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Apnoea ventilation................................................................................... 76

Setting Alarm Limits.................................................................................77

In the Event of an Alarm.......................................................................... 78
Cancel alarm tone..................................................................................... 79
Information 

J

............................................................................................ 79

Displaying Curves and Measured Values................................................ 80
Displaying measured values.......................................................................81
Trends.......................................................................................................82
Loops........................................................................................................83
Reference curve displays...........................................................................83
Single stroke displays................................................................................ 83
Zoom loops (optional)................................................................................83
Display loops in the upper graphic area..................................................... 84
Logbook....................................................................................................85
Screen freeze............................................................................................ 86

Special Functions.....................................................................................87
Manual inspiration......................................................................................87
Exspiration Hold........................................................................................ 87
Medicament nebulisation........................................................................... 88
Oxygen enrichment for bronchial suction................................................... 91
Special measurement procedure: intrinsic PEEP........................................93
Special measurement procedure: occlusion pressure P 0.1....................... 94
Shut-down.................................................................................................95

Selecting Standby Mode.......................................................................... 96
Quitting Standby Mode..............................................................................96

Calibration................................................................................................97
Calibrating O

2

 sensor................................................................................97

Calibrating flow sensor.............................................................................. 98
External flow source.................................................................................. 99
Checking/calibrating CO

2

 sensor............................................................100

CO

2

 zero checking................................................................................. 100

Testing CO

2

 calibration with test filter..................................................... 102

Testing CO

2

 calibration with test gas...................................................... 103

Calibrating CO

2

 sensor...........................................................................105

Resetting CO

2

 calibration........................................................................106

Configuration......................................................................................... 107

Sound.....................................................................................................108
Adjusting the volume of the alarm tone.....................................................108

7

Contents

Contents

Содержание Evita 4

Страница 1: ...Evita 4 Intensive Care Ventilator Instructions for Use Software 4 n 1 159 99 D M E D I C A L ...

Страница 2: ...t easier to locate the various parts of the equipment Elements mentioned in the text are highlighted Unnecessary details are avoided Screen displays prompt the user to proceed and confirm correct actions Working with these Instructions for Use Calibrating the CO2 sensor The CO2 sensor must be calibrated if the check values are not met on checking calibration with filter or calibration gas as part ...

Страница 3: ...d Additional weaning parameters available as software version 4 n plus upgrade in addition to the parameter occlusion pressure P 0 1 Evita 4 4n also determines the parameters RSB Rapid Shallow Breathing index and NIF Negative Inspiratory Force index External flow source available as software version 4 n plus upgrade The amount of external flow is calculated by Evita 4 4n e g for additional trachea...

Страница 4: ...4 ...

Страница 5: ...s Screen Page 25 Measurement Manoeuvre Screen Page 26 Calibration Screen Page 26 Configuration Screen Page 27 Positioning the Control Unit 27 Ergonomic Positioning 27 Preparation 29 Attaching components 30 Fitting expiration valve 30 Fitting flow sensor 30 Fitting O2 sensor capsule 31 Note on Use of Heat and Moisture Exchanger HME 31 Ventilation Adults and Children 32 Connecting Aquapor humidifier...

Страница 6: ...atient 42 Performing device check 43 Checking the hose system for leaks 46 Positioning the control unit 47 To position the control unit on the wall rail 47 To position the control unit on the device 47 Operation 49 Starting up 50 Switching on 50 Patient mode 50 Selecting the patient mode 51 Entering the ideal body weight 51 Select the previous settings 51 Starting ventilation 52 Setting Ventilatio...

Страница 7: ...cament nebulisation 88 Oxygen enrichment for bronchial suction 91 Special measurement procedure intrinsic PEEP 93 Special measurement procedure occlusion pressure P 0 1 94 Shut down 95 Selecting Standby Mode 96 Quitting Standby Mode 96 Calibration 97 Calibrating O2 sensor 97 Calibrating flow sensor 98 External flow source 99 Checking calibrating CO2 sensor 100 CO2 zero checking 100 Testing CO2 cal...

Страница 8: ...akage compensation On Off 122 Setting start up values for alarm limits 123 System Defaults 124 Setting external interface 124 Setting time and date 125 Setting language and units 125 Service diagnosis 126 Troubleshooting 127 Preparing 135 Dismantling 136 CO2 sensor optional 136 Temperature sensor 136 Medicament nebuliser 137 Ventilation hoses 137 Flow sensor 137 Expiration valve 138 Humidifier 138...

Страница 9: ...nd AutoFlow 160 Classic volume constant mandatory ventilation stroke 160 Manual pressure limiting with Pmax 160 AutoFlow 161 Start up procedure with AutoFlow 162 Sigh 163 SIMV 164 ASB 165 BIPAP 166 BIPAPAssist 167 APRV 168 MMV 168 Flow measurement 170 Compensation of the effect of hose system compliance 170 Conversion according to ambient conditions 170 Automatic leakage compensation 172 Weaning p...

Страница 10: ...Abbreviations 178 Symbols 181 Bibliography 182 Parts List 183 Order List 185 What was new in Evita 4 software 2 n 187 What was new in Evita 4 software 3 n 188 Index 189 10 Contents Contents ...

Страница 11: ...ard This apparatus is neither approved nor certified for use in areas where combustible or explosive gas mixtures are likely to occur Safe connection with other electrical equipment Electrical connections to equipment which is not listed in these Instructions for Use should only be made following consultations with the respective manufacturers or an expert Liability for proper function or damage T...

Страница 12: ... these parameters may be caused by Acute changes in the patient s condition Incorrect settings and faulty handling Equipment malfunctions Failure of power and gas supplies If a fault occurs in this equipment separate measuring instruments should be used 1 Dräger medical equipment meets the requirements for immunity to interference in accordance with the specific product standards and EN 60601 1 2 ...

Страница 13: ...Contents Intended Medical Application 14 13 Intended Medical Application Contents Intended Medical Application ...

Страница 14: ...Biphasic Positive Airway Pressure Pressure controlled ventilation combined with free spontaneous breathing during the complete breathing cycle and adjustable pressure increase to CPAP level Registered trade mark BIPAPAssist Biphasic Positive Airway Pressure Assisted Pressure controlled assisted ventilation APRV Airway Pressure Release Ventilation Spontaneous breathing on two pressure levels with l...

Страница 15: ...nd Confirmation 18 On Screen Parameter Setting Knobs 20 Screen Pages 21 Standard page 22 Adjustment Screen Page 22 Alarm Limits Screen Page 24 Measured values Screen Page 25 Measurement Manoeuvre Screen Page 26 Calibration Screen Page 26 Configuration Screen Page 27 Positioning the Control Unit 27 Ergonomic Positioning 27 Operating Concept Contents 15 Operating Concept ...

Страница 16: ... pressing a key or taking hold of a knob The display always contains only the screen keys and screen knobs required for function selection and or adjustment Settings and confirmations are made by turning and pressing the central rotary knob The keys for routine functions are placed to the right and left on the outside of the front panel Frequently used function keys are placed on the right e g the...

Страница 17: ...tains touch sensitive coloured screen keys and screen knobs Touching these controls with the fingertip is equivalent to pressing key or taking hold of a knob The colour displays the status of the control and LEDs green usable white not usable yellow adjust confirm black effective function display 1 2 3 FiO2 21 Ppeak 33 50 Pplat 27 MV 5 3 _ 7 0 4 0 IPPV BIPAP SIMV ASB Extra settings Basic settings ...

Страница 18: ...ple Operating Concept On Screen Controls 1 2 3 FiO2 21 Ppeak 33 50 Pplat 27 MV 5 3 _ 7 0 4 0 Table Trends Loops Logbook Zoom out Zoom in IPPV Assist A m 60 40 20 0 20 10 0 10 0 2 4 6 11 03 12 03 8 t s Paw mbar MV 11 06 total 1 5 spon 0 0 40 20 0 11 03 12 03 f 11 06 total 1 5 spon 0 0 Table Table 1 2 3 FiO2 21 Ppeak 33 50 Pplat 27 MV 5 3 _ 7 0 4 0 Limits Logbook Monitoring IPPV A m MV 5 3 L min fsp...

Страница 19: ...Turn the rotary knob adjust the alarm limit The value is displayed in the screen key 3 Press the rotary knob the colour changes from yellow to green and the set alarm limit is confirmed and effective To cancel the setting Touch the screen key again or touch another screen key Operating Concept On Screen Controls 9 3 3 1 2 3 1 MV 2 3 L min ...

