• Additional equipment connected to medical electrical equipment must comply with the respective IEC or ISO standards. Furthermore, all configurations must comply with the requirements for medical electrical systems

(see IEC 60601-1-1 or clause 16 of the 3Ed. of

IEC 60601-1, respectively). Anybody connecting additional equipment to medical electrical equipment configures a medical system and is therefore responsible that the system complies with the requirements for medical electrical systems. Also be aware that local laws take priority over the above mentioned requirements. If in doubt, consult your local representative or Technical Support. To prevent possible patient injury, do not block the holes between the HAMILTON-G5’s To patient and From patient ports. These holes are vents for the overpressure and ambient valves.

• To prevent back pressure and possible patient injury, do not attach parts not expressly recommended by HAMILTON MEDICAL to the exhaust port of the exhalation valve housing (for example, spirometer, tube, or other device).

• To prevent interrupted operation of the HAMIL-

TON-G5 or any accessories, use only accessories or cables that are expressly stated in this manual and supplied by HAMILTON MEDICAL.

• To prevent interrupted operation of the

HAMILTON-G5 due to electromagnetic interference, avoid using it adjacent to or stacking other devices on it. If adjacent or stacked use is necessary, verify the HAMILTON-

G5’s normal operation in the configuration in which it will be used.

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• To prevent possible personal injury and equipment damage use two persons to lift when crossing thresholds and ensure the device is attached securely to the trolley or shelf with screws.

CAUTION

• To prevent ventilator components from overheating, do not obstruct the cooling fan vents.

• To prevent possible equipment damage, avoid overloading the HAMILTON-G5’s basket and tray or placing objects on the HAMILTON-G5 that might compromise its stability.

• To prevent possible equipment damage, lock the trolley’s wheels when parking the ventilator

NOTE:

• Before using the ventilation for the first time,

HAMILTON MEDICAL recommends that you clean its exterior and sterilize its components as described in

Chapter 11, Maintenance.

• To electrically isolate the HAMILTON-G5 circuits from all poles of the supply mains simultaneously, disconnect the mains plug.

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2.2 Installing and positioning the Ventilation Cockpit

2.2.1 Mounting the Ventilation Cockpit

CAUTION

Handle the touchscreen with care. Do not pull on or place stress on the cable.

With the correct mounting rails you can mount the Ventilation

Cockpit to the top, front, or side of the ventilation unit or to

a hospital rail system (Figure 2-1

). Dismount and reinstall the cockpit as follows:

1. If necessary, disconnect the Cockpit from the ventilation unit by pushing on the cable release tab with a small screw-

2. Dismount the Cockpit by loosening the knob in the clamp assembly (Figure

2-3

3. Reinstall the Cockpit by positioning it over the rail or top mounting assembly and tightening the knob. Reconnect the cable as necessary.

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Figure 2-1. Ventilation Cockpit mounting positions

1 Front mounting on rail

2 Top mounting

3 Hospital rail mounting

4 Side mounting for use on shelf or pendant installation

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Figure 2-2. Disconnecting the Ventilation Cockpit

1 Ventilation Cockpit cable

2 Cable release tab

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2 Preparing for ventilation

Figure 2-3. Mounting the Ventilation Cockpit

2.2.2 Adjusting the Ventilation Cockpit (tilt and swivel)

Adjust the position of the Ventilation Cockpit by releasing either the tilt or swivel handle, positioning the Cockpit as

desired, then locking the handle (Figure 2-4

and Figure

2-5

2-6

Figure 2-4. Tilting the Ventilation Cockpit

1 Tilt assembly locking handle

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Figure 2-5. Swiveling the Ventilation Cockpit

1 Swivel assembly locking handle

2.3 Installing the patient tubing support arm

Install the patient tubing support arm on either side of the

HAMILTON-G5 (Figure

2-6

). Attach the patient tubing support arm only on the straight parts of the rail.

