PM-9000Vet Veterinary Portable Multi-Parameter Patient Monitor Operator’s Manual
CE Marking The product bears CE mark indicating its conformity with the provisions of the Council Directive 84/539/EEC and 2004/108/EC concerning medical devices. The product complies with the requirement of standard EN 60601-1-2 “Electromagnetic Compatibility – Medical Electrical Equipment”. Revision History This manual has a revision number. This revision number changes whenever the manual is updated due to software or technical specification change.
Intellectual Property Statement SHENZHEN MINDRAY BIO-MEDICAL ELECTRONICS CO., LTD. (hereinafter called Mindray) owns the intellectual property rights to this product and this manual. This manual may refer to information protected by copyrights or patents and does not convey any license under the patent rights of Mindray, nor the rights of others. Mindray intends to maintain the contents of this manual as confidential information.
Manufacturer’s Responsibility All information contained in this manual is believed to be correct. Mindray shall not be liable for errors contained herein nor for incidental or consequential damages in connection with the furnishing, performance, or use of this manual.
Return Policy In the event that it becomes necessary to return a unit to Mindray, follow the instructions below. 1. Return authorization. Contact the Customer Service Department and obtain a Customer Service Authorization number. This number must appear on the outside of the shipping container. Returned shipments will not be accepted if the number is not clearly visible. Please provide the model number, serial number, and a brief description of the reason for return. 2.
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 question, please contact us. This manual is an integral part of the product.
Conventions • Italic text is used in this manual to quote the referenced chapters or sections. • [ ] is used to enclose screen texts. • . is used to indicate operational procedures. • The terms danger, warning, and caution are used throughout this manual to point out hazards and to designate a degree or level or seriousness.
Contents 1 Safety................................................................................................................................ 1-1 1.1 Safety Information ..........................................................................................................1-1 1.1.1 Dangers .............................................................................................................. 1-2 1.1.2 Warnings .....................................................................................
2.2.3 Right Side Panel................................................................................................. 2-6 2.2.4 Rear Panel .......................................................................................................... 2-7 2.3 Control Panel................................................................................................................... 2-8 2.4 Display ...............................................................................................................
3.4.5 Connecting the Network Cable .......................................................................... 3-5 3.4.6 Auxiliary Output Port......................................................................................... 3-6 3.4.7 Connecting to VGA Monitor..............................................................................
3.4.8 Equipotential Grounding.................................................................................... 3-7 3.5 Powering on the Monitor ................................................................................................ 3-8 3.6 Powering off the Monitor................................................................................................ 3-8 4 System Menu ....................................................................................................................
4.4.5 Data Output ...................................................................................................... 4-12 4.4.6 Analog Output .................................................................................................. 4-13 4.4.7 Module Setup ................................................................................................... 4-14 4.4.8 Trace Setup....................................................................................................... 4-14 4.4.
5.1 Standard Screen............................................................................................................... 5-1 5.2 Trend Screen ................................................................................................................... 5-2 5.3 OxyCRG Screen.............................................................................................................. 5-3 5.4 Viewbed Screen..........................................................................................
6.1 Overview........................................................................................................................ 6-1 6.1.1 Alarm Categories................................................................................................ 6-1 6.1.2 Alarm Levels ...................................................................................................... 6-2 6.2 Alarm Modes...............................................................................................................
7 Freezing Waveforms ........................................................................................................ 7-1 7.1 Overview........................................................................................................................ 7-1 7.2 Freezing and Unfreezing................................................................................................. 7-1 7.3 FROZEN Menu.....................................................................................................
9.6 Non-Volatile Data Storage .............................................................................................. 9-9 10 Drug Calculation.......................................................................................................... 10-1 10.1 Drug Calculation......................................................................................................... 10-1 10.2 Titration Table ...................................................................................................
11.1 Overview......................................................................................................................11-1 11.1.1 ECG Waveform ...............................................................................................11-1 11.1.2 ECG Parameters ..............................................................................................11-3 11.2 ECG Monitoring Procedure .........................................................................................11-4 11.2.
11.5.6 Arrhythmia Recall .........................................................................................11-23 11.6 RESP Monitoring .......................................................................................................11-25 11.6.1 Overview .......................................................................................................11-25 11.6.2 Lead Placement .............................................................................................11-26 11.6.
12.3.3 Monitoring Procedure ...................................................................................12-11 12.3.4 Measurement Limitations..............................................................................12-11 12.3.5 SpO2 Setup Menu......................................................................................... 12-13 12.3.6 Accessories................................................................................................... 12-15 12.3.7 Nellcor Information.............
13.2.1 Cuff Selection and Placement ........................................................................ 13-3 13.2.2 Operation Guides ........................................................................................... 13-5 13.3 Measurement Limitations............................................................................................ 13-6 13.4 NIBP Setup Menu ....................................................................................................... 13-7 13.4.1 Calibration...
15.4.1 IBP Setup Menu ............................................................................................. 15-4 15.4.2 IBP Pressure Zero Menu ................................................................................ 15-8 15.4.3 IBP Pressure Calibration .............................................................................. 15-10 15.5 Maintenance and Cleaning........................................................................................ 15-13 16 CO Monitoring .................
17.2.3 CO2 Setup Menu ............................................................................................ 17-5 17.2.4 CO2 User Maintain Menu............................................................................... 17-9 17.2.5 Maintenance and Cleaning............................................................................17-11 17.3 Removing Exhaust Gases from the System ...............................................................17-11 18 Anesthesia Gas Monitoring .......................
18.1 Overview..................................................................................................................... 18-1 18.2 Measurement Principles and Procedure ...................................................................... 18-3 18.3 MAC ........................................................................................................................... 18-5 18.4 AG Setup Menu......................................................................................................
20.5 IBP Accessories........................................................................................................... 20-4 20.6 CO Accessories ........................................................................................................... 20-6 20.7 CO2 Accessories.......................................................................................................... 20-6 20.8 AG Accessories ..............................................................................................
A.13 IBP Specifications ......................................................................................................A-10 A.14 CO Specifications.......................................................................................................A-10 A.15 CO2 Specifications .....................................................................................................A-11 A.16 AG Specifications...................................................................................................
C Alarm Messages and Prompt Information....................................................................C-1 C.1 Physiological Alarm Messages.......................................................................................C-1 C.2 Technical Alarm Messages .............................................................................................C-2 C.3 Prompt Messages..........................................................................................................
FOR YOUR NOTES
1 Safety 1.1 Safety Information The safety statements presented in this chapter refer to the basic safety information that the operator of the patient monitor shall pay attention to and abide by. There are additional safety statements in other chapters or sections, which may be the same as or similar to the followings, or specific to the operations. DANGER • Indicates an imminent hazard situation that, if not avoided, will result in death or serious injury.
1.1.1 Dangers There are no dangers that refer to the product in general. Specific “Danger” statements may be given in the respective sections of this operation manual. 1.1.2 Warnings WARNING • The device is intended for animal monitoring by trained personnel in the specified places. • To ensure patient safety, verify the device and accessories can function safely and normally before use.
1.1.3 Cautions CAUTION • To ensure patient safety, use only parts and accessories specified in this manual. • Remove the battery from the patient monitor if it will not be used or not be connected to the power line for a long period. • Disposable devices are intended for single use only. They should not be reused as performance could degrade or contamination could occur.
1.1.4 Notes NOTE • Keep this manual close to the patient monitor so that it can be obtained conveniently when necessary. • This patient monitor complies with the requirements of CISPR11 (EN55011) class A. • Put the patient monitor in a location where you can easily see the screen and access the operating controls. • The instructions of this manual are based on the maximum configuration. Some of them may not apply to your patient monitor.
1.2 Equipment Symbols NOTE • Some symbols may not appear on your equipment. Attention: Consult accompanying documents (this manual). Power ON/OFF Power ON/OFF Alternating current (AC) Battery indicator Type CF applied part. The unit displaying this symbol contains an F-type isolated (floating) patient part providing a high degree of protection against shock, and is suitable for use during defibrillation. TYPE BF applied part. Defibrillator-proof protection against electrical shock.
ESD sensitivity Manufacture date Serial number European community representative This mark means that this device is fully in conformance with the Council Directive Concerning Medical Devices 84/539/EEC and 2004/108/EC. The following definition of the WEEE label applies to EU member states only. This symbol indicates that this product should not be treated as household waste.
2 The Basics 2.1 Monitor Description This monitor integrates the functions of parameter measurement, waveform monitoring, freezing, and recording, etc. Its color TFT liquid crystal display is able to show patient parameters and waveforms clearly. The monitor also features compact size, lightweight, easy-to-carry handle and built-in battery, which make it portable, especially in hospital transport.
2.1.2 Contraindications None. 2.1.3 Components This monitor consists of parameter measuring modules, blood pressure cuff, ECG, IBP and CO cables, SpO2 sensors, CO2 and AG measuring components. Some of the components are optional and may not apply to your patient monitor. 2.1.4 Functions This monitor is capable of monitoring the following parameters.
• IBP • 2 channels of IBP waveforms • Systolic (SYS), diastolic (DIA), and mean (MEAN) pressure • Pulse rate (PR) • CO • Temperature of blood (TB) • Cardiac output (CO) • CO2 • End-tidal carbon dioxide (EtCO2) • Fractional inspiratory carbon dioxide (FiCO2) • Air-way Respiration Rate (AwRR) • AG • Fraction of inspired carbon dioxide, nitrous oxide, oxygen or anesthetic gas (FiCO2, FiN2O, FiO2, FiAA), and End-tidal carbon dioxide, nitrous oxide or oxygen (EtCO2, EtN2O, EtO2, EtAA) AA refers to one of the fol
2.2 External Appearance 2.2.1 Front Panel Display Control knob Control panel Figure 2-1 Front Panel This monitor is designed to comply with the requirements of relative international safety standards (IEC60601-1) for medical electrical equipment. This monitor has floating inputs and is protected against the effects of defibrillation and electrosurgery. When proper electrodes are used and applied according to the manufacturer instructions, the screen will recover within 10 seconds after defibrillation.
2.2.2 Left Side Panel Your monitor may not have all connectors as shown below. 1 2 3 4 6 5 7 8 9 Figure 2-2 Left Side Panel 1. T1: Temperature probe connector (channel 1) 2. T2: Temperature probe connector (channel 2) 3. IBP1: IBP transducer connector (channel 1) 4. IBP2: IBP transducer connector (channel 2) 5. ECG: ECG cable connector 6. CO: CO cable connector (not available in USA) 7. NIBP: NIBP cuff hose connector 8. SpO2: SpO2 sensor connector 9.
2.2.3 Right Side Panel 1 3 2 Figure 2-3 Right Side Panel 1. Watertrap connector (Sidestream CO2 or AG module) 2. Exhaust outlet 3. Recorder NOTE • Some modules are optional. Their connectors may not be available on your patient monitor. • If your monitor is equipped with Sidestream CO2 module, then it can’t be equipped with AG module, vice versa.
2.2.4 Rear Panel 1 3 4 56 2 78 9 Figure 2-4 Rear Panel 1. Fan Vent 2. Speaker holes 3. Mounting holes for support bracket. 4. Network Connector: Standard RJ45 connector. Through network connector, this monitor can be connected with the central monitoring system, another monitor, or a PC. It enables the functions of viewbed monitoring, data output and on-line software upgrading. 5. Fuse: Standard T3.0A 6.
WARNING • Accessory equipments connected to this patient monitor must be certified according to the respective IEC standards (e.g. IEC 60601-1 for medical electrical equipment). Furthermore all configurations shall comply with the valid version of the system standard IEC 60601-1-1. Any person who connects additional equipment to the signal input or signal output is responsible to ensure the system complies with the requirements of the valid version of the system standard IEC 60601-1-1.
7. RECORD Press this key to start or stop recording. 8. NIBP Press this key to start or stop the non-invasive blood pressure measurement. 9. MENU Press this key to display the SYSTEM MENU. 10. Control Knob The main operator control is the control knob. The control knob rotates in either direction to highlight parameter labels and menu options. After highlighting the desired selection, press the control knob to execute an operation, make a selection, view a new menu or a small drop-down list.
1. Patient information area It displays patient bed number and patient type. If no patient is admitted, it displays “NO PATIENT ADMITTED”. If the patient’s information is incomplete, corresponding symbols will be displayed. 2. System time The system time of the monitor is displayed in two lines. The time format can be set in the TIME SETUP menu. 3. Technical alarms area Technical alarm messages or prompt information are displayed in this area.
Upon turning ON the monitor, prompt information, for example “NIBP alarm disabled”, will cover the network and battery icons. 9. STANDBY label You may select this label to enter the standby mode.
2.5 Batteries This monitor is designed to operate on battery power during intra-hospital patient transfer or whenever the power supply is interrupted. The battery is charged automatically when the monitor is connected to AC power, no matter the monitor is powered on or not. The battery symbol displayed on the main screen tells the status of the battery. • The battery is installed in the battery slot. The solid part indicates its capacity. • No battery is installed in the battery slot.
2.5.1 Battery Maintenance Conditioning a Battery A battery should be conditioned before it is used for the first time. A battery conditioning cycle is one uninterrupted charge of the battery, followed by an uninterrupted discharge of the battery. Batteries should be conditioned regularly to maintain their useful life. Condition a battery once when it is used or stored for two months, or when its run time becomes noticeably shorter. To condition a battery, follow this procedure: 1.
NOTE • Life expectancy of a battery depends on how frequent and how long it is used. For a properly maintained and stored lead-acid battery, its life expectancy is about 2 or 3 years respectively. For more aggressive use models, life expectancy can be less. We recommend replacing lead acid batteries every 2 years. • The battery might be damaged or malfunctioned if its operating time is too short after being fully charged. The operating time depends on the configuration and operation.
2.6 Wireless Network Card This monitor can be configured with a wireless network card, which is connected to the CMS (Central Monitoring System) in the wireless mode and constructs with the CMS the monitoring network. Yon only need to insert the network cable into the network connector. The following figure shows the wireless network card correctly installed.
3 Installation WARNING • The installation of the monitor must be carried out by personnel authorized by us. The software copyright of the monitor is solely owned by our company. Any action to change, copy or exchange the software copyright by any organization or person is regarded as copyright infringement and is not allowed. • Accessory equipments connected to this patient monitor must be certified according to the respective IEC standards (e.g. IEC 60601-1 for medical electrical equipment).
3.1 Unpacking and Checking Before unpacking, examine the packing case carefully for signs of damage. If any damage is detected, contact the carrier or our company. If the packing case is intact, open the package and remove the instrument and accessories carefully. Check all materials against the packing list and check for any mechanical damage. Contact our Customer Service Department in case of any problem. NOTE • Please save the packing case and packaging material for future transport and storage.
3.2 Environmental Requirements The operating environment of the monitor must meet the requirements specified in this manual. The environment where this monitor is to be used should be free from noise, vibration, dust, and corrosive or explosive and inflammable substances. For a cabinet mounted installation, allow sufficient room at the front and the rear of the cabinet for operation, maintenance and servicing. Besides, allow at least 2 inches clearance around the instrument for proper air circulation.
3.4 Installation Method 3.4.1 Bracket Mounting For details, please refer to the corresponding instructions for use of bracket mounting. 3.4.2 Connecting to AC Power Supply 1. Use the original three-wire AC power cord. 2. Connect the power cord to the receptacle for AC power cord on the rear panel of the monitor. 3. Connect the other end of the power cord to a compatible 3-prong hospital grade AC power outlet. The 3-prong power outlet must be ground.
WARNING • Make sure the battery door is securely latched. Falling batteries could seriously or fatally injure a patient. 3.4.4 Connecting Patient Sensors and Probes Connect the necessary patient sensors or probes to the monitor. For details, see the chapters for specific parameter monitoring in the following pages, or corresponding instructions for sensors and probes. 3.4.5 Connecting the Network Cable The network connector of the monitor is a standard RJ45 connector.
3.4.6 Auxiliary Output Port The auxiliary output port can be used to generate analog signals, nurse call signals or defibrillator synchronization signals. • Analog output signals can be generated when the monitor is connected to an oscilloscope or a pen recorder. • If the monitor is connected with the Nurse Call System of a hospital through a special nurse call cable, the monitor can generate nurse call signals when alarms occur.
3.4.7 Connecting to VGA Monitor This monitor can be connected with a standard color VGA monitor. The VGA monitor will display the patient waveforms and parameters measured by the patient monitor. To connect the patient monitor with the VGA monitor, follow the steps as below. 1. Power off the patient monitor. 2. Connect the signal cable of the VGA monitor to the VGA connector on the rear panel of the patient monitor. 3. Power on the VGA monitor and then the patient monitor.
3.5 Powering on the Monitor After installing the monitor, please follow the procedures described below to power on the monitor: 1. Before using the monitor, please carry out corresponding safety inspection as given in 19.1 Inspection. 2. Press the Power Switch on the control panel. A beep will be heard and, at the same time, the alarm indicator will flash once in yellow and then red. 3. The system begins self-testing and the product model will be displayed on the screen. 4.
4 System Menu 4.1 Overview This chapter only gives introduction to the system menu. Other menus will be described in the following chapters. 1 2 3 4 Figure 4-1 System Menu Most menus displayed by the monitor share the same structure. As shown above, a menu is made up of four parts: 1. Menu title: Summarizes the content of the current menu. 2. Main display area: Displays options, keys or prompt information, etc. “>>” means a submenu will pop up if the option is selected. 3.
4.2 Patient Setup Select PATIENT SETUP>> in SYSTEM MENU. The following menu appears. Figure 4-2 Patient Setup Menu This menu displays the patient’s information, as well as four buttons located below. If no patient is admitted, the buttons are: • CLEAR PATIENT DATA • QUICK ADMIT PATIENT • ADMIT PATIENT • MODIFY PATIENT If a patient is admitted, the CLEAR PATIENT DATA button turns to be DISCHARGE PATIENT.
4.2.1 Admit Patient To admit a new patient, please follow this procedure: 1. Select ADMIT PATIENT in PATIENT SETUP menu. 2. Select YES in the pop-up CONFIRM TO CLEAR THE DATA menu. The menu as shown below appears. Figure 4-3 Patient Information Setup 3. Enter the patient’s information details. If the patient’s information is entered incompletely, corresponding symbols will appear in the upper left hand of the monitor screen.
• WEIGHT Patient weight (unit: kg or Ib); Patient blood type: • BLOOD A, B, O, AB or N (N represents unknown) 4. Select OK button, and the patient is admitted. 5. If the monitor is connected with the central monitoring system, you can monitor the patient through the central monitoring system. Setting Patient Information To enter information in a field containing no mark, follow this procedure (take PAT NO as an example): 1. Rotate the control knob and highlight the field after PAT NO. 2.
4.2.2 Quick Admit Patient 1. Select QUICK ADMIT PATIENT in PATIENT SETUP menu. 2. Select YES in the pop-up CONFIRM TO CLEAR THE DATA menu. 3. The following menu appears. You can set the PAT TYPE and status of PACE. Figure 4-4 Quick Admit Patient 4. Select OK button, and the patient is admitted. 5. If the monitor is connected with the central monitoring system, you can monitor the patient through the central monitoring system. 4.2.
4.2.5 Discharge Patient To discharge the patient being monitored, please follow this procedure: 1. Select DISCHARGE PATIENT in PATIENT SETUP menu. 2. Select YES in the pop-up menu. 3. Prompt information will be displayed on the central monitoring system if the monitor is connected with it. 4.3 Configuration Setup Select CONFIG >> in the SYSTEM MENU. The following menu appears.
4.4 System Setup Select SYSTEM SETUP>> in SYSTEM MENU. The following menu appears.
4.4.1 Face Select Select FACE SELECT>> in SYSTEM SETUP menu. The following menu appears. Figure 4-7 Face Select In the FACE SELECT menu, options are available as shown above. For detailed information, see chapter Face Selection. 4.4.2 Alarm Setup Select ALARM SETUP>> in SYSTEM SETUP menu. The following menu appears.
You can perform the following settings in the menu above: Alarm selection • ALM SEL Options: COMMON ALM SETUP, XX ALM SETUP; (XX refers to physiological parameters such as HR, SPO2, etc.). If a parameter alarm setup is selected the corresponding alarm setup items will be displayed in the ALARM SETUP menu Alarm volume • ALARM VOL The volume can be set between 0 and 10. 0 means off and 10 is the maximum volume. The volume can not be set to 0 unless the ALARM SOUND OFF is set to ENABLE (Refer to 4.
With the control knob, you can change the year, month, day, hour, minute and second as well as select the displayed format of the time. YYYY, MM, and DD refer to year, month and day respectively. If the monitor is connected with the central monitoring system, the system time of the monitor will be updated in accordance with the central monitoring system, and the TIME SETUP option in SYSTEM SETUP menu will become disabled. 4.4.4 Recorder Setup Select RECORD>> in SYSTEM SETUP menu. The following menu appears.
NOTE • If a parameter is not displayed on the screen, this parameter will not be an option of REC WAVE 1, REC WAVE 2 and RECORD WAVE3.. Real-time recording time • RT REC TIME Options: CONTINUAL and 8s. Timing recording time • TIMING REC TIME The interval between automatic recordings. Options: OFF, 10MIN, 20MIN, 30MIN, 40MIN, 50MIN, 1HOUR, 2HOURS, 3HOURS and 4HOURS. The monitor will start recording at the selected interval, record for 8s and stop automatically.
4.4.5 Data Output Select DATA OUTPUT>> in SYSTEM SETUP menu. The following menu appears. Figure 4-11 Data Output Output Procedure 1. Disconnect all patient cables connected to the monitor. 2. Verify the monitor is connected to the PC and the PC is running the Patient Information Recall System software. 3. Select from the data source options. 4. Select OUTPUT in the menu and the prompt “CONNECTING…” is shown aside.
4.4.6 Analog Output Select ANALOG >> in SYSTEM SETUP menu. The following menu appears. Figure 4-12 Analog Output You can perform the following settings in the menu above: Analog output • ANALOG OUT Options: ON and OFF. When ON is selected, analog signals can be output from the auxiliary output port on the rear panel of the monitor. Options: ECG1, ECG2, IBP1 and IBP2; • ANALOG WAVE In the MULTI-LEADS DISPLAY mode, the ECG3, ECG4, ECG5 and ECG6 options are also available. NOTE • If DEFIB.
4.4.7 Module Setup Select MODULE SETUP>> in SYSTEM SETUP menu. The following menu appears. Figure 4-13 Module Setup This menu allows you to enable or disable a parameter module to determine the information displayed on the main screen. As shown in the figure above, “v” indicates an enabled module. A module without the “v” mark is disabled and the related waveform and parameter data disappear from the display. 4.4.8 Trace Setup Select TRACE SETUP>> in SYSTEM SETUP menu. The following menu appears.
This menu allows you to select the parameter waveform(s) to be displayed. The mark “v” indicates the parameter waveform will be displayed, and that without the mark will not be displayed. The TRACE SETUP menu merely contains the parameter modules enabled in the MODULE SETUP menu. Besides, in the MULTI-LEADS DISPLAY mode or the HALF-SCREEN MULTI-LEADS display mode, the ECG1 waveform and the ECG2 waveform are inactive.
This menu allows you to mark four different events, namely event A, B, C and D. The “@” symbol will appear in the frame of the event being selected. If you attempt to unmark an event, press the control knob again on the marked selection. The purpose of event marking is to define the records, such as dose taking, injections or therapy, which have influence on patients and parameter monitoring.
Alarm limit • ALM LIMIT ON: The alarm limits of parameters are displayed aside the parameter value; OFF: The alarm limits of parameters are not displayed aside. The brightness can be set between 1 and 10. 1 indicates the • BRIGHTNESS lowest brightness and 10 indicates the highest brightness. 4.6 Monitor Version You can select VERSION>> in the SYSTEM MENU to check the version information as shown below.. However, the VERSION menu of you monitor may be different.
Figure 4-19 Device Configuration List You can also see the device version by selecting DEVICE VERSION LIST>> as shown below. However, the DEVICE VERSION LIST menu of you monitor may be different.
4.7 Maintenance Select MAINTAIN>> in SYSTEM MENU. The following menu appears. Figure 4-21 Enter Maintain Password Enter USER KEY, then select CONFIRM button. The following menu appears.
You can perform the following settings: • MONI NAME • DEPT. • BED NO • NET TYPE • LOCAL NET NO • NOTCH FREQ. • LANGUAGE • AUX OUTPUT Monitor’s name. The department where the monitor is located. The bed number where the monitor is located. Network type Options: CMS and CMS+. It indicates the bed number of a monitor in the monitoring network. If the NET TYPE is CMS, the LOCAL NET NO can be set between 1 and 64.
2. NURSE CALL • If this option is selected, the auxiliary output port will be able to output nurse call signals, and you can perform the settings in the NURSE CALL SETUP submenu of the USER MAINTAIN menu. For details, see 4.7.4 Nurse Call Setup. • If not selected, the nurse call function will be disabled and the NURSE CALL SETUP>> option in USER MAINTAIN will become inactive. In this situation, you cannot set the information in the NURSE CALL SETUP submenu. 3. DEFIB.
• LEAD NAMING • SAVE AS USER CONFIG NOTE Options: AHA and EURO; You can change the monitor’s settings and save the changed settings as user configuration of this patient type so that you can load the user configuration when a new patient is admitted. • If you changed the net type and language, the settings take effect only after you restart the monitor. • The setting of the notch frequency can neither be saved as the user configuration nor changed when the factory configuration is selected.
• ALARM SOUND ENABLE: ALARM VOL can be set to 0. OFF DISABLE: ALARM VOL cannot be set to 0. MODE 1: the alarm sound interval of high level alarm is 8s and • AUDIO OFF that of medium level alarm is 24s. MODE 2: the alarm sound interval of high level alarm is 3s and that of medium level alarm is 14s. • PARA ALM TYPE LATCH, UNLATCH • ECG LEAD OFF Alarm level: HIGH, MED, LOW. • SpO2 SENSOR OFF Alarm level: HIGH, MED, LOW. WARNING • Select the setting of ALARM SOUND OFF with caution.
4.7.3 Self Definition of Color Select COLOR SELF-DEFINE >> in USER MAINTAIN menu. The following menu appears. Figure 4-25 Self-definition of color This menu allows you to choose in which color the waveform(s) and parameter(s) of a parameter module are to be displayed. • OTHER PARA refers to the parameters, NIBP and TEMP, which do not have waveform. • CO2 refers to the parameters measured by CO2 module or AG module. • AG O2, AG N2O and AG AA refer to corresponding parameters measured by AG module.
4.7.4 Nurse Call Setup Select NURSE CALL SETUP >> in USER MAINTAIN menu. The following menu appears. Figure 4-26 Nurse Call Setup You can perform the following settings: • SIGNAL DURATION Two options are available: PULSE, and CONTINUUM. 1. PULSE When pulse is selected, a nurse call signal is a pulse signal lasting 1s. When multiple alarms occur simultaneously, only one pulse signal will be output. If an alarm comes out before the previous alarm is cleared, another pulse signal will be output. 2.
Alarm level • ALM LEV Options: HIGH, MED (medium) and LOW. More than one option can be selected at one time. Alarm type • ALM TYPE Options: TECH. (technical) and PHYS. (physiological). Both options can be selected at one time. Trigger Conditions A nurse call signal will be triggered only if all the following conditions are met: 1. The nurse call function is enabled. 2. An alarm of the preset alarm level and alarm type comes out. 3. The monitor is not in the Alarms Paused or the System Silenced status.
4.7.7 Monitor Status Select STATUS >> in ENTER MAINTAIN PASSWORD menu. The following menu appears. Figure 4-27 Monitor Status This menu can display a maximum of ten status messages. In • UP-DOWN case of more than ten, you can select UP-DOWN to learn other status messages. Recording • REC You can select the REC option to record the status message displayed.
4.8 DEMO Function Select DEMO >> in SYSTEM MENU. The following menu appears. Figure 4-28 Input Demo Key The monitor enters the demonstration mode when the correct password is input in the menu above. The word DEMO will be displayed on the main screen. The purpose of the demonstration display is to demonstrate the performance of the monitor, and for training purposes.
FOR YOUR NOTES 4-28
5 Face Selection 5.1 Standard Screen You can open the FACE SELECT menu by selecting FACE SELECT >> in SYSTEM SETUP menu. Figure 5-1 Face Select The standard screen is the default screen. If the current screen is not the standard screen, you may enter the standard screen by selecting STANDARD SCREEN and then selecting EXIT in FACE SELECT menu. For more information about the standard screen, see 2.4 Display.
5.2 Trend Screen To enter the following screen, select TREND SCREEN in FACE SELECT menu and then select EXIT. Figure 5-3 Trend Screen • Trend graph Trend graphs locate to the right of the corresponding waveform in the waveform area, and display the trends of one parameter of each module. The parameter labels, as well as their scales, are displayed to the left of the trend graph. • Trend length The dynamic trend length, located below the trend graph, is 2 hours.
