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    Evita XL: Initial Start Up

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    The document provides information on operating the Evita XL ventilator, including: 1) Initial startup instructions and selecting the patient type. 2) Descriptions of the different ventilation modes - BIPAP, SIMV AutoFlow, CPAP/ASB, APRV, and BIPAP Assist. 3) Explanations of the hard key controls and options under ventilator settings, sensor parameters, and system setup.

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    Evita XL: Initial Start Up

    Uploaded by

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    45 views4 pages
    The document provides information on operating the Evita XL ventilator, including: 1) Initial startup instructions and selecting the patient type. 2) Descriptions of the different ventilation modes - BIPAP, SIMV AutoFlow, CPAP/ASB, APRV, and BIPAP Assist. 3) Explanations of the hard key controls and options under ventilator settings, sensor parameters, and system setup.

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    Evita_XL

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    The document provides information on operating the Evita XL ventilator, including: 1) Initial startup instructions and selecting the patient type. 2) Descriptions of the different ventilation modes - BIPAP, SIMV AutoFlow, CPAP/ASB, APRV, and BIPAP Assist. 3) Explanations of the hard key controls and options under ventilator settings, sensor parameters, and system setup.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    45 views4 pages

    Evita XL: Initial Start Up

    Uploaded by

    scribdbazo
    The document provides information on operating the Evita XL ventilator, including: 1) Initial startup instructions and selecting the patient type. 2) Descriptions of the different ventilation modes - BIPAP, SIMV AutoFlow, CPAP/ASB, APRV, and BIPAP Assist. 3) Explanations of the hard key controls and options under ventilator settings, sensor parameters, and system setup.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 4

    Evita XL

    Evita XL
    Initial Start Up
    After ventilator has completed a self test, put the machine into Standby.
    Select Standby on the touch screen and confirm by pressing the rotary dial
    The alarm will continue to alarm until you press ‘Alarm Reset’ on the top of the touch screen this also
    must then be confirmed by pressing the rotary dial.

    Patient Selection: The Evita XL’s are set up to start in Adult patient category to change the category
    select ‘New Patient’ on the touch screen and confirm by pressing the rotary dial
    Now you can select any patient type. Adult, Pediatric, and Neonate then confirm selection by pressing
    the rotary dial

    Set up Ventilator with Mode and parameter settings. Once completed ventilation can be started by
    selecting ‘Start’ on the touch screen then confirm selection by pressing the rotary dial

    Using NeoFlow Sensor


    The neo. Flowsensor can be used in both Neonatal and Pediatric patient categories. It is recommended
    not to be used on patients more than 10kgs due to the sensitivity (increased risk of ‘auto cycling’) and
    the restriction it will cause when using larger volumes and pressures.

    Calibration: Select NeoFlow Sensor (touch screen)


    Press Start
    Follow instructions on screen top left

    Deactivating NeoFlow Sensor: Select NeoFlow Sensor (touch screen)


    Press OFF then confirm by pressing rotary dial

    Modes of Ventilation

    BIPAP (Biphasic Intermittent Positive Airway Pressure)


    Is synchronised Pressure Control Ventilation. The machine allows the patient to spontaneously breath
    at anytime in the breath cycle. This is achieved by giving more flow or opening up the exhalation
    valve, which ever is needed to maintain the set Inspiratory Pressure and PEEP. ASB (pressure support)
    can also be added to assist patient’s efforts during the expiratory phase.
    Please Note: * When setting an ASB pressure it is set above PEEP. (eg ASB 5 cmH2O with
    PEEP of 5 patient’s total pressure is 10)

    SIMV AutoFlow
    Is synchronised Volume Ventilation. Autoflow helps to reduce Peak Airway Pressures that are caused
    by a fixed set flowrate. The flowrate automatically adjusts to deliver the set tidal volume using the
    least amount of pressure. Any spontaneous breaths above the set Respiratory Rate can be pressure
    supported with set ASB (pressure support).

    CPAP/ASB (Assisted Spontaneous Breathing)


    Is CPAP/Pressure Supported Ventilation. If there is no ASB set then CPAP mode. If ASB is set, then
    when the patient triggers the ventilator the breath is supported. The patient determines there own
    breath rate and inspiratory time.
    Please Note: * When setting an ASB pressure it is set above PEEP. (eg ASB 5 with PEEP of 5
    patient’s total pressure is 10)
    * In Neonate Ventilation, if ASB Mode is selected then a Inspiratory Time is set.
    This is a maximum you will allow the ventilator to be in inspiration. Adult maximum is 4
    seconds and Pediatric is 1.5 seconds. These are non-adjustable.

    Ventilator Handouts 2nd July 2007 Revision 1 Page 1 of 4


    Lisa Martin RRT Head of ITU Support, Biomedical Engineering Department
    Great Ormond Street Hospital for Children NHS Trust
    Evita XL

    APRV (Airway Pressure Release Ventilation)


    Is pressure ventilation using inverse I:E ratio. You set long periods of high pressure with short periods
    of low pressure. The patient can spontaneously breath at anytime during the cycle. The inspiratory and
    expiratory pressure remains constant by adding flow or opening the exhalation valve. The concept
    behind the short period to drop to a low pressure is to help with C02 removal.

    BIPAP Assist
    Is synchronised Pressure Control Ventilation. If the patient triggers above the set breath rate, then
    every triggered breath is delivered with the same settings as the mandatory breath.

    Hard Key Controls

    Alarm Silence Can silence an alarm for 2 minutes

    Alarm Limits Access to setting alarms


    MV (Minute Ventilation) High MV 0.1 – 41 L/min
    Low MV 0.01 – 40 L/min
    Paw (Peak Airway Pressure) 10 – 100 mbar will discontinue inspiration and
    exhalation valve will open for exhalation
    VTi (Inspiratory Tidal Volume) .004 – 4 L will limit the volume being taken or
    delivered
    fspn (spontaneous frequency) 5 – 120 bpm Monitors spontaneous breaths only
    TApnoea (Apnea Time) 5 – 60 seconds if reached ventilator will switch over to
    apnea ventilation
    etC02 (End tidal C02) High etC02 0.1 – 15 kPa
    Low etC02 0 – 14.9 kPa

    Ventilator Settings Access to Ventilator Modes and Parameter settings


    Ventilation parameters: (depending on mode selected)
    Basic Settings:
    02 Oxygen % delivered
    Tinsp (Inspiratory Time) seconds
    f (frequency) set breath rate
    Ramp (Pressure rise time) seconds - how quickly set Pinsp. or PASB is reached
    Pinsp (Inspiratory Pressure) mbar
    PEEP (Positive End Expiratory Pressure) mbar
    ∆PASB (Assisted Spontaneous Breathing Pressure) mbar - this is
    pressure support and must be added to the PEEP value for a total pressure
    reading.
    VT (tidal volume) litres
    THIGH (Time at high pressure setting) seconds
    TLOW (Time at low pressure setting) seconds
    PHIGH (High Pressure) mbar
    PLOW (Low Pressure) mbar
    Extra Settings:
    ATC Automatic Tube Compensation
    Based on % of compensation and tube size the ventilator does a
    mathematical calculation to determine airway pressure at the tracheal level

    Apnea Ventilation
    Neonatal patient category: set frequency and pressure
    Adult and paediatric patient category: set frequency and tidal volume
    *Please Note: Once ventilator has switched to Apnea Ventilation, it will
    remain in Apnea Ventilation until you are able to ‘Alarm Reset’.

    Ventilator Handouts 2nd July 2007 Revision 1 Page 2 of 4


    Lisa Martin RRT Head of ITU Support, Biomedical Engineering Department
    Great Ormond Street Hospital for Children NHS Trust
    Evita XL

    Flow Trigger Sensitivity


    Adjusted 0.3 - 15L/min

    Sensor Parameter
    Flow Manual Calibration of flow sensor
    Automatically done once everyday
    Flow sensor measuring capabilities can be switched off if required

    02 Manual calibration of 02 cell


    Automatically done once everyday
    Oxygen sensor measuring capabilities can be switched off if required

    C02 For calibrating C02 when etC02 is monitored via the ventilator
    End tidal measuring capabilities can be switched off if required

    NeoFlow
    For calibrating NeoFlow sensor when it is used (ideally only used on
    patients ≤ 10 kgs)
    When selected follow instruction at the top left of the screen
    NeoFlow sensor measuring capabilities can be switched off if required

    System Setup Allows access to the Evita XL configuration


    All the Evita XL’s are configured the same
    It also provides access to the service menu when repairs are made

    Start/Standby
    Provides access to standby if ventilator is ventilating
    From Standby provides access to:
    New Patient Selection of patient category (Neonatal, paediatric, or Adult)
    Tube/Mask Selection of non-invasive ventilation via the mask option
    Humidifier Selection for HME when used to humidify
    Check Pre-use checks carried out prior to release of ventilator for patient
    use (These checks are done by the ventilator technicians)

    Right hand on screen Controls

    Main If ventilating brings user to the screen which displays selected waveforms, mode of
    ventilation, set parameters and selected measured parameters

    If in standby it brings the user to the main standby screen which has access to new patient,
    tube/mask, humidifier, and check

    Data
    Values
    Customised Table Displays measured values in the order they appear on
    carevue and also displays current mode and settings
    Table 1 and Table 2 Displays measured values in Drager configuration and
    also displays current mode and settings

    Logbook Records all alarms and changes made to ventilator and


    also displays current mode and settings

    Trend Displays selected parameter trends

    Ventilator Handouts 2nd July 2007 Revision 1 Page 3 of 4


    Lisa Martin RRT Head of ITU Support, Biomedical Engineering Department
    Great Ormond Street Hospital for Children NHS Trust
    Evita XL

    Special procedure
    Additional Function
    Inspiration Hold Can be held for a maximum of 15 seconds
    Insp. Hold key can be used as a manual breath button in
    all modes except CPAP without ∆PASB. If used to activate
    a breath, the ventilation will be delivered with the current
    ventilation parameters.

    Expiration Hold Can be held for a maximum of 15 seconds

    Nebuliser This key will activate the nebuliser to function during the
    inspiratory phase only.

    Suction procedure *Adult patient category- increases 02 to 100% for 3


    minutes
    *Pediatric and Neonate patient category – increases 02 by
    25% of set Fi02 for 3 minutes
    The ventilator waits for a disconnection. Once there is a
    disconnection then upon reconnection the ventilator
    continues for 2 minutes of increased oxygen.
    *Please note: If < 4 mbar of PEEP is set then the
    ventilator automatically applies 4 mbar when 02 ↑
    Suction Key is depressed.

    Diagnostics
    P 0.1 Can be an indicator of neuro-muscular breathing drive

    PEEPi (intrinsic PEEP) Can measure pressure trapped in the


    lungs (eg. Air trapping, hyper-inflation)

    NIF (Negative Inspiratory Force) Measures patient’s maximum


    inspiratory effort which can be used as an indicator for
    weaning and/or extubation

    NewFlow sensor (See Sensor Parameters)

    Flow sensor (See Sensor Parameters)

    O2 Suction (See Special Procedure – Additional Function)

    Insp. Hold (See Special Procedure – Additional Function)

    Ventilator Handouts 2nd July 2007 Revision 1 Page 4 of 4


    Lisa Martin RRT Head of ITU Support, Biomedical Engineering Department
    Great Ormond Street Hospital for Children NHS Trust

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