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1. FENa Fractional excretion of sodium CH20 Free water clearance URKEx Urine potassium excretion CCr Creatinine clearance rate FEUr Fractional Excretion of Urea Na K Sodium potassium ratio CUUN Urine urea nitrogen clearance rate Cosm Osmolar clearance U P osm Urine to plasma osmolality ratio BUN SCr Blood urea nitrogen creatinine ratio U SCr Urine serum creatinine ratio 9 5 Oxygenation Calculation 9 5 1 Input Parameters Abbreviation English Full Name Description HT Height WT Weight C O Cardiac output FiO2 Percentage fraction of inspired oxygen PaO2 Partial pressure of oxygen in the arteries PaCO2 Partial pressure of carbon dioxide in the arteries SaO2 Arterial oxygen saturation PvO2 Partial pressure of oxygen in venous blood SvO2 Venous oxygen saturation Hb Hemoglobin CaO2 Arterial oxygen content CvO2 Venous oxygen content VO2 Oxygen consumption RQ Respiratory quotient ATMP Atmospheric pressure A Calculation and Titration Table ENSEMBLE CMS Central Monitoring System User Manual 9 5 2 Output Parameters Abbreviation English Full Name Description BSA Body surface area VO2 Calc Calculated oxygen consumption C a v O2 Arterial venous oxygen content difference O2ER Oxygen extraction ratio DO2 Oxygen transport PAO2 Partial pressure of oxygen in the alveoli AaDO2 Al
2. 24 ENSEMBLE CMS Central Monitoring System User Manual Review 5 2 Wave Review The ENSEMBLE CMS can review the change process of the physiological waveform of one patient in the latest 72 hours And the system can provide 72 hour waveform review To use 72 hour waveform review please click on Main Screen gt Review gt Wave Review On this screen you can Review normal waveforms or compressed waveforms Set wave speed Select wave Refresh waveform Print 5 2 1 Reviewing Normal Waveforms Normal waveform review is available to all parameter waveforms In the normal waveform review window the waveform is displayed with the same altitude and speed of the real time waveform You can select Show parameters Hide parameters If you select Show parameters the related parameter value will also be displayed accompanying the waveform you choose In this window waveforms can also be presented by automatically sliding forward 5 2 2 Reviewing Compressed Waveforms Compressed waveform review is only available to ECG waveforms In the compressed waveform review window the altitude of the ECG waveform will be compressed so that you can review the waveform containing longer time of data 5 2 3 Setting Wave Speed By clicking on the Wave Speed button you can set the width of waveforms displayed in the waveform area Available options are 6 25 mm s 12 5 mm s 25 mm s and 50 mm s Changing wave speed will affect t
3. CO lead off NIBP SYS HIGH CO lead off NIBP SYS HIGH NIBP SYS HIGH CO lead off NIBP SYS HIGH NIBP mmHg 68 60 62 CO lead off ST_AVL HIGH ST_AVL HIGH NIBP 2 mmHg 68 60 Figure 10 1 Main Screen of CMS WEB Structure of the main screen 1 Information area Displaying the hospital name and current system time 44 ENSEMBLE CMS Central Monitoring System User Manual CMS WEB Observer 2 Main monitoring screen Indicating the current status of each bedside monitor The onscreen bedside monitors are networked The red color in the alarm area of the patient section indicates the bedside monitor has high priority alarm The yellow color in the alarm area of the patient section indicates the bedside monitor has a medium or low priority alarm When four or less four bedside monitors are networked the layout of patient sections will be of single row as Figure 10 2 shows Test Hospital Current Time 12 20 2011 17 25 36 CO lead off STA IGH CO lead off CO lead off NIBP mmHg 62 60 69 Figure 10 2 When over four bedside monitors are networked the screen displays patient sections as shown in Figure 10 1 with a maximum of eight bedside monitors NOTE The number of displayed waveforms on each patient section will vary with the resolution of your computer monitor The maximum number of waveforms displayed on each patient section is four It is recommended to use comp
4. Physiological alarms are implemented by alarm limits which define a range in which a certain physiological parameter is considered to be in the normal status When a parameter value is beyond the range the system will consider it to be in an abnormal status and consequently give an alarm 6 1 2 Technical Alarm Technical alarms refer to the technical alarms of bedside monitor Technical alarms of bedside monitor refer to alarms other than physiological alarms including hardware failure communication error lead off etc For these technical alarms the system presents four different types of audible and visual prompts When a group of technical alarms for example transducer falls off produced by multi parameter monitors a piece of alarm prompt information in scrolling mode will appear on the main screen of ENSEMBLE CMS In addition the ENSEMBLE CMS will sound low level alarm and the corresponding bedside monitor status indicator will also show low level signal color NOTE The alarm signal will be delayed for no more than 5 seconds 6 2 Alarm Level Alarm level reflects the severity of an alarm The ENSEMBLE CMS has three levels of alarm High level alarm Medium level alarm Low level alarm The ENSEMBLE CMS indicates different levels of alarm by varying the color of the alarm area in the patient section 30 ENSEMBLE CMS Central Monitoring System User Manual Alarm Management 6 3 Alarm Mute Alarm mute mean
5. 5 4 2 Viewing Parameters selectively est nat 27 543 Refreshing DS IC Tm 28 SAR Printing Trend RevIGW s d i ie bc dee o 28 5 4 5 Selecting Trend Table Trend Graph ater ertet ii xs 28 S4 NIBP REVIEW niet eb Ri ct ib dtativistaisi bild ae eer ir de dad 28 SO l2 ead REVIEW AR IA RA 28 2 1 6 0 Meas re REVIEW En dC 29 5 8 Ouick Temp REVE Wain suas etal aout Pee sales Sala fo att od alate eu Pad ee 29 Chapter 6 Alarm Management soriano coran sesnenssseneaessusossoesssoouvostenssoastebavenesscnavesevasese 30 A a E eue i n e isst o M EE 30 6 1 1 Physiological Information A latii ideas ta tannins ans 30 6 1 2 Technical ATaEBE data 30 SN ATT M qiie d MUN E 30 6 3 Vigili c 31 ON AE Voice PAU SG EE O dde ene 31 OS Alarm Prompt RESPONSE id AAA nine Ten 31 5 6 Alarms TOt Networking Status sucht cot emt ea e en ee Re te ne 32 Chapter 7 PrIntllie 2nd osent o pn ne ka s sovnpedsusestcosasbnsuasvunssvseesoagnissenssvesevasss 33 7 1 Printing Report with a Printer eie tte aee nce ra mean ide ste 33 TAMPERE VA W SELLING A fee abcess me t ees Shay a occas et duo de 33 pus watananpaaeatraussaton 33 TD CLUBS ouv CN NS dt MALA TER ELM LA TS 34 1 3 Bxporting the PDF Pile euer refe en teri da 35 Chapter Database Management ccsisiccccisscessciecscncsscassctentosocseseavesdenuesscnssdsvesdevensnssencnstctoarennesee 36 8 1 Database Bac D nn a mures 36 8 2 Reviewing Backup DATA ASG is ss see tete do
6. Ensure that the ENSEMBLE CMS system can give the test sound after startup 12 ENSEMBLE CMS Central Monitoring System User Manual Basic Operations 3 2 2 Shutting down the system It is important to shut down the system properly Follow this simple procedure to properly shut down your system This prevents inadvertent errors from occurring during system shut down The ENSEMBLE CMS can work continuously for a long time You do not need to shut it down in order to achieve a longer working life You should follow the procedure to shut down the ENSEMBLE CMS Method 1 Select Shut Down on the main menu and enter the password Confirm the password by clicking OK and the ENSEMBLE CMS as well as the operating system will be shut down Method 2 Select System Setup gt User Maintain and enter the password select Other Setup Select Shut Down the ENSEMBLE CMS as well as the operating system will be shut down Select Return to Windows you will exit from ENSEMBLE CMS but the operating system will not be shut down WARNING 1 Shut down the system by strictly observing the shutdown procedure to avoid serious result 2 Although UPS is an optional configuration of this system if you really force to turn off the UPS it results in system failure and hence affects the operation of next time 3 If power cut off occurs turn off the system before the UPS exhausts its electricity CAUTION Hospitals without a stable power source sh
7. renal function calculation and ventilation calculation Patient information printing 12 lead analysis result printing C O review printing Quick TEMP review printing NOTE ENSEMBLE CMS only supports printing on A4 paper 7 2 Preview Settings 7 2 1 Preview Before the reports are printed you can preview them on the screen You will access the preview interface after you select the function of printing If a report consists of more than one page you may select a certain page to preview by turning to the page you want Besides you can adjust the zoom setting by choosing a certain option from the drop down list of the SIZE Below is the preview interface of the wave review 33 ENSEMBLE CMS Central Monitoring System User Manual Printing HOSPITAL DEBUG DEMO DEPARTMENT Sensor Off 2 P RESP APNEA 5 edan monitor Sensor Off 1 00 RESP APNEA 100 80 60 RE 99 79 59 2 edan monitor Sensor Off 2 0 RESP APNEA 7 edan monitor 100 8060 3 edan monitor Sensor Off 1 160 RESP APNEA 6 edan monitor 99 79159 Deno PMode 493171 80 4 edan monitor Sensor Off 2 E RESP APNEA Disconnected Patient Mgmt Single Bed View Wave Review Alarm Review Trend Review NIBP Review Parameter Waveform Setup 12 L Review Alarm NIBP Setup Calcula gt x AFull Screen print i ml 71 su SC cie Wave Review Fir T ime 08 01 2013 17 09 54 Wave End Time 08 01 2012 17 10 04 Sweep EI D
8. Calculation and Titration Table 9 1 General ENSEMBLE CMS provides functions including drug calculation and titration table hemodynamic calculation oxygenation calculation renal function calculation and ventilation calculation the calculation results can be printed out Click on Calculation in the status of single bed view to access the drug calculation screen ENSEMBLE CMS is able to save a maximum of 100 groups of results for every type of calculation In the calculation window you can use the Save button to save the calculation results and use Calculation Result List to review each calculation result 9 2 Drug Calculation From the Drug drop down list you can select one to calculate its amount liquid volume concentration etc Drug A EPINEPHRINE Drug B HEPARIN Drug C ISUPREL 9 Drug D LIDOCAINE 9 DrugE NIPRIDE AMINOPHYLLINE NITROGLYCERIN DOBUTAMINE PITOCIN DOPAMINE NOTE Drug A Drug B Drug C Drug D and Drug E are user defined drugs The calculation procedure is listed below 1 Confirm whether the patient type is correct and the weight is entered Select a drug to be calculated from the drug list 2 3 Input correct parameter values under the direction of a doctor 4 Select Basic Dose Type and Step for titration table 5 Click on the Cale button the calculation result will be displayed in the drug parameter area and titration table 37 ENSEMBLE CMS Central Mon
9. EUH u kd AA odo did FO main Screen f Audio Pause Review E System Setup Shut Down af Admission Figure 7 1 Preview 7 2 2 Settings Click on Print on the preview interface and a dialog box will pop up as follows Printer Name HP LaserJet 1020 v Properties Status HP LaserJet 1020 tatus PDFCreator Type HP LaserJet 1020 Where USBOO1 Comment Print range Copies All Number of copies 1 ET C Pages from 1 to 2 Cancel Figure 7 2 Settings Select the printer the print range and the number of copies in demand and then click on OK to confirm it 34 ENSEMBLE CMS Central Monitoring System User Manual Printing 7 3 Exporting the PDF File ENSEMBLE CMS can export the PDF file by installing a PDF printer software The software PDFCreator is recommended You can obtain the installation version of PDFCreator in the ENSEMBLE CMS installation disk Also you may download it from the website http www pdfforge org pdfcreator To export the PDF file please choose a PDF printer for instance PDFCreator from the drop down list when you select the printers Figure 7 3 and then confirm it by clicking on OK Printer Name PDFCreator X Properties HP LaserJet 1020 Status Eine Type PDFCreator Where PDFCreator Comment eDoc Printer Print range Copies e All Number of copies 1 Pages from 1 to 2 c Cpl spl el Cancel Figure 7 3 Select a PDF Print
10. Setting Waveforms and Parameters sets uma ethnies laces 22 4 11 1 Setting Waveforms to be Displayed nee lord coe een tk dona 22 4 11 2 Setting Parameters to be Displayed svc ene eue be oats 22 4 12 Bilateral Control in Patient Section eia ee A i er eb ee ded 23 4 12 1 Controlling NIBP Setup of Bedside Monitor 23 4 12 2 Controlling Alarm Setup of Bedside Monitor 23 Chapter S Review o0 etii bivese eva tec tresses sonne isa bun e Se bee esters Sen eee titre 24 e ds tnt 24 2 1 1 Discharging Patient cass cie etes t orto cetero etaed ver GO tat qul obe re 24 odd Ono Patient cease seg n trm eate rae e tacendum tu eie 24 5 2 Wave RO ah nee ut nt Monette 25 5 2 1 Reviewing Normal Waveforms nine nt nn dtr eden e ed uides 25 5 2 2 Reviewing Compressed Waveforms ssh ais s 25 512 3 Setting WAVE SPCC oce are snb AT dtu me hen edi 25 5 2 4 Refreshing Waveform miii e eaedem e foetum sce atu d 25 5 2 5 Selecting Waveform nilo latas 25 2 2 OM EIN eer et ce rate MC MM a a allie RN ANI ek 26 5 3 Alarm Review sees title ite bebo v E RH a Na E UR etus 26 5 3 1 Locking and Unlocking Alarm Information 26 2 3 2 Printing Alarm OO AAA e caus canted a paite PR del 26 2 9 2 36qdeneme the Alarm EISE cis oett e en a e etu tiet ool ums 26 9 9 Am ai PALIT e adt e oe a UE 27 5 3 0 PENAS Alarm EVENTS A a ia ein a e ERA D da 2I IV 5 4 Trend REVICW zoo o Gc RS antes SE RE Te e en LT Re ne 27 5 4 1 Setting RESON ON 5 oder etre Re ae i heute DAS 27
11. To add a new parameter to be displayed select the desired parameter name in Available Params and click on Add to add it into Current Params and then click on Refresh ParamGroup to update the parameters displayed on the patient section Removing a parameter displayed To remove a parameter displayed select the parameter in the Current Params box and click on Remove and Refresh ParamGroup Setting Parameter Order for Display To adjust the display position of the parameter select the parameter name in the Current Params box and click on Move UP or Move Down To make the change valid click on Update ParamGroup NOTE Due to the limited display space the displayed waveforms and parameters of each patient section will decrease as the displayed patient sections increase If you want more waveforms and parameters to be displayed on the screen please modify the display layout by reducing the displayed patient sections 22 ENSEMBLE CMS Central Monitoring System User Manual Viewing Single Bed 4 12 Bilateral Control in Patient Section 4 12 1 Controlling NIBP Setup of Bedside Monitor Click on Alarm NIBP Setup on the single bed view screen to access the bi control interface Here you can modify the measurement mode and measurement interval of NIBP The operation steps are shown as follows 1 Click on the NIBP Setup button on the bilateral control interface 2 Choose the desired measurement mode or measurement interval 3 Cl
12. Typical Screens of the ENSEMBLE CMS eene eee ue 7 2 4 Large PontDISpEdse s E tete tr babet ef E ur a de 9 2 4 1 Entering large Font WmdoW uso ctio dites a 9 2 4 2 Closing Large Font Window eer pa co eem a tO e obese Rs 11 Chapter 3 Basic Operations ss css de iia 12 O ES eae 12 3 2 0peratinig Method ii AA bad DR e EUR 12 20 A a ersten se Te cos e D A as 12 3 2 2 Shutting down the System sch sacer A t Ree edens 13 32 3 ON 13 32 4 MOUSE ODSPACIO SA Due art edt A Rr ettet uideat oe he re hee e edis 15 3 2 Patient SECTION end nant sesta ibo data 15 SAEI CIS LES LOL ed E TEUER DS MEC LEN 16 3 4 1 Common Setup e han ns ipee oH YR D Pede p e ende aa ae 16 3 42 User oot obstat dn iiem apa Mts KM M M Ou 17 Chapter 4 Viewing Single Bed oiscissicsccsessscscsssecsdssoodstscssoussessesdsdacsoansscepaes svndessucsscdondssseucsatsecssasease 20 4 1 Setting Patient InfOEriatiODuss eoe oe tad Cased ore m ef T etse 20 4 2 Hiding Showing Multi lead WayefOrtiks 5 ai ir tea te e bem IT 20 4 3 Real time Printing odo med een ter odd e renta etel ax e dus ent 20 44 Short Trend REVIEW e DES ride e ane Itin di sia mci pede 20 a R Ea 17A nn 21 A E een 21 4 1 Setting Wave REVIEW TE inene a oce a ate netu tae 21 4 LI Setting Wave Speed x ic amener mean ni tt At des 21 4 7 2 Refreshing WANE ROTTING SR nn ne ea 21 NE 21 4 8 Setting Alarm Reviews e e Les 21 4 9 Setting Drend ReVIEW AA dba 21 4 10 Setting NIBP REVICW Ads 22 4 11
13. displays the parameter names from which you can choose the right column displays the parameter names which have been selected Adding a parameter to be displayed To add a displayed parameter choose one from the left column and click on Add so that it can be added to the right column Deleting a displayed parameter To delete a displayed parameter choose one from the right column and click on Remove so that it can be deleted from the screen NOTE 1 You can only select a maximum of four parameters to be displayed on each patient section 2 You can only add or delete one parameter one time 10 4 1 6 Setting Wave Speed Select System Setup gt Common Setup gt WaveSpeed you can set the speed for a selected waveform Choose one waveform from the Wave Name list and the chosen one will be highlighted as shown in Figure 10 4 then select a speed from the drop down list of New Speed 48 ENSEMBLE CMS Central Monitoring System User Manual CMS WEB Observer v C3 Coramon Setup Speed mmis _ Personal Infor 1 25 _ Password Change 25 _ Unit Setup L Wave In Multi bed mero ee PE RESP III 25 25 L Language gt Ca Administrators Setup New Speed 12 5 Figure 10 4 Wave Speed Setup 10 4 1 7 Setting Language Select System Setup gt Common Setup gt Language click on Z and select a language from the drop down list NOTE To ensure the normal display of CMS WEB restart the system after you fini
14. effective 3 4 2 3 Alarm Setup Alarms triggered by a physiological sign that appears abnormal or by technical problems of the monitor are sent to the ENSEMBLE CMS by the monitors and then indicated to the users by the ENSEMBLE CMS All alarms originally come from the monitors The prompts coming from the ENSEMBLE CMS are displayed in the system prompt area on the upper screen The user can enable disable alarm mute function by selecting deselecting the Alarm Mute check box When Alarm Mute is not selected the alarm Mute is disabled When Alarm Mute is selected the alarm mute function is enabled The PY icon is displayed at the top area of the screen You can set the audio alarm mute duration to 1 min 2min or 3min from the drop down list The user can set alarm sound intervals by selecting Main Screen gt System Setup gt User Maintain gt Alarm Setup and set the desired intervals from the drop down list of High Alarm Interval s Med Alarm Interval s and Low Alarm Interval s NOTE Once a new alarm occurs the system will neglect the existing setting of alarm mute and generate a new alarm 3 4 2 4 Changing Language To change the display language please select Main Screen gt System Setup gt User Maintain and input the correct password Select Language Setup and select the desired language from the drop down list NOTE The user must restart the system to make the change effective 18 ENSEMBLE CMS Central Monit
15. its parameter alarm settings The obtained configuration will be displayed in the left templet pane Choose the monitors needing to be configured in the right pane and click Config to complete batch settings S47 ENSEMBLE CMS Central Monitoring System User Manual Basic Operations NOTE 1 The function of batch setting is not available for all monitors If the monitor is labeled as Not Supported in the Compatibility column in the right pane this function is not available for this monitor 2 If the patient type set in Templet of Alarm Limit Adjusting Range is different from the one set on the bedside monitor to be configured the system may fail to set the configuration for the monitor 3 The prompt message Success only indicates success in setting the configuration for current activated parameters on the monitor 3 4 2 2 Date Time Setup The user can set the correct date and time and their desired format There are three kinds of date and time format yyyy MM dd dd MM yyyy MM dd yyyy two kinds of time format HH mm ss 24 hours and hh mm ss tt 12 hours and three date separator and To change the date and time setup please select Main Screen gt System Setup gt Common Setup gt Date Time Setup and select the desired settings from the right menu The time and date displayed on the main screen will also change after change the date and time setup and their format NOTE The user must restart the system to make the change
16. section about refreshing waveform 4 7 3 Print For the details about the printing waveform please refer to the section about printing waveform 4 8 Setting Alarm Review For the details about the alarm review please refer to 5 3 Alarm Review 4 9 Setting Trend Review For the details about the trend review please refer to 5 4 Trend Review 21 ENSEMBLE CMS Central Monitoring System User Manual Viewing Single Bed 4 10 Setting NIBP Review For the details about the NIBP review please refer to 5 5 NIBP Review 4 11 Setting Waveforms and Parameters The Setup function is used to modify the display information at the patient section according to the real requirements By using this function you can observe the waveform and the parameter as your desire 4 11 1 Setting Waveforms to be Displayed The screen can display 4 waveforms maximumly at a time To change the waveforms displayed on the screen please click on any area of the patient section to enter the setting screen of the single bed patient and select Setup And tick the check box of the desired wave name and click on Update Wave Setup to confirm this operation 4 11 2 Setting Parameters to be Displayed The screen can display 4 parameters maximally at a time To change the parameters displayed on the screen please click on any area of the patient section to enter the setting screen of the single bed patient and select Setup Adding a parameter to be displayed
