How to use the Ventilator

The MOVES® SLC™ can be used on intubated patients and on spontaneously breathing patients. The intubated patient will be connected to a ventilator breathing circuit, while the spontaneously breathing patient may receive supplemental oxygen via a nasal cannula (nasal prongs) or oxygen mask.

Connecting an Intubated Patient

  1. Ensure that the ventilator cartridge and breathing circuit have been connected to MOVES® SLC™.
  2. Ensure startup test procedures have been completed and all tests passed. (Described in How to operate the MOVES® SLC™)
  3. Configure MOVES® SLC™ to operate in Ventilate mode. (Described in The MOVES® SLC™ Interface)
  4. Attach the elbow to the patient’s endotracheal tube.

Ventilator Cartridge and Breathing Circuit

The ventilator cartridge is intended to be used with the MOVES® SLC™ system to provide positive pressure ventilation for patients who are intubated. MOVES® SLC™ recycles exhaled oxygen. This cartridge is made of CO2 absorbent material to remove CO2 from any re-breathed gas. Because this material has a shelf life, there is an expiry date printed on the cartridge. Always check the expiry date on the ventilator cartridge before using to make sure the cartridge has not expired. As well, monitor your supply of spare cartridges with regard to their remaining “shelf life”. The ventilator cartridge should be kept in its packaging until use.

The ventilator cartridge is:

  • For use with the ventilator breathing circuit, which includes the ventilator hoses, patient filter, endotracheal tube connector, and sampling line.
  • For single patient use only. The cartridge should be discarded and replaced between patients and when MOVES® SLC™ triggers an audible or visual alarm indicating that the level of CO2 in the system is above 6 mmHg on inspiration.
  • Remove the ventilator cartridge after use, and absorb any excess liquid from the cartridge chamber. Do not store the ventilator cartridge inside of MOVES® SLC™ when the device is not in use, even between operating on different patients.

Note: do not remove the clear plastic banding around the ventilator cartridge.

Installing the Ventilator Cartridge

1. Lift the cartridge door lock/release latch to the vertical position.

2. Open the cartridge door by pulling it forward using its plastic handle.

Note: There should always be a Ventilator CO2 Scrubber Liner installed. See Replacing the Ventilator CO2 Scrubber Liner in The MOVES® SLC™ Ventilator section for more information.

3. Insert the cartridge into the cavity as shown. Press hard to ensure it is fully and securely seated.

Note: If you are replacing a used cartridge, use the clear plastic handle indicated in the photo at left to pull it out.

4. Close the door and push it in firmly.

5. Depress the cartridge door lock/release latch. It should close smoothly. If you feel any resistance, the door is not completely closed because the cartridge is not fully inserted. Open the door and push the cartridge in further and try again.

6. In the picture at the right, the latch is fully closed securing the cartridge door and the ventilator cartridge.

Changing the Ventilator Cartridge during operation

If the MOVES® SLC™ alarms are advising the operator to change the ventilator cartridge:

  1. Remove a new ventilator cartridge from packaging prior to making any changes to the system.
  2. Navigate to the Setup menu and change the system mode to Monitor Only to stop ventilation.
  3. Disconnect the water trap from the “from Patient’ port to allow the ventilator cartridge door to open.
  4. Open the ventilator cartridge door and remove the depleted ventilator cartridge.
  5. Insert the new ventilator cartridge, then close and lock the ventilator cartridge door.
  6. Reconnect the water trap to the ventilator cartridge door, and ensure ventilator breathing circuit patient hoses remain connected.
  7. Change the system mode back to Ventilate to immediately resumed patient ventilation.

Installing the Ventilator Breathing Circuit

1. Make sure there is a sample filter connected to the “Y” piece. If there is not, connect one.

Note: This sample filter, which is used to keep the Nafion tubing clean between uses, should be discarded after each use.

2. Connect one end of the Nafion tubing to the sample filter.

3. Connect the other end of the Nafion tubing to the Luer adapter (circled in red), and then the
Luer adapter to one end of the sampling line.

4. Connect the other end of the sampling line (with another sample filter on its end) to the ‘GAS SAMPLE’ port on the patient connections panel. The sample filter should be connected directly to the patient connection panel.

5. Unplug the protective covers from the “Hose to Patient” port and the “Hose from Patient” port on the ventilator cartridge door.

