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PHILIPS Respironics Trilogy 202 User Manual Download Page 62

Chapter 4 

Ventilator Setup

53

 CAUTION

The device may only be operated 
at temperatures between 5˚ C 
and 40˚ C (41˚ F and 104˚ F).

Connecting the AC Power 

Cord

 

WARNING

Periodically inspect the power 
cord for damage or signs of 
wear. Discontinue use and 
replace if damaged.

Note

: To remove AC power, 

disconnect the power supply 
cord from the electrical outlet.

Securing the Power Cord 
Using the Cord Retainer

2.  Plug the pronged end of the cord into a wall outlet not 

connected to a wall switch.

3.  Ensure that all connections are secure. If AC power is connected 

correctly and the device is operating properly, the green AC 
Power LED should be on.

4.  Secure the power cord using the cord retainer on the back of 

the device, as shown below. To secure the power cord, use a 
screwdriver to remove the screw on the cord retainer. Insert the 
cord as shown into the cord retainer, and then re-attach the cord 
retainer to the device by re-attaching the screw.

Summary of Contents for Trilogy 202

Page 1: ...User Manual REF 1067236 1067235 JH 12 3 09 ...

Page 2: ...com healthcare Authorized European Representative Respironics Deutschland GmbH Gewerbestrasse 17 D 82211 Herrsching Germany 49 8152 93060 2009 Koninklijke Philips Electronics N V All rights reserved This work is protected under Title 17 of the United States copyright code and is the sole property of Philips Respironics No part of this document may be copied or otherwise reproduced or stored in any...

Page 3: ......

Page 4: ... 11 Symbols 12 Front Panel 12 Rear and Side Panels 12 Chapter 2 System Description 15 Front Panel Features 15 Buttons 15 Visual Indicators 16 Display Screen 16 Side and Rear Panel Features 17 Chapter 3 Modes Features and Alarms 19 Therapy Modes 19 Breath Types 20 Therapy Mode Table 21 Volume Control Ventilation Therapy Modes 27 Trilogy 202 user manual Table of Contents ...

Page 5: ...of Power Alarm 41 Ventilator Inoperative Alarm 41 Ventilator Service Required Alarm 41 Check Circuit Alarm 42 Low Circuit Leak Alarm 42 High Expiratory Pressure Alarm 42 Low Expiratory Pressure Alarm 42 High Internal Oxygen Alarm 42 High Oxygen Flow 43 Low Oxygen Flow 43 High Oxygen Inlet Pressure 43 Low Oxygen Inlet Pressure 43 Circuit Disconnect Alarm 43 Apnea Alarm 44 High Vte Alarm 44 Low Vte ...

Page 6: ...ttery Discharging Stopped due to Temperature Info Message 48 Battery Not Charging due to Temperature Info Message 48 Battery Not Charging Info Message 48 Check External Battery Info Message 49 Battery Depleted Info Message 49 External Battery Disconnected Info Message 49 Detachable Battery Disconnected Info Message 49 Start On Battery Info Message 49 Card Error Info Message 49 Chapter 4 Ventilator...

Page 7: ...Screens 77 Changing and Viewing Settings in Full Menu Access Mode 78 Changing the Device Settings and Alarms 79 Viewing and Changing Options Menu Items 93 Viewing the Alarm Log 97 Viewing the Event Log 98 Viewing Device Information 99 Updating Prescriptions Using the SD Card 100 Changing and Viewing Settings in Limited Menu Access Mode 104 Activating a Primary or Secondary Prescription 105 Viewing...

Page 8: ...ventive Maintenance 126 Chapter 8 Troubleshooting 127 Chapter 9 Accessories 131 Adding a Humidifier 131 Adding Supplemental Oxygen to the Device 131 Oxygen Blending Module Warnings 132 Fixed Flow Oxygen Warnings 132 Using a Remote Alarm Unit 133 Using a Nurse Call System 134 Using a Secure Digital SD Card 134 Using the Philips Respironics DirectView Software 135 Chapter 10 System Checkout Procedur...

Page 9: ...Trilogy 202 user manual vi Chapter 11 Technical Specifications 151 Chapter 12 Glossary 155 Chapter 13 EMC Information 161 Index 165 Limited Warranty 169 ...

Page 10: ... Power Cord Flexible Tubing Universal Porting Block Reusable Gray Foam Filters Secure Digital SD Card pre installed Detachable Battery Active Exhalation Device with PAP pre installed Exhalation Valve Line Trilogy 202 Proximal Pressure Line Whisper Swivel II Active Exhalation Device with Flow Flow Sensor Universal Active PAP Tube Adapter 2 5 meter Supplemental Oxygen Hose Detachable Battery Cover P...

Page 11: ... at least 5 kg 11 lbs The device is intended to be used in hospitals and institutions and for portable applications such as wheelchairs and gurneys only when in an institutional setting It may be used for both invasive and non invasive ventilation It is not intended to be used as a transport ventilator The system is recommended to be used only with various combinations of Philips Respironics appro...

Page 12: ... to provide alternate therapy in the event of ventilator failure or inoperative equipment Patient Disconnect Protection For ventilator dependent patients do not rely on any single alarm to detect a circuit disconnect condition The Low Tidal Volume Low Minute Ventilation Low Respiratory Rate and Apnea alarms should be used in conjunction with the Circuit Disconnect and Low Peak Inspiratory Pressure...

Page 13: ...t and compatible with the patient after using this feature Installing the wrong prescription for a particular patient may result in improper therapy lack of appropriate safety monitoring and risk of death or injury to the patient Electrical Interference This device is intended for use in the electromagnetic environment specified in Chapter 13 of this manual The user of this device should make sure...

Page 14: ...ture Exchangers HMEs and filters should be carefully considered in relation to the potential for adverse effects on the patient s ventilatory management and device alarms Passive Circuits An exhalation port is required when using a passive circuit For the passive circuit at low expiratory pressures the flow through the exhalation port may be inadequate to clear all exhaled gas from the tubing some...

Page 15: ...he oxygen inlet cap while still connected to oxygen source Removing the cap may cause it to pop off and cause injury Fixed Flow Oxygen When administering fixed flow supplemental oxygen the oxygen concentration may not be constant The inspired oxygen concentration will vary depending on the pressures patient flows and circuit leak Substantial leaks may reduce the inspired oxygen concentration to le...

Page 16: ...dition The Low Tidal Volume Low Minute Ventilation Low Respiratory Rate and Apnea alarms should be used in conjunction with the Circuit Disconnect alarm Make sure the alarm volume is set loud enough to be heard by the caregiver Consider the use of a remote alarm Trilogy 202 offers the following circuit type selections Passive Active Flow Active PAP Proximal Airway Pressure The Passive circuit type...

Page 17: ...all outlet before cleaning the ventilator If the device has been exposed to rain or dampness dry the device including the area around the power cord connection with the power cord disconnected from the device before applying AC power Cautions A caution indicates the possibility of damage to the device Storage The internal and detachable batteries will self discharge in storage If it is desired to ...

Page 18: ...ng therapy Air Filter The reusable foam inlet filter is required to protect the ventilator from dirt and dust Wash periodically and replace when damaged for proper operation Cooling Air Vents Do not block the cooling air vents located on the base and the rear of the device This may cause the device to overheat in high ambient temperatures or at high therapy settings Battery Life The internal and d...

Page 19: ...y other adapter or cable may cause improper operation of the ventilator The ventilator should only be connected to an automotive electrical system using the Philips Respironics Trilogy Automotive Adapter when available This adapter is fused filtered and designed for safe connection to a standard automotive electrical system Use of any other adapter or cable may cause improper operation of the vent...

Page 20: ... invasive to invasive ventilation When prescribed the device provides numerous special features to help make patient therapy more comfortable For example the ramp function allows you to lower the pressure when trying to fall asleep The air pressure will gradually increase until the prescription pressure is reached Additionally the Flex comfort feature provides increased pressure relief during the ...