17. the patient section including single bed view control Waveform display area display a group of waveforms The waveform name is displayed on the upper left part of the waveform Parameter display area display the parameter information about the viewed bed Due to the limited display space you shall properly choose a group of parameters to better make use of the display area Alarm information area display the alarm information of the patient Status information of bedside monitor Patient information Due to the limited display space of the patient section users can select a maximum of four waveforms and four parameters to be displayed To set the displayed waveforms and parameters you can select Parameter Waveform Setup from the list shown in Figure 2 4 also you may select the tag Parameter Waveform Setup in the Single Bed window Refer to 4 9 Setting Waveforms and Parameters for more information For detail information please refer to the chapter about viewing single bed NOTE 1 Due to the delay of network transmission the waveform viewed at the ENSEMBLE CMS has a delay of 5 seconds compared with the waveform generated at the corresponding bedside monitor 2 Due to the operating system schedule the waveform scan of the ENSEMBLE CMS might be suspended for about 20 milliseconds in very few occasions After the suspension waveform scan will go back to normal status The quality of patient monitoring durin
18. the Single Bed View window you can freeze the waveform displayed in this window to analyze waveforms of interest by clicking Freeze and unfreeze the waveform by clicking Unfreeze The freeze time and a timeline will also be displayed in the window You can use the arrow buttons EN and A beside the timeline or drag the pointer on the freeze wave to review more details You can review a frozen waveform of 3 minute period in length 4 6 OxyCRG In the Single Bed View window click View Selection gt OxyCRG and the OxyCRG window will be open You can switch the display between respiratory rate and respiratory waveform by clicking RR and RESP You can also set the interval of the OxyCRG to 1 minute 2 minutes or 4 minutes 4 7 Setting Wave Review After click on Wave Review on this screen the bed No name gender and type and wave settings are displayed To change the displayed waveform select Select Wave on the screen and a list of available waveforms will be shown You can select a waveform by ticking its check box By default there are 4 waveforms displayed on this screen 4 7 1 Setting Wave Speed By clicking on the Wave Speed on this screen you can set the width of waveforms displayed in the waveform area Available options are 6 25mm s 12 5mm s 25mm s and 50mm s Changing wave speed will affect the time length of the waveform area 4 7 2 Refreshing Waveform For the details about the refreshing waveform please refer to the
19. you have not set the starting time the system will output the latest data by default If you have set the starting time the system will start to output data at the point of the set time The system allows you to output a maximum of 720 pieces of data NOTE The set starting time for printing will be invalid after the data is output For more details about trend review refer to relevant content for ENSEMBLE CMS in the section 5 4 Trend Review 10 5 6 NIBP Review In the NIBP Review window you can view up to 720 groups of NIBP measurements of an online patient The NIBP review window displays Serial No Measure Time SYS DIA MAP and PR for each measurement Additionally you can Refresh Print NOTE 1 Make sure a PDF reader has been installed in your computer which enables you to preview and open the printing document 2 CMS WEB only supports printing on A4 paper Make sure you have set the paper size to A4 in the printing setup 3 If the main menu is not displayed onscreen after clicking on the print button and return to the CMS WEB screen check your browser setup For Firefox browser select Tools gt Options gt Tabs and tick the check box of Always show the tab bar 52 ENSEMBLE CMS Central Monitoring System User Manual Safety Chapter 11 Safety 11 1 Control and Safety Index Windows XP Windows 7 workstation printer UPS optional Keyboard display and mouse should accord with the corresponding safe
20. 0 hour trend review for each bedside monitor 12 hour short trend dynamic display for each bedside monitor Alarm waveform 720 pieces of parameter alarm waveforms for each bedside monitor Alarm type Physiological Alarm Technical Alarm Alarm mode 3 levels of audible and visual alarms Waveform storage and 72 hour waveform for each bedside monitor review 56 ENSEMBLE CMS Central Monitoring System User Manual Specifications NIBP measurement storage 720 pieces of NIBP measurement for each bedside monitor and review 12 lead analysis results 720 pieces of 12 lead analysis results for each bedside monitor C O measurements 720 pieces of C O measurement for each bedside monitor Quick TEMP 720 pieces of Quick TEMP measurement for each bedside measurements monitor 57
21. 1 2 Setting Password Select System Setup gt Common Setup gt Password Change you can change the login password 10 4 1 3 Setting Parameter Unit Select System Setup gt Common Setup gt Unit Setup you can change the units of IBP NIBP CO AG CO AG O C O TB and TEMP 10 4 1 4 Setting Multi Bed Waveform Select System Setup gt Common Setup gt Wave In Multi bed you can set the physiological waveforms displayed on the patient sections In this window the left column displays the waveform names from which you can choose the right column displays the waveform names which have been selected Adding a waveform to be displayed To add a displayed waveform choose one from the left column and click on Add so that it can be added to the right column Deleting a displayed waveform To delete a displayed waveform choose one from the right column and click on Remove so that it can be deleted from the waveform display area 47 ENSEMBLE CMS Central Monitoring System User Manual CMS WEB Observer NOTE 1 You can only select a maximum of four waveforms to be displayed on each patient section Also the number of displayed waveforms is subject to the computer resolution 2 You can only add or delete one waveform one time 10 4 1 5 Setting Multi Bed Parameter Select System Setup gt Common Setup gt Para In Multi bed you can set the physiological parameters displayed onscreen In this window the left column
22. 162162 4 edan monitor Sensor Off 2 0 RESP APNEA Sp02 NIBP 164 62 62 Review Al Main Screen D Audio Pause Ca b System Setup Lo Shut Down Introduction 08 01 2013 17 14 49 Sensor Off 1 160 RESP APNEA Spo2 5 edan monitor 74 NIBP 163 61 61 NP leth A Moo LS J J 7 edan monitor 6 edan monitor NIBP 123 71 80 ro Demo Made Disconnected af Admission Figure 2 4 Large Font Menu When you want to view one bed s parameters in large font you can select the first command After clicking on the menu the parameters of the bed will be displayed in large font as shown in Figure 2 5 HOSPITAL DEBUG DEMO DEPARTMENT 1 edan monitor 08 01 2013 17 00 53 Sensor Off 1 P edan monitor 188 RESP APNEA Spo2 NIBP Sp02 99 103 86 89 CA A om 22 edan monitor MD RESP APNEA Sp02 7 edan monitor NIBP 102 85 88 69 RESP APNEA Sp02 6 edan monitor NIBP Va 1 NIBP BP fS x A NIBP 102 85 88 123 71 80 60 RESP APNEA E Disconnected NIBP 102 85 88 X System Setup Lo Shut Doun Figure 2 5 Viewing One Window in Large Font Review Pe Main Screen MN Audio Pause Ga b d Admission ENSEMBLE CMS Central Monitoring System User Manual Introduction When you want to view all parameters of current beds in large font you can select the Display all windows in large font command After selecting the command th
23. 6 10 3 2 Shutting Down the S VS Im See da 47 LOA SY Stetit SetuP eon A 47 10 44 Common STUD tri lee ess done ERA RR INR ERUAE Ue 47 10 4 2 Administrator Setup sec teo e aee a een e ESA 49 10 5 Viewing Single Bed due tovt eie tt 50 10 5 1 Patent fonat OM eee ceo Rn Nb EIS NEU RES uD dos 50 LOS 2 9 ingle Bed VIEN obe SA A ARS 50 DEO S Waveform REVIEW eei Rodeo aede er uiri Ce EIE 5 TOS dA Tace a A eet od tr E Gu Lud CC cte 5 10 5 5 Trend ROVIeW ao 51 VI UNC NIBP REVIEW ue eot A Det die 52 Chapter 11 SAV Pp bc pop S S3 111 Control o ee ie audeo A 53 11 2 Gharacteristics dre anne RON COPI IA ha ets ag ubi bad uino Pp tubas bru and 53 Ch pter 12 SERVICE ern tem Ma 54 Appendix I Specifications cirrus ronca eines 55 A1 1 Recommended Hardware Configuration ss 55 ANA Performante SERRE NES 56 VII ENSEMBLE CMS Central Monitoring System User Manual Intended Use and Safety Guidance Chapter 1 Intended Use and Safety Guidance 1 1 Intended Use ENSEMBLE CMS provides centralized monitoring and critical care management for patients monitored by MENNEN MEDICAL LTD bedside monitors From ENSEMBLE CMS clinicians can gain access to patient information for patients on the Network ENSEMBLE CMS displays waveforms parameters and alarm status of MENNEN MEDICAL LTD bedside monitors for up to 32 patients on a single screen or up to 64 patients using two screens 1 2 Safety Guidance To use the system safely and effectively and to avoid s
24. 6 Alarm Management for more information about alarms The display of the symbols KI and iJ The symbol i 4 indicates Pace is set to On The symbol Ne indicates Pace is set to Off 2 Information area The information area is at the top of the screen The hospital and department information is displayed on the left side of this area the system time is displayed on the right side and the prompt messages are displayed in the middle 3 Main menu The main menu Figure 2 3 is at the bottom of the screen Click on it to access corresponding windows or perform corresponding functions MB Main Screen Audio Pause 2 Review A System Setup 0 Shut Down Figure 2 3 Main Menu 4 Control icons Control icon area includes the following icons Icons Description Operating method KA Main Screen Click on it to return to the main screen Click on this symbol to make the alarm pause and the symbol x appears in place of the me Y And click Audio Pause x on the symbol to deselect the pause function and the symbol A appears in place of the symbol x Click on it to enter the review interface including patient n Review information review waveform review alarm review trend review and NIBP review ENSEMBLE CMS Central Monitoring System User Manual Introduction System Setup Click on it to enter the system setup menu Shut Down Click on it to shut down the ENSEMBLE CMS and the operati
25. 8 2 Reviewing Backup Database for more information You can select a patient from the list and click the Patient Mgmt tab to review detailed information of this patient Also you can double click the patient name in the list to open the patient management window 5 1 1 Discharging a Patient Discharging a patient is to terminate monitoring a patient and admit a new patient There are two ways to discharge a patient Click on Review gt Patient List to access the review interface for all patients Select a patient needed to be discharged from the patient list below and click on the Discharge button on the interface A dialog box will consequently pop up and ask for your confirmation Click on Yes the patient is discharged click on No the patient will remain If a patient is discharged from the Patient Review list partial information of his or hers can still be reviewed in the History Patient Review list If a patient is deleted from the History Patient Review list all information of this patient will be completely deleted from the system CAUTION If you delete a patient from the History Patient Review list his or her data will be completely removed from the system 5 1 2 Querying a Patient To querying a patient s information input one item of the patient s information such as serial No patient name and doctor and click on Query If the patient information is saved the corresponding information is displayed on the screen
26. MBLE CMS include 2 ECG waveform 1 RESP waveform 1 PLETH waveform 8 IBP waveform 1 CO waveform 4AG waveforms for CO O2 N20 and AA Physiological parameters of each bedside monitor that can be displayed on the ENSEMBLE CMS include ECG HR ST value PVCs RESP RR NIBP SYS DIA MAP SpO SpO PR IBP ART PA CVP RAP ICP LAP P1 P2 only IBP supported by the monitor will be displayed CO EtCO FiCO AwRR TEMP T1 T2 TD Quick TEMP AG EtCO FiCO AwRR EtO FiO EtN20 FiN20 HAL ISO ENF SEV DES Et Fi MAC C O C O TB 999 ENSEMBLE CMS Central Monitoring System User Manual Introduction This ENSEMBLE CMS can also make notification in both audio and visual ways for the alarm occurring at the bedside monitor in order to attract the doctor s attention as thus the alarm event can be dealt with accurately in time The ENSEMBLE CMS supports various kinds of peripheral devices such as printer that can output monitoring report The typical central monitoring system network is shown in Figure 2 1 Ward amp MFM CMS ZAS Figure 2 1 A Typical Central Monitoring System Network 2 2 System Functions The ENSEMBLE CMS can realize the following system functions Connecting of up to 64 bedside monitors simultaneously Alarm management of parameter alarms from bedside monitors Up to 240 hour of trend data storage and review for each bedside
27. Single Bed View window To review earlier NIBP measurement results click the NIBP Review button and enter the NIBP review interface through which you can view up to 720 groups of NIBP measurements of a patient The NIBP review window displays Serial No Measure Time SYS DIA MAP and PR for each measurement Additionally in this window you can Click Show parameters and the measurement values of all physiological parameters at the measure time specified in the selected item will be shown in the lower portion of the window If you click Hide parameters these measurements values will not be displayed Refresh Print out the current page Print out all pages 5 6 12 Lead Review Select 12 L Review and you can review up to 720 groups of 12 lead analysis results of the current patient in this window In the 12 L Review window the following data is available HR PR Interval QRS Duration QT QTC Interval P QRS T RV5 SV1 the value of RV5 SV1 and Diagnosis Result Select a diagnosis result from the list and select Waveform on the toolbar the related 12 lead ECG waveform will be shown You can print the diagnosis result list and waveform 28 ENSEMBLE CMS Central Monitoring System User Manual Review 5 7 C O Measure Review Select CO Measure Review and you can review up to 720 groups of C O measurement of the current patient in this window In the CO Measure Review window measure results are arranged c
28. bu eas a ate 36 Chapter 9 Calculation and Titration Table ce eee eese eene e ee eene eren ener en netta sete ta seen nose 37 9 1 Generales reed sisi DT eU oae t nieder oua Maas Ata eda ae sons 37 92 Drug Cale ulation tan a eo eaae ede tu cs tenue ot aut 37 9 2 1 Drug Calculation Formula i5 ere dcn terere aan A tre 38 9 2 2 Calculation of Titration Table ours osos veniet qe oe roe GE Peut eco e nds 38 9 3 Hemodynamic Calcula is e dass vd iau esta bd At nes 39 9 5 Input Paramelersaoso deu oie utu secum E D I Le ESL ee 39 9 3 2 Output Parameters ia alt xad ee be eee aaa heu ea ride 39 9 4 Renal Function Calculation uote e tr Ne ERAT E e IRA ERIT ER e EROS 40 TALA PA ds 40 9 4 2 Dutput Pardmetels A Ut Sc ne sr Ce se ud 40 9 5 Oxygenation Calculation Sis Facies resets areas do 41 9 5 T Input Parameters is ist e venne i e aere a in ae ee o YU 41 9 5 2 Qu tp t Parme SI SSSR A i die 42 9 6 Ventilation Calculations aussi poe d ER Ra e e RR ERAS NOSE RAT HAPUS URN UR BER NEUSS MAUS 42 DON TOPE Parameter S es T da LS b Ue eR M RUE EUR aes 42 9 0 2 Output Parameters soc O 43 Chapter 10 CMS WEB Observer iss sossisosscvesssonsssousdsovnsesiesanssevesensedsnsestosseussseeasaeataesccnusdeenassesbees 44 TD l General Se Re na 44 10 2 Typical Screens of the CMS WEB Etre ner rene 44 10 3 Starting Shutting Down the System s denso e Ete tona sedet II LER ne 46 10 3 T Starting the SySDem suede testi detect EN tte il Rd ven 4
29. charge to discharge a patient When the monitor is disconnected with ENSEMBLE CMS you may discharge a patient from the patient list Refer to 5 1 1 Discharging a Patient for more information 14 ENSEMBLE CMS Central Monitoring System User Manual Basic Operations 3 2 3 5 Transfer a Patient Select Single Bed View gt Patient Mgmt gt Transfer and you will see a list of online patients From this list select a patient whose bed will be considered as the destination bed and click OK and then the current patient will be transferred to the destination bed NOTE Transferring a patient to the destination bed will at the same time discharge the selected patient on the destination bed 3 2 3 6 Monitoring Statistics The monitoring statistics of the selected patients will be shown in the patient management window The monitoring statistics covers the total monitoring time for waveforms and trends the number of alarm events the number of NIBP measuring the number of C O measuring the number of 12 lead analysis and the number of Quick TEMP measuring Click Analysis the system will Analyze the number of high and low limit alarms for each physiological parameter and analyze the percentage of the limit alarms of the parameter in all limit alarms Analyze the number of arrhythmia events for each type of arrhythmia and analyze the percentage of a certain type of arrhythmia Analyze the average value maximum minimum valu
30. d waveforms interface please click on View Selection gt Multi lead on the interface To hide it click on it again and the multi lead waveforms disappear on the interface 4 3 Real time Printing To print real time data from ENSEMBLE CMS click Print in the Single Bed window or select Print from the list shown in Figure 2 4 After you select Print ENSEMBLE CMS starts to collect data for printing and the system will indicate Collecting Data at the top of the main screen After the system completes 11 second data collecting a dialog box for printing setup will appear The printout includes the 11 second waveform data starting from the time chosen as the beginning time for printing data of all physiological parameters at the time you select Print and the latest NIBP measurements 4 4 Short Trend Review After entering the single bed view interface click on View Selection gt Trend Screen and the short trend will be displayed on the left of the interface Click this area and a dialog box of short trend settings will pop up You can set the display mode of the short trend with the optional items in Param Select and Interval You may select the desired parameters needed to be displayed 20 ENSEMBLE CMS Central Monitoring System User Manual Viewing Single Bed from the drop down list of Param Select Also you can set the interval of the short trend by choosing from 1h 2h 4h 8h and 12h in the drop down list of Interval 4 5 Freeze In
31. e and measure time of the maximum minimum value for the trend values 3 2 4 Mouse operation Usually we use the following terms to describe mouse operation Left key 1 Click move mouse to the target then quickly press left key once and release it 2 Double click move mouse to the target then quickly press left key twice and release it 3 Drag move mouse to the target press left key and move to the destination and then release it Right key 1 Click move mouse to the target then quickly press right key once and release it 2 Double click move mouse to the target then quickly press right key twice and release it 3 3 Patient Section Patient section is used to display the real time monitoring data transmitted from bedside monitors including one two three or four selected waveforms a group of selected parameters and alarm of the bedside monitor etc Besides in this area you can also select the waveform and parameter group ENSEMBLE CMS can provide up to 64 patient sections with two displays The user can select the number of patient sections to be displayed on the monitor 15 ENSEMBLE CMS Central Monitoring System User Manual Basic Operations The patient section can be divided into five areas including physiological waveform area parameter value area alarm information display area patient information display area and status information area of bedside monitor And the user can perform various functions through
32. e monitor that has been offline due to network problems and is networked with ENSEMBLE CMS again you need not admit the patient of this monitor This monitor will be automatically online in the patient section to which it has been assigned WARNING For bedside monitors that have been networked with ENSEMBLE CMS for the first time you have to complete patient admission by using the methods mentioned above which enables the monitors to be online and observed by ENSEMBLE CMS Otherwise the monitors will not be online on ENSEMBLE CMS and the monitoring data will not be saved by ENSEMBLE CMS 3 2 3 2 Changing Patient Information You can change the patient information on ENSEMBLE CMS when you find the information incorrect To modify the patient information choose Single Bed View gt Patient Mgmt enter the correct information in the appropriate fields and click Update Monitor when you have finished modifying 3 2 3 3 Switching Patient Section For a disconnected patient section refer to Figure 2 2 click anywhere in it and choose a patient to be assigned to this section from the patient list For a connected patient section select Show from the list shown in Figure2 4 and choose another bedside monitor from the patient list the chosen bedside monitor will be displayed in this patient section 3 2 3 4 Discharging a Patient When the monitor is connected to ENSEMBLE CMS you may choose Single Bed View gt Patient Mgmt gt Dis
