Medtronic Plc. · NYSE:MDT
Medtronic — Technical Presentation (September 2016)
78 slides from Medtronic's technical presentation, Sep 16, 2016
Slide 1: The Puritan Bennett 980 Ventilator Education Presentation
THE PURITAN BENNETT 980 TM VENTILATOR EDUCATION PRESENTATION
Slide 2: Overview
OVERVIEW This guide is provided as a convenience companion document to the Operator’s Manual. It is not intended to replace the Operator’s Manual, which should always be available while using the ventilator. It is important to familiarize yourself with all information in the Operator’s Manual releva
Slide 3: Breathe More Naturally
BREATHE MORE NATURALLY The new Puritan Bennett™ 980 ventilator helps enable patients to SIMPLE breathe more naturally* through some of the most innovative breath SAFE delivery technology available. Our simple, safe and smart design SMART provides more natural ventilation that may help clinicians imp
Slide 4: Overview
OVERVIEW The Puritan Bennett™ 980 ventilator is designed for: ▪ Neonatal through adult populations ▪ In-room use and intra-hospital transport ▪ Invasive (via endotracheal tube) and noninvasive (via mask, nasal prongs, or uncuffed endotracheal tube) applications The ventilator is available in three m
Slide 5: Finding Your Way Around
FINDING YOUR WAY AROUND Medtronic Further, Together
Slide 6: Finding Your Way Around
FINDING YOUR WAY AROUND User interface Communication ports On/Off switch Expiratory To patient port Fan filter Breath delivery Hot-swappable unit batteries 6 Puritan BennettTM 980 Ventilator Education Presentation | September 16, 2016
Slide 7: Finding Your Way Around the User Interface
FINDING YOUR WAY AROUND THE USER INTERFACE Touch screen Patient data banner on top ▪ Additional patient data display tab ▪ Large font data display tab Left menu tab Graphics in middle Ventilator setup button lower left Constant access icons Bezel control keys Adjustment knob 7 Puritan BennettTM 980
Slide 8: Positioning the User Interface for Ease of Viewing
POSITIONING THE USER INTERFACE FOR EASE OF VIEWING The user interface can be repositioned for easier viewing. 8 Puritan BennettTM 980 Ventilator Education Presentation | September 16, 2016
Slide 9: Touch Screen Navigation
TOUCH SCREEN NAVIGATION ▪ Swipe ▪ Double-tap ▪ Drag ▪ Touch and hold ▪ Drag and drop ▪ “Touch, turn, accept” 9 Puritan BennettTM 980 Ventilator Education Presentation | September 16, 2016
Slide 10: Setting Up the Puritan Bennett Ventilator Prior to Use
SETTING UP THE PURITAN BENNETT 980 VENTILATOR ™ PRIOR TO USE
Slide 11: Setting Up Prior to Patient Use
SETTING UP PRIOR TO PATIENT USE Setting up for patient use will include installing: ▪ Filters ▪ Humidifier ▪ Breathing circuit ▪ EVQ* ▪ Air and oxygen hoses ▪ Puritan Bennett™ proximal flow sensor (if applicable) Powering on and performing a short self test (SST) * U.S. only 11 Puritan BennettTM 980
Slide 12: Installing the Filters
INSTALLING THE FILTERS Three filters help reduce the spread of pathogens. Inspiratory filters Expiratory filter is heated to keep the gas (internal and that flows through it from cooling to the dew external) point and creating condensate in the filter. Expiratory Reusable and disposable filter optio
Slide 13: Installing the Inspiratory Filter on the 'To Patient' Port
INSTALLING THE INSPIRATORY FILTER ON THE ‘TO PATIENT’ PORT ▪ Install the inspiratory filter on the “To Patient” port by pushing it directly onto the port. ▪ Ensure the direction of the flow arrow is pointing outward, toward the patient circuit’s inspiratory limb. * Only disposable inspiratory and ex
