T1 Patient Monitor Operator’s Manual
Copyright 2014 - 2016 Shenzhen Mindray Bio-Medical Electronics Co., Ltd. All rights reserved. Release time: October 2016 Revision: 4.0 WARNING Federal Law (USA) restricts this device to sale by or on the order of a physician or other practitioner licensed by U.S. state law to use or order the use of this device. Intellectual Property Statement SHENZHEN MINDRAY BIO-MEDICAL ELECTRONICS CO., LTD. (hereinafter called Mindray) owns the intellectual property rights to this Mindray product and this manual.
Manufacturer’s Responsibility Contents of this manual are subject to changes without prior notice. All information contained in this manual is believed to be correct. Mindray is not be liable for errors contained herein nor for incidental or consequential damages in connection with the furnishing, performance, or use of this manual.
THIS WARRANTY IS EXPRESSLY IN LIEU OF, AND MINDRAY EXPRESSLY DISCLAIMS, ANY OTHER EXPRESS OR IMPLIED WARRANTIES, INCLUDING ANY IMPLIED WARRANTY OF MERCHANTABILITY, NON-INFRINGEMENT, OR FITNESS FOR A PARTICULAR PURPOSE, AND OF ANY OTHER OBLIGATION ON THE PART OF MINDRAY. Damage to any product or parts through misuse, neglect, accident, or by affixing any non-standard accessory attachments, or by any customer modification voids this warranty.
Service Mindray maintains a network of service representatives and factory-trained distributors. Prior to requesting service, perform a complete operational check of the instrument to verify proper control settings. If operational problems continue to exist, In North America contact the Service Department at (800) 288-2121, ext: 8116 for Technical Support or (201) 995-8000 for assistance in determining the nearest field service location.
Company Contact Manufacturer: Shenzhen Mindray Bio-Medical Electronics Co., Ltd. Address: Mindray Building, Keji 12th Road South,Hi-tech industrial park, Nanshan, Shenzhen 518057,P.R.China Website: www.mindray.com E-mail Address: service@mindray.com.cn Tel: +86 755 81888998 Fax: +86 755 26582680 Distributor: Mindray DS USA, Inc. Address: 800 MacArthur Boulevard, Mahwah, New Jersey, 07430 USA Tel: 1.800.288.2121, 1.201.995.8000 Website: www.mindray.
Preface Manual Purpose This manual contains the instructions necessary to operate the product safely and in accordance with its function and intended use. Observance of this manual is a prerequisite for proper product performance and correct operation and ensures patient and operator safety. This manual is based on the maximum configuration and therefore some contents may not apply to your product. If you have any questions, please contact Mindray. This manual is an integral part of the product.
Contents 1 Safety ................................................................................................................................................................................. 1-1 1.1 Safety Information .......................................................................................................................................................................................... 1-1 1.1.1 Warnings ...................................................................................
3.10.1 Switching the Parameters On/Off ..........................................................................................................................................3-10 3.10.2 Accessing the Parameters Menu.............................................................................................................................................3-10 3.11 Operating Modes ...............................................................................................................................
6.5.1 Having a Split-Screen View of Minitrends ................................................................................................................................ 6-6 6.5.2 Setting Minitrends ............................................................................................................................................................................ 6-7 6.6 Viewing OxyCRG (only available with the external display).....................................................................
8.3.3 ECG Lead Placements ...................................................................................................................................................................... 8-3 8.3.4 Checking Paced Status.................................................................................................................................................................... 8-4 8.4 Understanding the ECG Display .....................................................................................
8.10.2 Extending the rhythm lead waveform area ........................................................................................................................8-24 8.11 Resting 12-Lead ECG Analysis ................................................................................................................................................................8-25 8.11.1 Accessing the 12-Lead Screen .........................................................................................................
11.5.10 Setting the SpO2 Tone Mode ................................................................................................................................................11-5 11.6 Measurement Limitations .......................................................................................................................................................................11-6 11.7 Masimo Information .......................................................................................................
14.6.5 Setting the Pressure Unit ...........................................................................................................................................................14-5 14.6.6 Enabling PPV Measurement and Setting PPV Source .....................................................................................................14-5 14.7 Overlapping IBP Waveforms ...............................................................................................................................
17.1 Introduction .................................................................................................................................................................................................17-1 17.2 Dose Calculations .......................................................................................................................................................................................17-2 17.2.1 Performing Calculations ......................................................
19.4.2 Transferring Data by Different Means ...................................................................................................................................19-2 19.5 Network Setup ............................................................................................................................................................................................19-3 19.5.1 Setting the Network Type.........................................................................................
A.1 Classifications ..................................................................................................................................................................................................A-1 A.2 Environmental Specifications ....................................................................................................................................................................A-1 A.3 Power Supply Specifications .............................................................
1 Safety 1.1 Safety Information WARNING Indicates a potential hazard or unsafe practice that, if not avoided, could result in death or serious injury. CAUTION Indicates a potential hazard or unsafe practice that, if not avoided, could result in minor personal injury or product/property damage. NOTE Provides application tips or other useful information to ensure that you get the most from your product.
1.1.1 Warnings WARNINGS Before putting the system into operation, the operator must verify that the equipment, connecting cables and accessories are in correct working order and operating condition. To avoid risk of electric shock, this equipment must only be connected to a supply mains with protective earth. If a properly grounded power outlet is not available, operate the monitor on battery power. The equipment is not intended to be used within the Magnetic Resonance (MR) environment.
1.1.2 Cautions CAUTIONS Only use parts and accessories specified in this manual. Disposable accessories are not designed to be reused. Reuse may cause a risk of contamination and affect the measurement accuracy. Always install or carry the equipment properly to avoid damage caused by a drop, impact, strong vibration or other mechanical force. Dry the equipment immediately in case of rain or water spray.
1.2 Equipment Symbols Some symbols may not appear on your equipment.
2 The Basics 2.1 Monitor Description 2.1.
2.1.2 Equipment Features The monitor is intended to be used in a hospital environment including, but not limited to, ICU, CCU, PICU, NICU, RICU, emergency room, operating room, postoperative observation ward, etc. The monitor can be used in two ways: As a stand-alone patient monitor, or As a multi-parameter module (MPM) for the Mindray Passport 17M and Passport 12M patient monitors, hereafter referred to as “the host monitor”.
2.2 Equipment Description 2.2.1 Main Unit 2.2.1.1 Front View 1 2 3 4 5 6 1. 7 Alarm lamp When a physiological alarm or technical alarm occurs, this lamp flashes as defined below. High level alarms: the lamp quickly flashes red. Medium level alarms: the lamp slowly flashes yellow. Low level alarms: the lamp lights yellow without flashing. 2. Display Screen 3.
7. Lock/unlock switch When the T1 is not connected with the external display, sliding this switch to the right locks/unlocks the touch screen. When the T1 is connected to the external display, sliding this switch to the right switches screen display between the T1 and the external display. 2.2.1.2 Left View 1 2 3 4 4 1. External DC power supply connector 2. Main unit multi-pin connector: connects the T1 to the T1 handle or T1 docking station. 3.
2.2.1.3 Right View 1 2 5 3 6 4 7 8 1. Temp probe 1 connector 2. Temp probe 2 connector 3. IBP cable connector 4. Multifunctional connector: outputs analog ECG, IBP and defibrillation synchronization signals. 5. NIBP cuff connector 6. ECG cable connector 7. SpO2 cable connector 8. Speaker 2.2.1.4 Bottom View 1 1. 2 Latch: locks the T1 when the T1 is in use with the host monitor, the T1 docking station, or the T1 handle.
2.2.2 T1 handle The T1 handle is used to connect a T1 and an external parameter module as well as providing bed rail mounting capability. It can also be connected to the T1 docking station. 2.2.2.1 Left View 1 2 1. Release button: pressing this button releases the T1 handle from the T1 docking station. 2. T1 handle multi-pin connector 1: connects the T1 handle and T1 docking station. 2.2.2.2 Right View 1 2 3 T1 handle multi-pin connector 2: connects the T1 handle and the T1. 2-6 2.
2.2.3 T1 Docking Station The T1 docking station is used to connect the T1 or T1 handle to provide power, charge the installed battery, and support connection to an external display, USB drive, network cables, and the Passport 12M/17M patient monitors. 2.2.3.1 Left View 1 2 3 4 1. Symbol: indicates the direction and angle that the T1 docking station can rotate when the T1 docking station is fixed onto a transverse or a vertical rod. 2.
2.2.3.3 Rear View 1 1. AC power input 2. Equipotential grounding terminal 2 3 4 5 6 When using the monitor together with other devices, connect their equipotential grounding terminals together to eliminate the potential differences between them. 3. VGA connector: connects the external display 4. External device connector: connects the T1 to the host monitor through a cable. 5. USB connector: connects USB devices, including the USB drive, mouse and keyboard. 6.
2.3 Installation The T1 handle and T1 docking station are part of the equipment. Use only the specified T1 handle and T1 docking station. 2.3.1 T1 in Use with the T1 Handle You can install the T1 and an external parameter module, if needed, to the T1 handle as indicated below: You hear a click when the T1 or the external module is pushed into place.
CAUTION To prevent the T1 from falling out, do not press the release button while transporting the T1 with the T1 handle. 2.3.2 T1 Handle in Use with the T1 Docking Station The T1 handle can be installed into the T1 docking station as indicated below: You hear a click when the T1 handle is pushed into place. To remove the T1 handle: 2-10 1. Press and hold down the release button at the top of the T1 handle. 2. Pull the T1 handle out as indicated.
2.3.3 T1 in Use with the T1 Docking Station You can also install the T1 directly to the T1 docking station as indicated below: You hear a click when the T1 is pushed into place. To remove the T1 from the T1 docking station: 1. Press and hold the latch at the bottom of the T1. 2. Pull the T1 out as indicated below.
2.4 Display Screen This monitor uses a high-resolution TFT LCD to display patient parameters and waveforms. A typical display screen is shown below. 1 2 3 4 6 5 7 1. Alarm Symbols 2. Patient Information/Technical Alarm Area 8 9 This area shows the patient information such as department, bed number, patient name, patient category and paced status. indicates that the patient has an implanted pacemaker. If no patient is admitted, selecting this area enters the [Patient Setup] menu.
6. QuickKeys Area This area contains QuickKeys that provides quick access to functions. Start or stop NIBP measurements Reset the alarms Enter/Exit the alarm paused state Enter the main menu if no menu is currently displayed. If a menu is didsplayed on the screen, pressing it closes that menu. 7. Prompt Message Area This area shows the current configuration name and prompt messages. 8. CMS status area If the [Select CMS] function is enabled, this area shows the currently selected CMS.
FOR YOUR NOTES 2-14 T1 Patient Monitor Operator’s Manual
3 Basic Operations 3.1 Installation WARNING Connect only approved devices to this equipment. Devices connected to the equipment must meet the requirements of the applicable IEC standards (e.g. IEC 60950 safety standards for information technology equipment and IEC 60601-1 safety standards for medical electrical equipment). The system configuration must meet the requirements of the IEC 60601-1 medical electrical systems standard.
3.1.1 Unpacking and Checking Before unpacking, examine the packing case carefully for signs of damage. If any damage is detected, contact the carrier or Mindray. If the packing case is intact, open the package and remove the equipment and accessories carefully. Check all materials against the packing list and check for any mechanical damage. Contact Mindray in case of any problems.
3.2 Getting Started 3.2.1 Connecting to Power Source Using DC Power Adapter To connect to the AC mains using the DC power adapter, connect one end of the power cord of the adapter with the DC power input on the equipment’s back panel and the other end with a wall AC mains outlet. Using the T1 Docking Station To connect to the AC power using the T1 docking station: 1. Install the monitor to the T1 docking station as described in section 2.3.3 T1 in Use with the T1 Docking Station. 2.
3.2.2 Turning Power On Once the monitor is installed, before beginning measurements: 1. Check the monitor for any mechanical damage, and make sure that all external cables, plug-ins and accessories are properly connected. 2. Check the power supply specifications are met if mains power is used. Only use a power outlet that is properly grounded. 3. Connect the power source: If you are using the DC adapter, plug the DC adapter into the T1.
