DPM 5 Patient Monitor Operator’s Manual
Revision History This manual has a revision number. This revision number changes whenever the manual is updated due to software or technical specification change. Contents of this manual are subject to change without prior notice. Revision number: 9.0 Release time: 2012-02 © Copyright 2008-2012 Mindray DS USA, Inc. All rights reserved. WARNING z Federal Law (USA) restricts this device to sale by or on the order of a physician.
Intellectual Property Statement Mindray DS USA, Inc. (hereinafter called Mindray DS) owns the intellectual property rights to this product and this manual. This manual may refer to information protected by copyrights or patents and does not convey any license under the copyright and patent rights of Mindray DS, nor the rights of others. Mindray DS intends to maintain the contents of this manual as confidential information.
Manufacturer’s Responsibility All information contained in this manual is believed to be correct. Mindray DS shall not be liable for errors contained herein nor for incidental or consequential damages in connection with the furnishing or use of this manual.
Return Policy In the event that it becomes necessary to return a unit to Mindray DS, follow the instructions below. 1. Return authorization. Contact the Customer Service Department and obtain a Customer Service Authorization number. This number must appear on the outside of the shipping container. Returned shipments will not be accepted if the number is not clearly visible. Please provide the model number, serial number, and a brief description of the reason for return. 2.
Contact Information Manufacturer: Mindray DS USA, Inc. Address: 800 MacArthur Blvd.Mahwah, New Jersey 07430 USA Tel: 1.800.288.2121 Website: www. mindray.com 1.201.995.
Preface Manual Purpose This manual contains the instructions necessary to operate the product safely and in accordance with its function and intended use. Observance of this manual is a prerequisite for proper product performance and correct operation and ensures patient and operator safety. This manual is based on the maximum configuration and therefore some contents may not apply to your product. If you have any question, please contact us. This manual is an integral part of the product.
Contents 1 Safety................................................................................................................................. 1-1 1.1 Safety Information .......................................................................................................... 1-1 1.1.1 Dangers .............................................................................................................. 1-2 1.1.2 Warnings ...................................................................................
4 System Menu .................................................................................................................... 4-1 4.1 Overview......................................................................................................................... 4-1 4.2 Patient Setup ................................................................................................................... 4-2 4.2.1 Admit Patient..................................................................................
6.2.1 Visual Alarms ..................................................................................................... 6-2 6.2.2 Audible alarms ................................................................................................... 6-3 6.2.3 Alarm Messages ................................................................................................. 6-3 6.2.4 Parameter Flashes............................................................................................... 6-4 6.2.
10.4 ECG Setup Menu ...................................................................................................... 10-10 10.5 ST Analysis ............................................................................................................... 10-18 10.5.1 Overview...................................................................................................... 10-18 10.5.2 3/5-Lead ST Analysis Menu......................................................................... 10-18 10.5.
12.4 NIBP Setup Menu ....................................................................................................... 12-5 12.4.1 Calibration...................................................................................................... 12-7 12.4.2 Testing for Air Leakage.................................................................................. 12-8 12.5 Maintenance and Cleaning..........................................................................................
17 Maintenance ................................................................................................................. 17-1 17.1 Inspection and Maintenance........................................................................................ 17-1 17.2 Cleaning ...................................................................................................................... 17-2 17.3 Disinfection and Sterilization................................................................................
1 Safety 1.1 Safety Information The safety statements presented in this chapter refer to the basic safety information that the operator of the patient monitor shall pay attention to and abide by. There are additional safety statements in other chapters or sections, which may be the same as or similar to the followings, or specific to the operations. DANGER z Indicates an imminent hazard situation that, if not avoided, will result in death or serious injury.
1.1.1 Dangers There are no dangers that refer to the product in general. Specific “Danger” statements may be given in the respective sections of this operation manual. 1.1.2 Warnings WARNING z z z z z z z z z z The device is intended for use by qualified clinical physicians or well-trained nurses in the specified places. To ensure patient safety, verify the device and accessories can function safely and normally before use.
1.1.3 Cautions CAUTION z z z z z z z To ensure patient safety, use only parts and accessories specified in this manual. Remove the battery from the patient monitor if it will not be used or not be connected to the power line for a long period. Disposable devices are intended for single use only. They should not be reused as performance could degrade or contamination could occur.
1.1.4 Notes NOTE z z z z z Keep this manual close to the patient monitor so that it can be obtained conveniently when necessary. This patient monitor complies with the requirements of CISPR11 (EN55011) class A. The software was developed per IEC601-1-4. The possibility of hazards arising from errors in software program is minimized. Put the patient monitor in a location where you can easily see the screen and access the operating controls.
1.2 Equipment Symbols NOTE z Some symbols may not appear on your equipment. Attention: Consult accompanying documents (this manual). Power ON/OFF Power ON/OFF Alternating current (AC) Battery indicator Type CF applied part. The unit displaying this symbol contains an F-type isolated (floating) patient part providing a high degree of protection against shock, and is suitable for use during defibrillation. TYPE BF applied part. Defibrillator-proof protection against electrical shock.
Gas outlet ESD sensitivity Manufacture date Serial number European community representative This mark means that this device is fully in conformance with the Council Directive Concerning Medical Devices 93/42/EEC. The number adjacent to the CE marking (0123) is the number of the EU-notified body that certified meeting the requirements of Annex II of the Directive. The following definition of the WEEE label applies to EU member states only.
2 The Basics 2.1 Monitor Description This monitor integrates the functions of parameter measurement, waveform monitoring, freezing, and recording, etc. Its color TFT liquid crystal display is able to show patient parameters and waveforms clearly. The monitor also features compact size, lightweight, easy-to-carry handle and built-in battery, which make it portable, especially in hospital transport.
2.1.4 Functions This monitor is capable of monitoring the following parameters.
2.2 External Appearance 2.2.1 Front Panel Handle Alarm indicator Display Control knob Control panel Figure 2-1 Front Panel This monitor is designed to comply with the requirements of relative international safety standards (IEC60601-1, EN60601-2-27 and EN60601-2-30) for medical electrical equipment. This monitor has floating inputs and is protected against the effects of defibrillation and electrosurgery.
2.2.2 Left Side Panel Your monitor may not have all connectors as shown below. 1 2 4 6 3 5 7 8 9 Figure 2-2 Left Side Panel 1. 2. 3. 4. 5. 6. 7. 8. 9.
2.2.3 Right Side Panel The right side panel differs with different configurations as shown below. 2 1 3 4 Figure 2-3 Right Side Panel 1. 2. 3. 4. CO2 sensor connector (Oridion CO2 module) Water trap connector (Mindray DS CO2 or AG module) Exhaust outlet Recorder NOTE z z Some modules are optional. Their connectors may not be available on your patient monitor. If your monitor is equipped with CO2 module, then it can’t be equipped with AG module, vice versa.
2.2.4 Rear Panel 1 2 3 4 5 6 7 1. 2. 3. 4. 5. 6. 7. 8. 9. 8 Figure 2-4 Rear Panel 9 Fan Vent Speaker holes Mounting holes for support bracket. Network Connector: Standard RJ45 connector. Through network connector, this monitor can be connected with the central monitoring system, another monitor, or a PC. It enables the functions of viewbed monitoring, data output and on-line software upgrading. Fuse: Standard T3.
WARNING z Accessory equipments connected to this patient monitor must be certified according to the respective IEC standards (e.g. IEC 60950 for information technology equipment and IEC 60601-1 for medical electrical equipment). Furthermore all configurations shall comply with the valid version of the system standard IEC 60601-1-1.
10. Control Knob The main operator control is the control knob. The control knob rotates in either direction to highlight parameter labels and menu options. After highlighting the desired selection, press the control knob to execute an operation, make a selection, view a new menu or a small drop-down list. This procedure is referred to as “select ” through out the manual. Remember rotate to highlight, and then press to select. 2.4 Display This monitor has a color TFT LCD display of high resolution.
2. System time The system time of the monitor is displayed in two lines. The time format can be set in the TIME SETUP menu. 3. Technical alarms area Technical alarm messages or prompt information are displayed in this area. In case of multiple messages, they will be displayed alternately. This area shows the patient name and sex when no message is to be displayed. Sound icon 4. 5. 6. 7. 8. 9. Alarms Paused; System Silenced; Alarm Sound Off. No icon is displayed under normal status.
2.5 Batteries This monitor is designed to operate on battery (sealed lead-acid or Lithium Ion battery) power during intra-hospital patient transfer or whenever the power supply is interrupted. The battery is charged automatically when the monitor is connected to AC power, no matter the monitor is powered on or not. Whenever the AC power is interrupted during patient monitoring, the patient monitor will automatically run power from the internal batteries.
2.5.1 Battery Guidelines Life expectancy of a battery depends on how frequent and how long it is used. For a properly maintained and stored lead-acid or lithium ion battery, its life expectancy is about 2 or 3 years respectively. For more aggressive use models, life expectancy can be less. We recommend replacing lead acid batteries every 2 years and lithium ion batteries every 3 years.
2.5.2 Battery Maintenance Conditioning a Battery A battery should be conditioned before it is used for the first time. A battery conditioning cycle is one uninterrupted charge of the battery, followed by an uninterrupted battery discharge and charge. . Batteries should be conditioned regularly to maintain their useful life. NOTE z z Condition a battery once when it is used or stored for 3 months, or when its operating time becomes noticeably shorter.
NOTE z z The battery might be damaged or malfunctioned if its operating time is too short after being fully charged. The operating time depends on the configuration and operation. For example, measuring NIBP more frequently will also shorten the operating time. When a battery has visual signs of damage, or no longer holds a charge, it should be replaced. Remove the old battery from the monitor and recycle it properly. 2.5.
In front of the wireless network card are three indicators that indicating its working status: POWER indicator OFF: The wireless network card is off or the patient monitor is off. Flashing: The wireless network card is resetting to the default. ON: The wireless network card is on and ready. WIRELESS/WLAN indicator OFF: The wireless network card is off or not associated with any access point. Flashing: The wireless network card is associating or transmitting wireless data.
3 Installation WARNING z z z The installation of the monitor must be carried out by personnel authorized by us. The software copyright of the monitor is solely owned by our company. Any action to change, copy or exchange the software copyright by any organization or person is regarded as copyright infringement and is not allowed. Accessory equipments connected to this patient monitor must be certified according to the respective IEC standards (e.g.
3.1 Unpacking and Checking Before unpacking, examine the packing case carefully for signs of damage. If any damage is detected, contact the carrier or our company. If the packing case is intact, open the package and remove the instrument and accessories carefully. Check all materials against the packing list and check for any mechanical damage. Contact our Customer Service Department in case of any problem. NOTE z Please save the packing case and packaging material for future transport and storage.
3.3 Power Source Requirements The power applied to the monitor must meet the requirements specified in this manual. WARNING z z Make sure that the operating environment and the power applied to the patient monitor complies with the specified requirements. Otherwise its performance might not meet the specifications claimed in this manual, and unexpected results, such as damages to the patient monitor, may be incurred. The monitor shall be powered according to the requirement for the system power voltage.
3.4.3 Installing the Battery If the monitor is to be powered by the internal battery, install the battery following the steps as below: 1. Open the door in the direction as marked on the battery door. 2. Move the battery catch above to one side using one finger. 3. Insert the battery into the battery slot per the “+” and “-” indications. 4. Move the battery catch to another side, and then insert the other one in the same way, if your monitor is equipped with two batteries. 5.
3.4.6 Auxiliary Output Port The auxiliary output port can be used to generate analog signals, nurse call signals or defibrillator synchronization signals. Analog output signals can be generated when the monitor is connected to an oscilloscope or a pen recorder. If the monitor is connected with the Nurse Call System of a hospital through a special nurse call cable, the monitor can generate nurse call signals when alarms occur.
3.4.8 Equipotential Grounding When other equipments are used together with the monitor, a grounding cable should be used to connect the equipotential grounding connectors of the monitor and of other equipments. This helps to reduce the potential differences between different pieces of equipment, and ensure the safety of the operator and patient. WARNING z If the grounding system is in doubt, the monitor must be supplied from its internal battery. 3.
4 System Menu 4.1 Overview This chapter only gives introduction to the system menu. Other menus will be described in the following chapters. 1 2 3 4 Figure 4-1 System Menu Most menus displayed by the monitor share the same structure. As shown above, a menu is made up of four parts: 1. Menu title: Summarizes the content of the current menu. 2. Main display area: Displays options, keys or prompt information, etc. “>>“ means a submenu will pop up if the option is selected. 3.
4.2 Patient Setup Select PATIENT SETUP>> in SYSTEM MENU. The following menu appears. Figure 4-2 Patient Setup Menu This menu displays the patient’s information, as well as four buttons located below. If no patient is admitted, the buttons are: CLEAR PATIENT DATA QUICK ADMIT PATIENT ADMIT PATIENT MODIFY PATIENT If a patient is admitted, the CLEAR PATIENT DATA button turns to be DISCHARGE PATIENT.
4.2.1 Admit Patient To admit a new patient, please follow this procedure: 1. Select ADMIT PATIENT in PATIENT SETUP menu. 2. Select YES in the pop-up CONFIRM TO CLEAR THE DATA menu. The menu as shown below appears. Figure 4-3 Patient Information Setup 3. Enter the patient’s information details. If the patient’s information is entered incompletely, corresponding symbols will appear in the upper left hand of the monitor screen.
NOTE z If the PAT NO or NAME has not been input, “PATI. INFO. IMCMP” will be displayed in the patient information area. 4. 5. Select OK button, and the patient is admitted. If the monitor is connected with the central monitoring system, you can monitor the patient through the central monitoring system. Setting Patient Information To enter information in a field containing no mark, follow this procedure (take PAT NO as an example): 1. Rotate the control knob and highlight the field after PAT NO. 2.
4.2.2 Quick Admit Patient 1. 2. 3. Select QUICK ADMIT PATIENT in PATIENT SETUP menu. Select YES in the pop-up CONFIRM TO CLEAR THE DATA menu. The following menu appears. You can set the PAT TYPE and status of PACE. Figure 4-4 Quick Admit Patient 4. 5. Select OK button, and the patient is admitted. If the monitor is connected with the central monitoring system, you can monitor the patient through the central monitoring system. 4.2.
4.3 Configuration Setup Select CONFIG >> in the SYSTEM MENU. The following menu appears. Figure 4-5 Configuration menu If you have changed some settings during monitoring a patient and the changed settings are not proper, especially when a new patient is admitted, you can restore the factory configuration. According to the patient category, the monitor provides 3 kinds of factory configurations: factory adult configuration, factory pediatric configuration and factory neonatal configuration.
4.4 System Setup Select SYSTEM SETUP>> in SYSTEM MENU. The following menu appears.
4.4.1 Face Select Select FACE SELECT>> in SYSTEM SETUP menu. The following menu appears. Figure 4-7 Face Select In the FACE SELECT menu, options are available as shown above. For detailed information, see chapter Face Selection. 4.4.2 Alarm Setup Select ALARM SETUP>> in SYSTEM SETUP menu. The following menu appears.
You can perform the following settings in the menu above: ALM SEL Alarm selection Options: COMMON ALM SETUP, XX ALM SETUP; (XX refers to physiological parameters such as HR, SPO2, etc.). If a parameter alarm setup is selected the corresponding alarm setup items will be displayed in the ALARM SETUP menu ALARM VOL Alarm volume The volume can be set between 0 and 10. 0 means off and 10 is the maximum volume. The volume can not be set to 0 unless the ALARM SOUND OFF is set to ENABLE (Refer to 4.
4.4.3 Time Setup Select TIME SETUP>> in SYSTEM SETUP menu. The following menu appears. Figure 4-9 Time Setup With the control knob, you can change the year, month, day, hour, minute and second as well as select the displayed format of the time. YYYY, MM, and DD refer to year, month and day respectively.
4.4.4 Recorder Setup Select RECORD>> in SYSTEM SETUP menu. The following menu appears. Figure 4-10 Recorder Setup In this menu, you can adjust the following items: REC WAVE1 Select the first waveform to be recorded. The setting of this item should be different with those of REC WAVE 2 and REC WAVE3; otherwise, the system will adjust the setting automatically. When OFF is selected, the first waveform will not be recorded. REC WAVE2 Select the second waveform to be recorded.
RT REC TIME Real-time recording time Options: CONTINUAL and 8s. TIMING REC TIME Timing recording time The interval between automatic recordings. Options: OFF, 10MIN, 20MIN, 30MIN, 40MIN, 50MIN, 1HOUR, 2HOURS, 3HOURS and 4HOURS. The monitor will start recording at the selected interval, record for 8s and stop automatically. NOTE z TIMING REC TIME cannot be saved after the monitor is turned off. But it can be saved as the user default configuration. RT REC TIME has priority over TIMING REC TIME.
Output Procedure 1. 2. 3. 4. 5. Disconnect all patient cables connected to the monitor. Verify the monitor is connected to the PC and the PC is running the Patient Information Recall System software. Select from the data source options. Select OUTPUT in the menu and the prompt “CONNECTING…” is shown aside. If you exit the DATA OUTPUT menu at this time, the prompt will be displayed in prompt information area at the lower left corner of the screen.
NOTE z If DEFIB. SYN or NURSE CALL is selected from the AUX OUTPTU options in the USER MAINTAIN menu, the ANALOG>> option in the SYSTEM SETUP menu will be inactive, and the monitor will be unable to output analog signals. For details, please refer to 4.7 Maintenance. 4.4.7 Module Setup Select MODULE SETUP>> in SYSTEM SETUP menu. The following menu appears. Figure 4-13 Module Setup This menu allows you to enable or disable a parameter module to determine the information displayed on the main screen.
4.4.8 Trace Setup Select TRACE SETUP>> in SYSTEM SETUP menu. The following menu appears. Figure 4-14 Trace Setup This menu allows you to select the parameter waveform(s) to be displayed. The mark “√” indicates the parameter waveform will be displayed, and that without the mark will not be displayed. The TRACE SETUP menu merely contains the parameter modules enabled in the MODULE SETUP menu.
4.4.9 Mark Event Select MARK EVENT>> in SYSTEM SETUP menu. The following menu appears. Figure 4-16 Mark Event This menu allows you to mark four different events, namely event A, B, C and D. The “@” symbol will appear in the frame of the event being selected. If you attempt to unmark an event, press the control knob again on the marked selection. The purpose of event marking is to define the records, such as dose taking, injections or therapy, which have influence on patients and parameter monitoring.
4.5 Selection Setup Select SELECTION>> in SYSTEM MENU. The following menu appears. Figure 4-17 Selection Setup You can perform the following settings in this menu: KEY VOL Key volume The volume can be set between 0 and 10. 0 indicates the volume is off and 10 indicates the maximum volume. HELP Online help ON: Indicates the online help is enabled and the help information will be displayed; OFF: Indicates the online help function is disabled and the help information will not be displayed.
4.6 Monitor Version You can select VERSION>> in the SYSTEM MENU to check the version information as shown below.. However, the VERSION menu of you monitor may be different. Figure 4-18 Version You can see the monitor’s configuration by selecting DEVICE CONFIG LIST>> as shown below. However, the DEVICE CONFIG LIST menu of you monitor may be different.
You can also see the device version by selecting DEVICE VERSION LIST>> as shown below. However, the DEVICE VERSION LIST menu of you monitor may be different. Figure 4-20 Device Version List 4.7 Maintenance Select MAINTAIN>> in SYSTEM MENU. The following menu appears.
Enter USER KEY, then select CONFIRM button. The following menu appears. Figure 4-22 User Maintain You can perform the following settings: MONI NAME Monitor’s name. DEPT. The department where the monitor is located. BED NO The bed number where the monitor is located. NET TYPE Network type Options: CMS and CMS+. LOCAL NET NO It indicates the bed number of a monitor in the monitoring network. If the NET TYPE is CMS, the LOCAL NET NO can be set between 1 and 64. NOTCH FREQ.
1. ANALOG OUT (analog output) If this option is selected, the auxiliary output port will be able to output analog signals, and you can perform the settings in the ANALOG menu. For details, see 4.4.6 Analog Output. If this option is not selected, the analog output function will be disabled and the ANALOG >> option in the SYSTEM SETUP menu will become inactive. In this situation, you cannot set the information in the ANALOG menu. 2.
NOTE z z z If you changed the net type and language, the settings take effect only after you restart the monitor. The setting of the notch frequency can neither be saved as the user configuration nor changed when the factory configuration is selected. Once set by a user, no operation except for manual adjustment can change it. The setting keeps the same even when the monitor is restarted. Do not change the BED NO when your monitor is using the wireless network feature. 4.7.
NOTE z In the case that alarm volume is set to 0, if you set ALARM SOUND OFF to DISABLE, alarm volume change to the default. WARNING z Select the setting of ALARM SOUND OFF with caution. 4.7.2 IP Address Setup When the monitor is connected with the central monitoring system, and the NET TYPE is CMS+, you need to set the IP address of your monitor. Select IP ADDRESS SETUP in USER MAINTAIN menu. The following menu appears.
4.7.3 Self Definition of Color Select COLOR SELF-DEFINE >> in USER MAINTAIN menu. The following menu appears. Figure 4-25 Self-definition of color This menu allows you to choose in which color the waveform(s) and parameter(s) of a parameter module are to be displayed. OTHER PARA refers to the parameters, NIBP and TEMP, which do not have waveform. CO2 refers to the parameters measured by CO2 module or AG module. AG O2, AG N2O and AG AA refer to corresponding parameters measured by AG module.
4.7.4 Nurse Call Setup Select NURSE CALL SETUP >> in USER MAINTAIN menu. The following menu appears. Figure 4-26 Nurse Call Setup You can perform the following settings: SIGNAL DURATION Two options are available: PULSE, and CONTINUUM. 1. PULSE When pulse is selected, a nurse call signal is a pulse signal lasting 1s. When multiple alarms occur simultaneously, only one pulse signal will be output. If an alarm comes out before the previous alarm is cleared, another pulse signal will be output. 2.
Trigger Conditions A nurse call signal will be triggered only if all the following conditions are met: 1. The nurse call function is enabled. 2. An alarm of the preset alarm level and alarm type comes out. 3. The monitor is not in the Alarms Paused or the System Silenced status. NOTE z z z If no option in ALM LEV or ALM TYPE is selected, the nurse call signal will not be triggered in whatever condition. The nurse call function can’t be used as the main alarm notice method.
4.7.8 Monitor Status Select STATUS >> in ENTER MAINTAIN PASSWORD menu. The following menu appears. Figure 4-27 Monitor Status UP-DOWN This menu can display a maximum of ten status messages. In case of more than ten, you can select UP-DOWN to learn other status messages. REC Recording You can select the REC option to record the status message displayed.
4.8 DEMO Function Select DEMO >> in SYSTEM MENU. The following menu appears. Figure 4-28 Input Demo Key The monitor enters the demonstration mode when the correct password is input in the menu above. The word DEMO will be displayed on the main screen. The purpose of the demonstration display is to demonstrate the performance of the monitor, and for training purposes.
5 Face Selection 5.1 Standard Screen You can open the FACE SELECT menu by selecting FACE SELECT >> in SYSTEM SETUP menu. Figure 5-1 Face Select The standard screen is the default screen. If the current screen is not the standard screen, you may enter the standard screen by selecting STANDARD SCREEN and then selecting EXIT in FACE SELECT menu. For more information about the standard screen, see 2.4 Display.
5.2 Trend Screen To enter the following screen, select TREND SCREEN in FACE SELECT menu and then select EXIT. Figure 5-3 Trend Screen Trend graph Trend graphs locate to the right of the corresponding waveform in the waveform area, and display the trends of one parameter of each module. The parameter labels, as well as their scales, are displayed to the left of the trend graph. Trend length The dynamic trend length, located below the trend graph, is 2 hours.
5.3 OxyCRG Screen To enter the following screen, select oxyCRG SCREEN in FACE SELECT menu and then select EXIT. 1 2 3 Figure 5-4 OxyCRG Screen Oxy CRG screen is located at the lower part of the waveform area, consisting of the HR trend, the SpO2 trend, and the RR (respiration rate) trend or the compressed respiration waveform. Below the RR trend or the compressed respiration waveform is the scale of the trend time.
5.4 Viewbed Screen This monitor can view one parameter waveform and measured data from another patient monitor (viewbed monitor) on the same monitoring network. To enter the following screen, open FACE SELECT menu, select VIEWBED SCREEN, and then select EXIT. When connecting by wireless network (if your monitor has this feature), viewbed function is disabled. 1 3 6 4 2 5 Figure 5-5 Viewbed Screen The monitor you are viewing from is called “host monitor”.
1. 2. 3. 4. 5. 6. Viewbed monitor label The viewbed monitor lable allows you to select the viewbed monitor you want to view. It displays the bed number and patient name of the viewbed monitor. If they are not entered, the label displays blank. If the host monitor is not connected with any other monitor on the same network, the label displays N/A. Viewbed waveform label The viewbed waveform label allows you to select a waveform of the viewbed monitor.
5.5 Large Font Screen To enter the following screen, open FACE SELECT menu, select LARGE FONT SCREEN, and then select EXIT. Figure 5-6 Large Font Screen As shown above, the HR, SpO2 and NIBP values (diastolic pressure, mean pressure and systolic pressure) are displayed in large font. The ECG and SpO2 waveforms are displayed on the upper left of the screen. In case the ECG, SpO2 or NIBP parameter module is turned off, the corresponding parameters and waveform disappear.
