Pulmonary Clearance Techniques

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Pulmonary Clearance Techniques
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Pulmonary Clearance
Techniques
Pulmonary Clearance Techniques
Pulmonary Clearance
Techniques
Notes
Pulmonary
Clearance
Techniques
Pulmonary Clearance Techniques
Patients/Clients & Caregivers
Introduction
A strong cough is important so you can remove mucous from your lungs. If you have weak
muscles you may not be able to cough out your mucous. Perhaps you cannot take a deep
breath in. Perhaps you cannot breathe out with enough force to bring up the mucous. For a
strong cough you need two things:
9 To be able to completely fill your lungs and
9 To be able to breathe out forcefully
There are ways to help you if your muscles are too weak. This section lists several methods
and exercises to help you cough. If you use these exercises daily, you will be able move the
mucous up from the airway into your throat or mouth, where it can be suctioned out.
Pulmonary Clearance Techniques may improve:
9 The amount of air you can breathe into and out of the lungs
9 Coughing and speaking
9 The amount of oxygen getting to the body
Pulmonary Clearance Techniques may prevent:
9 The air sacs from collapsing
9 Lung infections
Common Techniques
9
9
9
9
Breath Stacking
Assisted Cough Technique
Postive Expiratory Pressure (PEP)
Cough Assist Device
All these techniques have one thing in common. They all need someone to help you.
Page 1
Pulmonary Clearance Techniques
Patients/Clients & Caregivers
Breath Stacking
Breath stacking is a breathing exercise that can help people who have breathing problems
due to muscle weakness or poor chest movement.
You will need 2 manual resuscitation bags. You need one in case of emergencies where you
need to use it to manually ventilate. The second one will be changed to become your Breath
Stacking Bag. The bag used for breath stacking prevents the person from breathing out. The
bag used for breath stacking should be clearly marked “Not for resuscitation”
Making a Breath Stacking Bag
9
9
9
9
9
Manual resuscitator bag
One-way valve
Extension tube
Either a mask or mouthpiece
Nose clips
How is breath stacking done?
1. Have the person sit comfortably. They can lean back a bit, but they should not be
slouching
2. Put on nose clips
3. Look at the person being bagged and try to squeeze the bag as the person breathes in
4. Have the person take a deep breath in
5. Have them place their lips around the mouthpiece or hold the mask on their face
6. Have the person breathe in the air as the bag is squeezed
7. Ask them to try to to keep breathing in more air, as the bag is squeezed a second time
8. They should fill their lungs as full as possible and feel a stretch across the front of
their chest.
9. Have them hold the air in as long as possible before letting it go out. Use the air they
are breathing out to cough.
10. Regular breath stacking is good to do even if it is not used with an assisted cough. You
may find that breath stacking with an assisted cough is only needed once a day.
Page 2
Pulmonary Clearance Techniques
Patients/Clients & Caregivers
When breath stacking is done right, it should not result in:
9 dizziness
9 chest discomfort
9 chest pain
IMPORTANT! If you encounter dizziness, chest discomfort or
chest pain, stop the breath stacking exercise and rest.
How often should breath stacking be done?
Each time you do this exercise, do it 3 to 5 times. Breath stacking should not be done more
than every ten minutes. Breath stacking should be done 3 to 5 times a day.
Page 3
Pulmonary Clearance Techniques
Patients/Clients & Caregivers
Assisted Cough Method
Having someone push on your abdomen (belly) just when you are trying to cough out is called
the Assisted Cough method. If you are not able to have someone push on your abdomen,
then they could push on your rib cage as you try to cough.
IMPORTANT! If you are sitting when this is done be sure that
the chair will not tip over.
When should assisted cough be done?
Doing breath stacking and assisted cough method on a full stomach may cause you to vomit.
To prevent this from happening do it:
9 Before eating a meal
9 2 hrs after eating a meal
9 Bedtime
Helpful Hints for Children
Children 2 to 6 years of age are often not able to take a deep breath in while you insert the
mouthpiece or put the mask on. Ask them to pretend to blow out candles. This will help them
to empty their lungs. Try to catch them on their next breath-in and say “take a deep breath,
and another one, and another one”. Make eye contact with them the whole time. Then tell
them to “cough” or “breathe out” when they exhale.
Page 4
Pulmonary Clearance Techniques
Patients/Clients & Caregivers
Cough Assist Device
The Cough Assist Device helps you get rid of mucous by trying to create a stronger cough. You
hold a mask on the face and the machine delivers a slow pressure increase when you breathe
in. Then it is followed by a rapid ‘suction’ effect. The slow breath-in followed by a quick
breath out, creates a cough.
Figure 1: Cough Assist Device.
http://www.coughassist.com/default.asp
Reproduced with permission of Philips Respironetics
You can use either a mask or a mouthpiece with the Cough Assist Device. Small children and
people with muscle weakness will have trouble keeping a seal on a mouthpiece, so will need
to use a mask. When using a mask you will need a good seal. If using a mask, be sure you
have good head and neck support, such as against a head rest on a wheelchair.
How do I give a Cough Assist Treatment?
1. You need two people to do the Assisted Cough technique
2. Have the patient sit comfortably with good head and neck support. They can be in
bed, with their head partially supported.
3. Check that the suction unit is working and ready
4. Check that the pressure settings on the Cough Assist Device are what was ordered
B Turn on the unit
B Seal the mask with your hand while you operate the Cough Assist Device
B Look at the pressure settings on both the IN and EX side
Page 5
Pulmonary Clearance Techniques
Patients/Clients & Caregivers
5. Make eye contact with the patient
B Have the patient breathe out fully, then place the mask on their face just as they
B
begin to breathe in -ORHave the patient breathe in and hold their breath as you place the mask on their
face
6. Move the lever to IN side and hold while you call out clearly “IN, IN, IN”
7. Quickly switch lever to EX side and call out “Cough, Cough, Cough”
8. Remove mask right away
9. Suction, if needed
Young Children
Children need some time to become familiar with the sounds of the device. Let them play
with the mask and push the buttons so they can hear the sounds. When they are comfortable
with the sounds, let them try one assisted breath. Be patient. It will take some time for them
to be comfortable with the exercise.
Other Pulmonary Clearance Techniques
Chest Physiotherapy
Chest physiotherapy is a physical technique of removing secretions with the use of clapping,
percussion, vibrations and/or postural drainage. Talk to your healthcare professional to learn
more about this technique.
Positive expiratory pressure devices (PEP)
The PEP device is a small hand-held device where you breathe out against a pressure.
Page 6
Pulmonary Clearance Techniques
Patients/Clients & Caregivers
Clinical References
Miske LJ, Hickey EM, Kolb SM, Weiner DJ, Panitch HB. Use of the mechanical in-exsufflator in
pediatric patients with neuromuscular disease and impaired cough. Chest. 2004;125:
1406-1412.
Finder J. Overview of airway clearance technologies. July 2006. Available at:
http://www.rtmagazine.com/issues/articles/2006-07_06.asp. Accessed August 12, 2007.
Bach JR. Mechanical insufflation/exsufflation: has it come of age? A commentary. Eur Respir J.
2003;21:385-386.
Finder JD, Birnkrant D, Farber CJ, et al. Respiratory care of the patient with Duchenne
muscular dystrophy: ATS consensus statement. Am J Respir Crit Care Med. 2004;170:456-465.
Chatwin M, Ross E, Hart N, Nickol AH, Polkey MI, Simonds AK. Cough augmentation with
mechanical insufflation/exsufflation in patients with neuromuscular weakness. Eur Respir J.
2003;21:502-508.
Tzeng AC, Bach JR. Prevention of pulmonary morbidity for patients with neuromuscular
disease. Chest. 2000:118;1390-1396.
McCool DF, Rosen MJ. Nonpharmocologic airway clearance therapies: AACP evidence-based
clinical practice guidelines. Chest. 2006; 129:250-259.
Winck JC, Goncalves MR, Lourenco C, Viana P, Almeida J, Bach JR. Effects of mechanical
insufflation-exsufflation on respiratory parameters for patients with chronic airway secretion
encumbrance. Chest. 2004;126:774-780.
Resources
Ottawa Rehabilitation Center, www.rehab.on.ca
Page 7
Pulmonary Clearance Techniques
Patients/Clients & Caregivers
Notes
Page 8
Education Checklists
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Education Checklists
Education Checklists
Education Checklists
Notes
Routine Tasks
What to do
and when to do it
Routine Tasks
Patients/Clients & Caregivers
Task
Stoma care
Trach care
Clean reusable inner cannula or replace disposable inner
cannula
Clean speaking valves
Clean suction canister – warm soapy water
Change HME: if it is used all the time
Ventilator plugged in
Test ventilator alarms
Check ventilator settings
Test the ventilator circuit
Test the manual resuscitator bag, if used often
Make sterile distilled water
Daily
9
9
9
Weekly Monthly
9
9
9
9
9
9
9
9
Every 2-3
days
Test the manual resuscitator bag – if not used frequently
Clean suction canister in vinegar and water
Change HME: if being used only at night time
Wipe down suction machine
Change suction tubing
Clean and test manual resuscitation bag
Clean ventilator circuit
Clean puffer chamber
Clean humidifier
Unplug ventilator and wipe with a damp cloth
Check and order supplies
9
9
9
9
9
9
9
9
9
9
9
Change bacterial filter in breathing circuit
Clean or replace inlet filters (see manual)
Discharge and recharge ventilator internal battery
Discharge and recharge the D/C External battery
Change suction filter
Ventilator preventative maintenance by VEP or other
equipment provider
Update the ventilator equipment pool with any changes
Page 1
9
9
9
9
Every 2nd
month
As required by equipment
provider
As changes occur
Routine Tasks
Patients/Clients & Caregivers
Notes
Page 2
My Education
Checklist
and
Learning Log
My Education Checklist and Learning Log
Patients/Clients & Caregivers
Introduction to Checklist
Below is a list of learning goals. It is important that all caregivers take part in learning how to care
for someone who is ventilated. You will learn from many different healthcare professionals. This
checklist is a guide to make sure that everything you need to know is covered. At any time, if you
feel you need to redo something, or are unsure of something, just ask. Your healthcare
professionals are eager to help you.
Individual’s Name: ___________________________________________________
Learning Objectives
At the completion of the training, the participant will be able to…
Individual Care
Date
1. Describe in general terms normal anatomy and
physiology of the respiratory system:
B How we breathe
B Humidification
B Upper airway anatomy and placement of a
tracheostomy
B What is different with a tracheostomy
B Location and role of vocal cords
B Explain why an individual with a trach tube
might not be able to speak
2. Describe how changing body position or eating a
meal can affect breathing
3. Demonstrate safe technique for:
B Bathing
B Feeding/Eating
B Dressing
4. Explain the importance of drinking water and using
a humidifier to manage secretions
5. Describe why heart rate or breathing rate may
change with activity or illness
Page 1
Initials Caregiver
Initials
My Education Checklist and Learning Log
Patients/Clients & Caregivers
6. Describe possible signs and symptoms of a chest
infection and the steps to take if there is an
infection
7. Explain the importance of proper hand hygiene
and how the use of gloves and a mask can prevent
the spread of infection
8. Explain the purpose of breath stacking
9. Describe what equipment is needed for
breathstacking
10. Demonstrate how to do the breathstacking
technique
11. Describe the plan for follow-up care
12. Explain the role of the family physician in the care
of the individual
Home Equipment
Date
Initials Caregiver
Initials
Date
Initials Caregiver
Initials
1. Identify the hazards and safety implications for
someone with a trach due to a loss of the
protective mechanisms of the upper airway
2. Identify home environment hazards
3. Determine if there are sufficient number of
grounded plugs
Inhaled Medication
1. Explain the function, dose and frequency of
individual-specific Metered Dose Inhalers
(MDI)/puffers
2. Demonstrate/explain how to give an MDI/puffer
with the ventilator
Page 2
My Education Checklist and Learning Log
Patients/Clients & Caregivers
Humidification System
Date
Initials Caregiver
Initials
Date
Initials Caregiver
Initials
1. Explain the importance of humidification
2. Demonstrate when and how to use an heated
moister exchanger (HME)
3. Demonstrate how to use and clean a passover
humidifier
Tracheostomy Care
1. Define tracheostomy
2. Explain why an individual might need a
tracheostomy
3. Name the parts of the tracheostomy tube
4. Describe stoma care
5. Describe how to prevent and manage skin
breakdown
6. Describe how to recognize and treat skin problems
around stoma (e.g. granulomas) and neck
7. Demonstrate how to clean the stoma and describe
what equipment is needed
8. Demonstrate correct inflation and deflation of a
cuffed tracheostomy tube
9. Explain the purpose of an inner cannula
10. Demonstrate how to insert or remove an inner
cannula
11. Explain how a trach tube could become blocked
and how to clear it
12. Describe how to clean and take care of the trach
equipment
13. Demonstrate how to change the tracheostomy ties
or holder
14. Main role: Changes outer cannula, holds cannula
in place until helper is finished securing the trach
ties, assesses and maintains airway
Page 3
My Education Checklist and Learning Log
Patients/Clients & Caregivers
15. Helper role: removes ties, cleans neck and stoma,
positions and holds person for tube change,
suctions (tip or measured), secures ties when tube
is change
16. Describe and demonstrate the emergency
replacement of the trach tube
17. Trach Tube Change:
9 Demonstrates Helper role on patient
B Practice # 1
B Practice # 2
B Practice # 3
9 Demonstrates Main role on patient
B Practice # 1
B Practice # 2
B Practice # 3
9 Demonstrates Solo trach change competently
B Practice # 1
B Practice # 2
B Practice # 3
Speaking Valves and Other Adjuncts
1. Describe how a speaking valve works and when to
use it
2. Describe how to clean and take care of the
speaking valve
3. Explain the importance of cuff deflation before
using a speaking valve, if applicable
4. Trach Mask
5. Oxygen therapy
6. Explain the need for a specialty trach tube and
how to order one
Page 4
Date
Initials Caregiver
Initials
My Education Checklist and Learning Log
Patients/Clients & Caregivers
Oximeter
Date
Initials Caregiver
Initials
Date
Initials Caregiver
Initials
1. Explain what parameters the oximeter measures
including the waveform, and perfusion index
2. Demonstrate how to get a good saturation and
heart rate reading
3. Demonstrate correct application of probe
4. Explain when to use oximeter; asleep and/or
unattended
5. Identify oximeter assessment abilities
6. Demonstrate how to set correct alarm settings;
low and high settings for saturation and Heart
Rate (HR)
7. Describe when and how often to change probe,
every 4 hours and as needed (PRN)
8. Systematic troubleshooting (refer to user guide)
9. Explain the battery power requirements
10. Explain the routine monitor maintenance
Suctioning
1. Explain why an individual might need suctioning
2. Identify the appropriate interventions for
secretions that are: dry and thick, yellow or green,
blood tinged
3. Explain the purpose of suctioning
4. Identify the characteristics of secretions: colour,
consistency, amount, and odour and why it is
important
5. Demonstrate how to correctly set up the suction
equipment
6. Explain why it is important to use two gloves when
suctioning
7. Demonstrate clean suctioning technique including
asking the individual for direction before and
during suctioning
Page 5
My Education Checklist and Learning Log
Patients/Clients & Caregivers
8. Explain why suctioning should be done only when
needed, trying to avoid over suctioning or
frequent suctioning
9. Explain what to do if blood is suctioned from the
trachea, and explain what difference it might make
if the individual takes blood thinners
10. Explain how to troubleshoot the suction unit
11. Describe correct disposal of dirty suction
equipment including suction catheters and gloves
12. Demonstrate how to:
B Tip suction
B Tube suction
B Deep suction
13. Demonstrate how to stock the portable suction
bag for use outside the home
Manual Ventilation
Date
1. Demonstrate how to properly connect and
disconnect an individual from a ventilator
2. Demonstrate when and how to use the manual
resuscitation bag
3. Demonstrate how to test the manual resuscitation
bag for proper functioning
4. Demonstrate how to properly clean the manual
resuscitation bag
5. Demonstrate how to add oxygen when using the
manual resuscitation bag
Page 6
Initials Caregiver
Initials
My Education Checklist and Learning Log
Patients/Clients & Caregivers
Ventilator Care
Date
1. Describe the purpose of a ventilator and when an
individual might need one
2. Demonstrate what needs the check-out procedure
when starting the ventilator at the bedside: high
and low pressure testing
3. Demonstrate what needs to be turned on and
checked when starting the ventilator on the
wheelchair
4. Demonstrate how to change the water in the
humidifier, and describe what kind of water is
used in the humidifier
5. Explain what needs to be plugged in when the
wheelchair ventilator is not in use
6. Demonstrate how and when to make ventilator
setting changes, including oxygen
7. Demonstrate how to check the ventilator high and
low pressure alarms
8. Describe the kind of situations that make the
low-pressure alarm sound and what to do for the
individual
9. Describe the kind of situations that make the
high-pressure alarm sound and what to do for the
individual
10. Describe the kind of situations that make the
power switch over alarm sound and what to do for
the individual
11. Describe the kind of situations that make the
ventilator inoperative alarm sound and what to do
for the individual
12. Describe all ventilator alarms including high and
low pressure alarms
13. Describe what to do when there is a ventilator
IN OP alarm
14. Demonstrate how to assemble and disassemble
the ventilator circuit
Page 7
Initials Caregiver
Initials
My Education Checklist and Learning Log
Patients/Clients & Caregivers
15. Demonstrate changing the ventilator circuit and
checking the ventilator after changing the circuit
16. Describe how to use a PEEP valve (if applicable)
17. Demonstrate how to assemble and disassemble
the PEEP valve (if applicable)
18. Demonstrate how to clean the ventilator circuit
19. Describe how and when to clean the ventilator
circuit and change the filters
20. Demonstrate how to check the external and
internal battery
21. Discuss how long a battery should last
22. Discuss how often to check and discharge the
battery
23. Demonstrate how to charge and discharge the
battery
Page 8
My Education Checklist and Learning Log
Patients/Clients & Caregivers
Emergency Management
Date
1. Describe the emergency plan, i.e. when to call 911
2. Describe the role of the home care company in an
emergency
3. Describe the role of the acute care hospital in an
emergency or power failure situation
4. Describe the role of Hydro and the Fire
Department in an emergency
5. Explain the emergency preparedness plan,
including the procedure during a power failure
6. Explain what to do if the individual has an
obstructed air passage, such as how to clear the
airway
7. Explain how to identify and manage someone in
respiratory distress
8. Describe/demonstrate correct actions for each of
the following situations:
B Accidental decannulation
B Mucous Plug
B Trauma to stoma area
9. Identify and indicate how to contact local
emergency resources
10. Identify what information needs to be conveyed to
emergency personnel
11. Ensure family is provided with emergency contact
list
12. Caregivers are trained in CPR
13. Demonstrate manual ventilation of a
tracheostomy
14. Demonstrate how to ventilate should the trach
come out and you can’t replace it
Page 9
Initials Caregiver
Initials
My Education Checklist and Learning Log
Patients/Clients & Caregivers
Funding and Equipment Supply
Date
Initials Caregiver
Initials
1. Explain the role of Assistive Devices Program (ADP)
in funding the equipment and supplies
2. Explain the role of the Ventilator Equipment Pool
(VEP) and how to contact them
3. List the equipment provided by the VEP
4. List equipment not provided by the VEP
5. Explain the role of the home care company and
how and when to contact them
6. List the supplies that come from the home care
company, how to place an order and explain
funding
7. List the supplies not covered by ADP that the
individual is responsible for
8. Describe how to safely store equipment
9. Describe when to discard equipment (please refer
to guidelines in the Ventilation & Tracheostomy
Care section)
Healthcare Provider
Name/Designation
Signature
Page 10
Initials
My Education Checklist and Learning Log
Patients/Clients & Caregivers
Best Time for Education Sessions
Check off morning (M), afternoon (A) or evening (E) in the chart below for the best time for our
education sessions.
