Weinmann MEDUVENT Standard User manual

• Function check
• Ventilation start-up based on height
• Resuscitation with manual mode
• Anesthesia induction (RSI)
• NIV therapy
MEDUVENT Standard
Step-by-step instructions
Attention:
This document does
not replace the
instructions for use.
Full information can be
found in the instructions
for use.

Function Check
Hazardous therapy if device connected to patient during function check!
If the device is connected to the patient during the function check, this might lead to
therapy posing a risk as a result of excessively high pressures or unsuitable ventilation
volumes. This might expose the patient to the risk of serious or life-threatening injury.
Always disconnect the device from the patient for the function check.
Perform a function check at the following intervals:
Part Interval
Device • Before each use
• After each hygienic reprocessing
• After each repair
Breathing circuit • Before each use
• After each hygienic reprocessing
• After each repair

Preparing for the function check
1. Check battery status: The rechargeable battery must be fully charged.
If necessary: Charge rechargeable battery.
2. Check the following parts for external damage:
- Device
- Labels on the device
- Connectors and cables
- Breathing circuit
- Accessories
3. If necessary: Replace damaged parts.
4. Check the patient valve of the reusable breathing circuit.
5. If necessary: Replace the breathing circuit.
6. Checkthellleveloftheoxygencylinder.
7. If necessary: Replace the oxygen cylinder.
Performing a function check
You can perform the function check with the following test lungs:
• Testing bag WM 1453
• Testing bag WM 1454
• EasyLung for WEINMANN Emergency WM 28625
Requirement
• The device is disconnected from the patient.
• The rechargeable battery is fully charged.
• There is an SD card in the SD card slot.
• Thehygienelterisinsertedintheltercompartment.
• The oxygen supply is shut off.
• The function check has been prepared.
• The device is switched on.

4. If you want to test the oxygen supply:
Select “Yes”.
or
If you do not want to test the oxygen
supply: Select “No”.
The device skips the oxygen test
(steps 5 to 8 are skipped).
1. Select the “Function check” menu
item.
2. Prepare the device:
• Connect the breathing circuit to the
device.
• Connect the test lung to the
breathing circuit.
• Connect MEDUtrigger.
3. Select “Start”.
Follow the on-screen instructions.

5. Set the oxygen supply rate
(5-15 l/min).
6. Select “Start”.
9. If an alarm tone sounds: Select
“Yes”.
8. Select “Next”.
7. Stop the oxygen supply and close the
oxygen cylinder. This test item can be
skipped if no oxygen source is available.

14.Ifyouhavereplacedthehygienelter:Select“Reset”.
Color Action
Green Continuetousehygienelter.
Yellow Keephygieneltertohandororder
hygienelter.
Red Replacehygienelter.
11. Press all the controls except the On/
Off button one after another.
12. If the MEDUtrigger is not displayed
in the function check: Activate
MEDUtrigger in the Operator menu and
repeat the function check.
13.Proceedwiththehygienelterin
accordance with the following table:
10.IfthealarmLEDashesred:Select
“Yes”.

Display Meaning Action
Device ready for use Function check
passed.
Use device without restriction.
Device not ready for
use.
Function check failed
or function check
interrupted.
• Select “Details”. Check the
parts listed in the display and
replace them if necessary.
Repeat the function check.
• If the function check continues
to fail:
Contact your authorized dealer
or the manufacturer.
Device ready for use.
The service symbol
ashesinthestart
menu.
Information about the
scheduled service.
Contact your authorized dealer
or the manufacturer.
17. Select “Finish”.
18. Switch off the device.
19. Take the test lung off the breathing circuit.
16. The status report appears
(example: Function check passed).
15.Enterthelterresetcodespecied
in the Operator menu. On delivery, the
lterresetcodeis“0000”.
Select “OK”.
Proceed with the device in accordance with the following table:

