S8 AutoScore II User Guide July 2008
S8 AutoScore™ II System User Guide English
ResMed Ltd (Manufacturer) 1 Elizabeth Macarthur Drive Bella Vista NSW 2153 Australia • ResMed Corp (US Designated Agent) 14040 Danielson Street Poway CA 92064-6857 USA • ResMed (UK) Ltd (EU Authorised Representative) 65 Milton Park Abingdon Oxfordshire OX14 4RX UK • ResMed Offices Australia, Austria, Brazil, China, Finland, France, Germany, Hong Kong, India, Japan, Malaysia, Netherlands, New Zealand, Norway, Singapore, Spain, Sweden, Switzerland, UK, USA (see www.resmed.com for contact details). Protected by patents: AU 697652, EP 0661071, US 5199424, US 5522382, US 6240921, US 6705315. Other patents pending. Protected by design registrations: AU 302180, AU 302181, AU 302182, AU 302183, AU 302184, AU 302185, AU 302186, CN 200430121212.2, CN 200430121213.7, CN 200430121211.8, CN 200430121214.1, CN 200430121215.6, CN 200430121216.0, CN 200430121217.5, EP 269436, HK 0412901.9, JP 1257662, JP 1257663, JP 1266956, JP 1266957, JP 1267270, JP 1267271, NZ 405614, NZ 406923, NZ 406924, NZ 406925, NZ 406926, NZ 406927. Others pending. S8, S8 AutoScore,Mirage, HumidAire, HumidAire 3i, ResScan, Mirage Vista, Ultra Mirage, Mirage Activa, Mirage Swift, Mirage Liberty, Mirage Quattro, Papillon and SmartStart are trademarks of ResMed Ltd and HumidAire, Mirage, Swift, Vista and Activa are registered in U.S. Patent and Trademark Office. © 2007 ResMed Ltd. 338397/1 07 08
SETTING UP THE S8™
S8 AutoScore™ II System
© 2007 ResMed Ltd.
Component of 338397/1
SYSTEM COMPONENTS HumidAire 3i™
3 Air filter cover
© 2007 ResMed Ltd.
3 Note: Some products not available in all regions.
© 2007 ResMed Ltd.
© 2007 ResMed Ltd.
© 2007 ResMed Ltd.
HUMIDAIRE 3i AND S8
USING THE DATA CARD
Data communications port
© 2007 ResMed Ltd.
© 2007 ResMed Ltd.
Note: Some products not available in all regions.
© 2007 ResMed Ltd.
DATA CARD MODULE
CONTENTS Introduction... 1 Your Responsibility
Medical Information... 2 About the S8 AutoScore II Contraindications Warnings Cautions Adverse Effects
2 2 2 3 4
The S8 AutoScore II System... 5 S8 AutoScore II Masks Humidifier ResScan Data Card Module Accessories
5 5 6 6 6
How to Use the S8 AutoScore II... 7 Set Up the S8 AutoScore II Assemble the Mask Start Treatment Stopping Treatment Using the Mask-Fitting Feature
7 7 8 8 9
How to Attach a Humidifier... 10 Attach a HumidAire 3i Humidifier
How to use the Keypad... 11 How to Change the Settings... 12 How to Use the Standard Menu... 13 How to Use the Detailed Menu... 15 Settings Menu Results Menu Options Menu Servicing Menu
16 17 17 17
Messages on the S8 AutoScore II LCD... 18 S8 Modules... 19 Using a Blank Module Using a ResScan Data Card Module
Cleaning and Maintenance... 22 Daily Cleaning Weekly Cleaning
Periodic Cleaning Replacing the Air Filter Servicing
22 23 23
Frequently Asked Questions... 24 Troubleshooting... 26 System Specifications... 30 S8 AutoScore II (no Accessories) Accessories All Devices (where applicable)
30 31 31
Limited Warranty... 37 Index... 38
Introduction Thank you for choosing the S8 AutoScore™ II flow generator. The S8 AutoScore II is a compact, all-in-one package with an inbuilt power supply and the option of integrated data management and humidification. This user manual contains the information you need for the correct use of your S8 AutoScore II.
