of the delivered volume as a percentage The Leak value is updated at the beginning of each inhalation The 96 Leak is available for all patient types when the neonatal software option is loaded While the estimate for perce
130. connected to a viable AC power source The ventilator can be operating or in standby mode A new external battery fully charges within 15 hours The time required to recharge depends on the original charge level of the battery When the external battery is connected to a functioning AC power source the MAINS indicator located on the front of the ventilator is lit and the green AC indicator on the external battery is lit Figure 13 7 The yellow Battery Charging indicator on the external battery has the following indication modes e Continuous ON Battery is in deep charge mode Flashing Battery is approaching full charge e Off Battery is fully charged ACindicator Battery charging indicator Figure 13 7 External Battery Indicator Lights If the external battery does not reach full charge within 15 hours contact Respironics Customer Service at 1 800 345 6443 13 10 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories CAUTION The External Battery is designed to recharge only as described here Do not use any other method to recharge the External Battery CAUTION Ifthe ventilator is expected to be stored for more than 2 weeks the external battery ON OFF switch should be set to the OFF O position to avoid discharging the external battery This switch must be placed in the ON I position when the ventilator is removed from storage and returned to use Testing The ext
131. ctional integrity of the ventilator by testing all critical hardware subsystems and components Perform EST between patients as part of preventive maintenance a performance verification or if the operational integrity of the ventilator is in question EST is typically run by qualified trained personnel WARNING Never initiate EST while the patient is connected to the ventilator The high airway pressures and gas flows generated during EST can injure a patient WARNING Do not use a ventilator that has failed EST without verifying operational readiness by other means Doing so may place a patient at risk CAUTION If the optional external O sensor is in line it must be calibrated during EST Equipment required to run EST Patient circuit e Plug for the patient wye e High pressure O source Follow these steps to run EST 1 Enter Diagnostic Mode as described Entering Diagnostic Mode on page 11 2 Connect a patient circuit to the ventilator Press the EST button on the diagnostic screen Figure 11 1 Press START EST to begin EST Follow the prompts nou BW hl When EST completes successfully press the OK button Hardware The hardware function allows a trained service technician to operate critical components separately to help identify a faulty component in the event that the ventilator fails SST EST or performance verification testing For more information on the Hardware function see the Esprit V200 Ventilator S
132. cy alarm indicates that the monitored O concentration is at least 6 above the set value 9607 for 30 seconds Verify operation of the O sensor Alarm cannot be manually reset High Respiratory Rate The ventilator triggers a medium urgency alarm if the total respiratory rate is greater than the operator set High Respiratory Rate limit The ventilator evaluates this alarm condition at the start of inspiration after calculating the total respiratory rate including the just completed breath It is elevated to high urgency after one minute High Temperature Internal temperature monitor detects higher than allowed temperatures inside the enclosure Alarm cannot be silenced or manually reset Time Too Long The ventilator triggers a medium urgency alarm to indicate that a spontaneous breath has exceeded the maximum allowed inspiratory time of 3 5 seconds 2 5 seconds in Pediatric mode The alarm is elevated to high urgency after two consecutive breaths that meet the alarm criteria Low Backup Battery If the backup battery is low a high priority alarm will be triggered Immediately connect an AC power source to avoid a loss of power Provide AC power and or replace the backup battery Alarm cannot be silenced or manually reset 5 minutes or less of battery run time remains Low EPAP If the Exhalation Positive Airway Pressure is less than the operator set Low EPAP Pressure limit for one second the ventilator sig
133. d 1 2 o N O Ui A 9 Turn the ventilator OFF Disconnect the O sensor and its Tee from the inhalation limb of the patient circuit Leave the electrical connection Connect the inspiratory bacteria filter directly to the gas outlet port and connect the inhalation limb to the filter Turn the ventilator ON Set the O setting to 40 Wait at least 3 5 breaths the alarm should sound Set the O setting to 21 Wait for 3 5 breaths the alarm should reset Press the RESET key to clear the alarm 10 Turn the ventilator OFF and re insert the O5 sensor and Tee 11 Turn the ventilator ON Power Fail Alarm Test 1 While the system is ventilating normally pull the AC plug from the wall If the backup battery is attached the ventilator should continue ventilating and an alarm should sound every 60 seconds If no backup battery is attached the ventilator will stop operating and sound a continuous audible alarm Plug the power cord back in Appendix C 2 Respironics V200 Ventilator Operator s Manual REF 1057983 A Appendix C Alarm Testing Procedure 4 Alarm should reset If the backup battery is attached the ventilator should return to AC power If no battery is attached the ventilator will resume operating Apnea Alarm Test l Setthe rate to 1 breath per minute 2 Wait for 20 seconds 3 The Respironics V200 should begin ventilating at a rate of 20 BPM while activating the Apnea alarm 4 R
134. d The operator should always choose a value for an active button that is appropriate for the patient being ventilated e When the active mode is set to NPPV the HIP Limit Setting will automatically be adjusted to 10 cmH50 above the current IPAP setting e Pt Leak only appears on Patient Data block on Settings screen e The V200 Ventilator keeps a distinct set of alarm limits for each ventilation breath type VCV PCV and NPPV Any of the changes made in the screen shown in Figure 8 18 do not take effect until the operator switches to the new ventilation breath type in this case Pressure Control REF 1057983 A Respironics V200 Ventilator Operator s Manual 2 9 Chapter 2 Warnings Cautions and Notes If the EXP HOLD key is held continuously and the expiratory hold maneuver exceeds 5 seconds the ventilator automatically terminates the expiratory hold maneuver and begins a new inspiratory period If Auto PEEP as calculated in Equation 1 Auto PEEP Expiratory Pause Pressure End Expiratory Pressure is negative Auto PEEP will be displayed as All components of the patient circuit must not have leaks in order to pass SST If time is found to be incorrect more than once in the preoperational procedure an internal battery may have to be replaced Contact qualified service personnel or call Respironics Customer Service at 1 800 345 6443 Because conditions and practices in health care institutions vary this m
135. d Contact Respironics Customer Service Within the U S A 1 800 345 6443 Outside the U S A 724 387 4000 Figure 13 41 FIrak On Button Grayed Out Flow Trak is Not Loaded On the Screen When a patient initiates a Flow Trak breath the ventilator screen shows the Breath Indicator bubble change from mandatory Mand or Assist to spontaneous Spont Figure 13 42 Breath Indicator During Flow Trak Breath 13 84 Respironics V200 Ventilator Operator s Manual REF 1057983 A Breath Delivery Inspiratory Hold Respiratory Mechanics Chapter 13 Options and Accessories The Flow Trak option allows the ventilator to give additional flow to patients who are not receiving the flows or volumes they desire by monitoring the pressure during a mandatory or assist breath If the patient draws more flow or volume than what has been set the inhalation pressure drops and Flow Trak is initiated The target pressure during Flow Trak is 2 cmH5O above PEEP If the patient s effort to draw flow or volume drops below the set flows or volumes the ventilator returns to VCV The ventilator cycles to exhalation only if the set tidal volume plus compliance and BTPS compensation has been delivered unless HIP has been met If the patient effort ceases and set volume has not been met the breath will continue to deliver flow until volume has been met Flow Trak Cycling Condition following the delivery of set Vt Response The delivered flow meets th
136. d the ALARM SILENCE period will terminate and any active medium or high priority alarms will become audible REF 1057983 A Respironics V200 Ventilator Operator s Manual 9 3 Chapter 9 Alarms Alarm Volume Control Under the left hand bottom edge of the front panel is a partially exposed round control that enables you to control the volume of audible alarms Figure 9 3 Alarm Volume Control Knob Figure 9 3 Alarm Volume Control The volume control can be adjusted between a minimum and maximum setting to suit the particular clinical situation Alert Messages When the ventilator detects an alarm condition it presents an Alert insert below the Patient Data box in the middle of the screen While the alarm is active i e visual and audible alarms are still present the message in the Alert insert appears in bold faced type Once the alarm condition has been corrected the message automatically switches to regular face type Pressing ALARM RESET clears alarm messages When the operator presses the ALARM RESET button described above the alarm messages disappear from the alert window When the ventilator detects more than three alarm conditions the three highest priority alert messages will be displayed Alert messages along with the corresponding alarm descriptions are listed in Table 9 1 Alarm Alert Messages 9 4 Respironics V200 Ventilator Operator s Manual REF 1057983 A Alert Message Air Source Fault Chapter 9 Al
137. datory breaths only During the last saved Static C and R maneuver Plateau Pressure Ppiat is measured and displayed as a static value Static C and R are time stamped based on ventilator time and date Static compliance values from 0 to 350 mL cmH 50 and static resistance values from 0 to 400 cmH50 L s are displayed If either value exceeds its limits or a stable plateau pressure cannot be achieved only a message no data is displayed Range Static compliance 0 to 350 mL cmH50 Static resistance 0 to 400 cmH50 L s Plateau Pressure 20 to 130 cmH5 0 Resolution Static compliance 1 mL cmH50 Static resistance 1 cmH50 L s Plateau Pressure 1 cmH 0 Accuracy Static compliance 1 mL cmH 0 x 2096 of true value Static resistance 3 cmH O L s 20 of true value Plateau Pressure 0 5 cmH 20 10 of true value Inspiratory time divided by total breath time TI TTOT Calculated inspiratory time divided by total breath time or percent inspiratory time An eight breath running average Available in VCV PCV and NPPV Applicable to spontaneous and pressure supported breaths only If there were no spontaneous or pressure supported breaths within the last one minute is displayed Table 13 9 Respiratory Mechanics Maneuver Summary and Data Specifications 13 64 Respironics V200 Ventilator Operator s Manual REF 1057983 A Parameter Peak lung flow Peak L Flow Chapter 13 Options and Accessories
138. e Indicates that circuit pressure exceeds the high pressure limit When High Inspiratory Pressure condition occurs the ventilator immediately cycles into the exhalation phase and illuminates the low priority indicator Then on the second consecutive breath with a pressure violation sounds the audible alarm lights the Alarm High indicator and displays High Inspiratory Pressure message High Internal O3 Oxygen concentration internal to the enclosure is beyond allowable levels Indicative of an internal O5 leak Alarm cannot be silenced or manually reset High Leak Rate The average estimated leak from the previous breath has exceeded the set High Leak alarm limit alarm applies to NPPV mode only Medium urgency escalates to high urgency after 60 seconds The alarm cancels when the estimated leak from the previous breath equals or falls below the alarm setting if the ventilation type changes from NPPV to another ventilation mode or if the alarm is reset by the clinician Table 9 1 Alarm Alert Messages Sheet 1 of 4 REF 1057983 A Respironics V200 Ventilator Operator s Manual Chapter 9 Alarms Alert Message High Minute Volume Alarm Alert Messages Continued Description Indicates total minute ventilation VE measured in exhalation is higher than the set limit This alarm is available in Volume Control and Pressure Control modes It is elevated to high urgency after one minute High 0 A high urgen
139. e RS232 2 screen appears Turn the knob to highlight ESPRIT and then press the knob The INPUT OUTPUT screen appears Figure 13 47 ESPRIT Choice for RS232 2 Port Screen 13 90 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Turn the knob to highlight EXIT and then press the knob Turn the knob to highlight EXIT again and then press the knob The monitor returns to the SETUP screen The ventilator and the respiratory profile monitor will begin communication within 60 seconds RS 232 The bidirectional communication between the respiratory profile monitor and Communications ventilator is initiated by the monitor The ventilator recognizes the connect request message from the monitor and responds Information Transferred from the Respiratory Profile Monitor to the Ventilator The respiratory profile monitor provides the ventilator with the data listed in the following table The monitor sends the average value for each parameter for the previous 60 seconds Information Transferred from the Respiratory Profile Monitor to the Ventilator Data Description CO a Cardiac Output Average NOTE Available only when the Cardiac Output option is installed SpO5 O2 Saturation ETCO End Tidal CO VCO2 Volume CO Vtalv Alveolar Tidal Volume MValv Alveolar Minute Volume Table 13 18 Information Transferred from the Monitor to the Ventilator REF 1057983 A Respi
140. e subject to medical hazardous waste regulations Consult with local authorities for proper disposition of the system and accessories at the end of their useful life Table 12 16 Environmental Protection Alarms Alarms Alarm Audible Alarm adjustable 45 dB A to 85 dB A Controls Volume By Alarm Silence 120 seconds Alarm Reset Table 12 17 Alarms Sheet 1 of 2 12 8 Respironics V200 Ventilator Operator s Manual REF 1057983 A Connectors Chapter 12 Technical Specifications Alarms Continued Alarm High Inspiratory 10 to 105 cmH50 hPa Settings Pressure Low Inspiratory 3 to 105 cmH50 hPa Pressure Low PEEP 0 to 35 cmH50 hPa Pressure High Respiratory 0 to 150 Bpm Rate Low Exhaled 0 mL to 2500 mL Mandatory Tidal Volume Low Exhaled 0 mL to 2500 mL Spontaneous Tidal Volume Low Exhaled 0 to 60 Lpm Minute Volume High Exhaled 0 to 60 Lpm Minute Volume High Leak NPPV 0 to 60 Lpm mode only Alarm Normal Indicator Status Indicators High Urgency Alarm flashing red Medium Low Urgency Alarm flashing yellow steady yellow Alarm Silence Safety Valve Open Ventilator Inoperative steady red Screen Locked Table 12 17 Alarms Sheet 2 of 2 Connectors Inspiratory Limb Connector Gas outlet port 22 mm conical male Expiratory Limb Connector Gas return port on expiratory filter Proprietary barb fitting NOTE The
141. e MONITOR button The screen is shown in Figure 8 34 The patient data and settings displayed on this screen depend on the active breath type Refer to Table 8 8 Monitor Screen Settings Displayed and Figure 8 34 REF 1057983 A Respironics V200 Ventilator Operator s Manual 8 29 Chapter 8 Operating Instructions This screen is displayed in VCV This screen is displayed in PCV 15 This screen is displayed in NPPV 616 16 6 5 Figure 8 34 Monitor Screen Ventilation Breath Type Monitor Screen Settings Displayed VCV Rate Peak Flow Tidal Volume PEEP 960 Pressure Support PCV Rate Inspiration Time Pressure PEEP 0 Pressure Support NPPV Rate IPAP EPAP 9605 Table 8 8 Monitor Screen Settings Displayed 8 30 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 8 Operating Instructions Special Procedures Auto PEEP Calculation The ventilator allows the operator to calculate Auto PEEP from an expiratory hold procedure This function is active only at the end of a mandatory breath and is not available in the emergency ventilation mode Expiratory hold is initiated by pressing the EXP HOLD key on the front panel When exhalation ends in the breath during which the EXP HOLD key is being pressed an expiratory hold maneuver will begin and will continue only as long as the key is pressed During the expiratory hold maneuver the screen shown in Figure 8 35 below will appear P
142. e Pee UM NP ERU EA 4 2 List of Parts and Accessories liliis ees 4 2 Repackingt os gre fk hha het ea tae AT e spice b ate oe 4 3 Ventilator Positioning 2 rh 4 4 Backup Battery 22 se ee ub REEEL LIVRE Ete 4 4 Inspiratory Bacteria Filter Installation isses 4 16 Heated Expiratory Bacteria Filter Installation lees 4 18 Oxygen Source Connection sasaaa aa a 4 20 Patient Circuit Flex Arm Installation iilis 4 22 Setup ocius count io npud Cua dL ws 6 0 BEC Es dad oed bep d 5 1 Back Panel Connections and Controls iilis 5 1 Connecting AC Power Cord 5 3 Power On Off Loi 468 Reed a RR RR ERN REEXAM ERRARE 5 4 Entering Diagnostic Mode liiis en 5 5 User Configuration Screen 2 0 n 5 7 Backup Battery cord eee p P cata eee casts ou egal NE 5 11 Extended Self Test ES Thermus e bra eve a atio t p ee S Re DC 5 12 Connecting Additional Equipment 0 0 00 eee 6 1 Communication Interface noaua 6 1 Connecting Serial Communications Devices sasaaa ee 6 2 Connecting Remote Alarm Port ee 6 2 Connecting Humidifier llis 6 3 Connecting the Patient Circuit 2e 6 5 Connecting the Analog Port llle 6 7 Operating Theory 0 0 s 7 1 Introd Ct OD cete dr eus OR em ots eb act tat teh Od ar da 7 1 System Overview csse eue RR b pee ee Pea alee ba eee kee 7 1 Ventilator Breath Types 0 0 nen 7 1 Ventilation Modes Common to VCV and PCV 2 ce ere
143. e and terminate ventilation in an orderly fashion In this state the front panel dis plays Backup Battery Depleted Connect AC amp Cycle Power The backup alarm emits a continuous tone the high priority alarm LED flashes and the Safety Valve Vent Inop and Battery Low front panel indicators remain lit until power from the Backup Battery is completely gone Battery Capacity There is a great deal of variability in the power consumption of the ventilator depending on altitude ventilator settings and the age and amount of charge on the backup battery These parameters will determine the exact amount of time the ventilator can operate from the backup battery 4 14 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 4 Getting Started Battery Charging When the ventilator is plugged into a viable AC supply it will charge the backup battery if the Mains Circuit Breaker is on and the machine is operating as a ventilator or in diagnostic mode or the Power ON OFF switch is OFF Charging time will depend on the amount of charge the batteries require A fully discharged backup battery will be fully recharged within 10 hours If the backup battery does not reach a full charge within 10 hours contact Respironics Customer Service While the ventilator is charging the front panel indicator labeled Charging text version of the front panel as shown in Figure 4 17 or the charging battery symbol symbol version of the
144. e exhalation flow The ventilator transitions to exhalation threshold The exhalation threshold is either the flow trajectory that would have been followed had there not been a Flow Trak breath or 2596 of measured peak flow whichever is larger Exhalation effort detected pressure exceeds 4 5 The ventilator transitions to exhalation cmH50 above PEEP HIP condition has been met The alarm sounds and ventilator transitions to exhalation See Alarms on page 13 86 Time too long condition has been met The alarm sounds and ventilator transitions to exhalation See Alarms on page 13 86 Table 13 13 Breath Transitions If the actual I Time is greater than the calculated I Time the next scheduled mandatory inspiration is postponed to ensure exhalation time NOTE In VCV the calculated I Time is based on the set tidal volume peak flow and waveform shape Inspiratory hold is only allowed if the actual I Time is less than or equal to the calculated Time The Flow Trak option affects the following Respiratory Mechanics features REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 85 Chapter 13 Options and Accessories Respiratory Mechanics Maneuvers with Flow Trak Maneuver Affect of Flow Trak Static C amp R The maneuver is cancelled if the patient initiates a Flow Trak breath A message appears when the maneuver is cancelled due to the change in breath type Dynamic C amp R D
145. e same exhalation P0 1 maneuver touch the Start P0 1 button A message above the graphic display shows the results for the just completed breath The maneuver automatically ends after four preselected patient initiated breaths have occurred or one minute has elapsed whichever comes first Once touched either one of the Start buttons changes to Stop The Stop button allows you to cancel the maneuver at any time A high priority alarm also cancels the maneuver At the end of a successful maneuver a pop up screen displays the result of the maneuver and asks you to accept or reject the results by touching the Accept or Reject button 13 54 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories 5 Atthe end of the maneuver whether successful or cancelled the Stop button changes to Continue While the Continue button is displayed the graph is frozen and can be rescaled Touch Continue or exit the screen to unfreeze the display 6 Touch Continue the button changes to Start and you can repeat the maneuver WARNING Perform the MIP maneuver according to instructions Because machine assisted breath delivery apnea detection and detection of certain patient alarms are temporarily disabled during a MIP maneuver close clinical supervision is recommended WARNING Because PEEP is temporarily set to 0 cmH 0 during a MIP maneuver close clinical supervision is recommended Scale
146. e ventilator does when the machine power is turned on or if there has been a potential fault detected by the watchdog timer or the bus activity monitor POST has the constraint that it must be able to run safely when the ventilator has a patient attached POST checks the integrity of critical system electronics such as the self test hardware and microprocessor electronics POST also tests other critical ventilator components that can be tested A primary objective of POST is to ensure that the watchdog timer and the bus activity monitor hardware are working and will catch software malfunctions These are critical components of the safety system and therefore POST tests these components every time it runs POST also checks all critical digital hardware including the processor program memory data memory and functions of various measurement systems POST also checks pneumatic components that can be safely tested with the safety valve open If all of these tests pass the Respironics V200 ventilator will operate as a ventilator 11 10 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 11 Diagnostics Built In Test When the Respironics V200 ventilator is operating as a ventilator it is constantly making reasonableness checks on the operation of the hardware to ensure that failures have not occurred and that the hardware appears to be operating normally Also while the microprocessor is operating there is executi
147. eceives SNDA followed by a carriage return it will respond by transmitting the information shown in Table 13 4 Ventilation Report The ventilator responds to the SNDA command by returning a string Ventilator Settings with a variable length The second and third fields define the length of the Report message The second field indicates the number of characters between the start and stop codes The third field indicates the number of fields between the start and stop codes The fourth field is the start code 02H The last field in the string is the stop code 03H indicating the end of the message NOTE The SNDA command is only available in Normal mode Ventilation Report Description Example Resolution Range Units Comments Command Name MISCA N A N A N A 5 character field Number of characters 706 N A N A N A 3 character field between the start and stop codes Number of fields 97 N A N A N A 2 character field between the start and stop codes Start Code 0x02 N A N A N A ASCII Start Transmission Character STX Time of request 13 45 N A N A N A 24 hour clock hh mme Not used eeeccceceececeece N A N A N A 18 character field ooeee Outputs example value Table 13 4 Ventilation Report Sheet 1 of 10 13 40 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Ventilation Report
148. ed Data du ARE EERuWU RH 6S ear a a 13 111 Trended Data 2 53 cas ee ea eee EA ee ER ERR RW E EA 13 112 Discontinue Speaking Mode 1 1 iliis 13 115 Auto Trak Sensitivity lesse mr 13 117 Introduction zs E dake hk EE C aa e E eae ee E Ua ue EEMS 13 117 Compatible Patient Interfaces 2l 13 117 How to Select Auto Trak lesse 13 118 Turning Auto Trak Off decretar i e en 13 121 Triggering and Cycling with Auto Trak isses 13 121 Leak Detection and Compensation iilii 13 121 REF 1057983 A Respironics V200 Ventilator Operators Manual vii Contents RS 232 Communications Protocol 00 0005 A 1 RS 232 Configurations rex taken Ra cr PCR ERG ae ew E Wr uA A 1 Commands Transmitted to the Ventilator isses A 1 Transmission of Data from the Ventilator liiis A 1 Ventilator Report Command and Response VRPT o oo auaa A 1 Volume Control Ventilation Settings Report VCVS iilius sess A 11 Pressure Control Ventilation Settings Report PCVS 00005 A 14 Non Invasive Positive Pressure Ventilation Settings Report NPVS A 16 Patient Data Report PTDT 0 lisse nh A 18 Alarm Status Report ALRM sse ah A 21 Unrecognized Commands 1 aa nen A 24 Customer Service amp Warranty 00 000 ee uee B 1 Customer Service sure aati eases A Moh gaa cae RR RS B 1 Warranty 2s Sat aad kh e d Wee a eR ER ER B 1 Options
149. ed Each ventilation breath type has its own settings alarms and monitor screens Refer to Chapter 8 Operating Instructions Volume Control Ventilation VCV In Volume Control Ventilation breaths may be controlled by the ventilator mandatory or triggered by the patient spontaneous When controlled by the ventilator breaths will be flow controlled and time cycled thus delivering an operator TIDAL VOLUME set volume In Volume Control Ventilation the flow pattern can be selected between square and descending ramp waveforms Refer to Figure 7 1 REF 1057983 A Respironics V200 Ventilator Operator s Manual 7 1 Chapter 7 Operating Theory Pressure EP LED EE c NU ET Time Flow I Time E 1 Figure 7 1 Volume Control Ventilation VCV Waveform Pressure Control Ventilation PCV In Pressure Control Ventilation breaths may be controlled by the ventilator mandatory or by the patient spontaneous When controlled by the ventilator breaths are pressure limited and time cycled resulting in an operator set PRESSURE pressure being delivered for an operator set I TIME period of time Refer to Figure 7 2 Pressure mm Time I Time 1 M Rate Figure 7 2 Pressure Control Ventilation PCV Waveform 7 2 Respironics V200 Ventilator Operator s Manual REF 1057983 A Ventilation Modes Common to VCV and PCV Chapter 7 Operating Theory In Volume Control Ventilation and Pressure C
150. eds to drop to in order for inspiration to end End Expiratory Pressure End Exp the airway pressure measured at the end of exhalation The display is updated at the end of each exhalation Expiratory phase exhalation the part of the ventilatory cycle from the beginning of expiratory flow to the beginning of inspiratory flow Flow Trigger initiation of inspiration when the patients inspiratory effort exceeds the flow sensitivity setting threshold Indicator a light usually light emitting diode LED Inspiration Exhalation Ratio I E ratio a standard I E ratio It is displayed as XX 1 when exhalation period is larger than the inhalation period It is displayed as 1 XX when inhalation period is larger than the exhalation period Inspiratory phase inspiration the part of the ventilatory cycle from the beginning of inspiratory flow to the beginning of expiratory flow Any inspiratory pause plateau is included in the inspiratory phase Inspiratory time inspiratory time expressed in seconds is the duration of inspiration during mechanical ventilation As inspiratory time increases mean airway pressure increases and the I E ratio becomes lower Glossary 4 Respironics V200 Ventilator Operator s Manual REF 1057983 A Glossary Inspiratory pause inspiratory pause is a brief pause 0 1 to 2 seconds at end inspiration during which pressure is held constant and flow is zero The purpose of the pause is to improve gas distribut
151. elivered pressure AWV Volume Delivered volume sPSV set PSV Set pressure support ventilation sPEEP set PEEP Set positive end expiratory pressure X PIP PIP Measured peak inspiratory pressure MnAwP MAP Measured mean airway pressure Pplat Pi End Measured end inspiratory plateau pressure PEEP Pe End Measured positive end expiratory pressure sPVcP set pressure Set PCV pressure SpMV Spont VE Measured spontaneous minute volume MV VE Measured minute volume PtLeak Pt Leak Estimated patient leak X TV Vt Measured tidal volume sFIO 2 set 02 Set oxygen percentage fractional inspired oxygen X FIO 2 02 Measured oxygen percentage fractional inspired oxygen sinsTi set Time Set inspiratory time RiseTi Rise Time Set rise time SAWRR set Rate Set airway respiratory rate SpAWRR Spont Rate Measured spontaneous respiratory rate X AWRR Rate Measured airway respiratory rate F TV F Vt Ratio of frequency to tidal volume rapid shallow breathing index Noninvasive positive pressure ventilation NPPV parameters Mode and type of ventilation will always be displayed REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 33 Chapter 13 Options and Accessories Available CMS V200 ae message equivalent oman CareNet AWF Flow Delivered flow X AWP Pressure Delivered pressure AWV Volume Delivered volume SIPAP set IPAP Set inspiratory
152. en any of the Spontaneous Tidal ALARMe following alarms Volume Alarm status are active Low Mandatory Tidal Volume Alarm or Low Spontaneous Tidal Volume Alarm or Low Tidal Volume Alarm Outputs RESET when any of the above alarms are reset and none are active Outputs NORMAL when none of the above alarms are reset or active Low Exhaled Minute NORMAL N A NORMAL N A Volume Alarm status RESET ALARM High Respiratory Rate NORMAL N A NORMAL N A Alarm status RESET ALARM Low Oxygen Supply NORMAL N A NORMAL N A Pressure Alarm status RESET ALARM Air Source NORMAL N A NORMAL N A Inoperative Alarm RESET status ALARM Low Battery Alarm NORMAL N A NORMAL N A Status of Low status RESET Backup Battery ALARM Alarm Apnea Alarm status NORMAL N A NORMAL N A RESET ALARM Not used oooeee N A oooeee N A Outputs example value Not used oooeee N A ooooee N A Outputs example value Time 12 45 N A N A N A 24 hour clock hh mm same as field 5 Not used eetece N A oooeee N A Outputs example value Table 13 4 Ventilation Report Sheet 6 of 10 REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 45 Chapter 13 Options and Accessories Description Ventilation Report Example Resolution Range Units Comments Date FEB 23 1997 N A N A N A 12 character field MMM DDeYYYY Static Compliance Static Resistance 0 e 0 0ee 0 lo
153. entilator is in use on a patient e The ventilator complies with the requirements of IEC 601 1 2 EMC collateral standard including the E field susceptibility requirements at a level of 10 volts per meter However even at this level of immunity certain transmitting devices cellular phones walkie talkies etc emit radio frequencies that could disrupt ventilator operation if operated in a range too close to the ventilator DO NOT operate the ventilator in a Magnetic Resonance Imaging MRI environment e Vent Inop is a serious condition which is indicated by both visual and audible alarms If the ventilator is attached to a patient when Vent Inop occurs the patient must be supported with another means of life support ventilation When the battery low indicator is flashing red operation of the ventilator from battery power should be discontinued For patient safety the HIP Limit Setting should be set as close to the peak inspiratory pressure as patient conditions allow DONOT perform the preoperational procedure when the ventilator is on a patient e You will be warned if the compliance is 9 0 ml cmH 30 hPa or larger Patients should not be put on a patient circuit that does not meet this requirement Ahigh priority visual and audible alarm indicates a potentially life threatening condition and immediate response is required e When the safety valve open indicator is lit the ventilator does not provide any ve
154. ently selected Pressure or Flow value 3 Touch the Accept button in the I Trigger or E Trigger window The Settings screen will display the current I Trigger and E Trigger values as shown in Figure 13 70 In order to determine triggering and cycling sensitivity thresholds for each breath Auto Trak applies multiple algorithms derived from flow volume and pressure measurements throughout the breathing cycle Triggering Auto Trak monitors changes in pressure and flow patterns throughout exhalation applies compensation for circuit leaks and triggers an inspiration when the criterion for one of the triggering algorithms has been met As a backup Auto Trak uses pressure triggering at a fixed level of 3 cm H30 Cycling Auto Trak automatically cycles breathing based on the pressure and flow patterns at the end of inspiration and beginning of expiration The threshold used to cycle each breath changes with the patients breathing pattern and lung dynamics Patient leaks at the mask interface are a critical factor and are significant in determining triggering and cycling thresholds With noninvasive ventilation failure to compensate for these leaks can impact the patients work of breathing Patient leak is the average leak rate during a breath and is estimated as the delivered volume minus exhaled volume divided by the total breath time This average estimated leak value is displayed in LPM as Pt Leak in the Patient Data section of the Sett
155. entration Setting PCV Apnea Rate 120000 1 1 80 BPM Setting PCV Apnea Interval 200000 1 10 60 sec Alarm Limit Setting PCV High Inspiratory 35000 1 10 105 cmH50 Pressure Alarm Limit hPa Setting PCV Low Inspiratory 399999 1 3 105 cmH50 Pressure Alarm Limit hPa Setting PCV Low PEEP Alarm 099999 1 0 35 cmH 50 Limit Setting hPa PCV Low Mandatory 000000 1 0 2500 mL Tidal Volume Alarm Limit Setting PCV Low Spontaneous 00000 1 0 2500 mL Tidal Volume Alarm Limit Setting PCV High Respiratory 1504999 1 0 150 BPM Rate Alarm Limit Setting Table A 1 Ventilation Report Sheet 3 of 10 Appendix A 4 Respironics V200 Ventilator Operator s Manual REF 1057983 A Appendix A RS 232 Communications Protocol Ventilation Report Continued Description Example Resolution Range Units Comments PCV Low Minute 1 00 0 01 for 0 00 60 0 L Volume Alarm Limit Ried Setting to 60 0 PCV High Minute 60 000 0 01 for 0 00 60 0 L Volume Alarm Limit 0 00 to 9 99 Setting 0 1 for 10 0 to 60 0 NPPV Mode Setting SPONT T N A SPONT T SPONTO NPPV Patient Type ADULTe N A ADULTe PEDOO NEO o NPPV Respiratory 129999 1 1 80 BPM Rate Setting NPPV EPAP Setting 599999 1 2 25 cmH50 hPa NPPV IPAP Setting 599999 1 2 35 cmH50 hPa NPPV Inspiratory Time 1 0999 0 1 0 1 9 9 sec Setting NPPV Rise Time 0 1999 0 1 0 1 0 9 Sec NPPV I Trigger Type AUTO N A FLOWO N A AUTO NPPV Flow I Trigger
156. eous respiratory rate Spont T spontaneous timed Spont VE spontaneous volume exhaled STPD standard temperature standard pressure dry SVO safety valve open Tidal Vol tidal volume Total RR total respiratory rate Total VE total volume exhaled minute V volume V flow VAC volts of alternating current power VE expired minute ventilation Vent ventilator Vr tidal volume REF 1057983 A Respironics V200 Ventilator Operator s Manual Glossary 3 Glossary Definitions Airway Pressure the pressure in the patient circuit measured at the distal end of the exhalation filter Baseline as in baseline pressure The pressure at end exhalation Baud serial transmission speed usually bits second Bias flow a continuous flow of gas used during expiratory phase when flow triggering is active Bit binary digit Compliance a measure of stiffness for containers that hold gas i e lungs patient tubing The volume required to increase the pressure in the container by a unit of pressure i e L cmH20 hPa Continuous positive airway pressure CPAP a mode of ventilator operation that allows the patient to breath spontaneously from a continuous flow or demand valve at an elevated airway pressure same as CAP E Cycle The E Cycle setting on the ventilator determines when the ventilator will transition from inspiration to expiration in PSV and NPPV modes E Cycle defines the percent of peak inspiratory flow that end inspiratory flow ne
157. er 12 Technical Specifications Pressure Control Ventilation Settings Ranges amp Resolution Continued Setting Range Rise Time 0 1 to 0 9 seconds 960 2196 to 10096 Patient Type Adult Pediatric Table 12 4 Pressure Control Ventilation Settings Ranges amp Resolution Sheet 2 of 2 Resolution is one unit unless otherwise noted cmH50 is considered numerically equivalent to hPa Non Invasive Positive Pressure Ventilation Settings Ranges amp Resolution Setting Respiratory Rate Range 1 to 80 Bpm EPAP 2 to 25 cmH50 hPa IPAP 2 to 35 cmH50 hPa Inspiratory Time 0 1 to 9 9 seconds Resolution is 0 1 second Rise Time 0 1 to 0 9 seconds Inspiratory Trigger I trigger Flow Sensitivity 0 5 to 20 LPM from base flow of 3 LPM above sensitivity Resolution is 0 1 LPM Expiratory Trigger E Cycle Peak Flow 10 to 80 of inspiratory peak flow 960 21 to 100 Apnea Rate 1 80 Bpm Patient Type Adult P ediatric Table 12 5 Non Invasive Positive Pressure Ventilation Settings Ranges and Resolution Maximum delivered flow during pressure controlled breaths in NPPV is limited to 100 LPM for the pediatric patient type Apnea ventilation is considered equivalent to Assist Control with Apnea Rate in VCV and PCV In NPPV only mandatory breaths are delivered triggered either at the Apnea Rate or by the patient REF 1057983 A Respironics
158. er into housing 5 Reinstall housing 5 and new filter and close retaining bracket 2 10 Connect circuit 10 6 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 10 Care and Maintenance Periodic This section includes detailed operator maintenance Maintenance Schedule for Periodic Maintenance Frequency Component Maintenance During ventilator setup Inspiratory bacteria filter Ventilator and patient circuit components Inspiratory and expiratory filters Check filter for occlusions cracks and tears Perform SST Short Self Test whenever circuit components are changed Perform EST Extended Self Test between patient uses Ensure that the ventilator functions normally with both filters in place At least daily and as recommended by filter manufacturers CAUTION Inspiratory and expiratory filters Monitor performance of filters and replace as needed Review ventilator patient graphics frequently for changes in expiratory resistance which may indicate degradation of expiratory filter Follow filter manufacturer recommendations regarding duration of use maintenance for reusable filters removal and disposal Note that high humidity and aerosol medications may reduce expiratory filter life increase expiratory resistance and or cause filter damage Do not operate the ventilator without a properly functioning expiratory filter and heater Doing so may cau
159. er level determines the amount of pressure below the baseline pressure that the patient must create in order for the ventilator to deliver a breath The Flow Trigger level is the amount of flow that the patient must inspire from the base flow in order for the ventilator to deliver a breath REF 1057983 A Respironics V200 Ventilator Operator s Manual 7 5 Chapter 7 Operating Theory Ventilation Modes Common to NPPV Patient Leak Display Estimated patient leak Pt Leak is displayed in LPM and updated at each breath Pt Leak is the average leak rate during a breath delivered volume minus exhaled volume divided by the breath time Pt Leak is estimated breath by breath If the physical characteristics of the leak change there will be a corresponding change in the actual leak flow which will be detected and leak estimation will be updated in subsequent breaths Physical characteristics of leaks are determined by a number of factors for example the size and shape of the leak such as a gap in the seal between the mask and face Leaks that may occur during invasive ventilation are usually undesirable and are not compensated to allow easier leak detection Non Invasive Positive Pressure Ventilation NPPV In Non Invasive Ventilation gas is delivered to the patient via a nasal mask full face mask nasal pillows or mouthpiece with a lip seal The operator determines whether the mode is totally spontaneous Spont Ventilation Mode or s
160. ered by operator patient or ventilator SIMV VCV or PCV Synchronous intermittent mandatory ventilation breaths can be mandatory or spontaneous Mandatory breaths are triggered by operator patient or ventilator PSV is available CPAP VCV or PCV Continuous positive airway pressure all patient triggered breaths are spontaneous and can be pressure supported PSV is available The MANUAL BREATH key can be used to initiate a mandatory breath Spont NPPV Spontaneous ventilation all breaths are spontaneous and patient triggered The MANUAL BREATH key can be used to initiate a mandatory breath Spont T NPPV Spontaneous Timed ventilation breaths can be spontaneous or mandatory The MANUAL BREATH key can be used to initiate a mandatory breath Table 8 6 Summary Ventilation Modes and Availability 8 26 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 8 Operating Instructions The ventilation mode buttons are the selected not selected type Follow these steps to select the mode 1 Press the button for the mode you want to select the active mode is highlighted from the top bar f VCV or PCV breath types are active you can select A C SIMV or CPAP mode Figure 8 30 If NPPV is active you can select Spont T or Spont A C SIMV CPAP Spont T Spont Figure 8 30 Ventilation Mode buttons A C and Spont T active as shown 2 The ventilator asks you to confirm the mode change Figure 8 31 P
161. ernal battery should be tested during the regular preventative maintenance cycle of the ventilator or as required by your institutional procedures Perform the External Battery Verification Procedure included in the External Battery Service Instructions 1013569 Battery Specifications Part Number 1059955 Model V200 External Battery Type Lead Acid Output 24 V 33AH Class 1 Recharge Time 15 hours Charge Hold 14 days at 20 C Storage Conditions 20 C to 60 C at 10 95 relative humidity Batteries are considered hazardous waste and must be disposed of according to local regulations It is unlawful to dispose of these batteries except through a regionally approved recycling center For additional information contact Respironics Customer Service at 1 800 345 6443 REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 11 Chapter 13 Options and Accessories Warranty Respironics warrants the Respironics V200 external battery to be free from defects in material and workmanship for a period of twelve months from the date of installation provided that the unit is operated under conditions of normal use as described in this operator s manual At its discretion Respironics will make replacements repairs or issue credits for equipment or parts that are found to be defective This warranty does not apply to any unit or individual parts which have been repaired or altered in any way that in Res
162. ervice Manual P N 580 1000 02 Software The software function displays the ventilators serial number software part numbers and version numbers and the part numbers of other critical components Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 11 Diagnostics User Config The User Config function allows you to Set the date and time when first setting up the ventilator Set the altitude for the location of the ventilator This setting allows for more accurate tidal volume delivery Enable or disable the automatic patient circuit compliance compensation feature Compliance compensation corrects the delivered volumes of VCV mandatory breaths for patient circuit compliance It also corrects all exhaled volume for patient circuit compliance volume The COMPLIANCE button is grey when compliance compensation is disabled and white when compliance compensation is enabled Set the time format AM PM or 24 hour Enable or disable the confirmation that the backup battery is connected each time that the machine powers on Diagnostic Codes The Diagnostic Codes function allows you to review the diagnostic log in ventilator memory To view the diagnostic codes press the DIAGNOSTIC CODE button on the diagnostic screen The ventilator displays the following information Number Diagnostic codes are numbered in reverse order of occurrence most recent first Code The number assigned to a specific diagnostic c
163. erwise 99999 Monitored Oxygen 55 100 0 1 for0 0 0 0 100 The O2 display Concentration to 99 9 from the Patient 1 for 100 Data Screen Ti Ttot 0 23 0 01 0 00 1 00 N A The Ti Ttot display from the Mechanics Patient Status Screen Dynamic Resistance 5 43 0 01 for 0 00 400 cmH50 The Dynamic 0 00 to L Sec Resistance display 9 99 from the 0 1 for Mechanics Patient 10 0 to Status Screen 99 9 1 for 100 to 400 Dynamic Compliance 19 2 0 01 for 0 00 350 mL The Dynamic 0 00 to cmH50 Compliance display 9 99 from the 0 1 for Mechanics Patient 10 0 to Status Screen 99 9 1 for 100 to 350 Peak Lung Flow 35 10 0 1 for 300 300 LPM The Peak L Flow 99 9 to display from the 99 9 Mechanics Patient 1 for 100 Status Screen to 300 1 for 100 to 300 Vital Capacity 4500 1 0 9999 mL Vital Capacity Table A 1 Ventilation Report Sheet 6 of 10 display from Vital Capacity Screen REF 1057983 A Respironics V200 Ventilator Operator s Manual Appendix A 7 Appendix A RS 232 Communications Protocol Ventilation Report Continued Description Example Resolution Range Units Comments Vital Capacity Time of 11 14 1 minute 01 01 70 N A Time of Last Last Maneuver 01013 11 0 00 to Maneuver display 01 19 38 from the Vital 3 14 Capacity Screen 15 character field 24 hour clock MM DD YYuuHH MM MIP 54 1 0 1for 99 9 100 200 cmH50 MIP display from to 99 9 MIP PO 1 display 1 for 100 Screen and 100 to 200 MIP Time of
164. es that O5 gas supply is below acceptable levels and the 960 setting is above 21 Check O gas connections and inlet filter Alarm cannot be manually reset Low PEEP If PEEP is less than the operator set Low PEEP limit for one second during exhalation triggers a medium priority alarm If the Low PEEP alarm remains active for one minute the alarm moves to high priority Note A Low PEEP setting of zero 0 will disable this alarm Note If an inspiration is triggered immediately after the mandatory minimum exhalation time of 200 msec this alarm will not be activated unless this condition occurs for three consecutive breaths Low Tidal Volume The ventilator triggers a medium urgency alarm to indicate that the NPPV mandatory or spontaneous breath tidal volume is less than the set limit It is elevated to a high urgency alarm after one minute Note A Low Tidal Volume setting of zero 0 will disable this alarm Table 9 1 Alarm Alert Messages Sheet 3 of 4 REF 1057983 A Respironics V200 Ventilator Operator s Manual 9 7 Chapter 9 Alarms Alarm Alert Messages Continued Alert Message Description Low Vt Mandatory The ventilator triggers a medium urgency alarm to indicate that the VCV or PCV mandatory tidal volume is less than the set limit It is elevated to high urgency after one minute Note A Low Vt setting of zero 0 will disable this alarm Note If an inspiration is triggered immediately after the
165. esetthe rate to 10 BPM 5 RESET the alarm 6 The Respironics V200 should begin ventilating normally REF 1057983 A Respironics V200 Ventilator Operator s Manual Appendix C 3 Appendix C Alarm Testing Procedure This page is intentionally blank Appendix C 4 Respironics V200 Ventilator Operator s Manual REF 1057983 A Glossary Abbreviations 24 Hrs used to describe format for time of day when AM or PM does not appear AC alternating current power A C assist control ventilation AM PM used to describe format for time of day when AM or PM occurs ASCII commonly accepted 8 bit binary code for characters Assist assist control ventilation ATPS ambient temperature ambient pressure saturated with water vapor Auto PEEP end expiratory alveolar pressure above set PEEP level Aux auxiliary BTPS Body temperature 98 F ambient pressure 100 saturated with water vapor C compliance ratio of change in volume divided by change in pressure CL lung compliance cmH 0 unit of pressure measurement centimeters of water CMV controlled mechanical ventilation same as A C CPAP continuous positive airway pressure Crs compliance of respiratory system Cw chest wall compliance DISS Diameter Index Safety System E Cycle Expiratory Cycle End Exp end expiratory pressure EPAP expiratory positive airway pressure ETO ethylene oxide Gas used for sterilization REF 1057983 A Respironics V200 Ventilator Operator s Manual Glossary 1
166. f parameters see Table 13 K3 gt gt button Appears if more than one page of trended data is available for the selected category the next page displays a lt lt E button to return to the previous page Cancel button Exits the Trended Data pop up window without making changes Cancel Accept button Confirms the selected parameter and exits the Trended Data pop up window i Table 13 11 Summary of Trended Data Information REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 73 Chapter 13 Options and Accessories Using the Manual The Manual rescale buttons Figure 13 36 allow you to adjust the vertical 1 scale for most waveforms Press the top half of the scale to change the upper Rescale Function limit and the bottom half of the scale to change the lower limit A pop up window allows you to adjust the scale Press the Cancel button to exit the pop up window without making changes or press Accept to select the new value and exit the pop up window Manual rescale Pop up button window for adjusting scale Figure 13 36 Manually Rescaling a Vertical Axis on the Trending Screen Changing the Cursor The Cursor arrow buttons Figure 13 36 allow you to adjust the position of the Position cursor for all three waveforms You can also turn the knob to adjust the cursor position The data display window for each waveform shows the value of the data at the time indicated by the cursor positio
167. for input 1kV for input output lines output lines Surge 1kV differential 1kV differential Mains power quality should be mode mode that of a typical hospital IEC 61000 4 5 environment 2kV common mode 2kV common mode Voltage dips short interruptions and voltage variations on power supply input lines IEC 61000 4 11 lt 5 Uy gt 95 dip in Uy for 0 5 cycle 40 Ur 60 dip in Uy for 5 cycles 70 Ur 30 dip in Uy for 25 cycles 5 Ur gt 95 dip in U7 for 5 sec lt 5 Ur gt 95 dip in Uy for 0 5 cycle 40 UT 60 dip in Uy for 5 cycles 70 Ur 30 dip in Uy for 25 cycles 5 Ur gt 95 dip in Uy for 5 sec Mains power quality should be that of a typical hospital environment If the user of the ventilator requires continued operation during power mains interruptions it is recommended that the ventilator be powered from an external battery Power Frequency 50 60Hz magnetic field IEC 61000 4 8 3 A m 3 A m Power frequency magnetic fields should be at levels characteristic of a typical location in a typical hospital environment NOTE Ur is the a c mains voltage prior to application of the test level Table 12 27 EMC Declaration Immunity REF 1057983 A Respironics V200 Ventilator Operator s Manual 12 13 Chapter 12 Technical Specifications Guidance and Manufacturer s Declaration Electromagnetic Immunity The ve
168. for that parameter in an insert that allows the operator to adjust the settings value Figure 8 14 3 Press the bar to increase or decrease the setting to the value you want or use the front panel knob to adjust the value of the setting 4 Press the screen ACCEPT button or the front panel ACCEPT button to activate the new setting or CANCEL to leave the setting unchanged REF 1057983 A Respironics V200 Ventilator Operator s Manual 8 15 Chapter 8 Operating Instructions Push this bar to increase the value Peak Flow 140 Current or new value displayed digitally and graphically Increase Push this bar to decrease the value Decrease Press ACCEPT to activate the new setting Press CANCEL to leave the setting unchanged Figure 8 14 Changing a Setting When a value is entered as shown in Figure 8 14 the ventilator checks to assure that the value has been accepted by the operator is within limits and will not cause other settings to be out of limits If the new value causes these limits to be exceeded a diagnostic message will be displayed Refer to Value Entry Message on page 12 4 for more details about the diagnostic messages Selecting Alarm Limits Follow these steps to adjust currently active alarm limits 1 Push ALARM SETTINGS The ventilator displays the alarm limits for the currently active ventilation mode Figure 8 15 2 Push the button for the alarm limit you want to adjust The vent
169. formation via a bidirectional RS 232 serial link Through this link the ventilator supplies the monitor with breath type and FIO information and in turn the monitor provides the ventilator with data for trending parameters related to measuring CO elimination VCO System Requirements The following hardware and software is required for the proper use of the respiratory profile monitor interface Respiratory Profile Monitor Interface NICO Esprit Requirements Monitor NICO Monitor Model 7300 Part number varies by NICO Monitor Model 7600 language Respironics V200 Ventilator Trending option loaded and enabled Respironics V200 ventilator with the respiratory profile monitor interface option enabled NOTE Ventilators with the respiratory profile monitor software L2 e installed are identified by an option label located near the power switch Accessories RS 232 serial communications 3 cable 1018292 WARNING Use only Respironics approved cables when connecting to the communications port Mounting kit respiratory profile monitor 10060784 Table 13 16 respiratory profile monitor Interface Option Requirements REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 87 Chapter 13 Options and Accessories Communications When the respiratory profile monitor interface NICO Esprit option is installed the RS 232 communications port is configured for all communications functions
170. front panel as shown in Figure 4 18 will be on continuously When the backup battery is fully charged the indicator will turn off NOTE For optimal performance and battery life of a newly purchased backup battery establish full backup battery charge by plugging the ventilator into AC power for eight 8 hours maximum or until the charging indicator light turns off and then unplug the unit NOTE To monitor backup battery performance and life run the ventilator on battery power for at least 20 minutes at typical settings once a month Recharge the battery when the test is complete CAUTION The backup battery is designed to be charged only by the Respironics V200 Ventilator Under no circumstances should an attempt be made to charge it in any other way CAUTION Ifthe ventilator will not be used for 30 days or more the backup battery should be preserved Either disconnect the backup battery from the ventilator or keep the ventilator plugged into an active electrical outlet Warranty Respironics warrants the backup battery to be free from defects in material and workmanship for a period of one year from the date of purchase provided that the unit is operated under conditions of normal use as described in this operator s manual At its discretion Respironics will make replacements repairs or issue credits for equipment or parts that are found to be defective REF 1057983 A Respironics V200 Ventilator Operator s Manual 4 15
171. g a New Ventilation Breath Type VCV PCV or NPPV Chapter 8 Operating Instructions Changing IPAP or EPAP in NPPV When changing the IPAP or EPAP settings in NPPV the difference between IPAP and EPAP is displayed in the window insert as PSV cmH20 2 Cancel Accept Figure 8 23 Changing IPAP or EPAP in NPPV Follow these steps to select the ventilation breath type 1 Press the button for the new breath type you want to select from the bottom bar Figure 8 24 PCV in this example VCN Settings PCV Settings NPPV Settings Figure 8 24 Ventilation Control Buttons PCV settings selected 2 The setting screen for the selected breath type appears All of the settings are grayed out indicating that they are not currently active However you can use the grayed out buttons to change the settings as necessary with the exception of Set O5 and patient type which can be changed only in the active mode For example if you press PCV SETTINGS when the current breath type is NPPV all the PCV settings are grayed out Figure 8 25 because NPPV is currently active REF 1057983 A Respironics V200 Ventilator Operator s Manual 8 23 Chapter 8 Operating Instructions SIMY CPAP Activate ACTIVATE MV CPAI Eu D button Figure 8 25 Settings Screen PCV settings PCV not currently active 3 Pressthe ACTIVATE button The prompt in Figure 8 26 is displayed on the screen
172. gas return port on the ventilator is a cylindrical port which requires mating to a specified expiratory filter to seal the expiratory limb Oxygen Inlet DISS male DISS female NIST Air Liquide or SIS Fitting depending on country and configuration Table 12 18 Connectors REF 1057983 A Respironics V200 Ventilator Operator s Manual 12 9 Chapter 12 Technical Specifications Filters Inspiratory Filters See filter instruction sheets for complete specification Bacterial Filter Efficiency 99 999 96 Viral Filtration Efficiency 99 99 Expiratory Measuring and Display Devices See filter instruction sheets for complete specification Typical efficiency 99 9796 for nominal particle size of 0 3 micro meter micron at 100L min flow Table 12 19 Filters Measuring and Display Devices Pressure Measurements Type Solid State Sensing Position Inhalation output port Exhalation input port Measurements Patient airway pressure Volume Measurements Type Hot Film Anemometer flow integrated Sensing Position O air and exhalation Measurements O flow air flow and exhalation flow Oxygen Measurements Type Zirconia solid electrolyte Sensing Position Internal enclosure Measurements Oxygen concentration range 0 to 95 Type Galvanic cell Sensing Position Inspiratory limb of VBS Measurements Delivered 02 range 0 to 11
173. gs for maneuver breath are mode CPAP PEEP 0 cmH50 during the start of the next inhalation or exhalation following pressing the start button and PSV 2 0 cmH50 For the breath following the maneuver breath PSV 0 cmH50 and PEEP is restored to its original setting Any gas exhaled during an MIP maneuver is not applied to the tidal volume or minute volume calculations Results display MIP is displayed in cmH50 and is time stamped based on ventilator time and date Measured pressures from 100 to 200 cmH50 are displayed for the MIP maneuver If measured pressure exceeds these limits only a message no data is displayed Range 100 to 200 cmH 0 Resolution 1 cmH 0 Accuracy 10 of true value Table 13 9 Respiratory Mechanics Maneuver Summary and Data Specifications 13 62 Respironics V200 Ventilator Operator s Manual REF 1057983 A Parameter Occlusion pressure at 100 ms P0 1 maneuver Chapter 13 Options and Accessories Description Procedure No instructions to the patient are required Available in VCV and PCV Not available in NPPV During the maneuver Settings do not change during the P0 1 maneuver The ventilator briefly occludes the patient circuit and measures occlusion pressure in the first 100 ms of four preselected patient initiated breaths If you press Stop during a P0 1 maneuver results are displayed for the maneuver breaths that did occur Results display P0 1 is displayed in cmH50 and is
174. h fingers Gently remove the heater housing 5 Tap filter input port 7 if the filter does not come out easily Insert the new expiratory bacteria filter 1 into the heater housing 5 Reinstall housing 5 and filter 1 into receiving compartment 6 then close retaining bracket 3 Ensure that the retaining bracket 3 is securely closed and turn knob 2 clockwise to secure latch Connect the exhalation limb and water collection system of the patient circuit not shown to the inlet port of the exhalation filter 7 High humidity and aerosol medications may reduce expiratory filter life increase expiratory resistance and or cause filter damage Review ventilator patient graphics frequently for changes in expiratory resistance Consult filter manufacturer recommendations regarding duration of use maintenance and removal and disposal of expiratory filter REF 1057983 A Respironics V200 Ventilator Operator s Manual 4 19 Chapter 4 Getting Started Oxygen Source Connection WARNING WARNING WARNING CAUTION NOTE NOTE Figure 4 21 O Gas Connections and Filter All oxygen connections should be carefully inspected to ensure that leaks are not present Excessive leaks can result in higher than normal ambient oxygen concentrations and create a potentially hazardous oxygen enriched environment Worn frayed oxygen
175. he HARDWARE screen Press the SAFETY button so that it has a white background Attach a length of 22 mm I D tubing to the gas outlet port of the ventilator Set the air flow to 100 LPM Record what the inhalation pressure sensor is reading See Figure 13 54 Attach the filter to the end of the length of 22 mm I D tubing and again record the inhalation pressure sensor reading See Figure 13 54 The difference between the first pressure reading and second pressure reading should not be greater than 4 cmH50O or manufacturer s recommendations Inhalation Pressure Figure 13 54 Hardware Screen in Diagnostics Mode Inhalation Pressure reading REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 99 Chapter 13 Options and Accessories Initial Neonatal Settings Initial Patient Settings Ranges When the ventilator is first powered on and the neonatal patient type is selected the initial startup settings found in Table 13 21 are applied Each subsequent startup will display the settings from the last use of the ventilator of that patient type with the exception of O5 The last O5 setting used on the ventilator will remain regardless of patient type Ventilation Settings Value Ranges Ventilation Mode PCV SIMV AC SIMV CPAP Rate 20 BPM 1 150 BPM Pressure 10 cmH20 5 100 cmH20 Time 0 3 Sec 0 1 2 0 Sec PEEP 3 cmH 20 0 35 cmH20 PSV 0
176. he beginning of each exhalation PCMCIA Card PC Card Acronym for Personal Computer M emory Card International Association more commonly referred to as a PC Card This is a data storage device with an approximate physical size of a credit card used in conjunction with the Trending Option Positive End Expiratory Pressure PEEP the application and maintenance of pressure above atmospheric at the airway throughout the expiratory phase of positive pressure mechanical ventilation Pressure Support Ventilation PSV pressure limited assisted ventilation designed to augment a spontaneously generated breath the patient has primary control over the frequency of breathing the inspiratory time and the inspiratory flow REF 1057983 A Respironics V200 Ventilator Operator s Manual Glossary 5 Glossary Pressure Sensitivity a measure of the amount of negative pressure that must be generated by a patient to trigger a mechanical ventilator into the inspiratory phase alternatively the mechanism used to set or control this level Pressure Trigger initiation of inspiration when the patients inspiratory effort exceeds the sensitivity threshold PVC 0 Sensor Tee An external oxygen sensor adapter made of polyvinyl chloride PVC This O5 Sensor Tee is gray in color and cannot be autoclaved or chemically disinfected Rapid Shallow Breathing Index F Vr used to evaluate the adequacy of the patients spontaneous ventilation It is calculated by a
177. ia the Com2 option is for reference only Decisions for patient care should be based on the clinician s observations of the patient When the Com2 option is installed the RS 232 communications port is configured for all communications functions in the following manner Baud Rate 9 600 Data Bits 8 e Parity None e Stop Bits 1 NOTE In diagnostics mode with Com2 installed the baud rate is 19 200 To properly use the Com2 option connect the communications cable to the 9 pin serial connection on the back of the ventilator Serial Port Connection Figure 13 26 9 pin serial port connection REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 39 Chapter 13 Options and Accessories Commands Transmitted to the Ventilator Transmission of Data from the Ventilator SNDA lt CR gt Send Variable Length Commands are transmitted as a series of four ASCII characters followed by a carriage return Valid commands will be stored and response transmissions will be sent in the order the corresponding commands were received Unless stated otherwise all fields will be left justified and six 6 characters in length A comma will separate each field except for the field following the start code Each data transmission shall be terminated with a carriage return In the following subparagraphs a space is designated as When data is unavailable the output field shall contain 000 When the ventilator r
178. ian to set the displayed time in an AM PM e g 1 15 PM or 24 Hr e g 13 15 format When the 24 HR CLOCK button has a white background time is displayed in the 24 Hr format when it has a gray background time is displayed in the AM PM format 7 Pressthe 24 HR CLOCK button to toggle between AM PM and 24 Hr formats Observe the time display in the lower right hand corner of the diagnostic screen to confirm the format Altitude The User Configuration screen in the Diagnostic Mode is used to input the altitude of the location of the ventilator To enter Diagnostic Mode follow the instructions Entering Diagnostic Mode on page 5 6 At Figure 5 5 select USER CONFIG and the screen in Figure 5 10 appears Pressing the ALTITUDE button enables you to set the altitude to that of the present geographical location of the ventilator This factor ensures a more accurate tidal volume delivery Setting Altitude To adjust the altitude l Verify the altitude using an altimeter if available or estimate the altitude in feet or meters above sea level 2 Press the ALTITUDE button 3 When the window insert appears select either feet or meters Press the INCREASE or DECREASE button or rotate the control knob to change the value The longer the increase and decrease are touched the faster the value will change REF 1057983 A Respironics V200 Ventilator Operator s Manual 5 9 Chapter 5 Setup 4 Press ACCEPT to accept the changed v
179. ibration is performed during EST If recalibration of the O sensor is required follow the instructions for Extended Self Test EST in Chapter 11 Respironics warrants the O sensor to be free from defects in material and workmanship for a period of one year from the date of purchase provided that the unit is operated under conditions of normal use as described in this operator s manual At its discretion Respironics will make replacements repairs or issue credits for equipment or parts that are found to be defective The External Oxygen Sensor Adapters P Ns 8 100498 and 1020380 are also referred to as O Sensor Tees The PVC adapter is gray the Ultem is clear with an amber tint and both are compatible with the MSA and Analytical Industries External Oxygen Sensors Both tees are compatible with all ventilators Both tees have 22mm female male connections therefore the 22mm male male adapter P N 1002505 is not needed when using this adapter CAUTION PVC O P N 8 100498 00 and Ultem P N 1020380 Sensor Tees cannot be autoclaved or chemically disinfected 8 100498 00 N X y CON 1020380 PVC Gray Ultem amp p Clear Figure 13 4 Sensor Tee REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 5 Chapter 13 Options and Accessories This page is intentionally blank 13 6 Respironics V200 Ventilator Operator s Manual REF 1057983 A External Battery Option The V200 External
180. id depleting the cylinders To Use 0 Cylinders Open the O cylinder valves and disconnect the wall oxygen supply Transport Use When preparing for intra facility transport use first open the O cylinder valves and then disconnect the wall oxygen supply When transport is complete reconnect the wall oxygen supply and then close the O cylinder valves REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 17 Chapter 13 Options and Accessories This page is intentionally blank 13 18 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Graphics The Graphics software enhances the display screens with graphical data of the patient s flow pressure and volume The Graphics software offers a choice of Screens The Waveform screen displays two windows displaying pressure flow or volume within a specified time scale The Loops screen displays three windows a waveform window pressure flow or volume a flow volume loop window and a pressure volume loop window Graphics is available in all ventilation types Starting Gra phics To enter the graphics screens press the Graphics icon button in the lower right corner of the screen Figure 13 13 Figure 13 13 VCV Settings Screen and the Graphics Icon Button Using Graphics Press the WAVEFORMS button to view two waveforms or press the LOOPS button to view one waveform and two loops Figure 13 14 shows a
181. ilator displays the current value for that alarm limit in a display insert similar to Figure 8 14 Press the bar or use the front panel knob to adjust the value Press ACCEPT to activate the new alarm limit or CANCEL to leave it unchanged Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 8 Operating Instructions Active EPRPUEUAED ventilation Active Mode VCV A C Alarm Settings Monitor mode and i I SS AE breath type 7 120 High Pressure 40 A eee A button Low Insp Press 10 Setting displayed emH20 Rate 42 BPM towPEEP o L1 Pook row abit Mene 02 40 screen is for PEEP 0 Low Vt Mand 400 cmH20 VCV alarms Low Vt Spot OQ Patient Data High R PIP 383 c0 Mand up MAP 173cmH20 i ighRae j 35 S RR lom asne N High vE 24 0 w em N Push PtLeak 1 91PM Support gt button of cule 4 00 Spont e want to ad just VCV Settings PCV Settings gt Figure 8 15 Setting Alarm Limits That Are Currently Active The High Pressure Alarm Setting may be accessed through the Alarms Settings Screen or through the HIP Indicator adjacent to the manometer in the PCV and VCV Settings Alarm Settings Patient Data and Monitor Screens WARNING For patient safety the HIP Limit Setting should be set as close to the peak inspiratory pressure as patient conditions allow CAUTION If clinical conditions do not require setting the HIP Limit above 6
182. in the following manner Ventilator RS 232 Communications Port Settings Specification Setting Baud Rate 19200 Data Bits 8 Parity None Stop Bits 1 Table 13 17 Ventilator RS 232 Communications Port Settings NOTE The respiratory profile monitor interface NICO Esprit option uses the communications port on the ventilator exclusively The respiratory profile monitor interface NICO Esprit option and the RS 232 Communications Option 2 cannot be installed on the same ventilator Hardware Setup Once the software is loaded on the ventilator the necessary hardware can be attached l Attach the respiratory profile monitor to the mounting bracket and then attach the assembly to the ventilator Assembly instructions are included with the bracket Respiratory profile monitor B c Mounting bracket Ventilator Figure 13 43 Assembled Monitor Bracket and Ventilator 13 88 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories WARNING Always turn the ventilator power OFF before connecting additional equipment 2 Attach one end of the RS 232 serial communications cable to the RS 232 port 1 or 2 on the back of the respiratory profile monitor See Figure 13 44 3 Attach the other end of the RS 232 serial communications cable to the serial communications port on the back of the ventilator See Figure 13 44 2 7 2
183. ing button to display the Trending screen Figure 13 34 Trending button Figure 13 33 Patient Data Screen 13 70 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories The Trending screen Figure 13 34 displays three trending waveforms as well as a summary of ventilator settings and patient data You can change the waveforms and time scale at any time Active Mode VCV A C Parameter select button Manual rescale button Begin trending time Cursor time and date End Trending Time View 1 View 2 buttons Figure 13 34 Trending Screen Summary of Trending Screen Information Information type Description Parameter select buttons Selects which parameter to display in the trending waveform Manual rescale buttons Selects the upper and lower limits for the displayed parameter Cursor arrow buttons Changes the position of the cursor You can also use the front panel control knob to adjust cursor position 2 Hrs and 2 Hrs buttons Shifts the waveform forward or backward by 2 hours without changing the time scale If you press and hold the buttons the 2Hs 12 Hrs time scale shifts every 2 second If less than 2 hours of data exists the waveform shifts by the time available The button is grayed if the waveform cannot shift any further Zoom in out button Zoom in sets the time scale to 2 hours with time centered at the cursor position The
184. ing inspection should be corrected and or reported to Respironics before using the ventilator Using the packing list that accompanies the ventilator take an inventory of the entire shipment before assembling the ventilator In case of discrepancies immediately contact Respironics Customer Service at 1 800 345 6443 The Esprit V200 Ventilator Service Manual P N 580 1000 02 is available for qualified personnel It includes block diagrams components parts lists descriptions calibration instructions and other information that will assist appropriately qualified personnel to repair those parts of the equipment that are designated by the manufacturer as repairable For more information contact Respironics Customer Service at 1 800 345 6443 4 2 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 4 Getting Started NOTE We recommend that before using the ventilator for the first time wipe the exterior clean and disinfect or sterilize its components according to the instructions in Chapter 10 Care and Maintenance or the component manufacturer s instructions Repac king Should the ventilator need to be returned to Respironics for servicing or shipped elsewhere for any reason instructions for repacking are listed below The following instructions should be followed closely to avoid damage to the ventilator WARNING One person alone should not attempt to lift the ventilator or remove it from the shipping carto
185. ings screen Pt Leak is updated with each breath Bias flow through the patient circuit is adjusted according to the estimated leak and is quantified as follows REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 121 Chapter 13 Options and Accessories e For adult patients Bias flow 2 Pt Leak 5 LPM For pediatric patients Bias flow Pt Leak 3 LPM Patient flow is estimated as the delivered flow Bias flow during exhalation minus the estimated Leak Flow minus the measured expiratory flow flow through the exhalation valve e Patient flow Delivered flow Leak flow measured expiratory flow The estimated Leak Flow value in the above equation differs from the Patient Leak value defined earlier Leak Flow is the estimated leak at a given moment in time and is dependent upon pressure the higher the pressure the higher the leak flow and the physical characteristics of the leak itself The Patient Leak value is the average Leak Flow over an entire breath When Auto Trak is selected in NPPV mode the estimated exhaled tidal volume includes compensation for the estimated leak volume lost during exhalation Therefore all other parameters that depend on exhaled tidal volume also include this compensation for example minute ventilation and rapid shallow breathing index F Vt If the Graphics Option is enabled waveforms and loops displayed in NPPV mode will show estimated flows and volumes that include compensatio
186. internal RF Emissions CISPR 11 Group 1 function Therefore its RF emissions are very low and are not likely to cause interference in nearby electronic equipment RF Emissions CISPR 11 Class A The ventilator is suitable for use in all CNET TEE EK TAE establishments including domestic Class A establishments and those directly connected to IEC 61000 3 2 l the public low voltage power supply network that Voltage fluctuations flicker Complies supplies buildings used for domestic purposes emissions IEC 61000 3 3 p Table 12 26 EMC Declaration Emissions 12 12 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 12 Technical Specifications Guidance and Manufacturer s Declaration Electromagnetic Immunity The ventilator is intended for use in the electromagnetic environment specified below The user of the ventilator should assure that it is used in such an environment Immunity Test IEC 60601 Test Level Compliance Level Electromagnetic Environment Guidance Electrostatic Discharge ESD IEC 61000 4 2 6kV contact 8kV air 6kV contact t 8kV air Floors should be wood concrete or ceramic tile If floors are covered with synthetic material the relative humidity should be at least 30 Electrical Fast Transient burst 2kV for power supply lines 2kV for power supply lines Mains power quality should be that of a typical hospital environment IEC 61000 4 4 1kV
187. ion Available The Pressure or Flow values that previously appeared in the I Trigger and E Trigger windows are removed Figure 13 73 and Figure 13 74 Figure 13 73 Sample Inspiratory Trigger Window with Auto Trak Option Selected Pressure is not an available option for NPPV REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 119 Chapter 13 Options and Accessories Figure 13 74 Sample Expiratory Trigger Window with Auto Trak Option Selected 3 Touch the Accept button The ventilator does not begin using Auto Trak until you touch the Accept button The Settings screen now displays Auto as the I Trigger and E Trigger settings Figure 13 75 Figure 13 75 Settings Window with Auto Trak Selected 13 120 Respironics V200 Ventilator Operator s Manual REF 1057983 A Turning Auto Trak Off Triggering and Cycling with Auto Trak Leak Detection and Compensation Chapter 13 Options and Accessories l Touch either the I Trigger or E Trigger button in the Settings screen Figure 13 70 The I Trigger or E Trigger window will appear as shown in Figure 13 73 or Figure 13 74 2 Change the I Trigger setting to Pressure or Flow or change the E Trigger setting to Peak Flow When you change the I Trigger setting to Pressure or Flow the E Trigger reverts to the most recently selected 96P eak Flow value Similarly when you change the E Trigger setting to Peak Flow the I Trigger reverts to the most rec
188. ion throughout the lungs Same as Plateau pressure Intermittent Mandatory Ventilation IMV a mode of ventilatory support that allows spontaneous breathing in between mandatory breaths from the ventilator Mandatory Breath a breath whose inspiratory flow and or pressure is under the control of the ventilator Manual Breath a breath initiated by the operator Mean Airway Pressure MAP the average over one inspiration exhalation cycle The value displayed is the average of this calculation over one minute The display is updated at the end of each exhalation Medical gas a gas that has been refined and purified according to specifications in the United States Pharmacopoeia USP intended for human use in the diagnosis or treatment of disease Millisecond msec one thousandth of a second Minute Ventilation VE the total amount of gas moving out of the lungs during 1 minute Noninvasive pertaining to a diagnostic or therapeutic technique that does not require the skin to be broken or a cavity or organ of the body to be entered Mechanical ventilation via mask nasal prongs or mouthpiece Peak Inhalation Pressure PIP the greatest airway pressure during an inspiratory cycle no matter what the breath type The pressure is measured at the exhalation valve and the new data is displayed at the beginning of exhalation Plateau Pressure Plateau the pressure measured at the end of exhalation on every breath The display is updated at t
189. is an infrequent event REF 1057983 A Respironics V200 Ventilator Operator s Manual 11 11 Chapter 11 Diagnostics This page is intentionally blank 11 12 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 12 Technical Specifications Breath Types Breath Types Volume Controlled Ventilation VCV Pressure Controlled Ventilation PCV Non Invasive Positive Pressure Ventilation NPPV Apnea Ventilation Table 12 1 Breath Types Modes Modes Assist Control A C VCV PCV SIMV VCV PCV CPAP VCV PCV Spont T NPPV Spont NPPV Table 12 2 Modes Volume Ventilation Resolution is one unit unless otherwise noted cmH0 is considered Settings Ranges and numerically equivalent to hPa Resolution Volume Ventilation Settings Ranges amp Resolution Setting Respiratory Rate Range 1 to 80 Bpm Tidal Volume 50 to 2500 mL Peak Inspiratory Flow 3 to 140 Lpm Compliance compensated actual to 200 Lpm PEEP 0 to 35 cmH50 hPa PSV Pressure 0 to 100 cmH50 hPa Table 12 3 Volume Ventilation Settings Ranges and Resolution Sheet 1 of 2 REF 1057983 A Respironics V200 Ventilator Operator s Manual 12 1 Chapter 12 Technical Specifications Volume Ventilation Settings Ranges amp Resolution Continued Setting Range Inspiratory Trigger I trigger Pressure Sensitivity 20 to 0 1 cmH 0 hPa Resolution is 0 1 cmH 0 hPa Flow Sensitivity 0 5 to 20
190. ith the ventilator include an acceptable temperature control and monitoring mechanism as well as a temperature display and appropriate alarm capabilities refer to ISO 8185 CAUTION To avoid the possibility of damage to the ventilator do not connect a humidifier whose maximum rating exceeds 3 amps Ensure that the humidifier power cord is free from defects and any obvious wear and is properly grounded A humidifier connection is only available on 100 120VAC ventilators 9 Circuit Breaker Cover Circuit breaker cover not shown protects the Humidifier AC Circuit Breaker and Mains Circuit Breaker switches 10 Mains Circuit Breaker Circuit breaker for main AC circuit 11 Humidifier AC Outlet Connection for Humidifier AC power cord 12 Air Inlet Duct and Filter Filters room air drawn into the ventilator internal air source 13 Elapsed Time Meter Records time when the Power On Off Switch is on 14 0 Inlet Connector Connection for oxygen hoses 15 O Inlet Filter and Water Trap Filters oxygen entering the ventilator 16 Potential Equalization Connection Common grounding point 17 Cooling Fan Inlet Allows cooling air to enter the ventilator 5 2 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 5 Setup NOTE All volumes entered into the ventilator are assumed to be BTPS Body Temperature atmospheric Pressure Saturated with H5O volumes unless otherwise noted All volumes reported by the ventil
191. ithin 20 seconds of starting maneuver Maneuver cancelled by alarm condition Alarm condition occurs after maneuver Chapter 13 Options and Accessories Temporarily Disabled Alarms Low Exhaled Minute Volume Low Exhaled Mandatory Tidal Volume High Exhaled Minute Volume Low Exhaled Spontaneous Tidal Volume Low PEEP begins MIP Measurement out of range All patient alarms and the Low O2 Measured pressures exceed 100 to 200 alarm are disabled during the MIP cmH50 maneuver MIP unavailable due to alarm condition Alarm condition exists when maneuver requested Maneuver timed out MIP button held down for 30 seconds since starting maneuver Table 13 8 Respiratory Mechanics Error Messages and Alarms REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 59 Chapter 13 Options and Accessories Maneuver P0 1 Error Messages Temporarily Disabled Alarms Measurement out of range None all alarms are active during Measured pressures exceed 100 to 200 the P0 1 maneuver cmH50 P0 1 unavailable due to alarm condition Alarm condition exists when maneuver requested Maneuver cancelled Operator presses Stop button and no P0 1 maneuver breaths performed Maneuver cancelled by alarm condition Alarm condition occurs after maneuver begins Maneuver timed out One minute elapses with no P0 1 maneuver breaths performed Table 13 8 Respiratory Mechanics Error Messages and Alarms 13 6
192. ivating Speaking Mode NOTE Speaking Mode is available ONLY in invasive ventilation mode Patient Preparation Using Speaking Mode on a patient requires preparation before activating the mode Refer to the Sequence for Use diagram in Figure 13 58 and follow the necessary steps before starting Speaking Mode and discontinuing Speaking Mode The Speaking Mode Clinical Guide describes patient care steps in detail WARNING X Read and understand these Speaking Mode Option instructions before using Speaking Mode on a patient WARNING Wait at least 72 hours after a tracheostomy before initiating Speaking Mode 13 104 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories A Tracheosto mized patient ventilated in PSV PCV VCV SIMV C PAP mode assessment FAIL gt ETE A v PASS v Baseline clinical parameters v O bserve patient settings v Monitor with pulse oximeter v Instruct patient v Suction oral airway and tracheostomy tube v Position patient v D eflate cuff v Activate Speaking Mode on the ventilator Y pA airwa FAIL patency Y PASS FAIL Monitor patient Encourage speech 44 PASS Y Discontinue Speaking Mode Y Check ventilator Procedure E M gt gt Inflate cuff settings and al
193. l Respironics California Inc Cartsbad CA USA Model V200 P N XXXXXXX S N XXXXXXXXX Date of Manufacture M anufacturer Label t 1059179 REV A D 82211 Herrsching 0086 7 Germany c us MADE IN THE U S A IPX 1 Covered by one or more of the following patents 6 543 449 Other patents pending Manufacturer Label WARNING Lamps in display contain mercury Dispose of properly Mercury disposal warning label DANGER Explosion Hazard Do not use in the presence of flammable anesthetics WARNING Do not disassemble Refer servicing to qualified personnel CAUTION Read and understand operating instructions prior to use CAUTION Federal law USA restricts this device to sale by or use on the order of a physician Warning Label Attention Label AA Hot and Attention Label REF 1057983 A Respironics V200 Ventilator Operator s Manual 12 19 Chapter 12 Technical Specifications Ventilator Labels Continued Air Intake Label WARNING Air Intake Do Not Obstruct Protective Earth Ground Label 12 20 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Introduction This chapter lists and describes the Respironics V200 ventilator options and accessories Options and Accessories Page Part Number Software
194. l O5 sensor is installed ensure it is not dislodged When used O sensor is located between gas outlet 4 and filter 3 3 Insert new filter onto the gas outlet 4 with flow direction indicator on the filter pointing away from the ventilator 4 Reconnect circuit tubing 1 to new filter outlet 2 Removing and Replacing Expiratory Bacteria Filter Refer to the illustration below and follow the steps outlined below to remove and replace the expiratory bacteria filter WARNING The expiratory filter housing may be hot if removed from the ventilator immediately after use Wait 15 minutes after turning off ventilator power before removing the heated expiratory bacteria filter Exercise caution when handling the filter housing REF 1057983 A Respironics V200 Ventilator Operator s Manual 10 5 Chapter 10 Care and Maintenance e W N HL 8 9 Figure 10 3 Removing and Replacing Expiratory Bacteria Filter Disconnect circuit tubing from filter inlet not shown Unscrew knob 1 to unlatch retaining bracket 2 Open retaining bracket 2 Use tabs 3 to gently remove heater housing 5 and filter 4 from the ventilator Do not touch heater housing If ventilator has not been turned off and heater housing has not been allowed to cool it may be hot to the touch Carefully remove filter 4 from heater housing 5 Tap filter input port 6 if filter 4 cannot be easily removed from housing 5 Insert new filt
