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L1580 Revision D Copyright Bird Products 2002

Operators Manual

TBirdSeries

Ventilators


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2 Operators Manual

L1580 Revision D March 2003


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Revision History

Date Revision Pages Changes

May 2001 B All Initial ReleaseDecember 2002 C Cover, 2, 4, 5, 20, 26, 65 - 67,

98, 100Update, copy write, CE mark,sensitivity range, and parts list

March 2003 D 5 Tracking Notice


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4 Operators Manual


Warranty

TBird ventilation systems are warranted to be free from defects in material and workmanship and to

meet the published specifications for two (2) years or 8,000 hours, whichever occurs first.The liability of Bird Products under this warranty is limited to replacing, repairing or issuing credit, at thediscretion of Bird Products, for parts that become defective or fail to meet published specificationsduring the warranty period; Bird Products will not be liable under this warranty unless (A) Bird Productsis promptly notified in writing by Buyer upon discovery of defects or failure to meet publishedspecifications; (B) the defective unit or part is returned to Bird Products, transportation charges prepaidby Buyer; (C) the defective unit or part is received by Bird Products for adjustment no later than fourweeks following the last day of the warranty period; and (D) Bird Product's examination of such unit orpart shall disclose, to its satisfaction, that such defects or failures have not been caused by misuse,neglect, improper installation, unauthorized repair, alteration or accident.

Any authorization of Bird Products for repair or alteration by the Buyer must be in writing to preventvoiding the warranty. In no event shall Bird Products be liable to the Buyer for loss of profits, loss of

use, consequential damage or damages of any kind based upon a claim for breach of warranty, otherthan the purchase price of any defective product covered hereunder.

Bird Products warranties as herein and above set forth shall not be enlarged, diminished or affected by,and no obligation or liability shall arise or grow out of the rendering of technical advice or service byBird Products or its agents in connection with the Buyer's order of the products furnished hereunder.

Limitations of Liabilities

This warranty does not cover normal maintenance such as cleaning, adjustment or lubrication andupdating of equipment parts. This warranty shall be void and shall not apply if the equipment is usedwith accessories or parts not manufactured by Bird Products or authorized for use in writing by BirdProducts or if the equipment is not maintained in accordance with the prescribed schedule of

maintenance.

The warranty stated above shall extend for a period of two (2) years from date of shipment or 8,000hours of use, whichever occurs first, with the following exceptions:

1. Components for monitoring of physical variables such as temperature, pressure, or flow arewarranted for ninety (90) days from date of receipt.

2. Elastomeric components and other parts or components subject to deterioration, over which BirdProducts has no control, are warranted for sixty (60) days from date of receipt.

3. Internal and optional external batteries are warranted for ninety (90) days from the date ofreceipt.

The foregoing is in lieu of any warranty, expressed or implied, including, without limitation, any warranty

of merchantability, except as to title, and can be amended only in writing by a duly authorizedrepresentative of Bird Products.


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TBird Series Ventilators 5


Notices

Copyright NoticeCopyright 2002 Bird Products Corporation, a subsidiary of VIASYS Healthcare, Palm Springs,California.

This work is protected under Title 17 of the U.S. Code and is the sole property of Bird ProductsCorporation. No part of this document may be copied or otherwise reproduced, or stored in anyelectronic information retrieval system, except as specifically permitted under U.S. Copyright law,without the prior written consent of Bird Products Corporation. For more information, contact:

World Headquarters European Office

Bird Products Corporation Bird Products Corporation

1100 Bird Center Drive Rembrandtlaan 1bPalm Springs, CA 92262-8099 3723 BG Bilthoven

U.S.A. P.O. Box 299, 3720 AG Bilthoven

Phone: (760) 778-7200 The Netherlands

(800) 328-4139 Phone: (31) 30 2289 711

Fax: (760) 778-7274 Fax: (31) 30 2286 244

www.viasyshealthcare.comor www.birdprod.com

Trademark Notices

TBirdis a registered trademark of Bird Products Corporation, a subsidiary of VIASYS Healthcare, inthe United States and some other countries. All other brand names and product names mentioned inthis manual are trademarks, registered trademarks, or trade names of their respective holders.

EMC Notice

This equipment generates, uses, and can radiate radio frequency energy. If not installed and used inaccordance with the instructions in this manual, electromagnetic interference may result. Theequipment has been tested and found to comply with the limits set forth in EN60601-1-2 for MedicalProducts. These limits provide reasonable protection against electromagnetic interference whenoperated in the intended use environments described in this manual.

MRI NoticeThis equipment contains electromagnetic components whose operation can be affected by intenseelectromagnetic fields.

Do not operate the ventilator in an MRI environment or in the vicinity of high-frequency surgicaldiathermy equipment, defibrillators, or short wave therapy equipment. Electromagnetic interferencecould disrupt the operation of the ventilator.


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Intended Use Notice

The TBird Ventilator Series of ventilators are intended to provide continuous or intermittent ventilatorysupport for the care of individuals who require mechanical ventilation. The ventilator is a restrictedmedical device intended for use by qualified, trained personnel under the direction of a physician.Specifically, the ventilator is applicable for adult and pediatric patients weighing at least 10 kg (22 lbs.),who require the following general types of ventilatory support, as prescribed by an attending physician:

Positive pressure ventilation

Assist/Control, SIMV, or CPAP modes of ventilation

The TBird AVS Series, VSO2and VS ventilators are intended for institutional use.

The TBird Legacy Series is suitable for use in both institutional and home settings.

Regulatory Notice

Federal law restricts the sale of this device except by or on order of a physician.

Important Notice (Legacy only)

The US Food and Drug Administration has issued Tracking Orders for the TBird Legacy Ventilator inaccordance to 21CFR821. Distributors are required to have a tracking system in place to track thetransfer of the TBird Legacy Ventilator device to the person for whom the device is indicated.Distributors are required by Federal Law to make available upon request tracking records. BirdProducts Corporation will conduct an audit utilizing statistical sampling every six months for the firstthree years and once each year thereafter as required by FDA regulations. The audit may be in theform a formal audit survey or through an onsite visit. If the distributor ceases distributions of the trackeddevice, that person continues to be responsible for compliance to FDA tracking regulation unlessanother person affirmatively and in writing, assumes responsibility for continuing the tracking of devicespreviously distributed. Failure of compliance of the above warning constitutes misbranding by personsdistributing the device.

Declaration of Conformity Notice

This medical equipment complies with the Medical Device Directive, 93/42/EEC, and the followingTechnical Standards, to which Conformity is declared:

EN60601-1EN60601-1-2ISO 9001, EN 46001

MDD-Annex II

EU Notified Body:BSI (Reg. No. 0086)

Type of Equipment: Medical Equipment, Lung Ventilator

Trade names: TBird AVS, TBird AVS II, TBird AVS III, TBird VS, TBird VSO2, TBird Legacy

If you have a question regarding the Declaration of Conformity for this product, please contact BirdProducts.

0086


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IEC Classification

The AVS, VSO2and VS ventilators are suitable for use in institutional and transportenvironments. The Legacy is suitable for home and institutional environments.

Ordinary equipment not protected against the ingress of liquids.

Not protected/Not suitable for use in the presence of flammable anesthetic gases. Class I / Internally Powered, Type BF

Safety Information

Please review the following safety information prior to operating the ventilator. It lists warnings,cautions, and notes pertinent to the safe operation of the ventilator. Attempting to operate the ventilatorwithout fully understanding its features and functions may result in unsafe operating conditions.

If you have a question regarding the installation, set up, operation, or maintenance of the ventilator,contact Bird Products Technical Support as shown in Appendix A Contact & Ordering Information.

Terms

WARNINGS identify conditions or practices that could result in serious adverse reactions orpotential safety hazards.

CAUTIONS identify conditions or practices that could result in damage to the ventilator or otherequipment.

NOTES identify supplemental information to help you better understand how the ventilatorworks.

WarningsThe following warnings apply any time you work with the ventilator.

To avoid explosion, do not operate the ventilator in the presence of flammable anesthetics orin an atmosphere of explosive gases. Operating the ventilator in flammable or explosiveatmospheres may result in fire or explosion.

To avoid personal injury and the risk of electric shock, as well as damage to the ventilator, donot operate the ventilator with its covers or panels removed. Refer all servicing to a BirdCertified Service Technician.

All electromechanical systems are subject to malfunction or failure from both internal andexternal causes. Although the ventilator has been designed to detect and notify you of various

conditions by means of alarms, and to shut down in case of possible unsafe operatingconditions, anyone operating the ventilator should be trained to respond with a well-rehearsedprocedure to provide emergency ventilation in case the ventilator ceases to operate.

Care should be taken to ensure that the patient does not disconnect from the patient breathingcircuit. Such disconnections could be hazardous to the patient.

Use an accurate oxygen analyzer having high and low alarms to monitor oxygenconcentrations. This is required to ensure the desired fraction of inspired oxygen (FiO2) is


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being delivered to the patient. Consult a physician to determine the desired concentration ofinspired oxygen to be delivered.

Do not attach a one-way check valve to the outlet of the exhalation valve. Doing so mayadversely affect the operation of the ventilator and may be harmful to the patient.

Do not operate the ventilator without setting the adjustable alarms. All adjustable alarms must

be set to ensure safe operation. Ensure that all critical alarms, such as the Low Pressurealarm, have been set.

Operating an improperly functioning ventilator may be harmful to the patient or operator. If theventilator does not start up properly, or fails to pass the User Verification Tests (described inChapter 7), remove it from service and contact your Bird Certified Service Technician.

Do not operate the ventilator unless you are trained to do so. The ventilator is a restrictedmedical device intended for use by qualified, trained personnel under the direction of aphysician. Operation by untrained personnel may result in unsafe operating conditions.

Do not operate the ventilator unless qualified personnel are in attendance to promptly respondto alarms, inoperative conditions, or sudden malfunctions. Patients on life-support equipmentshould be visually monitored at all times. Qualified personnel should be prepared to provide an

alternate form of ventilation, if needed.

Lower air density at higher altitudes will effect tidal volume delivery and exhaled tidal volumemeasurements. Please refer to Chapter 6, Special Functions, for details on how tocompensate for higher altitudes.

Do not ignore audible alarms occurring at the ventilator. Alarms indicate conditions that requireyour immediate attention.

Do not try to service or repair an improperly functioning ventilator yourself. Contact your BirdCertified Service Technician for all repairs and service.

Do not use parts, accessories, or options that have not been authorized for use with theventilator. Using unauthorized parts, accessories, or options may be harmful to the patient or

damage the ventilator. Do not connect the ventilator to a patient without first pressure testing the patient breathing

circuit (see Chapter 7, User Verification Tests). Failing to pressure test the patient breathingcircuit may result in injury or inadequate therapy. If using a heated humidifier be sure toinclude it in the circuit when pressure testing.

Check the exhalation valve diaphragm daily. A worn or damaged exhalation valve diaphragmmay result in improper patient ventilation. Replace the diaphragm as necessary.

Check all audible and visual alarms daily to make sure they are operating properly. If an alarmfails to activate, contact your Bird Certified Service Technician.

Although the system will continue to ventilate with a XDCR FAULTalert, the accuracy of thetidal volume, minute volume, and pressure measurements may be reduced. Remove the

ventilator from service and contact your Bird Certified Service Technician.

Make sure the High Pressure alarm limit is not set above the Over Pressure Reliefsetting.Otherwise, a HIGH PRES alarm will not occur and the patient may be subjected to sustainedhigh pressures.

Although the system continues to ventilate when a NO CAL DATA alert is present, theaccuracy of the volume and pressures may be reduced. The system may generate pressuresand volumes that are inconsistent with the front panel settings. Remove the ventilator fromservice and contact your Bird Certified Service Technician.


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Disconnect the patient prior to accessing the UVTs. The ventilator does not deliver gas duringthe UVTs.

Delivered percentage oxygen may be higher than set at elevations above 5000 feet.

Cautions

The following cautions apply any time you work with the ventilator.

A protective ground connection by way of the grounding conductor in the power cord isessential for safe operation. Upon loss of protective ground, all conductive parts, includingknobs and controls, which may appear to be insulated, can render an electric shock. To avoidelectrical shock, plug the power cord into a properly wired receptacle, use only the power cordsupplied with the ventilator, and make sure the power cord is in good condition.

To avoid fire hazard, use only the fuse specified in the ventilators parts list and is identical intype, voltage rating, and current rating to the existing fuse. (See the TBird Ventilator SeriesService Manual, P/N L1314, for more information). Fuses should only be changed by a BirdCertified Service Technician.

To minimize the potential for electrostatic shock, do not use anti-static or electricallyconductive hoses and tubing with the ventilator.

Run the User Verification Tests (described in Chapter 7) prior to clinical application, at leastonce a month (or as specified by your department guidelines), and any time you suspect theventilator is not operating properly.

Do not store the ventilator in hot areas for prolonged periods of time. Temperatures above80F (27 C) can shorten battery life. Failing to charge the ventilator while in storage may alsoshorten battery life.

When the integrity of the external power earth conductor arrangement is in doubt, operate theventilator from its internal battery or the optional external battery.

The maximum voltage that can be applied to the Patient Assist Call modular connector is 25volts rms or 31 VDC.

The following cautions apply when cleaning the ventilator or sterilizing ventilator accessories.For more information, see Chapter 9, Cleaning And Sterilization.

Do not clean or dry the ventilator with a high-pressure air gun. Applying high-pressure air tothe ventilator may damage the internal components of the pneumatic circuit and render theventilator inoperable.

Do not over clean the ventilator. Repeated use of a cleaning agent can cause residue build-upon critical components. Excessive residue build up can affect ventilator performance.

Do not wash, rinse, soak, pasteurize, ethylene-oxide sterilize, or immerse the Bird Products

main flow bacteria filter in liquid sterilizing agents. Use a steam autoclave to sterilize the mainflow bacteria filter.

Do not sterilize the ventilator. Standard sterilization techniques may damage the ventilator.

Do not use cleaning agents that contain phenols, ammonium chloride, chloride compounds, ormore than 2% glutaraldehyde. These agents may damage the ventilators plastic componentsand front panel overlay.

When cleaning the ventilator:


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o Do not use harsh abrasives.

o Do not immerse the ventilator in liquid sterilizing agents or liquids of any kind.

o Do not spray cleaning solution into the exhalation valve or directly onto the front panel.

o Do not allow cleaning solution to pool on the front panel.

The exhalation valve assembly is a delicate precision assembly. Exercise care whenremoving, replacing, or cleaning the assembly:

Do not insert cleaning instruments (cloth, brush, pipe cleaner, and so on) into the exhalationvalve body.

Do not use a high-pressure gas nozzle to dry the exhalation valve body. High-pressure gasmay damage the differential pressure ports in the exhalation valve body.

Using a low flow gas source (less than 10 lpm) ensures the differential pressure ports are freeof moisture and debris.

To avoid possible damage to elastometric components, the peak temperature for BirdProducts accessories should not exceed 131F (55C) for gas (ETO) and 275F (135C) forsteam autoclave.

Be sure to check with the manufacturer of these chemicals and sterilizing equipment to ensuresafe handling procedures are followed.

It is not necessary to remove the four screws to remove the fan inlet filter. To do so will causemounting hardware to become loose within the ventilator, which may result in electricaldamage.


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Symbols

The following symbols may be used on the instrument or in accompanying documentation.

Symbol Compliance Meaning

Symbol #03-02 IEC 60878 Indicates ATTENTION, consult ACCOMPANYING DOCUMENTS

Symbol #5016 IEC 60417 This symbol indicates a FUSE.

Symbol #5034 IEC 60417

Symbol #01-36 IEC 60878This symbol indicates INPUT.


Symbol #01-37 IEC 60878 This symbol indicates OUTPUT


Symbol #01-20 IEC 60878This symbol indicates protective EARTH (ground).


Symbol # 01-24 IEC 60878

This symbol indicates the EQUIPOTENTIAL connection used toconnect various parts of the equipment or of a system to the samepotential, not necessarily being the earth (ground) potential (e.g., forlocal bonding).

Symbol # 5333 IEC 60417

Symbol #02-03 IEC 60878

This symbol indicates TYPE BF equipment, which indicates equipmentthat provides a particular degree of protection against electric shock,

particularly with regards to allowable leakage current and reliability ofthe protective earth connection.