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Figure 2-6. Installing the patient tubing support arm

1 Support arm

2 Support arm bracket

2.4 Installing the humidifier

CAUTION

To prevent possible patient injury and possible water damage to the HAMILTON-G5, make sure the humidifier is set to appropriate temperature and humidification settings.

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NOTE:

• Once installed, you can configure and monitor the

HAMILTON-H900 humidifier data and main settings directly on the ventilator screen, in the System ->

Humidifier window. You can also access the

Humidifier window using the Quick Access button on the main screen. For details, see Section

3.6

• The integrated humidifier is not available in all markets. Check with your distributor to determine availability.

• Before proceeding with installation, be sure to read the HAMILTON-H900 Operating Instructions, and the installation/configuration information in this section and in Chapter 3, Hardware Options.

Installation involves the following steps:

1. Connecting the power cord, and the communication cable between the humidifier and the ventilator. See Section

2.4.1

2. Installing the humidifier onto a mounting bracket. See Sec-

tion 2.4.1

3. Configuring the humidifier. See the HAMILTON-H900

Operating Instructions.

For details on the integration between the HAMILTON-H900 humidifier and the ventilator, see Section

3.6

2.4.1 Connecting and attaching the humidifier

NOTE:

When connecting the HAMILTON-H900 humidifier to the optional internal power socket on the ventilator, be sure to connect the grounding cable to the potential equalization terminal on the back of the ventilator and to a grounding connection in the ICU.

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2 Preparing for ventilation

The power and communication cable sockets are located on the bottom of the humidifier. The mounting bracket is on the back.

Two options are available for mounting the humidifier to the trolley:

• A fixed mount on the front of the trolley

• An adjustable-height mount on the side of the trolley

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Figure 2-7. Back of humidifier

1 Mounting bracket

2 AC mains power socket

3 COM port and communications cable (see detail in

Figure 2-8 )

4 Potential equalization terminal

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Figure 2-8. Power, communication connections (bottom)

1 AC mains power socket

2 COM port and communications cable

1. Attach the power cord to the power socket on the bottom of the humidifier. For details on AC power requirements, refer to the HAMILTON-H900 Operating Instructions. See

Figure

2-8 .

2. Attach the communication cable to the COM port on the bottom of the humidifier. See Figure

2-8 .

3. Attach the humidifier to the trolley or other designated location by sliding the bracket on the rear of the humidifier onto the mounting bracket from the top down.

For details on attaching the adjustable-height mount to the trolley, see the Adjustable Humidifier Kit Installation Guide .

4. Connect the humidifier power cable to AC mains power.

For details on AC power requirements, refer to the HAMIL-

TON-H900 Operating Instructions.

5. Connect the communications cable to the RS-232 port on the ventilator. See Figure

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Figure 2-9. HAMILTON-900 communications cable connected to RS-232 port on ventilator

For details on setting up the water chamber and connecting the rest of the humidifier tubes to the ventilator, see the

HAMILTON-H900 Operating Instructions.

For details on the integration between the HAMILTON-H900 humidifier and the ventilator, see Section

3.6

2.5 Installing the modules (CO

, SpO

, Aeroneb,

HAMILTON-H900 humidifier)

Install a module (Figure

2-10 ) by pushing it into its slot until the

connector engages and is locked.

Remove a module by pressing the release handle, then pulling the module out by its handle until the module disengages from the connector.

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Figure 2-10. CO

, SpO

, Aeroneb modules

1 CO

or SpO

connector

2 Aeroneb connector (Aeroneb/HAMILTON-H900 humidifier

module not shown)

2.6 Verifying the oxygen cell installation

This device uses an integrated oxygen cell to monitor the delivered oxygen concentration. Before operating the ventilator, verify the cell is present and properly connected (Figure

2-11 ).

If a cell is not present, install one according to the instructions

found in section 11.3.3

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Figure 2-11. Check for the oxygen cell

1 Oxygen cell

2.7 Installing the patient breathing circuit

WARNING

• To minimize the risk of bacterial contamination or physical damage, handle bacteria filters with care.

• To prevent patient or ventilator contamination, always use a bacteria filter between the ventilator and the inspiratory limb of the patient breathing circuit.

• To reduce the risk of fire, use only breathing circuits intended for use in oxygen-enriched environments. Do not use antistatic or electrically conductive tubing.

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NOTE:

• For optimal ventilator operation, use HAMILTON

MEDICAL breathing circuits or other circuits that meet the specifications given in Appendix A, Specifications. When altering the HAMILTON MEDICAL breathing circuit configurations (for example, when adding accessories or components), make sure not to exceed these inspiratory and expiratory resistance values of the ventilator breathing system, as required by EN 794-1/IEC 60601-2-12: adult, 6 cmH2O at

60 l/min; pediatric, 6 cmH2O at 30 l/min; and infant,

6 cmH2O at

5 l/min).

• Any bacteria filter, HME, or additional accessories in the expiratory limb may substantially increase flow resistance and impair ventilation and lead to alarms.

• To ensure that all breathing circuit connections are leak-tight, perform the tightness test every time you install a circuit or change a circuit part.

• Regularly check the water traps and the breathing circuit hoses for water accumulation. Empty as required.

• For neonatal patients with body weights > 7 kg, you may want to select the pediatric patient type. This prevents the need to change circuits and calibrate the flow sensor should you later decide that your patient requires more support.

• Do not combine the Infant CO

airway adapter and the adult flow sensor. Artifacts during the measurement are possible.

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2 Preparing for ventilation

Install the breathing circuit as follows:

1. Determine the patient type (adult, pediatric or neonatal)

from Table 2-1

. Select the correct breathing circuit parts for your patient. Note that the type of CO

airway adapter depends on tracheal tube size.

Table 2-1. Breathing circuit parts and patient types

Patient height

IBW

(kg)

Tracheal tube ID

(mm)

Breathing circuit tube OD

(mm)

Flow sensor

Infant

airway adapter

Infant < 50 cm

(19 in.)

30 to

150 cm

(11 to

59 in.)

> 130 cm

(51 in.)

≤ 10 ≤ 5

3 to

3 to 7

> 30 ≥ 5

Pediatric/ adult

Patient type

Neonatal

Pediatric

Adult

2. Assemble the patient breathing circuit. Figure

2-12 through

Figure

2-14 show four typical circuit configurations; for

ordering information, contact your HAMILTON MEDICAL representative. Follow the specific guidelines for the different parts.

3. Properly position the breathing circuit after assembly. Make sure the hoses will not be pushed, pulled, or kinked during the patient’s movement, nebulization, or other procedures.

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Figure 2-12. Patient breathing circuit for use with heater wire (pediatric/adult)

1 Paux connector

2 Nebulizer outlet

3 Flow sensor connectors

4 From patient

5 Expiratory valve membrane/ valve cover

6 Expiratory limb

7 CO

sensor

8 Flow sensor

9 CO

airway adapter

10 Y-piece

11 Heater wire

12 Humidifier

13 Inspiratory limb

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2 Preparing for ventilation

14 Water trap/heater wire

15 Inspiratory filter

16 To patient

2-18

Figure 2-13. Patient breathing circuit for use with heater wire (neonatal)

1 Paux connector

2 Nebulizer outlet

3 Flow sensor connectors

4 From patient

5 Expiratory valve membrane/ valve cover

6 Expiratory limb

7 CO

sensor

8 Flow sensor

9 15M x 15F adapter

10 CO

airway adapter

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11 Y-piece

12 Heater wire

13 Humidifier

14 Inspiratory limb

15 Water trap/heater wire

16 Inspiratory filter

17 To patient

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Figure 2-14. Patient breathing circuit for use with HME

1 Paux connector

2 Nebulizer outlet

3 Flow sensor connectors

4 From patient

5 Expiratory valve membrane/ valve cover

6 Expiratory limb

7 CO

sensor

8 Flow sensor

9 HME

10 CO

airway adapter

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11 Y-piece

12 Inspiratory limb

13 Inspiratory filter

14 To patient

Expiratory valve membrane :

NOTE:

Place the silicone membrane into the valve cover with the metal plate upward (Figure

2-15 ). The side that

is marked DOWN must be placed downward.

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Figure 2-15. Installing the expiratory valve membrane

1 Expiratory valve membrane

2 Expiratory valve cover

Position the cover and twist clockwise into place (Figure

2-16

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Figure 2-16. Installing the expiratory valve cover

WARNING

To prevent inaccurate flow sensor readings, make sure the flow sensor is correctly installed:

• The flow sensor tubings must not be bent.

• The flow sensor tubings must be secured with clamp (included with flow sensor).

• Use HAMILTON MEDICAL flow sensors only.

Flow sensor : Insert a flow sensor for the proper patient type between the Y-piece of the breathing circuit and the patient connection (Figure

2-17 ). Connect the blue and colorless tubes

to the flow sensor connectors in the front panel. The blue tube goes to the blue connector. The colorless tube goes to the silver connector.

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Figure 2-17. Installing the flow sensor

sensor and airway adapter (optional): Refer to Chapter 3.

2.8 Using the auxiliary pressure (Paux) measurement

WARNING

• To use the pressure at the end of the tracheal tube as the Paux pressure input, you must have the rinse flow enabled (disabled by default).

This must be done by an authorized HAMILTON

MEDICAL service person. When the rinse flow is enabled, the device generates a weak flow of about 9 ml/min in the patient’s direction to help keep the lumen of the carina clear of mucus.

• When the rinse flow is enabled, an esophageal balloon CANNOT be used to provide the Paux pressure input. If the rinse flow is enabled, the esophageal balloon can overinflate, resulting in possible patient injury.

The device uses the airway pressure (Paw) as it’s standard pressure input. You can reassign the device’s pressure input, so monitored numeric parameters are based on a pressure from a different site, such as the esophageal balloon catheter end

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of the tracheal tube. (This auxiliary pressure input can be particularly useful when conducting scientific studies.) For ARDS patients use the esophageal balloon catheter to determine the trans-pulmonary pressure. PEEP can be adjusted to maintain oxygenation and this action prevents damage to the lungs. You must connect the site to the ventilator through the Paux connector to use the auxiliary pressure input. To make the connection, use at minimum of 1 m (of 3 mm ID) tubing (flow sensor tubing works) for the connection. You must also set up the device’s monitoring functions to recognize the Paux input; otherwise, the ventilator will continue to use the standard

Paw input.

2.9 Using an expiratory filter

WARNING

• The use of an expiratory filter can lead to a significant increase in expiratory circuit resistance. Excessive expiratory circuit resistance can compromise ventilation and increased patient work of breathing or

AutoPEEP or both.

• Nebulization of drugs can cause an occlusion and an increased resistance of the filter.

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NOTE:

Monitored parameters for increased expiratory resistance are not specific to the breathing circuit and may indicate increased patient airway resistance and/or increased resistance of the artificial airway (if used).

Always check the patient and confirm adequate ventilation.

An expiratory filter is not required on the HAMILTON-G5, but you may use one according to your institution’s protocol. An expiratory filter is not required, because the expiratory valve design prevents internal ventilator components from contact with the patient’s exhaled gas.

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2 Preparing for ventilation

If you do use an expiratory filter:

1. Place it on the patient side of the expiratory valve cover.

2. Remove any expiratory filter or HME during nebulization.

See the Warnings and Notes in this section for guidance.

3. You must monitor closely for increased expiratory circuit resistance.

An Exhalation obstructed alarm can also indicate excessive expiratory circuit resistance. If the Exhalation obstructed alarm happens repeatedly, then remove the expiratory filter immediately. If you suspect increased expiratory circuit resistance, remove the expiratory filter or install a new filter to eliminate it as a potential cause.

2.10 Connecting to AC power

WARNING

• To minimize the risk of electrical shock, plug the ventilator power cord into a grounded AC power receptacle. It is the hospital’s responsibility to ensure that the receptacle is properly grounded (earth).

• To ensure grounding reliability, use a special hospital-grade receptacle (USA only).

NOTE:

To prevent unintentional disconnection of the power cord, make sure it is well seated into the ventilator’s socket and secured with the power cord retaining clip.

Connect the device to a grounded AC outlet using power of

100 to 240 Volt, 50/60 Hz. Always verify the reliability of the

AC outlet. The AC power symbol in the bottom right-hand corner of the screen is displayed with a frame around it. The

AC power LED on the ventilation unit will also be lit.

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2.11 Using the optional power strip

WARNING

• Connect only these devices to the power strip:

– HAMILTON MEDICAL VENTILAIRII medical air compressor

– HAMILTON-HC 180/200

– HAMILTON-H900 humidifier

– Fisher & Paykel MR 850 humidifier

– Aeroneb-Pro

• Connection of other electrical equipment to the power strip is responsibility of the operator to ensure that the power system complies with the requirements for medical electrical systems

(for details, see Section

2.1

) as well as local regulations.

• Do not connect additional auxiliary mains socket outlets or an extension cord to the system.

The device is optionally equipped with a power strip containing auxiliary mains socket outlets. These outlets can power up to three devices comprising the ventilator system.

2.12 Using the backup batteries

NOTE:

• The backup batteries are not intended to be a primary power source. They are intended for shortterm use only.

• HAMILTON MEDICAL recommends the ventilator’s batteries be fully charged before you begin to ventilate a patient. If the batteries are not fully charged you must pay close attention to the battery charge levels in the event the AC power fails.

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2 Preparing for ventilation

2.12.1 Introduction

Backup batteries, both the internal battery and the optional extended battery pack, protect the device from low or failure of AC power. When AC mains fail to provide power during ventilation, the ventilator power supply automatically switches to backup battery without an interruption in ventilation. An alarm sounds to signal the switchover. The alarm will continue sound until you silence the alarm. Silencing the alarm confirms operator notification of the power system change and resets the alarm.

When the device AC power supply is interrupted the ventilator shifts to the optional extended battery pack. If this is not available or adequately charged, the ventilator power supply will choose to switch to internal battery.

Important: The batteries power the ventilator until AC power is again adequate or until the batteries are depleted.

As a further safeguard, the device provides a “low-battery” alarm. The low-battery alarm is operated by a capacitor-driven buzzer that sounds for at least 2 minutes when either type of battery power is completely lost.

Both the internal and extended batteries power the ventilator for a minimum of 1 hour each (for new, fully charged batteries with the device at default settings and a 2 liter demonstration lung).

When the ventilator is connected to the AC mains power, the batteries are charged, with or without the ventilator power being switched ON.

The power source symbols are displayed in the bottom right-

hand corner of the screen (Figure 2-18

) indicating the available power sources. A frame around a symbol indicates the current ventilator power source (AC mains, internal battery, or extended battery).

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Figure 2-18. Electrical power symbols

1 Frame indicates current power source

2 AC mains symbol

3 Internal battery symbol

4 Extended battery symbol

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Observe the battery charge level before the ventilator is used on a patient, and before unplugging the ventilator for transport or other purposes.

• A green symbol indicates a fully charged battery.

• A red and green symbol indicates a partially charged battery.

• If a battery symbol is crossed out with a red X, the battery is discharged or defective.

If the batteries are not fully charged, recharge them by plugging in the ventilator for a minimum of 15 hours (for the internal battery) or 7 hours (for an extended battery pack), or until the battery charge level is 80 to 100%. If the internal battery is not fully charged at this time, have the ventilator serviced by authorized service personnel.

The extended battery pack requires a periodic recalibration.

Use the designated battery calibrator for the extended battery.

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2.12.2 Replacing the optional extended battery pack

CAUTION

Use HAMILTON MEDICAL batteries only.

Replace the extended battery pack as described below:

1. Open the ventilator’s front cover by grasping the indent on your right-hand side and swinging the front cover door open (Figure

2-19 ).

2. Press on the tab, and slide the extended battery pack out of the housing. When removed, replace with a freshly charged

battery pack (Figure 2-20

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Figure 2-19. To open the front cover

1 Indent for opening cover

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Figure 2-20. To remove the extended battery pack

1 Battery housing

2 Extended battery pack

3 Tab

2.13 Connecting gas supplies

WARNING

• Always check the status of the gas cylinders before using the HAMILTON-G5 during transport.

• Ensure the gas cylinders are equipped with pressure-reducing valves.

• To minimize the risk of fire, DO NOT use highpressure gas hoses that are worn or contaminated with combustible materials like grease or oil.

• To prevent possible hypoxia or death, connect the heliox gas supply containing at minimum of

20% oxygen.

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CAUTION

• To prevent damage to the ventilator, connect only clean, dry medical-grade gases. Inspect for water and particle build-up in the gas supply water traps before each use.

• To prevent heliox entering the wall supply, connect compressed air with a minimum pressure of 2.8 bar.

NOTE:

• When using a compressor with the device ventilator, connect a HAMILTON MEDICAL VENTILAIRII medical air compressor only.

• Use heliox blend of 78% (He)/ 22% (O

)! The 78/22 mixture is preferred, as it allows the maximum amount of helium to be used yet consumes less gas when used in conjunction with mechanical ventilation (80/20 and 79/21 mixtures are also permitted).

• Only use the HAMILTON MEDICAL mixer block with inlet fittings for oxygen, air and heliox.

• Select the appropriate gas source in the System ->

Gas source window. A mismatch of selected and actual source gas can result in inaccurate gas delivery and volume monitoring.

• After switching between air and heliox, it is recommended that you calibrate the flow sensor.

• After significant changes in oxygen concentration during heliox ventilation, it is recommended that you recalibrate the flow sensor.

• During heliox administration, O

monitoring is enabled and CANNOT be disabled.

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• Inspect heliox cylinder pressure, and keep the cylinder at a level sufficient for ventilation (> 2.8 bar

(280 kPa/41 psi)).

• To prevent under- or overheating during heliox therapy, use a patient circuit with heater wire and carefully monitor heated humidifier performance.

Heliox’s thermal conductivity, which is greater than that of nitrogen/oxygen mixtures, can affect the humidification device output. A febrile patient may transfer heat via the gas column to a proximal temperature sensor, leading to decreased humidifier output and desiccated airway secretions. In a heater wire breathing circuit, heat transfer from the patient can affect the heater wire output and result in increased condensation in the breathing circuit. In some humidifiers, you possibly need to reduce humidifier settings to prevent overheating of the breathing gas.

• Disconnect all gases if the device is not in use.

The device uses compressed air and oxygen (Table

A-3

). The gas fittings available are DISS, NIST or NF. Alternatively, you can select the heliox option in standby. The compressed gases can come from central gas supplies, from gas cylinders, or from the VENTILAIRII medical air compressor. The device’s universal trolley provides space for the compressor or two cylinders

(if you have the optional VENTILAIR II medical air compressor mounting kit or cylinder holder installed).

If you are using gases from cylinders, secure the cylinders to the trolley with the accompanying straps. Connect the gas hoses

to the device’s inlet fittings, shown in Figure 2-21

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2 Preparing for ventilation

Figure 2-21. HAMILTON-G5 inlet fittings

1 Oxygen inlet fitting

2 Heliox inlet fitting

3 Air inlet fitting

If you intend to use heliox, select the appropriate gas source in the System-> Gas source window. In standby, you can switch choices between air and heliox without exchanging the gas hoses.

2.14 Connecting to an external patient monitor or other device

NOTE:

All devices connected to the HAMILTON-G5 must be for medical use and meet the requirements of standard

IEC 60601-1.

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With the communications interface, you can connect your device to a patient monitor, to a PDMS or computer (via an

RS-232 port), or to a nurse call device. See Appendix I for details on the communications interface. Before connecting any other device, ensure your device is properly configured

(see Appendix J).

2.15 Starting up the ventilator

WARNING

To ensure the ventilator’s safe operation, always run the prescribed tests and calibrations before using the ventilator on a patient. If the ventilator fails any tests, remove it from clinical use immediately. DO NOT use the defective ventilator until necessary repairs are completed and all tests passed.

NOTE:

• To shut down the device in an orderly manner, avoid switching the power quickly OFF and ON. If the ventilator buzzer sounds continuously upon power ON, switch the power OFF, then wait for several seconds before switching the power ON again.

• If your device is new, be sure it has been properly configured for default language, ventilation philosophy, alarms, and others factors (see Appendix J).

• The Ventilation Cockpit must be connected to the ventilator unit.

1. Turn the ventilator power switch ON (Figure

2-22 ). The

ventilator will run a self-test. You will hear the emergency buzzer alarm momentarily activated.

The patient setup window load for a few moments (Figure

5-1 ).

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2 Preparing for ventilation

1 Power switch

Figure 2-22. Power switch

2. Run the required tests and calibrations listed in Table 4-1 ,

as described in Chapter 5, Setting up the ventilator.

3. Set up the ventilator as described in Section

5.2

2.16 Shutting down the ventilator

NOTE:

When you turn OFF the device, wait at least 2 seconds to permit an orderly shutdown before turning the ventilator back ON.

To shut down of the device, turn the power switch OFF.

Battery charging continues even when power is switched OFF, as long as the ventilator remains connected to AC mains.

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2.17 Ventilation cockpit navigation guidelines

Use the touch screen and the press-and-turn knob (referred to as the P&T knob) to access the device ventilation parameters and monitored data. You can use a combination of touching the screen attributes, rotating the knob, and pressing the knob to activate your configuration choices. The knob can be rotated in either direction (clockwise CW, or counter-clockwise

CCW), allowing you to scroll through choices displayed in the

Cockpit windows.

To open a window (other than a pop-up window) , touch a window tab to select and activate your selection; or scroll to it by rotating the P&T knob and then press the P&T knob to activate your selection. The selected item is framed in yellow.

To close a window (other than a pop-up window) , touch the window tab or the X

(close) in the upper left-hand corner; or scroll to the X by rotating the P&T knob and then press the P&T knob to activate your selection. The selected item is framed in yellow.

To adjust a control , touch the control to select and activate it; or rotate the P&T knob to select the control, then press it to activate your selection. The selected control is framed in yellow.

The activated control turns red. Rotate the P&T knob to increment or decrement the value. Press the P&T knob, or touch the control, activating the adjustment.

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Pulsing circle . When in automatic control, the circles turn blue and rotates using a pulsing motion. The speed with which the pulses move indicates a rapid or steady change in rate.

When the circle rotates to the right, the controlled value is increasing toward the target range. When the circle moves to the left, the controlled value is decreasing toward the target range.

When the circle turns red and stops moving, the patient parameters cannot be identified or are invalid. The adjusted parameters remain as set. The remaining time is also shown: for oxygen, 60 seconds, for PEEP, 360 seconds.

During O

enrichment , the oxygen control displays the currently applied oxygen concentration (value displayed in green) and the elapsed time.

To make a selection in a pop-up window , turn the P&T knob to scroll to and select the desired parameter, then press the P&T knob or touch the panel to activate your selection.

The window closes automatically.

To scroll through a log using the scroll bar or arrows , touch the scroll bar to select and activate it; or turn the P&T knob to select the scroll bar and then press it to activate your selection. Your selection is framed in yellow, and it becomes red when activated. Now turn the P&T knob to scroll through the log. Touch the scroll bar or turn the P&T knob to deactivate.

Alternatively, touch a scroll arrow repeatedly to scroll up or down, or turn the P&T knob to select one of the scroll directional arrows and then press it repeatedly to scroll up or down.

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To scroll through secondary monitoring parameters or P/V Tool History , touch a scroll arrow repeatedly.

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2 Preparing for ventilation

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