Infant Flow LP SiPAP Bonnet User Guide - CareFusion

Infant Flow ®
LP system bonnet

Table of contents
Prepare Infant Flow LP SiPAP driver.................1
Infant Flow LP components.............................2
Generator components...................................3
Low pressure generator..................................4
Nasal prongs..................................................5
Nasal mask.....................................................6
Nasal prongs and mask sizing.........................7
Bonnet sizing..................................................8
Generator assembly application......................9
Connect prongs or mask............................9
Attach gray straps....................................10
Apply the bonnet.....................................11
Remove the support cradle.......................12
Position the support cradle.......................13
Align the generator..................................14
Secure the generator ...............................15
Attach the gray straps..............................16
Adjust tension..........................................17
Final check of generator assembly................18
Check for proper application
of generator and prongs...........................18
Check placement of
exhalation tube........................................19
Verify proper nasal prongs position...........20
Incorrect nasal prong position...................21
Verify proper mask placement..................22
Incorrect mask size—too large..................23
Incorrect mask size—too small .................24
Warnings and cautions.................................25
Application tips............................................26
Final check and routine inspection................27
Notes......................................................28-29
i

NCPAP/
Pres Low
L/min
14
12
10
8
6
4
2
Infant Flow
SiPAP
30
XDCR
40
21
50
60
70
80
90
100
P PROX
Pres High
L/min
5
4
3
2
1
Prepare Infant Flow LP SiPAP driver
1. Attach the infant circuit to humidifier
and nCPAP driver.
2. Attach generator to the circuit.
3. Perform oxygen sensor calibration
and user verification.
4. Enter desired settings.
3 4
1
2
1

Infant Flow LP components
A. Masks and prongs
B. Generator
C. Bonnet sizing guide
D. Mask/prong sizing guide
E. Headgear
F. Bonnet
A
B
E
C
D
F
2

Generator components
A. Exhalation tube
B. Securing strap
C. Generator head
D. Fixation tab
B
A
E. Mask/prong
receiver base
F. Support cradle
G. Pressure and drive lines
C
D
E
F
G
3

Low pressure generator
• Lower drive pressure
– Prevents pressure backup into the
water auto-feed system
• Pressure relief valve
Pressure relief valve
4

Nasal prongs
Anatomically designed
A. Flared tip
B. Flexible bevel
C. Base
A
B
C
D
E
D. Size indicator
E. Key
A
B
C
D
5

Nasal mask
Anatomically designed
A
B
A. Nasal bridge cushion
B. Contour shape
C. Key
D. Flexible bellow
E. Assessment window
F. Size indicator
C
D
E
E
D
F
6

Nasal prongs and mask sizing
• Use sizing guide to determine appropriate
mask/prong size
• Nasal prongs: Choose dots that fill the
nare space
• If between sizes, choose the larger size
• Nasal masks: Choose the triangle that fits
over the nose
7

Bonnet sizing
• Measure from the center of the forehead to the nape of the neck back to the center of
the forehead
• The color squares and numbers correlate to bonnet size
8

Generator assembly application
Connect prongs or mask
Align the notch on the prongs/mask to straddle the pressure lines (step 3).
1.
2.
3.
4.
9

Attach gray straps
Insert end of strap
through the slit.
Pull until a small
loop is formed.
1.
2.
Place loop over
fixation arm.
Pull tight
and attach
second strap.
3. 4.
10

Apply the bonnet
1. Position the bonnet with the tip of support
cradle pad in alignment with the center of the
forehead and nose.
2. Gently pull the bonnet down.
1. 2.
3. Make sure the ears are covered and in
normal position.
3.
11

Remove the support cradle
1. Expand the collapsible corrugated tubing.
1.
2. Remove the support cradle from the
generator assembly.
2.
12

Position the support cradle
1. Align center of bonnet
with the midline of the
forehead and nose.
2. Center the support
cradle on the pad.
3. Press the three tabs
down to secure.
1. 2. 3.
13

