Servo-n

– hands-on guide

This document is intended to provide information to an international audience outside of the US.
 Introduction
There are different ways to navigate the user
interface, adjust settings and get support.

The objective with this Servo-n® cises can be done individually or

hands-on guide is to guide you through in sections. It takes approximately
some important steps you need to 30 minutes to do the entire Servo-n
familiarize yourself with when starting to hands-on guide. Knowledge Check
use the Servo-n ventilator. Please see the questions with answers can be
User Manual for more information. found at the end of the guide.

To go through these exercises you need NOTE: Some modes are options and
a Servo-n 3.0, O₂ and air supply, patient might not be included.
circuit, Y sensor and a test lung. The exer-

Tap and
Tap hold
Confirm the settings by tapping
Accept or the green check mark.

Drag and drop

Exit settings without changing
by tapping cancel or the red x.

Scroll vertically
or horizontally Close by tapping the green x.

Servo-n 3.0. This guide is intended for hospital personnel as a hands-on training using the Servo-n ventilator.
It does not cover all aspects of the Servo-n ventilator. Please see the user’s manual for more information.
Some modes and functions are options and might not be included.

SERVO -N HANDS ON GUIDE 2

Setting up the
Servo-n

Follow step by step (see corresponding

images and notes):
1. Plug in the power cord.

2. Open the hatch on the side and switch

the ventilator to on.
NOTE: When switching on the Servo-n, you
need to pull the ON/OFF switch downwards. 2

3. Connect the air and oxygen hoses.

4. Lock the wheels. It’s important to lock the wheels

when the ventilator is in use to avoid accidental
movement of the ventilator.

5. Start the PRE-USE CHECK.

(You need the test tube during the Pre-Use Check).

6. Follow the instructions on the screen.

7. Connect the patient circuit and the Y sensor.

NOTE: The patient circuit test must be performed

with a complete patient circuit, including all
accessories (e.g. active humidifier filled with water,
filter, CO₂ analyzer, Y sensor and nebulizer), that
is to be used with the patient. If the patient circuit
9
is changed after the pre-use check is completed,
perform a new pre-use check or a patient circuit test.

8. Connect a test lung to the patient circuit.

9. Connect the pressure line to the Y piece and module
and the cable to the Y sensor and module. Calibration
instruction will appear on the screen as soon as
calibration is needed. Calibrate the Y sensor. If you
would like to discontinue Y sensor measuring you need
to disconnect the Y sensor module.

10. Choose patient category: NEONATAL. (1)

11. Choose Ventilation type: INVASIVE. (2)

(You can also choose NON INVASIVE here).

12. Tap on Ventilation mode PRVC. (3)

(Depending on start up the configuration a different
mode can be shown here.)
10–12 1 2 3

SERVO -N HANDS ON GUIDE 3

 NOTE: Some modes are options and might not be
included.

Information is available for each mode.

13. Then tap and hold the PRVC tile. (1) 1

14. Close by tapping .

15. Select Mode by tapping PRVC.

16. Change the:

-- Tidal volume to 8 ml
-- Respiratory rate to 42 b/min
-- PEEP to 5.5 cm H₂O
13
17. ACCEPT the mode settings. (2)

18. Go to ALARM LIMITS in QUICK MENU. (3)

19. Change the alarm limits:

-- Alarm sound: 1
-- Ppeak: 30 cm H₂O
-- RR (Respiration Rate): High 40 b/min
-- MVe (Minute volume): Low 3.0 L/min

20. ACCEPT the alarm settings. (4)

21. Tap START VENTILATION.

16–17 2

19–21 4

SERVO -N HANDS ON GUIDE 4

 1 2 3

Alarms
22. The alarms are turned off for 30 seconds after
starting ventilation. (1)

NOTE: Alarms can be in one of three colours: red,

yellow or blue, depending on priority.

23. Tap the activated alarm in message bar (2) and read
4
the messages.

NOTE: The number of alarms that are active are

displayed in the status bar at. (3)

24. Tap the red tile in the numerical values MVe alarm. (4) 22–24
NOTE: By tapping the activated alarm in the
numerical values field, you gain access to the
7
alarm setting (shortcut).

25. Go to alarm limits. Adjust the alarms so none are

active.
NOTE: The arrow indicates the current measured
value. (5)

26. Activate the AUTOSET function by tapping. (6)

5
NOTE: The alarm autoset function can only be used
in controlled modes.
6
27. Tap the placed next to Ppeak alarm setting. (7)
You can find more information about the alarm
setting there.
NOTE: The information sign can be found in different
25–28
positions on the Graphic User Interface.

