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 - 13
Arrhythmia and ST Analysis Arrhythmia Alarms
ST segments are typically calculated on graph paper with a scale of 1cm/mV, and measured
in millimeters where one millimeter is equivalent to 0.1 mV. The reliability of ST
measurements is lowered with the presence of atrial fibrillation, flutter, and erratic baseline
changes.
Selecting leads that contain the least amount of baseline flutter will improve measurement
accuracy, but accurate ST deviation measurement is dependent on the correct location of the
ISO and ST points.
All available ECG leads are analyzed to measure deviations in the ST segment.
The displayed ST data is updated approximately every 10 seconds.
Learning
The process of learning is used to establish normal beat templates or a stable baseline for
accurate ST analysis. To establish this baseline, the system evaluates the first sixteen normal
beats based on readings from leads II, V, and I.
To establish an accurate baseline, it is recommended that learning be done when the patient
is in stable condition, not moving, and has an ECG rhythm that is free of artifact. Learning
should not be initiated during a primarily ventricular rhythm or other ECG rhythm irregularity
because an ectopic beat may be established as normal.
Learning automatically occurs when:
• Arrhythmia analysis is turned on
• ST analysis is turned on
• Patient monitoring resumes and patient is removed from the Standby mode
• A 3-wire lead set is in use and the current ECG lead is changed
ECG Filters
The ST segment of an ECG waveform often contains low amplitude signals with low
frequency content. To preserve low frequency signal content, the high pass filter is set to 0.05
Hz when ST analysis is turned on.
4.4 Arrhythmia Alarms
Arrhythmia alarms are activated based on the patterns in the patient ECG waveform rhythms.
Beat detection for a 5-lead wire set is determined by using a combination of leads II and V.
When using a 3-lead wire set, beat detection is determined by using only the viewed lead.
The following lethal and non-lethal arrhythmia alarms may be detected by the arrhythmia
algorithm. For additional information regarding alarm behavior at the Panorama Central
Station, refer to ‘‘Alarm Behavior’’ on page 3-1.
NOTE: Cardiac arrhythmia alarm condition events are detected and
processed by the bedside monitor. When using a Telepack
device, the detection and processing of the event is done by
the Panorama Central Station.