VICTORIAN RESPIRATORY SUPPORT SERVICE AUSTIN HEALTH GUIDELINES FOR THE OPERATION OF ASTRAL 100/150 SIZE: Width: 21.5cm Height: 9.3cm Depth: 28.5cm Weight:3.2kg
The ResMed Astral is a portable positive pressure ventilator. It delivers air to the user until a predetermined volume or pressure is reached. It can provide a range of delivery volumes or pressures, has an adjustable breath rate and can be operated in five modes. MODES OF VENTILATION: (S)T mode - Spontaneous Ventilation with backup rate - (S)T is a bilevel ventilation mode delivering breaths until the predetermined pressure. Inspiration is either initiated by the ventilator at a set rate or the patient. PS: Pressure Support Ventilation PS mode the ventilator provides pressure assisted breaths, delivering air until the predetermined pressure, and security volume if set, is reached. The user can trigger extra breaths if the trigger function is set. P(A)CV: Pressure (Assisted) Controlled Ventilation P(A)CV mode is pressure ventilation which is entirely controlled by the machine. P(A)CV mode allows the user to trigger extra breaths but all other parameters are machine controlled. (A)CV: (Assisted) Controlled Volume Ventilation: - (A)CV mode is volume controlled ventilation. In (A)CV mode the breath rate and inspiratory time are controlled by the ventilator, but the machine will allow the user to trigger extra breaths if the trigger function is set. P-SIMV - Pressure Synchronised Intermittent Mandatory Ventilation: - P-SIMV mode is a mode delivering pressure-controlled breaths at a set rate and allows the user to trigger extra pressure supported breaths. V-SIMV - Volume Synchronised Intermittent Mandatory Ventilation: V-SIMV mode is a mixed ventilation mode delivering volume-controlled breaths at a set rate and and allows the user to trigger extra pressure supported breaths. POWER SOURCE: It may be operated from AC Power, Internal Battery or External Battery. The green light indicates which power source is in use. In most circumstances AC power will be used. The top right side of the machine will indicate which power source is in use: AC (mains power supply) DC (external battery or car accessory adapter) Internal battery INTERNAL BATTERY: The ventilator will operate for approximately 6-8 hours from the internal battery, depending upon ventilator settings and battery age. The internal battery will take up 2-4 hours to fully re-charge when the ventilator is plugged into a power point but not being used and longer to fully re-charge when the ventilator is in operation. EXTERNAL BATTERY: The 24-volt external battery, if connected to the unit, will provide an extended period of operation, depending upon the type of battery and ventilator settings. The external battery does not charge through the ventilator, it must be connected to a 12 or 24-volt battery charger (depending on battery type). 2
FRONT PANEL 3. 5. 4. 1. Adaptor Port - Can be fitted with single limb circuit, single limb leak circuit or double limb circuit (Astral 150 only). An appropriate adapter is required for each of these circuits. 2. Carrying handle 3. Air outlet attach 22mm air tubing here and bacterial viral filter (when using a humidifier) 4. LCD screen touch screen, displays ventilation mode, power supply etc. 5. Alarm silence button 3
REAR PANEL 1. Mains Power/External battery connector 2. Device on/off button 3. Air inlet (complete with hypoallergenic filter) 4. Oxygen input 4
1. BREATHING CIRCUIT for N-V MASKS and TRACHEOSTOMY : The breathing circuit consists of ONE length of 22mm diameter smooth bore tubing, TWO lengths of 3mm diameter tubing and an exhalation valve. Valve and Pressure lines 22Mm Air Outlet Smooth Bore Tubing Connects from the Air Outlet (3) on the ventilator to the body of the exhalation valve. 3mm Tubing (for circuit with valve only) Connects from the exhalation valve port (1) on the ventilator to the nipple on top of the exhalation valve. 3mm Tubing (for circuit with valve only) Connects from the pressure port (1) on the ventilator to the pressure line on the side of the exhalation valve. Exhalation Valve 4 3 2 1 Daily take apart and wipe Diaphragm Consists of a Body (1), Green Diaphragm (2), Diaphragm Cap (3) and Lid (4). The Diaphragm (2) fits into the Body (1). The Diaphragm Cap (3) sits on top of the Diaphragm and is secured by the Lid (4) which locks with a clock-wise turn. Weekly take apart and wipe Diaphragm with an alcohol swab. Warm soapy wash rest of exhalation valve; rinse; dry & put back together. 5
1a BREATHING CIRCUIT for VENTED MASKS 6
2 CONTROL PANEL: 1. Touch screen 2. Power source indicators AC (mains power supply) DC (external battery or car accessory adapter) Internal battery 3. Therapy on/off indicator Device ready - Constant green display when the device is turned on but not ventilating. Device ventilating - Flashes blue when the device is ventilating and the Ventilation LED setting is 'ON'. Otherwise is 'OFF'. 4. Alarm silence/reset button lights up when an alarm is triggered and flashes when the sound is muted. 5. Alarm bar Flashing red High priority alarm Flashing yellow Medium priority alarm Constant yellow Low priority alarm 7