195. lam 099999 1 0 35 cmH 70 Limit Setting hPa VCV Low Mandatory 000000 1 0 2500 mL Tidal Volume Alarm Limit Setting VCV Low Spontaneous 000004 1 0 2500 mL Tidal Volume Alarm Limit Setting VCV High Respiratory 15000 1 0 150 BPM Rate Alarm Limit Setting VCV Low Minute 1 000 0 01 for 0 00 60 0 L Volume Alarm Limit 0 00 to 9 99 Setti 0 1 for 10 0 etting to 60 0 VCV Apnea Interval 200000 1 10 60 sec Alarm Limit Setting PCV Mode Setting AICOO N A AICOO N A SIMVO CPAP O PCV Patient Type ADULTe N A ADULT PEDOO NEO oo PCV Respiratory Rate 12000 1 1 150 BPM Setting PCV Pressure Setting 200000 1 5 100 cmH 50 hPa Table A 1 Ventilation Report Sheet 2 of 10 REF 1057983 A Respironics V200 Ventilator Operator s Manual Appendix A 3 Appendix A RS 232 Communications Protocol Ventilation Report Continued Description Example Resolution Range Units Comments PCV Inspiratory Time 1 000 0 01 0 1 9 9 sec Setting PCV PEEP Setting 099999 1 0 35 cmH50 hPa PCV Pressure Support 00000 1 0 100 cmH50 Setting hPa PCV I Trigger Type PRESSe N A PRESS N A FLOWS e AUTO PCV Pressure I Trigger 2 000 0 1 0 1 20 0 cmH 0 Setting hPa PCV Flow I Trigger 3 0000 0 1 0 3 20 0 LPM Setting PCV E Cycle Type 96 FLOWe N A FLOW N A AUTO PCV Flow Expiratory 25000 1 10 80 Cycle Setting PCV Rise Time 0 1999 0 1 0 1 0 9 sec PCV Oxygen 219999 1 21 100 Conc
196. last field in the string is the stop code 0x03 Non Invasive Positive Pressure Ventilation Settings Report Description Example Resolution Range Units Comments Command Name NPVS N A N A N A Number of characters 168 N A N A N A 3 character field between the start and stop codes Number of fields 23 N A N A N A 2 character field between the start and stop codes Start Code 0x02 N A N A N A ASCII Start Transmission Character STX Time of request 13 45 N A N A N A 24 hour clock hh mm Date FEB 2301997 N A N A N A 12 character field MMM DD YYYY Current Ventilation vcveee N A vcveee N A The ventilation Type PCVOOe type currently NPPVee being used by the ventilator Table A 4 Non Invasive Positive Pressure Ventilation Settings Report Sheet 1 of 3 Appendix A 16 Respironics V200 Ventilator Operator s Manual REF 1057983 A Appendix A RS 232 Communications Protocol Non Invasive Positive Pressure Ventilation Settings Report Continued Description Example Resolution Range Units Comments NPPV Mode Setting SPONT T N A SPONT T SPONTee NPPV Patient Type ADULT N A ADULT PEDOO NEO OO NPPV Respiratory 120000 1 1 80 BPM Rate Setting NPPV EPAP Setting 599999 1 2 25 cmH50 hPa NPPV IPAP Setting 599999 1 2 35 cmH50 hPa NPPVInspiratoryTime 1 099 0 1 0 1 9 9 Sec Setting NPPV Rise Time 0 1999 0 1 0 1 0 9 Sec NPPV I Trigger Type F
197. lected state the button has a gray background and black letters see PCV SETTINGS and NPPV SETTINGS in Figure 8 11 In the upper bar the buttons PATIENT DATA ALARM SETTINGS and MONITOR are also the selected not selected type When one of these selected not selected buttons is selected it indicates that the screen is being used to display the information described by the name of the button on the screen Making a setting screen selected for a breath type that is not active is the first step to activate that ventilation breath type Refer to Selecting a New Ventilation Breath Type VCV PCV or NPPV on page 8 23 8 12 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 8 Operating Instructions Figure 8 12 shows the real time manometer displays Waveform airway pressure Indicator versus time e we Active Upper limit of 420 real time display 21 i High pressure determined by alarm setting High Pressure O O press this button alarm setting Sec to modify HIP 1 BPM e 2 Mand Zero pressure h line Assist Q HIP Plate u s b Support has Spont vai 0 0 bai Exhale 20 Breath Indicator Manometer with Waveform Manometer only for mode setting screens Figure 8 12 Manometer common to operational screens Table 8 5 Breath Indicator describes the breath indicator Breath Indicator Breath Symbol Description Mand o Operator or ventil
198. leeve connector Remote alarm NO Ring connector amp cable NC Tip Common Sleeve Figure 6 2 Remote Alarm Port The port is configured to work with the Normally Open NO Normally Closed NC and Respironics LifeCare systems Each requires specific cabling identified in Table 6 1 6 2 Respironics V200 Ventilator Operator s Manual REF 1057983 A Connecting Humidifier Chapter 6 Connecting Additional Equipment Remote Alarm Cable Kits System Part Number Remote Alarm Cable Kit Normally Open Protocol 1003741 Remote Alarm Cable Kit Normally Closed Protocol 1003742 Remote Alarm Cable Kit Respironics LifeCare 1003743 Table 6 1 Remote Alarm Cable Kits WARNING Use only Respironics approved cables when connecting to the remote alarm port Be sure to fully insert the cable into the remote alarm port and into the remote alarm WARNING When using the Remote Alarm Port be sure to fully test the Remote Alarm Port and cable by Verifying that annunciated alarms on the ventilator are also annunciated on the remote alam Verifying that disconnecting the cable from the Remote Alarm port results in an alarm notification at the Remote Alarm Verifying that disconnecting the cable from the remote alarm results in an alarm notification at the Remote Alarm CAUTION The remote alarm port is intended to connect only to SELV safety extra low voltage and ungrounded system with basic ins
199. low an operator set percentage of the peak flow during this breath During Pressure Support the patient determines the respiratory rate and the patient and ventilator determine the inspiratory time and tidal volume Refer to Figure 7 4 Pressure Pressure Support Setting p Baseline Pressure Patient Initiated Breath Figure 7 4 Pressure Support Ventilation PSV 7 4 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 7 Operating Theory Positive End Expiratory Pressure PEEP The PEEP pressure is the operator set baseline pressure maintained during exhalation All breaths are referenced to this baseline pressure and the resulting pressure is in addition to the baseline pressure Refer to Figure 7 5 Pressure PEEP ia Baseline or PEEP Pressure Time Figure 7 5 Positive End Expiratory Pressure PEEP Rise Time Setting Rise Time applies to all pressure targeted breaths PSV PCV and IPAP in NPPV The operator can adjust the velocity of pressurization to better match the patient s demand for flow Refer to Figure 7 6 J Rise Time Pressure Rise Time il PCV Pressure Pressure Support Breath Pressure Control Breath Baseline Pressure Time Figure 7 6 Rise Time Patient Initiated Breath Triggering Patient initiated breaths can be flow or pressure triggered in A C SIMV CPAP for Pressure or Volume breath types or flow triggered in NPPV The pressure trigg
200. lue Inhalation Pressure uA i hPa from the Patient md 9 Data screen Measured Tidal 468999 1 0 2500 mL The Tidal Volume Volume value from the Patient Data screen Measured 0 00 0 01 for 0 00 60 0 L The Spont VE value Spontaneous Minute i id from the Patient Volume to dod Data screen Measured Minute 5 830 0 01 for 0 00 60 0 L The Total VE value Volume d from the Patient to 00 i Data screen Measured 0 0000 0 1for0 0 0 0 150 BPM The Spont Rate Spontaneous Breath to 9 9 value from the 1 for 10 to Rate 150 Patient Data Screen Measured Total Breath 12 09 0 1 for 0 0 0 150 BPM The Total Rate Rate x S l value from the ise 9 Patient Data Screen Measured Rapid 5 OOOO 1 0 500 BPM L TheF Vt value from Shallow Breathing Index Table A 1 Ventilation Report Sheet 5 of 10 the Patient Data screen Appendix A 6 Respironics V200 Ventilator Operator s Manual REF 1057983 A Appendix A RS 232 Communications Protocol Ventilation Report Continued Description Example Resolution Range Units Comments Measured I E Ratio 1 4 1 0 1 for9 9 1 4 1 1 1 99 N A The I E Ratio iUe display from the 199 Patient Data Screen Measured Patient 0 06999 0 1 for 0 0 0 0 140 LPM The Pt Leak Leak to 99 9 display 1 for 100 to 140 Measured Percent of 56 2 0 1for0 0 0 0 100 96 The Pt Trigger Breaths Triggered by to 99 9 display on the the Patient NPPV E NPPV Monitor Spont T mode only Screen oth
201. luminated Table 8 4 Front Panel Controls 8 10 Respironics V200 Ventilator Operator s Manual REF 1057983 A Ventilator Screens Chapter 8 Operating Instructions Front Panel Touch Display The front panel display allows you to select ventilation modes breath types settings alarms and access patient data The front panel display is a touch screen that lets you select settings and data so you can monitor the status of the patient ventilator and control ventilator operation There are two different categories of screens e Ventilator Screens that appear when the machine is functioning as a ventilator Diagnostic Screens that appear when the machine is not functioning as a ventilator and is running internal tests Refer to Chapter 11 Diagnostics for more information about displaying ventilator diagnostic information Common Ventilator Screen Components Except for the patient data screen screen configurations are determined by the selected ventilation breath type Figure 8 9 shows the elements that are common to all ventilator non diagnostic screens the top bar bottom bar and manometer Pac sw eene IN r1 o fo Cm Hos 00 Manometer Bottom Bar Figure 8 9 Elements Common to All Operational Screens VCV settings shown REF 1057983 A Respironics V200 Ventilator Operator s Manual 8 11 Chapter 8 Operating Instructions Figure 8 10 shows the top bar and describes its bu
202. lution summarizes the definitions display ranges and resolution for patient data parameters Active Mode VCV CPAP Patient Data Alarm Settings Monitor Rate Spont Rate 8 BPM Total Rate 19 FMt 97 E Ratio Spont O Exhale Waveforms Trending Figure 8 33 Patient Data Screen Patient Data Definitions Range Units amp Resolution Parameter Description Display Range Resolution PIP Peak Inspiratory Pressure 20 0 to 130 0 1 for 20 0 to The maximum airway pressure cmH50 hPa 99 9 during inspiration 1 for 100 to 130 MAP Mean Airway Pressure 20 0 to 120 0 1 for 20 0 to The average of airway pressure cmH50 hPa 99 9 during one full breath cycle 1 for 100 to 130 Pe End Pressure at End Expiration 20 0t099 9 0 1 The pressure measured at the cmH50 hPa end of expiration Pi End Pressure at End Inspiration 20 0 to 130 0 1 for 20 0 to The pressure measured at the cmH O0 hPa 99 9 end of inspiration or at the end 1 for 100 to 130 of Insp Hold if it is gt 0 Tidal Vol Exhaled Tidal Volume 0 to 9999 ml 1 The volume exhaled at each BTPS breath Compliance compensated if enabled Table 8 7 Patient Data Definitions Range Units amp Resolution Sheet 1 of 2 8 28 Respironics V200 Ventilator Operator s Manual REF 1057983 A Monitor Screen Chapter 8 Operating Instructions Patient Data Definitions Range Units amp Resolution Continued
203. lve Cracking Flow Not Stable 3122 Pressure Relief Valve Cracking Pressure Too Low Table 11 1 Diagnostic Codes and Descriptions Sheet 2 of 4 REF 1057983 A Respironics V200 Ventilator Operator s Manual 11 7 Chapter 11 Diagnostics Diagnostic Codes and Descriptions Continued Code Description 3123 O Valve Cracking Flow Outside Range 3124 O Valve Full Flow Outside Range 3125 AirFlow Sensor Exh Flow Sensor Disagreement or Inhalation Pressure Exhalation Pressure Disagreement 3126 Op Flow Sensor Exh Flow Sensor Disagreement 3127 Heated Filter Backpressure Out of Range 3128 Circuit Compliance Out of Range 3129 Pressure Leak Out of Range 3130 Safety Valve Cannot Open 3131 Patient Wye Not Blocked 3132 keyboard Failure 3133 Rotary Knob Failure 3134 Cannot Calibrate Air Flow Sensor 3135 Cannot Calibrate O Flow Sensor 3136 Cannot Calibrate Exh Flow Sensor 3137 Verify Failure Air Flow Sensor Cal 3138 Verify Failure O Flow Sensor Cal 3139 Verify Failure Exh Flow Sensor Cal 3140 Cannot Erase Flow Sensor Tables 3141 Cannot Open Inh Autozero Solenoid 3142 Cannot Open Exh Autozero Solenoid 3143 AirStep Position for Open Outside Range 3144 AirStep Position for Midpoint Outside Range 3145 Air Step Position for Close Outside Range 3146 0 Step Position for Open Outside Range 3147 Op Step Position for
204. lve Defective exhalation valve VALVE Stuck Open STUCK REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 35 Chapter 13 Options and Accessories Available CMS V200 ae message equivalent Seduta CareNet X HIGH INT High Temperature within ventilator enclosure exceeds TEMP Temperature maximum limit X HIGH INT High Internal Oxygen concentration within ventilator enclosure 02 02 exceeds maximum limit NOTE The following alarm messages are not displayed on the CMS Bad ERROR ADCWrap Sensor Bad Bat Service Due Volt Sensor Bad Int Using Default Altitude O2 Sensor Bad Int Using Default Compl Temp Sensor Battery Using Default Settings Charging Analog Output C hart The Communications Print option enables the ventilator to send ventilator data Rec order to a chart recorder or similar device using the analog output port Data displayed via the chart recorder is for reference purposes only Decisions for patient care should not be based solely on the data displayed via the chart recorder Table 13 3 summarizes the Analog Output pinout Respironics V200 Ventilator Analog Output Port Pinout Pin Number Signal 1 Flow signal return 2 Volume signal return 3 Pressure signal return 4 Alarm signal return 5 Nebulizer signal return 9 Flow 0 V 2 200 LPM 5 V 2200 LPM 10 Volume 0 V 2 0 ml 5 V 22500 ml 11 Pressure 0 V 2 20 cmH50 5 V 2 120 cmH50
205. ly followed by steam autoclave Follow all institutional guidelines for autoclaving Visually inspect tubing for nicks cuts and holes prior to use with the ventilator Reusable In line Water Traps Disassemble and clean water traps as per the manufacturers instructions Inspect for cracks or leaks prior to use with the ventilator Replace if cracked or leaking Bacteria filters are typically used on the inspiratory and expiratory port connections on the front of the ventilator Filter locations are illustrated below Expiratory Filter Inspiratory Filter Figure 10 1 Inspiratory and Expiratory Bacteria Filter Locations The inspiratory filter port is a 22mm standard connector Use the filter supplied with the ventilator The expiratory port includes a heated exhalation compartment Use the filter supplied with the ventilator WARNING Disposable or single patient filters must be discarded between patients Do not chemically disinfect or expose single patient use bacteria filters to ETO gas Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 10 Care and Maintenance Removing and Replacing Inspiratory Bacteria Filter Follow the steps outlined below to remove and replace the inspiratory bacteria filter Figure 10 2 Removing and Replacing Inspiratory Bacteria Filter 1 Disconnect circuit tubing 1 from inspiratory bacteria filter outlet 2 2 Disconnect filter 3 from the gas outlet 4 If optiona
206. m Status NORMAL N A NORMAL N A Low O gt ALARM concentration RESETe Low Minute Volume NORMAL N A NORMAL N A Alarm Status ALARM RESETe Low Mandatory Tidal NORMAL N A NORMAL N A Volume Alarm Status ALARMe RESETe High Minute Volume NORMAL N A NORMAL N A Alarm Status ALARM RESET Low Tidal Volume NORMAL N A NORMAL N A Alarm Status ALARMe RESETe Low Spontaneous NORMAL N A NORMAL N A Tidal Volume Alarm ALARMe Status RESETe I Time Too Long Alarm NORMAL N A NORMAL N A Status ALARM RESET High Respiratory Rate NORMAL N A NORMAL N A Alarm Status ALARM RESET High O Alarm Status NORMAL N A NORMAL N A ALARM RESET High Enclosure NORMAL N A NORMAL N A Temperature Alarm ALARM Status RESET High Internal Oxygen NORMAL N A NORMAL N A Concentration Alarm ALARM Status RESET Low PEEP Alarm NORMAL N A NORMAL N A Status ALARM RESET Table A 1 Ventilation Report Sheet 9 of 10 Appendix A 10 Respironics V200 Ventilator Operator s Manual REF 1057983 A Volume Control Ventilation Settings Report VCVS Appendix A RS 232 Communications Protocol Ventilation Report Continued Description Example Resolution Range Units Comments Low EPAP Alarm NORMAL N A NORMAL N A Status ALARM RESET High Leak Alarm NORMAL N A NORMAL N A Status ALARM RESET 100 O Function OFFeee N A ON OO N A Status of the Status OFF Ooo 100 O5 LED on the front panel Alarm Silence Status OFF
207. m messages appear in the front panel Alerts window When more than one alarm is active only the highest urgency level alarm is audibly annunciated Procedures for silencing audible alarms are described below Alarm Silence To silence alarms perform the following e Press the ALARM SILENCE key on the front panel The audible tone will cease and the alarm silence indicator will illuminate and remain lit for two minutes Specific alarms that cannot be silenced are listed in Table 9 1 Alarm Alert Messages When ALARM SILENCE is pressed before the end of the two minute period the two minute timer is reset and alarm silence begins anew Pressing ALARM SILENCE multiple times does not give multiple two minute silence periods If new alarms occur during alarm silence all visual alarm annunciation continues If the Alerts insert is not present it will appear The message for any alarms that occur during the alarm silence period will appear in the Alerts insert if there are fewer than three messages currently displayed or the new 9 2 Respironics V200 Ventilator Operator s Manual REF 1057983 A Alarm Reset Chapter 9 Alarms message is higher priority than one of the currently displayed messages The highest three priority messages will be displayed ALARM SILENCE is immediately terminated if ALARM RESET is pressed Any medium or high priority alarm that is active will immediately begin audible annunciation CAUTION The ventil
208. may result in increased EM emissions or decreased immunity of the system 13 2 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Oxygen Sensor Option The optional Oxygen sensor O sensor may be installed to allow monitoring of delivered O to the inspiratory limb of the patient circuit The ventilator will accept the MSA MiniOX O and Analytical Industries Inc sensors P N 1001454 g Bs Figure 13 1 O Sensor exploded view Assemble 0 Sensor Refer to Figure 13 1 for the following instructions MSA MiniOX 0 1 Remove the O sensor a from the package Discard the o ring and adapter not shown provided with the sensor 2 Place flat gasket b into the threaded hole of the Oz Sensor Tee c 3 Screw the O sensor b into the O sensor tee c Insert one end of the O5 sensor cord d into ventilator Insert other end of O sensor cord d into the sensor Fasten each end with knurled collars Analytical Industries Inc 1 Remove the O sensor a from the package 2 Screw the O sensor b into the Oz sensor tee c 3 Insert one end of the O sensor cord d into ventilator Insert other end of O5 sensor cord d into the sensor Fasten each end with knurled collars REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 3 Chapter 13 Options and Accessories Attaching the Sensor The O sensor attaches to the gas outlet port located bel
209. mines how inspiratory effort is detected by measuring a drop in airway pressure or an increase in patient inspiratory flow and when inspiration begins n VCV and PCV you can select a pressure or flow I Trigger n NPPV the I Trigger is always Flow Follow these steps to set the I Trigger 1 Push the VCV SETTINGS PCV SETTINGS or NPPV SETTINGS button 2 Push the I TRIGGER button The inspiratory trigger window insert Figure 8 21 appears 3 In VCV and PCV select Pressure or Flow Because only the flow trigger is available in NPPV the Pressure and Flow buttons do not appear in this insert in NPPV 4 Adjust and change the value as described above You can select Pressure or Flow in VCV or PCV In NPPV only Flow l Trigger is available these buttons do not appear Inspiratory Trigger Increase 20 LPM Decrease 05 Cancel Accept Figure 8 21 Inspiratory Trigger Window Settings with Calculated Values Certain window inserts that are used to modify values of settings can also have calculated results in them Figure 8 22 When the settings window insert being displayed is VCV Rate the calculated minute volume that results from the rate and tidal volume settings is displayed along with the rate value This is also the case when the tidal volume setting window insert is displayed When the setting window insert for PCV Rate is REF 1057983 A Respironics V200 Ventilator Operat
210. mmended separation distance d in meters m can be determined using the equation applicable to the frequency of the transmitter where P is the maximum output power rating of the transmitter in watts W according to the transmitter manufacturer NOTE 1 At 80 MHz and 800 MHz the separation distance for the higher frequency range applies NOTE 2 The ISM industrial scientific and medical bands between 150 kHz and 80 MHz are 6 765 MHz to 6 795 MHz 13 553 MHz to 13 567 MHz 26 957 MHz to 27 283 MHz and 40 66 MHz to 40 70 MHz NOTE 3 An additional factor of 10 3 is used in calculating the recommended separation distance for transmitters in the ISM frequency bands between 150 kHz and 80 MHz and in the frequency range 80 MHz to 2 5 GHz to decrease the likelihood that mobile portable communications equipment could cause interference if it is inadvertently brought into patient areas NOTE 4 These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people Table 12 29 EMC Declaration Recommended Distances 12 16 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 12 Technical Specifications Pneumatic System Internal Blower Inspiratory Module w SV and PRV Exhalation Valve Assembly Heated lt Exhalation From Patient Filter Assy SS 1 Expiratory Gas to Atmosphere System f
211. mpliance 3 Other more detailed service maintenance functions Calibration of inline Oxygen Sensor during EST only Some of these functions are discussed in detail in Chapter 12 Technical Specifications The functions of the Diagnostic Mode that are used to make the machine ready for use as a ventilator when it is first put into service are explained here REF 1057983 A Respironics V200 Ventilator Operator s Manual 5 5 Chapter 5 Setup Entering Diagnostic Mode 1 To access the Diagnostic Mode simultaneously press the ALARM RESET and 100 O keys on the front panel for approximately five seconds while turning the ventilator power on The following message will appear on the screen ca Figure 5 4 Warning in Diagnostic Mode 2 Press the OK button to enter the Diagnostic Mode The following screen appears Figure 5 5 Main Screen in Diagnostic Mode 5 6 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 5 Setup User Configuration The buttons across the top and bottom bars are used to select the Diagnostic Screen Mode functions To set up the machine for the first time for operation as a ventilator USER CONFIG should be selected When this button is pressed the following screen appears Figure 5 6 User Configuration Screen The User Configuration screen allows the operator to Set the date and time Activate or deactivate the automatic patient circuit compliance compensatio
212. mputations Dynamic Compliance Dynamic compliance is calculated using these equations Cr 2 n n n Yov Yo vv i 0 i 0 i 0 n n n 2 9 MF POI Y PTT i 0 i20 i 0 0 REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 65 Chapter 13 Options and Accessories Dynamic Resistance Dynamic resistance is calculated using this equation n n n n 2 Do T EFE i 0 i 0 i 0 i 0 n n 2 n You Yo Yv i 0 i 0 j 0 Where n Number of samples taken during for the calculation i Sample number Q Patient flow V Lung volume for the sample number Qa P Pressure sensor measurement for the sample number Static C and R Static C and R are calculated using these equations C Poplat Po P Pouf You e CR E rond Where 13 66 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories C The value of the combined compliance of the lungs and chest wall R The value of the combined resistance elements between the patient wye and the alveoli of the lungs V Lung volume Peplat End of plateau pressure Vplat Lung volume added during the plateau phase Qi eng Patient flow at the end of the delivery phase beginning of plateau phase Pg X Pressure at the start of inspiration Pg X Pressure at the end of inspiration REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 67 Chapter 13 Options and Accessorie
213. n A window at the bottom of the screen shows the time reflective of the cursor position Alarms are represented as active or inactive To see which alarm was active at a given time move the cursor to that time Up to three alarms that were active appear in the data display window They appear in order of priority Maneuvers display the value obtained when the maneuver was performed No data is displayed for times when the maneuver was not performed 13 74 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Cursor Begin Trending Time Cursor Time End Trending Time Figure 13 37 Changing Cursor Position on the Trending Screen Selecting the Time The selected time scale Figure 13 38 applies to all three waveforms on the Scale Trending screen To choose a different scale press the Time scale button a Time Scale pop up window allows you to select another scale Press the Cancel button to exit the pop up window without making changes or press Accept to select the new value and exit the pop up window The new value will appear on the time scale button NOTE If there is not enough recorded data to display a time scale then its respective button is grayed out REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 75 Chapter 13 Options and Accessories Using the 2 Hrs 2 Hrs buttons Using the Zoom Function Using the Rescale Button Grayed out button indi
214. n feature Set the proper altitude e Set 24 Hrs AM PM time display Activate or deactivate backup battery check at startup Date and Time The real time clock and calendar will last for approximately 2 5 years When the ventilator is received the clock s time will have to be changed to that of the existing time zone The date should be checked and changed if necessary Setting Date and Time Format To set time Figure 5 8 or date Figure 5 7 1 Press the desired date or time button month day year hour minute second 2 When the window insert appears press the INCREASE or DECREASE button or rotate the control knob to change the value of the selected parameter REF 1057983 A Respironics V200 Ventilator Operator s Manual 5 7 Chapter 5 Setup 3 Press the ACCEPT button to confirm the change and return to the User Config screen Press the CANCEL button to leave the value unchanged Window insert to change the value of Month Window insert to change the value of Hour Figure 5 8 Setting the Time After the date and time values have been set the changes will be shown on the screen Press the APPLY DATE and APPLY TIME buttons to activate the change 5 8 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 5 Setup Apply Date button Apply Time button Figure 5 9 User Configuration Screen After Date and Time are Set 6 The 24 HR CLOCK button allows the operator or technic
215. n for the estimated leak Exhaled tidal volume is leak compensated only in NPPV Leaks that may occur during invasive ventilation are intentionally not compensated for allowing them to be more easily detected 13 122 Respironics V200 Ventilator Operator s Manual REF 1057983 A Appendix A RS 232 Configuration Commands Transmitted to the Ventilator Transmission of Data from the Ventilator Ventilator Report Command and Response VRPT RS 232 Communications Protocol The ventilator will allow for the transmission of data from the ventilator via the RS 232 communications interface The ventilator receives commands from the remote device and responds with fixed format records The RS 232 communications port will be configured in the following manner for all communications functions Baud Rate 19 200 e Data Bits 8 e Parity None Stop Bits 1 Commands are transmitted as a series of four ASCII characters followed by a carriage return Valid commands will be stored and response transmissions will be sent in the order the corresponding commands were received Invalid commands will be returned in an error message Table A 7 Unrecognized Commands on page A 24 in sequence with all other commands Unless stated otherwise all fields will be left justified and six 6 characters in length A comma will separate each field Each data transmission shall be terminated with a carriage return In the following subpar
216. n of the front panel only Illuminates yellow to indicate backup battery CHARGING Symbol version of the front panel only Flashes red to indicate that the backup battery is LOW Symbol version of the front panel only MAINS battery indicator Symbol version of the front panel only EXTERNAL BATTERY is in use DANGEROUS VOLTAGE electrical shock hazard The portion of the circuit breaker that must be pushed in to turn the CIRCUIT BREAKER OFF Ojseguge ee The portion of the circuit breaker that must be pushed in to turn the CIRCUIT BREAKER ON o v d s ry CANADIAN STANDARDS ASSOCIATION approval DATE OF MANUFACTURE E MANUFACTURER Table 3 1 Symbols Sheet 3 of 5 REF 1057983 A Respironics V200 Ventilator Operator s Manual 3 3 Chapter 3 Symbols Symbols Continued Description The product must be disposed of in accordance with the WEEE directive SEALED NON SPILLABLE LEAD ACID BATTERY MUST BE RECYCLED SEALED NON SPILLABLE LEAD ACID BATTERY MUST BE RECYCLED RECYCLE THIS SIDE UP AT LEAST TWO PEOPLE ARE REQUIRED TO LIFT THE VENTILATOR TO AVOID POSSIBLE PERSONAL INJURY OR DAMAGE TO THE EQUIPMENT KEEP DRY 500 1060 hPa LIMIT TEMPERATURE TO BETWEEN 20 AND 60 4 AND 140 F T FRAGILE Table 3 1 Symbols Sheet 4 of 5 3 4 Respironics V200 Ventilator Operator s Manual REF 1057983 A Symbol y 10 95 Cha
