LP6 Plus and LP10 Volume Ventilator User Manual

For more information:

Contact your Puritan Bennett representative for information on our full line of medical equipment and related services. Or, you may contact Puritan Bennett directly. Phone: 800.635.5267 Authorized Representative: Tyco Healthcare UK LTD 154 Fareham Road Gosport PO13 0AS, U.K.

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Contents LP6 Plus and LP10 User’s Manual

Contents Purpose of this Manual... 1 Symbols and definitions... 3 Electrical Interference... 4 Introduction and Overview... 5 General Description... 8 Patient Ventilator Circuit... 8 Front Panel... 11 Installation... 16 Mounting or Positioning... 16 Emergency Vehicle... 17 Wheelchair... 18 Power Sources... 19 AC Power... 19 External Battery 12 Volt DC... 20 Using a Car Battery... 21 Battery Performance... 22 Testing the Batteries... 23 Special Precautions for External Battery... 23 Internal Battery 12 Volt DC... 24 Operating Controls... 25 Operating Modes... 27 Standby... 27 Assist/Control... 27 Assist/Control with Pressure Limit (LP10 Only)... 27 SIMV (Synchronized Intermittent Mandatory Ventilation) 27 SIMV with Pressure Limit (LP10 Only)... 28 Pressure Cycle... 28 Pressure Limit (LP10 Only)... 29 Routine Safety Check... 31 Monthly Safety Check... 33 Responding To Alarms... 35 Troubleshooting Guide... 37 Cleaning and Maintenance... 39 Patient Circuit and Humidifier... 39 Inlet Air Filter... 40 Ventilator Surface... 41 Storage of the Ventilator... 41 Specifications... 44 Manufacturer’s Declaration... 46 Service Policy... 54 Limited Warranty... 55 Keyword Index... 57

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Contents LP6 Plus and LP10 User’s Manual

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Purpose of this Manual LP6 Plus and LP10 User’s Manual

Purpose of this Manual This manual contains valuable information. Remember, your ventilator is an electrical device. It will provide years of useful service with the proper care. This manual tells you how to give it that care. As you read this manual, you’ll notice Cautions and Warnings in boxes on many pages. Pay very special attention to these boxes. They will tell you what to do and what to avoid as you use your ventilator. The difference between Warnings and Cautions is: A Warning contains information about possible hazards to the patient, the care provider, or the service technician. A Caution includes information about how to avoid equipment damage.

Warnings Always follow the physician’s prescription when using the ventilator.

Always operate and store the ventilator according to the specifications and instructions set forth in this manual. Use only Puritan Bennett-approved accessories and products with the ventilator. The use of other accessories may damage the unit and endanger the patient. Perform daily and monthly verification of the ventilator’s operation as identified in this manual.Always stabilize and verify ventilator performance before connecting the patient to the unit. All alarms indicate a potential risk to patient safety. When an alarm sounds, provide immediate attention, care, and support to the patient as dictated by the situation. Do not use in direct sunlight.

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Purpose of this Manual LP6 Plus and LP10 User’s Manual

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Caution

Refer any adjustments or procedures exceeding the scope of this manual to your physician, homecare provider, or a Puritan Bennett Service Representative. Refer to the Puritan Bennett Service Policy found on page 54. CAUTION: Federal Law (U.S.A.) restricts this device to sale or use by or on the order of a licensed physician.

Warnings The LP6 Plus and LP10 ventilators shall not be used with flammable anesthetic agents.

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Symbols and definitions LP6 Plus and LP10 User’s Manual

Symbols and definitions The following symbols appear on the LP6 Plus and LP10 ventilators.

I O

Power switch ON position, connection to mains power

!

Attention, consult accompanying manual.

Power switch OFF position, disconnection from mains power

Alternating current Direct current

V A

Volts Amperes Standby mode of operation Canadian Standards Association Battery test switch Alarm silence switch Alarm Power Patient pressure External battery connection Remote alarm Battery test level Manual reset

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Electrical Interference LP6 Plus and LP10 User’s Manual

Electrical Interference Caution

Your ventilator is an electronic instrument. Any electronic instrument is subject to electrical interference. Electrical interference in excess of 10 V/m may keep your ventilator from working properly. Television sets, cordless or cellular telephones, microwave ovens, air conditioners, food processors, and other appliances can be sources of electrical interference. To avoid electrical interference between your ventilator and these appliances, you must follow these instructions: •

Never place your ventilator near these appliances.

•

Never plug the ventilator into the same A.C. electrical outlet as these appliances, nor into electrical outlets on the same circuit as these appliances.

•

Never place the cables from ventilator accessories near these appliances.

Warning Electrical interference may keep your ventilator from working properly, which may create a hazard to the patient.

Note The ventilator is exempt under Section 15.801 (c)(5) of the no interference regulations adopted by the FCC. If television interference does occur, contact Technical Services at Puritan Bennett or a television repair technician for suggestions. Or, move the television to an A.C. electrical outlet that does not allow interference.

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Introduction and Overview LP6 Plus and LP10 User’s Manual

Introduction and Overview

The Puritan Bennett Model LP6 Plus and LP10 Volume Ventilators are intended for use in a non-acute ventilator care environment for pediatrics and adults. They are to be operated in accordance with the product labeling contained in the instruction manuals. The ventilator is a microprocessor-controlled volume ventilator. It provides continuous respiratory support for patients with respiratory insufficiencies in a home or hospital, or during transport. Because of its compact design and light weight, the unit is highly portable. The ventilator offers a wide range of delivery volumes, inspiratory times, and breathing rates. The physician or the respiratory therapist can set the appropriate ventilation parameters via the controls located in the recessed front panel. The magnetically latched door panel and the control knobs are designed to help prevent tampering and accidental resetting.

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Introduction and Overview LP6 Plus and LP10 User’s Manual

Your doctor has prescribed a ventilator. A ventilator’s main purpose is to help you breathe. You need this help because of your medical condition. Before getting into the ventilator’s operation, let’s look at how breathing happens. People don’t give much thought to breathing, because it’s something most of us take for granted. Air contains oxygen. A person cannot live without oxygen. It’s one of the fuels that keeps our bodies going. Oxygen transfers to the blood in the lungs. The blood goes to the heart which then pumps it to all parts of the body. As the blood delivers oxygen to the body’s cells, it picks up and returns carbon dioxide to the lungs. Carbon dioxide transfers to the air in the lungs and leaves the body when a person exhales. People inhale (breathe in) when their diaphragm drops (contracts) and their ribs move out. This motion expands the lungs which then have a negative pressure compared to the surrounding air. As a result, air rushes into the lungs. We call this inspiration. People exhale (breathe out) when they relax their muscles. Their diaphragms move up (relax) and their ribs squeeze in. This motion compresses the lungs and forces out the used air. We call this expiration. We call this whole process RESPIRATION. Every step of the process is important. RESPIRATORY INSUFFICIENCY or FAILURE occurs when a person cannot complete one or more of these steps. A person with respiratory insufficiency or failure may need a ventilator. It makes up for a missing step or steps in the respiration process. Your LP6 Plus or LP10 Volume Ventilator helps you breathe by gently moving air into your lungs. It does this in one of two ways. If you are strong enough to start a breath, the ventilator times its action to your efforts. These are assisted breaths. Depending on its settings, the ventilator may assist some or all of your breaths. But, if you cannot start the breathing process, the ventilator will deliver controlled breaths. Your doctor has prescribed how many times a minute you will receive these controlled breaths. That’s the way the ventilator helps you get the oxygen your body needs. As you exhale after every assisted or controlled breath, you rid your body of carbon dioxide. The pages that follow describe the ventilator in detail. Read all the information carefully. If you don’t understand something, ask your doctor, your caregiver, or a service technician to explain it.

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Introduction and Overview LP6 Plus and LP10 User’s Manual

Patient Ventilator Circuit

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General Description LP6 Plus and LP10 User’s Manual

General Description Patient Ventilator Circuit The Patient Ventilator Circuit has a long flexible hose and several other parts shown in the diagram. It attaches to the ventilator and is your link to the breaths you need. Inspect it every day to: • • • •

Make sure there are no cracks in the hose. Be certain all the connections fit securely to prevent leaks. Clean the Exhalation Manifold daily. Replace parts regularly before they wear out. Regular replacement is essential for successful ventilation. See the instructions that came with your patient ventilator circuit.

A. Flex Tube: Use this tube to connect the Patient Ventilator Circuit to a tube adaptor on your trach tube. The tube’s flexibility makes the circuit more comfortable. B. Exhalation Manifold: The Exhalation Manifold directs the flow of gases to and from the patient. Broadly speaking, this assembly consists of a manifold body, a mushroom valve, and a cap. Refer to the manufacturer’s instructions. Before using it with the patient, secure all connections and ensure the seating of the mushroom valve. During inhalation, the white mushroom inflates and allows air to enter your lung. During exhalation, the mushroom deflates and allows you to expel air from your lungs. Make sure this valve prevents the escape of any gases during inspiration and that it releases properly during exhalation.

