Hallowell EMC Vetronic Tafonius User manual

Tafonius
Auxiliary Mode Operating Manual
A USERS GUIDE
v09Feb2011

Tafonius Auxiliary Mode Operating Manual
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Notes:

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Table of Contents
Running Tafonius with the Auxiliary Control System...........................................................5
Turning Tafonius On.......................................................................................................5
Auxiliary Controller Boot Up Sequence .............................................................................6
INITIALISING DRIVE CONTROL ..............................................................................6
CHECKING DRIVE VOLTAGE: 27.9 14.0 13.9.....................................................6
VOLTAGES ALL OK..................................................................................................6
APPLYING POWER TO VIX DRIVE:.........................................................................6
SETTING COMMUNICATIONS TO DRIVE ...............................................................6
SETTING COMS RATE TO 19200 ............................................................................6
COMMS -SET AT 19200 BAUD -OK ...................................................................6
NOW TESTING VIX DRIVE INTEGRITY...................................................................6
INITIAL DRIVE CHECK OK.......................................................................................6
INITIALISATION COMPLETE ...................................................................................6
CHECKING FOR PC CONNECTION ........................................................................7
Initialising the Piston .........................................................................................................8
The Control Screen ...........................................................................................................8
1) Status and message information ...............................................................................8
2) Piston Graphic and Information .................................................................................9
MWPL .......................................................................................................................9
ASSIST .....................................................................................................................9
In STANDBY mode................................................................................................9
In IPPV mode ........................................................................................................9
3) Resultant Ventilation values ......................................................................................9
4) Patient Ventilator settings & recorded values ..........................................................10
Control of the Ventilator in Auxiliary Mode.......................................................................10
Setting Values using the control knobs –Change & Commit .......................................10
Control setting validation .............................................................................................10
THE CONTROL KNOBS .........................................................................................10
Tidal Volume: The range is 0.1L to 20.0L in 0.1L increments...........................10
Respiratory Rate: The range is 1 to 30 breaths per minute. .............................10
Inspiratory Time: The range is 0.5 to 4.0 in 0.1 second increments..................10
MWPL: The range is 10cm H2Oto 80cm H2Oin 1 cm increments. .................10
Controls on the Anesthesia Machine Side ...................................................................10
Oxygen Flowmeter ..................................................................................................10
Air Flowmeter ..........................................................................................................11
N2O Flowmeter ........................................................................................................11
Tafonius and Spontaneous Breathing...........................................................................11
View the Piston as a “Virtual bag .................................................................................11
Dictating the size of the “Virtual Bag”...........................................................................11
Ventilation measurements during Spontaneous Mode.................................................12
Tafonius and IPPV........................................................................................................12
Warning Messages –Alerts and Alarms..........................................................................13
Alerts...........................................................................................................................13
BATTERY1 LOW VOLTAGE and/or ........................................................................13
BATTERY2 LOW VOLTAGE ...................................................................................13
MAX PRESSURE EXCEEDED LIMIT......................................................................13
LOW SYSTEM RESERVE VOLUME.......................................................................13
CYLINDER EMPTY/OUT OF RESERVE.................................................................13
SYSTEM FULL ........................................................................................................13
CYLINDER OPEN ...................................................................................................13

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PISTON POSITION INFO ERROR ..........................................................................13
Alarms.........................................................................................................................14
* LOW BREATHING SYSTEM PRESSURE *........................................................14
* OXYGEN SUPPLY PRESSURE LOW *..............................................................14
* BATTERY 1 CRITICALLY LOW * and/or.............................................................14
* BATTERY 2 CRITICALLY LOW *........................................................................14
* ENCODER BOARD HAS FAILED *.....................................................................14
* CHECK POSITION SENSORS *.........................................................................14
* RD VACUUM FAILURE * ....................................................................................14
Technical Specifications: .................................................................................................15