5.3 OxyCRG Screen To enter the following screen, select oxyCRG SCREEN in FACE SELECT menu and then select EXIT. 123 Figure 5-4 OxyCRG Screen Oxy CRG screen is located at the lower part of the waveform area, consisting of the HR trend, the SpO2 trend, and the RR (respiration rate) trend or the compressed respiration waveform. Below the RR trend or the compressed respiration waveform is the scale of the trend time.
5.4 Viewbed Screen This monitor can view one parameter waveform and measured data from another patient monitor (viewbed monitor) on the same monitoring network. To enter the following screen, open FACE SELECT menu, select VIEWBED SCREEN, and then select EXIT. When connecting by wireless network (if your monitor has this feature), viewbed function is disabled. 13 6 4 2 5 Figure 5-5 Viewbed Screen The monitor you are viewing from is called “host monitor”. The monitor being viewed is called “viewbed monitor”.
1. Viewbed monitor label The viewbed monitor lable allows you to select the viewbed monitor you want to view. It displays the bed number and patient name of the viewbed monitor. If they are not entered, the label displays blank. If the host monitor is not connected with any other monitor on the same network, the label displays N/A. 2. Viewbed waveform label The viewbed waveform label allows you to select a waveform of the viewbed monitor.
5.5 Large Font Screen To enter the following screen, open FACE SELECT menu, select LARGE FONT SCREEN, and then select EXIT. Figure 5-6 Large Font Screen As shown above, the HR, SpO2 and NIBP values (diastolic pressure, mean pressure and systolic pressure) are displayed in large font. The ECG and SpO2 waveforms are displayed on the upper left of the screen. In case the ECG, SpO2 or NIBP parameter module is turned off, the corresponding parameters and waveform disappear.
5.6 Standby Mode During patient transport or temporary departure of a patient, the monitor can be set to STANDBY mode. In this mode, the monitor suspends the monitoring and measurement on the patient and shields all alarm indications. Besides the WORK MODE of CO2 and AG module (if available), which will also be changed to STANDBY, the previous menu settings and patient information keep unchanged. Entering the STANDBY mode 1. Disconnect all leads and sensors between the patient and the monitor. 2.
FOR YOUR NOTES
6 Alarms 6.1 Overview The monitor gives audible or visual alarms to indicate the medical staff, when a vital sign of the patient appears abnormal, or mechanical or electrical problems occur to the monitor. Upon turning on the monitor, a beep will be heard. At the same time, the alarm indicator will flash once in yellow and red. This is used to verify the audible and visual alarm function of the monitor.
3. Prompt information Strictly speaking, prompt information cannot be counted in alarms. It is usually information relating to the system, but not concerning vital signs of patients. For example, the monitor prompts “NIBP alarm disabled!” at the time the monitor is powered on. Besides, if a parameter module is turned on but the required leads or sensor are not connected, the monitor will prompt accordingly, such as “ECG LEAD OFF” or “SPO2 SENSOR OFF”, etc.
6.2 Alarm Modes When an alarm occurs, the monitor raises the user’s attention by the following audible or visual indications. • Visual alarms • Audible alarms • Alarm messages • Parameter flashes Besides, the visual alarms, audible alarms and alarm messages are given in different ways to identify different alarm levels. 6.2.1 Visual Alarms The alarm indicator on the front panel of the monitor varies its flash color and frequency to indicate different alarm levels.
6.2.3 Alarm Messages Alarm messages are given when alarms occur. The alarm messages are displayed in the physiological alarms area or the technical alarms area in black. For physiological alarms, asterisks are displayed before the alarm messages to identify the alarm level.
6.3 Alarm Statuses When an alarm occurs, normally the monitor gives indications in the modes mentioned above as per the alarm level. If necessary, you can set the monitor to the following alarm statuses. .. Alarms Disabled .. Alarms Paused .. System Silenced .. Alarms Silenced 6.3.1 Alarms Disabled If the alarm switch of a parameter is turned off, the monitor does not generate alarms even if the measured parameter value exceeds the alarm limit. This status is called Alarms Disabled.
6.3.2 Alarms Paused To pause all alarms of the monitor for 1, 2 or 3 minutes, press the SILENCE key on the control panel once (for less than 2 seconds). In Alarms Paused status, • Visual alarms and audible alarms are both paused. • The parameters generating physiological alarms and their upper or lower limits stop flashing. • Alarm messages are not displayed. • The physiological alarms area shows the rest time of alarms paused status. • The icon will be displayed in the sound icon area.
6.3.5 Status Switchover 1. In the Normal status, • Press the SILENCE key for less than 2 seconds to switch to the Alarms Paused status, or • Press the SILENCE key for 2 seconds or more to switch to the System Silenced status. 2. In the Alarms Paused status, • Press the SILENCE key for less than 2 seconds to switch to the Normal status, or • Press the SILENCE key for 2 seconds or more to switch to the System Silenced status. 3.
6.5 Clearing Alarms Generally the alarm indications of an alarm will automatically be cleared when the alarm condition that triggered the alarm ceases. However, you can also clear the alarm indications or the latched alarms by the following ways. 1.
6.6 When an Alarm Occurs WARNING • When an alarm occurs, always check the patient’s condition first. When an alarm occurs to the monitor, refer to the following steps and take action properly. 1. Check the patient’s condition. 2. Identify the alarming parameter and the alarm category. 3. Identify the cause of the alarm. 4. Take action to remedy the alarm cause. 5. Check if the alarm is cleared. For details about how to deal with specific alarms, see chapter Alarm Messages and Prompt Information.
FOR YOUR NOTES 6-10
7 Freezing Waveforms 7.1 Overview You can freeze the monitored waveforms of a patient as desired and view the waveforms of 40 seconds to gain a clear observation. Besides, the monitor can print three frozen waveforms using the recorder. The freezing function of the monitor has the following features. • When the monitor enters the frozen mode, it exits all other menus automatically. • The system freezes all waveforms displayed in the waveforms area. • The frozen waveforms can be reviewed and recorded. 7.
After exiting the frozen mode, all waveforms on the screen are cleared and new real-time waveforms are displayed. If the scan type of the monitor is set to REFRESH, the waveforms are refreshed from the left of the waveforms area to the right; if the scan type is set to SCROLL, the waveforms are displayed from the right of the waveforms area to the left and are scrolling. 7.3 FROZEN Menu The FROZEN menu is displayed at the lower left corner. You can perform the following settings in this menu.
7.4 Waveform Recall 1. In the frozen mode, select the RECALL option in the FROZEN menu, and the option name changes to L-RIGHT. 2. Rotate the control knob clockwise, and the frozen waveforms move to the right. At the lower right corner of the first waveform is an arrow pointing upward. The time is indicated below the arrow. The indication "0S" is used to mark the moment when the waveforms were frozen. 3. With the waveforms move to the right, the time mark, in turn, changes to -1S, -2S, -3S… 4.
FOR YOUR NOTES
8 Recording 8.1 Overview A thermal recorder can be equipped with the monitor. The performance of the recorder is described as below. • Records patient information and parameters. • Records a maximum of three waveforms. • The optional recording rates: 25mm/s and 50mm/s. • The recording grid is optional. • Multiple recording types are supported. For details about the recorder setup, please refer to 4.4.4 Recorder Setup. 8.
Real-time recording Pressing the RECORD key on the control panel, the real-time recording starts and the current parameters and waveforms are recorded. As described in 4.4.4 Recorder Setup, you can set the RT REC TIME to 8S or CONTINUUM in the RECORD menu. You can also select the three waveforms (REC WAVE 1, REC WAVE 2 and REC WAVE 3) to be recorded.
Frozen waveform recording In the frozen mode, the monitor can print the frozen waveforms displayed on the screen and the parameters measured at the moment when the waveforms were frozen. For details, see 7.5 Recording Frozen Waveforms. Trend graph/table recording When the trend graph/trend table or a recall window is opened, you can select the REC option to print out the trend graph, trend table, NIBP measurement, alarm event or arrhythmia event.
8.3 Recorder Operations Continuous real-time recording 1. Press the RECORD key to start recording. 2. Press the RECORD key again to stop the recording. 8-second real-time recording 1. Press the RECORD key to start recording. 2. The recording stops automatically in 8 seconds. Automatic recording 1. The recorder starts recording automatically at the preset interval (RT REC TIME). 2. The recording stops automatically in 8 seconds. Alarm recording 1.
Trend table recording 1. Select TREND TABLE>> in SYSTEM MENU to open the TREND TABLE window. 2. Select the REC option to start recording. 3. When the recording completes, the recorder stops automatically. NIBP measurement recording 1. Select NIBP RECALL>> in SYSTEM MENU to open the NIBP RECALL window. 2. Select the REC option to start recording. 3. When the recording completes, the recorder stops automatically. Alarm event recording 1. Select ALARM RECALL>> in SYSTEM MENU to open the ALARM RECALL window. 2.
3. Press START option to start a CO measurement. 4. Press REC option to start recording. 5. When the recording completes, the recorder stops automatically.
Hemodynamic calculation recording 1. Select EDIT>> in the WINDOW FOR CO MEASUREMENT to open the WINDOW FOR C.O. EDIT. 2. Select HEMO CALCULATE>> to open the HEMOD WINDOW. 3. Input the value of corresponding parameters, and then select CALCULATE option to start the calculation. 4. Press REC option to start recording. 5. When the recording completes, the recorder stops automatically. Titration table recording 1. Select DRUG CALC >> in SYSTEM MENU. 2.
8.4 Installing Recorder Paper Installing Procedure 1. Press the latch at the upper right of the paper compartment door to releases the door. 2. Lift the roller lever located at the upper left of the paper compartment as shown in the following figure. 3. Insert a new roll of recorder paper into the compartment as shown below. 4. The roller of the recorder scrolls automatically, and the paper comes out of the compartment. 5. Push down the roller lever. 6. Close the recorder door.
Removing the Paper Jam If the recorder does not function properly or produces unusual sound, open the recorder door to check for a paper jam. You can follow the operations below to remove the paper jam. 1. Open the recorder door. 2. Tear the paper off from the leading edge at the paper outlet. 3. Lift the lever on the upper left of the recorder. 4. Pull the paper from the paper inlet. 5. Re-insert the paper.
9 Recall 9.1 Overview The monitor is able to store important patient data so that the user can review and record the data as desired. • Trend Graph Recall You can review the latest 1-hour trend graph of a measured parameter displayed every 1 or 5 seconds, or the latest 96-hour trend graph displayed every 1, 5 or 10 minutes. • Trend Table Recall You can review the latest 96-hour trend table data of a measured parameter.
9.2 Trend Graph Recall Select TREND GRAPH >> in SYSTEM MENU. The following window appears. 1 2 3 5 6 4 1. Trend cursor 2. Cursor time 3. Trend graph 4. Y-axis 5. X-axis 6. Parameters area Figure 9-1 Trend Graph As shown above, PARA1, PARA2 and PARA3 allow you to select a parameter from the options. The trend graph of the selected parameter is displayed. If NIBP is selected, no trend graph is to be displayed.
• PARA SELECT (Parameter Selection) 1. Rotate the control knob and highlight the field at the right side of PARA1, PARA2 or PARA3. 2. Press the control knob, and a popup menu with all parameter options is opened. 3. Rotate the control knob and highlight your desired parameter, and then select it. The trend graph of the selected parameter is displayed in the TREND GRAPH window.
Rotate the control knob to highlight the CURSOR option, and then press. 2. Rotate the control knob, and the trend cursor moves as per the preset resolution. 3. The cursor time and the values displayed in the parameters area change accordingly.
• REC (Recording) The REC option allows you to print the currently displayed parameters and trend graph from the recorder. • Mark Event If an event is marked A, B, C or D, the mark ( A, B, C or D )will be displayed at the mark time on the trend graph. NOTE • The chapter uses "earlier" or "later" to indicate the time that an event happened. For example, May 28 is earlier than May 29, and 8:00 on May 29 is earlier than 9:00 on May 29. 9.3 Trend Table Recall Select TREND TABLE >> in SYSTEM MENU.
The TIME is displayed on the left of the trend table. On the top is the latest time. From the upper to the lower, the interval between two adjacent times depends on the preset resolution. And the date is contained in the brackets. On the right of the TIME is the EVENT. If a marked event happened at a specific time, the mark will be displayed aside that time in the EVENT field. On the right of the trend table are parameter names and the trend data. The symbol "..
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• Mark Event If an event is marked A, B, C or D, the mark ( A, B, C or D ) will be displayed aside the mark time on the trend table. 9.4 NIBP Recall Select NIBP RECALL >> in SYSTEM MENU. The following window appears. Figure 9-3 NIBP Recall The NIBP RECALL window shows the non-invasive systolic pressure (NS), non-invasive mean pressure (NM), non-invasive diastolic pressure (ND), puse rate (PR) and the measurement time (TIME). The optional pressure units (UNIT) are mmHg and kPa.
9.5 Alarm Event Recall Select ALARM RECALL >> in SYSTEM MENU. The following menu appears. Figure 9-4 Alarm Recall Condition Selections In this menu, you may select the conditions of alarm review: • ALARM RECALL TIME You can select the desired start time and end time for review. The end time can be set to either CURRENT TIME or SELF-DEFINE. • ALARM RECALL EVENT The drop-down menu of ALARM RECALL EVENT provides a list of parameter options to be reviewed.
This window contains the following information: 1. Time span (the start time and end time of alarm recall). 2. Alarm event type. 3. The alarming parameter, parameter value, alarm level and the alarm time. 4. The alarm event number (format: NO: n of N). N indicates the amount of alarm events and n indicates the sequence number of the currently displayed alarm event. 5. Parameter values at the time of the alarm event. 6. Two waveforms at the time of the alarm event.
• L-RIGHT You may select the L-RIGHT option and then rotate the control knob to review the 8,16,or 32-second waveforms stored. • REC This option allows you to print out all parameter data and waveforms displayed in the current window using the recorder. 9.6 Non-Volatile Data Storage To avoid losing patient’s data when the monitor is powered off intentionally or accidentally, the monitor can be equipped with a CF storage card (optional) to realize the non-volatile data storage function.
FOR YOUR NOTES 9-10
10 Drug Calculation 10.1 Drug Calculation Select DRUG CALC >> in SYSTEM MENU. The following window appears. Figure 10-1 Drug Calculation 10.1.1.
10.1.1.2 Operating Method 1. Select the drug name Open the drop-down menu of DRUG NAME and select one from the following 15 options: • DRUG A, B, C, D and E • AMINOPHYLLINE • DOBUTAMINE • DOPAMINE • EPINEPHRINE • HEPARIN NOTE • ISUPREL • LIDOCAINE • NIPRIDE • NITROGLYCERIN • PITOCIN • The DRUG names A, B, C, D and E are user-definable. 2. Input the patient weight Select the field on the right of WEIGHT and rotate the control knob to enter the patient weight correctly. 3.
2. DRUG D uses the unit series: Unit, k Unit and m Unit. 3. DRUG E uses the unit series: mEq.
NOTE • The prerequisite for drug calculation is that the drug name and the patient weight are selected. WARNING • The random values given by monitor cannot be used as the calculation reference. • After the drug calculation, verify the entered parameters are correct and the calculation results are proper. We are not responsible for the consequence caused by wrong entering and operation. 10.2 Titration Table After the drug calculation, select TITRATION in DRUG CALC window. The following window pops up.
• BASIC 1. Rotate the control knob to highlight the field on the right of BASIC. 2. Press and rotate the control knob to select DOSE, INF RATE or DRIP RATE. 3. The data in the trend table changes accordingly. • STEP 1. Rotate the control knob to highlight the field on the right of STEP. 2. Press and rotate the control knob to select a value in the range of 1-10. 3. The data in the trend table changes accordingly. • DOSE TYPE 1. Rotate the control knob to highlight the field on the right of DOSE TYPE. 2.
11 ECG/RESP Monitoring 11.1 Overview 11.1.1 ECG Waveform In the standard screen, one or two ECG waveform(s) is (are) displayed at the top of the display when LEAD TYPE is set to 3 LEADS or 5LEADS respectively in the ECG SETUP menu. 123 Figure 11-1 ECG Waveforms 45 As shown above, when 5 LEADS is selected, five labels are located above the ECG waveforms: 1. ECG lead of channel 1 (Primary lead) You can select the lead of channel 1 from the label options.
3. Filter Method The filtering enables clearer and more detailed waveforms. There are three filter methods for selection. • DIAGNOSTIC: The monitor displays the ECG waveforms without filter; • MONITOR: It effectively filters the artifacts that might cause false alarms; • SURGERY: This filter is used to reduce the artifacts and interference from electrosurgery equipment. The selected filter is applied to both channels, but the filter label is merely displayed above the first ECG waveform.
NOTE • If the amplitude of an ECG waveform is too large, the peak of the waveform might not be displayed. In this case, you should change the waveform gain properly. • The selected leads of channel 1 and channel 2 should not be identical. Otherwise, the system will change one of them automatically. In the MULTI-LEADS DISPLAY mode or the HALF-SCN MUTLI-LEADS display mode, the leads of both channels cannot be set. ECG label HR/PR 11.1.
11.2 ECG Monitoring Procedure 11.2.1 Preparation 1. Skin preparation The quality of ECG waveform displayed on the monitor is a direct result of the quality of the electrical signal received at the crocodile clip. Proper skin preparation is necessary for good signal quality at the crocodile clip. A good signal at the crocodile clip provides the monitor with valid information for processing the ECG data.
11.2.2.1 5-Lead Placement Following is the configuration per American standard when using five leadwires: Figure 11-3 5-Lead Placement • RA (right arm) lead: on the right foreleg. • LA (left arm) lead: on the left foreleg. • RL (right leg) lead: on the right hind leg. • LL (left leg) lead: on the left hind leg. • V (precordial) lead: exploring lead. NOTE • The exploring lead is used for diagnostic purposes as needed. Otherwise, it may be left unplugged.
11.2.2.2 3-Lead Placement Following is the configuration per European standard when using three leadwires: • R (right arm) lead: on the right foreleg. • L (left arm) lead: on the left foreleg. • F (left leg) lead: on the left hind leg. Figure 11-4 3-Lead Placement The chart below shows the label used to identify each leadwire. Included also is its associated color code per American (AHA) and European (IEC) standards.
11.2.2.3 Lead Placement for Surgical Patients Lead placement during surgery is dependent on the type of surgery being performed. For example, with open chest surgery, the leads might be placed laterally on the chest or on the back. In the operating room, artifact can sometimes affect the ECG waveform due to the use of electrosurgery equipment.
To display a 1-millivolt calibration pulse on the ECG wave, select the ECG CAL option in the ECG SETUP menu. A message “when CAL, can't monitor!” is displayed on the screen. NOTE • If the ECG waveform is too small, or not accurate, and the crocodile clips are securely and firmly placed to the patient, change the display to a different lead. 11.3 ECG Setup Menu To display the ECG SETUP menu, use the knob to select the ECG label in the parameter windows. The following menu appears.
• ALM REC Alarm recording ON: When a heart rate alarm occurs, the monitor enables the recording; OFF: When a heart rate alarm occurs, the monitor does not enable the recording. • ALM HI Upper alarm limit Determines the upper ECG alarm limit. • ALM LO Lower alarm limit Determines the lower ECG alarm limit. For different patient types, the upper/lower limits of the heart rate alarm may vary in the following range. Patient type Max. ALM HI Min.
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5. ALL: The monitor displays both the HR and the PR values. PR value is displayed at the right of SpO2 label or IBP label, SpO2 takes priority of IBP . The monitor will alarm for both abnormal HR and PR. HR is given priority in determining the source of the beep tone. If HR is not available, the sound will be from the PR.
In this menu, you can select any of the displayed option. All options are listed below. • SMART LEAD OFF ON: If there is a LEAD OFF in the HR-derived channel, the system will automatically switch to another lead to restore the display of the ECG waveform in the HR-derived channel. OFF: The SMART LEAD OFF is turned off.
• BEAT VOL Beat volume Range: 0-10. 0 indicates disabled and 10 indicates the maximum volume. • PACE ON: When ON is selected, a detected pacemaker signal is indicated by a "|" symbol above the ECG waveform. OFF: When OFF is selected, the pacemaker analysis is disabled. NOTE • When monitoring a patient with a pacemaker, PACE must be turned ON. Otherwise, the system will count the pacemaker pulse as QRS complex. Do not completely depend on the alarms of heart rate.
• CASCADE ECG cascade ON: The monitor displays the waveform of each channel in two lines. OFF: The monitor displays the waveform of each channel in one line. The CASCADE can be turned ON only if the monitor is set to NORMAL DISPLAY mode and the SCAN TYPE is set to REFRESH. • DEFIB SYNC Defibrillator synchronization ON: The function of defibrillation is enabled; OFF: The function of defibrillation is disabled.
WARNING • Improper defibrillation will endanger the patient’s safety. You user should decide whether to defibrillate the patient based on the patient’s actual condition. • Before defibrillating the patient, the user should ensure the defibrillator and the monitor have been tested as a system and the two devices can work together safely and effectively.
11.4 ST Analysis 11.4.1 Overview • The function of ST analysis is optional. • In the factory configuration, ST analysis is disabled. • When turning ST ANALYSIS on, the monitor selects DIAGNOSTIC mode automatically. You can set the monitor to MONITOR or SURGERY mode as required. However, the ST numerics might be severely distorted in these modes. • With the ST analysis, the variance of the ST segment at the waveform tracks of the selected lead can be measured.
In this menu, you can perform the following settings: • ST ANAL ST analysis ON: Enables the ST analysis; OFF: Disables the ST analysis. NOTE • When turning ST ANALYSIS on, the monitor selects DIAGNOSTIC mode automatically. You can set the monitor to MONITOR or SURGERY mode as required. However, the ST numerics might be severely distorted in these modes.
11.4.3 Adjusting ST Measurement Point The ST measurement for each beat complex is the ventical difference between two measurement points. The isoelectric point provides the baseline for the measurement and the ST point provides the other measurement point.
To adjust the points: 1. Select DEF POINT >> in the ST ANALYSIS menu to open the following window. Figure 11-11 ST Measurement Point 2. Select ISO or ST option, and then rotate the knob to adjust the position of each point respectively. • ISO: It is the base point, used to indicate the baseline point of the ST analysis. • ST: It is the ST measurement point.
11.5 Arrhythmia Analysis 11.5.1 Overview The monitor uses the user-selected primary or secondary ECG lead for arrhythmia analysis. In clinical application, the medical professionals can use the arrhythmia analysis to evaluate patients’ condition (such as heart rate, PVCs rate, rhythm and ectopic beat) and give proper treatment. The arrhythmia analysis of the monitor has the following characteristics: • Applicable to the monitoring of a patient either with a pacemaker or without a pacemaker.
11.5.2 Arrhythimia Options Your monitor has the following arrhythmia options. Arrhythmia Message Description ASYSTOLE No QRS complex for 4 consecutive seconds (in absence of ventricular fibrillation or chaotic signals). VFIB/VTAC A fibrillation wave for 4 consecutive seconds. A dominant rhythm of adjacent Vs and a HR > the V-Tach Heart Rate Limit. PNP No pace pulse within 1.75 average R-to-R intervals following a QRS complex (for paced patient only).
In this menu, you can perform the following settings: • ARR ANAL Arrhythmia analysis ON: Enables the arrhythmia analysis; OFF: Disables the arrhythmia analysis. • PVCs ALM PVCs alarm ON: When the PVCs alarm occurs, the monitor gives alarm indications and saves the alarm; OFF: When the PVCs alarm occurs, the monitor neither gives alarm indications nor saves the alarm; When OFF is selected, the icon is displayed on the right of PVCs in the parameter window. • ALM LEV Alarm level Options: HIGH, MED and LOW.
11.5.5 Arrhythmia Alarm Setup Select ARR ALARM >> in the ECG SETUP menu. The following menu appears. You can change the settings of the arrhythmia alarm in this menu. Figure 11-13 Arrhythmia Alarm Setup In the menu, the ALM field indicates the alarm on/off status, REC indicates the alarm recording on/off status and LEV indicates the alarm level. You can change the settings as described below.
11.5.6 Arrhythmia Recall Select ARR RECALL >> in the ARR ANALYSIS menu. The following menu appears. You can review any stored arrhythmia event in this menu. Figure 11-14 Arrhythmia Recall You can perform the following operations: • UP-DOWN A maximum of 10 arrhythmia events can be displayed in the window each time. In case of more than 10 events, you can use the UP-DOWN option to review more. At most 8 pages can be reviewed.
Figure 11-15 Arrhythmia waveform Review You can perform the following operations: • UP-DOWN This option allows you to page up and down to review the waveform and the parameters of other arrhythmia events. • L-RIGHT This option allows you to review 8-second waveform of the currently displayed arrhythmia event. • REC Selecting this option starts the recording of the waveform and the parameters of the currently displayed arrhythmia event. • EXIT This option allows you to return to the ARR RECALL window.
11.6 RESP Monitoring 11.6.1 Overview Respiration is detected by measuring thoracic impedance. The monitor measures the change of the impedanec between the RA and LA electrodes of the ECG lead I, or the RA and LL electrodes of the ECG lead II, and produces a respiration waveform as shown below. 123 45 Figure 11-16 Respiration Waveform and Parameter 1. Waveform name. 2. RESP lead: I or II 3. Waveform gain: 7 options are available: ×0.25, ×0.5, ×1, ×2, ×3, ×4, ×5.
11.6.2 Lead Placement Since the same leads are used for ECG and respiration monitoring, the lead placement is very important. Some patients, due to their clinical condition, expand their chest laterally, causing a negative intrathoracic pressure. In these cases it is better to place the two crocodile clips used for respiration monitoring laterally in the right axillary and left lateral chest areas, at the maximum point of the breathing movement, to optimize the respiratory waveform.
11.6.3 Respiration Setup Selecting the RESP label on the screen opens the following menu. Figure 11-18 RESP SETUP menu In this menu, you can perform the following settings. • ALM Alarm on/off ON: When a respiration rate alarm occurs, the monitor gives alarm indications and stores the alarm; OFF: When a respiration rate alarm occurs, the monitor neither gives alarm indications nor stores the alarm; When OFF is selected, the icon is displayed on the right of the RESP label.
For different patient types, the upper/lower limits of the respiration rate alarm may vary in the following range. Patient type Max. ALM HI Min. ALM LO Increment (breath/min) Feline 150 0 1 Canine 150 0 1 Other animals 150 0 1 • APNEA ALM Apnea alarm Determines whether the patient’s cessation of breath is an apnea event. Range: 10–40 seconds. • SWEEP Waveform speed Options: 6.25, 12.5 and 25.0 mm/s. • HOLD TYPE Calculation type Options: AUTO and MANUAL 1.
11.7 Maintenance and Cleaning WARNING • Before cleaning the ECG cable, be sure to disconnect the monitor from the ECG cable, or shut down the system and disconnect all power cords from the outlet. • If the ECG cable is damaged or aged, replace with a new one. • Cleaning The exterior surfaces of the ECG cable may be cleaned with a soft cloth, dampened with the alcohol, and then be air-dried or dried with a clean dry cloth. • Disinfection Disinfection may cause damage to the equipment.
FOR YOUR NOTES 11-30
12 SpO2 Monitoring 12.1 Overview The monitor measures the patients’ SpO2 (oxygen saturation) and displays: 1. Pulse rate (PR) value in the ECG or SpO2 parameter window. 2. PLETH waveform in the waveforms area. 3. Oxygen saturation (SpO2%) value in the SpO2 parameter window. The PR value is displayed in the ECG parameter window only if: 1. SpO2 is selected from the HR FROM options in the ECG SETUP menu; or 2. AUTO is selected from the HR FROM options in the ECG SETUP menu and no ECG signal is received.
PITCH TONE The PITCH TONE function refers to the monitor’s capability to vary the pitch of the heart rate tone or pulse rate tone with the change of the SpO2 reading. This monitor provides 22 pitch levels. The pitch rises as the SpO2 reading increases toward 100% and falls as it decreases.
12.2.2 Precautions WARNING • The SpO2 value might be overestimated in the presence of Hb-CO, Met-Hb or dye dilution chemicals. • Check if the sensor cable is in normal condition before monitoring. Do not use the SpO2 sensor once the package or the sensor is found damaged. • Verify sensor cable fault detection before beginning monitoring. Unplug the SpO2 sensor cable from the connector. The screen will display the prompt information “SPO2 SENSOR OFF” and the audible alarm is activated.
12.2.3.1 Tongue Sensor Placement You can easily place the tongue sensor as shown below. Figure 12-2 Tongue Sensor Placement NOTE • Be sure that the sensor cable is positioned along the side of the animal’s face and body to avoid entanglement with the animal. 12.2.4 Measurement Limitations If the accuracy of any measurement does not seem reasonable, first check the patient’s vital signs by an alternate method. Then check the instrument for proper function.
