Tempus Pro User/Operator Manual Part number 41-2001EN-00 Date of issue: 2019-07-03
This document contains legally protected information. All rights reserved. Copying in mechanical, electronic and any other form without the written approval of the manufacturer is prohibited. Copyright © 2013-2019 Remote Diagnostic Technologies Ltd. Manufacturer’s address RDT contact details The Tempus Pro is designed and manufactured by: Remote Diagnostic Technologies Limited Pavilion C2 Ashwood Park Ashwood Way Basingstoke Hampshire RG23 8BG UK Tel: +44 (0) 1256 362 400 Fax: +44 (0) 1256 362 415 www.
Table of Contents 1 Introduction 1.1 1.2 1.3 1.4 1.5 1.6 1.7 CE statement FDA prescription statement Proprietary notice Use of this manual Intended users Features list Patent and warranty 10 10 10 11 11 11 12 Patent claims Limited warranty Service support and returns 12 12 12 1.7.1 1.7.2 1.7.3 2 Warnings and cautions 2.1 2.2 2.3 13 Safety and note icons EMC information Indications for use 2.3.1 2.
Table of Contents 4 Setting up 4.1 4.2 4.3 Before deployment Unpacking the Tempus Pro Starting and stopping the Tempus Pro and selecting a patient 4.3.1 4.3.2 4.3.3 4.3.4 4.3.5 5 Switching on Tactical mode (optional) Setting the patient Starting and stopping iAssist Switching off Using the Tempus Pro 5.1 Controlling the Tempus Pro 5.1.1 5.1.2 5.1.3 5.1.4 5.1.5 5.2 The touchscreen Membrane buttons and LED indicators Status bar Status bar for communications Instrument readings Menus 5.2.1 5.2.
Table of Contents 6.6 6.6.1 6.6.2 6.6.3 6.6.4 6.6.5 6.6.6 7 7.2.1 7.2.2 7.2.3 7.2.4 7.3 7.4 7.5 7.5.1 7.5.2 7.6 7.7 7.8 7.9 8.1.1 8.1.2 8.1.3 8.1.4 8.2 8.2.1 8.2.2 8.2.3 8.3 8.3.1 8.3.
Table of Contents 9.3.3 9.3.4 9.3.5 9.4 Admitting a new patient Switching to a previous patient Entering patient details Digital camera 9.4.1 9.5 9.6 Annotation of digital pictures GPS location Connecting to an alternate location 9.6.1 9.6.2 9.6.3 9.6.4 9.6.5 9.6.6 9.
Table of Contents 12.1.1 12.1.2 12.1.3 12.1.4 12.1.5 12.1.6 12.1.7 12.1.8 12.1.9 12.1.10 12.1.11 12.1.12 12.1.13 12.1.14 12.1.
Table of Contents 15 Symbols used on the Tempus Pro 15.1 Symbols used 16 End user license agreement 16.1 Tempus Pro EULA 16.2 Mocana EULA 16.3 MPEG4 EULA 16.4 Masimo® EULA 16.5 Firebird – Interbase Public License 16.6 Info-Zip License 16.7 OpenSSL License 16.
1 Introduction This manual is for the Tempus Pro patient monitor. All Tempus Pro monitors have a standard configuration that provides ECG monitoring, NIBP, pulse oximetry (SpO2) and impedance respiration. Additional functions are available depending on Tempus Pro part number: 00-1004-R: standard configuration with invasive pressure (2 channels), ETCO2 and contact temperature (1 or 2 channels).
Chapter 1 Introduction 1.1 CE statement Marking by the above symbol indicates compliance of this device to the Medical Devices Directive (MDD) 93/42/EEC (as amended) and the Radio Equipment Directive (RED) 2014/53/EU (as amended). The CE mark is accompanied by the number 0413 which is the reference number for the Notified Body who certify RDT’s quality system.
1.6 Features list 1.4 Use of this manual The instructions and safety precautions provided in this manual must be observed during all phases of the operation, usage, service or repair of the Tempus or its accessories. Failure to comply with the information contained in this manual e.g. warnings, precautions, instructions etc. will violate the safety standards of design, manufacture and intended use of the products. Remote Diagnostic Technologies Ltd.
Chapter 1 Introduction 1.7 Patent and warranty 1.7.1 Patent claims RDT has applied for patents covering the Tempus Pro and its communications technology in the following jurisdictions: Patents Pending (US No.2006/0287586 EP 1734458 A & other areas). The capnography component of this product is covered by one or more of the following US patents: 6,428,483; 6,997,880; 6,437,316; 7,488,229; 7,726,954 and their foreign equivalents. Additional patent applications pending.
2 Warnings and cautions 2.1 Safety and note icons This manual uses the following icons are used to indicate safety, caution and warning messages (per ISO 3864-2): DANGER Indicates an imminently hazardous situation which, if not avoided, will result in death or serious injury. WARNING Indicates a potentially hazardous situation which, if not avoided, could result in death or serious injury.
Chapter 2 Warnings and cautions WARNING Operating high frequency electrosurgical equipment in the vicinity of the monitor can produce interference in the monitor and cause incorrect measurements. WARNING Do not use the monitor with nuclear spin tomography (MRT, NMR, NMT) as the function of the monitor may be disturbed. WARNING This system is intended for use by healthcare professionals only. This system may cause radio interference or may disrupt the operation of nearby equipment.
2.4 General warnings, cautions and notes 2.4 General warnings, cautions and notes DANGER ELECTRICAL SHOCK HAZARD when covers are removed. Do not remove covers. Refer servicing to qualified personnel authorised by RDT. DANGER Explosion Hazard: DO NOT use the Tempus Pro in the presence of flammable gasses such as fuels. Use of the Tempus Pro in such environment may present an explosion hazard.
Chapter 2 Warnings and cautions WARNING WARNING WARNING Portable and mobile Radio Frequency (RF) communication equipment may interfere with the operation of the device. Computers, cables and accessories not tested to IEC/EN60601-1-2 or equivalent IEC standards may result in increased emissions or decreased immunity of the device. Follow precautions for electrostatic discharge (ESD) and electromagnetic interference (EMI) to and from other equipment.
2.4 General warnings, cautions and notes WARNING Do not use the Tempus in a Magnetic Resonance Imaging (MRI) suite or a hyperbaric chamber. WARNING Do not place the monitor or its accessories in locations where they could fall onto the patient. When moving the product take care that any connected leads and sensors are not jerked so that they become detached or damaged.
Chapter 2 Warnings and cautions WARNING WARNING WARNING WARNING WARNING WARNING Ensure patient cabling or tubing is carefully routed on device to reduce the possibility of patient entanglement or strangulation. All numerical, graphical and interpretive data should be evaluated with respect to the patient's clinical and historical picture. Do not attempt to insert any connections from the Tempus Pro (including patient cables) directly into an electrical outlet. (IEC60601-2-34:2011, 2011).
2.4 General warnings, cautions and notes WARNING Do not disassemble the device. The device must only be serviced by trained and authorised biomedical engineers following RDT approved procedures and using parts provided by RDT. Any other changes or processes are unauthorised and should not be performed. No other modifications are allowed. Unauthorised processes, repairs, modifications, reworks or service not expressly approved by RDT could void any guarantees and warrantee and could be hazardous.
Chapter 2 Warnings and cautions CAUTION Dispose of batteries in accordance with applicable regulations which vary from country to country. In most countries, the disposal of used batteries is forbidden in general domestic and commercial waste and the end-users are invited to dispose of them properly, typically through not-for-profit profit organisations, mandated by local governments or organised on a voluntary basis by professionals.
2.4 General warnings, cautions and notes CAUTION The use of the RF communications equipment contained in the device and its accessories may cause interference with implanted pacemakers and other medically implanted equipment. A minimum distance of 2.3 m (7.5 ft) must be maintained between the device and its accessories (containing RF communications equipment) and other medical equipment (including implantable medical devices such as defibrillators and pacemakers).
Chapter 2 Warnings and cautions CAUTION When using the device with GAN terminals, in order to avoid the risk of interference from the output beam from the antenna of the terminal with the operation of the device, ALWAYS ensure that the device is situated at least 6m behind the face of the antenna. Since the power of the GAN terminal’s beam is high (25W approx.
2.4 General warnings, cautions and notes Note GSM usage is restricted by the network availability, roaming agreements and local provision of circuit mode connections. Note IP sealing is not guaranteed if the device is subject to rough handling, impact, improper use or rapid decompression. Note Device should be returned for service if it is subject to rough handling and IP sealing is needed to be relied upon. Note The device specifications are subject to change without notice.
Chapter 2 Warnings and cautions Tempus Pro User/Operator Manual - 41-2001EN-00 – Page 24
3 Introduction to the Tempus Pro The Tempus Pro is a multi-parameter vital signs monitor designed for use in pre-hospital and remote locations. It provides the user with conventional patient monitoring parameters for use in measuring and monitoring patient’s vital signs. The device also provides the user with the ability to capture patient incident data in electronic format.
Chapter 3 Introduction to the Tempus Pro 3.1 Overview of the Tempus Pro The Tempus Pro consists of a PC-ABS plastic enclosure which is over-moulded with TPU material to make it resistant to shock. The enclosure also includes the RapidPakTM clip which provides storage for the SpO2 sensor, the adult NIBP cuff and hose and the ECG cable. The unit has a clear window on the top which contains the alarm bar. This lights yellow or red for clinical alarms.
3.2 Key features of the unit 3.2.3 Tempus Pro rear Non-printer models If the Tempus Pro is not fitted with an internal printer (part number 00-1004-R or 00-1007-R): The rear houses the RapidPak clip (discussed above). Also on the rear is the aperture for the camera and backlight. The clip carries a general product label for regulatory purposes and also two labels which help guide the user to repack the SpO2 sensor and the ECG cable.
Chapter 3 Introduction to the Tempus Pro Printer models If the Tempus Pro is a printer model (part number 00-1022-R, 00-1024-R or 00-1026-R): The rear houses the internal thermal printer. Also on the rear are the camera, backlight and moveable foot. The RapidPak clip is absent. The ECG cables, SpO2 sensor and NIBP cuff are stored in the bag. (1) Rear alarm light (3) Printer (2) Camera and backlight The Rear of the Tempus Pro (printer model) 3.2.
3.2 Key features of the unit additional protection to prevent nuisance ingress of sand into the connectors in the event that a cable or sensor is not in place. ECG cable NIBP hose Pulse Oximetry (SpO2) patient cable Invasive Pressure door Capnometer door Contact Temperature doors Left side of the Tempus – medical connectors 3.2.5 Tempus Pro right side The right side of the Tempus houses the data communication and power connections. These comprise: Two USB 1.0 & 2.
Chapter 3 Introduction to the Tempus Pro WARNING Always use a Baaske MI 1005 isolation device when connecting from the Ethernet socket to any mains-powered communications device (e.g. router, access point, hub, communications terminal etc.). WARNING The Ethernet connection must only be connected to battery powered (non-mainspowered) communications devices such as laptop computers or satellite communications terminals such as BGAN or VSAT terminals.
3.3 Theory of operation Power socket Headset socket Tactical switch Ethernet RJ-45 socket Two USB A sockets for USB 1.0 & 2.0 communications Right Side of the Tempus – Communications Connectors 3.3 Theory of operation All of the measurements made by the Tempus Pro are displayed on the screen. Attaching a sensor to a patient will initiate measurements by that particular parameter. Monitoring will continue until the sensor is removed from the patient or the unit (and the consequent alarm is silenced).
Chapter 3 Introduction to the Tempus Pro Pulse rate and oxygen saturation are detected by a soft reusable finger probe packed on the rear of the device (disposable sensors may also be used). In particular it is also important that the sensor is not used on the same arm as the blood pressure cuff, because false readings may occur when the cuff is inflated. Readings will not be obtainable or may be inaccurate from patients with some colours of nail varnish or polish.
3.3 Theory of operation Moisture and patient secretions are extracted from the sample, while maintaining the shape of the CO2 waveform. The 50 ml/min. sampling flow rate reduces liquid and secretion accumulation, decreasing the risk of obstruction in the sample pathway in humid ICU environments. Once inside the Microstream® CO 2 sensor, the gas sample goes through a micro-sample cell (15 microliters).
Chapter 3 Introduction to the Tempus Pro 3.3.9 Summary Record of Care / Tactical Combat Casualty Care The Tempus contains an electronic patient record card known as a Summary Record of Care (SRoC). This is completed semi-automatically through the collection of vital signs and the use of the Event button. SRoC allows the user to record patient trauma details and to review historic events and trends. SRoC is automatically augmented with patient encounter data when: An arrhythmia alarm is triggered.
3.3 Theory of operation 3.3.15 Communications GPS The Tempus contains a Global Positioning Satellite (GPS) receiver. This can be used to detect signals from multiple geostationary satellites to obtain a location (expressed in terms of longitude and latitude). The GPS receiver needs a clear view of the sky to work and so must be used outside. Digital camera & waveform snapshot A miniature digital camera is mounted in the unit.
Chapter 3 Introduction to the Tempus Pro Bluetooth® communications The Tempus is fitted with a Bluetooth® radio. This enables it to communicate with other Bluetooth® enabled devices. The Tempus can be provided with an optional Bluetooth headset for providing voice communications. 3.3.16 On-screen user instructions The Tempus provides the user with a conventional vital signs monitoring user interface. It can also be set to provide additional on-screen instructions in the form of text and graphics.
4 Setting up 4.1 Before deployment Prior to deployment of Tempus Pro there are settings that user organisations need to configure. Carefully check all the relevant settings on each Tempus Pro before it is deployed. When deploying multiple units, you may set up a single unit and export the configuration from one unit to the others (cloning the settings). Three types of configuration are exporting and imported: events (summary record of care); new patient defaults; settings.
Chapter 4 Setting up 4.2 Unpacking the Tempus Pro The Tempus Pro is supplied from the factory in protective outer packaging. No special precautions are required when unpacking the Tempus Pro. RDT recommends that you keep the packaging. RDT recommends that the equipment is inspected and tested on receipt to confirm that the unit has not been damaged and that all expected items and accessories have been received and are in working order. New batteries should be charged up for at least 4 hours on receipt.
4.3 Starting and stopping the Tempus Pro and selecting a patient 4.3 Starting and stopping the Tempus Pro and selecting a patient 4.3.1 Switching on WARNING CAUTION Ensure the latches on both sides of the battery are fully engaged prior to using the Tempus - an incorrectly fitted battery could result in the Tempus losing power during use. Do not press any of the controls until the Tempus has started. To switch on the Tempus Pro, press and hold the button on the front panel for 1 second.
Chapter 4 Setting up Tempus Pro Tactical Switch When the switch is set closest to the symbol the Tempus will start in the following configuration: All alarm LEDs off; All audible signals off; Wireless functions (if enabled by configuration) off; Display set to mid brightness and standard contrast mode.
4.3 Starting and stopping the Tempus Pro and selecting a patient Note Toggling the Tactical Switch will immediately return the display settings to their previous configuration i.e. display brightness, all LEDs active, alarms set to the default level and high contrast off. Note The Tactical Switch disables the ac power and charging LEDs; these are only re-enabled using this switch. Note The battery charge LEDs are not disabled using the Tactical Switch. 4.3.
Chapter 4 Setting up To switch it on or off: 1. Press the Main Menu button . 2. Slide the iAssist switch to On or Off. When switched on, iAssist buttons appear at the bottom of the home screen. 4.3.5 Switching off Before switching the Tempus Pro off, you should make sure that it is not in use. To power off quickly with no countdown or confirmation: 1. Ensure the Tempus Pro is not in use. 2. Press and hold the button for 2 seconds. To power off with countdown and confirmation: 1.
5 Using the Tempus Pro The Tempus can be used laying on its back or standing on its foot. 5.1 Controlling the Tempus Pro Touchscreen Membrane buttons Tempus Controls The Tempus can be controlled through two different control interfaces. These are: The touchscreen; The graphically labelled membrane buttons. 5.1.1 The touchscreen Note Take care to press the touchscreen once for any control. Users should press the controls firmly with a finger (gloved or bare skin can be used).
Chapter 5 Using the Tempus Pro When the device is started it will present as follows: Vital signs readings are displayed in these areas alongside alarm limits (if applicable) 4 parameter channels are provided.
5.1 Controlling the Tempus Pro 5.1.2 Membrane buttons and LED indicators The Tempus can be controlled through the following membrane buttons: The On/Off button – pressing and holding down this starts and stops the Tempus – see “4.3.1 Switching on”. The Alarm Suspend button – pressing this latches all alarms off for 2 minutes (factory default – this is configurable by the operating institution) – see “7.6 Silencing or suspending alarms”.
Chapter 5 Using the Tempus Pro The Camera & Waveform Snapshot button – pressing and releasing this starts the waveform capture, pressing and holding will start the camera – see “8 Summary Record of Care”. Note that certain events will cause the Tempus to capture a waveform automatically – see “8.1.4 Automatic event capture”. Note for devices with software revisions earlier than v4 this button will only perform the camera function. Please contact RDT for software updates.
5.1 Controlling the Tempus Pro Battery status indicator The battery status indicator in the status bar shows the percentage of battery charge remaining: Icon Status Indication/Action Battery charge remaining: 51% - 100%. Green, no flash Tempus Pro battery is not currently charging. Battery charge remaining: 51% - 100%. Green with flash Tempus connected to mains power (charging in progress). Battery charge remaining: 26-50%. Orange, no flash Tempus Pro battery is not currently charging.
Chapter 5 Using the Tempus Pro 5.1.4 Status bar for communications The centre section of the status bar shows if any communications features are being used. If any Bluetooth® devices are in use, then the Bluetooth® symbol will be shown and along with the number of peripherals that are connected to the device. Note It does not identify the specific peripheral connected to the Tempus Pro. If a WiFi connection is in use, then this will be shown.
5.1 Controlling the Tempus Pro Response Centre (i2i) communication If a data connection is in progress this will be shown. The green icon will flash when the connection is in being established and the text will read “Data connecting”. When a link to the data centre (gateway) has been made the icon will stop flashing and the text will read “Data connected”.
Chapter 5 Using the Tempus Pro 5.2 Menus 5.2.1 The main menu If ever you are unsure of what to do, press one of the following membrane buttons: The Main Menu button - this will take you to a full menu to access all features of the product. The Home button - this returns the unit to the results screen.
5.2 Menus The Main Menu allows access to the following features and controls: Menu option Menu screen TDL Settings – for use with the Tempus ALS system. Quick Start Guide – pressing each numbered button will take you through a series of graphics which explain the features of the device. Medical Parameter Settings – open a menu from which all medical parameter settings can be accessed, see “6 Taking medical readings”.
Chapter 5 Using the Tempus Pro Menu option Communication Modes – configure the modes, see “9.6.4 Communications modes”. Wireless Enabled – disable or enable all wireless communications. If any of these features are not enabled (either not purchased or disabled in the device’s maintenance settings) then they will be greyed out. Connect – performs the same function as the membrane button, see “9.6 Connecting to an alternate location”.
5.2 Menus 5.2.2 Printer and Headset menu The current unit configuration can be viewed by accessing the Configuration screen from the Printer and Headset menu – see “5.2.1 The main menu”. The Printer and Headset menu allows access to settings and controls that the user may occasionally need to access. Note that the primary communication settings are designed only to be controlled by maintenance staff so these settings are only available behind the maintenance menu function in the main menu.
Chapter 5 Using the Tempus Pro Tempus Pro User/Operator Manual - 41-2001EN-00 – Page 54
6 Taking medical readings Note When a medical module is first started the word “initialising” may appear for a few seconds in the results area associated to the medical parameter being started. 6.1 Electrocardiography (ECG) The Tempus Pro allows the user to either monitor the patient’s ECG or take a diagnostic recording of their ECG (this is an optional feature). This section will explain how to use both features. The device defaults to ECG monitoring with either a 3-lead, a 4-lead or a 5-lead cable.
Chapter 6 Taking medical readings Do not touch the patient, bed, or any conductive material in contact with the patient during defibrillation. WARNING The Tempus Pro is protected against defibrillator discharge but rate meters and displays may be temporarily affected during defibrillator discharge but will rapidly recover. WARNING The Tempus Pro may not operate effectively on patients who are experiencing convulsions or tremors, or who are moving or are in motion (transport) environments.
6.1 Electrocardiography (ECG) CAUTION If the patient is attached to a cardiac defibrillator, care must be taken not to touch any part of the ECG cables while the patient is being shocked. Note The leads and cables of the ECG should be checked for fraying, tears, knots or other signs of damage before and after use. Note Ensure that all labelling including instructions for use, printed warnings and use-by dates associated with third-party ECG electrodes are adhered to. 6.1.1 Getting started 1.
Chapter 6 Taking medical readings 6.1.2 Monitoring ECG with a 3-lead cable By default, the Tempus Pro will be set to ECG monitoring when it is supplied. ECG monitoring with a 3-lead cable allows the user to monitor Leads I, II or III of the patient’s ECG. ECG monitoring requires the use of a 3-lead/electrode cable – see “12 Accessories list of the Tempus Pro”. The 3-lead cable may be pre-attached to the Tempus in the green connector. The Tempus Pro will automatically detect which cable type is in use.
6.1 Electrocardiography (ECG) 6.1.3 Monitoring ECG with a 4-lead cable ECG monitoring with a 4-lead cable allows the user to monitor Leads I, II, III, AvL, AvR and AvF. Up to two leads can be displayed at any time. Four wire ECG monitoring requires the use of a 4-lead/electrode cable – see “12 Accessories list of the Tempus Pro”. The 4-lead cable should be pre-attached to the Tempus in the green connector.
Chapter 6 Taking medical readings 6.1.4 Monitoring ECG with a 5-lead cable ECG monitoring with a 5-lead cable allows the user to monitor Leads I, II, III, AvL, AvR, AvF or a userplaceable V Lead. Up to two leads can be displayed at any time. Five wire ECG monitoring requires the use of a 5-lead/electrode cable – see “12 Accessories list of the Tempus Pro”. The 5-lead cable should be pre-attached to the Tempus in the green connector.
6.1 Electrocardiography (ECG) The picture below shows the Tempus monitoring Lead II and Lead I (using a 5-lead cable). Each ECG trace is labelled in the top left. The heart rate is shown on the right hand side for the uppermost trace. Tempus monitoring Lead II and Lead I (using a 5-lead cable) Selected 6.1.5 Monitoring ECG with a 12-lead cable Diagnostic 12 lead ECG is an option on the Tempus Pro.
Chapter 6 Taking medical readings These are labelled: Position AAMI Label/Colour IEC Label/Colour Right mid-clavicular line under clavicle / right wrist RA White R Red Left mid-clavicular line under clavicle / left wrist LA Black L Yellow Left hip / left ankle LL Red F Green Right hip / right ankle RL Green N Black V1 - 4th intercostal space at right sternal margin. V1 Red C1 Red V2 - 4th intercostal space at left sternal margin. V2 Yellow C2 Yellow V3 - Midway between V2 and V4 leads.
6.1 Electrocardiography (ECG) In 12 Lead mode, the other vital signs data remain displayed across the bottom of the display. All 12 ECG Leads are shown in the main display (each Lead is labelled).
Chapter 6 Taking medical readings The ECG recording can be scrolled through using these buttons 12 Lead ECG Recording Screen If an internal printer is fitted to the Tempus, you can print the 10 second recording using the Print button. For printer instructions see “9.9.2 Internal printer configuration (optional)”. If the Tempus Pro is fitted with an internal printer and automatic printing is enabled, it will print waveforms as soon as they are captured.
6.1 Electrocardiography (ECG) “Ischemic ST-T changes in lateral leads” (please see QRS Diagnostic Physician's Guide ECG Analysis for Resting 12-lead ECG for further information, Part number 630000-00). Waveform summary measurements – this includes; QT and QTc interval measurements, PR interval, QRS duration, P duration, P axis, QRS axis and T axis. Once a 12 lead ECG has been recorded you can view the ECG interpretation.
Chapter 6 Taking medical readings Press here to go to the ECG Interpretation page Press here to start monitoring the 12 lead ECG Press here to see the ECG recording ECG Summary Screen 6.1.7 ECG specifications ECG monitoring specifications The following disclosures are made in accordance with the requirements of AAMI EC13 and IEC60601-2-27: The ECG’s display includes the isoelectric segments of the QRS.
6.1 Electrocardiography (ECG) Per EC13, 4.1.4.1, heart rate is accurately indicated in the presence of effective pacemaker single pulses without overshoot, having width of up to 2 ms and amplitude up to 700 mV, and such pulses alone do not cause heart rate detection. In the case of ineffectively paced QRS, erratic readings may result for single pulses above 2 mV. Overshoot is specified according to EC13 4.1.4.1 Method B. Per EC13 4.2.9.
Chapter 6 Taking medical readings 6.1.8 ECG settings Pressing either of the ECG trace areas will bring up the ECG settings menu: Menu option Menu screen Heart rate limits (bpm) – open the the alarm limits editor (described below). Heart Rate Lead – (4-, 5- and 12-lead ECG only) change which lead the heart rate is taken from. Waveform / Lead selection - when using 4-, 5- or 12-lead ECG, press here to customise the selection of waveforms on the four waveform display, see “9.2.
6.1 Electrocardiography (ECG) Menu option Menu screen HR/PR beat volume – volume of the audible tone that the Tempus emits every time a heartbeat is detected. Use the up and down arrows to adjust the volume from zero (no tone) to 100%. The tone is based on the HR/PR source setting (see above): when set to ECG, QRS beats trigger a single tone at 1 kHz. When set to Pulse, pulse beats trigger pulse tones – see “6.3.6 Pulse oximeter settings”.
Chapter 6 Taking medical readings Note In order to reduce noise and artefact the Monitoring filter should be set to Monitor or Filtered diagnostic and the Mains filter should be switched on. When attached to a mains power supply noise may be observed on the ECG if these filters are switched off. Consequently, they should be left switched on when operating under mains power or mains power should be disconnected if the filters need to be switched off.
6.1 Electrocardiography (ECG) WARNING For patients with pacemakers, ensure pacemaker indication is turned on. WARNING Arrhythmia analysis is sourced from the ECG signal (including detection of extreme bradycardia, extreme tachycardia), this is independent of the heart rate display source selection (ECG or pulse). CAUTION Only start arrhythmia learning during periods of predominantly normal rhythm, and when the ECG signal is relatively noise-free.
Chapter 6 Taking medical readings Arrhythmia analysis is turned off, and either the low heart rate or high heart rate alarm limits are breached. Arrhythmia analysis is turned on, and either the low heart rate or high heart rate alarm limits are breached A high priority Extreme Brady or Extreme Tachy alarm is triggered when the heart rate continues past already breached alarm limits. A 20 second waveform snapshot is captured for all arrhythmia events that trigger an alarm – see “8.1 Event capture”.
6.1 Electrocardiography (ECG) The Tempus Pro presents the user ST elevation (+) and depression (-) measurements as well as QT duration measurements for the electrocardiogram (ECG) monitoring waveform and displays it in numeric format on the results screen. The Tempus makes ST and QT measurements on the 2 waveforms which are viewed on the home screen. These waveforms can be changed using the Lead Waveform selection option on the ECG menu.
Chapter 6 Taking medical readings 6.1.11 Monitoring respiration rate with ECG cable The Tempus Pro allows the user to monitor the patient’s respiration through the ECG cable by measuring the change in the patient’s impedance as their chest wall moves (impedance pneumography). This section will explain how to use this feature. The device defaults to impedance respiration being off.
6.1 Electrocardiography (ECG) CAUTION Users should note that in the case of supine patients, breathing may involve relatively greater movement of the abdomen (and consequently less expansion of the chest) during breathing. In this case chest impedance changes may not be significant to produce reliable readings. CAUTION If impedance respiration is being used, the ECG electrodes should be placed on the torso and not the limbs.
Chapter 6 Taking medical readings The pneumography (respiration) waveform is shown here The respiration rate is shown here Impedance respiration settings Pressing anywhere on the Respiration area brings up the Respiration Settings Menu. Note If capnography is in use, the waveform shown will be labelled “CAPNO” and will display the end tidal CO2. In this state pressing on the waveform will bring up the Capnometer Settings Menu.
6.1 Electrocardiography (ECG) 6.1.12 Monitoring heart/pulse rate with no leads If the ECG is not attached to the patient, then the heart rate will be taken from the pulse oximeter if this is attached to the patient. Otherwise no heart rate will be shown. Note If the ECG is not connected but the pulse oximeter is, the heart rate will be show in the same place, in green but the signal will be derived from the pulse oximeter. In this event the reading will be labelled as shown below.
Chapter 6 Taking medical readings 6.2 Non-invasive blood pressure (NIBP) WARNING This device should not be used when oscillometric pulses may be altered by other devices or techniques such as External Counter pulsation (ECP) or Intra-Aortic Balloon Pump Counter pulsation. WARNING DO NOT use the Blood pressure monitor for any purpose other than specified in this manual.
6.2 Non-invasive blood pressure (NIBP) WARNING Always set the Tempus Pro to the correct patient age to ensure the initial inflation pressure is set correctly. The Tempus uses the definitions of patient age provided in IEC80601-2-30 as follows: Neonate – Children 28 days old or less if born at term (based on 37-week gestation), otherwise up to 44 gestational weeks. Paediatric (Child) – Children of 29 days up to and including 12 years old. Adult – Individuals 13 years old or older.
Chapter 6 Taking medical readings this manual. Interpretation of blood pressure measurements should be made only by a physician or trained medical staff. CAUTION CAUTION Hoses of a certain material and/or durometer may cause the module to perform in an improper fashion. Only use hoses provided by RDT. Incorrectly sized cuffs may cause measurement inaccuracy or errors.
6.2 Non-invasive blood pressure (NIBP) 6.2.1 Getting started The Tempus is intended to be used to take non-invasive blood pressure readings from neonates, children, small adults, adults and large adults. Blood pressure measurements can be affected by the position, physiologic condition, or activity level of the patient, who should be seated, standing or lying down depending on the usage model for the device or procedure being performed on the patient.
Chapter 6 Taking medical readings Shows the Systolic, Mean and Diastolic results Shows the time the reading was taken Indicates that readings will be taken repetitively at the interval shown Press here to start and stop blood pressure readings.
6.2 Non-invasive blood pressure (NIBP) 6.2.3 NIBP settings Pressing anywhere on the non-invasive blood pressure area brings up the NIBP settings menu: Note The Tempus Pro Maintenance Manual describes how to set the Tempus to automatically clear the NIBP reading after 5 minutes if a new reading has not been taken. Menu option Menu screen Start – start or stop NIBP readings. Mode – select Manual, Auto or Rapid Cuff. Auto interval time (mins) – when in Auto mode, set the time between NIBP readings.
Chapter 6 Taking medical readings Initial inflation The user can adjust the initial NIBP inflation pressure. The default is set by the Tempus depending on patient age group – see “9.3.5 Entering patient details”. NIBP adjusts its inflation pressure dynamically between readings so this setting only applies to the first reading and when it is manually adjusted.
6.3 Pulse oximetry 6.3 Pulse oximetry WARNING Do not use this device in the presence of high EMI/RFI radiation. High EMI/RFI radiation may cause induced current to the SpO2 sensor resulting in patient injury. WARNING This device may give inaccurate readings in the presence of strong electromagnetic sources, such as electrosurgery equipment. WARNING This device may give inaccurate readings in the presence of computed tomography (CT) equipment.
Chapter 6 Taking medical readings WARNING Do not use the pulse oximeter for any other purpose than specified in this manual. It should NOT be used as an apnoea monitor. WARNING Pulse rate measurement is based on the optical detection of a peripheral flow pulse and therefore may not detect certain arrhythmias. The pulse oximeter should not be used as a replacement or substitute for ECG based arrhythmia analysis. WARNING A pulse oximeter should be considered an early warning device.
6.3 Pulse oximetry WARNING Motion artefact may lead to inaccurate SpMet, SpCO, SpHb, and SpOC measurements. WARNING Severe anaemia may cause erroneous SpO2 readings. WARNING Very low arterial Oxygen Saturation (SpO2) levels may cause inaccurate SpCO and SpMet measurements. WARNING With very low perfusion at the monitored site, the readings may read lower than core arterial oxygen saturation.
Chapter 6 Taking medical readings WARNING Before use, carefully read the sensor's Directions for Use. WARNING To avoid cross contamination only use Masimo single use sensors on the same patient. WARNING Unless otherwise specified, do not sterilize sensors or patient cables by irradiation, steam, autoclave or ethylene oxide. WARNING See the cleaning instructions in the directions for use for the Masimo re-useable sensors.
6.3 Pulse oximetry Note Any condition that restricts blood flow, such as use of a blood pressure cuff (other than the Tempus Pro cuff used in accordance with the instructions herein) may cause an inability to determine accurate pulse and SpO2 readings. Note SpO2 measurements may be adversely affected in the presence of high ambient light levels (e.g. strong sunlight). This may be more noticeable with disposable probes. If necessary, shield the sensor area (e.g. with a towel) or a Masimo® light shield.
Chapter 6 Taking medical readings Note Note Loss of pulse signal can occur in any of the following situation: The sensor is too tight. There is excessive illumination from light sources such as a surgical lamp, a bilirubin lamp, or sunlight. A blood pressure cuff is inflated on the same extremity as the one with a SPO2 sensor attached. The patient has hypotension, severe vasoconstriction, severe anaemia, or hypothermia. There is arterial occlusion proximal to the sensor.
6.3 Pulse oximetry The following warnings, cautions and notes are reproduced verbatim from Masimo document R-CSD-1117 (revision P): GENERAL WARNING The pulse co-oximeter is to be operated by, or under the supervision of, qualified personnel only. The manual, accessories, directions for use, all precautionary information, and specifications should be read before use. As with all medical equipment, carefully route patient cabling to reduce the possibility of patient entanglement or strangulation.
Chapter 6 Taking medical readings WARNING Inaccurate SpHb and SpOC readings may be caused by: o Improper sensor application o Intravascular dyes such as indocyanine green or methylene blue o Externally applied coloring and texture such as nail polish, acrylic nails, glitter, etc.
6.3 Pulse oximetry WARNING CAUTION Interfering Substances: Dyes or any substance containing dyes that change usual blood pigmentation may cause erroneous readings. The pulse co-oximeter should not be used as the sole basis for diagnosis or therapy decisions. It must be used in conjunction with clinical signs and symptoms. The pulse co-oximeter is not an apnoea monitor.
Chapter 6 Taking medical readings CAUTION Note Variation in haemoglobin measurements may be profound and may be affected by sampling technique as well as the patient's physiological conditions. Any results exhibiting inconsistency with the patient’s clinical status should be repeated and/or supplemented with additional test data. Blood samples should be analysed by laboratory devices prior to clinical decision making to completely understand the patient’s condition.
6.3 Pulse oximetry 6.3.1 Getting started To use the pulse oximeter, remove the soft finger probe from the back of the device. Attach it to a wellperfused finger of the patient taking care to ensure it is not the same arm which has a blood pressure cuff attached. The readings will begin a few seconds after the probe is attached to the patient.
Chapter 6 Taking medical readings administration (81% sensitivity). A PVI prior to volume expansion is predictive that a mechanically ventilated patient will not respond to fluid administration (100% specificity). PVI® is an option for Tempus Pro. The Pulse Oximetry Section with PVI The PVI value is shown here 6.3.3 Taking readings Note Depending on which of the features have been purchased, some of the features shown below may not be available on your Tempus Pro device. 1.
6.3 Pulse oximetry 6.3.4 Features The SpO2 reading is shown here The plethysmogram and signal strength are shown continuously Masimo Rainbow parameters are displayed here The SpCO index, Perfusion index and Pleth Variability Index of the site are shown here The Pulse Oximetry section of the home screen Depending on which features have been purchased for your Masimo Rainbow Pulse OX and which sensor you are using will depend on which of the following features the Tempus Pro can monitor.
Chapter 6 Taking medical readings CAUTION If the low perfusion indication is frequently displayed, find a better-perfused monitoring site. In the interim assess the patient and if indicated verify oxygenation status through other means. 6.3.5 Pulse oximetry probes The following pulse oximetry sensors may be used with the Tempus Pro: standard, SpCO or SpHb. Each sensor shows a different range of parameters. There is no single sensor that shows all parameters.
6.3 Pulse oximetry 6.3.6 Pulse oximeter settings Pressing anywhere in the plethysmogram area brings up the Pulse Oximeter Settings menu: The SpCO, SpMet, SpHb and SpOC limits are only activated when their Masimo licenses have been installed and the appropriate probes are plugged in. Note PI and PVI alarms are only available in Tempus Pro devices with part numbers ending in "-R". Menu option Menu screen SpO2, SpCO and SpMet limits (%) – set the upper and lower alarm limits for SpO2, SpCO and SpMet.
Chapter 6 Taking medical readings Menu option Menu screen PI limits (%) – set the upper and lower alarm limits for Perfusion Index. PVI limits (%) – set the upper and lower alarm limits for Pleth Variability Index. Pulse tones Pulse tones can be turned on from either the Pulse Oximeter Settings menu or the ECG Settings menu using the settings: HR/PR source = pulse HR/PR beat volume = 20% (or above) When pulse tones are turned on Tempus Pro emits a beep for each pulse beat detected.
6.3 Pulse oximetry Sensitivity mode The Pulse Oximeter is equipped with 3 different sensitivity modes. Each mode allows the clinician to change the sensitivity settings of the device to meet the increased demands of the patient’s physiological condition or enable it to work during periods of low perfusion and/or motion. They are as follows: Normal Sensitivity (Norm) – This is the recommended mode for patients that are experiencing some compromise in blood flow or perfusion.
Chapter 6 Taking medical readings 6.3.7 SpHb settings Pressing the SpHb settings button (if activated) brings up the SpHb settings page: Menu option Menu screen SpHb limits (g/dL) – set the upper and lower alarm limits for SpHb. SpHb mode – select Arterial or Venous. SpHb averaging – select Short, Medium or Long. Sensor life remaining – shows the remaining life of the pulse ox sensor. Sensor life remaining ‘Sensor life remaining’ shows the life of the sensor.
6.4 Capnography 6.4 Capnography The capnography component of the Tempus unit is covered by one or more of the following US patents: 6,428,483; 6,997,880; 6,437,316; 7,488,229, 7,726,954; and their foreign equivalents. Additional patent applications pending.
Chapter 6 Taking medical readings WARNING If too much moisture enters the sampling line (i.e., from ambient humidity or breathing of unusually humid air), the message Clearing FilterLine will appear in the message area. If the sampling line cannot be cleared, the message FilterLine Blockage will appear in the message area. Replace the sampling line once the FilterLine Blockage message appears.
6.4 Capnography Note The following conditions can potentially cause a change in the flow rate: Water, mucous or other patient contaminate has entered the sample tubing. The sample tubing is crimped or pinched so that the sample flow rate has decreased. Damage to the sample line. The sample line has been cut, or split, causing the flow rate to increase. Note The Capnometer will require warming up if it is started from cold. The warm up time is specified in section 14.1.4.
Chapter 6 Taking medical readings CAUTION Allowing dust, fluids or foreign objects to enter the Capnometer can cause permanent damage to the device. With the door open, attach a suitable patient airway adaptor (cannula) to the Capnometer socket of the Capnometer. An adult nasal cannula is typically supplied but a range of cannulas and other adaptors are available. Twist the cannula clockwise to insert and counter clockwise to remove.
6.4 Capnography The Respiration rate reading is shown here The capnogram is shown continuously The Capnography Section of the Home Screen The ETCO2 reading is shown here Once the Capnometer is active it will run until the cannula is unplugged from the Tempus. Note that the wave speed of the capnogram is slower that the ECG and Pleth by default. Once the Capnometer is started it will display the message “Warming up” for approximately 30 seconds.
Chapter 6 Taking medical readings Menu option Menu screen Operating mode – to switch off the pump (for suction or lavage), select Pause 5 mins or Pause 10 mins. Note The ETCO2 units can be presented on the home screen in either mmHg or kPa but measurements in the Trends table and at i2i are only available in mmHg.
6.5 Contact temperature 6.5 Contact temperature WARNING The thermometer is only intended for use with YSI series 400 sensors. Disposable and reusable 400 series sensors may be used. Do not use series 700 sensors with the Tempus. WARNING Application and use of metal-jacketed temperature sensors that come into contact with conductive objects or clinical personnel during electrocautery may cause burns at the patient-probe/electrode contact points.
Chapter 6 Taking medical readings 6.5.3 Contact temperature settings Pressing anywhere on the contact temperature area brings up the contact temperature settings menu. Note The thermometer performs a self-check to 38.8 C ±0.1 C constantly to ensure that its readings are accurate and within specification.
6.5 Contact temperature The two-channel Temperature Settings screen looks like this: Menu option Menu screen Temperature units – set the measurement units to C or F. T1 limits and T2 limits – set the lower and upper temperature alarm limits for each channel. Delta limits – set the delta temperature alarm limits, based on the difference between T1 and T2.
Chapter 6 Taking medical readings 6.6 Invasive pressure WARNING DO NOT use the Invasive Pressure monitor for any purpose other than specified in this manual. WARNING If electrocautery is used, always avoid using any transducer with a conductive (metal) case connected to its ground shield. Using a conductive transducer that is connected to its cable shield risks high-frequency burns at the ECG electrodes if the transducer case becomes grounded to earth.
6.6 Invasive pressure Note The invasive pressure meter will require warming up if it is started from cold. The warm up time is specified in section “14.1.6 Invasive pressure”. Once the Tempus is turned on and the invasive pressure parameter functional, the pressure waveform will appear on the display. Note Check all cables and connections before use. Request that an appropriate service technician check the function of the device (including operation of all audible and visual alarms) on a regular basis.
Chapter 6 Taking medical readings The channel label is shown here The Systolic, Diastolic and Mean measurements are shown here The pressure waveform is shown here Once a second channel of invasive pressure is in use, it will appear as shown below.
6.6 Invasive pressure 6.6.3 Invasive pressure settings Pressing anywhere on the invasive pressure area brings up the invasive pressure settings menu. CAUTION The settings of each invasive pressure channel can be set differently. Press on the area of the relevant channel to access its settings. Changes in settings made to one channel are never automatically made to any other channel. Menu option Menu screen The title bar shows the channel being configured (P1 in this example).
Chapter 6 Taking medical readings The channel is labelled here Press here to select the label and type of the channel Press here to change the format of the measurement The full description of the selected channel label will be shown here e.g.
6.6 Invasive pressure Label Application Colour Reading format Waveform height CVP – Central Venous Pressure Venous Blue (M) S/D 0-30 mmHg UVP – Umbilical Venous Pressure Venous Blue (M) S/D 0-30 mmHg PAP – Pulmonary Artery Pressure Pulmonary artery Pale yellow S/D (m) 0-50 mmHg ICP – Intra-Cranial Pressure Intra-cranial White M 0-50 mmHg BDR – Bladder Pressure Bladder White M 0-30 mmHg The reading format can be changed independently of the default settings.
Chapter 6 Taking medical readings 1. Ensure you are zeroing the correct channel 3. A zeroing message will appear here – this lasts a few seconds 2. Press here to zero the transducer 4. Once the zero has been achieved, the text will update to confirm the time the zero was performed Zeroing the transducer CAUTION Remember to zero the channel/transducer that you are using. Take care to differentiate between the two transducers and their settings.
6.6 Invasive pressure 6.6.6 Two channel USB invasive pressure module 2 Channel USB IP Module Connected to the Tempus Pro 2 Channel IP Module When the 2 channel USB IP Module is plugged into the Tempus Pro USB socket and a patient cable and transducers are connected, channels 3 and 4 of will appear as shown below. For part number details, see “12 Accessories list of the Tempus Pro”. For specification details for the module, see “14 Specifications and standards”.
Chapter 6 Taking medical readings Four channel invasive pressure display If four channels of invasive pressure are used, the third invasive pressure channel replaces the capnometer waveform and the fourth invasive pressure channel replaces the NIBP display: Fourth invasive pressure channel (numeric) Third invasive pressure channel Four Channels of Invasive Pressure results page Note If a fourth channel of invasive pressure is used, NIBP becomes unavailable and measurements are stopped.
6.6 Invasive pressure Three channel invasive pressure display If three channels of invasive pressure are used, the third invasive pressure channel replaces the capnometer waveform and the NIBP is displayed in short form: NIBP short form display (in this example, NIBP is active) Third invasive pressure channel Three Channels of Invasive Pressure results page Note If NIBP is active, the short form display does not include a Start button or a timer icon.
Chapter 6 Taking medical readings Tempus Pro User/Operator Manual - 41-2001EN-00 – Page 122
7 Alarms The Tempus produces both patient (physiological) alarms and technical alarms. Patient alarms are user configurable but technical alarms are not. Patient alarm settings are reset to factory defaults when a new patient is admitted or if you switch back to monitor a previous patient. If you turn the Tempus off and on and select to continue monitoring, the alarm settings will be retained (if the off period is less than 30 seconds) and the Tempus will revert to currently used settings.
Chapter 7 Alarms WARNING If relying on the alarms, ensure that the display and alarm bar are viewable from the user’s operating position. Ensure the handle and rear alarm light remain clean and unobstructed. Ensure the alarm speaker remains unobstructed and alarm volume is set to a level appropriate to the level of background noise expected. WARNING The alarm functions of the Tempus are intended to be used by the attendant user only.
7.2 Visual alarm characteristics 7.1 Audible alarm characteristics The Tempus provides audible alarm indications through a speaker mounted on the front of the device. WARNING If relying on the alarms, ensure that the display and alarm bar are viewable from the user’s operating position. Ensure the handle and rear alarm light remain clean and unobstructed. Ensure the alarm speaker remains unobstructed and alarm volume is set to a level appropriate to the level of background noise expected.
Chapter 7 Alarms 7.2.1 Alarm bar LEDs The alarm bar LEDs illuminate in one of the following ways: Flashing yellow LED (for patient alarms); Solid yellow (for technical alarm); Flashing red (for specific high priority alarms). CAUTION The alarm bar can also be user-configured to show a solid green LED to indicate no active alarms (this feature is enabled and disabled in the Maintenance Menu, refer to the Tempus Pro Maintenance Manual for details). 7.2.
7.2 Visual alarm characteristics Active technical alarms look like this Alarm Status Area – Technical Alarm When there is no alarm state, the alarm bar will display the time of the last patient alarm or “No Alarms Active” if there have not been any alarms. This shows that no alarms are active Alarm Status Area with no alarms active 7.2.3 Alarm limits bar For patient alarms only, on the Home screen, the Tempus highlights the alarm limits bar for the parameter that is alarming.
Chapter 7 Alarms Alarm limits bar for the parameter that is alarming Alarm Limits Bar 7.2.4 Bottom status bar For patient alarms only, on screens that have a bottom status bar, the Tempus highlights the parameter that is alarming in flashing white text on an orange background.
7.3 Patient alarms 7.3 Patient alarms The table below lists all patient alarms: Parameter Measurement Range Patient type Default Alarm Low Alarm Low Range Default Alarm High Alarm High Range ECG Heart rate 30-300 bpm Adult 50 bpm 30-238 bpm 120 bpm 32-239 bpm 30-300 bpm Paediatric 50 bpm 30-238 bpm 150 bpm 32-239 bpm 30-300 bpm Neonate 100 bpm 30-238 bpm 200 bpm 32-239 bpm -50 - +50 mm Adult -2.0 mm -10 – +2 mm +2.0 mm -2 – +10.
Chapter 7 Alarms Parameter SpMet Capnometer respiration Capnometer respiration – no breaths detected Capnometer ETCO2 NonInvasive Blood Pressure Systolic NonInvasive Blood Pressure Diastolic NonInvasive Blood Pressure Mean Contact temperature Measurement Range Patient type Default Alarm Low Alarm Low Range Default Alarm High Alarm High Range 0-25 g/dl Neonate 7.0 g/dl 1.0-23.5 g/dl 17.0 g/dl 2.0-24.5 g/dl 0.0-99.9% Adult OFF 0.1-99.0 % 3.0% 1.0-99.5 % 0.0-99.
7.
Chapter 7 Alarms Parameter Diastolic PAP Invasive Pressure – Mean PAP Invasive Pressure – Mean ICP Invasive Pressure – Mean BDR Measurement Range Patient type Default Alarm Low Alarm Low Range Default Alarm High Alarm High Range -99 – 310 mmHg Paediatric -4 mmHg -99 – 310 mmHg -4 mmHg -99 – 310 mmHg -99 – 310 mmHg Neonate -4 mmHg -99 – 310 mmHg -4 mmHg -99 – 310 mmHg -99 – 310 mmHg Adult 0 mmHg -99 – 310 mmHg 20 mmHg -99 – 310 mmHg -99 – 310 mmHg Paediatric 12 mmHg -99 – 310
7.4 Technical alarms Condition On-Screen Error Text Comment Communications error – connection failed Attention - Data Connection Repeat the process taking care to follow on-screen and written instructions Data export option Attention - Data Export The data link was unable to connect at this time. There is patient record data from other devices/times.
Chapter 7 Alarms Condition On-Screen Error Text Comment Bluetooth pairing error Bluetooth Pairing Error Repeat the process taking care to follow on-screen and written instructions Entered PIN is incorrect Bluetooth pairing error Warning - Bluetooth Bluetooth is not activated on this device. System error Internal Fault Detected A fault has been detected. Reason: exception. The Tempus will need to restart. If this problem persists please contact your supplier.
7.5 Setting alarms Condition On-Screen Error Text Comment USB connection error USB - Connection Remove and re-insert the stick into the USB socket The USB memory stick is not plugged into the Tempus USB socket, please plug in. If plugged in, check it's the USB and not the RJ45 socket. USB error USB - Connection Failed to connect with USB, please retry.
Chapter 7 Alarms Alarm Nominal Time to Delay (Excluding User Configurable Delay) SpHb high 2 seconds SpMet low 2 seconds SpMet high 2 seconds SpCO low 3 seconds SpCO high 4 seconds PI low 2 seconds PI high 2 seconds PVI low 2 seconds PVI high 2 seconds SpOC low 2 seconds SpOC high 2 seconds ETCO2 high 4 seconds ETCO2 low 4 seconds Respiration rate (from Capnometer) high 4 seconds Respiration rate (from Capnometer) low 4 seconds Respiration rate (from ECG) high 4 seconds Re
7.5 Setting alarms Alarm Nominal Time to Delay (Excluding User Configurable Delay) QT Alarm 60 seconds ST Alarm 60 seconds (*) The user configurable delay is not applicable to this alarm 7.5.
Chapter 7 Alarms Menu option Menu screen SpO2 limits – set alarm limits. SpHb limits – set alarm limits. SpCO limits – set alarm limits. SpMet limits – set alarm limits. SpOC limits – set alarm limits. Pulse ox. Alarms – turn pulse ox. alarms off or on. PI limits – set alarm limits. PVI limits – set alarm limits. ETCO2 limits – set alarm limits. Capno no breaths – set alarm limit. Respiration limits – set alarm limits.
7.5 Setting alarms Menu option Menu screen NIBP systolic limits – set alarm limits. NIBP mean limits – set alarm limits. NIBP diastolic limits – set alarm limits. NIBP Alarms – turn NIBP alarms off or on. P1 systolic limits – set alarm limits. P1 mean limits – set alarm limits. P1 diastolic limits – set alarm limits. P2 systolic limits – set alarm limits. P2 mean limits – set alarm limits. P2 diastolic limits – set alarm limits. P1 Alarms – turn P1 alarms off or on. P2 Alarms – turn P2 alarms off or on.
Chapter 7 Alarms Simply press on the alarm that you wish to set and an editor will appear. This will allow you to edit both upper and lower limits of the alarm. The editor shows the range of the alarm settings. You change the alarm settings by simply typing in the desired value using the keypad or the up and down arrows. You can save the changes you have made or cancel them by pressing the relevant buttons at the bottom right.
7.6 Silencing or suspending alarms It should be noted that other system configuration changes e.g. ECG lead selection, QRS beat volume, gain or waveform speed changes, communications mode and communications settings, iAssist mode etc. are all settings which are stored by the Tempus. Therefore, any changes to the Tempus configuration other than alarm settings will remain set even after the Tempus has been switched off and on again (for periods less than 72 hours). 7.
Chapter 7 Alarms This button prevents visual and audible alarms from occurring for a temporary period This button silences the alarm once it is in progress Alarm Suspend and Silence Buttons Alarms can also be silenced before they occur using the Alarm Suspend button . This enables users to prevent alarms from occurring for two minutes due to intentional intervention with the patient e.g. removing or moving a patient sensor such as an ECG electrode or pulse oximeter probe.
7.7 Viewing and clearing alarms When a patient alarm is silenced the visual indication will remain on screen until the condition has passed i.e. the patient’s vital signs have returned to a level within the alarm thresholds. The non-invasive blood pressure is a periodic measurement. For this reason, an NIBP alarm is cleared by pressing the Alarm Silence or Alarm Suspend button. The alarm may then return when the next periodic reading is taken. 7.
Chapter 7 Alarms A title and detailed description will be shown in the centre of the dialog box. Press here to acknowledge the message and clear the alarm state Clearing a technical alarm To clear technical alarms, use one of the following methods: Either: press the “Clear this message” button on the Alarm Description Dialog screen; Or: correct the error that caused the alarm to be raised, for example refit a patient sensor that has been disconnected. 7.
7.9 Testing alarms Once set, Tactical Mode can be turned off by switching the physical switch back to its original position – see “4.3.2 Tactical mode (optional)”. WARNING Do not leave a unit in tactical mode without careful observation for alarm conditions on the screen. 7.9 Testing alarms RDT recommends that visual and audible alarms are tested before use. The alarm bar will light and the audible alarm will sound on switch on (unless the tactical switch is enabled).
Chapter 7 Alarms Tempus Pro User/Operator Manual - 41-2001EN-00 – Page 146