3 LCD DISPLAY: 1. Access button should be locked 3. Information bar 4. Internal battery Indicator 5. Lock touch screen button 6. Menu bar 7. Bottom bar 8. Start/Stop ventilation button 9. Main screen 11. Pressure bar Note: Do not access Clinical mode unless directed by a clinician. 8
4 Turning on To turn on the Astral device, press the green power on/off button at the back of the device. The device will perform a system check as shown on the main screen. On completion of the system check, the Patient Home screen and active program is displayed. 5. Turning off To turn off the device, press the green on/off button at the back of the device and follow the On-screen prompts. Note: The unit cannot be turned off while ventilating ventilation must first be stopped before turning off unit. The Astral must be turned off before being disconnected from AC power for an extended period. Failure to do so may result in battery depletion and activation of alarms Note: While the device remains connected to external mains power, the internal battery continues to charge. 9
6 Starting and stopping ventilation Your clinician has set up one or more ventilation programs for your therapy. If more than one program has been set up, follow the directions given by your clinician for when and how each program should be used. To start ventilation: 1. Press the green on/off button at the back of the device (if power is not already on). 2. Press. Ventilation is started. 3. Add oxygen if required. To stop ventilation: Ventilation can be stopped at any time and from any screen. 1. If oxygen is connected, turn off the oxygen. 2. Press and hold 3. Release when prompted. 4. Press Confirm. Ventilation is stopped. Locking and unlocking the touch screen The touch screen can be unlocked at any time. To manually lock the touch screen, from the Information bar press is locked the button is highlighted orange.. When the touch screen Unlocking the touch screen Touch the screen anywhere and follow the on-screen prompts. 10
7. ALARMS: The Astral activates alarms to alert you to conditions that require attention to ensure patient safety. When an alarm is activated, the Astral device provides both audible and visual alerts, and displays an alarm message in the Alarm display on the Information bar. As soon as the activation condition is met, the Astral provides both audible and visual alerts without delay. 1. Alarm display- Displays either the alarm message for the highest priority active alarm, or the last alarm not yet reset. Press the Alarm display for further alarm information. Certain conditions may result in multiple alarms. indicates that there are multiple active alarms. Press and respond appropriately. when displayed to view all alarms 2. Active Alarms screen - Displays the full set of active alarms. Will automatically display upon activation of an alarm in Patient mode. 3. Information menu - Some alarms clear automatically. To view a history of alarms, view the alarm log through the Information menu. 4. Alarm silence/reset button State: no light no active alarms steady light active alarm/s flashing light alarm mute on. This button also allows you to: mute the audible alert reset the currently displayed alarm (if permitted). 5. Alarm bar Indicates the priority of the alarm in the Alarm display. 11
8. Alarm priority Alarms are classified into relative priority (high, medium and low) according to the severity and urgency of the alarm condition. Respond to all alarms. An immediate response is required for high priority alarms. 9. Replacing the air filter Inspect the condition of the air filter and check whether it is blocked by dirt or dust. With normal use, the air filter needs to be replaced every six months (or more often in a dusty environment). CAUTION Do not wash the air filter, it is not washable or reusable. To remove and replace the air filter 1. Unlock the air filter cover by turning in an anti-clockwise direction. 2. Pull the air filter cover from the device. 3. Pull the air filter from the cover and discard. 4. Insert a new filter into the cover. 5. Insert the air filter and cover into the device. 6. Turn in a clockwise direction to secure. 12
10. CLEANING AND MAINTENANCE: Do not place anything on top of the ventilator. Do not allow any water or other fluid to spill onto or into the ventilator. If a humidifier is in use a water trap should be placed between the humidifier tube and the ventilator to prevent fluid running back into the air outlet. Wipe the ventilator over with a lint free cloth dampened with water and/or a mild detergent. Do not allow any liquid to enter the ventilator. 11. Annual Service Authorised personnel will do a yearly service and performance test, as required by the manufacturers maintenance schedule. The VRSS Outreach Service will contact you to make arrangements for routine servicing. The expected life of the internal battery is 2 years. To ensure maximum battery life, the battery must be completely discharged once every 6 months. The internal battery will be replaced as part of routine service every 2 years. 13
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