PM8000 Express User Manual
PM8000 Express User Manual
PM8000 Express User Manual
Patient Monitor
Operation Manual
Penlon Ltd
Abingdon
UK
IMPORTANT
Technical Support
Penlon Limited
Abingdon Science Park
Barton Lane
Abingdon
OX14 3PH
UK
1. Type of equipment
2. Product name
3. Serial number
4. Approximate date of purchase
5. Apparent fault
(i)
FOREWORD
(ii)
Contents
Manufacturer’s Responsibility..............................................................................II
Warranty......................................................................................................... II
Exemptions..................................................................................................... II
Contents ..................................................................................................................V
Preface......................................................................................................................1
Manual Purpose...............................................................................................1
Intended Audience...........................................................................................1
Version Information ........................................................................................1
Illustrations and Names...................................................................................2
Conventions ....................................................................................................2
V
Contents
VI
Contents
VII
Contents
8 Recording............................................................................................................. 8-1
VIII
Contents
11.1 Overview....................................................................................................11-2
11.1.1 ECG Waveform ............................................................................11-2
11.1.2 ECG Parameters ...........................................................................11-4
11.2 ECG Monitoring Procedure .......................................................................11-5
11.2.1 Preparation....................................................................................11-5
11.2.2 Electrode Placement .....................................................................11-6
11.3 ECG Setup Menu .....................................................................................11-12
11.4 ST Analysis ..............................................................................................11-19
11.4.1 Overview ....................................................................................11-19
11.4.2 ST Analysis Menu ......................................................................11-19
11.5 Arrhythmia Analysis ................................................................................11-23
11.5.1 Overview ....................................................................................11-23
11.5.2 Arrhythmia Analysis Menu ........................................................11-24
11.5.3 Arrhythmia Alarm Setup ............................................................11-25
11.5.4 Arrhythmia Recall ......................................................................11-26
11.6 RESP Monitoring .....................................................................................11-28
11.6.1 Overview ....................................................................................11-28
11.6.2 Electrode Placement ...................................................................11-29
11.6.3 Respiration Setup .......................................................................11-30
11.7 Maintenance and Cleaning .......................................................................11-32
IX
Contents
X
Contents
XI
Contents
18 Appendices......................................................................................................... 18-1
XII
Preface
Manual Purpose
This manual provides the instructions necessary to operate the PM-8000 Express
Patient Monitor (hereinafter called as this monitor) in accordance with its function
and intended use. Observance of this manual is a prerequisite for proper
performance and correct operation, and ensures patient and operator safety.
This manual is written based on the maximum configuration. Part of this manual
may not apply to your monitor. If you have any question about the configuration of
your monitor, please contact our Customer Service.
This manual is an integral part of and should always be kept close to the patient
monitor, so that it can be obtained conveniently when necessary.
Intended Audience
This manual is geared for the clinical medical professionals. Clinical medical
professionals are expected to have working knowledge of medical procedures,
practices and terminology as required for monitoring of critically ill patients.
Version Information
This manual has a version number. This version number changes whenever the
manual is updated due to software or technical specification change. Content of this
manual is subject to change without prior notice. The version information of this
manual is as follows.
1.0 2005-11-4
1
Preface
All illustrations in this manual are provided as examples only. They may not
necessarily accord with the graph, settings or data displayed on your patient monitor.
All names appeared in this manual and illustrations are fictive. It is a mere
coincidence if the name is the same with yours.
Conventions
Italic text is used in this manual to quote the referenced chapters or sections.
The terms danger, warning, and caution are used throughout this manual to point
out hazards and to designate a degree or level or seriousness.
2
1 Safety
1-1
Safety
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
WARNING
CAUTION
NOTE
1-2
Safety
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 manual.
1.1.2 Warnings
WARNING
To ensure patient safety, verify the device and accessories can function
safely and normally before use.
ELECTRIC SHOCK: Do not open the monitor housing. All servicing and
future upgrades to this device must be carried out by personnel trained
and authorized by our company only.
1-3
Safety
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.
At the end of its service life, the product described in this manual, as
well as its accessories, must be disposed of in compliance with the
guidelines regulating the disposal of such products. If you have any
questions concerning disposal of the products, please contact with us.
Magnetic and electrical fields are capable of interfering with the proper
performance of the device. For this reason make sure that all external
devices operated in the vicinity of the monitor comply with the relevant
EMC requirements. Mobile phone, X-ray equipment or MRI devices are a
possible source of interference as they may emit higher levels of
electromagnetic radiation.
Before connecting the patient monitor to the power line, check that the
voltage and frequency ratings of the power line are the same as those
indicated on the label or in this manual.
1-4
Safety
1.1.4 Notes
NOTE
Keep this manual close to the patient monitor so that it can be obtained
conveniently when necessary.
Put the patient monitor in a location where you can easily see the screen
and access the operating controls.
1-5
Safety
NOTE
Power ON/OFF
Battery indicator
Equipotentiality
Gas inlet
Gas outlet
Auxiliary output
Network connector
1-6
Safety
VGA connector
Manufacture date
Serial number
ESD sensitivity
1-7
Safety
1.3 CE Marking
The patient monitor bears CE mark indicating its conformity with the provision of
Council Directive 93/42/EEC concerning medical devices, and fulfills the essential
requirement of Annex I of this directive.
1-8
Safety
1-9
Safety
1-10
2 The Basics
2-1
The Basics
The intended use of this monitor is to monitor a fixed set of parameters (see 2.1.4
Functions) for single adult, pediatric and neonatal patient, to display patient data
and waveforms, to store patient data in a trend database, and to generate alarms and
recordings.
This monitor is to be used in but not restricted to medical institutions such as ICU,
CCU, cardiopathy ICU, operating room, emergency room and postoperative
observation ward etc. This monitor may also be used during hospital transport or
ambulance. This monitor is not intended for helicopter transport or home use.
WARNING
2-2
The Basics
2.1.2 Contraindications
None.
2.1.3 Components
This monitor consists of parameter measuring modules, blood pressure cuff, ECG
and IBP cables, SpO2 sensors, and CO2 measuring components. Some of the
components are optional and may not apply to your patient monitor.
2.1.4 Functions
This monitor has additional functions including visual & audible alarms, freezing,
data storage and output, recall, recording and drug calculation etc. Please refer to the
following corresponding chapters for details of each specific function.
2-3
The Basics
Handle
Alarm indicator
Display
Control panel
Control knob
The alarm indicator of this monitor complies with the requirement of EN60825-1
A11 Class 1 for LED. The LED indicator varies its flash color and frequency to
indicate different alarm levels. For details, please refer to the section of 6.2.1 Visual
Alarms.
WARNING
Move or lift the monitor by the handle only. Do not use the patient cable
or the power cord to move or lift the monitor. It might cause the monitor
to fall, which might damage the monitor or injure the patient.
2-4
The Basics
4 7
1
5
10
8
2
11
9
3 12
Figure 2-2 Left Side Panel Figure 2-3 Right Side Panel
NOTE
2-5
The Basics
1
2
3
6 7 8 9
1. Fan Vent
2. Speaker holes
2-6
The Basics
To know details about the connections of the connectors, please refer to 3.1
Installation.
WARNING
2-7
The Basics
1
The control panel is located on the right side
of the front panel, as shown in the figure on 2 3
the right.
4 5
1. Power switch
This key turns the monitor ON and OFF. To turn 6 7
OFF the monitor, please press this key and hold
for more than 2 seconds.
8
2. AC power indicator
ON: AC power is applied to the monitor.
OFF: AC power is not applied to the monitor.
3. Battery indicator
The battery indicator tells the battery status. See 2.5 Batteries for more information.
4. FREEZE
This key is pressed to freeze and unfreeze waveforms. See 7 Freezing Waveforms
for more information.
5. SILENCE
You can press this key to pause alarms, silence the monitor or clear alarms. You can
also switch between different alarm statuses through this key. See 6.3.5 Status
Switchover for more information.
6. RECORD
Press this key to start or stop recording. See 8 Recording for more information.
7. NIBP
Press this key to start or stop non-invasive blood pressure measurement. See 13
NIBP Monitoring for more information.
8. 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. This procedure is referred to as “select ”
through out the manual. Remember rotate to highlight, and then press to select.
2-8
The Basics
2.4 Display
This monitor has a color TFT LCD display of high resolution. It is able to display
patient parameters and waveforms clearly. The following is the standard interface
when the monitor is operating normally.
1 2 3 4 5
6 7
8 9 10 11
Figure 2-5 Main Screen
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. For details, see 4.4.3 Time Setup.
2-9
The Basics
of multiple messages, they will be displayed alternately. This area shows the patient
name and sex when no message is to be displayed.
4. Sound icon
6. Waveforms area
For the maximum configuration, at most seven waveforms can be displayed in the
the waveforms area, including two ECG waveforms, one SpO2 plethysmogram, two
IBP waveforms, one CO2 waveform and one RESP waveform. In HALF-SCREEN
MULTI-LEADS display mode, a maximum of ten waveforms can be displayed,
among which six are ECG waveforms. You may select the waveforms to be
displayed and adjust the display positions. For details, see 4.4.8 Trace Setup.
7. Parameter windows
NIBP label
IBP label
CO2 label
The parameter windows are located on the right of the waveform area, and are
2-10
The Basics
divided by white lines. Each window is identified by a parameter label on the upper
left.
You may select a parameter label to open the setup menu of this parameter. Each of
the parameter is described in more detail in the following chapters. If you select to
turn OFF the alarm of a parameter in its corresponding setup menu, an Alarms
Disabled icon will be displayed aside the parameter label. For more information, see
6.3.1 Alarms Disabled.
9. Battery symbol
The battery symbol displays the status of the battery. For more information, please
refer to 2.5 Batteries.
2-11
The Basics
2.5 Batteries
This monitor is designed to operate run battery power when during transport 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.
Besides, the battery indicator also indicates the status of the battery.
ON: The battery is being charged or the battery is fully charged.
OFF: No battery is installed. If the battery is installed but the monitor is not
connected to AC power and not turned on, the indicator will also be off.
Flashes: The monitor is powered by the internal battery.
The capacity of the internal battery is limited. When the battery capacity is too low,
a high level alarm is triggered and the “Battery two low” message is given in the
technical alarms area. At this moment, the AC power shall be applied to the monitor.
For details about installation of the battery, refer to the section 3.1.5.3 Installing the
Battery.
NOTE
WARNING
2-12
The Basics
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.
The performance of a rechargeable battery may deteriorate over time. To check the
performance of a battery, follow this procedure:
1. Disconnect the monitor from the patient and stop all monitoring or measuring.
2. Apply AC power to the monitor and allow the battery to charge uninterrupted
for 10 hours.
3. Remove AC power and allow the monitor to run from the battery until it shuts
off.
4. The operating time of battery reflects its performance directly.
If your monitor has two battery slots, you can check two batteries at the same time.
Please replace the battery or contact with the maintenance personnel if its operating
time is significantly lower than the specified time.
2-13
The Basics
NOTE
When a battery has visual signs of damage, or no longer holds a charge, it should be
replaced. Remove the old battery from the monitor and recycle it properly. To
dispose of the batteries, follow local laws for proper disposal.
WARNING
2-14
The Basics
This monitor can be configured with a wireless compact flash adapter, which is
connected to the CMS (Central Monitoring System) in the wireless mode and
constructs with the CMS the monitoring network. For the installation of the wireless
compact flash adapter, refer to 3.1.5.8 Wireless Compact Flash Adapter. For the
settings of the wireless network, refer to 4.7.2 Wireless Net Setup.
In front of the wireless compact flash adapter is an indicator that indicating its
working status:
OFF: The wireless compact flash adapter is not plugged properly, or your
monitor does not support the wireless compact flash adapter.
FLASH: The wireless compact flash adapter is searching the network.
ON: The wireless compact flash adapter is connected to the network.
Note
Caution
Do not touch the wireless compact flash adapter when the monitor is
powered on because the adapter is sensitive to electro-static discharge.
Do not plug or unplug the wireless compact flash adapter when the
monitor is turned on.
2-15
The Basics
2-16
3 Installation and Maintenance
3-1
Installation and Maintenance
3.1 Installation
WARNING
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 for in case of any
problem.
NOTE
Please save the packing case and packaging material for future
transport and storage.
WARNING
3-2
Installation and Maintenance
The operating environment of the monitor must meet the requirements specified in
the section A.2 Environmental Specifications of Appendix A Product
Specifications.
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.
Condensation can form when the monitor is moved from one location to another,
and being exposed to differences in humidity or temperature. Make sure that during
operation the instrument is free from condensation.
The power applied to the monitor must meet the requirements specified in the
section A.3 Power Source Specifications of Appendix A Product Specifications.
WARNING
Make sure that the operating environment and the power applied to the
patient monitor complies the specified requirements. Otherwise its
performance might not meet the specifications claimed in Appendix A
Product Specifications, and unexpected results, such as damages to the
patient monitor, may be incurred.
For details, please refer to the corresponding instructions for use of bracket
mounting.
3-3
Installation and Maintenance
WARNING
NOTE
3-4
Installation and Maintenance
WARNING
1. Verify that the DC power supply meets the requirements specified in the section
A.3 Power Source Specifications.
2. Connect DC power supply to the DC power connector on the rear panel of the
monitor.
If the monitor is to be powered by the internal battery, install the battery following
the steps as below:
1. Slide the battery door toward the rear of the monitor to open it.
2. Press the battery catch to the upper using one finger.
3. Insert the battery into the battery slot.
4. Release the battery catch, and it will fix the battery.
5. Close the battery door.
WARNING
Make sure the battery door is securely latched. Falling batteries could
seriously or fatally injure a patient.
3-5
Installation and Maintenance
When other equipments are used together with the monitor, a grounding cable
should be used to connect the equipotential grounding connectors of the monitor and
of other equipments. This helps to reduce the potential differences between different
pieces of equipment, and ensure the safety of the operator and patient.
WARNING
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.
The network connector of the monitor is a standard RJ45 connector. It connects the
monitor with the central monitoring system, or with a PC for online upgrading or
data output. It can also connect with another patient monitor for viewbed
monitoring.
1. Connect one end of the network cable with the network connector of the
monitor.
2. Connect the other end of the network cable with the hub or switch of the central
monitoring system, or with the network connector of a PC, or with the network
connector of another patient monitor.
NOTE
3-6
Installation and Maintenance
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.
If the monitor is connected with a defibrillation equipment, the monitor can
generate defibrillator synchronization signals to the defibrillation equipment.
To generate different signals, you must first select the AUX OUTPUT to
corresponding options. For details, please refer to 4.7 Maintenance.
NOTE
The nurse call cable has two non-polarized conducers at the output end.
The installation should be performed by Mindray servicing engineers or
engineers of the hospital according to the specific nurse call system of
the hospital.
WARNING
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.
3-7
Installation and Maintenance
Caution
3-8
Installation and Maintenance
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.
NOTE
3-9
Installation and Maintenance
After installing the monitor, please follow the procedure described below to power
on the monitor:
1. Before using the monitor, please carry out corresponding safety inspection as
given in 3.2.1 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. Several seconds later, the system finishes the self-test and displays the main
screen.
5. The system will initiate every module, and display “XX alarm disabled!”
information in the lower left part of the screen. “XX” represents the name of
every module, such as NIBP, RESP etc.
6. At this time, you can operate the monitor using the control panel. “XX alarm
disabled!” information will disappear a few seconds later.
When the monitor is plugged into AC power and is turned OFF or not turn ON, the
monitor only provides the function of battery charging.
NOTE
3-10
Installation and Maintenance
3.2 Maintenance
WARNING
3.2.1 Inspection
Make sure the qualified service personnel have implemented a complete inspection
before putting the monitor into operation, after monitor servicing or system
upgrading, or after the monitor has been used for 6-12 consecutive months. This is
to ensure the normal operation of the system.
3-11
Installation and Maintenance
3.2.2 Cleaning
WARNING
Be sure to shut down the system and disconnect all power cords from
the outlet before cleaning the equipment.
