Puritan Bennett 520 Ventilator User's Manual

User’s Manual
Puritan Bennett
TM
520 Ventilator


Copyright information
COVIDIEN, COVIDIEN with logo, the Covidien logo and positive results for life
are U.S. and/or internationally registered trademarks of Covidien AG. All other
brands are trademarks of a Covidien company.
© 2012 Covidien.
The information contained in this manual is the sole property of Covidien and
may not be duplicated without permission. This manual may be revised or
replaced by Covidien at any time and without notice. You should ensure that
you have the most current applicable version of this manual; if in doubt, contact Covidien's Technical Support department or visit the Puritan Bennett
product manual web page at:
http://www.respiratorysolutions.covidien.com
While the information set forth herein is believed to be accurate, it is not a
substitute for the exercise of professional judgment.
The ventilator should be operated and serviced only by trained professionals.
Covidien’s sole responsibility with respect to the ventilator, and its use, is as
stated in the limited warranty provided.
Nothing in this manual shall limit or restrict in any way Covidien’s right to
revise or otherwise change or modify the equipment (including its software)
described herein, without notice. In the absence of an express, written agreement to the contrary, Covidien has no obligation to furnish any such revisions,
changes, or modifications (including software changes) to the owner or user
of the equipment described herein.
This User’s Manual is for a non-clinician user, and does not contain all the information provided in the Clinician’s Manual. The
Clinician’s Manual is on the CD delivered with the ventilator,
and a printed copy is also available upon request from your
equipment supplier or Covidien.
Contents
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Purpose of This Manual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Qualification of Personnel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Warranty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Technical Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
1
1
2
1 Safety Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.1
1.2
1.3
1.4
1–1
Definitions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1–1
Warnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1–1
Symbols and Markings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1–11
Labels / Identification and Instruction Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1–15
2 Ventilator Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.1
2.2
2.3
2.4
2.5
2.6
2.7
2.8
2.9
2.10
2.11
Indications for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Contraindications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Operational Use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Device Classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Front Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Back Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Control Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Ventilation Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Alarm Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
USB Memory Device Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If Ventilator Failure Occurs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2–1
2–1
2–2
2–2
2–3
2–4
2–5
2–6
2–7
2–8
2–9
2–9
3 Alarms and Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.1
3.2
3.3
3.4
3.5
3.6
3.7
3.8
3–1
Alarm Level of Priority. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3–2
Alarm Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3–3
Alarm Log Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3–4
Silencing the Audible Portion of Alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3–5
Pausing/Resetting Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3–6
Re-activating Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3–7
Overview of Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3–8
Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3–14
3.8.1
Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3–14
3.8.2
Additional Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3–21
4 Installation and Assembly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.1
4.2
User’s Manual
Installing the Ventilator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Connecting to External AC Power. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4–1
4–1
4–2
i
Contents
4.3
4.4
Connecting to an External DC Power Source. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Patient Circuit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.4.1
Choosing the Patient Circuit Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.4.2
Installing the Patient Circuit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.5 Filters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.6 Humidifier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.7 Oxygen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.7.1
Administering Oxygen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.7.2
Connecting the Oxygen Supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.8 Fitting the Ventilator into the Dual Bag. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.9 Mounting the Ventilator on a Wheelchair. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.10 Mounting the Ventilator on the Utility Cart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.11 Connecting the Nurse Call Cable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4–4
4–6
4–6
4–7
4–10
4–11
4–12
4–12
4–13
4–15
4–16
4–17
4–18
5 Operating Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5–1
5–1
5–3
5–3
5–4
5–4
5–5
5–6
5–7
5–9
5.1
5.2
5.3
5.4
5.5
Turning on the Ventilator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
USB Menu Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.2.1
USB Memory Device Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.2.2
USB Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.2.3
Transfer Continuously. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.2.4
Transfer Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Starting Ventilation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Stopping Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Turning Off the Ventilator. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Internal Battery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6.1
6.2
6.3
6.4
6.5
Battery Capacity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Battery Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Testing the Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recharging the Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7 Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7.1
7.2
7.3
Cleaning the Ventilator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cleaning the Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cleaning the Ventilator Between Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8 Routine Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8.1
8.2
8.3
Replacing the Air Inlet Filter. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recommended Schedule of Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Service Assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6–1
6–1
6–2
6–4
6–4
6–5
7–1
7–1
7–2
7–2
8–1
8–1
8–2
8–3
A Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A–1
A.1
A.2
A.3
A.4
A.5
ii
Physical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Electrical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Indicators and Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
A.4.1 Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Monitored Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
A–1
A–1
A–2
A–3
A–3
A–3
User’s Manual
Contents
A.6
A.7
A.8
A.9
A.10
A.11
Range, Resolution, and Accuracy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A–4
Environmental . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A–6
USB. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A–6
Pneumatic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A–7
Manufacturer’s Declaration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A–7
Standards Compliance and IEC Classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A–12
B Operational Verification Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
B–1
C Alarms Tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Low Pressure Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Power Failure Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Occlusion Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Testing the Battery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Involuntary Stop Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
C–1
C–1
C–1
C–2
C–2
C–3
D Unpacking and Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
D–1
E Parts and Accessories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
E–1
F Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
F–1
C.1
C.2
C.3
C.4
C.5
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User’s Manual
Figures
Figure 1-1.
Figure 1-2.
Figure 1-3.
Figure 2-1.
Figure 2-2.
Figure 2-3.
Figure 2-4.
Figure 2-5.
Figure 2-6.
Figure 3-1.
Figure 3-2.
Figure 3-3.
Figure 3-4.
Figure 3-5.
Figure 3-6.
Figure 3-7.
Figure 3-8.
Figure 4-1.
Figure 4-2.
Figure 4-3.
Figure 4-4.
Figure 4-5.
Figure 4-6.
Figure 4-7.
Figure 4-8.
Figure 4-9.
Figure 4-10.
Figure 4-11.
Figure 4-12.
Figure 4-13.
Figure 4-14.
Figure 4-15.
Figure 4-16.
Figure 4-17.
Figure 4-18.
Figure 4-19.
Figure 5-1.
Figure 5-2.
Figure 5-3.
User’s Manual
Locations of Labels – Top-Front View. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Location of Labels and Markings – Rear View . . . . . . . . . . . . . . . . . . . . . . . . .
Location of Labels – Bottom View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Front Panel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Back Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Control Panel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Ventilation Menu Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Alarm Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
USB Memory Device Menu. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Alarm Displays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Accessing Alarm Log Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Displaying the Alarm Log Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Alarm Log Display when No Alarm Activated . . . . . . . . . . . . . . . . . . . . . . . . . .
Silencing the Audible Portion of Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Manually Pausing Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Reactivating Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Alarm Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The Power Cable Holder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Inserting the Power Cable Holder Into the Notch . . . . . . . . . . . . . . . . . . . . . .
Power Cable Connected to the Ventilator . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Power Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Connecting the Ventilator to an External DC Power Source . . . . . . . . . . . .
Connecting the DC Power Cable to the Ventilator . . . . . . . . . . . . . . . . . . . . .
Single Limb Patient Circuit With Exhalation Valve . . . . . . . . . . . . . . . . . . . . .
Close-up of Exhalation Valve Tube and Proximal Pressure Tube . . . . . . . .
Single Limb Patient Circuit Without Exhalation Valve . . . . . . . . . . . . . . . . . .
Air Inlet Filter. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Bacteria Filter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Humidifier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rear Panel Oxygen Connector . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Connecting the Oxygen Supply System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Disconnecting the Oxygen Supply System . . . . . . . . . . . . . . . . . . . . . . . . . . .
Using the Dual Bag . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Mounting the Ventilator on the Utility Cart . . . . . . . . . . . . . . . . . . . . . . . . . . .
Using the Utility Cart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Connecting the Nurse Call Cable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Turning on the Ventilator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Welcome Menu Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Ventilation Menu Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1–16
1–16
1–17
2–4
2–5
2–6
2–7
2–8
2–9
3–3
3–4
3–4
3–5
3–5
3–6
3–7
3–7
4–2
4–3
4–3
4–4
4–5
4–5
4–8
4–8
4–9
4–10
4–11
4–12
4–13
4–14
4–15
4–17
4–17
4–18
4–18
5–2
5–2
5–3
v
Figures
Figure 5-4.
Figure 5-5.
Figure 5-6.
Figure 5-7.
Figure 5-8.
Figure 5-9.
Figure 5-10.
Figure 6-1.
Figure 6-2.
Figure 6-3.
Figure 6-4.
Figure 8-1.
Figure C-1.
Figure D-1.
Figure D-2.
vi
Selecting the USB Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Selecting Transfer Continuously. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Selecting Transfer Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Prompt to Start Ventilation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Starting Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Stopping Ventilation (1). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Stopping Ventilation (2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Internal Battery Indicator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Battery Reserve Capacity as a Percentage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Battery Reserve Capacity in Hours and Minutes . . . . . . . . . . . . . . . . . . . . . . . .
Power Indicators When Charging the Battery . . . . . . . . . . . . . . . . . . . . . . . . . .
Replacing the Air Inlet Filter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Blocking the Patient End of a Single Limb Circuit. . . . . . . . . . . . . . . . . . . . . . .
Puritan Bennett™ 520 Ventilator. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dual Bag . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5–4
5–4
5–5
5–7
5–7
5–8
5–8
6–3
6–3
6–3
6–5
8–2
C–2
D–2
D–2
User’s Manual
Tables
Table 1-1.
Table 1-2.
Table 3-1.
Table 3-2.
Table 3-3.
Table 5-1.
Table 5-2.
Table 6-1.
Table 7-1.
Table 8-1.
Table A-1.
Table A-2.
Table A-3.
Table A-4.
Table A-5.
Table A-6.
Table A-7.
Table A-8.
Table A-9.
Table A-10.
Table A-11.
Table A-12.
Table A-13.
Table A-14.
Table A-15.
Table A-16.
Table A-17.
Table A-18.
Table A-19.
Table A-20.
Table A-21.
Table A-22.
Table A-23.
Table B-1.
Table E-1.
Table E-2.
User’s Manual
Ventilator Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Ventilator Labels and Markings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Overview of Alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Alarms and Corrective Actions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Additional Troubleshooting and Corrective Actions. . . . . . . . . . . . . . . . . . .
USB Memory Device Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Trends Data Transfer Time from Ventilator to USB Memory Device . . . . .
Internal Battery Reserve Capacity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Approved Cleaning Solutions for Exterior Ventilator Surfaces . . . . . . . . . .
Consumables and Replacement Intervals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Physical Description (Excluding Accessories) . . . . . . . . . . . . . . . . . . . . . . . . . .
AC Electrical Supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Internal Lithium Ion Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Remote Alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Power Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Alarm Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Audio Alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Performance Parameter Specifications and Tolerances. . . . . . . . . . . . . . . . .
Monitored Parameter Specifications and Tolerances . . . . . . . . . . . . . . . . . . .
Ventilator Range, Resolution, and Accuracy . . . . . . . . . . . . . . . . . . . . . . . . . . .
Environmental Conditions for Storage or Transport . . . . . . . . . . . . . . . . . . . .
Environmental Conditions for Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
USB Memory Device Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Data Transfer Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Airway Resistances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Air Inlet Resistance (Filter) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Oxygen Inlet Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Performance Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Electromagnetic Emissions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Electromagnetic Immunity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Electromagnetic Immunity – Conducted and Radiated RF. . . . . . . . . . . . .
Recommended Separation Distances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Compliant Cables and Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Operational Verification Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
List of Consumables and Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
List of Circuits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1–11
1–15
3–8
3–14
3–21
5–3
5–6
6–2
7–1
8–2
A–1
A–1
A–1
A–2
A–2
A–3
A–3
A–3
A–3
A–4
A–6
A–6
A–6
A–6
A–7
A–7
A–7
A–7
A–8
A–9
A–10
A–11
A–12
B–1
E–1
E–2
vii
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viii
User’s Manual
Purpose of This Manual
Preface
Purpose of This Manual
This manual contains important information regarding the safe operation of your Puritan Bennett™
520 Ventilator. Your ventilator is an electrical device that can provide years of useful service with the
proper care, as described in this manual.
Ensure that you read and understand the instructions contained in this manual before operating the
ventilator.
WARNING
Before operating the ventilator, read, understand, and strictly follow the information contained in Chapter 1, “Safety Information”.
Qualification of Personnel
Installation and maintenance of the device must be made by authorised and trained personnel. In
particular, training for the handling of products sensitive to electrostatic discharges must include the
use of Electrostatic Discharge (ESD) protection devices and knowledge of the following symbol’s
.
meaning:
Warranty
Information regarding your product warranty is available from your sales representative or Covidien.
Extended Service
The Puritan Bennett™ 520 Ventilator offers extended service contracts/warranties for purchase when
the ventilator is purchased. Please contact your local Covidien Sales or Service Representative for
additional information.
For online technical support, visit the SolvITSM
Center Knowledge Base by clicking the link at
http://www.respiratorysolutions.covidien.com.
Here, you will find answers to frequently asked
questions about the product and other Covidien
products 24 hours a day, 7 days a week. If you
require further assistance, contact your local
Covidien representative.
User’s Manual
Preface-1
Preface
Technical Support
Technical Service Contacts:
Covidien Argentina
Aguero 351
Capital Federal - 1171 ABC,
Argentina
Tel: (5411) 4863-5300
Fax: (5411) 4863-4142
Covidien Belgie S.A.-N.V.
Generaal De Wittelaan 9/5
Mechelen
2800
België
Tel +32 152 981 37
Fax +32 152 167 83
Covidien Chile
Rosario Norte 530, Piso 12
Las Condes
Santiago de Chile, Chile
Tel: (562) 231-3411
Fax: (562) 231-3527
Covidien Czech Republic
Vyskocilova 1410/1
140 00
Praha
Ceska Republika
Tel +42 024 109 57 35
Fax + 42 02 3900 0437
Covidien ECE
Galvaniho 7/a
821 04 Bratislava
Slovenska Republika
Tel +42 124 821 45 73
Fax +42 124 821 45 01
Covidien Hungary
1095 Budapest
Mariassy u. 7
Magyarorszag
Hungary
Tel + 36 1880 7975
Fax + 36 1777 4932
Preface-2
Covidien Australia
52A Huntingwood Drive
Huntingwood, NSW 2148
Australia
Telephone (+61) 1800 350702
Fax +612 9671 8118
Covidien Brazil
Av. Nações Undias 23013-A
Vila Almeida
São Paulo, SP
Brasil 04795-100
Tel: (5511) 5683-8300
Fax: (5511) 5683-8349
Covidien Colombia
Edificio Prados de la Morea
Carretera Central Del Norte
(Cra 7a) Kilometro 18,
Chia-Cundinamarca
Bogota, Colombia
Tel: (571) 619-5469
Fax: (571) 619-5425
Covidien Danmark A/S
Langebrogade 6E, 4. sal
1411 København K
Danmark
Tel +45 702 753 50
Fax:+45 702 756 50
Covidien Finland Oy
Läkkisepäntie 23
00620 Helsinki
Finland
Te. +35 896 226 84 10
Fax +35 896 226 84 11
Covidien Ireland Commercial
Ltd
Block G, Ground Floor,
Cherrywood Technology Park,
Loughlinstown
County Dublin
Ireland
Tel +353 1 4381613
Covidien Austria GmbH
Campus21
Europaring F09402
Brunn am Gebrige
A-2345 Österreich
+43 223 637 88 39
+43 223 637 88 39 40
Covidien Canada
19600 Clark Graham
Baie d'Urfe, QC, H9X 3R8
Canada
Tel:1-514-695-1220, Ext.4004
Fax: 1-514-695-4965
Covidien Costa Rica
La Uruca 75 Metros al Oseste de
Faco
Oficentro La Virgen, Edificio "I"
San Jose, Costa Rica
Tel: (506) 256-1170
Fax: (506) 256-1185
Fax: (506) 290-8173
Covidien Deutschland GmbH
Technisches Service Center
Raffineriestr. 18
93333 Neustadt / Donau
Germany
Tel + 49 944 595 93 80
Fax + 49 944 595 93 65
Covidien France SA
Parc d’affaires Technopolis
Bat. Sigma, 3 Avenue du Canada
LP 851 Les Ulis
91975 Courtaboeuf Cedex France
Tel +33 169 821 400
Fax +33 169 821 532
Covidien Israel
5 Shacham St.
North Industrial Park
Caesarea
38900 Israel
Tel +97 246 277 388
Fax+97 266 277 688
User’s Manual
Technical Support
Technical Service Contacts:
Covidien Italia S.p.A. Via Rivoltana 2/D
20090 Segrate
Italy
Tel +39 027 031 72 61
Fax +39 027 031 72 84
Covidien Nederland BV
Hogeweg 105
5301 LL Zaltbommel
Nederland
Tel +31 41 857 66 68
Fax +31 41 857 67 96
Covidien Polska
Al. Jerozolimskie 162
Warszawa. 02-342
Polska
Tel +48 223 122 130
Fax +48 223 122 020
Covidien Russia
53 bld. 5 Dubininskaya Street
Moscow
RUSSIA. 119054 России
Tel +70 495 933 64 69
Fax +70 495 933 64 68
Covidien Spain S.L.
c/Fructuós Gelabert
6, pl. Sótano
08970 Sant Joan Despí
Barcelona, Spain
Tel +34 93 475 86 69
Fax +34 93 373 87 10
Covidien UK and Ireland
Unit 2, Talisman Business Park
London Road, Bicester
OX26 6HR, United Kingdom
Tel +44(0)1869 328092
Fax +44(0)1869 327585
User’s Manual
Covidien Japan Inc.
Technical Support Center
83-1, Takashimadaira 1-Chome
Itabashi-ku, Tokyo 175-0082
Japan
Tel: +81 (0) 3 6859 0120
Fax: +81 (0) 3 6859 0142
Covidien Norge AS
Postboks 343
1372 Asker.
Norway
Tel +47 668 522 22
Fax +47 668 522 23
Covidien Portugal Lda.
Estrada do Outeiro de Polima,
Lote 10-1° Abóboda
2785-521 S.Domingos de Rana
Portugal
Tel +35 121 448 10 36
Fax +35 121 445 1082
Covidien Saglik A.S.
Maslak Mahallesi Bilim Sokak No:
5, Sun Plaza Kat: 2-3
Sisli, Istanbul 34398
Turkey
Tel +90 212 366 20 00
Fax +90 212 276 35 25
Covidien Sverige AB
Box 54
171 74 Solna
Sweden
Tel +46 858 56 05 00
Fax + 46 858 56 05 29
Covidien Mexico
Calz.Ermita Iztapalapa 1514
Col. Barrio San Miguel
Del. Iztapalapa
Mexico, D.F. 09360 Mexico
Tel: (5255) 5804-1524
Fax: (5255) 5685-1899
Covidien Panama
Parque Industrial Costa del Esta
Calle Primera, Edifio # 109
Panama City, Panama
Tel: (507) 264-7337
Fax: (507) 236-7408
Covidien Puerto Rico
Palmas Industrial Park
Road 869 Km 2.0 Bdlg. #1
Cataño, PR 00962
Tel. 787-993-7250
Ext. 7222 or 7221
Fax 787-993-7234
Covidien South Africa
Corporate Park North
379 Roan Crescent
Randjespark
Midrand, South Africa
Tel +27 115 429 500
Fax +27 115 429 547
Covidien Switzerland
Roosstr. 53
Wollerau
8832
Schweiz
Tel +41 17865050
Fax +41 17865010
Asia: Tyco Healthcare Pte Ltd
Singapore Regional Service Centre
15 Pioneer Hub, #06-04
Singapore 627753
Tel (65) 6578 5187 / 8 / 9
Fax (65)6515 5260
Email: [email protected]
Preface-3
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Preface-4
User’s Manual
Definitions
1 Safety Information
1.1
Definitions
This manual uses three indicators to highlight critical information: Warning, Caution, and Note. They are defined
as follows:
WARNING
Indicates a condition that can endanger the patient or the ventilator operator.
Caution
Indicates a condition that can damage the equipment.
Note:
Indicates points of particular emphasis, that make operation of the ventilator more efficient or convenient.
It is essential to read, understand and follow these instructions before using the Puritan Bennett™ 520 Ventilator.
In order to use the ventilator correctly and efficiently and to help prevent incidents, please pay particular attention to section 1.2, “Warnings” , as well as all warnings and cautions contained throughout this manual.
Note:
Many of the functions of the ventilator are not accessible when the Locking key
assistance contact your Clinician or equipment representative.
1.2
is enabled. For additional
Warnings
Fire Hazard Warnings
•
•
The ventilator must not be used with flammable anesthetic substances.
•
In case of a burning smell or fire from the ventilator, immediately remove the patient from the
ventilator. Then, if you can safely do so, immediately shut off the oxygen supply and disconnect it from
the ventilator, and disconnect the ventilator from all external power sources. As necessary, ventilate
the patient with alternative means.
•
•
Never expose any batteries to direct flame.
To reduce the risk of a fire hazard, keep matches, lighted cigarettes, and all other sources of ignition
(such as flammable anesthetics and/or heaters) away from the ventilator and oxygen hoses.
In the event of an oxygen leak, shut down the supply of oxygen at its source. In addition, remove and/or
keep any heat source, including lightbulbs, away from the device, which may be enriched with oxygen.
Circulate fresh air into the room to reduce the oxygen concentration level.
Warnings about Reducing Infection
•
User’s Manual
To reduce the risk of infection, wash your hands thoroughly before and after handling the ventilator or
its accessories.
1-1
Safety Information
•
A patient treated by mechanical ventilation is highly vulnerable to the risks of infection. Dirty or
contaminated equipment is a potential source of infection. Clean the ventilator and its accessories
regularly and systematically before and after each use and following any maintenance procedure to
reduce the risks of infection.
•
•
Single Use accessories
should not be reused.
The air inlet filter is for use on a single patient and is not reusable; do not attempt to wash, clean, or
reuse it.
Warnings before Using Equipment
•
•
The ventilator must be used only under the responsibility and on the prescription of a doctor.
•
•
The ventilator must be used according to its intended use. Refer to 2.1, “Indications for Use”.
•
Before dispensing the ventilator to caregivers or the patient for home use, ensure the Locking Key is
activated so that critical ventilator settings are not modified.
•
Do not perform ventilator alarm tests while the patient is connected to the ventilator. Provide the
patient with an alternate means of ventilation before conducting these tests.
•
Verify the functionality of the alarm conditions before connecting the patient to the ventilator. Refer to
Appendix C, “Alarms Tests”.
•
If the ventilator fails the alarm tests or if you cannot complete the tests, refer to section 3, “Alarms and
Troubleshooting” or call your equipment supplier or Covidien.
•
The default setting for altitude compensation is YES. Altitude compensation should always be set to
YES for accurate volume delivery calculations at all elevations.
•
Patients on home care ventilation equipment should be appropriately monitored by clinicians,
caregivers and suitable monitoring equipment, as advised by the patient’s clinician. The Puritan
Bennett™ 520 Ventilator is not intended to be a comprehensive monitoring device and does not
activate alarms for all types of dangerous conditions for patients.
The ventilator is not intended to be used for patients without breathing autonomy or who are
ventilator dependent.
Do not start ventilation until you ensure that the device is suitably assembled, that the air inlet filter is
properly installed and is not obstructed, and that the cooling vents, and alarm sound diffusion holes
are not obstructed, and that there is proper clearance all around the unit. Also ensure that the patient
circuit is of the proper configuration, and is suitably connected to both the ventilator and the patient
and that the patient circuit, including all hoses, is not damaged,compressed or obstructed.
Warnings regarding Environment of Use
1-2
•
Alarm volume should be adjusted with respect to the ventilator’s operating environment and so that
the patient's caretakers can hear the alarms. The audible alarm vents located at the front of the device
should never be obstructed.
•
Do not operate the ventilator in direct sunlight, near heat sources, outdoors, or near installations
where liquid may pose a risk without first providing adequate protection for the device.
•
Avoid using the ventilator, if possible, in dusty environments. Dusty environments may require more
vigilant monitoring, cleaning, and/or replacement of air intake and other filters.
•
Before starting ventilation, ensure that the device is properly assembled and that the air inlet, cooling
vents, and alarm sound diffusion holes are not obstructed. Ensure also that the patient circuit is of the
proper configuration, properly connected to the ventilator, and that the circuit hoses are neither
damaged nor compressed and contain no obstructions or foreign bodies.
•
Ensure that the ventilator’s immediate surroundings allow for the proper operational connection of the
device without folding, pinching, or damaging any of the required cables or tubes, and that the
connection of the patient circuit to the patient provides for a secure, comfortable fit.
User’s Manual
Warnings
•
Place the ventilator in a safe place when ventilating and according to the recommendations in this
manual.
•
Do not place the ventilator in a position where a child can reach it or in any position that might cause it
to fall on the patient or someone else.
•
To ensure correct and lasting operation of the ventilator, ensure that its air circulation holes (main inlet
or cooling) are never obstructed. Place the device in an area where air can freely circulate around the
ventilator and avoid installing it near floating fabrics, such as curtains.
•
If the ventilator has been transported or stored at a temperature that differs more than 20 °C ( 36 °F)
from the temperature in which it will be operating, the ventilator should be allowed to stabilise in its
operating environment for at least two (2) hours prior to use.
•
If the ambient temperature where the device is operated is greater than 35 °C (95 °F), the flow supplied
at the device outlet may exceed 41 °C (106 °F). This may lead to undesirable side effects for the patient.
To avoid injury to the patient move the patient and the ventilator to a cooler location.
•
The default setting for altitude compensation is YES. Altitude compensation should always be set to
YES for accurate volume delivery calculations at all elevations.
•
To reduce the risk of a fire hazard, keep matches, lighted cigarettes, and all other sources of ignition
(such as flammable anesthetics and/or heaters) away from the ventilator and oxygen hoses.
•
Regularly check the cleanliness of the air inlet filter located on the rear of the ventilator. If necessary,
replace the filter before the recommended replacement period is over (see chapter 8, “Routine
Maintenance”). This is particularly important when the ventilator is installed on a wheelchair, because
environmental conditions may cause the filter to become dirty more rapidly.
•
Due to typical voltage fluctuations that occur during normal power wheelchair use, the wheelchair
mains battery should never be used to power the Puritan Bennett™ 520 Ventilator. The ventilator
should always be connected to an independent power source (e.g. AC power, extra batteries, or DC
power source).
•
Handle the ventilator with care during and after use, particularly when ambient temperatures are high.
Some ventilator surfaces may become hot, even if safety specifications are not exceeded.
Warnings Regarding Electromagnetic Interference
•
The Puritan Bennett™ 520 Ventilator requires special precautions for electromagnetic compatibility
and should be installed and started according to the recommendations found in Appendix B,
“Specifications.” In particular, the use of nearby mobile and portable communications equipment using
radio frequencies, such as mobile telephones or other systems exceeding the levels set in the IEC
60601-1-2 standard, may affect its operation. Refer to section B.10, “Manufacturer’s Declaration”.
•
The use of any accessory other than those specified, with the exception of the power supplies or cables
sold by Covidien, may lead to an increase in electromagnetic emissions or a decrease in the equipment
protection against electromagnetic emissions. If the ventilator is used adjacent to such accessories or
stacked with such devices, the ventilator’s performance should be monitored to verify normal
operation.
Warnings regarding Settings / Additional Warnings for the Clinician
User’s Manual
•
Before starting ventilation, always verify that all settings are properly set in accordance with the
required prescription.
•
The Puritan Bennett™ 520 Ventilator offers a variety of breath delivery modes. Throughout the
patient’s treatment, the clinician should carefully select the ventilation mode or modes to use for that
patient. This selection should be based on the clinician’s clinical judgment, considering the condition
and needs of the individual patient, as such condition and needs change from time to time, and
considering the benefits, limitations and operating characteristics of each mode.
1-3
Safety Information
•
When changing the mode during ventilation, significant transitions of pressure, flow or cycling rate
might occur, depending on the difference between the modes. Before setting the new mode, first
ensure that the settings between the different modes are compatible. This reduces the risk of
discomfort and harm to the patient.
•
The CPAP mode does not provide a set respiratory rate. Do not use this mode if it is not appropriate for
the patient’s condition.
•
Monitor the patient’s state of health in order to ensure that the ventilator’s settings are always suited to
the patient’s current physiological requirements.
•
Alarm volume should be adjusted with respect to the ventilator’s operating environment and so that
the patient's caretakers can hear the alarms.
•
•
Setting Alarm limits to extreme values can cause the ventilator alarms to malfunction.
•
Ensure that the I Sens setting is not set to OFF when ventilating patients capable of triggering
spontaneous breaths.
•
In adult or pediatric use ensure that the adjusted tidal volume is compatible with the needs of the
patient.
•
If the ventilator repeatedly triggers the same type of alarm, you should inform your clinician of the
repeat alarms, as the clinician may consider whether an adjustment in the alarm setting is appropriate.
•
•
•
If APNEA TIME is set to a value higher than 60/Control R then the APNEA alarm will not activate.
Adjustable alarms should not be systematically cancelled; instead, they should be adjusted according
to the needs and condition of the patient.
The Apnea Alarm should be set to YES if an audible alarm sound is desired when apnea events occur.
The inspiration trigger threshold should be carefully modified in order to avoid the risk of false
triggering or “autotriggering” of the ventilator. For example, Level 1P, the most sensitive mode, is
recommended for pediatric use. However, for an adult, this setting may result in autotriggering.
Warnings Applicable during Use of Equipment
1-4
•
•
•
The ventilator must be used only under the responsibility and on the prescription of a doctor.
•
Be aware this manual describes how to respond to the ventilator, but it does NOT tell you how to
respond to the patient.
•
While the ventilator is in use, an alternative means of ventilation should always be available in the
event of a ventilator problem. Supplementary observation, appropriate for the patient's condition, is
also recommended.
•
Patients should always be monitored by trained and competent medical personnel. Also, the caregiver
should be able and prepared to take suitable action in the event the ventilator identifies an alarm
condition or experiences. If you are the caregiver, then consult with the patient's physician to be sure
you are prepared with the information and equipment you need to take suitable action in the case of an
alarm or problem.