Страница 20: ...een and the setting is validated and takes effect While pressure values such as Pmax are being set they are displayed in the Paw t curve as a dashed black line To cancel the setting Press the screen knob again or press another screen knob 1 2 3 FiO2 21 Ppeak 33 50 Pplat 27 MV 5 3 _ 7 0 4 0 IPPV BIPAP SIMV ASB Extra settings Basic settings IPPV Assist A m 21 O2 500 VT 1 7 Tinsp 21 f 60 Flow 5 PEEP ...

Страница 21: ...screen The lower half of the screen shows curves and measured values or screen keys and screen knobs depending which screen page is selected Alarms are displayed on the right of the top line Measured values are displayed in the upper right hand quarter of the screen Help functions appear in the bottom line of the screen On the right Evita 4 provides setting instructions On the left Evita 4 provide...

Страница 22: ...the ventilation modes The screen key displayed in black IPPV in the example represents the currently activated ventilation mode The bottom left hand side of the screen contains the on screen rotary control knobs The values of the setting parameters are displayed in the screen knobs relevant to the ventilation mode The user definable start up settings are marked by an arrow j on the scales of the s...

Страница 23: ...nob setting will only be effective after the new ventilation mode has been switched on example PASB knob If the indicator LED is illuminated yellow the relevant knob setting is already active in the existing ventilation mode example O2 knob The start up values effective on switching on the ventilator are marked on the relevant knob scale with an arrow j Example PASB 0 mbar Press the rotary knob th...

Страница 24: ...Displaying Setting Alarm Limits Touch the Limits screen key The screen key will change to black The monitored measured values will be displayed together with their alarm limits Example MV 5 4 L min Left hand screen key lower alarm limit Right hand screen key upper alarm limit Set the alarm limit Touch the relevant screen key The key changes colour to yellow adjustable Turn the rotary knob adjust v...

Страница 25: ...ook are selected by the right hand block of screen keys Example table of measured values Table 1 For detailed operating instructions please refer to page 81 Display Logbook Touch the Logbook screen key Turn the dial knob select alarm events For detailed operating instructions please refer to page 85 Operating Concept Screen Pages 018 37 207 019 37 207 ...

Страница 26: ...dure Touch the Start screen key For detailed operating instructions please refer to page 93 and 94 Calibration Screen Page This page is used for calibrating the O2 sensor the Flow sensor the CO2 sensor Select the desired sensor with the O2 Flow or CO2 screen keys Calibration starts as soon as the relevant key is pressed Evita 4 provides the necessary calibration instructions in the Help Function l...

Страница 27: ...cting the language and measurement units Selecting service diagnosis For detailed operating instructions see page 107 Control Unit Location To adapt to the situation of the ventilation location the control unit can be placed either directly on the device or separately on a wall rail For detailed instructions on placing see page 47 Ergonomic Positioning To ensure best viewing free of reflections 1 ...

Страница 28: ...28 ...

Страница 29: ...rial filters 35 Supply and Connections 36 Electrical power supply 36 Note on use of a socket strip for ancillary equipment 36 Temporary interruption of power supply 36 Gas supply 37 Evita Remote optional 38 Connection 38 Note automatic self test 39 Nurse call optional 40 Technical Data 40 Before Using for the First Time 41 Selecting the language of the display texts 41 Device Check 42 Before use o...

Страница 30: ...he control unit upwards Push the expiration valve as far as it will go into the mounting Check that it is properly engaged by gently pulling the port Fitting the flow sensor 1 Push socket to left as far as it will go 2 Fit flow sensor with the probe facing towards the ventilator into the mounting and push it into the socket as far as it will go Then 3 Push flow sensor to the right as far as it wil...

Страница 31: ...ers The use of a heat and moisture exchanger HME in the patient connection can increase breathing resistance considerably An increase in breathing resistance will lead to greater effort in spontaneous breathing and greater trigger effort during assisted ventilation Under unfavourable conditions an increase in breathing resistance can lead to an inadvertent PEEP This breathing resistance in the pat...

Страница 32: ... use antistatic or conductive hoses Depending on the desired position of the ventilator in relation to the bed the hinged arm can be fitted to either side of the machine Attachment on left hand side 4 Turn both ports to the left 5 Turn Aquapor to the left The following description applies when the ventilation hoses have been attached on the left hand side ______________ DIN VDE 0750 Part 215 The u...

Страница 33: ...bber sleeve of the Y piece on the inspiratory side Fitting temperature sensor 4 Push sensor as far as it will go into the rubber sleeve on the inspiratory side of the Y piece Align the Y piece so that the sensor is at the top 5 Attach the sensor cable with hose clips 6 Insert the probe of the temperature sensor into the socket Temp m at the rear of the unit D 0 6m 0 4m 0 6m 0 4m 0 6m 1 3 2 33 Prep...

Страница 34: ...obe of the CO2 sensor in the socket CO2 m on the rear panel of the Evita 4 Ventilating Infants Up to 300 mL tidal volume VT Patient mode Paediatrics Do not use a heat and moisture exchanger at the same time as a humidifier Risk of increased breathing resistance because of condensation Fitting bacterial filter Fit the bacterial filter to the inspiratory port 1 2 Preparation Ventilation Adults and C...

Страница 35: ...g bacterial filters The use of expiratory bacterial filters on the ventilator is not recommended However if bacterial filters are nevertheless used on the expiration side an undesirable increase in breathing resistance is possible Especially during medicament nebulisation and humidifying the resistance of the bacterial filter may increase gradually For the patient the effect may be increased breat...

Страница 36: ...r supply is activated Without the 12 24 V DC power unit During a power interruption Evita 4 outputs a continuous alarm tone for max 2 minutes The duration of this alarm tone may be shorter if Evita 4 was switched on for less than 15 minutes Evita 4 tolerates power interruptions shorter than 10 milli seconds without any effect on ventilation In the case of power interrupts lasting longer then 10 mi...

Страница 37: ...for medical air and oxygen to the back panel of Evita 4 and insert their probes into the terminal units The compressed gases must be dry and free from dust and oil Gas pressure must be 3 to 6 bar 37 Preparation Supply and Connections Air O2 ...

Страница 38: ...t and end medicament nebulisation 6 O2 suction key for bronchial suctioning 7 Insp hold key for sustained manually induced inspiration 8 Exp hold key for extended and sustained expiration The function of the respective LEDs and keys is the same as that of the corresponding elements on the front panel of Evita 4 and is described in the application chapters of the Instructions for Use Connection Plu...

Страница 39: ...le the latter is switched on or when switching on Evita 4 after connecting the Remote Pad Do not press any keys on the Remote Pad All LEDs on the Remote Pad light up for 5 seconds Red LED Yellow LED Yellow LEDs in the keys The Remote Pad is tested by Evita 4 An advisory message is output if a fault is detected see page 127 Troubleshooting 39 Preparation Remote Pad ...

Страница 40: ... 78 Caution and advisory messages are not transmitted The nurse call is also activated when the internal loudspeaker in the ventilator is defective Background The hospital connections to the central alarm typically use only one channel The electronics for nurse call consequently also uses only one channel Technical Data Floating DC contact Input voltage Max 40 V Input current Max 500 mA Switching ...

Страница 41: ...itching off to switch off pivot the flap upwards and press the button in fully Evita 4 runs through its self test procedure Wait until the 10 second test phase is complete After the self test 1 Switch Evita 4 to Standby hold down key O for about 3 seconds 2 Switch off the standby alarm tone with the Alarm Reset key 3 Press the Configuration key Touch the System Defaults screen key Touch the Langua...

Страница 42: ...m The test results obtained from this device check and the calibration and zero checking values of the sensors remain stored until the next calibration even if the device is switched off If the hose system type of humidification or patient mode is changed after performing the device check the leakproofing test must be repeated before starting operation Preparing the adult test lung 84 03 201 for t...

Страница 43: ...ses you to do so on the screen Performing the device check Switch on the machine press power switch on the back panel until it clicks into position Evita 4 runs through its self test procedure Wait until the 10 second test phase has been completed After the self test 1 Switch Evita 4 to standby Hold down key O for about 3 seconds 2 Switch off the standby alarm tone with the Alarm Reset key Touch t...

Страница 44: ...by a yellow LED The humidifier selection is saved and remains effective even when the equipment is switched on again If the type of humidifier is changed and has to be reselected on the screen the following test steps are shown to be invalid after the device check Humidification Air tight check The operator is prompted to repeat the device check for these two steps Start the check procedure Press ...

Страница 45: ... Leakproofing of the hose system On completion of the device check a checklist is displayed on the screen to show the results of the check Correct result Incorrect result F Check not performed In the event of incorrect results e g if the hose system is not sufficiently leakproof Eliminate the cause of the fault Touch the Repeat check screen key Only the tests with incorrect results are repeated Af...

Страница 46: ...hose system is used by Evita 4 for automatically correcting the volume controlled ventilation strokes and the measured values of the flow monitoring system see page 170 The calculated resistance of the hose system is used by Evita 4 to correct the pressure measurement in the presence of a basic flow NeoFlow option When changing the patient mode or type of humidifier the device automatically sets t...

Страница 47: ...ath the bracket and turn it in the direction of the wall rail 1 Hold down the segments on the right and left and at the same time tilt the control unit to the desired position To position the control unit on the device Hold down the segments on the right and left and tilt the control unit fully downwards Release the control unit turn the latch away from the wall rail and lift the control unit off ...

Страница 48: ...48 ...

Страница 49: ...BIPAPAssist 62 CPAP CPAP ASB 63 MMV MMV ASB 65 APRV 67 Independent Lung Ventilation ILV 69 Preparation 69 Setting the master and slave device 71 Apnoea ventilation 76 Setting Alarm Limits 77 In the Event of an Alarm 78 Cancel alarm tone 79 Information J 79 Displaying Curves and Measured Values 80 Displaying measured values 81 Trends 82 Loops 83 Reference curve displays 83 Single stroke displays 83...

Страница 50: ...e the settings valid immediately before the interruption of operation remain in use Patient mode After switching on Evita 4 displays a choice of patient modes Adults adult patients Paed children Neo neonates when using the NeoFlow option prev patient previous patient The device also asks the user to enter the weight of the patient ideal body weight Example Adult ventilation With this information E...

Страница 51: ...revious setting is similarly prevented by Evita 4 if it was configured in such a way before switching off that the former patient mode is no longer available Selecting the patient mode if configured EITHER the Adults key or the Paed key or the Neo key NeoFlow option and enter the ideal body weight if configured With the ideal body weight Evita 4 determines the start up settings of the ventilation ...

Страница 52: ...n Evita 4 starts ventilation with the ventilation mode configured by the user The machine is factory set to IPPV Evita 4 displays the Settings screen page The user can check and correct the settings on the screen Operation Starting up 52 065 37 207 ...

Страница 53: ...ith fixed mandatory minute volume MV and user adjusted tidal volume VT and frequency f For patients having no spontaneous breathing Set the pattern of ventilation for IPPV with the ventilation parameters Tidal volume VT Insp Flow Flow Frequency f Inspiration time Tinsp O2 concentration O2 Positive end expiratory pressure PEEP To set Touch the relevant screen knob Adjust value turn rotary knob Conf...

Страница 54: ...xpiratory pressure increases for two ventilation strokes every 3 minutes by the set value of the intermittent PEEP AutoFlow for automatic regulation of the inspiration flow With AutoFlow the inspiration flow is decelerated and regulated so that at the selected tidal volume VT with the current lung compliance a minimum airway pressure is reached and pressure peaks are avoided Evita 4 delivers addit...

Страница 55: ...ilation PLV for manually limiting pressure peaks using the Pmax pressure limit The tidal volume remains constant as long as the pres sure curve shows a plateau and the inspiratory flow curve shows a brief flow pause between inspiration and expiration To set the Pmax pressure limit please refer to page 115 The value of Pmax is displayed as a dashed blue line in the Paw t curve The Inconstant volume...

Страница 56: ...56 ...

Страница 57: ... ventilation parameters Tidal volume VT Insp flow Flow Frequency f Inspiration time Tinsp O2 concentration O2 Positive end expiratory pressure PEEP Pressure support PASB Pressure rise time To set Touch the appropriate screen knob Adjust to the desired value turn rotary knob Confirm setting press the rotary knob SIMV and SIMV ASB can be expanded with the following ventilation parameters Flowtrigger...

Страница 58: ...mit VTi The patient can also breathe out during the inspiratory plateau phase The inspiratory pressure is limited by the Paw alarm limit Set the alarm limits MV and MV in order to avoid excessive or insufficient flow following rapid changes in compliance To set Example Apnoea Ventilation Touch the Extra settings screen key Touch the screen key corresponding to the desired function e g Apnoe Vent S...

Страница 59: ...the Pmax pressure limit please refer to page 115 The value of Pmax is displayed as a dashed blue line in the Paw t curve The Inconstant volume alarm is always active It is triggered automatically if the tidal volume VT can no longer be applied This visual and audible alarm can be suppressed with the Alarm Reset key until the cause of the alarm is remedied Please refer to page 160 for a detailed de...

Страница 60: ... mode is also indicated on the screen The screen key BIPAP and the screen knobs for setting the BIPAP parameters remain on display Set the pattern of ventilation for BIPAP and BIPAP ASB with the ventilation parameters Inspiration pressure Pinsp Frequency f Time Tinsp O2 concentration O2 Positive end expiratory pressure PEEP Pressure support PASB Pressure rise time The inspiration pressure Pinsp ca...

Страница 61: ...d of the usual symbol for the patient mode Apnoea Ventilation for automatic switch over to volume controlled mandatory ventilation if the patient stops breathing If breathing stops Evita 4 emits an alarm after the set alarm time TApnoea and starts volume controlled ventilation with the set ventilation parameters Frequency fApnoea Tidal volume VTApnoea To set Example Flowtrigger Touch the Extra set...

Страница 62: ...nts from those unable to breathe spontaneously to those breathing spontaneously before being weaned off the ventilator Set ventilation pattern for BIPAPAssist with the following parameters Inspiratory pressure Pinsp Frequency f Inspiration time Tinsp O2 concentration O2 Positive end expiratory pressure PEEP Pressure rise time Flow trigger FlowTrig The inspiratory pressure Pinsp is set as an absolu...

Страница 63: ...arameters Flowtrigger for synchronisation with attempted spontaneous breathing by the patient By setting the trigger level the mandatory ventilation strokes are synchronised with the patient s spontaneous breathing attempts Spontaneous breathing activity by the patient is indicated by the brief display of a lung symbol instead of the usual symbol for the patient mode Apnoea Ventilation for automat...

Страница 64: ...le Flowtrigger Touch the Extra settings screen key Touch the Flow trigger screen key Set the value touch the FlowTrig screen knob and turn and press the rotary knob Operation Setting Ventilation Modes 64 084 37 207 ...

Страница 65: ...me VT Insp flow Flow Frequency f Inspiration time Tinsp O2 concentration O2 Positive end expiratory pressure PEEP Pressure support PASB Pressure rise time To set Touch the appropriate screen knob Adjust to the desired value turn rotary knob Confirm setting press the rotary knob MMV and MMV ASB can be expanded with the following ventilation parameters Flowtrigger for synchronisation with attempted ...

Страница 66: ... screen knob and turn and press the rotary knob MMV and MMV ASB can be configured with the additional ventilation parameter Pmax Select Pmax pressure limiting see page 115 Pressure Limited Ventilation PLV for manually limiting pressure peaks using the Pmax pressure limit The tidal volume remains constant as long as the pres sure curve shows a plateau and the inspiratory flow curve shows a brief fl...

Страница 67: ...ration pressure Phigh Positive end expiratory pressure Plow O2 concentration O2 To set Touch the appropriate screen knob Adjust to the desired value turn rotary knob Confirm setting press the rotary knob APRV can be expanded with the following ventilation parameters Apnoea Ventilation for automatic switch over to volume controlled mandatory ventilation if the patient stops breathing If breathing s...

Страница 68: ...le Apnoea Ventilation Touch the Extra settings screen key Touch the Apnoea vent screen key Switch on the function touch the On screen knob and press in the rotary knob Set values touch the corresponding screen knob turn and press rotary knob 092 37 207 ...

Страница 69: ...ination of Evita 4 and Evita 2 dura Combination of Evita 4 and Evita 2 Combination of Evita 4 and Evita Requirements for combinations Evita 2 or Evita units must be fitted with the EvitaBus analogue interface optional Connecting cable 84 11 794 must be used to connect Evita 4 to another Evita 4 or with an Evita 2 dura Connecting cable 84 11 794 must be used to connect Evita 4 to an Evita 2 or Evit...

Страница 70: ... Evita 4 Evita 2 and Evita 4 Evita Connect the ILV port of the Evita 4 to the analogue interface of the other Evita unit using connecting cable 84 11 793 Operation Independent Lung Ventilation ILV 70 0 0 0 ...

Страница 71: ...al volume VT Insp flow Flow Frequency f Inspiration time Tinsp O2 concentration O2 Positive end expiratory pressure PEEP To set Touch the appropriate screen knob Adjust the desired value turn rotary knob Confirm setting press rotary knob ILV Master can be supplemented by the following ventilation parameters Flowtrigger ILV Master Assist for synchronisation with attempted spontaneous breathing by t...

Страница 72: ...mit please refer to page 115 Pressure Limited Ventilation PLV for manually limiting pressure peaks using the Pmax pressure limit The tidal volume remains constant as long as the pressure curve shows a plateau and the flow curve shows a brief flow pause between inspiration and expiration To set the Pmax pressure limit please refer to page 115 The value of Pmax is displayed as a dashed blue line in ...

