Neopuff Infant Resuscitator User Manual Compress

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Neopuff Infant

Resuscitator User Manual

Purpose
The purpose of the Neopuff TM Infant Resuscitator User
Manual is to enable the user to set up, test, and use the
Infant T-piece Resuscitator (900 series). The device is
used in urgent situations; therefore, it is necessary for
medical personnel to have previous training in order to
have confidence in their ability to complete these tasks.
The device is designed to be used on infants with a
maximum weight of 10kg.
A Quick Set Up and Operation Card from the Appen-
dix can be printed and laminated in anticipation of
future use.

Users
If you are a respiratory therapist (RT) or medical
doctor (MD), turn to page 1.
If you are a registered nurse (RN) or midwife, turn
to page 9.

Fisher & Paykel Healthcare


Last Updated: 2015
How this Manual is Organized

How this Manual is Organized


The key tasks for this user manual are divided into two
sections based on specialized skills:
• RT/MD
• RN
The Troubleshooting section, Appendix, Glossary and
Index are designed for both user groups. Refer to the Table
of Contents on the next page for more details.

Warnings
Important: Warnings will be identified by this icon.

Please read and understand the instructions fully before


using the Neopuff Infant Resuscitator and accessories. The
device is only to be used by personnel trained in infant
resuscitation. Refer to ILCOR/ERC/OHA/AC guidelines to
determine suitability of the device. (See Glossary.)
The purchaser must ensure that all users of this device
have been adequately trained in resuscitation techniques.
The Neopuff Infant Resuscitator must only be used after
checking that correct pressures will be delivered to the
baby.
Ensure no smoking, naked flames, or sources of ignition
are present when the device is in use.
For connection to flow-regulated oxygen or oxygen/air
mixture only. The allowable input gas flow rate is 5 to 15 L/
min. but the recommended operating flow is 8 L/min.
Never use a flow higher than 15 L/min.
Maximum Pressure Relief can be adjusted up to 80 cmH2O
in exceptional circumstances only. The factory setting is 40
cmH2O.

Use with Fisher & Paykel Healthcare gas lines and accesso-
ries.
An alternative means of resuscitation must be available
(bagging).

Neopuff TM is a trademark of Fisher & Paykel Healthcare.

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Table of Contents
RT/MD - - - - - - - - - - - - - - - - - - - 1
Setting up the Neopuff Infant Resuscitator - - - - - - - - 1
Gathering supplies - - - - - - - - - - - - - - - - - - - - 1
Learning the device features - - - - - - - - - - - - - - - 2
Connecting the device to a gas supply - - - - - - - - - - - 3
Connecting the device to a T-piece circuit - - - - - - - - - - 3
Adjusting pressure settings - - - - - - - - - - - - - - - - 3
Testing the Neopuff Infant Resuscitator - - - - - - - - - 5
Operating the Neopuff Infant Resuscitator - - - - - - - - 6
Fitting an infant mask - - - - - - - - - - - - - - - - - - 6
Connecting the T-piece to a mask or ET tube - - - - - - - - 6
Ventilating the infant- - - - - - - - - - - - - - - - - - - 7

RN - - - - - - - - - - - - - - - - - - - - - 9
Setting up the Neopuff Infant Resuscitator - - - - - - - - 9
Gathering supplies - - - - - - - - - - - - - - - - - - - - 9
Learning the device features - - - - - - - - - - - - - - - 10
Connecting the device to a gas supply - - - - - - - - - - - 10
Connecting the device to a T-piece circuit - - - - - - - - - - 11
Operating the Neopuff Infant Resuscitator - - - - - - - - 11
Fitting an infant mask - - - - - - - - - - - - - - - - - - 11
Connecting the T-piece to a mask or ET tube - - - - - - - - 12
Ventilating the infant- - - - - - - - - - - - - - - - - - - 12
Monitoring and documenting - - - - - - - - - - - - - - - 13

Troubleshooting - - - - - - - - - - - - - - - 15
Achieving an effective mask seal- - - - - - - - - - - - - - 16

Appendix - - - - - - - - - - - - - - - - - - 18
Cleaning procedures - - - - - - - - - - - - - - - - - - - 18

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Ordering supplies - - - - - - - - - - - - - - - - - - - - 18
Quick Set Up and Operation Card - - - - - - - - - - - - - 18
Specifications - - - - - - - - - - - - - - - - - - - - - - 19
Global Contacts - - - - - - - - - - - - - - - - - - - - - 20

Glossary of Acronyms - - - - - - - - - - - - 22

Glossary of Terms - - - - - - - - - - - - - - 23

Index - - - - - - - - - - - - - - - - - - - - 24

References - - - - - - - - - - - - - - - - - 26

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RT/MD

This chapter explains procedures for respiratory


therapists and physicians.
The chapter includes procedures for setting up, testing,
and operating the NeopuffTM Infant Resuscitator.

