Vapotherm precision flow User manual

Precision Flow®
Instructions For Use

Page 2 3001002 Rev. T
Precision Flow®Packaging contains:
Precision Flow® Unit
Instructions For Use (USB)
Quick Reference Guide
Power Cord
O2Sensor cell
Air & Oxygen Inlet Particulate Traps with Connectors
US ONLY- Air and Oxygen Hoses
Quick Set Up Sticker (English speaking countries only)
Delivery Tube clip
Table of Contents Page
Symbols 3
Section 1 Indications, Warnings and Cautions 4
Section 2 Overview 6
Section 3 Principles of operation 7
Section 4 Controls, displays & connections 8
Section 5 Modes of operation 11
Section 6 Initial assembly 12
Section 7 Setting up 13
Section 8 Adjustments 17
Section 9 Connecting to patient 18
Section 10 Operating guidelines 19
Section 11 Changing the disposable patient circuit 20
Section 12 Alarms 21
Section 13 Shut down 24
Section 14 Routine maintenance 24
Section 15 Cleaning and disinfection 25
Section 16 Specifications 26
Appendix:
Audio Tone Characteristics 28
Software modes 29
EMC Guidance 30

3001002 Rev. T Page 3
Symbols
Vapotherm Inc. has declared that this product conforms with the European
Council Directive 93/42/EEC Medical Device Directive when it is used in
accordance with the instructions provided in the Instructions For Use.
This symbol indicates that the waste of electrical and electronic equipment
must not be disposed as an unsorted municipal waste and must be collected
separately. Please contact an authorized representative of the manufacturer for
information concerning the decommissioning of your equipment.
Some Vapotherm accessories contain DEHP [Di-(2-Ethylhexyl) Phthalate] which
is the most frequently used plasticizer to add flexibility to medical tubing. The
medical tubing is intended for the transport of medical breathing gases and not for
the storage of substances that have chemical extraction properties. The European
Commission has issued the following statement:
“The Scientific Committee on Emerging and Newly Identified Health Risks
(SCENIHR) has evaluated the exposure to DEHP for the general population and
patients during medical procedures. In some cases the exposure is significant and
exceeds the toxic doses observed in animal studies. There is a reason for some
concern for prematurely born male neonates for which the DEHP exposure may
be transiently above the dose inducing reproductive toxicity in animal studies. So
far, there is no conclusive scientific evidence that DEHP exposure via medical
treatments has harmful effects in humans. But, it is recognized that especially
the potentially high exposure during medical treatments may raise a concern,
even in the absence of clinical or epidemiological evidence, for harmful effects in
humans.” – SCENIHR 2008
Pregnant and nursing women should consider the effects on a child that may
occur from medical respiratory treatments. The general population is exposed
to phthalates daily from dietary sources and the inhalation of air. The extent of
medical treatment exposure largely depends upon the medical treatments given
and the duration of the treatment
0297

