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BiLVL – Bi-Phasic Positive Airway Pressure

Course Content
Device Components
In this module, you will learn to identify the key external components and patient circuit elements of the eAdvantage ventilator system. Left Side Components: DC input connector Gas supply input Air filter intake 22 mm gas output connector Sensor connector 1 and sensor connector 2 Right Side Components: Two screw knobs Relief flapper Air/O₂ exhaust port Battery compartment Patient Circuit Overview: The patient circuit includes a 22 mm corrugated hose, breathing control hose, two pressure sensor hoses, a one-way valve, exhalation port, mushroom valve, flow sensor adapter, and an elbow connector. On the ventilator end, the circuit connects at three points to ensure accurate flow and pressure delivery. By the end of this module, you’ll be able to identify all major connectors and understand the structure and connections of the patient circuit.
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Device Components
Device Components
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Connecting Patient Circuit and Gas Supply
In this part of the O-Two e700 ventilator training video, viewers are guided through the proper steps to connect the patient breathing circuit and gas supply: Oxygen Supply Connection: Attach the high-pressure oxygen supply hose to the 9/16-inch DISS (Diameter Index Safety System) connector. Hand-tighten only — do not use tools. Sensor Hose Setup: Connect the sensor hose with the lower locking mechanism to Sensor Connector #1. Attach the second sensor hose to Connector #2 by simply pushing it on. Breathing Circuit Connection: Connect the 22mm breathing circuit hose to the male 22mm outlet on the ventilator. The other end of the oxygen supply hose should be connected to a regulated oxygen source — either a gas cylinder or a wall outlet. Gas Supply Activation: Turn on the gas supply slowly and fully. Patient Safety Precaution: Do not connect the breathing circuit to the patient while attaching the circuit to the ventilator. Optional Filter Use: A breathing circuit filter may be used, but it must be placed between the patient connection and the mask or ET tube. Elbow Connector Note: Ensure the elbow connector is always present and properly connected, as it is prone to falling off. This connector links the breathing circuit to the patient’s mask or endotracheal (ET) tube. This segment emphasizes accuracy and safety, ensuring that each component is securely and correctly connected before initiating ventilation. Oxygen Supply Connection: Attach the high-pressure oxygen supply hose to the 9/16-inch DISS (Diameter Index Safety System) connector. Hand-tighten only — do not use tools. Sensor Hose Setup: Connect the sensor hose with the lower locking mechanism to Sensor Connector #1. Attach the second sensor hose to Connector #2 by simply pushing it on. Breathing Circuit Connection: Connect the 22mm breathing circuit hose to the male 22mm outlet on the ventilator. The other end of the oxygen supply hose should be connected to a regulated oxygen source — either a gas cylinder or a wall outlet. Gas Supply Activation: Turn on the gas supply slowly and fully. Patient Safety Precaution: Do not connect the breathing circuit to the patient while attaching the circuit to the ventilator. Optional Filter Use: A breathing circuit filter may be used, but it must be placed between the patient connection and the mask or ET tube. Elbow Connector Note: Ensure the elbow connector is always present and properly connected, as it is prone to falling off. This connector links the breathing circuit to the patient’s mask or endotracheal (ET) tube. This segment emphasizes accuracy and safety, ensuring that each component is securely and correctly connected before initiating ventilation.
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Connecting the Patient Circuit and Gas Supply
Connecting the Breathing Circuit and Gas Supply
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Battery
This part of the video explains how the O-Two e700 ventilator is powered and provides step-by-step instructions for installing the internal battery. The O2E700 can operate using either its internal rechargeable battery or an external AC/DC power supply. For safety and uninterrupted ventilation, a fully charged battery must always be installed, even when using an external power source. This ensures continuous operation in case of power failure or disconnection. Battery Installation Steps: Ensure safety first – Turn off the ventilator and unplug it from the electrical supply. Open the battery compartment by turning the yellow screw knobs on the cover counterclockwise. Connect the battery leads carefully. Close the battery compartment and turn the yellow knobs clockwise to secure it. • Important Tip: When replacing the battery, never pull it by the connectors. Instead, use the battery standoff to gently remove it after disconnecting the leads.
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Battery Installation and Power Supply
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Powering the Ventilator and Battery Installation
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Quick Start
