Ultracare SLP100 User Manual

Ultracare SLP100
Perioperative Monitor
User’s Reference Manual
070-1206-00 Rev. C
©2005 Spacelabs Medical, Inc.
All rights reserved. Contents of this publication may not be reproduced in any form without the written permission of
Spacelabs Medical. Products of Spacelabs Medical are covered by U.S. and foreign patents and/or pending patents.
Printed in U.S.A. Specifications and price change privileges are reserved.
Spacelabs Medical considers itself responsible for the effects on safety, reliability and performance of the equipment
only if:
• assembly operations, re-adjustments, modifications or repairs are carried out by persons authorized by
Spacelabs Medical, and
• the electrical installation of the relevant room complies with the requirements of the standard in force, and
• the equipment is used in accordance with the operations manual.
Spacelabs Medical will make available, on request, such circuit diagrams, component part lists, descriptions,
calibration instructions or other information which will assist appropriately qualified technical personnel to repair those
parts of the equipment which are classified by Spacelabs Medical as field repairable.
Spacelabs Medical is committed to providing comprehensive customer support beginning with your initial inquiry
through purchase, training, and service for the life of your Spacelabs Medical equipment.
CORPORATE OFFICES
U.S.A.
Spacelabs Medical, Inc.

5150 220th Ave SE
Issaquah, WA 98029
Telephone: 425-657-7200
Telephone: 800-522-7025
Fax: 425-657-7212
Authorized EC Representative UNITED KINGDOM
Blease
Beech House, Chiltern Court
Asheridge Road, Chesham
Buckinghamshire HP5 2PX
Telephone: 44 (0) 1494 784422
Fax: 44 (0) 1494 794414
BirthNet, Clinical Browser, Data Shuttle, Flexport, Intesys, Mermaid, MOM, Multiview, PCIS, PCMS, PrintMaster,
Quicknet, Sensorwatch, TRU-CAP, TRU-CUFF, TruLink, Ultralite, Ultraview, Ultraview Care Network, Ultraview
Clinical Messenger, Ultraview Digital Telemetry, Ultraview SL, Uni-Pouch, UCW, Varitrend and WinDNA are
trademarks of Spacelabs Medical, Inc.
AS/3, Cardiocap, ComWheel, CS/3, D-fend, D-fend+, OxyTip+, D-lite, Patient Spirometry, Pedi-lite, and S/5 are
trademarks of Datex-Ohmeda Division, Instrumentarium Corp., now part of General Electric Corp.
Other brands and product names are trademarks of their respective owners.
Caution
Rx US Federal law restricts the devices documented herein to sale by, or on the order of, a
Only physician.
Before use, carefully read the instructions, including all warnings and cautions.
!
Table of Contents
Contents Page
About this Guide
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i-i
Classifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i-i
Responsibility of the Manufacturer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i-ii
Disposal of Electrical and Electronic Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i-ii
Monitor Description
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
Ultracare SLP100 Model and Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Parts of the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-5
Patient Connectors Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-6
Rear Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-7
Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-8
Delayed Standby Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-9
Backup Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-10
Installation and Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-10
Safety Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-11
ESD Precautionary Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-16
Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-17
ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-18
Impedance Respiration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-20
Noninvasive Blood Pressure (NIBP). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-20
Invasive Blood Pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-21
Temperature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-21
Pulse Oximetry, Standard. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-21
Pulse Oximetry, Nellcor Compatible . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-22
Airway Gases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-23
Spirometry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-26
NMT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-26
Recorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-27
Monitoring Basics
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
Keys and Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
Remote Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-4
Using Menus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-5
Monitoring a Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-7
Main Menu Map . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-10
Direct Access Key Maps. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-13
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-14
Monitor Setup
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Selecting a User Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Changing and Saving Configuration Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2
Parts of the Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3
Modifying Waveform Fields . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4
Modifying Digit Fields . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6
Splitting the Screen Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-7
Setting Time and Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9
Display Brightness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-10
Displaying Pulse Rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-10
Other Adjustable Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-11
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Ultracare SLP100 User’s Reference Manual
Alarms
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1
Alarm Categories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2
Alarm Activation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-4
Displaying Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-4
Adjusting Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-6
Changing Alarm Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-8
Suppressing Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-9
Transferring Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-11
Recording Alarms Automatically. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-11
Trends and Snapshots
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1
Most Common Tasks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-2
Graphical Trend View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-4
Minitrend View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-7
Numerical Trend View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-9
Snapshots. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-10
Special Functions
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-1
Network Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-1
Resetting a Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-3
Adding Demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-4
Loading a Previous Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5
Marking Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-6
Viewing Other Sites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-7
Recording and Printing
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1
Recording Waveforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2
Recording Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-7
Recorder Paper Replacement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-10
Printing to a Laser Printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-10
Troubleshooting
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-1
Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-1
Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-4
Other Situations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-9
Maintenance and Cleaning
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-1
Preventive Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-1
Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-3
ECG
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-1
Patient Connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-2
ECG Setup Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-6
Selecting a Lead . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-8
Viewing a Cascaded ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-8
Adjusting ECG Size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-9
Adjusting Beat Sound Volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-10
ST Segment Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-10
ii
Setting ECG Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-15
Table of Contents
Monitoring Pacemaker Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-15
Pacemaker Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-16
Other Adjustable Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-16
Impedance Respiration
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-1
Activating the Respiration Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-4
Choosing the Respiration Rate Source . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5
Improving Waveform Readability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-6
Improving Respiration Rate Detection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-6
Measurement Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-7
Pulse Oximetry
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-1
Opening the Pulse Oximetry Menu. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-2
During Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-6
Measurement Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-7
Noninvasive Blood Pressure (NIBP)
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-1
NIBP Setup Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-3
Starting NIBP Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-4
During Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-5
Autocycling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-6
Starting/Stopping a Continuous Measurement (STAT) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-7
Using Venous Stasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-7
Invasive Blood Pressure
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-1
Invasive Blood Pressure Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-2
Invasive Pressures Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-4
Invasive Line Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-5
Starting with Accurate Values. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-7
Measuring Pulmonary Capillary Wedge Pressure (PCWP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-9
Temperature
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-1
Temperature Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-2
Airway Gases
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-1
Sample Gas Exhaust Connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-6
CO2 Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-10
O2 Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-11
N2O Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-12
Agent Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-13
Automatic Agent Identification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-15
Selecting Alarm Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-15
Gas Calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-16
Interfering Gases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-19
Unit Conversions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-19
iii
Spirometry
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-1
Display of Spirometry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-2
Spirometry Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-6
Spirometry Loops . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-7
Scaling of Loops and Waveforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-9
Calibrating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-10
Neuromuscular Transmission (NMT)
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-1
Starting Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-6
Changing the Stimulus Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-8
Changing the Cycle Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-10
Changing the Stimulus Current. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-11
Enabling Recovery Note . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-12
Stopping and Restarting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-12
Measuring Deep Relaxation with PTC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-13
Regional Block Stimulation (Plexus Stimulation) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-13
Measurement Limitations and Artifacts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-15
iv
About this Guide
Contents
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .i
Classifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .i
Responsibility of the Manufacturer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii
Overview
Note:
Some features and options may not be available.
Intended Use
The Ultracare SLP100 perioperative monitor and accessories are indicated for indoor monitoring
of hemodynamic (ECG), impedance respiration, noninvasive blood pressure (NIBP), temperature,
pulse oximetry (SpO2), and invasive pressure, respiratory (CO2, O2, N2O, respiration rate,
anesthetic agent, and agent identification), ventilatory (airway pressure, volume, and flow), and
relaxation status (Neuromuscular Transmission — NMT) of hospital patients.
With the enhanced pulse oximetry option, monitoring of arterial oxygen saturation includes
monitoring hospital patients during conditions of clinical patient motion.
• Ultracare SLP100 is indicated for patients weighing 5 kg (11 pounds) or more.
• Impedance respiration measurement is indicated for patients ages 3 years and older.
• The monitor is indicated for use by qualified medical personnel only.
Caution
US Federal law restricts the sale of this device to, or on the order of, a licensed
medical practitioner.
Classifications
IEC/EN 60601-1
• Type of protection against electric shock — Class I
• Degree of protection against electric shock (indicated by a symbol beside each
connector) —Type BF or Type CF applied part
• Mode of operation — Continuous
• This equipment is not suitable for use in the presence of a flammable anesthetic mixture with
air, or with oxygen or nitrous oxide.
i-i
IEC/EN 60529
Degree of protection against the harmful ingress of water — IPX1
EU Medical Device Directive — IIb
CISPR 11 — Group 1, class A
Responsibility of the Manufacturer

Spacelabs Medical is responsible for the safety, reliability, and performance of the equipment only
if:
• Assembly, operation, extensions, readjustments, modifications, service, and repairs are
limited to qualified personnel trained by the manufacturer.
• Electrical installation complies with appropriate requirements.
• The equipment is used in accordance with Ultracare SLP100 User’s Guide (P/N 070-1200-xx)
and serviced and maintained in accordance with the Ultracare SLP100 Technical Reference
Manual (P/N 070-1205-xx).
• This product is CE marked by Datex-Ohmeda, Instrumentarium Corp.
0537
Disposal of Electrical and Electronic Equipment

This symbol indicates that the waste of electrical and electronic equipment must not be disposed
as unsorted municipal waste and must be collected separately. Please contact an authorized
representative of the manufacturer for information concerning the decommissioning of your
equipment.
i-ii
Monitor Description
Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Ultracare SLP100 Model and Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Parts of the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Patient Connectors Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Rear Panel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Delayed Standby Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Backup Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Installation and Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
ESD Precautionary Procedures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Impedance Respiration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Noninvasive Blood Pressure (NIBP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Invasive Blood Pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Temperature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Pulse Oximetry, Standard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Pulse Oximetry, Nellcor Compatible . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Airway Gases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Spirometry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
NMT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Recorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Introduction
This User’s Reference Manual contains detailed information about the features of the Ultracare
SLP100 monitor with Anesthesia software installed.
Note:
Some features and options may not be available.
Additional Information
The Ultracare SLP100 User’s Guide (P/N 070-1200-xx) ships with the monitor. It contains basic
information for using the Ultracare SLP100.
The Ultracare SLP100 Technical Reference Manual (P/N 070-1205-xx) describes installation,
maintenance, service, and repair procedures to be performed by authorized service personnel
only.
For information about other devices closely related to the Ultracare SLP100, refer to the Datex-
Ohmeda S/5™ Network and Central, User’s Reference Manual
Licensed accessories are listed in the Ultracare Ultracare ADS Supplies and Accessories
Catalog (P/N 084-1301-xx).
1-1
Clinical Application
This manual contains specific information about clinical and technical aspects of the
Ultracare SLP100. Application guides that contain detailed information about clinical applications,
such as Patient Spirometry™, CO2 monitoring, ST segment analysis, impedance respiration, etc.
are also available.
Configuration
This manual describes most configurable features of the Ultracare SLP100. Due to the possibility
of different factory configurations, some menus, displays, and functions described in this manual
may not be available in the monitor you are using.
When your monitor was delivered, it was configured with the default settings and ready to use.
Instructions for changing settings to make your own permanent configuration are located within the
appropriate chapters in this manual.
Configuration Passwords
Some features can be configured only from the Install/Service menu. A password is required to
access the Install/Service options. The default password is 16–4–34.
To enter the Install/Service menu:
1 Press the ComWheel and select Monitor Setup from the Main menu.
2 Select Install/Service.
3 Turn the ComWheel until the first number (16) appears in the adjustment window, then press
the ComWheel to select the number. Select the other password numbers (4, then 34) in the
same way. When you finish, the Install/Service menu opens.
Most modifications are temporary unless you save them in the Save Modes menu, a password-
protected submenu of the Install/Service menu. The default password for entering the Save
Modes menu is 13–20–31.
1-2
Ultracare SLP100 Model and Options
Monitor Description
The Ultracare SLP100 model is used for perioperative monitoring. This a hemodynamic monitor
with airway gas measurement that can be equipped with built-in options.
• All measurement parameter options and the recorder option, are factory-configured and
cannot be added after purchase.
• Data collection and management options may be added later.
Hemodynamic Monitor with Airway Gas Measurement

The Ultracare SLP100 model measures NIBP, ECG (3-lead and 5-lead), pulse oximetry (SpO2),
temperature (T1), impedance respiration, and airway gases. Gas measurement depends on which
airway gas option is installed:
N-XC Carbon Dioxide (CO2)
N-XCO CO2, N2O, and Patient Oxygen (O2)
N-XCAiO CO2, anesthetic agents, agent identification, N2O, and O2
The Ultracare SLP100 model with gas measurement can also be equipped with each of these
built-in options:
N-XP Two invasive pressure channels and second temperature (T2)
N-XV Patient Spirometry (N-XCO or N-XCAiO option required)
N-XREC Recorder
In addition, the F-MXG can be equipped with one of the following built-in options:
N-XOSAT Datex-Ohmeda enhanced pulse oximetry (SpO2)
N-XNSAT Nellcor compatible pulse oximetry (SpO2)
NeuroMuscular Transmission (NMT) for relaxation measurement and

N-XNMT
plexus stimulation (N-XCAiO option required)
Data Collection and Management Options

These options can be factory-built or added later as upgrades:
Network
Data Card and Network
1-3
Order Codes
Items and corresponding order codes are given in the table below:
Abbreviation Description Order code
N-XC Airway Gas Option (CO2) 014-0030-xx
N-XCO Airway Gas Option (CO2, O2 and N2O) 014-0010-xx
Airway Gas Option (CO2, O2, N2O and

N-XCAIO anesthesia agents with automatic 014-0020-xx
identification)
N-XV Patient Spirometry Option 014-0402-00
Invasive Pressure Option with second

N-XP 014-0401-00
temperature channel
N-XREC Recorder Option 014-0403-00
N-XNET Network Option 014-0404-00
014-0405-00 (EN)
N-XDNET Data Card and Network Option 014-0406-00 (FR)
014-0407-00 (GR)
N-XNMT NeuroMuscular Transmission (NMT) Option 014-0408-00
1-4
Parts of the Monitor
Monitor Description
1
2
12
11
10 6
9 7
8
Figure 1-1: Ultracare SLP100 monitor
Power ON/STANDBY key

External power indicator/Battery charge status LED
Alarm indicators
Insertion slots for two memory cards
Note:
A cover for the slots is available.
Direct access keys
Adjustable rear support
ComWheel™
Recorder
Note:
The two-button recorder (shown) is for Ultracare SLP100 monitors using software
version 3.0 or higher.
Patient connectors
Spirometry connectors
NIBP connector
D-fend™ housing
1-5
Patient Connectors Panel
Figure 1-2: Patient connectors
Spirometry
NMT
Invasive pressure, P2
Temperature, T2
Temperature, T1
Invasive pressure, P1
SpO2 (connector differs depending on pulse oximetry configuration)
Connector for Ultracare SLP100 standard pulse oximetry
ECG
NIBP
D-fend housing
1-6
Rear Panel
Monitor Description
1
2
13
3
4
12
11 10 9 8 7 6 5
Figure 1-3: Ultracare SLP100 rear panel
Built-in handle
Gas outlet, X6
Remote Control connector, X5
Ethernet connector, X4
Network connection LEDs
Network identification plug connector, X3
Serial communication interface/local printer connector, X2
Analog/digital output connector, X1 (includes nurse call and defibrillator
synchronization signals)
Mounting attachment
Dust filter
Potential equalization
Fuse and voltage information
Receptacle for mains power cord
Rear Panel Connections
Warning:
Electrical shock hazard. Use only hospital-grade, grounded electrical outlets.
Caution
• Turn OFF the power before making any rear panel connections.
• Place the monitor on a flat surface that can hold at least 10 kg (22 pounds).
• Use only the power cord provided to connect the monitor to the wall outlet.
1-7
Symbols
• Attention! Read accompanying instructions, including all warnings and

cautions, before using this device.
• This symbol has the following meanings when it appears on the screen:
- When displayed beside the O2 value, indicates that the FiO2 low-alarm
limit is set below 21%.
- When displayed next to the HR value, indicates that there is a risk that the
monitor counts pacemaker spikes (pacer is set ON R) or the monitor
counts T-waves (a wide QRS is selected).
• On the front panel indicates that protection against cardiac defibrillator
discharge is due in part to the accessories for pulse oximetry (SpO2),
temperature (T) and invasive pressure (P) measurement.
• On the rear panel, indicates the following warnings and cautions:
- Electric shock hazard. Do not open the cover or the back. Refer servicing
to qualified personnel.
- For continued protection against fire hazard, replace only with same type
and rating of fuse.
- Disconnect power supply before servicing.
- Do not touch battery-operated monitor during a defibrillation procedure.
Alarm silence indicator. When displayed at the upper left corner of the screen,
indicates that all alarms are silenced. When in a menu or digit field, indicates that
the alarm source has been turned OFF.
Main menu. Located beside the ComWheel to indicate you can open the
Main menu by pressing the Comwheel when no other menu is displayed.
Submenu. Appears in a menu to indicate the selection will open a new menu. A
submenu contains functions that are used less frequently.
The monitor is connected to the network.
Data Card (green) and/or the Menu Card (white) is inserted.
Flashes next to the heart rate value or pulse rate value to indicate the beats
detected.
Appears next to the respiration rate value to indicate that the respiration rate is
calculated from the impedance respiration measurement.
Battery operation and remaining capacity.
Battery charging.
1-8
Monitor Description
Type BF applied part (IEC 60601-1). Defibrillator-proof protection against electric
shock.
Type CF applied part (IEC 60601-1). Defibrillator-proof protection against electric

shock.
Gas outlet.
Ethernet connectors.
Equipotentiality. Monitor can be connected to potential equalization conductor.
Alternating current.
Fuse.
Power ON/Standby.
ESD warning symbol for electrostatic sensitive devices. Pins of connectors

identified with the ESD warning symbol should not be touched. Connections
should not be made to these connectors unless ESD precautionary procedures
are used. Refer to ESD Precautionary Procedure Training on page 1-16 for
details.
Symbol for non-ionizing electromagnetic radiation. Interference may occur in the

vicinity of equipment marked with the symbol.
Date of manufacturing
Delayed Standby Function

A delayed switch-OFF mechanism makes it possible to return to monitoring if the monitor is
accidentally switched to standby.
When the Power ON/Standby key is pressed, a message box is displayed in the center of the
waveform display and the waveform fields are frozen. After 8 seconds, the monitor display is
switched off and the monitor enters standby mode.
Pressing the Power ON/Standby key during this 8-second delay will allow you to continue
monitoring. The message box will be removed and all data and configurations will be retained.
1-9
Backup Battery
If mains power is lost during monitoring, the monitor can run on power from the internal battery.
The capacity of a fully charged internal battery is 15 minutes minimum.
Note:
The monitor can be switched on only when connected to mains power.
Battery Time
A symbol on the display indicates the remaining operating time of the battery. It is displayed only
when the monitor is not connected to mains power.
The operating time that remains is updated every minute.

• When about five minutes of battery operating time is left, a Batt low alarm is activated and the
monitor makes one beep.
• When about one minute of operating time is left, a Batt empty alarm is activated.
The battery is charged automatically when the monitor is connected to mains power. Battery
charging time is normally five hours.
A charging symbol is displayed during charging:
The symbol is removed from the display when the battery is fully charged.
During battery charging, the standby LED is flashing in standby mode.
Installation and Service

A separate Technical Reference Manual describes installation, interfacing, connectors, service,
maintenance and reparation procedures of the monitor. Medical electrical equipment needs
special precautions regarding EMC and needs to be installed and put into service according to the
EMC information provided in the Ultracare ADS7900 Anesthesia Ventilator Technical Reference
Manual (P/N 070-1198-xx) by qualified personnel. Service and reparations are allowed for
authorized service personnel only.
Warning
Before starting to use the system, ensure that the whole combination complies with the
international standard IEC 60601-1-1 and with the requirements of the local authorities.
Do not connect any external devices to the system other than those specified.
1-10
Safety Precautions
Monitor Description
This section lists the warnings and cautions you should know before using the monitor.
Warning
A WARNING indicates a situation in which the user or the patient may be in danger of
injury or death.
• It is possible for any device to malfunction; therefore, always verify unusual
data by performing a formal patient assessment.
• Connect only one patient to a monitor at a time.
• Use only hospital-grade grounded electrical outlets and power cords.
• Make sure external equipment is hospital-grade grounded before connecting
it. Do not connect any external equipment to the system, except equipment
specified by the manufacturer.
• Constant attention by a qualified professional is needed whenever a patient
is connected to a ventilator. Some equipment malfunctions may pass
unnoticed in spite of the monitor alarm.
• All invasive procedures involve risks to the patient. Use aseptic techniques.
Follow the catheter manufacturer’s instructions.
• To avoid an explosion hazard, do not use the monitor in the presence of
flammable anesthetics. The monitor measures only non-flammable
anesthetics.
• Do not use anti-static or electrically-conductive breathing tubes. They may
increase the risk of burns when an electrosurgery unit is used.
• Do not use the monitor in high electromagnetic fields (for example: Magnetic
Resonance Imaging — MRI).
• Use only accessories, including mounts and batteries, and defibrillator-proof
cables and invasive pressure transducers approved by the manufacturer.
For a list of approved supplies and accessories, refer to the Supplies and
Accessories Catalog. Other cables, batteries, transducers and accessories
may cause a safety hazard, damage the equipment or the system, result in
increased emissions or decreased immunity of the equipment or system or
interfere with the measurement. Protection against cardiac defibrillator
discharge is due in part to the accessories for pulse oximetry (SpO2),
temperature (T) and invasive pressure (P) measurement.
• To prevent erroneous readings, do not use physically damaged sensors or
sensor cables. Discard a damaged sensor or sensor cable immediately.
Never repair a damaged sensor or cable; never use a sensor or cable
repaired by others. A damaged sensor or a sensor soaked in liquid may
cause burns during electrosurgery.
• If liquid has accidentally entered the equipment, disconnect the power cord
from the power supply and have the equipment serviced by authorized
service personnel.
1-11
• Use only approved accessories, mounts and defibrillator-proof cables and

invasive pressure transducers. For a list of approved supplies and
accessories, refer to the Supplies and Accessories catalog. Other cables,
transducers and accessories may cause a safety hazard, damage the
equipment or system, result in increased emissions or decrease immunity of
the equipment or system or interfere with the measurement. Protection
against cardiac defibrillator discharge is due in part to the accessories for
pulse oximetry (SpO2), temperature (T) and invasive pressure (P)
measurement. Single-use accessories are not designed to be re-used. Re-
use may cause a risk of contamination and affect the measurement
accuracy.
• The monitor or its components should not be used adjacent to or stacked
with other equipment. If adjacent or stacked use is necessary, the monitor
and its components should be observed to verify normal operation in the
configuration in which it will be used.
Failure of Operation
It is possible for any device to malfunction; therefore, always verify unusual data by performing a
formal patient assessment.
The monitor or its components should not be used adjacent to or stacked with other equipment. If
adjacent or stacked use is necessary, the monitor and its components should be observed to
verify normal operation in the configuration in which it will be used.
Explosion Hazard
Warning
To avoid an explosion hazard, do not use the monitor in the presence of flammable
anesthetics. The monitor measures only non-flammable anesthetics.
Electrical Shock Hazard

• When you connect equipment to the Ultracare SLP100 input and output connectors, you are
configuring a medical system and are responsible for ensuring that the system complies with
IEC/EN 60601-1-1 and with local requirements.
• Do not connect external equipment to the system, except equipment specified by Spacelabs
Medical.
• Make sure external equipment is hospital-grade and grounded before connecting.
• Use only hospital-grade, grounded electrical outlets and power cords.
• Pins of connectors identified with the ESD warning symbol should not be touched.
Connections should not be made to these connectors unless ESD precautionary procedures
are used. Refer to ESD Precautionary Procedures on page 1-16 for details.
NMT
• Always stop NMT measurement before handling stimulation electrodes.
• Do not place the NMT stimulation electrodes on the patient’s chest.
1-12
Cleaning
Monitor Description
• Before cleaning, disconnect the monitor from the electrical outlet.
• After cleaning, or if liquid has accidentally entered the interior of the monitor, make sure that
every part of the monitor is dry before reconnecting it to the power supply.
• If liquid has accidentally entered the equipment, disconnect the power cord from the power
supply and have the equipment serviced by authorized service personnel.
Patient Safety
• All invasive procedures involve risks to the patient. Use aseptic technique. Follow the
instructions provided by the catheter manufacturer.
• The output signals are not floating and they must not be connected directly to a patient.
• Connect only one patient to one monitor at a time.
• Constant attention by a qualified professional is needed whenever a patient is under
anesthesia or connected to a ventilator. Some equipment malfunctions may pass unnoticed in
spite of the monitor alarm.
• Do not use anti-static or electrically-conductive breathing tubes. They may increase the risk of
burns when an electrosurgery unit is used.
• Do not use the Ultracare SLP100 during magnetic resonance imaging (MRI).
• Use only approved accessories, mounts, and defibrillator-proof cables and invasive pressure
transducers. For a list of approved supplies and accessories, refer to the Ultracare ADS
Supplies and Accessories Catalog (P/N 084-1301-xx). Other cables, transducers, and
accessories may cause a safety hazard, damage the equipment or system, result in increased
emissions or decreased immunity of the equipment or system or interfere with the
measurement. Protection against cardiac defibrillator discharge is due in part to the
accessories for pulse oximetry (SpO2), temperature (T), and invasive pressure (P)
measurement. Single-use accessories are not designed to be re-used. Re-use may cause a
risk of contamination and affect the measurement accuracy.
ECG, Impedance Respiration, Invasive Blood Pressure

Ensure proper contact of the return electrode of the electrosurgery unit to your patient to avoid
possible burns at sensor sites.
ECG, Impedance Respiration, NMT

Make sure that the lead set clips or snaps do not touch any electrically conductive material,
including earth.
In obstructive apnea, respiration movements and impedance variations may continue.
NIBP
The monitor sets the inflation pressure automatically according to the first measurement. Reset
the case to reset the inflation limit before measuring a new patient.
1-13

Make sure that no part of the patient connections touches any electrically conductive material,
including earth.
Patients with Pacemakers or Arrhythmia

The monitor may count pacemaker pulses as heart beats during cardiac arrest, some arrhythmias,
and with certain types of pacemakers particularly in ON R mode. Do not rely entirely upon rate
meter alarms. Keep patients with pacemakers and arrhythmias under close surveillance.
The impedance respiration measurement may cause rate changes in Minute Ventilation Rate
Responsive Pacemakers. Set the pacemaker rate responsive mode to OFF or turn OFF the
impedance respiration measurement on the monitor.
Gases
MAC values are empirical, not absolute. Ultracare SLP100 values correspond to those of healthy
adults and cannot be applied to children. Age and other individual factors influencing the effect of
volatile agents are not taken into account.
Pulse Oximetry
• A damaged sensor or a sensor soaked in liquid may cause burns during electrosurgery.
• Use clean and dry sensors and cables only. Moisture and debris on connectors may affect
measurement accuracy.
• Patient conditions (such as reddening, blistering, skin discoloration, ischemic skin necrosis,
and skin erosion) may warrant changing the sensor site frequently or using a different style of
sensor. For details, refer to the instructions supplied with the sensor.
• Conditions that may cause inaccurate readings and impact alarms include interfering
substances, excessive ambient light, electrical interference, ventricular septal defects (VSD),
excessive motion, low perfusion, low signal strength, incorrect sensor placement, poor sensor
fit, and/or movement of the sensor on the patient.
• To prevent erroneous readings, do not use an inflated blood pressure cuff or arterial blood
pressure measurement device on the same limb as the oximeter sensor.
Temperature
To prevent patient injury, only use temperature probes approved by Spacelabs Medical.
Alarms
Make sure that necessary alarm limits are set and alarms are on when you start monitoring a
patient.
When alarms are suppressed, observe the patient frequently.
1-14
Caution
Monitor Description
A CAUTION indicates a situation that may cause damage to the unit or devices
connected to it.
• US Federal law restricts this device to sale by or on the order of a licensed
medical practitioner.
• The system is intended for use by qualified medical personnel only.
• Do not apply pressurized air to any outlet or tubing connected to the
monitor. Pressure may destroy sensitive elements.
• Do not store the monitor outside the specified temperature range (-10° to
+50° C/14° to 122° F).
• Do not subject memory cards to excessive heat, bending, or magnetic fields.
• Use only cables and accessories approved by the manufacturer. Other
cables and accessories may damage the system or interfere with
measurements.
• Turn OFF the power before making any rear-panel connections.
• Vibrations during transport may disturb SpO2, ECG, impedance respiration,
and NIBP measurements.
• Leave space for circulation of air, to prevent the monitor from overheating.
• Dispose of the whole device, or parts of it (for example: the backup battery),
in accordance with local environmental and waste disposal regulations.
Airway Gas Measurement

Strong scavenging suction may change the operating pressure of the monitor and cause
inaccurate readings or internal damage.

