Dräger EVITA XL User manual

Pocket Guide
Evita XL
Software version 7.n
The Evita XL Pocket Guide is not a replacement or
substitute for the Instructions for Use.
Any use of the device requires full understanding and
strict observation of the Instructions for Use.
The user must be familiar with the device according to
the national and local laws and recommendations.
There will be no exchange of the Pocket Guide when
the product is updated/upgraded.

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2Pocket Guide Evita XL

Pocket Guide Evita XL 3
Contents
Contents
System Overview. . . . . . . . . . . . . . . . . . . . . . . . . 5
Control panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Front connections . . . . . . . . . . . . . . . . . . . . . . . . . 6
Back panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Trolley . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Preparation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
How to start the Evita XL . . . . . . . . . . . . . . . . . . . . 9
Connecting to the power supply . . . . . . . . . . . . . . 9
Connecting to the gas supply . . . . . . . . . . . . . . . . 9
Installing expiratory valve, flow sensor . . . . . . . . . 10
Connecting the breathing circuit . . . . . . . . . . . . . . 10
Switching on Evita XL . . . . . . . . . . . . . . . . . . . . . . 11
Activating Standby mode . . . . . . . . . . . . . . . . . . . . 11
Entering the humidification type . . . . . . . . . . . . . . 12
Check readiness for operation. . . . . . . . . . . . . . . . 12
Operating Concept . . . . . . . . . . . . . . . . . . . . . . . 14
Control panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Main screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Dialog windows and therapy controls . . . . . . . . . . 15
Controls and color scheme . . . . . . . . . . . . . . . . . . 15
Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Selecting the patient . . . . . . . . . . . . . . . . . . . . . . . 17
Starting ventilation . . . . . . . . . . . . . . . . . . . . . . . . . 18
Setting the ventilation mode . . . . . . . . . . . . . . . . . 18
Setting the ventilation parameters . . . . . . . . . . . . . 19
Bronchial suctioning . . . . . . . . . . . . . . . . . . . . . . . 20
NIV – non-invasive ventilation
(SW 6.12 or higher) . . . . . . . . . . . . . . . . . . . . . . . . 21
Standby mode (SW 6.12 or higher) . . . . . . . . . . . . 22
Switching off Evita XL . . . . . . . . . . . . . . . . . . . . . . 23
Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
On-screen alarm messages . . . . . . . . . . . . . . . . . 24
Displaying alarm information . . . . . . . . . . . . . . . . . 25
Setting alarm limits . . . . . . . . . . . . . . . . . . . . . . . . 26
Alarm messages . . . . . . . . . . . . . . . . . . . . . . . . . 27
Waveforms and logbook . . . . . . . . . . . . . . . . . . . 32
Displaying waveforms . . . . . . . . . . . . . . . . . . . . . . 32
Displaying the logbook . . . . . . . . . . . . . . . . . . . . . 32
Sensor calibration . . . . . . . . . . . . . . . . . . . . . . . . 33
Flow sensor calibration . . . . . . . . . . . . . . . . . . . . . 33
O2sensor calibration . . . . . . . . . . . . . . . . . . . . . . . 33
Cleaning and disinfection . . . . . . . . . . . . . . . . . . 34
Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

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4Pocket Guide Evita XL

Pocket Guide Evita XL 5
System Overview
System Overview
Control panel
ATouch-sensitive screen
BAudio paused 2 min. key for suppressing the
alarm tone for two minutes
CAlarm Limits key for setting alarm limits
DVentilator Settings key for setting ventilation
mode and ventilation parameters
EUnassigned key for future functions
FSensor Parameter key for calibrating sensors
and for switching monitoring on or off
GSystem Setup key for configuring device func-
tions
HStart/Standby key for switching between ope-
ration and Standby mode
IRotary knob for selecting and confirming settings
NOTE
The Evita XL Pocket Guide is not a replacement or substitute for the Instructions for Use.
Any use of the device requires full understanding and strict observation of the Instructions for Use.
002
A
B
C
D
E
F
G
H
I
1
2
3

6Pocket Guide Evita XL
System Overview
Front connections
AGas exhaust port
(EXHAUST – NOT FOR SPIROMETERS)
BFlow sensor
CFlow sensor flap (thermal cover)
DExpiratory valve with expiratory connector port
(GAS RETURN)
ELatch for expiratory valve
FNebulizer connection
GInspiratory connector port
(GAS OUTPUT)
HLocking screw for protective cover
(behind it: O2sensor)
003
HGFEDCBA

