Dräger Medical Evita 2 dura Instructions For Use Manual
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Dräger Medical Evita 2 dura Instructions For Use Manual

Intensive care ventilator
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M E D I C A L
Evita 2 dura
Intensive Care Ventilator
Instructions for Use
Software 4.n

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Summary of Contents for Dräger Medical Evita 2 dura

  • Page 1 M E D I C A L Evita 2 dura Intensive Care Ventilator Instructions for Use Software 4.n...
  • Page 2 Left-hand column... the text Patient mode After switching on, Evita 2 dura displays a choice of provides explanations and instructs the user step-by-step patient modes: – »Adults« = adult patients in the practical use of the product, with short, clear –...
  • Page 3 External flow source available as software version 4.n plus upgrade – The amount of external flow is calculated by Evita 2 dura 4.n (e.g. for additional tracheal gas insufflation) and adjusts the volume monitoring tolerances in order to avoid inadvertent alarms...

  • Page 5: Table Of Contents

    Contents Contents For Your Safety and that of Your Patients..........9 Intended Medical Application..............11 Operating Concept...................13 Ventilation Controls..................14 Setting ventilation parameters..............14 Selecting the ventilation mode..............14 Screen Operating Controls..............15 Keys for routine and additional functions............ 15 Power switch.................... 16 Standby key »...
  • Page 6 Contents Contents Displaying Curves and Measured Values..........40 In the main page..................40 Display measured values................41 Curve freezing...................42 Special Functions..................43 Manual inspiration..................43 Manual expiration hold................43 Medicament nebulisation................44 Oxygen enrichment for bronchial suction........... 47 Switching to Standby/Terminating standby mode........49 Calibrating....................50 Calibrating the O sensor manually............50...
  • Page 7 Contents Contents Fault – Cause – Remedy................71 Care......................79 Dismantling....................80 Removing parts..................80 Disinfecting/Cleaning/Sterilising............83 Disinfecting / cleaning / sterilising schedule..........85 Assembling....................86 Mounting the expiration valve..............86 Inserting the expiration valve..............86 Fitting the flow sensor................87 Fitting the O sensor.................
  • Page 8 Contents Contents BIPAP ..................... 115 Assist MMV....................... 116 Flow measurement.................. 117 Automatic leakage compensation.............119 Rapid Shallow Breathing RSB..............121 Negative Inspiratory Force NIF..............121 Insp. O concentration during medicament nebulisation..............122 Bibliography................... 123 What's what................... 125 Control unit..................... 126 Front connection block for ventilation............127 Back panel....................

  • Page 9: For Your Safety And That Of Your Patients

    For Your Safety and that of Your Patients For Your Safety and that of Your Patients Strictly follow the Instructions for Use Any use of the apparatus requires full understanding and strict observation of these instructions. The apparatus is only to be used for purposes specified here. Maintenance The apparatus must be inspected and serviced regularly by trained service personnel at six monthly intervals.
  • Page 10 If a fault is detected in Evita 2 dura so that its life-support occur. functions are no longer assured, ventilation using an...

  • Page 11: Intended Medical Application

    Intended Medical Application Contents Intended Medical Application Contents Intended Medical Application..............12...
  • Page 12 – IRV (Inversed Ratio Ventilation) If apnoea occurs, Evita 2 dura emits an alarm after the preset alarm period (T > ) and starts volume- Apnoea controlled ventilation.

  • Page 13: Operating Concept

    Operating Concept Contents Operating Concept Contents Ventilation Controls................14 Setting ventilation parameters..............14 Selecting the ventilation mode..............14 Screen Operating Controls..............15 Keys for routine and additional functions........... 15 Power switch................... 16 Standby key » «..................16 Screen Pages..................17 Structure of the main page............... 17 Structure of the application-specific pages..........17 »Settings«....................18 »Alarms«....................18...

  • Page 14: Ventilation Controls

    Operating Concept Ventilation Controls Ventilation Controls 1 Keys for selecting the ventilation modes: Evita 2 dura – IPPV – SIMV – BIPAP – other modes 2 Keys for selecting / setting ventilation parameters: – Tidal volume VT – Inspiration time Tinsp –...

  • Page 15: Screen Operating Controls

    Screen Operating Controls Screen Operating Controls 1 Menu keys for selecting the menu on the screen. Evita 2 dura 2 Central "turn-and-push" rotary knob for selecting and setting the options displayed on the screen. To select/set = turn the rotary knob To confirm = press the rotary knob.
  • Page 16 Standby key » « Placed on its own, away from other keys. Evita 2 dura For keeping the apparatus on standby for switching on ventilation. To switch to standby: Press and hold down the »...

  • Page 17: Screen Pages

    Operating Concept Screen Pages Screen Pages The screen pages consist of two basic structures: – the main page, displaying all important ventilation characteristics at a glance – the application-specific pages for functions and settings. Important functions are displayed in the same position in both structures: –...

  • Page 18: Settings

    Operating Concept Screen Pages The menu keys on the right-hand edge of the screen select the screen pages for the following specific Evita 2 dura application situations: – Settings – Alarms – Measurements – Measurement manoeuvre (optional) – Calib./Config. »Settings«...

  • Page 19: Calibration / Configuration

    Operating Concept Screen Pages »Calibration / Configuration« Sensors – Calibrating the sensors for O and flow – Switching the monitoring system on and off Device – Setting the volume of the acoustic alarm – Setting the screen contrast – Setting the date and time –...