Страница 73: ...Master device and selectable Slave mode For independent lung ventilation of patients with no spontaneous breathing To set Slave mode Touch the Extra settings screen key Touch the Slave Mode screen key To select the desired slave mode e g Async Touch the appropriate screen key and press the rotary knob Paw Flow Tinsp Te Pplat Insp pause Pmax configu rable PEEP 1 f Insp flow t t 099 37 207 ...

Страница 74: ...piration of the master device The end of inspiration incl pause time is determined by the Tinsp setting The I E ratio of the slave device is freely selectable Slave device Inverse The start of inspiration is synchronised with the start of expiration of the master device and vice versa The I E ratio of the slave device is the inverse of the I E ratio of the master device Operation Independent Lung ...

Страница 75: ...actic treatment of atelectasis Atelectasis can be prevented by switching on the Sigh function and setting the sigh in the form of an intermittent PEEP When the Sigh function is activated the end expiratory pressure is increased by the set value of the intermittent PEEP for 2 ventilation strokes every 3 minutes ILV Slave can also be configured with the additional ventilation parameter Pmax To set t...

Страница 76: ...can breathe spontaneously during apnoea ventilation and the mandatory ventilation strokes will be synchronised with the patient s spontaneous breathing The apnoea ventilation frequency remains constant To set Touch the Extra settings screen key Touch the Apnoea vent screen key Switch on the function touch the screen knob marked On and press the rotary knob Set values touch the appropriate screen k...

Страница 77: ...ch is automatically coupled with the PEEP setting The alarm limits do not have to be set for the O2 concentration These limits are automatically coupled to the O2 concentration setting Lower alarm limit Setting 4 Vol for settings up to 60 Vol Setting 6 Vol for settings from 60 to 100 Vol Upper alarm limit Setting 4 Vol for settings up to 60 Vol Setting 6 Vol for settings from 60 to 100 Vol Ventila...

Страница 78: ...ashes Warning messages are marked with two exclamation marks Example O2 supply pressure high Caution messages are displayed against a yellow background Evita 4 generates a 3 tone sequence that is repeated every 20 seconds Advisory low priority message The yellow lamp remains constantly lit Note messages are marked with one exclamation mark Example Malfunction fan Advisory messages are displayed ag...

Страница 79: ...ustic alarm will be cancelled for 2 minutes If the fault that triggered the alarm is still not remedied the acoustic alarm starts up again If you wish to reactivate the acoustic alarm temporarily 2 Press the g key with the yellow LED now switched off again Acknowledge 3 Press Alarm Reset to acknowledge the alarms that can be suppressed with Alarm Reset please refer to Troubleshooting on page 127 I...

Страница 80: ...n be selected see configuration page 109 or 111 onwards In all other screen pages e g Settings page Press Settings Settings display Right hand field 4 measured values as in the standard page Left hand field 1 curve To select one of the three measured value combinations Touch the screen key repeatedly To select three other curves Touch the screen key and touch the relevant screen key Measured value...

Страница 81: ...e following are displayed optionally VTASB inspiratory breathing volume during an ASB stroke RSB Rapid Shallow Breathing1 NIF Negative Inspiratory Force2 _____________ 1 For a detailed description of RSB refer to the Annex page 175 2 For a detailed description of NIF refer to the Annex page 175 For information on using NIF refer to Manual expiration page 87 81 Operation Displaying Curves and Measu...

Страница 82: ...the measured value at a specific time Position the l cursor on the time by turning the rotary knob The time and associated measured value are displayed above the trend curve To display another preset measured value trend Touch the screen key and touch the corresponding screen key To preselect measured values for the trend display please refer to Configuration on page 112 82 Operation Displaying Cu...

Страница 83: ...key available as upgrade Single stroke displays To display an individual breathing cycle in ventilation modes that have both mechanical and spontaneous components e g SIMV Press the Single stroke screen key If no single stroke is selected for display the entire breathing activity from mandatory stroke to mandatory stroke will be recorded Zoom loops available as upgrade The right hand loop can be z...

Страница 84: ...ased curves are replaced by the two loops in the upper graphic area The Freeze function can also be used with loops in the upper graphic area Loops in the upper graphic area cannot be configured when the Loops menu is open the Configuration key has been selected To restore the time based curves in the upper graphic area Touch the right hand screen key Touch the Curves screen key Operation Displayi...

Страница 85: ... box cursor over the desired line Example 17 10 11 14 O2 30 To select a more recent entry Turn the rotary knob counter clockwise and position the box cursor over the desired line Evita 4 enters all alarms in the logbook If an alarm is not displayed on the screen immediately when it occurs for instance because the device has signalled an alarm with higher priority the undisplayed alarm is correspon...

Страница 86: ...y turning the rotary knob The corresponding pair of measured values is displayed above and beside the curve The Reference key remains disabled as long as the Freeze function is active To display new curves loops again 1 Press Stop key again Screen freeze mode is automatically terminated 3 minutes after the rotary control was last turned Operation Displaying Curves and Measured Values 86 D Evita 4 ...

Страница 87: ...is triggered 1 Press Insp hold key and hold it down for as long as inspiration is required Either a just activated automatic ventilation stroke will be prolonged or a new ventilation stroke will be started and appropriately prolonged max 15 seconds Exspiration Hold This function may be used in all ventilation modes For determining the measured NIF1 value for weaning 2 Hold down the Exp hold key Th...

Страница 88: ...on is only possible with AutoFlow Unlike in adult ventilation the medicament nebuliser nebulises continuously in paediatric ventilation but the aerosol generated during expiration does not reach the lungs Depending on the set O2 concentration the medicament nebuliser is supplied by the ventilator with medical air oxygen or a mixture of medical air and oxygen Deviations in O2 concentration are ther...

Страница 89: ...iece 2 Connect the inspiration hose to the medicament nebuliser Place the medicament nebuliser in the vertical position Using clamps route the nebuliser hose back to the ventilator along the expiratory hose For use during paediatric ventilation 3 Insert the catheter connector ISO cone Ø15 Ø11 in the inlet of the medicament nebuliser 4 Insert the adapter ISO cone Ø22 Ø11 in the outlet 5 Fit the cor...

Страница 90: ...uring nebulisation During medicament nebulisation do not use a heat and moisture exchanger HME at the Y piece Risk of increased breathing resistance 2 Hold down key until the yellow LED lights up Note message on screen Nebuliser on The nebuliser operates for 30 minutes If medicament nebulisation needs to be stopped prematurely 2 Press key again The yellow LED goes out and the nebuliser is switched...

Страница 91: ...ode the enriched concentration is 25 higher than the set concentration During suction and for 2 minutes afterwards the lower alarm limit for the minute volume is switched off Other alarms are switched off during suction and for 15 seconds afterwards Oxygen enrichment is only possible with a fully functioning flow sensor and if flow monitoring is switched on Before suction 1 Hold down the O2 suctio...

Страница 92: ...oxygen enrichment program is interrupted All alarms are immediately reactivated Evita 4 continues ventilating in the set ventilation mode After reconnection After reconnection Evita 4 continues ventilating in the set ventilation mode except that for 120 seconds the increased oxygen concentration of 100 by volume for adults and 25 above the set concentration for paediatric ventilation will continue...

Страница 93: ...is procedure can distort the measured values Select the Intrinsic PEEP special procedure Press the Special proc key and touch the PEEPi screen key Display example The measured values and the time of the last measure ment are displayed on the screen To start the Intrinsic PEEP measurement Touch the Start screen key The Intrinsic PEEP measurement runs automatically At the end of the procedure the ne...

Страница 94: ...ll ventilation modes in order to check the breathing drive of a spontaneously breathing patient or to assess the amount of spontaneous breathing during controlled ventilation To select the P 0 1 occlusion pressure measuring procedure Press the Special proc key and touch screen key P 0 1 Display example The measured value and time of the last measurement is displayed on the screen To start the P 0 ...

Страница 95: ...xample Touch Monitoring screen key Display example For the example of switching off flow monitoring Touch the Flow off screen key The key changes colour from green to yellow To confirm that you wish to switch off Flow Monitoring Press rotary knob Flow Monitoring is switched off and the corresponding measured values disappear The alarm function is switched off After replacing the sensor Switch the ...

Страница 96: ...ter switching on standby To switch off the standby alarm tone 2 Press Alarm Reset key The standby alarm tone cannot be cancelled with the g key Display example If the patient mode or ideal body weight should be changed during Standby Evita 4 will determine new start values for ventilation see page 50 Terminating standby mode to continue ventilation 1 Press O key The LED goes out and the current ve...