Symbol #01-14 IEC 30878

This symbol is located on the rating plate. It indicates the equipment issuitable for alternating current.

Symbol# 5049 IEC 60417

This Symbol indicates the ON condition for a part of theequipment. When pressed the ventilator will operate from theMAINS voltage (if connected) or internal or external batteries ifthe battery charge is within operating specifications.

Symbol #5007 IEC 60417Symbol #01-01 IEC 60878

Indicates ON (Power)

Symbol #5008 IEC 60417Symbol #01-02 IEC 60878

Indicates OFF (Power)


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Table of Contents

Revision History ................................................................................................................................... 3

Warranty................................................................................................................................................ 4

Notices................................................................................................................................................... 5

Copyright Notice.............................................................................................................................................................. 5

Trademark Notices.......................................................................................................................................................... 5

EMC Notice ..................................................................................................................................................................... 5

MRI Notice....................................................................................................................................................................... 5

Intended Use Notice........................................................................................................................................................ 6

Regulatory Notice............................................................................................................................................................ 6

Declaration of Conformity Notice..................................................................................................................................... 6

Safety Information ................................................................................................................................ 7

Terms .............................................................................................................................................................................. 7

Warnings ......................................................................................................................................................................... 7

Cautions .......................................................................................................................................................................... 9

Symbols.........................................................................................................................................................................11

Table of Contents ................................................................................................................................12

Chapter 1 Introduction ........................................................................................................................15

TBird Series Models, Options & Configurations............................................................................................................ 15

Requirements to Operate a TBird Ventilator ................................................................................................................. 16

What to Do if the Ventilator Fails ................................................................................................................................... 16

Operator Replaceable Components .............................................................................................................................. 17

Chapter 2 Controls and Displays ......................................................................................................19

How To Set a Control .................................................................................................................................................... 19

Front Panel - Monitor Section........................................................................................................................................ 22

Front Panel - Alarm Section .......................................................................................................................................... 22

Front Panel - Control Section........................................................................................................................................ 24

Front Panel - Power Section ......................................................................................................................................... 28Front Panel - Special Control Section ........................................................................................................................... 30

Front Panel - Patient Connectors.................................................................................................................................. 33

Rear Panel .................................................................................................................................................................... 34

Chapter 3 Monitored Parameters .......................................................................................................37

Chapter 4 Alarms and Alerts ..............................................................................................................39


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Definitions......................................................................................................................................................................39

Alarms ...........................................................................................................................................................................39

Alerts .............................................................................................................................................................................49

Chapter 5 Unpacking, Setup and Operation.................................................................................... 55

Unpacking the Ventilator ...............................................................................................................................................55How to Attach a Patient Breathing Circuit .....................................................................................................................55

Adjusting Alarm Volume................................................................................................................................................56

Attaching Oxygen Lines................................................................................................................................................. 57

Attaching to a Patient Assist Call System......................................................................................................................59

To Turn the Ventilator ON .............................................................................................................................................59

To Turn the Ventilator OFF............................................................................................................................................60

Performance Checks..................................................................................................................................................... 60

TBirdSeries Ventilator Performance Checklist ...........................................................................................................63

Setting a Mode .............................................................................................................................................................. 65

Chapter 6 Special Functions ............................................................................................................. 69

How to Access the Special Functions ........................................................................................................................... 71

Ventilator Setup Group..................................................................................................................................................71

Alarm Setup Group........................................................................................................................................................ 77

Transducer Data Group................................................................................................................................................. 79

Transducer Test Group .................................................................................................................................................79

Event Codes Group....................................................................................................................................................... 80

Chapter 7 User Verification Tests ..................................................................................................... 81

Accessing the UVTs ...................................................................................................................................................... 81

Running the UVTs ......................................................................................................................................................... 82

Chapter 8 Basic Troubleshooting ..................................................................................................... 85

If the Ventilator Does Not Turn ON................................................................................................................................85

If a Vent Inop Occurs.....................................................................................................................................................86

If a UVT Fails................................................................................................................................................................. 86

If a Malfunction Occurs.................................................................................................................................................. 87

Chapter 9 Cleaning and Sterilization ................................................................................................ 89

How to Clean the Ventilator........................................................................................................................................... 89

To Clean, Sterilize, or Disinfect the Exhalation Valve Assembly................................................................................... 90

To Clean, Sterilize or Disinfect the Patient Breathing Circuit ........................................................................................91

Cleaning & Sterilization Compatibility Recommendations, Exhalation Valve and Patient Circuit.................................. 93

To Clean, Sterilize, or Disinfect Ventilator Accessories.................................................................................................93

To Clean, Sterilize, or Disinfect the Air Intake Filter ...................................................................................................... 94


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How to Clean and Replace the Fan Filter ..................................................................................................................... 95

Appendix A Contact & Ordering Information .................................................................................97

How to Call for Service.................................................................................................................................................. 97

Ordering Information .....................................................................................................................................................97

Approved Accessories and Part Numbers..................................................................................................................... 98Part Number.................................................................................................................................................................. 98

Appendix B Ventilator Specifications ...............................................................................................99

Physical Specifications.................................................................................................................................................. 99

Performance Specifications and Tolerances............................................................................................................... 100

Electrical Specifications............................................................................................................................................... 102

Environmental Specifications ...................................................................................................................................... 103

Appendix C Ventilator Illustrations .................................................................................................105

Illustrations .................................................................................................................................................................. 105

Appendix D Oxygen Computer Chart (VS & Legacy) ................................................................107

To Find O2 Input Flow.................................................................................................................................................107

To Find O2 Concentration ........................................................................................................................................... 107

Appendix E Operator Instruction Checklist....................................................................................109

Appendix F Event Codes .................................................................................................................111

Glossary .............................................................................................................................................115

Index ...................................................................................................................................................121


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Chapter 1 Introduction

This chapter covers the following material:

TBird series ventilators models, options & configurations

What you will need to operate the ventilator.

What to do in case the ventilator ceases to operate properly.

Which components are operator-replaceable.

TBird Series Models, Options & Configurations

Table 1.1 TBird Series Ventilator Models & Options

OPTION LEGACY VS VSO2 AVS AVS II AVS III

% O2 X X X X

100% O2 X X X X

Assist/Control X X X X X X

Breath Rate X X X X X X

CPAP X X X X X X

Expiratory Hold X X

Flow Cal X X X X X X

High Breath Rate X X X X X

High Pressure X X X X X X

Inspiratory Hold X X X X X X

Inspiratory Pause X X X

Inspiratory Time X X X

Low Pressure X X X X X X

Manual Breath X X X X X X

MIP/NIF X X

Peak Flow X X X X X X

PEEP X X X X X X

Pressure Control X X X

Pressure Support X X X X X X

Sensitivity X X X X X X

Sigh X X X X X XSIMV X X X X X X

Square Waveform X X X

Tidal Volume X X X X X X

VAPS X

The TBird Ventilator systems are easy to use, self-contained systems that combine an advancedpneumatic system with microprocessor-based technology. The result is a ventilation system providingexcellent ventilation and patient monitoring.


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The AVS Series Ventilator is available in three configurations: AVS, AVS II and AVS III. The AVS andAVS II can easily be upgraded in the field using Configuration Memory Cards. The VS and VSO2ventilators are excellent for critical care and sub-acute care environments. The TBird Legacy ventilatorcompletes the family as a homecare capable version. Packaged in a compact, lightweight unit, theTBird Ventilators provide all the features you would expect in larger ventilators.

Compressor-less technology, allowing uninterrupted ventilation. A broad range of operating modes including Control, Assist/Control, SIMV, and CPAP.

Volume Control, Pressure Control, Pressure Support, and VAPS ventilation.

Automatic Apnea Backup ventilation.

Adjustable and lockable front panel controls with integrated displays.

A comprehensive monitoring package, including PIP, MAP, Breath Rate, I:E Ratio, Tidal

Volume (Vte), Minute Ventilation (VE), Inspiratory Time (Ti), and PEEP.

Integrated real-time digital airway pressure manometer with adjustable high and low-pressurealarms.

Special Functions for viewing and setting parameters. Self-testing at power-up and background testing during normal operation.

Internal and optional external battery.

For ordering information on upgrades, see Appendix A or contact your Bird Products representative.

Requirements to Operate a TBird Ventilator

Power Source.The ventilator operates from a standard 100, 110, 220, or 240 VAC powersource, the internal battery or an optional external battery. The factory equipped internal

battery is capable of providing power during short-term patient transports or AC powerinterruptions. The optional external battery can be used for longer periods of support.

Pressurized Oxygen (for AVS models or VSO2).The oxygen source must provide clean,dry, medical grade oxygen at a line pressure of 40 to 60 PSIG (2.8 to 4.2 bar).

Low Flow Oxygen (for VS or Legacy). The low flow oxygen source must provide clean,medical grade oxygen not to exceed 80 lpm at 0.5 PSIG (0.035 bar).

What to Do if the Ventilator Fails

If a TBird ventilator detects a condition that could possibly prevent it from continuing to operate safely, itstops delivering gas and opens all valves so the patient can breathe spontaneously from room air. Italso generates a vent inop alarm. (For more information, see Chapter 4, Alarms and Alerts.)

If a vent inop occurs, provide an alternate means of ventilating the patient, take the ventilator out ofservice and contact your Bird Certified Service Technician.

WARNING

Do not operate the ventilator unless qualified personnel are in attendance to promptly respond to alarms,inoperative conditions, or sudden malfunctions. Patients on life support equipment should be visually monitored atall times. Qualified personnel should be prepared to provide an alternate form of ventilation, if needed.


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TBird Series Ventilators Chapter 1 Introduction 17


Operator Replaceable Components

The following components are operator replaceable:

Air intake filter

Patient breathing circuit Exhalation valve body

Exhalation valve diaphragm

External battery

Main flow bacteria filter

Fan filter

Contact your Bird Certified Service Technician to replace all other parts, including the internalbattery. See Appendix A, Contact & Ordering Information for information on how to order replaceablecomponents and request a service call.


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Chapter 2 Controls and Displays

This chapter describes the function and operation of your TBird ventilators controls and displays. It

covers the following points: How each control operates.

Why some controls may flash when you attempt to set them.

Why some controls are dimmed in certain modes.

For more information on where controls are located, see Appendix C, Ventilator Illustrations.

Table 2-1 List of Controls and Displays

%O2Control External Battery Power Indicator ON Indicator

100% O2 3-Minute Button Flow Cal Button Over Pressure Relief Valve

AC Power Indicator High Breath Rate Alarm Control Peak Flow Control

Airway Pressure Manometer High Pressure Limit Alarm Control PEEP/CPAP ControlAlarm Silence Button Inspiratory Hold Button Power Switch

Alarm Window Inspiratory Pause Control Pressure Control, Control

Altitude Compensation Inspiratory Time Control Pressure Support, Control

APNEA Interval Setting Internal Battery Charge StatusIndicator

Remote Alarm Button

Assist/Control Mode SelectionButton

Internal Battery Power Indicator Sensitivity Control

Bias Flow Setting Low Minute Volume Alarm Sigh Button

Breath Rate Control Low Pressure Alarm Control SIMV Mode Selection Button

Control Knob/Lock Manual Breath Button Square Waveform Button

CPAP Mode Selection Button MIP/NIF Button Tidal Volume Control

Effort Indicator Monitor Select Button VAPS Button

Expiratory Hold Button Monitor Window Vent Inop Indicator

External Battery Charge Status

How To Set a Control

The front panel contains several types of controls, including variable controls, mode select buttons, andpushbuttons.

Variable Controls

These controls are used to set ventilation parameters and alarms. Set the control by pressing thebutton located below its display. While the control is selected, all other control displays are dimmed.Turn the front panel control knob until the desired setting appears in the controls display. The newsetting takes effect upon the next breath. The other controls will illuminate again when the operatoreither:

Presses the button again, or

Presses a button for another variable control, or


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Allows five (5) seconds to elapse.

Table 2-2 shows you the controls available in each mode and the non-limited range of settings allowedin that mode.

Table 2-3 shows the available controls by breath type.

Table 2-2 Ranges of Variable Controls by Mode

FunctionControl & AssistControl Modes

SIMV Mode CPAP Mode

Breath Rate 2 - 80 bpm 2 - 80 bpm Dimmed

High Breath Rate OFF, 3 150 bpm OFF, 3 150 bpm Dimmed

High PressureLimit

5 - 120 cmH2O 5 - 120 cmH2O 5-120 cmH2O

Inspiratory Pause OFF, 0.1 2.0 sec OFF, 0.1 2.0 sec Dimmed

Inspiratory Time 0.3 10.0 sec 0.3 10.0 sec Dimmed

Low Min Volume 0.1 99.9 L 0.1 99.9 L Dimmed

Low Pressure OFF, 2 - 60 cmH2O OFF, 2 - 60 cmH2O Dimmed

O2% 21-100% 21-100% 21-100%

Peak Flow 10 - 140 L/min 10 - 140 L/min Dimmed

PEEP/CPAP 0 - 30 L/min 0 - 30 L/min 0 - 30 lpm

Pressure Control OFF, 1 - 100 cmH2O OFF, 1 - 100 cmH2O Dimmed

Pressure Support Dimmed OFF, 1-60 cmH2O OFF, 1-60 cmH2O

Sensitivity OFF, 1 20 L/min OFF, 1 20 L/min OFF, 1 20 L/min

Tidal Volume 50 - 2000 ml 50 - 2000 ml Dimmed

Table 2-3 Availability of Variable Controls by Breath Type

Function Volume Control1 Pressure

Control2

VAPS3

Breath Rate Active Active Active

High PressureLimit

Active Active Active

Inspiratory Pause Active Dimmed Active

Inspiratory Time Dimmed Active Dimmed

Low Min Volume Active Active Active

Low Pressure Active Active Active

O2% Active Active Active

Peak Flow Active Dimmed Active

PEEP/CPAP Active Active Active

Pressure Control Dimmed Active Active

Pressure Support Active Active Active

Sensitivity Active Active Active

Tidal Volume Active Dimmed Active

1Volume Control Breath = Pressure Control OFF, VAPS OFF

2Pressure Control Breath = Pressure Control ON, VAPS OFF

3VAPS Brea h = Pressure Control ON, VAPS ON


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TBird Series Ventilators Chapter 2 Controls & Displays 21


Mode Select Buttons

These buttons allow you to select a mode of ventilation1. The buttons are mutually exclusive. Selectingone mode automatically deselects the others. To select a mode, press the button once: theintegrated LED begins to flash. This flashing lasts for five seconds, indicating the system is ready tomake the transition from one mode to another. Press the button again while the LED is flashing to

enable the mode. If you do not press the button while the LED is flashing, the mode select operation iscanceled and the ventilator continues to operate in the previous mode.

Pushbuttons

These buttons allow you to perform a front panel action, such as delivering a manual breath, or turninga feature, such as the sigh breath feature, on or off. When the button is on, the integrated LEDilluminates. To toggle the button on or off, just press and release the button.

Dimmed Controls

A control dims when it is not available in the currently selected mode. Although dimmed, the control

retains its setting so you can switch modes without having to reset the control. You can also set adimmed controlprior to switching to a mode in which the control will be active.

Flashing Controls

A control may flash for several reasons:

1. There is a pre-set limit on the range of possible settings for the control, and you have reachedthat limit. The ventilator monitors all control settings and will automatically limit the range ofcertain controls to prevent incompatible settings. This is to ensure the following:

A minimum exhalation time of 250 msec for all breaths.

A minimum inhalation time of 30 msec for all breaths.

A minimum high pressure alarm setting of at least 5 cmH2O above PEEP for all modes. A maximum inverse I:E ratio of 4:1.

A peak flow > bias flow.

2. A required control has not been set.If a control is required in a particular mode, the ventilatorflashes the control until you set it. When you set the Low Peak Pressure alarm limit to OFF, forexample, the setting flashes to remind you to set the alarm before leaving the machine.

3. An alarm is active. When an alarm occurs, the associated display will flash. This enables you toidentify the cause of the alarm at a glance.

4. An alternate exhalation criteria has been met for a Pressure Support or Pressure Control breath.In Pressure Support, ordinarily a Termination Flow (TERMSENS) ends the inspiratory phase. Ifthe Time Limit (VARITIME) has been reached first, the Pressure Support control will flash. InPressure Control, ordinarily the Inspiratory Time control ends the inspiratory phase. If FlowTermination (FLOWTERM) is set and is reached first, the Pressure Control display will flash.

1The Assist/Control button selects both the Control and Assist Control modes of ventilation. To select the Control mode, set the Sensitivity to OFF.


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Front Panel - Monitor Section

Effort Indicator

Display only. Illuminates briefly when the patients inspiratory effort meets or exceeds the Sensitivitysetting and the breath is patient initiated.

Airway Pressure Manometer

Display only. Shows the patients real-time, airway pressure. Ranges from - 20 cmH2O (- 2 kPa) to120 cmH2O (12 kPa) in increments of 2.

The two amber LEDs indicate the currently set high and low pressure alarm limits.

Monitor Window (AVS models only)

Display only. Displays alerts, monitored parameters, Special Functions and User Verification Tests(UVTs).

Alarm Window (AVS models only)

Display only. Alarm messages appear in the alarm window. When the alarm is cleared, the alarmmessage disappears.

Alarm/Monitor Window (VS, VSO2 & Legacy)

Display only. Displays alarms, alerts, monitored parameters, special functions, and User VerificationTests (UVTs).

Alarm messages temporarily overwrite any parameters, special functions, or UVTs displayed in thealarm/monitor window. When the alarm is cleared, the alarm message disappears and the previouslydisplayed item is redisplayed.

Front Panel - Alarm Section

Low Pressure Alarm Control

Sets the alarm threshold for low circuit pressure during the inspiratory phase of machine and assistbreaths.

Press the button and turn the control knob to set the alarm to any value between 2 and 60 cmH2O orOFF. The setting is indicated on the manometer by an amber LED. If set to OFF, the display will flash,

indicating the alarm is disabled. The new setting takes effect on the next machine or assist inspiration.Once set, the ventilator generates a LOW PRES alarm if the circuit pressure fails to exceed the setvalue.

NoteThe alarm is disabled in the CPAP mode and during spontaneous and Pressure Support breaths. The alarm is enabled inCPAP mode when a manual or sigh breath is delivered.


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High Pressure Alarm Control

This sets the maximum allowable pressure in the patient breathing circuit to any value between 5 and120 cmH2O . The limit cannot be set less than 5 cmH2O above PEEP. The setting is indicated on themanometer by an amber LED. New settings take effect immediately. A HIGH PRES alarm isgenerated if the patient breathing circuit pressure (measured by the exhalation valve pressure

transducer) reaches the set value.If a HIGH PRES alarm occurs, the ventilator immediately terminates inspiration and cycles into theexhalation phase so pressure can return to PEEP. If the circuit pressure does not fall back to PEEP +5cmH2O within three seconds, the ventilator terminates all flow. Once the patient breathing circuitpressure falls to within PEEP +5 cmH2O, the ventilator clears the audible alarm, restarts the flow, andattempts to deliver another breath.

During a sigh breath, the alarm limit is automatically increased by 50% to a maximum of 120 cmH2O.This temporary increase does not appear on the High Pressure display.

Low Minute Volume Alarm Control

Sets the minimum threshold for the exhaled minute volume alarm. The volume is calculated byaveraging the previous eight exhaled Tidal Volumes, multiplying the resulting average by the totalbreath rate, and then dividing by 1,000 to convert from milliliters to liters.

New settings take effect immediately. To accommodate different institutions policy, two ranges areavailable: OFF to 99.9 liters and 0.1 to 99.9 liters. These ranges are accessed in the SpecialFunctions, Alarm Setup Group (see Chapter 6).

If the exhaled minute volume falls below the set value, the LOW VOLUME alarm occurs.

High Breath Rate Alarm Control (AVS models, VSO2, Legacy)

This sets the maximum threshold for total breath rate alarm between 3 and 150 breaths per minute orOFF. New settings take effect immediately.

If the total breath rate exceeds the alarm setting, a HIGH BREATH RATE alarm occurs.

Alarm Silence/Reset Button

Silences and resets any active alarms.

If the audible alarm is sounding, press the button once to silence the alarm for 60 seconds.If you correct the condition causing the alarm within the silence period, press the button againto clear the alarm message.

If the audible alarm is not sounding, but there is an alarm message displayed in the alarmwindow and the red silence-period indicator is turned off, press the button once to clear thedisplay.

If no alarm is sounding or displayed, press the button once to silence any alarms that mightoccur in the next 60 seconds. To cancel the preemptive silence period, press the button again.

When silenced, the red LED above the button illuminates for 60 seconds. At the end of the silenceperiod, the LED turns off and the audible alarm sounds again unless the condition causing the alarmhas been corrected.

If a vent inop occurs, turn the ventilator off before pressing Alarm Silence/Reset.


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Vent Inop Indicator

Display only. Illuminates when a Ventilator Inoperative (Vent Inop)condition is detected.

A Vent Inopoccurs whenever a condition develops that could affect the continued safe operation of theventilator. Because safe operation cannot be guaranteed in the presence of these conditions, theventilator ceases to operate and activates the Vent Inopalarm. The ventilator will default to a safeoperating condition, opening all valves, so the patient can breath spontaneously from room air.

If a Vent Inopoccurs, remove the ventilator from service, provide an alternate means of ventilation andhave it evaluated by your Bird Certified Service Technician.

Front Panel - Control Section

Monitor Select Button

Selects monitored parameters, Special Functions, and User Verification Tests (UVTs). This button isalso used to clear some alerts. To operate, press and release the button.

For information on how to use the Monitor Select button when working with monitored parameters, seeChapter 3, Monitored Parameters. For information on clearing alerts, see Chapter 4, Alarms and Alerts.For information on how to use this button with the Special Functions, see chapter 6, Special Functions.For information on how to use this button with the UVTs, see Chapter 7, User Verification Tests.

Mode Select Button

Selects desired mode. Modes available are Assist/Control, Control, SIMV and CPAP. Press the buttononce to select the mode. The built-in LED will flash to indicate a transitional state. To activate the mode,press the button again within five seconds, otherwise the mode remains unchanged.

All modes are mutually exclusive. Selecting one mode automatically disables the others. Controls thatare not active in this mode are dimmed.

Control: To operate the ventilator in a pure Control mode, set the Sensitivity setting to OFF. IfSensitivityis not set to OFF, the breath rate timing is reset whenever a breath is delivered in responseto patient effort to avoid breath stacking.

Control Knob/Lock

Used to set variable controls (e.g., Breath Rate, Tidal Volume), select Special Functions, and run UserVerification Tests (UVTs), this control allows you to dial through a range of values or a sequence ofselections. Also allows you to lock and unlock the front panel.

To set a variable control, press the controls button and turn the Control Knob clockwise to increase thesetting or counter-clockwise to decrease the setting. The faster you turn the knob the faster the setting

will change.To lock or unlock the front panel controls, press the Control Knob. When locked, the green LED next tothe lock icon illuminates. Locking or unlocking the front panel has no effect on the actual setting of thecontrols. Locking the front panels controls prevents unauthorized personnel from changing theventilators settings. All controls except the Monitor Select, Manual Breath, 100% O23 Min(VSO2,

AVS, II, III) and Alarm Silence/Resetbutton are secured when locked.


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To access the Special Functions, press and hold the Control Knob until VENT SETUP appears in themonitor window (approximately two seconds). Release the control Knob. When working with theSpecial Functions, you can back out of the functions by pressing the Control Knob.

The control lock itself can only be disabled using the Control Lock Enable function in the VentilatorSetup Group Special Functions (see Chapter 6). When disabled, pressing the control lock has no affecton the front panel controls: they remain unlocked.

NoteWhen operating in CPAP mode, certain controls must be set to clinically appropriate levels even though they are dimmed andinactive. Should the patient become apneic, the ventilator uses these settings when providing Apnea Backup ventilation. TheTBird Ventilator Series can provide Apnea Backup ventilation in Volume Control, Pressure Control or Volume AssuredPressure Support (VAPS), depending on the current settings. Refer to Chapter 5, for more information.

Tidal Volume Control

Sets the total volume of gas delivered to the patient during a Volume Control breath. During a VAPS

breath this control sets the minimum volume gas delivered to the patient. The Tidal Volume can be setto any value between 50 and 2,000 ml. New settings take effect on the next Volume Control or VAPSbreath.

For Volume Control Breaths, the Tidal Volume is delivered in a decelerating waveform (except AVSmodels offering a choice of square or decelerating).

WARNING

Lower air density at higher altitudes will effect tidal volume delivery and exhaled tidal volume measurements.Please refer to Chapter 6, Special Functions, for details on how to compensate for higher altitudes.

Breath Rate Control

This control sets the minimum number of machine breaths delivered to the patient each minutebetween 2 and 80 bpm. New rate settings take effect immediately.

This control is active in Control, Assist/Control mode, SIMV mode, and Apnea Backup ventilation. Thesystem uses the Breath Rate setting to compute the breath period.

NoteWhen operating in CPAP mode, certain controls must be set to clinically appropriate levels, even though they are dimmed andinactive. If the patient becomes apneic, the ventilator will use these settings to provide Apnea Backup ventilation. The TBirdVentilator Series can provide Apnea Backup ventilation in Volume Control, Pressure Control or Volume Assured PressureSupport (VAPS), depending on the current settings. Refer to Chapter 5, Unpacking, Setup and Operating Procedures, for moreinformation.

Peak Flow Control

In a Volume Controlled breath, the Peak Flow control sets the maximum inspiratory flow rate in Control,Assist/Control, and SIMV mode.


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In a VAPS breath, the Peak Flow Control sets the minimum flow generated and determines theexhalation criteria. It also sets the flow at which VAPS breaths guarantee the set minimum TidalVolume.

The flow rate can be set between 10 and 140 L/min. The new flow rate takes effect on the next machineor assist inspiration.

The inspiratory flow is delivered in either a square or decelerating waveform and is measured in litersper minute (L/min) delivered at Body Temperature Pressure Dry (BTPD).

NoteThe ventilator can deliver up to 180 lpm for patient breaths (spontaneous and pressure support).

Sensitivity Control

Sets the threshold below baseline flow at which the patient can flow trigger a breath between 1 and 20lpm or OFF. New settings take effect immediately.

Breaths can be flow triggered any time during the exhalation phase following the minimum exhalationtime. When the patient begins to inhale, flow is diverted from the bias flow into the patients lungs. If therate of this patient flow exceeds the Sensitivity setting, the ventilator triggers a breath. The lower theSensitivity level, the lower the patient effort required to trigger the breath.

If Sensitivity is set to a value, the patient is allowed to flow trigger breaths. If Sensitivity is turned OFF,the ventilator provides a pure Control Mode Ventilation (CMV), prohibiting the patient from triggeringbreaths.

WARNINGMake sure the Sensitivity is set to an appropriate value (1- 20 L/min). If set to OFF, the patient will be unable to

trigger breaths.

Figure 2.1 Sensitivity & Breath triggering

PEEP/CPAP Control

Sets the PEEP/CPAP pressure level between 0 and 30 cmH2O. New settings take effect immediately.


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Pressure Support Control

Sets the Pressure Support level above PEEP for all Pressure Support breaths between 1 and 60cmH2O or OFF. This control is only active in SIMV and CPAP modes. New settings take effect on thenext pressure support inspiration.

The total Peak Inspiratory Pressure (PIP) will equal the sum of the PEEP/CPAP and Pressure Supportsettings.

Figure 2.2 Pressure Support Waveforms

When the patient initiates a breath, the ventilator raises the inspiratory flow to meet the patientsdemands until the target pressure level is reached. The ventilator then maintains the patient breathingcircuit pressure at the target pressure, allowing flow to decrease as pressure equalizes between thecircuit and the patients lungs. When flow drops to the set percentage of that breaths peak inspiratoryflow, the ventilator cycles into the exhalation phase. The clinician determines this value and sets it inthe Special Functions (see Chapter 6), Vent Setup, Termination Sensitivity (TERMSENS).

If the inspiratory flow is unable to drop to the established percentage of peak flow (e.g., as a result of aleak), within the set inspiratory time (Variable Time Termination) or two breath periods, whicheveroccurs first, the ventilator terminates inspiration. When a breath is terminated because of time ratherthan flow, the Pressure Support control flashes.

% O2 Control (AVS models & VSO2)Sets the percentage of oxygen in the inspiratory flow from 21% to 100% in increments of 1%. The timerequired for the oxygen level in the gas flow to reach the %O2 setting depends on the bias flow andpatients minute volume demands. The set percentage is typically reached before the first two liters ofgas are delivered.

WARNINGDelivered percentage oxygen may be higher than set at elevations above 5,000 feet.

Pressure Control Control (AVS III, VSO2 & Legacy Only)

Sets the inspiratory pressure above the baseline (PEEP) when setting up a Pressure Control or VAPS (AVSIII only) breath to any value between 1 and 100 cmH2O or OFF. New settings take effect on the nextPressure Control or VAPS inspiration. When setting up a Volume Control breath, set this control to OFF.

The total Peak Inspiratory Pressure (PIP) will equal the sum of the PEEP/CPAP and Pressure Controlsettings.

For Pressure Control breaths, the ventilator raises the inspiratory flow to meet the patients demandsuntil the target pressure level is reached. The ventilator then maintains the patient breathing circuitpressure for the time specified by the Inspiratory Time control setting. The clinician may also choose to


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set a Flow Termination threshold for Pressure Control. The clinician determines this value and sets it inthe Special Functions (see Chapter 6), Vent Setup, Flow Termination (FLOWTERM). If this value isset, the breath will terminate when either the set Inspiratory Time or the set FLOWTERM is reached,whichever occurs first. When a breath is terminated because of flow rather than time, the PressureControl setting flashes.

For VAPS breaths, this control sets the inspiratory pressure above baseline (PEEP) for the pressuresupported portion of the breath.

Inspiratory Time Control ( AVS III, VSO2 & Legacy only)

Sets the inspiratory time for Pressure Control breaths between 0.3 and 10.0 seconds. The inspiratorytime determines the length of the inspiratory phase of the breath unless flow termination is reached first.New inspiratory time settings take effect on the next Pressure Control inspiration.

Inspiratory Pause Control (AVS models only)

This control sets the inspiratory pause time for Volume Controlled and VAPS breaths to any valuebetween 0.1 and 2.0 seconds (in 0.1 second increments), or OFF. New settings take effect on the next

Volume Control or VAPS breath.This control is only available for Volume Control or VAPS breaths. At the end of the inspiration, thecircuit pressure will be maintained for the set inspiratory pause period. At the end of this interval,exhalation will begin.

Front Panel - Power Section

On Indicator

Display only. Indicates the ventilator is turned ON and has power.

This indicator is normally green. If it is yellow or red, a problem has developed with the internal power

supplies or software. Discontinue using the ventilator and contact your Bird Certified ServiceTechnician.

Power Source Indicators

Display only. Indicates the power source the ventilator is using.

AC Indicator

This indicator remains on as long as sufficient AC power is present. It turns off if AC power fails or fallsbelow acceptable limits. If this occurs, the ventilator automatically switches to battery power andgenerates a BATTERY ON alert.

Internal Battery IndicatorIlluminates when the ventilator is operating on internal battery power. Color of the LED indicates thepower level of the internal battery when in use. See below for color code.

As the battery level drops from full to medium power, the ventilator generates an audible LOWBATTERY alarm (a chirp every three seconds) which can be cleared by pressing the AlarmSilence/Reset button twice. When the battery drops from medium to low power, a non-silencableaudible alarm will occur (continuous tone).


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The time remaining on the battery depends on the current front panel settings and the patientsdemands. Table 2-4 shows typical times expected for normal and heavy demands.

Table 2-4 Internal & External Battery Typical Operating Times

Internal Battery - When Indicator Is: Normal Load Heavy Load

Green 40 mins 7 minsYellow 14 mins 5 mins

Red 10 mins 4 mins

External Battery - When Indicator Is: Normal Load Heavy Load

Green 3.5 hours 55 mins

Yellow 1.5 hours 20 mins

Settings Normal Load Heavy Load

Tidal Volume 500 ml 1500 ml

Breath rate 12 bpm 30 bpm

Peak Flow 40 lpm 140 lpm

Sensitivity 2 lpm 2 lpm

PEEP 5 cmH2o 30 cmH2O

Lung Compliance 50 ml/cmH2O 17.5 ml/cmH2O

Lung Resistance 6 cmH2O/l/sec 3 cmH2O/L/sec

External Battery Indicator

Illuminates when the ventilator is operating on external battery power. Color of the LED indicates thepower level of the external battery when in use. See below for color code.

As the external battery gets low, the indicator changes from green to yellow. If the battery becomes fully

discharged, the ventilator automatically switches to internal battery power and activates the EXTBATTERY alarm.

The time remaining on the battery depends on the current front panel settings, battery condition and thepatients demands. Table 2-4 shows typical times expected for typical normal and heavy demands froma fully charged battery.

Color code for battery power source indicators:

If green, the battery is at full power.

If yellow, the battery is at medium power.

If red, the battery is at low power.

If off, the ventilator is either running on AC or the other battery source.

Battery Charge Status Indicators

Display only. Shows the status of the internal and external batteries while being charged.

When the ventilator is plugged into an AC source, it automatically charges both batteries (if present).The color of the indicator indicates the batterys charge status:

If off, the battery is not present or properly connected.

If green, the battery is between 90 and 100% fully charged.


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If yellow, the battery is being charged.

If red, a battery fault exists. Contact your Bird Certified Service Technician.

The typical amount of time required to recharge the batteries is as follows:

Internal battery:

If the external battery is fully charged or not present and the internal battery is depleted, thecharge time for the internal battery is approximately six (6) hours.

If both the internal and external batteries are depleted, the charge time for the internal batteryis approximately seven (7) hours.

External battery:

If the internal battery is fully charged and the external battery is depleted, the charge time forthe external battery is approximately seventeen (17) hours.

If both the internal and external batteries are depleted, the charge time for the external batteryis approximately twenty-four (24) hours.

Front Panel - Special Control Section

Sigh Button

Turns sigh breath feature ON or OFF. To operate, press the button. When ON, the green LEDilluminates.

A sigh breath is a Volume Control breath in which the Tidal Volume is equal to 1.5 times the TidalVolume setting. When you press this button, the ventilator delivers a sigh breath on the next assist ormachine breath regardless of how that breath is initiated. The ventilator then delivers a sigh breathonce every seven (7) minutes or 100 breaths, which ever occurs first.

When a sigh breath is delivered:

The Tidal Volume is increased by 50%.

The effective breath period is increased by 50%.

The inspiratory time is increased by 50% (not to exceed a maximum of 5.5 seconds). If theTidal Volume cannot be delivered in 5.5 seconds, the maximum possible Tidal Volume isdelivered for the current flow setting.

The preset high pressure alarm limit is increased by 50% (not to exceed a maximum of 120cmH2O).

Sigh breaths are not available in Pressure Control

Manual Breath Button

This control delivers a single machine breath to the patient. Press and release the button. When breathdelivery begins, the integrated LED turns on and stays on while the breath is being delivered.

When this control is activated, the ventilator delivers a breath according to the current ventilator settings(Tidal Volume and Peak Flow or Pressure Control and Inspiratory Time). If you press this button duringthe inspiratory phase or before the minimum exhalation time has elapsed, the ventilator ignores yourrequest.


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Remote Alarm Button

Future option.

Square Waveform Button (AVS models only)

Changes the waveform from decelerating to square when setting up a Volume Control breath. Pressthe button to toggle between a square and decelerating waveform. The LED illuminates when youselect a Square Wave.

This waveform controls how gas flow is delivered to the patient for Volume Control breaths.

VAPS Button (AVS III only)

This control activates Volume Assured Pressure Support (VAPS). Press the button to enable VAPS, theLED illuminates. Be sure to set the Pressure Control, Tidal Volume and Peak Flow controls toappropriate settings.

When turned ON, the ventilator delivers a VAPS breath using the Pressure Control setting for the targetpressure. The Pressure Control setting determines the circuit pressure above baseline to be delivered.

The Tidal Volume setting determines the minimum guaranteed Tidal Volume to be delivered. The PeakFlow setting determines the minimum delivered flow until the minimum volume is reached.

Inspiratory Hold Button (AVS models, VSO2 & Legacy only)

Performs an inspiratory hold maneuver to measure static compliance.

Press and hold this button prior to the delivery of a mechanical breath. The LED illuminates and the firstparameter Paw xxx cmH2O appears in the monitor window, where xxx is the real-time airway pressure.

At the end of inspiration, Paw xxx will change to Pplat xxx cmH2O, where xxx represents the plateaupressure. The Inspiratory Hold maneuver will end when the button is released or after six (6) seconds.

At this time,

Palvd xxx cmH2O Cst xxx ml/cmH2O

is displayed where Palvd is the alveolar distending pressure and Cst is static compliance.

The green LED now turns off and normal ventilator operation is resumed. The maneuver fails if theInspiratory Hold button is released too soon or a stable plateau could not be obtained. To clear thedisplay from the monitor window, press the Monitor Select Button.

NoteThe HIGH PRES alarm will automatically cancel the Inspiratory Hold maneuver.

Expiratory Hold Button (AVS II & AVS III only)

Performs an expiratory hold to measure AutoPEEP. To activate, press and hold this button to initiatethe Expiratory Hold maneuver. When the next machine breath would occur, the ventilator occludesinspiratory and expiratory flow, the built-in LED turns on and the following parameters will appear in themonitor window:

Paw nn Pex mm AUTOPEEP pp cmH2O


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where nn is the real time airway pressure, mm is the ending exhalation pressure and pp is themeasured AutoPEEP.

AutoPEEP characterizes the patients end expiratory alveolar pressure. This value is continuouslyupdated until six (6) seconds has elapsed or the button is released. At the end of the maneuver,

AutoPEEP is calculated as the difference between Pex and Paw.

Normal ventilation resumes at the end of the maneuver.

NoteThe HIGH PRES alarm will automatically cancel the Expiratory Holdmaneuver.

MIP / NIF Button (AVS II & AVS III only)

Performs a MIP/NIF maneuver to measure the patients inspiratory effort. To operate, press and hold.The built-in LED turns on and the following parameters are displayed:

Starting pressure (Pstart), airway pressure (Paw), and maximum inspiratory pressure (MIP). They are

displayed as follows:Pstart --- Paw --- MIP --- cmH2O

Continue to hold the button until the dashes are replaced by values.

The ventilator computes MIP by measuring the difference between the airway circuit pressure at thestart of the maneuver and the maximum negative pressure achieved during the maneuver. When youpress and hold the button, the ventilator locks out all front panel controls, displays the labels, and waitsfor the exhalation flow to end. Once this occurs, the inspiratory and exhalation flows are blocked andthe circuit pressure is displayed next to Pstart. The ventilator then displays the current airway pressurenext to Paw Each time a new maximum negative pressure is detected, the MIP value is updated withthe computed difference between Paw and Pstart. This value is continuously updated until you releasethe button, or 30 seconds have elapsed. Once the MIP period ends, the highest value is retained as the

MIP and ventilator returns to normal operation.

NoteThe HIGH PRES alarm will automatically cancel the MIP/NIFmaneuver.

100% O2 3 Min Button (AVS models & VSO2 only)

Delivers 100% oxygen to the patient for a maximum of three minuteswithout having to change the %O2setting.

Press the button to turn 100% oxygenation ON or OFF. The LED illuminates and the % O2display

flashes 100while 100% oxygen is being delivered.The percentage of oxygen increases to 100% for three minutes or until you turn 100% O2 OFF. Thelength of time required to actually reach the 100% oxygen level depends on the currently set bias flowand the patients minute volume demands. The 100% level is typically reached before the first two litersof gas are delivered.

After three minutes the unit returns to the previous Oxygen setting.


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Flow Cal.

This button allows you to override the automatic flow cal program and perform a manual flowcalibration. It will turn on the automatic flow cal program after a manual flow calibration has beenperformed.

