Impact Implements Uni-Vent 731 EMV+ Series User manual

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EMV+MAINFEATURES:FIGURE1

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TABLEOFCONTENTS
LISTOFFIGURES ............................................................................................................................................................5
CONVENTIONS,TERMINOLOGYANDABBREVIATIONS ...............................................................................................6
INTENDEDUSE...............................................................................................................................................................7
ACCESSORIESLIST .........................................................................................................................................................8
LIMITEDCOPYRIGHTRELEASE ......................................................................................................................................9
WARNINGSANDCAUTIONSREGARDINGUSE ...........................................................................................................10
EMV+ANDPULSEOXIMETER ..........................................................................................................................................10
PULSEOXIMETERSPECIFICWARNINGSANDCAUTIONS .........................................................................................................11
SYMBOLSANDICONS .................................................................................................................................................13
UNPACKING,ASSEMBLYANDCONNECTIONS............................................................................................................14
SET‐UP .........................................................................................................................................................................15
EXTERNALGASSOURCES ................................................................................................................................................16
VENTILATORCIRCUITCONNECTIONS .................................................................................................................................17
VENTILATORCIRCUITPATIENTCONNECTIONS ......................................................................................................................18
OPERATINGPOWERSELECTION&STOPPING......................................................................................................................19
SELFCHECK..................................................................................................................................................................19
TRANSDUCERCALIBRATION ............................................................................................................................................19
OPERATIONOVERVIEW ..............................................................................................................................................20
INTRODUCTION ............................................................................................................................................................20
PULSEOXIMETEROPERATION..........................................................................................................................................20
DESCRIPTIONOFCONTROLSANDDISPLAY................................................................................................................22
CONTROLS...................................................................................................................................................................23
VISUALINDICATORS ......................................................................................................................................................28
LCDALARMINDICATORS ...............................................................................................................................................29
POPUPMESSAGES ........................................................................................................................................................29
OPERATION .................................................................................................................................................................30
MODESOFOPERATION ..................................................................................................................................................30
SPONTANEOUS/ASSISTEDBREATHTRIGGER ......................................................................................................................30
OPERATIONALTESTPROCEDURE ......................................................................................................................................30
TOBEGINVENTILATION..................................................................................................................................................31
TOCHANGESETTINGS ....................................................................................................................................................32
BACKUPVENTILATOR ....................................................................................................................................................33
PULSEOXIMETER ..........................................................................................................................................................33
HUMIDIFICATION ..........................................................................................................................................................33
HAZARDOUSENVIRONMENTFILTERS ........................................................................................................................34
BACTERIAL/VIRALFILTERUSE .........................................................................................................................................34
CHEMICAL/BIOLOGICALFILTERUSE..................................................................................................................................34
HARSHENVIRONMENTOPERATION ..........................................................................................................................36
AIRBORNEPARTICULATES ...............................................................................................................................................36
EXTREMETEMPERATUREENVIRONMENTS .........................................................................................................................36
ALTITUDE ....................................................................................................................................................................36
RAINANDSNOW ..........................................................................................................................................................37

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ALARMFUNCTIONS.....................................................................................................................................................39
ALARMPRIORITIES ........................................................................................................................................................39
VENTILATORALARMCATEGORIES ....................................................................................................................................40
PULSEOXIMETERALARMS ..............................................................................................................................................42
ROUTINECARE:CALIBRATION,CLEANINGANDPREVENTATIVEMAINTENANCE.....................................................45
CALIBRATIONCHECKS ....................................................................................................................................................45
GENERALCLEANING ......................................................................................................................................................45
PREVENTATIVEMAINTENANCE ........................................................................................................................................45
REMOVABLEFOAMFILTERREPLACEMENT..........................................................................................................................45
FRESHGAS/EMERGENCYAIRINTAKEDISKFILTERREPLACEMENT ...........................................................................................46
POSTCONTAMINATEDENVIRONMENTCLEANING................................................................................................................46
BATTERYCAPACITY,CAREANDRECHARGING ...........................................................................................................47
BATTERYCAPACITY .......................................................................................................................................................47
BATTERYCAREANDCHARGING........................................................................................................................................47
INCASEOFDIFFICULTY ...............................................................................................................................................48
OPERATORCORRECTABLEPROBLEMS................................................................................................................................48
OPERATINGPROBLEMSREQUIRINGSERVICE.......................................................................................................................48
STORAGEINFORMATION............................................................................................................................................48
SPECIFICATIONS ..........................................................................................................................................................49
LIMITEDWARRANTY...................................................................................................................................................50
APPENDIX1:ALARMS .................................................................................................................................................51
APPENDIX2:PNEUMATICDIAGRAM .........................................................................................................................69
APPENDIX3:PULSEOXIMETERPRINCIPLESANDSPECIFICATION.............................................................................70
APPENDIX4:INTERNALBATTERYCHANGE/INSERTION ...........................................................................................72
APPENDIX5:INTERNALFILTERCHANGE/INSERTION ...............................................................................................73
APPENDIX6:USEOFLOWFLOWOXYGEN.................................................................................................................75
APPENDIX7:RECHARGINGGUIDELINES ....................................................................................................................77
APPENDIX8:POPUPMESSAGELIST ..........................................................................................................................78
INDEX...........................................................................................................................................................................79
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LISTOFFIGURES
EMV+MAINFEATURES:FIGURE1................................................................................................................................2
CONNECTORPANEL:FIGURE2...................................................................................................................................15
EXTERNALGASSOURCES:FIGURE3...........................................................................................................................16
FRESHGAS/EMERGENCYAIRINTAKE:FIGURE4........................................................................................................17
VENTILATORCIRCUIT,DEVICECONNECTIONS:FIGURE5...........................................................................................17
VENTILATORCIRCUIT,PATIENTCONNECTION:FIGURE6...........................................................................................18
CONTROLSANDINDICATORS:FIGURE7.....................................................................................................................21
EXAMPLEOUTLINED/NORMALTEXT:FIGURE8.......................................................................................................22
VISUALINDICATORS:FIGURE9...................................................................................................................................27
POPUPMESSAGEEXAMPLE:FIGURE10 ....................................................................................................................29
HAZARDOUSENVIRONMENTFILTERS:FIGURE11......................................................................................................35
ALARMDISPLAY:FIGURE12 .......................................................................................................................................38
PNEUMATICDIAGRAM:FIGURE13............................................................................................................................69
PULSEOXIMETERDISCRETESATURATIONTRANSFORM:FIGURE14 .........................................................................71
BATTERYCHANGEINSTRUCTIONS:FIGURE15(A)‐(E)................................................................................................72
FILTERCHANGEINSTRUCTIONS:FIGURE16(A)‐(I).....................................................................................................73