Page 21: ...erapy Start Stop Alarm Indicator Audio Pause AC Power Indicator Rear and Side Panels Symbol Description AC Power Connector Secure Digital SD Card Slot Serial Port Connector Remote Alarm Connector Ethernet Connector DC Power Connector O2 Oxygen Inlet Consult accompanying instructions for use Type BF Applied Part ...

Page 22: ...Chapter 1 Introduction 13 Separate collection for electrical and electronic equipment per EC Directive 2002 96 EC Class II Double Insulated Drip Proof Equipment ...

Page 23: ...Trilogy 202 user manual 14 ...

Page 24: ...minutes Each time the button is pressed the alarm silence period resets to two minutes See Chapter 6 for more information 3 Up Down Button This button allows you to navigate the display menu and edit device settings 1 2 4 5 3 Front Panel Controls and Display Screen Note When you start therapy the display backlight and the backlights on the buttons turn on the red and yellow alarm LEDs turn on mome...

Page 25: ...backlight is turned on in the device Options menu See Chapter 5 for more information 7 Red Alarm LED On the Alarm Indicator Audio Pause button a red light flashes to indicate a high priority alarm 8 Yellow Alarm LED On the Alarm Indicator Audio Pause button a yellow light flashes to indicate a medium priority alarm A solid yellow light indicates a low priority alarm Display Screen The display scre...

Page 26: ...ng circuit connector is located on the right side of the device You can connect your circuit tubing system here See Chapter 4 for details 3 Exhalation Porting Block Connect the exhalation device to the exhalation porting block located on the right side of the device See Chapter 4 for more information 4 Air Inlet and Filter Insert the filter supplied with the device into the air inlet 5 Secure Digi...

Page 27: ...connect a PC or router to this connector to upload therapy information to a secure web site so you can review therapy information remotely or remotely troubleshoot and service the device 9 External Battery Connector DC Power Inlet You can connect an external stand alone lead acid battery here using the Trilogy External Battery cable 10 High Pressure Oxygen Inlet If using high pressure supplemental...

Page 28: ...Continuous Positive Airway Pressure S Spontaneous Ventilation S T Spontaneous Timed Ventilation T Timed Ventilation PC Pressure Control Ventilation PC SIMV Pressure Controlled Synchronized Intermittent Mandatory Ventilation Volume Control ventilation delivers a prescribed inspired tidal volume to the patient according to set breath rate and set inspiratory time parameters This means that each brea...

Page 29: ...ontrols both the beginning triggering and end cycling of the inspiratory phase Assisted Breath An Assisted breath is controlled by both the patient and the ventilator Breaths are initiated by the patient s effort and air delivery is controlled by the current pressure or volume settings Volume Assisted breaths will deliver the prescribed Tidal Volume within the prescribed Inspiratory Time Pressure ...

Page 30: ...PS On Off IPAP Max Pressure IPAP Min Pressure EPAP Pressure Pressure Support PS PEEP Tidal Volume Breath Rate Inspiratory Time Trigger Type Flow Trigger Sensitivity Leak Compensation Flow Cycle Sensitivity Ramp Length Ramp Start Pressure Flex Rise Time Flow Pattern Sigh Circuit Disconnect Apnea Apnea Rate High Vte Low Vte High Vti Low Vti High Minute Ventilation Low Minute Ventilation High Respira...

Page 31: ...eous breaths Spontaneous S Mode In Spontaneous S mode the device delivers bi level pressure support This mode provides only spontaneous breaths In this mode an Inspiratory Positive Airway Pressure IPAP is delivered during inhalation and a lower Expiratory Positive Airway Pressure EPAP is delivered during exhalation The following illustration describes these concepts IPAP 26 cm H2 O EPAP 6 cm H2 O ...

Page 32: ... breaths per minute In this mode an IPAP is delivered during inhalation and a lower EPAP is delivered during exhalation The duration of a Spontaneous breath is determined by the patient effort The duration of a Mandatory breath is determined by the inspiratory time setting The following illustration describes these concepts Pressure Supported Spontaneous Breath Mandatory Breath note longer inspira...

Page 33: ...me settings This also means that the ventilator will not respond to patient effort In this mode an IPAP is delivered during inhalation and a lower EPAP is delivered during exhalation The following illustration describes these concepts IPAP 26 cm H2 O EPAP 6 cm H2 O Rate 10 BPM PS IPAP EPAP 20 cm H2 O 6 seconds 6 seconds 6 seconds 6 seconds 2 2 2 2 6 10 20 26 Mandatory Breath 2 Enter T mode 5 10 15...

Page 34: ...ronized Intermittent Mandatory Ventilation PC SIMV Mode The Pressure Control Synchronized Intermittent Mandatory Ventilation PC SIMV mode provides Spontaneous Assist and Mandatory breaths This mode uses a time window to decide what type of breaths should be delivered This time window is the maximum time between breaths according to the set Breath Rate When you enter PC SIMV mode the time window is...

Page 35: ...sure setting during inhalation and the PEEP setting during exhalation During the time window if patient effort continues to be detected after the first patient triggered breath Spontaneous breaths are delivered for the remainder of the window The figure below provides example breath patterns in PC SIMV mode 12 seconds 2 3 3 1 1 1 Pressure 26 cm H2 O Pressure Support 10 cm H2 O PEEP 6 cm H2 O Rate ...

Page 36: ...tory breaths A Mandatory breath is delivered according to the prescribed BPM setting for the prescribed Inspiratory Time This also means that the ventilator will not respond to patient effort In this mode the Tidal Volume is delivered during inhalation and PEEP is delivered during exhalation The following illustration describes these concepts 50 50 0 Enter CV mode 2 2 2 Tidal Volume 500 mL Rate 10...

Page 37: ...y Time 2 0 seconds Flow Pattern Square 5 15 10 20 FLOW TIME Mandatory Breath Assist Breath 3 2 6 seconds 6 seconds 5 seconds Synchronized Intermittent Mandatory Ventilation SIMV Mode In Synchronized Intermittent Mandatory Ventilation SIMV mode the device delivers both volume control and pressure control therapy This mode provides Spontaneous Assist and Mandatory breaths This mode uses a time windo...

Page 38: ...ng exhalation During the time window if patient effort continues to be detected after the first patient triggered breath Spontaneous breaths are delivered for the remainder of the window Spontaneous breaths deliver the prescribed Pressure Support setting above PEEP during inhalation and PEEP during exhalation The figure below provides example breath patterns in SIMV mode 12 seconds 12 seconds 12 s...

Page 39: ...ing diagram the dashed lines represent normal CPAP therapy in comparison to the bold line representing C Flex C Flex levels of 1 2 or 3 progressively reflect increased pressure relief PRESSURE CPAP TIME 3 1 2 Inhalation Exhalation C Flex pressure relief is determined by the C Flex setting and the amount of patient flow C Flex returns to the set pressure by the end of exhalation when the airway is ...

Page 40: ...e relief that will take place at the end of inspiration and at the beginning of expiration PRESSURE IPAP EPAP TIME BiPAP Bi Flex 3 1 2 Ramp The device is equipped with a linear ramp function In CPAP S S T T and PC modes the Ramp feature will reduce the pressure and then gradually increase ramp the pressure to the prescription pressure setting so patients can fall asleep more comfortably The figure...

Page 41: ...n a tidal volume VT equal to or greater than the target tidal volume Volume setting in the ventilator by automatically controlling the pressure support PS provided to the patient The AVAPS feature adjusts PS by varying the IPAP level between the minimum IPAP Min and maximum IPAP Max settings AVAPS averages VT and changes the PS value gradually This occurs over several minutes The rate of change is...