217. n or the cart At least two people are required to avoid possible personal injury or damage to the equipment CAUTION Always ship the ventilator using the original packing material If the original material is not available contact your Respironics representative to order replacements Repacking Instructions Refer to Figure 4 1 gt e W N HR Ui 9 10 Tools Required Heavy duty packaging tape Open carton so that bottom foam insert is facing up Place backup battery in the bottom foam insert if it is being shipped Place center foam insert into box on top of the bottom foam insert If you are also shipping the flex arm place it in its box not shown and place the box in the bottom of the center foam insert Remove all power cords and accessory items from the ventilator Set the open ventilator shipping bag not shown in the box on the middle foam insert Gently place the ventilator into the open bag Check to ensure that the ventilator is firmly positioned into bottom foam insert Close plastic bag over the ventilator Replace accessories box not shown in the center foam insert beside the ventilator if also being shipped Place top foam insert onto ventilator Ensure snug fit Close top flaps of carton and seal with heavy duty packaging tape REF 1057983 A Respironics V200 Ventilator Operator s Manual 4 3 Chapter 4 Getting Started Ventilator Positioning For information about mounting the ventilato
218. n types of alarm conditions once the causes of the alarms are corrected After an automatic reset the ventilator will clear the audible alarm and will display a Low Urgency Alarm alert in the Alert Message Insert to inform the operator that an alarm condition existed When this situation occurs use ALARM RESET to clear the visual alarm indicator oy 100 0 Function Press once to deliver 100 O to the patient for two minutes Subsequent button presses will reset the timer to two minutes NOTE If the 10096 O key is pressed and a 10096 O gas source is not available the Low O alarm will be active for the two minute 100 O delivery period Indicator Illuminated green is active only when the 10096 O2 front panel button has been pressed and the ventilator is delivering 100 O to the patient remains on for the duration of 100 O delivery two minutes NOTE If the operator sets the 0 setting to 100 the 100 O indicator does not light The 100 O indicator only lights when the 100 O front panel key has been pressed Table 8 3 Front Panel Keys Sheet 2 of 3 REF 1057983 A Respironics V200 Ventilator Operator s Manual 8 9 Chapter 8 Operating Instructions Front Panel Keys Continued Key Symbol Definition Description Manual Function Delivers an operator initiated mandatory OIM breath Delivery Breath of the breath is based on the current ventilation breath type settings NOTE Manual breaths
219. nals a medium urgency condition If the Low EPAP alarm remains active for one minute the ventilator elevates the alarm to high urgency Note A Low EPAP setting of zero 0 will disable this alarm Note If an inspiration is triggered immediately after the mandatory minimum exhalation time of 200 msec this alarm will not be activated unless this condition occurs for three consecutive breaths Table 9 1 Alarm Alert Messages Sheet 2 of 4 Respironics V200 Ventilator Operator s Manual REF 1057983 A Alert Message Low Insp Pressure Chapter 9 Alarms Alarm Alert Messages Continued Description If the peak airway pressure during any mandatory inhalation is less than the Low Insp Pressure limit the ventilator will immediately signal a high priority alarm Note If an inspiration is triggered immediately after the mandatory minimum exhalation time of 200 msec this alarm will not be activated unless this condition occurs for three consecutive breaths Low Minute Volume Indicates the measured patient minute ventilation VE is below the set limit It is elevated to high urgency after one minute Note A Low Minute Volume setting of zero 0 will disable this alarm Low O5 A high urgency alarm indicates that the monitored O concentration is 18 or at least 6 below set value for 30 seconds Verify operation of the Oz sensor Alarm cannot be manually reset Low O Supply A high urgency alarm indicat
220. nector Plug the ventilator into an AC outlet Allow the backup battery to charge as required see Battery Charging on page 4 15 When charging is complete attach a patient circuit and turn the ventilator on in the diagnostics mode Select the User Config touch key and enable the Backup Battery confirmation feature refer to Chapter 5 Backup Battery Run SST refer to Chapter 11 Diagnostics After SST has been successfully completed exit the diagnostics mode and power up the ventilator in the normal ventilation mode While the ventilator is cycling unplug the AC power from the wall The ventilator should continue ventilation without interruption of any kind The ventilator should have the In Use indicator text version of front panel or the battery symbol q symbol version of the front panel on and a non silenceable non resettable audible alarm should sound every 60 seconds Backup Battery On is displayed while the ventilator consumes power from the backup battery Plug the AC wall power back in and the ventilator should continue ventilation without interruption of any kind REF 1057983 A Respironics V200 Ventilator Operator s Manual 4 13 Chapter 4 Getting Started Backup Battery Operation When the backup battery is attached and the Respironics V200 Ventilator is op erating in normal ventilation mode anytime there is a loss of AC power the ven tilator will automatically switch to
221. nel Front Dispay 8 11 Patient Initiated Breath Triggering 7 5 Patient Leak Display 7 6 Pediatric Patient Circuit Kit 13 2 Positive End Expiratory Pressure PEEP 7 5 POST 11 10 Power Cord 5 3 Power On Self Test POST 11 10 Power Status Indicators 8 6 Pressure Support Ventilation PSV 7 4 PVC O2 Sensor Tee Cannot be autoclaved 10 2 Cannot be chemically disinfected 10 2 R Restart 11 11 Alarm 9 8 Rise Time Setting 7 5 S Safety Valve Open 12 9 Safety Valve Ventilator Inoperative 8 5 Schedule for Periodic Maintenance 10 7 Screen Lock Key 8 8 Screen Locked 12 9 Self Test Hardware 11 10 Serial Port 5 1 SIMV 7 3 Software Options 13 1 Spont Rate 8 29 Spontaneous Respiratory Rate Spont Rate G 6 Spontaneous Volume Exhaled Spont VE G SST 11 3 Symbols 3 1 Synchronized Intermittent Mandatory Ventilation SIMV 7 3 T Table Top Mounting 4 4 Tidal Volume G 6 Time Format 5 7 Time Setting 5 7 Total Rate 8 29 Total VE 8 29 Touch Display 8 11 U Using Default Altitude Alarm 9 8 Using Default Compliance Alarm 9 8 Using Default Settings Alarm 9 8 V Ventilator Inoperative 12 9 Ventilator Inoperative Indicator 8 5 W Warnings 2 1 Warranty 13 5 B 1 Index 4 Respironics V200 Ventilator Operator s Manual REF 1057983 A
222. ng of active ventilation type Not used 9999 N A N A N A D Outputs examp value Not used 9999 N A N A N A Outputs example value Not used Not used 9999 9999 N A N A N A N A N A N A Outputs examp value D Outputs examp value D Not used 9999 N A N A N A Outputs examp value oO Not used 9999 N A N A N A Outputs examp value D Not used 9999 N A N A N A Outputs examp value oO Not used 9999 N A N A N A Outputs examp value D Not used 9999 N A N A N A D Outputs examp value Not used 9999 N A N A N A Outputs example value Not used 9999 N A N A N A Outputs example value Not used 9999 N A N A N A D Outputs examp value Measured end inhalation pressure 20 0ee 0 1 orl 0 0 99 9 100 130 cm H20 Outputs eese when Ventilation type is PCV or NPPV or Ventilation modeis CPAP or Spont or VCV Insp Hold setting 0 PCV Pressure Setting 100 e 1 5 100 cm H20 Table 13 4 Ventilation Report Sheet 8 of 10 Output 0 when VCV is active PCV Pressure when PCV is active eeeeee when NPPV is active REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 47 Options and Accessories
223. nit or individual parts which have been repaired or altered in any way that in Respironics judgement affect its ability or reliability or which has been subjected to misuse negligence abuse or accident Unauthorized service and or failure to perform periodic maintenance may void this warranty This warranty does not cover damage that may occur in shipment Warranty Limits This warranty takes precedence over all other warranties expressed or implied This warranty also takes precedence over all other obligations or liabilities on the part of Respironics including but not limited to contingent or consequential damages such as costs of repairing or replacing other property which may be damaged as a direct result of Respironics V200 operation This warranty and the rights and obligations described herein is construed under and governed by the laws of the State of California U S A REF 1057983 A Respironics V200 Ventilator Operator s Manual Appendix B 1 Appendix B Customer Service amp Warranty Options and Warranties are available for various options and accessories See the specific Accessories option or accessory in Chapter 13 for complete warranty information Appendix B 2 Respironics V200 Ventilator Operator s Manual REF 1057983 A Appendix C Alarm Testing Procedure The following procedure is available if the operator wants to test the operation of the following alarms We recommend following Preoperational P
224. nk Module Displayed parameters are determined by the ventilation mode selected on the ventilator Any time the mode of ventilation is changed the CMS will revert to the Standard Parameter Interface SPI screen Pressing the button on the VueLink Module will then activate the CMS screen with more ventilator information If any alarms are active alarm messages are also displayed The CMS can only display one patient alarm and one ventilator alarm called an inop on the CMS at a time Alarms are listed in order of priority as defined by the ventilator Data displayed on the VueLink system is for reference purposes only Decisions for patient care should not be based solely on the data displayed on the VueLink system Connecting to the VueLink Module The Communications option enables the ventilator to connect to a VueLink module using aVueLink cable Respironics part number 1006912 aVueLink module M1032A A02 for connection to devices using the open device driver contact Philips sales representative for ordering information Figure 13 25 shows how to connect a ventilator to a VueLink module REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 29 Chapter 13 Options and Accessories Configuring the Vuelink Module RS 232 Serial Port Analog Port Ventilator Back Panel VueLink cable VueLink module Figure 13 25 Connecting a Ventilator to a VueLink Module A VueLink Ventilator Module M1032A A
225. nly available on 100 120VAC ventilators 3 Press the Power ON OFF switch to the ON position left side up WARNING The ventilator front panel LEDs will indicate the power source that is being used If the ventilator is plugged in and the MAINS LED is not lit either the circuit breaker is off or the wall power outlet is not functioning Turning the Ventilator Off 1 Press the Power ON OFF Switch to the OFF 5 position right side up WARNING The two circuit breakers MAINS Humidifier located on the back of the ventilator are covered to prevent unintentional ventilator power off Do not use the circuit breaker to power the ventilator on off The power switch is located on the front of the ventilator below the front panel NOTE Unless the Mains Circuit Breaker is turned OFF electrical power is applied to the ventilator even though the front panel switch is in the OFF position With the Mains Circuit Breaker ON if the backup battery is connected the ventilator will charge the battery if it requires a charge NOTE To disconnect the ventilator from MAINS power remove the AC plug from the wall power receptacle The MAIN switch circuit breaker is covered to prevent unintentional ventilator turn off Entering Diagnostic The Diagnostic Mode is used for Mode 1 Running tests of the operation of the ventilator that can only be run when a patient is not attached to the machine 2 Setting altitude time and date and circuit co
226. nsion REF 1057983 A Respironics V200 Ventilator Operator s Manual 11 9 Chapter 11 Diagnostics Self Test Introduction The Respironics V200 ventilator has an extensive system of checks designed into the system to ensure that it operates safely and detects fault conditions that can compromise the performance of the system as a ventilator These checks include hardware that checks the integrity of the software and software that checks the hardware to ensure that it is operating within normal ranges These checks are described below Self Test Hardware The self test hardware involves hardware components that check the integrity of the software The hardware components that perform these checks are the watchdog timer and the bus activity monitor e Watchdog Timer The watchdog timer is a timer that the software must reset If the timer times out it causes a reset that restarts the ventilator as if the power switch had been turned on Normally the software resets the watchdog timer and it never times out Bus Activity Monitor The bus activity monitor is a timer similar to the watchdog timer The bus activity monitor timer is a timer that only times out if there has been no activity on the microprocessor bus If there is no activity on the bus it would indicate there is a malfunction of some kind and the microprocessor is restarted in the same way that the watchdog timer does Power On Self Test POST POST is the test that th
227. nt leak is not a precise measurement it can be used to trend relative changes in leak delivered volume Percent Leak Figure 13 55 Patient Data Screen With Leak REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 101 Chapter 13 Options and Accessories Patient Leak Values Patient Leak values as seen in the Patient Data window Figure 13 56 between 0 and 1 LPM are rounded values Refer to Chapter 7 Operating Theory for more information about Patient Leak Display Patient Leak Figure 13 56 Patient Data Window 13 102 Respironics V200 Ventilator Operator s Manual REF 1057983 A Warnings Cautions and Notes Chapter 13 Options and Accessories Speaking Mode Option The Speaking Mode software option for the Respironics V200 Ventilator allows tracheostomized adult and pediatric patients who meet certain criteria to vocalize without the need of a speaking valve The Speaking Mode software when activated closes the ventilator s exhalation valve keeping it closed during the expiratory phase This action redirects airflow around the deflated balloon cuff on the tracheostomy tube through the larynx and pharynx and out through the mouth As the air flow passes through the vocal cords speech is returned Speaking Mode provides pressure control and volume control in A C SIMV CPAP Pressure Support and in the Flow Trak ventilator option if enabled Speaking Mode is not available in NPPV mode Respi
228. ntilator the startup is normal If the backup battery is not connected the ventilator displays a message at startup and a 5002 Diagnostic Code will be logged No Backup Battery Connected Figure 5 13 No Backup Battery Connected message REF 1057983 A Respironics V200 Ventilator Operator s Manual 5 11 Chapter 5 Setup Extended Self Test EST Press the OK button to clear the message from the screen You may continue to use the ventilator without the backup battery or power off the ventilator and reconnect the backup battery WARNING Always turn the ventilator power OFF before connecting additional equipment To turn this feature off enter Diagnostic Mode and deactivate the messaging feature by pressing the BKUP BATTERY button 1 Power off the ventilator 2 Power on the ventilator while holding down the ALARM RESET and 10096 O keys simultaneously for approximately 5 seconds 3 A message appears on the ventilator screen asking the user to Verify that the patient is disconnected prior to proceeding Press OK to enter Diagnostic Mode 4 Once you ve entered Diagnostic Mode select USER CONFIG button which takes you to the User Config screen 5 Press the BKUP BATTERY button The background color should return to blue signifying that this feature has been deactivated We recommend that you run an Extended Self Test EST upon receipt of the ventilator to ensure that there has been no shipping damage to the s
229. ntilator is intended for use in the electromagnetic environment specified below The user of the ventilator should assure that it is used in such an electromagnetic environment Immunity IEC 60601 Compliance Test Test Level Level Electromagnetic Environment Guidance Portable and mobile RF communications equipment should be used no closer to any part of the ventilator including cables than the recommended separation distance calculated from Conducted the equation applicable to the frequency of the RF transmitter Recommended separation distance Table 12 29 EMC Declaration Recommended IEC Distances 61000 4 6 3 Vrms150 3 5 kHz to 80 MHz outside V d I vP ISM bands 1 10 Vrms 12 JEUDI 10 Vrms d P Radiated 80 MHz in RF IEC 12 61000 4 3 19 vim d P 80Mhz to 800Mhz 1 80Mhz to 19m 3 199 d m A P 800Mhz to 2 5GHz 1 where P is the maximum output power rating of the transmitter in watts W according to the transmitter manufacturer and d is the recommended separation distance in meters m P Field strengths from fixed RF transmitters as determined by an electromagnetic site survey should be less than the compliance level in each frequency range Interference may occur in the vicinity of equipment marked with the o following symbol SE Table 12 28 EMC Declaration Immunity 12 14 Respironics V200 Ventilator Operator s Manual REF 1057983 A
230. ntilatory support to the patient Immediately use a backup means of ventilatory support e Visually monitor the patient and ventilator during the Alarm Silence period to ensure that alarms do not go undetected Allowing alarm conditions to continue without intervention may result in harm to the patient and or ventilator Do not expose expiratory and inspiratory bacteria filters or reusable patient tubing to ETO gas REF 1057983 A Respironics V200 Ventilator Operator s Manual 2 3 Chapter 2 Warnings Cautions and Notes Disposable or single patient filters must be discarded between patients Do not chemically disinfect or expose single patient use bacteria filters to ETO gas The patient must be disconnected from the ventilator before entering the Diagnostic Mode since normal ventilation is suspended Do not use a ventilator that has failed SST without verifying operational readiness by other means Doing so may place a patient at risk Never initiate SST while the patient is connected to the ventilator The high airway pressures generated during SST can injure a patient Never initiate EST while the patient is connected to the ventilator The high airway pressures and gas flows generated during EST can injure a patient Do not use a ventilator that has failed EST without verifying operational readiness by other means Doing so may place a patient at risk Remove the ventilator from service and contact trained service per
231. ode used in determining the cause of a possible failure Repeat If the same code occurs consecutively this parameter will be incremented rather than creating a new entry in the log For example if the diagnostic code 1002 occurs three consecutive times it is logged as diagnostic code 1002 and the repeat column is 2 The repeat column increments until a different diagnostic code occurs Time Diagnostic codes are time stamped in hour minute second format for example 09 15 23 When the same diagnostic code repeats the time stamp represents the most recent occurrence of the diagnostic code Date Diagnostic codes are date stamped in month day year format for example 03 12 98 When the same diagnostic code repeats the date stamp represents the most recent occurrence of the diagnostic code Corrupted The microprocessor cross checks the data in memory prior to display If it determines that the memory contents have been corrupted it logs a YES indicating that the memory contents validity is suspect REF 1057983 A Respironics V200 Ventilator Operator s Manual 11 5 Chapter 11 Diagnostics Diagnostic codes associated with EST and SST are only recorded the first time the failure is encountered The log holds the last 20 diagnostic codes The screen can only display 10 codes at a time Press NEXT PAGE button to see the next group of codes or PREV PAGE to view the previous group The CLEAR CODES
232. of life support ventilation When connecting a humidifier to the patient circuit follow the setup procedure supplied by the humidifier manufacturer The following steps should be followed to electrically connect the humidifier to the ventilator for 100 120 VAC ventilators For ventilators using voltage other than 100 120 VAC the humidifier must be connected to another AC outlet 1 Remove the cover of the humidifier AC power outlet on the back of the ventilator Figure 6 3 Circuit Breaker Cover not shown Humidifier AC Outlet Cover Figure 6 3 Humidifier AC Outlet Cover 2 Connect the humidifier AC plug to the humidifier AC power outlet Circuit Breaker Cover not shown Humidifier AC Plug Figure 6 4 Humidifier AC Plug 6 4 Respironics V200 Ventilator Operator s Manual REF 1057983 A Connecting the Patient Circuit Chapter 6 Connecting Additional Equipment 3 Run any test procedures recommended by the humidifier manufacturer before the ventilator and humidifier are used on a patient WARNING AC power is applied to the humidifier from the ventilator humidifier outlet only available on 100 120 VAC ventilators Under no circumstances does the Respironics V200 Ventilator provide control for the humidifier To ensure patient safety it is important that any humidifier used with the ventilator include an acceptable temperature control and monitoring mechanism as well as a temperature display and appropri
233. ol ventilation PCV Maximum Inspiratory Pressure MIP The MIP maneuver measures the maximum negative pressure resulting from the patient s inspiratory effort It is available only in VCV and PCV MIP is also known as negative inspiratory force NIF e Occlusion Pressure at 100 ms P0 1 The P0 1 maneuver measures the pressure change after the first 100 milliseconds ms of an inspiratory phase It is available only in VCV and PCV This maneuver is also known as P100 Static Compliance and Resistance Static C and R The static C and R maneuver estimates the compliance and resistance of the patient s lungs It is available only in VCV e Plateau Pressure P pjat is a measured value collected during the last saved Static C and R maneuver e The results of maneuvers are displayed graphically and numerically The Respiratory Mechanics option also displays dynamic compliance and resistance inspiratory time divided by total breath time rijrror and peak lung flow Peak L Flow Accessing Touch the Mechanics icon button at the bottom of the screen Figure 13 27 Respiratory Mechanics Data Figure 13 27 VCV Settings Screen and Mechanics Icon Button REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 51 Chapter 13 Options and Accessories Vital Capacity When you touch the Mechanics icon button the Patient Status screen appears see Figure 13 28 This screen displays patient data and includes derived lung
234. on the Alarm Silence key will illuminate with a steady yellow light whenever the operator presses the alarm silence control The indicator remains lit for two minutes after the Alarm Silence key is pressed If Alarm Silence is active and an alarm takes place that involves an operator alarm limit being exceeded the alarm will be anunciated visually but Alarm Silence will continue to be active and the Alarm Silence timer will continue to time out Alarms that can not be silenced are listed in Table 9 1 Alarm Alert Messages on page 9 5 If Alarm Reset is pressed at any time during the Alarm Silence period the Alarm Silence period is terminated If any high or medium priority alarm condition exists after pressing Alarm Reset an audible alarm sounds WARNING Visually monitor the patient and ventilator during the Alarm Silence period to ensure that alarms do not go undetected Allowing alarm conditions to continue without intervention may result in harm to the patient and or ventilator Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 10 Care and Maintenance General Information Cleaning Procedures for ventilator cleaning sterilizing and periodic maintenance must be performed to ensure consistent ventilator operation Institutional policies may also provide guidelines procedures and schedules for cleaning and sterilizing equipment before during and after patient use In addition recommended methods and time fr
235. on time available that is not required for ventilator operation When execution time is available the microprocessor runs many of the hardware tests that are run during POST These include Program memory RAM memory and other measurements that can be tested without interfering with the operations of the ventilator The ventilator s safety system of hardware checking software and software checking hardware means that the ventilator only operates as a ventilator if the extensive constraints of the safety system are met Restart During normal operation the ventilator performs background checks to ensure the integrity of the system If a problem is detected the ventilator enters the restart sequence in which it opens the safety valve while it performs additional integrity checks Restart is 10 to 20 seconds depending upon the reason for the restart The ventilator sounds an alarm and displays a visual message indicating the unit is in a restart sequence In some cases a countdown timer will display the number of seconds remaining until the ventilator completes the restart cycle If during the restart sequence an actual problem is confirmed the ventilator enters the Vent Inop state in which it activates audible and visual alarms while the safety valve remains open Alternatively if at the end of the restart sequence the ventilator determines it is safe to continue operation the unit will return to normal ventilation NOTE A restart
236. on vcveee N A vcveee N A The ventilation Type PCVOOe type currently NPPVee being used by the ventilator VCV Mode Setting AICOO N A AICOO N A SIMVee CPAPe e VCV Waveform Setting RAMP N A RAMP N A SQUARE VCV Patient Type ADULTe N A ADULTe PEDeee NEO O VCV Respiratory Rate 129999 1 1 80 BPM Setting VCV Tidal Volume 500OO 1 50 2500 mL Setting VCV Peak Flow Setting 30000 1 3 140 LPM VCV PEEP Setting 000000 1 0 35 cmH 70 hPa VCV Pressure Support 099999 1 0 100 cmH50 Setting hPa VCV I Trigger Type PRESSe N A PRESS N A FLOWS e AUTOee VCV Pressure l Trigger 2 0999 0 1 0 1 20 0 cmH 0 Setting hPa VCV Flow l Trigger 3 0000 0 1 0 5 20 0 LPM Setting Table A 1 Ventilation Report Sheet 1 of 10 Appendix A 2 Respironics V200 Ventilator Operator s Manual REF 1057983 A Appendix A RS 232 Communications Protocol Ventilation Report Continued Description Example Resolution Range Units Comments VCV E Cycle Type Flow N A FLOW N A AUTO VCV Flow Expiratory 25000 1 10 80 Cycle Setting VCV Rise Time 0 1999 0 1 0 1 0 9 Sec VCV Oxygen 219999 1 21 100 96 Concentration Setting VCV Plateau Setting 0 0000 0 1 0 0 2 0 Sec VCV Apnea Rate 120000 1 1 80 BPM Setting VCV High Inspiratory 350000 1 10 105 cmH20 Pressure Alarm Limit hPa Setting VCV Low Inspiratory 3OOOOO 1 3 105 cmH 0 Pressure Alarm Limit hPa Setting VCV Low PEEP A
237. ontrol Ventilation the operator can select between ventilation modes of Assist Control SIMV and CPAP Assist Control Ventilation A C With the Assist Control mode refer to Figure 7 1 or Figure 7 2 a minimal rate and tidal volume or inspiratory pressure are set by the operator The patient can trigger the ventilator at a more rapid rate but the operator set tidal volume or inspiratory pressure is delivered during each breath The ventilator delivers only mandatory breaths Assisted breaths may be either pressure or flow triggered If the trigger setting is adjusted so that the patient cannot trigger the ventilator all breaths will be delivered by the ventilator at the operator set rate and tidal volume or pressure Synchronized Intermittent Mandatory Ventilation SIMV SIMV is a ventilation mode where the patient is allowed to breathe spontaneously and the machine attempts to deliver volume VCV or pressure PCV mandatory breaths in synchrony with the patient s effort at the operator set rate and volume or pressure This is accomplished by a combination of spontaneous and mandatory windows that open and close The type of breath delivered depends upon whether the event during the window is patient initiated operator initiated or time initiated This logic is illustrated in Table 7 1 SIMV Logic SIMV Logic Current Next SIMV State Inputs Ventilator Response SIMV State Mand Time Trigger Deliver mandatory bre
238. or Important information concerning the construction or operation of the Respironics V200 Ventilator Additional Warnings Cautions and Notes pertaining to options and accessories are included in the documentation for each option or accessory Refer to Chapter 13 Options and Accessories Summary of Warnings Warnings Cautions and Notes Patients on life support equipment should be visually monitored by competent medical personnel since life threatening circumstances may arise that may not activate alarms Heed all appropriate alarms and follow the instructions and warnings in this operator s manual Always check life support equipment for proper operation before use Do not use in the presence of flammable anesthetics Possible explosion hazard One person alone should not attempt to lift the ventilator or remove it from the shipping carton or the cart At least two people are required to avoid possible personal injury or damage to the equipment To reduce the chance of contamination or infection always use an inspiratory and expiratory filter when the ventilator is in operation Refer to manufacturer s instructions and follow institutional infection control guidelines when replacing the inspiratory and expiratory filter Do not use anti static or conductive hoses or conductive patient tubing The expiratory filter housing may be hot if removed from the ventilator immediately after use Wait 15 minutes after turning off