Setting up the Neopuff Infant Resuscitator


The set up procedure includes:

1. Gathering required supplies

2. Learning the device features

3. Connecting the device to a gas supply

4. Connecting the device to a T-piece circuit

5. Adjusting pressure settings

Gathering supplies
Ensure that you have the following supplies:

• Neopuff Infant Resuscitator

• Green Gas Supply Line and access to gas supply

• T-piece circuit
Setting up the Neopuff Infant Resuscitator

• Infant masks in a selection of different sizes

• Intubation kit (if required)

Learning the device features

Figure 1. Device features

The device has the following features:

• Manometer

• Max Pressure Cover protecting the Max Pressure


Control Knob

• PIP Control Knob

• Gas Outlet Port

• Gas Inlet Port

Note the locations for the Gas Inlet and Outlet Ports for
the next step in the sequence.

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Setting up the Neopuff Infant Resuscitator

Connecting the device to a gas supply


Prior to every use, verify that the manometer reads zero
with no gas flow. If it does not, the device requires
recalibration by a biomedical technician. Contact the
appropriate department in your hospital to have the device
calibrated.
The manometer in Figure 1 shows a zero reading.

To connect the device to a gas supply:

Step 1. Locate the Gas Inlet Port on the device.


Step 2. Slide the connector on the gas supply line
firmly over the port.
Step 3. Attach the free end of the gas supply line to
the source of oxygen or oxygen/air blend.

Connecting the device to a T-piece circuit


The Neopuff Infant Resuscitator can be used with Classic
or Ergonomic styled T-pieces.

To connect the device to a T-piece circuit:

Step 1. Locate the Gas Outlet Port on the device.


Step 2. Connect the T-piece circuit to the port.
Step 3. Leave the blue cap in place on the T-piece.

Adjusting pressure settings


Refer to Figure 1 for the locations of the Max Pressure
Cover and the PIP Control Knob.
Adjust the gas supply to the required flow of 5 to 15 L/min.
Ensure the oxygen concentration of your gas supply is
monitored by an oxygen analyzer or preset using oxygen/
air flow rate graphs.
In order to adjust the pressure settings on the device, it is
necessary to follow these steps in sequence:

1. Set the maximum pressure

2. Set the PIP (Peak Inspiratory Pressure)

3. Set the PEEP (Positive End Expiratory Pressure)

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Setting up the Neopuff Infant Resuscitator

To set the Maximum Pressure:

Step 1. Ensure the gas supply is flowing at the


desired rate.
Step 2. Locate the PEEP Cap on the free end of the
T-piece circuit. The aperture can be adjusted
by twisting the cap.
Step 3. Pull the Max Pressure Cover out and pivot
the cover to the left. This will allow access to
the Max Pressure Control Knob.
Step 4. Using your finger or thumb, occlude the PEEP
cap.
Step 5. Turn the PIP Control Knob fully clockwise
until the knob cannot turn anymore.
Step 6. Watch the manometer. Continue to occlude
the PEEP Cap.
Step 7. Turn the Max Pressure Control Knob clock-
wise or counterclockwise to set the desired
maximum pressure.
Step 8. Replace the Max Pressure Cover.
Important: The factory setting for Maximum Pressure Relief is 40 cmH2O.

To set the PIP:

Step 1. Occlude the PEEP Cap with your finger or


thumb.
Step 2. Turn the PIP Control Knob counterclockwise
and, while monitoring the manometer, stop
turning the knob when the desired peak
inspiratory pressure is set.
The typical PIP setting for full-term neonates and infants is
30 cmH2O. In preterm neonates, reduce the PIP to 20-24
cmH2O to avoid lung injury.