33. e parameters of current beds will display in large font Figure 2 6 TO DEMO 08 61 2013 17 01 03 edan monitor 60 NIBP DIA High 5 edan monitor Sensor Off 2 hey VFIB VTAC HR bpm SpO2 HR bpm SpO2 NIBP 94 681 1149709 92 581 11319068 edan monitor Sensor Off 2 d VFIB VTAC T edan monitor Monitor is offline 2 bpm SpO2 NIBP 32 UN 113 9668 3 edan monitor Sensor Off 1 KE AEP Low 6 edan monitor HR DET NIBP HR bpm SpO2 NIBP 90 B1 11219567 60 99 123171180 4 edan monitor Sensor Off 1 Ae AEP Low Disconnected HR bpm SpO2 NIBP EL 61 11219567 Main Screen A Audio Pause CE Review X System Setup Shut Down dd Admission Figure 2 6 Viewing All Windows in Large Font 2 4 2 Closing Large Font Window Click on the bed number on the main screen and the large font menu pops up The user can close the large font window by clicking on the first menu command All current windows in large font can also be closed by clicking on the second menu command 11 ENSEMBLE CMS Central Monitoring System User Manual Basic Operations Chapter 3 Basic Operations 3 1 General The basic function of the ENSEMBLE CMS is to realize the monitoring of multiple patients at the same time Its basic monitoring information includes Display one group of waveforms in the physiological information transmitted from up to 64 bedside monitors Display one group of parameters in the physiological information transm
34. e waveforms Two options are available Pen Mode and Move Mode Click on the button gt and select one mode from the drop down list 10 5 Viewing Single Bed Via the function of viewing single bed you can check information of a patient Click on any area of the patient section and you will access the single bed window Available items including Patient Infor Single Bed View Wave Review Alarm Review Trend Review and NIBP Review will be displayed onscreen 10 5 1 Patient Information You may check patient information via Patient Infor window CMS WEB Observer displays the patient information collected by the ENSEMBLE CMS You can only view the patient information via CMS WEB but not modify them The readings of Height and Weight will vary with the unit selection Click on Print if you need to output the patient information 10 5 2 Single Bed View Multi waveform display Click on Multi lead in the window so that you can view multiple channels of waveforms displayed onscreen Click on it again to switch to single waveform display mode Freezing waveform Click on Freeze in the window so that you can freeze the waveform displayed onscreen which may help you analyze the waveform of interest Click on Freeze again to unfreeze the waveform 50 ENSEMBLE CMS Central Monitoring System User Manual CMS WEB Observer 10 5 3 Waveform Review In the Wave Review window you can Select waveforms Set wave speed Refresh wa
35. ements of the valid version of the system standard IEC EN 60601 1 1 If in doubt consult our technical service department or your local distributor The ENSEMBLE CMS can only be installed on the device recommended by MENNEN MEDICAL LTD Only use operating systems that are approved by MENNEN MEDICAL LTD such as Windows 7 Using operating systems that are not approved by MENNEN MEDICAL LTD may compromise the system performance and cause a potential hazard Do not rely on the information displayed on ENSEMBLE CMS to make therapeutic and diagnostic decisions Please follow hospital guidelines and best clinical practices Clinical decision making based on the output of the device is left to the discretion of the provider Prior to intervening based on data displayed on the Central Monitoring System providers must verify this data with the corresponding bedside monitor CAUTION Federal U S Law restricts this device to sale by or on the order of a physician Read this manual prior to using this system The system should be used within temperature from 50 to 400 Keep the environment clean Avoid vibration Keep it far from corrosive reagents dust areas high temperature and humid environment The user must check that the equipment cables and transducers do not have visible evidence of damage that may affect patient safety or monitoring capability before use The recommended inspection interval is once per week
36. er 35 ENSEMBLE CMS Central Monitoring System User Manual Database Management Chapter 8 Database Management ENSEMBLE CMS provides database backup and review which allows you to conveniently manage and maintain data 8 1 Database Backup To backup database please select Main Screen gt System Setup gt User Maintain and input the correct password Select Database Maintain and click on the button Browse to choose a directory for backup file storage Then click on Backup Database to start database backup NOTE 1 During database backup ENSEMBLE CMS automatically stops its patient monitoring ENSEMBLE CMS will restart automatically after it completes database backup 3 If the check box indicating Empty local database after backup is completed is ticked ENSEMBLE CMS will empty the local database after database backup is completed 8 2 Reviewing Backup Database ENSEMBLE CMS allows you to review the backup data at any time To review backup data select Review gt Patient List and select the directory for storing backup file from the drop down list of Offline Database Source For more information about review refer to Chapter 5 Review NOTE 1 It takes about 3 to 10 seconds for ENSEMBLE CMS to load the backup data 2 During reviewing backup data discharging or deleting patients is unavailable 36 ENSEMBLE CMS Central Monitoring System User Manual Calculation and Titration Table Chapter 9
37. g the suspension will not be affected 3 4 System Setup The System Setup function is used to modify the display information at the patient section according to the real requirements By using this function you can observe the waveform parameter and the parameter list as your desire There are Common Setup User Maintain and Factory Maintain to be set 3 4 1 Common Setup It is mainly used to make some conventional monitoring settings such as parameter unit setup color setup and layout setup 3 4 1 1 Parameter Unit Setup The user can change the unit of IBP NIBP CO AG CO AG O CO TB and TEMP For example to change the unit of IBP please select Main Screen gt System Setup gt Common 16 ENSEMBLE CMS Central Monitoring System User Manual Basic Operations Setup gt Param Unit Setup and select the desired unit among mmHg and kpa from the pull down list at the right of IBP 3 4 1 2 Color Setup The user can change the display color of all parameters and the other information of the parameter is displayed as the same color And the information includes waveform name gain and filter real time value upper limit and lower limit review waveform and so on To change the color of the parameter 1 Please select Main Screen gt System Setup gt Common Setup gt Color Setup and click on the Color Setup button on the interface to enter the color setup 2 And select the parameter from Param Select and selec
38. he time length of the waveform area 5 2 4 Refreshing Waveform Waveform will not update automatically Therefore if you want to view up to date waveform you have to refresh them manually Clicking on the Refresh button will refresh the waveform 5 2 5 Selecting Waveform Click on the Select Wave button and a list of available waveforms will be shown By default all waveforms are selected You can deselect a waveform by ticking its check box 25 ENSEMBLE CMS Central Monitoring System User Manual Review NOTE The 72 hour full disclosure waveform storage will occupy a lot of hard disc Therefore the user shall be cautious to add additional waveform to the selecting waveform setup 5 2 6 Print To print the waveform displayed on the current screen please select Print on the screen to print it by the laser printer 5 3 Alarm Review Alarm table and waveform may be generated when the ENSEMBLE CMS makes secondary notification for the alarm happening at the bedside monitor Alarm review helps the clinician observe the details of the monitoring information Alarm information can be stored by the user and thus become important alarm event An alarm strip in the alarm review is a 16 second waveform 5 3 1 Locking and Unlocking Alarm Information When the user thinks that an alarm is very important he she can save it by locking the alarm information with a symbol Y on the alarm review interface The symbol Y will appear to its righ
39. hronologically on the left Select a measure result and the measure value as well as the curve will be displayed on the right A maximum of six groups of measure results can be displayed simultaneously At the lower part of the window the average values of C O and CI of the selected measure results are displayed You can print the selected measure results 5 8 Quick Temp Review Select Quick TEMP Review and you can review up to 720 groups of Quick TEMP measurement in this window The Quick TEMP measure result and measure time are available You can also print the Quick TEMP measurement list 29 ENSEMBLE CMS Central Monitoring System User Manual Alarm Management Chapter 6 Alarm Management 6 1 General Alarms triggered by a physiological sign that appears abnormal or by technical problems of the monitor are sent to the ENSEMBLE CMS by the monitors and then indicated to the users by the ENSEMBLE CMS All alarms originally come from the monitors The prompts coming from the ENSEMBLE CMS are displayed in the system prompt area on the upper screen 6 1 1 Physiological Information Alarm It includes parameter alarm and arrhythmia alarm Physiological information alarm arouses the doctors attention by means of visual and audible methods specified in harmonized international standard Visual method is realized basically by the way of lightening or flicking of the color light Audible method is realized by the sound for different levels
40. ick on the Update Monitor button to validate changes 4 12 2 Controlling Alarm Setup of Bedside Monitor Click on Alarm NIBP Setup on the single bed view screen to access the bi control interface Here you can modify the alarm settings including the alarm switch alarm level and alarm limits The operation steps are shown as follows 1 Click on the Alarm Setup button on the bilateral control interface 2 Choose the parameter of interest and change the corresponding alarm settings 3 Click on the Update Monitor button to validate changes 23 ENSEMBLE CMS Central Monitoring System User Manual Review Chapter 5 Review ENSEMBLE CMS is capable of searching and reviewing the history data of patients It includes trend review alarm review wave review NIBP review 12 L Review CO measure review Quick Temp review and patient information review By clicking on the Review button on the main interface you can enter the review interface 5 1 Patient List Select Online Database Source you can review the monitored patients information including online patient review and history patient review There are Patient Review and History Patient Review available Patient Review shows the online patients History Patient Review shows the history patients that have been discharged The ENSEMBLE CMS is capable of query and review the data of the monitored patients Select Offline Database Source you can review the backup patient list Refer to
41. ing System User Manual Calculation and Titration Table 1 The core method for the calculation of titration table is concentration dose flow rate The calculating method of titration table is to keep the fixed concentration change the dose to calculate the flow rate or change the flow rate to calculate the dose Concentration here is obtained from drug calculation 2 The titration table can be displayed by way of dose and rate You can enter the rate step from 1 10 There are four options available for dose unit mg hour mg min mg Kg hour and mg Kg min among which mg will vary with the unit changes in drug calculation 3 The calculating result of titration table is displayed in the list You can click on the scroll bar to browse more calculating results WARNING The calculating result of titration table depends on the calculating result of drug First of all the calculating result of drug should be accurate And then the calculating result of titration is concerned with the input titration control parameters and the calculating formula Therefore you must ensure the correctness of all these mentioned operations Our company will not be liable for any consequence resulted from improper operations 9 3 Hemodynamic Calculation 9 3 1 Input Parameters Abbreviation English Full Name Description PAWP Pulmonary artery wedge pressure CVP Central venous pressure HR Heart rate AP MAP Mean Artery Pressu
42. ing of high level alarm The yellow color indicates the occurring of medium or low level alarm Alarm sound If the mute setup is ineffective the system will warn the user about the alarm with the alarm sound The alarm sound can be High level alarm sound DO DO DO DO DO DO DO DO DO DO Medium level alarm sound DO DO DO Low level alarm sound DO 31 ENSEMBLE CMS Central Monitoring System User Manual Alarm Management 6 6 Alarms for Networking Status When the monitor is online or offline the system will indicate it with a low level alarm sound If the monitor is offline without being discharged the system will indicate it with a low level alarm sound at an interval of 1 minute 5372 ENSEMBLE CMS Central Monitoring System User Manual Printing Chapter 7 Printing 7 1 Printing Report with a Printer ENSEMBLE CMS can output the reports by equipped with a laser printer HP LaserJet Series printers are recommended The laser printer working with the ENSEMBLE CMS is independent of the mainframe The printer has its independent power supply It is connected to the mainframe via a USB interface or a network wired or wireless The laser printer generates the following types of printing Waveform review printing Alarm wave printing Alarm table printing Trend graph printing Trend table printing NIBP review printing Printing for drug calculation hemodynamic calculation oxygenation calculation
43. itoring System User Manual Calculation and Titration Table WARNING 1 Be sure to input correct parameter values The user must verify the correctness of the calculations displayed on the screen before using them 2 The calculations in the titration table are subject to the drug calculations therefore the correctness of the drug calculations must be ensured Besides the basic step and dose type should be ensured correct 3 We assume no responsibility for the results arising from incorrect inputs and operations 9 2 1 Drug Calculation Formula Formulas for drug calculation are Concentration amount volume Flow rate dose concentration Total dose dose x duration Total volume flow rate x duration WARNING Prior to performing drug calculation you must confirm that the above formulas are what you need Our company will not be liable for any consequence resulted from using inappropriate formulas Relationship between calculation units 1 g 1000 mg 1 mg 1000 mcg 1 K unit 1000 units 1 M unit 1000 K units WARNING You must enter correct drug unit Our company will not be liable for any consequence resulted from incorrect input 9 2 2 Calculation of Titration Table Calculation of titration table is included on the screen of drug calculation The titration table is located at the lower part of the drug calculation screen The method for calculation of titration table is 38 ENSEMBLE CMS Central Monitor
44. itted from up to 64 bedside monitors Display the latest alarm messages in the alarm information transmitted from up to 64 bedside monitors The ENSEMBLE CMS realizes its basic monitoring functions by means of patient sections on the main screen 3 2 Operating Method 3 2 1 Starting monitoring NOTE Before starting the system please verify that the watchdog has been installed Otherwise you may fail to access the system When all of its components are correctly connected press the power button on the front panel of the device The power indicator on the front panel lights up and the device performs hardware self test If the device works normally the main screen appears If the device detects abnormity during self test it beeps to show alarm and displays error information on the screen In this case you should record the error information shut down the device and contact technical representative of MENNEN MEDICAL LTD After the system self test is completed you will access the ENSEMBLE CMS system interface and the system will also finish the environment self test automatically Meanwhile the system will sound Do Do Do a test sound The user should set the volume system and confirm that the volume of the system can be heard clearly CAUTION 1 Ensure that the sound equipment is always in a state of activation 2 The audio adapter and network adapter should be correctly installed or you may not access the ENSEMBLE CMS NOTE
45. l CMS WEB Observer Chapter 10 CMS WEB Observer 10 1 General The CMS WEB Observer system is a medical information device applied in clinical monitoring field It realizes remote monitoring by reviewing real time and history data from central monitoring system through web page A CMS WEB network system is constructed by connecting multiple monitors and ENSEMBLE CMS central monitoring systems Being the center of the monitoring network the system realizes remote monitoring by collecting processing and analyzing the physiological information from the central monitoring systems Medical staff can obtain patient information by visiting the server of ENSEMBLE CMS via the browser The CMS WEB Observer displays patients physiological information collected by the ENSEMBLE CMS central monitoring system The system displays information of up to 32 bedside monitors from the ENSEMBLE CMS NOTE The CMS WEB Observer is only available via the hospital local area network 10 2 Typical Screens of the CMS WEB The CMS WEB shares similar screen features with the ENSEMBLE CMS The main screen of the CMS WEB has three areas At the top of the screen is the area displaying the system prompt information The middle part is the main monitoring area The bottom part is the system menu area Figure 10 1 shows the main screen of the CMS WEB Current Time 2011 11 22 13 52 55 CO lead off NIBP SYS HIGH n CO lead off NIBP SYS HIGH NIBP mmHg 68 60 62
46. larm Note on the bottom of the alarm review interface Move the cursor lem left to the title Alarm Note and a pop up input box in which you can input detailed information for the alarm will appear After you complete your notes move the cursor out of the area of the input box and ENSEMBLE CMS will automatically save the input information NOTE Input characters are limited to 256 5 3 5 Filtering Alarm Events You can filter alarm events by selecting or clearing the check boxes before the items in the Alarm Level list and in the Param Select list The Alarm Review window will only display the alarm events whose alarm level levels has have be selected and the alarm events of selected parameters 5 4 Trend Review Clicking on the Trend Review button will enter the trend review button through which you can store and review up to 240 hours of trend data Change of trends can be observed through the graphic and tabular On this interface you can set the resolution view parameters selectively refresh the data print 5 4 1 Setting Resolution You can select a time period as the resolution for viewing the graph and table as required Options are 1s 5s 1m 5m 15m 30m 60m Display Time Points for NIBP Measurements and Display Time Points for Quick TEMP Measurements To change the resolution select Resolution Setting on the interface and select the desired option from the list 5 4 2 Viewing Parameters selectively In the pa
47. mennen M medical since 1963 Ensemble CMS Central Monitoring System USER MANUAL DDM 000 017 Rev A April 2014 About this Manual P N DDM 000 017 REV A Release Date April 2014 Copyright MENNEN MEDICAL LTD 2010 2014 All rights reserved Statement This manual will help you understand the operation and maintenance of the product better It is reminded that the product shall be used strictly complying with this manual User s operation failing to comply with this manual may result in malfunction or accident for which MENNEN MEDICAL LTD hereinafter called MENNEN MEDICAL LTD can not be held liable MENNEN MEDICAL LTD owns the copyrights of this manual Without prior written consent of MENNEN MEDICAL LTD any materials contained in this manual shall not be photocopied reproduced or translated into other languages Materials protected by the copyright law including but not limited to confidential information such as technical information and patent information are contained in this manual the user shall not disclose such information to any irrelevant third party The user shall understand that nothing in this manual grants him expressly or implicitly any right or license to use any of the intellectual properties of MENNEN MEDICAL LTD MENNEN MEDICAL LTD holds the rights to modify update and ultimately explain this manual Responsibility of the Manufacturer MENNEN MEDICAL LTD only considers itself resp
48. monitor 72 hour physiological waveforms Storage and review of up to 720 alarm events for each bedside monitor Up to 12 hour short trend review for each bedside monitor Review of 720 pieces of NIBP measurements Review of 720 pieces of 12 lead analysis results Review of 720 pieces of C O measurements Review of 720 pieces of Quick TEMP measurements Displaying multi lead ECG Monitoring reports of review and alarm records can be output in a certain format Displaying single bed information for one bedside monitor 9 999999999999 Search browse and maintaining management of patients monitoring data ENSEMBLE CMS Central Monitoring System User Manual Introduction Comprehensive system help function Power off storage function available for all kinds of review information Calculation of drug doses and titration tables Hemodynamic Calculation Oxygenation Calculation Renal Function Calculation Ventilation Calculation Various alarm indicating methods Supporting wired connected monitor Web observation in the hospital local area network Bilateral control HL7 9 999999999 2 3 Typical Screens of the ENSEMBLE CMS The main screen of the ENSEMBLE CMS has three areas At the top of the screen is the area displaying the system prompt information The middle part is the main monitoring area The bottom part is the system menu area The system will access the main screen automatically after power on as shown in Figure 2 2 The main
