PHILIPS Respironics BiPAP A40 User manual

This guide contains abstracted information from the User Manual; please refer
to the latest version for complete information regarding the BiPAP A40 device.
How to reach us
www.philips.com/healthcare
[email protected]
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[phone]
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[phone]
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[phone]
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Philips Respironics
1010 Murry Ridge Lane
Murrysville, PA 15668 USA
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[phone]
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[phone]
1300 766 488 (toll free,
Australia only)
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[phone]
[phone]
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[phone]
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[phone]
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[phone]
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[phone]
Philips Respironics Switzerland
[phone]
Philips Respironics
United Kingdom
[phone]
www.philips.com/respironics
© 2016 Koninklijke Philips N.V. All rights are reserved.
BiPAP A40 is registered trademark of Philips.
Philips Healthcare reserves the right to make changes in specifications and/or to
discontinue any product at any time without notice or obligation and will not be
liable for any consequences resulting from the use of this publication.
Broudy RP 4/24/16 MCI 4107145 PN 1098001

Battery module
4
Release
latch
Humidication
With device turned o, remove and fill chamber with water.
1. (a) Lift humidifier door until it locks in place. Do not force
door higher than the locked position. (b) Grasp front of
chamber and slide toward you.
2. (a) Gently push tab located inside round opening on top
of chamber. (b) Separate top and bottom of chamber.
3. Fill bottom chamber with distilled water.
4. Observe maximum fill lines located on sides of chamber.
5. Do not overfill.
Reassemble the chamber by placing the hinges on lid over the
two tabs on back of chamber. Close lid until it locks in place
with an audible click. Insert filled chamber into humidifier.
Humidication
With device turned o, remove and fill chamber with water.
1. (a) Lift humidifier door until it locks in place. Do not force
door higher than the locked position. (b) Grasp front of
chamber and slide toward you.
2. (a) Gently push tab located inside round opening on top
of chamber. (b) Separate top and bottom of chamber.
3. Fill bottom chamber with distilled water.
4. Observe maximum fill lines located on sides of chamber.
5. Do not overfill.
Reassemble the chamber by placing the hinges on lid over the
two tabs on back of chamber. Close lid until it locks in place
with an audible click. Insert filled chamber into humidifier.
Humidication
With device turned o, remove and fill chamber with water.
1. (a) Lift humidifier door until it locks in place. Do not force
door higher than the locked position. (b) Grasp front of
chamber and slide toward you.
2. (a) Gently push tab located inside round opening on top
of chamber. (b) Separate top and bottom of chamber.
3. Fill bottom chamber with distilled water.
4. Observe maximum fill lines located on sides of chamber.
5. Do not overfill.
Reassemble the chamber by placing the hinges on lid over the
two tabs on back of chamber. Close lid until it locks in place
with an audible click. Insert filled chamber into humidifier.
Humidication
With device turned o, remove and fill chamber with water.
1. (a) Lift humidifier door until it locks in place. Do not force
door higher than the locked position. (b) Grasp front of
chamber and slide toward you.
2. (a) Gently push tab located inside round opening on top
of chamber. (b) Separate top and bottom of chamber.
3. Fill bottom chamber with distilled water.
4. Observe maximum fill lines located on sides of chamber.
5. Do not overfill.
Reassemble the chamber by placing the hinges on lid over the
two tabs on back of chamber. Close lid until it locks in place
with an audible click. Insert filled chamber into humidifier.
Humidication
With device turned o, remove and fill chamber with water.
1. (a) Lift humidifier door until it locks in place. Do not force
door higher than the locked position. (b) Grasp front of
chamber and slide toward you.
2. (a) Gently push tab located inside round opening on top
of chamber. (b) Separate top and bottom of chamber.
3. Fill bottom chamber with distilled water.
4. Observe maximum fill lines located on sides of chamber.
5. Do not overfill.
Reassemble the chamber by placing the hinges on lid over the
two tabs on back of chamber. Close lid until it locks in place
with an audible click. Insert filled chamber into humidifier.
(bottom
view)
Undocking the battery
module or humidifier
To connect the battery module to
the BiPAP A40 device and install
the detachable battery, complete
the following steps:
1. Remove the side cover on the
therapy device
2. Line up the detachable battery
module and the therapy device
side by side
3. Press the two units together
until they snap into place
4. Insert the detachable battery
into the battery module, and
close the lid
3
4
2
Humidification
5

