Philips M1165/66/67/75/76/77A CMS Patient Monitoring System and Philips M1205A V24 and V26 Patient Monitor User’s Reference Manual Volume 1 System Information PHI Part Number M1046-9220L Printed 02/2003
Notice This document contains proprietary information which is protected by copyright. All Rights Reserved. Reproduction, adaptation, or translation without prior written permission is prohibited, except as allowed under the copyright laws. Philips Medical Systems Cardiac and Monitoring Systems 3000 Minuteman Road Andover, MA 01810 Publication number M1046-9220L Warranty The information contained in this document is subject to change without notice.
The M1165/66/75/76A Systems comply with UL544, CSA 22.2-125, IEC 601-1, EN 60601-1, and EN 60601-1-2 and carries 0366 Marking to Council Directive 93/42/EEC, European Medical Device Directive (MDD). The M1167/77A Systems comply with UL2601-1, CSA 22.2 No. 601.1-M90, IEC 601-1, EN 60601-1, and EN 60601-1-2 and carries 0366 Marking to Council Directive 93/42/EEC, European Medical Device Directive (MDD). The M1205A Systems comply with UL2601, IEC 601-1, CSA C22.2 no.
Electromagnetic Interference Anomalies due to electromagnetic interference are not unique to the M1165/66/67/75/76/77A or the M1205A but are characteristic of patient monitors in use today. This performance is due to the very sensitive high gain front end amplifiers used to display the physiological signals. Among the many similarly performing patient monitors already in use by customers, interference from electromagnetic sources is rarely a problem in actual use.
Intended Use Intended Use Description The Philips M1165/66/67/75/76/77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors are network connectable bedside patient monitoring devices. The Philips M1205A Models V24CT and V26CT may powered by either AC line power or by battery power.
Indications for Use Indications for Use Condition The Philips M1165/66/67/75/76/77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors are generally indicated when the clinician decides there is a need to measure and display multiple physiological parameters and waves, to generate alarms and recordings of adult, pediatric, or neonatal patients.
Indications for Use Prescription Versus Over-the-Counter The Philips M1165/66/67/75/76/77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors are prescription devices.
Indications for Use Warnings, Cautions, and Notes Warnings, cautions, and notes are used throughout this User's Manual to give you additional information about the Philips M1165/66/67/75/76/77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors. The warnings and cautions included in this safety section refer to the equipment in general. Warning A “warning” calls attention to the user of imminent hazard to people if proper procedures are not followed.
Indications for Use • Exposure of electrical contacts or connections to saline or other liquids and gels is dangerous. Electrical contacts and connections such as cable connectors, power supplies, parameter module plug-in connections and rack connections must be kept clean and dry. Thoroughly dry any electrical connections that become contaminated with liquids. If additional decontamination is required please contact your biomedical department or Philips Medical Systems Response Center.
Indications for Use • Replacement Parts - It is highly recommended that only Philips Medical Systems recommended parts and accessories be used with this equipment. Failure to do so may result in the degradation of performance. Accessories and parts for individual modules and components are listed at the back of the appropriate section in this manual. Note—A note gives special instructions to highlight an operating procedure or practice. Notes may precede or follow the applicable text.
Responsibility of the Manufacturer Responsibility of the Manufacturer Philips Medical Systems only considers itself responsible for any effects on safety, reliability and performance of the equipment if: assembly operations, extensions, re-adjustments, modifications or repairs are carried out by persons authorized by Philips, and the electrical installation of the relevant room complies with national standards, and the instrument is used in accordance with the instructions for use.
Responsibility of the Manufacturer xii
Contents This book is divided into three volumes. This volume contains chapters 1 to 13 (see the following table of contents for more details): 1. The CMS and V24 and V26 Patient Monitors 2. Getting Started 3. Setting up your Monitor 4. Other Patients 5. Alarm Functions 6. Recording Functions 7. Admit/Discharge/End Case 8. Trends and Calculations 9. Neonatal Event Review 10. Data Transfer 11. Monitor Installation and Patient Safety 12. Battery Information (V24CT and V26CT only) 13.
Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-v Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-v Purpose. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-v Environment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ECG Output and Defibrillator Marker Input . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-34 The V24 and V26 Parameter Module Rack . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-35 Operating Rules to Remember . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-36 Performance Specifications of the Philips Displays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Selecting the Number of Waves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-13 Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-13 Changing the Wave Overlap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-14 Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Changing the Configuration Set. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-53 Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-54 Changing Operating Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-55 Returning to Monitoring Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-2 Controls and Indicators on the Plug-In Recorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-3 Controls and Indicators on the 4-Channel Recorder (CMS only) . . . . . . . . . . . . . . . . . . . . . 6-4 Recorder Capabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Changing the Recorder Speed. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-43 Changing the Recorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-43 Continuing a Timed Recording. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-43 Inserting a Calibration Signal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Neonatal Event Review 9-1 Introduction to Neonatal Event Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-2 Viewing Neonatal Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-3 Manual Event Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-4 Graphical Details . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Explanation of Symbols used . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-12 Maintenance Checks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-14 Patient Cables and Leads . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-16 Controls and Connectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Pressure Module Self-Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-16 Performing the NBP Module Self-Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-17 Performing the SpO2/Pleth Module Self-Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-17 Performing the Cardiac Output Module Self-Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1 The CMS and V24 and V26 Patient Monitors This chapter provides an overview of the CMS Patient Monitoring Systems and V24 and V26 Patient Monitors. It includes the following sections: • • • • • • • • Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2 Parameter Modules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-16 V26CT/V24CT Power Supply . . . . . . . . . . . . . . . . . . . . . . . 1-14 Operating Levels . . . . . . . . . . . . . . . . . . . .
The CMS and V24 and V26 Patient Monitors Introduction Introduction The Philips M1165/66/67/75/76/77 CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors, hereafter referred to as the “patient monitor”, are modular patient monitors with networking and data management capabilities. All the systems can have modules added or removed at a later time as needed, or you can interchange the modules between systems in your unit.
M1167/77A System Display Module M1095A 10.
The CMS and V24 and V26 Patient Monitors Introduction M1167/77A System with External Alarm Device XGA Display External Alarm Device Computer Module Parameter Modules Display Module ITE Display of choicea b Computer Module M1046B Computer Module Parameter Modules Satellite Rack a. Philips offers the M1167/77A #H05 and #H07 (XGA Touchscreen display configuration). b. A 15” flat touchscreen display is also available separately under the order number M1097A #A02.
M1165/75A and M1166/76A System Model Types Display Module M1094A/B/92A 14” CRT Display Computer Module M1046A Computer Module Parameter Modules Integral and/or Satellite Rack All system types are also available as a choice of three different model types: Full Title Abbreviation The Philips CMS Patient Monitoring System CMS The Philips CMS Patient Monitoring System for Anesthesia Care ACMS The Philips CMS Patient Monitoring System for Neonatal Care NCMS Note—In this manual, the system will be
The CMS and V24 and V26 Patient Monitors Introduction Display Modules Below are labeled diagrams of the display modules provided by Philips Medical Systems. The control panel is described in more detail in the following sections .
V24 and V26 Patient Monitor Each V24 and V26 Patient Monitor consists of two individual parts. 1. One of two types of Display Modules, depending on the particular model monitor you have purchased—either: a. A monochrome display with control panel supporting the V24, or b. A color flat panel display with control panel supporting the V24C, the V24CT, the V26C and the V26CT. 2. The Rack with Parameter Modules The V24, V24C and V26C are powered by connection to an AC power supply.
The CMS and V24 and V26 Patient Monitors Introduction Control Panel Softkeys Hardkeys The control panel consists of softkeys, hardkeys and alarm lamps. The softkeys perform multiple functions. Their functions correspond to the labels displayed at the bottom of the screen. When no softkey labels are on the screen, the softkeys do not function. The hardkeys have only one function defined by the label on the key. The hardkeys are labeled in blue.
Alarm Lamps The alarm lamps are lit when a red or yellow alarm condition exists. CMS Control Panel Alarm Lamps Confirm Silence/ Reset Suspend * * * Alarms Main Screen Other Patients Monitor Setup Procedures Realtime Record * Trends/ Calcs Delayed Record * Module Setup * Alarms Suspended Lamp V24 and V26 Patient Monitor Control Panel Note—Earlier versions of the V24 feature a Trends key instead of the Trends/Calcs key.
The CMS and V24 and V26 Patient Monitors Introduction The Handheld Keypad (CMS only): The handheld keypad consists of the same softkeys and hardkeys that are available on the control panel. In addition, the keypad provides data entry keys which enable you to enter letters, numbers, punctuation marks, and arithmetic symbols. Note—The handheld keypad is the main means of operating the M1167/77A System with External Alarm Device.
• • External Alarm Device To enter numbers and arithmetic symbols (labeled in white), simply press the keys you want. To enter letters and punctuation marks (labeled in blue), press the Shift key. The lamp in the Shift key lights up and remains on until Shift is pressed again. The softkeys and hardkeys work as normal.
The CMS and V24 and V26 Patient Monitors Introduction Hardkey Functions Silence/Reset - press to silence an alarm or alarms that are sounding or, if alarms are latching, to reset them. Suspend - press to suspend or switch on all alarms. The current state is indicated by the Alarm Suspend Lamp. Main Screen - press to return to the main monitoring screen. Change Screen - (CMS only) press to change between screen layouts or to access a 2nd or 3rd display.
The arrow keys consist of up/down/left/right keys. They only function when illuminated. The arrow keys allow you to move between areas on operating screens to enable you to change or adjust settings, perform procedures, or make changes to the screen display. Confirm Key This key functions only when it is illuminated. A prompt message “...press CONFIRM...” appears on the screen when you need to use it. Airway Gases/Ventilation - (CMS only) Press to view airway gases or ventilator waves and numerics.
The CMS and V24 and V26 Patient Monitors V26CT/V24CT Power Supply V26CT/V24CT Power Supply The V24CT and V26CT are powered by an external AC (line power) or by their own internal battery power supply. Your monitoring needs will determine which power source is used. We recommend that you plug the monitor into line or AC power whenever the monitor is not being moved or used, or for long term bedside monitoring.
Battery life includes the time during the low battery alarm (INOP “Recharge Batteries”) until the unit shuts off. We recommend you use 2 fully charged batteries to get the optimum battery life when using the battery power supply. Battery Specifications • 1 or 2 lead-acid batteries. • 12 Volt. • Up to 1.25 hours battery capacity typical on two new fully charged batteries at 25°C, depending on modules used in the product. Note—Charging time is 4 hours to 90% of full capacity if the monitor is off.
The CMS and V24 and V26 Patient Monitors Parameter Modules Parameter Modules The parameter modules have one or more hardkeys on the front. The key labeled with the parameter name is called the Setup key, which gets you directly into the setup screen for that parameter. When you press the Setup key on the front of the module, and get into the parameter setup window or task window, a light appears above the key.
special Service Mode, either by your biomedical engineering department or the Philips service engineer. You can find a description of this behavior (called “Parameter Settings Transfer”) in Chapter 3. Symbols to Indicate Key Functions As detailed in the table below, some modules used with the M1046A CMS, and M1205A V24/26 patient monitors now use symbols, instead of words, to indicate the function of some keys.
The CMS and V24 and V26 Patient Monitors Parameter Modules Parameter modules can be plugged into the following types of rack: Rack Type Mounting Comments CMS Patient Monitoring System Integral Rack This is fitted to the front of the M1046A computer module. Cannot be used with the M1167/77A CMS Patient Monitoring System. 8-slot rack. Satellite Rack You can have one or more satellite racks attached to an I.V. pole, bedside or wall. Can be used with all CMS Patient Monitoring System.
For most types of parameter modules, the system allows only one of each type per patient (ECG, for example). Other types of modules allow more than one per patient (Invasive Pressure, for example). If too many modules or an unsupported module are plugged in, a message detailing where the extra module is, appears in the system message field: Currently ignored module in rack position R-P where: R is the number of the rack (e.g. 1=integral rack, 2=first satellite rack,...
The CMS and V24 and V26 Patient Monitors Operating Levels Operating Levels There are three types of screens which you will see on the display module. The three types of screen and the interconnections between them are shown below.
Main Screen This display shows the waveforms and numerical readouts of the parameters you have chosen to monitor, alarms, INOP messages, bed label, date and time, and arrhythmia messages (when assigned). You can configure the number and position of the waveforms on the display screen. The numerics are aligned with the corresponding waves. The numeric information is updated every two seconds. With the color model, the numeric appears in the same color that you have assigned to the corresponding waveform.
The CMS and V24 and V26 Patient Monitors Operating Levels ICU Adult 10 JAN 95 20:05 II CHANNEL #1 HR PULSE 70 F HR NUMERICS 0.3 -0.
Selection Window This is the first operating level where you can choose a specific activity or function. You get into a Selection Window by pressing one of the blue-labeled hardkeys on the control panel. When you get into the Selection Window the bottom line is always active. This is indicated by a bar below the keys and the yellow labeling. The selection can be changed within the Selection Window one line at a time. For information on how to change the selection see page 1-25.
The CMS and V24 and V26 Patient Monitors Operating Levels Task Window This is the second operating level, which allows you to make changes or adjustments to the parameters and screen displays, or to perform procedures. Each parameter or procedure has a series of Task Windows. There are two ways to get into the second operating level: via the Selection Window, or for parameters: by pressing the Setup key on the parameter module.
Getting into the Operating Levels Before you can start to make adjustments or changes to the parameters or perform a procedure, you need to know how to get into the operating levels and how to navigate through the selections. Follow the procedures below to get into the Selection and Task Windows. Selection Window 1. Press the blue-labeled hardkey for the function you require. 2. When you get into a Selection Window, the bottom line is always active.
The CMS and V24 and V26 Patient Monitors Operating Levels There are two reasons for changing the selection in the Task Windows: you will either want to move to the next Task Window, or make an adjustment to a setting. 1. To move to the next Task Window, press the softkey for the function you require, for example Filter/Mon/Diag . This gets you Pts Refernce into the Filter/Mon/Diag Task Window where you can make any necessary adjustments. 2.
Touch or Mouse/Trackball Operation The M1167A/77A systems also allow connection of XGA displays, enabling touch (requires touchscreen displays), mouse or trackball operation of the monitor. Since these displays do not contain a control panel, there are slight differences in operating the system. The following sections contain the instructions specific to touch, mouse or trackball operation. V24C and V26C monitors with option T01 allow touch operation in addition to the standard operation.
The CMS and V24 and V26 Patient Monitors Touch or Mouse/Trackball Operation Main Screen The layout of the main screen is basically the same as with other CMS, V24 and V26 Patient Monitoring Systems, with the only exception that it contains three additional buttons: the Silence/Reset button, the Suspend button (both in the upper right corner of the display) and the Control Panel button (in the lower right corner of the display).
Control Panel Task Window General Touch/ Mouse/ Trackball Operation (CMS only) If a touch-responsive object or area of the screen is selected (either by touch or by mouse-click), a white ‘+’ appears and the area is surrounded by a white frame. In addition, an audible click is issued. The white frame disappears automatically when the object is released. If an object or area of the screen that is not touch-responsive is touched, a white ‘x’ appears in the selected area.
The CMS and V24 and V26 Patient Monitors Touch or Mouse/Trackball Operation TouchResponsive Objects 1-30 Touch-responsive objects and areas of the screen include: • Numerics and Waves - When a numeric or wave is selected, the respective parameter setup window opens up. • Alarms/INOP messages - Selecting an Alarm or INOP Message opens the alarm messages window. • Task Windows/Selection Windows - All softkeys displayed in Task Windows and Selection Windows are touch-responsive.
Alphanumeric Entries A Touchboard can be accessed when alphanumerical data needs to be entered. This is an alternative to the entry of data with the handheld keypad. The Touchboard can be activated with the “Touch Board” softkey e.g. from the Patient Admit Task Window. The Touchboard Task Window contains a subtitle which references the Task Window from which the Touchboard was accessed. Data entry can be performed for one item at a time. Press to save edited data.
The CMS and V24 and V26 Patient Monitors Touch or Mouse/Trackball Operation Disabling Touch/ Mouse/ Trackball Operation In order to prevent unintended or uncontrolled operations of the monitor, touch operation must be disabled while cleaning the touchscreen. To disable touch and mouse/trackball operation press and hold or click and hold the control panel button in the lower right corner of the main screen for at least four seconds.
The CMS Computer Modules The signals from the parameters being monitored are transmitted to the computer module, where they are processed and then displayed on the screen as waveforms and numerical readouts. M1046A Computer Module The M1046A Computer Module is for use with the Philips M1165/66A and the Philips M1175/76A CMS Patient Monitoring System. Maximum Voltages ECG Output and Defib. Marker Input 3.