• Concentration of dysfunctional hemoglobin, such as carboxyhemoglobin and methemoglobin; • SpO2 too low; • Low circular perfusion of the applied part; • Shock, anemia, low temperature and application of vasomotor all reduce the arterial blood flow and may affect the pulse oximetry measurement. The absorption of oxyhemoglobin (HbO2) and deoxyhemoglobin to the light of special wavelength may also affect SpO2 measurement.
• ALM LEV Alarm level Options: HIGH and MED. • ALM REC Alarm recording ON: When a SpO2 alarm occurs, the monitor enables the recording; OFF: When a SpO2 alarm occurs, the monitor does not enable the recording. • SPO2 ALM HI SpO2 upper alarm limit • SPO2 ALM LO SpO2 lower alarm limit • PR ALM HI PR upper alarm limit • PR ALM LO PR lower alarm limit SpO2 and PR alarm limits: Parameter Max. upper limit Min.
• SWEEP Waveform speed Options: 12.5 and 25.0 mm/s. • PR SOUND Pulse volume Range: 0–10. 0 indicates the volume is closed and 10 indicates the maximum volume. • SENSITIVE Sensitivity of SpO2 calculation Options: HIGH, MED and LOW. When HIGH is selected, the monitor gives quick response to the change of the oxygen saturation but the measurement accuracy might be compromised. When LOW is selected, the monitor gives slow response to the change of the oxygen saturation but the accuracy is relatively high.
12.3 Nellcor SpO2 Module NOTE • This section is only applicable to the monitor equipped with a Nellcor SpO2 module. 12.3.1 Principles of Operation Bone, tissue, pigmentation, and venous vessels normally absorb a constant amount of light over time. The arteriolar bed normally pulsates and absorbs variable amounts of light during the pulsations. The Nellcor SpO2 module uses pulse oximetry to measure functional oxygen saturation in the blood.
• Automatic Calibration Because light absorption by hemoglobin is wavelength dependent and because the mean wavelength of LEDs varies, a monitor must know the mean wavelength of the sensor’s red LED to accurately measure SpO2. During manufacturing, the mean wavelength of the red LED is encoded in a resistor in the sensor.
Saturation (%) SpO2% Temperature PCO2 2,3-DPG PH Temperature PCO2 2,3-DPG Fetal Hb Saturation (%) SpO2% Temperature PCO2 2,3-DPG PH Temperature PCO2 2,3-DPG Fetal Hb Figure 12-4 Oxyhemoglobin Dissociation Curve 12.3.2 Precautions WARNING • Pulse oximeter can overestimate the SpO2 value in the presence of Hb-CO, Met-Hb or dye dilution chemicals. • ES (Electrosurgery) equipment wire and SpO2 cable must not be tangled up.
WARNING • Prolonged and continuous monitoring may increase the risk of burns at the site of the sensor. It is especially important to check the sensor placement, and ensure proper attachment on patients of poor perfusion or skin sensitive to light. Check the sensor location every 2–3 hours and move to another location if the skin deteriorates. More frequent examinations may be required for different patients. NOTE • SpO2 waveform is not proportional to the pulse volume. 12.3.
• Excessive patient motion; • Venous pulsations; • Intravascular dyes such as indocyanine green or methylene blue; • Defibrillation; Other physiological conditions or medical procedures that may interfere with the monitor’s measurements include significant levels of dysfunctional hemoglobin, low perfusion, and dark pigment.
12.3.5 SpO2 Setup Menu Selecting the SPO2 label in the parameter window opens the following menu. Figure 12-5 SpO2 Setup Menu You can perform the following settings in this menu. • ALM SpO2 alarm on/off status ON: When a SpO2 alarm occurs, the monitor gives alarm indications and stores the alarm; OFF: When a SpO2 alarm occurs, the monitor neither gives alarm indications nor stores the alarm; When OFF is selected, the icon is displayed on the right of the SPO2 label.
SpO2 and PR alarm limits: Parameter Max. upper limit Min. lower limit Step SpO2 100 0 1 PR 250 20 1 The SpO2 and PR alarm limits in factory configuration: Parameter Patient type Upper limit Lower limit Feline 100 90 SpO2 Canine 100 90 Other animals 100 90 Feline 180 120 PR Canine 110 60 Other animals 180 120 WARNING • Setting the SpO2 upper alarm limit to 100% will disable the upper alarm limit.
12.3.6 Accessories If your monitor is equipped with a Nellcor SpO2 module, use only Nellcor oximetry sensors for SpO2 measurements. Other sensors may cause improper pulse oximeter performance. Before use, carefully read the directions for the sensor. When selecting a sensor, consider, the patient’s weight and motion, the adequacy of perfusion, the available sensor sites, and the required disinfection. Biocompatibility testing has been conducted on Nellcor sensors.
12.3.7 Nellcor Information Nellcor Patents This device is covered under one or more the following U.S. Patents: 4,802,486; 4,869,254; 4,928,692; 4,934,372; 5,078,136; 5,351,685; 5,485,847; 5,533,507; 5,577,500; 5,803,910; 5,853,364; 5,865,736; 6,083,172; 6,463,310; 6,591,123; 6,708,049; Re.35,122 and international equivalents. U.S.A and international patents pending.
13 NIBP Monitoring 13.1 Overview The Non-invasive Blood Pressure (NIBP) module measures blood pressure using the oscillometric method. This monitor can be applied to felines, canines and other animals. Three modes of measurement are available: manual, automatic and continuous. • Manual: Pressing the NIBP key on the control panel starts a NIBP measurement. • Auto: The NIBP measurement is conducted automatically at a preset interval.
1. NIBP label: Selecting this label to access the NIBP SETUP menu. 2. Time of last measurement. 3. NIBP unit: mmHg or kPa. 4. Prompt information area: Shows the NIBP measurement mode and other information. 5. Systolic pressure value (NS) 6. Mean pressure value (NM) 7. Diastolic pressure value (ND) If a set of measured results appears in grey, it indicates this measurement is performed at least 1 hour ago. 13.
13.2.1 Cuff Selection and Placement To place the cuff, follow the procedure as below: 1. Identify the patient limb/tail circumference. 2. Select an appropriate cuff, which is identified with a specific limb circumference. 3. Verify the cuff is completely deflated. 4. Place the cuff over the proper site of the patient, making the cuff edge fall within the range of the <-> mark. 5. Verify that the cuff is not wrapped too tightly around the limb.
The metacarpus, metatarsus and anterior tibial are recommended for the cuff placement. For anesthetized patients, most surgeries are done on the posterior part of the body so the metacarpal area of the forelimb is most convenient. In situations where this is not possible, place the cuff around the metatarsus just proximal to the tarsal pad or around the hind leg next to the hock. For conscious patients, measurements from the coccygeal artery can be used over the tail site.
13.2.2 Operation Guides 1. To start a manual NIBP measurement • Access the NIBP SETUP menu and select MANUAL from the INTERVAL option; then, press the NIBP key on the control panel to start a manual NIBP measurement; or • During the interval between two auto NIBP measurements, press the NIBP key on the control panel to start a manual NIBP measurement. 2. To start auto NIBP measurement Access the NIBP SETUP menu and select a time (e.g.
13.3 Measurement Limitations Non-invasive blood pressure measurement uses the oscillometric method of measurement. The monitor detects the regular arterial pressure pulse. In some circumstances when the patient's condition makes it difficult to detect this pulse, the measurement becomes unreliable and the measurement time increases.
13.4 NIBP Setup Menu Selecting the NIBP label in the parameter area opens the following menu. Figure 13-4 NIBP Setup Menu You can perform the following settings in this menu. • ALM NIBP alarm on/off status ON: When a NIBP alarm occurs, the monitor gives alarm indications and stores the alarm; OFF: When a NIBP alarm occurs, the monitor neither gives alarm indications nor stores the alarm; When OFF is selected, the icon is displayed on the right of the NIBP label. • ALM LEV Alarm level Options: HIGH and MED.
• SYS ALM HI Determines the upper limit of the systolic pressure. • SYS ALM LO Determines the lower limit of the systolic pressure. • MEAN ALM HI Determines the upper limit of the mean pressure. • MEAN ALM LO Determines the lower limit of the mean pressure. • DIA ALM HI Determines the upper limit of the diastolic pressure. • DIA ALM LO Determines the lower limit of the diastolic pressure. If a measured pressure crosses a preset upper or lower alarm limit, an alarm will be triggered.
• UNIT Options: mmHg, kPa; • INTERVAL Select MANUAL to set the monitor to manual NIBP measurement mode, or select from the time options to determine the interval between automatic measurements. Optional intervals: 1, 2, 3, 4, 5, 10, 15, 30, 60, 90, 120, 180, 240, and 480MIN. • CUFF TYPE Options: BIG, MIDDLE, SMALL (short for big cuff, middle cuff, small cuff) Every CUFF TYPE corresponds to different cuff sizes, which are identified on the cuff.
13.4.1 Calibration If you select the CALIBRATE option, the monitor starts the NIBP calibration and the CALIBRATE option changes to STOP CAL. Selecting the option again stops the calibration. Calibrate the cuff pressure reading with a calibrated reference manometer (or mercury manometer) with accuracy higher than 1mmHg. To perform the calibration, follow the procedure shown below: 1.
13.4.2 Testing for Air Leakage The PNEUMATIC option is used to test air leakage. When the NIBP cuff is connected, select this option to start the NIBP inflation and test whether the air leakage occurs in the airway. If the test is passed, no prompt information will be displayed; if the test is not passed, corresponding prompt information will be displayed in the NIBP parameter window. To test air leakage, use the following procedure: 1. Connect the NIBP cuff with the NIBP cuff connector of the monitor. 2.
13.5 Maintenance and Cleaning WARNING • Do not press the rubber tube on the cuff with excessive strength. Disposable cuffs are intended for single patient use only. Do not sterilize or use autoclave sterilization for disposable cuffs. NOTE • Disposable blood pressure cuffs must be recycled or disposed of properly.
14 TEMP Monitoring 14.1 Overview The monitor is able to use two temperature probes simultaneously, to obtain two temperature values and the difference between them. The measurement values are displayed in the TEMP parameter window as shown below. 1 4 2 3 5 Figure 14-1 TEMP Parameter Window 1. TEMP label: Selecting this label opens the TEMP SETUP menu. 2. Temperature unit: . or .. 3. T1: Temperature channel 1. Displays the temperature measured at temperature channel 1. 4. T2: Temperature channel 2.
NOTE • Disposable temperature probes are for single patient use only. • The self-test of the temperature measurement is performed once per hour during monitoring. This self-test lasts about 2 seconds and does not affect the normal measurement of temperature. WARNING • Verify probe cable fault detection before beginning monitoring. Unplug the temperature probe cable of channel 1 or channel 2 from the connector on the monitor.
You can perform the following settings in this menu. • ALM • ALM LEV • ALM REC • T1 ALM HI • T1 ALM LO • T2 ALM HI • T2 ALM LO • TD ALM HI • TEMP UNIT • CONFIG >> Temperature alarm limits: Temperature alarm on/off status ON: When a temperature alarm occurs, the monitor gives alarm indications and stores the alarm; OFF: When a temperature alarm occurs, the monitor neither gives alarm indications nor stores the alarm; When OFF is selected, the icon is displayed on the right of the TEMP label.
Determines the upper alarm limit of temperature channel 1. Determines the lower alarm limit of temperature channel 1. Determines the upper alarm limit of temperature channel 2. Determines the lower alarm limit of temperature channel 2. Determines the upper limit of the temperature difference between channel 1 and channel 2. Options: . and . You can select this option to access the TEMP CONFIG menu, in which you may select FACTORY CONFIG or USER CONFIG.
Temperature alarm limits in factory configuration: Parameter Patient type Upper limit Lower limit Feline 39.5 37.5 T1 and T2 Canine 39.5 38 Other animals 39.5 37.5 Feline 2 / TD Canine 2 / Other animals 2 / 14.4 Maintenance and Cleaning WARNING • Before cleaning the monitor or the probe, make sure the equipment is turned off and disconnected from AC power. Reusable Temperature Probes • The temperature probe should not be heated to a temperature over 100. (212.).
15 IBP Monitoring 15.1 Overview The monitor provides two channels to measure the invasive blood pressure (IBP, including diastolic, systolic and mean pressures), and displays two waveforms. 1 2 1. CH1 label: select the waveform of channel 1 to be displayed. 2. CH2 label: select the waveform of channel 2 to be displayed.
4. Parameter values of channel 2: Systolic pressure, mean pressure and diastolic pressure (from the left to the right). When ART or ICP is selected for CH1 and CH2 respectively, the ICP and CPP values will be displayed, where CPP is equal to the mean pressure of ART minus ICP. 5. PR numeric 15.2 Precautions WARNING • Use only the IBP transducer specified in this operation manual. Disposable IBP transducers or domes should not be reused.
15.3 Monitoring Procedure 1. Plug the pressure cable into the IBP connector on the monitor and power on the monitor. 2. Prepare the pressure line and transducer by flushing the system with normal saline solution. Make sure the tubing and transducer system is free of air bubbles. NOTE • In case of any entrapped air in the pressure system, re-fill the system with normal saline. 3. Connect the catheter to the pressure line, making sure there is no air present in the catheter or pressure line. 4.
15.4 IBP Menu Selecting the IBP (1,2) label in the parameter window opens the following menu. Figure 15-4 IBP (1,2) Select Menu 15.4.1 IBP Setup Menu The IBP SETUP in IBP (1,2) SELECT menu allows you to access the following menu. Figure 15-5 IBP (1,2) Setup Menu You can perform the following settings in this menu.
• ALM LEV Alarm level Options: HIGH, MED and LOW. • AMP ADJUST Amplitude adjustment This option allows you to adjust the waveform amplitude. Options: MANUAL and AUTO. 1. MANUAL: If MANUAL is selected, you can select an IBP channel manually from the options, including ART, PA, CVP, RAP, LAP, ICP, P1 and P2, and then adjust the IBP scale in the SCALE ADJUST >> menu. 2. AUTO: If AUTO is selected, the waveform labels of IBP channels become P1 and P2 and the IBP scale is adjusted by the system automatically.
Options: mmHg, kPa and cmH2O. • IBP1 UNIT Options: mmHg, kPa and cmH2O. • ALM LIMIT SETUP >> This option allows you to access the following menu, whereby you can set the upper and lower alarm limits.