•
Monitor the patient’s state of health and promptly inform the patient’s clinician if there are changes so
that the clinician can take appropriate action, which may include changes to the ventilation settings.
•
Alarm volume should be adjusted with respect to the ventilator’s operating environment and so that
the patient's caretakers can hear the alarms.
•
Alarm volume is set by the clinician as part of the ventilator settings. If the alarm volume is insufficient
for your environment, contact the clinician to increase the alarm volume setting.
The ventilator must be used according to its intended use. Refer to section 2.1, “Indications for Use”.
The ventilator is not intended to be used for patients without breathing autonomy or who are
ventilator dependent.
User’s Manual
Warnings
User’s Manual
•
When an alarm condition is triggered, or there is evidence of a patient-ventilator fault or problem,
examine the patient first before examining the ventilator.
•
Adjustable alarms should not be systematically cancelled; instead, they should be adjusted according
to the needs and condition of the patient.
•
If the ventilator repeatedly triggers the same type of alarm, you should inform your clinician of the
repeat alarms, as the clinician may consider whether an adjustment in the alarm setting is appropriate.
•
Handle the ventilator with care during and after use, particularly when ambient temperatures are high.
Some ventilator surfaces may become hot, even if safety specifications are not exceeded.
•
A continuous alarm condition will be activated if the ventilator power switch is turned off while
ventilation is in progress. When the power switch is turned back on again, ventilation will resume
without having to press the VENTILATION ON/OFF button.
•
If the device is damaged, its external housing is not correctly closed, or it behaves in a way that is not
described in this manual (excessive noise, heat emission, unusual odour, alarms not triggered during
the start-up procedure), the oxygen and power supplies should be disconnected and use of the device
stopped immediately.
•
Even though the Puritan Bennett™ 520 Ventilator meets current safety standards, and although the
internal Lithium-ion battery of the device is considered to be Dangerous Goods for transport in
commerce, this devices lithium battery is below the 100Wh threshold and is therefore excepted from
being a Class 9 – Miscellaneous - Dangerous Goods (DG). As such, the Puritan Bennett™ 520 Ventilator
and/or the associated Lithium-ion battery are subject to some transport conditions under the
Dangerous Goods Regulation for air transport (IATA: International Air Transport Association),
International Maritime Dangerous Goods code for sea and the European Agreement concerning the
International Carriage of Dangerous Goods by Road (ADR) for Europe. Private individuals who
transport the device are excluded from these regulations although for air transport some requirements
apply. For air transport; the Puritan Bennett™ 520 Ventilator is permitted as checked-in or carry-on
baggage. Spare batteries may be taken on board as carry-on luggage only. This classification and
regulatory requirements may vary depending upon the country and mode of transport. Therefore it is
recommended that users verify with the carrier / airline as to which measures to take before the
voyage.
•
To minimise the risk of damage, you must use the ventilator’s Dual Bag to transport the ventilator. See
Table E-1, “List of Consumables and Accessories”.
•
To ensure that ventilation continues uninterrupted, ensure alternative power sources are available (AC
power source, extra batteries, or an auxiliary DC car adapter). Be prepared for the possibility of power
failure by having an alternative means of ventilation ready for use.
•
•
The ventilator must not be used with flammable anaesthetic substances.
•
To avoid damage to the ventilator, in particular the batteries or electrical components, fluids must not
be allowed to enter the device, particularly through the air inlet filter or the cooling apertures located
in the side, rear, and bottom panels of the ventilator.
•
To ensure correct and lasting operation of the device, ensure that the ventilator is installed and
operated in the environmental conditions recommended in Appendix A, “Specifications”
•
•
Do not leave power cables lying on the ground where they may pose a hazard.
•
Do not conduct the ventilator alarm test while the patient is connected to the ventilator. Switch the
patient to an alternate means of ventilation before testing.
The ventilator should never be immersed in any liquid, and any liquid on the surface of the device
should be wiped away immediately.
Do not allow a patient to remain connected to the ventilator when ventilation is stopped, because a
substantial quantity of exhalation gas, primarily carbon dioxide, may be inhaled by the patient. In
some circumstances, inhaling carbon dioxide may lead to under ventilation, suffocation, and serious
injury or death.
1-5
Safety Information
Warnings regarding Electrical Power
1-6
•
To ensure that ventilation continues uninterrupted, ensure alternative power sources are available (AC
power source, extra batteries, or an auxiliary DC car adapter). Be prepared for the possibility of power
failure by having an alternative means of ventilation ready for use.
•
Never connect your ventilator to an electrical outlet controlled by a wall switch because the power may
be inadvertently turned off.
•
To avoid damage to the ventilator, in particular the batteries or electrical components, fluids must not
be allowed to enter the device, particularly through the air inlet filter or the cooling apertures located
in the side, rear, and bottom panels of the ventilator.
•
•
Do not leave power cables lying on the ground where they may pose a hazard.
•
The operator should connect the ventilator to an AC power source whenever available, for safer
operation.
•
The maximum recommended shelf life of the internal battery is two (2) years. Do not use a battery that
has been stored for two years, or more, prior to its first use.
•
Periodic recharging is important to help maximise useful life of the battery. Do not store the internal
battery for extended periods, without recharging, as this may reduce the maximum life.
•
For the AC (“mains”) power cable to be properly secured, the attachment located on the power cable
must be fitted into the power cable holder incorporated in the battery access cover and located under
the AC (mains) power socket. Refer to section 4.2, “Connecting to External AC Power”
•
The power supply to which the ventilator is connected (both AC and DC) must comply with all
applicable standards and provide electrical power corresponding to the voltage characteristics
inscribed on the rear of the ventilator to ensure correct operation. Refer also to the electrical
specifications found in Appendix A, “Specifications”
•
Ensure that the ventilator’s internal battery is fully charged before using the ventilator withan external
DC power source. Powering the ventilator using an external 12– 30 VDC power source (via the DC power
cable) does not enable its internal battery to recharge.
•
Due to its limited internal battery’s reserve capacity, the ventilator should only be operated on the
internal battery when no other power source is available. Ensure that the internal battery never
becomes fully discharged. Alarms will sound when the charge on the internal battery is low. See
Table 3-1, Overview of Alarms.
•
When using a car auxiliary adapter (cigarette lighter) ensure the car has been started prior to plugging
in the ventilator’s DC adapter, and keep the car running while you continue to power the ventilator
from the DC adapter. Refer to section 4.3, “Connecting to an External DC Power Source”
•
In ambient temperatures above 40°C (104°F) the battery may not be fully charged even if the
“INTERNAL BATTERY” charging indicator is not lit. This is due to the battery’s internal heat safety
device. In this case, a HIGH LOW BATTERY alarm will be triggered. See Table 3-2, Alarms and Corrective
Actions.
•
When the “LOW BATTERY“ alarm is triggered, immediately connect the ventilator to an AC power
supply to maintain ventilation and recharge the internal battery.
•
•
Batteries should be disposed of according to environmental legislation in your country and locality.
Due to typical voltage fluctuations that occur during normal power wheelchair use, the wheelchair
mains battery should never be used to power the Puritan Bennett™ 520 Ventilator. The ventilator
should always be connected to an independent power source. (e.g. AC power, extra batteries, or DC
power source)
Ensure that the AC power cable is in perfect condition and not compressed. The device should not be
turned on if the AC power cable is damaged.
User’s Manual
Warnings
•
A continuous alarm condition will be activated if the ventilator power switch is turned off while
ventilation is in progress. When the power switch is turned back on again, the ventilation will resume
without having to press the VENTILATION ON/OFF button.
•
Before using the ventilator’s internal battery, ensure that the battery is fully charged and that the
charge holds.
•
Back up ventilators or those in storage should be connected to an AC power source to protect the
integrity of the battery.
•
To connect the ventilator to an external power source, first connect the desired power cable to the
ventilator. Then connect the power cable to the external power source.
•
To disconnect the ventilator from an external power source, first disconnect the power cable from the
external power source and then, the ventilator.
•
Connect the external DC power source by first connecting the power cable to the ventilator and then to
the external DC source. Follow the reverse procedure to disconnect the device from the external DC
power source.
Warnings Regarding Oxygen
User’s Manual
•
Oxygen therapy for patients with respiratory failure is a common and effective medical prescription.
However, be aware that inappropriate oxygen use may potentially lead to serious complications,
including, but not limited to, patient injury. Therefore, you should carefully follow the instructions of
the patient's clinician regarding the use of oxygen in ventilating the patient.
•
Strictly follow the instructions provided in section , “A connector (Figure 4-13, item 1) for an external
low pressure oxygen source is available at the rear of the ventilator. It is essential that you also use the
special coupler (item 2) supplied with the ventilator to attach the external low pressure oxygen source
to the connector. The connector is also fitted with a non-return airtight valve system. The non-return
airtight valve system includes a stud (item 3) and a locking tab (item 4).”, which include the use of a
special oxygen connector.
•
To avoid injury to the patient and/or possible damage to the ventilator: before connecting the
ventilator to the oxygen supply, ensure a flow meter (flow regulator) is connected to the ventilator to
regulate the oxygen supply to the required specification.
•
If using oxygen with the Puritan Bennett™ 520 Ventilator, Covidien recommends using an oxygen
analyser with minimum and maximum concentration alarms. Always measure the delivered oxygen
with a calibrated oxygen analyser that features a minimum and maximum concentration alarm in order
to ensure that the prescribed oxygen concentration is delivered to the patient.
•
The Puritan Bennett™ 520 Ventilator is designed to deliver a percentage of oxygen equal to or lower
than 50%. Do not exceed this value as this may cause the ventilator to malfunction and put the patient
at risk.
•
Ensure that the oxygen supply pressure to the machine never exceeds 7 psi (50 kPa) or a flow of 15 lpm.
Refer to see Table A-8, Performance Parameter Specifications and Tolerances, on page A-3 for
sensitivity tolerances.
•
In the event of an oxygen leak, shut down the supply of oxygen at its source. In addition, remove and/or
keep any incandescent source away from the device, which may be enriched with oxygen. Circulate
fresh air into the room to bring the oxygen level down to normal.
•
The hose connecting the ventilator to the oxygen source must be designed exclusively for use with
medical-grade oxygen. Under no circumstances should the oxygen hose be modified by the user. In
addition, the hose must be installed without the use of lubricants.
•
Ensure that the only gas supplied to the ventilator through the dedicated oxygen supply connector is
medical-grade oxygen.
•
The coupler must not remain connected to the oxygen connector unless it also connected to a leakproof, external oxygen gas source. When an oxygen supply is not being used with the ventilator,
disconnect the oxygen source completely from the ventilator.
1-7
Safety Information
•
To ensure stability, when the Puritan Bennett™ 520 Ventilator is mounted on a cart, the weight of the
oxygen bottle should not exceed 14 kg (30 lbs).
•
The oxygen supply hose ages even when it is not in use and should be replaced periodically. The
expiration date may be located on the back of the hose end-piece.
•
•
The oxygen supply must be regulated using a flow meter connected to the source gas outlet.
•
Before connecting the oxygen supply, ensure that the stud on the oxygen connector is protruding
outwards.
•
Inspect the oxygen coupler before use to ensure it has its black o-ring attached and in good condition.
Do not use an oxygen coupler with a missing, damaged, or worn o-ring.
The oxygen supply must be shut off when ventilation is interrupted. Before disconnecting the oxygen
hose, allow the ventilator to continue for a few cycles without oxygen to flush the patient circuit of
excess oxygen.
Warnings regarding Hoses and Accessories
1-8
•
The ventilator must not use, nor be connected to, any anti-static or electrically conductive hoses,
tubing, or conduits.
•
Before opening the packaging for the Patient Circuit, ensure that no damage is evident to the
packaging or its contents. Do not use if evidence of damage exists.
•
•
The patient circuit should not be changed during ventilation.
•
•
Single Use
•
The air inlet filter is for use on a single patient. It is not reusable; do not attempt to wash, clean, or reuse
it.
•
Failing to replace a dirty air inlet filter, or operating the ventilator without a filter, may cause serious
damage to the ventilator.
•
The patient circuit should always be positioned to avoid hindering the patient's movements, to prevent
accidental disconnection or leakage, and to minimise the risk of patient strangulation.
•
For pediatric use, ensure that the patient circuit type fits, and, in all respects, is suitable for use with a
child. Use a pediatric circuit for patients that weigh under 53 lb. (23 kg). To ensure proper performance
of the ventilator, see Table E-2, List of Circuits, on page E-2, for a list of recommended patient circuits.
•
The exhalation valve must allow rapid discharge of the circuit pressure. Ensure that the exhalation
valve is always clean and its evacuation aperture (exhaust port) is never obstructed.
•
Users must always possess an additional breathing circuit and exhalation valve while using the
ventilator.
•
Always ensure that the humidification device is positioned lower than both the ventilator and the
patient. Use water traps, if necessary, to limit water in the patient circuit and periodically empty these
water traps.
•
If a heated humidifier is used, you should always monitor the temperature of the gas delivered to the
patient. Gas delivered from the ventilator that becomes too hot may burn the patient's airway.
On a DAILY basis, inspect the patient circuit to ensure that it shows no signs of damage, is properly
connected, and is operating correctly without leakage.
accessories should not be reused.
During invasive ventilation (when an artificial airway bypasses the patient’s upper respiratory system),
the patient’s upper respiratory system cannot humidify the incoming gas. For this reason, the use of a
humidifier, to minimise drying of the patient’s airway and subsequent irritation and discomfort, is
required.
User’s Manual
Warnings
•
Adding accessories to the ventilator breathing circuit, such as a humidifier and water trap(s), may result
in a decrease in tidal volume delivered to the patient due to the added compressible volume of the
accessory. Always assure that the patient is receiving the appropriate inspired volume when altering
the breathing circuit configuration.
•
The level of inspiratory resistance of the circuit and accessories (bacteria filter, humidifier, HMEs etc)
must be as low as possible. Settings—particularly the PATIENT DISCONNECTION alarm, maximum
inspired volume (Max VTI), and minimum inspired volume (Min VTI) settings—must be periodically
adjusted according to changes in the patient circuit resistance—especially when filters are replaced.
Adding attachments to the ventilator breathing system can cause the pressure during exhalation at the
patient connection port to increase.
•
To ensure proper performance of the ventilator, use a patient circuit recommended by Covidien in this
manual; refer to chapter 4, “Installation and Assembly” and Appendix E, “Parts and Accessories” The
total specified length of the patient circuit tubing as measured from the ventilator outlet to the
ventilator inlet is 1.1 metres (3.6 feet) to 2.0 metres (6.6 feet). The tubing must conform to all applicable
standards and must be fitted with Ø 22 mm terminals that also conform to all applicable standards.
Ensure that both the length and the internal volume of the patient circuit are appropriate for the tidal
volume: a corrugated tube of Ø 22 mm for adult patients, and a corrugated tube of Ø 15 mm for
pediatric patients with a tidal volume lower than 200 ml.
•
To ensure proper performance of the ventilator, use only accessories (including oxygen accessories)
approved and recommended by Covidien. See Appendix E, “Parts and Accessories” or contact your
local Covidien Sales or Service Representative.
•
The oxygen supply hose ages even when it is not in use and should be replaced periodically. The
expiration date may be located on the back of the hose end-piece.
•
When using non-invasive ventilation (NIV) without an exhalation valve, use a vented nose or face mask
or a non vented mask combined with a leak accessory. When using non-invasive ventilation (NIV) with
an exhalation valve, use a non-vented mask.
•
•
Before using the Nurse Call system, ensure that its connections are secure and it operates properly.
•
Do not use Nurse Call devices that operate based on the closure of an electrical circuit, because the
devices often do not take into account possible cable disconnection or a total loss of power. Ensure that
the Nurse Call device is always connected to the ventilator.
•
To prevent any interference with the internal sensors of the ventilator, do not install a humidifier
upstream of the ventilator.
•
The use of any accessory other than those specified, with the exception of the power supplies or cables
sold by Covidien, may lead to an increase in electromagnetic emissions or a decrease in the equipment
protection against electromagnetic emissions. If the ventilator is used adjacent to such accessories or
stacked with such devices, the ventilator’s performance should be monitored to verify normal
operation.
To connect the ventilator to a Nurse Call device, check the ventilator's compatibility with the Nurse Call
device and order a suitable connection cable.
Warnings regarding Maintenance
User’s Manual
•
If a problem with the ventilator is suspected, FIRST CHECK THAT THE PATIENT IS NOT IN DANGER. If
necessary, remove the patient from the ventilator and provide an alternative means of ventilation.
•
Never use a ventilator or any components or accessories that appear to be damaged. If any signs of
damage are evident, contact your equipment supplier or Covidien.
•
If the ventilator is damaged or its external housing is not correctly closed or it behaves in a way that is
not described in this manual (excessive noise, heat emission, unusual odour, alarms not triggered
during the start-up procedure), the oxygen and power supplies should be disconnected and use of the
device stopped immediately.
•
If the ventilator fails the alarm tests or if you cannot complete the tests, refer to section 3.8,
“Troubleshooting” or call your equipment supplier or Covidien.
1-9
Safety Information
1-10
•
Do not attempt to open, repair or otherwise service the ventilator yourself. Doing so might endanger
the patient, damage the ventilator, and/or void your warranty. Only personnel authorised and qualified
by Covidien should repair, open or service the ventilator.
•
•
•
Regularly clean the ventilator’s Dual Bag according to manufacturer’s recommendations.
•
To avoid damage to the ventilator, in particular the batteries or electrical components, fluids must not
be allowed to enter the device, particularly through the air inlet filter or the cooling apertures located
in the side, rear, and bottom panels of the ventilator.
•
The air inlet filter is for use on a single patient and is not reusable; do not attempt to wash, clean, or
reuse it.
•
Regularly check the cleanliness of the air inlet filter located on the rear of the ventilator. If necessary,
replace the filter before the recommended replacement period is over; see chapter 8, “Routine
Maintenance” This is particularly important when the ventilator is installed on a wheelchair, because
environmental conditions may cause the filter to become dirty more rapidly.
•
Before cleaning the ventilator, first disconnect the ventilator and the patient circuit. If the ventilator is
used indoors, the condition of the air inlet filter should be checked monthly. If the ventilator is used
outdoors or in a dusty environment, the filter should be checked weekly and replaced as necessary.
•
To ensure proper servicing and avoid the possibility of physical injury to personnel or damage to the
ventilator, only personnel authorised and qualified by Covidien should attempt to service or make
authorised modifications to the Puritan Bennett™ 520 Ventilator.
•
If you cannot determine the cause of a problem with your ventilator, contact your equipment supplier.
Do not use the ventilator until the problem has been corrected.
•
To ensure proper performance of the ventilator, the preventative maintenance schedule should be
followed. For further information contact your equipment supplier or Covidien.
•
•
On a daily basis, ensure the proper connection and operation of the patient circuit.
•
Use all cleaning solutions and products with caution. Read and follow the instructions associated with
the cleaning solutions you use to clean your ventilator. Use only those solutions listed in Table 7-1 on
page 7-1.
•
Never use a liquid cleaner inside the patient circuit, or on any component of a gas pathway. Clean the
patient circuit only as specified by the manufacturer's instructions.
•
The patient circuit is intended for single use by a single patient
and should be changed according
to the manufacturer’s recommendations and according to the patient circuit lifetime. Refer to the
instructions for use supplied by the manufacturer of the patient circuit (included with the ventilator)
and to chapter 4, “Installation and Assembly”.
•
A patient treated by mechanical ventilation is highly vulnerable to the risks of infection. Dirty or
contaminated equipment is a potential source of infection. Clean the ventilator and its accessories
regularly and systematically before and after each use and following any maintenance procedure to
reduce the risks of infection.
•
Regularly check the cleanliness of the air inlet filter located on the rear of the ventilator. If necessary,
replace the filter before the recommended replacement period is over (see chapter 10, “Routine
Maintenance”). This is particularly important when the ventilator is installed on a wheelchair, because
environmental conditions may cause the filter to become dirty more rapidly.
Before cleaning the ventilator, first disconnect the ventilator and the patient circuit.
The ventilator should never be immersed in any liquid, and any liquid on the surface of the device
should be wiped away immediately.
After assembling, cleaning, or reassembling the patient circuit, and on a daily basis, inspect the hoses
and other components to ensure that there are no cracks or leaks and that all connections are secure.
User’s Manual
Symbols and Markings
Warnings to Protect the Environment
•
•
Batteries should be disposed of according to environmental legislation in your country and locality.
For environmental protection, the ventilator and its components, whatever their respective conditions
of operation, cannot be disposed of with household waste and must be submitted for suitable selective
collection and possible recycling of the materials. Observe all applicable regulations when disposing of
the ventilator and any of its components.
Warnings regarding USB Memory Device
•
1.3
Always verify the file ID before using a USB memory device to transfer data between the ventilator and
a PC.
Symbols and Markings
Table 1-1. Ventilator Symbols
Symbols
Descriptions
It is essential to read, understand, and follow these instructions before using the Puritan Bennett™ 520
Ventilator (ISO 7000-0434A).
This symbol appears on the ventilator’s back panel, see Table 1-2, item 2.
Type BF applied part (IEC 60417-5333).
A regulatory standard classification for protection against electrical shock for the part of the device that
contacts the patient.
This symbol appears on the ventilator’s back panel; see Table 1-2, item 4.
Direct current, DC (IEC 60417-5031).
This symbol appears on the ventilator’s back panel and keyboard; see Figure 1-2 and Figure 2-3 on
page 2-6, item 10.
Alternating current, AC (IEC 60417-5032).
This symbol appears on the ventilator’s back panel and keyboard; see Figure 1-2, item 6, and Figure 2-3 on
page 2-6, item 10.
Internal Battery.
This symbol appears on the ventilator’s keyboard; see Figure 2-3 on page 2-6, item 10.
Insulation class II equipment (IEC 60417-5172).
A regulatory standard classification for protection against electric shock. Class II equipment relies on
double insulation rather than protective earthing. This symbol appears on the ventilator’s back panel; see
Table 1-2, item 4.
Index of Protection rating for the ventilator’s enclosure, defined in IEC 60529 (BSEN60529:1991).
IP31
The first digit, 3, indicates protection against the intrusion of small foreign bodies (including fingers, tools,
wires, etc. with a diameter greater than 2.5 mm) into the ventilator. The second digit, 1, indicates
protection against water dripping or falling vertically, as well as an environment featuring water vapour
condensation and/or light rain.
This rating appears on the ventilator’s back panel; see Table 1-2, item 4.
CSA – Canadian Standards Association.
This symbol appears on the ventilator’s back panel; see Table 1-2, item 4.
CE - Conformity European
Signifies compliance with the medical device directive 2007/47/EC.
This symbol appears on the ventilator’s back panel; see Table 1-2, item 4.
User’s Manual
1-11
Safety Information
Table 1-1. Ventilator Symbols
Symbols
Descriptions
This symbol appears on the ventilator’s front panel UP key; see Figure 2-3 on page 2-6, item 4.
This key is used to: move the LCD display’s cursor upwards, line-by-line; increase the value of displayed
and selected parameter setting.
This symbol appears on the ventilator’s front panel DOWN key; see Figure 2-3 on page 2-6, item 6.
This key is used to: move the LCD display’s cursor downwards, line-by-line; decrease the value of
displayed and selected parameter settings.
This symbol appears on the ventilator’s front panel ENTER key; see Figure 2-3 on page 2-6, item 5.
This key is used to confirm command actions.
This symbol appears on the ventilator’s front panel ALARM CONTROL key; see Figure 2-3 on page 2-6,
item 2. (See my notes, to the left and below, in red).
This key is used to: cancel the audible portion of alarms for 60 seconds at a time; cancel an alarm. For
more information, refer to Appendix C, “Alarms Tests”
This symbol appears on the ventilator’s front panel MENU key; see Figure 2-3 on page 2-6, item 7.
This key is used to access the ventilator’s menus via the ventilator’s front panel LCD display.
This symbol (IEC 60417– 5009) appears on the ventilator’s front panel VENTILATION ON/OFF button; see
Figure 2-3 on page 2-6, item 8.
This key is used to Start and Stop ventilation.
To patient port.
This symbol appears on the front right of the ventilator, adjacent to the To Patient port; see Figure 1-1 on
page 1-16, item 1.
Patient proximal pressure port.
This symbol appears on the front right of the ventilator, adjacent to the To Patient port; see Figure 1-1 on
page 1-16, item 3 and Figure 1-3 on page 1-17.
Exhalation valve pilot port.
This symbol appears on the front right of the ventilator, adjacent to the To Patient port indicating the
connection of the tubing between the patient circuit exhalation valve; see Figure 1-1 on page 1-16, and
Figure 1-3 on page 1-17, item 3.
Oxygen inlet.
This marking appears on the back panel of the ventilator, adjacent to the oxygen inlet port; see Figure 1-2
on page 1-16, item 2.
Nurse Call connector.
This symbol appears on the back panel of the ventilator, adjacent to the nurse call connector; see
Figure 1-2 on page 1-16, item 10.
Switch in “Off” position (IEC 60417-5008).
O
This symbol appears on the I/O (power on/off ) switch on the back panel of the ventilator to indicate the
switch’s “Off” position. See Figure 2-2 on page 2-5, item 2.
Switch in “On” position (IEC 60417-5007).
I
This symbol appears on the I/O (power on/off ) switch on the back panel of the ventilator to indicate the
switch’s “On” position. See Figure 2-2 on page 2-5, item 2.
Software Lock Enabled.
This symbol appears on the upper-left of the ventilator’s LCD display when the keyboard Locking Key is
enabled. Refer to chapter 5.3, “Starting Ventilation”.
1-12
User’s Manual
Symbols and Markings
Table 1-1. Ventilator Symbols
Symbols
Descriptions
Internal Battery.
This symbol appears on the top-center of ventilator’s LCD display to indicate that the ventilator is being
powered by its internal battery. See Figure 2-4 on page 2-7, item 1 and refer to chapter 6, “Internal
Battery”, for more information.
Pressure rise times (inspiratory phase) parameter.
These symbols appear on the ventilation mode menu screens. In pressure ventilation modes, you can
select one of four rise times with setting 1 representing the fastest rise time and setting 4 representing
the slowest.
Selected line (filled square).
When making menu choices, this graphic indicates the line on which the cursor is currently positioned.
Non-selected line (empty square).
When making menu choices, this graphic indicates a line on which the cursor is currently not positioned.
Locked parameter line.
When making menu choices, this graphic indicates a line that cannot be selected (the Locking Key is
enabled).
Active parameter line.
When making menu choices, this graphic indicates that the current parameter is selected and can be
changed. See chapter 5, “Operating Procedures”.
Inspiratory Effort Detected.
This symbol appears in the front panel display’s Status window when the patient triggers a breath.
Parameter adjustment bar.
This graphic shows the current setting for parameters such as display contrast and alarm volume in the
Preferences menu.
WEEE (Waste Electrical and Electronic Equipment).
This symbol means that this product must not be disposed of with household waste. Observe local
ordinances for proper disposal. Refer to Table 1-2, item 4.
Year of Manufacture.
Manufacturer.
Audio Paused.
This symbol means the sounding of audible alarms is currently disabled. For more information, refer to
section 3.4, “Silencing the Audible Portion of Alarms”.
Alarm Paused (reset/cancelled).
This symbol means one or more alarms have been paused, or reset/cancelled. For more information, refer
to section 3.5, “Pausing/Resetting Alarms”.
Apnea Alarm Deactivated.
This symbol means that the Apnea Alarm has been deactivated.
User’s Manual
1-13
Safety Information
Table 1-1. Ventilator Symbols
Symbols
Descriptions
Exhalation Valve detected.
This symbol means that an exhalation valve has been detected during ventilation.
No Exhalation Valve detected.
This symbol means that no exhalation valve has been detected during ventilation.
Follow instructions for use (ISO 7000-1641).
This symbol directs the user to observe and adhere to the instructions contained in the product’s user
manuals.
USB port.
This symbol indicates a communications port for interfacing with a USB connector. See Figure 1-2, item 9.
PC connector.
This symbol indicates a port that can be used by authorised Puritan Bennett product service personnel or
Covidien service personnel for software maintenance. See Figure 1-2, item 8.
Atmospheric pressure limitation.
Humidity limitations.
Temperature limitations.
Fragile.
Keep dry.
Keep away from direct sunlight.
This side up.
1-14
User’s Manual
Labels / Identification and Instruction Information
1.4
Labels / Identification and Instruction Information
Various labels or specific markings are affixed to the ventilator that describe precautions to be taken for the correct use of the ventilator and contribute to the traceability of the product. Refer to Table 1-2 and the figures on
the following pages for illustrations of these labels and markings and their locations on the ventilator. Use the
item numbers in the following tables to locate the labels in Figure 1-1 to Figure 1-3.
Table 1-2. Ventilator Labels and Markings
1. Patient Gas Inlet Label
(Figure 1-1, Figure 1-3)
2. Oxygen Inlet Marking and Label
(Figure 1-2)
3. Exhalation Valve and Patient Pressure
Connection Label
(Figure 1-1, Figure 1-3)
Location of AC
Power Cable
Connector
4. Air Inlet Label
(Figure 1-2)
5. Identification Label
(Figure 1-3)
6. AC Power (Mains) Cable Connector
Marking
(Figure 1-2)
8. PC Connection marking
(Figure 1-2)
9. USB Port marking
(Figure 1-2)
N/A
N/A
Location of DC
Power Cable
Connector
7. External Cable Connector
Marking
(Figure 1-2)
10. Nurse Call Cable Connector
Marking
(Figure 1-2)
User’s Manual
1-15
Safety Information
Note: The item number callouts in the following figures refer to those listed in Table 1-2.
