Monitoring with the Vision

1
Monitoring with the Vision

• Alarms

2
Alarm Overview

• Alarm Warning Signal of an Event
• Event A Noteworthy Happening
• An abnormal clinical occurrence
• Requiring clinical awareness or action

3
Alarm Overview

• Events Are Related To
• Technical performance of the ventilator system
• or
• Patients clinical condition

4
Alarm Overview

• Two Types of Alarms
• System
• Adjustable

5
Alarm Overview

• Alarm Indications
• Visual
• Audible
• Two Tones
• Alarm Reset
• Manual
• Self-canceling
• Nurse Call/Remote

6
System Alarms

• Check Ventilator Performance
• Preset and Not Adjustable
• Continuous Tone

7
System Alarms

• Ventilator Inoperative
• Check Ventilator
• Pressure Regulation
• Proximal Pressure Line
• O2 Flow
• Exhalation Port
• Disconnect

8
Ventilator Inoperative
System Alarm Audible Visual

• Why?
• System Malfunction
• AC Power Failure
• What Happens?
• Ventilator Powers Down
• Valves Open to Atmosphere
• allows spontaneous breathing

9
Check Ventilator
System Alarm Audible Visual Manual Reset

• Abnormal Operating Condition
• What Happens?
• Ventilator Continues to Operate
• Unit Requires Service
• Visual Indicator Remains Until Condition
  Corrected

10
Check Ventilator
System Alarm Visual Audible Manual Reset

• Why?
• Internal Battery Voltage is Low
• What Happens?
• Internal Battery Cannot Sustain Audible Alarm
• AC Power Will Trickle Charge

Error Code 205
11
Pressure Regulation
System Alarm Audible Visual Self-canceling

• Why?
• Proximal and Set Pressure Vary
• /- 5 cm H2O
• What Happens?
• Ventilator Sends Available Flow to Achieve Set
  Pressure

P Regulation
12
Proximal Line Disconnect
System Audible Visual Self-canceling

• Why?
• Proximal Pressure lt 1 cmH2O
• What Happens?
• Ventilator Continues to Deliver Set Pressure

ProxLine Disc
13
Oxygen Flow
System Alarm Audible Visual Manual Reset

• Why?
• Insufficient Oxygen Flow
• What Happens?
• FIO2 Cannot be Maintained Ventilator Continues to
  Deliver Set Pressure

O2 Flow
14
Exhalation Port
System Alarm Audible Visual Self-Canceling

• Why?
• Baseline Flow Decreases Below Intentional Leak
  Rate
• 5L/min or 50
• What Happens?
• Ventilator Continues to Deliver Set Pressure

Exh Port
15
Learn Function

• Learns Base Flow
• Upon system start-up
• After mode changes
• Activated manually
• With circuit condition changes
• Modify Alarms screen

16
Disconnect Alarm
System Alarm Audible Visual Self-Canceling

• Why?
• Patient Disconnect
• High flow rates for 4 seconds

What Happens?
Disconnect

• Ventilator decreases flow to idle

17
Flow Limit Control

• What Is It ?
• Recognizes Patient Disconnection
• Decreases total flow to idle
• Flow Returns to Normal
• Spontaneous patient trigger

18
Benefits of System Alarms

• Monitor Operating Specifications
• Warn of Abnormal Operating Conditions
• Visual Messages Facilitate Troubleshooting

19
Adjustable Alarms

• Monitor Specific Patient Parameters
• Clinician Adjustable
• Multiple Tone

20
Adjustable Alarms

• High Pressure
• Low Pressure
• Low Pressure Delay
• Apnea

• Low Rate
• High Rate
• Low Minute Ventilation

21
High Pressure
Adjustable Alarm Audible Visual Self-canceling

• Why?
• Proximal Pressure Exceeds Hi P Alarm Limit
• What Happens? Inspiration is Terminated
• Safety Feature

Hi P
22
Low Pressure Low Pressure Delay
Adjustable Alarm Audible Visual Self-canceling

• Why?
• Proximal Pressure Below Lo P
• Limit for Set Time Delay
• What Happens?
• Ventilator Continues to Function

Lo P
23
Setting Pressure Alarms

• Hi P and Lo P
• Bracket IPAP
• Lo P Delay
• According to patient condition

24
Apnea
Adjustable Alarm Audible Visual Self-canceling

• Why?
• Absence of Spontaneous Trigger for Set Time
  Interval
• What Happens?
• Timed Breaths are Delivered at Set Rate

Apnea
25
Apnea (cont)

• Audible resets only when condition is corrected
• Two spontaneous triggers
• Safety feature
• Apnea Can be Disabled

26
Low Rate
Adjustable Alarm Audible Visual Self-canceling

• Why?
• Total Respiratory Rate is Below Lo Rate Limit
• Setting Lo Rate Alarm Limits
• Set Below Total Respiratory Rate
• And Above Set Rate

27
High Rate
Adjustable Alarm Audible Visual
Self-canceling

• Why?
• Total Respiratory Rate is Above Hi Rate Limit
• Setting Hi Rate Alarm Limits
• Set Above Total Respiratory Rate

28
Low Minute Ventilation
Adjustable Alarm Audible Visual
Self-canceling

• Why?
• Minute Ventilation Falls Below Set Lo MinVent
  Limit
• Setting Lo MinVent alarm limits
• Set 20 lt Total Minute Ventilation
• Use MinVent estimation

29
Benefits of Adjustable Alarms

• Monitor Patient Conditions
• Warn of Critical Changes in the Patient
• as determined by the clinician
• Visual Messages Facilitate Troubleshooting