Figure 15-6 IBP Alarm Setup Menu IBP alarm limits Pressure Label Max. Upper (mmHg) Min. Lower (mmHg) Step (mmHg) ART 300 0 1 PA 120 -6 1 CVP 40 -10 1 RAP 40 -10 1 LAP 40 -10 1 ICP 40 -10 1 P1 300 -50 1 P2 300 -50 1 The PR alarm limits are the same as those of the corresponding SpO2 module. • SCALE ADJUST >> This option allows you to open the following menu and set the positions of the high, reference and low scales for the two waveforms.
1. HI: Determines the high scale. The reference scale changes when the high scale is changed. 2. LO: Determines the low scale. The reference scale changes when the low scale is changed. 3. VAL: Determines the reference scale and position. The high and low scales remain unchanged when the reference scale is changed. NOTE • The high scale should not be smaller than the low scale; the low scale should not be larger than the high scale. • The waveform amplitude changes when the high and low scales are adjusted.
Pressure transducer interface cable Monitor Pressure transducer interface cable Monitor 15.4.2 IBP Pressure Zero Menu You can select IBP PRESURE ZERO in IBP (1,2) SELECT menu to open the following menu. Figure 15-9 IBP Pressure Zero Menu Pressure Transducer Zeroing Procedure 1. Disconnect the transducer from the patient. Pressure transducer 3-way stopcock Figure 15-10 Pressure Transducer Zeroing 2. Adjust the 3-way stopcock to close the channel leading to the patient.
NOTE • To ensure correct measurement, zero the transducer before it is used to zero the monitor. • Position the transducer at the same level with the patient’s heart. • Perform the pressure zeroing before monitoring, and at intervals during monitoring (at least once per day). The zeroing should also be conducted once the transducer cable is disconnected and then connected. Prompt Information Related to Zeroing Take channel 1 as an example.
15.4.3 IBP Pressure Calibration You can select IBP PRESSURE CALIBRATE in IBP (1,2) SELECT menu to open the following menu. Figure 15-11 IBP Pressure Calibration Menu Calibration Procedure 1. Disconnect the pressure transducer from the patient. Connect the 3-way stopcock, the sphygmomanometer and the inflation orb, using a T-shape connector, as shown below.
2. Perform the pressure transducer zeroing beforehand. If the zeroing succeeds, open the stopcock to the sphygmomanometer. 3. In the IBP PRESSURE CALIBRATE menu, select a value from the CH1 CAL VALUE or the CH2 CAL VALUE popup menu. The calibration pressure value of channel 1 or channel 2 is set. 4. Inflate using the inflation orb, until the mercury volume of the sphygmomanometer rises to the preset calibration pressure value. 5.
Prompt Information Related to Calibration Take channel 1 as an example. The monitor may give the following prompt information after the calibration has been finished. • CH1 SUCCESSFUL CALIBRATE Channel 1 works normally and can be applied to IBP monitoring. • CH1 SENSOR OFF, FAIL Verify the transducer of channel 1 is connected to the monitor, and then perform the calibration again. If the monitor continues to give this prompt information, contact our Customer Service.
15.5 Maintenance and Cleaning WARNING • Before cleaning the transducer, make sure the transducer is disconnected from the monitor, or the monitor is powered off and disconnected from AC power. Cleaning of IBP Transducer After the IBP monitoring operation is completed, remove the tubing and the dome from the transducer and wipe the transducer diaphragm with water.
Sterilization • Chemical Solution Sterilization After finishing the cleaning, select an effective sterilant for chemical solution sterilization of the operating room equipment. Buffered glutaraldehyde (e.g. Cidex or Hospisept) is recommended. Do not use quaternary cationic detergents such as zephiran chloride. If the whole unit is to be sterilized, immerse the transducer but not the electrical connector into the sterilant for the recommended sterilizing period. Ensure that the dome has been removed.
16 CO Monitoring 16.1 Overview • The Cardiac Output (C.O.) measurement is performed using thermodilution method. • The monitor is able to measure the patient’s blood temperature and cardiac output, and perform hemodynamic calculation. • You can choose either the ambient temperature injection or ice-water injection, using the injection system or a syringe. • You can perform up to six measurements before calculating the average cardiac output (C.O.) and the average cardiac index (C.I.).
16.2 Measurement Procedure WARNING • The accessories applied must meet the safety requirements for medical instruments. • When the accessories are in use, avoid contacting conductive metal objects. The following is the procedure to monitor patient’s cardiac output. 1. Connect the CO cable into the CO sensor connector of the monitor. 2. Connect the CO measurement catheter and the temperature probe correctly as shown in Figure 16-2. The blood temperature reading is displayed. 3. Open the C.O.
NOTE • Set the injectate temperature source properly in the CO setup menu. The ON/OFF state of the injectate temperature source, when measurement is finished, affects the CO calculation. Thus, do not change the injectate temperature source before the measurement is over. Monitor Injectate Cardiac Output Cable Thermodilution Catheter Injectate Sensor Hoursing Delivery System In-line Injectate Temperature probe Figure 16-2 CO Sensor Connections 5. You may repeat the measurement if necessary. 6.
16.2.1 Window for CO Measurement Selecting the CO label in the CO parameter window opens the CO SELECT menu. Then, select the CO MEASURE option to access the WINDOW FOR CO MEASUREMENT. If the CO sensor is not connected, “No sensor, unable to measure C.O.” will be displayed in the prompt information area of the window. 4 5 6 7 1 8 2 3 9 Figure 16-3 Window For CO Measurement 1. CO measurement curve 2. Prompt information 3. Measurement start time 4. CO: measured cardiac output 5. CI: cardiac index 6.
• START Selecting this option starts a measurement. • STOP • CANCEL • REC • Scale Y • Scale X • EDIT • EXIT Measurement Procedure In the process of the CO measurement, if the blood temperature cannot restore to its initial value for a long time and the measurement cannot stop automatically, you may select this option to stop the measurement. The measured CO and CI will be displayed. Selecting this option during a measurement cancels the measurement.
If you start measurement in the 0 - 30s level, it will be switched to 0 - 60s level automatically if the measurement cannot be finished within 30 seconds. After the switch, no further adjustment can be made to the X-axis. This option allows you to enter WINDOW FOR C.O. EDIT. This option allows you exit WINDOW FOR CO MEASUREMENT. 1. The cardio output measurement can be started when the prompt information “Ready for new measurement” appears in the window. 2.
To ensure the accuracy of the measurement, it is suggested two consecutive measurements be performed at an interval. The length of the interval can be set in the C.O. SETUP menu (time unit: second). The remaining time to the next measurement is displayed at the position of 2 in Figure 16-3. The next measurement cannot be performed until the time reduces to zero and the “Ready for new measurement” prompt information appears.
1. The curve for one of the six measurements and the corresponding CO value. 2. The average CO value. 3. The average CI value. 4. The function option in the window for CO editing. Values of selected measurements can be averaged and stored in the CO field in the HEMOD menu for Hemodynamic calculations. When you access the editing window for the first time, all the curves and the CO values of valid measurements are highlighted, indicating these values are to be averaged.
16.3 CO Setup Menu Select the CO label in the CO parameter window, and the C.O. SELECT menu pops up. You can select the C.O. SETUP option to enter the following menu. Figure 16-6 C.O. Setup Menu You can perform the following settings in this menu.
• TB ALM HI TB upper alarm limit • TB ALM LO TB lower alarm limit TB alarm limits: Parameter Maxi. Upper Mini. Lower Step TB 43 23 0.1 • CO.CONST This coefficient is related to the catheter and the injectate volume. After replacing the catheter, you should adjust this coefficient according to the instructions for use. • INJ. TEMP FROM Injectate temperature source ON: When this option is selected, the system obtains the real-time injectate temperature by placing a sensor in the way of the injectate.
confirmation.
16.4 Hemodynamic Calculation Select the HEMO CALCULATE >> option from WINDOW FOR C.O. EDIT, the HEMO WINDOW is opened. This window displays the input parameter values and the calculation result. Figure 16-7 Hemodynamic Calculation Window In the window above, you can rotate the control knob and highlight a parameter field to adjust the value of the selected parameter. After finishing all parameter settings, select the CALCULATE option. The calculation result is displayed in the window immediately.
Input parameters: • PAWP: Pulmonary Artery Wedge Pressure • CVP: Central Venous Pressure • CO: Cardiac Output • HR: Heart Rate • AP MAP: Mean Artery Pressure • LV_D: Left Ventricular Diameter • PA MAP: Mean Pulmonary Artery Pressure • HT: Height • WT: Weight Hemodynamic calculation result: Abbreviation Full name Calculation formula CI Cardiac index CO / BSA BSA Body surface area 0.0061×HT+0.0128×WT–0.1529 SV Stroke volume CO / hr × 1000 SVI Stroke volume index SV / BSA SVR Systemic vascular resistance 79.
16.5 Maintenance and Cleaning WARNING • Before cleaning the transducer, make sure it is disconnected from the monitor, or the monitor is powered off and disconnected from the AC power. CO Cable Cleaning • If the adhesive tape residue must be removed from the transducer cable, double seal tape remover can be used because it is very effective. Careful use minimizes the damage to the cable.
17 CO2 Monitoring 17.1 Overview The monitor is able to measure the CO2 pressure of the patient airway, and displays the CO2 waveform in the waveforms area of the monitor screen. The CO2 parameter window shows the following parameters: • End-tidal CO2 concentration (EtCO2) • Inspired Minimum CO2 (InsCO2) • Air Way Respiration Rate (AwRR) Figure 17-1 CO2 Waveform and Parameters 12 345 Waveform name 1. CO2 label: This option allows you to access the CO2 SETUP menu. 2. Pressure unit: mmHg or kPa. 3.
17.2 Sidestream CO2 Module NOTE • This section is only applicable to a monitor equipped with a sidestream CO2 module. 17.2.1 Principles of Operation WARNING • The CO2 module should be protected against crash and vibration. • Inaccurate measurement may occur when the monitor is operating in an environment of excessively high CO2 content (>0.5%). The monitor adopts sidestream CO2 module. The measurement of this module is based on the feature that the CO2 molecule absorbs infrared ray.
17.2.2 Preparations for CO2 Measurement 1. Plug the water trap into its receptacle before the measurement. 2. Open the CO2 SETUP menu and set WORK MODE to MEASURE. The “CO2 START UP” prompt information is displayed on the screen until the startup is finished. 3. After the module start-up, the “CO2 WARM UP” prompt information is displayed on the screen. At this time, the module is in the Warming–up status. 4. After the module warm-up, the module enters the Ready-to-measure status.
The calculation formulas in the above two compensations are as follows: ATPD: PCO2 (mmHg)= CO2 (vol%)× Pamp/100 BTPS: PCO2 (mmHg)= CO2 (vol%)×(Pamp-47)/100 In the above formulas, PCO2 refers to the CO2 partial pressure, vol% is the percentage of the gas concentration, and Pamp is the ambient pressure in the unit of mmHg. WARNING • Do not use the accessory if the packaging or the internal accessory is damaged. Return it to the manufacturer.
17.2.3 CO2 Setup Menu Selecting the CO2 label in the parameter window opens the following menu. Figure 17-3 CO2 Setup Menu You can perform the following settings in this menu. • ALM Alarm on/off status ON: When a CO2 alarm occurs, the monitor gives alarm indications and stores the alarm; OFF: When a CO2 alarm occurs, the monitor neither gives alarm indications nor stores the alarm; When OFF is selected, the icon is displayed on the right of the CO2 label. • ALM LEV Alarm level Options: HIGH and MED.
• APNEA ALM Determines the apnea alarm delay. If the apnea of the patient exceeds the preset apnea alarm delay, the monitor triggers an alarm and gives the " CO2 APNEA " alarm message. Options: 10S, 15S, 20S, 25S, 30S, 35S and 40S. • SWEEP Waveform speed Options: 6.25, 12.5 and 25.0. Unit: mm/s. • UNIT Options: mmHg, kPa and %. • WAVE SCALE Options: HIGH and LOW. This option allows you to adjust the amplitude of the CO2 waveform. • WORK MODE Options: MEASURE and STANDBY.
NOTE • The apnea alarm cannot be disabled. • When the CO2 monitoring is not required, it is recommended the water trap not be connected and the work mode be set to STANDBY. Other Setup Selecting OTHER SETUP option opens the following menu. Figure 17-4 CO2 Other Setup Menu You can perform the following settings in this menu. • PUMP RATE Determines the sampling rate of the CO2 module pump. • N2O COMPEN N2O compensation The presence of nitrous oxide causes the CO2 value to be higher than the actual value.
NOTE • The unit of N2O COMPEN, O2 COMPEN and Des COMPEN is “%”. The concentration of N2O, O2 and Desflurane can be obtained from the anesthesia machine. • Set the N2O COMPEN, O2 COMPEN and Des COMPEN according to the practical situation. Incorrect setting might incur errors from the actual value and cause misdiagnosis. • BTPS Body Temperature and Pressure, Saturated Options: ON and OFF.
17.2.4 CO2 User Maintain Menu Select CO2 USER MAINTAIN >> in USER MAINTAIN menu. The following menu appears. Figure 17-5 CO2 User Maintain Menu The following information is displayed in the menu above. • CO2 The currently measured CO2 content. Unit: %. In the field at the right of the CO2 value, you can select a standard gas containing a certain amount of CO2 for calibration. Options: 3%, 4%, 5%, 6% and 7%. • BAROMETRIC The currently measured barometric pressure. Unit: mmHg.
• ZERO CAL This option allows you to zero the CO2 module, so as to eliminate the adverse affect of the baseline drift in the process of measurement. Perform zeroing prior to concentration calibration. • CONFIRM CAL This option allows you to confirm the calibration of the CO2 module. Calibration Procedure 1. Verify the module enters the ready-to-measure status. 2. Connect a gas bottle with the CO2 sensor connector on the monitor as shown below.
17.2.5 Maintenance and Cleaning • The sampling line of the sidestream CO2 module is disposable and cannot be disinfected for reuse. • In case of an exception in the sampling system of the CO2 module, check for entanglement of the sampling line. If the sampling line is not entangled, remove it from the water trap. In this situation, if the screen displays a prompt information indicating the CO2 sampling line is abnormal, the water trap must have been blocked, and you must replace it with a new one.
FOR YOUR NOTES 17-12
18 Anesthesia Gas Monitoring 18.1 Overview The anesthesia gas (AG) monitoring can be used for measuring the anesthesia gas and respiration gas of the patient in the anesthetic status. This monitor can configure AION 02 AG module or AION 03 AG module. AG module provides the end-tidal numerics and inhaling numerics of the gases mentioned below. • Carbon dioxide (CO2): The measured numeric is EtCO2 (Max. exhaling value: Max. exhaling numeric detected during the respiration).
In addition, the patient monitor can display parameters, including CO2, N2O, O2 and AA (Which refers to the monitored anesthetic: DES, ISO, ENF, SEV or HAL). It also displays the inhaling and exhaling numerics as well as MAC (Minimum Alveolar Concentration)/MAL (balance gas) and AwRR. When the O2 module is not connected, no O2 waveform will be displayed. After the O2 module is connected, whether the O2 waveform is displayed depends on whether the O2 waveform is switched on in the configuration.
18.2 Measurement Principles and Procedure Measurement principle of AGs The AG concentration is measured based on the rationale that the AGs have the property of absorbing the infrared. The AG module can measure gases that have various properties of absorbing the infrared. To measure the concentration of a gas, send it to the sampling room, select the infrared of a specific wavelength with an optical infrared filter, and transmit it through the gas.
WARNING • Ensure the compactness of the connection when performing gas measurements. Any leakage in the system will lead to incorrect readings because this leakage will make the surrounding environmental air mix up with the patient gas. • The water trap is used for collecting water condensates to protect the module from the ingress of water; when the collected water in the water trap reaches a specific volume, it must be removed, thus to avoid clogging in the gas system.
18.3 MAC Minimum alveolar concentration (MAC) is the minimum concentration of the agent in the alveoli. It is a basic index to indicate the depth of anesthesia. MAC is defined as this: alveolar concentration of an inhaled anesthetic agent that, in the absence of other anesthetic agents and at equilibrium, prevents 50% of patients from moving in response to a standard surgical stimulus. Minimum alveolar concentration (MAC) values are listed below: Agent Des Iso Enf Sev Hal N2O 1 MAC 7.3% 1.15% 1.7% 2.1% 0.
18-5
18.4 AG Setup Menu Select the GAS label in the parameter window. The AG SETUP menu appears. Figure 18-4 AG SETUP menu In this menu, you can set the following items. • Agent Used to select the name of the anesthetic to be monitored, including AA, HAL, ENF, ISO, SEV and DES. If you select the AION 02 AG module, the patient monitor cannot identify the anesthetic type. Therefore, you have to select the used anesthetic before using the AG module so that the AG module can conduct measurements normally.
• O2 COMPEN The options include: OFF, 30%, 40%, 50%, 60%, 70%, 80%, 90%, and 100%. When the O2 concentration exceeds 60% and it is not being monitored, turn on this switch. • SWEEP Used to select the speed to scan the screen waveforms. Options: 6.25mm/s and 12.5mm/s. • WORK MODE Options: MEASURE and STANDBY. To monitor the anesthetic gas, select the MEASURE option. Otherwise, select the STANDBY option. Alarm Setup Menu Select ALARM SETUP >> in AG SETUP menu. The following menu appears.
• ALM REC ON: The recorder outputs the alarm information in case an AG alarm occurs. OFF: The recorder does not output the alarm information in case an AG alarm occurs.
• FiN2O ALM HI Set the upper limit of FiN2O which triggers the alarm 18-8
• FiN2O ALM LO Set the lower limit of FiN2O which triggers the alarm • EtAA ALM HI Set the upper limit of EtAA which triggers the alarm • EtAA ALM LO Set the lower limit of EtAA which triggers the alarm • FiAA ALM HI Set the upper limit of FiAA which triggers the alarm • FiAA ALM LO Set the lower limit of FiAA which triggers the alarm • APNEA ALM Used to set up the apnea alarm time. Options: 20s, 25s, 30s, 35s and 40s. Adjust Wave Amplitude Menu Select ADJUST WAVE AMP>> in AG SETUP menu.
18.5 Calibrating AG Calibrate the AG module every year or when the measured value has a great deviation. Tools required: • Gas bottle, with a certain standard gas or mixture gas. Gas concentration should meet the following requirements: AA>1.5%, CO2>1.5%, N2O>40%, O2>40%, of which AA represents an anesthetic agent. • T-shape connector • Tubing • Reservoir bag Follow this procedure to perform a calibration: 1. Select MAINTAIN>> in SYSTEM MENU, enter USER KEY, then select CONFIRM button.
6. Enter the vented gas concentration. If you use only one gas for calibration, set other gases’ concentration to 0. 7. Select CALIBRATE to start calibration. 8. If the calibration is finished successfully, the message CALIBRATION COMPLETED! is displayed. If the calibration failed, the message AG CAL. FAILED is displayed. Perform another calibration. 9. Select EXIT to exit the current menu. 18.6 Maintenance and Cleaning 18.6.
18.6.2 Removing Exhaust Gases from the System WARNING • Anesthetics: When using the AG 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.
19 Maintenance WARNING • Failure on the part of the responsible hospital or institution employing the use of the monitoring equipment to implement a satisfactory maintenance schedule may cause undue equipment failure and possible health hazard. • The safety inspection or maintenance, which requires opening the monitor housing, must be performed by trained and authorize personnel only. Otherwise, equipment failure and possible health hazard may be caused. 19.
19.2 Cleaning WARNING • Be sure to shut down the system and disconnect all power cords from the outlet before cleaning the equipment. Your equipment should be cleaned on a regular basis. If there is heavy pollution or lots of dust and sand in your place, the equipment should be cleaned more frequently. Before cleaning the equipment, consult your hospital’s regulations for cleaning, disinfecting and sterilizing equipment.
19.3 Disinfection and Sterilization Sterilization or disinfection may cause damage to the equipment. We recommend the sterilization and disinfection are contained in the hospital’s servicing schedule only when necessary. The equipment should be cleaned prior to sterilization and disinfection. Recommended sterilization material: Alcohol based (Ethanol 70%, Isopropanol 70%), and aldehyde based.
FOR YOUR NOTES 19-4
20 Accessories WARNING • Use accessories specified in this chapter. Using other accessories may cause damage to the patient monitor or not meet the claimed specifications. • The operating and storage conditions of the patient monitor should meet the specifications claimed by respective accessories. For environmental specifications of each accessory, refer to instructions for use of respective accessories. • Single-use accessories are not designed to be reused.
supported Compatible with Model Type Length Part No. 3-leadwire AHA/IEC EV 6102 3m 0010-30-12377 3/5-leadwire AHA/IEC EV 6101 Defibrillator-proof 0010-30-42782 Note: The cables listed in the table above must be used together with leadwires.
Cable Sets 3-Electrode Cable Sets Type Compatible with Model Length Part No. Remark Clip IEC EL6302A 0.6 m 0010-30-42725 / EL6304A 1 m 0010-30-42732 Long EL6306A 0.6 m 0010-30-42897 / EL6308A 0.6 m 0010-30-42899 / AHA EL6301A 0.6 m 0010-30-42726 / EL6303A 1 m 0010-30-42731 Long EL6305A 0.6 m 0010-30-42896 / EL6307A 0.6 m 0010-30-42898 / Snap IEC EL6302B 0.6 m 0010-30-42733 / EL6308B 0.6 m 0010-30-42901 / AHA EL6301B 0.6 m 0010-30-42734 / EL6307B 0.
Nellcor SpO2 Module Type Model Length Remark Part No. Extension cable / 2.5 m 6 pins 0010-20-42595 Reusable VetSat(V-Sat) 1.1 m clip 9101-10-58134 • The main cable must be used with the matching SpO2 sensor. • Wavelength emiited by the sensors intended for Mindray SpO2 module: 512D: red right: 660 nm, infrared light: 940 nm; other SpO2 sensors: red right: 660 nm, infrared light: 905 nm. • Wavelength emitted by the sensors intended for Nellcor SpO2 module: red light: 660 nm, infrared light: 890 nm.
20.4 TEMP Accessories Extension Cable Type Model Temp probe Length Part No. Reusable MR420 MR411, MR412 3 m 0011-30-90444 Temp Probes Type Model Patient Category Length Measurement Site Part No. YSI 409B 3.5 m Skin 900E-10-04881 YSI 401 3 m Esophageal/Rectal 0509-10-00095 YSI 427 3.5 m Skin 0010-10-12124 Reusable YSI 402 3 m Esophageal/Rectal 6000-10-01969 MR401 3 m Esophageal/Rectal 0011-30-90440 MR403 / 3.6 m Skin 0011-30-90442 MR402 3 m Esophageal/Rectal 0011-30-90441 MR404 3.
ICP Model Material Length Part No.
It is proved through tests that the following accessories are compatible with the patient monitor. Only the accessories proceeded by “*” are available from our company. If you want to purchase other accessories, contact respective manufacturers and make sure if these accessories are approved for sale in local.
20.6 CO Accessories Model Material Length Part No. COC-001-SL 6 Pin C.O. cable. 2.5 m 900E-30-04952 SP4042 IT Sensor / 6000-10-02079 SP5045 IT Sensor Housing / 6000-10-02080 12CC 12CC Control Syringe W/1CC Stop W/Rotator / 6000-10-02081 131HF7 Dilution Hose / 6000-10-02183 93610 CO syringe (93610 'EDWARTDS') / 0010-10-12317 20.7 CO2 Accessories Material Patient Category Remark Length Part No. DRYLINE Watertrap Reusable / 9200-10-10530 DRYLINE Watertrap / 9200-10-10574 Sampling Line 2.
20.9 Others Model Part No. Lead-acid battery M05-302R3R--Chinese power cord 509B-10-05996 U.S. power cord DA8K-10-14452 U.K.
FOR YOUR NOTES 20-8
A Product Specifications A.1 Safety Classifications Type of protection against electric shock Class I with internal electric power supply.
A.3 Power Source Specifications AC mains Input voltage 100 to 240 V Frequency 50/60 Hz Power 140 VA Fuse T 3 A, 250 V Internal battery Number of batteries 1 or 2 Type Sealed lead-acid battery Time to shutdown >5 min (after the first low-power alarm) Sealed lead-acid battery Nominal voltage 12 VDC Capacity 2.3 Ah Operating time 48 minutes or 120 minutes typical when powered by one or two new fully-charged batteries respectively (25., ECG, SpO2, NIBP measurement per 15 minutes).
LED indicator Alarm indicator 1 (yellow and red) Charge indicator 1 (green) Audio indicator Speaker Giving audio alarms (45 to 85 dB), keypad tones, and heartbeat/pulse tone. Supporting PITCH TONE and multi-level volume. Connectors Power supply 1 AC power connector Network 1 standard RJ45 network connector, 100 BASE-TX VGA 1 standard color VGA monitor connector, 15-PIN D-sub Auxiliary output 1 BNC connector Equipotentiality 1 equipotential grounding connector A.
Data rate 802.11g: 802.11b: 6, 9, 12, 18, 24, 36, 48, 54Mbps 1, 2, 5.
A.6 Data Storage Trend data Long trend: 96 hours, resolution 1min, 5 min or 10 min. Short trend: 1 hour, resolution 1 s or 5 s. Alarm events 70 alarm events and associated waveforms (with user selectable waveform length 8s, 16 or 32). ARR events 80 ARR events and associated waveforms with 8s wavelength. NIBP measurements 800 NIBP groups, including systolic pressures, mean pressures, diastolic pressures and measurement time. A.
A.8 ECG Specifications Lead type 3-lead (1 channel): 5-lead (2 channels): I, II, III I, II, III, aVR, aVL, aVF and V Lead naming style AHA, EURO Lead fault The lead resistance is no greater than 51 kO and it is in parallel with a 0.047 µF capacitor, it will not cause a lead fault condition. For 3/5-lead, differential offsets = ±300 mV, it will not cause a lead fault condition. Sensitivity selection 1.25 mm/mV (×0.125), 2.5 mm/mV (×0.25), 5 mm/mV (×0.5), 10 mm/mV (×1), 20 mm/mV (×2) and AUTO Sweep speed 12.
Recovery time after defibrillation < 5s Calibration signal 1 mV (peak-to-peak value), precision: ±5% ESU protection Incision mode: 300W Congelation mode: 100W Restore time: =10s ESU noise control Based on the ECG baseline, the peak noise = 2mV A-5
HR Measurement range Feline: Canine: Other animals: 15 to 350 bpm 15 to 350 bpm 15 to 300 bpm Resolution 1 bpm Precision ±1 bpm or ±1%, whichever is greater. Trigger threshold level 200 µV (lead II) Trigger indication There will be an audible beep on every beat captured.
Pace pulse Pulse indicator Pace pulses meeting the following conditions are marked by the PACE indicator. Amplitude: Width: Rise time: ±4 to ±700 mV 0.1 to 2 ms 10 to 100 µs Pulse rejection The heart rate meter rejects all pulses meeting the following conditions. Amplitude: Width: Rise time: Min. input slew rate: ±2 to ±700 mV 0.1 to 2 ms 10 to 100 µs 20 V/s RTI ST segment measurement Measurement range -2.0 to +2.0 mV Precision -0.8 to +0.8 mV: ±0.
A-7
RR Measurement range Feline, Canine, Other animals: 0 to 150 BrPM Resolution 1 BrPM Precision 7 to 150 BrPM: 0 to 6 BrPM: ±2 BrPM or ±2%, whichever is greater. Undefined. Apnea alarm delay 10 to 40 s A.10 SpO2 Specifications A.10.1 Mindray SpO2 Module SpO2 Measurement range 0 to 100% Resolution 1% Precision 70 to 100%: 70 to 100%: 0% to 69%: ±2 % (non-motion conditions) ±3% (in-motion conditions)* Undefined.
A.
Minimum time for accurate measurement Body surface: < 100s Body cavity: < 80s (YSI 400 series sensor) A-9
A.13 IBP Specifications Number of channels 2 Pressure readings Systolic, diastolic, mean pressures and PR Pressure labels ART, PA, CVP, RAP, LAP, ICP, P1 and P2 Linear input range will be -50 to.300 mmHg, after zeroing. Measurement range ART 0 to 300 mmHg PA -6 to 120 mmHg CVP/RAP/LAP/ICP -10 to 40 mmHg P1/P2 -50 to 300 mmHg Resolution 1 mmHg Precision ±2% or ±1mmHg, whichever is greater Excitation will be 5 Volts DC, ± 2% Minimum load resistance will be 300O per transducer.
A.
A.
Enf, Iso, Hal 0 to 1 ±0.15 1 to 5 ±0.
AwRR 2 to 60 BrPM ±1 BrPM > 60 BrPM Not specified Drift meet the requirement of accurancy in 6 hours Alarm range CO2: AwRR: 0 to 30 % (0 to 228 mmHg) 2 to 100 BrPM Apnea alarm delay AwRR: 20 to 40 s Refreshing rate 1s Calibration Yearly calibration requested. Calibration stability After module being used for 12 consective months, the error is < 1% Rise time (10 % to 90 %) Sampling flow 120ml/min, using the DRYLINE™ water trap and DRYLINE™ sampling line (2.
FOR YOUR NOTES A-14
B EMC The equipment meets the requirements of IEC 60601-1-2:2001. NOTE • Use of accessories, transducers, and cables other than those specified may result in increased emission and/or decreased immunity of the equipment. • The equipment should not be used adjacent to or stacked with other equipment, and if adjacent or stacked use is necessary, the equipment should be observed to verify normal operation in the configuration in which it will be used.
Fluctuations/Flicker Emissions IEC 61000-3-3 Compliance Pst ,Tdt (ms) Dmax(%) Dc (%) B-1
TABLE 2 Guidance and declaration — electromagnetic immunity The equipment is intended for use in the electromagnetic environment specified below. The customer or the user of the equipment should assure that it is used in such an environment. Immunity test IEC 60601 Test level Compliance level Electromagnetic environment — guidance Electrostatic ±6 kV contact ±6 kV contact Floors should be wood, concrete Discharge (ESD) ±8 kV air ±8 kV air or ceramic tile.
magnetic field of a typical location in a typical IEC 61000-4-8 commercial or hospital environment. UT is the A.C. mains voltage prior to application of the test level.
TABLE 3 Guidance and declaration — electromagnetic immunity The equipment is intended for use in the electromagnetic environment specified below.
applicable RF compliance level above, the equipment should be observed to verify normal operation. If abnormal performance is observed, additional measures may be necessary, such as reorienting or relocating the equipment. b Over the frequency ranges 150kHz to 80MHz, field strengths should be less than 3V/m.
TABLE 4 Recommended separation distances between portable and mobile RF communication and the equipment The equipment is intended for use in an electromagnetic environment in which radiated RF disturbance are controlled.
C Alarm Messages and Prompt Information NOTE • Your patient monitor may not include all the information listed in this section. C.1 Physiological Alarm Messages Note: XX represents the parameters being monitored, such as HR, RR, SpO2, etc. The “L” field indicates the alarm level, and 1 means high, 2 means medium, 3 mean low, * means the level is user-adjustable. Alarm messages L Cause Measure XX TOO HIGH 2* XX value exceeds the upper alarm limit.
C-1
PVC 2* The PVC arrhythmia event occurs to the patient. BIGEMINY 2* The bigeminy arrhythmia event occurs to the patient. TRIGEMINY 2* The trigeminy arrhythmia event occurs to the patient. TACHY 2* The patient is suffering from tachycardia. BRADY 2* The patient is suffering from bradycardia. PNC 2* No pacer signal is captured. PNP 2* The pacemaker is not paced. MISSED BEATS 2* The arrhythmia event of missed beats occurs to the patient. IRREG RHYTHM 2* Irregular rhythm occurs to the patient.
repair. XX EXCEED No No 1 The measured XX parameter value exceeds the measurement range.
C.2.2 ECG Module Alarm Messages Alarm message A B L Cause Measure ECG LEAD OFF No Yes 3 The ECG lead is not connected correctly. Check for correct connection of the leadwires. ECG X LEAD OFF No Yes 3 Note: X represents the leadwires, V, LL, RL, LA and RA, as per AHA standard, or C, L, F, R and N as per IEC standard. ECG NOISE No No 3 Large interference signals appear on the ECG signal. Make sure the leadwires are correctly connected. Check the patient for severe motion.
Weak No No 1 The ECG signal is too weak to be detected. Select a lead with better ECG signal output. Check the placement of the electrode or replace the leadwire. C.2.3 RESP Module Alarm Messages Alarm message A B L Cause Measure RESP DISTURBED No No 3 The module circuit is disturbed. If the problem occurs continuously, restart the monitor. If it still exits, contact our company for repair. RR EXCEED No No 1 The circuit is disturbed and the measurement is inaccurate.
C.2.4 TEMP Module Alarm Messages Alarm message A B L Cause Measure TEMP1 No Yes 3 The T1 sensor is not Check for correct SENSOR OFF connected correctly to the connection of the T1 patient or the monitor. sensor. TEMP2 No Yes 3 The T2 sensor is not Check for correct SENSOR OFF connected correctly to the connection of the T2 patient or the monitor. sensor. TEMP No No 1 Circuit fault of the Contact our company for SELFTEST temperature channel. repair.
SATUATED No Yes 3 RANGE EXCEEDED No Yes 3 Check the patient’s condition, and check if the patient type is correct. Replace with a EXCESSIVE MOTION No Yes 3 Excessive motion of the patient’s arms.
Alarm message A B L Cause Measure OVER PRESSURE No Yes 2 The airway might be blocked. proper cuff and connect it correctly. If the problem still exists, NIBP SYSTEM No Yes 2 Failure occurs in the pulse FAILURE measurement. The monitor cannot perform measurement, analysis, or calculation. contact our company for repair.NIBP TIME OUT No Yes 2 MEASURE FAIL No Yes 2 NIBP ILLEGALLY No Yes 2 Illegal reset comes out during the NIBP measurement. Check if the airway is blocked.
attention to the mark on the probe. SPO2 LOW No No 3 The pulse signal is too Move the sensor to a site PERFUSION weak. with better perfusion.
C.2.7 Nellcor SpO2 Module Alarm Messages Alarm message A B L Cause Measure SPO2 SENSOR OFF No Yes 3 The sensor is disconnected from the patient or the monitor. Make sure the sensor is placed on the patient’s finger or other parts, and the monitor is connected to cables correctly. SPO2 NO SENSOR Yes Yes 3 The sensor is disconnected from the patient or the monitor, or the sensor is not connected properly. Disconnect and reconnect the sensor as directed by the instructions.
PULSE No No 3 The detected pulse signal is too weak. C.2.8 IBP Module Alarm Messages Alarm message A B L Cause Measure IBP1 SENSOR No Yes 3 The invasive blood pressure Check if the IBP 1 sensor OFF cable of channel 1 is is properly connected. disconnected from the monitor. IBP2 SENSOR No Yes 3 The invasive blood pressure Check if the IBP 2 sensor OFF cable of channel 2 is is properly connected. disconnected from the monitor.
IBP2 NEED ZERO-CAL No No 3 The IBP transducer of channel 2 has not been zeroed. Zero the IBP transducer of channel 2. C.2.9 CO Module Alarm Messages Alarm message A B L Cause Measure TB SENSOR OFF No Yes 3 The cable for blood pressure measurement is disconnected from the monitor. Check for proper connection of TB cable. C.2.10 Sidestream CO2 Module Alarm Messages Alarm message A B L Cause Measure CO2 NO WATERTRAP No No 2 The water trap is not properly connected or is disconnected.
CO2 BAROMETRIC TOO HIGH No No 2 The barometric pressure is too high. CO2 BAROMETRIC TOO LOW No No 2 The barometric pressure is too low. CO2 HARDWARE ERROR No No 1 AD sampling 2.5V error CO2 HARDWARE ERROR No No 1 The pump malfunctions.
Alarm message A B L Cause Measure CO2 HARDWARE ERROR No No 1 The 3-way stopcock malfunctions. CO2 SAMPLE LINE ABNORMAL No No 2 The sample line is abnormal or blocked. Make sure the airway is not blocked. If the problem still exists, contact our company for repair. CO2 CALIBRATE ZERO ERROR No No 1 Zeroing failure. Restart the monitor. If the problem still exists, contact our company for repair. CO2 USER CALIBRATE FAIL No No 2 User calibration failure.
error. CO2 SYSTEM ERROR No No 1 Internal AD sample line error. CO2 SYSTEM ERROR No No 1 Self-test error CO2 COMM ERROR Yes No 1 CO2 module communication fault. Restart the monitor. If the problem still exists, contact our company for repair. CO2 INIT ERR Yes No 1 The CO2 module is not properly installed, or malfunctions. CO2 COMM STOP No No 1 CO2 module fault or communication fault.
C.2.11 AG Module Alarm Messages Alarm message A B L Cause Measure AG SENSOR OFF No Yes 3 The AG sensor is not properly connected or is disconnected. Make sure the AG sensor is properly connected. AG NO WATERTRAP No Yes 3 The AG water trap is disconnected from the monitor. Make sure the water trap is properly connected. CHANGE AG WATERTRAP Yes No 2 The AG water trap is replaced. Wait until the water trap has been changed. AG WATERTRAP TYPE WRONG Yes No 2 The AG water trap is of a wrong type.
with the host. Unplug and re-plug the module and then restart the monitor, or plug the AG module in another monitor to check if it operates properly. AG HARDWARE MALF No No 1 AG module hardware failure. The module enters the standby mode or stop AG monitoring. Remove the AG module from the monitor and send for authorized maintenance personnel.
AG HARDWARE ERROR Yes No 2 AG module hardware fault. The module remains AG monitoring. Unplug and re-plug the module and then restart the monitor. AG DATA LIMIT ERROR Yes No 2 AG module fault. AG ZREF FAIL Yes No 3 Failure in AG module zeroing. AG CAL FAIL Yes No 1 Failure in AG module calibration. CO2 ACCURACY UNSEPCIFIED Yes No 3 The measurement is out of specified range at specified accuracy. Check that appropriate gas is used and the clinical environment is stable.
AwRR ACCURACY UNSEPCIFIED Yes No 3 C-10
C.2.12 Recorder Module Alarm Messages Alarm message A B L Cause Measure RECORDER INIT ERR N Yes No 2 An error occurs during the recorder initialization. Contact the hospital’s engineers or our customer Service. Note: N represents the error number. RECORDER SELFTEST ERR Yes No 2 An error might occur to the RAM, ROM and CPU watchdog. Open the RECORD menu and select the CLEAR REC TASK option. If the problem remains, contact our company for repair. RECORDER VLT HIGH No No 1 A problem occurs to the system power.
OUT OF PAPER Yes Yes 3 The recorder paper is used up. Replace with a new paper roll. RECORDER PAPER JAM No No 2 The recording continues for more than 30 minutes. Place the recorder correctly and try again. RECORDER COMM ERR Yes No 2 Error in recorder communication. Open the RECORD menu and select the CLEAR REC TASK option. If the problem remains, contact our company for repair. TOO MANY REC TASKS No No 2 Quite a few alarm events occur at the same time. Check the patient’s condition and the alarms.
Alarm message A B L Cause Measure RECORDER PAPER W.P. Yes Yes 2 The paper roll of the recorder is not placed in the correct position. Place the paper roll correctly. RECORDER S. COMM ERR Yes No 2 Error in recorder communication. Open the RECORD menu and select the CLEAR REC TASK option. If the problem remains, contact our company for repair. REC NOT AVAILABLE No No 2 Error in the recorder work mode. C.2.
due to problems in the monitor’s network part. NET INIT ERR (Ram) No No 2 NET INIT ERR (Reg) No No 2 NET ERR (Run 1) No No 2 NET ERR (Run 2) No No 2 12V TOO HIGH No No 1 A problem occurs to the system power. If this alarm message is given for many times, contact our company for repair. 12V TOO LOW No No 1 BATTERY TOO LOW No No 1 The battery voltage is too low. Connect the monitor with AC power to recharge the battery.
C.3 Prompt Messages Prompt messages Cause Measure ECG1 SIGNAL SATURATION Signals of abrupt change interfere with the ECG signal. Check whether the electrodes and leads are well connected. ECG2 SIGNAL SATURATION SEARCH PULSE The SpO2 module is searching the pulse. Wait till the end of the searching. DOMINANT RHYTHM CHANGE A change happens to the patient’s dominant rhythm. None.
AG module AG STANDBY The AG module is in the standby mode. None AG IS STARTING The AG module is starting. Wait for the AG module to finish the startup. AG WARM UP The AG module is warming itself up. Wait for the AG module to finish warming itself up. NIBP module Manual measure... The NIBP module is performing the manual measurement. Wait for the NIBP module to finish the measurement. CONTINUAL... The NIBP module is performing the continuous measurement. Auto measuring...
C-14
D Symbols and Abbreviations Symbols and abbreviations that you may encounter while reading this manual or using the monitor are listed below with their meanings. D.1 Symbols A Ah bpm BrPM . cc cm dB DS .
centigrade cubic centimeter centimeter decibel dyne second fahrenheit gram gutta hour hundred pascal hertz inch kilogram kilopascal litre pound meter micrograms milli-equivalents milligrams minute milliliter millimeters millimeters of mercury D-1
ms millisecond mV millivolt mW milliwatt nm nanometer ppm part per million s second V volt VA volt ampere . ohm µA microampere µm micron µV microvolt W watt -minus % percent / per; divide; or ^ power + plus = equal to < less than > greater than = less than or equal to = greater than or equal to ± plus or minus × multiply © copyright D.
aVF left foot augmented lead aVL left arm augmented lead aVR right arm augmented lead AwRR Air way respiratory rate BSA body surface area BTPS body temperature and pressure, saturated CCU critical care unit CH channel cardiac index CISPR International Special Committee on Radio Interference CMS central monitoring system cmos Complementary Metal Oxide Semiconductor CO cardiac output CO2 carbon dioxide COHb carboxyhemoglobin CPU central processing unit CVP central venous pressure D
diastolic DC direct current DES desflurane DIA diastolic e.g.
IBP invasive brood pressure ICP intracranial pressure ICT/B intracranial catheter tip pressure transducer IEC International Electrotechnical Commission ID invasive diastolic brood pressure IM invasive mean brood pressure IS invasive systolic brood pressure Ins, INS Inspired Minimum InsCO2 Inspired Minimum carbon dioxide ISO isoflurane ISO International organization for standardization LA (L) left arm LAP left atrial pressure LCD liquid crystal display LED light emitting diode LL (F) left leg Loop loop read-
Reg test NE2000 registers fail RESP respiration RL (N) right leg ROM read-only memory RR respiration rate S systolic SEV sevoflurane SpO2 arterial oxygen saturation from pulse oximetry SYNC synchronization SYS systolic T1 temperature of channel 1 T2 temperature of channel 2 TB temperature of blood TD temperature difference TEMP temperature TFT Thin-Film Technology TI Temperature of Injectate VGA Video Graphic Array WT weight D-5
PN: 9102-20-30580 (1.