Pocket Guide Evita XL 7
System Overview
Back panel
APower switch with protective cover
BCOM 2, COM 3 ports for RS 232, 2 CAN interfaces,
and analog interface (optional)
CConnection for nurse call (optional)
DConnection for Remote Pad (optional)
ELAN connection for web application server of
SmartCare
FCooling-air filter
GOption overview plate (not visible) on the right-hand
side panel
HConnection for neonatal flow sensor (optional)
IILV socket for the connecting cable for independent
lung ventilation with two ventilators
JConnection for oxygen (O2)
KConnection for medical compressed air (AIR)
LTemp socket for temperature sensor (optional)
MCO2socket for CO2sensor (optional)
NCOM 1 RS 232C port for RS 232 interface, e. g., for
monitoring system
OAC fuses
PConnector for power cable (AC)
QDC socket
RCooling fan
004
ABC D F
H
I
JKLMN
O
P
Q
R
G
E
V
.

8Pocket Guide Evita XL
System Overview
Trolley
AEvita XL
BHandle
CTrolley column
DHose hook, 2x
EHumidifier holder (optional)
FUniversal bracket with standard rail (optional)
GDual castors with locking brakes, 4x
005
A
C
D
E
F
G
B
D

Pocket Guide Evita XL 9
Preparation
Preparation
How to start the Evita XL
Preparing the Evita XL
– Connect the power supply
– Connect the gas supply (Air + O2)
– Install expiratory valve, flow sensor
– Connect the breathing circuit
– Switch on Evita XL
– Activate Standby mode
– Enter the humidification type
Checking readiness for operation
– Perform the Device Check
– Perform the Airtight Check
– Test the DC power pack (batteries)
Selecting patient and therapy settings
– Select the patient
– Set the ventilation parameters
– Set the alarm limits
Starting ventilation
– Touch start button in the Start/Standby dialog win-
dow
Connecting to the power supply
The mains voltage must correspond to the voltage ran-
ge indicated on the rating plate.
zInsert plug into the mains power socket.
For operation with DC power pack and external battery
(DC power pack option):
zConnect optional external battery with cable.
Connecting to the gas supply
1Screw on the compressed air hose (A) to the Air inlet
connector and the compressed O2gas hose (B) to
the O2inlet connector on the back panel of Evita XL.
2Connect the plugs to the central gas supply wall ter-
minal units.
NOTE
The Evita XL Pocket Guide is not a replacement or substitute for the Instructions for Use.
Any use of the device requires full understanding and strict observation of the Instructions for Use.
Either: 220 V to 240 V
or: 100 V to 127 V
006
Air O2
AB

10 Pocket Guide Evita XL
Preparation
Installing expiratory valve, flow
sensor
Installing the expiratory valve
1Press down the segments on the right and left and
tilt the control panel (A) upwards.
2Push expiratory valve (B) into the mount until it
clicks into position. Check that it is properly engaged
by gently pulling on the port.
Mounting the flow sensor
1Push connector socket (A) all the way to the left.
2Place flow sensor (B) into its mount – with the con-
nector facing towards the device – and push into the
socket, as far as it will go.
3Push flow sensor to the right and into the rubber lip
seal of the expiratory valve, as far as it will go.
Connecting the breathing circuit
1Attach hinged arm (A) to the rail on the left-hand
side of the ventilator and tighten screws.
2Connect breathing hoses of appropriate lengths to
the ports (B). Observe the required hose lengths (in-
dicated in meters).
3Install water traps (C) in vertical position.
4Connect Y-piece (D), with the rubber sleeve of the
Y-piece on the inspiratory side.
5Insert the Y-piece in the opening of the hinged arm
(E).
6Connect test lung.
007008009
A
B
A
B
501
0.6m
0.6m
0.4m
1.1m
D
Evita XL
A
B
B
C
D
E

