Transcript Aircon humidifier

AIRcon Respiratory Gas Conditioner
BY
AHMAD YOUNES
PROFESSOR OF THORACIC MEDICINE
Mansoura faculty of medicine
Intended use
• AIRcon respiratory gas humidifier is a device for
heating and humidifying respiratory gases, such
as medical oxygen and/or compressed air or
else room air during mechanical ventilation or
respiratory therapy in both the clinical and
home care environments.
• AIRcon can be used for invasive as well as
noninvasive ventilation/respiratory therapy for
adults, children and newborn babies.
Intended use
• AIRcon is always positioned between therapy device
and patient.
• A tubing system and humidifier chamber are always
necessary for this connection.
• This tubing system must be matched beforehand to the
therapy device being used, to the medical indication and
to the respective patient group.
• Connect AIRcon with approved therapy devices (such
as ventilators, bilevel devices, CPAP devices, etc.).
• Respiratory gas is passed from the therapy device or
oxygen source to the humidifier chamber, where it is
heated, humidified with water vapor and then passed via
the inspiratory tube to the patient.
Intended use
• Three different basic modes, in conjunction with
the fact that temperatures can be freely adjusted
at any time at the humidifier chamber outlet and
also close to the patient, ensure that
humidification capacity can be adjusted or
controlled optimally for every application.
• AIRcon respiratory gas humidifier is not suitable
or intended for atomization of medications.
• AIRcon respiratory gas humidifier is suitable for
reuse. When changing patient and before reusing,
it is necessary to observe cleaning and
disinfection instructions .
Warnings (potentially serious consequences,
such as death, injury for patient or user)
• Position the respiratory gas humidifier below patient
level, to ensure that any condensate formed will not flow
into the patient’s respiratory passages, but instead will
be returned to the chamber.
• The respiratory gas humidifier generates moist air
having a relative humidity of approximately 100 %. This
high relative humidity is medically desired , but also
allows water to condense easily from the moist air.
• Condensation may occur at any time as a result of
changes in the climatic conditions in the hospital room
(for example, heating, air circulation) or of changes in
respiration or ventilation of the patient.
• Do not operate AIRcon with heated breathing tubes or
accessories that have not been released by WILAmed.
Warnings
• Insert the temperature sensor in such a way that the
temperature of the respiratory gas in the respiratory tube is
measured. Otherwise the temperature of the supplied
respiratory gas may rise above 41 °C.
• When AIRcon is started or restarted, the maximum
permissible temperature of the water in the humidifier
chamber is 30 °C .
• Respiratory gas must be flowing through the breathing tube
system before AIRcon is turned on and patient is connected
to the patient tubing system . AIRcon measures the
respiratory gas temperature flowing past the chamber outlet
and close to the patient , and uses these measured values
to control both of the temperatures. In absence of
respiratory gas, AIRcon is unable to determine
temperatures correctly.
Warnings
• Risk of burns! Heater plate and bottom of
humidifier chamber can reach temperatures higher
than 85 °C.
• Moist air from the humidifier chamber is heated in
the breathing tube via a heater wire . Danger of
overheating exists if the breathing tube were
covered with sheets or blankets, potentially
causing deformation or melting of the breathing
tube.
• Ensure the breathing tube system does not get in
contact with the patient skin as it may cause
reddening or burning.
Precautions (ensure safe and effective use
of the humidifier AIRcon )
• Check basic unit, its parts and accessories for
damage before each use.Do not use AIRcon and
its accessories in case of defects or damage.
• Do not use and dismiss damaged system
components.
• Humidity output may be impaired if the device is
operated outside specified environmental
temperatures.
• Humidity output is reduced when ventilation
device supplies respiratory gas at higher
temperature!
Precautions
• Temperature of the respiratory gas flowing into
the humidifier chamber should be at least 5 °C
cooler than set water chamber temperature.
• To prevent overheating, a continuous respiratorygas flow of at least 1 L/min is required in the
tubing system. If respiratory-gas flow is
interrupted , the device is to be turned off.
• Water to manually fill the water chamber must not
exceed 30 °C.
• Please pull power plug before any cleaning,
maintenance, inspection or repair.
Precautions
• Do not sterilize basic device or accessories and
do not dip them in liquids!
• Only a physicians are permitted to set or change
patient settings.
• A change of room climate (for example, heating,
air circulation) or input of new ventilation
parameters may lead to condensation in the
respiratory-tubing system. Condensation is
always to be monitored and kept to a minimum.
Precautions
• When lifting the breathing circuit, a water level detection
alarm due to recirculation of condensation may occur. In this
case, deactivate water level detection temporarily and be
aware that alarm is turned off when water level is too low.
• Respiratory gas humidifier and humidifier chamber are not
inhalation devices and are not approved for administration of
medications.
• Portable and mobile radiofrequency communication devices
(such as mobile telephones) may influence the respiratory
gas humidifier.
• Do not exceed maximum fill level when manually refilling the
water chamber . An alarm is triggered if water level is too
high and water from humidifier chamber may spill over into
breathing tube circuit.
Basic equipment
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Basic AIRcon device
Temperature sensor cable
Heater wire distributor cable
Power cord
Setup and startup
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Connect components
AIRcon is fitted with silicone feet and can be
mounted on a flat, firm and horizontal surface or
fastened in an appropriate claw by means of the
rear retaining strap.
The socket for the power cord is located at the
bottom of the AIRcon respiratory gas humidifier.
Insert the two-prong power plug into power
socket provided and place the power cord in the
guide channel in such a way that it is clamped
securely and firmly.
Connect power plug to a suitable outlet or
multiple outlet strip with a permissible voltage.
Setup and startup
• Sockets for heater wire distributor cable and
temperature sensor cable are mounted on the side of
the device.
• Both sockets are color marked , mechanically coded
and identified with symbols.
• Connecting plugs of both heater wires (inspiratory and
expiratory) are also identified by colors and are also
mechanically coded to prevent misconnection.
• Connect temperature sensor cable (blue) to blue socket
(symbol
).
• Connect heater wire distributor cable (yellow) to yellow
socket (symbol
).
Insert humidifier chamber
• AIRcon respiratory gas humidifier can be used with
common commercial humidification chambers.
• Those can be disposable or reusable chambers as well
auto-filling chambers.
• Unpack humidifier chamber and inspect for possible
damage before use.
• Important: Use only flawless humidifier chambers! Pull off
colored seal caps and dispose of properly.
• Correct alignment of humidifier chamber is determined by
the position of the basic device (right or left ) relative to the
patient’s bed.
• Viewed from the front, the two tubing ports of the humidifier
chamber should point toward the right and left of the basic
device.
Insert humidifier chamber
• Push bottom edge of the humidifier first under the strap of
the front structure and then under the fastening stirrup, until
stirrup snaps audibly into place.
• Only when humidifier chamber is correctly plugged in can
the sensory monitor signal to the microprocessor that device
is ready to operate.
• In case of using auto-filling chambers , steril water reservoir
needs to be attached to the supply tree . Remove seal plate
and insert perforater at the connection kit. If correctly
installed, water fills the humidifier chamber gradually.
• In case of using chambers without auto-filling mechanism,
chambers must be filled with sterile water manually.
• Ensure that the recommended water level is reached. During
operation correct water level must be checked regularly.
Refill water if necessary.
Connect tubing system
• Using the shorter connecting tube , connect
ventilation device to the tubing port of the air
supply (with insert).
• Attach angle connector of heated inspiratory tube,
which is identified by a green plug, to the other
tubing port (without insert).
• Insert first measuring head of temperature sensor
cable into the inlet of the angle connector and
second measuring head at the end of temperature
sensor cable into the inlet close to the patient.
• Both measuring heads must be inserted firmly and
securely into their respective bores.
Connect tubing system
• Conductor of temperature sensor cable can be
fixed in the corresponding hooks of the tubing
clamps, so that it does not dangle loosely. Green
coupling of heater wire supply must always be
connected to green heater wire plug of
inspiratory tube.
• AIRcon humidifier is ready to operate only when
inspiratory heater wire has been connected.
• Once the tubing system being used has been
fitted with a heated expiratory tube, the white
coupling of the heater wire supply must always
be connected to the white heater wire plug of
expiratory tube.
Connect tubing system
• Before connecting patient to patient tubing system,
make certain that the therapy device is functioning
perfectly , therapy values are correctly set and
respiratory gas is flowing without hindrance through
the tubing system.
• Heater wire distributor cable (yellow device plug)
can be used both for respiratory tubing systems
having a heater wire in the inspiratory tube (green
coupling) and for tubing systems having dual heater
wires (green coupling for inspiratory tube and white
coupling for expiratory tube).
• For connecting breathing tube systems with only
inspiratory heater wire , there is an equivalent heater
wire adapter available (P/N 100.942).
Any condensation in the breathing circuit, resulting from
application and environmental temperatures, shall be avoided.
Incorrect arrangement of breathing circuit Correct arrangement of breathing circuit
Connect tubing system
• An alarm signal may occur in case of
recirculation of condensation into the humidifier
chamber.
• Bear in mind, that connected breathing circuit is
assembled with a slight decline towards the
humidifier chamber.
• Correct direction of breathing circuit can be
achieved by using a circuit support arm and
circuit gears.
Switch-on device
• Turn on respiratory gas humidifier with the sidemounted main switch only when humidifier
chamber and water reservoir have been correctly
connected.
• AIRcon respiratory gas humidifier saves the last
setting and uses it for a restart (for example, after
a power failure).
• The device can be restored to factory setting as
described in “Operator control in normal mode”.
• After it has been turned on, the device first
displays product model and version and executes
a self-test. No inputs are possible during this
initialization.
Switch-on device
• The startup display is only an example for
illustration. Displayed software version can
differ.
Switch-on device
• After initialization, the operating
display appears. As an example,
factory setting IV (invasive) is
shown below.
• In its factory setting IV, the device
assumes the following fixed
parameters: target temperature
close to the patient = 39 °C,
chamber temperature = 37 °C.
• After device has been turned on,
heating phase lasts 30 minutes at
most (typically 15 minutes) and
symbol
is displayed.
Function keys
• There are four different display modes and
sometimes keys have different functions.
• HD = Hold down
PB = Press briefly
Operation in normal mode
Restoring to factory settings
• Device is delivered with factory setting “IV”, i.e.
target value of near-patient respiratory gas
temperature (upper measurement point): 39 °C
,target value of chamber temperature (lower
measurement point): 37 °C
• During operation, device can be restored to
factory setting by holding down the
and
keys simultaneously for 3 s.
• While factory setting is loading, a black screen
displays a yellow text, reading “FACTORY
RESET…” in the left lower corner.
Therapy pause
• Hold down the key
for 3 s in normal mode to
initiate a therapy pause.
• While therapy pause is active, status symbol
STOP is displayed in the right lower corner of the
screen.
• After 180 s, therapy pause is automatically
canceled and device resumes operating in last
mode of operation.
• During therapy pause , heater power of the tubing
heater is reduced. This reduces the risk of an
increased temperature at the patient outlet once
respiratory gas flow restarts after therapy pause.
Operation in modification mode
• Activate modification mode to adjust target
temperatures or heater power in the expiratory
tube by holding down
for approximately 3
seconds during normal mode.
• Target value for near-patient temperature can be
adjusted in the top row and target value for
chamber temperature can be adjusted in the row
below.
• In the bottom row, the heater power of the
heater wire in the expiratory tube can be
incremented or decremented in 5 stages.
• Select appropriate row with the
and cursor
keys in order to make changes.
Operation in modification mode
• At first, the selected element is shaded in white.
• When pressing
,the element is highlighted
in yellow.
• Highlighted values can be increased or
decreased by pressing
and
.
• Each adjustment must be confirmed by
pressing the key
.
• Press the key
to exit modification mode.
Reducing condensation in the inspiratory tube
• To reduce condensate in the inspiratory tube, it is
recommended to increase temperature difference
between near-patient and humidifier chamber target
temperature .
Changing humidity
• Humidity for the patient can be increased by raising the
humidifier chamber target temperature.
• The humidity for the patient can be decreased by
lowering the chamber target temperature.