3.3 Turning Off the Monitor Before turning off the monitor: 1. Ensure that the monitoring of the patient has been completed. 2. Disconnect the cables and sensors from the patient. 3. Make sure to save or clear the patient monitoring data as required. 4. Press and hold the power on/off switch to turn off the monitor. “System is shutting down…” is displayed on the screen and then the monitor shuts down.
3.5 Using the On-Screen Keyboard The onscreen keyboard enables you to enter information. Use the key to delete the previously entered character. Use the key to toggle between uppercase and lowercase letters. Select Select to access the symbol keyboard. Select to exit the symbol keyboard. to confirm what you have entered and close the onscreen keyboard. 3.6 Using the External Display The T1 can be connected to an external display through the VGA connector on the T1 docking station.
CAUTION Only use the display specified by Mindray. Using an unspecified display may result in unknown problems. 3.7 Using the Mouse and Keyboard When connected to the external display, the T1 can connect a mouse and a keyboard through the USB connector of the T1 docking station. When a mouse is in use, only the left mouse-button can be used. The right mouse-button is disabled. 3.8 Using the Main Menu To enter the [Main Menu], select the on-screen QuickKey.
3.9 Changing General Settings 3.9.1 Setting Up a Monitor To install a monitor or change its location: 1. Select [Main Menu] → [Maintenance >>]→[User Maintenance >>]→enter the required password. 2. In the [User Maintenance] menu, enter the [Monitor Name], [Department] and [Bed No.]. You can set [Changing Bed No.] to: [Unprotected]: enables you to change Bed No. in the [Patient Demographics] menu. [Protected]: disables you from changing the Bed No. in the [Patient Demographics] menu. 3.9.
3.9.4 Setting the Docking Station To make sure that the T1 can be used with the docking station for the patient transfer, you need to configure the docking station on the T1. To configure the docking station, select [Main Menu]→[Maintenance >>]→[User Maintenance >>]→enter the required password→[Others >>]→[Dock Setup >>]. NOTE The dock setup function is active only when the T1 is inserted into the docking station.
Setting the IP for CMS The IP of the CMS defines the IP address of the CMS to which the T1 is connected. The T1 can only be connected to the specified CMS. The IP address of the current CMS is shown in the prompt message area. You can select this area to pop up the [Central Station IP] menu. NOTE For the DPM Central Station with system software version 01.01.00 or greater, as long as a patient is admitted, the T1 can be automatically connected to DPM Central Station.
3.11.2 Night Mode To avoid disturbing the patient, the Night mode may be used. To activate the Night mode: 1. Select [Main Menu]→[Screen Setup >>]→[Night Mode >>]. 2. In the pop-up menu, set the desired brightness, alarm volume, QRS volume, key volume, NIBP end tone, and whether to stop NIBP measurements or not. When [Stop NIBP] is selected, all the NIBP measurements terminate after entering the Night mode. 3. Select the [Enter Night Mode] button. To cancel the Night mode: 1.
WARNING In the Privacy mode, all audible alarms are suppressed and the alarm light is deactivated at the monitor. Alarms sound only at the CMS. NOTE The Privacy mode can be used only when the monitor is connected to a CMS. 3.11.4 Outdoor Mode The Outdoor mode is intended for transporting patients in bright ambient light conditions. In this mode, the parameter color is white and unchangeable, and the screen brightness automatically changes to 10, the brightest.
Insert the T1 in the module rack of the host monitor To use the T1 with the host monitor, insert the T1 into the host monitor’s internal module rack or satellite module rack. Firmly push the T1 until you hear that the clip engages the module rack. To ensure that the T1 is properly connected, try to pull the T1 outward. The T1 is properly engaged in the module rack if you cannot pull the T1 out.
3.11.6 Standby Mode In the Standby mode, you can temporarily stop patient monitoring without turning off the monitor. To enter the Standby mode: 3-14 1. Select [Main Menu]→[Standby]. 2. Select [Yes] in the pop-up menu.
4 Managing Patients 4.1 Admitting a Patient The monitor displays ans stores physiological data in trends as soon as a patient is connected. This allows you to monitor a patient that is not admitted yet. However, it is recommended that you fully admit a patient so that you can clearly identify them on reports and network devices. To admit a patient: 1. Select [Main Menu]→[Patient Setup >>]. 2. Select [Admit Patient].
4.2 Quick Admitting a Patient Use [Quick Admit] only if you do not have the time or information to fully admit a patient. Complete the rest of the patient demographic details later. To quick admit a patient: 1. Select [Main Menu]→[Patient Setup >>]. 2. Select [Quick Admit]. If a patient has previously been admitted, select [Ok] to discharge the current patient. If no patient has previously been admitted, you can choose either: 3.
NOTE A keyword takes effect only when being defined in the eGateway. Refer to eGateway Integration Manager Installation Guide (P/N: 046-002447-00) for details. The monitor displays corresponding patient information only when all the keywords have been entered. 4.5 Editing Patient Information To edit the patient information after a patient has been admitted, or when the patient information is incomplete: 1. Select [Main Menu]→[Patient Setup >>]. 2.
WARNING Do not discharge a patient before the patient is successfully transferred. After a patient is successfully transferred, check if the patient settings (especially patient category, paced status and alarm limits settings, etc.) on the monitor are appropriate for this patient. NOTE The system automatically enables the HR alarm and lethal arrhythmia alarm after transferring the patient data. 4.7.1 Transferring Patient Data via a USB Drive To transfer patient data to a USB drive: 1.
3. After you select [Transfer], in the pop-up menu you can select the patient data content that need to be transferred. [Patient Demographics] must be selected.
4.9 Connecting to a CMS The monitor supports connection to a CMS. If your monitor is connected to a CMS: All patient information, measurement data and settings on the monitor can be transferred to the CMS. All patient information, measurement data and settings can be displayed simultaneously on the monitor and CMS. For some functions such as editing patient information, admitting a patient, discharging a patient, starting/stopping NIBP measurements, etc.
5 Managing Configurations 5.1 Introduction When performing continuous patient monitoring, the clinical professional often needs to adjust the monitor’s settings according to the patient’s condition. The collection of all these settings is called a configuration. Allowing you to configure the monitor more efficiently, the monitor provides different sets of configurations to accommodate the varying patient categories and departments.
5.2 Accessing the [Manage Configuration] Menu To access the [Manage Configuration] menu: 1. Select [Main Menu]→[Maintenance >>]→[Manage Configuration >>]. 2. Enter the required password and then select [Ok]. 5.3 Changing Department If the current department configuration is not the one you want to view, you can select [Change Department >>] in the [Manage Configuration] menu and then choose the desired department as shown below.
5.4 Setting Default Configuration The monitor will load the pre-set default configuration in the following cases: The monitor restarts after being switched off for more than 120 seconds. A patient is admitted. A patient is discharged. Patient data is cleared. Patient category is changed. To set the default configuration: 1. Select [Select Default Config. >>] in the [Manage Configuration] menu. 2. In the [Select Default Config.] menu, select [Load the Latest Config.
5.6 Editing Configurations To edit an existing configuration: 1. Select [Edit Config. >>] in the [Manage Configuration] menu. The pop-up menu shows the existing configurations on the monitor. Selecting [Config. on USB drive >>] will show the existing configurations on the USB drive. 2. Select the desired configuration and then select the [Edit] button. 3. Select [Alarm Setup >>], [Screen Setup >>] or [Parameters >>] to enter the corresponding menu in which settings can be changed.
5.9 Loading a Configuration You may make changes to some settings during operation. However, these changes or the pre-selected configuration may not be appropriate for the newly admitted patient. Therefore, the monitor allows you to load a desired configuration to ensure that all the settings are appropriate for your patient. To load a configuration: 1. Select [Load Configuration >>] from the [Main Menu]. The pop-up menu shows the existing configurations on the monitor. 2. Select [Config.
FOR YOUR NOTES 5-6 T1 Patient Monitor Operator’s Manual
6 User Screens 6.1 Adjusting the Screen Brightness To adjust the screen brightness: 1. Select the [Main Menu]→[Screen Setup >>]→[Brightness]. 2. Select the appropriate setting for the screen brightness. 1 to 10. 10 is the brightest, and 1 is the dimmest. Auto: Screen brightness will be adjusted automatically. If the monitor operates on battery power, setting a dimmer screen brightness will prolong the battery operating time.
To adjust the QRS volume: 1. Select the ECG parameter window →[Others >>], or the SpO2 parameter window. 2. Select [QRS Volume] or [Beat Vol] and then select the appropriate volume. 0 means off, and 10 is the maximum volume. 6.3 Configuring Your Screens You can configure your monitor’s screens by setting: Waveform line size The color in which each measurement’s numerics and waveforms are displayed The parameter to monitor CAUTION Changing some settings may be hazardous.
If the external display is connected, you can also choose: ECG 7-Lead Half-Screen if 5-lead or 12-lead ECG is selected Minitrends Screen OxyCRG Screen View Others Screen PAWP Screen 6.3.4 Changing the T1 Screen Layout To change screen layout, select [Main Menu]→[Screens] to enter the [Screens] menu. You can choose the desired screen type in the [Choose Screen] window. You can select the parameters and waveforms you want to view in the [Screen Setup] window.
WARNING Unallocated parameters in the [Screen Setup] window do not display. However, the monitor can still sound alarms for these parameters. 6.3.5 Changing Screen Layout on the External Display NOTE The keys mentioned in this section refer to the keys on the external display. To change the screen layout on the external display: Select the [Screens] QuickKey Select [Main Menu]→[Screen Setup >>]→[Screen Layout >>]→[Screen Setup].
The ECG parameter and the first ECG waveform always display in the first row. The configurable areas can be classified as Area A, Area B, and Area C. In Area A, you can choose to display the parameters windows and their waveforms (if one exists). Each parameter and the associated waveform are displayed in the same row. In Area B, you can choose to display the parameter windows.
6.5.1 Having a Split-Screen View of Minitrends You can split the normal screen so that the left hand side continuously shows graphic minitrends beside waveforms as shown in the figure below. To have a split-screen view of minitrends, you can select [Main Menu]→[Screen Setup >>]→[Screen Layout >>]→ [Choose Screen]→[Minitrends Screen]→ . Minitrend View The split-screen view provides minitrends for multiple parameters. In each field, the label and scale are respectively displayed at the top and left.
6.5.2 Setting Minitrends Select the minitrends area. From the pop-up [Minitrend Setup] menu, you can: Select the parameters to be displayed, or Select [Minitrend Length] and then select the appropriate setting. Time 6.6 Viewing OxyCRG (only available with the external display) NOTE The keys mentioned in this section refer to the keys on the external display.
The split-screen view covers the lower part of the waveform area and shows HR trend, SpO2 trend, SpO2b trend, RR trend and a compressed waveform (CO2 wave or Resp wave). At the bottom, there are controls: 1. Event You can enter the [Review] menu by selecting the [Event] button. 2. Trend length list box In the trend length list box, you can select [1 min], [2 min], [4 min], or [8 min]. 3.
NOTES Monitors using software version prior to 05.17.00 cannot view or be viewed by monitors of software version 05.17.00 or later. Re-set the Care Group if the monitor is moved to a department or different LAN. 6.7.2 Viewing the Care Group Overview Bar The Care Group Overview bar is located at the bottom of the [View Other Patient] window. In the overview bar, the department and bed label for any care group beds are displayed. For telemetry, # is displayed before the department label.
The [View Other Patient] window covers the lower part of the waveform area and consists of: 1. Information Area: shows the patient information (including department, bed number, patient name, etc.), and network status symbol. 2. View Area: shows physiological waveforms and parameters.
7 Alarms Alarms, triggered by an abnormal vital sign or technical issue with the monitor as visually and audibly indicated to the user. WARNING A potential hazard can exist if different alarm presets are used for the same or similar equipment in any single area, e.g. an intensive care unit or cardiac operating room. If your monitor is connected to a CMS, alarms can be controlled remotely. Remote suspension, inhibition, and reset of monitor alarms via the CMS may cause a potential hazard.