Page 4 3001002 Rev. T
Section 1 Indications, Warnings and Cautions
General Indications & Contraindications.
Primary Indications:
Precision Flow® is intended for use to add warm moisture to breathing gases from an external
source for administration to a neonate/infant, pediatric and adult patients in the hospital,
subacute institutions, and home settings. It adds heat and moisture to a blended medical air/
oxygen mixture and assures the integrity of the precise air/oxygen mixture via an integral
oxygen analyzer. The flow rates may be from 1 to 40 liters per minute via nasal cannula.
Contraindications:
General:
Precision Flow® : None Known
Specific to Nasal Cannula:
Patients with occluded or defective nares should not use the system.
Warnings and Cautions
A Warning indicates that a situation may occur which is potentially harmful to the patient or user.
A Caution indicates a condition that may lead to equipment damage, malfunction, or
inaccurate operation. A Note indicates a point of emphasis to make operation more efficient or
convenient.
Please take the time to familiarize yourself with the warnings, cautions, and notes listed in
these instructions. They cover safety considerations, special requirements, and regulations.
The user of this product shall have sole responsibility for any malfunction due to operation
or maintenance performed by anyone not trained by Vapotherm staff or official training
documentation.
When handling any part of the Precision Flow®, always follow hospital infection control
guidelines and Standard Precautions. Vapotherm also recommends that users follow the
Centers for Disease Control (CDC) publications: Guidelines for Maintenance of In-Use
Respiratory Therapy Equipment and Guidelines for Prevention of Nosocomial Pneumonia.
General Warnings
Federal Law (U.S.) restricts the sale of this device to, or by the order of any physician. This
device should be used ONLY by a trained operator.
This is a humidification device generally used for providing continuous flows of breathing gas.
The Precision Flow®is not a ventilator and should not be used as life support.
Oxygen supports combustion; this device should not be used near or around open flames, oil,
or grease, or flammables.
Service on the device should only be performed by qualified, certified service technicians.
To prevent injury, do not attempt to do any service to the Precision Flow®while a patient is
connected to the device.
If the device is damaged or not working properly, do not use. Contact Vapotherm or your
authorized Vapotherm representative.
Do not operate if power cord is damaged.
The device should not be placed in run mode and left unnattended in a non-care environment.
Do not use the Precision Flow®in or around water, other than the sterile water supply that feeds
the system.
Do not use the Precision Flow®system in combination with any other system intended for
humidification of respiratory gases (e.g. heat and moisture exchangers (HMES)).
Prior to use, the Precision Flow®should be positioned and secured to a Vapotherm approved roll
stand with the base of the unit no more than 40” (102cm) above the floor to reduce risk of tipping.

3001002 Rev. T Page 5
Section 1 Indications, Warnings and Cautions
Make sure all Disposable Patient Circuit connections have been properly secured.
The vapor transfer cartridge, disposable water path and delivery tube are labeled as single patient
use only and must be replaced after 30 days use on a single patient: do not attempt to sterilize or
reuse and follow all local and federal regulations for disposal. Outside the USA follow national or
international regulations.
Failure to utilize sterile water supply or clean gas supply may increase risk of bacterial contamination.
• Use aseptic technique.
• Gas supply must be clean dry medical grade gas to prevent harm to the patient and prevent
damage to the Precision Flow®
Precision Flow® is not a Continuous Positive Airway Pressure (CPAP) device. There are no
controls to deliver or monitor airway pressure. Precision Flow® should not be used to deliver pressure
in a closed system.
Never connect the unit to a patient until it reaches at least 33°C. Allow the unit to warm-up to purge
condensate and prevent patient discomfort due to cold or partly humidified gas.
Additional patient monitoring is necessary if the Precision Flow® is used to give supplementary oxygen.
The Precision Flow® is not MRI compatible.
The unit is provided with a Hospital Grade power cord. Do not use any other cord. Do not use
extension cords.For grounding reliability, the cord must be connected to an equivalent receptacle
marked “Hospital Grade” or “Hospital Only”. If any doubt exists as to the grounding connection, do
not operate the device.
Medical electrical equipment needs special precautions regarding electromagnetic radiation. Portable
and mobile RF communications equipment can affect medical equipment and should not be used
near the Precision Flow® .
The back-up battery is designed for temporary use only, when AC power to the unit has been
interrupted. After the battery is fully discharged the device will not operate and patient gas flow will
cease. There are no alarms or display indicators after the battery has discharged. The battery is not
intended for patient transport.
General Cautions
Read and understand these instructions prior to operating the system.
Clamp water supply when not in use, including Standby mode, to prevent damage by water ingress.
Aseptic sterile techniques (including hand washing and avoiding touching connection points) and
Standard Precautions should always be followed when handling medical equipment. Standard
Precautions should always be followed when coming into contact with patients
Do not cover the unit; blocking the vent may damage the unit.
Do not:
• Immerse the Precision Flow® in water.
• Steam or gas sterilize the Precision Flow® .
• Wipe with chlorine bleach solutions greater than 2% strength.
Flexible sterile water bags are recommended. If rigid or semi-rigid bottles are used, a Vapotherm
approved adapter must be used.
NOTE:The Precision Flow® may be operated with limited performance at gas inlet pressures as low
as 4 psi (28 kPa). However, for the full specified range of gas flows and oxygen percentages, both
gas inlet pressures must be 40 psi (276 kPa) or above. Precision Flow® has not been tested for use
in Field transport. When used with approved ancillary equipment the Precision Flow® may be used for
transferring patients within the hosiptal.

