Monaghan 225/SIMV Volume Ventilator - MRI Compatible

Description
The MRI version of the 225/SIMV Ventilator is suitable for ventilating patients in MRI environments up to 1.5 Tesla because virtually all-ferrous material is eliminated. Diagnostic imaging quality can now be maintained during passive ventilation. The MRI version of the 225/SIMV is light- weight, convenient and portable, and shows no attraction to the magnet.

Assembly

Place mainline bacteria filter in filter clamp with flow arrow pointing to the rear of the unit. Tighten clamp.
Place corrugated tubing from outlet port on unit to the inlet port on filter.
DO NOT use heater on this ventilator, as it will bother the MRI results.
Connect end of patient circuit (transport vent circuit) to other end of filter.
DO NOT use support arm in MRI as these have a high metal content.
Place a bacteria filter between the ventilator circuit and the patient; change between patients and PRN.
Wipe down ventilator with disinfectant(Cavacide) between patient uses.

Controls

Tidal volume
1. Ventilator is volume cycling when bellows delivers its full charge and neither the red Time Cycle nor Pressure Cycle indicators flash.
2. 100 to 3000 ml range
Respiration rate
1. Controls exhalation when volume or pressure cycling.
2. Time variable from < .54 to over 6 seconds.
3. Control adjustable from below 6 to over 60 bpm
Flow
1. Controls rate of flow of oxygen/air mixture to the patient.
2. Clockwise increases flow
% Oxygen
1. 21% - 100%
2. Verify with oxygen analyzer
PEEP
1. 0 - 20 cm H2O
2. Rotate fully counterclockwise to turn PEEP off.
Pressure Limit
1. 10 - 105+/- 15 cm H2O
2. Indicator flashes red and unit cycles to exhalation, if limit is reached.
Mode
1. Assist
  - When the unit is in this mode with SIMV off, the timer is inactivated and the patient or the Manual Inspiration pushbutton controls the breathing cycle.
  - Respiratory Rate control has no affect, while the patient Trigger Sensitivity is in effect.
2. Control
  - In the control mode with the SIMV off, the breathing cycle is controlled by the respiration rate timer or by manual inspiration pushbutton.
  - With SIMV off, the respiration rate can be set from 6 to 60 bpm.
  - Trigger sensitivity is inoperative in this mode.
3. Assist/Control
  - In the assist/control mode with SIMV off, the breathing cycle is controlled by the respiration rate timer, the patient, or the manual inspiration pushbutton, depending on the control settings.
  - The unit must be set in this mode when SIMV is in use.
  - Patient sensitivity is in effect in this mode.
4. SIMV
  1. 3 positions
    - off
    - 4 - 16 bpm (high mandatory breath rate range)
    - .3 - 5 bpm (low mandatory breath rate range)
  2. Unit must be in Assist/control mode when SIMV is in use or unit will autocycle.
  3. If SIMV control is placed accidentally between positions, the machine will be in the normal mode selected by the mode selector.
5. Trigger sensitivity
  1. Patient trigger indicator flashes green.
  2. When the control is turned fully counterclockwise, the effort to trigger inspiration in the Assist or Assist/Control modes will be greater than minus 10 cm H2O.
  3. To set Trigger sensitivity control for maximum
    - disconnect the patient circuit at the unit outlet
    - make sure unit is in Assist or Assist/Control
    - Press and hold the manual exhalation button while rotating the trigger sensitivity counterclockwise until the patient trigger flashes green.
    - Then, turn the knob slightly counterclockwise just until the indicator goes out.
    - When using PEEP, set the trigger sensitivity as described above after setting the PEEP control. After PEEP level set, the trigger level can be raised closer to the PEEP level by rotating the trigger sensitivity control slightly clockwise.
    - When PEEP is changed or removed always reset the trigger sensitivity.
6. Manual Inspiration/Manual Exhalation
  1. This button causes unit to go into the inspiration mode whenever it is pressed. An inflation-hold condition occurs when the button is held depressed.
  2. This button causes unit to go into the exhalation mode whenever it is pressed. This control is used when setting the triggering level of the unit.
7. Gauges
  1. Patient pressure gauge provides visual indication of the patient circuit pressure at the unit outlet of the machine.
  2. Pressure Limit gauge indicates the patient pressure limit set by the pressure limit control.

Volume Operation

Set pressure limit control at a value greater than that expected to be required to deliver the volume.

Using crank set bellows to desired volume.

Adjust flow control.

Set the Respiratory Rate using watch to time the cycles.

Select the desired %O2

Set the desired Mode(Assist, Control, or Assist/Control).

Set trigger sensitivity, if in Assist or Assist/Control modes, as explained above.

Set PEEP level once patient circuit is completely on patient. It is indicated on the patient pressure gauge.

SIMV
1. SIMV only works in Assist/Control mode.
2. Set SIMV mode control to 4-16 BPM.
3. In SIMV, unit does not time cycle to end inspiration because inspiration timer is deactivated.
4. Adjust Respiratory Rate control for desired SIMV rate.
For more complete operating instructions or other information refer to the operator's manual found in metal file cabinet in the office.