Peep Valves

Model 4804, 5 cm. H2O CLINICAL USE Boehringer Laboratories’ patented PEEP Valves are designed to be used in CPAP and ventilator circuits, as well as in anesthesia systems. The valves behave like a water PEEP system, without its inconvenience and can therefore be applied in procedures involving single lung ventilation. DESCRIPTION Boehringer Laboratories’: PEEP Valves utilize the deadweight measurement principle; a precision ground ball of given size and density occludes gas flow through a calibrated orifice until a threshold back pressure is obtained. At that point, the ball floats off the orifice, allowing gas flow, while maintaining the opening pressure. Unlike systems that depend on springs, pressures in the device are minimally flow dependent. In addition, the PEEP levels obtained in the valve are constant with time, whereas a water bottle PEEP device will accumulate water in a humidified circuit, resulting in pressure increases with time. The performance characteristics of the valves are comparable to those obtained using a water bottle set-up, with certain advantages. There is minimal pressure overshoot and pressures are well maintained during periods of apnea. To get graduations in PEEP, the valves are changed. Calibrations available include 2.5, 5, 10, and 15 cm. H2O. The valves are reusable and can be sterilized by gas, steam autoclave and Cidex. ADVANTAGES No adjustments Stepped calibration 2.5, 5, 10, and 15 cm. H2O (Stacking of valves not recommended for ± 4% calibration) Universal: fits common ventilators and anesthesia machines (elbow included in kit) No springs, screws, flappers, water Accuracy: deadweight calibration, no drift, end pressure ± 4% Constant pressure head, no water build-up overnight No pressure variance due to turbulent flow, as in a water bottle May be sterilized by gas, steam autoclave or Cidex Low flow sensitivity: large orifices One moving part Insensitive to entrained moisture Engraved identification furnished on all valves SPECIFICATIONS END PRESSURE: 2.5, 5, 10, AND 15 cm. H2O LENGTH: 2.5’ DIAMETER: 1.25" WEIGHT: 2.5 oz. FITTING: Elbow—22 mm. Male, 22 mm. Female MATERIALS: Body—Nylon; Ball—18-8 stainless steel, nylon or Teflon (depending on range) WARNING THE VALVES SHOULD BE SHAKEN PRIOR TO USE, TO ENSURE THAT THE BALL IS MOVING PROPERLY. IF INADVERTENTLY PLACED UPSIDE DOWN, THE VALVE WILL ALLOW THE PASSAGE OF GAS. IT IS A ONE-WAY VALVE; HOWEVER, SO CARE SHOULD BE EXERCISED WHEN INSTALLING IT IN A GIVEN SYSTEM, THE USE OF POSITIVE END EXPIRATORY PRESSURE MAY HAVE SOME UNDESIRABLE SIDE EFFECTS, THE MOST COMMON OF WHICH ARE PNEUMOTHORAX, DECREASED CARDIAC OUTPUT (ESPECIALLY IN THE HYPOVOLEMIC PATIENT), AND FLUID RETENTION. IN PATIENTS WITH SIGNIFICANT MUCOUS OR SECRETION PRODUCTION, CARE SHOULD BE EXERCISED TO COMPLETELY CLEAN AND REMOVE ENCRUSTED MATTER FROM THE VALVES DURING CLEANING. WE WERE NOTIFIED THAT, ON TWO OCCASIONS IN 1983 AND ON ONE OCCASION IN 1979, POSITIVE END EXPIRATORY PRESSURE VALVES HAVE BEEN INSERTED IN THE INSPIRATORY SIDE OF THE ANESTHETIC CIRCLE, RESULTING IN BRAIN DEATH FOR THE PATIENT. IN CIRCUIT PEEP REMAINS A VIABLE TREATMENT MODALITY. ITS USE, HOWEVER, MANDATES THAT CIRCUIT FLOW REMAIN NORMAL AND IS MONITORED FOLLOWING INSERTION. PLEASE FOLLOW THE INSTRUCTIONS CAREFULLY, REMEMBERING THAT PEEP VALVES ARE ONE-WAY VALVES, AND CIRCUIT FLOW MUST BE MONITORED AFTER INSERTION. BREATH SOUNDS BY STETHOSCOPE, FLOW BY SPIROMETER AND CO2 MEASUREMENT ARE ACCEPTABLE. THE USE OF ANESTHESIA VENTILATORS SEEMS TO HAVE BEEN CONDUCIVE TO LACK OF AWARENESS OF CIRCUIT FLOW IN THESE THREE CASES. IT SEEMS ESPECIALLY IMPORTANT TO CHECK FOR CIRCUIT FLOW WHEN USING A VENTILATOR.