OXYGENRESERVOIRBAGASSEMBLY(PART#704‐0004‐00):FIGURE17....................................................................76
EMV+STORAGECASE(PART#703‐0EMV‐03):FIGURE18..........................................................................................77
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CONVENTIONS,TERMINOLOGYANDABBREVIATIONS
CONVENTIONS
WARNING!
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AWARNINGstatementidentifiesconditionsorinformationthatcouldhaveanadverseeffectuponthepatientor
operatorwhichifnotavoided,couldresultindeathorseriousinjury.
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CAUTION!
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ACAUTIONstatementprovidesimportantinformationaboutapotentiallyhazardoussituationwhichifnotavoided
mayresultinminorormoderateinjurytothepatient,operatorordamagetotheequipmentorotherproperty.
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NOTE:
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ANOTEprovidesadditionalinformationintendedtoavoidinconvenienceduringoperation.
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ABBREVIATIONS
A/C‐Assist/Control LED‐LightEmittingDiode
ACLS‐AdvancedCardiacLifeSupportLPM‐LitersperMinute
ALS‐AdvancedLifeSupport ml‐Milliliters
ATLS‐AdvancedTraumaLifeSupportmm‐Millimeter
ACV‐Assist‐ControlVentilation O2‐Oxygen
ATPD‐AtmosphericTemperatureandPressure,Dry Paw ‐AirwayPressure
BPM‐BreathsperMinute PEEP‐PositiveEndExpiratoryPressure
B/V‐Bacterial/ViralFilterPIP‐PeakInspiratoryPressure
cmH2O‐CentimetersofWater psig‐PoundsperSquareInchGage
CPR‐CardiopulmonaryResuscitation USP‐UnitedStatesPharmacopeia
DISS‐DiameterIndexSafetySystem VAC‐VoltsAC
FIO2‐FractionofInspiredOxygen VDC‐VoltsDC
HME‐HeatandMoistureExchangerVT‐TidalVolume
HME/BV‐HeatandMoistureExchanger/BacterialViral
filtercombined WOB–WorkofBreathing
Hz
–
Hertz(asinfrequency,cyclespersecond)
ID‐InternalDiameter
L‐Liters
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INTENDEDUSE
TheModel731EMV+(EMV+)isindicatedforuseinthemanagementofinfantthroughadultpatientsweighing≥5
kgwithacuteorchronicrespiratoryfailureorduringresuscitationbyprovidingcontinuouspositive‐pressure
ventilation.Itisappropriateforuseinhospitals,outsidethehospital,duringtransportandinaustere
environmentswhereitmaybeexposedtorain,dust,roughhandlingandextremesintemperatureandhumidity.
Withanappropriatethird‐partyfilterinplace,itmaybeoperatedinenvironmentswherechemicaland/or
biologicaltoxinsarepresent(seeExternalFilterUse).Itisnotintendedtooperateinexplosiveenvironments.The
EMV+isintendedforusebyskilledcareproviderswithknowledgeofmechanicalventilation,emergencymedical
services(EMS)personnelwithabasicknowledgeofmechanicalventilationandbyfirstrespondersunderthe
directionofskilledmedicalcareproviders.
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TheEMV+ventilatorisasmall,extremelydurable,full‐featuredportablemechanicalventilatordesignedto
operateinhospitalsoraustereandunder‐resourcedenvironments.Itcanbeusedinprehospital(ALS,ATLS,ACLS),
fieldhospitalandhospitalsettings.Easy‐to‐use,durable,lightweightandportable,theEMV+isbuiltwiththesame
standardofquality,reliabilityandperformancethatallImpact®productsareknownfor.
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FEATURES
•Portablecriticalcareventilatorthatcanbeusedinthehospital,aeromedicalandgroundtransport,mass
casualtysituationsandextremeenvironments
•Multiplemodesofventilationforusewithacuteorchronicrespiratoryfailureinbothintubatedand
nonintubatedpatients.
•Intuitiveoperatorinterfaceminimizesoperatortrainingandprotectsexistingsettingsfrominadvertent
contactandmanipulation.
•Lightweight(9.7lbs,4.4kg)providesforeasytransport
•Rechargeablebatteryprovidesover10hoursofoperation(atfactorydefaultsettingswithpulseoximeter
operating).
•Operatingtemperaturerangefrom‐25°to75°C
•Altitudecompensationto‐2000to25,000feet
•Self‐containedsystemthatoperateswithorwithoutexternalO2.
•GasmanifolddesignallowsoperationwithbothhighandlowpressureO2sources.
•Sealedgaspathwithchemical/biologicalfilterconnectedtoassuresafebreathinggassupply.
•Sealedcaseandcontrolpanelprotectscomponentsfromweatherandfluids.
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SHIPPINGCONTENTS
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ACCESSORIESLIST
TheAccessoriesListcontainscommonitems,requiredfromtimetotime,someofwhicharenotprovidedwith
eachEMV+atthetimeofdelivery.Eachitemisprecededbyitspartnumber.Accessoriesmaybeordereddirect
fromImpactorthroughyourlocaldistributor.Whenordering,pleaseincludethepartnumber,descriptionand
quantityrequired.
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Sendpurchaseordersto:
ImpactInstrumentation,Inc. 
P.O.Box508Telephoneorders:973/882‐1212
WestCaldwell,NewJersey07007‐0508  Faxorders: 973/882‐4993
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Email:
GovernmentNon‐Government
[email protected][email protected]
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PARTNUMBERPARTDESCRIPTION
024‐0012‐00AC/DCPowerSupply,90‐264VAC,100Watts24Volts4.2A,IEC320Plug
708‐0042‐00ACPowerlinecord,6’,(UnitedStatesVersion)
402‐0032‐00Paddedcarrycase,tan,material
465‐0024‐00Filter,Bacterial/Viral(B/V)
465‐0025‐00Filter,HME/B/V,HeatandMoistureExchanger
465‐0027‐00Filter,Disk,B/V,EmergencyAirIntake
465‐0028‐00Removablefoamcompressorinletfilter
820‐0108‐00HeatandMoistureExchangeFilter(HMEF),Adult
820‐0109‐00HeatandMoistureExchangeFilter(HMEF),Pediatric
820‐0110‐00HeatandMoistureExchangeFilter(HMEF),Infant
704‐0004‐00Assembly,Kit,O2Reservoir,3Liter
704‐0EMV‐05Assembly,Cable,DC,ExternalPower,28V
704‐0EMV‐06Assembly,Cable,DC,ExternalPower,12V
708‐0036‐00PulseOximeterProbeSensor,AdultReusable
708‐0043‐00PulseOximeterPediatric,Reusable
708‐0037‐00PulseOximeterPatientCable,Reusable
708‐0039‐00PulseOximeterAdult‐Ear,Reusable
708‐0047‐00PulseOximeterInfant,SinglePatientUse
820‐0106‐00Circuit,Vent,SingleLimb,Pediatric/Adult(disposable)
820‐0106‐15Circuit,Vent,SingleLimb,Pediatric/Adult(disposable)(caseof15)
820‐0107‐00Circuit,Vent,SingleLimb,Infant/Pediatric(disposable)
820‐0107‐20Circuit,Vent,SingleLimb,Infant/Pediatric(caseof20)
825‐0002‐00HighpressureOxygenHose,DISSxDISS,oxygen,6’
907‐EMVP‐01QuickReferenceGuide,laminated
909‐EMVP‐02CDformatOperationManual(Commercial)
703‐0EMV‐03Carry‐allCasewithFoamInserts,Rechargeable
703‐0EMV‐11TransitCasewithWheelsandPullOutHandle,Rechargeable
703‐0EMV‐12TransitCasewithWheelsandPullOutHandle,Rechargeable/USB
703‐0EMV‐13TransitCasewithWheelsandPullOutHandle
703‐0EMV‐14TransitCase,Rechargeable
703‐0EMV‐15TransitCase,Rechargeable/USB
703‐0EMV‐16TransitCase
703‐0731‐01Assembly,BatteryPack,Lithium‐Ion,6.6Ah
704‐0EMV‐XXExtensionCord8’USHospitalGradeFemalePlugto***
708‐0041‐XXCordset,6’,IEC60320‐C5Plugto***
***CountrySpecific(Contactfactoryforcompletepart#foreachcountry)
NOTE:Shippingcontentsmaybedifferentformilitaryandgovernmentcustomersbasedon
contractspecifications.Pleaserefertothepackingslipenclosedwithyourunit.