Mechanical shock to the invasive blood pressure transducer may cause severe shifts in zero
balance and calibration and may produce erroneous readings.
Cleaning
• Do not disinfect or open the water trap cartridge. To avoid damage, do not touch or try to clean
the water trap hydrophobic membrane (other than to rinse it with water).
• Do not sterilize any part of the monitor with steam autoclave or ethylene oxide.
• Do not immerse any part of the device in liquids or allow liquid to enter the interior.
• Do not use hypochlorite, acetone-based, phenol-based, or ammonia-based cleaners.
Disposal
Dispose of the whole device and its parts in accordance with local environmental and waste
disposal regulations.
1-15
Points to Note
• Medical electrical equipment needs special precautions regarding electromagnetic
compatibility and needs to be installed and put into service according to the electromagnetic
compatibility information provided in the Technical Reference Manual by qualified personnel.
• Portable and mobile RF communications equipment can affect the medical electrical
equipment.
• The allowed cables, transducers, and accessories for the system are listed in the Supplies and
Accessories catalog delivered with the monitor.
• The equipment is suitable for use in the presence of electrosurgery. Please notice the possible
limitations in the parameter sections and in Safety Precautions on page 1-11.
• Service and reparations are allowed for authorized service personnel only.
• CISPR classifications:
Group 1 contains all ISM (Industrial, scientific, and medical) equipment in which there is
intentionally generated and/or used conductively coupled radio-frequency energy, which is
necessary for the internal functioning of the equipment itself.
Class A equipment is suitable for use in all establishments other than domestic and those
directly connected to the public low-voltage power supply network that supplies buildings used
for domestic purposes.
ESD Precautionary Procedures

To avoid electrostatic charges to build up, it is recommended to store, maintain, and use the
components at a relative humidity of 30% or greater. Floors should be covered by ESD dissipative
carpets or similar. Non-synthetic clothing should be used when working with the component.
To prevent applying a possible electrostatic discharge to the ESD-sensitive parts of the
component, one should touch the metallic frame of the component or to a large metal object
located close to the component. When working with the component and specifically when the ESD
sensitive parts of the component may be touched, a grounded wrist strap intended for use with
ESD-sensitive equipment should be worn. Refer to the documentation provided with the wrist
straps for details of proper use
ESD Precautionary Procedure Training

It is recommended that all potential users receive an explanation of the ESD warning symbol and
training in ESD precautionary procedures.
The minimum content of an ESD precautionary procedure training should include an introduction
to the physics of electrostatic charge, the voltage levels that can occur in normal practice and the
damage that can be done to electronic components if they are touched by and operator who is
electrostatically charged. Further, an explanation should be given of methods to prevent build-up
of electrostatic charge and how and why to discharge one’s body to earth or to the frame of the
equipment or bond oneself by means of a wrist strap to the equipment or the earth prior to making
a connection.
1-16
Specifications
Monitor Description
All specifications are subject to change without notice.
Warning
Operation of the monitor outside the specified values may cause inaccurate results.
Power Supply
Rated voltages and frequencies: 100 to 240 V 60/50 Hz
Allowed voltage fluctuations: ±10%
Maximum power consumption: 80 VA
Fuses (2): T2 AH/250 V
Backup Battery
Type: 12 V 2.6 AH lead acid
Backup battery time: At least 15 minutes when fully charged
Charging time (typical): 5 hours
Charging indicator
Green LED ON: Full charge, battery on the holding voltage
Green LED flashing: Charging
Environmental Requirements
Operating temperature: +10° to +40° C (50° to 104° F)
Storage and transport temperature: –10° to +50° C (14° to 122° F)
Relative humidity: 0 to 85% noncondensing; in airway 0 to 100%
condensing
Atmospheric pressure: 660 to 1060 hPa (500 to 800 mmHg)
Alarm Behavior
If the alarm mode is latched, the technical alarms are latched as well. This does not comply with
the NIBP (IEC 60601-2-30) and invasive pressure (IEC 60601-2-34) standard requirements.
1-17
ECG
Waveform display (with 50 Hz power supply frequency)
Monitoring filter: 0.5 to 30 Hz
ST filter: 0.05 to 30 Hz
Diagnostic filter: 0.05 to 100 Hz
Waveform display (with 60 Hz power supply frequency)
Monitoring filter: 0.5 to 40 Hz
ST filter: 0.05 to 40 Hz
Diagnostic filter: 0.05 to 100 Hz
Minimizing the effects of the line isolation monitor transients:
Crystal controlled oscillator is used as the
operating frequency source of the patient
isolation power supply.
Offset voltage range: ±0.4 V
Warning
The ±0.4 V offset voltage range of the ECG measurement may be insufficient to handle
the offset potentials when using ECG electrodes of dissimilar metals
The isolation barrier capacitance has been minimized to reduce the hazard of burns in the event of
a defect in the ESU return electrode connection.
Direct current for leads-off detection through any patient electrode:50 nA
The normalized respiration sensing current: 3.0 µA
Frequency of respiration sensing current: 31.25 kHz
Maximum Tall T wave amplitude that does not disturb the heart rate calculation time (according to
ANSI/AAMI EC13 4.1.2.1): 10 mV
Pacemaker pulse detection:
Detection level: 2 to 700 mV
Pulse duration: 0.5 to 2 ms
The monitor is specified for both of the methods A and B required in ANSI/AAMI EC13 4.1.4.2.
Pacer pulse rejection of fast ECG signals:
0.2 V/s with Sensit pacemaker selection and 1.6 V/s with other selections according to the test
defined in ANSI/AAMI EC13 section 4.1.4.3.
1-18
ST Segment Analysis
Monitor Description
Measured and displayed simultaneously for up to three ECG leads
ST level range: –6 to +6 mm (–0.6 to +0.6 mV)
QRS minimum detection level: Minimum level 0.5 mV with duration between
40 and 120 ms fulfils ANSI/AAMI EC13
standard
Display resolution: 0.1 mm (0.01 mV)
Averaging: Calculated from 16 QRS complexes
Display update interval: 5 seconds
Test result of ST segment measurement algorithm testing.

The algorithm testing has been performed by using The European Society of Cardiology ST-T
Database
Average results from ischemic ST detection
Episode sensitivity: 77
Episode positive predictive accuracy: 67
Duration sensitivity: 74
Duration positive predictive accuracy: 61
Heart Rate
Measurement range: 30 to 250 bpm
Measurement accuracy: ±5% or ±5 bpm
Pacemaker pulse detection level: 2 to 500 mV
Pacemaker pulse duration: 0.5 to 2 ms
Display averaging time: 10 seconds
Display update time: 5 seconds
The heart rate calculation operates with irregular rhythms of ANSI/AAMI EC13 4.1.2.1 (e) as
follows:
a 40 bpm
b 87 bpm
c 60 bpm
d 117 bpm
Average heart rate response time and time range of response time (according to ANSI/AAMI
EC13 4.1.2.1 (f)):
Response time 80 to 120 bpm: 5.0 seconds (3.7 to 6.2 seconds)
Response time 80 to 40 bpm: 6.5 seconds (4.1 to 9.2 seconds)
The average time and time range ( ) to alarm for tachycardia are as follows ANSI/AAMI EC13
4.1.2.1 (g)):
1-19
Figure 4a halved amplitude: 5.5 seconds (4.8 to 5.9 seconds)

Figure 4a normal amplitude: 6.6 seconds (4.8 to 7.2 seconds)
Figure 4a doubled amplitude: 7.2 seconds (5.3 to 9.4 seconds)
Figure 4b halved amplitude: 7.4 seconds (7.0 to 7.7 seconds)
Figure 4b normal amplitude: 6.2 seconds (4.7 to 8.1 seconds)
Figure 4b doubled amplitude: 6.4 seconds (4.4 to 8.2 seconds)
Auxiliary ECG Output

Bandwidth of auxiliary output: 0.5 to 40 Hz
Gain: 1 mV ECG signal is 1 V at the auxiliary output
Propagation delay: <15 ms
The pacemaker pulses are absent but may cause interference at the auxiliary ECG output.
An auxiliary device that fulfils the requirements of the IEC 60601-1 standard can be connected to
the auxiliary output. There are no other limitations, because the auxiliary output of the monitor is
galvanically isolated from patient applied part of the ECG measurement.
Respiration range: 4 to 120 breaths per minute (BPM)
Accuracy: ±5% or ±5 BPM

Measurement range:
Adult 25 to 260 mmHg
Child 25 to 195 mmHg
Infant 15 to 145 mmHg
Pulse rate range accepted: 30 to 250 bpm
Cuff pressure measurement range: -15 to +350 mmHg
Note:
The cuff pressure measurement range is equal with cuff nominal and cuff indication
ranges.
Typical measuring time:
Adult 23 seconds
Infant 20 seconds
1-20
Monitor Description
Measurement range: –40 to 320 mmHg
Measurement accuracy: ±5% or ±2 mmHg
Transducer sensitivity: 5 µV/V/mmHg, 5 VDC, maximum 20 mA
Pulse Rate
Accuracy: ±5% or ±5 bpm
Temperature
Measurement range: 10° to 45° C (50° to 113° F)
Measurement accuracy: 25° to 45.0° C ±0.1° C (77° to 113° F ±0.2° F)
10° to 24.9° C ±0.2° C (50° to 76.8° F ±0.4° F)
Probe type: Spacelabs Medical only. Refer to the Ultracare
Supplies and Accessories Catalog CD-ROM
(P/N 084-1301-xx)
Pulse Oximetry, Standard

Averaging time: Adjustable
Plethysmographic waveform scaling: Adjustable
SpO2
Calibration range: 50 to 100%
Calibrated against functional saturation
Measurement range: 40 to 100%
Measurement accuracy (% SpO2 ± 1SD): 80 to 100% ±2 digits
50 to 80% ±3 digits
Below 50% unspecified
Note:
SpO2 measurement accuracy is based on deep hypoxia studies using the
manufacturer’s or Datex-Ohmeda saturation sensors on volunteers. Arterial blood
samples were analyzed by a Radiometer OS CO-oximeter. Refer to the sensor
instructions for specific accuracy data.
1-21
Pulse Rate
Measurement accuracy: ±5% or ±5 bpm
Default Alarm Limits**

SpO2: High OFF, low 90%
Pulse rate: High 160, low 40
Note:
Limits are adjustable.†
Sensor Emitter Wavelength Ranges

Red LED: 660 nm
Infrared LED: 900 nm
Pulse Oximetry, Nellcor Compatible

Averaging time: 5 to 7 seconds
Plethysmographic waveform scaling: Automatic
SpO2
Calibrated against functional saturation
Measurement range: 1 to 100%
Measurement accuracy (% SpO2 ±1 SD): 70 to 100% (±2 digits to ±3.5 digits, depending
on the sensor)
Below 70% unspecified
Refer to the Pulse Oximetry on page 12-1 for a list of approved sensors and accuracy details.
Note:
SpO2 measurement accuracy is based on testing healthy adult volunteers in induced
hypoxia studies.
Pulse Rate
Measurement accuracy: ±3 digits
1-22
Monitor Description
SpO2: High OFF, low 90%
Pulse rate: High 160, low 40
Note:
Limits are adjustable.†
Sensor Emitter Wavelength Ranges

Red LED: 660 nm
Infrared LED: 920 nm
Airway Gases
Sampling rate*: 200 ml/minute
Sampling delay: 2.5 seconds typical with a 3 meter
sampling line
Total system response time: 2.9 seconds typical with a 3 meter sampling
line, including sampling delay and rise time
Warm-up time: 2 to 5 minutes, 30 minutes for full specification
Note:
Limits are adjustable within the measurement range. Alarm limits and their adjustment
range may vary depending on the mode used.
1-23
High Low
EtCO2 8% 3%
FiCO2 3% OFF
FiN2O 82%
EtO2 OFF 10%
FiO2 OFF 18%
EtDes 12% OFF
FiDes 18% OFF
EtEnf 3.4% OFF
FiEnf 5.1% OFF
EtHal 1.5% OFF
FiHal 2.2% OFF
EtIso 2.3% OFF
FiIso 3.4% OFF
EtSev 3.4% OFF
FiSev 5.1% OFF
Non-disturbing gases
Ethanol C2H5OH (<0.3%)
Acetone (<0.1%)
Methane CH4 (<0.2%)
Nitrogen N2
Carbon monoxide CO
Nitric oxide NO (<200 ppm)
Water vapor
Maximum effect on readings
CO2: <0.2 vol%
O2, N2O: <2 vol%
Anesthetic agents: <0.15 vol%
Effect of helium: Decreases CO2 readings <0.6 vol% typically
1-24
Respiration Rate (RR)
Monitor Description
Measurement range: 4 to 60 BPM
Detection criteria: 1% variation in CO2
Agent Identification
Identification threshold (typical value): 0.15 vol%
Carbon Dioxide (CO2), Oxygen (O2), and Nitrous Oxide (N2O)

Measurement Carbon Dioxide (CO2) Oxygen (O2) Nitrous Oxide (N2O)
0 to 15%, (0 to 15 kPa)
Range 0 to 100% 0 to 100%
(0 to 113 mmHg)
Accuracy* ±(0.2 vol% + 2% of reading) ±(0.1 vol% + 2% of reading) ±(0.2 vol% + 2% of reading)
Rise time <400 ms typical <400 ms typical <450 ms typical
<0.2 vol% <1 vol%
Gas cross <2 vol%
(O2, N2O, and anesthetic (anesthetic agents);
effects (anesthetic agents)
agents) <2 vol% (N2O)
1-25
Anesthetic Agent (AA)
Halothane, Isoflurane,
Measurement Sevoflurane Desflurane
Enflurane
Range 0 to 6% 0 to 8% 0 to 20%
0 to 5% vol %: ±0.2 vol%
Accuracy* ± 0.2 vol% ± 0.2 vol% 5 to 10% vol %: ±0.5 vol%
10 to 20% vol %: ±1.0 vol%
Rise time <400 ms typical
Gas cross effects <0.15 vol% N2O
Spirometry
Detection through D-lite™ or Pedi-lite™ flow sensor and gas sampler:
Measurement D-lite Flow Sensor Pedi-lite Flow Sensor

Tidal Volume
Measurement range 150 to 2000 ml 15 to 300 ml
Accuracy (typical value) ±6% or 30 ml ±6% or 4 ml
Minute volume
Measurement range 2 to 20 L/minute 0.5 to 5 L/minute
Accuracy (typical value) ±6% ±6%
Airway Pressure
Measurement range† –20 to +100 cmH2O –20 to +100 cmH2O
Accuracy (typical value) ±1 cmH2O not applicable
Flow
Measurement range 1.5 to 100 L/minute 0.25 to 25 L/minute
Compliance
Measurement range 4 to 100 ml/cmH2O 4 to 100 ml/cmH2O
Airway Resistance
0 to 40 cm 0 to 40 cm
Measurement range
H2O/L/second H2O/L/second
Sensor Specifications
Dead space 9.5 ml 2.5 ml
Resistance at 30 l/minute 0.5 cmH2O not applicable
Resistance at 10 l/minute not applicable 1.0 cmH2O
NMT
Stimulation modes: Train of four (TOF)
Double burst (3.3) (DBS)
Single twitch (ST)
50 Hz tetanic + post-tetanic count (PTC)
1-26
Measurement intervals
Monitor Description
TOF and DBS: Manual; 10 seconds, 12 seconds, 15 seconds,
20 seconds, 1 minute, 5 minutes, 15 minutes
ST: Manual; 1 second, 10 seconds, 20 seconds
Stimulator
Stimulus pulse: Square wave, constant current
Pulse width: 100, 200, or 300 µs
Stimulus current range (supramax and manual):
10 to 70 mA with 5 mA steps
Stimulus current accuracy: 10% or ±3 mA (whichever is greater)
Max load: 3 kΩ
Max voltage: 300 V
Regional Block Mode

Stimulation mode: Single twitch (ST)
Intervals: 1 second, 2 seconds, 3 seconds
Stimulus pulse: Square wave, constant current
Pulse width: 40 µs
Stimulus current range: 0 to 5.0 mA with 0.1 mA steps
Stimulus current accuracy: 20% or 0.3 mA (whichever is greater)
Recorder
Principle: thermal array
Print resolution
Vertical: 8 dots/mm (200 dots/inch)
Horizontal: 32 dots/mm (800 dots/inch) at speed of
25 mm/second and slower
Paper width: 50 mm; printing width 48 mm
Traces: Selectable; 1, 2, or 3 traces
Print speed: 1, 6.25, 12.5, 25 mm/second
* Typical value.
** Alarm limits and their adjustment range may vary depending on the mode used.
† The user may set the SpO2 low alarm limit lower than 80% and the Ppeak alarm limit higher
than 50 cmH2O during normal use of the monitor. To guarantee patient safety, the user
cannot save such limits as user default values.
1-27
Monitoring Basics
Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Keys and Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Remote Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Using Menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Monitoring a Patient. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Main Menu Map . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Direct Access Key Maps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Introduction
You can control Ultracare SLP100 monitoring with the ComWheel, the direct access keys, or the
optional Remote Control.
• The ComWheel provides access to all monitor functions.
• The direct access keys provide direct access to frequently-used functions that are also
available through the Main menu.
• The Remote Control menu key lets you enter all monitoring functions. Each Remote Control
Direct Access key lets you enter a common function.
Refer to Main Menu Map on page 2-10 and Direct Access Key Maps on page 2-13 for the menus
you can access from the Main menu and by pressing the direct access keys.
2-1
Keys and Controls
2
Silence
Alarms
3
Trends
4
Invasive
Pressures
5
ECG
NIBP 6
NIBP
Start/Cancel 7
Normal
Screen 8
Figure 2-1: Ultracare SLP100 keys and controls
Power ON/Standby key

Silence Alarms key
Trends Direct Access key
Pulse Oximetry, Invasive Pressures, or NMT Direct Access key (depending on configuration)
ECG Direct Access key
NIBP Direct Access key
NIBP Start/Cancel key
Normal Screen key
ComWheel
2-2
Key Functions
Monitoring Basics
Power ON/Standby key.
Note:
The monitor will start only when connected to mains power.
Silences an active alarm or pre-silences all alarms for two minutes (press the key
once) or five minutes (press the key for three seconds). Pressing the key once
again clears the alarm message field of all alarm messages and enables new
alarms. A lighted yellow LED indicates a yellow alarm; a lighted red LED indicates
a red alarm.
Displays trends (numerical and graphical) and snapshots. Press the Normal
Screen key to return to monitoring mode.
The next oval-shaped key can be Pulse Oximetry, Invasive Pressures, or NMT, depending on
which built-in options your monitor contains.
Displays the menu for adjusting oxygen saturation measurement settings

(all models with no Invasive Pressure or NMT option)
Displays the menu for adjusting Invasive Pressure measurement settings

(all models with the Invasive Pressure option and no NMT option)
Displays the menu for adjusting NMT measurement settings

(all models with the NMT option).
Displays the menu for adjusting ECG measurement settings.
Displays the menu for adjusting NIBP measurement settings.
Starts or cancels a single noninvasive blood pressure measurement, STAT, and

manual measurements; stops venous stasis.
Returns to the normal monitoring display.
The ComWheel is the main tool for all menu functions. You turn and/or press it to
access, navigate, and choose all menu options.
Pushing the ComWheel while no menu is displayed opens the Main menu from
which you have access to all monitor functions.
2-3
Recorder Keys
Refer to the Recording and Printing on page 7-1 for descriptions of the keys on the optional
recorder.
Remote Control
The optional Remote Control contains keys that help you in most common situations and tasks.
You can use these direct access keys to start or end a function.
Silence
Alarms
Take Record
Snapshot Wave
Zero ALL
Pressures Other
Special
Patients
Start
Start Wedge Start
C.O. NIBP
Freeze Normal
Menu Screen
Figure 2-2: Remote control
Remote Control Keys
Key Function
Take Creates a freeze frame, which is saved to the monitor memory. Pressing the
Snapshot key also marks a number beside the numerical trend.
Opens the Main menu from which you can access all menus and functions of
Menu
the monitor.
Silence
Silences an active alarm or pre-silences all alarms for two or five minutes.
Alarms
Zero ALL
Zeroes all invasive pressure channels.
Pressures
Freezes the waveform sweep for 60 seconds. To unfreeze the waveforms,

Freeze
press the Freeze key again (or press the Normal Screen key).
2-4
Monitoring Basics
Key Function
Record
Records the selected real-time waveforms.
Wave
Other If the monitor is connected to the network, it is possible to view alarms and
Patients general views for another site.
Start
Starts a single NIBP measurement and cancels any measurement.
NIBP
Normal
Closes open menus and returns to normal monitoring display.
Screen
Start
Displays the customized wedge view and starts wedge measurement.
Wedge
Special Not in use with Ultracare SLP100.
Start
Not in use with Ultracare SLP100.
C.O.
Using Menus
A menu is a list of functions or commands displayed on the screen.
Figure 2-3: Parts of a menu
Header of the menu List of menu selections

Indicates the present selection Entry indicator to submenus
Adjustment window with other options Short instructions
2-5
Opening the Main Menu

If you press the ComWheel when no menu is displayed, you will open the Main menu.
The Main menu provides access to all other menus.

To display a different menu, such as the
Parameters menu, select it from the Main menu.
You can enter the Main menu from other menus by
using the ComWheel to select the previous menu
until you reach the Main menu.
To exit the Main menu, select Normal Screen or
press the Normal Screen key.
Figure 2-4: Main menu
Using the Direct Access Keys

The direct access keys allow you to bypass the Main menu and go directly to the menu activated
by the direct access key. For example:
To quickly enter the ECG menu, press

the ECG Direct Access key.
The menu related to the key you
pressed is displayed.
2-6
Choosing Menu Options
Monitoring Basics
Once a menu is displayed, you use the ComWheel to make selections and adjustments. For
example, to make adjustments in the ECG menu:
1 Turn the ComWheel to move to

and highlight the menu item.
2 Then, press the ComWheel to

enter the adjustment window or a
submenu.
3 Turn the ComWheel to choose

the adjustment.
4 Press the ComWheel to confirm

the change.
Returning to the Normal Display

Press the Normal Screen key to exit a menu and return to the normal monitoring display.
Monitoring a Patient
Use only supplies and accessories approved by Spacelabs Medical for use with the
Ultracare SLP100. Refer to the Ultracare Supplies and Accessories Catalog
CD-ROM (P/N 084-1301-xx).
Preparations
1 Check that the monitor and patient accessories are clean and intact.
2 Press the Power ON/Standby key to turn ON the monitor.
Note:
The monitor will start only when connected to mains power.
3 Tilt the monitor to the optimal viewing angle:
Press the center of the foot and adjust.
• Make sure both feet are at the same angle.
2-7
Note:
If wall mounting is used, make sure the monitor’s front and back attachment bars fit
tightly to the edges of the mounting plate and the locking bolt in the back of the
monitor locks into place.
4 If necessary, change the operating mode:
• Press the ComWheel and select Monitor Setup from the Main menu.
• Select Select Mode.
The operating mode defines what is displayed on the screen and in the trends. Note that changing
the mode also changes, for example, the alarm limits.
Starting Monitoring
1 Prepare the patient connections. Refer to the applicable measurement parameter chapter(s)
later in this manual. Use only supplies and accessories approved by the manufacturer.
2 Alarms are operative and the parameter default settings are active when the patient is
connected to the monitor. To review alarm limits, press the ComWheel and select Alarms
Setup from the Main menu.
• You can also select Alarms Setup through the corresponding parameter menu.
3 Check that you have the desired waveforms and digits in the fields. To adjust them:
• Press the ComWheel and select Monitor Setup from the Main menu.
• Select Screen Setup.
• Select Waveform Fields or Digit Fields.
4 Carry out measurement-specific start-up. For example, start NIBP measurement to get the
reference values.
5 Enter patient data (press the ComWheel and select Patient Data from the Main menu).
During Monitoring
If you need to suppress alarms, press the Silence Alarms key.
• To silence the alarms for two minutes, press the key once.
• To silence the alarms for five minutes, press the key for more than three seconds.
If you accidentally press the Power ON/Standby key during monitoring, the Switching to
standby mode in X seconds message is displayed. If the Power ON/Standby key is not pressed
again within eight seconds, the monitor will switch to standby mode.
To return to monitoring, press the Power ON/Standby key again within eight seconds.
2-8
Ending Monitoring
Monitoring Basics
1 Press the ComWheel to open the Main menu.
2 To print necessary information, select Record/Print; wait until printing is finished.

