PHILIPS Respironics BiPAP S/T C Series User manual

Important! Remove this manual before giving the device to the patient. Only medical professionals should adjust
pressure settings.
Note: If required by the physician, ensure that an alternative means of ventilation is available in the event of a
system failure.
This manual must be used with the User Manual when used by a medical professional. Read and
understand both the User Manual and Provider Manual before setting up the device. This manual
provides you with instructions on how to access and navigate the provider screens used to modify
device settings.
Note: The screens shown throughout this manual are examples only. Actual screens may vary slightly.
Intended Use
The BiPAP S/T device is intended to provide non-invasive ventilatory support to treat adult patients
weighing over 66 lbs (30 kg) and pediatric patients 7 years or older and weighing over 40 lbs (18 kg)
with Obstructive Sleep Apnea (OSA) and Respiratory Insuciency. This device may be used in the
hospital or home.
Caution: US federal law restricts this device to sale by or on the order of a physician.
BiPAP S/T Provider Manual

BiPAP S/T
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Table of Contents
Intended Use............................................................................................................................................................ 1
Accessing the Provider Mode Screens............................................................................................................ 3
Navigating the Provider Mode Menu ............................................................................................................. 3
Setup Screen ...................................................................................................................................................4
Updating Software Using the SD Card ........................................................................................................... 9
Therapy Features ...................................................................................................................................................11
Ramp ................................................................................................................................................................11
Bi-Flex Comfort Feature.............................................................................................................................11
Rise Time.........................................................................................................................................................12
Digital Auto-Trak Sensitivity.....................................................................................................................13
Clear Patient Data for Multiple Users .............................................................................................................15
Cleaning for Multiple Users ...............................................................................................................................16
Heated Humidier Performance Conrmation..........................................................................................16
Adding Supplemental Oxygen.........................................................................................................................17
Supplemental Oxygen Concentrations.........................................................................................................17
Verifying the Pressure..........................................................................................................................................19
Verifying the Alarms.............................................................................................................................................21
Patient Disconnect Alarm Test ................................................................................................................21
Apnea Alarm Test.........................................................................................................................................21
Low Minute Ventilation Alarm Test .......................................................................................................21
Loss of Power Alarm Test...........................................................................................................................22
Specications..........................................................................................................................................................22

Provider Manual
3
Accessing the Provider Mode Screens
There are two levels of access:
•Provider Mode
•User Mode
Note: Refer to the User Manual for device details about User Mode.
Accessing provider mode unlocks settings that cannot be modied by the user. To access
provider mode:
1. Supply power to the device: Plug the socket end of the AC power cord into the power supply,
and then plug the pronged end of the AC power cord into an electrical outlet not controlled by
a wall switch. Finally, plug the power supply cord’s connector into the power inlet on the back
of the device.
2. Once the device is powered, the Main Menu appears, shown below. Turn the Wheel to toggle
between the four options, and highlight “Setup” or the icon.
Therapy
Info
Comfort
Setup
Icon View - Blower OText View Icon View - Blower On
3. Once “Setup” or the icon is highlighted, press and hold both the Control Wheel and the
Ramp button on the device for at least 5 seconds.
4. You will hear a quick double beep to indicate that you are now in provider mode and can
access the provider mode settings.
Note: You will remain in provider mode until you exit the Setup screen using the “Back” selection, or until a screen
time-out occurs after one minute.
Navigating the Provider Mode Menu
To navigate the provider mode menu:
Turn the Wheel to toggle between options and settings on the screen. Press the Wheel to choose
an option or setting that is highlighted. If you choose “Back” or the icon, you will exit provider
mode and go back to the previous screen.

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Setup Screen ( )
From the Provider screen, highlight “Setup”or the icon and press the wheel. The following Setup
screen will appear. Once you’ve entered provider mode, the Setup screen below appears. The screen
will only display a few lines at a time. As you rotate the Wheel to toggle over dierent options, the
screen slides up and down accordingly.
Note: The menu options will vary depending on what therapy mode you are in.
Note: If the text is too long to completely t on the screen, it will scroll horizontally across the screen when highlighted.
S/T
CPAP 12
EPAP 5
10
TI2.0
FLEX 2
3
10
4
15
10
60
MinVent 2.0
English
cmH2O
3
Setup
Mode S/T
CPAP 12
EPAP 5
BPM 10
Ti2.0
Flex Lock on
Bi-Flex 2
Rise Time Lock on
Rise Time 3
Ramp Time 10
Ramp Start Pressure 4
Tubing Type Lock on
Tubing Type 15
Apnea Alarm 10
Patient Disconnect Alarm 60
Low Min Vent Alarm 2.0
Backlight on
Language English
hPa/cmH2O cmH2O
Humidier 3
Reset Therapy Hrs no
Reset Blower Hrs no
Provider Mode on
Back
Icon View Text View
Setup Parameter Display LeakLeak
IPAP 20 IPAP 20
Back
Heated Tube Humidication o
Humidity Level 4
Tube Temperature 3
System One Humidication on
4
3
SYSTEM
ONE
System One Resistance X1
X1
System One Resistance Lock on
Clear Patient Data no
0

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The sections below describe the settings on the Setup screen.
Therapy Settings
•Mode ( ) - Choose the therapy mode setting (CPAP, S, or S/T). The default setting is S/T.
•CPAP (CPAP) - If CPAP is the therapy mode, you can set the CPAP setting in 1.0
increments. The default setting is 10.
•IPAP (IPAP) - You can set the IPAP setting in 1.0 increments. The default setting is 12.
•EPAP (EPAP)- In any mode except CPAP, you can set the EPAP setting in 1.0 increments.
The default setting is 4.
Warning: High EPAP pressures can cause patient discomfort. Carefully evaluate the patient if you set the
EPAP level above 15.
•BPM (BPM)- If you are in S/T mode, you can set the Breaths Per Minute setting from
0-30 in 1.0 BPM increments. The default is 10.
•Ti- If you are in S/T mode, you can set the Inspiratory Time setting from 0.5 to 3 seconds
in 0.1 increments. The default setting is 1.0.
Comfort Settings
•Flex Lock ( )- When in S mode, you can allow the user to adjust the Bi-Flex
setting by selecting “o”, or you can lock the Bi-Flex setting so the user cannot adjust it by
selecting “on”.
•Bi-Flex (FLEX) - When in S mode, you can enable or disable the Bi-Flex setting by
selecting O, 1, 2, or 3. This setting allows you to adjust the level of air pressure relief
that the patient feels when exhaling during therapy. The default setting is O.
Note: If you did not lock the Bi-Flex setting, the user can only adjust the setting from 1-3. They cannot disable Bi-Flex.
Note: Bi-Flex is available up to 25 cmH2O in S mode.
Note: The patient also has access to the Bi-Flex setting if it is enabled and unlocked.
•Rise Time Lock ( ) - You can allow the user to adjust the Rise Time setting by
selecting “o”, or you can lock the Rise Time setting so the user cannot adjust it by
selecting “on”.
•Rise Time ( )- You can adjust the Rise Time from 1-6. Rise time is the time it takes for
the device to change from EPAP to IPAP. This allows you to adjust the rise time so you can
nd the most comfortable setting for the patient. The default setting is 1.
Note: If you did not lock the Rise Time setting, the user can adjust the setting from 1-6.

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•Ramp Time ( )- You can adjust the ramp time from 0 (o) - 45 minutes in 5-minute
increments. The default setting is 0.
•Ramp Start Pressure ( )- If Ramp is enabled, you can adjust the Ramp Start Pressure
from 4 to the CPAP or EPAP setting (depending on your therapy mode) in increments of
1. The default is 4. The user can also adjust this setting.
•Heated Tube Humidication ( ) - This setting will only display if you are using the
heated tube. You can enable (1) or disable (0) this feature.
•Humidity Level ( ) - This setting will only display if you are using the heated tube.
This setting allows you to choose the desired humidity setting for the humidier: 1, 2 or 3.
This setting can only be changed from the Setup screen.
•Tube Temperature ( ) - This setting will only display if you are using the heated tube.
This setting allows you to choose the desired temperature for the heated tube: 0, 1, 2, 3, 4
or 5. If you choose zero (0), this will turn o both the humidier and the heated tube .
Note: When using Heated Tubing, the control wheel can also be used to change this setting.
•System One Humidication (
SYSTEM
ONE
)- System One humidity control maintains a
consistent mask humidity by monitoring and adjusting for changes in room temperature
and room humidity. You can enable (1) or disable (0) this feature. If the System One
humidity control has been disabled, the classic style of basic temperature controlled
heated humidication will be used. This will only display if the humidier is attached .
Note: The System One Humidication option is only available if the Heated Tubing is removed or has been disabled.
•Humidier ( ) - If the humidier is attached to the device, you can select from 0 (o)
to 5 in increments of 1 to enable or disable the humidier setting. The default is 0 (o). If
the System One humidity control has been disabled, the classic style of basic temperature
controlled heated humidication will be used and the display will show: 0, C1, C2, C3, C4
or C5 for these settings. This setting only displays if a humidier is attached to the device.
Please refer to the humidier manual if using a humidier.
Note: The Humidier option is only available if the Heated Tubing is removed or has been disabled.
Note: When not using Heated Tubing, the control wheel can also be used to change this setting.
•Tubing Type Lock ( ) - You can lock the Tubing Type setting for either the 22 mm or
the 15 mm tubing.“1” turns the lock “on”and “0” turns the lock “o”.
Note: If locked, the patient will still see this setting with a “lock” icon next to it, but they will not be able to change it.
Note: This will not prevent the user from using Heated Tubing at a later date.

Provider Manual
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•Tubing Type ( )- You can select the correct size diameter tubing that you are using
with the device. Choose either “22” for the Philips Respironics 22 mm tubing, or “15” for
the optional Philips Respironics 15 mm tubing. When using Heated Tubing, the device
will automatically change this setting to the appropriate tubing type (15H).
Note: If the Heated Tubing is removed, the device will default back to the previous tubing type setting.
•System One Resistance Lock ( ) - This enables you to lock the “System One”
resistance control setting if you do not want the patient to change it. “1” turns the lock
“on” and “0” turns the lock “o” .
Note: If you lock this setting, the patient will see a “lock” icon next to the setting.
•System One Resistance ( ) - This setting allows you to adjust the level of air
pressure relief based on the specic Respironics mask. Each Respironics mask may have
a “System One” resistance control setting. System One resistance compensation can be
turned o by choosing the setting “0 “.
Note: The patient also has access to this setting, if the System One Resistance Lock is o.
Alarm Settings
•Patient Disconnect Alarm ( )- You can enable or disable the Patient Disconnect
alarm by choosing 0, 15, or 60 seconds. The alarm will sound when a large, continuous air
leak is detected in the circuit for more than the specied alarm setting. The default is 0.
•Apnea Alarm ( )- The Apnea alarm detects the cessation of spontaneous
breathing. You can enable or disable the Apnea alarm by choosing 0 (o), 10, 20, or
30 seconds. The alarm will sound when the time between patient-triggered breaths is
greater or equal to the specied apnea alarm setting. The default is 0.
•Low MinVent Alarm (
MinVent
) - You can enable or disable the Low Minute
Ventilation alarm by choosing 0 (o) to 99 lpm in 1.0 increments. The alarm will sound
when the calculated minute ventilation is less than or equal to the specied setting. The
default is 0 (o).
System Settings
•Backlight ( ) - You can turn the button backlights “on” or “o”with this setting.
•Language ( ) - This feature allows you to choose which language to display on
the interface when in “Text mode”. You can also turn o (0) text mode which means the
device will display the“Icon Mode” on the interface.
Note: Both “Icon Mode” and “Text Mode” are shown throughout this guide for your reference.

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8
•hPa/cmH2O ( ) - You can select the units of pressure that are displayed on-screen.
Choose “hPa” or “cmH2O ”.
•Setup Parameter Display ( ) - You can select which measured parameters will display
on the Monitor Pressure screen. Choose from Leak, BPM (Breaths Per Minute), Min vent, or Vte.
See the Measured Parameter section in the User Manual for more information.
•Reset Therapy Hours ( ) - Resets the Therapy Hours back to the default of 0 hours.
This setting is only available to the Provider.
•Reset Blower Hours ( ) -You can select “yes” if you want to reset the blower
hours (e.g., to track device usage between patients), or “no”if you do not want to reset
the blower hours.
•Provider Mode ( )- You can choose “on” or “o” to enable or disable provider
mode. Selecting “on”will put the device in provider mode (and the device will not
automatically return to user mode when the screen times out or you select the Back
option). Selecting “o” keeps the device in user mode.
•Clear Patient Data ( ) - You can choose to clear the patient data stored in internal
memory by setting the Clear Patient Data menu to“yes”. If“no”is selected, the conrmation
screen is removed, and patient data is not erased from memory or the SD Card.

Provider Manual
9
Updating Software Using the SD Card
You can update the device software using the SD Card. The software update must be done when
the therapy is o.
Note: The screens may vary slightly from the examples shown here (e.g., software version may be dierent than
screens shown here.)
1. Insert an SD Card with the new software version into the device. One of the following screens
appears on the display (depending if the Language parameter is set to a specic language or Icon):
1.1?
Icon View Text View
Do you wish to upgrade
from version 1.0 to
version 1.1?
yes
2. Press the Wheel to select “yes”or the displayed to start the software upgrade.
3. Rotate the Wheel to display“no” or , as shown below, and press the Wheel to cancel the
software upgrade.
1.1?
Icon View Text View
Do you wish to upgrade
from version 1.0 to
version 1.1?
no
4. If there was a problem with the software on the SD Card before the upgrade process begins,
the following informational alert is displayed:
Software Upgrade
Failed!

BiPAP S/T
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5. While the software upgrade is in progress, the following screen appears on the display. The
progress bar will ll as the software upgrade process completes.
1.1
6. If the software update process was successful, the following screen appears on the display.
Remove the SD Card from the device to restart the device and use the new software.
1.1
7. If the software update process was not successful after it was initiated, the following
screen appears on the display. Remove the SD Card from the device. Reload the new
software onto the SD Card or load the new software onto another SD Card and try again.
If the problem persists, contact Philips Respironics Customer Service department at
1-724-387-4000 or 1-800-345-6443.
1.1

Provider Manual
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Therapy Features
The device provides the following therapy features. These features are enabled or disabled only in
provider mode.
Note: Refer to the User Manual for detailed information about the device therapy modes.
Ramp
If enabled, the device is equipped with a linear ramp function. The Ramp feature will reduce the
pressure and then gradually increase (ramp) the pressure to the prescription pressure setting so
patients can fall asleep more comfortably. The gure below illustrates how the ramp function works.
Bi-Flex Comfort Feature
If enabled, the device provides a comfort feature called Bi-Flex in S mode only. The Bi-Flex attribute
adjusts therapy by inserting a small amount of pressure relief during the latter stages of inspiration
and during active exhalation (the beginning part of exhalation). In the following diagram, the bold
lines represent Bi-Flex in comparison to the dashed line representing normal BiPAP therapy. Bi-Flex
levels of 1, 2, or 3 progressively reect increased pressure relief that will take place at the end of
inspiration and at the beginning of expiration.

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Rise Time
In S and S/T modes, rise time is the amount of time it takes the device to change from the expiratory
pressure setting to the inspiratory pressure setting. Rise time levels of 1, 2, 3, 4, 5, or 6 progressively
reect slowed response of the pressure increase that will take place at the beginning of inspiration.
Adjust the rise time to nd the most comfortable setting for the patient. A setting of 1 is the fastest
rise time while 6 is the slowest. Rise time cannot be adjusted when Bi-Flex is enabled.
Note: When Bi-Flex is enabled, Rise Time is xed at 3.
PRESSURE
IPAP
EPAP
TIME
Rise Time

Provider Manual
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Digital Auto-Trak Sensitivity
An important characteristic of the device is its ability to recognize and compensate for
unintentional leaks in the system and to automatically adjust its trigger and cycle algorithms to
maintain optimum performance in the presence of leaks. This feature is known as Digital Auto-Trak
Sensitivity. The following sections examine this function in detail by describing the leak tolerance
function and sensitivity.
Leak Tolerance
A microprocessor monitors the total ow of the patient circuit and calculates patient ow values.
A. Leak Estimation: Average and Parabolic
The device uses two leak estimation algorithms. A conservation of mass algorithm is used to
compute the average leak for a given pressure support relationship. This average leak is used
when large leak variations are present in the system. Average leak is a high estimate during
EPAP pressure and a low estimate during IPAP pressure.
A better leak estimate, enabled by the digital system, is the parabolic leak algorithm. Parabolic
leak is proportional to the square of the patient pressure; therefore, the leak estimate is
correlated to the changing patient pressure. Both algorithms include unintentional circuit leak
and are averaged over several breaths.
B. Patient Flow
The total circuit ow is comprised of the circuit leak and the patient ow. The calculated patient
ow is the total ow minus the circuit leak. Patient ow is a primary input into the triggering
and cycling mechanisms.
Sensitivity
An essential feature of the device while operating in the S and S/T modes is its ability to eectively
sense spontaneous breathing eorts, which causes the ventilator to trigger to IPAP and cycle to
EPAP. Because no preset sensitivity threshold can assure patient and machine synchrony with
changing breathing eorts and circuit leaks, the device continuously tracks patient breathing pat-
terns and automatically adjusts sensitivity thresholds to ensure optimum sensitivity as breathing
patterns change or as circuit leaks change. The algorithms used to ensure optimum sensitivity are
the Volume Trigger, Shape Signal, and the Spontaneous Expiratory Threshold (SET).

BiPAP S/T
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Volume Trigger (EPAP to IPAP)
The volume trigger is one method used to trigger IPAP during spontaneous breathing in the S and
S/T modes. The volume trigger threshold is 6 ml of accumulated patient inspiratory volume. When
patient eort generates inspiratory flow causing 6 ml of volume, IPAP is triggered.
Shape Trigger/Shape Cycle (EPAP to IPAP) (IPAP to EPAP)
The shape trigger/cycle is another method used to trigger IPAP and/or cycle from IPAP to EPAP
during spontaneous breathing in the S and S/T modes. This method continuously tracks patient
inspiratory and expiratory flow and adjusts the spontaneous trigger and cycle thresholds for
optimum sensitivity. The Shape Signal appears as a shadow image of the patient’s actual flow. The
shape signal functions as a sensitivity threshold at either inspiration or expiration. When the patient’s
flow rate crosses the shape signal the device changes pressure levels. The following gure illustrates
how the shape signal is superimposed onto the actual waveform to trigger and cycle o IPAP.
The shape signal is created by osetting the signal from the actual patient flow by 15 lpm and
delaying it for a 300 msec period. This intentional delay causes the shape signal to be slightly
behind the patient’s flow rate. A sudden change in patient flow will cross the shape signal, causing
the pressure level to change.
Pressure
Flow
IPAP
EPAP
Shape
Signal
Estimated
Patient
Flow
Trigger to
IPAP
Crossover
Point
Cycle to
EPAP
Crossover
Point
Tracking the patient’s flow pattern with the Shape Signal provides a sensitive mechanism to trigger
to IPAP or cycle to EPAP in response to changing breathing patterns and circuit leaks.

Provider Manual
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Spontaneous Expiratory Threshold (IPAP to EPAP)
A second method used to cycle o IPAP during spontaneous breathing in the S and S/T modes is
called Spontaneous Expiratory Threshold (SET). The SET rises in proportion to the inspiratory flow
rate on each breath. When the Spontaneous Expiratory Threshold (SET) and actual patient flow
value are equal, the device cycles to EPAP.
Maximum IPAP Time (IPAP to EPAP)
A maximum IPAP time of 3.0 seconds acts as a safety mechanism to limit the time spent at the IPAP
level during spontaneous breathing in the S and S/T modes. Once the time limit is reached, the
device automatically cycles o IPAP to the EPAP level.
Flow Reversal (IPAP to EPAP)
As ow begins to decrease during IPAP, a ow reversal can occur due to a large leak around the
mask or because the patient’s mouth is open. When the device senses this ow reversal, the device
automatically cycles to the EPAP level.
Clear Patient Data for Multiple Users
If you are using the device on multiple users, you must use the “Clear Patient Data” option
available through the Setup screen. Refer to the “Setup Screen” section of the User Manual for
additional information.

