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Maquet SERVO-i V3.1 User Manual Download Page 188

186

Servo

… 

 User´s manual

US edition
Order No: 66 00 261

7

 

Infant

     

Adult

  

 

Universal

   

 

Options

 Servo Ultra Nebulizer

WARNINGS!

• Servo Humidifier/HME must be 

disconnected during nebulization. 
Otherwise the humidifier may be blocked.

• The heated humidifier must be switched 

off during nebulization. Otherwise the 
particle size may be affected.

• When a Servo Ultra Nebulizer is used, 

always consult the drug manufacturer 
regarding the appropriateness of 
ultrasonic nebulization for certain 
medications.

• The nebulizer must not be used without 

buffer liquid (sterile water). Otherwise the 
ultrasonic generator crystal may break. 

• Continuously check that the buffer liquid 

level is between MIN. and MAX. during 
nebulization.

• During nebulization: Continuously check 

that moisture is generated in the 
medication cup.

• During nebulization a filter must be 

connected to the expiratory inlet of the 
ventilator. Always carefully monitor the 
airway pressure during nebulization. 
Increased airway pressure could be 
caused by a clogged filter. The filter should 
be replaced if the expiratory resistance 
increases or every 24 hours when the 
nebulizer is being used.

• When the ventilator is running on batteries 

the nebulizer module is inoperative to 
reduce the power consumption.

Cautions:
• Check that the medication cup is 

undamaged and that it is firmly in place 
before the nebulizer is started.

• If a nebulizer and a CO

2

 analyzer are in use 

simultaneously, the CO

2

 reading may be 

affected.

Important:The Servo Ultra Nebulizer may be 
interrupted shortly due to overheating. It will 
automatically start again when the buffer 
water has cooled. During this short period of 
time no alarm is activated and the timer is not 
interrupted.

Note: For information about the stand alone 
Aeroneb Professional Nebulizer System, 
refer to separate manual.

Note: The 

 Y Sensor measurement can be 

incorrect when the Aeroneb Professional 
Nebulizer System is in use. Therefore, we 
recommend that the Y Sensor is removed 
from the patient circuit during nebulization.

Nebulization

Summary of Contents for SERVO-i V3.1

Page 1: ...User s manual US Version VENTILATOR SYSTEM SERVO i V3 1 ...

Page 2: ......

Page 3: ...ation 15 3 Patient safety 71 4 Device description 81 5 Set ups and preparations 119 6 Pre use check 145 7 Operating your Servo i 157 8 Routine cleaning 191 9 Maintenance 211 10 Troubleshooting 225 11 Technical data 241 12 Abbreviations and definitions 255 13 Appendix User Interface 259 14 Index 273 Contents ...

Page 4: ...2 Servo User s manual US edition Order No 66 00 261 Infant Adult Universal Options ...

Page 5: ...Adult Universal Options 1 Before use Brief device description 4 Intended use 4 Intended user 4 Warnings Cautions and Important in this manual 4 Symbols 5 Support material related to the Servo i system 7 General warnings 9 General cautions 10 Context related warnings 12 ...

Page 6: ... advanced functionality It may be used only by professional health care providers who have sufficient experience in ventilator treatment Intended population The Servo i Ventilator System can be delivered in three configurations Servo i Infant range 0 5 30kg NIV PC PS Infant range 3 30kg NIV Nasal CPAP range 0 5 10kg Servo i Adult range 10 250kg Servo i Universal range 0 5 250kg NIV PC PS Infant ra...

Page 7: ...age alarm field when the patient triggers a breath NIV symbol The NIV symbol appears in the Mode pad field during Non Invasive Ventilation Patient Unit CE label The device complies with the requirements of the Medical Device Directive 93 42 EEC CSA label The device complies with the Canadian standards Class I equipment Type B The device classification according to according to IEC 60601 1 EN 6060 ...

Page 8: ...me from the patient Alarm output connection option External alarm output communication In this manual Adult Information valid for the Adult configuration Infant Information valid for the Infant configuration Universal Basic and Extended editions Information valid for the Universal configuration Options Single use Special waste This product contains electronic and electrical components Discard disp...

Page 9: ...know This User s manual covers functionality and use but should not be regarded as all inclusive within the very complex field of ventilatory treatment Clinical judgements or settings are therefore not described in this manual Authorized medically competent health care providers with good knowledge of Servo i Ventilator System have the responsibility to determine the clinical judgement and setting...

Page 10: ...p by step instructions for the set ups These instructions you will find in the drawer above the ventilator when positioned on the Mobile Cart Recommended use These documents are intended to be used as a guide for the experienced user Wall diagram Overviews and step by step instructions for cleaning to be posted on a wall Recommended use Checklist for the experienced user Ventilator Information mat...

Page 11: ...disassembling and cleaning the ventilator Service mode may only be used when no patient is connected to the ventilator Positive pressure ventilation can be associated with the following adverse events barotrauma hypoventilation hyperventilation or circulatory impairment The Servo i Ventilator System is verified against and complies with IEC 60601 1 2 regarding electromagnetic compatibility It is t...

Page 12: ...for anything other than its intended use as specified in this User s manual A resuscitator should always be readily accessible for extra safety When connected to a patient the system must never be left unattended The nebulizer module is inoperative when the ventilator is running on batteries to reduce the power consumption The Expiratory cassette must not be lifted up when the ventilator is in ope...

Page 13: ...degraded system performance and safety The displayed information about set and corresponding measured parameters shall continously be compared by the operator Important This symbol on the unit means Attention consult accompanying documents Note The are two versions of this symbol depending on System version The gases supplied must be free from water oil particles and other contaminants Air H2O 7 g...

Page 14: ...nitiated by the system and not by the patient This should always be avoided by decreasing the trigger sensitivity page 23 This is also important during transport as the movement of the body and the breathing system may lead to false triggering When you turn a Direct Access Knob ventilation will change accordingly from the next breath without additional confirmation For further information see page...

Page 15: ... for electrical safety of anaesthetic machines are suitable For adult pediatric patients never fill the medication cup with more than 10 ml page 129 For neonatal patients never fill the medication cup with more than 4 ml page 129 If the patient unit of the nebulizer is tilted the drug can flow into the patient s lungs or the ventilator The nebulizer must not be left unattended when connected to a ...

Page 16: ...14 Servo User s manual US edition Order No 66 00 261 1 Infant Adult Universal Options Notes ...

Page 17: ...ions 29 Controlled ventilation PRVC 32 Controlled ventilation Volume Control 35 Controlled ventilation Pressure Control 38 Supported ventilation Volume Support 40 Supported ventilation Pressure Support 43 Spontaneous CPAP 46 Automode 48 SIMV 52 Bi Vent 59 Non Invasive Ventilation NIV 61 NIV Pressure Control 62 NIV Pressure Support 63 NIV Nasal CPAP 64 Open Lung Tool 65 Ventilatory parameters overv...

Page 18: ...ues and parameter settings refer to page 249 Application The Servo i ventilator system also contains tools to assist the user in application of lung recruitment methodologies Scope ventilatory needs The ventilator can be used for true 1 controlled ventilation 2 supported ventilation or 3 spontaneous breathing CPAP 4 7 It also allows for combined ventilatory control or support Spontaneous breathing...

Page 19: ...e level is maintained during inspiration Pressure Control Pressure Support Flow volume in focus In the flow volume oriented modes a constant inspiratory volume is maintained The inspiratory flow is constant during each breath Volume Control Extra flow and extra breaths In flow volume oriented modes of ventilation additional on demand flow can be triggered during inspiration Additional breaths can ...

Page 20: ...18 Servo User s manual US edition Order No 66 00 261 2 Infant Adult Universal Options Basic functionality An overview Modes of ventilation ...

Page 21: ...uency and duration of the breaths which show a decelerating flow pattern 4 Spontaneous breathing CPAP When sufficient inspiratory volumes are achieved spontaneous breathing without ventilator support is allowed for in Volume Support 5 Pressure Control Breaths are delivered mandatorily at a preset pressure level causing a decelerating flow pattern 6 Pressure Support Inspiration is supported by a co...

Page 22: ... breathing effort the ventilator immediately switches to a support mode of ventilation If the patient is not making any breathing effort the ventilator will return to the controlled mode and deliver controlled breaths Synchronized intermittent Mandatory ventilation SIMV The ventilator provides mandatory breaths which are synchronized with the patient s spontaneous efforts at a preset rate The mand...

Page 23: ...ly expiratory pressure 6 End expiratory pressure Flow Time waveform Points and regions of interest X Inspiration time Y Pause time Z Expiration time 7 Peak inspiratory flow 8 Zero flow phase 9 Peak expiratory flow 10 Slope decelerating expiratory limb 11 End expiratory flow Volume Time waveform Points and regions of interest X Inspiration time Y Pause time Z Expiration time 12 Start of inspiration...

Page 24: ...pressure 3 End expiratory pressure Flow Time waveform Points and regions of interest X Inspiration time Z Expiration time 4 Peak inspiratory flow 5 End inspiratory flow 6 Peak expiratory flow 7 End expiratory flow Volume Time waveform Points and regions of interest X Inspiration time Z Expiration time 8 Start of inspiration 9 End inspiration 10 End expiration 1 2 3 4 5 6 7 8 10 9 I E V X Z t t t P...

Page 25: ...be set in the range 20 to 0 cmH2O in reference to set PEEP level white area on the bar When the trigger sensitivity is set above 0 green and red area on the bar flow triggering is set i e the amount of the bias flow that the patient has to inhale to trigg a new breath The sensitivity can be set from 100 of the bias flow left to 0 of the bias flow right For information about the different colors of...

Page 26: ...acheal tube is used Triggering will then be initiated by the system and not by the patient This should always be avoided by decreasing the trigger sensitivity Stronger patient effort 1 At a Trigger sensitivity level below zero 0 the ventilator senses negative pressures created by the patient Required preset negative pressure to initiate a breath is shown numerically The more to the left on the sca...

Page 27: ...nt For adults the range is 0 0 4 seconds and for infants the range is 0 0 2 seconds Note When the ventilator is configured for setting of Inspiration time the unit for Inspiratory rise time then automatically switches to seconds for all ventilation modes Normally in supported modes the Inspiratory rise time should be increased from the default setting and so give more comfort to the patient Inspir...

Page 28: ...rigger Timeout is the maximum allowed apnea time in Automode before controlled ventilation is activated It is applicable in Automode Volume Control Volume Support PRVC Volume Support Pressure Control Pressure Support The settings are within the ranges Infant 3 15 seconds Adult 7 12 seconds Initially the ventilator adapts with a dynamic Trigger Timeout limit This means that for the spontaneously tr...

Page 29: ...et Note The configuration is done by a service technician with a service card Volume setting Depending on the ventilator configuration the inspiratory volume can be set as Minute Volume or Tidal Volume Note The configuration is done by a service technician with a service card Controlled supported pressure level PC Pressure Control level above PEEP is the set inspiratory pressure level for each man...

Page 30: ...n mode settings by pressing the Accept pad Note The previous ventilation mode function is not available after a Pre use check changing of patient category admitting a new patient use of the same ventilation mode for more than 24 hours or after start up cold start of the system In backup ventilation the ventilator shows the settings for the supported mode when previous mode is activated A recall of...

Page 31: ...l Options 2 Fixed keys 1 Start breath 2 O2 breaths 3 Expiratory hold 4 Inspiratory hold can all be chosen by manually pressing the respective fixed key Start breath The ventilator will initiate a new breath cycle according to the current ventilator settings Special functions ...

Page 32: ...pressing the O2 breaths fixed key during the 1 minute interval Expiratory hold Expiratory and inspiratory valves are closed after the expiration phase is completed for as long as the fixed key is depressed up to a maximum of 30 seconds Expiratory hold provides an exact measurement of the end expiratory pause pressure It can be used for static compliance measuring and to determine the total PEEP Th...

Page 33: ...ventilation Back up ventilation is available in all support modes not applicable in Automode and NIV Pressure Support mode The Back up function switches Volume Support to Volume Control Pressure Support and CPAP to Pressure Control During Back up ventilation default settings are used for I E ratio Respiratory Rate and Inspiratory rise time Apnea alarm can be set in infant mode 5 45 seconds and in ...

Page 34: ... parameters are set 1 Tidal Volume ml or Minute Volume l min 2 Respiratory Rate b min 3 PEEP cmH2O 4 Oxygen concentration 5 I E ratio Insp time 6 Inspiratory rise time s 7 Trigg Flow Trigg Pressure The ventilator delivers a pre set Tidal Volume The pressure is automatically regulated to deliver the pre set volume but limited to 5 cmH2O below the set upper pressure limit The flow during inspiration...

Page 35: ... time 2 The inspiratory pressure level is constant during each breath but automatically adapts in small increments breath by breath to match the patient s lung mechanical properties for target volume delivery 3 Inspiration starts according to a preset frequency or when the patient triggers Expiration starts a After the termination of preset inspiration time b If the upper pressure limit is exceede...

Page 36: ...d test breath with Pause time set to 10 The measured pause pressure of this breath is then used as the pressure level for the following breath An alarm is activated if the pressure level required to achieve the set target volume cannot be delivered due to a lower setting of the upper pressure limit 5 cmH2O SVX 697_EN Controlled ventilation PRVC ...

Page 37: ...ndent on the tidal volume inspiration time and the resistance and compliance of the respiratory system The set tidal volume will always be delivered An increase in the resistance and decrease in compliance will lead to an increased airway pressure To protect the patient s lungs from excessive pressure it is very important to set the upper pressure limit to a suitable value It is possible for the p...

Page 38: ...ered The waveform illustrations above show some practical consequences of this enhanced functionality the top waveform shows the trace for a normal Volume Controlled breath the second waveform shows a situation when inspiration is prematurely interrupted as the set tidal volume has been delivered the third waveform shows a situation where the patient maintains a flow rate higher than the calculate...

Page 39: ...If the patient makes an inspiratory effort during the inspiratory period the ventilator will switch to Pressure Support to satisfy the patient s flow demand Expiration starts a When the preset tidal volume is delivered and after the preset pause time b When the flow returns to the set value after the preset tidal volume is delivered and after the preset pause time on demand support The patient is ...

Page 40: ...istance in the patient tube system and airways This means that the Tidal Volume can vary Pressure Controlled mode is preferred when there is leakage in the breathing system e g due to uncuffed endotracheal tube or in situations when the maximum airway pressure must be controlled The flow during inspiration is decelerating The patient can trigger extra breaths If the patient tries to exhale during ...

Page 41: ...ing each breath with a decelerating flow 3 Inspiration starts according to the preset frequency or when the patient triggers Expiration starts a After the termination of preset inspiration time b If the upper pressure limit is exceeded Active expiratory valve If a patient tries to exhale during the inspiration pressure increases When it increases 3 cmH2O above the set inspiratory pressure level th...

Page 42: ... effort and the target Tidal Volume The following parameters are set 1 Tidal Volume ml 2 PEEP cmH2O 3 Oxygen concentration 4 Inspiratory rise time s 5 Trigg Flow Trigg Pressure 6 Inspiratory Cycle off If the patient s activity increases the inspiratory pressure support will decrease provided the set Tidal Volume is maintained If the patient breathes below the set Tidal Volume the inspiratory press...

Page 43: ...mH2O until preset Tidal Volume is delivered If the pressure support level causes a larger Tidal Volume than preset the support pressure is lowered in steps of maximum 3 cmH2O until the preset Tidal Volume is delivered The maximum time for inspiration is Infant 1 5 seconds Adult 2 5 seconds An alarm is activated if the pressure level required to achieve the set target volume cannot be delivered due...

Page 44: ...ring each breath but alters in small increments breath by breath to match the patient s breathing ability and lung mechanical properties 3 Inspiration with Volume Support starts When the patient triggers Expiration starts a When the inspiratory flow decreases below a preset fraction of the inspiratory peak flow Inspiratory cycle off b If the upper pressure limit is exceeded c Maximum time for insp...

Page 45: ...ressure control level above PEEP cmH2O During Pressure Supported ventilation the patient regulates the respiratory rate and the Tidal Volume with support from the ventilator The higher the pre set inspiratory pressure level from the ventilator the more gas flows into the patient As the patient becomes more active the pressure support level may be gradually reduced It is important to set the Inspir...

Page 46: ...atient triggers a breath gas flows into the lungs at a constant pressure Since the pressure provided by the ventilator is constant the flow will decrease until the Inspiratory Cycle off is reached Expiration starts when The inspiratory flow decreases to the pre set Inspiratory Cycle off level If the upper pressure limit is exceeded If the flow drops to a flow range between 25 of the peak flow and ...

Page 47: ... patient effort 2 The preset pressure level is controlled by the ventilator while the patient determines frequency and inspiration time 3 Inspiration starts when the patient triggers Expiration starts a When the inspiratory flow decreases below a preset fraction of the inspiratory peak flow Inspiratory cycle off b If the upper pressure limit is exceeded 1 2 3 SVX 9004_XX Supported ventilation Pres...

Page 48: ... continuous positive pressure is maintained in the airways Properly set this may prevent collapse of airways Inspiration starts upon patient effort Expiration starts as for Pressure Support above Always set the Apnea time appropriate to the individual patient situation If the apnea alarm limit is reached the ventilator will automatically switch back to a Back up mode The alarm should alert staff t...

Page 49: ...hout support automatically regulated by the ventilator b In Pressure Support when the inspiratory pressure level is set to zero c In Automode when either of the above defined conditions is met Inspiration starts upon patient effort Expiration starts a When the inspiratory flow decreases below a preset fraction of the inspiratory peak flow Inspiratory cycle off b If the upper pressure limit is exce...

Page 50: ... adapts to the patient s varying breathing capacity and automatically shifts between a control mode and a support mode using a fixed combination of ventilation modes There are three different combinations depending on the modes installed Volume Control Volume Support PRVC Volume Support Pressure Control Pressure Support Note Automode is not possible in NIV SVX 602_EN Automode ...

Page 51: ...eath as a reference pressure for the first Volume Supported breath PRVC Volume Support The first supported breath delivered to the patient has the same pressure level as the preceding PRVC breath Pressure Control Pressure Support In this combination of Automode Pressure Control and Pressure Support the Direct Access Knob will regulate the PC above PEEP Pressure Control level Automode ...

Page 52: ...t target volume b In Pressure Support the ventilator assures that the preset inspiratory pressure level is maintained constantly during the entire inspiration 3 Exceeding the default or manually set trigger timeout limit without a sufficient patient effort will cause a In Volume Support a PRVC or Volume controlled breath will be delivered according to the selected automode functionality b In Press...

Page 53: ...al US edition Order No 66 00 261 Infant Adult Universal Options 2 PRVC Volume Support Volume Control Volume Support Pressure Control Pressure Support SVX 165_EN 1 2a 4 3a SVX 222_EN 2a 3a 1 4 SVX 167_EN 1 4 3b 2b Automode ...

Page 54: ... Inspiratory rise time and Breath cycle time Note In the Minute Volume configuration the Tidal Volume is determined by Minute Volume divided by SIMV rate The Breath cycle time is the length of the mandatory breath in seconds For example A SIMV rate of 6 a breath cycle time of 3 seconds with an I E ratio of 1 2 means that the inspiration will take 1 second and the expiration 2 seconds During the SI...

Page 55: ... Volume l min 2 SIMV rate b min 3 PEEP cmH2O 4 Oxygen concentration 5 I E ratio Insp time 6 Inspiratory rise time s 7 Breath cycle time s Note The soft key Breath cycle time is not shown when an SIMV mode is selected and inspiration time is configured Refer to page 27 8 Trigg Flow Trigg Pressure 9 Inspiratory Cycle off 10 PS Pressure Support level above PEEP cmH2O SIMV ...

Page 56: ... attempt within a time window equal to 90 of the set Breath cycle time a mandatory breath is delivered The Breath cycle time is the total time for one mandatory breath 3 The mandatory breath is defined by the basic settings mode of ventilation breath cycle time respiratory pattern and volumes pressures 4 The spontaneous pressure supported breaths are defined by the setting for Pressure Support 3 4...

Page 57: ... Volume l min 2 SIMV rate b min 3 PEEP cmH2O 4 Oxygen concentration 5 I E ratio Insp time 6 Pause time s 7 Inspiratory rise time s 8 Breath cycle time s Note The soft key Breath cycle time is not shown when an SIMV mode is selected and inspiration time is configured Refer to page 27 9 Trigg Flow Trigg Pressure 10 Inspiratory Cycle off 11 PS Pressure support above PEEP cmH2O SIMV ...

Page 58: ...igger attempt within a time window equal to 90 of the set Breath cycle time a mandatory breath is delivered The Breath cycle time is the total time for one mandatory breath 3 The mandatory breath is defined by the basic settings mode of ventilation breath cycle time respiratory pattern and volumes pressures 4 The spontaneous pressure supported breaths are defined by the setting for Pressure Suppor...

Page 59: ... level above PEEP cmH2O 2 SIMV rate b min 3 PEEP cmH2O 4 Oxygen concentration 5 I E ratio Insp time 6 Inspiratory rise time s 7 Breath cycle time s Note The soft key Breath cycle time is not shown when an SIMV mode is selected and inspiration time is configured Refer to page 27 8 Trigg Flow Trigg Pressure 9 Inspiratory Cycle off 10 PS Pressure Support level above PEEP cmH2O SIMV ...

Page 60: ...rigger attempt within a time window equal to 90 of the set Breath cycle time a mandatory breath is delivered The Breath cycle time is the total time for one mandatory breath 3 The mandatory breath is defined by the basic settings mode of ventilation breath cycle time respiratory pattern and volumes pressures 4 The spontaneous pressure supported breaths are defined by the setting for Pressure Suppo...

Page 61: ... two shifting pressure levels with the patient being able to breath spontaneously on both these levels Since Bi Vent is basically a controlled mode of ventilation apnea alarm and back up ventilation are not available It is also very important to set lower and upper alarm limit for expired Minute Volume Every Bi Vent cycle is regarded as autonomous and therefore most of the measured values are upda...

Page 62: ...orted ventilation at two different pressure levels These basic levels are individually set as well as the time in seconds at each level The ventilator always tries to synchronize with the patient s breathing 1 Bi Vent cycle THigh TPEEP 2 PEEP 3 PHigh 4 The pressure support level is set individually PS above PEEP 5 PS above PHigh 3 1 2 2 3 4 5 SVX 184_XX 1 Bi Vent ...

Page 63: ...essive leakage The dead space will increase when use of a mask prongs NIV is not intended to be used on intubated patients CO2 measurement will be affected by mask prongs leakage Cautions Mask prongs leakage might affect the nebulizer efficiency It is not recommended to use the nebulizer during NIV as the nebulized drug might come in contact with the patient eyes in case of leakage Important The m...

Page 64: ...during 120 seconds Press the Start ventilation pad to start the ventilation During NIV the ventilator automatically adapts to the variation of leakage in order to maintain the required pressure and PEEP level If the leakage is excessive the ventilator will issue a high priority alarm deliver a continuous flow and pause breath cycling Ventilation will resume automatically if the leakage decreases V...

Page 65: ...ts to the variation of leakage in order to maintain the required pressure and PEEP level If the leakage is excessive the ventilator will issue a high priority alarm deliver a continuous flow and pause breath cycling Ventilation will resume automatically if the leakage decreases Ventilation can also be started manually by pressing the Start ventilation pad in the excessive leakage dialog During Pre...

Page 66: ...p ventilation available in Nasal CPAP The apnea alarm can be turned off in Nasal CPAP The following functions are not available during Nasal CPAP ventilation Volume curve Loops Open Lung Tool Additional values Additional settings Inspiratory hold Expiratory hold CO2 Analyzer WARNING Patient effort and artifacts affecting patient flow or pressure such as heart beats movement of patient tubings inte...

Page 67: ...the Open Lung Tool to change Read more about the Open Lung Tool Operating page 175 The following parameters are presented In the top window measured End Inspiratory Pressure EIP and Positive End Expiratory Pressure PEEP are simultaneously presented breath by breath In the middle window measured Inspiratory tidal volume VTi and Expiratory tidal volume VTe are simultaneously presented breath by brea...

Page 68: ...nspiratory rise Time to full inspiratory flow or pressure at the start of each breath as a percentage of the breath cycle time or in seconds s 6 I E ratio I E Inspiration time Pause time Expiration time 7 Inspiration time Ti Time for active flow or pressure delivery to the patient s 8 Pause time Tpause Time for no flow or pressure delivery or s 9 Trigger sensitivity a Below zero Trigger sensitivit...

Page 69: ...SIMV inspiratory pause expiratory Set in seconds 13 SIMV rate Rate of controlled mandatory breaths b min 14 Trigger timeout The maximum allowed apnea time in Automode after which the system switches to controlled ventilation s O2 concentration O2 Conc O2 concentration in inspiratory gas not shown in the figure SVX 218_EN SVX 203_EN Ventilatory parameters overview ...

Page 70: ...piratory pressure support level for breaths triggered during the THigh period in Bi Vent cmH2O 18 Pressure Support above PEEP PS above PEEP Inspiratory pressure support level for breaths triggered during the TPEEP period in Bi Vent cmH2O 19 Pressure high PHigh Positive End Expiratory Pressure at the upper level in Bi Vent cmH2O 20 PEEP Positive End Expiratory Pressure at the lower level in Bi Vent...

Page 71: ...69 Servo User s manual US edition Order No 66 00 261 Infant Adult Universal Options 2 Notes ...

Page 72: ...70 Servo User s manual US edition Order No 66 00 261 2 Infant Adult Universal Options Notes ...

Page 73: ...l 72 High priority alarms 72 Medium priority alarms 72 Low priority alarms 72 Technical alarms 72 Alarm output connection option 72 The alarm profile window 73 The alarm window 74 Alarms Visual audible 75 Audio off Silence Pre silence of alarm 76 General 76 Audio off of non latching alarms 76 Built in safety precautions 78 ...

Page 74: ...yellow background For more information about the low priority alarms see page 234 Technical alarms Technical problem identified by a code For more information about the high priority alarms see page 239 Alarm signals All alarms are visual and audible WARNINGS To protect the patient against high airway pressures the Upper pressure limit must always be set to the relevant value so as to provide adeq...

Page 75: ...itting a new patient Always make sure that values are appropriate for the patient Non Invasive Ventilation 1 Press the Alarm profile key to show the applicable alarms for Non Invasive Ventilation NIV 2 The bell indicates if the alarm is audible active or Audio off permanently silenced a crossed bell The apnea alarm can be turned off in Nasal CPAP 3 To turn off the apnea alarm in Nasal CPAP continu...

Page 76: ...hown in a window This is dynamic and will be updated if more alarms occur while the window is open The alarms are listed by priority and 10 alarm messages are displayed at the most 3 Press the History pad 4 The last 16 alarm dependent events are listed chronologically The most recent event is at the bottom Note For viewing more than the latest 10 alarms use the Event log to view all logged alarms ...

Page 77: ...as been active but for which the condition has returned to normal is latched and requires manual resetting Latched alarms The alarm text remains even though the alarm condition ceases Note NIV alarm Leakage out of range is not latched Two bells in the alarm message area indicate that more than one alarm is activated Audible An active alarm is indicated by a distinct but soft alarm signal The sound...

Page 78: ...ed alarms Minute volume Respiratory rate PEEP End tidal CO2 CO2 Analyzer CPAP Nasal CPAP By pressing the corresponding bell symbol in the alarm profile window the button changes to a crossed bell to indicate Audio Off It is also possible to configure these alarms individually to be set to the Audio Off state by default Note When an alarm is silenced Audio off in the NIV mode a symbol will appear o...

Page 79: ... latched alarms the alarm text remains even though the alarm condition ceases An alarm silence Audio pause symbol and the remaining time are then displayed in the message area Pre silence alarm Audio pause 1 If you press the Audio pause Silence Pre silence alarm key for more than two seconds The active alarms are silenced Audio pause i e a two minute period is started All other alarms are silenced...

Page 80: ... the ventilator will automatically switch over to battery operation The switch is indicated by a medium priority alarm The remaining battery capacity is displayed in the status menu on top of the screen In case of a mains failure and no Battery module has been inserted or connected a high priority alarm is activated The inspiratory and expiratory valves are opened to allow for breathing through th...

Page 81: ...79 Servo User s manual US edition Order No 66 00 261 Infant Adult Universal Options 3 Notes ...

Page 82: ...80 Servo User s manual US edition Order No 66 00 261 3 Infant Adult Universal Options Notes ...

Page 83: ...ch screen 90 Main Rotary Dial 90 Fixed keys 91 Adjusting parameter values 91 Waveforms 92 Measured value boxes 92 User Interface Positioning 93 User Interface Accessories 94 Patient Unit Patient Unit Connections and labels 96 Patient Unit Expiratory cassette 98 Mobile Cart Servo i 99 Holders 100 Servo Ultra Nebulizer 102 CO2 Analyzer Servo i 104 Y Sensor measuring 106 Battery module 108 Ventilatio...

Page 84: ... is compared with the User Interface settings and a difference between the actual measured value and the preset calculated values will cause adjusted gas delivery according to the target flow volume pressure The Servo i Ventilator System has two gas modules one for air and one for O2 Gas can be connected from a medical pipeline system a compressor or gas tanks Air can also be supplied by a compres...

Page 85: ...ed edition is an advanced ventilator to be used with infants and adults Enhanced functionality i e a comprehensive array of different ventilation modes extended Tidal Volume range allows for advanced ventilatory treatment in both categories 2 The User Interface where all settings are made and effects are monitored 3 The Patient Unit where gases are administrated also has slots for Battery modules ...

Page 86: ...puter via the Ventilation record card for further processing and storage 2 Signals are conveyed from the User Interface for controlling of drug nebulization Important Only valid for the built in Servo Ultra Nebulizer 3 Data communication to a Personal Computer is possible via the Communication Interface Emulator CIE and the serial communication port RS 232C 4 An alarm output connection option make...

Page 87: ... t t t page 48 Bi Vent t t t t page 59 CO2 Analyzer t t t t pages 104 151 NIV Non Invasive Ventilation t t t t pages 61 160 Nasal CPAP t t t page 64 Open Lung Tool t t t pages 65 175 176 Pressure Control t page 38 Pressure Support page 43 PRVC Pressure Reg Volume Control t t t page 32 SIMV Press Contr Pressure Support t pages 52 57 SIMV PRVC Pressure Support t t pages 52 53 SIMV Vol Contr Pressure...

Page 88: ...fier MR730 MR850 page 127 Gas cylinder restrainer Servo i pages 101 248 Gas trolley Servo i pages 101 126 248 Holder Servo i pages 100 124 248 Humidifier Holder pages 100 127 IV pole pages 100 248 Mobile Cart Servo i pages 97 123 248 O2 cell O2 Sensor pages 98 213 Patient tubing 10 15 22 mm diameter pages 120 121 122 Servo guard viral bacterial filter page 137 Servo humidifier page 136 Servo Ultra...

Page 89: ...n be shown as waveforms and or as numerics The measured value boxes are always visible also while setting the ventilator Alarm limits are displayed adjacent to the measured value All functions and necessary information are gathered in the User Interface Do not use sharp tools on the screen Read more about the User Interface Positioning page 93 Operating page 159 Alarm settings page 165 Cleaning pa...

Page 90: ...88 Servo User s manual US edition Order No 66 00 261 4 Infant Adult Universal Options User Interface Connections and labels ...

Page 91: ...rmative text messages A purple symbol indicates patient triggering 18 Alarm messages 19 The waveform area which monitors two to four parameters individually scaled You can add an pressure flow loop with the ordinary waveforms still visible This waveform area is also used for the trend presentation 20 A section where measured values and set alarm limits are displayed in boxes You can choose which p...

Page 92: ...h pad turns blue again To set more parameter values repeat steps 2 4 5 To activate your settings press Accept 6 To cancel your settings press Cancel Note For more information about settings and operating refer to page 145 Main Rotary Dial 1 Turn the Main Rotary Dial until the desired menu touch pad is marked with a blue frame 2 Press the Dial to confirm The menu touch pad is highlighted in white w...

Page 93: ...Press to activate Note For more information about settings and operating refer to page 157 Adjusting parameter values Immediate adjustment 1 Turn the Direct Access Knob to the desired value When you reach the defined safety limits the knob is inoperative for 2 seconds to make you aware that you have passed a safety limit Combined adjustments 2 Press Additional settings and adjust values Confirm yo...

Page 94: ...can also be adjusted For further information see page 157 The settings are effective from the first breath after adjustment The displayed waveforms can be configurated using Waveform configuration For further information see page 169 Measured value boxes The measured value boxes show measured calculated values in numerics and the unit being used 1 Set Lower and Upper alarm limits are also shown 2 ...

Page 95: ...the Mobile Cart a table a shelf or a pipe 1 Lift the User Interface straight up 2 Place the panel on a table shelf or on a pipe and fasten it securely by turning the handle of the locking screw Note Make sure that the User Interface is fastened firmly When positioned on a pipe the dimension of the pipe must be between 15 30 mm User Interface Positioning ...

Page 96: ... edition Order No 66 00 261 4 Infant Adult Universal Options Knob cover The knob cover protects the Direct Access Knobs against inadvertent activation Raise the cover to access the Direct Access Knobs User Interface Accessories ...

Page 97: ...s 4 User Interface panel cover The User Interface panel cover protects the screen from inadvertent activation of settings and mechanical damage during transport While attached the user can still access the vital settings Raise the cover to access the screen User Interface Accessories ...

Page 98: ...s manual US edition Order No 66 00 261 4 Infant Adult Universal Options Note Refer to chapter Before use page 5 for more information about symbols on the Servo i Ventilator system Patient Unit Connections and labels ...

Page 99: ...et Caution When external 12 V DC is used at least one installed Battery module is required to ensure proper operation 16 Fuse for external DC power supply 17 Optional connector 18 User Interface connector 19 RS232 connector 20 Expiratory outlet 21 Cover inspiratory channel 22 Expiratory inlet 23 Battery lock 24 Module compartment Note The slots are numbered 1 2 3 from top to bottom 25 Nebulizer co...

Page 100: ...he patient system s inspiratory tubing The inspiratory channel also contains a safety valve 8 The patient system s expiratory tubing is connected to the expiratory inlet The inlet also contains a moisture trap 9 The gas flow through the expiratory channel is measured by ultrasonic transducers 10 The expiratory pressure is measured by the expiratory pressure transducer located inside the ventilator...

Page 101: ...nsole so that it can easily be moved from the Mobile Cart or rotated to switch sides for the patient breathing system The Mobile Cart has side rails for accessories such as a humidifier and slots in the column for the Support Arm IV pole with holder etc Two of the wheels can be locked Read more about the Mobile Cart Positioning page 123 System transport page 116 Cleaning page 191 Technical data pa...

Page 102: ...cher or a standard rail Servo i Shelf base The shelf base allows for positioning of the Patient Unit on a shelf Support Arm 177 The Support Arm can be attached on the Mobile Cart Humidifier Holder The Humidifier Holder can be attached on the Mobile Cart IV Pole The IV pole with holder can be attached on the Mobile Cart SVX 037_XX SVX 695_XX SVX 036_XX SVX 568_XX SVX 569_XX Holders ...

Page 103: ...ns 4 Servo i Gas trolley The Gas trolley can be attached on the Mobile Cart or to a separate wall clamp Servo i Gas cylinder restrainer The Gas cylinder restrainer is mounted onto the Mobile Cart For details please refer to the Installation instructions SVX 605_XX SVX 572_XX Holders ...

