pNeuton Transport Ventilator

mini Ventilator

Self Guided Tour

Program Objectives

This program is a self guided tour of the

pNeuton mini Ventilator.

At the end of this tour you will be able to:

Describe the main operating features of the ventilator Identify the controls and connections Describe the patient circuit Set-up the ventilator for patient operation Define various clinical environments for ventilator application Clean and maintain the ventilator

Features and Controls – Side Panel

Driving Gas Inputs

Connections for high pressure oxygen and medical grade compressed air source gas

Always use a high flow gas source that can provide 55 + 15 psi (3.8 + 1 bar) pressure at a minimum of 20 L/min

Insure that the compressed air is clean and free of water

Features and Controls – Side Panel

Remote Alarm Output

Remote Alarm connection A properly configured

Remote Alarm will indicate an active ventilator alarm condition in a remote location

Features and Controls – Side Panel

Patient Connection

Connection for the large bore hose of the patient circuit

Features and Controls – Side Panel

Prox Pressure

Patient circuit medium hose connection

Connects to the blue tube from the proximal patient pressure port on the patient circuit

Features and Controls – Side Panel

Exp Valve

Patient circuit small hose connection

Connects to the clear tube for the expiratory valve on the patient circuit

Features and Controls – Side Panel

Audible Alarm Audible alarm sound generator Used for patient disconnect, high

pressure and low gas supply alarms

Will not turn off during low gas supply alarm

Do NOT put tape over the holes, push sharp objects into the holes or interfere in any way with the alarm

The alarm is for patient protection. If you suspect the alarm is not operating properly have the unit serviced immediately

Features and Controls – Front Panel

PEEP / CPAP Control

Adjusts the PEEP / CPAP from 0 to 20 cm H2O

Operates in either mode Automatic sensitivity Oxygen concentration is

maintained at set % Oxygen control

Features and Controls – Front Panel

Peak Pressure Control

Limits peak airway pressure from 15 to 60 cm H2O

Operates only in the IMV + CPAP mode

Used to set the pressure limit during mandatory breath delivery

Features and Controls – Front Panel

Continuous Flow Control

Sets baseline continuous flow for 6, 8, 10, 15 or 20 L/min

Operates in either mode Used to set the flow used for both

spontaneous breaths and mandatory breath delivery

Features and Controls – Front Panel

Inspiratory Time Control

Sets inspiratory time for mandatory breaths from 0.25 to 2.0 seconds

Operates only in the IMV + CPAP mode

Can be used to preset tidal volume using the tidal volume chart on the top of the ventilator

Features and Controls – Front Panel

Expiratory Time Control

Sets expiratory time of mandatory breaths from 0.25 to 20 seconds

Operates only in the IMV + CPAP mode

Use with the respiratory rate chart on the top of the ventilator to determine mandatory breath breath rate

Features and Controls – Front Panel

% Oxygen Control

Delivered oxygen choice from 21 to 100%

Operates in either mode Sets oxygen

concentration of the continuous flow

Features and Controls – Front Panel

Visual Alarm Indicator

Illuminates for an active alarm condition

Alarm warns of patient disconnect after 10 seconds

Alarms for high pressure and low gas supply

Will turn off when alarm is corrected or Reset / Silence Button is pressed

Will not turn off during low gas supply alarm

Features and Controls – Front Panel

Alarm Reset / Silence Button

Press button to silence the alarm system for 25 seconds

Every time the button is pressed the alarm silence period will reset for 25 seconds

Features and Controls – Front Panel

Mode Control

Activates IMV + CPAP mode for delivery of ventilator breaths

Mode is the same as CMV + PEEP

CPAP mode provides continuous flow and CPAP for spontaneous breathing patients

No ventilator breaths in the CPAP mode

Features and Controls – Front Panel

Pressure Gauge

Represents pressure in patient circuit at the patient wye of the circuit

All patient alarms are sensed at the patient wye

Features and Controls – Front Panel

High Pressure Alarm Control

Sets the high pressure alarm from 15 to 70 cm H2O

Independent audible and visual alarm from the Peak Pressure Control

Patient Circuit

Patient circuit is a disposable, dual limb system All hoses attach to the side of the ventilator Patient end connects for clinical intervention

Directly to an endotracheal tube Use NIV kit to provide nasal prong or nasal mask

application in neonates and infants Use full face CPAP mask (non-vented)

Patient Circuit

Which size circuit - Neonatal or Pediatric? The neonatal circuit uses 10 mm hoses and is designed for

patients up to 3 kg The pediatric circuit uses 15 mm hoses and is designed for

patients above 3 kg If your patient needs 10 L/min or more continuous flow to

meet spontaneous flow demand, you should use the pediatric circuit to minimize expiratory flow resistance

Patient Circuit

Use only Airon Corporation patient circuits Calibration of the PEEP / CPAP and Peak Pressure controls is

based on the Airon circuit and exhalation valve Using other manufacturers circuits / exhalation valve may

cause: errors in pressure delivery high expiratory flow resistance interference with CPAP setting

Program Objectives

pNeuton mini Ventilator self guided tour, objectives completed so far

Describe the main operating features of the ventilator

Identify the controls and connections Describe the patient circuit

With an understanding of pNeuton’s capabilities, let’s look at patient application.