Connection to oximetry
6
Nurse call connector
Accessory slot
(cover shown)
SD card slot
DC power inlet
AC power inlet
Filter area
6
5
4
3
2
1
5
6
4
3
2
1
To connect the oximetry module:
ARemove the cover from the accessory
slot on the back of the BiPAP A40
BRemove the cover from the oximetry
accessory
CPlug the oximetry accessory into the
accessory slot
DPlug the oximetry sensor of your choice
into the oximetry module
When the oximetry module is connected,
and detailed view ON, the SpO2and heart
rate values are monitored on the main
screen (see below).
Back of device
A
B
C
D
Humidifier
cm
H2O
cm
H2Oml l/min
l/min BPM
S/T AVAPS: 0.5
0 5 10 15 20 25 30
Menu
Pressure
12.1
Vte
325
Leak
0.0
MinVent
3.9
Heart Rate
79
SpO2
95
RR
12
I:E Ratio
1:1.0
A
2

Guidelines for ventilation set-up
7
Important: Guidelines are intended to serve only as a reference. They shall be
used only in conjunction with the instructions and/or protocol set forth by the
physician and institution in which the assist device is being used. The guidelines are
not intended to supersede established medical protocols.
Initial
settings
IPAP = 8 - 10 cmH2O, EPAP = 4 cmH2O and RR = 10 - 12 BPM
IPAP Increase IPAP if the patient wants more air, targeting patient tidal
volume at 8 ml/kg of ideal weight
EPAP • without OSAS (Obstructive Sleep Apnea Syndrome): 4 - 5 cmH2O
• with OSAS: increase EPAP to remove obstructive apnea events
• with intrinsic PEP (stable chronic COPD): 5 - 6 cmH2O
BPM Set to 2 - 3 BPM under patient’s spontaneous frequency
Rise
time
Obstructive patients prefer short rise time:
from 1 - 4 (100 ms - 400 ms)
Restrictive patients prefer long rise time:
from 3 - 6 (300 ms - 600 ms)
Ti Set Ti between 25% and 33% for obstructive patients
Set Ti between 33% and 50% for restrictive patients
(refer to table opposite)
AVAPS
OHS COPD Other restrictive
diseases (NMD, etc.)
Vt target 8 - 10 ml/kg of ideal body weight (refer to table opposite)
IPAP
window
(IPAPmin
and
IPAPmax)
Allow a wide range
of pressure variation
to ensure the right
pressure at the right
time.
• IPAPmin = EPAP
• IPAPmax =
25 - 30 cmH2O
Allow a more
restrictive pressure
window to combine
comfort and efficacy.
• IPAPmin =
comfortable IPAP
• IPAPmax =
IPAPmin + 5 cmH2O
Allow a more restrictive
pressure window to
combine comfort and
safety.
• IPAPmin =
efficient IPAP
• IPAPmax =
IPAPmin + 5 cmH2O
AVAPS
rate
AVAPS rate setting depends on patient needs and clinical condition:
0.5 - 3 cmH
2
O/min so target tidal volume is reached smoothly
3 - 5 cmH
2
O/min so target tidal volume is reached more rapidly
Check patient arterial blood gases (PaCO2and PaO2) and oxygen saturation (SpO2).

