Acuity and Mobile Acuity LT Central Monitoring Systems ® Directions for use Software version 8.
ii Welch Allyn Acuity Central Monitoring System © 2013 Welch Allyn. All rights are reserved. To support the intended use of the product described in this publication, the purchaser of the product is permitted to copy this publication, for internal distribution only, from the media provided by Welch Allyn. No other use, reproduction, or distribution of this publication, or any part of it, is permitted without written permission from Welch Allyn. Welch Allyn FOSS.
iii Contents 1 - General information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Indications for use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 General description. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Conventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 General warnings and cautions. . . . . .
iv Contents Welch Allyn Acuity Central Monitoring System 7 - Move a monitored patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125 Move the patient and monitor to a new location . . . . . . . . . . . . . . . . . . . . . . . 125 Move the patient to a different monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 8 - Discontinue Acuity System monitoring . . . . . . . . . . . . . . . . . . . . 133 Stop monitoring a patient . . . . . . . . . . . . . . . . . . . . . .
1 1 General information Indications for use The Acuity® Central Monitoring Station is intended to be used by clinicians for the central monitoring of neonatal, pediatric, and adult patients in health care facilities. In addition to the central monitoring of patient data, waveforms, alarms and alerts, the Acuity software can include operational modules to provide extended recording of patient data (Full Disclosure), arrhythmia monitoring and ST analysis.
2 Chapter 1 General information Welch Allyn Acuity Central Monitoring System Acuity System software further processes data acquired from patient monitors. Acuity Systems with the Arrhythmia Analysis module calculate heart rate using multiple ECG leads and arrhythmia analysis algorithms. The Acuity System is not directly connected to patients. It is designed to be used as a central monitoring system for a set of patient monitors that support both continuously and intermittently acquired data.
Directions for use Chapter 1 General information 3 General warnings and cautions Warnings Related to system components and configuration WARNING Use only accessories approved by Welch Allyn. The use of any other accessories can result in inaccurate patient data, can damage the equipment, and can void your product warranty. See the accessory list or visit www.welchallyn.com. WARNING Always use accessories according to the standards of your facility and according to the manufacturer's directions.
4 Chapter 1 General information Welch Allyn Acuity Central Monitoring System WARNING Ensure that the volume level on your computer is not set too low or is not set to mute as this may cause you to miss audible alarms generated from the Acuity System. WARNING Replace central station hardware within the the lesser of 3 years or the original equipment manufacturer’s specification. Failure to perform preventative maintenance can impact system performance and availability.
Directions for use Chapter 1 General information 5 WARNING Do not use the Arrhythmia Analysis or ST Analysis feature on neonates. The Arrhythmia Analysis and ST Analysis options are not intended for use with neonatal patients. WARNING Keep all pacemaker patients under close observation. Rate meters might continue to count the pacemaker rate during occurrences of cardiac arrest or some arrhythmias. Do not rely solely upon rate meter alarms.
6 Chapter 1 General information Welch Allyn Acuity Central Monitoring System WARNING Whenever an interruption in Acuity System CPU operation occurs, please contact Welch Allyn Technical Service soon to ensure that your entire system has returned to normal operating condition and that it does not require further service. WARNING Auto-reboots can occur during internal software checks, and wireless connection can be occasionally disrupted.
Directions for use Chapter 1 General information Acuity System compliance with safety standards The CE Mark and Notified Body Registration Number signify that the product meets all essential requirements of European Medical Device Directive 93/42/EEC. Table 1.
8 Chapter 1 General information Welch Allyn Acuity Central Monitoring System Related documents Acuity and Mobile Acuity LT Central Monitoring Systems Directions for use Acuity and Mobile Acuity LT Central Monitoring Systems directions for use and in-service guide CD-ROM (multilanguage) Acuity and Mobile Acuity LT Central Monitoring Systems directions for use Acuity Central Monitoring System in-service guide (English) Mobile Acuity LT installation guide (printed) Mobile Acuity LT System installation guide
9 2 Acuity System overview System configurations Acuity Central Monitoring System Mobile Acuity LT System The Acuity System consists of an Acuity Central Station that receives, displays and analyzes information from various wireless and hardwired monitoring devices. Mobile Acuity LT Central Stations are laptop computers. Some Acuity Systems can send patient data to Internet browsers and hospital information systems (HISs) via the optional Welch Allyn Connectivity Server (WACS).
10 Chapter 2 Acuity System overview Welch Allyn Acuity Central Monitoring System Diagram of the System B A C D K E F L J G H I A. Hallway message panel Optional panels, located throughout a unit, visually indicate alarms and some alerts. B. Welch Allyn 1500 Patient Monitor Hardwired, full-featured monitors with 12-lead ECG analysis and large displays C. Propaq Encore monitor Hardwired, portable, full-featured vital-sign monitors D.
Directions for use Chapter 2 Acuity System overview 11 Networked Acuity System features Networked Acuity Systems include various features. This section presents these network features: • Remote Patient List Review (PLR) station • Paired system CPUs (high-availability pairs) Remote Patient List Review (PLR) station Networked Acuity System with a remote Patient List Review (PLR) station Some networked Acuity Systems include one or more remote Patient List Review stations.
12 Chapter 2 Acuity System overview Welch Allyn Acuity Central Monitoring System To open a Waveform Window on a PLR station screen PLR stations are typically part of an extended Acuity System network. To open a patient’s Waveform Window from a PLR station, first locate the patient via the Patient List, and then open the patient’s Waveform Window. 1. In the lower left corner of the Acuity Central Station screen, click . The Patient List window appears. 2. Scroll the patient list.
Directions for use Chapter 2 Acuity System overview 13 Flexible patient access (FPA) using virtual network computing (VNC) Note The FPA using VNC configuration is a licensable feature. To order this feature, contact your Welch Allyn sales representative (see page ii). The flexible patient access option allows you to connect to a Patient List Remote using a VNC connection. Each purchased VNC license allows one VNC client to view real-time and full-disclosure data on monitored patients.
14 Chapter 2 Acuity System overview Welch Allyn Acuity Central Monitoring System 4. Enter your VNC client password. If you are using the VNC Enterprise Edition Server, enter your user name and password. 5. Press OK. The Remote Patient List Review window appears. For more information see “Remote Patient List Review (PLR) station” on page 11. Note FPA connections are not shared between individual client connections. The Acuity Central Station allows only one client to connect to each display session.
Directions for use Chapter 2 Acuity System overview 15 Paired system CPUs (High-availability pairs) and switchovers Acuity Systems that typically support at least 29 patients include a high availability (HA) central processing unit (CPU). The HA CPU is a redundant Acuity System CPU. An HA CPU assumes control if the Acuity System CPU’s operation is interrupted. An HA CPU “switchover” occurs to ensure minimal loss of Acuity Central Station monitoring capability.
16 Chapter 2 Acuity System overview Welch Allyn Acuity Central Monitoring System Central station screen Note Depending upon the default screen color scheme of your Acuity Central Station (black-on-white or color-on-black), your screen colors may not match those shown in this manual. Depending upon the selected screen view, the Acuity Central Station screen can include these areas: • Map area • Virtual Monitor • Utility space • Waveform Windows area E. Virtual Monitor F. Screen view buttons G.
Directions for use Chapter 2 Acuity System overview 17 F. Screen view buttons Change the overall Acuity System screen view. They vary in appearance according to your system configuration. G. Message window Displays the date and time or the location of alarms and alerts. It matches (optional) hallway message panel messages. Note Welch Allyn Acuity Systems communicate with some patient monitors that include Masimo® Corporation SpO2 measurement capabilities.
18 Chapter 2 Acuity System overview Welch Allyn Acuity Central Monitoring System System screen views You can change the screen view of the Acuity Central Station display by clicking these buttons along the top left of the Acuity Central Station screen. Your system includes some or all of these choices. If your system includes multiple screens, the additional screens show Waveform Windows or Virtual Monitors. Button Description Expands the map to cover most of the Acuity Central Station screen.
Directions for use Chapter 2 Acuity System overview 19 System buttons The system buttons in the lower left corner of the Acuity Central Station screen provide quick access to frequently used system-wide functions. The Patient List button opens the Patient List window, which enables you to preadmit, readmit, transfer, and discharge patients in your Acuity System. You can also view and print stored waveforms and trends of patients who have not been monitored by the Acuity System for (up to) 96 hours.
20 Chapter 2 Acuity System overview Welch Allyn Acuity Central Monitoring System Central station map and status icons Your system includes a map that is similar to one of these examples. An Acuity Central Station map shows status icons for these things: • System components • Each patient monitor (and associated patient) that is communicating with the Acuity System For a complete description of all Acuity status icons, see “Status icons” on page 137. Wireless Monitor: F. Room assigned G.
Directions for use Chapter 2 Acuity System overview 21 D. Patient/monitor status icon Icons appear at locations with active monitors. Click a map icon once to open the patient’s Waveform Window or twice to open the Virtual Monitor. For details about all map icons, see “Patient/monitor status icons” on page 138. E. Inactive Acuity System location No hardwired monitor is connected to this Acuity System port, or no wireless monitor has been assigned to this location. Wireless Monitor: F.
22 Chapter 2 Acuity System overview Welch Allyn Acuity Central Monitoring System Waveform Window A Waveform Window is an abbreviated Virtual Monitor. E. ECG lead F. Note G. Patient mode/alarm and alert messages A. Alarm limits D. Patient/monitor status icon C. Snapshot printing area B. Vital-sign values A. Alarm limits Alarm limit settings B. Vital-sign values Vital signs in alarm are shown by numbers in a red field. Click in this area to suspend or resume an audible alarm tone.
