Propaq® Encore Vital Signs Monitor Reference Guide Model 202EL, 204EL, 206EL Software version 2.
Copyright © 2004 by Welch Allyn. Welch Allyn® is a registered trademark of Welch Allyn. Propaq®, Propaq Encore®, and Acuity® are registered trademarks of Welch Allyn. Welch Allyn is protected under various patents and patents pending. Masimo ® and SET® are registered trademarks and Signal Extraction Technology™ is a trademark of Masimo Corporation. NELLCOR®, DURASENSOR®, C-LOCK® and OXISENSOR® are registered trademarks of Nellcor Puritan Bennett, Inc.
Contents General Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Safety Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Propaq Encore Documentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Contents What You Can Do With In-Service Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37 What You Cannot Do With In-Service Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38 Patient Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 ECG/RESP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Contents CO2 Measurements and Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 CO2 Display Menus and Status Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 Mainstream CO2 Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 How to Set Up the CO2 Channel and Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Contents Printing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 Printing Patient Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 Printing Waveforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .107 Printing NIBP Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Contents Extended Storage Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127 Printer Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128 Loading Paper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128 Customer Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Contents Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
General Information Safety Summary This Safety Summary should be read by all Propaq Encore users. Specific warnings and cautions will be found throughout the Propaq Encore documentation where they apply. Caution Caution: Federal (U.S.A.) law restricts this device to sale, distribution, or use by or on the order of a licensed medical practitioner. Warning This monitor is to be operated by qualified personnel only.
Safety Summary Warning Make frequent electrical and visual checks on cables and electrode wires. Avoid electrosurgery burns at monitoring sites by ensuring proper connection of the electrosurgery return circuit so that the return paths cannot be made through monitoring electrodes and probes. During defibrillation, keep the discharge paddles away from ECG and other electrodes, as well as other conductive parts in contact with the patient.
Safety Summary Warning Safe interconnection between the Propaq monitor and other devices must comply with applicable medical systems safety standards such as IEC 60601-1-1. Within certain governmental jurisdictions, all interconnected accessory equipment must be labeled by an approved testing laboratory. After interconnection with accessory equipment, risk (leakage) current and grounding requirements must be maintained.
Safety Summary Off (Standby) Patient connections are Type CF, isolated for direct cardiac application, and protected against defibrillation. Transformer meets requirements of a short-circuit-proof safety-isolating power transformer. On Alternating current For continued fire protection, use only the specified fuse. Patient connections are Type BF, and protected against defibrillation. For indoor use only (on power adapter only) Direct current Patient connections are Type B.
Propaq Encore Documentation Propaq Encore Documentation The Documentation Set The Propaq Encore documentation set consists of documents for the clinician, the biomedical technician, and the department head or purchaser of accessories for the Propaq Encore monitors. This Propaq Encore Reference Guide contains important safety and operating information for the clinician.
Propaq Encore Documentation Welch Allyn 14 Propaq Encore Reference Guide
Getting Started Introducing the Propaq Encore Intended Use Before using the Propaq Encore on a patient, be sure you understand the Safety Summary at the front of this book. It provides important information about safely using the Propaq Encore. The Propaq Encore monitor is intended to be used by skilled clinicians for multiparameter vital signs monitoring of neonatal, pediatric, and adult patients in health care facility bedside applications; as well as for intra- and interfacility transport.
Introducing the Propaq Encore Expansion Module The Propaq Encore Expansion Module attaches to the monitor and houses additional capabilities. The Expansion Module can be fitted with the SpO2, CO2, and Printer options.
Introducing the Propaq Encore Impedance Pneumography (RESP) Option The RESP option detects the rate or absence of respiratory effort, and is configured with the Pulse Oximetry option. Printer Option The Expansion Module with Printer (EMP) provides a lightweight 3-channel recorder. Propaq-to-Acuity Option This option allows communication between the Propaq Encore and the Acuity Central Monitoring System by means of an ethernet network system installed in your facility.
Using the Propaq Encore Using the Propaq Encore System Controls (Right Side Panel) MONITOR On/Off Switch DEFIB SYNCHRO Defib Sync Connector ! Real-time ECG Output Connector Speaker Input Fuse 3A 2AG EKG x 1000 ! Power Input Connector ! Battery Charging Light Connector for Acuity or Modem-Propaq 12-28V, 3A Warning Safe interconnection between the Propaq Encore and other devices must comply with applicable medical systems safety standards such as IEC 601-1-1.
Using the Propaq Encore Defib Sync Connector This connector allows connection with a LIFEPAK 5 or LIFEPAK 6s defibrillator for synchronized cardioversion. See page 131 for more information. Real-Time ECG Output Connector This connector provides a real-time analog ECG signal output. Battery Charging Light This green light turns on when a power source (ac power adapter or external dc source) is connected and the battery is charging.
Using the Propaq Encore Power-up Screen PROTOCOL SYSTEMS INC. MODEL PROPAQ 204 DIAGNOSTICS IN PROGRESS When you first turn on the monitor, the power-up screen displays information about the Propaq Encore and the monitor runs diagnostic tests to ensure proper functioning. BATTERY: 8.3 VOLTS SOFTWARE VERSION 2.00.00 (c) PROTOCOL SYSTEMS INC. 1988-1998 A few seconds later, the top two lines of the screen are replaced with text indicating the current patient mode (adult, pediatric, or neonatal).
Using the Propaq Encore Powerup Equipment Alert: Program Fault, Settings Lost If a PROGRAM FAULT: SETTINGS LOST, TIME/DAY RESET equipment alert appears when you turn on the monitor, the monitor cannot recall the programmed custom settings and current time and date. This can occur if the battery is drained or after new software has been installed. If this occurs, the monitor provides a special sequence of display windows to help you regain use of your monitor as quickly as possible. Do the following: 1.
Using the Propaq Encore Patient Connections The left side panels differ depending on the Propaq Encore model. All models have ECG, NIBP, and two temperature connectors. The Propaq Encore 204 left side panel includes one invasive-pressure connector, and the Propaq Encore 206 includes two invasive-pressure connectors. ECG / EKG RESP INV. BP P1 ECG / EKG RESP INV. BP P1 ECG / EKG RESP ! NIBP PSNI T1 NIBP PSNI ! T1 NIBP PSNI ! T2 T2 T2 INV.
Using the Propaq Encore Option Connectors CO2 CO2 ! ! Sidestream CO2 Connector Mainstream CO2 Connector Cable: see Welch Allyn Products and Accessories Guide (810-0409-XX) Cable: see Welch Allyn Products and Accessories Guide (810-0409-XX) Masimo SpO2 Connector (motion tolerant) Masimo SpO2 Connector (motion tolerant) SpO2 ! NELLCOR SENSORS/CAPTEURS Nellcor SpO2 Connector (older style, without motion tolerance) Nellcor SpO2 Connector (newer style, motion tolerant) Propaq Encore Reference Guide
Using the Propaq Encore Propaq Encore Display The display shows waveforms, vital sign numeric values, Propaq Encore status, and alarm information in different windows. Different vital sign numeric values (such as heart rate and blood pressures) have upper and lower range limits. If the Propaq Encore detects a vital sign value outside of the Propaq's measurable range, the monitor displays – – – (below the range) or + + + (above the range) instead of the vital sign value.
Using the Propaq Encore You can select up to three waveforms to be shown on the Propaq. When only one waveform is selected, a trend window automatically appears below the waveform. While changing Propaq Encore settings, a status window may appear below the waveform. 12:45:28 NIBP S 122 T1 102.
Using the Propaq Encore The five buttons below the screen, and their associated labels located on the screen, provide access to the menus. Later in this manual, the notation A , B , C is used as a shorter way to say “Press Button A, then B, then C.” Propaq Encore Menus Menus for some patient vital signs are displayed only if that option is included in your Propaq.
Using the Propaq Encore Key-press Route to Setup Menu 1 NIBP ECG/RESP INV PRS SpO2/CO2 SETUP WAVE SEL TRENDS MORE SETUP MENU 1 STATSCALE ALARMS (MORE button takes you to next Setup Menu) TRENDS MENU PRINT NXT TRND OXYCRG ALARMS MENU STAT SET SUSPEND RESUME ALL ALRM LIMITS PREV MENU ALARM LIMITS MENU* NEXT UP DOWN ON/OFF NEXT PAGE (*ON/OFF button is not displayed for HR/PR alarm limits if the HR/PR ALARM LIMITS setting is set to CANNOT TURN OFF.
Using the Propaq Encore Key-press Route to Setup Menu 2 NIBP ECG/RESP INV PRS SpO2/CO2 SETUP SCATSCALE ALARMS WAVE SEL TRENDS MORE *(Service menu tests are for use by authorized service personnel only, and are available only when in the Adult patient mode.
Monitor Setup Monitor Setup Setup Menu 1 is accessed by pressing the SETUP button on the Main Menu. STATSCALE ALARMS WAVE SEL TRENDS MORE STATSCALE Automatically readjusts all waveform scales. ALARMS Allows access to the Alarms menu. WAVE SEL Allows you to turn on and off desired waveforms or NIBP numerics for display. TRENDS Allows access to the Trend settings and display.