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Cleaning for Multiple Users
Warning: If you are using the device on multiple users, discard and replace the bacteria lter each time the
device is used on a dierent person.
If you are using the device on multiple users, complete the following steps to clean the device
before each new user.
1. Unplug the device before cleaning.
2. Clean the outside of the device only. Use a cloth with one of the following cleaning agents to
clean the exterior of the device.
•Mild detergent
•70% Isopropyl Alcohol
•DisCide Towelettes
•10% Chlorine bleach solution
3. Allow the device to dry completely before plugging in the power cord.
Note: Additional cleaning details may be found in the User Manual.
Heated Humidier Performance Conrmation
Humidier preheat mode can be used to determine if the System One Heated Humidier is working
properly. The following steps should be followed if there is a desire to conrm the performance of
the System One Heated Humidier.
Warning: It is important to follow the exact steps below when performing this test in order to ensure no injury.
Read all steps rst before performing this test.
Warning: Do not place your hand directly on the heater plate at any time during this test as it could result in a burn.
1. Disconnect the patient tubing (if attached) and remove the water tank.
2. While the therapy device is not running, place your hand above the heater plate (without
touching it) to assess the temperature of the heater plate when o for later comparison.
3. In order to activate the preheat mode, the blower must be“o” and a humidier must be
attached. From the device Home screen, highlight “Therapy” or the icon, then press and hold
down the control wheel for 5 seconds. You will hear a single beep and the device will now be in
preheat mode. The humidier icon ( ) will illuminate during this time.

Provider Manual
17
4. Allow the device to run in preheat mode for 30 seconds.
5. Place your hand above the heater plate (without touching it) to conrm an increase in heater
plate temperature.
6. Press the control wheel while “Therapy” or the icon is highlighted on the Home screen to
enter therapy and end preheat mode.
7. Press and hold the control wheel again to turn o therapy.
Adding Supplemental Oxygen
Please note the oxygen warnings listed in the User Manual when using supplemental oxygen.
The delivered oxygen concentration varies with changes in ow in the circuit. The following may
have an impact on oxygen concentration:
•Pressure settings
•Patient Tidal Volume
•Peak Inspiratory Flow
•I:E Ratio
•Respiratory rate
•Circuit leak rate
•Oxygen ow rate
To add oxygen to the patient circuit, the oxygen supply must comply with the local regulations for
medical oxygen. The oxygen ow into the patient circuit cannot exceed 15 lpm and the pressure
cannot exceed 50 psi.
Supplemental Oxygen Concentrations
The following gures illustrate the potential range of oxygen concentration available to the patient
at a given tidal volume, supplemental oxygen ow, and pressure setting. The gures represent
bench test results without inadvertent mask leaks when oxygen is administered at the ventilator
outlet. Substantial leaks around the mask may reduce the expected oxygen concentration delivered
to below the levels shown in these gures. This guideline may be used as a starting point for
initiating oxygen therapy. Oxygen ow should be gradually adjusted until the patient’s oxygen
needs are adequately met.

BiPAP S/T
18

Provider Manual
19
Verifying the Pressure
Warning: If the device fails to perform within the stated specications, have the system serviced by a qualied
Philips Respironics-approved service facility.
If part of your patient setup procedure is to verify actual pressure with a manometer, please use the
following instructions to ensure that the device is functioning properly. You will need the following
equipment to verify the pressure:
Philips Respironics Pressure Calibration Kit includes:
•Philips Respironics Whisper Swivel II
•Philips Respironics O2Enrichment Final Assembly
•Closed end cap
•Philips Respironics exible tubing
•Pressure tubing

BiPAP S/T
20
•Philips Respironics Digital Manometer or equivalent
Minimum Specications:
•0 - 30 cm H2O (or better)
•±0.3 cm H2O accuracy
•±0.1 cm H2O resolution
•Foam lter
Note: The device automatically compensates for pressure drops associated with a 6-foot (1.83 m) smooth bore tube.
Additional pressure drops will occur when restrictive elements such as a bacteria lter or Pass-over humidier are
added to the patient circuit. Always use a manometer to verify patient mask pressure.
To verify the pressure, complete the following steps:
1. Install the foam lter into the back of the device.
2. With the device unplugged, connect the system as illustrated in the diagram.
3. Turn the manometer on. If it does not display a reading of zero, adjust the manometer to
calibrate it. If the manometer has variable settings for devices, set it to cm H2O.
4. Supply power to the device then place the device in provider mode.
5. Set the therapy parameters according to the patient specic data.
6. Set the device to the specic pressure value for the patient.
7. Verify that the pressure setting matches the pressure displayed on the manometer. If the
pressure setting does not match the measured value for the device, contact Philips Respironics
or an authorized service center to have the device serviced.
8. Set up the remaining parameters and exit provider mode. The unit is ready for patient use.