28. ACCEPT the alarm settings.

NOTE: When ventilating, you can see that the
compliance tubing compensation is active by the
symbol – The symbol will not appear if compliance 8
compensation is not activated, and it requires a
patient circuit test has been done. (8)
9
29. When leakage compensation is activated, the
delivered and measured volume and flow values are
automatically leakage compensated, as indicated by
the symbols on the affected values. (9)
10
30. Leakage is measured and presented in percent. (10)

31. When leakage compensation is used in invasive

modes such as PRVC and VS in the neonatal patient
category, it ensures volume delivery at the level set. 28 Note–31

SERVO -N HANDS ON GUIDE 5

32. Increase the PEEP to 11 cm H₂O (use the direct access
keys) and increase the scale by tapping the . (1)
Cancel the settings by tapping the .
NOTE: The color changes when the settings are
changed outside the normal range.

VT/BW
33. Tap BW or the VT/BW to open PATIENT DATA. (2)
32 1

34. Enter WEIGHT 800 g.

2
NOTE: The weight should be updated when
patient change.

35. Check the ml/kg calculated value. (3)

36. Go to the direct access bar and change the TIDAL

VOLUME so you receive 6ml/kg. (4)

33–34

35–36 4

SERVO -N HANDS ON GUIDE 6

Mode setting
37. Tap the mode PRVC and open the mode setting.

38. Change the TRIGGER value to pressure triggering

-1 cm H20.
NOTE: Read the text by the scaling. Less patient
effort and more patient effort. (1)

39. Change the Ti (or the I:E if this is configured).

NOTE: The changes of the dynamic images.

40. CANCEL changes. 38 1

41. Make a quick change of O2 to 100%. Change the O2
setting in the direct access bar to 100% by tapping on
the 100% directly on the sliding scale. (2)

42. CANCEL the changes by tapping the .

HFOV modes
NOTE: If a circuit not recommended for HFOV is
tested, information is presented after the patient
circuit test. There is also additional information if 41–42 2
you are using a non recommended HFOV circuit
and switch to HFOV.

43. Tap MODES and choose HFO (if available). Change

the Pampl to 40 and Pmean to 12. Accept.

44. Go to manuevers and PAUSE OSCILLATION,

and then resume.

44

SERVO -N HANDS ON GUIDE 7

45. Disconnect the Y sensor cable. Pmean will be
estimated. Calibrate the Y sensor.
3
NOTE: The asterisk on the metric indicating that
the value is uncertain (1).

46. Calibrate the Y sensor.

47. Choose HFO (V TGT) mode. Set the VT/HF so that you
receive 2ml/kg.

48. Go to alarm limits and set the Pampl 5 cmH₂0 above

the measured Pampl.

49. Disconnect the Y sensor cable. Pmean will be

esti­mated. Ventilation is switched to backup HFO.
45
NOTE: The back up amplitude will never go above the
upper alarm limit that is set. Its possible to adjust the
Pampl in backup.

50. Calibrate the Y sensor.

47

50

SERVO -N HANDS ON GUIDE 8

51. Change to PRVC mode. Go to ALARM LIMITS and
read the text information available. Turn off the
Leakage alarms. Accept. Make a small leakage in the
circuit and note the leakage metric.

52. Change to PS/CPAP.

53. Change the END INSPIRATION to 40 % and then

to 60%. Look at how the dynamic image changes.

54. ACCEPT 60%.

55. ACCEPT PS/CPAP mode.

56. Compress the test lung to trigger breaths.

NOTE: The white indicates the triggering in the

56
waveforms, depending on how the trigger is set
(pressure or flow) the colour indication changes
- if pressure triggering is set- white indication in 1
pressure waveform. If flow triggering is set- white
indication in flow waveform. Also there is a lung on
the screen indicating the triggered breath.

57. Stop compressing the test lung.

NOTE: The colour changes to bold white for PC and

the BACKUP settings. The mode and settings that are
not active are grey. (1)

58. Tap the in the direct access bar (2), you then have
access to all the mode settings directly.

59. Go to MODES and change back to PRVC.

NOTE: It is marked previous. (3)

57–58 1 2
60. Accept previous settings.

59 3

SERVO -N HANDS ON GUIDE 9

Views
61. Go to VIEWS in QUICK MENU. (1)
Change to BASIC view.
2
62. Use the to find additional values. (2) 1
63. Go through the different views; DISTANCE, FAMILY,
LOOPS and SERVO COMPASS ® view.

64. Go to SCREEN LAYOUT.

65. Change to filled waveforms by tapping the

61–64
waveform image. (3)

66. Change back to non-filled waveforms.

Media
67. Tap the RECORDER once and tap the CAMERA in the
status bar three times. (4) 3
NOTE: A 30 second recording will be made starting
15 seconds before and lasting until 15 seconds after
the recording is initiated.
64–66
68. Choose (5) to access MEDIA. Navigate between the
different screenshots and the recording.
4 5
NOTE: Screenshots are displayed at the bottom of
the window.

69. Find the USB port under the base of the screen.

NOTE: You can use a USB memory stick to export the

data (e.g. screenshots).

67–68

SERVO -N HANDS ON GUIDE 10

NAVA &
NIV NAVA 1

70. Go to EDI & NAVA in QUICK MENU. (1)

71. Find the workflow of NAVA/NIV NAVA under the .

72. Go to CALCULATION TOOL.

73. Chose 6 FR 49 CM EDI CATHETER.

70
74. Chose NASAL insertion.

75. Enter NEX 18 cm.

76. Edi catheter insertion distance is presented.

NOTE: The insertion distance calculation often

needs to be titrated using the ECG.

77. Go to EDI CATHETER POSITIONING.

78. Tap the .

NOTE: The yellow curve is the pressure waveform

and the grey curve is the pressure estimated for
NAVA.

79. Close by tapping the .

80. Go to NAVA MODE.

71–77
NOTE: The mode is divided in NAVA and PC
(backup mode).

81. Edi avareage can be seen on additional values and is a

average over 30 seconds.

78–79
Grey Curve Yellow Curve

SERVO -N HANDS ON GUIDE 11

Disconnect/
Suction 2

82. Go to DISCONNECT/SUCTION in QUICK MENU. (1)

1
83. Change the O2 CONCENTRATION to 40%. (2)

84. Accept DISCONNECT/SUCTION function.

85. Disconnect the test lung.

82–84
86. Reconnect the test lung.

87. CANCEL post-oxygenation.

NOTE: When disconnection/suction is activated the

ventilator system is prevented from cycling without
activating alarms. The disconnect/suction function
should not be used when closed suctioning is used.

Maneuvers
88. Go to MANEUVERS in QUICK MENU. (3)
88–90
89. Activate MANUAL BREATH by tapping. The ventilator
system will initiate a new breath cycle according to
the current ventilator settings.

90. Go to STATIC MEASUREMENT.

91. Here you can find INSPIRATION and EXPIRATION

HOLD.

91

SERVO -N HANDS ON GUIDE 12

92. Go to NEBULIZATION.

NOTE: You can choose continuous nebulization

or a nebulization period . The time
for nebulization can be changed. When nebulization
is activated there will be the corresponding
nebulization symbol on the screen. By tapping the
symbol you can stop nebulization.

Battery 92

93. Unplug the mains cable. 1

94. Tap on the battery symbol . (1)

NOTE: You can see how much capacity

remains for each battery.

Lock screen 2

95. LOCK the screen is found in Quick Menu, 93–95

Lock screen. (2)

96. Tap anywhere on the screen and see what happens.

97. UNLOCK the screen by tapping on the

Locking Symbol.

SERVO -N HANDS ON GUIDE 13

O2 boost
98. Activate O2 BOOST by tap and hold. (1)

NOTE: O₂ boost is active for one minute.

99. CANCEL O₂ boost by tapping .

100. Go to MANEUVERS and select O2 BOOST. It is possible

to change the desired level for the O₂ boost function.
Change the O₂ boost to 20%.
1
101. Observe the new O2 BOOST level .
98

Trends
2
102. Go to TRENDS. (2)

103. Change the trend scale to 1 hour. (3)

104. Drag the cursor and note that each event/changes

have been trended.
4
105. Tap ORGANIZE to change the order of the trends. (4)

Note: Trend values are stored every 60 seconds

102–107 3
and retained for a maximum of 72 hours.

106. Put the RR sp, RR at the top by dragging and dropping

TRENDS.

Note: you can see the trend of VT/BW and backup.

107. Close the window by tapping .

Stop ventilation
108. Tap STANDBY in QUICK MENU and then tap and hold
STOP VENTILATION. 108

NOTE: If Edi is connected it is possible to go directly

to Edi Monitoring in standby.

SERVO -N HANDS ON GUIDE 14

Knowledge check
1. Why is it important to have the same patient circuit
that will be used for the patient when performing the
patient circuit test?

2. Which priority level does the red alarm have? HIGH,

MEDIUM or LOW priority?

3. Can autoset of alarm settings be used in

supported modes?

4. Is pressure Triggering of -1 easier or more difficult

than Flow triggering of 1.6 l/min. (for the patient
to trigger the breath)?

5. How can you see on the screen that

the patient is triggering?

SERVO -N HANDS ON GUIDE 15

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This document is intended to provide information to an international audience outside of the US. Servo-n may be
© Maquet Critical Care AB 2018 · Servo-n is a trademark of MAQUET Critical Care AB · MX-7426 Rev01 · English
1. If the correct circuit is not tested, the following 4. Flow triggering of 1.6l/min is easier to trigger the
risks may arise: breath than pressure triggering of -1.
• In volume-based modes, the volume delivered to
5. There is a lung on the screen indicating the triggered
the patient will be incorrect.
breath. Also there is a white indication in the wave-
• In pressure-based modes, the volume measured forms. (if pressure triggering is set- white indication in
will be incorrect. pressure waveform and if Flow triggering is set- white
indication in flow curve).
2. Red – High Priority alarms. Yellow – Medium priority
alarms. Blue – Low priority alarms.
3. Autoset is not available in supported or NIV modes or
in STANDBY because the ventilator system requires
patient values in order to propose alarm limits.
Answers