3 To clear patient data and return settings to their defaults:
• Select Reset Case in the Main menu.
• Select Reset ALL and YES.
4 Turn the Power switch to Standby if the monitor will not be used.
5 Clean the monitor according to the instructions.
2-9
Main Menu Map
* Menu is displayed when the NMT Regional Block Adapter is connected to monitor.
2-10
Monitoring Basics
2-11
2-12
Direct Access Key Maps
Monitoring Basics
* Menu is displayed when the NMT Regional Block Adapter is connected to monitor.
2-13
Abbreviations
The abbreviations that appear on the monitor screen and/or in this manual are listed below.
Abbreviation Meaning
AA anesthetic agent
ABP arterial blood pressure
AirW airway temperature
APN apnea
Art arterial
Asy asystole
ATMP atmospheric pressure
ambient temperature and pressure, dry

ATPD
gas
augmented voltage foot — usually left

AVF
(ECG)
AVL augmented voltage left (ECG)
AVR augmented voltage right (ECG)
Axil axillary temperature
B-To-B beat to beat
Blad bladder temperature
BP blood pressure
BSA body surface area
body temperature and pressure,

BTPS
saturated gas
°C degrees Celsius
Casc. cascaded (ECG)
CO2 carbon dioxide
Compl compliance
Cont. continuous recording
Contrl controlled ventilation
2-14
Monitoring Basics
Core central temperature
CVP central venous pressure
DBS double burst stimulation (NMT)
Des desflurane
Dia diastolic pressure
Diagn diagnostic (ECG filter)
DIFF difference
Dyn dynamic
E expiratory
ECG electrocardiography
ECG1 first ECG waveform (top)
ECG1/r real time ECG
ECG2 second ECG waveform
ECG3 third ECG waveform
EMC electromagnetic compatibility
EMG electromyography (NMT)
Enf enflurane
ESD electrostatic discharge
Eso esophageal temperature
ET, Et end tidal concentration
Exp expired
°F degrees Fahrenheit
FI, Fi fraction of inspired gas
FiO2 fraction of inspired oxygen
Flow airway gas flow
FVloop flow volume loop
Graph. graphical
Hemo hemodynamic
2-15
Hal halothane
Hgb hemoglobin
HR heart rate
I inspiratory
ICP intra cranial pressure
ID identification
Imped. impedance
indep. independent
Inv. invasive
Iso isoflurane
LAP left atrial pressure
LED light emitting diode
MAC minimum alveolar concentration
Mean mean of diastolic and systolic pressures
Monit monitoring (ECG filter)
MV minute volume
MYO myocardial temperature
N 2O nitrous oxide
Naso nasopharyngeal temperature
Net network
NIBP noninvasive blood pressure
NMT neuromuscular transmission
normal temperature and pressure, dry

NTPD
gas
Num. numerical trends
O2 oxygen
Oxy oxygen
P1, P2 invasive pressure channels
2-16
Monitoring Basics
PA pulmonary arterial pressure
PaCO2 arterial carbon dioxide level
Pedi pediatric
Paw airway pressure
PCWP pulmonary capillary wedge pressure
PEEPtot positive end expiratory pressure
Pleth plethysmograph waveform
Ppeak airway peak pressure
Pplat airway plateau (pause) pressure
PR pulse rate
Prev. previous
PTC post tetanic count (NMT)
PVloop pressure volume loop
PVC premature ventricular contraction
RAP right atrial pressure
Raw airway resistance
Rect rectal temperature
Resp respiration rate
Room room temperature
RR respiration rate
RVP right ventricular pressure
S/D systolic/diastolic
SaO2 arterial oxygen saturation
Sev sevoflurane
Skin skin temperature
Snaps. snapshot
Spiro spirometry
2-17
oxygen saturation measured by pulse

SpO2
oximeter
Spont spontaneous breathing
ST single twitch stimulation (NMT)
ST ST segment of ECG
ST inf. ST segment on inferior leads (II, III, aVF)
ST lat. ST segment on lateral leads (I, aVL, V5)
continuous NIBP cuff inflation for 5

STAT
minute
Stfilt ST filter (ECG)
standard temperature and pressure, dry

STPD
gas
Surf skin temperature
Sw software
Sys systolic pressure
T1, T2 temperature
first stimulus as a percentage of the

T1%
reference value (NMT)
Tab. tabular trends
Temp temperature
TOF train of four stimulation (NMT)
ratio of the fourth response to the first

TOF%
response (NMT)
TV tidal volume
Tymp tympanic temperature
V precordial (chest) lead (ECG)
Vol volume
2-18
Monitor Setup
Contents
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Selecting a User Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Changing and Saving Configuration Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Parts of the Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Modifying Waveform Fields . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Modifying Digit Fields . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Splitting the Screen Display. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Setting Time and Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Display Brightness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Displaying Pulse Rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Other Adjustable Features. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Overview
The Ultracare SLP100 has setup options for display, parameters, alarms, etc. You can change the
settings to suit your specific needs. General monitor settings can be changed in the Monitor
Setup menu. Other settings are changed in setup menus for each parameter.
Modifications remain in effect until the case is ended, a user mode is changed, or for 15 minutes
after the monitor is turned OFF. Replacing the CPU board also returns settings to their defaults.
Note:
You can load or reload the settings using the network.
Selecting a User Mode

User modes are pre-defined groups of settings that include general monitor settings and some
measurement-specific settings. A user mode defines, for example, what is displayed on the screen
and in trends. The pre-configured, factory-default user modes are General, Regional, and
Pediatric.
General Mode for basic general anesthesia and for low- and medium-risk adult patients.
Regional Mode for all types of regional anesthesia and anesthesia care.
Pediatric Mode for basic general anesthesia and for low- and medium-risk pediatric patients.
The monitor always starts in Start-up mode. Start-up mode is one of your user modes, chosen
during configuration. You can change mode settings during monitoring.
3-1
To change the Start-up mode to another mode:
1 Press the ComWheel and select Monitor

2 Select Select Mode.
3 Select GENERAL, REGIONAL, or
PEDIATRIC.
The mode you select is marked with an arrow.
Changes made separately are maintained when returning to the previous mode.
Changing and Saving Configuration Settings

Permanent changes to the configuration are made in the Install/Service menu, a submenu of the
Monitor Setup menu. You need a password to enter this menu and change the configuration.
Almost all modifications are only temporary unless you save them in the Save Modes menu,
which is a submenu of the Install/Service menu. A password is also required to enter this menu
and save changes.
Refer to Configuration on page 1-2 for the default passwords needed to enter the Install/Service
menu and the Save Modes menu.
If you wish to make permanent changes, we recommend that you contact the person responsible
for the entire configuration. When settings are changed and saved, they should be recorded.
3-2
Parts of the Display
Monitor Setup
Figure 3-1: Parts of the display
Alarm silence indicator

Alarm message field (for five messages)
Actual time
Waveform fields with corresponding numeric information on the right
Digit fields
Note:
Waveform fields and digit fields are configurable.
Display Setup
At start-up, the display is arranged according to the start-up mode definitions. Unused parameters
are not displayed and no space is reserved for them.
Figure 3-2: Display fields
3-3
Changing Setup Temporarily

You can choose which waveforms and numeric information are displayed, and how they are
arranged on the screen.
To change the set-up:

2 Select Screen Setup.
3 Select Waveform Fields, Digit Fields,
Split Screen, or Minitrend Length.
Note:
Choosing to display the same parameter in the Waveform field and the Digit field
makes the previously chosen field disappear so that the same information is not
displayed in two fields at the same time.
Modifying Waveform Fields

You can choose which parameters are displayed on the waveform fields, and in which order they
are arranged.
Figure 3-3: Waveform field
Up to six waveforms can be displayed at a time. When fewer than six waveforms are displayed,
the remaining waveforms are enlarged to fill the entire waveform area.
3-4
Changing the waveform also changes the numerical field on the right of the waveform. It may also
Monitor Setup
change the digit fields. If you choose the same measurement in the waveform field that is currently
in the digit field, the digit field will disappear so that the same information will not be displayed in
two fields at the same time.
To set the parameters for the waveform fields:

3 Select Waveform Fields.
4 Choose the parameter to be displayed in
each field.
The invasive pressure waveforms are displayed only when the transducer is connected to the
monitor.
Selecting Combine Pressures in the Waveform Fields menu displays invasive pressures in the
same waveform field with individual scales.
When you use a 5-lead set in the ECG measurement, up to three different ECG leads can be
displayed simultaneously in different fields.
Changing Sweep Speeds

You can change the waveform sweep speed. Alternatives are Fast (6.25 mm per second) and
Slow (0.62 mm per second). Slow waveforms have a sweep speed one tenth of normal. Slow
waveforms show changes better than fast waveforms.
To change the sweep speeds:
2 Select Sweep Speeds.
3 Select the parameter and choose the sweep speed.
3-5
Modifying Digit Fields

Measured patient data may be displayed in up to four digit fields, which are located on the lower
part of the screen. You may change the contents or turn each field OFF. If a Digit field is turned
OFF, the Digit field to its left is usually enlarged to fill the space.
Figure 3-4: Digit fields
The digit fields are numbered from left to right in the Digit Fields menu (Lower Field 1 is the left-
most field; Lower Field 4 is the right-most field).
Changing the Digit field may also change the Waveform Field setup. If you choose the same
measurement in the Digit field that is currently in the Waveform field, the Measurement
Waveform field will disappear so that the same information will not be displayed in two fields at the
same time.
To modify digit fields:

3 Select Digit Fields.
4 Choose the parameter to be displayed in
each digit field.
3-6
Splitting the Screen Display
Monitor Setup
You can split a display so that one part always displays spirometry or trend data.
Figure 3-5: Split screen view
3-7
To select a split screen view:

3 Select Split Screen and choose the option
you wish.
• Spiro 1: Basic spirometry view
information.
• Spiro2: Basic spirometry view with
additional values.
• Trend: Minitrend of the parameters
selected to the waveform field.
Minitrend View
You can choose to view the Minitrend data from the last five minutes or the last 30-minute period
next to the waveform field for the parameter. The 5-minute minitrend is updated every 10 seconds,
the 30-minute minitrend is updated once every minute.
To modify the trend split screen view:
3 Select Minitrend Length and choose 5 min or 30 min.
3-8
Setting Time and Date
Monitor Setup
The time is shown in the upper right corner of the screen. The clock format is 24 hours. Turning
the monitor OFF does not affect the clock.
If the monitor is connected to the network, the Time and Date menu are not available. The monitor
follows the time and date settings for the network.
Note:
To prevent the loss of trend data, you cannot change the time settings after starting a
new case.
To set the time and date:

2 Select Time and Date.
3 Select the option you want to adjust.
• Hour, minutes, and seconds.
• Day, month, and year.
3-9
Display Brightness
To adjust display brightness according to environmental conditions:

2 Select Display Brightness.
3 Choose the desired adjustment
(30% to 100%).
Displaying Pulse Rate

Combined Heart Rate and Pulse Rate can be displayed next to the ECG waveform. The current
HR source is displayed with bigger font and the QRS symbol flashes next to it.
To display a combined Heart Rate and Pulse Rate:

1 Press the ECG key.
2 Select ECG Setup.
3 Select Display with HR.
3-10
Other Adjustable Features
Monitor Setup
This section describes other adjustable features associated with setting up the monitor. A
password is required for entering the Install/Service menu where the adjustments are made. If
you wish to make changes, we recommend that you contact the person responsible for the entire
configuration.
Changing Parameter Colors

You can select the color of each parameter to be yellow, white, green, red, or blue.
To change the color:
2 Select Install/Service and enter the password.
3 Select Colors.
4 Select the desired parameter and the color you wish for it in the opened adjustment window.
3-11
Changing Units Of Measurement

You can choose the units for height, weight, and for individual parameters.
To change the units:
3 Select Installation.
4 Select Units and choose the units for Height and Weight.
5 To review and/or change the units for a specific parameter, select Parameters.
3-12
Alarms
Contents
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Alarm Categories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Alarm Activation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Displaying Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Adjusting Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Changing Alarm Sources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Suppressing Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Transferring Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Recording Alarms Automatically . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Overview
When an alarm for the monitored parameter becomes active, an audible tone sounds and the
screen changes as shown and described below:

Figure 4-1: View of alarms
1 Alarm messages appear in order of priority in the message field.

2 The measurement value flashes. The background color signifies the alarm category.
3 In some cases, a message in the digit or waveform fields gives more detailed information, using
the color of the corresponding parameter.
Warning
• Patient safety. Make sure that necessary alarm limits are set and alarms are
on when you start monitoring a patient.
• Patient safety. When alarms are suppressed, observe the patient frequently.
4-1
Alarm Categories
Alarms are classified into three categories according to their priority: RED ALARM (highest
priority), YELLOW ALARM, and NOTE (white color).
The alarm type depends primarily on the physiological significance and the duration (generally a
minimum of 20 seconds) of the alarm. Thus, for example, asystole advances rapidly to a red
priority, whereas apnea is allowed a slightly longer duration.
The monitor has three choices of alarm tones and patterns:
• ISO
• ISO2 (the default)
• General
Note:
• There is also a sound for catastrophic situations. A continuous beep sounds if the
FiO2 is less than 18% and EtO2 less than 10%, FiN2O is high, or Ppeak is high.
• To change the alarm pattern, contact the person responsible for the configuration.
ISO Pattern Alarms
Visual Tone pattern Meaning

Triple + double beep every 5
seconds.
Red LED and
––– ——5––– ——5
measurement Life-threatening situation.
Exception: The second tone
value flash
pattern is produced 1 second
after the first pattern.
Yellow LED and
Triple beep every 19 seconds. Serious, but not a life-threatening
measurement
– – – 19 – – – 19 situation.
value flash
Single beep Advisory note that may be equipment-
White
– related, such as Leads off.
4-2
ISO2 Pattern Alarms
Alarms
The difference between the ISO pattern and the ISO2 pattern is the rising sound of the tone
pattern in the ISO2.

Rising triple + double beep
every 5 seconds. Exception to
Red LED and
this is the second tone pattern
which is produced 1 second
value flash
after the first pattern.
——5 –– ——5
––– –
Yellow LED and Triple beep every
Serious, but not a life-threatening
measurement 19.5 seconds.
situation.
value flash – – – 19.5 – – – 19.5
Single beep. Advisory note that may be equipment-
White
— related, such as Leads off.
General Pattern Alarms

Red LED and
Continuous beeping.
-----
value flash
Yellow LED and
Double beep every 5 seconds. Serious, but not a life-threatening
measurement
––5––5––5 situation.
value flash
Single beep. Advisory note that may be equipment-
White
— related, such as Leads off.
4-3
Alarm Activation
To make the alarms operative, connect the patient cables. Alarms are operative even when the
measurement is not selected on the display (except for the respiration measurement), unless the
alarm source is selected OFF.
Individual alarms have their own specific requirements before they become active:
• Apnea requires five breaths to be activated.
• Invasive pressures are required to be within alarm limits for 20 seconds after zeroing.
Displaying Alarms
Patient alarm limits can be viewed and adjusted in the Alarms Setup menu.
To display the Alarms Setup menu:
1 Press the ComWheel.
2 Select Alarms Setup from the Main menu.
Figure 4-2: Alarms Setup menu and limits screen
List of selections.
Exit the alarm limit adjustment area and return to the Alarms Setup menu.
Parameter box with high- and low-limit values with a 10-minute trend displayed to show the
current status.
4-4
Alarms Setup Menu Options
Alarms
Adjust Limits Adjusts individual measurement alarm limits. The adjustment menu can
also be accessed through each parameter menu.
Auto Limits Auto limits are calculated from the displayed patient reading at the time
when auto limits are selected. They are calculated from the last two
minutes.
Default Limits Sets the alarms to the default alarm limits. Default limits can be changed
and saved to modes.
Note:
Resetting the case also returns alarm limits to their defaults.
Cancel Changes Returns all limits to the ones set before entering the Alarms Setup menu, if
you have not yet exited the menu.
Alarm Volume Adjusts the volume of the audio alarms. The range is from 1 (silent) to
10 (loud). Alarm Volume does not totally silence audible alarms.
Audio ON/OFF Displays the following options:
Activate Alarms activates the silenced alarms.

Silence Apnea silences Apnea and disconnection alarms as well as respiration rate, CO2, low
Ppeak, PEEP, and minute volume limit alarms.
Silence ECG silences asystole alarm and heart rate limit alarms.
Silence apnea & asy is the same as Silence Apnea and Silence ECG combined (refer
above).
Silence ALL silences all alarms permanently, except FiO2<18% (or EtCO2< 10%),
FiN2O>82%, and Ppeak > 70 cmH2O alarms.
Alarm History Displays a list of the last 20 alarms which have reached the yellow or the
red alarm level. The alarm list items have the occurrence time and the type
beside them.
Remove Menu Displays only the alarm limits and 10-minute trends.
4-5
Adjusting Alarm Limits
Changing Limits
To change alarm limits for parameters:
1 Press the ComWheel and select Alarms Setup

from the Main menu.
2 Select Adjust Limits.
3 Turn the ComWheel to highlight the
measurement you wish.
4 Press the ComWheel to display an adjustment
window.
5 Turn the ComWheel to change the High Alarm

Limit and/or press the ComWheel to accept the
limit.
The cursor moves to the Low setting.
6 Turn the ComWheel to change the Low Alarm

Limit and/or press the ComWheel to accept the
limit.
7 To adjust other measurements, select Previous
Menu.
-OR-
To return to the Alarms Setup menu, select
Alarms Setup.
-OR-
To return to the normal monitoring display, press
the Normal Screen key.
You can also enter the Alarm Limit Adjustment window through the Measurement menus. When
you are in a parameter menu, select the alarm for that parameter or enter the Setup menu for that
parameter, then select the alarm.
Note:
The ST alarm limits, located in the HR alarm limits menu, can be set after the ST
learning sequence. For ST, you receive advisory messages only.
4-6
Cancelling Changes
Alarms
Before you exit the Alarms Setup menu, select Cancel Changes to return all limits to those that
were in effect before you entered the Alarms Setup menu.
Returning to Default Limits

Select Default Limits in the Alarms Setup menu to set the alarms to the factory default alarm
limits.
Choosing Automatic Limits

To get automatic patient-related alarm limits that enable close patient control, select Auto Limits
in the Alarms Setup menu. These limits are calculated using the displayed patient readings
during the two minutes immediately prior to the time when Auto Limits is selected.
Calculation Formulas for Automatic Limits

The basis for calculating automatic limits is shown below.
Parameter Calculation Formula

Pulse Oximetry
SpO2 high (100) = OFF
SpO2 low SpO2 – 5%
Temperature
T1 high T1 + 1° C
T1 low T1 – 1° C
T2 high T2 + 1° C
T2 low T2 – 1° C
Hemodynamic Parameters
HR high HR * 1.25
HR low HR * 0.75
NIBP sys, dia, mea high NIBP sys/dia/mea * 1.25 + 10
NIBP sys, dia, mea low NIBP sys/dia/mea * 0.75 – 10
P1, P2 high P * 1.25 + 5/10 depending on the label
P1, P2 low P * 0.75 – 5/10 depending on the label
Gases
EtCO2 high EtCO2 + 1%
EtCO2 low EtCO2 – 1%
Resp high RR * 1.25 + 2
Resp low RR * 0.75 – 2
Spirometry
Ppeak high Ppeak + 10
Ppeak low Ppeak – 10
4-7
Parameter Calculation Formula

PEEP high PEEP + 5
PEEP low PEEP – 5
Mvexp high Mvexp + 2
Mvexp low Mvexp – 2
Changing Alarm Sources

For NIBP, invasive pressure, O2, anesthetic agents, and temperature, you can select which
measured values trigger the alarm.
• For the pressures, the choices are Systolic, Diastolic, Mean, or OFF. If OFF is selected, the
parameter box with the 10-minute trend is not displayed.
• For O2 and anesthetic agents, the alternative alarm sources are ETO2 or FiO2.
• Temperature choices are T1 and T2. Only the last-modified source is active.
To change the alarm source:
1 Press the ComWheel and select Alarms Setup from the Main menu.
3 Turn the ComWheel to highlight the measurement you wish, then press the ComWheel.
An adjustment window is displayed.
4 Wheel as many times as required to get from the limit setting to the menu selections.
5 Select the desired alarm and press the ComWheel to change the selection to OFF or ON.
4-8
Suppressing Alarms
Alarms
APN. When alarms are suppressed, this warning symbol is displayed.
ASY.
Note:
If alarms are suppressed and a power interruption occurs, or if the monitor is turned
off for up to 15 minutes, check the alarm status before you resume monitoring or
begin monitoring a new patient.
Warning
Patient Safety. When alarms are suppressed, observe the patient frequently.
Suppressing Audible Alarms Permanently

For special cases, such as lung operations, it may be desirable to suppress certain audible alarms
entirely.
2 Select Audio ON/OFF.
3 Select Silence Apnea, Silence ECG, Silence Apn&ECG, or Silence ALL.
If an active alarm is suppressed, a reminder beep sounds every two minutes. You can adjust the
volume of the reminder beep in the Audio ON/OFF menu.
4-9
Reactivating Alarms
Select Activate Alarms to turn audible alarms ON.
Suppressing Audible Alarms for Two or Five Minutes

• To suppress audible alarms for two minutes, press the Silence Alarms key once.
• To suppress audible alarms for five minutes, press the Silence Alarms key for more than
three seconds.
If the alarms are not active when you press the Silence Alarms key, they are pre-silenced for
2 minutes or 5 minutes. Exception: FiO2 < 18%, EtO2 < 10%, FiN2O > 82%, and high Ppeak alarms
are silenced for 20 seconds. New alarms are displayed.
Reactivating Suppressed Alarms

Press the Silence Alarms key during the silent period to activate new alarms immediately,
activate silenced alarms (after 1 minute), and the apnea alarm (after five breaths).
Suppressing Alarms for Individual Parameters

You can turn OFF the alarms without changing the alarm limits for the following parameters:
• FiCO2
• EtO2 and FiO2
• NIBP (Sys, Dia, and Mean)
• ST (Lat. and Inf.)
• Temperature (T1 and T2)
To turn OFF or turn ON alarms for a parameter:
3 Turn the ComWheel to highlight the measurement and press the ComWheel.
4 In the adjustment window that is displayed, press the ComWheel as needed to move to the
menu selections.
5 Select the parameter alarm to be suppressed from the menu and press the ComWheel to turn
the selection OFF.
This symbol is displayed in the digit field for each alarm you
suppress.
-OR-
Select the parameter alarm to be reactivated from the menu and press the ComWheel to turn
the selection ON.
4-10
Transferring Alarms
Alarms
All alarms can be transferred to the network, or to another monitor that is connected to the
network.
1 Press the ComWheel and select Patient Data from the Main menu.
2 Select Other Patients.
3 Select Receive Alarms.
4 Select one of the sites on the list that is displayed.
Recording Alarms Automatically

You can choose to generate an automatic strip chart recording when asystole, heart rate, and
pressure alarms reach the red alarm level. The recorder will print the ECG + Art waveforms.
To record on alarms automatically:
1 Press the ComWheel and select

Record/Print from the Main menu.
2 Select Record Waveforms.
3 Select Start on Alarms and choose YES.
Recording will start from the following alarms:
Alarm Recorded parameters

Asystole ECG + P1 waveforms, 25 mm/sec
HR High/Low ECG + P1 waveforms, 25 mm/sec
P1 High/Low ECG + P1 waveforms, 25 mm/sec
Recording time is 30 seconds: 12 seconds recording from the recorder memory, 18 seconds real-
time recording. Alarm recordings are annotated with the alarm source.
4-11

This section describes the other adjustable features related to alarms. A password is required for
entering the Install/Service menu where the adjustments are made. If you wish to make changes,
we recommend that you contact the person responsible for the entire configuration.
Displaying Limits
Alarm limits can be displayed next to the numerical parameter value as shown below.
To display alarm limits:

2 Select Install/Service and enter the
password.
4 Select Alarms Options.
5 Select Show Limits and choose YES or NO.
Make sure the alarm source is selected. The

alarm limits become visible when patient
monitoring begins and the monitor receives
patient data.
4-12
Changing the Tone Pattern
Alarms
The monitor has three choices of alarming tone patterns: ISO, ISO2, and General.
To change the tone pattern:
5 Select Alarm Tones and choose ISO, ISO2, or General.
Latching Alarms
Latching alarms enables unattended monitoring. If Latching Alarms is active, alarm messages
continue to be displayed even if the initial alarm condition has ceased. A reminder beep sounds
every 10 seconds.
• To clear all inactive alarm messages and the beep, press the Silence Alarms key once.
• To clear all inactive and active alarm messages, enabling only new upcoming alarm
messages, press the Silence Alarms key twice.
To select latching alarms:
5 Select Latching Alarms and choose YES.
4-13
Alarm Behavior
If the alarm mode is latched, the technical alarms are latched as well. This does not comply with
the NIBP (IEC 60601-2-30) and invasive pressure (IEC 60601-2-34) standard requirements.
Automatic Snapshots and Printouts of Them

When an Asystole, HR high or low, or P1 high or low alarm occur, the monitor can automatically
create and print a snapshot that you can view in the Trends menu. A snapshot is created when
the Asystole, heart rate, or P1 red alarm is activated. The snapshot contains data from the last
15 seconds.
To create a snapshot on alarms and print it automatically:

3 Select Trends & Snapshot.
4 Select Snapshot.
5 Select Create on Alarms and choose YES.
6 Select Automatic Print and choose Alarms.
4-14
Contents
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Most Common Tasks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Graphical Trend View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Minitrend View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Numerical Trend View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Snapshots . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Overview
A trend is a collection of the measured patient data. The monitor displays two types of trend
information: graphical and numerical. You can create snapshots (frozen frames saved to memory)
of this information.
The monitor collects graphical and numerical trend data automatically from the trended
parameters. You can select between 20 minutes and 24 hours of trend time.
You can view the trends in the Trends menu, or you can continuously display graphical
“minitrends” next to the waveform fields. A minitrend is a view of collected trend data from the last
5-minute period or 30-minute period, depending on which period of time you chose.
Trended Parameters
The trend parameters are listed below.
• Electrocardiograph (HR)
• ST Analysis
• Invasive pressure
• Noninvasive blood pressure
• Oxygen saturation (Pleth, SpO2)
• Gases (CO2, O2, N2O, AA, MAC, Resp)
• Respiration rate (RR)
• Temperature
• Airway pressure
• Airway flow
• Derived values from airway pressure and flow
• NMT
Trend data is stored in memory for 15 minutes after the power is turned to Standby.
5-1
Factory Default Parameters

For factory default parameters, contact the person responsible for the entire configuration.
The configuration and the mode determine which parameters are displayed.
The unit of the parameter matches the real-time waveform settings for that parameter.
To change the snapshot or graphical trend settings, refer to Configuring Snapshot and Graphical
Trend Pages on page 5-15.
Note:
You cannot change the contents of Numerical Trend fields. Numerical Trend fields
cannot be configured.
Most Common Tasks
Press the Trends key to open the Trends menu.

To display trends The trend (graphical or numerical) that was displayed last
appears beside the Trends menu.
1 Select Cursor.
2 Turn the ComWheel to move the cursor.
To scroll time with the trend
cursor 3 For the graphical trend, the numeric measurement values
for the displayed time are next to the cursor.
4 Press the ComWheel to return to the Trends menu.
To see more parameters on
Select Next Page.
other pages
Select Time Scale and the trend time

To change time scale
(20 min or 1, 2, 4, 6, 8, 10, 12, 24 hours).
To change trend type or a

Select Graphical, Numerical, or Snapshot.
snapshot to be viewed
To change scaling Select Trend Scales.

1 Select Monitor Setup in the Main menu.
To select minitrend split
screen
3 Select Split Screen and Trend.
To create snapshots Select Take Snapshot in the Trends menu.
Press the Record Trend/Stop key.

