O_TWO CAREvent ATV User manual

CAREvent®
ATV/ATV+ & MRI
01CV6000 01CV7000
01CV6000 01CV7000
USER MANUAL
(FOR STANDARD AND G2K® MODELS)
CAREvent® ATV/ATV+ & MRI User Manual - REV 24 Mar, 2020
CAREvent® ATV+
01CV6000
CAREvent® ATV+
01CV7000

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CAREvent® ATV/ATV+ & MRI - User Manual
TABLE OF CONTENTS
1. Introduction 4
1.1. Warranty 4
1.2. Warnings 4
1.3. Terms and Definitions 6
1.4. CAREvent® MRI 7
1.5. General Information 7
1.6. General Description 8
1.7. Principles of Operation 9
1.8. Modes of Operation 9
1.9. Alarms and Gauges 11
1.10. Accessories 13
1.11. Control Adjustment 14
1.12. Technical Data 15
2. Preparation for Use 17
2.1. Component List 17
2.2. Connection of Hoses 18
2.3. Pre-use Functional Check 18
3. Operating Instructions 22
3.1. Setting of the Ventilation Parameters 22
3.2. Frequency/Minute Volume Chart 22
3.3. Operation in Extreme Conditions 23
4. After Use Cleaning and Testing 23
4.1. Dismantling and Cleaning 23
4.1.1. Changing the Air Intake Filter 24
4.2. After Use and Monthly Checking 24
5. Maintenance Schedule 25
5.1. Annual Preventative Maintenance Inspection 25
6. Trouble Shooting Chart 26
7. CAREvent® Accessories 27

4CAREvent® ATV/ATV+ & MRI - User Manual
1. Introduction
1.1. Warranty
WARRANTY
The CAREvent® ATV+ and MRI are manufactured from the finest
quality materials. Each individual part is subject to strict quality control
tests to ensure exceptionally high standards. The manufacturer
warrants to the purchaser of the Automatic Transport Ventilator
that its component parts are free from defects in material and
workmanship for a period of two years from the date of purchase.
The manufacturer will replace and/or repair all parts of the Automatic
Transport Ventilator at its option for two years from the date of
purchase at no cost to the purchaser, upon the notification
of the defects, in writing by the purchaser and confirmation of said
defect by the manufacturer. All shipping costs shall be borne by the
purchaser. The manufacturer shall be liable under this warranty only
if the Automatic Transport Ventilator and its parts have been
used and serviced in the normal manner described in the instruction
manual. There are no other expressed or implied warranties. This
warranty gives no specific legal rights.
Note: THIS DEVICE MUST BE SERVICED BY AN O-TWO SYSTEMS
AUTHORIZED SERVICE CENTER.
1.2. Warnings
The CAREvent® ATV+ and MRI are intended for use by suitably
trained and qualified personnel.
The following precautions should always be observed:
1. Read this manual prior to attempting to use the ventilator.
2. When the unit is in use, do not smoke or use near open flame
either during use or when changing the cylinder.
3. When not in use, always turn o the gas supply.
4. Never allow oil or grease to come into contact with any part of
the cylinder, regulator or ventilator.
5. This device is not designed for use with heated humidifiers.
6. This resuscitator is not recommended for use on neonates
and pregnant or nuring women.

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CAREvent® ATV/ATV+ & MRI - User Manual
7. Do not disassemble any part of the ventilator except where
described in this manual as any unauthorized disassembly
will invalidate the warranty.
8. After use, always ensure that all components are cleaned
in accordance with the instructions provided in this manual.
(See section 4)
9. Always use the check list to ensure thatall components are
reassembled correctly and ready for use.
10. It is recommended that an alternative means of ventilating the
patient be available in case of gas supply failure.
11. During use, the patient should not be left unattended.
12. The use of this device in areas where the ambient air may be
hazardous or explosive should be avoided as entrainment
of ambient air during the use of the air mix mode will permit
the patient to inhale atmospheric gas.
13. Only the CAREvent® MRI unit may be used in a magnetic
resonance imaging department.
14. Only patient circuits supplied by o-two systems should be
used, as the use of other circuits may adversely aect the
output performance of the ATV.
15. The use of gas pressure regulators that do not maintain
a minimum output pressure and flowrate in line with the
requirements of the specification may cause the device to fail
resulting in the patient not being ventilated.
16. The use of this device in carring case of any type may,
when used in the 60% air mix mode, result in an increase in
oxygen concentration. If the air mix mode is to be used it
is recommended that the ventilator be placed in its normal
operating orientation and that the air intake on the rear of the
ventilator is not obstructed.

6CAREvent® ATV/ATV+ & MRI - User Manual
1.3. Terms and Definitions
Airway Resistance: Pressure drop across the airway per unit flow.
ATV: Automatic Transport Ventilator
CMV: Controlled Mandatory Ventilation.
CPAP: A positive pressure applied to the lungs during all
ventilation phases (Continuous Positive Airway Pressure).
Demand Valve: A valve that delivers gas to the patient at a flowrate equivalent
to that demanded by the patient’s inspiratory eort.
Expiratory Phase: The time period from the end of the inspiratory
flow to the end of the expiratory flow.
Expiratory Time (Te): Duration of the expiratory phase.
Frequency (f): The number of breaths in one minute
(also expressed as BPM).
Inspiratory Flow: The flow delivered to the patient by the ventilator
during the inspiratory phase.
Inspiratory Phase: The interval from the start of the inspiratory flow
to the start of the expiratory phase.
Inspiratory Time (Ti): Duration of the inspiratory phase.
Lung Compliance: Volume added per unit pressure increase when
gas is added to a human or artificial lung.
Maximum Patient
Inflation Pressure:
The maximum airway pressure delivered by the ventilator
to the patient.
Minute Volume (Vm): The total volume of gas delivered to the patient
in one minute.
Oxygen
Concentration:
The oxygen content of the inspired gases
expressed as a percentage.
Proximal Airway
Pressure: The airway pressure measured at the patient valve.
Patient Valve:
The valve which directs the flow of gas into the
lungs and out of the expiratory port to atmosphere
during expiration.

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CAREvent® ATV/ATV+ & MRI - User Manual
PEEP Valve:
A device which, when attached to the expiratory
port of the patient valve, holds a positive pressure
in the patients airway at the end of the expiratory
phase. (Positive End Expiratory Pressure)
Pressure Relief
Valve:
Valve which limits the maximum lung inflation pressure
by venting excess gas to atmosphere.
Tidal Volume (Vt): Volume of gas delivered to the patient during
each inspiratory phase.
G2K® :
Guidelines 2000 compliance. Complies with the
requirements of the ERC and AHA for 15:2
compression : ventilation ratio.
1.4. CAREvent® MRI
The CAREvent® MRI has been designed to meet the requirements
of ventilation within the MRI environment. The CAREvent® MRI has
been tested in a 1.5 Tesla MRI environment (unshielded magnet -
spatial gradient of <23Mt/m/sec and a slew rate of 120 T/m/sec
at an RF transmitter power of 2000 watts) and a 3.0 Tesla MRI
environment (unshielded magnet - spatial gradient of < 40Mt/m/
sec and a slew rate of 150 T/m/sec at an RF transmitter power
of 8000 watts) during a head phanton spectroscopy test scan
with the device located no less than 12 inches from the magnet
aperture which would be its normal use position during clinical
use.
In addition, the CAREvent® MRI model can be attached to the
CAREvent® MRI mounting plate or attachment to a cart or wall/
medirail mounting bracket.
1.5. General Information
The CAREvent® ATV+ and MRI are designed for use in the
prehospital, intrahospital, interhospital and air ambulance settings.
Designed to be used by suitably trained personnel, the various
modes of operation of the device support the resuscitation and
transportation of a wide range of patients (from infants to adults)
who require ventilatory support. The features and controls oered
by the device comply with the various International Standards for
Transport Ventilators.

8CAREvent® ATV/ATV+ & MRI - User Manual
The G2K® models have been manufactured to comply with the
latest Guidelines 2000 for CPR and ECC from the European
Resuscitation Council and the American Heart Association.
1.6. General Description
The CAREvent® ATV+ and MRI consist of a ruggedly constructed,
portable control module, input hose and optional single use
(or reusable where available) patient circuit. The ergonomically
designed control groupings facilitate the selection and setting of
the breathing parameters. The colour groupings provided on the
controls adds to this ease of use concept.
The unique pneumatic alarm for low input pressure improves
the level of safety for the patient by warning the operator of any
problems of insuIcient or failed gas supply.
The air mix capability of the ventilator improves the operating time
on bottled oxygen for long duration transports. The extremely
low drive gas consumption ensures full utilization of the cylinder
contents.
Controls
The controls provided are as follows:
• Ventilation Frequency
• Pressure Relief (Proximal Airway Pressure)
• Minute Volume
• Delivered Oxygen Concentration (%)
• Manual Ventilation
• Manual/AUTO Selector
• CPAP/PEEP Control
• BSI Alarm Silence Button
Visual Indicators
• Proximal Airway Pressure Gauge (cmH2O)
• Gas Supply Status Indicator
• BSI Alarm Indicator
Connections
Connections are provided on the side of the ventilator for the
Oxygen Input and the Gas Output.