Page 6 3001002 Rev. T
Section 2 Overview
The Precision Flow®is a system for high flow humidified respiratory therapy by nasal cannula.
It incorporates the Vapotherm core humidification technology with an electronic blender
and flow controller. The water and gas pathways are both incorporated into a removable,
disposable patient circuit.
Features
• The patient circuit is detachable and disposable: no
disinfection necessary
• Minimal downtime between patients: less than
five minutes to change disposables
• Built-in oxygen/air blender
• Built-in electronic flowmeters and controllers
• Self-testing and self-calibrating
• Internal battery backup maintains flow and
oxygen percentage for at least 15 minutes if AC
power is cut off. Battery recharges in 2 hrs.
• All internal sensors self-calibrating and self
monitoring
• Single button starts and stops the device
• Temperature, flow and oxygen percentage are
adjusted via a single setting control knob on
the front panel
• All values and alarms displayed in a single large
color-coded panel
• Flow range 1-40 lpm
• Oxygen percentage is fully adjustable from 21 to 100% when two 40 psi (276 kPa) gas
sources are used
• Inlet gas pressure range is 4-85 psi (28-586 kPa)
• Single gas operation: the Precision Flow® detects inlet gas pressure and blends flow
based on demand required and available supply. Supply pressure determines FiO2and
delivered flow; if demand exceeds supply an alarm sounds
• At low gas inlet pressures, maximum flow rate and oxygen percentage settings are
automatically reduced to match the inlet pressure
• Automatically senses cartridge type: maximum flow setting is automatically reduced if
low-flow cartridge is installed
• Warm-up time less than five minutes
• Sterile water supply is connected to the disposable water path using a standard
spike
• Universal power requirements allow use anywhere with only a change of power cord
• Scheduled maintenance: gas inlet filters replaced at 6-month intervals, oxygen
sensor replaced annually, battery replaced every two years
Precision Flow®

3001002 Rev. T Page 7
Section 3 Principles of operation
The Precision Flow® warms and humidifies breathing gas for delivery by nasal cannula at flows
from 1 to 40 lpm. The unit incorporates an electronic blender and flow sensors that allow the
oxygen percentage and total gas flow to be set independently.
The Precision Flow®
consists of two parts:
Main unit
•The main unit which contains all the electrical and electronic components including the
electronic blender and flow controllers, and remote sensors to monitor the disposable water
path. The main unit has no water pathways and the gas pathway contains only dry gas at room
temperature, and consequently does not need internal cleaning or disinfection.
• The flow of oxygen and air are measured by mass flow sensors. The operating software
calculates the required flow of each needed to reach the target flow and oxygen percentage
set by the operator. The system controls gas flows accordingly by adjusting proportional
solenoid valves on the gas lines. An oxygen sensor monitors the gas mixture and signals any
discrepancy between target and measured percentage. The oxygen sensor is automatically
calibrated with oxygen at power-up and every 24 hours.
• Firmware running in the main unit uses sensors to monitor gas pressure, water temperature, and
to detect air leaks into the disposable patient circuit (bubble detector). Alarms are displayed if any
parameters are outside the normal range. Other indicators show low charge in the backup battery, and
the type of cartridge installed. See Appendix for a description of the firmware states and transitions.
• After a two hour charging period, an internal battery backup will maintain the set flow and
oxygen blend for at least 15 minutes without AC power. The battery is not operator replaceable.
WARNING: The back-up battery is designed for temporary use only, when AC power to the unit
has been interrupted. After the battery is fully discharged the device will not operate and patient
gas flow will cease. There are no alarms or display indicators after the battery has discharged.
The battery is not intended for patient transport.
Disposable patient circuit
• The disposable patient circuit (DPC) is comprised of the disposable water path (DWP), vapor
transfer cartridge (VTC) and delivery tube. Conditions in the circulating water and gas streams
are sensed remotely via the interface between the main unit and the disposable water path.
• Vapor transfer cartridge. In the cartridge, blended gas passes through the lumens of hundreds
of parallel hollow fibers made of a specially developed polymer. Warm water circulates around
the fibers and diffuses as vapor through the fiber material into the gas stream flowing through
each fiber. Unlike most humidifiers, there is no direct contact between the water and gas
streams. The gas stream leaves the cartridge saturated with vapor at the set temperature.
Note:Use only approved cartridges from Vapotherm Inc.
• Patient delivery tube.The warmed humidified gas passes through the center of a triple-lumen
heated delivery tube. The center lumen is surrounded by two outer lumens circulating warmed
water to maintain the temperature of the inner lumen and to minimize rain-out. A proprietary
short nasal cannula is connected to the end of the delivery tube and passes the humidified
breathing gas to the patient’s nares. It is normal for non-DEHP PVC tubing to appear slightly
cloudy, or yellow, especially during longer use or when operated at higher temperatures.
• Disposable water path. The disposable water path houses a water reservoir, pump,connections
for the vapor transfer cartridge and delivery tube, and sensor interfaces to the main unit.
Water is pumped past a heater plate through the outer lumens of the delivery tube. Returning
water passes through the outer jacket of the specially designed vapor transfer cartridge where
some water is lost as vapor to the gas stream. There is no direct contact between water and gas
flows. The water then returns to the pump reservoir. Heater power automatically maintains the
set temperature. Water flows into the circuit from the sterile water supply to replace evaporative
losses in the vapor transfer cartridge. Air is purged to atmosphere from the circulation via a
hydrophobic filter membrane.
See Section 5 for a description of the modes of operation.