Page 104: ...er Otherwise the ultrasonic generator crystal may break When a Servo Ultra Nebulizer is used always consult the drug manufacturer regarding the appropriateness of ultrasonic nebulization for certain medications When the ventilator is running on batteries the nebulizer module is inoperative to reduce the power consumption During nebulization a filter must be connected to the expiratory inlet of the...

Page 105: ...re mounting the T piece The medication mist is carried to the patient by the inspiratory flow 6 The T piece has a mechanical particle separation system baffles This ensures a mass median diameter MMD of approximately 4 0 μm of droplets in the mist Larger droplets are re nebulized 7 Injection membrane Nebulizer Holder The holder can be used when the Servo Ultra Nebulizer is not in use or when filli...

Page 106: ...n ml per minute indicates the volume of expired CO2 per minute CO2 tidal elimination VTCO2 expressed in ml per breath indicates the volume of expired CO2 per breath Note CO2 Minute elimination CO2 and Tidal CO2 elimination VTCO2 Elimination of CO2 from the body takes place via expired gas from the lung Production of CO2 takes place in cellular compartments and body tissues Cautions Do not insert t...

Page 107: ...3 Connector 4 Airway adapter 5 Capnostat sensor 6 Reference cell 7 Zero cell Basic principles 1 Gas flow through the airway adapter in the Capnostat sensor 2 The sensor uses a solid state and IR based optical system with no moveable parts The difference between a reference light beam and one filtered for CO2 wave length is measured CO2 Analyzer Servo i ...

Page 108: ...orms and metrics are always displayed on the User Interface the internal pressure and flow sensors are at all times active as back up Their readings are compared with the Y Sensor measurement and the Y Sensor is disabled if there is a significant deviation or malfunction When this occurs a dialog box will inform the User that the Y Sensor measuring has been disabled If conditions change so that th...

Page 109: ... manual US edition Order No 66 00 261 Infant Adult Universal Options 4 Y Sensor measuring parts 1 Y Sensor module 2 Connector for sensor 3 Connector 4 Y piece 5 Y Sensor 6 Endotracheal tube SVX 9037 Y Sensor measuring ...

Page 110: ... modules In both cases the ventilatory settings and stored data remain intact The ventilator chooses the Battery module powered with the highest voltage to be the prime module for powering the ventilator where the other modules adopt an assistance role This automatic changeover enhances system safety in case of a malfunctioning Battery module Important When delivered the Battery modules may not be...

Page 111: ...al time left and at least one battery module must be replaced If possible connect the ventilator to the mains power supply The Battery status window shows status information for each battery module mounted in the ventilator See Battery status window on page 111 for more information Battery modules are automatically charged when the ventilator is connected to the mains power supply During Battery m...

Page 112: ...ge the information dialog box The remaining Pre use check is then completed Access the Battery status window to identify the Battery module to be replaced See Battery status window on page 111 for a detailed description of both how to access this window and a thorough description of the information found there Replace the poor or old Battery module with a new Battery module Dispose of the discarde...

Page 113: ...User Interface The Status window is displayed Press the Batteries pad The Battery status window is displayed Note The total usable backup time is the sum of the estimated operation time displayed for each Battery module minus 10 minutes This is a safety feature The following information is displayed for each mounted Battery module Slot number Serial number Charge indicator where 0 boxes filled 10 ...

Page 114: ...ration Text message Remedy Check battery status Mains voltage disappears Problem with battery module One or more Battery modules must be replaced Open the Battery status window for information Replace and discard battery Activity instruction Remedy Expires soon The Battery module will soon need to be replaced Order a new battery Replace battery The Battery module has either exceeded its life span ...

Page 115: ...self off Battery storage Battery modules should not be stored over long periods of time This will negatively affect their capacity If Battery modules need to be stored for short periods of time one week then store them fully charged in a cool 15 20 C and dry environment Caution Stored batteries need to be recharged before operation Special waste This product contains electronic and electrical comp...

Page 116: ...screen dump is never overwritten on the card by new information The card can only be erased in a personal computer Important The Ventilation record card and its contents should be handled according to national regulations hospital routines and established routines for diskettes pc cards Basic principles Data can be copied to the card in Standby mode or during ventilatory care The card is inserted ...

Page 117: ... ventilator if the central compressed air supply fails The compressor automatically stops when the central air supply returns The Compressor Mini is fitted with two alarms a temperature alarm that is activated if the compressor overheats and a pressure alarm that is activated if the air pressure drops or increases outside the acceptable range Alarms are audible and visible with error message displ...

Page 118: ...tion Follow the hospital guidelines Check that there is no damage to the Mobile Cart During transport During transportation of the ventilator with or without a patient connected make sure that the following conditions are fulfilled Gas cylinders are connected with a sufficient amount of gas the Battery module is charged and the resuscitator is functioning Follow the hospital guidelines Important I...

Page 119: ...gering Cautions To prevent the ventilator from tipping over the Patient Unit must be pushed into its locked position during transportation If Battery modules are inserted the ventilator should be connected to the mains when not in use The Battery modules are then charged automatically Batteries and O2 cell must not be disposed of with ordinary waste Lock the gas cylinders firmly to the Mobile Cart...

Page 120: ...118 Servo User s manual US edition Order No 66 00 261 4 Infant Adult Universal Options Notes ...

Page 121: ...reparations Support Arm 125 Preparations Gas trolley 126 Preparations Fisher Paykel 127 Preparations Servo Ultra Nebulizer 128 Preparations Modules 133 Preparations CO2 Analyzer Servo i 134 Preparations Y Sensor measuring 135 Preparations Servo Humidifier 136 Preparations Servo guard 137 Preparations Battery module Servo i 139 Preparations Ventilation Record Card 140 Preparations Start up configur...

Page 122: ...anual 7 Nipple connector for nebulizer 8 Tube connection 9 Y piece 10 CO2 sensor 11 Servo humidifier must be disconnected during nebulization page 136 12 Angled connector for endotracheal tube 13 Nipple connector 14 Water trap mandatory if a heated humidifier is used 15 Nipple connector 16 Humidifier Fisher Paykel must not be active during nebulization page 127 17 Patient tube heater 18 Probe hous...

Page 123: ...refer to separate manual 6 Tube connection 7 Y piece 8 CO2 sensor 9 Servo humidifier must be disconnected during nebulization page 136 10 Angled connector for endotracheal tube 11 Water trap mandatory if a heated humidifier is used 12 Nipple connector 13 Humidifier Fisher Paykel must not be active during nebulization page 127 14 Patient tube heater 15 Patient tube with probe housing 16 Y Sensor Ad...

Page 124: ... refer to separate manual 5 Y piece 6 CO2 sensor 7 Servo humidifier must be disconnected during nebulization page 136 8 Angled connector for endotracheal tube 9 Water trap mandatory if a heated humidifier is used 10 Nipple connector 11 Humidifier Fisher Paykel must not be active during nebulization page 127 12 Patient tube heater 13 Probe housing 14 Y Sensor Adult Infant with adapter Important Som...

Page 125: ... Patient Unit oriented towards the left or right 6 Lift the locking handle and rotate the Patient Unit until you hear a click 7 Lift the locking handle 8 Push in the Patient Unit to its end position until you hear a click Cautions The ventilator must only be used in an upright position Ensure the ventilator is positioned into its locked position on the Mobile Cart Servo i to prevent unintentional ...

Page 126: ...tient Unit with the handle 3 Adjust the support and secure with the screws 4 Place the holder on a Rail or bed or stretcher 5 Lock the holder with the arm Shelf base positioning Note Be sure that the Servo i Shelf base is securely fixed on the shelf 1 Place the Patient Unit on the Servo i Shelf base 2 Secure the Patient Unit with the handle Preparations Holder ...

Page 127: ... Arm CO2 airway adapter and snap the breathing system into the grip Cautions Use the Support Arm to relieve the patient from the weight of the tubing system Ensure the Support Arm is firmly fixed before attaching the tubing When moving the Support Arm or changing position watch the patient connection carefully to see that no pulling or other movement occurs SVX 148_XX Preparations Support Arm ...

Page 128: ...n 2 Hinge the gas trolley and lift it up into locking position a click is heard 3 Secure the docking with the security chains Note Press the brakes to lock the wheels on the Mobile Cart before positioning the gas trolley Note The Gas trolley can also be mounted to a separate wall clamp Refer to installation instructions Preparations Gas trolley ...

Page 129: ...the system a water trap should be used on the expiratory tubing to avoid condensation in the system During operation the water traps must be checked regularly and if necessary emptied Important It is recommended only to use original tubing from MAQUET Soft tubing may negatively effect the performance of the ventilator Humidifier Holder A special holder allows for left or right positioning of the h...

Page 130: ...ilator The nebulizer must not be left unattended when connected to a patient When the ventilator is running on batteries the nebulizer module is inoperative to reduce the power consumption During nebulization a filter must be connected to the expiratory inlet of the ventilator Always carefully monitor the airway pressure during nebulization Increased airway pressure could be caused by a clogged fi...

Page 131: ...tion Check that the injection membrane is in place and not damaged Important Invisible damage will be detected during the Pre use check A faulty injection membrane may cause system leakage To change the membrane please refer to page 217 Refill Fill a sterile syringe with medication Note that the diameter of the needle must not be more than 1 0 mm Carefully inject the medication into the medication...

Page 132: ...izer to the Patient Unit of the ventilator Refer to page 120 to 122 10 mm breathing system 15 mm breathing system 22 mm breathing system Function test A function test must always be done after cleaning and maintenance If any malfunction is detected the Servo Ultra Nebulizer must not be used before the malfunction is remedied SVX 144_XX SVX 631_XX SVX 560_XX Preparations Servo Ultra Nebulizer ...

Page 133: ...opriate level 2 Remove the T piece and fill the medication cup with approximately 5 ml water 3 Put the T piece back 4 Connect the connection cable Start the nebulizer See also page 187 5 Press the Nebulizer pad 6 Press the Time pad 7 Set the time by using the Main Rotary Dial 8 To accept the time press Accept SVX 554_XX Preparations Servo Ultra Nebulizer ...

Page 134: ...ant Adult Universal Options 9 Check that mist is produced 10 Disconnect the connection cable from the Servo Ultra Nebulizer Patient unit 11 Make sure an alarm text is given 12 Connect the connection cable 13 Stop the nebulizer Preparations Servo Ultra Nebulizer ...

Page 135: ... Servo i Ventilator System If external equipment such as computers monitors humidifiers or printers are connected the total system must comply with IEC 60601 1 1 Inserting disconnecting Insert a module 1 Insert the module into the slot 2 Make sure it clicks into place Remove a module 3 Push the lock handle aside Remove the module Note The slots are numbered 1 2 3 from top to bottom SVX 5094_XX Pre...

Page 136: ...laced vertically to minimize condensation on the windows 4 Snap the Capnostat sensor onto the airway adapter Note The etCO2 concentration low alarm can be permanently silenced Audio off when the message Silence alarm permanently is shown Cautions The Capnostat sensor with airway adapter should be removed during nebulization Do not insert two CO2 Analyzers at the same time The Servo i Ventilator sy...

Page 137: ... the module will be damaged Caution The Y Sensor is intended for single patient use only do not re use clean or sterilize Avoid kinking the sensor tubing otherwise the measuring is impaired Condensed water or other fluids in the Y sensor may impair measurement accuracy immediately or as a long term drift Therefore it is recommended to always check if the sensor is affected by condensed water or ot...

Page 138: ...n and the Y piece 2 If the sampling port is to be used connect it to the Luer port standard Luer connection WARNING Servo Humidifier HME must be disconnected during nebulization Otherwise the humidifier may be blocked Important It is recommended only to use original tubing from MAQUET Soft tubing may negatively effect the performance of the ventilator Read more about the Servo humidifier General o...

Page 139: ...or cleaning and autoclaving of the expiratory cassette WARNING During nebulization a filter must be connected to the expiratory inlet of the ventilator Always carefully monitor the airway pressure during nebulization Increased airway pressure could be caused by a clogged filter The filter should be replaced if the expiratory resistance increases or every 24 hours when the nebulizer is being used C...

