GE CARESCAPE R860 User manual

CARESCAPE™
R860 Ventilator
Quick Reference Guide
gehealthcare.com

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Notice
The materials contained in this document are intended for educational purposes only. This document does not
establish specifications, operating procedures or maintenance methods for any of the products referenced.
Always refer to the official written materials (labeling) provided with the product for specifications, operating
procedures and maintenance requirements.

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Contents
Before Powering the System On.........................................................................4
Powering the System On ................................................................................4
Patient Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
System Check...........................................................................................6
Setting a Ventilation and Backup Mode..................................................................7
Starting Patient Ventilation .............................................................................8
Making Ventilator Changes When in an Active Mode.....................................................8
Alarm Management .....................................................................................8
Nebulizer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Procedures............................................................................................ 12
Navigation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
To Review Patient Data................................................................................ 13
To Review Patient Trends.............................................................................. 14
Pausing Ventilation.................................................................................... 14
Powering the System Off.............................................................................. 15
Note! Always refer to the User Reference Manual before use. Refer to the User Reference Manual
for information on all warnings and precautions.

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Before Powering the System On
1. Connect the Inspiratory Safety Guard (ISG) to the
inspiratory port.
2. Connect the Exhalation Valve Assembly (EVA) to the
exhalation port.
3. Familiarize yourself with the hard keys on the display.
a. 2-minute audio pause
b. Increase O2
c. Snapshot
d. Lock/Unlock
e. Home
f. Trim Knob
4. Attach the breathing circuit and all accessories that will
be used to ventilate the patient.
Powering the System On
1. Connect the air and oxygen supply hoses to the gas
supply source.
2. Plug power cord into an approved electrical outlet.
3. Press the power switch to turn on the ventilator.
Note:
• Wait 30 seconds to allow the system to power on.
• Listen for 2 distinctly different audio tones to make sure the
primary speaker and backup buzzer are working properly.
• Watch and verify that the alarm light on the top of the
display cycles through blue, yellow and red.
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Aerogen®nebulizer
Connection
Occlusion
port
Hard keys on the CARESCAPE R860 Ventilator display
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Patient Setup
1. Select NEW PATIENT.
2. Select Adult, Pediatric or Neonatal patient type.
Note: When selecting neonatal, a neonatal flow sensor
is recommended for improved tidal volume delivery
and monitoring.
3. Select Patient ID (Identification), if necessary, and
enter 10 characters and select Confirm.
Note: Only English alpha-numeric characters may
be entered.
4. Select Gender (male or female).
5. Select Height.
6. Select Weight.
7. Select Tube Type (Endotrach, Trach, or ---).
8. Select Tube Diameter.
9. Verify and confirm settings by pressing Confirm.
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System Check
Circuit Setup
1. Select CIRCUIT SETUP.
2. Select check box for the HME or Humidifier.
Note: Settings are confirmed when the setting
is changed.
3. Select Xto close the menu.
Note: Use Circuit Setup to select settings that must be
compensated for in the patient circuit measurements.
Running a System Check
1. From Standby, select SYSTEM CHECK.
Note: The Run System Check menu shows.
2. Attach the breathing circuit and all accessories that
will be used to ventilate the patient.
Note: Complete the system check using the appropriate
flow sensor per patient type. Use the neonatal flow sensor
when completing a system check for a neonatal patient.
3. Occlude the patient wye using the occlusion port.
Note: The occlusion port sits below the exhalation valve
assembly (EVA).
4. Select Start.
Note: When performing the resistance check, the wye-piece
and the breathing accessories (D-lite+™or Pedi-lite™Sensor
and HME) should remain on the occlusion port.
5. Select the information icon to see the System Check
Details menu.
a. As the system check is running, the results of each
check will be displayed.
Note: Follow all on-screen system check instructions. A green
check mark will display if the check passes. If the check fails,
a red X is shown, and a Help icon displays next to the failed
check to provide possible causes and help for troubleshooting.
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Setting a Ventilation and Backup Mode
1. Select Current Mode.
2. Select the desired ventilation mode.
a. Depending on the facility default setup for ventilation
modes, the Mode Settings menu may contain 2 icons,
a partial list and a full list.
3. Select Assist Control, Leak Comp or Trigger Comp,
if desired.
Note: Assist Control is only available in the following
ventilation modes: A/C VC, A/C PC, A/C PRVC.
4. Set the desired settings for the ventilation mode
and confirm.
Note: When the ventilator settings are confirmed, the
Mode Settings menu closes, and the selected ventilation
modes show in Current Mode.
5. To set a Backup Mode, select Current Mode.
6. Select Backup Settings.
a. Set the desired settings for the backup mode
and confirm.
7. Confirm all ventilation mode settings by pressing
Confirm Backup.
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Starting Patient Ventilation
1. From Standby, select Start Ventilation.
2. After ventilation has started, connect the breathing circuit
to the patient.