Figure 1-1. Locations of Labels – Top-Front View
9
8
7
6
4
10
2
2
Figure 1-2. Location of Labels and Markings – Rear View
1-16
User’s Manual
Labels / Identification and Instruction Information
3
1
5
Figure 1-3. Location of Labels – Bottom View
User’s Manual
1-17
Safety Information
This page intentionally blank
1-18
User’s Manual
Indications for Use
2 Ventilator Overview
2.1
Indications for Use
The Puritan Bennett™ 520 Ventilator is indicated for the continuous or intermittent mechanical
ventilatory support of patients weighing at least 11 lb (5 kg) who require mechanical ventilation. The
ventilator is a restricted medical device intended for use by qualified, trained personnel under the
direction of a doctor. It is essential to read, understand, and follow these instructions before using the
Puritan Bennett™ 520 Ventilator.
Target Patients
Specifically, the ventilator is applicable for adult and pediatric patients who require the following
general types of invasive or non-invasive ventilatory support, as prescribed by an attending doctor:
• Positive Pressure ventilation
• Assist/Control, PSV or CPAP modes of ventilation
• Breath types including Pressure Control and Pressure Support
Target Environments
The ventilator is suitable for use in institutional, home, and portable settings. It is not intended for use
as an emergency transport ventilator.
The Puritan Bennett™ 520 Ventilator is suitable for use on commercial aircraft, per FAA requirements.
Refer to section A.11, “Standards Compliance and IEC Classification”. Patients travelling with the
Puritan Bennett™ 520 Ventilator may be required by their airline to demonstrate evidence of
compliance with the RTCA/DO-160F standard, as well as other requirements. Contact your airline prior
to travel to determine airline specific requirements and documentation.
WARNING
Even though the Puritan Bennett™ 520 Ventilator meets current safety standards, and although the
internal Lithium-ion battery of the device is considered to be Dangerous Goods for transport in commerce,
this devices lithium battery is below the 100Wh threshold and is therefore excepted from being a Class 9 –
Miscellaneous - Dangerous Goods (DG) . As such, the Puritan Bennett™ 520 Ventilator and/or the
associated Lithium-ion battery are subject to some transport conditions under the Dangerous Goods
Regulation for air transport (IATA: International Air Transport Association), International Maritime
Dangerous Goods code for sea and the European Agreement concerning the International Carriage of
Dangerous Goods by Road (ADR) for Europe. Private individuals who transport the device are excluded
from these regulations although for air transport some requirements apply. For air transport, the Puritan
Bennett™ 520 Ventilator is permitted as checked-in or carry-on baggage. Spare batteries may be taken on
board as carry-on luggage only. This classification and regulatory requirements may vary depending upon
the country and mode of transport. Therefore it is recommended that users verify with the carrier / airline
as to which measures to take before the voyage.
Target Operators
The ventilator may be operated by:
• Respiratory therapists
• Doctors
• Nurses
User’s Manual
2-1
Ventilator Overview
• Homecare providers
• Patient and patient’s families
WARNING
This ventilator must be used only under the responsibility and on the prescription of a doctor.
The ventilator is not intended to be used for patients without breathing autonomy or who are ventilator
dependent.
2.2
Contraindications
This ventilator is not for use with anesthetic gases, and is not intended for use as an emergency
transport ventilator. It is not intended to be used for patients without breathing autonomy or who are
ventilator dependent.
2.3
Operational Use
The Puritan Bennett™ 520 Portable Ventilator uses a micro-turbine to provide ventilatory support to
patients. Clinicians may use a variety of interfaces to connect patients to the ventilator: nasal masks or
full face masks; endotracheal or tracheotomy tubes. User-selectable ventilation modes are:
• Assisted Controlled Pressure (P A/C)
• Continuous Positive Airway Pressure (CPAP)
• Pressure Support Ventilation with apnea ventilation (PSV/ST)
Safety Net
Incorporated in the ventilator design is an alarm system that continuously monitors both patient and
machine for signs of specific errors or faults that could lead to an unsafe condition. Should any of
these errors or faults be detected, the alarm system announces the specific alarm condition both
audibly and visually. The machine-related alarm conditions are factory set, whereas the patientrelated alarm conditions are defined by alarm-threshold values selected by an operator (a clinician or
a caregiver). For more information, refer to chapter 3, “Alarms and Troubleshooting.”
WARNING
Patients on home care ventilation equipment should be appropriately monitored by clinicians, caregivers
and suitable monitoring equipment, as advised by the patient’s clinician. The Puritan Bennett™ 520
Ventilator is not intended to be a comprehensive monitoring device and does not activate alarms for all
types of dangerous conditions for patients.
Settings
A software key, known as the “Locking Key,” restricts access to ventilation parameter settings and
ventilation mode changes in order to distinguish between “clinician” usage and “patient” usage.
Oxygen Enrichment
Oxygen may be supplied from an external, low pressure source, but the oxygen flow must be limited
to 15 lpm (50 kPa, 7 PSI). The ventilator automatically compensates for the extra flow created by the
external oxygen supply (refer to chapter 4, “Installation and Assembly.”
2-2
User’s Manual
Device Classification
WARNING
To reduce the risk of a fire hazard, keep matches, lighted cigarettes, and all other sources of ignition (such
as flammable anesthetics and/or heaters) away from the ventilator and oxygen hoses.
Oxygen therapy for patients with respiratory failure is a common and effective medical prescription.
However, be aware that inappropriate oxygen use may potentially lead to serious complications,
including, but not limited to, patient injury.
Users must always possess an additional breathing circuit and exhalation valve while using the Puritan
Bennett™ 520 Ventilator.
Breathing Circuit
The ventilator is used with a single limb patient circuit. For more information, refer to section 4.4,
“Patient Circuit,” on page 4-6.
2.4
Device Classification
The ventilator’s IEC / EN 60601-1 classification is as follows:
•
•
•
•
•
•
Protection/Insulation class (electric shock): Class II
Protection index of enclosure: IP31
Medical device directive classification: II B
Degree of protection against risk of electric shock: BF
Power: External (AC – mains, or DC – cigarette lighter) or internal (DC – battery)
Operation mode: Continuous operation
For additional information, refer to Appendix A, “Specifications.”
User’s Manual
2-3
Ventilator Overview
2.5
Front Panel
1
2
6
6
3
6
5
4
1
LCD Display – Displays information about the ventilator
including patient hours and software version, ventilation
modes and settings, and monitored and calculated
patient data. The display also allows the user to view and,
using the Control Panel, adjust the ventilator’s operating
and alarm configuration settings.
4
Patient Pressure Monitoring Port – Nipple for
monitoring proximal patient pressure.
2
Control Panel – Features the controls for setting up and
operating the ventilator, and LEDs to indicate the
ventilator's power source, ventilation On/Off status, and
alarm priority level. Control functions include turning on
and off the ventilation, configuring ventilation modes,
silencing and cancelling alarms, and setting device and
alarm parameters.
5
Exhalation Valve Port – Nipple for providing
piloting pressure to the exhalation valve. Controls
the open-closed position of the exhalation valve.
3
Patient Connection Port – Provides an outlet for the gas
to be delivered to the patient via the patient circuit.
6
Lateral and Front Openings – Vents that allow for
air circulation to cool the ventilator’s internal
components. In addition, these openings function as
sound ports for audible alarms.
WARNING
Do not cover or obstruct these openings.
Figure 2-1. Front Panel
2-4
User’s Manual
Back Panel
2.6
Back Panel
1
2
3
11
4
10 9 8
7
6
5
1
Ergonomic carrying handle.
7
PC Cable Connector:
USB mini-B connector used for Puritan Bennett™
Ventilator Test Software.
2
On/Off (I/O) switch with protective cover:
Device powered on in position I; device switched
off in position 0.
8
O2 Inlet Port:
Connects the ventilator to a low pressure oxygen
source via an adaptor connected to the O2 Inlet
(refer to section 4.7.1 , “Administering Oxygen.”).
3
AC power (“Mains”) cable connector.
9
Nurse Call Output Connector:
Used to connect the ventilator to the nurse call
system.
4
AC power (“Mains”) cable holding system:
Secures AC power cable to avoid accidental
disconnection.
10
USB Memory Device connection:
USB connection to be used with Puritan Bennett™
Respiratory Insight Software. There are two USB
type A ports.
5
Access cover for the internal battery.
11
Air Inlet Filter:
Filters air as it enters the ventilator.
6
DC power cable connector with key.
WARNING
Do not cover or obstruct these openings.
Figure 2-2. Back Panel
User’s Manual
2-5
Ventilator Overview
2.7
Control Panel
1
2
10
3
9
4
8
5
7
6
1 Alarm indicators (two LEDs):
6
DOWN key:
•
Red indicator:
Moves the cursor down and decreases parameter values.
•
Continuous: Very High Priority (VHP) alarm
activated
• High priority (HP) alarm activated.
Yellow indicator:
•
Medium priority (MP) alarm activated.
2 ALARM CONTROL key:
•
•
7
3 Display screen:
When a USB memory device is inserted into the ventilator,
press this key to display the USB memory device screen.
8
•
Moves the cursor up and increases
parameter values.
VENTILATION ON/OFF button:
•
•
Display of modes, ventilation settings, patient
data, configuration of the ventilator and alarm
management.
4 UP Key:
MENU key:
Changes the displayed menu. From the Ventilation menu
screen, press this key to display the Alarm menu screen.
Press once to silence an audible alarm for
60 seconds.
Press twice to halt visual and audible alarms.
If alarm is remedied, the alarm is cancelled
(other than the high pressure alarm).
9
Ventilation status indicator:
•
•
5 ENTER key:
•
•
Access to a setting value and validation of
the modification of this setting.
Access to a sub-menu.
ON: Press briefly and release to start ventilation.
OFF: Press and hold for three (3) seconds, then press again
to stop ventilation.
Blue indicator illuminated: device is powered on and
ventilation is off (on standby).
Blue indicator off: ventilation is on.
10 Electrical power source indicators:
•
•
•
•
AC POWER indicator lit: AC power source connected.
DC POWER indicator lit: DC power source connected.
INTERNAL BATTERY indicator lit continuously: Internal
battery in use (no external power source connected.)
INTERNAL BATTERY indicator flashing: battery charging.
Figure 2-3. Control Panel
2-6
User’s Manual
Ventilation Menu
2.8
Ventilation Menu
1
Ventilation menu with ventilation on
standby.
2
5
3
6
4
1
Ventilation menu during ventilation.
2
5
6
3
4
1 General information line:
2
Displays the current ventilation mode,
along with the following:
•
•
•
•
•
•
•
•
Displays pressure generation during
ventilation.
3
Displays the specific ventilation
parameter values for the
currently selected ventilation
mode.
Battery
symbol if the device is
powered by the internal battery.
Audio paused
symbol if an
alarm is currently inhibited.
Alarm paused
symbol if an
alarm has been cancelled manually
and the cause of the alarm remains.
Apnea Alarm deactivation
Exhalation valve
symbol.
No exhalation valve
symbol.
Absolute ABS symbol.
Relative REL symbol.
4 Bargraph:
Ventilation settings:
5
Status/monitored data window:
•
•
•
Ventilation stopped
(Standby): displays the
message, “PRESS
TO
START VENTILATION.”
Ventilation on: parameters
are monitored and displayed.
The Inspiratory Effort
Detected symbol
appears
adjacent to the monitored I:E
ratio when the patient
actively triggers a breath.
Preferences menu access line:
Highlight this line and press
the ENTER
key to display
the Preferences menu.
6
Alarm conditions window:
For Active alarms, scrolls
through active alarm
messages in flashing reverse
video.Refer to chapter 3,
“Alarms and
Troubleshooting” for details.
Figure 2-4. Ventilation Menu Display
User’s Manual
2-7
Ventilator Overview
2.9
Alarm Menu
1
4
Alarm menu with ventilation on standby.
2
5
3
1
4
Alarm menu when not in standby.
2
5
3
1 Title line:
Displays ventilation mode and the
following symbols:
•
•
•
•
•
•
Battery
if the ventilator is
powered by the internal battery.
Audio paused
if an alarm is
currently inhibited.
Alarm paused
if an alarm has
been cancelled manually and the
cause of the alarm remains.
Apnea Alarm deactivation
Exhalation valve
symbol.
No exhalation valve
symbol.
4 Status/monitored data window:
•
•
•
Ventilation stopped (Standby):
displays the message, “PRESS
TO START VENTILATION.”
Ventilation on: parameters are
monitored and displayed.
The Inspiratory Effort Detected
appears adjacent to the
symbol
monitored I:E ratio when the
patient actively triggers a breath.
2 Alarm settings:
Displays the specific alarm parameter
values for the currently selected
ventilation mode, which are:
•
•
Min and Max alarm threshold
settings, and
Current monitored patient
readings, or hyphen (-) when
ventilation is in standby.
3 Access line to Alarm Log
menu.
Highlight this line and
press the ENTER
key to display the Alarm
Logs menu.
Refer to manual section
3.3, “Alarm Log Menu.”.
5 Alarm message window:
•
For Active alarms, scrolls through
active alarm messages in flashing
reverse video.
• For Inactive alarms, displays the last
alarm along with its trigger date
and end-of-event time.
Refer to chapter 3, “Alarms and
Troubleshooting” for more
information.
Figure 2-5. Alarm Menu
2-8
User’s Manual
USB Memory Device Menu
2.10 USB Memory Device Menu
1
2
3
4
1
Title line
3
USB Memory Device Menu
2
Ventilator serial number
4
Dialogue box
Figure 2-6. USB Memory Device Menu
2.11 If Ventilator Failure Occurs
If a problem with the ventilator is suspected, FIRST CHECK THAT THE PATIENT IS NOT IN DANGER. If
necessary, remove the patient from the ventilator and provide an alternate means of ventilation.
Keep in mind that troubleshooting information is available in this manual to assist you in the event of
a problem. Refer to chapter 3, “Alarms and Troubleshooting”.
If you cannot determine the cause of a problem, contact your equipment supplier or Covidien. Refer
to Appendix 8.3, “Service Assistance”.
User’s Manual
2-9
Ventilator Overview
This page intentionally blank
2-10
User’s Manual
3 Alarms and Troubleshooting
WARNING
When an alarm condition is triggered, or there is evidence of a patient-ventilator fault or problem,
examine the patient first before examining the ventilator.
Alarm volume should be adjusted with respect to the ventilator’s operating environment and so that the
patient's caretakers can hear the alarms. The audible alarm vents located at the front of the device should
never be obstructed.
If the ventilator repeatedly triggers the same type of alarm, you should inform your clinician of the repeat
alarms, as the clinician may consider whether an adjustment in the alarm setting is appropriate.
Setting Alarm limits to extreme values can cause the ventilator alarms to malfunction.
Adjustable alarms should not be systematically canceled; instead, they should be adjusted according to
the needs and condition of the patient.
Note:
Many of the functions of the ventilator are not accessible when the Locking key
assistance contact your Clinician or equipment representative.
is enabled. For additional
The alarms or faults generated by your Puritan Bennett™ 520 Ventilator are classified into two
categories:
• Ventilation (or utilisation) alarms
• Technical faults
Some of the ventilator alarms are adjustable, depending on ventilation modes.Automatic, nonadjustable alarms also exist to create a safety net for safer patient ventilation.
Alarms indicate events likely to affect the ventilation in the short term and necessitate rapid
intervention (refer to section 3.8, “Troubleshooting,” on page 3-14).
Technical faults do not directly affect machine operation. Therefore, the user is not alerted to technical
faults. Only authorised and trained technicians may consult the maintenance menu (refer to the
Puritan Bennett™ 520 Ventilator Service Manual).
Note:
Default alarm setting preferences should be entered prior to using the ventilator.
User’s Manual
3-1
Alarms and Troubleshooting
3.1
Alarm Level of Priority
The alarm hierarchy for signalling the level of alarm criticality is listed below.
• Very High Priority (VHP): Immediate critical situation; ventilation is impossible:
Continuous Sound Signaling / With or Without Continuous Red LED Illumination / With or
Without Message / With or Without Display Lighting (it is possible for an alarm condition to
occur that may not have both a message and lighting).
• High Priority (HP): Critical situation in the short term; ventilation is potentially
compromised:
High Speed Intermittent Sound Signaling / Flashing Red LED Illumination / With Message /
With Display Lighting
• Medium Priority (MP): Critical situation in the long term; ventilation is not affected in the
short term:
Medium Speed Intermittent Sound Signaling / Flashing Yellow LED Illumination / With
Message / With Display Lighting
Note:
There are currently no Low Priority (LP) Alarms.
If there is no corrective action and if the audible alarm is not inhibited (Audio Paused) or reset (Alarm Reset)
within 60 seconds, High Priority alarms will sound at the maximum level of 85 dB(A).
3-2
User’s Manual
Alarm Display
3.2
Alarm Display
During operation, when an alarm is activated:
• One of the red or yellow alarm indicators to the left of the ALARM CONTROL key illuminates and
flashes.
• An alarm tone sounds.
• A message is displayed and flashes in reverse video at the bottom of the Ventilation Menu or
Alarm Menu.
ALARM INDICATORS
VENTILATION MENU
ALARM MENU
ALARM MESSAGES
Figure 3-1. Alarm Displays
Note:
There are currently no Low Priority (LP) Alarms.
When an alarm is triggered, if the current menu displayed is not the Ventilation parameters or Alarm
menu, the display automatically switches to one of these menus to display the alarm message.
In the event several alarms are activated at the same time, the highest priority audible and visual
alarm is highlighted; however, all active messages are displayed, in the sequence in which they
occurred.
User’s Manual
3-3
Alarms and Troubleshooting
3.3
Alarm Log Menu
All alarms are recorded in the internal memory of the ventilator at the time they are activated.
The Alarm Log menu is used to display the last eight (8) alarms activated, along with their date and
time of activation.
To access the Alarm Log menu, do the following:
1. Press the MENU key to access the alarm setting menu (if this is not the menu currently displayed).
2. Press the DOWN key several times or press until the cursor is on the “Alarm Log” line at the bottom
of the page. The display appears as follows:
Figure 3-2. Accessing Alarm Log Menu
3. Press the ENTER key. The Alarm Log screen is displayed.
Figure 3-3. Displaying the Alarm Log Screen
Note:
When no alarm has been activated, “NO DATA” is displayed on the screen (see Figure 3-4).
For more information on the “USER’S CLEAR ALERTS” line, refer to section 3.6, “Re-activating Alarms,”
on page 3-7.
3-4
User’s Manual
Silencing the Audible Portion of Alarms
Figure 3-4. Alarm Log Display when No Alarm Activated
To dismiss the Alarm Log screen manually:
Press the ENTER key when the cursor is on the “Back” line.
The Alarm Log screen is dismissed automatically:
• After 15 seconds if no keyboard action is detected
• When a High Priority alarm is triggered
Note:
Only qualified service personnel may access all alarms and events recorded by the ventilator. Qualified personnel
should refer to the Puritan Bennett™ 520 Ventilator Service Manual for further information.
3.4
Silencing the Audible Portion of Alarms
You may silence the audible portion of alarms for 60 seconds at a time. This is referred to as the Audio
Paused function.
To silence the audible portion of activated alarms:
Press the ALARM CONTROL key.
• The audible portion of all activated alarms is paused.
• The visual portions (light indicator and message) of activated alarms remain visible.
• The Audio Paused symbol is displayed at the top right of the screen while the audio pause
function is active.
Figure 3-5. Silencing the Audible Portion of Alarms
If several alarms are activated at the same time, pressing the ALARM CONTROL key affects all current
alarms.
User’s Manual
3-5
Alarms and Troubleshooting
The audible portion of activated alarms is automatically reactivated:
• After 60 seconds, if the cause(s) of the alarm(s) persist(s)
• Whenever a new alarm is activated
Note:
If a key is stuck or held down for 45 seconds a keypad alarm will occur.
3.5
Pausing/Resetting Alarms
WARNING
When an alarm condition is triggered, or there is evidence of a patient-ventilator fault or problem,
examine the patient first before examining the ventilator.
Alarm volume should be adjusted with respect to the ventilator’s operating environment and so that the
patient's caretakers can hear the alarms. The audible alarm vents located at the front of the device should
never be obstructed.
Some alarms are not automatically cancelled when the condition causing the alarm clears e.g. HIGH
PRESSURE. For those alarms, the alarm sound will stop when the alarm condition clears, but the alarm
message will continue to blink until the alarm is cancelled manually by pressing the ALARM
CONTROL key twice.
Some of the other alarms can be paused manually even if the cause(s) of their activation remain(s).
To manually pause an alarm that has been triggered, proceed as follows:
Press the ALARM CONTROL key twice.
• The alarm is paused until the alarm condition is corrected and the condition reoccurs: the
audible portion, light indicator, and message are all halted (for the alarms which can be
paused manually). The alarm is recorded in the Alarm Log and can still be accessed there. See
section 3.3, “Alarm Log Menu,” on page 3-4. The cancelled alarm will continue to display in the
alarm message window in the Alarms menu until another alarm (of any type) is activated.
The Alarm Paused symbol is displayed at the top right of the Ventilation and Alarms screens. Refer to
Figure 3-6.
Figure 3-6. Manually Pausing Alarms
When no other alarms are currently activated, the last alarm cancelled is displayed continuously in the
alarm message window in the Alarms menu, along with the date and time of its activation. The High
Pressure alarm must be manually reset. Refer to section 3.7, “Overview of Alarms,” on page 3-8.
To manually reset the High Pressure Alarm, proceed as follows:
Press the ALARM CONTROL key twice.
3-6
User’s Manual
Re-activating Alarms
• The visual alarms will be reset.
3.6
Re-activating Alarms
Alarms that have been paused and whose activation conditions continue to exist can be reactivated.
To reactivate alarms, proceed as follows:
1. Press the MENU key to access the Alarm Setting menu, if this is not the menu currently displayed.
2. Press the DOWN key to position the cursor on the “Alarm Log” line, if this is not already the case.
Refer to Figure 3-7:
Figure 3-7. Reactivating Alarms
3. Press the ENTER key, to confirm access to the “Alarm Log” menu.
4. Press the UP key to position the cursor on the “USER’S CLEAR ALERTS” line. Refer to Figure 3-8 :
Figure 3-8. Alarm Log
5. Press the ENTER key for at least three (3) seconds. The following events occur:
•
•
•
•
•
•
User’s Manual
A “beep” sounds.
An audible alarm sounds.
An alarm indicator illuminates.
The messages of all active alarms are displayed in a loop in the Ventilation and Alarm menus.
The Audio Paused symbol disappears (if it was displayed).
The Alarm Paused symbol disappears.
3-7
Alarms and Troubleshooting
3.7
Overview of Alarms
Note:
The message: “*IF PERSISTS RESTART/SRVC” will occur for certain alarms only if the alarm condition continues for
longer than 30 seconds. These alarms are listed in See Table 3-1, Overview of Alarms and See Table 3-2, Alarms
and Corrective Actions.
If the message “*IF PERSISTS RESTART/SRVC” occurs, restart the ventilator. If the alarm condition is not cleared,
call a service representative.
For corrective actions and troubleshooting of the following alarms, See Table 3-2, Alarms and Corrective Actions
on page 3-14.
Table 3-1. Overview of Alarms
Alarm
Paused
Avail.
Alarm Message
Cause/Ventilator Response
AC POWER
DISCONNECTION
Cut-off of the AC (mains) power
supply.
Alarm activation occurs:
• After 5 seconds if ventilation
is stopped
• At the start of a ventilation
cycle when ventilation is in
progress.
Consequence: the ventilator will
automatically switch to external
DC power supply if present,
otherwise to the internal
battery.
MP
Yes
Yes
APNEA
No inspiratory trigger detected
by the ventilator after the apnea
time set in PSV and CPAP, modes.
Automatically clears itself after
two successive patient breaths.
MP
Yes
Yes – except
for CPAP
Ventilator has detected an
internal battery fault.
Consequence: the internal
battery is disabled from use.
MP
Yes
No
MP
Yes
No
MP
Yes
Yes
MP
Yes
No
BATTERY FAULT1
RESTART/SRVC
BATTERY FAULT2
RESTART/SRVC
BUZZER
LOW BATTERY
BUZZER FAULT1
RESTART/SRVC
3-8
Priority
Audio
Paused
Avail.
No internal battery detected.
Occurs when the buzzer battery
is too low to sound the POWER
SUPPLY LOSS alarm.
Defective operation of the
buzzers.
BUZZER FAULT2
RESTART/SRVC
Failure detected in the Very High
Priority buzzer.
Consequence: no audible alarm
in case of POWER SUPPLY LOSS
alarm.
MP
Yes
Yes
BUZZER FAULT3
RESTART/SRVC
Battery Charge Failure due to
incorrect voltage. Contact your
service representative for
assistance.
HP
Yes
No
User’s Manual
Overview of Alarms
Table 3-1. Overview of Alarms (Continued)
Priority
Audio
Paused
Avail.
Alarm
Paused
Avail.
MP
Yes
Yes
MP
Yes
Yes
*IF PERSISTS
RESTART/SRVC
Inspired tidal volume during
exhalation < 20% of Inspired
tidal volume and Inspired tidal
volume > 20 mL.
Exhalation valve obstructed.
HP
Yes
No
CHECK EXH VALVE
PRESSURE
Internal ventilation fault related
to exhalation valve detection
sensor. (pressure sensor)
HP
Yes
Yes
MP
Yes
No
Alarm Message
Cause/Ventilator Response
BUZZER FAULT4
RESTART/SRVC
Buzzer Battery Failure. The
Battery Buzzer Voltage is too
low.
Internal technical problem that
prevents the battery sounding
the POWER SUPPLY LOSS alarm.
CHECK BATTERY
CHARGE
Internal battery charging failure.
Consequence: charging of the
internal battery impossible.
IF PERSISTS
RESTART/SRVC
CHECK EXH VALVE*
1. Loss of signal from the
proximal pressure sensor.
CHECK PROXIMAL
LINE1*
*IF PERSISTS
RESTART/SRVC
Consequence: switch to internal
pressure sensor for the pressure
measurement.
Alarm activation occurs:
In the event of signal loss (1):
After one ventilation cycle
or
In the event of signal loss (2) and
after the 17th breath cycle: After
17 seconds for P A/C mode, or
after the maximum time
between 17 seconds and
Apnea Time + 4 seconds for
CPAP and PSV mode.
User’s Manual
CHECK REMOTE
ALARM
No activation of Nurse Call or
remote alarm system when an
alarm is in progress.
MP
Yes
Yes
CHECK SETTINGS
Alarm activation occurs:
• Systematically after software
versions have changed.
• Loss of memorised
parameters
Consequence:
• Locking Key disabled
• Out-of-range settings are
replaced by their default
values
MP
Yes
Yes
3-9
Alarms and Troubleshooting
Table 3-1. Overview of Alarms (Continued)
Priority
Audio
Paused
Avail.
Alarm
Paused
Avail.
CONNECT VALVE OR
CHANGE PRESS
No exhalation valve connected
with PEEP set to less than 4 mbar
or
PIP set to more than 30 mbar
when relative pressure is set to
OFF.
HP
Yes
No
CONTROLLED
CYCLES
The ventilator is delivering
apnea ventilation at set back up
rate.
NA
No
No
COOLING FAN
RESTART/SRVC
Ventilator cooling fan operating
speed not suited to the internal
ambient temperature of the
device.
MP
Yes
Yes
DC POWER
DISCONNECTION
Cut-off of the external DC power
supply.
Consequence: switch-over to
the internal battery.
MP
Yes
Yes
DEVICE FAULT3
RESTART/SRVC
Failure in the 24 V power supply.
HP
Yes
No
DEVICE FAULT5
RESTART/SRVC
Detection of a fault in the
electrical power supply system.
Consequence: the internal
battery capacity is not displayed
beside the battery symbol.
MP
Yes
Yes
DEVICE FAULT7
RESTART/SRVC
Detection of a fault in internal
voltage measurement.
HP
Yes
No
DEVICE FAULT9
RESTART/SRVC
POST RAM Error. RAM
Read/Write does not match
memory setting.
VHP
No
No
DEVICE FAULT10
RESTART/SRVC
POST FLASH Checksum Error.
Startup FLASH computed
checksum does not match
memory setting.
VHP
No
No
DEVICE FAULT11
RESTART/SRVC
POST EEPROM Error. Startup
EEPROM does not match
memory setting.
VHP
No
No
DEVICE FAULT12
RESTART/SRVC
POST Reference Voltage Error. 5V
or 10V reference voltage error.
VHP
No
No
VHP
No
No
Alarm Message
DEVICE FAULT13
RESTART/SRVC
3-10
Cause/Ventilator Response
Software Version Error
User’s Manual
Overview of Alarms
Table 3-1. Overview of Alarms (Continued)
Alarm
Paused
Avail.
Alarm Message
Cause/Ventilator Response
EMPTY BATTERY
Internal battery capacity
< 10 min. or 3%.
(battery voltage < 22.5V)
Consequence: ventilation comes
to a halt.
HP
No
No
Battery temperature out of
tolerance.
Consequence: battery charging
stops.
MP
Yes
Yes
Device internal ambient
temperature out of tolerance
range.
MP
Yes
Yes
The LEAK estimated by the
ventilator exceeds the Max LEAK
alarm threshold.
MP
Yes
No
HIGH / LOW BATTERY
TEMP*
*IF PERSISTS
RESTART/SRVC
HIGH INT TEMP
COOL VENT*
*IF PERSISTS
RESTART/SRVC
HIGH LEAKAGE
•
In PSV, CPAP or P A/C, modes, if
Inspiratory Pressure is higher
than (P Support or P Control +
PEEP) + 5 mbar up to 29 mbar or
+ 10 mbar over 30 mbar during
three consecutive cycles.
or
•
HIGH PRESSURE
In PSV or CPAP mode and
P Support is set to off, if
Inspiratory Pressure is higher
than PEEP + 10 mbar during
three consecutive cycles.
Alarm activation occurs:
•
After three consecutive
breaths.
Consequence:
•
HP
Note:
When
alarm
condition
clears,
alarm
priority
indicator
must be
manually
reset by
pressing
the
key.
No
Yes
(The visual
portion of
the alarm
may be
paused)
Switch to exhalation phase.
Rate measured greater than
Max Rtot set during three
consecutive breaths.
Alarm activation occurs:
• After three consecutive
breaths.
MP
Yes
No
HIGH VTI
Inspired tidal volume greater
than Max VTI set during three
consecutive breaths in PSV,
CPAP, and P A/C modes.
Alarm activation occurs:
• After three consecutive
breaths.
HP
Yes
No
INTENTIONAL VENT
STOP
Ventilation has been stopped
voluntarily by the caregiver or
patient.
HP
Yes
Yes
HIGH RATE
User’s Manual
Priority
Audio
Paused
Avail.
3-11
Alarms and Troubleshooting
Table 3-1. Overview of Alarms (Continued)
Priority
Audio
Paused
Avail.
Alarm
Paused
Avail.
HP
No
No
Internal battery capacity
< 30 min. or 8%.
HP
Yes
No
Inspired tidal volume less than
Min VTI set during three
consecutive breaths in PSV,
CPAP and P A/C modes.
Alarm activation occurs:
• After three consecutive
breaths.
MP
Yes
No
Proximal pressure < 0.6 mbar for
100 ms during inspiration phase
of 3rd breath cycle.
Ventilator response: Switch to
internal pressure sensor for
pressure measurement.
MP
Yes
No
Occurs in VALVE configuration
when the tidal volume is
measured below 20 mL during
three consecutive breaths for
PSV, CPAP and P A/C modes.
Alarm activation occurs after
three consecutive breaths, if
tidal volume is less than 20 mL.
HP
Yes
No
Occurs in LEAK configuration
when the LEAK level is not
sufficient to flush the CO2 from
patient exhalation. The built-in
LEAK in the mask may be
obstructed.
The built-in leak for the mask is
not sufficient for the settings.
HP
Yes
No
HP
Yes
No
Alarm Message
Cause/Ventilator Response
KEYPAD FAULT
RESTART/SRVC*
*IF PERSISTS
RESTART/SRVC
Keyboard key held down for
more than 45 seconds.
LOW BATTERY
LOW VTI
NO PROXIMAL
LINE2*
*IF PERSISTS
RESTART/SRVC
OCCLUSION CHECK
CIRCUIT*
*IF PERSISTS
RESTART/SRVC
OCCLUSION CHECK
CIRCUIT
PATIENT
DISCONNECTION*
*IF PERSISTS
RESTART/SRVC
Alarm activation occurs if
conditions remain for the
maximum time between:
• disconnection time and 60/RRate in P A/C mode
• disconnection time and
(Apnea time +2 sec) in CPAP
and PSV mode
If the flow is greater than
130 lpm during the inspiratory
phase.
In PSV, CPAP and P A/C modes if
patient pressure is lower than (P
Support + PEEP) - 20% or (P
Control + PEEP) - 20%.
3-12
User’s Manual
Overview of Alarms
Table 3-1. Overview of Alarms (Continued)
Priority
Audio
Paused
Avail.
Alarm
Paused
Avail.
MP
Yes
Yes
VHP
No
Yes
PRES SENS FLT1
RESTART/SRVC
Faulty internal pressure sensor
signal.
Alarm activation occurs:
• After 15 seconds.
HP
Yes
No
PROX SENS FLT2
RESTART/SRVC
Faulty proximal pressure sensor
signal.
Alarm activation occurs:
• After 15 seconds.
MP
Yes
Yes
REMOVE VALVE
The ventilation settings are not
compatible with the type of
patient circuit used.
Remove exhalation valve to start
CPAP ventilation.
HP
Yes
No
REMOVE VALVE OR
CHANGE PRES
The ventilation settings are not
compatible with the type of
patient circuit used.
With a valve circuit, the
difference between PIP and
PEEP should not be less than
5 mbar.
HP
Yes
No
SOFTWARE VERSION
ERROR
Detection of a wrong software
version.
NA
NA
NA
Turbine speed too low and
temperature too high.
Consequence: ventilation stops
immediately and O2 supply
stops.
HP
No
No
The internal battery is not
recognised as a Puritan
Bennett™ product battery or is
not the correct battery for the
Puritan Bennett™ 520 ventilator.
MP
Yes
No
Alarm Message
POWER FAULT
RESTART/SRVC
Cause/Ventilator Response
Detection of a fault in the
electrical power supply system.
1. Electrical power supply to the
machine is interrupted with the
I/O switch when ventilation is in
progress
or
POWER SUPPLY LOSS
(no message)
CPAP MODE
TURB OVERHEAT
RESTART/SRVC
UNKNOWN BATTERY
User’s Manual
2. Battery fully discharged when
it was the only source of power
to the ventilator.
Consequence: ventilation stops
immediately. Ventilation restarts
immediately when the switch is
pressed in case 1 (above) or after
restoration of the AC or DC
supply in case 2 (above).
3-13
Alarms and Troubleshooting
3.8
Troubleshooting
WARNING
This manual tells you how to respond to ventilator alarms, but it does NOT tell you how to respond to the
patient.
To ensure proper servicing and avoid the possibility of physical injury to personnel or damage to the
ventilator, only personnel authorised and qualified by Covidien should attempt to service or make
authorised modifications to the Puritan Bennett™ 520 Ventilator.
3.8.1 Alarms
Table 3-2 offers a guide to the most likely ventilator alarms, possible reasons for the alarms, and
corrective actions.
WARNING
Do not attempt to open, repair or otherwise service the ventilator yourself. Doing so might endanger the
patient, damage the ventilator, and/or void your warranty. Only personnel authorised and qualified by
Covidien should repair, open or service the ventilator.
When an alarm condition is triggered, or there is evidence of a patient-ventilator fault or problem,
examine the patient first before examining the ventilator.
Note:
The ventilator screen must be unlocked before setting and parameters can be changed.
Table 3-2. Alarms and Corrective Actions
Alarm Message or
Symptom
Possible Reason(s) For The Alarm Event
AC (“mains”) power source cut off.
Cancel the alarm then check the supply
cable and/or the effective availability of a
voltage on the AC power (“mains”) port.
Cancel the alarm then check the power
cable availability of a voltage on the AC
power (“mains”) outlet.
Starting with 12 – 30 VDC external power
supply.
Cancel the alarm.
Current-limiting fuse of the device blown.
Replace the ventilator and call for the
maintenance technician.
Patient’s breathing effort less than the
Sensitivity control setting.
Ensure the patient is breathing and adjust
the inspiratory setting appropriately
based on patient’s respiratory needs.
Patient apnea.
Examine the patient for breathing effort
and stimulate if necessary.
If patient status has changed adjust the
ventilator settings based on patient’s
respiratory needs.
Defective sensors.
Have a qualified technician replace the
defective component(s) and call your
customer service representative.
BATTERY FAULT1
RESTART/SRVC
Battery problem that prevents it from
operating.
Restart ventilator to see if alarm clears. If
not, replace the ventilator and call your
customer service representative.
BATTERY FAULT2
RESTART/SRVC
Internal battery missing or not detected.
Restart ventilator to see if alarm clears. If
not, replace the ventilator and call your
customer service representative.
AC POWER
DISCONNECTION
APNEA
3-14
Corrective Action(s)
User’s Manual
Troubleshooting
Table 3-2. Alarms and Corrective Actions (Continued)
Alarm Message or
Symptom
Possible Reason(s) For The Alarm Event
Corrective Action(s)
BUZZER FAULT1
RESTART/SRVC
Defective operation of the buzzers.
Consequence: no audible tone when an
alarm is activated.
Restart ventilator to see if alarm clears. If
not, replace the ventilator and call your
customer service representative.
BUZZER FAULT2
RESTART/SRVC
Internal technical problem that prevents
the very high priority “POWER SUPPLY
LOSS” alarm from triggering.
Ensure that the protective cover over the
I/O switch located on the rear of the
device is intact and functioning properly.
This cover helps prevent accidental
pressing of the I/O switch and stoppage of
the ventilation.
Ensure that the device is stabilised.
Call your customer service representative.
BUZZER FAULT3
RESTART/SRVC
Internal technical problem that prevents
the battery from correctly charging.
Restart ventilator to see if alarm clears. If
not, replace the ventilator and call your
customer service representative.
BUZZER FAULT4
RESTART/SRVC
Internal technical problem that prevents
the battery warning buzzer from sounding
POWER SUPPLY LOSS alarm.
Connect the ventilator to AC power and
switch on the device using the on/off at
the rear of the ventilator (I/O). Leave to
charge for at least 15 minutes.
If persists restart ventilator to see if alarm
clears. If not, replace the ventilator and
call your customer service representative.
BUZZER LOW BATTERY
Buzzer battery is too low to sound POWER
SUPPLY LOSS alarm.
Connect the ventilator to AC power and
switch on the device using the on/off at
the rear of the ventilator (I/O). Leave to
charge for at least 15 minutes.
Battery charging impossible.
Do not disconnect the ventilator from the
AC power supply. Ensure that the power
cable is installed according to the
instructions in chapter 4, “Installation and
Assembly”, so that the power cable
cannot be involuntarily disconnected.
In the event the internal battery capacity
is low, use an alternate device to ventilate
the patient.
Call your customer service representative.
Obstruction or abnormal damage of the
exhalation valve.
Clean or replace the exhalation valve
and/or its control tube.
Excessive moisture in the exhalation valve.
Remove moisture from exhalation valve.
Verify exhalation valve is seated properly.
Reduce temperature of the humidifier.
Defective connection or defective
exhalation valve tubing.
Reconnect the valve or replace the
exhalation valve and/or the exhalation
valve pilot pressure tube.
Defective inspiratory flow sensor.
Have a qualified technician replace the
defective component(s) and call your
customer service representative.
CHECK BATTERY
CHARGE
CHECK EXH VALVE*
*IF PERSISTS
RESTART/SRVC
CHECK EXH VALVE
PRESSURE
User’s Manual
The exhalation valve may not be detected
by the ventilator when ventilation is
started.
Or the exhalation valve may be falsely
detected when ventilation is started.
Restart ventilator to see if alarm clears. If
not, replace the ventilator and call your
customer service representative.
3-15
Alarms and Troubleshooting
Table 3-2. Alarms and Corrective Actions (Continued)
Alarm Message or
Symptom
Possible Reason(s) For The Alarm Event
Corrective Action(s)
No connection of the proximal pressure
tube when ventilation starts.
Reconnect the proximal pressure line.
Proximal pressure line disconnected or
obstructed.
Reconnect the connection line or replace
it if obstructed.
Check for moisture or occlusion of the
proximal line.
Reduce humidifier temperature.
Switch to a heated wire circuit.
Defective proximal pressure sensor or
internal leak of the machine.
Restart ventilator to see if alarm clears. If
not, have a qualified technician replace
the defective component(s) and call your
customer service representative.
Nurse Call or remote alarm system is
disconnected.
Connect the Nurse Call or remote alarm
cable to the ventilator.
Relay control voltage problem.
Carefully monitor the patient to detect
possible alarm triggering and call for the
maintenance technician.
Loss of memorised parameters.
Check and adjust the prescribed
parameters, if necessary.
Software versions have changed.
Check and adjust the prescribed
parameters, if necessary.
The ventilation settings are not compatible
with the type of patient circuit used.
No exhalation valve connected with PEEP
set to less than 4 mbar
or
PIP set to more than 30 mbar when relative
pressure is set to OFF.
Connect exhalation valve.
Decrease PIP to less than 30 mbar in
absolute pressure.
Increase PEEP to more than 3 mbar.
Note:
Always consult the clinician before
changing PEEP, pressure or Rate settings.
The ventilator is delivering apnea
ventilation at set back up rate.
Check that the patient circuit is correctly
attached and the patient is correctly
ventilated.
Operating speed of the cooling fan not
properly adjusted for the internal ambient
temperature of the device.
Restart ventilator to see if alarm clears. If
not, replace the ventilator and call your
customer service representative.
12 – 30 VDC power supply cut off when
there is no AC (“mains”) power supply.
Cancel the alarm then check the supply
wiring and/or the effective availability of
voltage on the external source.
Ventilator’s current-limiting fuse blown.
Replace the ventilator and call your
customer service representative.
IF PERSISTS
RESTART/SRVC
24 V supply failure.
Restart ventilator to see if alarm clears. If
not, replace the ventilator and call your
customer service representative.
DEVICE FAULT5
Internal problem in the electrical power
supply.
Restart ventilator to see if alarm clears. If
not, replace the ventilator and call your
customer service representative.
Internal technical problem.
Restart ventilator to see if alarm clears. If
not, replace the ventilator and call your
customer service representative.
CHECK PROXIMAL LINE1*
*IF PERSISTS
RESTART/SRVC
CHECK REMOTE ALARM
CHECK SETTINGS
CONNECT VALVE
OR CHANGE PRESS
CONTROLLED CYCLES
COOLING FAN
RESTART/SRVC
DC POWER
DISCONNECTION
DEVICE FAULT3
IF PERSISTS
RESTART/SRVC
DEVICE FAULT7
IF PERSISTS
RESTART/SRVC
3-16
User’s Manual
Troubleshooting
Table 3-2. Alarms and Corrective Actions (Continued)
Alarm Message or
Symptom
Possible Reason(s) For The Alarm Event
POST RAM Error. RAM Read/Write does not
match memory setting.
If patient has been disconnected,
reconnect patient to reset the fault.
If persists restart ventilator to see if alarm
clears. If not, replace the ventilator and
call your customer service representative.
POST FLASH Checksum Error. Startup
FLASH computed checksum does not
match memory setting.
Restart ventilator to see if alarm clears. If
not, replace the ventilator and call your
customer service representative.
POST EEPROM Error. Startup EEPROM does
not match memory setting.
Restart ventilator to see if alarm clears. If
not, replace the ventilator and call your
customer service representative.
POST Reference Voltage Error. 5V or 10V
reference voltage error.
Restart ventilator to see if alarm clears. If
not, replace the ventilator and call your
customer service representative.
Incorrect software version detected.
Restart ventilator to see if alarm clears. If
not, replace the ventilator and call your
customer service representative.
Internal battery capacity is less than
10 min. (or 3%) —battery operation
overextended.
Reconnect the device to an AC power
outlet, connect it to an external DC power
source, or replace the battery.
Reminder: the internal battery can be
charged only when the ventilator
connected to an AC power supply.
DEVICE FAULT9
IF PERSISTS
RESTART/SRVC
DEVICE FAULT10
IF PERSISTS
RESTART/SRVC
DEVICE FAULT11
IF PERSISTS
RESTART/SRVC
DEVICE FAULT12
IF PERSISTS
RESTART/SRVC
DEVICE FAULT13
IF PERSISTS
RESTART/SRVC
EMPTY BATTERY
Corrective Action(s)
Note: Ensure that you are operating the
ventilator within the proper temperature
range (refer to Appendix A,
“Specifications”).
Put the device in a warmer environment
(if the ambient temperature is too low) or
in a cooler environment (if the ambient
temperature is too high). For example,
ensure the ventilator is not in direct
sunlight or next to an air conditioning
vent.
HIGH INT TEMP
COOL VENT
Internal ambient temperature of the device
out of the tolerance ranges.
WARNING
In case of operation in a high ambient
temperature, handle the ventilator with
care; some portions of the device may
have high surface temperatures.
WARNING
In the case of high ambient temperatures,
it may take a significant period of time to
cool the internal temperature of the
ventilator to the proper operating range.
To avoid injury to the patient, ensure that
the air inspired by the patient does not
exceed 41 °C (106 °F). If in doubt, replace
the ventilator.
Defective internal temperature probe or
any other technical anomaly.
User’s Manual
Replace the ventilator and call your
customer service representative.
3-17
Alarms and Troubleshooting
Table 3-2. Alarms and Corrective Actions (Continued)
Alarm Message or
Symptom
HIGH/LOW BATTERY
TEMP*
Battery temperature out of the tolerance
ranges.
Corrective Action(s)
CAUTION: Ensure that ventilator is being
used according to the operating
instructions found in Appendix A,
“Specifications”.
If the ambient temperature is too low,
place the device in a warmer
environment. 
If the ambient temperature is too high,
place the ventilator in a cooler
environment.
For example, ensure the ventilator is not
in direct sunlight or next to an air
conditioning vent. The temperature fault
alarm does not interfere with the
operation of the ventilator.
*IF PERSISTS
RESTART/SRVC
Defective internal temperature probe or
any other technical anomaly inside the
battery.
HIGH LEAKAGE
The LEAK estimated by the ventilator
exceeds the Max LEAK alarm threshold.
Readjust mask to reduce leakage or
Increase the alarm settings.
Adjustment of the Max VTI level too low
(for PSV, CPAP and P A/C modes).
Note:
Always consult the clinician before
changing PEEP, pressure or Rate settings.
Modify the Max VTI level.
Adjustment of the pressure level too high
for the volume required (for PSV, CPAP and
P A/C modes).
Note:
Always consult the clinician before
changing PEEP, pressure or Rate settings.
Modify the pressure level.
A leak in the patient circuit causing
increased bias flow.
Check and properly connect the patient
circuit.
HIGH VTI
3-18
Possible Reason(s) For The Alarm Event
WARNING
In case of operation in a high ambient
temperature, handle the ventilator with
care; some portions of the device may
have high surface temperatures.
Restart ventilator to see if alarm clears. if
the alarm message persists, please
contact technical services.
CAUTION: Do not attempt to charge a
defective battery; such a battery cannot
be charged.
Inappropriate patient circuit.
Replace the patient circuit.
Defective flow sensor or internal leak in the
machine.
Have a qualified technician replace the
defective component(s) and call your
customer service representative.
User’s Manual
Troubleshooting
Table 3-2. Alarms and Corrective Actions (Continued)
Alarm Message or
Symptom
HIGH PRESSURE
HIGH RATE
INTENTIONAL
VENT STOP
Possible Reason(s) For The Alarm Event
Airway obstruction.
Check patient’s trachea and clear the
obstruction. If the filter is obstructed,
replace the filter.
Proximal pressure tube or patient circuit
obstructed.
Clean the proximal pressure tube or the
patient circuit or replace them.
Coughing or other high-flow exhalation
efforts.
Treat patient’s cough.
Silence the alarm, if necessary.
Patient inspiratory resistance or
compliance changes.
Have physician determine if ventilator
settings are appropriate for the patient.
Defective internal circuits of the machine or
pressure sensor.
Replace the ventilator and call your
customer service representative.
Adjustment of the Max Rtot level too low.
Re-adjust Max Rtot.
Adjustment of the I Sens level too low.
Adjust I Sens according to the patient.
Patient hyperventilating.
Silence the alarm and call for a medical
team if the symptoms persist.
Check for auto-cycling and adjust
inspiratory sensitivity, manage leaks or
drain condensation from patient circuit.
Defective inspiratory flow sensor.
Have a qualified technician replace the
defective component(s) and call your
customer service representative.
The user / caregiver has stopped
ventilation using the VENTILATION
ON/OFF
key. Ventilation is in stand-by.
LOW VTI
NO PROXIMAL LINE2
User’s Manual
Check that the ventilation was switched
off on purpose.
Pressing a key for more than 45 seconds.
Press and release keys in the normal,
prescribed manner. Do not press keys for
45 seconds or more.
A key on the keyboard is stuck.
If unsuccessful in releasing the stuck
key(s), restart ventilator to see if alarm
clears. If not, replace the device and call
your customer service representative if
the situation persists.
Internal battery capacity is less than
30 min. (or 8%)—battery operation
overextended.
Immediately connect the ventilator to an
AC power outlet, or connect it to an
external DC power source.
Reminder: the internal battery can be
charged only when the ventilator is
connected to an AC power supply.
Adjustment of the Min VTI level too high
(for PSV, CPAP and P A/C modes).
Modify the Min VTI level.
Adjustment of the pressure level not
enough to reach the volume required (for
PSV, CPAP and P A/C modes).
Modify the pressure level according to the
physician’s prescription.
Patient circuit obstructed or disconnected.
Clean, unblock, and/or reconnect the
patient circuit.
Inappropriate patient circuit.
Replace the patient circuit.
Defective flow sensor or internal leak in the
machine.
Check patient, replace the device and call
your technician or customer service
representative.
The proximal pressure line is disconnected.
Connect proximal pressure line.
KEYPAD FAULT
RESTART/SRVC
LOW BATTERY
Corrective Action(s)
3-19
Alarms and Troubleshooting
Table 3-2. Alarms and Corrective Actions (Continued)
Alarm Message or
Symptom
Possible Reason(s) For The Alarm Event
OCCLUSION CHECK
CIRCUIT
Patient circuit obstructed.
*IF PERSISTS
RESTART/SRVC
OCCLUSION CHECK
CIRCUIT
A non-vented configuration is being used
or the built-in leak in the mask or in the
circuit may be obstructed or insufficient for
the settings.
Note :
A high respiratory rate or backup rate may
not sufficiently flush out CO2 in some
vented pediatric masks.
PATIENT
DISCONNECTION
*IF PERSISTS
RESTART/SRVC
POWER FAULT
RESTART/SRVC
RESTART/SRVC
REMOVE VALVE OR
CHANGE PRES
3-20
Replace the non-vented circuit with a
vented one. Clean, unblock the mask or
the circuit of the vented system or switch
to a vented system with a larger leak
configuration. Try to reduce patient’s
backup rate if possible.
Check the patient circuit connections to
the ventilator; examine all connections for
leakage and tightness.
Replace the patient circuit if necessary.
Inspiratory flow exceeds 130 LPM.
Adjust Apnea alarm setting.
Inappropriate patient circuit.
Replace the patient circuit.
Defective internal circuits of the machine or
pressure sensor.
Restart ventilator to see if alarm clears. If
not, have a qualified technician replace
the defective component(s) or call your
customer service representative.
Internal problem in the electrical power
supply.
Restart ventilator to see if alarm clears. If
not, replace the ventilator and call your
customer service representative.
Electrical power supply cut off by the main
switch when ventilation is in progress.
Press the I/O switch to restore electrical
power to the ventilator and allow
ventilation to continue.
To stop ventilation, press the
VENTILATION ON/OFF key for three
seconds. Press the VENTILATION ON/OFF
key again to confirm stop. (refer to
chapter 5, “Operating Procedures”).
The internal battery that supplies the
ventilator is entirely discharged.
Immediately connect the ventilator to an
AC power outlet or an external DC power
source; otherwise, use an alternate device
to ventilate the patient.
Defective internal pressure sensor.
Restart ventilator to see if alarm clears. If
not, have a qualified technician replace
the defective component(s) and call your
customer service representative.
Defective proximal pressure sensor or
internal leak of the machine.
Restart ventilator to see if alarm clears. If
not, have a qualified technician replace
the defective component(s) and call your
customer service representative.
The ventilation settings are not compatible
with the type of patient circuit used.
Remove exhalation valve to start
ventilation with less than 5 mbar of
difference between PEEP and PIP or
Increase the difference between PEEP and
PIP to a minimum of 5 mbar.
PRES SENS FLT1
PROX SENS FLT2
Clean, unblock, and/or properly connect
the patient circuit.
Leak or loose connection in the patient
circuit.
Circuit disconnection from patient or
ventilator.
POWER SUPPLY LOSS
(without message)
RESTART/SRVC
Corrective Action(s)
User’s Manual
Troubleshooting
Table 3-2. Alarms and Corrective Actions (Continued)
Alarm Message or
Symptom
Possible Reason(s) For The Alarm Event
REMOVE VALVE
CPAP MODE
SOFTWARE VERSION
ERROR
TURB OVERHEAT
RESTART/SRVC
UNKNOWN BATTERY
Corrective Action(s)
The ventilation settings are not compatible
with the type of patient circuit used.
Remove exhalation valve to start CPAP
ventilation.
Incorrect software version detected.
Call your customer service representative.
Turbine overheated because of blockage
during operation.
Ensure side and front openings are not
obstructed.
Check air inlet filter.
Restart ventilator to see if alarm clears. If
not, replace the ventilator and call your
customer service representative.
Internal battery not recognised as a 
Puritan Bennett™ product battery or the
battery is not intended for the Puritan
Bennett™ 520 Ventilator.
Switch to a 2400 MAh battery intended for
the Puritan Bennett™ 520 Ventilator or call
your customer service representative.
3.8.2 Additional Troubleshooting
Table 3-3 provides other possible ventilator problems, causes, and corrective actions.
WARNING
If the device is damaged, its external housing is not correctly closed, or it behaves in a way that is not
described in this manual (excessive noise, heat emission, unusual odour, alarms not triggered during the
start-up procedure), the oxygen and power supplies should be disconnected and use of the device stopped
immediately.
If you cannot determine the cause of a problem with your ventilator, contact your equipment supplier. Do
not use the ventilator until the problem has been corrected.
Note:
Buzzer and battery alarms may occur when the unit is first powered on after the internal battery has been
completely drained. Connect to an AC power source and switch on ventilator.
Many of the functions of the ventilator are not accessible when the Locking key
assistance contact your Clinician or equipment representative.
is enabled. For additional
Table 3-3. Additional Troubleshooting and Corrective Actions
Conditions
User’s Manual
Possible Causes
Corrective Actions
The screen
backlight never
switches off
during ventilation
Backlight set to OFF in Preferences
menu.
Set Backlight to YES in Preferences menu
Alarm sound level
too low or too
high
Adjustment of the alarm sound level is
incompatible with the patient’s
environment.
Re-adjust sound level.
Poor visibility of
the displays
Contrast adjustment is incompatible
with the luminosity of the environment.
Re-adjust contrast.
3-21
Alarms and Troubleshooting
Table 3-3. Additional Troubleshooting and Corrective Actions (Continued)
Conditions
Corrective Actions
Unusual display
on the screen
Problem with the display unit.
Adjust contrast or call your customer
service representative if the problem
persists.
Ensure that the ventilator is not exposed
to direct radiation from the sun.
The ventilator
does not operate
after pressing
I/O switch
No external power source and the
internal battery is completely
discharged.
Connect the ventilator to the AC power
source.
Turbine noise.
Replace the ventilator and call your
customer service representative.
Filter and/or turbine silencer
deteriorated.
Replace the ventilator and call your
customer service representative.
Valve membranes damaged.
Replace the ventilator and call your
customer service representative.
Obstruction of main or secondary air
inlets of the casings.
Remove obstructions from all blocked
ventilator air inlets and outlets.
Liquid entered the device.
Replace the ventilator and call your
customer service representative.
Light noise
Whistling noise or
vibrations
Excessive heat
emitted
Condensation
inside the device
3-22
Possible Causes
User’s Manual
Installing the Ventilator
4 Installation and Assembly
WARNING
Before operating the ventilator, read, understand, and strictly follow the information contained in Chapter 1, “Safety Information”.
The ventilator is not intended to be used for patients without breathing autonomy or who are ventilator
dependent.
A patient treated by mechanical ventilation is highly vulnerable to the risks of infection. Dirty or
contaminated equipment is a potential source of infection. Clean the ventilator and its accessories
regularly and systematically before and after each use and following any maintenance procedure to
reduce the risks of infection. The use of a bacterial filter at the ventilator’s outlet is highly recommended.
Refer to chapter 7, “Cleaning”.
4.1
Installing the Ventilator
To install your Puritan Bennett™ 520 Ventilator:
• Choose an area where air can circulate freely; avoid proximity to loose fabrics such as curtains.
• Avoid direct exposure to sunlight.
• Set the ventilator on a flat and stable surface so that its feet are all in contact with the surface. The
ventilator may operate in any position, provided that the air inlets are not obstructed and the
device cannot fall and possibly cause damage and/or personal injury.
WARNING
The operator should connect the ventilator to an AC power source whenever available, for safer operation.
To ensure correct and lasting operation of the ventilator, ensure that its air circulation holes (main inlet or
cooling) are never obstructed. Place the device in an area where air can freely circulate around the
ventilator and avoid installing it near floating fabrics, such as curtains.
Do not place the ventilator in a position where a child can reach it or in any position that might cause it to
fall on the patient or someone else.
Ensure that the ventilator’s immediate surroundings allow for the proper operational connection of the
device without folding, pinching, or damaging any of the required cables or tubes, and that the
connection of the patient circuit to the patient provides for a secure, comfortable fit.
Do not operate the ventilator in direct sunlight, near heat sources, outdoors, or near installations where
liquid may pose a risk without first providing adequate protection for the device.
If the ambient temperature where the device is operated is greater than 35 °C (95 °F), the flow supplied at
the device outlet may exceed 41 °C (106 °F). This may lead to undesirable side effects for the patient. To
avoid injury to the patient move the patient and the ventilator to a cooler location.
To reduce the risk of a fire hazard, keep matches, lighted cigarettes, and all other sources of ignition (such
as flammable anesthetics and/or heaters) away from the ventilator and oxygen hoses.
Never connect your ventilator to an electrical outlet controlled by a wall switch because the power may be
inadvertently turned off.
User’s Manual
4-1
Installation and Assembly
In ambient temperatures above 40°C (104°F) the battery may not be fully charged even if the “INTERNAL
BATTERY” charging indicator is not lit. This is due to the battery’s internal heat safety device.
The use of any accessory other than those specified, with the exception of the power supplies or cables
sold by Covidien, may lead to an increase in electromagnetic emissions or a decrease in the equipment
protection against electromagnetic emissions. If the ventilator is used adjacent to such accessories or
stacked with such devices, the ventilator’s performance should be monitored to verify normal operation.
The Puritan Bennett™ 520 Ventilator requires special precautions for electromagnetic compatibility and
should be installed and started according to the recommendations found in Appendix A, “Specifications”.
In particular, the use of nearby mobile and portable communications equipment using radio frequencies,
such as mobile telephones or other systems exceeding the levels set in the IEC / EN 60601-1-2 standard,
may affect its operation. Refer to section A.10, “Manufacturer’s Declaration,” on page A-7.
The ventilator must not use, nor be connected to, any anti-static or electrically conductive hoses, tubing,
or conduits.
4.2
Connecting to External AC Power
Any of four power sources: AC power, 12 – 30 VDC power, Internal Battery power, or Auxiliary DC car
adapter (cigarette lighter) can be used to power the ventilator. But when AC power is available, the
ventilator will automatically select AC power as its operating power source.
WARNING
The power supply to which the ventilator is connected (both AC and DC) must comply with all current and
applicable standards and provide electrical power corresponding to the voltage characteristics inscribed
on the rear of the ventilator to ensure correct operation.
Ensure that the AC power cable is in perfect condition and not compressed. The device should not be
turned on if the AC power cable is damaged.
Connect the external electrical power source by first connecting the power cable to the ventilator and
then to the external power source. Follow the reverse procedure to disconnect the device from electrical
power sources.
Never connect your ventilator to an electrical outlet controlled by a wall switch because the power may be
inadvertently turned off.
Do not leave power cables lying on the ground where they may pose a hazard.
To prevent accidental disconnection of the AC power cable, use the power cable holder (Figure 4-1,
item 1) that is inserted into the notch (Figure 4-1, item 2) of the battery cover: AC Power Cable Holder.
2
1
Figure 4-1. The Power Cable Holder
4-2
User’s Manual
Connecting to External AC Power
To secure the AC power cable:
1. Insert the power cable holder (Figure 4-2, item 1) into the notch of the battery cover.
1
2
Figure 4-2. Inserting the Power Cable Holder Into the Notch
2. Push the AC power cable into the power cable holder (Figure 4-2, item 2).
3. Connect the female end of the ventilator’s AC power cable (Figure 4-3, item 1) to the AC connector
on the back of the ventilator.
1
Figure 4-3. Power Cable Connected to the Ventilator
4. Connect the male end of the AC power cable to the AC power outlet.
• The AC POWER indicator on the top left corner of the ventilator illuminates.
• The indicator flashes while the battery charges and then turns off when the battery is fully
charged. (Refer to Figure 4-4 on page 4-4.)
If the AC power cable becomes disconnected or the AC power source fails, an “AC POWER
DISCONNECTION“ alarm signals an automatic switch to the external DC power source (if the DC power
cable is connected) or to the ventilator’s internal battery.
One of three power indicators, located on the upper-left of the ventilator’s front panel, illuminates to
signal which of the three possible power sources are currently in use by the device (refer to
Figure 4-4).
Note:
The only time the AC POWER and indicators are illuminated at the same time is when the ventilator is connected
to an AC supply and the battery is charging (indicator is flashing).
User’s Manual
4-3
Installation and Assembly
Figure 4-4. Power Indicators
To disconnect the AC power cable:
1. Disconnect the AC power cable from the AC power outlet.
2. Disconnect the AC power cable from the ventilator’s AC connector at the rear of the device.
3. Grasp the AC power cable at the level of the power cable holder and turn the cable
counterclockwise while lifting it upwards and out of the holder.
4.3
Connecting to an External DC Power Source
WARNING
Ensure that the ventilator’s internal battery is fully charged before using the ventilator with an external
DC power source. Powering the ventilator using an external 12– 30 VDC power source (via the DC power
cable) does not enable charging of its internal battery.
When using a car auxiliary adapter (cigarette lighter) ensure the car has been started prior to plugging in
the ventilator’s DC adapter and keep the car running while you continue to power the ventilator from the
DC adapter.
Note:
An alternative means of ventilation should always be available, particularly when the patient is in transit or away
from wall power.
While using the ventilator on external battery power it is vital that a qualified caregiver (capable of providing
necessary corrective actions in the event of alarm conditions) is present.
When AC power is not available usean external DC powersource prior to using internal battery power.
To connect the ventilator to an external power source do the following:
1. Ensure the car’s engine is started prior to connecting the ventilator.
2. Firstly connect the DC power cable into the ventilator.
4-4
User’s Manual
Connecting to an External DC Power Source
3. Then connect the DC power cable into the car auxiliary adapter.
Note:
Whenever AC power is unavailable, the ventilator can operate from a continuously powered external 12 – 30 VDC
power source via a DC power cable (Figure 4-5, item 1) that connects to the ventilator’s rear panel DC power input
connector (Figure 4-5, item 2). The DC power cable is optional; refer to Appendix E, “Parts and Accessories”, for
more information. It is possible to use the DC auxiliary port (cigarette lighter) in a car as a power source.
1
2
Figure 4-5. Connecting the Ventilator to an External DC Power Source
WARNING
Connect the external DC power source by first connecting the power cable to the ventilator and then to
the external DC source. Follow the reverse procedure to disconnect the device from the external DC power
source.
To connect the DC power cable to the ventilator:
1. Line up the red marker dot on the ventilator’s DC power connector with the marker on the DC
power cable (Figure 4-6, item 1).
1
Align the red markers
(dots and/or lines)
before connecting
the cable.
3
2
Push in to Connect the
DC Power Cable
Figure 4-6. Connecting the DC Power Cable to the Ventilator
2. Push the DC power cable onto the ventilator’s DC power connector (Figure 4-6, item 2).
• You will hear a locking “click”.
User’s Manual
4-5
Installation and Assembly
• The DC POWER indicator on the top left corner of the ventilator illuminates (see Figure 4-4).
To disconnect the DC power cable from the ventilator, slide the locking ring (Figure 4-6, item 3) back
and pull the plug away from the ventilator’s rear panel to disengage it.
An “DC POWER DISCONNECTION“ alarm signals an automatic switch to the internal battery in case the
external DC power source fails or becomes disconnected.
4.4
Patient Circuit
WARNING
Before opening the packaging for the Patient Circuit, ensure that no damage is evident to the packaging
or its contents. Do not use if evidence of damage exists.
For pediatric use, ensure that the patient circuit type fits, and, in all respects, is suitable for use with a
child. Use a pediatric circuit for patients that weigh under 53 lb. (23 kg). See Table E-2, List of Circuits on
page E-2 for a list of recommended patient circuits.
The patient circuit should always be positioned to avoid hindering the patient's movements, to prevent
accidental disconnection or leakage, and to minimise the risk of patient strangulation.
Ensure that the ventilator’s immediate surroundings allow for the proper operational connection of the
device without folding, pinching, or damaging any of the required cables or tubes, and that the
connection of the patient circuit to the patient provides for a secure, comfortable fit.
The patient circuit is intended for single use by a single patient
and should be changed according to
the manufacturer’s recommendations and according to the patient circuit lifetime. Refer to the
instructions for use supplied by the manufacturer of the patient circuit (included with the ventilator) and
chapter 4, “Installation and Assembly”.
After assembling, cleaning, or reassembling the patient circuit, and on a daily basis, inspect the hoses and
other components to ensure that there are no cracks or leaks and that all connections are secure.
To ensure proper performance of the ventilator, use a patient circuit recommended by Covidien in this
manual; refer to chapter 4, “Installation and Assembly” and Appendix E, “Parts and Accessories”. The total
specified length of the patient circuit tubing as measured from the ventilator outlet to the ventilator inlet
is 1.1 metres (3.6 feet) to 2.0 metres (6.6 feet). The tubing must conform to all applicable standards and
must be fitted with Ø 22 mm terminals that also conform to all applicable standards. Ensure that both the
length and the internal volume of the patient circuit are appropriate for the tidal volume: a corrugated
tube of Ø 22 mm for adult patients, and a corrugated tube of Ø 15 mm for pediatric patients with a tidal
volume lower than 200 ml.
Adding accessories to the ventilator breathing circuit, such as a humidifier and water trap(s), may result in
a decrease in tidal volume delivered to the patient due to the added compressible volume of the
accessory. Always assure that the patient is receiving the appropriate inspired volume when altering the
breathing circuit configuration.
Users must always possess an additional breathing circuit and exhalation valve while using the Puritan
Bennett™ 520 Ventilator.
4.4.1 Choosing the Patient Circuit Type
Be sure to choose the appropriate circuit in the menu preferences; in particular, ensure that Pediatric
Circuit Yes/No is set to YES when using a pediatric circuit (refer to Appendix H, “Parts and
Accessories”).
For information regarding validated circuits, visit the SolvITSM Center Knowledge Base by clicking the
link at http://www.respiratorysolutions.covidien.com or contact your Puritan Bennett™ product
representative.
4-6
User’s Manual
Patient Circuit
4.4.2 Installing the Patient Circuit
The patient circuit is mounted depending on the setup of the circuit used and the accessories used.
The following procedures describe the installation of the patient circuit with a humidifier. To add
other accessories, refer to the installation instructions for the specific accessories used.
To connect a single limb circuit with an exhalation valve: (refer to Figure 4-7)
1. Inspect the components of the patient circuit for any signs of damage, such as cracks (which might
cause leakage). Do not use damaged components to assemble the patient circuit.
2. Install the bacteria filter (item 3) on the TO PATIENT outlet port, as shown.
3. Attach one end of the short circuit tubing (item 4) to the bacteria filter (item 3).
4. Attach the other end of the circuit tubing (item 4) to the inlet port of the humidifier (item 10).
5. Place a water trap (item 5) between the outlet port of the humidifier and the inlet of the
exhalation valve (item 7).
6. Ensure the exhalation valve (item 7) is placed as close as possible to the patient.
7. Connect one end of the proximal pressure tubing (item 11) to the proximal pressure port on the
exhalation valve (item 8) and the other end onto the ventilator patient pressure port (item 2).
8. Connect one end of the exhalation valve tubing (item 9) to the exhalation valve port on the
exhalation valve (item 7) and the other end onto the ventilator exhalation valve port (item 1).
9. Place a patient interface to the end of the patient circuit (item 6).
User’s Manual
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Installation and Assembly
Figure 4-7. Single Limb Patient Circuit With Exhalation Valve
Note:
Although shown here, the humidifier (item 10), water trap (item 5), and tubes upstream of the single limb patient
circuit are not included with the ventilator. Contact your supplier for more information.
Figure 4-8. Close-up of Exhalation Valve Tube and Proximal Pressure Tube
Figure 4-8 shows details of the connections of the proximal pressure tube (item 1) and the exhalation
valve tube (item 2).
To connect a single limb circuit without an exhalation valve (NIV only):
Refer to Figure 4-9.
4-8
User’s Manual
Patient Circuit
1. Inspect the components of the patient circuit for any signs of damage, such as cracks (which might
cause leakage). Do not use damaged components to assemble the patient circuit.
2. Install the bacteria filter (item 1) on the TO PATIENT outlet port, as shown.
3. Attach one end of the short circuit tubing (item 2) to the filter (item 1).
4. Attach the other end of the circuit tubing (item 2) to the inlet port of the humidifier (item 6).
5. Place a water trap (item 3) between the outlet port of the humidifier and the patient end of the
patient circuit.
6. Connect one end of the proximal pressure tubing (item 7) as close as possible to the patient at the
mask or cannula entry (item 5) and the other end onto the ventilator patient pressure port (item
8).
7. Place a vented (NIV) interface to the end of the patient circuit (item 4).
Figure 4-9. Single Limb Patient Circuit Without Exhalation Valve
The end of the proximal pressure tube should be connected as close as possible to the patient (at the
mask or cannula entry, if possible) so that the ventilator can account for all load losses due to the
circuit and its potential accessories. If this is not possible, it is best to modify the PATIENT
DISCONNECTION triggering threshold by setting a Max VTI alarm limit for pressure modes. As a
reminder: Ensure that the length and the internal volume of the patient circuit are compatible with
the tidal volume: ringed tube Ø 22 mm for adults and ringed tube Ø 15 mm for pediatric patients with
tidal volumes lower than 200 ml. Use, if necessary, a 22F-15M link on the outlet.
WARNING
When using non-invasive ventilation (NIV), without an exhalation valve, use a vented nose or face mask or
a non vented mask combined with a leak accessory. When using non-invasive ventilation (NIV), with an
exhalation valve, use a non vented mask.
User’s Manual
4-9
Installation and Assembly
The level of inspiratory resistance of the circuit and accessories (bacteria filter, humidifier, HMEs etc) must
be as low as possible. Settings—particularly the PATIENT DISCONNECTION alarm, maximum inspired
volume (Max VTI), and minimum inspired volume (Min VTI) settings—must be periodically adjusted
according to changes in the patient circuit resistance—especially when filters are replaced. Adding
attachments to the ventilator breathing system can cause the pressure during exhalation at the patient
connection port to increase.
The exhalation valve must allow rapid discharge of the circuit pressure. Ensure that the exhalation valve is
always clean and its evacuation aperture (exhaust port) is never obstructed.
Do not start ventilation until you ensure that the device is suitably assembled, that the air inlet filter is
properly installed and is not obstructed, and that there is proper clearance all around the unit. Also ensure
that the patient circuit is suitably connected to both the ventilator and the patient and that the patient
circuit, including all hoses, is not damaged or obstructed.
Adding accessories to the ventilator breathing circuit, such as a humidifier and water trap(s), may result in
a decrease in tidal volume delivered to the patient due to the added compressible volume of the
accessory. Always assure that the patient is receiving the appropriate inspired volume when altering the
breathing circuit configuration.
4.5
Filters
WARNING
Regularly check the cleanliness of the air inlet filter located on the rear of the ventilator. If necessary,
replace the filter before the recommended replacement period is over (see chapter 8, “Routine
Maintenance”). This is particularly important when the ventilator is installed on a wheelchair, because
environmental conditions may cause the filter to become dirty more rapidly.
The ventilator features two filter types:
• air inlet filter
• bacteria filter
Air Inlet Filter
Consisting of foam and fine particle filter media and located at the rear of the ventilator, this filters the
air as it enters the ventilator.
Figure 4-10. Air Inlet Filter
4-10
User’s Manual
Humidifier
WARNING
The air inlet filter is for use on a single patient and is not reusable; do not attempt to wash, clean, or reuse
it.
Failing to replace a dirty air inlet filter, or operating the ventilator without a filter, may cause serious
damage to the ventilator.
Bacteria Filter
It is highly recommended that you install a bacteria filter (see Figure 4-11) on the single limb patient
circuit, connected to the TO PATIENT port:
This filter protects the ventilator from contamination by the patient (primarily, rebreathed gas). Refer
to Figure 4-11, item 1.
Figure 4-11. Bacteria Filter
Refer to the manufacturer’s instructions for more information about the use and maintenance of the
bacteria filter(s).
4.6
Humidifier
The humidifier (Figure 4-12) adds moisture (water vapour) and warms the gas in the patient circuit. It
is inserted into the patient circuit between the main outlet and the patient (refer to Figure 4-8 and
Figure 4-9).
WARNING
During invasive ventilation (when an artificial airway bypasses the patient’s upper respiratory system),
the patient’s upper respiratory system cannot humidify the incoming gas. For this reason, the use of a
humidifier, to minimise drying of the patient’s airways and subsequent irritation and discomfort, is
required.
Always position a humidification device so that it is lower than both the ventilator and the patient. Use
water traps, if necessary, to limit water in the patient circuit and periodically empty these water traps.
If a heated humidifier is used, you should always monitor the temperature of the gas delivered to the
patient. Gas delivered from the ventilator that becomes too hot may burn the patient's airway.
Adding accessories to the ventilator breathing circuit, such as a humidifier and water trap(s), may result in
a decrease in tidal volume delivered to the patient due to the added compressible volume of the
accessory. Always assure that the patient is receiving the appropriate inspired volume when altering the
breathing circuit configuration.
User’s Manual
4-11
Installation and Assembly
Figure 4-12. Humidifier
When a humidification device is used, any condensation that forms in the patient circuit is collected in
the water trap. If you notice any moisture in the patient circuit, you need to replace the wet circuit
components with dry ones.
Refer to the humidification device’s instruction for information on operating, cleaning, and sterilising
the humidifier.
4.7
Oxygen
WARNING
The ventilator must not be used with flammable anesthetic substances.
To reduce the risk of a fire hazard, keep matches, lighted cigarettes, and all other sources of ignition (such
as flammable anesthetics and/or heaters) away from the ventilator and oxygen hoses.
4.7.1 Administering Oxygen
WARNING
Oxygen therapy for patients with respiratory failure is a common and effective medical prescription.
However, be aware that inappropriate oxygen use may potentially lead to serious complications,
including, but not limited to, patient injury.
Oxygen administered to the patient is introduced from an external source into the machine through
the oxygen connector at the rear of the ventilator. It is then integrated into the total volume of
delivered gas. Remove the oxygen inlet connector from the back of the ventilator when external
oxygen is not in use.
The specific oxygen flow to the patient depends on the physiological characteristics of the patient
and the ventilator settings.
The oxygen flow setting should be adjusted for each patient and established in relation to a calibrated
oxygen analyser. Since the factors that affect administered oxygen flow may change over time, you
must ensure that these settings always correspond to the current oxygen therapy objectives specified
by the physician.
4-12
User’s Manual
Oxygen
WARNING
To avoid injury to the patient and/or possible damage to the ventilator: before using the ventilator, use a
flow meter (flow regulator) to regulate the oxygen supply to specifications before connecting the
ventilator to the oxygen supply.
Ensure that the oxygen supply pressure to the machine never exceeds 7 psi (50 kPa) or a flow of 15 lpm.
Refer to Table A-8 on page A-3 for sensitivity tolerances.
The Puritan Bennett™ 520 Ventilator can be used with an oxygen analyser with minimum and maximum
concentration alarms. Always measure the delivered oxygen with a calibrated oxygen analyser that
features a minimum and maximum concentration alarm in order to ensure that the prescribed oxygen
concentration is delivered to the patient.
4.7.2 Connecting the Oxygen Supply
WARNING
Ensure that the only gas supplied to the ventilator through the dedicated oxygen supply connector is
medical-grade oxygen.
The hose connecting the ventilator to the oxygen source must be designed exclusively for use with
medical-grade oxygen. Under no circumstances should the oxygen hose be modified by the user. In
addition, the hose must be installed without the use of lubricants.
A connector (Figure 4-13, item 1) for an external low pressure oxygen source is available at the rear of
the ventilator. It is essential that you also use the special coupler (item 2) supplied with the ventilator
to attach the external low pressure oxygen source to the connector. The connector is also fitted with a
non-return airtight valve system. The non-return airtight valve system includes a stud (item 3) and a
locking tab (item 4).
1
2
3
4
Figure 4-13. Rear Panel Oxygen Connector
User’s Manual
4-13
Installation and Assembly
WARNING
Before connecting the oxygen supply, ensure that the stud on the oxygen connector (Figure 4-13, item 3)
is protruding outwards.
Inspect the oxygen coupler (Figure 4-14, item 2) before use to ensure it has its black o-ring attached and in
good condition. Do not use an oxygen coupler with a missing, damaged, or worn o-ring.
To connect the oxygen supply system to the ventilator:
Refer to Figure 4-14 as required:
1. Inspect the oxygen supply’s connector (Figure 4-14, item 1) to ensure that connector’s black
O-ring (item 2) is not missing.
2. Push the oxygen supply’s oxygen connector (item 1) into the ventilator’s oxygen connector
(Figure 4-14, item 3).
• The ventilator’s oxygen connector’s locking stud (item 4) retracts.
• The ventilator’s oxygen connector’s locking tab (item 5) is released, ensuring that the oxygen
connection is locked and secured in place.
1
2
4 5
3
Figure 4-14. Connecting the Oxygen Supply System
To disconnect the oxygen supply system from the ventilator:
Note:
Ensure the oxygen source is turned off prior to placing the ventilator in Standby or turning off the ventilator.
1. Stop the oxygen flow from the oxygen supply.
4-14
User’s Manual
Fitting the Ventilator into the Dual Bag
2. Press the locking tab of the ventilator’s oxygen connector, as shown in Figure 4-15, to unlock the
oxygen connection.
Figure 4-15. Disconnecting the Oxygen Supply System
3. Disconnect the oxygen supply’s oxygen connector by pulling it towards you.
The ventilator’s oxygen connector’s locking stud (Figure 4-14, item 4) will then extend outwards,
which is required before the oxygen connector can be reconnected.
WARNING
The coupler must not remain connected to the oxygen connector unless it also connected to a leak-proof,
external oxygen gas source. When an oxygen supply is not being used with the ventilator, disconnect the
oxygen source completely from the ventilator.
In the event of an oxygen leak, shut down the supply of oxygen at its source. In addition, remove and/or
keep any incandescent source away from the device, which may be enriched with oxygen. Circulate fresh
air into the room to bring the oxygen level down to normal.
To prevent any interference with the internal sensors of the ventilator, do not install a humidifier
upstream of the ventilator.
4.8
Fitting the Ventilator into the Dual Bag
The Dual Bag is a carrying bag with a dual function. It allows the Puritan Bennett™ 520 Ventilator to
either be mounted onto a wheelchair or carried as a backpack. (See Figure 4-16.)
WARNING
Ensure that the ventilator is switched off and disconnected from all external power supplies before
installation.
To fit the ventilator into the Dual Bag do the following:
1. Open the rear panel of the Dual Bag.
2. Slip the ventilator into the Dual bag, pushing it completely to ensure a snug fit.
3. Shut the rear panel of the Dual Bag ensuring that the hook and loop fastener strips are securely
fastened.
User’s Manual
4-15
Installation and Assembly
4.9
Mounting the Ventilator on a Wheelchair
WARNING
To reduce the risk of a fire hazard, keep matches, lighted cigarettes, and all other sources of ignition (such
as flammable anesthetics and/or heaters) away from the ventilator and oxygen hoses.
Due to its limited internal battery’s reserve capacity, the ventilator should only be operated on the
internal battery when no other power source is available. Ensure that the internal battery never becomes
fully discharged. Alarms will sound when the charge on the internal battery is low. See Table 3-1, Overview
of Alarms.
Do not operate the ventilator in direct sunlight, near heat sources, outdoors, or near installations where
liquid may pose a risk without first providing adequate protection for the device.
To avoid damage to the ventilator, in particular the batteries or electrical components, fluids must not be
allowed to enter the device, particularly through the air inlet filter or the cooling apertures located in the
side, rear, and bottom panels of the ventilator.
Before using the ventilator’s internal battery, ensure that the battery is fully charged and that the charge
holds.
Back up ventilators or those in storage should be connected to an AC power source to protect the integrity
of the battery.
Due to typical voltage fluctuations that occur during normal power wheelchair use, the wheelchair mains
battery should never be used to power the Puritan Bennett™ 520 Ventilator, nor should the ventilator’s
battery be used to power the wheelchair. The ventilator should always be connected to an independent
power source (e.g. AC power, extra batteries, or DC power source).
Regularly check the cleanliness of the air inlet filter located on the rear of the ventilator. If necessary,
replace the filter before the recommended replacement period is over (see chapter 8, ‘Routine
Maintenance”. This is particularly important when the ventilator is installed on a wheelchair, because
environmental conditions may cause the filter to become dirty more rapidly.
To minimise the risk of damage, you must use the ventilator’s Dual Bag to transport the ventilator. See
Table E-1, List of Consumables and Accessories.
To install the Dual Bag onto a wheelchair do the following and refer to Figure 4-16:
1. Unclip the two backpack straps from the side clips.
2. Clip the suspension belt onto the central ring.
3. Secure the Dual Bag on the wheelchair’s push handle.
4. Attach the non adjustable side of the maintaining belt to the side clip of the Dual Bag.
5. Pass the maintaining belt around the back of the wheelchair.
6. Adjust the length of the maintaining belt and attach the adjustable side of the belt to the clip on
the other side of the Dual Bag.
4-16
User’s Manual
Mounting the Ventilator on the Utility Cart
Figure 4-16. Using the Dual Bag
4.10 Mounting the Ventilator on the Utility Cart
Match the mounting holes (item 1) on the bottom of the Puritan Bennett™ 520 Ventilator to the
mounting studs (item 2) on the top of the utility cart platform.
Figure 4-17. Mounting the Ventilator on the Utility Cart
1
2
User’s Manual
4-17
Installation and Assembly
Figure 4-18. Using the Utility Cart
4.11 Connecting the Nurse Call Cable
Connect the Nurse Call cable (Figure 4-19, item 1) to the Nurse Call Monitor Connector (item 2).
1
2
Figure 4-19. Connecting the Nurse Call Cable
WARNING
Before using the Nurse Call system, ensure that its connections are secure and it operates properly.
To connect the ventilator to a Nurse Call device, check the ventilator's compatibility with the Nurse Call
device and order a suitable connection cable.
Do not use Nurse Call devices that operate based on the closure of an electrical circuit, because the devices
often do not take into account possible cable disconnection or a total loss of power. Ensure that the Nurse
Call device is always connected to the ventilator.
The Nurse call function provides for remote alerts of ventilator alarm conditions (for example, when
the ventilator is used in an isolation room), and features the following:
• The ventilator signals an alarm using a normally open (NO) or a normally closed (NC) signal.
• A remote alarm is activated when an alarm condition occurs, unless either of the following is true:
• The audio paused function is active.
• The ventilator power switch is OFF.
• The remote alarm port is an 8-pin female connector; allowable current is 100 mA at 24 VDC (max).
4-18
User’s Manual
Turning on the Ventilator
5 Operating Procedures
5.1
Turning on the Ventilator
WARNING
Before operating the ventilator, read, understand, and strictly follow the information contained in Chapter 1, “Safety Information”.
The ventilator is not intended to be used for patients without breathing autonomy or who are ventilator
dependent.
If the ventilator has been transported or stored at a temperature that differs more than 20 °C ( 36 °F)
from the temperature in which it will be operating, the ventilator should be allowed to stabilise in its operating environment for at least two (2) hours prior to use.
To reduce the risk of a fire hazard, keep matches, lighted cigarettes, and all other sources of ignition (such
as flammable anesthetics and/or heaters) away from the ventilator and oxygen hoses.
While the ventilator is in use, an alternative means of ventilation should always be available in the event of
a ventilator problem. Supplementary observation, appropriate for the patient's condition, is also recommended.
To ensure that ventilation continues uninterrupted, ensure alternative power sources are available (AC
power source, extra batteries, or an auxiliary DC car adapter). Be prepared for the possibility of power failure by having an alternative means of ventilation ready for use.
Do not start ventilation until you ensure that the device is suitably assembled, that the air inlet filter is
properly installed and is not obstructed, and that there is proper clearance all around the unit. Also ensure
that the patient circuit is suitably connected to both the ventilator and the patient and that the patient circuit, including all hoses, is not damaged or obstructed.
Users must always possess an additional breathing circuit and exhalation valve while using the Puritan
Bennett™ 520 Ventilator.
Verify the functionality of the alarm conditions before connecting the patient to the ventilator. Refer to
chapter C, “Alarms Tests"
Before starting ventilation, always verify that all settings are properly set in accordance with the required
prescription.
If the ventilator fails the alarm tests or if you cannot complete the tests, refer to chapter 3.8, “Troubleshooting” or call your equipment supplier or Covidien.
Due to its limited internal battery’s reserve capacity, the ventilator should only be operated on the internal battery when no other power source is available. Ensure that the internal battery never becomes fully
discharged. Alarms will sound when the charge on the internal battery is low. See Table 3-1, Overview of
Alarms.
To turn the ventilator on:
• Set the I/O switch (a covered, rocker-type switch located at the rear of the ventilator) to the I
position, as shown in Figure 5-1 below.
User’s Manual
5-1
Operating Procedures
Figure 5-1. Turning on the Ventilator
The following events occur:
• The ventilator is powered on.
• A Power On Self Test (POST) is carried out (when plugged in to an AC power source).
• The front panel indicators flash (except for the indicator showing the type of power supply in
use, which remains lit).
•
•
•
•
The audible alarms briefly sound.
The display’s backlight turns on.
The PURITAN BENNETT logo is displayed momentarily.
The blue VENT STDBY indicator to the right of the VENTILATION ON/OFF key illuminates,
indicating the device is in standby mode.
• A Welcome Menu screen is displayed for about five (5) seconds, which includes the machine
hours counter and patient hours counter, as shown in Figure 5-2.
Figure 5-2. Welcome Menu Screen
Note:
If the ventilator had been previously stopped by use of the I/O switch while ventilation was in progress, the
ventilator starts directly in ventilation mode and does not show the Welcome Menu screen.
The Alarm, Technical Fault, and Event logs are stored in non-volatile memory on the Main CPU PCB, ensuring that
the information is retained when the ventilator is powered off and during power loss conditions.
5-2
User’s Manual
USB Menu Parameters
To skip the Welcome Menu:
• Press VENTILATION ON/OFF to start ventilation immediately.
The Ventilation menu is then displayed.
Figure 5-3. Ventilation Menu Parameters
By default, the starting ventilation mode is the last one used, the settings being those that were active
when the machine was last stopped.
If the ventilator’s memory of the settings is faulty, a “CHECK SETTINGS” alarm is activated. If this
occurs, the desired parameters should be reset and saved; otherwise the machine will operate on
default parameter values.
5.2
USB Menu Parameters
The USB menu is accessible even if the Locking Key has been enabled (refer to section 5.3, “Starting
Ventilation,” on page 5-6).
The USB menu is automatically displayed when the USB memory device is connected to the ventilator,
when ventilation is either on or off.
Only one USB memory device shall be connected at any time, otherwise an error message will be
displayed. The USB Menu is not accessible from the Setup Menu or Maintenance menu.
To access patient data via a PC, a dedicated software package, Puritan Bennett™ Respiratory Insight
Software, is available for Clinicians. Contact Covidien or your Puritan Bennett product representative
for further information.
5.2.1 USB Memory Device Specifications
Table 5-1. USB Memory Device Specifications
User’s Manual
Characteristics
Supported Formats
USB compatibility
USB flash memory USB 2.0 or USB 1.1, 32 bit format
Number of files
Maximum 999 (sector size: 512-2,048 bytes)
USB size
128 MB to 4GB (to guarantee accuracy of transfer time, at least
10% of the USB memory device capacity must be free).
5-3
Operating Procedures
5.2.2 USB Menu
To access the USB menu when a USB memory device is connected:
Press the MENU key several times, until the USB Menu appears:
Figure 5-4. Selecting the USB Menu
In case of high priority alarm activation the ventilator will automatically display the alarm page. To
return to the USB Menu, press the MENU key.
The adjustable parameters in this menu are:
• Transfer continuously
• Transfer trends
• Erase key
5.2.3 Transfer Continuously
Up to 48 hours worth of data can be transferred from a ventilator to a USB memory device.
