In stru ctio ns fo r Use Avalon Fetal Monitor FM20/30, FM40/50, Avalon CL R el e a s e L .3 w i t h So f t w a re Re v i s i o n L .3 x .
1 Table of Contents 1 Introduction Who this Book is For Confirm Fetal Life Before Using the Monitor Introducing the Avalon Family of Fetal Monitors 2 What's New What's New in Release L.3 What's New in Release J.
Battery Lifetime Management Patient Transport Within the Hospital Underwater Monitoring 5 FM20/30 Battery Option External Power Supply M8023A Using Batteries Optimizing Battery Performance Storing the Battery Cableless Monitoring with FM20/30 Battery Option Patient Transport Within the Hospital 6 Alarms Alarm Mode Nurse Call Systems Visual Alarm Indicators Audible Alarm Indicators Acknowledging Alarms Acknowledging Disconnect INOPs Alarm Reminder Pausing or Switching Off Alarms Alarm Limits Reviewing Alar
11 Cross-Channel Verification (CCV) Misidentification of Heart Rates Cross-Channel Verification Functionality Overview of Cross-Channel Comparisons Coincidence Examples Recommended Actions for Coincidence INOP 12 Monitoring FHR and FMP Using Ultrasound Technical Description Limitations of the Technology Misidentification of Maternal HR as FHR What You Need Cableless Monitoring - Important Considerations Preparing to Monitor Selecting Fetal Heart Sound Changing the Fetal Heart Sound Volume Fetal Movement Pr
Monitoring DECG Suppressing Artifacts Troubleshooting Testing DECG Mode 17 Monitoring Uterine Activity Externally What You Need External Toco Monitoring Toco Sensitivity Troubleshooting 18 Monitoring Uterine Activity Internally What You Need Internal (IUP) Monitoring Troubleshooting 19 Monitoring aFHR, aHR, and aToco Fetal Heart Rate aFHR Uterine Activity aToco What You Need At the Monitor Troubleshooting 20 Monitoring Maternal Heart / Pulse Rate Priority for Maternal Heart / Pulse Rate Misidentificatio
23 Monitoring SpO2 Selecting an SpO2 Sensor Applying the Sensor Connecting SpO2 Cables Measuring SpO2 SpO2 Signal Quality Indicator (FAST SpO2 only) Assessing a Suspicious SpO2 Reading Understanding SpO2 Alarms Setting Up Tone Modulation Setting the QRS Volume 24 Monitoring Maternal Temperature Measuring Tympanic Temperature Entering Temperature Manually 243 243 243 244 244 245 246 246 247 247 249 249 254 25 Paper Save Mode for Maternal Measurements 255 26 Recovering Data 257 Recovering Traces on Pap
Tympanic Temperature Accessories Recorder Paper Batteries 30 Specifications and Standards Compliance 285 285 285 287 Environmental Specifications Physical Specifications Interface Specifications Performance Specifications Recorder Specifications External Displays: FM40/FM50 Only Manufacturer's Information Trademark Acknowledgment Regulatory and Standards Compliance Environment Monitoring After a Loss of Power ESU, MRI, and Defibrillation Cardiac Pacemakers and Electrical Stimulators Fast Transients/Burst
1 1 Introduction Who this Book is For This book is for trained healthcare professionals using the Avalon FM20, FM30, FM40, and FM50 fetal/maternal monitors, and the Avalon CL Transducer System. It describes how to set up and use the monitor and transducers. Familiarize yourself with all instructions including warnings and cautions before starting to monitor patients.
1 Introduction FM30 Avalon CL Avalon CTS • Monitor refers to the entire fetal/maternal monitor. Display refers to the physical display unit. Screen refers to everything you see on the monitor's display, such as measurements, alarms, patient data, and so forth. • Whenever a monitor’s identifier appears to the left of a heading or paragraph, it means that the information applies to that monitor only. Where the information applies to all models, no distinction is made.
1 Introduction • Movement of the ultrasound transducer. • The ultrasound transducer detecting a maternal movement source, such as the mother coughing. See also “Monitoring FHR and FMP Using Ultrasound” on page 165 and “Monitoring FHR Using DECG” on page 199. To reduce the possibility of mistaking the maternal HR for an FHR, it is recommended that you monitor both maternal and fetal heart rates.
1 Introduction WARNING The fetal/maternal monitors are not intended for: • use during defibrillation, electro-surgery, or magnetic resonance imaging (MRI). • Electrocardiography (ECG) measurements on patients connected to electrical stimulator or with cardiac pacemakers.
1 Introduction Indications for Use Avalon Fetal/Maternal Monitor FM20 Indicated for use by trained health care professionals whenever there is a need for monitoring the physiological parameters uterine activity, heart rate, oxygen saturation, noninvasive blood pressure, pulse rate, and temperature of pregnant women, and the fetal heart rates of single fetuses, twins, and triplets in labor and delivery rooms, in antepartum testing areas, in private households and during transports in healthcare facilities.
1 Introduction Electrical Hazards WARNING Electrical shock hazard: Do not open the monitor housing. Refer all servicing to qualified service personnel. • Always use the supplied power cord with the earthed mains plug to connect to an earthed AC mains socket. Never adapt the mains plug from the fetal monitor to fit an unearthed AC mains socket. • Do not use AC mains extension cords or multiple portable socket-outlets. • FM20/FM30 only: The protective earth conductor is required for EMC purposes.
1 Introduction • For paced patients: The radiated SRR power of the CL SpO2, CL NBP Pods, CL F&M Pod, and the CL Wide Range Pod, and other sources of radio-frequency energy, when used in very close proximity of a pacemaker, might be sufficient to interfere with pacemaker performance. Due to shielding effects of the body, internal pacemakers are somewhat less vulnerable than external pacemakers. However, caution should be exercised when monitoring paced patients.
1 Introduction Prohibited Environments: • The monitors and their transducers, Pods, and accessories are not intended for use in an MRI environment or in an oxygen-enriched environment (for example, hyperbaric chambers). Alarms WARNING • Do not rely exclusively on the audible alarm system for fetal monitoring. Adjustment of alarm volume to a low level or off during monitoring may result in a dangerous situation.
1 Introduction Security Information Protecting Personal Information Protecting personal health information is a primary component of a security strategy. Each facility using the monitors must provide the protective means necessary to safeguard personal information consistent with country laws and regulations, and consistent with the facility’s policies for managing this information.
1 Introduction About the EU Directives If applicable, your facility’s security strategy should include the practices set forth in the Directive on the protection of individuals with regard to the processing of personal data and on the free movement of such data (Directive 95/46/EC of the European Parliament and of the Council of 24 October 1995).
1 Introduction Avalon FM20/FM30 and FM40/ FM50 Wired Transducers Avalon CL Base Station Avalon CL Transducers CL Pods US transducer (wired) Avalon CL US Transducer (cableless) Avalon CL Fetal & Maternal Pod 866488 M2736A 866076 Toco/ Toco MP transducer (wired) Avalon CL Toco+ MP Transducer Avalon CL Wide Range Pod (cableless) 866487 M2734A and M2734B 866075 19
1 Introduction Avalon FM20/FM30 and FM40/ FM50 Wired Transducers Avalon CL Base Station Avalon CL Transducers CL Pods Toco+ transducer with ECG/IUP Avalon CL ECG/IUP Transducer IntelliVue CL NBP Pod capability (wired) (cableless) (cableless) 865216 M2735A 866077 Patient Module for ECG/IUP IntelliVue CL SpO2 Pod (cableless) M2738A 865215 20
2 2 What's New This section lists the most important new features and improvements to the fetal monitors and their user interface introduced with Release L.3. You may not have all of these features, depending on the fetal monitor configuration purchased. What's New in Release L.3 Avalon CL Fetal & Maternal Pod The Avalon CL Fetal & Maternal Pod is an extension of the Avalon CL solution. The Avalon CL Fetal & Maternal Pod is used together with a single use patch with five abdominal electrodes.
2 What's New Avalon CL Wide Range Pod The Avalon CL Wide Range Pod is an extension of the Avalon CL solution. The Avalon CL Wide Range Pod extends the signal range of the cableless measurements. It transmits the cableless measurement signals via the hospital WLAN/WiFi to the fetal monitors. Wearing the CL Wide Range Pod, the patient can walk freely within the hospital's WLAN/WiFi range during monitoring. Prior to use, the Avalon CL Wide Range Pod is charged and assigned at the Avalon CL base station.
2 What's New What's New in Release J.3 Avalon CL Transducer System The Avalon CL Transducer System provides cableless monitoring with the Avalon FM20/FM30 and FM40/FM50 with the same functionality and performance as the wired measurement devices (e.g. twin and triplets monitoring). The Avalon CL Transducer System has a straight-forward handling and operating concept. The CL transducers are assigned by simply docking them at the CL base station, no further configuration is necessary.
2 What's New Manually Entered Maternal Temperature Measurements Manually measured temperatures can be entered at the fetal monitor. They are displayed as a numeric on screen, and are printed out on the recorder trace (“Monitoring Maternal Temperature” on page 249). SpO2 Recordings and Transmissions SpO2 annotation on local recorder You can now configure the interval for printing the SpO2 numeric values on the recorder trace.
2 What's New Increased Internal Back-up Memory The internal back-up memory is now able to store traces and data from at least the last 3.5 hours with the software revision J.3, and minimum 7 hours with the new mainboard hardware revision A 00.18 (see “Manually Recording Stored Data” on page 258 and “Recovering Data” on page 257).
2 What's New Alarm Reminder In Configuration Mode, you can set now an Alarm Reminder. The Alarm Reminder emits an audible reminder of alarm conditions that remain active after the alarm is acknowledged. This reminder may take the form of a repetition of the alarm tone for a limited time, or an unlimited repetition of the alarm tone (this is the same as a new alarm).
3 3 Basic Operation This chapter gives you an overview of the monitor and its functions. It tells you how to perform tasks that are common to all measurements (such as entering data, switching on a measurement, changing some monitor settings, and setting up the recorder). The alarms section gives an overview of alarms. The remaining sections tell you how to perform individual measurements, and how to care for and maintain the equipment.
3 Basic Operation Supported Measurements Different measurements for the same physiological parameter may have a different appearance on the trace, due to: variability (HR), averaging, delay, amplitude, or artifacts. Before interpreting the trace, regard the fetal monitor setup and transducers used.
3 Basic Operation Avalon FM20 and FM30 This section outlines the capabilities of your monitor. Avalon FM20 The Avalon FM20 fetal/maternal monitor provides a solution for external fetal monitoring applications, and optional noninvasive maternal vital signs.
3 Basic Operation FM20/30 with Battery Option #E25 Only The battery option for the FM20/30 provides support for the in-transport monitoring of all measurements when disconnected from a power supply. Existing data storage is automatically uploaded to OB TraceVue or IntelliSpace Perinatal after reconnecting it to the system. Trace printing during transport is also possible. Avalon FM40 and FM50 This section outlines the capabilities of your monitor.
3 Basic Operation Avalon FM50 The Avalon FM50 fetal/maternal monitor offers a solution for both external and internal fetal monitoring applications, and noninvasive maternal vital signs. The Avalon FM50 shares all the features and capabilities of the Avalon FM40. In addition, you can monitor one FHR internally with a direct fetal electrocardiogram (DECG), and uterine activity internally using an intrauterine pressure (IUP) catheter together with a Toco+ transducer or patient module.
3 Basic Operation with Battery Option 1 On/Standby button with power LED 2 MSL connector for external power supply 1 SpO2 socket (optional) 2 Noninvasive Blood Pressure socket (optional) 3 Fetal sensor sockets Left Side Each of the fetal sensor sockets accepts any fetal transducer, one Avalon CL or one Avalon CTS Cableless Fetal Transducer System base station, or an event marker.
3 Basic Operation You can use two of the five optional interfaces at the same time. Optional Interfaces 1 LAN/RS232 system interface 2 Dual PS/2 system interface Description Flexible nurse call interface card Quad.
3 Basic Operation Getting to Know Your Avalon FM40/FM50 Front 1 Touchscreen color display 2 Transparent paper guide with tear-off edge 3 Paper eject button 4 Power LED 5 On/Standby button 6 Recorder paper table 7 Fetal sensor sockets 8 Noninvasive blood pressure socket (optional) 9 SpO2 socket (optional) Connect any fetal sensor or patient module at the fetal sensor sockets, including an Avalon CL or an Avalon CTS via interface cable (with red connector).
3 Basic Operation Rear 1 Reserved for future use: protective earth intended for use in system installations 2 Equipotential grounding point 3 Power cord connector 4 Loudspeaker 5 Slot 01 for optional LAN/RS232 system interface (for connection to an obstetrical information and surveillance system) 6 Slot 03 reserved for future use 7 Video output (VGA) 8 Telemetry interface 9 Slot 02 for optional interfaces: Either dual PS/2 system interface (A) for mouse and keyboard connection) Or MIB inte
3 Basic Operation Connecting the Monitor to AC Mains WARNING • Always use the supplied power cord with the earthed mains plug to connect to an earthed AC mains socket. Never adapt the mains plug from the fetal monitor to fit an unearthed AC mains socket. • Check that the line frequency is correctly configured in the Global Settings menu. • FM20/FM30 only: The protective earth conductor is required for EMC purposes. It has no protective function against electric shock.