Page 140: ...ent tubing are in use and there is a draught from an air condition patient cooling fan etc that cools down the expiratory outlet To avoid problems with condensation a water collector can be connected to the expiratory outlet The water collector also works as an insulation of the expiratory outlet and therefore reduces the amount of condensation SVX 6110_XX Water collector ...

Page 141: ...ease button to the right 2 until the battery is released from the ventilator Note On more recent ventilators Slots 1 and 2 are locked to ensure that two Battery modules are always present in the ventilator These can be opened using an Allen key 1 or similar Remove the battery from the ventilator Note On delivery one fixed battery module is installed Dummy modules covers the other slots Extra batte...

Page 142: ...t the slot cover and turn the slot cover aside 2 Insertion Insert the Ventilation record card into the slot guide Gently push the card into the slot guide until the eject button comes out 3 Remove the card Press the eject button Draw the card out of the slot Put the slot cover back in position 2 3 SVX 9012_XX Preparations Ventilation Record Card ...

Page 143: ...s settings Note The ventilator must be in Standby mode Refer to page 159 1 Press the fixed key Menu 2 Press the Biomed pad and enter the access code 1973 factory setting Note The access code can be changed by the user from a Biomed sub menu The Biomed submenus are Service Edit configuration Copy configuration Set date and clock Change access code Edit a Start up configuration 1 Press the Edit conf...

Page 144: ...fault settings 6 Press the Next pad to view a summary of the Start up configuration 7 Press Accept pad to save the Start up settings Note The ventilator must be restarted to activate the new settings Copy configuration 1 Press Copy configuration pad and follow the on line instructions Note It is possible to either save or restore a configuration SVX 9048 Preparations Start up configuration ...

Page 145: ...atest check below the touch pad After the Pre use check is completed or if a Pre use check is not performed a dialog will appear asking if old patient related data shall be erased or kept 4 Enter data for the new patient including body weight and body height The calculation of tidal and minute volume is based on entered body weight You can omit this data input Default values will then be used for ...

Page 146: ...144 Servo User s manual US edition Order No 66 00 261 5 Infant Adult Universal Options Notes ...

Page 147: ...k Pre use check 147 Start up 147 Internal tests 147 Automatic switch between mains battery 148 Patient breathing system Y Sensor 148 Compensate for circuit compliance 149 Alarm output connection option test 150 Complete the Pre use check 150 Calibration CO2 Analyzer Servo i 151 Cell zero 153 Verification 154 ...

Page 148: ... Standby refer to page 178 does not replace the Pre use check To avoid electrical shock hazard connect the ventilator power cord to a mains outlet equipped with a protective ground If any malfunctions are detected during the start up procedure please refer to Chapter 10 Troubleshooting If a malfunction persists the ventilator may not be connected to the patient Caution The Expiratory cassette must...

Page 149: ...t the ventilator to On 3 To start the automatic test Press Yes and follow the on line instructions Note If the Pre use check is not performed a dialog will appear asking if old patient related data shall be erased or kept Internal tests 4 Connect the blue test tube between the inspiratory outlet and the expiratory inlet Pre use check ...

Page 150: ... module refer to page 220 Patient breathing system Y Sensor 7 Connect a complete breathing system including if available a humidifier and a Servo Ultra Nebulizer Note If a Y Sensor with a Y Sensor module is connected to the ventilator go direct to step 9 8 Block the Y piece Important Make sure there is no leakage when blocking the Y piece because a leakage will affect the circuit compliance compen...

Page 151: ...w expiratory flow passing from the patient through the expiratory channel By observing the difference between the Vti and Vte values presented on the User Interface a leakage can be detected and its extent easily controlled The first time an unacceptably large leakage occurs around the tube correct this problem to avoid triggering the Low Expiratory Minute alarm If the leakage still persists adjus...

Page 152: ...w the on line instructions To cancel the test press No Complete the Pre use check A message is shown after each test case when the test is completed Refer to page 218 for Pre use check messages 13 Press OK to confirm and to have the test logged The ventilator now switches back to Standby mode Note After the Pre use check is completed a dialog will appear asking if old patient related data shall be...

Page 153: ... The Capnostat sensor must be warm before calibration can begin Values displayed during warm up have reduced accuracy If calibration is needed the operator will be notified with a message Note The etCO2 concentration low alarm can be permanently silenced Audio off when the message Silence alarm permanently is shown Important During calibration no CO2 waveforms or measured CO2 values will be displa...

Page 154: ...ell zero The cell zero calibration is used when the Capnostat sensor has been shifted 5 Verification The verification calibration includes cell zeroing verification against reference cell and adapter zeroing Note The verification calibration is recommended A verification should always be performed when the airway adapter is altered if a faulty Capnostat sensor is suspected or when prompted This en...

Page 155: ...ptions 6 Cell zero 1 Select Cell zero if the Capnostat sensor has been shifted 2 When instruction appears on screen place the Capnostat sensor on the zero cell Note For information about CO2 calibration error messages refer to page 221 SVX 5078_XX Calibration CO2 Analyzer Servo i ...

Page 156: ...nsor on the zero cell 3 When instruction appears on screen Place the Capnostat sensor on the reference cell When instruction appears on screen 4 Place the Capnostat sensor on a non connected airway adapter containing room air Note For information about CO2 calibration error messages refer to page 221 Read more about the CO2 Analyzer Description page 116 Preparation page 137 Cleaning page 192 Troub...

Page 157: ...155 Servo User s manual US edition Order No 66 00 261 Infant Adult Universal Options 6 Notes ...

Page 158: ...156 Servo User s manual US edition Order No 66 00 261 6 Infant Adult Universal Options Notes ...

Page 159: ...ngs Direct Access Knobs 166 Initial settings Additional settings 167 Initial settings Additional values 168 Operating Waveform configuration 169 Operating Suction Support 170 Operating Save one recording 172 Operating Copy screen 173 Operating Copy patient data 174 Operating Open Lung Tool 175 Operating Adjustments 177 Operating Patient circuit test 178 Monitoring Monitoring Menu key 179 Monitorin...

Page 160: ...System and which have been processed in auxiliary equipment must not be used as a substitute for therapeutic or diagnostic decisions Such decisions can be made only by staff with medical expertise according to established and accepted practice If auxiliary equipment that has not been manufactured by MAQUET is used MAQUET denies all responsibility for the accuracy of signal processing When combinin...

Page 161: ... the User Interface to turn the ventilator to the on position Starting the ventilation refer to page 163 Note The plug in battery continues to charge when connected to the mains refer to page 88 2 Press Yes to perform a Pre use check and follow the on line instructions Refer to page 145 SVX 9026_XX SVX 9041 Turn on the ventilator ...

Page 162: ... NIV Non Invasive Ventilation Note The background color on the touch pads is changed when NIV is activated 3 Press the Standby key to start the ventilation Refer to page 163 This selection determines default values alarm limits and operating ranges Note The factory default values may have been changed in the Start up Configuration Initial settings Type of ventilation ...

Page 163: ...es alarm limits and operating ranges Note The factory default values may have been changed in the Start up Configuration Changing patient category In running mode 1 Press on the Menu pad 2 Press the Change patient category pad 3 Press Yes to continue or 4 Press No to stop Note Always check the alarm settings after changing the patient category refer to page 165 Initial settings Patient category ...

Page 164: ...eight 9 To enter the patient s name press Name 10 Press the pad Close keyboard 11 When ID is activated a keyboard is shown in the window for entering data 12 To confirm press Accept 13 If you want to cancel the information press Cancel Important For Adult the weight is in kilograms and for Infant the weight is in grams Copy patient data before you enter a new name or ID otherwise all previous pati...

Page 165: ...the fixed Start Stop ventilation Standby key 4 Press on the Yes pad to stop ventilation NIV Non Invasive Ventilation 1 When the Standby key is pressed a waiting position dialog is shown Note All patient related alarms are turned off during 120 seconds 2 Press Start ventilation pad to start the ventilation Note The ventilation also starts upon patient effort Read more about NIV NIV ventilation page...

Page 166: ...de green indication in spontaneous breathing Note Automode is not available in NIV 5 When you have selected another mode all related parameters can be set in this window You will also find related calculations in the window 6 Values are adjusted by turning the Main Rotary Dial 7 Confirm each setting by pressing the parameter touch pad 8 To activate all settings in the window press Accept 9 To canc...

Page 167: ...r the patient If not the settings must be set manually Current alarm limits are also displayed during running mode in smaller figures to the right of the display Note Autoset is not possible in NIV modes 6 Activate by pressing Accept Audio pause Silence Pre silence alarms 1 Silence or pre silence Audio pause alarms for two minutes 2 The Alarm Audio pause symbol is then shown the remaining time The...

Page 168: ...e setting is too low or too high compared to what are generally considered safe limits advisory information 4 If the bar turns red the setting is significantly outside what are generally considered safe limits advisory warning accompanied by an audible signal and an advisory message When you come to a safety limit the knob is inactive during 2 seconds This is a safety precaution intended to make y...

Page 169: ...ly considered safe limits advisory information 5 If the bar turns red the setting is significantly beyond what is generally considered safe limits advisory warning accompanied by an audible signal and an advisory message 6 Values are adjusted by turning the Main Rotary Dial 7 The waveforms and measured values are visible next to this window Thus the effects of the adjustments made can be checked i...

Page 170: ...tions 1 Press the Additional values pad 2 Check desired values 3 If desired activate Next page for more additional values Note In NIV only one page of additional values is shown In Nasal CPAP there is no additional value page available SVX 5092_EN Initial settings Additional values ...

Page 171: ...er is connected can be displayed hidden independent of each other Adjusting waveforms scales Scales Set sweep speed and amplitude for displayed waveforms auto scale is possible 1 Press the fixed key Quick access 2 Activate Scales 3 Press the touch pad for desired waveform or sweep speed 6 10 or 20 mm s 4 Turn the Main Rotary Dial to the desired value or use auto scale Auto To adjust another wavefo...

Page 172: ... The Cancel pad will close down the Suction Support program Preparation phase The user has 120 seconds for preparation before the ventilator automatic returns to ventilation with previous oxygen setting The ventilator will stop cycling and enter the disconnect phase if the patient is disconnected during the preparation phase During the preparation phase the Check tubing alarm is turned off Disconn...

Page 173: ...o 66 00 261 Infant Adult Universal Options 7 1 The fixed key Save can be used either to save one recording or Copy screen on a Ventilation record card Note Copy screen only possible if a Ventilation record card is inserted Operating Saving data ...

Page 174: ...us recording will also be erased if Admit patient is used Recorded waveforms 1 Press the fixed key Menu 2 Press the Review pad 3 Press the Recorded waveform pad 4 Vertical grey lines indicates the time when the Save key was pressed 5 Measured calculated values are shown next to the line 6 Settings opens a list of parameter settings used at the time Save pad was activated 7 Cursor activates an extr...

Page 175: ...rt the Ventilation record card Refer to page 140 1 Press the fixed key Menu 2 Press the Copy pad 3 Press the Copy screen pad Insert the Ventilation record card Refer to page 140 4 Press OK to continue 5 Press the fixed key Save to make a copy of the screen on the Ventilation record card Note To make a new screen copy press the Save key again When the Ventilation record card is removed or the venti...

Page 176: ...ion record card Refer to page 140 4 Press the Copy data pad The following data is copied Event log Trends Recordings OLT data Included in all data files are patient name and ID ventilator serial number and pre use check status Remove the Ventilation record card Refer to page 140 Read more about the Ventilation record card Description page 114 Insert remove card page 140 Technical data page 246 Ope...

Page 177: ...patient circuit may cause the values in the Open Lung Tool to change 3 Activate Cursor to be able to analyze the stored breath by breath data This may assist in identifying opening and collapse pressures of the lung To move the cursor use the Main Rotary Dial or touch screen Note If the cursor pad is activated the cursor values will be shown in the value field 4 To clear all waveforms press Clear ...

