Аппарат ивл гамильтон т1 инструкция по применению

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This Quick Guide is intended as a useful reference for ventilation of adult and pediatric patients.

It does not replace the clinical judgment of a physician or the content of the HAMILTON-T1

Operator’s Manual, which should always be available when using the HAMILTON-T1 ventilator.

Some functions are optional and not available in all markets.

© 2015 Hamilton Medical AG. All rights reserved. Printed in Switzerland.

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Table of contents

1. HAMILTON-T1 basics ……………………………………………………………………………………………………………….. 4

2. Setting up the ventilator ………………………………………………………………………………………………………….. 10

3. Tests and calibrations ……………………………………………………………………………………………………………… 18

4. Ventilating a patient ……………………………………………………………………………………………………………….. 22

5. Monitoring patient data …………………………………………………………………………………………………………. 28

6. Ensuring an adequate oxygen supply for patient transport ……………………………………………………………. 30

7. Glossary of control parameters ……………………………………………………………………………………………….. 32

Hamilton Medical | HAMILTON-T1 Quick Guide

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4

1. HAMILTON-T1 basics

1.1 Ventilator front view

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1

Alarm lamp.

Red = high-priority alarm, yellow = medium- or low-priority alarm.

2

Touch screen.

Provides access to measurements and controls.

3

Power/Standby key.

Turns the ventilator on and off and accesses standby.

4

Battery charge indicator.

Lit = battery is fully charged. Flashing = battery is charging.

5

5

Day/Night key.

Switches between the Day and Night display brightness setting.

Screen lock/unlock key. Prevents inadvertent change of settings.

6

6

7

7

Manual breath/inspiratory hold key. Triggers a mandatory breath when pressed and released during exhalation. Triggers an inspiratory hold when held down during any breath phase. When active, the green indicator is lit.

O2 enrichment key. Delivers 100% oxygen for 2 min. Press the key a second time to cancel. Press O2 key and disconnect patient to start a suctioning maneuver.

Print screen key. Save a JPG file of the current ventilator screen to a USB memory drive.

Nebulizer on/off key. Activates pneumatic nebulizer for 30 minutes or until pressed again during the inspiration phase if high-pressure oxygen (HPO) is connected.

8

Alarm silence key.

Silences the main ventilator audible alarm for 2 min. Press the key a second time to cancel the alarm silence.

9

Press-and-turn (P&T) knob.

Use to select and adjust ventilator settings.

10

Front cover and battery.

The backup batteries are located inside the front cover.

11

Underside of ventilator.

Expiratory valve bleed port. Do not obstruct.

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6

1.2 Ventilator side view, with gas connections

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5

6

7

8

1

2

3

4

USB connector

High-pressure oxygen DISS or NIST inlet fitting

Low-pressure oxygen connector

AC power receptacle

Cooling air intake and dust filter. Do not obstruct.

AC power cord with retaining clip

Serial number label

DC power receptacle

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8

1.3 Main display

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1

Active mode & patient group.

2

Main controls.

Touch the

Controls

button

(3)

to display all controls for the selected mode.

3

Window tabs.

Open the associated windows.

4

Input power.

Shows available power sources.

5

Alarm silence indicator and countdown.

Shows whether alarm silence has been activated, and displays the remaining silence time.

6

Graphic display.

Shows a user-selectable waveform or an Intelligent Panel graphic

(Dynamic Lung, ASV graph, Vent Status).

7

Main monitoring parameters (MMP).

View other numeric parameters from the monitored parameter windows.

8

Message bar.

Displays color-coded alarm messages. If an alarm is active, view the alarm buffer by touching the message bar.

9

Pressure/time waveform.

Always displayed.

The red line is the Pmax high pressure alarm setting.

The blue line is the pressure limit automatically 10 cmH2O below the

Pmax alarm setting.

The pink triangles indicate the patient is triggering a breath.

The

Freeze

button freezes the graphic for up to 30 s.