Your Responsibility The owner or user of this system shall have sole responsibility and liability for any injury to persons or damage to property resulting from: • operation which is not in accordance with the operating instructions supplied • maintenance or modifications carried out unless in accordance with authorised instructions and by authorised persons. Please read this manual carefully before use. This manual contains special terms and icons that appear in the margins to draw your attention to specific and important information. • Warning alerts you to possible injury. • Caution explains special measures for the safe and effective use of the device. • Note is an informative or helpful note.
Medical Information About the S8 AutoScore II The S8 AutoScore II continuous positive airway pressure (CPAP) system is indicated for the treatment of obstructive sleep apnoea (OSA) in adult patients. The S8 AutoScore II CPAP system is intended for home and hospital use.
Contraindications The S8 AutoScore II is not a life support device and may stop operating during power failure or certain fault conditions. It should not be used by patients who are dependent on continuous therapy. Positive airway pressure therapy may be contraindicated in some patients with the following pre-existing conditions: • severe bullous lung disease • pneumothorax • pathologically low blood pressure • dehydration • cerebrospinal fluid leak, recent cranial surgery or trauma.
Warnings The entire manual should be read before using the S8 AutoScore II. Advice contained in this manual should not supersede instructions given by the prescribing physician. • A patient should not connect a device to the data communication port unless instructed to do so by their health care provider or physician. Only ResMed products are designed to be connected to the data communication port. Connecting other devices could result in injury, or damage to the S8 AutoScore II device. • The S8 AutoScore II should be used with masks (and connectors*) recommended by ResMed, or by a physician or respiratory therapist. A mask should not be used unless the S8 AutoScore II device is turned on and operating properly. The vent hole or holes associated with the mask should never be blocked. Explanation: The S8 AutoScore II is intended to be used with special masks (or connectors*) which have vent holes to allow continuous flow of air out of the mask. • •
When the device is turned on and functioning properly, new air from the device flushes the exhaled air out through the mask vent holes. However, when the device is not operating, insufficient fresh air will be provided
Ports may be incorporated into the mask or in connectors that are near the mask.
through the mask, and the exhaled air may be rebreathed. Rebreathing of exhaled air for longer than several minutes can, in some circumstances, lead to suffocation. This applies to most models of CPAP devices. In the event of power failure or machine malfunction, remove the mask. The S8 AutoScore II can be set to deliver pressures up to 20 cm H2O. In the unlikely event of certain fault conditions, pressures up to 30 cm H2O are possible. • If oxygen is used with this device, the oxygen flow must be turned off when the device is not operating. If oxygen has been left on while the device is not operating, disconnect the oxygen and wait 30 minutes before turning on the device. Explanation: When the CPAP device is not in operation and the oxygen flow is left on, oxygen delivered into the air delivery tubing may accumulate within the CPAP machine enclosure and create a risk of fire. This applies to most types of CPAP machines. • •
Oxygen supports combustion. Oxygen should not be used while you are smoking or in the presence of an open flame. • Always ensure airflow is being generated by the device before the oxygen supply is turned on. • Always turn the oxygen supply off before stopping the airflow from the device. Note: At a fixed rate of supplemental oxygen flow, the inhaled oxygen concentration will vary, depending on where the oxygen is introduced, the pressure settings, patient breathing pattern, mask selection and leak rate. • Do not use the S8 AutoScore II if there are obvious external defects or unexplained changes in performance. • Do not open the S8 AutoScore II case. There are no user serviceable parts inside. Repairs and internal servicing should only be performed by an authorised service agent. • Explosion hazard-do not use in the vicinity of flammable anaesthetics. •
Cautions • •
• • •
At low pressures, the flow through the exhalation ports of your mask may not clear all exhaled gas from the tubing. Some rebreathing may occur. The airflow for breathing produced by this device can be as much as 6°C higher than the temperature of the room. Caution should be exercised if the room temperature is warmer than 32°C. When AC mains power (100/240V AC) is not available, always use a ResMed DC-12 converter. (The DC-12 converter is available as an optional accessory.) If supplied, the ResScan™ Data Card module is designed for use with specific ResMed devices. Only use the ResScan Data Card module (if supplied) as specified in this manual.
Note: The above are general warnings and cautions. Specific warnings, cautions and notes appear with the relevant instructions in the manual. Medical Information
Adverse Effects Patients should report unusual chest pain, severe headache or increased breathlessness to their prescribing physician. An acute upper respiratory tract infection may require temporary discontinuation of treatment. The following side effects may arise during the course of therapy with the S8 device: • drying of the nose, mouth or throat • nosebleed • bloating • ear or sinus discomfort • eye irritation • skin rashes • chest discomfort.
The S8 AutoScore II System The S8 AutoScore II device is part of a system that consists of six elements: • S8 AutoScore II flow generator • Mask • Humidifier • Data management products • Premium noise guard (front cap) • Accessories.
S8 AutoScore II Please refer to the illustrations in section A of the illustration sheet.
Front view (A-1) Shows the keypad and LCD screen, and the air outlet.
Rear view (A-2) Shows where the module attaches, and the location of the air filter and power sockets.
Power cord (A-3) Power cord to attach the S8 AutoScore II to the AC (mains) power.
Travel bag (A-4) Air tubing (A-5) The 2 m air tubing connects the S8 AutoScore II to your mask.
Masks You will also need a ResMed mask system (supplied separately). The ResMed mask systems that are recommended for use with the S8 AutoScore II are:
Nasal Masks Mirage Vista™ Nasal Mask Ultra Mirage™ II Nasal Mask Mirage™ Nasal Mask Mirage Activa™ Nasal Mask • Papillon™. • • • •
Nasal Pillows Systems • •
Mirage Swift™ Nasal Pillows System Mirage Swift™ II Nasal Pillows System.
Full Face Masks Mirage™ Liberty Full Face Mask Mirage™ Quattro Full Face Mask • Ultra Mirage™ Full Face Mask. • •
Note: Not all masks are available in all regions. The S8 AutoScore II System
WARNING For optimal product performance and data recording, ResMed mask systems should be used with the S8 AutoScore II. Please refer to “Warnings” on page 2.
Humidifier Please refer to the illustration in section B of the illustration sheet. A humidifier may be required if you are experiencing dryness of the nose, throat or mouth. The S8 AutoScore II is compatible for use with the HumidAire 3i integrated heated humidifier.
ResScan Data Card Module The ResScan™ Data Card module and ResScan Data Card (C-1) may be used with the S8 AutoScore II either to help your clinician to monitor your treatment or to provide you with updates to your device settings. See “Using a ResScan Data Card Module” on page 19 for information about how to use the Data Card module and Data Card.
Accessories Please refer to the illustrations in section C of the illustration sheet. Other accessories for use with the S8 AutoScore II: • Premium noise guard (front cap): standard with S8 AutoScore II (C-2) • Air tubing (3 m) (C-3) • DC-12 converter (C-4) • Blank module (C-5). Note: ResMed regularly releases new products. Please check our website at www.resmed.com.
The S8 AutoScore II System
How to Use the S8 AutoScore II Please refer to the illustrations in section D of the illustration sheet.
Set Up the S8 AutoScore II 1 Place the S8 AutoScore II on a table near the head of your bed.
CAUTION Be careful not to place the device where it can be bumped or where someone is likely to trip over the power cord. Note: You can also place your S8 AutoScore II on the floor beside or underneath your bed. Ensure that the area is free from dust and clear of bedding, clothes or any other objects that could block the air inlet.
2 Connect the power cord to the socket at the rear of the flow generator (D-1). Plug the other end of the power cord into the power outlet.
WARNING Make sure the power cord and plug are in good condition and the equipment is not damaged.
3 Connect one end of the air tubing firmly onto the air outlet (D-2).
WARNING Only ResMed air tubing should be used with your flow generator. A different type of air tubing may alter the pressure you actually receive, reducing the effectiveness of your treatment. • Blocking the air inlet or tubing while in operation could lead to overheating of the device. • In the clinical environment any personal computer that is used with your CPAP system must be at least 1.5 m away from, or at least 2.5 m above, the patient. It must also comply with the relevant test standard. For personal computers the international standard is IEC 60950 or equivalent. •
Assemble the Mask 1 Assemble your mask system according to the mask user instructions. 2 Connect your mask system to the free end of the air tubing (D-3). 3 Check that the mask setting on the MASK screen is the one recommended for the mask you are using (see the table in “How to Select the Mask Type” on page 16). The S8 AutoScore II is now ready for use (D-4).
How to Use the S8 AutoScore II
Start Treatment 1 Make sure the power is on. A welcome message is displayed briefly on the LCD screen, then the standby (Ramp) screen appears. The key and LCD backlights also turn on.
2 Lie down and arrange the air tubing so that it is free to move if you turn in your sleep.
CAUTION Do not leave long lengths of air tubing around the top of your bed. They could twist around your head or neck while you are sleeping. • Make sure the area around the flow generator is dry and clean. It should also be clear of bedding, clothes and other potential blockages. •
3 Alter the ramp time if required (see “How to Change the Ramp Time” on page 12). To start treatment, press the Start/Stop key, unless your clinician has set up your device to start delivering therapy automatically. If so, your device will start when you breathe into your mask (see “SmartStart” for details).
4 Fit your mask as described in the mask user instructions.
WARNING A mask should not be used unless the S8 AutoScore II device is powered and operating properly.
5 When ramping begins, the LCD will display the word "RAMPING", with the current pressure indicated as dashes. Each dash is approximately equivalent to 2 cm H2O. For example, 6 dashes represents approximately 12 cm H2O pressure.
SmartStart™ The S8 AutoScore II has a function called SmartStart™ that your clinician can enable. If SmartStart is enabled, your device will start automatically when you breathe into your mask, and will stop automatically when you take your mask off. This means you do not have to press the Start/Stop key to begin or end treatment. Note: Do not use SmartStart when using a mask with an anti-asphyxia valve, such as the Mirage Full Face Mask.
Stopping Treatment To stop treatment at any time, remove your mask and press the Start/Stop key or if your clinician has enabled SmartStart, simply remove your mask and treatment will end.
How to Use the S8 AutoScore II
Using the Mask-Fitting Feature You can use the S8 AutoScore II mask-fitting feature to help you fit your mask properly. This feature delivers air pressure for a three-minute period, prior to starting treatment, during which you can check and adjust your mask fit to minimise leaks. Note: Make sure that the mask setting on the MASK screen is the same as the mask you are using. To use the mask-fitting feature:
1 Fit your mask as described in the mask user instructions. 2 Hold down the Start/Stop key for at least three seconds until air pressure delivery starts. The following display will appear on the LCD screen indicating that the maskfitting feature is operating. Your S8 device will ramp to the mask-fit pressure and will remain at this pressure for three minutes. The LCD also displays a mask-fit star rating. See Table 1, “Definitions of MaskFit Star Rating,” on page 10.
mask-fit star rating
Note: The mask-fit star rating display disappears after three minutes. The mask-fitting feature can only be started from the RAMP screen. The mask-fit pressure is the set treatment pressure or 10 cm H20, whichever is greater.
3 Adjust your mask, mask cushion, and headgear until you have a secure and comfortable fit. Once you have a secure and comfortable fit, check your mask-fit star rating on the LCD screen. Table 1 explains the mask-fit star ratings. Note: If there is another person nearby to check your mask-fit star rating, you can adjust your mask, mask cushion and headgear while lying down.
4 After three minutes, the pressure reverts to the set pressure and treatment will begin. • If you do not wish to wait three minutes, hold down the Start/Stop key for at least three seconds to start treatment immediately. • If you press the Start/Stop key for less than three seconds, the unit will return to standby mode (the RAMP screen is displayed).
How to Use the S8 AutoScore II
Table 1: Definitions of Mask-Fit Star Rating Star rating
How to Attach a Humidifier Attach a HumidAire 3i Humidifier Please refer to the illustration in section E of the illustration sheet, and your HumidAire 3i manual. The HumidAire 3i humidifier attaches to the front of the S8 AutoScore II to provide heated humidification. No other accessories are required for its use. Notes: a. Make sure the water chamber of the HumidAire 3i is empty before you attach or detach the humidifier. b. Remove the connector plug on the S8 AutoScore II before you attach the HumidAire 3i. Reattach the connector plug firmly after you detach the humidifier.
Storing the HumidAire 3i Store the HumidAire 3i in the S8 AutoScore II travel bag when not in use.
How to Attach a Humidifier
How to use the Keypad The control panel of the S8 AutoScore II includes an LCD screen and keypad for navigating through the menus and delivering treatment.
LCD screen Up key Right key
LCD Screen The LCD screen displays the menus and treatment screens.
The LCD backlight turns off after two minutes of inactivity. It turns back on when you press a key.
Keypad Keys The S8 AutoScore II keypad has the following keys: Key
• Starts or stops treatment. • Extended hold (for at least three seconds) starts the maskfitting feature.
• Allows you to scroll through the S8 AutoScore II menus and submenus, and increase the setting options.
• Allows you to scroll through the S8 AutoScore II menus and submenus, and decrease the setting options.
• Performs the function indicated by the guiding text displayed above it on the LCD screen. Guiding text includes menu, change and apply.
• Performs the function indicated by the guiding text displayed above it on the LCD screen. Guiding text includes exit and cancel.
How to use the Keypad
When the S8 device is in standby mode all keys remain lit. During therapy, the keypad backlight turns off after two minutes of inactivity and the Start/Stop key dims.
How to Change the Settings You can change settings on the S8 AutoScore II by using the keypad and LCD. When the S8 AutoScore II is in standby mode you can display a series of screens (a menu) on the LCD screen in order to view and change the settings for a particular function. Your clinician will preset the menu to either a standard view or a detailed view. See “How to Use the Standard Menu” on page 13 and “How to Use the Detailed Menu” on page 15 for more information.
How to enter the menu screens When the S8 AutoScore II standby (RAMP) screen is displayed you will see the word ‘menu’ in the left-hand corner. To select an S8 AutoScore II menu, press the Left key.
How to scroll through the menu When you are in the menu, scroll through items by pressing the Up or Down keys.
How to change a setting option When you have scrolled to the item you require: 1. Press the Left key (Change). 2. Press the Up or Down keys until you see the setting option that you require. 3. Press the Left key (Apply) to select the setting option. If you wish to exit without changing the option, press the Right key (Cancel).
How to exit out of a menu Press the Right key (Exit). This will take you back to the standby (RAMP) screen.
How to exit out of an item within the menu Press the Right key (Exit).
How to Change the Ramp Time During ramp time, the pressure increases from a low pressure to the prescribed treatment pressure. You can set the ramp time in 5-minute intervals, from 0 minutes (OFF) up to a maximum ramp time set by your clinician. The standby screen displays the current ramp time in the right-hand corner. To change the ramp time, press the Up or Down key until the desired ramp time appears. Once a ramp time is selected, begin therapy by pressing the Start/Stop key.
How to Change the Settings
How to Use the Standard Menu Figure 1 shows the standard menu. WELCOME >>>>>> RAMP: 10min menu
EPR SETTING: 1 change exit
USED HRS: 08000 exit USAGE: 1000/1068 exit
MASK: ULTRA change exit SW: SX3960200 exit
Figure 1: Standard menu screen
You enter the standard menu from the standby (RAMP) screen, by pressing the Left (menu) key.
How to Change the Expiratory Pressure Relief Setting Your clinician may have set up your device to deliver expiratory pressure relief (EPR). This can be used to help ease any discomfort you may experience when breathing out during treatment. There are four settings: • OFF (no EPR) • 1 (lowest EPR) • 2 • 3 (highest EPR). The EPR SETTING screen only appears if your clinician has enabled access to EPR settings. To change the EPR setting, select Change (Left key). Press the Up or Down keys until you see the setting that you require.
How to Select the Mask Type Scroll to MASK and select Change (Left key). Press the Up or Down keys until you see the mask type that you require.
How to Use the Standard Menu
The following table shows the setting that should be selected for each mask type. Settings
Ultra Mirage II Nasal Mask
Mirage Liberty Full Face Mask Mirage Quattro Full Face Mask Ultra Mirage Full Face Mask
Mirage Activa Nasal Mask
Mirage Swift Nasal Pillows System Mirage Swift Nasal II Pillows System
Mirage Nasal Mask
Mirage Vista Nasal Mask Papillon
Other viewable information You can also view the total number of hours of treatment (USED HRS); the number of sessions for which the S8 AutoScore II was used in a usage period (USAGE); and the current software version (SW).
How to Use the Standard Menu