The CMS and V24 and V26 Patient Monitors The CMS Computer Modules M1046B Computer Module The M1046B Computer Module is for use with the Philips M1167/77A CMS. Maximum Voltage ECG Output and Defib. Marker Input 3.2 V p-p The parameter modules are inserted into one or several satellite racks. They cannot be attached to the front of the computer module. ECG Output and Defibrillator Marker Input Applies to both the M1046A and M1046B Computer Modules.
The V24 and V26 Parameter Module Rack The V24 and V26 parameter module rack is attached to the display module by a cable to a connector on the left side of the display module. In addition, the V24CT and V26CT allow you to dock a 6-slot rack directly to the mainframe. Warning Do not connect a second rack by a cable when using the V24CT or V26CT with a 6 wide rack docked to the mainframe. Docking a second rack by a cable may disrupt module communication.
The CMS and V24 and V26 Patient Monitors Operating Rules to Remember Operating Rules to Remember 1-36 • Pressing Main Screen key always returns you to the Main Screen. • To get into a Selection Window press a hardkey. • What is labeled in yellow and appears “pushed in” is active. • Softkeys function only in the Selection and Task Windows (with the exception of the Alarm Volume Control and the QRS Tone Volume Control on the V24 and V26 Patient Monitors).
Performance Specifications of the Philips Displays M1095A Flatscreen Display M1094A/B and M1092A CRT Display M1097A #A02 XGA Flatscreen Display Useful Screen: (±5% unless otherwise noted) 158 mm x 211 mm (6.2” x 8.3”) Pixel Size 0.33 mm x 0.33 mm Storage Time at 25 mm/sec 5.5 seconds Trace Speeds 6.25, 12.5, 25, 50 mm/sec ±10% Useful Screen: (±5% unless otherwise noted) 180 mm x 225 mm (7.1” x 8.9”) Pixel Size 0.22 mm x 0.35 mm Storage Time at 25 mm/sec 6 seconds Trace Speeds 6.25, 12.
The CMS and V24 and V26 Patient Monitors Using an ITE Display Using an ITE Display The M1167A/77A CMS Patient Monitoring System provides means for customers to use ITE displays. There are several restrictions associated with this option.
Using an ITE Display EMC 1. The display must either fulfill the requirements of the EN60601-1-2 {IEC 601-1-2}, or it must conform to the requirements of the EMC standard for ITE devices, EN50082-1: 1997 and EN50081-1 / CISPR 22. 2. The video cable between M1167A/77A CMS Patient Monitoring System and the ITE display must not exceed a length of 3.0m. For cables exceeding 3.0m EMC testing according to IEC 801-4:1988 has to be done.
Using an ITE Display 1-40 The CMS and V24 and V26 Patient Monitors
2 Getting Started Now that you have been introduced to the monitor you are probably ready to start using it. This chapter will help you get started. It contains the following sections: • • • Setting up the Monitor (V24 and V26 only) . . . . . . . . . . . . 2-2 Setting up the Parameter Modules . . . . . . . . . . . . . . . . . . . 2-5 Attaching the Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Setting up the Monitor (V24 and V26 only) Setting up the Monitor (V24 and V26 only) Getting Started 1. Attach the parameter module rack to the display module by a cable to the connector on the left side of the display module. If you are using the V24CT or V26CT you can attach the 6-slot rack to the back of the mainframe display without the need for a cable. The two components will snap or dock together.
2. If you are using the V24CT and V26CT and the batteries are not already in place, insert 2 Philips 40488A 12 Volt 2.3 Amp-hour sealed lead-acid batteries into the spring-loaded battery door in the back of the monitor. The batteries should be inserted with the grey Philips battery label facing upwards and the contacts pointing into the monitor. The batteries will snap or click into place when properly inserted.
Setting up the Monitor (V24 and V26 only) 4. Switch on the system using the power On\Off switch. A self test is then performed. Warning Getting Started Connecting the Philips monitoring network (SDN) cable when the product is powered on is not supported. Error codes and Philips monitoring network (SDN) interface lock-up may occur. Power cycling the product will recover the product. No permanent damage will result.
Setting up the Parameter Modules Setting up the Parameter Modules 2. Make sure the appropriate modules are plugged into the rack. If not, insert the module into the rack until the lever on the base of the module clicks into place. To remove a module, press the lever upwards and pull the module out. (See diagram below.) 3. Check that you have the correct patient cables and transducers plugged into the modules.
Attaching the Patient Attaching the Patient Getting Started 1. Attach the electrodes, probes, transducers, and insert pressure catheters as required for monitoring the patient. 2. Connect the electrodes, probes and transducers to the appropriate modules. After less than 10 or 20 seconds you should see a display on the screen similar to the one under “Main Screen” in Section 1. The number of waveforms depends on the waveforms you have selected to have displayed and also on the model of your system.
Attaching the Patient V24 and V26: The brightness or contrast of the screen display can be adjusted by using the dial located behind the edge of the display, on the lower right side of the monitor. The V24 uses a contrast control. V24C, V24CT, V26C and V26CT are equipped with a brightness control. Make sure that all of the screen information is visible.
Attaching the Patient Getting Started Starting Monitoring The patient's vital signs are now appearing on the screen. The preconfigured default settings for the parameters and screen display, that were set up at installation or have been stored in the module (“Parameter Settings Transfer”), are active. If you want to make changes to the screen display see the section “Configuring the System”. If you want to make changes to the parameter settings see the individual parameter sections.
Attaching the Patient this message stays as long as the ECG module is not plugged in. On the Main Screen display the prompt and status messages are shown below the alarm and INOP messages. Prompt messages appear for 3 seconds. Status message are displayed in rotation for 3 seconds each. In the Task Window the prompt and status messages remain until the appropriate user action is performed. Reserving a Channel A parameter module may be turned OFF, but left in the rack.
Attaching the Patient Power Failure If a power failure occurs, any alarm conditions that were stored in the monitor will NOT be retained when power is restored. Settings such as alarm limits stored in “T” modules ARE retained - see “Parameter Settings Transfer” on page 3-61. Getting Started Caution You are advised to check all the monitor settings after any power failure.
If your monitor is connected to a Philips patient care system while the monitor is in standby, no parameter data from your monitor is sent over the system. Instead, a message indicating that your monitor is in “Standby” is sent to other beds in the system, and is displayed at the central station. If your bed is configured to receive alarms, and another bed in the system goes into alarm, the status message “Other Bed in Alarm” is displayed on your monitor.
Getting Started Attaching the Patient 2-12 Getting Started
3 Setting up your Monitor This chapter describes the characteristics of your system that can be changed during monitoring, using the Monitor Setup key. It includes the following sections: • • • • • • • • • • • • • • • • • • • • • • • • • Changing Display Screens . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2 Selecting a Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3 What you Can Configure. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Changing Display Screens Changing Display Screens A display screen is a pre-selected arrangement of realtime waveforms, numerics and overlayed application windows. A particular display screen can, for instance, be created to monitor a patient during a specific procedure in a department or unit. There are five separate display screens which can be configured. The default names of these screens are Screen A, Screen B, Screen C, Screen D and Screen E.
Selecting a Screen Selecting a Screen If the screen you want to change is not the currently active screen, you must select the required screen (for example, Screen A, Screen B, Screen C, screen D or Screen E). 1. Press the hardkey Change Screen (CMS) or Monitor Setup (V24 and V26). 2. Press the softkey corresponding to the screen you want to change. The Main Display appears for the selected screen.
Freezing Waves (CMS only) Freezing Waves (CMS only) You can freeze any wave movement on the screen via the Change Screen → Freeze Waves keys. Press Start Waves or any other key except Suspend or Silence/Reset to restart the waves. Setting up your Monitor You can also freeze the waves on your 2nd and 3rd independent display. To restart the waves on an independent display, press Start Waves .
What you Can Configure What you Can Configure Changes and adjustments you make to the settings in Monitor Setup screens remain active while the system is switched on. With the exception of changes to the date and time, all settings revert back to their default settings (factory defaults or user defaults) if the system is switched off for longer than 60 seconds. The settings for the date and time are stored by the system when it is switched off. Note—If necessary, these default settings can also be changed.
Changes to the Configuration Changes to the Configuration To make changes to the settings, you need to get into the Monitor Setup Selection Window. The key sequence to get into the Task Windows is shown above the screen figures in this guide. The softkeys are indicated in the text like this: Display . The hardkeys are indicated in the text like this: Setting up your Monitor Monitor Setup .
Making Changes to the Main Display Making Changes to the Main Display The following describes how to change screen A, B, C, D, or E and assign a label.
Assigning Waves to Screen Channels Assigning Waves to Screen Channels You can assign realtime waves to positions on the screen. This defines where the waves appear on the Main Screen. Display1 Setup Setting up your Monitor Monitor Setup Notes— • 3-8 You can also return to the Display Setup Task Window from the Realtime Speeds Task Window by pressing the softkey Display Setup.
Assigning Waves to Screen Channels Select Item 1. Press screen. repeatedly to select a channel on the 2. Press Change Content to move the selection to the wave you want to place in your selected channel. 3. Repeat steps 1 and 2 for each wave position you want to change. 4. Press Main Screen to return to the Main Screen screen.
Selecting a Screen Selecting a Screen You can switch between the five available screens (A-E) in the Display Setup Task window. Display1 Setup Select Item Setting up your Monitor Monitor Setup Procedure Select Item 1. Press screen. until “Screen Choice” is selected on the 2. Press Change Content to select a screen (A-E). The selected screen choice and its screen label will appear at the top of the Task Window.
Selecting Screen Labels for Realtime Display Screens Selecting Screen Labels for Realtime Display Screens A screen label may be selected for a realtime display screen. There are eleven choices. Display1 Setup Select Item Setting up your Monitor Monitor Setup Procedure Select Item 1. Press screen. until “Screen Label” is selected on the 2. Press Change Content to select the key label that you require. The choices are: a. Neuro b. Cardvasc c. SwanGanz d. Standard e. Ventilat f. Perfusn g.
Selecting Screen Labels for Realtime Display Screens h. i. j. k. l. Inductn Non Invasive OxyCRG3. Blank (No screen label). User Def (user defined screen label - see below) 3. Press Monitor Setup to return to the Selection Window or press Main Screen to return to the Main Screen screen. User Defined Screen Labels In addition to the pre-defined screen labels, you can define your own labels for each screen (A-E). To define a screen label: 1. Select User Def in the Display Setup Task Window. 2.
Selecting the Number of Waves Selecting the Number of Waves You can select how many waves you want displayed on the screen (within the capabilities of the model you have ordered). Display1 Setup Select Item Setting up your Monitor Monitor Setup Procedure Select Item 1. Press screen. until “NumbrOfWaves” is selected on the 2. Press Change Content to choose 4, 6, or 8 waves to be displayed depending on your model. 3.
Changing the Wave Overlap Changing the Wave Overlap The wave overlap refers to the position of particular waves on the screen. You can select to have overlapping and non-overlapping waves. Overlapping waves allow a larger wave amplitude and you can compare waveforms of various parameters (i.e. pressure waves). Display1 Setup Select Item Setting up your Monitor Monitor Setup Procedure 1. Press Select Item until “Overlap” is selected on the screen. 2.
Selecting Realtime Wave Speeds Selecting Realtime Wave Speeds The same speed can be selected for all the waveforms or different speeds can be chosen for different waveforms. You can select the speed for the waveforms from the following: 50 mm/sec 25 mm/sec 12.5 mm/sec 6.25 mm/sec Display1 Setup Realtime Speeds Setting up your Monitor Monitor Setup Procedure To select different speeds for the waveforms: 1.
Selecting Realtime Wave Speeds Press the softkey Display Setup to return to the Display Setup Window, press Monitor Setup to return to the Selection Window or Main Screen to return to the Main Screen. To select the same speed for all the waveforms: 1. Press Global Speed repeatedly to select the speed you require. 2. Press the softkey Display Setup to return to the Realtime Waves Task Window, press Monitor Setup to return to the Selection window or Main Screen to return to the Main Screen.
Selecting Realtime Wave Speeds To tailor the numeric display format to specific needs, individual numerics can be switched on or off. This is possible for each individual screen (A-E) of an independent display. When monitoring many parameters, switching off the numerics for some of the parameters results in more of the remaining numerics being displayed in large digits. Monitor Setup Display1 Setup Numerics1 On/Off Setting up your Monitor Numerics On/Off 1.
Selecting Realtime Wave Speeds If numerics are switched off, the status message “Not all numerics displayed” is displayed. This message can be disabled in configuration mode by your biomedical engineer or by the Philips service engineer. Numeric Positioning Parameter numerics on the Main Screen screen are shown as aligned numerics - the numerics are next to the corresponding waveforms.
Selecting Realtime Wave Speeds Numeric Sizes: Parameter numerics on the screen are displayed in 2 sizes - big or small. When there are too many large numerics to be displayed on the Main Screen display, the monitor performs the following actions to make more space available: • The large numerics decrease in size, starting from bottom to top.
Selecting an Application Window Selecting an Application Window One of three application windows can be selected for display in each screen: • • • Split Screen oxyCRG CSA They are described in more detail in the following sections. Display1 Setup Select Item Setting up your Monitor Monitor Setup Procedure Select Item 1. Press screen. until “ApplicWindow” is selected on the 2. Press Change Content to choose Split, OxyCRG, CSA or None (no application window) to be displayed. 3.
Selecting an Application Window Note—If you have configured a second or third independent display, oxyCRG and CSA can only be on one of these displays at a time. Split Screen can be configured for all displays simultaneously. Special Implications for Touch or Mouse Operation • If Split Screen is active and a split trend is selected, the Graph Trends Window opens up displaying the selected parameter in combination with the adjacent parameters.
Displaying Split Screen Trends Displaying Split Screen Trends Setting up your Monitor Split Screen trends display the last 30 minutes of the patient's trend data along with any alarm limits that are set. The trend values are updated every minute. The trend value itself is calculated as the average of all the values sampled with the previous minute. With Split Screen trending you can: • Display the preceding 30 minutes of trend data for all vital signs next to their waves.
Displaying Split Screen Trends The alarm limits are represented by a rectangle, filled with the parameter’s color at low intensity. When a measurement exceeds an alarm limit, it is clearly visible against the screen’s black background. The limits themselves are displayed on the right side of the trend display, next to their corresponding boundaries. The alarm-limit values are always displayed within the rectangle defined by alarm limits, if they fit.
Displaying Split Screen Trends In addition to this, the trend to which the alarm limits apply is displayed with a thicker line than the other trends. Viewing Trend Data for Noninvasive Blood Pressure Because the NBP is not a continuously measured parameter, a special symbol is used to display the trend values, as shown in the diagram below.
oxyCRG Display oxyCRG Display The oxyCRG (oxygen CardioRespiroGram) display provides a simultaneous presentation of the following three waveforms overlayed on the Main Screen: • • • Beat-to-beat heart-rate trend An oxygen parameter trend Compressed respiration wave Setting up your Monitor Approximately the last six minutes of information is displayed for each parameter.
oxyCRG Display Approximately the bottom two thirds of the Main Screen area are covered with the three oxyCRG waveforms. The number of realtime waves that you can display simultaneously with oxyCRG is related to the maximum number of realtime waves that your system is capable of displaying.
oxyCRG Display is switched off, and one which happens after the power is restored. • If you are using a touchscreen, selecting the oxyCRG display either via touch or mouse-click will open up the Neonatal Event Review Task Window (or the Graph Trends Window, if Neonatal Event Review is not available). Setting up your Monitor You can find information about oxyCRG recording in Chapter 6.
CSA Display (CMS only) CSA Display (CMS only) Setting up your Monitor The CSA (Compressed Spectral Array) is a format presenting the processed EEG. It compresses a large amount of data into a compact, easy to read trend and consists of 30 complete spectral lines. The bottom half of the Main Screen area is covered with the CSAs. The number of realtime waves that you can display simultaneously with CSA is related to the maximum number of realtime waves that your system is capable of displaying.
CSA Display (CMS only) Notes on CSA Standard Display CSA Display 4 realtime waves CSA + 2 realtime wave 6 realtime waves CSA + 3 realtime waves 8 realtime waves CSA + 4 realtime waves • The CSA information is overlayed on the realtime waves at the bottom of the Main Screen. These realtime waves disappear from the display, but the parameters are still being monitored, and the parameter alarms are still active.
Wave Replace Wave Replace Wave Replace enables the monitor to fill a currently unused channel, which is assigned to a specific wave, and replace it temporarily with another wave. Display1 Setup Select Item Setting up your Monitor Monitor Setup Procedure Select Item 1. Press screen. until “Wave Replace” is selected on the 2. Press Change Content to enable or disable Wave Replace. With Wave Replace enabled, assigned, but currently unused channels will be filled with another wave. 3.
Trace Mode Trace Mode Trace Mode allows you to choose between fixed and moving traces: Display1 Setup Select Item Setting up your Monitor Monitor Setup Procedure Select Item 1. Press screen. until “Trace Mode” is selected on the 2. Press Change Content to choose fixed or moving traces. 3. Press Monitor Setup to return to the selection window or Main Screen to return to the Main Screen.
Configuring a Second Independent Display (CMS only) Configuring a Second Independent Display (CMS only) The second independent display is normally configured as a true surgeon’s display. We suggest that “Surgeon” is the most appropriate key label. It does NOT contain any alarm indications (blinking messages or ) or alarm controls or outputs (alarm sounds or lamps). You can change the screen to have the same display as the main display or you can have a different configuration.
Other Functions You Can Configure Other Functions You Can Configure Parameters On/Off Individual parameters can be switched ON or OFF on the monitor. No alarms or INOPs are reported for parameters that are switched off, and they are not available for display, trending, or recording on the monitor. Parametr On/Off Setting up your Monitor Module Setup 1. Press the softkey Select Parametr to highlight the required parameter. To view parameters which are not displayed, press the softkey Next Page . 2.
Other Functions You Can Configure 4. Press Main Screen to return to the Main Screen. You can also switch OFF parameters in the following ways: • Any parameter: unplug the module, and suspend or silence the alarms. • Any parameter except ECG, RESP or NBP: disconnect the transducer or adapter cable from the module, and suspend or silence the alarms.
Adjusting the Volume Control Adjusting the Volume Control You can adjust the QRS and alarm volume independently. The QRS tone is the audible tone produced by the ECG pulse channels to indicate each QRS complex or pulse trigger event picked up. CMS: Monitor Setup Alarms/Volume SpO2 → → → Volume Control or Volume Control or Volume Control Setting up your Monitor Procedure 1. Increase or decrease the QRS or alarm tone volume by pressing the corresponding softkeys.
Adjusting the Volume Control 2. Press Monitor Setup to return to the Selection Window or Main Screen to return to the Main Screen. Note—Tone Modulation can also be set to On or Off in this window using the On/Off Tone Mod key. (see also SpO2 Module chapter in Volume 2) Note—If the alarm tone volume is set to zero the warning “ALARM VOL = 0” will appear in the lower right corner of the display. V24 and V26 Patient Monitor: If not already in the Main Screen, press Main Screen .
Adjusting the Date and Time Adjusting the Date and Time You can set the date and time to be displayed on the screen. Once it has been set, the internal clock retains the setting even when the system is turned off. If your monitoring system is connected to a central station via a Philips monitoring network, the date and time on your monitor is automatically taken from the central station. Date Time Setting up your Monitor Monitor Setup Procedure 1.
Adjusting the Date and Time 3. Press Monitor Setup to return to the Selection Window or Main Screen to return to the Main Screen. Note—If you are using a touchscreen display, arrow buttons will appear Setting up your Monitor above and below the date and time fields. These can be selected to adjust the date and time instead of pressing the arrow keys.
Selecting Waves for Central Recorders Selecting Waves for Central Recorders You can select two waves to be used for delayed alarm recordings at a Philips patient care system central recorder. The waves you select can also be displayed at the central station. With a single channel recorder you can record the primary wave, or with a dual channel recorder you can record the primary and secondary waves.
Configuring Module, Bedside and Central Recordings Configuring Module, Bedside and Central Recordings Note—Recordings on a 4-channel bedside recorder are only possible with the CMS. The Recordng Setup key enables you to configure five types of recordings: 1. Delayed and Alarm Recordings on a module, bedside or central recorder. A maximum of four delayed waves can be recorded, depending on the type of recorder.
Other Patients Controls Other Patients Controls Setting up your Monitor If your system is connected via the Philips monitoring network to other bedsides you can choose to send alarms, receive alarms and assign your bed to a care group. The procedures for setting up the networking system are described in Chapter 4 “Other Patients”.
The Status Log Function The Status Log Function Setting up your Monitor The softkey Status Log is used by service engineers. It produces a list of accumulated error codes.
The Monitor Revision Function The Monitor Revision Function Setting up your Monitor The softkey Monitor Revision is used by service engineers. It gives information about the current hardware and software revision of the monitor.
Changing Default Settings and Patient Category Changing Default Settings and Patient Category Each system is configured in the factory with the factory default settings. The settings are collected together to form Configuration Sets. There are 4 Configuration Sets available with universal settings: Configuration Set 1 is for adult, intensive care unit application. Configuration Set 2 is for adult, operating room application. Configuration Set 3 is for neonatal, intensive care unit application.
Changing the Patient Category Changing the Patient Category The monitor processes patient signals in different ways (using different algorithms) depending on the patient category. The patient category within a Configuration Set can be changed during normal monitoring. Adult/Pedi/Neo → Change PatCateg Setting up your Monitor Monitor Setup In general, all the parameter settings and patient data management information are kept if you change the patient category without changing Configuration Set.
Changing the Patient Category The following table details the differences between the patient categories for those parameters where differences occur: Patient Category Parameter Setting up your Monitor Adult Pedi Neo NBP Adult Pedi Neo ECG Adult Neo Neo HR/PULSE Adult Neo Neo RESP Adult Adult Neo Inv. Pressure Adult Neo Neo CO2 Adult Adult Neo For example: The ECG parameter uses the neonatal algorithm if you choose either the Neonatal or Pediatric patient category.
Changing the Patient Category NBP The patient's tolerance for the cuff pressure (i.e. stress) when an NBP measurement is made is an important factor to consider when choosing patient category. The amount of stress is determined by: • the size of the cuff, and • the duration of time the cuff pressure is applied. Since a neonate can usually tolerate less stress than a pediatric patient, and a pediatric patient can tolerate less than an adult, the System algorithm has category-dependent safety values.
Changing the Patient Category These safety values effect the measurement range of each category. The Adult category has the greatest range (systolic 30 to 270 mmHg) and the Neonate has the smallest (systolic 30 to 130 mmHg). Therefore you cannot use Neonate or Pediatric if the expected pressure values are outside the measurement range for that category. The following tables list the measurement ranges and safety values for each patient category.
Changing the Patient Category NBP Safety Values for Differing Patient Categories Safety Value Patient Category Adult Pedi Neo Max. deflation time 80s 80s 60s Max. measurement time 100s 100s 60s Overpressure protection1 300 mmHg 300 mmHg 150 mmHg Cuff Size A to E Any Cuff 1 to 4 & A 125 mmHg 100 mmHg Default Inflation Pressure 165 mmHg 1 NBP Recommendations Philips Medical Systems makes the following recommendations when selecting a patient category for NBP: 1.
Changing the Patient Category Recommendation Choose the patient category according to the QRS morphology, rather than the patient's age. Use Adult if the duration of the QRS base is 50 to 70 ms: use Neonate/Pediatric if the duration is less than 50 ms. Weak signal The signal may be weak due to the patient's constitution, the electrode placement or other factors. A 1 mV calibration bar at the left side of the ECG channel enables you to estimate the quality of the signal.
Changing the Patient Category Heart Rate (HR) / Pulse Adult (bpm) Pedi/Neo (bpm) Cardiotach Range 15 to 300 15 to 350 HR Alarm Limit Range 15 to 250 15 to 300 Pleth/Pressure Pulse Alarm Limit Range 30 to 250 30 to 300 The expected range can be estimated by performing a manual pulse count.
Changing the Patient Category CO2 Adult/Pedi Neo AWRR High Range 10 to 100 rpm 30 to 150 rpm AWRR Low Range 0 to 95 rpm 0 to 145 rpm Delay before alarm sounds 20 s 20 s Setting up your Monitor Note—The Apnea alarm delay time cannot be changed 3-52 Setting up your Monitor
Changing the Configuration Set Changing the Configuration Set If you want to change the application of your system, for example, from Configuration Set 1 adult to Configuration Set 3 neonatal, you can do this in monitoring mode by getting into the Monitor Setup setup. This procedure will not modify a Configuration Set, but will change completely from one Configuration Set to another. Note—Changing the Configuration Set causes all the monitor's settings to revert automatically to user default settings.
Changing the Configuration Set Procedure • Remove the plug-in modules from the rack before starting the procedure. • Ask your biomedical engineering department or Philips service engineer to set Parameter Settings Transfer to OFF. The current Configuration Set for the monitor is highlighted and the universal settings are displayed at the top of the Task Window. 1. Press the softkey Change ConfSet to select the Configuration Set you require.
Changing Operating Modes Changing Operating Modes This function will be mainly used by service engineers for configuring the system on installation or for servicing the system. Before you can operate in this Task Window you have to use a password. There are three levels of password: Level 1 password allows you to select Monitor or Config mode only. Level 2 password allows you to select Monitor or Service mode only. Monitor This is the usual operating mode and fully supports patient monitoring.
Changing Operating Modes Setting up your Monitor Monitor Setup Returning to Monitoring Mode Operatng Modes To exit Config, Demo or Service Mode, press Monitor Setup Resume Monitor . This will return you to Monitoring Mode without having to enter a password. It is also possible to exit demo mode by powering down and restarting the monitor.
Changing Operating Modes 1. Enter the password by pressing the appropriate combination of softkeys which are numbered 1-5. If you enter the password correctly, you can proceed with the next step. If not, exit the Task Window by pressing Main Screen and try again. 2. Press the softkey Change Opmode . Move the highlighting to the mode you require. 3. The prompt message “Press CONFIRM to switch to selected mode“ appears. Press the hardkey Confirm .
The Test Signals Function The Test Signals Function The Test Signals function allows a check of the way signals are processed from the parameter module to the screen. The aim of the function is to identify broken lines and cables in the signal processing areas. Note—While the Test Signals function is active, no patient monitoring is Setting up your Monitor supported - parameter values are not collected. Alarms will occur, depending on the test values, as part of the monitor's self test procedure.
The Test Signals Function Procedure 1. Press hardkey Monitor Setup 2. Press softkey Test Signals Selection Window. in the Instrument Configuration The monitor returns to Main Screen. Test waves for each parameter being monitored are generated for 30 seconds to test the processing abilities of the monitor. The message “Test Signals active - no monitoring” appears on the screen. After 30 seconds, the monitor automatically switches back to Monitoring Mode.
The Test Signals Function System Self-Test Values: Module Test Numeric Limits Test Waveforms ECG and ECG/ RESP ECG RESP 100 bpm in ADULT mode 125 bpm in NEO/PEDI mode Simulated square wave and numeric 15 rpm in ADULT mode 30 rpm in PEDI mode 55 rpm in NEO mode Simulated Resp wave and numeric Pressure Simulated square wave and numerics Setting up your Monitor Systolic Diastolic 120 mmHg ADULT 60 mmHg PEDI/NEO 0 mmHg ADULT/PEDI/NEO SpO2/Pleth SpO2 100% Numeric only Pleth Wave on display Sim
Parameter Settings Transfer Parameter Settings Transfer Parameter modules which are labeled on the front with a small “T” in the upper right hand corner can be transported from one rack to another (or from one Philips system to another) and still keep their parameter settings. The settings (such as alarm limits) are stored inside the module. You could even unplug a satellite rack full of these modules from one monitor, and plug it into another monitor without losing the parameter settings.
Parameter Settings Transfer or • by resetting all parameter settings to their default values when changing Configuration Sets or operating modes. You can find more information about Parameter Settings Transfer in each of the parameter chapters, in particular Chapter 20, “Pressure Module Section”, and Chapter 17, “Temperature Module Section”. Setting up your Monitor If Parameter Settings Transfer for your monitor is set OFF, parameter settings are NOT transferred with your modules.
Parameter Settings Transfer Messages Parameter Settings Transfer Messages Message Condition Action required (Parameter name) no settings transfer capability The indicated parameter module is not a T module. Insert a module that has a T on the front. (Parameter name) check settings'' No settings are stored in the module, or the settings are incorrectly stored. Enter the parameter Task Window and check the settings. The settings are automatically stored when you exit the Task Window.
Parameter Settings Transfer Messages Condition Action required (Parameter name) reading settings from plug-in module'' A parameter key has been pressed while parameter settings are being taken from the indicated module. Wait for the message to disappear before pressing the key for that parameter. (Pressure label) check zero and transducer level'' A pressure module has been plugged-in with the transducer connected. Zero and calibration values will be taken from the module.
4 Other Patients This chapter describes the Other Patients function. It includes the following sections: • • • Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2 Philips Patient Care System . . . . . . . . . . . . . . . . . . . . . . . . . 4-3 Using Philips Patient Care System with an Arrhythmia Computer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Overview Overview If you are connected to a Philips patient care system the Other Patients function allows you to put your bed into groups, send and receive alarms between beds in the groups and view data from other beds in your group. If you require information about the automatic alarm Other Patients function, see the next section.
Philips Patient Care System Philips Patient Care System The Philips Patient Care System is a network which transports information. If your system is connected to such a monitoring network you can send information to other systems or central stations, and receive information from them. One aspect of this information transmission capability is called Other Patients. The Other Patients setup, based on nursing care assignments, allows you to view data from another bed in your group or the “ALL” group.
Philips Patient Care System The frame around the softkey for a bed in alarm will blink until the alarm is silenced by that bed. If the alarms on a bed in your Other Patients Selection Window are suspended, the symbol will appear on the respective softkey. Automatic Alarm Other Patients Incoming Alarm If your bed is configured to receive alarms, you receive alarms from beds in your Other Patients group which are configured to transmit alarms.
Philips Patient Care System The Alarm Bed Task Window shows the bed label of the other bed in alarm, the primary wave, up to 10 numerics of the parameters being monitored, INOP and ALARM messages in a rotating field. The alarm parameter numeric will be blinking. If the alarm at the other bed has been silenced, the message SILENCED appears below the wave.
Philips Patient Care System Other Patients the alarm stack viewed by other monitors in the Other Patients group. No arrow next to a bed number means: either there are no more new alarms or all the existing alarms have been acknowledged.
Philips Patient Care System With the Other Patients Controls you can place your own bed into one of eight groups: A, B, C, D, E, F, G or the ALL group, based on nursing care assignments within a unit. The Other Patients Controls Task Window allows you to change the Send/ Receive alarms configuration for your bed. Note—When a bed is assigned to the ALL group, alarms can be received from and sent to beds in group A-G as well as the other beds in the ALL group.
Using Philips Patient Care System with an Arrhythmia Computer Using Philips Patient Care System with an Arrhythmia Computer Note—The patient monitors perform analysis on the patient’s ECG waveform. This includes triggering alarms on asystole, bradycardia, ventricular fibrillation and tachycardia conditions. Enhanced arrythmia monitoring is available when the patient monitor is connected to one of Philips’ arrhythmia systems via the Philips monitoring network interface (see below).
Using Philips Patient Care System with an Arrhythmia Computer If arrhythmia monitoring for your system is on, the heart-rate on your screen is that calculated by the arrhythmia computer. Alarm messages from the arrhythmia computer are also displayed. Within the ECG channel, arrhythmia information is displayed on the rhythm and abnormal beat status of the patient. In the “Delayed ArrhWave” Task Window the delayed ECG arrhythmia waveform displays a beat label with each QRS complex.
Using Philips Patient Care System with an Arrhythmia Computer Arrhythmia Alarms on the 78560A and 78720 Arrhythmia Computers Alarm Minimum Condition Required for Alarm ASYSTOLE (***) No QRS for 4 consecutive seconds in absence of V fib or chaotic signal. VENT FIB/TACH (***)| Fibrillatory waveform detected for 4 consecutive seconds. Other Patients HR BRADY XXX < BBB (***) Heart rate < lower HR limit set or 40 bpm whichever is lower.
Using Philips Patient Care System with an Arrhythmia Computer Minimum Condition Required for Alarm R-on-T VPBs (**) For HR < 100, a VPB with R-R interval < 1/3 second and< 1/3 of the average R-R interval followed by a compensatory pause, or 2 such Vs without a compensatory pause in 5 min. (When HR > 100, 1/3 R-R interval is too short for detection. VENT BIGEMINY (**) Dominant rhythm of SV, V, SV,V. VENT TRIGEMINY (**) Dominant rhythm of SV, SV, V, SV, SV, V.
Using Philips Patient Care System with an Arrhythmia Computer Arrhythmia Alarms on the 78560A Arrhythmia Computer Alarm Minimum Condition Required for Alarm RUN VPBs > X (**) Run of more than X VPB's, where X is adjustable from 2 to 9 using the Change Limits display. PACER NON-FUNCT (**) Missed beat without pace pulse in paced patient VPBs > XX/min (**) More than XX VPBs per minute, where XX is adjustable from 1 to 30 using the Change Limit display.
Using Philips Patient Care System with an Arrhythmia Computer Message Minimum Condition Requiring an Alarm *** ASYSTOLE No QRS for 4 consecutive seconds *** V-FIB/TACH Fibrillatory wave for 4 consecutive seconds *** V-TACH Consecutive PVCs >/= V-Tach Run limit and HR > V-Tach HR limit *** TACHY yyy > xxx Heart Rate (yyy) greater than the Extreme Tachy limit (xxx) *** BRADY yyy < xxx Heart Rate (yyy) less than the Extreme Brady limit (xxx) ** NON-SUSTAIN VT A run of Vs having a ventricular HR>V
Other Patients Using Philips Patient Care System with an Arrhythmia Computer 4-14 Message Minimum Condition Requiring an Alarm ** R-ON-T PVCs For HR <100, a PVC with R-R interval <1/3 the average interval followed by a compensatory pause of 1.25 x average R-R interval or 2 such Vs without a compensatory pause occurring within 5 min. of each other. (When HR >100, 1/3 R-R interval is too short for detection.
Extended Overview (CMS only) Extended Overview (CMS only) Note—The Extended Overview feature is optional and requires the M1272A Inter-Philips monitoring network gateway. Extended Overview enables you to review the status of patients on another Philips monitoring network - either in another care unit or in a care unit larger than 24 beds.
Extended Overview (CMS only) To View an Extended Other Patients Bed 1. Press Other Patients . 2. Depending on your monitor’s configuration, select a group softkey (in the following display labeled View CCU ) to bring up bed labels in another unit or other Beds for bed labels in a unit larger than 24 beds. if necessary. Other Patients 3. Select the bed, using More Beds The Extended Overview Task Window will be displayed.
Extended Overview (CMS only) 4. To view another bed in the group, select the appropriate group label. To select any bed not in the group, press Other Patients Alert Notification Alert Notification provides automatic notification of Alarms and INOPs from other extended Other Patients beds within a single unit of more than 24 beds. With one keypress at the bedside, you can view the alarming bed waves and numerics.
Extended Overview (CMS only) Note—If the gateway is configured to provide Alert Notification and the Other Patients gateway is inoperational, the message “SDN comm error - inter-network gateway failed” will be displayed in the message area of the main screen display. The Alert Notification display is removed if Silence/Reset is pressed on the source bedside monitor or Silence on the central station. All ***-star, **-star and hard INOP alerts will generate alert notification.
5 Alarm Functions This chapter provides general information on alarm functions and what to do if an alarm occurs. It includes the following sections: • • Alarm Display. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-2 Alarm Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Alarm Display Alarm Display The alarm messages are displayed across the top of the screen. When you switch the power on, the system alarm capability is switched off. This is indicated by an ALARMS SUSPENDED or ALARMS SUSPND 1, 2 or 3 MIN message at the top right corner of the screen, depending on the alarm suspended mode which is configured on the monitor. The Alarm Suspend symbol( ) on the control panel is also illuminated.
Alarm Display Alarm Lamps Red and yellow alarm lamps on the control panel signify the severity of the cause of the alarm. One of these lamps is always lit in the event of an alarm sound. In the case of more than one alarm, the highest severity alarm lamp is always lit. What the Symbol Means When the alarm capability is suspended by using the Suspend Alarms softkey, or the Suspend hardkey, the sign on the control panel is illuminated.
Alarm Display If all the alarms have been turned off using the Suspend Alarms softkey or the Suspend hardkey, they can all be turned back on by pressing the SwitchOn Alarms softkey or the Suspend hardkey. While the alarms are suspended (permanently or for 1, 2 or 3 minutes), INOP messages continue to be displayed but alarm messages, lamps and alarm tones are not active. The nurse call relay is inactive.
Alarm Display • Latching Alarms - The alarm continues when the alarm condition is eliminated. Latching alarms can be reset by pressing the Silence/Reset key. Alternatively, all latching alarms can be turned off using the Suspend Alarms softkey or the Suspend hardkey. Latching alarms for individual parameters can be turned off in the Adjust Alarms Task Window or the Alarm Limits Task Window. • Non-latching Alarms - These automatically reset when the alarm condition is eliminated.
Alarm Display Alarm Reminder Reminder Time Re-alarm 2 or 3 mins Alarm Behavior Full alarm tone Alarm lamp New Alarm Recording Nurse call relay signals A full alarm tone is reannounced after 2 or 3 minutes. The alarm tone will sound continuously until it is silenced by pressing the Silence/Reset key. The alarm reminder clock starts counting from the beginning again every time the Silence/Reset key is pressed.
Alarm Display Silence/Reset Non-latching alarms Latching alarms Visual Latching Audible Non-Latching Audible alarm Alarm lamp Alarm message, blinking numerics Audible alarm Alarm lamp Alarm message, blinking numerics Audible alarm Alarm lamp Alarm message, blinking numerics Alarm Automatic reset situation no longer present Audible alarm Alarm lamp Alarm message, blinking numerics Alarm lamp Alarm message, blinking numerics Audible alarm reset Alarm situation still present Audible alarm silenced
Alarm Display Alarm Priorities • Red alarms - Highest priority alarms, displayed in the top right corner of the display screen. These are marked with three asterisks (***) next to the alarm message, for example, ***ASYSTOLE. • Yellow alarms - displayed in the top center of the display screen. There are two types of yellow alarms; continuous yellow alarms and short yellow alarms. The continuous yellow alarms are associated with preset alarm limits.
Alarm Display Viewing Alarm Messages The monitor alarms are arranged in increasing severity across the screen: 1. Press Alarms/Volume or Alarms hardkey 2. Press Alarm Messages in the Alarms Selection Window. Note—When an alarm occurs, you should always check the patient's condition first.
Alarm Display Individual Parameter Alarms When you plug in a parameter module and connect the transducer or adapter cable, the parameter is automatically switched on (ECG, RESP and NBP are automatically switched on when you plug in the relevant module). Whether the parameter alarms are switched on or off at start-up can be selected for each parameter separately in the Configuration Mode.
Alarm Display The alarm messages appear across the top of the screen. You need to identify the alarm and act appropriately, according to the cause of the alarm. • • • • • Identify which monitor is in alarm. Check the patient's condition. Identify the cause of the alarm. Silence the alarm, if necessary. When alarm condition is eliminated check that the alarm has reset. You will find the alarm messages for the individual parameters in the appropriate parameter sections of the Manual.
Alarm Setup Alarm Setup In the Alarm Limits Task Window you are able to review all of the alarm limits that have been set for a patient. In this Task Window you are able to turn off individual parameter alarms and adjust the limits. This means that if you just want to adjust an alarm limit you do not have to get into the individual parameter setups. Getting into the Alarms Selection Window Press the hardkey Alarms/Volume or Alarms .
Alarm Setup Alarms/Volume --> Alarm Limits 1. Press Select Parametr adjust. to highlight the parameter that you want to 2. Use the On/Off Alarms softkey to switch the parameter's alarms on or off. When the alarms are turned off, a appears next to the parameter alarm limits. Low Limit 3. Use adjust the limits. and High Limit softkeys if you want to 4. If there are more than 10 alarm bars to review, press the Next Page softkey, and the remaining alarm bars appear on the screen. 5.
Alarm Setup Setting the Volume Control The QRS and the alarm tone volume can be set independently. 1. Press Alarms/Volume hardkey. 2. Press Volume Control in the Alarms Selection Window. The QRS and alarm tone are each represented by the outline of a triangle which can be filled in. When the triangle is completely filled, this represents maximum tone volume. 3. Press the up and down arrow softkeys to fill each triangle to the required amount.
Alarm Setup Note—The nurse call relay is not available for the V24CT and V26CT. The nurse call relay is a paging system which warns the nurse if an alarm occurs on a monitor. It becomes active in one of four situations depending on the way it has been configured: • Red only alarms • Red and Yellow alarms • Red and INOP alarms • Red and Yellow INOP alarms. The nurse call relay is not active when the monitor’s alarm capability is switched off.
Alarm Functions Alarm Setup 5-16 Alarm Functions
6 Recording Functions This chapter contains information on the recordings that can be made using the patient monitors, and the recorders which can produce them. It includes the following sections: • • • • • • • • • • • • • • General Recorder Information . . . . . . . . . . . . . . . . . . . . . . 6-2 Types of Recordings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-7 Delayed Recording . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-8 Alarm Recording . . . . . . . . . . .
Recording Functions General Recorder Information General Recorder Information Recorders The following recorders are available for use with the patient monitors: Recorder Model Number Plug-In M1116A/Ba 4-Channel Bedside M1117A (CMS only) 2-Channel Bedside 78574A (CMS only) a. Only the M1116B can be used with the Philips Information Center The Plug-In recorder has 2 channels, and can also be used at a central location. The 4-channel thermal recorder can also be used at a central location.
Controls and Indicators on the PlugIn Recorder REC M1116B a RUN/ CONT STOP b c a. Continue light Flashes if the currently printing recording is continuous b. RUN/CONT key Starts a timed delayed recording and/or makes a currently printing recording continuous (if possible) c.
Recording Functions General Recorder Information Controls and Indicators on the 4Channel Recorder (CMS only) 6-4 a. Power On/Off key Switches recorder power on (in) and off (out) b. Out-of-paper light Lights when paper is out or recorder door is open c. TEST key Initiates a self-test to check that the recorder is working properly and prints a test strip d. Speed selection lights Lights to indicate current speed setting e.
h. Cont key Makes currently printing recording continuous if possible i. Stop key Stops the currently printing recording Recorder Capabilities Plug-In Recorder (M1116A/B) 4-Channel Recorder (M1117A) (CMS only) Can record up to 3 waveforms (if 2 waveforms are overlapped). • Makes delayed recordings of any waveforms you select. • Makes realtime vital signs recordings.
Recording Functions General Recorder Information Central Recorder (1, 2 or 4 channel recorder) • Makes delayed recordings of waveforms broadcast over the Philips patient care system. (These are waveforms viewed at the central station and other monitors in overview mode.) Single channel recorder records only the primary wave. If ECG is monitored, it must be selected as the primary wave. It cannot be deselected.
Types of Recordings The monitor produces several different types of recordings. Alarm recordings are generated automatically by the monitor when clinical criteria are violated. In addition, you can make the following types of strip chart recordings from the monitor: • Delayed • Monitoring Procedure • Realtime Waves Realtime recordings can either be made from a pre-selected set of waves or selected when the recording is initiated.
Recording Functions Delayed Recording Delayed Recording Definitions Delayed Recordings - recordings of waveforms that are delayed in time, so that if you see a waveform you want to record, you can record it even if it has passed off the monitor screen. A delayed recording runs for a preset time and begins with delayed waveform from before the recording was initiated.
Configuring Delayed Recordings For Plug-In and 4-Channel Bedside Recorders Monitor Setup Recordng Setup Delayed & Alarm On/Off On/Off 1. Select the recorder and layout: a. Press Change Recorder to select the recorder. b. Press Select Overlap to select wave layout. The sector sizes in millimeters and the ECG gain required for 1 mV to equal 1 centimeter on a strip appear below the layout choices. c. Press Change Speed to change recorder speed. 2. Select wave for each channel a.
Recording Functions Delayed Recording For Central Recorders Monitor Setup → System Waves . On/Off Waves 1. Select the central recorder in the Delayed/Alarm Recording Task Window (see steps 1-3 for Plug-In and 4-Channel Bedside Recorders above). 2. Select the waves in the System Waves Task Window a. Press Change Primary to select the primary wave. The Change Primary key does not function if an ECG wave is available. In this case the primary wave is always ECG-CH1. b.
Making Delayed Recordings To initiate a delayed recording on any recorder, press Delayed Record. On the Plug-In recorder only, press RUN/CONT. Delayed recordings can also be initiated from the Preset Recordings Task Window. Here, the waves pre-selected for a delayed recording are identified above the Delayed softkey label. Note—If a delayed recording is configured so that it is produced on a Plug- In recorder or a 4-Channel Bedside Recorder, alarm recordings are also produced on this recorder.
Recording Functions Alarm Recording Alarm Recording Alarm recordings are a type of delayed recording, that is, the recording includes waveform information from before the alarm event so you can see the change in the patient's condition. When a patient goes into an alarm condition, an alarm recording is generated automatically according to the monitor's configuration. You can determine the alarm severity on a parameter-by-parameter basis that will cause an alarm recording to run.
Configuring Alarm Recordings Monitor Setup Recordng Setup AlarmRec On/Off On/Off On/Off 1. Press Select Parametr to highlight a parameter to change. 2. Press Change AlarmRec to select the severity (Red, Red/Yellow, Yellow, Off). 3. Press All Rec On to enable recordings for all red and yellow conditions. 4. Press All Rec Off for no alarm recordings.
Recording Functions Alarm Recording Alarm Recording Priorities Alarm Recording Examples In a delayed recording, waves are recorded in the order assigned in the Delayed/Alarm Recording Task Window, and the number of waves recorded is determined by the recorder configured for delayed recordings. In alarm recordings, the alarming parameters replace the waves in the lower channels. In the default alarm recording, the top channel contains the first delayed wave, usually ECG.
Channel 4 Respiration A yellow CO2 alarm would produce a recording ordered as: Channel 1 ECG Channel 2 Pressure 1 Channel 3 Pressure 2 Channel 4 CO2 alarm If a red P3 alarm occurred, the recording order would then become: Channel 1 ECG Channel 2 Pressure 1 Channel 3 P3 alarm Channel 4 CO2 alarm For alarm recordings with oxyCRG (to document neonatal events without the Neonatal Event capability), the alarm recording items should be set to the following: AlRecType oxyCRG All AlarmRec Off C
Recording Functions Procedure Recordings Procedure Recordings Recordings can be made during cardiac output measurements. Configuring Procedure Recordings You first select the recorder which will record the curve. Monitor Setup Recordng Setup Procedur Recordng 1. Press Change Recorder to select the recorder that will produce the recording. 2. Press Main Screen to return to the standard monitoring display.
Making Procedure Recordings Procedures C.O. See Cardiac Output Section for details on cardiac output measurements. When a cardiac output measurement has been made, the curve in the Measure C.O. Task Window can be recorded by pressing Record Curve . The recording strip shows the curve and is annotated with the date, time, cardiac output value, computation constant, blood and injectate temperatures. Note—Only the most recent cardiac output curve can be recorded.
Recording Functions Procedure Recordings Procedures → Wedge → Edit Wedge See the Pressure Section for details on Pulmonary Artery Wedge Pressure (PAWP) Measurements. When a PAWP measurement has been performed, the PAWP waveform can be recorded by pressing the Record Curve softkey. If displayed, the CO2 or RESP waveform is also recorded. The recording strip is also annotated with the date, time, and wedge value.
(91MIA) 25 mm/sec ST 1mV 01 DEC 93 8:35 Ref 01 DEC 8:30 /01 DEC 8:35/Change ST1 II -0.2 /II 2.1 /+2.3 ST2 aVR 0.0 /aVR -1.0 /-1.0 ST3 V 0.0 /V -0.5 /-0.5 Iso = -72 ms. ST Pt = 100 ms (Ref) Iso -72 ms.
Recording Functions Realtime Wave Recordings Realtime Wave Recordings Definitions Realtime Recordings - recordings of waveforms from the time of your request. There are two types of realtime recordings: Preset Recordings the user presses one of the pre-configured recording keys to initiate recording of preselected waveforms on a pre-selected recorder. The waves are identified above the key labels; the recorder name appears on the key label.
Configuring Preset Recording Modes Monitor Setup Recordng Setup Mode A Recordng . 1. Select the recorder and layout. a. Press Change Recorder to select the recorder that will produce the recordings. b. Press Select Overlap to change the layout of the waves on the recording strip. c. Press Change Speed to change the recorder speed. 2. Select wave for each channel. a. Press Select Channel to select required recorder channel. b. Press Assign Wave to highlight the wave for selected channel. 3.
Recording Functions Realtime Wave Recordings Making Preset Recordings Realtime Record Making NonPreset Recordings Realtime Record Mode B , or Preset Recordng if available Mode C . Mode A , Select RecWaves if available. Select the wave(s) to be recorded. Selected waves are identified in the window after the recorder name in the order they were selected. Each wave that is selected is also identified below the key label. The recording is always continuous, running at 25 mm/s in nonoverlapped mode.
Note—(CMS only): The number of recording channels available depends on the recorder. If you change from a 4- to a 2-channel recorder, only the first two waves are recorded. Note—Non-preset recordings are made on the same recorder as procedure recordings (selected in the Procedure Recordings Task Window). If the power is off for more than 1 minute, a non-preset recording automatically reverts to the default waves and recorder for Mode A.
Recording Functions Realtime Wave Recordings For central recorders, the requests are run and queued according to the priority for that recorder. See the operating guide of the recorder for information. For the M1116A/B Plug-In Recorder and the Philips M1117A Bedside Recorder, the recording prints when the recorder is free.
Realtime Vital Signs / Blood Recordings Definitions 1. Realtime Recordings - recordings of vital signs / blood analysis from the time of your request. 2. Automatic Recordings - automatic recordings of vital signs / blood analysis by an NBP measurement or by a blood analysis measurement. The NBP measurement can be taken by the M1008A/B module or an NBP monitor connected through VueLink. Recordings can also be triggered by a timer when an independent NBP monitor is used. 3.
Recording Functions Realtime Vital Signs / Blood Recordings Depending on the number of parameters being monitored, a vital signs / blood recording may take up to 15 seconds to complete. The recording speed is set by the system, and cannot be adjusted. Note—If vitals signs / blood recordings are configured on when the monitor is turned off, a vital signs recording will be generated within the 30 seconds after the monitor is turned back on.
Making a Single Vital Signs/Blood Recording If your monitor is configured to have a VS/Blood PLUG-IN softkey in the Preset Recordings Task Window, you can initiate a single vital signs or blood recording. Making Timed Sequences of Vital Signs/Blood Recordings An automatic sequence of vital signs / blood recordings can be enabled or disabled in monitoring mode in the Vital Signs/Blood Recording Task Window under Monitor Setup/Recorder Setup.
Recording Functions Realtime Vital Signs / Blood Recordings If you are configured for vital signs / blood recordings and you are in Mode B, selecting the Vital Signs / Blood Recording key produces a recording consistent with NBP configuration.
Trended Vital Signs Recordings You can record the contents of the Vital Signs display in a tabular format on an M1116A/B plug-in recorder. The recorder selection must be set to “PLUG-IN” (the default) in the Procedure Recordings task window before trended vital signs can be recorded. You can access the Procedure Recordings task window by selecting: Header Information • Monitor Setup on the control panel and • Recordng Setup in the Monitor Setup selection window.
Recording Functions Trended Vital Signs Recordings 6. Medical record number Trend Data Depending upon the number of trended parameters, the header page is followed by one or more pages of trend data. A trend data recording may take from 15 seconds to 50 seconds to complete. The recording speed is set by the system and cannot be adjusted. The trended parameters are recorded in the same order as those displayed in the Vital Signs task window and the Vital Signs report.
1. Time line. 7. Diastolic. 2. Data that has been transferred. 8. Mean. 3. Date. 9. Time of measurement. 4. Time setting has been altered during time period 10. Questionable value. 5. Parameter labels. 11. More than one value is available in the time period. 6. Systolic 12. Value has been entered manually.
Recording Functions Trended Vital Signs Recordings Making Trended Vital Signs Recordings Vital Signs Trends / Calcs The trended data displayed in the Vital Signs task window can be recorded by selecting the Vitals PLUG-IN softkey. To stop trended vital signs recordings: The recording can be stopped at any time by selecting: • Stop Recordng • STOP • in the Preset Recording task window, on the recorder itself or by beginning another procedure recording.
Neonatal Event Review Recordings Tabular Neonatal Event Recordings You can record the contents of the Event Review task window in a tabular format on an M1116A/B plug-in recorder. The recorder selection must be set to “PLUG-IN” (the default) in the Procedure Recordings task window before neonatal events can be recorded. You can access the Procedure Recordings task window by selecting: • Monitor Setup on the control panel and • Recordng Setup in the Monitor Setup selection window.
Recording Functions Neonatal Event Review Recordings Depending upon the number of events stored, a neonatal event recording may take from 15 seconds to 40 seconds to complete. The recording speed is set by the system and cannot be adjusted . Making a Tabular Neonatal Event Recording Alarms/Volume Event Review The data displayed in the Event Review task window can be recorded in a tabular format by selecting the Record Summary softkey.
OxyCRG Episode Data The oxyCRG episode is recorded with the same labels, recorder grid and scale labels as those which appear on a standard oxyCRG recording. The oxyCRG episode depicts 2 minutes prior and 2 minutes past the captured event (alternatively 1 minute / 3 minutes configurable). For manually captured events 4 minutes prior the captured event are depicted. A typical oxyCRG episode recording takes about 20 seconds to complete. The recording speed is set by the system and cannot be adjusted.
Recording Functions oxyCRG Recordings oxyCRG Recordings You can record the contents of the oxyCRG display on an M1116B PlugIn recorder. Note—oxyCRG recordings can only be made on the M1116B Plug-In recorder. The M1116A Plug-In recorder, the M1117A four channel recorder, and the central recorder do not support oxyCRG recording. You can manually request an oxyCRG recording, and you can configure an alarm recording of oxyCRG.
The oxyCRG is shown in three distinct non-overlapping “channels” on the strip. The time, the three wave labels, and the scales for the oxygen and beat-to-beat Heart Rate channels are printed periodically on the recording. Three speeds are available for oxyCRG recording: 1, 2, or 3 cm/min. You can choose the speed in the oxyCRG Task Window .
Recording Functions oxyCRG Recordings oxyCRG Alarm Recording Monitor Setup Recordng Setup Delayed & Alarm Pressing the Change AlRecTyp softkey allows you to choose between “Standard” alarm recording or “oxyCRG” alarm recording. If you select “oxyCRG”, an oxyCRG recording is started when an alarm occurs. Six minutes of pre-alarm data and two minutes of post-alarm data are recorded. Any manually initiated recording that is in progress will be interrupted, and the oxyCRG recorded instead.
Additional Information Annotations Delayed and realtime recordings are annotated with codes which identify: 1. 2. 3. 4. 5. The type of recording The monitor operating mode The application area The type of patient The delay time The following table shows the annotation codes.
Recording Functions Additional Information For example, the complete code (8AMIN360) at the beginning of a recording strip means: The recording is delayed (8A). The monitor is in monitoring mode (M). The application area is ICU (I). The patient type is neonatal (N). The delay time is 6 minutes, and the recording is an oxyCRG one (360).
CAL @@@ DEG C BY 5 SEC where @@@ is the signal value as follows: Cal Pulse @@@ Scale 0.25 0.5 0.50 1.0 1.00 2.0 (90DIA) HARVEY SMITH 25 mm/sec 09 AUG 91 18:04 BED 18 ABP Scale (0/40.0/80.0/120) ALARMS SUSPENDED CHECK STATUS LOG PULSE 60 HR 80 ETCO2 40 IMCO2 0 AWRR 25 FIO2 0.
Recording Functions Additional Information Changing the Recording Length Delayed and realtime recordings can be extended or continued. Extending a timed recording resets the runtime. You can extend a recording as many times as needed. In the example below, the recording with a runtime of 12 seconds is extended after it has been running 6 seconds. The runtime is reset, producing a recording of 18 seconds of waveforms.
Changing the Recorder Speed The recording speed can be changed for delayed, realtime, and oxyCRG recordings made on a bedside recorder. Changes made in the Change Recording Speed window affect only the last requested and running recording. Note—If more than one bedside recording is running, the Change Recording Speed window affects only the last requested and running recording.
Recording Functions Additional Information Inserting a Calibration Signal You can insert a calibration signal into the waveform display on the monitor and into any actively running recording. Calibration signals are automatically generated for calibrated waves. The signals can then be used to determine the amplification of the waveform. To insert the signal, press Trends/Calcs , then Mark Event .
Layout Choices on Recorder M1117A Layout Sector 1 Sector 2 Sector 3 Sector 4 #11 25 mm Wave1 25 mm Wave 2 25 mm Wave 3 25 mm Wave 4 #2 25 mm Wave 1 75 mm Wave 2-4 #3 25 mm Wave 1 25 mm Wave 2 #4 50 mm Wave 1 50 mm Wave 2-4 50 mm Wave 3,4 Recording Functions 6-45 Recording Functions Additional Information
Recording Functions Recording Status Messages Recording Status Messages When a recording is running, you get a message in the top center of the monitor display, telling you which parameters are being recorded. In addition, the following messages provide information on the status of your recording request. Message Meaning Continuous Recording Mode: Waves Being Recorded A continuous recording is currently running on a Bedside or Central Recorder.
Message Meaning Wrong Procedure Recorder Configuration A trended vital signs recording or neonatal event recording has been requested but not supported by the selected procedure recorder. Check Paper/Door on Recorder Name Recorder| The bedside recorder is out of paper or the recorder door is open - load new paper and/ or shut the door.
Recording Functions Accessories and Ordering Information Accessories and Ordering Information You can order parts and accessories from Philips supplies at www.medical.philips.com or consult your local Philips representative for details. Warning Reuse: Never reuse disposable transducers, sensors, accessories and so forth that are intended for single use, or single patient use only. Philips’ approval: Use only Philips-approved accessories.
Loading Paper Central Recorders To load paper into the central recorders, see the operating guide for the instrument. Loading Paper into the Plug-In Recorder Directions for loading paper into the Plug-In Recorder are given on the next pages. Before starting, pull the paper storage door open and remove the remaining paper core. Caution For superior performance and top quality recordings, it is strongly recommended that you use Philips paper (Philips order part number 40477A or 40477B).
Recording Functions Loading Paper To Replace Paper in the Plug-In Recorder 1. Insert new roll with paper feeding from the TOP. Pull paper out until it clicks into place. 2. Pull out some paper and discard first 2 inches; tear or fold front edge of paper at a 45° angle. 3. Feed paper UNDER roller, using left edge of paper as a guide. 4. Pull paper out and close door. Note—To test if paper is loaded correctly, initiate a recording. If no printing appears, paper is loaded backwards. Remove and reload.
If the Paper is Loaded Backwards If you have loaded the paper backwards, to remove the roll, do the following: 1. Tear off paper, then open recorder door. 2. Pinch paper at shelf below roller, and pull paper off of roller (see illustration below). 3. Gently push excess paper back onto paper roll. 4. With paper rolled loosely, pinch several thicknesses of the loose paper with your fingers at front of roll, and pull roll out from recorder.
Recording Functions Loading Paper Cleaning the Print head in the Plug-In Recorder If very slow speed (1 or 2 cm/min) recordings are run for extended periods of time, deposits of paper debris may collect on the print head. Symptoms of this are recordings that are unevenly fainter in horizontal stripes. To clean the print head, remove the recorder from the rack. Open the recorder door and un-thread the paper from behind the rubber roller.
message “no alarm recording available” will be displayed periodically on the monitor screen. Loading Paper into the Four Channel (M1117A) Recorder (CMS only) Directions for loading paper into the four channel recorder are given on this page and the next. Before starting to load the paper, check to see that the power is on. Caution To avoid damage to the instrument: -- Make sure hands are clean before loading paper -- Use only the approved paper (Philips order part number 40469A).
Recording Functions Loading Paper Step 2 Unfold the first one or two sheets. Then, place the paper pack in the compartment with the black squares on the left-hand side, facing up, as shown. Note—No more than one sheet should be left hanging outside of the unit. Tear off extra sheets if necessary.
Loading Paper Step 3 Close the door. The paper should feed automatically. Note—The first sheet will come out folded, as shown. Cleaning the Roller on the Four Channel (M1117A) Recorder Equipment Required Directions If the paper doesn’t move through the roller properly, a possible cause is that the roller needs to be cleaned. (Be sure your hands are clean before touching the roller). • Lint-free cloths or wipes • Alcohol solvent that is low in water content.
Loading Paper 6-56 Recording Functions
7 Admit/Discharge/End Case This chapter describes the procedures for reviewing patient admit information, entering height and weight and deleting patient records using the Admit, Discharge, and End Case functions. These functions are accessible under the Procedures key. Discharge and End Case are not operational during a transfer to or from the Philips M1235A Data Transfer module; the Admit function is not accessible during a transfer to the monitor.
Admitting a Patient Admitting a Patient Admit/Discharge/End Case The patient monitors provide you with a display of demographic information on your patient. Patient name and medical record number will appear if the monitor is connected to a central station (the patient must be admitted at the central station) or patient demographic information transferred with the Data Transfer module (M1235A). Alternatively the information can be entered at the bedside with the cursor keys.
Admitting a Patient Items Required or Optional Instructions Patient Name Recommended Enter up to 18 characters. Medical Record No. Recommended Enter up to 12 characters. Date of Admission Optional Enter up to 14 characters in any form. Height Required for calculations Enter a value (either cm or in). Weight Required for calculations Enter a value (g, kg, or lb). Sex Optional One character allowed (use either F or M). Date of Birth Optional Enter up to 14 characters in any form.
Admitting a Patient Admit/Discharge/End Case Admission Information (OR Mode) Items Required or\ Optional Instructions Patient Name Recommended Enter up to 18 characters. Medical Record No. Recommended Enter up to 12 characters. Date of Procedure Optional Enter up to 14 characters in any form. Height Required for calculations Enter a value (either cm or in). Weight Required for calculations Enter a value (g, kg, or lb). Sex Optional One character allowed (use either F or M).
Admitting a Patient Before you admit a new patient, existing data - demographic and monitored - from the current patient must be cleared from the monitor in order to avoid combining information from two patients in one record. Depending on the monitor's configuration, either the Discharge Patient or End Case Task Window is displayed. Press Confirm to clear data.
Admitting a Patient Select Line Moves the cursor up and down Pts Refernce Clear Line erases the input of a whole line Admit/Discharge/End Case Pts Refernce ABC/123 V24 and V26 only Pts Refernce toggle key to switch between Numeric and Alphabetical input.
Admit/Discharge/End Case Admitting a Patient ICU Mode (Adult/Pediatric) ICU Mode (Neonatal) Admit/Discharge/End Case 7-7
Admit/Discharge/End Case Admitting a Patient OR Mode 7-8 Admit/Discharge/End Case
Discharging a Patient/ Ending a Case Patient data for the current patient can be erased in the Patient Information Task Window under Procedures --> Discharge Patient Pts Refernce (ICU configuration sets) or the End Case Task Window under Procedures --> End Case (OR configuration sets). Discharge Patient Pts Pts Refernce Refernce in ICU Configuration Sets erases the entire patient database. You must press Confirm for the discharge to take effect. The system returns to the Admit Patient Task Window.
Admit/Discharge/End Case Admitting a Patient endcase.
8 Trends and Calculations This chapter gives you information on the patient data trends and calculations of the patient monitors. It includes the following sections: • • • • • Introduction to Trends & Calculations. . . . . . . . . . . . . . . . 8-2 Viewing Patient Data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-3 Performing and Reviewing Calculations . . . . . . . . . . . . . 8-20 Printing Reports. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-26 Drug Calculator .
Introduction to Trends & Calculations Introduction to Trends & Calculations Trends and Calculations The patient monitors provide you with several tools to manage and present patient data. These tools are available in the Trends or Trends/ Calcs displays. You can: • View patient vital signs in graphs or tables. • Mark and review clinical events in Graph Trends. • Perform hemodynamic, ventilation, and oxygenation calculations.
Viewing Patient Data Viewing Patient Data There are two ways to view patient data: In graphs where parameter values are points plotted on a graph along a time axis In tables where parameter values and the times the values were collected are listed in a table The number of parameters available to be viewed depends on the patient data management configuration and the options purchased.
Viewing Patient Data Extended Database (CMS only) No. of Parameters Resolution Size 16 12 seconds 9 hours 16 1 minute 48 hours 32 12 seconds 4 hours 32 1 minute 24 hours If data is stored every minute, the values displayed are the stored averaged values of samples taken every 12 seconds for a one-minute interval (5 samples per minute). If data is stored every 12 seconds, the values displayed are the exact values taken at one of the 12-second intervals.
Viewing Patient Data Vital Signs and Graph Trends are not functional during a transfer of data from the Philips M1235A Data Transfer Module to the monitor. Trending Priority Trending priority enables you to specify which parameters will be trended. This is done by assigning a “must” status to parameters in the Trending Priority Task Window. Initially, parameters which have been stable for at least one minute are listed with a priority of “normal”. A maximum of 16/321 musts can be chosen.
Viewing Patient Data You can access the Blood Review task window by selecting Blood Review from the Blood Analysis task window or by selecting Blood Review from the Trends/Calcs Selection Window. Trends and Calculations On CMS, the Blood Review task window allows you to view blood results up to 48 hours old or a maximum of 96 data points for each blood parameter.
Viewing Patient Data • • • • • • • • A “T” next to the time indicates that the data was transferred to the monitor using the Data Transfer module. A question mark beside a time (?7:15) indicates the blood measurement occurred prior to clock changes at the bedside or central station. A question mark preceding a blood measurement value (?5.0) indicates that blood measurement has been invalidated by a user.
Viewing Patient Data The table below describes how reference ranges appear on monochrome and color displays. Status Monochrome Display Color Display Printout Inside Range Full intensity White Normal print Outside Range Inverse full-intensity Yellow Bold print CrossConnection to Vital Signs When the Vital Signs key is pressed in the Blood Review Task Window, the Vital Signs Task Window opens up and the column closest in time to the column selected in the Blood Review Task Window is selected.
Viewing Patient Data Patient data can be shown in a table three minutes after monitoring begins. The table appears in the default data time interval (1-min., 5-min., 15-min., 1-hr., 2-hrs., or 3-hrs.) with the most recent data at the right of the screen. The number of hours of patient data available (maximum 24 hours or 48 hours (CMS only)) depends on the patient data management configuration of the monitor and the options purchased.
Viewing Patient Data For example, when you press Graph Trends from a Vital Signs display at one-minute resolution, the total time the graphs spans is 1 hour. Conversely, when you go directly from Graph Trends with a 2-hour span to the Vital Signs display, the intervals are 15-minute. Note—If configured for the OR environment, the data is stored every 12 Trends and Calculations seconds.
Viewing Patient Data Aperiodic parameters (parameters which are not monitored continuously such as C.O.) are shown with their collection times below them. An uparrow beside an aperiodic parameter indicates that more than one value is available for this time column. On CMS, up to 96 data points for each aperiodic parameter can be stored for 24 hours1. On a V24 or V26 monitor, up to 48 data points for each aperiodic parameter (96 for selected configurations) can be stored for 24 hours.
Viewing Patient Data “Recording Functions” section (chapter 6) of this manual for further information. Trends and Calculations Selecting Parameters for Graph Trends You can select up to 9 parameters to be displayed in the Graph Trends Task Window by using the On / Off / Combined softkey.
Viewing Patient Data Patient data can be shown in a graph three minutes after monitoring begins. The graph appears in the default time period with the most recent data at the right of the screen. The times appear along the X-axis (horizontal) in 24-hour format (for example, 18:00 means 6:00 p.m.). For all database configurations except 9-hour, the default time period is 1, 2, 8, 16, or 24 hours. The parameter labels are listed on the Y-axis (vertical).
Viewing Patient Data The values plotted are the stored averaged values of readings taken every 12 seconds for a one-minute interval. Invalid data (such as a noisy ECG) is not plotted on the graph. Instead, a gap will appear in the graph. If you have configured your monitor for the OR, up to 4 hours of data at 12-second time intervals is available. In this case, the values are the stored values for each 12-second reading. Up to three graph channels are presented on the screen at once.
Viewing Patient Data If you change a value in Hemodynamics Calculations, (for example, you change ABP from 120 to 140), the new value will be identified in Patient Data graphs by a star (*). Note—(CMS only) For the 9-hour database, the default time period is 9 Trends and Calculations hours, with 4.5 hours of information displayed at any one time. Data within the other 4.
Viewing Patient Data Marking Events The Mark Event function enables you to mark events and then review them in Graph Trends. Events are labelled A, B, C, or D. You decide for your unit what each letter means (for example, A = drug administration, B = out of bed, C = suctioning, etc.). For instance, you may want to mark an event such as drug administration. Pressing the event key with the appropriate label (for example, Event A ) stores the event time and label.
Inserting a Calibration Mark The Mark Event function also enables you to insert a calibration reference into displayed waves. When checking the magnitude of a displayed wave, it can be useful to have a reference or standard to compare against. The Cal Signals key momentarily interrupts the displayed ECG, RESP, and pressure waves and inserts the cal pulse(s) for reference. (This calibration wave is in addition to the calibration reference bar that is always displayed on the ECG and RESP waves.
Viewing Patient Data Procedure to Insert a Calibration Pulse Trends and Calculations Trends/Calcs Mark Event Cal Signals When you press Cal Signals , you'll hear a beep as the calibration pulse appears in the displayed waves. The event label softkeys and the Cal Signals softkey disappear. In the time period between the Cal Signals softkey being pressed and it disappearing from the screen, parameter numeric values are not collected and alarms are not active.
Viewing Patient Data The calibration pulse varies according to the wave type: ECG 1 mV square wave RES 1 ohm M-shaped wave All Pressures Stepped wave with 30, 60, 120, and 180 mmHg increments For pressure scales of 240 and 180, all four steps are displayed. At lower ranges, however, not all the steps are displayed since one or more steps exceeds the full scale range.
Performing and Reviewing Calculations Performing and Reviewing Calculations There are two calculation functions available: Perform calculations where parameter values can be entered automatically or manually to perform calculations in a specified group Review calculations where previously made calculations can be examined Trends and Calculations The three calculation groups available are Hemodynamics, Ventilation, and Oxygenation. Examples of values which can be calculated are given below.
Performing and Reviewing Calculations Calculations can be performed using automatically-entered values or manually-entered values. If a parameter is being continuously monitored, its value is automatically entered. Values which are not monitored must be entered manually. You can also change any of these values if needed.
Performing and Reviewing Calculations Trends and Calculations Calculation Task Window Calculation Task Window for Touch Screen 8-22 Trends and Calculations
Performing and Reviewing Calculations BSA Formula • If you plan to use monitored parameter values in Calculations, be sure that when you are configuring parameters, you assign the parameter the same label that is used in Calculations. For example, ABP should be used instead of ART because ABP is the label used by Calculations. • When you enter the Task Window, the Calculation time will be the last C.O. time or the current time, depending on how the monitor is configured. If C.O.
Performing and Reviewing Calculations Resampling Vital SIgns Resampling of vital signs enables you to override the values in the Trends database, which are stored every 12 seconds or averaged over 1 minute, depending on the monitor’s configuration. Resampling enables you to use the most recent continuously monitored values. Resampling sets the calculation time to the current time, and displays the corresponding values for the previous second in the calculations task window.
Performing and Reviewing Calculations Changing or Entering an Input Value The arrow keys are used to select a parameter and the keypad is used to enter or change the selected value. With a touchscreen, you can select a parameter by selecting the touch button in front of the parameter label. A numeric touchboard will be included in the task window to enter or change values. If you enter a value which cannot be stored, the message Parameter value input range X: “Y OUT OF RANGE” will appear.
Printing Reports Printing Reports You can print reports manually through task windows or automatically through pre-scheduled printing. You can print a report of the data shown in the Task Window you are viewing. These reports are available for Patient Information, Graphs, Blood Review, Vital Signs (all parameters for the displayed time period), Calculations, Calculation Review, and Drug Calculator Titration Table, if available.
Printing Reports To turn the scheduled report capability on or off, press SchedRep On/Off in the Patient Data Selection Window. This brings you to the Scheduled Reports On/Off Task Window. The current setting (On or Off) is indicated, and a softkey is highlighted (for example, if scheduled reports are off, the SchedRep On key is highlighted). Press the highlighted key to change the setting. To cancel a report, press Cancel Report in the Selection Window under Trends/Calcs .
Printing Reports DAVID SCHULTZ MR # : 012-34-56789 DOB : 22 FEB 1945 Bed : CCU 7 Adm Phys : M.M¤LLER Att Phys : R.
Printing Reports DAVID SCHULTZ MR# : 012-34-56789 DOB : 22 FEB 1945 Bed : CCU 7 Adm Phys : M.MULLER Att Phys : R.SCHWARTZ Report : 28 JAN 1996 Admit : 27 JAN 1996 17:22 10:15 MEMORIAL MEDICAL CENTER, BOSTON, MA 27 JAN 10:00 HR ABP S ABP D ABP M PAP S PAP D PAP M T1 C.O. 88 115 75 95 35 18 24 37.8 5.3^ 2:50 PAWP 13 2:52 11:00 12:00 13:00 14:00 15:00 16:00 17:00 85 125 90 100 28 15 19 37.5 87 110 71 92 24 11 15 37.6 5.1 6:47 83 112 72 90 25 13 17 37.8 85 115 75 95 23 12 16 37.
Printing Reports What to Do If Your Report Does Not Print During normal report printing, messages appear in the status message area of the display. However, sometimes a printing status message may alert you to a problem that needs to be corrected. The following information describes printing messages that may appear, what they mean, and what you may need to do to correct a problem (should there be one).
Printing Reports MESSAGE: Report Request Accepted Meaning: The report has been accepted for printing. What Do You Need to Do: You don't need to do anything. MESSAGE: Too Many Reports In Line - Please Wait Meaning: The printer has reports waiting to print and cannot accept another report request. What Do You Need to Do: Do not send a new report request to the printer. Wait and send your request when the message “Report Complete'' appears.
Drug Calculator Drug Calculator The drug calculator provides drug infusion information at the bedside for up to 24 drugs. Using the calculator, you can determine infusion rate, dose, amount, or volume, and display or print a titration table for each drug. The drug calculator is accessed through the Trends/Calcs key and the Drug Calc softkey. Trends and Calculations The first window - Drug Selection - lists the drugs available for use with the calculator.
Drug Calculator Trends and Calculations By pressing Perform Calc , you will enter the Drug Calculation task On/Off drug. In this window, the input values and units window for the selected configured for the selected drug are listed on the left. The unknown value and the concentration are shown on the right. Here you can enter or change values for the inputs using the keypad or the up and down arrow keys. You can also select a different unknown value to calculate.
Drug Calculator Caution Trends and Calculations If you use the Drug Calculator for any patient other than the one currently being monitored, the current patient's history will be altered when another patient's weight is stored.
Drug Calculator Trends and Calculations The Titration Table task window notes the relationship between dose and rate as configured during system installation. This table can be printed directly from the Titration Table task window, or from the Drug Calculation task window. When a patient is discharged, any modifications made to the inputs or in the unknown value for the discharged patient will be discarded, and the configured defaults will be re-initialized for the next patient.
Trends and Calculations Drug Calculator 8-36 Trends and Calculations
9 Neonatal Event Review This chapter contains information on how to view and interpret Neonatal Events and oxyCRG Episodes for an individual Event. • • • • Introduction to Neonatal Event Review. . . . . . . . . . . . . . . 9-2 Viewing Neonatal Events . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-3 Viewing oxyCRG Episodes. . . . . . . . . . . . . . . . . . . . . . . . . 9-14 Adjusting Neonatal Event Review Settings . . . . . . . . . . .
Introduction to Neonatal Event Review Introduction to Neonatal Event Review The Neonatal Event Review application enables the patient monitors to automatically detect, store, display and document up to 48* neonatal events over a period of 24 hours. The neonatal events detected by the monitors are: • Apnea, • Bradycardia, • Desaturations and/or a combination of the three. In addition, events (e.g. breathing patterns) can be stored manually.
Viewing Neonatal Events Viewing Neonatal Events Once an event has been captured and stored by the monitor, it is displayed in the Event Review task window. You can access the Event Review task window by selecting: Alarms/Volume • Event Review on the control panel and in the Alarms/Volume selection window. The information displayed in the Event Review task window is presented in a graph format and is divided up into the following four channels: 1.
Viewing Neonatal Events 4. The Manual Event Channel The graph provides an overview of the total number of events and how they were distributed over the last 24 hours. If you would like to capture an event manually, press Alarms/Volume followed by Capture Episode .
Viewing Neonatal Events Graphical Details The following information is displayed on the graph in the Event Review task window 1. Event bars. 2. Event threshold lines. 3. Event time. 4. Event numerics. 5. Event summary line. A neonatal event is indicated by one or more vertical bars which are displayed across one or more graph channels. Each event bar can be selected by the graph cursor. Isolated Events: indicated by one event bar, displayed in one graph channel.
Viewing Neonatal Events (1) Associated Event (2) Isolated Event (3)Cursor The severity of an event is indicated by the length of the event bar; the longer the event bar, the more severe the event. Neonatal Event Review The Bradycardia and Desaturation event bars start at the top of their channels and extend downwards. The Apnea event bars start at the bottom of the Apnea channel and extends upwards. The Manual Event Bar is only a marker to be selected by the graph cursor.
Viewing Neonatal Events The patient monitors can be adjusted in monitoring mode so that an event is either triggered by an alarm or by criteria defined specifically by the user. The event trigger level is represented in the graph by a threshold line, located in each graph channel. This line enables the user to see the following: 1. Whether a trigger is active.
Viewing Neonatal Events Event Time The time at which the event was captured is stored with each event. To display the event time, move the cursor onto the event you wish to view. The event time is displayed immediately in the top right hand corner of the task window.
Viewing Neonatal Events When the cursor is moved onto an event bar, specific numerical data for that event is displayed in the three boxes on the right hand side of the task window. The background of one of the three boxes is always highlighted. This indicates which one of the parameters triggered the capture of the event. Note—When an event is captured manually, all boxes contain the word “Manual” and no box is highlighted. (1) This value represents the most severe value during an event.
Viewing Neonatal Events Event Summary Line The event summary line is located above the graph, along the top of the task window. The user can view, at a glance, the total number of stored events. The events are divided into five categories: Total Apneas (with or without associated Desaturation). 2. B(D) => Total Bradycardias (with or without associated Desaturation) 3. AB(D) => Associated Apnea and Bradycardia (with or without associated Desaturation). 4. D => Isolated Desaturation. 5.
Viewing Neonatal Events Event Review 19 Stored Events: A(D): 4(2) B(D): 3(0) AB(D): 1(1) D: 9 M: 2 Event Storage • A total of 19 neonatal events are stored. • Four Apnea events occurred, of which two resulted in a Desaturation. • Three isolated Bradycardia events occurred, none of them resulted in a Desaturation. • One associated Apnea and Bradycardia occurred which also resulted in a Desaturation. • Nine isolated Desaturations occurred. • Two events were manually captured and stored.
Viewing Neonatal Events If the event storage is full, the newest (49th1) event will enter the graph on the right hand side and push the oldest (1st) event off the graph on the left hand side. This information cannot be retrieved. To document the event review before the event storage becomes overfull, you should initiate an event summary recording. To free up space in the event storage and remove unwanted events from the Event Review graph, you can delete events in the oxyCRG Episode task window.
Viewing Neonatal Events Note—The oxyCRG Episode softkey is only active if at least one event is stored. Printing the Event Summary Changing the Neonatal Event Trigger Conditions Selecting the Record Summary softkey documents in tabular form the numerical data (not graphical) of all events displayed in the Event Review task window for the last 24-hours, on the bedside M1116B Recorder Module.
Viewing oxyCRG Episodes Viewing oxyCRG Episodes The oxyCRG Episode task window displays a four minute oxyCRG episode for the event currently selected in the Event Review task window. It enables you to view the event in context, by showing the oxyCRG reading during the Pre and Post-Event Time. Note—Manual Events are only shown with 4 minutes Pre-Event Time.
Viewing oxyCRG Episodes 1. The btb HR trend channel with a range from 60 up to 220 bpm. 2. The SpO2 trend channel with a range from 60 up to 100%. Neonatal Event Review 3. The RESP compressed wave channel.
Viewing oxyCRG Episodes The exact time an event was triggered is indicated by a vertical line which is positioned on the graph according to the monitor's configuration.
Viewing oxyCRG Episodes Recording an Episode Selecting the Record Episode softkey documents the selected oxyCRG episode in a graphical format on the bedside M1116B Recorder Module with fast paper speed. Please refer to the “Making Recordings” section of this manual (Chapter 6) for further details on recording neonatal events and associated oxyCRG episodes. Printing an Episode Selecting the Print Episode oxyCRG display.
Adjusting Neonatal Event Review Settings Adjusting Neonatal Event Review Settings The Event Setup task window enables you to adjust event settings to determine how and when an event is detected and stored. You can access the Event Setup task window by selecting: Neonatal Event Review • Event Setup in the Event Review task window.
Adjusting Neonatal Event Review Settings The Event Setup task window enables you to adjust the following items: Apnea Event Settings The trigger mode determines whether an event is triggered by a physiological alarm or by criteria defined specifically by the user. Trig Threshold The trigger threshold can be adjusted if the user defined trigger mode setting has been selected Trigger Time The trigger time can be adjusted if the user defined trigger mode setting has been selected.
Adjusting Neonatal Event Review Settings Bradycardia Event Settings Alarm Triggered The Bradycardia event is triggered by a Red*** Brady alarm. The Bradycardia alarm limit can be viewed but not adjusted in the Event Setup task window. The alarm limit must be adjusted in Monitoring Mode in the HR/PULSE or Alarm Limits task window and the trigger time must be adjusted in Configuration Mode in the HR/PULSE task window.
Adjusting Neonatal Event Review Settings Desaturation Event Settings Alarm Triggered The Desaturation events are derived from the first SpO2 bedside module and triggered either by a Red*** Desat alarm or a Yellow** low limit SpO2 alarm. The Desat/SpO2 alarms and trigger times can be viewed but not adjusted in the Event Setup task window. These settings must be adjusted in Monitoring Mode in the SpO2 task window.
Adjusting Neonatal Event Review Settings Selecting the Change Content softkey enables you to change the contents of an item.
10 Data Transfer This chapter describes the Philips M1235A Data Transfer module. It includes the following sections: • • • • • • Data Transfer Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-2 Types of Transfer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-7 Combining Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-14 Vital Signs, Blood Review and Graphs . . . . . . . . . . . . . . 10-17 Troubleshooting . . . . . . . . . . . . . . . . . . .
Data Transfer Module Data Transfer Module The Philips M1235A Data Transfer module allows for rapid, convenient, and easy transfer of patient data among V24 and V26 Patient Monitors, CMS Patient Monitoring Systems and Component Transport Systems. For example, if a patient is moved to another location, the Data Transfer module can be used to transfer the patient's data, along with the patient, to the new location.
Data Transfer Module CMS M1235A DTM ! CMS V24/V26 Data Transfer 10-3 Data Transfer CTS
Data Transfer Module Data transfer presents no interruptions to realtime monitoring and provides near-continuous trends. However, some functions under Trends/Calcs and Procedures are not available during the transfer of data. The ST Analysis task windows are unavailable during a transfer to the monitor. M1235A DATA TRANSFER M1235A MODULE MONITOR ! The front of the module has two keys: • The Monitor key for initiating a transfer from the module to the monitor.
Data Transfer Module When the module is unplugged, it retains data for at least one hour. After data is transferred to the monitor, the module is automatically erased. This is to ensure that the module is empty when it is used for the next transfer. Symbols to Indicate Key Functions As detailed in the table below, some versions of this module now use symbols, instead of words, to indicate the function of some keys.
Data Transfer Module The order in which the parameters are listed on the display is relative to the destination monitor, not the originating monitor. Patient demographics have the highest priority in the order of data being transferred. The aperiodic parameters are transferred next, before continuously monitored parameters, for each hour.
Types of Transfer Types of Transfer There are two types of transfer to the module and one type of transfer to the monitor. 1. Transfer All Data - Any data existing in the module is erased Pts Refernce before the transfer begins. After the transfer, updates continue once per minute until they are manually stopped. Transfer All Data to Module 2. Collect New Data - Patient demographics plus all data starting at Pts time is transferred to the module.
Types of Transfer Data Transfer Updates continue once per minute until the transfer is manually stopped.
Types of Transfer Append New Data to the Module (Patient matching) Data Transfer 10-9 Data Transfer Append New Data to the Module (Patient not matching)
Types of Transfer To Monitor When a Data to Monitor transfer is selected, all the module contents Pts to the destination monitor. If patient information Refernce will be transferred exists in the monitor, the message “Discharge monitor patient before transfer?” gives you the option of erasing the previous patient's data before transferring. After a transfer to the monitor, the module contents are automatically erased.
Types of Transfer Identifying the Software Release of your Monitor The transfer of blood analysis data from one monitor to another will vary depending upon the software level of your monitor. Please refer to one of the scenarios on the next pages to transfer blood analysis data. To identify the software release of your monitor, press Monitor Setup → Monitor Revision → Show SW Rev .
Types of Transfer Blood Analysis Data Transfer Scenarios • Transferring data from a source monitor to a destination monitor where: – The source monitor is: — CMS Release G or later or — V24 and V26 Release A.0 or later – The destination monitor is: — CMS Release E or later or — V24 and V26 Release A.0 or later or — V24 Release E 1. Plug the Data Transfer Module into the rack of the source monitor. 2. Press the Module hardkey on the module and transfer all data to the module. 3.
Types of Transfer • Transferring data from a source monitor via a transit monitor to a destination monitor requires special handling if: – The source monitor and the destination monitor are: — CMS Release G or later or — V24 or V26 Release A.0 or later and – The transit monitor is: — CMS Release E or F — V24 Release E — CTS 1. Plug the Data Transfer Module into the rack of the source monitor. 2. Press the Module hardkey on the module and transfer all data to the module. 3.
Combining Data Combining Data In some situations, the patient name and/or ID in the monitor and module may not match (see Append New Data display on previous page). In other cases, one or both names may be blank. The Data Transfer Combine Task Window enables you to combine files when the demographic data is missing or different. Time Conversion Data in a monitor can be stored at either 1-minute or 12-second resolution, depending on the monitor's configuration.
Combining Data Database Conversion - Transfers to Module Monitor Database What will be Stored in Module 16 param, 24hr, 1 min 16 param, 24 hr, 1 min 16 param, 4 hr, 12 sec 16 param, 4 hr, 1 min CMS Only: 16 param, 48 hr, ext 1 min 16 param, 24 hr, 1 min 32 param, 24 hr, ext 1 min 32 param, 12 hr, 1 min 16 param, 9 hr, ext 12 sec 16 param, 9 hr, 1 min 32 param, 4 hr, ext 12 sec 32 param, 4 hr, 1 min Transfers to the Monitor The following table shows the mapping for transfers to the monitor whe
Data Transfer Combining Data Module Database Monitor Configuration What will be Stored in Monitor 32 param, 12 hr, 1 min 16 param, 4 hr, 12 sec 32 param, 12 hr, 1 min 32 param, 12 hr, 1 min 32 param, 24 hr, Ext 1 min 32 param, 12 hr, 1 min 32 param, 12 hr, 1 min 16 param, 9 hr, Ext 12 sec 32 param, 4 hr, 1 min 32 param, 12 hr, 1 min 32 param, 4 hr, Ext 12 sec 32 param, 4 hr, 1 min 10-16 Data Transfer
Vital Signs, Blood Review and Graphs Vital Signs, Blood Review and Graphs Some functions under Trends and Procedures are unavailable during transfers of patient data.
Vital Signs, Blood Review and Graphs The destination monitor creates the time stamp for transferred data by determining how old each data sample is and subtracting the age of the data from the current monitor time. Caution Hemodynamic, oxygenation, and ventilation calculations result values may show slightly different times before and after being transferred, because a different set of valid parameters was used for the calculation at calculation time.
Troubleshooting Troubleshooting Caution In a centrally networked system, if the previous patient is discharged only at the monitor and a new patient's data is transferred to the monitor, the new patient's name and ID will be overwritten by the central station's broadcast of the previous patient's name. To prevent this situation from occurring, the previous patient should be discharged from central station before the transfer.
Performance Specifications Performance Specifications For safety and environmental specifications, please refer to Chapter 11, “Monitor Installation and Patient Safety”. Data Transfer Module Transfer Time A typical transfer time for 24 hours of data is under 30 seconds. The transfer time could be as high as 60 seconds for highly customized trends.
11 Monitor Installation and Patient Safety This chapter contains important information on the installation requirements for the monitor. It includes the following sections: • • • • • • • • • • Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-2 Installation Information . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5 The Front Panel of the M1046A Computer Module . . . 11-17 The Front Panel of the M1046B Computer Module . . .
Monitor Installation and Patient Safety Introduction Introduction This section contains important information on patient safety and installation requirements for the: • • • • • CMS ACMS NCMS Philips M1026A Anesthetic Gas Module V24 and V26 The M1165/66/75/76A Systems are designed to comply with the following international safety requirements for medical electrical equipment: • • • • UL 544 CSA 22.
The M1205A V24 and V26 Patient Monitors and compatible modules and accessories are designed to comply with the following international safety requirements for medical electrical equipment: • • • • UL 2601-1 CSA C22.2 No. 601-1 IEC 601-1 IEC 601-1-1 Classification (IEC 601-1): Class 1, type CF, continuous operation. IP20 indicates ordinary protection against the ingress of liquids.
Monitor Installation and Patient Safety Introduction Caution If liquid is spilled on the equipment or accessories, contact your biomedical engineering department or the Philips Service Engineer.
Installation Information Power Source Requirements The CMS systems and the Anesthetic Gas Module can be operated from an AC source of 100 - 120V ± 10%, or 220 - 240V ± 10%, 50 - 60Hz. Typical input currents for the monochrome and color systems are: Monochrome CRT 100 - 120V = 2.2 amps 200 - 240V = 1.2 amps Color CRT 100 - 120V = 2.6 amps 200 - 240V = 1.4 amps Color Flatscreen 110 - 120V = 2.0 amps 200 - 240V = 1.0 amps Typical input current for the Anesthetic Gas Module is: 100 - 240V = 1.
Monitor Installation and Patient Safety Installation Information If the computer and display module of the M1165/66/75/76A Systems and the Anesthetic Gas Module are set up together, connect the grounding wire to the equipotential grounding terminal on the display. If the computer and display module of the M1165/66/75/76A Systems and the Anesthetic Gas Module are separated, connect one grounding wire to the display, one to the computer module and one to the Anesthetic Gas Module.
Safety Ground (Protective Earth) (V24 and V26 only) Additional Protective Earth (Secondary Ground Wire) Hazardous leakage currents can be caused when other equipment is interconnected with either monitor. A secondary ground wire is provided with the CMS, V24 and V26 to comply with IEC 601-1-1. This additional protection ensures against excessive chassis leakage current in the event of a single fault in the health care facility's primary grounding means.
Monitor Installation and Patient Safety Installation Information Combining Equipment If it is not evident from the instrument specifications whether a particular instrument combination is hazardous or not, for example due to summation of leakage currents, the user should consult the manufacturers concerned or else an expert in the field, to ensure that the necessary safety of all instruments concerned will not be impaired by the proposed combination.
Environment To ensure a completely safe electrical installation, follow the instructions described later in this section. The environment where the system will be used should be reasonably free from vibration, dust, corrosive or explosive gases, extremes of temperature, humidity, and so on. For a cabinet mounted installation, allow sufficient room at the front for operation and sufficient room at the rear for servicing with the cabinet access door open.
Monitor Installation and Patient Safety Installation Information Philips M1167/77A CMS for Critical, Anesthesia and Neonatal Care Operating Storage Temperature Range 5 to 45°C (41 to 113°F) -20 to 60°C (-4 to 140°F) Humidity up to 95% RH at 40°C (104°F) up to 85% RH at 50°C (122°F) Altitude Range up to 4,600m (15,000 ft) up to 4,600m (15,000 ft) Philips M1165/66/75/76A CMS for Critical, Anesthesia and Neonatal Care Operating Storage Temperature Range 0 to 45°C (32 to 113°F) -40 to 70°C (-40
Philips M1205A V24CT and V26CT Operating Storage Temperature Range 5 to 35°C (41 to 95°F) -15 to 40ºC (5 to 104ºF) Humidity up to 95% RH at 35°C (95°F) up to 90% RH at 40ºC (104ºF) Altitude Range up to 4,600m (15,000 ft) up to 4,600m (15,000 ft) Condensation Make sure that during operation, the instruments are free of condensation. Condensation can form when equipment is moved from one building to another, thus being exposed to moisture and differences in temperature.
Monitor Installation and Patient Safety Installation Information Explanation of Symbols used Attention: Consult accompanying documents. This symbol appears next to certain connectors located on the front and/or rear of the instrument. It indicates that the connectors are designed to have special protection against electric shocks and are defibrillator proof. An electrical output. This symbol is also used to indicate the gas output on the ssCO2 module and the Anesthetic Gas Module.
Switch position is on/off. Contrast. Alternating current. Protective earth Contains parts to be recycled Contains parts which may not be put into the normal waste disposal but must be recycled or dealt with as chemical waste. Altitude or atmospheric pressure Temperature Humidity 1999 - 07 This symbol identifies the date of manufacture. The date format is Year - Month, e.g.
Monitor Installation and Patient Safety Maintenance Checks Maintenance Checks Before commencing monitoring on a patient, carry out the following checks on the system: • Check for any mechanical damage • Check all the external leads, plug-ins and accessories • Check all the functions of the instrument which will be needed to monitor the patient, and ensure that the instrument is in good working order.
Maintenance Frequency Source of Information Electrical Safety Tests At least every two years, after system installation, after any repairs, or as needed. See “Testing and Maintaining the CMS” in the “CMS Service Guide” or “Testing and Maintaining the V24 and V26“in the “V24 and V26 Service Guide”. Testing of all cables and cords. Daily. See “Testing and Maintaining the CMS” in the “CMS Service Guide” or “Testing and Maintaining the V24 and V26“in the “V24 and V26 Service Guide”.
Monitor Installation and Patient Safety Maintenance Checks Patient Cables and Leads Inspect the patient cables and leads and their strain reliefs for general condition. Examine cables carefully to detect breaks in the insulation and to ensure that they are gripped securely in the connectors of each end to prevent rotation or other strain.
Controls and Connectors This section describes the various controls and connectors on the front and/or rear panels of: • • • • • The Front Panel of the M1046A Computer Module the Computer Modules the Display Modules the External Alarm Device the Anesthetic Gas Module the V24 and V26 Patient Monitor The M1046A Computer Module is a component of the M1165A/66A/75A/ 76A Systems. The front of the M1046A Computer Module can be mounted with an integral plug-in module rack or a blank rack.
Monitor Installation and Patient Safety Controls and Connectors Maximum Voltages Connectors of the M1046A Computer Module (1) Rack Connector 60 V (2) ECG Output 3.2 V p-p (3) Module Connectors 60 V The connectors on the front panel of the computer module are: 1. Rack Connector; female interface connector used to connect a satellite rack to the computer module. 2. ECG Output; used to output an ECG wave to synchronize a defibrillator and provide an input for the defibrillator marker signal. 3.
The Front Panel of the M1046B Computer Module The M1046B Computer Module is a component of the M1167A/77A System. The M1046B has a detachable front panel which must be removed to view the connectors (except for the ECG Output connector, which is also visible when the front panel is attached). The connectors on the front panel of the M1046B Computer Module are shown in the following diagram: Maximum Voltages Rack Connector 60 V ECG Output 3.
Monitor Installation and Patient Safety Controls and Connectors Connectors of the M1046B Computer Module The connectors on the front panel of the computer module are: 1. Local Power Connector; a 3-pin, 90° connector is used to input the local line voltage. 2. Rack Connector; female interface connector used to connect a satellite rack to the computer module. 3. ECG Output; used to output an ECG wave to synchronize a defibrillator and provide an input for the defibrillator marker signal. 4. Power-on LED.
The Rear Panel of the M1046A/B Computer Modules The rear panel of the M1046A and M1046B computer modules has several connectors. The connectors, and their position, depends upon which function cards are fitted; as the rear panel is made up of small panels that are attached to certain function cards. A typical computer module rear panel is shown below.
Monitor Installation and Patient Safety Controls and Connectors Maximum Voltages RS232 Connectors ±12 V HDLC Connector 5V Video Out (9) 5V Flatscreen Remote Power Supply On/Off 15 V Video Out (11) 60 V Note—Do not apply a voltage of more than ±12V to any of these outputs. The connectors on the rear panel of the computer module (together with their connecting function cards) are: 1.
(or receive inputs from the Ohmeda 7800/7810 Ventilator or the Anesthetic Gas Module). Warning Make sure all devices connected to the RS232 connectors are isolated. Consult your biomedical engineer, who will verify this for you. 8. HDLC Connector; this is used to connect to a STRIP recorder (such as the Philips M1117A). 9. Video Out Connector (CDSPC-Video or DSPC); this is a connector used to output information to be displayed on the display module. 10. PS ON/OFF connector (DSPC_FLAT); this is left open.
Monitor Installation and Patient Safety Controls and Connectors M1092A/M1094A Display Module.
M1094B Display Module Maximum Voltages Controls of the M1092A, M1094A and M1094B Displays System Power Connector 60 V Human Interface Connector 12 V Local Power Connector 240 V Video Out Connector 5V Video In Connector 5V 1. Video Termination Switch; thus switch is used to terminate the video signal at this display: this must be switched to the “75Ω” position if only a master display is used and must be switched to the “HIGH IMP.” position if a second, duplicate display is used.
Monitor Installation and Patient Safety Controls and Connectors 2. V AMP; this is the vertical amplitude control used to adjust the height of the displayed video. 3. V SHIFT; this is the vertical shift control used to adjust the vertical position of the displayed video. 4. H AMP; this is the horizontal amplitude control used to adjust the width of the displayed video. 5. EAST WEST; this control is used to adjust the pin-cushion effect of the displayed video.
6. Human Interface Link Connector; this is a Philips HIL connector, used to output the information from the keypad and control panel to the Utility CPU function card in the computer module. 7. Equipotential Grounding Terminal; this is a grounding stud connector, used to connect the system to an equipotential grounding system.
Monitor Installation and Patient Safety Controls and Connectors M1095A Display Module Controls of the M1095A Display Connectors of the M1095A Display 1. Brightness Control 2. Standby Switch 3. Combined Video In / Power Connector; a male SCSI connector with 25 pin pairs is used to input the video signal and the 60 V dc line voltage. 4. Human Interface Link Connector In; this is a Philips HIL connector used to connect the handheld keypad. 5.
The Rear Panel of the M1109A External Alarm Device M1109A External Alarm Device 4 1 2 3 Controls and Connectors of the M1109A External Alarm Device 1. Standby Switch 2. Human Interface Link Connector Out; this is a Philips HIL connector used to output the information from the handheld keypad to the Utility CPU function card in the computer module. 3. Human Interface Link Connector In; this is a Philips HIL connector used to connect the handheld keypad. 4.
Monitor Installation and Patient Safety Controls and Connectors loudspeaker is not covered and can be heard. The most suitable location for the External Alarm Device is in close proximity to the ITE display. The Rear Panel of the M1026A Anesthetic Gas Module The connections on the rear panel of the Anesthetic Gas Module are shown in the following diagram: MONITOR The rear of the Anesthetic Gas Module has the following connections: 1.
Caution • The System Power Outlet cannot be used to output power to other devices such as the Philips M1167A/77A ACMS. • The System Power Outlet can only be used to supply power to the ACMS when the total leakage current does not exceed 300 µA. 4. Equipotential Grounding Terminal; this is used to connect the Anesthetic Gas Module to the hospital´s grounding system. 5. Line protection fuses, T1.6 H 250V. 6. Anesthetic Gas Exhaust.
Monitor Installation and Patient Safety Controls and Connectors M1167/77A System The display module (M1095A) cannot be attached to the computer module (M1046B). It is designed for mounting on a horizontal or vertical rail such as an I.V. pole. For further details, please refer to the CMS Service Guide, chapter 2; Installing CMS. The computer module can be attached to the top or bottom of the Anesthetic Gas Module by a locking device.
Lifting the Display Module The M1092A display module weighs 26 lbs (12kgs) The M1094A display module weighs 42 lbs (19kgs) The M1094B display module weighs 43 lbs (19.5kgs) When carrying the display module, hold it firmly from underneath. For safety reasons it is strongly recommended that at least two people should lift the display unit. One person on their own should not attempt to do so.
Monitor Installation and Patient Safety Controls and Connectors The V24 and V26 Connectors The monitor has several connectors which are shown below. DEFIB CONNECTOR RACK CONNECTOR AC LINE INPUT RS232 CONNECTOR (Rear Housing with Serial Prefix <3608) PROTECTIVE EARTH GROUND RS232 CONNECTOR (Rear Housing with Serial Prefix >=3608) EQUIPOTENTIAL GROUNDING marge3.
4. Philips monitoring network connector (SDN Interface); this is a proprietary Philips system connector, used to input/output information to a Philips monitoring network. Warning Connecting the Philips monitoring network (SDN) cable when the product is powered on is not supported. Error codes and Philips monitoring network (SDN) interface lock-up may occur. Power cycling the product will recover the product. No permanent damage will result.
Monitor Installation and Patient Safety Controls and Connectors Assembling the V24 and V26 The monitors consist of two individual parts. 1. One of two types of Display Modules, depending on the particular model monitor you have— either: a. A monochrome display with control panel supporting the V24, or b. A color flat panel display with control panel supporting the V24C, V24CT, V26C and V26CT 2.
Accessories and Ordering Information M1276A Six Slot Satellite Rack M1041A Eight Slot Satellite Rack 8120-5236 Four Meter Satellite Rack Cable 78599AI-#J03 0.91 m (3 ft.) Local Distribution Cable 78599AI-#J06 1.8 m (6 ft.) Local Distribution Cable 78599AI-#J10 3.0 m (10 ft.) Local Distribution Cable 78599AI-#J20 6.1 m (20 ft.
Monitor Installation and Patient Safety Accessories and Ordering Information 11-38 Monitor Installation and Patient Safety
12 Battery Information (V24CT and V26CT only) The V24CT and V26CT can be operated on AC line or DC battery power. This chapter provides information on battery power. It includes the following sections: • • • • • AC and DC (Battery) Operation . . . . . . . . . . . . . . . . . . . . 12-2 Battery Indicator and Messages . . . . . . . . . . . . . . . . . . . . 12-6 External Battery Charger . . . . . . . . . . . . . . . . . . . . . . . . . . 12-8 Battery Care and Maintenance . . . . . . . . . . . . . . . . . . .
AC and DC (Battery) Operation AC and DC (Battery) Operation Battery Information (V24CT and V26CT You should only use Philips 40488A 12 Volt sealed lead-acid batteries obtained from Philips Medical Systems for use with the Philips M1205A V24CT. Use of other camcorder-type batteries could result in inaccurate estimates of battery capacity remaining or in shorter battery life.
AC and DC (Battery) Operation The following is a list of AC and battery operating instructions. • The batteries continuously charge when the instrument is connected to AC power. Charging occurs whether the monitor is turned Off or On. Caution Philips Medical Systems recommends you fully charge the batteries before using the V24CT for the first time. Plug the monitor into AC power (line power) for an initial charging cycle. • AC power is indicated by the AC Power green LED indicator.
AC and DC (Battery) Operation Note—When AC is connected and the monitor is on, the Battery Charge Battery Information (V24CT and V26CT LEDs may take some time to cycle to the appropriate charge indication. The V24CT or V26CT may under report battery capacity during this setting period. Use the fuel gauge rather than the Battery Charge LEDs during this period to estimate battery capacity or turn the monitor off to accelerate the charge setting time.
AC and DC (Battery) Operation • The lead-acid batteries need not be fully discharged prior to charging. Unlike Ni-Cad batteries, lead-acid battery capacity is not affected by depth of discharge. Battery Charging LED will flash continuously. The Battery Charged LED will not light even when the one battery is fully charged. This is to remind you that both batteries are not fully charged. The one battery will provide enough power to run the monitor.
Battery Indicator and Messages Battery Information (V24CT and V26CT Battery Indicator and Messages • The battery fuel gauge, located on the lower right of the display, indicates the remaining capacity of the batteries in a bar graph form. As power discharges from the batteries, the number of segments within the battery fuel gauge will decrease.
Battery Indicator and Messages • A low battery alarm INOP tone will sound and the flashing message “RECHARGE BATTERIES” will replace the battery gauge. Remaining monitoring time on the batteries is typically 15 minutes with new batteries at room temperature, 25°C. • The Silence/Reset • When new batteries are inserted or the monitor is plugged into AC line power, the low battery condition will be cleared. • Alarm tones for patient alarms will have higher priority than the low battery INOP tone.
External Battery Charger External Battery Charger Battery Information (V24CT and V26CT We suggest that you use the Philips M1278A external battery charger to charge the M1205A batteries. This battery charger can charge up to 4 sealed lead-acid batteries at one time in two-and-a-half hours. LED indicators will indicate the status of each battery during a charging cycle. Note—Use of other battery chargers may result in shorter battery life and is not recommended.
Battery Care and Maintenance The Philips 40488A sealed lead-acid batteries used in the V24CT provide optimum performance and battery life when properly cared for. Proper handling of batteries is essential to the life of the battery and safety of the user. Storage • Store batteries in a cool dry area. A refrigerator is an excellent place to store batteries. Allow batteries to return to room temperature before charging or use. • The charge in the batteries gradually deteriorates even during storage.
Battery Care and Maintenance Battery Information (V24CT and V26CT Care and Handling • Do not disassemble the battery. Strong acid electrolyte may burn your skin or clothes. • Check the batteries for any sign of irregularities in appearance. Replace the battery if any damage, such as a crack, or electrolyte leakage is found on the case or cover. • Do not short the battery by directly connecting the positive and negative terminals.
Accessories and Ordering Information 40488A 12 Volt Lead-Acid Batteries M1278A Battery Charger Battery Information (V24CT and V26CT only) 12-11 Battery Information (V24CT and V26CT Accessories and Ordering Information
Battery Information (V24CT and V26CT Accessories and Ordering Information 12-12 Battery Information (V24CT and V26CT only)
13 Maintenance This chapter details the cleaning and maintenance procedures for the monitor. It includes the following sections: • • • General cleaning of the System . . . . . . . . . . . . . . . . . . . . . 13-2 Monitor Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-6 Performance Assurance Checks . . . . . . . . . . . . . . . . . . .
General cleaning of the System General cleaning of the System The patient monitor should be kept free of dust and dirt. Exterior cleaning of the case and screen is recommended. Clean it with a lint-free cloth, moistened with either warm water (40°C/104°F.
General cleaning of the System 7. Do not allow cleaning agent to remain on any of the equipment surfaces - wipe it off immediately with a cloth dampened with water. Caution Maintenance If you want to clean a touch enabled display such as the M1097A #A02 Flatscreen Display, the touch operation has to be disabled during the cleaning procedure. If you use a mouse and want to clean it, mouse operation has to be disabled during the cleaning procedure.
General Disinfecting of the System General Disinfecting of the System We recommend that you disinfect the product only when necessary as determined by your hospital’s policy, to avoid long term damage to the product. We also recommend that the products being disinfected be cleaned first, as described under “General cleaning of the System” on page 13-2. Use the recommended disinfecting substances listed below:.
General Disinfecting of the System 5. Do not pour liquid onto the system during cleaning. 6. Never use abrasive material (such as steel wool or silver polish). 7. Do not allow any disinfecting agent to remain on any of the equipment surfaces – wipe it off immediately with a cloth dampened with water. Caution Warning Philips makes no claims regarding the efficacy of the listed chemicals or methods as a means of controlling infection.
Monitor Maintenance Monitor Maintenance The following is a list of the tasks and procedures to maintain the monitor. • • • • Performance Assurance Test Functional Testing procedures Preventative Maintenance Check Accuracy and Calibration of NBP and Temperature The recommended maintenance schedule is shown in the following table. Maintenance Recommended Maintenance Schedule Procedure Frequency Source of Information Testing of all cables and cords. Daily. See the following pages of this chapter.
Procedure Frequency Source of Information Preventative Maintenance Replace backlight tube assembly Cleaning procedures 2.5 years of continuous use or as needed Perform the Preventive Maintenance Procedure for the M1180A #A01/A02 Wall Mount Assembly every year. See “Testing and Maintaining the CMS” in the “CMS Service Guide” or “Testing and Maintaining the V24 and V26“in the “V24 and V26 Service Guide”. Full performance checks including safety checks.
Monitor Maintenance Inspect the System Inspect the Exterior of the Monitor The following lists what to look for when inspecting the system: 1. Examine the exterior of the unit for cleanliness and general physical condition. Ensure that plastic housings are intact, that all hardware is present and tight, and that there are no spilled liquids or other serious abuse. 2.
Monitor Maintenance Perform a Start-up Sequence Test of the System The System automatically starts every time the system is switched ON. Verify the Integrity of the Display Note the position of the contrast control on the V24 (or the brightness control on the V24C/V24CT/V26C/V26CT) before starting tests so that they are returned to their previous positions (assuming they are correct) at the end of the testing procedure.
Monitor Maintenance Perform a System SelfTest The following lists how to perform the system self-test. 1. Examine all controls for physical condition. During the course of this examination, ensure that the controls perform their proper function 2. Check that the parameter module LED's light up when first plugged in. 3. Confirm that the display lights up and displays a Main Screen. 4. Press the ECG key on the front of the ECG module in a system that is turned On.
Performance Assurance Checks Performance Assurance Checks The following performance assurance checks are designed to be completed to verify proper operation when: • • • The monitor has been installed An assembly has been repaired To verify the operation any time the unit is suspect. The performance assurance checks fall into two parts: 1. Verification of overall operation by completing the Performance Assurance Test You can perform any of the checks in any order you choose.
Performance Assurance Checks 4. If you are using the V24CT or V26CT, make sure the battery Charging and Charged LEDs are behaving consistent with the battery charged.
Performance Assurance Checks Functional Testing Procedures The system has a module self-test which generates and displays test waveforms and corresponding numerics for all the modules that are connected and turned on. The test signals are displayed for about 30 seconds and then the display returns to monitoring mode. The test signal will be displayed only if the system self-test was successful and the parameter is plugged into the system and turned on.
Performance Assurance Checks Procedure Overview 1. Choose a patient category (Adult/Pedi/Neo) by pressing: Monitor Setup Config Sets Pts Refernce Change Pat Categ Pts Refernce 2. Display 30 seconds of the waveforms and numerics of all connected modules by pressing: Monitor Setup Test Signals Pts Refernce Signals 3. Repeat Step 2 as necessary to check the individual test waveforms and numerics for the category. 4. Use Step 1 to choose a new patient category and repeat Steps 2 and 3.
Performance Assurance Checks Module Test Numeric Test Waveform Cardiac Output 5 l/min (+0.1 l/min) (Blood Temp: 37°C) (Inj Temp: 0°C) No wave tcpO2/tcpCO2 No wave tcpO2 60 mmHg (8.0 kPa) tcpCO2 40 mmHg (5.3 kPa) CO2 ETCO2 40 mmHg (6.0 kPa) IMCO2 0 mmHg (0.
Performance Assurance Checks Performing the Invasive Pressure Module SelfTest Auto Check - The check for these modules is started every time the system is switched ON and checks the complete module circuitry, including the sensitivity detection circuit. Self-Test - The test signals lasts about 30 seconds and then the display returns to the normal monitoring mode.
Performance Assurance Checks Performing the NBP Module SelfTest Auto Check - The NBP module performs a check periodically during operation. Performing the SpO2/ Pleth Module SelfTest Auto Check - None Self-Test - None Self-Test - The SpO2/Pleth module self-test may be performed at any time. The integral waveform generator in the module produces test signals using the current driver at the beginning of the processing circuitry.
Performance Assurance Checks Performing the tcpO2/ tcpCO2 Module SelfTest Auto Check - The check is performed automatically when the system is switched on, during calibration and continuously when no transducer is connected. When the auto check fails, the INOP message “Equipment Malfunction'' is given (refer to the Troubleshooting Chapter in the service manual for troubleshooting details). Self-Test - The tcpO2/tcpCO2 module self-test may be performed at any time.
Performance Assurance Checks Performing the CO2 Module SelfTest Auto Check - None Self-Test - The self-test may be performed at any time. The test signals last about 30 seconds, and then the display returns to the normal monitoring mode. TEST - If a transducer is connected to the module, the following conditions must be met: • • The motor in the transducer is running. No heater malfunction is reported.
Performance Assurance Checks Performing the Blood Analysis Module SelfTest Auto Check - The Blood Analysis Module performs a check when the system is switched on Self-Test - The Self-Test with the External Simulator M3634A may be performed at any time. TEST - Insert the External Simulator into the cartridge slot of the module. Maintenance RESULT - Either PASS or FAIL will be displayed on the Monitor to indicate whether the module has passed the self-test or not.
Performance Assurance Checks There are no Self-Tests for the M1032A Vuelink Module and the M1026A Anesthetic Gas Module. The M1032A Vuelink Module performs automatic checks periodically during operation. The M1026A Anesthetic Gas Module performs a 2-minute check automatically when the system is switched on.
Maintenance Performance Assurance Checks 13-22 Maintenance
Index of Volume 1 A B AC, 1-14 operating instructions, 12-3 accessories tcpO2/tcpCO2, 6-48 Adjusting, 2-7 contrast, 2-7 volume control, 3-35 Admit, 7-2 general information, 7-1 Alarm functions, 5-3 alarm limits, review of|, 5-13 alarm reminder, 5-4 alarm symbol, 5-2 Alarms Selection Window, 5-12 audible alarms, 5-8 INOP priorities, 5-8 latching alarms, 5-4 non-latching alarms, 5-4 parameter alarms, 5-10 resetting alarms, 5-4 SilenceReset key, 5-4 summary of alarm behavior, 5-7 suspending alarm, 5-3 visual
Monitor Setup Selection Window, 3-2 numeric display on/off, 3-17 numeric positioning, 3-18 operating modes, 3-55 other patients controls, 3-41 parameter settings transfer, 3-61 parameters on/of, 3-33 recordings, 3-40 screen display, 3-3 screen display selection, 3-5 screen display wave overlap, 3-14 screen display waveform speeds, 3-15 screen display waveforms, 3-8 status log function, 3-42 test signals function, 3-58 the display, 3-6 volume control, 3-35 what you can configure, 3-2 Continuous Pressure, 3-4
L Loading paper four channel bedside recorder (M1117A), 653 plug-in recorder (M1116A), 6-50 plug-in recorder (M1116A/B), 6-49 M Main Screen, 1-21 Monitor rear panel, 11-34 rear panel connectors, 11-35 Monitor Standby with Data Transfer, 10-6 monitoring network, 4-3 N network arrhythmia alarms, 4-10 automatic alarm Other Patients, 4-4 multiple incoming alarms, 4-5 O Operating levels, 1-20 getting into, 1-25 highlighting, moving, 1-26 Main Screen, 1-21 selection, 1-25 selection window, 1-23 task window, 1-
inserting a calibration signal, 6-44 loading paper, 6-49 making calibrated ECG recordings, 6-23 making delayed recordings, 6-11 making non-preset recordings, 6-22 making procedure recordings, 6-17 making realtime configured recordings, 6-22 messages, 6-46 queueing recordings, 6-23 recording strip layouts, 6-44 using a Patient Information Center, 6-23 Recording Types Alarm, 6-12 Delayed, 6-8 oxyCRG, 6-36 Procedure, 6-16 realtime, 6-20 ST segment, 6-18 Vital Signs, 6-39 Reports events, 8-16 general informatio
