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Puritan Bennett 560 Ventilator User's Manual - Covidien

Puritan Bennett 560 Ventilator User's Manual - Covidien

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Installation and Assembly<br />

5. Place a water trap (item 3) between the outlet port of the humidifier and the patient end.<br />

6. Place a vented (NIV) interface to the end of the patient circuit. (item 5)<br />

5<br />

Figure 4-10. Single limb Patient Circuit Without Exhalation Valve<br />

For both types of circuits, shown previously, you should connect the end of the proximal pressure tube as close<br />

as possible to the patient (at the mask or cannula entry, if possible) so that the ventilator can account for all<br />

load losses due to the circuit and its potential accessories. If this is not possible, it is best to modify the PATIENT<br />

DISCONNECTION triggering threshold by doing one of the following: set a Max VTI alarm limit for pressure<br />

modes or a Min VTE alarm limit for all ventilation modes if using a dual limb circuit.<br />

As a reminder: Ensure that the length and the internal volume of the patient circuit are compatible with the<br />

tidal volume: ringed tube Ø 22 mm for adults and ringed tube Ø 15 mm for pediatric patients with tidal volumes<br />

lower than 200 ml. Use, if necessary, a 22F-15M link on the outlet and a 15M-22M link on the exhalation<br />

block for a double limb circuit.<br />

Warning<br />

When using non-invasive ventilation (NIV), without an exhalation valve, use a vented nose or<br />

face mask or a non vented combined with a leak accessory. When using non-invasive ventilation<br />

(NIV), with an exhalation valve, use a non vented mask.<br />

The level of inspiratory resistance of the circuit and accessories (bacteria filter, humidifier, and<br />

so on) must be as low as possible. Settings—particularly the PATIENT DISCONNECTION alarm,<br />

High inspired volume (High VTI), and Low inspired volume (Low VTI) settings—must be<br />

periodically adjusted according to changes in the patient circuit resistance—especially when<br />

filters are replaced.<br />

Resistance of the exhalation valve and accessories (water traps, filters, HMEs etc) must be as<br />

low as possible.<br />

The exhalation valve must allow rapid discharge of the circuit pressure. Ensure that the<br />

exhalation valve is always clean and its evacuation aperture (exhaust port) is never obstructed.<br />

Do not start ventilation until you ensure that the device is suitably assembled, that the air inlet<br />

filter is properly installed and is not obstructed, and that there is proper clearance all around<br />

the unit. Also ensure that the patient circuit is suitably connected to both the ventilator and the<br />

patient and that the patient circuit, including all hoses, is not damaged or obstructed.<br />

Adding accessories to the ventilator breathing circuit, such as a humidifier and water trap(s),<br />

may result in a decrease in tidal volume delivered to the patient due to the added compressible<br />

volume of the accessory. Always assure that the patient is receiving the appropriate inspired<br />

volume when altering the breathing circuit configuration.<br />

4-10 User’s <strong>Manual</strong><br />

4<br />

1<br />

2<br />

3

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