Pocket Guide Evita XL 11
Preparation
Switching on Evita XL
1Press On/Off switch (A) until it engages.
The protective cover pivots down over the On/Off switch
to protect against inadvertent switching off.
The Selftest screen with version no., date, and part no.
of the software is now displayed.
The Selftest is performed automatically.
2Wait for this test to be completed.
Evita XL then displays the "Start" screen.
Evita XL will start ventilation with the pre-configured set-
tings unless values are changed or Standby mode is ac-
tivated within 30 seconds.
Activating Standby mode
1Touch Standby button within 30 seconds and press
rotary knob to confirm.
The alarm message Standby activated !!! is displayed
in the header bar.
To acknowledge this message:
2Touch Alarm Reset button to the right of the mes-
sage and press rotary knob to confirm.
Evita XL is in Standby mode:
Standby is displayed in the header bar of the screen
(A). Standby is displayed on the screen (B)
010
A
029
A
B

12 Pocket Guide Evita XL
Preparation
Entering the humidification type
1Touch the Humidifier tab (A).
Evita XL offers the following selections:
2Touch button corresponding to the type of humidifi-
cation used. The button turns yellow.
3Press rotary knob to confirm. The button turns
green.
Selecting the humidification type is only possible in
Standby mode.
Check readiness for operation
Performing the Device Check
The Device Check can only be performed in Standby
mode.
1Touch the Check tab (A).
Evita XL displays the date and result (B) of the last De-
vice Check and Airtight Check.
2Touch the Device Check tab (C).
Evita XL displays a list of the individual checks (D). The
scope of this list depends on the options available on
the ventilator.
No Device Check is possible while the ventilator is per-
forming an automatic calibration of the flow sensor or O2
sensor.
zIn this case, wait until calibration is complete and re-
start Device Check.
011
Active Humid. (B)= Active breathing gas
humidifier
HME/ Filter (C) = Heat and Moisture Exchanger
A
BC
012013
A
B
C
E
D

Pocket Guide Evita XL 13
Preparation
Starting the Device Check
1Touch the Check button (E).
Evita XL performs the following test steps:
System
– Fit and functionality of expiratory valve
– Fit of flow sensor
– Fit of neonatal flow sensor (optional)
– Type of humidification
– Completeness of breathing circuit
– Fit of temperature sensor (optional)
Function
– Test of the Air/O2switchover valve
– Test of the safety valve
– Gas supply
– Test of the back-up alarm (power failure alarm)
Sensors
– Calibration of the flow sensor
– Calibration of the neonatal flow sensor (optional)
– Calibration of the O2sensor
– Zero calibration of the CO2sensor (optional)
– Position of the CO2sensor (optional)
Device Check procedure
Evita XL guides the operator through each test step in a
question-and-answer dialog format. Questions are dis-
played in the information field in the header bar and
must be answered by touching the Yes or No buttons.
The instructions for performing the test steps are dis-
played.
Evita XL indicates a correct result with a checkmark
( ). Faulty results are marked with F.
Two dashes (- -) appear if a test step is not performed.
In the event of faulty results F:
1Eliminate the cause of the problem.
2Touch the Repeat button.
Test steps may be skipped by touching the Next test
button if this is acceptable.
Performing the Airtight Check
The Airtight Check must be performed after the follo-
wing actions:
– Device Check
– Change of the breathing circuit
– Change of breathing gas humidification
The Airtight Check can only be performed in Standby
mode.
Prerequisite: The Start / Standby dialog window must
be open.
1Touch the Check tab (A).
2Touch the Airtight Check tab (B).
3Touch the Check button (C)
Testing the DC power pack (batteries)
Changeover test to battery operation
1Pull out the power plug.
If the DC power pack is available, Evita XL switches
over to internal or external battery mode and does not
interrupt operation.
If the DC power pack is not available, the audible power
failure alarm is triggered.
2Plug in the power plug again.
The device switches to mains operation.
After successful checking of readiness for operati-
on, Evita XL is ready for use.
014
A
B
C

14 Pocket Guide Evita XL
Operating Concept
Operating Concept
Control panel
The control panel is characterized by a 15" touch
screen, its clear layout and easy operation.
Its main elements are:
ALarge screen with all the information and controls
needed for ventilation.
BFixed function keys beside the screen - for rapid ac-
cess to major functions.
CRotary knob for selecting and confirming settings on
the screen.
Main screen
AHeader bar with the following fields:
– Alarms, messages, and instructions for the ope-
rator
– Therapy status: Therapy type (ventilation or O2
Therapy), ventilation mode, and additional set-
tings
– Patient category
BMain menu bar with buttons for opening dialog win-
dows and activating functions
CPower supply display
DField for device status with type of humidification
ETherapy bar with therapy controls for the ventilation
parameters of the active ventilation mode and its ad-
ditional settings
FMonitoring area with waveforms, loops, trends, and
measured values
NOTE
TheEvita XL Pocket Guide is not a replacement or substitute for the Instructions for Use.
Any use of the device requires full understanding and strict observation of the Instructions for Use.
002
B
C
A
015
A
FB
CDE

Pocket Guide Evita XL 15
Operating Concept
Main menu bar
The main menu bar contains fixed and freely configu-
rable buttons. Touching a button opens the correspon-
ding dialog window or activates the corresponding
function.
Fixed buttons
, , for selecting a different set of measured
values in the field for measured values.
Main for selecting the main screen.
Data ... for displaying all measured values, the logbook,
or trends on an additional card.
Special Procedure ... for selecting additional functions,
e. g., medication nebulization or oxygenation for bron-
chial suctioning.
Dialog windows and therapy
controls
Dialog windows
Dialog windows consist of one or several pages which
are displayed by touching the corresponding horizontal
or vertical tab. Dialog windows contain elements for
operating the device and inform the operator of current
settings. Dialog windows can be opened by pressing a
key or by touching a button in the main menu bar.
ADialog window title
BButton for accessing additional information (if appli-
cable)
CButton for closing the dialog window
DTab – touch the relevant tab to open a page
ESetting assistance field
Therapy bar
The therapy bar on the main screen contains the thera-
py controls for the active ventilation mode.
ATherapy controls
Therapy controls
The therapy controls are used to set the ventilation pa-
rameters.
Therapy controls are contained in the therapy bar of the
active ventilation mode and in the dialog window for
specifying the ventilation settings.
ATherapy controls
Controls and color scheme
The following controls are available to the operator:
– Tabs
– Therapy controls
– Buttons
The touch-sensitive screen controls are used in a simi-
lar way as real keys and rotary knobs:
– Touching these controls with a fingertip is equivalent
to pressing a key or taking hold of a knob.
– Settings are made and confirmed by turning and
pressing the rotary knob.
016
123 123 123
E
D
CB
DA
017016
A
A

16 Pocket Guide Evita XL
Operating Concept
Colors are used to indicate the status of the screen con-
trols:
For buttons:
1to select = touch,
2the button turns yellow,
3to confirm = press rotary knob,
4the button turns pale green or dark green.
For therapy controls:
1to select = touch,
2the therapy control turns yellow,
3to set = turn rotary knob,
4to confirm = press rotary knob,
5the therapy control turns pale green or dark green.
gray = not available
yellow = ready for use
pale green = available, but is not active
dark green = available and is active
018019
12 4
3
12
3
4
5

Pocket Guide Evita XL 17
Operation
Operation
Selecting the patient
After switching on Evita XL, the operator can select bet-
ween:
– Admitting a new patient
– Using the settings of the previous patient
Admitting a new patient
For a new patient, Evita XL determines the start-up set-
tings for the ventilation parameters based on the ideal
body weight (factory setting) or based on the patient ca-
tegory. The settings can be configured. Only when a
new patient is admitted, the body weight or the patient
category can be changed.
Prerequisite: The Start / Standby dialog window must
be open. Evita XL must be in Standby mode.
1Touch New Patient tab (A).
Depending on the patient category:
2Touch Adult (B), Ped. (C), or Neo. (D) button.
3Touch Ideal Body Weight button (E).
4Turn rotary knob to enter the ideal body weight [kg],
press rotary knob to confirm.
Evita XL determines the tidal volume VTand respiratory
rate fbased on the ideal body weight and displays these
values in the lower part of the dialog window (F). The
other ventilation parameters displayed in the lower part
of the dialog window are start-up values.
Using the settings of the previous patient
Specific patient settings in effect before Evita XL was
switched off may be restored, including alarm limits, ap-
plication mode, and ventilator status. Monitoring is al-
ways active after the ventilator has been switched on.
Prerequisite: The Start / Standby dialog window must
be open. Evita XL must be in Standby mode.
zTouch Previous Patient tab (A) and press rotary
knob to confirm.
The previous ventilation settings are again effective.
NOTE
The Evita XL Pocket Guide is not a replacement or substitute for the Instructions for Use.
Any use of the device requires full understanding and strict observation of the Instructions for Use.
020
A
BCD E
F
046
A

