ResMed CPAP S6 User manual

CLINICIAN’SMANUAL
Reorder number: 218021/5 01 07
RESMED CPAP S6
™

RESMED
CLINICIAN’SMANUAL
Reorder number: 218021/5 01 07
RESMED CPAP S6
™

Protected by: EP(DE,FR,GB) 0088761, JP 1697822, US 4944310, US 5199424, US 5522382. Other patents pending.
Copyright subsists in ResMed products. AutoScan, Bubble Cushion, HumidAire, Mirage, SmartStart and Ultra Mirage are trademarks of ResMed
Ltd.
© 2001 ResMed Ltd. All rights reserved.
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iii
CONTENTS
CONTENTS
MEDICAL INFORMATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
DEFINITION OF TERMS 1
INDICATED USE 1
CONTRAINDICATIONS 1
WARNINGS 3
PRECAUTIONS 4
OXYGEN USE 4
ADVERSE EFFECTS 4
RESMED CPAP S6 SERIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
SETTING UPTHE RESMED CPAP S6 . . . . . . . . . . . . . . . . . . . . . . . . . . 7
ASSEMBLING THE DEVICE 7
SETTING UPFOR PATIENT USE 11
USING THE RESMED CPAP S6. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
CALIBRATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
CLEANING & MAINTENANCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
SERVICING. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
TROUBLESHOOTING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
ACCESSORIES/SPARE PARTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
SPECIFICATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
INDEX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

iv

1
MEDICAL INFORMATION
MEDICAL INFORMATION
DEFINITION OF TERMS
This manual contains special terms and icons that appear in the margins.
!
WARNING Alerts you to possible injury.
!
PRECAUTION Explains special measures for the safe and effective use of the device.
i
NOTE Is an informative or helpful note.
INDICATED USE
The ResMed CPAP S6 system is intended for the treatment of obstructive sleep
apnoea (OSA) in adult patients.
CONTRAINDICATIONS
Nasal CPAP therapy must not be used in patients with the following conditions:
• pneumothorax or pneumomediastinum
• decompensated cardiac failure or hypotension, particularly if associated with
intravascular volume depletion (risk of further hypotension or reduction in
cardiac output)
• pneumoencephalus, recent trauma or surgery (for example, pituitary or nasal)
that may have produced cranio-nasopharyngeal fistula (risk of entry of air or
other material into the cranial cavity)
• otitis media or perforated ear drum
•massiveepistaxis.

2
Nasal CPAP therapy should be used with caution in patients with the following
conditions:
• existing respiratory failure (risk of increased work of breathing, due either to
incomplete reversal of upper airway obstruction or to breathing at high lung
volume, leading to worsening respiratory failure)
• emphysematous bullae, or past history of pneumothorax (risk of
pneumothorax)
• previous history of massive epistaxis (risk of recurrence)
• acute sinusitis.
The clinician should assess on a case-by-case basis the relative risks and benefits of
CPAP therapy in such a subject. When assessing the relative risks and benefits, the
clinician should understand that the ResMed CPAP S6 unit can be set to deliver
pressures up to 20 cmH2O. In the unlikely event of certain fault conditions, static
pressures of up to 35 cmH2O are possible. If it is believed that such a pressure could
present a risk to a particular patient, then this device must not be used.
As with all fixed pressure and autotitrating CPAP units, the ResMed CPAP S6 unit
may not work:
• in the presence of severe mask leaks; furthermore, in the case of leaks in
excess of 0.7 L/sec, some or all reported parameters may be inaccurate, and
either insufficient or excess pressure may be delivered in some cases
• with patients who breathe predominantly or exclusively through the mouth,
due to loss of pressure via the mouth; furthermore, some or all reported
parameters may be inaccurate, and either insufficient or excess pressure may
be delivered in some cases
• in patients with lung disease, because the ResMed CPAP S6 system will treat
only the upper airway obstruction, and there may be residual hypoxaemia or
hypoventilation due to the lung disease
• in patients with particularly high nasal resistance.
For patients with limited respiratory capacity during sleep (eg emphysema; reduced
central drive; neuromuscular, chest wall or lung parenchymal disease; and similar
conditions), the use of the SmartStart/Stop feature may not be advisable. If the unit
is stopped inadvertently by this feature (due to leak, for example) the patient may
not breathe strongly enough to restart the unit.

3
MEDICAL INFORMATION
WARNINGS
The following are general warnings. Specific warnings appear next to the relevant
instructions in the manual.
!
WARNING • THIS IS NOT A LIFE SUPPORT DEVICE. It may stop operating due to power
interruption or a device fault.
• Explosion hazard—do not use in the vicinity of flammable anaesthetics.
• Special care should be exercised in patients who may be dehydrated, or may
become dehydrated, for example as a result of fluid restriction or diuretic
therapy, including changes or inadvertent changes in therapy.
• If there is any doubt about the likely effect of positive pressure on cardiac
output in a particular patient, the patient’s immediate blood pressure and
heart rate response to therapy should be assessed, at the highest intended
pressure setting for the patient. Symptoms of faintness or dizziness should be
monitored over the first few minutes of therapy.
• If, during therapy, particularly on commencing therapy each night, the patient
feels faint or lightheaded, they should immediately discontinue therapy and
seek medical advice.
• The air flow for breathing produced by this device can be as much as 6oC
(11oF) higher than the temperature of the room. Caution should be exercised
if the room temperature is warmer than 32oC (90oF).
• ResMed CPAP devices have been designed and manufactured to provide
optimum performance using ResMed mask systems. Other mask systems may
be used. However, swings and delivered pressure with non-ResMed masks
may be different from those with ResMed masks. If in doubt, measure
delivered pressure at the mask. Masks with extremely low exhaust vent flow
(less than 15 L/min at 4 cm H2O) may cause somewhat greater temperature
rises in the delivered air than normally expected.
Use of non-ResMed masks may also affect the SmartStart and SmartStop fea-
tures of the CPAP device.
• Inadvertent triggering of SmartStop in high leak situations is more likely
in masks with particularly high exhaust vent flow rates. It is important to
confirm that SmartStart works correctly in these masks when the leak has
reduced somewhat, so that therapy is restarted promptly.
• When the combined flow resistance of the mask and tubing system is too
high, the device may not SmartStop when the mask is off the face and
may continue to log usage hours.
• Do not enable SmartStart when using a mask with an anti-asphyxia valve,
such as the Mirage Full Face Mask.
• A mask should not be worn unless the machine is turned on and operating
properly. The vent holes associated with the mask should never be blocked.

4
Explanation: this device is intended to be used with special masks which have
vent holes to allow continuous flow of air out of the mask. When the device is
turned on and functioning properly, new air from the device flushes the
exhaled air out through the mask vent holes. However, when the device is not
operating, insufficient fresh air will be provided through the mask, and the
exhaled air may be rebreathed. Rebreathing of exhaled air for longer than
several minutes can, in some circumstances, lead to suffocation.
• At low pressures, the flow through the exhalation ports may be inadequate to
clear all exhaled gas from the tubing. Some inconsequential rebreathing may
occur.
PRECAUTIONS
The following are general precautions. Specific precautions appear next to the
relevant instructions in the manual.
!
PRECAUTION • The patient should never open the ResMed CPAP S6 case. There are no user
serviceable parts inside. Repairs and internal servicing should only be
performed by an authorised service agent.
OXYGEN USE
!
WARNING • If oxygen is used with this device, the oxygen flow must be turned off when
the device is not operating.
Explanation: when the device is not in operation and the oxygen flow is left
on, oxygen delivered into the air delivery tubing may accumulate within the
device enclosure and create a risk of fire.
• Oxygen supports combustion. Oxygen should not be used while smoking or in
the presence of an open flame.
i
NOTE At a fixed rate of supplemental oxygen flow, the inhaled oxygen concentration will
vary, depending on the pressure settings, patient breathing pattern, mask selection
and leak rate.
ADVERSE EFFECTS
The following adverse effects may arise during the course of CPAP treatment:
headache; middle ear or sinus discomfort; chest pain; dryness of the nose, mouth
or throat; bloating; skin irritation due to sensitivity to the materials in the mask
system.

5
RESMED CPAP S6 SERIES
RESMED CPAP S6 SERIES
Please take some time to become familiar with the features of the ResMed CPAP
S6 flow generator. For details on the range of accessories available, see
“Accessories/Spare Parts” on page 29.
Figure 1 : ResMed CPAP S6 system
Air tubing
Carry handle
Flow generator
Control panel
PC, modem
Ultra Mirage mask
or ResControl
connection port

6

7
SETTING UPTHE RESMED CPAP S6
SETTING UPTHE RESMED CPAP S6
ASSEMBLING THE DEVICE
1Check that you have the following items (see Figure 1, ResMed CPAP S6 system,
on page 5):
•aResMedCPAP S6 flow generator unit
• a power cord
•ResMedairtubing
• a mask system (supplied separately)
2Place the flow generator on a table near the head of the bed.
!
PRECAUTION Be careful to place it where it cannot be bumped and where someone will not trip
over the power cord.
i
NOTE The flow generator may be placed on the floor beside or underneath the
patient’s bed. However, you should ensure that the area is free from dust and
clear of bedding, clothes or any other objects that could block the air inlet.
3Plug one end of the power cord into the power socket at the rear of the flow
generator and the other end into a power outlet.
Power plug
On/Off switch
(may not be on all devices)(

8
!
WARNING Make sure the power cord and plug are in good condition and the equipment is not
damaged.
4Assemble the mask system according to the user instructions supplied with the
mask.
!
WARNING • ResMed CPAP devices have been designed and manufactured to provide
optimum performance using ResMed mask systems. Other mask systems may
be used. However, swings and delivered pressure with non-ResMed masks
may be different from those with ResMed masks. If in doubt, measure
delivered pressure at the mask. Masks with extremely low exhaust vent flow
(less than 15 L/min at 4 cm H2O) may cause somewhat greater temperature
rises in the delivered air than normally expected.
Use of non-ResMed masks may also affect the SmartStart and SmartStop fea-
tures of the CPAP device.
• Inadvertent triggering of SmartStop in high leak situations is more likely in
masks with particularly high exhaust vent flow rates. It is important to
confirm that SmartStart works correctly in these masks when the leak has
reduced somewhat, so that therapy is restarted promptly.
• When the combined flow resistance of the mask and tubing system is too
high, the device may not SmartStop when the mask is off the face and
may continue to log usage hours.

9
SETTING UPTHE RESMED CPAP S6
5Attach one end of the air tubing firmly to the air outlet on the ResMed CPAP S6 and
the other end to the mask system.
i
NOTE If the patient is using an axial swivel connector, connect this also. For further
information, please refer to the user instructions supplied with the axial
swivel.
If you are connecting a humidifier, please refer to the instructions supplied with
the humidifier. Use medium length air tubing to connect the flow generator to the
humidifier and attach the long air tubing and mask system to the humidifier port
closer to the bed. Do not position the humidifier on top of the flow generator. You
will need to set the Humidifier ON. See “Elite model” on page 16.
HumidAire Passover

10
6Turn the flow generator switch to ON.
The flow generator is now assembled.