To set the PEEP:

Step 1. Locate the PEEP Cap on the free end of the T-


piece circuit.
Step 2. Ensure the PEEP Cap is NOT occluded.
Step 3. Turn the Cap clockwise or counterclockwise
to adjust the aperture. Using the manometer
to monitor the pressure, adjust the aperture

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Testing the Neopuff Infant Resuscitator

smaller for a higher PEEP and larger for a


lower PEEP.
Step 4. Turn off the gas supply if immediate use is
not required.
A typical PEEP setting for neonates and infants is 5 cmH2O.

Testing the Neopuff Infant Resuscitator


A test lung can be used to confirm the pressures obtained
during the set up procedure.
Prior to 2012, the test lungs included with the device were
black in colour and contained latex.
Important: Latex can cause severe allergic reactions in some people.

Newer test lungs are manufactured from silicon and


contain no latex.

To test the Neopuff Infant Resuscitator:

Step 1. Ensure the gas supply is set to the desired


flow rate.
Step 2. Ensure the test lung has no obvious signs of
damage such as discolouration or holes.
Step 3. Remove the blue cap from the T-Piece.
Step 4. Slide the plastic connector of the test lung
into the T-piece.
Step 5. Alternate occluding and unblocking the PEEP
Cap with your thumb or finger. Mimic the
rhythm of the inspiratory and expiratory
phases of the respiratory cycle.
Step 6. Monitor the manometer to ensure you are
achieving the desired PIP and PEEP. If not,
adjust the settings according to the instruc-
tions on page 4 and 5.
Step 7. Turn off the gas flow when you are complete.
Step 8. Remove the test lung with plastic connector
and replace the blue cap on the T-piece.
Important: Always remove the test lung when you are complete.
Attempting to operate the device without doing so can cause unaccept-
able treatment delay.

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Operating the Neopuff Infant Resuscitator

Operating the Neopuff Infant Resuscitator


The Neopuff Infant Resuscitator can be used to resuscitate
infants who are intubated or require noninvasive positive
pressure ventilation.
Operating procedures include:

• Fitting an infant mask


• Connecting the T-piece to the mask or endotracheal
tube

• Ventilating the infant

Fitting an infant mask


If your patient is intubated, skip to the next section.
Infant masks come in sizes ranging from 35 to 72mm in
diameter. They are latex-free and designed for single
patient use.
Select the most appropriate mask size to ensure the nose
and mouth of the infant are fully covered. Avoid any gaps
between the mask and the skin. This will help to create a
complete seal during the resuscitation procedure.

Connecting the T-piece to a mask or ET tube


The T-piece of the circuit is designed to be compatible with
either the infant mask or an endotracheal tube.

To connect the T-piece:

Step 1. Ensure the gas is flowing at the desired rate.


Step 2. Remove the blue cap from the T-piece.
Step 3. Insert the mask connector into the T-piece by
twisting, or, slide the T-piece firmly down
onto the connector of the ET tube.

Ventilating the infant


The Neopuff Infant Resuscitator provides a system to
provide optimal pressures and the ability to monitor those
pressures during infant resuscitation. However, it does not
provide automatic cycles of inspiratory and expiratory
phases like other mechanical ventilators. The user

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Operating the Neopuff Infant Resuscitator

manually creates the cycle by alternately occluding and


unblocking the PEEP Cap.

To ventilate the infant:

Step 1. Occlude the PEEP Cap with your finger or


thumb to provide the inspiratory phase of the
cycle.
Step 2. Unblock the PEEP Cap to provide the expi-
ratory phase of the cycle.
If you are using an infant mask, you must hold the mask in
position against the infant’s face while performing this
procedure. If you are having difficulty achieving an
effective mask seal, refer to page 16.
Infant respiratory rates normally vary from 30 to 60 per
minute. This means completing the cycle of occluding and
unblocking the PEEP cap every 1 to 2 seconds. The target
rate for neonatal resuscitation is 40-60 respirations per
minute. Room air (O2 21%) is the standard starting
concentration for resuscitation of term or preterm
neonates. Guidelines for very premature neonates are less
clear. Pulse oximetry should be used to measure
oxygenation in all neonates and infants, and guide the
physician or respiratory therapist in adjusting the oxygen
concentration.
Ensure you follow Neonatal Advanced Life Support (NALS)
or Pediatric Advanced Life Support (PALS) guidelines to
provide optimal ventilation.
The ventilation procedure must be continued until the
resuscitation is complete or the infant’s respirations are
maintained by a mechanical ventilator.