Reducing condensation in the expiratory tube
• To reduce condensate in the expiratory tube, it is
recommended to raise heat output of the expiratory
heater wire.
Operation in configuration mode
In normal mode, hold down the key
for 3 s to open
configuration menu . Configuration menu allows you to make
individual adjustments as shown below:
Operation in configuration mode
• Select desired function with and
.
• Selection is highlighted in yellow and must be
confirmed with
.
• Press
to open the next menu page up to
operating mode.
Operation in configuration mode
Mode of operation
Factory setting “NIV” (noninvasive) works with
fixed operating parameters as follows:
• respiratory gas temperature (upper
measurement point): 34 °C
• chamber temperature (lower measurement
point): 31 °C
Factory setting “IV” (invasive) works with
fixed operating parameters as follows:
• respiratory gas temperature (upper
measurement point): 39 °C
• chamber temperature (lower measurement
point): 37 °C
Option “FREE” allows individual operating
parameters adjustments for respiratory gas
and chamber temperature.
Set temperatures
• This menu page is displayed only if user has
selected operating mode “FREE”.
• In contrast to factory setting for invasive and
noninvasive ventilation, user must set desired patient
and chamber temperatures manually.
• Regardless of mode of operation (including IV and
NIV),temperature can be adapted to patients needs (for
example , respiratory gas too humid / too dry) by
holding down the key
for approximately 3 s.
• During any change of temperature parameters, the
device automatically switches to “FREE” mode of
operation, even from factory setting (IV or NIV).
Set humidification
• In non-invasive ventilation (NIV) and
invasive ventilation (IV) mode, the humidity
output can be individually adjusted in three
levels.
• A single drop indicates humidification
minimum, three drops indicate
humidification maximum.
• Depending on the selected breathing tube
system and applied form of therapy, the user
is allowed to adapt patients’ humidification
in a more flexible way; potential
condensation in the breathing tube system
can be reduced.
Set chamber
• AIRcon active humidifier automatically detects water level
in the humidifier chamber.
• Acoustic and optical alarms are triggered if water level in
humidifier chamber rises above the maximum value or
drops below the minimum value.
• The following selectable options are available for
automatic water level detection:
ON= function activated OFF= function deactivated.
• A prerequisite for correct functioning of automatic
water level detection is the use of transparent unlabeled
humidifier chambers (example: WILAmed AF200). If
outside wall of humidifier chamber is labeled or if a
humidifier chamber with a high-flow insert is used, water
level detection must be deactivated
Operation in alarm mode
Alarm muting
• Press briefly to suppress acoustic alarm signal
for 120 s. The background illumination of the
key in question will continue to flash as an
optical alarm.
• After muting time has elapsed, the acoustic
alarm sounds once again, but may be muted
again if necessary.
• If fault is not corrected during repeated muting
period, the device turns off the heaters after 10
minutes.
• Status is displayed with letters “OFF” under
flashing
symbol
.
Alarm delay
• Alarm delay suppresses an alarm for 3 minutes
and is automatically activated if a target
temperature is changed.
• This function prevents the alarm from being
triggered by unusual parameter corrections,
such as a change of more than 2 °C in the target
temperature close to the patient.
• Alarm delay is also active at the end of a
therapy pause.
Alarm delay is activated when:
• Patient temperature too high (does not apply
when exceeding 43 °C threshold)
• Patient temperature too low
• Chamber temperature too high
• Chamber temperature too low
• Heater plate sensor system defective
Heating time
• After device has been turned on ,“temperature
alarms” and also alarm delay are disregarded
for a certain time.
• This heating time may last for 30 minutes at
most and is shortened to 5 minutes if both
actual temperatures have exceeded their target
limits for the first time.
Inspiratory heater missing/defect
Expiratory heater missing/defect
Respiratory gas temperature too high
Respiratory gas temperature too low
Humidifier chamber temperature too high
Humidifier chamber temperature too low
Temperature sensor cable missing/defective
Heater plate defective
Humidifier chamber missing
Water level too low
Water level too high
VT_ALM
Forced disconnection of heater
wire and heater plate
Heater plate too hot
Service due
Format eeprom
Measurement in progress