Page 8 3001002 Rev. T
Section 4 Controls, displays & connections
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3
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6
7
Note:The Precision Flow® has no ON/OFF switch. Plug the unit into a wall outlet to keep
the battery fully charged
1. Battery low or charging
2. Disposable water path faulty or
absent
3. Vapor transfer cartridge type
4. Vapor transfer cartridge fault
5. Gas supply fault
6. Run/Stop Status LED
7. Run/Standby button (see note)
8. Setting control knob
9. Alarm mute button
10. Alarm muted LED
11. General fault
12. Water out
13. Blocked tube
14. Temperature display
15. Flow display
16. Oxygen % display

3001002 Rev. T Page 9
Section 4 Controls, displays & connections
Front view
1. Folding carrying handle
2. Multi-function display:
• Shows set values for oxygen %, flow
and temperature
• Icons indicate alarm conditions
3. Alarm mute:
• Press to silence alarms for up to
2 minutes
• LED indicates one or more alarms are
muted
4. Setting control knob:
• Press to select which variable to adjust
• Rotate to adjust to new value
• Press again to set value
5. Hinged door:
• Opens to install or remove dispos-
able water path
6. Status light:
• Amber in standby
• Flashing green when output does not match
settings (e.g. during warmup)
• Steady green when unit is operating
normally
7. Run/standby button:
• Press to start unit after water and gas are
connected
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4
5
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7

Page 10 3001002 Rev. T
Section 4 Controls, displays & connections
Rear view
1. Hinged door
• Open to install or remove disposable water path
2. Vent
3. Access panel for oxygen sensor (see note)
4. Pole clamp
5. Power cord connection and fuse holder
6. DISS or NIST oxygen connection
7. DISS or NIST air connection
8. Gas inlet filters and traps
Note: Using a permanent marker, write an expiration date on the O2sensor
cell that is one year from the date it is removed from its packaging.
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3001002 Rev. T Page 11
Section 4 Controls, displays & connections
WARNING:
Heater plate may
be hot!
Docking station for disposable water path
Arrows show location of optical sensor ports.
Do not scratch or scrub the ports.
Do not apply organic solvents or bleach.
Section 5 Modes of operation
Mode Action Indicator light color
Sleep Display in sleep mode, no gas flow Amber
Standby Input parameters can be adjusted, no gas flow Amber
Run Warming to set point temperature, gas flow
Unit operating at set point, gas flow
Flashing green
Solid green
See Appendix for a description of the software operating modes.