Страница 97: ...on The applied O2 concen tration is not affected by calibration The calibration of the CO2 sensor can be checked during ventilation Calibrating the O2 sensor Before operation during the device check After replacing the O2 sensor wait for the 15 minute warm up time of the O2 sensor If the measured value and set value deviate from each other by more than 2 Vol The O2 sensor can be calibrated during ...

Страница 98: ... Flow sensors which have been disinfected in ethanol must be left to dry in air for at least 30 minutes Press the Calibration key Touch the Flow screen key Touch the Start Cal screen key The LED in the screen key turns yellow Display Evita 4 uses the next inspiration phase for the calibration Short inspiration times are prolonged to about 1 second Message in the help line at the bottom of the scre...

Страница 99: ... calculates the external flow The following message is displayed on Evita 4 during this time External flow is being measured When the external flow has been calculated it is displayed by Evita 4 with the time and date The following prompt is also displayed on Evita 4 Confirm value with Confirm press rotary knob Calculation of the external flow is interrupted by Evita 4 if it is greater than 12 L m...

Страница 100: ...tion can be performed during ventilation CO2 zero calibration if the device requests CO2 zero calibration with the screen message CO2 zero calibration if the CO2 curve no longer returns to zero after each inspiration before each calibration test page 102 onwards before each CO2 calibration page 105 Switch on Evita 4 Wait about 3 minutes for completion of the warm up phase of the CO2 sensor After a...

Страница 101: ... performed Display CO2 zero calibration After about 5 seconds the device confirms with the message CO2 zero ok Fit the sensor back on the cuvette A failed zero calibration is indicated by the device with the message CO2 sensor not zeroed See Troubleshooting page 127 Repeat CO2 zero calibration 101 Operation Calibrating 1 2 Evita 4 ...

Страница 102: ...d wait for about 3 minutes for the CO2 sensor to complete its warm up phase Press the Calibration key Display example Touch the CO2 screen key Display example Carry out CO2 zero calibration see page 100 After CO2 zero calibration Touch the Filter Check screen key Display example Place the test filter in the CO2 sensor 141 37 207 142 37 207 ...

Страница 103: ...e test value is outside the permitted tolerance the test gas must be checked or calibrated Push the CO2 sensor back on to the cuvette Checking CO2 calibration with calibration gas if the specified calibration value was not met when testing with the test filter at least once per half year Switch on Evita 4 Wait about 3 minutes for the CO2 sensor to complete its warm up phase Press the Calibration k...

Страница 104: ... calibration gas from the test cylinder 3 Calibration gas e g 5 Vol CO2 95 Vol N2 Enter these concentration values with the on screen parameter setting knobs Touch the relevant screen knob Enter the concentration turn rotary knob If the calibration gas consists only of CO2 and N2 set the O2 and N2O concentrations to 0 Touch the Start screen key The CO2 concentration FCO2 is displayed on screen Aft...

Страница 105: ...example Touch CO2 screen key Display example Carry out CO2 zero calibration page 100 After the CO2 zero calibration Touch the Cal screen key Connect the calibration gas supply Use the cuvette from the calibration set 1 Connect the calibration gas cylinder and the cuvette of the calibration set to the hose 2 Remove the CO2 sensor from its park bracket and fit it to the cuvette of the calibration se...

Страница 106: ... message CO2 calibration ok Failed calibration is indicated by the device with the message CO2 calibration interrupted or CO2 calibration not ok Repeat the calibration of the CO2 sensor Resetting CO2 calibration If calibration with calibration gas was unsuccessful the factory set calibration value can initially be used Press the Calibration key Touch the CO2 screen key On the CO2 calibration side ...

Страница 107: ...e 116 Apnoea ventilation On Off 117 Selecting patient mode 118 Start up values for ventilation parameters and alarm limits 119 Setting start up values for ventilation parameters VT f 119 Setting start up values for ventilation parameters Pressure O2 I E 121 Leakage compensation On Off 122 Setting start up values for alarm limits 123 System Defaults 124 Setting external interface 124 Setting time a...

Страница 108: ...d screen key Display example Touch the Loudness screen key Display example Adjust volume Turn rotary knob The band displayed on the screen shows the current setting between minimum and maximum Confirm setting press rotary knob After confirmation the alarm tone is sounded to test the volume 152 37 207 153 37 207 ...

Страница 109: ...ues in the right hand field of each screen page A second or third group can be displayed by touching the key These groups can be put together in the configuration page Press the Configuration key Touch the Screen screen key Display example Touch the Values screen key Display example 1 2 3 154 37 207 155 37 207 ...

Страница 110: ...ed value by another Touch the corresponding screen key The selection list with all available measured values is displayed next to the screen keys Select the other measured value e g R Resistance turn rotary knob Confirm selection press rotary knob 156 37 207 ...

Страница 111: ...Screen screen key Display example Touch the Curves screen key Display example Replace one displayed curve by another Touch the corresponding screen key Display example Flow The selection list containing all available curves is displayed next to the screen keys Select the other curve turn rotary knob Confirm selection press rotary knob 157 37 207 158 37 207 159 37 207 ...

Страница 112: ... example Touch the Trends screen key Display example To replace one displayed trend by another Touch the relevant screen key Display example Trend 1 MV The selection list containing all available measured values is displayed next to the screen keys Select the other measured value e g FiO2 for the trend display turn rotary knob Confirm selection press rotary knob 160 37 207 161 37 207 162 37 207 ...

Страница 113: ...nd alarm limits active on switching on the device The configuration menu for the ventilation criteria can only be opened after entering access code 3032 This precaution is intended to prevent unauthorised modifications to the ventilation criteria Selecting ventilation modes To select the ventilation modes on the Settings screen page Press the Configuration key Display Touch the Ventilation screen ...

Страница 114: ... this example IPPV Evita 4 starts in this ventilation mode immediately after being switched on To replace one displayed mode by another Press the corresponding screen key Display example IPPV The selection list with all available ventilation modes is displayed next to the screen keys Select another mode turn rotary knob Confirm selection press rotary knob 164 37 207 165 37 207 166 37 207 ...

Страница 115: ...tion key Display example Touch Ventilation screen key Enter access code 3032 Touch the corresponding screen keys Display example Touch the Modes screen key Display example Touch the screen key Pmax On Confirm selection press rotary knob Pmax pressure limiting is selected The Pmax screen knob is displayed on the Settings screen page 163 37 207 168 37 207 169 37 207 ...

Страница 116: ...after switching on Press Configuration key Touch Ventilation screen key Display example Enter access code 3032 Touch the corresponding screen keys Display example Touch the Modes screen key Display example To activate AutoFlow in the start up ventilation mode Touch the On screen key Confirm selection press rotary knob The AutoFlow option will be automatically activated the next time the apparatus ...

Страница 117: ...xample Enter access code 3032 Touch the corresponding screen keys Display example Touch the Modes screen key Display example To prepare apnoea ventilation Touch the On screen key Confirm press rotary knob The LED in the key lights up Apnoea ventilation is automatically ready for use when the device is switched on again 117 Configuration Ventilation 163 37 207 174 37 207 175 37 207 ...

Страница 118: ... mode Press the Configuration key Touch the Ventilation screen key Display example Enter access code 3032 Touch the corresponding screen keys Display example Touch the Patients screen key Display example The selection list with the two patient modes appears next to the screen keys Select the corresponding patient mode turn rotary knob Confirm the patient mode press rotary knob 163 37 207 177 37 20...

Страница 119: ...l body weight or as a function of the patient mode paediatrics or adults Press Configuration key Touch the Ventilation screen key Enter access code 3032 Touch the corresponding screen keys Touch the Start up settings screen key Display example To determine the start up values of the ventilation parameters VT f on the basis of the ideal body weight Touch the screen key VT f by weight and confirm wi...

Страница 120: ...uch the screen key of the parameter to be changed Change value turn rotary knob Confirm value press rotary knob If you wish to return to the factory settings Touch Dräger Reset screen key Weight kg Tidal volume VT mL Ventilation frequency f bpm Tidal volume VT mL Ventilation frequency f bpm 3 20 30 15 110 26 65 450 13 100 700 10 Factory settings Hospital specific settings Tidal volume VT mL Ventil...

Страница 121: ...play example Touch the Pressure O2 I E screen key Starting values of Pressure O2 I E 1 PASB PASB PEEP The hospital specific start up settings can be entered in the table To change the start up values of Pressure O2 I E Touch the screen key for the parameter to be changed Change value turn rotary knob Confirm value press rotary knob PEEP mbar Pinsp mbar PASB1 mbar Pmax mbar O2 Vol I E Factory setti...

Страница 122: ...he device is restarted Press the Configuration key Touch the Ventilation screen key Enter access code 3032 Touch the corresponding screen keys Touch the More settings screen key Display Touch the Leak Comp screen key Touch the On or Off screen key Confirm press rotary knob The selected key is highlighted by the yellow LED _____________ 1 For a detailed description of the leakage compensation funct...

Страница 123: ...mple Start up values of the alarm limits The factory specific start up settings can be entered in the table To change the start up values of the alarm limits Touch the screen key of the alarm limit you wish to change Change value turn rotary knob Confirm value press rotary knob Alarm limit Factory settings Hospital specific settings Paw high mbar 50 MV low L min VT f 20 MV high L min VT f 50 VT hi...

Страница 124: ...ired interface protocol with the screen keys Printer MEDIBUS and LUST Display example Select the interface parameters for the selected interface protocol Touch the screen key for the parameter e g Baud rate Change value turn rotary knob Confirm value press rotary knob For MEDIBUS protocol Baud rate Parity check bits see Operating Manual of the connected device Number of stop bits see Operating Man...

Страница 125: ...e time interval in progress will remain unaffected Setting time and date Press Configuration key Touch System Defaults screen key and touch Time Date screen key Display example Change value in cursor Example 95 turn rotary knob Confirm value press rotary knob Selecting language and units To select the desired language for the screen texts To select the units for pressure and CO2 concen tration Pre...

Страница 126: ... Touch the Units screen key Display example Touch the relevant screen key e g pressure Select unit turn rotary knob Confirm unit press rotary knob Service diagnosis Only for trained personnel with the appropriate servicing documentation 187 37 207 ...

Страница 127: ...Contents Troubleshooting 128 127 Troubleshooting Contents Troubleshooting ...

Страница 128: ... is less than 6 bar Airway pressure high The upper alarm limit for the airway pressure has been exceeded The patient is fighting the ventilator cough Check patient condition Check ventilation pattern Correct alarm limit if necessary Ventilation hose buckled Check hose system and tube Airway pressure low Leaking cuff Inflate cuff and perform leak test Leak or disconnection Check hose system for tig...

Страница 129: ...Replace defective CO2 sensor CO2 zero Zero outside the permitted tolerance Perform zero calibration page 100 Zero calibration unsuccessful Perform CO2 zero calibration correctly page 100 Device failure Device faulty Call DrägerService etCO2 high End expiratory CO2 concentration above upper alarm limit Check condition of patient check pattern of ventilation correct alarm limit if necessary etCO2 lo...

Страница 130: ...e 97 Faulty mixer function Call DrägerService Flow measurement inop Water in flow sensor Dry flow sensor Flow sensor faulty Calibrate flow sensor page 98 replace if necessary Flow measurement malfunction Call DrägerService Flow monitoring off Flow monitoring is switched off Switch on flow monitoring again as described on page 95 or immediately ensure an adequate external monitor function Flow sens...

Страница 131: ...gh Check fan function clean cooling air filter or call DrägerService MEDIBUS COM inop The connector of the MEDIBUS cable was unplugged during operation Plug the connector in again and secure it against disconnection with the two screws MEDIBUS cable defective Use a new MEDIBUS cable Interface defective Call DrägerService Mixer inop Mixer malfunction FiO2 can deviate considerably Immediately ventil...

Страница 132: ...y possible in pressure controlled ventilation or with AutoFlow Select the patient mode Restart nebulisation Acknowledge the alarm with Alarm Reset Only in paediatric mode only for ventilation with AutoFlow Flow sensor not ready for measure ment Switch on flow monitoring or calibrate flow sensor page 98 or replace flow sensor or change mode Restart nebulisation Acknowledge the alarm with Alarm Rese...

Страница 133: ...nction Call DrägerService Standby activated Evita 4 has been switched to standby Confirm standby with Alarm Reset key Temperature high Breathing gas temperature higher than 40 ºC Switch off humidifier Temperature meas inop Temperature sensor faulty Fit new temperature sensor see page 33 Temperature sensor Temperature sensor probe has been disconnected during operation Reconnect probe Sensor cable ...

Страница 134: ...trolled ventilation so that the set inspiratory pressure volume is achieved with only a very small volume Check condition of patient check machine settings Volume not constant Due to pressure limit or time limit the set tidal volume VT has not been applied Prolong inspiratory time Tinsp Increase inspiratory flow Flow Increase pressure limit Pmax Press the Alarm Reset key to suppress the visual and...

Страница 135: ...xpiration valve 138 Humidifier 138 Disinfecting Cleaning 139 Assembling 142 Fitting expiration valve 142 Before Reusing on Patient 143 Maintenance Intervals 143 Replacing cooling filter 144 Disposing of batteries and O2 sensors 144 Removing fitting ambient air filter 144 Correct disposal of apparatus 145 135 Preparing Contents Preparing ...

Страница 136: ...er cone from the cuvette Prepare the CO2 sensor for wipe disinfecting Prepare the cuvette for disinfecting and cleaning in the autoclave Temperature sensor 4 Remove from the Y piece or from the mounting of hose set K Do not pull the cable Unplug the connector from the back of the Evita 4 Prepare the temperature sensor for wipe disinfecting The temperature sensor is not suitable for autoclaving or ...

Страница 137: ...n hoses Remove from the adapters and ports Remove the water traps from the ventilation hoses Remove the collecting jars from the water traps Prepare the ventilation hoses water traps and their collecting jars and the Y piece for cleaning in the autoclave Flow sensor Tilt the control unit upward 6 Push the flow sensor to the left as far as it will go and 7 pull out The flow sensor cannot be disinfe...

Страница 138: ...r by hand and remove together with the diaphragm Do not disassemble the expiration valve any further Prepare the expiration valve for disinfecting and cleaning by autoclave and prepare the expiration valve for hot steam sterilisation Place the open expiration valve in the basket so that it cannot be damaged by other parts Humidifier Dismantle in accordance with the specific Instructions for Use an...

Страница 139: ...each disinfectant by its active agents For countries where the DGHM list is not available we recommend the types of disinfectant given above Disinfectants often contain besides their main active agents additives that can also damage materials If in doubt ask the supplier manufacturer of the disinfectant cleaning agent A list of substances used is given on page 158 Do not sterilise parts in ethylen...

Страница 140: ... 144 CO2 Cuvette Wipe off dirt in particular inside and outside the windows with disposable tissue and cotton buds Disinfect with moist heat 93 C 10 minutes in a cleaning and disinfecting machine Use only cleaning agent Or Disinfect in bath of disinfectant based on the listed active substances e g Cidex Johnson Johnson Norderstedt Or Steam sterilise at 134 C CO2 Sensor Wipe off dirt with cotton bu...

Страница 141: ...ailable Bath disinfecting e g with Sekusept Henkel Comply with manufacturer s instructions Then rinse with clean water preferably from a soft water supply Shake water out thoroughly and leave the products to dry Expiration valve and individual parts after rinsing steam sterilise at 134 C Or Expiration valve Rinse thoroughly with clear water preferably from a soft water supply Shake water out thoro...

Страница 142: ...the collar of the stopper Be careful to fit the diaphragm properly Insert stopper with diaphragm on top into the housing from below and screw in tightly If the expiration valve has an optional water trap Fit the collecting jar Medicament nebuliser Assemble in accordance with separate Instructions for Use Install see page 89 Preparing Assembling 142 ...

Страница 143: ...alibration is impossible Disposal see page 144 Ambient air filter Clean or replace after 4 weeks Cooling air filter see page 144 Replace every year Dispose of with normal domestic waste Filters in the com To be replaced by trained service pressed gas inlets personnel every 2 years Lithium battery To be replaced by trained service for data protection personnel every 2 years Disposal see page 144 Cl...

Страница 144: ...rge batteries Batteries and O2 sensors must be disposed of as special waste Disposal must conform to local waste disposal regulations Information may be obtained from the local environmental and public health authorities and from approved waste disposal companies Removing and reinserting ambient air filter Filter must be cleaned or replaced when soiled or at the latest after 4 weeks Replace filter...

Страница 145: ...apparatus at the end of its useful life After contacting the competent waste disposal company hand over Evita 4 for appropriate disposal The applicable legal regulations must be observed 145 Preparing Maintenance Intervals ...

Страница 146: ...146 ...

Страница 147: ...Contents Control unit 148 Front connections 149 Back panel 150 147 What s what Contents What is what ...

Страница 148: ... for selecting the standard screen page 11 O key for switching between operating and standby mode 12 Central rotary dial knob for selecting and confirming settings 13 Key for displaying the Configuration screen page 14 Key for displaying the Calibration screen page 15 Key for displaying the Special Procedures screen page For measuring PEEPi and Occlusion Pressure 16 Touch sensitive screen for disp...

Страница 149: ... port 3 Latch for expiration valve 4 Inspiratory port 5 Locking screw for protective cover behind it O2 sensor and ambient air filter 6 Connections for optional pressure measurement not used 7 Gas supply port for the medicament nebuliser 149 What s what 1 2 3 4 5 7 6 ...

Страница 150: ... Connection for oxygen 9 Connection for medical air 10 Temp m socket for temperature sensor 11 CO2 m socket for CO2 sensor 12 Sync socket for C Lock ECG synchronisation for optional SpO2 measurement 13 SpO2 m socket for functional SpO2 measurement optional 14 COM1 RS232C socket for RS 232 interface e g for printer 15 Mains fuses 16 Connector for power cord 150 What s what 14 13 12 11 10 9 8 1 2 3 ...

Страница 151: ...ngs 152 Performance data 153 Measured value displays 153 Monitoring 155 Operating data 156 Machine outputs 157 Electromagnetic compatibility EMC 158 Classification 158 UMDNS Code 158 Materials used 158 151 Technical Data Contents Technical Data ...

Страница 152: ...spiratory Flow Paediatrics 6 to 30 L min Adults 6 to 120 L min Inspiratory pressure Pinsp 0 to 80 mbar Inspiratory pressure limit Pmax 0 to 100 mbar O2 concentration 21 to 100 Vol Accuracy 5 of set value or 2 Vol whichever is greater Positive end expiratory pressure PEEP or interm PEEP 0 to 35 mbar Trigger sensitivity 0 3 to 15 L min Pressure assist PASB 0 to 80 mbar Rise time for pressure assist ...

Страница 153: ...bar L s Exp Resistance 3 8 mbar L s Dead Space Volume incl CO2 cuvette 16 mL Equipment compliance with Fisher Paykel MR 730 humidifier and tubing system paediatric 1 mL mbar Insp Resistance 4 1 mbar L s Exp Resistance 4 1 mbar L s Dead Space Volume incl CO2 cuvette 6 mL Additional functions Inspiratory relief valve opens if medical air supply fails pressure 1 2 bar enables spontaneous breathing wi...

Страница 154: ...n Accuracy 1 min T 0 90 approx 35 s Breathing gas temperature measurement Range 18 to 51 ºC Resolution 1 ºC Accuracy 1 ºC CO2 measurement in main flow End expiratory CO2 concentration etCO2 Range 0 to 100 mmHg or 0 to 13 3 Vol or 0 to 13 3 kPa Resolution 1 mmHg or 0 1 Vol or 0 1 kPa Accuracy for 0 to 40 mmHg 2 mmHg for 40 to 100 mmHg 5 of measured value T 10 90 25 ms Warm up time max 3 minutes CO2...

Страница 155: ...r values less than 0 1 L min 0 01 L min Accuracy 18 of measured value T 0 90 approx 35 s Rapid Shallow Breathing RSB Range 0 to 9999 1 min x L Resolution 1 min x L Accuracy see measurement of VT and f Negative Inspiratory Force NIF Range 45 to 0 mbar Resolution 1 mbar Accuracy 2 mbar Curve displays Airway pressure Paw t 10 to 100 mbar Flow Flow t 150 to 180 L min Volume V t 0 to 2000 mL Exp CO2 co...

Страница 156: ...0 Vol with 6 Vol Endexspiratory CO2 concentration etCO2 Upper alarm limit alarm if the upper alarm limit has been exceeded Setting range 0 to 100 mmHg or 0 to 15 kPa Lower alarm limit alarm if the lower alarm limit fell below Setting range 0 to 99 mmHg or 0 to 14 kPa Insp breathing gas temperature Upper alarm limit alarm when temperature reaches 40 ºC Evita 4 can also be used without temperature s...

Страница 157: ...dust Gas consumption of control system Medical air or O2 approx 3 5 L min Output for pneumatic Medical air or O2 medicament nebuliser max 2 bar max 10 L min Automatic gas switch over if one gas fails inlet pressure 1 5 bar the device switches to the other gas Sound pressure level max 47 dB A for free field measurement over a reflecting surface Dimensions W x H x D Basic machine 530 x 290 x 450 mm ...

Страница 158: ...output optional for output and reception via a CAN interface Analogue output optional for output of analog data Electromagnetic compatibility EMC Tested in accordance with EN 60601 1 2 conforming to European Directive 89 336 EEC Classification II b as per EC Directive 93 42 EEC Annex IX UMDNS Code 17 429 Universal Medical Device Nomenclature System Nomenclature for medical products Materials used ...

Страница 159: ...ation of the effect of hose system compliance 170 Conversion according to ambient conditions 170 Automatic leakage compensation 172 Weaning parameters 174 Occlusion pressure P 0 1 174 Rapid Shallow Breathing RSB 175 Negative Inspiratory Force NIF 175 Intrinsic PEEP 176 Insp O2 concentration during medicament nebulisation 177 Abbreviations 178 Symbols 181 Bibliography 182 Parts List 183 Order List ...

Страница 160: ...d in the same form in almost all intensive care ventilators has two serious drawbacks If the lungs are extremely non homogeneous the pressure peaks can lead to the overdistension of specific lung areas and the limited inspiration flow and closed inspiration and expiration valves during the inspiratory pause can cause the patient to fight the machine unless the pattern of ventilation is regularly a...

Страница 161: ...d inspiration flow 0 before the inspiration time Tinsp has fully elapsed the control system for the inspiration and expiration valves ensures that the patient can breathe in and out during the remaining inspiration time even during a constant pressure plateau Pplat If the patient breathes in or out during mandatory inspiration the plateau pressure Pplat is not changed for this ventilation stroke o...

Страница 162: ...synchronised with the patient s own efforts with the aid of the variable Flowtrigger Only in IPPV mode can Flowtrigger be fully switched off IPPV Assist IPPV The steepness of the pressure rise from the PEEP level to the inspiration level can be even more closely adapted to the needs of the patient in SIMV and MMV modes by means of the pressure rise time Start up procedure with AutoFlow On switchin...

Страница 163: ...ases the sigh function is achieved by increasing the ventilation stroke however due to the short time available the filling of the slow alveoli is only marginally improved In Evita 4 the sigh operates during expiration with an intermittent PEEP for two ventilation strokes every 3 minutes The average airway pressure is higher and a longer filling time is normally available To avoid overinflation of...

Страница 164: ...nchronisation of the mandatory ventilation stroke reduces the effective SIMV time which would result in an undesirable increase in effective IMV frequency Evita 4 prolongs the subsequent breathing time by the missing time difference T thus preventing an increase in SIMV frequency The frequency para meter f remains constant This parameter in combination with the tidal volume VT sets the minimum ven...

Страница 165: ...e in pressure Evita 4 supports the insufficient spontaneous breathing of the patient with a high peak flow With a slow increase in pressure Evita 4 begins gently with regular inspiratory flow The patient has to take over more breathing effort and tone of breathing muscles improves With the patient adjusted pressure increase and the present ASB level the patient s own breathing activity defines the...

Страница 166: ... trigger window is 5 seconds long in adult mode and 1 5 seconds long in paediatric mode For expiration times shorter than 5 seconds or 1 5 seconds the trigger window covers the entire expiration time At Pinsp level the trigger window is 1 4 Tinsp seconds long As recent clinical research has shown this smooth adaptation to the patient s spontaneous breathing requires less sedation so that the patie...

Страница 167: ...tory pressure Pinsp and or frequency f BIPAPAssist Biphasic Positive Airway Pressure Assisted Pressure controlled assisted ventilation The inspiratory strokes are the same as for BIPAP except that the change from Pinsp to PEEP is not synchronised with expiration by the patient The duration of Pinsp depends on Tinsp The patient can breathe spontaneously throughout the ventilation process Every dete...

Страница 168: ...datory breathing only if spontaneous breathing is not yet sufficient and has fallen below a pre selected minimum ventilation This minimum ventilation is controlled by the two set values tidal volume VT and frequency f and results from the product VT x f Unlike SIMV the mandatory strokes are not given regularly but only in cases of insufficient ventilation The frequency of mandatory strokes is dete...

Страница 169: ...e set minimum ventilation Evita 4 tolerates a longer breathing pause In extreme cases of sudden apnoea after a phase of heavy breathing the response time will be 7 5 seconds plus the trigger time with a minimum of 1 IMV cycle time Response times longer than 15 seconds may only occur if the minimum ventilation with a low IMV frequency f is set to correspondingly low values In this case Evita 4 trig...

Страница 170: ... provides basic compensation for hose compliance during ventilation Compensation of the effect of hose system compliance During the device check before ventilation Evita 4 determines the compliance of the ventilation hoses and then during ventilation compensates for the effect of compliance on volumetric flow measurement Depending on the airway pressure Evita 4 increases the tidal volume by the am...