To record continuously, the USB memory device must be permanently connected to the ventilator
with ventilation active.
The following data will be recorded to the USB memory device:
• Monitoring: pressure, leak waveforms and inspired flow
• Trends: leaks, VTI, Rate, I:E, M. Vol, PIP and PEEP measurements.
The data can be accessed by a doctor or service provider using the Puritan Bennett™ Respiratory
Insight Software.
Figure 5-5. Selecting Transfer Continuously
5-4
User’s Manual
USB Menu Parameters
To transfer continuous data from a ventilator to a USB memory device:
1. Use the UP or DOWN arrow keys to place the cursor at the “Transfer Continuously” position.
2. Press ENTER.
• The cursor changes to the plus/minus symbol.
• The parameter selected to be modified flashes.
3. Press UP or DOWN to change the selected parameter’s value.
4. Press ENTER to confirm the new parameter setting.
• The new parameter setting is displayed continuously.
• The cursor is placed at the STOP position.
5. To manually stop continuous transfer, press the ENTER key.
If a parameter change is not confirmed by pressing ENTER before seven (7) seconds elapse, the
ventilator resets the parameter to its previous value.
Note:
All ventilator menus remain accessible during transfer time.
The message “TRANSFER IN PROGRESS... REMAINING TIME” is displayed during the transfer time.
Other functions of the USB memory device are not available during continuous recording.
If the memory capacity on the USB memory device is insufficient the message “TRANSFER NOT ALLOWED - USB
CAPACITY INSUFFICIENT” is displayed and data transfer is not allowed. Delete the data on the USB memory device
before restarting data transfer.
In case of USB memory device disconnection or transfer error, the message “TRANSFER ERROR - USB
DISCONNECTION” or “TRANSFER ERROR - TECHNICAL PROBLEM” is displayed. In this case restart the transfer
process. If the problem persists contact your technical service representative.
5.2.4 Transfer Trends
Up to one year’s worth of trend data can be transferred from a ventilator to a USB memory device.
Ventilation trends such as leaks, VTI, Rate, I:E, M. Vol, PIP and PEEP measurements can be transferred
from the ventilator to a USB memory device.
The data can be accessed by a doctor or service provider using the Puritan Bennett™ Respiratory
Insight Software.
Figure 5-6. Selecting Transfer Trends
User’s Manual
5-5
Operating Procedures
To transfer trend data from a ventilator to a USB memory device:
1. Use the UP or DOWN arrow keys to place the cursor at the “Transfer Trends” position.
2. Press ENTER.
• The cursor changes to the plus/minus symbol.
• The parameter selected to be modified flashes.
3. Press UP or DOWN to change the selected parameter’s value.
4. Press ENTER to confirm the new parameter setting.
• The new parameter setting is displayed continuously.
• The cursor is placed at the STOP position.
5. To manually stop trend transfer, press ENTER.
If a parameter change is not confirmed by pressing ENTER before seven (7) seconds elapse, the
ventilator resets the parameter to its previous value.
Table 5-2. Trends Data Transfer Time from Ventilator to USB Memory Device
Amount of trends data
(in months)
Transfer time from ventilator
to USB memory device
3 months
Approximately 2 minutes
6 months
Approximately 4 minutes
9 months
Approximately 6 minutes
12 months
Approximately 8 minutes
Note:
The message “TRANSFER IN PROGRESS... REMAINING TIME” is displayed during the transfer time.
Other USB memory device functions are available during transfer of trends.
If the memory capacity on the USB memory device is insufficient the message “TRANSFER NOT ALLOWED - USB
CAPACITY INSUFFICIENT” is displayed and data transfer is not allowed. Delete the data on the USB memory device
before restarting data transfer.
In case of USB memory device disconnection or transfer error, the message “TRANSFER ERROR - USB
DISCONNECTION” or “TRANSFER ERROR - TECHNICAL PROBLEM” is displayed. In this case restart the transfer
process. If the problem persists contact your technical service representative.
5.3
Starting Ventilation
Before starting ventilation, refer to Appendix B, “Operational Verification Checklist”.
WARNING
Verify the functionality of the alarm conditions before connecting the patient to the ventilator.
Before starting ventilation, ensure that the device is properly assembled and that the air inlet, cooling
vents, and alarm sound diffusion holes are not obstructed. Ensure also that the patient circuit is of the
proper configuration, properly connected to the ventilator, and that the circuit hoses are neither damaged
nor compressed and contain no obstructions or foreign bodies.
Note:
Many of the functions of the ventilator are not accessible when the Locking key
assistance contact your Clinician or equipment representative.
5-6
is enabled. For additional
User’s Manual
Stopping Ventilation
When the ventilator is in standby (the ventilator is on, but ventilation has not started), a message that
prompts the ventilator operator to press VENTILATION ON/OFF to start ventilation is displayed in the
right-hand window of the ventilation and alarm menus (Figure 5-7).
Figure 5-7. Prompt to Start Ventilation
To start ventilation:
Press and release VENTILATION ON/OFF (Figure 5-8, item 1).
• The blue light indicator, at the upper right of the VENTILATION ON/OFF key (Figure 5-8, item
2), turns off.
• A “beep“ sounds.
• The ventilation starts.
• The values of the monitored parameters are displayed in the right-hand window.
Figure 5-8. Starting Ventilation
5.4
Stopping Ventilation
WARNING
Do not allow a patient to remain connected to the ventilator when ventilation is stopped, because a substantial quantity of expiratory gas, primarily carbon dioxide, may be inhaled by the patient. In some circumstances, inhaling carbon dioxide may lead to under-ventilation, suffocation, and serious injury or
death.
You can stop your ventilator at any time.
User’s Manual
5-7
Operating Procedures
To stop the ventilator:
1. Press and hold down the VENTILATION ON/OFF key (Figure 5-8, item 1) for three (3) seconds.
• A message prompting the user to keep the button pressed appears on the monitoring
window, as shown in the graphic below:
Figure 5-9. Stopping Ventilation (1)
2. While keeping the VENTILATION ON/OFF key pressed:
• A new message appears that directs the user to press the key again to confirm ventilation
stop. (shown in the graphic below).
Figure 5-10. Stopping Ventilation (2)
• A double “beep“ sounds.
3. Release VENTILATION ON/OFF key.
4. Press the VENTILATION ON/OFF key again to confirm ventilation stop, otherwise ventilation will
continue.
• Ventilation stops.
• The blue LED located to the upper-right of the VENTILATION ON/OFF key (Figure 5-8, item 2)
illuminates to indicate ventilation is on Standby.
• A prompt for a new start of ventilation is displayed (see Figure 5-7 on page 5-7).
5-8
User’s Manual
Turning Off the Ventilator
5.5
Turning Off the Ventilator
WARNING
When the ventilator is switched back on, it will immediately begin ventilating—without the user first having to press the VENTILATION ON/OFF key.
Handle the ventilator with care after use, particularly when ambient temperatures are high. Some ventilator surfaces may be very hot, even if safety specifications are not exceeded.
Set the I/O switch to the O position to power off the ventilator.
• The blue LED to the right of the VENTILATION ON/OFF key turns off.
• The ventilator screen switches off.
Note:
When the ventilator is completely stopped, but is still connected to the AC power source (the green AC POWER
indicator is illuminated), the internal battery continues charging.
A continuous alarm condition will be activated if the ventilator power switch is turned off while ventilation is in
progress. When the power switch is turned back on again, the ventilation will resume without having to press the
VENTILATION ON/OFF button.
User’s Manual
5-9
Operating Procedures
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5-10
User’s Manual
Battery Capacity
6 Internal Battery
WARNING
Ensure that the ventilator’s internal battery is fully charged before using the ventilator with an external
DC power source. Powering the ventilator using an external 12– 30 VDC power source (via the DC power
cable) does not enable charging of its internal battery.
The maximum recommended shelf life of the internal battery is two (2) years. Do not use a battery that
has been stored for two years or more prior to its first use.
Periodic recharging is important to help maximise useful life of the battery. Do not store the internal
battery for extended periods, without recharging, as this may reduce the maximum life.
Even though the Puritan Bennett™ 520 Ventilator meets current safety standards, and although the
internal Lithium-ion battery of the device is considered to be Dangerous Goods for transport in commerce,
this devices lithium battery is below the 100Wh threshold and is therefore excepted from being a Class 9 –
Miscellaneous - Dangerous Goods (DG). As such, the Puritan Bennett™ 520 Ventilator and/or the
associated Lithium-ion battery are subject to some transport conditions under the Dangerous Goods
Regulation for air transport (IATA: International Air Transport Association), International Maritime
Dangerous Goods code for sea and the European Agreement concerning the International Carriage of
Dangerous Goods by Road (ADR) for Europe. Private individuals who transport the device are excluded
from these regulations although for air transport some requirements apply. For air transport, the Puritan
Bennett™ 520 Ventilator is permitted as checked-in or carry-on baggage. Spare batteries may be taken on
board as carry-on luggage only. This classification and regulatory requirements may vary depending
upon the country and mode of transport. Therefore it is recommended that users verify with the carrier /
airline as to which measures to take before the voyage.
6.1
Battery Capacity
The reserve capacity offered by the internal battery depends on the level of ventilation parameters,
the environmental conditions (primarily in terms of temperature) and the physiological characteristics
of the patient.
With a fully charged battery at a normal room temperature of 25 ºC (± 5 ºC), the ventilator can be
expected to operate on internal battery power for the average durations shown in Table 6-1.
Checking the battery charge level requires that the ventilator be running on battery power at the time
of the battery check. To check the battery charge level, temporarily disconnect the ventilator from AC
power (while in Stand By mode or while providing ventilation) and read the percent charge level
displayed adjacent to the battery icon displayed at the top of the ventilator's display screen.
User’s Manual
6-1
Internal Battery
Table 6-1. Internal Battery Reserve Capacity
Displayed Values
Average Operating Time on Internal Battery Power1
Vt 200 ml (± 5 ml)
PIP  10 mbar (± 2 mbar)
5 hours (–10%)
Rtot  20 bpm
Vt300ml (± 5 ml)
PIP  20 mbar (± 2 mbar)
4 hours (–10%)
Rtot  15 bpm
Vt500 ml (± 5 ml)
PIP  30 mbar (± 2 mbar)
3 hours (–10%)
Rtot  15 bpm
Vt750 ml (± 5 ml)
PIP  45 mbar (± 2 mbar)
Rtot  20 bpm
2 hours (–10%)
(Maximum Ventilation Parameters)
1. Average durations shown are with a fully charged battery having less than 50 charge/recharge cycles. Actual
operating time may be shorter than the average time depending on the level of ventilation parameters, the environmental conditions (primarily in terms of temperature) and the physiological characteristics of the patient.
6.2
Battery Operation
WARNING
Before using the ventilator’s internal battery, ensure that the battery is fully charged and that the charge
holds.
Back up ventilators or those in storage should be connected to an AC power source to protect the integrity
of the battery.
Note:
Buzzer and battery alarms may occur when the unit is first powered on after the internal battery has been
completely drained. Connect to an AC power source and recycle power.
In the event of AC power interruption or disconnection of the external AC or DC power supply, the
ventilator automatically switches to its internal battery and the following events occur:
• The battery symbol is displayed at the top on the general information line.
• Battery reserve capacity is displayed on the right of the battery symbol.
• The internal battery indicator at the top left of the ventilator’s front panel is continuously lit
(Figure 6-1).
6-2
User’s Manual
Battery Operation
Figure 6-1. Internal Battery Indicator
• A loss of external power supply alarm is activated.
If ventilation is stopped, the internal battery reserve capacity is displayed as a percentage of battery
charge. Refer to Figure 6-2.
Figure 6-2. Battery Reserve Capacity as a Percentage
If the ventilator is running, the internal battery reserve is momentarily displayed as a percentage.
Then, after the ventilator calculates the battery time remaining (which takes about two minutes,
depending on the power consumption of the ventilator), the internal battery reserve is then displayed
in hours and minutes (rounded to the nearest fifteen minutes). Refer to Figure 6-3.
Figure 6-3. Battery Reserve Capacity in Hours and Minutes
The “LOW BATTERY“ and “EMPTY BATTERY“ alarms (refer to chapter 3, “Alarms and Troubleshooting”)
are triggered when the internal battery reserve is reduced.
User’s Manual
6-3
Internal Battery
WARNING
Due to its limited internal battery’s reserve capacity, the ventilator should only be operated on the
internal battery when no other power source is available. Ensure that the internal battery never becomes
fully discharged. Alarms will sound when the charge on the internal battery is low. See Table 3-1, Overview
of Alarms.
When the “LOW BATTERY“ alarm is triggered, immediately connect the ventilator to an AC power supply to
maintain ventilation and recharge the internal battery.
From the time that an “EMPTY BATTERY“ alarm is activated, if no external supply is connected to the
ventilator, other alarms may be triggered due to insufficient supply voltage.
In the final discharge phase, the “EMPTY BATTERY” alarm will become continuous, and ventilation
may be interrupted at any time during this phase.
Note:
The “EMPTY BATTERY” alarm symbol may disappear shortly before the ventilator completely stops, but it always
triggers a final, continuous alarm until the battery is fully depleted.
6.3
Testing the Battery
Your ventilator continuously and automatically checks the state of the internal battery, even when the
battery is not used as the main source of energy. The “BATTERY FAULT1“ alarm is activated whenever a
problem is detected in the battery or the charger.
However, on a monthly basis you should disconnect the ventilator from the external power supply to
check that the internal battery functions correctly.
6.4
Recharging the Battery
In the event that the battery charge level is considered insufficient, as per the reserve capacity display,
recharge of the internal battery is necessary. In general, it is recommended that the ventilator be
allowed to charge when the battery drops below 80%, and that the ventilator be recharged
systematically after storage and before using it again.
Note:
To avoid cycling and extend battery life while connected to an AC power source, the battery will not begin
charging until it has dropped below an 85%-90% charge.
To charge the internal battery, do the following:
Connect the ventilator to the AC power source.
• The “AC POWER” indicator illuminates (Figure 6-4, item 1).
6-4
User’s Manual
Storage
• The “INTERNAL BATTERY“ indicator flashes (Figure 6-4, item 2).
1
2
Figure 6-4. Power Indicators When Charging the Battery
When the battery charge is complete, the “INTERNAL BATTERY“ indicator turns off.
WARNING
In ambient temperatures above 40°C (104°F) the battery may not be fully charged even if the “INTERNAL
BATTERY” charging indicator is not lit. This is due to the battery’s internal heat safety device.
Although it is not necessary to start the ventilator to charge the battery, charging the battery during
operation will increase the time required to fully charge the internal battery.
When recharging a depleted internal battery, it may be necessary to leave the ventilator on charge for
up to six (6) hours if the ventilator is on standby and about 13 hours if ventilation is operating.
WARNING
Ensure that the ventilator’s internal battery is fully charged before usingthe ventilator with an external DC
power source. Powering the ventilator using an external 12–30 VDC power source (via the DC power cable)
does not enable charging of its internal battery.
6.5
Storage
If the ventilator is to be stored for an extended period of time, it is not necessary to remove the
battery. However, the ventilator should be stored in cool, dry, well-ventilated environment, as follows:
• Temperature: approximately 21 °C (70 °F)
• Humidity: less than 80% RH
Note:
When the device is in storage it should be recharged monthly to maximise battery life. To charge the battery, plug
the ventilator into AC power (mains).
If the battery is stored for more than one month at a temperature greater than 21 °C (70 °F), or for
more than one or two weeks at a temperature greater than 45 °C (113 °F), the reserve capacity of the
battery may be affected. It will then be necessary to recharge the battery before using it again.
If the ventilator has been in storage for longer than 30 days, connect it to an AC power source, turn on
the unit by the I/O switch at the rear of the ventilator, and let it charge for 15 minutes prior to starting
ventilation.
The battery should not be stored for more than two years, whatever the conditions.
Note:
Fully charge the internal battery prior to disconnecting from AC Power source (“mains”).
User’s Manual
6-5
Internal Battery
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6-6
User’s Manual
Cleaning the Ventilator
7 Cleaning
WARNING
A patient treated by mechanical ventilation is highly vulnerable to the risks of infection. Dirty or
contaminated equipment is a potential source of infection. Clean the ventilator and its accessories
regularly and systematically before and after each use and following any maintenance procedure to
reduce the risks of infection.
To reduce the risk of infection, wash your hands thoroughly before and after handling the ventilator or its
accessories.
7.1
Cleaning the Ventilator
Clean all external panels and surfaces before and after each patient use and as often as necessary to
keep the ventilator clean. You should clean the ventilator periodically, whenever it is soiled or dirty,
before any maintenance operation, and before storing the ventilator.
WARNING
Use all cleaning solutions and products with caution. Read and follow the instructions associated with the
cleaning solutions you use to clean your ventilator. Use only those solutions listed in Table 9-1.
The ventilator should never be immersed in any liquid, and any liquid on the surface of the device should
be wiped away immediately.
To avoid damage to the ventilator, in particular the batteries or electrical components, fluids must not be
allowed to enter the device, particularly through the air inlet filter or the cooling apertures located in the
side, rear, and bottom panels of the ventilator.
To clean the surface of the ventilator:
1. Dip a clean, soft cloth into a mixture of mild soap and water, or other approved cleaning solution.
Refer to Table 9-1 for a list of approved cleaning solutions.
2. Squeeze the cloth thoroughly to remove excess liquid.
3. Lightly wipe the external casing of the ventilator, taking care not to allow excess moisture to enter
any of the openings on the ventilator’s surface. See the warning, above.
4. Dry the ventilator surface with a clean, soft, lint-free cloth.
Table 7-1. Approved Cleaning Solutions for Exterior Ventilator Surfaces
Description
Mild dishwashing detergent
70% isopropyl alcohol (rubbing alcohol)
10% chlorine bleach (90% tap water)
Glutaraldehyde
Hospital disinfectant cleaners
User’s Manual
7-1
Cleaning
Table 7-1. Approved Cleaning Solutions for Exterior Ventilator Surfaces (Continued)
Description
Hydrogen peroxide
15% ammonia (85% tap water)
Ammonia-based household cleaners
Household cleaners
7.2
Cleaning the Accessories
Follow the accessory manufacturer’s instructions for cleaning the ventilator’s accessories and
components, including the patient circuit.
WARNING
After assembling, cleaning, or reassembling the patient circuit, and on a daily basis, inspect the hoses and
other components to ensure that there are no cracks or leaks and that all connections are secure.
Never use a liquid cleaner inside the patient circuit, or on any component of a gas pathway. Clean the
patient circuit only as specified by the manufacturer's instructions.
7.3
Cleaning the Ventilator Between Patients
To prepare the ventilator for use with a new patient, do the following:
1. Change the patient circuit and all filters.
2. Clean the ventilator. (See section 7.1, ‘Cleaning the Ventilator”)
7-2
User’s Manual
Replacing the Air Inlet Filter
8 Routine Maintenance
WARNING
On a DAILY basis, inspect the patient circuit to ensure that it shows no signs of damage, is properly
connected, and is operating correctly without leakage.
Do not attempt to open, repair or otherwise service the ventilator yourself. Doing so might endanger the
patient, damage the ventilator, and/or void your warranty. Only personnel authorised and qualified by
Covidien should repair, open or service the ventilator.
8.1
Replacing the Air Inlet Filter
WARNING
Regularly check the cleanliness of the air inlet filter located on the rear of the ventilator. If necessary,
replace the filter before the recommended replacement period is over. This is particularly important when
the ventilator is installed on a wheelchair, because environmental conditions may cause the filter to
become dirty more rapidly.
Failing to replace a dirty air inlet filter, or operating the ventilator without a filter, may cause serious
damage to the ventilator.
The air inlet filter is for use on a single patient. It is not reusable; do not attempt to wash, clean, or reuse it.
If the ventilator is used indoors, the condition of the air inlet filter should be checked monthly. If the
ventilator is used outdoors or in a dusty environment, the air inlet filter should be checked weekly and
replaced as necessary.
To replace the air inlet filter:
1. Hold the filter between your fingers (see Figure 8-1, item 1).
2. Remove the filter (Figure 8-1, item 2) and discard it.
3. Place the new filter in the device, while ensuring that:
a. The fine particle side of the filter faces outwards, away from the ventilator.
b. The filter is properly installed in its housing. Proper installation of the filter prevents particles
from entering the device.
User’s Manual
8-1
Routine Maintenance
2
1
Figure 8-1. Replacing the Air Inlet Filter
8.2
Recommended Schedule of Maintenance
Consumables and Replacement Intervals
When used under normal circumstances - a relatively dust-free atmosphere, and without damage to
the device and its components (shocks, cracks, significant dirt) - the intervals for replacing the
ventilator’s consumable elements are as follows:
Table 8-1. Consumables and Replacement Intervals
Elements
Air Inlet Filter
(Foam + Fine Particle)
Inspiratory Bacteria Filter
Patient Circuit
Recommended Replacement Intervals
Once a month or more often, depending on the extent of soiling
See manufacturer’s recommendation
See manufacturer’s recommendation
Single use Single patient
Note:
For a list of parts and accessories, refer to Appendix E, “Parts and Accessories” or contact your service
representative or consult http://www.respiratorysolutions.covidien.com.
For all additional accessories not necessarily considered as consumables consult the manufacturer’s
recommendations.
To prevent any risk of cross contamination Covidien recommends the use of STERIVENT filters (Ref: 351/5856 or
equivalent) to protect the patient outlet port.
WARNING
Regularly check the cleanliness of the air inlet filter located on the rear of the ventilator. Replace it when
necessary— even before the recommended replacement period has elapsed, and particularly when the
ventilator is installed on the wheelchair. Environmental conditions may cause the filter to become dirty
more rapidly.
Failure to observe these recommendations may result in a loss of performance, excessive overheating,
a loss of certain functions and, in the long term, compromise the longevity of the ventilator.
8-2
User’s Manual
Service Assistance
Maintenance of the Internal Battery
The internal battery does not need to be removed to verify its correct operation.
Periodic Test of the Internal Battery
Your ventilator continuously and automatically checks the state of the internal battery, even when the
internal battery is not used as the main power source.
However, the battery charge status should be checked MONTHLY by disconnecting the ventilator
from external power supplies (refer to section 6.2, “Battery Operation”). Such a test is imperative after
opening the ventilator or after a prolonged period of non-use (one month or more), in order to ensure
the correct operation of internal connections linking the battery to other components.
WARNING
The maximum recommended shelf life of the internal battery is two (2) years. Do not use a battery that
has been stored for two years or more prior to its first use.
Periodic recharging is important to help maximise useful life of the battery. Do not store the internal
battery for extended periods, without recharging, as this may reduce the maximum life.
Replacement of the Internal Battery
The internal battery should be replaced when the battery capacity drops below 1920 mAh. Keep in
mind that, for environmental protection, the ventilator and its components—including its internal
battery—cannot be disposed of with household waste. You must submit the ventilator and its
components for suitable selective collection and possible recycling and observe all applicable
regulations.
Note:
As the total number of battery charge/discharge cycles approaches 300, a drop in potential of as much as 20%
may be detected.
8.3
Service Assistance
WARNING
If a problem with the ventilator is suspected, FIRST CHECK THAT THE PATIENT IS NOT IN DANGER. If
necessary, remove the patient from the ventilator and provide an alternative means of ventilation.
Do not attempt to open, repair or otherwise service the ventilator yourself. Doing so might endanger the
patient, damage the ventilator, and/or void your warranty. Only qualified service personnel should open,
repair or service the ventilator.
In the event of a problem with the ventilator, refer to chapter 3, “Alarms and Troubleshooting”. If you
cannot determine the cause of the problem, contact your equipment supplier or Covidien.
For more information and local Covidien Technical Service Contact details, refer to chapter , “Technical
Support” in Preface chapter.
User’s Manual
8-3
Routine Maintenance
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8-4
User’s Manual
Physical
A Specifications
A.1
Physical
Table A-1. Physical Description (Excluding Accessories)
Ventilator Weight
9.9 lb. (4.5 kg)
Ventilator Dimensions
9.25 in wide x 12.40 in deep x 6.0 in high
(235 mm wide x 315 mm deep x 154 mm high)
Connectors
Inspiratory limb connector: ISO 22 mm (OD) conical
Oxygen inlet: Female Connector with valve
Device airway volume
2000 ml
Breathing circuit volume
•
•
Adult, single limb
550 ml
Pediatric, single limb
300 ml
Air Inlet Filter
Dimensions: 70 mm long x 60 mm wide
Composition: Polypropylene fiber electrostatic filter material, which is
laminated onto polyurethane open-celled foam.
Efficiency: 99.999982% at 30 Lpm (filtering microbes 3.3 μm)
Inspiratory Bacteria Filter
Requirement
A.2
Maximum allowable flow resistance: 4mbar at 60 lpm
Electrical
Table A-2. AC Electrical Supply
Voltage
Frequency
Consumption
100 VAC to 240 VAC
50 Hz / 60 Hz
180 VA max
12 VDC
NA
8.3 A
30 VDC
NA
3.3 A
Table A-3. Internal Lithium Ion Battery
Voltage
25.2 VDC
Full-load capacity
2.4 Ah
Ampere-hour rating
On standby: 1.5 Ah
During ventilation: 0.5 Ah
Watt hour rating
62Wh to 63Wh
Charging current
•
•
User’s Manual
Standby mode
Ventilation mode
1.5 A/hr. (duration: < 4 hr.)
0.5 A/hr. (duration: < 8 hr.)
A-1
Specifications
Table A-3. Internal Lithium Ion Battery (Continued)
Average operating time at 25 °C (± 5 ºC) with a fully charged battery (having less than
50 charge/discharge cycles) at the following displayed values:
Vt = 200 ml (± 5 ml), PIP = 10 mbar (± 2 mbar), Rtot = 20 bpm
5 hr. (–10%)
Vt = 300 ml (± 5 ml), PIP = 20 mbar (± 2 mbar), Rtot = 15 bpm
4 hr. (–10%)
Vt = 500 ml (± 5 ml), PIP = 30 mbar (± 2 mbar), Rtot = 15 bpm
3 hr. (–10%)
Vt = 750 ml (± 5 ml), PIP = 45 mbar (± 2 mbar), Rtot = 20 bpm
2 hr. (–10%)
(maximum settings)
Table A-4. Remote Alarm
Remote Alarm Port:
4
Also known as the Nurse’s Call port, it
provides for remote alerts of ventilator alarm
conditions.
3
5
1
7
2
An example of a setting that requires such a
feature is when the ventilator is used in an
isolation room.
6
8
Nurse call pin-out (view from back of ventilator)
The ventilator signals an alarm using a
normally open (NO) or a normally closed
(NC) signal.
A remote alarm is activated when an alarm
condition occurs, unless either of the
following is true:
•
•
Audio paused function is active
Ventilator power switch is turned off
The remote alarm port is an 8-pin female
connector. Allowable current is 100 mA at
24 VDC (maximum).
A.3
Pin
Signal
Remote
Alarm Wire
color
1
relay common
black
2
normally open (NO)
brown
3
normally closed (NC)
orange
4
remote supply - (not
used)
5
RX Signal (not used)
6
TX Signal (not used)
7
remote supply + (not
used)
Indicators and Alarms
Table A-5. Power Indicators
A-2
Ventilation ON/OFF
AC power
DC power
Internal Battery
•
•
Green
Green
•
Blue in standby mode
Not lit if ventilation is in
progress.
•
Flashing if the battery
charge is in progress.
Continuously lit if the
ventilator is powered by
the internal battery.
User’s Manual
Performance
Table A-6. Alarm Indicators
High Priority
Medium Priority
Red flashing LED
Yellow flashing LED
Table A-7. Audio Alarms
A.4
Audio Paused
Alarm Volume
60 s ± 1 s
65 to 85 dB (A) ± 10% at 1 meter
Performance
A.4.1 Specifications
Table A-8. Performance Parameter Specifications and Tolerances
A.5
Settings
Range
Tolerances
Pressure
5 to 55 mbar
± (1 mbar +10%)
Time
0.3 to 6.0 s
± 50 ms or 10%, whichever is greater
Rate
1 to 60 bpm
± 1 bpm
Inspiratory Sensitivity
1P to 5
N/A
Exhalation Sensitivity
5 to 95%
± (4 lpm +10%) of target exhalation flow based on E
Sens within 50ms
I:E
1:4 to 1:1
± 50 ms or 10%, whichever is greater
I/T
20% to 50%
± 50 ms or 10%, whichever is greater
Monitored Parameters
Table A-9. Monitored Parameter Tolerances
Ventilator Parameters
Tolerances
Peak Inspiratory Pressure (PIP)
± (2 mbar + 8%)
1
Positive End Expiratory Pressure (PEEP)
± (2 mbar + 8%)
Inspiratory Tidal Volume (VTI)
± (10 ml + 10%VTI)*Rate
Total Breath Rate (Rtot)
± 1 bpm
I:E Ratio (I:E)
± 50 ms or 10%, whichever is greater
I/T Ratio (I/T)
± 50 ms or 10%, whichever is greater
Inspiratory Time (I Time)
± 100 ms
Inspiratory Minute Volume (M VoI)
+/- (10ml + 10%)
Leak
± (3 lpm + 20%)
Apnea Index (AI)
± 1 ev/h
Apnea Time
±1s
% Spontaneous (Spont)
±1%
1. The Puritan Bennett™ 520 Ventilator does not have the capability to reduce pressure below the PEEP pressure
during the exhalation phase.
User’s Manual
A-3
Specifications
A.6
Range, Resolution, and Accuracy
Table A-10 lists the ranges, resolutions, and accuracies for ventilator settings, alarm settings, and
patient data.