Page 12 3001002 Rev. T
Section 6 Initial assembly
Certain accessories must be installed in the Precision Flow® unit before it can be used. These
will normally be supplied in a separate package from the main unit as some are country-
specific.The power cord plugs into the IEC60320-compliant receptacle on the rear panel.
6a. Oxygen sensor installation
CAUTION:The oxygen sensor is in a sealed
package. Un-sealing the package admits oxygen
to the sensor, which should be replaced after 1
year. Do not open the package until the unit is to
be used. Write the expiration date on the oxygen
sensor cell.
1. Loosen three (3) captive screws from the access
panel. Pull the panel away from the unit.
2. Insert the threaded end of oxygen sensor into
port, and screw into place. Sensor should be
hand-tight only. Do not use tools.
3. Plug sensor cable into connector. Replace cover.
When replacing cover, be sure not to pinch cables.
Do not over-tighten screws.
6b. Inlet gas filter trap assemblies.
Gas inlet filters and traps are supplied in a separate box with the O2sensor and must be
installed before first-time use. The inlet filter and trap assemblies have a quick-disconnect
fitting which connects to the main unit, and a gas fitting for either an oxygen or an air hose.
Note: The quick-disconnect tubes for the oxygen and air filters are different sizes, so that they
can not be connected incorrectly.
WARNING: Never attempt to run the Precision Flow® unit without the gas inlet filters installed
in line. Particles in the inlet gas flow may cause irreparable damage to the mass flow
sensors.
Installing the gas inlet filters
Push the filter assembly firmly into the correct connector opening until it is fully engaged and
it clicks. The filter can rotate but not pull out. Filter bowls should be vertical (glass side down)
when in use.
Removing gas inlet filter assembly from main unit
Note:It is not normally necessary to remove the inlet filter and trap assemblies unless doing
preventative maintenance, but shipping and packing are easier if the filters are detached first.
1. Press the filter assembly into the main unit.
2. Hold the locking ring in place and push it back against the main unit backplate.
3. Pull the filter assembly straight out.
Oxygen Sensor
Access Panel

3001002 Rev. T Page 13
Oxygen
Air
Power
cord
Pole
clamp
Section 7 Setting up
7-1. Hang the sterile water supply from hook on
Vapotherm approved roll stand.
7-2. Attach the unit to Vapotherm approved roll stand
below lowest point of the sterile water supply.
NOTE:The Precision Flow® oxygen and air supply
inlet fittings are gas-specific to ensure correct connection.
WARNING: Unit weighs 10.6 lb.(4.81kg) To prevent
possible injury or damage from falling, it must be
securely fixed to a Vapotherm approved roll stand,
with the base of the unit not more than 40” (102cm)
above the floor. Fixed rail supports may also be used.
Use with Vapotherm approved roll stands.
7-3. Connect oxygen and air supply hoses to correct
inlets, then connect them to the wall outlets.
7-4. Connect power cord.
7-5. Open the bags containing the disposable water path,
vapor transfer cartridge, and delivery tube, and
assemble them as follows:
7-5-1. Remove the rubber plugs from the vapor transfer cartridge.
Install a high or low-flow vapor transfer cartridge in disposable waterpath as shown.
The vapor transfer cartridge may be inserted either way up. Align the vapor transfer
cartridge ports with the disposable water path openings and press firmly into place.
A High Flow Vapor Transfer Cartridge is shown below. It is indicated with a
REF: PF-VTC-HIGH and blue caps. High Flow Cartridges are for flow rates of 5-40 LPM.
A Low Flow Vapor Transfer Cartridge is shown below. It is indicated with a
REF: PF-VTC-LOW, red caps and the addition of two black stripes. Low Flow
Cartridges are for flow rates of 1-8 LPM.

Page 14 3001002 Rev. T
Section 7 Setting up
7-5-2. Connect the delivery tube to the disposable water path as shown.
Press firmly into place.
NOTE:If the door does not close easily, check that the cartridge is installed correctly
and the disposable water path is fully inserted into the docking station.
CAUTION: Do not remove the disposable patient circuit while the unit is operating
7-6. Inserting disposable patient circuit:
7-6-1. Open door to expose the docking station.
7-6-2. Hold disposable patient circuit by its handle,
with the delivery tube downward as shown.
7-6-3. Slide disposable patient circuit downward into
the docking station until it stops.
7-6-4. Press down firmly so there is no gap between the
bottom of the Disposable Water Path and the docking
station floor.
7-6-5. Close door.

3001002 Rev. T Page 15
Section 7 Setting up
7-6-6.General Guidelines
After connecting to the sterile water supply and unclamping the water inlet tube make sure
water is flowing into the disposable patient circuit (DPC). Wait approximately 90 seconds (or
180 seconds if using a hard water bottle) before pressing the Run/Standby button. If screen is
dark, press any button or turn the setting control knob prior to placing in Run mode. Uncoil and
straighten the delivery tube to allow water to more easily flow into the DPC. If air pockets are
observed, gently tap the delivery tube to remove the air. Insufficient water flow may lead to a
temperature out of range alarm. Holding the distal end of the delivery tube below the Precision
Flow®unit may further assist with water flow into the DPC.
After pressing the Run/Standby button, confirm that water is properly circulating through the
machine by making sure the patient delivery tube is warm across the entire length. If good
circulation cannot be confirmed, check that the water flow is not obstructed by air bubbles in
the water inlet tube connected to the water supply, or in the patient delivery tube. Gently tap
and wiggle the tubing, or lift it up and down in order to remove any air seen in the lines.
Reference Section 12 of the Precision Flow®Instruction For Use for information regarding
alarms. Additional alarm information:
If a medium priority Water Out Alarm occurs, this may be due to the sterile water supply being
empty, an obstructed inlet tube, or accumulation of air within the DPC. If the sterile water
supply is empty, replace sterile water supply. If the inlet tube is obstructed, straighten the inlet
tube. If necessary, remove and reseat the DPC to ensure that the DPC is fully seated in the
Precision Flow®unit. Press Run/Standby button to restart the unit. If alarm persists, disconnect
patient from therapy.
The DPC may be used up to 30 days. Circuit life may be less than 30 days, especially when
running at higher flow rates and temperatures which may reduce the useful life of the Vapor
Transfer Cartridge. This typically results in the sterile water bag filling up with air and/or a vapor
transfer cartridge fault alarm occurring due to gas bubbles in the water path.
After addressing any alarm condition, especially those involving an obstruction of the gas or
water flow, check all connections for leaks and make sure the Vapor Transfer Cartridge (VTC)
is fully seated into the DPC.

Page 16 3001002 Rev. T
WARNING: Use high–flow cartridge for flows 5-40 lpm and low-flow cartridge for flows 1-8 lpm.
7-7. Plug in power cord, and check that all the display indicators light. The Precision Flow®
performs a self-test:
• all icons and numeric displays light up for a few seconds
• internal sensors and control systems are checked
• if no faults are detected the unit enters STANDBY mode
• “Water Out” icon indicates there is no water in the disposable water path
• status LED is amber
7-8. The Precision Flow®unit has three controls.
Run/Standby Button – Powers the unit on and places it in standby.
Setting Control Knob - Allows you to adjust the parameters.
Alarm Mute Button – Will intermittently silence alarms
and also dims the display panel.
The Precision Flow®has three modes. Those are Sleep,
Standby, and Run. In Sleep mode, the unit will have a
blank screen and an amber light showing. The unit
cannot be started from sleep.
To put the unit in Standby, simply rotate the blue
Control Setting Knob to illuminate the display. You
will see the three parameters of Flow, percent
oxygen, and Temperature. There will also be a
corresponding vapor transfer cartridge indicator
on the lower right hand side which will identify
what type of disposable patient circuit is
in place (Blue/High or Red/Low).
To enter Run Mode, with the screen illuminated,
simply press and release the Run/Standby Button.
The machine will give a series of 10 beeps, and begin to power up. At this point the small
light above the Run/Standby Button will change from Amber to flashing Green. During this
start up, you will also see two amber alarm indicators illuminated. This is normal and is
part of the Precision Flow®start up self test.
7-9. Push or rotate the control setting knob in either direction to light up the display in
STANDBY mode.
7-10. Press the Mute button to change between bright and dim display (this function is only
available if no alarms are active).
7-11. To connect the sterile water supply, remove spike cap and disinfect spike with 70-90%
isopropyl alcohol or equivalent. Firmly insert spike into spike port of the sterile water supply,
avoiding direct hand contact. Unclamp the water inlet tube so that water (>200 ml) flows into
the disposable water path and the “Water Out” alarm icon clears. Wait approximately 90
seconds (or 180 seconds if using a hard water bottle) before pressing the Run/Standby button.
7-12. Press Run/Standby button to start gas flow, pump and heater.
Press twice if the display is initially blank.
Section 7 Setting up
Run/Standby
button

3001002 Rev. T Page 17
Check that the unit beeps while it tests the disposable
water path and pump (see Notes below).
7-13. If all tests are passed the unit enters RUN mode. Water circulates and fills the delivery
tube. The three numeric displays for flow, temperature and oxygen % display initial
factory settings or the last settings used. The Status LED flashes then shows
continuously green when the unit reaches desired temperature.
NOTES on startup:
• When the Run/Standby button is pressed, the unit enters a detection mode. A prompt
sounds and the disposable water path icon flashes for approximately five seconds.
In this mode the unit inspects the disposable water path to confirm that: a vapor
transfer cartridge is present; the disposable water path is present; and the water level
is correct. Power is then applied to the water pump. After five seconds the unit checks
that the water pump has started and is running at the correct speed.
• If the “water out” icon is displayed and accompanied by an alarm, place unit in standby
and allow DPC to fully prime. Press run/standby button.
• Purging of air bubbles from the circulation can not be seen, because the gas escapes
through a membrane at the top of the DWP, not into the water container.
• Clamp the inlet tube to stop the flow of water into disposable patient circuit
whenever the unit is in standby mode.
To adjust settings: See section 8 (Adjustments)
For alarms and troubleshooting: See section 12 (Alarms)
Section 7 Setting up
Section 8 Adjustments
Flow, oxygen % and temperature are all adjusted using the
setting control knob in the center of the front panel.
8-1. To enter Adjustment mode, press and release
the setting control knob. One displayed value
will flash to show that it is selected for
adjustment. Press the knob repeatedly to
cycle the active selection through flow,
oxygen % and temperature.
8-2. To change the selected variable, rotate the
knob until the desired value is displayed.
Press the knob again to enter this value and
select the next variable.
8-3. If the knob is not rotated for five (5) seconds,
the unit returns to the normal Run mode.
To re-enter Adjustment mode, press the knob
again. Rotating the knob has no effect unless
one of the settings has been selected and
one of the displayed values is flashing.
NOTES on settings:
• When gas inlet pressures are less than 40 psi
(276 kPa) the full specified range of flows and oxygen mixtures is not available. The
Precision Flow® detects the actual inlet pressures and calculates the range of values that can
be achieved. An alarm sounds if the operator attempts to make settings outside this range.
Setting control knob

Page 18 3001002 Rev. T
Section 8 Adjustments
• If oxygen is not connected, the blender setting will be fixed at 21%. If air is not connected
the setting is fixed at 100%. An audio signal sounds if the operator attempts to set any
other value.
• If a HIGH-FLOW cartridge is installed the flow can not be set below 5 lpm.
• If a LOW-FLOW cartridge is installed the flow can not be set above 8 lpm.
NOTES on adjustment:
• Transient temperature changes may occur after rapid changes in flow settings.
• During warmup the temperature display shows actual temperature, not the set value.
• In Run mode the display shows the current set values for flow, oxygen % and
temperature.
• The setting control knob is sensitive to speed. Rotate quickly for large increments and
slowly for small increments.
• If the unit is completely powered down (disconnection of AC power), then the unit will
return to default settings.
Section 9 Connecting to patient
9-1. Wait for desired set temperature to be reached before placing the cannula on the end of
the patient delivery tube. The flashing green Status LED becomes steady when the set
temperature is reached.
9-2. Check water level, temperature display, gas flow rate, and oxygen percentage.
9-3. Size cannula to patient by ensuring that nasal prongs do not fit tightly into nares (1/2 the
diameter of the nares).
9-4. Attach correct sized cannula for the patient and vapor transfer cartridge onto the delivery
tube. Adjust the flow to the desired rate and fit the cannula to the patient. See appendix
table for cannula flow rates. DPC flow ranges are shown in the table below:
Cartridge Cannula type Operational flow rates
High Flow Adult, pediatric & small adult,
pediatric small* 5-40 lpm
Low Flow
Premature, solo, neonatal,
infant, intermediate infant,
pediatric small*
1-8 lpm
*Pediatric small cannula is intended to deliver flows from 1-20 lpm