Patient Application

Set Main Controls PEEP / CPAP can be set

to minimum Determine peak

ventilating pressure Set desired continuous

flow to meet patient needs Set Inspiratory Time Set Expiratory Time Choose % Oxygen Adjust High Pressure

Alarm for safety

Patient Application

Initial Set-up Attach Airon patient circuit

to ventilator Attach a test lung to the

patient connection on the circuit

Attach high pressure oxygen and air hoses to the side of the ventilator

Attach these hoses to the gas supplies

Patient Application

Begin Ventilation Turn ON gas supplies Alarm system will

immediately activate Press Alarm Silence button if

desired For IMV or CMV, set Mode

control to IMV+CPAP Ventilator will start to provide

breaths at the settings on the controls

Patient Application

Set PEEP / CPAP Adjust the PEEP / CPAP

control to the level desired Adjust continuous flow to

meet patient demand – not too high to create expiratory flow resistance – not to low to cause pressure swings and high patient effort Use 6 – 8 for neonates Use 8 - 10 for infants Use 10 – 20 for children

Ventilator Operation

Alarm System Functionality Alarm preset to activate within 10 seconds Pressing the Alarm Silence button equals 25

second delay Disconnect Alarm is looking for a specific

minimum pressure of at least 3 cm H2O at all times

If there is not at least 3 cm H2O CPAP or mandatory breaths pressure of 3 cm H2O, the alarm will sound

High pressure alarm activates whenever the pressure in the circuit exceeds the alarm control setting.

Input Gas Pressure below 40 psi (2.8 bar) will activate the alarm

Ventilator Operation

Peak Pressure Limit Operates to limit the peak airway

pressure during mandatory breaths

For volume ventilation, set the Peak Pressure 10 cm H2O above the pressure needed to deliver the set Tidal Volume

Peak Pressure control is not an alarm. Use the High Pressure Alarm control for this function

Ventilator Operation

% Oxygen Control Set % Oxygen control to the

desired oxygen level Accuracy is plus / minus 3% The ventilator uses the oxygen

gas supply for internal operation so high oxygen concentrations may deplete tanks quicker

Clinical Issues

Neonatal Ventilation Inspiratory time setting 0.25 to 2.0 sec Use low continuous flow for proper

breath delivery and minimize expiratory flow resistance

Inspiratory time, flow and pressure (along with lung compliance / resistance and ET-Tube leak) will determine tidal volume to the patient

Use the respiratory rate chart on top of the ventilator to estimate ventilator rate

Use NIV kit for nCPAP Monitor closely for patient synchrony

Clinical Issues

Non-invasive Ventilation (NIV) Use Airon NIV kit with nasal prongs or

masks Proximal pressure measured will

display on pressure gauge and be used by alarm system

Effective patient interface seal will insure proper alarms

Rotate from nasal masks to prongs every few hours for patient comfort and proper skin care

Clinical Issues

Pediatric Volume Ventilation

Set the Peak Pressure to a safe pressure level

Refer to the Tidal volume chart on the top of the ventilator for I-Time / Flow combinations to determine the proper settings for the tidal volume desired

Adjust Inspiratory Time control / flow to increase or decrease tidal volume - more flow or time equals larger tidal volume

Adjust PEEP / CPAP to established baseline pressure

Clinical Issues

MRI Operation pNeuton mini is compatible with MRI

scanners up to 3 Tesla in strength While tests show that pNeuton functions at

the bore of the MRI unit, a minimum proximity of 12 inches (0.3 meter) from the bore is recommended

Safe MRI practice calls for all devices used in the proximity of a MRI scanner, including pNeuton mini, be anchored to prevent inadvertent movement

Clinical Issues

Altitude Operation The pNeuton mini may be used for air

transports in unpressurized cabins up to 15,000 feet

Inspiratory time will increase and expiratory time will decrease as altitude increases

Pressure settings will not change as altitude changes

Always use external monitors and pulse oximeters to monitor your patient

Patient Safety

pNeuton - Patient Safety Features

Audible and Visual Alarms for patient disconnect, high pressure and low supply gas pressure

High Pressure Release – pressure is relieved at the Peak Pressure control setting

Internal Safety Pressure Release – limits circuit pressure to 70 cm H2O, regardless

of the setting of the Peak Pressure control Anti-Suffocation System – in the event of

ventilator malfunction an internal valve will allow ambient air to enter the patient circuit

Cleaning and Maintenance

Clean ventilator between patient use applications using a soft cloth and a mild detergent / disinfectant

Do not immerse the ventilator in water Patient circuit is disposable, single use

application and should not be cleaned, disinfected or reused

Ventilator should receive preventative maintenance every 2 years

Program Objectives

pNeuton mini Ventilator self guided tourcompleted; you should now be able to:

Describe the main operating features of the ventilator Identify the controls and connections Describe the patient circuit Set-up the ventilator for patient operation Define various clinical environments for ventilator application Clean and maintain the ventilator

Next Step – consider reviewing the pNeuton Case Study and completing the competency evaluation

Contact Information

Thank you for you interest in the pNeuton mini Ventilator

For more information visit www.AironUSA.com

or call Airon Corporation at

USA + Canada toll free 888-448-1238International +1-321-821-9433