5.6 Standby Mode During patient transport or temporary departure of a patient, the monitor can be set to STANDBY mode. In this mode, the monitor suspends the monitoring and measurement on the patient and shields all alarm indications. Besides the WORK MODE of CO2 and AG module (if available), which will also be changed to STANDBY, the previous menu settings and patient information keep unchanged. Entering the STANDBY mode 1. 2. 3. 4. Disconnect all leads and sensors between the patient and the monitor.
FOR YOUR NOTES 5-8
6 Alarms 6.1 Overview The monitor gives audible or visual alarms to indicate the medical staff, when a vital sign of the patient appears abnormal, or mechanical or electrical problems occur to the monitor. Upon turning on the monitor, the alarm indicator will flash once in yellow and red. Then, a beep will be heard. This is used to verify the audible and visual alarm function of the monitor.
6.1.2 Alarm Levels The alarms are divided into three priority levels: high level alarms, medium level alarms and low level alarms. 1. 2. 3. High level alarms The patient ‘s life is in danger and requires emergency treatment, or Serious technical problem occurs to the monitor, such as error in ECG module initialization.
6.2.2 Audible alarms The monitor uses different alarm tones to indicate different alarm levels. High level alarm: “DO-DO-DO--DO-DO---DO-DO-DO--DO-DO”. Medium level alarm: “DO-DO-DO”. Low level alarm: “DO”. Different intervals correspond to different alarm levels: High level alarm phonates once every 3 or 8 seconds. Medium level alarm phonates once every 14 or 24 seconds. Low level alarm phonates once every 24 seconds. For details, please refer to 4.7 Maintenance.
6.2.4 Parameter Flashes An alarm is triggered when a patient parameter exceeds the parameter limit. At the same time, the measured parameter value in the parameter window flashes every second. If the ALM LIMIT in the SELECTION menu is turned ON, the exceeded upper or lower alarm limit also flashes every second. 6.2.5 Reminder Tones When system sounds are silenced or alarm tones are turned off, the patient monitor will give a single beep in case of an active alarm condition.
NOTE z When a new parameter module is installed or when a parameter module is turned ON, all the parameter alarms and technical alarms related to this module are disabled in the first 30-second operating time. The other module alarms are not influenced. 6.3.2 Alarms Paused To pause all alarms of the monitor for 1, 2 or 3 minutes, press the SILENCE key on the control panel once (for less than 2 seconds). In Alarms Paused status, Visual alarms and audible alarms are both paused.
6.3.5 Status Switchover 1. In the Normal status, Press the SILENCE key for less than 2 seconds to switch to the Alarms Paused status, or Press the SILENCE key for 2 seconds or more to switch to the System Silenced status. 2. In the Alarms Paused status, Press the SILENCE key for less than 2 seconds to switch to the Normal status, or Press the SILENCE key for 2 seconds or more to switch to the System Silenced status. 3.
6.5 Clearing Alarms Generally the alarm indications of an alarm will automatically be cleared when the alarm condition that triggered the alarm ceases. However, you can also clear the alarm indications or the latched alarms by the following ways. 1.
6.6 Testing Alarms When the monitor starts up, a selftest will be performed automatically. The alarm indicator will flash once in yellow and red. Then, the system gives a beep indicating that the visible and audible alarm indicators are functioning correctly. The start-up screen is displayed. For further testing of individual measurement alarms, perform the measurement on yourself (for example SpO2 or CO2) or use a simulator. Adjust alarm limits and check if alarms behave correctly. 6.
7 Freezing Waveforms 7.1 Overview You can freeze the monitored waveforms of a patient as desired and view the waveforms of 40 seconds to gain a clear observation. Besides, the monitor can print three frozen waveforms using the recorder. The freezing function of the monitor has the following features. When the monitor enters the frozen mode, it exits all other menus automatically. The system freezes all waveforms displayed in the waveforms area. The frozen waveforms can be reviewed and recorded. 7.
7.3 FROZEN Menu The FROZEN menu is displayed at the lower left corner. You can perform the following settings in this menu. WAVE 1 Waveform 1 It determines the first frozen waveform to be printed on the recorder paper. The options of waveform 1 include all waveforms displayed on the screen and OFF. The waveform 1 will not be recorded when OFF is selected. WAVE 2 Waveform 2 It determines the second frozen waveform to be printed on the recorder paper.
7.4 Waveform Recall 1. 2. 3. 4. 5. In the frozen mode, select the RECALL option in the FROZEN menu, and the option name changes to L-RIGHT. Rotate the control knob clockwise, and the frozen waveforms move to the right. At the lower right corner of the first waveform is an arrow pointing upward. The time is indicated below the arrow. The indication "0S" is used to mark the moment when the waveforms were frozen.
FOR YOUR NOTES 7-4
8 Recording 8.1 Overview A thermal recorder can be equipped with the monitor. The performance of the recorder is described as below. Records patient information and parameters. Records a maximum of three waveforms. The optional recording rates: 25mm/s and 50mm/s. The recording grid is optional. Multiple recording types are supported. For details about the recorder setup, please refer to 4.4.4 Recorder Setup. 8.
Alarm recording Alarm recording is measured parameter recording. When a parameter alarm occurs, the recorder automatically records two waveforms of 8, 16 or 32 seconds (respectively 4, 8 or 16 seconds before and after the alarm. See 4.4.2 Alarm Setup) and some measured parameters. NOTE z For a parameter alarm recording, you must first set the ALM and ALM REC options to ON.
8.3 Recorder Operations Continuous real-time recording 1. 2. Press the RECORD key to start recording. Press the RECORD key again to stop the recording. 8-second real-time recording 1. 2. Press the RECORD key to start recording. The recording stops automatically in 8 seconds. Automatic recording 1. 2. The recorder starts recording automatically at the preset interval (RT REC TIME). The recording stops automatically in 8 seconds. Alarm recording 1. 2.
Trend table recording 1. 2. 3. Select TREND TABLE>> in SYSTEM MENU to open the TREND TABLE window. Select the REC option to start recording. When the recording completes, the recorder stops automatically. NIBP measurement recording 1. 2. 3. Select NIBP RECALL>> in SYSTEM MENU to open the NIBP RECALL window. Select the REC option to start recording. When the recording completes, the recorder stops automatically. Alarm event recording 1. 2. 3. 4. 5.
8.4 Installing Recorder Paper Installing Procedure 1. 2. 3. 4. 5. 6. Press the latch at the upper right of the paper compartment door to releases the door. Lift the roller lever located at the upper left of the paper compartment as shown in the following figure. Insert a new roll of recorder paper into the compartment as shown below. The roller of the recorder scrolls automatically, and the paper comes out of the compartment. Push down the roller lever. Close the recorder door.
Removing the Paper Jam If the recorder does not function properly or produces unusual sound, open the recorder door to check for a paper jam. You can follow the operations below to remove the paper jam. 1. Open the recorder door. 2. Tear the paper off from the leading edge at the paper outlet. 3. Lift the lever on the upper left of the recorder. 4. Pull the paper from the paper inlet. 5. Re-insert the paper.
9 Recall 9.1 Overview The monitor is able to store important patient data so that the user can review and record the data as desired. Trend Graph Recall You can review the latest 1-hour trend graph of a measured parameter displayed every 1 or 5 seconds, or the latest 96-hour trend graph displayed every 1, 5 or 10 minutes. Trend Table Recall You can review the latest 96-hour trend table data of a measured parameter.
9.2 Trend Graph Recall Select TREND GRAPH >> in SYSTEM MENU. The following window appears. 4 1 2 3 5 6 1. 4. Trend cursor 2. Y-axis 5. Cursor time X-axis 3. 6. Trend graph Parameters area Figure 9-1 Trend Graph As shown above, PARA1, PARA2 and PARA3 allow you to select a parameter from the options. The trend graph of the selected parameter is displayed. If NIBP is selected, no trend graph is to be displayed.
1. 2. 3. 4. 1. 2. 3. 1. 2. 3. When “OFF” is selected for “PARA1”, “PARA2” or “PARA3”, its trend graph will disappear, and then the trend graphs of other parameters will increase in amplitude and evenly occupy Parameters area. You can not select the same option for “PARA1”, “PARA2” and “PARA3” simultaneously other than “OFF”. RESOLUTION Rotate the control knob and highlight the field at the right of RESOLUTION. Press the control knob, and a menu pops up.
9.3 Trend Table Recall Select TREND TABLE >> in SYSTEM MENU. The following window appears. Figure 9-2 Trend Table The TIME is displayed on the left of the trend table. On the top is the latest time. From the upper to the lower, the interval between two adjacent times depends on the preset resolution. And the date is contained in the brackets. On the right of the TIME is the EVENT. If a marked event happened at a specific time, the mark will be displayed aside that time in the EVENT field.
1. UP-DOWN Rotate the control knob to highlight the UP-DOWN option, and press. 2. If the mark is displayed at the lower right of the TIME field, you can rotate the control knob anticlockwise to page down and review the trend data of earlier time. 3. If the mark is displayed at the upper right of the TIME field, you can rotate the control knob clockwise to page up and review the trend data of later time. L-RIGHT 1. Rotate the control knob to highlight the L-RIGHT option, and then press. 2.
9.4 NIBP Recall Select NIBP RECALL >> in SYSTEM MENU. The following window appears. Figure 9-3 NIBP Recall The NIBP RECALL window shows the non-invasive systolic pressure (NS), non-invasive mean pressure (NM), non-invasive diastolic pressure (ND), puse rate (PR) and the measurement time (TIME). The optional pressure units (UNIT) are mmHg and kPa. NUM indicates the current measurement times. PR is derived from NIBP measurements. A maximum of ten measurements can be displayed on the screen once.
9.5 Alarm Event Recall Select ALARM RECALL >> in SYSTEM MENU. The following menu appears. Figure 9-4 Alarm Recall Condition Selections In this menu, you may select the conditions of alarm review: ALARM RECALL TIME You can select the desired start time and end time for review. The end time can be set to either CURRENT TIME or SELF-DEFINE. ALARM RECALL EVENT The drop-down menu of ALARM RECALL EVENT provides a list of parameter options to be reviewed.
5. 6. Parameter values at the time of the alarm event. Two waveforms at the time of the alarm event. You can set the waveform length by selecting from the ALM REC TIME options in the ALARM SETUP menu. Please refer to 4.4.2 Alarm Setup. 1 2 3 4 5 6 Figure 9-5 Alarm Event Recall UP-DOWN The monitor is able to store a maximum of 70 alarm events. But only one alarm event can be displayed in the ALARM RECALL window once.
9.6 Non-Volatile Data Storage To avoid losing patient’s data when the monitor is powered off intentionally or accidentally, this monitor can realize the non-volatile data storage function (optional). During monitoring, the patient’s data, including trend data, NIBP measurement results, alarm events, and relative waveforms, will be saved into the monitor. When the monitor is powered on again, you can review the saved data using the TREND GRAPH, the TREND TABLE or the NIBP RECALL menu, etc.
FOR YOUR NOTES 9-10
10 ECG/RESP Monitoring 10.1 Overview Two algorithm packages are optional for ECG monitoring: 1. Mindray DS algorithm package This package provides 3/5-lead monitoring. 2. Mortara algorithm package This package provides 3/5/12-lead monitoring, ST-segment analysis and extended ARR analysis. 10.2 ECG Monitoring Procedure 10.2.1 Preparation 1. Skin preparation The quality of ECG information displayed on the monitor is a direct result of the quality of the electrical signal received at the electrode.
10.2.2 Electrode Placement WARNING z z z z z z z z Use only the specified ECG cable for monitoring. When applying electrodes or connecting cables, make sure they are not connected to any conductive part or the ground. Verify that all ECG electrodes, including neutral electrodes, are securely attached to the patient. Skin irritation may result from the continuous application of the ECG electrodes. These should be checked each day.
3-Leadwire Electrode Placement Following is the configuration per European standard when using three leadwires: R (right arm) electrode: near the right shoulder, directly below the clavicle. L (left arm) electrode: near the left shoulder, directly below the clavicle. F (left leg) electrode: on the left hypogastrium. Figure 10-1 Positions of 3-Leadwire Electrode Placement The chart below shows the label used to identify each leadwire.
5-Leadwire Electrode Placement Following is the configuration per American standard when using five leadwires: Figure 10-2 5-Leadwire Electrode Placement RA (right arm) electrode: near the right shoulder, directly below the clavicle. LA (left arm) electrode: near the left shoulder, directly below the clavicle. RL (right leg) electrode: on the right hypogastrium. LL (left leg) electrode: on the left hypogastrium. V (precordial) electrode: on the chest.
When attaching the chest electrode to the back of a patient, place it at one the following sites: V7: On the 5th intercostal space at the left posterior axillary line of the back. V7R: On the 5th intercostal space at the right posterior axillary line of the back. Figure 10-3 Positions of Chest Electrode The chart below shows the label used to identify each leadwire. Included also is its associated color code per American (AHA) and European (IEC) standards.
10-Leadwire Electrode Placement Figure 10-4 10-Leadwire Electrode Placement 12-lead ECG monitoring uses 10 electrodes which are placed on the patient’s four limbs and chest. The limb electrodes should be placed on the soft skin and the chest electrodes placed according to the physician’s preference. Electrode Placement for Surgical Patients Electrode placement during surgery is dependent on the type of surgery being performed.
WARNING z z When using Electrosurgery equipment, patient leads should be placed in a position that is equal distance from the Electrosurgery electrotome and the grounding plate to avoid burns to the patient. The Electrosurgery equipment wire and the ECG cable must be kept separated and not allowed to tangle. When using Electrosurgery equipment, never place the ECG electrodes near the grounding plate of the Electrosurgery device. This will cause a great deal of interference with the ECG signal. 10.2.
10.3 ECG Display 10.3.1 ECG Waveform In the standard screen, one or two ECG waveform(s) is (are) displayed at the top of the display when LEAD TYPE is set to 3 LEADS or 5LEADS respectively in the ECG SETUP menu. 1 2 4 5 3 Figure 10-6 ECG Waveforms As shown above, when 5 LEADS is selected, five labels are located above the ECG waveforms: 1. ECG lead of channel 1 (Primary lead) You can select the lead of channel 1 from the label options.
WARNING z Only in the DIAGNOSTIC mode will the monitor provide non-processed real signal waveforms. In the MONITOR or SURGERY mode, the ECG waveforms may have slight distortions and the result of the ST segment analysis may be affected greatly. In the SURGERY mode, the ARR analysis result may be affected to some extent. Hence, the DIAGNOSTIC mode is recommended when monitoring a patient in an environment with slight interference. 4.
10.4 ECG Setup Menu To display the ECG SETUP menu, use the knob to select the ECG label in the parameter windows.
The options of ECG SETUP menu are listed below. However, your algorithm package may not include some of these options. HR ALM Heart rate alarm on/off status ON: When a heart rate alarm occurs, the monitor gives alarm indications and stores the alarm; OFF: When a heart rate alarm occurs, the monitor neither gives alarm indications nor stores the alarm; When OFF is selected, the the ECG label. icon is displayed on the right of ALM LEV Alarm level Options: HIGH, MED and LOW.
1. 2. 3. 4. 5. ECG: HR is always calculated from ECG. SpO2: If the ECG signal is seriously interfered, you can select SPO2, which means PR will be derived from PLETH waveform. In this case, PULSE is displayed to the right of the ECG label while the PR reading is displayed below. The monitor activates pulse beeps instead of heartbeat beeps. IBP: If the ECG signal is seriously interfered, you can select IBP which means PR will be calculated by IBP module.
Other Setup Select OTHER SETUP >> in the ECG SETUP menu. The following menu appears. The options available in the menu vary with each algorithm package. Figure 10-10 Other ECG Setup (Mindray DS Algorithm Package) Figure 10-11 Other ECG Setup (Mortara Algorithm Package) In this menu, you can select any of the displayed option. All options are listed below. Your algorithm package may not include some of these options.
When ECG is in NORMAL DISPLAY mode, if the SMART LEAD OFF is configured ON and there is a LEAD OFF in the HR-derived channel, the system will automatically switch to another lead to restore the display of the ECG waveform in the HR-derived channel. When the LEAD OFF condition is corrected, the leads are automatically switched back.
NOTE z z z When monitoring a patient with a pacemaker, PACE must be turned ON. Otherwise, the system will count the pacemaker pulse as QRS complex. Do not completely depend on the alarms of heart rate. The patient with a pacemaker must be nearly monitored. When PACE is turned ON, the system will neither detect the arrhythmia relating to premature ventricular beats (including PVCs counting) nor perform the ST analysis. When monitoring a patient without a pacemaker, PACE should be turned OFF.
NOTE z If the filter method of the ECG waveform is set to a non-diagnostic mode, only the NOTCH option ON is active and the monitor filters the signals of the power line frequency. CASCADE ECG cascade ON: The monitor displays the waveform of each channel in two lines. OFF: The monitor displays the waveform of each channel in one line. The CASCADE can be turned ON only if the monitor is set to NORMAL DISPLAY mode and the SCAN TYPE is set to REFRESH.
ECG CAL Select this option to begin calibrating the ECG. To stop calibration, select this option again, or change the ECG lead selection on the screen. ADJUST WAVE POS >> This is used to adjust the position of the ECG waveform on the screen. Select this option to access the ADJUST WAVE POS menu. Open the CH NAME popup menu and select the channel to be adjusted. Afterwards, select the UP-DOWN option and rotate the control knob to adjust the position of the selected channel on the screen.
10.5 ST Analysis 10.5.1 Overview The function of ST analysis is optional. In the factory configuration, ST analysis is disabled. When turning ST ANALYSIS on, the monitor selects DIAGNOSTIC mode automatically. You can set the monitor to MONITOR or SURGERY mode as required. However, ST analysis will turn off automatically. With the ST analysis, the variance of the ST segment at the waveform tracks of the selected lead can be measured.
ST ANAL ST analysis ON: Enables the ST analysis; OFF: Disables the ST analysis. NOTE z z ST analysis can be carried out only when the filter method is set to DIAGNOSTIC. When ST analysis is switched on, the filter method will automatically switch to DIAGNOSTIC if it is not in the diagnostic mode. However, if you switch the filter method to MONITOR or SURGERY, ST analysis will turn off automatically.
10.5.3 Adjusting ST Measurement Point The ST measurement for each beat complex is the ventical difference between two measurement points. The isoelectric point provides the baseline for the measurement and the ST point provides the other measurement point.
Mortara algorithm package To adjust the points: 1. Select DEF POINT >> in the ST ANALYSIS menu to open the following window. Three vertical cursors indicate the positions of the ISO, J and ST points. Figure 10-15 ST Measurement Point 2. 3. Select VIEW LEADS option, and then rotate the knob to select a suitable ECG lead for ST measurement, with a visible J-point and a visible P wave. Select ISO, J or ST option, and then rotate the knob to adjust the position of each point respectively.
10.6 Arrhythmia Analysis 10.6.1 Overview The monitor uses the user-selected primary or secondary ECG lead for arrhythmia analysis. In clinical application, the medical professionals can use the arrhythmia analysis to evaluate patients’ condition (such as heart rate, PVCs rate, rhythm and ectopic beat) and give proper treatment. The arrhythmia analysis of the monitor has the following characteristics: Applicable to the monitoring of a patient either with a pacemaker or without a pacemaker.
10.6.2 Arrhythimia Options Mortara algorithm package When Mortara algorithm package is configured, your monitor has the following extended arrhythmia analysis option. Arrhythmia Message Description ASYSTOLE No QRS complex within the defined time in absence of ventricular fibrillation or chaotic signals. VFIB Ventricular fibrillation occurs and persists for 6 seconds. VTAC Ventricular HR is greater or equal to the defined limit and the number of consecutive PVCs is greater than the defined value.
10.6.3 Arrhythmia Analysis Menu Select ARR ANALYSIS >> in ECG SETUP menu. The following menu appears. The menu items vary with the algorithm packages. Figure 10-16 Arrhythmia Analysis (Mortara algorithm package) In this menu, you can perform the following settings: ARR ANAL Arrhythmia analysis ON: Enables the arrhythmia analysis; OFF: Disables the arrhythmia analysis.
10.6.4 Arrhythimia Relearn During ECG monitoring, you may need to start an arrhythmia relearn when a dramatic change in the patient’s ECG pattern has occurred. A change in the ECG pattern could result in: Incorrect arrhythmia alarms, Loss of ST measurements, and/or Inaccurate heart rate. Arrhythmia relearn allows the monitor to learn the new ECG pattern to correct arrhythmia alarms and heart rate value, and to restore ST measurements.
Figure 10-17 Arrhythmia Alarm Setup (Mortara algorithm package) In the menu, the ALM field indicates the alarm on/off status, REC indicates the alarm recording on/off status and LEV indicates the alarm level. You can change the settings as described below.
10.6.6 Arr Threshold Select ARR THRESHOLD >> in the ECG SETUP menu and the following menu appears. You can change the threshold settings in this menu. An alarm will be triggered when a rate exceeds a threshold. Figure 10-18 ARR Threshold Setup ARR Event Range Default Step Unit ASYS DELAY 3 to 10 5 1 s VTAC RATE 100 to 200 130 5 bpm VTAC PVC 3 to 12 6 1 Beats MULTIF.
10.6.7 Arrhythmia Recall Select ARR RECALL >> in the ARR ANALYSIS menu. The following menu appears. You can review any stored arrhythmia event in this menu. Figure 10-19 Arrhythmia Recall You can perform the following operations: UP-DOWN A maximum of 10 arrhythmia events can be displayed in the window each time. In case of more than 10 events, you can use the UP-DOWN option to review more. At most 8 pages can be reviewed.
Figure 10-20 Arrhythmia waveform Review You can perform the following operations: UP-DOWN This option allows you to page up and down to review the waveform and the parameters of other arrhythmia events. L-RIGHT This option allows you to review 8-second waveform of the currently displayed arrhythmia event. REC Selecting this option starts the recording of the waveform and the parameters of the currently displayed arrhythmia event.
10.7 12-Lead 10.7.1 12-Lead Monitoring Display You can enter the 12-lead monitoring display if your monitor is configured with the 12-lead monitoring. To enter the ECG 12-Lead monitoring screen: 1. Place the 10 electrodes on the patient. 2. Select the ECG label to enter the ECG SETUP menu. 3. Set LEAD TYPE to 12 LEADS. 4. Set the ECG DISPLAY to 12-LEAD DISPLAY. Rhythm lead label Figure 10-21 12-Lead Display A total of 12 ECG waves and 1 rhythm wave will be displayed on the screen.
In the 12-Lead Monitoring Display: Labels except the ECG-related ones (ECG, ST, GAIN, RHYTHM) are all disabled. The REC button on the control panel is disabled. You can press the MAIN and MENU buttons on the control panel to exit the 12-Lead Monitoring Display and return to the normal monitoring display. 10.7.2 12-lead ST Analysis Menu Select the ST label in the parameter area, or select ST ANALYSIS >> in the ECG SETUP menu. The following menu appears.
ST ALM ST segment alarm ON: If the measured ST numerics exceed the alarm limit, the monitor gives alarm indications and saves the alarm; OFF: If the measured ST numerics exceed the alarm limit, the monitor does not give alarm indications or save the alarm. When OFF is selected, the right of the ST data area.
10.8 RESP Monitoring 10.8.1 Overview Respiration is detected by measuring thoracic impedance. The monitor measures the change of the impedanec between the RA and LA electrodes of the ECG lead I, or the RA and LL electrodes of the ECG lead II, and produces a respiration waveform as shown below. 4 1 2 3 5 Figure 10-23 Respiration Waveform and Parameter 1. 2. 3. 4. 5. Waveform name. RESP lead: I or II Waveform gain: 7 options are available: ×0.25, ×0.5, ×1, ×2, ×3, ×4, ×5.
10.8.2 Electrode Placement Since the same electrodes are used for ECG and respiration monitoring, the electrode placement is very important. Some patients, due to their clinical condition, expand their chest laterally, causing a negative intrathoracic pressure. In these cases it is better to place the two electrodes used for respiration monitoring laterally in the right axillary and left lateral chest areas, at the maximum point of the breathing movement, to optimize the respiratory waveform.
10.8.3 Respiration Setup Selecting the RESP label on the screen opens the following menu. Figure 10-25 RESP Setup Menu In this menu, you can perform the following settings. ALM Alarm on/off ON: When a respiration rate alarm occurs, the monitor gives alarm indications and stores the alarm; OFF: When a respiration rate alarm occurs, the monitor neither gives alarm indications nor stores the alarm; When OFF is selected, the of the RESP label.
For different patient types, the upper/lower limits of the respiration rate alarm may vary in the following range. Patient type Upper Limit Lower Limit Increment (breath/min) Adult (lower limit+2) ~120 0~(upper limit-2) 1 Neonate/pediatric (lower limit+2) ~150 0~(upper limit-2) 1 APNEA ALM Apnea alarm Determines whether the patient’s cessation of breath is an apnea event. Range: 10–40 seconds. SWEEP Waveform speed Options: 6.25, 12.5 and 25.0 mm/s.
10.9 Maintenance and Cleaning WARNING z z Before cleaning the ECG cable, be sure to disconnect the monitor from the ECG cable, or shut down the system and disconnect all power cords from the outlet. If the ECG cable is damaged or aged, replace with a new one. Cleaning The exterior surfaces of the ECG cable may be cleaned with a soft cloth, dampened with the alcohol, and then be air-dried or dried with a clean dry cloth. Disinfection Disinfection may cause damage to the equipment.
FOR YOUR NOTES 10-38
11 SpO Monitoring 2 11.1 Overview The monitor measures the patients’ SpO2 (oxygen saturation) and displays: 1. Pulse rate (PR) value in the ECG or SpO2 parameter window. 2. PLETH waveform in the waveforms area. 3. Oxygen saturation (SpO2%) value in the SpO2 parameter window. The PR value is displayed in the ECG parameter window only if: 1. SpO2 is selected from the HR FROM options in the ECG SETUP menu; or 2. AUTO is selected from the HR FROM options in the ECG SETUP menu and no ECG signal is received.
PITCH TONE The PITCH TONE function refers to the monitor’s capability to vary the pitch of the heart rate tone or pulse rate tone with the change of the SpO2 reading. This monitor provides 22 pitch levels. The pitch rises as the SpO2 reading increases toward 100% and falls as it decreases.
11.2.2 Precautions WARNING z z z z z z z The SpO2 value might be overestimated in the presence of Hb-CO, Met-Hb or dye dilution chemicals. Check if the sensor cable is in normal condition before monitoring. Do not use the SpO2 sensor once the package or the sensor is found damaged. Verify sensor cable fault detection before beginning monitoring. Unplug the SpO2 sensor cable from the connector. The screen will display the prompt information “SPO2 SENSOR OFF” and the audible alarm is activated.
NOTE z Place the SpO2 sensor cable at the backside of the patient hand. Make sure the fingernail is just opposite to the light emitted from the sensor. Neonate Sensor Placement Neonate SpO2 sensor consists of a Y-shape SpO2 sensor and its sheath. Insert the LED and PD ends of the Y-shape SpO2 sensor respectively into the upper and lower grooves on the sheath (Figure 11-3). The Figure 11-4 shows us the neonate SpO2 sensor after insertion.
Figure 11-5 Neonate Sensor Placement (3) NOTE z z If the sensor cannot be positioned accurately to the part to be measured, it may result in inaccurate SpO2 reading, or the SpO2 even cannot be measured because no pulse is detected. In this case, you must position the sensor again. The excessive patient movement may result in inaccurate reading. In this situation, you must keep the patient quiet or change the measured position to reduce the adverse influence of excessive movement.
11.2.4 Measurement Limitations If the accuracy of any measurement does not seem reasonable, first check the patient’s vital signs by an alternate method. Then check the instrument for proper function.
11.2.5 SpO2 Setup Menu Selecting the SPO2 label in the parameter window opens the following menu. Figure 11-6 SpO2 Setup Menu You can perform the following settings in this menu. ALM SpO2 alarm on/off status ON: When a SpO2 alarm occurs, the monitor gives alarm indications and stores the alarm; OFF: When a SpO2 alarm occurs, the monitor neither gives alarm indications nor stores the alarm; When OFF is selected, the of the SPO2 label.
SpO2 and PR alarm limits: Parameter Upper Limit Lower Limit Step SpO2 (lower limit+1) ~100 0~(upper limit-1) 1 PR (lower limit+2) ~254 0~(upper limit-2) 1 The SpO2 and PR alarm limits in factory configuration: Parameter SpO2 PR Patient type Upper limit Lower limit Adult 100 90 Pediatric 100 90 Neonate 95 90 Adult 120 50 Pediatric 160 75 Neonate 200 100 WARNING z Setting the SpO2 upper alarm limit to 100% will disable the upper alarm limit.
CONFIG >> You can select this option to access the SPO2 CONFIG menu, in which you may select FACTORY CONFIG or USER CONFIG. After finishing your selection and exiting the menu, the system pops up a dialog box asking for your confirmation. 11.3 Nellcor SpO2 Module NOTE z This section is only applicable to the monitor equipped with a Nellcor SpO2 module. 11.3.1 Principles of Operation Bone, tissue, pigmentation, and venous vessels normally absorb a constant amount of light over time.
Automatic Calibration Because light absorption by hemoglobin is wavelength dependent and because the mean wavelength of LEDs varies, a monitor must know the mean wavelength of the sensor’s red LED to accurately measure SpO2. During manufacturing, the mean wavelength of the red LED is encoded in a resistor in the sensor.
11.3.2 Precautions WARNING z z z z z z z z Pulse oximeter can overestimate the SpO2 value in the presence of Hb-CO, Met-Hb or dye dilution chemicals. ES (Electrosurgery) equipment wire and SpO2 cable must not be tangled up. Carefully route patient cabling to reduce the possibility of patient entanglement or strangulation. Do not use this instrument and the sensors during magnetic resonance imaging (MRI). Induced current could potentially cause burns.
11.3.4 Measurement Limitations If the accuracy of any measurement does not seem reasonable, first check the patient’s vital signs by an alternate method. Then check the instrument for proper function.
11.3.5 SpO2 Setup Menu Selecting the SPO2 label in the parameter window opens the following menu. Figure 11-8 SpO2 Setup Menu You can perform the following settings in this menu. ALM SpO2 alarm on/off status ON: When a SpO2 alarm occurs, the monitor gives alarm indications and stores the alarm; OFF: When a SpO2 alarm occurs, the monitor neither gives alarm indications nor stores the alarm; When OFF is selected, the right of the SPO2 label.
SpO2 and PR alarm limits: Parameter Upper Limit Lower Limit Step SpO2 (lower limit+1) ~100 0~(upper limit-1) 1 PR (lower limit+2) ~254 0~(upper limit-2) 1 The SpO2 and PR alarm limits in factory configuration: Parameter SpO2 PR Patient type Upper limit Lower limit Adult 100 90 Pediatric 100 90 Neonate 95 80 Adult 120 50 Pediatric 160 75 Neonate 200 100 WARNING z Setting the SpO2 upper alarm limit to 100% will disable the upper alarm limit.
11.3.6 Accessories If your monitor is equipped with a Nellcor SpO2 module, use only Nellcor oximetry sensors for SpO2 measurements. Other sensors may cause improper pulse oximeter performance. Before use, carefully read the directions for the sensor. When selecting a sensor, consider, the patient’s weight and motion, the adequacy of perfusion, the available sensor sites, and the required disinfection.
FORYOURNOTES 11-16
12 NIBP Monitoring 12.1 Overview The Non-invasive Blood Pressure (NIBP) module measures blood pressure using the oscillometric method. This monitor can be applied to adult, pediatric, and neonatal patients. Three modes of measurement are available: manual, automatic and continuous. Manual: Pressing the NIBP key on the control panel starts a NIBP measurement. Auto: The NIBP measurement is conducted automatically at a preset interval.
If a set of measured results appears in grey, it indicates this measurement is performed at least 1 hour ago. 12.2 Monitoring Procedure WARNING z z z z You must not perform NIBP measurements on patients with sickle-cell disease or under any condition in which the skin is damaged or expected to be damaged. For a thrombasthemia patient, it is important to determine whether measurement of the blood pressure shall be done automatically. This monitor is suitable for use in the presence of electrosurgery.
5. 6. Make sure that the cuff edge falls within the range of the <-> mark. If it does not, use a larger or smaller cuff that will fit better. The limb chosen for taking the measurement should be placed at the same level as the patient's heart. If this is not possible, use the following method to correct the measurement result: If the cuff is placed higher than the heart level, add 0.75 mmHg (0.10 kPa) for each centimeter of difference. If it is placed lower than the heart level, deduct 0.75 mmHg (0.
3. To start a continuous NIBP measurement Selecting CONTINUAL in NIBP SETUP menu starts a continuous NIBP measurement. The monitor continues measuring NIBP for five minutes. 4. To stop a NIBP measurement During an auto, manual or continuous measurement, pressing the NIBP key on the control panel stops the ongoing measurement. NOTE z If you are in doubt about the accuracy of any reading(s), check the patient's vital signs by an alternative method before checking the function of the monitor. 12.
12.4 NIBP Setup Menu Selecting the NIBP label in the parameter area opens the following menu. Figure 12-2 NIBP Setup Menu You can perform the following settings in this menu. ALM NIBP alarm on/off status ON: When a NIBP alarm occurs, the monitor gives alarm indications and stores the alarm; OFF: When a NIBP alarm occurs, the monitor neither gives alarm indications nor stores the alarm; When OFF is selected, the right of the NIBP label.
SYS ALM HI Determines the upper limit of the systolic pressure. SYS ALM LO Determines the lower limit of the systolic pressure. MEAN ALM HI Determines the upper limit of the mean pressure. MEAN ALM LO Determines the lower limit of the mean pressure. DIA ALM HI Determines the upper limit of the diastolic pressure. DIA ALM LO Determines the lower limit of the diastolic pressure. If a measured pressure crosses a preset upper or lower alarm limit, an alarm will be triggered.
NS NM ND PR DATE TIME 108 84 70 68 2006-6-12 16:06:00 108 80 70 67 2006-6-12 16:11:00 108 80 70 72 2006-6-12 16:16:00 UNIT Options: mmHg, kPa; INTERVAL Select MANUAL to set the monitor to manual NIBP measurement mode, or select from the time options to determine the interval between automatic measurements. Optional intervals: 1, 2, 3, 4, 5, 10, 15, 30, 60, 90, 120, 180, 240, and 480MIN. RESET Select this option to restore the initial settings of the pressure pump.
Monitor NIBP cuff connector Reference manometer Hose Ball pump Metal vessel Figure 12-3 NIBP Calibration NOTE z The calibration of the NIBP measurement should be performed every two years or performed according to the Hospital Procedure. 12.4.2 Testing for Air Leakage The PNEUMATIC option is used to test air leakage. When the NIBP cuff is connected, select this option to start the NIBP inflation and test whether the air leakage occurs in the airway.
5. If no information appears on the bottom of the NIBP parameter area, it indicates the airway is in good condition and an air leak does not exist. However if the information “PNEUMATIC LEAK” appears, it indicates the airway may have an air leak. In this case, check for loose connections. After confirming all connections are secure, perform the test again. If there is still a failure, contact our Customer Service. NOTE z z Set PAT TYPE to ADU in the PATIENT SETUP menu before leakage test.
Figure 12-5 Replacing the Rubber Bladder To replace the rubber bladder in the cuff: 1. Place the bladder on top of the cuff so the rubber tubes line up with the large opening on the long side of the cuff. 2. Roll the bladder lengthwise and insert it into the opening on the long side of the cuff. 3. Hold the tubes and the cuff and shake the complete cuff until the bladder is in position. 4. Thread the rubber tubes from inside the cuff, and out through the small hole under the internal flap.
13 TEMP Monitoring 13.1 Overview The monitor is able to use two temperature probes simultaneously, to obtain two temperature values and the difference between them. The measurement values are displayed in the TEMP parameter window as shown below. 1 2 3 4 5 Figure 13-1 TEMP Parameter Window 1. TEMP label: Selecting this label opens the TEMP SETUP menu. 2. Temperature unit: ℃ or ℉. 3. 4. 5. T1: Temperature channel 1. Displays the temperature measured at temperature channel 1. T2: Temperature channel 2.
13.2 Measurement Procedure To measure the temperature of a patient, 1. If a disposable temperature probe is used, plug the temperature probe cable in the temperature probe connector on the side panel of the monitor, and then connect the temperature probe with the cable; if a reusable temperature probe is used, connect the temperature probe with the temperature probe connector directly. 2. Attach the temperature probe to the patient properly. 3. Power on the monitor.
13.3 TEMP Setup Menu Selecting the TEMP label in the parameter window opens the following menu. Figure 13-2 TEMP Setup Menu You can perform the following settings in this menu. ALM Temperature alarm on/off status ON: When a temperature alarm occurs, the monitor gives alarm indications and stores the alarm; OFF: When a temperature alarm occurs, the monitor neither gives alarm indications nor stores the alarm; When OFF is selected, the of the TEMP label.
between channel 1 and channel 2. TEMP UNIT Options: ℃ and ℉ CONFIG >> You can select this option to access the TEMP CONFIG menu, in which you may select FACTORY CONFIG or USER CONFIG. After finishing your selection and exiting the menu, the system pops up a dialog box asking for your confirmation. Temperature alarm limits: Parameter Upper Limit Lower Limit Step T1 and T2 (lower limit+1) ~50 0~(upper limit-1) 0.1 TD (lower limit+1) ~50 0~(upper limit-1) 0.
14 IBP Monitoring 14.1 Overview The monitor provides two channels to measure the invasive blood pressure (IBP, including diastolic, systolic and mean pressures), and displays two waveforms. 1 2 Figure 14-1 IBP Waveform 1. CH1 label: select the waveform of channel 1 to be displayed. 2. CH2 label: select the waveform of channel 2 to be displayed.
14.2 Precautions WARNING z z z z z Use only the IBP transducer specified in this operation manual. Disposable IBP transducers or domes should not be reused. Parts and accessories used must meet the safety requirements of the medical electrical equipment standards. The need for the operator to avoid conductive connection to the applied part likely to degrade safety. (For example, by not contacting metal cocks, if used.
14.3 Monitoring Procedure 1. 2. Plug the pressure cable into the IBP connector on the monitor and power on the monitor. Prepare the pressure line and transducer by flushing the system with normal saline solution. Make sure the tubing and transducer system is free of air bubbles. NOTE z 3. 4. 5. 6. In case of any entrapped air in the pressure system, re-fill the system with normal saline. Connect the catheter to the pressure line, making sure there is no air present in the catheter or pressure line.
14.4 IBP Menu Selecting the IBP (1,2) label in the parameter window opens the following menu. Figure 14-4 IBP (1,2) Select Menu 14.4.1 IBP Setup Menu The IBP SETUP in IBP (1,2) SELECT menu allows you to access the following menu.
You can perform the following settings in this menu. ALM IBP alarm on/off status ON: When a IBP alarm occurs, the monitor gives alarm indications and stores the alarm; OFF: When a IBP alarm occurs, the monitor neither gives alarm indications nor stores the alarm; When OFF is selected, the of the IBP (1,2) label. icon is displayed on the right ALM LEV Alarm level Options: HIGH, MED and LOW. AMP ADJUST Amplitude adjustment This option allows you to adjust the waveform amplitude.
Figure 14-6 IBP Alarm Setup Menu IBP alarm limits Pressure Label Upper Limit (mmHg) Lower Limit (mmHg) Step (mmHg) ART (lower limit+2) ~300 0~(upper limit-2) 1 PA (lower limit+2) ~120 -6~(upper limit-2) 1 CVP (lower limit+2) ~40 -10~(upper limit-2) 1 RAP (lower limit+2) ~40 -10~(upper limit-2) 1 LAP (lower limit+2) ~40 -10~(upper limit-2) 1 ICP (lower limit+2) ~40 -10~(upper limit-2) 1 P1 (lower limit+2) ~300 -50~(upper limit-2) 1 P2 (lower limit+2) ~300 -50~(upper limit-2)
1. 2. 3. HI: Determines the high scale. The reference scale changes when the high scale is changed. LO: Determines the low scale. The reference scale changes when the low scale is changed. VAL: Determines the reference scale and position. The high and low scales remain unchanged when the reference scale is changed. NOTE z z The high scale should not be smaller than the low scale; the low scale should not be larger than the high scale.
14.4.2 IBP Pressure Zero Menu You can select IBP PRESURE ZERO in IBP (1,2) SELECT menu to open the following menu. Figure 14-9 IBP Pressure Zero Menu Pressure Transducer Zeroing Procedure 1. Disconnect the transducer from the patient. Pressure transducer 3-way stopcock Pressure transducer interface cable Monitor Figure 14-10 Pressure Transducer Zeroing 2. 3. Adjust the 3-way stopcock to close the channel leading to the patient. The transducer is open to the atmosphere through the stopcock.
NOTE z z z To ensure correct measurement, zero the transducer before it is used to zero the monitor. Position the transducer at the same level with the patient’s heart, approximately mid-axillary line. Perform the pressure zeroing before monitoring, and at intervals during monitoring (at least once per day). The zeroing should also be conducted once the transducer cable is disconnected and then connected. Prompt Information Related to Zeroing Take channel 1 as an example.
14.5 Maintenance and Cleaning WARNING z Before cleaning the transducer, make sure the transducer is disconnected from the monitor, or the monitor is powered off and disconnected from AC power. Cleaning of IBP Transducer After the IBP monitoring operation is completed, remove the tubing and the dome from the transducer and wipe the transducer diaphragm with water.
Sterilization Chemical Solution Sterilization After finishing the cleaning, select an effective sterilant for chemical solution sterilization of the operating room equipment. Buffered glutaraldehyde (e.g. Cidex or Hospisept) is recommended. Do not use quaternary cationic detergents such as zephiran chloride. If the whole unit is to be sterilized, immerse the transducer but not the electrical connector into the sterilant for the recommended sterilizing period. Ensure that the dome has been removed.
FORYOURNOTES 14-16
15 CO Monitoring 2 15.1 Overview The monitor is able to measure the CO2 pressure of the patient airway, and displays the CO2 waveform in the waveforms area of the monitor screen. The CO2 parameter window shows the following parameters: End-tidal CO2 concentration (EtCO2) Inspired Minimum CO2 (InsCO2) Air Way Respiration Rate (AwRR) 2 1 Waveform Name 3 4 Figure 15-1 CO2 Waveform and Parameters 1. 2. 3. 4. 5.
15.2 Mindray DS CO2 Module NOTE z This section is only applicable to a monitor equipped with a Mindray DS CO2 module. 15.2.1 Principles of Operation WARNING z z z The CO2 module should be protected against crash and vibration. This CO2 module is applicable to neonate, pediatric as well as adult patients. Inaccurate measurement may occur when the monitor is operating in an environment of excessively high CO2 content (>0.5%). The monitor adopts sidestream CO2 module.
15.2.2 Preparations for CO2 Measurement 1. 2. 3. 4. Plug the water trap into its receptacle before the measurement. Open the CO2 SETUP menu and set WORK MODE to MEASURE. The “CO2 START UP” prompt information is displayed on the screen until the startup is finished. After the module start-up, the “CO2 WARM UP” prompt information is displayed on the screen. At this time, the module is in the Warming–up status. After the module warm-up, the module enters the Ready-to-measure status.
The calculation formulas in the above two compensations are as follows: ATPD: PCO2 (mmHg)= CO2 (vol%)× Pamp/100 BTPS: PCO2 (mmHg)= CO2 (vol%)×(Pamp-47)/100 In the above formulas, PCO2 refers to the CO2 partial pressure, vol% is the percentage of the gas concentration, and Pamp is the ambient pressure in the unit of mmHg. WARNING z z z z z Do not use the accessory if the packaging or the internal accessory is damaged. Return it to the manufacturer.
You can perform the following settings in this menu. ALM Alarm on/off status ON: When a CO2 alarm occurs, the monitor gives alarm indications and stores the alarm; OFF: When a CO2 alarm occurs, the monitor neither gives alarm indications nor stores the alarm; When OFF is selected, the right of the CO2 label. icon is displayed on the ALM LEV Alarm level Options: HIGH and MED.
Alarm limits: Parameter Upper Limit Lower Limit Step CO2 (lower limit+2) ~100 0~(upper limit-2) 1 INS 0~100 / 1 AwRR (lower limit+2) ~150 0~(upper limit-2) 1 Patient type Upper limit Lower limit Adult 50 15 Pediatric 50 20 Neonate 45 30 Adult 4 / Pediatric 4 / Neonate 4 / Adult 30 8 Pediatric 30 8 Neonate 100 30 Default alarm limits: Parameter CO2 INS AwRR NOTE z z The apnea alarm cannot be disabled.
Other Setup Selecting OTHER SETUP option opens the following menu. Figure 15-4 CO2 Other Setup Menu You can perform the following settings in this menu. PUMP RATE Determines the sampling rate of the CO2 module pump. N2O COMPEN N2O compensation The presence of nitrous oxide causes the CO2 value to be higher than the actual value. Use this option to compensate for the presence of N2O.
When BTPS is turned ON, the system performs BTPS compensation automatically; when BTPS is turned OFF, the BTPS compensation is disabled. When measuring the CO2 content inside the patient’s lung, turn ON BTPS. Normally, the lung temperature of the patient is 37℃ and the water vapor is sufficient or regarded as saturated. But the temperature and water vapor content of the sampling line are different from the patient’s exhalation.
15.2.4 CO2 User Maintain Menu Select CO2 USER MAINTAIN >> in USER MAINTAIN menu. The following menu appears. Figure 15-5 CO2 User Maintain Menu The following information is displayed in the menu above. CO2 The currently measured CO2 content. Unit: %. In the field at the right of the CO2 value, you can select a standard gas containing a certain amount of CO2 for calibration. Options: 3%, 4%, 5%, 6% and 7%. BAROMETRIC The currently measured barometric pressure. Unit: mmHg.
CONFIRM CAL This option allows you to confirm the calibration of the CO2 module. Calibration Procedure 1. 2. Verify the module enters the ready-to-measure status. Connect a gas bottle with the CO2 sensor connector on the monitor as shown below. Tube Decompression valve T-shape connector opening to the atmosphere Monitor Gas bottle Figure 15-6 Connections for Calibration 3. 4. 5. 6. 7.
15.3 Oridion CO2 Module NOTE z z This section is applicable to a monitor equipped with the Oridion CO2 module only. When the sample flow is lower than 42.5 ml/min, alarm message will be displayed, and the CO2 module will stop work. 15.3.1 Principles of Operation WARNING z z z The CO2 module should be protected against crash and vibration. This CO2 module is applicable to neonate, pediatric as well as adult patients.
15.3.2 Preparations for CO2 Measurement 1. 2. 3. Plug the sampling line into its receptacle before the measurement. Open the CO2 SETUP menu and set WORK MODE to MEASURE. The “CO2 START UP” prompt information is displayed on the screen until the startup is finished. Figure 15-7 CO2 Module Airway Connections When the monitor is powered on for the first time, the CO2 module enters the STANDBY mode by default. To activat the CO2 module, you must change the work mode to MEASURE.
15.3.3 CO2 Setup Menu Selecting the CO2 label in the parameter window opens the following menu. Figure 15-8 CO2 Setup Menu You can perform the following settings in this menu. ALM Alarm on/off status ON: When a CO2 alarm occurs, the monitor gives alarm indications and stores the alarm; OFF: When a CO2 alarm occurs, the monitor neither gives alarm indications nor stores the alarm; When OFF is selected, the right of the CO2 label. icon is displayed on the ALM LEV Alarm level Options: HIGH and MED.
AWRR ALM LO Lower alarm limit of AwRR APNEA ALM Determines the apnea alarm delay. If the apnea of the patient exceeds the preset apnea alarm delay, the monitor triggers an alarm and gives the “CO2 APNEA” alarm message. Options: 10S, 15S, 20S, 25S, 30S, 35S and 40S. SWEEP Waveform speed Options: 6.25, 12.5 and 25.0. Unit: mm/s. UNIT Options: mmHg, kPa And %. WAVE SCALE Options: HIGH and LOW. This option allows you to adjust the amplitude of the CO2 waveform.
You can perform the following settings in this menu. MAX HOLD If Max Hold is configured to 10 sec or 20 sec, the etCO2 numeric shows the highest CO2 value measured within the previous 10 or 20 seconds. If set to Off the etCO2 numeric shows breath-to-breath value. BTPS Body temperature and pressure, Saturated Options: ON and OFF. When BTPS is turned ON, the system performs BTPS compensation automatically; when BTPS is turned OFF, the BTPS compensation is disabled.
15.3.4 CO2 User Maintain Menu Select CO2 USER MAINTAIN >> in USER MAINTAIN menu. The following menu appears. Figure 15-10 CO2 User Maintain Menu The following information is displayed in the menu above. CO2 The currently measured CO2 content. Unit: %. In the field at the right of the CO2 value, you can select a standard gas containing a certain amount of CO2 for calibration. BAROMETRIC The currently measured barometric pressure. Unit: mmHg.
Calibration Procedure 1. 2. Verify the module enters the Full Accuracy Mode. Connect a gas bottle with the CO2 sensor connector on the monitor as shown below. Tube Decompres sion valve T-shape connector opening to the atmosphere Monitor Gas bottle Figure 15-11 Connections for Calibration 3. 4. 5. 6. 7. Fill the gas bottle with a standard gas of certain CO2 content (4% to 6%), and input the gas to the monitor.
15.3.6 Oridion Information This trademark is registered in Israel, Japan, Germany and US. Oridion Patents This device and the CO2 sampling consumable designed for use herewith is covered by one or more of the following USA patents: 4,755,675; 5,300,859; 5,657,750; 5,857,461 and international equivalents. USA and international patents pending.
16 Anesthesia Gas Monitoring 16.1 Overview The anesthesia gas (AG) monitoring can be used for measuring the anesthesia gas and respiration gas of the patient in the anesthetic status. This monitor can configure AION 02 AG module or AION 03 AG module. AG module provides the end-tidal numerics and inhaling numerics of the gases mentioned below. Carbon dioxide (CO2): The measured numeric is EtCO2 (Max. exhaling value: Max. exhaling numeric detected during the respiration).
Parameters: CO2: N2O: O2: AwRR: HAL: ISO: ENF: SEV: DES: Carbon dioxide Nitrous oxide (laughing gas) Oxygen Airway respiration rate (respiration per minute, BrPM) Halothame Isoflurane Enflurane Sevoflurane Desflurane Measured numerics of AGs MAC numeric Figure 16-2 AG parameters AG label AwRR numeric NOTE z z The AG module is not intended to monitor multiple halogenated anaesthetic gases.
16.2 Measurement Principles and Procedure Measurement principle of AGs The AG concentration is measured based on the rationale that the AGs have the property of absorbing the infrared. The AG module can measure gases that have various properties of absorbing the infrared. To measure the concentration of a gas, send it to the sampling room, select the infrared of a specific wavelength with an optical infrared filter, and transmit it through the gas.
WARNING z z z z z z z Ensure the compactness of the connection when performing gas measurements. Any leakage in the system will lead to incorrect readings because this leakage will make the surrounding environmental air mix up with the patient gas. The water trap is used for collecting water condensates to protect the module from the ingress of water; when the collected water in the water trap reaches a specific volume, it must be removed, thus to avoid clogging in the gas system.
16.3 MAC Minimum alveolar concentration (MAC) is the minimum concentration of the agent in the alveoli. It is a basic index to indicate the depth of anesthesia. The standard ISO 21647 defines MAC as this: alveolar concentration of an inhaled anesthetic agent that, in the absence of other anesthetic agents and at equilibrium, prevents 50% of patients from moving in response to a standard surgical stimulus.
16.4 AG Setup Menu Select the GAS label in the parameter window. The AG SETUP menu appears. Figure 16-4 AG SETUP menu In this menu, you can set the following items. Agent Used to select the name of the anesthetic to be monitored, including AA, HAL, ENF, ISO, SEV and DES. If you select the AION 02 AG module, the patient monitor cannot identify the anesthetic type. Therefore, you have to select the used anesthetic before using the AG module so that the AG module can conduct measurements normally.
O2 COMPEN The options include: OFF, 30%, 40%, 50%, 60%, 70%, 80%, 90%, and 100%. When the O2 concentration exceeds 60% and it is not being monitored, turn on this switch. SWEEP Used to select the speed to scan the screen waveforms. Options: 6.25mm/s and 12.5mm/s. WORK MODE Options: MEASURE and STANDBY. To monitor the anesthetic gas, select the MEASURE option. Otherwise, select the STANDBY option. Alarm Setup Menu Select ALARM SETUP >> in AG SETUP menu. The following menu appears.
EtCO2 ALM LO Set the lower limit of EtCO2 which triggers the alarm FiCO2 ALM HI Set the upper limit of FiCO2 which triggers the alarm FiCO2 ALM LO Set the lower limit of FiCO2 which triggers the alarm EtO2 ALM HI Set the upper limit of EtO2 which triggers the alarm EtO2 ALM LO Set the lower limit of EtO2 which triggers the alarm FiO2 ALM HI Set the upper limit of FiO2 which triggers the alarm FiO2 ALM LO Set the lower limit of FiO2 which triggers the alarm If FiO2 is lower
Adjust Wave Amplitude Menu Select ADJUST WAVE AMP>> in AG SETUP menu. The following menu appears. Figure 16-7 ADJUST WAVE AMP menu In the ADJUST WAVE AMP menu, you can set the following items. CO2 WAVE AMP Used to adjust the display amplitude of CO2 waveform. N2O WAVE AMP Used to adjust the display amplitude of N2O waveform. O2 WAVE AMP Used to adjust the display amplitude of O2 waveform. AA WAVE AMP Used to adjust the display amplitude of AA waveform.
16.5 Calibrating AG Calibrate the AG module every year or when the measured value has a great deviation. Tools required: Gas bottle, with a certain standard gas or mixture gas. Gas concentration should meet the following requirements: AA>1.5%, CO2>1.5%, N2O>40%, O2>40%, of which AA represents an anesthetic agent. T-shape connector Tubing Reservoir bag Follow this procedure to perform a calibration: 1. Select MAINTAIN>> in SYSTEM MENU, enter USER KEY, then select CONFIRM button.
8. 9. If the calibration is finished successfully, the message CALIBRATION COMPLETED! is displayed. If the calibration failed, the message AG CAL. FAILED is displayed. Perform another calibration. Select EXIT to exit the current menu. 16.6 Maintenance and Cleaning 16.6.1 Occlusion handling If the AG module passage is occluded, the screen will prompt “AG OCCLUSION”. Following are a few examples of occlusion, which you may remove one by one until this message disappears.
FOR YOUR NOTES 16-12
17 Maintenance WARNING z z Failure on the part of the responsible hospital or institution employing the use of the monitoring equipment to implement a satisfactory maintenance schedule may cause undue equipment failure and possible health hazard. The safety inspection or maintenance, which requires opening the monitor housing, must be performed by trained and authorize personnel only. Otherwise, equipment failure and possible health hazard may be caused. 17.
17.2 Cleaning WARNING z Be sure to shut down the system and disconnect all power cords from the outlet before cleaning the equipment. Your equipment should be cleaned on a regular basis. If there is heavy pollution or lots of dust and sand in your place, the equipment should be cleaned more frequently. Before cleaning the equipment, consult your hospital’s regulations for cleaning, disinfecting and sterilizing equipment.
17.3 Disinfection and Sterilization Sterilization or disinfection may cause damage to the equipment. We recommend the sterilization and disinfection are contained in the hospital’s servicing schedule only when necessary. The equipment should be cleaned prior to sterilization and disinfection. Recommended sterilization material: Alcohol based (Ethanol 70%, Isopropanol 70%), and aldehyde based.
FOR YOUR NOTES 17-4
18 Accessories WARNING z z z z Use accessories specified in this chapter. Using other accessories may cause damage to the patient monitor or not meet the claimed specifications. The operating and storage conditions of the patient monitor should meet the specifications claimed by respective accessories. For environmental specifications of each accessory, refer to instructions for use of respective accessories. Single-use accessories are not designed to be reused.
18.1 ECG Accessories ECG Electrodes Model Quantity Patient Category Part No. 210 10 pieces Adult 0010-10-12304 2258-3 3 pieces Neonate 900E-10-04880 Separate Trunk Cable Leadwire supported Compatible with 3-leadwire 3-leadwire Model EV 6122 AHA 3/5-leadwire EV 6102 EV 6101 Type Defibrillator -proof Patient Category Part No.
18.2 SpO2 Accessories Extension Cable Module type Part No. Mindray DS SpO2 Module 0010-20-42594 SpO2 Sensors The SpO2 sensor material that patients or other staff will come into contact with have undertaken the bio-compatibility test and is verified to be in compliance with ISO 10993-1. Mindray SpO2 Module Type Single patient use Model Patient Category Part No.
18.3 NIBP Accessories Tubing Type Reusable Patient Category Part No. Adult, pediatric 509B-30-06259 Neonate 509B-30-06260 Reusable Cuff Model / Patient Category Measurement Site Blood Pressure Cuff Starter Kit Limb Circumference (cm) Part No. / 0020-00-018401 Limb Circumference (cm) Part No. 3.1 to 5.7 001B-30-70692 4.3 to 8.0 001B-30-70693 5.8 to 10.9 001B-30-70694 7.1 to 13.
18.4 TEMP Accessories Extension Cable Type Model Temp probe Part No. Reusable MR420 MR411, MR412 0011-30-90444 Temp Probes Type Model Patient Category MR401 Reusable MR403 MR402 MR404 Disposable MR411 MR412 Adult Pediatric, neonate / Measurement Site Part No.
Manufacturer Accessory Smith Medical (Medex) MX961Z14 trunk cable MX960 transducer MX9605A monitoring kit MX960E6441 transducer seat MX261 single channel transducer holder MX262 dual-channel transducerr holder (More transducer holders are available.
18.6 CO2 Accessories 18.6.1 Mindray DS CO2 Accessories Material Patient Category Remark DRYLINE Watertrap Adult, pediatric DRYLINE Watertrap Neonate Sampling Line, Adult 2.5m Adult, pediatric 9200-10-10533 Sampling Line, Neonate, 2.5m Neonate 9200-10-10555 Adult Nasal CO2 Sample Cannula Adult Pediatric Nasal CO2 Sample Cannula Pediatric M02A-10-25938 Infant Nasal CO2 Sample Cannula Infant M02B-10-64509 DRYLINE Airway Adapter / Reusable Disposable Straight Part No.
18.8 Others Model Lithium battery CF storage card Part No. M05-010001-06 (black) 0146-00-0099 023-000034-00 0000-10-10798 Data output software package 7000-30-24590 U.S.
A Product Specifications A.1 Safety Classifications Type of protection against electric shock Class I with internal electric power supply.
A.3 Power Source Specifications AC Power Supply Specifications Input voltage 100 to 240 V～ Current 1.4A to 0.6A Frequency 50/60 Hz Fuse T 3 A, 250 V Internal battery Number of batteries 2 Type Sealed lead-acid battery or lithium-ion battery Time to shutdown >5 min (after the first low-power alarm) Sealed lead-acid battery Nominal voltage 12 VDC Capacity 2.
A.4 Hardware Specifications Physical Size 318 × 270 × 137mm (width×height×depth) Weight Different due to different configurations Standard configuration: 4.7kg Maximum weight: ≤ 7.5kg Display Type Color TFT LCD Size 12.
A.5 Data Storage Trend data Long trend: 96 hours, resolution 1min, 5 min or 10 min. Short trend: 1 hour, resolution 1 s or 5 s. Alarm events 70 alarm events and associated waveforms (with user selectable waveform length 8s, 16 or 32). NIBP measurements 800 NIBP groups, including systolic pressures, mean pressures, diastolic pressures and measurement time. A.6 Wireless Network Standards IEEE 802.11g, Wi-Fi compatible Frequenct range 2.412 to 2.
Conducting resistance < 1Ω Isolation voltage > 1500 VAC Signal type Normally open or normally closed, selectable Defibrillator synchronization pulse Maximum time delay 35 ms (R-wave peak to leading edge of the pulse) Amplitude 3.5 V (min) at 3 mA sourcing; 0.8 V (max) at 1 mA sinking Pulse width 100 ms ±10% Rising and falling time < 3 ms VGA Connector type 15-PIN D-sub socket Signal RGB: 0.7 Vp-p/75Ω; Horizontal/vertical synchronization: TTL level A.8 ECG Specifications A.8.
Input signal range ±8mV (peak-to-peak value) Accuracy of input signal reproduction Methods A and D were used to establish overall system error and frequency response according to EC11. Auxiliary current (Leads off detection) Active electrode: < 0.
Response time of tachycardia alarm Tall T-Wave Rejection When tested in accordance with ANSI/AAMI EC13 Section 4.1.2.1 g, the response time is as follows: Figure 4ah – range: 15.7 to 19.2s, average: 17.4s 4a – range: 5.7 to 8.5s, average: 7.5s 4ad – range: 3.6 to 5.1s, average: 4.2s Figure 4bh – range: 11.5 to 14.7s, average: 12.9s 4b – range: 4 to 14s, average: 7.2s 4bd – range: 6.6 to 14.5s, average: 10.5s When tested in accordance with the ANSI/AAMI EC13 Section 4.1.2.
A.8.2 Mortara Software Package Lead naming style AHA, EURO Lead fault The lead resistance is no greater than 51 kΩ and it is in parallel with a 0.047 µF capacitor, it will not cause a lead fault condition. For 3/5-lead, differential offsets ≤ ±300 mV, it will not cause a lead fault condition. For 12-lead, differential offsets ≤ ±500 mV, it will not cause a lead fault condition. Sensitivity selection 1.25 mm/mV (×0.125), 2.5 mm/mV (×0.25), 5 mm/mV (×0.
The monitor complies with the test method in EC13 Section 5.2.9.14. HR Measurement range Neonate: Pediatric: Adult: Resolution 1 bpm Precision ±1 bpm or ±1%, whichever is greater. Trigger threshold level 200 μV (lead II) Trigger indication There will be an audible beep on every beat captured. Heart Rate Averaging The average Heart Rate is computed in line with the ANSI/AAMI EC13 Section 4.1.2.
Amplitude: ±4 to ±700 mV (3/5-lead) ±2 to ±700 mV (12-lead) 0.1 to 2 ms 10 to 100 µs Width: Rise time: When tested in accordance with the ANSI/AAMI EC13: Sections 4.1.4.1 and 4.1.4.3, the heart rate meter rejects all pulses meeting the following conditions. Pulse rejection Amplitude: Width: Rise time: Min. input slew rate: ±2 to ±700 mV 0.1 to 2 ms 10 to 100 µs 20 V/s RTI ST segment measurement Measurement range -2.0 to +2.0 mV Precision -0.8 to +0.8 mV: ±0.
A.10 SpO2 Specifications A.10.1 Mindray DS SpO2 Module All SpO2 sensors specified in the section Mindray DS SpO2 Accessories meets the following specifications when used with Mindray DS SpO2 module.
A.10.2 Nellcor SpO2 Module All SpO2 sensors specified in the section Nellcor SpO2 Accessories meets the following specifications when used with Nellcor SpO2 module. SpO2 measurement range and precision Sensor Range Precision* MAX-A, MAX-AL, MAX-N, MAX-P, MAX-I and MAX-FAST 70 to 100% 0% to 69% ±2% Undefined OxiCliq A, OxiCliq N, OxiCliq P, OxiCliq I 70 to 100% 0% to 69% ±2.
A.
A.12 TEMP Specifications Number of channels 2 Displayed parameters T1, T2 and TD Measurement range 0 to 50°C (32 to 122°F) Resolution 0.1°C Precision ±0.1°C (excluding the sensor) ±0.2°C (including the YSI 400 series sensor) Update period 1s Minimum time for accurate measurement Body surface: < 100s Body cavity: < 80s (YSI 400 series sensor) A.
Resolution 1 bpm Pressure transducer Excitement voltage 5 VDC, ±2% Sensitivity 5 uV/V/mmHg Impedance range 300 to 3000Ω Volume displacement (ABBOTT) ＜0.04 mm3 /100 mmHg A.14 CO2 Specifications Measurement technique Infrared absorption technique Displayed parameter EtCO2, FiCO2, Respiration Rate CO2 function Meet the requirements of EN ISO21647/ISO 21647 and ISO9918. A.14.
<3 s @ 100 ml/min <3.5 s @ 70 ml/min When measured with an adult watertrap and a 2.5m-long adult sampling line: <5 s @ 100 ml/min <6.
A.
Enf, Iso, Hal O2 (Optional) AwRR >8 Not specified 0 to 1 ±0.15 1 to 5 ±0.2 >5 Not specified 0 to 25 ±1 25 to 80 ±2 80 to 100 ±3 2 to 60 BrPM ±1 BrPM > 60 BrPM Not specified Drift meet the requirement of accurancy in 6 hours Alarm range CO2: AwRR: 0 to 10 % (0 to 76 mmHg) 2 to 100 BrPM Apnea alarm delay AwRR: 20 to 40 s Refreshing rate 1s Calibration Yearly calibration requested.
Effect of interference gases on AG measurements Gas Concentration(％) CO2 N2O Agent 1) 2) / / / Nitrogen Xenon Quantitive effect(%ABS)3) CO2 N2O Agent 1) O2 0.1 / 0.15) 0 0 0.1 0.14) 0.2 0.2 1 ≤78％ / 0.1 0.15) 0 0 0 ＜100% 0.1 0 0 0.5 Helium ＜50％ 0.1 0 0 0.5 Ethanol ＜0.1％ 0 0 0 0.5 Acetone ＜1％ 0.1 0.1 0 0.5 Methane Saturated Isopropanol vapour Metered dose inhaler propellants, Methoxyflurane ＜1％ 0.1 0.1 0 0.5 / 0.1 0 0 0.
FOR YOUR NOTES A-20
B EMC The equipment meets the requirements of EN 60601-1-2. NOTE z z z z z Use of accessories, transducers, and cables other than those specified may result in increased emission and/or decreased immunity of the equipment. The equipment should not be used adjacent to or stacked with other equipment, and if adjacent or stacked use is necessary, the equipment should be observed to verify normal operation in the configuration in which it will be used.
TABLE 2 Guidance and declaration — electromagnetic immunity The equipment is intended for use in the electromagnetic environment specified below. The customer or the user of the equipment should assure that it is used in such an environment. Immunity test IEC 60601 Test level Compliance level Electromagnetic environment — guidance Electrostatic Discharge (ESD) IEC 61000-4-2 ±6 kV contact ±8 kV air ±6 kV contact ±8 kV air Floors should be wood, concrete or ceramic tile.
TABLE 3 Guidance and declaration — electromagnetic immunity The equipment is intended for use in the electromagnetic environment specified below. The customer or the user of the equipment should assure that it is used in such an environment Immunity test Conduced RF IEC 61000-4-6 Radiated RF IEC 61000-4-3 IEC 60601 Test level 3 Vrms 150kHz to 80MHz 3 V/m 80MHz to 2.
TABLE 4 Recommended separation distances between portable and mobile RF communication and the equipment The equipment is intended for use in an electromagnetic environment in which radiated RF disturbance are controlled.
C Alarm Messages and Prompt Information NOTE z Your patient monitor may not include all the information listed in this section. C.1 Physiological Alarm Messages Note: XX represents the parameters being monitored, such as HR, RR, SpO2, etc. The “L” field indicates the alarm level, and 1 means high, 2 means medium, 3 mean low, * means the level is user-adjustable. Alarm messages L Cause Measure XX TOO HIGH 2* XX value exceeds the upper alarm limit.
PVC 2* The PVC arrhythmia event occurs to the patient. BIGEMINY 2* The bigeminy arrhythmia event occurs to the patient. TRIGEMINY 2* The trigeminy arrhythmia event occurs to the patient. TACHY 2* The patient is suffering from tachycardia. BRADY 2* The patient is suffering from bradycardia. PNC 2* No pacer signal is captured. PNP 2* The pacemaker is not paced. MISSED BEATS 2* The arrhythmia event of missed beats occurs to the patient.
C.2.2 ECG Module Alarm Messages Alarm message A B L Cause Measure ECG LEAD OFF No Yes 3 ECG X LEAD OFF No Yes 3 The ECG lead is not connected correctly. Check for correct connection of the leadwires. Note: X represents the leadwires, V, LL, RL, LA and RA, as per AHA standard, or C, L, F, R and N as per IEC standard. ECG NOISE No No 3 Large interference signals appear on the ECG signal. Make sure the leadwires are correctly connected. Check the patient for severe motion.
C.2.4 TEMP Module Alarm Messages Alarm message A B L Cause Measure TEMP1 SENSOR OFF No Yes 3 The T1 sensor is not connected correctly to the patient or the monitor. Check for correct connection of the T1 sensor. TEMP2 SENSOR OFF No Yes 3 The T2 sensor is not connected correctly to the patient or the monitor. Check for correct connection of the T2 sensor. TEMP SELFTEST ERROR No No 1 Circuit fault of the temperature channel. Contact our company for repair.
Alarm message A B L Cause NIBP SYSTEM FAILURE No Yes 2 NIBP TIME OUT No Yes 2 MEASURE FAIL No Yes 2 Failure occurs in the pulse measurement. The monitor cannot perform measurement, analysis, or calculation. NIBP ILLEGALLY RESET No Yes 2 Illegal reset comes out during the NIBP measurement. Measure repair. Check if the airway is blocked. Deal with the blocking and perform the measurement again. If the problem still exists, contact our company for repair. C.2.
C.2.7 Nellcor SpO2 Module Alarm Messages Alarm message A B L Cause Measure SPO2 SENSOR OFF No Yes 3 The sensor is disconnected from the patient or the monitor. Make sure the sensor is placed on the patient’s finger or other parts, and the monitor is connected to cables correctly. SPO2 NO SENSOR Yes Yes 3 The sensor is disconnected from the patient or the monitor, or the sensor is not connected properly. Disconnect and reconnect the sensor as directed by the instructions.
C.2.8 IBP Module Alarm Messages Alarm message A B L Cause Measure IBP1 SENSOR OFF No Yes 3 The invasive blood pressure cable of channel 1 is disconnected from the monitor. Check if the IBP 1 sensor is properly connected. IBP2 SENSOR OFF No Yes 3 The invasive blood pressure cable of channel 2 is disconnected from the monitor. Check if the IBP 2 sensor is properly connected. IBP1 NEED ZERO-CAL No No 3 The IBP transducer of channel 1 has not been zeroed.
Alarm message A B L Cause Measure CO2 BAROMETRIC TOO HIGH No No 2 The barometric pressure is too high. CO2 BAROMETRIC TOO LOW No No 2 The barometric pressure is too low. CO2 HARDWARE ERROR No No 1 AD sampling 2.5V error CO2 HARDWARE ERROR No No 1 The pump malfunctions. CO2 HARDWARE ERROR No No 1 The 3-way stopcock malfunctions. CO2 SAMPLE LINE ABNORMAL No No 2 The sample line is abnormal or blocked. Make sure the airway is not blocked.
Alarm message A B L Cause CO2 INIT ERR Yes No 1 The CO2 module is not properly installed, or malfunctions. CO2 COMM STOP No No 1 CO2 module fault or communication fault. Measure our company for repair. C.2.11 Oridion CO2 Module Alarm Messages Alarm message A B L Cause Measure CO2 CHECK CALIBRATION No No 2 Calibration error Make sure the calibration gas is proper. CO2 CHECK FLOW No No 2 Airway error Check for leaks in the airway. CO2 OCCLU.
Alarm message A B L Cause Measure CO2 CALIB ERROR No No 2 Including the error messages displayed at the lower part of the menu (like gas error, measurement error, zeroing failure, etc.) Take measures specific to the errors. For instance, in case of a gas error, check if the gas concentration is wrong. A measurement error indicates the module is removing the occlusion or the filter line is not connected properly. CO2 INIT ERR Yes No 1 An error occurs during the CO2 initialization.
exceeds 1 second. AG SELF-TEST ERR Yes No 1 AG module fails or fails to communicate with the host. Unplug and re-plug the module and then restart the monitor, or plug the AG module in another monitor to check if it operates properly. AG HARDWARE MALF No No 1 AG module hardware failure. The module enters the standby mode or stop AG monitoring. Remove the AG module from the monitor and send for authorized maintenance personnel. AG HARDWARE ERROR Yes No 2 AG module hardware fault.
C.2.13 Recorder Module Alarm Messages Alarm message A B L Cause Measure RECORDER INIT ERR N Yes No 2 An error occurs during the recorder initialization. Contact the hospital’s engineers or our customer Service. Note: N represents the error number. RECORDER SELFTEST ERR Yes No 2 An error might occur to the RAM, ROM and CPU watchdog. Open the RECORD menu and select the CLEAR REC TASK option. If the problem remains, contact our company for repair.
C.2.14 System Alarm Messages Alarm message A B L Cause Measure REAL CLOCK NEED SET No No 1 The system time is incorrect. Reset the system time and then restart the monitor. REAL CLOCK NOT EXIST No No 1 No button battery, or the battery power is depleted. Add, or replace with a new button battery. KEYBOARD INIT ERR N No No 1 Keyboard error. The keyboard cannot be used. Contact our company for repair. Note: N represents the error number. KEYBOARD ERROR No No 2 NET INIT ERR (G.
C.3 Prompt Messages Prompt messages Cause Measure ECG1 SIGNAL SATURATION Signals of abrupt change interfere with the ECG signal. Check whether the electrodes and leads are well connected. SEARCH PULSE The SpO2 module is searching the pulse. Wait till the end of the searching. DOMINANT RHYTHM CHANGE A change happens to the patient’s dominant rhythm. None.
Prompt messages Cause Measure AG IS STARTING The AG module is starting. Wait for the AG module to finish the startup. AG WARM UP The AG module is warming itself up. Wait for the AG module to finish warming itself up. Manual measure... The NIBP module is performing the manual measurement. Wait for the NIBP module to finish the measurement. CONTINUAL... The NIBP module is performing the continuous measurement. Auto measuring... The NIBP module is performing the auto measurement. Resetting...
FOR YOUR NOTES C-16
D Symbols and Abbreviations Symbols and abbreviations that you may encounter while reading this manual or using the monitor are listed below with their meanings. D.
mmHg millimeters of mercury ms millisecond mV millivolt mW milliwatt nm nanometer ppm part per million s second V volt VA volt ampere Ω ohm µA microampere µm micron µV microvolt W watt - minus % percent / per; divide; or ^ power + plus = equal to < less than > greater than ≤ less than or equal to ≥ greater than or equal to ± plus or minus × multiply © copyright D-2
D.
ERR error ES electrosuigical ESU electrosuigical unit Et end-tidal EtCO2 end-tidal carbon dioxide EtN2O end-tidal nitrous oxide EtO Ethylene Oxide EtO2 end-tidal oxygen EURO European Fi fraction of inspired FiCO2 fraction of inspired carbon oxygen FiN2O fraction of inspired nitrous oxide FiO2 fraction of inspired oxygen fpga Field Programmable Gate Array HAL halothane Hb-CO Carbon mono-oxide hemoglobin HR heart rate HT height IBP invasive brood pressure ICP intracrania
MAC minimal alveolar concentration MAP mean arterial pressure MDD Medical Device Directive MEAN mean pressure MetHb methemoglobin Mii initialize MII registers fail MRI magnetic resonance imaging N2O nitrous oxide N/A not applied NEO neonate, neonatal NIBP noninvasive blood pressure ND NM NS non-invasive diastolic brood pressure non-invasive mean brood pressure non-invasive systolic brood pressure O2 oxygen oxyCRG Oxygen Cardio-respirogram P power PA pulmonary artery PD photo
SYNC synchronization SYS systolic T1 temperature of channel 1 T2 temperature of channel 2 TB temperature of blood TD temperature difference TEMP temperature TFT Thin-Film Technology TI Temperature of Injectate VGA Video Graphic Array WT weight D-6
Mindray DS USA, Inc. 800 MacArthur Blvd. Mahwah, New Jersey 07430 USA Tel:1.800.288.2121 Tel:1.201.995.8000 www.mindray.com P/N: 046-000182-00(9.