Monitor Setup HR/PR TONE Sets the Heart Tone volume to HIGH, MEDIUM, LOW, or OFF. PATIENT MODE Pressing CHANGE in this selection displays the following Patient Mode window: BATTERY: 9.2 VOLTS ( 85) PATIENT MODE SELECT PATIENT MODE BASED ON AGE: PA 35/ 18 MCO2 BR NEO : < 44 WEEKS GEST. AGE PED : > 44 WEEKS GEST.
Monitor Setup Selecting Waveforms for Display To select waveforms for display, press SETUP, WAVE SEL.
Monitor Setup Time/Day Settings and Trends Warning Changing the hour/minute/second setting for the monitor in the Time/Day window can cause the monitor to erase previously stored patient trend data. When you change the hour/minute/second setting for the monitor in the Time/Day window, the monitor deletes any patient trend data that is older than five hours for nonNIBP trends or older than eight hours for NIBP trends according to the new clock setting.
Monitor Setup DECIMAL Sets the decimal character as either a period (.) or a comma (,). HR/PR ALARM LIMITS Allows or prohibits turning off the HR/PR alarm limits. If CANNOT TURN OFF is selected, the ON/OFF button is not displayed on the HR/PR Alarm Limits Menu. CO2 UNITS Sets the CO2 display units as mmHg, kPa, or percent (%). If you change the units, the CO2 trends will be cleared and CO2 alarm limit settings change to the factory default settings for the currently-used patient mode.
Monitor Setup Whenever you change the patient mode, the alarm limit settings automatically change to the settings for that mode. From the Main Menu, press SETUP, MORE, CHANGE, SETUP. The Mode Setup window appears: ZEROED MODE SETUP BATTERY: 9.3 VOLTS P2 NO ZERO FACTORY: *ADULT PED NEO MCO2 BR CUSTOM : ADULT PED NEO * = PATIENT MODE ON POWERUP NEXT POWERUP* USE NOW SAVE 38 12 97 PREV MENU mmHg Sp02 The asterisk (*) indicates which patient mode is currently selected for powerup.
Printer Functions Printer Functions Press SETUP, MORE, PRINTER to display the printer menu and setup window. 18:45:28 NIBP S 122 T1 102.3 °F III mV 1cm MON PRINTER SETUP PAGE CONTINUOUS : 25.0 mm/s AUTO PRINT : 15 minutes ALARM PRINT : OFF : OFF NIBP TICKET APNEA TICKET : OFF OXYCRG ON ALARM: OFF NEXT CHANGE PR TREND MORE HR ART 80 122 58 ( 85) PA 35/ 18 MCO2 BR 35 12 92 PREV MENU mmHg SpO2 NEXT Selects the next setting in the status window. CHANGE Changes the currently selected display setting.
Printer Functions PRINTER FAULT Messages These PRINTER FAULT messages can appear in an equipment alert window. LOW BATTERY, PRINTER DISABLED This message appears when the Propaq’s battery voltage is less than 7.6 volts. To continue operation, plug the ac power adapter into the Propaq. CHECK DOOR The door on the bottom of the printer is open. Close door to remove this message. PAPER OUT To add printer paper, see page 128. OVERHEATING The printer is overheating. Service may be required.
Learning the Propaq Encore Learning the Propaq Encore Using In-Service Mode You can practice using the Propaq Encore without a patient simulator by using the Propaq's in-service mode of operation. The in-service mode cannot be activated while you are monitoring a patient. The message “SIMULATING” alternates with the time of day and patient mode on the display. To begin practicing with your Propaq, disconnect all patient cables connected to the monitor.
Learning the Propaq Encore NIBP For noninvasive pressure measurements, keep the Propaq Encore in manual NIBP operating mode and take pressure measurements by pressing the START button. You can also press the NIBP Menu's TURBOCUF button to consecutively take pressure measurements for five minutes. Printer Message Simulated data can be printed on the Propaq Encore Printer.
Patient Monitoring ECG/RESP Intended Use–Impedance Pneumography (RESP) The Respiration channel is intended to detect the rate or absence of respiratory effort, deriving the signal by measuring the AC impedance between the selected terminals of the ECG electrodes. RESP displays a respiration rate and waveforms. Two respiration lead selections are available, Lead 1 (RA-LA) and Lead 2 (RA-LL).
ECG/RESP Impedance pneumography is not recommended for use with high frequency ventilation. Since RESP is derived from the same leads as the ECG channel, the Propaq Encore determines which signals are cardiovascular artifact and which signals are a result of respiratory effort. If the breath rate is within five percent of the heart rate or a multiple or sub-multiple of the heart rate, the monitor may ignore breaths and trigger an apnea alarm.
ECG/RESP Warning High-intensity radio frequency (RF) energy from external sources, such as an improperly connected electrosurgical unit, can induce heat into electrodes and cables which can cause burns on the patient. Reading errors and damage to equipment may also result.
ECG/RESP Preparation Warning Use only ECG safety cables that are designed so that they cannot accidently be plugged into an AC mains outlet or make contact with other hazardous electrical potentials including earth ground. To prevent damage during defibrillation, don’t use ECG cables without 1K series resistors. Preparing for ECG monitoring with the Propaq Encore requires you to prepare the monitor, prepare the patient, set up the ECG channel, and then set the ECG alarms. Preparing the Monitor 1.
ECG/RESP Some electrodes may be subject to large offset potentials due to polarization. This effect is most likely when dissimilar metals are used for different electrodes, and may be severe enough to prevent obtaining an ECG trace. Furthermore, recovery time after application of defibrillator pulses may be compromised when using electrodes of dissimilar metals. Squeeze bulb electrodes, even if all of the same metal, are particularly vulnerable to this effect.
ECG/RESP Two RESP leads are available. Choose the one that gives you the best signal. If neither signal is adequate, it may be necessary to experiment with nonstandard electrode placement such as placing the RA and LA electrodes on the respective mid-axillary lines just above the level of the nipples. 6. If an electrosurgical unit is going to be used, place the ECG cable and electrode wires as far as possible from the surgical site and from the electrosurgical return electrode and its cables.
ECG/RESP How ECG/RESP is Displayed Because of the critical nature of monitoring ECG, it is always displayed in the top part of the waveform display area. The ECG waveform is the only waveform that cannot be turned off using the Setup Wave Select Menu. Respiration rate numerics are sourced from the CO2 channel and displayed as BR when CO2 is active. Otherwise, respiration rate numerics are sourced from the ECG/RESP channel and displayed as RR.
ECG/RESP When you press MORE in the first ECG/RESP Menu, a status window appears showing you the current ECG/RESP settings and additional selections. Selected ECG lead Sensitivity factor Bandwidth Selection Available with the Impedance Pneumography Option 18:45:28 NIBP T1 102.3 °F III mV 1cm MON ECG/RESP HR/PR TONE : LOW PACER DISPLAY: ON ECG BANDWIDTH: MONITOR (0.
ECG/RESP The Propaq Encore counts as “breaths” respiratory efforts that are larger than two times background Cardiovascular Artifact (CVA). Since RESP is derived from the same leads as the ECG channel, the Propaq Encore determines which signals are cardiovascular artifact and which signals are a result of respiratory effort. If the breath rate is within five percent of the heart rate or a multiple or sub-multiple of the heart rate, the monitor may ignore breaths and trigger an apnea alarm.
ECG/RESP Noise on the signal Noise on the ECG signal may be detected as pacer signals, causing the pacer indicator to appear on the display. If you don't need to indicate pacemaker signals, you may want to turn off the pacemaker indicator for a better display of the ECG waveform. Warning The presence of much pacer-like noise can cause the displayed heart rate to be erratic even though the ECG trace may look clean with the pacer indicator off.
ECG/RESP RESP Messages LEAD FAIL. One or more electrodes are making very poor or no contact. Check for proper connection; replace electrodes if needed. INAPPROPRIATE ECG CABLE. ECG cable appears not to contain 1K current limiting resistors. These resistors are required for RESP operation and to protect the Propaq Encore from damage during defibrillation. Replace cable with proper type. NOISY SIGNAL, CHECK ELECTRODES. Electrodes are making poor contact and may be dried out. Replace electrodes.
Invasive Pressure Invasive Pressure This section applies only to Propaq Encore Models 204EL and 206EL. If you don't have one of these models, you can skip this section. Intended Use The Propaq Encore invasive pressure channel is intended for measuring arterial, venous, and intracranial pressures using invasive transducers with 5 µV/V/mmHg sensitivity. The Propaq Encore can be used with many types of transducers, including nondisposable, disposable dome, and fully disposable.
Invasive Pressure Preparation Preparing for invasive pressure monitoring with the Propaq Encore requires you to prepare the transducer, zero the transducer, set up the pressure channel, and set the invasive pressure alarm limits. Preparing the Transducer 1. Inspect the transducer cable for wear, breakage, or fraying. Replace it if the cable shows signs of any of these. Replace the transducer dome if necessary. 2. Apply the transducer according to your hospital's procedures.