When the ventilator is turned ON, the Flow Cal. LED will flash while the software is establishing the flowcalibration. Once this is reached the LED will be illuminated continuously. Flow calibration determinesthe bias flow exiting the Exhalation Valve Flow transducer which may differ from the set bias flow. If theLED continues to flash, the ventilator is unable to establish the calibration and the clinician can performa manual flow calibration.

To perform a manual flow calibration, press and hold the Flow Cal button during the exhalation phase ofa breath. The following message appears:

FC nn.n

Where nn.n is the current volume of gases moving through the exhalation valve sensor. Continue tohold the button until the flow calibration value nn.n stabilizes within 3 L/min of the set bias flow. Thedisplay will appear as:

FC nn.n OK

NoteAlthough the system continues to ventilate without an established flow cal value, indicated by the flashing LED, the accuracy ofthe exhaled tidal volume and minute volume measurements and the sensitivity may be reduced.

Front Panel - Patient Connectors

Patient Outlet.

22mm OD outlet for patient circuit.

Exhalation valve

Connector for exhalation valve body and tubing from patient.

Over Pressure Relief Valve

Sets the maximum pressure allowed in the system. Provides a safety backup for the high-pressurealarm.

To set the Over Pressure Relief Valve, do the following:

1. Attach a Bird test lung (P/N 04845 or equivalent) to the patient breathing circuit2. Set the High Pressure Limit Controlto 120 cmH2O.

3. Set the Tidal Volumeand Peak Flowto achieve at least 100 cmH2O as displayed on themanometer

4. Monitor PIP

5. Adjust the valve until the pressure shown on the manometer reaches the desired pressure.


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6. Lower the High Pressure Limit Controlto 5-15 cmH2O (or to the value dictated by hospitalprotocol) below the Over Pressure Relief setting.

This control must be set 5-15 cmH2O above the high-pressure limit

WARNING

Make sure the high-pressure alarm limit is not set above the Over Pressure Reliefsetting. Otherwise, a HIGHPRES alarm will not occur and the patient may be subjected to sustained high pressures.

Figure 2.3 Over Pressure Relief

Rear Panel

Power Switch

Switches the ventilator between STANDBY and ON. Press the upper half of the switch to turn theventilator ON. Press the lower half of the switch to return the ventilator to STANDBY.

When ON, the ventilator will operate on AC, internal battery, or optional external battery power,depending on the power source available.

When in STANDBY position and plugged into an AC power source, the ventilator charges the internalbattery and optional external batteries.

Fan Intake Filter

Filters air drawn into the ventilator.

Alarm Volume Control

Enables you to set the sound level of the audible alarm. Typically would be set to far clockwise

position.

Fiberoptic Interface Port

Allows attachment of the optional Bird Graphics Monitor.

Patient Assist Call Connector

Allows connection to an existing Patient Assist Call system in an institution.


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Fuses

Oxygen Inlet Port, Low Flow (Legacy, VS)

Allows entrainment of oxygen into the gas flow. Low flow oxygen (up to 80 lpm) can be attached froman oxygen concentrator or regulated oxygen source.

Two (2) DISS high pressure connectors for oxygen. High pressure oxygen (40 to 60 psi) sources canbe attached.

Air Inlet Filter

Filters air drawn into the turbine.


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Chapter 3 Monitored Parameters

The ventilator features a comprehensive package that continually monitors breath parameters. These

parameters include: Total Breath Rate (f)

I:E Ratio (I:E)

Minute Volume (VE)

Spontaneous Minute Volume (sVE)

Machine Minute Volume (mVE)

Peak Inspiratory Pressure (PIP)

Mean Airway Pressure (MAP)

Inspiratory Time (Ti)

Positive End Expiratory Pressure (PEEP)

Exhaled Tidal Volume (Vte)

These parameters are displayed singularly on the TBird VS, VSO2and Legacy models and in sets oftwo or three on the TBird AVS models. As each set of parameters is monitored, the values appear inthe monitor window. If autoscanning is turned on, the system automatically advances through theparameters, displaying each set for approximately four seconds. You can hold the scan at a particularset of parameters by pressing the Monitor Selectbutton.

If autoscanning is turned off, you can manually advance through the list by pressing the Monitor Selectbutton. The selected parameters will be displayed until you press the Monitor Selectbutton again toadvance to the next parameter.

To enable or disable autoscanning, use the Autoscan function described in Chapter 6, SpecialFunctions.

When autoscan is enabled, a rising arrow ( ^ ) appears in the far right of the monitor window.

Table 3-1 describes each of the monitored parameters and shows the range of values displayed.

Table 3-1 Monitored Parameters

Monitored Parameter Display Range Description

Breath rate f 0 to 250 bpm Shows the total number of breaths per minute includingboth spontaneous and machine breaths. The displayedvalue is based on an eight breath moving average andis updated at the beginning of each inspiration.

I:E Ratio I:E 99:1 to 1:99 Shows the ratio of inspiratory to expiratory time for all

breaths including spontaneous breaths and is updatedat the end of every breath. Inverse I:E ratios aredisplayed as well as regular I:E ratios

Minute Volume VE 0 to 99.9 L/min Shows the average volume delivered to the patienteach minute, it is updated at the end of each exhalation.The minute volume is a moving average calculated bymultiplying the breath rate by the average of theprevious eight tidal volumes. Spontaneous breaths areincluded.

Spontaneous Minute Volume sVE 0 to 99.9 L/min The average volume delivered to the patient during a


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Monitored Parameter Display Range Description

minute for spontaneous breaths only.

Machine Minute Volume mVE 0 to 99.9 L/min The average volume delivered to the patient during aminute for machine breaths

Peak Inspiratory Pressure PIP 0 to 140 cmH2O Shows the highest circuit pressure to occur duringinspiration as measured at the exhalation valve. The

display is updated at the end of inspiration. PIP is notupdated for spontaneous breaths.

Mean Airway Pressure MAP 0 to 99 cmH2O Shows the MAP over the last minute and is based on aone minute moving average. The display is updatedevery 10 seconds

Inspiratory time Ti 0.01 99.99 sec Displays the Inspiratory Time for all breath types and isupdated at the end of every breath.

Positive End ExpiratoryPressure

PEEP 0 to 99 cmH2O Shows the measured end expiratory pressure. Thedisplay is updated at the end of the exhalation phase.

Machine exhaled Tidal Volume mVte 0 - 4,000 ml Shows the average exhaled volume for machine typebreaths as measured by the exhalation flow transducer.The default average is for the previous 8 breaths and isupdated at the end of each exhalation.

Spontaneous exhaled TidalVolume

sVte 0 - 4,000 ml Exhaled Tidal Volume of the previous spontaneousbreath


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Chapter 4 Alarms and Alerts

This chapter describes the various alarms and alerts that can occur while operating the ventilator. The

following topics are covered: How alarms and alerts are generated.

How to respond to each alarm or alert.

Definitions

Alarms

When the ventilator detects an operating condition that requires your immediate attention, it activatesthe audible alarm, flashes a message in the alarm window, and flashes any dedicated indicators orcontrols associated with the alarm. The audible and visual components of the alarm remain active foras long as the condition causing the alarm exists. Once the condition no longer exists, the audiblecomponent automatically clears itself. The visual component may or may not be automatically cleared,depending on the nature of the alarm. If the visual component is not automatically reset, press the

Alarm Silence/Reset button. To clear the audible portion of an alarm, press the Alarm Silence/Resetbutton.

The volume of the audible alarm can be physically adjusted using the alarm volume control on the backpanel.

Alerts

When the ventilator detects an operating condition that needs to be addressed, it flashes an alert

message in the monitor window to signal you to the condition. After addressing an alert, press theAlarm Silence/Reset button to clear the alert.

Alarms

APNEA Alarm

Cause

The elapsed time between inspiratory starts has exceeded the current apnea interval. The elapsed timeis measured from the start of one inspiration to the start of the next, regardless of breath type (machine,

assist, or patient).

Ventilator Response

The ventilator:

Switches to Apnea Backup ventilation, which is delivered in the Assist/Control mode.

Sounds the audible alarm.

Displays APNEA xx BPM in the alarm window, where xx is the apnea ventilation breath rate.


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Resets the breath rate to 12 bpm if the set rate is less than 12 bpm.

Highlights the controls used for breaths given during Apnea Backup ventilation.

Note

You cannot switch modes when t

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