Puritan bennett 840 Use and care manual

Ve ntilator System

840 Operator’s and

Technical Reference Manual

4-070088-00 Rev.H (09/09) Puritan Bennett 840 Ventilator System Operator’s & Technical Reference Manual

Part No. 4-070088-00

Rev. H

September 2009

4-070088-00 Rev.H (09/09) Puritan Bennett 840 Ventilator System Operator’s & Technical Reference Manual

accordance with Nellcor Puritan Bennett LLC proprietary information, covered by

one or more of the following U.S. Patents and foreign equivalents: 4,954,799;

5,161,525; 5,271,389; 5,319,540; 5,339,807; 5,390,666; 5,407,174; 5,660,171;

5,771,884; 5,791,339; 5,813,399; 5,865,168; 5,881,723; 5,884,623; 5,915,379;

5,915,380; 6,024,089; 6,161,539; 6,220,245; 6,269,812; 6,305,373; 6,360,745;

6,369,838; 6,553,991; 6,668,824; 6,675,801; 7,036,504; 7,117,438; and RE39225.

840, 800 Series, DualView, SandBox, SmartAlert, Flow-by, and PTS 2000 are

trademarks of Nellcor Puritan Bennett LLC.

The information contained in this manual is the sole property of

Nellcor Puritan Bennett LLC and may not be duplicated without permission. This

manual may be revised or replaced by Nellcor Puritan Bennett LLC at any time

and without notice. You should ensure you have the most current applicable

version of this manual; if in doubt, contact Nellcor Puritan Bennett LLC or visit

the Puritan Bennett product manual web page at:

http://www.puritanbennett.com/serv/manuals.aspx

While the information set forth herein is believed to be accurate, it is not a

substitute for the exercise of professional judgment.

The ventilator should be operated and serviced only by trained professionals.

Nellcor Puritan Bennett’s sole responsibility with respect to the ventilator, and its

use, is as stated in the limited warranty provided.

Nothing in this manual shall limit or restrict in any way Nellcor Puritan Bennett’s

right to revise or otherwise change or modify the equipment (including its

software) described herein, without notice. In the absence of an express, written

agreement to the contrary, Nellcor Puritan Bennett LLC has no obligation to

furnish any such revisions, changes, or modifications to the owner or user of the

equipment (including its software) described herein.

Puritan Bennett 840 Ventilator System Operator’s & Technical Reference Manual 4-070088-00 Rev.H (09/09)

Applicability

The information in this manual applies to Puritan Bennett

840 ventilator versions manufactured or updated after August

2005. Some of this information may not apply to earlier versions.

Contact your Puritan Bennett representative if in doubt.

Definitions

This manual uses three special indicators to convey information

of a specific nature. They include:

Warning

Indicates a condition that can endanger the patient or the

ventilator operator.

Caution

Indicates a condition that can damage the equipment.

NOTE:

Indicates points of particular emphasis that make

operation of the ventilator more efficient or

convenient.

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iii

Warnings, cautions, and notes

Please take the time to familiarize yourself with the following

safety considerations, special handling requirements, and

regulations that govern the use of the Puritan Bennett

840 ventilator.

• To ensure proper servicing and avoid the possibility of physical

injury, only qualified personnel should attempt to service or

make authorized modifications to the ventilator.

The user of this product shall have sole responsibility for any

ventilator malfunction due to operation or maintenance

performed by anyone not trained by Puritan Bennett.

• To avoid an electrical shock hazard while servicing the

ventilator, be sure to remove all power to the ventilator by

disconnecting the power source and turning off all ventilator

power switches.

• To avoid a fire hazard, keep matches, lighted cigarettes, and all

other sources of ignition (e.g., flammable anesthetics and/or

heaters) away from the Puritan Bennett 840 ventilator and

oxygen hoses.

Do not use oxygen hoses that are worn, frayed, or

contaminated by combustible materials such as grease or oils.

Textiles, oils, and other combustibles are easily ignited and

burn with great intensity in air enriched with oxygen.

In case of fire or a burning smell, immediately disconnect the

ventilator from the oxygen supply, facility power, and backup

power source.

• When handling any part of the Puritan Bennett

840 ventilator, always follow your hospital infection control

guidelines for handling infectious material.

Puritan Bennett recognizes cleaning, sterilization, sanitation,

and disinfection practices vary widely among health care

institutions. It is not possible for Puritan Bennett to specify or

require specific practices that will meet all needs, or to be

responsible for the effectiveness of cleaning, sterilization, and

other practices carried out in the patient care setting. As a

manufacturer Puritan Bennett does not have any guidelines or

recommendations regarding specific pathogens as they relate

Puritan Bennett 840 Ventilator System Operator’s & Technical Reference Manual 4-070088-00 Rev.H (09/09)

to the usage of our products. In regards to transmission of any

specific pathogen Puritan Bennett can offer the specifications

of our products as well as our recommendations for cleaning

and sterilization. Any further clarification regarding pathogens

as they relate to our products should be brought to the

attention of your lab Pathologist as well as your infection

control personnel and/or risk committee.

• Patients on life-support equipment should be appropriately

monitored by competent medical personnel and suitable

monitoring devices.

• The Puritan Bennett 840 Ventilator System is not intended to

be a comprehensive monitoring device and does not activate

alarms for all types of dangerous conditions for patients on

life-support equipment.

• For a thorough understanding of ventilator operations, be sure

to thoroughly read this manual before attempting to use the

system.

• Before activating any part of the ventilator, be sure to check

the equipment for proper operation and, if appropriate, run

SST as described in this manual.

• Do not use sharp objects to make selections on the graphic

user interface (GUI) display or keyboard.

• US federal law restricts this device to sale by or on the order of

a physician.

• Check the ventilator periodically as outlined in the Puritan

Bennett 840 Ventilator System Service Manual; do not use if

defective. Immediately replace parts that are broken, missing,

obviously worn, distorted, or contaminated.

• An alternative source of ventilation should always be available

when using the Puritan Bennett 840 Ventilator System.

Warranty

The Puritan Bennett 840 Ventilator System is warranted against

defects in material and workmanship in accordance with the

Puritan Bennett Medical Equipment Warranty supplied with your

ventilator. Keep a maintenance record to ensure the validity of the

warranty.

4-070088-00 Rev.H (09/09) Puritan Bennett 840 Ventilator System Operator’s & Technical Reference Manual

Year of manufacture

The graphic user interface (GUI), breath delivery unit (BDU),

backup power source (BPS), and compressor contain a specific

year of manufacture applicable only for that assembly. The year of

manufacture is indicated by the fifth and sixth digits of the serial

number which is located at the back panel of the GUI, BDU, and,

BPS, and the side panel of the compressor.

Manufacturer

Electromagnetic susceptibility

The Puritan Bennett 840 Ventilator System complies with the

requirements of

IEC 60601-1-2:2004 (EMC Collateral Standard), including the E-

field susceptibility requirements at a level of 10 volts per meter, at

frequencies from 80 MHz to 2.5 GHz, and the ESD requirements

of this standard.

However, even at this level of device immunity, certain

transmitting devices (cellular phones, walkie-talkies, cordless

phones, paging transmitters, etc.) emit radio frequencies that

could interrupt ventilator operation if operated in a range too

close to the ventilator. It is difficult to determine when the field

strength of these devices becomes excessive.

Practitioners should be aware radio frequency emissions are

additive, and the ventilator must be located a sufficient distance

from transmitting devices to avoid interruption. Do not operate

the ventilator in a magnetic resonance imaging (MRI)

environment.

Nellcor Puritan Bennett LLC

4280 Hacienda Drive

Pleasanton, CA 94588 USA

Authorized representative

Tyco Healthcare UK LTD

154 Fareham Road

Gosport PO13 0AS, U.K.

Puritan Bennett 840 Ventilator System Operator’s & Technical Reference Manual 4-070088-00 Rev.H (09/09)

Warning

Accessory equipment connected to the power receptacle,

analog, and digital interfaces must be certified according

to IEC 60601-1. Furthermore, all configurations shall

comply with the system standard IEC 60601-1-1. Any

person who connects additional equipment to the power

receptacle, signal input part, or signal output part of the

Puritan Bennett 840 ventilator configures a medical

system, and is therefore responsible for ensuring the

system complies with the requirements of the system

standard IEC 60601-1-1. If in doubt, consult

Puritan Bennett Technical Services at 1.800.255.6774 or

your local representative.

This manual describes possible ventilator alarms and what to do if

they occur. Consult with your institution’s biomedical

engineering department in case of interrupted ventilator

operation, and before relocating any life support equipment.

Customer assistance

For further assistance contact your local Puritan Bennett

representative.

For online technical support, visit the

SolvITSM Center Knowledge Base at

http://www.puritanbennett.com

The SolvIT Center provides answers to

frequently asked questions about the

Puritan Bennett 840 Ventilator System and other Puritan Bennett

products 24 hours a day, 7 days a week.

Preface

This manual is divided into two parts: the operator’s manual and

the technical reference. The operator’s manual describes how to

operate the Puritan Bennett 840 Ventilator System. It also

provides product specifications and accessory order numbers. The

technical reference includes background information about how

the ventilator functions, including details on its operating modes,

self-tests, and other features. In the table of contents and index,

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vii

the prefix OP- identifies page numbers in the operator’s manual,

and the prefix TR- identifies page numbers in the technical

reference.

Any references to the software options BiLevel®, Volume Ventilation

Plus®(VV+) which includes VC+ and VS breath types, NeoMode®,

Proportional Assist Ventilation®(PAV+), Tube Compensation (TC),

Respiratory Mechanics (RM) and Trending in this manual assume

that the option has been installed on the ventilator. If these

options aren’t installed, then references to their functions do not

apply.

While this manual covers the ventilator configurations currently

supported by Puritan Bennett, it may not be all-inclusive and may

not be applicable to your ventilator. Contact Puritan Bennett for

questions about the applicability of the information.

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Contents

Operator’s Manual

1 Introduction OP 1-1

1.1 Technical description. . . . . . . . . . . . . . . . . . . . . . . . . . OP 1-3

1.1.1 General background . . . . . . . . . . . . . . . . . . . . . . OP 1-3

1.1.2 Pressure and flow triggering . . . . . . . . . . . . . . . . OP 1-5

1.1.3 Breathing gas mixture . . . . . . . . . . . . . . . . . . . . . OP 1-5

1.1.4 Inspiratory pneumatics . . . . . . . . . . . . . . . . . . . . OP 1-6

1.1.5 Patient circuit . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 1-6

1.1.6 AC mains and backup power system . . . . . . . . . . OP 1-7

1.1.7 Ventilator emergency states. . . . . . . . . . . . . . . . . OP 1-8

1.2 Graphic user interface . . . . . . . . . . . . . . . . . . . . . . . . . OP 1-9

1.3 User interface controls and indicators . . . . . . . . . . . . . OP 1-11

1.3.1 Onscreen symbols and abbreviations . . . . . . . . . . OP 1-19

1.4 Ventilator system labeling symbols. . . . . . . . . . . . . . . . OP 1-25

2 How to set up the Puritan Bennett 840 ventilator OP 2-1

2.1 How to connect the electrical supply . . . . . . . . . . . . . OP 2-3

2.2 How to connect the air and oxygen supplies . . . . . . . . OP 2-8

2.3 How to connect the patient circuit components . . . . . OP 2-11

2.3.1 How to select and connect a patient circuit . . . . . OP 2-12

2.3.2 How to install the expiratory filter

and collector vial . . . . . . . . . . . . . . . . . . . . . . . . . OP 2-15

2.3.3 How to install the flex arm. . . . . . . . . . . . . . . . . . OP 2-18

2.3.4 How to install the humidifier . . . . . . . . . . . . . . . . OP 2-19

2.3.5 How to use the ventilator cart . . . . . . . . . . . . . . . OP 2-22

3 How to run Short Self Test (SST) OP 3-1

3.1 Introduction to SST . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 3-1

3.2 When to run SST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 3-2

3.3 SST components and requirements . . . . . . . . . . . . . . . OP 3-3

3.4 SST Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 3-4

3.5 SST Results. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 3-12

3.5.1 How to interpret individual SST test results . . . . . OP 3-14

Contents

Puritan Bennett 840 Ventilator System Operator’s and Technical Reference Manual 4-070088-00 Rev H (09/09)

3.5.2 SST outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 3-15

4 How to use the Puritan Bennett 840 ventilator OP 4-1

4.1 Structure of user interface . . . . . . . . . . . . . . . . . . . . . . OP 4-2

4.2 Patient setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-3

4.2.1 How to ventilate with most recent

control parameters . . . . . . . . . . . . . . . . . . . . . . . OP 4-4

4.2.2 How to ventilate with new control parameters . . OP 4-4

4.2.3 Patient data and current settings. . . . . . . . . . . . . OP 4-8

4.2.4 Ideal Body Weight (IBW). . . . . . . . . . . . . . . . . . . OP 4-10

4.3 How to change the main ventilator

control parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-16

4.4 Ideal Body Weight (IBW), vent type, mode,

and other changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-17

4.5 How to select a constant timing variable during

respiratory rate changes . . . . . . . . . . . . . . . . . . . . . . . . OP 4-19

4.6 How to change apnea ventilation settings. . . . . . . . . . OP 4-21

4.7 How to set alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-22

4.8 How to change other settings . . . . . . . . . . . . . . . . . . . OP 4-24

4.9 Expiratory pause maneuvers . . . . . . . . . . . . . . . . . . . . OP 4-25

4.10 Inspiratory pause maneuvers. . . . . . . . . . . . . . . . . . . OP 4-26

4.11 How to interpret inspiratory pause maneuver

results for static compliance and resistance . . . . . . . . OP 4-28

4.12 How to use NIV. . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-29

4.12.1 NIV intended use . . . . . . . . . . . . . . . . . . . . . . . OP 4-29

4.12.2 NIV breathing interfaces . . . . . . . . . . . . . . . . . . OP 4-29

4.12.3 NIV setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-30

4.12.4 High spontaneous inspiratory time limit setting. OP 4-34

4.12.5 Apnea setup . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-34

4.12.6 Alarm setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 4-34

4.12.7 Changing patient from INVASIVE

to NIV Vent Type . . . . . . . . . . . . . . . . . . . . . . . OP 4-36

4.12.8 Changing patient from NIV to

INVASIVE Vent Type . . . . . . . . . . . . . . . . . . . . . OP 4-37

4.12.9 NIV patient data . . . . . . . . . . . . . . . . . . . . . . . . OP 4-38

Contents

4-070088-00 Rev H (09/09) Puritan Bennett 840 Ventilator System Operator’s and Technical Reference Manual

5 How to handle alarms OP 5-1

5.1 Ventilator alarm classifications . . . . . . . . . . . . . . . . . . . OP 5-1

5.2 Alarm silence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 5-2

5.3 Alarm reset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 5-4

5.4 Alarm log. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 5-5

5.5 Alarm volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 5-6

5.6 Alarm messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 5-7

6 How to view graphics OP 6-1

6.1 Graphics display function. . . . . . . . . . . . . . . . . . . . . . . OP 6-1

6.2 How to set up a graphics display . . . . . . . . . . . . . . . . . OP 6-3

6.3 Graphics display details and calculations . . . . . . . . . . .OP 6-4

6.4 How to adjust displayed graphics. . . . . . . . . . . . . . . . . OP 6-5

6.5 The graphics display FREEZE function . . . . . . . . . . . . . OP 6-6

6.6 How to print patient data graphics . . . . . . . . . . . . . . . OP 6-7

6.7 Automatic display of graphics . . . . . . . . . . . . . . . . . . . OP 6-7

6.8 When graphics are not accessible . . . . . . . . . . . . . . . . OP 6-8

7 Preventive maintenance OP 7-1

7.1 How to dispose of used parts. . . . . . . . . . . . . . . . . . . . OP 7-1

7.2 How to clean, disinfect and sterilize parts . . . . . . . . . . OP 7-2

7.2.1 How to clean components. . . . . . . . . . . . . . . . . . OP 7-6

7.3 Disinfection and sterilization . . . . . . . . . . . . . . . . . . . . OP 7-6

7.4 Preventive maintenance procedures for the operator . . OP 7-8

7.4.1 Total operational hours . . . . . . . . . . . . . . . . . . . . OP 7-9

7.4.2 Inspiratory and expiratory bacteria filters . . . . . . . OP 7-12

7.4.3 Daily or as required: collector vial and drain bag . OP 7-14

7.4.3.1 How to remove the collector vial . . . . . . . . . OP 7-14

7.4.3.2 How to remove the drain bag . . . . . . . . . . . OP 7-14

7.4.4 Daily or as required: in-line water traps . . . . . . . . OP 7-15

7.4.5 Every 250 hours: compressor inlet filter . . . . . . . . OP 7-15

7.4.6 Every year: ventilator inspection. . . . . . . . . . . . . . OP 7-16

7.4.7 Every year or as necessary: oxygen sensor . . . . . . OP 7-17

7.4.7.1 Oxygen sensor replacement procedure . . . . OP 7-17

Contents

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Puritan Bennett 840 Ventilator System Operator’s and Technical Reference Manual 4-070088-00 Rev H (09/09)

7.5 Additional preventive maintenance procedures. . . . . . OP 7-23

7.6 Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP 7-25

7.7 Repacking and shipping . . . . . . . . . . . . . . . . . . . . . . . OP 7-25

A Specifications OP A-1

A.1 Physical characteristics . . . . . . . . . . . . . . . . . . . . . . . . OP A-2

A.2 Environmental requirements . . . . . . . . . . . . . . . . . . . . OP A-3

A.3 Pneumatic specifications . . . . . . . . . . . . . . . . . . . . . . . OP A-4

A.4 Electrical specifications . . . . . . . . . . . . . . . . . . . . . . . . OP A-5

A.5 Compliance and approvals . . . . . . . . . . . . . . . . . . . . . OP A-9

A.5.1 Manufacturer’s Declaration . . . . . . . . . . . . . . . . . OP A-10

A.6 Technical specifications. . . . . . . . . . . . . . . . . . . . . . . . OP A-20

A.7 Ranges, resolutions, and accuracies. . . . . . . . . . . . . . . OP A-25

A.7.1 Recommended limits . . . . . . . . . . . . . . . . . . . . . OP A-25

A.7.2 Software options. . . . . . . . . . . . . . . . . . . . . . . . . OP A-26

B Part numbers OP B-1

C Pneumatic schematic OP C-1

D Alarm and oxygen sensor calibration testing OP D-1

D.1 Alarm test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP D-1

D.2 Oxygen sensor calibration test . . . . . . . . . . . . . . . . . . OP D-7

E Remote alarm and RS-232 ports OP E-1

E.1 Remote alarm port . . . . . . . . . . . . . . . . . . . . . . . . . . . OP E-2

E.2 RS-232 port. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP E-3

E.3 How to configure the RS-232 ports . . . . . . . . . . . . . . . OP E-4

E.4 Printers and cables . . . . . . . . . . . . . . . . . . . . . . . . . . . OP E-5