Guidelines for ventilation set-up
Conversion table to set the inspiratory time for controlled breaths
Set back up breath rate
(BPM)
I/E 1/3,
Ti/Ttot 25%
I/E 1/2,
Ti/Ttot 33%
I/E 1/1,
Ti/Ttot 50%
10 1.5 s 2.0 s 3.0 s
11 1.4 s 1.8 s 2.7 s
12 1.3 s 1.7 s 2.5 s
13 1.2 s 1.5 s 2.3 s
14 1.1 s 1.4 s 2.1 s
15 1.0 s 1.3 s 2.0 s
16 0.9 s 1.3 s 1.8 s
17 0.9 s 1.2 s 1.7 s
18 0.8 s 1.1 s 1.6 s
19 0.8 s 1.1 s 1.5 s
20 0.8 s 1.0 s 1.5 s
21 0.7 s 1.0 s 1.4 s
22 0.7 s 0.9 s 1.3 s
23 0.7 s 0.9 s 1.3 s
24 0.6 s 0.8 s 1.2 s
25 0.6 s 0.8 s 1.2 s
Set the inspiratory time in seconds: Ti (second) = 60/Respiratory rate x % Ti
Conversion table to set the target tidal volume in relation to the ideal weight
Height Calculated ideal
weight (if BMI = 23)
Target Vte
if 8 ml/kg
Target Vte
if 10 ml/kg
1.50 m 52.0 kg 410 ml 520 ml
1.55 m 55.0 kg 440 ml 550 ml
1.60 m 59.0 kg 470 ml 590 ml
1.65 m 62.5 kg 500 ml 620 ml
1.70 m 66.5 kg 530 ml 660 ml
1.75 m 70.5 kg 560 ml 700 ml
1.80 m 74.5 kg 600 ml 740 ml
1.85 m 78.5 kg 630 ml 780 ml
1.90 m 83.0 kg 660 ml 830 ml
Calculated with an ideal Body Mass Index of 23 kg/m2(BMI = weight/height2)
Initial
settings
IPAP = 8 - 10 cmH2O, EPAP = 4 cmH2O and RR = 10 - 12 BPM
IPAP Increase IPAP if the patient wants more air, targeting patient tidal
volume at 8 ml/kg of ideal weight
EPAP • without OSAS (Obstructive Sleep Apnea Syndrome): 4 - 5 cmH2O
• with OSAS: increase EPAP to remove obstructive apnea events
• with intrinsic PEP (stable chronic COPD): 5 - 6 cmH2O
BPM Set to 2 - 3 BPM under patient’s spontaneous frequency
Rise
time
Obstructive patients prefer short rise time:
from 1 - 4 (100 ms - 400 ms)
Restrictive patients prefer long rise time:
from 3 - 6 (300 ms - 600 ms)
Ti Set Ti between 25% and 33% for obstructive patients
Set Ti between 33% and 50% for restrictive patients
(refer to table opposite)
AVAPS
OHS COPD Other restrictive
diseases (NMD, etc.)
Vt target 8 - 10 ml/kg of ideal body weight (refer to table opposite)
IPAP
window
(IPAPmin
and
IPAPmax)
Allow a wide range
of pressure variation
to ensure the right
pressure at the right
time.
• IPAPmin = EPAP
• IPAPmax =
25 - 30 cmH2O
Allow a more
restrictive pressure
window to combine
comfort and efficacy.
• IPAPmin =
comfortable IPAP
• IPAPmax =
IPAPmin + 5 cmH2O
Allow a more restrictive
pressure window to
combine comfort and
safety.
• IPAPmin =
efficient IPAP
• IPAPmax =
IPAPmin + 5 cmH2O
AVAPS
rate
AVAPS rate setting depends on patient needs and clinical condition:
0.5 - 3 cmH
2
O/min so target tidal volume is reached smoothly
3 - 5 cmH
2
O/min so target tidal volume is reached more rapidly
Check patient arterial blood gases (PaCO2and PaO2) and oxygen saturation (SpO2).