10

Alarm indicator (i-icon).

Touch the icon to view information about alarms.

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2. Setting up the ventilator

1

2

3

Expiratory valve membrane

Expiratory valve housing

Metal plate facing the ventilator

Installing the expiratory valve

1

2

Holding the expiratory valve housing, seat the silicone membrane onto the housing.

The metal plate must face up and be visible.

Position the housing and twist clockwise until it locks into place.

Single use and autoclavable expiratory valves are available.

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2.2 Connecting a coaxial breathing circuit

5

6

7

8

9

1

2

3

4

To patient (inspiratory port)

From patient (expiratory port)

Adult/pediatric expiratory valve set

Nebulizer outlet

Flow sensor connectors

Limb connector

Coaxial inspiratory/expiratory limb

Flow sensor

HMEF

Hamilton Medical | HAMILTON-T1 Quick Guide

Connect the breathing circuit to the inspiratory and expiratory ports

(1, 2)

and the flow sensor tubes to the flow sensor connectors

(5)

.

Use either a bacteria filter or a combined heat-moisture exchanger and filter (HMEF).

11

12

2.3 Connecting a dual limb circuit

5

6

7

8

9

1

2

3

4

10

To patient (inspiratory port)

From patient (expiratory port)

Adult/pediatric expiratory valve set

Nebulizer outlet

Flow sensor connectors

Bacteria filter

Inspiratory limb

Expiratory limb

Y-piece (integrated with breathing circuit)

Flow sensor

Use either a bacteria filter or a combined heat-moisture exchanger and filter

(HMEF).

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2.4 Connecting an adult/pediatric flow sensor

2.5 Connecting the internal pneumatic nebulizer

1

2

3

4

5

6

Expiratory limb

Inspiratory limb

Nebulizer

Tube

Flow sensor

Coaxial breathing circuit

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2.6 Connecting a CO2 mainstream sensor

Attaching the CO2 sensor to the airway adapter

1

2

3

CO2 sensor

Airway adapter

Connect to CO2 port on ventilator

Connecting the CO2 sensor/ adapter to the patient circuit

You can connect the CO2 sensor before or after the flow sensor according to your institution’s protocol.

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2.7 Connecting a CO2 sidestream sensor

1

2

3

4

Inserting the sample cell into the

CO2 module

Connect to CO2 port on ventilator

Sample cell clicks into place

LoFlow sidestream CO2 module

Airway adapter

Hamilton Medical | HAMILTON-T1 Quick Guide

Attaching the CO2 sensor to the airway

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2.8 Connecting an SpO2 monitor

2

3

4

Masimo SET pulse oximeter components

1

5

Adapter, which contains the oximeter hardware

Cable connection ports

Sensor and cable

Patient cable (connects to adapter and sensor)

Adapter cable (connects the adapter to

SpO2 connector on ventilator)

Connecting the cables

X X

Connect the ventilator, patient, and sensor cables as shown.

Not all options are available in all markets.

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2.9 Enabling CO2/SpO2 monitoring

1

2

3

4

System

Sensors on/off

CO2 and SpO2

Sensor status

To enable CO2 / SpO2 monitoring

1

2

Open the System > Sensors on/off window.

Select the CO2 and/or SpO2 checkboxes, and close the window.

The status text Active appears next to the checkbox as long as the adapter is connected to the ventilator. If the status area is empty, the adapter is not connected.

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3. Tests and calibrations

3.1 Performing the preoperational checks

1

2

3

Connect ventilator to AC or DC power and an oxygen supply.

Assemble the patient breathing circuit.

Turn on power.

The ventilator runs a self-test and displays the

Standby window. Use only if ventilator passes all tests.

Preop check

Step one

1

2

Touch

Preop check

in the Standby window.

The System > Tests & calib window is displayed.

Touch the

Tightness

button to perform the tightness test.

Tightness

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When prompted, block the patient end of the breathing circuit. Hold until prompted.

Pass or fail and date/time of completed test are displayed.

Step two

1

2

3

Touch the

Flow Sensor

flow sensor.

button to calibrate the

When prompted, turn the flow sensor and connect to Y-piece using the calibration adapter.

Calibration starts automatically.

When prompted, turn the flow sensor again and remove the calibration adapter.

Calibration starts automatically.

Pass or fail and date/time of completed test are displayed.

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Step three

1

2

If necessary, and if prompted by calibration.

next to the

O2 test

button, perform the O2 sensor

Touch the

O2 test

button.

If O2 cell calibration needed alarm is active, repeat O2 calibration once device has warmed up

(after 30 minutes).

Step four

To demonstrate the alarm’s operation, perform an alarm test.

Loss of external power test

1

2

3

4

5

Ensure the ventilator is connected to AC power.

Disconnect the power cord.

Verify that the Loss of external power alarm is generated and that the ventilator is powered by its backup battery.

Reconnect the ventilator to AC power.

Verify that the alarm resets and that the ventilator is again powered by AC.

The HAMILTON-T1 is ready to ventilate .

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3.2 If the preoperational check fails

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4. Ventilating a patient

4.1 Using Quick Setup

1

2

3

4

Patient group

Quick Setup buttons

Gender and patient height

Start ventilation

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A Quick setup refers to a group of settings you define, including patient characteristics (group and weight), mode selection and some control settings, alarm limit settings, and weaning zone limits, that is automatically applied when the setup is selected in the Standby window.

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The HAMILTON-T1 has three configurable Quick Setup buttons.

Settings can be configured in advance according to your institution’s standard protocols.

Once configured, you can start ventilation in six easy steps.

4

5

6

1

2

3

Touch one of the three Quick Setup buttons.

Touch

Male

or

Female

.

Touch

Pat. Height

and adjust patient height using the Press-and-Turn knob.

The ventilator uses patient height and gender to calculate the ideal body weight (IBW). IBW is

used to determine several startup settings (see page25).

If required, touch

Modes

tab to change ventilation mode.

Review control and alarm settings.

Touch

Start ventilation

.

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4.2 Selecting modes

1

2

3

4

Active mode

Modes

New mode to apply

Confirm

To change the mode

1

2

Select the desired ventilation mode.

Touch

Confirm

.

The Controls window opens.

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4.3 Adjusting controls

To adjust controls

1

2

3

Touch the control to adjust.

The control button turns orange.

Use the P&T knob to change to the desired setting.

Confirm changes to the setting by touching the control again or by pressing the

P&T knob.

The control button turns blue.

Confirm changes before modifying another control.

The following parameters are set based on ideal body weight (IBW): Vt, Rate, Thigh, Tlow, TI,

ExpMinVol, and Vt alarm limits. The ventilator uses the Vt/IBW setting to set the initial delivered Vt in volume-controlled modes.

See glossary of control parameters on page 32.

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4.4 Adjusting alarm limits

1

2

3

Alarms

Limits 1, 2, 3

Red or yellow bar (depending on alarm priority) indicates the moni-

4

tored value is out of range

Current monitored value

5 Auto

button

Changing the High pressure and VT high alarm settings may affect ventilation.

See next page.

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High pressure alarm

The High pressure alarm sets the pressure limit 10 cmH2O below the Pmax setting. Changing the

Pressure high alarm limit

Pressure high alarm limit

VT high alarm

Inspiratory volume is limited to 1.5 times the set VT high alarm limit. Changing the VT high alarm may limit the inspiratory volume. Volume limitation is disabled in NIV modes.

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5. Monitoring patient data

X X

Touch the

Monitoring

button to access patient data.

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5.1 Monitoring patient data using the dynamic lung

The dynamic lung shows compliance ( Cstat) and resistance (Rinsp) breath-by-breath relative to

“normal” values for the patient’s height.