Страница 171: ...ons are marked NTPD The difference between measured values under NTPD and BTPS conditions is typically approx 12 Example a tidal volume of 500 mL NTPD is increased to 564 mL BTPS by heating to 37 C and humidifying to 100 r h Evita 4 delivers the tidal volume after conversion so that the set tidal volume is effective in the lung under BTPS conditions ____________ BTPS Body Temperature Pressure Satu...

Страница 172: ...compensation the set VT determines the volume delivered by Evita 4 Leakage compensation On With automatic leakage compensation Evita 4 delivers 550 mL on the basis of the measured leakage minute volume instead of the 500 mL set 500 mL enter the lung and the displayed inspiratory tidal volume VT is 500 mL The volume of 450 mL measured on the expiration side is displayed without compensation even wh...

Страница 173: ...s consequently greater than the inspiratory minute volume delivered to the patient Unlimited volume compensation is inappropriate Evita 4 compensates for losses of up to 100 of the set tidal volume VT Due to technical tolerances a small leakage minute volume may be displayed even if the hose system is leakproof 173 Description Ventilation Modes ...

Страница 174: ...ro muscular breathing drive For patients with healthy lungs and regular breathing P 0 1 will be about 3 to 4 mbar A higher P 0 1 signifies a high breathing drive which can only be maintained for a limited period P 0 1 values about 6 mbar e g for a COPD patient indicate impending exhaustion RMF respiratory muscle fatigue When weaning COPD patients off the Ventilator measurement of P 0 1 can define ...

Страница 175: ... s maximum inhalation effort after exhaling The patient system is closed during measurement of the NIF This value is also known as the Maximum Inspiratory Pressure MIP As a result of the inhalation effort during manually extended expiration the patient generates a negative pressure in relation to PEEP The probability that the patient can be weaned successfully increases with the magnitude of this ...

Страница 176: ...t the end of measuring time 1 Evita 4 opens the expiration valve and measures the expiratory flow genera ted by Intrinsic PEEP during a defined measuring time 2 During this period the lung is depressurised to PEEP Measuring phase 2 is ended when the expiration flow has returned to 0 but at the earliest after 0 5 seconds at the latest after 7 seconds in adult mode or after 3 5 seconds in paediatric...

Страница 177: ...s is generated by switching over between compressed gases medical air and oxygen in synchronisation with inspiration In paediatric ventilation the nebuliser is operated continuously with medical air or oxygen in alternation The drive gas of the medicament nebuliser therefore roughly corresponds to the set FiO2 The graph shows the possible deviations of the applied O2 concentration as a function of...

Страница 178: ...ic pressure C Compliance CPAP Continuous Positive Airway Pressure Breathing with continuous positive pressure in the airways etCO2 End expiratory CO2 concentration FeCO2 Expiratory CO2 concentration f Frequency fApnoea Frequency setting for apnoea ventilation fmand Mandatory mechanical portion of overall breathing frequency fspn Spontaneous breathing portion of overall breathing frequency Fail to ...

Страница 179: ...re Phigh Set value of the upper pressure level APRV Pinsp Set value of the upper pressure level in BIPAP Plow Set value of the lower pressure level in BIPAP Pmax Set value for pressure limited ventilation Pmean Mean airway pressure PLV Pressure Limited Ventilation Ppeak Peak pressure Pplat End inspiratory airway pressure PS Pressure Support R Resistance RSB Rapid Shallow Breathing Quotient of spon...

Страница 180: ...lume VTApnoea Setting for tidal volume of apnoea ventilation VTASB Inspiratory breathing volume during an ASB stroke VTe Expiratory tidal volume VTi Inspiratory tidal volume Vtrap Volume trapped in the lung by intrinsic PEEP and exhaled during subsequent expiration 180 Description Abreviations ...

Страница 181: ...dard page G Cancel acoustic alarm for 2 minutes Alarms E Standby Operation Select other measured value combination π Select other curve s Time setting for pressure increase during PASB _ Lower upper alarm limit Observe Instructions for Use m Type B m Type BF Insert flow sensor Unlocking expiration valve A m Patient mode Adults P m Patient mode Paediatrics Spontaneous breathing activity by the pati...

Страница 182: ...e multicenter trial Critical Care Medicine 19 1234 1241 10 Sassoon CSH TeTT Mahutte CK Light RW Airway occlusion pressure An important indicator for succesful weaning in patients with chronic obstructive pulmonary disease Am Rev Respir Dis 1987 135 107 113 11 E Voigt BIPAP Anwendungshinweise und Kasuistik Dräger Mitteilungen Medizintechnik aktuell 1 94 12 E Bahns BIPAP Zwei Schritte nach vorn in d...

Страница 183: ...r 84 05 029 10 2 Set of spare brackets 84 03 345 11 Temperature sensor 84 05 371 12 23 Hose set adult blue socket 84 12 092 12 Spiral hose adult silicone 0 6 m 21 65 627 Item Name Description Order No No 13 13 1Water traps 84 04 985 13 1 Water container 84 03 976 14 Spiral hose adult silicone 0 35 m 21 65 619 15 Connector M 25 647 16 ISO elbow connector M 25 649 17 Y piece straight 84 05 435 18 Ca...

Страница 184: ...Mounting set clamps for rail 84 11 074 28 Double temperature sensor 84 11 048 29 30 Humidifier chamber MR 340 84 11 047 Item Name Description Order No No 30 Filter paper set of 200 not illustr 84 11 073 31 Single strand wire 1 5 m not illustr 84 11 050 32 43 Hose set paediatrics Fisher Paykel 84 12 081 32 32a Condensation trap expiration 84 09 627 32 Water container 84 03 976 33 Double conical con...

Страница 185: ...trip 84 11 969 Breathing air compressor 84 13 890 for supplying Evita 4 with medical air MEDIBUS cable 83 06 488 Printer cable 83 06 489 Water trap for expiration valve 84 13 125 Name Description Order No Basic unit Evita 4 84 11 900 Accessories required for operation Hinged arm 84 09 609 or Quick fix hinged arm 2 2M 85 706 O2 connecting hose 3 m blue M 29 231 or O2 connecting hose 5 m blue M 29 2...

Страница 186: ...otection 18 35 343 For hinged arm Holder 84 09 746 Hose clamp 84 09 841 Name Description Order No For adult ventilation Temperature sensor 84 05 371 Replacement set of lids for Aquapor 84 06 135 Aquapor bowl 84 05 739 Float for Aquapor 84 04 738 Spiral hose adult silicone 0 6 m 21 65 627 Spiral hose adult silicone 0 35 m 21 65 619 Water traps 84 04 985 Water container 84 03 976 Hose clamp 84 03 56...

Страница 187: ...de balances the leakage and indicates this as the measured value MVleak The applied tidal volume VTi is automatically corrected by the amount of the measured MVleak The same also applies for the Flow and VTe values measured on the expiratory side The measured minute volume values are not corrected for safety reasons Apnoea ventilation with SIMV pattern The patient can breathe spontaneously during ...

Страница 188: ... To extend expiration To occlude the ventilation system following expiration Medicament nebulisation Can also be applied during paediatric ventilation Bronchial suctioning In the patient modes Paediatric and Neonates Evita 4 increases the set O2 concentration commensurately but not up to 100 by volume Warning Volume not constant Can be suppressed Automatic Tube Compensation ATC optional For specif...

Страница 189: ...ption 159 Device check 42 Disinfection 139 Dismantling 136 Disposal batteries O2 sensor 144 Electric power supply 36 Equipment options 186 Evita Remote 38 Exp hold 87 Expiration valve 30 138 External flow sources 99 External interface 124 Filter cooling air 144 Filter hose system 34 35 Filter room air emergency valve 144 First time use 41 Flow measurement 170 Flow sensor 26 82 Flow sensor calibrat...

Страница 190: ...ions 127 Remote Pad 38 Replacement parts 183 186 Room air filter 144 RSB Rapid Shallow Breathing index 175 Screen freeze stop image 86 Screen page Alarm limits 24 Screen page Calibration 26 Screen page Configuration 27 Screen page Measured values 25 Screen page Settings 22 Screen page Special procedures 26 Screen pages 21 Settings 49 107 Sigh 54 163 SIMV SIMV ASB 57 164 Single stroke display 83 So...

Страница 191: ...191 ...

Страница 192: ...ormation only and are not intended for use with any specific machine or device 90 37 207 GA 5664 552 en Dräger Medical AG Co KGaA 3rd edition December 2001 Subject to alteration Dräger Medical AG Co KGaA Germany H Moislinger Allee 53 55 23542 Lübeck T 04 51 8 82 0 X 26 80 70 FAX 04 51 8 82 20 80 http www draeger com ç Directive 93 42 EEC concerning Medical Devices ...

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