Set-up guide
1
2
3
4
6
7
5
Getting started
Main screen
Menus
Battery module
Connection to oximetry
Guidelines for ventilation set-up
Humidification
BiPAP A40

Display screen
Perform action specified on-screen
(humidifier setting, cancel action
or exit menu)
Navigate menus or change settings
Perform action specified on-screen
(activate ramp, select/modify/
confirm parameters)
Audio pause button
Start/stop button
6
5
4
3
2
1
Humidifier Ramp
cm
H2O
S/T AVAPS: 0.5
0 5 10 15 20 25 30
Menu
12/30/2010
06:12 PM
A
1
1
2 3 4
5
6
How to start therapyDevice navigation
• Connect the
device to AC
or DC power
source, or
use detachable
battery module
• Press to switch on the
device
• Select to start
the treatment
S/T AVAPS: 0.5
Menu
Setup
Therapy
A
12/30/2010
06:12 PM
Getting started
1

How to stop therapy
How to start therapy
Navigate
OK
Cancel
cm
H2O
cm
H2Oml l/min
S/T
0 5 10 15 20 25 30
Pressure
3.5
Vte
0
ml
RR
20
Leak
0.0
Standby
Power Off
• Press
• To keep power on but stop
therapy, select ‘Standby’
• Then select
• To turn power off, select
‘Power Off’
• Then select
How to unlock
To unlock the device
• Press and hold and
for a few seconds to access
Setup page
• Scroll down and select ‘Options’
• Modify ‘Menu access’ from
‘Limited’ to ‘Full’
• Press to validate
• Press and
to come back to
the main screen
When appears on the main
screen, the device is unlocked
cm
H2O
cm
H2Oml l/min
l/min BPM
S/T AVAPS: 5.0
0 5 10 15 20 25 30
Menu
Pressure
12.6
Vte
0
Leak
0.0
MinVent
0.0
RR
11
I:E Ratio
1:1.0

Humidifier Ramp
cm
H2O
cm
H2Oml l/min
l/min BPM
S/T AVAPS: 0.5
0 5 10 15 20 25 30
Menu
Pressure
12.1
Vte
325
Leak
30.0
MinVent
3.9
RR
12
I:E Ratio
1:3.0
A
1
AVAPS activated
with a speed rate
of 0.5cmH2O/min.
Breath
indicator
(patient or
machine settable
in Options)
Device
unlocked
Humidifier
connected,
setting 1
Pressure bar graph
Real-time
monitored values
when detailed
view ON
(Options settings)
Mode of ventilation
Detachable
battery connected
and in use
SD card inserted
Symbols and icons
FLEX enabled
FLEX enabled and FLEX setting
(eg. 1)
Humidifier connected and
Humidifier setting (eg. 1)
Bad humidifier state
(flashing symbol displays)
Ramp activated
SD Card error
(bad memory card inserted)
AVAPS
AVAPS: 1
FLEX
FLEX: 1
A
1
AVAPS
AVAPS: 1
FLEX
FLEX: 1
A
1
AVAPS
AVAPS: 1
FLEX
FLEX: 1
A
1
AVAPS
AVAPS: 1
FLEX
FLEX: 1
A
1
AVAPS
AVAPS: 1
FLEX
FLEX: 1
A
1
AVAPS
AVAPS: 1
FLEX
FLEX: 1
A
1
AVAPS
AVAPS: 1
FLEX
FLEX: 1
A
1
AVAPS
AVAPS: 1
FLEX
FLEX: 1
A
1
AVAPS
AVAPS: 1
FLEX
FLEX: 1
A
1
AVAPS
AVAPS: 1
FLEX
FLEX: 1
A
1
AVAPS
AVAPS: 1
FLEX
FLEX: 1
A
1
AVAPS
AVAPS: 1
FLEX
FLEX: 1
A
1
AVAPS
AVAPS: 1
FLEX
FLEX: 1
A
1
AVAPS
AVAPS: 1
FLEX
FLEX: 1
A
1
Apnea alarm enabled
Audio pause is active
Circuit disconnect
alarm enabled
Detachable battery is 80% capacity
Detachable battery is 20% capacity
Detachable battery is
nearly depleted
Detachable battery is
being charged
Detachable battery in use
Main screen
2

