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advantage life systems we like to say
we've never met a test we don't like we
texted boxin over and over and over
again and we'll continue testing Locsin
until the end of time it's also
important that we test all of our own
skills and particularly our clinical
skills so I brought with me Craig Morris
who's going to introduce himself the
role of Levin Tech clinical team and
then Craig's gonna test me hello my name
is Craig as Chris introduced me
I am ICU trained therapists with over 10
years of experience within Hospital
community and I am also clinical
specialist with Ventech life systems and
I've been with FinTech life systems for
a little over three years now and Chris
has done a great job introducing boxin
to you today but I'm here to test
Chris's knowledge are you ready Chris
I'm ready okay well first of all let's
turn boxing on okay so what I'm seeing
here is I've got my external power core
connected I can see that boxing is
charging right now and I'm going to go
ahead and hit the power button because
my circuit is connected and in this case
I'm connected to my patient so I'll turn
on the power button here boxin does take
a few seconds to power up well I have a
list of questions for you sir okay so
after box and death start up I'm gonna
ask you to do a series of taps
okay now the noises that we're hearing
as boxing is powering up is that what
you expected to hear yes so I heard a
sound which is good I also heard a
clicking sound that clicking sound is
the sound of the box and cough therapy
valve throwing back and forth so of
auxin who's going to run a
self-diagnostic
every time it starts up to make sure
that valve is working correctly so when
you hear that click click that's a good
thing okay now that boxing is running
can we exit to our home screen yes and
normally we would always want to run a
pre use test in this particular case
we're going to bypass the previews test
and continue with our knowledge check
and now that we have lungs and running I
would like you to take out the
swappable battery okay and replace them
again okay so I'm gonna remove the left
battery icon that's currently charging
I've got three battery indicators there
I'm removing the left battery as you can
see here that indicator then goes away
I'm going to check the battery charge
right now you can see that it's at 100%
or very near to 100% I would replace
this battery and I would simply slot the
battery in and push down on the tab okay
and Chris if we're at full charge how
long would boxing last using vanilla
Asian alone if I'm using ventilation at
alone for a normal ventilated patient
it's roughly about nine hours and if
we're using all five therapies that are
available for boxing how long would the
batteries last it's a good question so
battery use is always variable so if I'm
running the ventilator only it's about
nine hours but I find running therapies
and frequently a little bit of oxygen
cough suction nebulizer
you're probably somewhere around six
hours if I'm running six liters per
minute of oxygen
lots of high breath REITs frequent
suction frequent nebulization I could be
as low as three hours with foxing and
can you describe to me the importance of
vents and filters with boxing yes so we
always like to say that boxing can
breathe so if you put a bag over my head
or you prevent me from breathing in air
I'm gonna have a problem the same thing
is true with Vox on a couple of reasons
why one you've got cooling and heat
valves that are all around boxing so
it's very important that boxing has the
opportunity to take in cold air and get
rid of the hot air that's generated from
running the system the other thing
that's very important with boxing is
that it's generating oxygen so it's not
uncommon for facilities or in the home
to want a shower with boxing if you want
to shower with rocks and people tend to
think you have to put a bag over boxing
if you put a bag over Vox it's just like
putting a bag over my head what happens
is I breathe in the air in the bag and I
start to consume the oxygen and I
breathe out co2 what's left in the bag
is only nitrogen so as you start to run
down the oxygen and an enclosed space
the fio2 level drops from 21% 19% a
10% and as it drops below 18% there's
not enough oxygen in that enclosed space
probe oxen to generate enough oxygen to
create supplemental oxygen so boxin will
alarm so it's very important both in
terms of heating and cooling you keep
enough space around boxing but it's also
very important because boxing isn't just
a ventilator it's also an oxygen
concentrator so you want to make sure
it's gathering enough oxygen that it can
actually concentrate that option and
create supplemental oxygen okay great
let's change some presets in the therapy
mode okay so let's say I want to change
the ventilation presets so a couple of
things to note here I'm in the therapy
screen I'm going to go to the
ventilation icon here so as you can see
here I've got three different presets
I've got my day mode my night mode and
my mobile mode it's very important here
and this is a particularly confusing
screen sometimes as you can see I've got
my now active icon and I've got my start
icon so it's very important to look
boxin is telling you exactly what's
happening don't just rush through the
system take your time go slow and listen
to Vox and read what's actually
happening so if you look here this
preset is letting you know it's now
active when I move off that preset the
now active is still visible again
boxing's going to communicate to you
it's going to tell you what's happening
so if I want to switch between presets I
simply select the preset that I want to
move to and I hit the start button when