This segment of the video demonstrates how to quickly power on the O-Two e700 ventilator and begin the initial setup. Turning On the Device: Press and hold the On/Off key for one second. Upon startup, the ventilator displays three patient silhouettes representing: Infant Child Adult Patient Size Selection: Rotate the control knob to highlight the desired patient size. Press the control knob to confirm your selection. If no selection is made within 20 seconds, the ventilator will automatically default to Child mode. Each patient category includes preset ventilation parameters to simplify and speed up the setup process, allowing caregivers to begin ventilation promptly without needing to manually configure initial settings.
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Quick Start – Powering On and Selecting Patient Size
Powering On and Initial Patient Setup
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Ventilator Controls
This section of the video provides an overview of the user interface and control elements used to operate the O-Two e700 ventilator. The device is managed using a combination of membrane keys and a control selection knob, allowing users to access and adjust ventilation settings easily. Main Controls and Their Functions: On/Off Button Press for 1 second to power on the ventilator. Press for 4 seconds to power off the ventilator. Control Selection Knob Rotate to navigate settings and modes. Press to confirm selections. Manual Key During exhalation, pressing this key delivers a mandatory breath using the set flow or pressure. Holding the key after inspiratory time triggers the inspiratory hold function (up to 6 seconds), maintaining lung pressure by closing the exhalation port. After the hold time, the ventilator automatically transitions to the exhalation phase. Enabled in all modes except CPAP and CPR. Brightness Key Adjusts screen color and contrast for better visibility. Silence Key Mutes audible alarms for 2 minutes. Can be used proactively even when no alarm is active. Displays a mute symbol on the screen. Pause Key Pauses ventilation while keeping other controls active (except Manual). Activates a pause symbol and confirmation prompt on the screen. If not confirmed by pressing the knob within 10 seconds, the pause is canceled. Lock Key Disables all buttons except On/Off, Silence, Brightness, and the Control Knob. Displays a lock icon to indicate the function is active. Press again to unlock. Waveform Selection Key Toggles between pressure and flow waveforms on the display. Cancel Key Cancels the last unconfirmed changes and restores previous settings.
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Ventilator Controls – O-Two e700 Interface Overview
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User Interface and Control Functions
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Screen Layout
The O-Two e700 ventilator features an intuitive display divided into seven distinct sections, each providing essential information and control feedback to the user in real time: 1. Battery Status Displays battery level and charging status. Shows whether the ventilator is charging or discharging. 2. Live Ventilator Parameters Shows current real-time data such as: Tidal volume Respiratory rate Pressure levels FiO₂ (oxygen concentration) Crucial for monitoring patient status during ventilation. 3. Ventilation Modes Indicates the currently selected ventilation mode (e.g., SIMV, CPAP). Enables quick recognition of operational status. 4. Alarms and Warnings Displays active alarms, warnings, or system alerts. Alerts are prioritized by color or symbol to draw immediate attention. 5. Ventilation Waveforms Graphical representation of pressure or flow curves. Helps clinicians analyze breathing patterns and ventilator performance. 6. Setup Parameters Shows configurable settings like: Inspiratory time Expiratory time PEEP, etc. Allows easy adjustment and review of ventilation parameters. 7. Confirmation & System Feedback Displays confirmation prompts for actions (e.g., "Pause?", "Lock?") Also shows messages related to: Patient effort detection Invalid settings Conflicting parameters
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Screen Layout Overview
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Understanding the O-Two e700 Ventilator Screen Layout
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Alarm Settings
The alarm configuration is essential to ensure patient safety and to detect ventilation issues. These settings are located in the bottom left corner of the screen. Pressure Alarm Limits Pmax (Maximum Pressure Limit) Triggers an alarm if pressure exceeds the set maximum. Possible causes include: Coughing Endotracheal or tracheostomy tube obstruction Excessive condensation in the ventilator circuit Downward migration of the endotracheal tube into a mainstem bronchus Bronchospasm Patient clashing with the ventilator Low lung compliance due to: Pulmonary edema Pneumothorax Lung consolidation Pmin (Minimum Pressure Limit) Triggers an alarm if the peak airway pressure is too low. Possible causes include: Circuit disconnection Upward migration of the endotracheal tube Leaks at circuit connection points Endotracheal cuff issues Low tidal volume Visual and Audible Alarms The illuminated warning triangle provides a visual indication of an alarm condition. The TFT display shows the cause of the alarm. Alarm levels are color-coded: Yellow for low-priority alarms Red for high-priority alarms Power Indicators (LEDs) Located to the left of the key membrane, the three power LEDs indicate the ventilator's power source and battery status: LED Location Indicates Top LED Ventilator running on internal battery Middle LED Ventilator running on mains (external) power Bottom LED Battery is charging Summary Proper alarm settings help detect patient or equipment issues promptly. Pressure alarms are triggered by abnormal airway pressure conditions. Visual and audible alerts provide immediate feedback to the user. Power LEDs clearly indicate operating and charging status.