-OR-
To record trends 1 Select Record/Print in the Main menu.
2 Select Record Trends.
3 Select Record Numerical or Record Graphical.
5-2

• To print the currently viewed trend data, press the
Trends key and select Print Page.
• To print graphical trend data, select Print Graphical in
To print trends
the Record/Print menu.
• To print numerical trend data, select Numerical and
then Print Page.
1 Select Reset Case in the Main menu.
To erase trend history
2 Select Reset Trends and Yes in the adjustment window.
Recording Trend Data

1 Press the Record Trend/Stop key.
-OR-
1 Press the ComWheel and select Record/Print from the Main menu.
3 Select Record Numerical or Record Graphical.
Graphical trends are recorded from the time period that corresponds to the time scale
(20 minutes to 24 hours) chosen for them in the Trends menu.
Changing Graphical Trend Parameters

To change the recorded parameters for graphical trends:
3 Select Graphic Trend 1 and choose the parameter to be recorded.
4 Select Graphic Trend 2 and choose the parameter to be recorded.
Printing Trend Data

1 Press the Trends key.
2 Select Graphical or Numerical.
3 Select Print Page.
If you wish to print trend data located on other pages, select Next Page and Print Page.
Printing Selected Pages of Graphical Trend Data

2 Select Print Graphical.
3 Select the page (Page 1, Page 2, etc.).
5-3
Erasing Trend Data

1 Press the ComWheel and select Reset Case from the Main menu.
2 Select Reset Trends.
3 In the opened window, select YES to erase the trends.
-OR-
4 Select NO to cancel the function.
Graphical Trend View

Graphical trend pages contain up to four pages with five fields on each page. All five fields are
usually visible and can be printed.
Parameter scale, label, unit, and color follow the real-time waveform settings for each parameter.
Exceptions: you can select the HR and temperature scales in the Trend Scales menu.
Figure 5-1: Graphical trend view
Trends menu
Trend measurement field
Real-time ECG
Numeric value of a measurement at the trend cursor point
Trend page number
Indication of the amount of data gathered and viewed
Time and marker field
5-4
Graphical Trend View Symbols

Trend bar, parameter scale to the left. The gap shows the mean value (except in
the Paw field where it indicates Pplat).
Trend bar, parameter scale to the right. The gap shows the mean value (except
in the Paw field where it indicates Pplat).
NIBP trend bar.
A dotted vertical line across the trend field indicates a change, such as a change
of ECG lead, anesthetic agent, or zeroing the invasive blood pressure channel.
A blue, white, or red line above the marker field indicates the following:
• Blue line: the left end of the line is the point at which gathering of trend
data started. The right end shows the last moment data was gathered.
• White line: the proportion of data shown on the screen. If the line is on the
left, leaving space on the right, there is more data to see after the current
view. If the line is on the right, there is more data before the current view. If
the line is in the middle, there is more data at the beginning and end of the
case.
• Red line: the time period during which a 20-minute trend was gathered.
Changing the Time Scale (Trend Length and Resolution)

Adjust the time scale (and/or parameter scale) as needed to view the desired level of trend detail.
To change trend length and resolution:
1 Press the Trends key and select Time Scale in the Trends menu.
2 Select the trend length.
Trend Length on the Trended Time

Resolution
Display Period
20 min 10 seconds last 30 minutes
1h 1 minute last 24 hours
2h 1 minute last 24 hours
5-5
Trend Length on the Trended Time

Resolution
Display Period
4h 2 minutes last 24 hours
10 h 5 minutes last 24 hours
Moving on Graphical Trend Pages

Numerical measurement values for trended parameters appear next to the cursor on the graphical
trend. The displayed values were measured at the time indicated by the cursor.
To view trend values for specific times:
1 Press the Trends key and select Cursor.
2 Turn the ComWheel to move the cursor and scroll the values for specific times.
3 To return to the Trends menu, press the ComWheel.
4 To see more parameters on other pages, select Next Page in the Trends menu.
5-6
Minitrend View

Figure 5-2: Minitrend view
You can split the Normal Screen display so that one fourth of the display (on the left) shows
continuous graphical minitrends. Minitrends show the measurements selected for the waveform
fields.
Note:
The split screen option is possible only with displays that have waveforms on the
Normal Screen.
5-7
Adding a Minitrend
To split the screen and show minitrends:

3 Select Split Screen and choose Trend.
Choosing the Length of Minitrend Data

You can view a minitrend consisting of the last 5 minutes or the last 30 minutes of trend data.
A 5-minute minitrend is updated every 10 seconds; a 30-minute minitrend is updated once every
minute.
To choose the length of the minitrend data:
3 Select Minitrend Length and choose 5 min or 30 min.
Removing a Minitrend
To remove the minitrend from the display:
3 Select Split Screen and choose None.
5-8
Numerical Trend View

Numerical trends contain:
• One to four pages of trend information (24 hours maximum).
• Real-time ECG at the top of each page.
The resolution is 5 minutes.
Figure 5-3: Numerical trend page
Trend menu
Page number
Real-time ECG
Real-time digit fields, if the waveform display is Normal Screen
Scrolling Numerical Trend Pages

Use the ComWheel to scroll the trend vertically.
When the highlight reaches the top or the bottom of the view, the next 5 minutes of information
appears.
5-9
Snapshots
A snapshot is a frozen frame that is saved to the monitor memory. A snapshot captures the
contents of the frozen frame chosen during configuration, not the image you are currently viewing
when you take the snapshot. A snapshot can contain waveforms, numerical trends, and graphical
trends.
Figure 5-4: Waveform snapshot page
Trends menu
Real-time ECG
Waveform snapshot
Time of the snapshot (if created on an alarm, the cause of the alarm appears)
Real-time digit fields, if the waveform display is Normal Screen
Page number
Waveform cursor
Graphical trend snapshot
Time and marker field
To change the content of the snapshot page, refer to Configuring Snapshot and Graphical Trend
Pages on page 5-15.
5-10
Viewing Snapshots

A snapshot includes 15 seconds of a waveform and/or graphical trend from the time period that
corresponds to the time scale selected for the graphical trend and/or the numerical trend.
Figure 5-5: Waveform snapshot
Numerical label
Time when saved
The rest of the settings depend on the current settings for each real-time waveform.
There is one configurable waveform snapshot page. The page contains up to six fields that can
include snapshots of waveforms and graphical and numerical trends.
You can see five fields on the display but six on the printout.
Figure 5-6: Snapshot fields
To view snapshots:
1 Press the Trends key and select Snapshot from the Trends menu.
2 Select Next Snapshot.
3 Turn the ComWheel to move the cursor in the time and marker field.
4 When the cursor reaches the saving time of a snapshot (marked with an S in the time axis), the
snapshots that were saved at that time appear.
5 Press the ComWheel to return to the menu.
5-11
Creating Snapshots
To create a snapshot, press the Trends key and select Take Snapshot.
The waveforms and trends that are currently selected to the Snapshot page will be saved. You can
take up to 16 snapshots, depending on the data load and the amount of fields chosen to contain
information on the snapshot page.
Marking an Event
At the time Take Snapshot is selected, a number is inserted in the numerical trends beside the
trend information. This number marks the event at which a snapshot was created.
Also, NIBP measurement marks a trend line. If there are several measurements during one
minute, a one-minute average appears instead of individual measurements.
Figure 5-7: Marking numerical trends
The event number also appears on numerical trend printouts.
Erasing Snapshots
The snapshots will be erased when you reset the case or reset the trends. They are also erased
after 24 hours automatically.
To erase snapshots:
1 Press the ComWheel and select Reset Case from the Main menu.
2 Select Reset Trends or Reset ALL, and choose YES.
As memory fills up, older snapshots are overwritten automatically.
5-12

This section describes the other adjustable features related to trends and snapshots. A password
is required for entering the Install/Service menu where the adjustments are made. If you wish to
change the adjustments, contact the person responsible for the entire configuration.
Creating Snapshots on Alarms

The monitor can automatically create snapshots when the following alarms occur: Asystole, HR
high, HR low, P1 high, P1 low.

password.
4 Select Snapshot.
5 Select Create on Alarms and choose YES.
5-13
Printing Snapshots Automatically

Snapshots can be printed on request, on alarms, or when they are created.

password.
4 Select Snapshot.
5 Select Automatic Print.
Choose NO, if you want printing to occur only
on request.
-OR-
Choose ALARMS, if you want to print only
snapshots that are created on alarms.
-OR-
Choose ALL, if you want to print all
snapshots immediately after they are
created.
Printing Loops on Snapshots

You can have Spirometry loops printed whenever snapshots are taken.
4 Select Snapshot.
5 Select Print Loops.
6 Select YES.
5-14
Configuring Snapshot and Graphical Trend Pages

You can change the parameters on the snapshot page and on graphical trend pages.
• For the snapshot page, you can also select graphical trend boxes.
• For graphical trend pages, you can also select events. An event list will appear if there is no
menu to hide it.
Note:
Numerical trend pages cannot be configured.
To configure the snapshot page and/or graphical trend pages:
4 Select Snapshot.
-OR-
5 Select Graphical Trends and select the trend page you want to configure.
6 Select the parameter for each field.
The field numbers start on the top of the display. Select one parameter for each field on the
trend page, or turn the field OFF.
When all fields are OFF, the page is displayed with empty fields. The time scale and page
number appear at the bottom of the page.
If several Equal fields are selected on top of each other, they will form one higher field. Equal
fields can not be defined separate from each other.
5-15
Special Functions
Contents
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Network Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Resetting a Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Adding Demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Loading a Previous Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Marking Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Viewing Other Sites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Overview
The Ultracare SLP100 monitor continuously collects and saves patient data, such as trends.
Saving is activated when the monitor receives vital signs. With a single, stand-alone monitor, you
can add patient demographics and place markers on the trends.
The data management capabilities can be expanded if your monitor is connected to the GE Datex-
Ohmeda S/5 Network and iCentral or if you use memory cards to store and transfer data.
Network Options
The monitor can be equipped with the following options to enhance network and data continuity
capabilities:
• Network
- The Network option allows real-time information sharing between your Ultracare SLP100
and monitors that are connected to the same network. When the monitor is connected to
the monitor network (the GE Datex-Ohmeda S/5 Network and iCentral), patient information
is saved to the network computer. The network offers the possibility of viewing real-time
patient information, such as alarms, from another monitor on the network.
• Data Card and Network
- The Data Card and Network option offers the same capabilities as the network option and,
in addition, it enables you to load trend data from a Data Card. With this option, you can
assure the continuity of patient data by gathering all previously-collected information for a
patient, then adding new information to the same patient file.
Using the Network

Using either option, you can connect the monitor to the GE Datex-Ohmeda S/5 Network and
iCentral for central monitoring and printing services.
This symbol is displayed when the monitor is connected to the
network.
• Time and date are set by the network and cannot be adjusted in the monitor.
• The patient’s ID entered in the Patient Data menu can be displayed on the GE Datex-
Ohmeda S/5 Network and iCentral and printed on the laser printouts.
6-1
• Measured and entered patient data can be viewed on the GE Datex-Ohmeda S/5 Network and
iCentral.
• Measured patient data and alarms can be viewed on other GE Datex-Ohmeda S/5, CS/3™,
and AS/3™ monitoring systems, and vice versa, when networked.
Connecting to the Network

To connect your monitor to the network:
1 Connect the Ethernet and location ID plug to the corresponding connectors on the rear panel
of the monitor.
2 Configure the location IDs on the GE Datex-Ohmeda S/5 Network and iCentral.
Using Memory Cards

With the Data Card and Network option, you can load collected patient data from a monitor that is
connected to the same network or from a Data Card.
The Data Card and the Menu Card are memory cards. Each is housed internally in a built-in
memory module.
• The Data Card is for storing and transferring trend data.
• The Menu Card is for storing menus.
When the Data Card is inserted, continuous patient trend data is stored on it automatically. The
capacity of the card is approximately 48 hours, depending on the complexity of the saved data.
When the card is full, the oldest data is erased.
The trend data stored on a Data Card can be transferred to and viewed at all other
Ultracare SLP100 monitors.
Refer to Loading a Previous Case on page 6-5 for information about loading trend data.
Caution
Do not subject memory cards to excessive heat, bending, or magnetic fields.
Inserting a Memory Card

You can insert a Memory Card into either slot. The monitor recognizes whether the inserted card is
a Data Card or a Menu Card.
Figure 6-1: Inserting and removing a memory card
6-2
Insert the end of the card with the small connectors first. Push the card firmly into place. The
Special Functions
release button will come up. To remove the card, press the release button, then pull the card out of
its slot.
This symbol appears on the display to indicate that a Memory Card is inserted.
The Data card inserted or Menu card inserted message appears in the
message field of the display.
Resetting a Case
At the beginning of a new procedure, you should erase the screen layout, trend data, and all alarm
and parameter settings of the previous case.
To reset a case:
1 Press the ComWheel and select Reset Case

from the Main menu.
2 Select Reset ALL and choose YES.
Selecting Reset ALL returns you to the starting

mode and its settings (screen layout, trend
parameters, alarm limits, etc.).
6-3
Adding Demographics
To add demographics:
1 Press the ComWheel and select Patient Data

from the Main menu.
2 Select Demographics.
3 Enter the patient’s height and weight.
Height Adjustable from 15 cm to 250 cm

Weight Adjustable from 1 kg to 250 kg
BSA The body surface area is calculated automatically using the du Bois
formula. The body surface area is used when calculating index values of
certain parameters.
6-4
Loading a Previous Case
Special Functions
To load data from a previous case:
1 Press the ComWheel and select Patient

Data from the Main menu.
2 Select Load Prev. Case.
Load Prev. Case

When the network is not in use, you can retrieve the trend data of the previous case from the
monitor memory. You can retrieve trend data that was stored during the previous 24 hours under
these circumstances:
• The monitor was turned off for less than 15 minutes.
• The monitor remained ON (even if the case was reset).
Reloading trend data after the case has been closed for several hours is not recommended. The
period that contains no information results in empty record pages.
Patient from Net.

You can retrieve the last 24 hours of trend data from the network if the monitor is connected to it.
Patient from Card

When the Data Memory Card is inserted, you can load trend data from a case on that card. The
Data Card saves previous patient data from the time it is inserted in the monitor. You can retrieve
approximately 24 hours of information. The memory capacity depends on the complexity of the
saved data.
6-5
Marking Events
During monitoring, you can place numbers beside the numerical trend to mark the event.
To mark events:
1 Press the Trends key.
2 Select Take Snapshot.
The events are numbered from 1 to 16, depending on the data load. A number is displayed beside
the numerical trend information that was recorded at the time Take Snapshot was selected.
Figure 6-2: Marked events in trends
A trend printout is also marked with this number.

A snapshot is created at the same time. For more information about Snapshots, refer to Trends
and Snapshots on page 5-1.
6-6
Viewing Other Sites
Special Functions
With your Ultracare SLP100 monitor you can see the numerics, waveforms, and alarms of another
Ultracare SLP100 monitor if both monitors are connected to the same monitor network.
To view data for a patient at another site:
3 Select Show Vital Signs.
4 Select the site you wish to view.
Figure 6-3: Data from another site
6-7
Viewing Other Site Alarms

With a networked Ultracare SLP100 monitor, you can view the alarms of another monitor on the
same network, including the iCentral station.
To view the alarms of a monitor at another site:

3 Select Receive Alarms.
4 Select the site you wish to view.
The sites from where the alarms are forwarded to your monitor are marked by a bell next to the
site name.
6-8
Contents
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Recording Waveforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Recording Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Recorder Paper Replacement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Printing to a Laser Printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Overview
You can record waveforms, values, and loops and print them to a laser printer that is either
connected to the monitor or accessible over the network.
Recording and printing options are located in the Record/Print menu and its submenus.
• You can record or print just one loop or one view of trends from within the corresponding
measurement menu.
• You can record or print several pages, several parameters, or all gathered information from
the Record/Print menu.
Recorder
You can use the optional built-in recorder to do the following:
• Record the graphical or numerical trend and print up to 24 hours of trend data.
• Record up to three real-time waveforms simultaneously.
• Display recordings of numerical information (in horizontal and vertical plane).
Note:
Thermal paper printouts may be destroyed when exposed to light, heat, alcohol, etc.
Make a photocopy for your archives.
Figure 7-1: Built-in recorder
7-1
Note:
The two-button recorder (shown) is for Ultracare SLP100 monitors using software
version 3.0 or higher.
Record Waveform/Stop key. Press to start or stop recording selected real-time waveforms.
This key functions like the Record Start/Stop key on a one-button recorder.
Record Trend/Stop key. Press to start or stop recording selected numerical or graphical trend
data. Since this key is not available on a one-button recorder, use the Record/Print menu
options to print trend data.
Key to release and open the recorder paper compartment.
Recorder paper.
Recorder paper compartment.
Recording Waveforms
Figure 7-2: Sample recording
Note:
Waveform scaling follows the displayed parameter scaling, when applicable.
Start/Stop Recording Waveforms

To record waveforms:
1 Make sure paper is installed in the recorder.
2 Press the Record Waveform/Stop key.
-OR-
Press the ComWheel and select Record/Print from the Main menu.
Select Record Waveforms.
Select Record Wave.
3 The waveforms are recorded according to the current waveform selections.
4 To stop recording, press the Record Waveform/Stop key again.
-OR-
Select Stop Wave in the Record Waveforms menu.
7-2
Controlling Paper Speed

To see the waveforms more clearly or more generally, you can adjust the paper speed:

3 Select Paper Speed and choose the speed
you prefer (1, 6.25, 12.5, or 25 mm/second).
Selecting Waveform Parameters

To select the waveforms you want to record:

3 Select Waveform 1, Waveform 2, or Waveform 3 and choose the parameter to be recorded.
7-3
You can record up to three waveforms simultaneously. If you want to record only one
waveform, select OFF for the other waveform fields.
4 Choose the parameter for the waveform.
Scroll toward –More– to see additional options.
7-4
Controlling the Recording Time

You can select 30 seconds (the default) or continuous as the recording time.
To select the length of the recording:

3 Select Length and choose 30 s or Cont.
Note:
When recording is activated by alarms, the recording time is always 30 seconds.
Selecting the Recording Time Initiation

The recorder can record only real-time data (delay of 0 seconds) or the first 12 seconds from
memory (delay of 12 seconds, the recording delay default).
You can set the recording delay to 0 seconds and record only real-time data.
To change the delay:
3 Select Delay and choose 0 sec.
Note:
When recording is activated by alarms, the delay is always 12 seconds.
7-5
Recording Waveforms on Alarms

You can generate a strip chart recording automatically when asystole, heart rate, and pressure
alarms reach the red-alarm level, by setting up the recorder to start recording on alarms.
To start recording on an alarm:

3 Select Start on Alarms and choose YES.
.
The alarms listed below will start the recording:
Alarm Recorded Parameters

Asystole ECG + P1 waveforms, 25 mm/second
HR High/Low ECG + P1 waveforms, 25 mm/second
P1 High/Low ECG + P1 waveforms, 25 mm/second
Alarm recordings are annotated with the alarm source.
7-6
Recording Trends

Adjust the parameter and time scales to record the desired level of trend detail.
Start/Stop Recording Trends

To record numerical or graphical trends:
1 Make sure paper is installed in the recorder.
2 Press the Record Trend/Stop key.
-OR-
Press the ComWheel and select Record/Print from the Main menu.
Select Record Trends.
Select Record Numerical or Record Graphical.
A numerical or graphical trend is recorded according to the current selections.
3 To stop recording, press the Record Trend/Stop key again.
-OR-
Select Stop Numerical or Stop Graphical in the Record Trends menu.
Numerical Trend Printout

You do not need to choose parameters for a numerical trend recording.
Figure 7-3: Numerical trend printout
7-7
Numerical trend recordings contain the following parameters:
Parameter Printed Values and Units

HR and SpO2 bpm/SpO2
NIBP sys/dia or mean mmHg
P1 “Art” sys/dia or mean mmHg
P2 “CVP” sys/dia or mean mmHg
T1 Celsius or Fahrenheit
T2 Celsius or Fahrenheit
CO2 Et/Fi %, kPa or mmHg
O2 Et/Fi %
AA Et/Fi %
Resp. Rate Breaths per minute
Either Sys/Dia or mean pressures are recorded, depending on the digit format selected in the
pressure setups.
Changing the Resolution

To select the resolution for a numerical trend record:
3 Select Trend Resolution and choose from the options.
7-8
Selecting Graphical Trend Parameters

You can record graphical trends for two parameters.
To choose the parameters for a graphical trend recording:
3 Select Graphic Trend 1 or Graphic Trend 2.
4 Choose the parameter for the graphical trend.
5 Scroll toward –More– to see additional options.
7-9
Recorder Paper Replacement
Figure 7-4: Recorder paper replacement
To change the paper in the recorder:

1 Press the key that releases the paper compartment door.
2 Remove the roll and insert a new roll.
3 Close the paper compartment door.
Printing to a Laser Printer

You can print the following to a laser printer:
• Graphical and numerical trends.
• Spirometry values and loops.
You can print several pages, all saved loops, or trend data from the Record/Print menu. You can
print one page or one loop from the corresponding parameter menu.
7-10
Changing the Printer

To check or change the printer connection:
1 Press the ComWheel and select Record/Print

from the Main menu.
2 Select Printer Connection.
3 Select Serial, Net, or None.
• Choose Serial if the printer is connected
to your monitor.
• Choose Net if your monitor is connected
to the network.
Printing Trend Data

Adjust the parameter and time scales to print the desired level of trend detail.
To print a specific trend view:
1 Press the ComWheel and select Trends from the Main menu.
2 Select the trend type you wish to print: Snapshot, Numerical, or Graphical.
3 Select Next Page to choose a specific trend page.
To print all numerical trend data:
1 Press the ComWheel and select Trends from the Main menu.
2 Select Numerical.
To print several pages of graphical trend data:
2 Select Print Graphical.
7-11
Printing Spirometry Loops

To print a pair of loops:
1 Press the ComWheel and select Parameters from the Main menu.
2 Select Airway Gas.
3 Select Spirometry Loops.
4 Select Print Saved.
To print all saved loops:
2 Select Print Loops.

This section describes the other adjustable features related to recording and printing. A password
is required for entering the Install/Service menu where the adjustments are made. If you wish to
make changes, we recommend that you contact the person responsible for the entire
configuration.
Changing the Format for Recorded Numerical Trends

You can select the kind of numerical trend that will be recorded when you select Record
Numerical from the Record/Print menu
4 Select Printer & Recorder.
5 Select Num Trend Type.
6 Select Num. or Tab.
7-12
Troubleshooting
Contents
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Other Situations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Overview
This chapter consists of three parts that should help you solve common monitoring problems:
Checklist, Messages, and Other Situations.
Checklist
Check the following items to ensure you remember to make all essential preparations before
monitoring. They also help if problems occur during monitoring.
General
Check that
• The monitor has no visual defects, such as cracks or loose parts.
• The power cord is connected to an electrical wall outlet and to the monitor.
• The D-fend water trap is empty and properly pushed into its place (as applicable).
• The sampling line is connected to the monitor (as applicable).
• Patient connection cables are attached to the connectors so that the color coding on the plug
matches the color coding on the connector.
• Trends of the previous patient are erased.
• Alarm limits are suitable for the patient.
ECG
Check that
• Electrodes are positioned correctly, electrode gel is moist, and skin contact is good.
• Correct lead-wire set is selected (3-lead or 5-lead) and correct lead-wire type is selected in the
ECG Setup menu.
• Lead-wire set is properly connected to the ECG extension cable.
• ECG extension cable is plugged into the blue connector.
• Pacemaker selection in the ECG Setup menu is Show when a pacemaker is used.
• ECG is selected for display (Main Menu > Monitor Setup > Screen Setup).
8-1
Check that
• Electrodes are positioned correctly, electrode gel is moist, and skin contact is good.
• Correct lead-wire set is selected (either 3 or 5 lead) and correct lead-wire type is selected in
the ECG Setup menu.
• Lead-wire set is properly connected to the extension cable.
• ECG extension cable is plugged into the blue connector.
• Resp is selected for display (Main Menu > Monitor Setup > Screen Setup).
Pulse Oximetry
Check that
• Correct sensor is selected for the size of the patient and sensor is positioned correctly on the
patient.
• The sensor is completely dry after cleaning.
• Sensor cable is plugged into the gray connector and is properly connected to an extension
cable or sensor, as applicable.
• SpO2 is selected for display (Main Menu > Monitor Setup > Screen Setup).

Check that
• Correct NIBP hose is used (black hose for adults and children; white hose for infants).
• NIBP cuff is not loose; correct cuff for patient size is used.
• O-rings on hose connectors and cuff connector are intact; cuff connector is firmly pushed
inside the cuff tube.
• NIBP hose is properly connected to the monitor connector and will not detach by pulling.
• There are no holes or cracks in the cuff bladder or cuff tube.
• Symbol indicating the center of the bladder is over the artery.
• All residual air is squeezed out of the cuff before wrapping it around the arm.
• Cuff is at heart level.
• Cuff tubes and NIBP tube are not kinked or squeezed together.
• Noninvasive blood pressure is selected for display
(Main Menu > Monitor Setup > Screen Setup).
If a leak is suspected, start venous stasis and check that the pressure is stable during stasis.
8-2
Troubleshooting
Check that
• Invasive blood pressure transducer cable is plugged into a red connector.
• Pressure transducer is connected to the cable.
• Patient catheter is connected to the pressure line.
• There is no air in the transducer dome or catheter line.
• Transducer is at mid-heart level.
• Pressure transducer is zeroed.
• Invasive blood pressure is selected for display
Temperature
Check that
• You are using an approved temperature probe.
• Temperature probe is positioned correctly.
• Temperature probe is inserted properly into the appropriate temperature connector.
• Temperature is selected for display (Main Menu > Monitor Setup > Screen Setup).
Airway Gases
Check that
• D-fend water trap is properly placed in the monitor.
• Water trap container is empty.
• A new sampling line is used after each patient.
• Sampling line is connected to the water trap and to the airway adapter.
• Monitor is turned ON and self-check is performed with the sampling line attached.
• Humidification and/or bacteria filter is placed correctly.
• Breathing circuit or accessories are free of residuals from alcohol-based disinfectants.
• Desired gas parameter is selected for display (Main Menu > Monitor Setup > Screen Setup).
8-3
Patient Spirometry
Check that
• Correct flow sensor is used (D-lite for adults and Pedi-lite for pediatrics).
• Correct flow sensor type is selected
(Main Menu > Parameters > Airway Gas > Spirometry Setup).
• Straight luer connectors of the spirometry tube are attached to the connector on the monitor
and the angled luer connectors are attached to the sensor.
• Spirometry tube is not kinked or squeezed.
• D-lite and spirometry tube are free of water drops.
• Humidification and/or bacteria filter is placed correctly.
• Desired spirometry parameter is selected for display

Check that
• The application site of the electrodes is cleaned of oil and dirt.
• Electrodes are positioned correctly, electrode gel is moist, and skin contact is good. Avoid
placement over lesions or excessive body hair.
• NMT is selected for display (Main Menu > Monitor Setup > Screen Setup).
Messages
Message Explanation and/or Corrective Action
Acknowl. alarms Acknowledged alarms are silenced. (Silence Alarms key pressed
silenced during silencing period).
Air leakage in NIBP cuff or hose. Check all connections and test the
Air leakage
cuff tightness using venous stasis.
No change detected in CO2 during the last 20 seconds.

Apnea (Impedance respiration) No change detected in impedance
respiration waveform for 20 seconds.
Apnea deactivated Apnea alarm is silenced until reactivation after five breaths.
Unsuccessful NIBP measurement. Patient is moving, shivering, or

Artifact(s) breathing deeply; also marked arrhythmia or irregular beats. Calm
the patient and start a new measurement.
Asystole, no QRS detected in ECG.

Asystole
Note:
This does not depend on the heart rate source.
8-4
Troubleshooting
Backup battery is discharged or faulty. Use mains power for 4 hours,

Backup batt. failure then switch to battery power. If the message reappears, contact
authorized service personnel.
Cable off NMT or regional block cable is not connected.
Calibrate Agent ID Agent identification error. Perform gas calibration.
Calibration not
NIBP — Contact authorized service personnel.
protected
NIBP Calibration protection switch at the bottom of the monitor is

Calibration switch ON
turned to the right. Contact authorized service personnel.
NIBP hardware error. Note the error number (X) and contact
Call service: Error X
authorized service personnel.
Check D-fend Check that the water trap is properly attached.
Pulse search active for 20 seconds but no acceptable pulse is found.

Check SpO2 probe Either there is no detectable SpO2 signal, the sensor is faulty, or it is
detached from the patient.
Check stim. NMT stimulus current could not be delivered due to poor stimulus
electrodes electrode connection or damaged cable.
NIBP alarm limit was exceeded and a new measurement was

Control measurement
started automatically.
NIBP cuff is loose or not attached to the patient. Hose is not

Cuff loose
connected to the monitor.
Check NIBP cuff hose and tubes; restart measurement. If the

Cuff occlusion
problem persists, contact qualified service personnel.
NIBP cuff is squeezed during measurement and pressure safety

Cuff over-pressure
limits are exceeded.
Faulty EEPROM circuit on the CPU board. Contact authorized

EEPROM Error
service personnel.
NMT — EMG recording electrodes are off. Electrodes or stimulus

EMG electrodes off
clip is loose.
EtAA high / EtAA low Measured EtAA is equal to or above/below the alarm limit.
EtCO2 high / EtCO2

Measured EtCO2 is equal to or above/below the alarm limit.
low
EtO2 high / EtO2 low Measured EtO2 is equal to or above/below the alarm limit.
8-5
FiAA high / FiAA low Measured FiAA is equal to or above/below the alarm limit.
FiN2O high Measured FiN2O is equal to or above 82%.
FiO2 high / FiO2 low Measured FiO2 is equal to or above/below the alarm limit.
Heart rate (ECG or invasive pressure) or pulse rate (pulse oximetry)

HR high / HR low
is equal to or exceeds the upper/lower alarm limit.
Infl. limits! Check Adult or child NIBP cuff is being used but the selected infant mode
setup keeps the inflation pressure too low.
One or more cables are disconnected or off the patient. Check ECG
cable, all leads, and the neutral electrode (RL/N). Offset voltage
Leads off between two electrodes is too high.
Note:
This message may appear during defibrillation.
NIBP measurement is prolonged over the maximum measurement

Long measurement time (two minutes with adult or child inflation limits; one minute with
time infant inflation limits). Reapply the cuff, calm the patient, and start a
new measurement.
NMT — Cable is connected but measurement has not started.