Start up more quickly and ventilate more accurately
From now on, you no longer need to spend time considering which tidal volume and
which respiratory rate (Vt) is best suited to your patient. With MEDUVENT Standard,
you can now start ventilation even more accurately and quickly. When you enter the
patient’s height and gender, your ventilator automatically calculates all the ventilation
parameters via ideal body weight (IBW). IBW is an important indicator for setting
ventilation parametersi.
Ventilation Start-Up Based
on Height
iGajic, O. et al. Ventilator-associated lung injury in patients without acute lung injury at the onset
of mechanical ventilation. Critical Care Medicine, 2004, No. 32, p. 1817-1824.
Risk of injury resulting from incorrectly set limitation of maximum airway pressure!
An excessively high airway pressure might expose the patient to serious or life-
threatening injury.
Always set the pressure limit pMax to suit the current patient and the current
therapy.

3. Enter patient’s gender and height and
select ventilation mode.
4.Conrmwith“Next”.
5. The device shows a preview of the
ventilation parameters calculated. If
necessary: Adjust ventilation parame-
ters. Select “Start”.
6. The device shows current ventilation
parameters.
2. Select “New patient”.1. Switch on ventilator.

Using presets and working within 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) is calculated from stated height (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 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, p. 195–201.
(2) Source: DEVINE, Ben J. Gentamicin therapy. The Annals of Pharmacotherapy, 1974, 8th year No.
11, p. 650-655
IBW (male) = 50 kg + 2.3 kg • 185 cm
2.54 cm -60 = 79.52 kg
Vt = 79.52 kg • 6 ml
kg 477 ml 480 ml

Resuscitation with
Manual Mode
2. Select patient group and switch to
“Manual” mode. Alternatively, select
“New patient”, set the patient’s gender
and height and select “Manual” mode.
Note: It is possible to switch to “Man-
ual” ventilation mode from any ventila-
tion mode at any time.
3. Check ventilation parameters.
Hold the mask over the patient’s mouth
and nose using the “double C grip”.
Keep the button on the MEDUtrigger
depressed until two mechanical breaths
have been administered.
In order to achieve maximum possible
oxygen concentration, set the displayed
“For max. O2i set” value in l/min on the
oxygen supply.
1. Switch on ventilator.

4. Once the airway has been secured,
switch to IPPV ventilation via the menu
button and “Ventilation mode”.
5. Ventilate continuously in “IPPV”
mode. The device shows the parameters
for IPPV ventilation.
Info: If the set pMax is reached during
CPR, MEDUVENT Standard restricts
inspiratory pressure.
Therapydisruptedbyexcessivelyhighow!Iftheowexceedsthemaximumper-
mitted value of 15 l/min, the pressure relief valve may open unintentionally during
inspiration, putting therapy at risk.
This might injure the patient.
Feedinoxygenonlyatamaximumowof15l/min.

ERWEITERTE REANIMATIONSMASSNAHMEN
Patient reagiert nicht
fehlende oder nicht normale Atmung
CPR 30:2
Debrillator/Monitor anschließen
Schockbar
(VF/PULSLOSE VT)
Nicht-schockbar
(PEA/ASYSTOLIE)
Rhythmuskontrolle
1 Schock
Sofort wieder Thoraxkompressionen
für 2 Minuten
Return of spontaneous
circulation (ROSC)
Sofort wieder Thoraxkompressionen
für 2 Minuten
Rettungsdienst- oder
Reanimationsteam rufen
Hochwertigen Thoraxkompressionen und
• Sauerstoffgabe
• Kapnograe
• Kontinuierliche Thoraxkompressionen wenn der
Atemweg gesichert ist
• Minimale Unterbrechungen der Thoraxkompression
• IV- oder IO-Zugang
• Adrenalin alle 3-5 Minuten
• Amiodaronnach3Debrillationsversuchen
• ErkennenundBehandelnreversiblerUrsachen
Erkennen und Behandeln reversibler Ursachen
• Hypoxie
• Hypovolämie
• Hypo-/Hyperkalämiemetabolisch
• Hypo-/Hyperthermie
• Herzbeuteltamponade
• Intoxikation
• Thrombose, koronar oder pulmonal
• Spannungspneumothorax
Eventuell Sonographie und Bildgebung zum
Erkennen reversibler Ursachen einsetzen
Eventuell
• KoronarangiograeundPCI
• MechanischeReanimationfürPatiententransport/Therapie
• ExtrakorporaleCPR
Nach ROSC
• NachABCDEvorgehen
• Zielwert SpO294–98%undnormalerPaCO2
• 12-Kanal-EKG
• Erkennen und Behandeln der Ursache
• Targeted temperature management
www.grc-org.de; www.erc.edu publiziert Mai 2021 durch German Resuscitation Council, c/o Universitätsklinikum Ulm, Sektion Notfallmedizin, 89070 Ulm Copyright: © European Resuscitation Council vzw Referenz: Poster_ALS_Algorithmus_GER_2021 über GRC
Advanced Life Support
European Resuscitation Council Guidelines 2021
https://cprguidelines.eu/
ADVANCED LIFE SUPPORT
Unresponsive with absent
or abnormal breathing
CPR 30:2
Attach debrillator/monitor
Shockable
(VF/PULSELESS VT)
Non-shockable
(PEA/ASYSTOLE)
Assess rhythm
1 shock
Immediately resume chest
compressions for 2 minutes
Return of spontaneous
circulation (ROSC)
Immediately resume chest
compressions for 2 minutes
Call EMS/Resuscitation team
Give high-quality chest compressions and
• Give oxygen
• Use waveform capnography
• Continuous compressions if advanced airway
• Minimise interruptions to compressions
• Intravenous or intraosseous access
• Give adrenaline every 3-5 min
• Give amiodarone after 3 shocks
• Identify and treat reversible causes
Identify and treat reversible causes
• Hypoxia
• Hypovolaemia
• Hypo-/hyperkalemia/metabolic
• Hypo-/hyperthermia
• Thrombosis – coronary or pulmonary
• Tension pneumothorax
• Tamponade- cardiac
• Toxins
Consider ultrasound imaging to identify
reversible causes
Consider
• Coronary angiography/percutaneous coronary
intervention
• Mechanical chest compressions to facilitate transfer/treatment
• Extracorporeal CPR
After ROSC
• Use an ABCDE approach
• Aim for SpO2 of 94-98% and normal PaCO2
• 12 Lead ECG
• Identify and treat cause
• Targeted temperature management
Give high-quality chest
compressions and
• Give oxygen
• Use waveform
capnography
• Continuous
compressions if
advanced airway
• Minimise interruptions
to compressions
• Intravenous or
intraosseous access
• Give adrenaline
every 3-5 min
• Give amiodarone after
3 shocks
• Identify and treat
reversible causes
Identify and treat
reversible causes
• Hypoxia
• Hypovolaemia
• Hypo-/hyperkalemia/
metabolic
• Hypo-/hyperthermia
• Thrombosis –
coronary or
pulmonary
• Tension
pneumothorax
• Tamponade- cardiac
• Toxins
Consider ultrasound
imaging to identify
reversible causes
Consider
• Coronary
angiography/
percutaneous
coronary
intervention
• Mechanical chest
compressions to
facilitate transfer/
treatment
• Extracorporeal CPR
After ROSC
• Use an ABCDE
approach
• Aim for SpO2of
94-98% and
normal PaCO2
• 12 Lead ECG
• Identify and treat
cause
• Targeted temperature
management

Anesthesia Induction (RSI)
with Manual Mode
2. Set the patient’s gender and height
and select “CPAP” or “CPAP+PS”
ventilation mode for pre-oxygenation.
Conrmwith“Next”.
3. Select a low PEEP for pre-oxygenation
of a spontaneously-breathing patient. If
possible, use of pressure support (PS)
should be considered.
4. Pre-oxygenate at a low PEEP and set
theowrateontheoxygensupply.
Note: If you want an oxygen concen-
tration of 100 %, use the administered
minute volume (MVi) as a guide.
1. Switch on ventilator.