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Alarm Settings
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Alarm Settings
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Ventilation Modes
The O-Two e700 offers versatile ventilation support, suitable for both invasive (via endotracheal tube) and non-invasive (via mask) applications. In every mode, the ventilator allows for spontaneous breathing: if a patient requires more flow than what’s set, they can inhale additional volume from ambient air. Available Ventilation Modes: ACV (Assist Control Ventilation) Provides mandatory breaths at a set rate, while also assisting spontaneous breaths. SIMV (Synchronized Intermittent Mandatory Ventilation) Delivers preset mandatory breaths and allows spontaneous breathing between them. CPAP (Continuous Positive Airway Pressure) Maintains a continuous pressure throughout the breathing cycle. Pressure Support Ventilation (PSV) can be added in this mode. Bi-Level Positive Airway Pressure (BiPAP) Alternates between two pressure levels for better control of inspiration and expiration. CPR (Cardiopulmonary Resuscitation Mode) Specifically designed for resuscitation scenarios, ensuring consistent support during emergency care. Each mode activates with its default settings when selected. If no changes are made, ventilation will proceed using those pre-configured values.
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Adjusting Ventilation Settings
Modifying Ventilation Parameters
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A/CV Mode
A/CV is the default mode that appears upon startup of the O-Two e700 ventilator. It offers the widest range of settings and can operate in two ventilation types: Volume-Controlled Ventilation (VCV) Pressure-Controlled Ventilation (PCV) 🔄 How It Works: The ventilator delivers mandatory breaths at a preset rate. Patient effort is not required to initiate breaths (but can trigger them if enabled). If the trigger is disabled, breaths will be delivered purely based on time. 🔧 Default Trigger Sensitivity: 3 L/min (adjustable from 1 to 15 L/min) 📋 Main Settings in A/CV Mode: Setting Description VT (Tidal Volume) Sets the volume of air delivered per breath (used in VCV only) Rate Number of breaths per minute MV (Minute Volume) Total air delivered per minute (VT × Rate) I:E Ratio Ratio of inspiration to expiration time TI (Inspiratory Time) Duration of the inspiratory phase PEEP Pressure maintained at the end of exhalation O₂% Fraction of inspired oxygen (choice between 60% and 100%) MV Max/Min Alarm limits for high and low minute volume P Max/Min Alarm limits for high and low airway pressure 🔁 Switching Between Volume and Pressure Control: Volume Mode (default): You set the tidal volume (VT). The ventilator delivers the exact set volume with each breath. Pressure Control Ventilation (PCV): Activated by selecting PCV Pressure. VT setting is disabled. The ventilator delivers air until the set pressure is reached, maintained for the preset inspiratory time. Useful when the patient is completely unable to breathe. Cycle is time-triggered and pressure-limited. 💡 Summary: ACV mode is ideal for patients who cannot breathe adequately or at all. Can be tailored for either precise volume delivery or pressure-targeted support. It provides full control over respiratory support, while allowing optional patient triggering.
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A/CV Mode – Assist-Control Ventilation
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ACV Mode on the O-Two e700 Ventilator
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CPAP Mode
In CPAP mode, the O-Two e700 ventilator delivers a constant flow of air to maintain positive airway pressure throughout the entire breathing cycle. This is essential for patients who are breathing spontaneously but require assistance in maintaining open airways. How CPAP Mode Works: The ventilator uses a control valve to regulate and maintain the set CPAP level. A continuous flow is provided to ensure a stable pressure environment in the airway. Two Breathing Options in CPAP Mode: PSV = 0 (Dash Displayed) – Flow-Regulated CPAP This is a passive support mode. The ventilator automatically adjusts the flow to maintain an average airway pressure close to the set CPAP value. Appears as a dash when pressure support is set to zero (also seen in SIMV). PSV Set to Value – Active Pressure Support When Pressure Support Ventilation (PSV) is set, the ventilator delivers the preset PSV pressure during inspiration (starting from the trigger point) until the exhalation phase begins. Helps patients with weak spontaneous effort by boosting inspiratory flow. Apnea Backup Function Safety Feature: If the patient stops breathing and does not trigger spontaneous breaths within the apnea period (T apnea) set by the user: The ventilator automatically switches to Assist Control Ventilation (ACV). This ensures continuous support in case of patient apnea. 🛠️ Default Trigger in CPAP Mode: Pressure trigger, typically set at 2 cm H₂O. Settings Available in CPAP Mode: Below the CPAP display, the following parameters can be configured: CPAP: Sets the baseline airway pressure. PSV: Defines the pressure delivered during inspiratory support. Trig: Adjusts sensitivity to patient’s inspiratory effort. Termination: Ends the inspiratory phase when a condition is met. FiO₂ (%): Sets oxygen concentration. MV Max/Min: Maximum and minimum minute volume alarms. P Max/Min: Pressure limits to ensure safe ventilation. P Apnea: Time setting that determines when backup mode is activated due to apnea. Backup Settings in CPAP Mode: In preparation for possible apnea and automatic switch to ACV, the following parameters can be pre-set: Rate (breaths per minute) VT (Tidal Volume) I:E Ratio MV (Minute Volume) If not pre-set, the ventilator will use default values based on the selected patient size.
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CPAP Mode – Continuous Positive Airway Pressure
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CPAP Mode on the O-Two e700 Ventilator
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SIMV Mode
The SIMV mode provides a flexible combination of mandatory and spontaneous breaths, adapting to the patient’s breathing efforts while maintaining a consistent backup ventilation rate. How SIMV Works: The ventilator delivers mandatory breaths at a fixed rate set by the user. Between these breaths, the patient is allowed to breathe spontaneously. If the patient initiates a breath before the next scheduled mandatory breath, the ventilator synchronizes and delivers a volume-controlled breath in coordination with the patient’s effort. 🔄 Trigger Sensitivity (Flow Trigger): Default value: 3 L/min Adjustable range: 1 to 15 L/min If the patient meets this trigger condition, the ventilator synchronizes the mandatory breath accordingly. Pressure Support in SIMV Mode During spontaneous breaths, the ventilator can provide Pressure Support Ventilation (PSV): PSV assists patients who can initiate breaths but need help maintaining adequate ventilation. Once the ventilator senses an inspiratory effort, it delivers a constant pressure to support the breath. This reduces the patient’s work of breathing while maintaining respiratory efficiency. ⚙️ Termination (also known as Timation): Adjusts the flow percentage at which the inspiratory phase ends, allowing the ventilator to adapt to the patient's breathing pattern. Available Settings in SIMV Mode SIMV mode includes many of the same adjustable parameters as ACV mode, such as: VT (Tidal Volume) Rate (Mandatory breaths per minute) MV (Minute Volume) I:E Ratio (Inspiratory to Expiratory time) DI (Inspiratory Time) PEEP (Positive End-Expiratory Pressure) Trigger Sensitivity FiO₂ (%) (Oxygen concentration) MV Max/Min (Minute volume alarms) P Max/Min (Pressure alarms) SIMV is especially useful for weaning patients off mechanical ventilation, offering full support when needed while encouraging natural breathing between assisted breaths.
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SIMV Mode – Synchronized Intermittent Mandatory Ventilation
SIMV Mode on the O-Two e700 Ventilator
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CPR Mode
The CPR mode on the O-Two e700 ventilator is designed to support resuscitation efforts by synchronizing ventilation with chest compressions, providing audible prompts, visual guidance, and automated breath delivery for both intubated and mask-ventilated patients. 🧍‍♂️ Two Sub-Modes in CPR: Mask-Ventilated Patients (Default Mode) This is the default configuration when CPR mode is activated. CPR is divided into two timed phases: Chest Compression Phase: 30 compressions delivered over 18 seconds Synchronized with audible cues and on-screen visual animations Ventilation Phase: 2 mandatory breaths, each lasting 1 second Delivered over a 5-second window Follows the standard 30:2 compression-to-breath ratio for basic life support. Intubated Patients Can be selected at any time during CPR mode. Features continuous chest compressions at a rate of 100 per minute. 1 mandatory breath is automatically delivered every 6 seconds (equivalent to 10 breaths per minute). Also includes audible and visual prompts for compressions. 💨 Ventilation Settings in CPR Mode Default Mode: Flow-controlled ventilation Default Volume: Based on the initial patient size selection (Infant, Child, or Adult) Custom Adjustments: Ventilation volume can be modified if needed after entering CPR mode. 🛠️ Optional Pressure-Controlled Ventilation (PCV): Can be enabled by setting the PCV pressure parameter. When activated, flow-controlled ventilation is automatically disabled. ⚠️ Oxygen Delivery in CPR Mode Oxygen is fixed at 100% FiO₂ to ensure maximum oxygenation during resuscitation efforts. 🧠 Key Takeaways: CPR mode provides a structured, automated sequence for resuscitation. Audible and visual prompts guide the caregiver through compressions and ventilation. Compatible with mask and intubated ventilation strategies. Offers a balance of automation and control, including PCV options.
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CPR Mode – Cardiopulmonary Resuscitation Support
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CPR Mode on the O-Two e700 Ventilator
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BiLVL Mode
The Bi-Level mode (also referred to as "By Level") on the O-Two e700 ventilator combines features of pressure ventilation and spontaneous breathing support, making it similar to SIMV, but with more control over inspiratory and expiratory pressures. How Bi-Level Mode Works: The ventilator cycles between two pressure levels: Inspiratory Pressure (Pi) Expiratory Pressure (PEEP) It provides a set number of pressure-controlled breaths per minute, while also allowing spontaneous breathing at any time during the respiratory cycle. 🫁 If the patient breathes spontaneously: The ventilator detects the effort and assists the breath using the PSV (Pressure Support Ventilation) setting. If the patient demands more flow than the ventilator is delivering, they can inhale additional air from the ambient environment via the air filter intake. 🔄 Trigger Sensitivity (Flow Trigger): Default: 3 L/min Adjustable: 1–15 L/min Controls how sensitive the ventilator is to detecting a patient’s inspiratory effort. Key Features of Bi-Level Mode: Hybrid functionality: Allows both mandatory pressure-controlled breaths and spontaneous assisted breaths. Automatic cycle adjustment: The ventilator modifies its timing and flow in real-time based on patient effort. Settings Available in Bi-Level Mode: Setting Description Pi Sets the inspiratory pressure level Rate Sets the number of breaths per minute PEEP Sets the positive end-expiratory pressure I:E Ratio Defines the ratio of inspiration to expiration time Ti Sets the inspiratory time PSV Defines pressure support during spontaneous inspiration Trig (L/min) Adjusts the flow sensitivity for detecting a patient-triggered breath Termination Sets the flow percentage at which the ventilator ends inspiration O₂% Sets the inspired oxygen concentration MV Max/Min Alarm thresholds for minute volume (high and low) P Max/Min Alarm thresholds for airway pressure (high and low) When to Use Bi-Level Mode: Ideal for patients who require pressure-controlled ventilation but can breathe spontaneously between cycles. Offers a more physiological breathing pattern and can help in weaning or supporting patients with variable respiratory efforts.
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BiLVL – Bi-Phasic Positive Airway Pressure
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Bi-Level Mode on the O-Two e700 Ventilator
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Live Monitoring
Live monitoring parameters are displayed in Section Two of the ventilator's screen. This section allows the operator to observe real-time outcomes based on settings adjusted in Section Six. These values are continuously updated and provide essential information about the patient's ventilation status. Key Monitoring Parameters 1. MVE (Minute Volume, in liters) Represents the total volume of air exhaled over the last 60 seconds. Calculated using the average of the last eight breaths. Value is recalculated and updated at the end of each exhalation phase. When the unit is first powered on, resumed after a pause, or when a new mode is selected, the minute volume calculation will begin incrementally from the first to the eighth exhalation, then continue as a rolling average. 2. VTE (Tidal Volume Exhaled, in milliliters) Measures the volume exhaled by the patient during a breath. Applies to mandatory, spontaneous, or pressure support ventilation modes. Calculated from the total expired flow. The VTE display updates at the beginning of the next inspiratory phase (immediately after exhalation ends). 3. Paw AV (Average Airway Pressure, in cmH₂O) Represents the average airway pressure over the last 60 seconds. Continuously monitored across all modes. The value is updated every 15 seconds. 4. Paw Peak (Peak Airway Pressure, in cmH₂O) Indicates the maximum pressure during the inspiratory phase. Displayed for mandatory inspiration phases in ACV, SIMV, B-level, and CPR modes, as well as for spontaneous inspiration in CPAP mode. Updated at the end of each inspiratory phase. 5. Rate (Breaths Per Minute, BPM) Displays the number of breaths delivered or initiated in one minute. Calculated using the time between two consecutive breaths (Rate = 60 ÷ breath interval in seconds). Updated after each breath, and reflects both spontaneous and mandatory breathing. Summary The live monitoring section provides immediate, accurate feedback on the patient's ventilatory status, enabling timely clinical decisions. Values update automatically based on real-time measurements and give insight into both spontaneous and controlled ventilation performance.
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Live Monitoring
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Live Monitoring Parameters on the O-Two e700 Ventilator
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After Use
To ensure safety and proper maintenance of the O-Two e700 ventilator, follow these steps after each use: 1. Powering Down the Ventilator Press and hold the On/Off button for 4 seconds to turn off the device. 2. Gas Supply Disconnection Turn off the gas supply to the ventilator. Disconnect the gas supply hose from the patient connection. 3. Power Cable Management Unplug the power cable if charging is not required. 4. Cleaning and Disinfection Clean and disinfect the ventilator housing and supply hose using a damp cloth as recommended in the user manual. Follow proper infection control guidelines for all surfaces and accessories. 5. Patient Circuit Replacement Replace the patient circuit with a new, sterile circuit before the next use. 6. Additional Guidance Always consult the O-Two e700 user manual and visit O-Two Medical’s official website for detailed and updated information regarding cleaning, maintenance, and safe operation.
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Post-Use Procedures for the O-Two e700 Ventilator
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e700 Ventilator Training Center
About Lesson

The BiLVL mode (also referred to as “By Level”) on the O2E700 ventilator combines features of pressure ventilation and spontaneous breathing support, making it similar to SIMV, but with more control over inspiratory and expiratory pressures.

How BiLVL Mode Works:

  • The ventilator cycles between two pressure levels:

    • Inspiratory Pressure (Pi)

    • Expiratory Pressure (PEEP)

  • It provides a set number of pressure-controlled breaths per minute, while also allowing spontaneous breathing at any time during the respiratory cycle.

🫁 If the patient breathes spontaneously:

  • The ventilator detects the effort and assists the breath using the PSV (Pressure Support Ventilation) setting.

  • If the patient demands more flow than the ventilator is delivering, they can inhale additional air from the ambient environment via the air filter intake.

🔄 Trigger Sensitivity (Flow Trigger):

  • Default: 3 L/min

  • Adjustable: 1–15 L/min

  • Controls how sensitive the ventilator is to detecting a patient’s inspiratory effort.

Key Features of BiLVL Mode:

  • Hybrid functionality: Allows both mandatory pressure-controlled breaths and spontaneous assisted breaths.

  • Automatic cycle adjustment: The ventilator modifies its timing and flow in real-time based on patient effort.

Settings Available in BiLVL Mode:

Setting Description
Pi Sets the inspiratory pressure level
Rate Sets the number of breaths per minute
PEEP Sets the positive end-expiratory pressure
I:E Ratio Defines the ratio of inspiration to expiration time
Ti Sets the inspiratory time
PSV Defines pressure support during spontaneous inspiration
Trig (L/min) Adjusts the flow sensitivity for detecting a patient-triggered breath
Termination Sets the flow percentage at which the ventilator ends inspiration
O₂% Sets the inspired oxygen concentration
MV Max/Min Alarm thresholds for minute volume (high and low)
P Max/Min Alarm thresholds for airway pressure (high and low)

When to Use BiLVL Mode:

  • Ideal for patients who require pressure-controlled ventilation but can breathe spontaneously between cycles.

  • Offers a more physiological breathing pattern and can help in weaning or supporting patients with variable respiratory efforts.

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