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Operating the Neopuff Infant Resuscitator

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RN

This chapter explains the following procedures for


registered nurses and midwives:

• Setting up the NeopuffTM Infant Resuscitator

• Operating the Neopuff Infant Resuscitator

Setting up the Neopuff Infant Resuscitator


The set up procedure includes:

1. Gathering required supplies

2. Learning the device features

3. Connecting the device to a gas supply

4. Connecting the device to a T-piece circuit

Gathering supplies
Ensure that you have the following supplies:

• Neopuff Infant Resuscitator

• Green Gas Supply Line and access to gas supply

• T-piece circuit

• Infant masks in a selection of different sizes


Setting up the Neopuff Infant Resuscitator

• Intubation kit (if required)

Learning the device features

Figure 2. Device features

The device has the following features which are important


to the set up procedure:

• Manometer

• Gas Inlet Port

• Gas Outlet Port

Connecting the device to a gas supply


Prior to every use, verify that the manometer reads zero
with no gas flow. If it does not, the device requires
recalibration by a biomedical technician. Contact the
appropriate department in your hospital to have the device
calibrated.
The manometer in Figure 2 shows a zero reading.

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Operating the Neopuff Infant Resuscitator

To connect the device to a gas supply:

Step 1. Locate the Gas Inlet Port on the device.


Step 2. Slide the connector on the gas supply line
firmly over the port.
Step 3. Attach the free end of the gas supply line to
the source of oxygen or oxygen/air blend.

Connecting the device to a T-piece circuit


The Neopuff Infant Resuscitator can be used with Classic
or Ergonomic styled T-pieces as shown in Figure 3.

To connect the device to a T-piece circuit:

Step 1. Locate the Gas Outlet Port on the device.


Step 2. Connect the T-piece circuit to the port.
Step 3. Leave the blue cap in place on the T-piece.
The set up procedure is now complete. The device is ready
for pressures to be adjusted and set by the respiratory
therapist or physician.

Figure 3. T-pieces
If you are a nurse or midwife who works in a remote
location without the support of a respiratory therapist, you
may wish to review the RT/MD procedures on page 1.
Ensure that you have current NRP (Neonatal Resuscitation
Program) training and are comfortable with full set up and
operation of the device.

Operating the Neopuff Infant Resuscitator


The Neopuff Infant Resuscitator can be used to resuscitate
infants who are intubated or require noninvasive positive
pressure ventilation.
Operating procedures include:

• Fitting an infant mask

• Connecting the T-piece to the mask or endotracheal


tube

• Ventilating the infant

Fitting an infant mask


If your patient is intubated, skip to the next section.

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Operating the Neopuff Infant Resuscitator

Infant masks come in sizes ranging from 35 to 72mm in


diameter. They are latex-free and designed for single
patient use.
Select the most appropriate mask size to ensure the nose
and mouth of the infant are fully covered. Avoid any gaps
between the mask and the skin. This will help to create a
complete seal during the resuscitation procedure.

Connecting the T-piece to a mask or ET tube


The T-piece of the circuit is designed to be compatible with
either the infant mask or an endotracheal tube (ET).

To connect the T-piece:

Step 1. Ensure the gas is flowing at the desired rate.


Important: Allowable gas flow rate is 5 to 15 L/min. but the recommended
rate is 8 L/min.

Step 2. Remove the blue cap from the T-piece.


Step 3. Insert the mask connector into the T-piece by
twisting, or, slide the T-piece firmly down
onto the connector of the ET tube.

Ventilating the infant


The Neopuff Infant Resuscitator provides a system to
provide optimal pressures and the ability to monitor those
pressures during infant resuscitation. However, it does not
provide automatic cycles of inspiratory and expiratory
phases like other mechanical ventilators. The user
manually creates the cycle by alternately occluding and
unblocking the PEEP Cap.

To ventilate the infant:

Step 1. Occlude the PEEP Cap with your finger or


thumb to provide the inspiratory phase of the
cycle.
Step 2. Unblock the PEEP Cap to provide the expi-
ratory phase of the cycle.
If you are using an infant mask, you must hold the mask in
position against the infant’s face while performing this

| 12 | Neopuff Infant Resuscitator 2015


Operating the Neopuff Infant Resuscitator

procedure. If you have difficulty achieving an effective


mask seal, refer to page 16.
Infant respiratory rates normally vary from 30 to 60 per
minute. This means completing the cycle of occluding and
unblocking the PEEP cap every 1 to 2 seconds. The target
rate for neonatal resuscitation is 40-60 respirations per
minute.
Ensure you follow Neonatal Advanced Life Support (NALS)
or Pediatric Advanced Life Support (PALS) guidelines to
provide optimal ventilation.
The ventilation procedure must be continued until the
resuscitation is complete or the infant’s respirations are
maintained by a mechanical ventilator.

Monitoring and documenting


The manometer indicates the pressures achieved during
the inspiratory and expiratory phases of the respiratory
cycle.
Visually check the manometer to confirm these pressures.
Ensure that you document these pressures in your clinical
notes along with ventilation rate and other vital signs.
Important: During a resuscitation, look at the infant, not the manometer!

Effective ventilation is confirmed by three signs:

1. An increase in the heart rate above 100/minute.

2. A slight rise of the chest and upper abdomen with


each inflation.

3. An improvement in oxygenation.

Clinical signs of improvement in the patient are more


important than achieving a set PIP on the manometer.

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Operating the Neopuff Infant Resuscitator

Figure 4. Using the device to ventilate an infant

| 14 | Neopuff Infant Resuscitator 2015


Troubleshooting

I am using the test lung:

Problem Solution

I am unable to achieve the PIP Check that the gas flow rate is set
and PEEP pressures that were to 8 – 10 L/min.
obtained during the set up
Inspect the test lung for signs of
procedure.
damage.
Ensure firm connections between
the gas supply, device, and T-
piece circuit.
Ensure the test lung is firmly
connected to the T-piece.
I am still unable to achieve the Confirm that the manometer
desired PIP & PEEP. registers zero with no gas flow.
Check the maximum pressure
relief is set correctly at 40 cm
H2O.
I am ventilating the infant:

Problem Solution

The infant’s chest and Confirm a good seal between the mask and
upper abdomen are not infant’s face has been achieved (look for a
rising during the pressure of 5 cmH2O after expiration and listen
inspiratory cycle. for a soft whistle of gas through the PEEP Cap).

Achieving an effective mask seal:

1. Position the infant’s head in a neutral position.


2. Place the third finger onto the chin tip (the
“guide finger”).
3. Line up the outer edge of the mask into the
groove between the guide finger and the chin tip.
4. Roll the mask onto the face from the chin
upwards.
5. Holding the mask in place, use the thumb and
index finger to place slight downward pressure on
the mask (“two point top hold”).
6. Apply a jaw lift with the remaining fingers to
create upward pressure.
I am still unable to Reposition the infant’s head and apply the face
achieve the set PIP mask again

I continue to be unable Consider intubation if mask ventilation is


to achieve the set PIP, unsuccessful
or there are no clinical
signs of improvement.

Mask seal technique from http://www.neoresus.org.au/

| 16 | Neopuff Infant Resuscitator 2015


Appendix
Cleaning procedures:
Infant masks and T-piece circuits are designed for single patient use. Do not attempt
to clean and reuse.
The exterior surface of the gas supply line can be wiped with isopropyl alcohol if
required. If your facility reuses gas supply lines, they must be cleaned and sterilized
between patients.
Clean external surfaces of the device with a damp cloth and mild soapy water. Rinse
and dry. You may also wipe the external surfaces with isopropyl alcohol.

Ordering supplies:
A product catalogue is available at
https://www.fphcare.ca/CMSPages/GetFile.aspx?guid=21381be5-6425-
4350-a47d-ee447f7af60e

Quick Set Up and Operation Card

1. Connect gas supply line to source and 9. Replace the Max Pressure Cover.
Gas Inlet Port on device.
2. Connect T-piece circuit to Gas Outlet 10. Adjust the PIP Control Knob to the
Port. desired PIP.
3. Ensure manometer has a zero reading. 11. Take your thumb off the PEEP Cap.
4. Turn on gas supply (5 to 15 L/min.) 12. Adjust the aperture of the PEEP Cap
to set the desired PEEP.
5. Open the Max Pressure Cover. 13. Remove the blue cap from the T-piece.
6. Occlude the PEEP Cap with your 14. Connect the T-piece to the infant mask
thumb. or ET tube.
7. Turn the PIP Control Knob clockwise 15. Occlude the PEEP Cap to provide
until it won’t turn any more. inspiratory cycle.
8. Adjust the Max Pressure Control 16. Unblock the PEEP Cap to provide
Knob to the desired maximum pres- expiratory cycle.
sure.

2015 Neopuff Infant Resuscitator | 18 |


Specifications

| 19 | Neopuff Infant Resuscitator 2015


Global Contacts
For more information, please contact your local Fisher & Paykel Healthcare
representative.

Please visit our website at https://www.fphcare.ca

2015 Neopuff Infant Resuscitator | 20 |


| 21 | Neopuff Infant Resuscitator 2015
Glossary of Acronyms

AC: Accreditation Canada


CPS: Canadian Pediatric Society
ERC: European Resuscitation Council
ET: endotracheal (tube)
ILCOR: International Liaison Committee on Resuscitation
NALS: Neonatal Advanced Life Support
NRP: Neonatal Resuscitation Program
OHA: Ontario Hospital Association
PALS: Pediatric Advanced Life Support
PEEP: Positive End Expiratory Pressure
PIP: Peak Inspiratory Pressure

2015 Neopuff Infant Resuscitator | 22 |


Glossary of Terms

circuit: tubing that connects the resuscitator to the patient


infant: human child from the time of birth to one year of age
manometer: an instrument for measuring the pressure of a gas
neonatal: pertaining to the first four weeks after birth
respiratory cycle: the full sequence of a single breath including the inspiratory
phase, the expiratory phase, and pauses
resuscitation: administering emergency measures to sustain life
ventilation: providing inflation to the lungs to allow exchange of gases between the
environment and the lung tissues

| 23 | Neopuff Infant Resuscitator 2015


Index

A I
adjusting pressure settings 3-5 infant
attaching. See connecting. masks 6, 11
monitoring 13
ventilation 7, 12
C Inlet Port, Gas 2, 10
intubation 16

calibrating. See recalibrating.


circuit, T-piece 6, 11, 12
cleaning procedures 18
L
connecting
to gas supply 3, 10 lung, test 5
to T-piece circuit 3, 11
contacts, global 20
M
D manometer 2, 10
mask
documenting 13 sealing 16
sizes 6, 12
Max Pressure Cover 2, 4
F maximum pressure setting 4
MD 1
midwives 9, 11
features of Neopuff 2, 10 monitoring the infant 13

G O
Gas Inlet Port 2, 10 operating the Neopuff 6, 11
Gas Outlet Port 2, 10 ordering supplies 18
global contacts 20 Outlet Port, Gas 2, 10
glossary 22, 23

P
H
PEEP, adjusting 5
Help. See Troubleshooting. PEEP Cap 4, 5, 12
PIP, adjusting 4
PIP Control Knob 2, 4

2015 Neopuff Infant Resuscitator | 24 |


pressure settings
maximum pressure 4 S
peak inspiratory pressure 4
post expiratory end pressure 5 sealing, mask 16
procedures sizes, mask 6, 12
cleaning 18 set up procedure 1, 9
set up 1,9 setting pressures 4, 5
testing 5 specifications, product19
product specifications 19 suppliers. See global contacts.
supplies, ordering 18

Q
T
Quick Set Up and Operation Card 18
test lung 5
testing procedure 5
R T-piece circuit 6, 11, 12
troubleshooting 15
two-point top hold 16
recalibrating 2, 10
respiratory rate 7, 13
resuscitation 23
RN 9 V
RT 1
ventilating the infant 7, 12

| 25 | Neopuff Infant Resuscitator 2015


References
Bellettato, M et al. Assisted Ventilation of the Newborn. 2012. http://emedicine.medscape.com/
article/979268-overview. Accessed January 2015.

Booth, J et al. Pediatric Resuscitation. 2014. http://emedicine.medscape.com/article/1948389-


overview. Accessed January 2015.

de Winter, J et al. Noninvasive respiratory support in newborns. Eur J Pediatr 2010. 169:777-782.

Finan, E et al. Neonatal resuscitation guidelines update: A case-based review. Pediatric Child
Health 2011. 16(5): 289-291.

Neopuff Infant Resuscitator Operating Instructions, Fisher & Paykel Healthcare, 2011.

RD1300-10 T-piece Circuit User Instructions, Fisher & Paykel Healthcare, 2011.

Neonatal Resuscitation Masks User Instructions, Fisher & Paykel Healthcare, 2010.

RD020-01 Test Lung User Instructions, Fisher & Paykel Healthcare, 2011.

T-piece Resuscitation: Optimal Resuscitation with F&P Neopuff. Product brochure, Fisher &
Paykel Healthcare, 2011.

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