HAMILTON MEDICAL G5 Mechanical Ventilator User Manual
- June 6, 2024
- HAMILTON MEDICAL
Table of Contents
G5 Mechanical Ventilator
.
HAMILTON-G5
Operator’s Manual
REF 159001, 159002, 159003
Software version 2.8x 624074/13 | 2020-08-14
0 1 9 7
Operator’s Manual
HAMILTON-G5
2020-08-14 624074/13
Be sure to read the Addendum/Errata for the Operator’s Manual, included at the
end of this document. The Addendum/Errata is
also available at www.hamilton-medical.com, in MyHamilton.
© 2020 Hamilton Medical AG. All rights reserved. Printed in Switzerland. No part of this publication may be reproduced, stored in a database or retrieval system, or transmitted in any form or by any means, electronic, mechanical, or by photocopying, recording, or otherwise, without prior written permission of Hamilton Medical AG. This document may be revised, replaced, or made obsolete by other documents by Hamilton Medical AG at any time and without notice. Ensure that you have the most current applicable version of this document; if in doubt, contact the technical support department of Hamilton Medical AG, Switzerland. While the information set forth herein is believed to be accurate, it is not a substitute for the exercise of professional judgment. Nothing in this document shall limit or restrict in any way Hamilton Medical AG’s right to revise or otherwise change or modify the equipment (including its software) described herein, without notice. In the absence of an express, written agreement to the contrary, Hamilton Medical AG has no obligation to furnish any such revisions, changes, or modifications to the owner or user of the equipment (including software) described herein. The equipment must be operated, serviced, or upgraded only by trained professionals. Hamilton Medical AG’s sole responsibility with respect to the equipment and its use is as stated in the limited warranty provided in the device Operator’s Manual. Hamilton Medical AG shall not be liable for any loss, cost, expense, inconvenience, or damage that may arise out of misuse of the product, or if non-Hamilton Medical AG parts were used when replacing parts, or if serial numbers were amended, deleted, or removed.
If returning parts to Hamilton Medical AG, be sure to use the standard
Hamilton Medical returned goods authorization (RGA) procedure. Disposal of
parts shall follow all local, state, and federal regulation with respect to
environmental protection.
Hamilton Medical AG will make available, on request, circuit diagrams,
component parts lists, descriptions, calibration instructions, or other
information that will assist appropriately trained personnel to repair those
parts of the equipment designated by Hamilton Medical AG to be repairable.
For all proprietary as well as third-party trademarks used by Hamilton Medical
AG, see www.hamilton-medical.com/trademarks. Product and/or company names
marked with a § symbol may be the trademarks and/or registered trademarks of
their respective owners, including but not limited to Aerogen§, Nihon Kohden§,
Masimo§, Masimo SET§, Masimo rainbow SET§, Respironics§.
Manufacturer
Hamilton Medical AG Via Crusch 8, CH-7402 Bonaduz, Switzerland Phone: (+41) 58
610 10 20 Fax: (+41) 58 610 00 20 info@hamilton-medical.com www.hamilton-
medical.com
Distributor in USA
Hamilton Medical, Inc. 4990 Energy Way, P.O. Box 30008 Reno, NV 89520 Phone:
775-858-3200 Toll-free:
800-426-6331 Fax:
775-856-5621 marketing@hamilton-
medical.net
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Table of Contents
Preface ……………………………………………………………… 17 Chapter 1 Safety information
………………………………………………. 19
1.1 Overview……………………………………………………………………………. 20
1.2 Electromagnetic susceptibility ………………………………………………… 20
1.3 Fire and other hazards………………………………………………………….. 21
1.4 General operation and setup…………………………………………………. 21 1.4.1 General operation
and setup………………………………………….. 21 1.4.2 Electrical: power and
batteries………………………………………… 22 1.4.3 Gas supply ………………………………………………………………….. 23
1.4.4 CompactFlash port……………………………………………………….. 24
1.5 Setting up for ventilation………………………………………………………. 24 1.5.1 Patient
breathing circuits, components, and accessories ……… 24 1.5.2 Preoperational
check and tests ……………………………………….. 25 1.5.3
Humidifier…………………………………………………………………… 26 1.5.4
IntelliCuff……………………………………………………………………. 26 1.5.5 CO2 sensor setup and operation
…………………………………….. 27 1.5.6 Nebulization………………………………………………………………… 29
1.6 Ventilating the patient …………………………………………………………. 29 1.6.1 Specifying
patient settings……………………………………………… 29 1.6.2 Neonatal ventilation
……………………………………………………… 30 1.6.3 Apnea backup……………………………………………………………… 30 1.6.4
TRC settings………………………………………………………………… 30 1.6.5 Noninvasive
ventilation………………………………………………….. 31 1.6.6 P/V Tool Pro
………………………………………………………………… 31 1.6.7 Using high flow oxygen therapy
……………………………………… 31
1.7 Monitoring and alarms…………………………………………………………. 31
1.8 Using the trolley………………………………………………………………….. 32
1.9 Maintenance………………………………………………………………………. 32 1.9.1 General maintenance,
cleaning, and disinfection……………….. 32
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1.9.2 Preventive maintenance ………………………………………………… 34 1.9.3 O2 sensor
…………………………………………………………………… 34
1.10 Service and testing ………………………………………………………………. 34
Chapter 2 System overview …………………………………………………. 35
2.1 Overview……………………………………………………………………………. 36 2.1.1 Standard features and
options ……………………………………….. 36
2.2 Physical descriptions…………………………………………………………….. 39 2.2.1 About the
ventilator……………………………………………………… 39 2.2.2 About the main display
…………………………………………………. 44 2.2.3 About the patient breathing circuits
………………………………… 46 2.2.4 About the trolley and mounting variations ………………………..
51 2.2.5 Setting up the monitor………………………………………………….. 52
2.3 Navigating the windows and controls……………………………………… 53 2.3.1 Accessing
windows ………………………………………………………. 53 2.3.2 Adjusting controls
………………………………………………………… 54 2.3.3 Selecting list items………………………………………………………… 54
Chapter 3 Preparing the ventilator………………………………………… 55
3.1 Overview……………………………………………………………………………. 56
3.2 Connecting to a power source ………………………………………………. 56 3.2.1 Using battery
power……………………………………………………… 56
3.3 Connecting the oxygen supply ………………………………………………. 57 3.3.1 Working with
heliox as a gas source………………………………… 57 3.3.2 Selecting the gas source type
…………………………………………. 58
3.4 Setting up the patient breathing circuit …………………………………… 58 3.4.1 Breathing
circuit connections on the ventilator ………………….. 59 3.4.2 Working with the
expiratory valve set………………………………. 59 3.4.3 Selecting the breathing circuit
components ………………………. 60 3.4.4 Assembling the patient breathing circuit
………………………….. 61 3.4.5 Positioning the breathing circuit ……………………………………… 61
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3.5 Setting up esophageal/transpulmonary pressure monitoring ……….. 62 3.6
Turning the ventilator on and off …………………………………………… 62
Chapter 4 Setting up external devices and sensors…………………… 63
4.1 Overview……………………………………………………………………………. 64 4.2 Installing a
module………………………………………………………………. 64 4.3 Setting up a
humidifier…………………………………………………………. 64 4.4 Setting up the IntelliCuff cuff
pressure controller………………………. 65
4.4.1 About the IntelliCuff tubing …………………………………………… 66 4.4.2 Setting up
IntelliCuff …………………………………………………….. 66 4.5 Setting up CO2 monitoring
…………………………………………………… 66 4.5.1 Mainstream CO2 measurement………………………………………. 67
4.5.2 Sidestream CO2 measurement ……………………………………….. 69 4.6 Setting up SpO2
monitoring………………………………………………….. 70 4.7 Enabling sensors
…………………………………………………………………. 70 4.8 Setting up nebulization
………………………………………………………… 71 4.8.1 Setting up a pneumatic nebulizer
……………………………………. 71 4.8.2 Setting up an Aerogen nebulizer …………………………………….. 72
4.9 Connecting to an external patient monitor or other device …………. 72
Chapter 5 Specifying ventilation settings ……………………………….. 73
5.1 Process overview …………………………………………………………………. 74 5.2 Selecting the patient
group …………………………………………………… 74
5.2.1 About system defaults: pre-configured settings …………………. 75 5.3 Entering
patient data …………………………………………………………… 75 5.4 Performing the preoperational
check, tests, and calibrations ………. 76
5.4.1 Performing the preoperational check……………………………….. 77 5.4.2 Performing
the breathing circuit tightness test ………………….. 78 5.4.3 Calibrating the
adult/pediatric flow sensor ……………………….. 79 5.4.4 Calibrating the O2
sensor………………………………………………. 80 5.4.5 Performing a zero calibration on the CO2
sensor/adapter……. 81
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5.4.6 Testing the alarms………………………………………………………… 82 5.5 Selecting the
ventilation mode ………………………………………………. 84
5.5.1 Reviewing and adjusting ventilation settings……………………… 85 5.5.2 About the
trigger types …………………………………………………. 86 5.5.3 About apnea backup
ventilation……………………………………… 88 5.5.4 About tube resistance compensation (TRC)
………………………. 89 5.6 Setting alarm limits ……………………………………………………………… 91 5.7
Starting ventilation………………………………………………………………. 93 5.8 Stopping ventilation
…………………………………………………………….. 93 5.9 About the control parameters
……………………………………………….. 93
Chapter 6 Specifying neonatal settings …………………………………..101
6.1 Setting up for neonatal ventilation …………………………………………. 102 6.1.1 Setting
the patient group and weight………………………………. 102 6.1.2 Setting up the patient
breathing circuit ……………………………. 103
6.2 Performing the preoperational check, tests, and calibrations ………. 105
6.2.1 Calibrating the neonatal flow sensor ……………………………….. 106
6.3 Selecting the ventilation mode ………………………………………………. 107 6.4 Setting the
patient weight for ventilation ………………………………… 107 6.5 Alarms for neonatal
ventilation ……………………………………………… 108 6.6 O2 enrichment for neonates
…………………………………………………. 108 6.7 Specifying volume limitation for neonates
……………………………….. 108
Chapter 7 Ventilation modes ………………………………………………..109
7.1 Overview……………………………………………………………………………. 110 7.1.1 Breath types and timing
options……………………………………… 110 7.1.2 Ventilation modes ………………………………………………………… 110
7.1.3 Ventilation controls and settings …………………………………….. 112
7.2 Volume-controlled modes, flow control…………………………………… 114 7.2.1 (S)CMV mode
……………………………………………………………… 114 7.2.2 SIMV mode …………………………………………………………………. 115
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7.3 Volume-controlled modes, flow cycled ……………………………………. 116 7.3.1 Volume
Support (VS)…………………………………………………….. 116
7.4 Volume-targeted modes, adaptive pressure control …………………… 118 7.4.1 APVcmv
mode …………………………………………………………….. 118 7.4.2 APVsimv mode……………………………………………………………..
120
7.5 Pressure-controlled modes ……………………………………………………. 121 7.5.1 P-CMV mode
………………………………………………………………. 121 7.5.2 P-SIMV mode ………………………………………………………………. 122
7.5.3 DuoPAP mode……………………………………………………………… 123 7.5.4 APRV
mode…………………………………………………………………. 123 7.5.5 SPONT mode………………………………………………………………..
125
7.6 Intelligent Ventilation …………………………………………………………… 126 7.6.1 ASV
mode…………………………………………………………………… 126 7.6.2 INTELLiVENT-ASV mode
………………………………………………… 128
7.7 Noninvasive modes ……………………………………………………………… 128 7.7.1 NIV
mode……………………………………………………………………. 129 7.7.2 NIV-ST
mode……………………………………………………………….. 130 7.7.3 nCPAP-PS mode……………………………………………………………
131 7.7.4 High flow oxygen therapy ……………………………………………… 132
7.8 Ambient state …………………………………………………………………….. 133 7.9 Working with
noninvasive modes…………………………………………… 134
7.9.1 Required conditions for use……………………………………………. 134 7.9.2
Contraindications…………………………………………………………. 134 7.9.3 Potential adverse reactions
…………………………………………….. 135 7.9.4 Control settings in noninvasive
ventilation………………………… 135 7.9.5 Alarms in noninvasive
ventilation…………………………………….. 135 7.9.6 Monitored parameters in noninvasive
ventilation……………….. 136 7.9.7 Additional notes about using noninvasive
ventilation………….. 136
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7.10 Working with ASV ………………………………………………………………. 137 7.10.1 Clinical workflow
with ASV ……………………………………………. 137 7.10.2 Maintaining adequate ventilation
……………………………………. 139 7.10.3 Reviewing alarm settings……………………………………………….. 139
7.10.4 Monitoring ASV …………………………………………………………… 140 7.10.5 Weaning
…………………………………………………………………….. 141 7.10.6 Functional overview
……………………………………………………… 142
Chapter 8 Monitoring ventilation ………………………………………….149
8.1 Overview……………………………………………………………………………. 150 8.2 Viewing numeric patient
data ……………………………………………….. 150
8.2.1 About the main monitoring parameters (MMP) …………………. 150 8.2.2 About the
secondary monitoring parameters (SMPs) ………….. 151 8.2.3 Viewing patient data
in the Monitoring window ……………….. 152 8.3 Viewing graphical patient
data………………………………………………. 152 8.3.1 Selecting a display layout
………………………………………………. 153 8.3.2 Selecting display options ………………………………………………..