The exterior surfaces of the equipment may be cleaned with a clean and soft cloth,
sponge or cotton ball, dampened with a non-erosive cleaning solution. Drying off
excess cleaning solution before cleaning the equipment is recommended. Following
are examples of cleaning solutions:
Diluted soap water
Diluted ammonia water
Diluted sodium hyoichlo (bleaching agent)
Diluted formaldehyde (35 to 37%)
Hydrogen peroxide (3%)
Ethanol (70%), or Isopropanol (70%)
For cleaning information of accessories, please refer to the chapters for specific
patient parameters and the instructions for use of the accessories.
3-12
Installation and Maintenance
WARNING
The cleaning solutions above can only be used for general cleaning. If
you use them to control infections, we shall assume no responsible for
the effectiveness.
NOTE
ALWAYS wipe off all the excess liquids on the equipment surface and
accessory surface with a wet cloth;
3-13
Installation and Maintenance
3-14
4 System Menu
4-1
System Menu
4.1 Overview
You can set the settings of the monitor by opening the menus above. Most settings
could be saved after the minitor is turned off. Few settings, which could not be saved,
will be specified in the relevant sections.
This chapter only gives introduction to the system menu. Other menus will be
described in the following chapters. Select the MENU label on the main screen. The
SYSTEM MENU appears as shown below.
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.
4-2
System Menu
3. Online help: The help information changes with the highlighted selection.
4. Exit key: Exits from the current menu.
Some menus do not have the EXIT key. Instead, a YES and a NO key or a
CONFIRM and a CANCEL key are provided. You can confirm the operations with
these keys.
Details about the TREND GRAPH>>, TREND TABLE>>, NIBP RECALL>> and
ALARM RECALL>> are given in 9 Recall. While the DRUG CALC is detailed in
10 Drug Calculation.
4-3
System Menu
This menu displays the patient’s information, as well as four buttons located below.
If no patient is admitted, only the default settings of PAT TYPE and PACE are
displayed, and DISCHARGE PATIENT and MODIFY PATIENT buttons are
disabled.
4-4
System Menu
4-5
System Menu
NOTE
If the PAT NO or NAME has not been input, “PATI. INFO. IMCMP” will be
displayed in the patient information area.
To enter information in a field containing the mark “ ”, follow this procedure (take
SEX as an example):
1. Rotate the control knob and highlight the field after SEX.
2. Press the control knob. A pop-up menu opens.
3. Rotate the control knob and select the desired option.
To set a feild containing the mark “ ”, follow this procedure (take BED NO as an
example):
1. Rotate the control knob and highlight the field after BED NO.
2. Press the control knob.
3. Rotate the control knob and select the desired bed number. The bed number
increases or decreases by one as the control knob rotates.
4-6
System Menu
To modify the information of the patient being monitored, follow this procedure:
1. Select MODIFY PATIENT button in PATIENT SETUP menu.
2. The menu as shown in Figure 4-3 opens.
3. Modify the patient’s information as described above, and select OK button.
4. Prompt information will be displayed on the central monitoring system if the
monitor is connected with it.
4-7
System Menu
You can also modify the configuration of the monitor and save the modified
configuration as the user-defined default configuration of the corresponding patient
type. When the monitor begins monitoring a new patient, you may to choose the
user-defined default configuration directly, loosing from performing the settings
again. However, the user-defined configuration must be appropriate and correct.
1. Verify the modified configuration is appropriate and correct.
2. Select the SAVE CURRENT AS USER CONFIG option.
3. Select YES in the popup dialog box to save current configuration as the
user-defined default configuration.
4. Select NO to cancel the operation.
4-8
System Menu
4-9
System Menu
Select FACE SELECT>> in SYSTEM SETUP menu. The following menu appears.
In FACE SELECT menu, options are available as shown above. For detailed
information, see 5 Face Selection.
4-10
System Menu
Select ALARM SETUP>> in SYSTEM SETUP menu. The following menu appears.
If a parameter alarm setup is selected from the drop-down list of ALM SEL, the
corresponding alarm setup items will be displayed in the ALARM SETUP menu.
4-11
System Menu
Select TIME SETUP>> in SYSTEM SETUP menu. The following menu appears.
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.
4-12
System Menu
NOTE
4-13
System Menu
NOTE
TIMING REC TIME cannot be saved after the monitor is turned off. But it
can be saved as the user default configuration.
4-14
System Menu
Select DATA OUTPUT>> in SYSTEM SETUP menu. The following menu appears.
Output Procedure
NOTE
During data output, the NEW PATIENT option in the PATIENT SETUP
menu is inactive.
4-15
System Menu
Select ANALOG >> in SYSTEM SETUP menu. The following menu appears.
NOTE
4-16
System Menu
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, “√”
indicates an enabled module. A module without the “√” mark is disabled and the
related waveform and parameter data disappear from the display.
4-17
System Menu
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 “√” 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.
In addition, the WAVE SEQUENCE >> option allows you choose in which sequence
the parameter waveforms are displayed from the upper to the lower.
4-18
System Menu
Select MARK EVENT>> in SYSTEM SETUP menu. The following menu appears.
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 even 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. A
mark will be displayed on the trend graph/table indicating the time the mark was
initiated in relation to the event it represents.
4-19
System Menu
4-20
System Menu
You can see the software versions of the monitor. The DEVICE CONFIG LIST>>
option allows you to see the configuration of the monitor.
4-21
System Menu
The DEVICE VERSION LIST>> option allows you to see the following version
information.
4-22
System Menu
4.7 Maintenance
Enter USER KEY, then select CONFIRM button. The following menu appears.
4-23
System Menu
4-24
System Menu
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.
WARNING
NOTE
The setting of the line frequency can neither be saved as the default user
configuration nor changed when the default factory configuration is
selected. Once set by a user, no operation except for manual adjustment
can change it. The setting keeps the same even when the monitor is
restarted.
4-25
System Menu
When the monitor is connected with the central monitoring system, and the NET
TYPE is CMS+, you need to set the IP address of your monitor. Select IP
ADDRESS SETUP in USER MAINTAIN menu. The following menu appears. For
details, please contact with the technician responsible for the central monitoring
system in your hospital.
4-26
System Menu
This monitor can be configured with wireless network, which is connected to the
CMS (Central Monitoring System) in the wireless mode and constructs with the
CMS the monitoring network.
Note
Select WIRELESS NET SETUP in USER MAINTAIN MENU. The following menu
appears. If the monitor connects with the central monitoring system through a
compact flash adapter, the ESS ID and CHANNEL NUMBER must be correctly set.
For details, please contact with the technician responsible for the central monitoring
system in your hospital.
4-27
System Menu
This menu allows you to choose the color in which 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 waveforms.
4-28
System Menu
Select NURSE CALL SETUP >> in USER MAINTAIN menu. The following menu
appears.
SIGNAL TYPE
1. NORMAL OPEN: Select this option when the hospital’s call system is set to
NORMAL OPEN.
2. NORMAL CLOSE: Select this option when the hospital’s call system is set to
NORMAL CLOSE.
4-29
System Menu
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.
NOTE
If no option in ALM LEV or ALM TYPE is selected, the nurse call signal
will not be triggered in whatever condition.
The nurse call function can’t be used as the main alarm notice method.
Medical stall must combine the audible and visual alarms, the clinical
vital signs of the patient to determine the patient’s situation.
In the Alarms Paused or the System Silenced status, the nurse call
function of the monitor will be disabled automatically.
4-30
System Menu
Selecting CO2 USER MAINTAIN >> in USER MAINTAIN menu opens the CO2
USER MAINTAIN menu. The options contained in this menu are relative with the
CO2 module that you monitor is equipped with. For details, please refer to 16.2.4
CO2 User Maintain Menu and 16.3.4 CO2 User Maintain Menu.
4-31
System Menu
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.
WARNING
4-32
5 Face Selection
5-1
Face Selection
As described in 4.4.1 Face Select, you can open the FACE SELECT menu by
selecting FACE SELECT >> in SYSTEM SETUP menu.
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
Face Selection
To enter the following screen, select TREND SCREEN in FACE SELECT menu and
then select EXIT.
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. On the trend
graph, the scale of the right end of the X-axis is 0 hour while the left end is -2 hour.
5-3
Face Selection
To enter the following screen, select oxyCRG SCREEN in FACE SELECT menu
and then select EXIT.
1 2 3
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. In addition, three labels are displayed beneath the time
scale (see 1, 2 and 3 in the figure above). The labels are detailed as below.
1. Trend length
This label allows you to select the time duration of the trend graphs displayed. You
can select either 1 minute, 2 minutes or 4 minutes.
2. Compressed respiration waveform/RR trend
With this lable, you can select to display the compressed respiration waveform or
the RR trend beneath the SpO2 trend.
3. Recording
You can select the REC label to print out the the trends or the waveform displayed in
the oxyCRG screen using the recorder.
5-4
Face Selection
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, viewbed function is disabled.
1 3
The monitor you are viewing from is called “host monitor”. The monitor being
viewed is called “viewbed monitor”. The viewbed screen is always displayed at the
lower part of the host monitor’s waveform area. As shown in Figure 5-5, it consists
5-5
Face Selection
Automatic Selection
When the viewbed screen is opened, the host monitor automatically selects a
viewbed monitor on the same network and a waveform of this monitor to view. In
case the monitor being viewed is disconnected, the host monitor automatically
closes the display of alarms, parameters and the waveform of the viewbed monitor.
However, the host monitor will not automatically select to view other monitor. You
must make the selection using the viewbed monitor label manually.
5-6
Face Selection
To enter the following screen, open FACE SELECT menu, select LARGE FONT
SCREEN, and then select EXIT.
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. If all
the three modules are closed, no waveform or parameter is displayed on the screen.
NOTE
When you open a menu in the large font screen mode, the monitor will
enter the standard screen automatically. When you exit the menu, the
monitor will return to the large font screen.
5-7
Face Selection
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. The previous menu
settings and patient information keep unchanged.
1. Disconnect all leads and sensors between the patient and the monitor.
2. Select the STANDBY label at the lower right corner of the main screen. A dialog
box pops up, and you can choose to enter the standby mode or not.
3. Select YES, and the monitor will enter the standby mode as shown below.
4. Select NO, and the monitor will return to the previous screen.
Press any key other than the power switch on the control panel or turn the control
knob in the STANDBY mode, and a dialog box will pop up. Select YES in the
dialog box, and you will exit the STANDBY mode and return to the previous screen.
5-8
6 Alarms
6-1
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. If no beep is heard, or the alarm indicator
doesn’t flash normally, please do not use the monitor, and contact our customer
service.
For details about alarm setup of this monitor, please refer to 4.4.2 Alarm Setup.
The alarms are divided into three categories: physiological alarms, technical alarms
and prompt information.
1. Physiological alarms
A physiological alarm either indicates that a monitored physiological parameter is
out of specified limits or indicates an abnormal patient condition. For example: HR
TOO LOW, ECG LOST or RESP ARTIFACT, etc. Physiological alarm messages are
displayed in the physiological alarms area of the main screen.
2. Technical alarms
Technical alarms are also referred to as system error messages. A technical alarm
indicates that the monitor or parts of the monitor is not capable of accurately
monitoring the patient’s condition due to improper operation or system failure. For
example: ECG INIT ERR or TEMP SELFTEST ERROR, etc. Technical alarm
messages are usually displayed in the technical alarms area of the main screen. But
the technical alarms related to NIBP are displayed in the lower part of the NIBP
parameter window.
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
6-2
Alarms
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. Prompt information is usually displayed in the
technical alarms area. But the prompt information relating to NIBP is displayed in
the lower part of the NIBP paramter window.
NOTE
The alarms are divided into three priority levels: high level alarms, medium level
alarms and low level alarms.
The levels of all technical alarms and some physiological alarms are not
user-adjustable, because they have been fixed when the monitor is produced.
However, you can change the levels of some physiological alarms in the
corresponding parameter setup menus.
All physiological alarms, technical alarms and prompt information are given in
Appendix C Alarm Messages and Prompt Information.
6-3
Alarms
When an alarm occurs, the monitor raise 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.
The alarm indicator on the front panel of the monitor varies its flash color and
frequency to indicate different alarm levels.
High level alarm: red and quick flash;
Medium level alarm: yellow and slow flash;
Low level alarm: yellow light without flash.
The monitor uses different alarm tones to indicate different alarm levels.
High level alarm: “DO-DO-DO--DO-DO---DO-DO-DO--DO-DO”.
Medium level alarm: “DO-DO-DO”.
Low level alarm: “DO”.
Different intervals correspond to different alarm levels: High level alarm phonates
once every 3 or 8 seconds. Medium level alarm phonates once every 14 or 24
seconds. Low level alarm phonates once every 24 seconds. For details, please refer
to 4.7 Maintenance.
6-4
Alarms
NOTE
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.
High level alarms: triple asterisks “***”
Medium level alarms: dual asterisks “**”
Low level alarms: single asterisk “*”
The monitor varies the background color of the technical and physiological alarm
messages to indicate the alarm level.
High level alarms: red background color
Medium level alarms: yellow background color
Low level alarms: yellow background color
NOTE
An alarm is triggered when a patient parameter exceeds the parameter limit. At the
same time, the measured parameter value in the parameter window flashes every
second. If the ALM LIMIT in the SELECTION menu is turned ON, the exceeded
upper or lower alarm limit also flashes every second.
6-5
Alarms
When an alarm occurs, normally the monitor gives indications in the modes
mentioned above as per the alarm level. If necessary, you can the set the monitor to
the following alarm statuses.
Alarms Disabled
Alarms Paused
System Silenced
Alarms Silenced
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.
To disable the alarms of a parameter, you should open the setup menu of the
parameter. Take heart rate (HR) as an example.
1. Rotate the control knob and highlight the ECG parameter label.
2. Press the control knob. The ECG SETUP menu pops up.
3. Rotate the control knob and highlight the field on the right of HR ALM.
4. Press the control knob, and then select OFF from the pull-down list.
5. The HR alarms are disabled. The icon will be displayed on the right of the
ECG parameter label.
NOTE
6-6
Alarms
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.
If the alarms paused time is over or a new technical alarm occurs in the Alarms
Paused status, the monitor will terminate the Paused Alarm status and return to
normal status. Besides, you can also termiante the Alarms Paused status by pressing
the SILENCE shortly.
To silence the system, press the Silence key for no less than 2 seconds. In the
System Silenced status, all system sounds are shielded and the icon is displayed
in the sound icon area. However, other modes of alarms (excluding audible alarms)
are given as normal. If a new alarm occurs, the System Silenced status will be
terminated.
The system sounds include the audible alarms, key tones, heart beat tones and pulse
tones. Among them, key tones refer to the sounds produced when the control knob is
rotated and pressed.
In Alarms Silenced status, all audible alarms are suppressed, but other modes of
alarms and other sounds are not influenced. The icon will be displayed in the
sound icon area. To silence the audible alarms, first access the USER MAINTAIN
menu, and then set the AUDIO ALARM to OFF. For details, please refer to 4.7
Maintenance.
6-7
Alarms
6-8
Alarms
As described in 4.4.2 Alarm Setup, the parameter alarm type can be set to either
LATCHED or UNLATCHED.
If the parameter alarm type is set to LATCHED, before or during the occurence of a
parameter alarm, the alarm message will be latched even if the initial alarm
condition has ceased. The alarm messsage continues to be displayed, but the
alarming modes change as follows:
The measured parameter value and the upper or lower parameter limits stop
flashing.
The generated time of the alarm is displayed behind the alarm message in the
physiological alarms area.
If the parameter alarm type is set to UNLATCHED, the monitor stops giving any
indication for this alarm when the initial alarm condition has ceased.
6-9
Alarms
Generally the alarm indications of an alarm will automatically be cleared when the
alarm condition that triggers the alarm ceases. However, you can also clear the alarm
indications or the latched alarms by the following ways.
Please refer to Appendix C Alarm Messages and Prompt Information to see for
which technical alarms that the audible and visual indications can be cleared.
Please refer to Appendix C Alarm Messages and Prompt Information to see for
which technical alarms that all alarm indications can be cleared.
6-10
Alarms
DANGER
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 Appendix C Alarm Messages
and Prompt Information
6-11
Alarms
6-12
7 Freezing Waveforms
7-1
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
two frozen waveforms using the recorder.
1. Press the FREEZE key on the control panel when the monitor is not in frozen
mode.
2. The system exits all displayed menus (if displayed), and the FROZEN menu
pops up.
3. All displayed waveforms are frozen. In other words, the waveforms stop being
refreshed or scrolling.
