Transcript Monitoring with the Vision

Monitoring with the Vision
Alarms
Alarm Overview
Alarm: Warning Signal of an Event
Event: A Noteworthy Happening
• An abnormal clinical occurrence
• Requiring clinical awareness or action
Alarm Overview
Events Are Related To:
• Technical performance of the
ventilator system
or
• Patient’s clinical condition
Alarm Overview
Two Types of Alarms
System
Adjustable
Alarm Overview
Alarm Indications
• Visual
• Audible
• Two Tones
Alarm Reset
• Manual
• Self-canceling
Nurse Call/Remote
System Alarms
Check Ventilator Performance
Preset and Not Adjustable
Continuous Tone
System Alarms
Ventilator Inoperative
Check Ventilator
Pressure Regulation
Proximal Pressure Line
O2 Flow
Exhalation Port
Disconnect
Ventilator Inoperative
System Alarm
Audible & Visual
Why?
• System Malfunction
• AC Power Failure
What Happens?
• Ventilator Powers Down
• Valves Open to Atmosphere
allows spontaneous breathing
Check Ventilator
System Alarm
Audible & Visual
Manual Reset
Abnormal Operating Condition
What Happens?
• Ventilator Continues to Operate
• Unit Requires Service
• Visual Indicator Remains Until
Condition Corrected
Check Ventilator
System Alarm
Visual & Audible
Manual Reset
Why?
• Internal Battery Voltage is
Low
What Happens?
Error Code 205
• Internal Battery Cannot
Sustain Audible Alarm
• AC Power Will Trickle Charge
Pressure Regulation
System Alarm
Audible & Visual
Self-canceling
Why?
• Proximal and Set Pressure Vary
+/- 5 cm H2O
What Happens?
P Regulation
• Ventilator Sends Available Flow to
Achieve Set Pressure
Proximal Line Disconnect
System
Audible & Visual
Self-canceling
Why?
• Proximal Pressure < 1 cmH2O
What Happens?
ProxLine Disc
• Ventilator Continues to Deliver Set
Pressure
Oxygen Flow
System Alarm
Audible & Visual
Manual Reset
Why?
• Insufficient Oxygen Flow
What Happens?
O2 Flow
• FIO2 Cannot be Maintained
Ventilator Continues to Deliver
Set Pressure
Exhalation Port
System Alarm
Audible & Visual
Self-Canceling
Why?
• Baseline Flow Decreases Below
Intentional Leak Rate
5L/min or 50%
What Happens?
Exh Port
– Ventilator Continues to Deliver Set
Pressure
Learn Function
Learns Base Flow
• Upon system start-up
• After mode changes
• Activated manually
With circuit condition
changes
Modify Alarms screen
Disconnect Alarm
System Alarm
Audible & Visual
Self-Canceling
Why?
• Patient Disconnect
High flow rates for 4
seconds
What Happens?
Disconnect
•Ventilator decreases flow to idle
Flow Limit Control
What Is It ?
• Recognizes Patient Disconnection
Decreases total flow to idle
• Flow Returns to Normal
Spontaneous patient trigger
Benefits of System Alarms
Monitor Operating Specifications
Warn of Abnormal Operating
Conditions
Visual Messages Facilitate
Troubleshooting
Adjustable Alarms
Monitor Specific Patient Parameters
Clinician Adjustable
Multiple Tone
Adjustable Alarms
High Pressure
Low Pressure
• Low Pressure
Delay
Apnea
Low Rate
High Rate
Low Minute
Ventilation
High Pressure
Adjustable Alarm
Audible & Visual
Self-canceling
Why?
• Proximal Pressure Exceeds
Hi P Alarm Limit
• What Happens?
Inspiration is Terminated
Safety Feature
Hi P
Low Pressure
& Low Pressure Delay
Adjustable Alarm
Audible & Visual
Self-canceling
Why?
• Proximal Pressure Below
Lo P
• Limit for Set Time Delay
What Happens?
• Ventilator Continues to
Function
Lo P
Setting Pressure Alarms
Hi P and Lo P
• Bracket IPAP
Lo P Delay
According to patient condition
Adjustable Alarm
Audible & Visual
Self-canceling
Apnea
Why?
• Absence of
Spontaneous Trigger
for Set Time Interval
What Happens?
• Timed Breaths are
Delivered at Set Rate
Apnea
Apnea (con’t)
Audible resets only when
condition is corrected
• Two spontaneous triggers
Safety feature
Apnea Can be Disabled
Low Rate
Adjustable Alarm
Audible & Visual
Self-canceling
Why?
• Total Respiratory Rate is Below Lo
Rate Limit
Setting Lo Rate Alarm Limits
• Set Below Total Respiratory Rate
• And Above Set Rate
High Rate
Adjustable Alarm
Audible & Visual
Self-canceling
Why?
• Total Respiratory Rate is Above Hi
Rate Limit
Setting Hi Rate Alarm Limits
• Set Above Total Respiratory Rate
Low Minute Ventilation
Adjustable Alarm
Audible & Visual
Self-canceling
Why?
• Minute Ventilation Falls Below Set
Lo MinVent Limit
Setting Lo MinVent alarm limits
• Set ~ 20% < Total Minute
Ventilation
Use MinVent estimation
Benefits of Adjustable Alarms
Monitor Patient Conditions
Warn of Critical Changes in
the Patient
as determined by the
clinician
Visual Messages Facilitate
Troubleshooting