154 8.3.3 Working with waveforms ………………………………………………. 155 8.3.4 Working with
Trend graphs……………………………………………. 159 8.3.5 Working with
loops………………………………………………………. 160 8.4 Working with Intelligent
panels……………………………………………… 161 8.4.1 Dynamic Lung panel: real-time ventilation
status ……………….. 161 8.4.2 Vent Status panel: real-time ventilator dependence
status …… 164 8.4.3 ASV Graph panel: real-time patient condition and targets
…… 166 8.4.4 ASV Monitoring panel: real-time values……………………………. 167 8.5
Monitoring transpulmonary/esophageal pressure ……………………… 167 8.6 About the
monitored parameters …………………………………………… 168 8.7 Viewing patient ventilation
time …………………………………………….. 178 8.8 Viewing device-specific information
……………………………………….. 178
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Chapter 9 Responding to alarms …………………………………………..179
9.1 Overview……………………………………………………………………………. 180 9.1.1 Alarm limit indicators
……………………………………………………. 182 9.1.2 Responding to an alarm ………………………………………………… 182
9.1.3 Temporarily silencing an alarm ……………………………………….. 183
9.2 About the alarm buffer ………………………………………………………… 183 9.3 Adjusting alarm
loudness (volume) …………………………………………. 185 9.4 Troubleshooting
alarms………………………………………………………… 185 9.5 Working with a distributed alarm system
(DAS) ………………………… 201
9.5.1 Enabling global AUDIO OFF……………………………………………. 202 9.5.2 About DAS-related
alarms……………………………………………… 202
Chapter 10 Ventilation settings and functions …………………………..205
10.1 Overview……………………………………………………………………………. 206 10.2 Accessing settings during
ventilation ………………………………………. 206
10.2.1 Accessing patient data during ventilation …………………………. 206 10.2.2
Accessing settings during ventilation ……………………………….. 207 10.3 Entering/exiting
Standby ………………………………………………………. 208 10.4 Oxygen
enrichment……………………………………………………………… 209 10.4.1 Adjusting the oxygenation level
for O2 enrichment ……………. 209 10.4.2 Suctioning maneuver …………………………………………………….
210 10.5 Manual breath ……………………………………………………………………. 210 10.6 Inspiratory and
expiratory hold ………………………………………………. 211 10.6.1 Inspiratory hold
……………………………………………………………. 211 10.6.2 Expiratory hold……………………………………………………………..
211 10.7 Working with a nebulizer ……………………………………………………… 212 10.7.1 Specifying
duration and synchronization settings……………….. 212 10.7.2 Working with a
pneumatic nebulizer……………………………….. 213 10.7.3 Working with an Aerogen
nebulizer………………………………… 214 10.8 Locking and unlocking the touch
screen………………………………….. 214
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10.9 Capturing a screenshot ………………………………………………………… 215 10.10 About the Event
log …………………………………………………………….. 215 10.11 Setting display options
…………………………………………………………. 216
10.11.1 Setting date and time……………………………………………………. 216 10.11.2 Day and night
display brightness …………………………………….. 217
Chapter 11 Working with P/V Tool ………………………………………….219
11.1 Overview……………………………………………………………………………. 220 11.1.1 Conditions for
use………………………………………………………… 220 11.1.2 Indications for use…………………………………………………………
221 11.1.3 Contraindications for use ………………………………………………. 221
11.2 Using the P/V Tool……………………………………………………………….. 221 11.3 Opening the P/V
Tool …………………………………………………………… 222 11.4 Adjusting the control
settings………………………………………………… 223 11.5 Performing a P/V Tool maneuver
……………………………………………. 224
11.5.1 Viewing data……………………………………………………………….. 224 11.5.2 Choosing the data to
display………………………………………….. 225 11.6 Analyzing the data
………………………………………………………………. 227 11.7 Using reference curves
…………………………………………………………. 227 11.8 Performing a recruitment maneuver
……………………………………….. 228
Chapter 12 Working with external devices………………………………..229
12.1 Working with the HAMILTON-H900 humidifier ………………………… 230 12.1.1 Accessing
humidifier controls on the ventilator………………….. 231 12.1.2 About the humidifier
operating modes…………………………….. 232 12.1.3 Changing humidity using temperature
controls …………………. 234 12.1.4 Entering Standby………………………………………………………….. 235
12.1.5 Turning the humidifier on/off …………………………………………. 235 12.1.6 About
humidifier-related alarms……………………………………… 236 12.1.7 About humidifier-related
parameters……………………………….. 239
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12.2 Working with IntelliCuff……………………………………………………….. 239 12.2.1 Accessing
IntelliCuff controls on the ventilator ………………….. 240 12.2.2 Turning
IntelliCuff on and off…………………………………………. 241 12.2.3 About IntelliCuff modes
………………………………………………… 242 12.2.4 Setting the cuff pressure ………………………………………………..
243 12.2.5 Deflating the cuff…………………………………………………………. 244 12.2.6 About
IntelliCuff-related alarms ……………………………………… 244 12.2.7 About IntelliCuff-
related parameters ……………………………….. 246 12.2.8 Last Patient settings with
IntelliCuff…………………………………. 246
Chapter 13 Maintenance……………………………………………………….247
13.1 Overview……………………………………………………………………………. 248
13.2 Cleaning, disinfection, and sterilization …………………………………… 248 13.2.1
General guidelines for cleaning ………………………………………. 248 13.2.2 General guidelines
for disinfection ………………………………….. 249
13.3 Preventive maintenance ……………………………………………………….. 250
13.4 Performing maintenance tasks ………………………………………………. 252 13.4.1 Maintaining
the filters …………………………………………………… 252 13.4.2 Replacing the galvanic O2 sensor
……………………………………. 253 13.4.3 Charging and storing batteries ………………………………………..
254 13.4.4 Replacing batteries……………………………………………………….. 254
13.5 Repacking and shipping ……………………………………………………….. 255
Chapter 14 Configuration ……………………………………………………..257
14.1 Overview……………………………………………………………………………. 258
14.2 Accessing Configuration mode………………………………………………. 258
14.3 Configuring general settings …………………………………………………. 258 14.3.1 Selecting
the language………………………………………………….. 258 14.3.2 Selecting the breath timing
philosophy…………………………….. 258 14.3.3 Selecting the units of measure
……………………………………….. 258 14.3.4 Configuring adjustable alarms………………………………………… 259
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14.3.5 Setting the minimum alarm loudness (volume) ………………….. 259 14.3.6
Enabling the Check flow sensor for water alarm………………… 260 14.4 Configuring
MMPs………………………………………………………………. 260 14.5 Configuring Vent Status settings
……………………………………………. 260 14.6 Configuring communication options ……………………………………….
261 14.6.1 Configuring I:E timing …………………………………………………… 261 14.6.2 Selecting a
communication protocol………………………………… 261 14.6.3 Configuring HAMILTON-H900
humidifier communication …… 262 14.6.4 Configuring distributed alarm system
(DAS) communication… 262 14.7 Configuring nebulization options
…………………………………………… 262 14.8 Activating IntelliCuff ……………………………………………………………. 262
14.9 Activating SpO2 and CO2 measurement …………………………………. 262 14.10 Defining
system default settings …………………………………………….. 263 14.10.1 Exporting or importing
default settings ……………………………. 264 14.10.2 Choosing the ASV version
……………………………………………… 264 14.10.3 Enabling the display of resistance- and
compliance-related
parameters………………………………………………………………….. 264 14.11 Configuring software and
hardware options ……………………………. 265
14.11.1 Reviewing installed options ……………………………………………. 265 14.11.2 Adding
software options……………………………………………….. 265 14.11.3 Activating hardware options
………………………………………….. 265 14.12 Copying configuration settings……………………………………………….
266
Chapter 15 Parts and accessories…………………………………………….267
15.1 Overview……………………………………………………………………………. 268
Chapter 16 Specifications ………………………………………………………277
16.1 Physical characteristics………………………………………………………….. 278 16.2 Environmental
requirements………………………………………………….. 279 16.3 Pneumatic specifications
………………………………………………………. 280 16.4 Electrical specifications
…………………………………………………………. 281
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16.5 Control settings ………………………………………………………………….. 283 16.6 Monitored
parameters …………………………………………………………. 288 16.7 Alarms
………………………………………………………………………………. 295 16.8 Configuration
…………………………………………………………………….. 297 16.9 ASV technical data
………………………………………………………………. 300 16.10 Ventilator breathing system specifications
……………………………….. 302 16.11 Technical performance data ………………………………………………….. 303
16.11.1 Accuracy testing…………………………………………………………… 309 16.11.2 Essential
performance …………………………………………………… 309 16.12 Functional description of
ventilator system ………………………………. 309 16.12.1 Gas supply and
delivery…………………………………………………. 310 16.12.2 Gas monitoring with the flow
sensor……………………………….. 311 16.12.3 Pneumatic diagram ………………………………………………………. 312
16.13 Symbols used on device labels and packaging ………………………….. 313 16.13.1
Symbols used on the trolley……………………………………………. 315 16.14 Standards and
approvals ………………………………………………………. 315 16.15 Disposal and year of manufacture
………………………………………….. 316 16.16 Warranty……………………………………………………………………………. 317
Glossary ……………………………………………………………..319 Index …………………………………………………………………327
Addendum HiFlow ………………………………………….. Add-1 Addendum HAMILTON-G5/S1…………………………….
Add-5
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Preface
HAMILTON-G5 Documentation This guide is part of a documentation suite that
includes, among others, the following documents:
Table 1. HAMILTON-G5 documentation suite
Document title
Description
Operator’s Manual (this guide)
Provides detailed information about the setup and use of the HAMILTON-G5 ventilator.
INTELLiVENT-ASV Operator’s Manual
Provides setup and use information for the INTELLiVENT-ASV ventilation mode.
Pulse Oximetry Instructions for Use
Provides setup and use information for using SpO2 and related sensors with the ventilator.
Volumetric Capnography User Guide Provides reference information for CO2 capnography.
HAMILTON-H900 Instructions for Use Provides specifications, and setup and use information for the HAMILTON-H900 humidifier.
IntelliCuff Instructions for Use
Provides specifications, and setup and use information for the IntelliCuff cuff pressure controller.
Aerogen Solo/Aerogen Pro Instructions Provides specifications, and setup and use information
for Use
for the Aerogen Solo and Aerogen Pro nebulizers.
Communication Interface User Guide
Provides an overview of the communication interface, including how to connect the ventilator to external devices for data communication and support for nurse call remote alarms.
Service Manual
Provides information about installing and setting up the medical equipment, as well as additional technical and servicing information for the ventilator.
EMC Declarations Guide
Provides emissions and EMC-related safety and use information.
Be sure to read the documentation before using the device or accessories.
To download the latest version of this manual or other documents, free of
charge, visit the MyHamilton website. To register, go to:
https://www.hamiltonmedical.com/MyHamilton
Hamilton Medical offers the Hamilton Medical College, which provides a variety of learning modules free of charge. To register, go to: http://college.hamiltonmedical.com
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Preface
Conventions used in this guide In this manual: · Button and tab names are
shown in a
bold font. · The notation XX > XX shows the
sequence of buttons/tabs to touch to open the associated window. For example,
the text Open the System > Settings window means touch the System button, then
touch the Settings tab. · Software version: The software version for the
ventilator is displayed in the System > Info window and should match the
version on the title page of this manual. · Units of measure: Pressure is
indicated in cmH2O, length in cm, and temperature in degrees Celsius (°C). The
unit of measure for length is configurable. · The graphics shown in this
manual may not exactly match what you see in your environment. Safety messages
are displayed as follows:
WARNING A WARNING alerts the user to the possibility of injury, death, or
other serious adverse reactions associated with the use or misuse of the
device.
CAUTION A CAUTION alerts the user to the possibility of a problem with the
device associated with its use or misuse, such as device malfunction, device
failure, damage to the device, or damage to other property.
NOTICE A NOTICE emphasizes information of particular importance. In tables,
safety messages are indicated as follows:
WARNING!
CAUTION!
NOTICE!
Intended use The HAMILTON-G5 ventilator is designed for intensive care
ventilation of adult and pediatric patients, and optionally infant and
neonatal patients. The device is intended for use in the hospital and
institutional environment where health care professionals provide patient
care. The HAMILTON-G5 ventilator is intended for use by properly trained
personnel under the direct supervision of a licensed physician. The
HAMILTON-G5 ventilator may be used for transport within a hospital or hospital
type facility provided compressed gas is supplied. The device is not to be
used in the presence of flammable anesthetic agents or other ignition sources.
The ventilator is not to be used in an environment with magnetic resonance
imaging (MRI) equipment. The device is not intended for transportation outside
the hospital or for use in the home environment.
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Safety information
1.1 Overview…………………………………………………………………………….. 20 1.2 Electromagnetic
susceptibility …………………………………………………. 20 1.3 Fire and other
hazards…………………………………………………………… 21 1.4 General operation and
setup………………………………………………….. 21 1.5 Setting up for
ventilation……………………………………………………….. 24 1.6 Ventilating the patient
………………………………………………………….. 29 1.7 Monitoring and alarms…………………………………………………………..
31 1.8 Using the trolley…………………………………………………………………… 32 1.9
Maintenance……………………………………………………………………….. 32 1.10 Service and testing
……………………………………………………………….. 34
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1 Safety information
1.1 Overview
This chapter provides safety information related to setting up and operating
the ventilator and trolley, as well as providing service.
Be sure to review this Operator’s Manual before using the ventilator and any
accessories.
Be sure to read the Instructions for Use provided with any devices and
accessories used with the ventilator before use.
Carefully review all sections of this safety chapter before setting up the
ventilator and accessories, and ventilating the patient.
If you have questions about any of the information in this manual, contact
your Hamilton Medical representative or technical service personnel.
1.2 Electromagnetic susceptibility
WARNING · MR UNSAFE. Keep away from mag-
netic resonance imaging (MRI) equipment. The HAMILTON-G5 poses unacceptable
risks to the patient, medical staff, or other persons within the MR
environment. · Correct function of the device may be impaired by the operation
of high-frequency surgical equipment, microwaves, shortwaves, or strong
magnetic fields in close proximity. · Follow precautions for electrostatic
discharge (ESD) and electromagnetic interference (EMI) to and from the
ventilator and any connected devices and accessories.
· Use of accessories, transducers, and cables other than those specified or
provided by the manufacturer of this equipment can result in increased
electromagnetic emissions or decreased electromagnetic immunity of this
equipment, and may result in improper operation.
· Portable RF communications equipment, including peripherals such as antenna
cables and external antennas, should be placed no closer than 30 cm (12 in) to
any part of the HAMILTON-G5 ventilator, including any cables specified by the
manufacturer. Otherwise, degradation of the performance of this equipment can
occur.
· The emissions characteristics of this equipment make it suitable for use in
industrial areas and hospitals (CISPR 11, class A). If it is used in a
residential environment (for which CISPR 11, class B is normally required)
this equipment might not offer adequate protection to radio-frequency
communication services. The user might need to take mitigation measures, such
as relocating or reorienting the equipment.
The HAMILTON-G5 complies with the IEC 60601-1-2 EMC (Electromagnetic
Compatibility) Collateral Standard. The ventilator requires special
precautions regarding electromagnetic compatibility (EMC). It must be
installed and put into service according to the EMC information provided in
the ventilator EMC Declarations (PN 624896). Portable and mobile RF
communications equipment can affect the ventilator and all medical electrical
equipment.
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1 Fire and other hazards
1.3 Fire and other hazards
1.4.1 General operation and setup
WARNING · It is not permitted to use any of the
equipment with flammable gases or anesthetic agents, or in insufficiently
ventilated areas. Danger of fire! · Do not use the ventilator with any
equipment or high-pressure gas hoses that are worn or contaminated with oil or
grease. · Highly compressed oxygen together with flammable sources could lead
to spontaneous explosions. · In case of fire, immediately secure the patient’s
ventilatory needs, turn off the ventilator, and disconnect it from its gas and
electrical sources. · Do not use if primary power source cables are damaged. ·
The HAMILTON-G5 can be used in an oxygen-enriched environment. To reduce the
risk of fire, use only breathing circuits intended for use in oxygen-enriched
environments. Do not use antistatic or electrically conductive tubing.
1.4 General operation and setup
This section provides the following safety information: · General operation
and setup · Electrical: power and batteries · Gas supply · USB ports
WARNING
· Modifications to the device and any accessories are not permitted.
· An O2 sensor must be installed. · In case of ventilator failure, the lack of
immediate access to appropriate alternative means of ventilation can result in
patient death. · If a fault is detected in the ventilator or its life-support
functions are in doubt, disconnect the ventilator from the patient and
immediately start ventilation with an alternate device (for example, a
resuscitation bag), using PEEP and/or increased oxygen concentration when
appropriate. The ventilator must be removed from clinical use and serviced by
a Hamilton Medical authorized service engineer. · Use only parts and
accessories specified in Chapter 15 and in the product e-catalog, or that are
specified as being compatible with this ventilator. Doing so ensures proper
ventilation operation, avoids degraded performance, and keeps your warranty in
force. · The use of this equipment is restricted to one patient at a time. ·
Only use the ventilator and its components and accessories according to the
intended use and as described in the associated Instructions for Use. · Do not
connect any component or device to the exhaust port of the expiratory valve
unless authorized by Hamilton Medical. · The ventilator must not be used in a
hyperbaric chamber.
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1 Safety information
· If there is damage to any part of the ventilator, do not use the device.
Technical service is required.
· Do not simultaneously touch conductive components (for example, the USB
port) or conductive parts of the ventilator enclosure and the patient.
· Additional equipment connected to medical electrical equipment must comply
with the respective IEC or ISO standards. All configurations must comply with
the requirements for medical electrical systems, IEC 60601-1, clause 16.
· Anybody connecting additional equipment to medical electrical equipment
configures a medical system and is responsible for ensuring that the system
complies with the requirements for medical electrical systems. Local laws take
priority over the above-specified requirements.
· Do not block the holes between the HAMILTON-G5’s To patient and From patient
ports. These holes are vents for the overpressure and ambient valves.
CAUTION To prevent possible patient injury and ventilator overheating, do NOT
block the cooling fan vents.
NOTICE · The barometric pressure is only mea-
sured and compensated during ventilator installation and setup, and with every
service. There is no automatic calibration for barometric compensation. · Due
to the ventilator’s base flow, the exhaust gas output is larger than the
patient’s actual exhaled volume.
1.4.2 Electrical: power and batteries
WARNING · Ventilation stops if the battery or bat-
teries are discharged and no external power supply is connected. · To minimize
the risk of electrical shock, plug the ventilator power cord into an
appropriate grounded power receptacle. It is the hospital’s responsibility to
ensure that the receptacle is properly grounded (earth). · The HAMILTON-G5
requires protective earth grounding, because it is a class I device, as
classified according to IEC 60601-1. · Power sockets that can lead to a
failure of ventilation must have a locking device. · It is the responsibility
of the operator to ensure that the power system of any device connected to the
ventilator power outlet complies with the requirements for medical electrical
systems as well as local regulations. · Periodically check or replace the
battery.
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1 Gas supply
· Check the battery charge level before ventilating a patient and before
unplugging the ventilator for transport or other purposes.
· Connect only the HAMILTON-H900 to the power strip.
CAUTION To electrically isolate the ventilator electrical circuits from all
poles of the primary power supply simultaneously, disconnect the power plug.
NOTICE · Set up the ventilator in a location
where the primary power supply is accessible. · Only authorized service
personnel may replace the power cable. · Battery life indications are
approximate. The actual battery life depends on ventilator settings, battery
age, and level of battery charge. To ensure maximum battery life, maintain a
full charge and minimize the number of complete discharges. · After power has
been interrupted, the device stores the last settings, including any specified
alarm limits. Upon reconnection with the power supply, the device resumes
ventilation with these stored settings.
1.4.3 Gas supply
CAUTION Always check the status of the oxygen and air cylinders or other
supply before using the ventilator during transport.
NOTICE · To prevent damage to the ventilator,
connect only clean, dry medical grade oxygen and air. · When the ventilator is
not in use, disconnect all gases.
1.4.3.1 Working with Heliox
WARNING To prevent possible hypoxia or death, connect a heliox gas supply that
contains a minimum of 20% oxygen. The ventilator supports the following gas
mixtures (HE% / O2%): 78/22, 79/21, and 80/20.
CAUTION To prevent heliox from entering the wall gas supply, connect
compressed air with a minimum pressure of 2.8 bar.
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1 Safety information
NOTICE
· When Heliox is in use: The alarm lamp is illuminated in blue (when an
alarm is generated, the lamp alternates blue with yellow or red, depending on
the alarm priority) O2 monitoring cannot be disabled
· Heliox is disabled when any of the following are selected or active:
Nebulization INTELLiVENT-ASV mode Tube resistance compensation (TRC)
· In the System > Gas source window, ensure that the selected gas source type
matches the gas source connected to the ventilator. A mismatch can result in
inaccurate gas delivery and volume monitoring.
· Calibrate the flow sensor after: Switching between air and heliox
connections Significant changes in O2 concentration during heliox
ventilation
1.5 Setting up for ventilation
This section provides the following safety information: · Patient breathing
circuits, components,
and accessories · Performing preoperational checks and
testing · Humidifier · IntelliCuff · CO2 monitoring setup and operation ·
Nebulization · SpO2 monitoring setup and operation
See the Pulse Oximetry Instructions for use.
1.5.1 Patient breathing circuits, components, and accessories In addition to
the information provided in this section, carefully review the information in
Sections 1.3 and 1.4.
1.4.4 CompactFlash port
NOTICE The CompactFlash port is for data export and program update only
(screenshots and log files). A Hamilton Medical CompactFlash card is
recommended.
WARNING
· To prevent patient or ventilator contamination, always use a bacteria filter
or HMEF between the patient and the inspiratory port. If no bacteria filter is
used, the exhaled gas can contaminate the ventilator.
· Ensure that all of the components of the breathing circuit set, including
but not limited to flow sensor, humidifier, and other accessories, match the
associated intended use for the target patient group.
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1 Preoperational check and tests
· Adding attachments or other components/assemblies to a breathing system can
change the pressure gradient across the ventilator, which can adversely affect
ventilator performance.
· For each new patient, always use a new or reprocessed breathing circuit to
avoid cross contamination.
· During ventilation, regularly check the breathing circuit filter for
increased resistance and blockage.
NOTICE · Any bacteria filter, HMEF, or addi-
tional accessories in the expiratory limb may substantially increase flow
resistance and impair ventilation. · When adding components to the Hamilton
Medical breathing circuit configurations, do not exceed the inspiratory and
expiratory resistance values of the ventilator breathing system as specified
in Section 16.10, as required by ISO 80601-2-12. · Pressure and volume
measurement accuracy may be affected by using a breathing circuit with high
resistance. Accuracy was tested with Hamilton Medical devices using the
breathing circuits PN 260039 for adults, PN 260189 for pediatrics, and PN
151969 for neonates.
1.5.2 Preoperational check and tests
CAUTION · To prevent possible patient injury, dis-
connect the patient from the ventilator before running the preoperational
tests, and use another source of ventilatory support. · To ensure the
ventilator’s safe operation, always run the preoperational check before using
the ventilator on a patient. · Do NOT use the ventilator until necessary
repairs are completed and all preoperational tests have passed.
NOTICE · To ensure that all breathing circuit
connections are leak-tight, perform the tightness test every time you connect
a circuit or change a circuit part. · If there is a mismatch between the
selected patient group and the type of flow sensor connected, the calibration
fails. Ensure you are using the correct flow sensor for the patient. · Wait 2
minutes before calibrating the flow sensor following a switch between air and
heliox, or a significant change in the Oxygen setting. This allows the mixture
to stabilize.
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1 Safety information
1.5.3 Humidifier
1.5.4 IntelliCuff
WARNING · Before using a humidifier, review the
Instructions for Use as well as the Instructions for Use provided with its
accessories. · To prevent possible patient injury and equipment damage, do not
turn the humidifier on until the gas flow has started and is regulated. Turn
the humidifier off before stopping gas flow. · Adding attachments or other
components/assemblies to a connected humidifier can change the pressure
gradient across the ventilator, which can adversely affect ventilator
performance. · Regularly check the water traps and the breathing circuit limbs
for water accumulation. Empty as required.
NOTICE The humidifier is not powered by the ventilator when operating on the
backup battery.
WARNING · Never connect the tubing to any other
device or connector other than to the IntelliCuff port on the ventilator and
to the inflating tube on the tracheal tube or tracheostomy tube. · Disconnect
the IntelliCuff tubing from the tracheal or tracheostomy tube when IntelliCuff
is turned off. · When the IntelliCuff tubing is connected to the ventilator,
IntelliCuff starts applying the last-set or default pressure as soon as a
pressure above 0 is detected in the tubing, even if IntelliCuff is disabled
and the ventilator is in Standby.
CAUTION · Use only Hamilton Medical disposable
tubing with a filter and safety valve. Use of any other tubing will result in
the immediate loss of cuff pressure if disconnected at the ventilator. Use of
any other tubing without a filter may result in the device being contaminated.
· Check tubing regularly. Bent or kinked tubes can provide incorrect
monitoring information.
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1 CO2 sensor setup and operation
1.5.5 CO2 sensor setup and operation
WARNING · Monitor the CO2 waveform (capno-
gram) on the ventilator display. If it appears abnormal, check the patient,
settings, and the breathing circuit components, including the CO2 sensor
sampling line. Adjust and replace components as appropriate. · If the
capnogram appears abnormal, inspect the CO2 airway adapter and replace if
needed. · Elevated baseline can be caused by sensor problems or an issue with
the patient. · Do not use any CO2 sensor/adapter if they appear to be damaged
or if they fail to operate properly. Refer servicing to Hamilton Medical
authorized personnel. · Do not use the CO2 components when they are wet or
have exterior condensation. · In NIV and neonatal ventilation with uncuffed
tubes, leaks may influence the volumetric capnogram and the measured values. ·
Always connect all components securely and check for leaks according to
standard clinical procedures. Displacement of the nasal or combined nasal-oral
cannulas can cause lowerthan-actual CO2 readings.
· Positioning of tubes and cables: Do not position the cables or tubing in
any manner that may cause patient entanglement or strangulation. Support the
tubing to avoid stress on the ET tube. Do not apply excessive tension to any
cable or tubing.
· During use, a system leak, such as that caused by an uncuffed ET tube or
damaged CO2 sensor may significantly affect sensor readings, including flow,
volume, pressure, and other respiratory parameters.
· Leakages in the breathing or sampling system may cause the displayed CO2
values to be significantly underreported (too low).
· Keep all cleaning agents away from the CO2 sensor electrical connections.
· For the CO2 sensor/adapter, use only cleaning and disinfection agents that
are recommended in the Approved cleaning agents for CO2 components, available
on MyHamilton.
· Periodically check the sensor and tubing for excessive moisture or secretion
build-up, and replace if needed. Excessive moisture can affect measurements.
· LoFlo sidestream CO2 sensor. Do not use with patients who cannot tolerate
the removal of 50 ml ±10 ml/ min from their total minute volume. In adaptive
modes (such as ASV, APVcmv, and APVsimv), the removal is fully compensated.
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1 Safety information
· LoFlo sidestream CO2 sensor. Use of devices containing PVC plasticized with
DEHP should be limited to the amount of time treatment is medically necessary,
especially for neonates and pregnant or nursing mothers.
CAUTION · All devices are NOT protected against
reanimation with a defibrillator. Disconnect the CO2 sensor before using a
defibrillator on the patient. · Always use the correct CO2 adapter. In adult
patients, smaller geometrics increase airway resistance and induce low tidal
volumes and intrinsic PEEP. In neonatal patients, large geometrics impede
effective CO2 removal. · Do NOT place the CO2 sensor on the patient. It can
burn the skin as the sensor may reach a temperature of 46°C (115°F). · Use
during nebulization may influence the CO2 measurements. In addition, the
medication can contaminate the sensor windows, causing the sensor to fail
prematurely. · LoFlo sidestream CO2 sensor. Remove the sampling kit sample
cell from the module when not in use. · LoFlo sidestream CO2 sensor. Do NOT
stick finger into the sample cell receptacle.
NOTICE
· Position airway adapters with windows in a vertical, not a horizontal,
position. This helps keep patient secretions from pooling on the windows. If
pooling occurs, remove the adapter, rinse with water, and reconnect.
· Do not combine the neonatal CO2 airway adapter and the adult flow sensor.
Doing so can increase resistance, create artifact, or lead to hypoventilation,
intrinsic PEEP, or overinflation.
· Do not place the CO2 sensor/adapter between the ET tube and the elbow, as
this may allow patient secretions to enter the tubing and block the adapter
windows.
· The CO2 sensors and accessories that have contact with the patient are not
made with natural rubber latex.
· Nitrous oxide, elevated levels of oxygen, helium, and halogenated
hydrocarbons can influence the CO2 measurement.
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1 Nebulization
1.5.6 Nebulization For additional safety information related to Aerogen§
nebulizers, see the Aerogen Solo/Aerogen Pro Instructions for Use.
WARNING · Nebulization of drugs can cause an
occlusion and increased resistance of a connected expiratory filter. Check the
filter frequently for increased resistance or blockage. · Connect the
nebulizer in the inspiratory limb per your institution’s policy and
procedures. Connecting the nebulizer between the flow sensor and the
endotracheal tube increases dead space and causes incorrect volume
measurements. · Pneumatic nebulization affects the delivered oxygen
concentration. · Nebulization can affect the accuracy of CO2 measurements.
CAUTION To prevent the expiratory valve from sticking due to nebulized
medications, regularly check and clean or replace the expiratory valve
membrane and/or the expiratory filter.
NOTICE · Pneumatic nebulization is disabled:
During neonatal ventilation (if needed, use an Aerogen nebulizer1) When
using Hi Flow O2 When using heliox · Only use approved piezo nebulizers with
the HAMILTON-G5.
1.6 Ventilating the patient
This section provides the following safety information: · Specifying patient
settings · Neonatal ventilation · Apnea backup · TRC settings · P/V Tool Pro ·
Noninvasive ventilation · Using high flow oxygen therapy
1.6.1 Specifying patient settings
WARNING · It is the clinician’s responsibility to
ensure that all ventilator settings are appropriate, even when “automatic”
features, such as ASV, or default settings are used. · To prevent possible
patient injury: Make sure the ventilator is set up for the appropriate
patient group with the appropriate breathing circuit components. For each
patient group, make sure you select the correct patient sex and height
(Adult/Pediatric) or weight (Neonatal). Correct entries help prevent hyper- or
hypo-ventilation. · The ventilator is a high-flow device that can operate with
flows above 60 l/min and with a high oxygen concentration.
1 Not available in all markets.
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29
1 Safety information
1.6.2 Neonatal ventilation In addition to the information provided in this
section, carefully review the information in Sections 1.5 and 1.6.
WARNING Prolonged exposure to high oxygen concentrations may cause
irreversible blindness and pulmonary fibrosis in preterm neonates. Be
especially careful when performing oxygen enrichment.
CAUTION · To prevent increased CO2, do NOT
use an adult airway adapter for neonates as it will increase dead space. · To
determine appropriate tidal and minute volumes for neonatal patients, you must
consider (anatomic) dead space. Artificial airways (Y-piece, flow sensor, ET
tube, CO2 airway adapter) may increase the dead space. · When using active
humidification, prevent water accumulation in the flow sensor by ensuring that
the flow sensor is positioned at a 45° angle relative to the floor. Excess
water can affect the flow sensor measurements and lead to inaccurate volume
delivery, potentially resulting in hypoventilation.
NOTICE When switching between the Adult, Pediatric, and Neonatal patient
groups, you must calibrate the flow sensor and perform the tightness test.
1.6.3 Apnea backup
CAUTION We recommend you enable apnea backup ventilation whenever a mode that
allows spontaneous breathing is selected. Apnea backup is enabled by default.
1.6.4 TRC settings
WARNING To ensure patient safety, check that the Pressure alarm limit is set
appropriately when using TRC, as real pressure may be higher than the set
pressure.
CAUTION To prevent patient injury, be especially careful when defining TRC
settings, as using the incorrect tube type or size setting can endanger the
patient.
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1 Noninvasive ventilation
1.6.5 Noninvasive ventilation
NOTICE · As a precaution, you must be pre-
pared to intubate the patient and start invasive ventilation at any time while
noninvasive ventilation is in use. · The use of a mask can increase dead
space. Always comply with the mask manufacturer’s instructions when using
noninvasive ventilation.
1.6.6 P/V Tool Pro
WARNING Do not attempt to use the P/V Tool on an active patient as it can
cause patient discomfort and erroneous readings.
NOTICE · During a maneuver and for 30
seconds following the end of the maneuver, all patient alarms are silenced. ·
Apnea time begins after the end of the maneuver. · Use of the P/V Tool
provides information that, in conjunction with hemodynamic data and other
clinical information, may be used to optimize PEEP and other ventilator
settings. · During the maneuver, the high Pressure alarm is automatically set
to Ptop + 5 cmH2O. When the maneuver is finished, the high Pressure alarm
limit returns to the previous setting. If IntelliCuff is connected, Pcuff may
also be affected. For details, see Section 12.2.4.1.
· A calibrated flow sensor and a tight circuit produce the best results.
1.6.7 Using high flow oxygen therapy
WARNING · Use only interfaces intended for high
flow oxygen therapy that allow the patient to exhale, such as a nonocclusive
high-flow nasal cannula, tracheal adapter, or tracheal mask. This is important
because exhalation through the expiratory valve is not possible when using
high flow oxygen therapy. · Ensure the ventilator’s gas pipeline system does
not exceed the pipeline design flow capacity. If the system exceeds the flow
capacity, it can interfere with the operation of other equipment using the
same gas source. · Always use active humidification during high flow oxygen
therapy.
1.7 Monitoring and alarms
CAUTION · To prevent possible patient injury,
make sure the alarm limits are appropriately set before you place the patient
on the ventilator. · The HAMILTON-G5 oxygen monitoring function can be
disabled, except when Heliox is in use. Ensure that an alternative means of
oxygen monitoring is always available and enabled.
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1 Safety information
· To ensure that oxygen monitoring is always fully functional, replace an
exhausted or missing O2 sensor as soon as possible or use an external monitor
that complies with ISO 80601-2-55.
NOTICE · The HAMILTON-G5 is not intended to
be a comprehensive vital sign monitor for patients on life-support equipment.
Patients on life-support equipment should be appropriately monitored by
qualified medical personnel and suitable monitoring devices. · The use of an
alarm monitoring system does not give absolute assurance of warning for every
type of issue that may arise with the ventilator. Alarm messages may not
pinpoint a problem exactly; the exercise of clinical judgment is necessary. ·
It is recommended that additional independent monitoring devices, including
pulse oximeters measuring SpO2, be used during mechanical ventilation. The
operator of the ventilator must still maintain full responsibility for proper
ventilation and patient safety in all situations. · Do not pause the audible
alarm when leaving the patient unattended. · The Auto function is not
available during neonatal ventilation.
1.8 Using the trolley
WARNING · To prevent possible personal injury
and equipment damage, including tipping: Lock the trolley’s wheels when
parking the ventilator. Take care when crossing thresholds. · To prevent
accidental extubation, check the patient tubing support arm joints and secure
as necessary.
1.9 Maintenance
This section provides the following safety information: · Maintenance,
cleaning, and disinfection · Preventive maintenance
1.9.1 General maintenance, cleaning, and disinfection
WARNING · Reprocessing of Hamilton Medical sin-
gle-use products can affect the product properties and may cause injury to the
patient. For example, a change to the surface structure during reprocessing
may lead to a change in the tear strength or cause actual cracking.
Furthermore, an altered surface structure may result in a microbial
aggregation of spores, allergens and pyrogens, for example, or cause an
increase in the number of particles released as a result of chemical changes
in the material properties.
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1 General maintenance, cleaning, and disinfection
· To reduce the risk of cross-contamination, regularly clean and replace the
fan filter. For details, see Table 13-3 and Section 13.4.1.
· To prevent patient exposure to sterilizing agents and to prevent premature
deterioration of parts, sterilize parts using only the techniques recommended
in Chapter 13 and in any associated Reprocessing Guide or Instructions for Use
provided with each part.
· Hamilton Medical does not assume any liability for the proper functioning of
single-use items if they are reprocessed and reused by the user.
· Always use caution when handling bacteria filters to minimize the risk of
bacterial contamination or physical damage. Dispose of used filters
immediately after use. Follow your hospital procedures for disposal.
· Follow the cleaning, disinfection, and sterilization procedures for each
component as described in this guide and in the cleaning agent manufacturer’s
Instructions for Use.
· Always disconnect the device and any accessories, including CO2 sensor/
adapter, from electrical power before cleaning and disinfection to reduce the
risk of electric shock.
CAUTION · Do NOT sterilize or immerse the CO2
sensor in liquids. · Do NOT attempt to sterilize the inte-
rior components of the ventilator. · Do NOT attempt to sterilize the entire
device with ETO gas. · Incorrect concentrations or residence
times of sterilization agents may lead to bacterial resistance.
Hamilton Medical | HAMILTON-G5 Operator’s Manual
· To prevent premature deterioration of parts, make sure the disinfecting
chemical is compatible with the part material. Use only registered/ approved
cleaning and disinfection solutions, as approved by your institution’s
protocol, after each patient use, according to the cleaning agent
manufacturer’s recommendations.
· Intrusion of fluids, or immersing parts in fluids, will damage the device.
· Do NOT pour fluids onto the device surfaces.
· Do NOT use abrasives materials (for example, steel wool or silver polish),
hard brushes, pointed instruments, or rough materials on surfaces.
· Thoroughly rinse all patient or airway contact component to ensure removal
of residual cleaning/disinfection agents.
· Cleaning and disinfection agent residues can cause blemishes or fine cracks,
especially on parts exposed to elevated temperatures during sterilization.
NOTICE · Because sanitation practices vary
among institutions, Hamilton Medical cannot specify specific practices that
will meet all needs or be responsible for the effectiveness of these
practices. · This Operator’s Manual only provides general guidelines for
cleaning, disinfecting, and sterilizing. It is the operator’s responsibility
to ensure the validity and effectiveness of the actual methods used.
33
1 Safety information
· For specific information on cleaning, disinfecting, and sterilizing
autoclavable (reusable) accessories and components, refer to the appropriate
Reprocessing Guide and Instructions for Use provided with each part.
1.9.2 Preventive maintenance
NOTICE · Dispose of all parts removed from the
device according to your institution’s protocols. Comply with all local,
state, and federal regulations with respect to environmental protection,
especially when disposing of the electronic device or parts of it (for
example, O2 sensor). · We recommend that you document all maintenance
procedures. · It is not allowed to perform service or maintenance on the
device while a patient is connected. · If no bacteria (inspiratory) filter is
used, the device must be considered contaminated and must be serviced.
1.9.3 O2 sensor
NOTICE · To prevent leakage within the ventila-
tor, make sure an O2 sensor is installed at all times, even if you use an
external monitor or disable oxygen monitoring. · The paramagnetic O2 sensor
must only be replaced if it fails. In this case, have the ventilator serviced.
1.10 Service and testing
· To ensure proper servicing and to prevent possible physical injury, only
Hamilton Medical authorized service personnel may service the ventilator using
information provided in the Service Manual. In addition, all accessories and
devices must only be serviced by Hamilton Medical authorized service
personnel.
· The manufacturer can only be responsible for the safety, reliability, and
performance of the ventilator if all of the following requirements are met:
Appropriately trained personnel carry out assembly operations, extensions,
readjustments, modifications, maintenance, or repairs. The electrical
installation of the relevant room complies with the appropriate requirements.
The ventilator system is used in accordance with the operator’s manual. Do
not attempt service procedures other than those specified in the service
manual.
· Any attempt to modify the ventilator hardware or software without the
express written approval of Hamilton Medical automatically voids all
warranties and liabilities.
