ESCORT Prism™ & Prism SE Patient Monitor Reference Manual Prism Model 20401 20403 Prism SE Model 20411 20412 20413 20414
ESCORT Prism™ & Prism SE Patient Monitor Reference Manual Prism SE Model 20411 20412 20413 20414 Prism Model 20401 20403 Federal law restricts this device to sale by or on the order of a physician.
Preface The ESCORT Prism and Prism SE Series monitors are intended only as an adjunct to patient assessment. They cannot replace skilled nursing care and proper surveillance. Carefully read this reference manual, all directions for use of monitor accessories, and all precautionary information before attempting clinical use of any Prism or Prism SE. Always keep high-risk patients under close surveillance.
Safety Considerations (Prism & Prism SE) Read the following sections before using the Prism or Prism SE monitors. These cautions and warnings are presented to both increase patient safety and prevent damage to the monitor. WARNING: Shock hazard. Do not remove cover. There are NO user serviceable parts. Contact qualified service personnel for all service and repair. Do not under any circumstances remove grounding conductor from power plug.
CAUTION: Always locate the Prism or Prism SE and its power cord away from any electrosurgery and diathermy equipment and its power cord and cables. CAUTION: When operating either the Prism or Prism SE monitor from an AC power source, the wall receptacle must be a three-wire, grounded, hospital grade outlet. Use only the monitor’s original hospital grade AC power plug and cord, or an equivalent hospital grade plug and cord.
Table of Contents Chapter 1 – Physical Description ........................................................................................................... 1-1 Prism & Prism SE Front Panel ..................................................................................................... 1-1 Fixed Function Keys (USA and International)............................................................................. 1-2 ON/STBY .................................................................................
AC Power Cord Input Connector and Optional Power Cord Mounting Bracket................. 1-13 Auxiliary Output Connector ................................................................................................ 1-14 Add-On Module Interface.................................................................................................... 1-14 Recorder Release Lever ....................................................................................................... 1-14 Model & Serial Number Label..
Measuring a Patient’s Temperature with Continuous Probes .............................................. 3-10 Measuring a Patient’s Temperature with SureTemp® .......................................................... 3-10 Noninvasive Blood Pressure Measurements (NIBP).................................................................. 3-11 Selecting an appropriate NIBP Cuff .................................................................................... 3-13 Displaying the NIBP Table......................
System Setup Factory Defaults .................................................................................................... 6-1 Recorder Factory Defaults............................................................................................................ 6-2 Vital Signs Chart Factory Defaults............................................................................................... 6-2 ECG Setup Factory Defaults ..............................................................................
Chapter 9 – Clinical Information System.............................................................................................. 9-1 Introduction............................................................................................................................ 9-1 Operation ............................................................................................................................... 9-1 Accessing the CIS Menu.....................................................................
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Chapter 1 – Physical Description This section describes the controls, indicators, and features located on the front, back, and side panels of the Prism and Prism SE Patient Monitors. Prism & Prism SE Front Panel 1. Monitor On/Standby Keys 2. Battery Charging Indicator 3. AC Power Indicator 4. Alarm Indicator Lights When flashing, one or more parameters are alarming When lit, one or more alarms are suspended, OR all alarms are turned off 5. Alarm Suspend Key (180 seconds) 6. Alarm Setup Key 7.
10. Patient Type Selection Key (Adult, Ped, Neo) 11. Start/Stop Manual Recordings 12. Display System Setup Menu 13. Return to Home Page 14. Seven Parameter/System Softkeys Fixed Function Keys (USA and International) The Prism & Prism SE monitor includes the following nine (9) fixed functions keys: ON/STBY, ALARM SUSPEND, ALARM SETUP, FREEZE, NIBP START/STOP, PATIENT TYPE, SYSTEM SETUP, PAGE HOME, and RECORD.
ALARM SETUP Displays the alarm status for all vital sign parameters. Alarm ON/OFF status, alarm priority level, high and low limits, and recording type for each active parameter are displayed. A bell… … next to the listed parameter indicates that one or more alarms for that parameter is ON. An X is displayed when all alarms for the associated parameter are OFF. FREEZE Freezes all displayed waveforms for evaluation purposes. Pressing FREEZE again releases waveforms.
RECORD Initiates a 16-second recording of any one or two parameter waveforms. To stop a recording in process, press RECORD prior to completion of a manual or alarm recording. To specify the parameters to be recorded, press the softkey(s) of the desired parameter(s) within two seconds after pressing the RECORD key. If no parameters are selected after pressing record, a 16-second strip of ECG waveform will be recorded. NOTE: Active waveforms (i.e.
Indicators The monitor includes up to four indicators, which illuminate to notify the operator of a specific activity or situation. These indicators notify the operator of AC power, battery charging, and alarm status. AC ON INDICATOR The green AC ON LED (Light Emitting Diode) illuminates when the monitor is connected to AC power. BATTERY CHARGING INDICATOR The yellow CHARGING LED illuminates when the monitor’s batteries are charging.
Prism & Prism SE Display Screen 1. ECG Lead in Use 2. Softkey Labels for Parameters Displayed in the Waveform Display Zone (WDZ) 3. Alarm Status for Parameters in the Waveform Display Zone 4. Alarm Status for Parameters in the Numeric Only Display Zone 5. Numeric-Only Display Zone (NODZ) 6. Message Area for Parameters in the Numeric Only Display Zone 7. System Message Area 8. Message Area for Parameters in the Waveform Display Zone 9. Waveform Display Zone with Associated Numerics 10.
1. ECG Lead in Use Indicates the ECG lead displayed in the top trace of the WDZ. Choices include lead I, II, III, or V LD (and depending on hardware and software, choices may include aVF, aVL, or aVR) (for “chest lead” in a 5-lead configuration). If heart rate is being derived from SpO2 or Invasive Blood Pressure, PULSE is displayed. 2.
7. System Message Area A message that is not specific to a single parameter, such as “ALARMS SUSPENDED 180”, is displayed in a reverse-video box, just below the WDZ. Message display is temporarily obscured when a parameter or system setup page is displayed. In the HOME PAGE state, the message continues to be displayed as long as the message condition exists. 8.
Prism SE Rear Panel 1. External DC` Input Connector (optional) 2. Fuse Holder 3. AC Power Cord Input Connector 4. Battery Compartment 5. Model & Serial Number Label 6. Add-On Module Interface (MDE Modules) 7. Auxiliary Output Connector (optional) 8. VGA Output Connector (optional) 9. Serial Interface (ISP Port) 10.
1. External DC Input (12 - 28V) Connector Allows an external DC power source to be connected for extended use during transport where AC power is not available. Batteries are also charged with external DC power. 2. Fuse Holder and Fuse Replacement The fuse holder contains the fuses for the monitor. Open the door of this holder to replace fuses. It is recommended that qualified technical service personnel replace fuses when necessary.
4. Battery Compartment This compartment houses one battery (or up to two batteries on earlier units) which provide power in transport situations or when AC power is not available. 5. Model & Serial Number Label This label contains the model number and serial number of the monitor. 6. Add-On Module Interface If a transceiver module is connected here, wireless communications between the monitor and an MDE Central Station can be established.
Prism Rear Panel 1. External DC Input Connector (optional) 2. Equipotential Connector (grounding terminal) (optional) 3. Batteries 4. Defibrillator/ Pacer Interface 5. Fuse Holder/Voltage Selector 6. AC Power Cord Input Connector 7. Auxiliary Output Connector 8. Add-On Module Interface (J1 Connector) 9. Recorder Release Lever 10.
1. External DC Input (12 - 28V) Connector Allows an external DC power source to be connected for extended use during transport where AC power is not available. Batteries are not charged with external DC power. 2. Equipotential Connector (Grounding Terminal) Provides grounding for the monitor when the monitor is used with other medical equipment. It must be used as a protective ground terminal when the monitor is operated with external DC power. 3.
7. Auxiliary Output Connector Provides analog waveform or alarm relay closure interface signals from the monitor to other clinical instruments. WARNING: When connecting the Prism to any other instrument, verify proper operation before clinical use. Refer to the other instrument’s operation manual for complete instructions. 8. Add-On Module Interface If a transceiver module is connected here, wireless communications between the monitor and an MDE Central Station can be established.
Prism SE Side Panel 1-15
Connector Panel The Prism SE can monitor several parameters. They include ECG, SPO2, IBP (Invasive Blood Pressure), NIBP (Noninvasive Blood Pressure), Respiration, ETCO2, Cardiac Output and Temperature. Dual Channel Recorder The Recorder unit provides manual and alarm recordings of any one or two waveforms simultaneously. SureTemp Unit Allows you to take a patient’s temperature with different types of SureTemp probes and measurements sites.
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Multiparameter Module The Multiparameter Module is configured for several parameters; however your Multiparameter Module may be configured for fewer parameters. The parameters include ECG, SPO2, IBP (Invasive Blood Pressure), NIBP (Noninvasive Blood Pressure), Respiration, ETCO2, Cardiac Output, Temperature and SureTemp. This module may be interchanged with any Prism monitor. Dual Channel Recorder Module The Recorder module provides manual and alarm recordings of any one or two waveforms simultaneously.