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CAREvent® ATV/ATV+ & MRI - User Manual
1.7. Principles of Operation
The CAREvent® ATV+ and MRI are time-cycled, Intermittent
Positive Pressure devices providing a range of frequencies
of ventilation and Minute Volume settings to provide a
comprehensive range of delivered tidal volumes and ventilation
rates. The design of the micro-pneumatic circuitry in the
Automatic Transport Ventilator maintains a consistent I:E ratio
of 1:2 across the Minute Volume/frequency combinations to
optimise the exchange of gases in the alveoli. This helps avoid
the risk of inconsistent ventilations and protracted expiratory
times that may cause additional physiological acidosis or short
inspiratory times that may not allow for complete alveolar filling
or may generate high airway pressures.
1.8. Modes of Operation
Automatic Ventilation Mode
In the automatic mode (selected by turning the Manual/AUTO
Selector on the ventilator control panel to AUTO while pressing
and holding the Selector Release Button) the ventilator will supply
the patient with positive pressure ventilations of a frequency
and minute volume as selected using the Ventilation Frequency
and Minute Volume Selectors on the front panel. The I:E ratio is
maintained at a constant 1:2 to ensure that good gas exchange
takes place in the lung.
Manual Ventilation Mode
To allow the operator to control the patient’s breathing manually,
a Manual Ventilation Override button is located on the front
panel. In the AUTO mode, when the Manual Override Button is
depressed, the ventilator will cease automatic cycling and will
deliver a constant flowrate equivalent to that selected on the
flowrate selector for as long as the button is depressed. Releasing
the button will allow the ventilator to re-cycle into an automatic
ventilation mode following a delay period of approximately 1.5
times the expiratory time for the frequency setting selected
(10 seconds in the G2K® model). This delay allows the operator
sucient time to provide chest compressions or initiate a further
manual breath should they so wish. If the Manual Override Button
is depressed for too long the patient is protected from high airway
pressure by the Pressure Relief system.
Note: The design of these ventilators does not incorporate a negative
pressure phase during either automatic or manual ventilation.

10 CAREvent® ATV/ATV+ & MRI - User Manual
In the Manual mode, depressing the Manual override button will
allow the operator to manually ventilate the patient at a flowrate
equivalent to the Minute Volume selected.
Demand Breathing
During automatic ventilation, the Demand Breathing mode will
allow the patient to commence spontaneous breathing through
the ventilator while causing the automatic cycling to cease. As
with the Manual Override, there is an increase in the expiratory
time before the next automatic breath is delivered to allow the
patient to continue demand breathing. This system ensures that
the patient receives a sucient minute volume should their
inspiratory eorts be erratic. Demand Breathing is available to
the patient in both the inspiratory and expiratory phases of the
ventilation cycle.
In the Manual mode the patient can Demand Breathe at their own
rate and volume.
Note: It is important to constantly observe the patient’s respirations
to ensure that adequate perfusion is occurring.
Note: If used in conjunction with external chest compressions the
Auto Circuit Shut O function may be actuated should the
depth of compression create sucient tidal volume on chest re-
coil. Under these circumstances a manual breath may be delivered
(if deemed necessary) between sets of compressions.
Note: Small children may not be able to demand at a sucient
flowrate to disable the automatic cycling.
Adjustable Pressure Relief
This control allows the operator to vary the maximum delivered
airway pressure. This is achieved by diverting the excess delivered
volume to atmosphere should the set airway pressure be reached.
Air Mix Mode
To conserve oxygen during long transports or when a patient’s
respiratory condition demands an oxygen concentration of less
than 100%, the air mix mode can be selected. This reduces the
oxygen concentration to 60%. In this mode the ventilator entrains