1

2

3

Low compliance

Normal compliance

High compliance

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2

3

Normal resistance

Moderately high resistance

High resistance

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6. Ensuring an adequate oxygen supply for patient transport

Before transporting a patient, ensure an adequate oxygen supply by checking the O2 consumption parameter. During ventilation the current oxygen consumption rate is displayed in the O2 consumption parameter (l/min) in the System > Info window.

The oxygen consumption of a nebulizer attached to the device is not included in the

O2 consumption parameter value.

30

O2 consumption

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6.1 Estimating O2 consumption for transport

Prior to transport you can estimate the patient’s O2 consumption.

For smaller patients, ≤ 70 cm, IBW ≤ 8 kg

O2 consumption = [(ExpMinVol * 2) + 3 l/min] * (FiO2 – 20.9) / 79.1

For larger patients, > 70 cm, IBW > 8 kg

O2 consumption = (ExpMinVol + 3 l/min) * (FiO2 – 20.9) / 79.1

Additional amount for the nebulizer oxygen use

Nebulizer O2 consumption = 8 l/min * Insp time/total breath time

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Parameter

Apnea Backup

ETS

Flow trigger

Gender

I:E

%MinVol

Oxygen

Pasvlimit

Pat. height

7. Glossary of control parameters

Definition

A function that provides ventilation after the adjustable apnea time passes without breath attempts. If “Automatic” is enabled, control parameters are calculated based on the patient‘s IBW.

Expiratory trigger sensitivity. The percentage of peak inspiratory flow at which the ventilator cycles from inspiration to exhalation.

The patient’s inspiratory flow that triggers the ventilator to deliver a breath.

Sex of patient. Used to compute ideal body weight (IBW) for adults and pediatrics.

Ratio of inspiratory time to expiratory time. Applies to mandatory breaths.

Percentage of minute volume to be delivered in ASV mode. The ventilator uses the %MinVol, Pat. height, and Gender settings to calculate the target minute ventilation.

Oxygen concentration to be delivered.

The maximum pressure to apply in ASV mode. Changing Pasvlimit or the Pressure alarm limit automatically changes the other: The Pressure alarm limit is always 10 cmH2O greater than Pasvlimit.

Patient height. It determines the ideal body weight (IBW), which is used in calculations for ASV and startup settings for adult and pediatric patients.

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Glossary of control parameters

Parameter

Pcontrol

PEEP/CPAP

P high

Pinsp

P low

P-ramp

Psupport

Rate

Sigh

Definition

The pressure additional to PEEP/CPAP.

Positive end expiratory pressure.

The high pressure setting in APRV and DuoPAP modes. Absolute pressure, including PEEP.

Pressure (additional to PEEP/CPAP) to apply during the inspiratory phase. Applies in PSIMV+ IntelliSync and NIV-ST.

The low pressure setting in APRV.

Pressure ramp. Time required for inspiratory pressure to rise to the set (target) pressure.

Pressure support for spontaneous breaths in SPONT, NIV, and SIMV+ modes.

Respiratory frequency or number of breaths per minute.

Breaths delivered at a regular interval (every 50 breaths) at a pressure up to 10 cmH2O higher than non-sigh breaths, as allowed by the Pressure alarm limit.

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Glossary of control parameters

Parameter

Thigh

TI

TI max

T low

Vt

VT/kg

Definition

Length of time at the higher pressure level, P high, in DuoPAP and APRV modes.

Inspiratory time, the time to deliver the required gas (time to reach the operator-set Vt or Pcontrol value).

Used with Rate to set the breath cycle time.

Maximum inspiratory time for flow-cycled breaths in NIV, NIV-ST, and SPONT in neonatal modes.

Length of time at the lower pressure level, P low, in APRV mode.

Tidal volume delivered during inspiration in (S)CMV+ and SIMV+ modes.

Tidal volume per weight.

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Manufacturer:

Hamilton Medical AG

Via Crusch 8, 7402 Bonaduz, Switzerland



+41 58 610 10 20 [email protected]

www.hamilton-medical.com

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