Covidien 840 User manual

“GETTING OVER ONE MORE HURDLE”
NEONATAL SOFTWARE AND SCREEN CHANGES
e NeoMode soware has enabled the use of the Puritan Bennett™ 840 ventilator
on neonates and adults, providing a more consistent approach to mechanical
ventilation for respiratory departments. More important, this also allows the latest
technology to be used to ventilate neonatal patients.
e following steps serve as a set-up guide for neonatal patients.
Step 1
Determine which circuit and expiratory lter to use
Circuit Size Patient Size Expiratory Filter to Use
Neonate 0.3 to 7.0 kg Specialized green disposable filter with
reusable mounting plate
Pediatric 7.0 to 24 kg Normal full-size expiratory filter
Adult 25 kg and higher Normal full-size expiratory filter
Step 2
Turn on the unit; let it warm up for 10 minutes
If the ventilator has not reached normal operating temperatures from recent use,
allow it to warm up for at least 10 minutes before running SST to ensure accurate
testing (per ventilator operator’s manual). Because you can ventilate down to 5 ml of
volume, make sure delivered volumes/ows are accurate. is only applies to a cold
start and not when you are just changing tubing on a patient when the machine has
already been running. You don’t have to have the machine cycling; just “on.”
The Puritan Bennett™
840 Neonatal/Pediatric Ventilator
Set-Up Guide

Step 3
Complete the SST (the following is specic to neonates)
When you start the SST, make sure you change the “circuit type” to pediatric or neo-
nate (neonate conguration shown, #2 [part # 4-076408-00], #4 [part # 4-076405-00]).
Step 4
Select “new patient”
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screen where you enter ideal body weight.
 
ow trigger.”
Input IBW followed by initial ventilation parameters (following are an example of
common starting points, which will vary based on patient condition/needs).
1
2
4
3

Pressure Control Settings (example of settings)
I.T. 0.30 to 0.40 Seconds, Rate 20-40, Inspiratory Pressure 16, and PEEP 4 cm
Flow Sensitivity – 0.3 to 0.5 L/min (default is 0.5 L/min)
Rise Time % – default of 50%
Expiratory Sensitivity – default of 25% (Pressure Support Termination)
Pressure Support – Some clinicians add Pressure Support to overcome the work
imposed by the artificial airway.
Note: Inspiratory pressure is about PEEP, so when you set an inspiratory pressure
of 20 and a PEEP of 4, you start on a PEEP of 4 cm and go up another 20 cm to a
total of 24 cm of peak pressure on the Puritan Bennett™ 840 ventilator. Other ven-
tilators, like the Sechrist™* and Infant Star®*, with the same settings of 20/4 would
stop at 20 cm total.
Other Tips to Remember
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ventilation alarm can be turned o only in the neonatal mode to prevent nuisance
alarms.
 
humidity approach; the graphics are not.
 
values with the same circuit you may have available (i.e., pediatric circuit for pa-
tients at 6 kg). Weight of the circuit plays a rule as you overlap the recommended

Verify the Ventilator was Tested with the Correct Circuit
In the top le-hand side of the upper screen you will see what type of circuit was
used in the SST.

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are trademarks of a Covidien company. ™* and ®* are trademarks of their
respective owners. ©2011 Covidien. All rights reserved. 11-VE-0261
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-- 
Practice Initial Settings
Points to Remember
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auto triggering you will need to increase the ow sensitivity.
 -
tion you may get an “inspiration too long” alarm. If you see this, increase the ESENS
from 25% until it stops; check graphics for ne-tuning.