3 Basic Operation 1 Cable - connects to any of the four fetal sensor sockets on the monitor The M2736AA US transducer is identical to the M2736A US transducer, including all specifications Ultrasound Transducer (M2736A) 1 Connector - for connecting ECG/IUP adapter cables (M2735A Toco+ transducer only) 1 Butterfly belt clip (shown fitted; for use with belts without button holes) 2 Close-up of MECG adapter cable connected to Toco+ transducer 3 Close-up of active finder LED 1 Connector - for conne
3 Basic Operation Operating and Navigating Your monitor has a touchscreen. Everything you need to operate the monitor, except the on and off switch, is contained on its screen. Most screen elements are interactive. Screen elements include measurement numerics, screen keys, information fields, status indicators, alarms fields, and menus. Operator Position The typical operator's position is in front of the monitor.
3 Basic Operation Screen Elements Monitor Information Line 1 LAN connection status indicator only. RS232 system connection is not indicated. The locomotive icon indicates if the fetal monitor is connected to OB TraceVue/IntelliSpace Perinatal, via a LAN cable or not.
3 Basic Operation Measurement Area 1 Antenna symbol (indicates a cableless measurement from a connected Avalon CL or Avalon CTS system) 2 Configurable alarm limits 3 NST test 4 Audio source symbol 5 Measurement numeric 6 Alarms off symbol 7 Fetal trace recorder - status indicator 8 Avalon CL or Avalon CTS system - status indicator 9 Battery status indicator 10 Status line - shows status and prompt messages 11 Signal quality indicator: good, acceptable, poor 12 Fetal heart rate measuremen
3 Basic Operation Screen Details Icon Description The antenna symbol indicates a cableless measurement (Avalon CL or Avalon CTS). Indicates a short range radio measurement (CL Pods).
3 Basic Operation Keys The monitor has three different types of keys. Permanent Keys A permanent key is a graphical key that remains permanently on the screen, giving you fast access to functions. Key Name Function Silence Acknowledges all active alarms by switching off audible alarm indicators. Main Screen Closes all open menus and windows and returns to the main screen. SmartKeys SmartKeys are configurable graphical keys, located at the bottom of the main screen.
3 Basic Operation SmartKey Name Function Call Patient Pages the patient. Only enabled if at least one CL transducer is currently active cl F&M Status Calls up the cl F&M Electrode Status window Pause Alarms Pauses alarm indicators. Pause duration depends on monitor configuration.
3 Basic Operation Pop-Up Keys Pop-up keys are context-sensitive graphical keys that appear automatically on the monitor screen when required. For example, the Confirm pop-up key appears when you need to confirm a change. Using the Touchscreen Select screen elements by pressing them directly on the monitor's screen. Disabling Touchscreen Operation 1 To temporarily disable the touchscreen operation of the monitor, press and hold the Main Screen permanent key for about three seconds.
3 Basic Operation Mode Description Password Protected Configuration Mode The Configuration Mode is for personnel trained in configuration tasks. You can change and store the default values and patient profiles permanently in the Configuration Mode. These tasks are described in the Configuration Guide. During installation, the fetal monitor is configured for use in your environment. This configuration defines the default settings you work with when you switch on the fetal monitor.
3 Basic Operation User Default The User Defaults are a complete configuration stored in the monitor's long-term memory. You can store the active settings, modified to your preference, in the User Defaults (in Configuration Mode). In Monitoring Mode, you can load the User Defaults settings to return to your preferred settings: 1 Select the Defaults SmartKey. 2 Select Confirm in the dialog box to load the User Defaults.
3 Basic Operation Changing Monitor Settings To change monitor settings such as brightness, or touch tone volume: 1 Enter the Main Setup menu. 2 Select the setting you want to change, or select User Interface to enter a sub menu where you can change user interface settings. Adjusting the Screen Brightness 1 Enter the Main Setup menu. 2 Select User Interface. 3 Select Brightness. 4 Select the appropriate setting for the screen brightness. 10 is the brightest, 1 is the least bright.
3 Basic Operation When disconnected from AC power, the monitor retains the date and time setting for at least two months. If the monitor is off longer than two months, and the operating system detects that the date and time settings are invalid, the monitor initiates a "cold" start and sets the date to 1 Jan 1997 and the time to 00:00. Checking Your Monitor Revision 1 Select Main Setup, Revisions to open the Monitor Revision menu.
3 Basic Operation Switching On: FM40/FM50 1 Connect the monitor to AC mains. – The green LED lights up. 2 Press the On/Standby switch. – The monitor performs a self-test as it starts up. Selftest: OK, the serial number, and revisions for the software and firmware are printed on the fetal trace paper (if recorder Auto Start is configured to On). – The monitor display comes on. – There is a start-up tone from the loudspeaker.
3 Basic Operation 3 To fold the display, pull the display forwards as far as it will go. 4 Then push the display all the way back until it clicks shut. If your monitor is wall-mounted, the display should be folded flat. Fastening Belts and Transducers You can use more than one belt if, for example, you are monitoring uterine activity and FHR simultaneously. There are two basic ways to fasten belts and transducers: • Belts with button fixings. • Velcro belts together with the butterfly belt clip.
3 Basic Operation Using Belts with Button Fixings 1 Place the transducer belt across the bed, so that the fixing button will face away from the mother when it is fastened. 2 Lie the patient on the bed and arrange the belt around her until it is tight but still comfortable. 3 Fasten the belt by pushing the fixing button through the overlapping section of the belt. Ensure that the fixing button and the loose ends of the belt are at the patient's side.
3 Basic Operation 5 Alternatively, attach the butterfly belt clip to the transducer belt button and use this to attach the transducer to the belt. The clip allows you to slide the transducer for easy repositioning. Using Belt with Velcro Fixings Insert one end of the belt between the belt guides on one side of the butterfly belt clip, and secure with the velcro fixing.
3 Basic Operation Repositioning Transducers A patient possibly wears transducers for long periods without interruption. In rare cases, skin irritations may occur if a transducer is attached to one location for a longer period. To ensure there are no adverse effects on the patient's skin, inspect the transducer application site at least every three hours. If the skin quality changes, move the transducer to another site.
3 Basic Operation For the FM20 and FM30, you can connect an Avalon CL or Avalon CTS Cableless Fetal Transducer system interface cable (red connector) to one of the fetal sensor sockets at the left side of the monitor.
3 Basic Operation The blue finder LED on a wired fetal transducer lights up when you touch the measurement on the screen, allowing you to identify the corresponding transducer. finder LED 1 The white finder LED on a cableless fetal transducer lights up when you touch the measurement on the screen, allowing you to identify the corresponding transducer. 1 finder LED cableless transducer The recorder prints an annotation showing the date, time, recorder speed, and Monitoring Mode.