Measurement off
(Impedance respiration) Measurement has been turned OFF.
Monitor is Temperature inside the monitor is above the maximum limit. Check
overheating the dust filter at the back of the monitor.
MVexp high / Measured expiratory minute volume value is above/below the set
MVexp low volume limit.
Exhaled volume is noticeably smaller than inhaled. Check the whole

MVexp<<MVinsp
system for leakage.
MVexp<0.5 l/min
Measured volumes are too small for reliable calculation and, for
(MVexp<0.2 l/min with
example, waveforms and loops may be unreliable.
Pedi-lite)
Network connection
Too many monitors may be active on the network.
down
NIBP high / NIBP low NIBP value is equal to or above/below the alarm limit.
NIBP manual Autocycling is interrupted because of air leakage or loose cuff.
No P1/P2 transducer Invasive pressure or transducer cable not connected.
SpO2 sensor is not connected to the monitor. Faulty or wrong type of

No SpO2 probe SpO2 sensor. Use only sensors approved for use with the type of
pulse oximetry installed in the monitor.
8-6
Troubleshooting
Pulse signal is found but then lost for 10 seconds or longer. Try a
No SpO2 pulse
different site.
ECG — Unreliable heart rate (HR) calculation or distorted waveform

due to:
• Too much high frequency or electrical mains noise in ECG.
Noise • The DC offset voltage between two electrodes is too high.
Note:
This message may appear during defibrillation.
P1/P2 high Invasive pressure of marked channel is equal to or above/below the

P1/P2 low alarm limit.
PEEP high / PEEP low Measured PEEP value is above/below the set pressure limit.
Monitor makes a two-point calibration test for temperature

Performing temp test immediately after the warm-up time and after that once every
10 minutes. The test lasts 10 seconds.
Ppeak high / Ppeak

Measured peak pressure is above/below the pressure limit setting.
low
Printer is out of paper or paper is jammed. Printer is not on-line or is

Printer error
not turned on. Printer cable is loose or broken.
Printer failure Printer is not responding, see Printer error. Select another printer.
Printing Laser printer is printing.
Pulse search Monitor is searching for pulse oximetry signal.
Faulty RAM circuit on the CPU board. Contact authorized service

RAM Error
personnel.
Rebreathing Measured FiCO2 is equal to or above the alarm limit.
Recorder: cover open The lid of the recorder is open.
Recorder: input
voltage high
Call service to check the monitor.
Recorder: input
voltage low
Recorder: out of
Insert a new roll of paper.
paper
Recorder: system
(n can be 1, 2 or 3) Contact authorized service personnel.
error n
Recorder: thermal
Wait for the recorder to cool down.
array overheat
8-7
NMT — Deviation between the four reference stimulation responses

Reference not stable is too big, causing reference setting to fail. Can be caused by
movement artifact; may occur when patient is relaxed.
Replace D-fend D-fend water trap is partially blocked. This decreases air flow.
Resp high / Resp low Respiration rate (RR) is equal to or above/below the alarm limit.
NMT — The maximum gain is insufficient to increase the response

signal amplitude to a measurable level. Can occur if:
Stimulation current is too weak.
Stimulation electrodes are not connected or they are improperly
placed on the nerve.
Response too weak
Recording electrodes are disconnected.
One or more electrodes are dry and should be replaced.
The skin at the electrode site is not properly prepared.
Reposition the stimulating or recording electrodes. Change the site
of the measuring electrodes.
The gas sampling line inside or outside the monitor is blocked or the
Sample line blocked
water trap is occluded.
Gas measuring sensor is inoperative or the temperature in the

Sensor inop.
monitor has increased. Contact authorized service personnel.
Setting reference NMT reference search in progress.
Small resp. curve Impedance Respiration — Signal amplitude is less than 0.4 ohms.
Snapshot memory full Creating a new snapshot will erase older ones.
SpO2 high / SpO2 low SpO2 is equal to or above/below the alarm limit.
SpO2 sensor is not attached to the patient, site is unsuitable, or

SpO2 probe off
sensor is faulty. Check connections; try a new site or sensor.
Faulty SRAM circuit on the CPU board. Contact authorized service

SRAM Error
personnel.
NMT — Supramaximal stimulus current (70 mA) was not found. Stop
Supramax not found measurement, reposition the stimulating or recording electrodes,
and restart the measurement.
Supramax search NMT — Supramaximal stimulus current search in progress.
A repeated temperature test has failed. Contact authorized service

Temperature error
personnel.
Tetanic NMT — Tetanic stimulation is ON.
Unable to measure NIBP — Accurate diastolic pressure not achieved because of

Dia artifacts, weak pulsation, etc.
8-8
Troubleshooting
NIBP — Initial inflation pressure is not high enough to enable proper

Unable to measure
measurement. Systolic pressure is higher than maximum inflation
Sys
pressure; artifacts interfere in systolic area.
Unstable zero Pressure is unstable when starting the NIBP measurement. Calm
pressure the patient and retry.
Voltage error Erroneous voltage level detected. Contact service personnel.
Wait for the

Venous stasis is attempted while a regular measurement is under
measurement to be
way.
done
(NIBP) Weak or unstable oscillation signal due to:

Improper cuff position or attachment; small air leakage.
Weak pulsation Weak or abnormal blood circulation.
Slow heart rate associated with artifacts.
Patient is moving or disturbed during measurement.
… lead off A lead wire (…) is disconnected.
Other Situations
Other problem situations which may occur during monitoring, with possible explanations and
instructions, are listed below.
Situation Cause and/or Recommended Action
Bad electrode quality or positioning.

Extra Asystole alarms Remove the ECG cable from the monitor and insert again.
Enlarge the size from 1.0 to 2.0 mV.
ECG lead cable is looped.

Other electrical power cables are near the ECG wires.
ECG baseline is thick
Incorrect ECG filter.
Incorrect power frequency of the monitor.
Patient is shivering.
ECG is noisy Incorrect ECG filter.
Bad electrode quality or positioning.
Cuff too small or loose.

NIBP readings are high
Cuff is under mid-heart level.
8-9
Situation Cause and/or Recommended Action
Check that:
The pacer markers have been selected ON.
Pacer markers are not
The pacemaker was adjusted correctly and is not above R.
visible
The pacemaker functions correctly; check that ECG cables,
electrodes, and setup are correct.
Spirometry accuracy is
An adult sensor is used for a pediatric patient and the monitor’s
poor—TV less than
spirometry sensor selection is Pediatric. Use a pediatric
50 ml reported as
sensor.
0 (zero) ml
An adult sensor is used for an adult patient, but the monitor’s

Spirometry values are
spirometry sensor selection is Pediatric. Change the selection
1/4 of real values
to Adult.
Spirometry values are A pediatric sensor is used for a pediatric patient, but the
4 times larger than real monitor’s spirometry sensor selection is Adult. Change the
values selection to Pediatric.
A pediatric sensor is used for an adult patient and the monitor’s

Spirometry Paw-Vol
spirometry sensor selection is Pediatric. Use an adult sensor
loop is vertical
and change the selection to Adult.
Air bubbles or a swinging catheter are causing a resonating

waveform.
Pressure readings are Wrong zero because the transducer position in relation to the
high patient has changed (too low).
Transducer failure.
Incorrect calibration.
Dampened waveform because of air bubbles, clotting or kinked

tubes.
Pressure readings are
Transducer is positioned above patient’s mid-heart level.
low
Transducer failure.
Incorrect calibration.
Approved temperature probe is not being used.

Temperature is not
The temperature may be outside the measurable range
displayed on monitor
(10° to 45° C).
screen
If problem persists, contact authorized service personnel.
Cannot see some trend Adjust the parameter and time scales to see the desired trend
details detail.
8-10
Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Preventive Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Introduction
For safe, reliable function and operation of the monitor, regular care has to be carried out
according to the instructions in this manual and the Planned Maintenance procedures described in
the Ultracare SLP100 Technical Reference Manual (P/N 070-1205-xx).
If the monitor does not function as it should, and information in the Troubleshooting on page 8-1
does not provide help, contact your sales representative. Do not perform cleaning or maintenance
procedures other than those described in the Ultracare SLP100 manuals.
Preventive Maintenance
Daily Tasks
Check that all accessories, cables and monitor parts are clean and intact.
Clean the device as described in Cleaning on page 9-3.
Check the parameter items as directed below:
ECG and Respiration

The Leads off message is displayed when the cable is connected to the monitor and the leads are
not connected. Shorting all the leads should make the message disappear (ASY alarm appears).
Pulse Oximetry
Sensor functions when properly connected to the patient.
NIBP
Cuff hose detection (Adult/Infant) works properly.
Pump is not restarting in Venous Stasis mode. If it starts, there may be a leak in the cuff.
InvBP
The monitor recognizes the cable connection (activates the display) for all the pressure channels
used.
Zeroing of all transducers is working correctly.
9-1
Temperature
Measurement starts when a temperature probe is connected.
Airway Gases and Spirometry

The Sample line blocked message appears within 30 seconds after you have occluded the
airway adapter; gas waveforms show zero at the same time.
The D-fend water trap is empty. If the green D-fend+™ is used (patient with extensive mucus
secretion), replace it daily with a new one.
NMT
Check that the electrodes are correctly positioned on the ulnar nerve and the message Supramax
search is displayed. Ensure that you get a stimulus response. If the supramaximal stimulus
current is not found, the message Supramax not found is displayed. If the current is set manually
the message Setting reference is displayed directly. Always check the electrode quality.
Every Month
Cooling Fan Dust Filter

Check the fan filter on the rear panel of the monitor. Replace the filter if it is damaged.
Clean the fan filter every month or whenever needed:
1 Pull the filter out.
2 Wash in detergent solution.
3 Allow to dry before reinserting. Do not use pressurized air.
Every Two Months
Black D-fend
Replace the D-fend water trap at least every two months, or when a Sample line blocked or
Replace D-fend alarm message persists.
Every Six Months
Gas Calibration
Perform gas calibration according to the instructions in Airway Gases on page 16-1.
If gas measurement is in extensive use, calibration is recommended every two months to ensure
that measurement accuracy stays within specifications.
9-2
Backup Battery Check

The power supply includes a backup battery that saves up to 15 minutes of information.
To check the battery:
1 Switch ON the monitor.
2 When the battery is fully charged, the charging symbol is not displayed on the screen.
Disconnect the monitor from mains power.
The monitor should function normally for 15 minutes.
Every 12 Months
Planned Maintenance Check

The Planned Maintenance check detailed in the Ultracare SLP100 Technical Reference Manual
(P/N 070-1205-xx) requires trained service person and appropriate testing tools and equipment.
Calibration check of temperature, NIBP and invasive blood pressures

Calibration check of temperature, NIBP, and invasive blood pressures should be performed at
least once a year by qualified service personnel as a part of the Planned Maintenance, refer to the
Ultracare SLP100 Technical Reference Manual (P/N 070-1205-xx).
Cleaning
The appropriate cleaning procedure depends on where and how the part or accessory is used,
and on the condition of the patient.
Table 1: Cleaning, Disinfection, and Sterilization Procedures
Method Why? Which Items? How?
Wipe away visible organic material.

All parts daily.
To remove dirt and Rinse as recommended by the
Cleaning Items to be disinfected or
most microbes. detergent manufacturer.
sterilized.
Allow to dry completely.
Accessories and supplies

With heat:
(other than SpO2 sensors) in
Wash in a washing machine at
contact with the patient’s skin
85° C (185° F) for at least one
or airways.
minute.
With chemicals:
To kill and remove Note:
Disinfecting Immerse in 2% glutaraldehyde for
pathogenic microbes. Some SpO2 sensors
10 minutes (pH=6.5). After
cannot be disinfected.
tuberculosis, HIV, or hepatitis
Read the sensor
patient, immerse for 20 minutes.
instructions before
Rinse carefully or wipe with alcohol
attempting to disinfect a
and let dry.
sensor.
9-3
Table 1: Cleaning, Disinfection, and Sterilization Procedures
Method Why? Which Items? How?
Steam autoclave for 15 minutes at

121° C (250° F) maximum.
Use ethylene oxide mixture at
50° to 60° C (120° to 140° F).
Accessories and supplies
To kill microbes and Follow the sterilizer manufacturer’s
Sterilizing penetrating the patient’s
bacterial spores. recommendations for required
tissue.
aeration times.
Immerse in 2% glutaraldehyde for
three hours, rinse carefully, and let
dry.
Warning
• Electrical Shock Hazard. Before cleaning, disconnect the monitor from the
electrical outlet.
• Electrical Shock Hazard. After cleaning, or if liquid has accidentally entered
the equipment, disconnect the power cord from the power supply and have
the equipment serviced by authorized service personnel.
Caution
• Do not sterilize any part of the monitor with steam autoclave or ethylene
oxide.
• Do not immerse any part of the monitor in liquids or allow liquid to enter the
interior.
• Do not use hypochlorite, acetone-based, phenol-based, or ammonia-based
cleaners.
Monitor
To clean the monitor:
1 When the display surface becomes dusty, wipe it gently with absorbent cotton, chamois or other
soft material. The display may also be cleaned using a small amount of normal hexane. Do not
use acetone, toluene or alcohol because they cause chemical damage to the polarizer.
2 Wipe the monitor with a mild detergent solution. Do not leave liquid spills on any metal part.
Let dry completely before connecting to power source.
The internal sampling system does not need to be cleaned nor sterilized. The D-fend water trap
functions as a bacteria filter and there is no reverse flow to the patient.
ECG Cables
Wipe the cables with a mild detergent solution. Disinfect when necessary.
9-4
Pulse Oximetry Sensors

Warning
Patient Safety — A damaged sensor or a sensor soaked in liquid may cause burns
during electrosurgery.
Disposable sensors are for single-patient use only. Do not attempt to clean them.
For cleaning instructions and recommended cleaning agents for a reusable sensor, consult the
instructions for using that sensor.
Consider possible patient allergies when selecting the cleaning agent.
In general, to clean any reusable sensor or sensor cable, detach it from the patient and the
monitor. Wipe it with a pad moistened with a mild cleaning solution, such as 70% isopropyl
alcohol. Allow the sensor and/or cable to dry completely before use.
NIBP Cuff Hose

Wipe the cables and hose with a mild detergent solution. Disinfect when necessary.
NIBP Cuff
Clean only when necessary. Remove the bladder from the cuff. Wash the bladder and the cuff in
mild detergent solution. Do NOT use alcohol.
Cables for Invasive Pressure

Wipe the cables with a sterile alcohol-based detergent. After cleaning, rinse surfaces by wiping
them with a cloth damped with sterile water. Dry with a dry cloth.
Temperature Probes
Clean with a mild detergent solution and rinse with water. Disinfect or sterilize when necessary.
NMT Sensor Cable, Sensors, and Regional Block Adapter

Wipe the cable, sensor, and adapter with mild detergent solution.
If disinfection is required, use ethanol or isopropyl alcohol. Do not use hypochlorite.
Do not immerse in liquid.
Reusable D-lite Sensor

Reusable D-lite sensors can be washed in a dishwasher. After cleaning, allow the sensor to dry
thoroughly.
Make sure that the sensor is intact. Connections must be tight for exact measurements.
9-5
Airway Adapter
Replace the single-use adapter after each patient.
A reusable adapter can be disinfected with glutaraldehyde or alcohol. A reusable steel adapter
may be autoclaved.
If you want to clean the adapter before use, submerge it in 70% alcohol solution for 30 seconds
and rinse carefully with water.
Rinse away all traces of alcohol or detergent. Dry the adapter before connecting to the patient.
Sampling Line
Do not reuse the sampling line. Attempting to clean and reuse a sampling line may affect
measurement results.
D-fend Water Trap

The D-fend water trap contains a hydrophobic membrane that prevents water and secretions from
entering the measuring chamber. Condensed water and saliva are collected into a washable
container.
The green D-fend+ is for patients with extensive mucus secretion and for single-patient use only.
Replace it every 24 hours or when a Sample line blocked or Replace D-fend message persists.
The water trap container can be cleaned with disinfecting solutions or sterilized using cold
chemicals or ethylene oxide.
Caution
Do not disinfect or open the water trap cartridge. To avoid damage, do not touch or try
to clean the water trap hydrophobic membrane (other than to rinse it with water).
To lengthen the lifetime of your monitor and minimize downtime:
• Empty the water trap container whenever it is more than half full.
• Do not open, wash, or sterilize the D-fend water trap cartridge.
• After washing or disinfecting the airway adapter or water trap container, make sure no alcohol
or detergent remains. Traces of alcohol or other organic cleaning solutions may affect
measurement.
• Do not force air or oxygen through the D-fend; do not allow smoke or dust to enter the D-fend.
• While administering nebulized medication, disconnect the gas sampling line from the patient
circuit for 30 minutes.
• If a Sample line blocked alarm occurs, replace the sampling line and empty the water trap
container.
9-6
Removing the Water Trap

Figure 9-1: Emptying the water trap container
To remove the water trap:

1 Push the water trap latch to the right. The water trap is spring-loaded. The Check D-fend
message appears.
2 Detach the container from the water trap cartridge by pulling it carefully downward.
3 Empty and clean the container.
4 Attach the container back into the cartridge tightly.
5 Push the whole unit into its housing on the front panel until the latch is set.
6 Press the Normal Screen key to restart monitoring. Check that the Check D-fend message is
no longer displayed.
Other Accessories
Refer to the accessory packages for checkout and cleaning instructions. Do not reuse disposable
accessories.
9-7
ECG
Contents
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Patient Connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
ECG Setup Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Selecting a Lead . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Viewing a Cascaded ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Adjusting ECG Size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Adjusting Beat Sound Volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
ST Segment Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Setting ECG Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Monitoring Pacemaker Patients. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Pacemaker Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Overview
The electrocardiograph, ECG, reflects the electrical activity generated by the heart muscle. ECG
monitoring is used for heart rate measurement and to detect arrhythmias, pacemaker function, and
myocardial ischemia.
When you use a 5-lead set, you may monitor the waveforms of up to three different ECG leads.
When you use a 3-lead set, the monitor displays one ECG lead.
When monitoring ECG, the monitor simultaneously analyzes ST segment changes. Changes of up
to three different ECG leads are analyzed depending on your lead set.
ECG and Heart Rate Display
Figure 10-1: ECG and HR display
ECG1 displayed first

ECG2 displayed below ECG1
ECG3 displayed below ECG2
10-1
Selected lead label

ECG gain bar (1 mV reference)
Heart rate (HR) label
Heart rate calculation source and message field for HR messages
HR value is always displayed with ECG1
Heart beat detector is flashing with every detected heart beat
ST values appear next to ECG1; the lead with the largest absolute ST value is also displayed
Selected ST leads
ST label
Message field for parameter messages
Note:
You can choose the number of ECG waveforms on the display in the Monitor Setup
menu (select Screen Setup and Waveform Fields). You choose the ECG leads in
the ECG menu.
Patient Connections
Patient Preparation
Good signal quality requires good skin contact with the electrodes. Excessive body hair or skin oil
can affect the contact. Pre-gelled electrodes are recommended. Check that the electrodes are
moist and have not dried out during storage.
Warning
Make sure the lead set clips or snaps do not touch any electrically conductive material
including earth.
When placing the electrodes, avoid bones close to the skin, obvious layers of fat, and major
muscles.
Figure 10-2: Standard electrode positioning with 3-lead set
10-2
You can use a CB5-lead when you want the 3-lead set connection to resemble the 5-lead set V5
ECG
connection. The red (IEC standard) or white (AAMI standard) electrode, which is shaded, is on the
back.
Figure 10-3: Modified electrode positioning, CB5, with 3-lead set
When you use routine positioning with a 5-lead set, place the chest electrode on one of the six
places indicated in the picture. If the lead set follows the IEC standard, the chest electrode is
white; if the set follows the AAMI standard, the chest electrode is brown.
Figure 10-4: Standard electrode positioning with 5-lead set
10-3
Cable Set
RED (IEC) YELLOW (IEC) RED (IEC) RED (IEC) YELLOW (IEC)
WHITE (AAMI ) BLACK (AAMI) WHITE (AAMI) WHITE (AAMI) BLACK (AAMI)
LEAD I
1
1 2
LE 3 5 6
AD 4
II
GREEN (IEC) GREEN (IEC) YELLOW (IEC) BLACK (IEC) GREEN (IEC)
RED (AAMI) RED (AAMI) BLACK (AAMI) GREEN (AAMI) RED (AAMI )
Figure 10-5: ECG Setup
ECG electrode(s)
Trunk cable
3-lead set or 5-lead set
Warning
Patient Safety — Ensure proper contact of the return electrode of the electrosurgery
unit to your patient to avoid possible burns on the patient via ECG electrodes and
probes.
Note:
The module input circuits are protected against the effects of electrosurgery and
defibrillation. However, the ECG trace on the monitor screen may be disturbed during
electrosurgery.
10-4
Color and Letter Coding
ECG
3-LEAD IEC STANDARD 5-LEAD IEC STANDARD
R = red (right arm)

L = yellow (left arm) N = black (neutral)
F = green (foot) L = yellow (left arm)
R = red (right arm) F = green (foot)
C = white (chest)
3-LEAD AAMI STANDARD 5-LEAD AAMI STANDARD
RA = white (right arm)

LA = black (left arm) RL = green (right leg)
LL = red (left leg) LA = black (left arm)
RA = white (right arm) LL = red (left leg)
V = brown (chest)
Connecting the Lead Wires and the Trunk Cable

To make lead wires and trunk cable connections:
1 Attach the lead wires to the corresponding electrodes, paying attention to the color codes.
2 Connect the lead wire set to the trunk cable and ensure a proper connection.
3 Plug the trunk cable into the corresponding monitor connector.
4 It takes about 10 minutes for the electrodes to stabilize. During this time errors may occur in the
signal.
10-5
ECG Setup Menu

To open the ECG setup menu:
2 Select ECG Setup.
HR Source
Selects the heart rate source. When ECG is selected, the HR source is always calculated
from ECG 1. If the ECG signal is affected by too much noise for a reliable heart rate
calculation, heart rate can be calculated from pressure (Art and ABP) or the
plethysmographic pulse waveform.
The selected heart rate source is shown above the numerical heart rate display. The heart
rate color is the same as the source parameter.
The AUTO selection priorities for heart rate calculation are: ECG, Pressure (Art or ABP),
and Plethysmographic pulse waveform. The first heart rate source available is selected.
Display with HR
Select PR to display combined Heart Rate and Pulse Rate next to the ECG waveform.
The current HR source is displayed in a larger font size and the QRS symbol flashes next
to the reading.
10-6
Filter
ECG
Filters the ECG signal high frequency noise and slow respiratory artifacts. The selections
are Monit, Diagn, and STfilt.
- Monit (monitor) filter is used in routine monitoring. It effectively filters the high
frequency artifacts caused by the electrosurgery unit and respiration, for example.
- Diagn (diagnostic) filter is used if more accurate information of the waveform is needed
(e.g., of P-wave or AV block). The diagnostic filter is more susceptible to both high
frequencies and baseline wander than the monitor filter.
- STfilt (ST filter) permits more accurate of ST segment information. It filters the high
frequency artifacts caused by an electrosurgery unit but catches the slow changes in
ST segment. The ST filter is more susceptible to baseline wander than the monitor
filter.
5-lead Cable
This selection is visible only when a 5-lead trunk cable is connected to the monitor. Select
5elect if you are using 5 electrodes or 3elect if you are using 3 electrodes with the 5-lead
trunk cable.
ECG Grid
Selects a background to be shown on the ECG waveforms, making it easier to evaluate
the waveform. The grid scale is 0.5 mV.
Pacemaker
Selects how the pacing pulse of a cardiac pacemaker is displayed. The selections are
Show, Hide, ON R, and Sensit.
- Show — the pacer pulse is filtered away from ECG data but the pulse is displayed as a
constant height marker.
- Hide — the pacer pulse is filtered away from ECG data.
- ON R — pacer pulses are not filtered away from ECG data. This improves ECG
monitoring with A-V pacemaker patients, as QRS complexes are counted even if the
pacer pulse hits the QRS complex. However, during asystole the monitor may count
pacer pulses as heart beats.
- Sensit — uses a more sensitive pacemaker detection. A pacemaker spike is displayed
on ECG.
- QRS Type — QRS detection and HR calculation may be affected by the shape of the
QRS complex. Normal QRS type detects a heart beat between 40 and 120 ms. Wide
QRS type detects a beat between 40 and 220 ms.
10-7
Selecting a Lead
The following lead selections are possible:
• With 3-lead set: I, II, III
• With 5-lead set: I, II, III, aVR, aVL, aVF and V5
To select the ECG1 lead:

2 Select ECG1 Lead.
You can select all the leads (ECG1, ECG2 and
ECG3) in the ECG menu.
The label of the lead is displayed in the ECG field and above the numeric HR.
Note:
It is possible to connect a 3-lead set to a 5-lead trunk cable. The combination
functions as a 3-lead set.
Viewing a Cascaded ECG

If more than one ECG waveform is configured to be displayed in the waveform fields when using a
3-lead set, the same ECG is displayed in each of these fields. Thus, more QRS complexes are
displayed at the same time.
With a 5-lead set, a cascaded ECG or different leads can be displayed. Select the different leads
in the ECG menu.
10-8
Adjusting ECG Size
ECG
Increasing or decreasing the ECG gain affects the size of the 1 mV bar at the left end of the ECG
waveform, and the size of the ECG waveform accordingly.
To make adjustments in ECG size:

2 Select Size.
10-9
Adjusting Beat Sound Volume

When the monitor detects a QRS complex or a pulse (pleth or pressure), a beep tone sounds. You
can raise, lower, or turn off the beat sound volume. Adjusting the beat sound volume also affects
the SpO2 beat sound volume.
When SpO2 is monitored, the monitor provides a variable pulse beep, so that the tone of the pulse
beep rises with increasing oxygen saturation and falls as saturation decreases. This also affects
the ECG tone.
To adjust the beat volume:

2 Select Beat Sound Volume and turn the
ComWheel to choose the volume. The range is
from 1 (silent) to 10 (loud) or 0 (OFF).
ST Segment Analysis
The ST value illustrates the electrical activity difference between ISO points and ST points. The
points are based on R-wave detection.
Myocardial ischemia manifests itself in the ECG by causing the ST segment to deviate from the
isoelectric line (ISO point). The ST segment generally rises above the PQ isoelectric line in the
presence of transmural ischemia and is pressed below the isoelectric line in the subendocardial
ischemia. Ischemic heart disease may result in myocardial infraction, fatal arrhythmias, or acute
coronary insufficiency.
ST segment changes may also be affected by other factors than myocardial ischemia. These
factors can be, for example, drugs, or metabolic or conduction disturbances.
10-10
Monitoring the ST Segment
ECG
The monitor continuously analyzes the ST segment changes in active leads. ST numerical data is
shown on the right of the second real-time ECG waveform field.
When monitoring begins or when a lead is changed, the monitor starts to learn the ST segment.
During a learning period of 16 accepted beats, the ST values are displayed beat to beat.
Optimal leads for ST Analysis are:
• With 5-lead set: II, aVF and V5
• With 3-lead set: CB5
Note:
Select the ST filter (in the ECG Setup menu) as well as the monitored leads (in the
ECG menu) at the beginning of the case. Changing the filter and/or the lead affects
the ST measurement values.
Accessing ST Analysis View

To access the ST analysis view:

2 Select ST Analysis.
When the ST analysis view is accessed, the display shows three measured ECG leads and an
averaged QRS complex for each ECG lead. In addition, a graphic trend display for each ECG lead
is shown. Changing the lead causes a new learning of the ST segment. The learning period is
shown as a line in the trend display.
10-11
Figure 10-6: ST analysis view
ST view showing QRS complex average for each lead with ST and ISO point cursors
Lead label, ST values
ECG waveform area showing three ECG leads
A trend of ST values of each selected lead
Current ST values displayed continuously
ST Display in a Digit Field

You can also select ST numerical data to the lower digit field.
Message field
The lead that has the largest absolute ST value
ST values of ECG1, ECG2, and ECG3
Lead label
Figure 10-7: ST number field
To do this:
10-12
Setting ST Point Manually
ECG
In the monitor, the ST point is initially set 80 ms after the R detection. If this setting is changed, the
original point is shown as a dashed line. If the ST point is set manually, the set value remains until
the monitor is turned OFF or reset.
To set the ST point:

3 Select Set ST point.
4 Set the ST point by turning the ComWheel. To confirm the
setting, press the ComWheel.
10-13
Setting ISO Point Manually

The ISO (isoelectric) point is initially set 74 ms before the R detection. If this setting is changed,
the original point is shown as a dashed line. If the ISO point is set manually, the set value remains
until the monitor is turned off or reset.
To set the ISO point:

3 Select Set ISO point.
4 Set the ISO-point by turning the ComWheel. Confirm the
setting by pressing the ComWheel.
Note:
The ST algorithm has been tested for accuracy of the ST segment data. The
significance of the ST segment changes must be determined by a clinician.
10-14
Setting ECG Alarms
ECG
You can set the ST alarm limit and change the high and low heart rate alarms from the ECG menu
(as described below). You can also make the adjustments by selecting Adjust Limits in the
Alarms Setup menu.
To adjust ST and heart rate alarms:

2 Select ECG Alarms.
3 Select Adjust Limits and make the desired
adjustments.
Monitoring Pacemaker Patients

2 Select ECG Setup - Pacemaker and select one of the following:
• Show — Pacemaker spike is displayed on ECG.
• Sensit — Sensitive pacemaker detection; spike is displayed on ECG.
• ON R — Pacemaker suppression weakened; asystole alarm may not be reliable with
active pacemakers.
• Hide — Pacemaker spike is not displayed on ECG.
Note:
• Pacemaker detector may not operate correctly during the use of high-frequency
(HF) surgical equipment. The disturbances of HF surgical equipment typically
cause false positive pacer detection.
• The pacemaker may change the shape of the QRS complex so much that QRS
detection may be affected.
10-15
Warning
Do not rely entirely upon rate meter alarms when monitoring patients with pacemakers.
The monitor may count the pacemaker pulses as heartbeats. In this case, asystole and
ventricular fibrillation may go undetected. Always keep these patients under close
surveillance and monitor their vital signs carefully.
Pacemaker Markers
The monitor detects and rejects pacemaker pulses (see the Pacemaker selection in the ECG
Setup menu). Sometimes this may lead to unnecessary asystole alarms.
Note:
The pacemaker may change the shape of the QRS complex so much that QRS
detection may be affected.
Warning
Patients with Pacemakers or Arrhythmias — The monitor may count pacemaker pulses
as heart beats during cardiac arrest, some arrhythmias, and with certain types of
pacemakers particularly in ON R mode. Do not rely entirely upon rate meter alarms.
Keep patients with pacemakers and arrhythmias under close surveillance.

This section describes other adjustable features related to ECG measurement. A password is
required for entering the Install/Service menu where the adjustments are made. If you wish to
change a feature, we recommend that you contact the person responsible for the entire
configuration.
Analog Signal Output
Warning
Output signals are not floating and must not be connected directly to a patient.
4 Select Analog Outputs.
For more information, refer to the Ultracare SLP100 Technical Reference Manual
(P/N 070-1205-xx).
10-16
Contents
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Activating the Respiration Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Choosing the Respiration Rate Source . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Improving Waveform Readability. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Improving Respiration Rate Detection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Measurement Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Overview
Impedance respiration is measured across the thorax. When the patient is breathing or is
ventilated, the volume of air changes in the lungs, resulting in impedance changes between the
electrodes. A respiration rate is calculated from these impedance changes, and a respiration
waveform is displayed on the monitor screen.
Respiration Detection
The respiration rate is the sum of respirations that exceed the detection limit.
The dotted lines are the zero line and the detection limit.
The signal strength produced by a respiration should thus
exceed this minimum limit to be included in the respiration
rate calculation. Peaks within the grids are not calculated.
If AUTO detection mode is chosen, the grid lines are the minimum limits but the limits in use may
be larger. The RR value can include fewer respirations than indicated by the gridline.
Respiration Rate Calculation

Respiration rate is calculated automatically when ECG is measured, unless respiration
measurement is turned OFF or CO2 is measured.
When CO2 is measured, the respiration rate is automatically calculated from the CO2.
Respiration rate calculation switches back to impedance respiration if you press the Silence
Alarms key during an Apnea alarm.
The respiration rate source is displayed above the respiration numeric value.
Figure 11-1: Respiration rate source indication for impedance and CO2
The impedance respiration waveform is also displayed next to the RR value when the RR value is
calculated from CO2.
11-1
Impedance Respiration Display
Figure 11-2: Monitor display with impedance respiration measurement
Figure 11-3: Impedance respiration waveform and respiration rate numeric value
11-2
Patient Connections
The setup for impedance respiration is the same as for ECG measurement. If you do not have the
ECG setup, refer to Patient Connections on page 10-2.
You can use 3-lead or 5-lead ECG sets.
Electrode positioning Modified positioning Electrode positioning

with a 3-lead set. with a 3-lead set. with a 5-lead set.
RED (IEC) YELLOW (IEC) RED (IEC) RED (IEC) YELLOW (IEC)
WHITE (AAMI ) BLACK (AAMI) WHITE (AAMI) WHITE (AAMI) BLACK (AAMI)
LEAD I
1
1 2
LE 3 4 5 6
AD
II
GREEN (IEC) GREEN (IEC) YELLOW (IEC) BLACK (IEC) GREEN (IEC)
RED (AAMI) RED (AAMI) BLACK (AAMI) GREEN (AAMI) RED (AAMI )
Figure 11-4: Impedance respiration Setup
ECG electrode(s)
Trunk cable
3-lead set or 5-lead set
Note:
Use of the impedance respiration measurement is recommended only for patients
over three years old.
Warning
• In obstructive apnea, respiration movements and impedance variations may
continue.
• Patient Safety — Ensure proper contact of the return electrode of the
electrosurgery unit to avoid possible burns at sensor sites.
• Make sure that the lead set clips or snaps do not touch any electrically
conductive material including earth.
11-3
Activating the Respiration Measurement

The respiration information is not included in the trends and the alarms are not operative unless
respiration is selected in a waveform or in a digit field.
To select respiration in a waveform or a digit field:

Monitor Setup from the Main
menu.
3 Select Waveform Fields or Digit
Fields.
4 Choose Resp.
Turning the Measurement ON

To turn on the impedance respiration measurement:
1 Press the ComWheel and select Parameters

from the Main menu.
2 Select Resp Setup.
3 Select Measurement and choose ON.
11-4
Turning the Measurement OFF
In case the impedance respiration measurement signal interferes with other
measurements, such as ECG, you can turn it OFF:
3 Select Measurement and choose OFF.
Choosing the Respiration Rate Source

To manually choose the respiration rate source:

Parameters from the Main menu.
3 Select Resp Rate Source and choose
AUTO, CO2, or Imped.
11-5
Improving Waveform Readability

To improve the readability of the waveform, increase its size:

3 Select Size and turn the ComWheel to
change the size of the waveform.
The bar at the left of the waveform always
indicates a 1 W reference.
Improving Respiration Rate Detection

When respirations are weak, you can adjust the detection limits (measurement sensitivity) closer
to each other to ensure that all respirations are included in the RR value. In this case, the dotted
line represents the absolute detection limits.
When there are numerous artifacts, you can separate smaller artifacts from larger, true respiration
peaks by adjusting the grids farther apart. The small peaks fall within the grids and are not
calculated; the larger peaks cross the grids and are calculated as true respirations.
During spontaneous breathing, the ventilator may support the patient’s ventilation with an extra
inspiration. If these ventilator inspirations are substantially larger than the spontaneous breaths,
the respiration calculation may mistakenly count only the ventilator-produced inspirations and
expirations. You can correct this by adjusting the detection limit.
11-6
To adjust the detection limit:
3 Select Detection Limit.
The percentage is the ratio to the 1 Ω reference
bar, which is 100%.
Measurement Limitations
Movement Artifact
Changing the patient position, moving the head or the arms, or shaking will result in movement
artifacts. Also, the heart may cause noticeable movement and sometimes this may interfere with
the respiration measurement.
Electrical Interference
Electrical devices that emit electromagnetic disturbance, such as electrosurgery units and infrared
heaters, will result in artifacts or may disable the respiration measurement.
Pacemaker Patients
Warning
Pacemaker Patients — The impedance respiration measurement may cause rate
changes in Minute Ventilation Rate Responsive Pacemakers. Set the pacemaker rate
responsive mode OFF or turn the impedance respiration measurement OFF on the
monitor.
11-7
Pulse Oximetry
Contents
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Opening the Pulse Oximetry Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
During Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Measurement Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Overview
Oxygen saturation (SpO2) is the percentage of saturated hemoglobin compared to total
hemoglobin as measured by a two-wavelength pulse oximeter (also called functional or in vivo
oxygen saturation).
SpO2 is measured with light absorption techniques: red and infrared light are emitted from the
emitter side of the sensor. The light is partly absorbed when it passes through the monitored
tissue. The amount of transmitted light is detected in the detector side of the sensor. When the
pulsative part of the light signal is examined, the amount of light absorbed by arterial hemoglobin
is discovered and the saturation level is calculated.
The plethysmographic pulse wave is derived from variations of the intensity of the transmitted
light. It reflects the blood pulsation at the measuring site. Thus, the amplitude of the waveform
reflects the perfusion.
Note:
Refer to Pulse Oximetry on page 1-14 for more details.
Pulse Oximetry Options

The Ultracare SLP100 monitor offers three oxygen saturation measurement technologies:
• Standard pulse oximetry.
• Enhanced pulse oximetry.
• Nellcor compatible pulse oximetry.
Note:
Use only sensors identified for use with a specific option.
Consult the Ultracare SLP100 User’s Guide (P/N 070-1200-xx) for appropriate sensors.
12-1
Pulse Oximetry Display
Figure 12-1: Display of SpO2 value and Pleth waveform
Scale of Plethysmogram
Label(s)
Oxygen saturation (SpO2) value
Pulse oximetry message field
Opening the Pulse Oximetry Menu

Note:
Models with the Invasive Pressures or NMT option do not have the Pulse Oximetry
Direct Access key.
To open the Pulse Oximetry menu:
1 Press the Pulse Oximetry key.

-OR-
Then, select Pulse Oximetry.
12-2
Menu Selections
Pulse Oximetry
Pleth Scale
The scale of the plethysmographic waveform display is set automatically during Pulse
search. To adjust it further, select 2, 5, 10, 20, 50, or AUTO.
Note:
This selection is not available for some options.
When AUTO scaling is used, the scale changes automatically if the amplitude of the pleth
waveform exceeds the current scale or falls below the maximum value of the next lower
scale by 10% for 30 seconds or more. When the scale changes, the Scale changed
message is displayed.
The scale indicator number appears at the left of the waveform.
SpO2 Response
Selects the SpO2 averaging time: b-to-b (beat to beat), Normal (10 seconds), or Slow:
(20 seconds, the default setting).
Note:
This selection is not available for some options.
Beat Sound Volume
Adjusts the SpO2 beat volume. This adjustment also affects the ECG beat volume.
When SpO2 is monitored, the tone of the pulse beep rises as oxygen saturation increases
and falls as it decreases.
HR Source
Selects the heart rate source. If the ECG signal is affected by too much noise for a reliable
heart rate calculation, the heart rate can also be calculated from the invasive pressure
(Art) or from the plethysmographic pulse waveform (Pleth).
The selected heart rate source is shown above the numerical display of the heart rate. The
color of the heart rate is the same as the source parameter.
If AUTO is selected, the heart rate calculation priorities are: ECG (the lead with the
highest R-wave), invasive pressure (Art), then Plethysmographic pulse waveform (Pleth).
SpO2 Alarm
Select to adjust the SpO2 alarm limits as described in Alarms on page 1-14.
Plethysmographic Pulse Wave

If the site is poorly perfused, use smaller scale indicators to display an optimal pulse wave. A small
pulse wave may be a sign of impaired circulation that may require increased attention.
Higher scale indicators together with a well-defined pulse wave indicate strong circulation and a
relaxed patient.
12-3
Patient Connections
Selecting the Sensor

Choose a sensor that is appropriate for the patient and the monitoring requirements. Sensors are
categorized as reusable (durable) or disposable (single-patient use). Examples of both types are
shown and described below.
Reusable Sensors Description
OxyTip+ Finger Sensor. Quick application is possible;

Recommended for short term monitoring and spot checks.
Designed for use on adult and pediatric patients >20 kg
(44 lbs)
OxyTip+ Ear Sensor. Similar in appearance to finger sensor,

but smaller. Recommended for short to medium term
monitoring. Designed for use on adult and pediatric patients
>10 kg (22 lbs)
OxyTip+ Wrap Sensor. Recommended for short to medium

term monitoring. Ideal for high motion environments if used
with adhesive tape. Recommended for fragile skin if used
with foam wrap. Ideal for patients with long fingernails, acrylic
nails or arthritic fingers. May be used on fingers and toes and
on the fleshy part of hands and feet on patients 3 to 20 kg
(6.6 to 44 lbs)
Adhesive Sensors Description
OxyTip+ Sensitive Skin Sensor. Semi-reusable sensor

designed for use from premature infants <3 kg (6.6 lbs)
through small adults. Recommended for medium to long term
monitoring. Ideal for patients with long fingernails or acrylic
nails. May be used on hands, feet, fingers and toes.
OxyTip+ Adult Pediatric Adhesive Sensor, for use on fingers

or toes. Recommended for short to long term monitoring in
high motion environments, low-perfusion conditions. Ideal for
infection control. Designed for use on patients >20 kg
(>44 lbs). A separate sensor cable snaps into a connector on
sensor.
12-4
Pulse Oximetry
OxyTip+ AllFit adhesive sensor for use on fingers, toes and
the fleshy part of hand or foot depending on patient weight.
Recommended for short to long term monitoring in high
motion environments, low-perfusion conditions. Ideal for
infection control. Designed for use on all patient weight
ranges. Ideal for patients with arthritic fingers, long or acrylic
finger nails.
Note:
Sat Sensors and OxyTip+™ sensors are latex-free, PVC free and Cadmium free.
A finger sensor is usually appropriate for short-term patient monitoring. For long-term monitoring, a
single-patient, disposable sensor or a wrap-type sensor is commonly used.
Warning
Patient safety — Use clean and dry sensors and cables only. Moisture and debris on
connectors may affect measurement accuracy.
Choosing a Site
Site selection depends on the type of sensor and the weight of the patient. When choosing a site
for a sensor, refer to the instructions for that sensor.
• Choose a well-perfused site on a nondominant hand or foot, or the fleshy upper or lower part
of the ear when using an ear sensor.
• Clean the application site you choose, if necessary.
• Finger or toe — remove nail polish and artificial fingernails; clip long fingernails.
- Ear — remove earrings. Positioning sensor over a pierced area may adversely affect the
SpO2 reading.
Connecting the Sensor

Warning
Patient safety — To prevent erroneous readings, do not use an inflated blood pressure
cuff or arterial blood pressure measurement device on the same limb as the oximeter
sensor.
1 Connect the sensor (or sensor extension cable) to the SpO2 connector on the monitor.
Monitor Connection
Ultracare SLP100 standard pulse

oximetry
12-5
2 If applicable, connect the sensor cable to the extension cable.

Cable Connection
3 Position the sensor and attach it to the patient. For proper sensor positioning and application,
consult the instructions that accompany the sensor.
4 To minimize movement, attach the sensor cable to the wrist or bed clothes.
The Pulse search message appears. After the pulse search is completed, the plethysmographic
pulse waveform and the SpO2 reading appear on the screen.
Disconnecting the Sensor

When disconnecting a sensor, grasp the connector, not the cable. Some connectors contain
“buttons” on each side of the connector that you press to release the connector.
During Monitoring
Warning
• Patient safety — Do not use a pulse oximeter with magnetic resonance
imaging (MRI).
• Patient safety — A damaged sensor or a sensor soaked in liquid may cause
burns during electrosurgery.
• Patient safety — Patient conditions (such as reddening, blistering, skin
discoloration, ischemic skin necrosis, and skin erosion) may warrant
changing the sensor site frequently or using a different style of sensor. For
details, refer to the instructions supplied with the sensor.
Patient condition or prolonged use may require changing the sensor site periodically. Check skin
integrity, circulatory status, and correct alignment.
For patients with poor peripheral blood circulation, change the site at intervals of 30 minutes to one
hour. To confirm the circulatory status, observe the size of the plethysmographic waveform with
with a fixed pleth scale.
Be especially careful when monitoring infants.
12-6
Measurement Limitations
Pulse Oximetry
Use Ultracare SLP100 pulse oximetry only for patients weighing 5 kg (11 pounds) or more, even if
the SpO2 sensor can be used for patients weighing less than 5 kg.
Interfering Substances
Warning
Data validity — Conditions that may cause inaccurate readings and impact alarms
include interfering substances, excessive ambient light, electrical interference,
ventricular septal defects (VSD), excessive motion, low perfusion, low signal strength,
incorrect sensor placement, poor sensor fit, and/or movement of the sensor on the
patient.
The pulse oximeter cannot distinguish between oxyhemoglobin and dyshemoglobins
(methemoglobin or carboxyhemoglobin, for example). Dyes that change usual arterial
pigmentation, or substances containing dyes, may also cause erroneous readings.
Carboxyhemoglobin may erroneously increase readings in all pulse oximeters. The level of
increase is approximately equal to the amount of carboxyhemoglobin present. Cigarette smokers
and victims of smoke inhalation often have increased levels of carboxyhemoglobin. Therefore, the
saturation values may be somewhat higher for smokers and for patients with carbon monoxide
(CO) intoxication.
NIBP Measurement and Cold Infusions

Do not attach the pulse oximetry sensor to a limb that is used for noninvasive blood pressure
measurement or for administrating cold infusions. These circumstances reduce the pulsation and
perfusion and may affect the pulse oximetry measurement.
12-7
Contents
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NIBP Setup Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Starting NIBP Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
During Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Autocycling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Starting/Stopping a Continuous Measurement (STAT) . . . . . . . . . . . . . . . . . . . . . . . . 7
Using Venous Stasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Overview
The noninvasive blood pressure (NIBP) measurement uses the oscillometric measuring principle.
The cuff is inflated with a pressure slightly higher than the presumed systolic pressure, then slowly
deflated at a speed based on the patient’s heart rate, collecting data from the oscillations produced
by the pulsating artery. Based on this data, the unit calculates values for systolic, mean and
diastolic pressures.
The measurement can be used for adults, children and infants. The monitor automatically
recognizes the type of cuff hose (black hose for adults and children, white hose for infants) used
for each patient type at the beginning of each measurement.
It is possible to set an automatic cycling mode to make measurements at desired time intervals. It
is also possible to measure NIBP continuously for five minutes in STAT mode or take separate
single measurements.
NIBP Display
NIBP can be displayed in the digit field:
Figure 13-1: NIBP digit field display
Label
Systolic and diastolic pressure value of noninvasive blood pressure
Mean pressure value of NIBP
Time since the last autocycle measurement
NIBP autocycle time indicator
13-1
Patient Connections
Figure 13-2: Cuff positioning
Selecting the Cuff Hose

Two different cuff hoses with different cuff connections are available:
• BLACK hose for adults and children
• WHITE hose for infants
The monitor automatically recognizes the hose and selects the appropriate inflation pressure.
Another inflation limit can be selected in the NIBP Setup menu. Adult inflation limits cannot be
selected for an infant cuff.
Note:
The NIBP system incorporates a safety circuit to prevent over-pressurization or
prolonged inflation of the cuff.
Selecting the Cuff

To determine whether the cuff size is correct, check that the white index line on the outer edge of
the cuff falls between the range lines. If not, use a larger or smaller cuff.
Cuff Color Limb Circumference Hose

Child Green 12-19 cm Adult - Black
Small Adult Royal Blue 17-25 cm Adult - Black
Adult Navy Blue 23-33 cm Adult - Black
Adult Long Navy White 23-33 cm Adult - Black
Long Adult Wine 31-40 cm Adult - Black
Large Adult Long Wine 31-40 cm Adult - Black
Thigh Brown 38-50 cm Adult - Black
Infant Orange 8-13 cm Infant - White
Neonatal #3 White 6-11 cm Infant - White
13-2
• The material of the reusable cuffs is soft, durable Nylon.

• The material of the disposable cuffs is soft, durable, latex-free vinyl.
Note:
When using infant cuffs, the white infant cuff hose must be used. Also make sure the
Inflation Limits selection is set to Infant or Auto.
NIBP Setup Menu

To open the NIBP Setup menu:
1 press the NIBP key.
2 Select NIBP Setup.
Ready Prompt
Gives an audible tone when the NIBP measurement is ready. Adjust the volume of the
beep tone from 1 (silent) to 10 (loud), or to 0 (OFF).
Inflation Limits
The selections are: Infant, Child, Adult, and AUTO.
When the selection is AUTO (default), the monitor automatically identifies the cuff hose
and selects the right inflation pressure and alarm limits. The Child selection decreases the
maximum inflation pressure to 200 mmHg when using adult hoses/cuffs.
Note:
• When using infant cuffs, the white infant cuff hose must be used. The Child
selection increases the maximum inflation pressure to 200 mmHg when using
infant hoses/cuffs.
• When using very large adult cuffs, use Adult limits to prevent a Cuff loose
message from appearing.
13-3
Calibration Check
Enables a calibration check using an external manometer. Refer to NIBP Calibration
Check on page 13-4.
NIBP Calibration Check

1 Remove the cuff from the connector before entering the NIBP Setup menu.
2 To enter the NIBP Setup menu, press the NIBP key and select NIBP Setup.
3 Attach an external manometer with pump to the NIBP connector.
4 Pump to about 200 mmHg.
5 Compare the readings of the manometer and the display.
If the difference is greater than 4 mmHg, calibration by authorized service personnel is
recommended.
Starting NIBP Measurement

To start a single NIBP measurement:
1 Press the NIBP Start/Cancel key.

-OR-
2 Press the NIBP key and select Start
Manual.
In the beginning of the measurement, the sys and dia labels are replaced with the inflation limit
indication (adult, child, infant) for five seconds. The cuff pressure will be displayed in the mean
pressure value field.
If motion artifacts are detected, the monitor automatically holds deflation until the motion stops
(maximum of 30 seconds). If the artifacts prevent proper measurement, a new measurement is
automatically started.
When the measurement is ready, a short beep appears and result numbers flash.
13-4
Warning

The monitor sets the inflation pressure automatically according to the first
measurement. Reset the case to reset the inflation limit before measuring a new
patient.
During Measurement
• Observe the cuffed limb frequently. Measurement may impair blood circulation.
• Make sure that tubes are not bent, pressed, or stretched. Measurement may impair blood
circulation. Intervals below 10 minutes and STAT measurements are not recommended for
extended periods of time.
Note:
The presence of some arrhythmias during NIBP measurement may increase the time
required for the measurement. For details about the test results of the function of
NIBP measurement in the presence of arrhythmias, refer to the Ultracare SLP100
User’s Reference Manual (P/N 070-1206-xx).
• Blood pressure values may be affected by a change in the patient’s position.
Automatic NIBP Double-Check

If the NIBP value exceeds the alarm limits, a new measurement is taken automatically
(immediately, if Manual measurement is selected, and after 30 seconds, if AUTO measurement is
selected). If an alarm situation persists, an alarm will be given.
Canceling a Measurement
To cancel any measurement, press the NIBP Start/Cancel key.
13-5
Autocycling
It is possible to set automatic NIBP measurement ON and OFF at selected intervals. Autocycling is
synchronized to real time. For example, if the first measurement is at 12:02 with a 5-minute cycle
time, the next measurement will be at 12:05 and again at 12:10, 12:15, etc.
Setting the Cycle Time

The possible intervals for autocycling are 1, 2.5, 3, 5, 10, 15, 30, or 60 minutes.
To set the cycle time:
1 Press the NIBP key.

2 Select Cycle Time and choose the time.
Starting/Stopping Autocycling
• To start autocycling, press the NIBP key and select Start Cycling.
The bar at the bottom of the NIBP display shows the

remaining time until the next measurement.
• To stop autocycling.
Press the NIBP key and select Stop Cycling.
-OR-
If you wish to cancel the present measurement but start a new one after the selected interval
time, press the NIBP Start/Cancel key.
13-6
Starting/Stopping a Continuous Measurement (STAT)

The STAT mode initiates continuous measurement for five minutes. A new NIBP measurement
starts immediately after the previous one. After five minutes, the monitor automatically returns to
the previously selected cycling interval or to manual mode.
• To start a continuous measurement, press the NIBP key and select Start STAT.
In STAT mode, the earlier systolic value is measured

and displayed until the final result of a new one is
available.
• To stop a continuous measurement, press the NIBP Start/Cancel key.
Using Venous Stasis

Venous Stasis initiates and holds the pressure in the cuff to help venous cannulation. A constant
pressure of 40 (infant), 60 (child), or 80 mmHg (adult) is maintained in the cuff for one (infant) or
two minutes (child, adult). The value is selected automatically after the inflation limits (adult, child
or infant) are set.
To start Venous Stasis:
1 Press the NIBP key.
2 Select Start Ven. Stasis.
The pressurization time is displayed in the NIBP field and STASIS flashes during the last
15 seconds.
To release the pressure before two minutes has expired, press the NIBP Start/Cancel key before
two minutes has expired.
13-7
Contents
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Invasive Blood Pressure Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Invasive Pressures Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Invasive Line Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Starting with Accurate Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Measuring Pulmonary Capillary Wedge Pressure (PCWP). . . . . . . . . . . . . . . . . . . . . 9
Overview
The Ultracare SLP100 monitor with the Invasive Pressures option enables you to measure and
monitor two invasive blood pressures at the same time.
During the invasive blood pressure measurement, the transducer converts the pressure variations
into electrical signals. The electrical signals are amplified and displayed as numeric pressure
values and waveforms.
Warning
All invasive procedures involve risks to the patient. Use aseptic technique. Follow
catheter manufacturer’s instructions.
Invasive Blood Pressure Display

You can display the two invasive pressure waveforms separately (one above the other) or you can
combine them. Combining the waveforms increases the size of the waveform.
Figure 14-1: Top: Separated waveforms

Bottom: Waveforms combined in several fields
14-1
Invasive blood pressure waveforms with zero and reference lines

Selected pressure label
Selected pressure scale
Field for messages and alarm limit settings
Systolic, diastolic and mean pressure values of invasive blood pressures
Displaying a Combined Pressure Waveform

To display combined pressure waveforms:
4 Select Combine Pressures and YES.
Invasive Blood Pressure Setup
1
Disposable
2
3
Disposable
Reusable
Figure 14-2: Invasive blood pressure set-up
Heparinized fluid bag with pressure infusor

Flushing set
Transducer
Adapter cable for using disposable transducers
Note:
Patient connections made according to the picture above using manufacturer-
specified accessories are defibrillator proof.
Refer to the transducer manufacturer’s instructions on how to remove trapped air from the
transducer.
14-2
Warning

• Mechanical shock to invasive blood pressure transducer may cause severe
shifts in zero balance and calibration, and cause erroneous readings.
electrosurgery unit to your patient to avoid possible burns at sensor sites.
• Make sure that no part of the patient connections touches any electrically
conductive material including earth.
• Use only defibrillator-proof transducers and cables.
Patient Connections
Make the connections as follows:
1 Connect the pressure transducer to the transducer cable and the cable to the monitor’s red
connector.
2 Prepare the transducer kit according to the manufacturer’s instructions. Mount the kit with the
transducer zeroing port at mid-heart level.
3 Ensure that there is no air in the transducer dome or in the catheter line. Refer to transducer
manufacturer’s instructions on how to remove trapped air from the transducer.
4 Connect the patient catheter to the pressure line.
5 Connect the patient catheter to the pressure line.
6 Open the dome stopcock to room air.
7 Zero the transducer. Refer to Starting with Accurate Values on page 14-7.
8 Open the dome stopcock to pressure catheter and check the quality of the waveform.
14-3
Invasive Pressures Menu

Note:
Monitors with the NMT option do not have the Invasive Pressures key.
To open the Invasive Pressures menu:
1 Press the Invasive Pressures key.

-OR-
Parameters.
3 Then select Invasive Press.
Wedge Pressure
Used for Pulmonary Capillary Wedge Pressure Measurement (PCWP). Refer to
Measuring Pulmonary Capillary Wedge Pressure (PCWP) on page 14-9.
P 1 ‘Art’ Setup and P2 ‘CVP’ Setup
Used to set the label, scale, and other attributes of the P1 or P2 channel. Refer to Invasive
Line Setup on page 14-5.
Ventilation Mode
Respiration causes artifacts in invasive pressures. The artifact is smallest at the end of
expiration. You can select Spont for spontaneous respiration or Contrl for controlled
ventilation.
14-4
Invasive Line Setup

To open the setup menu for an invasive pressure line:

-OR-
Press the ComWheel and select Parameters.
Then select Invasive Press.
2 Select P1 ‘Art” Setup or P2 ‘CVP’ Setup.
Setup Menu Options

Label
The label sets the features of the pressure channel. Refer to Labelling the Invasive Line
on page 14-6.
Scale
The scale is assigned when the channel is labelled. The scale can be adjusted from
10 mmHg to 300 mmHg in steps of 10.
Digit Format
With the numeric display format, you can choose to display the Systolic/Diastolic (S/D)
numbers or the Mean pressure value in a large font size.
Filter Frequency
Filters the measured signal to remove noise and artifacts. The filter can be adjusted from 4
to 22 Hz.
HR Source
If the ECG signal is affected by too much noise for a reliable heart rate calculation, heart
rate can be calculated mechanically from the pressure (Art) or plethysmographic pulse
waveform. The heart rate source is shown above the numerical heart rate display. The
color used for the heart rate is the same as the source parameter.
The AUTO selection prioritizes the heart rate calculation in a specified order: ECG (the
lead with highest R-wave), pressure (Art), and plethysmographic pulse waveform.
14-5
P 1 ‘Art’ Alarm
Alarms can be adjusted in this menu or in the Alarms Setup menu. Refer to Adjusting
Alarm Sources and Limits on page 14-7.
Labelling the Invasive Line

When a pressure channel is labelled, the display scales, waveform color, filter, alarm source, and
alarm limits are also changed. The label sets the other features.
To change the label:

-OR-
Press the ComWheel and select Parameters.
Then select Invasive Press.
2 Select P1 ‘Art” Setup or P2 ‘CVP’ Setup.
3 Select Label and choose the label.
Invasive Blood Pressure Labels and Descriptions

The labels are as follows:
P1, P2 Standard, start-up labels
Art Arterial pressure
CVP Central venous pressure
PA Pulmonary arterial pressure
RAP Right atrial pressure
RVP Right ventricular pressure
LAP Left atrial pressure
ICP Intracranial pressure
ABP Arterial Blood Pressure
Both Art and ABP labels are available for situations when two arterial lines are desired but you
want to use different settings or alarm labels.
14-6
Assigning a label automatically changes the other pressure settings as shown below:

P1, Art,
LABEL P2, CVP RAP, LAP ICP PA RVP
ABP
Scale 200 20 20 20 60 60
Digit Format Sys/Dia Mean Mean CPP Sys/Dia Sys/Dia
Filter 22 9 9 9 9 9
Alarm Source Sys OFF OFF OFF OFF OFF
Color Red Blue White White Yellow White
Adjusting Alarm Sources and Limits

You can adjust or turn OFF pressure alarm limits.
To do this:
-OR-
Press the ComWheel and select Parameters. Then select Invasive Press.
2 Select P1 ‘Art’ Setup and P1 ‘Art’ Alarm.
-OR-
Select P2 ‘CVP’ Setup and P2 ‘CVP’ Alarm.
You can choose Sys (Systolic), Dia (Diastolic), or Mean as a source for each pressure
channel. The limits are on for only one source at a time.
For more information about alarms, refer to Alarms on page 4-1.
Starting with Accurate Values

Pressure transducers generally produce a small signal even when no pressure is applied to them.
It is necessary to zero the monitor with the transducer to establish an accurate electrical zero
point.
The position of the transducer affects the accuracy of the measurement. An error of 10 mmHg of
static pressure will be introduced for every 13.6 cm (5.4 inches) difference in height between the
mid-heart and the transducer.
14-7
To zero the transducer:
1 Open the transducer to air.

Press the Invasive Pressures key.
-OR-
Press the ComWheel and select
Parameters. Then select Invasive Press.
2 Zero each channel.
Zero ALL...Zeros all transducers (except
ICP) to atmospheric pressure.
Zero P1 …Zeros P1 transducer only.
Zero P2 …Zeros P2 transducer only.
The Zeroing message is displayed during the zeroing process. After the transducer has been
zeroed, the Zeroed message appears in the digit field.
After each channel has been zeroed, the time when zeroing occurred appears in the menu.
Note:
Check the zero level after power interruptions.
14-8
Measuring Pulmonary Capillary Wedge Pressure (PCWP)

Pulmonary capillary wedge pressure (PCWP) is the occlusion pressure of the pulmonary artery.
PCWP can be measured with a pulmonary artery flotation catheter. When the balloon at the tip of
the catheter is inflated, the pulmonary artery is occluded. The pressure (PCWP) indirectly reflects
the filling pressure of the left ventricle.
The monitor uses an algorithm to automatically detect the pressure values at the end of expiration
when the artifact caused by respiration is minimal. The mean pressure value is PCWP.
Figure 14-3: Position of Swan-Ganz catheter in pulmonary artery and

Pressure waveforms from balloon-tipped pulmonary catheter during insertion
The speed of the waveforms in the Wedge Pressure menu is 12.5 mm/s.
Note:
During wedge pressure measurement, PA values are not trended and PA alarms are
disabled.
Starting PCWP Measurement

Note:
Because the PCWP measurement site is in an extremely delicate area, only specially
qualified medical personnel should perform the insertion of the Swan-Ganz catheter.
Follow the catheter manufacturer’s instructions.
1 Position the Swan-Ganz catheter in the pulmonary artery. Continuous monitoring of the
pressures along the route of the catheter tip will help to identify the location of the tip. Use the
distal lumen for the pressure line.
2 PCWP measurement is dedicated to the invasive pressure channel labelled PA.
14-9
To check the label:

• Press the Invasive Pressures key.
-OR-
Press the ComWheel and select Parameters. Then select Invasive Press.
• Check that the wedge pressure channel is labelled PA. If it is not, label the channel as
described in Labelling the Invasive Line on page 14-6.
3 Check that the monitor has correct ventilation status information for the patient:
In the Invasive Pressures menu, select Ventilation Mode and choose Spont (spontaneous)
or Contrl (controlled).
4 Select Wedge Pressure.
5 Select Measurement.
6 Inflate the catheter balloon when the Inflate the balloon message is displayed in the PA
waveform field.
The monitor searches the end expiratory mean pressure value. The pressure is displayed in
the waveform field and menu. After 20 seconds, the waveform is automatically frozen and the
Deflate the balloon message is displayed.
7 Deflate the balloon when the Deflate the balloon message is displayed in the PA waveform
field.
The pressure waveform will stay frozen until you accept the PCWP level.
8 Adjust the PCWP level by turning the ComWheel. Press the ComWheel to accept the PCWP
level that represents the true PCWP level.
After accepting the PCWP level, normal pressure monitoring continues.
Note:
You can also manually freeze the waveform before 20 seconds has elapsed by
selecting Freeze/Adjust.
14-10
Adjusting PCWP

To manually adjust the PCWP pressure level:
1 In the Wedge menu, select Freeze/Adjust.
2 Turn the ComWheel to move the cursor to a point on the waveform that represents the true
PCWP level.
3 Press the ComWheel.

4 Select Confirm.
Cancelling PCWP Measurement

If the measurement did not succeed, select Cancel.
This cancels the whole measurement. The first menu appears so you may start a new
measurement.
14-11
Temperature
Contents
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Temperature Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Overview
You can use Spacelabs Medical-approved temperature probes to measure esophageal,
nasopharyngeal, rectal, and skin temperature, for example.
Monitoring perioperative body temperature is recommended when inducing hypothermia or if
unexpected temperature changes occur. Refer to the Ultracare Supplies and Accessories Catalog
CD-ROM (P/N 084-1301-xx) for more information.
Warning
Patient Safety — To prevent patient injury, use only Spacelabs Medical-approved
temperature probes.
Temperature Display
Figure 15-1: Temperature digit display
Label
Temperature measurement value
Automatic Temperature Test

The temperature measurement function is tested periodically. The Performing temp test
message appears during the test. If the test fails, an error message is displayed.
15-1
Patient Connections
Figure 15-2: Temperature setup
To make the connections:

1 Attach the temperature probe to the patient.
2 Connect the temperature probe to monitor connector T1 or T2.
Temperature Menu
You can change the label of the temperature measurement site, the temperature units, and set
temperature alarms in the Temp Setup menu.
Note:
The Temp Alarms selection in the Temp Setup menu opens a menu in which you
can adjust the temperature alarm limits. For instructions, refer to Alarms on page 4-1.
Changing the Temperature Label

2 Select Temp Setup.
3 Select T1 Label.
-OR-
Select T2 Label.
15-2
Temperature
4 Select the label you wish to use for the temperature measurement site:
Eso Esophageal temperature Skin Skin temperature

Naso Nasopharyngeal temperature AirW Airway temperature
Tymp Tympanic temperature Room Room temperature
Rect Rectal temperature Myo Myocardial temperature
Blad Bladder temperature Core Core temperature
Axil Axillary temperature Surf Surface temperature
Changing the Temperature Units

2 Select Temp Setup.
3 Select Unit and choose °C or °F.
15-3
Airway Gases
Contents
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Sample Gas Exhaust Connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
CO2 Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
O2 Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
N2O Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Agent Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Automatic Agent Identification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Selecting Alarm Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Gas Calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Interfering Gases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Unit Conversions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Overview
With the Ultracare SLP100, you can measure and monitor the gases delivered to an anesthetized
patient and exhaled by the patient through the anesthesia circuit.
Respiratory rate is the frequency of peak (end tidal) CO2 measurements per minute. A breath is
defined as a change in the CO2 signal that exceeds 1% (8 mmHg). All concentrations are
measured and displayed breath by breath.
Display of Gases
Figure 16-1: Airway gas waveform display
Gas waveforms
Scale
Message field for gases
Gas label
Symbol to indicate that FiO2 low alarm limit is set below 21%
Digit field for ET and FI gas values, and FI-ET difference
Respiration rate
MAC value, based on measured AA and N2O ET values
16-1
Figure 16-2: Fewer digit field for gases
Agent Mixture
During an agent mixture situation, the Agent mixture message appears in the lower digit field for
gases. The labels of both agents and their concentrations are displayed.
Patient Connections
Caution
• Keep the monitor horizontal. Tilting the monitor may cause erroneous
results in the readings and damage the monitor.
• Use only approved cables and accessories. Other cables and accessories
may damage the system or interfere with measurement. Single-use
accessories are not designed to be reused.
Take the gas sample as close to the patient’s airway as possible.
1 Before making patient connections, check that:
• The airway adapter connections are tight and the adapter is operating properly.
• The D-fend container is empty and properly attached. The container should be changed or
cleaned between patients and emptied when it is more than half full.
2 Connect the sample gas outlet to gas scavenging if N2O or volatile agents are used.
3 Attach the gas sampling line to the connector on the D-fend water trap.
Note:
The Sampling line blocked message may appear if you attach the sampling line to
the water trap after you turn ON the monitor.
4 Turn ON the monitor. A self-check is performed and automatic agent identification is activated.
5 When the Calibrating gas sensor message disappears, make the patient connections as
described below.
6 Connect the sampling line to the patient’s airway adapter. Position the adapter’s sampling port
upwards to prevent condensed water from entering the sampling line.
16-2
Airway Gases
Figure 16-3: Airway gases set-up
Gas sampling line

Y-piece
Airway adapter with sampling line connector
Heat and moisture exchanger with filter HMEF
Note:
If you are administering medication using a nebulizer, disconnect the HMEF and
airway adapter while the nebulizer is in use.
Caution
Remove the airway sampling line from the patient airway while nebulized medications
are being delivered.
16-3
Airway Gases Setup Alternatives
Figure 16-4: Normal endotracheal intubation
Intubation tube with 15 mm connector

Airway adapter
Figure 16-5: Tracheostomy
Tracheostomy tube with 15 mm connector

Heat and Moisture Exchanger (HME)
Airway adapter
16-4
Airway Gases
Figure 16-6: Mask ventilation
Mask
Bacteria filter
Airway adapter
3
2
Figure 16-7: Endotracheal intubation of pediatric patients
Endotracheal tube
Pediatric airway adapter (Replaces regular pediatric endotracheal tube connector. For sizes
2.5 to 4.0 endotracheal tubes.)
Pediatric heat and moisture exchanger (HME)
Fresh gas inlet
16-5
Sample Gas Exhaust Connections

When N2O or volatile anesthetics are used, take precautions against venting these gases into
room air. Return the sample gas to the patient circuit or remove it through a scavenging system.
Connect the monitor’s sample gas outlet to the scavenging system either
• through the ventilator, or
• directly to the vacuum scavenging system.
Caution
Strong scavenging suction may change the operating pressure of the monitor and
cause inaccurate readings or internal damage.
Connect sample gas outlet only to open scavenging system where gas is removed in room
pressure.
Scavenging Through the Ventilator Reservoir

To scavenge through the ventilator reservoir:
1 Connect an exhaust line to the sample gas outlet on the rear panel of the monitor.
2 Attach the other end of the line to the ventilator reservoir. Make sure that the reservoir tube
diameter is at least two to three times larger than the exhaust line.
Figure 16-8: Scavenging through ventilator reservoir
Scavenging Through the Anesthesia Gas Scavenging System

Anesthesia machines are equipped with an anesthesia gas scavenging system (AGSS), and in
some machines you can connect the sample gas outlet directly to that.
16-6
For example, connect the gas module sample gas outlet to the GE Datex-Ohmeda S/5 Avance:
Airway Gases
Figure 16-9: Connecting sample gas outlet directly to the anesthesia gas scavenging system
Note:
Refer to the anesthesia machine’s documentation to find out where and how the
sample gas can be connected.
Connecting Directly to a Vacuum Scavenging System

To scavenge through a direct connection:
1 Connect the exhaust line (717-0408-00, 5/pkg) to the sample gas outlet on the monitor.
2 Connect the exhaust line only to an open scavenging system where gas is removed at room
pressure. Do not connect the monitor directly to a vacuum scavenging system.
16-7
Returning Gas to the Patient Circuit

In some anesthesia machines, you can return the sample gas to the patient circuit, refer to the
anesthesia machines manuals. For example, if you use the Datex-Ohmeda S/5 Anesthesia
Delivery Unit (ADU), connect an optional adapter (717-0855-00, 5/pkg) to the patient breathing
tubes.
Figure 16-10: Gas return to patient circuit in ADU
Scavenging Through Direct Connection

Connect the sample gas exhaust to an open scavenging system where gas is removed at room
pressure.
Caution
Strong scavenging suction may change the operating pressure of the monitor and
cause inaccurate readings or internal damage.
To scavenge through a direct connection:
1 Connect the exhaust line (717-0408-00, 5/pkg) to the sample gas outlet on the monitor.
2 Attach a T-fitting (717-0874-00, 5/pkg) between the exhaust line and the scavenging tube to
prevent vacuum in the tube.
16-8
Airway Gases
Figure 16-11: Connection directly to a scavenging system
16-9
CO2 Setup
3 Select CO2 Setup.
4 To change the scale, select Scale and choose the scale.

The 0 to 6% scale is used in normal situations. The 0 to 10% and 0 to 15% scales are used if
hypercarbia is expected.
5 To change the source used for the respiration rate, select Resp Rate Source.
You can choose to have the rate calculated from the ECG or the CO2 measurement. If AUTO
is selected, the respiration rate is calculated from CO2, when CO2 is measured, and from the
ECG measurement otherwise.
Respiration rate calculation switches back to impedance respiration if you press the Silence
Alarms key during an Apnea alarm.
6 Select CO2 Alarm or Resp Rate Alarm to open the corresponding Alarms Adjustment menu
where you can change the CO2 or respiration rate alarm limits.
16-10
O2 Setup
Airway Gases
To open the O2 Setup menu:
3 Select O2 Setup.
4 To select the scale for the waveform oxygram, select Scale.

The monitor measures inspiratory and expiratory O2 continuously and displays an O2
waveform oxygram. It also calculates and displays the difference of inspired and expired O2.
The scale allows you to select the following ranges for oxygram: difference scales DIFF 6,
DIFF 10, DIFF 15, DIFF 30, 10 to 60%, 0 to 100%.
The monitor determines the maximum measured O2 concentration and automatically sets the
reference level for the difference scales. DIFF 30 and 10 to 60% are used in the recovery
room when the patient is oxygenated, for example. Scale 0 to 100% enables you to inspect the
full range of O2. It is used during pre-oxygenation, for example.
5 Select Measurement and choose ON or OFF.
You can turn OFF O2 measurement when no O2 alarms or digit information is desired.
If OFF is selected, this symbol is displayed in the Digit field and the
Measurement OFF message is displayed in the O2 Waveform field.
16-11
6 Select O2 Alarm to open the O2 Alarms Adjustment menu where you can change the O2
alarm limits as described in Alarms on page 4-1.
This symbol is displayed beside the O2 value when the FiO2 low alarm limit
is set below 21%.
N2O Setup
Note:
N2O and Agent adjustments are made in the same menu. To adjust for agent
measurement, refer to Agent Setup on page 16-13.
To open the Agent/N2O setup menu:
3 Select Agent/N2O Setup.
4 Select N2O Measurement and choose ON or OFF.
16-12
• When the measurement is ON, the FiN2O alarm limit is FI × 82%.
Airway Gases
• In cases where no N2O alarms or digit information is desired, you can turn off the N2O
measurement.
If OFF is selected, this symbol is displayed in the digit field and the
Measurement OFF message is displayed in the N2O Waveform field.
Agent Setup
Note:
Agent and N2O adjustments are made in the same menu. To adjust for N2O
measurement, refer to N2O Setup on page 16-12.
To open the Agent/N2O Setup menu:
3 Select Agent/N2O Setup.
4 To select the anesthetic agent waveform scale, select Agent Scale and choose 0 to 1.2%,
0 to 2.5%, 0 to 5%, 0 to 10%, or 0 to 20%.
Scale 0 to 1.2% is used with concentrations <1%. Scales 0 to 2.5% and 0 to 5% are normal
scales, 0 to 5% being used in induction, for example. The maximum scale is 0 to 20%.
5 Select Agent Measurement and choose ON or OFF.
You can turn OFF agent measurement when no agent alarms or digit information is desired.
16-13
If OFF is selected, this symbol is displayed in the digit field and the
Measurement OFF message is displayed in the Agent Waveform field.
6 Select Agent Alarm to open the Agent Alarms Adjustment menu where you can change
agent alarms.
MAC Values
To display the MAC value on the screen:
4 Select one of the lower digit fields and choose MAC.
1 MAC (Minimum Alveolar Concentration) is the alveolar concentration (end-tidal) of the agent
at which 50% of individuals fail to move in response to a noxious stimulus, such as a surgical
incision.
Warning
MAC values are empirical, not absolute. Ultracare SLP MAC values correspond to those
of healthy adults and cannot be applied to children. Age and other individual factors
influencing the effect of volatile agents are not taken into account.
The monitor calculates MAC values according to the following formula:
MAC(AA) = %(EtAA) + %EtN2O

x (AA) 100
where x(AA) is Hal = 0.75%, Enf = 1.7%, Iso = 1.15%, Sev = 2.05%, Des = 6.0%
Table 1: MAC numbers of different anesthetics in oxygen *
HAL ENF ISO SEV DES N2 O
1 MAC 0.75% 1.7% 1.15% 2.05% 6% 100%
2 MAC 1.5% 3.4% 2.3% 4.1% 12%
3 MAC 2.3% 5.1% 3.45% 6.2% 18%
Table 2: MAC numbers of different anesthetics in 65% N2O *
HAL ENF ISO SEV DES N2 O
1 MAC 0.3 0.7 0.45 0.8 2.8-4 —
16-14
* Quasha AL. Eger EI II, Tinker JH. Determination and application of MAC. Anesthesiology
Airway Gases
1980; 53: 315.
Automatic Agent Identification

The agent identification option automatically identifies and selects Halothane, Enflurane,
Isoflurane, Sevoflurane and Desflurane on the basis of the identification. Automatic agent
identification is activated after power ON.
When the monitor identifies and selects the agent, it displays the XXX selected message (XXX
being HAL, ENF, ISO, SEV or DES). The message is displayed for 60 seconds. The inspiratory
and expiratory concentrations of the agent are shown in the digit field.
The minimum concentration for the identification is 0.15 vol%. The agent selection remains active
even if the concentration decreases below 0.15 vol% during the case.
Automatic agent identification operates after the normal warm up of the monitor (approximately
five minutes).
Agent Mixtures
The agent identification warns you if a mixture of anesthetic agents is detected. The mixture
warning is activated at the latest when the concentration of the minor agent is greater than
0.3 vol% and more than 15% of the total anesthetic agent concentration.
When a mixed agent is detected, the Agent mixture message is displayed and an audible alarm
sounds. The message remains active as long as the situation persists.
When there is an agent mixture, the anesthetic agent concentrations and labels of two anesthetic
agents are displayed.
When changing the anesthetic agent, the monitor will detect an agent mixture until the first agent is
washed out of the patient and the circuit. When the second agent begins to dominate, the
measurement is based on the new agent. The Agent mixture message disappears when the
concentration of the first agent becomes insignificant. When this event occurs, the exact limits
depend on the mixture of agents.
Selecting Alarm Sources

Alarm sources can be selected in the Alarm Sources submenu under the Alarms Setup menu.
The selections are FI or ET as the high- and low- alarm limits. For more information, refer to
Alarms on page 4-1.
16-15
Gas Calibration
Perform a gas calibration every six months or whenever there are indications of errors in the gas
readings. The time of the last calibration is shown at the bottom of the Gas Calibration menu.
Calibration is not available during the first five minutes of monitoring and during a gas sampling
warning.
Note:
• During gas calibration, % units are always used for CO2 regardless of selected
measuring units.
• Anesthetic agent is always calibrated with Desflurane.
Equipment and use
• Use only Spacelabs Medical-approved calibration gas to calibrate the gas measurement.
Otherwise, the calibration will not succeed.
• The calibration gas container may be used until the pressure indicator reaches the red zone.
• If separate gas containers are used, each gas must be calibrated separately.
• If you use an older brass regulator, the feeding pressure should be adjusted between 5 and
7 psi. The use of an old regulator with the new aerosol containers requires an adapter. For
ordering details refer to the Ultracare SLP and Ultracare ADS Supplies and Accessories
Catalog (P/N 084-1301-xx).
Calibrating the Monitor

To calibrate the monitor:
1 Turn on the monitor. For maximum accuracy, let the monitor warm up for 30 minutes.
2 Attach the regulator to the gas container.
Figure 16-12: Attaching the regulator to the gas container
16-16
3 Attach a new sampling line to the water trap. Connect the loose end of the sampling line to the
Airway Gases
regulator on the gas container.
Figure 16-13: Connecting a sampling line to the gas valve and feeding gas
The Gas Calibration selection remains gray (inactive) until the Calibrating gas sensor
message is no longer displayed.
6 Select Gas Calibration.
7 Wait until the Zero ok and then Feed gas messages appear on the screen after each gas.
If the Zero error message is displayed, press the Normal Screen key and repeat the
calibration procedure. If the problem persists, contact authorized service personnel.
8 Open the regulator and feed the calibration gas until Adjust appears, then close the valve.
16-17
Note:
When the monitor is in automatic agent ID mode and it detects a calibration gas and
no anesthetic agent, the Cal gas found message appears. If the identification sensor
fails, the Agent id inop message will be displayed.
9 Check that the displayed gas values match the values on the calibration gas container.
Calibration Adjustments
Calibration adjustments may be required if the gas values displayed during calibration do not
match the values on the calibration gas container.
If adjustments are required:
1 Select Gas Calibration in the Airway Gas

menu.
2 Turn the ComWheel to highlight the first gas
to be adjusted. Press the ComWheel to open
an adjustment window.
3 Turn the ComWheel until the displayed value
matches the desired value. Press the
ComWheel to confirm the adjustment.
4 Repeat steps 2 and 3 for each gas.
Autozeroing Intervals
Autozeroing intervals after start-up are: 5 minutes, 5 minutes, 5 minutes, 15 minutes, 15 minutes,
15 minutes, and every hour thereafter. Autozeroing may also occur after agent selection.
16-18
Interfering Gases
Airway Gases
Known effects of gases NOT MEASURED by the monitor:
Helium (He)
Affects the CO2 measurement, decreases the CO2 readings.
For example:
5% CO2, 30% O2, balance He: CO2 reading decreases 8.5% relative.
Nitrogen (N2)
The monitor compensates for the effect of nitrogen in the gas measurement. Nitrogen is
used as the balance gas in gas measurement.
Unit Conversions
Relationship between gas concentration and its partial pressure:
Reading in mmHg (dry gas) =
(ambient pressure in mmHg × gas concentration in %)/100
Reading in mmHg (water vapor saturated gas) =
[(ambient pressure in mmHg – 47 mmHg) × gas concentration in %]/100
Reading in kPa (dry gas) =
(ambient pressure in mmHg × gas concentration in %)/750
Reading in kPa (water vapor saturated gas) =
[(ambient pressure in mmHg – 47 mmHg) × gas concentration in %]/750
Note:
47 mmHg is the partial pressure of the saturated water vapor at 37° C.

This section describes other adjustable features related to measuring airway gases. A password is
configuration.
16-19
Changing Units
To change the CO2 measurement unit:
4 Select Units.
5 Select Parameters.
6 Select CO2 and choose the unit (%, kPa, or mmHg).

You can choose yellow, white, green, red, or blue as the color used in the waveform and digit
fields for CO2, O2, or agent gas readings. For gases, you can also select orange or violet.
The factory default colors for anesthetic agents are:
Desflurane: Blue Halothane: Red Sevoflurane: Yellow
Enflurane: Orange Isoflurane: Violet
To change a color:
3 Select Colors.
4 Select Gases and choose the color.
16-20
Spirometry
Contents
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Display of Spirometry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Spirometry Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Spirometry Loops . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Scaling of Loops and Waveforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Calibrating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Overview
The Spirometry option enables monitoring of the patient’s airway pressures, volumes, lung
mechanics, and the ventilator operation.
In Spirometry measurement, the airway pressures are measured as close to the patient as
possible (between patient circuit and intubation tube), using the D-lite and Pedi-lite sensors. The
same sensors are used for gas sampling.
The D-lite and Pedi-lite sensors measure kinetic pressure by a two-sided Pitot tube. Pressure is
transferred to the monitor through a spirometry tube and measured by a pressure transducer. The
pressure difference across a flow restrictor, together with the gas concentration information, is
used to calculate flow. The volume information is obtained by integrating the flow signal.
Measured Parameters
• Expiratory and inspiratory tidal volumes (TVinsp/exp)
• Expiratory and inspiratory minute volumes during controlled mechanical ventilation and during
spontaneous breathing (MVinsp/exp)
• Airway pressures:
Peak pressure (Ppeak)
Plateau pressure (Pplat plateau)
Mean pressure (Pmean)
Real-time pressure waveform (Paw)
• End expiratory pressure (PEEP)
• Flow real-time waveform (Flow)
• Compliance (Compl)
• Airway resistance (Raw)
• Ratio of the inspiratory and expiratory time (I:E)
• Pressure-volume loop (Paw-Vol. loop)
• Flow-volume loop (Flow-Vol. loop)
17-1
Note:
Airway resistance and PEEP are not measured with spontaneous breaths compliance
or with pressure-supported breaths.
Measurement Principles
Pplat — the pressure at the reversal point of the flow, at the end of the inspiration phase, after the
inspiratory pause.
Ppeak — the maximum pressure during one breath.
PEEP — the pressure in the lungs at the end of the expiration, measured at the moment when the
expiratory phase changes to inspiratory flow.
Compliance (Compl) — tells how big a pressure difference is needed to deliver a certain volume
of gas into the patient. Compliance is calculated for each breath from the following equation:
TVexp
Compl =
Pplat - PEEP
Raw — the airway resistance, is calculated from an equation that describes the kinetics of the gas
flow between the lungs and the flow sensor. The pressure at the sensor can be derived at any
moment of the breath cycle from the following equation:
p(t) = Raw • V'(t) + V(t) / Compl + PEEP
Where p(t), V'(t) and V(t) are pressure, flow, and volume measured at the sensor at a
certain time (t).
Display of Spirometry
Continuous Waveforms
Figure 17-1: Spirometry waveform display
Pressure and flow waveforms

Label
Scale
Digit field for Ppeak, Pplat, and PEEP values
Digit field for tidal or minute volume
17-2
Lower Digit Field Display
Spirometry
Figure 17-2: Digit fields for Paw, Paw + TV, Flow, and Compl. + Raw
You can choose to display tidal volume (TV) or minute volume (MV) in the Spirometry Setup
menu. This selection also affects the Spiro1 split screen display (refer to Figure 17-3).
Split Screen Display
Figure 17-3: Spiro1 (left) and Spiro2 (right) split screen options
Scale
Label
Real-time loop
Digit field
Spiro1 — the basic spirometry view, shows Ppeak, Pplat, PEEP, Compliance, TVinsp, Tvexp, MVinsp,
and MVexp.
Spiro2 — shows the same parameters as the basic view plus Pmean, I:E, and Raw.
For both views, TVinsp/exp and MVinsp/exp values are displayed according to the Spirometry Setup
selections.
17-3
To select the spirometry values for the split screen display:

3 Select Split Screen and choose from the options.
Patient Connections
To make the connections:
1 Connect a new spirometry tube to the flow sensor by inserting the angle connectors into the
sensor connectors.
2 Connect the other end of the spirometry tube to the pressure connectors on the monitor.
3 Connect a gas sampling line to the luer connector on the other side of the flow sensor.
4 Connect the other end of the gas sampling line to the sampling line connector on the D-fend
water trap. Confirm that the connections are secure.
5 Select the type of sensor you use, D-lite (the factory default) or Pedi-lite:
Press the ComWheel and select Parameters. Then, select Airway Gases and Spirometry
Setup. Select Sensor Type and choose the sensor.
6 Complete the other patient connections as shown below.
Patient tubes
1 2 3 4
Sampling line
connector
Spirometry 5
connectors
Figure 17-4: Patient spirometry set-up
Y-piece
Spirometry tube
D-lite sensor
Bacterial filter
Gas sampling line
17-4
Spirometry
To prevent condensed water from
entering the lines, position the gas
sampling line and the spirometry tube
connections so that they head upward
from the patient.
Figure 17-5: Connector positioning
The gas sampling line can be aligned along the groove of the spirometry tube for a more
serviceable setup.
Note:
• If you are using a nebulizer to administer medication, disconnect the HME-F filter
and the flow sensor while the nebulizer is in use.
• When using a Bain circuit, the inspiratory volumes are erroneously high. This can
be corrected by using a filter.
Selecting the Sensor

Adult and pediatric patients are measured with different sensors.
To select the correct sensor type:
3 Select Spirometry Setup.
4 Select Sensor Type and choose Adult or Pedi.
Both D-lite and Pedi-lite sensors also work as airway adapters with a connector for airway gas
monitoring.
Adult D-lite Sensor

D-lite sensors are reusable (transparent yellow) or disposable (non-transparent yellow).
The D-lite sensor is for patients with

a tidal volume of 150 to 2000 ml.
The filter smoothes the flow profile
and prevents mucus or humidity
from entering the D-lite.
The outer diameter of the D-lite at
the patient end allows connection of
the D-lite sensor to a mask.
Figure 17-6: D-lite sensor
17-5
Pediatric Pedi-lite Sensor

Pedi-lite sensors are reusable (transparent yellow).
The Pedi-lite sensor is intended for

patients having a tidal volume from
15 to 300 ml.
Figure 17-7: Pedi-lite sensor
Spirometry Setup
To open the Spirometry Setup menu:
3 Select Spirometry Setup.
Note:
For detailed information about the Scaling selection, refer to Scaling of Loops and
Waveforms on page 17-9.
4 Select Sensor Type and choose Adult (the factory default) or Pedi (pediatric) according to the
flow sensor in use.
17-6
5 Select TV or MV and choose tidal volume (TV) or minute volume (MV) for display in the digit
Spirometry
field. Your selection also affects the Spiro1 Split Screen.
6 Select Paw Alarms to open the Paw Alarms Adjustment menu. You can adjust Ppeak and
PEEP alarms in the same menu.
7 Select MVexp Alarm to open the MVexp Alarms Adjustment menu.
Spirometry Loops
Spirometry parameters are viewed in the Spirometry display.
• If CO2 is detected and the respiration rate is below 15/minute, the loops are updated every
breath.
• If no CO2 is detected or the respiration rate is 15/minute or higher, the loops are updated
every other breath.
The values are always updated breath by breath.
To open this menu:
3 Select Spirometry Loops.
17-7
Spirometry Selections
Print Saved
Prints the saved loops.
You can also print all saved loops by pressing the ComWheel and selecting Record/Print
from the Main menu. Then select Print Loops.
Paw-Vol Loop
Displays the pressure-volume loop. A 45° angle is equal to a compliance of 30 ml/cmH2O
for adults and 10 ml/cmH2O for pediatrics.
With pediatric measurement, the ratio of the loop axis is changed to maintain the
normalized 45° loop slope also in pediatric measurement.
Flow-Vol Loop
Displays the flow-volume loop.
Scaling
Changes the size of the Paw-Vol and Flow-Vol loops. Refer to Scaling of Loops and
Waveforms on page 17-9.
Save Loop
Saves up to six pairs of reference loops in memory. Both loops are saved at the same
time. When more than six pairs are saved, the most recent one is erased from the memory
and the Saving next will override last loop message is displayed.
The time the saved loop pair is saved appears at the upper right of the spirometry view. A
frame around the time of saving indicates which loop is currently displayed.
Reference Loop
Recalls a selected reference loop from memory. One real-time loop and one reference
loop are displayed simultaneously.
To recall, highlight the stamp of the loop with the ComWheel and press the ComWheel.
The real-time loop is drawn with a blue line, the reference loop is drawn with a white,
dotted line.
Flow-Vol loop Paw-Vol loop
60 Flow 1200 Vol

l/min ml
Vol
ml
1200 0
Paw
cmH20
Ð60
0 40
–––– Reference Loop

Real-Time Loop
17-8
Reference Off
Spirometry
If you do not want the reference loop to be displayed, choose this option.
Erase Loop
Erases the selected reference loop from memory.
To erase, turn the ComWheel to highlight the number of the loop. The loop is drawn with a
blue line. Press the ComWheel to erase.
To return to the menu without erasing a loop, select Exit instead of the number of the loop.
Scaling of Loops and Waveforms

If the flow or pressure waveform, or flow, volume, or pressure axis of the loop is not drawn to suit
your needs you can change the scaling.
To change the scaling:
1 Press the ComWheel and select Parameters

from the Main menu.
3 Select Spirometry Loops or Spirometry
Setup.
4 Select Scaling.
Scaling
AUTO (the factory default) automatically adjusts the scaling of parameters to suit the
situation. Complete loops and waveforms are always displayed.
Vol results in interdependent scales. A change to one scale affects the others so that the
ratio between pressure and volume and flow and volume scales remains constant.
Indep. allows independent and separate changes to the volume, pressure, and flow
scales. A change in one scale does not affect the scaling of other scales. This selection
may be needed, for example, with pediatric or ARDS patients whose airway pressure is
high but the tidal volume low.
17-9
Scaling Speed
Changes the speed at which loops and waveforms are rescaled during AUTO scaling.
Slow rescales to a higher scale after two breaths are above the selected scale. Rescaling
to a lower scale occurs after four breaths are within the limits of the lower scale.
Fast rescales to a higher scale after one breath is above the selected scale. Rescaling to
a lower scale occurs after two breaths are within the limits of the lower scale. For example,
select Fast as the scaling speed for manual ventilation.
Figure 17-8: Vol Scale, Paw Scale, and Flow Scale options
Calibrating
The flow measurement should be calibrated once a year, or when there is a permanent difference
between inspiratory and expiratory volume.
Calibration should be performed by trained service personnel using a special spirometry tester
designed by Datex-Ohmeda. For more information, refer to the Ultracare SLP100 Technical
Reference Manual (P/N 070-1205-xx).

This section describes other adjustable features related to patient spirometry measurement. A
password is required for entering the Install/Service menu where the adjustments are made. If
you wish to make changes, we recommend that you contact the person responsible for the entire
configuration.
17-10
Spirometry
You can choose yellow, white, green, red, or blue as the color used in the waveform and digit
fields for CO2, O2, N2O, agent gas readings, Paw, and Flow. You can also select orange or violet
for gases.
To change the color:
3 Select Colors.
4 Select Gases or select More Parameters and Paw or Flow.
5 Choose the color.
Specifying Measurement Conditions

You can specify measurement conditions of pressure, temperature, and humidity for volume
measurement.
4 Select Units.
5 Select Parameters.
6 Select TV based on and choose ATPD, NTPD, BTPS, or STPD.
TV Measuring Conditions
Table 1: TV Measuring Conditions
Relative
Condition Temperature Pressure
Humidity
ATPD Ambient Ambient 0%
NTPD 20° C (68° F) 760 mmHg 0%
BTPS 37° C (98.6° F) Ambient 100%
STPD 0° C (32° F) 760 mmHg 0%
17-11
Contents
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Starting Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Changing the Stimulus Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Changing the Cycle Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Changing the Stimulus Current . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Enabling Recovery Note . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Stopping and Restarting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Measuring Deep Relaxation with PTC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Regional Block Stimulation (Plexus Stimulation) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Measurement Limitations and Artifacts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Overview
The Ultracare SLP100 monitor with the NMT option delivers stimulating electrical pulses to a
motor nerve and measures the muscle response to these stimulations.
Two electrodes are needed for electrical stimulation of a peripheral nerve. The resulting response
can be measured with a MechanoSensor or an ElectroSensor.
• The MechanoSensor is attached between the thumb and index finger. It is easier to use and
more suitable for routine clinical use. It measures movements with a piezoelectric wafer.
• The ElectroSensor uses three recording electrodes for electromyography (EMG) and is mainly
intended for research purposes.
Displaying NMT
You can choose three different NMT views on the display: current numeric values, waveforms
illustrating the progression of the stimulation responses during measuring, and graphical trends.
Note:
When waveforms are selected for the display, the digit field with the NMT measurement
disappears automatically.
Selecting NMT on a Digit Field

To select an NMT digit field:
4 Select one of the fields and choose NMT.
18-1
Selecting NMT on a Waveform Field

During the NMT stimulation cycle, you can observe the progression of the stimulation responses
as waveforms. The waveform display is mainly for research purposes.
To select an NMT waveform field:
4 Select one of the fields and choose NMT.
The first waveform is saved as a reference waveform automatically. It appears on the background
of the display during other measurements. The reference waveform is a different color than the
real-time NMT waveform.
Patient Connections
Before connecting the electrodes, clean the application site of oil or dirt. Avoid placement over
excessive body hair or lesions. Pay attention to the condition and placement of the electrodes.
Good signal quality requires good skin contact with the electrodes. Only Spacelabs Medical-
approved NMT electrodes are recommended.
Stimulating Electrodes
To stimulate the motor nerve correctly on standard conditions, the stimulating electrodes (white
and brown) are recommended to be placed along the ulnar nerve on a site where the nerve is as
near to the skin as possible.
To locate the nerve, locate the ulnar artery which runs side by side with the ulnar nerve. The wrist
area is the easiest site for locating the artery, and thus the nerve. The wrist area is a site where the
nerve is near the skin. Fat or muscle does not hinder detection at this site.
Figure 18-1: Ulnar nerve and the corresponding muscles
18-2
Warning

• Electrical Shock Hazard. Do not place the NMT stimulation electrodes on the
patient’s chest.
• Electrical Shock Hazard — Always stop the NMT measurement before
handling the stimulation electrodes.
electrosurgery unit to your patient to avoid possible burns at sensor sites.
• Patient Safety — Make sure that the lead set clips do not touch any
electrically conductive material including earth.
The electrodes should not touch each other.
Figure 18-2: Stimulating electrodes
18-3
ElectroSensor Setup
Grounding Electrode
For measuring EMG response, the grounding electrode (black) may be placed where convenient,
but placing it between the stimulation and recording electrodes at the palmar groove may reduce
stimulation artifact.
Figure 18-3: Grounding electrode of EMG measurement
Recording Electrodes
Place one green recording electrode on the adductor pollicis. Place a second recording electrode
on the muscle's tendon or insertion site. The hand should be immobilized.
Figure 18-4: Measurement from the adductor pollicis muscle
18-4
The adductor pollicis muscle is customarily used for the measurement. When the thenar is

preferred, electrode placement becomes crucial. The adductor pollicis and flexor pollicis brevis
muscles lie next to each other and may be recorded on the radial surface of the palm between the
first and second metacarpals. Interference due to median nerve stimulation is more likely than on
the hypothenar side.
Cable Set
Figure 18-5: NMT setup with ElectroSensor
NMT sensor cable

ElectroSensor
MechanoSensor Setup
The MechanoSensor is attached between the thumb and index finger with a piece of tape. Make
sure that the thumb can move freely.
Figure 18-6: MechanoSensor attachment
18-5
Cable Set
Figure 18-7: NMT setup with MechanoSensor
NMT sensor cable

MechanoSensor
Starting Measurement
NMT monitoring should be started before a muscle relaxant drug is administered. It is, however,
advisable to begin after the induction of sleep to prevent voluntary muscle contraction and tension
from interfering with the reference search.
If the patient is already relaxed, the reference level is not usually found, however, monitoring can
proceed without a reference level. In some cases, the reference level may be found but may be
erroneous.
To start a measurement:
1 Press the NMT key.
2 Select Start-Up.
Supramaximal Current Search

The monitor begins by searching for the supramaximal stimulation current, which is needed for
activating all the fibers of the stimulated (recorded) muscles. When a stimulation pulse is
delivered, a star (*) is displayed in the digit field for each pulse. Optionally, a beep will sound at the
same time. The delivered stimulus current is measured and the star is displayed if the current is
the same as adjusted.
The search for the supramaximal stimulation current begins with a 10 mA stimulus and the
response is measured. The current is increased by 5 mA steps until the increase in current does
not increase the response. This maximal current is automatically increased by 15%, resulting in a
supramaximal current.
18-6
Note:

When the ElectroSensor is used, a reference level for the stimulation responses is determined
after the search.
For adults, the supramaximal current is usually between 35 and 55 mA. The current is displayed in
the digit field during the search for supramaximal current. It is also displayed in the NMT Setup
menu directly after the current selection.
Defasciculating doses of nondepolarizing neuromuscular blocking agents (precurarisation) do not

normally affect the supramaximal current or the reference value.
Supramaximal current may not be found if the patient is already relaxed. If the supramaximal
current is not found or if the response is too weak for searching a supramaximal current, the
current is set to 70 mA.
If the monitor is unable to find the supramaximal stimulation current, the fault is usually in the
electrode placement—the nerve is outside the dense current flow or both the ulnar and median
nerves are stimulated. Progressively more muscle activity is detected as the increasing stimulation
current activates new motor units.
Increasing Pulse Width

To help find the supramaximal current, you can increase the pulse width to increase the
effect of the stimulation:

2 Select NMT Setup.
3 Select Pulse Width and 300 ms.
4 To start a new measurement, select Start-
up in the NMT menu.
18-7
Determining Response Reference Level

The supramaximal current search is followed by determination of a response reference level.
The monitor delivers four stimuli of supramaximal current at 1-second intervals. A mean of four
stimulation responses is calculated and is determined as a 100% reference level.
• With the ElectroSensor, this reference is used to calculate the T1% (T1/Tref *100), the ratio of
the first twitch’s response to the determined reference level.
• With the MechanoSensor, the reference is used only for scaling the bar graph.
Each stimulation response is displayed as a bar in the digit field. If the bars are not similar, the
responses are not repeatable and the reference level will not be accepted.
If the patient is paralyzed at the time of start-up, it does not make the measurement impossible or
the results useless. When nondepolarizing blocking agents are used, the responses will fade and
the reference value is rejected, however, values other than T1% are available.
If the block is depolarizing at start-up, T1% should not be used because the reference level is
incorrect.
Changing the Stimulus Mode

Note:
To ensure a correct reference value, the stimulus mode should be changed before monitoring
starts.
To change the stimulus mode:
2 Select Stimulus Mode.
3 Select the stimulus mode
(TOF, DBS, or ST).
18-8
Train of Four (TOF) Stimulation

Train of Four (TOF), the factory default setting, is recommended for most cases.
During Train of Four stimulation, four stimulation pulses are generated at 0.5-second intervals.
The response is measured after each stimulus and the ratio of the fourth to the first response of
the TOF sequence is calculated, resulting in TOF%.
If you use the ElectroSensor, T1% is displayed below the

stimulation pulse bars, and a scale is included if the
reference is successfully found. Scale markers
represent 0%, 25%, 50%, 75% and 100% reference
values.
NMT
When no reference is available, no T1% is displayed and
TOF% 30
Count 4 the displayed bars are not scaled.
0 20 sec
When relaxation deepens, the TOF% declines until the

fourth response disappears and no TOF% is calculated.
When no TOF% is available, the degree of neuromuscular block is estimated from the number of
responses, or Counts. The Count tells how many responses have been detected to the 4 stimuli.
The fewer responses detected, the deeper the relaxation.
Number of Responses Neuromuscular Muscle Power

(Count) Block (% of Control)
1 95% 5%
2 90% 10%
3 85% 15%
4 75% 25%
Perioperatively, this can be seen in the trends where the bars represent the TOF%.
Figure 18-8: Perioperative stimulus response
Adequate clinical recovery from competitive block is normally reached when the TOF% is over 70.
18-9
Double Burst Stimulation (DBS)

Double Burst Stimulation (DBS) enables better visual observation of fading responses. It is
practical when the MechanoSensor cannot be used with infants.
For example:
DBS includes two separate bursts where each burst consists of three pulses directly after
each other, at 50 Hz frequency. The response ratio of the second to the first burst is
calculated, resulting in DBS%. DBS% is equivalent to TOF%.
Single Twitch (ST) Stimulation

In single twitch stimulation, one pulse is generated and its response is measured. Single Twitch is
practical when using depolarizing relaxants, since TOF% does not give additional information
about the state of the patient.
Changing the Cycle Time

Check that the desired cycle time is selected.
To change the cycle time:
2 Select Cycle Time.
3 Select the time interval.
Note:
The TOF and DBS cycle times are as
shown. The ST cycle times are 1, 10, and
20 seconds.
18-10
Changing the Stimulus Current

Check that the correct stimulus current strength is set. The current is either supramaximal
(automatic start-up search) or manually selected between 10 and 70 mA. Smaller currents may be
desirable for children.
To change the stimulus current:

2 Select NMT Setup.
3 Select Current and choose the current.
18-11
Enabling Recovery Note

The Recovery Note alarms when the count reaches the set value. It indicates that the patient is
responding more clearly to the stimuli and the neuromuscular block is decreasing. The note can be
used, for example, to help maintain a certain relaxation level.
To make the note operative and set the limit for the alarming count number:

2 Select Recovery Note.
3 Select the count limit for activating the
note.
When the note is activated, you will hear a
note sound and a beep. The Block recovery
message is displayed.
Activation Principle
Activation of the note depends on the Count number set as the recovery note and the cycle time.
When the cycle time is less than one minute, the monitor requires that the Count is below the
Count limit in two successive measurements before the Recovery Note is enabled. Then, to give
the note, the monitor requires that the number of Counts exceeds the limit, or is the same as the
limit, twice in one minute. The note disappears when two measurements are below the limit again.
If the cycle time is one minute or more, or if the measurement is done manually, the monitor
requires that at least one Count is below the chosen limit before the note is enabled. Then, to give
the note, the monitor requires one Count to exceed or to be the same as the Count limit. The note
disappears when one measurement is below the limit again.
Stopping and Restarting

• To discontinue the NMT measurement, press the NMT key and select Stop.
• To continue with same patient, press the NMT key and select Continue.
Do not select Start-up if you want to preserve the current and reference values.
18-12
Measuring Deep Relaxation with PTC

When neuromuscular block deepens, different parameters are needed to measure the response.
At first, when the response to the fourth TOF stimulation pulse disappears, or the first twitch is very
weak, the TOF% is not available and only the number of detected counts can be observed.
Table 1: Relaxation Meter
100 TOF% 20 4 Count 0 10 PTC 0
Light Deep
When stimulation pulses no longer give any stimulation response, the Count is not available either.
To monitor the relaxation level, you can start tetanic stimulation and estimate the relaxation level
from the Post Tetanic Count (PTC).
Tetanic stimulation is a continuous, 5-second stimulation. The stimulation makes the muscle more
responsive. After the tetanic stimulation, single-twitch stimulations are generated. The number of
detected responses to the stimulations is counted and expressed as PTC. The fewer responses
detected, the deeper the relaxation.
For example, when the patient is relaxed with pancuronium, the TOF response will return in about
5 minutes when PTC is 8, and in 15 minutes when PTC is 5. These values are general guidelines
and may differ from case to case.
If the responses do not fade away, a maximum of 20 responses are counted and >20 is displayed.
After tetanic stimulation, NMT measurements are stopped for one minute. After this the monitor
continues with the previously selected cycle automatically.
Regional Block Stimulation (Plexus Stimulation)

Regional block stimulation is used for locating a nerve.
Regional block requires its own adapter cable. When the regional block adapter cable is
connected, the Regional Block menu can be selected from the NMT menu. Once the cable is
connected, the digit field displays only the stimulation current value.
The monitor delivers single stimulation pulses at a selected rate until manually stopped. The
responses to these stimulations are observable visually, the monitor does not measure them. You
adjust the current manually.
18-13
To manually adjust the current:

1 Set up the regional block cable, adapter, and needle as shown below.
Figure 18-9: Sensor cable, regional block adapter, and needle with syringe
2 Connect the cable to the NMT connector on the monitor.

4 Select Cycle Time and choose the cycle time.
5 Select Regional Block to open the Regional Block menu.
6 Select Run.
The monitor is automatically in single twitch mode.
When the needle approaches the motor nerve, reduce the current so that the response stays
small. The closer the needle is to the nerve, the lower the current that is needed to give a
response.
Note that the pulse width is 40 µs and somewhat higher currents may be needed when
compared to other similar systems. However, shorter pulse width is less painful to the patient.
7 To stop the stimulation, select Stop in the Regional Block menu.
18-14
Measurement Limitations and Artifacts

Stimulation Artifact
If electrodes are placed incorrectly, the wrong nerves are stimulated. Consequently, the wrong
muscles are stimulated and the measuring electrodes are improperly placed to measure the
stimulation response.
When multiple nerves are stimulated, the measured response may be affected by the electrical
activity of other muscles.
If the stimulation electrodes are placed very close to the palm of the hand, the muscles are
stimulated directly by the stimulation pulses.
If the current is too strong, the muscles may be stimulated directly by the current.
Movement Artifact
All movements of the hand are measured as a response to the stimulation. Therefore, moving or
touching the patient during a measurement may cause incorrect results. If possible, immobilize the
hand during NMT measurements.
Electrosurgery
The measurement results may be incorrect during electrosurgery.
Verifying Reliability
The reliability of the response can be estimated by looking at the bar graph or the NMT trend.
The bars of the graph should be in a smoothly descending order from left to right, and the NMT
trend should indicate that the T1% has remained steady. If this is not the case, the newest
response is unreliable. Relaxation level does not usually decrease greatly in one minute even with
short-acting relaxants.
To verify the observations, start a new measurement manually right after completing the previous
measurement. Sometimes the selected cycle time has been so long (five minutes, for example)
that the relaxation level has changed considerably between the measurements.

This section describes other adjustable features related to NMT measurement. A password is
configuration.
18-15
Selecting NMT Trend

If you want the NMT trend in a Trend field or you want to change the NMT trend page
number, do the following:

password.
4 Select Graphical Trends.
5 Select the page you wish.
6 Select the field and choose NMT.
18-16

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Spacelabs Medical, Inc.

Authorized EC Representative UNITED KINGDOM

Setting ECG Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-15

Responsibility of the Manufacturer

Disposal of Electrical and Electronic Equipment

Ultracare SLP100 Model and Options

Hemodynamic Monitor with Airway Gas Measurement

N-XC Carbon Dioxide (CO2)

N-XCO CO2, N2O, and Patient Oxygen (O2)

N-XCAiO CO2, anesthetic agents, agent identification, N2O, and O2

N-XP Two invasive pressure channels and second temperature (T2)

N-XV Patient Spirometry (N-XCO or N-XCAiO option required)

N-XOSAT Datex-Ohmeda enhanced pulse oximetry (SpO2)

N-XNSAT Nellcor compatible pulse oximetry (SpO2)

NeuroMuscular Transmission (NMT) for relaxation measurement and

Data Collection and Management Options

Abbreviation Description Order code

N-XC Airway Gas Option (CO2) 014-0030-xx

N-XCO Airway Gas Option (CO2, O2 and N2O) 014-0010-xx

Airway Gas Option (CO2, O2, N2O and

N-XV Patient Spirometry Option 014-0402-00

Invasive Pressure Option with second

N-XREC Recorder Option 014-0403-00

N-XNET Network Option 014-0404-00

N-XNMT NeuroMuscular Transmission (NMT) Option 014-0408-00

Parts of the Monitor

Power ON/STANDBY key

Patient Connectors Panel

Figure 1-2: Patient connectors

Connector for Ultracare SLP100 standard pulse oximetry

Figure 1-3: Ultracare SLP100 rear panel

Rear Panel Connections

• Attention! Read accompanying instructions, including all warnings and

The monitor is connected to the network.

Data Card (green) and/or the Menu Card (white) is inserted.

Battery operation and remaining capacity.

Type CF applied part (IEC 60601-1). Defibrillator-proof protection against electric

Equipotentiality. Monitor can be connected to potential equalization conductor.

ESD warning symbol for electrostatic sensitive devices. Pins of connectors

Symbol for non-ionizing electromagnetic radiation. Interference may occur in the

Delayed Standby Function

The operating time that remains is updated every minute.

Installation and Service

• Use only approved accessories, mounts and defibrillator-proof cables and

Electrical Shock Hazard

ECG, Impedance Respiration, Invasive Blood Pressure

ECG, Impedance Respiration, NMT

Invasive Blood Pressure

Patients with Pacemakers or Arrhythmia

Airway Gas Measurement

Invasive Blood Pressure

ESD Precautionary Procedures

ESD Precautionary Procedure Training

Test result of ST segment measurement algorithm testing.

Figure 4a halved amplitude: 5.5 seconds (4.8 to 5.9 seconds)

Auxiliary ECG Output

Noninvasive Blood Pressure (NIBP)

Invasive Blood Pressure

Pulse Oximetry, Standard