Caregiver
Relationship to
Patient
Additional Comments
Page 11
Su Mo Tu We Th
Fr
Sa
My Education Checklist and Learning Log
Patients/Clients & Caregivers
I understand that, although I may complete this education checklist, I am not being certified to
do any of the acts described. Any actions that I take following this training will be done under
the direction and responsibility of the patient or their authorized agent.
Caregiver Signature: _________________________________ Date: _______________________
Facility Name: ___________________________________________________________________
Address: _______________________________________________________________________
Instructor Signature: _________________________________ Date: _______________________
Facility Name: ___________________________________________________________________
Address: _______________________________________________________________________
Page 12
Oximeter
Teaching
Checklist
Oximeter Teaching Checklist
Patients/Clients & Caregivers
This is a checklist for the healthcare professional to use when reviewing the oximetry
equipment with the caregiver. Verify receipt of the equipment, probes, the reference manual
and user guide.
1. Ensure all probes and cables are working
by testing them on either yourself or
patient. Ensure caregiver performs the
same test on the child
2. Review and explain parameters:
‰ Spo2
‰ Heart rate
‰ Waveform
‰ Perfusion Index
4. Review and explain:
‰ Power indicator light
‰ Battery indicator (four shaded
segments = fully charged)
‰ Heart rate volume
‰ Alarm volume
‰ Backlight
‰ Lock function
‰ Alarm silence button – one for two min
silence; three quick will silence
indefinitely – press once to reset to
normal function
3. Review and explain alarms (must be
ordered by physician):
‰ Low Saturation
5. Review battery power:
‰ High Saturation (if a patient is not on
‰ Needs 3.5 hours to completely charge
oxygen this can be turned off as
internal battery
ordered by physician)
‰ Battery life – 24 hours if completely
‰ Low Heart Rate
charged (if backlight is on the internal
‰ High Heart Rate
battery lasts 12 hours)
‰ Explain that adjusting alarms must have
a physician’s order
6. Troubleshooting:
‰ Demonstrate how to adjust alarms
‰ Review the troubleshooting guide in
(in case physician orders it to be made
the technical reference manual
at home)
page 3-1
7. Contact information to tell family/
caregiver:
‰ Contact Ventilator Equipment Pool
(VEP)
‰ Explain to the caregiver when
equipment is no longer needed and
physician has discontinued use,
caregiver to contact VEP to return
_________________________________
Caregiver Signature and Date
_______________________________
RRT Signature and Date
Page 1
Oximeter Teaching Checklist
Patients/Clients & Caregivers
Notes
Page 2
Troubleshooting
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Troubleshooting
Troubleshooting
Troubleshooting
Notes
Troubleshooting
Guide
Troubleshooting Guide
Patients/Clients & Caregivers
Problems and Solutions
When caring for patients on long term ventilation, you need to be aware of problems that
may arise. The problems may be related to what is happening with the patient or what is
happening with the ventilator.
Problems Related to the Patient
Whenever there is a problem, the first thing you need to do is look at the patient to see if
they are having any breathing problems. Patients will try to tell you if they are having trouble
breathing, are in pain, or need something. Every person is different, but common ways of
getting your attention include:
9 Clicking their tongues
9 Making unusual sounds
9 Triggering an emergency bell or a ventilator alarm
If the patient is having trouble breathing they may look:
9 Short of breath
9 Pale, dusky or blue
9 Scared or frightened
Consider using a baby monitor alarm, so others can hear if there is a problem.
IMPORTANT! If the patient cannot speak or communicate,
then they are not getting any air. If this happens, manually
ventilate using the resuscitation bag. A patient with a
speaking valve who cannot talk usually means they are not
getting any air.
What do I do if the patient is in distress?
1. Try to find out what the problem is by asking the patient “What is the problem?” or
“Are you getting enough air?” or “Do you need to be suctioned?”
2. Manually ventilate using a resuscitation bag
3. Use oxygen with the resuscitation bag, if needed
Page 1
Troubleshooting Guide
Patients/Clients & Caregivers
4. If the patient has nodded yes to “Do you need to be suctioned?” then suction them
immediately
5. Call out for help to anyone who can hear you, such as a family member. Phone 911 or
your regional emergency number for an ambulance
6. Keep on manually ventilating the patient until help arrives
7. Stay with the patient. Tell the patient what is happening, and that help is on the way
8. Once emergency support has arrived explain the problem to the attendants
The following table lists problems and some steps to take to solve them. If you at any
time do not feel that you are able to correct the problem, do not wait to call for help.
Problem
What to do
B Blocked Airway
B Choking on food
B Mucous in the airway
9 Suction to remove mucous or food
9 Manually ventilate using the resuscitation bag
9 If there is an inner cannula, change it
Patient is “not getting enough
air”
9 Manually ventilate using the resuscitation bag
9 Suction to remove anything that may be blocking the
9
9
9
9
9
9
9
9
9
9
airway
Tighten all ventilator tubing connections
Check that there is no leak in the system
Make sure the humidifier hose is connected
Make sure the ventilator settings are set correctly
Check to see if there is a trach tube cuff leak
If oxygen is being used, check that the oxygen supply is set
up correctly
If patient is short of breath right after activity, allow them
to settle or rest a little to see if there is improvement
The patient may need their bronchodilator (puffer); if it is
part of the care plan, then give the dose now
If you have an oximeter, check the reading
If there is a cuffed trach tube, make sure the cuff is properly
inflated
Page 2
Troubleshooting Guide
Patients/Clients & Caregivers
Problem
What to do
Problem with the Trach Tube
9 Make sure the ventilator tubing is not pulling on the trach
9
9
9
9
9
9
tube
Reposition the patient so the tube is not being pulled on
Reposition the head and neck
If on the ventilator, and you hear air coming from around
the trach, you may have a trach tube cuff leak
Check that the inner cannula is not blocked and is locked in
place
Check that the trach ties are tied securely, but not too tight
May need a trach tube change
Possible infection:
B Stoma is red, swollen or
painful to touch
B Mucous is yellow or green
B There is more mucous
B You need to suction more
often
B Needs more puffer
medicine
B Has a fever or chills
B Is not feeling well and is
really tired
B Oximeter reading, if you
have one, is low
9 If you have an action plan that the doctor has given you,
The patient is very anxious
9 Instill 2-5 mls of normal saline into trach and apply manual
9
9
9
9
9
follow that
Call the doctor or healthcare professional right away
resuscitator or ventilator for a few breaths
Use Breath Stacking and Cough Assist techniques to move
any mucous up the airway
Try to remain calm and tell them what you are doing to
solve the problem
Have patient do relaxation exercises
If necessary, give medication as ordered
Page 3
Troubleshooting Guide
Patients/Clients & Caregivers
Problem
What to do
There is a lot of mucous and it
is difficult to suction it all out
9 Suction
1. Lubricate the suction catheter with water and try
suctioning again
2. Use manual resuscitation bag to deliver 3-5 breaths
3. Change the inner cannula, if there is one
4. Suction
5. Repeat steps 1-4, if needed
9 Use Pulmonary Clearance Techniques – such as Breath
9
9
9
The trach tube has fallen out
and the patient is not having
any trouble breathing
Stacking. This will help move the mucous up so it can be
suctioned out
Moving often will help a patient cough up their mucous.
You can turn the patient every 1-2 hours or have them sit in
a chair several times a day
If you have learned how, change the trach tube
Call 911 if airway is still blocked
9 Try to put the trach tube back in. Only try this once. If this
does not work, get a new trach tube to insert
1. Completely deflate the cuff of the new trach tube
2. Lubricate the trach tube with water soluble lubricant
3. Insert obturator into the new trach tube
4. Slide new trach tube into stoma, but do not force
5. Remove the obturator
6. Insert the inner cannula, if there is one
7. Reinflate cuff, if there is one
8. Try to ventilate with a manual resuscitation bag
9. Check that the chest is rising and falling with each
breath
10. Place patient back on the ventilator
11. Check patient to make sure they are okay
9 If you are not able to re-insert the trach tube:
1. Use a manual resuscitation bag with mask and
ventilate the patient
2. CALL 911
3. Contact your doctor and your respiratory therapist
Page 4
Troubleshooting Guide
Patients/Clients & Caregivers
Problem
What to do
The patient is in pain
9 Determine the type and location of the pain. For example;
9
9
9
The trach tube has fallen out
and the patient is having
trouble breathing
is the pain with coughing, swallowing or only on breathing
in?
Try to reposition the patient
Give pain medicine, if ordered
If there is chest tightness, then give inhaled medicine
(puffer), if ordered
9 Attempt to re-insert trach tube ONCE (see above)
9 CALL 911
9 If you cannot reinsert a trach tube of same size: try
9
9
9
inserting either a tube that is one size smaller or a cuffless
tube
Put a mask on the manual resuscitator bag
If the patient needs oxygen: remove oxygen supply from
ventilator and connect to the manual resuscitation bag
Place the mask over the patient’s mouth and nose and give
manual breaths. Have a second person cover the stoma
while you manually ventilate
IMPORTANT! Always use a manual resuscitation bag to give
breaths while you are troubleshooting.
Page 5
Troubleshooting Guide
Patients/Clients & Caregivers
Problems and Solutions – The Ventilator
IMPORTANT! When a ventilator alarms, always look at the
patient first, not the ventilator. Look to make sure that the
chest is moving up and down. Make eye contact with the
patient and ask “Are you okay?”
Ventilators will alert you to a safety problem with a visual or an audible alarm. Some
situations will trigger a visual or an audible alarm. Serious situations will trigger both audible
and visual alarms together. You need to learn what the alarms mean on your ventilator.
Whatever the warning signal is, follow these steps:
1. Never leave the patient alone until the problem has been fixed
2. Use a manual resuscitation bag to ventilate the patient while you are trying to fix a
ventilator problem
3. Find out which alarm went off
4. Correct any problems, if you find any
5. Replace any broken equipment
6. Change the ventilator circuit, if needed. You should always have a spare ventilator circuit
set up, ready for use
7. Any equipment that failed is called ‘defective’. Do not use defective equipment. If your
ventilator is defective, manually ventilate the patient. If there is no other ventilator
available then call for an ambulance to take the patient to the nearest hospital
8. Once the patient is stable and taken care of, call the VEP to report the problem. The
telephone number for VEP is 1-800-633-8977. A respiratory therapist is on hand 24 hours
a day to help with ventilator issues and problems. Follow the prompts on the message for
service after business hours
9. For other replacement disposable supplies, contact the home care company
The following table lists specific problems and what you can do to solve them. Please see
manufacturer’s instructions for a complete list of alarms for your ventilator.
Page 6
Troubleshooting Guide
Patients/Clients & Caregivers
Alarm
Possible cause
What to do
High Pressure
9 Mucous plugs or mucous
9 Coughing, swallowing or
9 Suction to remove mucous
9 If coughing, may need puffer or
9
9
9
Low Pressure/
Apnea
hiccupping
Bronchospasm
Changes in patient’s breathing
pattern. Patient is not
responding to medicine or
suctioning
Alarm set incorrectly
9 Leaks in the ventilator circuit
9 Water in pressure line
9 Patient is disconnected from
9
Setting
ventilator
Leaks around trach or trach tube
cuff
9
9
suctioning
Give inhaled medicine, if ordered
Contact the appropriate
healthcare provider
9 Change alarm to proper setting
9 Look and feel for any leaks:
9
9
exhalation valve, humidifier,
pressure line, and tubing for
leaks
Drain water
Reconnect patient to ventilator
9 Reposition patient and, or the
trach tube. Try to deflate/
reinflate the cuff
Reset alarm to proper setting
Replace filter
9 Alarm set incorrectly
9 Dirty inlet filter
9
9
9 Settings are incorrect
9 Ventilator malfunction
9 Reset settings
9 Manually ventilate patient and
call the equipment provider
Power Switch
Over
9 Power source has changed from 9 Ensure ventilator is plugged in
9
Low Power
AC to internal or external power
source
Power source has changed from
external to internal
9 Internal battery is discharged
9
and there is power
If switching to or from an
external battery, then press the
reset button to cancel the
audible and visual alarm
9 Plug in and operate ventilator on
AC power for at least three
hours. If no power is available
then manually ventilate
Page 7
Troubleshooting Guide
Patients/Clients & Caregivers
Notes
Page 8
Emergency Contacts & Planning
<
Emergency
Preparedness Guide
for People with Disabilities /
Special Needs
!ZJ
'!
www.ontario.ca/emo
Emeergency Contacts
& Planning
Emergency Contacts & Planning
Emergency Contacts
& Planning
Notes
Emergency
Contacts and
Planning
Emergency Contacts and Planning
Patients/Clients & Caregivers
All About You
Your Contact Information
First Name: _________________________________________________________________
Middle Name: _______________________________________________________________
Last (Family) Name: __________________________________________________________
Street Address: ______________________________________________________________
City: ______________________________ Postal Code: ______________________________
Home Phone: _______________________ Cell Phone: ______________________________
Fax: ______________________________ Email: ___________________________________
Date of Birth: ___________________________
Allergies: ___________________________________________________________________
Your Ventilator Settings
These settings have been determined by your doctor and healthcare professionals team. Do
not change the settings without first talking with your doctor and healthcare professionals.
Make: ______________________________ Model: ________________________________
Mode: ______________________________
Volume: ____________________________ Breath Rate: ____________________________
Low Minute Volume: __________________Pressure: ______________________________
IMPORTANT! You need to have a complete list of your
ventilator settings, even those settings that do not appear on
the front panel of the ventilator.
Page 1
Emergency Contacts and Planning
Patients/Clients & Caregivers
If you use a speaking valve, first deflate the cuff. Then change the ventilator settings to:
Volume: _____________________________ Breath Rate: ____________________________
Inspiratory Time (I:E ratio): _____________________________________________________
Breath Effort (sensitivity): ______________________________________________________
Low Alarm: ___________________________ High Alarm: ____________________________
Keep track of ventilator setting changes
Ventilator Setting Change
Reason for Change
Date Changed
Your Trach Tube
Make: ______________________________ Model: _______________________________
Type/Serial #: ________________________ Size: _________________________________
Ordering information: _______________________________________________________
Page 2
Emergency Contacts and Planning
Patients/Clients & Caregivers
Keep track of when the trach tube was changed
Date of
Change
Tube
Make/Model
Tube
Size
Tube
Type
Location
Who
changed it?
Keep track of medicine taken
Drug Name
What it does
How much or how
many
Page 3
When to take
Emergency Contacts and Planning
Patients/Clients & Caregivers
Special Instructions
Page 4
Emergency Contacts and Planning
Patients/Clients & Caregivers
Your Personal Support Network
Your personal support networks are people who know about your healthcare needs and can
be called upon to help you in an emergency.
Family Doctor
Name: ________________________________________________________________
Phone: ____________________
Other Doctor Specialty: __________________________________________________
Name: ________________________________________________________________
Phone: ____________________
Home Healthcare Professional Specialty: _____________________________________
Name: _________________________________________________________________
Phone: ____________________
Home Healthcare Professional Specialty: _____________________________________
Name: _________________________________________________________________
Phone: ____________________
Equipment Supplier
Name: _________________________________________________________________
Phone: ____________________
Page 5
Emergency Contacts and Planning
Patients/Clients & Caregivers
Family Friend
Name: _____________________________________________________________
Phone: ____________________
Family Friend
Name: _____________________________________________________________
Phone: ____________________
Other Contact Specialty: Ventilator Equipment Pool
Name: _____________________________________________________________
Phone: ____________________
Other Contact Specialty: Home Care Company
Name: _____________________________________________________________
Phone: ____________________
Page 6
Emergency Contacts and Planning
Patients/Clients & Caregivers
Your Personal Emergency Plan
Developing a personal plan can help you to cope during an emergency. Completing the
information below will help you to develop a good plan.
What to do if there is a power failure?
Use your external D/C battery, given to you by the Ventilator Equipment Pool (VEP), for
emergency use. A full charged battery should last 5-12 hours.
9 Go somewhere where there is power. Somewhere close to your home. This could be a
hospital, a hotel, a fire or ambulance hall. These places usually have power even during a
power outage
9 Call family or friends to see if their power is out. If they still have power, you could go
there. Make sure there is at least one person on your contact list that lives close by and
understands your needs
9 Plan on how you might escape from your home. Getting out of your home quickly and
safely can be difficult, so you need a plan. For example, if you live in a high rise
apartment, it may not have adequate back up power for a long power outage. It may not
be easy to get out of the building when the elevators are not working. So you need to
have a plan
You need two external D/C batteries, if you want to be mobile with your ventilator. One
battery to use when you are mobile, and the other battery in case of a power failure. The
backup battery from the VEP is not to be used with your wheelchair. You need to buy another
D/C external battery if you want to use your ventilator while you are mobile.
If you are having trouble paying for a second battery, consider going to Assistance for
Children with Sever Disabilities (ACSD) or Ontario Disability Support Program (ODSP),
insurance, or various service clubs to ask for help. Sometimes they can help with funding.
Consider where you could go if there was a prolonged power outage: List friends, family,
hospital or fire station address here.
Page 7
Emergency Contacts and Planning
Patients/Clients & Caregivers
Family/Friend: _____________________________________________________________
Street Address: ____________________________________________________________
City: ______________________________ Postal Code: ___________________________
Contact Person: _____________________ Home Phone: __________________________
Cell Phone: _________________________
Out-of-Town Family/Friend: __________________________________________________
Street Address: ____________________________________________________________
City: ______________________________ Postal Code: ___________________________
Contact Person: _____________________ Home Phone: __________________________
Cell Phone: _________________________
Page 8
Emergency Contacts and Planning
Patients/Clients & Caregivers
Long-term Emergency Refuge
If the power outage is long term you will have to leave your home and stay somewhere else
for a while. Make plans on where you will go if this happens.
Street Address: _____________________________________________________________
City: _______________________________ Postal Code: ___________________________
Contact Person: ______________________ Home Phone: __________________________
Cell Phone: ________________________
How will I get there?
Have a transportation plan ready in case you need to leave home quickly.
Contact Person: ________________________ Home Phone: ________________________
Cell Phone: ____________________________
Travel Bag Checklist
In an emergency you will have to leave your home quickly. Have a travel bag packed with
everything you would need to take with you in an emergency. The contents of your travel bag
should include:
‰
‰
‰
‰
‰
‰
‰
‰
Spare trach tubes: current trach tube size and another one that is one size smaller
Ventilator settings
Spare ventilator circuit and HMEs
Your Contact List
B Healthcare team names and phone numbers
B Personal support network names and phone numbers
B VEP phone number
B Equipment supplier name and phone number
B Oxygen supplier name and phone number
List of medicines and inhalers (puffers)
Resuscitation bag and mask
Portable suction unit and supplies
D/C Battery
Page 9
Emergency Contacts and Planning
Patients/Clients & Caregivers
Fire Precautions
Fire Extinguishers
9 Have two fire extinguishers in the home
9 Your fire extinguishers need to be checked once a year
Smoke Detectors
9 Have one smoke detector on every level in your home
9 Change the batteries in your smoke detectors twice a year. Many people change their
smoke alarm batteries twice a year; when they change their clocks in the spring and the
fall. Write the date you changed the batteries, on the smoke detector
9 Post a “No Smoking/Flame” sign, if oxygen is in use
Emergency Supplies
An emergency situation may occur that requires you to stay in your home for a long period of
time. So it is wise to have some emergency supplies. Have enough supplies for a week.