  • Page 20: Colour Screen

    Colour screen Colour screen For differentiating various items of information on the screen. For messages: = Alarm Yellow = Caution or advisory message Blue = Alarm is no longer active Example: "!!! Apnoea" alarm For menu buttons: Green = Can be selected Black = Has been selected Example: Menu button »Device + + «...

  • Page 21: Operation

    Operation Contents Operation Contents Starting up....................22 Switching on.................... 22 Patient mode.................... 22 Selecting the patient mode............... 23 Starting ventilation..................24 Setting Ventilation Modes...............25 IPPV......................27 SIMV, SIMV/ASB..................29 BIPAP, BIPAP/ASB................. 31 BIPAP ....................32 Assist CPAP, CPAP/ASB.................. 33 MMV, MMV/ASB..................34 Apnoea ventilation..................

  • Page 22: Starting Up

    After power cuts and after standby mode, the settings valid immediately before the interruption of operation remain in use. Patient mode After switching on, Evita 2 dura displays a choice of patient modes: – »Adults« = adult patients – »Paed.« = children –...

  • Page 23: Selecting The Patient Mode

    – Previous application mode – tube or mask for optional NIV (example: NIV) The key »prev. patient« is not displayed by Evita 2 dura following a loss of data or removal of a previously used option (e.g. NeoFlow), thus preventing restoration of the previous setting.

  • Page 24: Starting Ventilation

    30 seconds with the last selected patient mode and ventilation mode and the associated ventilation parameters. The main page is displayed on the Evita 2 dura screen. The user can check and correct the settings in the display fields next to the parameter keys.

  • Page 25: Setting Ventilation Modes

    Setting Ventilation Modes Setting Ventilation Modes To set the ventilation parameters: Evita 2 dura 1 Press the appropriate ventilation mode key. The yellow LED in the key will light up. 2 Set the desired value = turn the rotary knob.
  • Page 26 Operation Setting Ventilation Modes To prevent settings being changed inadvertently Evita 2 dura 1 Press the » « Its yellow LED will light up. The parameter keys and ventilation mode keys will be protected against inadvertent setting. Before setting a new value: 1 Press the »...

  • Page 27: Ippv

    Operation Setting Ventilation Modes IPPV IPPV Intermittent Positive Pressure Ventilation Insp. Volume-controlled ventilation with a fixed mandatory pause minute volume MV, set with the tidal volume V frequency f. plat For patients unable to breathe spontaneously. Set ventilation pattern for IPPV via the keys for the ventilation parameters: insp Tidal volume »V...
  • Page 28 Operation Setting Ventilation Modes IPPV Sigh – to prevent atelectasis. Atelectasis can be prevented by activating the Sigh function and setting the sigh in the form of an intermittent PEEP. When the Sigh function is activated, the end-expiratory pressure is increased by the set intermittent PEEP for 2 ventilation strokes every 3 minutes.

  • Page 29: Simv, Simv/Asb

    PEEP If breathing stops, Evita 2 dura activates an alarm after the set alarm time (T > ) and starts volume- Apnoea controlled ventilation with the set ventilation parameters: Frequency »f...
  • Page 30 Operation Setting Ventilation Modes SIMV, SIMV / ASB Pmax SIMV, SIMV / ASB can be supplemented with the ventilation parameter Pmax Activate »Pmax pressure limit«, see page 64. Set the value of Pmax with the »Pinsp.« Pressure limited ventilation PLV* – for manually limiting pressure peaks using the Pmax pressure limit.

  • Page 31: Bipap, Bipap/Asb

    Apnoea ventilation – for automatic switchover to volume- controlled mandatory ventilation if the patient stops breathing. If the patient stops breathing, Evita 2 dura activates an alarm after the set alarm time (T > ) and starts Apnoea...

  • Page 32: Bipap Assist

    Operation Setting Ventilation Modes BIPAP Assist BIPAP Assist Biphasic Positive Airway Pressure Assisted pressure-controlled, assisted ventilation fast slow rise time rise time The inspiratory strokes are the same as for BIPAP, but the changeover from Pinsp to PEEP is not synchronised Pinsp with expiration by the patient.

  • Page 33: Cpap, Cpap/Asb

    Apnoea ventilation – for automatic switchover to volume- controlled mandatory ventilation if the patient stops breathing. If the patient stops breathing, Evita 2 dura activates an alarm after the set alarm time (T > ) and starts Apnoea...

  • Page 34: Mmv, Mmv/Asb

    Operation Setting Ventilation Modes MMV, MMV / ASB MMV, MMV / ASB Mandatory Minute Volume Ventilation* Assisted Spontaneous Breathing The overall minute volume is preset to a mandatory level, which can be adjusted by means of the tidal volume V ASB pressure support and frequency f.
  • Page 35 Operation Setting Ventilation Modes MMV, MMV / ASB Pmax MMV, MMV/ASB can be supplemented with the ventilation parameter Pmax. To activate »Pmax pressure limit«, see page 64. Pressure limited ventilation PLV* – for manually limiting pressure peaks using the Pmax pressure limit. The tidal volume remains constant as long as the pressure curve continues to show a short plateau, and the flow curve shows a brief pause in the flow between...

  • Page 36: Apnoea Ventilation

    It can be switched on in the ventilation modes SIMV, Spontaneous breathing BIPAP, CPAP, APRV. with ASB pressure support Evita 2 dura emits an apnoea alarm if during the set alarm PEEP period »T « no expiration flow is measured or Apnoea insufficient inspiratory gas is delivered.

  • Page 37: Setting Alarm Limits

    Operation Setting Alarm Limits Setting Alarm Limits Press the »Alarms« menu key. Example display: »Limits« This page displays all the alarm limits that can be set/adjusted. = lower alarm limit = upper alarm limit Example: Setting the upper alarm limit for f spont Select the f screen field with the cursor = turn the...

  • Page 38: In The Event Of An Alarm

    2 The alarm message is displayed in the right-hand corner of the top line of the screen. Evita 2 dura assesses the alarm message according to its priority, marks the text with exclamation marks and generates the various alarm tone sequences.

  • Page 39: Suppressing The Audible Alarm

    In the Event of an Alarm Once the fault has been remedied, the audible alarm is switched off. Evita 2 dura Caution messages (!!) and advisory messages (!) disappear automatically. Alarm messages (!!!) are then displayed in the colour of the status line and must be acknowledged: 1 Press the »Alarm Reset«...

  • Page 40: Displaying Curves And Measured Values

    To select a second group of 6 measured values: 1 Press the »Values « key. Evita 2 dura To select another pair of curves: 2 Press the »Curves « key. Measured values and curves can be selected, see "Combine displayed measured values", page 59 and...

  • Page 41: Display Measured Values

    Display measured values Press menu button »Measured values«. Display example: »Table 1« Evita 2 dura displays the measured values and their units of measure in the form of a table. The menu »Table 1« is displayed with all standard available measured values.

  • Page 42: Curve Freezing

    Operation Curve freezing Curve freezing To study the curve(s) in detail: 1 Press the »Freeze « key. Evita 2 dura To return to displaying new curve(s): 1 Press the »Freeze « key again.

  • Page 43: Special Functions

    Active in all ventilation modes. For determining the weaning value NIF 2 Hold down the »Exp. hold« key. The expiration phase remains effective and Evita 2 dura determines the measured NIF value as long as the key is pressed. After 15 seconds, the system automatically interrupts the expiration phase.

  • Page 44: Medicament Nebulisation

    Medicament nebulisation Medicament nebulisation During adult ventilation Applicable in every ventilation mode. Evita 2 dura applies the medicament aerosol in synchronisation with the inspiratory flow phase and maintains the minute volume constant. Depending on the set O concentration, the ventilator supplies the medicament nebuliser with medical air, pure oxygen or a mixture of medical air and oxygen.
  • Page 45 Operation Special Functions Medicament nebulisation The medicament nebuliser is automatically switched off after 30 minutes. After administration of the aerosol, the flow sensor is automatically cleaned and calibrated in order to prevent malfunctions in flow measurement. Use only medicament nebuliser 84 12 935 (white middle section).
  • Page 46 Operation Special Functions Medicament nebulisation 1 Connect the nebuliser hose to the port on the front panel of the Evita 2 dura. Evita 2 dura Fill the medicament nebuliser in accordance with its specific Instructions for Use. Warning: the effect of aerosols on sensors, filters and heat and moisture exchangers (HME) must be taken into account.

  • Page 47: Oxygen Enrichment For Bronchial Suction

    Evita 2 dura offers a programme for oxygen enrichment during the removal of secretions. After the programme is started, Evita 2 dura ventilates the patient in the selected ventilation mode for an initial oxygen enrichment phase of 180 seconds. In adult mode,...
  • Page 48 Special Function Oxygen enrichment for bronchial suction After disconnection for suction Evita 2 dura delivers a minimal flow for the duration of disconnection in order to detect the end of the disconnection phase automatically. In the help line at the bottom of the screen, the amount of time available...

  • Page 49: Switching To Standby/Terminating Standby Mode

    No ventilation takes place in standby mode! – to select the patient mode – to perform the device check – to maintain Evita 2 dura ready for operation – to preset ventilation parameters and alarm limits. Switching to Standby 1 Hold down the »...

  • Page 50: Calibrating

    Operation Calibrating Calibrating The saved calibration / zeroing values remain stored even when the machine is switched off. The pressure sensors for measuring the airway pressure are calibrated automatically. The O sensor and flow sensor are calibrated automatically every day. The flow sensor and O sensor can be calibrated manually at any time, even during ventilation.

  • Page 51: Calibrating The Flow Sensor Manually

    Select the »Flow« screen key = turn the rotary knob. Start calibration = press the rotary knob. Display (example): Evita 2 dura uses the next inspiration phase for the calibration. Short inspiration times are prolonged to about 1 second. Message in the help line at the bottom of the screen:...

  • Page 52: External Flow Source

    Confirm value via Confirm = press rotary knob. Determination of the external flow is aborted by Evita 2 dura if it exceeds 12 L/min or if flow measurement by Evita 2 dura is faulty. When the external flow has been determined...

  • Page 53: Switching Off The Monitor Functions

    = press rotary knob. Once the external flow has been measured by Evita 2 dura, its inclusion can be reactivated at any time: Select screen key »Extern. flow« = turn rotary knob, confirm = press rotary knob.

  • Page 55: Configuration

    Configuration Contents Configuration Contents System Settings..................56 Adjusting the volume of the audible alarm..........56 Setting the contrast................... 56 Country-specific settings................. 57 Selecting the language................57 Setting the date and time................57 Selecting measuring units................57 Interface....................58 Selecting the interface................58 Screen......................59 Selecting the displayed combination of measured values......59 Selecting the displayed curves..............61...

  • Page 56: System Settings

    Configuration System Settings System Settings Adjusting the volume of the audible alarm Press the »Calib./Config.« menu key. Press the »Device j« menu key. The »System« menu appears. Display (example): Select the »Loudness« screen field = turn the rotary knob. Activate = press the rotary knob. Set the desired volume = turn the rotary knob.

  • Page 57: Country-Specific Settings

    Configuration Country-specific settings Country-specific settings Selecting the language Evita 2 dura is supplied in the language of the customer's country. The following languages can be selected: – English – French – Italian – Spanish – Dutch – Swedish – American English –...

  • Page 58: Interface

    Configuration Interface Interface Selecting the interface Evita 2 dura offers the following interface protocols: – Printer (HP Deskjet 500 Series 500 and compatible printers with serial interface) – MEDIBUS (Dräger communications protocol for medical appliances) – LUST (List-controlled universal interface driver program, compatible with the Evita RS 232 interface as from software version 7.n)

  • Page 59: Screen

    Screen Screen Selecting the displayed combination of measured values Evita 2 dura displays a group of 6 selectable measured values in the right-hand field of the main page. An alternative second group can be displayed by pressing the »Values « key.
  • Page 60 Configuration Screen Display (example): Replacing MV Select the other measured value, e.g. »MV« = turn the rotary knob. Confirm = press the rotary knob.

  • Page 61: Selecting The Displayed Curves

    Configuration Screen Selecting the displayed curves Evita 2 dura shows two curves in the left-hand field of the main page. A different pair of curves can be selected by pressing the »Curves « key. The curve pairs can be combined as required.

  • Page 62: Ventilation Defaults

    Configuration Ventilation Defaults Ventilation Defaults – For defining the patient-specific start-up parameters »f« and »V «. – Ventilation parameters active on starting up the device. – Alarm limits active on starting up the device. – Ventilation mode. The »Ventilation« menu for the default settings active on starting ventilation can only be accessed after entering the code number 3032.

  • Page 63: Default Ventilation Parameter Values

    Configuration Ventilation Defaults Patient-specific defaults V , f: Factory-set Hospital-specific settings* Patient mode Tidal volume Ventilation frequency Tidal volume Ventilation frequency f 1/min f 1/min Paediatric ................Adult ................* The hospital-specific defaults for your hospital can be entered in the table. Default ventilation parameter values –...

  • Page 64: Activating / Deactivating Pressure Limit Pmax

    Configuration Ventilation Defaults Default ventilation parameters The hospital-specific defaults can be entered in the table below. PEEP Ramp Trigger insp mbar mbar mbar L/min Vol.% Factory setting Hospital- specific ................................setting* * The hospital-specific defaults for your hospital can be entered in the table.

  • Page 65: Apnoea Ventilation On/Off

    Configuration Ventilation Defaults Set the value for »Pmax«: Evita 2 dura Press the »Pinsp« parameter key. Set the desired value = turn the rotary knob. Confirm = press the rotary knob. Apnoea ventilation on/off To determine whether apnoea ventilation is automatically ready for use when starting.

  • Page 66: Leakage Compensation On/Off

    Configuration Leakage compensation on/off Leakage compensation* on/off Automatic leakage compensation allows the unit to compensate leakages up to 100 % of the set tidal volume in all volume-controlled ventilation modes. The setting for "Leakage compensation on/off" is saved and remains effective when the unit is restarted. Press menu button »Calib./Config.«, Press menu button »Ventilation jj«...

  • Page 67: Default Alarm Limits

    Configuration Ventilation Defaults Default alarm limits Press the »Calib./Config.« menu key. Press the »Ventilation jj« menu key. Enter code number »3032«. With the »Ventilation jj« menu key, select the »Alarms« menu. Display (example): Select the screen field of the desired alarm limit = turn the rotary knob.
  • Page 68 Configuration Ventilation Defaults Default alarm limits Hospital-set Ventilation parameters Factory-set defaults defaults* ..L/min +50 % total total ..–20 % total > mbar ..> + 100 % ..> Apnoea ..> 1/min spon ..* The selected hospital-specific defaults can be entered in the table.

  • Page 69: Default Ventilation Mode

    Configuration Ventilation Defaults Default ventilation mode After switching on, Evita 2 dura starts up in the ventilation mode displayed when this screen key is selected. If you require a different start-up ventilation mode: Press the »Calib./Config.« menu key. Press the »Ventilation jj« menu key.

  • Page 71: Fault - Cause - Remedy

    Fault – Cause – Remedy Contents Fault – Cause – Remedy Contents Fault – Cause – Remedy................. 72...
  • Page 72 Fault – Cause – Remedy The priority for alarm messages is marked by exclamation Fault – Cause – Remedy marks: Warning = Message with top priority Alarm messages in the alarm display field are displayed in Caution = Message with medium priority hierarchical order.
  • Page 73 Flow sensor not calibrated or defective. Calibrate flow sensor, page 51, replace if necessary. Expiration valve faulty. Replace expiration valve. External Flow Evita 2 dura calculates the externally Deactivate calculation of the external supplied flow when monitoring correct flow, see page 53. functioning of the flow measurement.
  • Page 74 Fault – Cause – Remedy Message Cause Remedy !!! Flow sensor ? Flow sensor not fully inserted in rubber Insert flow sensor correctly. lip of expiration valve. Hard key xx failed Key xx (e.g. » « ) can no longer be Call DrägerService.
  • Page 75 Remote Pad is faulty. Reset«. Call DrägerService at the next opportunity. The original ventilation functions of Evita 2 dura are not affected. Correct functioning of the nurse call or Remote Pad is not guaranteed, however: remove the nurse call and/or Remote Pad.
  • Page 76 Replace expiration valve, page 86, then clean and dry. Pressure measurement malfunction. Call DrägerService. !!! Standby activated Evita 2 dura has been switched to Confirm standby with »Alarm Reset« key. standby. !!! Temperature high Breathing gas temperature higher than Switch off humidifier.
  • Page 77 Leak or disconnection. Check that hose system connections are leakproof. !!! Tube blocked Evita 2 dura only applies a very small Check condition of patient, volume with each mechanical stroke, check tube. e.g. because the tube is blocked.

  • Page 79: Care

    Care Contents Care Contents Dismantling..................... 80 Removing parts..................80 Disinfecting/Cleaning/Sterilising............83 Disinfecting / cleaning / sterilising schedule..........85 Assembling..................... 86 Mounting the expiration valve..............86 Inserting the expiration valve..............86 Fitting the flow sensor................87 Fitting the O sensor................87 Note on the use of heat and moisture exchangers........

  • Page 80: Dismantling

    Temperature sensor (option) Remove the temperature sensor from the Y-piece – do not tug on cable. Remove the sensor probe from the back panel of Evita 2 dura. The temperature sensor is designed for wipe- disinfection. The temperature sensor is not suitable for...
  • Page 81 Care Dismantling Medicament nebuliser (option) 1 Disconnect nebuliser hose from medicament nebulizer and from the port on the unit. 2 Disconnect the medicament nebuliser from the adult hose system or 2 from the paediatric hose system. 3 Remove catheter connector (ISO cone ø 15 / ø 11) from the inlet.
  • Page 82 Care Dismantling Expiration valve Push the catch to the right, pulling off the expiration valve at the same time. If the expiration valve has an optional water trap: Remove the collecting jar. Only strip down the expiration valve if badly soiled: Unscrew stopper by hand and remove together with the diaphragm.

  • Page 83: Disinfecting/Cleaning/Sterilising

    Preparing Disinfecting/Cleaning/Sterilising Disinfecting/Cleaning/Sterilising Use surface disinfectants. For surface compatibility, use disinfectants based on: – aldehydes, – quaternary ammonium compounds. To avoid the possibility of damage to material, do not use any disinfectants based on: – alkylamine-based compounds – phenol-based compounds, –...
  • Page 84 Care Disinfecting / Cleaning / Sterilising Ventilator without ventilation hoses, gas supply hoses, temperature sensor Wipe disinfect e.g. with Buraton 10 F or Terralin (Schülke & Mayr, Norderstedt, Germany). Comply with the manufacturer's instructions. Cooling air filter, room air filter Filters must be cleaned or replaced when soiled or at the latest after 4 weeks, see page 107.

  • Page 85: Disinfecting / Cleaning / Sterilising Schedule

    Care Disinfecting / Cleaning / Sterilising Disinfecting / cleaning / sterilising schedule for Evita 2 dura Intensive Care Ventilator Applicable for use with non-infectious patients. For infectious patients, all parts that conduct breathing gas must be additionally sterilised after disinfecting and cleaning.

  • Page 86: Assembling

    Care Assembling Assembling Only use duly prepared components! Mounting the expiration valve The parts must be entirely dry to prevent malfunctioning. Be careful to fit the diaphragm in the correct position. Hold stopper by the flange and place diaphragm on the collar of the stopper.

  • Page 87: Fitting The Flow Sensor

    Care Assembling Fitting the flow sensor 1 Push the socket to the left as far as it will go. 2 Insert the flow sensor – with the probe facing towards the ventilator – into the mounting and push it into the socket as far as it will go.

  • Page 88: Note On The Use Of Heat And Moisture Exchangers

    Care Assembling Note on the use of heat and moisture exchangers The use of a heat and moisture exchanger (HME) ("artificial nose") in the patient connection can increase breathing resistance considerably. An increase in breathing resistance will in turn lead to greater effort in spontaneous breathing and/or greater trigger effort during assisted ventilation.

  • Page 89: For Ventilating Adults And Children

    Attachment on left-hand side: Evita 2 dura 4 Turn both ports to the left. 5 Turn Aquapor to the left. The following description applies when the ventilation hoses have been attached on the left-hand side.
  • Page 90 Care Assembling 1 Hang the hinged arm from the rail on the left-hand side and tighten screws. Connect ventilation hoses, and note length of hose (metres). 2 Turn ports in direction of hoses. 3 Install water traps in vertical position at the lowest point of their hose lines.

  • Page 91: For Ventilating Infants

    300 mL tidal volume V in »Ped.« patient mode. Fitting humidifier and ventilation hoses Evita 2 dura Fit the bacteria filter to the inspiratory port. Do not use a heat and moisture exchanger (HME) at the same time as a humidifier.

  • Page 92: Supply And Connections

    2 minutes. This continuous tone may be output for a shorter period if Evita 2 dura was switched on for less than 15 minutes. Evita 2 dura tolerates power interruptions shorter than 10 milliseconds – without any effect on ventilation.

  • Page 93: Gas Supply

    The compressed gases must be free of dust and oil and must be dry. Gas pressure must be 3 to 6 bar. Screw the connecting hoses for medical air and oxygen to the back panel of Evita 2 dura and insert their probes into the terminal units. Air O...

  • Page 94: Evita Remote (Optional)

    Instructions for Use. Connection Plug the lead of the Remote Pad into the socket » « on the rear of Evita 2 dura. The plug can be connected or disconnected at any time without impairing operation of Evita 2 dura.

  • Page 95: Note Automatic Self-Test

    Hook holder onto a standard rail and clamp into place. Hang Remote Pad into holder from above. Note automatic self-test – when connecting the Remote Pad to Evita 2 dura while the latter is switched on – when switching on Evita 2 dura after connecting the Remote Pad.

  • Page 96: Nurse Call (Optional)

    The nurse call is activated also when the internal loudspeaker in the ventilator is faulty. Connection of a nurse call does not relieve staff of their duty to check the monitoring on the Evita 2 dura screen at regular intervals. Screen displays must be checked regularly.

  • Page 97: Before Using For The First Time

    Immediately before using on the patient, check that the machine is working properly and is ready for operation. Evita 2 dura supports this "device check" by means of a built-in checklist that guides the user through the test in dialogue mode.
  • Page 98 The test lung consists of a tracheal tube CH 12 to simulate the resistance of the airways and a small bellows to simulate compliance. Only insert the elbow connector into the Y-piece when Evita 2 dura advises you to do so on the screen.

  • Page 99: Performing The Device Check

    Evita 2 dura runs through its self-test procedure. Wait until the 10-second test phase has been completed. After the self-test: 1 Switch Evita 2 dura to standby = Hold down key » « for about 3 seconds. Evita 2 dura The audible standby alarm tone is sounded.
  • Page 100 – Active humidifier, e.g. Dräger Aquapor – HME/Filter (artificial nose) If the type of humidifier is known, Evita 2 dura can take the temperature and moisture situation into account when measuring the volume parameters. Touch the »Humid.« screen key.

  • Page 101: Device

    Select the »Yes« screen key = turn the rotary knob. Confirm = press the rotary knob. Correct functioning of the expiration valve is checked by Evita 2 dura. Flow sensor 2 Correctly installed? Select the »Yes« screen key = turn the rotary knob.
  • Page 102 Care Device Check Air-O changeover valve Select the »Yes« screen key = turn the rotary knob. Confirm = press the rotary knob. Connect adult test lung to the Y-piece. Do not use an overstretched breathing bag, because it may cause artefacts during the device check.

  • Page 103: Leakproofing

    Care Device Check Flow sensor calibration Automatic sensor calibration Automatic Leakproofing With the »Check jj« menu button, select the »Tightness« menu. Activate the »Start« screen key = press the rotary control. Leakage The device determines leakage in L/min with reference to a pressure of 60 mbar. The »Tightness«...
  • Page 104 Care Device Check On completion of the device check, a checklist is displayed on the screen to show the results of the check. Correct result Incorrect result Check not performed : – – In the event of incorrect results, e.g. if the hose system is not sufficiently leakproof: Eliminate the cause of the fault Select the »Repeat«...
  • Page 105 1 Immediately start up Evita 2 dura, press » «, Evita 2 dura 2 Switch off Evita 2 dura for later use. Switch on back panel = pivot the cover-flap to the side, press button in as far as it will go and release.
  • Page 106 A leakage flow of 300 mL/min at a pressure of 60 mbar is permitted. After the leak test, the Evita 2 dura unit determines the compliance and resistance of the hose system. The calculated compliance of the hose system is used by...

  • Page 107: Maintenance Intervals

    Care Maintenance Intervals Maintenance Intervals Clean and disinfect equipment and / or components before any maintenance procedures – and before returning for repair! sensor replace when the following message is displayed: measurement inop and when calibration is no longer possible. Spent O sensors can be returned to Dräger for disposal.

  • Page 108: Removing And Reinserting Ambient-Air Filter

    Dräger Correct disposal of apparatus – at the end of its useful life After contacting the competent waste disposal company, hand over Evita 2 dura for appropriate disposal. The applicable legal regulations must be observed.

  • Page 109: Description

    Description Contents Description Contents Ventilation Modes................. 110 Volume-controlled ventilation with PLV............110 Sigh (intermittent PEEP)................. 111 SIMV..................... 112 ASB.......................113 BIPAP....................114 BIPAP .................... 115 Assist MMV......................116 Flow measurement................. 117 Automatic leakage compensation............119 Rapid Shallow Breathing RSB..............121 Negative Inspiratory Force NIF............... 121 Insp.

  • Page 110: Ventilation Modes

    Pplat in the curve Paw (t). insp Flow Manual pressure limiting with Pmax Insp.flow Evita 2 dura can prevent peaks of pressure, while maintaining the set tidal volume V , by means of the pressure limit Pmax. The tidal volume V remains...

  • Page 111: Sigh (Intermittent Peep)

    "slow" alveoli. In the Evita 2 dura, the sigh operates during expiration with an intermittent PEEP. The average airway pressure is higher, and a longer filling time is normally available.

  • Page 112: Simv

    SIMV time and therefore would normally result in an undesirable increase in the effective IMV frequency, Evita 2 dura adds back the reduced SIMV time by prolonging the subsequent spontaneous breathing phase by the SIMV time difference ∆...

  • Page 113: Asb

    With a slow increase in pressure Evita 2 dura begins gently with regular inspiratory flow. The patient has to take over more breathing effort, and so the tone of the breathing muscles gradually improves.

  • Page 114: Bipap

    Description Ventilation Modes BIPAP Biphasic Positive Airway Pressure The BIPAP ventilation mode is a pressure/time-cycled ventilation mode in which the patient can always breathe fast slow pressure assist spontaneously. BIPAP is therefore often described as a rise time rise time fast slow timed alternation between two CPAP levels.*...

  • Page 115: Bipap Assist

    Description Ventilation Modes Using BIPAP mandatory synchronised spontaneous As with IPPV, the time pattern is set using the basic BIPAP-Hub BIPAP-Hub breathing setting parameters of frequency f and inspiration time Tinsp. The lower pressure level is set with the PEEP parameter, while the upper level is set with Pinsp.

  • Page 116: Mmv

    This positive allowance is progressively reduced to zero by Evita 2 dura within a maximum of 7.5 seconds after apnoea. In other words, the response time of Evita 2 dura before...

  • Page 117: Flow Measurement

    IMV frequency f is set to correspondingly low values. In this case, Evita 2 dura triggers an apnoea alarm that is cancelled again as soon as the mandatory ventilation strokes have been applied. If the cycle time is set to a longer period than the T >...
  • Page 118 Example: a tidal volume of 500 mL NTPD is increased to 564 mL BTPS by heating to 37 °C and humidifying to 100 % r.h.. Evita 2 dura delivers the tidal volume after conversion, so that the set tidal volume is effective in the lung under BTPS conditions.

  • Page 119: Automatic Leakage Compensation

    This difference provides a measure of the amount of leakage and is displayed by Evita 2 dura as the leakage minute volume MV . Evita 2 dura can compensate for leak this leakage in volume controlled ventilation.
  • Page 120 Unlimited volume compensation is inappropriate. Evita 2 dura compensates for losses of up to 100 % of the set tidal volume V Due to technical tolerances, a small leakage minute volume may be displayed even if the hose system is leakproof.

  • Page 121: Rapid Shallow Breathing Rsb

    RSB index < 100 1 /(min x L) were weaned with a probability of 80 %, while 95 % of those with an RSB index > 100 were not yet ready to be weaned. Evita 2 dura indicates the RSB index in CPAP/ASB and PPS modes. Negative Inspiratory Force NIF The Negative Inspiratory Force index (NIF)** measures the patient's maximum inhalation effort after exhaling.

  • Page 122: Insp. O 2 Concentration During Medicament Nebulisation

    O concentration! To minimise the deviation from the set O concentration, Evita 2 dura generates a mixed gas to drive the medicament nebuliser. In adult ventilation, this mixed gas is generated by switching over the compressed gases (medical air and oxygen) in synchronisation with inspiration.

  • Page 123: Bibliography

    Description Bibliography Bibliography (1) Baum, M., Benzer, H., Putensen, Ch., Koller, W., Putz, G.: Biphasic Positive Airway Pressure (BIPAP) – eine neue Form der augmentierenden Beatmung Anaesthesist 38 (1989), 452-458 (2) Luger, Th.J., Putensen, Ch., Baum, M., Schreithofer, D., Morawetz, R.F., Schlager, A.: Entwöhnung eines Asthmatikers mit Biphasic Positi- ve Airway Pressure (BIPAP) unter kontinuierlicher Sufentanil Gabe...

  • Page 125: What's What

    What's what Contents What's what Contents Control unit.................... 126 Front connection block for ventilation............127 Back panel..................... 128 Abbreviations..................129 Symbols....................132...

  • Page 126: Control Unit

    What's what Control unit 21 20 19 18 17 15 14 13 12 Screen for displaying application-specific screen 13 Key for the BIPAP ventilation mode. pages. 14 Key for the SIMV ventilation mode. Menu keys for displaying the application-specific 15 Key for the IPPV ventilation mode. screen pages.

  • Page 127: Front Connection Block For Ventilation

    What's what Front connection block for ventilation 1 Flow sensor 2 Expiration valve with expiration port 3 Latch for expiration valve 4 Gas supply port for the medicament nebuliser 5 Inspiratory port 6 Connections for optional pressure measurement (not yet used) 7 Locking screw for protective cover (behind it: O sensor and ambient-air filter)

  • Page 128: Back Panel

    What's what Back panel 14 13 Power switch with protective flap »COM2«, »COM3« sockets for RS 232 and analogue interfaces (optional) Connection » « for Remote Pad, optional Connection » « for nurse call, optional Cooling-air filter ILV socket, optional Connection for oxygen Connection for medical air 10 »Temp...

  • Page 129: Abbreviations

    Abreviations Abbreviations Abreviation Definition APRV Airway Pressure Release Ventilation Spontaneous breathing at continuous positive airway pressure with short-term pressure release Assisted Spontaneous Breathing Pressure supported spontaneous breathing BIPAP Biphasic Positive Airway Pressure Ventilation mode for spontaneous breathing at continuous positive airway pressure with two different pressure levels BIPAP Biphasic Positive Airway Pressure Assisted Assist...
  • Page 130 Abreviations Abreviation Definition Ratio of Inspiration to Expiration Mandatory Minute Volume Ventilation Minute Volume Leakage minute volume leak Spontaneous breathed minute volume Negative Inspiratory Force Maximum inhalation effort Set value for inspiratory oxygen concentration [Vol.%] Set value of ASB pressure support Airway pressure PEEP Positive End-Expiratory Pressure...
  • Page 131 Abreviations Abreviation Definition Setting for tidal volume Setting for tidal volume of apnoea ventilation Apnoea Inspiratory breathing volume during an ASB stroke Expiratory tidal volume Inspiratory tidal volume Volume trapped in the lung by intrinsic PEEP, trap and exhaled during subsequent expiration.

  • Page 132: Symbols

    Symbols Symbols Symbol Definition Switch medicament nebuliser on / off ” Activate/deactivate oxygen enrichment for bronchial suction Suction Start manual inspiration ” Exp. Manually extend the expiration phase hold ⁄ Switch help function on / off ” Print Manual printer logging ”...