E.5 RS-232 port commands. . . . . . . . . . . . . . . . . . . . . . . . OP E-7

Technical Reference

Contents

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xiii

1 Introduction to breath delivery TR 1-1

Detecting and initiating inspiration TR 2-1

2.1 Internally triggered inspiration. . . . . . . . . . . . . . . . . . . TR 2-2

2.1.1 Pressure sensitivity . . . . . . . . . . . . . . . . . . . . . . . TR 2-2

2.1.2 Flow sensitivity . . . . . . . . . . . . . . . . . . . . . . . . . . TR 2-4

2.1.3 Time-cycled inspiration . . . . . . . . . . . . . . . . . . . . TR 2-6

2.2 Operator-triggered inspiration . . . . . . . . . . . . . . . . . . . TR 2-6

3 Detecting and

initiating exhalation TR 3-1

3.1 Internally initiated exhalation. . . . . . . . . . . . . . . . . . . . TR 3-1

3.1.1 Time-cycled exhalation . . . . . . . . . . . . . . . . . . . . TR 3-1

3.1.2 End-inspiratory flow method . . . . . . . . . . . . . . . . TR 3-2

3.1.3 Airway pressure method . . . . . . . . . . . . . . . . . . . TR 3-3

3.2 Backup limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 3-4

3.2.1 Time limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 3-4

3.2.2 High circuit pressure limit . . . . . . . . . . . . . . . . . . TR 3-4

3.2.3 High ventilator pressure limit . . . . . . . . . . . . . . . . TR 3-4

4 Mandatory breath delivery TR 4-1

4.1 Comparison of pressure- and volume-based

mandatory breaths . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 4-1

4.2 Compliance compensation for volume-based

mandatory breaths . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 4-3

4.3 BTPS compensation for volume-based

mandatory breaths . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 4-5

4.4 Manual inspiration. . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 4-5

5 Spontaneous breath delivery TR 5-1

6 Assist/control (A/C) mode TR 6-1

6.1 Breath delivery in A/C . . . . . . . . . . . . . . . . . . . . . . . . . TR 6-1

6.2 Rate change during A/C . . . . . . . . . . . . . . . . . . . . . . . TR 6-3

Contents

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Puritan Bennett 840 Ventilator System Operator’s and Technical Reference Manual 4-070088-00 Rev H (09/09)

6.3 Changing to A/C mode. . . . . . . . . . . . . . . . . . . . . . . . TR 6-3

7 Synchronous intermittent mandatory ventilation

(SIMV) TR 7-1

7.1 Breath delivery in SIMV . . . . . . . . . . . . . . . . . . . . . . . . TR 7-3

7.2 Apnea ventilation in SIMV . . . . . . . . . . . . . . . . . . . . . . TR 7-4

7.3 Changing to SIMV mode. . . . . . . . . . . . . . . . . . . . . . . TR 7-5

7.4 Rate change during SIMV . . . . . . . . . . . . . . . . . . . . . . TR 7-7

8 Spontaneous (SPONT) mode TR 8-1

8.1 Breath delivery in SPONT . . . . . . . . . . . . . . . . . . . . . . TR 8-1

8.2 Changing to SPONT mode . . . . . . . . . . . . . . . . . . . . . TR 8-1

9 Apnea ventilation TR 9-1

9.1 Apnea detection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 9-1

9.2 Transition to apnea ventilation . . . . . . . . . . . . . . . . . . TR 9-3

9.3 Key entries during apnea ventilation . . . . . . . . . . . . . . TR 9-3

9.4 Resetting apnea ventilation . . . . . . . . . . . . . . . . . . . . . TR 9-3

9.4.1 Resetting to A/C . . . . . . . . . . . . . . . . . . . . . . . . . TR 9-4

9.4.2 Resetting to SIMV . . . . . . . . . . . . . . . . . . . . . . . . TR 9-4

9.4.3 Resetting to SPONT . . . . . . . . . . . . . . . . . . . . . . TR 9-4

9.5 Phasing in new apnea intervals . . . . . . . . . . . . . . . . . . TR 9-5

Detecting occlusion and disconnect TR 10-1

10.1 Occlusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 10-1

10.2 Disconnect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 10-3

10.3 Occlusions and disconnect annunciation. . . . . . . . . . TR 10-5

11 Phasing in setting changes TR 11-1

12 Ventilator settings TR 12-1

12.1 Apnea ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-1

12.2 Circuit type and Ideal Body Weight (IBW) . . . . . . . . TR 12-2

Contents

4-070088-00 Rev H (09/09) Puritan Bennett 840 Ventilator System Operator’s and Technical Reference Manual

