Infant Flow

SiPAP comprehensive
quick guide
 Table of contents

Section 1: Circuit setup.................................. 1 Soft key operation.................................. 13–14

Open bed and isolette..................................... 2 Operational modes................................. 15–16
Abdominal sensor........................................... 3 Alarm Set/Confirm screen............................. 17
Pressure Nomogram for Mode Select screen....................................... 18
Infant Flow LP generator............................. 4 Parameter Adjust screen............................... 19
Alarm test................................................... 5–6 Incompatible settings............................... 20
Two point oxygen calibration...................... 7–8 Main screen.................................................. 21
Disabling oxygen sensor.................................. 9 Monitored Parameter screen......................... 22
Startup menu and leak test..................... 10–11 Alarm management...................................... 23
Section 2: Operation.................................... 12 Final check and routine inspection................ 24
Infant Flow SiPAP front panel........................ 12 Troubleshooting............................................ 25

i
Section 1: Circuit setup
WARNING:

• Do not attach generator to

patient until verification and Infant Flow
SiPAP

NCPAP/ Pres High

initial setup are complete.

Pres Low
L/min L/min

14 50 60
70
5
40 80
12
30 90
4
10
8 21 100

3
6

4
2
2
1

CAUTION: XDCR PPROX

• Follow manufacturer’s
instructions for setup and
operation of humidifier.

OPTIONAL:

• Use transducer interface

for Apnea and Low Breath
Rate alarm, and BiPhasic
Tr mode (Intl only).

1
Open bed or crib Isolette

Use extension tube with isolette.

Remove extension tube if excessive
condensation occurs.

2
Abdominal sensor

1. Connect transducer to driver.

2. Connect respiratory sensor to transducer.

3. Compress the sensor gently; LED on the transducer illuminates.

4. Apply the sensor to the infant:

a. Pressure line perpendicular to tape.

b. Place between the umbilicus

and xiphisternum.

c. Alternative placement—the side

of the abdomen.

5. Verify correct placement. Transducer LED illuminates on expiration, and front panel
LED on inspiration.

OPTIONAL:

• Use transducer interface for Apnea detection and BiPhasic Tr mode.

3
Pressure Nomogram for Infant Flow System

The Infant Flow SiPAP system is subject to a direct relationship between the controlled gas flow
and airway pressure. For example, 8 to 9 LPM gas flow provides approximately 5 cmH2O.
15.0

13.0

11.0

9.0
(cmH2O)

7.0

5.0

3.0

1.0

4.0 6.0 8.0 10.0 12.0 14.0 16.0 18.0

(LPM)

Flow pressure nomogram for SiPAP when used with

the Infant Flow LP or AirLife ® variable-flow generator.

4
Alarm test

WARNING:
Alarm test initial settings
Prior to patient application, ensure that all User Air supply > 30 psig (2.1 bar)
Verification testing and calibration procedures are O2 supply > 30 psig (2.1 bar)
successfully completed. User Verification testing and Infant Flow LP generator/circuit
calibration procedures must be done off the patient. nCPAP/press low 9 LPM

1. Connect air and O2 gas supply. Connect %O2 30%

power cord to AC outlet. Attach patient Press high flow 3 LPM

circuit, generator and patient interface. Mode nCPAP

Occlude the opening to the patient. Use settings below for step 9
Rate 30 bpm
2. Power up the driver and allow Power On
Check to complete. Ti 0.3 sec

Apnea/LBR interval 20 sec

3. From nCPAP mode, with alarms set, remove
occlusion from opening to the patient. Low
pressure alarm activates. Restore the occlusion
and reset the alarms.

5
Alarm test (continued)

4. Adjust the nCPAP/pres low flow meter to 11 LPM. The high airway pressure alarm activates.
Decrease flow to 8 LPM. Reset the alarms.

5. Adjust the %O2 control to 35%. The High %O2 alarm activates. Return the O2 setting to
30%. Reset alarms.

6. Adjust the %O2 to 25%. The Low %O2 alarm activates. Return the O2 setting to 30%. Reset
the alarms.

7. Disconnect the AC power cord from the wall outlet. The Loss AC alarm activates. Reconnect
the AC power cord. Reset alarms.

8. Occlude exhalation line and increase nCPAP pressure to 11 cmH2O. The High Circuit pressure
alarm activates. Decrease flow to 8 LPM and reset alarms.

9. Select and confirm BiPhasic mode. Change the mandatory rate control setting to 1. Low
Breath rate alarm activates after the default interval of 20 seconds. Return to a rate of 30.
Reset the alarms.

6
Two point oxygen calibration

1. Adjust flow meters and turn on driver.

2. Press the Tool button in the Setup screen.

3. Adjust the Oxygen Control to 21%:

a. Press the flashing button to confirm.

b. Allow reading to stabilize.

c. A check mark appears, and %O2 display should

read 21%.

4. Adjust the Oxygen Control to 100%:

a. Press the flashing button to confirm.

b. Allow reading to stabilize.

c. A check mark appears, and %O2 display should

read 100%.

5. Press Exit button.

7
Two point oxygen calibration (continued)

NOTE:

• If calibration fails, a red “X” is displayed, the alarm

sounds and an Error code is displayed; repeat the
calibration procedure.

• Two point calibrations are required with initial setup

and circuit changes.

8
Disable oxygen sensor

Disable O2 button

1. From Setup screen, press the calibration

(CAL) button.

2. Press the O2 Disable button:

a. Oxygen monitoring and the

audible oxygen alarms are disabled.

b. Error Code 55 is displayed.

3. Use an external oxygen analyzer to monitor FiO2.

WARNING

• Always use an external oxygen monitor if the

oxygen sensor is disabled.

9
Startup menu and leak test

1. Connect prong or mask to generator; occlude

opening to patient.

2. Set nCPAP flow to 9 LPM and press high flow

to 3 LPM.

3. Switch on the driver.

4. Verify measured pressure is 5 ±1% if less than

5 cmH2O is displayed.

5. Touch flashing icon to confirm.

6. Adjust O2% dial to desired setting. Verify

measured value is within 3%.

7. Touch flashing icon to confirm.

8. Adjust high flow as desired and

verify setting.

10
Startup menu and leak test (continued)

9. Touch flashing icon to confirm.

10. Connect transducer assembly to the traducer

interface connector on the front of the Infant
Flow SiPAP, if desired. Touch flashing icon to
confirm. A red “X” indicates the transducer
assembly is not connected.

11. Touch nCPAP or Alarm Mute/Reset button

to set alarms.

12. Measured CPAP should be 5 cmH2O. If not,

check for leaks.

13. Remove occlusion to prongs or mask. Measured

CPAP should drop to 0 to 2 cmH2O. If not, check
for occlusions.

11
Section 2: Operation
Infant Flow SiPAP front panel A B C

A. Power LED
XDCR

B. Alarm warning bar

C. Transducer interface LED D

D. LCD touch screen

E. %O2 control
Infant Flow®
SiPAP
F. Press High flow meter
NCPAP/
Press Low Press High

G. Connection proximal pressure line L/min L/min

50 60 70

H. Transducer interface connection 40 80

30 90
E
J 21 100
I. Circuit connection inspiratory limb
F
J. nCPAP/Press Low flow meter
I
H G
PPROX
XDCR

12
Soft key operation

Description Example
A button that is enabled.

A button that is inhibited due to non-availability of the designated feature or pending

acknowledgement of an active alarm condition.

A selected mode or control pending confirmation that is visually highlighted and intermittently
flashes between yellow and white text.

While a button is pressed, the edges are highlighted to provide a pressed appearance.

13
Soft key operation (continued)

Description Example
When there is an active alarm associated with a measured value, the measured value concerned
is displayed with RED FLASHING text. The associated limit value (if any) is displayed in RED.

When an alarm associated with a measured value is resolved, the device remains in a LOW priority
alarm state, with the measured value displayed in YELLOW FLASHING text and the associated limit
displayed in YELLOW, until the alarms are cleared by the operator.

Manual Breath delivers a single BiPhasic cycle at current settings for T-High, Press High and %O2.
Only one BiPhasic cycle is delivered regardless of button press duration.

If no screen interactions occur for a period of 120 seconds and there are no active alarms, the
screen goes to a “locked” state to prevent inadvertent entries. To lock the screen, press the screen
lock button.

14
Operational modes

CPAP is a constant single level of positive

pressure to the infant’s airway, facilitating the
restoration of functional residual capacity and
correction of hypoxemia.

BiPhasic is two levels of pressures, delivered

based on set Time High (T-High) criteria,
rate and pressure settings. Small incremental
pressure increases of 2 to 3 cmH2O augment
functional residual capacity and can off-load
work of breathing.

15
Operational modes (continued)

BiPhasic tr enables patient-triggered pressure

assists via a respiratory abdominal sensor, with
breath rate monitoring, adjustable Apnea time
interval, Apnea alarm and adjustable Apnea backup
rate. This enables respiratory support without the
need of an endotracheal tube (ET tube).

Apnea detection is via a respiratory abdominal

sensor. The Apnea alarm will be triggered when
the set time interval is exceeded. If the infant
breath is detected within the next time out
period, the alarm will silence.

16
Alarm set/confirm screen

1. Touch the nCPAP or Alarm button for

3 seconds to set the alarm limits. If neither
button is touched within 2 minutes,
the alarm limits will automatically set.

2. The Mode Select screen will display with

the driver operating in nCPAP mode.

17
Mode Select screen

1. Press the desired mode button. The

display will change to the Parameter
Adjust screen.

NOTE:
• Only the available modes will be
displayed on the menu bar.
• For Apnea and Biphasic trigger (tr)*
modes, attach the transducer assembly
and respiratory abdominal sensor.

18
Parameter Adjust screen

1. Press the desired parameter button to change.

Only the relevant controls are visible. The
selected parameter and associated numeric
display are highlighted in yellow.
2. Use the up and down arrow buttons to adjust
the setting.
3. Confirm the change by pressing the parameter
button. If no action is taken, the new
parameter will automatically take effect after
15 seconds.

NOTE:
• Parameter changes can be made during initial
setup and normal operation.

19
Incompatible settings

• When one parameter (A) change is incompatible with another parameter (B), the software
will automatically make an adjustment to that parameter (B).
• If the adjusted parameter (A) is restored in less than 15 seconds, the parameter (B) change
is reversed.
• When parameter adjustments cause a reduction in
another parameter to maintain requirements for
minimum breath interval, the reduced parameter
is displayed in red for 15 seconds.

EXAMPLE:
• BiPhasic mode with T-High = 2.0 seconds: As rate is increased above 28 breaths per minute,
the constraint on minimum T-Low requires a reduction in T-High. If rate is increased to 29,
then T-High will automatically reduce to 1.9 seconds. If rate is reduced back to 28 within
15 seconds, the previous T-High setting (2.0 sec) is restored.

NOTE:
• T-High automatically reduces to maintain a minimum T-Low of 100 milliseconds.

20
Main screen

• The Main screen displays current mode of

operation alarm status, battery charge status,
monitored parameters and pressure time
graphic display.
• Only the active parameters for the selected
mode are available for adjustment.
• With breath monitoring active, spontaneous
breaths are indicated in yellow below delivered
the airway pressure graph.
• Press the Change Screen button to access
the Monitored Parameter screen.

21
Monitored Parameter screen

1. The Monitored Parameter screen displays

measured values and parameter settings
for all BiPhasic modes.
2. Active parameters are available
for adjustment.
3. Press the Change Screen button to return
to the Main screen.

22
Alarm management

Audible alarm priority

• High priority: A series of 10 tones every
10 seconds, flashing red
• Medium priority: Three audible tones
every 15 seconds, flashing yellow
• Low priority: Two audible tones every
30 seconds, solid yellow

Silencing audible alarms

Press the Alarm Reset button to silence
active alarms for up to 30 seconds. A new
high priority alarm condition will cancel the
alarm silence.

Resetting alarms
Press the Alarm Reset button for 3 seconds
to clear resolved and low priority alarms and
to reset alarm limits.

23
Final check and routine inspection
Inspect the system at least every 3 to 4 hours to:

• Ensure the patient is receiving the prescribed level of CPAP.

• Ensure the generator is stable, secure and not pulling upward on the nose.

• Check for deformation or irritation to the nose or surrounding tissue.

• Ensure the patient’s septum is clearly visible when using prongs.

• Ensure the patient’s eyes are clearly visible and the nares are not blocked, when using masks.

• Inspect the fixation device and straps for proper tension and adjust as needed to maintain
a proper fit.

• Monitor the patient for gastric insufflation and abdominal distension.

• Monitor for excessive condensation in circuit and generator.

24
Troubleshooting

Alarm Priority Possible cause Potential actions

%O2 < 18% High O2 CAL required Reset FiO2 above limit, O2 CAL

%O2 > 104% High O2 CAL required Reset FiO2 below limit, O2 CAL

High %O2 High %O2 setting changed, supply gas Correct FiO2, reset alarm limits
failure, water trap overflow

Low %O2 High Blender setting changed, supply gas Correct FiO2, reset alarm limits
failure, water trap overflow

Over pressure High Flow rate set too high, occlusion of Check exhaust tube/filter, reduce flow
exhalation limb, blocked silencer/filter rate, reset alarm limits

Low battery Warning Battery charge status change Connect to AC

Low battery voltage Medium Battery disconnect, fails to hold charge Connect to AC

Loss AC High AC power disconnected Connect to AC

High nCPAP/ High Setting change, circuit disconnect Reset alarm limits
press low

Low nCPAP/ High Setting change, circuit disconnect, leak Reset alarm limits, check for leaks
press low

High BiPhasic pressure High Press high setting change, Reset alarm limits
circuit disconnect

25
 WARNING—U.S. Federal Law restricts this device to sale by or on the order of a physician.

CareFusion
22745 Savi Ranch Parkway
Yorba Linda, CA 92887
800.231.2466 toll-free
714.283.2228 tel
714.283.8493 fax

carefusion.com
© 2015 CareFusion Corporation or one of its subsidiaries. All rights reserved. AirLife, Infant Flow, CareFusion and the CareFusion logo
are trademarks or registered trademarks of CareFusion Corporation or one of its subsidiaries. RC4684 (0215/500) L3416 Rev. C