Menu: Settings and alarms
Mode CPAP, S, S/T, PC, T, AVAPS-AE
Trigger type Auto-Trak /Flow Trigger/
Auto-Trak (sensitive)
Flex Lock (only in S mode) On (locked)/Off (unlocked)
Flex (only in S mode) On/Off
AVAPS On/Off
AVAPS rate 0.5 - 5 cmH2O/min, in 0.5 cmH2O/min increments
Tidal volume*200 - 1500 ml, in 10 ml increments
IPAP max*IPAPmin - 40 cmH2O, in 0.5 cmH2O increments
IPAP min*4 - IPAPmax, in 0.5 cmH2O increments
EPAP 4 - 25 cmH2O, in 0.5 cmH2O increments
Breath rate 0 - 40 BPM (4 - 40 BPM for T mode)
Inspiratory time 0.5 - 3 sec, in 0.1 sec increments
Rise time lock On (locked)/Off (unlocked)
Rise time 1 (fastest) to 6 (slowest)
Ramp length 0 - 45 minutes, in 5 minute increments
Ramp start pressure 4 cmH2O - prescribed EPAP,
in 0.5 cmH2O increments
System One humidification On (System One Humidity Control)/
Off (classic mode)
Humidifier 1 (coolest) to 5 (hottest)
*only when AVAPS is enabled
Menus
3

Menu: Settings and alarms (cont.)
Tubing type lock On (locked)/Off (unlocked)
Tubing type 15 mm/22 mm
System One resistance lock On (locked)/Off (unlocked)
System One resistance (interface type) 0, X1, X2, X3, X4, X5 or Invasive
Circuit disconnect alarm Off; 15 or 60 sec
Apnea alarm Off; 10, 20 or 30 sec
Low tidal volume alarm
(only when AVAPS is enabled)
On/Off
Low minute ventilation alarm Off; 1 - 99 LPM
High respiratory rate alarm Off; 4 - 60 BPM
Settings Range
AVAPS rate 0.5 - 5 cmH2O/min, in 0.5 cmH2O/min increments
Tidal volume 200 ml - 1500 ml
Maximum pressure 6 - 40 cmH2O
Pressure support Max 2 - 36 cmH2O
Pressure support Min 2 - 36 cmH2O
EPAP Max pressure 4 - 25 cmH2O
EPAP Min pressure 4 - 25 cmH2O
Breath rate Auto/0 - 40 BPM
Menu: Settings and alarms: AVAPS-AE

To navigate through the Options
menu:
• Use to scroll
through the menu.
• Use the left and right
buttons to perform the actions
specified on the on-screen buttons
and set according to your preference.
Menu: Options
Menu access Full (device unlocked)/Limited (device locked)
Detailed view On (monitored data on the screen)/Off
(no monitored data on the screen, only time and date)
Language You have the choice between 22 different languages
Pressure units cmH2O/hPa
Breath indicator Patient (spontaneous breath)/machine (controlled breath)
Keypad lock On (buttons inactive)/Off (buttons active)
Keypad backlight On/Off
LCD brightness 1 (darkest) to 10 (lightest)
Screen saver Dim (backlight is decreased)/Breath (black screen,
but manometer and breath indicator are visible)/
Off (no screen saver)
Date and
time format
Date and time settings
Blower hours Number of hours the blower has been active (resettable)
Therapy hours Number of hours the patient receives therapy
(resettable)
SpO2Date of the last complete SpO2session (at least 4 hours)
Menu access Full
Detailed view ON
Language English
Pressure units cmH20
Breath Indicator Patient
Menu Options
S/T AVAPS: 0.6
1/18
Navigate
Setup
Modify
Finish
A
Under ‘Options’, you have access to the following parameters: