Weinmann MEDUMAT Standard2 User manual

• Start ventilation by height
• NIV therapy
• Resuscitation (CPR) with IPPV
- Resuscitation (CPR) with CCSV
• Anesthesia induction (RSI)
MEDUMAT Standard2
Step-by-step instructions
Important:
This document
does not replace the
instructions for use.
Complete information
can be found in
the instructions
for use.

Operating steps
21
Switch on ventilator Select “New patient”.
3 4
Select patient height and gender Select “next”
5 6
Select the ventilation mode and check
the displayed ventilation parameters
Start ventilation

Start up quickly and ventilate accurately
From now on, you no longer need to spend time considering which tidal volume (Vt)
and which respiratory rate (Freq.) are best suited to your patient. With MEDUMAT
Standard
2
, you can now initiate ventilation even more precisely and quickly. By
entering the patient’s height and gender, your ventilator automatically calculates
all ventilation parameters for the ideal body weight (IBW). The IBW serves as an
important indicator for setting the ventilation parameters
i
. MEDUMAT Standard
2
enables you to start ventilation more quickly and far more precisely – giving you
more time for all the other important tasks.
Start ventilation by height
Risk of injury resulting from incorrectly set restriction of maximum airway pressure!
An excessively high airway pressure might cause the patient serious or life-
threatening injury.
Always set the pressure limit pMax to match the current patient and the current
therapy.

Use presets and work according to guidelines
In the Start menu, you can set the patient's height under the “New patient” menu
item. This section explains how the ventilator automatically calculates the ideal tidal
volume using height and gender.
Ideal body weight (IBW) in kg is calculated from stated height in cm (x) as shown
below:
Example
IBW (female) = 45 kg + 2.3 kg • x
2.54 cm -60
• Child(1) (height < 154 cm):
IBW child = 2.05 kg • exp x
50 cm
IBW (male) = 50 kg + 2.3 kg • x
2.54 cm -60
• Adult(2) (height > 154 cm):
The tidal volume for the patient is calculated with the aid of ideal body weight and
the setting Vt per kg body weight (Vt/body weight) in the Operator menu:
• Patient, male, height 185 cm
Vt = IBW • Vt
Body weight
• Setting for Vt/body weight = 6 ml/kg
(1)
Source: TRAUB, S.L.; JOHNSON, C.E.: Comparison of methods of estimating creatinine
clearance in children. In: American journal of hospital pharmacy 37, 1980, No.2, pp. 195–201.
(2) Source: DEVINE, Ben J. Gentamicin therapy. The Annals of Pharmacotherapy, 1974, 8. year No.
11, pp. 650-655
IBW (male) = 50 kg + 2.3 kg • 185 cm
2.54 cm -60 = 79.52kg
ml
Vt = 79.52 kg • 6 kg = 477 ml 480 ml

NIV therapy
Switch on ventilator.
1
Select “New patient” in the start
menu.
2
Set the patient’s height and gender or
select the appropriate patient group:
Adult, Child, Infant.
3

Select the desired CPAP therapy using
the navigation knobs: PEEP, pMax,
ΔpASB. After adjusting the values,
begin the ventilation via “start”.
5
Now connect the patient to MEDUMAT
Standard². It is possible to adjust the
values using the navigation knobs while
the ventilation is running. The right-
hand navigation knob provides access
to additional ventilation parameters.
The ventilation mode can be changed
by pressing the menu button.
6
Select one of the following
ventilation modes: CPAP +
ASB (if available) or CPAP (CPAP is the
ventilation form
“CPAP + ASB” with a ΔpASB
of 0 mbar).
4

Modied in accordance with therapy recommendations for emergency medicine 2022
published by the Association of Emergency Physicians of Northern Germany
(Arbeitsgemeinschaft in Norddeutschland tätiger Notärzte e.V. - AGNN).
Indications
• Hypoxemic ARI with respiratory rate > 25/min (count!) and
SpO2< 90 % despite O2administration; e.g. cardiogenic pulmonary edema.
• Hypercapnic ARI = clinical ventilatory insufciency with high respiratory rate/low
TV; e.g. acute exacerbated COPD (aeCOPD), bronchial asthma.
Contraindications
• Absolute: Absence of spontaneous respiration, gasping, airway obstruction,
gastrointestinal bleeding or ileus, non-hypercapnic coma
• Relative: Hypercapnic coma, high-grade hypoxemia agitation, pronounced
secretion, hemodynamic instability with shock, mask leakages.
Procedure
• Ensure logistical requirements: Check oxygen supply: at least a 2-l bottle; lled.
Check and adjust ventilator.
• Monitoring of respiratory rate (count!), SpO2, ECG and etCO2as soon as NIV
initiated
• Commence NIV with patient semi-seated or seated.
• Slowly adjust the patient’s face mask; the patient can initially hold the mask in
place themselves where possible. The most important aim of the adaptation
phase is the synchronization of the ventilator and the patient.
• If the patient is highly agitated, careful sedation may be helpful and necessary.
A benzodiazepine, opiate or Propofol in a sub-anesthetic dose can be used here.
• In the case of continuing leakage or patient apnea, the device switches to Apnea
ventilation (if activated). This mode can also be selected before connection to
the patient.
SOP
Non-invasive ventilation (NIV)
in the case of acute respirators insufciency (ARI)

Adjusting the ventilation mode in the case of hypoxemic ARI
Mode: ................................................................... CPAP (without pressure support)
Initial PEEP: ..................................................................................................5 mbar
Initial FiO2: .................................................................................................... 100%
Target: ........................................................... SpO2> 94 % (with COPD 88 – 92 %)
Reduce the FiO2accordingly in the case of a more pronounced SpO2increase
Increase PEEP in the case of insufcient SpO2increase:.......................... 7 – 10 mbar
In the case of insufcient tidal volume:
Pressure support: .................................5 mbar (increase gradually where applicable)
Inspiratory trigger: .......................................................................As low as possible
Adjusting the ventilation mode in the case of hypercapnic ARI
Mode: ....................................................................... CPAP (with pressure support)
Initial PEEP: ................................................................................................. 5 mbar
Initial pressure support: ............................................................................... 5 mbar
Inspiratory trigger: ..................................................................... As low as possible
Expiratory trigger: ..................................................................... As high as possible
Initial FiO2: ...................................................................................... 40% or AirMix
Aim: .............................................................................................. SpO288 – 92 %
Reduce the FiO2accordingly in the case of a more pronounced SpO2increase
In the case of insufcient tidal volume:
Pressure support: ....................................... Increase gradually (up to max. 20 mbar)
In the case of pronounced ventilatory insufciency: ................... Change to BiLevel-
ventilation if necessary
Success criteria
Decrease in dyspnea, respiratory and heart rate, increase in SpO2, improved
vigilance, reduced etCO2where applicable.
Caution
• Close clinical observation, stop if condition deteriorates
• Do not delay pharmacological/interventional therapy
• Be ready to intubate at all times when using NIV, above all in the case of relative
contraindications
• Timely advance information to the receiving hospital

Inspiratory trigger
The inspiratory trigger triggers a pressure support or a
mechanical breath as soon as inhalation effort is detected.
Trigger level Corresponding unit value
Level 1 (sensitive) Approx. 3l/min
Level 2 (medium) Approx. 5 l/min
Level 3 (insensitive) Approx. 10 l/min
Setting the levels of the inspiratory trigger:
(If “3 levels” has been chosen as the trigger setting in the operator menu)
1 l/min
Very sensitive
5 l/min
Sensitive
10 l/min
Insensitive
15 l/min
Very insensitive
Trigger sensitivity:
1 l/min-15 l/min
Flow