Ramp??? Phillips respronics System Remstar BIPAP Pro 660P

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Ramp??? Phillips respronics System Remstar BIPAP Pro 660P

Post by Java » Tue Aug 26, 2014 11:54 pm

I just picked up my Phillips respronics System Remstar BIPAP Pro with Bi-Flex(660P) today from Apria and they have it set all wrong. I cannot for the life of me find how to turn the ramp feature off and on. Right now it is off and the machine starts blowing at 20 and it's too strong. When my doctor (Kaiser) sent me home with a test unit it started on 13. I know how to get in the clinicians menu, that is not the problem. The problem is I cannot find any way to turn on the ramp feature in the clinician menu or the user menu. Any help would be appreciated. Thanks!!
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Re: Ramp??? Phillips respronics System Remstar BIPAP Pro 660P

Post by Wulfman... » Wed Aug 27, 2014 12:15 am

See if this will help.

Den

.

Navigating the Device Screens
Turn the Wheel to toggle between options and settings on the screen. Press the Wheel to choose an option or setting that is highlighted. If you choose “Back” on any screen, it will take you back to the previous screen.
Note: The screens shown throughout this manual are examples only. Actual screens may vary slightly. Examples are for reference only.
Starting the Device
1. Supply power to the device.
2. The Home screen will appear, shown below.
TherapyInfoFlexSetup
Home Screen
Note: “Flex” shown above will display as the current Flex setting chosen by the provider.
3. Put on your mask assembly.
Note: If you are having trouble with your mask, refer to the instructions supplied with the mask.
4. Turn the Wheel to toggle between the four options. Highlight “Therapy”. Press the Wheel to turn on the airflow and begin therapy. The Therapy screen will appear which will show the current pressure setting being delivered.
5. Make sure that no air is leaking from your mask into your eyes. If necessary, adjust the mask and headgear until the air leak stops. See the instructions provided with your mask for more information.
Note: A small amount of mask leak is normal and acceptable. Correct large mask leaks or eye irritation from an air leak as soon as possible.
6. If you are using the device in a bed with a headboard, try placing the tubing over the headboard. This may reduce tension on the mask.
7. Press the Wheel again to turn off therapy and return to the Home screen.
8. User Manual
Ramp Feature
The device is equipped with an optional ramp feature that your home care provider can enable or disable. This feature reduces the air pressure when you are trying to fall asleep and then gradually increases (ramps) the pressure until your prescription setting is reached, allowing you to fall asleep more comfortably.
If ramp is enabled on your device, after you turn on the airflow, press the RAMP button on the top of the device. You can use the RAMP button as often as you wish during the night.
Note: If the ramp feature is disabled, nothing will happen when you press the RAMP button.
Note: If in Auto mode, there is no ramp at minimum pressure when starting. Ramp would only be useful if you wake in the middle of the night.
Flex Screen
From the Home screen, highlight the “Flex” option and press the wheel. The following Flex screen will appear.
Flex Screen
Note: “Flex” shown above will display as the current Flex setting chosen by the provider.
• .Flex - The Flex comfort feature allows you to adjust the level of air pressure relief that you feel when you exhale during therapy. Your home care provider can enable, lock or disable this feature. When your provider enables Flex, a level will already be set for you on the device. If this is not comfortable, you can increase or decrease the setting. The setting of “1” provides a small amount of pressure relief, with higher numbers providing additional relief. If the provider has disabled this feature, the flex screen will display “Flex is disabled”. If the provider has locked this feature, a lock symbol will display next to the setting.
• Flex demo - The Flex setting allows you to set the Flex level prior to beginning therapy. The Flex demo setting allows you to try out the different Flex settings in real time. After a period of time of inactivity, the device will stop therapy and will use the last Flex demo setting as the new Flex setting for your device. When therapy is again started from the Home screen, the device will operate using the new Flex setting.
Setup Screen
From the Home screen, highlight the “Setup” option and press the wheel. The following Setup screen will appear. The user can change settings in the Setup menu.
SYSTEM ONE resistance X1 X2 X3 X4 X5Ramp start 4.0 - (auto min) or (CPAP pres)
Setup Screen
Note: The screen will only show 4 lines at a time. As you rotate the Wheel to toggle over different options the screen will slide up and down accordingly.
Note: If the text is too long to completely fit on the screen, it will scroll horizontally across the screen when highlighted.9 User Manual
• Flex - This displays the Flex level set by your home care provider. “Flex” will display as the current Flex setting chosen by the provider. Your home care provider will either enable, lock, or disable Flex. If Flex is enabled and the setting is not comfortable, you can increase or decrease this setting. If your provider has locked a Flex setting into place, you can view the setting but cannot change it, and the screen will display a lock symbol. If your provider has disabled Flex, you will not see this setting.
• Humidifier - This displays the humidifier setting. This will only display if the humidifier is attached. Please refer to the humidifier manual if using a humidifier.
• Ramp Start - This displays the ramp starting pressure. You can increase or decrease the ramp starting pressure in 0.5 cm H2O increments. This is only available if Ramp time has been set to >0 and auto min or CPAP pressure >4 cm H2O. This will not display if your provider enabled Split night on your device.
• SYSTEM ONE resistance ( ) - This setting allows you to adjust the level of air pressure relief based on the specific Respironics mask. Each Respironics mask may have a “System One” resistance control setting which will appear next to the symbol (ex. X3). Contact your home care provider if you cannot find this resistance setting for your mask. If your provider has locked the resistance setting into place, you can view the setting but cannot change it, and the screen will display a lock symbol. If your provider has disabled resistance, you will not see this setting.
• Auto on - You can enable this feature if you want the device to automatically turn the airflow on whenever you apply the interface (mask) to your airway.
• Auto off - You can enable this feature if you want the device to automatically turn the airflow off whenever you remove the interface (mask) from your airway.
• Mask alert - You can enable or disable the mask alert setting. If this feature is enabled, the mask alert will appear on the display screen when a significant mask leak is detected, and an audible alert will sound. Refer to the Device Alerts section for more information about the mask alert.
• LED backlight - You can enable or disable the LED backlight for the humidifier icon and settings on the device.
Info Screen
From the Home screen, highlight the “Info” option and press the wheel. The following Info screen will appear. The user cannot change settings in the Info menu.
Note: These screens are only for reference. Your home care provider may periodically ask you for this information.
Compliance VICDays > 4
Info Screen
Note: The screen will only show 4 lines at a time. As you rotate the Wheel to toggle over different options the screen will slide up and down accordingly.
• Status - This displays information sent from a peripheral (SD card, modem, etc.). If two peripherals are attached, two lines will appear with corresponding icons.10 User Manual
• Phone-in - This screen displays the total therapy hours for the device, the total blower hours, and the total number of days used when the sessions were greater than 4 hours since the device was last reset by the home care provider. This screen also displays a compliance number used by your home care provider to validate that the data provided by you is the data taken from this screen. This setting only appears if your provider has enabled this feature.
• Compliance VIC (Visual Inspection Check) - This screen displays the start date and the total number of days used when the sessions were greater than 4 hours. This screen also displays a check code number used by your home care provider to validate that the data provided by you is the data taken from this screen. This setting only appears if your provider has enabled this feature.
• Therapy hours - The device is capable of recognizing the difference between the time the patient is actually receiving therapy and the time when the blower is simply running. This screen displays the average amount of time the patient is actually receiving therapy on the device over a 7 day and 30 day time frame (provided the device has at least 7 or 30 days of data respectively). If the device has only 5 days of data to use for the calculation, the 5 day average value will be seen under the 7 day display.
• Days > 4 - This screen displays the cumulative number of device therapy sessions that exceeded 4 hours over a 7 day and 30 day time frame.
• System leak - During any given night, the device recognizes the percentage of time the patient was experiencing what it deemed to be a large leak. Large leak is defined as the level of leak that is so large, it is no longer possible to determine respiratory events with statistical accuracy. This screen displays the average of these individual nightly values of percentage of time in large leak over a 7 day and 30 day time frame (provided the device has at least 7 or 30 days of data respectively). If the device has only 5 days of data to use for the calculation, the 5 day average value will be seen under the 7 day display. If you see a large increase in the percent of time in large leak indicated here, contact your home care provider for assistance. This screen only displays if your home care provider has enabled it.
• AHI - The device accumulates individual Apnea/Hypopnea indices (AHI) for each session the patient used the device. This screen displays the average of these individual nightly AHI values over a 7 day and 30 day time frame (provided the device has at least 7 or 30 days of data respectively). If the device has only 5 days of data to use for the calculation, the 5 day average value will be seen under the 7 day display.
• Periodic Breathing - During any given night, the device recognizes the percentage of time the patient was experiencing period breathing. This screen displays the average of these individual nightly values of periodic breathing over a 7 day and 30 day time frame (provided the device has at least 7 or 30 days of data respectively). If the device has only 5 days of data to use for the calculation, the 5 day average value will be seen under the 7 day display. If you see a large increase in the percent of time in periodic breathing indicated here, contact your home care provider for assistance. This screen only displays if your home care provider has enabled it.
• 90% Pressure - During any given night, the device recognizes the 90% Pressure achieved by the Auto Algorithm. 90% Pressure is defined as the pressure at which the device spent 90% of the session time at or below. For example, if the device recognized airflow for 10 hours, and 9 hours were spent at or below 11 cm H2O, and 1 hour was spent above 11 cm H2O, then the 90% Pressure would be 11 cm H2O. This screen displays the average of these individual nightly values of 90% Pressure over a 7 day and 30 day time frame (provided the device has at least 7 or 30 days of data respectively). If the device has only 5 days of data to use for the calculation, the 5 day average value will be seen under the 7 day display. This screen only displays if the device was set to Auto-CPAP therapy.

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Re: Ramp??? Phillips respronics System Remstar BIPAP Pro 660P

Post by JDS74 » Wed Aug 27, 2014 4:17 am

Get to the clinician menu and scroll down to the RAMP function.
Select it and set the time to something other than zero (setting it to zero disables the ramp function).
I suggest setting it to 20 minutes since that will give you time to get to sleep.
I suggest setting the starting pressure to 15 since that is similar to what you had with the testing unit.
Try those settings for a night and see how they feel.
Adjust as necessary perhaps making the time longer or the starting pressure lower.

Remember, during the low pressure phase of RAMP, the therapy is less effective so less time there is better but not to the extent that you can't tolerate the machine. It's a trade-off. After some time, you will adjust and can gradually eliminate using RAMP at all. That comes later.

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Re: Ramp??? Phillips respronics System Remstar BIPAP Pro 660P

Post by Pugsy » Wed Aug 27, 2014 7:54 am

I have a PR S1 660 machine. The Ramp on/off choice is there along with a choice for how long you want it to ramp.

Do you have the provider/clinical manual for your new machine? If not, go here and request it.. Instructions near the bottom of the page. It's all explained in the manual.
http://www.apneaboard.com/adjust-cpap-p ... tup-manual

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Re: Ramp??? Phillips respronics System Remstar BIPAP Pro 660P

Post by Java » Wed Aug 27, 2014 2:09 pm

JDS74 wrote:Get to the clinician menu and scroll down to the RAMP function.
That is my problem. There is no RAMP function in my clinician menu.
Unless there is a super secret clinician menu other than holding down the circle and ramp button till it beeps..
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Re: Ramp??? Phillips respronics System Remstar BIPAP Pro 660P

Post by Pugsy » Wed Aug 27, 2014 2:14 pm

It's in the clinical menu...you aren't though or you would see it.

You have to be in the "Setup" square. I bet you are still in the "Therapy" Square.
See this link with pictures and even a little video
http://www.apneaboard.com/pr-system-one ... structions

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Re: Ramp??? Phillips respronics System Remstar BIPAP Pro 660P

Post by Java » Thu Aug 28, 2014 2:16 am

Well this is absolutely crazy! I would have never figured this out. I took my new BiPap machine to the sleep clinic today and the respiratory therapist showed me why I didn't have a Ramp feature. It was because the EPAP was set at 4.0. As soon as he turned the EPAP to 4.5 the Ramp option appeared in the menu. I would have never found it. Never thought to change EPAP or IPAP to get Ramp to appear.

All good now. Thank you everyone for your help.
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Re: Ramp??? Phillips respronics System Remstar BIPAP Pro 660P

Post by palerider » Thu Aug 28, 2014 9:10 am

Java wrote:Well this is absolutely crazy! I would have never figured this out. I took my new BiPap machine to the sleep clinic today and the respiratory therapist showed me why I didn't have a Ramp feature. It was because the EPAP was set at 4.0. As soon as he turned the EPAP to 4.5 the Ramp option appeared in the menu. I would have never found it. Never thought to change EPAP or IPAP to get Ramp to appear.

All good now. Thank you everyone for your help.
you started out saying that the machine started blowing at 20, if you'd said that it was starting at 4, then we might have told you that there's no need for ramp when you already start at the minimum pressure.

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Re: Ramp??? Phillips respronics System Remstar BIPAP Pro 660P

Post by Java » Thu Aug 28, 2014 1:10 pm

palerider wrote: you started out saying that the machine started blowing at 20, if you'd said that it was starting at 4, then we might have told you that there's no need for ramp when you already start at the minimum pressure.
It's a BiPap so it was blowing in at 20 and exhaling at 4. I really didn't think the exhale had anything to do with activating a Ramp feature!! Live and Learn I guess. Thanks again everyone!
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Re: Ramp??? Phillips respronics System Remstar BIPAP Pro 660P

Post by Pugsy » Thu Aug 28, 2014 1:36 pm

Java wrote:It's a BiPap so it was blowing in at 20 and exhaling at 4.
That means the settings would be EPAP at 4 and IPAP at 20 since this is the 660 Pro BiPap. That's a really big pressure support going on there.

I had no idea that with IPAP at 20 your EPAP was at 4 which of course does turn off ramp access since that's where ramp normally defaults to. There's nothing to ramp to or from. If I had known that then I would have rethought my response.

Glad you got it figured out though.

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Re: Ramp??? Phillips respronics System Remstar BIPAP Pro 660P

Post by palerider » Thu Aug 28, 2014 2:40 pm

Java wrote:
palerider wrote: you started out saying that the machine started blowing at 20, if you'd said that it was starting at 4, then we might have told you that there's no need for ramp when you already start at the minimum pressure.
It's a BiPap so it was blowing in at 20 and exhaling at 4. I really didn't think the exhale had anything to do with activating a Ramp feature!! Live and Learn I guess. Thanks again everyone!
wow, having a pressure support of 16 must be incredible.... my vpap auto won't go above 10.

of course, the machine doesn't switch to ipap until you start to inhale, so when you'd first turn the machine on, it'd be at four, until you inhaled, then BAM...

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