3 Basic Operation Paper Guide FM40/FM50 The recorder in the FM40 and FM50 features a transparent paper guide which: • facilitates correct alignment of the paper, both during loading and while the recorder is running. See “Loading Paper FM40/FM50” on page 65. • incorporates a tear-off edge, which not only allows you to tear off the trace paper where you like (not necessarily at a fold), but also helps to avoid paper misalignment while doing so (see “Tearing Off the Paper” on page 61).
3 Basic Operation 1 Fetal heart rate label 2 Uterine activity label The current monitoring modes (if any transducers are connected to the monitor) are printed.
3 Basic Operation 1 Time stamp printed every ten minutes The trace records maternal parameters also. When measuring noninvasive blood pressure, the annotation is made at the end of the measurement. If the noninvasive blood pressure measurement repetition time is short, the noninvasive blood pressure numeric may not always be printed.
3 Basic Operation Recording Elements A variety of information can appear on the recorder trace. Here is a sample trace with some of the most common elements and their meaning. Each trace header contains the last name and first name, the patient ID, patient date of birth, the current date and time, patient's bed label, and the gestational age of the pregnancy.
3 Basic Operation Caution The trace contains sensitive personal data. For information how to protect personal information, see “Protecting Personal Information” on page 17. Choosing Recorder Speed You can choose a recorder speed of 1, 2, or 3 centimeters per minute (cm/min). The default setting is 3 cm/min. The ACOG technical bulletin on FHR monitoring states that "accurate pattern recognition is difficult if not impossible at 1 cm/min and that 1 cm/min is only recommended for more economic screening.
3 Basic Operation A small arrow is printed on the heart rate scale on the trace paper. This reflects exactly when the marker button was first pressed; keeping the button pressed has no influence on the annotation. Tearing Off the Paper CAUTION Never pull on the paper to advance it, as this can cause misalignment of the paper. Always tear off the paper along the perforation.
3 Basic Operation shown). You may want to use both hands to guarantee that the paper is not misaligned during the tear off. 3 FM20/FM30 If you wish to tear off the paper at a fold, select the Paper Advance SmartKey, wait for the paper to stop, then tear it off. The FM20/FM30 does not have a paper guide. The procedure is the same as described for the FM40/ FM50 with the exception that you should advance the paper to a perforation.
3 Basic Operation FM20/FM30 To load a pack of paper: 1 If the recorder is on, press the recorder Start/ Stop SmartKey or the Stop Recordng SmartKey to turn it off before loading a new pack of paper. 2 Press the paper table release to unlock the paper drawer and then pull the table forward to open it fully. 3 Lift out any remaining paper from the tray. 4 Prepare to place the new pack of paper in the tray with the bottom side down.
3 Basic Operation 64 5 Unfold the top page of the pack and position the uterine activity scale on the right. 6 Slide the pack into the tray.
3 Basic Operation 7 Push the paper drawer back until it "clicks" closed. 8 Press the recorder Start/ Stop SmartKey or the Start Recordng SmartKey to switch on the recorder. Annotations of trace information are printed on the trace paper (see “Switching the Recorder On and Off” on page 56 for details). Loading Paper FM40/FM50 CAUTION Using recorder paper that is not approved by Philips can result in accelerated paper fading and can damage the thermal line printhead.
3 Basic Operation 3 Lift out any remaining paper from the tray. 4 Press and hold the paper eject button to partially eject the paper, thus making it easier to remove. 5 Hinge the transparent paper guide forward. It is held in the closed position by a small protrusion on each side of the holder. A - Protrusion holds paper guide in closed position.
3 Basic Operation 6 Prepare to place the new pack of paper in the tray with the bottom side down. The bottom side is indicated by the word STOP printed on the final page of the new pack. 7 Unfold the top page of the pack and position the uterine activity scale on the right. 8 Slide the pack into the tray. 9 Feed the paper evenly through the paper guide. Do not close the paper guide yet.
3 Basic Operation 10 Close the paper drawer. 11 Now close the paper guide. 12 Press the recorder Start/ Stop SmartKey or the Start Recordng SmartKey to switch on the recorder. Annotations of trace information are printed on the trace paper (see “Switching the Recorder On and Off” on page 56 for details).
3 Basic Operation Entering Notes Your monitor has a set of 15 factory pre-configured notes (see below). It is possible to edit these notes in Configuration Mode (see the Configuration Guide). The maximum length of one single note is 30 characters. To enter a note: 1 Select the Enter Notes SmartKey to open the Enter Note menu. 2 Scroll if necessary, then select the note you wish to enter. A confirmation dialog box opens: 3 Select Confirm to enter the note.
3 Basic Operation Typing Notes Other than the pre-configured notes selectable in the Enter Note menu, a note can be typed in manually. To type a note: 1 Select the Enter Notes SmartKey to open the Enter Note menu. 2 Select Type a note and a window with a touch keypad opens. 3 Type the note and select Enter. The typed note can be up to 30 characters long. The note is shown in the status line of the display, and is annotated on the fetal trace if the fetal recorder is on.
3 Basic Operation Switching the Monitor to the Standby Screen To switch the monitor to the Standby screen: Either 1 Select the Monitor Standby SmartKey. Or 1 Enter the Main Setup menu using the SmartKey. 2 Select Monitor Standby. 3 Pressing any key or selecting any field on the screen will resume monitoring.
3 Basic Operation Monitoring After a Power Failure • A fetal monitor that was switched on prior to a temporary power loss, switches on again when power is restored. • A fetal monitor that was switched off prior to a temporary power loss, remains off when power is restored. • If the fetal monitor is without power for less than one minute, monitoring will resume with all active settings unchanged.
4 4 Cableless Monitoring Avalon CL Transducer System The Avalon CL Fetal Transducer System lets you monitor the patient continuously with cableless transducers during the antepartum period, labor, and delivery.
4 Cableless Monitoring Basics of Cableless Systems Avalon CL Transducer System Avalon CTS Transducer System Assigning Cableless Devices The cableless devices of the Avalon CL are assigned by simply docking them at the base station connected to the patient’s fetal monitor. See the Avalon CTS Instructions for Use for the assignment of the CTS transducers. Activating Cableless Devices The CL devices of the Avalon CL are activated by picking them up from the base station.
4 Cableless Monitoring Twins and Triplets Support Twins and Triplets Singletons only Avalon CL Transducer System and CL transducers Avalon CTS System Avalon CL Transducer System with CL Fetal & Maternal Pod Configuration of Cableless Systems You have to configure the radio channels of the Avalon CL and Avalon CTS transducer system for communication to work, and not to interfere with any other telemetry devices.
4 Cableless Monitoring Getting to Know Your Avalon CL Front 1 Transducer docking slots 2 On/Standby button with LED 3 Device label 4 LED for optional cableless Pods 5 Docking slot for cableless Pods WARNING 76 • To avoid magnetic interference affecting the mode of the pacemaker, ensure that the Avalon CL base station does not come into close contact with implanted pacemakers.
4 Cableless Monitoring Docking Slots for Cableless Transducers The Avalon CL base station has three docking slots to hold the CL transducers. The transducers are charged while docked. The base station has a built-in radio interface with an integrated antenna to communicate with the transducers. On/Standby Button Pressing the On/Standby button switches the Avalon CL base station between the two modes On and Standby. 1 On/Standby button If you switch the base station to On, the LED button lights up green.
4 Cableless Monitoring Docking Slot for Cableless Measurement Pods The Avalon CL base station has one docking slot to hold a CL F&M Pod or an IntelliVue CL Pod. The CL Pod is charged while docked. The LED under the docking slot indicates the battery status of the CL Pod. The base station has a built-in short range radio interface with an integrated antenna to communicate with the CL Pod.
4 Cableless Monitoring Rear and Bottom 1 Name plate 1 Manufacturer label 2 Cable reel 79
4 Cableless Monitoring Connection Options The fetal monitors FM20/FM30 and FM40/FM50 are compatible with the Avalon CL and Avalon CTS Transducer Systems. Regard the following points for cableless monitoring: 80 • You can connect one Avalon CL base station with a red connector to an FM20/FM30 or an FM40/FM50 (fetal socket), or one Avalon CL base station with a black connector to an FM40/ FM50 (telemetry socket).
4 Cableless Monitoring • You cannot connect two Avalon CL base stations to an FM40/FM50, if one Avalon CL base station has a red connector, and the other Avalon CL base station has a black connector. • You can connect one Avalon CTS system to an FM20/FM30 or FM40/FM50 at a time (either fetal or telemetry socket).
4 Cableless Monitoring 82 • You cannot connect an Avalon CTS and an Avalon CL at the same time to the same fetal monitor. • Monitoring a multiple pregnancy using cableless transducers is supported by the Avalon CL system only. • Using a mixture of wired and cableless fetal transducers is not supported. You can use either wired or cableless fetal transducers. • If you cannot get sufficient signal quality using Avalon CTS transducers, switch to wired transducers.
4 Cableless Monitoring Connecting Two CL Base Stations to an FM40/50 Monitor Two base stations can be connected to an FM 40/50 fetal monitor at the rear black telemetry ports. At both base stations CL transducers and CL Pods can be assigned, activated, and redocked for charging. The base stations work as one extended system together. Pressing the Standby key of either base station, puts both base stations in Standby mode. The Tele Info window shows both base stations in operation.
4 Cableless Monitoring Cableless Transducers The cableless Avalon CL transducers have a built-in radio interface with an on-board, integrated antenna. The fetal monitor connected to the Avalon CL base station can control the transducer using radio communication. The CL transducer transmits measured values, alarms, and status information to the fetal monitor. The CL transducers are assigned by simply docking them at the Avalon CL base station.
4 Cableless Monitoring CL ECG/IUP transducer Connector Cap for the CL Toco+ MP Transducer The CL Toco+ MP transducer is delivered with a connector cap covering the MECG/DECG/IUP connector. The connector cap is designed to cover the connector, not to protect it from water. (The connector itself is water-proof and may be immersed in water).
4 Cableless Monitoring Cableless Transducer LED Indication The cableless transducers have a multi-color LED that indicates the status of the transducer with specific colors. This LED remains visible when the transducer is correctly attached to the transducer belt (Philips standard belt). 1 LED LED Status Meaning White The LED lights up to identify the transducer among other transducers, and to easily verify the correct transducer assignment (transducer finder).
4 Cableless Monitoring Audio Signal CL Transducers The Avalon CL transducers have three audio signals: • If an ascending tone sequence is played three times, the transducer was triggered by the fetal monitor to page the patient wearing it, or to locate a not docked transducer. • If the CL transducer's battery is empty, the transducer issues three beeps in intervals. • An INOP tone indicates that the transducer has detected a technical problem (INOP).
4 Cableless Monitoring Using CL Transducers with a Belt Clip The Avalon CL transducers can also be used with an optional belt clip to be ordered separately (989803184851).
4 Cableless Monitoring CL Pods CL Fetal & Maternal Pod The CL F&M Pod provides measurement values for FHR, Toco, and HR. It communicates them to the fetal monitor using short range radio (SRR). It is controlled via SRR from the Avalon CL base station and the connected fetal monitor. The CL F&M Pod is assigned by docking it at the Avalon CL base station. Before monitoring, the CL F&M Pod is mounted on a single-use electrode patch, and held in place by integrated magnets.
4 Cableless Monitoring CL Fetal & Maternal Pod LED Indication The CL F&M Pod has a multi-color LED that indicates the status of the CL F&M Pod with specific colors. 1 LED LED Status Meaning White The LED lights up to identify the CL Pod, and to easily verify the correct assignment (finder). The finder LED is controlled by the fetal monitor. Select the numerics to identify the corresponding CL Pod. The LED also lights up when the mother is paged with the Call Patient SmartKey.
4 Cableless Monitoring CL Fetal & Maternal Electrode Patch The single-use disposable adhesive electrode patch holds the CL F&M Pod at the intended application site on the abdomen of the patient. The electrode patch has five adhesive electrodes. The CL F&M Pod is held in place during monitoring with magnetic contacts, and a connector. The electrode patch and the CL F&M Pod can only be used together and within the Avalon Cableless Transducer System solution for monitoring.
4 Cableless Monitoring IntelliVue CL Pods The two IntelliVue CL Pods provide measurement values for SpO2 and NBP on the built-in display, and communicate them to the fetal monitor using short range radio (SRR). They are controlled with SRR from the Avalon CL base station and the connected fetal monitor. The maternal measurement pods are assigned by docking them at the Avalon CL base station.
4 Cableless Monitoring Battery Status LED for CL Pods The CL Pods do not have their own battery status LED, but a small battery gauge on their display. On the Avalon CL base station, the battery status LED for the CL Pods is located directly under the docking slot. 1 Battery status LED for CL Pods The battery status LED shows five different states: Status Meaning Green The docked CL Pod is fully charged. Yellow The docked CL Pod is charging.
4 Cableless Monitoring Telemetry Tele Info Window The Tele Info window of the fetal monitors allows you to manage the Avalon CL or CTS system. Below is an exemplary view of the Tele Info window. Your window may differ depending on the status of the connected system. To open the Tele Info window, you can: 1 Configure a Tele Info SmartKey to open the window, 2 select the CL symbol on the main screen, or 3 select the Main Setup and then Tele Info.
4 Cableless Monitoring Cableless Status Indication When the monitor recognizes a connected Avalon CL or Avalon CTS interface cable (red or black connector), it confirms the recognition with the following status indicators displayed in the lower right-hand corner of the screen: Avalon CTS Indicator Description Avalon CTS interface cable is connected to the monitor, but the Avalon CTS base station is not connected to the interface cable, or it is disconnected from AC mains, or is in Standby mode.
4 Cableless Monitoring Indicator Avalon CL A base station is connected to the monitor, it is on, and minimum one assigned cableless transducer or cableless Pod is active. The CL Wide Range Pod is activated and trying to connect to the monitor. A base station is connected to the monitor, it is on, and minimum one assigned cableless transducer or cableless Pod is active. The CL Wide Range Pod is activated and connected to the monitor.
4 Cableless Monitoring Use Priority When Combining Cableless and Wired Measurements CL Transducers versus wired transducers CL transducers have priority over wired transducers. If an Avalon CL or Avalon CTS base station is connected to the fetal monitor, and both wired and CL transducers are connected to the monitor, all the wired transducers are disabled whenever one CL transducer is active.
4 Cableless Monitoring CL Transducer Assignment The CL transducers are assigned by simply docking them at the Avalon CL base station connected to the patient’s fetal monitor. Since twins and triplets can be monitored with the Avalon CL base station, it can be delivered with up to six CL transducers: one CL Toco+ MP, three CL US, and two CL ECG/IUP transducers. Up to four CL transducer can be assigned at one time to the Avalon CL base station.
4 Cableless Monitoring NOTE When a CL transducer is unassigned, all the measurements from this transducer are no longer monitored; e.g. if you unassign a CL Toco+MP transducer, the Toco measurement, maternal Pulse, or possibly also MECG or DECG are no longer monitored. CL Pod Assignment The CL Pods are assigned by simply docking them at the Avalon CL base station connected to the patient’s fetal monitor.
4 Cableless Monitoring Preparing to Monitor Cablelessly When monitoring cablelessly with the FM20/30/40/40 monitors, most of the same procedures apply as described in “Preparing to Monitor” on page 48. Additions and deviations applying to cableless devices and existing procedures are described here. CL Transducers 1 To monitor cablelessly with the CL transducers, assign them at the base station as described in “CL Transducer Assignment” on page 98.
4 Cableless Monitoring At the Mother's Side 1 Have a new single-use electrode patch ready, and make sure that the pouch is still intact. Check the expiration date that is printed on the pouch. 2 Clean the application area on the abdomen of the patient. Use mild soap to wash any cream, oil, or gel from the abdomen. Make sure to thoroughly wipe the area dry afterwards, ideally using paper towels. 3 Take the electrode patch from its pouch.
4 Cableless Monitoring 12 For the last remaining electrode attached to the long flexible cable, identify the small area of skin to prepare, so that the center of this reference electrode will be positioned on the midline, approximately 6 cm (2.4 in) above the rim of the symphysis pubis. For patients with a displaced umbilicus, very obese patients, or patients with a large panniculus: Place the electrode on top of the panniculus approximating to the point 6 cm (2.4 in) vertically from the symphysis pubis.
4 Cableless Monitoring At the Monitor After you have placed the CL F&M Pod on the electrode patch, the cl F&M Electrode Status window opens at the monitor. In the cl F&M Electrode Status window, the electrodes and their skin contact status are shown. The skin contact status indicates, whether the skin preparation at each electrode site was successful. 1 Electrode Status There are three methods to reopen a closed cl F&M Electrode Status window.
4 Cableless Monitoring Electrode Status Description What to Do Further skin preparation is required. 1 Electrode status is unknown. Carefully remove the electrode from the skin. 2 Dry the skin. 3 Repeat the skin preparation procedure. 4 It is not recommended to skip the electrode status check, if bad skin contact quality is persistently indicated for one or more electrodes. This status may be shown temporarily, or in case of a patch malfunction, combined with an INOP message.
4 Cableless Monitoring After Monitoring 1 After monitoring is done, remove the CL F&M Pod from the electrode patch. 2 Clean and disinfect the CL F&M Pod, see “Care and Cleaning” on page 261. 3 Dock the CL F&M Pod back at the base station. 4 Gently remove the electrode patch and the electrodes from the abdomen of the patient. 5 Dispose of the electrode patch. 6 Remove the residuals of the adhesive from the patient's skin.
4 Cableless Monitoring Battery Lifetime Management The lifetime of a Lithium Ion battery depends on the frequency and duration of use. CL Transducers Battery replacement is recommended after 500 charge-discharge cycles, or if the battery is older than 4 years whatever is reached first. If the battery of a cableless transducer has aged and an exchange of the battery is highly recommended, a prompt message is displayed at the fetal monitor for ca. 60 seconds.
4 Cableless Monitoring The date of manufacture and number of charge-discharge cycles can be printed out in a battery report. Patient Transport Within the Hospital During transport, the patient wearing the CL transducers can be transferred from one fetal monitor to another fetal monitor. 1 To stop monitoring, discharge the patient at the fetal monitor. Do not switch the CL base station to Standby.
4 Cableless Monitoring Underwater Monitoring Only the battery-operated CL transducers of the Avalon CL and Avalon CTS systems can be used to monitor under water. You can use them to monitor patients in a bathtub or shower. This does not apply to the IntelliVue CL SpO2, CL NBP, and the CL Wide Range Pod, do not immerse the CL Pods into water. The CL F&M Pod can be worn within the shower, if the Pod is securely placed on the electrode patch, so that the contacts cannot get wet.
5 5 FM20/30 Battery Option You can switch between battery-powered and mains-powered (AC) operation without interrupting monitoring. The monitor is connected to the AC mains power via the external power supply. NOTE The battery option is not available for the FM40/FM50. External Power Supply M8023A The external power supply M8023A (option #E25) allows you to operate the fetal monitor from an AC (alternating current) power source of 100 V to 240 V (±10%) and 50/60 Hz (±5%).
5 FM20/30 Battery Option 1 AC power cord, connected to AC mains socket 2 Measurement Link (MSL) cable, supplies the power to the monitor for operation and for battery charging 3 Power-on LED, the green light is on when the external power supply is connected to the AC mains WARNING • Always use the supplied power cord with the earthed mains plug to connect the external power supply M8023A (option #E25) to an earthed AC mains socket.
5 FM20/30 Battery Option Battery LED The possible battery LED status on the right side of the monitor is described in the table below.
5 FM20/30 Battery Option Battery malfunction symbols: Normal battery function is indicated by the battery power gauge, together with the remaining operating time, on the main screen. You are informed of problems or changes in the status of the battery by the battery status/malfunction indicator. This consists of a blank battery gauge containing a "!" symbol. If the symbol is red, this indicates a critical situation.
5 FM20/30 Battery Option Symbols indicating critical situations are colored red.
5 FM20/30 Battery Option Charging the Battery To charge the battery: 1 Connect the monitor to the external power supply (M8023A). 2 Charge the battery until it is full, the battery LED is green, and the battery power gauge is filled. During high load of the monitor (usage of multiple measurements) the battery may not charge.
5 FM20/30 Battery Option Battery Safety Information WARNING Use only Philips batteries part number M4605A. Use of a different battery may present a risk of fire or explosion. Do not open batteries, or dispose of them in fire, or cause them to short circuit. They may ignite, explode, leak, or heat up, causing personal injury. If battery leakage should occur, avoid contact with skin. Refer to qualified and authorized service personnel.
5 FM20/30 Battery Option Cableless Monitoring with FM20/30 Battery Option The CL Pods can be used with the FM20/30 with battery option #E25. The CL Pods can be assigned and activated, but will not be charged. The only exception to this is the CL F&M Pod, which can also be charged. The charging time of the CL transducers can take up to 6 hours if they are charged from an FM20/30 with battery option.
6 6 Alarms The alarm information here applies to all measurements. Measurement-specific alarm information is contained in the sections on individual measurements. The fetal monitor has two different types of alarm: patient alarms and INOPs. Patient Alarms Patient alarms are red and yellow alarms. A red alarm indicates high priority, such as a potentially life threatening situation (for example, SpO2 below the desaturation alarm limit).
6 Alarms • The time between the displayed numerical values exceeding an alarm limit and the alarm indication on the monitor. This delay is the sum of the alarm delay configured for the specific measurement plus the system alarm delay. The system alarm delay is the processing time the system needs for any alarm on the monitor to be indicated after the measurement has triggered the alarm.
6 Alarms Visual Alarm Indicators Alarm message: An alarm message appears in the alarm status area on the second line at the top of the screen indicating the source of the alarm. If more than one measurement is in an alarm condition, the message changes every two seconds, and has an arrow at the side. The background color of the alarm message matches the alarm priority: red for red alarms and red INOPs, yellow for yellow alarms and yellow INOPs, and cyan for INOPs.
6 Alarms Standard Philips Alarms • Red alarms and red INOPs: a high pitched sound is repeated once a second. • Two-star yellow alarms and yellow INOPs: a lower pitched sound is repeated every two seconds. • One-star yellow alarms (short yellow alarms): the audible indicator is the same as for yellow alarms, but of shorter duration. • Standard INOPs: an INOP tone is repeated every two seconds.
6 Alarms Minimum Volume for Severe Yellow or Red INOPs Severe yellow or red INOPs require action to ensure the well-being of the patient. Therefore the minimum volume for the INOP tone is set to at least alarm volume 8, irrespective of the current alarm volume setting. The INOP tone will sound even if the monitor alarm volume is set to zero.
6 Alarms Alarm Reminder If Alarm Reminder is configured on for your monitor, you will get an audible reminder of alarm conditions that remain active after you have acknowledged the alarm. This reminder may take the form of a repetition of the alarm tone for a limited time, or an unlimited repetition of the alarm tone (this is the same as a new alarm). Alarm Reminder is available only for yellow and red alarms and INOPs and not for standard cyan INOPs.
6 Alarms To Switch All Alarms Off You can switch alarms off permanently if your monitor is configured to allow infinite alarms pause, and the SmartKey is labeled Alarms Off. Select the Alarms Off SmartKey. Or 1 Select Main Setup. 2 Select Alarms. 3 Select Alarms Off. While Alarms are Paused or Off When red alarms are paused or off: In the alarm field, the monitor displays the message Al. Paused x:yy or Alarms Off, together with the alarms paused symbol or the alarms off symbol.
6 Alarms Extending the Alarm Pause Time If your monitor has the function extended alarm pause enabled, you can extend the alarm pause time. Use this to prevent alarms being indicated, for example, while you are washing a patient or carrying out a procedure. Only extend the alarm pause time when you are sure that clinical personnel are available to monitor the patient's condition closely. To extend the alarm pause time to five or 10 minutes: 1 Select one of the alarm fields.
6 Alarms If your monitor is not configured to show the alarm limits next to the numeric, you can see them in the related measurement setup menu. Select the measurement numeric to enter the menu and check the limits. Changing Alarm Limits To change individual measurement alarm limits using the measurement's setup menu: 1 In the measurement's setup menu, select the alarm limit you want to change. This calls up a list of available values for the alarm limit.
6 Alarms Reviewing Alarms To review the currently active alarms and INOPs, select any of the alarm status areas on the fetal monitor screen. The Alarm Messages window pops up. All alarms and INOPs are erased from the monitor's alarm history when you discharge a patient, or if you leave the Demonstration Mode. Alarm Messages Window The Alarm Messages window shows all the currently active alarms and INOPs in chronological order, beginning at the top with the most recent.
6 Alarms Viewing the Alarm Latching Settings To see the alarm latching setting for your monitor: 1 In the monitor's Main Setup menu, select Alarms. 2 Select Alarm Settings, and see the Visual Latching and Audible Latching settings. This setting can be changed in Configuration Mode. You should be aware of the settings chosen for your unit. There are three possible choices each for visual and audible latching: Red & Yellow, Red Only, and Off.
6 Alarms Testing Alarms When you switch the fetal monitor on, a self test is started. You should hear a single tone. This indicates that the audible alarm indicators are functioning correctly. For further testing of individual measurement alarms, perform the measurement on yourself (for example SpO2 or NBP) or use a simulator. Adjust alarm limits and check that appropriate alarm behavior is observed.
7 7 Patient Alarms and INOPs This chapter lists alarms and technical alarms (INOPs) for the fetal monitors irrespective of their priority. Alarm Messages Fetal alarms are identified by either "FHR", "dFHR", or aFHR. All other alarms without these identifiers refer to maternal parameters. Alarm messages can be configured with the Enhanced setting to give more information. These messages are shown additionally in the table below, with xxx for the measured value and yyy for the alarm limit concerned.
7 Patient Alarms and INOPs Alarm Message From Condition Indication *** Brady (Pulse) SpO2 The heart rate from the Pulse signal has fallen below the bradycardia limit. Numeric flashes, red alarm message, alarm tone. ***Brady/P xxx
7 Patient Alarms and INOPs Alarm Message From Condition Indication ** HR High MECG The maternal heart rate obtained from the maternal ECG has risen above the high alarm limit. Numeric flashes and high limit is highlighted, yellow alarm message, alarm tone. **HR xxx>yyy xxx denotes the highest measured value, and yyy is the high alarm limit. ** HR Low MECG **HR xxx
7 Patient Alarms and INOPs Technical Alarm Messages (INOPs) Monitor INOPs INOP Message Indication What to do 2nd Tele Incompatible Monitor: INOP tone One of the connected base stations is not supported by the monitor. Check software revisions. Bus Master Incomp Monitor: INOP tone The Bus Master board or firmware is incompatible and cannot be used with this monitor software revision. Contact your service personnel.
7 Patient Alarms and INOPs INOP Message Indication What to do OBR Interference Monitor: INOP tone OBR (OB Radio) communication is disturbed by other devices (not necessarily other wireless measurements). Contact service personnel. Paper End Monitor: INOP tone The end of the paper pack is detected. Insert a new pack of paper. Settings Malfunct Monitor: INOP tone The monitor cannot use the predefined settings for monitoring. Contact your service personnel.
7 Patient Alarms and INOPs INOP Message Indication What to do Batt Low Monitor: INOP tone The estimated battery-powered operating time remaining is less than 20 minutes. Batt Malfunction Monitor: INOP tone The monitor cannot determine the battery status. If the INOP persists, replace the faulty battery. If the condition persists and the monitor is not connected to mains power, this INOP is reissued two minutes after you acknowledge it. Battery at the monitor flashes.
7 Patient Alarms and INOPs Wired Transducer INOPs FHR (Ultrasound) INOP Message Indication What to do FHR1 Equip Malf Monitor: INOP tone There is a problem with the FHR hardware. Contact your service personnel. FHR2 Equip Malf FHR3 Equip Malf FHR3 Signal Loss The input signal quality is not sufficient to process the INOP tone if Alarm Mode is measurement. Adjust the position of the transducer to set to All. No tone if Alarm obtain a better signal. Mode is set to INOP only.
7 Patient Alarms and INOPs Cableless Transducer INOPs INOP Message Indication What to do cl US Batt Empty Monitor: INOP tone (configurable cyan, yellow, red) The remaining monitoring time with this transducer is below 15 minutes. Charge battery.
7 Patient Alarms and INOPs CL Fetal & Maternal Pod INOPs INOP Message Indication What to do aFHR1 Signal Loss Monitor: INOP tone The input signal quality is not sufficient to process the measurement. Reapply the electrodes of the electrode patch. aFHR2 Signal Loss aFHR3 Signal Loss cl F&M Batt Empty !!cl F&M BattEmpty !!!cl F&M BatEmpty Numeric is replaced by a -?INOP tone if Alarm Mode is set to All. No tone if Alarm Mode is set to INOP only.
7 Patient Alarms and INOPs INOP Message Indication What to do cl F&M Chk Electr. Monitor: INOP tone • without tone, if no CL F&M Pod parameter shows -?- Not all electrodes have sufficient skin contact: Prepare the skin at the application site further with the abrasive pad. CL F&M Pod: cyan LED • One or more leads between the measurement Pod and the electrode(s) is broken: Replace the electrode patch. • Contact problem between the CL F&M Pod and the electrode patch: Reconnect the CL F&M Pod.
7 Patient Alarms and INOPs CL Wide Range Pod INOPs INOP Message Indication What to do cl WRP Batt Empty Monitor: INOP tone (configurable cyan, yellow, red) The remaining time with the CL Wide Range Pod is below 15 minutes. Charge the battery.
7 Patient Alarms and INOPs DECG and MECG INOPs INOP Message Indication What to do dFHR1 Equip Malf Monitor: INOP tone There is a problem with the DECG hardware. Contact your service personnel. Monitor: INOP tone One or more DECG lead is not attached. Make sure that all required leads are attached, and no electrodes have been displaced. Check all connections are sound, and that the leg plate attachment electrode is properly attached.
7 Patient Alarms and INOPs NBP INOPs INOP Message Indication Cuff Not Deflated Monitor: INOP tone (severe Remove the cuff from the patient. Make sure that the yellow/red INOP tone) tubing is not kinked or twisted. Try restarting the Numeric is replaced by a -?- measurement. You can silence the INOP, but the INOP message remains visible until the next measurement is During this INOP, alarms started, or the Stop All SmartKey is selected. cannot be paused or switched off.
7 Patient Alarms and INOPs INOP Message Indication What to do NBP Interrupted Monitor: INOP tone Check the tubing and cuff for leakages or kinks. Check that you are using the correct cuff size and placement, and that the correct patient category is selected. Try restarting the measurement. If the INOP occurs repeatedly, contact your service personnel.
7 Patient Alarms and INOPs INOP Message Indication What to do cl NBP Batt Temp Monitor: INOP tone The temperature of the battery in the CL NBP Pod is critically high. Check that the Pod is not covered or exposed to a heat source. If the INOP persists, remove the Pod from the patient, and contact your service personnel.
7 Patient Alarms and INOPs SpO2 INOPs INOP Message Indication What to do SpO₂ Equip Malf Monitor: INOP tone There is a problem with the SpO2 hardware. Contact your service personnel. SpO₂ Erratic Monitor: INOP tone Check the sensor placement. Try another adapter cable and sensor. If the INOP persists, contact your service personnel. Numeric is replaced by a -?SpO₂ Extd.
7 Patient Alarms and INOPs INOP Message Indication What to do SpO₂ Upgrade Monitor: display only The SpO2 measurement is currently in upgrade mode. Monitoring is not possible in this mode. Numeric unavailable SpO₂Interference Monitor: INOP tone Numeric is replaced by a -?- There is too much interference caused by a high level of ambient light, and/or electrical interference. Cover the sensor to minimize ambient light.
7 Patient Alarms and INOPs INOP Message Indication What to do cl SpO₂ Chk Sett Monitor: INOP tone If this INOP appears and an INOP tone sounds, check the Cableless Measurement Device and patient settings before you resume making measurements. If the settings are unexpected, there may be a problem with the Cableless Measurement Device software. Contact your service personnel. CL SpO2 Pod: display message If this INOP is acknowledged at the Cableless Measurement Device, it is cleared.
8 8 Admitting and Discharging The fetal monitor can store basic patient demographic information used to identify patients. Admit/Discharge on the Monitor This section describes how you admit and discharge patients when using the monitor as a stand-alone device (that is, when not used with an obstetrical information and surveillance system such as OB TraceVue/IntelliSpace Perinatal). Admitting a Patient The fetal monitor displays physiological data as soon as a patient is connected.
8 Admitting and Discharging Quick Admitting a Patient Use Quick Admit to quickly admit a patient using only a limited set of demographic data. 1 Select the Quick Admit SmartKey. 2 Enter the required data (ID fields or last name depending on configuration) with the keyboard or a barcode scanner. 3 Select Enter. 4 In the confirmation window, select Confirm to stop monitoring for the previous patient.
8 Admitting and Discharging New Patient Check The fetal monitor can be configured to ask you in certain situations: • after a specified power-off period • after a specified standby period whether a new patient is now being monitored. The pop-up window is entitled Is this a New Patient?. The monitor offers a Yes key, to discharge the previous patient and begin monitoring a new patient, and a No key, to continue monitoring with the current patient data and settings.
8 Admitting and Discharging OB TraceVue/IntelliSpace Perinatal via RS232 In contrast to a LAN connection, when the monitor is connected to an OB TraceVue/IntelliSpace Perinatal system over an RS232 connection, the OB TraceVue/IntelliSpace Perinatal system does not have full control over the monitor's patient admission and discharge functions.