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2
System overview
2.1 Overview…………………………………………………………………………….. 36 2.2 Physical
descriptions……………………………………………………………… 39 2.3 Navigating the windows and
controls………………………………………. 53
35
2 System overview
2.1 Overview
The HAMILTON-G5 ventilator system comprises the following main components: ·
Detachable monitor with integrated
alarm lamp and touch screen display · Ventilation unit for gas mixing and
control, and patient breathing circuit for gas delivery and exchange · Oxygen
monitoring using a galvanic or optional paramagnetic sensor · Optional
connections to a humidifier, IntelliCuff cuff pressure controller, SpO2 and
CO2 sensors, and external data interfaces · Trolley, shelf, or pendant mount
The ventilator system offers the following main features: · Monitoring: Real-
time waveforms,
numerical monitoring, trends, loops, and Intelligent panels showing the
patient’s real-time breathing status, ventilator dependence, and targets, CO2
and SpO2 measurements (when enabled) · Alarms: Adjustable and non-adjustable
to ensure patient safety · Configurable startup settings for each patient
group · Monitoring and control of the HAMILTON-H900 humidifier from the
ventilator · Monitoring and control of the IntelliCuff cuff pressure
controller from the ventilator · Transpulmonary pressure measurement · Support
for pneumatic or Aerogen nebulization
2.1.1 Standard features and options The ventilator offers a robust set of standard equipment and features, as well as optional modes and features for the supported patient groups. Table 2-1 lists the standard software configuration and options. Table 2-2 lists the standard equipment (hardware) and options.
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2 Standard features and options
Table 2-1. Standard software configuration and options
Function
Patient group
Adult/Pediatric
Neonatal
Standard: X Option: O Not applicable: —
Patient groups
X
O
Modes
Intelligent ventilation modes
ASV
X
—
INTELLiVENT-ASV
O
—
Volume-targeted, pressure-controlled modes
APVcmv
X
X
APVsimv
X
X
Volume-controlled, flow-controlled modes
(S)CMV
X
—
SIMV
X
—
Volume-controlled, flow-cycled mode
Volume Support (VS)
X
X
Pressure-controlled modes
DuoPAP, APRV
X
X
P-CMV
X
X
P-SIMV
X
X
SPONT
X
X
Noninvasive modes
Hi Flow O2
O
O
NIV, NIV-ST
X
—
nCPAP-PS
—
O
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2 System overview
Function
Other functions P/V Tool, P/V Tool Pro Intellisync+ Flow and pressure triggers
TRC Suctioning tool Trends/Loops
Patient group
Adult/Pediatric
Neonatal
O
O
O
—
X
X
X
X
X
X
X
X
Table 2-2. Standard equipment (hardware) configuration and options
Functions Standard: X Option: O
Trolley, shelf mount, or pendant mount solution (selected when ordering)
External battery Modules for external sensors/devices: CO2, SpO2, Nebulizer,
Humidifier Heliox ventilation Extended communication ports: CompactFlash, USB,
DVI, COM (RS-232), Special interface Communication protocols (for use with the
COM ports): HAMILTON-G5 / Polling, HAMILTON-G5 / Block, HAMILTON-G5 / Block
(ACK), Galileo / Polling, DraegerTestProtocol, Humidifier Paramagnetic O2
sensor Paux port HAMILTON-H900 humidifier integration IntelliCuff cuff
pressure controller integration
HAMILTON-G5
X O O
O X
O
O X O O
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2 Physical descriptions
2.2 Physical descriptions
This section provides an overview of the ventilator, breathing circuit sets,
and trolley. Figure 2-1. HAMILTON-G5 with accessories
2.2.1 About the ventilator Figures 2-2 through 2-5 provide an overview of the device.
1 Support arm and infusion arm
2 Display and controls
3 Breathing circuit connections
4 Breathing circuit 5 Humidifier 6 Trolley
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2 System overview
Figure 2-2. Front view, ventilator monitor
1
Alarm lamp*
6
Screen lock/unlock
2
Touch screen display (Figure 2-6)
7
Nebulizer key
3
Manual breath key
8
Standby key
4
O2 enrichment key
9
Print screen key
5
Audio Pause key
10 Press-and-Turn (P&T) knob
- The alarm lamp illuminates in blue when heliox is in use.
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Figure 2-3. Front view, ventilator body
2 About the ventilator
1
Paux port
7
2
Nebulizer port
8
3
Flow sensor connection
9
ports
4
IntelliCuff port
10
5
Expiratory valve set
11
6
From patient expiratory port
Hamilton Medical | HAMILTON-G5 Operator’s Manual
Exhaust port To patient inspiratory port Inspiratory filter
CO2/SpO2/Aerogen/ Humidifier option module ports Status indicator panel
(Section 2.2.1.1)
41
2 System overview
Figure 2-4. Rear view, ventilator body
1
Fan filter
8
AC power socket
2
Serial number label
9
Monitor cable
3
Power button
10 Fuse compartment
4
High-pressure air DISS or NIST inlet
fitting
11 Oxygen sensor with cover
5
High-pressure oxygen DISS or NIST inlet 12 Potential equalization conductor
fitting (for heliox, see Section 3.3)
6
High-pressure gas water trap with filter 13 RS-232 COM1, COM2 ports
7
Reservoir pressure relief valve exhaust
14 Special interface
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Figure 2-5. Rear view, ventilator monitor
2 About the ventilator
1
Monitor cable storage
5
CompactFlash port
2
Tilt-release lever
6
USB port
3
Monitor cable
7
DVI-I connection port
4
Mounting post with swivel lock/
release latch
CAUTION! For training purposes only. Not for use with a connected patient.
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2 System overview
2.2.1.1 About the status indicators on the ventilator Indicator lights on the front of the ventilator unit show important ventilation status information. Table 2-3. Status indicator panel
Symbol
Description
Alarm indicator. Solid red when an alarm is active.
For alarm related information, see Chapter 9.
Primary power indicator. Solid blue when the ventilator is plugged in and
connected to primary (AC) power.
Power indicator. Solid green when the ventilator is turned on.
2.2.2 About the main display Directly access all the windows for mode, controls, alarms, and monitoring from the main display during normal ventilation (Figure 2-6).
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Figure 2-6. Main display
2 About the main display
1
Message bar (color coded)
8
Window buttons: Alarms, Controls,
Monitoring, Graphics, Tools, Events,
System
2
Configurable graphic display
9
Power source
3
Window buttons: Patient, Additions,
Modes
10 Humidifier quick access icon
4
INTELLiVENT-ASV button
11 Main monitoring parameters (MMP)
5
Active mode and selected patient group 12 Secondary monitoring parameters (SMP)
6
IntelliCuff quick access icon and/or
Heliox icons (when installed and
selected)
13 Audio Pause indicator and countdown timer
7
Main controls for the active mode
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2 System overview
2.2.3 About the patient breathing circuits For details about connecting and
setting up the breathing circuit, see Section 3.4. When setting up the patient
breathing circuit, keep in mind the following important points: · To prevent
patient or ventilator con-
tamination, be sure to connect a bacteria (inspiratory) filter or HMEF between
the patient and the inspiratory port.
Figure 2-7. Adult/pediatric breathing circuits Adult/Ped: Dual limb with
humidifier
· Connect the CO2 sensor in front of or behind the flow sensor, according to
your institution’s protocol.
· During neonatal ventilation with active humidification, prevent water
accumulation in the flow sensor by ensuring that the flow sensor is positioned
at a 45° angle relative to the floor.
Adult/Ped: Coaxial with HMEF
1
To patient inspiratory port
9
Y-piece
2
From patient expiratory port
10 CO2 sensor/adapter
3
Expiratory valve set
11 Flow sensor
4
Flow sensor connection ports
12 Humidifier
5
Bacteria filter
13 Coaxial inspiratory/expiratory limb
6
Inspiratory limb to humidifier
14 Expiratory limb extension
7
Heated inspiratory limb with tempera- 15 HMEF
ture sensor, to patient
8
Heated expiratory limb
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2 About the patient breathing circuits
Figure 2-8. Adult/pediatric breathing circuit: high flow oxygen therapy
Adult/Ped: Dual limb, high flow oxygen therapy
Adult/Ped: Single limb, high flow oxygen therapy
1
To patient inspiratory port
7
Heated expiratory limb
2
From patient expiratory port
8
Y-piece
3
Expiratory valve set
9
Adapters (various)
4
Bacteria filter
10 Nasal cannula
5
Inspiratory limb to humidifier
11 Attachment strap
6
Heated inspiratory limb with tempera- 12 Humidifier
ture sensor, to patient
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2 System overview
Figure 2-9. Neonatal breathing circuits Neonatal/pediatric: Dual limb with
humidifier
Neonatal/pediatric: Dual limb with HMEF
1
To patient inspiratory port
9
Heated expiratory limb
2
From patient expiratory port
10 Y-piece
3
Expiratory valve set
11 CO2 sensor/adapter
4
Flow sensor connection ports
12 Flow sensor
5
Bacteria filter
13 Humidifier
6
Inspiratory limb to humidifier
14 Inspiratory limb
7
Heated inspiratory limb with tempera- 15 Expiratory limb
ture sensor, to patient
8
Unheated inspiratory limb extension,
for use in incubator
16 HMEF
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2 About the patient breathing circuits
Figure 2-10. Neonatal breathing circuits: high flow oxygen therapy
Neonatal/pediatric: Dual limb, high flow oxygen therapy
Neonatal/pediatric: Single limb, high flow oxygen therapy
1
To patient inspiratory port
7
Unheated inspiratory limb extension,
for use in incubator
2
From patient expiratory port
8
Heated expiratory limb
3
Expiratory valve set
9
Y-piece
4
Bacteria filter
10 Connection to patient interface (options not shown)
5
Inspiratory limb to humidifier
11 Humidifier
6
Heated inspiratory limb with tempera-
ture sensor, to patient
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2 System overview
Figure 2-11. Neonatal breathing circuit: nCPAP-PS Neonatal: nCPAP-PS
1
To patient inspiratory port
2
From patient expiratory port
3
Expiratory valve set
4
Flow sensor connection ports
5
Bacteria filter
6
Inspiratory limb to humidifier
7
Heated inspiratory limb with tempera-
ture sensor, to patient
8
Unheated inspiratory limb extension,
for use in incubator
9
Heated expiratory limb
10 Flow sensor (connected to expiratory port)
11 Y-piece
12 Humidifier
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2 About the trolley and mounting variations
2.2.4 About the trolley and mounting variations The HAMILTON-G5 can optionally
be ordered with a standard trolley, pendant mount, or a shelf mount solution.
The trolley has space for oxygen cylinders.
2.2.4.1 Preparing the trolley for intrahospital transport Before proceeding,
review the safety information in Chapter 1.
WARNING · Only the components listed in this
section are approved for intrahospital transport. · Use of additional items,
such as a patient support arm, can result in the trolley tipping over.
If using a HAMILTON-G5 trolley, the ventilator and its components, as well as
the trolley, must be configured and positioned as follows during transport
within the hospital:
· The oxygen cylinders must be securely attached to the trolley.
· Only the following components are allowed to be connected during transport:
Breathing circuit Flow sensor CO2 sensor (mainstream or sidestream)
SpO2 sensor, including Masimo adapter Infusion arm (water bottle holder)
CAUTION To prevent possible equipment damage, avoid overloading the
HAMILTON-G5’s basket and tray, or placing objects on the HAMILTON-G5 that
might compromise its stability.
NOTICE The O2 cylinder can only be mounted on the Universal trolley.
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2 System overview
2.2.5 Setting up the monitor The HAMILTON-G5 offers multiple mounting options
for the monitor. You can also adjust the tilt and view angle of the monitor.
2.2.5.1 Mounting the monitor The following mounting options are available for
the ventilator monitor: · Top of the trolley (1) · Trolley rail (2) · Standard
hospital rail (3) · Shelf (4) · Pendant system (4) Figure 2-12. Mounting
options
2.2.5.2 Adjusting the monitor You can adjust the monitor’s position and set it
to the desired orientation and angle by turning and tilting it, as needed.
To tilt the monitor up and down 1. Pull the tilt handle toward you (1), and
adjust the angle of the monitor (2). 2. Release the handle to lock the moni-
tor’s position. Figure 2-13. Tilting the monitor up and down
Contact your Hamilton Medical representative for more information.
To turn the monitor side to side 1. Press the bottom of the monitor post
latch to unlock it (1), and turn the monitor to the desired angle (2). 2.
Press the top of the latch to lock the monitor’s position.
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2 Navigating the windows and controls
Figure 2-14. Turning the monitor side to side
2.3 Navigating the windows and controls
Use the touch screen and the Press-andturn knob (referred to as the P&T knob)
to access data and specify settings. You interact with the HAMILTON-G5 user
interface as follows: · Touch elements on the display to open
windows and make selections. · Use the P&T knob to select, specify,
and confirm selections. A selected item is highlighted in yellow. This section
describes how to navigate the interface.
2.3.1 Accessing windows
To open a window
4 Do any of the following to open a window: Touch the button and any needed
tabs. Turn the P&T knob to move the cursor to the button or tab, then press
the P&T knob.
To close a window
4 Do any of the following to close a window: Touch the window button again.
Touch the X button. Turn the P&T knob to move the cursor to the X button, then
press the P&T knob.
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2 System overview
2.3.2 Adjusting controls
Specifying settings involves activating a control, setting a value, and
confirming the setting.
To adjust a control setting 1. Activate the control by doing any of
the following: Touch the control to select and activate it. Turn the P&T knob
to move the cursor to the control, then press the P&T knob to activate it. The
activated control is orange.
Figure 2-15. Selected control (yellow outline), activated control (orange)
2.3.3 Selecting list items Some selections are presented in a scrollable list.
To select a list item 1. In a list, touch the scroll bar to select
and activate it. 2. Turn the P&T knob to scroll through
the list, and when the desired selection is highlighted, press the knob to
select it.
2. Adjust the value by turning the P&T knob to increase or decrease the
value.
3. Confirm the setting by doing any of the following: Touch the control
again. Press the P&T knob.
The new setting is immediately applied.
