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Document No. 715-7000
Revision E
Page 63 of 63
2)
AeroNOx
Portable & Bedside Set-Up
COMPETENCY BASED PERFORMANCE CHECK-OFF #2 of 2
Employee Name:
Date of Check-Off:
Supervised by:
CRITICAL ELEMENTS
Check
1. Completed Calibration check off
2.
AeroNOx
SET-UP: TRANSPORT or BEDSIDE
Attach regulators to 800 ppm NO tanks
3.
SOURCE GAS:
Attach high pressure quick connect from regulator(s) to AeroNOx
.
4.
DELIVERY:
Attach delivery tubing (P/N 415-0001) from AeroNOx
to pt. circuit at least 30 - 40 cm upstream from
the sampling site.
5.
SAMPLING:
Attach AeroNOx
luer sample line from AeroNOx
to inspiratory limb / bagger near patient
connection.
6.
Double check [NO] of the cylinder & record =
ppm
7.
Double check NO tank pressure =
psig
8. Calculate initial NO flow to achieve the desired [NO] (see
SECTION V
).
9.
Ventilator flow / gas flow = LPM
10.
Tank [NO] =
ppm
11.
Desired [NO] =
ppm
12.
Calculated Initial NO flow =
LPM
13. Calculate maximal FiO
2
(see
SECTION VII
).
Maximum FiO
2
=
14. Perform flush procedure.
15. Set NO flow @ the initial flow rate you calculated (# 12).
16. After readings stabilize, record the following from the AeroNOx
Record [NO]
ppm
Record
[NO
2
]
ppm
Record
%
O
2
ppm
17.
Calculate the cylinder NO duration in hours & minutes (see SECTION VII).
This
L tank of NO gas @
psig
will last
Hrs
Min @
LPM.
NAME:
, employee #
has successfully
completed the AeroNOx
Portable & Bedside Set-Up competency.
Date:
Signature: