NoxBox NOxBOXi Operating Instructions Manual
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NoxBox NOxBOXi Operating Instructions Manual

Intelligent nitric oxide delivery system
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®
NOxBOX
& NOxMixer
i
Before you use the NOxBOX Ltd NOxBOX
Ensure the device does not require maintenance (monthly) and that the maintenance is not due during the expected duration of the therapy such as:
•
NO sensor high calibration
•
NO
sensor high calibration
2
•
Pump calibration
•
Vent calibration

Checklist

•
Ensure the device is clean and free from damage
•
Ensure the water trap is empty and has been cleaned from previous use
•
Ensure all single use items from previous patient have been discarded
Equipment you will need for set-up:
•
A NOxBOX
system test kit (NOXBOX-I TEST)
i
•
A NOXKIT (inspiratory limb size dependant)
•
Two cylinders of delivery gas
Additional items
•
NOxAIR Environmental monitors
•
EMER kit- Emergency backup
•
Oxygen hose for NOxMixer
•
A 22mm one-way valve for HFO ventilator circuits (FXS555)
NOTE: If you do not have the parts listed above or the device has not been maintained the NOxBOX
set-up the device. Failure to follow these procedures may result in harm to to the operator or the patient.
NOxBOX Ltd, Station Road, Harrietsham, Maidstone, Kent, ME17 1JA
+44 (0)1622 854868
Issue 7.0 (Software V.17.1) March 2016. Part No: LAB637
© NOxBOX Ltd
NOxBOX Limited reserves the right to change or update this literature without prior notice. Registered office: England and Wales. Registered No: 9563860
1
intelligent Nitric Oxide delivery and monitoring system it is important to follow these steps:
i
+44 (0)1622 854860
ask@noxboxltd.com
Set- Up
may not be suitable for use and you may be unable to
i
www.noxboxltd.com
www.noxboxltd.com

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Summary of Contents for NoxBox NOxBOXi

  • Page 1 +44 (0)1622 854860 ask@noxboxltd.com www.noxboxltd.com Issue 7.0 (Software V.17.1) March 2016. Part No: LAB637 © NOxBOX Ltd www.noxboxltd.com NOxBOX Limited reserves the right to change or update this literature without prior notice. Registered office: England and Wales. Registered No: 9563860...
  • Page 2 ® NOxBOX & NOxMixer Operating Instructions Setup Engage trolley brakes to Carefully attach monitor Connect power supply to Press power button to start stabilise system prior to use. to trolley and fully tighten suitable rated mains outlet. system. clamp. Once zero test is complete, Connect to patient circuit;...
  • Page 3 ® NOxBOX & NOxMixer Operating Instructions Cylinder setup 1000 Engage trolley brakes to Check cylinder concentration Check regulator surfaces Load cylinders onto trolley. stabilise system prior to matches the setting for the and O ringsare damage free. Secure with straps.
  • Page 4 ® System tests NOxBOX & NOxMixer Operating Instructions System test circuit set-up: System test takes approx. Re-open NO cylinder. NOxFlow arrow points in Connect O supply to 5 minutes to run. This purges direction of flow. 1m vent NO2 and ensures correct NOxFlow inlet.
  • Page 5 ® NOxBOX & NOxMixer Operating Instructions Ventilator connections The NOxFlow is single Push and click-to-lock twin Select a vent connector with Connect sample line and patient use. Unwrap and sensor line to unit. luer port from the NOXKIT hydrophobic filter.
  • Page 6 & NOxMixer Operating Instructions (Gas available) (Depleted) To set or change dose press ‘edit dose’ . The NOxBOX will then guide you through setting the dose and high/low alarms. Once confirmed the delivery The navigation tabs access the alarm history and user settings screens.
  • Page 7 ® NOxBOX & NOxMixer Operating Instructions Cylinder replacement Fully close cylinder valve. Engage trolley brakes to Detach hose from monitor and Check regulator gauge stabilise system prior to depressurise on purge needle. pressure is relieved and changing cylinder. remove regulator from depleted cylinder.
  • Page 8 ® NOxBOX & NOxMixer Operating Instructions Shutdown When ready to shutdown Confirm on-screen that Fully close each cylinder and Check regulator gauge the system, briefly press the shutdown is required. Follow depressurise the supply lines pressure is relieved and power button on the on-screen instructions.
  • Page 9 All alarms are graded into high priority or medium priority alerts. NOTE: In all instances of alarms sounding, the health and condition of the patient must be ensured before attempting to resolve any issue with the NOxBOX system.
  • Page 10 & NOxMixer Operating Instructions NOxBOX Troubleshooting Guide Notifications at Switch on The below are a series of notifications which may be seen at start-up (before the home screen) if an issue is detected with the NOxBOX Notification Priority Possible Cause Recommended...
  • Page 11 Operating Instructions NOxBOX Troubleshooting Guide High Priority Alarms during therapy The below are a series of alarms which may be seen during therapy (once the device has been setup) if an issue is detected with the NOxBOX Alarm Priority Possible Cause...
  • Page 12 Check water trap (including barrel thread) for below the alarm setting boundary. damage and/or leaks. Check sample line is correctly attached to ventilator circuit and NOxBOX water trap inlet. Check no ventilator circuit breaks or leakages have occurred. The NO gas is balanced in N2, this is Check O concentration setting at ventilator.
  • Page 13 High Battery NOxBOX is running from internal battery and Reconnect the NOxBOX system to the mains using the NOxBOX power supply. This will ensure battery charge level has been detected as critical. Critical continued powered operation of the NOxBOX and will start to recharge the internal battery.

  • Page 14: Operating Instructions

    Check there is not a serious leak or break in the ventilator circuit. Attend to the ventilator circuit requirements. Check the ventilator is connected and supplying sufficient flow. High Critical The NOxBOX has detected a critical If another system is not readily available and patient requires therapy, engage the Delivery fault within the intelligent delivery...
  • Page 15 Priority Possible Cause Recommended Action Zero Medium Every 24 hours during use the NOxBOX prompts No special connections are required; the zero calibration is fully automatic. the user to perform a sensor zero. This operation Calibration ensures the most accurate system performance Press the tick to start the zero calibration.
  • Page 16 NOxBOX Troubleshooting Guide High Calibration Medium To keep the NOxBOX functioning accurately, it is This action may be performed whilst the system is in use via the service important that the system sensors be fully calibrated by engineer area. However Bedfont strongly recommend that the sensor high Overdue a suitably qualified Service Engineer once a month.
  • Page 17 Check the Oxygen source is flowing. cannot accurately deliver and monitor Nitric Oxide Check the NOxFLOW is connected to the Oxygen source and the NOxBOXi-TEST kit. inintelligent mode. Check the correct orientation of NOxFLOW.
  • Page 18 ® NOxBOX Troubleshooting Guide NOxBOX & NOxMixer Operating Instructions NOxMixer Issue Possible Cause Recommended action NOxMixer is not delivering a Ensure mode selector valve is dose (NO monitor shows no NO correctly oriented. Ensure all lines are connected. dose) Flow meter ball stuck...
  • Page 19 ® NOxBOX & NOxMixer Operating Instructions Manual override Use the look-up tables in this Find the vent flow setting to guide. To set flow rate, find best match patient settings. the table matching NO The column lists the approx. supply concentration.
  • Page 20 2. Ventilator Inspiratory Port 3. NOxFLOW (use 22F or 15M to vent tube adaptors) 4. Humidifier 5. 0.7m-1.3m Corrugated Tubing (15mm or 22mm) 6. NOxBOX Sample Line 7. 10M-10F, 12M-12F, 15M-15F or 22M-22F luer port connector 8. Patient Y-piece 9. Expiratory limb 10.
  • Page 21 ® NOxBOX & NOxMixer Operating Instructions Emergency backup Image showing two ends of EMER Attach the end of the tubing tubing. End 1-without luer without the luer to the outlet of End 2- with luer NOxMixer. Switch to manual override once...
  • Page 22 Dose look-up table ® NOxBOX & NOxMixer Operating Instructions 1000ppm, 900ppm, 800ppm, 500ppm Flow valve setting Minute flow volume Clinder Concentration (ppm) WARNING: Dose >40 ppm Dose over 20ppm Minute Volume (L/Min) 1000 Dial 10.5 11.5 12.5 13.5 14.5 15.5 16.5...
  • Page 23 Dose look-up table ® NOxBOX & NOxMixer Operating Instructions 450ppm, 400ppm , 300ppm, 250ppm Flow valve setting Minute flow volume Clinder Concentration (ppm) WARNING: Dose >40 ppm Dose over 20ppm Minute Volume (L/Min) Dial Minute volume (L/Min) Dial 10.5 11.5 12.5...
  • Page 24 Dose look-up table ® NOxBOX & NOxMixer Operating Instructions 225ppm, 200ppm, 100ppm Flow valve setting Minute flow volume Clinder Concentration (ppm) WARNING: Dose >40 ppm Dose over 20ppm Minute Volume (L/Min) Dial Minute Volume (L/Min) Dial Minute Volume (L/Min) 10.5 11.5...

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