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3
Preparing the ventilator
3.1 Overview…………………………………………………………………………….. 56 3.2 Connecting to a power
source ……………………………………………….. 56 3.3 Connecting the oxygen supply
……………………………………………….. 57 3.4 Setting up the patient breathing circuit
……………………………………. 58 3.5 Setting up esophageal/transpulmonary pressure
monitoring ………… 62 3.6 Turning the ventilator on and off ……………………………………………. 62
55
3 Preparing the ventilator
3.1 Overview
Preparing the ventilator for use comprises the following steps:
To …
Connect to a power source.
Connect the oxygen supply.
Set up the patient breathing circuit, including performing the preoperational
check.
Connect external devices and sensors.
Turn on the ventilator.
Select the patient group, mode, and alarm limits, and enter patient data.
See … Section 3.2 Section 3.3 Section 3.4
Chapter 4
Section 3.6 Chapter 5
3.2 Connecting to a power source
Before proceeding, review the safety information in Chapter 1. Always check
the reliability of the primary power outlet before plugging in the ventilator.
When connected to primary power, the AC power symbol in the bottom right
corner of the display shows a frame around it. In addition, the primary power
symbol on the status indicator panel is lit.
To connect the ventilator to a primary power supply 1. Connect the ventilator
to an outlet
that supplies AC power. Make sure the power cord is well seated into the
ventilator socket and secured with the power cord retaining clip to prevent
unintentional disconnection. 2. Connect one end of a grounding cable to the
equipotential grounding post on the ventilator (Figure 2-4) and the other to a
properly grounded outlet.
3.2.1 Using battery power A mandatory backup battery protects the ventilator
from low power or failure of the primary power source. The backup battery is
labeled INT on the ventilator. When the primary power source fails, the
ventilator automatically switches to operation on backup battery with no
interruption in ventilation. An alarm sounds to signal the switch-over.
Silence the alarm to confirm notification of the power system change and reset
the alarm. If battery power is completely lost, a buzzer sounds continuously
for at least two minutes. Batteries are charged whenever the ventilator is
connected to the primary power supply, whether or not it is turned on. The
battery and power source symbols in the bottom right corner of the display
show the power source in use. See Table 3-1. A frame around a power symbol
indicates the current ventilator power source. An optional second battery is
available. It is labeled EXT on the display, and is only shown when installed.
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3 Connecting the oxygen supply
Figure 3-1. Power source indicators on display
Table 3-1. Battery/power state
Power icon Battery/power state on display
Device is plugged into primary power and the battery is charging.
Device is running on battery power.
Battery is fully charged.
Battery is partially charged.
Power icon on Status indicator panel
Battery has less than 10% charge left.
Battery is either defective or not installed.
See Section 2.2.1.1.
If a battery is not fully charged, recharge it by connecting the ventilator to the primary power source. For details, see Section 16.4. Chapter 13 describes how to replace the optional battery.
3.3 Connecting the oxygen supply
Before proceeding, review the safety information in Chapter 1. High-pressure
oxygen, provided by a central gas supply or a gas cylinder, is supplied
through DISS or NIST male gas fittings. The ventilator uses high-pressure
oxygen, air, and heliox from wall supplies, cylinders, or the VENTILAIR II
medical air compressor. With the optional cylinder holder, you can mount
oxygen cylinders to the trolley. If you use gases from cylinders, secure the
cylinders to the trolley with the accompanying straps. To connect the gas
supply to the ventilator 4 Connect the gas hose to the ventila-
tor’s oxygen inlet fitting (Figure 2-4).
3.3.1 Working with heliox as a gas source Before proceeding, review the safety
information in Chapter 1. Heliox is a mixture of helium and oxygen, and can be
indicated for patients in cases of acute and life-threatening upper airway
obstruction. This action is taken as a temporary measure to provide a decrease
in the patient’s work of breathing while the cause of the obstruction is
treated. Administering heliox can make it easier to ventilate, because its
lower density can allow a patient to produce inspiratory and expiratory flows
with less turbulence.
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3 Preparing the ventilator
3.3.2 Selecting the gas source type
Before starting ventilation, be sure to select the appropriate gas source.
You set the source in Standby mode.
To select the gas source 1. In Standby mode, open the System >
Gas Source window. 2. Touch the appropriate button for the
desired gas source. Select Air or Heliox as appropriate. When Heliox is
selected, the alarm lamp on top of the display is lit blue. 3. Close the
window. 4. Calibrate the flow sensor.
Figure 3-2. Gas source window
3.4 Setting up the patient breathing circuit
Before proceeding, review the safety information in Chapter 1. Connecting the
breathing circuit comprises the following steps. For neonatal ventilation, see
Chapter 6.
To …
Install the expiratory valve.
Select the appropriate breathing circuit and components.
Assemble the breathing circuit.
Adjust the position of the breathing circuit.
Connect external devices and sensors.
Perform any required tests, calibrations, and the preoperational check.
See … Section 3.4.2 Section 3.4.3
Section 3.4.4 Section 3.4.5 Chapter 4 Chapter 5
1 System 2 Gas Source
3 Air, Heliox2
2 If the option is installed and activated.
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3 Breathing circuit connections on the ventilator
3.4.1 Breathing circuit connections on the ventilator Figure 3-3 illustrates
the key ports on the ventilator for connecting the breathing circuit set. For
breathing circuit diagrams, see Section 2.2.3.
Figure 3-3. Key connection ports, front of ventilator
3.4.2 Working with the expiratory valve set This section describes how to
assemble, install, and disassemble the expiratory valve set.
To assemble/install the expiratory valve set 4 Position the expiratory valve
set
(Figure 3-4) in the expiratory port (1) and twist clockwise until it locks
into place (2). Figure 3-4. Installing the expiratory valve set
To disassemble the expiratory valve set 4 Remove the expiratory valve set from
the expiratory valve port on the ventilator.
1 To patient inspira- 5 Nebulizer port tory port
2 From patient expiratory port
6 Flow sensor connection ports
3 Expiratory valve exhaust
7 IntelliCuff tubing port
4 Paux port
8 CO2, SpO2, Aerogen, and Humidifier module ports, if installed
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3 Preparing the ventilator
3.4.3 Selecting the breathing circuit components
Select the correct breathing circuit parts for your patient.
For neonatal ventilation, see Chapter 6.
Table 3-2. Breathing circuit component specifications
Patient data/ Component
Patient height (cm)
Adult > 130
Pediatric 30 to 150
IBW (kg)
30
Tracheal tube ID > 4 (mm)
Breathing circuit 15 to 22 limb ID (mm)3
Flow sensor
Adult/Ped
3 to 48 > 4
10 to 22
Adult/Ped
CO2 airway adapter
Adult/Ped4 Adult/Ped4
3.4.3.1 Using a filter in the breathing circuit Before proceeding, review the safety information in Chapter 1. Inspiratory bacteria filter To prevent patient or ventilator contamination, be sure to connect a bacteria (inspiratory) filter or HMEF between the patient and the inspiratory port. For neonatal patients, use a neonatalpediatric bacteria (inspiratory) filter or HMEF.
If no inspiratory filter is used, the exhaled gas can contaminate the
ventilator. If you are not using an inspiratory filter, and an exhalation
obstructed alarm is generated, the ventilator may be contaminated. Have the
ventilator serviced.
Expiratory bacteria filter Before using an expiratory filter with
nebulization, review the safety information in Section 1.5.6. An expiratory
filter is not required on the HAMILTON-G5, but you may use one according to
your institution’s protocol. It is not required because the expiratory valve
design prevents internal ventilator components from coming into contact with
the patient’s exhaled gas. If you use an expiratory filter, place it on the
patient side of the expiratory valve cover. Monitor closely for increased
expiratory circuit resistance. An Exhalation obstructed alarm may also
indicate excessive expiratory circuit resistance. If the Exhalation obstructed
alarm occurs repeatedly, remove the expiratory filter immediately. If you
otherwise suspect increased expiratory circuit resistance, remove the
expiratory filter or replace the filter to eliminate it as a potential cause.
Heat and moisture exchanging filter (HMEF) The HMEF is a passive
humidification component used together with a bacteria filter. Use an HMEF
when ventilating with a coaxial breathing system.
3 When using coaxial breathing sets, follow the manufacturer’s recommendations
for each patient group. 4 When tracheal tube ID > 4 mm.
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3 Assembling the patient breathing circuit
3.4.4 Assembling the patient breathing circuit
Assemble the appropriate breathing circuit for your patient. Commonly used
standard breathing circuit configurations are illustrated in Section 2.2.3.
For neonatal ventilation, see Chapter 6.
3.4.4.1 Connecting the flow sensor
NOTICE To prevent inaccurate flow sensor readings, make sure the flow sensor
is correctly connected.
Before proceeding, review the safety information in Chapter 1.
To connect a flow sensor to the breathing circuit
1. Insert a flow sensor into the breathing circuit in front of the patient
connection. See also the breathing circuit diagrams in Section 2.2.3.
Flow sensor connection dual limb circuit, Y-piece
The blue tube attaches to the blue connection port. The clear tube attaches to
the silver connection port. 3. Calibrate the flow sensor and perform the
Tightness test. See Section 5.4.
3.4.5 Positioning the breathing circuit
NOTICE · To prevent water accumulation in the
flow sensor and tubing, position the flow sensor tubing on top of the flow
sensor. · Ensure there is no undue stress placed on any tubing or cables.
After assembly, position the breathing circuit so that the hoses will not be
pushed, pulled, or kinked as a result of a patient’s movement, transport, or
other activities, including scanner bed operation and nebulization. The next
step is to perform all required tests, calibrations, and the preoperational
check. See Chapter 5.
Flow sensor connection coaxial circuit
2. Attach the blue and clear tubes to the flow sensor connection ports on the ventilator (Figure 3-3).
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3 Preparing the ventilator
3.5 Setting up esophageal/ transpulmonary pressure monitoring
The Paux port allows you to use pressure readings other than airway pressure
(Paw), for example, from an esophageal balloon catheter, for monitoring
purposes. Transpulmonary pressure is also calculated using a combination of
the Paw and Paux pressures.
To display Paux-related parameters 1. Connect an esophageal catheter to
the Paux port on the front of the ventilator (Figure 2-3). 2. Open the
Monitoring > Paw/Paux window. 3. Touch the Pes (Paux) button to activate Paux
as the standard pressure input. To revert to using airway pressure, touch the
Paw button. The associated pressure-related parameters are available in the
Monitoring window. For details, see Section 8.5.
3.6 Turning the ventilator on and off
To turn on the ventilator 4 Press the Power button on the back of
the ventilator. The ventilator runs a self-test. After a short time, the
Standby window is displayed. Proceed with setting up the ventilator and
patient, as appropriate.
Figure 3-5. Power button
To turn off the ventilator Note that while using IntelliCuff, you must first
deflate the cuff and turn off the device before turning off the ventilator. 1.
From active ventilation, press the
Standby key to open the Activate Standby window. 2. Touch the Activate standby
button to confirm. 3. Press the power button on the back of the ventilator.
The ventilator turns off. In the event of a technical fault or the device will
not turn off 4 Press and hold the Power button (Figure 2-4) on the back of the
device for about 10 seconds to turn off the ventilator.
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4
Setting up external devices and sensors
4.1 Overview…………………………………………………………………………….. 64 4.2 Installing a
module……………………………………………………………….. 64 4.3 Setting up a
humidifier………………………………………………………….. 64 4.4 Setting up the IntelliCuff cuff
pressure controller……………………….. 65 4.5 Setting up CO2 monitoring
……………………………………………………. 66 4.6 Setting up SpO2 monitoring…………………………………………………… 70
4.7 Enabling sensors ………………………………………………………………….. 70 4.8 Setting up
nebulization …………………………………………………………. 71 4.9 Connecting to an external patient
monitor or other device ………….. 72
63
4 Setting up external devices and sensors
4.1 Overview
The HAMILTON-G5 supports a variety of external devices and sensors for
ventilation, including: · Humidifier · IntelliCuff cuff pressure controller ·
CO2 monitoring sensors · Pulse oximetry (SpO2 monitoring)
sensors · Nebulizers
This chapter describes how to set them up for ventilation.
4.2 Installing a module
For SpO2 and CO2 sensors, and Aerogen nebulizer use, the associated option
module must be installed. An additional HAMILTON-H900 humidifier module is
also available.
To install a module 1. If present, remove the cover plate
from the module slots. 2. Slide in the module until it clicks into
place.
Figure 4-1. Sensor, nebulizer, and humidifier connection modules
1 Release button
2 Connection modules
To remove a module 1. Press the release button on top of the
module, and pull the module out. 2. If desired, replace the module slot
cover.
4.3 Setting up a humidifier
Before proceeding, review the safety information in Chapter 1. When used with
the HAMILTON-H900 humidifier, the ventilator supports integration of
humidifier operation and data monitoring directly from the ventilator
display5. Other humidifiers are supported, without the integration. To connect
a non-Hamilton Medial humidifier, refer to the manufacturer’s instructions for
use.
5 Not available in all markets.
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4 Setting up the IntelliCuff cuff pressure controller
To connect the HAMILTON-H900 humidifier to the ventilator 1. First, enable the
Humidifier option on
the ventilator, and ensure either a COM port is configured for the humidifier
or the Humidifier module is installed. For details, see Sections 14.11.3 and
14.6.3. 2. Connect the HAMILTON-H900 humidifier power cable to the dedicated
power socket on the ventilator (Figure 2-4). 3. Connect a potential
equalization cable to the humidifier and to a grounding socket at your
facility. 4. Connect the communication cable to the bottom of the humidifier,
and to the ventilator. On the ventilator, you can either connect the cable to
the configured RS-232 COM port on the back of the ventilator (option 1 below)
or to the Humidifier module on the front (option 2 below), whichever is
available. Figure 4-2. Connecting the humidifier communication cable to COM
port (1) or to module port (2)
If data export is configured, humidifier data is also transmitted from the
ventilator to an external monitoring system.
For additional details about: · Connecting the humidifier to the
breathing circuit, see Section 2.2.3. · Working with the humidifier, see the
HAMILTON-H900 Instructions for use. · Controlling the humidifier from the
ventilator, see Chapter 12.
4.4 Setting up the IntelliCuff cuff pressure controller
The ventilator supports the use of an optional IntelliCuff cuff pressure
controller, and offers integrated operation and monitoring of the device. For
details on using IntelliCuff during ventilation, see Section 12.2. The
following options are available: Integrated and standalone Integrated
IntelliCuff The IntelliCuff port on the front of the ventilator connects
inside the ventilator to an integrated automatic cuff pressure controller
module. The integrated cuff controller comprises a small pump and pressure
monitoring device with two independent pressure sensors. When in use, the cuff
controller increases the cuff pressure as needed, compensates for leaks, and
reduces any excess pressure, if required. To aid with intubation and
extubation, the cuff controller generates a small vacuum to completely deflate
the cuff. For setup details, see Section 4.4.2.
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4 Setting up external devices and sensors
Standalone IntelliCuff IntelliCuff is connected as a standalone device, and all controls and operations are available on the device itself. For details on using IntelliCuff as a standalone device, see the IntelliCuff Instructions for use.
Figure 4-3. Connect IntelliCuff tubing to IntelliCuff port on ventilator (1)
4.4.1 About the IntelliCuff tubing The IntelliCuff connector allows connection
only from the ventilator end (with the shut-off valve) of the Hamilton Medical
cuff pressure tubing. The ventilator end of the tubing has a built-in shut-off
valve, which prevents loss of cuff pressure in the event of a disconnection
from the ventilator. The patient end of the tubing fits the connector (pilot
balloon) for cuff pressure measurement on the ET tube or the tracheotomy
cannula.
4.4.2 Setting up IntelliCuff For each patient, you connect the cuff and tubing
to the patient and to the ventilator, and specify the desired settings.
To connect the cuff tubing 1. Connect the cuff tubing to the patient
as described in the IntelliCuff Instructions for use. 2. Connect the other end
of the cuff tubing to the IntelliCuff port on the front of the ventilator
(Figure 2-3).
To enable the IntelliCuff option on the ventilator, see Section 14.11.3. For
operation details, see Section 12.2 and the IntelliCuff Instructions for use.
4.5 Setting up CO2 monitoring
Before proceeding, review the safety information in Chapter 1. CO2 monitoring
data is helpful for the assessment of the patient’s airway integrity or
ensuring proper endotracheal tube placement, among other applications. Two CO2
measurement options are available: mainstream and sidestream. Which option you
use depends on the clinical setting.6 Enabling CO2 measurement on the
ventilator requires enabling the CO2 hardware (in Configuration) and enabling
the sensor. In addition, the CO2 module must be installed.
6 The volumetric capnogram is only available when using a mainstream CO2
sensor.
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4 Mainstream CO2 measurement
Table 4-1. CO2 measurement overview
For details about … Mainstream CO2 measurement, connection, and use Sidestream
CO2 measurement, connection, and use Enabling the CO2 hardware
Installing a module Enabling the CO2 sensor
See … Section 4.5.1
Section 4.5.2
Section 14.11.3 Section 4.2 Section 4.7
Figure 4-4. Mainstream CO2 monitoring components and assembly
4.5.1 Mainstream CO2 measurement The CO2 monitoring option comprises the following components (shown in Figure 4-4): communication module, airway adapter, and CO2 sensor. The sensor generates infrared light and beams it through the airway adapter to a detector on the opposite side. CO2 from the patient, flowing through the mainstream airway adapter, absorbs some of this infrared energy. The system determines the CO2 concentration in the breathing gases by measuring the amount of light absorbed. The ventilator displays CO2 measurements as numeric values, waveforms, trends, and loops.
1 Communications module with CO2 connection port
3 CO2 sensor
2 Airway adapter
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4 Setting up external devices and sensors
4.5.1.1 Connecting the mainstream CO2 sensor
CAUTION When using active humidification, prevent water accumulation in the
CO2 adapter/sensor by ensuring that they are positioned at a 45° angle
relative to the floor. Excess water can affect the sensor measurements.
Do not place the airway adapter between the ET tube and the elbow, as this may
allow patient secretions to accumulate in the adapter.7 The sensor cable
should face away from the patient. 5. Secure the sampling line safely out of
the way.
Figure 4-5. Connecting CO2 sensor/adapter (1) to breathing circuit (Adult/Ped
shown)
NOTICE You must use an appropriate adapter to connect the mainstream CO2
sensor to a neonatal flow sensor.
Before proceeding, review the safety information in Chapter 1. Ensure the CO2
sensor and adapter are clean and dry before connection.
To set up mainstream CO2 monitoring 1. Connect the sensor cable to the CO2
connection port (1) on the ventilator (see Figure 4-4). 2. Attach the CO2
sensor (3) to the airway adapter (2), aligning the arrows on both components.
Press the components together until they click. 3. When connecting a CO2
sensor for the first time, perform the zero calibration of the sensor/adapter,
if needed, as described in Section 5.4.5. 4. Connect the sensor/adapter to the
breathing circuit proximal to the patient, in a vertical position. See Figure
4-5.
To verify the quality of the connection 4 Check the capnogram (CO2 wave-
form) on the ventilator display. If CO2 levels are higher than expected, check
the patient condition. If you determine that the patient’s condition is not
contributing, calibrate the sensor (Section 5.4.5).
To remove the sensor cable 4 Pull back on the connector sheath and
disengage from the connection port on the ventilator.
7 You can connect the CO2 sensor in front of or behind the flow sensor according to your institution’s protocol.
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4 Sidestream CO2 measurement
4.5.2 Sidestream CO2 measurement The LoFlo CO2 module is a sidestream CO2
monitoring system comprising the following components: communication module,
airway sampling adapter, and CO2 module. See Figure 4-6. The module generates
infrared light and beams it through the sample cell to a detector on the
opposite side. CO2 from the patient that is aspirated into the sample cell
absorbs some of this energy. The system uses a sampling rate of 50 ml/min. The
system determines CO2 concentration in the breathing gases by measuring the
amount of light absorbed by these gases. The ventilator displays CO2
measurements as numeric values, waveforms, trends, and loops.
Figure 4-6. Sidestream CO2 monitoring components and assembly
4.5.2.1 Connecting the sidestream CO2 sensor
Before proceeding, review the safety information in Chapter 1.
To set up CO2 sidestream monitoring 1. Connect the CO2 module cable to the
CO2 connection port (1) on the ventilator (see Figure 4-6). 2. Insert the
sample cell (4) into the CO2 module (2) as shown in Figure 4-6. It clicks into
place. Inserting the sample cell into the module automatically starts the
sampling pump. Removing the cell turns the pump off. 3. Perform the zero
calibration of the adapter, if necessary, as described in Section 5.4.5 before
connecting it to the breathing circuit. 4. Connect the adapter between the
inspiratory limb and the flow sensor (or between the inspiratory limb and
HMEF, if used). See Figure 4-7. The sampling line should face away from the
patient. 5. Secure the sampling line safely out of the way.
Figure 4-7. Connecting CO2 adapter (1) to the breathing circuit
1 Communications module with CO2 connection port
2 CO2 module
3 Airway adapter
4 Sampling cell
5 Connecting sampling cell to module
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4 Setting up external devices and sensors
To remove the sample cell 1. Remove the airway adapter from the
breathing circuit. 2. Press down on the locking tab and
remove the sample cell from the CO2 module.
4.6 Setting up SpO2 monitoring
The HAMILTON-G5 supports input of SpO2 and related pulse oximetry data, and
provides integrated monitoring and data display. Enabling SpO2 measurement on
the ventilator requires enabling the SpO2 hardware (in Configuration) and
enabling the sensor(s). Table 4-2. SpO2 measurement overview
For details about …
See …
Activating the SpO2 hard- Section 14.11.3 ware
Installing a module
Section 4.2
Enabling the SpO2 sensor(s)
Section 4.7
Working with SpO2 data
Pulse Oximetry Instructions for Use
4.7 Enabling sensors
Before proceeding, review the safety information in Chapter 1. In addition to
hardware activation for CO2 and SpO2 measurement (Section 14.11.3, the O2,
CO2, and/or SpO2 sensors must be individually enabled for monitoring data to
be available.
To enable sensor monitoring 1. Open the System > Sensors on/off
window. 2. Select the appropriate checkboxes
(O2, CO2, SpO2 left, SpO2 right) to enable/disable the monitoring functions,
as desired. The ventilator always enables O2 monitoring upon restart. Figure
4-8. System > Sensors on/off window
1 System 2 Sensors on/off
3 O2, CO28, SpO2 left8, SpO2 right8
8 If the option is installed and activated.
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4 Setting up nebulization
4.8 Setting up nebulization
The HAMILTON-G5 supports the following nebulizer types: · Pneumatic ·
Aerogen§, 9, 10
This section describes how to connect and set up the nebulizer for use.
Nebulizer and operation details are provided in Section 10.7.
To connect a pneumatic nebulizer to the breathing circuit set 1. Connect the
nebulizer as shown in
Figure 4-9. 2. Connect the nebulizer tubing to the
ventilator Nebulizer port (Figure 2-3).
Figure 4-9. Connecting a pneumatic nebulizer
4.8.1 Setting up a pneumatic nebulizer Setting up and using a pneumatic
nebulizer comprises the following steps:
Table 4-3. Nebulizer setup and use overview
To …
See …
Enable or disable volume compensation in Configuration. By default, enabled.
Section 14.7
Connect the nebulizer to the breathing circuit and ventilator, and set it up for use.
This section
Configure duration and breath cycle synchronization settings, and start
nebulization.
Information about supported nebulizers and their operation is also provided.
Section 10.7
1 Breathing circuit (coaxial shown)
2 Nebulizer
3 Nebulizer tubing to ventilator
4 Flow sensor
For additional details, refer to the manufacturer’s instructions for use.
9 Not available in all markets. 10 If the option is installed and activated.
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4 Setting up external devices and sensors
4.8.2 Setting up an Aerogen nebulizer Before proceeding, review the safety information in Chapter 1. The HAMILTON-G5 supports the use of an Aerogen nebulization system11. The system comprises the Aerogen module and connection port on the ventilator (Figure 2-3), and the Aerogen Solo or Aerogen Pro nebulizer. Setting up and using an Aerogen nebulizer comprises the following steps:
To …
See …
If not installed, install the Aerogen module.
Section 4.2
In Configuration, enable the Aerogen option.
Section 14.7
Connect Aerogen to the breathing circuit and the ventilator, and set it up for use.
Aerogen Solo/ Aerogen Pro Instructions for Use
Configure duration and breath cycle synchronization settings, and start
nebulization.
Information about supported nebulizers and their operation is also provided.
Section 10.7
4.9 Connecting to an external patient monitor or other device
You can connect the ventilator to a patient monitor, PDMS, computer, or
distributed alarm system using the communication ports on the ventilator. For
details, see the Communication Interface User Guide, available on MyHamilton.
By connecting the ventilator to a distributed alarm system, you can activate
global AUDIO OFF for most alarms for an unlimited period of time. For details,
see Section 9.5.
11 If the option is activated.
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5
Specifying ventilation settings
5.1 Process overview ………………………………………………………………….. 74 5.2 Selecting the patient
group ……………………………………………………. 74 5.3 Entering patient data
……………………………………………………………. 75 5.4 Performing the preoperational check, tests,
and calibrations ……….. 76 5.5 Selecting the ventilation mode
……………………………………………….. 84 5.6 Setting alarm limits ………………………………………………………………. 91
5.7 Starting ventilation……………………………………………………………….. 93 5.8 Stopping ventilation
……………………………………………………………… 93 5.9 About the control parameters
………………………………………………… 93
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5 Specifying ventilation settings
5.1 Process overview
This section explains how to set up the HAMILTON-G5 for ventilation on an
individual patient. Setting up ventilation generally comprises the following
steps, each of which is described in this chapter: · Selecting the patient
group · Specifying patient data · Performing the preoperational check,
including: Performing a breathing circuit tightness test Calibrating the
flow sensor, O2 sensor, and zero calibration of the CO2 sensor · Testing
alarms · Selecting the ventilation mode · Reviewing and adjusting control
settings · Reviewing and adjusting alarm limits
5.2 Selecting the patient group
Before proceeding, review the safety information in Chapter 1. The HAMILTON-G5
supports the following patient groups: Adult, Pediatric, and Neonatal. Table
5-1. Patient groups
Adult
Sex: M, F
Height: 130 to 250 cm
IBW: 30 to 139 kg
Minimum delivered tidal volume: 100 ml
Pediatric
Neonatal
Sex: M, F
Height: 30 to 150 cm
IBW: 3 to 42 kg
Minimum delivered tidal volume: 20 ml
Weight: 0.2 to 30 kg
Minimum delivered tidal volume: 2 ml
To select the patient group and initial settings
4 For a new patient, touch the desired patient group tab in the Standby window
(Figure 5-1): Adult Pediatric Neonatal Touch Last patient to reuse the
last active ventilator parameters. The selected patient group appears under
the mode name (Figure 2-6).
The settings saved with the selected patient group are loaded and displayed
(Section 5.2.1), in addition to the default patient sex/height/IBW
(Adult/Pediatric) or weight (Neonatal).