7.2 Alarm Levels The monitor’s alarms can be classified into three seerity categories: high level, medium level and low level. High level Physiological alarms Technical alarms Indicatess that the patient is in a life Indicates a severe device malfunction or an improper operation threatening situation, such as Asystole, which could make it possible that the monitor cannot detect Vfib/Vtac and so forth, and emergency critical patient status and thus threaten the patient’s life.
Additionally, the alarm message has a different background color which corresponds to the alarm level: High level alarms: red Medium level alarms: yellow Low level alarms: yellow You can view the alarm messages by selecting the physiological or technical alarm area. Refer to 2.4 Display Screen for details. 7.3.
7.3.5 Alarm Status Symbols Apart from the aforementioned alarm indicators, the monitor still uses the following symbols telling the alarm status: indicates alarms are paused. indicates alarm is reset. indicates the alarm sound is turned off. indicates individual measurement alarms are turned off or the system is in alarm off status. 7.4 Alarm Tone Configuration 7.4.1 Setting the Minimum Alarm Volume To set the minimum alarm volume: 1.
7.4.3 Setting the Interval between Alarm Sounds If you choose the ISO pattern, you can change the interval between alarm tones. To change the interval between alarm tones: 1. Select [Main Menu]→[Maintenance >>]→[User Maintenance >>]→enter the required password. 2. Select [Alarm Setup >>] to enter the [Alarm Setup] menu. 3. Select [High Alarm Interval (s)], [Med Alarm Interval (s)] and [Low Alarm Interval (s)] in order and then select the appropriate settings.
7.4.5 Setting the Reminder Tones When the alarm volume is set to zero, or the alarm tone is silenced or turned off, the monitor issues a periodic reminder tone. To set the reminder tones: 1. Select [Main Menu]→[Maintenance >>]→[User Maintenance >>]→enter the required password. 2. Select [Alarm Setup >>] to enter the [Alarm Setup] menu. To switch the reminder tones on or off, select [Reminder Tones] and then select [On] or [Off].
When a Panorama CMS is used, the [Alarm Setup] menu displays as below: NOTE The On/Off column is only not visible with Panorama CMS. Refer to chapter 8 Monitoring ECG for how to change ST alarm settings, how to change arrhythmia alarm settings, and how to set the threshold for some arrhythmia alarms. 7.5.1 Setting Alarm Properties for All Parameters In the [Main Menu], select [Alarm Setup >>]→[Parameters]. You can review and set alarm limits, alarm switches, and alarm level for all parameters.
To get accurate auto alarm limits, you need to collect a set of measured vital signs as a baseline. Then, in the [Main Menu], select [Alarm Setup >>]→[Parameters]→[Auto Limits] →[Ok]. The monitor will create new alarm limits based on the measured values. Before applying these automatically created alarm limits, confirm if they are appropriate for your patient in the [Alarm Setup Menu]. If not, you can adjust them manually.
Module Low alarm limit Parameter Adult/ Neonate pediatric P1-P4 Adult/ pediatric IBP-D (whichever is (Arterial greater) pressure) (Mean – 15) IBP-M (Dia × 0.86＋32) mmHg (Dia × 0.68＋6) mmHg mmHg mmHg (Mean + 15) or or (whichever is (Mean × 0.86 + 95 mmHg 35) mmHg (whichever is smaller) greater) PA (whichever is smaller) (Mean × 0.68 + 35 mmHg 8) mmHg Neonate (Diav15) or 80 (Dia – 15) or 20 FAP/ LV/ High alarm limit IBP-S SYS × 0.75 SYS × 0.75 SYS × 1.25 SYS × 1.
7.5.3 Setting Alarm Delay Time You can set the alarm delay time for alarms of continuously measured parameters. If the alarm condition is resolved within the delay time, the monitor will not sound the alarm. To set the alarm delay time: 1. Select [Main Menu]→[Maintenance >>]→[User Maintenance >>]. Enter the required password and then select [Ok]. 2. Select [Alarm Setup >>]→[Alarm Delay].
7.5.5 Setting Recording Length You can change the length of the recorded waveforms. In the [Others] window of the [Alarm Setup] menu, select [Recording Length] and then select [8 s], [16 s] or [32 s]: [8 s]: 4 seconds respectively before and after the alarm or manual event trigger moment. [16 s]: 8 seconds respectively before and after the alarm or manual event trigger moment. [32 s]: 16 seconds respectively before and after the alarm or manual event trigger moment. 7.5.
7.7 Switching Off All Alarms If [Alarm Pause Time] is set to [Permanent]: the monitor will enter into the alarm off status after the QuickKey is pressed. During the alarm off status: As for physiological alarms: no alarm lamps flash and no alarms are sounded. As for physiological alarms: no numerics or alarm limits flash. No physiological alarm messages are shown. [Alarm Off] is displayed in the physiological alarm area with red background.
Technical alarms give different alarm indicators when the alarm system is reset: For some technical alarms, including the NIBP-related alarms, a √ appears before the alarm message and appears in the alarm symbol area, indicating that the alarm is acknowledged. The indication of the alarm lamp depends on the alarm light setting. Some technical alarms are changed to the prompt messages. Some technical alarms are cleared. The monitor gives no alarm indications.
7.10 Testing Alarms When the monitor starts up, a self-test is performed. In this case the alarm lamp is lit in yellow and red respectively, and the system gives a beep. This indicates that the visible and audible alarm indicators are functioning correctly. For further testing of individual measurement alarms: perform the measurement on yourself (for example, SpO2 or CO2) or use a simulator. Then, adjust alarm limits and check that appropriate alarm behaviour is observed. 7.
7.11.3 Resetting Care Group Alarms You can reset the alarm of the currently viewed bed in the View Other Patient window. To enable this function: 1. Select [Main Menu]→[Maintenance>>]→[User Maintenance>>]→enter the required password→[Alarm Setup>>]. 2. In the [Alarm Setup] menu, set [Reset Other Bed’s Alarms] to [On]. When your monitor is viewed by other monitors and [Alarm Reset By Other Bed] is switched on, alarms on your monitor can be reset by other monitors.
FOR YOUR NOTES 7-16 T1 Patient Monitor Operator’s Manual
8 Monitoring ECG 8.1 Introduction The electrocardiogram (ECG) measures the electrical activity of the heart and displays it on the monitor as a waveform and a numeric. ECG monitoring provides the following algorithms: Advanced ECG algorithm The Advanced ECG algorithm provides 3-, 5- and 12-lead ECG monitoring, ST-segment analysis, and extended arrhythmia analysis. Mortara ECG algorithm The Mortara ECG algorithm provides 3-, 5- and 12-lead ECG monitoring, ST-segment analysis, and arrhythmia analysis.
CAUTION Interference from a non-grounded instrument near the patient and electrosurgery interference can cause problems with the waveform. NOTE After defibrillation, the screen display recovers within 10 seconds if the correct electrodes are used and applied in accordance with the instructions for use. 8.3 Preparing to Monitor ECG 8.3.1 Preparing the Patient and Placing the Electrodes To prepare the patient and place the electrodes: 1. Prepare the patient’s skin.
8.3.3 ECG Lead Placements The electrode placement illustrations in this chapter adopt the AHA standard. 3-Leadwire Electrode Placement Following is an electrode configuration when using 3 leadwires: RA placement: directly below the clavicle and near the right shoulder. LA placement: directly below the clavicle and near the left shoulder. LL placement: on the left lower abdomen.
12-Leadwire Electrode Placement 12-lead ECG uses 10 electrodes, which are placed on the patient’s four limbs and chest. The limb electrodes should be placed on the soft skin and the chest electrodes placed according to the physician’s preference. Lead Placement for Surgical Patients The surgical site should be taken into consideration when placing electrodes on a surgical patient. e.g. for open-chest surgery, the chest electrodes can be placed on the lateral chest or back.
WARNING For paced patients, you must set [Paced] to [Yes]. If it is incorrectly set to [No], the monitor could mistake a pace pulse for a QRS and fail to alarm when the ECG signal is too weak. On ventricular paced patients, episodes of Ventricular Tachycardia may not always be detected. False low heart rate indicators or false Asystole calls may result with certain pacemakers because of pacemaker artifact such as electrical overshoot of the pacemaker overlapping the true QRS complexes.
8.5 Changing ECG Settings 8.5.1 Accessing ECG Menus By selecting the ECG parameter window or waveform area, you can access the [ECG Setup] menu. 8.5.2 Setting Pacemaker Rate (For Mortara ECG Algorithm only) Some pacemaker pulses can be difficult to reject. When this happens, the pulses are counted as a QRS complex and could result in an incorrect HR and failure to detect some arrhythmias. You can set [Pacemaker Rate] to the pacemaker’s rate in the [ECG Setup] menu.
8.5.5 Changing the ECG Filter Settings The ECG filter setting defines how ECG waves are smoothed. To change the filter setting, select [Filter] from [ECG Setup] and then select the appropriate setting. [Mon]: Use under normal measurement conditions. [Diag]: Use when diagnostic quality is required. The unfiltered ECG wave is displayed so that changes such as R-wave notching or discrete elevation or depression of the ST segment are visible.
8.5.8 Setting the Notch Filter The notch filter removes the line frequency interference. Only when [Filter] is set to [Diagnostic], the [Notch Filter] is adjustable. To set the notch filter: 1. Select the ECG parameter window or waveform area to enter its setup menu. Then select [Others >>]. 2. Set [Notch Filter] to: [Strong]: when waveform interference is strong (such as spikes). [Weak]: when waveform interference is weak. [Off]: to turn the notch filter off.
8.5.12 Adjusting QRS Volume QRS sounds are produced based on the alarm source. To adjust the QRS volume, 1. Select [Others >>] from the [ECG Setup] menu. 2. Select [QRS Volume] from the pop-up menu and select the appropriate setting. When a valid SpO2 measured value is available, the system adjusts the pitch tone of QRS sound based on the SpO2 value. 8.5.
8.5.14 About the Defibrillator Synchronization A synchronization pulse (100 ms, +5 V) is output through the multifunctional connector each time the monitor detects an R-wave. To use the defibrillator synchronization function, connect the monitor and the defibrillator with a synchronization cable. WARNING Improper use of a defibrillator may cause injury to the patient. The user should determine whether to perform defibrillation or not according to the patient’s condition. 8.
8.6.1 Switching ST Monitoring On and Off To switch ST monitoring on or off: 1. In the [ECG Setup] menu, select [ST Analysis >>]. 2. Select [ST Analysis] and then select [On] or [Off]. Reliable ST monitoring cannot be ensured if: You are unable to get a lead that is not noisy. Arrhythmias such as atrial fib/flutter cause irregular baseline. The patient is continuously ventricularly paced. The patient has left bundle branch block.
Select the ST parameter window or ST segment area to enter the [ST Analysis] menu. 8.6.4 Saving the Current ST Segment as Reference Select [Save Ref.] in the [ST Analysis] menu to save the current segment as a reference. Up to 20 references segment groups can be saved. NOTE If the memory is full and you do not delete a group before saving a new one, the earliest saved group is deleted automatically. 8.6.5 Changing the Reference Segment Select the and arrow keys beside the [Change Ref.
8.6.9 Adjusting ST Measurement Points As shown in the figure below, the ST measured for each beat complex is the vertical difference between two measurement points with the R-wave peak as the baseline for the measurement. R-wave peak J point P T Q Isoelectric point Difference=ST value ST measurement point The ISO and ST points need to be adjusted when you start monitoring and if the patient’s heart rate or ECG morphology changes significantly.
2. Set [ST Point]. The ST-point is positioned a fixed distance from the J-point. Move the J-point to position the ST-point at the midpoint of the ST segment. Position the ST-point relative to the J-point at either [J+60/80 ms], [J+40 ms], [J+60 ms] or [J+80 ms]. When [J+60/80 ms] is selected, the ST-point will be positioned 80 ms (heart rate 120 bpm or less) or 60 ms (heart rate more than 120 bpm) from the J-point. NOTE Only Advanced ECG algorithm has the function of automatic J point detection.
8.7.
8.7.3 Displaying QT/QTc Parameters and Waveform To display QT numerics and waveform: 1. Select [Main Menu] →[Screens] to enter the [Screens] window 2. Select the [Screen Setup] tab. 3． Select the parameter area where you want to display the QT parameters and select [QT]. NOTE QTc values are calculated based on the QT-HR, not the ECG HR. To view the QT-HR, open the QT View window. The following picture shows the QT numeric area.
The following picture shows the QT view. The current waveform is shown in the upper half in green. The reference waveform is shown below in yellow. The start of QRS complex and the end of the T wave are marked with vertical lines. In some conditions, no QT measurement can be calculated. Then the cause of failed QT measurement is shown at the bottom of the QT numerics area. Additionally the message “Cannot Analyze QT” is shown in the technical alarm area.
8.7.6 Changing QTc Formula The monitor uses as a default the Hodges correction formula to correct the QT interval for heart rate. To change the QTc formula: 1. Select the QT parameter area or waveform area to enter the [QT Analysis] menu. 2. Set [QTc Formula]. Hodges: QTc QT 1.75 HeartRate 60 HeartRate 2 QTc QT 60 Bazett: HeartRate 3 QTc QT 60 Fridericia: 60 QTc QT 154 1 HeartRate Framingham: 1 1 8.
8.8.1 Understanding the Arrhythmia Events Mortara ECG algorithm Arrhythmia Message Asystole Vfib Vtac PVCs Pacer Not Pacing Pacer Not Capture Multif. PVC Couplet Description Category No QRS complex detected within the set time threshold (in absence of ventricular fibrillation or chaotic signals). Ventricular fibrillation occurs and persists for 6 seconds.
Advanced ECG algorithm Arrhythmia message Asystole Vfib/Vtac Vtac Vent. Brady Description Category No QRS detected within the set time threshold in absence of ventricular fibrillation or chaotic signal. A fibrillatory wave for 6 consecutive seconds. A dominant rhythm of adjacent Vs and a HR > the V-Tac HR limit. The consecutive PVCs ≥ Vtac PVCs limit, and the HR ≥ the Vtac rate limit.
8.8.2 Changing Arrhythmia Alarm Settings To change arrhythmia alarm settings, select the ECG parameter area or waveform area →[ECG Setup]→ [Arrh. Analysis >>]. In the pop-up menu, you can set the [Alm Lev] to [High], [Med], [Low] or [Message], or switch on lethal arrhythmia analysis alarms only or switch on/off all arrhythmia analysis alarms. In the [Alarm Setup] menu from the [User Maintenance] menu, you can enable/disable turning off lethal arrhythmia analysis alarms.
Advanced ECG algorithm Arrh. event Range Default Step Unit PVCs High 1 to 100 10 1 /min Asys. Delay 3 to 10 5 1 s Tachy High 60 to 300 Adult: 120 5 bpm 5 bpm 5 bpm 5 bpm Pediatric: 160 Neonate: 180 Brady Low 15 to 120 Adult: 50 Pediatric: 75 Neonate: 90 Extreme Tachy 120 to 300 Adult: 160 Pediatric: 180 Neonate: 200 Extreme Brady 15 to 60 Adult: 35 Pediatric: 50 Neonate: 60 Multif.
8.9 ECG Relearning 8.9.1 Initiating an ECG Relearning Manually During ECG monitoring, you may need to initiate an ECG relearning when the patient’s ECG template changes dramatically. A change in the ECG template could result in: Incorrect arrhythmia alarms Loss of ST measurement, and/or Inaccurate heart rate ECG relearning allows the monitor to learn the new ECG template so as to correct arrhythmia alarms and HR value, and restore ST measurements.
8.10 12-Lead ECG Monitoring To access the 12-lead ECG monitoring screen: 1. Refer to section 8.3.3 ECG Lead Placements for placing the electrodes. 2. In the [ECG Setup] menu, select [Others>>] to enter the [Others Setup Menu]. 3. Set [Lead Set] to [12-Lead], set [ECG Display] to [12-Lead]. There are a total of 12 ECG waves and 1 rhythm wave displayed on the screen. The rhythm lead is ECGⅠbefore entering the 12-lead ECG monitoring screen.
8.11 Resting 12-Lead ECG Analysis The equipment incorporates the Glasgow algorithm, developed by the University of Glasgow, to provide an interpretation of the resting 12-lead ECG in all situations. 8.11.1 Accessing the 12-Lead Screen To access the 12-lead screen: 1. In the [ECG Setup] menu, select [Others>>] to enter the [Other Setup Menu]. 2. Set [Lead Set] to [12-Lead]. 3. Set [ECG Display] to [12-Lead].
8.11.3 12-Lead Setup In the 12-lead screen, select [Setup] to enter the [12-Lead Setup] menu to change the settings related to 12-lead ECG analysis. In the [12-Lead Setup] menu, you can also select [Report Setup>>] to set the format and contents of the ECG reports. 12-lead Setup Menu item Filter Option Default Description Diagnostic, Diagnostic Set filter mode.
QTc Formula Hodges, Hodges Selects QTc formula. Hodges: QTc QT 1.75 HeartRate 60 Bazett, Fridericia, Bazett: QTc QT HeartRate Framingham 60 1 2 1 HeartRate 3 QTc QT 60 Fridericia: 60 QTc QT 154 1 HeartRate Framingham: Waveform Standard, Layout Cabrera Standard Select ECG lead sequence for displaying and printing. [Standard]: the sequence is I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6.
8.11.4 Resting 12-lead ECG Analysis Before 12-lead ECG interpretation, check that all electrodes are correctly connected to the lead wires and the ECG trunk cable is properly connected. Check that patient information is correct. To start analyzing, select the [Analyze] key. The resting 12-lead analysis takes about 10 seconds. During this period, keep the patient still. After analysis finishes, the following dialog-box pops out.
8.11.5 12-lead ECG Report The format and contents of the 12-lead ECG report are configurable. Refer to Report Setup in 8.11.312-Lead Setup for details. The following is a sample of the12-lead ECG report with default configuration. 1 5 2 6 7 1. Patient information 2. Time of resting 12-lead ECG analysis 3. Measurements 4. Diagnosis statement 5. Waveform amplitude 6. Paper speed 7. Frequency range 8.
8.12 Troubleshooting This section lists the problems that might occur. If you encounter the problems when using the equipment or accessories, check the table below before requesting for services. If the problem persists, contact your service personnel. CAUTION Never try to disassemble the equipment or supplied accessories. There are no internal user-serviceable parts. Symptoms Possible Cause Correction Action Noisy ECG traces Loose or dry electrodes Apply fresh and moist electrodes.
Symptoms Possible Cause Correction Action No ECG Waveform Gain set too low Set the gain as required. For details, refer to section 8.5.4 Changing ECG Wave Settings. Base Line Wander Lead wires and patient cable not fully Check that the leadwires and patient cables are or properly inserted properly connected. Cable or lead wires damaged Change cable and lead wires. Patient moving excessively Secure leadwires and cable to patient.
FOR YOUR NOTES 8-32 T1 Patient Monitor Operator’s Manual
9 Monitoring Respiration (Resp) 9.1 Introduction Impedance respiration is measured across the thorax. When the patient is breathing or ventilated, the volume of air changes in the lungs, resulting in impedance changes between the electrodes. Respiration rate (RR) is calculated from these impedance changes, and a respiration waveform appears on the monitor screen. 9.2 Safety Information Warning When monitoring the patient’s respiration, do not use ESU-proof ECG cables.
9.4 Placing Resp Electrodes As the skin is a poor conductor of electricity, preparing the skin is necessary for a good respiration signal. You can refer to the ECG section for how to prepare the skin. For details, refer to section 8.3.1 Preparing the Patient and Placing the Electrodes. As the respiration measurement adopts the standard ECG electrode placement, you can use different ECG cables (3-lead, 5-lead or 12-lead).
9.4.3 Abdominal Breathing Some patients with restricted movement breathe mainly abdominally. In these cases, you may need to place the left leg electrode on the left abdomen at the point of maximum abdominal expansion to optimise the respiratory wave. 9.4.4 Lateral Chest Expansion In clinical applications, some patients (especially neonates) expand their chests laterally, causing a negative intrathoracic pressure.
Use manual detection mode for situations where: The respiration rate and the heart rate are close. Patients have intermittent mandatory ventilation. Respiration is weak. Try repositioning the electrodes to improve the signal. In Auto Detection Mode, if you are monitoring Resp and ECG is switched off, the monitor cannot compare the ECG and Resp rates to detect cardiac overlay. The respiration detection level is automatically set higher to prevent the detection of cardiac overlay as respiration.
The RR source options and description are shown in the table below. Option Description Auto RR source is automatically selected according to the priority. CO2 RR source is from CO2 measurement. ECG RR source is from impedance respiration measurement. 9.10 Setting Alarm Properties Select [Alarm Setup >>] from the [Resp Setup] menu. In the pop-up menu, you can set alarm properties for this parameter.
FOR YOUR NOTES 9-6 T1 Patient Monitor Operator’s Manual
10 Monitoring PR 10.1 Introduction The pulse numeric counts the arterial pulsations that result from the mechanical activity of the heart. You can display a pulse from any measured SpO2 or any arterial pressure (see chapter 14 Monitoring IBP). The displayed pulse numeric is color-coded to match its source. PR value NOTE A functional tester or SpO2 simulator can be used to determine pulse rate accuracy. 10.2 Setting the PR Source The current pulse source is displayed in the PR parameter area.
10.3 Selecting the Active Alarm Source In most cases the HR and pulse numerics are identical. In order to avoid simultaneous alarms on HR and PR, the monitor uses either HR or PR as its active alarm source. To change the alarm source, select [Alm Source] in the [ECG Setup] or [SpO2 Setup] menu and then select either: [HR]: The monitor will use the HR as the alarm source for HR/pulse. [PR]: The monitor will use the PR as the alarm source for HR/pulse.
11 Monitoring SpO 2 11.1 Introduction SpO2 monitoring is a non-invasive technique used to measure the amount of oxygenated haemoglobin and pulse rate by measuring the absorption of selected wavelengths of light. The light generated in the probe passes through the tissue and is converted into electrical signals by the photo detector in the probe. The SpO2 module processes the electrical signal and displays a waveform and digital values for SpO2 and pulse rate.
5. Pulse rate (derived from the pleth wave): detected pulsations per minute. NOTE A functional tester or SpO2 simulator cannot be used to assess the accuracy of a SpO2 module or a SpO2 sensor. 11.2 Safety WARNING Use only SpO2 sensors specified in this manual. Follow the SpO2 sensor’s instructions for use and adhere to all warnings and cautions.
WARNING If the sensor is too tight because the application site is too large or becomes too large due to edema, excessive pressure for prolonged periods may result in venous congestion distal from the application site, leading to interstitial edema and tissue ischemia. 11.5 Changing SpO2 Settings 11.5.1 Accessing SpO2 Menus By selecting the SpO2 parameter window or waveform area, you can access the [SpO2 Setup] menu. 11.5.
11.5.5 Monitoring SpO2 and NIBP Simultaneously When monitoring SpO2 and NIBP on the same limb simultaneously, you can switch [NIBP Simul] on in the [SpO2 Setup] menu to lock the SpO2 alarm status until the NIBP measurement ends. If you switch [NIBP Simul] off, low perfusion caused by NIBP measurement may lead to inaccurate SpO2 readings and therefore cause false physiological alarms. 11.5.
After approximately 10.9 seconds, a Sat-Second alarm would sound, because the limit of 50 Sat-Seconds would have been exceeded. SpO2 Seconds Saturation levels may fluctuate rather than remaining steady for a period of several seconds. Often, the patient % SpO2 may fluctuate above and below an alarm limit, re-entering the non-alarm range several times.
WARNING The same SpO2 tone mode shall be used for the same patient monitors in a single area. 11.6 Measurement Limitations If you doubt the SpO2, measurement, check the patient’s vital signs first. Then check the patient monitor and SpO2 sensor.
11.8 Nellcor Information Nellcor Patents This device may be covered by one or more of the following US patents and foreign equivalents: 5,485,847, 5,676,141, 5,743,263, 6,035,223, 6,226,539, 6,411,833, 6,463,310, 6,591,123, 6,708,049, 7,016,715, 7,039,538, 7,120,479, 7,120,480, 7,142,142, 7,162,288, 7,190,985, 7,194,293, 7,209,774, 7,212,847, 7,400,919.
Symptoms Possible Cause Correction Action Dashes “- -” display in place of Measurement is invalid. Check that the sensor is properly applied. Change numerics. Do not see SpO2 parameter the application site if necessary. Parameter not configured to display. tiles in display. Switch the SpO2 monitoring function on as described in section 3.10.1 Switching the Parameters On/Off.
12 Monitoring NIBP 12.1 Introduction The monitor uses the oscillometric method for measuring the non-invasive blood pressure (NIBP). This measurement can be used for adults, pediatrics and neonates. Automatic non-invasive blood pressure monitoring uses the oscillometric method of measurement. To understand how this method works, we’ll compare it to the auscultative method. With auscultation, the clinician listens to the blood pressure and determines the systolic and diastolic pressures.
12.2 Safety WARNING Be sure to select the correct patient category setting for your patient before measurement. Do not apply the higher adult settings for pediatric or neonatal patients. Otherwise it may present a safety hazard. Do not measure NIBP on patients with sickle-cell disease or on the limb where skin damage has occurred or is expected.
12.5 Setting Up the NIBP Measurement 12.5.1 Preparing the Patient In normal use, perform NIBP measurement on a patient who is in the following position: Comfortably seated Legs uncrossed Feet flat on the floor Back, arm and feet supported Middle of the cuff at the level of the right atrium of the heart NOTE It is recommended that the patient relaxes as much as possible before performing measurement and that the patient do not talk during measurement.
WARNING Continuous cuff pressure due to connection tubing kinking may cause blood flow interference and resulting harmful injury to the patient. NOTE Equipment use is restricted to one patient at a time. 12.5.3 Starting and Stopping Measurements Select the on-screen QuickKey or [Main Menu]→[NIBP Measure] to start an NIBP measurement. You can select [Stop NIBP] in the main menu to stop NIBP measurements. 12.5.
NOTE The measurement on clock feature is only available for patient monitors supporting Advanced ECG algorithm. Measurement on clock is effective only when NIBP Interval is set to [5min] or an option greater than 5 min. 12.5.7 Starting a STAT Measurement To start a STAT measurement: 1. Select the NIBP parameter window to enter the [NIBP Setup] menu. 2. Select [NIBP STAT]. The STAT mode initiates 5 minutes of continuous, sequential, automatic NIBP measurements.
12.7 Changing NIBP Settings By selecting the NIBP parameter window, you can enter the [NIBP Setup] menu. 12.7.1 Setting the Initial Cuff Inflation Pressure You can set the initial cuff inflation pressure manually. In the [NIBP Setup] menu, select [Initial Pressure] and then select the appropriate setting. NOTE For known hypertensive patients, you need to set initial cuff pressure to a higher value to reduce the measurement time. 12.7.
12.8 Assisting Venous Puncture You can use the NIBP cuff to cause sub-diastolic pressure to block the venous blood vessel and therefore help venous puncture. 1. Select [VeniPuncture >>] from the [NIBP Setup] menu. In the pop-up menu, verify that the [Cuff Press.] value is appropriate. Change it if necessary. 2. Select [VeniPuncture]. 3. Puncture vein and draw blood sample. 4. Select the on-screen QuickKey to deflate the cuff.
13 Monitoring Temp 13.1 Introduction The equipment is used to monitor skin temperature and core temperature. It can simultaneously monitor two temperature sites. 13.2 Safety WARNING Verify that the probe detection program works correctly before monitoring. Remove the temperature probe cable from the T1 or T2 connector, and the monitor can display the message [T1 Sensor Off] or [T2 Sensor Off] and give alarm tones correctly. 13.3 Taking a Temp Measurement To take a Temp measurement: 1.
13.4 Understanding the Temp Display The temperature monitoring is displayed on the monitor as three numerics: T1, T2 and TD. By selecting this area, you can enter the [Alarm Setup] menu. 13.5 Setting the Temperature Unit Select [Unit Setup >>] from the [User Maintenance] menu. In the pop-up menu, select [Temp Unit] and then select [ºC] or [ºF].
14 Monitoring IBP 14.1 Introduction The monitor can monitor two invasive blood pressures and displays the systolic, diastolic and mean pressures and a waveform for each pressure. 14.2 Safety WARNING Use only pressure transducers specified in this manual. Never reuse disposable pressure transducers. Make sure that the applied parts never contact other conductive parts.
14.3 Zeroing the Transducer To avoid inaccurate pressure readings, the monitor requires a valid zero. Zero the transducer in accordance with your hospital policy (at least once per day). Zero whenever: A new transducer or adapter cable is used. You reconnect the transducer cable to the monitor. The monitor restarts. You doubt the readings. To zero the transducer: 1. Turn off the stopcock to the patient. Pressure transducer 3-way stopcock Pressure adapter cable Monitor 2.
14.4 Setting Up the Pressure Measurement To set up the pressure measurement: 1. Plug the pressure cable into the IBP connector. 2. Prepare the flush solution. 3. Flush the system to exhaust all air from the tubing. Ensure that the transducer and stopcocks are free of air bubbles. WARNING If air bubbles appear in the tubing system, flush the system with the infusion solution again. Air bubbles may lead to incorrect pressure readings. 4. Connect the pressure line to the patient catheter. 5.
14.5 Understanding the IBP Display The IBP measurement is displayed on the monitor as a waveform and numeric pressures. The figure below shows the waveform and numerics for the Art pressure. For different pressures, this display may be slightly different. 5 6 4 3 1 1. Waveform 2. Systolic pressure 3. Mean pressure 4. Diastolic pressure 5. PPV measurement 6. Pressure label 2 For some pressures, the parameter window may show the mean pressure only.
14.6.2 Setting Alarm Properties Select [Alarm Setup >>] from the parameter setup menu. You can set alarm properties for this parameter in the pop-up menu. 14.6.3 Changing Averaging Time The IBP value displayed on the monitor screen is the average of data collected within a specific time. The shorter the averaging time is, the quicker the monitor responds to changes in the patient’s blood pressure.
WARNING This monitor can calculate PPV from beat-to-beat values of any arterial pulsatile pressure. The circumstances under which the calculation of a PPV value is clinically meaningful, appropriate and reliable must be determined by a physician. The clinical value of the derived PPV information must be determined by a physician.
Selecting the overlapped IBP waveforms on the main screen opens the [Overlapping Waveform Setup] menu, where you can: Set [Left Scale] and [Right Scale] and then set the scales for the overlapped waveforms. The left scale is for Art, LV, Ao, FAP, BAP, UAP, and the arterial waveforms of P1~P4; the right scale is for CVP, ICP, LAP, RAP, UVP, and the venous waveforms of P1~P4. Set [CVP Scale] individually If the cvp waveform is combined and CVP unit is different from IBP unit.
14.8.1 Preparing to Measure PAWP To prepare for a PAWP measurement: 1. Connect the catheter and transducer as shown below. Make sure that: The PA catheter is in place in the patient. The IBP transducer is properly connected to the IBP connector on the monitor. Monitor Heparinized fluid bag Pressure transducer Stopcock PA catheter Balloon inflation port Since PAWP is measured on PA, selecting [PA] as the IBP label is recommended. 2.
14.8.2 Setting Up the PAWP Measurement To set up the PAWP measurement: 1. Wedge the flotation catheter into the pulmonary artery. Then inflate the balloon and pay attention to the PA waveform changes on the screen. .2 After obtaining a stable PAWP waveform, press the [Freeze] key to freeze the waveform and deflate the balloon. 3. You can adjust the PAWP scale to an appropriate position by adjusting or beside the [Adjust] button. Press the [Confirm] key to save one PAWP measurement. 4.
14.9 Troubleshooting This section lists the problems that might occur. If you encounter the problems when using the equipment or accessories, check the table below before requesting for services. If the problem persists, contact your service personnel. CAUTION Never try to disassemble the equipment or supplied accessories. There are no internal user-serviceable parts.
15 Monitoring CO 2 15.1 Introduction CO2 monitoring is a continuous, non-invasive technique for determining the concentration of CO2 in the patient’s airway by measuring the absorption of infrared (IR) light of specific wavelengths. CO2 has its own absorption characteristic and the amount of light passing the gas probe depends on the concentration of the measured CO2. When a specific band of IR light passes through respiratory gas samples, some of IR light will be absorbed by the CO2 molecules.
15.2 Identifying CO2 Modules This monitor uses an external module with the T1 handle to perform CO2 monitoring. From left to right are sidestream CO2 module and microstream CO2 module. 1 1 2 2 3 4 5 3 1. Setup key to enter the CO2 setup menu 2. Measure/standby 3. Gas outlet 4. CO2 watertrap seat 5. Sampling line connector 15.3 Preparing to Measure CO2 WARNING Check that the alarm limit settings are appropriate before taking measurement.
15.3.1 Making a Sidestream CO2 Measurement Attach the watertrap to the module and then connect the CO2 components as shown below. The message [CO2 Sensor Warmup] is displayed. After warm-up is finished, you can perform CO2 measurements. Watertrap fixer Sampling line Watertrap CAUTION Do not apply adult watertrap to the neonate patient. Otherwise, patient injury could result. The watertrap collects water drops condensed in the sampling line and therefore prevents them from entering the module.
15.3.2 Making a Microstream CO2 Measurement Connect the sampling line to the module and then connect the CO2 components as shown below. The message [CO2 Sensor Warmup] is displayed. After warm-up, you can perform CO2 measurements. The message [CO2 Sensor Warmup] is displayed. Connector for sampling line Sampling line 15.4 Changing CO2 Settings 15.4.1 Accessing CO2 Menus By selecting the CO2 parameter window or waveform, you can access the [CO2 Setup] menu. 15.4.
For the sidestream CO2 module: 1. Select the CO2 parameter window to access the [CO2 Setup] menu.. 2. According to the actual condition, set the concentration required for the following compensations: [O2 Compen] [N2O Compen] [Des Compen] For the microstream CO2 module, gas compensations are not required. 15.4.
15.4.6 Choosing a Time Interval for Peak-Picking For microstream CO2 modules, you can select a time interval for picking the highest CO2 as the EtCO2 and the lowest as the FiCO2. To set the time interval: 1. Select the CO2 parameter window to access the [CO2 Setup] menu. 2. select [Max Hold] and then select [Single Breath], [10 s], [20 s] or [30 s] (for microstream CO2 module only). [Single Breath]: EtCO2 and FiCO2 are calculated for every breath.
15.4.10 Barometric Pressure Compensation Both sidestream and microstream CO2 modules have the function of automatic barometric pressure compensation (the system automatically measures the barometric pressure which the patient monitor is exposed to). 15.4.11 Entering the Standby Mode By default, the CO2 module is in measure mode. To enter or exit the Standby mode manually: 1. Select the CO2 parameter window to access the [CO2 Setup] menu. 2. Select [Operating Mode] and then select [Standby] or [Measure].
15.5 Measurement Limitations Some adverse effects can influence CO2 performance.
15.8 Removing Exhaust Gases from the System WARNING Anesthetics: When using the Sidestream or Microstream CO2 measurement on patients who are receiving or have recently received anesthetics, connect the outlet to a scavenging system, or to the anesthesia machine/ventilator, to avoid exposing medical staff to anesthetics. To remove the sample gas to a scavenging system, connect an exhaust tube to the gas outlet connector of the module. 15.
15.11 Oridion Information This trademark is registered in Israel, Japan, German and America. Oridion Patents The capnography component of this product is covered by one or more of the following US patents: 6,428,483; 6,997,880; 6,437,316; 7,488,229; 7,726,954 and their foreign equivalents. Additional patent applications pending.
16 Review 16.1 Accessing Respective Review Windows To access the review windows: 1. Select [Main Menu]→[Review >>]. 2. Select [Graphic Trends], [Tabular Trends], [Events], or [Full Disclosure] to access their respective review windows. 16.2 Reviewing Graphic Trends In the [Review] menu, select [Graphic Trends] to access the following window. 1 2 3 4 5 1. Event mark area 2. Time axis 3. Graphic trends area 4. Parameter area 5. Cursor Events are marked with colors in the event mark area.
In this review window: Select [Trend Group] and you can select a trend group for viewing in the pop-up menu. If [Custom 1] or [Custom 2] is selected, you can further select [Define Trend Group]. Then you can select the parameters for viewing in the popup menu. Select [Zoom] to set the time length of review window. Select [Waves] to set the number of waves displayed in one page.
16.4 Reviewing Events 16.4.1 Marking Events During patient monitoring, some events may affect the patient and change the displayed waveforms or numerics displayed on the monitor. To help analyze these waveforms or numeric changes, you can mark these events. Select [Main Menu]→[Mark Event >>]. In the pop-up menu, you can select the waves to store after triggering a manual event.
You can select the button or the button to navigate through the waveforms. You can select the button or the button beside the [Event] button to switch between events. You can select the You can set the desired [Gain] for ECG waveform. You can set the desired [Sweep]. Select the [Events List] button to view the events list. Select the [Print] button to print the displayed alarm events to the preconnected laser printer.
16.5 Reviewing Waveforms In the [Review] menu, select [Full Disclosure] to access the following window. In the [Full Disclosure] window: You can select the To review full-disclosure waveforms, you need to save waveforms first. Select [Save Waves >>] and then select the button to go to the next page and select the desired button. parameters whose waveforms you want to view. Select the [Beat Annotation] button to display or hide beat labels above the first ECG waveform.
In this window: Select [Details] to view the trends, waveform and measurement numerics of selected parameters. Select or beside the [Scroll] button to switch between events. Select or to switch between pages. Select the button at the lower right corner of this window to change the parameter events to be displayed. After selecting the [Details] button, you can access the following window.
17 Calculations (Only Available with the External Display) 17.1 Introduction The calculation feature is available with your monitor when mounted on the T1 docking station and connected to an external display. The calculated values, which are not directly measured, are computed based on the values you provide.
17.2 Dose Calculations 17.2.1 Performing Calculations To perform a dose calculation: 1. Select [Main Menu]→[Calculations >>]→[Dose >>], or select [Calculations] QuickKey→[Dose >>]. 2. Select, in turn, [Patient Cat.] and [Drug Name] and then select the appropriate settings. The dose calculation program has a library of commonly used drugs, of which Drug A through Drug E are for those not specified in this library. 3.
17.2.3 Titration Table To open the titration table, select [Titration Table >>] in the [Dose Calculation] window after the dose calculation is finished. In the titration table, when you change: [Reference] [Interval] [Dose Type] The titrated values change accordingly. You can also: select or , or or beside the vertical scrollbar to view more values. 17.2.4 Drug Calculation Formulas Abbreviation Unit Formula Conc.
In the [Oxygenation Calculation] window, you can: Change the pressure unit, Hb unit and oxygen content unit by selecting [Press. Unit], [Hb Unit] and [OxyCont Unit] and then selecting the appropriate settings. The changes take effect automatically. Review the previously performed calculations by selecting [Review]. 17.3.2 Entered Parameters Abbreviation Unit Full spelling C.O.
17.4 Ventilation Calculations 17.4.1 Performing Calculations To perform a ventilation calculation: 1. Select [Main Menu]→[Calculations >>]→[Ventilation >>], or select [Calculations] QuickKey→[Ventilation >>]. 2. Enter values for calculation. If the patient monitor is connected to an anesthesia machine or a ventilator, the system automatically loads the supported parameter values to the [Ventilation Calculation] window. 3. Select the [Calculate] button.
17.4.
17.5.2 Entered Parameters Abbreviation Unit Full spelling C.O. L/min cardiac output HR bpm heart rate PAWP mmHg pulmonary artery wedge pressure Art Mean mmHg artery mean pressure PA Mean mmHg pulmonary artery mean pressure CVP mmHg central venous pressure EDV ml end-diastolic volume Height cm height Weight kg weight 17.5.3 Calculated Parameters and Formulas Formula Abbreviation Unit Full spelling BSA m2 body surface area Wt 0.425 × Ht 0.725 × 0.007184 C.I.
17.6 Renal Calculations 17.6.1 Performing Calculations To perform a renal calculation: 1. Select [Main Menu]→[Calculations >>]→[Renal >>], or select [Calculations] QuickKey→[Renal >>]. 2. Enter values for calculation. 3. Select the [Calculate] button. The system performs a calculation per the current settings and displays the calculated values. If a calculated value is outside the range, its background will highlight in yellow. You can select [Range] to view its normal range in the unit field.
17.6.3 Calculated Parameters and Formulas Formula Abbreviation Unit Full spelling URNaEx mmol/24h urine sodium excretion Urine × URNa / 1000 URKEx mmol/24h urine potassium excretion Urine × URK / 1000 Na/K % sodium potassium ratio 100 × URNa / URK CNa ml/24h clearance of sodium URNa × Urine / SerNa Clcr ml/min creatinine clearance rate Ucr × Urine / Cr / (BSA / 1.
FOR YOUR NOTES 17-10 T1 Patient Monitor Operator’s Manual
18 Printing 18.1 Printer The monitor can output patient reports via a connected printer. The monitor supports the following printers: HP LaserJet 1505n HP LaserJet P2035n HP LaserJet P4015n HP LaserJet Pro 400 M401n HP LaserJet 600 M602 HP LaserJet Enterprise M605 The reports specifications are: Paper: A4, Letter Resolution: 300 dpi For more details about the printer, see the document accompanying the printer.
Search for a printer If your selected printer is not in the list or a new printer is added into the network, you can select the [Search Printer] to search for all printers in the network. Set up the paper size Select [Paper Size] and then select [A4] or [Letter]. 18.
18.6.2 Setting Up Tabular Trends Reports To set up tabular trends reports, select [Main Menu]→[Print Setup >>]→[Tabular Trends Reports >>]. [Start time]: set a time period whose trend data will be printed out by setting [From] and [Back]. For example, if you set [From] as 2014-4-2 10:00:00 and [Back] as [2 h], the outputted data will be from 2014-4-2 08:00:00 to 2014-4-2 10:00:00.
18.8 Printer Statuses 18.8.1 Printer Out of Paper When the printer runs out of paper, the printer will not print until the paper is replaced. If there are too many print jobs that are not printed, a printer error may occur. In this case, you need to install paper and then re-send the print request. Restart the printer if necessary. To avoid this, ensure that there is enough paper in the printer before sending a print request. 18.8.
19 Other Functions 19.1 Analog Output The monitor is configured with a multifunction connector for analog output. You can contact your service personnel for more details. 19.2 Exporting the Log The monitor stores system status information, including failures, abnormity, and technical alarms, into the log. You can export the log to a USB drive. To export the log: 1. Connect a USB drive to the monitor’s USB connector. See section 2.2.1.4 Bottom View for the proper location of the USB connector. 2.
19.4 Transferring Data You can transfer the patient data saved in the monitor to a PC via a crossover network cable, or within a LAN for data management, review or print. 19.4.1 Data Export System You must install the data export system (PN: G-6800-30-51205) on the intended PC before performing the data transfer operation. Refer to the document accompanying the data export system installation CD-ROM for installation instructions.
19.5 Network Setup CAUTION Disconnecting from the network may result in loss of transmitted data, including parameter waveforms and measurements, alarm events, trends and patient data, or cause function failure. In case of network disconnection, check the patient and solve the network problem as soon as possible. 19.5.1 Setting the Network Type The monitor supports both wired and wireless network. To set the network type: 1.
19.5.2.2 Setting the Wireless Network To set the wireless network: 1. Select [Main Menu]→[Maintenance>>]→[User Maintenance>>]→enter the required password→select [Ok]. 2. Select [Network Setup >>]. 3. Select [Monitor Network Setup >>]. 4. Set [Network Type] to [WLAN]. 5. Set the desired [Address Type]. [Manual] : Indicates that the operator will manually enter network settings including IP Address, Subnet Mask, Gateway.
19.5.3 Certificates Maintenance WPA)/WPA2 Enterprise can deliver a higher level of security compared with other security encryption modes such as WPA2 PSK. You need to import the desired certificates to the monitor before implementing WPA/WPA2 Enterprise encryption on your WLAN. If you do not need to use certificates, you can also delete them from the monitor. 19.5.3.1 Importing Certificates To import certificates to the monitor: 1. Create a folder named “cert” in the USB drive 2. .
19.5.4.1 Selecting a CMS If there is no CMS in the network where your monitor is located, you need to set [Select CMS] to [Off]. Otherwise, the “???” three question marks will be displayed at the bottom of the screen. If there is a CMS in the network where your monitor is located, you need to set [Select CMS] to [On]. You can select the desired CMS for the current monitoring. To select a CMS, select the CMS status area at the bottom of the screen. Then the selected CMS name will display. 19.5.4.
20 Battery 20.1 Overview This monitor is designed to operate from rechargeable Lithium-ion battery power when an external power supply is not available. It is recommended to always install a fully charged battery in the monitor to ensure normal monitoring in case of accidental power failure. . If the external power supply is interrupted during patient monitoring, the monitor automatically runs from the battery.
20.2 Safety CAUTION Keep the battery out of children’s reach. Use only specified batteries. Keep the batteries in their original package until you are ready to use them. Do not expose batteries to liquid. High ambient temperature shortens battery run time. Extremely high ambient temperature may cause battery overheat protection, resulting the monitor power off. If the battery shows signs of damage or signs of leakage, replace it immediately. Do not use a faulty monitor battery.
The shelf life of a lithium Ion battery is about 6 months when the battery is stored with the battery power being 50% of the total power. In 6 months the battery power must be depleted before the Lithium Ion battery is fully charged. Then run the monitor on this fully charged battery .When its battery power becomes 50% of the total power, take out the battery from the monitor and store it. Store batteries properly. For details, refer to 20.8 Storing a Battery. 20.
20.6 Conditioning a Battery The performance of rechargeable batteries may deteriorate over time. If the battery is not conditioned for a prolonged time, its charge indication may not be accurate and you may wrongly evaluate the remaining battery runtime. Keeping the battery continuously fully charged without conditioning will speed up battery aging and shorten its life time.
20.7 Checking Battery Performance The performance of a rechargeable battery will deteriorate over time. You should check the battery performance every two months or if you doubt the battery may fail. 1. Disconnect the T1 monitor from the patient and stop all monitoring and measuring procedures. 2. Turn off the T1 monitor. Disconnect the T1 monitor from the external power supply if a DC adapter or T1 docking station is connected. 3. Install the battery to be conditioned in the T1 monitor.
20.9 Recycling Batteries Discard the battery in the following situations: The battery has visual signs of damage. The battery fails. The battery is aged and its runtime significantly less than the specification. The battery has been used for more than two years. Properly dispose of batteries according to local regulations. WARNING Do not open batteries, heat above 60 °C, incinerate batteries, or short the battery terminals.
21 Care and Cleaning In this chapter we only describe cleaning and disinfection of the main unit. To clean or disinfect reusable accessories, refer to instructions for use of corresponding accessories. CAUTION Use only Mindray approved cleaners and disinfectants and methods listed in this chapter to clean or disinfect your equipment. Warranty does not cover damage caused by unapproved substances or methods.
21.2 Cleaning Your equipment should be cleaned on a regular basis. Before cleaning the equipment, consult your hospital’s regulations for cleaning the equipment.
21.3 Disinfecting Disinfect the monitor as required in your hospital’s servicing schedule. Cleaning equipment before disinfecting is recommended. The following table lists approved disinfectants: Product Name Product Type Ingredients Sodium hypochlorite bleach Liquid Sodium hypochlorite 10% Isopropanol Liquid Isopropanol 70% Powder Used as 1% solution* Ⓡ Rely+On Virkon TM Biocidal active: Pentapotassium bis (peroxymonosulphate) bis (sulphate) (500g/kg) Contains dipotassium peroxodisulphate.
FOR YOUR NOTES 21-4 T1 Patient Monitor Operator’s Manual
22 User Maintenance CAUTION Failure on the part of the responsible individual hospital or institution using this equipment to implement a recommended maintenance schedule may cause undue equipment failure and possible health hazards. The safety checks or maintenance involving any disassembly of the equipment should be performed by professional servicing personnel. Otherwise, undue equipment failure and possible health hazards could result. No modification of this equipment is allowed.
22.2 Maintenance and Testing Schedule The following maintenance and tests, except for visual inspection, power on test, touchscreen calibration, battery check, ECG verification, NIBP Leakage test, and CO2 Leakage test, should be carried out by the service personnel only. Ensure the monitor is safe and the performance tested by qualified service personnel before initial installation, after upgrade, or during regular scheduled maintenance. Contact your service personnel if any maintenance is required.
22.3 Checking Monitor and Module Information To view the information about system start time, self-test, etc., select [Main Menu] → [Maintenance >>] → [Monitor Information >>]. The information will not be saved after the monitor is shut down. You can also view the information about the monitor configuration and system software version by selecting [Main Menu]→[Maintenance >>]→[Software Version >>]. 22.4 ECG Verification The ECG signal may be inaccurate due to hardware or software problems.
3. Wrap the cuff around the cylinder as shown below. Cylinder Monitor Connector for Air tubing NIBP cuff 4. Cuff Select [Main Menu]→[Maintenance >>]→[User Maintenance >>]. Enter the required password and then select [Ok]. 5. Select [Module Maintenance >>]→[NIBP Leakage Test]. The NIBP display shows [Leakage Testing…]. After about 20 seconds, the monitor will automatically deflate. This means the test is completed.
22.7 Calibrating the Touchscreen To calibrate the touchscreen: 1. Select [Main Menu]→[Maintenance >>]→[Cal. Touchscreen]. The symbol will appear at different positions of the screen. 2. Select, in turn the middle of the symbol. After the calibration is completed, the message [Screen Calibration Completed!] is displayed. 3. Select [Ok] to confirm the completion of the calibration. NOTE You cannot calibrate the touchscreen if it is locked.
FOR YOUR NOTES 22-6 T1 Patient Monitor Operator’s Manual
23 Accessories The accessories listed in this chapter comply with the requirements of IEC 60601-1-2 when in use with the patient monitor. The accessory material that contacts the patients has undertaken the bio-compatibility test and is verified to be in compliance with ISO 10993-1. For details about the accessories, refer to the instructions for use provided with the accessory. WARNING Use accessories specified in this chapter.
12-PinTrunk Cables Model PN Description Applicable patient EV6222 040-000754-00 ECG cable, 12-pin, 3-lead, defibrillation-proof, DIN Neonate, infant connector EV6201 0010-30-42719 ECG cable,12-pin, 3/5-lead, defibrillation-proof, AHA/IEC Adult, pediatric EV6202 0010-30-42720 ECG cable,12-pin, 3-lead, defibrillation-proof, AHA/IEC Neonate, infant EV6203 0010-30-42721 ECG cable, 12-lead, defibrillation-proof, AHA Adult EV6211 0010-30-42723 ECG cable, 12-pin, 3/5-lead, ESU-proof, AHA/IEC
5-Electrode Leadwires Model PN Description Applicable patient EL6501A 0010-30-42727 ECG leadwires, 5-lead, AHA, pinch Adult, pediatric EL6503A 0010-30-42729 ECG leadwires, 5-lead, AHA, pinch, long Adult, pediatric EL6501B 0010-30-42735 ECG leadwires, 5-lead, AHA, snap Adult, pediatric / 0012-00-1503-02 ECG Leadwires, 5-lead, Snap, 24" (61.0 cm), AAMI Adult, pediatric / 0012-00-1503-03 ECG Leadwires, 5-lead, Snap, 36" (101.
Wavelength of Masimo SpO2 sensors: red light: 660 nm; infrared light: 940 nm. The maximum photic output consumption of the sensor is less than 18 mW. The information about the wavelength range and maximum photic output consumption can be especially useful to clinicians (for example, when photodynamic therapy is performed). 23.3 NIBP Accessories NIBP hose Model Part No.
Model Part No.
23.5 IBP Accessories IBP Accessories Model Part No. Description Applicable patient IM2202 001C-30-70757 12-pin IBP cable, BD All IM2201 001C-30-70759 12-pin IBP cable, Abbott All / 040-001029-00 IBP extended cable with dual-receptacle All / 0010-20-42795 IBP cable adapter (12 pin to 6 pin) / / 0010-21-12179 12 Pin IBP Cable for Edwards / / 0010-21-43082 12 Pin IBP Cable for Memscap (SP844 82031 transducer) / Model Part No.
23.7 Mount and Mounting Accessories Part No.
FOR YOUR NOTES 23-8 T1 Patient Monitor Operator’s Manual
A Product Specifications A.1 Classifications The patient monitor is classified, according to IEC60601-1: Type of protection against electrical shock Degree of protection against electrical shock Mode of operation Class I, equipment energized from an external and internal electrical power source.
T1 handle, T1 docking station Item Operating conditions Storage conditions Temperature (°C) 0 to 40 -20 to 60 Relative humidity (noncondensing) 15% to 95% 10% to 95% Barometric (mmHg) 57.0 to 107.4 16.0 to 107.4 NOTE The environmental specifications of unspecified parameters are the same as those of the main unit. A.
A.4 Physical Specifications Size Weight Patient monitor (with battery) 143 mm×77 mm×102 mm (5.6 inch×3.0 inch×4.0 inch) 0.93 kg (2.0 pound) Battery 74 mm×47 mm×24 mm (2.9 inch×1.8 inch×0.9 inch) 0.12 kg (0.3 pound) T1 handle 164 mm×128 mm×164 mm (6.4 inch×5.0 inch×6.4 inch) 0.6 kg (1.3 pound) T1 docking station 186 mm×121 mm×153 mm (7.3 inch×4.7 inch×6.0 inch) 0.89 kg (1.9 pound) Sidestream CO2 module 136.5×80.5×102 mm (5.4 inch×3.2 inch×4.0 inch) <0.48 kg (1.
A.5.3 LEDs Main unit Alarm lamp 1 (two colors: yellow and red) Power on LED 1 (green) External power LED 1 (green) Battery LED 1 (green) T1 docking station Connection status indicator 1 (green) External power supply indicator 1 (green) A.5.4 Audio Indicator Speaker Give alarm tones (45 to 85 dB), key tones, QRS tones; support PITCH TONE and multi-level tone modulation; alarm tones comply with IEC60601-1-8. A.5.
Alarm output (RJ45 connector) Alarm delay time from patient monitor to remote equipment The alarm delay time is equal to or smaller than 2 s, measured from the time of the patient monitor alarm signal generation to the time of the remote equipment alarm signal generation. A.
time. The wireless functions of the monitor are normal when the following conditions exist simultaneously: 1. The distance between interfering devices (including wireless devices at the frequency of 2.4GHz such as cellular communication devices, microwave ovens, intercoms, cordless phones and electro-surgical units, excluding Wi-Fi) and the Resistance to wireless interference monitor is greater than 20 cm. 2. Co-channel interference (CCI) on the Wi-Fi network should be no greater than -85dBm. 3.
Lead-off detection current Input offset current Measuring electrode: <0.1 μA Drive electrode: <1 μA Measuring electrode: ≤0.1 μA Drive electrode: ≤1 μA Baseline recovery time <5 s (after defibrillation) Patient leakage current <10 μA Calibration signal 1mV (peak-to-peak value) Accuracy: ±5% Cut mode: 300 W ESU protection Coagulate mode: 100 W Recovery time: ≤10 s In compliance with the requirements in clause 202.6.2.
In compliance with the requirements in In compliance with the requirements in IEC60601-2-27: Clause 201.7.9.2.9.101 IEC60601-2-27: Clause 201.7.9.2.9.101 b) 3) of, the following method is used: b) 3) of, the following method is used: If the last 3 consecutive RR intervals are Heart rate is computed by averaging greater than 1200 ms, the 4 most recent the most recent 16 RR intervals, unless RR intervals are averaged to compute the HR by averaging the most recent 4 the HR.
Measurement range Accuracy -2.0 to +2.0 mV RTI -0.8 to +0.8 mV: ±0.02 mV or ±10%, whichever is greater Beyond this range: Not specified Refreshing rate Per 16 heartbeats (Mortara ECG algorithm), or 10 s (Advanced ECG algorithm) Resolution 0.
A.8.
Nellcor SpO2 Module Standards Meet standards of ISO9919 Measurement range 0 to 100% Resolution 1% Response time ≤ 30 s (PI > 0.3, no disturbance, SpO2 value sudden change within 70% - 100%) 70% to 100%: ±2% (adult/pediatric) Accuracy 70% to 100%: ±3% (neonate) 0 to 69%: Not specified.
PR from IBP Module Measurement range 25 to 350 bpm Resolution 1 bpm Accuracy ±1 bpm or ±1%, whichever is greater Refreshing rate 1s PR from NIBP Module Measurement range 40 to 240 bpm Resolution 1 bpm Accuracy ±3bpm or ±3%, whichever is greater A.8.5 NIBP Standards Meet standards of EN60601-2-30/IEC60601-2-30 Technique Oscillometry Mode of operation Manual, Auto and STAT Auto mode repetition intervals STAT mode cycle time Max measurement time 1 min, 2 min, 2.
Alarm limit Range (mmHg) Step (mmHg) Adult: (low limit+5) to 270 Sys High Pediatric: (low limit+5) to 200 Neonate: (low limit+5) to 135 Sys Low 40 to (high limit-5) Adult: (low limit+5) to 230 Mean High Pediatric: (low limit+5) to 165 Neonate: (low limit+5) to 110 Mean Low 5 20 to (high limit-5) Adult: (low limit+5) to 210 Dia High Pediatric: (low limit+5) to 150 Neonate: (low limit+5) to 100 Dia Low 10 to (high limit-5) *Measurement accuracy verification: In adult and pediatric modes, the b
A.8.7 IBP Standards Meet standard of EN60601-2-34/IEC60601-2-34.
Measured with a neonatal watertrap and a 2.5-meter neonatal sampling line, or an adult watertrap and a 2.5-meter adult sampling line: <400 ms @ 70 ml/min Rise time <330 ms @ 100 ml/min <300 ms @ 120 ml/min <240 ms @ 150 ml/min Measured with a neonatal watertrap and a 2.5-meter neonatal sampling line: <4 s @ 100 ml/min <4.5 s @ 70 ml/min Measured with an adult watertrap and a 2.5-meter adult sampling line: Gas sampling delay time <4.5 s @ 150 ml/min < 5 s @ 120 ml/min <5.5 s @ 100 ml/min <6.
Microstream CO2 Module Standard Meet standard of ISO 80601-2-55 CO2 Measurement range 0 to 99 mmHg Accuracy* Accuracy drift 0 to 38 mmHg: ±2 mmHg 39 to 99 mmHg: ±5% of the reading+0.08% of (the reading-38) Meet the requirement for measurement accuracy within 6 hours * Accuracy applies for respiration rate up to 80 rpm. For respiration rate above 80 rpm, the accuracy is 4 mmHg or ±12% of the reading, whichever is greater, for EtCO2 exceeding 18 mmHg.
B EMC and Radio Regulatory Compliance B.1 EMC The device meets the requirements of IEC 60601-1-2. All the accessories listed in chapter 23 Accessories also meet the requirements of IEC 60601-1-2 when in use with this device. CAUTION Using accessories, transducers and cables other than those specified may result in increased electromagnetic emission or decreased electromagnetic immunity of the monitor. The monitor or its components should not be used adjacent to or stacked with other equipment.
Guidance and Declaration - Electromagnetic Emissions The device is intended for use in the electromagnetic environment specified below. The customer or the user of the device should assure that it is used in such an environment. Emission tests Compliance Electromagnetic environment - guidance Radio frequency (RF) emissions Group 1 The device uses RF energy only for its internal function.
If the system is operated within the electromagnetic environment listed in Table Guidance and declaration — electromagnetic immunity, the system will remain safe and provide the following essential performance, Operating mode Accuracy Function Accessories identification Data stored Alarm Detect for connection Guidance and Declaration - Electromagnetic Immunity The device is intended for use in the electromagnetic environment specified below.
Guidance and Declaration - Electromagnetic Immunity The device is intended for use in the specified electromagnetic environment. The customer or the user of the device should assure that it is used in such an environment as described below.
WARNING The device is configured with a wireless network connector to receive wireless signal. Other devices may interfere with this device even though they meet the requirements of CISPR. Recommended separation distances between portable and mobile RF communications equipment and the device The device is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled.
B.2 Radio Regulatory Compliance RF parameters Type of Radio IEEE 802.11b/g/n (2.4G) IEEE 802.11a/n (5G) Modulation mode DSSS and OFDM OFDM Operating frequency 2412-2462MHz 5150-5350MHz, 5725-5850MHz Channel spacing 5 MHz 20 MHz Output power < 30 dBm (Peak Power) < 20 dBm (Average Power) Federal Communications Commission (FCC) Statement The wireless module has been tested and found to comply with the limits for a class B digital device, pursuant to Part 15 of the FCC rules.
C Default Configurations This chapter lists some of the most important factory default settings in configuration management. You cannot change the factory default configuration itself. However, you can make changes to the settings from the factory default configuration and then save the changed configuration as a user configuration. C.1 Parameters Configuration C.1.
Item Name Configurable Default In Config Mode In Monitor Mode No Yes Normal Yes Yes 60 screen only) ECG Waveform Area (12-lead screen only) Pacemaker Rate (Mortara algorithm only) ST Analysis Item Name ST Analysis Configurable In Config Mode In Monitor Mode Yes Yes Default General, OR, ICU, NICU: Off CCU: On Alarm Yes Yes Off Alm Lev Yes Yes Med ST-X High Yes Yes When ST Unit is mV: 0.20 When ST Unit is mm: 2.0 When ST Unit is mV: -0.20 When ST Unit is mm: -2.
Arrhythmia Threshold Settings (Mindray) Item Name Configurable Default PVCs High Yes Yes 10 Asys. Delay Yes Yes 5 Vtac Rate Yes Yes 130 Vtac PVC Yes Yes 6 Multif.
Arrhythmia Alarm Settings (Mindray) Item Name Configurable Default Run PVCs Alarm Yes Yes Off Low Couplet Alarm Yes Yes Off Message Multif. PVC Alarm Yes Yes Off Med PVC Alarm Yes Yes Off Message Bigeminy Alarm Yes Yes Trigeminy Alarm Yes Yes Tachy Alarm Yes Yes Off Med Brady Alarm Yes Yes Off Med Pacer Not Pacing Alarm Yes Yes Off Message Pacer Not Capture Alarm Yes Yes Off Message Missed Beats Alarm Yes Yes Off Message Nonsus.
Arrhythmia Alarm Settings (Mindray) Item Name Configurable Irr. Rhythm Alarm Yes Default Yes Off Message C.1.2 Resp Item Name Configurable Default In Config Mode In Monitor Mode Alarm Yes Yes On Alm Lev Yes Yes Med RR High Yes Yes RR Low Yes Yes Apnea Delay Yes Yes Lead Yes Yes Gain Yes Yes X2 Sweep Yes Yes 6.
C.1.
C.1.6 NIBP Item Name Configurable Default In Config Mode In Monitor Mode Alarm Yes Yes On Alm Lev Yes Yes Med General: 15 min OR: 5 min Interval Yes Yes ICU: 15 min NICU: 30 min CCU: 15 min NIBP End Tone Yes Yes Off Clock Yes Yes On Initial Pressure (mmHg) Cuff Press.
C.1.7 IBP Item Name Configurable Default In Config Mode In Monitor Mode Alarm Yes Yes On Alm Lev Yes Yes Med P1 Measure Yes Yes All P2 Measure Yes Yes All P3 Measure Yes Yes Mean P4 Measure Yes Yes Mean PPV Measurement Yes Yes Off PPV Source Yes Yes Auto Sensitivity Yes Yes Med Sweep Yes Yes 25 mm/s Filter Yes Yes 12.
PA Alarm Limit PA-S High (mmHg) Yes Yes PA-S Low (mmHg) Yes Yes PA-M High (mmHg) Yes Yes PA-M Low (mmHg) Yes Yes PA-D High (mmHg) Yes Yes PA-D Low (mmHg) Yes Yes Adu: 35 Ped, Neo: 60 Adu: 10 Ped, Neo: 24 Adu: 20 Ped, Neo: 26 Adu: 0 Ped, Neo: 12 Adu: 16 Ped, Neo: 4 Adu: 0 Ped, Neo: -4 Adu: 10 Ped, Neo: 4 CVP, LAP, RAP, ICP, UVP, P3-P4 Venous Pressure Alarm Limits IBP-M High (mmHg) Yes Yes IBP-M Low (mmHg) Yes Yes 0 Yes Yes 0-160 Yes Yes 0-30 Yes 0-2
C.1.8 CO2 Item Name Configurable Default In Config Mode In Monitor Mode Alarm Yes Yes On Alm Lev Yes Yes Med Apnea Delay Yes Yes Operating Mode Yes Yes Measure Sweep Yes Yes 6.
C.2 Routine Configuration C.2.1 Alarm Configurable Item Name In Config Mode Alm Volume Yes In Monitor Mode Yes Default General: 2 2 OR: 1 ICU, NICU, CCU: 2 Reminder Vol Yes Yes Low Recording Length Yes Yes 16 s Apnea Delay Yes Yes Alarm Delay Yes Yes 6s ST Alarm Delay Yes Yes 30 s Adu, Ped: 20s Neo: 15 s C.2.
C.2.4 Night Mode Configurable Item Name Default In Config Mode In Monitor Mode Brightness No Yes 1 Alm Volume No Yes 2 QRS Volume No Yes 1 Key Volume No Yes 0 Stop NIBP No Yes Unselected C.2.5 Outdoor Mode Configurable Item Name Default In Config Mode In Monitor Mode Measurement Color No Yes White Brightness No Yes 10 Key Volume No Yes 5 Alm Volume No Yes 5 Reminder Tone No Yes High QRS Volume No Yes 5 C.2.
C.2.7 Event Configurable Item Name In Config Mode In Monitor Mode Waveform 1 No Yes Waveform 2 No Yes Waveform 3 No Yes Default II General, OR, ICU, CCU: I NICU Pleth General, OR, ICU, CCU: Pleth NICU Resp C.2.
C.3 User Maintenance Items Item Name Configurable Default In Config Mode In Monitor Mode Changing Bed No. No Yes Protected Atmospheric Pressure No Yes 760 mmHg Height Unit No Yes cm Weight Unit No Yes kg ST Unit No Yes mV Press.
Item Name Configurable Default In Config Mode In Monitor Mode Clear CMS IP at startup Yes Yes Off Transferred Data Length No Yes 4h Parameter Switch Yes Yes Selected T1 Patient Monitor Operator’s Manual C-15
FOR YOUR NOTES C-16 T1 Patient Monitor Operator’s Manual
D Alarm Messages This chapter lists only the most important physiological and technical alarm messages. Some messages appearing on your monitor may not be included.
Measurement Alarm messages L Missed Beats M* Afib M* Irr. Rhythm M* Vent. Rhythm M* Multif. PVC M* Nonsus. Vtac M* Pause M* Pacer Not Pacing M* Pacer Not Capture M* Cause and solution The pacer appears abnormal. Check the pacer. The respiration signal was too weak for the monitor to perform Resp Apnea H respiration analysis. Check the patient’s condition and the Resp connections. Resp Resp Artifact H The patient’s heartbeat has interfered with his respiration.
D.2 Technical Alarm Messages Measurement Alarm message L I Cause and solution YY YY SelfTest Err H C An error occurred to the YY module, or there is a YY Init Err H A problem with the communications between the module YY Init Err N H A and the monitor. Restart the monitor. If the problem persists, contact your service personnel. N is within 1 to 8 YY Comm Err H A YY Comm Stop H C YY Comm Abnormal H A YYLimit Err L C YY parameter alarm limit was accidentally changed.
Measurement SpO2 Alarm message L I Cause and solution T2 Sensor Off L A or the module. Check the sensor connections. Temp Cal. Err H C SpO2 Sensor Off L* B The SpO2 sensor has become detached from the patient SpO2 Sensor Fault L C or the module, or there is a fault with the SpO2 sensor, or SpO2 No Sensor L B an unspecified SpO2 sensor has been used.
Measurement Alarm message L I Cause and solution NIBP Excessive Motion L A Check the patient’s condition and reduce the patient motion. NIBP Cuff Overpress. L A The NIBP airway may be occluded. Check the airway and measure again. NIBP Equip Err H A An error occurred during NIBP measurement and NIBP Timeout L A therefore the monitor cannot perform analysis correctly. NIBP Measure Failed L A Check the patient’s condition and NIBP connections, or replace the cuff.
Measurement Power Alarm message L I Cause and solution CO2 No Filterline L A Make sure that the filterline is connected. CO2 No Sensor L A Make sure that the sensor is connected. CO2 Main Board Err H C There is a problem with the CO2 module. Re-plug the CO2 Checking Sensor L C module or restart the monitor. CO2 Replace Scrubber&Pump L C CO2 15V Overrange H C CO2 Hardware Err H C 12V Too High H C There is a problem with the system power supply.
Measurement Alarm message L I Cause and solution Storage Card Err M C Restart the monitor. If the problem persists, format the SD card. Storage Card Space Low L B The storage card has abnormal data. Format the storage card. USB Drive Space Low L A Delete unnecessary data from the USB memory, or replace the USB memory. Read Dock E2PROM Error H C Disconnect the T1 from the docking station and reconnect it, or replace the external display.
FOR YOUR NOTES D-8 T1 Patient Monitor Operator’s Manual
E Symbols and Abbreviations E.
V volt VA volt ampere Ω ohm W watt – minus, negative % percent / per; divide; or; none; not applicable + plus = equal to < less than > greater than ≤ less than or equal to ≥ greater than or equal to ± plus or minus × multiply E.
CMOS complementary metal oxide semiconductor CMS central monitoring system CO2 carbon dioxide COHb carboxyhemoglobin Compl compliance CP cardiopulmonary CPI cardiac power index CPO Cardiac Power Output Cstat static compliance CVP central venous pressure DC direct current Des desflurane Dia diastolic DPI dot per inch dPmx left ventricular contractility DVI digital video interface ECG electrocardiograph EDV end-diastolic volume EEC European Economic Community EEG electro
I:E inspiratory-expiratory ratio IBP invasive brood pressure IBW ideal body weight ICP intracranial pressure ICT/B intracranial catheter tip pressure transducer ICU intensive care unit ID identification I:E inspiratory time: Expiratory time ratio IEC International Electrotechnical Commission IEEE Institute of Electrical and Electronic Engineers IP internet protocol IT injectate temperature ITBI Intrathoracic Blood Volume Index ITBV Intrathoracic Blood Volume LA left arm LAP le
pArt-M mean artery pressure pArt-S systolic artery pressure PD photodetector Ped pediatric Pleth plethysmogram PPV Pulse Pressure Variation PR pulse rate PVC premature ventricular contraction PVR pulmonary vascular resistance PVRI pulmonary vascular resistance index PVPI pulmonary vascular permeability index PPV pulse pressure variation pArt artery pressure pCVP central venous pressure R right RA right arm RAM random access memory RAP right atrial pressure Rec record, re
E-6 Tplat plateau time Trect rectal temperature Trise rise time Tslope time for the pressure to rise to target pressure Tube ID tube ID UAP umbilical arterial pressure UPS uninterruptible power supply USB universal serial bus UVP umbilical venous pressure VAC volts alternating current WLAN wireless local area network WOB work of breathing WOBimp imposed work of breathing T1 Patient Monitor Operator’s Manual
P/N: 046-006734-00 (4.