Page 42: ...get tidal volume is not reached Conversely as patient effort increases AVAPS will reduce PS IPAP will not fall below IPAP Min even if the target tidal volume is exceeded If the Ramp function has been activated it will take precedence over the AVAPS feature Once ramp is complete AVAPS will resume IPAP Max IPAP Min EPAP TIME 15 30 45 60 TIME 15 30 45 60 PRESSURE Target Volume VOLUME AVAPS Feature ...

Page 43: ...therapy modes Square Ramp Square With a square wave pattern airflow is generally constant throughout inspiration of the breath FLOW TIME Ramp With a ramp flow pattern the airflow starts high and decreases throughout inspiration of the breath 50 of Peak Flow FLOW TIME Square Flow Pattern Ramp Waveform Pattern ...

Page 44: ... flow pattern may provide a pattern that more closely resembles a Square flow pattern Sigh Feature The sigh feature is available for Volume ventilation modes only When the sigh feature is enabled the ventilator delivers a sigh breath in place of every 100th mandatory or assisted breath delivered regardless of the mode of operation i e AC CV and SIMV The Sigh breath is delivered using a volume equa...

Page 45: ...ions examine this function in detail by describing the leak tolerance function and sensitivity Leak Tolerance A microprocessor monitors the total flow of the patient circuit and calculates patient flow values A Leak Estimation Average and Parabolic The device uses two leak estimation algorithms A conservation of mass algorithm is used to compute the average leak for a given pressure support relati...

Page 46: ...chine synchrony with changing breathing efforts and circuit leaks the device continuously tracks patient breathing patterns and automatically adjusts sensitivity thresholds to ensure optimum sensitivity as breathing patterns change or as circuit leaks change The algorithms used to ensure optimum sensitivity are the Volume Trigger Shape Signal Spontaneous Expiratory Threshold SET Flow Reversal Maxi...

Page 47: ...as a sensitivity threshold at either inspiration or expiration When the patient s flow rate crosses the shape signal the unit changes pressure levels The following figure illustrates how the shape signal is super imposed onto the actual waveform to trigger and cycle off IPAP The shape signal is created by offsetting the signal from the actual patient flow by 15 l min and delaying it for a 300 msec p...

Page 48: ...nit cycles to expiration Pr es s ur e Fl ow I PAP EPAP Spont aneous Expi r at or y Thr es hol d Flow Reversal Inspiration to Expiration As flow begins to decrease during inspiration a flow reversal can occur due to a large leak around the mask or because the patient s mouth is open When the device senses this flow reversal it automatically cycles to expiration Maximum IPAP Time Inspiration to Expi...

Page 49: ... method When using the Active PAP Circuit configuration leak compensation is not available When using the Active Flow Circuit configuration flow trigger with leak compensation may be enabled The default setting when using the Active Flow Circuit is Leak Compensation On The clinician has the option to turn off leak compensation however unintentional leak will not be compensated Both options measure...

Page 50: ... source in use and was completely depleted Ventilator Inoperative Alarm This is a high priority alarm It occurs when the ventilator detects an internal error or a condition that may affect therapy The device will shut down if the cause of the failure indicates that the device cannot deliver therapy safely If the device can deliver therapy at a limited level the device will continue to deliver limi...

Page 51: ...ched tubing or the patient having a fast breath rate The device continues to operate The alarm will automatically terminate when the delivered pressure comes within 5 cmH2 O of the target patient pressure during the expiratory phase Low Expiratory Pressure Alarm This is a high priority alarm It occurs when the delivered pressure is 5 cmH2 O or more below the target patient pressure during the expi...

Page 52: ... measures greater than 87 psi Low Oxygen Inlet Pressure This is a high priority alarm It occurs when the pressure of the oxygen from the oxygen source measures less than 40 psi This could be caused by the oxygen source being disconnected from the device an occlusion in the tubing from the oxygen source to the device or a problem with the output of the oxygen source Circuit Disconnect Alarm This is...

Page 53: ...priority alarm It occurs when the estimated exhaled tidal volume is lower than the Low Vte alarm setting for three consecutive breaths The device continues to operate The alarm will automatically terminate when a breath occurs in which the exhaled tidal volume exceeds the Low Vte alarm setting When AVAPS is on this alarm will occur when the calculated tidal volume is less than 90 of the target tid...

Page 54: ...he alarm will automatically terminate when the measured respiratory rate is greater than the Low Respiratory Rate alarm setting High Inspiratory Pressure Alarm This alarm occurs in several stages and escalates from an audible beep for the first two occurrences to a high priority alarm if the problem continues It is detected differently for volume and pressure therapy modes For volume modes the ala...

Page 55: ...e Ventilation alarm setting Low Minute Ventilation Alarm This alarm is a high priority alarm It when the patient s minute ventilation is less than the Low Minute Ventilation alarm setting The device continues to operate The alarm will automatically terminate when the calculated minute ventilation is greater than the Low Minute Ventilation alarm setting Low Battery Alarm The Low Battery alarm occur...

Page 56: ... several stages from low to high priority The device continues to operate when the alarm is the low priority alarm If the alarm is reset without removing the battery the alarm will be regenerated once every hour until the detachable battery is removed The device continues to operate the detachable battery is not used and the power source is switched to the next available power source if the alarm ...

Page 57: ...ssage occurs when the detachable or internal battery becomes overheated while providing power for the device The device continues to operate unless you are using an internal battery and have no other available power source The battery is not used and the power source is switched to the next available power source Battery Not Charging due to Temperature Info Message This info message occurs when th...

Page 58: ...cted or the internal battery if no other source is available If external battery power returns the ventilator will beep but no message will appear on the display Detachable Battery Disconnected Info Message This info message occurs when the detachable battery power source is lost and the device has switched to an alternate power source the internal battery if no other source is available If detach...

Page 59: ...Trilogy 202 user manual 50 ...

Page 60: ...ontinuously monitored by qualified personnel These personnel should be prepared to provide alternate therapy in the event of ventilator failure or inoperative equipment WARNING Do not use the ventilator on a patient until a system checkout has been performed See Chapter 10 of this manual WARNING For ventilator dependent patients always have alternate ventilation equipment such as a back up ventila...

Page 61: ...isper Cap back into place Supply Power to the Device The device can operate on AC or DC power The ventilator accesses power from potential sources in the following order AC Power External Battery Detachable Battery Pack Internal Battery Using AC Power An AC power cord is provided with the device 1 Plug the socket end of the AC power cord into the AC power inlet on the side of the device To prevent...

Page 62: ...er Cord Using the Cord Retainer 2 Plug the pronged end of the cord into a wall outlet not connected to a wall switch 3 Ensure that all connections are secure If AC power is connected correctly and the device is operating properly the green AC Power LED should be on 4 Secure the power cord using the cord retainer on the back of the device as shown below To secure the power cord use a screwdriver to...

Page 63: ...r the internal battery External Battery The ventilator can operate from a 12 VDC deep cycle marine type lead acid battery using the Philips Respironics Trilogy External Battery Cable This cable is pre wired and properly terminated to ensure safe connection of an external battery to the ventilator Battery operating time depends on the characteristics of the battery and usage of the device Due to a ...

Page 64: ...t the tip of a screwdriver in the top of the battery cover to pry the cover from the device as shown below When you are not using a detachable battery you can attach this cover to the device by completing the following steps 1 Insert and securely latch the detachable battery cover into the device as shown below Properly Installed Detachable Battery Cover Insert Detachable Battery Cover CAUTION The...

Page 65: ...al patient conditions Whenever the ventilator is connected to AC power it will automatically recharge the detachable battery pack A completely discharged detachable battery will reach 80 charge status within 8 hours when charging at approximately 23 C 73 F ambient temperature Insert and securely latch the detachable battery into the device as shown below Properly Installed Detachable Battery Inser...

Page 66: ... between external power sources emergency situations or short durations when the user needs to be mobile The length of time the ventilator will operate on internal power depends on many factors such as device settings battery charge level and condition or age of the battery When fully charged a new battery can power the ventilator for approximately three hours under typical patient conditions When...

Page 67: ...d external battery symbols that will display on the Monitoring screen are shown below The detachable and external battery symbols will only appear on screen if a detachable or external battery is attached to the device Battery Symbol Internal Battery Detachable Battery External Battery Note Under normal operating conditions the internal battery symbol will always display on the Monitoring screen I...

Page 68: ...dicator Medium Priority When the device detects that an in use battery s charge is low has approximately 20 minutes of charge left the inside of the box surrounding the battery symbol turns yellow In addition to the battery indicator on the Monitoring screen a medium priority alarm message will display indicating Low Battery See Chapter 6 for more information The yellow indicator is for the last a...

Page 69: ...r inlet to the breathing circuit connection located on the side of the ventilator If you are not using a viral bacteria filter not recommended connect the tubing directly to the device s breathing circuit connection Bacteria Filter Flexible Tubing Trilogy Breathing Circuit Connection 2 Connect the other end of the flexible tubing to a separate exhalation device a If your circuit type is Passive an...

Page 70: ...tion valve line to the active exhalation device with proximal pressure and the Universal Porting Block on the device as described below A Connect the Trilogy Universal Active PAP Tube Adapter to the top striped port on the Universal Porting Block on the ventilator Connecting the Passive Exhalation Device Note The device does not provide circuit compliance compensation in volume modes Active Exhala...

Page 71: ...e Line Proximal Pressure Port Exhalation Valve Port on Universal Porting Block Trilogy Universal Active PAP Tube Adapter Refer to the instructions included with the Active Exhalation Device for more information c If your circuit type is Active Flow 1 Connect the Flow Sensor to an active exhalation device as shown below Flow Sensor Note Make sure that components marked with an arrow are oriented pr...

Page 72: ...ation Valve port on the Universal Porting Block Exhalation Valve Line Flow Line Exhalation Valve Port on Porting Block Universal Porting Block on Trilogy Device White Striped Flow Line Exhalation Valve Port Refer to the instructions included with the active exhalation device for more information Note If the active exhalation device has the proximal pressure line connected when you are setting up a...

Page 73: ...ed with the Oxygen Inlet Connector configuration kit sold separately To remove the DISS oxygen connector and install a different fitting complete the following steps 1 Remove the two screws on the O2 inlet retainer plate and remove the DISS oxygen connector 2 Install the appropriate oxygen inlet adapter whichever fitting your institution uses as shown below The sample illustration below shows the ...

Page 74: ...nks to indicate that an alarm condition exists The remote alarm will sound when any of the following conditions exist The ventilator is off Any alarm occurs and is not silenced or reset Refer to the Accessories chapter of this manual for information on which remote alarm systems are compatible with the device Refer to the instructions included with the Remote Alarm Adapter Cable for information on...

Page 75: ...Trilogy 202 user manual 66 ...

Page 76: ... hold the Right button for 5 seconds An audible indicator sounds when the keypad is successfully unlocked Once the display is unlocked you can enter the Menu as you normally would by pressing the Up button Note There is a keypad lock inactivity time out period After you have unlocked the keypad as indicated the keypad will re lock after five minutes of inactivity to prevent someone from accidental...

Page 77: ...tton and the Alarm Indicator Audio Pause button simultaneously for several seconds This will temporarily place the device in Full Menu Access mode When you perform this key sequence from the Monitor screen the Main Menu screen appears and an audible indicator sounds indicating you are now in Full Menu Access mode An example Main Menu screen is shown below Note The Full Menu Access key sequence can...

Page 78: ...e Options menu and permanently change the Menu Access setting to Full Menu Access Otherwise the device will return to the Menu Access mode stored in the setting once you exit the menu screens or if one minute passes without pressing any device buttons If you are in the Setup mode and an SD card is in the device Write Event Log to SD Card will appear in the menu Setup Screen with Setup panel and Me...

Page 79: ...alled the Monitor panel shows the therapy mode and if you set up a dual prescription for the patient the Prescription indicator appears indicating Primary or Secondary prescription The patient breath symbol also displays during a patient triggered breath and a bar graph displays the current pressure level The center section of the screen displays the current date and time The bottom section called...

Page 80: ... the therapy mode a graph displaying the current pressure and the current date and time Additionally this panel also displays patient pressure respiratory rate RR exhaled tidal volume Vte and leak The second panel in Detailed view is the Measured Settings panel It provides patient related data including Peak Inspiratory Pressure PIP I E Ratio Peak Inspiratory Flow Mean Airway Pressure MAP FiO2 and...

Page 81: ...tion If you set up a dual prescription for the patient the words Primary or Secondary appear in the top left corner of the panel to indicate which prescription is active Therapy Mode The current therapy mode displays at the top of the panel for example CPAP S S T etc If a special feature such as Flex AVAPS or Sigh is active this feature will appear next to the therapy mode Note Dashes on the displ...

Page 82: ...sure alarm occurs the Peak Pressure symbol changes from blue to red Low Pressure Indicator L If you enable a volume therapy mode this indicator appears below the manometer bar indicating the low pressure alarm setting High Pressure Indicator H If you enable a volume therapy mode this indicator appears below the manometer bar indicating the high pressure alarm setting Pressure This indicator displa...

Page 83: ...ion PIP Peak Inspiratory Pressure displays the maximum pressure delivered to the patient during the previous breath I E Ratio Displays a comparison of the time spent in inspiration to the time spent in expiration during the previous breath Peak Flow Displays the maximum inspiratory flow delivered to the patient during the previous breath in l min BTPS MAP Displays the Mean Airway Pressure which is...

Page 84: ...en shading shown in the symbol indicates the battery capacity and will go down as the battery charge level decreases When the entire symbol is green the battery is fully charged Displays at all times when a detachable battery is attached to the ventilator The level of green shading shown in the symbol indicates the battery capacity and will go down as the battery charge level decreases When the en...

Page 85: ... Displays when the Alarm Indicator Audio Pause button has been pressed and Audio Pause is active The alarm is silenced for two minutes when the Alarm Indicator Audio Pause button is pressed Displays when the Ramp feature is active Note If a battery in use is very low less than 20 minutes remaining the inside of the box surrounding the battery symbol will change to yellow and all of the bar indicat...

Page 86: ... Left button on the device The center on screen button specifies the action for the Up Down buttons on the device The right on screen button specifies the action for the right button on the device Navigating the Menu Screens To navigate through all of the menu screens and settings Use the Up Down button to scroll through the menu options and settings Use the Left and Right buttons to perform the a...

Page 87: ...arms Options View and change device settings such as Full or Limited Access mode Detailed View Language etc Alarm Log View a list of the 20 most recent alarms that have occurred Event Log View a list of all events that have occurred such as ventilator setting changes ventilator inoperative conditions alarms etc Information View detailed information about the device such as the device s software ve...

Page 88: ...l therapy modes Dual Prescription Setting You can turn the dual prescription setting on or off Enable the setting if you want to create two separate prescriptions for the patient For instance you may want to set up a daytime prescription and then a separate nighttime prescription If you enable this setting then the menu options on the Main Menu will change to include three new options Switch to Pr...

Page 89: ...the settings available in each therapy mode Note This chapter describes how to enable all of the device settings including device alarms For detailed information about each alarm please refer to Chapter 6 The Main Menu screen will look like the screen below Mode Setting You can change the Mode setting on the Settings and Alarms screen to one of the following therapy modes CPAP S S T T PC PC SIMV C...

