patient education program 4156 South 52 nd Street, Omaha, NE 68117 800-747-7334 402-734-6741 ChildrensOmaha.org/HomeHealthcare We know children CHILDREN S HOME HEALTHCARE Trilogy Ventilator Instructions Your child s ventilator should be worn as directed by physician. Your child s ventilator settings are: Mode Circuit Tidal volume Pressure Control Pressure Support PEEP Respiratory Rate Inspiratory Time Sensitivity. Your child s alarm settings are: High Pressure Low Pressure Low Minute Volume High Respiratory Rate Low Respiratory Rate. Turning on/off your child s ventilator: Turning on- Push the On/Off button. o Always check to ensure your child s settings are correct before use! Turning off- Push and hold the On/Off button. o The message POWER OFF will display and ask Yes or No o Choose Yes by pressing the right button below the word YES. Steps to setting up your ventilator for home use: 1. Items you will need: Circuit Exhalation valve Active exhalation valve(if NEEDED) Corrugated tubing(length will be 3-4 sections) Chamber Pot Filter HME Test Lung 2. Remove Circuit from package. 3. Slide the Chamber pot into the Fischer Paykel Heater ensuring it properly seated on the hot plate. 4. Place the white filter on blue breathing circuit connection. Trilogy Ventilator Instructions Updated 8/14/2013 Page 1 of 6
5. Attach the blue corrugated tubing to the end of the white filter. 6. Place the other end blue corrugated tubing to the top of the chamber pot. c 7. Attach the white circuit to the other port on the top of the chamber pot. 8. Attach the exhalation valve inline closest to your child. 9. NOTE: If using active circuit, find the 2 pressure line connections on the right side of the vent just behind the white filter. The 2 pressure lines are sized differently and only connect to their appropriate connection point. Insert the active circuit exhalation valve inline at the end of the circuit closest to your child, ensuring the arrow on the bottom is facing towards your child. Trilogy Ventilator Instructions Updated 8/14/2013 Page 2 of 6
10. Attach the Omni Flex to the end of the circuit. 11. Connect the HME and the TEST LUNG to the end of the circuit to keep your circuit clean. 12. Remove the heater plugs from the circuit and place the corresponding temperature probes into those spots. 13. Insert the white heater wire attached to the circuit into the black heater wire cable. 14. Your child s ventilator is now ready for use. Trilogy Ventilator Instructions Updated 8/14/2013 Page 3 of 6
Steps to setting up your ventilator for portability: 1. Items you will need: Circuit Filter Exhalation valve Active exhalation valve (IF NEEDED) HME Test lung 2. Remove circuit from package. 3. Place the white filter on blue breathing circuit connection. 4. Connect the white circuit to the end of the filter. 5. Attach the exhalation valve inline closest to your child. 6. NOTE: If using active circuit, find the 2 pressure line connections on the right side of the vent just behind the white filter. The 2 pressure lines are sized differently and only connect to their appropriate connection point. Insert the active circuit exhalation valve inline at the end of the circuit closest to your child, ensuring the arrow is facing towards your child. 7. Attach the Omni Flex to the end of the circuit. 8. Connect the HME and the TEST LUNG to the end of the circuit to keep your circuit clean. 9. Ensure all the heater plugs are still intact so there are no leaks. 10. Your ventilator is ready for use. Using your Heater/Humidifier: The heater is used to create humidity in the ventilator circuit to keep your child s secretions moist. This allows the secretions of be able to be moved up or suctioned out. Start by setting up the circuit as shown above and plugging in the heater. Turn on the heater by flipping the on/off switch on the right side of the machine. The display window will show 888 and all the indicator lights will be lit for 1 second. The following will then display for 1 second each. o Model number: example 730 o Software version: example 3.0 o Set temperature: example 37 o Chamber control setting: example -2 o Heater plate maximum temperature: example 110 Ensure that the settings match your child s temperature settings. Adjusting your child s temperature control wheel between 34 and 37 is acceptable, if you need to make any other adjustments please call CHHC respiratory therapy for assistance. Always ensure that the Heater Wire button is on by looking at the light next to the button. It is located to the right of the temperature control wheel. It should always be lit up GREEN. should stop. If it is not lit up green you will be getting an alarm press the button and it Oxygen use with your child s ventilator: On the back side of your child s ventilator you will find a white nipple. Connect the oxygen tubing to the white nipple and the oxygen will flow through the ventilator and to your child. When to clean/change the circuit and supplies: Your complete circuit should be changed out once per month and disposed of. The filter inline of the circuit should be changed out weekly to prevent water damage to the ventilator. Trilogy Ventilator Instructions Updated 8/14/2013 Page 4 of 6
Using an internal and external battery: The Trilogy ventilator has 3 options for battery use. Internal, External and Detachable. o The battery that is being used will have a black box around the symbol as shown below. Internal battery Has approximately 3 hours of battery life. Detachable battery- Has approximately 3 hours of battery life. External battery- Battery operating time depends on the characteristics and usage of battery. When the battery in use is low (approximately 20 minutes left of use) the inside of the box around the symbol will turn yellow and a medium priority alarm message will display LOW BATTERY. Plug the ventilator to external power source quickly. When the battery in use is nearly depleted (approximately 10 minutes left of use) the inside of the box around the symbol will turn red. A high priority alarm message will display LOW BATTERY Plug the ventilator to external power source immediately. Supplies: The Charging symbol indicates an AC power source is present and the batteries will be charged as needed. A discharged battery will reach 80% charge status within approximately 8 hours. (2) Trilogy Ventilators (4) Circuits (1) Box of Corrugated tubing (4)Chamber Pots (1) Test Lung (1) Marine battery (1) Floor stand for Ventilator Alarms: (4) Filters (1) Power Cord (1) Portable ventilator bag (1)Fisher Paykel Heater (1) Heater wire and Temp probe (14) Sterile water bag 1000mL (1)Power Inverter (1) Ambu bag There are three types of alarms o High Priority- RED FLASHING INDICATOR with a series of beeps repeated twice the pattern is 3 beeps a pause and then 2 more beeps. Requires prompt response o Medium Priority- YELLOW FLASHING INDICATOR with a series of 3 beeps. Requires prompt response o Low Priority- YELLOW SOLID INDICATOR with a series of 2 beeps. Require operator awareness. These alarm alerts you to a change in the ventilator status. To silence the alarms press silence button in the right hand corner of the ventilator. Different types of alarms: Different types of alarms: The alarms listed below are the most typical alarms. If you get an alarm that you don t see in the list or don t understand, do not hesitate to call CHHC respiratory therapy for assistance. o Apnea- The time period between breaths is exceeded the APNEA alarm is generated. The ventilator will automatically go in the backup mode that is set by your physicians order. The vent will continue to alarm until the apnea is resolved or the Silence button is pressed. Stimulate your child to ensure your child is ok. If they DO NOT respond, follow the steps of CPR which includes when to contact 911. If they DO respond watch your child to ensure their safety. If this problem continues call your physician and CHHC respiratory therapy for assistance. Some of your child s settings may need to be changed. Trilogy Ventilator Instructions Updated 8/14/2013 Page 5 of 6
o o o o Circuit Disconnect- When the breathing circuit is disconnected or has a large leak the Circuit Disconnect alarm is generated. Ensure the circuit is attached to your child s trach. Check for any leaks in the circuit by listening for any hissing sounds. If you can t find the leak and alarm continues replace circuit with your back up circuit. High Inspiratory Pressure - When the pressure in the patient circuit is greater than the high pressure limit setting the High Inspiratory Pressure alarm is generated. Look at your child, are they coughing. If so this can cause the high pressure alarm to sound. Suction your child to ensure their airway is clear. A mucus plug could be causing the high pressure alarm. If you can t pass the catheter remove the trach and place the backup trach in. If problem continues call your physician or call CHHC respiratory therapy for assistance. Low Minute Ventilation - When the exhaled minute volume (VE) is less than the low minute volume setting the Low Minute Ventilation alarm is generated. This alarm indicates that some of the air it delivered was not exhaled back into the tubing for measurement. Your response should be to look for disconnected tubing or an air leak. Check the circuit for any leaks Check to ensure there isn t a large leak around the trach. Reposition the trach if so. Low Inspiratory Pressure -When the peak inspiratory pressure for a selected breath is less than the Low Pressure setting, the LOW PRESSURE alarm is generated. This alarm indicates that either the ventilator did not reach the pressure it expected. Your response should be to look for disconnected tubing or an air leak. Check the circuit for any leaks or the tubing has been disconnected from the trach. Check for a large leak around the trach. Reposition the trach if so. Troubleshooting: If you receive an alarm that is not stated above please place your child on the backup ventilator and call CHHC respiratory therapy for assistance. Auto Cycling: The vent is cycling a breath without patient effort causing it. Water in the circuit- the sloshing of the water causes a pressure change which will cause the vent to cycle breath. Pour the water into the water trap and empty. Low sensitivity setting- If the sensitivity is set low just moving the circuit can cause a breath to cycle. Some children need their sensitivity set low it is determined by your physician if the problem continues let your physician or CHHC respiratory therapist know. Leak around the trach- The vent is trying to compensate for the leak by triggering more breaths. Adjust the trach to get a better seal. If the problem continues let your physician or CHHC respiratory therapist know. Things to Remember: 1. Always check to ensure your child s settings are correct before use! 2. Always ensure that the Heater Wire button is on by looking at the light next to the button. It is located to the right of the temperature control wheel. 3. Your complete circuit should be changed out once per month and disposed of. 4. When responding to an alarm always look at your child first and respond accordingly. Trilogy Ventilator Instructions Updated 8/14/2013 Page 6 of 6