Directions for use Chapter 2 Acuity System overview 23 Virtual Monitor An Acuity System Virtual Monitor represents a patient monitor and the information obtained from the monitor. The appearance and button sequences can differ from the actual patient monitor. Options or monitor functions that are not available are shown in faint gray type. H. ECG lead I. Color indicates status. A. CO2, IPI B. Bells G. Waveforms C. Numerics D. Buttons F. Patient/ monitor status icon E. Patient mode/ messages A.
24 Chapter 2 Acuity System overview Welch Allyn Acuity Central Monitoring System H. ECG lead The adjacent waveform is derived from this ECG lead. If you want to review waveforms from all leads, click Review, Waveforms to open the Waveforms Review window. I. Color indicates status.
25 3 Admit and begin monitoring Preadmit a patient to Acuity System monitoring If you know a patient’s ID number before the patient is admitted, you can save time that would be spent later by preadmitting the patient at the Acuity Central Station. When a preadmitted patient arrives: • If the patient is connected to a wireless monitor, at the patient monitor you can simply confirm the patient ID and add a room number.
26 Chapter 3 Admit and begin monitoring Welch Allyn Acuity Central Monitoring System To assign a room number for a preadmitted patient, via the Patient List 1. In the lower left corner of the Acuity Central Station screen, click The Patient List window appears. 2. Select the patient’s name. 3. Click Transfer. The Transfer Patient window appears. 4. Click a unit name in the list. 5. Click a room. 6. Click Confirm. The information is stored. .
Directions for use Chapter 3 Admit and begin monitoring 27 Readmit a discharged patient You can readmit a patient to the Acuity System if the patient’s name still remains in the Patient List. If a patient has been discharged from the Acuity System, but the system still holds the patient’s data, the patient remains in the list. The Acuity System stores patient data for 24 to 96 hours after monitoring stops. To readmit a discharged patient 1.
28 Chapter 3 Admit and begin monitoring Welch Allyn Acuity Central Monitoring System Begin patient monitor communication with the system For information about patient monitors that are part of your Acuity System but are not shown in this chapter, consult the patient monitor manufacturer’s literature. Connect a hardwired monitor to the system To connect the monitor to the system 1. Connect the Acuity System network cable. a.
Directions for use Chapter 3 Admit and begin monitoring 29 3. Attach the cables to the monitor last, to optimize waveform interpretation during the initial Acuity System learning phase. To respond to the CONFIRM PATIENT? prompt 1. If you see the CONFIRM PATIENT? prompt, respond as follows: WARNING Carefully verify the patient’s ID and name before you respond to the CONFIRM PATIENT? prompt.
30 Chapter 3 Admit and begin monitoring Welch Allyn Acuity Central Monitoring System At the central station, the patient map icon remains in the yellow ID or RM unconfirmed state until the ID and room are confirmed. To enter patient information 1. Verify that the patient mode matches the monitored patient’s age (Adult, Pediatric or Neonate). • For a Propaq CS monitor: If the mode shown at the top of the screen is incorrect, touch SETUP, MORE, CHANGE, and then touch the appropriate mode.
Directions for use Chapter 3 Admit and begin monitoring 31 Start communication between a wireless monitor and the system For information about patient monitors that are part of your Acuity System but are not shown in this chapter, consult the patient monitor manufacturer’s literature. Note If a wireless patient monitor operates outside of its wireless communication area, the monitor aggressively searches for connection with the central station and depletes its battery life at a faster rate.
32 Chapter 3 Admit and begin monitoring Welch Allyn Acuity Central Monitoring System To enter patient information 1. If prompted, press to highlight the unit in which the patient will be monitored, and then press to select it. If the keys are locked, simultaneously hold down and to release the menus. 2. Scroll the patient list, and take one of these steps: • If you see the patient’s ID/name, select it, and then select the patient’s room number. The patient is confirmed at the Acuity Central Station.
Directions for use Chapter 3 Admit and begin monitoring 33 Propaq LT monitor To start Propaq LT monitor communication with the Acuity System and connect the patient to the monitor 1. Use a Propaq LT monitor that is designated for use within the Acuity System network in which the patient will be monitored. 2. Turn on the monitor. 3. In the top right area of the Propaq LT monitor screen, verify that the battery icon is green, which indicates that the battery is fully charged.
34 Chapter 3 Admit and begin monitoring Welch Allyn Acuity Central Monitoring System To enter patient information 1. Specify whether existing patient data will be saved. • If the patient matches the name on the Propaq LT monitor screen, press an arrow key to highlight Continue Patient, and then press to select it. The patient’s data is saved and a unit list appears.
Directions for use Chapter 3 Admit and begin monitoring 35 Wireless Propaq CS monitor To start wireless Propaq CS monitor communication with the system 1. Use a Propaq CS monitor that is designated for use within the Acuity System network in which the patient will be monitored. 2. Verify that the Acuity System network cable is not plugged into the Acuity System network connector on the monitor. 3.
36 Chapter 3 Admit and begin monitoring Welch Allyn Acuity Central Monitoring System To enter patient information 1. If you see the CONFIRM PATIENT? prompt, follow the prompts. For instructions, see “To respond to the CONFIRM PATIENT? prompt” on page 29 2. If the monitor displays a choice of units, scroll to highlight the unit in which the patient will be monitored, and then touch Select. A patient list appears. 3.
Directions for use Chapter 3 Admit and begin monitoring 37 Important considerations: connecting a monitor to the Acuity System Related to specific patient populations WARNING Always check patient mode in the border of the Waveform Window or Virtual Monitor. Incorrect patient mode can result in unsuitable alarm settings, inaccurate heart rate readings and inappropriate arrhythmia and ST-segment analyses.
38 Chapter 3 Admit and begin monitoring Welch Allyn Acuity Central Monitoring System Related to leads, cables and the ECG display WARNING Ensure that the Acuity System network cable is neither damaged nor broken. An Acuity System cable is the sole link between a hardwired monitor and an Acuity System. WARNING Always replace disconnected lead wires immediately. If a lead wire becomes disconnected and a second lead is not available, the Virtual Monitor might show the same lead for ECG1 and ECG2.
Directions for use Chapter 3 Admit and begin monitoring 39 WARNING Ensure these things to minimize false HR, Arrhythmia Analysis and ST Analysis alarms, and to achieve optimal event detection and analysis: • ECG cable, lead wires and electrodes are undamaged. • Patient’s skin is properly prepared. • Electrodes are placed using standard good practices. • 5-wire ECG cable is used.
40 Chapter 3 Admit and begin monitoring Welch Allyn Acuity Central Monitoring System Enter and confirm a patient’s ID or room at the central station A patient’s Acuity System window borders and icons are in a yellow (alert) state if the patient’s ID and room number have not been confirmed. You can scan or type missing patient information and confirm the information at the central station in the Patient ID Setup window.
Directions for use Chapter 3 Admit and begin monitoring 41 7. Click Next Page to enter additional patient demographics such as date of birth, gender, height, weight, ethnicity, and medications. The second page of the Patient ID setup window appears. Patient ID window 2 To confirm the patient 1. Carefully review your entries for accuracy. 2. Click Confirm.
42 Chapter 3 Admit and begin monitoring Welch Allyn Acuity Central Monitoring System
43 4 Adjust monitoring settings and patient information Set up typical monitoring at the Virtual Monitor This table presents typical monitoring functions that you can set up at the Acuity Central Station using the Virtual Monitor. Note When a patient is intentionally disconnected from the central station, or a patient connected to the Welch Allyn 1500 Patient Monitor is in Standby mode, the patient’s waveform display resets to the default view when reconnected to the central station. Table 2.
44 Chapter 4 Adjust monitoring settings and patient information Welch Allyn Acuity Central Monitoring System Table 2. Typical monitoring functions at the Virtual Monitor Response time: SpO2 and CO2 Task Clicks at Virtual Monitor Notes (Propaq Encore and CS monitors) Set SpO2 response time. 1. 2. 3. 4. SpO2 or SpO2/CO2 SpO2 MORE RESPONSE Can be changed also at the patient monitor. (Propaq Encore and CS monitors) Set CO2 response time. 1. 2. 3. 4.
Directions for use Chapter 4 Adjust monitoring settings and patient information 45 Table 2. Typical monitoring functions at the Virtual Monitor Lead selection: ECG and respiration Task Clicks at Virtual Monitor Notes Change the RESP lead. 1. ECG/RESP 2. MORE 3. RESP LEAD Lead indicators are shown in the respiration waveform areas of the Virtual Monitor and Waveform Window. Select or change ECG lead for display. 1. ECG or ECG/RESP 2. ECG1 LEAD 3.
46 Chapter 4 Adjust monitoring settings and patient information Welch Allyn Acuity Central Monitoring System Adjust a patient’s alarm limits In the Alarms Setup window, you can adjust a patient’s alarm limits individually or as a group. WARNING Before you set customized alarm limits for a patient, confirm the patient’s ID and room number. Otherwise, customized limits might be lost. To adjust a patient’s alarm limits 1. In the patient’s Virtual Monitor, click Setup, Alarms.
Directions for use Chapter 4 Adjust monitoring settings and patient information 47 Important considerations: adjusting alarm limits WARNING Patients for whom alarming has been turned off must be kept under close physical surveillance. Turning off alarming disables both audio and visual alarm indicators. WARNING Do not use Stat Set or Auto Set for a patient in an alarm state! Use these buttons only when your patient’s vital sign values are in an acceptable range.
48 Chapter 4 Adjust monitoring settings and patient information Welch Allyn Acuity Central Monitoring System Adjust general printing settings This section presents information about these tasks: • Setting preferences for a patient’s Acuity Central Station vital-signs printouts. • Coordinating printers and print jobs for the entire Acuity System.
Directions for use Chapter 4 Adjust monitoring settings and patient information 49 Adjust preferences for a patient’s central station printouts This section presents the Printouts Setup window, in which you can specify details regarding automatic central station printouts. To adjust preferences for a patient’s printouts 1. In the patient’s Virtual Monitor, click Setup, Printouts. The Printouts Setup window appears. Prints a Snapshot printout at the Acuity Central Station.
50 Chapter 4 Adjust monitoring settings and patient information Welch Allyn Acuity Central Monitoring System Coordinate system print jobs and central station printers This section presents the Acuity Central Station Printer window, from which you can coordinate printers and pending print jobs for the entire Acuity System. To coordinate print jobs 1. On the Acuity Central Station map where the Acuity Central Station icon is located, click .
Directions for use Chapter 4 Adjust monitoring settings and patient information 51 Adjust a patient’s waveform displays You can select waveforms for display in a patient’s Virtual Monitor and Waveform Window. Note Only three waveforms can be displayed at a time in the Virtual Monitor. These waveforms are displayed based on their priority. Make sure you turn off all waveforms you do not want displayed. For a list of waveform priorities, see “Virtual Monitor” on page 189 or “Waveform Window” on page 190.
52 Chapter 4 Adjust monitoring settings and patient information Welch Allyn Acuity Central Monitoring System Arrhythmia Analysis option The Acuity System Arrhythmia Analysis module analyzes patient ECG data to detect specific changes in cardiac rhythms. The system uses up to three ECG leads to detect normal beats, ventricular beats and to analyze arrhythmias. The Arrhythmia Analysis options are not intended for use on neonatal patients, and arrhythmia analysis is disabled in the Neonate mode.
Directions for use Chapter 4 Adjust monitoring settings and patient information 53 relearn. An Arrhythmia Analysis function that causes the Acuity system to relearn a patient’s normal ECG rhythm. The Acuity System uses the relearned rhythm as a guideline to identify arrhythmia events (arrhythmia relearn) and to analyze deviation of the ECG ST-segment offset (ST relearn).
54 Chapter 4 Adjust monitoring settings and patient information Welch Allyn Acuity Central Monitoring System Arrhythmia event definitions The Acuity System Arrhythmia Analysis module is not an atrial arrhythmia analysis package. Depending upon which arrhythmia analysis option that your Acuity System includes, your system detects one of these groups of arrhythmia types: • Lethal Arrhythmia Analysis option: The system detects only lethal arrhythmias (VFib, asystole and VTach).
Directions for use Chapter 4 Adjust monitoring settings and patient information Lethal Arrhythmia Analysis option: events detected Table 4. Definitions of lethal arrhythmia eventsa Arrhythmia event and definition Waveform example VFib b(ventricular fibrillation) Chaotic quivering of the ventricles accompanied by rapid irregular waves but no formed QRS complexes. Asystole Absence of any detected beat for 4 or more seconds.
56 Chapter 4 Adjust monitoring settings and patient information Welch Allyn Acuity Central Monitoring System Full Arrhythmia Analysis option: additional events detected Table 5. Full Arrhythmia Analysis option: events detected in addition to lethal events Arrhythmia event and definition PVC run (ventricular run) A run of three to six consecutive, premature ventricular beats that meets or exceeds the patient’s VTach alarm limit.
Directions for use Chapter 4 Adjust monitoring settings and patient information Table 5. Full Arrhythmia Analysis option: events detected in addition to lethal events Arrhythmia event and definition Bradycardia A HR less than or equal to the patient’s bradycardia alarm limit. If the bradycardia limit is increased past the HR low limit, the HR low limit will increase to a value equal to the bradycardia limit. Pause The R-to-R interval that is greater than or equal to two times the average R-to-R.
58 Chapter 4 Adjust monitoring settings and patient information Welch Allyn Acuity Central Monitoring System Open an Arrhythmia Alarms Setup window In the Arrhythmia Alarms Setup window, you can adjust some or all these preferences for a patient, depending on your Arrhythmia Analysis option: • Turn off alarming for all arrhythmia types except the lethal arrhythmias (VFib, asystole and VTach). • Adjust alarm limits for one arrhythmia type at a time or set all arrhythmia limits to Presets values.
Directions for use Chapter 4 Adjust monitoring settings and patient information 59 Turn off alarming for all arrhythmia types except lethal arrhythmias WARNING Turning off alarming for arrhythmia types and ST Analysis disables both audio and visual alarm indicators. Although alarming for lethal arrhythmias cannot be turned off, patients susceptible to arrhythmias must be kept under close physical surveillance if their alarming has been turned off for any arrhythmia types.
60 Chapter 4 Adjust monitoring settings and patient information Welch Allyn Acuity Central Monitoring System Adjust a patient’s arrhythmia alarm limits WARNING If you set the bradycardia alarm limit higher than the HR lower limit, the Acuity System adjusts the HR lower limit to the new bradycardia limit. If you set the tachycardia limit lower than the HR upper limit, the Acuity System sets the HR upper limit to the new tachycardia limit.
Directions for use Chapter 4 Adjust monitoring settings and patient information 61 Adjust preferences for a patient’s arrhythmia alarming To adjust preferences for a patient’s arrhythmia alarming 1. In the patient’s Virtual Monitor, click Setup, Arrhythmia Alarms. Single ECG enables you to select one lead for arrhythmia analysis. This is useful if false alarms occur because of a patient’s unique beat morphology. For details, see Table 14 on page 156.
62 Chapter 4 Adjust monitoring settings and patient information • Welch Allyn Acuity Central Monitoring System Print on Alarm: To specify that central station alarm printouts occur for a specific arrhythmia type alarm, check the Print on Alarm box next to the arrhythmia type. 3. If the patient has a pacemaker, see “To set additional arrhythmia analysis preferences for a pacemaker patient” on page 62.
Directions for use Chapter 4 Adjust monitoring settings and patient information 63 Initiate relearn of a patient’s ECG rhythm Description of the relearn function Relearn is an Arrhythmia Analysis function that causes the Acuity system to relearn a patient’s normal ECG rhythm. The Acuity System uses the relearned rhythm as a guideline to identify arrhythmia events (arrhythmia relearn) and to analyze deviation of the ECG ST-segment offset (ST relearn).
64 Chapter 4 Adjust monitoring settings and patient information Welch Allyn Acuity Central Monitoring System . WARNING In Acuity Systems that include an Arrhythmia option, a relearn function causes the system to learn a patient's normal ECG rhythm. If the system learns an abnormal rhythm or learns a rhythm during noise, it designates the learned rhythm as a normal. Thereafter, rhythms of this type might not trigger an alarm. A relearn event can be initiated by a user or by the system.
Directions for use Chapter 4 Adjust monitoring settings and patient information 65 To initiate relearn of a patient’s ECG rhythm for arrhythmia and ST-segment analyses The relearn operation cannot be undone. 1. In the patient’s Virtual Monitor, click Setup, Arrhythmia Alarms. The Arrhythmia Alarms Setup window appears. If your window appears abbreviated, your system includes the Lethal Arrhythmia Analysis option (lethal arrhythmia detection, only). 2.
66 Chapter 4 Adjust monitoring settings and patient information Welch Allyn Acuity Central Monitoring System Important considerations: Arrhythmia Analysis Related to Arrhythmia Analysis options, patient populations and patient surveillance WARNING The Acuity System Arrhythmia Analysis options are not atrial arrhythmia analysis packages: they are ventricular analysis packages.
Directions for use Chapter 4 Adjust monitoring settings and patient information 67 Related to patient monitor heart rate indications WARNING All heart rate alarms are valid, even if the HR value at the central station differs from that at the monitor. If your system includes an Arrhythmia Analysis option, the Acuity System heart rates for adult and pediatric patients are a result of system software analysis.
68 Chapter 4 Adjust monitoring settings and patient information Welch Allyn Acuity Central Monitoring System WARNING Carefully monitor lead-wire connections of patients prone to arrhythmia events. If a lead wire disconnects during an event, the Acuity System’s ability to accurately detect the event can be compromised. WARNING Minimize patient movement during a RELEARN, as movement creates noise during the reading.
Directions for use Chapter 4 Adjust monitoring settings and patient information 69 ST Analysis option The Acuity System ST Analysis option analyzes the ST segment of current ECG beats relative to the ST segment of a reference beat. Specifically, the system reports mm or mV of deviation between the current beat’s ST-segment offset and the reference beat’s ST-segment offset. The system learns the reference beats when a learning or relearn function occurs.
70 Chapter 4 Adjust monitoring settings and patient information Welch Allyn Acuity Central Monitoring System Examine the ST Analysis Setup window The ST Analysis Setup windows in this section are shown in alarm. To open an ST Analysis Setup window • In the patient’s Virtual Monitor, click Setup, ST Analysis. The ST Analysis Setup window appears. I. Measurement offset A. Current beat (white) J. J-points (green) B. Deviation from reference beat C. Measurement leads D.
Directions for use Chapter 4 Adjust monitoring settings and patient information I. Measurement offset The point at which the ST-segment analysis is performed, as determined by the number of ms or mV after the J-point. J. J-points (green) Vertical green reference line intersects each beat at the J-point, the end of QRS and the start of the ST segment. 71 Turn on or off ST analysis WARNING If a patient’s ST analysis is turned off, the patient’s ECG is not analyzed for ST-segment deviations.
72 Chapter 4 Adjust monitoring settings and patient information Welch Allyn Acuity Central Monitoring System View current beats and ST-segment deviation values To view current beats and ST-segment deviation values 1. In the patient’s Virtual Monitor, click Setup, ST Analysis. The ST Analysis Setup window appears. 2. Beneath the waveforms, click the arrows to select the leads used for one or both lead displays. 3. View current ST-segment deviation values in the Deviation column. Alarm values are red.
Directions for use Chapter 4 Adjust monitoring settings and patient information Set analysis preferences for a patient’s ST analysis To set analysis preferences for ST analysis 1. In the patient’s Virtual Monitor, click Setup, ST Analysis. The ST Analysis Setup window appears. J-points (green) 2. Leads: In the Lead column, check leads to be used for ST Analysis. Depending on the patient monitor, some of these choices cannot be deselected. 3. Measurement Offset: Click to set the offset from the J-point.
74 Chapter 4 Adjust monitoring settings and patient information Welch Allyn Acuity Central Monitoring System Set alarm preferences for ST Analysis WARNING Turning off alarming for arrhythmia types and ST Analysis disables both audio and visual alarm indicators. Although alarming for lethal arrhythmias cannot be turned off, patients susceptible to arrhythmias must be kept under close physical surveillance if their alarming has been turned off for any arrhythmia types.
Directions for use Chapter 4 Adjust monitoring settings and patient information 75 Initiate a relearn of a patient’s reference beats for ST analysis Description of the Relearn function Arrhythmia and ST relearn is an Arrhythmia Analysis function that causes the Acuity system to relearn a patient’s normal ECG rhythm. The Acuity System uses the relearned rhythm as a guideline to identify arrhythmia events (arrhythmia relearn) and to analyze deviation of the ECG ST-segment offset (ST relearn).
76 Chapter 4 Adjust monitoring settings and patient information Welch Allyn Acuity Central Monitoring System To initiate a relearn of a patient’s reference beats for ST-segment analysis The relearn operation cannot be undone. 1. In the patient’s Virtual Monitor, click Setup, ST Analysis. The ST Analysis Setup window appears. 2.
Directions for use Chapter 4 Adjust monitoring settings and patient information 77 Important considerations: ST Analysis WARNING Before you set customized alarm limits for a patient, confirm the patient’s ID and room number. Otherwise, customized limits might be lost. WARNING Do not use the Arrhythmia Analysis or ST Analysis feature on neonates. The Arrhythmia Analysis and ST Analysis options are not intended for use with neonatal patients.
78 Chapter 4 Adjust monitoring settings and patient information Welch Allyn Acuity Central Monitoring System WARNING In Acuity Systems that include an Arrhythmia option, a relearn function causes the system to learn a patient's normal ECG rhythm. If the system learns an abnormal rhythm or learns a rhythm during noise, it designates the learned rhythm as a normal. Thereafter, rhythms of this type might not trigger an alarm. A relearn event can be initiated by a user or by the system.
Directions for use Chapter 4 Adjust monitoring settings and patient information 79 Edit patient information You can revise information within the Acuity System as follows: • Edit a patient name • Edit clinical information • Edit a patient ID (Add an amended patient ID) • Add a note to a patient’s Waveform Window If you want to change a patient’s room number, see “Arrange a patient move from the patient monitor” on page 129.
80 Chapter 4 Adjust monitoring settings and patient information Welch Allyn Acuity Central Monitoring System Edit a patient ID number: add an amended (revised) patient ID Once a patient ID number is confirmed, it cannot be changed. However, if your Acuity System includes the amended ID feature, you can revise an original patient ID number by adding an amended ID. If necessary, you can change this amended ID again later.
Directions for use Chapter 4 Adjust monitoring settings and patient information 81 Add or remove a note in a patient’s Waveform Window If you would like to attach a note or reminder to a patient’s Waveform Window, such as when the patient temporarily moves to another location, you can enter the information in the Patient ID Setup window The note remains in the Waveform Window until you remove it, even during wireless dropout.
82 Chapter 4 Adjust monitoring settings and patient information Welch Allyn Acuity Central Monitoring System
83 5 Respond to alarms and alerts Overview of central station alarm and alert indications • Alarms indicate patient vital-sign violations by showing red window borders, icons and vital-sign highlights. All alarms are associated with audible tones. • Alerts indicate equipment problems or low-level patient information alerts by showing yellow window borders and icons. Some alerts are associated with audible tones. When conditions are corrected, the green, “patient monitoring OK” state is restored.
84 Chapter 5 Respond to alarms and alerts Welch Allyn Acuity Central Monitoring System Suspend an audible alarm or alert tone for 90 seconds All patient alarms and some alerts are associated with tones (for details, see Table 6 on page 95). You can silence tones temporarily from these places: • Acuity Central Station • Patient monitor • (Optional) Mobile device running AcuityLink Clinician Notifier software To suspend an audible alarm or alert tone from a Waveform Window Suspend Area 1.
Directions for use Chapter 5 Respond to alarms and alerts 85 Important considerations: suspending an audible alarm or alert tone Related to indications WARNING During an alarm or alert suspension period, be aware of new visual alarm indications that might occur on the patient monitor or Virtual Monitor.
86 Chapter 5 Respond to alarms and alerts Welch Allyn Acuity Central Monitoring System Related to heart rate (HR) and arrhythmia alarms WARNING All heart rate alarms are valid, even if the HR value at the central station differs from that at the monitor. If your system includes an Arrhythmia Analysis option, the Acuity System heart rates for adult and pediatric patients are a result of system software analysis.
Directions for use Chapter 5 Respond to alarms and alerts 87 Remove a latched arrhythmia alarm If your Acuity System is configured to allow latched alarms, indications for certain arrhythmia alarms remain (or latch) in the Waveform Window, even after the alarm condition has ceased. • Depending on configuration, lethal, high-level and possibly medium-level arrhythmia alarms visually latch in Waveform Windows.
88 Chapter 5 Respond to alarms and alerts Welch Allyn Acuity Central Monitoring System Respond to specific alarms and alerts This section describes a few of the Acuity System alarms and alerts and how to respond to them. Respond to a DROPOUT alert When there is a loss of bi-directional communication between a wireless monitor and the Acuity System, an audible DROPOUT equipment alert occurs at the monitor and at the Acuity Central Station.
Directions for use Chapter 5 Respond to alarms and alerts 89 Dismiss a CHECK PATIENT HR/PR alert A patient monitor uses a single lead to calculate heart rate, and an Acuity System with an Arrhythmia Analysis option uses more sophisticated arrhythmia analysis algorithms. Thus the patient monitor and Acuity Central Station heart rate readings for the same patient can differ.
90 Chapter 5 Respond to alarms and alerts Welch Allyn Acuity Central Monitoring System Dismiss an arrhythmia or ST alarm message When you suspend an arrhythmia or ST alarm, the audible alarm tone is suspended for 90 seconds as usual. However, the Acuity System Virtual Monitor displays a visual message to call attention to the alarm. To dismiss an arrhythmia or ST alarm message • Click DISMISS. The border remains red, but the message is dismissed and you can see the waveforms.
Directions for use Chapter 5 Respond to alarms and alerts 91 Respond to a RELEARN alert WARNING In Acuity Systems that include an Arrhythmia option, a relearn function causes the system to relearn a patient's normal ECG rhythm. If the system learns an abnormal rhythm or learns a rhythm during noise, it designates the learned rhythm as normal. Thereafter, rhythms of this type might not trigger an alarm. A relearn event can be initiated by a user or by the system.
92 Chapter 5 Respond to alarms and alerts Welch Allyn Acuity Central Monitoring System To respond to a RELEARN alert 1. In the patient’s Virtual Monitor, carefully evaluate the new ECG rhythm to ensure that the Acuity System has learned an appropriate rhythm. 2. Check the relearned ECG rhythm in the Waveforms Review window: a. Click Review, Waveforms. The Waveforms Review window appears. b. Click the Arrhythmia Relearn event marker (▼) shown at the time of the Relearn event. c.
Directions for use Chapter 5 Respond to alarms and alerts 93 Respond to a CHECK LEADS alert The visual CHECK LEADS alert appears when the number of PVCs exceeds the normal ranges of PVC activity. The alert remains for a brief period. To respond to a CHECK LEADS alert 1. Verify that the patient’s lead wires and electrodes are in good condition. 2. Verify that the electrodes were placed using standard good practices. 3. Click Review, Waveforms. The Waveforms Review window appears. 4.
94 Chapter 5 Respond to alarms and alerts Welch Allyn Acuity Central Monitoring System Respond to an arrhythmia NOISE alert The visual NOISE alert occurs when the Acuity System can’t analyze arrhythmia because of excessive electrical noise. The Acuity System invalidates individual noisy leads and then re-validates them when noise is no longer detected. At the Acuity Central Station, there is no heart rate reading during this alert, but the patient monitor might present a heart rate.
Directions for use Chapter 5 Respond to alarms and alerts 95 Summary of Acuity System alarm and alert levels Alarm and alert levels determine which alarms or alerts are indicated if multiple alarms or alerts occur for a patient. This table shows a summary of alarm and alert levels. For a complete list of icons, see “Status icons” on page 137. Table 6.
96 Chapter 5 Respond to alarms and alerts Welch Allyn Acuity Central Monitoring System
97 6 Review or print patient data Review patient data If your Acuity System includes the Full Disclosure option, waveforms and trend information for all patients are stored for a configurable period, up to 96 hours. Locate patient data This section describes how to locate data for a patient in any unit within your Acuity System or networked Acuity System. To locate a patient 1. In the lower left corner of the Acuity Central Station screen, click . The Patient List window appears. 2.
98 Chapter 6 Review or print patient data Welch Allyn Acuity Central Monitoring System To view the patient’s data 1. In the Patient List window or Other Patients Lists window, click a patient’s name in the list. 2. Click one of these buttons: • Click Summary to view a summary of the patient’s monitoring history. Summary is not available in the Other Patient List screen. • Click to view the patient’s Graphical Trends Review window. • Click to view the patient’s Tabular Trends/Events Review window.
Directions for use Chapter 6 Review or print patient data 99 Review graphical trends In the Graphical Trends Review window, you can review and print data in these ways: • Scroll graphical trend data for up to five vital signs at once. • Locate red alarm periods along the trend graphs. • View event markers above the top graph. • Click graphs to see numeric values and event identifiers. • Jump to the next or previous alarm.
100 Chapter 6 Review or print patient data Welch Allyn Acuity Central Monitoring System Adjust the graphical trends display and locate events ▼ Event marker ♥ Arrhythmia event marker SpO2 Perfusion Index (PI). For more information, refer to Masimo Corporation literature. Cursor bar Time line To adjust the time period shown in the graphs area of the window 1. Under Time Span, click a button. Time markers show along the top of the graphs area. 2.
Directions for use Chapter 6 Review or print patient data 101 Review tabular trends and events In the Tabular Trends and Events Review window, you can review and print trends in these ways: • • • • View vital-sign values and alarm events in a tabular format, at various intervals. Click events in the list to view (up to two) corresponding waveforms. (Arrhythmia option) View normal and ventricular ECG beat labels along the waves. In the waveforms, jump to the next or previous alarm.
102 Chapter 6 Review or print patient data Welch Allyn Acuity Central Monitoring System Adjust the content of the tabular list Time line To adjust the time period covered in the tabular list 1. Click a number under the time line to adjust the line’s scope, in hours. 2. On the time line, click an area in which you are interested (events are red). The blue box moves. The box indicates the time span covered in the list. 3. Under Time Span, click to specify the number of hours spanned in the list.
Directions for use Chapter 6 Review or print patient data Adjust the waveform display 103 Beat labels: Normal (•) and ventricular (v) To display waveform(s) that correspond to a trend or event in the tabular list 1. In the list, locate a trend or event in which you are interested. 2. Click the trend or event. The corresponding waveform(s) appear in the waveform pane. 3. Scroll the waveform. Click or to scroll forward or backward. Click or to page forward or backward. 4.
104 Chapter 6 Review or print patient data Welch Allyn Acuity Central Monitoring System Review waveforms (Full Disclosure option) In the Waveforms Review window, you can review and print the waveforms in these ways: • Scroll up to five vital-sign waveforms at once. • (Arrhythmia option) View normal and ventricular ECG beat labels along the waves. • Click graphs to identify event markers above the waveforms.
Directions for use Chapter 6 Review or print patient data 105 Display waveforms and events Beat labels: Normal (•) and ventricular (v) Time Line To select and adjust waveforms 1. Check up to five boxes to display waveforms for corresponding vital-signs and ECG lead sources. If the patient monitor includes SpO2 Signal IQ detection and you check SpO2, SIQ occupies a waveform slot in the display. 2. Click Scales, and then make a selection. 3. Click under mm/sec to adjust sweep speeds.
106 Chapter 6 Review or print patient data Welch Allyn Acuity Central Monitoring System To locate and display alarm and event information Cursor bar 1. Along the top of the waveforms, click an event marker. • • • ▼ event markers show Relearn, Learning Done or Snapshot Print events. ♥ ♥ event markers show that an arrhythmia alarm was recorded.
Directions for use Chapter 6 Review or print patient data 107 Review arrhythmia events (Arrhythmia Analysis option) In the Arrhythmia Events Review window, you can review and print arrhythmia events in these ways: • List arrhythmia events and event counts, by type. • Review ECG waveforms associated with arrhythmia events. • View normal and ventricular ECG beat labels. • Jump to the next or previous alarm or arrhythmia event.
108 Chapter 6 Review or print patient data Welch Allyn Acuity Central Monitoring System Open an Arrhythmia Events Review window To open an Arrhythmia Events Review window 1. Open the window for one of these types of patients: • Current patient in local unit: In the patient’s Waveform Window, click • . Non-monitored patient or patient in a networked Acuity System unit: a. In the Acuity Central Station screen’s lower left corner, click b.
Directions for use Chapter 6 Review or print patient data 109 Adjust the content of both list sections Event counts section Numbers of arrhythmia events that occurred in the selected time span are listed here. Events list section All events checked in the event counts section (left) are listed and described here. To adjust the time period covered in both list sections 1. Click a number under the time line to adjust the line’s scope, in hours. 2.
110 Chapter 6 Review or print patient data Welch Allyn Acuity Central Monitoring System Adjust the waveform display Beat labels: Normal (•) and ventricular (v) Arrhythmia event marker Event in events list section To display waveform(s) that correspond to an event 1. In the events list section, click an event. The corresponding waveform(s) appear in the waveform pane, and the blue cursor bar indicates the event. 2. Scroll the waveform. Click or to scroll forward or backward.
Directions for use Chapter 6 Review or print patient data 111 Delete or undelete an arrhythmia event marker from review windows and printouts (Advanced Arrhythmia Analysis option) Event counts section Numbers of arrhythmia events that occurred in the selected time span are listed here. Events list section All events checked in the event counts section (left) are listed and described here. To delete an event from review windows and printouts 1.
112 Chapter 6 Review or print patient data Welch Allyn Acuity Central Monitoring System Review ST analysis information This section explains how to review ST analysis review information. In the ST Analysis Setup window, you can do these things: • View current beats for specific leads • View current ST-segment deviation values, including alarm values If you are would like information about setting up ST-segment analysis, see “ST Analysis option” on page 69.
Directions for use Chapter 6 Review or print patient data 113 Review OxyCRG information (Full Disclosure option) In the OxyCRG review window, you can review and print oxygen cardiorespirogram information in these ways: • Scroll respiration and CO2 waveforms and graphical trend data for HR/PR and SpO2. • Locate red alarm periods along the trend graphs. • Click graphs to see vital-sign values. • Jump to the next or previous alarm. Open an OxyCRG Review window To open an OxyCRG Review window 1.
114 Chapter 6 Review or print patient data Welch Allyn Acuity Central Monitoring System Adjust the OxyCRG display and locate alarms . Time marker HR and SpO2 lines are connected trend values. Red lines indicate alarms. Perfusion Index (PI). For information, refer to Masimo Corporation literature. To adjust the time period shown in the display area of the window 1. Under Time Span, click a button. Time markers show along the top of the graphs area. 2.
Directions for use Chapter 6 Review or print patient data 115 Print and review printouts The Acuity System includes six types of printouts: • Snapshot printouts • Review printouts • Alarm printouts • Patient List printouts • 12-Lead printouts • Hemodynamic Report printouts Snapshot printouts Snapshot printouts provide an instant snapshot of a currently monitored patient’s data and waveforms.
116 Chapter 6 Review or print patient data Welch Allyn Acuity Central Monitoring System Print a Snapshot printout on demand To print a snapshot from a Waveform Window Print Area • Bring your pointer into the window and click PRINT, or click anywhere in the Waveform Area. A printout occurs at the Acuity System printer. To print a snapshot from a Virtual Monitor • Click Snapshot. A printout occurs at the Acuity System printer.
Directions for use Chapter 6 Review or print patient data 117 Review printouts Review printouts capture information shown in a current or non-monitored patient’s review window.
118 Chapter 6 Review or print patient data Welch Allyn Acuity Central Monitoring System Read a review printout To read a review printout A. Type of printout Thursday B. Number of deleted events 13−October−2005 Medical Center 04:00:00 Katarina Watson 2002 Name Patient ID # ZONE−1 1334B Amended ID Location 12 Hour Arrhythmia Event Review Adult 04:00 16:00 Selected Events for Review 2 2 2 1 6 2 1 3 2 1 1 C. Deleted event D.
Directions for use Chapter 6 Review or print patient data 119 Alarm printouts If Print on Alarm is set for a patient’s parameter and the parameter alarms, an alarm print occurs at the central station.
120 Chapter 6 Review or print patient data Welch Allyn Acuity Central Monitoring System Review an alarm printout Portland Westside Medical Clinic Thursday 4-May-2000 14:51:03 A Bun Keat Heng T663123555 Name Patient ID # C B CCU-West 1324A Location ALARM 25 mm/sec Adult/Pediatric 14:51:03 HR = 89 PVCs/min = 3 I = -0.3 II = -0.2 III = 0.1 aVR = 0.2 aVL = -0.3 aVF = -0.3 V = -0.2 II 1mV/cm V 1 14:51:10 Bigeminy aVR 1mV/cm V D 0.
Directions for use Chapter 6 Review or print patient data 121 Patient List printouts You can print lists of patients in your unit. If your system is part of an Acuity System network, you can print lists of patients in any units within the network.
122 Chapter 6 Review or print patient data Welch Allyn Acuity Central Monitoring System 12-lead printouts You can perform 12-lead ECG interpretation and create printouts through the Welch Allyn 1500 Patient Monitor. Note The 12-lead ECG interpretation measurements are not saved on the monitor and are printed out at the Acuity System printer. However, Acuity will support reprinting of the 12-lead reports. Files are saved for 96 hours.
Directions for use Chapter 6 Review or print patient data Review a 12-lead report A B C A. Patient information appears if patient is confirmed in the Acuity System. This data includes extended demographics such as date of birth, height, weight, gender, ethnicity, and other measurements. B. Print information. This data includes when the report was printed, clinician and physician information, and a list of medications the patient may be taking. A comment field is also available. C.
124 Chapter 6 Review or print patient data Welch Allyn Acuity Central Monitoring System Hemodynamic Report printouts Hemodynamic Reports are a collection of calculations derived from the cardiac output feature of the Welch Allyn 1500 Patient Monitor. Print a Hemodynamic Report To print a Hemodynamic Report 1. Run a cardiac output measurement at the Welch Allyn 1500 Patient Monitor. 2. Select Hemodynamic Calculations at the monitor. 3. Select Transfer Data.
125 7 Move a monitored patient You can move a monitored patient in these ways: • Move a patient and monitor to a new room within the unit or transfer to a new unit within the same Acuity System network. • Move a patient to a different monitor anywhere within the same Acuity System network. If the patient’s original Acuity System review information is still available within the Acuity System network (24 to 96 hours after disconnect), it is available in the new location after the move.
126 Chapter 7 Move a monitored patient Welch Allyn Acuity Central Monitoring System Arrange a patient move from the Acuity Central Station If you want to arrange a patient transfer to another unit, you must do so in the unit from which the patient is transferring. To arrange a patient move from the Acuity Central Station 1. In the lower left corner of the Acuity Central Station screen, click . The Patient List window opens. 2. Click the patient name. 3. Click Transfer.
Directions for use Chapter 7 Move a monitored patient 127 Move patients and their hardwired monitors Propaq CS monitor Propaq Encore monitor Welch Allyn 1500 Patient Monitor To disconnect, move and reconnect a hardwired monitor to a new network connector Throughout this procedure and the move, leave the monitor turned on. 1. On a Propaq CS monitor: Press NET OFF in the top left corner of the screen. On a Propaq Encore monitor: Press NET OFF on the top right corner of the casing.
128 Chapter 7 Move a monitored patient Welch Allyn Acuity Central Monitoring System To switch a hardwired Propaq CS monitor to a wireless connection WARNING When a hardwired Propaq CS monitor is disconnected from an Acuity System, if the monitor has wireless capability, it attempts to connect wirelessly to an Acuity System. After connection, go to the Acuity Central Station where you want the monitor to have connected. Ensure that the patient monitor’s icon appears on the central station map.
Directions for use Chapter 7 Move a monitored patient 129 Move patients and their wireless monitors Micropaq monitor Propaq LT monitor Propaq CS monitor Arrange a patient move from the patient monitor To arrange a patient move from a Micropaq monitor 1. Press to highlight ACUITY, and then press to select it. 2. Take one of these steps: • Select NEW ROOM to move the patient to a new room within the unit, and then select a new room. The patient is confirmed with the new room.
130 Chapter 7 Move a monitored patient Welch Allyn Acuity Central Monitoring System To arrange a patient move from a wireless Propaq CS monitor 1. From the main menu, touch SETUP, ACUITY, PATIENT. 2. Take one of these steps: • Select NEW ROOM to move the patient to a new room within the unit, and then select the new room. The patient is confirmed with the new room. • Select TRANSFER to transfer the patient to a different unit, select the new unit, and then select the new room.
Directions for use Chapter 7 Move a monitored patient 131 Move the patient to a different monitor You can move patients who are connected to hardwired or wireless monitors to different monitors within the same Acuity System network. Move a patient from a hardwired monitor to a different monitor 1. On a Propaq CS monitor: Press NET OFF in the top left corner of the screen On a Propaq Encore monitor: Press NET OFF on the top right corner of the casing. 2. Turn off the monitor.
132 Chapter 7 Move a monitored patient Welch Allyn Acuity Central Monitoring System 5. Enter or confirm the patient information. For instructions, see “Enter and confirm a patient’s ID or room at the central station” on page 40. To move a patient from a Propaq LT monitor to a different monitor 1. On the Propaq LT monitor, press the arrow keys to underline the top of the screen, and then press to select it. at 2. Select Acuity menu. 3. Select END TELE. The monitor disconnects from the Acuity System. 4.
133 8 Discontinue Acuity System monitoring Stop monitoring a patient You can either temporarily interrupt or permanently stop patient monitoring. For information about patient monitors that are part of your Acuity System but are not shown in this chapter, consult the patient monitor manufacturer’s literature. Temporarily interrupt monitoring To temporarily interrupt monitoring a patient 1. Disconnect sensor cables from the monitor. Leave the monitor turned on. Equipment alert(s) appear. 2.
134 Chapter 8 Discontinue Acuity System monitoring Welch Allyn Acuity Central Monitoring System WARNING If your system includes arrhythmia analysis, and if you connect, change or move an electrode, ensure that a RELEARN alert occurs at the patient monitor and the virtual monitor. Moving or changing an electrode can change the beat morphology. If the system does not learn the new morphology, it might not alarm or it might cause false alarms.
Directions for use Chapter 8 Discontinue Acuity System monitoring 135 Permanently stop monitoring To permanently stop monitoring a patient 1. From the monitor’s Main Menu, take these steps. For Propaq CS and Encore monitors: a. In the top left or right corner of the monitor, press NET OFF. The monitor disconnects from the Acuity System. b. Turn off the monitor. The trend information for this patient is erased from the monitor. For a Micropaq monitor: a.
136 Chapter 8 Discontinue Acuity System monitoring Welch Allyn Acuity Central Monitoring System For instructions, see “Discharge a patient from Acuity System monitoring” on page 136. Discharge a patient from Acuity System monitoring A patient’s waveform and trend information is available for review and printing for 24 to 96 hours after Acuity System monitoring has stopped for the patient.
137 9 Status icons Status icon colors The color of a status icon conveys the status of the patient, patient monitor or Central Station component that the icon represents. Table 7. Colors of Acuity System status icons Icon color Meaning of icon color Gray Acuity System is not receiving patient information from this site because no communication is established. Blue When the icon represents Acuity System components, the components are operating successfully.
138 Chapter 9 Status icons Welch Allyn Acuity Central Monitoring System Patient/monitor status icons Patient/Monitor status icons show status and act as buttons to open patient Virtual Monitors and Waveform Windows.
Directions for use Chapter 9 Status icons 139 Patient/monitor status icons and recommended action This table illustrates these things about patient/monitor status icons: • Display priority • Location on the central station map • Messages at the top of the Acuity Central Station screen • Messages in message panels (when present) • Recommended action Table 8.
140 Chapter 9 Status icons Welch Allyn Acuity Central Monitoring System Table 8. Icons and messages that represent patient and monitor status Patient/monitor status icon Alarm Tone Suspended with No Violation Icon display priority Icon location on map Messages in Recommended action hallway message panels and at top of Acuity Central Station screen Beneath alerts and alarms Locations representing monitors with audible alarm tones suspended when no alarm or alert violation has occurred.
Directions for use Chapter 9 Status icons 141 Table 8. Icons and messages that represent patient and monitor status Patient/monitor status icon Too Many Hardwired Monitors Icon display priority Icon location on map Messages in Recommended action hallway message panels and at top of Acuity Central Station screen Takes priority over low-level alerts. Location representing the [room #] Equipment Audible alert tone extra monitor. continues until you disconnect a monitor.
142 Chapter 9 Status icons Welch Allyn Acuity Central Monitoring System Table 8. Icons and messages that represent patient and monitor status Patient/monitor status icon Monitor Communication Lost Alert Tone Suspended Icon display priority Icon location on map Messages in Recommended action hallway message panels and at top of Acuity Central Station screen Take priority over low-level alerts. Locations representing problem monitors.
Directions for use Chapter 9 Status icons 143 Table 8. Icons and messages that represent patient and monitor status Patient/monitor status icon Icon display priority Icon location on map Messages in Recommended action hallway message panels and at top of Acuity Central Station screen Take priority over alerts.
144 Chapter 9 Status icons Welch Allyn Acuity Central Monitoring System Table 8. Icons and messages that represent patient and monitor status Patient/monitor status icon Icon display priority Only lethal events interrupt Alarm Tone Suspended the suspension period. All other newly occurring alarms are indicated only visually, and the icon image remains the same. Newly occurring alerts are not indicated.
Directions for use Chapter 9 Status icons System component status icons Acuity System component icons do these things: • Show component status • Open Central Station windows (some icons) Locations of system component icons These icons appear in two places on the Acuity System map: • At the Acuity Central Station area • If your Acuity System is part of a network, at the Acuity System network area Acuity System network area Acuity Central Station area Acuity Central Station area Opening windows a
146 Chapter 9 Status icons Welch Allyn Acuity Central Monitoring System System component status icons and recommended action This table illustrates these things about system component status icons: • Display priority • Location on the central station map • Messages at the top of the Acuity Central Station screen • Corresponding messages in message panels (when present) • Recommended action Table 9.
Directions for use Chapter 9 Status icons Table 9. Icons and messages that represent the status of Acuity System components Acuity System component icon Central Printer Problem Central Printers OK Icon display priority Icon location on map Messages at top of Acuity Central Station screen Low-level alert Yellow icon: appears at Yellow icon: Check Laser Printer Acuity Central Station area and in the Central Station Printer window if or printer has a problem.
148 Chapter 9 Status icons Welch Allyn Acuity Central Monitoring System Table 9. Icons and messages that represent the status of Acuity System components Acuity System component icon Icon display priority Icon location on map Low-level alert Acuity Central Station area No Devices Running Clinician Notifier are Reachable Messages at top of Acuity Central Station screen Recommended action Notifier Fault System includes a Welch Allyn connectivity server (WACS) with the AcuityLink option.
149 10 Troubleshooting and maintenance Contact information If you are unable to find the answer to a question, or if you encounter a problem that cannot be corrected by ordinary operating procedures described in this manual, please contact Welch Allyn Technical Services: Phone (within the U.S.A.): 1 800 289 2501 Phone (worldwide): +1 503 530 7500, ask for Technical Service Fax: +1 503 526 4970 e-mail: solutions@welchallyn.com Internet http://www.welchallyn.com/support/default.
150 Chapter 10 Troubleshooting and maintenance Welch Allyn Acuity Central Monitoring System Contents Troubleshooting Central station displays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .151 Connection, patient room and patient ID. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .152 Equipment alerts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .154 Alarm limits . . . . . . . . . . . . . . . . . . . . . . . .
Directions for use Chapter 10 Troubleshooting and maintenance 151 Troubleshooting WARNING Replace central station hardware within the the lesser of 3 years or the original equipment manufacturer’s specification. Failure to perform preventative maintenance can impact system performance and availability. Central station displays Table 10.
152 Chapter 10 Troubleshooting and maintenance Welch Allyn Acuity Central Monitoring System Table 10. Troubleshooting the central station display Problem Explanation No audible alarm or alert tones are coming from the central station display. Look for a mute button on the display, and push it to restore sound. Contact your Biomedical Engineering department if tones are not restored.
Directions for use Chapter 10 Troubleshooting and maintenance 153 Table 11. Troubleshooting connection, patient room and patient ID Problem Explanation Sometimes patients are assigned an ID number that I didn’t give them. If you do not enter a patient ID number, after (up to) five minutes the Acuity System might generate an automatic patient ID number for you. The number is created from the room number (or for wireless monitors, part of the serial number of the monitor), and the time.
154 Chapter 10 Troubleshooting and maintenance Welch Allyn Acuity Central Monitoring System Equipment alerts Table 12. Troubleshooting equipment alerts Problem Explanation When I connect a monitor to the Acuity Only monitors with Acuity System network connectors on their sides, with System, a Communication Alert message Acuity System authorization and with software versions indicated in occurs. Table 19 on page 175 can communicate with the Acuity System.
Directions for use Chapter 10 Troubleshooting and maintenance 155 Table 12. Troubleshooting equipment alerts Problem Explanation A Cuff Not Detected or a No Pulses This condition usually occurs for one of these reasons: Detected equipment alert is occurring at • The monitor wasn't turned off and on again to clear settings (including both the patient monitor and Virtual Auto NIBP) before the new patient was connected to it. Monitor, but NIBP is not being monitored.
156 Chapter 10 Troubleshooting and maintenance Welch Allyn Acuity Central Monitoring System Patient alarm indications Table 14. Troubleshooting patient alarm indications Problem Explanation False arrhythmia alarms are occurring because of a patient’s abnormal beat morphology. The Acuity System analyzes patient ECG data to detect specific changes in cardiac rhythms. The system uses up to three ECG leads to detect normal beats, ventricular beats and to analyze arrhythmias.
Directions for use Chapter 10 Troubleshooting and maintenance 157 Table 14. Troubleshooting patient alarm indications Problem A false alarm occurred for Heart rate, ECG, ST analysis or arrhythmia analysis. Explanation WARNING Ensure these things to minimize false HR, Arrhythmia Analysis and ST Analysis alarms, and to achieve optimal event detection and analysis: •ECG cable, lead wires and electrodes are undamaged. •Patient’s skin is properly prepared.
158 Chapter 10 Troubleshooting and maintenance Welch Allyn Acuity Central Monitoring System Table 14. Troubleshooting patient alarm indications Problem Explanation Audible alarm or alert tones are delayed at the patient monitor. To minimize disturbance to patients, a 10-second delay occurs before an alarm or alert tone sounds at most patient monitors connected to the Acuity System network. However, visual indications at the patient monitor and Acuity Central Station occur at the same time.
Directions for use Chapter 10 Troubleshooting and maintenance 159 Heart rate and ECG displays Table 15. Troubleshooting heart rate and ECG displays Problem Heart rate values on the patient monitor differ from HR values at the Acuity Central Station. or --- appears instead of the HR/PR numeric reading. ECG signal interruption is occurring. Explanation WARNING All heart rate alarms are valid, even if the HR value at the central station differs from that at the monitor.
160 Chapter 10 Troubleshooting and maintenance Welch Allyn Acuity Central Monitoring System CO2, SpO2, IPI, and NIBP displays Table 16. Troubleshooting CO2, SpO2, IPI, and NIBP displays Problem Explanation When I try to change CO2 units at CO2 units are an Acuity System installation choice set by your system administrator. the patient monitor, a message Acuity System requires a single CO2 unit to ensure that the CO2 units are displayed says I must use the Acuity System correctly. units.
Directions for use Chapter 10 Troubleshooting and maintenance 161 Arrhythmia Analysis and ST Analysis Table 17. Troubleshooting arrhythmia and ST-segment analyses Problem Arrhythmia analysis or ST analysis does not seem to be optimal. Explanation WARNING Ensure these things to minimize false HR, Arrhythmia Analysis and ST Analysis alarms, and to achieve optimal event detection and analysis: •ECG cable, lead wires and electrodes are undamaged. •Patient’s skin is properly prepared.
162 Chapter 10 Troubleshooting and maintenance Problem Welch Allyn Acuity Central Monitoring System Explanation WARNING In Acuity Systems that include an Arrhythmia option, a relearn function causes the system to learn a patient's normal ECG rhythm. If the system learns an abnormal rhythm or learns a rhythm during noise, it designates the learned rhythm as normal. Thereafter, rhythms of this type might not trigger an alarm. A relearn event can be initiated by a user, or by the system.
Directions for use Chapter 10 Troubleshooting and maintenance 163 Printing Table 18. Troubleshooting printing Problem Explanation There is a delay in the Virtual Monitor or Waveform Window data display when a printout takes place. Is any data lost? No data is lost. In snapshots or alarm prints, sometimes four Although a Virtual Monitor can show up to three waveforms at once, if or five waveforms are printed, and sometimes additional waveforms are turned on for display, all are printed.
164 Chapter 10 Troubleshooting and maintenance Welch Allyn Acuity Central Monitoring System Maintenance Adjust Acuity System time If your facility had an internet server available at the time of Acuity System installation, Welch Allyn encouraged you to synchronize the Acuity System clock to a network time protocol (NTP) server.
Directions for use Chapter 10 Troubleshooting and maintenance 165 Identify or change a monitor’s network name (ESSID) This section describes how to identify or change the extended service set identifier (ESSID) for each type of wireless patient monitor that can connect to an Acuity System wireless local area network (WLAN). This information is useful if you want to do these things: • Set up a Mobile Acuity LT System network. • Move a patient monitor from one Acuity System network to another.
166 Chapter 10 Troubleshooting and maintenance Welch Allyn Acuity Central Monitoring System Identify or change a Micropaq monitor network name To identify a Micropaq monitor network name 1. Press to highlight SYSTEM INFORMATION, and then press . The System Information menu appears. 2. Press to highlight NETWORK STATUS, and then press . The Network Status screen appears. 3. Locate the Network Name in the list. 4. Press to exit. To change a Micropaq monitor network name 1.
Directions for use Chapter 10 Troubleshooting and maintenance 167 Identify or change a Propaq LT monitor network name To identify a Propaq LT monitor network name and prepare to change it (if desired) 1. Highlight SpO2, and then press . 2. Highlight Setup, and then press . The Setup menu appears. 3. Highlight Service, and then press . The Service menu appears. 4. Highlight Radio, and then press . The Radio menu appears, and Show Info is highlighted 5.
168 Chapter 10 Troubleshooting and maintenance Welch Allyn Acuity Central Monitoring System Identify or change a Wireless Propaq CS network name To identify a wireless Propaq CS monitor network name and prepare to change it (if desired) 1. Touch , SETUP, MORE, MORE, SERVICE, YES, MORE, MORE, RADIO. The Network Status screen opens, and the NET NAME is listed. 2.
Directions for use Chapter 10 Troubleshooting and maintenance 169 Mobile Acuity LT Systems: Adjust localization parameters If your Acuity System is a mobile (laptop computer) system, you can adjust these system parameters.
170 Chapter 10 Troubleshooting and maintenance Welch Allyn Acuity Central Monitoring System Power outages To turn off the Acuity System 1. Notify staff members so that procedural changes in patient care can be put into place. It is not necessary to disconnect monitors from bedside network connectors. 2. On the Acuity System screen, move the pointer into the gray area of the upper right corner. 3.
Directions for use Chapter 10 Troubleshooting and maintenance 171 To turn on the Acuity System 1. Turn on the power to these components, in this sequence: a. Acuity System laser printer(s) b. Terminal server (located in the equipment room) c. Acuity Central Station display(s) d. Acuity Central Station computer The computer power-up process takes several minutes, and several system messages appear on the screen. The Acuity System logs in and starts up the Acuity System screen.
172 Chapter 10 Troubleshooting and maintenance Welch Allyn Acuity Central Monitoring System Periodically check equipment for safety The Acuity System network cable Regularly inspect network cables, and replace them once every 12 months. Discard all cables that have been in use for a year or longer. To inspect Acuity System network cables • Inspect for damaged connectors and intact connector securing clips.
Directions for use Chapter 10 Troubleshooting and maintenance 173 Equipment disposal Acuity Central Monitoring System Do not dispose of this product as unsorted municipal waste. Prepare this product for reuse or separate collection as specified by Directive 2002/96/EC of the European Parliament and the Council of the European Union on Waste Electronic and Electrical Equipment (WEEE). If this product is contaminated, this directive does not apply. For more specific disposal information, see www.
174 Chapter 10 Troubleshooting and maintenance Welch Allyn Acuity Central Monitoring System
175 11 Specifications Monitor/Acuity System compatibility Table 19. Patient monitor/Acuity System compatibility Patient monitor Acuity System Micropaq monitor, 1.3 software or higher Acuity System software version 8.2x Propaq CS monitor, 3.0 software or higher Propaq LT monitor 1.00.01 software or higher Propaq Encore monitor, 1.2 software or higher Welch Allyn 1500 Patient Monitor, 1.1x or 1.4 software General system monitoring capabilities Table 20.
176 Chapter 11 Specifications Welch Allyn Acuity Central Monitoring System Table 21. Networked Acuity System capabilities Function Primary Acuity System Auto-Open Secondary (AOS) Acuity Central Station Patient List Review (PLR) Acuity Central Station Direct connection between patient’s monitor and Acuity System Duplicate Acuity Central Station that derives information from the primary Acuity System. Duplicate Acuity Central Station that derives information from the primary Acuity System.
Directions for use Chapter 11 Specifications 177 Acuity System heart rate Table 22. Acuity System heart rate calculation Acuity System configuration Method of HR calculation Acuity System with Arrhythmia Analysis module Acuity Central Station display is determined by Acuity System Arrhythmia Analysis software, and patient monitor display is determined by patient monitor. Patient monitor HR can be different from Central HR.
178 Chapter 11 Specifications Welch Allyn Acuity Central Monitoring System Acuity System pacemaker detection Table 24. Pacemaker detection with the Acuity System Arrhythmia Analysis module Monitor Characteristic Specification Micropaq Acuity System Virtual Monitor Pacer indicator shown on screen if PACER display turned ON; pacer spike always shown if of sufficient amplitude. Pacer Pulse Detection/ Rejection Pacer detection range (i.e., shows the dashed vertical marker) for ±3 mV to ±700 mV @ 0.
Directions for use Chapter 11 Specifications 179 Acuity System alarm and alert indications Table 25.
180 Chapter 11 Specifications Welch Allyn Acuity Central Monitoring System Table 26.
Directions for use Chapter 11 Specifications 181 Table 27. Alarm and alert indications at the Acuity System Virtual Monitor Alarms (red) Monitor equipment alerts (yellow) System-wide equipment alerts (yellow) Display Priority Virtual Monitors in alarm “bump” those not in alarm, when necessary. Virtual Monitors in alert state No displays in are not automatically Virtual Monitor. displayed. Indications Equipment Alert status window appears in Virtual Monitor.
182 Chapter 11 Specifications Welch Allyn Acuity Central Monitoring System Table 28. Alarm and alert indications at the Waveform Window Alarms (red) Display Priority Monitor equipment alerts (yellow) System-wide equipment alerts (yellow) Patient information alerts (yellow) Acuity System automatically displays Waveform Windows in No displays in Waveform Waveform Windows in alarm state in alert state are not automatically displayed. Window. all views containing Waveform Windows.
Directions for use Chapter 11 Specifications Table 29. Alarm and alert indications at (optional) hallway message panels and in message window at the top of the Acuity Central Station screen Alarms (red) Monitor equipment alerts (yellow) System-wide equipment alerts (yellow) Message “RM number” followed by alarm-type and violating vital sign. Specific messages for specific alerts. Priority Only highest priority message for each patient/monitor Messages appear only is displayed.
184 Chapter 11 Specifications Welch Allyn Acuity Central Monitoring System Electromagnetic standards compliance The Acuity Central Monitoring System complies with all applicable and required standards for electromagnetic interference. • It does not normally affect nearby equipment and devices. • It is not normally affected by nearby equipment and devices. • It is safe to operate the Acuity System in the presence of high-frequency surgical equipment.
Directions for use Chapter 11 Specifications 185 Guidance and Manufacturer’s Declaration—Electromagnetic Immunity The Acuity System is intended for use in the electromagnetic environment specified below. The customer or the user of the Acuity System should assure that it is used in such an environment.
186 Chapter 11 Specifications Welch Allyn Acuity Central Monitoring System Guidance and Manufacturer’s Declaration—Electromagnetic Immunity The Acuity System is intended for use in the electromagnetic environment specified below. The customer or the user of the Acuity System should assure that it is used in such an environment.
Directions for use Chapter 11 Specifications 187 Recommended Separation Distances Between Portable and Mobile RF Communications Equipment and the Acuity System The Acuity System is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled.
188 Chapter 11 Specifications Welch Allyn Acuity Central Monitoring System Acuity System customizable defaults and factory defaults Acuity System default settings appear in Acuity System windows upon patient monitor connection, when a patient’s window is first opened. There are two types of Acuity System default settings: • Customizable default settings: Settings that can be customized to match your clinical workflow model, at the point of installation.
Directions for use Chapter 11 Specifications 189 Virtual Monitor and Waveform Window Table 32.
190 Chapter 11 Specifications Welch Allyn Acuity Central Monitoring System Table 32. Virtual Monitor Features Customizable default Factory default Heart rate (HR) For patients being monitored for arrhythmias, the HR value is derived from the arrhythmia library instead of from the patient monitor. Table 33. Waveform Window Features Factory default Waveform Window auto open In waveforms views: 1. Upon monitor connection to Acuity System if empty window 2.
Directions for use Chapter 11 Specifications Table 35.
192 Chapter 11 Specifications Welch Allyn Acuity Central Monitoring System Table 35. Setup window—Arrhythmia Alarms Features Clicking Arr/ST Relearn or RELEARN Clicking Analyze Pacers Clicking Single ECG Note: A RELEARN button instead of an Arr/ST Relearn button indicates that the system does not include ST Analysis or the ST Analysis Setup window.
Directions for use Chapter 11 Specifications 193 Table 36. Setup window—ST Analysis Features Customizable default ST Analysis On Factory default ST analysis is disabled for these monitors • Patient monitors in the Neonate mode • Virtual Monitors with Analyze Pacers on in the Arrhythmia Alarms Setup window.
194 Chapter 11 Specifications Welch Allyn Acuity Central Monitoring System Table 36. Setup window—ST Analysis Features Customizable default Presets values Alarm limits: 1.0 mm Alarm level: Low Measurement Offset: Auto Print on Alarm: Off Factory default Clicking the ST RELEARN button System relearns a patient’s normal ECG rhythm and uses the relearned rhythm as a guideline to analyze deviation of the ECG ST-segment offset.
Directions for use Chapter 11 Specifications 195 Review windows Table 39.
196 Chapter 11 Specifications Welch Allyn Acuity Central Monitoring System Table 40.
Directions for use Chapter 11 Specifications 197 Table 41. Review window—Waveforms Features Factory default Display priority of waveforms Up to five (ten in the full-screen review view) monitored within the last 24 hours in following order of priority: 1. ECG 2. P1 3. P2 4. P3 5. P4 6. CO2 7. RESP 8.
198 Chapter 11 Specifications Welch Allyn Acuity Central Monitoring System Table 42. Review window—Arrhythmia Events Features Factory default Waveform display 1. Arrhythmia 2. ECG waveforms used at the time of arrhythmia analysis (one visible in Half Screen view, more visible in Full Screen view depending on space and monitor type).
Directions for use Chapter 11 Specifications 199 Table 43.
200 Chapter 11 Specifications Welch Allyn Acuity Central Monitoring System
201 Warranty LIMITED WARRANTY: ACUITY CENTRAL MONITORING SYSTEM AND ACCESSORIES This product is sold by Welch Allyn under the warranties set forth in the following paragraphs. These warranties are extended only to the end user with respect to the purchase of this product directly from Welch Allyn or Welch Allyn’s authorized distributors as new merchandise.
202 Warranty Welch Allyn Acuity Central Monitoring System
203 Index A Access point, ethernet 10 Acuity System adjust time 164 Central Station 10 Central Station screen 16 compatibility with monitors 175 components 10 components, don’t change 3 components, inspect 172 discontinue monitoring 133 documents 8 general information 1 heart rate calculation 177 if inoperable 4 Intended Use 1 networked or remote 11, 19, 20, 97, 121, 145, 176 opening Central Station windows 145 overview 9 secondary recommended 3 set language 165 specifications 175 status icons 20 troublesh
204 Index false alarms 159 Full or Lethal Only options 54 learning period during 64, 78, 91, 162, 171 lethal, definition of 52, 95 pacemaker patients and 62 physiologic differences 66 Print On Alarm 62, 74 remove a latched alarm 87 terms 52 troubleshooting 161 types detected 66 Artifact, definition of 52 Asystole definition 55 not detected 161 Auto prints, setting up 49 Auto Set button 46 B Barcode scanner 40 Bigeminy definition 56 Border, Virtual Monitor color 83 Buttons system 19 C Cable check network
Directions for use check periodically 172 ESSID, identifying or changing a 165 Ethernet, access point 10 Event definitions, Arrhythmia 54 Event marker definition of 52 delete arrhythmia 111 list and counts 109, 111 Event, definition of 52 Events/tabular trends, review 101 F Factory defaults and specifications 188 False alarms ECG and arrhythmia 159 SpO2 158 FlexNet 9 G General information 1 Glossary of arrhythmia terms 52 Graphical Trends Review window 99, 113, 117 specifications 195 H Hallway message p
206 Index incorrect 37 Monitor clearing trends and alarm limits 28, 35 compatibility with Acuity System 175 connection to Acuity System 28, 35 model and serial number 40 not connecting 152 saving trends and alarm limits 28, 35 Monitor status icons 138 Monitoring begin 25 networked patients 9, 19, 176 set up typical 43 starting hardwired 28 stop 133 Move patient and hardwired monitor 127 patient from wireless monitor 129 patient to different monitor 131 N Neonatal patients do not use arrhythmia feature wi
Directions for use outages 170 supply, uninterruptible 3 Preadmit patient 25 Presets button 46, 60, 74 Print Next button 50 Print On Alarm arrhythmia 62, 74 printout 119 Printer enable or disable parallel 165 optional laser 10 paper size, set system 165 set ISO encoding 169 view status of 50 Printing Alarm printouts 62, 74, 119 coordinate jobs 50 delete selection 50 Patient List 121 print next 50 print on alarm setup 49 Review printouts 117 review prints 104 Setup window 49 Setup window specifications 194
208 Index Specifications 175 alarm and alert 179 EMC 184 factory defaults 188 general monitoring 175 heart rate calculation 177 pacemaker 178 Patient List 188 printing 188 Setup windows 190 system compatibility 175 Virtual Monitor 189 SpO2 114 false alarms 158 Masimo PI and SIQ indicators 17, 23, 100, 105, 114 OxyCRG print setup 49 response time 44 troubleshooting 159 ST Analysis alarms off 71 check leads for 73 detection and ECG electrodes 77 disabled when 69 dismiss alarm 90 reference beat 70 set prefer
Directions for use W WACS 1, 10 Warnings and cautions arrhythmia analysis 66 connecting monitor to Acuity System 37 ST Analysis 69 suspending alarm, alert tones 85 Waveform Window Acuity Central Station screen 16 add patient note in 81 border colors 22 close on Acuity System screen 51 close on PLR Acuity System screen 12 numeric display 182 open from a PLR station 12 open from map 21 open from the map 22 patient note in 22 print a Snapshot 22 resume alarm tones from 22 Setup window 51 Setup window specific
210 Index Welch Allyn Acuity Central Monitoring System