3001002 Rev. T Page 19
Section 9 Connecting to patient
Section 10 Operations: General Guidelines
10-1. Check that water is properly circulating through the disposable by making sure the patient
delivery tube is warm across the entire length. If good circulation cannot be confirmed,
check that the water flow is not obstructed by air bubbles in the patient delivery tube.
10-2. Check that the patient delivery tube will not be occluded by the patient’s position or
moving bed structures.
10-3. Take precautions to minimize cooling of the unheated cannula by trying to maintain
contact with the patient’s skin and insulating the exposed portion of the cannula
with bedding.
10-4. During operation the door should be closed.
10-5. Check inlet gas traps for contaminates and press valve to empty any condensate,
if present.
10-6. Check that nothing blocks the vent on the back of the unit.
NOTE: Condensation in the cannula may occur in certain ambient conditions at flow rates
less than 5 lpm (low flow cartridge) or less than 10 lpm (high flow cartridge). To minimize
condensation it is recommended not to set the temperature higher than 34°C, if using flow
rates less than 5 lpm.
WARNINGS:
• Always follow aseptic technique (including proper hand washing and avoiding direct
hand contact with connection points) when setting up the Precision Flow®and Standard
Precautions when placing on a patient.
• Cannula prongs should not obstruct more than 50% of the nares of the patient.
• Change nasal cannulas when soiled.
NOTES:
• The Vapotherm approved interface should be connected to the patient only when the unit
has reached at least 33°C.
• Droplets of condensation may appear at the end of patient delivery tube while unit is
warming up. This is normal and will stop within a few minutes when set temperature is
reached and the cannula is fitted to the patient.
• Some condensation around the nose is possible. In addition, a high moisture level may
mobilize mucus from nose and sinuses. Make sure patient has a supply of tissues.
• The unit should not be placed in Standby mode for extended periods of time. For
pauses in therapy, keep the unit in RUN mode, remove cannula from the patient, and set
the parameters to the lowest available setting. To reinitiate therapy, before the cannula is
placed on patient, clear accumulated condensation.
WARNING:
Never connect the unit to a patient until it reaches at least 33°C. Allow the unit to
warm-up to purge condensate and prevent patient discomfort due to cold or partly
humidified gas.

Page 20 3001002 Rev. T
Section 11 Changing the disposable patient circuit
The disposable patient circuit, consisting of the disposable water path, vapor transfer
cartridge and delivery tube, is marked for single patient use. They may be used for
up to 30 days on a single patient but must then be replaced.
11-1. Stop the unit by pressing the Run/Standby button.
11-2. Clamp the water inlet tube connected to the sterile water supply.
11-3. Open the door to expose the disposable water path.
11-4. Lift the disposable patient circuit out of the Precision Flow®unit and discard in accordance
with institutional guidelines.
11-5. Wipe down the docking station with 70-90% isopropyl alcohol wipes or other approved
Vapotherm cleaning agents.
NOTE: If the door does not close easily, check that the vapor transfer cartridge is installed
correctly and the disposable water path is fully inserted into the docking station.
11-8. Slide the disposable patient circuit into the docking station and close the door.
11-9. Hang new sterile water supply on the hook of the Vapotherm approved roll stand.
11-10. Wipe the spike on the water inlet tube with 70-90% isopropyl alcohol and insert into
spike port of the sterile water supply.
11-11. Re-start the unit.
WARNINGS:
• The heater plates on the docking station and
disposable water path may be hot !
• Universal precautions and aseptic technique must be used in
handling the disposable parts.
CAUTIONS:
• The sensor windows in the docking station must not be scratched or damaged. If
necessary, wipe down the docking station with 70-90% isopropyl alcohol wipes or
other Vapotherm approved cleaning agents. Never use sharp instruments or
abrasive cleaners to clean windows.
11-6. Open a new vapor transfer cartridge, delivery tube and disposable water path.
11-7. Install the vapor transfer cartridge and delivery tube in the disposable water path as
described in Section 7 (Setting up).