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Demonstrate knowledge to Asses appropriateness of this device for by DWt7kRZs

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									                                                    Profile’s Competency based Education Package



Demonstrate knowledge to Asses appropriateness of this device for the intended patient
Basic understanding of the anatomy and physiology of the human body relating to the device that is to be
used.
Practical Understanding                              Knowledge and Understanding
Respiratory Anatomy & Physiology
Effects of Positive Pressure Ventilation

Can explain underlying principles of Non Invasive        Non Invasive Ventilation refers to the provision of
Positive Pressure Ventilation                            ventilatory support through the patient’s upper airway
                                                         using a mask or similar device. BTS Guideline Non
                                                         Invasive ventilation in acute respiratory failure Thorax
                                                         2002;57: 192-211

Define BiPAP                                          BiPAP stands for Bi-level pressure support. The two
                                                      levels are known as IPAP (inspiratory positive airways
                                                      pressure) and EPAP (expiratory positive airways
                                                      pressure) BTS Guidelines Non Invasive ventilation in
                                                      acute respiratory failure. Thorax 2002; 57: 192-211
Basic understanding of the principals of how the medical device works
Practical Understanding                               Knowledge and Understanding
Principles of operation                               The BiPAP Vision is a control assist ventilator that
                                                      operates in either Continuous Positive Airway Pressure
                                                      (CPAP) or Spontaneous/Timed (S/T) Mode.

                                                         It draws in ambient air through a filter at the back of the
                                                         machine, a blower assembly pressurizes the air which is
                                                         then delivered at a preset pressure level.
                                                         The machine is connected to an external psi oxygen
                                                         supply the oxygen module within the machine enables
                                                         the provision of a controlled source of supplemental
                                                         oxygen up to 100%.
                                                         The ventilator continuously monitors machine pressure
                                                         (set pressure)against proximal airway pressure (patient
                                                         pressure) to ensure accurate and responsive delivery of
                                                         pressure despite circuit leaks. See pg 3-1 BiPAP Vision
                                                         Clinical Manual.

Triggering Mechanism                                  The triggering is automatic. BiPAP Vision has Autotrac
                                                      Sensitivity feature ensuring optimal patient ventilator
                                                      synchrony despite changes in breathing patterns &
                                                      circuit leaks. See pg3-8 – 3-11 BiPAP Vision Clinical
                                                      Manual
The limitations of a particular device and what circumstances the medical device should not be used or
relied upon.
Practical Understanding                               Knowledge and Understanding
The Vision is an assist ventilator and is intended to Contraindications:
augment the ventilation of a spontaneously breathing  The BiPAP Vision should not be used on patients with
patient. It is NOT intended to provide the total      severe respiratory failure WITHOUT a spontaneous
ventilatory requirements of the patient.              respiratory drive.

Inclusion & Exclusion criteria should be determined at   The BiPAP Vision may also be contraindicated on
a local level                                            patients:
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                                                        Incapable of maintaining life sustaining ventilation in
                                                        the event of a brief circuit disconnect or loss of therapy

                                                        Unable to maintain a patent airway or adequately clear
                                                        secretions

                                                        At risk of aspiration of gastric contents

                                                        With acute sinusitis or otitis media

                                                        With allergy or hypersensitivity to mask materials

                                                        With epistaxis causing pulmonary aspiration of blood

                                                        With severe hypotension

General knowledge
Knowledge of the pre operatives checks required before using the medical device and action to be taken
Practical Understanding                              Knowledge and Understanding
Self Test                                            All system internal functions are checked automatically
                                                     at start up & periodically throughout normal operation.

Circuit Check See Diagram pg 6-1 BiPAP Vision           A circuit provided by Profile Respiratory should always
Clinical Manual                                         be used it should always contain the following:
                                                        Smooth bore circuit. Not corrugated tubing
                                                        Bacterial filter (low resistance). Not HME filters
                                                        Proximal pressure line
                                                        Exhalation port this is essential & must be part of all
                                                        the circuits used with the Vision.

Exhalation Port Test                                    The exhalation port test characterizes the patient circuit
                                                        by analyzing the amount of leak at the exhalation port.
                                                        During the test the Vision learns the intentional leak at
                                                        the exhalation port over the complete pressure range.

                                                        The test is accessed after the machine has completed its
                                                        self test comprehensive step by step instructions are
                                                        provided on screen for the user to follow.

                                                    An exhalation port test should always be carried out
                                                    prior to initialising therapy failure to do so may result in
                                                    inaccurate readings & monitoring parameters
                                                    subsequently altering accuracy of alarm settings. Pg3-14
                                                    BiPAP Vision Clinical Manual
Action to be taken upon abnormal occurrences during use
Practical Understanding                             Knowledge and Understanding
System Alarms pg 3-12 BiPAP Vision Clinical Manual

Check Ventilator                                        The yellow eye illuminates on the display panel with an
                                                        audible alarm. The Ventilator continues to operate but
                                                        should be referred for a service ASAP.
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Ventilator Inoperative                                      The red wrench illuminates with an audible alarm. The
                                                            Ventilator will immediately power down. Check power
                                                            source if this is adequate remove the ventilator from the
                                                            patient immediately & contact Profile Respiratory to
                                                            report fault.
Understanding the device
Practical Understanding                                     Knowledge and Understanding
Clinical staff should have an understanding of all of the
above.
Discuss all features controls and indicators.
Practical Understanding                                     Knowledge and Understanding
                                                            Clinical User should demonstrate an understanding:

Autotrac                                                    that the triggering does not need to be set & is automatic

Leak coping capabilities                                    The BiPAP Vision can cope with leaks at the circuit and
                                                            patient interface. It is recommended that between 6-
                                                            20l/min of leak are present to ensure patient comfort
                                                            and that the interface is fitted correctly.
Controls & Displays

The user should be able to identify all symbols on the
BiPAP Vision. Please see pg 1-3 BiPAP Vision
Clinical Manual

The Clinical User should be able to navigate their way
around the 4 display screens on the BiPAP Vision and
alter parameters accordingly. They should be able to
identify & explain all values in all screens. See chpt 4
BiPAP Vision Clinical Manual



Monitoring screen                                           No parameter, alarm or mode changes can be made
                                                            whilst in monitoring screen. The monitoring screen can
                                                            be considered the home screen. It displays the
                                                            following:
                                                            Current operating Mode
                                                            Graphic displays of pressure, volume & flow
                                                            Numerical data displays for calculated & measured
                                                            parameters. IPAP, EPAP, Respiratory rate, Tidal
                                                            Volume, MinVentilation, Peak Inspiratory Pressure
                                                            Oxygen Concentration

Parameters Screen                                           The Parameters Screen allows the user to review &
                                                            modify parameters in the active mode. In addition to the
                                                            information displayed in the Monitoring screen the
                                                            following values are displayed:
                                                            Back up breath rate, Timed Inspiration, IPAP Rise
                                                            Time, Ti/Tot, Patient Leak, Percentage of patient
                                                            triggered breaths.

Alarms Screen                                               The Alarms screen allows the operator to review &
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                                                             modify alarms in the active mode. Alarms available are:

                                                             High & Low pressure (NB both these alarms should
                                                             bracket the IPAP pressure)
                                                             Low Pressure delay
                                                             Apnoea
                                                             Low Minute Ventilation
                                                             High Resp Rate
                                                             Low Resp Rate
                                                             In addition there is a learn base flow key . Activate learn
                                                             base flow when you make a circuit change or add
                                                             supplemental flow to the circuit (i.e. Nebuliser) see pg
                                                             9-11 BiPAP Vision Clinical Manual

Mode Screen                                                  The change Mode screen allows the operator to review
                                                             & select a new mode of ventilation. Modes available
                                                             are:
                                                             CPAP
                                                             S/T
                                                             PAV/T
How to set device up/ use
Practical Understanding                                      Knowledge and Understanding
Clinical user needs to be able to:
See Chapter 6 BiPAP Vision Clinical Manual

Assemble circuit for use with BiPAP Vision plain or
heated wire circuit for use with Fischer & Paekel
Humidifier.

Turn on machine & complete the exhalation port test



Set up ventilator in appropriate mode & pressure             NB: The pressure to be set will obviously be prescribed
parameters.                                                  by the individual Cliniucian. However an EPAP >4
Select, size & fit appropriate patient interface (mask       must be used in order to ensure the exhalation port
full face or nasal)                                          works effectively in the elimination of CO2

Initiate therapy


Accessories attributed to the device
The checks required of any reusable item on the medical device, and know which reusable items can be
changed by the learner or other professional. Inc Filters and internal accessories

Practical Understanding                                      Knowledge and Understanding
All circuits, interfaces, headgear, bacterial filters
should be Respironics single patient use.

Dust Filter                                                  At the back of the Vision there is a dust/pollen filter this
                                                             should be checked regularly & changed when necessary.
                                                             The need for filter replacement will be dictated by the
                                                             environment in which the ventilator is used & the
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                                                            frequency of operation. See Chpt 15 BiPAP Vision
                                                            Clinical Manual

Care and Maintenance
Cleaning/decontamination. Including internal parts and filters
Practical Understanding                              Knowledge and Understanding
Clinical Users should only clean the exterior of the
Vision.

Front Panel                                                 Clean Front screen as needed with water or 70%
                                                            Isopropyl Alcohol only.

Enclosure                                                   Clean the exterior enclosure as required with any
                                                            bacterial agent but DO NOT allow water to enter the
                                                            ventilator.
General maintenance issues
Practical Understanding                                     Knowledge and Understanding

Disposing of single use items.
Practical Understanding                                     Knowledge and Understanding
The BiPAP Vision requires an intentional leak port to
remove exhaled air from the circuit. Therefore specific
masks & circuits using an intentional leak port are
required. These can be obtained from Profile
Respiratory Systems Ltd
Profile Respiratory Systems Ltd recommend single
patient use circuits, interfaces, & headgear these should
be used for one patient only, for no longer than 7 days.

Trouble shooting
Describe the different alarms and the actions to be taken
Practical Understanding                                 Knowledge and Understanding
Clinical User should demonstrate an understanding of    Adjustable alarms are used to monitor pt parameters.
how to troubleshoot for Adjustable Alarms.              They can be adjusted through the Modify Alarms
                                                        Screen.
                                                        A comprehensive guide to troubleshooting alarms is
                                                        provided in chapter 13 of BiPAP Vision Clinical
                                                        Manual
The dangers that may occur and ways of maintaining the safety to patient.
Practical Understanding                                 Knowledge and Understanding
Correct equipment should always be used as
recommended by Profile Respiratory Systems.
Where to access help if required
Practical Understanding                                 Knowledge and Understanding
Product Specialist Miss Helen Pentelow 07740896639
Profile Respiratory Systems Ltd 08707703436

								
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