7-2
Freezing Waveforms
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.
The FROZEN menu is displayed at the lower left corner. You can perform the
following settings in this menu.
WAVE 1 Waveform 1
It determines the first frozen waveform to be printed on the recorder
paper. The options of waveform 1 include all waveforms displayed
on the screen and OFF. The waveform 1 will not be recorded when
OFF is selected.
WAVE 2 Waveform 2
It determines the second frozen waveform to be printed on the
recorder paper. The options of waveform 2 include all waveforms
displayed on the screen and OFF. The waveform 2 will not be
recorded when OFF is selected.
RECALL Waveform recall
It changes to L-RIGHT when selected. At this time, you can rotate
the control knob to view the frozen waveform.
REC Record
When selected, the recorder starts printing out the selected
waveform 1 and waveform 2.
EXIT This option allows you to exit the FROZEN menu and unfreeze the
waveforms.
7-3
Freezing Waveforms
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 lowest 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. The time mark is applied to all waveforms displayed on the screen.
5. Rotate the control knob anticlockwise, and the waveforms move to the left.
7-4
8 Recording
8-1
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 two 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.
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 two waveforms (REC WAVE 1 and REC WAVE 2) to
be recorded. If one of the two waveforms is set to OFF, the recorder will merely
8-2
Recording
print out one waveform and all the measured parameters; if both are set to OFF, the
recorder will only print out all the measured parameter.
Automatic recording
The monitor starts recording at the selected interval (TIMING REC TIME) and
record for 8s waveforms automatically. For details, see 4.4.4 Recorder Setup.
Alarm recording
NOTE
For a parameter alarm recording, you must first set the ALM and ALM
REC options to ON.
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.
8-3
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.
You can select the TITRATION option in the DRUG CALC menu and open the
TITRATION window. The REC option in the window allows you to print the
calculation result of the titration table.
OxyCRG recording
In the oxyCRG screen, you can press the RECORD key on the control panel to print
the three trend graphs or waveforms from the recorder.
The REC option in the STATUS menu allows you to print the status information of
the monitor.
8-4
Recording
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
8-5
Recording
8-6
Recording
1. Select the ECG label in the ECG parameter window to the ECG SETUP menu
pops up.
2. Select the ARR ANALYSIS >> option in the ECG SETUP menu, and a popup
menu is opened.
3. Select ARR RECALL>> to open the ARR RECALL window.
4. Select the WAVE >> option to open the ARR WAVE RECALL window
5. Select REC to start recording.
6. When the recording completes, the recorder stops automatically.
OxyCRG recording
8-7
Recording
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.
Roller
CAUTION
Use the specified recorder paper only. Other recorder paper may cause
the recorder to print with poor quality, function improperly or not at all,
or bring damage to the thermal print head.
Do not pull the recorder paper with force when the printing is in process.
Otherwise, damages to the recorder may be incurred.
Do not leave the recorder door open except you are replacing the
recorder paper or removing a fault.
8-8
Recording
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.
8-9
Recording
8-10
9 Recall
9-1
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.
This chapter only gives introduction to the first four recalls mentioned above. For
details about the arrhythmia event recall, please refer to 11 ECG/RESP Monitoring.
NOTE
9-2
Recall
Select TREND GRAPH >> in SYSTEM MENU. The following window appears.
As shown above, PARA SELECT allows 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. Instead, the u mark indicates the systolic pressure, the t
mark indicates the diastolic pressure and the * mark indicates the mean pressure.
The x-axis shows the time scale while the y-axis shows the value scale of a
parameter. The trend cursor is used to identify a specific time in the whole trend
time, and it is displayed below the title “TREND GRAPH”. All the parameter values
measured at the time of the cursor are displayed in the parameters area.
9-3
Recall
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.
RESOLUTION
1. Rotate the control knob and highlight the field at the right of RESOLUTION.
2. Press the control knob, and a menu pops up.
3. Select 1S or 5S to review a 1-hour trend graph, or
4. Select 1MIN, 5MIN or 10 MIN to review a 96-hour trend graph.
L-RIGHT
1. Rotate the control knob to highlight the L-RIGHT option, and then press.
2. If the mark is displayed at the upper left corner of the trend graph, you can
rotate the control knob anticlockwise to review the earlier trend graph.
3. If the mark is displayed at the upper right of the trend graph, you can rotate
the control knob clockwise to review the later trend graph.
ZOOM
1. Rotate the control knob to highlight the ZOOM option, and then press.
2. Rotate the control knob to adjust the vertical value scale.
3. The amplitude of the trend curve changes at the vertical direction accordingly.
Any data that is beyond the maximum value of the scale will not be displayed.
Instead, it is represented by the maximum scale value.
CURSOR
1. 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.
9-4
Recall
Select TREND TABLE >> in SYSTEM MENU. The following window appears.
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 "――" means the parameter is not
measured at the corresponding time. Besides, the L-RIGHT option allows change of
the parameter name and the trend data.
If you select to review the NIBP trend data, the measurement results as well as the
specific measurement time (in the TEST AT filed) are displayed. If more than one
measurement results are obtained in a time interval, only one result is to be
displayed in the measurement result field. Meanwhile, the " * " mark is to be
displayed in the MORE field, indicating two or more measurement results exit.
9-5
Recall
RESOLUTION
1. Rotate the control knob to highlight the field at the right of RESOLUTION.
2. Press the control knob, and a popup value with the options, 1MIN, 5 MIN,
10MIN, 30MIN and 60MIN, is opened.
3. The time displayed in the TIME filed changes with the resolution.
UP-DOWN
1. Rotate the control knob to highlight the UP-DOWN option, and press.
2. If the mark is displayed at the lower right of the TIME field, you can rotate
the control knob anticlockwise to page down and review the trend data of earlier
time.
3. If the mark is displayed at the upper right of the TIME field, you can rotate
the control knob clockwise to page up and review the trend data of later time.
L-RIGHT
1. Rotate the control knob to highlight the L-RIGHT option, and then press.
2. Rotate the control knob to select a parameters set.
The “>” mark on the right of the parameter names indicates the following page is
available, and the “<” mark on the left of the parameter names indicates the previous
page is available.
3. The parameter names and the trend data changes with the selected parameter set.
REC
The REC option allows you to print out the trend data of the currently displayed
parameter(s).
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.
9-6
Recall
Select NIBP RECALL >> in SYSTEM MENU. The following window appears.
The NIBP RECALL window shows the non-invasive systolic pressure (NS),
non-invasive mean pressure (NM), non-invasive diastolic pressure (ND) and the
measurement time (TIME). The optional pressure units (UNIT) are mmHg and kPa.
NUM indicates the current measurement times. A maximum of ten measurements
can be displayed on the screen once. If there are more, you may use the UP-DOWN
option to review the data of a later or earlier time. If the measurement times surpass
800, only the latest 800 measurements are to be displayed. The REC option allows
you to print out all measurement data of NIBP RECALL.
9-7
Recall
Select ALARM RECALL >> in SYSTEM MENU. The following menu appears.
ALARM RECALL>>
If the ALARM RECALL TIME and the ALARM RECALL EVENT are both
selected, you can select the ALARM RECALL >> option to open the ALARM
RECALL window as shown in Figure 9-5.
9-8
Recall
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. You can set the waveform length
by selecting from the ALM REC TIME options in the ALARM SETUP menu.
Please refer to 4.4.2 Alarm Setup.
1
2
3 4
UP-DOWN
The monitor is able to store a maximum of 70 alarm events. But only one alarm
event can be displayed in the ALARM RECALL window once. You can select the
UP-DOWN option and then rotate the control knob to view an earlier or later 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.
9-9
Recall
To avoid losing patient’s data when the monitor is powered off intentionally or
accidentally, this monitor can be equipped with a CF storage card (optional) to
realize the non-volatile data storage function. During monitoring, the patient’s data,
including trend data, NIBP measurement results, alarm events, arrhythmia events,
and relative waveforms, will be saved into the CF storage card. When the monitor is
powered on again, you can review the saved data using the TREND GRAPH, the
TREND TABLE, the NIBP RECALL or the ARR RECALL menu, etc.
For the installation of the CF storage card, refer to 3.1.5.9 CF Storage Card.
Note
Once the CF storage card is plugged properly, there will be a mark “√”
in front of “POWER-OFF DATA STORAGE” in the DEVICE CONFIG LIST
menu (See 4.6 Monitor Version).
Data may not be saved into the CF storage card within a short time after
the monitor is powered on.
Caution
9-10
10 Drug Calculation
10-1
Drug Calculation
Select DRUG CALC >> in SYSTEM MENU. The following window appears.
10-2
Drug Calculation
DOPAMINE
EPINEPHRINE
HEPARIN
ISUPREL
LIDOCAINE
NIPRIDE
NITROGLYCERIN
PITOCIN
NOTE
10.1.1.3 Units
Each drug has its fixed unit or unit series. The operator must select the proper unit
according to the doctor’s instruction. Among a unit series, one unit may change to
another automatically depending on the entered parameter value. If a parameter
value exceeds the system-defined range, "——" will be displayed. The units of the
self-definable drugs are as follows :
1. DRUG A, B and C uses the unit series: g, mg and mcg.
2. DRUG D uses the unit series: Unit, k Unit and m Unit.
3. DRUG E uses the unit series: mEq.
10-3
Drug Calculation
NOTE
The prerequisite for drug calculation is that the drug name and the
patient weight are selected.
WARNING
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.
10-4
Drug Calculation
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.
10-5
Drug Calculation
DOSE TYPE
1. Rotate the control knob to highlight the field on the right of DOSE TYPE.
2. Press and rotate the control knob to select either DOSE/min, DOSE/hr,
DOSE/kg/min or DOSE/kg/hr in the popup menu.
3. The data in the trend table changes accordingly.
UP-DOWN
1. Rotate the control knob to highlight the UP-DOWN option in the window.
2. Rotate the control knob to review more data.
REC
The REC option allows you to print the currently displayed data from the recorder.
NOTE
10-6
11 ECG/RESP Monitoring
11.1 Overview....................................................................................................11-2
11.1.1 ECG Waveform ............................................................................11-2
11.1.2 ECG Parameters ...........................................................................11-4
11.2 ECG Monitoring Procedure .......................................................................11-5
11.2.1 Preparation....................................................................................11-5
11.2.2 Electrode Placement .....................................................................11-6
11.3 ECG Setup Menu .....................................................................................11-12
11.4 ST Analysis ..............................................................................................11-19
11.4.1 Overview ....................................................................................11-19
11.4.2 ST Analysis Menu ......................................................................11-19
11.5 Arrhythmia Analysis ................................................................................11-23
11.5.1 Overview ....................................................................................11-23
11.5.2 Arrhythmia Analysis Menu ........................................................11-24
11.5.3 Arrhythmia Alarm Setup ............................................................11-25
11.5.4 Arrhythmia Recall ......................................................................11-26
11.6 RESP Monitoring .....................................................................................11-28
11.6.1 Overview ....................................................................................11-28
11.6.2 Electrode Placement ...................................................................11-29
11.6.3 Respiration Setup .......................................................................11-30
11.7 Maintenance and Cleaning .......................................................................11-32
11-1
ECG/RESP Monitoring
11.1 Overview
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.
1 2 3
As shown above, when 5 LEADS is selected, five labels are located above the ECG
waveforms:
1. ECG lead of channel 1
You can select the lead of channel 1 from the label options.
When you use a 3-lead set, the monitor gives three lead options: I, II and III;
When you use a 5-lead set, the monitor gives seven lead options: II, III, aVR,
aVL, aVF, V and I.
3. Filter Method
The filtering enables clearer and more detailed waveforms. There are three filter
methods for selection.
11-2
ECG/RESP Monitoring
WARNING
4. ECG lead of channel 2: You can select the lead of channel 2 in the same method
used to select the channel-1 lead.
5. Gain of the channel-2 waveform: You can adjust the gain of the channel-2 ECG
waveform in the same method used for channel 1.
NOTE
11-3
ECG/RESP Monitoring
The parameters related to ECG are displayed to the right of the ECG waveforms as
shown above. The heartbeat indicator flashes in the same rate with the patient’s
heartbeat. On the right of the heart rate value are the ON/OFF status or value of
PACE, ST1, ST2, PVCs and NOTCH.
11-4
ECG/RESP Monitoring
11.2.1 Preparation
1. Skin preparation
The quality of ECG information displayed on the monitor is a direct result of the
quality of the electrical signal received at the electrode. Proper skin preparation is
necessary for good signal quality at the electrode. A good signal at the electrode
provides the monitor with valid information for processing the ECG data. Choose
flat, non-muscular areas to place electrodes. Following is a suggested guideline for
skin preparation:
Shave hair from skin at chosen sites.
Gently rub skin surfaces at sites to remove dead skin cells.
Thoroughly cleanse the site with a mild soap and water solution (do not use
ether or pure alcohol because they will increase skin impedance).
Dry the skin completely before applying the electrodes.
11-5
ECG/RESP Monitoring
WARNING
When applying electrodes or connecting cables, make sure they are not
connected to any conductive part or the ground. Verify that all ECG
electrodes, including neutral electrodes, are securely attached to the
patient.
Skin irritation may result from the continuous application of the ECG
electrodes. These should be checked each day. If there is an indication
of excess skin irritation, replace the electrodes or change the location of
the electrodes every 24 hours.
When applying the ECG cable with no resistance to our patient monitor
or other patient monitor that has no current limit resistance in it, the
monitor cannot be applied to defibrillation.
Verify the lead fault detection prior to the start of monitoring. Unplug the
ECG cable from the ECG connector and the screen should display the
error message “ECG LEAD OFF” and an audible alarm should be
activated.
11-6
ECG/RESP Monitoring
Following is the configuration per American standard when using five leadwires:
RA (right arm) electrode: near the right shoulder, directly below the clavicle.
LA (left arm) electrode: near the left shoulder, directly below the clavicle.
RL (right leg) electrode: on the right hypogastrium.
LL (left leg) electrode: on the left hypogastrium.
V (precordial) electrode: on the chest.
Attach the chest (V) electrode to one of the following positions indicated in Figure
11-4:
V1: On the 4th intercostal space at the right sterna margin.
V2: On the 4th intercostal space at the left sterna margin.
V3: Midway between V2 and V4 electrodes.
V4: On the 5th intercostal space at the left clavicular line.
V5: On the left anterior axillary line, horizontal with V4 electrode.
V6: On the left middle axillary line, horizontal with V4 electrode.
V3R-V7R: On the right side of the chest in positions corresponding to those
on the left
VE: Over the xiphoid.
When attaching the chest electrode to the back of a patient, place it at one the
following sites:
11-7
ECG/RESP Monitoring
V7: On the 5th intercostal space at the left posterior axillary line of the back.
V7R: On the 5th intercostal space at the right posterior axillary line of the back.
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.
11-8
ECG/RESP Monitoring
Following is the configuration per European standard when using three leadwires:
R (right arm) electrode: near the right shoulder, directly below the clavicle.
L (left arm) electrode: near the left shoulder, directly below the clavicle.
F (left leg) electrode: on the left hypogastrium.
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.
11-9
ECG/RESP Monitoring
WARNING
11-10
ECG/RESP Monitoring
As shown in Figure 11-6, the normal QRS complex should exhibit the following
characteristics.
Tall and narrow with no notches.
With a tall R-wave completely above or below the baseline.
With a pacer spike no higher than the height of the R-wave.
With the T-wave less than one-third of the height of the R-wave.
With the P-wave much smaller than the T-wave.
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 electrodes are
secure and firmly attached to the patient, change the display to a
different lead.
11-11
ECG/RESP Monitoring
Select the ECG label in the parameter windows. The following menu appears.
11-12
ECG/RESP Monitoring
For different patient types, the upper/lower limits of the heart rate alarm may vary in
the following range.
Adult 300 15 1
Pediatric 350 15 1
Neonate 350 15 1
NOTE
Always set the alarm limits according to the clinical condition of the
individual patient.
In many cases, the upper limit of heart rate alarms should not exceed 20
beats per minute higher than the patient's heart rate.
1. ECG: The monitor detects the heart rate through the ECG.
2. SPO2: The monitor detects the heart rate through the SPO2. PULSE is displayed
to the right of the ECG label while the PR (pulse rate) value is displayed below.