According to the “Emergency Preparedness Guide for People with Disabilities/Special Needs”
from Emergency Management Ontario. Here is what they suggest:
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
Respiratory travel bag
Enough medications
MedicAlert® bracelet or identification
Bottled water
Food (non-perishable)
Manual can opener
Flashlight(s) & batteries
Battery operated radio & batteries or crank radio
Spare batteries
Candles and matches/lighter
Important papers (identification)
Clothing and footwear
Blankets or sleeping bags
Toilet paper and other personal items
Telephone that can work during a power disruption
Extra car keys and cash
Page 10
Emergency Contacts and Planning
‰
‰
‰
‰
Patients/Clients & Caregivers
Whistle (to attract attention, if needed)
Playing cards
First-aid kit
Backpack or duffle bag
This Guide may found at the web site www.emergencymanagementontario.ca. Make sure
that your supplies do not become too old to use. For example, keep your medicine up to
date. Buy bottled water and food with a long expiry date. You should also check your
flashlight(s) and replace the batteries from time to time.
Page 11
Emergency Contacts and Planning
Patients/Clients & Caregivers
Notes
Page 12
Emergency
Preparedness
Guide
Acknowledgement of
Source
The following document, titled “Emergency Preparedness Guide for People with
Disabilities/Special Needs” has been provided by Emergency Management Ontario.
The following acknowledges the original copyright claimed by the Queen’s Printer of Ontario:
© Queen’s Printer for Ontario, 2007. Reproduced with permission.
The document is being reproduced here with permission from Emergency Management
Ontario in the form originally made available.
Emergency
Preparedness Guide
for People with Disabilities /
Special Needs
www.ontario.ca/emo
Acknowledgements
This Emergency Preparedness Guide for People with Disabilities and/or Special Needs
was prepared by the Government of Ontario’s Emergency Management Ontario in
partnership with the Accessibility Directorate of Ontario.
In order to produce a guide that promotes the values and protects the integrity,
independence and safety of all Ontarians, the following organizations were consulted
for their subject matter expertise and special insights, for which we are most
appreciative:
■
■
■
■
■
■
■
■
■
■
■
■
■
■
■
■
■
■
■
■
Canadian Diabetes Association
Canadian MedicAlert® Foundation
Canadian Paraplegic Association (Ontario)
Canadian Red Cross
Centre for Independent Living in Toronto (CILT) Inc.
CNIB
Foreign Affairs and International Trade Canada
Learning Disabilities Association of Ontario
Ministry of Community and Social Services Emergency Management Unit
Ministry of Government Services
Multiple Sclerosis Society of Canada, Toronto Chapter and Ontario Division
National (USA) Organization on Disability - Headquarters
Office of the Fire Marshal – Ontario Head Office
Ontario March of Dimes (Provincial Office)
Ontario Seniors’ Secretariat
Ontario SPCA (Ontario Society for the Prevention of Cruelty to Animals)
SOS Emergency Response Technologies
St. Demetrius Development Corporation
The Canadian Hearing Society
Toronto Rehabilitation Institute
Special appreciation is also extended to all the people that volunteered their time
to pose for the pictures throughout this guide.
Emergency Management Ontario
Accessibility Directorate of Ontario
Ministry of Community Safety
and Correctional Services
www.ontario.ca/emo
Ministry of Community
and Social Services
www.mcss.gov.on.ca
Since not every emergency situation is similar or predictable, every person should rely on and use
their best judgement when offering assistance to others in an emergency, without putting their own
or other people's safety at risk.
© Queen’s Printer for Ontario 2007
All material created in this guide is protected by Crown Copyright, which is held by the Queen's Printer for Ontario. No materials can be reproduced
or copied in part or in whole without the expressed written permission of the Ministry of Community Safety and Correctional Services.
Contents
Introduction
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Emergency Survival Kit Checklist . . . . . . . . . . . . . . . . 3
Service Animal Emergency Kit Checklist . . . . . . . . . . . 4
Important Considerations
. . . . . . . . . . . . . . . . . . . . . . 5
Categories
Mobility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Vision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Hearing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Non-Visible Disabilities
. . . . . . . . . . . . . . . . 14
Seniors with Special Needs . . . . . . . . . . . . . . 16
Highrise Safety . . . . . . . . . . . . . . . . . . . . . . . 18
Travel Considerations . . . . . . . . . . . . . . . . . . 20
For More Information . . . . . . . . . . . . . . . . . . . . . . . . . 22
1
Introduction
Emergencies can occur suddenly and without any advance warning.
Although Ontario has effective emergency management legislation
and programs, individuals and families play a vital role in preparing
for times of crisis when emergency services and other government
resources may be strained. It is important that individuals and
families prepare to be self-reliant for at least three (3) days
immediately after or during an emergency. This guide provides special emergency
preparedness considerations and advice for the estimated 1.5 million Ontarians with
disabilities and/or special needs, including seniors with special needs.
Prepare Now
Emergency preparedness includes developing and practising a family emergency
response plan and the preparation of an emergency survival kit.
For those living with a physical, visual, auditory and/or other non-visible disability,
emergency preparedness should also involve incorporating special accommodations
into their family emergency response plan. To best prepare for an emergency
according to one’s special needs, please refer to the appropriate category in this
guide for a list of suggested emergency survival kit items and contingency planning
considerations.
For more information on emergency management arrangements in your area contact your
municipal Emergency Management Coordinator through your local government office.
Using this Guide
This guide covers topics relevant to the emergency preparedness needs of people
with visible and/or non-visible disabilities and seniors with special needs.
• Disabilities/special needs are identified as separate categories according to colour
and a symbol shown on the top right hand corner of each page.
• Each category provides information on how individuals should prepare for an
emergency given their special needs, how the public can best assist a person with
a disability and additional suggested survival kit items.
• The last page is an additional contact information resource for the reader.
• Copies of this guide are available in both English and French, and in alternative
formats upon request. Please contact:
Emergency Management Ontario
Accessibility Directorate of Ontario
General Tel: 416-314-3723
Toll-free Phone: 1-877-314-3723
General Tel: 416-326-0207
Toll-free Phone: 1-888-520-5828
TTY: 416-326-0148
Toll-free TTY: 1-888-335-6611
2
Emergency Survival Kit Checklist
This Emergency Survival Kit checklist outlines the basic items every individual
should keep in an easy-to-reach place to help them be self-reliant for at least
three (3) days immediately after or during an emergency. Since emergency
supply requirements vary for individuals with different disabilities, please refer
to the appropriate category in this guide for additional suggested survival kit
items.
Prepare Now,
Emergency Survival Checklist
Learn How…
❍ Flashlight and batteries
❍ Radio and batteries or crank radio
❍ Spare batteries (for radio,
flashlight, assistive devices, etc.)
❍ First-aid kit
❍ Telephone that can work during
a power disruption
❍ Candles and matches/lighter
❍ Extra car keys and cash
❍ Important papers (identification)
❍ Non-perishable food and bottled
water
❍
❍
❍
❍
Manual can opener
Clothing and footwear
Blankets or sleeping bags
Toilet paper and other
personal items
❍ Medication
❍ MedicAlert® bracelet or
identification
❍ Backpack/duffle bag
❍ Whistle (to attract attention,
if needed)
❍ Playing cards
3
Service Animal Emergency Kit Checklist
This Service Animal Emergency Kit checklist outlines the basic items every
person with a service animal should have prepared in advance to keep their
service animals comfortable during the stress of an emergency situation.
It is advisable to keep all items in a transportable bag that is easy to access
should evacuating the home become necessary. Also, remember to check the
kit twice a year (an easy way to remember is to do it when you check your
smoke alarms bi-annually) to ensure freshness of food, water and medication,
and to restock any supplies you may have “borrowed” from the kit.
Service Animal Emergency Kit Checklist
❍ Minimum 3-day supply of
bottled water and pet food
❍ Portable water and food bowls
❍ Paper towels and can opener
❍ Medications with a list
identifying reason (e.g., medical
condition), dosage, frequency
and contact information of
prescribing veterinarian
❍ Medical records including
vaccinations
❍ Leash/harness
❍
❍
❍
❍
Muzzle (if required)
Blanket and favourite toy
Plastic bags
Up-to-date ID tag with your
phone number and the
name/phone number of your
veterinarian (microchipping is
also recommended)
❍ Current photo of your service
animal in case they get lost or
separated from you
❍ Copy of licence (if required)
Pet Owners:
While service animals are accepted at shelters in an emergency, family pets
are not. Hence, it is advisable for pet owners to prepare a similar emergency
kit for each family pet according to the needs of each different animal
(e.g., cat, rabbit, bird, etc.). In the case of cats, include a cat carrier, little
pan, litter, scooper and plastic bags. It is also recommended for pet owners
to have prior arrangements made with family or friends to take care of their
animal, should evacuating the home be necessary during an emergency.
For additional information on pets and emergencies, please visit the
Emergency Management Ontario website at www.ontario.ca/emo.
4
Important Considerations
Remember…
The emergency survival kit items listed in this guide are only a
suggestion and may or may not apply to every emergency situation and/or
a person’s special needs. Therefore you should decide which
essential items to include for yourself and your family members.
During an emergency you may have no electrical power.
During an emergency you may need to go to an emergency evacuation
shelter. It is recommended that you and your family have a designated
contact person that resides outside of your immediate community. This way,
in the event of an evacuation, family members can easily notify each other
by calling their designated contact person.
Pack and store all emergency survival items (including medications, medical
supplies and/or assistive devices) in an easy-to-access and easy-totransport container should you need to evacuate.
Select a network of individuals at work and at home that will be able
to assist you during an emergency. (Make sure you inform your network of
where you keep your emergency survival kit.)
Prepare a list of any food or drug allergies you might have and all the
medications you are taking. You may want to provide this list to your
designated network and also keep a copy in your emergency survival kit, on
your person, at home, your workplace and in your car (if applicable).
On your list of medications, specify the reason for each medicine that you
are taking (e.g., medical condition being treated) including the generic
name, dosage, frequency, and the name and contact information of the
prescribing physician.
If you have children with a disability or special needs, prepare a similar list
for each of your children and provide it to their caregiver, school, emergency
contact members, etc.
If you have an allergy, chronic medical condition, or special medical need
you may want to consider owning and wearing a MedicAlert® bracelet or
identification as part of your emergency preparedness plan.
For more information visit: www.medicalert.ca.
5
Important Considerations
Remember…
Regularly check expiration dates on all medications, bottled water, and
canned/packaged food in your emergency survival kit. It is best to replace
food and bottled water at least once a year.
Prepare a contact information list of all your emergency contact persons and
provide a copy to your designated network at work and/or home. Also keep a
copy in your survival kit, on your person, at home, at your workplace and in
your car (if applicable).
Provide written instructions for your network on how best to assist
you and your service animal (if applicable) during an emergency.
Label all of your special needs equipment and attach laminated instruction
cards on how to use, retrieve and/or move each assistive device during an
emergency.
Since your medications, assistive devices, etc. may change over time, it is
advisable for you to regularly assess your needs and incorporate any changes
to your emergency survival kit supplies and your family emergency plan.
If your personal needs require regular attendant care and/or life sustaining
apparatus, arrange with your network to check on you immediately if an
emergency occurs or if local officials issue an evacuation order.
Carry a personal alarm that emits a loud noise to draw attention to
your whereabouts.
If you rely on any life sustaining equipment/apparatus, develop an
emergency back-up plan that will ensure the equipment/apparatus works
in the event of a power outage.
Install working smoke alarms on every floor of your home and outside all
sleeping areas.
Test smoke alarms on a monthly basis by pushing the test button. Replace
smoke alarm batteries every six months and whenever the low-battery
warning sounds.
Develop and practise a home fire escape plan or refer to your building’s fire safety
plan so that everyone in your home knows what to do in the event of a fire.
Practise your emergency plan with your network at least twice a year.
If during an emergency your support network cannot assist you for whatever
reason, ask other individuals around you to help you. Remember to inform
them of your special needs and how they can best offer any assistance to you.
6
Important Considerations
Tips on Helping a Person with a Disability
☛
☛
☛
“Ask First” if the person needs or wants your help – do not just assume
that they do.
Allow the person to identify how best to assist them.
Do not touch the person, their service animal and/or their assistive
device/equipment without their permission.
☛
Follow instructions posted on special needs equipment and/or assistive
☛
Avoid attempts to lift, support or assist in moving someone unless you
☛
Never administer any food or liquids to an unconscious or unresponsive
☛
Be aware that some people who have disabilities may request that you
☛
Ask the person with special needs if areas of their body have reduced
device during an emergency.
are familiar with safe techniques.
person.
use latex-free gloves to reduce spread of viral infection to them.
sensation and if they need you to check those areas for injuries after a
disaster.
7
Mobility
• If you use a wheelchair
or scooter, request that
an emergency
evacuation chair be
stored near a stairwell
on the same floor that
you work or live on, so
that your network can
readily use it to help
you safely evacuate
the building.
Mobility limitations may make it difficult for a person
to use stairs or to move quickly over long distances.
These can include reliance on mobility devices such as
a wheelchair, scooter, walker, crutches or a walking
cane. In addition, people with a heart condition or
various respiratory difficulties can experience certain
levels of mobility limitations.
Your Emergency Plan:
• Ask your network
to practise moving
your special needs
equipment during
your emergency
practice plan.
8
This will help your
network become more
comfortable handling or
using your special
needs equipment during
an emergency.
• In your instruction list
for your network,
identify areas of your
body that have reduced
sensation so these
areas can be checked
for injuries after an
emergency, if you
cannot check them
yourself.
• Check with your local
municipal office to
find out if emergency
evacuation shelters
in your area are
wheelchair accessible.
Additional Items
Emergency Survival Kit
Dos
& Don’ts
Assisting People with Disabilities
✔ Use latex-free gloves when
■ Tire patch kit.
■ Can of seal-in-air product (to
repair flat tires on your wheelchair
or scooter).
■ Supply of inner tubes.
providing personal care whenever
■ Pair of heavy gloves (to protect
possible. (People with spinal cord
your hands while wheeling or
injury have a greater risk of
making way over glass or other
developing an infectious disease
sharp debris).
during an emergency. Gloves
help control secondary medical
conditions that can easily arise if
personal care is disrupted during
an emergency.)
✔ Ensure that the person’s wheelchair
goes with the person.
✘ Do not push or pull a person’s
wheelchair without their permission.
■ Latex-free gloves (for anyone
providing personal care to you).
■ Spare deep-cycle battery for
motorized wheelchair or scooter.
■ A lightweight manual wheelchair for
backup to a motorized wheelchair
(if feasible).
■ Spare catheters (if applicable).
■ An emergency back-up plan that
will ensure any life sustaining
equipment/apparatus is operable in
the event of a power outage.
■ Any other contingency supplies
unique to your special needs.
9
Vision
Your Emergency Plan:
• Have a long cane
available to readily
manoeuvre around
debris on the floor or
furniture that may
have shifted after an
emergency.
• Mark all emergency
supplies in advance
with fluorescent tape,
large print or in braille.
• Mark gas, water and
electric shutoff valves
in advance with
fluorescent tape,
large print or in braille.
Vision loss can include a broad range of conditions
ranging from complete blindness to partial or low
vision that cannot be corrected with lenses or surgery.
A person’s ability to read signs or move through
unfamiliar environments during an emergency may be
challenged, creating a feeling of being lost and/or
being dependent on others for guidance.
10
• Familiarize yourself in
advance with all escape
routes and locations of
emergency doors/exits
on each floor of any
building where you
work, live and/or visit.
Additional Items
Emergency Survival Kit
Dos
& Don’ts
Assisting People with Disabilities
✔ Always ask first if you can be of
any assistance to them.
✔ For people who are deaf-blind, use
your finger to draw an “X” on their
back to let them know you are
there to help during an emergency.
✔ To communicate with a deaf-blind
person, try tracing letters with your
finger on the palm of their hand.
✔ To guide the person, offer them
your arm instead of taking theirs
■ Extra white cane, preferably a
cane that is longer in length.
■ Talking or braille clock.
■ Large-print timepiece with extra
batteries.
■ Extra vision aids such as an
electronic travel aid, monocular,
binocular or magnifier.
■ Extra pair of prescription glasses –
if you wear them.
■ Any reading devices/assistive
technology to access information/
portable CCTV devices.
■ Any other contingency supplies
unique to your special needs.
and walk at their pace. Keep half a
step ahead of them.
✔ If the person has a service dog,
ask them where you should walk to
avoid distracting the animal.
✔ Provide advance warning of
upcoming stairs, curbs, major
obstacles, or changes in direction.
✔ Watch for overhangs or protrusions
the person could walk into.
✘ Do not assume the person cannot see
you, or that they need your help.
✘ Never grab or touch a person with
vision loss.
✘ Do not touch, make eye contact or
distract the person’s service dog as
this can seriously endanger the owner.
✘ Do not shout at a person with vision
loss. Speak clearly and provide
specific and precise directions.
✘ Avoid the term “over there”. Instead,
describe locating positions such as,
“to your right/left/straight ahead/
behind you”, or by relaying clock face
positions. (For example: 12 o’clock)
11
Hearing
A person can be deaf, deafened or hard of hearing.
The distinction between these terms is based on the
individual’s language and means of communicating
rather than the degree of hearing loss.
In an emergency, the method in which emergency
warnings are issued becomes critical to how a person
with hearing loss is able to respond and follow
instructions to safety.
Your Emergency Plan:
• If your network is
unavailable during an
emergency, seek the
assistance of others to
whom you can
communicate your
hearing loss by spoken
language, moving
your lips without
making a sound,
pointing to your ear,
using a gesture, or if
applicable, pointing to
your hearing aid.
• Keep a pencil and paper
handy for written
communication.
12
• Obtain a pager that
is connected to an
emergency paging
system at your
workplace and/or the
building that you live in.
• Install a smokedetection system that
includes smoke alarms
and accessory flashing
strobe lights or
vibrators to gain your
attention if the alarms
sound.
• Test smoke alarms on
a monthly basis by
pushing the test button.
• Replace batteries in
battery-operated smoke
alarms every six
months and whenever
the low-battery warning
sounds.
• Keep a laminated card
on your person and in
your survival kit that
identifies you as deaf
or hard of hearing and
explains how to
communicate with you.
Additional Items
Emergency Survival Kit
Dos
& Don’ts
Assisting People with Disabilities
✔ Get the person’s attention via a
visual cue or a gentle touch on
their arm before speaking to them.
✔ Face the person and make eye
contact when speaking to them as
they may rely on speechreading.
✔ Communicate in close proximity.
✔ Speak clearly and naturally.
✔ Use gestures to help explain the
meaning of what you are trying to
communicate to the person.