Slide 14: Installing the Expiratory Filter Assembly: Pediatric-Adult Application
INSTALLING THE EXPIRATORY FILTER ASSEMBLY: PEDIATRIC- ADULT APPLICATION 1) Assemble the 3) Insert the new condensate vial filter* assembly. and reusable expiratory filter. 2) Raise the expiratory 4) Lower the filter latch to unlock expiratory filter the expiratory filter latch. door. * Only disposab
Slide 15: Installing the Expiratory Filter Assembly: Neonatal Application
INSTALLING THE EXPIRATORY FILTER ASSEMBLY: NEONATAL APPLICATION 1) Raise the latch, 3) Insert the new (remove adult door filter assembly. if applicable), install the neonatal filter door if applicable. 2) Raise the expiratory 4) Lower the filter latch to unlock expiratory filter the expiratory filte
Slide 16: Installing the Humidifier
INSTALLING THE HUMIDIFIER ▪ The humidifier bracket accommodates Teleflex (Hudson RCI) and Fisher & Paykel humidifiers. ▪ To install, slide the rear of the humidifier into the corresponding slot on the humidifier bracket, until it is fully seated. ▪ During SST, enter the humidifier volume setting whe
Slide 17: Installing the Breathing Circuit
INSTALLING THE BREATHING CIRCUIT The breathing circuit type should be selected based on the patient’s predicted body weight (PBW). If changing a breathing circuit type, run an SST. ▪ The circuit type and PBW entered during the SST will determine the new patient ventilation and alarm settings and als
Slide 18: Puritan Bennett Proximal Flow Sensor (Neonatal Application Only)
PURITAN BENNETT™ PROXIMAL FLOW SENSOR (NEONATAL APPLICATION ONLY) Measures flow, volume and pressure at the patient wye; does not control flow volume or pressure Intended for neonatal invasive ventilation To install the sensor: ▪ Install during SST (according to prompts). ▪ Install the sensor end at
Slide 19: About the Exhalation Valve Flow Sensor Assembly (EVQ)
ABOUT THE EXHALATION VALVE FLOW SENSOR ASSEMBLY (EVQ) ▪ Contains the expiratory port, expiratory flow sensor, exhalation valve diaphragm, expiratory filter seal and pressure sensor filter ▪ Can be cleaned and disinfected if a high-risk communicable contamination occurs ▪ Disinfection is not required
Slide 20: Powering On
POWERING ON Power on using the ON/OFF switch 20 Puritan BennettTM 980 Ventilator Education Presentation | September 16, 2016
Slide 21: Why Perform the Short Self Test (SST)?
WHY PERFORM THE SHORT SELF TEST (SST)? ▪ Impacts accuracy of breath delivery and spirometry ▪ The SST is a way of calibrating the ventilator to the circuit and humidifier you are using. It impacts both breath delivery and spirometry. ▪ The power-on self test (POST) does basic testing of the system.
Slide 22: Performing a Short Self Test (SST)
PERFORMING A SHORT SELF TEST (SST) ▪ Select the patient circuit type and humidification, and then follow the amber-colored prompts. ▪ As a general rule, keep doing what you are prompted to do until you are told to do something else. For instance, if you are prompted to occlude the patient wye, keep
Slide 23: Patient Setup
PATIENT SETUP Medtronic Further, Together
Slide 24: Patient Setup
PATIENT SETUP New patient Manual setup Quick start ▪ You can choose to 1. Select PBW or Gender and Height 1. Touch New set up a new patient 2. Select ventilation type—Invasive or Patient. or the same patient. Noninvasive (NIV) 2. Enter PBW or gender and 3. Select a Mode ▪ In New Patient setup, 4. Se
Slide 25: How to Enable and Disable the Proximal Flow Sensor
HOW TO ENABLE AND DISABLE THE PURITAN BENNETT™ PROXIMAL FLOW SENSOR ▪ To enable/disable the Proximal Flow Option ▪ Touch the Configure/Wrench icon ▪ Touch the Options tab ▪ Touch the Prox tab ▪ Touch the Enabled or Disabled button. ▪ To initiate a Manual Purge, touch the Start button 25 Puritan Benn