Invasive Pressure 3. Wait for a tone to briefly sound and the word ZEROED to appear in the blood pressure numerics window. You will then see the pressure scale to the left of the waveform, and the pressure numerics appear. 4. Close the transducer's stopcock. 5. If the transducer will not zero, the words ZERO REJECTED (or NO ZERO, depending on zone) will appear in the numerics window. Press CANCEL and try zeroing again.
Invasive Pressure Warning If a ZERO button is pressed after an invasive pressure channel has been successfully zeroed and is currently monitoring a pressure waveform, the message ZERO REJECTED will display in the invasive pressure numerics window. This message will preempt the valid invasive pressure numerics until the CANCEL button in the Invasive Pressure Menu is pressed.
Invasive Pressure RANGE Sets the display to Range Mode. All invasive pressure waveforms monitored are displayed against the same scale. You can select one of five Propaq Encore pressure scales. If two waveforms have a great difference in their pressures, the higher pressure waveform may not be visible if it is out of range of the scale. Press RANGE until the desired scale appears. RESCALE Sets the display to Rescale Mode. Each invasive pressure waveform is displayed against its own scale.
Invasive Pressure ZERO REJECTED (or REJECT). Unable to establish a zero reference value. The message remains until the CANCEL button is pressed. CANCELED. This message appears if CANCEL is pressed while the channel is zeroing. These equipment messages can appear in an equipment alert window. TRANSDUCER NOT DETECTED. The transducer connection is broken. TRANSDUCER SHORT CIRCUIT. This message appears when the Propaq Encore senses a short in the transducer. The transducer should be replaced.
NIBP NIBP Intended Use The Propaq Encore noninvasive blood pressure channel (NIBP) indirectly measures arterial pressures using an inflatable cuff. If ECG is also monitored, the Propaq Encore synchronizes the NIBP measurement process to the occurrences of the R-wave, increasing accuracy in cases of extreme artifact, diminished pulses, or some dysrhythmias. Warning The patient's limb should be periodically observed to ensure that the circulation is not impaired for a prolonged period of time.
NIBP NIBP measurements are affected by normal physiological pressure variations from reading to reading. Normal respiration may affect pressure by as much as 10 to 20 mmHg. Patient’s emotional state, body position, and cuff fit may also adversely affect NIBP measurements. In some individuals, the act of taking blood pressure readings may alter the blood pressure. Successive readings on the same patient may vary for the above reasons.
NIBP If artifact is so severe while Smartcuf is enabled that it affects the accuracy of an NIBP measurement, that measurement is marked with a special symbol on the display and on printouts This symbol indicates the NIBP reading was taken in the presence of high artifact while monitoring ECG with Smartcuf enabled. Artifact can affect accuracy.
NIBP Warning When monitoring NIBP, match the Propaq patient mode to the style of the cuff. For neonates, set the monitor to Neonatal Mode unless the circumference of the limb is too large for the cuff. In that case, use the Pediatric Mode. In the Pediatric Mode, the maximum cuff inflation pressure can exceed 150 mmHg, and two retries are allowed. For information about patient mode specifications, see “NIBP Specifications” on page 142.
NIBP A cuff that is not properly connected to the patient may result in a false reading if the patient and cuff are moved by motion artifact or clinical personnel during the NIBP measurement. Always verify the cuff is properly placed on the patient. 3. Screw the hose connector onto the NIBP connector on the monitor's left side. 4.
NIBP AUTO/MAN This button switches the mode between Automatic or Manual Mode. The Manual Mode is the default unless you change it by reprogramming your Propaq. Measurements can be taken at intervals of 1, 2, 3, 5, 10, 15, 30, and 60 minutes. Press START to initiate a measurement. INTERVAL Selects the interval at which NIBP measurements are automatically taken. The interval you select, ranging from one minute to 60 minutes, is shown on the display next to the word TIME.
NIBP Set the NIBP Alarm Limits Set the alarm limits according to your hospital's standards. NIBP Display Default Settings To select which vital sign waveforms are displayed, press MAIN MENU, SETUP, WAVE SEL to display the Wave Select window. SETUP ECG ART PA CO2 NEXT WAVE SELECT : : : : ON ON OFF OFF ON/OFF RESP : OFF SpO2 : ON NIBP : ON INSERV ( 85) PA 35/ 18 MCO2 BR 35 12 92 PREV MENU mmHg SpO2 To enable the display of a waveform or large NIBP numerics, select ON (ECG cannot be set to OFF).
NIBP AIR LEAK, CHECK HOSE (ERR# 1). The Propaq Encore could not properly inflate cuff. Check the hose and cuff for obvious leaks, such as O-rings in the hose connections. CUFF NOT DETECTED (ERR# 2). During cuff inflation the detected pressure did not sufficiently rise. Check that the cuff connection is tight and take the measurement again. KINKED HOSE, CHECK HOSE (ERR# 3). The Propaq Encore could not properly inflate cuff. Check for a kinked hose between the monitor and the patient.
NIBP LOW BATTERY, NIBP DISABLED (ERR# 11). The battery lacks sufficient voltage to be able to operate the NIBP channel. Connect the Encore to the ac power adapter. SERVICE REQUIRED, NIBP DISABLED (ERR# 12). Have the monitor serviced. CUFF TOO LARGE FOR PATIENT MODE (ERR# 13) . The monitor detects a cuff too large for the current patient mode. First, verify the patient mode. If the patient mode is correct, make sure the cuff fits snugly.
NIBP NIBP IN PROGRESS Message NIBP IN PROGRESS P2 PLEASE WAIT FILTERING ARTIFACT 9 12/ 7 SpO2 PRESS ANY KEY BELOW TO ACKN0WLEDGE 99 The monitor displays this message when noise or artifact such as vehicle motion causes a delay while measuring NIBP. To remove the message, press any button below the screen. To cancel the NIBP measurement, press STOP.
Temperature Temperature Intended Use Propaq Encore monitors provide two temperature channels (except for the HP-side panel option). When both channels are active, the difference temperature (∆T) is also displayed. You can select °C or °F. Temperature Connectors and Probes Propaqs are intended to be used with approved temperature probes listed in the Welch Allyn Products and Accessories booklet.
Temperature Temperature Messages The following messages can appear in an equipment alert window. A temperature caution message will also appear in the temperature numeric window when one of these messages appears (except PROBE NOT DETECTED). PROBE NOT DETECTED. This message occurs when the Propaq Encore has successfully measured temperature and a probe is then disconnected. Reconnect the probe or acknowledge the equipment alert by pressing any menu button. PROBE SHORT.
Pulse Oximetry (SpO2) Pulse Oximetry (SpO2) Warning Oxygen saturation measurements using pulse oximetry are highly dependent on proper placement of the sensor and patient conditions. Patient conditions such as shivering and smoke inhalation may result in erroneous oxygen saturation readings. If pulse oximetry measurements are suspect, verify the reading using another clinically accepted measurement method, such as arterial blood gas measurements on a co-oximeter.
Pulse Oximetry (SpO2) If NIBP will be monitored while using SpO2, place the NIBP cuff on a different limb than the SpO2 sensor to help reduce unnecessary SpO2 alarms. For optimal measurements, avoid placing the SpO2 sensor on the same limb as an arterial catheter or intravascular line.
Pulse Oximetry (SpO2) 4. Press SIZE to adjust the waveform size for best viewing (1x, 2x, 4x, or 8x). 5. Adjust the placement of the sensor until a good SpO2 waveform is displayed. A waveform with artifact may cause erroneous oxygen saturation readings. 6. Set alarm limits according to your hospital’s standards. To help minimize false alarms, the Propaq monitor briefly delays or "holds off" triggering both audible and visual alarms for limit violations for SpO 2% and Pulse Rate for 10 seconds.
Pulse Oximetry (SpO2) Caution If you see the error message DEFECTIVE SpO2 SENSOR, either the sensor is not compatible with the monitor or the sensor is not working properly. Check the Welch Allyn Products and Accessories booklet (8100409-XX) to be sure the sensor is compatible. If compatibility is not a problem, try another sensor. The monitor displays STANDBY in the SpO2 numeric window until it measures and displays the SpO2 value.
Pulse Oximetry (SpO2) Response Indications for Use NORMAL: 5-7 seconds Use for relatively stable patients. FAST: 2-3 seconds Use when patient movement or other artifact is not present. SLOW: 10-15 secondsa Use when patients exhibiting movement are preventing accurate measurement at NORMAL setting. a.SLOW setting is not applicable to the Nellcor SpO2 option with motion tolerance. 9. If the C-LOCK function is desired, press C-LOCK to set it to ON.
Pulse Oximetry (SpO2) Perform SpO2 “Spot-Check” Monitoring The SpO2 Standby Mode allows you to remove the SpO2 sensor from a patient without having to disable all alarms or disconnect the SpO2 sensor cable from the Propaq monitor. You can therefore perform intermittent or “spot-check” SpO2 monitoring. 1. While monitoring SpO2, remove the SpO2 sensor from the patient, but leave it connected to the monitor.