Note:
• It is recommended that a system check is completed prior
to starting ventilation.
• If the Start Ventilation button is yellow, the Complete
System Check warning alert will display the following:
– Select Continue to bypass System Checkout and start
ventilation. Select Cancel to remain in Standby.
Making Ventilator Changes When
in an Active Mode
1. Select the parameter to change using the ventilator
quick keys.
2. Turn the Trim Knob to adjust the setting.
3. Press the Trim Knob or select the quick key to activate
the change.
Alarm Management
Alarm Bar
Gives visual indication of parameter and technical alarms.
• If there are no current active alarms, the alarm status
shows no alarms and the alarm bar is green.
• If there are active alarms, the alarm status shows the alarm
message for the most recent alarm with the highest priority.
The alarm bar color shows the priority of the alarm. The
alarm list contains all of the active alarms, as well as previous
alarms requiring user acknowledgment.
• If the alarm bar is grey, there are no active alarms, but a
previous alarm requires user acknowledgment.
1. Audio Pause
2. Alarm Status
3. Alarm Setup
4. Audio Pause Timer
5. Active Alarm Count
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Alarm Priority
Audio and visual indicators tell the priority of the alarm.
Alarm Setup
1. Apnea Time: Set apnea time up to 60 seconds.
2. Alarm Light Brightness: Set the brightness level
of the alarm light. The range is 1 (Low) to 5 (High).
3. Alarm Volume: Set the alarm volume of the alarm
tone. The range is 1 (Low) to 5 (High).
4. High Alert Audio: Set the delay time in which a
high-priority alarm must be resolved before the audio
tone pitch and volume increases to the maximum level.
The range is 0 to 30 seconds or Off. A general message
shows when High Alert Audio is set to Off.
5. Alarm Limits: Select the check box to show alarm
limits adjacent to the measured data in the patient
data workspace. The alarm limit always shows when
an alarm occurs for the measured data, even if it is
set to Off.
6. Auto Limits: Select to set auto alarm limits based on
current measured data for:
a. MVexp-Low and High
b. VTexp-Low and High
c. Rate-Low and High
d. EtCO2-Low and High
e. PEEPe-Low and High
To Adjust the Alarm Settings:
1. Select either the Low or High alarm limit, and then use the
Trim Knob to adjust the setting.
OR
2. Select within the border of the active alarm on the measured
data screen to open the Alarm Setup menu. If necessary,
use the Trim Knob to adjust the setting for the alarm limit.
Note:
• Alarm setting changes that are not conrmed prior to the
end of a timeout period are cancelled.
• Alarm Limits for EtCO2, EtO2and PEEPi are only available
when an airway module with these measurement capabilities
is installed. If the patient type is Neonatal, these alarm limits
are not shown.
Priority Color Light Tone
High Red Flashes red Series of five
tones twice
Medium Yellow Flashes yellow Series of
three tones
Informational Blue Solid blue Single tone
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Nebulizer
Warning
• Do not use a filter, heat-moisture exchanger or heat-moisture
exchanger filter between the nebulizer and the patient airway.
• Use of a heat-moisture exchanger or nebulizer in the breathing
circuit can substantially increase flow resistance when a
nebulizer is active. Monitor the breathing system filter
frequently for increased resistance and blockage.
• Use of an external pneumatic nebulizer may significantly
impact volume delivery and monitoring, decrease trigger
sensitivity, and cause alarms if external flow is introduced
and Pneumatic Nebulizer Flow Compensation is not used.
Caution
• It is strongly recommended to use an expiratory filter when a
nebulizer is used to help protect the expiratory flow sensor.
Nebulizer Treatment
The ventilator supports the Aerogen®Pro In-line Nebulizer
and Aerogen®Solo Disposable In-line Nebulizer. The
nebulizer time can be set for specific duration delivery
times or for the volume of medication that will be delivered
to the patient. A general message shows the nebulizer
treatment time remaining.
1. Select Menu.
2. Select Nebulizer.
3. Select Aerogen.
4. Select Time or Continuous.
Note: Time and approximate volume of nebulized
medication are shown in the table.
5. Select Start.
Note: To end nebulizer treatment before the set time,
select Stop.
Time
(min) 7 8 11 16 21 26 32
Volume
(ml) 2.5 3.0 4.0 6.0 8.0 10.0 12.0
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Warning
• Do not use a filter, heat-moisture exchanger or heat-moisture
exchanger filter between the nebulizer and the patient airway.
• Use of a heat-moisture exchanger or nebulizer in the breathing
circuit can substantially increase flow resistance when a
nebulizer is active. Monitor the breathing system filter
frequently for increased resistance and blockage.
• Use of an external pneumatic nebulizer may significantly
impact volume delivery and monitoring, decrease trigger
sensitivity, and cause alarms if external flow is introduced
and Pneumatic Nebulizer Flow Compensation is not used.
