415 Viasys Avea Ventilator 415 / Page 1 of 10

415 Viasys Avea Ventilator 415 / Page 1 of 10
415
Viasys Avea Ventilator
415 / Page 1 of 10
Description
The Avea is a servo-controlled, software driven ventilator that provides ventilation to Neonatal,
Pediatric and Adult patients. A precision gas delivery engine with servo controlled active
inhalation and exhalation. The Comprehensive Model Avea (which we have in our institution)
can also deliver Heliox to all patient ranges. The ventilator will compensate for the lower density
of the gas, all volumes (numeric and graphic) are automatically compensated for accurate
display.
The AVEA may be configured for conventional ventilation or non-invasive positive pressure
ventilation.
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An external flow sensor is required for neonatal application.
Available Modes of Ventilation.
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Volume Control
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Assisted Volume Control
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Volume Control with Flow Sync (also known as Autoflow to Draeger users)
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Assisted Volume control with Flow Sync
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Pressure Regulated Volume Control (PRVC) – also known as Autoflow for Draeger users
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Pressure Control
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Assisted Pressure Control
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Pressure Control Inverse Ratio
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Volume Control SIMV
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Volume Control SIMV with Pressure Regulated Volume Control
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APRV
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Pressure Support
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CPAP
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Apnea Ventilation
Other Features of the AVEA include:
1. Artificial Airway Compensation (AAC) – ventilator compensates the pressure delivered
to patient based on a calculated pressure drop through the ETT. Calculation takes
account of flow, gas composition, tube size, length, and curvature.
2. Leak Compensation – During exhalation the flow control valve (FCV) on the AVEA
supplies flow when the pressure drops below target PEEP up to a maximum flowrate for
patient size. Not active during breath delivery.
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3. Circuit Compliance Compensation – The volume of gas delivered during a volume
controlled or targeted breath is increased to include the set volume, plus the volume lost
in ventilator circuit.
See Section 400 Mechanical Ventilators for standard procedure, orders, house formula and
complications. See manufacturer’s manual of operations for complete description of
controls and alarms.
Patient Setup and Ranges
1. Power On – Using screen keys and dial knob, adjust and accept menu selections.
2. Patient Selection Screen
(select one of the following)
a. Resume Current
b. New Patient
c. Patient Accept – Press “Patient Accept” after selection
3. Patient Size Select
a. Breaths per Minute – 1-120 bpm (Adult), Pediatric/Neo – 1-150 bpm.
b. Volume - .10 to 2.50 L (Adult), 25-500 ml (Pediatric), 2.0-300 ml (Neonate)
c. Insp Pres – 0 to 90 cm H2O (Adult/Pediatric), 0-80 cmH20 (Neonate)
d. Flow – 3 to 150 l/min (Adult), 1 to 75 l/m (Pediatric), 0.4 to 30 l/m (Neonate)
e. Tinsp – 0.20 to 5.0 sec (Adult/Pediatric), 0.15 to 3.00 sec (Neonate)
f. Peep – 0-50 cm H2O
g. Flow Trigger – 0.1 – 20.0 L/min
h. Oxygen 21% to 100%
4. *Perform EST (Extended Systems Test) Follow Screen prompts; 90 sec. test.
During the EST the ventilator will perform:
a. Patient circuit leak test
b. Patient circuit compliance measurement
c. Two point calibration of O2 sensor
d. Once test is complete, press “Continue” to return to set up screen
5. Ventilation Setup Screen
a. Artificial Airway Compensation (AAC) ON/OFF, Defaults to OFF
b. Leak Compensation ON/OFF ; Compensates for ETT leaks, maintains PEEP level
w/leak
c. Circuit Compliance – Compensates for volume loss in ventilator circuit
d. *active only if EST is performed-NOT active in Neonate
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e. Select Active or Passive Humidification (ON/active or OFF/passive
f. Enter Patient Weight
g. Press “SIZE ACCEPT’ after selection
Setting Ventilation Breath Type and Mode
(Operational considerations for this ventilator)
1. Mode Selection
2. Press “Mode” membrane button to left of the screen
3. Volume Control breaths
a.
A/C or SIMV, default breath type for adult and pediatric patient
b. Controlled by flow (inspiratory)
c. Limited by pre-set volume or maximum inspiratory pressure
d. Cycled by volume, flow and time
4. Intra-Breath Demand System in Volume Ventilation
a. Provides additional flow to the patient during periods of demand. AVEA
measures the Peak Insp Pressure (Ppeak) every 2 milliseconds throughout the
breath cycle and sets a “virtual” Pressure Support Target of the greater of PEEP +
2 cm H2O or Ppeak – 2 cm H2O.
b. Inspiratory Flow – Once the set Vt has been delivered, ventilator evaluates
inspiratory flow. If Peak inspiratory flow is > than set peak flow, vent determines
that patient is continuing to demand flow and cycles breath when inspiratory flow
falls to 25% of peak inspiratory flow.