Pulse Oximetry (SpO2) STANDBY is displayed in the numeric window when the SpO2 sensor is disconnected from the patient, an alarm occurs, and you press the STANDBY button. STANDBY is also displayed if you first plug the SpO2 sensor cable into the monitor connector before attaching the SpO2 sensor to the patient. DEFECTIVE SpO2 SENSOR. If you see the error message DEFECTIVE SpO2 SENSOR, either the sensor is not compatible with the monitor or the sensor is not working properly.
Capnography (CO2) Capnography (CO2) Intended Use The Propaq’s Capnography (CO2) option is intended to noninvasively measure the following vital signs or events: End-tidal CO2 (ETCO2), Inspired CO2 (INCO2), Breath Rate, and Apnea. The CO2 option is available as Mainstream CO2, Sidestream CO2, or Dualstream CO2. Although Dualstream CO2 provides both Mainstream CO2 and Sidestream CO2 monitoring, only one method can be used at a time. The v option is required for any Propaq equipped with the CO2 option.
Capnography (CO2) Mainstream CO2 Option The Mainstream CO2 option measures the carbon dioxide content of a patient’s inhaled and exhaled breath. A mainstream sensor is attached to an airway adapter in series with a ventilator’s patient breathing circuit. Patients using Mainstream CO2 must either be intubated or breathing through a well-fitting face mask connected to a breathing system such as an anesthesia circle system.
Capnography (CO2) 19:02:28 Sidestream CO2 is active. NIBP S 122 T1 102.3 °F III mV 1cm MON S 60 C 30 O 2 0 S p O 2 S Y 2 N x C NIBP HR ART 80 122 58 ( 85) PA 35/ 18 SCO2 BR 35 12 92 SpO2/CO2 SETUP mmHg SpO2 ECG/RESP INV PRS Displayed values of ETCO2 and INCO2 are the highest and lowest values (respectively) of CO2 measured during the time interval set by the RESPONSE setting on the CO2 Menu. You can set upper and lower alarm limits for ETCO2, and an upper alarm limit for INCO2.
Capnography (CO2) UNCAL indicates the monitor has detected a problem such as a lack of calibration, an obstruction, or a low battery. WARM UP indicates Mainstream CO2 has been activated and is preparing for operation. This typically requires 30 seconds at room temperature. START UP indicates Sidestream CO2 has been activated and is preparing for operation. This typically requires 30 seconds at room temperature.
Capnography (CO2) SWEEP SPEED The CO2 and RESP display sweep speed (set by the mm/s button) BAROMETER The ambient barometric pressure To change CO2 units, use the Settings Menu under the Service Menus. Changing these units will clear CO2 trends.
Capnography (CO2) Mainstream CO2 Monitoring 1. Select the appropriate airway adapter. Use only accessories provided or recommended in the Welch Allyn Products and Accessories booklet. Always refer to the manufacturer's Directions for Use for instructions about operation, cleaning, and replacement. Warning Do not attempt to verify operation of the CO2 sensor by blowing through it directly. Always blow through an attached airway adapter.
Capnography (CO2) Warning When attaching the airway adapter, position the adapter so the sensor is on top to avoid fluid collection in the sensor airway slot. Any concentration of fluids here can cause inaccurate CO2 readings. Always check to make sure there are no leaks in the breathing circuit. Check all of the connections. 3. Plug in the CO2 sensor cable to the Mainstream CO2 connector on the Propaq left side panel. 4. Set up the CO2 channel and alarms. Follow the steps described on page 81.
Capnography (CO2) If an inspired value is displayed indicating patient rebreathing (non-zero INCO2), check the patient breathing circuit for proper function. Verify the sensor calibration against room air. If the Propaq continues to display inspired values, return the sensor to Welch Allyn for service. 3. Press mm/s to select either 3.13, 6.25 or 12.5 mm/sec. The default setting is 6.25 mm/ sec. This sweep speed also applies to RESP. 4. Press MORE to view the CO2 status window. 5.
Capnography (CO2) Warning For patient safety, it is recommended that the Breath Rate alarm limits always be turned on and set appropriately. Motion artifact or other factors can cause false RR/BR alarms. To help minimize false alarms, the Propaq delays or “holds off” triggering a RR/BR alarm for 5 seconds. After this holdoff period begins, if the Propaq detects that the patient’s RR/BR vital sign has returned to acceptable limits, the Propaq cancels the alarm holdoff.
Capnography (CO2) 3. Connect to a non-intubated patient. OR 4. Connect to an intubated patient. Use only accessories provided or recommended in the Welch Allyn Products and Accessories booklet. Always refer to the manufacturer's Directions for Use. Breath rates greater than 50 breaths/minute may reduce the reported ET CO2 values. Select the 175 ml/min flow rate to minimize errors at higher breath rates. The 175 ml/min flow rate is recommended for intubated adult patients.
Capnography (CO2) Connect to a Non-Intubated Patient 1. Position the cannula on the patient according to the manufacturer’s instructions. Warning The cannula is disposable and should only be used for a single patient. Do not reuse the cannula for another patient. If oxygen is being delivered while using Sidestream CO2 , be sure to use a CO2 Sampling and O2 Delivery Cannula. Using a different type of cannula could obstruct oxygen delivery.
Capnography (CO2) Connect to an Intubated Patient 1. Connect the gas sampling elbow and elbow connector into the patient’s breathing circuit according to the manufacturer’s instructions. Warning The exhaust port for Sidestream CO2 is an output for the expired gases from the patient and any connected breathing apparatus. The exhaust port is intended only for connection to gas collection equipment such as gas scavenger devices. Do not allow any other connection to the exhaust port.
Capnography (CO2) ALTIMETER FAILURE - RATE. The altimeter has detected that the ambient pressure is changing at a rate greater than 100 mmHg/minute. When the rate of change is back within the 100 mmHg/minute range, disconnect and reconnect the CO2 sensor to the Propaq. DEGRADED WAVEFORM, CHECK ADAPTER (UNCAL appears in the numerics area). The Mainstream CO2 adapter is obstructed or the CO2 sensor has failed. The CO2 waveform is displayed without range values. Replace the adapter or replace the sensor.
Capnography (CO2) Sidestream CO2 Messages Equipment messages for the Sidestream CO2 option can appear on the display in an equipment alert window. ALTIMETER FAILURE - RANGE. The Propaq is operating at an altitude outside the Sidestream CO2 option’s operating altitude range of -2,000 to 15,000 feet. Returning the monitor to within this range automatically cancels this message and restores operation. ALTIMETER FAILURE - RATE.
Capnography (CO2) OCCLUSION - CHECK WATERTRAP/TUBING. Blockage has been detected on the Sidestream CO2 input. Check the watertrap, sample line, and any connected tubing for occlusion. PUMP FAILURE, SERVICE REQUIRED. The pump is not able to maintain the target flow rate. Send the Propaq to a Biomedical Engineer for service. SIDESTREAM STICK EEPROM FAILURE. Send the Propaq to a Biomedical Engineer for service. SSP BOARD EEPROM FAILURE. Send the Propaq to a Biomedical Engineer for service.
Capnography (CO2) Welch Allyn 90 Propaq Encore Reference Guide
Alarms and Limits Alarms Window and Menu You can set the alarms in normal operating mode or in-service mode. You can also have the Propaq Encore automatically print the patient's vital sign information when an alarm occurs. Alarm Status Window This status window shows, with a bell symbol, the alarm status of each patient channel. Bells only appear when at least one limit is turned on and the vital sign parameter is being monitored.
Alarms Window and Menu To adjust the alarm tone volume, press SETUP, then MORE. The status window appears. Use the NEXT button to select ALARM TONE, and the CHANGE button to change the setting. SETUP CURRENT SOURCE : SELECTED SOURCE : SWEEP (mm/s) : ALARM TONE : HR/PR TONE : PATIENT MODE : NEXT CHANGE HR/PR RR/BR ( 85) PA 35/ 18 ECG MCO2 MCO2 BR ART --12.5 3.
Types of Propaq Alarms Types of Propaq Alarms Patient Alarms: Definitions and Indications The Propaq Encore can alert you to changing patient conditions through its programmable alarm functions. After you set alarm limits, any vital sign that violates any of its limits results in both audible and visual alarm indications. The Propaq Encore also shows you when any alarm limit is turned off by illuminating the amber ALARM(S) OFF light.
Types of Propaq Alarms The alarm tones are summarized in the table: Alarm Condition Tone Patient alarm Continuous ON Apnea alarm ON for 1 second, OFF for 1 second Equipment alert ON for 1 second, OFF for 4 seconds Life-Threatening Alarms Life-threatening alarms are automatically turned on when the channel is activated, and cannot be turned off by the user. A life-threatening alarm is the highest priority patient alarm. You are notified of any life-threatening alarm as soon as it is detected.
Types of Propaq Alarms Responding to Patient Alarms Suspend an Alarm Tone You can temporarily turn off an alarm tone by pressing the SUSPEND/RESUME key to the left of the screen or the SUSPEND button in the Patient Alarm Menu. The tone is suspended for 90 seconds. During that period, the visual alarm indications continue. When you suspend the alarm, the red ALARM light is on.
Types of Propaq Alarms The ON/OFF button is not available for HR/PR alarm limits if HR/PR ALARM LIMITS in the Settings window is set to CANNOT TURN OFF. • Manually change the violated alarm limit value by selecting the violated limit value and adjusting it • Turn off all alarm limits by pressing MAIN MENU, SETUP, ALARMS, ALL ALRM Responding to Life-Threatening Alarms During a life-threatening alarm, you can suspend the alarm tone and adjust the Alarm Limits.
Alarm Holdoffs Alarm Holdoffs Propaq Audio and Visual Alarm Holdoffs Motion artifact or other factors can cause false vital sign alarms. To help minimize false alarms, the Propaq briefly delays or “holds off” triggering alarms for certain vital sign limit violations. After the alarm holdoff period begins, if the monitor detects that the patient’s vital sign has returned to acceptable limits, the Propaq cancels the alarm holdoff.
Setting Alarm Limits Setting Alarm Limits Adjust Limits with STAT SET When you want to quickly set all alarm limits, the Propaq Encore can calculate new alarm limits using the patient’s current values. Press the STAT SET button in the Alarms Menu (SETUP, ALARMS, STAT SET). The Propaq Encore activates all alarms and calculates the limits for all monitored vital signs, except apnea delay.
Setting Alarm Limits Warning If a patient’s vital sign value falls outside of the upper or lower alarm range limit, STAT SET turns off the alarm and the alarm limit except for the following: 1. The lower alarm limits for SpO2 and ETCO2 are not turned off by STAT SET. 2.
Setting Alarm Limits Customizing Propaq Encore Alarm Limits Although adjusting the Propaq's alarm limits can be automatic with STAT SET, you can also customize the limits you want to take effect every time you turn on the monitor. See “Setting the Current, Custom, and Power-up Modes” on page 33.
Equipment Alerts Equipment Alerts Definitions and Indications The Propaq Encore can alert you to changing equipment conditions, such as disconnected or faulty sensors, low battery voltage, lost programmed settings, and other conditions that can affect patient monitoring. If an equipment alert condition is detected, a high-pitched alarm tone sounds for one second at five-second intervals.
Equipment Alerts If the equipment condition also caused a patient alarm, you will need to first suspend the alarm tone by pressing SUSPEND, then take the required action. The Propaq Encore returns the channel to its settings prior to the equipment alert. If a patient alarm occurred and you turned off any alarm limits, you will need to turn them back on. You can see which alarm limits are turned on by pressing SETUP, ALARMS.
Trends Every two minutes, the Propaq Encore collects the monitored vital sign numerics and stores them in its trend memory, which can save the last five hours of trend information. (See “NIBP Trends “on the next page for exceptions.) All this information can be printed and viewed as a trend print. The Trend Status Window and Menu There are five trends: NIBP, RESP, P1, P2, and TEMP. Except for NIBP, all vital signs are continuously monitored from the time monitoring begins to the time it ends.
How Trends are Accumulated How Trends are Accumulated For each of the four continuous trends, numerics are sampled every two minutes to a maximum of 150 samples (up to five hours). When the maximum is reached, the trending continues but the older data is no longer stored. The readings are displayed in descending order, most recent first. The following is programmable: which trend window comes up first. The NIBP trend window is the factory default.
Displaying Trends Selecting a Trend (NXT TRND) Select the trend you want displayed by pressing the NXT TRND button. The trend is identified by a label at the top of the table.
Displaying Trends Welch Allyn 106 Propaq Encore Reference Guide
Printing Printing Patient Data Printing Waveforms If you have an expansion module set up with your monitor, you can print any waveform by pressing either the SNAPSHOT or START/STOP button on the expansion module when the waveform is displayed on the monitor. You can also set the monitor to print automatically. The number of seconds of data shown on the printout depends on the print speed set in the Printer Setup window. Patient vital sign numerics are printed above the waveforms.
Printing Patient Data CO2 and RESP Waveforms CO2 waveforms are printed on a grid with major divisions (vertical dotted lines) every 5 mm, and the pressure scale grids are printed horizontally. The waveforms and numerics are labeled as MCO2 for Mainstream CO2 and SCO2 for Sidestream CO2. If neither CO2 option is active, the label is simply CO2. On the SNAPSHOT command only, the CO2 and RESP waveforms will be printed with different sweep speeds than the other waveforms.
Printing Patient Data Printing NIBP Measurements You can print the results of an NIBP measurement each time one occurs. This printout is called the NIBP Ticket. The NIBP Ticket must be turned on in the Printer Setup window. 1. To turn on NIBP TICKET, press SETUP, MORE, PRINTER. The printer setup window appears. 2. Use the NEXT and CHANGE buttons to select and turn on the NIBP TICKET. This symbol indicates that the NIBP reading was taken in the presence of high motion artifact while monitoring ECG.
Printing Patient Data Printing the Apnea Ticket The Apnea Ticket documents the length of each apnea episode. The Apnea Ticket is printed after the patient resumes breathing . . . . . . and/or 60 seconds after the last breath was detected if the patient has not resumed breathing To set the Propaq to print an Apnea Ticket after an apnea event, follow these steps. 1. From the main menu, press the following buttons: SETUP, MORE, PRINTER. 2.
Printing Patient Data Printing When a Patient Alarm Occurs To set up the printer to print on a patient alarm, follow these steps. 1. From the Main Menu, press the following buttons: SETUP, MORE, PRINTER. 2. Press the NEXT button to select ALARM PRINT in the printer setup window. 3. Press the CHANGE button until ALARM PRINT is set to ON. PRINTER SETUP PAGE ( 85) PA 35/ 18 CONTINUOUS : 25.
Printing Patient Data OxyCRG The OxyCRG is a graphical printout of two minutes of continuous HR/PR and SpO2 numerics, and a condensed respiratory waveform. If any of the parameters have been completely inactive for the two minutes prior to the initiation of the print, the associated band will be empty. OxyCRG on Alarm When an alarm condition is detected, a print will be initiated if OXYCRG ON ALARM is turned on.
Printing Trends Printing Trends Printed trends are useful for reviewing the patient's vital signs over the last several minutes to the last five hours. The Propaq enables you to print one trend or several trends with a press of a button, or automatically at 4-hour intervals. Printing a Single Trend The best way to print just one trend is with the PRINT button in the Trends Menu. When you press the PRINT button, the displayed trend is printed.
Printing Trends Automatic Trend Prints To automatically print trends at 4-hour intervals, activate AUTO TREND and select the print times. Use the CHANGE button to set the trend print times according to the start time (clock hour) of each shift or to OFF. Once the Propaq is set up, it will print all the selected trends at each 4-hour interval. You can place the printouts in the patient's record at the end of each work shift.
Acuity Central Monitoring System Intended Use Warning Use of equipment, accessories, and parts not recommended or supplied by Welch Allyn could result in inaccurate patient information or damage to the system. When Acuity is inoperable, be sure to keep Acuity patients under close surveillance, especially those prone to arrhythmias. Use Acuity only in conjunction with close surveillance by trained clinicians. Connect the Propaq Encore to an Acuity system only.
Connecting to the Acuity System 2. If the Propaq Encore is not already connected to the patient, attach leads and sensors to the patient as described in Chapter 2 of this reference guide. 3. Plug in the Acuity network cable to the Acuity network jack on the Propaq Encore side panel shown in the following figure. Plug in the other end of the cable to the bedside Acuity network jack.
Press NET OFF to Disconnect from Acuity Warning If you don’t set alarm limits, Acuity uses preset settings (for arrhythmia limits), and the powerup default settings for the Propaq Encore. When a Propaq Encore in Adult or Pediatric Mode is connected to an Acuity System, the audio alarms at the bedside Propaq can be delayed up to 4 minutes and 15 seconds. The delay time is selected in Acuity software at the time of Acuity installation. Visual alarm indications are not delayed.
Printing at Acuity 2. Within 15 seconds, disconnect the Acuity network cable from either the Propaq Encore side panel or the bedside jack. If the patient will no longer be monitored with the Propaq Encore, turn off the monitor to erase trend information. If you do not disconnect the Acuity network cable within about 30 seconds, the monitor and Acuity attempt to reconnect and prompt you to confirm the patient ID.
Power Sources For in-hospital operation and recharging from ac mains, an ac power adapter plugs into the monitor. Use only a Welch Allyn ac power adapter to ensure protection against risk (leakage) current hazards. The Propaq Encore can also be powered and recharged from a dc source (isolated from ac mains) capable of supplying 12-28 Vdc and continuously supplying 25W.
Power Adapter Intended Use Verifying Proper Power Adapter Configuration Prior to using the power adapter, check it for proper voltage selection by looking in the small indicator window on the front end (by the power switch). If the number in the window does not match your ac mains source voltage (100-120V or 200-240V), the adapter should be reconfigured. See the illustration on page 121.
Power Adapter Intended Use Procedure 1. Unplug the power adapter’s removable cord from the ac mains outlet and the power adapter. 2. Turn the power adapter so you can see the window that indicates the voltage setting. 3. Using a small, flat-blade screwdriver, carefully pry the fuse module from the power adapter. 4. Replace both fuses with the specified type. Both fuses should be replaced at the same time, even if only one fuse has opened due to an overcurrent situation.
Power Adapter Intended Use Caution Make sure the voltage selector indicates the proper ac input voltage. If you change the adapter voltage setting, you must replace all fuses to match the appropriate type specified on the bottom of the power adapter. The only fuses contained in the power adapter when shipped from the factory are fuses specified for the original adapter input voltage setting.
Battery Care Battery Care Caution Leaving the monitor's lead-acid batteries in a completely discharged state may result in permanent battery damage. The batteries should be kept fully charged. Recharging Time The battery charges to full capacity within eight hours (if the monitor remains off). Monitor Functions Resumed In most instances, most monitor functions are usable immediately after plugging in the ac power adapter and cycling the power switch.
Battery Care Monitor Functions Based on Battery Voltage As battery voltage drops during extended monitor battery operation, error messages are displayed and monitor functions are discontinued in order of priority. Checking Battery Voltage The Propaq’s battery voltage is displayed on the initial powerup screen. The battery voltage is also displayed with the Settings window.
Care and Maintenance Inspect and Clean the Monitor and Accessories Before cleaning, thoroughly inspect the monitor and all accessories for any signs of damage, cracks, or improper mechanical function of keypads, switches, connectors, and printer paper door. While gently bending and flexing cables and tubing, inspect for damage, cracks, cuts, abrasions, extreme wear, exposed wires or bent connectors. Confirm connectors securely engage. Report damage or improper function to your service department.
Maintenance Caution Do not autoclave this product or its accessories. Do not immerse the monitor in liquid when cleaning. Do not immerse accessories in liquid when cleaning unless the accessory manufacturer’s cleaning instructions instruct you to do so. Maintenance Service Interval Recommendations At the intervals recommended below, verify the Propaq Encore for proper operation of all channels and internal circuitry.
Monitor Care Product Recycling You can return a Propaq Encore to Welch Allyn for recycling when the monitor reaches the end of its life (7 to 10 years). You can also return an Encore’s internal battery to Welch Allyn for recycling when it reaches the end of its life (3-4 years). Monitor Care Environmental Operating and Storage Limits Whenever possible, store the Propaq Encore at room temperature in a dry environment. For environmental operating instructions, see page 153.
Printer Maintenance Printer Paper Removal Caution If a Propaq Encore has a battery installed or ac power connected and is stored for an extended period without use, the printer paper can cause damage to the printhead. Before storing a Propaq Encore for more than two months without use, remove the roll of printer paper. Printer Maintenance Loading Paper Paper is loaded through the bottom of the printer. Caution Use only low-debris printer paper purchased from or recommended by Welch Allyn.
Printer Maintenance Load the new paper roll onto the spindle on the door. Feed the paper through the printer mechanism. 5. Slide the end of the paper into the slot of the printing mechanism until it extends out of the paper exit slot. 6. Close the paper door. 7. Place the monitor on its feet. 8. Simultaneously press the START/STOP button and the PRINT TRENDS button to produce a test print.
Customer Services Customer Services Ordering and Customer Service For ordering information, for the location of your nearest Welch Allyn sales representative or service center, or for more information on other Welch Allyn products, contact: Welch Allyn 8500 SW Creekside Place Beaverton, OR 97008-7107 USA Worldwide: (503) 530-7500 In the USA, toll-free: (800) 289-2500 FAX: (503) 526-4200 Technical Service If you need technical assistance on troubleshooting, are interested in customer technical training on
Defibrillator Synchronization These instructions are not intended to replace existing hospital procedures relative to the provision of cardiac electrical therapy and operation of the specific models of defibrillators. Use all safety standards and clinical protocols as defined by your institution. The Defibrillator Synchronization feature is designed to operate only with the PhysioControl LIFEPAK 5® and LIFEPAK 6s® defibrillators.
Removing the Defib Sync Interface from the LIFEPAK 5 2. Slide the Propaq Encore Defib Sync interface onto the left side of the LIFEPAK 5 until it snaps in place. 3. Connect the cable end to the Propaq’s DEFIB SYNCHRO connector on the right side panel. Removing the Defib Sync Interface from the LIFEPAK 5 1. To remove the interface, disconnect the cable end from the Propaq Encore. 2. Press the lever on the side of the LIFEPAK 5 and slide the interface forward until it is free from the defibrillator. 3.
Synchronized Cardioversion Using the LIFEPAK 5 Synchronized Cardioversion Using the LIFEPAK 5 1. Set up the LIFEPAK 5 Defibrillator and any other instrumentation according to institutional procedures and manufacturer’s operating instructions. Use the instructions above for installing the Propaq Encore Defib Sync interface. 2. Verify the integrity of the ECG patient electrodes and the fidelity of the ECG waveform on the Propaq Encore for tall, distinct R-waves and minimal artifact.
Synchronized Cardioversion Using the LIFEPAK 6s Sync Markers for the LIFEPAK 5 and LIFEPAK 6s T1 102.3 °F 18:45:28 II NIBP mV 1cm MON N I B P HR SYS DIA 135 81 88 135 (103) 81 MCO2 BR MEAN 35 mmHg 12 (103) SpO2 mmHg TIME SINCE READING: 10 min NIBP ECG/RESP INV PRS SpO2/CO2 99 SETUP Warning If the R-wave synchronization markers do not appear to be nearly simultaneous with the R-wave peaks on the Propaq Encore display or are not present, do not proceed with synchronized cardioversion.
Synchronized Cardioversion Using the LIFEPAK 6s 2. Verify the integrity of the ECG patient electrodes and the fidelity of the ECG waveform for tall, distinct R-waves and minimal artifact. Warning The R-wave amplitude must be at least 0.5 mV (5 mm tall when the Propaq Encore ECG sensitivity—SIZE button—is set to 1 mV/cm) to guarantee that the defibrillator sync pulse will occur no later than 35 milliseconds after the peak of an R-wave.
Defib Sync Message Warning If the R-wave synchronization markers do not appear to be nearly simultaneous with the R-wave peaks on the Propaq Encore display or are not present, do not proceed with synchronized cardioversion. You must press the LIFEPAK 6s SYNC button and check for appropriate synchronization markers on the Propaq Encore before each cardioversion. Welch Allyn cannot guarantee the delay from the sync marker to the defibrillator discharge.
Specifications ECG The ECG channel meets all the requirements for Cardiac Monitors Heart Rate Meters and Alarms specified ANSI/AAMI EC13-1992, except for Standardizing Voltage (section 3.2.9.9). The channel also meets the American National Standard, Safe Current Limits for Electromedical Apparatus (ANSI/AAMI ES1-1993). ECG Specifications Characteristic Specification Connector AAMI 6 pin or Hewlett-Packard compatible 12-pin style connector (optional). (See the illustration at the bottom of this table.
ECG Characteristic Specification QRS Detector Adult or Pediatric Amplitude Range: 0.22 to 5.0 mV (RTI) Neonatal Amplitude Range: 0.1 to 5.0 mV (RTI) Neonatal and Pediatric Width Range (Duration): 40 to 120 msec Adult Width Range (Duration): 70 to 120 msec Heart Rate Range 25 to 350 beats per minute (measurement) 25 to 300 beats per minute (display) Heart Rate Meter Response Time Responds to change in heart rate within 5 to 9 seconds depending on physiological waveform.
Real-Time ECG Analog/Defib Sync R SHIELD LA LA RL LL C RL LL C RA SHIELD HP 12-pin ECG connector side panel view AAMI 6-pin ECG connector side panel view Real-Time ECG Analog/Defib Sync Special cables are required to interface the defib sync connector to the Physio-Control LIFEPAK 5 or LIFEPAK 6s defibrillator. Real-Time ECG Analog/Defib Sync Signals Signal Specification Sync Output 0 to 5V pulse, 100 ±5ms wide, starts within 35 ms after peak of Rwave. 15 mA short circuit current.
Impedance Pneumography (RESP) Impedance Pneumography (RESP) Impedance Pneumography (RESP) Specifications Characteristic Specification Display Characteristics Sweep speed 3.13, 6.25, 12.5 mm/sec; user-selectable Amplitude range 1x, 2x, 4x, 8x, 16x Performance Characteristics Excitation signal characteristics 65 µA RMS ±5% at 63.
Invasive Pressure Invasive Pressure Applies only to models 204 and 206. Invasive Pressure Specifications Characteristic Specification Transducer Type Strain-gauge resistive bridge, or HP quartz (with HP Option). a Transducer Excitation Impedance Range 200 to 2000 Ω Transducer sensitivity 5 µV/V/mmHg Excitation Voltage 4.85V Pulsed dc @ 181 Hz b Connector ITT-Cannon plug MS3106F-14S-6P Std. Hewlett-Packard compatible 12-pin connector (optional).
