User's Manual

Radical-7 Appendix: Best Practices for Comparisons to Reference Measurements
www.masimo.com 143 Masimo
Pulse-Oximeter Sensor Placement
 Place finger sensor on middle or ring finger of hand opposite the blood pressure cuff.
 For reusable sensors, make sure the fingertip just touches the rubber stopper at the end
of the sensor without going over it.
 Ensure sensor is right side up with the cable running in line with finger, not at an angle
on dorsal (back side) of hand.
Monitoring
 Ensure RRa device is turned on and connected to computer with automatic data capture.
 Connect sensor to cable.
 If RRa values are not displayed after 2 minutes or if the RRa value has dropped out, check
the following:
  Confirm appropriate sensor placement, orientation and site selections.
  Confirm that optical pulse-oximeter sensor is placed properly on the
patient's finger.
  Confirm that all cables are plugged in at each of the various connection
points and hubs.
  Auscultate with stethoscope to listen for air sounds on the side opposite
sensor. If breath sounds are present, remove sensor and replace with new
sensor on opposite side of neck.
  Change the sensor out if RRa value continues to not display.
  Verify that there is not excessive hair or a gap between the sensor and
the neck and that it is placed.
 Simultaneously record the RRa and respiratory rates and from other methods. If
comparing RRa to capnography respiration rate, a mask is recommended. Sidestream
methods with a nasal cannula are not recommended because of dilution effect in the
supplemental flow of gasses, inability to measure both nasal and oral airflow, and nasal
cannula mispositioning. When recording values, confirm that there are no SIQ messages
displayed on the device.
 Suggested directions to record manual respiration rate are as follows:
  Use stethoscope to listen for breath sounds, count each breath cycle as
one breathe, count for 60 seconds.
  Alternate method to stethoscope, count the number of chest
rises/inhalations during a 60 second period. Record manual respiration rate
to compare with RRa.
 Adjust respiratory pause settings as necessary, default is 30 seconds (options are: 15, 20,
25, 30, 35, or 40 seconds).
 Document patient events and time of event (based on computer clock). Include events
that may affect performance, these include:
  Patient talking, picking at the sensor or nasal cannula, excessive
movement, ambient noise present, fans or air blowing at sensor
 Inaccurate measurements may be caused by: