The ventilator is one of the most critical devices in clinical emergency care in major hospitals, and it plays an important role in modern hospital equipment. However, because the ventilator is a rescue device and has its own special factors, it is often one of the most prone to problems in clinical use and difficult to use. Therefore, the daily maintenance of the ventilator is particularly important. In the absence of the corresponding testing equipment, it is very important to give full play to the ventilator's own intelligent detection (self-test). It is necessary to first determine whether the ventilator is in normal working condition and find the problem in time to ensure that the ventilator is always in the most Good performance status.
There are four main types of ventilators commonly used in our hospital: Puritan-Bennett (PB), New Port, SIEMENS, and Drager. The degree of intelligence of these models is different, and the allowable errors of setting, detection, and measurement are different, so there are differences in performance tests during smart detection (self-test). Some are very simple, as long as the indicator panel lights up when they are turned on, they can pass through a few minutes without any human operation (such as Nubbon, Dräger, etc.), while others are more complicated, more complicated, and more time consuming. It needs to be completed after a certain operation (such as PB, Siemens, etc.).
3, the steps of intelligent detectionDifferent types and different grades of ventilators have different self-test procedures, some are relatively simple and easy, and some are more complicated and time-consuming. The self-test of PB840 ventilator is taken as an example to describe its operation process and precautions. There are three main types of self-tests for PB840 ventilators: POST (Power On Self Test) - Power On Self Test, SST (Short Self Test) - EST (Extended Self Test) - Complete Self Test.
3.1 POST (Power On Self Test) - power on self test:It is mainly used for system faults caused by hardware integrity and non-operation of ventilator circuit. It will automatically run when the machine is turned on or restarted. Under normal circumstances, POST takes 7.25 seconds.
3.2 SST (Short Self Test) - Quick Self Test:It is mainly used to test patient tube leaks, correct patient lines and measure the resistance of bacterial filters at the exhalation end. SST is performed before the ventilator is connected to the patient, after 15 days of use, after replacement of the patient circuit, after maintenance of the machine, and when replacement of accessories such as humidified dishes, water cups, etc. that affect airway resistance and compliance.
SST implementation steps: 1 Connect the power and air supply and breathing circuit, turn on the ventilator power, then the selection menu will appear on the display, touch SST, select fast self-test, then press the ventilator within 5 seconds The TEST button on the left side of the main unit will enter the quick self-test mode. 2 After entering the self-test mode, an SST setup menu will appear on the screen, and the type of ventilator circuit and humidifier will be selected. 3 After selecting the type of ventilator circuit and humidifier, press Accept to confirm, the ventilator will automatically start the self-test process:
1) SST Flow Sensor Test: Firstly, the screen will prompt the breathing circuit to connect to the filter and without humidifier. After the implementation, the screen will prompt you to block. Hold the Y port (Block wye), confirm it after execution, the instrument will detect the flow sensor, and the detection screen will display: If the humidifier is used, please connect the humidifier (Connect humidifier if applicable), confirm after execution. , the breathing opportunity automatically enters the next step;
2) Circuit Pressure Test;
3) Circuit Leak pipe leak test;
4) Expiratory Filter Test: The screen prompts you to disconnect the pipe connected to the outgoing filter (Disconnect at FROM PATIENT port), confirm after execution, and the test will automatically enter the next step;
5) Circuit Resistance pipe resistance test: Firstly, the screen will prompt to release the Y port (Block wye), after the implementation, the breathing will automatically enter the next step;
6) Compliance calibraTIon compliance test: the screen will prompt to release the Y port, confirm after execution, the instrument will detect, then the screen will prompt to block the Y port, confirm after execution, the instrument will detect. All SST test items are completed after the test. Finally choose EXIT SST to exit the quick self test.
3.3 EST (Extended Self Test) - complete self-test:Mainly used to check the entire gas path of the ventilator and part of the circuit (including gas mechanics, compressors, sensors, power supply parts, etc.), EST contains some of the steps of POST and SST. When the ventilator is running for 6 months, after repairing, after replacing parts or after servicing the machine, EST can effectively help us find faulty parts.
EST execution steps: 1 The machine is preheated for at least 10 minutes. 2 Connect the power supply, and connect the air and oxygen gas source (the air compressor can be used as the air source), remove the suction end filter, and connect the suction end and exhalation of the ventilator directly with the gold standard test circuit (golden pipeline). end. 3 Turn on the power switch of the machine. When the indicator light of the air supply unit is on, press the Test button on the left side of the ventilator within 1 second to enter the system maintenance mode. 4 After entering the maintenance mode of the system, touch the EST button, then press Accept to confirm, the ventilator will automatically start to enter the EST process:
1) Circuit Pressure Test, then the ventilator prompt will prompt: Connect air and oxygen, to remove inspiratory filter, and to install test circuit. (Connect air and oxygen, remove the suction end bacteria filter Install the test tube) After pressing the ACCEPT button, the breathing machine will enter the automatic detection. If PASSED, it will automatically enter the next step;
2) Flow sensors cross check test, the breathing opportunity enters the automatic detection, if PASSED, automatically enters the next step;
3) EST Gas Supply/SV Test, this step will detect whether there is wall air connection, if there is no wall air connection, it will give a prompt: Connect wall air. If there is a wall Connect the air, then press the ACCEPT button. If there is no wall air, press the CLEAR button, then the block to paTIent port. will be prompted, and then the disconnect oxygen will be prompted. (Disconnect oxygen), press ACCEPT after disconnecting, and then prompt disconnect air. (Disconnect air) After disconnecting, press ACCEPT button, then you will be prompted to connect oxygen. (Connect oxygen) After pressing the ACCEPT button, you will be prompted to reconnect wall air, unblock to paTIent port, and reconnect test circuit. (Reconnect the wall air, remove the plug that plugs the suction port, reconnect the test tube) After pressing ACCEPT button, if PASSED, automatically enter the next step;
4) Leak Test, the breathing opportunity enters the automatic detection, if PASSED, automatically enters the next step;
5) GUI Keyboard Test, will prompt: press "*" key, (press the corresponding button), if PASSED, automatically enter the next step;
6) EST GUI Knob Test, will prompt turn knob counterclockwise and clockwise. (first counterclockwise rotation and then clockwise rotation), if PASSED, automatically enter the next step;
7) GUI Lamp Test, will prompt acknowledge that LED is on. (press the ACCEPT button when the light is on), press the ACCEPT button 11 times, if PASSED, automatically enter the next step;
8) BD Lamp Test, will prompt the LEDs are on. (Press the ACCEPT button when the light is on), press the ACCEPT button 3 times, if PASSED, automatically enter the next step;
9) GUI Audio Test, prompt prompt user to verify that GUI alarm sounds. Press ACCEPT button 3 times, if PASSED, automatically enter the next step;
10) GUI Nurse Call Test, which will prompt whether or not test is to be performed. (If the nurse call system is installed, press the ACCEPT button, if the nurse call system is not installed, press the CLEAR button), if PASSED, automatically enter the next step;
11) BD Audio Test, will prompt acknowledge audible alarm. (If you hear the sound, press ACCEPT button, if you don't hear the sound, press CLEAR button), if PASSED, automatically enter the next step;
12) PSOL Loop back Test, if PASSED, automatically enters the next step;
13) Safety System Test, if PASSED, automatically enters the next step;
14) Exp Valve Loopback Test, if PASSED, automatically enters the next step;
15) Exp Valve Seal Test, if PASSED, automatically enters the next step;
16) Exp Valve Test, if PASSED, automatically enters the next step;
17) EV Velocity Transducer Test, if PASSED, automatically enters the next step;
18) Exp Heater Test, if PASSED, automatically enters the next step;
19) Compressor Test first checks if the air compressor is installed. If it is not installed, skip this step. If it is installed, run this step automatically, and check if the wall air is connected, and prompt: disconnect wall Air (If the wall air is connected, press ACCEPT after disconnecting, and will also prompt reconnect wall air, reconnect the wall air; if there is no wall air, press CLEAR), if PASSED, automatically enter the next step;
20) Analog Data Display, if PASSED, automatically enters the next step;
21) GUI Touch Test, if PASSED, automatically enters the next step;
22) GUI Serial Port Test, if PASSED, automatically enter the next step;
23) Battery Test, will first check whether the battery is installed or not. If it is not installed, skip this step and complete the EST; if the battery is installed, it will prompt: Disconnect ac. (disconnect AC), press after completion ACCEPT button, if PASSED, EST is all completed.
There are three results for each self-test:
PASSED: Pass, no action is required.
ALERT: Alarm, you must check the airflow in the peripheral line of the ventilator and other conditions that may affect clinical use. If there is no special situation, you can skip it. In the last operation menu select OVERRIDDEN to skip. Exit to the normal menu to use and operate the ventilator.
FAILURE: Failure, the ventilator will not be used. The SST must be done from start to finish. The result is PASSED before the ventilator can be used normally. Otherwise, professional engineers should be notified to carry out maintenance.
The above is a summary and summary of the self-test process of the PB840 ventilator. Of course, the self-test process and precautions of different types and different grades of ventilators are not the same. As medical engineers, we should master each type. The operation steps of the ventilator self-test, in case of emergency.
4, summaryBy repeatedly using the sophisticated intelligent detection carried by the ventilator itself, the full play of its role in use, convenient, fast and accurate identification of the cause of the machine failure, can win valuable time for the treatment of critically ill patients. Similar intelligent detection procedures for modern ventilators are increasingly perfect, making full use of these procedures, performing maintenance checks on equipment on a regular basis, and some hidden dangers can be dealt with in a timely and effective manner.
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