✔ Write a message if there is time
and keep a pencil and paper handy.
✘ Avoid approaching the person from
behind.
✘ Refrain from shouting or speaking
unnaturally slowly.
✘ Do not make loud noises as hearing
aids amplify sounds and can create
a physical shock to the user.
■ Extra writing pads and pencils for
communication.
■ Flashlight, whistle or noisemaker.
■ Pre-printed key phrases you would
use during an emergency.
■ Assistive devices - unique to your
needs (e.g., hearing aid, pager,
personal amplifier, etc.).
■ Portable visual notification devices
that allow you to know if a person
is knocking on the door, ringing
the doorbell, or calling on the
telephone.
■ Extra batteries for assistive devices.
■ A CommuniCard (produced by
The Canadian Hearing Society)
that explains your hearing loss and
also helps identify how rescuers
or assisters can communicate with
you during an emergency.
■ Any other contingency supplies
unique to your special needs.
Note: Typically people who are
deafened or hard of hearing will need
information presented in a text format.
13
Non-Visible Disabilities
Non-visible disabilities can include communication,
cognitive, sensory, mental health, learning or
intellectual disabilities in which an individual’s ability
to respond to an emergency is restricted. They can
also range from allergies, epilepsy, hemophilia,
diabetes, thyroid condition, multiple sclerosis,
pulmonary or heart disease and/or dependency on
dialysis, sanitary or urinary supplies. Individuals with
non-visible disabilities may have difficulty performing
some tasks without appearing to have a disability.
Your Emergency Plan:
• Prepare an easy-tounderstand list of
instructions or
information for yourself
that you think you may
need in an emergency.
• Keep an emergency
contact list on your
person of key people
that are aware of your
special needs.
14
• Inform your designated
support network of
where you store your
medication.
• Keep a pencil and paper
or portable electronic
recording device handy
to write down or record
any new instructions
provided to you in an
emergency.
• Consider owning and
wearing a MedicAlert®
bracelet or identification
because it will help
notify emergency
responders about your
non-visible disabilities.
For more information
visit: www.medicalert.ca.
• Request a panic pushbutton to be installed in
the building you work
and/or live in, so that
in the event of an
emergency you can
notify others of your
whereabouts and that
you need special
assistance.
• People with Multiple
Sclerosis: Symptoms
are often made worse
by heat and humidity.
Be prepared to keep
cool and dry.
• People with Diabetes:
Keep frozen water
bottles or ice packs in
your freezer. Have an
insulated bag or cooled
thermos ready to store
your insulin, should
there be a power
outage or you need
to evacuate.
Additional Items
Emergency Survival Kit
Dos
& Don’ts
Assisting People with Disabilities
✔ Allow the person to describe what
help they need from you.
✔ Find effective means of
communication (e.g., provide drawn
or written instructions. When giving
directions use landmarks instead of
terms “go left” or ”turn right”).
✔ Be patient, flexible and maintain eye
contact when speaking to the person.
✔ Repeat instructions (if needed).
✔ Ask the person about their medication
and if they need any help taking it.
(Never offer medicines not
prescribed by their physician.)
✔ Keep people with multiple sclerosis
cool and dry to avoid making their
symptoms worse.
✘ Avoid shouting or speaking quickly.
Instead, speak clearly but not so
slowly as to offend the person.
✘ Do not restrain a person having a
convulsion. Instead, roll them on
their side to keep their airway clear
and place something soft (e.g., your
jacket) under their head to protect it
from injury. Once the convulsion
passes and they become conscious,
help them into a resting position.
■ Supply of food items appropriate to
your disability or dietary restrictions.
■ List of instructions that you can
easily follow in an emergency.
■ Personal list and minimum three days
supply of all needed medications,
medical supplies and special
equipment (e.g., ventilator for asthma,
nitrolingual spray for heart condition,
Epinephrine pen against allergic
reaction/anaphylactic shock, etc.).
■ Detailed list of all prescription
medications.
■ MedicAlert® identification.
■ Any other contingency supplies
unique to your special needs.
For Example: People with Diabetes
■ Extra supply of insulin or oral agent.
■ Extra supply of syringes, needles
and insulin pens (if used).
■ Small container for storing used
syringes/needles (if applicable).
■ Blood glucose testing kit, spare
batteries and record book.
■ Supply of blood glucose and urine
ketone testing strips.
■ Fast-acting insulin for high blood
glucose (if applicable).
■ Fast-acting sugar for low blood
glucose.
■ Extra food to cover delayed meals.
■ Ice packs and thermal bag to store
insulin (if applicable).
15
Seniors with Special Needs
social workers, etc., at
your place of residence
(if applicable), including
the hours they keep.
• Familiarize yourself with
all escape routes and
location of emergency
doors/exits in your
home.
Since an emergency situation or an evacuation can be
a frightening and confusing time, it is important that
seniors, especially those with special needs, know the
steps to take in an emergency. This includes seniors
contacting their local municipal office to find out about
programs and services available in their community
that will help them during an emergency and assist
them to return to their regular routine.
Your Emergency Plan:
• Create an emergency
contact list with names
and telephone numbers
of your physicians, case
worker, contact for your
seniors group,
neighbours, building
16
superintendent, etc.
Keep a copy of this list
in your survival kit and
on your person.
• Write down the names
and phone numbers of
on-site doctors, nurses,
• Know the location of
emergency buttons.
(Many seniors’ buildings
have emergency
buttons located in
bedrooms and
washrooms that have
a direct link to 911
or the building’s
superintendent.)
• If asked to evacuate,
bring with you any
equipment or assistive
devices you may need
immediately.
• Always wear your
MedicAlert®
identification.
Additional Items
Emergency Survival Kit
Dos
&
Don’ts
Assisting People with Disabilities
✔ Check on neighbours who are seniors
with special needs to find out if they
need your help during an emergency
or evacuation.
✔ Allow the person to describe what
help they need and how it can be
provided to them.
✔ Be patient, listen actively.
✔ If the person appears anxious or
agitated, speak calmly and provide
assurance that you are there to help.
✔ If evacuation is necessary, offer a
ride to seniors who do not have
access to a vehicle.
✔ If time permits, offer to carry the
person’s emergency survival kit to
your car, along with any equipment
or assistive devices they will need.
✔ Follow instructions posted on special
needs equipment and/or assistive
devices during an emergency.
■ Supply of food items appropriate to
your disability or dietary restrictions.
■ Assistive devices needed such as
canes, walkers, lightweight manual
wheelchair, hearing aids, breathing
apparatus, blood glucose monitoring
device, etc.
■ Prescription eyewear and footwear
(if required).
■ Extra supply of medications and
vitamin supplements.
■ Personal disability-related list of all
your needed medical supplies and
special equipment.
■ Copies of all medication
prescriptions.
■ Extra dentures (if required) and
cleaner.
■ Latex-free gloves (to give to anyone
providing personal care to you).
■ Any other contingency supplies
unique to your special needs.
For Seniors with Diabetes:
■
Please refer to previous “Other
Non-Visible Disabilities” category.
✘ Refrain from shouting or speaking
unnaturally slowly.
✘ Avoid being dismissive of the person’s
concerns or requests.
17
Highrise Safety
High-rise buildings present unique challenges when
evacuation is necessary during an emergency.
Residents should make themselves aware of:
✔
✔
✔
✔
✔
Building superintendent’s name and phone number.
Who sits on the Building Safety Committee.
Who the floor monitors are.
Who conducts evacuation drills, and how often.
Location of fire extinguishers, automated external
defibrillator units, and oxygen tank.
✔ Location of emergency evacuation device(s).
Your Emergency Plan:
• Advise your building
manager/superintendent
of your special needs
and/or requirements
during an emergency.
• Familiarize yourself
with your building’s
evacuation plan.
• Know where all
escape routes and
location of emergency
doors/exits are on
each floor.
• Know the location of
emergency buttons in
the building and exits
18
that are wheelchairaccessible (if applicable).
• Request that an
emergency evacuation
chair be installed on the
floor you live or work
on, preferably close to
the stairwell
(if applicable).
• If you live in a
highrise building, create
a ‘buddy’ system with
your neighbours and
regularly practise your
emergency response
plan with them.
• If you rely on any life
sustaining equipment/
apparatus, develop an
emergency back-up
plan that will ensure
the equipment/
apparatus is operable
in the event of a power
outage.
• Obtain large printed
signs from the building
manager that you can
place in your window
in the event of an
emergency, indicating
that you need assistance.
Additional Items
Emergency Survival Kit
Dos
&
Don’ts
Assisting People with Disabilities
✔ Check on neighbours and/or
■ Personal alarm that emits a loud
noise to draw attention to your
whereabouts.
■ Supply of food items appropriate
to your dietary restrictions.
co-workers with special needs to find
out if they need your help during an
emergency or evacuation.
✔ Listen actively to what the
individual with special needs is
saying.
✔ During an emergency evacuation
(if time permits), offer to carry the
person’s emergency survival kit
for them along with any special
equipment or assistive devices
they will need.
✔ Review previous categories in this guide
■ Supply of medications and assistive
devices appropriate to your
disability.
■ Supply of plastic bags for storing
garbage/personal waste.
■ Names and contact information of
your neighbours, superintendent
and property/building manager.
■ Laminated copy of your building’s
evacuation plan and diagram of
escape routes and location of
on how to assist people with specific
emergency doors/exits on each
disabilities and/or special needs.
floor.
✘ In general, avoid attempts to lift,
support or assist in moving a person
down the stairs, unless you are
■ Any other contingency supplies
unique to your special needs.
familiar with safe techniques.
19
Travel Considerations
Whether travelling locally or internationally, people with
disabilities and seniors with special needs should take
extra time to research and plan their trip to make their
travel experience safe and enjoyable. This includes
preparing in advance, an emergency plan and
“Ready-Go-Bag” with emergency survival items.
Your Emergency Plan:
• Before travelling, visit
the Foreign Affairs and
International Trade
Canada website at
www.voyage.gc.ca
where you can register
and find other helpful
travel information
safety tips.
• Discuss your particular
accommodation needs
with your travel agent.
• Discuss your trip with
your doctor to prepare
contingency plans in
case of illness.
• Obtain necessary travel
medical insurance.
• Carry a copy of the
20
booklet Bon Voyage,
But..., that contains
contact information for
your destination's
Canadian office and
Emergency Operations
Centre. You can order it
free of charge at
www.voyage.gc.ca.
• Divide your medications
and medical supplies
between your carry-on
and check-in baggage,
keeping them in their
original labelled
containers. Bring copies
of your prescriptions
with you.
• Always wear your
MedicAlert® bracelet.
• Inform your travel
companion(s) on how
to assist you in an
emergency.
• If travelling alone,
establish a network
(e.g., hotel staff) that
can assist you during
an emergency.
• If you have difficulty
using stairs request a
room on a lower floor.
• Review the hotel
emergency exit plan.
• If needing to evacuate,
bring your emergency
“Ready-Go-Bag” and
any assistive devices
you may need.
Additional Items
Emergency Survival Kit
Dos
& Don’ts
Assisting People with Disabilities
✔ Check on fellow travellers with
visible disabilities or special needs
to find out if they need your help
during an emergency or evacuation.
✔ Listen actively to what the individual
with special needs is saying and how
they might need your help.
✔ If they speak in a foreign language
that you do not understand, try to
communicate using gestures.
✔ During an emergency evacuation
(if time permits), offer to carry the
person’s emergency survival kit
for them along with any special
equipment or assistive devices
they will need.
✔ Review previous categories in this
guide on how to assist people with
specific disabilities or special needs.
✘ Do not let the person be separated
from their wheelchair or mobility aids.
■ Supply of food items appropriate to
your dietary restrictions.
■ Supply of medications/assistive
devices appropriate to your disability
(e.g., Glucagen injection if you manage
your diabetes with insulin and you are
travelling to a remote location that
does not have ambulance service).
■ Laminated personal information card
that you keep on your person at all
times when travelling. (Card identifies
your special needs, lists all
medications you are taking, any food/
drug allergies you might have, your
treating physician’s name and contact
information, and your next of kin.)
■ Copy of your travel medical insurance
and other important travel documents.
■ A personal alarm that emits a loud
noise to draw attention to your
whereabouts.
■ Small container that can store or
disintegrate syringes or needles
safely (if applicable).
■ Anti-nausea and anti-diarrhea pills
and pain medication.
■ Sunblock.
■ Insect repellent.
■ Dictionary to help you communicate
in a foreign language.
■ Any other contingency supplies unique
to your disability or special needs.
21
For More Information
Specific Disabilities and Special Needs
Canadian Diabetes Association
Tel: 416-363-3373
Toll-free Phone: 1-800-226-8464
Fax: 416-408-7117
www.diabetes.ca
Canadian Paraplegic Association Ontario
Tel: 416-422-5644
Toll-free Phone: 1-877-422-1112
Fax: 416-422-5943
Email: [email protected]
www.cpaont.org
Canadian Red Cross
Tel: 905-890-1000
Fax: 905-890-1008
www.redcross.ca
Centre for Independent Living in Toronto
(CILT) Inc.
Tel: 416-599-2458
TTY: 416-599-5077
24hr Newsline: 416-599-4898
Fax: 416-599-3555
Email: [email protected]
www.cilt.ca
CNIB
Tel: 416-486-2500
Toll-free Phone: 1-800-563-2642
TTY: 416-480-8645
Fax: 416-480-7700
www.cnib.ca
Learning Disabilities Association of
Ontario
Tel: 416-929-4311
Fax: 416-929-3905
www.ldao.ca
Local Emergency Management Contact:
© Queen’s Printer for Ontario, 2007
ISBN 978-1-4249-2380-9
10M 01/07
Disponible en français
Multiple Sclerosis Society of Canada –
Toronto Chapter and Ontario Division
Tel: 416-922-6065
Toll-free Phone: 1-866-922-6065
Fax: 416-922-7538
www.mssociety.ca
Ontario Seniors’ Secretariat
Tel: 416-326-7076 (Seniors’ INFOline)
Toll-free Phone: 1-888-910-1999
Toll-free TTY: 1-800-387-5559
Fax: 416-326-7078
www.ontarioseniors.ca
Ontario March of Dimes
Tel: 416-425-3463
Toll-free Phone: 1-800-263-3463
Fax: 416-425-1920
www.dimes.on.ca
Emergency Preparedness
Ontario SPCA (Ontario Society for the
Prevention of Cruelty to Animals)
Tel: 905-898-7122
Toll-free Phone: 1-888-ONT-SPCA
(668-7722)
Fax: 905-853-8643
E-mail: [email protected]
www.ontariospca.ca
Emergency Management Ontario
Tel: 416-314-3723
Toll-free Phone: 1-877-314-3723
Fax: 416-314-3758
www.ontario.ca/emo
For Information on MedicAlert®
Bracelets or Identification
The Canadian Hearing Society
Tel: 416-928-2500
Toll-free Phone: 1-877-347-3427
TTY: 416-964-0023
Toll-free TTY: 1-877-347-3429
Fax: 416-928-2523
www.chs.ca
Canadian MedicAlert® Foundation
Tel: 416-696-0142
Toll-free Phone: 1-800-668-1507
Toll-free Fax: 1-800-392-8422
www.medicalert.ca
Toronto Rehabilitation Institute
Tel: 416-597-3422
Fax: 416-597-1977
www.torontorehab.com
For Travel Advice and
Registration Service when
Travelling Abroad
Accessibility Initiatives
Accessibility Directorate of Ontario
Tel: 416-326-0207
Toll-free Phone: 1-888-520-5828
TTY: 416-326-0148
Toll-free TTY: 1-888-335-6611
Fax: 416-326-9725
www.mcss.gov.on.ca
Foreign Affairs and International Trade
Canada
Tel: 613-944-6788
TTY: 613-944-1310
In Canada and USA:
Toll-free Phone: 1-800-267-6788
Toll-free TTY: 1-800-394-3472
www.voyage.gc.ca
This guide is courtesy of:
© Imprimeur de la Reine pour l'Ontario 2007
ISBN 978-1-4249-2386-1
10M 01/07
Available in English
Useful Web
Resources
Useful Web Resources
Patients/Clients & Caregivers
Respiratory Related Sites
West Park Healthcare Centre
Includes online e-learning modules, example:
B Respiratory Anatomy and Physiology
B Tracheal Suctioning and Manual Ventilation
B Tracheostomy Tubes and Stoma Care
B Introduction to Long Term Mechanical Ventilation (Invasive)
http://www.ltvcoe.com
The Institute for Rehabilitation Research and Development (The Rehabilitation Centre
Ottawa)
Includes “Respiratory Protocols for SCI and Neuromuscular Diseases”:
B Anatomy and Physiology
B Clinical Pathway
B Interventions (LVR with bag, MI-E, ventilator, and GPB)
B CoughAssist™ - New Generation of MI-E
B Mechanical Insufflation/Exsufflation Policy
B Lung Volume Recruitment with Resuscitation Bag Policy
http://www.irrd.ca/education/
The Ventilator Equipment Pool
http://www.ontvep.ca/
The Ministry of Health & Long-Term Care, Assistive Devices Program, Respiratory Devices
Category Administration Manual (June 2007)
http://www.health.gov.on.ca/english/providers/pub/adp/resp_manual_20070627.pdf
Aaron’s Tracheostomy Page
A web site that provides information about tracheostomy
http://www.tracheostomy.com/
Page 1
Useful Web Resources
Patients/Clients & Caregivers
Information on Diseases
ALS Society of Canada
http://www.als.ca
Chronic Obstructive Airway Disease (COPD)-Canadian Lung Association
http://lung.ca/diseases-maladies/copd-mpoc_e.php
Cystic Fibrosis
http://www.cysticfibrosis.ca
Multiple Sclerosis Society of Canada
http://www.mssociety.ca/en/default.htm
Muscular Dystrophy of Canada
http://www.muscle.ca
Ontario March of Dimes/March of Dimes Canada
http://www.marchofdimes.ca/dimes
Post Polio Health International
http://www.post-polio.org
Spinal Muscular Atrophy
http://www.smafoundation.org
Page 2
Useful Web Resources
Patients/Clients & Caregivers
Government Listings and Publications
Assistive Devices Program (Ontario Ministry of Health & Long Term Care)
http://www.health.gov.on.ca/english/public/program/adp/adp_mn.html
ADP Respiratory Manual
http://www.health.gov.on.ca/english/providers/program/adp/product_manuals/respiratory_
devices.pdf
How to Hand Wash
http://www.health.gov.on.ca/en/ms/handhygiene/video/hand_wash.aspx
Best Practices for Hand Hygiene in all Healthcare Settings
http://www.health.gov.on.ca/english/providers/program/infectious/diseases/best_prac/bp_
hh_20080501.pdf
Health Canada: Health Products and Food Branch
http://www.hc-sc.gc.ca/index-eng.php
Ontario’s Community Care Access Centres
http://www.health.gov.on.ca/english/public/contact/ccac/ccac_mn.html
Page 3
Useful Web Resources
Patients/Clients & Caregivers
Associations/Agencies
Canadian Paraplegic Association Ontario
http://www.cpaont.org
Canadian Sleep Society
http://www.css.to
College of Physicians and Surgeons of Ontario
http://www.cpso.on.ca
College of Respiratory Therapists of Ontario
http://www.crto.on.ca
Canadian Society of Respiratory Therapists
http://www.csrt.com
International Ventilator Users Network
http://www.ventusers.org
Ontario Hospital Association
http://www.oha.com
Respiratory Therapy Society of Ontario
http://www.rtso.ca/
The BC Association for Individualized Technology and Supports for People with Disabilities:
Home of the Provincial Respiratory Outreach Program (PROP)
http://www.bcits.org/default.htm
The Canadian Lung Association
http://www.lung.ca
The Ontario Lung Association
http://www.on.lung.ca
Page 4
Useful Web Resources
Patients/Clients & Caregivers
Home/Long Term Ventilation Education
AARC Clinical Practice Guideline
Long-Term Invasive Mechanical Ventilation in the Home – 2007 Revision & Update
http://www.rcjournal.com/cpgs/pdf/08.07.1056.pdf
AARC Clinical Practice Guideline
Providing Patient and Caregiver Training
http://www.rcjournal.com/cpgs/pcgtcpg.html
AARC Clinical Practice Guideline
Training the Health-Care Professional for the Role of Patient and Caregiver Education
http://www.rcjournal.com/cpgs/thcpcpg.html
AARC Clinical Practice Guideline
Pulse Oximetry
http://www.rcjournal.com/cpgs/pulsecpg.html
Battery University is an on-line resource that provides practical battery knowledge
http://www.batteryuniversity.com
Emergency Management Ontario: Emergency Preparedness Guide for People with
Disabilities/Special Needs
http://www.emergencymanagementontario.ca/stellent/idcplg/webdav/Contribution%20Fold
ers/emo/documents/Disability%20Guide_Eng.pdf
http://www.getprepared.ca
IVUN-Home Ventilator Guide
http://www.ventusers.org/edu/HomeVentGuide.pdf
The Institute for Rehabilitation Research and Development: The Rehabilitation Centre,
Ottawa: Respiratory Protocols for Spinal Cord Injuries and Neuromuscular Disease
http://www.irrd.ca/education/default.asp
The Toronto East General Hospital Progressive Weaning Centre
Provincial Centre of Excellence
http://www.tegh.on.ca/bins/content_page.asp?cid=3-2850&lang=1&pre=view
Page 5
Useful Web Resources
Patients/Clients & Caregivers
West Park Healthcare Centre Long-Term Ventilation Centre of Excellence: On-line e-learning
modules
http://www.ltvcoe.com/index.html
Chronic Ventilation Strategy Task Force: Final Report, June 30, 2006
http://www.health.gov.on.ca/english/providers/program/critical_care/docs/report_cvtg.pdf
Page 6
Useful Web Resources
Patients/Clients & Caregivers
Vendors
The Porta-Lung
http://portalung.com/index.htm
Breathing Pacemakers: Avery Biomedical
http://www.averylabs.com/index.html
Diaphragm Pacing System: Synapse Biomedical
http://www.synapsebiomedical.com/products/neurx.shtml
Cough Assist Device
http://www.coughassist.com
Respironics
http://www.healthcare.philips.com/main/homehealth/index.wpd
Resmed Corporation
http://www.resmed.com/en-en
Fisher & Paykel HealthCare
http://www.fphcare.com
Carestream Medical
http://www.carestream.com
Draegar Medical-Canada
http://www.draeger.com/CA/en_US/
Quadromed Inc.
http://www.quadromed.com/en/index.html
Passy-Muir Tracheostomy and Speaking Valves
http://www.passy-muir.com
Bivona Tracheostomy Tubes
http://www.smiths-medical.com/catalog/bivona-tracheostomy-tubes
Page 7
Useful Web Resources
Patients/Clients & Caregivers
Shiley® Tracheostomy Tubes
http://www.nellcor.com/prod/list.aspx?S1=AIR&S2=TTA
Instrumentation Industries, Inc
http://www.iiimedical.com
Intersurgical Complete Respiratory Systems
http://www.intersurgical.com
Hans Rudolph Inc.
http://www.rudolphkc.com
DeVilbiss Healthcare
http://www.devilbisshealthcare.com
Cardinal Health
http://www.cardinalhealth.com
Covidien
http://www.covidien.com
Lifetronics
http://www.lifetronics.com
Advance for Managers of Respiratory Care
At-a glance charts detailing various interface/mask products available
http://respiratory-caremanager.advanceweb.com/Sharedresources/advanceforMRC/Resources/DownloadableReso
urces/MR040108_p64AirwayBG.pdf
Page 8
Appendix A
Assistive Devices Program
Equipment/Supply Authorization Form (Sample)
Introduction &
Glossary of Terms
Section #4: Appendices
Appendix B
Quick Reference Guide to LTV® 900, 950 & 1000 Series Ventilators
Healthcare
Professionals
Appendix C
Quick Reference Guide to LTV® 1200/1150 Series Ventilators
Patients/Clients
& Caregivers
Appendices
Introduction &
Glossary of Terms
Healthcare
Professionals
Patients/Clients
& Caregivers
Appendices
Section #4: Appendices
Appendix A
Assistive Devices Program
Equipment/Supply Authorization Form (Sample)
Appendix B
Quick Reference Guide to LTV® 900, 950 & 1000 Series
Ventilators
Appendix C
Quick Reference Guide to LTV® 1200/1150 Series Ventilators
Appendix A
Equipment/Supply Authorization
Form (Sample)
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Appendix A
Equipment/Supply
Authorization Form
Appendix A
Equipment/Supply Authorization
Form (Sample)
Appendix A
Equipment/Supply
Authorization Form
Notes
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Appendix B
Quick Reference Guide for
LTV® 900, 950 & 1000 Series Ventilators
=E(]5R9-])!]
Appendix B
Quick Reference
LTV® 900, 950 & 1000
Appendix B
Quick Reference Guide for
LTV® 900, 950 & 1000 Series Ventilators
Appendix B
Quick Reference
LTV® 900, 950 & 1000
Notes
LTV® Series Ventilators
(LTV® 900, 950, and 1000)
Quick Reference Guide
P/N 10674, Rev. H
TABLE OF CONTENTS
Front and Side Panel Reference ................................................................................. 1
Front Panel Display and Description.......................................................................... 1
Side Panel Descriptions............................................................................................. 3
Turning the Ventilator On and Off .............................................................................. 5
Turning the Ventilator On .......................................................................................... 5
Turning the Ventilator Off .......................................................................................... 6
Ventilator Checkout Tests ........................................................................................... 7
Alarm Test ................................................................................................................. 8
Display Test............................................................................................................... 9
Control Test ............................................................................................................. 10
Leak Test................................................................................................................. 11
Vent Inop Alarm Test............................................................................................... 12
Set Defaults ............................................................................................................. 13
Exit .......................................................................................................................... 14
Variable Controls........................................................................................................ 15
Setting Up Modes of Ventilation ............................................................................... 17
Setting Up Control Mode ......................................................................................... 17
Setting Up Assist/Control Mode............................................................................... 19
Setting Up SIMV Mode ............................................................................................ 21
P/N 10674, Rev. H
®
LTV Series Ventilators
iii
Setting Up CPAP Mode ........................................................................................... 23
Setting Up NPPV Mode ........................................................................................... 25
Monitored Data ........................................................................................................... 27
Extended Features ..................................................................................................... 29
Using AC/DC Power ................................................................................................... 57
Using the AC Adapter.............................................................................................. 57
Using an External DC Power Source....................................................................... 58
Power Displays and Indicators ................................................................................. 59
Attaching a Breathing Circuit.................................................................................... 63
Oxygen Computer Chart............................................................................................ 65
Alarms ......................................................................................................................... 67
P/N 10674, Rev. H
®
LTV Series Ventilators
iv
FRONT AND SIDE PANEL REFERENCE
Front Panel Display and Description
P/N 10674, Rev. H
®
LTV Series Ventilators
1
A - Mode and Breath Selection – Selects ventilation modes. Selects breath types.
B - Power – Turns ventilator “On” or to “Standby.”
C - Variable Control Settings – Sets ventilation characteristics, such as Tidal Volume
and Breath Rate.
D - Display Window – Displays Alarm Messages, Monitored Data, Extended Features
menu.
E - Airway Pressure Display – Displays real-time airway circuit pressure.
F - Patient Effort Indicator – LED is lit briefly each time a patient trigger is detected.
G - Power Source – Displays power source and charge levels.
H - Variable Alarm Settings – Sets variable alarm levels.
I-
Alarm Silence/Reset – Silences audible alarms. Clears visual alarms.
J - Set Value Knob – Changes variable control settings. Navigates Extended
Features menu.
K - Special Controls – Activates special controls such as Manual Breath, Low
Pressure O2 Source, Insp/Exp Hold or Control Lock feature.
P/N 10674, Rev. H
®
LTV Series Ventilators
2
FRONT AND SIDE PANEL REFERENCE
Side Panel Descriptions
P/N 10674, Rev. H
®
LTV Series Ventilators
3
A - 22mm Outlet Port – Patient Breathing Circuit outlet port.
B - Flow Xducer – Flow Transducer high pressure sensing port.
C - Flow Xducer – Flow Transducer low pressure sensing port.
D - Exh Valve – Exhalation Valve drive line port.
E - Alarm Sounder Port
F - Cooling Fan
G - DC Input – External DC power port (earlier version)
or DC power port pigtail connector (current version).
H - Patient Assist – Patient Assist Call jack.
I-
Comm Port – Communications port.
J - O2 Inlet – Oxygen Inlet fitting.
K - Filter – Air Inlet.
P/N 10674, Rev. H
®
LTV Series Ventilators
4
TURNING THE VENTILATOR ON AND OFF
Turning the Ventilator On
To turn the LTV® ventilator on:
1)
Connect the ventilator to an external power source:
x The AC power adapter may be used or the ventilator may be connected to an
external battery.
x If you do not connect the ventilator to an external power
source, it will operate from the internal battery.
2)
Press and release the On/Standby button. The ventilator will
commence operation:
x The On/Standby LED is lit and the Power On Self Tests (POST) are run.
During POST;
x The front panel displays are illuminated.
x Verify the audible alarm is activated for 1 second (only on ventilators with a
symbol on the back panel label).
x Verify a confirming audible chirp is activated (only on ventilators with a
symbol on the back panel label).
Once POST is successfully completed, the ventilator begins operating using the
stored control settings.
3)
P/N 10674, Rev. H
®
LTV Series Ventilators
5
Turning the Ventilator Off
To turn the LTV® ventilator off:
1)
Disconnect the patient from the ventilator.
2)
Press and hold the On/Standby button for 3 seconds. The ventilator
ceases operating, the audible alarm sounds continuously and the Vent
Inop LED is lit.
3)
Press the Silence/Reset button to silence the audible alarm.
x
4)
Verify a confirming audible chirp is activated immediately after the
alarm is silenced (only on ventilators with a symbol on the back
panel label).
The ventilator continues to charge the internal battery as long as it is connected to
an external power source.
Note: The Vent Inop LED will remain lit for a minimum of 5 minutes and does not
affect battery life.
P/N 10674, Rev. H
®
LTV Series Ventilators
6
VENTILATOR CHECKOUT TESTS
WARNING - Disconnect the patient from the ventilator prior to running the Ventilator
Checkout tests and ventilate the patient using an alternative method. The
ventilator does not deliver gas during the Ventilator Checkout tests.
To enable the Ventilator Checkout menu:
1) Begin with the ventilator in Standby mode (off) and connected to a valid AC power
source.
x Verify that the External Power and Charge Status LEDs are illuminated.
2)
Press and hold the Monitor Select button. While holding
the Select button, press the On/Standby button.
x REMOVE PTNT alarm message is displayed and an
audible alarm is sounded.
3)
Clear the alarm by pressing the Silence/Reset button.
x Audible alarm is silenced and VENT CHECK is displayed.
4)
Press the Select button to move to the first test.
x The first Ventilator Checkout Test, ALARM, is
displayed.
P/N 10674, Rev. H
®
LTV Series Ventilators
7
Alarm Test
The alarm Test is used to verify that the audible alarm is working correctly.
1) Press the Select button while ALARM is displayed.
2) Verify the audible alarm is sounded.
x
If a Patient Assist Call System or Remote Alarm is connected via the
ventilator’s Patient Assist Port, verify the device also activates (audible/visual),
as specified by its manufacturer.
3) When the alarm has sounded for at least 2 seconds, press the
Select button again.
x
The audible alarm is silenced and the next menu item is displayed.
4) For ventilators with an audio sound symbol ( ) on the back panel label, verify a
confirming audible chirp occurs after the alarm is silenced.
P/N 10674, Rev. H
®
LTV Series Ventilators
8
Ventilator Checkout Tests
Display Test
The display Test is used to verify that the ventilator displays are working correctly.
To run the Display Test:
1)
Press the Select button while DISPLAY is displayed.
2)
All segments of the 7-segment control displays, all dots of the dot-matrix window
displays and all LEDs are illuminated.
x
x
3)
The External Power and Charge Status LEDs are tested and verified when
the AC adapter is connected to the ventilator (see page 7).
The Vent Inop LED is tested and verified during the Vent Inop Alarm Test (see
page 12).
To end the display test, press the Select button again and the
next menu item is displayed.
P/N 10674, Rev. H
®
LTV Series Ventilators
9
Control Test
The Control Test is used to verify that the ventilator buttons and controls are working
correctly.
To run the Control Test:
1)
Press the Select button while CONTROL is displayed.
2)
SELECT is displayed in the display windows.
3)
To test each control, press the button. The name of the button is
displayed in the display window. To test the Set Value knob, turn it
clockwise and counterclockwise. The direction of rotation is
displayed in the display window.
4)
To exit the control test, press the Select button again and the next
menu item is displayed.
P/N 10674, Rev. H
®
LTV Series Ventilators
10
Ventilator Checkout Tests
Leak Test
The Leak Test is used to test the patient circuit for leaks. The patient circuit should be
tested with all accessories, such as humidifiers or water traps, in place.
To run the Leak Test:
1)
2)
Cap or otherwise occlude the patient circuit wye.
Press the Select button while LEAK is displayed.
x
x
3)
To perform the Leak Test, the ventilator closes the exhalation valve, sets the
flow valve to a near-closed state, elevates the turbine motor speed and elevates
the circuit pressure.
At the conclusion of the test, the display shows LEAK xx.x pass or fail, where
xx.x is the measured leak.
To exit the Leak Test, press the Select button again and the next
menu item is displayed.
P/N 10674, Rev. H
®
LTV Series Ventilators
11
Vent Inop Alarm Test
The Vent Inop Alarm Test is used to verify that the Inop Alarm is working correctly.
To run the Vent Inop Alarm Test:
1) To run the Vent Inop Alarm Test, the ventilator must be on (running) for at least 60
seconds and the Ventilator Checkout menu must be enabled.
2) Turn the ventilator off by pressing and holding the On/Standby button for
a minimum of 3 seconds. DO NOT press the Silence/Reset button.
3) Observe the ventilator for 15 seconds.
x Listen for the alarm tone
x Watch the Vent Inop LED
4) For all ventilators, verify that both of the following conditions existed;
x The alarm tone sounded continuously for the full 15-second duration.
x The Vent Inop LED illuminated continuously for the full 15-second duration.
5) If a Patient Assist Call System or Remote Alarm is connected via the ventilator’s Patient
Assist Port, verify the device also activates (audible/visual), as
specified by its manufacturer.
6) Silence the alarm by pressing the Silence/Reset button.
7) For ventilators with an a audio sound symbol ( ) on the back panel
label, verify the following condition existed;
x A confirming audible chirp occurred after the alarm was silenced.
P/N 10674, Rev. H
®
LTV Series Ventilators
12
Ventilator Checkout Tests
When the Ventilator Checkout Tests have been completed, proceed to Exit for instructions
to exit the vent check mode, or see below concerning the use of the Set Defaults option.
Set Defaults
The Set Defaults option is used to reset user settable Controls and Extended Features
settings to their factory-set default values (see the LTV® 1200 Series Ventilators Operator’s
Manual for factory-set default values).
To set the default values:
1) Turn the Set Values knob until EXIT is displayed and press the Select button.
x VENT CHECK is displayed
2) Turn the Set Values knob until VENT OP is displayed and press the Select button.
3) Turn the Set Values knob until DEFAULTS is displayed and press the Select button.
x SET DEFAULTS is displayed.
4) Press the Select button while SET DEFAULTS is displayed.
x Except for the Language selected and the Date/Time settings and format, all user
settable Controls and Extended Features options are reset to their factory-set default
values.
x A DEFAULTS SET alarm will be generated the next time the ventilator is powered up
in normal ventilation mode (see Alarms, DEFAULTS SET for additional information).
P/N 10674, Rev. H
®
LTV Series Ventilators
13
Exit
To return to any of the VENT CHECK tests, turn the Set Value knob until the desired
test is displayed.
To Exit:
1)
Press the Select button while EXIT is displayed, and VENT CHECK
is displayed.
2)
Turn the Set Value knob until EXIT is displayed again.
3)
Press the Select button.
The Ventilator performs a Self Test (POST) and resumes normal operation.
P/N 10674, Rev. H
®
LTV Series Ventilators
14
VARIABLE CONTROLS
P/N 10674, Rev. H
®
LTV Series Ventilators
15
To set a variable control:
1) Select the control by pressing the associated button. The display for the selected
control will be displayed at normal brightness and all other control displays will be
dimmed.
2) Change the control value by rotating the Set Value Knob. Rotate
clockwise to increase and counter-clockwise to decrease the value.
3) The new control value goes into effect when the operator:
x
Presses the selected button again, or
x
Selects another control, or
x
Presses the Control Lock button, or
x
Waits 5 seconds
All controls will then return to their normal brightness.
P/N 10674, Rev. H
®
LTV Series Ventilators
16
SETTING UP MODES OF VENTILATION
Setting Up Control Mode
P/N 10674, Rev. H
®
LTV Series Ventilators
17
To set the ventilator up in Control mode:
Press the Select button twice to toggle the modes between Assist/Control and
SIMV/CPAP. Select the Assist/Control mode.
2) Press the Select button twice to toggle between Volume and Pressure ventilation.
®
Select Volume or Pressure, as desired. (Not available on the LTV 900.)
3) Set the Breath Rate.
4) If Volume ventilation is selected, set the Tidal Volume. The calculated peak flow
Vcalc is displayed in the window while Tidal Volume is being changed.
5) If Pressure ventilation is selected, set the Pressure Control. (Not available on the
LTV® 900.)
6) Set the Inspiratory Time. The calculated peak flow Vcalc is displayed in the window
while Inspiratory Time is being changed. Vcalc only applies to volume ventilation.
®
7) Set O2% (LTV 1000 only).
8) Set the Sensitivity to Off (dash “-“).
9) Set the High Pressure Limit alarm.
10) Set the Low Pressure alarm.
11) Set the Low Minute Volume alarm.
12) Set the PEEP control on the exhalation valve.
1)
P/N 10674, Rev. H
®
LTV Series Ventilators
18
SETTING UP MODES OF VENTILATION
Setting Up Assist/Control Mode
P/N 10674, Rev. H
®
LTV Series Ventilators
19
To set the ventilator up in Assist/Control mode:
Press the Select button twice to toggle the modes between Assist/Control and
SIMV/CPAP. Select the Assist/Control mode.
2) Press the Select button twice to toggle between Volume and Pressure ventilation.
®
Select Volume or Pressure, as desired. (Not available on the LTV 900).
3) Set the Breath Rate.
