MACS CPAP System

1. MACS CPAP System Self Guided Tour

2. Program Objectives This program is a self guided tour of the MACS CPAP System. At the end of this tour you will be able to: • Describe the main operating features of MACS • Identify the controls and connections • Describe the patient breathing circuit • Set-upMACS for patient operation • Define various clinical environments for CPAP application • Clean and maintain the MACS

3. Features and Controls – Rear Panel Driving Gas Input • Connection for 55 psi (3.8 bar) oxygen source gas • Always use a high flow gas source (pressure take-off) that can provide 55 + 15 psi pressure at a minimum of 40 L/min

4. Features and Controls – Rear Panel Air Entrainment • Ambient air is entrained for internal gas mixing • External housing contains air filter • Air filter replacement is part of the preventative maintenance

5. Features and Controls – Front Panel CPAP Control • Adjusts the CPAP from 0 to 20 cm H2O • Automatic sensitivity • Flow adjusts automatically to meet patient demand up to 140 L/min • Oxygen concentration is maintained at set % Oxygen control

6. Features and Controls – Front Panel % Oxygen Control • Delivered oxygen choice • 65% • 100% • Sets the spontaneous breath oxygen concentration

7. Features and Controls – Front Panel Pressure Gauge • Shows pressure in patient circuit at the output of MACS • Compare with control setting to insure proper operation • Gives an indication of patient effort

8. Features and Controls – Front Panel Circuit Connection 1 • Connection for the large bore hose of the patient circuit

9. Features and Controls – Front Panel Circuit Connection 2 • Patient circuit small hose connection • Connects to the expiratory valve on the patient circuit

10. Patient Breathing Circuit Patient circuit is a single limb system • Both hoses attach to the front of MACS • Patient end connects for clinical intervention • Directly to an endotracheal tube (invasive) • Face mask (noninvasive)

11. Patient Breathing Circuit Use only Airon Corporation patient circuits • Calibration of the CPAP control is based upon the Airon patient circuit • Using other manufacturers circuits may cause • errors in pressure delivery • high expiratory flow resistance • interference with CPAP sensitivity • increased oxygen usage

12. Patient Breathing Circuit Accessories to optimize patient care • In-line medication nebulizer • Fits between the mask and patient circuit • Nebulizer can be removed to add medication while maintaining pressure • CO2 monitoring • For In-line sampling place the Tee between the mask and circuit • Or use the nasal prongs under the mask • Expiratory bacteria / viral filter can be added using the 90 degree expiratory port elbow

13. Program Objectives MACS CPAP System self guided tour, objectives completed so far: • Describe the main operating features of MACS • Identify the controls and connections • Describe the patient breathing circuit With an understanding of MACS’s capabilities, let’s look at patient application.

14. Patient Application Initial Set-up • Attach Airon patient circuit to MACS • Attach a high pressure oxygen hose to the rear of MACS • Attach the other end of the high pressure hose to the oxygen source

15. Patient Application Set % Oxygen Control • Set % Oxygen control to the desired oxygen level • All breaths receive set oxygen level + 10% • Oxygen tank time almost doubles with 65% setting • Caution - with rapid, large tidal volumes on 100% oxygen, the actual delivered percentage may be less than 100%

16. Patient Application Start CPAP • Turn on oxygen source • Attach patient breathing circuit to the patient using either a mask or endotracheal tube • Adjust the CPAP control to the level desired • If the patient is not attached to the circuit, or there is a large leak, a high flow of gas will occur

17. Patient Application Monitor patient • Assess per your protocol • patient breathing rate • comfort • oxygenation • CO2

18. Clinical Issues Let’s look at various clinical environments for CPAP application • Using CPAP • Pediatric support • Medication nebulization • CO2 monitoring • Altitude operation

19. Clinical Issues Using CPAP • Used on spontaneous breathing patients in respiratory failure including • Congestive Heart Failure (CHF) • COPD and Asthma • Near Drowning • CO poisoning • Set CPAP level as needed • Can be used with mask or ET-Tube

20. Clinical Issues Pediatric Support • MACS is safe for pediatric - adult patients • Use the lowest possible settings • Monitor closely for patient synchrony

21. Clinical Issues Providing nebulized medications • A medication nebulizer may be placed between the patient connection and the patient • Patient will inhale medication during every breath and exhale back out through patient circuit • Expiratory filter may be added for personnel safety

22. Clinical Issues CO2 Monitoring • Any type of CO2 analyzer may be used • With in-line style analyzers place the sensor Tee between the patient circuit connection and the patient • With sidestream analyzers place the nasal prong sampling tube under the face mask

23. Clinical Issues Altitude Operation • MACS can be used for air transports in unpressurized cabins up to 15,000 feet • Pressure settings will not change as altitude changes

24. Patient Safety Patient Safety Features • Internal Safety Pressure Release – limits circuit pressure to 40 cm H2O • Anti-Suffocation System – in the event of device malfunction, an internal valve will allow ambient air to enter the patient circuit

25. Cleaning and Maintenance • Clean MACS between patients using a soft cloth and a mild detergent / disinfectant • Do not immerse MACS in water • Disposable patient circuit is for single use application and should not be cleaned, disinfected or reused • MACS should receive preventative maintenance every 2 years

26. Program Objectives MACS CPAP System self guided tour completed; you should now be able to: • Describe the main operating features of MACS • Identify the controls and connections • Describe the patient breathing circuit • Set-up MACS for patient operation • Define various clinical environments for CPAP application • Clean and maintain MACS Next Step – consider reviewing the MACS Case Study and completing the competency evaluation

27. Contact Information Thank you for you interest in the MACS CPAP System For more information visit www.AironUSA.com or call Airon Corporation at: 1-321-821-9433 1-888-448-1238 (toll free North America)