I hit the start button again slow down
read each pop-up verify circuit
configuration and press ok to begin pre
use tests so by changing my preset I am
forcing a change of circuits because
this preset has a different circuit type
so when I do that I click ok and what
Vox is going to do it's gonna ask me to
run a pre use test I'm gonna skip out of
the pre use test for purposes of our
knowledge check and I'm going to go back
to the night mode where we currently
work okay let's step it up I'm gonna
create an alarm I want you to recognize
it and correct it okay
okay what I'm seeing now is a medium
priority alarm so it's yellow banner I
can see that it says battery use I can
double check but the only alarm
currently active is the battery use
alarm so to resolve the battery use
alarm I can either plug in to power but
in this case because Vox n is a
particularly mobile system I'm not gonna
plug back into power what I'm going to
do is I'm going to hit the alarm
silence that just allows me to think a
little more clearly as I'm adjusting to
what's happening within boxing but
you'll notice this is now flashing but
this is also still indicating that the
alarm condition has not been resolved
when you activate the battery use alarm
we really want to confirm that you
understand that the battery power source
has changed so we ask you to go into the
alarm log and clear the list it's a
two-step process
you can't just silence the alarm you
also have to clear the list that will
end and resolve the alarm condition all
right let's step it up I'm gonna have
you change some alarms let's change the
low pressure and high pressure alarm
okay I often say this is one of the
hardest things to do within boxing but
we can learn it and make it pretty
simple so Craig is asking me to change a
setting within the ventilator so I'm in
the therapy screen I'm gonna go to the
ventilation icon and then I'm gonna go
to settings and alarms I'm gonna change
the now active preset as you can see
there are three different presets here
I'm gonna change the now active preset
and I'm gonna adjust the alarms in the
active preset to find the alarms all I
have to do is scroll down the first
thing that pops up are the ventilator
settings to find the alarms I simply
just keep scrolling down when I see the
alarms tab here I simply keep scrolling
down until I find the specific alarm to
Craig a stocking around in this case he
wants me to set the low and high
inspiratory pressure alarms to do that
I've selected the alarm we want to set
I'm gonna click Edit
now the fun begins it's a three-step
process to adjust the low and high
alarms step one you have to tell Vox in
which alarm you want to change is it the
low or is that the high there are two
alarms to change
it needs to know which one you actually
want to set in this case I want to set
the low the second thing you have to do
is tell boxing if you want that alarm on
or off in this case the alarm is already
on but I could turn that alarm off or I
could turn that alarm back on the third
thing I need to do is adjust the alarm
and except to adjust the alarm I just
set the number that I want let's say I
want it to be six I click accept and the
setting has been changed and implemented
I can repeat that same process for the
high-pressure alarm okay let's do a
therapy change how about turn on the
internal oxygen concentrator for me okay
right now I'm in the ventilation
settings common trick I like to tell
people when in doubt exit out there are
two ways you can use the exit button the
first is this upper navigation button
when I'm in a submenu this is where
you're going to find the exit icon I
click exit here when I'm on a therapy
screen there's a nice little exit icon
here I click that exit icon and I'm back
to the therapy screen now Craig is
asking me to change the oxygen settings
I'm going to go into the oxygen icon
here and then I'm going to activate one
of the presets you can see here I've got
three different presets for my three
different sources of oxygen this first
one says preset 1 5 liters a minute
pulse dose and it also tells me my
source internal Oh 2 concentrator the
second one says Oh to bleed in low
pressure Oh - you can also see there's
no setting here that's letting me know
that I'm getting oxygen from a low
pressure source but there's no setting
here because I can't control that low
pressure source from boxing what I have
to do is go to that other oxygen
concentrator and make that settings
change on the other oxygen concentrator
over here preset 3 you can see I've got
my fio2 at 85% and I'm running external
high-pressure now all of these say start
none of them say now active
unlike ventilation and the oxygen system
you can start and stop therapies so
right now there are currently no oxygen
therapies activate we can get
confirmation of that by looking at the
therapy icons up here
only the ventilator is currently active
you will always see the ventilator when
I turn on the oxygen concentrator you
will see the therapy icon up here for oh
so in this case I'm going to turn on the
internal oxygen concentrator at preset
one which is five liters per minute I'm
going to hit start you can say verify
circuit configuration and press ok to
begin pre use test as you can see here
most importantly I am running boxin
connected to a vent tech one circuit
with oxygen to include it it's very
important when you're running the
internal Vox and oxygen concentrator I'm
going to say okay we've already run this
pre used test but normally I would run
it again as you can see here and have
the option to stop oxygen I can also
verify that it's running and boxing does
have two onboard oxygen sensors one of
them is specifically focused on
monitoring the internal auction
concentrator I can see the calculated
fio2 monitor here it lets me know that
boxin is working and it's letting me
know what my calculated fio2 would be
next I'd like you to select Oh to flush
for me Oh chip it okay so right now
we're running at five liters per minute
with this setting let's say I need more
maybe I want to do a suction therapy or
a patient really has a high demand for
option all I have to do is look for that
six liters a minute
Oh to flush icon I click that and as you
can see it's a little hourglass type
icon so it's slowly counting down to let
me know that that Oh to flush is going
to be active for three minutes and the
o2 flush is done the three minutes is
complete it'll revert back to the five
meters per minute of oxygen and can you
stop though to flush for you absolutely
to stop the o2 flush I just hit the O to
flush the o2 flush is stopped and I'm
back to 5 meters per minute of oxygen
okay Chris I want you to set up suction
therapy
and I want you to talk through what you
would need to do to accomplish that okay
so right now I'm currently running
auction you can see the beat and the oh
I'm gonna take my boxing travel suction
canister here I'll attach it to the side
of auxin put it in the unlock position
first attach it to the side of auxin
secure it I'll take my quarter inch
suction tube here attach the tube to the
back of the travel suction canister and
then I would touch this end any
traditional suction suction adapter so a
Yank our or suction catheter now to
activate the suction a couple things are
going to happen
Moxon can do a lot of things but I can't
do everything so boxin can run oxygen
suction or nebulizer but it can't run
them all at the same time so in this
particular example I'm running the
oxygen concentrator if I go to suction
my patient the oxygen is going to pause
as I suction my patient so in this case
I'm going to section my patient what I
probably will do is I'll do the o2 flush
I operate my patient as much as possible
let that run for three minutes once
that's done I'll accelerate the process
here I'll just stop my own to flush I
would then go to the suction icon here
when I'm in my suction screen I would
set the vacuum pressure to what is
desirable right now the suction default
is set at 250 let's say I want to
increase that to 310 again above 300 is
when you're going to really start to see
the high suction flows from boxing I'm
going to confirm that I want those high
suction flows I'm gonna go right to 310
now watch the screen very closely I'm
gonna hit the start button here but look
a pop-up has happened it's most
important we see a pop-up stop and read
the pop-up starting suction therapy will
pause oxygen therapy that's letting you
know but if you're going to suction your
patient oxygen is going to be
momentarily paused I'm gonna say okay
because I need to clear this patient
secretions I click okay and you see this
little spinning wheel let lets me know
the auction system is shutting down
after about five or six seconds you can
see this little green icon shows up here
the oxygen concentrator has shut down
and I can now suction my patient so what
we just saw there was about as long as
it takes
it's anywhere from one to five seconds
the cycle of the oxygen concentrator
until you can switch between therapies
so what's most important here as you can
run oxygen suction or nebulizer you can
only one one of those therapies at a
time so anytime you're switching between
those therapies be sure to watch the
spinning wheel that we just saw there
and be sure to understand that oxygen is
paused during this time period so I've
completed my suction experience I'm
gonna hit stop if I hit stop you can see
action will automatically resume now a
couple things have happened when go into
facilities if you're used to an oxygen
concentrator being very noisy and most
oxygen concentrators are much louder
than the boxing system it's very easy
not to hear the Vox an oxygen
concentrator system so if you go in and
use suction against sections much
quieter you're not used to hearing these
audible cues so it's very important
you're focused when you're running your
suction that you remember to turn back
on the oxygen concentrator by hitting
the stop button if you forget to do that
there is a fail-safe within boxing that
after two minutes it will automatically
turn back on the oxygen system okay one
thing I would like to add is you can
look at the icons and see for visual
cues here at the top as well to let you
know what therapy you're running great
point I would like to have you now
instead of coffee era P okay I'm gonna
stop my oxygen concentrator it's gonna
say press ok to stop oxygen therapy and
I'm gonna exit out now I'm gonna go to
my cough there appear again I've got
three different presets I can adjust any
of those presets by simply going to the
Settings icon here and I can adjust any
of my various presets here to activate
the coffee repiy all I have to do is hit
the start button here
as you can see the spinning wheel lets
me know the waiting for breath sink I
can trigger that breath naturally just
as a patient would and then I can
visually see what's happening with each
pop therapy I can stop that simply by
hitting the stop button if I want to
stop the cop terapy earlier if you
wanted to restart cough there appeal
what would you do Chris I would hit this
restart button here and it would simply
go right back to the screen and allow me
to start coffee repeat please test and
test often gives familiar as you can
with inbox and test your friends become
familiar with the system prior to going
on any patients thank you thank you
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