PRESENTED BY LEE FAH HOONG PRINCIPAL TECHNICAL SUPPORT ENGINEER, SEA

840 USER INTERFACE WORKSHOP

WORKSHOP REQUIREMENTS

PB840 Vent

AC

BPS

Inspiratory and Expiratory Filters

Wall Air and Wall Oxygen sources & hoses

Grasp the Oxygen Hose firmly and push the Quick Connect fitting into the Oxygen Outlet:

CONNECTING THE GAS SOURCES:

CONNECT THE PATIENT CIRCUIT, FILTERS & LUNG

NOTE: to eliminate leaks, make sure that the barbs of the patient circuit wye fit snuggly in the patient circuit tubing grooves.

THE RIGHT WAY TO POWER UP THE 840:

The 840 should always be powered on with an open circuit.

By leaving the Expiratory Bacteria Filter Latch open, you’ve created an open circuit condition. You can also leave the test lung disconnected.

NORMAL OPERATION STARTUP SCREENS

On power up the ventilator runs POST.

Default startup screen is displayed there

are no failure conditions

Note what is displayed on the upper

screen:

Vent Startup in progress

Circuit type?

Humidification type?

Time and date?

SST & EST overall test result?

“NORMAL OPERATION” LOWER SCREEN DISPLAY AT START-UP

NOTE: Running EST

wipes out the SAME

PATIENT settings from

the previous setup.

In that case, you may

only see NEW PATIENT

& SST buttons available

in normal operation.

IMPROPER 840 START-UP:

For safety, the ventilator issues a Procedure Error

Alarm and initiates Safety Ventilation Mode if a

patient (or closed circuit condition) is detected

before all of the ventilator settings have been

entered and confirmed (accepted).

Safety ventilation is an emergency mode of

ventilation per the displayed settings.

SAFETY VENTILATION

After POST: 840 generates 10 LPM Flow to check for patient connection.

If the measurement circuitry detects the 10 LPM flow, Procedure Error is initiated.

GUI STATUS INDICATOR PANEL

GUI KEYBOARD

Rotary Encoder Knob

ACCEPT key

CLEAR key

MANUAL INSP key

100% O2 / CAL 2 min key

RESET key

2 min key

VOL key

SCREEN LOCK key

GUI SCREEN SECTIONS Patient Data

Alarm and Status

Miscellaneous Data

SandBox

Primary Settings

Symbols Definitions

Prompt Area

LOWER STARTUP SCREEN

• Press the “Same Patient”

button

LOWER STARTUP SCREEN

• A button is activated when it turns orange.

• Press ACCEPT.

UPPER GUI SCREEN

• Now lower the blue expiratory bacteria filter latch

THE NEXT SCREEN DEFAULTS TO THE APNEA SETUP SCREEN AFTER

SELECTING SAME PATIENT OR COMPLETING A NEW PATIENT SETUP

ALWAYS PRESS THE ALARM SETUP BUTTON TO ADJUST THE ALARM

SETTINGS OR TO TURN THEM OFF IF YOU ARE EVALUATING (ASSESSING) THE

VENT OR RUNNING PVT. HOWEVER, FOR NOW, DO NOT ADJUST THEM.

PATIENT DATA – WHAT DOES IT MEAN?

CIRCUIT & HUMIDIFICATION TYPE AND TIME & DATE

THE MORE INFORMATION SCREEN IF LEAK COMPENSATION IS ENABLED

O2 Sensor Reading – if the reading is out, can calibrate, disable or replace

ALARM LOG ICON

SAMPLE MORE ALARMS SCREEN

ALARMING DOGGIES

PRESS THE OTHER SCREENS BUTTON & TO VIEW THE OTHER

SCREENS. AFTER SELECTING A SCREEN TO VIEW, YOU MUST

PRESS THE OTHER SCREENS BUTTON AGAIN TO BRING BACK

THE SCREEN SELECT MENU BELOW:

PRESS TEST SUMMARY

Next, press the Other Screens button to bring back the screen select menu.

PRESS VENTILATOR CONFIGURATION Ventilator S/W

POST S/W

GUI & Ventilator

serial numbers (S/N)

Compressor S/N

SAAS S/W

Options

Next, press the Other Screens button to bring back the screen select menu.

SAAS = Safety Audible Alarm System

PRESS DIAGNOSTIC CODE LOG

Next, press the Other Screens button to bring back the screen select menu.

PRESS OPERATIONAL TIME LOG

Next, press the Other Screens button to bring back the screen select menu.

PRESS SST RESULTS LOG

Next, press the Other Screens button to

bring back the screen select menu.

PRIMARY SETTINGS AREA: CONTAINS VENTILATOR

SETTINGS DEFINING HOW A BREATH IS DELIVERED TO THE

PATIENT.

10

A/C VC V-TRIG 50

365 44 21

RAMP

1. Which button represents how often the vent will deliver a

controlled breath?

2. Which button represents how much oxygen is delivered?

3. Which button represents how much volume is delivered?

4. Which button represents how much positive pressure is

maintained during exhalation?

5. Which button represents the rate of volume delivery?

SYMBOLS DEFINITIONS AREA – PRESS THE PEAK FLOW BUTTON TO VIEW ITS NAME:

When a button is pressed, you know it is activated

because it changes to an

orange color.

10 44 21

AC

RAMP

CHANGING THE IBW FROM VENT SETUP TOUCH THE IBW BUTTON:

50 110 50

110

CURRENT

SETUP

Current Vent Settings

Sandbox

CHANGING THE IBW FROM VENT SETUP: TURN THE KNOB TO LOWER THE IBW BELOW RECOMMENDED S/W LIMITS:

12

A/C VC V-TRIG 50

400 50 21

RAMP 0

25 55 Press OK

& continue to

turn the knob.