Page 178: ...ble 1 Press the fixed key Quick access 2 Press the Open Lung Tool scales pad 3 Press the touch pad for desired waveform 4 Turn the Main Rotary Dial to the desired value To adjust another waveform repeat steps 3 to 4 Note Out of range values will be indicated by a flashing set max value 5 For more information about Open Lung Tool refer to page 65 Operating Open Lung Tool scales ...

Page 179: ...ssible to temporarily adjust the reading of the O2 concentration during ventilation By activating this function the measured O2 concentration will be adapted in relation to the set O2 concentration This adjustment will only be valid until the ventilator is switched off Note Pre use check is recommended to use to calibrate the O2 cell 1 Press the fixed key Menu 2 Press the Biomed pad 3 Press the O2...

Page 180: ...ies are connected The test evaluates circuit leakage and measures the circuit compliance 1 Press Patient circuit test pad and follow the on line instructions Note Refer to page 145 for information about the Pre use check WARNING A Pre use check must always be done before connecting the ventilator to a patient The separate Patient circuit test which can be performed in Standby refer to page 178 doe...

Page 181: ...pages 71 165 Profile History Mute 5 Review Trends refer to page 181 Recorded waveform refer to page 171 Event log refer to page 180 View configuration refer to page 184 6 Options refer to page 151 7 Circuit compliance compensation refer to pages 86 149 229 8 Copy to Ventilation record card refer to pages 173 174 9 Biomed refer to pages 177 268 269 10 Panel lock activates panel lock e g during tran...

Page 182: ...ition Order No 66 00 261 7 Infant Adult Universal Options Showing Event log 1 Press the fixed key Menu 2 Press the Review pad 3 Press the Event log pad to view all logged events 4 Use the arrows to scroll list Monitoring Event log ...

Page 183: ...o quit the trend window press the pad Close 6 Use the Hours button to alter the resolution on the time axis alter with the Main Rotary Dial 7 When activating the Cursor a vertical cursor line is shown Move it back and forth on the time axis using the Main Rotary Dial or touch screen 8 Time type of event and ventilation mode Time valid for the cursor position is shown When the cursor is on an event...

Page 184: ...the relationship flow volume and pressure volume 1 Press the fixed key Quick access 2 Press the Loops pad 3 Press Reference loop to store a reference loop Time for the reference loop is shown above the pad 4 Press Overlay loops to see the two previous loops and present loop simultaneously 5 To close the window press Close Monitoring Loops ...

Page 185: ...consumption is shown in minutes in figures External 12V indication when the ventilator is running on external 12V DC Caution When external 12 V DC is used at least one installed Battery module is required to ensure proper operation 1 Press the Status pad 2 General system information 3 Status of O2 cell O2 Sensor 4 Status of Expiratory cassette 5 Status of Batteries 6 Status of CO2 module if availa...

Page 186: ...e fixed key Menu 2 Press the Review pad 3 Press the View configuration to system configuration General Units Invasive ventilation Adult alarm limits Invasive ventilation Infant alarm limits Displayed values NIV adult alarm limits NIV infant alarm limits Start up Configuration SVX 9015_XX Monitoring View configuration ...

Page 187: ...ing spontaneous breathing and Bi Vent ventilation MVe sp Spontaneous expiratory minute volume Bi Vent MVe sp MVe The relation between spontaneous expired minute volume and total expired minute volume only applicable in Bi Vent MVi Inspiratory Minute Volume MVe Expiratory Minute Volume Leakage Leakage NIV VTi Inspiratory Tidal Volume VTe Expiratory Tidal Volume ee End expiratory flow O2 Measured Ox...

Page 188: ...the airway pressure during nebulization Increased airway pressure could be caused by a clogged filter The filter should be replaced if the expiratory resistance increases or every 24 hours when the nebulizer is being used When the ventilator is running on batteries the nebulizer module is inoperative to reduce the power consumption Cautions Check that the medication cup is undamaged and that it is...

Page 189: ...e press Accept 5 Check that medication mist is produced 6 During nebulization the remaining time is indicated 7 The Nebulizer pad is shown as a bar with the remaining nebulizing time Press the Nebulizer pad to change the time or cancel the operation Read more about the Servo Ultra Nebulizer Description page 102 Breathing systems page 120 122 Preparations page 128 Cleaning page 205 Technical data p...

Page 190: ...lity without the ventilator is ensured 1 Disconnect the patient 2 Press Standby 3 Press on the Yes pad to stop ventilation 4 Set the ventilator to Off Use the On Off switch on the rear side to turn the ventilator to the off position refer to page 159 The plug in battery continues to charge when connected to the mains SVX 9058 Disconnect the patient ...

Page 191: ...189 Servo User s manual US edition Order No 66 00 261 Infant Adult Universal Options 7 Notes ...

Page 192: ...190 Servo User s manual US edition Order No 66 00 261 7 Infant Adult Universal Options Notes ...

Page 193: ...ns 8 Routine cleaning Hygiene 192 Cleaning flows 193 Preparation and Dismantling 196 Disinfection procedures 199 Sterilization procedure not recommended 201 Drying the expiratory cassette 203 Assembling 204 Function test 204 Servo Ultra Nebulizer cleaning 205 CO2 Analyzer Servo i cleaning 207 ...

Page 194: ...Neonatal is supplied NON STERILE in a plastic bag The Y Sensor can be sterilized before use by EtO or radiation using normal hospital procedures When handling any part of the Servo i Ventilator System always follow your hospital s guidelines for handling infectious material Since cleaning sterilization sanitation and disinfection practices vary widely among health care institutions it is not possi...

Page 195: ...lternative to disinfection Immediate rinsing increases the probability of removing particles and minimizes the risk of cross contamination between patients After processing always make sure that the cassette is dry If not the cassette may fail the Pre use check Never dry the cassette by applying high pressure air Internal tubing may be damaged Recommended cleaning procedure Cleaning procedure when...

Page 196: ...an external bacterial filter has been used Refer to page 199 D2 Disinfecting with medical dish disinfector when no external bacterial filter has been used Refer to page 199 D3 Disinfecting with liquid disinfectant and sterilization methods when no external bacterial filter has been used Refer to page 199 D1 SVX 6042_EN D2 SVX 6043_EN D3 SVX 6044_EN Cleaning flows ...

Page 197: ...r has been used Refer to page 201 Autoclaving reduces the lifetime of the expiratory cassette Sterilization of the Expiratory cassette is not necessary as it is not an invasive instrument MAQUET have clear indications that autoclaving will reduce the lifetime of the Expiratory cassette and therefore do not recommend it as a method for cleaning SVX 6046_EN Cleaning flows ...

Page 198: ...xpiratory cassette tilt it upwards and remove WARNING After removing the Expiratory cassette do not pour any fluid into the Expiratory cassette compartment Avoid contact with electrical connectors Important The Expiratory cassette is a precision instrument and must be handled carefully The Expiratory cassette can be exchanged between different Servo i Ventilator Systems The ventilator may be used ...

Page 199: ...us waste infectious These parts must not be disposed of with ordinary waste Important During normal conditions the filter of the cooling fan page 96 no 6 does not need to be cleaned other than during preventive maintenance In a dusty and warm environment it is recommended to regularly check that the filter looks clean i e black If dusty it can be removed snap off snap on and rinsed in water Shake ...

Page 200: ...nt When ServoGuard filter or equivalent is used the only cleaning needed is to wipe the ventilator and accessories with a soft lint free cloth moistened in soap water or detergent based disinfectant Note In case of more contaminated surfaces use ethyl alcohol or isopropyl alcohol Hazardous waste infectious Hazardous waste infectious Recommended cleaning procedure ...

Page 201: ...ean the ventilator system as soon as possible Rinse before disinfection Rinse the parts thoroughly in water Let the water flow through the parts Rinse the expiratory cassette with water 35 C 95 F to remove organic matter e g blood and other residue Medical dish disinfector Wash the parts with water in a medical dish disinfector at a temperature of 85 95 C 185 203 F The water pressure in the dish d...

Page 202: ...maged Rinse after disinfectant Rinse the parts thoroughly in water to remove all traces of disinfectant Let the water flow through the parts Rinse the expiratory cassette by dip it in water and carefully shake and tilt the cassette holding it vertically in both directions repeat this 3 4 times Mineral deposits on the expiratory cassette affects the function It is important to rinse the expiratory ...

Page 203: ...with 18 minutes sterilization time at 134º C 273º F Important If autoclaving is conducted in a prolonged cycle 4 min at 134 C 273 F the estimated remaining time of use of the Expiratory cassette may be negatively affected Before placing the Expiratory cassette in an autoclave make sure that no water remains inside the cassette The Expiratory cassette must be dried before use if not dry the Expirat...

Page 204: ...ically in both directions repeat this 5 7 times or use a test lung for 10 min Other drying aternatives are drying cabinet 1 hour in maximum 70 C 158 F or 12 24 hours in room air depending on surrounding conditions Caution Never dry the cassette by applying high pressure air as you may damage the internal tubing Autoclave Instrument parts should be autoclaved in a validated process at a temperature...

Page 205: ...ding conditions Caution Never dry the cassette by applying high pressure air as you may damage the internal tubing Note The time for drying can be shorter if the medical dish disinfector has a drying phase Note Normally the expiratory cassette does not have to be dried after sterilization as most steam autoclaves have a drying phase in the end of the autoclave cycle If there is no drying phase the...

Page 206: ...ft the locking handle 4 Push back the unit until you hear a click Caution The Expiratory cassette must be pressed all the way down into its bottom position Make sure that the button on the top of the cassette is completely ejected to ensure that the cassette is firmly locked Important Note on a log sheet that a routine cleaning has been performed Refer to hospital guidelines Function test After cl...

Page 207: ...ter each patient or according to hospital routine Only T piece and nipples can be autoclaved Do not autoclave or use a medical dish disinfector when cleaning the nebulizing chamber Perform a function test of the Servo Ultra Nebulizer after the cleaning Refer to page 130 The medication cup must not be disposed of with ordinary waste Hazardous waste infectious Preparation 1 Disconnect the Servo Ultr...

Page 208: ...ash the T piece and nipples in a medical dish disinfector at a maximum temperature of 85 95 C 185 203 F Important Do not put the nebulizing chamber in a medical dish disinfector Disinfection procedure aldehyde Let the nebulizing chamber the T piece and the nipples soak in a disinfectant agent such as 2 Glutaraldehyde solution CidexOPA Hexanios G R Aniosyme DD1 Important Follow the disinfectant age...

Page 209: ...h patient or according to hospital routine Do not immerse the CO2 Analyzer module nor the Capnostat sensor in any fluid Preparations 1 Disconnect the Capnostat sensor and airway adapter from the ventilator Wiping Wipe the adapter and Capnostat sensor with a soft cloth moistened in soap water or detergent based disinfectant SVX 6082_EN CO2 Analyzer Servo i cleaning ...

Page 210: ...ult adapter can be sterilized using either Steam or ETO ethylene oxide gas methods The Neonate adapter can be sterilized using ETO ethylene oxide gas method After sterilization procedure the adapters must be dried before use The adult adapter can be autoclaved in a validated process at a temperature of 134 C 273 F Disinfection procedure Capnostat sensor 1 Wipe the Capnostat sensor with a soft clot...

Page 211: ...209 Servo User s manual US edition Order No 66 00 261 Infant Adult Universal Options 8 Notes ...

Page 212: ...210 Servo User s manual US edition Order No 66 00 261 8 Infant Adult Universal Options Notes ...

Page 213: ...Options 9 Maintenance General 212 Replacement of O2 cell filter 214 Assembling 217 Nebulizer membrane 217 Extended cleaning of Inspiratory channel 218 WARNING Always disconnect the ventilator if any operation which may involve risk for the patient will be done e g replacement of O2 cell ...

Page 214: ...tion The current operating time and time to next preventive maintenance is presented under the Status menu on the User Interface Important Always perform a regular cleaning and an extended cleaning of the Inspiratory channel before performing a preventive maintenance The extended cleaning must only be performed by personnel who are well trained in its use Fisher Paykel Humidifier MR730 MR850 Refer...

Page 215: ... may cause severe burns to the skin and eyes In case of contact immediately flush continuously with water for at least 15 minutes and seek medical attention especially if the eyes are affected Important Make sure the O2 cell is for the Servo i model O2 cell package must have a blue label Replacement of the O2 cell and filter and extended cleaning must only be performed by personnel who are well tr...

Page 216: ...button at the back of the screen 2 Disconnect the ventilator from the mains and gas supply 3 Lift the locking handle and pull out the Patient Unit Check that the Inspiratory channel is in the front If not Push the locking handle upwards and turn until you hear a click 1 Lift the handle and fold it over the Expiratory cassette 2 Loosen the screw 3 Lift off the cover SVX 076_EN SVX 075_XX Replacemen...

Page 217: ...ell 3 Remove and discharge the bacteria filter Hazardous waste infectious The filter must not be disposed of with ordinary waste Ensure that the rubber seal is intact then firmly put a new bacteria filter into it 4 Connect the rubber seal tightly with the filter 5 Put the O2 cell in position 6 Close the locking catch SVX 072_EN Replacement of O2 cell filter ...

Page 218: ... components Discard disposable replaced and left over parts in accordance with appropriate industrial and environmental standards Remove and discharge the bacteria filter Hazardous waste infectious These parts must not be disposed of with ordinary waste 3 Ensure that the new rubber seal is not damaged then firmly put a new bacteria filter into it 4 Connect the connector Connect the rubber seal tig...

Page 219: ...formation see page 145 Nebulizer membrane A faulty injection membrane on the Servo Ultra Nebulizer Servo i may cause system leakage and must be replaced Replacement of membrane Peel off the old membrane Put a new membrane in place Make sure the new membrane is properly attached This is easiest to see from the inside Check the Servo Ultra Nebulizer for leakage Pre use check page 145 SVX 077_XX SVX ...

Page 220: ...must only be performed by personnel who are well trained in its use Preparations 1 Set the ventilator to off by pressing the button at the back of the screen 2 Disconnect the ventilator from the mains and gas supply 3 Lift the locking handle and pull out the Patient Unit 1 Lift the upper handle and fold it over the expiration cassette 2 Loosen the screw 3 Lift off the cover SVX 589_XX SVX 254_XX E...

Page 221: ...ions 9 If an O2 cell is installed 1 Lower the locking catch 2 Disconnect the connector and lift the O2 cell If an O2 sensor is installed 1 Disconnect the connector and carefully unlock the latches 2 Lift the O2 sensor ServoS 0114_XX 2 1 2 1 SVX 9060_XX Remove the O2 cell O2 sensor ...

Page 222: ...nfection Sterilization instructions for the Inspiratory channel and tube please refer to chapter Routine cleaning page 191 Insert the Inspiratory channel and tube 1 Put the new bacteria filter in position and connect the filter to the tube 2 Put the silicon cuffs in position 3 Press the latches and insert the Inspiratory channel Important There shall always be clearance between the cuffs and gas m...

Page 223: ...ll is used 1 Connect the O2 cell connector and put the O2 cell in position 2 Close the locking catch If an O2 sensor is used 1 Put the O2 sensor in position 2 Connect the O2 sensor a click is heard 3 Connect the O2 sensor connector ServoS 0111_XX 1 2 2x 2 3 1 SVX 9059_XX Insert the O2 cell O2 sensor ...

Page 224: ...e and push it down in position 4 Patient Unit Lift the locking handle and 5 push back the unit until you hear a click After assembling Note on a log sheet that a extended cleaning of the Inspiratory channel has been performed Connect patient tubing and accessories Perform a Pre use check For further information see page 145 SVX 077_XX SVX 588_XX Assembling ...

Page 225: ...223 Servo User s manual US edition Order No 66 00 261 Infant Adult Universal Options 9 Notes ...

Page 226: ...224 Servo User s manual US edition Order No 66 00 261 9 Infant Adult Universal Options Notes ...

Page 227: ...rms 234 Pre use check messages 235 CO2 Analyzer Calibration error messages 238 Technical error messages 239 WARNING Always disconnect the ventilator if any operation which may involve risk for the patient will be done e g replacement of O2 cell Caution The Expiratory cassette must not be lifted up when the ventilator is in operation This may however be done when in Standby setting ...

Page 228: ... is disconnected or not connected properly Connect the Expiratory cassette Replace the Expiratory cassette Perform a Pre use check if a new Expiratory cassette is inserted Expiratory Minute Volume High Preset or default alarm limit exceeded Increased patient activity Ventilator self triggering auto cycling Improper alarm limit setting Check patient and breathing system Check trigger sensitivity se...

Page 229: ... problem with nebulizer hardware Temperature too high Change the nebulizer If the problem still remains contact a service technician No battery capacity Less than 3 minutes left of battery operation Connect to mains Insert charged Battery modules Recharge Battery module by leaving the ventilator plugged into mains No patient effort detected The time between two consecutive inspiratory efforts has ...

Page 230: ...r settings and alarm limits Restart ventilator Software related error Restart the ventilator and perform a Pre use check If the problem still remains take the unit out of operation and contact a service technician Safety valve test failed During Pre use check the system found failures during the check of the opening pressure for the safety valve Contact a service technician Settings lost Restart v...

Page 231: ...detected and its extent easily controlled The first time an unacceptably large leakage occurs around the tube correct this problem to avoid triggering the Low Expiratory Minute alarm If the leakage still persists adjust the alarm limit right down to its lowest level i e 10 ml if this step is clinically judged to be appropriate Finally if the leakage still has not been remedied then deactivate the ...

Page 232: ...imits Check CO2 airway adapter Either the data or reference channel or both channels are out of range Usually caused when the airway adapter is removed from the Capnostat or when there is an optical blockage on the windows of the airway adapter May also be caused when changed the adapter type without performing verification to correct for adapter type Make sure that the adapter is completely inser...

Page 233: ...eakage with high bias flow CO2 sensor Y piece HME Check patient circuit Ventilator settings etCO2 low Hyperventilation Leakage with high bias flow CO2 sensor Y piece HME Check patient circuit Ventilator settings Exp cassette exchanged Expiratory cassette has been exchanged during operation No Pre use check performed after exchange Perform a Pre use check Inspiratory flow overrange Combination of s...

Page 234: ...k Check ventilator settings Check the alarm settings PEEP Low The measured end expiratory pressure is below the preset or default alarm limit for three consecutive breaths Note Setting the alarm to 0 zero is equal to alarm off Leakage in patient breathing system Leakage at patient connection cuff tracheal tube Check patient breathing system Check patient connection cuff pressure tracheal tube size...

Page 235: ...dules are connected at the same time Remove one of the Y Sensor modules Y Sensor Module error Hardware error in the Y Sensor measuring module Check that the module is properly plugged in Re insert the module if necessary If the error persists it is probably hardware related Change module Contact a service technician Y Sensor Module temp high Possible hardware error The Y Sensor module temperature ...

Page 236: ...tions Problem Display message Possible cause Remedy Touch screen or knob press time exceeded Screen or knob has been pressed for more than one minute Screen or knob hardware time out Check screen and knobs If the problem still remains contact a service technician Low priority alarms ...

Page 237: ...e technician Not completed The test was not completed Not completed means that the test case passed with some reservations The message will be shown if The battery option is installed and the battery capacity is less than 10 minutes or The test could not be completed due to a missing gas Note The ventilator may still be used limited if the message Not completed is shown If the missing gas is appli...

Page 238: ...pressures Air and O2 measured by the internal gas supply pressure transducers are within the specified range Check that the connected gas supply pressure Air and O2 is within the specified range Internal leakage test Checks the internal leakage with test tube connected using the inspiratory and expiratory pressure transducers Allowed leakage 10ml min at 80 cmH2O If message Leakage or Excessive lea...

Page 239: ...m persists change Y sensor If problem still presists change Y module Pressure transducer test Calibrates and checks the inspiratory and expiratory pressure transducers If the Internal leakage test passed see above Check replace Insp or Exp pressure transducer Check that there is no excess water in the expiratory cassette Refer to pages 202 and 203 Safety valve test Checks and if necessary adjusts ...

Page 240: ... restored Perform a verification calibration If problem persists it may be a hardware error Call a service technician CO2 cell zero failed An error was found during cell zero calibration The calibration was cancelled and old cell zero parameters were not restored Perform a Cell zero calibration If problem persists it may be a hardware error Call a service technician Verification against Ref erence...

Page 241: ...an Technical error no 28 20004 Alarm sound level too low Check that the loudspeaker outlet is not obstructed Restart the ventilator and perform a Pre use check If the problem still remains take the unit out of operation and contact a service technician Technical error no 38 39 Barometer failures Contact a service technician Technical error no 8 9 33 35 41 Timeout failures Contact a service technic...

Page 242: ...240 Servo User s manual US edition Order No 66 00 261 10 Infant Adult Universal Options Notes ...

Page 243: ...ry channel 243 Monitoring 243 Alarms 244 Ventilation modes 244 Trend function 245 Log function 245 Communication Interface 246 Servo Ultra Nebulizer 246 CO2 Analyzer Servo i 247 Y Sensor measuring 248 Drawer Kit Servo i 248 Holder Servo i 248 Shelf base Servo i 248 Gas cylinder restrainer Servo i 248 IV Pole 248 Gas trolley Servo i 248 Compressor Mini 248 Default values and parameter settings 249 ...

Page 244: ...ackup 2 6 battery modules rechargable 12 V 3 5 Ah each Recharge time approximately 3 h battery Battery backup time approximately 3 h when using 6 batteries External 12V DC 12 0V 15 0V DC 10A Caution When external 12 V DC is used at least one installed Battery module is required to ensure proper operation Max power consumption At 110 120V 2A 190VA 140W At 220 240V 1A 190VA 140W The ventilator Gener...

Page 245: ...ccuracy 6 6 Expiratory channel Pressure drop Max 3 cmH2O at a flow of 1 l s Internal compressible factor Max 0 1 ml cmH2O PEEP regulation Microprocessor controlled valve PEEP setting range 0 50 cmH2O Inaccuracy 5 or 1 cmH2O7 Expiratory flow measurements Flow range 0 3 2 l s Rise time 12 ms for 10 90 response at a flow of 0 05 3 2 l s Inaccuracy 5 or 2 5 ml s Monitoring Expiratory Minute Volume Adu...

Page 246: ... end tidal carbon dioxide concentration 25 Lower end tidal carbon dioxide concentration etCO2 end tidal carbon dioxide concentration 25 Audio pause Alarm silence reset 2 minute silence and reset of latched alarms Ventilation modes Controlled ventilation Pressure Control PC Pressure controlled ventilation Volume Control VC Volume controlled ventilation Pressure Reg Volume Control PRVC Pressure regu...

Page 247: ...ired Minute Volume MVe Leakage fraction Leakage Inspired Tidal Volume VTi Expired Tidal Volume VTe End Expiratory Flow ee Measured Oxygen concentration O2 CO2 End tidal concentration etCO2 CO2 Minute elimination CO2 CO2 Tidal elimination VTCO2 Dynamic Characteristics Cdyn Static Compliance Cstatic Elastance E Inspiratory Resistance Ri Expiratory Resistance Re Work of Breathing ventilator WOB v Wor...

Page 248: ...o approximately 5000 hours of operation The current operating time is presented under the Status menu on the user interface Battery modules must be replaced after 3 years Original parts from MAQUET must be used Service repair must be done only by MAQUET authorized personnel Service mode should only be used without a patient connected to the ventilator Servo Ultra Nebulizer Patient Unit Weight Appr...

Page 249: ...e of 1013hPa Measuring range 0 to 100 mmHg CO2 partial pressure 0 to 13 3 kPa CO2 partial pressure 0 to 13 2 CO2 volume at a barometric pressure of 1013hPa Accuracy 0 to 40 mmHg 2mmHg 41 to 70 mmHg 5 of reading 71 to 100 mmHg 8 of reading 0 to 5 3 kPa 0 3 kPa 5 4 to 9 3 kPa 5 of reading 9 4 to 13 3 kPa 8 of reading 0 to 5 3 0 3 5 4 to 9 2 5 of reading 9 3 to 13 2 8 of reading Measurement condition...

Page 250: ... to 40 l min Airway adapter dead space Adult 9 0 ml Infant 0 45 ml Mobile cart Servo i Weight 20 kg Dimensions W 542 mm x L 622 mm x H 1010 mm Drawer Kit Servo i Weight 4 5 kg Dimensions W 300 mm x L 210mm x H 240mm Holder Servo i Weight 3 5 kg Dimensions W 159 mm x L 247 mm x H 352 mm Shelf base Servo i Weight 1 2 kg Dimensions W 159 mm x L 205 mm x H 29 mm Gas cylinder restrainer Servo i Max loa...

Page 251: ...4 1 4 0 5 15 1 15 0 5 15 1 15 CMV frequency b min 30 15 30 15 4 150 4 100 4 150 4 150 Compensate for compliance OFF OFF OFF OFF ON OFF ON OFF ON OFF ON OFF CPAP cmH2O in NIV Nasal CPAP 5 5 2 20 2 20 Flow trig sensitivity level fraction of bias flow 50 50 50 50 0 100 0 100 0 100 0 100 I E ratio 1 2 1 2 1 2 1 2 1 10 4 1 1 10 4 1 1 10 4 1 1 10 4 1 Inspiratory cycle off of peak flow 30 30 30 30 1 70 1...

Page 252: ...15 15 15 PEEP 1 50 PEEP 1 50 PEEP 1 50 PEEP 1 50 Press trig sensitivity level cmH2O 20 0 20 0 20 0 20 0 Pressure level above PEEP cmH2O 20 20 20 20 0 80 PEEP 0 120 PEEP 0 80 PEEP 0 120 PEEP Pressure level above PEEP in NIV cmH2O 5 5 5 5 0 32 PEEP 0 32 PEEP 0 32 PEEP 0 32 PEEP PS above PEEP cmH2O 0 0 0 0 0 80 PEEP 0 120 PEEP 0 80 PEEP 0 120 PEEP PS above Phigh cmH2O 0 0 0 0 0 80 PHigh 0 120 PHigh 0...

Page 253: ...10 0 30 0 30 0 30 Tpause s 0 4 0 2 0 4 0 1 5 0 1 5 0 1 5 TPEEP s 1 2 1 2 0 2 10 0 2 10 0 2 10 0 2 10 Weight kg 3 50 3 50 0 5 30 10 250 0 5 30 10 250 Parameter Factory set default Setting range Infant Adult Universal Infant Adult Universal Infant Adult Infant Adult Default values and parameter settings ...

Page 254: ...20 10 20 5 45 15 45 5 45 15 45 CPAP high limit cmH2O 10 10 10 10 0 55 0 55 0 55 0 55 CPAP lower limit cmH2O Note Setting the alarm to 0 zero is equal to alarm off 10 10 10 10 0 47 0 47 0 47 0 47 End expiratory pressure high limit cmH2O 10 10 10 10 0 55 0 55 0 55 0 55 End expiratory pressure lower limit cmH2O Note Setting the alarm to 0 zero is equal to alarm off 10 10 10 10 0 47 0 47 0 47 0 47 etC...

Page 255: ...ory set default Setting range Infant Adult Universal Infant Adult Universal Infant Adult Infant Adult etCO2 upper limit Note In NIV low limit can be set to 0 zero 6 5 6 5 6 5 6 5 0 5 20 0 5 20 0 5 20 0 5 20 mmHg 49 49 49 49 4 100 4 100 4 100 4 100 kPa 6 5 6 5 6 5 6 5 0 5 14 0 5 14 0 5 14 0 5 14 Expired minute volume lower limit l min 2 0 5 0 2 0 5 0 0 01 20 0 0 5 40 0 0 01 20 0 0 5 40 0 Expired mi...

Page 256: ...254 Servo User s manual US edition Order No 66 00 261 11 Infant Adult Universal Options Notes ...

Page 257: ...ime to full inspiratory flow or pressure at the start of each breath as a percentage or in seconds of the breath cycle time or s Leakage Leakage during inspiration Minute Volume Volume per minute or target volume l MVe expiratory Minute Volume MVe sp Spontaneous expiratory minute volume MVe sp MVe The relation between spontaneous expired minute volume and total expired minute volume only applicabl...

Page 258: ... triggered set breath T Time Tc Time constant Ti Inspiration time Ti Ttot Duty cycle or ratio of inspiration time to total breathing cycle time only during spontaneous breathing Tidal Volume Volume per breath or target volume ml Thigh Time at Phigh level in Bi Vent s TPEEP Time at PEEP level in Bi Vent s Flow CO2 CO2 Minute elimination leak Leakage flow l min Ventilation record card Documentation ...

Page 259: ...257 Servo User s manual US edition Order No 66 00 261 Infant Adult Universal Options 12 Notes ...

Page 260: ...258 Servo User s manual US edition Order No 66 00 261 12 Infant Adult Universal Options Notes ...

Page 261: ... 260 Start Stop Standby key Main Rotary Dial 262 Direct Access Knobs 263 Keys 264 Fixed keys 264 Special function keys 265 Quick access key 266 Main Screen key 267 Menu key in Standby mode 268 Menu key during ventilation 269 Biomed menu Standby mode 270 Screen touch pads 271 13 Appendix User Interface ...

Page 262: ...ans of the knobs or dial and fixed keys There is a Main Rotary Dial fixed keys and Direct Access Knobs which allow immediate adjustments Data can be shown as wave forms numerical displays and or loops The measured value boxes are always available while you are setting the ventilator Screen brightness is automatically adjusted depending on the ambient light levels Volume control Mode SVX 5001_EN Ge...

Page 263: ...t category 2 Menu touch pad 3 Text and alarm messages 4 Fixed keys 5 Waveform area 6 Measured value boxes 7 Main Rotary Dial 8 Special function keys 9 Direct Access Knobs 10 Mains indicator green 11 Start ventilation Stop ventilation Standby 12 Service connector 13 On Off switch rear side General ...

Page 264: ...art ventilation 5 Stop ventilation i e set to Standby 6 Push the fixed Start Stop ventilation Standby key 7 Press on the Yes pad to stop ventilation Main Rotary Dial The Main Rotary Dial is a hardware dial that provides a means of selecting on screen elements and changing values by turning and pressing The Main Rotary Dial can be turned 1 either clockwise or counter clockwise and then it is presse...

Page 265: ...ameter box above the knob 2 If the bar is white the setting is within what is generally considered safe limits 3 If the bar turns yellow the setting is too low or too high compared to what are generally considered safe limits advisory information 4 If the bar turns red the setting is significantly outside what are generally considered safe limits advisory warning accompanied by an audible signal a...

Page 266: ...xed keys Note Autoset is not possible in NIV The Save key can be used either to copy screen or save one recording 10 s before and 10 s after pressing the key Note In NIV the alarm sound can be permanently silenced Audio off Audio off Audio pause Silence or pre silence alarms SVX 580_EN Keys ...

Page 267: ...y and expiratory valves close after expiration This function can provide an exact measurement of the end expiratory lung pressure It can be used for static compliance measurement and to determine the total PEEP Inspiratory hold is activated by manually pressing the fixed key The maximum time is 30 seconds The inspiratory and expiratory valves close after inspiration This function can provide an ex...

Page 268: ... apnea minute volume frequency alarm check tubing EtCO2 low PEEP during suction support Note Suction Support is not available when NIV or O2 Breaths is activated The sweep speed mm s can be set to 6 10 or 20 mm s default Note Open Lung Tool is not available in NIV Possibility to increase the space viewing the waveform curves This in turns means that more detailed information can be gained These th...

Page 269: ...er No 66 00 261 Infant Adult Universal Options 13 Main Screen key Main screen Main screen The Main screen fixed key will return you to the Main screen cancelling current work from wherever you are in the Menu dialog windows SVX 582_EN Keys ...

Page 270: ... upper Minute Volume lower and upper Respiratory Rate lower and upper End Expiratory Pressure lower Alarm sound level 20 100 End Tidal CO2 lower and upper By pressing the autoset in controlled modes of ventilation the alarm limits are automatically set for Pressure Volume Resp Rate PEEP In spontaneous modes an alarm setting for apnea time is available This shows alarms that have been activated The...

Page 271: ...m sound can be permanently silenced Audio off Alarm profile setup Possible selections Pressure upper Minute Volume lower and upper Respiratory Rate lower and upper End Expiratory Pressure lower Alarm sound level 20 100 End Tidal CO2 lower and upper By pressing the autoset in controlled modes of ventilation the alarm limits are automatically set for Pressure Volume Resp Rate PEEP In spontaneous mod...

Page 272: ...u Standby mode Enter code 1973 to access the Biomed menues Note The access code can be change by the user Change acces code Change access code to Biomed menu Start up configuration NIV infant alarm NIV adult alarm Alarm sound level Copy configuration to from PC Card Technical alarms SVX 632_EN Keys ...

Page 273: ...2 SVX 579_EN Note In NIV only one page is available NIV Backup This pad is only visible during NIV Pressure Support mode the bar is white when the pressure triggering is selected Batteries Y Sensor Measuring Status of batteries Status ofY Sensor module if available O cell sensor 2 Status of O cell sensor 2 Touch pads ...

Page 274: ...272 Servo User s manual US edition Order No 66 00 261 13 Infant Adult Universal Options Notes ...

Page 275: ...ing Cleaning procedures 193 CO2 Analyzer cleaning 207 Disinfection procedures 199 Drying 202 203 Nebulizer cleaning 205 Preparation 196 Sterilization procedures 201 CO2 Analyzer Calibration 151 Cleaning 207 Description 104 General 83 84 86 92 Maintenance 212 Setup 134 135 Technical data 247 Troubleshooting 238 CO2 calibration 152 Communication Interface 84 246 Compliance compensation 149 Compresso...

Page 276: ...270 NIV Backup 271 NIV Infant alarm 270 NIV Nasal CPAP range 4 NIV rate 78 Non Invasive Ventilation 61 73 163 Non operating conditions 242 O O2 breaths 30 O2 cell 177 213 216 O2 cell adaptation 177 O2 Sensor 213 Open Lung Tool 65 85 175 Open Lung Tool scales 176 Operating conditions 242 Options 85 Options Accessories 86 P Panel cover 95 Panel lock 179 269 Parameter settings 249 Patient breathing s...

Page 277: ... priority alarms 234 Medium priority alarms 230 Pre use check messages 235 236 Technical errors 239 Type of ventilation 160 U Universal range 4 User Interface 87 88 89 93 259 User s manual 8 V Ventilation Automode 48 Basic functionality 18 Bi Vent 59 Combined modes 20 Controlled ventilation 32 35 38 62 Extra flow and extra breaths 17 IE ratio Inspiration time 27 Implementation 17 Mandatory breath ...

Page 278: ...276 Servo User s manual US edition Order No 66 00 261 14 Infant Adult Universal Options Notes ...

Page 279: ......

Page 280: ... immediate access to special windows 8 The Main Rotary Dial 9 Special function keys for immediate ventilatory functions 10 Direct Access Knobs 11 Mains indicator green 12 Standby indicator yellow 13 Start Stop Standby ventilation key 14 On Off switch rear side 15 Slot for Ventilation record card 16 Luminiscens detector 17 Informative text messages 18 Alarm messages 19 The waveform area 20 Field fo...

Page 281: ...Servo User s manual US edition Order No 66 00 261 Infant Adult Universal Options Turn page according to picture above for more information about the User Interface SVX 701_XX ...

Page 282: ...Equipment services and tech h nologies are supplied under the brands ARJO for patient hygiene patient handling and wound care GETINGE for infection control and prevention within healthcare and life science and MAQUET for Surgical Workplaces Cardiopulmonary and Critical Care Maquet Critical Care AB 2005 All rights reserved y MAQUET reserves the right to modify the design and specifications containe...

Page 283: ...VENTILATOR SYSTEM V 3 1 USER S MANUAL US VERSION SERVO i ...

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