6. Auscultate tube position by getting
MEDUtrigger to trigger manual
mechanical breaths. In an emergency,
perform mask ventilation using
MEDUtrigger.
7. Once the airway has been secured
successfully, perform continuous man-
datory ventilation, switching to “IPPV”
mode to do so. The ventilation param-
eters from Item 2 set at the beginning
are adopted automatically.
8. Ventilate continuously in “IPPV” or
“PRVC+PS” mode. The device shows
controlled ventilation parameters.
5. Following successful pre-oxygen-
ation, switch to “Manual” mode.

Indications for prehospital emergency anaesthesia
• Acuterespiratoryinsufciency(hypoxiaand/orrespiratoryrate*
< 6 or > 29/min) and contraindications for or failure of non-invasive ventilation
• Lossofconsciousness/neurologicaldecitwithriskofaspiration
• Multiple trauma/severe trauma with
i) hemodynamic instability, systolic BP < 90 mmHg or
ii) hypoxia with SpO2< 90% despite = 2 l/min O2 administration or
iii) traumatic brain injury with GCS < 9
*inthepresenceofnotrapidlyreversiblecauses
Excerpt from the S1 guideline
”Prehospital Emergency Anaesthesia in Adults” of the DGAI
(German Society for Anesthesiology & Intensive Care Medicine)
If required
Management of complications
Indication: patient-, mission-, and user-related factors,
experience of the emergency medical team, situation at the scene,
transport times, air and ground rescue
Communication in the team: Site of anesthesia induction, clear allocation of
tasks, selection of medicines, other important notes and agreements
Optimal positioning: "Light, space, warmth" concept, ideal for upper body
elevation in the ambulance (caution: not with spinal immobilization or
hemodynamicallyunstablepatients),headin"snifng"position.
Pre-oxygenation:
For a spontaneously breathing
patient, at least 3-4 min O2
insufationwith12-15l/minvia
a face mask with reservoir or
demand valve, if applicable, NIV or
mask ventilation.
parallel
Standardized preparation:
Anaesthesia and emergency medications,
respiratory alternatives, suction,
capnography.
Monitoring: Pulse oximetry,
ECG, blood pressure, capnography.
Two peripheral venous accesses: In case of
difcult puncture conditions, consider in-
traosseous puncture in a time-critical manner.
Rapid Sequence Induction (RSI)
Continuous monitoring: Anesthesia management and monitoring

Rapid Sequence Induction (RSI)
• If applicable, remove the cervical spine immobilization and begin
manual in-line stabilization
• Announcement of the Anaesthesia medication with active
substance and dosage, step-by-step application
• Wait for loss of consciousness and relaxation effect
• Airwaymanagementwithoutintermediateventilationinnormoxicpatients*
• Tube position check (capnography, auscultation, insertion depth)
• If applicable, stop manual in-line stabilization and close the
cervical spine immobilization brace again
*Inindividualcases,despitetheincreasedriskofaspiration,intermediateventilationmaybe
necessary in order to maintain oxygenation.
Please note that these are excerpts from the S1 Guideline "Prehospital Emergency Anesthesia
inadults".ThecompleteguidelineisavailableonthewebsiteoftheScienticMedicalSociety's
Working Group (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaft e.V.)
at: awmf.org.
Source: Anästh Intensivmed 2015;56:317-335 Aktiv Druck & Verlag GmbH
(Translation by WEINMANN Emergency)
Please note that different standard operating procedures or guidelines may apply in your region.

NIV therapy
2. Select “New patient”. Alternatively,
select the corresponding Emergency
mode: Adult, Child, Infant.
3. Set patient’s gender and height.
1. Switch on ventilator.