Ulco Integrus PSV Troubleshooting

• First make sure that your device is up to date on routine services. To do so, see section 4.6.
• Check that the 5 IEC outlets are properly connected internally on the device. They can be clearly seen after removing the rear cover. Then check to make sure the one IEC outlet is mounted in the side strip of the machine for use in powering vaporisers. For further detail, see section 2.17.
• Ulco equipment is to be used only in rooms where the mains power is equivalent to that of a typical commercial or hospital environment.
• Ulco recommends that the unit be connected to a suitable mains supply when on STANDBY to ensure that maximum in-use life is obtained. The life of the main supply battery is typically two years in service. The unit will automatically switch off if the battery is too low to ensure reliable operation.
• For Electromagnetic Emissions concerns, see section 9.2.

Pressure limiting 67 cmH2O (pressure limiting valve)

PEEP 2 cmH2O (Auto PEEP), 4 – 30 cmH2O

Max set working pressure 60 cmH2O

1. Disconnect the wall supply hoses from the wall outlets
2. Install Oxygen cylinder and turn cylinder outlet to the on position
3. Check that the oxygen cylinder gauge on the front of the machine shows a pressure greater than 700 kPa
4. Close the oxygen cylinder outlet and check that the pressure on the gauge does not drop. This would indicate a leak in the oxygen supply line
5. Repeat steps 2 -4 for each of the nitrous oxide and air cylinder supplies
6. Reconnect the wall supply hoses
7. Check that each of the supply gases show pressures of 400 – 415 kPa
8. To confirm that pipeline gas supplies are not crossed, use a multi-gas analyser to check gas composition at the common gas outlet, for each of the oxygen, nitrous oxide and air outlets in turn

• 5.3.1 Drive Gas Pressure Sensor Calibration
• 5.3.2 Drive Flow Sensor Calibration
• 5.3.3 Flow Valve Profile Calibration
• 5.3.4 Pressure Sensor Calibration
• 5.3.5 Commit New Calibration File

Can be caused by two things—an issue with tubes or an issue with valves

• Steps to help prevent leaking here (see section 2.14)
• Steps for testing and fixing leaks in tubes here (see sections 3.1.2.2.2 through 3.1.2.2.5)

• Steps for testing and fixing leaks in valves here (see section 7.6)

• While in use on a patient, it is important to do a final check to make sure there are no leaks. To do so, set a fresh gas flow of 300 ml/min and ensure that the pressure rises to >30 cm H2O from zero.
• Bodok seals must be examined and replaced if necessary every time the cylinders are replaced.
• All seals on high pressure components such as the first stage regulators must be lightly greased with Krytox or similar  grease  certified  safe  for  use  in  high  pressure  oxygen  environments.  Low  pressure  components  in the patient airway may use standard silicone greases.
• Make sure that all equipment used has been designed or supplied by Ulco.

An alarm message is displayed at the top of the screen in red. The message will stay displayed until the problem is fixed. All alarms can be silenced by pressing the “Mute” softkey.

Low priority alarm. This alarm is triggered if the AC mains are lost. Ventilator automatically switches to battery power. Check to make sure the power cord for the ventilator is plugged into the outlet.

High priority alarm. This alarm is triggered when the battery voltage falls below a critical level. Try:

• Plug ventilator into main AC power
• See Battery Replacement Guide ++here++ in section 6.4.4

High priority alarm. Alarm is triggered when there is no pressure to drive supply oxygen to the patient. Check to make sure a PEEP pressure exists and that the absorber is working. In case of emergency, switch to use the CBS manually. This can be done by:

1. Find the switch on top of the absorber assembly
2. Flip the switch from “Ventilator” to “Bag”

High priority alarm. This alarm is triggered if the airway pressure exceeds 15 cmH2O during the expiration phase. Check the patient and check for leaks or loose tubes.

This is a medium priority alarm. This alarm is triggered due to pressure concerns in the airway. This is caused by a leak or a loose tube so see the troubleshooting section on leaks.

This is a low priority alarm. It is triggered when the pressure in the air flow pathway is too low. Check on the patient first and then check for loose tubes or leaks.

This is a low priority alarm. Triggered when the ventilator is in Standby state, which means it is not cycling. This means the ventilator is not running. To fix this, select either automatic or manual cycling by finding the switch on top of the absorber.

Electrical failure within the ventilator. Check all power supply and the battery. In case of assistance, call a medical technician.

See section 5 of the service manual ++here++ to look at all calibration procedures.

See “Calibrating the patient flow sensor” in section 5.5 ++here++

These are low priority alarms. Triggered when the expired volume threshold has been breached. To fix this problem, either change the range of the threshold or disable the threshold alarms.

These are low priority alarms. Triggered when the threshold for minute volume has been breached. To fix this problem, either change the range of the threshold or disable the threshold alarms.

This is a medium priority alarm. This alarm is triggered if the maximum airway pressure during inspiration remains below the alarm threshold. To fix this, adjust the threshold range accordingly for each patient.

This is a high priority alarm. This alarm is triggered if the airway pressure exceeds the pressure alarm threshold. Check the patient. The ventilator should respond to this alarm by automatically cycling into expiration. If the pressure rises above 60 cmH2O, the ventilator will stop cycling. If the pressure rises above 67 cmH2O, a mechanical valve will operate to limit the pressure

++See section 7++. Pages 69-80 details how to fully clean the ventilator.