Oscillator Set Up Picture Guide

Transcription

Oscillator Set Up Picture Guide
Code (Ref 766897)
HFOV – Equipment Required (Filtered circuit)
pg1
Diaphragm &
water trap
Code (Ref 16390-102)
Long and short
circuit tubing.
Connect pt. end
directly to ET
tube
DO NOT USE A
CATHETER MOUNT
Code (Ref 11438)
Colour coded
lines – Place the
shortest line to
the closest cap
Conventional
chamber wire
and double split
heater wire
Side view of connection
Place slightly angled upwards
Code (Ref MR290HFV)
Humidification
Chamber must be
MR290 HFV type
and not standard or
will crack
Change inspiratory filter WEEKLY
(Ref PN12151)
Change expiratory filter DAILY
(Ref PN12152)
ALL PACKAGED TUBING IS SINGLE PATIENT USE AND DISPOSABLE
TURN BELLOWS SCREWS
CLOCKWISE TO SECURE
Keep Bellows tubing
In a 6 o’ clock position
ON/OFF
MINIMUM WATER LEVEL
(never empty fully or it will lead to
a pressure loss)
KEEP VALVE IN CLOSED
HORIZONTAL POSITION
N.B. ALL 4 BELLOWS SCREWS MUST BE CORRECTLY SECURED FOR THE OSCILLOTR TO FUNCTION
HFOV – Machine Set Up Instructions
Pg 2
Machine Set Up Instructions
Step 1 Gather equipment – diaphragm with water trap, pre packaged long &
short tubing (contains caps & inspiratory/expiratory filters), Colour coded
lines, Humidification chamber (MR290HFV), conventional
longofchamber
Side view
connectionwire,
Place
slightly
upwards
double split heater wire, sterile bag of water & air inlet
(pics
pg angled
1)
Step 2 Remove the white dome protector, push back the metal dome and
attach the diaphragm to the machine (pic opposite). Ensure all diaphragm
surfaces are flush with machine. Ensure that the tubing hanging from the
bellows hangs in a 6 o’clock position before locking the diaphragm in place.
Turn all 4 screws in a clockwise direction to lock. All screws must be in a fully
locked position for the machine to operate correctly.
Step 3 Place the water trap into the holder that is directly below the
diaphragm ensuring the tap is in a horizontal locked position otherwise the
system will leak air and lose pressure when operational.
Step 4 Place the Humidification chamber on the humidifier (must be MR290
HFV type as a standard chamber will crack) and attach to the sterile water
bag. Ensure the chamber fills to its preset filling level. Spike the sterile water
with an air inlet.
Step 5 Connect the short
circuit tubing with its
inspiratory viral filter from
the humidification
chamber to the rear of the
machine (Pic opposite)
HFOV – Machine Set Up Instructions (continued)
Pg 3
Step 6 Leave the green stopper in the pt end of the long circuit
tubing. Attach the widest piece of the tubing to the central
Side view of connection
connection on the diaphragm -this can be quite
stiff to angled
attachupwards
(pic
Place slightly
opposite).
Step 7 Ensure the black angle rest is positioned in a slightly upward
position for this section to rest on
Step 8 Attach the 2nd widest piece of tubing of the long circuit (has
a heater within) to the humidifier chamber.
There are 4 colour coded points directly above the
diaphragm.
Step 9 Attach the remaining long tubing with the white end from the
long circuit tubing to the white point above the diaphragm and the
remaining short tubing to the top end of the water trap
Step 10 Attach the colour coded lines from their points above the
diaphragm to the white caps on the circuit tubing. (Shortest line the
nearest cap) so green line to the first, red to the next and blue to the
cap on the short circuit tubing (pic opposite).
Step 11 Connect the machine to the air and oxygen source and
connect to mains
Step 12 Calibrate the O2 analyser (instructions on side of analyser)
Step 13 Switch the machine on (button next to water trap)
CARRY OUT A PATIENT CIRCUIT CALIBRATION TEST
(described overleaf & on the R side of the machine)
HFOV – Machine Set Up & Calibration
Oscillator
Mean Pressure Monitor
Pg 4
Calibration Instructions
found on the R side
Mean Pressure
Bias Flow
KEEP AT 40LPM
Amplitude
Start at Map +5cm H2o
Start at 4cmH20
Alarms
RESET/POWER
FAIL
% Inspiratory time
Start at 33%
OSCILLATOR START/STOP
Frequency
Start at 6 Hz
Ensure LPM rate line
Is midway on flow ball
For lung recruitment to pressurise the system hold down reset/power fail button while increasing the mean pressure to a minimum of 10cmH20.