Page 90: ...rent from traditional active circuit ventilation where the cuff or mask leak reduces the tidal volume delivered to the patient Volume ventilation with the Passive circuit delivers an inspiratory tidal volume close to the device setting regardless of leak this should be considered when transitioning a patient from an active to a passive circuit With a Passive circuit Vte is estimated based on the c...

Page 91: ...h button appears on screen if the FiO2 setting is greater than 21 Pressing this button displays the following confirmation screen Selecting Yes allows you to temporarily increase the delivered oxygen concentration to 100 for two minutes After the two minutes is completed the oxygen concentration will return to the previous FiO2 setting Selecting No cancels the action and does not change the FiO2 s...

Page 92: ...lated tidal volume is less than 90 of the target tidal volume setting This alarm can be set to on or off High Vte This setting enables or disables the High Vte alarm The alarm activates when the estimated exhaled tidal volume is greater than or equal to this setting You can choose Off to disable this alarm or you can increase or decrease the setting from 50 ml to 2000 ml in 5 ml increments It cann...

Page 93: ...alarm The alarm activates when the calculated minute ventilation reaches or exceeds this setting You can choose Off to disable this alarm or you can increase or decrease the setting from 1 l min to 99 l min in 1 l min increments It cannot be set lower than the Low Minute Ventilation setting except to be turned off Low Respiratory Rate This setting enables or disables the Low Respiratory Rate alarm...

Page 94: ...in CV AC and SIMV modes The High Inspiratory Pressure cannot be set lower than the Low Inspiratory Pressure You can increase or decrease the High Inspiratory Pressure from 10 to 80 cmH2 O in increments of 1 cmH2 O For pressure modes this alarm is not user settable Additional Settings Specific to Therapy Modes The Settings and Alarms menu also contains many additional settings specific to the vario...

Page 95: ...ates based on the Flow Trigger Sensitivity setting 3 Flow Trigger Sensitivity If you set the Trigger Type to Flow Trigger the Flow Trigger Sensitivity setting displays You can increase or decrease the setting from 1 to 9 l min in 1 l min increments The flow trigger initiates when the patient s inspiratory effort creates a flow equal to or greater than the flow sensitivity setting 4 Leak Compensati...

Page 96: ...u select Off the IPAP setting displays If you select On the IPAP Max Pressure and IPAP Min Pressure display Note The Ramp Start Pressure setting will not display if the Ramp Length is set to Off or if the CPAP pressure is set to 4 cmH2 O Note Ramp Start Pressure is less than or equal to CPAP 1 cmH2 O in CPAP mode Note In CPAP mode Flex is only available when CPAP is greater than 4 cmH2 O Note In S...

Page 97: ...e IPAP Max Pressure must be equal to or greater than the IPAP Min value 4 IPAP Min Pressure The IPAP Min Pressure setting displays if AVAPS is enabled You can increase or decrease the setting from 4 to 50 cmH2 O in increments of 1 The IPAP Min Pressure must be equal to or greater than the EPAP value and it must be less than or equal to the IPAP Max Pressure 5 EPAP You can increase or decrease the ...

Page 98: ...e ventilator will deliver per minute 2 Inspiratory Time You can adjust the Inspiratory Time setting from 0 3 to 5 0 seconds in 0 1 second increments Inspiratory Time is the duration for the inspiratory phase of a mandatory breath Timed T Mode All of the settings available in S T mode are available in T mode except for the Trigger Type setting Please refer to the descriptions in the S and S T Mode ...

Page 99: ... The following settings described in the S and S T mode sections of this chapter also are available in PC SIMV mode Breath Rate Inspiratory Time Trigger Type Flow Trigger Sensitivity if Trigger Type is set to Flow Trigger Flow Cycle Sensitivity if Trigger Type is set to Flow Trigger Rise Time In addition to these the following settings are also available in PC SIMV mode 1 Pressure You can increase...

Page 100: ... CV mode Tidal Volume Breath Rate Inspiratory Time PEEP High Inspiratory Pressure Low Inspiratory Pressure In addition to these the following settings are also available in CV mode 1 Flow Pattern You can choose either Ramp or Square for the Flow Pattern setting 2 Sigh You can enable or disable the Sigh setting by selecting On or Off A Sigh is a breath that is delivered every 100 breaths at 150 of ...

Page 101: ... Sensitivity Sigh High Inspiratory Pressure Low Inspiratory Pressure Synchronized Intermittent Mandatory Ventilation SIMV Mode The SIMV mode contains the following settings described in the S S T PC SIMV and CV mode sections in this chapter Please refer to the descriptions in those sections for detailed information Tidal Volume Breath Rate Inspiratory Time Pressure Support Flow Pattern PEEP Trigge...

Page 102: ... screen below The following settings are available on the Options menu Menu Access You can select Full or Limited menu access Full menu access allows operators to access all ventilator and prescription settings Limited menu access allows operators to access only certain settings and does not allow them to change prescription settings Main Menu Screen with Options Selected Options Menu ...

Page 103: ...e Monitor screen The figures below show examples of the Monitor screen with Detailed View on or off Language The next item on the Options menu allows you to select the Language that the software will appear in English French German etc The information on the screens will display in the language selected here Monitor Screen Detailed View On Monitor Screen Detailed View Off ...

Page 104: ... enable the feature or Off to disable it Keypad Backlight The next item you can set is the Keypad Backlight You can turn the backlight On or Off using this setting Whenever you press the button to begin therapy the keypad backlight temporarily lights up Once therapy is being provided the keypad will be lit according to this Keypad Backlight setting If the setting is On the backlight remains on whi...

Page 105: ...e will exit the screen saver And any alarm or informational message will also exit the screen saver Date Format You can choose either mm dd yyyy or dd mm yyyy as the date format that will display on the device screens Time Format You can choose to display either an AM PM time format or 24 Hour time format for example 2 49 PM or 14 49 Month The month defaults to the current month The adjustable ran...

Page 106: ...his value Viewing the Alarm Log From the Main Menu screen you can select Alarm Log to access the Alarm Log screen An example is shown below The alarm log displays the alarms in chronological order with the most recent events displayed first It lists the 20 most recent alarms or messages that appeared on the device display When the device is in Limited Menu access mode the alarm log cannot be clear...

Page 107: ...ges appears in the upper right corner of the panel in the example above shown as 1 6 In the event log descriptions any description beginning with a 1 or 2 is a prescription change event The 1 represents a change to a primary setting and the 2 represents a change to a secondary setting This is followed by the setting that was changed The last two columns indicate setting and alarm changes If the en...

Page 108: ...econds This causes the detailed view of the Monitor Screen and the Information Menu to be displayed temporarily This key sequence is valid from the Monitor Screen while in Full or Limited Access An example is shown below The Information screen provides you with a summary of the current prescription settings device settings and system settings You can use the Up Down buttons to scroll through the i...

Page 109: ...ing on whether the device is on or off WARNING When you change the device prescription alarms and other settings using the SD card Trilogy 202 requires that the caregiver review and verify the changes prior to the changes being used by the device The caregiver or health care professional is responsible to ensure that the prescription settings are correct and compatible with the patient after using...

Page 110: ...e airflow was off or the Monitor Standby screen if the airflow was on Select Yes to start the prescription update process Once the prescription is read in and validated one of the following screens appears on the display to allow you to ensure the prescription is correct Ventilator Off Prescription Display Screen Ventilator On Prescription Display Screen ...

Page 111: ...ation screen If the SD card is removed at any time during the prescription update the process aborts and the screen returns to the initial state before the prescription update started A confirmation screen will appear if errors occur during this process The following table summarizes the prescription errors their possible causes and the actions to take Note Make sure you closely review the prescri...

Page 112: ...entilator is correct remove the card and replace the prescription on the card with a prescription containing the correct circuit type Prescription Failed Card is Read Only Displayed when the prescription is write protected Remove the card and check that the small switch on the side of the SD Card is not in the Locked position If you continue to receive this message remove the card and have the pre...

Page 113: ... to remove the SD card When the Remove SD Card confirmation message appears remove the card If you press the left cancel button or don t remove the card within 30 seconds the confirmation message will close and the ventilator will continue writing to the card My Settings View and change certain prescription settings such as rise time or ramp starting pressure if these settings were enabled Note If...

Page 114: ...ght Select button A screen like the one shown below appears with a confirmation message The confirmation message will vary depending on which prescription you are changing to The screen shown below appears if you are changing to a secondary prescription 3 Press the Right Yes button to switch to the new prescription If you decide not to change the prescription press the Left No button The display r...

Page 115: ...utton to save the new setting Or if you decide not to change the setting press the Left Cancel button 5 You can now either navigate to the next setting you want to change using the Up Down Navigate button or exit the My Settings menu by pressing the Left Finish button to return to the Main Menu Note The options on the My Settings screen will vary depending on how the device has been set up Note Fo...

Page 116: ...he patient to become acclimated to the therapy over a period of time The setting can be adjusted from 4 0 to the prescription pressure setting in increments of 1 Flex The optional Flex feature allows you to adjust the level of air pressure the patient feels during exhalation If this feature is enabled you can adjust the setting from 1 to 3 Sample My Settings Screen with Ramp Start Pressure Selecte...

Page 117: ... started therapy and adjusted your ventilator settings as needed you can connect the breathing circuit to the patient The illustration below shows the breathing circuit connected to a mask You can also connect the breathing circuit to a tracheostomy tube Note Trilogy 202 provides features to control access to the device prescription settings and to transfer new device settings onto the device usin...

Page 118: ...s informational messages and confirmation alerts that notify you of conditions that need attention but do not qualify as alarm conditions Note If multiple alarms occur at the same time all alarms are processed and displayed but the alarms are ordered first by priority and then by occurrence with the newest highest priority alarms at the top of the list The alarm precedence is in the following orde...

Page 119: ... front of the ventilator lights up as follows whenever an alarm is detected Red Flashing Indicator When the device detects a high priority alarm the Alarm Indicator Audio Pause button flashes red Yellow Flashing Indicator When the device detects a medium priority alarm the Alarm Indicator Audio Pause button flashes yellow Yellow Solid Indicator When the device detects a low priority alarm a solid ...

Page 120: ...alarm descriptions later in this chapter display this indicator as High Priority Audible Indicator When a high priority alarm is detected a series of beeps sound in the following pattern which is repeated twice 3 beeps a pause and then 2 more beeps This indicator continues until the cause of the alarm is corrected or the audible alarm is paused The alarm descriptions later in this chapter display ...

Page 121: ...larm The highlight color matches the alarm LED color on the Alarm Indicator Audio Pause button If an alarm is manually reset by the user the Alarms and Messages screen is removed and the Monitoring Screen is re displayed If the alarm self cancels the Alarms and Messages screen remains displayed but the highlight for the active alarm is removed the LED is unlit and the audible alarm stops The scree...

Page 122: ...hen an alarm is displayed in the menu banner If an alarm is manually reset by the user or self cancels the menu banner on screen before the alarm occurred will reappear If a Ventilator Inoperative alarm occurs the entire display screen turns red and the Ventilator Inoperative message appears on screen as shown below Alarm in Menu Banner Screen Ventilator Inoperative Alarm Screen ...

Page 123: ...s to turn the ventilator off and stop the audible alarm Selecting the Left button No will return the screen to the Ventilator Inoperative Alarm Screen without silencing the audible alarm Remote Alarm When the ventilator detects an alarm condition if you are using a remote alarm system a signal is sent from the ventilator to activate the remote alarm The Remote Alarm is discussed in Chapter 4 Venti...

Page 124: ...ccurred by pressing the Alarm Indicator Audio Pause button while no alarms are active Then if an alarm occurs the audible indicator does not sound until the Audio Pause time limit has expired The LED and display will still show the alarm but the audible alarm will not sound Alarm Reset The Reset button is used to clear the currently active alarm s from the display and stop the LED and audible alar...

Page 125: ...ashing 3 Look at the display to check the alarm message that appears on screen and whether it is highlighted in red or yellow 4 Press the Alarm Indicator Audio Pause button to temporarily silence the audible alarm A visual indicator displays if you are on the Monitor screen or an Audio Pause message appears in the menu banner on the Alarm Display screen 5 Look up the alarm in the alarm description...

Page 126: ...e Required High Red flashing button Ventilator Service Required message Continues to operate If alarm continues have the device serviced Check Circuit High Red flashing button Check Circuit message Continues to operate Verify patient status Verify that breathing circuit setup is correct Correct any errors If alarm continues have device serviced Low Circuit Leak High Red flashing button Low Circuit...

Page 127: ...s Respironics or an authorized service representative Please have the the device model number and serial number information when you call Low Oxygen Flow High Red flashing button Low Oxygen Flow message Continues to operate Check hose from oxygen source to device Check oxygen source The inlet supply should be 175 SLPM If problem continues contact Philips Respironics or an authorized service repres...

Page 128: ... button Low Vte message Continues to operate Verify patient status High Vti High Red flashing button High Vti message Continues to operate Verify patient status Low Vti High Red flashing button Low Vti message Continues to operate Verify patient status High Respiratory Rate High Red flashing button High Respiratory Rate message Continues to operate Verify patient status Low Respiratory Rate High R...

Page 129: ...appears in yellow On Status Panel box around battery is yellow High Priority Red flashing button Low Detachable Battery Low External Battery or Low Internal Battery message appears in red On Status panel box around battery is red Continues to operate Switch to alternate battery or AC power while you recharge low battery If low battery is recharged and alarm continues replace battery High Temperatu...

Page 130: ...e power source Check batteries and recharge f necessary Restore AC power if available Keypad Stuck Low Solid yellow button Keypad Stuck message Continues to operate Check keys to determine if they are lodged in the case If alarm continues place patient on alternate source of ventilation and have device serviced Battery Discharging Stopped Due to Temperature Info Batt Discharge Stopped Temp message...

Page 131: ...attery in use Switches to alternate power source Check external battery and recharge if necessary Restore AC power if available Detachable Battery Disconnected Info Detachable Batt Disconnected message and a box appears around battery in use Switches to alternate power source Check detachable battery and recharge if necessary Restore AC power if available Start On Battery Info Start On Battery mes...

Page 132: ...into the ventilator case or detachable battery pack After cleaning use a soft dry cloth to remove any residual cleaner Use extra care when cleaning the display Abrasive cleaners can scratch the display 3 Allow the device to dry completely before plugging in the power cord WARNING To avoid electrical shock always unplug the power cord from the wall outlet before cleaning the ventilator CAUTION Do n...

Page 133: ...liness and integrity 4 Wash the gray foam filter in warm water with a mild detergent Rinse thoroughly to remove all detergent residue Allow the filter to air dry completely before reinstalling it If the foam filter is torn or damaged replace it Only Philips Respironics supplied filters should be used as replacement filters CAUTION The reusable foam inlet filter is required to protect the ventilato...

Page 134: ...n s protocol Inspect components for deterioration prior to use Cleaning the Reusable Exhalation Devices Disassemble the exhalation device from the patient circuit Follow the detailed cleaning instructions included with your exhalation device Reinstalling the Filter CAUTION Exhalation devices patient circuits and water traps are shipped clean not sterile Cleaning and disinfection of these parts sho...

Page 135: ...ed on the device Preventive Maintenance The ventilator should be checked and maintained by authorized service personnel every 12 months at a minimum Contact Philips Respironics or an authorized service center for more information Refer to the Preventive Maintenance label located on the bottom of the device for the service date or hours The label is shown below Service Due Date Number of Blower Hou...