9
LIMITEDCOPYRIGHTRELEASE
Permissionisherebygrantedtoanymilitary/governmentalagencytoreproduceallmaterialsfurnishedhereinfor
useinamilitary/governmentalservicetrainingprogramand/orothertechnicaltrainingprogram.
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MASIMOPULSEOXIMETER
ThisdeviceusesMasimoSET®technologytoprovidecontinuouspulseoximeterandheartratemonitoringandis
coveredunderoneormoreofthefollowingU.S.A.patents:5,758,644,5,823,950,6,011,986,6,157,850,6,263,222,
6,501,975andotherapplicablepatentslistedatwww.masimo.com/patents.htm.

10
WARNINGSANDCAUTIONSREGARDINGUSE
EMV+ANDPULSEOXIMETER
WARNING!Electricshockhazard:Donotremoveequipmentcoversexcepttoreplacebatteries!Anoperatormay
onlyperformmaintenanceproceduresspecificallydescribedinthismanual.ReferservicingtoImpactoran
authorizedImpactServiceCenterintherepairofthisequipment.

WARNING!Thedeviceisintendedforusebyqualifiedpersonnelonly!Theoperatorshouldreadthismanual,all
precautionaryinformation,andspecificationsbeforeusingthedevice!

WARNING!Possibleexplosionhazardifusedinthepresenceofflammableanestheticsorotherflammable
substancesincombinationwithair,oxygen‐enrichedenvironmentsornitrousoxide!

WARNING!DuringoperationtheEMV+unitshouldnotbestackedontopoforunderothermedicalequipment
duetothepossibilityofelectromagneticinterferencebetweentheEMV+andotherequipment.












WARNING!Toensurepatientelectricalisolation,connectonlytootherequipmentwithelectronicallyisolated
circuits!

WARNING!Donotuseantistaticorconductivehosesortubingwiththisdevice!

WARNING!Donotconnecttoanelectricaloutletcontrolledbyawallswitchordimmer!

WARNING!Aswithallmedicalequipment,carefullyroutetheventilatorcircuithoseandtubing,patientcabling,
andexternalpowercablestoreducethepossibilityofpatiententanglementorstrangulation!

WARNING!DonotplacetheEMV+orexternalpowersupplyinanypositionthatmightcauseittofallonthe
patient!DonotlifttheEMV+bythepowersupplycord,ventilatorcircuitorpulseoximeterpatientcable!

WARNING!DonotusetheEMV+,itspulseoximeterorpulseoximetrysensorsduringmagneticresonanceimaging
(MRI)scanning!Inducedcurrentcouldpotentiallycauseburns.TheEMV+and/oritspulseoximetermayaffect
theMRIimageandtheMRIunitmayaffectEMV+operationortheaccuracyoftheoximetrymeasurements.

WARNING!TheEMV+mustbeconnectedtoagroundedACpowersupplywhenconnectedtoACpower.The
EMV+anditsintegratedpulseoximeterarereferredtoasanIEC601/Fdeviceinthesummarysituationtable
containedinIEC‐601‐1‐1.

WARNING!USBInterconnection:DonotoperatethedeviceonapatientwhentheUSBisconnectedtoanyother
device.


CAUTION!Federallawrestrictsthisdevicetosalebyorontheorderofaphysician.

CAUTION!Serviceistobeperformedbyqualifiedbiomedicalequipmenttechniciansonly.

WARNING!Grounding:
•ConnecttheEMV+onlytoathree‐wire,grounded,hospital‐gradereceptacle!Thethree‐conductorplug
mustbeinsertedintoaproperlywiredthree‐wirereceptacle;ifathree‐wirereceptacleisnotavailable,a
qualifiedelectricianmustinstalloneinaccordancewiththegoverningelectricalcode.
•Donotunderanycircumstancesremovethegroundingconductorfromthepowerplug!
•Donotuseextensioncordsoradaptersofanytype!Thepowercordandplugmustbeintactand
undamaged.
•Ifthereisanydoubtabouttheintegrityoftheprotectiveearthconductorarrangement,operatethe
oximeteroninternalbatter
y

p
oweruntiltheAC
p
owersu
pp
l
y

p
rotectiveconductorisfull
y
functional!
NOTE:TheUSBinterconnectiondoesnotsupportautomaticrecordkeeping.