239. or Operator s Manual 4 7 Chapter 4 Getting Started 4 Remove the screws 4 holding the battery tray to the cart Battery tray mounting screws Figure 4 7 Removing the Battery Tray 5 Gently pull up the battery tray and remove it from the cart Figure 4 8 Removing the Battery Tray 4 8 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 4 Getting Started 6 If a battery is present in the battery tray disconnect the old battery from the battery tray s cable Figure 4 9 Disconnecting the Old Battery from the Battery Tray s Cable 7 Undo the straps remove the old battery if present and place the new battery in the battery tray Figure 4 10 Inserting Battery Into Tray REF 1057983 A Respironics V200 Ventilator Operator s Manual 4 9 Chapter 4 Getting Started 8 Position the D ring on the straps as shown below NOTE If the D rings are not positioned properly the excess strap will interfere with the tray s channel guide Figure 4 11 Positioning the D Rings on the Battery Straps 9 Connect the battery to the battery tray s cable Figure 4 12 Connecting the Battery to the Battery Tray s Cable 10 Insert the battery tray into the cart s center column by mating the battery tray s channel guide to the tray s channel guide of the center column CAUTION When inserting the battery tray into the cart s center column make sure not to crimp cable connections between the ba
240. or s Manual 8 21 Chapter 8 Operating Instructions displayed the calculated value for the I E ratio that will result from the PCV rate value is also displayed When the setting window insert for VCV Apnea Rate is displayed the calculated minute ventilation that will exist if the ventilator goes into Apnea Ventilation in VCV is shown When the setting window insert for PCV Apnea Rate is displayed the I E Ratio shown is the I E Ratio that will exist if the ventilator goes into Apnea Ventilation in PCV PCV Settings Window Insert VCV Settings Window Insert Setting to be changed on the top Setting that is calculated as the setting above changes below E Ratio is the parameter that is VE is the parameter that is calculated and displayed in certain calculated and displayed in certain PCV setting window inserts These VCV setting window inserts These are PCV Rate PCV I Time and PCV Figure 8 22 Settings Window Inserts With Calculated Results Rate and Apnea Rate Settings Relationship For all breath types VCV PCV and NPPY the ventilator ensures the Apnea Rate setting is equal to or greater than the set Rate up to 20 BPM When set rate is equal to the Apnea Rate and less than 20 BPM increasing the Set Rate increases the Apnea Rate equally up to 20 BPM Above 20 BPM the Apnea Rate can be greater than or less than the Set Rate down to 20 BPM Respironics V200 Ventilator Operator s Manual REF 1057983 A Selectin
241. or the intended environment i e DISS U S A and Canada Ohmeda Germany NIST UK Air Liquide France SIS Australia All volumes entered into the ventilator are assumed to be BTPS Body Temperature atmospheric Pressure Saturated with H50 volumes unless otherwise noted All volumes reported by the ventilator are reported as BTPS volumes All pressures are assumed to be relative to atmospheric pressure unless otherwise noted The Air Inlet Filter houses a reusable foam filter that should be periodically cleaned Refer to Chapter 10 Care and Maintenance for more information on filter changes Unless the Mains Circuit Breaker is turned OFF electrical power is applied to the ventilator even though the front panel switch is in the OFF position With the Mains Circuit Breaker ON if the backup battery is connected the ventilator will charge the battery if it requires a charge 2 8 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 2 Warnings Cautions and Notes e To disconnect the ventilator from MAINS power remove the AC plug from the wall power receptacle The MAIN switch circuit breaker is covered to prevent unintentional ventilator turn off e If the operator sets the 0 setting to 100 the 100 O indicator does not light The 100 O indicator only lights when the 100 O front panel key has been pressed The ventilator selects its power source based on the following prioritization AC po
242. ore placing the Respironics V200 Ventilator into service If you have questions contact Respironics Customer Service at 1 800 345 644 Save the shipping container in case the backup battery has to be returned to Respironics We recommend that before using the ventilator for the first time wipe the exterior clean and disinfect or sterilize its components according to the instructions in Chapter 10 Care and Maintenance or the component manufacturer s instructions Follow institutional infection control guidelines when replacing the inspiratory or expiratory bacteria filter When adding attachments or other components or subassemblies to the breathing system for example an HME or humidifier ensure that the inspiratory and expiratory resistances measured at the patient connection port do not exceed 6 cmH50 hPa at a flow of 60 L min for adults 30L min for pediatrics High humidity and aerosol medications may reduce expiratory filter life increase expiratory resistance and or cause filter damage Review ventilator patient graphics frequently for changes in expiratory resistance Consult filter manufacturer recommendations regarding duration of use maintenance and removal and disposal of expiratory filter The ventilator should only be connected to an appropriate medical grade 100 O gas source capable of delivering a regulated 40 to 90 PSIG 276 620 kPa The ventilator is shipped with the appropriate gas fittings and hoses f
243. ow the front panel on to the Ventilator the ventilator s lower right corner Figure 13 2 O Sensor Orientation 1 Rotate the sensor assembly so that the sensor is pointing up Flow Figure 13 3 Connecting O Sensor and Patient Circuit 2 Connect the T fitting 2 to the gas outlet port 1 3 Insert the inspiratory bacteria filter 4 into the T fitting 2 using the 22mm connector 3 if necessary Some bacteria filters provide an arrow or other mark to indicate the direction of flow The flow indicator should be pointed away from the ventilator toward the patient circuit connection CAUTION To prevent contamination of the O sensor always locate it between the ventilator gas output port and the inspiratory bacteria filter 13 4 Respironics V200 Ventilator Operator s Manual REF 1057983 A Warranty 0 Sensor Tee Chapter 13 Options and Accessories 4 Connect inspiratory limb of patient circuit 5 to bacteria filter 4 5 Ensure that all connections are tight NOTE Record O sensor manufacturing or warranty numbers and installation date for future reference NOTE To ensure accurate O5 monitoring check O sensors periodically and replace as per manufacturer specification NOTE Sensor performance and expected operating life information is outlined in the sensor manufacturer s instructions for use Thoroughly review all O sensor instructions prior to installation and use with the ventilator NOTE O sensor cal
244. pacity at the next inspiration then exhale completely followed by a normal inspiration The maneuver automatically ends at the next inspiration following the maneuver breath or if 20 seconds elapse without another inspiration Available in VCV and PCV Not available in NPPV During the maneuver Once the maneuver starts settings for maneuver breath are mode CPAP PEEP 0 cmH50 during the start of the next inhalation or exhalation following pressing the start button and PSV 0 cmH50 For the breath following the maneuver breath PSV 0 cmH50 and PEEP is restored to its original setting Pre maneuver settings are restored during exhalation of the breath following the maneuver breath Any scheduled breaths that were postponed by the VC maneuver are delivered after the maneuver is complete Results display Measured volumes from 0 to 9999 mL are displayed for the VC maneuver if measured volume exceeds these limits only a message no data is displayed VC is displayed in mL and is time stamped based on ventilator time and date Range 0 to 9999 mL Resolution 1 mL Accuracy 10 of true value Maximum Inspiratory Pressure MIP maneuver Procedure To perform a MIP maneuver the clinician asks the patient to inhale as forcefully as possible against a closed circuit that allows the patient to exhale through a one way valve Available in VCV and PCV Not available in NPPV During the maneuver Once the maneuver starts settin
245. parameters Mode and type of ventilation will always be displayed AWF Flow Delivered flow X AWP Pressure Delivered pressure AWV Volume Delivered volume sPSV set PSV Set pressure support ventilation sPEEP set PEEP Set positive end expiratory pressure X PIP PIP Measured peak inspiratory pressure MnAwP MAP Measured mean airway pressure Pplat Pi End Measured end inspiratory plateau pressure PEEP Pe End Measured positive end expiratory pressure SpMV Spont VE Measured spontaneous minute volume sTV set TV Set tidal volume MV VE Measured minute volume PtLeak Pt Leak Estimated patient leak X TV vt Measured tidal volume sFIO 2 set 9602 Set oxygen percentage fractional inspired oxygen 13 32 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Available on ES pane Comments CareNet Message equivalent X FIO 2 02 Measured oxygen percentage fractional inspired oxygen sPkFI set Peak Flow Set peak flow RiseTi Rise Time Set rise time SAWRR set Rate Set airway respiratory rate SpAWRR Spont Rate Measured spontaneous respiratory rate X AWRR Rate Measured airway respiratory rate F TV F M Ratio of frequency to tidal volume rapid shallow breathing index Pressure control ventilation PCV parameters Mode and type of ventilation will always be displayed X AWF Flow Delivered flow AWP Pressure D
246. pendix A RS 232 Communications Protocol Alarm Status Report Description Example Range Comments Command Name ALRM N A Number of characters between the start 202 N A 3 character field and stop codes Number of fields between the start and 28 N A 2 character field stop codes Start Code 0x02 N A ASCII Start Transmission Character STX Time of request 13 45 N A 24 hour clock hh mm Date FEB 2301997 N A 12 character field MMM DD YYYY Occlusion Alarm Status or SM Occlusion NORMAL NORMAL Status ALARM RESET Safety Valve Status NORMAL NORMAL ALARM RESET Low Internal Battery Alarm Status NORMAL NORMAL ALARM RESET Nonvolatile Memory Failure Using NORMAL NORMAL Default Settings ALARM RESET Primary Alarm Failure NORMAL NORMAL ALARM RESET High Inspiratory Pressure Alarm Status NORMAL NORMAL ALARM RESET Apnea Alarm Status NORMAL NORMAL ALARM RESET Low Inspiratory Pressure Alarm Status or NORMAL NORMAL Disconnect Alarm Status ALARM RESET Air Source Fault Alarm Status NORMAL NORMAL ALARM RESET O Valve Stuck Closed Alarm Status NORMAL NORMAL ALARM RESET Table A 6 Alarm Status Report Sheet 1 of 3 Appendix A 22 Respironics V200 Ventilator Operator s Manual REF 1057983 A Appendix A RS 232 Communications Protocol Alarm Status Report Continued Description Exhalation Valve Stuck Open Alarm Status Example NORMAL Range NORM
247. pironics judgment affect its ability or reliability or which has been subjected to misuse negligence abuse or accident Unauthorized service and or failure to perform periodic maintenance may void this warranty This warranty does not cover damage that may occur in shipment This warranty takes precedence over all other warranties expressed or implied This warranty also takes precedence over all other obligations or liabilities on the part of Respironics including but not limited to contingent or consequential damages such as costs of repairing or replacing other property which may be damaged as a direct result of Respironics V200 Ventilator operation This warranty and the rights and obligations described herein is construed under and governed by the laws of the State of California U S A 13 12 Respironics V200 Ventilator Operator s Manual REF 1057983 A Kit Contents Oxygen Manifold Option The oxygen manifold allows two O cylinders and one wall oxygen supply line to be used as inputs to the ventilator Each of the three inlets has a check valve that prevents pressure loss when disconnecting from the wall or cylinders This allows quick easy transfer between oxygen supplies without interruption of flow Easy transfer of oxygen supply facilitates patient transport within the facility and allows replacement of one cylinder while operating from the other Figure 13 8 Oxygen Manifold Assembly Oxygen Manifold As
248. pontaneous with a backup rate Spont T Ventilation Mode Spontaneous Ventilation Mode Spont In Spontaneous Ventilation Mode the operator sets the pressure during exhalation EPAP and the target pressure during inspiration IPAP The patient triggers the breath based on the Flow Trigger setting Exhalation is determined by the setting E Trigger which is a percentage of peak flow during the breath Refer to Figure 7 7 Spontaneous Timed Ventilation Mode Spont T In the Spontaneous Timed Ventilation Mode the patient can breathe spontaneously or receive machined controlled breaths The machine controlled breaths are delivered for a set inspiratory time at a set breath rate In Spont T mode every patient initiated breath is spontaneous and restarts the breath period timer If the patient triggers a breath before the breath period elapses the ventilator delivers a spontaneous supported breath based upon the settings If the breath period elapses without a patient trigger the ventilator delivers a ventilator initiated mandatory breath at the set IPAP level Patient initiated time cycled breaths are not delivered in Spont T mode Refer to Figure 7 7 7 6 Respironics V200 Ventilator Operator s Manual REF 1057983 A Emergency Modes of Ventilation Chapter 7 Operating Theory I Flow Peak Flow Flow Trigger EM 4 ES o Peak Flow Time gt Pressure 5 d Rise Time Time Spont T Mode in NPPV Machine
249. position Continue button unfreeze graphics Figure 13 19 Frozen Loops Display with Numeric Data Windows Save and Overlay Follow these steps to save a frozen loop for later reference against future data Features for example before and after bronchodilator therapy 1 Press the FREEZE button to save the Loops screen Use the arrow buttons or knob to select a breath Press the SAVE button Press CONTINUE to unfreeze the screen n AeA W N Press the OVERLAY button to superimpose a gray image of the saved loop on the current display the Overlay feature works on frozen or unfrozen displays 6 Press the SINGLE VIEW button to view current graphics without the saved loops Figure 13 20 illustrates the Overlay feature REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 23 Chapter 13 Options and Accessories SAVE button OVERLAY icon button 588686888 SINGLE VIEW icon button Figure 13 20 Loops Display with Overlay Feature Active Inspiratory Area The Loops screen includes a window for the inspiratory area Figure 13 21F This window displays a numeric value that represents the ventilator imposed work of breathing and is only calculated and displayed for a frozen loop If the ventilator is supporting the entire breath the Insp Area window displays 0 000 If the Insp Area window shows dashes the ventilator is not calculating inspiratory area because the loops are not frozen D
250. prompt for the password Enter the password 1245 If the password is entered correctly the Change OpM ode key will be highlighted Press Change OpM ode and select Config or Monitor Press Confirm a If Config was selected in step 5 the display will become blank and the message Config mode active NO MONITORING will appear at the top of the screen Continue with the Preselecting Devices section below b If Monitor was selected in step 5 the VueLink system will begin to display data Make sure that the LED next to Open Device is lit while in Monitoring mode to display ventilator data If it is not lit press the button on the VueLink Module select Open Interface and press confirm Pressing the button on the VueLink Module will then display the Standard Parameter Interface SPI screen Pressing the VueLink Module button a second time will activate the ventilator screen with more information Preselecting Devices Once in Configuration Mode the Open device must be selected as one of the three preselected devices for the VueLink Ventilator Module To do this follow the steps below l 2 Press Module Setup or Module Config on the CMS Highlight VENTILTR OPEN INTRFACE OR ESPRIT VENT and press Confirm Note Only one of the above choices will be available at a time The choice depends on how the module is already configured Verify Prefer d Module is set to Ventiltr and choose whether
251. protective earth connection SUITABLE FOR ALTERNATING CURRENT 2 04 650 OR DIRECT CURRENT DRIP PROOF Chart recorder ANALOG OUTPUT Pin 12 signals an unsilenced high or medium urgency alarm 0 VDC active alarm 1 5 VDC no alarm or silenced alarm Voltage signal for flow and pressure reserved for future use DC BATTERY CONNECTION n m 3 ah nnn Table 3 1 Symbols Sheet 1 of 5 REF 1057983 A Respironics V200 Ventilator Operator s Manual 3 1 Chapter 3 Symbols Symbols Continued Description DC BATTERY CONNECTION HOT SURFACE warning EUROPEAN CONFORMITY REMOTE ALARM connection RS 232 serial output PARALLEL PORT printer connection ALARM SILENCE Silences alarm for two minutes p 3 8EBE I Cj L4 N I BRIGHTNESS ADJUST AUDIO ALARM VOLUME CONTROL ACCEPT ALARM RESET 100 OXYGEN OBOR Located between the ALARM RESET and 100 02 buttons this symbol indicates that the two keys ALARM RESET AND 100 02 must be pressed simultaneously for approximately five seconds to enter Diagnostic Mode Table 3 1 Symbols Sheet 2 of 5 3 2 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 3 Symbols Symbols Continued Description MANUAL BREATH EXPIRATORY HOLD SCREEN LOCK Symbol version of the front panel only IIluminates yellow to indicate backup battery IN USE backup Symbol versio
252. pter 3 Symbols Symbols Continued Description STORE AT 1096 9596 RELATIVE HUMIDITY L I Do not stack 2 high Table 3 1 Symbols Sheet 5 of 5 REF 1057983 A Respironics V200 Ventilator Operator s Manual 3 5 Chapter 3 Symbols This page is intentionally blank 3 6 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 4 Getting Started Unpacking The Respironics V200 Ventilator has been carefully packaged to assure safe shipping In addition the packing container has been designed for easy unpacking Do not discard packing materials Before unpacking the ventilator examine the shipping carton s for visible damage If the shipping carton s arrives damaged or if you suspect the contents are damaged contact the carrier for an inspection report If any damage is evident we recommend that you photograph the carton s before the shipment is unpacked Report any damage to the shipping container or ventilator to your local authorized Respironics distributor and to the carrier Save all packing material after removing the ventilator In the event that the ventilator or backup battery needs to be repacked and reshipped use the original packing material or order replacement material from a Respironics representative NOTE The contents of the shipping carton may vary lt lt Top Foam Insert Respironics V200 Ventilator Center Foam Insert
253. r on a table top see the Esprit Operator s Manual 580 1000 01 If the ventilator is on a cart lock the cart wheels as needed as shown in Figure 4 2 ee Figure 4 2 Locking Ventilator Wheel Bac kup Batte ry The ventilator will automatically switch to operating on backup battery power when the AC power fails or the system is disconnected from AC mains power A fully charged backup battery will operate the ventilator for approximately 30 minutes dependent upon the specific ventilator setting WARNING The batteries backup battery in the battery compartment are non spillable sealed lead acid Recycle or dispose of batteries properly WARNING Do not connect the DC power cord from the backup battery while the Respironics V200 is functioning as a ventilator Always turn the Power On Off switch to off 5 WARNING Backup battery operating life may be affected by battery age and the number of times it has been discharged and recharged Over time the battery will degenerate and will not provide the same amount of operating time per charge that is available from a fully charged new battery Use only the Respironics backup battery P N 1059956 4 4 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 4 Getting Started Backup Battery Removal and Installation Required Tool Philips screwdriver Remove the backup battery from the internal packaging material and shipping bag Do not discard packing materials until the
254. r than necessary can shorten the useful life of the product Rinse parts thoroughly to remove all detergent residues Wipe parts dry Detergent residue can cause blemishes or fine cracks especially on parts exposed to elevated temperatures during sterilization REF 1057983 A Respironics V200 Ventilator Operator s Manual 10 1 Chapter 10 Care and Maintenance Sterilization WARNING Do not expose expiratory and inspiratory bacteria filters or reusable patient tubing to ETO gas NOTE Because conditions and practices in health care institutions vary this manual can only describe general guidelines It is the user s responsibility to ensure the validity and effectiveness of the methods used Do not clean disinfect sterilize or reuse disposable products Steam Autoclaving The O sensor tee P N 1001736 and the O sensor coupling P N 1002505 may be steam autoclaved The PVC O sensor tee P N 8 100498 00 gray in color cannot be autoclaved CAUTION X Autoclavable parts will withstand repeated steam autoclaving at temperatures not to exceed 135 C 275 1 Ensure that the part has been disassembled cleaned and partially reassembled as applicable 2 Separately wrap the part in muslin or equivalent paper wrapper 3 Steam autoclave according to the autoclave manufacturers instructions In many institutions it may be routine to place a biological indicator in the autoclave load as a subsequent test for sterility 4
255. ratory Mechanics and Neonatal options Ventilators installed with Speaking Mode option software have the following identifying label located near the power switch Lo 9 Figure 13 57 Speaking Mode Option Label Warnings A warning indicates a condition that could cause injury to a patient or operator if instructions are not followed Read and understand these Speaking Mode Option instructions before using Speaking Mode on a patient Wait at least 72 hours after a tracheostomy before initiating Speaking Mode Monitor patients with trained medical personnel when using Speaking Mode COMPLETELY DEFLATE the tracheostomy tube cuff before activating Speaking Mode Do not use while patient is sleeping unresponsive or comatose Do not use with patients with upper airway obstruction Do not use with foam cuff tracheostomy tubes REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 103 Chapter 13 Options and Accessories Do not use with neonatal tracheostomy tubes Do not use on neonates Do not inflate the tracheostomy tube cuff until Speaking Mode has been turned off Do not use on patients who are dependent on PEEP therapy Do not use with HME filters Discontinue using Speaking Mode promptly and institute appropriate ventilation if the patient experiences difficulty or their status deteriorates from baseline parameters Perform an airway patency test immediately after act
256. res Check the software revision of the ventilator Set user configuration including time and date compliance compensation enable disable e local altitude and time format backup battery confirm at startup enable disable Check diagnostic codes WARNING The patient must be disconnected from the ventilator before entering the Diagnostic Mode since normal ventilation is suspended CAUTION Troubleshooting and repair should be performed only by a qualified NOTE service technician The Hardware function and EST in the Diagnostics Mode should only be run by qualified personnel REF 1057983 A Respironics V200 Ventilator Operator s Manual 11 1 Chapter 11 Diagnostics Entering Diagnostic Mode To enter Diagnostic Mode hold down the ALARM RESET and 100 O keys for approximately 5 seconds while you turn on the ventilator A message appears on the ventilator prompting you to confirm that the patient is disconnected before entering Diagnostic Mode Figure 11 1 Press OK to enter Diagnostic Mode Figure 11 1 Entering Diagnostic Mode Once you ve entered Diagnostic Mode you can select any of diagnostic functions by pressing its button Change values in Diagnostic Mode the same way you change ventilator settings Respironics V200 Ventilator Operator s Manual REF 1057983 A Diagnostic Functions Chapter 11 Diagnostics Short Self Test SST SST verifies the integrity of the patient circuit tubing
257. ress YES to confirm or press NO to leave the mode as is Change mode to SIMV Yes No Figure 8 31 Mode Change Confirmation Message 3 Once you confirm a mode change the ventilator changes the mode selected to active Figure 8 32 SIMV CPAP SpontT Spont Figure 8 32 Ventilation Mode buttons SIMV and Spont shown as active Apnea Ventilation Apnea ventilation provides an emergency mode of ventilation if the ventilator does not deliver a breath for an operator set interval of time The apnea time can be set between 10 and 60 seconds Upon entering this mode of ventilation the ventilator will immediately start using the Apnea Rate setting specified In PCV and VCV the ventilator will begin delivering breaths in Assist Control A C but with the operator set Apnea Rate In NPPV the ventilator will deliver only machine controlled breaths either at the set Apnea Rate or in response to patient effort In Apnea ventilation the alarms used are the ones used for machine controlled breaths in the active breath type VCV PCV and NPPV that the ventilator was in when Apnea occurred REF 1057983 A Respironics V200 Ventilator Operator s Manual 8 27 Chapter 8 Operating Instructions Patient Data Screen You can view the patient data screen Figure 8 33 by pressing the PATIENT DATA button in the top bar The format of this screen is the same in VCV PCV and NPPV Table 8 7 Patient Data Definitions Range Units amp Reso
258. ressure versus time waveform Figure 8 35 Expiratory Hold Maneuver While the EXP HOLD key is held the exhalation valve and the air and O valves will be closed During this period there is no flow of gas into or out of the patient circuit from the ventilator You can monitor the airway pressure by watching the EXPIRATORY PAUSE PRESSURE digital display and by watching the pressure versus time waveform When you determine the airway pressure has stabilized the EXP HOLD key should be released If the key is held for 5 seconds the ventilator will automatically terminate the maneuver and perform the calculation if stability was achieved The ventilator then calculates Auto PEEP as shown in the equation below e Auto PEEP Expiratory Pause Pressure End Expiratory Pressure NOTE If the EXP HOLD key is held continuously and the expiratory hold maneuver exceeds 5 seconds the ventilator automatically terminates the expiratory hold maneuver and begins a new inspiratory period NOTE If Auto PEEP as calculated in Equation 1 Auto PEEP Expiratory Pause Pressure End Expiratory Pressure is negative Auto PEEP will be displayed as REF 1057983 A Respironics V200 Ventilator Operator s Manual 8 31 Chapter 8 Operating Instructions Preoperational The preoperational procedure verifies that the ventilator is ready for use on a Procedure patink WARNING Ensure that an alternative means of ventilation that is
259. rl 0 350 0 1 99 9 100 400 ml cm H20 cm H30 L s Outputs eese when Mechanics option is not installed or no maneuver was performed Outputs eese when Mechanics option is not installed or no maneuver was performed Dynamic Compliance 0 e 0 350 ml cm H30 Outputs eeeee when Mechanics option is not installed Dynamic Resistance 0 0ee 0 10r1 0 1 99 9 100 400 cm H50 L s Outputs eese when Mechanics option is not installed Maximum Inhalation Pressure 0 e 0 100 cm H20 Outputs eese when Mechanics option is not installed or no maneuver was performed Vital Capacity 0 0ee 0 1 0 1 9 9 Outputs eeeeee when Mechanics option is not installed or no maneuver was performed when the value is out of range output iseeee ee Peak Lung Flow 0 e 0 200 LPM Outputs ee ee when Mechanics option is not installed Bias Flow 205555 LPM Outputs 0 when pressure trigger is active otherwise outputs Flow trigger plus three 3 Table 13 4 Ventilation Report Sheet 7 of 10 13 46 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Description Example Ventilation Report Resolution Range Units Comments Flow trigger setting 2 9 T 1 20 LPM Outputs Flow trigger setti
260. rm Limit Setting PCV High Respiratory 15000 1 0 150 BPM Rate Alarm Limit Setting PCV Low Minute 1 00 0 01 for 0 00 60 0 L Volume Alarm Limit 0 00 to Setting 9 99 0 1 for 10 0 to 60 0 Table A 3 Pressure Control Ventilation Settings Report Sheet 2 of 3 REF 1057983 A Respironics V200 Ventilator Operator s Manual Appendix A 15 Appendix A RS 232 Communications Protocol Non Invasive Positive Pressure Ventilation Settings Report NPVS Pressure Control Ventilation Settings Report Continued Description Example Resolution Range Units Comments PCV High Minute 60 00 0 01 for 0 00 60 0 L Volume Alarm Limit 0 00 to Setting 9 99 0 1 for 10 0 to 60 0 Stop Code 0x03 N A N A N A ASCII End Transmission Character ETX Table A 3 Pressure Control Ventilation Settings Report Sheet 3 of 3 When the ventilator receives NPVS followed by a carriage return it will respond by transmitting the information shown in Table A 4 Non Invasive Positive Pressure Ventilation Settings Report The ventilator responds to the NPVS command by returning a string with a variable length Fields 2 through 4 define the length of the message The last character transmitted is a stop code indicating the end of the message The second field indicates the number of characters between the start and stop codes The third field indicates the number of fields between the start and stop codes The fourth field is the start code 0x02 The