Prism’s Modular Components There are several modular (user-movable) components that can be shared by all Prism monitors. • Multiparameter Module (MPM) – allows you to share various configurations of parameters between monitors. • Dual Channel Recorder Module – provides manual and alarm recordings of any one or two waveforms simultaneously. • Modular Batteries – supplies battery power to the Prism monitor for operation in transport situations, or when AC power is not available.
Prism SE’s Modular Components There are several modular (user-movable) components that can be shared by all Prism & Prism SE monitors. • Transceiver Module – provides two-way wireless communication to the ESCORT-Link or ESCORT Vision Central Station, and serves as a repeater for the wireless network. • Telemetry Module – allows for bedside monitoring of telemetry patients. • CIS Communication Module – provides serial and Ethernet TCP/IP interface to HIS/CIS systems for automated charting.
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Chapter 2 – General Instructions for Using the Patient Monitor Determine the Power Source The Prism and Prism SE can be powered in one of three ways: AC, battery, and external DC power. An optional auxiliary DC connector (center pin positive) labeled EXT DC 12-28V, 30VA is located on rear panel of monitor to allow external DC power source when AC is not available. NOTE: Monitor should be plugged into AC power at every opportunity to allow batteries (optional) to charge.
To install the Multiparameter Module: 1. Align the Multiparameter Module’s front panel with the parameter labels facing you and right-side up. Insure the edges of module are square with the edges of monitor housing. 2. Push the Multiparameter Module into monitor until it clicks into place. To remove the Multiparameter Module: 1. Turn power OFF by pressing the STBY key or unplugging the power cord. 2. Release the Multiparameter Module by squeezing the side handles toward center of module. 3.
ALARM ON/OFF—Allows alarm to be turned ON/OFF. ALARM LIMITS—Allows adjustment of limits through use of ↑↓ arrow keys. SIZE/SCALE—Allows adjustment of waveform in size or sensitivity. In an invasive waveform, allows adjustment of scale for waveform being displayed. TONE—Allows audible tone for ECG, SpO2, and Respiration. WF ON/OFF—Allows waveform for vital sign to be turned ON or OFF. VITAL SIGN ON/OFF—Alarms for vital sign must be turned off to allow vital sign to be turned off.
2. Press the TRACE SEL softkey to open the following menu. DISP VSC DISP OCRG TRACE 2 AUTO TRACE 3 AUTO TRACE 4 AUTO MORE 3. Press the softkey under desired TRACE until the parameter to be displayed is highlighted. Note that the only available parameters are those that are turned ON. 4. Press the PAGE HOME key. The change will occur on the screen. Note that by selecting AUTO, the monitor will automatically assign parameters to traces according to the factory-defined hierarchy.
6. Use the UP ARROW ↑ ↑ and DOWN ARROW ↓ ↓ softkeys to adjust the date and time settings. 7. Press the PAGE HOME key. Monitor Default Settings If you need to change power-up defaults so that your monitor powers up every time in a specialized mode or with settings different than the factory defaults, please refer this process to service personnel.
To adjust tone volumes for all parameters: 1. Press the SYSTEM SETUP key to open the System Setup menu.
CLEAR PT DATA STORE VS DISP VSC PT SETUP HR AUTO ECG TRACE SEL MORE 2. Press the MORE softkey to open the following menu. ADULT PED NEO VOL DISP OCRG REC SETUP TIMER CLOCK MORE 3. Press the VOL softkey to cycle through the 8 volume selections. The menu that displays after pressing VOL also allows you to set up tone volumes for all parameter alarms. NOTE: Minimum alarm volume can be defined in the power-up defaults.
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Chapter 3 – Vital Sign Parameter Usage NOTE: The Prism SE monitor can be used during defibrillation, but certain parameter readings may be inaccurate for a short time. ECG Prism and Prism SE monitors provide clinical viewing of the conduction of electrical impulses through various parts of the heart (ECG). Limb lead (I, II, and III) measurements are available when using a 3-lead ECG cable.
Patient Preparation When doing any patient monitoring, proper skin prep and electrode placement are critical to ensuring patient safety as well as accurate ECG, heart rate, and respiration readings. Follow the steps and diagrams below carefully: 1. Shave areas where electrodes are to be applied if hair is present. 2. For adult patients, rub electrode location briskly with dry gauze until skin is pink.
Neonatal Electrode Placement This placement is also good for RESP monitoring Alternate Method: Position RA and LA electrodes at the 2nd intercostal space, midclavicular line To monitor a patient’s ECG: 1. Open the ECG SETUP menu by pressing the softkey next to the ECG label. ALM ON OFF ALM LIM SIZE LEAD SEL PACE ON OFF MORE 2. Press the ALM LIM softkey to adjust the values for current heart rate alarms. 3. Press the SIZE softkey to allow increase or decrease of QRS display.
Selecting a Telemetry Patient to Monitor “Telemetry-monitored” patients must be prepared properly for telemetry functions to work. A 3-lead or 5-lead ECG cable (depending on the type of transmitter used) must be correctly connected to both the patient and the telemetry transmitter. The transmitter must then be secured to the patient with an appropriate transmitter pouch. 1. Open the ECG SETUP menu by pressing the softkey next to the ECG label. ALM ON OFF ALM LIM LEAD SEL SIZE PACE ON OFF MORE 2.
Respiration Respiratory monitoring may be done either by impedance pneumography via ECG leads of RA (right arm) and LA (left arm) or through ETCO2. Location of ECG electrodes may need to be altered to allow correct count of RESPS. Review lead placement charts for respiratory monitoring. The monitor can be set to look via an AUTO mode for source of RESPS. To monitor a patient’s Respiration: 1. Open the RESP SETUP menu by pressing the softkey next to the RESP label. ALM ON OFF ALM LIM SIZE MM/S 25 12.
Pulse Oximetry (SPO2) A noninvasive method for continuously measuring oxygen saturation and pulse rate. Hospital policies, along with the sensor's directions for use, should be followed in care and rotation of monitored sites. Insure correct sensor is being used for the type of oximetry in your monitor. To monitor a patient’s SPO2: 1. Apply sensor to appropriate sensor site on patient. SPO2 monitoring commences automatically. 2. Open the SPO2 menu by pressing softkey next to SPO2 label.
MODE for Nellcor MP405 *NORM (NOT USED) FAST (NELLCOR Mode 2) Averaging Time Application (NOT USED) (NOT USED) Typically 7-8 seconds for average pulse. All monitoring situations. Varies + – with pulse quality and other functions. *SLOW (NOT USED) (NOT USED) (NOT USED) *Nellcor OxiSmartXL Technology has eliminated the need for operation in NORM and SLOW modes. Refer to the following NOTE.
SPO2 Sensor Accessories—Nellcor Nellcor Sensors – Contact Nellcor Sensor Model Patient size Oxisensor® II oxygen transducers (Sterile, Single-use only) N-25/N-25LF I-20 D-20 D-25/D25-L R15 <3 or > 40Kg 3 to 20 Kg 10 to 50Kg >30Kg >50Kg Oxiband® oxygen transducer (reusable with nonsterile adhesive) OXI-A/N OXI-P/I <3 or > 40 Kg <3 to 40Kg Durasensor® oxygen transducer (Reusable, Nonsterile) DS-100A >40Kg OxiCliq® oxygen transducers (sterile, single use only) P N I A 10 to 50 Kg <3 or > 40Kg 3 t
• • There is arterial occlusion proximal to sensor Patient is in cardiac arrest or is in shock SPO2 Sensor Accessories—Masimo Name/Type ® Model Number ® LNOP - ADT LNOP - ADT ® ® LNOP - PDT LNOP - PDT ® ® LNOP - NEO LNOP - NEO ® ® Application Adult, digit Adult/Pediatric Neonatal < 10 kg LNOP - NEO PT Neonatal < 1 kg LNOP® - DC I Adult/Pediatric PC04 Patient Cable: 4 Ft. PC04 Adult/Pediatric/Neonatal PC08 Patient Cable: 8 Ft.
Temperature Monitoring The Prism and Prism SE can accommodate a variety of continuous temperature probes, as well as MDE SureTemp oral/axillary and rectal fast temperature probes. The unit automatically senses and configures the monitor for the probe type that it detects. MDE SureTemp temperature measurements can be accomplished in either “normal” or “monitor” modes. In normal mode, the thermometer “predicts” body temperature in about 4 seconds for oral readings and 15 seconds for rectal.
T1 WAIT. DO NOT place probe into position until message reads T1 READY and an audible tone is heard. 3. When ready, place probe in position. ORAL and RECTAL methods require caregiver to hold probe in position. 4. An audible tone for NORM mode signals completion of the measurement. A message on screen displays T1 FINAL. The MONIT mode is continuous monitoring of temperature so no audible tone will occur to signal a final temperature. The message on screen notes T1 MONITOR. 5.
Each NIBP reading, recording, and trend printout will display an ET (elapsed time) number. This number indicates the number of minutes that have passed since the start of the last NIBP measurement. To manually measure NIBP: 1. Select proper cuff size and patient-monitoring mode for patient. 2. Place cuff snugly on patient with artery indicator over artery to be assessed. 3. Press the NIBP/PNI START/STOP key. To set automatic intervals: 1.
Selecting an Appropriate NIBP Cuff For patient safety and accurate NIBP readings, it is essential to select an appropriate cuff for patient type and size being monitored.
Displaying the NIBP Table The Prism and Prism SE monitors stores up to 100 NIBP readings, as well as any other parameters being monitored, with their corresponding time of measurement. When you turn the NIBP table ON, the most recent readings will be displayed in tabular format in the NIBP trace (NIBP must be set up in one of the three lower traces in the waveform display zone). Additionally, tabular information for all other parameters being monitored will also display in their corresponding times.
10. Press the SITE softkey to cycle through site labels for invasive pressure line. Highlight desired site. 11. Press the MORE softkey to access second page of menu. SMD S/D MEAN CAL BP1 ON OFF 12. Displayed values for SYSTOLIC/MEAN/DIASTOLIC are chosen by pressing the SMD-S/D-MEAN softkey. 13. Press the CAL softkey to initiate a calibration wave (waveform must be displayed in trace). 14. Press the BP ON/OFF softkey to turn vital sign on/off. Alarm must be OFF to turn parameter off.
4. Press the CURSOR ↑↓ softkeys to align cursor bar with end expiration. Note value displayed on cursor bar and at bottom of screen changes as cursor bar is moved. 5. Press the SAVE PAWP softkey to store PAWP value for hemodynamic calculations. Press the FREEZE key to release (if FREEZE key was used to hold display). 6. For a PA catheter that is not to be wedged, the monitor can store pulmonary artery diastolic value in place of PAWP. Press the PAWP=CURSOR/PAD softkey to select PAD. 7.
If a BP in TRACE 4 or 5 is turned OFF, that BP will be removed from the waveform zone. The remaining BP will be expanded into the full Trace 4 area. The 5th TRACE Mode will then be terminated. Turning BP ON again will not restore it as the 5th TRACE. Cardiac Output and Hemodynamic Calculations The monitor allows cardiac output injections and hemodynamic calculations. Use only a SwanGanz® (or equivalent catheter). Follow hospital policy/procedure for assembling cardiac output setup.
Injections are labeled as RUN 1, 2, etc. Subsequent injections are completed once START is redisplayed. A total of 6 RUNS can be displayed. Further RUNS require deletion of one of the 6. 11. Press the VIEW RUN 1 (2-6) softkey to view injection. To delete the run, press DEL RUN 1 (2-6) softkey and press the YES softkey. 12. Press the AVG CO softkey after all runs to be computed in the average are present. The preliminary hemodynamic table is displayed.
End Tidal Carbon Dioxide (ETCO2) (Prism Only) End tidal carbon dioxide (ETCO2) monitoring can show early indications of circulatory and pulmonary problems. In order to have a “normal” ETCO2 (CO2) reading a patient must have active cellular metabolism that produces CO2, a functional cardiovascular system to transport CO2 to the lungs and a normal intrinsic pulmonary function or proper ventilator-assist function. The Prism monitor uses infrared absorption spectroscopy to measure CO2.
WARNING: Do not allow CO2 sensor to come in contact with patient’s skin for prolonged period of time. CO2 sensor heats to prevent fogging of airway adapter windows. WARNING: Do not use damaged sensor or one with exposed electrical contacts. Refer any servicing to qualified personnel. CAUTION: Do not apply tension to sensor cable. CAUTION: only. CO2 sensor is for use with approved airway adapters CAUTION: CO2 airway adapter is non-sterile and intended for single patient use only.
1. Inspect circular window on airway adapter for cracks or blemishes. Replace if necessary. 2. Attach airway adapter and sensor in line proximally to patient between endotracheal, nasotracheal or tracheal tube and ventilator circuit, T-tube setup or bag/valve setup. 3. Carefully press sensor down onto airway adapter being careful not to damage glass window. 4. Connect ETCO2 cable to port on monitor. Function automatically activates. 5. Allow device to warm up for 45-60 seconds.
ETCO2 (CO2) Sensor and Airway Adapter Maintenance (Prism Only) CO2 sensor is a precision instrument, which requires proper maintenance to verify accuracy and durability. Great care must be exercised in handling the CO2 sensor. There are no user serviceable parts inside sensor.
UNIT % mmHg O2 ON OFF N2O ON OFF ETCO2 allows numeric information and waveform to be displayed. ETCO2 waveform can be placed in a trace slot. Refer to configuration instructions. CAUTION: Do not over tighten FilterLine tubing in connector. CAUTION: The Microstream CO2 FilterLine tubing is for use with approved airway adapters only. CAUTION: CO2 airway adapter and FilterLine are non-sterile and intended for single patient use only.
1. Position nasal cannula on patient. 2. Connect ETCO2 tubing to Prism SE’s connector panel. 3. Observe WARM UP message on screen. ETCO2 monitoring will commence approximately 10 seconds following connection. If an error message appears, check tubing for blockage. If this does not correct problem, see the Troubleshooting section. Graphical Trends Graphical trend allows view of compilation of data collected for given parameter over defined time period.
Vital Sign Chart (VSC) VSC is a feature that allows storage, display, documentation and editing of vital signs. The monitor stores 100 sets of tabular vital signs with most recent visible when VSC is viewed. To continuously display VSC in a trace slot, refer to configuration page. 1. VSC can be temporarily viewed in trace slot. Press SYSTEM SETUP key, then softkey under DISP VSC. CLEAR PT DATA STORE VS DISP VSC PT SETUP HR AUTO ECG TRACE SEL MORE 2.
(bell) Entry made when an alarm is violated (alarming vital sign is shown in inverse video). n Entry made when a user-initiated NIBP reading is completed. a Entry made when an automatic (timed interval) NIBP reading is completed. t Entry made when a predictive SureTemp reading is completed. v Entry made when the user presses the STORE VS key (indicates “validated” entry). m Entry made when the vital signs are manually entered via the CIS module or Guardian telemetry transmitter.
CLEAR PT DATA STORE VS DISP VSC PT SETUP HR AUTO ECG TRACE SEL MORE 2. Press the CLEAR PT DATA softkey and press YES softkey. 3. Press the PAGE HOME key. Oxycardiorespirogram (OxyCRG/CRG) OxyCRG is an optional trend that allows display of compressed respiration waveform (1mm/sec) correlated with trend data derived from heart rate and SpO2 over most recent two minutes of monitoring. ECG, Respiration, and SpO2 must be actively monitored for proper monitoring of OxyCRG.
5. To remove temporary display, press the PAGE HOME key. To display OxyCRG in Trace 2: 1. Monitor ECG, Respiration, and SpO2. 2. Press the SYSTEM SETUP key. CLEAR PT DATA STORE VS DISP VSC PT SETUP HR AUTO ECG TRACE SEL MORE 3. Press the TRACE SEL softkey to display the following menu. DISP VSC DISP OCRG TRACE 2 CRG TRACE 3 AUTO TRACE 4 AUTO MORE 4. Press TRACE 2 until CRG is highlighted. 5. Press the PAGE HOME key. OxyCRG information will display in TRACE 2.
Alarms Alarm ON/OFF status and limits can be set from individual parameter menus or from ALARM SETUP page. Do not temporarily silence or disable audible alarm if patient safety would be compromised. During alarm, bell next to parameter will flash. To temporarily suspend patient alarms: 1. ALARMS IN CURRENT VIOLATION – Press the ALARM SUSPEND key to temporarily silence any alarm in violation. Note screen message says ALARM SILENCED.
understand the ramifications of turning alarms off, silencing alarms, suspending alarms, and resetting alarm criteria from factory defaults. Please read this section carefully. WARNING: Do not temporarily silence or disable an audible alarm if patient safety would be compromised. In the event of an adverse patient condition, the audio alarm will not sound if it has been temporarily silenced or disabled.
(FLASHING) A solid bell will flash if one or more alarm criteria are violated for associated parameter, and an alarm message will display in parameter’s message area. When monitored vital sign has returned within set up alarm limits, or when alarm is suspended, bell will stop flashing. On color monitor, bell will turn from white to red when in alarm. (BLANK) If there is no bell displayed, associated parameter is not enabled. Alarm Tones Alarm tone priorities can be assigned to each parameter.
Continuous recordings: 1. For ECG, press and hold the RECORD key for approximately three seconds. 2. For all other parameters, press the RECORD key followed by pressing softkey next to selected parameter for approximately three seconds. To stop a recording in progress: 1. Press the RECORD key to stop current recording. To install or remove the dual channel recorder module: (Prism only) 1.
CLEAR PT DATA STORE VS DISP VSC PT SETUP HR AUTO ECG TRACE SEL MORE 2. Press the MORE softkey to display the following menu. ADULT PED NEO VOL DISP OCRG REC SETUP TIMER CLOCK MORE 3. Press the REC SETUP softkey to access the Recorder Setup page. REC ON OFF DELAY ON OFF TRACE SNGL DUAL MARK EVENT MORE 4. Press MARK EVENT to access the event marker softkeys. MARK EVENT E1 MARK EVENT E2 MARK EVENT E3 MARK EVENT E4 MARK EVENT E5 MORE 5.
1. Press the door release to open recorder. 2. Remove the empty spool. 3. Install new roll with paper unrolling from bottom side. 4. Pull out five (5) inches (12.7 cm) of paper. 5. Close the recorder door. 6. Tear excess paper using downward motion.
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Chapter 4 – Additional User Information Wireless Communication to a Central Station The Prism and Prism SE monitors have the capability to send vital sign data and waveforms wirelessly to ESCORT-Link and ESCORT Vision central stations via modular transponders (900 MHz - MDE part #20011 or 20011V, and 2.4 GHz - MDE part #20019 or 20019V) that attach to the back of monitor. It is recommended service personnel install this if not already installed. NOTE: Transponders (both 900 MHz and 2.
Maintenance and Calibration There are no user-serviceable parts in Prism or Prism SE monitors. MDE recommends a yearly performance check to verify all functions on the Prism and Prism SE monitors. All maintenance and calibration should be performed by qualified personnel only. Refer to Chapter 9 in the ESCORT Prism or ESCORT Prism SE Patient Monitor Service Manual for periodic maintenance and calibration instructions. If returned to MDE, the Prism/Prism SE must be shipped in packaging specified by MDE.
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Chapter 5 – Main Setup Menus This section describes the main system setup and vital sign menus on the Prism and Prism SE monitors. The menus are the same for both monitor types. System Setup Menus Pressing the System Setup key accesses the following menus: CLEAR PT DATA STORE VS DISP VSC PT SETUP HR AUTO ECG TRACE SEL MORE CLEAR PT DATA—Clears all stored readings (NIBP, Temp) and trended data. STORE VS—Manually stores a Vital Sign Chart (VSC).
ECG Setup Menus ECG function menus are accessed by pressing the softkey adjacent to the ECG label. The menus are as follows: ALM ON OFF ALM LIM SIZE PACE ON OFF LEAD SEL MORE ALM ON OFF—Toggles ECG alarms ON or OFF. ALM LIM—Accesses alarm limits menu. SIZE—Accesses menu to increase/decrease ECG size. LEAD SEL—Accesses menu to select ECG cable (3/5) and ECG lead (I, II, III, V). PACE ON OFF—Turn on to reject and flag pacer artifact. MORE—Displays next menu. TONE ON OFF FILT ON OFF MM/S 25 12.
RR AUTO LEADS—Selects RESP source, ECG leads, CO2, or AUTO detect. APNEA DELAY 20S—Selects allowable apnea period before alarming. MORE—Displays the next menu. TONE ON OFF CVA ON OFF RESP ON OFF TONE ON OFF—Toggles RESP tone ON or OFF. CVA ON OFF—Toggles cardiovascular artifact detection ON or OFF. RESP ON OFF—Turns RESP monitoring ON or OFF. Pulse Oximetry (SPO2) Setup Menus SPO2 function menus are accessed by pressing the softkey adjacent to the SPO2 label.
SITE OFF ART—Adds label next to numeric to identify IBP sites. ZERO ALL—Zeroes all connected transducers. ZERO BP1—Zeroes the transducer offset. MORE—Displays the next menu. SMD S/D MEAN BP1 ON OFF CAL SMD S/D MEAN—Selects numeric display format. CAL—Simulates a 100/50 mmHg square wave (hold for 5-10 sec.). BP1 ON OFF—Turns BP monitoring ON or OFF. Noninvasive Blood Pressure (NIBP) Setup Menus Noninvasive Blood Pressure function menus are accessed by pressing the softkey adjacent to the NIBP label.
NIBP ON OFF—Press the NIBP softkey to turn ON or OFF. Continuous Temperature Setup Menus Continuous Temperature menus may be accessed by pressing the softkey adjacent to either of the Temp labels (TMP1, TMP2). Note that these menus are different for SureTemp (shown later): ALM ON OFF UNIT °C °F ALM LIM MORE ALM ON OFF—Toggles Temp alarms ON or OFF. ALM LIM—Accesses alarm limits menu. UNIT °C / °F—Switches between °C and °F for temperature measurement. MORE—Displays the next menu.
ALM ON OFF ALM LIM SCALE 50 75 MM/S 12.5 6.25 CO2 ON OFF MORE ALM ON OFF—Toggles CO2 alarms ON or OFF. ALM LIM—Accesses alarm limits menu. SCALE 50/75—Selects CO2 waveform scale (50, 75, 100 mmHg). MM/S 12.5/6.25—Selects CO2 sweep speed. CO2 ON OFF—Turns CO2 monitoring OFF (alarms must be disabled). MORE—Displays the next menu. UNIT % mmHg O2 ON OFF N2O ON OFF UNIT % / mmHg—Toggles measurement units (% or mmHg). O2 ON OFF—Toggles O2 compensation ON or OFF (Prism only).
CONST .470 (ARROW ON 4)—Use to change the tenths column of the constant. CONST .470 (ARROW ON 7)—Use to change the hundredths column of the constant. CONST .470 (ARROW ON 0)—Use to change the thousandths column of the constant. MORE—Displays the previous menu Vital Sign Chart (VSC) Setup Menus VSC menus are accessed by pressing the softkey adjacent to the VSC label.
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Chapter 6 – Factory Defaults When the Prism & Prism SE monitor is powered on for the first time, it will be in the Neonatal mode, and all parameters will be set to their factory defaults. Each parameter has defaults for adult, pediatric, and neonatal modes (ADULT, PED, NEO). All parameter and system defaults can be user-configured. It is important to recognize that changes made to these functions determine the status of those functions upon every subsequent power-up.
Recorder Factory Defaults RECORDER SETUP RECD DELAY ALRM RECDNG DUAL RECDNG REMOTE RECD ADULT ON ON ON OFF PED ON ON ON OFF NEO ON ON ON OFF ADULT PED NEO OFF ON ON ON OFF ON ON ON OFF ON ON ON 30 30 30 OFF ON ON ON ON ON ON ON OFF ON ON ON ON ON ON ON OFF ON ON ON ON ON ON ON DESCRIPTION Four second delay Alarm recording enable/disable Dual trace recording Telemetry recording Vital Signs Chart Factory Defaults VITAL SIGNS CHART STORE AUTO STORE NIBP STORE TMP STORE CO VALID TIME STORE ALAR
ECG Setup Factory Defaults ECG SETUP ALARMS ALARM LEVEL LATCH ALARMS HIGH LIMIT LOW LIMIT RCD ON ALARM FILTER SIZE VCTR 1 SIZE VCTR 2 SWEEP SPEED PACE DETECT LEAD SELECT 5 LEAD QRS TONE WAVEFORM ON PRAM COLOR ADULT ON 2 OFF 140 50 WF ON 1.00 1.00 25 OFF II OFF OFF ON GREEN PED ON 2 OFF 180 80 WF ON 0.80 0.80 25 OFF II OFF OFF ON GREEN NEO ON 2 OFF 200 100 WF ON 0.80 0.
SPO2 Setup Factory Defaults SPO2 SETUP ADULT PED NEO OFF ON ON ALARM LEVEL 2 2 2 Sets alarm priority level (1, 2, or 3) ALARM DELAY 5 5 5 Delay time for alarm LATCH ALARMS OFF OFF OFF Latches the SPO2 alarm until reset ALARM TONE STD STD STD Tone during alarm HIGH LIMIT 100 100 95 High alarm limit setting LOW LIMIT 85 85 80 Low alarm limit setting PRAM AVAIL ON ON ON SPO2 enable or disable PRAM ON / OFF OFF OFF OFF SPO2 standby RCD ON ALARM VS VS VS Record
BP1 Setup Factory Defaults BP1 SETUP ALARMS ALARM LEVEL LATCH ALARMS SYS HI LIMIT SYS LO LIMIT DIA HI LIMIT DIA LO LIMIT MN HI LIMIT MN LO LIMIT PRAM AVAIL PRAM ON / OFF RCD ON ALARM SIZE SCALE DISPD VALUES SITE PRAM COLOR ADULT OFF 2 OFF 170 90 100 50 120 60 ON OFF WF 120 OFF S/D OFF RED PED OFF 2 OFF 130 65 90 40 100 50 ON OFF WF 120 OFF S/D OFF RED 6-5 NEO OFF 2 OFF 100 50 70 30 80 35 ON OFF WF 120 OFF S/D OFF RED DESCRIPTION Enables BP1 alarm Sets alarm priority level (1, 2, or 3) Latches the BP1 a
BP2 Setup Factory Defaults BP2 SETUP ALARMS ALARM LEVEL LATCH ALARMS SYS HI LIMIT SYS LO LIMIT DIA HI LIMIT DIA LO LIMIT MN HI LIMIT MN LO LIMIT PRAM AVAIL PRAM ON / OFF RCD ON ALARM SIZE SCALE DISPD VALUES SITE PRAM COLOR ADULT OFF 2 OFF 50 20 25 5 30 10 ON OFF WF 30 OFF S/D OFF YELLW PED OFF 2 OFF 40 5 15 00 25 5 ON OFF WF 30 OFF S/D OFF YELLW 6-6 NEO OFF 2 OFF 20 5 10 00 15 5 ON OFF WF 30 OFF MEAN OFF YELLW DESCRIPTION Enables BP2 alarm Sets alarm priority level (1, 2, or 3) Latches the BP2 alarm un
BP3 Setup Factory Defaults BP3 SETUP ALARMS ALARM LEVEL LATCH ALARMS SYS HI LIMIT SYS LO LIMIT DIA HI LIMIT DIA LO LIMIT MN HI LIMIT MN LO LIMIT PRAM AVAIL PRAM ON / OFF RCD ON ALARM SIZE SCALE DISPD VALUES SITE PRAM COLOR ADULT OFF 2 OFF 25 5 5 00 5 00 ON OFF WF 30 OFF MEAN OFF LTBLU PED OFF 2 OFF 25 5 5 00 5 00 ON OFF WF 30 OFF MEAN OFF LTBLU 6-7 NEO OFF 2 OFF 25 5 5 00 5 00 ON OFF WF 30 OFF MEAN OFF LTBLU DESCRIPTION Enables BP3 alarm Sets alarm priority level (1, 2, or 3) Latches the BP3 alarm unti
NIBP Setup Factory Defaults NIBP SETUP ALARMS ALARM LEVEL LATCH ALARMS SYS HI LIMIT SYS LO LIMIT DIA HI LIMIT DIA LO LIMIT MN HI LIMIT MN LO LIMIT PRAM AVAIL PRAM ON/OFF RCD ON ALARM AUTO INTERVAL 1ST INFLATE TABLE DSPLY DISPD VALUES TONE SITE PRAM COLOR ADULT OFF 2 OFF 170 90 100 50 120 60 ON ON VS OFF 5MIN 170 OFF S/D ON OFF ORNGE PED OFF 2 OFF 130 65 90 40 100 50 ON ON VS OFF 5MIN 140 OFF S/D ON OFF ORNGE 6-8 NEO OFF 2 OFF 100 50 70 30 80 35 ON ON VS OFF 5MIN 90 OFF S/D ON OFF ORNGE DESCRIPTION Enab
CO2 Setup Factory Defaults CO2 SETUP ADULT PED NEO OFF OFF OFF 2 2 2 OFF OFF OFF HIGH LIMIT 50 50 50 High alarm limit setting LOW LIMIT 25 25 25 Low alarm limit setting ICO2 LIMIT 8 8 8 Inspired CO2 alarm limit setting PRAM AVAIL ON ON ON CO2 enable or disable PRAM ON/OFF OFF OFF OFF CO2 standby RCD ON ALARM WF WF WF Record when CO2 alarm enabled SCALE 50 50 50 CO2 waveform scale size UNITS mmHg mmHg mmHg O2 COMPNSAT OFF OFF OFF O2 compensation enable
Temp1 Setup Factory Defaults TEMP1 SETUP ALARMS ALARM LEVEL LATCH ALARMS UNITS HIGH LIMIT LOW LIMIT PRAM AVAIL PRAM ON/OFF TONE PRAM COLOR ADULT OFF 2 OFF ο C 38.0 36.0 ON OFF ON WHITE PED OFF 2 OFF ο C 38.0 36.0 ON OFF ON WHITE NEO OFF 2 OFF ο C 37.5 36.
Chapter 7 – System & Parameter Messages System and parameter messages remind, prompt, or warn you about the current condition of the monitor or its parameters. These messages are displayed in reverse video and may flash on and off to get your attention. System Messages The system messages, explained in the following tables, are displayed in a reverse-video box, just below the WDZ. They apply to conditions of the monitor that are not specific to any one parameter.
Battery Messages MESSAGE BATTERY LEVEL MONITOR BAT HI > 60% Charge MONITOR BAT MID 20-60% Charge MONITOR BAT LOW < 20% Charge BATTERY VERY LOW (Intermittent Alarm Tone Sounds) Approximately 10 minutes of battery life remains Parameter Messages The following tables explain messages that are parameter specific. Messages concerning parameters displayed in the WDZ will be displayed in a video box below the numeric data for the corresponding waveform parameters.
SPO2 Messages SPO2 MESSAGE SPO2 SRCH (Nellcor only) NO C-LOCK (Nellcor only) MEANING The monitor cannot locate the patient’s pulse. The patient’s perfusion may be too poor to detect an acceptable pulse. Confirm proper application of the sensor; make sure the ECG parameter is available for C-LOCK synchronization; try another sensor site; or try the OXISENSOR II R-15 sensor. Indicates loss of synchronization between the ECG and SPO2 pulse waveform.
Noninvasive Blood Pressure (NIBP) Messages NIBP MESSAGE MEANING ET = MM:SS Indicates elapsed time (ET) since last NIBP measurement. AET = MM:SS Indicates elapsed time since last NIBP measurement while auto timer is on. AUTO Monitor is in NIBP AUTO mode. CUFF = XXX Displays as the cuff inflates and deflates, giving the pressure in mmHg. LOW OSCIL Oscillation amplitudes are too low to obtain measurement. ARTIFACT Excessive artifact precluded measurement within a 145-second timeout.
SureTemp Messages SURETEMP MESSAGE MEANING T1 INITIAL This message display for a few moments as the probe warms up. T1 WAIT This message displays momentarily when the probe is removed from the well. T1 READY This message means it is time to insert the probe (orally or rectally). T1 FINAL This message displays when the final temperature is reached. T1 POSITN If a “t1 POSITN” error displays during the reading, reposition the probe, and initiate a new measurement.
Cardiac Output (CO) Messages CO MESSAGE MEANING NO CATH No catheter connected to the monitor. NO PROBE No temperature probe (bath or injectate) connected to the monitor. ∧ ∧ RANGE ∧ ∧ Signal over range. ∨ ∨ RANGE ∨ ∨ Signal under range. << RANGE >> Cardiac output out of range. BASELINE Noisy baseline detected. IRG CURVE Irregular curve detected. PEAKS Multiple curve peaks detected. INJ LATE Delayed injection detected. DRIFT Excessive thermal drift detected.
Chapter 8 – Defibrillator/Pacer Introduction The portable ESCORT defibrillator/pacer can attach to any ESCORT 300, II 300, or Prism monitor to provide full resuscitation and pacing capability during transport or at the bedside via AC power or modular batteries. NOTE: The Prism monitor must be equipped with a “defibrillator slide mount” (Option 21) to properly attach to the defibrillator. During AC power operation, the internal batteries in both the Prism and the defib/pacer unit are continuously charged.
connection, the unit must be operated by battery power. CAUTION: Make sure to use an ECG cable with an inline resistor so the monitor is protected from high voltage during defibrillation. CAUTION: Do not operate defibrillator in the presence of highenergy electrical fields. External electrical noise may corrupt the ECG tracing. CAUTION: Do not immerse paddles, cables, or electrical connector in liquids during cleaning and disinfecting.
Defibrillator/Pacer Front Overview 1. Defibrillator/Pacer Carrying Handle 2. APEX Defibrillator Paddle 3. Energy CHARGE (transparent/lighted) and DISCHARGE (red) Buttons on APEX Paddle 4. Energy DISCHARGE Button on Sternum Paddle 5.
Defibrillator/Pacer Rear Overview 1. AC Receptacle 2. Defibrillator Test Lamp 3. Voltage Select/Fuse Holder 4. Battery 5.
Defibrillator/Pacer Front Panel 1. External Pace Rate Adjustment Knob 2. QRS Indicator 3. External Pacing Mode Key 4. Pace Current Adjustment Knob 5. Pace STOP/START Key 6. CHECK PACE ELECTRODES Indicator 7. ENERGY SELECTOR Control 8. INTNL PADDLE DISCHG Key (Internal Paddle Discharge) 9. BATTERY CONDITION Indicators 10. Battery Charging Indicator 11. AC Power Indicator 12. ECG Lead Source Key 13. Synchronized Cardioversion Selector 14. Energy DISARM Key 15. Defib/Pacer Power ON Key 16.
17. Defib Energy CHARGE Key Using Defibrillator and Pacer Paddles and Electrodes External Paddles The STERNUM defibrillating paddle contains a discharge button and serves as the negative ECG electrode (placed on the upper right sternum) when the defib ECG source key is set to PADDLE. The APEX defibrillating paddle contains both a discharge button and a charge button with ready light that functions the same as the CHARGE key on the defibrillator front panel.
To Apply Disposable Adhesive Electrodes to the Patient: 1. In a non-emergency application, clean and dry skin in electrode areas, preferably with a coarse dry terry cloth. If necessary, use alcohol for removal of lotions or moisturizers, and allow area to dry completely prior to application of pads. Do not shave electrode sites. 2. Check expiration date stamped on the electrode package. Do not use beyond this date. Remove Defib/Pace Electrodes from package and pull apart lead wires to required length. 3.
Operating the Defibrillator 1. Ensure that the paddle cable is connected to the back of the defib/pacer behind the monitor. 2. Apply conductive gel (MDE part # E2700-83 or equivalent) to paddles. Do not let conductive gel form an alternate conductive path to the operator or between paddle sites. Otherwise, energy may flow across, rather than into, the chest cavity. 3. Follow numbered sequence on front panel, starting with Number “1”—with the Prism powered ON, press the POWER ON key on the defib/pacer.
6. Place defibrillator paddles firmly on the patient’s chest with the STERNUM paddle near the upper sternum and slightly toward the patient’s right shoulder, and the APEX paddle over the cardiac apex. 7. Instruct all personnel to stand away from the patient and the bed before proceeding. 8. Press the paddles firmly against the chest wall (about 25 pounds of pressure per paddle) and discharge by pressing BOTH red paddle discharge buttons simultaneously. 9.
3. Number “2”—select the energy to be delivered using the ENERGY SELECT knob on the front panel. NOTE: If the energy select knob is changed after a charge is initiated, the energy will change to the new level immediately, and an intermittent tone will sound during the change. Once it has reached the new level, the tone will sound continuously. 4. Number “3”—press the CHARGE button on the defib/pacer front panel.
7. Observe the patient and check Prism monitor to determine results. If repeat defibrillation is necessary, readjust the energy level as prescribed by ACLS (Advanced Cardiac Life Support) protocol, and repeat the above steps. Synchronized Cardioversion Synchronized cardioversion is the delivery of a defibrillator shock synchronized with the patient’s R-wave in order to convert abnormal rhythms to a normal sinus rhythm.
6. Follow defibrillation procedure in the section “Operating the Defibrillator”. NOTE: The defib/pacer automatically goes to defib (async) mode after sync discharge. Operating the Pacer You can use MDE’s standard disposable adhesive electrodes for either pacing, or for both pacing and defibrillation. In either case, it is necessary to capture the patient’s ECG with a standard 3lead cable and proper ECG electrodes.
4. Select the desired pace rate with the external pace rate switch on the defib/pacer front panel. 5. Select either asynchronous (continuous) or synchronous (demand) pacing with the ASYNC/DMAND MODE key. The current operating mode will be shown by the green indicator light. In demand mode the QRS indicator will flash if R-waves are being detected properly for synchronization. If the indicator does not flash, QRS sensing may not be occurring because of artifact.
• the pacing cable is properly connected to the electrodes and to the pace output connector Pacing and Defibrillating with the Same Electrodes In order to both pace and defibrillate a patient through the same set of electrodes, you will need the “Hands-Off” Adapter Cable (MDE part #E2700-66), the Multifunction Adapter (MDE part #E2700-89), as well as disposable adhesive electrodes. See the following for proper connection: 1.
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Chapter 9 – Clinical Information System Introduction The CIS Communication Module when attached to a Prism or Prism SE Patient Monitor, allows for the remote gathering of patient vital signs and data, and automatically recording them into the patient(s) records on a remote computer system. This is performed by connecting the CIS Communication Module to the user’s Clinical Information System via the Local Area Network (Ethernet) or via an RS-232 system.
1. CIS Status Message Zone 2. CIS Parameter Label 3. Softkeys for Interfacing with the CIS Menu 4. CIS Menu Display Zone NOTE: At power up, the CIS Status Message Zone (item 1 above) will begin flashing either a “NO CIS FOUND”, “SETUP PATIENT”, or “CONFIRM PATIENT” message depending on your configuration. This indicates the CIS Communication Module was successfully recognized by the patient monitor. If you do not see the message after a few moments, contact service personnel to inspect your monitor .
3. Press the PAGE HOME key to remove the CIS Menu display and replace the regularly monitored parameters in the waveform display zone. The display will automatically return to the Home page if there is no interaction with the CIS softkeys for 90 seconds. To set up CIS for continuous display in Trace 2: 1. Press the SYSTEM SETUP key to open the System Setup menu. CLEAR PT DATA STORE VS DISP VSC HR AUTO ECG PT SETUP TRACE SEL MORE 2. Press the TRACE SEL softkey to open the following menu.
The action taken upon the selection of a softkey is determined by the current menu selections displayed on the CIS menu located in the Trace 2 waveform zone. To select a function, press the monitor softkey associated with the appropriate key label. During certain menu operations, the F1-F5 function key selections may be replaced by other softkey selections to match the on-screen choices displayed in the CIS Menu.
A brief overview of the patient confirmation process is included here to provide a better understanding of the significance and overall scope of this process. Upon turning the monitor ON or after selecting a NEW PATIENT via the CIS menu, the operator will interact with the monitor to “ask” the hospital ADT system which patient is listed in that room/bed location. This is known as the patient “query” process.
location, must be queried using the “Query By Patient Identification” method described below. Monitors that are situated between multiple room/bed locations may be configured to present the user with a list of query options. In this case, a room/bed query can be initiated by: (a) Selecting the desired room/bed location presented in the CIS menu (choices F1-F2). (b) Selecting the desired room/bed location from a list of locations preconfigured in the module (F3 Selection).
Confirming the Patient: CIS STATUS MESSAGE: CIS STATUS MESSAGE: “CONFIRM PT” (flashing) Displays Confirmed Patient’s Name and Identification Once the query has been performed, the CIS Communication Module will display the results of that query in the CIS display zone. The results should be checked for accuracy and the name/ID verified as correct. If the information matches the patient that will be monitored, select the “Confirm This Patient” option from the CIS menu display.
Using the VSC Function to Set Up CIS Charting Intervals Each monitor includes the ability to store vital signs in a tabular format at user-selectable intervals. This feature is identified as “VSC” in the monitor, short for Vital Sign Chart. This VSC feature permits the operator to determine how often and under which circumstances vital signs should be stored in the VSC table.
In the sample VSC table illustration, notice that there is an unlabeled column to the left of the TIME column. This column is used to display a letter or symbol that represents the catalyst for that entry in the VSC table. This allows the operator to differentiate types of vital sign entries, which may be important in determining which entries should be included in the patient’s permanent record.
1. Press the SYSTEM SETUP key then select the CLEAR PT DATA softkey. Be sure to select “YES” when faced with the “Are You Sure?” question. CLEAR PT DATA STORE VS DISP VSC PT SETUP HR AUTO ECG TRACE SEL MORE —OR— 2. Select the “NEW PATIENT” function from the CIS menu. This will clear the VSC table in preparation for the new patient record.
NOTE: Episodic measurements will not post to a VS chart more than once for all automatic entries, even if they are displayed and within the Valid Time. There is one exception to this rule: the STORE VS softkey will capture ALL measurements displayed on the monitor at a given time, regardless of their continuous or episodic nature. The purpose of this exception is to ensure that ALL vital signs displayed at the time the user selects the STORE VS softkey will be sent to the VSC table and CIS.
5. Press the PAGE HOME key return to the main monitoring screen. when you have finished setting up VSC to Assigning VSC to a Waveform Trace 1. Press the SYSTEM SETUP key to open the System Setup menu. CLEAR PT DATA STORE VS DISP VSC PT SETUP HR AUTO ECG TRACE SEL MORE 2. Press the TRACE SEL softkey to open the following menu. DISP VSC DISP OCRG TRACE 2 CIS TRACE 3 VSC TRACE 4 AUTO MORE 3. Press any of the TRACE keys until VSC appears as the selection. 4.
Refer to section “Deleting Vital Signs Entries”, for details on the DEL VSC ENTRY option. Manually Entering Vital Signs Data Using the CIS Menu Vital signs that are not directly monitored can still be filed into the patient record using the “Enter Vital Signs” function in the CIS menu. The parameters RESPIRATION, TEMPERATURE, NIBP, SPO2, and PULSE RATE can be entered by this process with the manual entry sent to the VSC table and CIS.
2. Press the CIS softkey associated with the ENTER VITAL SIGNS function. The following CIS menu will be displayed with the corresponding CIS softkeys shown below. NOTE: the following values depict the default values. RESP: TEMP: NIBP: SPO2: PR: 12 98.6 (37.0) 120 / 80 (95) 95 95 3. Enter manual vital sign data using softkeys shown below. NEXT ↓↓ →→ ADJ ↑↑ ADJ ↓↓ F4 F5 NEXT ↓ ↓→ → —Moves cursor to the next parameter. ADJ ↑ ↑—Increases value. ADJ ↓ ↓—Decreases value.
1. Display the VSC parameter in the monitor waveform zone (refer to section “Assigning VSC to a Waveform Trace”). 2. Press the softkey adjacent to the VSC parameter label to display the VSC function keys at the bottom of the monitor (refer to section “VSC Function Keys” for additional information regarding these keys). 3. Press the MORE softkey to display the second page of VSC function keys. 4. Press the DEL VSC ENTRY key. Using the arrow keys, highlight the desired entry and press the DEL ENTRY softkey.
NOTE: If the network connection is lost per the above situation, the CIS Status Message at the top of the monitor will no longer simply display the confirmed patient name. Instead, the patient name will flash and alternate with the message “NO CIS FOUND”. This will not only alert you to the fact that your network connection is lost, but will also indicate the patient the CIS Module is saving vital sign data for in the absence of the network connection.
Using the Temporary Name Feature CIS STATUS MESSAGE: Displays Temporary Patient’s Name (Flashing) Patient vital signs information that is taken on an unconfirmed patient must be assigned a temporary patient name at the monitor. This will assist in identifying which patient record in the Clinical Information System the stored data should be sent to when the operator is ready and able to send the vital sign data to the CIS.
The optional keyboard can be used to facilitate entry of the temporary name. To use the keyboard: 1. Access the TEMP NAME function as described in the previous section “Using the Temporary Name Feature”. 2. Type in the name using the keyboard and press on the keyboard. Retrieving Vital Signs from Previous Patients Previous patient information can be filed to the Clinical Information System any time a connection to the network exists.
To change the filing mode for this record, select the F2 key. The filing mode will toggle between FINAL and REVIEW modes. Refer to section “Selecting the Appropriate Filing Mode” for a description of the filing mode feature. To cancel filing for this patient, select the F3 softkey. RS-232 Communication Port 1 of the CIS module is a shielded EIA/TIA RS-232 (9-pin mini-DIN) connector that allows for serial data acquisition by the user’s Clinical Information System once the port is configured for this mode.
HR HIGH LIMIT is 1 byte long and represents heart rate HIGH alarm limit (not currently supported at this time). HR LOW LIMIT is 1 byte long and represents heart rate LOW alarm limit (not currently supported at this time). REMOTE STATUS is 1 byte long (see Table 5 for Remote Status). REMOTE RECORD is 1 byte long. BACKPORT WAVEFORM is 1 byte long. The Backport Waveform byte is divided into three fields, Port 1, Port 2, and Port 3. The value of each field is defined in Table 6.
Sample Waveform Packet Packet ID 2 bytes Waveform Number 1 byte Length 1 byte Data Check Sum 1 byte 1b 57 00 13 83 83 81 80 7d 98 b3 cb b3 96 7a 7e 80 81 83 83 83 83 83 7e Table 3: Parameter Indices Parameter # 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Waveform # 0 1 2 5 Not Available 11 Not Available Not Available Not Available 15 Parameter Name ECG Respiration BP1 Systolic BP1 Diastolic BP1 Mean BP2 Systolic BP2 Diastolic BP2 Mean NIBP Systolic NIBP Diastolic NIBP Mean SaO2 Temperature CO - Esco
Table 5: Remote Status Remote Status Hex Value Null Status Low Battery Alarm Suspend Description 00h 10h 70h No activity Battery voltage is low Alarm Suspend activated NOTE: In the event a low battery condition occurs coincident with an alarm suspend, the monitor will prioritize the event. Priority will be given to the low battery signal and the CIS module will transmit 10h. Table 6.
Additional Waveforms As previously stated, the CIS module transmits two type of packet information, a parameter packet and a waveform packet. The ECG waveform is always transmitted through the serial port by default. The Clinical Information System may request additional waveforms by issuing the following command: [1Bh] [52h] The CIS Module will respond by sending the additional waveform packet in the previously described format (for example,
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Chapter 10 – Troubleshooting General Solutions Problem Monitor does not turn on. Possible Causes AC power may not be connected. Action/Solution Verify AC ON light is on. Parameter labels display, but without alarm status or data. Sensor or cable is not connected to monitor. Connect appropriate sensor or cable to monitor. Parameter does not display label or data. Parameter is “not available” in power-up defaults. Contact service personnel to change power-up status.
Respiration Solutions Problem Erratic Respiration rate and waveform. Possible Causes Poor electrode placement or conductivity. Action/Solution Confirm proper electrode placement and adhesion. Respiration rate displayed less than actual rate. Respiration waveform amplitude is too low. Use RESP SIZE function to increase waveform amplitude. Respiration rate displayed higher than actual rate. Cardiovascular artifact (CVA) is interfering with signal. Reposition LA electrode to reduce CVA.
NO SENSOR is displayed. Sensor not connected. Check sensor connections. Damaged Sensor or cable. Verify red light on sensor illuminates. Replace cable if necessary. Unknown sensor connected. Replace with Masimo sensor. Invasive Blood Pressure Solutions Problem Will not zero - ZERO OUT OF RANGE displays. Possible Causes Faulty transducer or transducer not zeroed. Action/Solution Try new transducer or rezero current transducer. Will not zero - NO ZERO: PULSE DETECT displays.
Mainstream ETCO2 Solutions (Prism Only) Problem NO SENSOR message. Possible Causes Sensor not connected. Action/Solution Confirm proper sensor connection. LOW SIGNAL message. Airway adapter obstructed. Check airway adapter for obstruction. Use another airway adapter. OCCLUSION message. Particulate matter obstructing airway. Check airway adapter for obstruction. Use another airway adapter. BAD SENSOR message. Sensor not functioning properly. Try sensor with different monitor.
ETCO2 Solutions (Prism SE Only) Problem Possible Causes Action/Solution No Sensor message. No filterline connected. Connect a filterline to monitor. Filt Occl message. Filter occluded/airway blockage detected. Remove/Replace filterline. SureTemp Solutions Problem Possible Causes Action/Solution T1 Position message. Incorrect probe placement or movement. Check location of probe to verify monitor is set for position used. For example, axillary, oral, or rectal. Unit never displays T1 Ready.
Cardiac Output (CO) Solutions Problem NO CATH message. Possible Causes Catheter not connected. Action/Solution Confirm catheter connected properly. NO PROBE message. Either injectate probe or bath temperature probe not connected. Confirm both probes connected properly. Without probe, monitor assumes 0o C injectate temperature. ∧ ∧RANGE∧ ∧ message. Blood temperature change greater than 4o C at beginning of run. Verify initial blood temperature change not greater than 4o C. ∨ ∨RANGE∨ ∨ message.
power. Defib/Pacer Solutions Problem Defibrillator will not charge (beeps intermittently) when CHARGE key is pressed. Possible Causes Defibrillator cable is either disconnected or defective. Action/Solution Ensure that defibrillator cable is properly connected to the defibrillator behind the Prism monitor. If problem persists, replace defibrillator cable. Defibrillator beeps intermittently when attempting to charge the internal paddles. Internal paddle cable is either disconnected or defective.
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Chapter 11 – Supplies, Accessories, & Options The supplies, accessories, and options listed in this section can be ordered by calling Medical Data Electronics at the following telephone number: (818) 768-6411 To make the order of the process smoother, note the part or option/model number of the item(s) you are ordering, and be prepared to give the number to MDE personnel.
Part Number E2700-03 E2700-80A E2900-07 3840000161 3840000160 3840000162 E2700-64 E2700-65 E2700-66 E2700-69 E2700-70 E2700-72 E2700-73 E2700-83 E2700-89 E2900-54 E2900-52 Part Number E2900-01 401603 401503 E2900-02 401604 401504 E2700-24 E2700-25 E2700-46 E2700-47 E2700-43 E2700-62 E2700-75 E2700-77 E2700-78 E2700-27 Defibrillator / Pacer Accessories / Supplies GCX Defib Slide Mount Adapter Plate – Allows monitor equipped with Defib base to attach to a GCX wall mount or rolling stand Defib/Pacer Tester (O
Part Number E2900-04 E2900-03 E2700-60 401505 401506 E2700-76 E2700-61 E2700-63 Part Number E2800-30 E2800-31 E2800-33 E2800-34 E2800-32 Part Number 20020 20021 E2900-20 E2900-21 E2900-26 E2900-38 E2900-39 ECG Accessories – CE Approved 5-Lead ECG Safety Cable (Red, Yellow, Green, Black, White) 3-Lead ECG Safety Cable (Red, Yellow, Green) 24 inch 3-Lead Safety Snap Leadwires (Red, Yellow, Green) (10 sets) 24 inch 3-Lead Safety Pinchclip Leadwires (1 set) 24 inch 5-Lead Safety Pinchclip Leadwires (1 set) 24
Part Number E2910-20 E2910-21 E2910-22 E2910-35 E2910-34 E2910-28 E2910-29 E2910-30 Contact MDE Technical Support Part Number E2910-01 E2910-02 E2910-03 E2910-10 E2910-04 E2910-05 E2910-06 E2910-07 E2910-08 E2910-09 E2810-06 E2810-11 E2810-12 E2810-13 Microstream ETCO2 Accessories / Supplies (Prism SE Only) Adult / Pediatric Filterline & Airway Adapter Set – for intubated CO2 sampling, 6 foot (box of 25) Adult / Pediatric Filterline & Airway Adapter Set – High Humidity – for long term intubated CO2 samplin
Part Number E2800-06 E2800-11 E2810-12 E2810-13 E2910-06 E2910-07 E2910-08 E2910-09 E2910-12 E2910-13 E2910-14 E2910-15 E2910-16 E2910-17 404016 404017 404018 403958 3607000020 Part Number 401609 E2700-34 E2700-10 E2700-91 E2700-11 E2700-90 NIBP Accessories / Supplies – Screw Type Fittings Adult / Pediatric Hose Assembly (12 foot) Neonatal Hose Assembly (8 foot) SE to EII NIBP CUFF ADAPTER (Quick disconnect to screw fitting) EII to SE NIBP CUFF ADAPTER (Screw fitting to Quick Disconnect) Neo Size 1 – Box o
Part Number E2810-50 E2810-51 E2810-52 E2810-53 E2810-54 E2810-55 E2810-56 E2810-57 E2810-58 E2810-59 E2810-60 E2810-61 Part Number E2800-50 E2800-64 Part Number E2900-55 E2900-56 E2900-57 E2900-58 E2900-62 Part Number E3202-05 E3202-08 E3202-06 E2900-91 E2900-90 E2900-98 E2900-95 E2900-94 SPO2 Accessories / Supplies – Masimo Adult Finger Sensor-Reusable Adult Disposable Adhesive Sensors (box of 20) Pediatric Disposable Adhesive Sensors (box of 20) Neonatal Disposable Adhesive Sensors (box of 20) Neonatal
Part Number E2800SC25 E2800SC50 E2800PC50 Part Number E2900-49 E2900-50 Part Number E2700-32 E2700-54 E2700-14 E2900-51 E2900-30 E2900-31 E2900-33 E2700-87 Part Number E9040-62 E9040-63 E9040-55 E9030-31 E9030-33R E9030-36 E9040-54 Video Cable 25 Foot Standard Cable 50 Foot Standard Cable 50 Foot Plenum Cable Remote Display Power Isolation Transformers Power Isolation Transformer 150VA floor mount, single outlet 110 volts Power Isolation Transformer 150VA wall mount, single outlet 110 volts Miscellaneous A
Part Number OPT25 OPT37 OPT53A OPT53B OPT70 OPT103 OPT104 20002 20002CVR 20202 OPT21 500256 E2900-40A E2900-40B Options (Prism Only) BEDRAIL HANDLE – Need 9040-60 upgrade on older units CRG and OXYCRGS – Provides CRG (Cardiorespirogram) to standard MPM equipped with ECG/Resp. Provides OXYCRG (Oxycardiorespirogram) when and SpO2 option is purchased. VGA Output for Prism model 20401 Only – Permits all Prism waveforms and numeric data to be displayed on any standard VGA display.
20001-M 20001-N 20001CVR OPT101-N OPT101-M OPT28 OPT30-M OPT30NEL OPT31 OPT31I OPT31M OPT33 OPT33I OPT33M OPT48 OPT48I OPT48M OPT35 OPT36 OPT38-M OPT38-N OPT39 OPT72 OPT50 OPT50S OPT54 OPT54I MULTIPARAMETER MODULE – M MPM for use with Masimo SpO2 or when no SpO2 is ordered. Includes single or dual lead ECG and Respiration. MULTIPARAMETER MODULE – N MPM for use with Nellcor SpO2. Includes single or dual lead ECG and Respiration.
Part Number OPT53-SE OPT70-SE OPT27-SE OPT30SEM OPT30SENEL OPT36-SE OPT37-SE OPT31-SE OPT33-SE OPT48-SE OPT72-SE OPT73-SE OPT54-SE OPT50-SE OPT03-SE OPT61-SE OPT25-SE OPT105-SE OPT103-SE Options (Prism SE Only) VGA Output for Prism SE series monitors – Permits all Prism SE waveforms and numeric data to be displayed on any standard VGA display. The remote display may require an Isolation Transformer depending upon its location.
Part Number 20011V 20011 20019V 20019VS Part Number 20012V 20012VDP 20012V-M6 Part Number 20030-MT1 20030-HB1 20030-CN1 20030-EC1 20030RS232 E9040-26 Wireless Communication Modules VISION TRANSCEIVER MODULE – (900 MHz BAND) Spread Spectrum communication with Vision central station. Requires (1) per monitor. ESCORT-LINK TRANSCEIVER MODULE – (900 MHz BAND) Spread Spectrum communication with existing E3200B central stations. Requires (1) per monitor. VISION TRANSCEIVER MODULE – (2.
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Chapter 12 – Specifications PRISM & PRISM SE SPECIFICATIONS PHYSICAL (Prism Only) Size: 9.3 x 11.8 x 10.2 in./23.6 x 30.0 x 25.9 cm (HWD) Weight: 12.35 lb/5.6 kg (includes MPM with ECG, NIBP, SPO2, Temp) Weight with 2 Batteries: add 2.9 lb/1.3 kg PHYSICAL (Prism SE Only) Size: 8.9 x 11.8 x 8.3 in./22.6 x 30.0 x 21.1 cm (HWD) Weight: 10.5 lb/4.8 kg (includes one battery pack) DISPLAY Type: Color Active Matrix TFT LCD Size: 10.4 in./26.
Range: 10 to 300 BPM Accuracy: ±2% or ±2 BPM Sweep Speed: 12.5, 25 mm/sec selectable Display Update Information: Display update interval is 2 seconds High Limit Range: 50 to 250 BPM in 5 BPM steps Low Limit Range: 20 to 150 BPM in 5 BPM steps Bandwidth: 0.5 to 40 Hz (monitor); 0.05 to 100 Hz (diagnostic) Leads: 3 lead: I, II or III selectable; 5 Lead/Dual Vector: I, II, III, or V selectable Sensitivity: 0.25 to 3 mV/cm selectable (12 levels) Pacer Rejection: 0.
Range: 20 to 50° C (68 to 122° F) Alarm Limit Range 20-44° C Accuracy: ±0.1° C Probe: YSI 700 or 400, autosensing Connector: 1/4 inch (0.6 cm) stereo phone jack SURETEMP® TEMPERATURE Patient Temperature Range: 28.9 to 42.2 ° C (84.0 to 108.0 ° F) Predictive Temperature Range: 34.5 to 42.2 ° C (94.0 to 108.0 ° F) Accuracy: ±0.1 ° C (±0.2 ° F) Response Time: Oral - approx. 4 sec., Rectal - approx. 15 sec., Axillary – continuous Monitor Mode: 3 minutes Cord Length: 9 ft. or 16 ft.
Pulse Tone: Pitch varies with SpO2 value ECG Sync: NELLCOR C-LOCK SpO2 (Nellcor MP405) Display: % SpO2, Plethysmographic Waveform or Pulse Amplitude Bar Range: 0 to 100% Accuracy: ADULT: 0 to 69% unspecified; 70 to 100% ±2 digits; NEO: 0 to 69% unspecified; 70 to 100% ±3 digits Pulse Rate Range: 20 to 250 BPM Pulse Rate Accuracy: ±3 BPM High Limit Range: 70 to 100% Low Limit Range: 50 to 99% Sensors: Neonatal through Adult (NELLCOR) Pulse Tone: Pitch varies with SpO2 value ECG Sync: NELLCOR C-LOCK SpO2 (M
PED NEO 0-150 mmHg 0-150 mmHg Mean: ADULT 0-200 mmHg PED 0-170 mmHg NEO 0-170 mmHg Display Scale: 15, 30, 60, 120, 180, 240 mmHg selectable Input Connector: Std 6 pin MS, 5 uV/V/mmHg CARDIAC OUTPUT/HEMODYNAMIC CALCULATIONS CO Range: 0.1 to 19.99 liters/minute CO Repeatability: ±2% or 0.2 liters/minute from mean value, whichever is greater, as measured by electronically generated standard flow curves REF Range: 1% to 85% Blood Temperature Range: 17.5 to 43° C Blood Temperature Accuracy: ±0.5° C from 17.
Operating Pressure: 430 to 795 mmHg Maximum Change Rate in Pressure: 12.4 mmHg/min Operating Altitude: -1,250 to 15,000 ft. Maximum Change Rate in Altitude: 500 ft./min Relative Humidity: 10 to 95% Ambient CO2: 0 to 700 ppm Flow Rate: 50 ml.min ±7.5 ml/min Resp Range: 0 to 150 bpm BTPS: 37° C, 47 mmHg System Response Time: 2.9 seconds Rise Time Adult and Neonatal: 190 msec max Delay Time: 2.7 seconds typical CO2 Report Resolution: 1 mmHg Calibration Interval: 4000 operating hours or I year Power: 1.
Weight: 0.85 lb (0.39 kg) with full roll of paper (Prism SE Only) AutoNet TRANSCEIVER MODULE Indicator: Green light indicates comm. Status Frequency: Spread spectrum 902 to 928 MHz or 2.4 GHz Transmission: Bidirectional with seamless auto-retry Weight: 0.55 lb (0.
POWER Modular Batteries: 1-each 12V; 2.
© 2003 Medical Data Electronics Inc.
