Penlon AV-S Introduction Manual
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Penlon AV-S Introduction Manual

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Penlon
InterMed
AV-S Ventilator
Introduction
Partnership for Life

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Summary of Contents for Penlon AV-S

  • Page 1 Penlon InterMed AV-S Ventilator Introduction Partnership for Life...
  • Page 2 Penlon InterMed AV-S Ventilator ◆ Product Overview ◆ Introduction ◆ Characteristics ◆ Configuration ◆ Sub-assemblies Partnership for Life...
  • Page 3 Penlon InterMed AV-S Ventilator ◆ Operation ◆ Ventilator control settings ◆ Operation workshop ◆ Pre-operative checkout procedure Partnership for Life...
  • Page 4 Penlon InterMed AV-S Ventilator ◆ TECHNICAL DESCRIPTION ◆ AV-S Pneumatic description. ◆ AV-S Electrical description. Partnership for Life...
  • Page 5 Penlon InterMed AV-S Ventilator ◆ Practical: ◆ Disassembly. ◆ Planned maintenance. ◆ Test and calibration procedures. ◆ Fault finding. Partnership for Life...

  • Page 6: Product Overview

    Penlon InterMed AV S ventilator Product Overview Partnership for Life...

  • Page 7: Aims And Objectives

    AV-S ventilator. ◆ Objective: ◆ By the end of this module the student will be able to: ◆ Describe the features of the AV-S. ◆ Recognise user controls. ◆ Recognise AV-S configuration. Partnership for Life...
  • Page 8 Penlon InterMed AV-S Ventilator ◆ Pneumatically driven. ◆ Software controlled. ◆ Multi-mode ventilator. ◆ Time-cycled, volume/pressure controlled and pressure limited. ◆ Compliance & fresh gas compensated. ◆ User adjustable sigh & inspiratory pause. Partnership for Life...
  • Page 9 Penlon InterMed AV-S monitoring Integrated monitoring: ◆ Inspired oxygen measurement. ◆ Measured from inspiratory limb. ◆ Airway pressure measurement. ◆ Measured in the expiratory limb. ◆ Tidal/Minute volume measurement. ◆ Dual spirometry system. Partnership for Life...
  • Page 10 Penlon InterMed AV-S features ◆ Large 8.4” high definition colour screen. ◆ Touch screen. ◆ Rotary control dial. ◆ Single/ Dual waveform display. ◆ Designed to integrate with: ◆ PrimaSP; SP2 and SP3. ◆ A100SP; A200SP. Partnership for Life...
  • Page 11 Penlon InterMed AV-S features ◆ Print outs & interfacing: ◆ USB, Serial Port, Analogue outputs, HPPCL4 printer output. ◆ 30 minutes battery back up as standard: ◆ Optional 60 minute battery available. Partnership for Life...
  • Page 12 Penlon InterMed AV-S features Membrane keys LED power indicators: On/Off Switch Yellow when connected /battery charging Alarm silence/mute key. LED on/off indicator. Green when switched on Menu selection key Rotary control dial. Partnership for Life...

  • Page 13: Modes Of Ventilation

    Penlon InterMed Modes of ventilation ◆ Mandatory modes: ◆ Volume Mode. ◆ Pressure Mode. ◆ Spontaneous breathing support modes: ◆ SIMV. ◆ SMMV. ◆ Pressure Support. Partnership for Life...
  • Page 14 Penlon InterMed Modes of ventilation Volume Controlled Ventilation ◆ AV-S delivers a mandatory set volume of gas at fixed breath intervals. ◆ The Patient is making no respiratory effort. ◆ AV-S is volume limited and time cycled. ◆ Tidal volume setting range, 20 to 1600ml.
  • Page 15 Penlon InterMed Modes of ventilation ◆ Airway Flow and Pressure Patterns Inspiration Airway Flow Expiration Airway Pressure Partnership for Life...
  • Page 16 Penlon InterMed Modes of ventilation Volume ventilation parameter limits: ◆ Tidal volume adjustable from 20 – 1600 mL ◆ Rate adjustable from 4 – 100 bpm ◆ I:E ratio adjustable from 1:0.3 – 1:8 ◆ Peep 'Off' or adjustable from 4 –...
  • Page 17 Penlon InterMed 1.87.xx display Partnership for Life...

  • Page 18: Fresh Gas Compensation

    Penlon InterMed Fresh Gas Compensation AV-S uses spirometry information to adjust for: ◆ Gas added to the system from the anaesthesia machine. ◆ Losses in the system: ◆ Gas compliance. ◆ Maximum adjustment - 60% of set tidal volume. ◆...

  • Page 19: Compliance Compensation

    Penlon InterMed Compliance Compensation ◆ Corrects volume delivery for pressure losses in Circuit. ◆ Used if Fresh Gas Compensation is off. ◆ Switched off or Spirometry not available. ◆ Requires Breathing Circuit Compliance measurement. ◆ Carried out as pre-use check.
  • Page 20 Penlon InterMed Modes of ventilation Pressure controlled ventilation. ◆ Delivers a volume of gas to achieve a set pressure at fixed breath intervals. ◆ The Patient is making no respiratory effort. Partnership for Life...
  • Page 21 Penlon InterMed Modes of ventilation Pressure controlled ventilation ◆ AV-S is Pressure limited and time cycled. ◆ Pressure setting range, 5 to 70cmH ◆ Inspiration terminated after a preset time. ◆ Decelerating staged flow delivery. ◆ Reduces Inspiratory flow rate at 75% target pressure.
  • Page 22 Penlon InterMed Modes of ventilation ◆ Airway Flow and Pressure Patterns Airway Flow Airway Pressure Insp Partnership for Life...
  • Page 23 Penlon InterMed Modes of ventilation Pressure ventilation parameter limits: ◆ Inspiratory pressure adjustable 5 - 70 cmH ◆ Rate adjustable from 4 – 100 bpm ◆ I:E ratio adjustable from 1:0.3 – 1:8 ◆ Peep 'Off' or adjustable from 4 – 20 cmH ◆...
  • Page 24 Penlon InterMed Modes of ventilation Spontaneous respiration mode: ◆ Absorber must be in ‘Bag’ mode. ◆ Patient parameters monitored. ◆ Rate, I:E, Pressure, Tidal volumes Inspiratory oxygen. Partnership for Life...
  • Page 25 Penlon InterMed Software 1.87 xx Partnership for Life...
  • Page 26 Penlon InterMed Modes of ventilation Special / Support modes: ◆ SIMV, SMMV & PSV. ◆ These must be pre-selected. ◆ Absorber must be switched to ‘Vent’ mode. Partnership for Life...

  • Page 27: Special Modes

    Penlon InterMed Modes of ventilation Selecting Support Modes: ‘Standby’ ‘Special Modes’ ‘Select Mode(s)’ Partnership for Life...
  • Page 28 Penlon InterMed Modes of ventilation Using Support Modes: ◆ Touch special mode on- screen key x2 to select and confirm mode. ◆ Ensure absorber is switched to ‘Vent’ mode. ◆ Adjust ventilation parameters as required. Partnership for Life...
  • Page 29 Penlon InterMed Modes of ventilation ◆ SIMV/SMMV/PSV are used when a patient’s spontaneous respiratory rate, effort or tidal volume drops: ◆ Due to a deepening of the depth of anaesthesia. ◆ A safety net for a weak spontaneously breathing patient.
  • Page 30 Penlon InterMed Modes of ventilation Synchronised Intermittent Mandatory Ventilation ◆ Mandatory breaths delivered at a wide interval. ◆ Patient breathes spontaneously between mandatory breaths. ◆ Mandatory breath is synchronised with a patient breath. ◆ If no patient breath a mandatory breath is still delivered.
  • Page 31 Penlon InterMed SIMV spontaneously breathing patient Partnership for Life...

  • Page 32: Simv Non-Breathing Patient

    Penlon InterMed SIMV non-breathing patient Partnership for Life...

  • Page 33: Simv - Default Settings

    Penlon InterMed SIMV - default settings Adult Paediatric ◆ 3.6l 1.2l ◆ ◆ Insp. (Ti) ◆ Trig.level 1.0 l/min 1.0 l/min ◆ Vt can be adjusted before SIMV is confirmed Partnership for Life...
  • Page 34 Penlon InterMed Software 1.87 xx Partnership for Life...
  • Page 35 Penlon InterMed Modes of ventilation Synchronised Mandatory Minute Ventilation ◆ Mandatory breaths delivered at wide interval. ◆ If the patient’s minute volume less than pre-set value. ◆ Patient breathes spontaneously between mandatory breaths. ◆ No mandatory breath if patient minute volume greater than pre set minute volume.
  • Page 36 Penlon InterMed Modes of ventilation Synchronised Mandatory Minute Ventilation ◆ Mandatory breath is synchronised with a patient breath. ◆ Mandatory breaths are delivered in presence of apnoea. ◆ SMMV guarantees a minimum level of minute volume ventilation. Partnership for Life...

  • Page 37: Smmv Spontaneously Breathing Patient

    Penlon InterMed SMMV spontaneously breathing patient Spontaneous breaths Variable volume Mandatory breath Volume of Mandatory Breath = Vm/BPM – Volume spontaneously breathed during cycle Partnership for Life...

  • Page 38: Smmv Non-Breathing Patient

    Penlon InterMed SMMV non-breathing patient No spontaneous breaths Full volume Mandatory breath Partnership for Life...

  • Page 39: Smmv - Default Settings

    Penlon InterMed SMMV - default settings Adult Paediatric ◆ 3.6 l ◆ ◆ Insp. (Ti) ◆ Trig.level 1.0 l/min 1.0 l/min ◆ Vt can be adjusted before SMMV is confirmed Partnership for Life...
  • Page 40 Penlon InterMed Software 1.87 xx Partnership for Life...
  • Page 41 Penlon InterMed Modes of ventilation Pressure Support Ventilation ◆ Used to support spontaneously breathing patients. ◆ Each breath is supported by a synchronized, set inspiratory pressure. ◆ No patient effort then no support breath. ◆ No guarantee of minimum level of ventilation.

  • Page 42: Psv - Pressure Support

    Penlon InterMed PSV - Pressure Support Partnership for Life...

  • Page 43: Psv - Default Settings

    Penlon InterMed PSV - default settings Adult Paediatric ◆ P. Supp ◆ Insp. (Ti) ◆ Trig.level 1.0 l/min 1.0 l/min ◆ Support Pressure can be adjusted before PSV is confirmed. Partnership for Life...
  • Page 44 Penlon InterMed Software 1.87 xx Partnership for Life...

  • Page 45: Additional Functions

    InterMed Additional functions Electronic PEEP PEEP = Positive End of Expiratory Pressure ◆ AV-S uses an electronic integrated PEEP system. ◆ Controlled and regulated using secondary pressure on exhaust diaphragm. ◆ Allows flow from the bellows circuit to limit pressure.
  • Page 46 Penlon InterMed Additional functions Electronic PEEP cont’: ◆ Variable from 4-20 cmH O in increments of 1 cmH ◆ In Pressure (and volume) mode 10 cmH O differential is maintained ◆ Clear “OFF” indication when not in use ◆ Switch off the ventilator, and PEEP is switched off ◆...
  • Page 47 Penlon InterMed Integration ◆ Integrated with PrimaSP / PrimaSP2 anaesthesia machine. ◆ Ventilator can be switched on/off manually or via Prima SP/SP2 interface. ◆ Supply gas from auxiliary outlets. Partnership for Life...
  • Page 48 Penlon InterMed Integration ◆ Integrated with A200SP / A100SP absorbers. ◆ All leads located at rear. ◆ Spirometry measurement ◆ Bag/Vent switch position ◆ Inspired oxygen monitor ◆ Airway pressure monitor Partnership for Life...

  • Page 49: Rear Panel Connections

    Penlon InterMed Rear Panel connections LVDS output for Ethernet port allows remote mounted screen data to be viewed by configurations remote terminal Spirometry and USB is used for Switching interface software updates for absorber and and for information anaesthesia downloading...
  • Page 50 Penlon InterMed 1.87.xx Display Airway Pressure Limit Set Tidal Volume PEEP Select Tidal Volume I:E Ratio Breath Rate measured Partnership for Life...

  • Page 51: Any Questions

    Penlon InterMed Any Questions? Partnership for Life...

  • Page 52: Operation

    Penlon InterMed AV-S Ventilator Operation Partnership for Life...

  • Page 53: Aims And Objectives

    InterMed Aims and Objectives ◆ Aim: ◆ The aim of this module is to familiarise the student with the operation of the AV-S Ventilator ◆ Objectives: ◆ By the end of this module the student will be able to: ◆...
  • Page 54 Penlon InterMed Operation Switch On Short internal test Yellow indicator is sequence illuminated whenever Switch Off power is applied to the Short power down unit and internal battery sequence with audible is being charged tones 120 seconds Alarm silence for most alarms...
  • Page 55 Penlon InterMed Operation ◆ Check power connected ◆ Press and hold On/Off switch ◆ Ensure green LED illuminates ◆ Ensure audible signal sounds ◆ Check default screen displayed. Partnership for Life...
  • Page 56 Penlon InterMed Start up screen 1.87.xx ◆ Select desired mode: ◆ Site. ◆ Adult. ◆ Paediatric. Partnership for Life...
  • Page 57 Penlon InterMed Operation ◆ Adjust parameters by: ◆ Selecting parameter with rotary control dial or, Touching screen parameter ◆ key. Adjust value with rotary ◆ control dial. ◆ Confirm by: Pressing control dial or, ◆ ◆ Double touching parameter key.
  • Page 58 Penlon InterMed Operation Standby mode: ◆ Parameters can be pre- set. ◆ Alarms are active: ◆ High airway pressure (‘P Limit’ setting ). ◆ High/Low inspired O ◆ Negative pressure (-20 ◆ Incorrect Rate/Ratio. ◆ High Continuous Pressure (30 cmH...
  • Page 59 Penlon InterMed Operation Standby mode: ◆ Gas mix selection key 1. Measured FiO with upper and ◆ lower alarm limits displayed 2. ◆ Touch the on-screen parameter key to display O menu. ◆ Adjust values with rotary control dial and touch to confirm new setting.
  • Page 60 Penlon InterMed Operation Mode selection: ◆ ◆ After selection each mode Other parameter are pre- must be confirmed by set: touching again. ◆ Rate. ◆ ◆ I:E. Changing to Pressure Mode. ◆ PEEP. ◆ ‘Target’ can be pre-adjusted. ◆ P Limit (Vol. mode).
  • Page 61 Penlon InterMed Operation Mode specific features: ◆ Mode selections enable additional features. ◆ Pressure Mode. ◆ Changes ‘P Limit’ to ‘P Target’. ◆ Volume mode (Menu Functions). ◆ Sigh function. ◆ Ratio adjustable to 1, 2, 3, or 4 sigh breaths in 50.
  • Page 62 Penlon InterMed Operation Special Support modes: ◆ Support modes are pre- selected from the 'Special Modes' menu with ventilator in ‘Standby’. ◆ SIMV; SMMV; PSV. ◆ Absorber must be switched from ‘Bag’ to ‘Vent’ position. ◆ Screen message requests confirmation if no absorber switch detected.
  • Page 63 Penlon InterMed Operation User Controls: ◆ Previously used mode is underlined 1. ◆ T+PS INIT can be pre-set 2. ◆ If user switches from Press’ Vent to Vol’ Vent, the pressure limit, 3, is automatically set to 5 cm H O above the existing press’...
  • Page 64 Penlon InterMed Operation User controls: ◆ Trigger setting defaults to 1.0 litres/min. ◆ Adjustable between 0.7 and 4.0 litres/min. Partnership for Life...
  • Page 65 Penlon InterMed Operation Waveforms: ◆ Default waveform is Pressure v Time. ◆ Second waveform can be displayed. ◆ Volume vs Time. ◆ Volume vs Pressure (compliance loop). ◆ First loop can be frozen. ◆ Subsequent loops overlaid. ◆ Select using menu control or touch screen.
  • Page 66 Penlon InterMed Operation Partnership for Life...
  • Page 67 Penlon InterMed Operation Changing scale: ◆ ‘Plimit’ value changes Y axis. -10 to 40,60,80cmH ◆ ◆ In Vol v Time mode ‘Vt’ value changes Y axis (0 to 0.5,1,2 ltr). ◆ ‘Rate’ value changes X axis. ◆ 0 to 15, 5, 3 sec.
  • Page 68 Penlon InterMed Operation Changing scale: ◆ In Vol’ vs Pres mode ‘Plimit’ value changes X axis (-10 to,60,80cmH Partnership for Life...
  • Page 69 Penlon InterMed Operation On-screen settings: ◆ Tidal volume, Rate, I:E ratio, PEEP and Plimit settings are all available on the stand-by screen and can be pre-set by the user. Partnership for Life...
  • Page 70 Penlon InterMed Operation Setting adjustment: ◆ Tidal volume, Rate and I:E ratio settings are all limited by a maximum and minimum inspiratory flow. ◆ 2-75 Litres/min. ◆ Vt x BPM x (I + E) = Flow rate (L/pm). Partnership for Life...
  • Page 71 Penlon 600ml / 2sec = 18 l/min InterMed 75 l/min Breath rate of 10 bpm gives a cycle time of 6 seconds I:E ratio of 1:2 Vt (ml) gives an inspiratory time of 2 seconds 2 l/min With a tidal...
  • Page 72 Penlon InterMed Operation Additional features: ◆ Absorber connected indicator. ◆ Adult mode indicator (teddy bear symbol used for paediatric mode). Partnership for Life...
  • Page 73 Penlon InterMed Operation Using the menus: ◆ Menus can be opened by pressing the Menus Select soft-key located on the front of the ventilator, or by touching the relevant area of the touch-screen. ◆ Use control dial to select item.

  • Page 74: Main Menu

    Penlon InterMed Operation Main menu: ◆ Available from stand-by EXIT MENUS mode. O2 MONITOR & SPIROMETRY LEAK TEST MENU ◆ Not all subsequent menus FRESH GAS COMPENSATION: ON are available for alteration SPECIAL MODES by the user. WAVEFORM ALARM SETTINGS ◆...
  • Page 75 Penlon InterMed Operation Monitor & Spirometry menu: ◆ monitor can be switched On or Off. ESCAPE FROM MENU ◆ Allows calibration of O cell. MONITOR: ON > ◆ CALIBRATION: 100% 100% (recommended). HIGH ALARM SET: 105 ◆ 21%. LOW ALARM SET: 18 ◆...
  • Page 76 Penlon InterMed Operation Monitor & Spirometry menu: ◆ Spirometry function can be ESCAPE FROM MENU switched On or Off. MONITOR: ON ◆ CALIBRATION 100% Allows calibration of HGH ALARM SET: 105 Spirometry transducers. LOW ALARM SET: 18 ◆ Users - daily zero cal.
  • Page 77 Penlon InterMed Operation Leak Test menu: ◆ Checks system for leaks. ◆ Pressurises system to 30 ESCAPE FROM MENU ◆ > START/STOP LEAK TEST Holds pressure for 25 LEAK TEST STATUS: Excellent seconds. LEAK LEVEL: 39 ml/min ◆ Excellent under 50 ml/min.
  • Page 78 Penlon InterMed Operation Leak test menu cont’: ◆ Measures Breathing system compliance. ESCAPE FROM MENU ◆ > START/STOP LEAK TEST Typical 5-7 ml/cmH LEAK TEST STATUS: Excellent ◆ Max. 18 ml/cmH LEAK LEVEL: 39 ml/min BSYS COM: 7.0 ml/cmH ◆...
  • Page 79 ◆ Automatically OFF if Spirometry is switched off. ◆ If ‘Fresh Gas Comp.’ is Off ‘Compliance Comp’ is automatically ON (if turned on in the Penlon Options menu. > FRESH GAS COMPENSATION: ON Partnership for Life...
  • Page 80 Penlon InterMed Operation Fresh Gas Compensation menu cont’: ◆ Compliance compensation: ◆ Must be enabled in ‘Penlon Options’ menu. ◆ Delivered volume compensated for system compliance losses. ◆ Requires accurate ‘BSYS Comp’ value. ◆ Does not compensate for Fresh Gas Flow.
  • Page 81 Penlon InterMed Operation Mode selection menu: ◆ Support mode selection. ◆ SIMV; SMMV; PSV; NONE. > ESCAPE FROM MENU ◆ Trigger level adjustment. SUPPORT MODE: none ◆ 0.7 – 4.0 l/min. VOLUME TYPE: TIDAL ◆ Sigh Enable switches on or off...
  • Page 82 Penlon InterMed Operation Waveform menu: ◆ User can select the EXIT MENUS required second > SECOND WAVEFORM: off graphical display. ◆ OFF. ◆ Volume / Time. ◆ Volume / Pressure. Partnership for Life...
  • Page 83 Penlon InterMed Operation Alarm settings menu: ◆ Alarm mode. ESCAPE FROM MENU > ALARM MODE: default ◆ Default. HIGH TIDAL VOLUME: off ◆ Uses + 50% of front panel setting. min: 0.3 L (dflt) ◆ User. max: 0.9 L (dflt) ◆...
  • Page 84 Penlon InterMed Operation Alarm settings menu cont’: ◆ Alarm limits. ◆ min 0.0 – 7.4 ltr. ◆ max 0.1 – 7.5 ltr. ◆ min 10 – 1600 ml. ◆ max 20 – 2400 ml. ◆ Alarm volume. ◆ 50% – 100%.
  • Page 85 Penlon InterMed Operation Gas Mixture selection menu: ◆ Used for gas density correction to provide accurate spirometry. > GAS MIXTURE: O2+AIR ◆ + AIR. ◆ ◆ No individual sub menu. ◆ If O monitoring is off a 40/60 O /other gas mixture is assumed.
  • Page 86 Penlon InterMed Operation Service menu: ◆ Language: ESCAPE FROM MENU LANGUAGE: ENGLISH ◆ English. > PATIENT LOG MENU ◆ Italian. SITE DEFAULTS SERIAL MODE: none ◆ Turkish. ABSORBER SWITCH: on ◆ Polish. CLOCK MENU ◆ Spanish. UPGRADE MENU AMBIENT PRESSURE: 988 mBar ◆...
  • Page 87 Penlon InterMed Operation Service menu cont’: ◆ Patient Log Menu: ◆ Provides up to 8 hours of trend information. ◆ Prints ventilator performance ESCAPE FROM MENU > and patient data parameters for PRINT PATIENT DATA LOGGING: off up to 8 hours: Log Status : Disabled ◆...
  • Page 88 Penlon InterMed Operation Service menu cont’: ESCAPE FROM MENU ◆ Site Defaults LANGUAGE: ENGLISH ◆ Sets default start up parameters PATIENT LOG MENU ◆ > SITE DEFAULTS Serial Mode SERIAL MODE: none ◆ Sets output port to a monitor type ABSORBER SWITCH: on ◆...
  • Page 89 Penlon InterMed Operation Service menu cont’: ◆ Clock menu ESCAPE FROM MENU ◆ LANGUAGE: ENGLISH Date time adjustment PATIENT LOG MENU ◆ Upgrade menu > SITE DEFAULTS SERIAL MODE: none ◆ Software version ABSORBER SWITCH: on ◆ Feature enhancement CLOCK MENU UPGRADE MENU ◆...
  • Page 90 Penlon InterMed Operation Site Defaults Menu: ESCAPE FROM MENU ◆ Saves current values to site > SAVE TO SITE defaults. VIEW: SITE DEFAULTS ◆ VOLUME TYPE: Tidal View site, adult or paediatric Vt SET: 550ml default values. Vm SET: 5.5 litres ◆...
  • Page 91 Code required before access to SERIAL MODE: none Engineer menu. ABSORBER SWITCH: on ◆ Engineer menu. CLOCK MENU ◆ Access to Penlon Options and UPGRADE MENU Diagnostic menus. AMBIENT PRESSURE: 988 mBar > ◆ All system voltages; Valve DISPLAY HISTORY control;...

  • Page 92: Any Questions

    Penlon InterMed Any Questions? Partnership for Life...
  • Page 93 Penlon InterMed Workshops ◆ Complete Operations workshop. ◆ Complete Calibrations workshop. Partnership for Life...

  • Page 94: Technical Description

    Penlon InterMed AV-S Ventilator Technical Description Partnership for Life...
  • Page 95 By the end of this module the student will be able to ◆ Describe the operation of the AV-S pneumatic system ◆ Describe the operation of the AV-S electronic system ◆ Describe the function of optional devices used with the AV-S Partnership for Life...
  • Page 96 Penlon InterMed Components Control module: ◆ Electrical power supply. ◆ Inlet Manifold. ◆ Pneumatic Control Manifold. ◆ Patient Valve Block. ◆ Main PCB tray. ◆ Front panel assembly. Partnership for Life...
  • Page 97 Penlon InterMed Components Bellows assembly: ◆ Adult or paediatric bellows. ◆ Paediatric adaptor plate. ◆ Diaphragm valve. Partnership for Life...
  • Page 98 Penlon InterMed Components Electrical Box: ◆ User removable. ◆ Contains Spirometers and Bag/Vent switch. Partnership for Life...

  • Page 99: Bellows Function

    Penlon InterMed Bellows function Drive Gas proportioning valve Pressure relief valve Patient proportioning Exhaust valve valve Partnership for Life...

  • Page 100: Inspiratory Phase

    Penlon InterMed Inspiratory phase The diaphragm is held closed, the bellows is driven down and gas is delivered to patient circuit The Drive Gas proportional valve opens and drive gas is delivered The Patient proportional to bellows housing. valve opens and flows gas through the bleed valve.

  • Page 101: Expiratory Phase

    Penlon InterMed Expiratory phase Both the Drive Gas and Patient proportional valves close and exhaust valve opens. Patient gas returns to bellows. As bellows lifts redundant drive gas is pushed out through the exhaust valve. Partnership for Life...

  • Page 102: Exhalation Diaphragm

    Penlon InterMed Exhalation diaphragm With the bellows at the top of its housing fresh gas continues to flow. To prevent a high pressure build up the bellows diaphragm valve lifts and allows gas to exit through the exhaust valve. Partnership for Life...

  • Page 103: Peep Control

    Penlon InterMed PEEP control As fresh gas flows in the patient circuit, any pressure increase above PEEP pressure in the bellows will cause gas to bleed past the exhaust valve. A continuous flow from the Inspiratory proportional valve ensures that any fall in...

  • Page 104: Monitoring Devices

    Penlon InterMed Monitoring devices ◆ Oxygen monitor: ◆ Galvanic cell. ◆ Mounted in inspiratory line. ◆ Spirometry system: ◆ Two transducers are used. ◆ Inspiratory and expiratory limbs. Partnership for Life...

  • Page 105: Galvanic Fuel Cell

    Penlon InterMed Galvanic Fuel Cell ◆ Oxygen diffuses through the membrane. ◆ Oxygen in the electrolyte Membrane will cause electrons to Electrolyte flow. ◆ Current is proportional to the oxygen concentration. Resistor Partnership for Life...

  • Page 106: Flow Sensors

    Penlon InterMed Flow Sensors ◆ Two electronic flow sensors in absorber electrical box 1. ◆ Measures volume delivered to and from the circuit. ◆ Inspiratory sensor: ◆ Breath detection. ◆ Volume waveforms. Partnership for Life...

  • Page 107: Flow Sensor

    Penlon InterMed Flow Sensor Cont’: ◆ Expiratory sensor. ◆ Expired Volume measurement: ◆ >300ml ±10%. ◆ >100ml <300ml ±20%. ◆ <100ml ±50%. ◆ Lead connects to 'D' connector on rear of control module. Partnership for Life...

  • Page 108: Laminar Flow Sensor

    Penlon InterMed Laminar flow sensor Partnership for Life...

  • Page 109: Spirometry Measurement

    Penlon InterMed Spirometry measurement ◆ Mass flow sensor: ◆ The gas flow cooling effect is a function of velocity and density. ◆ Current is passed through a substrate, heating it to a certain temperature. As gas flows across the surface, the substrate cools.

  • Page 110: Volume Measurement

    Penlon InterMed Volume measurement ◆ Flow rates are sampled every 10 ms. ◆ Raw volume data is calculated. ◆ Gas mixture correction made using O measurement. ◆ Expired tidal volume is displayed. ◆ In normal alarm mode, if less or more than 50% of set volume, Low or High Volume alarm is given.

  • Page 111: Volume Measurement Cont

    Penlon InterMed Volume measurement cont’ ◆ With Fresh Gas Compensation 'ON' fresh gas flow is calculated and the next breath is adjusted as necessary. ◆ In ‘Spont’ mode Inspiratory and Expiratory phases are detected by respective flow being greater than the other.

  • Page 112: Pneumatic Block Diagram

    Penlon InterMed Pneumatic Block Diagram Partnership for Life...

  • Page 113: Gas Inlet Manifold Components

    Penlon InterMed Gas Inlet manifold components ◆ Gas supply O or Air: ◆ 310 – 689 kPa. ◆ 45 – 100 psi. ◆ 80 L/min. ◆ Inlet filter: ◆ 40 micron. ◆ Accessible from outside the unit. ◆ High Pressure switch: ◆...
  • Page 114 Penlon InterMed Gas Inlet manifold components ◆ Gas regulator: ◆ Set to 260 ±21 kPa (38 ± 3 psi) @ 5 L/min. ◆ Cut Off Valve: ◆ Once on power is reduce by 30%. ◆ Removes gas supply when unit is switched off.

  • Page 115: Gas Inlet Manifold Gas Path

    Penlon InterMed Gas Inlet Manifold gas path High Pressure regulator Cut-Off valve DISS connector Inlet filter Partnership for Life...

  • Page 116: Pneumatic Control Block

    Penlon InterMed Pneumatic Control Block ◆ Drive Gas Proportional valve. ◆ Microprocessor generates a PWM signal to control current in proportional valve. ◆ Operates between 3.5 - 13.5 Vdc. ◆ Flow Sensor. ◆ Provides feedback control to ensure correct output from proportional valve.
  • Page 117 Penlon InterMed Pneumatic Control Block ◆ Low pressure regulator ◆ Approximately 14kPa Adjusted to give 95 cmH O at ◆ diaphragm valve ◆ Patient Proportional Valve ◆ Controls flow through bleed resistor to set pressure on diaphragm ◆ Approximately 95 cmH...
  • Page 118 Penlon InterMed Pneumatic Control Block Continuous bleed during inspiratory phase @ 2 l/min Output to diaphragm Inlet from Gas valve inlet manifold Patient Low pressure proportioning regulator valve Nominal 14 kPa Partnership for Life...

  • Page 119: Patient Valve Block

    Penlon InterMed Patient Valve Block ◆ Removable and Auto-clavable. ◆ Check valve: ◆ Duck-bill style valve. ◆ Prevents exhaust gases entering the drive gas system. ◆ Diaphragm valve: ◆ Diaphragm closed during Inspiratory phase. ◆ Approx. 95 cmH ◆ Variable pressure applied to diaphragm sets pressure control and PEEP.
  • Page 120 Penlon InterMed Diaphragm valve (Inspiratory Phase) Partnership for Life...
  • Page 121 Penlon InterMed Diaphragm valve (Expiratory Phase) Partnership for Life...

  • Page 122: Main Tray Assembly

    Penlon InterMed Main Tray Assembly Partnership for Life...
  • Page 123 ◆ The main tray assembly controls all the functionality of the AV-S. ◆ Due to prohibitive costs Penlon do not repair defective or faulty boards. Boards will be replaced under warranty or can be supplied if outside of warranty period.

  • Page 124: Main Pcb Connections

    Penlon InterMed Main PCB connections Airway Pressure sensor (Green) Drive Pressure sensor (Yellow) Front Panel Controls Patient Valve pressure sensor Navigator Wheel (Red) Membrane keypad Touch screen Display Connection Supply Pressure switch On/Off valve; Inspiratory valve; Expiratory valve; Driving gas flow sensor...

  • Page 125: Pcb Features

    Penlon InterMed PCB Features Lithium battery Speaker TFT cable & connection LED indicators Partnership for Life...

  • Page 126: Led Indicators

    Penlon InterMed LED indicators ◆ LED-11 (nearest front): heartbeat ◆ LED-10: lit when drive valve is powered ◆ LED-9: lit when patient valve is powered ◆ LED-8: lit when touch-screen pressed ◆ LED-7: lit when I/O board running in test-harness mode ◆...

  • Page 127: Front Panel

    Penlon InterMed Front panel ◆ 8.4" TFT colour screen. ◆ Touch screen is resistive X-Y matrix. ◆ Light touch membrane. ◆ Direct graphic cable from main board CPU core. ◆ Ribbon cable to Encoder Board routes. ◆ Serial communications signals for Led's, Membrane switches, Rotary encoder and touch screen.

  • Page 128: Cpu Core And Ti Processor

    Penlon InterMed CPU Core and TI Processor ◆ CPU Core: ◆ Mounted in removable card slot. ◆ Holds main software. ◆ Main ventilator control. ◆ External communications. ◆ LCD and VGA controller. ◆ I/O Board processor: ◆ Control and communication with internal peripheral devices.

  • Page 129: Power Supplies

    Penlon InterMed Power Supplies ◆ Main supply. ◆ 14.2 Vdc from power supply unit. ◆ Battery supply. ◆ 12Vdc 1.2Ah lead acid - 3 Amp delay fused. ◆ Will power ventilator for 30 minutes from full charge. ◆ Screen goes to low power mode on battery.
  • Page 130 Penlon InterMed Power Supplies ◆ Lithium battery: ◆ Support real time clock for error. ◆ Vent’ Inoperative if defective. Partnership for Life...
  • Page 131 Penlon InterMed Power supplies ◆ Medical grade filtered IEC connector ◆ Line and neutral fused T2A ◆ 14.25 Vdc supplied from switch mode power supply ◆ Voltage and Current limited ◆ On board supplies ◆ Regulated +12Vdc ◆ LT1074 switch mode converter provides ◆...

  • Page 132: Drive Gas Proportioning Valve

    Penlon InterMed Drive Gas Proportioning valve ◆ Uses +12V supply. ◆ Initial output set according to +12Vdc user settings. ◆ gives 2 – 75 l/min. Proportioning Flow ◆ Current through valve valve sensor controlled using FET. ◆ FET controlled by micro-...

  • Page 133: Patient Proportional Valve

    Penlon InterMed Patient Proportional valve ◆ Uses +12V supply +12Vdc ◆ Initial pressure on diaphragm set according to user settings Proportioning ◆ Current through valve valve controlled using FET ◆ FET controlled by micro- Pressure processor through a sensor digital/analogue converter to give 3.5 –...

  • Page 134: Pressure Switches And Sensors

    Penlon InterMed Pressure Switches and Sensors ◆ Supply Pressure switch: ◆ Monitors gas supply pressure. ◆ Switch is normally open. ◆ Greater than 262 kPa (38psi) and switch closes. ◆ Less than 240 kPa (35psi) and switch opens. ◆ Drive Gas pressure sensor: ◆...

  • Page 135: Pressure Transducers

    Penlon InterMed Pressure transducers ◆ Airway and barometric pressure: ◆ Measures from expiratory line. ◆ Highly accurate device < 0.1% drift per year. ◆ As pressure applied to silicon the resisters generate a proportional voltage. Partnership for Life...

  • Page 136: Interface Connections

    Penlon InterMed Interface connections ◆ Parallel printer port: ◆ Uses HPPCL4. ◆ VGA: ◆ Provides output for external display. ◆ RS232: ◆ Proprietary use only. ◆ LVDS: ◆ Used for remote control panel ventilators. ◆ Ethernet: ◆ Allows network connection.

  • Page 137: Data Outputs

    Penlon InterMed Data outputs ◆ DB15 socket. ◆ 6 Analogue channels 0-5Vdc: Paw –10 to +100 cmH Average Paw –10 to +100 cmH Vt measured 0 – 2 litres. Inspiratory Flow 0 – 100 l/min. Vm measured 0 – 160 litres.

  • Page 138: Any Questions

    Penlon InterMed Any Questions? Partnership for Life...
  • Page 139 Penlon InterMed AV-S Ventilator Service and calibrations Practical workshop Partnership for Life...
  • Page 140 InterMed Aims and objectives ◆ ◆ The aim of this module is to explain the service, maintenance and calibration procedures required for the AV-S ◆ Objective ◆ By the end of this module the student will be able to ◆...

  • Page 141: Removal Of Sub-Assemblies

    Penlon InterMed Removal of sub-assemblies ◆ Front panel display. ◆ PCB tray. ◆ Pneumatic Control manifold. ◆ Power supply unit. ◆ Battery. ◆ Patient Block. ◆ Gas Inlet manifold. ◆ Bellows assembly. Partnership for Life...

  • Page 142: Front Panel Display Removal

    Penlon InterMed Front panel display removal ◆ Disconnect mains supply and remove top cover. ◆ Remove five screws: ◆ Two from each side at rear of front panel. ◆ One from centre of panel. ◆ Unplug two cables from front panel.

  • Page 143: Pcb Tray Removal

    Penlon InterMed PCB tray removal ◆ Disconnect mains supply and remove covers. ◆ Remove battery fuse. ◆ Remove two tray screws. ◆ Lift up tray. ◆ Disconnect five electrical connectors. ◆ Identify: ◆ Core Processor. ◆ Pressure transducer. ◆ Power circuit test points.

  • Page 144: Patient Block Removal

    Penlon InterMed Patient Block removal ◆ Undo two thumb screws and withdraw Patient Block. ◆ Identify: ◆ Diaphragm valve. ◆ Pressure connector. ◆ Bleed connector. ◆ One way valve. ◆ Pressure relief valve. Partnership for Life...
  • Page 145 Penlon InterMed Patient Block removal Partnership for Life...

  • Page 146: Pneumatic Components Removal

    Penlon InterMed Pneumatic components removal ◆ Disconnect gas supply. ◆ Remove PCB tray. ◆ Remove Patient Block. ◆ Remove two screws from underneath. ◆ Unscrew DISS fitting nut. ◆ Disconnect the Patient Airway Pressure transducer (Green). ◆ Disconnect two tubes.

  • Page 147: Gas Inlet Block Components

    Penlon InterMed Gas Inlet block Components ◆ Identify the following: ◆ Inlet filter. ◆ High pressure switch. ◆ Regulator. ◆ Pressure test point. ◆ On/Off valve. Partnership for Life...

  • Page 148: Pneumatic Control Block Components

    Penlon InterMed Pneumatic Control block components ◆ Identify the following: ◆ Drive Gas valve. ◆ Patient valve. ◆ Drive Gas pressure sensor. ◆ Drive Gas Flow sensor. ◆ Patient valve pressure sensor. ◆ Low Pressure regulator. ◆ Drive Gas connector.

  • Page 149: Power Supply Removal

    Penlon InterMed Power supply removal ◆ Remove PCB tray. ◆ Disconnect fuse. ◆ Disconnect two electrical connectors. ◆ Remove two screws holding PSU to mounting plate. Partnership for Life...

  • Page 150: Battery Removal

    Penlon InterMed Battery removal ◆ Remove fuse. ◆ Remove PCB tray. ◆ Lift out battery detaching from adhesive pad on chassis. ◆ Identify: ◆ 3 Amp battery fuse. ◆ Blade type. Partnership for Life...

  • Page 151: Bellows Assembly

    Penlon InterMed Bellows assembly ◆ Twist the canister 90 remove. ◆ Ease bellows from rim. ◆ Undo three screws and remove expiratory valve: ◆ Note o-ring under valve. Partnership for Life...

  • Page 152: Service Procedure

    Penlon InterMed Service Procedure ◆ Four year Service program: ◆ 6 Monthly. ◆ No Preventive maintenance Kit (PMK) required. ◆ Annual service. ◆ PMK Pt No – 57298. ◆ 2 Year service. ◆ PMK Pt No – 57299. ◆ 4 Year service.

  • Page 153: Preventive Maintenance Kits

    Penlon InterMed Preventive Maintenance Kits ◆ All kits come with a data One year Kit Part No 57298 Patient Block Assembly: sheet listing components Exhaust diaphragm 300580 One-way valve 300581 and detailed fitting O-ring 5 mm 041204 O-ring 7 mm 041245 instructions.

  • Page 154: Service Procedure - 6 Monthly

    Penlon InterMed Service Procedure - 6 Monthly ◆ Check: ◆ Mechanical damage. ◆ Electrical safety (IEC class 1type B device). ◆ Power on; display; control functions. ◆ Supply voltages. ◆ Error history. ◆ Bellows diaphragm valve. ◆ Operation in all modes.
  • Page 155 Penlon InterMed Service Procedure - 6 Monthly ◆ Calibrate: ◆ sensor. ◆ 100%. ◆ Check at 21%. ◆ Check Calibration: ◆ Spirometery. ◆ Gas Delivery. Partnership for Life...
  • Page 156 Penlon InterMed Service Procedure - 6 Monthly ◆ Remove Patient Block. ◆ Examine Diaphragm valve. ◆ Clean as necessary. ◆ Strip and clean Spring, End Cap, and Insert. Partnership for Life...

  • Page 157: Service Procedure - Annual

    Penlon InterMed Service Procedure - Annual ◆ In Addition to 6 monthly procedure. ◆ Check primary regulator. ◆ Check Patient valve pressure. ◆ Check proportional valves. ◆ Replace the following: ◆ Probe o-rings. ◆ Patient valve Diaphragm. ◆ Patient valve Check valve.

  • Page 158: Service Procedure - 2 Year

    Penlon InterMed Service Procedure - 2 year ◆ In addition to annual Service. ◆ Replace: ◆ Mains back-up battery. Partnership for Life...

  • Page 159: Service Procedure - 4 Year

    Penlon InterMed Service Procedure – 4 year ◆ In addition to 2 year Service. ◆ Replace: ◆ Patient block o-rings. ◆ Patient block Pressure relief valve. ◆ Lithium battery. ◆ Bellows diaphragm. Partnership for Life...
  • Page 160 Penlon InterMed Service procedure ◆ Practical workshop: ◆ Carry out an annual service in accordance with Service Manual section 7. Partnership for Life...

  • Page 161: Any Questions

    Penlon InterMed Any Questions? Partnership for Life...
  • Page 162 Penlon InterMed AV-S Ventilator Calibrations and Adjustments Practical Workshop Partnership for Life...

  • Page 163: Primary Regulator Calibration

    Penlon InterMed Primary regulator calibration ◆ Dynamic measurement: ◆ 260 kPa +21kPa (38psi +3psi) @ 5lpm flow. ◆ Connect test manometer to self sealing test point. ◆ Adjust gas flow to 5lpm. ◆ Set front panel controls to: ◆ Vt – 500 ml.

  • Page 164: Secondary Regulator Calibration

    Penlon InterMed Secondary regulator calibration ◆ Dynamic measurement: ◆ Provides 140 cmH O on diaphragm with bleed flow. ◆ Approximately 2 l/min. ◆ Connect test manometer into the 4mm test point 2. ◆ Set front panel controls to default settings.

  • Page 165: Alternative Method Of Secondary Regulator Calibration

    Penlon InterMed Alternative method of Secondary regulator calibration ◆ Dynamic measurement: ◆ Provides 95 cmH O on diaphragm with bleed flow. ◆ Approximately 2 l/min. ◆ Remove Patient Block. ◆ Connect test manometer smallest probe from Pneumatic Control Manifold. ◆...

  • Page 166: Barometric Calibration

    Penlon InterMed Barometric Calibration ◆ Ensure all tubes disconnected from rear of ventilator. ◆ In ‘Penlon Options’ menu select ‘Cal Pressure’. ◆ Adjust to current barometric pressure and confirm. ◆ Zeros all pressure transducers: ◆ Drive Valve. ◆ Patient Valve.

  • Page 167: Spirometry Zero Calibration

    Penlon InterMed Spirometry zero calibration ◆ Disconnect fresh gas hose from anaesthesia machine. ◆ Set bag vent switch to bag and disconnect bag from bag-arm. ◆ Remove breathing circuit from absorber. ◆ Select 'SPIRO CALIBRATION:0 L/min' from menu and confirm.

  • Page 168: Patient Valve - Zero And Cal

    Penlon InterMed Patient valve – Zero and Cal ◆ Connect ventilator to circle system as for normal use with patient Y-piece occluded. ◆ Set anaesthesia machine to 5 l/min. ◆ Select ‘PV Zero‘. ◆ Patient valve is slowly opened. As diaphragm is closed circuit pressure will increase by 5 cmH ◆...

  • Page 169: Drive Valve - Zero

    Penlon InterMed Drive valve - Zero ◆ Fit Patient Block: ◆ Disconnect drive gas hose and occlude connector. ◆ Select ‘DV zero‘ from Cal Valves menu: ◆ Patient valve automatically closes. ◆ Drive valve PWM slowly incremented until pressure increase detected.

  • Page 170: Drive Valve - Measure

    Penlon InterMed Drive valve - Measure ◆ Connect calibrated flowmeter to Drive gas outlet. ◆ Select ‘DV Measure’. ◆ Drive Valve opens until Drive flow sensor reads 20 l/min. ◆ Compare with calibrated flowmeter and adjust with Trim Flow. ◆...

  • Page 171: Drive Flow Curve Calibration

    Penlon InterMed Drive Flow Curve Calibration ◆ Ensure Leak Test is completed successfully. ◆ Connect ventilator, absorber and breathing circuit with re-breathing bag fitted. ◆ Remove bellows from canister. ◆ Select ‘<Start/Stop Curve Cal>’. ◆ Bag is filled at 20 l/min: ◆...

  • Page 172: External Spirometry Calibration

    Penlon InterMed External Spirometry calibration ◆ Ensure Drive Flow has been calibrated. ◆ Disconnect fresh gas hose from anaesthesia machine and connect to Bag arm. ◆ Close APL valve and set bag vent switch to bag. ◆ Disconnect Vent Drive hose from rear of absorber and connect to Expiratory port (use Pt no 52036).
  • Page 173 Penlon InterMed Any Questions? Partnership for Life...
  • Page 174 Penlon InterMed The End Partnership for Life...

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