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5 About system defaults: pre-configured settings
Figure 5-1. Standby window
The Default setups are defined in Configuration (Chapter 14).
5.3 Entering patient data
1 New patient, Last patient tabs
2 Patient groups
3 Preop check
4 Gender/height/ IBW (or Weight for Neonatal) for selected default
5 Start (When Hi Flow O2 is selected: Start therapy)
6 INTELLiVENTASV12
5.2.1 About system defaults: pre-configured settings For each of the patient
groups, a different default configuration can be defined. During patient
setup, you can then quickly pre-configure the ventilator according to your
standard protocols, and modify settings as needed. Each Default setup defines
a ventilation mode, mode control settings, graphic display selection, and O2
enrichment and nebulizer settings.
12 Not available in all markets.
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CAUTION Entering the correct patient data ensures safe ventilation settings
for start up and apnea backup. Before proceeding, review the safety
information in Chapter 1. Specifying the correct patient data is particularly
important, as the ventilator uses this data as a basis for some calculations
and initial mode control settings. · For the Adult and Pediatric patient
groups, the ventilator uses sex and patient height to calculate the ideal body
weight (IBW). · For Neonatal patients, the ventilator uses the patient body
weight. To enter patient data 4 In the Standby window: Adult/Pediatric.
Specify the patient sex and height. The device calculates the patient IBW.
Neonatal. Specify the patient weight.
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5 Specifying ventilation settings
5.4 Performing the preoperational check, tests, and calibrations
The tests and calibrations described in this section help verify the safety
and reliability of the ventilator. If a test fails, troubleshoot the
ventilator as indicated or have the ventilator serviced. Make sure the tests
pass before you return the ventilator to clinical use. The test results are
stored in memory, including when the ventilator is turned off. This allows the
ventilator to be checked and kept in storage, ready for use. The audible alarm
is paused during calibration. Table 5-2. When to perform tests and
calibrations
Test or calibration
CO2 sensor/ adapter zero calibration (mainstream/ sidestream)
Alarm tests
When to perform
Required after connecting a CO2 sensor or when a related alarm occurs.
Recommended after switching between different airway adapter types.
As desired
To access tests and calibration functions 1. Do either of the following:
Open the System > Tests & calib window. From the Standby window, touch the
Preop check button. 2. Touch the button for the desired operation.
Figure 5-2. System > Tests & calib window
Test or calibration
Preoperational check
Flow sensor calibration and tightness test
O2 sensor calibration, if needed
When to perform
Before connecting a new patient to the ventilator.
After connecting a new breathing circuit or component (including a flow
sensor).
After installing a new O2 sensor or when a related alarm occurs. Not required
with a paramagnetic O2 sensor.
1 System
2 Tests & calib 3 Flow Sensor
4 Tightness (shown uncalibrated)
5 O2 sensor
6 CO2 sensor (shown disabled)
A checkmark indicates the component is calibrated and ready. A red X indicates the calibration was unsuccessful. A box with
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5 Performing the preoperational check
no marks indicates the test/calibration has not been performed. A grayed-out box indicates the CO2 sensor is not enabled.
5.4.1 Performing the preoperational check Before proceeding, review the safety
information in Chapter 1.
When to perform Before connecting a new patient to the ventilator. To perform
the preoperational check 1. Use a setup as described in Table 5-3. 2. Perform
all of the steps in Table 5-4. To ensure that the ventilator functions
according to specifications on your patient, we recommend that your test
circuit be equivalent to the circuit used for ventilation. Table 5-3. Test
breathing circuit setup
Component Breathing circuit Flow sensor
Test lung
Specification Adult/pediatric, ID10 to ID22
Adult/pediatric, with calibration adapter Demonstration lung, 2 liter, with
adult ET tube between flow sensor and lung
If using heliox, follow the preoperational steps described in Table 5-5.
Table 5-4. Preoperational check
Do or observe…
Verify …
1 Connect ventilator to primary power and an oxygen supply.
2 Assemble the
The breathing
patient breath- circuit is assembled
ing circuit.
correctly.
3 Turn on the ventilator.
During the self test, the alarm lamp is lit red and the buzzer sounds briefly.
4 With the ventila- The System > Tests
tor in Standby, & calib window
touch Preop
opens.
check in the
Standby
window.
5 Perform the tightness test.
The test passes. See Section 5.4.2.
6 Calibrate the flow sensor.
The calibration is successful. See Section 5.4.3.
7 If necessary, run The calibration is
the O2 sensor successful. See
calibration.
Section 5.4.4.
8 If necessary, run The zero calibration the CO2 sensor is successful. See zero calibration. Section 5.4.5.
9 Generate test alarms.
The corresponding alarm message is displayed in the message bar. See Section
5.4.6.
Note that patient alarms are suppressed in Standby.
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5 Specifying ventilation settings
Table 5-5. Preoperational check with Heliox
Do or observe…
Verify …
1 Connect ventilator to primary power, Heliox, compressed air, and oxygen supplies.
2 Assemble the
Breathing circuit is
patient breath- assembled correctly.
ing circuit.
3 Turn on the ventilator.
During the self test, the alarm lamp is lit red and the buzzer sounds briefly.
4 Select Air as the See Section 5.4.6.1. gas source, disconnect the air
supply, and generate an Air
supply failed alarm.
5 Select Heliox as See Section 5.4.6.1. the gas source, disconnect the Heliox
supply, and generate a
Heliox supply failed alarm.
6 Select the gas source to use for ventilation.
7 Perform the tightness test.
The test passes. See Section 5.4.2.
8 Calibrate the flow sensor.
The calibration is successful. See Section 5.4.3.
9 If necessary, cal- The calibration is
ibrate the O2
successful. See
sensor.
Section 5.4.4.
10 If necessary, run The zero calibration the CO2 sensor is successful. See zero calibration. Section 5.4.5.
78
Corrective action A checkmark indicates the component is calibrated and ready.
A red X indicates the calibration was unsuccessful. If the ventilator does not
pass the preoperational check, have it serviced.
5.4.2 Performing the breathing circuit tightness test Before proceeding,
review the safety information in Chapter 1. This test checks for leakage in
the patient breathing circuit.
When to perform After installing a new or decontaminated breathing circuit or
component (including a flow sensor). To perform the tightness test 1. Set up
the ventilator for ventilation,
complete with breathing circuit and flow sensor. 2. In the System > Tests &
calib window, touch Tightness. The text Disconnect patient is now displayed.
3. Disconnect the breathing circuit at the patient side of the flow sensor. Do
not block the open end of the flow sensor. The text Tighten patient system is
now displayed.
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5 Calibrating the adult/pediatric flow sensor
4. Block the opening (wearing a glove is recommended).
If the problem still persists, have the ventilator serviced.
The text Patient system tight is now displayed. 5. Connect the patient. 6.
When the test is complete, verify that there is a checkmark in the Tightness
checkbox.
To cancel the test while it is in progress 4 Touch Tightness again.
In case of test failure If the test fails, a red X is displayed in the
Tightness checkbox. Perform the following checks, repeating the tightness test
after each one, until the test is successful: · Check the breathing circuit
for a dis-
connection between the ventilator and the flow sensor, or for other large
leaks (for example, breathing circuit, humidifier). · Check that the flow
sensor and expiratory valve set are properly seated. · If the calibration
still fails, replace the flow sensor. · If the calibration still fails,
replace the expiratory valve membrane. · If the calibration still fails,
replace the expiratory valve set. · If the calibration still fails, replace
the breathing circuit.
5.4.3 Calibrating the adult/pediatric flow sensor This calibration checks and
resets the calibration points specific to the flow sensor in use, and measures
circuit resistance compensation. Ensure you are using the correct flow sensor
for the selected patient group. If there is a mismatch, calibration fails. For
details about calibrating a neonatal flow sensor, see Section 6.2.1.
When to perform After connecting a breathing circuit or component. To
calibrate an adult/pediatric flow sensor 1. Set up the ventilator for
ventilation,
complete with breathing circuit and flow sensor. 2. In the System > Tests &
calib window, touch Flow Sensor. If you have not already disconnected the
patient, the message line displays Disconnect patient. 3. Disconnect the
patient now.
4. When prompted, attach the calibration adapter to the flow sensor and flip
them 180° so the adapter is
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5 Specifying ventilation settings
directly connected to the limb (as shown below). 5. When prompted, flip the flow sensor/ adapter 180° again, so the flow sensor is directly connected to the limb, and remove the calibration adapter.
· Check the breathing circuit for a disconnection between the ventilator and
the flow sensor, or for other large leaks (for example, breathing circuit,
humidifier).
· Check that the flow sensor and expiratory valve set are properly seated.
· If the calibration still fails, replace the flow sensor.
· If the calibration still fails, replace the expiratory valve membrane.
· If the calibration still fails, replace the expiratory valve set.
If the problem persists, have the ventilator serviced.
6. When calibration is complete, verify that there is a checkmark in the Flow
Sensor checkbox.
7. When successful, continue with other tests or ventilation.
To cancel an ongoing calibration 4 Touch Flow Sensor again.
In case of calibration failure If the calibration fails, a red X is displayed
in the Flow Sensor checkbox. Perform the following checks, repeating the
calibration after each one, until calibration is successful: · Ensure that the
flow sensor is appropri-
ate for the selected patient group.
5.4.4 Calibrating the O2 sensor The device tests the O2 sensor and resets the
calibration points specific to the sensor in use. The galvanic O2 sensor
requires approximately 30 minutes startup time to reach stable values. O2
monitoring during this time period may be more variable. We recommend waiting
30 minutes prior to calibrating the O2 sensor. The paramagnetic O2 sensor does
not require startup time, and is only calibrated once, upon installation.
To perform O2 sensor calibration 1. Ensure the appropriate gas supplies
are connected to the ventilator. 2. In the System > Tests & calib window,
touch O2 sensor. 3. When calibration is complete, the
message O2 sensor calibration OK is displayed. Verify that there is a
checkmark in the O2 sensor checkbox.
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5 Performing a zero calibration on the CO2 sensor/adapter
In case of calibration failure If the calibration fails, a red X is displayed
in the O2 sensor checkbox. Perform the following checks, repeating the
calibration after each one, until calibration is successful: · Ensure a
Hamilton Medical O2 sensor is
installed. · If the second calibration attempt fails,
and you are using a galvanic O2 sensor, replace the sensor. If the problem
persists, have the ventilator serviced.
5.4.5 Performing a zero calibration on the CO2 sensor/adapter
CAUTION · Always perform zero calibration with
the CO2 sensor (mainstream) or CO2 module (sidestream) connected to the airway
adapter. · Be sure NOT to cover both ends of the airway adapter with your
fingers.
Before proceeding, review the safety information in Chapter 1. The CO2 adapter
zero calibration compensates for optical differences between airway adapters
and for sensor drift. Note that the CO2 sensors are calibrated at the factory;
you only need to zero the adapters as described below.
Zero calibration requirements for mainstream CO2 sensors Perform a zero
calibration in the following cases:
· With the first use of the sensor
· When changing between airway adapter types (for example, from single use to
reusable)
· When the CO2 sensor calibration needed alarm is generated
Zero calibration requirements for sidestream CO2 sensors
You only need to perform a zero calibration with sidestream CO2 sensors when
the CO2 sensor calibration needed alarm is generated.
Wait at least 20 seconds — and for best results, 2 minutes — to perform the
zero calibration after removing the adapter from the patient’s airway. This
time allows any CO2 remaining in the adapter to dissipate.
To perform the zero calibration of the CO2 sensor/adapter (mainstream) and
sensor/ module (sidestream)
For reference, see Figure 4-4 for the mainstream CO2 assembly and Figure 4-6
for the sidestream assembly. 1. Connect the CO2 sensor (mainstream)
or the CO2 module (sidestream) to the ventilator, and ensure CO2 monitoring is
enabled. Once connected, wait approximately 90 seconds for the device to warm
up. 2. Disconnect the CO2 adapter from the breathing circuit. 3. Attach the
CO2 adapter to the sensor (mainstream) or plug the sample cell into the CO2
module (sidestream).
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5 Specifying ventilation settings
Place these components away from all sources of CO2 (including the patient’s
and your own exhaled breath) and the exhaust port of the expiratory valve. 4.
In the System > Tests & calib window, touch CO2 sensor. Do not move the
components during calibration. 5. When the zero calibration is complete,
verify that there is a checkmark in the CO2 sensor checkbox.
In case of zero calibration failure
If the zero calibration fails, a red X is displayed in the CO2 sensor
checkbox. Perform the following checks, repeating the zero calibration after
each one, until it is successful: · Check the airway adapter and clean if
necessary. · If the zero calibration still fails, ensure
there is no source of CO2 near the airway adapter. · If the zero calibration
still fails, connect a new adapter. · If the zero calibration still fails,
connect a new CO2 sensor (mainstream) or CO2 module (sidestream).
If the problem persists, have the ventilator serviced.
5.4.6 Testing the alarms The HAMILTON-G5 performs a self-check that verifies
proper alarm function during startup. We recommend testing the alarms as part
of the preoperational check. For all of the tests, use a demonstration lung
assembly as described in Section 5.4.1.
5.4.6.1 Testing the air and Heliox supply failure alarms
To test the Air supply failure alarm 1. In Standby, open the System > Gas
source window, and touch the Air button. 2. Dis
References
- medical.com is for sale | www.brandforce.com
- medical.com is for sale | www.brandforce.com
- HAMILTON-G5 - The modular high-end ventilation solution | Hamilton Medical
- Hamilton Medical - Intelligent Ventilation since 1983
- Intelligent mechanical ventilation | Hamilton Medical
- Trademarks | Hamilton Medical
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