LTV 1200 Operator's Manual - CareFusion Emergency Preparedness

LTV ® Ventilator Settings Checklist
The LTV ® 1200 Ventilator Settings Checklist may be used by caregivers as a reminder that all
appropriate controls on the ventilator were properly set, adjusted and/or recorded.
Patient Name: Ordered By: Date:
Controls: (Fill in (x.x), or Confirm (X)) Check-up
Volume Mode: - or - Pressure Mode: By: Date:
Assist Control Mode:
- or - NPPV Mode:
- or - SIMV / CPAP Mode:
By: Date:
Breath Rate: bpm By: Date:
Tidal Volume: ml By: Date:
Pressure Control: cmH2O By: Date:
Inspiratory Time: Seconds By: Date:
Pressure Support: cmH2O By: Date:
Sensitivity: Lpm By: Date:
PEEP: cmH2O By: Date:
Alarms: (Fill in (x.x), or Confirm (X)) Check-up
High Pressure Limit: cmH2O By: Date:
Low Pressure Limit: cmH2O By: Date:
Low Minute Volume: Liters By: Date:
Extended Features-Alarms: (Fill in (x.x), or Confirm (X)) Check-up
Apnea Interval: Seconds By: Date:
High f:
HIGH f
OFF
High PEEP: HI PEEP
OFF
- or -
Page 12-10 LTV ® 1200 Ventilator Operator’s Manual
p/n 18247-001, Rev. G
Bpm
Seconds
By: Date:
- or - cmH2O By: Date:
Low PEEP: LO PEEP
OFF
- or - cmH2O By: Date:
High Pressure Delay: No Delay, 1 BRTH - or - 2 BRTH By: Date:
LPP Alarm: All Breaths - or - VC/PC Only By: Date:
Extended Features-Ventilator: (Fill in (x.x), or Confirm (X)) Check-up
Rise Time Profile: (1 to 9) By: Date:
Flow Termination: 10-40% of Peak Flow By: Date:
Pressure Support Time
Termination:
Pressure Control Flow
Termination:
Seconds
By: Date:
YES - or - NO By: Date:
Leak Compensation: ON - or - OFF By: Date: