Operation

Operation
Updated 28 March 2020
This page describes the operation of the MIT E-Vent Units 002. (Three units of the
same design exist.) This is our best attempt to provide a minimally viable control
system with wide applicability globally. Groups may want to add additional layers of
safeties. This is just a guide.
Note: While the mechanical hardware design is changing rapidly and some of the
underlying electronics are being upgraded for prototype purposes. the operating
principles are relatively design frozen.
Figure 1. The two main components: the control box and the ventilator at a testing
facility.
Scenario
The system will initially be setup by a clinician explicitly skilled in respiratory
management. The parameters must be tuned and the patient monitored carefully.
Once stable, they can be left in the care of a clinician not skilled in respiratory
management. In the case of any change in patient condition or an alarm, the system
must again be tuned by a skilled clinician. In the case of any serious concern, the
bag can be manually removed from the machine and squeezed by hand until the
fault is addressed.
Figure 2. Control the ventilator and read pressure information from the top of the
control box.
Figure 3. There are 6 pieces of information displayed on the LCD screen which
update after each breath cycle. Alarm messages will display on the top bar.
Figure 4. Ensure that all wires are connected and that the power switch is in the off
position.
Figure 5. The ventilator fingers in ward motion controls the inflation and deflation of
the bag. The clear sheets on either side of the fingers are for mounting the bag.
These are replaced with adjustable metal mounts.
Figure 6. Correct bag placement is centered between the fingers vertically and
axially. Confirm placement by manually moving driving the fingers to lightly touch the
bag. Supports should be adjusted vertically and laterally to support the bag in this
operating position.
Operation
1. Gently open the fingers by hand if not already open. This takes some force,
but it is safe.
2. Position the Ambu Bag in the cradle between the fingers, following the
directions given in Figure 6.
3. Ensure that all dials shown in Figure 2 are turned counter clockwise to the
lowest position.
4. Check that nothing is in the way of the fingers.
5. Power up the system. The system will start moving immediately and home to
the fully open position. Then it will slowly move to the edge of the bag. (This
position is hard coded; it could be settable in a more sophisticated version.)
6. Set the desired Respiratory Rate, Tidal Volume and I:E knobs, as shown in
Figure 2, and confirm the values on the display, shown in Figure 3. Press
the Set button to apply.
7. Increase the Tidal Volume to a low setting (as determined by clinician) and
press the Set button to apply. The system will start pumping. Confirm correct
operation.
8. Once the machine is confirmed pumping, connect to patient and increase
the Tidal Volume to the desired larger value and press the Set button.
9. Monitor the peak and plateau pressures and adjust parameters as per clinical
guidance. PEEP pressure should be observed to match the setting on the
PEEP valve.
10. Do not leave the patient unattended.
11. Monitor vital signs, listen for alarms and respond.
12. If Assist Control mode is desired, increase the Threshold knob and press
the Set button to apply. This will increase the setpoint with respect to the
PEEP.
13. Respiratory Rate should beset to less than the expected patient respiratory
rate, i.e. the machine waits longer than the patient would.
Note: Spinning potentiometers (POTs) will cause the display valued to change, but
will not change machine behavior until the Set button is pressed. If the Set button is
not pressed within 5 seconds to apply the new settings system will alarm.
Caution: If a POT is changed, but Set is not pressed, a potentially confusing

situation will arise whereby the machine is different from knob settings. Potential
solutions better than the alarm include: 1. Shielding the potentiometers to prevent
accidental turning. 2. Using a potentiometer that must be pulled out to set. 3. A
rotary encoder with a pushbutton; this will allow the button to be activated, set and
deactivated. More sophisticated hardware and software solutions can be
implemented.
Alarms
In the case of an alarm, the system should attempt to maintain operation. The
Silence button will pause the alarm for 1 minute. Alarm conditions are checked for
once per cycle.
Caution: Not all of these alarms are fully implemented. The logic is still being
developed. This is not an exhaustive lists of failure conditions.
Alert Condition detected Response

Whenever the patient fails to trigger Clinician adjusts respiratory parameters as
ASSIST A
inhalation the alarm sounds for 1 s per clinical guidance
Machine maintains settings
Potentiometer has been moved but
NOT SET Pressing Set button sets values and clears
change was not confirmed
alarm
LOW Pressure lower than expected (how Machine maintains operation Clinician
PRESSURE to define this is an open question) corrects situation; alarm will clear
HIGH Pressure reached 40 cm H O (pop off Machine maintains operation Clinician
2
PRESSURE will activate) corrects situation; alarm will clear

Arms do not follow commanded
Home for ~3 seconds: re-initiate operation If
POSITION position and velocity; probable
condition corrected alarm clears If not
ERROR mechanical interference of encoder
corrected, convert to manual bagging
fault
Motor drew excessive current or
controller overheats; probable Clinician corrects situation; alarm will clear If
ELECTRICAL
mechanical interference or electrical not corrected, convert to manual bagging
fault
The homing switch was not touched
HOMING
during homing or touched during Clinician corrects situation; restart
FAULT
operation

Operation

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Operation

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Operation

Updated 28 March 2020

Caution: If a POT is changed, but Set is not pressed, a potentially confusing

Alert Condition detected Response

PRESSURE will activate) corrects situation; alarm will clear

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