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Running Tafonius with the Auxiliary Control System
Turning Tafonius On
Press the soft ON/OFF control button (1). The auxiliary screen (2) and the soft ON/OFF
button immediately illuminate. There is a single output (beep) from the speaker and the
auxiliary screen shows “PUSH ANY KNOB FOR PRESSURE SENSOR SETUP”. The user
has 2seconds to push any of the rotary knobs to enter the Pressure Sensor setup screen.
Experience over the last 4 years has indicated that this feature will very rarely be needed or
used. If there is a discrepancy between the two offset values seen on the screen below, it
usually indicates some problem other that pressure sensor drift. Most frequently you’ll find
water in the pressure sampling line. It is recommended that you blow out the pressure
sensing line on a regular basis. To facilitate this process all machines produced after T21
will be shipped with a stopcock at the machine end of the sampling line. You can easily add
one to older machines yourself. To flush the line out attach a 60cc syringe to the open port
on the stopcock, turn the stopcock handle to shut off the port entering the machine and
flush the line with the air in the 60cc syringe as shown to the right below.
1
1
2

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Should one chooses to enter the Pressure Sensor Setup routine there are two options:
•Pressing any of the four control knobs will use the factory default value as shown.
•Pressing the RUN / IPPV button will use the actual current measured value, which is
constantly being updated on the screen.
The chosen value is stored in the non-volatile memory and will remain unchanged until the
Pressure Sensor Setup routine is run again.
Use the Pressure Sensor setup routine if there is piston movement when no patient is
attached the wye piece is not capped AND you have flushed the sensing line.
The initialisation procedure continues into the Auxiliary Controller Boot Up Sequence.
Auxiliary Controller Boot Up Sequence
After the option for pressure sensor setup, the following sequence occurs:
INITIALISING DRIVE CONTROL
At this stage the servomotor drive, the ViX Drive, is presumed un-initialised and its
initialisation begins. The software version is displayed at the bottom left hand corner of the
screen. The 24 volt supply line feeding the motor drive as well as the individual battery
voltages are measured and its value displayed on the screen e.g.
CHECKING DRIVE VOLTAGE: 27.9 14.0 13.9
If the supply voltage, 27.9 above, is less than 16.0 volts, then the shutdown procedure starts
as there is insufficient battery power to safely run the system. In this instance you should
connect the mains power and re-start the system.
If the voltages are sufficient one beep is heard as the screen displays the following.
VOLTAGES ALL OK
APPLYING POWER TO VIX DRIVE:
The power to the servomotor drive is applied and tested. Then after successful
communications have been established with the ViX drive, two beeps are heard and the
following is displayed.
SETTING COMMUNICATIONS TO DRIVE
SETTING COMS RATE TO 19200
COMMS -SET AT 19200 BAUD -OK
The servomotor drive is then initialised. The next stage checks the Motor Drive Integrity as
the following is displayed
NOW TESTING VIX DRIVE INTEGRITY
Assuming all is well then the message
INITIAL DRIVE CHECK OK
is displayed, followed by a string of ones and zeros on the screen. if at any time during this
Auxiliary initialisation procedure an error is detected then an error message is displayed and
the whole system shuts down. If everything is as it should be then the screen shows
INITIALISATION COMPLETE
At this stage the Auxiliary Screen looks like the screen below.

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The auxiliary controller next displays
CHECKING FOR PC CONNECTION
and waits while it checks for the presence of a USB attached device. If no USB device is
detected, as is the case when running without a PC monitor the auxiliary controller will
change the display (to below left) and wait for the Tafonius software to boot up and take
over control. Should the Tafonius software not claim control within two minutes
controller proceeds with piston initialisation and displays instructions to DISCONNECT THE
PATIENT AND PUSH THE RUN BUTTON.