11
CAUTION!Internalcomponentsaresusceptibletodamagefromstaticdischarge.Donotremovedevicecovers.



covers.









PULSEOXIMETERSPECIFICWARNINGSANDCAUTIONS
WARNING!Apulseoximetershouldnotbeusedasanapneamonitor.

WARNING!Apulseoximetershouldbeconsideredanearlywarningdevice.Asatrendtowardspatient
deoxygenationisindicated,bloodsamplesshouldbeanalyzedbyalaboratoryco‐oximetertocompletely
understandthepatient’scondition.











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
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WARNING!InterferingSubstances:Carboxyhemoglobinmayerroneouslyincreasereadings.Thelevelofincrease
isapproximatelyequaltotheamountofcarboxyhemoglobinpresent.Dyes,oranysubstancecontainingdyes,that
changeusualarterialpigmentationmaycauseerroneousreadings.

WARNING!ALARMSCheckalarmlimitseachtimethepulseoximeterisusedtoensurethattheyareappropriate
forthepatientbeingmonitored.
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WARNING!BesuretoreadandfollowallinformationprovidedwiththeMasimopulseoximetersensorsand
accessories.
NOTE:ThisOperationManualisnotmeanttosupersedeanycontrollingstandardoperatingprocedureregarding
thesafeuseofassistedventilation.
WARNING!MEASUREMENTS
Iftheaccuracyofanymeasurementdoesnotseemreasonable,firstcheckthepatient’svitalsignsbyalternate
meansandthencheckthepulseoximeterforproperfunctioning.
Inaccuratemeasurementsmaybecausedby:
•Incorrectsensorapplicationoruse
•Significantlevelsofdysfunctionalhemoglobin(e.g.,carboxyhemoglobinormethemoglobin)
•Intravasculardyessuchasindocyaninegreenormethyleneblue
•Exposuretoexcessiveillumination,suchassurgicallamps(especiallyoneswithaxenonlightsource),
bilirubinlamps,fluorescentlights,infraredheatinglamps,ordirectsunlight(exposuretoexcessive
illuminationcanbecorrectedbycoveringthesensorwithadarkoropaquematerial)
•Excessivepatientmovement
•Venouspulsations
•Placementofasensoronanextremitywithabloodpressurecuff,arterialcatheter,orintravascularline
•Thepulseoximetercanbeusedduringdefibrillation,butthereadingsmaybeinaccurateforashorttime.
WARNING!Lossofpulsesignalcanoccurinanyofthefollowingsituations:
•Thesensoristootight
•Thereisexcessiveilluminationfromlightsourcessuchasasurgicallamp,abilirubinlamp,orsunlight
•AbloodpressurecuffisinflatedonthesameextremityastheonewithaSpO2sensorattached
•Thepatienthashypotension,severevasoconstriction,severeanemia,orhypothermia
•Thereisarterialocclusionproximaltothesensor
•Thepatientisincardiacarrestorisinshock
NOTE:Followallgoverningregulationsregardingthedisposalofanypartofthismedicaldevice.
NOTE:Followallgoverningregulationsregardingthehandlingofmaterialscontaminatedbybodyfluids.
NOTE:FollowallgoverningregulationsregardingshipmentoftheLibatteries.

12
CAUTION!Possessionorpurchaseofthisdevicedoesnotconveyanyexpressedorimpliedlicensetousethe
devicewithunauthorizedsensorsorcableswhichwould,alone,orincombinationwiththisdevicefallwithinthe
scopeofoneormoreofthepatentsrelatingtothisdevice.Impactcannotassuretheproperfunctioningofthis
deviceifitisusedwithunauthorizedsensorsorcables.
WARNING!Sensors:

•Beforeuse,carefullyreadtheLNCS®sensordirectionsforuse.
•UseonlyMasimooximetrysensorsforSpO2measurements.Otheroxygentransducers(sensors)maycause
improperperformance.
•TissuedamagecanbecausedbyincorrectapplicationoruseofanLNCS®sensor,forexamplebywrapping
thesensortootightly.InspectthesensorsiteasdirectedinthesensorDirectionsforUsetoensureskin
integrityandcorrectpositioningandadhesionofthesensor.
•DonotdamageLNCS®sensors.DonotuseanLNCS®sensorwithexposedopticalcomponents.Donot
immersethesensorinwater,solvents,orcleaningsolutions(thesensorsandconnectorsarenot
waterproof).Donotsterilizebyirradiation,steamorethyleneoxide.Seethecleaninginstructionsinthe
directionsforreusableMasimoLNCS®sensors.
•Donotusedamagedpatientcables.Donotimmersethepatientcablesinwater,solventsorcleaning
solutions(thepatientcablesarenotwaterproof).Donotsterilizebyirradiation,steamorethyleneoxide.
SeethecleaninginstructionsinthedirectionsforreusableMasimopatientcables.

13
SYMBOLSANDICONS
(UsedwiththeEMV+andthismanual)


14
UNPACKING,ASSEMBLYANDCONNECTIONS
UNPACKING
CompareshippingcasecontentsagainstShippingContentslist.Examinethedeviceandaccessoriesforany
obvioussignsofshippingdamage.Ifthereisnoapparentsignofmechanicaldamage,readinstructionscontained
withinthismanualbeforeattemptingoperation.
ASSEMBLY
TheEMV+onlyrequiresthattheoperatorattachthebreathingcircuittobeginventilationusingeitherinternalor
externalpower.Boththeventilatorandbreathingcircuitaresuppliedcleanandarereadyforuseonapatient.

TheEMV+batteriesmaynotbeinstalledwithintheunit(dependinguponthecontractualrequirementsorthe
storageenvironmentasdescribedintheBatteryCareandRechargingsection).Batteryinstallationmaybe
requiredpriortooperation.(SeeAppendix4forBatteryInstallation.)
CONNECTIONS
OXYGENINPUT–connectstheunittotheoutputofanappropriateO2regulatorattachedtoamedical‐grade(USP)
O2cylinder.TheOXYGENINfittinghasamaleoxygenDiameterIndexSafetySystem(D.I.S.S.)thread.Itislocated
ontheConnectorPanelatthetopoftheunit(seeFigure2).Agreen(whiteforsomeinstallations),6footlong
high‐pressureoxygenhosewithcompatiblefittingsthatprovidesforconnectionbetweentheunitandtheO2
sourceisrequired.(AlsoseeHarshEnvironmentOperationsection).


GASOUTPUT‐connectstotheventilatorcircuit22mmIDcorrugatedhose.Theconnectorisa22mmmale
conicalconnection.ItislocatedontheConnectorPanelatthetopoftheunit(seeFigure2).

FRESHGAS/EMERGENCYAIRINTAKE–allowsambientairintotheEMV+’sinternalcompressor.Theportalso
functionsastheinternalanti‐asphyxiavalvewhichallowsthepatienttobreatheambientairintheeventofa
ventilatorfailure.Theintakecontainsaparticulatefilterandpermitstheoperatortoconnecteithera
bacterial/viralorachemical/biologicalfilterdependingonambientconditions(seeFigure2).

TRANSDUCER(PatientAirwayPressure)–connectstotheventilatorcircuit3/16"IDtransducertubing.Thebarb‐
typeconnectoriscoloredablue/greentodistinguishitfromtheotherconnectors(seeFigure2).



EXHALATIONVALVE–connectstotheventilatorcircuit1/4"IDexhalationvalvetubing.Thebarb‐typeconnector
isclearanodizedaluminumtodistinguishitfromtheotherconnectors(seeFigure2).


EXTERNALPOWERINPUT–TheExternalPowerInputconnectorislocatedonthetopoftheunit.ItacceptsDC
voltagesbetween11and32volts(negativeground).Theinputmateswiththeoutputconnectorplugofthe
AC/DCPowerSupply,12and28VDCPowerCables(bothareavailableasaccessories)ortheexternalbattery(see
Figure2).
NOTE:
T
he3/16"IDventilatorcircuittransducertubingisablue/green(darker)color.Itislocatedon
theConnectorPanelatthetopoftheunit.
NOTE:IfexternalO2isconnectedthegaspressuremustbeatleast41‐psig(±2psig)whenSELF‐CHECKis
performed.
NOTE:The1/4"IDventilatorcircuitexhalationvalvetubingisclear.ItislocatedontheConnectorPanel
atthetopoftheunit.

15


















CONNECTORPANEL:FIGURE2
SET‐UP
TheEMV+canbeconfiguredtosuitmostapplications.Additionalhoses,fittingsandadaptersmayberequiredfor
particularuses.
1. ForusewithexternalO2:connectagreen(whiteforsomeinstallations)high‐pressureO2hosetothe
OXYGENINfittinganda55psigexternalsource.


2. ConnectthedisposableventilatorcircuittotheGASOUTPUT,TRANSDUCER,andEXHALATIONVALVE
connectorsonEMV+ConnectorPanel.Followthedirectionsincludedwiththedisposableventilator
circuit.
3. Inahigh‐dustorbiologicalenvironment,abacterial/viralfiltershouldbeattachedtotheFresh
Gas/EmergencyAirIntaketoprevententrainmentofparticulateorbiologicalmatter.(Seesectionon
HazardousEnvironmentFilters.)
4. Intoxicbiologicalorchemicalenvironmentstheusercanattachachemical/biologicalfiltertotheFresh
Gas/EmergencyAirIntake.Thethreadedinterfaceaccommodateschemical/biologicalfilterswithanRd
40x1/7interface(seeBSEN148‐11999Respiratoryprotectivedevices–threadsforfacepieces).(See
sectiononHazardousEnvironmentFilters.)
5. ForusewithACpower:connecttheAC/DCPowerSupply(supplied)totheExternalPowerInput(see
Figure2).





WARNING!Alwaysassurethatthereisanalternatemeansofprovidingventilation.Abag‐valveresuscitatorand
anappropriatemaskforthepatientbeingventilatedshouldbeimmediatelyavailable.
NOTE:TheEMV+canoperatefrominternalbatteryorfromexternalACorDCpowersources.See
sectionentitledOperatingPowerSelection&Stoppingfordetails.
NOTE:Useonlywithmedical‐grade(USP)oxygen. Whenusingwithanoxygencylinder,thecylinder
mustbesecured.
PULSE
OXIMETER
CONNECTOR
FRESH
GAS/EMERGENCY
AIR INTAKE
EXHALATION
VALVE
TRANSDUCER
(PATIENT
AIRWAY
PRESSURE)
EXTERNAL POWER
INPUT
GAS
OUTPUT
HIGH PRESSURE
OXYGEN INPUT
USB
CONNECTOR

16
EXTERNALGASSOURCES
TheEMV+canoperateusinghigh‐pressureO2fromeitherbottledO2orpipedO2sources,asillustratedinFigure3.




EXTERNALGASSOURCES:FIGURE3

17




FRESHGAS/EMERGENCYAIRINTAKE:FIGURE4

WARNING!NeverblocktheFRESHGAS/EMERGENCYAIRINTAKE.Afreeflowofairisrequiredduringcompressor
operationorintheeventofadevicefailuretoallowspontaneousbreathing.TheFRESHGAS/EMERGENCYAIR
INTAKEalsoactsasananti‐asphyxiaportintheeventofaventilatorfailure.

VENTILATORCIRCUITCONNECTIONS
TheEMV+isdesignedtooperateusingastandarddisposableventilatorcircuit.Thecircuitisattachedtothe
ventilatorasshowninFigure5.
VENTILATORCIRCUIT,DEVICECONNECTIONS:FIGURE5
CAUTION!Alwaysdisposeofthecircuitaftersinglepatientusefollowingtheinstitutionalguidelinesfor
biologicallycontaminatedmaterial.Reusingthecircuitcanresultincrosscontaminationbetweenpatients.

18


VENTILATORCIRCUIT,PATIENTCONNECTIONS
TheEMV+iscompatiblewitheitheroneoftwodifferentsinglelimbventcircuits:Infant/Pediatric(Part#820‐
0107‐00)andPediatric/Adult(Part#820‐0106‐00).TheseareillustratedinFigure6.

VENTILATORCIRCUIT,PATIENTCONNECTION:FIGURE6

19
OPERATINGPOWERSELECTION&STOPPING
TheEMV+isdesignedtooperateusinganyoneofthreepowersources:

1. Internal14.8Vlithiumion(LiIon)rechargeablebatterywith6.6Ahcapacity(fullycharged,thebattery
provides10hoursofoperationatfactorydefaultsettingswithpulseoximeteroperatingat25°C).
2. ExternalAC/DCPowerSupply(90to260VAC47to440Hz)withIEC320styleACinputconnector
(supplied).TheAC/DCPowerSupplyprovidesaDCoutputof24Vat4.2A.
3. ExternalDCpowerfromastandardvehicleDCoutletusingthe12or28VDCPowerCables.Theinput
connectoroftheEMV+isdesignedtoacceptDCvoltagesbetween11and32volts,negativeground.


ThePOWERswitchisthemasterpowerswitch.Usethisswitchtoinitiateorendoperation.

WARNING!Neverstarttheventilatorwiththepatientconnected.Alwaysstarttheventilator,selectthepatient
settings,assureoperation,andthenconnectthepatient.Alwaysmanuallyventilatethepatientwhentheyarenot
connectedtotheventilator.

TheEMV+isdesignedtouseexternalpowerwhenavailableratherthanitsinternalbatterypack.Whenan
acceptableexternalpowersourceispresent,theinternalbatterypackisautomaticallychargedwhiletheunit
operates.Whenanexternalpowerfailureoccurs,theEMV+automaticallyswitchestoitsinternalbatterypackfor
operatingpowerandactivatestheEXTERNALPOWERFAILUREalarm;thereisnointerruptioninoperation.When
externalpowerreturns,operatingpowerautomaticallyswitchesfrominternalpowertotheexternalsource.

SELF‐CHECK
AtstartuptheEMV+automaticallyperformsaselfcheckthatincludesacheckforpre‐existingalarmconditions.
Followingstartup,thepresenceofalarmconditionsischeckedcontinuously.Theventilatorcircuitmustbeopen
toambientatmosphere(notconnectedtothepatient)duringstartup.Ventilatoroperationbeginsimmediately
followingtheselfcheck.

WARNING!Untiltheoperatorhasdeterminedthattheventilatorisfunctioningproperlyandthattheventilator
parametersaresetcorrectlyforthepatient,thepatientshouldnotbeconnectedtotheventilator.

TRANSDUCERCALIBRATION(AUTOCAL)
Theventilatorcircuitconnectstoapressuretransducer(pressure‐sensingdevice)intheventilator.Periodically,
thetransducerrecalibratesitselfusingtheambientairpressureasareference.Thisprocessmaintainsaconsistent
transducerbaselineoverawidetemperatureandaltituderangetoassuredisplay,monitoring,andtriggering
accuracy.TheAUTOCALisperformedduringSELF‐CHECK,andthenevery5minutesthereafter.However,ifa
temperaturechangeexceeding+/‐1.5°Cissensed,theAUTOCALtimeintervalisreducedautomaticallytoassure
astablepressuremeasurementbaseline.

CAUTION!WhenusingthestandardvehicleDCoutlet,thevehicleshouldnotbejumpstartedduringoperation
oftheventilator.

20
OPERATIONOVERVIEW
INTRODUCTION
TheEMV+isavolumeandpressuretargeted,timeorflowcycledventilatordesignedtouseeitheroxygen(O2)
froma55psigsourceorfreshairusingitsinternalcompressortodeliverapositivepressurebreath.Theuser
interfaceallowstheoperatortoinitiateoperationoftheEMV+tobeginoperationatdefaultsettingvalues.
Whenhigh‐pressureO2isconnectedtheinternalblenderallowstheFIO2tobesetfrom21to100%.Backpressure
fromthepatientconnectiondoesnotaffectthedeliveredaccuracyofthevolume,flow,pressureorFIO2.When
theFIO2issetto21%,operatorsmayconnectalowflowoxygensourceattheFreshGas/EmergencyAirIntake
usingthereservoir(seeAppendix6:UseofLowFlowOxygen).Asuiteofalarmsalerttheoperatorwhen
conditionsexceedparameterlimitsorwhenoperationisaffectedbyanexternalorinternalfaultorfailure.When
analarmoccurstheoperatorisalertedbyaudibleandvisualindicatorswhilecontextsensitivehelpmessagesare
displayedintheLCD’sAlarmMessageCenterguide.OperatingpowerisfromanexternalAC/DCpowerconverter
connectedtoliveACmains,externalDCpower,orfromtheinternalrechargeablelithiumionbattery.Freshairis
filteredusingaparticulatefilteror,whentheoperatingenvironmentrequires,abacterial/viralfilterora
chemical/biologicalfiltermaybeattached.

PULSEOXIMETER
AtstartuptheEMV+checksthepulseoximeterconnection;ifasensorisconnectedtheunitbeginsthepulse
searchandallpulseoximeteralarms(SpO2,HRandsignal)areactive.Duringthefirstminuteofoperationalarms
aredisabledtoallowtheoperatortoconfigurethedeviceandsensor.Ifnosensorisdetectedtheunitstartswith
thepulseoximeterfunctionsturnedoff.TheheartrateandSpO2parameterwindowsdisplay“off”toremindthe
operatorthatthesefunctionsarenotavailable.Pulseoximeterfunctionswillautomaticallystartwhenthe
operatorconnectsapulseoximetersensor.SeeAppendix3:PulseOximeterPrinciplesandSpecifications.

Thepulseoximeteranditsaccessoryprobesandcablesareintendedforcontinuousnoninvasivemonitoringof
functionaloxygensaturationofarterialhemoglobin(SpO2)andpulserate(measuredbytheSpO2sensor)foradult,
pediatricandinfantpatientsusingtheappropriatesensorforpatient.Thepulseoximeterbecomesoperationalin
allventilatormodeswhenitscableandsensorareproperlyattachedtotheSpO2connector(seeFigure5).

Tooperatethepulseoximeter,connectitsprobetoitspatientcableandthepatientcabletotheSpO2connector.
Themonitoringfunctionwillcontinuouslydisplaythepatient’spulserateandSpO2value.SeethePulseOximeter
AlarmsintheVentilatorAlarmCategoriessectionformoreinformationonpulseoximeteralarms.


Thepulseoximeterreadingcanbeaffectedbythefollowingconditions:

1. Thesensoristootight.
2. Thereisexcessiveilluminationfromlightsourcessuchasasurgicallamp,abilirubinlamp,orsunlight.
3. AbloodpressurecuffisinflatedonthesameextremityastheonewithaSpO2sensorattached.
4. Thepatienthashypotension,severevasoconstriction,severeanemia,orhypothermia.
5. Thereisanarterialocclusionproximaltothesensor.
6. Thepatientisincardiacarrestorisinshock.
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
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NOTE:WhenafunctioningpulseoximeterprobeisconnectedtotheEMV+thepulseoximeterfunctions
cannotbeturnedoff.Theoperatormustremovetheprobeandthenturnoffthepulseoximeter.