Once reached release the reset/powerfail button and increase mean pressure to the therapeutic level (previous conventional MAP + 5cm H2O).
Patient Circuit Calibration (Sensormedics 3100B amchine)
Before use on a patient, each patient circuit must undergo a patient circuit calibration procedure. Instructions found on the right side of the machine and also( outlined below)
Step 1 Complete all set up instructions as described ensuring you leave the green stopper at the patient end of the long tubing until the calibration procedure is completed
Step 2 Turn on the Bias Flow Gas to 40LPM ensuring the 40 LPM line is at the middle of the ball
Step 3 Set Max PAW Alarm to 59 cmH2O
Step 4 Rotate the Mean Pressure (green Dial) and set the control to “Max”
Step 4 Adjust the Bias Flow to 20LPM again ensuring that the 20LPM line is at the middle of the ball
Step 5 (leave Oscillator Off) Depress and hold Reset/Power Fail and check that the Mean Pressure Monitor display reads 39-43cm H2O. If it does not refer to dept of anaesthetics
Prior to patient commencement (Sensormedics 3100B machine)
•Prior to patient connection return the mean pressure adjustment dial to min and increase the bias flow to 40LPM (ensure the 40LPM line is midway on the flow ball)
•Set the FiO2 setting to 1.0, the Amplitude to 4 cm H2O, the % inspiratory time to 33% and the Frequency to 6Hz
•Ensure the following equipment is kept by the patient:1. A conventional ventilator (set up in the bed-space). 2 A self inflating bag (e.g Ambubag - N.B. additional O2
source required) & 3 a green bung (to pressurise the circuit) Follow the units guidelines for steps to be taken prior to HFOV initiation and recruitment
strategies for patient commencement (rapid and slow manoeuvres)
•The guidelines also cover indications, initial & general management initial settings, weaning and discontinuation
HFOV Machine -- ALARMS
Pg 5
PRESET HIGH AND LOW MEAN PRSEEURE
AIRWAY ALARMS
Upon activation the oscillator will stop and the circuit
pressure will vent to ambient.
YOU WILL NEED TO RE-RECRUIT
HIGH MEAN PRESSURE ALARM
Activation of this alarm will trigger the Auto Limit System.
The Auto Limit System will open the “blue” limit valve on
the circuit and vent pressure.
The valve will then re-pressurise to it’s normal operational
state unless it pressure reaches Paw>60cmH2O before
the issue is resolved. If this happens the circuit pressure
will vent to ambient, the oscillator will stop and
YOU WILL NEED TO RE-RECRUIT
LOW MEAN AIRWAY PRESSURE ALARM
SOURCE GAS
LOW ALARM
If either of the high
pressure gas supplies
fall below 30 PSI. This
will activate the visual
indicator only Check
gas supply if activated
BATTERY LOW
ALARM
If the nine volt
alarm battery needs
replaced.
this will activate a
visual indicator only
OSCILLATOR
OVERHEATED
ALARM If the linear
motor temperature
exceeds 150 degrees
Centigrade this will
activate a visual
indicator only.
OSCILLATOR STOPPED
ALARM
If the oscillatory amplitude is
at or below 7 cmH2O and
the oscillatory system is
pressurised
( the green LED on the start
stop button will be lit) both
audible and visual indicators
will be activated
Activation of this alarm will only provide audible and visual
alarms. The visual alarm will automatically reset after the fault
condition has resolved unless the pressure drops to Paw<5cm
H20 before the fault is resolved. If this happens the circuit
pressure will vent to ambient,
the oscillator will stop and
YOU WILL NEED TO RE-RECRUIT
AFTER RESOLUTION OF THE FAULT THE
VISUAL ALARM CAN BE CLEARED BY
PRESSING THE RESET/POWER FAIL
BUTTON