  • Page 133: Technical Data

    Technical Data Contents Technical Data Contents Environmental conditions................ 134 Settings....................134 Performance data...................135 Measured value displays................ 136 Monitoring....................137 Operating data..................138...

  • Page 134: Environmental Conditions

    Technical Data Technical Data Environmental conditions In operation 10 to 40 °C Temperature Atmospheric pressure 700 to 1060 hPa Rel. humidity 0 to 90 % In storage –20 to 60 °C Temperature Atmospheric pressure 500 to 1060 hPa Rel. humidity 0 to 100 % Settings Ventilation modes...

  • Page 135: Performance Data

    Technical Data Positive end-expiratory pressure PEEP or interm. PEEP 0 to 35 mbar Trigger sensitivity 0.3 to 15 L/min Pressure assist P 0 to 80 mbar rise time for pressure support 0 to 2 s (Ramp) 1:9.5 to 4:1 (can only be configured in default settings) Performance data Control principle Time-cycled, volume-constant, pressure-controlled...

  • Page 136: Measured Value Displays

    Technical Data Measured value displays Airway pressure measurement Max. airway pressure Ppeak Plateau pressure Pplat Pos. end-exp. pressure PEEP Mean airway pressure Pmean Min. airway pressure Pmin Range 0 to 99 mbar Resolution 1 mbar ±2 mbar Accuracy measurement in main flow (inspiratory side) Inspiratory O concentration FiO Range...

  • Page 137: Monitoring

    Technical Data Computed value displays Compliance C Range 0.7 to 200 mL/mbar Resolution Range 0.7 to 99.9 mL/mbar 0.1 mL/mbar Range 100 to 200 mL/mbar 1 mL/mbar ±20 % of measured value* Accuracy Resistance R Range 3 to 200 mbar/L/s Resolution Range 3 to 99.9 mL/mbar 0.1 mbar/L/s...

  • Page 138: Operating Data

    60 Vol.% and over: ±6 Vol.% Insp. breathing gas temperature Upper alarm limit alarm when temperature reaches 40 ºC (Evita 2 dura can also be used without temperature sensor if the sensor is not connected on switching on). Tachypnoea monitoring Alarm when the spontaneous breathing frequency is exceeded during spontaneous breathing.
  • Page 139 Technical Data Protection class Machine Class I sensor (sensor connected) Type BF Temperature sensor AWT 01 Type BF (sensor connected) Gas supply gauge pressure 3 bar –10 % to 5.5 bar +10 % at 60 L/min (peak flow 200 L/min) connection thread M 12 x 1, female air gauge pressure...
  • Page 140 Technical Data Cable length Up to 15 m Load impedance 3000 to 7000 ohm Signal level (at load impedance 3000 to 7000 ohm) Between 3 and 15 V High Between –3 and –15 V Electrical isolation Port COM 1 is electrically isolated from the machine electronics. The test voltage for the electrical isolation equals 1500 V.

  • Page 141: Parts List / Order List

    Parts List / Order List Contents Parts List / Order List Contents Parts List....................142 For adults ventilation ................142 For paediatric ventilation ................143 Order List....................144 Index..................... 146...

  • Page 142: Parts List

    84 12 384 Catheter connector, straight, Cooling-air filter 84 12 384 size 12.5 (set of 10) M 23 841 (back of Evita 2 dura, not illust.) Hose clamp 84 03 566 "EvitaMobil" trolley (high) 84 11 950 Corrugated hose 0.32 m 84 02 041 "EvitaMobil"...

  • Page 143: For Paediatric Ventilation

    Double conical connector 84 09 897 Cooling-air filter 84 12 384 Temperature sensor mounting 84 11 044 (back of Evita 2 dura, not illust.) Adapter K90 84 03 075 "EvitaMobil" trolley (high) 84 11 950 Cap 5x 84 01 645 "EvitaMobil"...

  • Page 144: Order List

    Y-piece, catheter connectors For trolley: Cabinet unit 8H, 360 mm high M 31 796 For supplying Evita 2 dura with medical air: For paediatric ventilation Breathing air compressor 84 13 890 Humidifier, basic unit, MR 730...
  • Page 145 Order No. Installation set, CapnoPlus 84 13 780 For adult ventilation: Temperature sensor 84 05 371 Accessories for Evita 2 dura CapnoPlus: Replacement set of lids for Aquapor 84 06 135 Adult cuvette 68 70 279 Aquapor bowl 84 04 739...

  • Page 146: Index

    Index Index bbreviations............129 lectricity supply............92 Accessories..............9 Evita Remote..............94 Expiration valve..........86, 101 Adequate monitoring..........10 External flow sources..........52 Adult ventilation............89 External interface............58 Advisory messages............ 71 Alarm..............38, 71 ault – Cause – Remedy..........71 Alarm limits Filter (cooling air) factory settings............37 Filter (hose system)............
  • Page 147 Index ain power switch.............16 ear................ 128 Maintenance............10, 107 Remote Pad............... 94 Manual expiration............43 Replacement parts..........141-145 Manual inspiration............43 Resistance............... 103 Manual ventilation............10 Room air filter............108 Maximum negative inspiratory force......121 RSB (Remote shallow breathing index).....121 Measured values..........18, 40 Measured values, overview.........41 ave settings.............
  • Page 148 These Instructions for Use apply only to Evita 2 dura with Serial No.: If no Serial No. has been filled in by Dräger these Instructions for Use are provided for general information only and are not intended for use with any specific machine or device.

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