Table A-10. Ventilator Range, Resolution, and Accuracy
Ventilator Settings
Range, Resolution, and Accuracy
Mode
Range: P A/C, PSV, CPAP
Resolution: N/A
Accuracy: N/A
Default value: P A/C
Vt Target
Range: 50 mL to 2000 mL
Resolution: 10 mL
Accuracy: Vt target < VTI < Vt target +20% if Max P is high
enough to reach Vt target
Default value: OFF (100 mL)
Peak Inspiratory Pressure
Range: 5 mbar to 55 mbar in valve configuration
(PIP)
Range: 5 mbar to 30 mbar in leak configuration
Resolution: 1 mbar
Accuracy: ± (1 mbar + 10%) of P Control + PEEP setting
Default value: 15 mbar
Depends on PEEP when Relative Pressure is set to YES
Pressure control
Range: 5 mbar to 55 mbar in valve configuration
(P Control)
Range: 6 mbar to 30 mbar in leak configuration
Resolution: 1 mbar
Accuracy: ± (1 mbar + 10%) of P Control + PEEP setting
Default value: 15 mbar
Depends on PEEP when Relative Pressure is set to YES
Pressure support (P Support)
Range: OFF or 5 mbar to 55 mbar in valve configuration
Range: 6 mbar to 30 mbar in leak configuration
Resolution: 1 mbar
Accuracy: ± (1 mbar + 10%) of P Support + PEEP setting
Default value: 15 mbar
Depends on PEEP when Relative Pressure is set to YES
I:E Ratio (I:E)
Range: from 1:1 to 1:4
Resolution: 1/0.1 s
Accuracy: ± 50 ms or 10%, whichever is greater
Default value: 1/2
I/T Ratio (I/T)
Range: 20% to 50%
Resolution: 1%
Accuracy: ± 50 ms or 10%, whichever is greater
Default value: 33%
Respiratory rate (R-Rate)
Range: 5 bpm to 60 bpm in P A/C mode
Resolution: 1 bpm
Accuracy: ± 1 bpm
Default value: 13
A-4
User’s Manual
Range, Resolution, and Accuracy
Table A-10. Ventilator Range, Resolution, and Accuracy (Continued)
Ventilator Settings
Range, Resolution, and Accuracy
Inspiratory sensitivity (I Sens)
Range: 1P-5
Resolution: 1
Accuracy: NA
Default value: 2
in CPAP, I Sens is set to 2 and is not adjustable
Exhalation sensitivity (E Sens)
Range: 5% to 95% of peak flow
Resolution: 5%
Accuracy: ± (4 lpm +10%) of target exhalation flow based on E
Sens within 50ms
Default value: 25%
In CPAP, E Sens is fixed at 25% and is not adjustable.
PEEP
Range: OFF (0.5 mbar) to 20 mbar
Resolution: 1 mbar
Accuracy: ± (1 mbar + 10%) mbar
Default value: OFF
Depends on: PIP in P A/C and PSV modes when Relative
Pressure is set to YES
Rise time
Range: 1-4
Resolution: 1
Default value: 2
Depends on: Insp time
Backup rate
Range: 4-40 bpm
Resolution: 1 bpm
Default value: 13
Depends on: Min I time
Apnea time
Range: AUTO or 1-60 s
Resolution: 1 s
Default value: AUTO
Depends on: Backup R
In PSV, Apnea time: AUTO = 60/Backup R
In CPAP, Apnea Time: AUTO = 30
Minimum Inspired Tidal Volume (Min VTI)
Range: 30 mL to 1990mL
Resolution: 10 mL
Default value: 300
Depends on: Max VTI
Maximum Inspired Tidal Volume (Max VTI)
Range: 80 mL to 3000 mL
Resolution: 10 mL
Default value: 2000 mL
Depends on: Min VTI
Maximum Respiratory Rate (Max Rtot)
Range: 10 bpm to 70 bpm
Resolution: 1 bpm
Default value: OFF
Depends on: R-Rate
User’s Manual
A-5
Specifications
Table A-10. Ventilator Range, Resolution, and Accuracy (Continued)
Ventilator Settings
Range, Resolution, and Accuracy
Minimum Inspiratory Time (Min I time)
Range: 0.1 to 2.8s
Resolution: 0.1 s
Default value: AUTO (Rise time + 300 ms)
Depends on: Max I Time, Backup R, Rise time
Maximum Inspiratory Time (Max I time)
Range: 0.8 to 3 s
Resolution: 0.1 s
Default value: AUTO {Min [3 s; (30/R-Rate)]}
Depends on: Min I Time, R-Rate
A.7
Environmental
The following environmental conditions shall be observed:
Table A-11. Environmental Conditions for Storage or Transport
Temperature
Humidity
Atmospheric
pressure
Altitude
-40° C to +70° C
10% to 95% RH
500 hPa to 1060 hPa
-152 m to 3964 m
(7.2 psi to 15.4 psi)
(-500ft to 13,000 ft)
(-40°F to +158 °F)
Table A-12. Environmental Conditions for Operation
Temperature
Humidity
Atmospheric
pressure
Altitude
+5°C to 40°C
10% to 95% RH
600 hPa to 1100 hPa
-152 m to 3964 m
(8.7 psi to 16.0 psi)
(-500 ft to 13,000 ft)
(+41 °F to104 °F)
Under extreme conditions of use that are beyond the recommendations above but within the limits of
a supply voltage of –20%, compared to the nominal temperature or the combination of a temperature
of 45 °C (113 °F) and humidity of 75% RH, the ventilator should not malfunction nor endanger the
user. However, operating the device for prolonged periods or repeatedly under such extreme
conditions could result in premature aging of components and more frequent maintenance.
A.8
USB
Table A-13. USB Memory Device Specifications
Characteristics
Supported formats
USB compatibility
USB flash memory USB 2.0 or USB 1.1
Memory file format
USB 32 bit format (sector size: 512 - 2,048 bytes)
Number of files
Maximum 999
USB size
128 MB to 4 GB
Table A-14. Data Transfer Characteristics
A-6
Ventilator data description
Capacity
Trends capacity
86 MB
User’s Manual
Pneumatic
Table A-14. Data Transfer Characteristics
A.9
Ventilator data description
Capacity
Events capacity
512 KB or 5,500 events
Monitorings capacity
42 MB / 48 hours
Pneumatic
Table A-15. Airway Resistances
Inspiratory
Exhalation
1.0 mbar at 30 lpm flow ± 0.1 mbar
0.5 mbar at 30 lpm ± 0.1 mbar
3.7 mbar at 60 lpm flow ± 0.1 mbar
1.1 mbar at 60 lpm ± 0.1 mbar
Table A-16. Air Inlet Resistance (Filter)
1.1 cmH20 (1.079 mbar)at 30 lpm flow
Table A-17. Oxygen Inlet Specifications
Maximum pressure
Maximum flow
See Table A-8, “Performance Parameter
Specifications and Tolerances”
50 kPa (7 psi)
15 lpm
Table A-18. Performance Specifications
Working
pressure
Sound pressure
level
Maximum
pressure limit
Internal
compliance
(ventilator)
Inspiratory
triggering
response time (Ttr)
5 mbar – 55 mbar
30 dBA (per NF
EN ISO 17510-1
test conditions)
60 mbar
.0001 l/mbar
100 ms
A.10 Manufacturer’s Declaration
The following tables, Table A-19 through Table A-22, contain the manufacturer’s declarations for the
ventilator’s electromagnetic emissions, electromagnetic immunity, and recommended separation
distances between the ventilator and portable and mobile RF communications equipment, as well as
a list of compliant cables.
WARNING
The Puritan Bennett™ 520 ventilator requires special precautions for electromagnetic compatibility and
should be installed and started according to the recommendations found in Appendix B, “Specifications.”
In particular, the use of nearby mobile and portable communications equipment using radio frequencies,
such as mobile telephones or other systems exceeding the levels set in the IEC 60601-1-2 standard, may
affect its operation. Refer to section B.10, “Manufacturer’s Declaration”.
The use of any accessory other than those specified, with the exception of the power supplies or cables
sold by Covidien, may lead to an increase in electromagnetic emissions or a decrease in the equipment
protection against electromagnetic emissions. If the ventilator is used adjacent to such accessories or
stacked with such devices, the ventilator’s performance should be monitored to verify normal operation.
User’s Manual
A-7
Specifications
Table A-19. Electromagnetic Emissions
The Puritan Bennett™ 520 Ventilator is intended for use in the electromagnetic environment specified below.
The customer or the user of the ventilator should assure that it is used in such an environment.
RF emissions
Group 1
The ventilator uses RF energy only for
its internal functions. Therefore, its RF
emissions are very low and are not
likely to cause any interference in
nearby electronic equipment.
Class B
The ventilator is suitable for use in all
establishments including domestic
establishments and those directly
connected to the public low-voltage
power supply network that supplies
buildings used for domestic
purposes.
CISPR 11 / EN 55011
RF emissions
CISPR 11 / EN 55011
Harmonic emissions
Class A
IEC / EN 61000-3-2
Voltage fluctuations/
flicker emissions
Complies
IEC / EN 61000-3-3
A-8
User’s Manual
Manufacturer’s Declaration
Table A-20. Electromagnetic Immunity
The ventilator is intended for use in the electromagnetic environment specified below. The customer or the user of the
ventilator should ensure that it is used in such an environment.
Immunity Test
IEC / EN 60601 Test Level
Compliance Level
Electrostatic discharge
(ESD)
± 6 kV contact
± 6 kV contact
IEC / EN 61000-4-2
± 8 kV air
± 8 kV air
Electrical fast
transient/burst
± 2 kV for power supply lines
± 2 kV for power supply lines
IEC / EN 61000-4-4
± 1 kV for input/output lines
± 1 kV for input/output lines
Surge
± 1 kV lines/lines
± 1 kV lines/lines
± 2 kV lines/earth
± 2 kV lines/earth
IEC / EN 61000-4-5
Voltage dips, short
interruptions and
voltage variations on
power supply input
lines
@ 5% UT
@ 5% UT
(# 95% dip in UT for
0.5 cycle)
(# 95% dip in UT for
0.5 cycle)
IEC / EN 61000-4-11
40% UT
40% UT
(60% dip in UT for 5 cycles)
(60% dip in UT for 5 cycles)
70% UT
70% UT
(30% dip in UT for 25 cycles)
(30% dip in UT for 25 cycles)
@ 5% UT
@ 5% UT
(# 95% dip in UT for 5 s)
(# 95% dip in UT for 5 s)
3 A/m
3 A/m
Power frequency
(50/60 Hz) magnetic
field
IEC/ EN 61000-4-8
Electromagnetic
Environment–Guidance
Floors should be wood,
concrete, or ceramic tile. If
floors are covered with
synthetic material, the relative
humidity should be at least
30%.
AC power (“mains”) quality
should be that of a typical
commercial or hospital
environment.
AC power (“mains”) power
quality should be that of a
typical commercial or hospital
environment.
AC power (“mains”) power
quality should be that of a
typical commercial or hospital
environment. If the user of the
ventilator requires continued
operation during power mains
interruptions, it is
recommended that the
ventilator be powered from an
uninterruptible power supply
or a battery.
Power frequency magnetic
fields should be at levels
characteristic of a typical
location in a typical commercial
or hospital environment.
Note: UT is the AC mains voltage prior to application of the test level.
User’s Manual
A-9
Specifications
Table A-21. Electromagnetic Immunity – Conducted and Radiated RF
The ventilator is intended for use in the electromagnetic environment specified below. The customer or the user of the
ventilator should assure that it is used in such an environment.
IEC / EN 60601-1-2 Test
Level
Immunity Test














Compliance Level







Electromagnetic Environment–
Guidance
Portable and mobile RF communications equipment should be used no
closer to any part of the ventilator,
including cables, than the recommended separation distance calculated from the equation applicable to
the frequency of the transmitter.
Recommended separation
distance
Conducted RF
3 Vrms
3 Vrms
IEC / EN 61000-4-6
150 kHz to 80 MHz outside
ISM bandsa
150 kHz to 80 MHz outside
ISM bands

d =0.35√P

10 Vrms
inside ISM bandsa
10 Vrms
inside ISM bands
d=1.2√P
10 V/m 80 MHz to 2.5 GHz
10 V/m 80 MHz to 2.5 GHz
Radiated RF
IEC / EN 61000-4-3
d=1.2√P80 MHz to 800 MHz
d =2.3√P 800 MHz to 2.5 GHz
where P is the maximum output
power rating of the transmitter in
watts (W) according to the transmitter manufacturer and d is the recommended separation distance in
metres (m)b.
Field strengths from fixed RF
transmitters, as determined by an
electromagnetic site surveyc, should
be less than the compliance level in
each frequency ranged.
Interference may occur in the vicinity
of equipment marked with the
following symbol:
A-10
User’s Manual
Manufacturer’s Declaration
Table A-21. Electromagnetic Immunity – Conducted and Radiated RF (Continued)
Note:
•
•
At 80 MHz and 800 MHz, the higher frequency range applies.
These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection
from structures, objects, and people.
a
The ISM (industrial, scientific, and medical) bands between 150 kHz and 80 MHz are 6.765 MHz to 6.795 MHz’; 13.553 MHz to 13.567 MHz; 26.957 MHz to
27.283 MHz; and 40.66 MHz to 40.70 MHz.
The compliance levels in the ISM frequency bands between 150 kHz and 80 MHz and in the frequency range 80 MHz to 2.5 GHz are intended to decrease the
likelihood that mobile/portable communications equipment could cause interference if it is inadvertently brought into patient areas. For this reason, an
additional factor of 10/3 is used in calculating the recommended separation distance for transmitters in these frequency ranges.
c
Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land mobile radios, amateur radio, AM and FM radio
broadcast and TV broadcast cannot be predicted theoretically with accuracy. To assess the electromagnetic environment due to fixed RF transmitters, an
electromagnetic site survey should be considered. If the measured field strength in the location in which the ventilator is used exceeds the applicable RF
compliance level above, the Puritan Bennett™ 520 Ventilator should be observed to verify normal operation. If abnormal performance is observed,
additional measures may be necessary, such as reorienting or relocating the Puritan Bennett™ 520 Ventilator.
d
Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 10 V/m.
b
Table A-22. Recommended Separation Distances
The ventilator is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled. The
customer or the user of the ventilator can help prevent electromagnetic interference by maintaining a minimum distance
between portable and mobile RF communications equipment (transmitters) and the ventilator as recommended below,
according to the maximum output power of the communications equipment.
Separation Distance According to Frequency of Transmitter
Rated Maximum
Output Power of
Transmitter (W)
150 kHz to 80 MHz
(outside ISM bands)
150 kHz to 80 MHz
(in ISM bands)
80 MHz to 800 MHz
800 MHz to 2.5 GHz
d=0.35 √P
d= 1.2 √P
d = 1.2 √P
d = 2.3 √P
0.01
0.035 m
0.12 m
0.12 m
0.23 m
0.1
0.11 m
0.38 m
0.38 m
0.73 m
1
.35 m
1.2 m
1.2 m
2.3 m
10
1.1 m
3.8 m
3.8 m
7.3 m
100
3.5 m
12 m
12 m
23 m
For transmitters rated at a maximum output power not listed above, the recommended separation distance d in metres (m)
can be determined using the equation applicable to the frequency of the transmitter, where P is the maximum output
power rating of the transmitter in watts (W) according to the transmitter manufacturer.
Note:
•
•
At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.
The ISM (industrial, scientific, and medical) bands between 150 kHz and 80 MHz are 6.765 MHz to 6.795 MHz;
13.553 MHz to 13.567 MHz; 26.957 MHz to 27.283 MHz; and 40.66 MHz to 40.70 MHz.
•
An additional factor of 10/3 is used in calculating the recommended separation distance for transmitters in the ISM
frequency bands between 150 kHz and 80 MHz and in the frequency range 80 MHz to 2.5 GHz to decrease the
likelihood that mobile/portable communications equipment could cause interference if it is inadvertently brought into
patient areas.
•
These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection
from structures, objects, and people.
User’s Manual
A-11
Specifications
Table A-23. Compliant Cables and Accessories
Cable or Accessory
Maximum length
UK AC power cable assembly
1.8 m (5.9 ft)
Japan AC power cable assembly
1.8 m (5.9 ft)
China AC power cable assembly
1.8 m (5.9 ft)
South Africa AC power cable assembly
1.8 m (5.9 ft)
India AC power cable assembly
1.8 m (5.9 ft)
Australia AC power cable assembly
1.8 m (5.9 ft)
Europe AC power cable assembly
1.8 m (5.9 ft)
Canada AC power cable assembly
1.8 m (5.9 ft)
Nurse call cable
5 m (16.4 ft)
12V DC car adapter cable
5 m (16.4 ft)
Oxygen inlet connector
-
A.11 Standards Compliance and IEC Classification
General Standards
• Medical Electrical Equipment: General Requirements for Safety IEC 60601-1:1990 and EN
60601-1:1990 and all its amendments up to 1995.
• The ventilator will be constructed to comply with the following product Classifications as
detailed in Clause 5 of 60601-1:
•
•
•
•
•
•
•
•
Class II Equipment
Internally Powered Equipment
Type BF Applied Parts
IP31 with respect with respect to access to hazardous parts and ingress of moisture
Not suitable for use in the presence of flammable anesthetic mixtures
Not suitable for sterilisation
Suitable for continuous operation
Detachable power supply cable
• Supplement No. 1-94 to CAN/CSA-C22.2 No. 601.1-M90 - Medical Electrical Equipment - Part 1:
General Requirements for Safety.
• UL 60601-1 Medical Electrical Equipment - Part 1: General Requirements for Safety: 2003.
Collateral Standards
• Medical Electrical Equipment - Part 1: General Requirements for Safety -2- Collateral standard
Electro-Magnetic Compatibility requirements and tests IEC 60601-1-2:2007 and EN 60601-1-2:
2007.
• Medical Electrical Equipment - Part 1: General Requirements for Safety -2- Collateral standard:
Programmable Electrical Medical Systems IEC 60601-1-4:2000 and EN 60601-1-4:2004.
• Medical Electrical Equipment - Part 1: General Requirements for Safety -2- Collateral standard:
Usability IEC 60601-1-6:2006 and EN 60601-1-6:2007.
• General Requirements, tests and guidance for alarm systems in medical electrical equipment
and medical electrical systems IEC 60601-1-8:2003 and EN 60601-1-8:2007.
A-12
User’s Manual
Standards Compliance and IEC Classification
Particular Standards
• Lung Ventilator for Medical Use-Particular Requirements for Basic Safety and Essential
Performance Part 6: Home-care ventilatory support devices EN ISO 10651-6: 2009.
• Lung Ventilators for Medical Use- Particular Requirements for Basic Safety and Essential
Performance Part 1: Home Care Ventilator Support YY 0600.1-2007 (ISO 10651-6:2004, MOD).
• Anesthetic and respiratory equipment - Conical connectors - Part 1: Cones and sockets EN ISO
5356-1:2004.
Air Transportation Standards
• Environmental Conditions and Test Procedures for Airborne Equipment - RTCA/DO-160:2007.
User’s Manual
A-13
Specifications
This page intentionally blank
A-14
User’s Manual
B Operational Verification Checklist
The operational verification and safety checks listed in Table B-1 below should be performed to
ensure the ventilator is operating properly in the following circumstances:
• Prior to using the ventilator with a patient.
• Regularly, according to institutional protocol.
• Following maintenance or changes in ventilator settings.
If the ventilator fails any of the safety checks below, or if you cannot complete these checks, refer to
section 3.8, “Troubleshooting,” on page 3-14 or call the equipment supplier or Covidien (refer to
section 8.3, “Service Assistance,” on page 8-3).
WARNING
Provide the patient with an alternate means of ventilation before conducting these tests.
To reduce the risk of infection, wash your hands thoroughly before and after handling the ventilator or its
accessories.
Table B-1. Operational Verification Checklist
1
Verify the proper appearance and cleanliness of the ventilator.
2
Verify all of the labels and markings on the ventilator are clear and
legible.
3
Confirm the air inlet filter is clean and correctly installed.
4
Ensure the AC power cable does not exhibit any signs of damage, such
as kinks, breaks, or damaged insulation.
5
Connect the AC power cable.
Ensure that all power supply indicators on the front panel flash, except
for the AC power supply (mains) indicator, which should remain lit.
6
Push the power switch I/O to the I position to activate the ventilator test:
Check that the two alarm indicators and the Standby indicator (located
key) flash. Ensure also that the
close to the VENTILATOR ON/OFF
two alarm buzzers sound.
7
Perform the Functioning Alarms Test regularly according to institutional
protocol (refer to Appendix C, “Alarms Tests”).
8
Verify the alarm volume is adapted to the patient environment.
9
Verify that the preventive maintenance schedule for the ventilator is
followed. Refer to chapter 8, “Routine Maintenance”.
Pass
Ensure the patient breathing circuit is correctly attached to the
ventilator, with all the necessary components, and is free from any signs
of damage and leaks.
Pass
10
User’s Manual
Pass
Pass
Pass
Pass
Pass
Pass
Pass
Pass
B-1
Operational Verification Checklist
This page intentionally blank
B-2
User’s Manual
Low Pressure Test
C Alarms Tests
Before connecting the ventilator to the patient, perform the following tests to ensure the ventilator‘s
alarms are working properly.
WARNING
Do not perform ventilator alarm tests while the patient is connected to the ventilator. Provide the patient
with an alternate means of ventilation before conducting these tests.
If the ventilator fails any alarm test or if you cannot complete these tests, see the Troubleshooting section
(refer to chapter 3, “Alarms and Troubleshooting”) of this manual or call your equipment supplier or
Covidien (refer to section 8.3, “Service Assistance,” on page 8-3).
Note:
Many of the functions of the ventilator are not accessible when the Locking key
assistance contact your Clinician or equipment representative.
is enabled. For additional
Most of these tests require that an approved patient circuit be connected to the ventilator. Ensure that your
patient circuit is properly connected prior to performing these tests.
C.1
Low Pressure Test
1. Before proceeding, set the ventilation and alarm parameters specified by the patient’s clinician
and install a single limb circuit setup.
2. Press the VENTILATION ON/OFF key to start ventilation.
3. Keep the patient‘s end of the breathing circuit open and allow ventilation to continue.
4. Wait for (Apnea Time + 2 seconds; Apnea time is not always 5 seconds), then ensure that:
• the High priority indicator (red colour) lights up
• the “PATIENT DISCONNECTION” alarm is displayed
• the audible alarm sounds
5. Press the ALARM CONTROLkey once to silence the alarm.
6. Press and hold the VENTILATION ON/OFF key for three (3) seconds, then release it. Press the
VENTILATION ON/OFF key again to confirm stop. The ventilator will switch to Standby mode and
cancel the alarms.
C.2
Power Failure Test
Note:
If the ventilator is operating on either the external power supply or the internal battery, you must plug it in to an
AC power source before beginning this test.
1. Disconnect the ventilator from its AC power supply. Ensure that the following events occur:
• the Medium priority indicator (yellow colour) illuminates
User’s Manual
C-1
Alarms Tests
• the “AC POWER DISCONNECTION“ alarm activates
• an audible alarm sounds
• the DC POWER indicator illuminates if the DC power source is connected; otherwise, the
INTERNAL BATTERY indicator illuminates
2. Press the ALARM CONTROL key twice to reset the alarm.
Reconnect the ventilator to its AC power supply.
C.3
Occlusion Test
Note:
Occlusion testing can only be done in Pressure modes.
1. Verify that the pressure tube of the patient circuit is properly connected to the appropriate fitting
on both the ventilator and the proximal pressure port (refer to section 4.4, “Patient Circuit,” on
page 4-6).
2. Block the exhalation port on the exhalation valve of the patient circuit. Refer to Figure C-1 on
page C-2.
Figure C-1. Blocking the Patient End of a Single Limb Circuit
3. Press the VENTILATION ON/OFF key to start ventilation.
4. Allow the ventilator to deliver three (3) consecutive breaths. At the beginning of the fourth breath,
ensure that the following events occur:
• the High priority indicator (red colour) illuminates
• the “Occlusion“ alarm activates
• an audible alarm sounds
5. Press the ALARM CONTROL key to silence the alarm.
6. Unblock the exhalation port.
• the occlusion alarm is cancelled.
7. Press and hold the VENTILATION ON/OFF key for three (3) seconds, then release it. Press the
VENTILATION ON/OFF key again to confirm stop.
• Ventilation stops.
C.4
Testing the Battery
The ventilator is capable of testing the power of the battery (refer to chapter 6, “Internal Battery”). You
can determine which power source the ventilator is using by checking the power indicator, located on
the top panel. The indicator light will be lit to indicate which power source is currently available.
C-2
User’s Manual
Involuntary Stop Test
1. Disconnect the AC power supply cable and the DC power cable (if it is connected) from the
ventilator.
• a POWER DISCONNECTION alarm will trigger.
2. Press the ALARM CONTROL key twice to pause the alarm. Ensure that the following events occur:
• the INTERNAL BATTERY indicator to the upper-left of the display illuminates
• the BATTERY symbol is displayed at the top of the screen (along with its reserve capacity)
3. Connect the AC (mains) power supply. Ensure that the following events occur:
• the AC POWER indicator to the upper-left of the display illuminates
• the indicator to the upper-left of the display is flashing, which indicates that the battery is
charging (this only occurs if the ventilator has run on battery power long enough to lose
enough charge that the charger will turn on)
• the BATTERY to the upper-left of the display symbol is no longer displayed at the top of the
screen
C.5
Involuntary Stop Test
To verify proper functioning of the Very High Priority audible alarm, perform the following:
1. Press the VENTILATION ON/OFF key to start ventilation.
2. Set the I/O switch to the O (off ) position to power-down the ventilator during ventilation. Ensure
that the following events occur:
• An audible alarm sounds continuously
• The ventilator turns off. There should be no alarm indicators illuminated and no alarm
messages displayed.
3. Press the ALARM CONTROL key once to silence the audible alarm.
User’s Manual
C-3
Alarms Tests
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C-4
User’s Manual
D Unpacking and Preparation
The Puritan Bennett™ 520 Ventilator is delivered with the following items:
(1) Printed User's Manual (language as requested by the customer)
(1) Clinician's Manual on CD (a print copy is available upon request by the customer)
(1) Patient circuit and valve
(1) Set of six (6) combination foam/fine particle air inlet filters
(1) Carrying bag
(1) Oxygen connector
(1) AC power cable
WARNING
Users must always possess an additional circuit and valve while using the Puritan Bennett™ 520 Ventilator.
To minimise the risk of damage, you must use the Dual Bag to transport the Puritan Bennett™ 520
Ventilator. Refer to Figure G-2.
To unpack and prepare the ventilator, follow the steps below.
1. From the plastic bag, remove the following:
• Plastic pocket containing the Clinician’s Manual.
• The ventilator and its components and/or accessories.
2. Remove the patient circuit, the AC (“Mains”) power cable, and the set of fine-particle air inlet filters
3. Inspect the ventilator and ensure that:
• the ventilator’s outer casing and the I/O switch’s protective cover do not have any dents or
scratches, which may indicate possible damage.
• the ventilator’s labels and markings are clear and legible.
• the AC power cable does not exhibit any signs of damage, such as kinks, breaks, or cuts.
WARNING
Never use a ventilator or any components or accessories that appear to be damaged. If any signs of
damage are evident, contact your equipment supplier or Covidien.
4. Clean the ventilator with a mild soap solution, if necessary (refer to chapter 7, “Cleaning”).
5. Ensure that the air inlet filter is installed.
User’s Manual
D-1
Unpacking and Preparation
Figure D-1. Puritan Bennett™ 520 Ventilator
Figure D-2. Dual Bag
D-2
User’s Manual
E Parts and Accessories
Table E-1 provides a list of accessories that are available for the Puritan Bennett™ 520 Ventilator.
To order parts or accessories, contact your equipment supplier or Covidien representative.
Note:
The ventilator is delivered with the following items: a printed User’s Manual, a CD with Clinician’s Manual (printed
copy available upon request); one patient circuit with valve; one set of six (6) combination foam/fine particle air
inlet filters; one carrying bag; one O2 connector; and one AC power cable.
Table E-1. List of Consumables and Accessories
Description
Carrying bag (grey)
Oxygen inlet connector
Ventilator Cart
Dual Bag (blue or pink)
delivered with:
Backpack Padded Straps, 2 ea.
Suspension belt
Carrying belt
WARNING
To minimise the risk of damage, you must use the
ventilator’s Dual Bag to transport the ventilator. See
Figure D-2 on page D-2.
AC (mains) power cable
DC power cable (for connection to an external DC power
source, such as a car 12 volt DC outlet)
Nurse call cable (5 metres)
Inlet air combi-filter, fine (pack of 6)
Note: This is the “foam plus fine particle” filter listed in
Table 8-1, Consumables and Replacement Intervals, on
page 8-2).
Internal battery
External battery
3-way DAR™ valve
DAR™ Inspiratory Bacteria Filters
Barrierbac
Barrierbac S
Barrierbac S Angled
Hygrobac
Hygrobac S
Hygrobac S Angled
User’s Manual
E-1
Parts and Accessories
Table E-1. List of Consumables and Accessories
Description
Hygroboy
Hygroster
Hygroster Mini
Sterivent
Sterivent S
Sterivent Mini
Hygrolife II
Table E-2 provides a list of consumable parts available for the ventilator.
WARNING
To ensure proper performance of the ventilator, use a patient circuit recommended by Covidien in this
manual; refer to chapter 4, “Installation and Assembly” and Appendix E, “Parts and Accessories”. The total
specified length of the patient circuit tubing as measured from the ventilator outlet to the ventilator inlet
is 1.1 metres (3.6 ft) to 2.0 metres (6.6 feet). The tubing must conform to all applicable standards and must
be fitted with Ø 22 mm terminals that also conform to all applicable standards. Ensure that both the
length and the internal volume of the patient circuit are appropriate for the tidal volume: a corrugated
tube of Ø 22 mm for adult patients, and a corrugated tube of Ø 15 mm for pediatric patients with a tidal
volume lower than 200 ml.