TOUCH CONTINUE & PRESS THE ACCEPT KEY

12

A/C VC V-TRIG 50

400 50 21

RAMP 0

9 20

UPDATED IBW SETTING

12

A/C VC V-TRIG 50

400 50 21

RAMP 0

9 20

9

Now change the IBW

Back to 50 kg!

Peak Pressure = PEEP + Pi

20

Now change the PC breath type back to VC and PEEP

from 10 to 3cmH2O.

Pressure Control Ventilation

ALARM SETUP ICON

Ppeak (High circuit pressure limit) – sets the maximum circuit pressure allowed during inspiration

ALARM SETUP ICON

fTot (Breath rate) – sets the maximum breath rate limit (may be an indicator of breath stacking, autocycling or patient distress)

VeTot (Minute Volume) – sets the min & max exhaled minute volume for mandatory & spontaneous breath types

ALARM SETUP ICON

Vte mand (Mandatory exhaled tidal volume limit) – sets the min and max mandatory exhaled tidal volume limit

ALARM SETUP SCREEN

Medium urgency alarm High urgency alarm

LAST 200 BREATHS TO HELP CLINICIANS SET APPROPRIATE ALARM LIMITS

TURNING OFF THE 840 ALARMS

Touch the alarm setup icon in the lower screen to activate that screen if it is not already selected.

Turn off all alarms by pressing the gray alarm buttons and turning the knob to raise the upper limit alarms until they read OFF or 100 cmH2O for Ppeak (it’s max setting).

Turn off all the lower limit alarms until they read OFF or 0.050 ml for Vetot (it’s min setting).

OTHER SCREENS ICON

Click on each of

the buttons

to view the

associated

screen

WORK?

Performed during normal operation when ventilating – should be performed DAILY when in use

When the 100% O2 Cal 2 MIN key is pressed, vent performs a single-point oxygen sensor calibration during the 100% suctioning procedure

Allows you to calibrate the sensor without having to disconnect the patient

Oxygen Sensor Calibration

CALIBRATE THE OXYGEN SENSOR Press the 100% O2/CAL 2min key on the keyboard to

calibrate the Oxygen sensor.

Press the More Information icon in the Upper Screen to view the O2 Sensor reading:

UNDERSTANDING THE VT VS VTE RELATIONSHIP Locate Vt in lower screen and compare to Vte in

upper screen

Vte Must be +/-10mls +/- 10% of set

VtVte = Spirometry = Patient’s Exhaled Tidal Volume

Set Tidal Volume (Vt) 365 mls

+ 10 mls

375 mls

+ 36.5 mls (+ 10%)

High Limit 411.5 mls

Set Tidal Volume (Vt) 365 mls

- 10 mls

355 mls

- 36.5 mls (- 10%)

Low Limit 318.5 mls

5 CONDITIONS THAT MAY CAUSE THE SPIROMETRY READING TO BE INACCURATE.

1. A leak 2. An obstruction 3. Wrong humidifier type 4. Wrong circuit type 5. A bad Q3 exhalation flow

sensor.

Time &

Date Stamps

Scroll Bar

Alarm Log

Can store up to 80 of the most recent events

Tracks PATIENT RELATED ALARMS, Device Alerts, and System Faults such as Low/Loss AC, Low/Loss of O2 and/or Air, Circuit Disconnects, and Occlusions

Completing a new patient setup clears log memory

ALARM LOG The Alarm Log shows

alarm events in order of occurrence, with the most recent event at the top of the list:

Time stamped alarms

Alarm silences

Alarm resets

The question mark in a triangle appears if the log contains an event that has/had not been viewed yet.

ALARMS

High-urgency alarm indicator

Medium-urgency alarm indicator

Low-urgency alarm indicator

Alarms on the 840 Ventilator

System are classified as

High, Medium, or Low

urgency

! !

!

High Priority Alarm: 5 tones

SMART ALARMS

High urgency- requires immediate attention.

Red high urgency !!! indicator flashes rapidly

High urgency audible alarm sounds (5 tones repeated twice)

Upper screen flashes alarm message

ALARMS

CIRCUIT DISCONNECT ALARM

Press the Alarm Log icon in the upper GUI screen and the Alarm setup icon in the lower GUI screen.

Create a tubing disconnect by removing the test lung from the patient wye.

What urgency alarm is generated? What is displayed in the upper GUI screen? Does pressing the Alarm Silence button silence the alarm? What new entry is in the Alarm Log?

Reconnect the test lung. What happened? Does the Alarm Log reflect the series of events?

Medium Priority Alarm: 3 tones

SMART ALARMS

Alarms

Medium urgency requires prompt attention

Yellow medium urgency !! indicator flashes slowly

Medium urgency audible alarm (a repeating 3 tone sound) is enunciated

The upper screen flashes an alarm message

Low Priority Alarm: 2 tones

Smart Alarms

Low urgency alarms tell you there has been a change in patient-ventilator system

Yellow low urgency !! indicator lights

Low urgency audible alarm (two tone non-repeating sound) is enunciated

Upper screen displays an alarm message

ALARMS

Alarm handling:

Medium urgency alarms may escalate to high or de-escalate to low urgency

Low urgency alarms may escalate to medium or high urgency

All patient alarms will auto-reset if the criteria is reached

ALARMS

2 of last 4 mand breaths < set limit.

Check for leaks, changes in patient’s R & C.

V TE MAND Base Message:

Analysis:

Remedy:

ALARMS

GOLDEN RULE #1

If possible, always review and, if applicable, make

note of the Alarm Log, Ventilator Settings, Alarm Settings, and

Apnea Settings, before doing anything to the ventilator:

Turn to the Sample Alarm Log on pages 4 & 5 of the Reference Manual Addendum

End!

QUESTIONS? Q&A