6. Attach the water trap to the “Hose from Patient” port on the ventilator cartridge door.

7. Attach one patient breathing circuit hose to the “Hose to Patient” port on the ventilator cartridge door and the other to the water trap.

Using an External Gas Supply

It is possible to use an External Gas Supply to reach FiO2 above the capacity of the Oxygen Concentrator. It is important to note that External Oxygen Supply is only used for Ventilate Mode. For O2 supplementation, use the oxygen source directly.

1. Locate the O2 Inlet port located on the RIGHT side of the MOVES® SLC™ unit near the Ventilator Driving Gas Inlet.

2. Open the protective cover of the O2 Inlet port (by raising it) to access the O2 Inlet.

3. Attach the External Gas Supply tube to the O2 Inlet nipple.

Please note the following:

  • When using the O2 Inlet, concentrations other that 100% are controlled with an external air/oxygen mixer. No other gasses can be used.
  • MOVES® SLC™ uses an oxygen conserving ventilation system that normally requires less than 1 LPM of oxygen to maintain an FiO2 of 100% to the patient. Therefore, when using the O2 Inlet, gas flows of 1 to 2 LPM can be used to conserve external oxygen tanks, with higher flows used briefly to pre-charge or flush the circuit, or if the desired FiO2 is not being achieved.
  • When using the O2 Inlet, the system should be set to a Vent FiO2 slightly under the external gas mix and NEVER set to Air or Maximum. For example, setting the system to a Vent FiO2 of 85% while applying 100% O2 into the external gas inlet will only run the concentrator if the FiO2 drops to 82%, working as a backup for the external O2 supply.

Connecting a Spontaneously Breathing Patient

  1. Ensure startup test procedures have been completed and all tests passed. (Described in How to operate the MOVES® SLC™)
  2. Attach the O2 sampling adaptor to the MOVES® SLC™ O2 Outlet port.
  3. Attach the sampling line filters and tubing between the O2 sampling adaptor and the Gas Sample port in the Patient Connections panel.
  4. Attach one end of the O2 tubing to the O2 sampling adaptor.
  5. Attach the nasal cannula or mask to the O2 tubing.
  6. Configure MOVES® SLC™ to operate in O2 Supplement mode. (Described in The MOVES® SLC™ Interface)
  7. Attach the nasal cannula or mask to the patient.

Delivering Supplementary Oxygen (O2)

1. Locate the O2 Outlet port located on the LEFT side of the MOVES® SLC™ unit towards the FRONT and beside the Ventilator Driving Gas Inlet.

2. Open the protective cover of the O2 Outlet port (by pulling it up) to access the O2 Outlet.

3. Locate the O2 Outlet Sampling Adaptor

4. Attach the green flexible tubing end of the O2 Outlet Sampling Adaptor to the O2 Outlet by placing it over the outlet and applying downward pressure until the adaptor fits snugly.

5. Attach the Sample Line Filter that is connected to the Nafion tube end of the Sampling Line to the O2 Outlet Sampling Adaptor by fitting it onto the clear, hard-plastic port on the O2 Outlet Sampling Adaptor and rotating it clockwise until it is snug.

6. Attach the Sample Line Filter at the other end of the Sampling Line to the Gas Sample port in the Patient Connections Panel by placing it over the port and rotating the filter clockwise until it is snug.

Note: In both O2 Supplement mode and Ventilate mode, the sample system should be connected from the sample port in the following sequence: filter, sample line, adapter, Nafion tube, filter.

7. Attach one end of the green O2 tube to the metallic outlet on the O2 Outlet Sampling Adaptor by placing it over the metallic outlet and applying downward pressure until the tube end fits snugly. Attach the other end of the O2 tube to the nasal cannula or mask.

8. On the Setup screen, set the system to run in O2 Supplement mode.

NOTE: In O2 Supplement mode, the Vent O2 setting (under CONCENTRATOR) is grayed out, indicating that it (and its value) does not apply in O2 Supplement mode. As mentioned above, the concentrator provides 2.5 LPM of >87% O2 directly to the patient.

9. When you switch to O2 Supplement mode, a confirmation message is displayed to ensure that this switch is intentional. User input is required (choose NO or YES) in order to proceed.

10. Attach the O2 Mask line or the Nasal Cannula line to remaining available end of the fire suppression device.