NIBP NIBP NIBP Specifications Characteristic Specification Method Oscillometric Control Automatic and manual measurement control Auto Intervals 1, 2, 3, 5, 10, 15, 30, and 60 minutes Turbocuf Maximum measurements allowable in a 5-minute period Displayed Pressures Systolic, Diastolic, and Mean plus on-screen manometer Systolic Range Adult: 30 to 260 mmHg Ped: 30 to 160 mmHg Neonate: 25 to 120 mmHg Diastolic Range Adult: 20 to 235 mmHg Ped: 15 to 130 mmHg Neonate: 10 to 105 mmHg Mean Range A
Temperature Characteristic Specification Minimum Time between automatic measurements 30 seconds (Auto Mode) 2 seconds (Turbo Mode) Electrosurgery Interference Suppression Included in all models: 202EL, 204EL, 206EL NIBP Performance Per EN 1060-1, EN 1060-3, and ANSI-AAMI SP10-1992 NIBP Safety Per IEC 601-2-30 Temperature Temperature Specifications Characteristic Specification Range 0° to +50°C; 32° to +122°F Displays T1, T2, and ∆T Probes Compatible with YSI Series 400 and 700 probes.
Pulse Oximetry (SpO2) Pulse Oximetry (SpO2) Masimo SpO2 Specifications Characteristic Saturation (% SpO2) Range Resolution Alarm Limits Probe Accuracy (25° to 41° C) Adults, Pediatrics: No motion Specification 1% to 100% 1% 52% to 100% (upper) 50% to 98% (lower) 70% to 100% ±2 counts 0% to 69% unspecified Neonates: No motion 70% to 100% ±3 counts 0% to 69% unspecified Adults, Pediatrics, Neonates: During Motiona,b 70% to 100% ±3 counts 0% to 69% unspecified Pulse Rate Range: No motion Range: During m
Pulse Oximetry (SpO2) Nellcor SpO2 Specifications Specificationa Characteristic Saturation (% SpO2) Range Resolution Alarm Limitsb Probe Accuracyc (saturation levels between 70% and 100%, 28° to 42°C) Adult/Pediatric Neonatal Pulse Rate Ranged Alarm Limits Pulse Rate Accuracy No Motion During Motion 0% to 100% 1% 52% to 100% (upper) 50% to 98% (lower) Digit accuracy: ±2 counts Digit accuracy: ±3 counts Motion tolerant option: 25 to 249 beats per minute Option without motion tolerance: 25 to 250 beats p
Capnography (CO2) Capnography (CO2) General CO2 Specifications Characteristic Specification CO2 Display Screen Display CO2 waveform and ETCO2 and INCO2 (when in alarm) numerics Numeric Display Ranges ETCO2 INCO2 Waveform Scale (Maximum) 0-100 mmHg, 0-14 kPa, 0-14% Units mmHg, kPa,%; user-selectable Sweep Speed 3.13, 6.25, 12.5 mm/sec; user-selectable Response Modes Fast Normal Slow Gas Compensation OFF O2 > 50%, No N2O N2O > 50% Alarm Limit Ranges ETCO2 INCO2 0-99 mmHg, 0-13.2 kPa, 0-23.
Capnography (CO2) Characteristic Specification Barometric Pressure Pressure Compensation Automatic Operating Range -2,000 to 15,000 ft (-610 to 4572 m), 817 to 429 mmHg Screen Display Numeric (CO2 Status Window) Units mmHg or kPa Accuracy ±3 mmHg or 2.5% of difference from calibration pressure, whichever is greater a.Lower if in alarm. b.
Capnography (CO2) Mainstream CO2 Specifications Characteristic Specification Mainstream CO2 Sensor Sensor Type Mainstream Principle of Operation Non-dispersive, infrared, single-beam, single path/wavelength, ratiometric Warm-up time (CO2 sensor and monitor) 45 sec typical, 3 min maximum Response Time 30 ms typical, 60 ms maximum Waveform Rise Time <120 ms to 90% after step change Calibration Verify semi-annually, calibrate only as required Sensor Housing Temperature 42°C nominal Mainstream
Capnography (CO2) Sidestream CO2 Specifications Characteristic Specification Sensor Type Sidestream, internal Principle of Operation Non-dispersive, infrared, single-beam, single path/wavelength, ratiometric Operating Ambient Temperature 5° to 40°C Startup Time 30 seconds typical, 3 minutes maximum Rise Time 240 ms (10% to 90%) at 175 ml/min Delay Time 1.12 seconds maximuma Total System Response Time 1.
Alarms Alarms Alarms Specifications Characteristic Specification Indicators Flashing red ALARM light indicates patient alarm; continuously on ALARM light indicates patient alarms are suspended. Continuously on ALARM(S) OFF light indicates one or more alarm limits have been disabled. A flashing ALARM(S) OFF light indicates an equipment alert. Tone Frequency 900 Hertz Tone is steady for a patient alarm and sounds for 1 second every 4 seconds for an equipment alert.
Trends Trends Trends Specifications Specificationa Characteristic Model 202 Parameters NIBP, T1, T2, ∆T, HR (heart rate/pulse rate), SpO2, End-tidal CO2, Inspired CO2, Breath Rate Model 204 Parameters NIBP, P1, T1, T2, ∆T, HR (heart rate/pulse rate), SpO2, End-tidal CO2, Inspired CO2, Breath Rate Model 206 Parameters NIBP, P1, P2, T1, T2, ∆T, HR (heart rate/pulse rate), SpO2, End-tidal CO2, Inspired CO2, Breath Rate Duration 5 hours for non-NIBP trends (up to 150 readings) A maximum of 128 readings
Monitor (Environmental) Monitor (Environmental) Monitor Environmental Specifications Characteristic Specification Operating Temperature 0° to 40° C Shipping and Storage Temperature -20° to 60° C Operating Altitude -2,000 to 15,000 ft (-610 to 4,572 m) Shipping and Storage Altitude -2,000 to 40,000 ft (-610 to 12,192 m) Operating Relative Humidity 15% to 95%, noncondensing per MIL STD 810E, Procedure 1-natural Shipping and Storage Relative Humidity 15% to 95%, noncondensing per MIL STD 810E, Pr
Monitor (Physical) Monitor (Physical) Monitor Physical Specifications Characteristic Specification Protection Classifications, all Configurations a Type of Protection against Electric Shock:—Power Adapter Power adapter class 1 Protective earth not available in monitor. Monitor designed and tested Type of Protection against Electric Shock—Monitor (when connected to to meet Double Insulation Requirement.
Printer Printer Printer Specifications Characteristic Specification Operation Operating Modes Continuous, Snapshot, Freeze Print, Auto Print, Auto Trend, Tabular Trend, Alarm Print, NIBP Ticket, Apnea Ticket, OxyCRG, OxyCRG on Alarm Auto Print Intervals 15 min, 30 min, 1 hour, 2 hours, 4 hours Auto Trend Shifts Once every 4 hours Number of Waveforms Up to three: ECG, P1, P2, SpO2, CO2, RESP Grid 5 mm and 1 mm gradations Annotation Date, Time, Print Mode, Speed, Heart Rate, Systolic, Diastolic,
Power Characteristic Specification Electromagnetic Compatibility (EMC) Per IEC 601-1-2, which is a collateral standard of IEC 601-1, for electromagnetic compatibility.
Power Adapters Power Adapters Power Adapter General Specifications Characteristic Specification Protection Classifications, all Adapters a Type of Protection Against Electric Shock Class I, (Protectively Earthed) Degree of Protection Against Harmful For ordinary, indoor locations only.
Power Adapters Power Adapter Physical Specifications Characteristic Specification Universal Power Adapter, Part No. 503-0054-00, 503-0093-XX Length 5.0 in (12.7 cm) Width 3.6 in (9.1 cm) Height 3.1 in (7.9 cm) Weight 3.1 lb (1.4 kg) Rated Input 100V-120V ac, 500 mA, 50/60 Hz Rated Fuses T800 mA/250V, Time-Delay, 5x20mm Rated Output (Continuous) 16-24V dc, 25 VA Additional Features Detachable power cord, pilot light Universal Power Adapter, Part No. 503-0054-01, 503-0092-XX Length 5.
Factory Default Settings Factory Default Settings Factory Default Settings Characteristic Specification Datea MO/DA/YR, DA.MO.YR, or YR/MO/DA Decimala . (Period) HR/PR Sweep 25 mm/sec RR/BR Sweep 6.25 mm/sec Alarm Tone MEDIUM HR/PR TONE LOW HR/PR SOURCE ECG RR/BR Source CO2 if ON or ECG (if CO2 OFF) Patient Mode Adult ECG Bandwidth Monitor ECG Size 1 mV/cm ECG Lead II ECG Filtera 60 Hz ECG Pacer ON RESP size 2X RESP lead Ld2 RESP sweep 6.