5. Volume Control Advance settings
a. Vsync
b. Vsync rise
c. Sigh
d. Waveform
e. Bias Flow
f. Pressure trigger
g. Volume Limit (w/Vsync ON)
h. PSV rise (SIMV)/PSV cycle, PSV Tmax
6. Pressure Control Breaths - A/C or SIMV
a. Controlled by pressure (inspiratory + PEEP)
b. Limited by pressure (inspiratory + PEEP+margin)
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c. Cycled by time or flow
7. Pressure Control Advance settings
a. Machine volume limit
b. Insp. Rise time: 1 = fastest; 9 = slowest
c. Flow cycle – inspiration terminates based on % set of Peak insp. Flow rate
d. Pressure trigger: Set higher than flow trigger.
e. PSV cycle/ PSV rise / Tmax
Note: about pressure trigger vs flow trigger. One trigger will override the
other depending on patients interaction w/vent. Pressure trigger
defaults to 3.0 cm H2O, range 0.1 – 20 cm H2O. ***If decreased below
3.0 cm H2O, be sure to assess pt for autocycling.
8. PRVC
a. A/C or SIMV; not available for neonates (known as Autoflow to us Draeger
users)
b. Pressure level is automatically modulated to achieve a preset volume
c. Controlled by pressure (inspiratory + PEEP) and volume
d. Limited by pressure (inspiratory + PEEP + margin)
e. Cycled by time or flow.
f. When PRVC is selected, a decelerating flow, volume controlled test breath, to the
set Vt w/ a 40 msec pause, is delivered to patient. The vent sets the target
pressure at EIP (end inspiratory pressure) of the “test breath” for the first pressure
control breath. The next breath and all subsequent breaths are delivered as
pressure control breaths. Inspiratory pressure is based on the dynamic compliance
of the previous breath and the set Vt.
g. Maximum step change between two consecutive breaths is 3cmH20.
h. Test Breath sequence initiated when:
i. Entering the Mode (PRVC)
ii. Changing the set Vt while in PRVC
iii. Reaching the Volume Limit setting
iv. Delivered Vt ≥ 1.5 times set Vt
v. Flow termination of the test breath
vi. Exiting Standy
vii. Activation of Alarms: High Pip, Low Pip, Low Peep, Disconnect, I-time
limit.
9. PRVC Advance Settings:
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a. Insp rise
b. Bias flow
c. Pressure trigger
d. Volume limit
e. PSV cycle/PSV rise/PSV Tmax
10. Pressure Support/CPAP - spontaneous demand breath
a. Minimum pressure support is PEEP + 2cm H2O
b. Minimum pressure level for neonates = 0
c. PSV breaths are:
i. Controlled by pressure (preset PSV level + PEEP)
ii. Limited by pressure (Preset PSV level + PEEP)
iii. Cycled by time (PSV Tmax) or flow (PSV Cycle)
d. When in PSV/CPAP or APRV/ BiPHASIC you must:
i. set primary and advanced settings
ii. select breath type for APNEA backup mode
iii. press MODE ACCEPT button
11. Pressure Support/CPAP Advance Settings:
a. Volume limit
b. PSV rise / PSV cycle/ PSV Tmax
c. Bias Flow
d. Pressure trigger
12. Apnea Ventilation:
When patient exceeds the Apnea interval set in the Alarm limits window, apnea ventilation is
initiated and remains until the following criteria are met:
a. The patient initiates a spontaneous breath
b. A manual breath is delivered
c. The mandatory respiratory rate is increased above apnea interval setting
13. APRV/BiPhasic Airway Pressure Release Ventilation
a. Time Cycled Pressure mode in which the ventilator cycles between two different
baseline pressures, Pressurehigh/Pressurelow
b. based on a preset time.
c. vent cycles between two different baseline pressures based on Timehigh / Timelow
d. synchronized w/patient effort
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e. Pressure High 0-100 cm H2O
f. Pressure Low 0-45 cm H2O
g. Time High
0.2 to 30 sec
h. Time Low
0.2 to 30 sec
14. APRV Advanced Settings:
a. Volume limit
b. PSV cycle /PSV rise/ PSV Tmax
c. Bias flow
15. TCPL (Time Cycled Pressure Limited
a. A/C or SIMV – default and only available in neonatal selection
b. controlled by inspiratory flow
c. limited by pressure (inspiratory + PEEP)
d. Cycled by time, flow (inspiratory), or volume (volume limit)
16. TCPL Advance Setting:
a. volume limit
b. flow cycle
c. bias flow
d. pressure trigger
e. PS cycle, rise, Tmax
f. Cable with flowsensor is required for Neonatal Ventilation
17. Standby
a. To initiate Standby, press Screen membrane, SCREEN SELECT box is
displayed,
b. press STANDBY
c. Select “YES”
d. STANDBY NOT VENTILATING will be displayed in screen
Monitors and Displays
Select choices by pressing membrane keys and control dial. To make your selection, touch the
touch screen menu again or press the Accept membrane button next to control dial.
1. Main Screen
a. press any of the 5 parameter buttons to select desired parameter to measure
b. press waveforms, choose desired graphic display
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2. Loop choices
a. Flow/volume
b. Pressure/volume
c. up to 4 reference loops can be saved
3. Monitor Screen
a. display 15 different monitored values
b. configure parameter in desired order
4. Maneuver Screen
a. vent is capable of performing AutoPEEP, MIP, LIP
Alarms
Avea vent alarms are grouped into 3 categories
1. High priority (warning)
a. Sounds a series of 5 tones, 3 low and 2 high.
b. Requires immediate action
c. Alarm Indicator is RED
2. Medium priority (caution)
a. sounds 3 tones,
b. Alarm indicator is YELLOW
3. Low priority (advisory)
a.
sounds a single tone.
b. Alarm indicator is YELLOW
4. Set Alarm limits per department policy and procedure.
5. To set Alarm Limits
a. press red Alarm Limits membrane
b. ALARM LIMITS screen appears
c. Press touch screen over alarm control,
d. rotate dial to desired level,
e. press screen over control again to confirm.
6. Alarm Silence – disable audible alarm for 2 minutes, pressing alarm silence key again
will cancel the “silence”
7. Special consideration w/alarm messages
a. Safety Valve Open
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i. High priority audible/visual alarm
ii. occurs whenever safety valve is open.
b. Ventilator Inoperative
i. High priority audible/visual alarm
ii. VENT INOP is displayed
iii. safety valve opens, patient is allowed to breath room air.
c. Circuit Disconnect Alarm
i. High priority audible/visual alarm.
ii. Sounds when total expiratory flow, including bias flow is less than 10% of
total inspiratory flow for 5 seconds.
Heliox Delivery:
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Heliox can be delivered by the Avea Ventilator by simply changing a connector on the
back panel.
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This connector is referred to as “Smart Connect”. The Heliox Smart Connector is
designed for use with 80/20 Heliox tanks only.
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Ventilator will display accurate pressure and flow data when Heliox is used. Bring double
Heliox tanks w/stepdown regulators to the patients bedside. Tanks are located in 4F34
Heliox Procedure
1. Remove Air Smart Connector from air inlet port on back of ventilator
2. Remove the parked Heliox smart connector from its storage port and insert in place of the
removed air smart connector. (See picture below).
3. Be very careful, the connector has a fragile pin that requires some attention and delicate
manipulation when making the connection.
4. Connect high pressure hose from dual Heliox tanks w/regulators to the 50 psi stepdown
regulator mounted on the back of the Avea.
5. Turn both tanks on and follow P&P for use of this system.
6. Once the Heliox is connected a small green tank icon will be displayed in lower right
hand corner of ventilator screen display.
7. Do not use the nebulizer feature when delivering Heliox.
8. To deliver the Helium/oxygen mixture simply set desired FIO2, The balance of the
breathing gas is helium. ex. FIO2 of .30 = .60/.40 Heliox mixture.
9. There must be an order for changes in Heliox concentration.
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Battery
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Avea should be plugged into power source at all times.
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Internal battery provides 30 minutes of battery power when fully charged.
Battery Indicators
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There are visual status indicators on the ventilator front panel for the mains power and
the internal and external batteries.
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The sequence in which the power sources are used by the ventilator is:
1. Main AC Power External Battery (if installed)
2. Internal Battery
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Power On Indicator The green Power On indicator lights up whenever the power switch
is on ( I ) and power is being supplied from any of the available power sources (AC,
external battery, or internal battery).
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AC Power Indicator the green AC indicator is on whenever the ventilator is connected
to AC power. It displays whether the power switch is on ( I ) or off (O).
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Battery Status Indicators On the lower right hand corner of the screen the battery
status indicator for the Internal battery or External battery option will illuminate
incrementally depending on the available charge remaining in the battery.
o Green (%80 or more charge remaining for external battery, %90 or more charge
remaining for internal battery)
o Yellow (less than %80 for external battery, %90 for the internal battery)
o Red (less than %40 for external battery, %30 for internal battery)
Maintenance and Cleaning
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Wipe down ventilator w/ hospital germicidal wipes. The screen does not require any special
cleaner like the Drager. The water trap/exhalation assembly is to be autoclaved by CPD. Dispose
of Infrasonics disposable filter.
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If external flow sensor was used when ventilating a neonate, send to SPD for sterilization.
RCS SFGH
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