11
SETTING UPTHE RESMED CPAP S6
SETTING UPFOR PATIENT USE
LIGHTWEIGHT, PLUS AND ELITE MODELS
Before the flow generator may be used by the patient, you need to set up or enable
the following functions:
•HourMeter
• Treatment Pressure
•DelayTimers
•StartPressure
• Real-time Clock, SmartStart and Humidifier option (Elite model only, see
“Elite model” on page 16).
You may adjust the settings directly on the flow generator or use a ResControl™
clinical control unit or AutoScan™software to set up these functions remotely.
i
NOTE A ResControl provides remote setting of Start Pressure, Treatment Pressure,
Delay Timers, SmartStart and Humidifier options when it is connected to a
ResMed CPAP S6 using the port on the side of the flow generator. ResControl
can also display leak and pressure measurements while the flow generator is
operating. For further details, please refer to the ResControl Clinician’s
Manual.
For the ResMed CPAP S6 Plus and Elite models, you can use AutoScan
software (versions 3.0 or later) to adjust the Start Pressure, Treatment
Pressure, Delay Timers and the Real-time Clock. You can also enable
SmartStart and humidifier use and erase stored compliance data. Your
computer can be interfaced to the flow generator via cable connection. To
obtain a clinical interface kit, please contact your ResMed representative.
SULLIVAN® UCU1 and UCU2 control units are not compatible with the
ResMed CPAP S6 Elite model enhanced compliance software. These control
units cannot be used to change pressure settings on the Elite model.
Both UCU1 and UCU2 control units do function correctly to change pressure
settings on the ResMed CPAP S6 Plus model. Note, however, that the control
unit will identify the flow generator as a SULLIVAN V Plus rather than a
ResMed CPAP S6 Plus.
RESETTING THE HOUR METER
The ResMed CPAP S6 is equipped with an Hour Meter that displays the total
number of hours the motor has been running, providing an indication of
compliance. The Hour Meter is on the underside of the flow generator.

12
The Hour Meter should be reset to zero when the flow generator is given to a
patient.
i
NOTE You should reset the Hour Meter before setting the Treatment Pressure or Start
Pressure.
To reset the Hour Meter:
1. Hold down the Start, 5 minute and 10 minute buttons while you turn on the
main power switch at the rear of the flow generator. Keep the buttons pressed
until the Start, 5 minute and 10 minute buttons illuminate.
2. Press the Stop and 20 minute buttons together and then release them. The
motor will start running.
i
NOTE At this point, if you press the Start, 5 minute or 10 minute buttons alone, it may
interfere with the flow generator’s pressure calibration. If one of these buttons
has been pressed by mistake, all factory defaults will need to be recalibrated.
See “Calibration” on page 21.
3. Press the 20 minute button to reset the Hour Meter.
Foam pad
Hour Meter
(Plus and Elite only)
Carry handle
Air outlet

13
SETTING UPTHE RESMED CPAP S6
4. Press the Stop button to revert to normal operating mode or turn the flow
generator off.
SETTING THE TREATMENT PRESSURE
To set the Treatment Pressure, you will need a reference manometer with a range
of 0 to 22 cmH2O in intervals of 0.1 cmH2O, fitted with a sensor tube (2.5 or 3 mm
internal diameter) and a standard Luer taper fitting.
Figure 2 : Setting the Treatment Pressure
1. Assemble the flow generator as the patient would normally use it, complete
with air tubing, but do not connect the mask system. Connect all accessories
(eg, humidifier, filters, O2etc) that are normally used. Ensure that
SmartStart®/Stop is disabled (Elite model only).
2. Turn on the flow generator to allow the unit to warm up. If the motor does
not start running, press the Start button to start the flow. Let the flow
generator warm up for 15 minutes.
3. While the unit is warming up, remove the plug from one of the access ports
on the mask, and attach the Luer taper end of the sensor tube. The other end
of the sensor tube should be fitted to the manometer. If you have a blind
Bubble Cushion®, attach it to the mask.
100
0
200
300
Manometer
Sensor tube Access port

14
4. When the motor has been running for 15 minutes, press the Stop button to
stop the flow and turn off the main power switch at the rear of the flow
generator. In the case of the ResMed CPAP S6 Lightweight with a fixed power
cord, you will need to unplug the power cord from the power outlet
to do this.
5. Connect the mask system to the air tubing.
6. Hold down the Start and 20 minute buttons while you turn on the main power
switch at the rear of the flow generator. In the case of the ResMed CPAP S6
Lightweight with a fixed power cord, you will need to plug the power cord
back into the power outlet. Keep the buttons pressed until the Start and 20
minute buttons illuminate. The motor will start running and will build up to the
current pressure setting.
7. If you do not have a blind Bubble Cushion, or are using the Mirage®Mask,
you will need to block the opening of the mask with the palm of your hand
(however, be careful not to block the mask exhalation vent).
8. Read the pressure on the manometer. Use the 5 minute button to decrease
pressure and the 10 minute button to increase pressure. Alternatively, you may
wish to set the pressure to 10 cmH2O by pressing the Start button.
i
NOTE The Hour Meter on the underside of the flow generator will display the
Treatment Pressure while in pressure setting mode. However, a manometer
should be used when accurate pressure setting is required.
9. Press the Stop button to revert to normal operating mode.
Remember to replace the plug in the access port of the mask.
i
NOTE The Elite model uses a pressure sensor to accurately determine the treatment
pressure at the patient’s mask. If a leak should occur, the flow generator will
automatically increase the air flow slightly to maintain the treatment pressure
at the set level. There is no need to program this feature.
LIMITING THE DELAY TIMER
The Delay Timer starts treatment very gently while the patient falls asleep and
slowly increases to full operating pressure over a selected time period. You can limit
the delay times available to the patient. The delay times are 0 (no) minutes, 5
minutes, 10 minutes and 20 minutes.
1. Hold down the 5 minute and 10 minute buttons while you turn on the main
power switch at the rear of the flow generator. Keep the buttons pressed until
the Stop and Start buttons illuminate. Some other buttons may also light up.
2. The lit buttons indicate which delay times are available. Press the 20 minute
button to add delay times and the Start button to remove them.
3. Press the Stop button to revert to normal operating mode. If this is not done,
the SmartStart/SmartStop function may not work optimally.

15
SETTING UPTHE RESMED CPAP S6
i
NOTE During operation, if the patient presses a delay button that has been disabled, it
will activate the next enabled delay. For example, if the 20 minute delay has been
disabled, pressing the 20 minute delay button will activate the 10 minute delay. If
all the time delays have been disabled, pressing any of the delay buttons will start
the flow generator.
SETTING THE START PRESSURE
The Start Pressure is the pressure at which the flow generator starts when the
Delay Timer is used. To set the Start Pressure, you will need a reference
manometer with a range of 0 to 22 cmH2O in intervals of 0.1 cmH2O, fitted with
a sensor tube (2.5 or 3 mm internal diameter) and a standard Luer taper fitting.
1. Assemble the flow generator as the patient would normally use it, complete
with air tubing, but do not connect the mask system. Connect all accessories
(eg, humidifier, filters, O2etc) that are normally used. Ensure that SmartStart/
Stop (Elite model only) is disabled (see Figure 2, Setting the Treatment
Pressure, on page 13).
2. Turn on the flow generator to allow the unit to warm up. If the motor does
not start running, press the Start button to start the flow. Let the flow
generator warm up for 15 minutes.
3. While the unit is warming up, remove the plug from one of the access ports
on the mask and insert the Luer taper end of the sensor tube. The other end
of the sensor tube should be fitted to the manometer. If you have a blind
Bubble Cushion, attach it to the mask.
4. When the motor has been running for 15 minutes, press the Stop button to stop
the flow and turn off the main power switch at the rear of the flow generator.
In the case of the
ResMed CPAP S6 Lightweight with a fixed power cord, you
will need to unplug the power cord from the power outlet to do this.
5. Connect the mask system to the air tubing.
6. Hold down the 5 minute and 20 minute buttons while you turn on the main
power switch at the rear of the flow generator. In the case of the ResMed
CPAP S6 Lightweight with a fixed power cord, you will need to plug the
power cord back into the power outlet. Keep the buttons pressed until the 5
minute and 20 minute buttons illuminate. The motor will start running and
will build up to the current Start Pressure setting.
7. If you do not have a blind Bubble Cushion, or are using the Mirage Mask,
you will need to block the opening of the mask with the palm of your hand
(however, be careful not to block the mask vent).
8. Read the pressure on the manometer. To adjust the Start Pressure, use the 5
minute button to decrease pressure and the 10 minute button to increase
pressure. If you wish to set the Start Pressure to 4.0 cmH2O, press the Start
button.
9. Press the Stop button to revert to normal operating mode.
Remember to replace the plug in the access port of the mask.