Pneumatic Nebulizer
The ventilator can compensate for additional flow
introduced by a pneumatic nebulizer into the
patient circuit.
WARNING! Use of an external pneumatic nebulizer may
significantly modify the mixture of gas that is delivered
to the patient.
• Using external pneumatic nebulization may significantly
impact volume delivery and monitoring, decrease trigger
sensitivity and cause alarms if external flow is introduced
and Pneumatic Nebulizer Flow Compensation is not used.
• When the Pneumatic Nebulizer Flow Compensation is On,
flow and volume accuracy may be decreased.
• Leaks and flow sensor alarms may not be identified by
the ventilator when Pneumatic Nebulizer Flow Compensation
is On.
1. Select Menu.
2. Select Nebulizer.
3. Select Pneumatic.
4. Select Flow value.
Note: Set the flow to match the amount of flow that will be
introduced to the circuit.
5. Select Start.
Note: A general message shows when Nebulizer Flow
Compensation is On. To end the nebulizer treatment, turn
the pneumatic nebulizer flow source off, then select Stop.
6. Introduce the pneumatic nebulizer into the patient circuit.
Note: For best results, introduce the pneumatic nebulizer into
the circuit within approximately 15 seconds after selecting Start.
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Procedures
Suction
Any ventilation mode may be used with a closed suction
catheter. Patient disconnected, RR low, MVexp low, Vtexp
low, Apnea and other alarms may occur during use of a
closed suction catheter.
To perform a suctioning without nuisance alarms, an open
suction procedure is provided by the ventilator:
1. Select Menu.
2. Select Suction.
3. Select Start.
4. Wait for the pre-oxygenation phase, and then disconnect
the patient at the wye. An audible tone sounds to indicate
the patient is disconnected and ventilation is paused.
5. Suction the patient.
6. Reconnect the patient to resume ventilation.
Note: The suction procedure will end after the oxygenation
phase completes if Stop is selected.
Performing an Increase O2Procedure
1. Select Menu.
2. Select Procedures.
3. Select Increase O2or press the Increase O2hard key.
4. Use the factory default setting for the Increase O2%
(note: factory default setting for neonatal is +25% and
+100% for adults and pediatric patients) or adjust the
O2% to the desired concentration and confirm the setting.
5. Select Start.
Note: The oxygen general message shows along with the
progress bar and a 2-minute countdown timer. The procedure
will end when a.) the time has elapsed or b.) when Stop is
selected or c.) when the Increase O2favorite is selected or
d.) when the Increase O2hard key is pressed.
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Navigation
1. Past/Historical Trends Workspace.
2. Present/Patient Status Workspace.
3. Future/Clinical Decision Support Workspace.
To Review Patient Data:
1. Touch the icon to display the Present/Patient Status
Workspace or swipe to the right or left to move from
the Past and Future workspaces.
2. From the Present/Patient Status Workspace, choose
any option below:
a. Basic View: Use this view to see measured data in a
large format that can be easily viewed from a distance.
b. Basic Waveform View: Use this view to see patient
waveforms and measured data.
c. Advanced Waveform View: Use this view to see
additional measured data associated with the
patient waveforms.
d. Splitscreen View: Use this view to see spirometry,
measured data, and waveforms. Select the upper right
corner of the spirometry waveform to change settings.
e. Charting View: Use this view to see a complete list
of patient data.
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To Review Patient Trends:
1. Touch the icon to display the Past/Historical Trends
Workspace or swipe to the right to move from the
Present/Patient Status Workspace.
2. From the Past/Historical Trends Workspace, choose
any option below:
a. Graphical Trends View: Use this view to review
historical waveforms and patient trends.
b. Numerical Trends View: Use this view to review
patient ventilation modes and setting, measured
data, and alarm settings.
c. Trends Log View: Use this view to review patient
alarms and settings, and events that have occurred
during ventilation.
d. Snapshot Trends View: Use this view to save
patient data.
Pausing Ventilation
1. Disconnect the patient from the breathing circuit.
2. Select Standby.
3. Select Pause Ventilation.
Note: Select Pause Ventilation to go into Standby.
Ventilation and monitoring will be stopped. Select Cancel
to continue ventilation if a warning message is displayed.
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Powering the System Off
1. Disconnect the patient from the breathing circuit.
2. Select Standby.
3. Select Pause Ventilation.
Note: Select Pause Ventilation to go into Standby. Ventilation
and monitoring will be stopped. Select Cancel to continue
ventilation if a warning message is displayed.
4. Press the power switch on the back of the ventilator
to the Off position.
Note: If the ventilator is turned off during ventilation, an
alarm sounds, and ventilation and monitoring continue.
This ensures the ventilator cannot be accidentally shut
off during ventilation.