4) If Volume ventilation is selected, set the Tidal Volume. The calculated peak flow
Vcalc is displayed in the window while Tidal Volume is being changed.
5) If Pressure ventilation is selected, set the Pressure Control. (Not available on the
LTV® 900.)
6) Set the Inspiratory Time. The calculated peak flow Vcalc is displayed in the window
while Inspiratory Time is being changed. Vcalc only applies to volume ventilation.
®
7) Set O2%, (LTV 1000 only).
8) Set the Sensitivity to a setting from 1 to 9.
9) Set the High Pressure Limit alarm.
10) Set the Low Pressure alarm.
11) Set the Low Minute Volume alarm.
12) Set the PEEP control on the exhalation valve.
1)
P/N 10674, Rev. H
®
LTV Series Ventilators
20
SETTING UP MODES OF VENTILATION
Setting Up SIMV Mode
P/N 10674, Rev. H
®
LTV Series Ventilators
21
To set the Ventilator up in SIMV mode:
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
13)
Press the Select button twice to toggle the modes between Assist/Control and
SIMV/CPAP. Select the SIMV/CPAP mode.
Press the Select button to toggle between Volume and Pressure ventilation. Select
®
Volume or Pressure, as desired. (Not available on the LTV 900).
Set the Breath Rate.
If Volume ventilation is selected, set the Tidal Volume. The calculated peak flow
Vcalc is displayed in the window while Tidal Volume is being changed.
If Pressure ventilation is selected, set the Pressure Control. (Not available on the
LTV® 900.)
Set the Inspiratory Time. The calculated peak flow Vcalc is displayed in the window
while Inspiratory Time is being changed. Vcalc only applies to volume ventilation.
Set the Pressure Support, if desired.
Set O2% (LTV® 1000 only).
Set the Sensitivity to a setting from 1 to 9.
Set the High Pressure Limit alarm.
Set the Low Pressure alarm.
Set the Low Minute Volume alarm.
Set the PEEP control on the exhalation valve.
P/N 10674, Rev. H
®
LTV Series Ventilators
22
SETTING UP MODES OF VENTILATION
Setting Up CPAP Mode
P/N 10674, Rev. H
®
LTV Series Ventilators
23
To set the ventilator up in CPAP mode:
1) Press the Select button twice to toggle the modes between Assist/Control and
SIMV/CPAP. Select the SIMV/CPAP mode.
2) Press the Select button twice to toggle between Volume and Pressure ventilation for
Apnea backup. Select Volume or Pressure for Apnea backup. (Not available on the
LTV® 900).
3) Set the Breath Rate to Off (dashes “- -“).
4) If Volume ventilation is selected, set the Tidal Volume for Apnea backup. The calculated
peak flow Vcalc is displayed in the window while Tidal Volume is being changed.
5) If Pressure ventilation is selected, set the Pressure Control for Apnea backup. (Not
available on the LTV® 900.)
6) Set the Inspiratory Time for Apnea backup. The calculated peak flow Vcalc is displayed
in the window while Inspiratory Time is being changed. Vcalc only applies to volume
ventilation.
7) Set the Pressure Support, if desired.
NOTE: Although Tidal Volume, Pressure
Control and Insp Time are dimmed,
8) Set O2% (LTV® 1000 only).
they should be set to clinically
9) Set the Sensitivity to a setting from 1 to 9.
appropriate levels as the ventilator uses
10) Set the High Pressure Limit alarm.
these settings for Apnea back-up
ventilation.
11) Set the Low Pressure alarm for Apnea backup.
12) Set the Low Minute Volume alarm.
13) Set the PEEP control on the exhalation valve.
P/N 10674, Rev. H
®
LTV Series Ventilators
24
SETTING UP MODES OF VENTILATION
Setting Up NPPV Mode
P/N 10674, Rev. H
®
LTV Series Ventilators
25
To set the Ventilator up in NPPV mode:
1) Set the ventilator controls for Control, Assist/Control, SIMV, or CPAP mode, as
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
13)
described in the preceding section.
Set the ventilator controls for Volume or Pressure ventilation, as described in the
preceding section.
Set all other ventilation parameters, as described in the previous section.
Set the High Pressure Limit alarm.
Enter Extended Features by pressing and holding the Monitor Select button for 3
seconds.
Turn the Set Value knob until VENT OP is displayed.
Press the Monitor Select button.
Turn the Set Value knob until NPPV Mode is displayed.
Press the Monitor Select button.
Turn the Set Value knob until NPPV On is displayed.
Press Monitor Select button.
The NPPV LED will be illuminated.
Exit the Extended Features menus by turning the Set Value knob until Exit is
displayed, and pressing Select button until monitored data is displayed in the
window.
P/N 10674, Rev. H
®
LTV Series Ventilators
26
MONITORED DATA
The monitored data displays may be automatically scrolled or manually scrolled. To
cycle through the available monitored data automatically from a halted scan, press the
Monitor Select button twice. Pressing the Select button once while scan is active shall
halt scanning and the currently display monitor shall remain in the display window. Each
time you press the button once; the next data item in the list will be displayed. To
resume scan, press the scan button twice. The monitored data is displayed in the
following order.
Display
PIP
MAP
PEEP
f
Vte
Description
Displays the Peak Inspiratory Pressure measured during the
inspiratory phase. PIP is not updated for spontaneous breaths.
Displays a running average of the airway pressure for the last 60
seconds.
Displays the pressure in the airway circuit at the end of exhalation.
Displays the breaths per minute and includes all breath types.
Displays the exhaled tidal volume as measured at the patient wye.
P/N 10674, Rev. H
®
LTV Series Ventilators
Display
VE
I:E
Vcalc
27
Description
Displays the exhaled tidal volume for the last 60 seconds as calculated
from the last 8 breaths.
Displays the ratio between measured inspiratory time and measured
exhalation time. Both normal and inverse I:E Ratios are displayed.
Is based on the Tidal Volume and Inspiratory Time settings. Displayed
when selected and whenever Tidal Volume or Inspiratory Time is
selected for change.
P/N 10674, Rev. H
®
LTV Series Ventilators
28
EXTENDED FEATURES
Navigating the Extended Features Menus:
To enter the Extended Features menu (in normal ventilation mode),
press and hold the Monitor Select button for three seconds.
To view the next item in a menu, turn the Set Value knob
clockwise.
To view the previous item, turn the Set Value knob counterclockwise.
To enter a menu item or select a setting, press the
Select button.
To exit a menu, turn the Set Value knob until the EXIT option is
displayed, then press the Select button or press Control Lock.
®
P/N 10674, Rev. H
LTV Series Ventilators
P/N 10674, Rev. H
LTV Series Ventilators
®
29
30
EXTENDED FEATURES
Alarm Operations
Alarm Volume
After accessing Extended Features, ALARM OP is displayed. Press the Select button
and ALARM VOL is displayed.
1)
Press the Select button.
2)
VOL xx dBA is displayed, where xx is the currently set volume.
3)
Turn the Set Value knob until the desired setting is displayed.
4)
Press the Select button.
P/N 10674, Rev. H
®
LTV Series Ventilators
31
Alarm Operations
Apnea Interval
After accessing Extended Features, ALARM OP is displayed. Press the Select button
and ALARM VOL is displayed. Turn the Set Value knob until APNEA INT is displayed.
1)
Press the Select button.
2)
APNEA xx sec is displayed, where xx is the currently set Apnea interval.
3)
Turn the Set Value knob until the desired setting is displayed.
4)
Press the Select button.
P/N 10674, Rev. H
®
LTV Series Ventilators
32
EXTENDED FEATURES
Alarm Operations
High Pressure Alarm Delay
This menu item is used to select immediate or delayed audible notification for High
Pressure alarms.
After accessing Extended Features, ALARM OP is displayed. Press the Select button
and ALARM VOL is displayed. Turn the Set Value knob until HP DELAY is displayed.
1)
Press the Select button.
2)
Turn the Set Value knob until the desired setting is displayed,
NO DELAY, DELAY 1 BRTH, or DELAY 2 BRTH.
3)
Press the Select button.
P/N 10674, Rev. H
®
LTV Series Ventilators
33
Alarm Operations
Low Peak Pressure Alarm
This item is used to select the type of breaths that the Low Pressure Alarm applies to.
After accessing Extended Features, ALARM OP is displayed. Press the Select button
and ALARM VOL is displayed. Turn the Set Value knob until LPP ALARM is displayed.
1)
Press the Select button.
2)
Turn the Set Value knob until the desired setting is displayed,
ALL BREATHS, VC/PC ONLY.
3)
Press the Select button.
P/N 10674, Rev. H
®
LTV Series Ventilators
34
EXTENDED FEATURES
Alarm Operations
1
High PEEP Alarm
This menu item is used to set a high PEEP alarm value. When the current PEEP value
exceeds the set high PEEP alarm value, an audible alarm will be sounded and a
flashing HIGH PEEP message will be displayed.
After accessing Extended Features, ALARM OP is displayed. Press the Select button
and ALARM VOL is displayed. Turn the Set Value knob until HIGH PEEP is displayed.
1) Press the Select button.
2) Turn the Set Value knob until the desired setting is displayed,
HI PEEP OFF or PEEP xx cmH2O.
3) Turn the Set Value knob until the desired setting is displayed.
4) Press the Select button.
1
The HIGH PEEP alarm is only available on ventilators with software version 3.15 or
higher installed.
P/N 10674, Rev. H
®
LTV Series Ventilators
35
Alarm Operations
PNT Assist 2
This menu item is used to configure the patient Assist Port output signal to be
generated for use with remote alarm systems.
After accessing Extended Features, ALARM OP is displayed. Press the Select button
and ALARM VOL is displayed. Turn the Set Value knob until PNT ASSIST is displayed.
1) Press the Select button.
2) Turn the Set Value knob until the desired setting is displayed,
NORMAL or PULSE.
3) Press the Select button.
2
The PNT ASSIST option is only available on ventilators with software version 3.15 or
higher installed.
P/N 10674, Rev. H
®
LTV Series Ventilators
36
EXTENDED FEATURES
Alarm Operations
Exit
To return to the top of the ALARM OP menu:
1)
Turn the Set Value knob until EXIT is displayed.
2)
Press the Select button while EXIT is displayed
P/N 10674, Rev. H
®
LTV Series Ventilators
37
Ventilator Operations
Variable Rise Time
The variable Rise Time option is used to select the rise time profile for Pressure Control
and Pressure Support breaths. The rise time profiles are numbered 1 through 9, where
1 is the fastest rise time and 9 is the slowest rise time.
After accessing Extended Features, ALARM OP is displayed. Turn the Set Value knob
until VENT OP is displayed. Press the Select button, and RISE TIME is displayed.
1)
Press the Select button.
2)
PROFILE x is displayed, where x is the currently set value.
3)
Turn the Set Value knob until the desired Rise Time Profile is displayed.
4)
Press the Select button.
P/N 10674, Rev. H
®
LTV Series Ventilators
38
EXTENDED FEATURES
Ventilator Operations
Variable Flow Termination
The Variable Flow Termination is used to select the percentage of peak flow used for cycling
Pressure Support breaths. Pressure Support breaths are cycled from inspiration to
exhalation when the flow reaches the set percentage of the peak flow, or when flow goes
below 2 lpm.
When Pressure Control Flow Termination is enabled, the Variable Flow Termination setting
is used for flow termination of Pressure Control breaths as well.
After accessing Extended Features, ALARM OP is displayed. Turn the Set Value knob until
VENT OP is displayed. Press the Select button.
1)
Turn the Set Value knob until FLOW TERM is displayed.
2)
Press the Select button.
3)
% OF PEAK xx is displayed, where xx is the current Flow Termination setting.
4)
Turn the Set Value knob until the desired Flow Termination percentage
is displayed.
5)
Press the Select button.
P/N 10674, Rev. H
®
LTV Series Ventilators
39
Ventilator Operations
Variable Time Termination
The Variable Time Termination is used to select maximum inspiratory time for cycling
Pressure Support breaths. Pressure Support breaths are cycled from inspiration to
exhalation, if this time is reached before the flow reaches the set percentage of the
peak flow. When a breath is cycled based on the time setting, the Pressure Support
display is flashed briefly.
After accessing Extended Features, ALARM OP is displayed. Turn the Set Value knob
until VENT OP is displayed. Press the Select button.
1)
Turn the Set Value knob until TIME TERM is displayed.
2)
Press the Select button.
3)
TERM x.x sec is displayed, where xx is the current Time Termination setting.
4)
Turn the Set Value knob until the desired Time Termination is
displayed.
5)
Press the Select button.
P/N 10674, Rev. H
®
LTV Series Ventilators
40
EXTENDED FEATURES
Ventilator Operations
Pressure Control Flow Termination
The Pressure Control Flow Termination option is used to enable or disable flow
termination for Pressure Control breaths.
When this option is on, Pressure Control breaths are cycled at the set percentage of
peak flow, if it is reached before the set Inspiratory Time elapses. The percentage of
peak flow is set in the Variable Flow Termination option.
After accessing Extended Features, ALARM OP is displayed. Turn the Set Value knob
until VENT OP is displayed. Press the Select button.
1)
2)
Turn the Set Value knob until PC FLOW TERM is displayed.
Press the Select button.
3)
4)
PC FLOW ON or PC FLOW OFF is displayed.
Turn the Set Value knob until the desired state is displayed.
5)
Press the Select button.
P/N 10674, Rev. H
®
LTV Series Ventilators
41
Ventilator Operations
Leak Compensation
Use the Leak Compensation option to enable or disable tracking of the Baseline Flow to
improve triggering when a circuit leak is present.
When Leak Compensation is on, the system is gradually adjusted to maintain set
sensitivity, if the leak is stable and there is no auto cycling.
After accessing Extended Features, ALARM OP is displayed. Turn the Set Value knob
until VENT OP is displayed. Press the Select button.
1)
Turn the Set Value knob until LEAK COMP is displayed.
2)
Press the Select button.
3)
LEAK COMP ON or LEAK COMP OFF is displayed.
4)
Turn the Set Value knob until the desired state is displayed.
5)
Press the Select button.
P/N 10674, Rev. H
®
LTV Series Ventilators
42
EXTENDED FEATURES
Ventilator Operations
NPPV Mode
After accessing Extended Features, ALARM OP is displayed. Turn the Set Value knob
until VENT OP is displayed. Press the Select button.
1)
Turn the Set Value knob until the NPPV MODE is displayed.
2)
Press the Select button.
3)
NPPV MODE ON or NPPV MODE OFF is displayed.
4)
Turn the Set Value knob until the desired state is displayed.
5)
Press the Select button.
P/N 10674, Rev. H
®
LTV Series Ventilators
43
Ventilator Operations
Control Unlock
When the Easy method is selected, unlock the controls by pressing and releasing the
Control Lock button.
When the Hard method is selected, unlock the controls by pressing and holding the
Control Lock button for 3 seconds.
After accessing Extended Features, ALARM OP is displayed. Turn the Set Value knob
until VENT OP is displayed. Press the Select button.
1)
Turn the Set Value knob until CTRL UNLOCK is displayed.
2)
Press the Select button.
3)
UNLOCK EASY or UNLOCK HARD is displayed.
4)
Turn the Set Value knob until the desired setting is displayed.
5)
Press the Select button.
P/N 10674, Rev. H
®
LTV Series Ventilators
44
EXTENDED FEATURES
Ventilator Operations
Language Selection
After accessing Extended Features, ALARM OP is displayed. Turn the Set Value knob
until VENT OP is displayed. Press the Select button.
1)
Turn the Set Value knob until LANGUAGE is displayed.
2)
Press the Select button.
3)
ENGLISH or the currently selected language is displayed.
4)
Turn the Set Value knob until the desired language is displayed.
5)
Press the Select button.
P/N 10674, Rev. H
®
LTV Series Ventilators
45
Ventilator Operations
Software Versions
After accessing Extended Features, ALARM OP is displayed. Turn the
Set Value knob until VENT OP is displayed. Press the Select button.
Turn the Set Value knob until VER xx.xx.xx is displayed, where
xx.xx.xx is the current software version.
Usage Meter
After accessing Extended Features, ALARM OP is displayed. Turn the
Set Value knob until VENT OP is displayed. Press the Select button.
Turn the Set Value knob until USAGE xxxxx.x is displayed, where
xxxxx.x is the current number of hours the ventilator has been in
operation.
P/N 10674, Rev. H
®
LTV Series Ventilators
46
EXTENDED FEATURES
Ventilator Operations
Communications Setting
The ventilator may be connected to printer, a graphics monitor, or a modem. The
Communications Setting option is used to select the communications protocol for data
transmission.
After accessing Extended Features, ALARM OP is displayed. Turn the Set Value knob
until VENT OP is displayed. Press the Select button.
1)
Turn the Set Value knob until COM SETTING is displayed.
2)
Press the Select button.
3)
MONITOR or the currently selected protocol is displayed.
4)
Turn the Set Value knob until the desired protocol is displayed.
5)
Press the Select button.
P/N 10674, Rev. H
®
LTV Series Ventilators
47
Ventilator Operations
Set Date
After accessing Extended Features, ALARM OP is displayed. Turn the Set Value knob
until VENT OP is displayed. Press the Select button.
1)
Turn the Set Value knob until SET DATE is displayed.
2)
Press the Select button.
3)
The current date is displayed in the currently selected date format.
4)
Press the Control Lock button to exit, or continue to modify the Date.
To modify the Date:
1)
Press the Select button, YEAR xxxx is displayed.
2)
3)
4)
5)
6)
7)
Turn the Set Value knob until the desired year is displayed.
Press the Select button, MONTH xx is displayed.
Turn the Set Value knob until the desired month is displayed.
Press the Select button, DAY xx is displayed.
Turn the Set Value knob until the desired day is displayed.
Press the Select button to accept the new date.
P/N 10674, Rev. H
®
LTV Series Ventilators
48
EXTENDED FEATURES
Ventilator Operations
Set Time
After accessing Extended Features, ALARM OP is displayed. Turn the Set Value knob
until VENT OP is displayed. Press the Select button.
1) Turn the Set Value knob until SET TIME is displayed.
2)
Press the Select button.
3)
4)
The current time is displayed.
Press the Control Lock button to exit, or
To modify the Time:
1)
Press the Select button, HOUR xx is displayed.
2)
Turn the Set Value knob until the desired hour is displayed.
3)
4)
5)
Press the Select button, MIN xx is displayed.
Turn the Set Value knob until the desired minute is displayed.
Press the Select button to accept the new time. The seconds are automatically
reset to 00.
P/N 10674, Rev. H
®
LTV Series Ventilators
49
Ventilator Operations
Date Format
The Date Format option is used to select the display format for the current date.
After accessing Extended Features, ALARM OP is displayed. Turn the Set Value knob
until VENT OP is displayed. Press the Select button.
1)
Turn the Set Value knob until DATE FORMAT is displayed.
2)
Press the Select button.
3)
MM/DD/YYYY or the currently selected date format is displayed.
4)
Turn the Set Value knob until the desired format is displayed.
5)
Press the Select button.
P/N 10674, Rev. H
®
LTV Series Ventilators
50
EXTENDED FEATURES
Ventilator Operations
PIP LED
After accessing Extended Features, ALARM OP is displayed. Turn the Set Value knob
until VENT OP is displayed. Press the Select button.
1)
Turn the Set Value knob until PIP LED is displayed.
