User Manual
Table Of Contents
- 08-0308 - Manual Cover.pdf
- 0070-10-0690-01 Panorama Operations Maual with Telepack 2.4 - CH16 REVISED2.pdf
- Foreword
- Warnings, Precautions and Notes
- Indications for Use
- Unpacking Information
- Symbols and Descriptions
- Technical Support
- 1.0 System Overview
- 1.1 Components of the Panorama System
- 1.2 Licensing Key
- 1.3 Supported Devices
- 1.3.1 Panorama Central Station
- 1.3.2 Panorama ViewStation and WorkStation
- 1.3.3 Panorama Telemetry Server
- 1.3.4 Panorama Wireless Transceiver
- 1.3.5 Panorama Gateway
- 1.3.6 Panorama Web Viewer
- 1.3.7 Passport 2® Bedside Monitor
- 1.3.8 Spectrum™ Bedside Monitor
- 1.3.9 Spectrum OR™ Bedside Monitor
- 1.3.10 Panorama Telepack
- 1.3.11 Network Printer
- 1.4 Troubleshooting
- 2.0 Getting Started
- 3.0 Alarm Behavior
- 4.0 Arrhythmia and ST Analysis
- 5.0 Patient Setup Functions
- 5.1 Demographics Tab
- 5.2 Transfer Tab
- 5.3 Discharge Tab
- 5.4 Display Tab
- 5.5 Standby Tab
- 5.6 Wave Gain Tab (Patient)
- 5.7 Print Setup Tab (Patient)
- 6.0 Patient Alarm Functions
- 7.0 Views
- 7.1 Bedside Tab
- 7.2 Trends Tab
- 7.3 Events Tab
- 7.4 Disclosure Tab
- 7.4.1 Accessing the Disclosure Tab
- 7.4.2 Disclosure Tab (Waveforms View)
- 7.4.2.1 Accessing the Waveforms View
- 7.4.2.2 Components of the Waveforms View
- 7.4.2.3 Navigating in the Waveforms View of the Disclosure Tab
- 7.4.2.4 ST Button
- 7.4.2.5 Comments Dialog Box (Optional)
- 7.4.2.6 Sidebar Buttons
- 7.4.2.7 Printing a Full Disclosure Zoom In Report from the Waveforms View
- 7.4.2.8 Troubleshooting
- 7.5 ST Tab
- 8.0 Report Functions
- 8.1 Patient Reports Tab
- 8.2 System Reports Tab
- 8.3 Print Status Tab
- 8.4 Additional Reports
- 9.0 System Setup Functions
- 9.1 Parameter Color Tab
- 9.2 Touch Screen Tab
- 9.3 Installation Setup Tab
- 9.4 Care Group Tab
- 9.5 Volume Tab
- 9.6 System Alarms Tab
- 9.7 Passwords Tab
- 9.8 Equipment Setup Tab
- 9.9 More Tab
- 9.10 Previous Tab
- 9.11 Date/Time Tab
- 9.12 Print Setup Tab (System)
- 9.13 Unit Priorities Tab
- 9.14 Unit Choices Tab
- 9.15 Wave Gain Tab (System)
- 9.16 Wireless Tab
- 10.0 Telepack (Optional)
- 11.0 User Maintenance
- 12.0 Parameter Specifications
- 12.1 Parameter Specifications
- 12.1.1 Heart Rate: HR
- 12.1.2 Respiration: Resp
- 12.1.3 NIBP
- 12.1.4 SpO2
- 12.1.5 Nonin SpO2
- 12.1.6 IBP: mmHg
- 12.1.7 CO2
- 12.1.8 O2
- 12.1.9 INSP/ET O2
- 12.1.10 N2O
- 12.1.11 Anesthetic Agents: Iso, Enf, Des, Sev, Hal, Agent
- 12.1.12 Premature Ventricular Contraction (PVC)
- 12.1.13 Temp: T1,T2, Delta T, and T Blood
- 12.1.14 ST
- 12.1.15 Cardiac Output
- 12.1.16 Cardiac Index
- 12.1.17 Pulmonary Artery Wedge Pressure (PAWP)
- 12.1.18 Battery Percentage
- 12.2 Invalid Data Display
- 12.1 Parameter Specifications
- 13.0 Alarms and Events
- 14.0 Network Tab (Optional)
- 14.1 Network Tab
- 14.1.1 Accessing the Network Tab
- 14.1.2 Sorting the Contents of the Network Tab List Box
- 14.1.3 Assigning Patient Tiles in the Network Tab
- 14.1.4 Removing a Patient Tile Assignment in the Network Tab
- 14.1.5 Removing All Patient Tile Assignments in the Network Tab
- 14.1.6 Refreshing the Network Tab List Box
- 14.1.7 Troubleshooting
- 14.1 Network Tab
- 15.0 Paging Tab (Optional)
- 15.1 Paging Password Tab
- 15.2 Paging Tab
- 15.2.1 Accessing the Paging Tab
- 15.2.2 Adding a Pager
- 15.2.3 Assigning a Patient Tile
- 15.2.4 Adding All Patient Tiles to a Pager
- 15.2.5 Removing a Patient Tile Assignment
- 15.2.6 Removing All Patient Tiles from a Pager
- 15.2.7 Editing a Pager
- 15.2.8 Removing a Pager
- 15.2.9 Resending a Failed Page
- 15.2.10 Generating a Paging Report
- 15.2.11 Troubleshooting
- 17.0 Glossary
Panorama™ Operating Instructions 0070-10-0690-01 4 - 11
Arrhythmia and ST Analysis Arrhythmia Algorithm
Some of the causes of ECG noise include poor skin preparation, improperly attached
electrodes, dried electrode gel, defective lead wires, and patient movement. The algorithm
uses several techniques to differentiate a patient’s QRS complexes from noise sources.
If noise levels are too high, the following will occur until the signal quality is re-established:
• Beat detection is suspended
• All rhythm calls are suspended
•An ECG Noise message is displayed in the Patient Status line at the Panorama
Central Station when the noise continues beyond the configured noise delay
Heart Rate Meter
Heart Rate is computed using the 16 most recent R-R intervals for heart rates above 48 beats
per minute while 4 R-R intervals are used at rates equal to or less than 48 beats per minute.
All detected beats are used to compute the heart rate. A separate ventricular rate is used in
the algorithm to determine rhythms like ventricular tachycardia and ventricular run.
Filtering Pacer Signals
In order to prevent pacer pulses from being mistaken for QRS complexes, they are removed
from the ECG data sent to the arrhythmia algorithm for analysis. Pacer pulses are shown on
the Panorama Central Station and bedside monitors as exaggerated vertical lines.
ECG Amplitude
The QRS detection threshold algorithm setting is fixed between 0.15 and 0.45 mV to avoid
detecting noise spikes or P-waves as valid beats. Changing the display gain (or wave gain)
on the monitor does not affect the signal that is used by the algorithm for beat detection. For
optimal performance, the leads selected for monitoring should have an amplitude of 0.5 to 1
mV or more.
Learning
The process of learning is used to establish a normal beat template for a patient. The learn
period is dependent on heart rate and dominant pattern. Learning should not be initiated
during a primarily ventricular rhythm because an ectopic beat may be established as normal.
A learn should be initiated when beats are not being properly detected, or when they are
being erroneously classified. However, if a signal is not strong enough, or lead data is
extremely noisy, better signal quality must be established before a learn can be effective.