The monitor activates pulse beeps instead of heartbeat beeps. Besides, the
monitor gives indications to PR alarms but gives no indication to the HR alarms.
3. AUTO: The monitor determines the heart rate source depending on the signal
quality. The ECG takes priority of the SPO2. The SPO2 is selected as the heart
rate source only if the quality of the ECG signal is too poor to be analyzed. Once
the ECG signal restores to normal situation, it is selected as the heart rate source
again.
4. BOTH: The monitor displays both the HR and the PR values. The later is
displayed at the right of the SPO2 label. 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.
11-13
ECG/RESP Monitoring
NOTE
ARR
For details, see 11.5 Arrhythmia Analysis.
ANALYSIS
Other Setup
Select OTHER SETUP >> in ECG SETUP menu. The following menu appears.
11-14
ECG/RESP Monitoring
NOTE
A pacemaker may produce an overshoot signal after the pacemaker pulse, which
probably causes false R-wave detection. For this reason, the function of pacemaker
pulse rejection with overshoot should be enabled in the calculation. If this function
is enabled for a pacemaker without overshoot signals, the R-wave detection might
be omitted. Hence, the doctor should choose the PACE DETECT mode carefully
according to the pacemaker type.
The PACE DETECT option is active only if PACE is turned ON. When PACE is
turned OFF, the PACE DETECT is switched to MODE1 automatically. In this
situation, you cannot adjust the PACE DETECT as desired. When PACE is turned
ON, you can choose from the PACE DETECT options.
11-15
ECG/RESP Monitoring
NOTE
When PACE is turned ON, the system will neither detect the arrhythmia
relating to premature ventricular beats (including PVCs counting) nor
perform the ST analysis. When monitoring a patient without a
pacemaker, PACE should be turned OFF.
The mode of PACE DETECT cannot be saved after the monitor is turned
off or be saved as the factory or the user default configuration. When the
monitor is started, restarted or when the factory or user default
configuration is selected, PACE DETECT returns to MODE1.
The PACE tag can be printed in the real-time recording when PACE is
turned ON.
NOTE
11-16
ECG/RESP Monitoring
When the defibrillator synchronization is enabled, the “Defib Sync ON!” message is
displayed in the prompt information area, at the lower left corner of the screen. This
message disappears after 10 seconds. Besides, the technical alarms area also shows
the “DEFIB SYNC ON” message.
NOTE
WARNING
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.
Before defibrillating the patient, the user should ensure the defibrillator
has been connected to the auxiliary output port of the monitor, the
defibrillation synchronization function is enabled, and the filter mode is
set to DIAGNOSTIC.
11-17
ECG/RESP Monitoring
ECG CAL Select this option to begin calibrating the ECG. To stop
calibration, select this option again, or change the ECG
lead selection on the screen.
ADJUST This is used to adjust the position of the ECG waveform on
WAVE POS the screen. Select this option to access the ADJUST
WAVE POS menu. Open the CH NAME popup menu and
select the channel to be adjusted. Afterwards, select the
UP-DOWN option and rotate the control knob to adjust the
position of the selected channel on the screen. The BACK
TO DEFAULT option allows you to restore the waveform
to the default position on the screen.
DEFAULT You can use this option to access the ECG DEFAULT
CONFIG menu. You may choose the FACTORY
DEFAULT CONFIG or the USER DEFAULT CONFIG.
After finishing the selection, a dialog pops up asking for
confirmation of your selection.
11-18
ECG/RESP Monitoring
11.4 ST Analysis
11.4.1 Overview
Select ST ANALYSIS >> in ECG SETUP menu. The following menu appears.
11-19
ECG/RESP Monitoring
NOTE
The alarm limits for two ST segment numerics are identical. You cannot
set the alarm limit of one channel separately.
11-20
ECG/RESP Monitoring
ST Measurement Point
As shown above, the DEF POINT window shows the QRS complex template. Two
vertical lines indicate the positions of the ISO and ST points.
ISO: It is the base point, used to indicate the baseline point of the ST analysis.
The default is 78ms.
ST: It is the ST measurement point. The default is 109ms.
The two measurement points, ISO and ST, should be adjusted if the patient’s HR or
ECG morphology changes significantly. You can select the ISO or the ST option in
the window and then rotate the control knob to adjust its position.
11-21
ECG/RESP Monitoring
R wave
T wave
P wave
ST measurement
Base point ISO ST measurement point value
As shown above, the peak of the R wave is the reference point for ST measurement.
The ST measurement value for a beat complex is equal to the vertical difference
between the two measurement points.
NOTE
11-22
ECG/RESP Monitoring
11.5.1 Overview
11-23
ECG/RESP Monitoring
Select ARR ANALYSIS >> in ECG SETUP menu. The following menu appears.
11-24
ECG/RESP Monitoring
Select ARR ALARM >> in ECG SETUP menu. The following menu appears. You
can change the settings of the arrhythmia alarm in this menu.
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.
ALL ALM ON All alarms on
Enables all arrhythmia alarms;
ALL ALM OFF All alarms off
Disables all arrhythmia alarms;
ALL REC ON All recording on
Enables the recording of all arrhythmia alarms;
ALL REC OFF All recording off
Disables the recording of all arrhythmia alarms;
ALM LEV Options: HIGH, MED and LOW.
Sets the level of all arrhythmia alarms to the same value.
11-25
ECG/RESP Monitoring
Selecte ARR RECALL >> in ARR ANALYSIS menu. The following menu appears.
You can review any stored arrhythmia event in this menu.
11-26
ECG/RESP Monitoring
11-27
ECG/RESP Monitoring
11.6.1 Overview
1 2 3 4 5
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. If the
gain is too large, the upper part of the waveform may not be normally displayed.
4. RESP label: Selecting this label, you can open the RESP SETUP menu.
5. RR: Respiration rate numerics.
NOTE
11-28
ECG/RESP Monitoring
Since the same electrodes are used for ECG and respiration monitoring, the
electrode 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 electrodes 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.
NOTE
Please select the ECG cable with no resistance for RESP monitoring.
Try to avoid placing the electrodes so the liver area and the ventricles of
the heart are in path between the electrodes used for respiration, to
avoid cardiac artifact to overlay on the ECG. This is particularly
important when monitoring neonate patients.
11-29
ECG/RESP Monitoring
Selecting the RESP label on the screen opens the following menu.
11-30
ECG/RESP Monitoring
For different patient types, the upper/lower limits of the respiration rate alarm may
vary in the following range.
Adult 120 0 1
Neonate/pediatric 150 0 1
11-31
ECG/RESP Monitoring
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.
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. We recommend the disinfection
be contained in the hospital’s servicing schedule only when necessary. The
equipment should be cleaned prior to disinfection.
Sterilization
Sterilization may cause damage to the equipment. We recommend the sterilization
be contained in the hospital’s servicing schedule only when necessary. The
equipment should be cleaned prior to sterilization.
11-32
12 SpO2 Monitoring
12-1
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.
As the following figure shows, the PLETH waveform is located on the left while the
SpO2 parameter window on the right. The SpO2 value is displayed by percentage
and is followed by a perfusion indicator (pro rata with the pulse intensity). Besides,
the SpO2 label at the upper left corner of the parameter window allows you to access
the SpO2 SETUP menu.
1 2 3 4
1. PLETH waveform 2. SPO2 label
3. SpO2 value 4. Perfusion indicator
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. Although the tone pitch cannot be adjusted manually, the
tone volume can be adjusted by one of the following two ways, depending on the
setting of the HR FROM item in the ECG SETUP menu:
If the HR FROM is set to SPO2, you can adjust the PITCH TONE volume by
12-2
SpO2 Monitoring
changing the setting of the PR SOUND item in the SPO2 SETUP menu;
In case of other settings, you can adjust the PITCH TONE volume by changing
the setting of the BEAT VOL item in the ECG SETUP menu.
If the PR SOUND or BEAT VOL is set to 0, the PITCH TONE function will be
muted; if the SpO2 module is disabled, the PITCH TONE function will be disabled
as well.
This monitor can be equipped with any of the following SpO2 modules:
Mindray SpO2 module
Masimo SpO2 module
Nellcor SpO2 module
NOTE
12-3
SpO2 Monitoring
NOTE
The sensor measurement wavelengths are nominally 660nm for the red LED and
940nm for infrared LED. The maximum optical power output for LED is 4mW.
12-4
SpO2 Monitoring
12.2.2 Precautions
WARNING
Do not put the SpO2 sensor on the limb with arterial catheter or venous
syringe.
12-5
SpO2 Monitoring
Sensor selection for SpO2 measurement depends on the patient type. For an adult
patient, you can choose a finger SpO2 sensor; for an infant patient, you can choose a
hand or toe sensor. Refer to the following procedure.
1. Power on the monitor.
2. Attach the sensor to the proper site on the patient.
3. Plug the connector of the sensor extension cable into the SpO2 connector on
monitor.
NOTE
Place the SpO2 sensor cable at the backside of the patient hand. Make
sure the fingernail is just opposite to the light emitted from the sensor.
Neonate SpO2 sensor consists of a Y-shape SpO2 sensor and its sheath. Insert t he
LED and PD ends of the Y-shape SpO2 sensor respectively into the upper and lower
grooves on the sheath (Figure 12-3). The Figure 12-4 shows us the neonate SpO2
sensor after insertion.
12-6
SpO2 Monitoring
Wind the SpO2 sensor around a hand or foot of a neonate patient. Hold the sensor,
pull the belt and fit one of its sides with “V” edge into the “V” groove on the
corresponding side of the sheath. Appropriately elongate the belt to about 20mm,
and fit the “V” edge of the other side of the belt into the “V” groove of the other side
of the sheath. Then, loosen the belt. After the “V” edges of the two sides of the belt
fit well into the “V” grooves on the two sides of the sheath, put the belt into the first
lock bar to fasten the belt. See Figure 12-5. If the belt is too long, you may put it into
the second lock bar. You must position the SpO2 sensor in this way so as to make the
photoelectric component face the correct position. Besides, note not to elongate the
belt too much, which may lead to inaccurate measurement and block the blood
circulation severely.
12-7
SpO2 Monitoring
NOTE
WARNING
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. Inaccurate measurements may be caused by:
Improper SpO2 sensor;
High-frequency electrical noise, including noise created by the host system, or
noise from external sources, such as electrosurgical apparatus connected to the
system;
Oximeters and oximetry sensors used during magnetic resonance imaging (MRI)
scanning. Induced current could potentially cause burns;
Intravascular dye injections;
Excessive patient motion;
12-8
SpO2 Monitoring
Selecting the SPO2 label in the parameter window opens the following menu.
12-9
SpO2 Monitoring
SpO2 100 0 1
PR 254 0 1
Adult 100 90
SpO2 Pediatric 100 90
Neonate 95 80
Adult 120 50
PR Pediatric 160 75
Neonate 200 100
12-10
SpO2 Monitoring
WARNING
Setting the SpO2 upper alarm limit to 100% will disable the upper alarm
limit. High oxygen levels may predispose a premature infant to
retrolental fibroplasia. Therefore, the upper alarm limit for oxygen
saturation must be carefully selected in accordance with the commonly
accepted clinical practices.
12-11
SpO2 Monitoring
NOTE
The pulse oximetry measurement module (Masimo Set, which is called MS-7) is
based on three principles:
Oxyhemoglobin and deoxyhemoglobin differ in their absorption of red and
infrared light (spectrophotometry).
The volume of arterial blood in tissue and the light absorbed by the blood
changes during the pulse (plethysmography).
Arterio-venous shunting is highly variable, and the fluctuating absorbance by
venous blood is a major component of noise during the pulse.
The working principle of MS-7 uses is similar to the traditional SpO2 module. It
calculates the SpO2 value by passing red and infrared light into a capillary bed and
measuring changes in light absorption during the pulsatile cycle. The red and
infrared light-emitting diodes (LEDs) in oximetry sensors serve as the light sources,
and the photodiode serves as the photodetector.
Traditional pulse oximeter assumes that all pulsations in the light absorbance signal
are caused by oscillations in the arterial blood volume. This assumes that the blood
flow in the region of the sensor passes entirely through the capillary bed rather than
through any arterio-venous shunts. The traditional pulse oximeter calculates the ratio
of pulsatile absorbance (AC) to the mean absorbance (DC) at each of two
wavelengths, 660 nm and 940 nm:
This traditional instrument then calculates the ratio of these two arterial pulse-added
12-12
SpO2 Monitoring
absorbance signals:
R = Re d (660) / Ir (940)
This value of R is used to find the SpO2 in a look-up table built into the instrument’s
software. The values in the look-up table are based upon human blood studies
against a laboratory co-oximeter on healthy adult volunteers in induced hypoxia
studies.
This MS-7 assumes that arterio-venous shunting is highly variable and that
fluctuating absorbance by venous blood is the major component of noise during the
pulse. The MS-7 decomposes S(660) and S(940) into an arterial signal plus a noise
component and calculates the ratio of the arterial signals without the noise:
Re d (660) = Sr + Nr
Ir (940) = Si + Ni
R = Sr / Si
Again, R is the ratio of two arterial pulse-added absorbance signals and its value is
used to find the saturation SpO2 in an empirically derived equation into the software.
The values in the empirically derived equation are based upon human blood studies
against a laboratory co-oximeter on healthy adult volunteers in induced hypoxia
studies.
The above equations are combined and a noise reference (N’) is determined:
The equation for the noise reference is based on the value of R, the value being
seeked to determine the SpO2. This instrument’s software sweeps through possible
values of R that correspond to SpO2 values between 1% and 100% and generates an
N’ value for each of these R values. The S (660) and S (940) signals are processed
with each possible N’ noise reference through an adaptive correlation canceler (ACC)
which yields an output power for each possible value of R (i.e., each possible SpO2
from 1% to 100%). The result is a Discrete Saturation Transform (DST™) plot of
relative output power versus possible SpO2 value as shown in the following figure
where R corresponds to SpO2 = 97%:
12-13
SpO2 Monitoring
65 70 75 80 85 90 95 97 100
%SpO2
The DST plot has two peaks: the peak corresponding to the higher saturation is
selected as the SpO2 value. This entire sequence is repeated once every two seconds
on the most recent four seconds of raw data. The SpO2 value therefore corresponds
to a running average of arterial hemoglobin saturation that is updated every two
seconds.
12.3.2 Precautions
WARNING
The pulse wave from the MS-7 module must NOT be used for apnea
monitoring.
12-14
SpO2 Monitoring
Do not use this instrument and the sensors during magnetic resonance
imaging (MRI). Induced current could potentially cause burns. The
monitor may affect the MRI image, and the MRI unit may affect the
accuracy of the oximetry measurements.
Do not use the supplied sterile SpO2 sensors if the packaging or the
sensor is damaged. Return them to the distributor or manufacturer.
NOTE
Place the SpO2 sensor cable at the backside of the patient hand. Make
sure the patient nail is just opposite to the light emitted from the sensor.
12-15
SpO2 Monitoring
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. Inaccurate measurements may be caused by:
Incorrect sensor application or use;
Significant levels of dysfunctional hemoglobins (e.g., carboxyhemoglobin or
methemoglobin);
Intravascular dyes such as indocyanine green or methylene blue;
Exposure to excessive illumination, such as surgical lamps (especially ones
With a xenon light source), bilirubin lamps, fluorescent lights, infrared heating
lamps, or direct sunlight (exposure to excessive illumination can be corrected by
covering the sensor with a dark material);
Excessive patient motion;
Venous pulsations;
Placement of a sensor on the same extremity with a blood pressure cuff, arterial
catheter, or intravascular line;
The monitor can be used during defibrillation. However, the readings may take a
short period of time to return to normal.
12-16
SpO2 Monitoring
A blood pressure cuff is inflated on the same extremity as the one with a SpO2
sensor attached;
The patient has hypotension, severe vasoconstriction, severe anemia, or
hypothermia;
There is arterial occlusion proximal to the sensor;
The patient is in cardiac arrest or is in shock.
Selecting the SPO2 label in the parameter window opens the following menu.
12-17
SpO2 Monitoring
SpO2 100 0 1
PR 240 25 1
Adult 100 90
SpO2 Pediatric 100 90
Neonate 95 80
Adult 120 50
PR Pediatric 160 75
Neonate 200 100
WARNING
Setting the SpO2 upper alarm limit to 100% will disable the upper alarm
limit. High oxygen levels may predispose a premature infant to
retrolental fibroplasia. Therefore, the upper alarm limit for oxygen
saturation must be carefully selected in accordance with the commonly
accepted clinical practices.
12-18
SpO2 Monitoring
NIBP SIMUL ON: When measuring NIBP and SpO2 at the same side, the
SpO2 alarm status remains unchanged until the NIBP
measurement is finished;
OFF: The function of NIBP SIMUL is disabled.
DEFAULT You can select this option to access the SPO2 DEFAULT
CONFIG menu, in which you may select FACTORY
DEFAULT CONFIG or USER DEFAULT CONFIG. After
finishing your selection and exiting the menu, the system
pops up a dialog box asking for your confirmation.
If your monitor is equipped with a Masimo SpO2 module, use only Masimo oximetry
sensors for SpO2 measurements. Other sensors may cause improper pulse oximeter
performance. Before use, carefully read the directions for the LNOP sensor. Tissue
damage can be caused by incorrect application or use of a sensor. An example is
wrapping the sensor too tightly. Inspect the sensor site as specified in the directions to
ensure skin integrity, correct positioning, and adhesion of the sensor.
CAUTION
Do not use damaged sensors. Do not use a sensor with exposed optical
components. Do not immerse the sensor in water, solvents, or cleaning
solutions (the sensors and connectors are not waterproof). Do not
sterilize by irradiation, steam, or ethylene oxide.
Do not use damaged patient cables. Do not immerse the patient cables
in water, solvents, or cleaning solutions (the sensors and connectors are
not waterproof). Do not sterilize by irradiation, steam, or ethylene oxide.
12-19
SpO2 Monitoring
When selecting a sensor, consider, the patient’s weight, the adequacy of perfusion,
the available sensor sites, and the duration of monitoring. For more information refer
to the following table or contact Masimo. Use only Masimo sensors and sensor
cables. Select an appropriate sensor, apply as directed, and observe all warnings and
cautions presented in the directions for use accompanying the sensor.
High ambient light sources such as surgical lights (especially those with a xenon
light source), bilirubin lamps, fluorescent lights, infrared heating lamps, and direct
sunlight can interfere with the performance of a SpO2 sensor. To prevent interference
from ambient light, ensure that the sensor is properly applied, and cover the sensor
site with dark, opaque material, if required. Failure to take this precaution in high
ambient light conditions may result in inaccurate measurements.
Only use Masimo oximetry patient cables for SpO2 measurements. Other patient
cables may cause improper pulse oximeter performance.
Reusable patient cables of various lengths are available. All cables that marked by
the Masimo SET logo are designed to work with any Masimo LNOP sensor, and
with any pulse oximeter or multi-parameter instrument marked by the Masimo SET
logo.
NOTE
If the sensor fails to track the pulse consistently, the sensors may be
incorrectly positioned. Reposition the sensor or choose a different
monitoring site.
12-20
SpO2 Monitoring
This method can be used to clean emitting and receiving parts too. The cables should
be cleaned with a 3% Hydrogen peroxide, a 70% isopropyl alcohol or other
solutions. Keep the cleaning solution away from the sensor connections.
WARNING
Before cleaning the monitor or the sensor, make sure the equipment is
switched off and disconnected from AC power.
CAUTION
12-21
SpO2 Monitoring
Masimo Patents
This device is covered under one or more the following U.S. Patents: 5,482,036;
5,490,505; 5,632,272; 5,685,299; 5,758,644; 5,769,785; 6,002,952; 6,036,642;
6,067,462; 6,206,830; 6,157,850 and international equivalents. U.S.A and
international patents pending.
No Implied License
Possession or purchase of this device does not convey any express or implied license
to use the device with replacement parts which would, alone, or in combination with
this device, fall within the scope of one or more of the patents relating to this device.
12-22
SpO2 Monitoring
NOTE
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. Pulse oximetry
works by applying a sensor to a pulsating arteriolar vascular bed, such as a finger or
toe. The sensor contains a dual light source and a photodetector. The ratio of light
absorbed is translated into a measurement of functional oxygen saturation (SpO2).
Oximetry Overview
Pulse oximetry is based on two principles:
1. Oxyhemoglobin and deoxyhemoglobin differ in their absorption of red and
infrared light (i.e., spectrophotometry).
2. The volume of arterial blood in tissue (and hence, light absorption by that blood)
changes during the pulse (i.e., plethysmography).
A monitor determines SpO2 by passing red and infrared light into an arteriolar bed
and measuring changes in light absorption during the pulsatile cycle. Red and
infrared low-voltage light-emitting diodes (LEDs) in the oximetry sensor serve as
light sources; a photodiode serves as the photo detector.
12-23
SpO2 Monitoring
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. During monitoring,
the monitor reads this resistor and selects coefficients that are appropriate for the
wavelength of that sensor’s red LED; these coefficients are then used to determine
SpO2.
This resistor is read when the monitor is turned on, periodically thereafter, and each
time a new sensor is connected. Additionally, to compensate for differences in tissue
thickness, the intensity of the sensor’s LEDs is adjusted automatically.
Fractional saturation
Functional saturation = ×100
100 - (%carboxyhemoglobin + %methemoglobin)
12-24
SpO2 Monitoring
12.4.2 Precautions
WARNING
Do not use this instrument and the sensors during magnetic resonance
imaging (MRI). Induced current could potentially cause burns. The
monitor may affect the MRI image, and the MRI unit may affect the
accuracy of the oximetry measurements.
Do not put the SpO2 sensor on the limb with arterial catheter or venous
syringe.
Do not use the supplied sterile SpO2 sensors if the packaging or the
sensor is damaged. Return them to the distributor or manufacturer.
12-25
SpO2 Monitoring
WARNING
Before performing the testing, check the sensor cable. After unplugging
the SpO2 sensor cable from the socket, the system shall display the
prompt information "SPO2 SENSOR OFF" and give the audible alarm.
NOTE
Place the SpO2 sensor cable at the backside of the patient hand. Make
sure the fingernail is just opposite to the light emitted from the sensor.
12-26
SpO2 Monitoring
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.
If patient movement presents a problem, try one or more of the following remedies
to correct the problem.
Verify that the sensor is properly and securely applied.
Move the sensor to a less active site.
Use an adhesive sensor that tolerates some patient motion.
Use a new sensor with fresh adhesive backing.
12-27
SpO2 Monitoring
If poor perfusion affects performance, consider using the Oxisensor R-15 sensor; it
obtains measurements from the nasal septal anterior ethmoid artery, an artery
supplied by the internal carotid. This sensor may obtain measurements when
peripheral perfusion is relatively poor. For low peripheral perfusion, consider using
the Nellcor RS-10 sensor, which is applied to the forehead or temple. These are sites
that may be spared during peripheral vasoconstriction.
Selecting the SPO2 label in the parameter window opens the following menu.
12-28
SpO2 Monitoring
SpO2 100 0 1
PR 250 20 1
Adult 100 90
SpO2 Pediatric 100 90
Neonate 95 80
Adult 120 50
PR Pediatric 160 75
Neonate 200 100
WARNING
Setting the SpO2 upper alarm limit to 100% will disable the upper alarm
limit. High oxygen levels may predispose a premature infant to
retrolental fibroplasia. Therefore, the upper alarm limit for oxygen
saturation must be carefully selected in accordance with the commonly
accepted clinical practices.
12-29
SpO2 Monitoring
12.4.6 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.
12-30
SpO2 Monitoring
Before attempting to clean a SpO2 sensor, read the directions for use enclosed with
the sensor. Each sensor model has cleaning instructions specific to that sensor.
WARNING
12-31
SpO2 Monitoring
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.
No Implied License
Possession or purchase of this device does not convey any express or implied license
to use the device with replacement parts which would, alone, or in combination with
this device, fall within the scope of one or more of the patents relating to this device.
12-32
13 NIBP Monitoring
13-1
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 adult, pediatric, and neonatal
patients. 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.
Continuous: The NIBP measurement is performed as many times as possible in
five minutes.
The NIBP measurement does not produce any waveform. Instead, it displays the
measurement result in the NIBP parameter window as shown below.
1 2 3
5 6 7
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)
13-2
NIBP Monitoring
WARNING
13-3
NIBP Monitoring
5. Make sure that the cuff edge falls within the range of the <-> mark. If it does not,
use a larger or smaller cuff that will fit better.
6. The limb chosen for taking the measurement should be placed at the same level
as the patient's heart. If this is not possible, use the following method to correct
the measurement result:
If the cuff is placed higher than the heart level, add 0.75 mmHg (0.10 kPa) for
each centimeter of difference.
If it is placed lower than the heart level, deduct 0.75 mmHg (0.10 kPa) for each
centimeter of difference.
WARNING
The width of the cuff should be either 40% of the limb circumference
(50% for neonates) or 2/3 of the upper arm length. The inflatable part of
the cuff should be long enough to circle 50-80% of the limb. The wrong
size cuff can cause erroneous readings. If the cuff size is in question,
use a larger cuff.
Make sure the air tubing connecting the blood pressure monitor is not
blocked, twisted, or tangled.
13-4
NIBP Monitoring
During the interval between two auto NIBP measurements, press the NIBP key
on the control panel to start a manual NIBP measurement.
WARNING
NOTE
If you are in doubt about the accuracy of any reading(s), check the
patient's vital signs by an alternative method before checking the
function of the monitor.
13-5
NIBP Monitoring
Patient Movement
E.g.The patient is moving, shivering, or having convulsions.
Cardiac Arrhythmia’s
E.g. The patient's cardiac arrhythmia has caused an irregular heartbeat.
Heart-lung Machine
E.g. Measurements will be impossible if the patient is connected to a heart-lung
machine.
Pressure Changes
E.g.The patient's blood pressure is changing rapidly over the period of time during
which the arterial pressure pulses are being analyzed to obtain the measurement.
Severe Shock
E.g. If the patient is in severe shock or hypothermia, reduced blood flow to the
peripheries will cause reduced pulsation of the arteries.
13-6
NIBP Monitoring
Selecting the NIBP label in the parameter area opens the following menu.
13-7
NIBP Monitoring
If a measured pressure crosses a preset upper or lower alarm limit, an alarm will be
triggered. The NIBP alarm limits are as follows:
Patient type Adult Pediatric Neonate
Systolic pressure 40–270 mmHg 40–200 mmHg 40–135 mmHg
Mean pressure 20–230 mmHg 20–165 mmHg 20–110 mmHg
Diastolic pressure 10–210 mmHg 10–150 mmHg 10–100 mmHg
DISPLAY WAY 1 GROUP: The NIBP parameter area only displays a group
of NIBP values obtained in the latest measurement.
GROUPS: Multiple groups of measurement values are
displayed at the lower left corner of the screen as shown
below.
NS NM ND DATE TIME
108 84 70 2005-6-12 16:06:00
108 80 70 2005-6-12 16:11:00
108 80 70 2005-6-12 16:16:00
13-8
NIBP Monitoring
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. Remove the blood pressure cuff from the monitor and replace it with a rigid
metal container or vessel with a capacity of 500 ml ± 5%.
2. Connect a calibrated reference manometer (with an error less than 1 mmHg) and
a ball pump using “T” connectors as shown below.
3. Select the CALIBRATE option.
4. Inflate the metal container using the ball pump until the reference manometer
reads 0, then 50, and finally 200 mmHg.
5. The difference between the indicated pressure of the reference manometer and
the indicated pressure of the monitor will not exceed 3 mmHg. Contact our
Customer Service if these values are not met.
Monitor Reference
manometer
NIBP cuff Hose
connector
NOTE
13-9
NIBP Monitoring
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.
Cylinder
Monitor
NOTE
Set PAT TYPE to ADU in the PATIENT SETUP menu before leakage test.
13-10
NIBP Monitoring
WARNING
Do not press the rubber tube on the cuff with excessive strength.
The cuff is not suitable for dry-cleaned. Instead, it should be machine or hand
washed. Hand washing, may prolong the service life of the cuff. Before washing,
remove the latex rubber bladder. Allow the cuff to dry thoroughly after washing, and
then reinsert the rubber bladder. The cuff can be disinfected by means of
conventional autoclaving, gas, or radiation disinfection in hot air ovens, or sterilized
by immersion in decontamination solutions. Remember to remove the rubber
bladder if you use this method
13-11
NIBP Monitoring
CAUTION
Disposable cuffs are intended for single patient use only. Do not sterilize or use
autoclave sterilization for disposable cuffs.
NOTE
13-12
14 TEMP Monitoring
14-1
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 2
3
4
5
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. Displays the temperature measured at temperature
channel 2.
5. TD: Temperature difference, namely the difference between temperature 1 and
temperature 2.
14-2
TEMP Monitoring
NOTE
WARNING
14-3
TEMP Monitoring
Selecting the TEMP label in the parameter window opens the following menu.
14-4
TEMP Monitoring
DEFAULT >> You can select this option to access the NIBP DEFAULT
CONFIG menu, in which you may select FACTORY
DEFAULT CONFIG or USER DEFAULT CONFIG. After
finishing your selection and exiting the menu, the system
pops up a dialog box asking for your confirmation.
T1 and T2 50 0 0.1
TD 50 0 0.1
14-5
TEMP Monitoring
WARNING
Before cleaning the monitor or the probe, make sure the equipment is
turned off and disconnected from AC power.
The temperature probe should not be heated to a temperature over 100℃ (212
℉). It is only able to bear the temperature between 80 and 100℃ (176 to 212℉)
for a short time.
The probe must not be disinfected in steam.
Only detergents containing alcohol can be used for disinfection.
The rectal probes should be used, if possible, in conjunction with a protective
rubber cover.
To clean the probe, hold the tip with one hand and with the other hand rub the
probe down in the direction of the connector using a moist lint-free cloth.
NOTE
14-6
15 IBP Monitoring
15-1
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
Besides, each waveform is followed by three scale lines, among which the upper and
the lower ones are marked by scales on the left.
The parameter window locates to the right of the IBP waveforms as shown below.
1 2
1. IBP (1,2) label: This label allows you to access the IBP (1,2) SELECT menu.
2. Pressure unit: mmHg or kPa.
3. Parameter values of channel 1: Systolic pressure, mean pressure and diastolic
pressure (from the left to the right).
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.
15-2
IBP Monitoring
15.2 Precautions
WARNING
Parts and accessories used must meet the safety requirements of the
medical electrical equipment standards.
Do not contact the metal part connected to the electrical appliance when
connecting or using the accessory.
The transducer (except for the ICT/B transducer) specified in this operation manual
is able to protect against electrical shock, especially the leakage current, and the
interference of cardiac defibrillation. It can be used in surgical operation. During
defibrillation, the pressure waveform might become temporarily distorted. However,
the monitor returns to normal operation after the defibrillation, with the operation
mode and the user configuration being unaffected.
NOTE
15-3
IBP Monitoring
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. Position the transducer so it is at the same level with the patient’s heart,
approximately mid-axillary line.
5. Verify the correct label is selected.
6. Zero the transducer.
Normal
saline Pressure
with Transducer
heparin
Valve
3-way
stopcock
Drip Pressure transducer
chamber interface cable
Pressure
line
Monitor
15-4
IBP Monitoring
Selecting the IBP (1,2) label in the parameter window opens the following menu.
The IBP SETUP in IBP (1,2) SELECT menu allows you to access the following
menu.
15-5
IBP Monitoring
FILTER This option allows you to select the filter method of the IBP
waveform. Three options are available:
NORMAL: 16Hz filtering;
SMOOTH: 8Hz filtering;
NO FILTER: Displays the original waveform.
The default is NO FILTER.
ALM LIMIT This option allows you to access the following menu,
SETUP >> whereby you can set the upper and lower alarm limits.
15-6
IBP Monitoring
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
SCALE This option allows you to open the following menu and set
ADJUST >> the positions of the high, reference and low scales for the
two waveforms.
HI: Determines the high scale. The reference scale changes when the high scale is
changed.
LO: Determines the low scale. The reference scale changes when the low scale is
changed.
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.
15-7
IBP Monitoring
EXPAND Selecting this option opens the following menu. You can
PRESSURE select the pressure to be measured by P1 and P2.
Options: SYS, MEAN, DIA (three pressures are all
measured); MEAN (only the mean pressure is measured).
DEFAULT >> You can select this option to access the IBP (1,2)
DEFAULT CONFIG menu, in which you may select
FACTORY DEFAULT CONFIG or USER DEFAULT
CONFIG. After finishing your selection and exiting the
menu, the system pops up a dialog box asking for your
confirmation.
You can select IBP PRESURE ZERO in IBP (1,2) SELECT menu to open the
following menu.
15-8
IBP Monitoring
Pressure
transducer
3-way
stopcock
Pressure transducer
interface cable
Monitor
2. Adjust the 3-way stopcock to close the channel leading to the patient. The
transducer is open to the atmosphere through the stopcock.
3. Select CH1 ZERO or CH2 ZERO in IBP PRESSURE ZERO menu to start
zeroing.
NOTE
Position the transducer at the same level with the patient’s heart,
approximately mid-axillary line.
15-9
IBP Monitoring
Take channel 1 as an example. The monitor may give the following prompt
information after the pressure transducer zeroing has been finished.
IN DEMO, FAIL
Make sure the monitor is not in DEMO mode, and perform pressure transducer
zeroing again. If the monitor continues to give this prompt information, contact our
Customer Service.
15-10
IBP Monitoring
You can select IBP PRESSURE CALIBRATE in IBP (1,2) SELECT menu to open
the following 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.
Pressure
transducer
3-way
stopcock
Pressure transducer
T-shape connector interface cable
Monitor
Hydrargyrum
pressure meter
15-11
IBP Monitoring
NOTE
WARNING
15-12
IBP Monitoring
Take channel 1 as an example. The monitor may give the following prompt
information after the calibration has been finished.
IN DEMO, FAIL
Make sure the monitor is not in DEMO mode, and perform the calibration again. If
the monitor continues to give this prompt information, contact our Customer
Service.
15-13
IBP Monitoring
WARNING
After the IBP monitoring operation is completed, remove the tubing and the dome
from the transducer and wipe the transducer diaphragm with water. To clean the
transducer and the cable, soak or wipe them using soap or the detergents listed
below:
Cetylcide
Wavicide-01
Wescodyne
Cidex
Lysol
Vesphene
Do not immerse the connector in any liquid. After cleaning, dry the transducer
thoroughly before storing. Slight discoloration or temporary increase of surface
stickiness of the cable should not be considered abnormal. If it is necessary to
remove the adhesive tape residue from the transducer cable, the double seal tape
remover is recommended; use the remover with special caution to minimize the
damage to the cable. Acetone, Alcohol, Ammonia and Chloroform, or other strong
solvents are not recommended because they are harmful to the vinyl cabling if used
for a long time.
NOTE
15-14
IBP Monitoring
Sterilization
Gas Sterilization
For more complete asepsis, use gas sterilization. The transducer should be
completely dry after cleaning. When ethylene oxide gas is used as the gas
disinfectant, follow the operating instructions provided by the manufacturer of the
gas disinfectant.
NOTE
15-15
IBP Monitoring
15.6.1 Introduction
The ICT/B has an atmospheric reference pressure channel that connects the back of
the sensing area to the ambient air pressure via the luer fitting on the connector. All
measurements are the difference value compared with ambient air pressure.
Reference
Transducer
Luer fitting for barometric
drive
zero check by pressure
Extension
Measured Calibration ballon inflation
cable
pressure sleeve
Pressure
transducer Temperature compensation and Signal
bridge balance network output
A significant feature of the ICT/B is the ability to check the zero drift of the ICT/B
and pressure monitor in-vivo. Not only does this allow accurate measurements, but
also allow the moving of the patient with the ICT/B in the epidural space and easy
reconnection to another monitor.
There is a flat silicone rubber membrane, or balloon, covering the pressure sensing
diaphragm. Two internal tubes connect the two sides of the diaphragm to a female
luer fitting on the connector shell. By introducing approximately 0.2 to 0.3ml of air
from a 1ml syringe the pressure in these tubes will be greater than the ICP being
measured. The exact amount of air is not critical if only it does not exceed the
permitted maximum. When this air is injected, the pressure will cause the balloon to
be lifted from the surface of the sensor and the same pressure will be applied to the
back of the sensor. The strain gauge senses equal pressure above and below which is
equivalent to having zero pressure applied. Thus by injecting a small volume of air,
one undeflects the pressure sensor and checks the zero of the transducer and
amplifier.
15-16
IBP Monitoring
15.6.2 Precautions
NOTE
The monitor using the ICT/B pressure transducer must meet the current
safety standards of the country, where the monitor is or is to be used,
and should be able to work with the strain gauge pressure transducer.
The monitor must provide electrical isolation from the transducer and
any electrical equipment to which the monitor is connected.
Carefully check for cuts on the silicone of the catheter and sensor tip
before use.
When placing the ICT/B transducer, the burr hole edges must be
rounded and the bone chips must be removed, so as to insert the
catheter into the epidural space in an ''S'' bend. The catheter should be
protected in the position of the sutures, to avoid any damage to the
catheter when pulling sutures tight. When removing the catheter, special
caution should be taken to avoid damaging the device while cutting
sutures. Slowly pull the catheter to remove the ICT/B transducer.
CAUTION
Do not press with thumb and forefinger on the tip of the ICT/B.
Enormous pressures will be generated and the device will be subject to
possible damage. To see if the ICT/B is operating normally, gently touch
the sensor tip.
WARNING
Do not plug the female luer on the proximal end of the catheter during
ethylene oxide sterilization. Otherwise, damage to the transducer may
be caused.
15-17
IBP Monitoring
Calibration
The ICT/B is supplied with a minimal zero offset and the sensitivity is set at 5
uV/V/mmHg. To ensure accurate settings of the amplifier and recorder, the controls
should be zeroed at ambient pressure and then calibrated at a known pressure. For
instance, use the calibration tube, syringe and manometer, or immerse it into a
known depth of water column and then set the gain of the system to the required
level. The procedure above should be performed once again to verify the zero
baseline does not changed due to the gain change.
Tighten the collet on the calibration tube over the sliding calibration sleeve to seal
the ICT/B catheter. Use a male luer fitting to form a connection to a reference
pressure, such as a syringe and manometer. The output of the transducer and
amplifier system can be reliably and quickly confirmed.
Manometer
Monitor
Zeroing
15-18
IBP Monitoring
to zero value on the meter. Remove the syringe and the monitor will immediately
begin to measure intracranial pressure.
CAUTION
The total volume of air injected from a 1ml syringe to check the zero
must not exceed 0.5ml. Otherwise, the membrane over the sensor might
be ruptured.
With the known pressure applied to the ICT/B, inject approximately 0.3cc air into
the female luer using a 1ml syringe. Note that the monitor does not reach zero
immediately. When the ICT/B moves rapidly up and down in a water column, the
pressure waveform changes instantly. The ICT/B has a high frequency response.
Thus you will see excellent pressure waveform in actual operation. It also reflects
that the exact amount of air injected for zeroing is insignificant.
NOTE
Always leave the luer fitting open to the ambient pressure during
measurement.
15-19
IBP Monitoring
NOTE
The ICT/B is intended for the measurement of epidural pressures. It can measure
positive pressures only. Thus, it is not recommended to measure intraventricular
pressures. The ICT/B may be applied using a variety of surgical techniques.
Therefore, surgeons are advised to choose the best way according to their knowledge
and experience.
Method 1
The ICT/B can be inserted during surgery through a burr hole. The pressure sensor
of the transducer should be placed facing the dura and under the cranium. The
transducer is marked by 2.5cm scale on its back. Thus the scale is visible if the
sensor is placed correctly. The placement site should be away from any craniotomy
flap. A contralateral burr hole is recommended.
To protect the catheter, use thick sutures and put tape around the catheter before suturing.
Remove all bone chips. Use bone wax.
15-20
IBP Monitoring
The dura mater should be carefully stripped at least 2cm under the skull and 180° in
arc before insertion. Failure to do this will result in wedging of the pressure sensor
and inaccurate readings. Reseat the transducer tip after a few days since the dura
may rapidly tighten and change its physical characteristics.
If possible, round the bone at the point where the catheter makes its first bend into
the burr hole and round the bone where the catheter makes the second bend under
the cranium. This helps to prevent from tearing the catheter or tip during insertion or
removal. In case of a tear of the catheter, the catheter must be returned to the
manufacturer for repair, incurring a lot of inconveniences.
The catheter is led out through the wound through a drain. It may make sharp bends
without disturbing the operation of the ICT/B. Care should be taken though, to avoid
pinching the catheter by bending onto itself at acute angles for this will seal and
possibly damage the internal lumens required for proper operation.
The catheter should be restrained from moving once the tip is in place. It may be
fixed to the scalp by encircling sutures or with a silicone rubber suture collar
provided by the manufacturer, such as the peritoneal shunt systems. The latter
method is preferred, as it will help prevent from damage to the catheter by sutures or
during removal of sutures.
Method 2
First send the catheter to the burr hole through a tunnel under the skin (a small
incision is made on the skin, and the catheter enters the tunnel from a point distal to
the burr hole). The ICT/B can be guided in the tunnel by a disposable tube, which
can be removed afterwards from the burr hole. This method is preferred from both a
mechanical stability point of view and from the low incidence of infection. The
catheter can later be removed in the manner of a drain and the burr hole incision
sutured.
The physician is urged to examine the ICT/B for physical damage to the silicone
rubber covering anywhere on the tip or catheter before use. In case of any damage,
do not use the catheter and return it to the manufacturer for repair. Proper function
should be verified before insertion into the epidural space, by gently touching the tip
of the transducer and observing a pressure change displayed the monitor. Once the
ICT/B has been inserted into the epidural space, the physician should check the
proper function again, by injecting 0.3cc air for zeroing of the ICT/B. The monitor
should respond correctly as described above.
15-21
IBP Monitoring
Summary
1. When preparing the burr hole, it is required that the hole be rounded at the edges
where the catheter is inserted with an "S" bend into the epidural space.
2. Remove all bone chips
3. A small pledgelet of woven bandage should be placed around the catheter at the
position of sutures. This prevents damages to the catheter when pulling sutures
tight. Otherwise the catheter will be easily cut.
4. Use some bone wax on the edges of bone where the catheter and tip make
contact with bone.
5. When removing the catheter, special attention should be paid to avoid damaging
the device while severing the sutures. Remove the ICT/B by slowly pulling the
catheter.
6. The dura mater should be stripped to give sufficient space so that the tip of the
sensor is inserted easily.
7. Do not use haemostats or forceps that might damage the device. Do not squeeze
the sensor with the thumb and the forefinger.
15-22
IBP Monitoring
WARNING
Right after the catheter is removed from the patient, check the silicone coating for
damage. Use a 1ml syringe to inject 0.5cc air into the luer and immerse the catheter
in water. If small bubbles are seen from any part of the catheter or tip, dry the
catheter by a cloth and sterilize. Then, return to the manufacturer for repair.
Inspect for cuts or damage to silicone coating before immersing it in any liquid.
Avoid getting liquid on the connector pins or inside the connector via the luer fitting.
Wash the catheter with soap solution. Avoid damaging the sensing area. Do not use
synthetic detergents or oil-based soaps as this may result in a foreign body reaction.
Transducers may be cleaned gently with alcohol. But, do not soak it in alcohol. The
cold aqueous solutions of detergicide (e.g. Cidex), formalin or by ethylene oxide gas
can be used for disinfection.
NOTE
15-23
IBP Monitoring
1. Unplug the female luer on the proximal connector before the ETO disinfection
cycle. Failure to do this will result in damage to the ICT/B or even disable it.
2. The luer must be open to allow the incoming and the outgoing of ETO gas.
3. Coil the ICT/B and put it in a package filled with ETO. The package shall be
indicated by an approved disinfection mark.
4. Disinfection—The disinfection procedure should be accepted by the hospital
staff responsible for disinfection. Follow the manufacturer's instructions for
disinfection.
To prevent liquids from entering the female luer on the electrical connector, a male
plug may be used. But this plug must be removed during normal use and the ETO
disinfection.
1. Rinse and soak the catheter transducer in the glutaraldehyde solution, following
the instructions provided by manufacturer of the chemical agent. Note that
disinfection is not equivalent to sterilization, and you must refer to the
manufacturer’s instructions to see the effect of the glutaraldehyde solution.
2. Before using the disinfected catheter transducer, rinse with pyrogen-free, sterile
distilled water or saline solution recommended by the disinfectant manufacturer.
15-24
IBP Monitoring
Precautions
The metal sensor is robust and can withstand severe shocks and vibrations. However,
it cannot be recovered if damaged by sharp objects or overpressure, for instance by
squeezing the tip using the forefinger and the thumb.
The silicone coating on the sensing area allows a small amount of water absorption.
But if the water absorption lasts for an hour or more, the baseline may drift several
mmHgs. In this case, put the device in water or saline solution for a few hours to
stabilize before use.
Liquids entering the back of the sensor will cause damage to the sensor. Cutting on
the outer coating should be avoided and repaired immediately once detected. You
may return it to the manufacturer or apply a temporary repair using a suitable
silicone sealant to the damage.
The most common reason for failure of the ICT/B pressure transducer is physical
damage to the device's silicone catheter and/or tip. The cuts are usually caused by
sharp bone chips or edges and are not always visible to the naked eye. If such
damage remains undetected, fluids may enter the device and damage the sensing
parts.
15-25
IBP Monitoring
Questions Answers
15-26
IBP Monitoring
15.6.6.2 Troubleshooting
When you inject air The catheter or tip is cut and The readings are unreliable. Remove
to zero and calibrate cannot hold zero for a long the ICT/B and use a spare. The
the device, the time. waveforms will be displayed
baseline reappears correctly.
with the waveform
displayed.
The monitor Either the tip is ‘wedged’ or If the tip is wedged, pull back a few
indicates ‘damaged the tip sensor was millimeters to free it. This will allow
gauge’ or ‘over over-pressured against the dura the monitor to be zeroed. If the above
range’. No matter during insertion. Therefore the action does not help, the transducer
you inject air or not, monitor detects a transducer must have been damaged. Remove the
you cannot see the that has a very high initial zero transducer and return it the
waveform. and finds this zero out of its manufacturer for repair.
range. Sometimes raising the scale of the
monitor requires a high zero offset.
Try raising the pressure scale to 90,
120 or 300mmHg and then zero. This
solution may work but the waveform
resolution will be compromised. It is
recommended to return the catheter
for repair when the measurement is
finished.
When everything Although over-pressured or Try raising the pressure scale to 90,
runs normally, the wedged, the sensor zero must 120 or 300mmHg and then zero.
‘damaged gauge’ or have been just within the range
‘over-range’ light of the monitor. As conditions
suddenly starts changed, the total pressure
flashing. (=zero amount+ICP) pushed
the monitor beyond its
measurement range.
The transducer can The sensor face must be flat It is important that the transducer face
be zeroed and we (planar) against the dura. If its be placed against an intact section of
have good pressure facing the inner table of the dura.
waves, but the ICP skull, you will get pressure If required, use a contralateral burr
reading always waves and be able to zero it hole.
remains around zero but not obtain actual ICP
mmHg. readings.
15-27
IBP Monitoring
15-28
16 CO2 Monitoring
16-1
CO2 Monitoring
16.1 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)
Waveform name 1 2
3 4 5
Figure 16-1 CO2 Waveform and Parameters
1. CO2 label: This option allows you to access the CO2 SETUP menu.
2. Pressure unit: mmHg or kPa.
3. EtCO2: The measured value of EtCO2.
4. InsCO2: The measured value of InsCO2.
5. AwRR: The measured value of AwRR.
The monitor can be equipped with either Mindray CO2 module or Oridion CO2
module. Introduction to these modules are given in the following pages. You can
read the pages corresponding to your monitor configuration, and operate your
monitor accordingly.
NOTE
16-2
CO2 Monitoring
NOTE
WARNING
Our CO2 module is only applicable to pediatric and adult patients, but
not to neonate patients.
The monitor adopts our sidestream CO2 module. The measurement of this module is
based on the feature that the CO2 molecule absorbs infrared ray. The measurement
procedure is as follows : send the CO2 to a measurement chamber inside the module
through the airway system, and then irradiate 4.26um infrared ray at one side of the
chamber and use the sensor to measure the attenuation degree of the received
infrared ray at the other side. Since the attenuation degree of the infrared ray is
proportional to the concentration of CO2, the CO2 concentration is calculated. The
measured CO2 concentration is thereafter converted into the partial pressure under
the same temperature and pressure, and then displayed.
The relation between the partial pressure and the CO2 concentration is given below:
CO2 partial pressure (mmHg)=
CO2 concentration (%)×Pamp (ambient pressure, mmHg)/100
CO2 partial pressure (kPa)= CO2 partial pressure (mmHg)/7.5
16-3
CO2 Monitoring
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.
When the monitor is powered on for the first time, the CO2 module enters the
STANDBY mode by default. To activate the CO2 module, you must change the work
mode to MEASURE. The work mode of the CO2 module keeps unchanged when the
monitor is restarted. For instance, if the monitor is power off when the CO2 module
is working in the MEASURE mode, the CO2 module will automatically enter the
MEASURE mode after the monitor is restarted. For details about WORK MODE,
please refer to the section Other Setup in 16.2.3 CO2 Setup Menu.
The CO2 concentration is displayed in ATPD by default. ATPD means the CO2 value
is measured in ambient temperature and pressure and dry gas, while BTPS means
the CO2 is measured at a temperature of 37℃, a relative humidity of 95% and a
47mmHg (pH2O) partial pressure of moisture.
16-4
CO2 Monitoring
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
“CO2 START UP” and “CO2 WARM UP” displayed on the screen indicate
that the sensor is starting up and warming up. During the warming up,
the module can measure CO2, but the measurement is not standard.
After the above information disappears, the standard measurement can
be performed.
The water trap is used to collect water drops condensed in the sampling
airway and prevent water drops from entering the module. When the
collected water reaches to a certain amount, remove the water to avoid
blocking the airway.
In the long-term use, dust or other substances may lower the air
permeability of the filter material in the water trap and may block the
airway. In this situation, the water trap must be replaced.
16-5
CO2 Monitoring
Selecting the CO2 label in the parameter window opens the following menu.
16-6
CO2 Monitoring
NOTE
16-7
CO2 Monitoring
Other Setup
PUMP RATE Determines the sampling rate of the CO2 module pump.
Options: 150ml/min, 100ml/min
N2O COMPEN N2O compensation
ON: Select ON, when the N2O content in the measured gas
is no smaller than 30%.
OFF: Select OFF, when the N2O content in the measured
gas is smaller than 30%.
O2 COMPEN O2 compensation
ON: Select ON, when the O2 content in the measured gas is
no smaller than 50%.
OFF: Select OFF, when the O2 content in the measured gas
is smaller than 50%.
Des COMPEN Desflurane compensation
ON: Select ON, when the desflurane is contained in the
measured gas.
OFF: Select OFF, when the deflurane is not contained in the
measured gas.
BTPS Body Temperature and Pressure, Saturated
Options: ON and OFF.
16-8
CO2 Monitoring
NOTE
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.
When BTPS is turned ON, the system performs BTPS compensation automatically;
when BTPS is turned OFF, the BTPS compensation is disabled.
When measuring the CO2 content inside the patient’s lung, turn ON BTPS. Normally,
the lung temperature of the patient is 37℃ and the water vapor is sufficient or
regarded as saturated. But the temperature and water vapor content of the sampling
line are different from the patient’s exhalation. Thus, when the patient’s exhalation
passes the sampling line, the accuracy of the CO2 concentration measured by the
sensor will be adversely affected. To ensure an accurate measurement, you should
turn ON the BTPS. In this mode, the system adjusts the calculation coefficient
automatically, so that the measured value is just the actual CO2 content in the
patient’s lung.
When measuring the CO2 content of the environment or a certain vessel, turn OFF
BTPS. In the standard ambient pressure and dry gas, the accuracy of the sensor
measurement is not affected.
NOTE
16-9
CO2 Monitoring
Select CO2 USER MAINTAIN >> in USER MAINTAIN menu. The following
menu appears.
ZERO CAL This option allows you to zero the CO2 module, so as to
eliminate the adverse affect of the baseline drift in the
16-10
CO2 Monitoring
Calibration Procedure
Decompression
Tube
valve
Gas bottle
3. Fill the gas bottle with a standard gas of certain CO2 content (3%, 4%, 5%, 6%
and 7%), and input the gas to the monitor.
4. Open the CO2 USER MAINTAIN menu, and set the CO2 field to a value, which
is the same with the CO2 content of the gas bottle.
5. When the CO2 USER MAINTAIN menu displays the currently measured CO2
content, wait until a stable reading is indicated, and then select the CONFIRM
CAL option to start calibrating the CO2 module.
6. If the calibration succeeds, “CALIBRATE SUCCESS!” will be displayed in the
CO2 USER MAINTAIN menu. If fails, “CAL FAIL, TRY AGAIN!” will be
displayed, and re-calibration is required.
7. Select the EXIT option to exit the CO2 USER MAINTAIN menu.
16-11
CO2 Monitoring
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. If no prompt
information is given, the sampling line must have been blocked, and you should
replace with a new sampling line.
Routine calibration of the sidestream CO2 module is not required. But the
calibration must be performed every year, or when great inaccuracy of
measurement is found.
16-12
CO2 Monitoring
NOTE
WARNING
The monitor adopts the sidestream Oridion CO2 module. The measurement of this
module is based on the feature that the CO2 molecule absorbs infrared ray. The
measurement procedure is as follows : send the CO2 to a measurement chamber
inside the module through the airway system, and then irradiate 4.26um infrared ray
at one side of the chamber and use the sensor to measure the attenuation degree of
the received infrared ray at the other side. Since the attenuation degree of the
infrared ray is proportional to the concentration of CO2, the CO2 concentration is
calculated. The measured CO2 concentration is thereafter converted into the partial
pressure under the same temperature and pressure, and then displayed.
The relation between the partial pressure and the CO2 concentration is given below:
CO2 partial pressure (mmHg)=
CO2 concentration (%)×Pamp (ambient pressure, mmHg)/100
CO2 partial pressure (kPa)= CO2 partial pressure (mmHg)/7.5
16-13
CO2 Monitoring
1. Plug the sampling line into its receptacle before the measurement.
2. Open the CO2 SETUP menu and set WORK MODE to MEASURE.
3. The "CO2 START UP" prompt information is displayed on the screen until the
startup is finished.
When the monitor is powered on for the first time, the CO2 module enters the
STANDBY mode by default. To activat the CO2 module, you must change the work
mode to MEASURE. The work mode of the CO2 module keeps unchanged when the
monitor is restarted. For instance, if the monitor is power off when the CO2 module
is working in the MEASURE mode, the CO2 module will automatically enter the
MEASURE mode after the monitor is restarted. For details about WORK MODE,
please refer to the section 16.3.3 CO2 Setup Menu.
WARNING
16-14
CO2 Monitoring
Selecting the CO2 label in the parameter window opens the following menu.
16-15
CO2 Monitoring
NOTE
16-16
CO2 Monitoring
Other Setup
When BTPS is turned ON, the system performs BTPS compensation automatically;
when BTPS is turned OFF, the BTPS compensation is disabled.
When measuring the CO2 content inside the patient’s lung, turn ON BTPS. Normally,
the lung temperature of the patient is 37℃ and the water vapor is sufficient or
regarded as saturated. But the temperature and water vapor content of the sampling
line are different from the patient’s exhalation. Thus, when the patient’s exhalation
passes the sampling line, the accuracy of the CO2 concentration measured by the
sensor will be adversely affected. To ensure an accurate measurement, you should
turn ON the BTPS. In this mode, the system adjusts the calculation coefficient
automatically, so that the measured value is just the actual CO2 content in the
patient’s lung.
When measuring the CO2 content of the environment or a certain vessel, turn OFF
BTPS. In the standard ambient pressure and dry gas, the accuracy of the sensor
measurement is not affected.
16-17
CO2 Monitoring
NOTE
16-18
CO2 Monitoring
Select CO2 USER MAINTAIN >> in USER MAINTAIN menu. The following
menu appears.
16-19
CO2 Monitoring
Calibration Procedure
Decompression
Tube
valve
Monitor
T-shape connector opening
to the atmosphere
Gas bottle
3. Fill the gas bottle with a standard gas of certain CO2 content (4% to 6%), and
input the gas to the monitor.
4. Open the CO2 USER MAINTAIN menu, and set the CO2 field to a value, which
is the same with the CO2 content of the gas bottle.
5. When the CO2 USER MAINTAIN menu displays the currently measured CO2
content, wait until a stable reading is indicated, and then select the CONFIRM
CAL option to start calibrating the CO2 module.
6. If the calibration succeeds, “CALIBRATE SUCCESS!” will be displayed in the
CO2 USER MAINTAIN menu. If fails, “CAL FAIL, TRY AGAIN!” will be
displayed, and re-calibration is required.
7. Select the EXIT option to exit the CO2 USER MAINTAIN menu.
16-20
CO2 Monitoring
The sampling line of the micorstream CO2 module is disposable and cannot be
disinfected for reuse.
Routine calibration of the microstream CO2 module is not required. But the
calibration must be performed if it is prompted in the CO2 USER MATINTAIN
menu, or great inaccuracy of measurement is found.
16-21
CO2 Monitoring
Oridion Patents
This device and the CO2 sampling consumable designed for use herewith is covered
by one or more of the following USA patents: 4,755,675; 5,300,859; 5,657,750;
5,857,461 and international equivalents. USA and international patents pending.
No Implied Licence
Possession or purchase of this device does not convey any express or implied license
to use the device with unauthorized consumable CO2 sampling consumable products
which would, alone, or in combination with this device, fall within the scope of one
or more of the patents relating to this device and/or CO2 sampling consumable
products.
16-22
17 Accessories
17-1
Accessories
Description PN
17-2
Accessories
Description PN
17-3
Accessories
Description PN
17-4
Accessories
Description PN
Description PN
17-5
Accessories
Description PN
17-6
Accessories
Description PN
17-7
Accessories
Description PN
17-8
Accessories
Description PN
17-9
Accessories
Description PN
17-10
18 Appendices
18-1
Appendices
Degree of protection
against harmful ingress of Not protected (ordinary)
water
18-2
Appendices
Operating conditions
Storage conditions
18-3
Appendices
AC mains
Frequency 50/60 Hz
Power 110 VA
External DC power
Power 70 W
Internal battery
Number of batteries 1
Capacity 2.3 Ah
75 minutes typical when powered by a new fully-charged battery
Operating time
(25℃, ECG, SpO2, NIBP measurement per 15 minutes).
Charge time 6 hours maximum (in the running status or standby mode)
Lithium battery
Capacity 4.4 Ah
180 minutes typical when powered by a new fully-charged
Operating time
battery (25℃, ECG, SpO2, NIBP measurement per 15 minutes).
Charge time 6.5 hours maximum (in the running status or standby mode)
18-4
Appendices
Physical
Recorder
Recorded waveforms 2
LED indicator
Audio indicator
Control
1 knob
Control knob
It can be rotated clockwise/counterclockwise or pressed.
5 buttons
Button
Power Switch, FREEZE, SILENCE, RECORD, NIBP
18-5
Appendices
Connectors
1 AC power connector
Power supply
1 standard DC input connector
18-6
Appendices
Driver Relay
Electrical specifications ≤60W, ≤2A, ≤36VDC, ≤25VAC
Isolation voltage > 1500 VAC
Signal type Normally open or normally closed, selectable
Maximum time delay 35ms (R-wave peak to leading edge of the pulse)
Amplitude 3.5 V (min) at 3 mA sourcing; 0.8 V (max) at 1 mA
sinking
Pulse width 100 ms ±10%
Current limit 15 mA
Rising and falling time < 3ms
VGA
18-7
Appendices
Diagnostic mode: ≥ 90 dB
Monitor mode: ≥ 105 dB
Common mode rejection
Surgery mode: ≥ 105 dB
Differential input
≥ 5 MΩ
impedance
HR
Resolution 1 BPM
Response time to heart rate Meets the requirement of ANSI/AAMI EC13-2002: Section
changes 4.1.2.1 f).
18-8
Appendices
Pace pulse
ST segment measurement
Arrhythmia analysis
18-9
Appendices
Differential input
> 2.5 MΩ
impedance
Baseline impedance range 200 to 2500 Ω (using an ECG cable with 1kΩ resistance)
RR
Resolution 1 BrPM
18-10
Appendices
SpO2
Resolution 1%
Refreshing rate 1s
PR
Resolution 1bpm
Refreshing rate 1s
SpO2
Resolution 1%
Refreshing rate 1s
PR
18-11
Appendices
Resolution 1bpm
Refreshing rate 1s
70 to 100% ±3.5%
MAX-R, D-YSE and D-YSPD
0 to 69% Undefined
Refreshing rate 1s
*: When sensors are used on neonatal subjects as recommended, the specified precision range is
increased by ±1%, to account for the theoretical effect on oximeter measurements of fetal
hemoglobin in neonatal blood.
18-12
Appendices
Measurement interval in
1/2/3/4/5/10/15/30/60/90/120/180/240/480 minutes
auto mode
Measurement time in
5 minutes
continuous mode
Systolic
40 to 270 40 to 200 40 to 135
Measurement range in pressure
normal mode Diastolic
10 to 210 10 to 150 10 to 100
pressure
Resolution 1mmHg
18-13
Appendices
Number of channels 2
Resolution 0.1℃
Update period 1s
18-14
Appendices
Number of channels 2
PA –6 to 120 mmHg
Measurement range
CVP/RAP/LAP/ICP –10 to 40 mmHg
Resolution 1 mmHg
Update period 1s
Pressure transducer
Sensitivity 5 uV/V/mmHg
18-15
Appendices
0 to 40 mmHg: ±2mmHg
Precision* 41 to 76 mmHg: ±5%
77 to 99 mmHg: ±10%
< 1min.
Start-up time of CO2
The module enters the warming up status after the startup. Ten
module
minutes later, it enters the ready-to-measure status.
0 to 70 BrPM: ±2 BrPM
Precision
> 70 BrPM: ±5 BrPM
18-16
Appendices
0 to 38 mmHg: ±2mmHg
Precision*
39 to 99 mmHg: ±5% + 0.08%× (reading - 38mmHg)
Waveform: 0.1mmHg
Resolution
Value: 1mmHg
0 to 70BrPM: ±1BrPM
AwRR measurement
70 to 120BrPM: ±2BrPM
precision
121 to 150BrPM: ±3BrPM
* Precision applies for breath rates of up to 80 bpm. For breath rates above 80 bpm, accuracy
complies with EN 864/ISO 9918 (4 mmHg or ±12% of reading whichever is greater) for EtCO2
values exceeding 18 mmHg. To achieve the specified accuracies for breath rates above 60
breaths/minute, the Microstream® FilterLine H Set for Infant/Neonatal (p/n 006324) must be
used.
The accuracy specification is maintained to within 4% of the values indicated in the above table
in the presence of interfering gases according to EN864 Section Eleven, Part 101.
18-17
Appendices
Appendix B EMC
NOTE
Operation of the device, in the case that the patient physiological signal
is lower than the minimum amplitude and/or value specified in the
product specifications, may cause inaccurate results.
18-18
Appendices
TABLE C-1
18-19
Appendices
TABLE C-2
18-20
Appendices
TABLE C-3
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 IEC 60601 Compliance
Electromagnetic environment — guidance
test Test level level
Portable and mobile RF communications equipment
should be used no closer to any part of the
equipment, including cables, than the recommended
separation distance calculated from the equation
Conduced 3 Vrms applicable to the frequency of the transmitter.
RF IEC 150kHz to 3 Vrms Recommended separation distance
61000-4-6 80MHz
d = 1.2 x P
symbol:
Note — At 80 MHz and 800 MHz, the higher frequency range applies.
Note — These guidelines may not apply in all situations. Electromagnetic propagation is
affected by absorption and reflection from structures, objects and people.
a
Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless)
telephones and land mobile radios, amateur radio, AM and FM radio broadcast and TV
broadcast cannot be predicted theoretically with accuracy. To assess the electromagnetic
environment due to fixed RF transmitters, an electromagnetic site survey should be considered.
If the measured field strength in the location in which the equipment is used exceeds the
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.
18-21
Appendices
TABLE C-4
18-22
Appendices
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.
XX TOO HIGH 2* XX value exceeds the upper alarm limit. Make sure the alarm
XX TOO LOW 2* XX value exceeds the lower alarm limit. limits are appropriate for
the patient, and check
the patient’s condition.
ECG LOST 1 The ECG signal is so weak that the monitor can’t Check the connection of
perform ECG analysis. the patient cable and
RESP ARTIFACT 1 The patient’s heartbeat interferes with his respiration. lead wires, and then
The respiration rate cannot be measured correctly. check the patient’s
NO PULSE 1 The pulse signal of the patient is so weak that the condition.
monitor cannot perform pulse analysis.
CO2 APNEA 1 The respiration signal of the patient is so weak that
RESP APNEA 1 the monitor cannot perform respiration analysis.
ASYSTOLE 1* The asystole arrhythmia event occurs to the patient.
VFIB/VTAC 1* The ventricular tachycardia or ventricular fibrillation
arrhythmia event occurs to the patient.
R ON T 2* The R ON T arrhythmia event occurs to the patient.
VT > 2 2* The VT>2 arrhythmia event occurs to the patient.
COUPLET 2* The couplet arrhythmia event occurs to the patient.
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.
18-23
Appendices
Note: XX represents the parameter modules like ECG, NIBP and SpO2, or the
parameters being monitored like HR, PR and SpO2.
The A field indicates whether an alarm can be completely cleared; the B field
indicates whether the visual and audible indications of an alarm can be cleared; the
“L” field indicates the alarm level, and 1 means high, 2 means medium, 3 mean low,
* means the level is user-adjustable.
ECG LEAD OFF No Yes 3 The ECG lead is not connected Check for correct connection
ECG X LEAD OFF No Yes 3 correctly. of the leadwires.
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 Make sure the leadwires are
on the ECG signal. correctly connected. Check
the patient for severe
motion.
ECG CH1 Yes No 1 An error occurs in the ECG Restart the monitor. If the
SELFTEST ERR initialization. error remains, contact our
ECG CH2 Yes No 1 company for repair.
SELFTEST ERR
18-24
Appendices
TEMP1 SENSOR No Yes 3 The T1 sensor is not connected Check for correct connection of
OFF correctly to the patient or the the T1 sensor.
monitor.
TEMP2 SENSOR No Yes 3 The T2 sensor is not connected Check for correct connection of
OFF correctly to the patient or the the T2 sensor.
monitor.
TEMP SELFTEST No No 1 Circuit fault of the temperature Contact our company for repair.
ERROR channel.
TEMP No No 2 Error in temperature channel Restart the monitor. If the error
CALIBRATION calibration. remains, contact our company
ERR for repair.
NIBP SELFTEST Yes Yes 1 Error in NIBP initialization. Select RESET from the NIBP
ERR SETUP menu. If the error
remains, contact our company
for repair.
LOOSE CUFF No Yes 3 The NIBP cuff is not properly Check the patient’s condition,
connected. and check if the patient type is
AIR LEAK No Yes 3 Leak in the airway. correct. Replace with a proper
PNEUMATIC No Yes 3 cuff and connect it correctly. If
LEAK the problem still exists, contact
CUFF TYPE ERR No Yes 2 The cuff applied is not our company for repair.
appropriate to the patient type.
AIR PRESSURE No Yes 3 Failure occurs in the pulse
ERROR measurement. The monitor cannot
18-25
Appendices
SPO2 SENSOR No Yes 3 The sensor is disconnected from Make sure the sensor is placed
OFF the patient or the monitor. 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 Disconnect and reconnect the
the patient or the monitor, or it is sensor as directed by the
not properly connected. instructions. If the alarm
remains, the sensor or the cable
might have been damaged.
The SpO2 is connected upside Disconnect and reconnect the
down. sensor as directed by the
instructions. Pay attention to the
mark on the probe.
SPO2 LOW No No 3 The pulse signal is too weak. Move the sensor to a site with
PERFUSION better perfusion.
18-26
Appendices
SPO2 SENSOR Yes Yes 3 The sensor is disconnected Make sure the sensor is placed on
OFF from the patient or the monitor. the patient’s finger or other parts,
and the monitor is connected to
cables correctly.
SPO2 PULSE No No 3 The monitor is searching for If the pulse reading is not
SEARCH the pulse signal of the patient. displayed after 30 seconds, check
if the probe is properly connected
to the patient. Change the sensor
site for better signals if necessary.
SPO2 No No 3 The pulse signals are subject to Reduce or remove external
INTERFERENCE great external interference. interference.
SPO2 LOW No No 3 The pulse signal detected by Change the sensor site for better
PERFUSION the monitor is too weak. signals.
SPO2 TOO MUCH No No 3 Too much light on the patient Turn down or off the lighting,
LIGHT and sensor. move the probe to a place of
weaker light or cover the probe.
SPO2 No No 3 The monitor cannot recognize Check for correct probe type.
UNRECOGNIZED the SpO2 probe type.
SENSOR
SPO2 BOARD No No 1 The SpO2 set board Stop using the SpO2module, and
FAULT malfunctions and might be contact biomedical engineers or
unable to measure the pulse our company for maintenance.
signals correctly.
SPO2 SENSOR No No 1 The probe is damaged. Stop using the sensor.
FAULT
SPO2 NO SENSOR Yes Yes 3 The sensor is disconnected Disconnect and reconnect the
from the patient or the monitor, sensor as directed by the
or the sensor is not properly instructions. If the alarm remains,
connected. the sensor or the cable might have
been damaged.
The SpO2 probe is inserted Disconnect and reconnect the
upside down. sensor as directed by the
instructions. Pay attention to the
mark on the probe.
SPO2 LOW No No 3 The pulse signals detected by Move the sensor to a site with
SIGNAL IQ the monitor are of poor quality. better signals.
SPO2 No No 3 The SpO2 probe is Stop using the sensor.
INCOMPATIBLE incompatible to the monitor, or
SENSOR is damaged.
18-27
Appendices
SPO2 SENSOR No Yes 3 The sensor is disconnected Make sure the sensor is placed on the
OFF from the patient or the patient’s finger or other parts, and the
monitor. monitor is connected to cables
correctly.
SPO2 NO SENSOR Yes Yes 3 The sensor is disconnected Disconnect and reconnect the sensor
from the patient or the as directed by the instructions. If the
monitor, or the sensor is not alarm remains, the sensor or the
connected properly. cable might have been damaged.
The SpO2 probe is inserted Disconnect and reconnect the sensor
upside down. as directed by the instructions. Pay
attention to the mark on the probe.
SPO2 No No 3 The pulse signals are subject Reduce or remove external
INTERFERENCE to great external interference. interference.
SPO2 BOARD No No 1 The SpO2 set board Stop using the SpO2module, and
FAULT malfunctions and might be contact biomedical engineers or our
unable to measure the pulse company for maintenance.
signals correctly.
SPO2 MOTION No No 3 The patient is moving. Reduce patient motion.
SPO2 SENSOR No No 1 The probe is damaged. Stop using the sensor.
FAULT
SPO2 WEAK No No 3 The SpO2 signal is weak. Change the sensor site for better
SIGNAL signals.
SPO2 WEAK No No 3 The detected pulse signal is
PULSE too weak.
IBP1 SENSOR OFF No Yes 3 The invasive blood pressure Check if the IBP 1 sensor is
cable of channel 1 is properly connected.
disconnected from the monitor.
IBP2 SENSOR OFF No Yes 3 The invasive blood pressure Check if the IBP 2 sensor is
cable of channel 2 is properly connected.
disconnected from the monitor.
IBP1 NEED No No 3 The IBP transducer of channel Zero the IBP transducer of channel
ZERO-CAL 1 has not been zeroed. 1.
IBP2 NEED No No 3 The IBP transducer of channel Zero the IBP transducer of channel
ZERO-CAL 2 has not been zeroed. 2.
18-28
Appendices
CO2 NO No No 2 The water trap is not properly Make sure the sidestream CO2
WATERTRAP connected or is disconnected. water trap is firmly connected.
CO2 SENSOR No No 1 The temperature of the sensor Restart the monitor if necessary. If
TEMP HIGH assembly is too high. the problem remains, contact our
CO2 SENSOR No No 1 The temperature of the sensor company for repair.
TEMP LOW assembly is too low.
CO2 AIRWAY No No 2 The pressure inside the airway
PRES TOO HIGH is too high.
CO2 AIRWAY No No 2 The pressure inside the airway
PRES TOO LOW is too low.
CO2 No No 2 The barometric pressure is too
BAROMETRIC high.
TOO HIGH
CO2 No No 2 The barometric pressure is too
BAROMETRIC low.
TOO LOW
CO2 HARDWARE No No 1 AD sampling 2.5V error
ERROR
CO2 HARDWARE No No 1 The pump malfunctions.
ERROR
CO2 HARDWARE No No 1 The 3-way stopcock
ERROR malfunctions.
CO2 SAMPLE No No 2 The sample line is abnormal or Make sure the airway is not
LINE ABNORMAL blocked. blocked. If the problem still exists,
contact our company for repair.
CO2 CALIBRATE No No 1 Zeroing failure. Restart the monitor. If the problem
ZERO ERROR still exists, contact our company
for repair.
CO2 USER No No 2 User calibration failure. Make sure the preset calibration
CALIBRATE FAIL gas concentration consists with the
input calibration gas. If the
problem remains, contact our
company for repair.
CO2 SYSTEM No No 1 EEPROM reading address Contact our company for repair.
ERROR error.
CO2 SYSTEM No No 1 EEPROM reading length error.
ERROR
CO2 SYSTEM No No 1 EEPROM response to
ERROR component error.
18-29
Appendices
18-30
Appendices
RECORDER INIT Yes No 2 An error occurs during the Contact the hospital’s engineers or
ERR N recorder initialization. our customer Service.
Note: N represents the error number.
RECORDER Yes No 2 An error might occur to the Open the RECORD menu and
SELFTEST ERR RAM, ROM and CPU select the CLEAR REC TASK
watchdog. option. If the problem remains,
contact our company for repair.
RECORDER VLT No No 1 A problem occurs to the system If this alarm message is given for
HIGH power. many times, contact our company
RECORDER VLT No No 1 for repair.
LOW
RECORDER No No 1 The thermal head of the Resume the recording till the
HEAD HOT recorder is too hot. recorder cools down completely. If
the problem still exists, contact our
company for repair.
REC HEAD IN Yes Yes 3 The thermal head of the Restore the control lever of the
WRONG POS. recorder is in wrong position. recorder to its previous position.
RECORDER OUT Yes Yes 3 The recorder paper is used up. Replace with a new paper roll.
OF PAPER
18-31
Appendices
RECORDER No No 2 The recording continues for Place the recorder correctly and
PAPER JAM more than 30 minutes. try again.
RECORDER Yes No 2 Error in recorder Open the RECORD menu and
COMM ERR communication. select the CLEAR REC TASK
option. If the problem remains,
contact our company for repair.
TOO MANY REC No No 2 Quite a few alarm events occur Check the patient’s condition and
TASKS at the same time. the alarms. Open the RECORD
menu and select the CLEAR REC
TASK option. If the problem
remains, contact our company for
repair.
RECORDER Yes Yes 2 The paper roll of the recorder is Place the paper roll correctly.
PAPER W.P. not placed in the correct
position.
RECORDER S. Yes No 2 Error in recorder Open the RECORD menu and
COMM ERR communication. select the CLEAR REC TASK
REC NOT No No 2 Error in the recorder work option. If the problem remains,
AVAILABLE mode. contact our company for repair.
18-32
Appendices
REAL CLOCK No No 1 The system time is incorrect. Reset the system time and then
NEED SET restart the monitor.
REAL CLOCK No No 1 No button battery, or the Add, or replace with a new button
NOT EXIST battery power is depleted. battery.
KEYBOARD INIT No No 1 Keyboard error. The keyboard Contact our company for repair.
ERR N cannot be used.
Note: N represents the error number.
KEYBOARD No No 2
ERROR
NET INIT ERR No No 2 The system cannot be
(G.) connected to the network due
NET INIT ERR No No 2 to problems in the monitor’s
(Ram) network part.
NET INIT ERR No No 2
(Reg)
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 If this alarm message is given for
12V TOO LOW No No 1 power. many times, contact our company
for repair.
BATTERY TOO No No 1 The battery voltage is too low. Connect the monitor with AC
LOW power to recharge the battery.
18-33
Appendices
ECG1 SIGNAL Signals of abrupt change interfere with the Check whether the electrodes and
SATURATION ECG signal. leads are well connected.
ECG2 SIGNAL
SATURATION
SEARCH PULSE The SpO2 module is searching the pulse. Wait till the end of the searching.
CO2 START UP The CO2 module is starting. Wait for the CO2 module to finish
the startup.
CO2 CALIBRATE The CO2 module is in the zeroing status. Wait for the CO2 module to finish
ZERO the zeroing.
CO2 WARM UP The CO2 module is warming itself up after Wait for the CO2 module to finish
startup. warming itself up.
CO2 START UP The CO2 module is starting. Wait for the CO2 module to finish
the startup.
CO2 CALIBRATE The CO2 module is in the zeroing status. Wait for the CO2 module to finish
ZERO the zeroing.
CO2 SENSOR START The CO2 sensor is warming itself up after Wait for the CO2 module to finish
UP startup. warming itself up.
CO2 CALIBRATE The CO2 module is in the calibrating status. Wait for the CO2 module to finish
the calibration.
CO2 PURGING The CO2 module is in the purging status. Wait for the CO2 module to finish
the purging.
Recorder
RECORDER The recorder is in the initializing status. Wait for the recorder to finish the
18-34
Appendices
INITIALIZING initialization.
RECORDER BUSY The recorder is recording. Wait for the recorder to finish the
recording.
NIBP module
Manual measure... The NIBP module is performing the manual Wait for the NIBP module to finish
measurement. the measurement.
Resetting... The NIBP module is being reset. Wait the NIBP module to finish
the resetting.
Resetting...
Please start This message appears after the auto Press the NIBP button to start the
measurement interval is selected. measurement.
CALIBRATE... The NIBP module is performing the Wait for the NIBP module to finish
calibration. the calibration.
PNEUMATIC... The NIBP module is checking the pneumatic Wait for the NIBP module to finish
system for leakage. checking the pneumatic system.
Pneum test over The NIBP finishes checking the pneumatic None
system for leakage.
ST LEARNING The QRS complex template for the ARR Wait till the end of the ARR
analysis is forming. learning.
ARR LEARNING
DEFIB. SYNC.ON The DEFIB. SYNC. switch is turned on. It indicates that the auxiliary
output port is outputting DEFIB.
SYNC. signals.
18-35
Appendices
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 ampere
Ah ampere hour
℃ centigrade
cc cubic centimeter
cm centimeter
dB decibel
℉ fahrenheit
g gram
GTT gutta
hr hour
Hz hertz
inch inch
kg kilogram
kPa kilopascal
l litre
lb pound
m meter
mcg micrograms
mEq milli-equivalents
mg milligrams
18-36
Appendices
min minute
ml milliliter
mm millimeters
ms millisecond
mV millivolt
mW milliwatt
nm nanometer
s second
V volt
VA volt ampere
Ω ohm
µA microampere
µm micron
µV microvolt
W watt
- minus
% percent
/ per; divide; or
^ power
+ plus
= equal to
± plus or minus
× multiply
© copyright
18-37
Appendices
D.2 Abbreviations
AC altenating current
ADT adult
AP access point
ARR arrhythmia
ART arterial
CH channel
COHb carboxyhemoglobin
D diastolic
DC direct current
DIA diastolic
ECG electrocardiograph
18-38
Appendices
ERR error
ES electrosuigical
Et end-tidal
EURO European
Fi fraction of inspired
HR heart rate
HT height
18-39
Appendices
M mean
MetHb methemoglobin
O2 oxygen
P power
PA pulmonary artery
PD photodetector
PED pediatric
PLETH plethysmogram
PM Patient Monitor
PR pulse rate
18-40
Appendices
RESP respiration
RR respiration rate
S systolic
SYNC synchronization
SYS systolic
T1 tempertature of channel 1
T2 tempertature of channel 2
TD temperature difference
TEMP temperature
18-41
Appendices
18-42
Penlon Limited
Abingdon Science Park
Barton Lane
Abingdon
OX14 3PH
UK