1. Initial Connections & Leak Test
1.1 Connect the INOvent delivery system as described in the Operations
and Maintenance Manual
1.2 Check the cables and hoses for signs of wear or damage and replace
1.3 Turn the INOvent delivery system ON and confirm that the buzzer
and the speaker sound.
1.4 Confirm for your records that a Monthly System Checkout has been
donein the last month. If it hasn't, do a Monthly System Checkout.
(see manual section 4.2)
- Allow 5 minutes for the system to warm up. Wait
for the start-up routine to finish. (The
- Power-On display appears during self-tests followed
by a normal display.)
|1.5 Do a system high pressure leak test
a. With the INO vent delivery system ON, turn each cylinder
valve ON thenOFF. Check for adequate cylinder pressures (minimum
200 psig -red zone on gauge). Wait for 30 seconds & check for pressure
tank knob turner too
NO tank gauge on front of INOvent
2. System Purge and Performance
- b. If there is any decrease, make sure that the auxillary oxygen flowmenter
to the Manual NO System is not turned on and check for leaks around thehose
using soapy water
- c. Check for leaks at the NO cylinder valve outlet connection using soapy
water. Note: The pressure drop leak testwill not
detect leaks at the cylinder valve outlet connection
becauseof the check valve in the
regulatorhose. See Section 13/Appendic B - Cylinde information of the
Operationand Maintenance Manual, if you suspect a leak.
WARNING: Make sure a purge has been completed
within five minutes before the start of NO therepy. If not,repeat
the perfomance test as described here, making sure the NO2 is less
than the value listed for the cylinder concentration being used.
2.1 Connect the Injector Module to an O2 auxillary flowmeter
usingO2 tubing, a 4.5 mm to 15 mm adapter and a breathing circuit adapter
tocondition the flow before the Injector Module. (See Figure 1)
2.2 Connect a sample tee to the outlet of the Injector Module with
300mm of 22mm hose to ensure gas mixing prior to gas sampling. (See Figure
1) Attach a sampling line from the sample tee to the sample connector onthe
2.3 Do a low range calibration ofthe
NO, NO2 and O2 monitors (See Section 4/Calibration of the
Operation and Maintenance Manual)
2.4 Make sure both NO cylinders are turned off after beingturned
2.5 Set the oxygen flow to 15 L/min and the Set NO concentration
to it's maximum setting.
2.6 Make sure both cylinder high pressure gauges go to zero
to purge both high pressure circuits.
2.7 Check that the NO2 value is higher than 0.2 ppm toverify
that the NO2 monitor is functional.
2.8 Make sure that these two alarms occur:
LowNO/N2 Pressure Delivery Failure (This
may take a few minutes depending on the cylinder pressures at the startof
2.9 When the alarms have occured,turn
on the NO cylinder with which you intend to start therapy.
Leave the other
cylinder turned off.
2.10 Set the O2 flow on the auxillary flowmeter
to 15 L/min and the Set NO to 40 ppm.
a. Wait for 3 minutes or until the monitor readings
b. Make sure that the O2, NO2 and NO readings
are withing the acceptable ranges given below.
Note:These acceptable readings include the errors of the NO delivery system
& the NOtherapy gas.
At NO 40ppm O2 %v/v (+/-3%v/v) = 95
NO2v ppm max.+ 1.5 NO ppm (min/max)+ 32
2.11 Perform the monitor high range calibrations
3. Manual NO Delivery System Purge
Place the Injector
Modulein line with the manual resuscitator to
maintainNO delivery during manual ventilation.
4. Changing NO Cylinders & Purging
the Regulator Assembly
WARNING: You must purge the regulator ssembly
immediately before using a new NO cylinder
tomake sure the patient continues to receive
the correct NO concentration and does not
receivegreater than 3.0 ppm of NO2.
IMPORTANT: Replace an NO therapy gas cylinder
when its pressure is less than 200 psig.
Theregulator assembly must be purged before using a new NO therapy gas cylinder.
A small purge manifold allows you topurge
the regulator assembly. The manifold is located either betweenthe
regulators on the transport cartor attached to
the wall mount regulator inlet
4.1 To purge the regulator assembly before using a new NO therapy
a. Determine which regulator assembly is not being used and requires
purging. the cylinder valve should be closed on the regulator
assembly that is not being used.
b. On the regulator assembly that requires purging, disconnect the
lowpressure hose quick connect fitting from the NO.N2 input on the
rear of the INOvent delivery system (shown in Figure 2-2 of theOperation
and Maintenance Manual.)
c. Open the cylinder valve on the new NO therapy gas cylinder.
d. Close the cylinder valve on the old NO therapy gas cylinder.
e. Check for leaks at the cylinder valve outlet connection of the
newtherapy cylinder using soapy water. See section 13/Appendic B of the Operationa
and Maintenance Manual.
f. Insert the low pressure hose quick-connect fitting into the purge
manifold (See Figure 3)
g. Firmly push and hold the quick-connect fitting in place while the
pressure drops to zero on the regulator gauge.
.h. After the pressure
drops to zero (approx. 215 serconds) reconnectthe low pressure hose
quick connect fitting to the NO/N2 input on the rear of the INOvent delivery
4.2 Open the cylinder valve on the new cylinder
4.3 Close the cylinder valve on the empty cylinder and label appropriately
4.4 Replace the empty NO therpy gas cylindr See Section 13/Appendix
B of the Operation and Manintenance Manual. Leave the cylinder
valve on the replacement cylinder turned off until needed. The
purge procedure will be performed on this cylinder immediately beforeits
5. Injector Module Circuit Assembly
-SIMV & HFO
The diagram below shows placement of the sample tee (6-12" before
pt.)for conventional (Bird & Drager) ventilation.
Assure that the sensor line is up.
Sampleport-conventional insp. line
Sampleport-HFO insp. line
For Sensormedics, cut the insp limb tygon tubing 6-12 " before the
patientand insert the tee using the provided adaptor and a 15/15 mm adaptor
6. Calibration of the System while
on NO Tx.
Calibrate low daily -make no changes during calibration
calibrate -power flush 2 minutes set display to Cal NO and set same
value as the refrence gas.
flush with air/O2 for two minutes
alarms set 3ppm above and below ordered dose
splice the flow injector between the ventilator flow outputand the
humidifier. (place after O2 analyzer with Bird VIP)
Splice the sampling port into the inspiratory limb of thecircuit 6-12"
before the patient ett connection manifold.
Cal tank system
Ohmeda Customer Service