Note For your safety, upon start-up, the ventilator dumps the first breath through the exhalation manifold. The unit’s microprocessor requires one cycle to establish its reference point; that is, the operating mode and settings to use. This operation prevents delivery of incorrect volumes that could result in excessive pressure build-up.

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General Description LP6 Plus and LP10 User’s Manual

Warning Ensure the proper connection and operation of the patient venti-

lator circuit daily. The patient could be at risk if the manifold does not function as intended. Connecting patient pressure and exhalation tubes to the incorrect port prevents proper patient ventilation. C. Patient Air Hose: This is the large hose between the Bacteria Filter and the Exhalation Manifold. Re-order part numbers: Reusable Adult Circuit, metal reinforced Y-6267 Reusable Adult Circuit, plastic reinforced Y-6268 Disposable Adult Circuit Y-6463 Disposable Pediatric Circuit Y-6464. Obtain replacement parts from your health care provider. D. Patient Pressure Tube (included with patient air hose): This small tube connects the Patient Pressure port on the ventilator to the Exhalation Manifold. Re-order part number: Tubing, Replacement Pressure Line, 8' lengths Y-6197 Obtain replacement parts from your health care provider. E. Exhalation Tube (included with patient air hose): This small tube connects the Exhalation Valve port to the Exhalation Manifold. Re-order part number: Tubing, Replacement Exhalation Valve, 8' lengths Y-6196 Obtain replacement parts from your health care provider. F. Bacteria Filter: This filter cleans the incoming air before you inhale it. Re-order part numbers: Filter, bacteria L-006197-000 Filter, DAR® Sterivent® 351U5856 Obtain replacement parts from your health care provider. Other accessories are available. When using any accessory, always follow the manufacturer’s recommendations and instructions.

Caution

Adding attachments or other components to the breathing system will increase the inspiratory and expiratory resistance. Page 9

General Description LP6 Plus and LP10 User’s Manual

Warning Certain types of ventilators, including the LP Series, have a Low

Inspiratory Pressure Alarm. The purpose of this alarm is to alert the clinician or caregiver when the pre-set alarm parameters are violated. As set forth in the LP Series Clinician’s and User’s Manuals, a number of environmental factors and circuit accessories/ components can affect the pressure in the breathing circuit. These factors may prevent circuit pressure from violating the low-pressure parameters, even in the event of a circuit being disconnected from the patient. Therefore, it is important for the clinician to consider and monitor these environmental factors when establishing pressure alarm parameters. Depending on the specific clinical situation (e.g., risk of disconnect perceived as high, patient is ventilator dependent) a secondary means of monitoring ventilation (e.g., pulse oximetry) should be considered.

Warnings Some active humidifiers do not have temperature monitoring or

alarm capabilities. Failure to monitor air temperature may allow inspired air to become too hot. Thermal injury to the patient’s airway may result. Always follow the recommendation of the humidifier manufacturer. To ensure the prescribed oxygen concentrations are delivered to the patient, measure the oxygen with a calibrated analyzer. A ventilator patient is highly susceptible to respiratory infections. Dirty or infected equipment may be a source of infection. Clean equipment and proper use of bacteria filters are essential to reduce the chance of infection. Always use a Bacteria Filter to minimize the risk of respiratory infection. Antistatic or electrically conductive hoses or tubing should not be used.

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General Description LP6 Plus and LP10 User’s Manual

Front Panel The Front Panel of the ventilator has three sections: •

The upper section has small lights, two touch button pads, and a meter. • The lower left section has the operating controls. Your doctor prescribes their setting. To prevent accidental resetting, they are behind a closed panel. • The lower right section has the pressure limit controls (LP10 only) and the connections for the Patient Circuit. Upper Section

1. Alarm Lights: When flashing or continuously lit, they identify a condition that demands immediate attention. There is also an audible tone when these lights begin flashing. 2. Alarm Silence/Reset Button: This has five uses. • • • •

Push to test the alarms. Push to silence alarms for 60 seconds. Push to reset the alarm after correcting the problem. Push simultaneously with the Battery Test Button for operating hours. (See the Scheduled Maintenance portion of the manual, page 42.) • Use this button with other controls to start the self-test (see page 34). 3. Power Source Lights: • • •

The top light is green when the ventilator is AC powered. The middle light is amber when an external battery powers the ventilator. The bottom light flashes amber when the ventilator’s internal battery is in use. A single tone also beeps every five minutes. Page 11

General Description LP6 Plus and LP10 User’s Manual

4. Battery Test Button: It has four uses. • When pressed, the Pressure Meter displays the charge status of the battery in use (internal or optional external battery) when the ventilator is disconnected from AC power. • Push simultaneously with the Alarm Silence/Reset button for an indication of operating hours. (See the Scheduled Maintenance portion of this manual, page 42.) • Press the button to print a report from an attached printer. • Use this button with other controls to start the self-test (see page 34). 5. Breathing Effort Light: This light turns green whenever the ventilator senses your effort to breathe. The Breathing Effort control sets the sensitivity. 6. Patient Pressure Meter: The meter displays three pieces of information: • Pressure at the Exhalation Manifold. • The number of hours of ventilator operation. • The charge status of the internal or attached external battery. Lower Left Section

1. Control Panel Door: This door is latched magnetically to protect the controls from accidental resetting. 2. Alarm Reference Guide: Consult this guide for a summary of alarms and the action you should take. You will find the Guide on the inside of the Control Panel Door. 3. Control Knobs: They are behind the closed Control Panel Door. Your doctor prescribes the settings for these controls. See page 25 for details. Page 12

General Description LP6 Plus and LP10 User’s Manual

Lower Right Section

1. Patient Air Tube: The Patient air hose connects to this tube. The ventilator delivers air through this tube. 2. Exhalation Valve Port: The Exhalation Pressure Tube of the Patient Circuit connects to this port. 3. Patient Pressure Port: The Patient Pressure Tube of the Patient Circuit connects to this port. 4. Pressure Limit Control (LP10 Only): This control sets the air pressure limit during a breath. For use in Assist/Control or SIMV modes only; use in other modes may not allow effective ventilation.

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General Description LP6 Plus and LP10 User’s Manual

Rear Panel Vent

AC Plug Holder

Carrying Handle Recess

External 12 Volt DC Battery Connector

10

9

8

6

Mounting Rails

Remote Alarm Connector

7

DC Circuit Breaker

12

14

Communication Port

4 Inlet Filter

5

1

Serial Number Plate

11 Pressure Relief

2

13

3

Cord Wrap Rear Feet

Voltage Select Switch

AC Power Switch

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General Description LP6 Plus and LP10 User’s Manual

1. Inlet Filter: The ventilator draws in air through this filter.

Warning Do not block the inlet filter port. (Keep away from curtains.)

Note

2. Cord Wrap and Rear Feet: There is a foot at each corner. 3. AC Power Switch/Circuit Breaker: This is the ON/OFF switch for AC power. It also has a built-in circuit breaker. 1 is power connected to mains and 0 is power disconnected from mains. 4. Communications Port: A special cable fits here and leads to an optional printer. The ventilator and printer should be turned off before connection or disconnection of the printer. 5. Serial Number Plate: This has Puritan Bennett’s identification number for the ventilator. It also lists the unit’s power requirements. 6. External 12 Volt DC Battery Connector: This is where you plug in an external battery cable. 7. Remote Alarm Connection: A remote alarm (optional) can summon the caregiver when an alarm sounds. 8. Rear Carrying Handle Recess 9. AC Plug Holder 10. Vent: Warm air from the unit’s circuitry leaves the ventilator and cool air enters through this vent. This cools the ventilator.

Warning Do not block rear panel vent 11. Pressure Relief: This prevents the air pressure from exceeding approximately 100 cmH2O/hPa.

Warning Do not block the pressure relief valve. 12. DC Circuit Breaker: This circuit breaker protects the ventilator when it is powered by an external battery.

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Installation LP6 Plus and LP10 User’s Manual

13. Voltage Select Switch: This switch selects 110 or 220 volts when it is powered by an external battery

Caution An incorrect switch setting may damage your ventilator. 14. Mounting Rails: These are used to mount and connect accessories to the ventilator.

Installation Mounting or Positioning Position the ventilator on a table or nightstand within six feet of an electrical outlet. Keep the rear panel free of draperies or other items that could impede the air flow to the Inlet Filter port. Protect the ventilator from accidental liquid spills. Never place food or liquids on top of the ventilator. When used in a humid environment, and when cleaning: •

Take precautions to protect the setting switches.

•

Keep the front panel door closed.

•

Avoid spilling or allowing liquid to enter the unit.

Allow for the space requirements of additional equipment, e.g., humidification and supplemental oxygen. When in use, keep active humidifiers or the patient circuit at an elevation lower than the patient’s trachea. Moreover, keep the humidifier and the circuit lower than the ventilator’s Patient Air tube to prevent moisture from entering the ventilator.

Warning Never allow liquids to contact internal ventilator components under any circumstances. Moisture will damage the ventilator.

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