Align the generator
1. Center the generator assembly over patient nose
and support cradle.
2. Use a gentle rocking motion to insert the
nasal prongs.
3. Place the drive line and pressure line into the
support cradle with the exhaust tubing resting
on top.
1. 2. 3.
14

Secure the generator
4. Wrap the locking strap over the exhalation tubing
and attach to the side of the support cradle.
4.
5. Position the small slit over the corrugate
of the exhalation tube.
5.
15

Attach the gray straps
1. Weave the gray strap
through the bonnet
holes, starting from
the inside of the
colored hole.
2. Thread up through
the colored hole.
3. Continue threading
through the third
colored hole.
1. 2. 3.
16

Adjust tension
1. Use the gray straps to adjust tension.
1.
2. Tie the ends of the bonnets (optional).
3. Tuck strap ends under the bonnet folds.
2. 3.
17

Final check of generator assembly
Check for proper application of generator and prongs
• Generator assembly centered with nose
• Side straps low on cheek
• Bellows on prongs visible
• Locking strap in place
18

Check placement of exhalation tube
Incorrect
Correct
19

Verify proper nasal prongs position
• Bellows are visible
• Septum is visible
• Generator assembly has
minimal contact with skin
20

Incorrect nasal prongs position
• Too tight,
bevels compressed
• Prong outside of nare
• Base not seated on the
generator head
21

Verify proper mask placement
• Mask covers nasal profile
• Mask rests below the eye
• Bellows not compressed
• Side strap low on neck
22

Incorrect mask size—too large
• Mask cuts into the infant’s eye
and sits high on the bridge of
the nose
• Bottom of the mask rests
on upper lip
23

Incorrect mask size—too small
• Mask blocks the nares
• Mask unable to cover nose
24

Warnings and cautions
WARNING:
• Use this product only as directed in the product literature to reduce the risk of nasal irritation,
septal distortion, skin irritation and pressure necrosis
• To be used by a trained practitioner, under the direct supervision of a qualified physician
• Only use the Infant Flow LP generator with variable flow nCPAP drivers
• Do not over tighten the fixation straps
25

Application tips
• Select the appropriate size nasal mask to minimize leaks and dead space
• Select the appropriate size nasal prongs; if between sizes, select the larger size
• Application of an incorrectly sized prong, mask, bonnet or headgear will affect stability of
the generator
• Consider alternating the use of prong and mask interfaces at set intervals to change pressure
points on the infant’s face
• Continuously monitor patient’s respiratory status (respiratory rate, heart rate,
oxygen saturation)
• Cover both ears evenly; ensure the ears are not folded
• Adjust the straps to stabilize the generator and maintain a seal at the nose using the least
tension possible
• Recommend humidification be used with nCPAP systems
• The Infant Flow LP has a built in “pop-off” that is activated if the drive pressure exceeds
60 cmH 2 O
26

Final check and routine inspection
Inspect the system at least every 3 to 4 hours to:
• Ensure the patient is receiving the prescribed level of CPAP
• Ensure the generator is stable, secure and not pulling upward on the nose
• Check for deformation or irritation to the nose or surrounding tissue
• Ensure the patient’s septum is clearly visible when using prongs
• Ensure the patient’s eyes are clearly visible and the nares are not blocked when
using masks
• Inspect the fixation device and straps for proper tension and adjust as needed to maintain
a proper fit
• Monitor the patient for gastric insufflation and abdominal distension
• Monitor for excessive condensation in circuit and generator
27

Notes
28

Notes
29

WARNING—U.S. Federal Law restricts this device to sale by or on the order of a physician.
CareFusion
22745 Savi Ranch Parkway
Yorba Linda, CA 92887
800.231.2466 toll-free
714.283.2228 tel
714.283.8493 fax
CareFusion Germany 234 GmbH
Leibnizstrasse 7
97204 Hoechberg
Germany
+49 931 4972-0 tel
+49 931 4972-423 fax
carefusion.com
© 2011 CareFusion Corporation or one of its subsidiaries. All rights reserved.
Infant Flow is a trademark or registered trademark of CareFusion Corporation
or one of its subsidiaries. RC2664 (0711/5000) L3415 Rev. A