1. The importance of intelligent detection
The ventilator is one of the most critical equipment in clinical emergency treatment in major hospitals, and occupies an important position in modern hospital equipment. However, because the ventilator is a rescue device and has its own special factors, it is often one of the most prone to clinical problems and difficult to use equipment, so the daily maintenance of the ventilator is particularly important. In the absence of corresponding testing equipment, it is extremely important to make full use of the ventilator's own intelligent testing (self-test) to determine whether the ventilator is in normal working order and discover problems in a timely manner to ensure that the ventilator is always in the most Good performance status.
2. The difference of intelligent detection
There are four main types of ventilator series commonly used in our hospital: the United States Puritan-Bennett (abbreviated as PB), Newport (New Port), Germany Siemens (SIEMENS), Dräger (Drager). These models have different levels of intelligence and different allowable errors in setting, testing, and measurement. Therefore, there are also differences in performance testing during intelligent testing (self-testing). Some are very simple, as long as the observation panel indicator lights up when turned on, and can be passed without any human operation in a few minutes (such as Newbond, Dräger, etc.), while others are more complicated, more complicated, and more time-consuming , It takes a certain operation to complete (such as PB, Siemens, etc.).
3. The steps of intelligent detection
Different types and different grades of ventilator have different self-checking processes, some are simpler and easier to do, while others are more complicated and time-consuming. Taking the self-checking of PB840 ventilator as an example to briefly describe the operation process and precautions. There are three main types of self-test for PB840 ventilator: POST (Power On Self Test)-power-on self-test, SST (Short Self Test)-fast self-test, EST (Extended Self Test)-complete self-test.
3.1 POST (Power On Self Test) —Power on self test:
Mainly used for system failure caused by the hardware integrity of the ventilator circuit and non-operation. It will automatically run when the machine is turned on or restarted. POST normally takes 7.25 seconds.
3.2 SST (Short Self Test) —fast self-test:
It is mainly used to test the leakage of the patient pipeline, correct the patient pipeline and measure the resistance of the bacterial filter at the exhalation end. SST must be performed before the ventilator is connected to the patient, after 15 days of use, after replacing the patient circuit, after repairing the machine, and when replacing accessories such as humidification dishes and water cups that affect airway resistance and compliance.
SST implementation steps: â‘ Connect the power supply, air source and breathing circuit, turn on the ventilator power supply, then the selection menu will appear on the display, touch SST, select quick self-test, and then press the ventilator within 5 seconds With the TEST button on the left side of the main unit, the ventilator immediately enters the quick self-test mode. â‘¡After entering the self-test mode, an SST setting menu will appear on the screen, and choose the type of ventilator circuit and humidifier. â‘¢ After selecting the type of ventilator circuit and humidifier, press Accept (confirm key) to confirm, the ventilator will automatically start the self-test process:
1) SST Flow Sensor Test flow sensor test: first, the screen will prompt that the breathing circuit is directly connected to the suction end filter without a humidifier (Connect circuit with insp filter and without humidifier), after execution, confirm, the screen will prompt you to block Hold the Y port (Block wye), confirm after execution, the instrument will carry out the detection of the flow sensor, after the detection, the screen displays: If a humidifier is used, please connect the humidifier (Connect humidifier if applicable), and confirm after execution , Breathing opportunities automatically enter the next step;
2) Circuit Pressure Test pipeline pressure test;
3) Circuit Leak pipeline leak test;
4) Expiratory Filter Test: the screen prompts you to disconnect the pipeline connected to the exhalation filter (Disconnect at FROM PATIENT port), confirm after execution, and the test will automatically enter the next operation;
5) Circuit Resistance pipeline resistance test: First, the screen will prompt to release the Y port (Block wye), confirm after execution, the breathing machine will automatically enter the next step;
6) Compliance calibraTIon compliance test: the screen will prompt to release the Y port, confirm after execution, the instrument will detect, then the screen will prompt to block the Y port, confirm after execution, the instrument will detect. After testing, all SST testing items are completed. Finally select EXIT SST to exit the quick self-test.
3.3 EST (Extended Self Test) —complete self-test:
It is mainly used to check all the gas circuits and some circuits of the ventilator (including gas mechanics, compressors, sensors, power supply parts, etc.). EST includes some steps of POST and SST. When the ventilator runs for 6 months, after repairs, after replacing parts or after maintaining the machine, EST must be run. EST can effectively help us find faulty parts.
EST implementation steps: â‘ The machine should be warmed up for at least 10 minutes. â‘¡ Connect the power supply, and connect the air and oxygen sources (the air compressor can be used as an air source), remove the suction end filter, and directly connect the suction end and exhalation of the ventilator with the gold standard test circuit (gold pipeline) end. â‘¢Turn on the power switch of the machine. When you see the indicator light of the air supply unit, press the Test button on the left side of the ventilator within 1 second to put the machine into the maintenance mode of the system. â‘£ After entering the maintenance mode of the system, touch the EST key, and then press Accept (confirm key) to confirm, the ventilator will automatically enter the EST process:
1) Circuit Pressure Test, then the ventilator prompt box will prompt: Connect air and oxygen, to remove inspiratory filter, and to install test circuit. (Connect air and oxygen, remove the bacterial filter on the suction end Press the ACCEPT button after completion, the breather will enter the automatic detection, if PASSED, automatically enter the next step;
2) Flow sensors cross check Test (flow sensor comparison test), the breathing machine enters the automatic detection, if PASSED, automatically enters the next step;
3) EST Gas Supply / SV Test (gas supply and safety valve test), this step will detect whether there is wall air connection, if there is no wall air connection, it will give a prompt: Connect wall air. (Connect wall air) if there is a wall Connect the air, then press the ACCEPT button, if there is no wall air, press the CLEAR button, and then it will prompt block to paTIent port. (Block the suction port), and then prompt disconnect oxygen. (Disconnect oxygen), After disconnecting, press ACCEPT button, then it will prompt disconnect air. (Disconnect air) After disconnecting, press ACCEPT button, then it will prompt connect oxygen. (Connect oxygen), press ACCEPT button after connecting, and then it will prompt to reconnect wall air, unblock to paTIent port, and reconnect test circuit. (Reconnect the wall air, remove the plug that blocks the suction port, and reconnect the test line). After connecting, press the ACCEPT key. If PASSED, automatically enter the next step;
4) Leak Test (leak test), the breathing machine enters the automatic detection, if PASSED, automatically enters the next step;
5) GUI Keyboard Test (GUI keyboard test), it will prompt: press "*" key, (press the corresponding key), if PASSED, automatically enter the next step;
6) EST GUI Knob Test (GUI knob test), it will prompt turn knob counterclockwise and clockwise. (Rotate counterclockwise and then clockwise), if PASSED, automatically enter the next step;
7) GUI Lamp Test (GUI Lamp Test), it will prompt acknowledge that LED is on. (Press ACCEPT key when the light is on), press ACCEPT key 11 times, if PASSED, automatically enter the next step;
8) BD Lamp Test (BDU Lamp Test), it will prompt acknowledge that LEDs are on. (Press ACCEPT key when the light is on), press ACCEPT key 3 times in total, if PASSED, automatically enter the next step;
9) GUI Audio Test (GUI alarm sound test), prompt users to verify that GUI alarm sounds. (Press the ACCEPT key when you hear the sound), press the ACCEPT key 3 times, if PASSED, automatically enter the next step;
10) GUI Nurse Call Test, it will prompt acknowledge whether test is to be performed. (If the nurse call system is installed, press the ACCEPT button, if the nurse call system is not installed, press the CLEAR button), if PASSED, Automatically enter the next step;
11) BD Audio Test (BDU alarm sound test), will prompt acknowledge audible alarm. (If you hear the sound, press the ACCEPT button, if you do not hear the sound, press the CLEAR button), if PASSED, automatically enter the next step;
12) PSOL Loop back Test (PSOL closed loop current test), if PASSED, automatically enter the next step;
13) Safety System Test (safety system test), if PASSED, automatically enter the next step;
14) Exp Valve Loopback Test (exit valve closed loop current test), if PASSED, automatically enter the next step;
15) Exp Valve Seal Test (exhalation valve seal test), if PASSED, automatically enter the next step;
16) Exp Valve Test (exhalation valve test), if PASSED, automatically enter the next step;
17) EV Velocity Transducer Test (exhalation valve rate sensor test), if PASSED, automatically enter the next step;
18) Exp Heater Test (exhaler heater test), if PASSED, automatically enter the next step;
19) Compressor Test (compressor test) will first check whether the air compressor is installed, if not installed, skip this step, if installed, automatically run this step, and check whether the wall air is connected, and prompt: disconnect wall air (if wall air is connected, press ACCEPT after disconnection, and will prompt to reconnect wall air, reconnect wall air; if there is no wall air, press CLEAR), if PASSED, automatically enter the next step;
20) Analog Data Display (analog data display), if PASSED, automatically enter the next step;
21) GUI Touch Test (GUI touch screen test), if PASSED, automatically enter the next step;
22) GUI Serial Port Test (GUI serial port test), if PASSED, automatically enter the next step;
23) Battery Test (backup battery test), will first detect whether the battery is installed or not, if not installed, skip this step and complete the EST; if the battery is installed, it will prompt: Disconnect ac. ACCEPT key, if PASSED, EST is all completed.
There are three results for each self-test:
PASSED: Pass, without any operation.
ALERT: Alarm, you must check whether there are leaks in the peripheral circuits of the ventilator and other conditions that may affect clinical use. You can skip if there are no special circumstances. In the last operation menu, select OVERRIDDEN to skip. You can use and operate the ventilator after exiting to the normal menu.
FAILURE: Failed. If this result occurs, the ventilator cannot be used. SST must be done from beginning to end, so that the result is PASSED before the ventilator can be used normally. Otherwise, a professional engineer must be notified to carry out maintenance.
The above is a summary and summary of the self-test process of the PB840 ventilator. Of course, the self-test process and precautions of different types and different grades of ventilator are also different. As medical engineering personnel, we should master each The operation steps of the self-check of the ventilator in case of unexpected need.
4. Summary
By repeatedly using the complete intelligent tests carried by the ventilator itself, it can fully play its role in use, and find out the cause of the machine's failure conveniently, quickly and accurately, which can win valuable time for the treatment of clinically critical patients. The intelligent detection procedures of similar modern ventilators are becoming more and more perfect. Taking full advantage of these procedures and carrying out regular maintenance checks on the equipment, some hidden troubles of failures can be dealt with in a timely and effective manner.
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