261. rocedure on page 8 32 before performing the Alarm Testing procedure It is assumed that the preoperational procedure has been run before the Alarm Testing Procedure is followed Setup 1 2 3 4 Connect O supply to the Respironics V200 Ventilator Connect optional O sensor Run EST Attach the test lung to the patient wye Use the test lung provided with your system Use the following settings e Mode VCV A C e Tidal Vol 400ml e High Pressure HIP 50cmH50 hPa or higher if required by the test lung e Rate 10 Bpm Low Insp Press 3 cmH50 hPa e Peak Flow 40 Lpm PEEP 4 cmH50 hPa e Low PEEP 2 cmH50 hPa Low Vt Mand 0 mL e PSV 0 cmH50 hPa e Low Vt Spont 0 Lpm Trigger 2 cmH50 hPa High Rate 150 Bpm e 05 2196 e LowVE 1L Insp Hold 0 sec e Apnea 15 sec e Apnea Rate 20 Bpm REF 1057983 A Respironics V200 Ventilator Operator s Manual Appendix C 1 Appendix C Alarm Testing Procedure High Inspiratory Pressure Alarm Test 1 2 3 During inhalation squeeze the test lung for at least two breaths until the High Pressure alarm sounds Wait for one normal breath the alarm auto resets RESET the alarm Low Volume Alarm Test 1 2 3 4 Set the Low Vt Mand alarm limit to 500 ml Wait for one breath and alarm should sound Set the Low Vt Mand to 0 ml Wait for one breath and RESET the alarm Low O Alarm Test If optional O sensor is installe
262. rom the last eight breaths and projecting what that rate would be if it continued for one minute Total Volume Exhaled Total VE the total exhaled volume that would come from all the patient s breaths projected over one minute The calculation is done by averaging the total exhaled tidal volume from the last eight breaths and projecting what that volume would be if it continued for one minute This value is updated at the end of each exhalation Glossary 6 Respironics V200 Ventilator Operator s Manual REF 1057983 A Glossary Trigger normally a patient effort to begin inhalation Volume space occupied by matter measured in milliliters or liters Window either a period of time or a portion of a screen depending on the context REF 1057983 A Respironics V200 Ventilator Operator s Manual Glossary 7 Glossary This page is intentionally blank Glossary 8 Respironics V200 Ventilator Operator s Manual REF 1057983 A Index Symbols 10096 02 Key 8 9 A AIC Assist Control 7 3 AC Inlet 5 2 ACCEPT key 5 8 8 2 Accept Key 8 8 Accessories 4 2 13 1 Adjust Control Knob 8 11 12 7 Adult Disposable Patient Circuit 13 2 Patient Circuit Kit 13 2 Adult Pediatric Keys 8 20 Air Inlet Filter 5 1 Air Source Fault Alarm 9 5 Airway Pressure 7 4 Alarm Reset Key 8 9 Alarm Silence 12 9 Alarm Silence Key 8 9 Alarm Status Indicators 8 5 Alarms 9 1 Audible 9 2 Auto Reset of 9 3 Descriptions 9 5 9 8 High
263. ronics V200 Ventilator Operator s Manual 13 91 Chapter 13 Options and Accessories Information Transferred from the Ventilator to the Respiratory Profile Monitor The ventilator provides the respiratory profile monitor with the following information Information Transferred from the Ventilator to the Respiratory Profile Monitor Data Description Breath Type Mandatory Assisted Spontaneous or Supported FIO The percentage of oxygen in the gas delivered to the patient NOTE If the optional oxygen sensor for the ventilator is used this number will be the FIO measured by the sensor If the optional oxygen sensor is not used this will be the set FIO Table 13 19 Information Transferred from the Ventilator to the Monitor Trended NICO Data The ventilator captures the data sent from the respiratory profile monitor and stores it on the PCMCIA card PC Card The Trending screen makes it possible to display ventilator and monitor information for intervals from 2 to 72 hours To access the respiratory profile monitor trended data 1 Touch the Patient Data button at the top of any settings screen VCV PCV or NPPV NOTE If the Graphics option is not installed the Graphics button is grayed out and Trending is only accessible from the Patient Data screen 13 92 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Patient Data button Figure 13 48 VCV Settings Screen
264. rotocol Patient Data Report Continued Description Example Resolution Range Units Comments Measured End 2 0000 0 1 20 0 99 9 cmH 20 The End Exp value Expiratory Pressure hPa from the Patient Data Data screen Measured End 24 000 0 1 for 20 0 to 99 9 20 0 130 cmH 20 The Plateau value Inhalation Pressure 1 for 100 to 130 hPa from the Patient Data screen Measured Tidal 168000 1 0 2500 mL The Tidal Volume Volume value from the Patient Data screen Measured 0 00 0 01 for 0 00 to 0 00 60 0 L The Spont VE value Spontaneous 9 99 from the Patient Minute Volume 0 1 for 10 0 to 60 0 Data screen Measured Minute 5 83 0 01 for 0 00 to 0 00 60 0 L The Total VE value Volume 9 99 from the Patient 0 1 for 10 0 to 60 0 Data screen Measured 0 0000 0 1 for 0 0 to 9 9 0 0 150 BPM The Spont Rate Spontaneous 1 for 10 to 150 value from the Breath Rate Patient Data screen Measured Total 12 099 0 1 for 0 0 to 9 9 0 150 BPM The Total Rate Breath Rate 1 for 10 to 150 value from the Patient Data screen Measured Rapid 599999 1 0 500 BPM L TheF Vt value from Shallow Breathing the Patient Data Index Screen Measured E Ratio 1 4 19 0 1 for 9 9 1 to 1 9 9 4 1 1 1 99 N A The I E Ratio 1 for 1 10 to 1 99 display from the Patient Data screen Measured Patient 10 0999 0 1 for 0 0 to 99 9 0 0 140 LPM The Pt Leak Leak 1 for 100 to 140 display Measured Percent 56 2 0 1 for 0 0 to 99
265. rotocol Pressure Control Ventilation Settings Report PCVS When the ventilator receives P CVS followed by a carriage return it will respond by transmitting the information shown in Table A 3 Pressure Control Ventilation Settings Report The ventilator responds to the PCVS command by returning a string with a variable length Fields 2 through 4 define the length of the message The last character transmitted is a stop code indicating the end of the message The second field indicates the number of characters between the start and stop codes The third field indicates the number of fields between the start and stop codes The fourth field is the start code 0x02 The last field in the string is the stop code 0x03 Pressure Control Ventilation Settings Report Description Example Resolution Range Units Comments Command Name PCVS N A N A N A Number of characters 195 N A N A N A 3 character field between the start and stop codes Number of fields 27 N A N A N A 2 character field between the start and stop codes Start Code 0x02 N A N A N A ASCII Start Transmission Character STX Time of request 13 45 N A N A N A 24 hour clock hh mme Date FEB 2301997 N A N A N A 12 character field MMM DD YYYY Current Ventilation vcveee N A vcveee N A The ventilation Type PCVOOe type currently NPPVee being used by the ventilator PCV Mode Setting A Ceee N A AICOO N A SIMVO CPAPe e PCV Patient Type ADULTe
266. rsion of the power status indicators is shown in Figure 8 6 NOTE The ventilator selects its power source based on the following prioritization AC power if present external battery then backup battery In Use Charging Low Mains Ext Battery co Battery Figure 8 5 Power Status Indicators Text Version 1 Ca x E c SS Figure 8 6 Power Status Indicators Symbol Version Power Status Indicators Battery Indicator Status Description In Use Yellow active The ventilator is running on backup battery power The backup battery is used when there is no AC power and no other battery is available Charging Yellow active The backup battery is charging The battery should not be considered a fully charged power qd NA source when this indicator is illuminated The Charging indicator will stay on for the duration of the charging cycle which can last up to ten hours Once the battery has fully charged the Charging indicator will turn off Low Flashing red The backup battery has approximately 5 minutes of power remaining WARNING When the battery low indicator is flashing red operation of the ventilator from battery power should be discontinued Table 8 2 Power Status Indicators Sheet 1 of 2 8 6 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 8 Operating Instructions Power Status Indicators Continued Battery Indicator Status Description Mains Green
267. rts and Outlets on the Rear Panel REF 1057983 A Respironics V200 Ventilator Operator s Manual 6 1 Chapter 6 Connecting Additional Equipment Connecting Serial Communications Devices Connecting Remote Alarm Port The serial port is designed to transmit data on a one device to one device serial communications channel In the connection between the two devices the ventilator assumes the slave role and responds to commands transmitted to it via the serial port by the external master The serial communications port uses a standard RS 232 null modem pin configuration The ventilator assumes the serial communications is set up for 19 200 bits second baud rate e 8 data bits e o parity bit e 1 stop bit The ventilator is sent commands that are 4 ASCII characters from the external device and responds with a fixed format message The commands and the responses are specified in Appendix A RS 232 Communications Protocol The ventilator is equipped with a remote alarm port enabling ventilator alarm conditions to be sounded at remote locations away from the ventilator Pressing ALARM SILENCE deactivates the remote alarm The ventilator signals an alarm using a normally open or normally closed relay contact The de energized state of the relay represents an alarm state any Medium or High Priority alarm and the energized state represents no alarms The remote alarm port is a standard Y inch female phono jack ring tip s
268. s This page is intentionally blank 13 68 Respironics V200 Ventilator Operator s Manual REF 1057983 A Accessing Trending Data Chapter 13 Options and Accessories Trending Option The Trending option allows the ventilator to store and display ventilator information for intervals from 2 to 72 hours Trended data includes Patient data e Ventilator settings Lung mechanics data most of the data in this category is available only if the Respiratory Mechanics option is installed Respiratory profile monitor data data in this category is available only if the respiratory profile monitor interface NICO Esprit option is installed All data is date and time stamped and 32 parameters are stored for use by the Trending option You can view three trended parameters at a time and you can change the displayed parameters and time scale at any time Touch either the Patient Data button at the top of any settings screen VCV PCV or NPPV or the Graphics icon button at the bottom of the screen Figure 13 32 If the Graphics option is not installed the Graphics button is grayed and Trending is only accessible from the Patient Data screen REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 69 Chapter 13 Options and Accessories Patient Data button Graphics button Figure 13 32 VCV Settings Screen In the Patient Data screen Figure 13 33 or Graphics screen not shown touch the Trend
269. s 7 3 Ventilation Modes Common toNPPV 0 00000 ee 7 6 Emergency Modes of Ventilation 2 0 lees 7 7 REF 1057983 A Respironics V200 Ventilator Operator s Manual iii Contents 10 11 12 Operating Instructions lisse eise 8 1 OVerViBWz x yo deu ue edd pA qu CAU UR ERAT RB ed x WE E I IE 8 1 The Front Panel 23 2 4 nice e ba aoe Heath ase eed dn 8 3 Ventilator Screens ccce RR res ed ERA E xd ed ears 8 11 Settings Scr ens i cins iai lE eh eae eee bea RU a ERREUR ES 8 14 Selecting a New Ventilation Breath Type VCV PCV or NPPV 8 23 Selecting the Mode A C SIMV CPAP or Spont Spont T 000 8 26 Apnea Ventilation x uice e EX a na Ae bee ce a eS 8 27 Patient Data Screen css co up ERE XR X4 EAE 8 28 Monitor S Creek s a us tot be gn dese e eodd do dicto Rus Ren ni od Deck dow 8 29 Special Procedures sllleee ee 8 31 Preoperational Procedure silii 8 32 Alarm Testing Procedure 0 0 es 8 34 Where To Go For Help llslesisseeee eee 8 34 Alarms ehe e ox IEEE abe tebe ial een ed REC be T EMI 9 1 Introd Uctlonrs sc o ceb eater cette bate tess og rue X QU DM ERISW e eua 9 1 Visual Alarms is bae meg uw ERAS OE EY QE REX NE XA EY ERU 9 1 Audibl amp Alarms innere Se ee oe aO RI RP ES RH 9 2 Alarm Reset ze coe EE ARA ERG NEP CAN Mete e XAR 9 3 AlettiMessages va a aver der ert a ae eee Reet Sot agitate een i Dg eres 9 4 Alarm IndiCatoEs celu RR eeu
270. s shown below fM Spont Rate Spont VE Resistance The pressure drop across a pneumatic device i e bacteria filter patient circuit tubing for a unit of flow when the volume of the device remains constant i e CMH 0 hPa mL sec Risetime the time required for a pressure support or pressure controlled breath to reach its target pressure RS 232 ANSI standard for communication Spontaneous Respiratory Rate Spont Rate the average rate of the spontaneous breaths in the last eight breaths delivered by the ventilator Spontaneous Volume Exhaled Spont VE the exhaled volume that would come from spontaneous breaths projected over one minute The calculation is done by averaging the spontaneous exhaled tidal volume from the last eight breaths and projecting what that volume would be if it continued for one minute Tidal Volume Tidal Vol the volume of patient gas as measured at the exhalation flow transducer The display shows an average unless the current breath differs substantially from the average When there is a substantial change the current breath is displayed The average for tidal volume is restarted when the operator changes the tidal volume setting and the machine is delivering mandatory breaths Time Trigger initiation of inspiration by the ventilator according to the respiratory frequency Rate setting Total Respiratory Rate Total RR the total breaths taken spontaneous breath rate mandatory breath rate f
271. se damage to delicate ventilator components such as the expiratory flow sensor which may lead to inaccurate spirometry or a Vent Inop condition WARNING Vent Inop is a serious condition which is indicated by both visual and audible alarms If the ventilator is attached to a patient when Vent Inop occurs the patient must be supported with another means of life support ventilation At least daily Oxygen supply water trap and filter Check and empty as required every shift At least every 250 hours Air Inlet amp Fan Filters Inspect and clean Some environments cause a quicker collection of lint and dust than others requiring maintenance more frequently than every 250 hours Annually Annual preventive maintenance kit P N 1034840 Kit contents are subject to change Install annual preventive maintenance kit Clean ventilator interior and exterior Complete performance verification procedure CAUTION The annual preventive maintenance procedure is to be performed only by a qualified service technician REF 1057983 A Respironics V200 Ventilator Operator s Manual 10 7 Chapter 10 Care and Maintenance 12 500 hours 12 500 hour preventive Install 12 500 hour preventive maintenance kit P N maintenance kit 1001733 Kit contents are Clean ventilator interior and exterior subject to change Complete performance verification procedure CAUTION The 12 500 hour preventive maintenance
272. sembly Oxygen Manifold Bracket with Grommet 4 0mm Allen wrench 1 1 2 24 inch Medical Hose Assemblies Oxygen 1 2 M6 x 10mm BUTTON HEAD SCREWS SOC CAP REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 13 Chapter 13 Options and Accessories WARNING The Oxygen Manifold is for oxygen use only WARNING Maximum inlet pressure 90 PSIG Minimum inlet pressure 50 PSIG at 200 SLPM WARNING Keep all hoses within the limits of the ventilator footprint to prevent a tripping or snag hazard CAUTION Use this kit with the Respironics V200 Ventilator only CAUTION Do not use the oxygen manifold or oxygen hoses to move the ventilator Assembly Instructions 1 Lock the front wheels of the ventilator d Figure 13 9 Locking Ventilator Wheel 13 14 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Attach the oxygen manifold assembly to the ventilator by threading the adapter fitting onto the oxygen inlet elbow fitting Using the manifold for leverage rotate the oxygen inlet elbow fitting until the manifold assembly is vertical as shown in Figure 13 10 Figure 13 10 Ventilator With Oxygen Manifold REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 15 Chapter 13 Options and Accessories 3 Position the manifold support bracket so that the Wall O connection of the manifold fits snugly into the manifold
273. service personnel once power to the ventilator is off To avoid the possibility of damage to the ventilator do not connect a humidifier whose maximum rating exceeds 3 amps Ensure that the humidifier power cord is free from defects and any obvious wear and is properly grounded A humidifier connection is only available on 100 120VAC ventilators Before connecting the ventilator to the AC power source ensure that the total electrical load does not exceed the ampere rating of the AC branch circuit especially when using the ventilator with other electrical equipment An AC branch circuit includes all outlets serviced by a single circuit breaker If the maximum current drain through a branch circuit exceeds the circuit breaker s rating the branch circuit will open causing the REF 1057983 A Respironics V200 Ventilator Operator s Manual 2 5 Chapter 2 Warnings Cautions and Notes ventilator to lose power For further information consult a service technician or a trained biomedical technician The ventilator is shipped with a power cord that complies with electrical safety standards Do not use substitute power cords unless specifically instructed to do so by an authorized distributor or qualified personnel Do not modify the power cord or connect it with electrical extension cords or outlet adapters To prevent the risk of excessive leakage due to external equipment being connected to the ventilator via the communication ports a
274. should be observed to verify normal operation If abnormal performance is observed additional measures may be necessary such as re orienting or relocating the ventilator d Over the frequency range 150 kHz to 80 MHz field strengths should be less than 1 V m Table 12 28 EMC Declaration Immunity REF 1057983 A Respironics V200 Ventilator Operator s Manual 12 15 Chapter 12 Technical Specifications Recommended Separation Distances Between Portable and Mobile RF Communications Equipment and the Respironics V200 Ventilator The ventilator is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled The user of the ventilator can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment transmitters and the ventilator as recommended below according to the maximum output power of the communications equipment Separation Distance According to Frequency of Transmitter Meters Rated 150 kHz to 80 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2 5 GHz Maximum MHz Outside ISM in ISM Bands Output Bands Power of 12 12 23 Transmitter d y P d lg JP d Ex JP Watts V E E 0 01 0 12 0 12 0 12 0 23 0 1 0 38 0 38 0 38 0 74 1 1 20 1 20 1 20 2 30 10 3 80 3 80 3 79 7 40 100 12 00 12 00 12 00 23 00 For transmitters rated at a maximum output power not listed above the reco
275. sonnel if any diagnostic codes appear with the exception of 1 3 2000 3000 5000 5002 8003 or 8004 Use of a ventilator that has not passed SST or EST is against the strongest recommendation of Respironics Please contact Respironics Customer Service at 1 800 345 6443 or consult your service manual if any diagnostic codes are encountered When connecting a humidifier to the humidifier outlet available only on 100 120 VAC ventilators allowable leakage current values may be exceeded The use of accessories cables and transducers other than those specified may result in increased EM emissions or decreased immunity of the system We recommend that you use an oxygen monitor that complies with 150 7767 Oxygen Monitors or Monitoring Patient Breathing Mixtures Safety Requirements This requirement ensures that the desired fraction of inspired oxygen FiO2 is delivered to the patient The batteries backup battery in the battery compartment are non spillable sealed lead acid Recycle or dispose of batteries properly Do not connect the DC power cord from the backup battery while the Respironics V200 is functioning as a ventilator Always turn the Power On Off switch to off 4 2 4 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 2 Warnings Cautions and Notes e Backup battery operating life may be affected by battery age and the number of times it has been discharged and recharged Over time the bat
276. t The ventilator responds to the PTDT command by returning a string with a variable length Fields 2 through 4 define the length of the message The last character transmitted is a stop code indicating the end of the message The second field indicates the number of characters between the start and stop codes The third field indicates the number of fields between the start and stop codes The fourth field is the start code 0x02 The last field in the string is the stop code 0x03 Patient Data Report Description Example Resolution Range Units Comments Command Name PTDT N A N A N A Number of 275 N A N A N A 3 character field characters between the start and stop codes Number of fields 32 N A N A N A 2 character field between the start and stop codes Start Code 0x02 N A N A N A ASCII Start Transmission Character STX Time of request 13 45 N A N A N A 24 hour clock hh mme Date FEBe92391997 N A N A N A 12 character field MMM DD YYYY Measured Peak 24 100 0 1 for 20 0 to 99 9 20 0 130 cmH5 O The PIP value from Inspiratory 1 for 100 to 130 hPa the Patient Data Pressure screen Measured Mean 5 60699 Airway Pressure 0 1 for 20 0 to 99 9 20 0 120 cmH 20 The MAP value 1 for 100 to 120 hPa from the Patient Data screen Table A 5 Patient Data Report Sheet 1 of 4 Appendix A 18 Respironics V200 Ventilator Operator s Manual REF 1057983 A Appendix A RS 232 Communications P
277. t ventilation REF 1057983 A Respironics V200 Ventilator Operator s Manual 9 9 Chapter 9 Alarms When a ventilator inoperative condition is detected the Vent Inop indicator will display a steady red light and the ventilator will sound a five tone audible alarm sequence The Vent Inop alarm cannot be reset by an operator It cannot be auto reset or silenced The ventilator must be serviced by a qualified service representative in order for the Vent Inop audible and visual alarms to be cleared Safety Valve This indicator signals that the Safety Valve is open and the ventilator is not providing breath support to the patient It is accompanied by a five tone audible alarm sequence and a Safety Valve Open message in the touch screen display The Safety Valve opens automatically whenever the ventilator is not able to provide breath support to the patient It allows the patient to spontaneously breathe room air through the ventilator system The Safety Valve Open condition is normal during start up and restart and it automatically turns off when the start up sequence is complete If this condition occurs at any other time it cannot be reset Immediately use an alternative ventilation source and call for service WARNING When the safety valve open indicator is lit the ventilator does not provide any ventilatory support to the patient Immediately use a backup means of ventilatory support Alarm Silence The indicator C
278. t 4 1 I E Ratio must be less than Readjust the I Time or or equal to 4 1 Check adjust Apnea Rate or Rate Apnea Rate I Time I Time Rise Time Time must greater than or Increase the Rise Time or equal to Rise Time increase the I Time Rise Time Rise Time Time Rise Time must be less Decrease the Rise Time or than I Time increase the I Time Table 12 7 Pressure Control Ventilation Value Entry Reasonability Checks 12 4 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 12 Technical Specifications Non Invasive Ventilation Value Entry Reasonability Checks Message E Ratio must be less than or equal to 4 1 Check I Time Changed Readjust the Apnea Rate or adjust I Time or Rate E Ratio must be less than or equal to 4 1 Check Apnea Rate Readjust the I Time or adjust Apnea Rate or Rate IPAP must be greater than or equal to EPAP Readjust IPAP higher or adjust EPAP lower EPAP must be less than or equal to I PAP Readjust EPAP lower or adjust IPAP higher Item Limit Exceeded Apnea Rate 1 E Ratio gt 4 1 Time I E Ratio gt 4 1 IPAP IPAP EPAP EPAP EPAP IPAP Rise Time Rise Time Time Rise Time must be less than I Time Decrease the Rise Time or increase the I Time Table 12 8 Non Invasive Ventilation Value Entry Reasonability Checks General Value Entry Reasonability Checks Item Limit Exceeded Apnea Message Apnea R
279. t Panel Keys us cp xx RP aa RARE KA WE ERU 12 6 Level Controles zs ux PAR Ue Pi ate Bie eee eux ae era t a Es 12 7 Calculated Values from Expiratory Hold Maneuver 0000005 12 7 Interface Ports cro poh yee ke bee PEGDEWPG x REGE nk ex BY ed 12 7 Environmental Specifications 2 2 lille 12 8 Environmental Protection senes 12 8 AlariTis nei eR bx uer al aes abe aftu ss 12 8 Connectors se bp RE Exe CAO ae eee YR RIA 12 9 Filt tiS co duces tad bi en de S oe ode sot eR belts IB rada h Ron ubi sd 12 10 Measuring and Display Devices l l 12 10 AC Power and Battery Indicators liie 12 10 Leakage Current i voc ou seated bth be a E SEDES 12 11 Compliance and Approvals iles 12 11 Power Requirements 0 0 0 0 ee 12 11 Dimensions and Weights 0 0 iliis ee 12 12 Electromagnetic Compatibility Declaration isle 12 12 Pneumatic Systemsin pia 2 3 sd eed eee Ee E LV ER PE EYE RES 12 17 labels 25 ote in fata atin Peete eee wh om eet MAO Ete 12 18 Options and Accessories 0 ccc cece eens 13 1 Introduction cred dE oe Se oa eee ORAN EUER GERA CREE ea 13 1 Oxygen Sensor Option s r rirpu eee ees 13 3 Assemble O2 Sensor l i 13 3 Attaching the Sensor to the Ventilator llis 13 4 Watranty asi eee Seta Pe bade Raa Gee ase ae eee aE 13 5 Oz Sensor Tee ved ped ees eh ee he ean ek Gada EUR RE RR 13 5 External Battery Option 0 cece eee eee ees 13 7 lristallationis
280. t the end of a successful maneuver a pop up screen displays the result of the maneuver and asks you to accept or reject the results by touching the Accept or Reject button At the end of the maneuver whether successful or cancelled the Stop button changes to Continue While the Continue button is displayed the graph is frozen and can be rescaled Touch Continue or exit the screen to unfreeze the display Touch Continue the button changes to Start and you can repeat the maneuver Return the active ventilation mode from VCV to the previous mode if necessary Pressure Volume and Pressure Time buttons Rescale button P Plat window Static C and R Windows Figure 13 31 Static C and R Screen Information type Description Pressure Volume or Pressure Volume Displays a real time pressure volume loop Pressure Time button Pressure Time Displays a real time pressure time waveform Start button Starts the maneuver Changes to Stop when the maneuver is started Changes to Continue when the maneuver is complete or when the Stop button is touched Changes to Start when Continue is touched Static C and Static R Displays the most recently accepted maneuver results The date and windows time of the maneuver appear below each window Table 13 7 Summary of Static C and R Screen Information REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 57 Chapter 13 Options and Accessories Information t
281. ter The printer must be connected to the ventilator s parallel port and use PCL3 or PCL5 printer language Connecting to a Printer Figure 13 24 shows how to connect a ventilator to a printer Use a standard 25 pin parallel printer cable to connect the ventilator to the printer REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 27 Chapter 13 Options and Accessories Parallel Printer Port Ventilator Back Panel Parallel Printer Cable Figure 13 24 Connecting the Ventilator to a Printer Printing a Screen To print a screen touch the printer icon in the lower right corner of the screen While the ventilator processes the print screen request the screen freezes typical freeze time of 30 60 seconds depending on ventilator settings and the printer icon turns gray Ventilation and monitoring continue uninterrupted although the screen does not update during this time Certain screens and popup menus cover the printer icon and are not available for printing The print screen function is also not available any other time the printer icon is gray Canceling a Print Screen Request To cancel a print screen request e g during an alarm touch the frozen screen at any location Any contact with the touch screen including the gray printer icon while the printer icon is gray cancels the print in progress Print Screen Messages Table 13 2 summarizes print screen messages that can occur The actual message displayed
282. ter with DISS hose connector 4 If gas source is not already turned on turn it on and verify that no O gas is leaking REF 1057983 A Respironics V200 Ventilator Operator s Manual 4 21 Chapter 4 Getting Started Patient Circuit Flex A patient circuit flex arm is provided for use on the ventilator The patient Arm Installation circuit flex arm may be installed on either the left or right side rail on the cart Figure 4 22 Patient Circuit Flex Arm Installation Patient Circuit Flex Arm Installation Instructions Refer to Figure 4 22 l Slide flex arm bracket 1 on to the side rail of the cart one per side 2 Tighten black screw knob 2 on flex arm bracket 3 Insert base of flex arm 3 into flex arm bracket and tighten 4 Place patient circuit hose clamp 4 into the flex arm clamp 5 and tighten 4 22 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 5 Setup Back Panel Connections and Controls 1 RS 232 2 Remote 3 Parallel 4 PCMCIA Serial Port Alarm Nurse Printer Port Card Slot 5 Andlog Port C 6 DC Battery Connector 17 Cooling 7 AC Inlet Fan 8 Humidifier AC Inlet Circuit Breaker 16 Potential Equalization Connection 10 Mains Circuit 15 O Inlet Breaker Filter and 11 Humidifier Water Trap AC Outlet 14 O Inlet Connector 12 Air Inlet Duct and Filter 13 Elapsed Time Meter Figure 5 1 Back Panel 1 232 Serial Port
283. tery will degenerate and will not provide the same amount of operating time per charge that is available from a fully charged new battery Use only the Respironics backup battery P N 1059956 e Titrate the EPAP level such that the masks air entrainment valve if present remains closed to room air Always evaluate and monitor patient condition when adjusting EPAP or other settings The backlight lamps in the monitor display contain mercury which must be recycled or disposed of in accordance with local state or federal laws Within this system the backlight lamps in the monitor display contain mercury Cautions Federal law USA restricts this device to sale by or on the order of a physician Besureto check all exterior parts of the ventilator Problems found during inspection should be corrected and or reported to Respironics before using the ventilator e Always ship the ventilator using the original packing material If the original material is not available contact your Respironics representative to order replacements Do not operate the ventilator without a properly functioning expiratory filter and heater Doing so may cause damage to delicate ventilator components such as the expiratory flow sensor which may lead to inaccurate spirometry or a Vent Inop condition The ventilator oxygen filter should be replaced annually as a part of preventive maintenance The PCMCIA card should only be removed by trained
284. th and mild detergent Do not use liquid or aerosol bactericide Do not allow moisture to come in contact with the touch panel screen or to collect between the keypad and front bezel assembly CAUTION DO NOT allow liquid to penetrate the ventilator rear or front panel DO NOT attempt to sterilize the ventilator by exposing to ETO gas DO NOT steam autoclave CAUTION Care should be taken when cleaning the touch display Refer to Figure 8 2 on page page 8 3 A soft moist cloth should be used that does not drip water and or soap solution when in contact with the display After cleaning and rinsing with a damp cloth remove all moisture with a dry soft cloth Never allow solutions of any kind to collect on the bottom bezel of the display Never use a brush or device that can cause abrasion to clean the touch display or its bezel they will cause irreparable damage Patient Circuit Support Arm Wipe the patient circuit support arm clean with alcohol or bactericide O Gas Supply Filter Water Trap Wipe the exterior of the Oz gas supply filter water trap with a mild solution of soap and water Rinse and dry parts Do not steam autoclave chemically disinfect or expose to ETO gas Do not allow liquid to migrate into the inlet port REF 1057983 A Respironics V200 Ventilator Operator s Manual 10 3 Chapter 10 Care and Maintenance Bacteria Filters Reusable Patient Circuit Tubing Couplings and Connectors Disassemble and clean manual
285. the front panel knob to adjust the value as shown in Figure 8 14 Press ACCEPT to activate the new alarm limit or CANCEL to leave it unchanged 8 18 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 8 Operating Instructions Grayed out buttons indicate that the alarm limits are not active Active Mode NPPV Spont T Patient Data XT Activate vate Push button of High Pre Pressure Control alarm settingto adjust zaii Press this ACTIVATE button to switch to the ventilation breath type indicated The ventilation breath type Apes this butt indicates which alarm L_ CWSetings rovserings wrpvseninse onion oo y set is shown on this Figure 8 18 Setting Alarm Limits That Are Not Currently Active NOTE Any of the changes made in the screen shown in Figure 8 18 do not take effect until the operator switches to the new ventilation breath type in this case Pressure Control Selecting Waveforms VCV only Two inspiratory flow waveforms for mandatory VCV breaths are available descending ramp and square wave Figure 8 19 The selected waveform is highlighted and defines the inspiratory flow for all mandatory VCV breaths whether they are initiated by the patient the ventilator or the operator The waveform selection is not applicable to PCV or NPPV REF 1057983 A Respironics V200 Ventilator Operator s Manual 8 19 Chapter 8 Operating Instructions ETS Patient Dat
286. the upper or lower portion of the scale you want to change 2 Pressthe INCREASE or DECREASE bar or tum the knob to adjust the scale range 3 Press ACCEPT onscreen button or offscreen key Figure 13 17 shows an example of how to adjust an upper scale limit REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 21 Chapter 13 Options and Accessories Press the INCREASE or Upper portion DECREASE of Scale bar or turn knob to adjust scale range Lower portion of Scale Figure 13 17 Manually Adjusting a Scale Freeze Feature The FREEZE button Figure 13 18 pauses the Waveforms or Loops windows for extended viewing when the waveform window is full Freeze button Ses nepleting 14 0 21 ve Figure 13 18 Freeze Button Once the Freeze feature is in effect each graphics window shows numeric data for the cursor position on the waveform display To adjust the cursor position and select which breath appears on the loops windows and view the exact flow pressure and volume at different points of each breath press the arrow button or tum the knob Press the CONTINUE button to unfreeze graphics Figure 13 19 shows a frozen Loops display 13 22 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Cursor position EE waveform and Flow Pressure Volume position and corresponding points on loops Use arrow buttons or knob to set cursor
287. tions and Accessories Available CMS V200 e message equivalent SOR lie CareNet X HIGH High Leak High leak alarm limit violation Yellow Alarm LEAK Rate RATE X LOW EXH Low Vt Low mandatory tidal volume limit violation Yellow MAND TV Mandatory Alarm X HIGHEXH High Minute High exhaled minute volume limit violation Yellow MV Volume Alarm X LOW EXH Low Tidal Low exhaled tidal volume limit violation Yellow Alarm TV Volume X LOW EXH Low Vt Low spontaneous tidal volume limit violation Yellow TV SPNT Spontaneous Alarm X INS TI l Time Too Maximum inspiratory time exceeded Yellow Alarm TOO Long LONG X HIGH High High respiratory rate limit violation Yellow Alarm RESP Respiratory RATE Rate X HIGH High 02 High measured oxygen concentration Yellow Alarm 02 X LOW Low PEEP Low PEEP limit violation Yellow Alarm PEEP EPAP X LOW Low EPAP Low EPAP limit violation Yellow Alarm PEEP EPAP X BACKUP BatteryIn Use Ventilator has switched from AC power to Backup BATT ON indicator on Battery operation Yellow Alarm ventilator front panel Inops X LOSS OF Gas Supplies Oxygen and air sources lost safety valve open GAS SVO Lost SVO X LOW Low Backup Low Backup Battery voltage BACKUP Battery BATT X ALARM Audible Alarm Audible alarm failure FAILURE Failed X AIR Air Source Internal air source failure FAULT Fault X O2 VALVE O2 Valve Defective oxygen valve STUCK Stuck Closed X EXH Exp Va
288. tive to atmospheric pressure unless otherwise noted 8 2 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 8 Operating Instructions The Front Panel The text version of the ventilator s front panel includes the indicators and controls shown in Figure 8 2 The symbol version of the front panel is shown in Figure 8 3 Alarm Status Indicators Touch Display Power Status Indicators Front Panel Keys AME 100 Reset Level Controls Power On Off Switch Figure 8 2 Front Panel Text Version REF 1057983 A Respironics V200 Ventilator Operator s Manual 8 3 Chapter 8 Operating Instructions Alarm Status Indicators Touch Display Power Status Indicators Front Panel Keys Level Controls Power On Off Switch Figure 8 3 Front Panel Symbol Version 8 4 Respironics V200 Ventilator Operator s Manual REF 1057983 A Alarm Status Indicators The alarm status indicators located at the top of the ventilator alert you to the ventilator s alarm conditions Refer to Chapter 9 Alarms for more detailed descriptions Normal Chapter 8 Operating Instructions Alarm High Alarm Med Low Figure 8 4 Alarm Status Indicators Alarm Status Indicators Alarm Indicator Status Description Normal Green No active or auto reset alarm condition exists High Flashing red A high priority alarm condition exists Med Low Flashing A medium priority alarm
289. tor to a properly grounded AC power outlet The ventilator front panel LEDs will indicate the power source that is being used If the ventilator is plugged in and the MAINS LED is not lit either the circuit breaker is off or the wall power outlet is not functioning The two circuit breakers MAINS Humidifier located on the back of the ventilator are covered to prevent unintentional ventilator power off Do not use the circuit breaker to power the ventilator on off The power switch is located on the front of the ventilator below the front panel Always turn the ventilator power OFF before connecting additional equipment Use only Respironics approved cables when connecting to the remote alarm port Be sure to fully insert the cable into the remote alarm port and into the remote alarm 2 2 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 2 Warnings Cautions and Notes When using the Remote Alarm Port be sure to fully test the Remote Alarm Port and cable by e Verifying that annunciated alarms on the ventilator are also annunciated on the remote alarm e Verifying that disconnecting the cable from the Remote Alarm port results in an alarm notification at the Remote Alarm e Verifying that disconnecting the cable from the remote alarm results in an alarm notification at the Remote Alarm Ensure that an alternative means of ventilation that is a resuscitator or similar device is available while the v
290. ttery tray and cart 4 10 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 4 Getting Started Figure 4 13 Installing the Battery Tray 11 Slide the battery halfway down the center column and insert the circular right angle battery connector into the cutout Pull the cable downward as the tray is fully inserted into the cart s center column Figure 4 14 Inserting the Circular Right Angle Battery Connector Into the Cutout REF 1057983 A Respironics V200 Ventilator Operator s Manual 4 11 Chapter 4 Getting Started 12 Fasten the battery tray to the cart using the 4 screws used when the tray was removed Battery tray mounting screws Figure 4 15 Battery Tray Mounting Screws 13 Set the ventilator back on the cart ensuring that the four ventilator feet meet the four circular recesses on the top of the cart Tighten the four mounting screws that were loosened in step 3 4 12 Respironics V200 Ventilator Operator s Manual REF 1057983 A 14 15 16 17 18 19 20 21 22 23 Chapter 4 Getting Started Routing the backup battery cable from the tray between the rear of the ventilator and the rear handle of the cart connect the cable to the circular battery connector on the back of the ventilator Snap the rear channel cover back into place r uw e ll J Battery backup connector 3 771 EE 6 6 L la 6 e e e gt Figure 4 16 Backup Battery Con
291. ttons Active Mode push to display the Active Alarms push to show current alarm settings for the active ventilation mode settings for the active ventilation mode and and breath type breath type Active Mode VCV A C Patient Data Alarm Settings wee Patient Data push to show Monitor push to display the monitor the Patient Data screen screen ventilator settings and patient data Figure 8 10 Top Bar common to all operational screens Figure 8 11 shows the bottom bar and describes its buttons VCV Settings push to display VCV NPPV Settings push to display NPPV Respiratory Graphics settings screen which allows you to settings screen which allows you to Mechanics button selects view and change settings for volume view and change settings for button selects option if controlled ventilation noninvasive positive pressure option if installed ventilation installed VCV Settings PCV Settings NPPV Settings option aay By PCV Settings push to display PCV settings Option for use in the Printer Available if screen which allows you to view and future Communications change settings for pressure controlled option is installed ventilation Figure 8 11 Bottom Bar common to all operational screens Buttons in the bottom bar have two states selected and not selected In the selected state the button has a white background and black letters see VCV SETTINGS in Figure 8 11 In the not se
292. turn Speaking Mode off 3 Inflate the tracheostomy tube cuff if Yes was pressed Press Noto remain in Speaking Mode Figure 13 69 Turn Speaking Mode Off Message Box When discontinuing Speaking Mode we recommend reviewing alarm and ventilator settings again Continue to monitor patient s respiratory effort and clinical status REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 115 Chapter 13 Options and Accessories This page is intentionally blank 13 116 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Auto Trak Sensitivity Introduction Auto Trak Sensitivity is a feature designed to enhance patient comfort and ventilation effectiveness and reduce patient work of breathing Auto Trak automatically triggers and cycles breathing without the need for user adjustment of I Trigger sensitivity and E Trigger cycling thresholds Auto Trak is available in Volume Control Ventilation VCV Pressure Control Ventilation PCV and Noninvasive Positive Pressure Ventilation NPPV Compatible Patient Respironics recommends the following patient interfaces for compatibility with Interfaces the V200 Ventilator in NPPV Refer to the usage instructions provided with each mask for detailed instructions e hRespironics Image3 Full Face Mask e MRespironics Spectrum Disposable Full Face Mask Respironics Total Face Mask e MRespironics Disposable Contour Delu
293. ual REF 1057983 A Code 2134 Chapter 11 Diagnostics Diagnostic Codes and Descriptions Continued Description Cannot Calibrate Air Flow Sensor 2135 Cannot Calibrate O5 Flow Sensor 2136 Cannot Calibrate Exh Flow Sensor 2137 Verify Failure Air Flow Sensor Cal 2138 Verify Failure O5 Flow Sensor Cal 2139 Verify Failure Exh Flow Sensor Cal 2140 Cannot Erase Flow Sensor Tables 2141 Cannot Open Inh Autozero Solenoid 2142 Cannot Open Exh Autozero Solenoid 2152 Patient Wye Not Unblocked 3XXX Extended Self Test 3000 EST Passed 3100 Canceled By User 3101 Air Stepper Motor Outside Range 3102 O5 Stepper Motor Outside Range 3103 Air Flow Outside Range 3104 O Flow Outside Range 3105 Exh Flow Outside Range 3106 Patient Circuit Leak 3107 Inh Pressure Too Low 3108 Exh Pressure Outside Range 3109 Check Valve 2 Leak 3110 Check Valve 3 Leak 3111 O5 Not Connected 3112 O Not Disconnected 3113 FiO Sensor Sample Out of Range 3114 FiO Sensor Average Out of Range 3115 Primary Audio Not Sounding 3116 Backup Audio Not Sounding 3117 Crossover Circuit Fault 3118 Blower Off Switch Failure 3119 Blower DAC Failure 3120 Pressure Relief Valve Cracking Pressure Too High 3121 Pressure Relief Va
294. uctions Push USER CONFIG to check time time format date and altitude and set compliance compensation as required Figure 8 37 If time is found to be incorrect more than once in the preoperational procedure an internal battery may have to be replaced Contact qualified service personnel or call Respironics Customer Service at 1 800 345 6443 Press START SST to begin Short Self Test and follow the screen prompts Use a cap to plug the patient port of the patient circuit wye at the prompt During SST as each test is performed the ventilator displays test results Figure 8 37 Do not proceed until the ventilator completes SST without failures Push USER WARNING The Dagnestes Mode s not Yo be used when a patient amp connected Yo the ventilator CONFIG to set Verdy that the patient i disconnected peior 10 proceeding time date Cancel Circuit Compliance 1 49 ml cm H20 altitude compliance compensation enable and time format PASS PASS PASS Figure 8 37 SST Results WARNING You will be warned if the compliance is 9 0 ml cmH 0 hPa or larger Patients should not be put on a patient circuit that does not meet this requirement REF 1057983 A Respironics V200 Ventilator Operator s Manual 8 33 Chapter 8 Operating Instructions Altitude set Date set Compliance compensation enable disable Time format 12 or Time set 24 hour set Backup Battery confirm at startup enable disable Figure 8 38 User Config
295. ulation to ground in accordance with IEC60601 1 To prevent damage to the remote alarm the signal input should not exceed the maximum rating of 24 VAC or 36 VDC at 500 mA with a minimum current of 1 mA We recommend only those humidifiers that comply with ISO 8185 for use on the ventilator You should consult with the manufacturer s of the active humidification system humidifier and patient circuit components for their most recent recommendations regarding circuit configurations Additionally unless specifically contraindicated by these manufacturers recommendations we recommend the use of a drop down tube and water collection vial water trap placed between the expiratory filter and the expiratory limb of the patient circuit This is necessary to prevent damage to the expiratory filter Reference P N 1006241 Water Collection System or equivalent CAUTION Failure to protect the expiratory filter from damage by using inappropriate patient circuit configurations may cause damage to delicate ventilator components such as the expiratory flow sensor which may lead to inaccurate spirometry or a Vent Inop condition REF 1057983 A Respironics V200 Ventilator Operator s Manual 6 3 Chapter 6 Connecting Additional Equipment WARNING Vent Inop is a serious condition which is indicated by both visual and audible alarms If the ventilator is attached to a patient when Vent Inop occurs the patient must be supported with another means
296. ut of range output set to 99 9 Table 13 4 Ventilation Report Sheet 3 of 10 13 42 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Ventilation Report Description Example Resolution Range Units Comments Measured peak 0 0 0 1o0r1 0 0 99 9 cm Outputs ee ee inhalation pressure 100 130 H20 when ventilation mode is CPAP or Spont and No Apnea alarm is present Measured mean 0 9 0 lorl 0 0 99 9 cm airway pressure 100 130 H 0 Measured end 7 0 0 10r1 0 0 99 9 cm Outputs eese inhalation pressure 100 130 H20 when Ventilation type is PCV or NPPV or Ventilation modeis CPAP or Spont or VCV Insp Hold setting 0 Measured I E ratio 0 2 e 0 1 0 1 9 9 N A Fractional 10 99 representation of 1 X X with one 1 decimal place e g 4 1 20 3 High Inhalation 20 eeee 1 10 105 cm Outputs high Pressure Alarm H20 inhalation pressure setting setting for active ventilation type PCV or VCV or IPAP 10 if NPPV is active Low Inhalation 3eeeee 1 3 105 cm Outputs Low Pressure Alarm H30 Inhalation setting Pressure setting for active ventilation type Low PEEP or Low Oreree 1 0 35 cm Outputs Low PEEP EPAP Alarm setting H20 from active type VCV or PCV When active type is NPPV uses Low EPAP Table 13 4 Ventilation Report Sheet 4 of 10 REF 1057983 A Respironics
297. ventilator may not have respiratory profile monitor software If the NICO button on Trended Data screen is grayed out the respiratory profile monitor interface option is loaded but not enabled on the ventilator Contact Respironics Technical Service 1 800 345 6443 Any other condition What to Do Contact Respironics Technical Service 1 800 345 6443 13 96 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Neonatal Option The Neonatal option allows the Respironics V200 Ventilator to ventilate intubated neonatal patients with an ideal body weight range of 0 5 6 5 kg 1 10 14 33 Ib and an endotracheal tube I D range from 2 5 4 0 mm The option provides pressure control in A C SIMV and Apnea ventilation and also provides pressure support in SIMV and CPAP The Neonatal Option is not available in VCV or NPPV modes System Requirements The Neonatal option requires the following software and accessories for proper use Neonatal option Requirements Respironics V200 Ventilator Neonatal option loaded and enabled NOTE Ventilators with the Neonatal option software x installed are identified by the option label NEONATAL located near the power switch Recommended Accessories Part Number Neonatal patient circuits 10 mm I D Fisher amp Paykel reusable circuit 900MR780 Hudson RCI disposable circuit 780 07 Fisher amp Paykel disposable circuit RT13
298. wer if present external battery then backup battery The ventilator may automatically reset certain types of alarm conditions once the causes of the alarms are corrected After an automatic reset the ventilator will clear the audible alarm and will display a Low Urgency Alarm alert in the Alert Message Insert to inform the operator that an alarm condition existed When this situation occurs use ALARM RESET to clear the visual alarm indicator For optimal performance and battery life of a newly purchased backup battery establish full backup battery charge by plugging the ventilator into AC power for eight 8 hours maximum or until the charging indicator light turns off and then unplug the unit To monitor backup battery performance and life run the ventilator on battery power for at least 20 minutes at typical settings once a month Recharge the battery when the test is complete e If the 100 O key is pressed and a 100 O gas source is not available the Low O alarm will be active for the two minute 100 O delivery period Manual breaths are not permitted during the inspiratory phase of a breath whether manual or spontaneous Pressing the MANUAL BREATH key during these times will not result in the delivery of a manual breath Some settings buttons appear active despite the fact they are not being used in the ACTIVE MODE This is because the setting is used in Apnea Ventilation or when manual inspiration is presse
299. xe Nasal Mask e Respironics Disposable Small Child Nasal Mask Respironics Disposable Nasal Mask The V200 Ventilator s built in exhalation valve satisfies any Respironics mask requirement for an exhalation port in the patient circuit Do not use an additional exhalation device for example Whisper Swivel amp Plateau Exhalation Valve or equivalent If the mask you are using has an air entrainment valve be sure to titrate the EPAP level such that the entrainment valve remains closed to room air This will ensure that the oxygen mix and breath triggering remain unaffected WARNING Titrate the EPAP level such that the masks air entrainment valve if present remains closed to room air Always evaluate and monitor patient condition when adjusting EPAP or other settings REF 1057983 A Respironics V200 Ventilator Operator s Manual 13 117 Chapter 13 Options and Accessories How to Select Auto 1 Touch either the I Trigger or E Trigger button in the Settings screen Trak Figure 13 70 Figure 13 70 Settings Screen 2 When the I Trigger or E Trigger window appears touch the Auto button Figure 13 71 and Figure 13 72 Figure 13 71 Sample Inspiratory Trigger Windowwith Auto Trak Option Available Pressure is not an available option for NPPV 13 118 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Figure 13 72 Sample Expiratory Trigger Window with Auto Trak Opt
300. ynamic C amp R are not calculated for Flow Trak breaths Ti Ttot Ti Ttot is not calculated for Flow Trak breaths Peak Lung Flow Peak Lung Flow is calculated for Flow Trak breaths Table 13 14 Respiratory Mechanics Maneuvers with Flow Trak Alarms The Flow Trak option does not change the ventilator alarms with the exception of those alarms found below in Table 13 15 For a complete listing of ventilator alarms and descriptions see Chapter 9 Alarms Table 9 1 Alarm Alert Messages Flow Trak Affected Alarms Alert Message Description I Time too long The breath transitions from inhalation to exhalation when 3 5 seconds has passed for adults or 2 5 seconds for pediatrics from the start of the mandatory breath If the operator s settings result in a calculated I Time gt 3 5 seconds for adults or 2 5 seconds for pediatrics then the calculated I Time is the cycling criteria Low Inspiratory Pressure Not available for the Flow Trak triggered breath only Table 13 15 Flow Trak Affected Alarms NOTE The I Time too long alarm and or the Low Inspiratory Pressure alarm will sound if a circuit disconnect were to occur 13 86 Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 13 Options and Accessories Respiratory Profile Monitor Interface NICO Esprit Option The respiratory profile monitor interface NICO Esprit software allows the ventilator and the respiratory profile monitor to exchange in
301. ype Description P plat window Displays the most recently accepted maneuver results The date and time of the maneuver appear below each window Scale button at left of Allows you to adjust graphic scales manually The default scales for the graphic display Static C amp R screen are 0 cmH50 to the High Pressure limit for pressure 0 to Vt 100 mL for volume Default scales are in effect every time you enter the Static C and R screen Rescale button Allows software to adjust the vertical scales for waveforms and vertical and horizontal scales for loops Table 13 7 Summary of Static C and R Screen Information Alarms and Error If an alarm occurs during Respiratory Mechanics an Alerts window lists the M essages active alarms Any active maneuvers are cancelled if a high priority alarm occurs If there is a preexisting alarm of any priority when you attempt to start a maneuver the maneuver cannot be performed and an error message is displayed Table 13 8 Respiratory Mechanics Error Messages and Alarms summarizes error messages and changes that can occur during Respiratory Mechanics 13 58 Respironics V200 Ventilator Operator s Manual REF 1057983 A Maneuver Error Messages vc Measurement out of range Measured volume exceeds 9999 mL Vital Capacity unavailable due to alarm condition Alarm condition exists when maneuver requested Maneuver cancelled Operator presses Stop button Maneuver timed out Noinspiration w
302. ystem We also recommend that you run EST between patients to verify the overall functional integrity of the ventilator Refer to chapter 11 for instructions on running EST If EST was run successfully and all configuration information has been entered the ventilator is ready to be used Follow the recommended Preoperational Procedure on page 8 32 once a patient has been selected To exit the Diagnostics Mode you must turn the Power On Off switch OFF 4 and then turn it ON Respironics V200 Ventilator Operator s Manual REF 1057983 A Chapter 6 Connecting Additional Equipment Communication Interface WARNING Always turn the ventilator power OFF before connecting additional equipment CAUTION To prevent the risk of excessive leakage due to external equipment being connected to the ventilator via the communication ports a means for external separation of the conductive earth paths must be provided CAUTION All equipment used and connected to the ventilator communications ports analog parallel and serial must comply with the medical electrical equipment IEC601 1 or other applicable standards The ventilator provides three communications interfaces one serial RS 232 port an analog output port and a parallel port The parallel port is reserved for use by the Communications Option Parallel Remote Alarm AC Power Cord Serial Circuit Breaker cover not shown Humidifier AC Outlet Figure 6 1 Po
303. zzii ke Saeed Lod ae ee ae bL Rd xis 13 8 Power Consumption Sequence saasaa ee 13 8 External Battery Backup Battery Operation 0 0 0 0 iles 13 8 Battery Capacity sae cae sd ee E gad Soe Ba XR RUM E RUE 13 10 Battery Charging cas oes te rex eere EAD i e Pate RR RS 13 10 Testihgz s idee eas he phe be oie Bove aetna 4 T RE 13 11 Battery Specifications sisse ee 13 11 A Narranitys cis steep ORE Y freies eeu cor Eee eR o GE 13 12 Oxygen Manifold Option ccc cece eee e eee mmm 13 13 Kit Contents csse bed vba ws RAPERE aha Salk ee ea bg eck 13 13 Assembly InstructionsSs iei eot sanp ong eek neser inama se tag ev 13 14 Replacement Parts 2 0 cee en 13 17 Using the Manifold sosse lille ee 13 17 REF 1057983 A Respironics V200 Ventilator Operator s Manual V Contents Graphics a pr CE 13 19 Starting Graphles uvxadoesd ta beo dnd Uo Ta XR A XA Ede E A 13 19 Using Graphics sas ils y UE Re E ee ws IU eM RUE E P RENE 13 19 Replotting and Scrolling 2 lille 13 20 Rescaling the Display isle eh 13 20 Freeze Featur amp cea PRS hata hy Erra TA wei Det ees 13 22 Save and Overlay Features sien 13 23 inspiratory Area ies te Rn eee ack CREER ee 13 24 Alarms During Graphics sue x ER REX T AES 13 25 Communications Option Com1 lise 13 27 PrintScreens cuu eerta EE tee a T Pes eee encase Pie agen dee 13 27 VueLink Compatibility 0 0 RR mee 13 29 Configuring the VueLink

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