12.3 Disconnect sensitivity (DSENS) . . . . . . . . . . . . . . . . . . TR 12-3

12.4 Expiratory sensitivity (ESENS). . . . . . . . . . . . . . . . . . . . TR 12-3

12.5 Expiratory time (TE) . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-4

12.6 Flow pattern . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-4

12.7 Flow sensitivity (VSENS). . . . . . . . . . . . . . . . . . . . . . . . TR 12-5

12.8 High spontaneous inspiratory time limit (2TI SPONT). .TR 12-6

12.9 Humidification type . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-7

12.10 I:E ratio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-7

12.11 Ideal body weight (IBW) . . . . . . . . . . . . . . . . . . . . . TR 12-7

12.12 Inspiratory pressure (PI) . . . . . . . . . . . . . . . . . . . . . . TR 12-8

12.13 Inspiratory time (TI) . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-8

12.14 Mode and mandatory breath type. . . . . . . . . . . . . . TR 12-9

12.15 O2% . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-12

12.16 Peak inspiratory flow (VMAX) . . . . . . . . . . . . . . . . . . TR 12-13

12.17 PEEP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-13

12.17.1 PEEP restoration. . . . . . . . . . . . . . . . . . . . . . . . TR 12-14

12.18 Plateau time (TPL) . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-14

12.19 Pressure sensitivity (PSENS) . . . . . . . . . . . . . . . . . . . . TR 12-15

12.20 Pressure support (PSUPP) . . . . . . . . . . . . . . . . . . . . . TR 12-15

12.21 Respiratory rate (f) . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-16

12.22 Rise time % . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-16

12.23 Safety ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-17

12.24 Spontaneous breath type. . . . . . . . . . . . . . . . . . . . . TR 12-18

12.25 Tidal volume (VT). . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-19

12.26 Vent type. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 12-19

13 Alarms TR 13-1

13.1 Alarm handling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 13-1

13.1.1 Alarm messages. . . . . . . . . . . . . . . . . . . . . . . . . TR 13-3

13.1.2 Alarm summary . . . . . . . . . . . . . . . . . . . . . . . . . TR 13-5

13.2 AC POWER LOSS alarm . . . . . . . . . . . . . . . . . . . . . . . TR 13-22

13.3 APNEA alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 13-22

13.4 CIRCUIT DISCONNECT alarm . . . . . . . . . . . . . . . . . . TR 13-23

13.5 DEVICE ALERT alarm . . . . . . . . . . . . . . . . . . . . . . . . . TR 13-23

13.6 High circuit pressure (PPEAK) alarm. . . . . . . . . . . . . . TR 13-24

Contents

xvi

Puritan Bennett 840 Ventilator System Operator’s and Technical Reference Manual 4-070088-00 Rev H (09/09)

13.7 High delivered O2% (O2%) alarm . . . . . . . . . . . . . . TR 13-25

13.8 High exhaled minute volume (VETOT

) alarm. . . . . . TR 13-25

13.9 High exhaled tidal volume (VTE) alarm . . . . . . . . . . TR 13-26

13.10 High inspired tidal volume alarm

(VTI, VTI MAND,

VTI SPONT) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 13-26

13.11 High respiratory rate (fTOT) alarm . . . . . . . . . . . . . TR 13-27

13.12 INSPIRATION TOO LONG alarm . . . . . . . . . . . . . . . TR 13-27

13.13 Low circuit pressure alarm (PPEAK) . . . . . . . . . . . . . TR 13-28

13.14 Low delivered O2% (O2%) alarm . . . . . . . . . . . . . TR 13-28

13.15 Low exhaled mandatory tidal volume

(VTE MAND) alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 13-29

13.16 Low exhaled spontaneous tidal volume

(VTE SPONT) alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 13-30

13.17 Low exhaled total minute volume (VE TOT) alarm . TR 13-30

13.18 PROCEDURE ERROR alarm. . . . . . . . . . . . . . . . . . . . TR 13-31

14 Patient data TR 14-1

14.1 Delivered O2% . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 14-1

14.2 End expiratory pressure (PEEP) . . . . . . . . . . . . . . . . . TR 14-2

14.3 End inspiratory pressure (PI END) . . . . . . . . . . . . . . . . TR 14-2

14.4 Exhaled minute volume (VE TOT) . . . . . . . . . . . . . . . . TR 14-3

14.5 Exhaled tidal volume (VTE) . . . . . . . . . . . . . . . . . . . . TR 14-4

14.6 I:E ratio (I:E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 14-4

14.7 Intrinsic (auto) PEEP (PEEPI) and total PEEP (PEEPTOT) TR 14-5

14.8 Mean circuit pressure (PMEAN). . . . . . . . . . . . . . . . . . TR 14-5

14.9 Peak circuit pressure (PPEAK) . . . . . . . . . . . . . . . . . . . TR 14-5

14.10 Plateau pressure (PPL) . . . . . . . . . . . . . . . . . . . . . . . TR 14-6

14.11 Spontaneous minute volume (VE SPONT) . . . . . . . . . TR 14-6

14.12 Static compliance and resistance (CSTAT and RSTAT).TR14-7

14.13 Total respiratory rate (fTOT) . . . . . . . . . . . . . . . . . . . TR 14-13

15 Safety net TR 15-1

15.1 Patient problems. . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 15-1

15.2 System faults. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 15-2

Contents

4-070088-00 Rev H (09/09) Puritan Bennett 840 Ventilator System Operator’s and Technical Reference Manual

xvii

15.3 Ongoing background checks. . . . . . . . . . . . . . . . . . . TR 15-3

15.4 Hardware monitoring circuitry. . . . . . . . . . . . . . . . . . TR 15-4

15.5 Power on self test (POST). . . . . . . . . . . . . . . . . . . . . . TR 15-5

15.6 Short self test (SST) . . . . . . . . . . . . . . . . . . . . . . . . . . TR 15-5

15.7 Extended self test (EST) . . . . . . . . . . . . . . . . . . . . . . . TR 15-5

15.8 Oxygen sensor calibration . . . . . . . . . . . . . . . . . . . . . TR 15-6

15.9 Exhalation valve calibration . . . . . . . . . . . . . . . . . . . . TR 15-6

15.10 Ventilator inoperative test . . . . . . . . . . . . . . . . . . . . TR 15-6

15.11 Flow sensor offset calibration . . . . . . . . . . . . . . . . . . TR 15-7

15.12 Atmospheric pressure transducer calibration . . . . . . TR 15-7

16 Power on self test (POST) TR 16-1

16.1 Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 16-1

16.2 POST characteristics. . . . . . . . . . . . . . . . . . . . . . . . . . TR 16-2

16.3 POST following power interruptions . . . . . . . . . . . . . TR 16-3

16.4 POST fault handling. . . . . . . . . . . . . . . . . . . . . . . . . . TR 16-4

16.5 POST system interface . . . . . . . . . . . . . . . . . . . . . . . . TR 16-4

16.6 POST user interface . . . . . . . . . . . . . . . . . . . . . . . . . . TR 16-5

17 Short self test (SST) TR 17-1

18 Extended self test (EST) TR 18-1

18.1 EST results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 18-2

18.2 EST failure handling. . . . . . . . . . . . . . . . . . . . . . . . . . TR 18-3

18.3 EST safety considerations . . . . . . . . . . . . . . . . . . . . . . TR 18-3

19 RS-232 commands TR 19-1

19.1 RSET command . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 19-1

19.2 SNDA command . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 19-1

19.3 SNDF command . . . . . . . . . . . . . . . . . . . . . . . . . . . . TR 19-8

Glossary

Index

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