Page 136: ...therapy The audible indicator does not sound and the backlights on the buttons do not light The AC power cord is not plugged in and the internal battery is not charged Note The device requires AC power to charge the internal battery when a new device is powered up for the first time Plug the AC power cord into the device and a wall outlet that is not controlled by a switch This powers the system a...

Page 137: ...sentative or Philips Respironics to have the device serviced Please have the model number and serial number ready when you call Unexplained changes in the performance of the device The device is not working properly or is making unusual sounds The device has been dropped or mishandled or is in an area of high EMI emissions Press the Start Stop button and then select the Right button to shut off th...

Page 138: ...umber and serial number ready when you call Mask Discomfort The mask feels uncomfortable to wear there is significant air leakage around the mask or the patient experiences other mask related issues This could be due to improper headgear adjustment or improper mask fitting Make sure the patient is properly fitted with the correct size mask If the problem continues try fitting the patient with a di...

Page 139: ... in the proximal flow or exhalation valve lines and the condensation is causing the system to alarm or not properly trigger on patient effort Excessive humidity from the heated humidifier the patient or the cleaning process condensed in the tubing or exhalation valve diaphragm Droplets of water affected the ability of the ventilator to measure proximal patient flow and pressure and trigger on a pa...

Page 140: ...fier for complete setup information Adding Supplemental Oxygen to the Device This ventilator is equipped with an oxygen blending module which allows oxygen to be delivered to the patient within a range of 21 to 100 concentration Circuit leak rate may have an impact on FiO2 The Trilogy O2 should be connected to an oxygen gas pipeline that complies with national country regulations The oxygen input ...

Page 141: ...lemental oxygen the oxygen concentration may not be constant The inspired oxygen concentration will vary depending on the pressures patient flows and circuit leak Substantial leaks may reduce the inspired oxygen concentration to less than the expected value Appropriate patient monitoring should be used as medically indicated such as an alarming pulse oximeter Do not connect the device to an unregu...

Page 142: ... your Remote Alarm unit and adapter cable assembly if you have questions on how to use it with device WARNING The remote alarm should be tested daily When using a remote alarm make sure you fully test the remote alarm connector and cable by verifying that Annunciated alarms on the ventilator are also annunciated on the remote alarm Disconnecting the remote alarm cable from the ventilator or from t...

Page 143: ... Note Use only SD cards available from Philips Respironics or the type listed in the specifications section of this manual WARNING Ensure that the Nurse Call systems used do not exceed SELV Safety Extra Low Voltage levels as described in IEC 60601 1 SELV levels do not exceed a nominal value of 25VAC or 60VDC at rated supply voltage on the transformer or converter between conductors in an earth fre...

Page 144: ...ightly ejected from the device Using the Philips Respironics DirectView Software You can use the Philips Respironics DirectView software to download the prescription data from the SD card to a computer DirectView can be used by clinicians to receive and report stored data from the SD card DirectView does not perform any automatic scoring or diagnosing of a patient s therapy data Note Remote prescr...

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Page 146: ...g and Changing Settings Tools Required Universal Porting Block Active PAP Exhalation Device Active Flow Exhalation Device with Flow Sensor Trilogy Universal Active PAP Tube Adapter Passive Exhalation Device Test Lung High Pressure O 2 Hose Oxygen Monitor Small Flat Head Screwdriver Trilogy 202 clinical manual 10 System Checkout Procedures Note The actual circuit configuration to be used on the pat...

Page 147: ...ve Flow or Passive 3 Connect the device to a suitable high pressure O2 source 4 Connect and set up an external O2 monitor per the manufacturer s instruction manual 5 Follow the instructions in Chapter 5 to access the Setup Screen Settings and Alarms Tests Complete the following steps to set up the settings and alarms tests 1 Setup A Settings And Alarms Menu Modify the settings in the Settings and ...

Page 148: ...tion Active Flow circuit type On Flow Cycle Sensitivity Active PAP or Active Flow circuit type 20 Rise Time 1 Ramp Length Off All other alarms Off B Options Menu Modify the settings in the Options menu to match those shown below in Table 2 Setting Value Menu Access Full Detailed View On All other settings Discretionary C Turn Device Power On Press the Start Stop button on the front of the ventilat...

Page 149: ...seconds and verify the following alarm signals The High Priority audible indicator sounds A red light flashes on the Alarm Indicator Audio Pause button The High Tidal Volume alarm condition appears on the screen highlighted in red C Modify Ventilator Alarm Settings Modify the High Tidal Volume alarm setting to match the one shown below in Table 4 Setting Value High Vte High Vti 500 ml D Verify Res...

Page 150: ... power as described in the Initial Setup section A Change Alarm Ventilator Setting Modify the Low Tidal Volume alarm setting to match the one shown below in Table 6 Setting Value Low Vte Low Vti 500 ml B Verify the Alarm Wait up to 40 seconds and verify the following alarm signals The High Priority audible indicator sounds A red light flashes on the Alarm Indicator Audio Pause button The Low Tidal...

Page 151: ...you have attached the test lung verified ventilator settings and turned on ventilator power as described in the Initial Setup section A Change Circuit Disconnect Ventilator Setting Modify the Circuit Disconnect ventilator setting to match the value shown below in Table 9 Setting Value Circuit Disconnect 10 seconds B Disconnect Test Lung Disconnect the test lung from the circuit C Verify the Alarm ...

Page 152: ...tting Value Circuit Disconnect Off 5 Verify the High Inspiratory Pressure Alarm This procedure verifies that the High Inspiratory Pressure alarm is working properly It assumes that you have attached the test lung verified ventilator settings and turned on ventilator power as described in the Initial Setup section A Change Ventilator Settings Modify the ventilator settings and change the following ...

Page 153: ...Alarm Indicator Audio Pause button The High Inspiratory Pressure alarm condition appears on the screen highlighted in yellow C Modify Ventilator Alarm Settings Modify the High Inspiratory Pressure setting to match the one shown below in Table 12 Setting Value High Inspiratory Pressure 60 cmH2 O D Verify Reset Wait 40 seconds and verify the following auto reset conditions The Medium Priority audibl...

Page 154: ...owing values shown below in Table 13 Setting Value Mode CV Tidal Volume 500 ml FiO2 21 Breath Rate 12 BPM Inspiratory Time 1 0 seconds Flow Pattern Ramp PEEP 4 cmH2 O Sigh Off Circuit Disconnect Off Low Inspiratory Pressure 40 cmH2 O High Inspiratory Pressure 60 cmH2 O Apnea Off All other alarms Off B Verify the Alarm Wait up to 40 seconds and verify the following alarm signals The High Priority a...

Page 155: ... alarm and the Low Oxygen Inlet Pressure alarm are working properly These alarms apply to all circuit types It assumes that you have attached the test lung verify the ventilator settings and turned on the ventilator power as described in the Initial Setup section Setup A Connect an external O2 Monitor in accordance with the recommended manufacture s guidelines in line with the patient tube Make su...

Page 156: ...e indicator sounds A red light flashes on the Alarm Indicator Audio Pause Button The following alarm conditions appear on the screen highlighted in red Low Oxygen Flow Low Oxygen Inlet Pressure Verify Reset A Reconnect or turn on the source of high pressure O2 to the ventilator B Wait 1 minute and verify the following The set level of FiO 2 is satisfied using an external O2 monitor The High Priori...

Page 157: ...AC Power source from the device Verify that the AC Power Disconnected alarm message appears on the display and the green AC LED is not lit Press Reset Verify that the detachable battery symbol shows the level of charge noted in the previous step and that the device continues to operate Verify that the detachable battery symbol has a black box around it to indicate that it is in use E Disconnect th...

Page 158: ...Disconnected alarm message appears on the display and the green AC LED is not lit Press Reset Verify that the external battery symbol shows the level of charge as noted in the previous step and the device continues to operate Verify that the external battery symbol has a black box around it to indicate that it is in use E Reconnect the AC Power source Alarm and Event Log Clean Up 1 In the Setup Me...

Page 159: ...d prior to connection to the patient If any of the tests fail to complete as indicated if possible correct the error clear the alarm and resume testing If correction of the failed portion is not possible return the device to Philips Respironics or an authorized service center for service and repair ...

Page 160: ...accuracy the environmental conditions are Temperature 20 30 C Humidity 50 relative Altitude nominally 380 meters Physical Dimensions 21 13 cm L x 28 45 cm W x 23 52 cm H Weight Approximately 6 1 kg with the detachable battery installed Standards Compliance This device is designed to conform to the following standards IEC 60601 1 Medical electrical equipment Part 1 General requirements for safety I...

Page 161: ...Class II Internally Powered Equipment Degree of Protection Against Electric Shock Type BF Applied Part Degree of Protection against Ingress of Water Device Drip Proof IPX1 Mode of Operation Continuous Fuses There are no user replaceable fuses Pressure Output 4 to 50 cmH2 O SD Card and SD Card Reader Use only SD cards and SD card readers available from Philips Respironics or the following SanDisk S...

Page 162: ...cmH2 O for Passive Circuits 4 to 19 cmH2 O in CPAP mode 8 of setting 2 Full Scale Ramp Length Off 5 to 45 minutes 2 minutes Flex Off 1 to 37 N A Flow Trigger Sensitivity 1 to 9 l min N A Flow Cycle 10 to 90 N A Apnea Rate 4 to 60 BPM Greater of 1 BPM or 10 of setting FiO2 Output 21 to 100 21 to 50 is 3 50 to 95 is 5 100 is 5 O 2 Input Pressure Rating 40 to 87 PSI N A Specifications listed are base...

Page 163: ... cmH2 O Greater than 2 cmH2 O or 10 of reading Patient Triggered Breaths 0 to 100 N A I E Ratio 9 9 1 1 9 9 Calculation based on Inspiratory Time and Expiratory Time All flows and volumes are measured at BTPS conditions Spontaneous Breathing During Power Failure Conditions Flow Set Point l min Inspiratory Resistance cmH2 O Expiratory Resistance cmH2 O Active Circuit Active Circuit with Proximal Fl...

Page 164: ... which the breath is patient triggered and the ventilator controls how the air is delivered based on defined settings An assisted breath is not cycled until the inspiratory time setting has been reached AVAPS Average Volume Assured Pressure Support feature available in S S T T and PC therapy modes Blower Hours The total number of hours that the blower has been on over the life of the device This v...

Page 165: ... volume This is a Volume Control mode DC Direct Current EPAP Expiratory Positive Airway Pressure ESD Electrostatic Discharge FiO2 Fractionally Inspired Oxygen The percentage of oxygen in the air inhaled Flex The device provides the Flex comfort feature The C Flex feature provides increased pressure relief during the expiratory phase of breathing The Bi Flex feature provides a level of pressure rel...

Page 166: ...entilation value displayed on the screen represents the average Minute Ventilation over six breaths and is updated at the end of each exhalation Operational Hours This is the total number of hours that the blower has been on since this value was last reset You can reset this value each time you give the device to a new patient to help track their device usage OSA Obstructive Sleep Apnea PC Pressur...

Page 167: ...e the number of breaths per minute SD Card Secure Digital card This card records usage and therapy data from the device Sigh A breath that is delivered every 100 mandatory or assisted breaths at 150 of the normal volume SIMV Synchronous Intermittent Mandatory Ventilation therapy mode SIMV mode delivers Spontaneous Assisted and Mandatory breaths with a user defined inspired tidal volume This is a V...

Page 168: ...hat it can also deliver a mandatory breath if the patient does not spontaneously breathe within a set time Tidal Volume The amount of air passing in and out of the lungs for each breath Timed T Mode Timed pressure support therapy mode In Timed mode all breaths delivered are mandatory Volume Control Ventilation VCV Ventilation in which breaths are controlled by an operator defined volume flow patte...

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Page 170: ...ice uses RF energy only for its internal function Therefore its RF emissions are very low and are not likely to cause any interference in nearby electronic equipment RF emissions CISPR 11 Class B The device is suitable for use in all establishments including domestic establishments and those directly connected to the public low voltage power supply network that supplies building used for domestic ...

Page 171: ... 1 kV differential mode 2 kV common mode 1 kV differential mode 2 kV for common mode Mains power quality should be that of a typical home or hospital environment Voltage dips short interruptions and voltage variations on power supply input lines IEC 61000 4 11 5 UT 95 dip in UT for 0 5 cycle 40 UT 60 dip in UT for 5 cycles 70 UT 30 dip in UT for 25 cycles 5 UT 95 dip in UT for 5 sec 5 UT 95 dip in...

Page 172: ...nce in meters m Field strengths from fixed RF transmitters as determined by an electromagnetic site surveya should be less than the compliance level in each frequency range b Interference may occur in the vicinity of equipment marked with the following symbol NOTE 1 At 80 MHz and 800 MHz the higher frequency range applies NOTE 2 These guidelines may not apply in all situations Electromagnetic prop...

Page 173: ...8 3 8 3 8 7 3 100 12 12 12 23 For transmitters rated at a maximum output power not listed above the recommended separation distance d in meters m can be estimated using the equation applicable to the frequency of the transmitter where P is the maximum output power of the transmitter manufacturer Note 1 At 80 MHz and 800 MHz the higher frequency range applies Note 2 The ISM industrial scientific an...

Page 174: ...ory Pressure 47 Low Exhaled Tidal Volume 45 Low Minute Ventilation 46 Low Peak Inspiratory Pressure 45 Low Respiratory Rate 45 Power Alarms 117 System Alarms Ventilator Service Recommended 47 B Bacteria Filter Replacing 126 Battery Function Verification 146 Breathing Circuit Connection 21 Breathing Circuit Connection 88 Breath Rate 89 Breath Types Assist 20 C Cautions 8 15 134 Circuit Type Setting...

Page 175: ...on 15 Up Down Button 16 H High Minute Ventilation 84 High Respiratory Rate 84 High Tidal Volume Alarm 83 Humidifier 131 I Inspiratory Time 89 IP Address Mode Setting 97 IPAP 88 IPAP Max Pressure 88 K Keypad Backlight 95 Keypad Lock Feature 67 95 L Language Setting 94 LCD Brightness Setting 95 Low Respiratory Rate 85 Low Tidal Volume 83 M Main Menu Screen 104 Menu Access 93 Monitor Screen 70 Indica...

Page 176: ...D Card 17 134 Sensitivity 36 Digital Auto Trak Sensitivity Auto Trak Sensitivity 37 Leak Tolerance 36 Flow Trigger 40 Serial Connector 18 Settings and Alarms Tests 138 Setup Screen 69 Sigh Feature 91 SIMV Mode 28 92 Specifications Control Accuracy 152 Electrical 152 Environmental 151 Pressure 152 Standards Compliance 151 T Tidal Volume 88 Timed Mode 89 Time Format 96 Trigger Type Auto Trak 86 Flow...

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Page 178: ...bove limitation or exclusion may not apply to you Accessories and replacement parts including but not limited to circuits tubing leak devices exhaust valves filters and fuses are not covered under this warranty However Respironics warrants that the Product s internal and detachable battery where supplied will be free from defects in material and workmanship under normal and proper use and when cor...

Page 179: ...rights under this warranty contact your local authorized Respironics Inc dealer or contact Respironics Inc at 1001 Murry Ridge Lane Murrysville Pennsylvania 15668 8550 1 724 387 4000 Deutschland Gewerbestrasse 17 82211 Herrsching Germany 49 8152 93060 ...

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