18 Pocket Guide Evita XL
Operation
Starting ventilation
Before using on the patient
zCheck readiness for operation.
zCheck therapy settings:
– For alarm limits.
– For ventilation modes and ventilation parame-
ters.
In the Start / Standby dialog window:
zTouch Start button (A) and press rotary knob to con-
firm.
Evita XL now starts ventilation.
Setting the ventilation mode
Opening ventilation settings
The Ventilator Settings dialog window can be opened as
follows:
zPress Ventilator Settings key.
or
zTouch a therapy control in the therapy bar.
Evita XL opens the Ventilator Settings dialog window.
The page of the active ventilation mode (A) with the
Basic settings (B) appears by default. The correspon-
ding therapy controls (C) are displayed. The selected
therapy control is yellow and can be set. With the
Add. settings tab (D), the active ventilation mode can
be extended by additional parameters.
The following ventilation modes are factory-configured:
–SIMV
–CMV
–PCV+
–CPAP/P
Supp
Other ventilation modes (optional) can be selected via
the more tab (E):
– MMV
– PCV+ Assist
–APRV
– PPS (optional)
The ventilation modes can also be supplemented with
additional settings.
Changing the ventilation mode
Prerequisite: The Basic settings page must be open in
the Ventilator Settings dialog window.
1Touch the relevant tab, e. g., SIMV (A). The tab
turns yellow.
2If necessary, set the ventilation parameters.
3Confirm the ventilation mode by pressing the rotary
knob. The color of the tab changes to dark green.
The ventilation mode is active. The settings are effective
for the patient.
020021
A
AE
CB
D
022
A

Pocket Guide Evita XL 19
Operation
Setting the ventilation parameters
Prerequisite: The Basic settings page must be open in
the Ventilator Settings dialog window.
1Touch the relevant therapy control, e. g., (A).
2Turn the rotary knob to set the value.
3Press rotary knob to confirm.
Additional ventilation parameters derived from the ven-
tilation parameter are calculated by Evita XL and dis-
played in the setting assistance field (B).
When the limit set for the parameter has been reached,
Evita XL displays a message.
Setting additional functions
Prerequisite: The Ventilator Settings dialog window
must be open.
1Touch Add. settings tab (A).
The additional settings of the active or selected ventila-
tion mode are displayed.
2Touch the tab for the relevant additional setting,
e. g., (B).
The page for setting the associated parameter is dis-
played.
3Touch therapy control (C).
4Set the value using the rotary knob and confirm.
To switch on an additional setting:
5Touch (D) button and press rotary knob to confirm.
To switch off an additional setting:
6Touch (E) button and press rotary knob to confirm.
The ventilation modes can be combined with additional
settings to optimize ventilation.
023025
A
B
A
B
024
C
DE

20 Pocket Guide Evita XL
Operation
Overview of the availability of additional
settings
Bronchial suctioning
Before suctioning
1Touch Special Procedure ... button in the main
menu bar.
The Additional Function page (A) appears by default.
2Touch O2
↑ suction button (B).
3Press rotary knob to confirm.
The oxygenation procedure is started.
Evita XL ventilates the patient in the set ventilation
mode with the appropriately increased O2concentrati-
on.
The preoxygenation phase with the remaining time in
seconds is displayed continuously in the header bar.
Preoxygenation lasts for a maximum of 180 seconds.
During this time, Evita XL waits for the disconnection
necessary for suctioning. If no disconnection is detected
within 180 seconds, Evita XL terminates the oxygenati-
on procedure.
During suctioning
The time available for suctioning is displayed in se-
conds in the header bar. If suctioning is completed and
the patient reconnected within the time available,
Evita XL will end the disconnection phase.
After suctioning
After reconnection, Evita XL resumes ventilation in the
set ventilation mode. For postoxygenation, the O2con-
centration is increased for the first 120 seconds.
The postoxygenation phase with the remaining time in
seconds is displayed in the header bar.
Canceling oxygenation
Touch O2 ↑ suction button.
Ventilation
mode
Additional settings
ATC
(optional)
Apnea venti-
lation
Flowtrigger Inspiratory
termination
AutoFlow Sigh PLV
CMV X X X X X
SIMV X X X X X X
MMV X X X X X
ILVMaster XX XX
ILVSlave XXX
PCV+ X X X X
PCV+ Assist X X
APRV X X
CPAP/ PSupp X X X X
PPS (optional) X X X
026
A
B