2)
Press the Select button.
3)
PIP LED ON or PIP LED OFF is displayed.
4)
Turn the Set Value knob until the desired setting is displayed.
5)
Press the Select button.
P/N 10674, Rev. H
®
LTV Series Ventilators
51
Ventilator Operations
Model Number / Serial Number
After accessing Extended Features, ALARM OP is displayed. Turn the Set Value knob
until VENT OP is displayed. Press the Select button.
®
To view the LTV model number:
Turn the Set Value knob until LTV XXXX is displayed, where XXXX is
the model of the ventilator.
To view the LTV® serial number:
1) Press the Select button while LTV XXXX is displayed.
x The serial number is displayed on the left side of the display
area as XXXXXX, where XXXXXX is the serial number of the ventilator.
2) Press the Select button to return to the model number option.
To view LTM™ compatibility:
1) Press the Select button while LTV XXXX is displayed.
x
2)
LTM will be displayed if software and internal hardware in the
LTV® Ventilator are LTM™ compatible.
Press the Select button to return to the model number.
P/N 10674, Rev. H
®
LTV Series Ventilators
52
EXTENDED FEATURES
Ventilator Operations
Valve Home Position
After accessing Extended Features, ALARM OP is displayed. Turn the Set Value knob
until VENT OP is displayed. Press the Select button.
To view the valve home position:
Turn the Set Value knob until Vhome XXX is displayed, where XXX is the
home position for the flow valve installed in the ventilator.
Set Defaults
The Set Defaults option is only displayed and accessed through the VENT CHECK and
VENT MTNCE menus and is used to reset user settable Controls and Extended
Features settings to their factory-set default values. See Ventilator Checkout Tests,
®
Set Defaults for instructions on how to set default values and the LTV Series
Ventilators Operator’s Manual for factory-set default values.
P/N 10674, Rev. H
®
LTV Series Ventilators
53
Ventilator Operations
Exit
To return to the top of the VENT OP menu:
1)
Turn the Set Value knob until EXIT is displayed.
2)
Press the Select button.
XDCR ZERO
This item is used to view the Transducer Autozero results and schedule the Transducer
Autozero to be run (please refer to the Operator’s Manual).
P/N 10674, Rev. H
®
LTV Series Ventilators
54
EXTENDED FEATURES
Ventilator Operations
RT XDCR DATA
This menu displays the Real Time Transducer Data (please see the Service Manual for
more information).
EVENT TRACE
This menu displays the Events Codes stored by the ventilator (please see the Service
Manual for more information).
P/N 10674, Rev. H
®
LTV Series Ventilators
55
Ventilator Operations
Exiting Extended Features
To return to Monitored Parameters:
1)
Turn the Set Value knob until EXIT is displayed.
2)
Press the Select button.
3)
Repeat Steps 1 and 2 until the Monitored Parameters are displayed.
P/N 10674, Rev. H
®
LTV Series Ventilators
56
USING AC/DC POWER
Using the AC Adapter
To run the ventilator from an external AC
power source.
1)
Connect the power jack (straight or 90°)
from the AC adapter to the power port
(earlier version ventilators) or power port
pigtail connector (current version
ventilators) on the left side of the ventilator.
2)
Connect the proper AC power cable (110
or 220 V plug) to the AC power adapter.
3)
Connect the 110 or 220 V power cable to a suitable power source.
While the ventilator is plugged in, the internal battery is continuously charged.
CAUTION: Release Button – To avoid damaging the ventilator or the power connector,
press the release button on the connector before removing it from the ventilator power
port pigtail connector.
P/N 10674, Rev. H
®
LTV Series Ventilators
57
Using an External DC Power Source
To run the ventilator from an external DC power source.
1)
Connect the power port of the external DC power adapter cable to the power port
on the left side of the ventilator (earlier version ventilators), or the power port pigtail
connector (current version ventilators).
2)
Connect the DC jack to the DC power source.
P/N 10674, Rev. H
®
LTV Series Ventilators
58
POWER DISPLAYS AND INDICATORS
Indicators
Battery Level
The Battery Level indicator shows the level of available internal battery power while
running from the internal battery.
Approximate Battery Time
@ nominal settings
LED Color
Battery Level
Green
Internal battery level is acceptable
45 minutes
Amber
Internal battery level is low
10 minutes
Red
Off
Internal battery level is critically low
Ventilator is running on AC or
External Battery
5 minutes
P/N 10674, Rev. H
®
LTV Series Ventilators
59
Indicators
Charge Status
When the ventilator is plugged into an External Power source, it automatically charges
the internal battery.
LED Color
Flashing
Amber
Green
Amber
Red
P/N 10674, Rev. H
Charge Status
The ventilator is performing pre-charge qualification testing of the
battery prior to starting the charge process. This happens when
external power is first applied to the ventilator. The qualification
process normally takes a few seconds but may take up to an hour
on a deeply discharged battery.
The internal battery is charged to full level.
The battery has not reached a full charge level and is still charging.
The ventilator has detected a charge fault or internal battery fault.
The internal battery cannot be charged. Contact your Pulmonetic
Systems Certified Service Technician.
®
LTV Series Ventilators
60
POWER DISPLAYS AND INDICATORS
Indicators
External Power
The External Power indicator shows the level of external power while the ventilator is
operating from an external power source. When the ventilator is running from the
internal battery, the External Power indicator is off. When running from external power,
the indicator shows the following levels.
LED Color
Power Level
Green
External Power level is acceptable
Amber
External Power level is low
External power may be provided by connecting the ventilator to an external battery or to
an external AC power source.
P/N 10674, Rev. H
®
LTV Series Ventilators
61
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P/N 10674, Rev. H
®
LTV Series Ventilators
62
ATTACHING A BREATHING CIRCUIT
How to attach a patient breathing circuit.
1)
Connect the main breathing tube
to the 22 mm outlet port on the
right side of the ventilator.
2)
Connect the two exhalation flow
transducer sense lines to the
ports marked Flow Xducer on the
right side of the ventilator. These
are non-interchangeable Luer
fittings.
3)
Connect the Exhalation Valve
driver line to the port marked Exh
Valve on the right side of the
ventilator.
P/N 10674, Rev. H
®
LTV Series Ventilators
63
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P/N 10674, Rev. H
®
LTV Series Ventilators
64
OXYGEN COMPUTER CHART
P/N 10674, Rev. H
®
LTV Series Ventilators
65
Oxygen Computer Chart
To determine O2 Input Flow:
1) Find the desired FIO2 on the horizontal axis.
2)
Project up to the minute volume.
3)
Project horizontally to the left vertical axis and read the oxygen flow.
To determine O2 Concentration:
1)
Find the O2 input flow on the vertical axis.
2)
Project horizontally right to the minute volume.
3)
Project vertically down to the horizontal axis and read the FIO2.
P/N 10674, Rev. H
®
LTV Series Ventilators
66
ALARMS
How to Silence and Reset Alarms
To silence an alarm, press the Silence Reset button.
To reset an alarm that has been corrected, press the Silence Reset button
again.
Alarm
Cause
APNEA XX bpm Occurs when the time since the last breath
Solution
Reevaluate the
start exceeds the set Apnea Interval. When patient’s condition.
an Apnea alarm occurs, the ventilator will
enter Apnea Back up ventilation mode.
Reevaluate ventilator
settings.
APNEA
An Apnea alarm has occurred and cleared
The ventilator is no longer in Apnea Backup mode.
Reevaluate the
patient’s condition.
Reevaluate ventilator
settings.
P/N 10674, Rev. H
Alarm
BAT EMPTY
BATTERY LOW
DEFAULTS
®
LTV Series Ventilators
Cause
Solution
Occurs when the ventilator is operating
from the internal battery power and the
batter charge level is critically low. This
alarm can be temporarily silenced but
cannot be cleared.
Occurs when the ventilator is operating
from internal battery power and the battery
charge level is low.
Attach the ventilator to
external AC or DC
power.
Occurs during POST when the ventilator
detects an invalid setting stored in nonvolatile memory.
DEFAULTS SET Occurs when the ventilator is first powered
up after the SET DEFAULTS option has
been used to reset all controls and
extended features settings to their factoryset default values.
P/N 10674, Rev. H
67
®
LTV Series Ventilators
Attach the ventilator to
external AC or DC
power.
Reevaluate power
requirements.
Push the
Silence/Reset button
twice to reset alarm.
Reevaluate ventilator
settings.
Push the
Silence/Reset button
twice to reset alarm.
Reevaluate ventilator
settings.
68
Alarms
Alarm
DISC/SENSE
HIGH O2 PRES
P/N 10674, Rev. H
Alarm
3
HIGH PEEP
HIGH PRES
HW Fault
3
Cause
Occurs when the ventilator detects one of
the following conditions:
x
The patient circuit or proximal
pressure sense line has become
disconnected.
x
The low side exhalation flow
transducer sense line has become
disconnected.
x
The proximal pressure sense line is
pinched or occluded.
Occurs when the average oxygen inlet
pressure exceeds the acceptable limit for
the type of oxygen source.
Solution
Check Patient Circuit
assembly for
disconnects.
Check pressure
sensing lines for
occlusions.
Reduce O2 inlet
pressure.
®
LTV Series Ventilators
Cause
Occurs when the ventilator detects one of
the following conditions:
x
The patient circuit positive end
expiratory pressure (PEEP) exceeds
the High PEEP alarm setting.
x
Patient Circuit, Exhalation valve
and/or PEEP valve occluded.
Occurs when the circuit pressure exceeds
the set High Pressure Limit setting.
Occurs when the ventilator detects a
problem with the ventilator hardware.
69
Solution
Reevaluate ventilator
settings.
Disassemble, clean
and reassemble the
Patient Circuit,
Exhalation Valve and
PEEP Valve.
Reevaluate ventilator
settings.
Inspect Patient Circuit
for occlusions or kinks.
Reevaluate patient.
If alarm reoccurs,
contact your Service
Rep or Pulmonetic
Systems.
The HIGH PEEP alarm is only available on ventilators with software version 3.15 or
higher installed.
P/N 10674, Rev. H
®
LTV Series Ventilators
70
Alarms
Alarm
INOP
LOCKED
LOW MIN VOL
Cause
Solution
A ventilator INOP occurs when:
x
The ventilator is switched from On to
Standby.
x
The ventilator detects any condition
that is deemed to make the ventilator
unsafe.
If an INOP alarm
occurs during
operation, remove
ventilator from service
and contact your
Service Rep.
The LOCKED message is displayed when
a button is pressed while the controls are
locked. No audible alarm is given.
Press the Control Lock
button.
Occurs when the exhaled minute volume is
less than the set Low Minute Volume.
If locked alert
continues, press and
hold the Control Lock
button for three
seconds.
Examine Exhalation
Valve body for
disconnects.
Reevaluate patient.
P/N 10674, Rev. H
Alarm
LOW O2 PRES
®
LTV Series Ventilators
Cause
Occurs when the average oxygen inlet
pressure is less than the minimum
acceptable inlet pressure of 35 PSIG.
LOW PRES
Occurs when the peak inspiratory pressure
for a machine or assist breath is less than
the Low Pressure setting.
NO CAL DATA,
NO CAL
Occurs when the ventilator detects invalid
or missing calibration records on power up.
POWER LOST
Occurs when the ventilator is operating on
external power and the voltage drops
below the useable level and switches to
internal battery operation.
P/N 10674, Rev. H
®
LTV Series Ventilators
71
Solution
Increase O2 inlet
pressure.
If using O2 cylinder,
replace used cylinder
with a new one.
Examine Patient
Circuit for disconnect.
Reevaluate ventilator
settings.
Reevaluate patient.
Remove ventilator
from service, perform
Calibration procedure.
Evaluate power
requirements.
Attach ventilator to an
external AC or DC
power source.
72
Alarms
Alarm
POWER LOW
REMOVE PTNT
RESET
4
Cause
Occurs when the ventilator is operating on
external power and the voltage drops to the
low level.
Occurs when the ventilator is powered up
in the Ventilator Checkout or Ventilator
Maintenance modes. The ventilator is not
delivering gas.
A RESET alarm occurs if the ventilator
restarts following a condition other than
being shut down by pressing the
On/Standby button.
Solution
Evaluate power
requirements.
Ensure patient is
disconnected from
ventilator and is being
ventilated by
alternative means.
May be caused by
Internal Battery
depletion during
operation 4 or ESD. If
the problem reoccurs,
remove from service
and contact your
Service Rep or
Pulmonetic Systems
Only available on ventilators with software version 3.13 or higher installed.
P/N 10674, Rev. H
Alarm
XDCR FAULT
P/N 10674, Rev. H
®
LTV Series Ventilators
Cause
Occurs when a transducer autozero test
fails.
®
LTV Series Ventilators
73
Solution
Press Silence/Reset
button twice to reset
alarm. If problem
occurs frequently,
remove from service
and contact your
Service Rep. or
Pulmonetic Systems.
74
Pulmonetic Systems®
17400 Medina Rd., Suite 100
Minneapolis, Minnesota 55447-1341
Tel: (763) 398-8500
(800) 754-1914
Fax: (763) 398-8400
www.Pulmonetic.com
Appendix C
Quick Reference Guide for
LTV® 1200/1150 Series Ventilators
Appendix C
Quick Reference
LTV® 1200/1150
Appendix C
Quick Reference Guide for
LTV® 1200/1150 Series Ventilators
Appendix C
Quick Reference
LTV® 1200/1150
Notes
ASSISTANCE
Cardinal Health
Pulmonetic Systems
17400 Medina Rd., Suite 100
Minneapolis, Minnesota 55447-1341
Customer Care: (800) 754-1914
(763) 398-8500
Fax:
(763) 398-8403
Website:
www.cardinalhealth.com/viasys
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
ii
TABLE OF CONTENTS
Table of Contents:
Front and Side Panel Reference ................................................................................. 1
Front Panel Display and Description.......................................................................... 1
Side Panel Descriptions............................................................................................. 3
Turning the Ventilator On and Off .............................................................................. 5
Turning the Ventilator On .......................................................................................... 5
Turning the Ventilator Off .......................................................................................... 6
Variable Controls.......................................................................................................... 7
SETTING UP MODES OF VENTILATION..................................................................... 9
Setting Up Assist/Control Mode................................................................................. 9
Setting Up SIMV Mode ............................................................................................ 11
Setting Up CPAP Mode ........................................................................................... 13
Setting Up NPPV Mode ........................................................................................... 15
Monitored Data ........................................................................................................... 17
Extended Features ..................................................................................................... 19
SBT (Spontaneous Breathing Trial)......................................................................... 21
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
iii
Using AC/DC Power ................................................................................................... 25
Using the AC Adapter.............................................................................................. 25
Using an External DC Power Source....................................................................... 26
Power Displays and Indicators ................................................................................. 27
Attaching a Breathing Circuit.................................................................................... 30
Oxygen Computer Chart............................................................................................ 31
Alarms ......................................................................................................................... 33
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
iv
FRONT AND SIDE PANEL REFERENCE
Front Panel Display and Description (LTV® 1200 shown)
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
1
A - Mode and Breath Selection – Selects ventilation modes, and selects breath
types.
B - On/Standby Button – Turns the ventilator “On” or to “Standby”.
C - Variable Control Settings – Sets and displays each ventilation characteristic.
D - Display Window – Displays Alarm Messages, Monitored Data, and Extended
Features menus.
E - Airway Pressure Display – Displays real-time airway circuit pressure.
F - Patient Effort Indicator – LED is lit briefly each time a patient trigger is detected.
G - Power Source – Displays power source and charge levels.
H - Variable Alarm Settings – Sets and displays variable alarm levels.
I-
Alarm Silence/Reset – Silences audible alarms. Clears visual alarms.
J - Set Value Knob – Changes variable control settings. Navigates Extended
Features.
K - Special Controls – Activates special controls such as Manual Breath, Low
®
Pressure O2 Source (LTV 1200 only), Insp/Exp Hold and Control Lock feature.
L - PEEP – PEEP control setting and display.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
2
FRONT AND SIDE PANEL REFERENCE
Side Panel Descriptions
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
3
A - 22mm Outlet Port – Patient Breathing Circuit outlet port.
B - Flow Xducer – Flow Transducer high pressure sensing port.
C - Flow Xducer – Flow Transducer low pressure sensing port.
D - Exh Valve – Exhalation Valve drive line port.
E - Alarm Sounder Port
F - Cooling Fan
G - DC Input – DC power port pigtail connector.
H - Patient Assist – Patient Assist Call jack.
I-
Comm Port – Communications port.
J - O2 Inlet – Oxygen Inlet fitting.
K - Filter – Air Inlet.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
4
TURNING THE VENTILATOR ON AND OFF
Turning the Ventilator On
1) Push the On/Standby button.
If the Patient Query feature is enabled/on when the ventilator is
powered up, ventilation and alarm activation are suspended and the message SAME
PATIENT is displayed.
x
To enable the suspended alarms and begin ventilation with the settings in use
during the last power cycle, press the Select button while SAME PATIENT is
displayed.
x
To enable the suspended alarms and begin ventilation with Preset values
appropriate for a new patient, turn the Set Value knob until NEW PATIENT is
displayed and press the Select button. Then turn the Set Value knob until the
desired patient type is displayed (INFANT, PEDIATRIC or ADULT) and press the
®
®
Select button (see the LTV 1200 or LTV 1150 Operator’s Manual, Chapter 10,
for detailed settings and information).
If the Patient Query feature is disabled/off when the ventilator is powered up and
passes POST, it will begin ventilation (appropriate alarms enabled) using the settings in
use during the last power cycle.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
5
Turning the Ventilator Off
To turn the ventilator off:
1)
Disconnect the patient from the ventilator.
2)
Press and hold the On/Standby button for 3 seconds. The ventilator
ceases operating, the audible alarm sounds continuously and the Vent
Inop LED is lit.
3)
Press the Silence/Reset button to silence the audible alarm.
x
4)
Verify a confirming audible chirp is activated immediately after the
alarm is silenced.
The ventilator continues to charge the internal battery as long as it is connected to
an external power source.
Note: The Vent Inop LED will remain lit for a minimum of 5 minutes and does not
impact battery life.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
6
VARIABLE CONTROLS
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
7
To set a variable control:
1) Select the control by pressing the associated button. The display for the selected
control will be displayed at normal brightness and all other control displays will be
dimmed.
2) Change the control value by rotating the Set Value Knob. Rotate
clockwise to increase and counter-clockwise to decrease the value.
3) The new control value goes into effect when the operator:
x
Presses the selected button again, or
x
Selects another control, or
x
Presses the Control Lock button, or
x
Waits 5 seconds
All controls will then return to their normal brightness.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
8
SETTING UP MODES OF VENTILATION
Setting Up Assist/Control Mode
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
9
Setting Up the Ventilator in Assist/Control Mode:
Press the Select button twice to toggle the modes between Assist/Control and
SIMV/CPAP. Select the Assist/Control mode.
2) Press the Select button twice to toggle between Volume and Pressure ventilation.
Select Volume or Pressure, as desired.
3) Set the Breath Rate.
4) If Volume ventilation is selected, set the Tidal Volume. The calculated peak flow
Vcalc is displayed in the window while Tidal Volume is being changed.
5) If Pressure ventilation is selected, set the Pressure Control.
6) Set the Inspiratory Time. The calculated peak flow Vcalc is displayed in the
window while Inspiratory Time is being changed. Vcalc only applies to volume
ventilation.
®
7) Set O2% (LTV 1200 only).
8) Set the Sensitivity to a setting from 1 to 9.
9) Set the High Pres. Limit alarm.
10) Set the Low Pressure alarm.
11) Set the Low Min. Vol. alarm.
12) Adjust the PEEP control.
1)
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
10
SETTING UP MODES OF VENTILATION
Setting Up SIMV Mode
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
11
To set the Ventilator up in SIMV mode:
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
13)
Press the Select button twice to toggle the modes between Assist/Control and
SIMV/CPAP. Select the SIMV/CPAP mode.
Press the Select button to toggle between Volume and Pressure ventilation.
Select Volume or Pressure, as desired.
Set the Breath Rate.
If Volume ventilation is selected, set the Tidal Volume. The calculated peak flow
Vcalc is displayed in the window while Tidal Volume is being changed.
If Pressure ventilation is selected, set the Pressure Control.
Set the Inspiratory Time. The calculated peak flow Vcalc is displayed in the
window while Inspiratory Time is being changed. Vcalc only applies to volume
ventilation.
Set the Pressure Support, if desired.
Set O2% (LTV® 1200 only).
Set the Sensitivity to a setting from 1 to 9.
Set the High Pres. Limit alarm.
Set the Low Pressure alarm.
Set the Low Min. Vol. alarm.
Adjust the PEEP control.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
12
SETTING UP MODES OF VENTILATION
Setting Up CPAP Mode
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
13
To set the ventilator up in CPAP mode:
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
13)
Press the Select button twice to toggle the modes between Assist/Control and
SIMV/CPAP. Select the SIMV/CPAP mode.
Press the Select button twice to toggle between Volume and Pressure ventilation
for Apnea backup. Select Volume or Pressure for Apnea backup.
Set the Breath Rate to Off (dashes “- -“).
If Volume ventilation is selected, set the Tidal Volume for Apnea backup. The
calculated peak flow Vcalc is displayed in the window while Tidal Volume is being
changed.
If Pressure ventilation is selected, set the Pressure Control for Apnea backup.
Set the Inspiratory Time for Apnea backup. The calculated peak flow Vcalc is
displayed in the window while Inspiratory Time is being changed. Vcalc only
applies to volume ventilation.
Set the Pressure Support, if desired.
®
Set O2% (LTV 1200 only).
Set the Sensitivity to a setting from 1 to 9.
Set the High Pres. Limit alarm.
Set the Low Pressure alarm for Apnea backup.
Set the Low Min. Vol. alarm.
Adjust the PEEP control.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
14
SETTING UP MODES OF VENTILATION
Setting Up NPPV Mode
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
15
To set the Ventilator up in NPPV mode:
Set any desired Extended Features options and:
1) Push the Assist/Control, SIMV/CPAP mode button until the NPPV LED flashes.
Press the button once more to confirm. The NPPV LED continues to flash and
SET IPAP displays. The Pres. Support control display is bright and all other
controls dim.
2) Turn the Set Value knob to adjust the IPAP value (shown in Pres. Support LED
window). Press the Pres. Support button to confirm, SET EPAP will display. The
PEEP control display is bright and all other controls are dim.
3) Turn the Set Value knob to adjust the EPAP value (shown in the PEEP LED
window). Press the PEEP button to confirm.
4) The PEEP button push confirms NPPV operation and LED then turns solid.
®
5) Set O2% (LTV 1200 only).
6) Set the High Pres. Limit alarm.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
16
MONITORED DATA
The monitored data displays may be automatically scrolled or manually scrolled. To
cycle through the available monitored data automatically from a halted scan, press the
Monitor Select button (left of display window) twice. Pressing the Select button once
while scan is active shall halt scanning and the currently display monitor shall remain in
the display window. Each time you press the button once; the next data item in the list
will be displayed. To resume scan, press the Select button twice within 0.3 seconds.
The monitored data is displayed in the following order:
Display
PIP
MAP
PEEP
f
Vte
VE
Description
Displays the Peak Inspiratory Pressure measured during the
inspiratory phase. PIP is not updated for spontaneous breaths.
Displays a running average of the airway pressure for the last 60
seconds.
Displays the pressure in the airway circuit at the end of exhalation.
Displays the breaths per minute and includes all breath types.
Displays the exhaled tidal volume as measured at the patient wye.
Displays the exhaled tidal volume for the last 60 seconds as calculated
from the last 8 breaths.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
Display
I:E
I:Ecalc
Vcalc
SBT min
f/Vt f
17
Description
Displays the ratio between measured inspiratory time and measured
exhalation time. Both normal and inverse I:E Ratios are displayed.
Displays the ratio between the set Breath Rate and Inspiratory Time.
The display is updated in real-time while the Breath Rate setting is
being changed.
Is based on the Tidal Volume and Inspiratory Time settings. Displayed
when selected and whenever Tidal Volume or Inspiratory Time is
selected for change.
Displays the time remaining until the number of minutes preset in the
SBT OP, MINUTES menu have elapsed. (Only displayed in the SBT
mode of ventilation.)
f/Vt is computed every time the Total Breath Rate (f) or Total Minute
Volume (VE) is calculated. (Only displayed when SBT mode is
selected.)
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
18
EXTENDED FEATURES
Navigating the Extended Features Menus:
To enter the Extended Features menu (in normal ventilation mode),
press and hold the Monitor Select button for three seconds.
To view the next item in a menu, turn the Set Value knob
clockwise.
To view the previous item, turn the Set Value knob counterclockwise.
To enter a menu item or select a setting, press the
Select button.
To exit a menu, turn the Set Value knob until the EXIT option is displayed, then press
the Select button or press Control Lock.
®
19
®
20
P/N 18409-001, Rev. A
LTV 1200/1150 Ventilator
P/N 18409-001, Rev. A
LTV 1200/1150 Ventilator
EXTENDED FEATURES
SBT (Spontaneous Breathing Trial)
Using the Spontaneous Breathing Trial option you can temporarily minimize ventilatory
support and perform clinical assessments of a patient’s dependence on, or ability to be
removed from positive pressure ventilation. SBT mode should be used only while
attended by a Respiratory Therapist or other properly trained and qualified personnel
(please refer to the LTV® 1200 or LTV® 1150 Operator’s Manual, Chapter 10, for more
information).
When the Spontaneous Breathing Trial mode is turned on (SBT ON selected);
x
The ventilator switches to CPAP mode.
x
Pressure Support and FiO2 control settings on the front panel are overridden
with the values preset in the SBT OP menus.
x
The High Breath Rate alarm (HIGH f) in the ALARM OP menu is disabled (as
long as the SBT mode is on).
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
21
EXTENDED FEATURES
SBT (Spontaneous Breathing Trial)
To modify the Spontaneous Breathing Trial settings:
1)
Turn the Set Value knob until SBT START is displayed, push
the Select button, and SBT OFF or SBT ON is displayed.
Turn the Set Value knob until the desired setting is
displayed, and push the Select button.
x
When SBT ON is selected, the Spontaneous Breathing Trial
ventilation mode is turned on using the current SBT menu settings. If the SBT
menu settings were not previously reset, the factory set default settings will be
used. All SBT menu settings are to be reviewed for applicability and/or
set as necessary, prior to selecting the SBT ON menu option.
x
When the Spontaneous Breathing Trial ventilation mode is active and SBT
OFF is selected, the Spontaneous Breathing Trial ventilation mode is
terminated and ventilation returns to the previously set modes/settings.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
22
SBT (Spontaneous Breathing Trial)
2)
SBT Menu Options
SBT OP
SBT START
PRES SUPPORT
PEEP
®
SBT FIO2 (LTV 1200 only)
MINUTES
HIGH f/Vt
LOW f/Vt
SBT HIGH f
SBT LOW f
DISPLAY f/Vt
EXIT
Turn the Set Value knob until desired SBT menu option is displayed, push the
Select button and the value setting is displayed.
Turn the Set Value knob until the desired setting is displayed, push the Select
button, and the desired value is set.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
23
EXTENDED FEATURES
Exiting Extended Features
To return to Monitored Parameters:
1)
Turn the Set Value knob until EXIT is displayed.
2)
Press the Select button.
3)
Repeat Steps 1 and 2 until the Monitored Parameters are displayed.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
24
USING AC/DC POWER
Using the AC Adapter
To run the ventilator from an external AC
power source.
1)
Connect the power jack (straight or 90°)
from the AC adapter to the power port
pigtail connector on the left side of the
ventilator.
2)
Connect the proper AC power cable (110
or 220 V plug) to the AC power adapter.
3)
Connect the 110 or 220 V power cable to a
suitable power source.
While the ventilator is plugged in, the internal battery is continuously charged.
CAUTION: Release Button – To avoid damaging the ventilator or the power connector,
press the release button on the connector before removing it from the ventilator power
port pigtail connector.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
25
Using an External DC Power Source
To run the ventilator from an external DC power source.
1)
Connect the power port of the external DC power adapter cable to the power port
pigtail connector on the left side of the ventilator.
2)
If applicable, connect the DC jack to the DC power source.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
26
POWER DISPLAYS AND INDICATORS
Indicators
Battery Level
The Battery Level indicator shows the level of available internal battery power while
running from the internal battery.
Approximate Battery Time
@ nominal settings
LED Color
Battery Level
Green
Internal battery level is acceptable
45 minutes
Amber
Internal battery level is low
10 minutes
Red
Off
Internal battery level is critically low
Ventilator is running on AC or
External Battery
5 minutes
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
27
Indicators
Charge Status
When the ventilator is plugged into an External Power source, it automatically charges
the internal battery.
LED Color
Flashing
Amber
Green
Amber
Red
Charge Status
The ventilator is performing pre-charge qualification testing of the
battery prior to starting the charge process. This happens when
external power is first applied to the ventilator. The qualification
process normally takes a few seconds but may take up to an hour
on a deeply discharged battery.
The internal battery is charged to full level.
The battery has not reached a full charge level and is still charging.
The ventilator has detected a charge fault or internal battery fault.
The internal battery cannot be charged. Contact a Pulmonetic
Systems Certified Service Technician.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
28
POWER DISPLAYS AND INDICATORS
Indicators
External Power
The External Power indicator shows the level of external power while the ventilator is
operating from an external power source. When the ventilator is running from the
internal battery, the External Power indicator is off. When running from external power,
the indicator shows the following levels.
LED Color
Power Level
Green
External Power level is acceptable
Amber
External Power level is low
External power may be provided by connecting the ventilator to an external battery or to
an external AC power source.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
29
ATTACHING A BREATHING CIRCUIT
How to attach a Patient Breathing
Circuit.
1)
Connect the main breathing tube
to the 22 mm outlet port on the
right side of the ventilator.
2)
Connect the two exhalation flow
transducer sense lines to the
ports marked Flow Xducer on the
right side of the ventilator. These
are non-interchangeable Luer
fittings.
3)
Connect the Exhalation Valve
driver line to the port marked Exh
Valve on the right side of the
ventilator.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
30
OXYGEN COMPUTER CHART
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
31
Oxygen Computer Chart
To determine O2 Input Flow:
1) Find the desired FiO2 on the horizontal axis.
2)
Project up to the minute volume.
3)
Project horizontally to the left vertical axis and read the oxygen flow.
To determine O2 Concentration:
1)
Find the O2 input flow on the vertical axis.
2)
Project horizontally right to the minute volume.
3)
Project vertically down to the horizontal axis and read the FiO2.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
32
ALARMS
How to Silence and Reset Alarms
To silence an alarm, press the Silence Reset button.
To reset an alarm that has been corrected, press the Silence Reset button
again.
Alarm
Cause
APNEA XX bpm Occurs when the time since the last breath
Solution
Reevaluate the
start exceeds the set Apnea Interval. When patient’s condition.
an Apnea alarm occurs, the ventilator will
enter Apnea Back up ventilation mode.
Reevaluate ventilator
settings.
APNEA
An Apnea alarm has occurred and cleared
The ventilator is no longer in Apnea Backup mode.
Reevaluate the
patient’s condition.
Reevaluate ventilator
settings.
P/N 18409-001, Rev. A
Alarm
BAT EMPTY
BAT LOW
DEFAULTS
®
LTV 1200/1150 Ventilator
33
Cause
Solution
Occurs when the ventilator is operating
from the internal battery power and the
batter charge level is critically low. This
alarm can be temporarily silenced but
cannot be cleared.
Occurs when the ventilator is operating
from internal battery power and the battery
charge level is low.
Attach the ventilator to
external AC or DC
power.
Occurs during POST when the ventilator
detects an invalid setting stored in nonvolatile memory.
DEFAULTS SET Occurs when the ventilator is first powered
up after the SET DEFAULTS option has
been used to reset all controls and
extended features settings to their factoryset default values.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
Attach the ventilator to
external AC or DC
power.
Reevaluate power
requirements.
Push the
Silence/Reset button
twice to reset alarm.
Reevaluate ventilator
settings.
Push the
Silence/Reset button
twice to reset alarm.
Reevaluate ventilator
settings.
34
Alarms
Alarm
DISC/SENSE
HIGH f
Cause
Occurs when the ventilator detects one of
the following conditions:
x
The patient circuit or proximal
pressure sense line has become
disconnected.
x
The low side exhalation flow
transducer sense line has become
disconnected.
x
The proximal pressure sense line is
pinched or occluded.
Occurs when the Total Breath Rate (f)
exceeds the high breath rate and time
period alarm values.
HIGH O2 PRES Occurs when the average oxygen inlet
(LTV® 1200 only) pressure exceeds the acceptable limit for
Solution
Check Patient Circuit
assembly for
disconnects.
Check pressure
sensing lines for
occlusions.
Check Patient Circuit
assembly for leaks.
Check HIGH f alarm
values.
Reduce O2 inlet
pressure.
the type of oxygen source.
P/N 18409-001, Rev. A
Alarm
HIGH PEEP
HIGH PRES
HW Fault
®
LTV 1200/1150 Ventilator
Cause
Occurs when the ventilator detects one of
the following conditions:
x
The patient circuit positive end
expiratory pressure (PEEP) exceeds
the High PEEP alarm setting.
x
Patient Circuit, Exhalation valve
and/or PEEP valve occluded.
Occurs when the circuit pressure exceeds
the set High Pressure Limit setting.
Occurs when the ventilator detects a
problem with the ventilator hardware.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
35
Solution
Reevaluate ventilator
settings.
Disassemble, clean
and reassemble the
Patient Circuit,
Exhalation Valve and
PEEP Valve.
Reevaluate ventilator
settings.
Inspect Patient Circuit
for occlusions or kinks.
Reevaluate patient.
If alarm reoccurs,
contact your Service
Rep or Pulmonetic
Systems.
36
Alarms
Alarm
INOP
LOCKED
LOW MIN VOL
Cause
Solution
A ventilator INOP occurs when:
x
The ventilator is switched from On to
Standby.
x
The ventilator detects any condition
that is deemed to make the ventilator
unsafe.
If an INOP alarm occurs
during operation,
remove ventilator from
service and contact
your Service Rep.
The LOCKED message is displayed when Press the Control
a button is pressed while the controls are
Lock button.
locked. No audible alarm is given.
If locked alert
continues, press and
hold the Control Lock
button for three
seconds.
Occurs when the exhaled minute volume
Examine Exhalation
is less than the set Low Minute Volume.
Valve body for
disconnects.
Reevaluate patient.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
Alarm
Cause
LOW O2 PRES Occurs when the average oxygen inlet
(LTV® 1200 only) pressure is less than the minimum
acceptable inlet pressure of 35 PSIG.
LOW PEEP
Occurs when the patient circuit Positive
End Expiratory Pressure (PEEP) is less
than the Low PEEP alarm setting.
LOW PRES
Occurs when the peak inspiratory pressure
for a machine or assist breath is less than
the Low Pressure setting.
NO CAL DATA,
NO CAL
Occurs when the ventilator detects invalid
or missing calibration records on power up.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
37
Solution
Increase O2 inlet
pressure.
If using O2 cylinder,
replace used cylinder
with a new one.
Reevaluate ventilator
settings.
Disassemble, clean
and reassemble the
Patient Circuit,
Exhalation Valve and
PEEP Valve.
Examine Patient
Circuit for disconnect.
Reevaluate ventilator
settings.
Reevaluate patient.
Remove ventilator
from service, perform
Calibration procedure.
38
Alarms
Alarm
POWER LOST
Cause
Evaluate power
requirements.
Attach ventilator to an
external AC or DC
power source.
Occurs when the ventilator is operating on Evaluate power
external power and the voltage drops to the requirements.
low level.
Occurs when the ventilator is powered up
Ensure patient is
in the Ventilator Checkout or Ventilator
disconnected from
Maintenance modes. The ventilator is not
ventilator and is being
delivering gas.
ventilated by
alternative means.
POWER LOW
REMOVE PTNT
P/N 18409-001, Rev. A
Alarm
RESET
SBT < f
SBT > f
SBT < f/Vt
SBT > f/Vt
SBT OFF
XDCR FAULT
Solution
Occurs when the ventilator is operating on
external power and the voltage drops
below the useable level and switches to
internal battery operation.
®
LTV 1200/1150 Ventilator
Cause
A RESET alarm occurs if the ventilator
restarts following a condition other than
being shut down by pressing the
On/Standby button.
39
Solution
May be caused by
Internal Battery
depletion or ESD. If
the problem reoccurs,
remove from service
and contact your
Service Rep or
Pulmonetic Systems
These alarms are only active in the
Spontaneous Breathing Trial (SBT) mode
of ventilation (see the LTV® 1200 or LTV®
1150 Operator’s Manual, Chapter 9, for
more information on each alarm setting).
Occurs when a transducer autozero test
fails.
P/N 18409-001, Rev. A
®
LTV 1200/1150 Ventilator
Press Silence/Reset
button twice to reset
alarm. If problem
occurs frequently,
remove from service
and contact your
Service Rep. or
Pulmonetic Systems.
40
Cardinal Health
Pulmonetic Systems
17400 Medina Rd., Suite 100
Minneapolis, Minnesota 55447-1341
Customer Care:
Fax:
(800) 754-1914
(763) 398-8500
(763) 398-8403
www.cardinalhealth.com/viasys
Notes
On the CD
3 Glossary of Terms
3 Oximeter Teaching Checklist
3 Identification and Preparation Tool
3 Troubleshooting Guide
3 Preparation for ICU Discharge
3 Emergency Contacts and Planning
3 Preparation for Hospital Discharge
3 Useful Web Resources
3 Home Ventilation & Tracheostomy Care
(for Adults)
3 Emergency Preparedness Guide for People
with Disabilities/Special Needs
3 Non-Invasive Positive Pressure Ventilation
(for Adults)
3 Assistive Devices Program Equipment/
Supply Authorization Form
3 Home Ventilation and Tracheostomy Care
(for Paediatrics)
3 Quick Reference Guide to LTV® 900, 950 &
1000 Series Ventilators
3 Pulmonary Clearance Techniques
3 Quick Reference Guide to LTV® 1200/1150
Series Ventilators
3 Routine Tasks
3 My Education Checklist and Learning Log
Resource CD
Partners
Funding provided by
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Toronto, Ontario M5G 1Z8
Tel: 416-591-7800
Fax: 416-591-7890
Toll free: 1-800-261-0528
Email: [email protected]
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