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Initialising the Piston
As stated, before Tafonius can be used the system needs to locate the zero position, the
bottom of travel, of the piston.
The RUN button will be flashing, after the boot sequence, while waiting for the user. Make
sure there is nothing attached to the Y-piece before pushing RUN the button. Once the
button is pushed the screen shows the message MOVING PISTON TO ZERO. During this
piston movement the airway pressure is monitored. If there is a patient attached or an
obstruction to airflow then the following message appears:
ERROR. PRESSURE TOO HIGH
DISCONNECT PATIENT
THEN PUSH RUN BUTTON
Clear the obstruction or remove the patient before continuing. There are 2 other possible
reasons why the initialisation procedure may be interrupted: The first is that the cylinder is
not closed properly. The second is that the vacuum surrounding the piston is too low. In
either of these instances warning messages will appear alerting you to the cause and
remedy of the interruption. Once the piston reaches the bottom of its travel, a zero reading
is taken and ZEROING PISTON POSITON is displayed briefly. Three beeps are heard and
the control screen is displayed, see below. The piston is at the very bottom waiting for the
user to pre-fill the system with oxygen and anaesthetic for induction. Tafonius is ready
for use in its Auxiliary Mode.
The Control Screen
Before continuing here is an explanation of what you see on the auxiliary screen. It is
divided into 4 main regions:
1) Status and message information
Area 1 shows status information on the system batteries, whether the machine is running on
mains or battery power, the software version, the vacuum level around the piston and also
2
1
3
4
1) Status and message information
2) Piston Graphic and information
3) Resultant Ventilation values
4) Patient Ventilator settings &
Measured values

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displays any error or warning messages. The battery information shows the actual voltages
of the two batteries used in Tafonius and whether or not they are being charged When
there are no warning or error messages, the name TAFONIUS is displayed.
2) Piston Graphic and Information
Area 2 shows a representation of the piston. The dark area shows the volume of gas in the
piston and the numerical value at the top of the list to the right gives the amount in litres.
See the photo on the front cover as the piston in the photo above is at the bottom with 0.0
litres under it. The piston position and volume is constantly updated and shows the position
of the piston at all times. Two asterix (* *) will appear at the top of the piston area whenever
the Dump Valve, an electric pop-off valve, is open.
Below the volume display in litres are three settings that are not otherwise always display on
the screen.
MWPL
The Maximum Working Pressure Limit in cmH2Ois generally seen above the right most
control knob used to set its value however it will not be displayed there when using the
Assist Mode. The MWPL is set as a high pressure safety limit the value of which is
continuously compared to the breathing system pressure. Tafonius is a volume or time
cycled ventilator so the MWPL does NOT set how high the pressure will go but if the
pressure should reach the set level the machine will alarm and immediately, terminate
inspiration and switch to the expiratory phase of the breathing cycle.
ASSIST
The ASSIST function is a mechanism that detects a patient’s efforts to breathe then gives
an assisted breath if that effort meets or exceeds a user set minimum level. The value next
to the text ASST is the level of inspiratory flow, in liters per minute, the patient must
generate or exceed to trigger and assisted breath.
In STANDBY mode
In STANDBY, spontaneous breathing, mode this effort level can be set but is not active until
the IPPV/RUN button is pushed. To use the ASSIST function, press the ASSIST button
once, the ASSIST button will flash slowly and the MWPL legend on the auxiliary screen will
be replaced with the text “SENS” for sensitivity followed by a value e.g. 60 LPM. This value
of 60 litres per minute is the inspiratory flow rate that the patient must meet or exceed in
order to trigger the next IPPV stroke. This will not happen unless the ventilator is in IPPV
mode. Pressing the RUN/IPPV button will cause the IPPV button to be lit and the ASSIST
button will then remain lit continuously.
In IPPV mode
Alternatively the ASSIST mode can be chosen when the patient is receiving IPPV. In this
case the ASSIST mode will be lit continuously to show that the ASSIST mode is active. In
this state the ventilator is waiting for an effort from the patient. If this effort level is not met
within the time required for 3 breath cycles based on the set RR a mandatory breath is
given. If the patient triggers a breath then the timing of the mandatory breath is reset. In
either case, the delivered breath will be based on the set TV and I-time. Pressing the
RUN/IPPV button will return the ventilator to spontaneous mode and cancel the ASSIST
function.
This is a new feature and we currently have no guidelines on values to set. The software
offers a range of between 1 LPM and 200 LPM as trigger values. We would welcome
feedback on the settings found useful or normal in practice.
3) Resultant Ventilation values
Area 3 shows the values that result from the settings of the independent variables Tidal
Volume, Respiratory Rate and Inspiratory Time. The dependent variables displayed in this
area are Minute Volume (MV) in liters per minute (lpm), Inspiratory Flow Rate (IF) in lpm, I:E

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ratio and expiratory time (ET) in seconds. These are updated whenever a ventilation
parameter is changed. This feature allows the user to see how other parameters are
affected by the change being made. One can also “set” a dependent variable. For example
you can set the MV by changing the TV and or the RR and watch the resulting effect on the
MV display. Similarly one could “set” the I:E Ratio by changing the RR and or the I-time.
4) Patient Ventilator settings & recorded values
Area 4 shows the set values for Tidal Volume (TV), Respiratory Rate (RR), Inspiratory Time
(IT) and Maximum Working Pressure Limit (MWPL). The values in parentheses above these
settings are the measured values taken during spontaneous breathing.
Control of the Ventilator in Auxiliary Mode
In Auxiliary mode the Tafonius ventilator is controlled via the 4 control knobs below the
Auxiliary screen, the RUN/IPPV/ button, Assist button, CPAP/PEEP button, Oxygen Flush
button, Dump Valve button and the soft power ON/OFF switch.
Setting Values using the control knobs –Change & Commit
The process of setting any value uses the concept of “Change & Commit”
Turning the Tidal Volume knob for example will change the value and a small asterisk will
appear next to the changed value. To commit this new value push in the Tidal Volume knob
(or any of the 4 knobs) until a single beep is heard. The asterisk disappears and the new
value is held on the screen. If the value is not committed by pressing a control knob then
after 4 seconds the setting will revert to the original value. This process prevents accidental
or inadvertent changing of ventilation parameters.
Control setting validation
There are 4 control knobs sitting directly beneath the parameter they control. When
adjusting any of the values comparisons are made with existing settings to ensure that
settings which exceed the capabilities of the machine are not made. For example if the
Inspiratory Time is set to 1.0 seconds then it will be impossible to set the Tidal Volume
setting to anything greater than 17.3L since this would otherwise exceed the machines
capacity to deliver the inspiratory stroke at 1000 litres per minute. Similarly a Respiratory
Rate of greater than 17 cannot be set if the Inspiratory time is 3.0 seconds and the tidal
volume is 17.3L because this would require an expiratory flow rate of over 1000L per minute
–if the RR was more than 15 then the Expiratory time would be less than 1 second.
THE CONTROL KNOBS
Tidal Volume: The range is 0.1L to 20.0L in 0.1L increments.
Respiratory Rate: The range is 1 to 30 breaths per minute.
Inspiratory Time: The range is 0.5 to 4.0 in 0.1 second increments.
MWPL: The range is 10cm H2Oto 80cm H2Oin 1 cm increments.
Assist: The range is 1 lpm to 200 lpm inspiratory flow, 1 lpm increments.
CPAP/PEEP The range is 0 to 80 cmH2O.
Controls on the Anesthesia Machine Side
These include the oxygen flowmeter, air and N2Oflowmeters if fitted, the scavenging
flowmeter and the dump valve switch.
Oxygen Flowmeter
The oxygen flowmeter has a 0 -10 lpm scale but considerably more flow can be delivered
when the ball is off the top of the scale. Use this flowmeter as you would on any other
anaesthesia machine.