Table E-2. List of Circuits
Description
Part Number
DAR™ Single limb patient circuit with exhalation valve,
180 cm, PVC, ADULT
5093600
DAR™ Single limb patient circuit with exhalation valve,
180 cm, PVC, PEDIATRIC
5093500
DAR™ Single limb patient circuit without exhalation valve,
180 cm, PVC, ADULT
5093300
DAR™ Single limb patient circuit without exhalation valve,
180 cm, PVC, PEDIATRIC
5093100
For more information regarding parts and accessories for the Puritan Bennett™ 520 Ventilator contact
your service representative or http://www.respiratorysolutions.covidien.com.
E-2
User’s Manual
F Glossary
AC Power
Alternating current.
Alarm Pause
The audible and visual alarms cease and the
symbol appears. The symbol will remain until the
cause of the alarm is addressed. For example, when the ventilator is running on internal battery, the
AC Disconnection alarm may be paused, and the alarm paused symbol will appear until the device is
plugged into AC. The paused alarm will be captured in the alarm log screen and can be reactivated.
Alarm Reset
Used only for the High Pressure alarm, this function resets the visual alarm message.
Apnea
The absence of breathing or a breathing pattern capable of supporting an individual's respiratory
needs.
Apnea Index (AI)
The Apnea index is average number of apnea events per hour of ventilation. It is based on the Apnea
Alarm.
Apnea Time
Time allowed between breath starts before APNEA alarm occurs when no patient effort is detected.
Assist/Control
In Assist/Control mode, the ventilator delivers an assisted breath of a set pressure when the patient's
breathing effort creates a flow or pressure drop that is greater than the SENSITIVITY setting. In
absence of patient breathing effort, the ventilator will deliver a controlled breath of the set pressure.
(Does not apply in PSV/CPAP mode).
Assisted Breath
A pressure breath triggered by the patient but then controlled and terminated by the ventilator.
Audio Pause
Pauses the audible alarm for 60 seconds at a time and shows the
“Alarm Silence.”
symbol; often referred to as
Back Up Rate
Rate of control cycles in PSV mode during apnea phase.
Battery Level
Display of the remaining battery capacity; located adjacent to the battery symbol.
User’s Manual
F-1
Glossary
Bias flow
Turbine flow during exhalation phase through the patient circuit to avoid rebreathing.
bpm
An abbreviation for “breaths per minute,” which is the unit of measure for breath rate (see below).
Breath Rate (Back Up R)
The total number of breaths, both machine and spontaneous, delivered by a ventilator in one minute.
Caregiver
An individual who assists a patient with the tasks of daily living. This may be a family member, a live-in
assistant, or the nursing staff of a health care facility.
cmH2O
An abbreviation for “centimetres of water,” which is a unit of measure for pressure.
Continuous Positive Airway Pressure (CPAP)
Continuous airway pressure maintained throughout a spontaneous breath cycle.
Controlled breath
A pressure breath triggered, controlled and terminated by the ventilator.
DC Power
Direct current.
Exhalation Phase
Phase of the breath cycle during which the patient exhales.
Exhalation Sensitivity
The exhalation sensitivity (E Sens) level is a percentage of peak flow at which a pressure-supported
breath will be terminated.
Fraction of Inspired Oxygen (FiO2)
Amount of oxygen delivered to the patient.
Flow
Volume of gas delivered by the ventilator compared to time, expressed in litres per minute (lpm).
hPa
An abbreviation for “hectopascal“ which is a unit of measure for atmospheric pressure.
I:E ratio
Inspiratory time versus exhalation time ratio.
Inspiratory Phase
Phase of the breath cycle during which the patient inspires.
F-2
User’s Manual
Inspiratory Sensitivity (I Sens)
Level of inspiratory effort the patient has to provide during the initiation of a machine breath. The
sensitivity levels (from 1P to 5) correspond to differences in flow compared to the bias flow. Level 1P is
the most sensitive (for a pediatric use) and requires the least effort to trigger a breath. Level 5 requires
the most amount of effort to trigger a breath.
Inspiratory Tidal Volume (VTI)
Volume delivered to the patient at each inspiratory phase.
I Time (Inspiratory Time)
Inspiratory time measure.
Intentional Vent Stop Alarm
Intentional Ventilation Stop Alarm - Ventilation has been switched off by the user / caregiver and the
ventilator is in stand-by.
I/T Ratio
Inspiratory time versus total breath time ratio.
L
litres (a unit of volume).
Leak
When ventilating in leak configuration, it is the averagepatient/circuit leak during each cycle and over
the past 24 hour period.
LED
Light Emitting Diode; used as indicator lights on the ventilator’s front panel.
lpm
Litres Per Minute (a unit of volume flow rate).
Machine Hours Counter
Counter for the total ventilation time since manufacture or the last CPU board change.
Mains
AC power supply.
Max Leak
The maximum alarm setting of a high leakage threshold. An alarm will be triggered in the event the
calculated leakage is exceeded.
Max Rtot (Total breath rate)
The maximum alarm setting to prevent hyperventilation or ventilator autotriggering. The HIGH RATE
alarm will be triggered if the total breath rate exceeds the maximum limit set.
Max P (Maximum Inspiration Pressure)
Max P allows the ventilator to adjust the inspiratory pressure up to a maximum limit in order to reach
the target tidal volume (Vt Target).
User’s Manual
F-3
Glossary
Mbar
An abbreviation for “millibar“ which is a unit of measure for atmospheric pressure.
Mean Airway Pressure
Average patient pressure during each breath.
Minimum Exhalation Time
Minimum exhalation time before allowing the patient inspiratory trigger.
Minimum Inspiratory Time
Minimum inspiratory time before allowing the patient to exhale.
M Vol (Minute Volume)
Flow delivered at each breath to the patient is measured by the inspiratory flow sensor and that
measurement is used to calculate minute volume (Vt x Rtot)
P A/C (Pressure Assist /Control)
A ventilator mode which provides machine-initiated breaths delivered at a clinician-set pressure,
inspiratory time, and rate.
Patient Breath
Breathing cycle initiated by the patient.
Patient circuit
Tubing between the ventilator and the patient.
Patient effort
Inspiratory effort initiated by the patient.
Patient Hours Counter
Counter of ventilation time for the patient.
Peak Airway Pressure (PAW)
The Peak Airway Pressure is the average peak pressure during the inspiratory phase, measured by
each cycle and over the previous 24 hour period.
Peak Inspiratory Pressure (PIP)
The highest pressure measured in the patient circuit during the inspiration phase.
Positive End Expiratory Pressure (PEEP)
Pressure in the patient circuit at the end of expiration.
Pressure Control (P Control)
Augmentation of the patient's ventilation synchronously with inspiratory effort until a preset pressure
is met. Pressure is maintained throughout patient inspiratory flow, and is cycled to expiration by time
(controlled by the selected Inspiratory Time setting). Used in Assist/Control mode.
F-4
User’s Manual
Pressure Support (P Support)
Augmentation of the patient’s ventilation synchronously with inspiratory effort until a preset pressure
is met. Pressure is maintained until inspiratory flow is reduced to a percentage of peak flow that
depends on the exhalation sensitivity setting for the inspiration, when the ventilator cycles into
exhalation. Available in Spontaneous mode.
PSI
Pounds Per Square Inch.
PSV (Pressure Support Ventilation)
Pressure support ventilation.
Rebreathing
The patient breathes his/her exhaled gas.
Respiration rate
The number of breath cycles (inspiration + expiration) completed within one minute. Normal resting
adult respiratory rates are from 12 – 20 breaths per minute (bpm).
RESTART/SRVC
This is an alarm message. If the message “*IF PERSISTS RESTART/SRVC” occurs, restart the ventilator. If
the alarm condition is not cleared, call a service representative.
Rise Time
This determines how the target pressure will be reached, and indirectly defines the minimum
inspiration time.
Rtot
Parameter measured by the ventilator equal to the total number of breaths per minute (bpm).
Sensitivity
This adjustable parameter determines the amount of inspiratory effort required by the patient before
the ventilator delivers an assisted breath, or demands flow in the case of a spontaneous breath.
The Puritan Bennett™ 520 Ventilator is pressure-triggered, with sensitivity levels in the range from 1P
to 5: the lower the number, the more sensitive the trigger.
Spont Cyc (Spontaneous Cycling)
This is the percentage of ventilation cycles initiated by the patient over the previous 24 hour period.
Spontaneous
A ventilation mode that delivers assisted breaths only. Spontaneous mode does not provide breaths if
the patient does not make an inspiratory effort greater than the sensitivity settings and there is no
apnea backup rate.
Standby
The operational mode of the ventilator where it is powered (power supply I/O button set to the 
I position), but is not ventilating the patient.
User’s Manual
F-5
Glossary
Vent Time (Ventilation Time)
The ventilation duration data is based on the patient counter and shows the total ventilation time in
hours and minutes over the previous 24 hour period.
Vt Target (Target volume)
The Vt Target feature enables the ventilator to reach a set volume of gas to be delivered to the patient
using a range of pressures in the pressure-based ventilation modes.
F-6
User’s Manual
Index
A
AC power
connecting to. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2
indicator. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5
AC power cable
disconnecting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-4
securing to ventilator . . . . . . . . . . . . . . . . . . . . . . . . . 4-3
AC POWER DISCONNECTION alarm message 3-8, 3-14
Accessories
cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2
Air circulation (Warning) . . . . . . . . . . . . . . . . . . . . .1-3, 4-1
Air inlet filter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-10
replacement interval . . . . . . . . . . . . . . . . . . . . . . . . . . 8-2
replacing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-1
Air inlet filter, replacing (figure) . . . . . . . . . . . . . . . . . . 8-2
Air outlet (antibacterial) filter
replacement interval . . . . . . . . . . . . . . . . . . . . . . . . . . 8-2
Air transport
Air transportation standard . . . . . . . . . . . . . . . . . . A-13
use on commercial aircraft . . . . . . . . . . . . . . . . . . . . 2-1
Alarm levels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2
Alarm Logs menu
dismissing automatically . . . . . . . . . . . . . . . . . . . . . . 3-5
dismissing manually . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5
Alarm messages
AC POWER DISCONNECTION . . . . . . . . . . . . 3-8, 3-14
APNEA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-8, 3-14
BATTERY FAULT1 . . . . . . . . . . . . . . . . . . . 3-8, 3-14, 6-4
BATTERY FAULT2 . . . . . . . . . . . . . . . . . . . . . . . 3-8, 3-14
BUZZER FAULT1 . . . . . . . . . . . . . . . . . . . . . . . . 3-8, 3-15
BUZZER FAULT2 . . . . . . . . . . . . . . . . . . . . . . . . 3-8, 3-15
BUZZER FAULT3 . . . . . . . . . . . . . . . . . . . . . . . . 3-8, 3-15
BUZZER FAULT4 . . . . . . . . . . . . . . . . . . . . . . . . 3-9, 3-15
BUZZER LOW BATTERY . . . . . . . . . . . . . . . . . . 3-8, 3-15
CHECK BATTERY CHARGE . . . . . . . . . . . . . . . 3-9, 3-15
CHECK EXH VALVE . . . . . . . . . . . . . . . . . . . . . . 3-9, 3-15
CHECK EXH VALVE PRESSURE. . . . . . . . . . . . 3-9, 3-15
CHECK PROXIMAL LINE1 . . . . . . . . . . . . . . . . 3-9, 3-16
CHECK REMOTE ALARM . . . . . . . . . . . . . . . . . 3-9, 3-16
CHECK SETTINGS. . . . . . . . . . . . . . . . . . . . . . . . 3-9, 3-16
CONNECT VALVE OR CHANGE PRESS . . . 3-10, 3-16
CONTROLLED CYCLES. . . . . . . . . . . . . . . . . . 3-10, 3-16
COOLING FAN . . . . . . . . . . . . . . . . . . . . . . . . . 3-10, 3-16
DC POWER DISCONNECTION . . . . . . 3-10, 3-16, 4-6
DEVICE FAULT 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-10
DEVICE FAULT10 . . . . . . . . . . . . . . . . . . . . . . . 3-10, 3-17
DEVICE FAULT11 . . . . . . . . . . . . . . . . . . . . . . . 3-10, 3-17
DEVICE FAULT12 . . . . . . . . . . . . . . . . . . . . . . . 3-10, 3-17
DEVICE FAULT13 . . . . . . . . . . . . . . . . . . . . . . . 3-10, 3-17
User’s Manual
DEVICE FAULT3 . . . . . . . . . . . . . . . . . . . . . . . . 3-10, 3-16
DEVICE FAULT5 . . . . . . . . . . . . . . . . . . . . . . . . 3-10, 3-16
DEVICE FAULT7 . . . . . . . . . . . . . . . . . . . . . . . . 3-10, 3-16
DEVICE FAULT9 . . . . . . . . . . . . . . . . . . . . . . . . 3-10, 3-17
EMPTY BATTERY . . . . . . . . . . . . . . . . . . .3-11, 3-17, 6-4
HIGH INT TEMP COOL VENT . . . . . . . . . . . . 3-11, 3-17
HIGH LEAKAGE . . . . . . . . . . . . . . . . . . . . . . . . 3-11, 3-18
HIGH PRESSURE. . . . . . . . . . . . . . . . . . . . . . . . 3-11, 3-19
HIGH RATE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-11, 3-19
HIGH VTI. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-11, 3-18
HIGH/LOW BATTERY TEMP . . . . . . . . . . . . . 3-11, 3-18
INTENTIONAL VENT STOP . . . . . . . . . . . . . . 3-11, 3-19
KEYPAD FAULT . . . . . . . . . . . . . . . . . . . . . . . . 3-12, 3-19
LOW BATTERY . . . . . . . . . . . . . . . . . . . . .3-12, 3-19, 6-4
LOW VTl . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-12, 3-19
NO PROXIMAL LINE2 . . . . . . . . . . . . . . . . . . . 3-12, 3-19
OCCLUSION CHECK CIRCUIT. . . . . . . . . . . . 3-12, 3-20
PATIENT DISCONNECTION . . . . . . . . . . . . . 3-12, 3-20
POWER FAULT . . . . . . . . . . . . . . . . . . . . . . . . . 3-13, 3-20
POWER SUPPLY LOSS . . . . . . . . . . . . . . . . . . 3-13, 3-20
PRES SENS FLT1. . . . . . . . . . . . . . . . . . . . . . . . 3-13, 3-20
PROX SENS FLT2 . . . . . . . . . . . . . . . . . . . . . . . 3-13, 3-20
REMOVE VALVE CPAP MODE . . . . . . . . . . . 3-13, 3-20
REMOVE VALVE OR CHANGE PRES . . . . . . 3-13, 3-20
SOFTWARE VERSION ERROR . . . . . . . . . . . . 3-13, 3-21
TURB OVERHEAT . . . . . . . . . . . . . . . . . . . . . . . 3-13, 3-21
UNKNOWN BATTERY . . . . . . . . . . . . . . . . . . . 3-13, 3-21
Alarm tests
Involuntary stop test . . . . . . . . . . . . . . . . . . . . . . . . . . C-3
Alarms
display of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3
Level of priority . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2
Logs menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4
menu. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-8
NO DATA message . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4
overview of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-8
re-activating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-7
resetting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6
silencing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5
tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-1
Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-14
Alarms and troubleshooting . . . . . . . . . . . . . . . . . . . . . 3-1
Alarms tests
continuing pressure . . . . . . . . . . . . . . . . . . . . . . . . . . C-2
low pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-1
power failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-1
Alarms, utilisation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Alarms, ventilation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Antibacterial filter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-11
Index-1
Index
APNEA alarm message . . . . . . . . . . . . . . . . . . . . . .3-8, 3-14
Audible alarms
silencing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5
B
Back panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-5
BATTERY FAULT1 alarm message. . . . . . . 3-8, 3-14, 6-4
BATTERY FAULT2 alarm message. . . . . . . . . . . .3-8, 3-14
Battery, internal
capacity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-1
indicator, front panel (figure). . . . . . . . . . . . . . . . . . 6-3
operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-2
reserve capacity display, ventilation running
(figure). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-3
reserve capacity display, ventilation stopped
(figure). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-3
reserve capacity, displayed. . . . . . . . . . . . . . . . . . . . 6-2
symbol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-2
Beep . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5
Breathing Circuit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-6
BUZZER FAULT1 alarm message. . . . . . . . . . . . .3-8, 3-15
BUZZER FAULT2 alarm message. . . . . . . . . . . . .3-8, 3-15
BUZZER FAULT3 alarm message. . . . . . . . . . . . .3-8, 3-15
BUZZER FAULT4 alarm message. . . . . . . . . . . . .3-9, 3-15
BUZZER LOW BATTERY alarm message . . . . . .3-8, 3-15
C
Capacity of the battery. . . . . . . . . . . . . . . . . . . . . . . . . . . 6-1
Carbon dioxide
risk of inhalation and suffocation . . . . . . . . . . . . . . 5-7
Carrying bag, ventilator (figure) . . . . . . . . . . . . . . . . . . D-1
CHECK BATTERY CHARGE alarm message. . . .3-9, 3-15
CHECK EXH VALVE alarm message . . . . . . . . . .3-9, 3-15
CHECK EXH VALVE PRESSURE alarm message3-9, 3-15
CHECK PROXIMAL LINE1 alarm message. . . . .3-9, 3-16
CHECK REMOTE ALARM alarm message . . . . .3-9, 3-16
CHECK SETTINGS alarm message . . . . . . . . . . . .3-9, 3-16
Classification of device. . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3
Cleaning
accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2
solutions and products, approved . . . . . . . . . . . . . 7-1
ventilator. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1
CONNECT VALVE OR CHANGE PRESS alarm message. .
3-10, 3-16
Connecting to
AC power. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2
DC power . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-4
oxygen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-13
oxygen supply (figure) . . . . . . . . . . . . . . . . . . . . . . . 4-14
the oxygen supply . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-13
Consumables
replacement intervals. . . . . . . . . . . . . . . . . . . . . . . . . 8-2
Continuing pressure test. . . . . . . . . . . . . . . . . . . . . . . . . C-2
Contraindications
against use of ventilator . . . . . . . . . . . . . . . . . . . . . . 2-2
CONTROLLED CYCLES alarm message . . . . . 3-10, 3-16
Index-2
COOLING FAN alarm message. . . . . . . . . . . . . 3-10, 3-16
D
DC power
cable
connecting to ventilator. . . . . . . . . . . . . . . . . . . . 4-5
disconnecting from ventilator . . . . . . . . . . . . . . 4-6
connecting to. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-4
DC POWER DISCONNECTION alarm message . . . .3-10,
3-16, 4-6
Device classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3
DEVICE FAULT 11 alarm message. . . . . . . . . . . . . . . . 3-10
DEVICE FAULT10 alarm message . . . . . . . . . . 3-10, 3-17
DEVICE FAULT11 alarm message . . . . . . . . . . 3-10, 3-17
DEVICE FAULT12 alarm message . . . . . . . . . . 3-10, 3-17
DEVICE FAULT13 alarm message . . . . . . . . . . . . . . . . 3-10
DEVICE FAULT3 alarm message . . . . . . . . . . . 3-10, 3-16
DEVICE FAULT5 alarm message . . . . . . . . . . . 3-10, 3-16
DEVICE FAULT7 alarm message . . . . . . . . . . . 3-10, 3-16
DEVICE FAULT9 alarm message . . . . . . . . . . . 3-10, 3-17
Display
of alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3
Dual Bag (figure). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-2
E
Electrical specifications . . . . . . . . . . . . . . . . . . . . . . . . . . A-1
Electromagnetic compatibility
and mobile/portable communications equipment .
4-2
Electromagnetic emissions
and use of accessories . . . . . . . . . . . . . . . . . . . . . . . . 4-2
EMPTY BATTERY alarm message. . . . . . .3-11, 3-17, 6-4
Environment
suitable for use of ventilator. . . . . . . . . . . . . . . . . . . 2-1
Environmental specifications. . . . . . . . . . . . . . . . . . . . . A-6
F
FAA requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
Faults, technical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Filters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-10
air inlet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-10
antibacterial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-11
Front panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-4
H
HIGH INT TEMP COOL VENT alarm message 3-11, 3-17
HIGH LEAKAGE alarm message . . . . . . . . . . . . 3-11, 3-18
HIGH PRESSURE alarm message . . . . . . . . . . . 3-11, 3-19
HIGH RATE alarm message . . . . . . . . . . . . . . . . 3-11, 3-19
HIGH VTI alarm message . . . . . . . . . . . . . . . . . . 3-11, 3-18
HIGH/LOW BATTERY TEMP alarm message. 3-11, 3-18
Holes, air circulation . . . . . . . . . . . . . . . . . . . . . . . . .1-3, 4-1
Hot surfaces
ventilator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-9
Humidifier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-11
User’s Manual
Index
I
I/O switch (figure). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-2
Ignition sources (warning) . . . . . . . . . . . . . . . . . . . . . . . 4-1
Indications for use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
Indicator
VENT STDBY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-2
Indicators
AC power. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5
INTERNAL BATTERY . . . . . . . . . . . . . . . . . . . . . . .6-2, 6-5
Inhalation port closeup (figure) . . . . . . . . . . . . . . . . . . 4-8
Installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1
placing the ventilator . . . . . . . . . . . . . . . . . . . . . . . . . 4-1
Installation and Assembly . . . . . . . . . . . . . . . . . . . . . . . . 4-1
INTENTIONAL VENT STOP alarm message. . 3-11, 3-19
Internal battery
charging (Warning) . . . . . . . . . . . . . . . . . . . . . . .4-2, 6-5
maintenance (none required) . . . . . . . . . . . . . . . . . 8-3
recharging. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-4
replacement interval . . . . . . . . . . . . . . . . . . . . . . . . . . 8-3
storing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5
test interval. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-3
testing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-4, C-2
INTERNAL BATTERY indicator. . . . . . . . . . . . . . . . . . . . . 6-5
Involuntary stop test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-3
NO PROXIMAL LINE2 alarm message . . . . . . 3-12, 3-19
Notes
definition of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
Nurse Call cable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-18
Nurse call system
connecting the cable to the ventilator . . . . . . . . 4-18
O
OCCLUSION CHECK CIRCUIT alarm message3-12, 3-20
OCCULSION CHECK CIRCUIT alarm message . . . . . 3-20
Operational verification checklist. . . . . . . . . . . . . . . . . B-1
Operator/Users
targeted for use of ventilator . . . . . . . . . . . . . . . . . . 2-1
O-ring, oxygen coupler (Caution). . . . . . . . . . . . . . . . 4-14
Oxygen
connecting the supply . . . . . . . . . . . . . . . . . . . . . . . 4-13
connector stud . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-14
disconnecting the supply from the ventilator . 4-14
enrichment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
rear panel connector (figure) . . . . . . . . . . . . . . . . . 4-13
special coupler . . . . . . . . . . . . . . . . . . . . . . . . 4-13, 4-14
supply connection . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-13
using medical-grade only (Warning) . . . . . . . . . . 4-13
P
K
Keyboard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-6
KEYPAD FAULT alarm message . . . . . . . . . . . . 3-12, 3-19
Keys
VENTILATION ON/OFF. . . . . . . . . . . . . . . . . . . . . . . . . 5-2
L
Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-15
Liquids
avoid ingress into ventilator (Warning) . . . . . . . . 1-2
Logs menu
alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4
LOW BATTERY alarm message . . . . . . . . 3-12, 3-19, 6-4
Low pressure test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-1
LOW VTl alarm message. . . . . . . . . . . . . . . . . . . 3-12, 3-19
M
Machine counter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-2
Maintenance
schedule, recommended . . . . . . . . . . . . . . . . . . . . . . 8-2
Manufacturer’s declaration specifications. . . . . . . . . A-7
Markings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-11, 1-15
Menu
alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-8
ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-7
Monitored parameters
specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-3
N
NO DATA message, Alarm Logs screen . . . . . . . . . . . 3-4
User’s Manual
Parts and accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-1
Patient
outlet port connections (figure) . . . . . . . . . . . . . . . 4-8
Patient circuit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-6
attaching to ventilator . . . . . . . . . . . . . . . . . . . . . . . . 4-6
choosing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-6
installing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-7
length and internal volume . . . . . . . . . . . . . . . . . . . 4-9
replacement interval . . . . . . . . . . . . . . . . . . . . . . . . . . 8-2
single limb, connecting . . . . . . . . . . . . . . . . . . .4-7, 4-8
Patient counter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-2
PATIENT DISCONNECTION alarm message . 3-12, 3-20
Patients
targeted for use of ventilator . . . . . . . . . . . . . . . . . . 2-1
Performance specifications . . . . . . . . . . . . . . . . . . . . . . A-3
Physical specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1
Placing the ventilator (installing) . . . . . . . . . . . . . . . . . 4-1
Pneumatic specifications. . . . . . . . . . . . . . . . . . . . . . . . . A-7
Power failure test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-1
POWER FAULT alarm message . . . . . . . . . . . . 3-13, 3-20
Power On Self Test (POST). . . . . . . . . . . . . . . . . . . . . . . . 5-2
POWER SUPPLY LOSS alarm message. . . . . . 3-13, 3-20
Precautions for use
electromagnetic interference . . . . . . . . . . . . . . . . 1-11
Precautions for use, cautions
general . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-11
installation
environment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-11
maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-11
Precautions for use, warnings
general . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
Index-3
Index
maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-11
oxygen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-11
settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-11
Preference menu
displaying . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-4
PRES SENS FLT1 alarm message . . . . . . . . . . . 3-13, 3-20
Problems. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-21
PROX SENS FLT2 alarm message . . . . . . . . . . 3-13, 3-20
R
Range, resolution, and accuracy specifications. . . . A-4
Reactivating alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-7
Recharging the internal battery . . . . . . . . . . . . . . . . . . 6-4
REMOVE VALVE CPAP MODE alarm message. . . . . 3-13,
3-20
REMOVE VALVE OR CHANGE PRES alarm message . . . .
3-13, 3-20
Repairing the ventilator
qualified personnel only (Warning) . . . . . . . . 8-1, 8-2
Replacement intervals
air inlet filter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-2
air outlet (antibacterial) filter . . . . . . . . . . . . . . . . . . 8-2
consumables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-2
patient circuit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-2
Replacing
air inlet filter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-1
Resetting alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6
RESTART . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-10
Risk of fire (warning) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1
S
Safety
onboard alarm system . . . . . . . . . . . . . . . . . . . . . . . . 2-2
Service assistance information . . . . . . . . . . . . . . . . . . . 8-3
SOFTWARE VERSION ERROR alarm message3-13, 3-21
Specifications
electrical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1
environmental. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-6
manufacturer’s declaration. . . . . . . . . . . . . . . . . . . . A-7
monitored parameters . . . . . . . . . . . . . . . . . . . . . . . . A-3
performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-3
physical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1
pneumatic. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-7
range, resolution, and accuracy . . . . . . . . . . . . . . . A-4
standards compliance and IEC classification . . A-12
ventilator. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1
Standards, compliance, and IEC classification
specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-12
Starting ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6
Stopping ventilation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-7
Storing the internal battery . . . . . . . . . . . . . . . . . . . . . . 6-5
Stud, oxygen connector . . . . . . . . . . . . . . . . . . . . . . . . 4-14
T
Technical faults. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Testing
Index-4
internal battery . . . . . . . . . . . . . . . . . . . . . . . . . . 6-4, C-2
Transfer continuously, USB Memory Device. . . . . . . 5-4
Transfer Trends USB Memory Device . . . . . . . . . . . . . 5-5
Transport, emergency
ventilator not intended for . . . . . . . . . . . . . . . . . . . . 2-2
Troubleshooting
alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-14
other problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-21
TURB OVERHEAT alarm message . . . . . . . . . . 3-13, 3-21
Turning off the ventilator . . . . . . . . . . . . . . . . . . . . . . . . 5-9
Turning on the ventilator . . . . . . . . . . . . . . . . . . . . . . . . 5-1
U
UNKNOWN BATTERY alarm message . . . . . . 3-13, 3-21
Unpacking and preparing the ventilator . . . . . . . . . . D-1
USB Memory Device
Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-3
Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-3
Supported formats. . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-3
Transfer continuously . . . . . . . . . . . . . . . . . . . . . . . . . 5-4
Transfer Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5
USB Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-4
USB Menu parameters . . . . . . . . . . . . . . . . . . . . . . . . 5-3
V
VENT STDBY indicator. . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-2
Ventilation
menu. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-7
starting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6
stopping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-7
Ventilation modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
VENTILATION ON/OFF key . . . . . . . . . . . . . . . . . . . . . . . 5-2
Ventilator
carrying bag (figure) . . . . . . . . . . . . . . . . . . . . . . . . . . D-1
cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1
connecting the nurse call cable. . . . . . . . . . . . . . . 4-18
connections, proper (warning) . . . . . . . 1-2, 4-1, 4-6
failure of. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-9
filters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-10
mounting on a wheelchair . . . . . . . . . . . . . . . . . . . 4-16
parts and accessories . . . . . . . . . . . . . . . . . . . . . . . . . E-1
patient outlet port connections (figure). . . . . . . . 4-8
potentially hot surfaces . . . . . . . . . . . . . . . . . . . . . . . 5-9
specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1
symbols and markings . . . . . . . . . . . . . . . . . . . . . . . 1-11
turning off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-9
turning on . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1
unpacking and preparation . . . . . . . . . . . . . . . . . . . D-1
Ventilator, and liquid ingress (Warning). . . . . . . . . . . 1-2
W
Warnings
definition of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
general list of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
Warranty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
Welcome Menu screen
User’s Manual
Index
display of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-2
skipping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-3
Wheelchair
mounting the ventilator onto . . . . . . . . . . . . . . . . 4-16
User’s Manual
Index-5
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10056025 Rev C 03/2012
COVIDIEN, COVIDIEN with logo and Covidien logo are U.S.
and/or internationally registered trademarks of Covidien
AG.
™ Trademarks of a Covidien company.
™* Trademarks of their respective owner.
© 2012 Covidien.
Covidien llc, 15 Hampshire Street, Mansfield, MA
02048 USA.
Covidien Ireland Limited, IDA Business &
Technology Park,Tullamore.

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www.covidien.com
[T] 1-800-635-5267
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