Factory Default Settings Characteristic Specification Display Wave Select All waves are on except NIBP Trend Group NIBP Alarm Limits All are ON except P2 HR Limits Adult: 50, 120 beats per minute Ped: 50, 150 beats per minute Neonate: 100, 200 beats per minute NIBP Limits - Systolic Adult: 75, 220 mmHg Ped: 75, 145 mmHg Neonate: 50, 100 mmHg NIBP Limits - Diastolic Adult: 35, 110 mmHg Ped: 35, 100 mmHg Neonate: 30, 70 mmHg NIBP Limits - Mean Adult: 50, 120 mmHg Ped: 50, 110 mmHg Neonate: 35,
In-Service Simulated Values In-Service Simulated Values In-Service Values Channel Display Initial Value Alternate Value ECG Waveform Normal sinus rhythm, 1mV, Lead II Normal sinus rhythm ECG Heart Rate 80 beats per minute 125 beats per minute RESP Respiration Rate 12 breaths/minute 31 breaths/minute P1 Waveform Arterial Same as Initial Value P1 Pulse Rate 80 pulses per min 125 pulses per min P1 Systolic 121 mmHg 120 mmHg P1 Diastolic 79 mmHg 85 mmHg P1 Mean 96 mmHg 103 mm
Glossary ∆T Difference temperature. The difference between T1 and T2. AAMI Association for the Advancement of Medical Instrumentation (United States of America). AC Power Adapter The device that plugs into the 12-28V dc receptacle on the Propaq Encore's side panel to allow operation and battery charging from ac mains. Acuity Welch Allyn’s trade name for its central station patient monitoring system.
Auto Interval The interval at which NIBP measurements are initiated when operating in the automatic mode. Bell The symbol that appears in a window to indicate alarm limits status. If alarm limits have been set, a bell appears. BP Blood pressure bpm Beats per minute Blood Pressure Numerics Windows The two larger windows below the heart rate. These windows can display invasive pressures and NIBP pressures. BR Breath rate, expressed in units per minute or 1/min. BR is derived from CO2. See also RR.
CO2 A patient channel indicating the by-product of respiration, carbon dioxide, which is exhaled by the lungs. Configuration The patient channels included with each Propaq Encore model. A table in Chapter 1 lists the configuration of each Propaq Encore model. Cursor The highlighted block in a status window that indicates the selection you make by pressing the NEXT button. CVA Cardiovascular artifact. CVP Central venous pressure (label for an invasive blood pressure channel).
Equipment Alert Occurs when the Propaq Encore detects an equipment condition requiring operator assistance. A message describing the condition is displayed. Equipment Alert Window The window that appears during an equipment alert. Error Message The message that appears when the monitor detects a malfunction requiring factory service. Error Message Window The window that appears when the monitor detects a malfunction requiring factory service. This window contains error messages and numbers.
Gas Compensation A correction factor required to obtain accurate CO2 readings when elevated levels of O2 or N2O are present in respired gases. Heart Rate Source See Heart Rate/Pulse Rate Source. Heart Rate/Pulse Rate The heart rate derived from the heart rate/pulse rate source and expressed in units per minute or 1/min. See also Heart Rate/Pulse Rate Source. Heart Rate/Pulse Rate Source The source from which heart rate/pulse rate is derived. This source can be ECG, any pressure, including NIBP, or SpO2.
In-service Mode A user training aid built into all Propaq Encores that provides simulated signals for all patient parameters so that function of the display, alarms, and printer can be explored easily. The in-service mode is activated by the INSERV button. Invasive Pressure Label The two or three-character label that appears in the Invasive Pressure Numerics Window identifying the source of blood pressure. Labels The names appearing above the buttons.
PA Pulmonary artery (label for an invasive blood pressure channel). Parameter See Vital Sign Parameter. Patient Alarm The condition that exists when a vital sign parameter numeric violates an alarm limit. Patient Channel ECG, P1, P2, T1, T2, SpO2, CO2, NIBP and RESP. Patient Mode Selects Adult, Pediatric, or Neonatal mode settings for the monitor. These settings determine default alarm limits, maximum cuff inflation pressure, and other internal settings.
Rescale Mode The method used in invasive pressure display to show each waveform against its own scale. The scale is automatically selected for best viewing of the entire waveform. Respiration The exchange of oxygen and carbon dioxide in the lungs and with the cells of the body. RR Respiration rate, a measure of the frequency of respiration. See also Impedance Pneumography. Sensors The electrodes, transducers, probes, etc. used to obtain patient information.
SYNC Synchronization. Two uses apply: • A digital output pulse from the right side panel that starts within 35 msec of the peak of a QRS complex and is used for cardioversion. • A message in the SpO2 display indicating successful C-Lock. Temporary Patient Alarm An alarm limit violation that occurred and was corrected without operator intervention. Trend The accumulation of several hours of data at two-minute intervals.
Window An area on the display screen in which information is displayed. YSI An acronym for Yellow Springs Instrument Company. Zeroing The process by which an invasive pressure zero reference is obtained so that pressures can be related to atmospheric pressure. This process also nulls out any residual pressure indicated by a transducer with zero pressure applied.
Index AUTO/MAN button 61 Automatic intervals (NIBP) 62 Automatic NIBP measurements 61, 62 Automatic trend prints 114 A ac adapter connector 18 Accessories Products & Accessories book 13 Acuity System 115 Acuity menu 117 connecting 115 Intended use 115 Network Fault message 118 printing at Acuity 118 Adult Mode 56 Alarm Holdoffs 97, 150 ALARM light 19 Alarm Limits Menu 27 ALARM PRINT setting 35, 111 ALARM TONE setting 29 ALARM(S) OFF light 19 Alarms bells 91 changing individual limits 99 definitions and ind
Index ECG 45 INV PRS 53 NIBP 60 CO2 Menu 1 mm/sec button 78, 82 RANGE button 78, 81 CO2 Menu 2 FLOWRATE button 79 GAS COMP button 78, 79, 82 RESPONSE button 78, 79, 82 SOURCE button 78, 79 Connectors ac adapter 18 defibrillator synchronization 131, 135 ECG 41 INV PRS 50 NIBP 58 patient 22 power input 18 temperature probes 66 CONTINUOUS (print speed) setting 35 Cuff (NIBP) placement 59 sizes 58 CURRENT SOURCE setting 29 Custom patient modes 33 Customer services 130 CVP, label for central venous pressure 54
Index LABEL (P1/P2) buttons 54 Invasive pressure accessories 50 connectors 50 displaying 53 intended use 40, 50 Menu 1 26 Menu 2 26 messages 51, 54–55 numerics 53 numerics formats 54 preparing for monitoring 51 printing waveforms 107 range 50 rezeroing a transducer 52 scales 54 specifications 141 transducer sensitivity 50 transducer zeroing 51 Invasive pressure labels ART (arterial) 54 CVP (central venous pressure) 54 ICP (intracranial pressure) 54 P1 54 P2 54 PA (pulmonary artery) 54 selecting 52 UA (umbi
Index NIBP button 60, 61 SETUP button 29 SpO2/CO2 button 26 MAIN MENU button 25 Mainstream Capnography (see CO2) Mainstream CO2 monitoring 80 Maintenance monitor care 127 power adapters 119 printer 128 replacing monitor fuse 124 service intervals 126 Marriott Configuration (MCL), electrode placement 43 Menus Alarm Limits 27 Alarms 27, 91 CO2 Menu 1 26, 78 CO2 Menu 2 26 CO2 Menu2 78 ECG Menu 1 26 ECG Menu 2 26 ECG/RESP 45 INV PRS Menu 1 26, 53 INV PRS Menu 2 26, 53 Main 26 NIBP 26, 60 Patient Alarm 95 Print
Index AUTO/MAN button 61 INTERVAL button 61 START button 60 STOP button 60 TURBOCUF button 61 NIBP TICKET setting 35 NO INSRV button 28 Noninvasive blood pressure (see NIBP) Numerics, flashing 95 NXT TRND button 103, 105, 113 Power input connector 18 specifications 155 Power adapters 119 specifications 156 Powerup patient modes 33 Powerup tones expansion module/SpO2 module 20 monitor 20 PR TREND button 35, 113 PREV MENU button 35 PRINT button 103, 113 PRINT TRENDS button 36, 113, 129 Printer 17 loading pa
Index PRINT button (see also Trends Menu) 113 Printer Setup window 110 RESP waveforms 108 Setup Menu 2 109 speed 107 SpO2 waveforms 107 sweep speeds with SNAPSHOT 108 trends 113 trends according to shift 114 with an expansion module 107 Probes, temperature 66 Products & Accessories book 13 Programmable settings effect of battery removal 127 lost 21, 102 Propaq buttons 25 documentation set 13 screen display 24 Propaq CS Physical inspection 125 Propaq-to-Acuity option overview 17 Pulse oximetry (see SpO2) S
Index continuous monitoring 103 how to display 104 how to select 105 maximum number of samples 104 Menu 27, 103 NIBP 104 NIBP and symbol 104 NXT TRND button 103, 105, 113 OXYCRG button 103 P1 103 P2 103 PRINT button 103, 113 printing each shift 114 printing one 113 printing several 113 programmable default 104 RESP 103 specifications 151 status window 103 Symbol and NIBP 104 TEMP 103 TRENDS button 104 TRENDS button 29, 104 TURBOCUF button 61 Sensor selection 69, 70 size indicator 107 specifications 144 Sp
Index SpO2 70, 71 Waveforms display priorities 31 ECG 31 scales 54, 81 size 45 Windows Propaq screen 24 Z ZERO (P1/P2) buttons 54 Zeroing messages 51 transducers 51 Propaq Encore Reference Guide 178 Welch Allyn