Slide 26: How the Proximal Flow Sensor Impacts Monitoring
HOW THE PURITAN BENNETT™ PROXIMAL FLOW SENSOR IMPACTS MONITORING When the Proximal Flow Sensor is enabled, new and replacement data values appear, representing data measured with the Proximal Flow Sensor. The monitored volume labels have a Y added to indicate that the measurement comes from the Prox
Slide 27: How Proximal Flow Sensor and Leak Sync Software Affect Monitoring
HOW PURITAN BENNETT™ PROXIMAL FLOW SENSOR AND PURITAN BENNETT™ LEAK SYNC SOFTWARE AFFECT MONITORING Inspired tidal volume (mandatory or spontaneous) VTLY at patient circuit wye (Leak Sync enabled and leak adjusted) Inspired tidal volume (mandatory or spontaneous) VTL (Leak Sync enabled and leak adju
Slide 28: Making Settings Changes After Initial Setup
MAKING SETTINGS CHANGES AFTER INITIAL SETUP
Slide 29: Making Settings Changes After Initial Setup
MAKING SETTINGS CHANGES AFTER INITIAL SETUP There are several ways to access settings changes after initial setup: Swipe the Menu tab on the left margin of the touch screen and touch the Setup button. Touch the Vent Setup button in the bottom-left corner of the touch screen display. Touch a paramete
Slide 30: Managing Alarms
MANAGING ALARMS Medtronic Further, Together
Slide 31: Managing Alarms
MANAGING ALARMS There are three ways to access the Alarms screen: Touch the hotlink from an alarm violation message. Swipe the Menu tab to open the Settings menu, then touch the Alarms settings tab. Touch the alarm icon (constant access icon). 31 Puritan BennettTM 980 Ventilator Education Presentati
Slide 32: Apnea Alarm Not on the Alarm Screen
APNEA ALARM NOT ON THE ALARM SCREEN ▪ Touch the Vent Setup button to access the Apnea settings tab. ▪ Apnea alarm triggers apnea backup: ▪ Current apnea ventilation settings are displayed. ▪ Non-apnea ventilation settings may be changed during apnea backup. ▪ Apnea timer resets with every breath. ▪
Slide 33: Alarm Conditions
ALARM CONDITIONS ▪ Alarm violations are visually indicated in three places: ▪ The omnidirectional lamp on top of the touch screen ▪ On the alarm banners ▪ On the alarm settings screen ▪ Low-, medium- and high-priority alarms—unique sounds ▪ Alarm loudness escalates if a high-priority alarm is not ac
Slide 34: Omni-Directional LED
OMNI-DIRECTIONAL LED Normal ▪ Steadily lit green mode ▪ LED flashes—color Alarm corresponds to alarm condition priority Concurrent ▪ LED displays alarms highest-priority color ▪ Latched (sides) displays highest Alarm priority de-escalates ▪ Center displays current alarm priority 34 Puritan BennettTM
Slide 35: Alarm Priorities
ALARM PRIORITIES Alarm priority Visual indicator Audible indicator/Reset criteria Low ▪ Yellow LED ▪ Low-priority audible alarm (two tone, A change in the ▪ Yellow alarm banner on screen non-repeating) patient-ventilator ▪ Yellow bar next to alarm setting icon ▪ LED indicator turns off and autoreset
Slide 36: Audio Paused
AUDIO PAUSED ▪ Temporarily mutes the audible alarm for 2 minutes. ▪ Audio Paused key LED illuminates. ▪ Countdown timer appears. ▪ Press Alarm Reset to cancel audio paused interval. ▪ If the condition that caused the alarm still exists, the alarm activates again. ▪ Press Audio Paused key again to re
Slide 37: Alarm Reset
ALARM RESET ▪ Use for any non-technical alarm. ▪ Resets the color of the dome light. ▪ Reinitializes the algorithm the ventilator used to detect the alarm (except for A/C POWER LOSS, LOW BATTERY, NO AIR SUPPLY, NO O2 SUPPLY, PROCEDURE ERROR alarms and active battery alarms). ▪ Captured in the log if
Slide 38: Alarm Log – Up to 1000 Events
ALARM LOG – UP TO 1000 EVENTS The Alarm Log contains the last 1000 alarms that have occurred, whether they have been reset or autoreset, the priority level, and their analysis messages. ▪ Accessible during Normal and ▪ If one or more alarms have Service states occurred since the last time ▪ Records:
Slide 39: Patient Data and Data Monitoring
PATIENT DATA AND DATA MONITORING
Slide 40: Locating Commonly Used Patient Data Values
LOCATING COMMONLY USED PATIENT DATA VALUES ▪ Patient data banner ▪ Graphics Status display ▪ Additional patient data screen ▪ Large-font patient data screen 40 Puritan BennettTM 980 Ventilator Education Presentation | September 16, 2016
Slide 41: Patient Data Banner
PATIENT DATA BANNER ▪ Eight patient data measurements are displayed across the top of the touch screen. ▪ Four on the right can be swiped to the left or right in order to display additional data. ▪ Double-tap a cell to show the data available for viewing and select the one to be displayed. ▪ A “blan
Slide 42: Graphics
GRAPHICS ▪ The Puritan Bennett™ 980 ventilator displays color-coded waveforms for flow, pressure and volume versus time. ▪ It also displays color-coded loops for volume versus pressure and flow versus volume. ▪ The inspiratory portion of a mandatory breath is green, the inspiratory portion of a spon
Slide 43: Graphics: Changing the Scale and Maximizing/Minimizing
GRAPHICS: CHANGING THE SCALE AND MAXIMIZING/MINIMIZING Two ways to change the scale of a graphic: ▪ Touch and drag the scale. ▪ Touch to select the scale and then use the adjustment knob to change the scale. Graphics can also be enlarged to full screen by double-tapping the graph, swiping upward, or
Slide 44: Graphics: Pause and Review
GRAPHICS: PAUSE AND REVIEW ▪ Graphics can be paused, and historical data (up to 60 seconds) can be reviewed. ▪ Touch the Pause icon in the lower-right corner. ▪ Drag or use the adjustment knob to move the cursor and identify measurements along the waveform(s) or loop. ▪ Numerical data continues to u
Slide 45: Graphics: Storing a Screen Image
GRAPHICS: STORING A SCREEN IMAGE ▪ Touch the camera icon to store an image of the screen. ▪ May be used with or without Pause. ▪ Data continues to update during the pause— graph and numerical data on a stored image will not likely be aligned. ▪ Open the Menu tab (left margin of screen) and touch Scr
Slide 46: Screen Layout for Graphics
SCREEN LAYOUT FOR GRAPHICS ▪ Use the waveform layout icon to access alternate screen configurations. ▪ You can choose to display up to three waveforms and two loops simultaneously in the waveform area. 46 Puritan BennettTM 980 Ventilator Education Presentation | September 16, 2016
Slide 47: Additional Patient Data
ADDITIONAL PATIENT DATA ▪ Tap or swipe down the tab in the center of the lower margin of the patient data banner to display additional patient data. ▪ View page 1 or tap page 2 to view another set of additional patient data. ▪ Additional patient data values have fixed positions. 47 Puritan BennettTM
Slide 48: Patient Data Large Font Screen
PATIENT DATA LARGE FONT SCREEN ▪ Tap the tab in the center of the lower margin of the additional patient data screen to view the large-font patient data screen. ▪ Double-tap a cell to show the data and waveforms/loops available for viewing and select the one to be displayed. 48 Puritan BennettTM 980
Slide 49: Status Display (on Breath Delivery Unit)
STATUS DISPLAY (ON BREATH DELIVERY UNIT) VISIBLE WHENEVER POWER IS ON – NOT INTERACTIVE During ventilation, the status display shows gas sources, power source, battery status, alarm volume setting, ventilation hours and circuit pressure graph: pressure units, ↑PPEAK alarm setting and PPEAK/PEEP valu
Slide 50: Patient Data Log: Historical Record of Patient Data
PATIENT DATA LOG: HISTORICAL RECORD OF PATIENT DATA ▪ The patient data log records data every minute for a total of up to 4320 patient data entries. ▪ 3 tabs are contained in the patient data log: vital patient data, additional patient data-1, additional patient data-2. ▪ During ventilator operation
Slide 51: Menu Tab
MENU TAB Medtronic Further, Together
Slide 52: Menu Tab
MENU TAB ▪ Swipe to the right to access Setup, Respiratory Mechanics, Stand-by and Screen Capture menus. ▪ Touch the Setup button to view the Vent, Apnea, Alarms and More Settings tabs. This is another way to access mode and breath type changes. 52 Puritan BennettTM 980 Ventilator Education Presenta
Slide 53: More Settings
MORE SETTINGS ▪ Leak Sync: Enabled/Disabled ▪ O2 sensor: Enabled/Disabled/Calibrate ▪ Humidification type: Heated Exp Tube/Non-heated Exp Tube/HME (impacts expiratory spirometry) 53 Puritan BennettTM 980 Ventilator Education Presentation | September 16, 2016
Slide 54: More Settings
MORE SETTINGS ▪ DSENS ▪ DSENS determines the amount of lost volume (inspiration versus exhalation) that is used to determine that the breathing circuit is disconnected. ▪ A low setting (minimum 20%) is the most sensitive and a high setting (maximum 95%) is least sensitive to a leak or disconnect. ▪
Slide 55: Stand-By
STAND-BY Stand-by state can be used to pause ventilation during a planned disconnect of the breathing circuit. ▪ Stop spray from circuit during disconnect. ▪ Ventilation resumes automatically when the circuit is reconnected to the patient. Setup: 1. Touch the Menu tab on the left side of the touch s
Slide 56: During Stand-By
DURING STAND-BY ▪ Patient-related alarms are temporarily suppressed. ▪ The ventilator displays an indicator that it is in stand-by state and a timer indicating the elapsed time the ventilator has been in stand-by state. ▪ The exhalation valve is open. ▪ Base flow is set to 10 L/min. ▪ 100% O2 is del
Slide 57: Respiratory Mechanics
RESPIRATORY MECHANICS Medtronic Further, Together
Slide 58: Respiratory Mechanics
RESPIRATORY MECHANICS Respiratory Mechanics Maneuvers are used to make certain patient data measurements and calculations, for example: ▪ Plateau Pressure (PPL) ▪ Static Compliance (CSTAT) ▪ Static Resistance (RSTAT) ▪ Intrinsic PEEP (PEEPI) ▪ Negative Inspiratory Force (NIF) ▪ Occlusion Pressure (P
Slide 59: Respiratory Mechanics – Inspiratory Pause
RESPIRATORY MECHANICS – INSPIRATORY PAUSE There are two ways to access this function, which ▪ The Inspiratory Pause can be done in two ways, automatically or maneuver is used to manually: determine plateau pressure, static compliance and static 1. Access via Menu tab: resistance. a) Automatic → touc
Slide 60: Respiratory Mechanics – Expiratory Pause
RESPIRATORY MECHANICS – EXPIRATORY PAUSE ▪ The Expiratory Pause There are two ways to access this function, which maneuver is used to can be done in two ways, automatically or determine Total PEEP manually: (PEEPTOT) and intrinsic PEEP 1. Access via Menu tab: (PEEPI). a) Automatic → touch RM key → t
Slide 61: Respiratory Mechanics – Vital Capacity
RESPIRATORY MECHANICS – VITAL CAPACITY ▪ This maneuver is done to determine the maximum amount of air that a patient can exhale after inhaling all the 1. Touch or swipe the Menu tab on the way. left side of the screen. ▪ The Vital Capacity (VC) maneuver 2. Touch the RM key. is a coached maneuver. 3.
Slide 62: Respiratory Mechanics – Occlusion Pressure (P0.1)
RESPIRATORY MECHANICS – OCCLUSION PRESSURE (P0.1) ▪ The Occlusion Pressure (P0.1) maneuver is used to determine the patient’s neuromuscular drive to breathe. 1. Touch or swipe the Menu tab on ▪ Like the NIF maneuver, it is done by the left side of the screen. having the patient pull against an 2. To
Slide 63: Respiratory Mechanics – Negative Inspiratory Force (NIF)
RESPIRATORY MECHANICS – NEGATIVE INSPIRATORY FORCE (NIF) ▪ The Negative Inspiratory Force 1. Touch or swipe the Menu tab on the (NIF) maneuver is used to determine left side of the screen. the patient’s ability to pull a 2. Touch the RM key. negative inspiratory pressure 3. Touch the NIF tab. agains
Slide 64: Additional Icons, Keys, Buttons
ADDITIONAL ICONS, KEYS, BUTTONS
Slide 65: User Interface
USER INTERFACE Constant access icons Function Home icon (house) Dismisses all open dialogs on the touch screen. Resumes showing ventilator waveforms screen. Configure (wrench icon) Opens the configure display to access SST, (history), Options, Comm Setup and Date/Time change tabs. Logs (clipboard ic
Slide 66: Yellow Triangle – Unread Items Icon
YELLOW TRIANGLE – UNREAD ITEMS ICON. PAY ATTENTION – CHECK OR VIEW THE TAB PROMPT 66 Puritan BennettTM 980 Ventilator Education Presentation | September 16, 2016
Slide 67: Breath Phase Indicator
BREATH PHASE INDICATOR Breath Phase Indicator A Assisted mandatory breath C Controlled mandatory breath S Spontaneous breath A, C, or S glows in reverse video during inspiratory phase A, C, or S appears solid during expiratory phase 67 Puritan BennettTM 980 Ventilator Education Presentation | Septem
Slide 68: Indicators: Patient Circuit Indicator
INDICATORS PATIENT CIRCUIT INDICATOR (ADULT, PEDIATRIC OR NEONATAL) ▪ This indicator appears right above the Vent Setup button. ▪ It indicates the patient type of the patient circuit cleared during the SST. 68 Puritan BennettTM 980 Ventilator Education Presentation | September 16, 2016
Slide 69: Indicators: Screen Opacity Icon
INDICATORS SCREEN OPACITY ICON ▪ Appears on the vent setup screen and on all of the respiratory mechanics maneuvers screens. ▪ Select and then use the adjustment knob to adjust the opacity of the displayed information between 50% and 100%. ▪ The lower the percentage, the more the waveform display wi
Slide 70: Indicators: Pushpin Icon
INDICATORS PUSHPIN ICON ▪ Appears in the corner of the settings screen. ▪ Touch the Pushpin Icon to keep a settings window open. ▪ To reverse the action, unpin or touch the home icon. 70 Puritan BennettTM 980 Ventilator Education Presentation | September 16, 2016
Slide 71: User Interface: Bezel Control Keys
USER INTERFACE BEZEL CONTROL KEYS (OFF SCREEN) 1. Display Brightness 2. Display Lock 3. Alarm Volume 4. Manual Inspiration 5. Adjustment Knob 6. Inspiratory Pause Easy to Access 7. Expiratory Pause 8. Alarm Reset 9. Audio Paused 71 Puritan BennettTM 980 Ventilator Education Presentation | September
Slide 72: Additional Safety Features
ADDITIONAL SAFETY FEATURES Medtronic Further, Together
Slide 73: Ventilation Assurance Feature
VENTILATION ASSURANCE FEATURE ▪ Provides continued ventilation if the background diagnostics detect a problem with certain components in the gas mix, inspiratory or expiratory subsystems. ▪ If the gas mix system has a problem, either 100% oxygen or room air gas will be delivered. ▪ If the inspirator
Slide 74: Other Safety Assurance Systems
OTHER SAFETY ASSURANCE SYSTEMS Status display shows: ▪ Power source—plug symbol versus ▪ Presence of oxygen and air source battery symbol ▪ Presence of compressor ▪ Presence of batteries and their charging status ▪ Ventilator operational hours ▪ Relative available battery charge ▪ Alarm loudness lev
Slide 75: Breath Delivery Unit Hot-Swappable Batteries
BREATH DELIVERY UNIT HOT-SWAPPABLE BATTERIES ▪ Two battery slots ▪ Primary hot-swappable LiOn battery must be installed to pass POST ▪ Primary hot-swappable LiOn battery on right side should not be removed during normal operation ▪ Extended hot-swappable LiOn battery is optional ▪ Up to one hour of
Slide 76: Additional Assistance
ADDITIONAL ASSISTANCE Medtronic Further, Together
Slide 77: Medtronic Representative
MEDTRONIC REPRESENTATIVE Contact your Medtronic representative [Name, phone email] 77 Puritan BennettTM 980 Ventilator Education Presentation | September 16, 2016
Slide 78: Help Via SolvIT Center Knowledge Base
Help Via SolvIT Center Knowledge Base ▪ The SolvIT Center provides answers to frequently asked questions about the ventilator system and other Puritan Bennett™ products 24 hours a day, 7 days a week. ▪ www.medtronic.com/covidien/support/solvit- center-knowledge-base © 2016 Medtronic. All rights rese