Ventec Life Systems V-Home - Checkout Worksheet

Checkout Procedure
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Checkout Worksheet
The checkout procedures listed in the following worksheet should be performed before using V*Home on a patient,
and periodically during use. Print and complete a copy of this worksheet to verify V*Home checkout procedures were
completed.
NOTE: If V*Home is in long‑term use with a patient, these testing procedures may be performed using the existing
V*Home conguration. Periodically verify the monitors and alarms described in this chapter are functioning correctly.
Function Settings Requirement Pass / Fail / NA
Visual
Inspection
N/A No part of the device or connected components appear
damaged
Inop alarm N/A Two audible tones sound at V*Home power up
Power N/A VOCSN functions on external, removable battery, and internal
battery power
Ventilation Ventilation Mode: AC-Volume
Tidal Volume: 400 mL
PEEP: 5 cmH2O
Breath Rate: 12 BPM
Inspiratory Time: 1.7 seconds
Flow Trigger: 4 L/min
The Vte monitor reads between 279 and 541 mL
The Leak monitor reads between 20 and 40 L/min
The PEEP monitor reads between 2 and 8 cmH2O
The delivered Breath Rate is 12 BPM
There are no active alarms
Alarms Maintain settings congured
as part of Ventilation checkout
procedure.
Decannulation causes Patient Circuit Disconnect and/or Low
Minute Volume alarm to activate as expected
Disconnecting the Ventec One-Circuit causes Patient Circuit
Disconnect and/or Low Minute Volume alarm to activate as
expected
Remote alarm activates as expected (optional)
V*Home Serial Number:_______________________________________________________________________________________
Tester Name: ___________________________________________________________Date: ______________________________
Signature:__________________________________________________________________________________________________