49. monitoring area displays 8 patient sections darlas nic DEMO 08 01 2013 16 56 23 edan monitor LN T edan monitor Sensoroff2 RESP APNEA NIBP NIBP Ts S LPS I LPS ES UE sal TE 1 1 6 6 3 6 8 x sl FS Bis Sed e ILE 1 1 5 l 6 2 6 7 D edan monitor Sensor Off 2 AS se LUI Er 4 edan monitor Monitor is offline NIBP it SF TN ZWEIEN PR SES JE 1 1 5 62 67 y se J 3 edan monitor ENT EEE edan monitor wine Demo Mode A eden monitor Sensor offa o RES ARA Disconnected NIBP Peru RL RE 11461166 re Main Screen j Audio Pause a Review X System Setup O Shut Down el Admission Figure 2 2 Main Screen e ENSEMBLE CMS Central Monitoring System User Manual Introduction Structure of the main screen 1 Main monitoring screen The black background with the white font Disconnected in a patient section indicates no bedside monitor is assigned to this patient section The display of patient information and the low level alarm message Monitor is offline in the patient section indicates the bedside monitor in this patient section is offline without being discharging The system will indicate it with a low level alarm sound The display of patient information waveforms trend data and alarm information indicates the bedside monitor is properly networked and under observation Alarm area in the patient section indicates physiological alarms and technical alarms Refer to Chapter
50. ng system Admission X Click on it to open the patient admission window System Volume pa 1 Adjustor Click on it the volume adjustor icon te appears Select the Mute check box and then enter the password in the text box on the pop up window the entire system become mute even if an alarm occurs and the symbol X appears To deselect the silence function tick the Mute check box again and the symbol x appears Additionally the user can drag the volume adjustor to your desired volume E Network i Connecting Click on it to view all networked bedside monitors 2 4 Large Font Display 2 4 1 Entering large Font Window Click the patient information area in the patient section and a menu appears The first and the second items on the menu are Display the window in large font Display all windows in large font The first menu command is to view one window in large font and the second one is to view all windows in large font You can view a window or all current windows in large font mode by clicking on the menu commands Figure 2 4 ENSEMBLE CMS Central Monitoring System User Manual HOSPITAL DEBUG DEMO DEPARTMENT 1 edan monitor Sensor Off 1 E JEN Display the window in large font pene Display all windows in large font Parameter Waveform Setup 7 5 Print Show NIBP 163 61 61 69 RESP APNEA Sp02 75 165 63 63 Sensor Off 2 D RESP APNEA 66 75 Y 164
51. oard Mouse PS 2 or USB mouse Display Specifications Dimensions inch Resolution pixel 19 widescreen 1440X900 19 regular screen 1280X1024 17 widescreen 1280X1024 Recommended Quantity For 1 to32 bedside monitors one display For 33 to 64 bedside monitors two displays Printer LaserJet UPS 1000 W 55 ENSEMBLE CMS Central Monitoring System User Manual Specifications Network device Structure Ethernet 802 3 So Device Network switch Transmission rate 10M 100M Transmitted information Waveforms parameters and alarms of all networked bedside monitors Compatible monitors Patient monitors complying with MENNEN MEDICAL LTD network protocol Maximum number of networked 64 monitors Speaker Built in speaker is recommended CAUTION Ensure that the computer hardware can meet the requirements of the software installation and running Also the video adapter the audio adapter the network adapter and their respective drivers should been installed well in the computer otherwise the software may not run normally NOTE 1 The hardware specifications require the use of PC that complies with IEC EN requirements for ITE equipment 2 The configuration mentioned above is for reference and not permanent MENNEN MEDICAL LTD preserves the right to change and upgrade system settings A1 2 Software Performance Trend 24
52. onsible for any effect on safety reliability and performance of the equipment if Assembly operations extensions re adjustments modifications or repairs are carried out by persons authorized by MENNEN MEDICAL LTD and The electrical installation of the relevant room complies with national standards and The instrument is used in accordance with the instructions for use Upon request MENNEN MEDICAL LTD may provide with compensation necessary circuit diagrams and other information to help qualified technician to maintain and repair some parts which MENNEN MEDICAL LTD may define as user serviceable Terms Used in this Manual This guide is designed to give key concepts on safety precautions WARNING A WARNING label advises against certain actions or situations that could result in personal injury or death CAUTION A CAUTION label advises against actions or situations that could damage equipment produce inaccurate data or invalidate a procedure NOTE A NOTE provides useful information regarding a function or a procedure II Table of Contents Chapter 1 Intended Use and Safety Guidance oooonnooccooonnnoononoconanoconanocononoconanonnncnconcanononaconononono 1 LT Intended Uses ondas et ens t iam ta a udi en auo CR ag ha 1 12 Safety Guida a a tnt it nn baa Amelie 1 1 3 Explanation of S AOS o 3 Chapter 2 INTO uct OM ic dd 5 O T TL 5 2 2 System FUNCTIONS sends qoa re tust dus deste ash An tua diae eas Rae 6 2 3
53. or less If damage is evident replacement is recommended before using it 9 2 ENSEMBLE CMS Central Monitoring System User Manual Intended Use and Safety Guidance 6 10 11 12 Turn off the system power before connecting or disconnecting any accessory to the system CAUTION Please do not operate the system if it is not operating normally or requires service Turn off the system power and remove the power cable before maintaining the system Preventive maintenance of the system including periodic cleaning and appearance checking can be finished by the user because this maintenance does not touch the interior Avoid using attrite material to clean Removing all dust from the exterior surface of the equipment with a soft brush or cloth or with a soft cloth slightly dampened with a mild detergent solution or cool disinfector Especially the tie in and panel edge should be noticed Avoid pouring liquids on the equipment while cleaning and do not immerse any parts of the equipment into any liquids The system data will be delayed for no more than 5 seconds NOTE The illustrations in this manual are for reference only 1 3 Explanation of Symbols BH Consult Instructions For Use SN Serial number C The symbol indicates that the device complies with the European T Council Directive 93 42 EEC concerning medical devices Authorized representative in the European community ENSEMBLE CMS Cen
54. oring System User Manual Basic Operations 3 4 2 5 HL7 Users can set the interval for HL7 data to be sent and set the format of HL7 packing data sent by ENSEMBLE CMS The interval can be set to 1 to 120 minutes HL7 data is sent in the format of HL7 Lower Level Protocol by default If the item XML is selected the data sent by ENSEMBLE CMS will be packed in the XML format NOTE HL7 data is sent via the port 9100 by default 3 4 2 6 Database Backup For detailed information about database backup refer to 8 1 Database Backup 3 4 2 7 Other Setup On this interface you can Set Hospital Info and Department The hospital information and department will be displayed at the top left corner on the main screen Choose to display or conceal the grid in the View window by selecting or clearing the check box of Display Grid on View Return to Windows Switch off the system 3 4 2 8 User Password Setting To modify the password enter the old password in the Old Password filed and a new one in the New Password field after which you have to confirm the new password to complete the modification NOTE If you forget the password please contact the technical representative of MENNEN MEDICAL LTD 3 4 2 9 About It offers information about the software compiled time and software version 19 ENSEMBLE CMS Central Monitoring System User Manual Viewing Single Bed Chapter 4 Viewing Single Bed The display setup function is
55. ould use a UPS to provide power to the ENSEMBLE CMS The UPS must not be turned off When there is a power failure the system should be shut down by following the specified shutdown procedure before the UPS is exhausted If the system has a sudden power failure system failure may occur and consequently the system may work correctly next time or even have a serious result NOTE If you forget the password please contact the technical representative of MENNEN MEDICAL LTD 3 2 3 Patient Management 3 2 3 1 Admitting a Patient Once ENSEMBLE CMS starts up and the bedside monitor is properly connected with 243 ENSEMBLE CMS Central Monitoring System User Manual Basic Operations ENSEMBLE CMS the system will prompt the user to admit patients by displaying the number of pending patients at the information area You can admit a patient by either of the methods below Method 1 Click Admission on the main menu to display the pending patient list which contains the patients to be admitted Select the patients you want to admit from the list Click the Admission button at the bottom of the pending patient list to complete patient admission The patients who have been chosen will be monitored by ENSEMBLE CMS Method 2 Click anywhere in a disconnected patient section to display the menu on which you point to Admission and from the submenu select a bed No of which the bedside monitor will be assigned to this patient section For the bedsid
56. rameter list Param Select you can select modules or parameters by ticking their check boxes as required Only the selected parameters are displayed in the graph or table When a parameter module is selected or unselected all of its parameters will be selected or unselected accordingly 27 ENSEMBLE CMS Central Monitoring System User Manual Review 5 4 3 Refreshing Data Trend data will not update automatically Therefore if you want to view up to date trend data you have to refresh them manually Click on the Refresh button to refresh the data to up to date After refreshing them the select status and order of parameters remain unchanged 5 4 4 Printing Trend Review Clicking on Trend Review gt Print gt Print Trend Table Print Trend Graph you can print the trend table or the trend graph By default the system will print the latest data 5 4 5 Selecting Trend Table Trend Graph To review the trend table only the user can select View Selection on the interface and then select the Trend Table option from the drop down list To review the trend graph the user can select View Selection on the interface and then select the Trend Graph option from the drop down list To review the trend table and trend graph the user can select View Selection on the interface and then select the Trend Table Trend Graph option from the drop down list 5 5 NIBP Review Results of four latest NIBP measurements are displayed in the NIBP area in the
57. re LV_D Left Ventricular Diameter PA MAP Pulmonary artery mean pressure HT Height WT Weight 9 3 2 Output Parameters Abbreviation English Full Name Description BSA Body surface area SV Stroke volume SVI Stroke volume index SVR Systemic vascular resistance 39 ENSEMBLE CMS Central Monitoring System User Manual Calculation and Titration Table SVRI Systemic vascular resistance index PVR Pulmonary vascular resistance PVRI Pulmonary vascular resistance index LCW Left cardiac work LCWI Left cardiac work index RCW Right cardiac work RCWI Right cardiac work index LVSW Left ventricular stroke work LVSWI Left ventricular stroke work index RVSW Right ventricular stroke work RVSWI Right ventricular stroke work index EF Ejection fraction 9 4 Renal Function Calculation 9 4 1 Input Parameters Abbreviation English Full Name Description HT Height WT Weight URK Urine pstassium Posm Plasm osmolality SCr Serum creatinine URNa Urinary sodium Uosm Urine osmolality UCr Urine creatinine UUN Urine urea nitrogen Urine Urine SerNa Serun sodium BUN Blood urea nitrogen 9 4 2 Output Parameters Abbreviation English Full Name Description URNaEx Urine sodium excretion CNa Clearance of sodim 40 ENSEMBLE CMS Central Monitoring System User Manual
58. s that when an alarm occurs the system will not give an alarm sound but only maintain a visual prompt 6 4 Alarm Voice Pause Alarm Voice Pause means that during a period of time when an alarm occurs the system will not give alarm announcement The duration of alarm voice pause can be set to 1 minute 2 minutes and 3 minutes And the duration setting is introduced in 3 4 2 2 Alarm Setup When the duration of alarm pause has lasted for the preset time the system will stop the status of alarm pause and resume normal alarm automatically NOTE 1 Once a new alarm occurs the system will neglect the existing settings of Alarm Mute or Alarm Voice Pause and generate a new alarm 2 The alarm mute and alarm pause function is only valid for ENSEMBLE CMS itself ENSEMBLE CMS cannot silence or pause the bedside monitor s audible alarm 6 5 Alarm Prompt Response Alarm information can be prompted by means of visual and audible methods Because the alarm information is very important and timely response to the alarm information is highly required the ENSEMBLE CMS provides the following methods to indicate to the user the occurrence of the alarm Background refreshing When a physiological alarm occurs the system will warn the user by refreshing the background of the corresponding patient section of the bedside monitor into different colors Background color of the alarm area in the patient section The red color indicates the occurr
59. sh the language configuration 10 4 2 Administrator Setup 10 4 2 1 User Management Select System Setup gt Administrators Setup gt User Manage the administrator can set the user access authority Creating a user In the User Manage window input the User Name Name User Type Gender Department and so on click on Insert and a new user will be created The default password for creating users is 123456 Deleting a user Select a user to be deleted from the user list click on Delete and the user will be removed 49 ENSEMBLE CMS Central Monitoring System User Manual CMS WEB Observer Modifying user information Select a user whose information is to be modified and enter new information for the user then click on Modify to complete the modification NOTE The administrator cannot modify his her information here Refer to the section 10 4 1 1 for details Resetting user password Select a user whose password is to be reset and click on Reset password confirm it by clicking on Confirm on the pop up dialog box The password will be reset to the default password 10 4 2 2 Setting Date Time Format Select System Setup gt Administrators Setup gt TimeFormat click on the button TJ beside Date Format or Time Format and select a format from the drop down lists 10 4 2 3 Setting Waveform Refresh Type Select System Setup gt Administrators Setup gt Refresh Type you can set the refresh type of the real tim
60. t on this interface when the alarm is locked The locked alarm cannot be deleted automatically You can click on the symbol to unlock the locked alarm the symbol Y will disappear 5 3 2 Printing Alarm Information If the user wants to print alarm table he she can click on Print on the interface to print it by a laser printer NOTE 1 The important alarm events can be deleted but not automatically The non important alarm events can be automatically replaced by new alarm events when they have accumulated to a certain amount 2 The alarm stripe displays the physiological waveform at 25mm s when an alarm takes place 5 3 3 Sequencing the Alarm List You can sequence all alarms ascendingly or descendingly by clicking on the heading of any column Alarm Time Clicking on it will sequence all alarms ascendingly or descendingly by time Alarm Information Clicking on it will sequence all alarms ascendingly or descendingly by parameter Alarm Level Clicking on it will sequence all alarms ascendingly or descendingly by level At the same time one of the following symbols will appear to the right of the heading 26 ENSEMBLE CMS Central Monitoring System User Manual Review The symbol A indicates ascending sequence and The symbol v indicates descending sequence 5 3 4 Annotating Alarm You can add notes to illuminate an alarm To annotate an alarm select a certain alarm stripe and you will see the title A
61. t it complies with the requirements of the valid version of the system standard IEC EN60601 1 1 If in doubt consult our technical service department or your local distributor 8 Ensure that the environment in which the system is operated is not subject to any sources of strong electromagnetic interference such as radio transmitters mobile telephones etc Keep them far away 9 This equipment must be used by or under the guide of physician This equipment is not intended for home use ENSEMBLE CMS Central Monitoring System User Manual Intended Use and Safety Guidance 10 13 14 N gt WARNING ENSEMBLE CMS system can only collect supervise record store and display the information from Multi parameter patient monitor but can not replace the monitoring function of the Multi parameter patient monitor Ensure that the system can meet the requirements of standard IEC EN 60601 1 1 before other devices are connected to the system Other equipments connected to the interfaces of PC station must comply with the respective IEC EN standards e g IEC EN 60950 for data processing equipment and IEC EN 60601 1 for medical equipment Furthermore all configurations should comply with the valid version of the system standard IEC EN 60601 1 1 Everybody who connects additional equipment to the signal input connector or signal output connector configures a medical system and is therefore responsible for the system complying with the requir
62. t the desired color from the Color Setup on this interface 3 After this click on OK to exit the function 3 4 1 3 Layout Setup The user can set the bed numbers to be viewed on the screen through the button To change the screens to be viewed please select Main Screen gt System Setup gt Common Setup gt Layout Settings and choose the desired bed number 4 6 8 10 12 14 16 32 64 from the drop down list of display bed NOTE Two screens are needed if you want to simultaneously display the information of 64 bedside monitors 3 4 1 4 Help Help information is available on this interface 3 4 2 User Maintain To access the settings interface of user maintain you have to input a user password The default password is abc 3 4 2 1 Monitor Batch Settings You can configure the alarm limit alarm switch and alarm level for a group of bedside monitors You need to choose a patient type from Adult Pediat or Neonat before you configure the alarm settings in Templet of Alarm Limit Adjusting Range Choose the monitors needing to be configured in the right pane in which you may see a list of bedside monitors and click Config The configuration in the left templet pane will be applied to the chosen monitors Besides from the right pane you can choose a monitor whose alarm settings will serve as the source of batch settings for other monitors Select one monitor in the right pane and click Obtain Monitor Configuration to obtain
63. the IP address of the server is 192 168 11 138 to start the CMS WEB you should enter http 192 168 11 138 ENSEMBLE CMS into the address bar of the browser and input user name as well as password in the login window to access the system NOTE 1 The default user name for administrator is admin default password is test You can change the user name and password after accessing the system 2 The administrator is able to create other administrators and users The default password for creating new users is 123456 46 ENSEMBLE CMS Central Monitoring System User Manual CMS WEB Observer 10 3 2 Shutting Down the System You can shut down the system via either of the following two methods Method 1 Click on the Logout button at the bottom right corner onscreen Method 2 Click on the button ix at the top right corner onscreen 10 4 System Setup You can access the system setup menu by clicking on System Setup and configure the following items Common Setup and Administrators Setup NOTE The available setup items may vary with different users due to different users access authority Both Common Setup and Administrators Setup are available for the administrator while only Common Setup is available for general users 10 4 1 Common Setup 10 4 1 1 Setting User Information Select System Setup gt Common Setup gt Personal Infor and you can change the user name name gender department and so on 10 4
64. tral Monitoring System User Manual Intended Use and Safety Guidance ul Date of manufacture iud Manufacturer P N Part Number The symbol indicates that the device should be sent to the special ps agencies according to local regulations for separate collection after its useful life Federal U S Law restricts this device to sale by or on the order of a Rx only U S physician ENSEMBLE CMS Central Monitoring System User Manual Introduction Chapter 2 Introduction 2 1 General ENSEMBLE CMS Central Monitoring System is a medical information device widely applied in clinical monitoring field A monitoring network system is constructed by connecting multiple monitors Being the center of the monitoring network the system realizes central monitoring by collecting processing and analyzing the physiological information from multiple bedside monitors The central system frees the doctors and nurses from multifarious clinical monitoring work and greatly improves monitoring quality This ENSEMBLE CMS is capable of connecting up to 64 bedside monitors that comply with the manufacturer network protocol This ENSEMBLE CMS connects bedside monitors via network and displays physiological information of the patients being monitored by bedside monitors This system can simultaneously display the information from up to 64 bedside monitors Physiological waveforms of each bedside monitor that can be displayed on the ENSE
65. ty requirements They are not suitable for installed in the patients environment 11 2 Characteristics The standard ENSEMBLE CMS includes the following characteristics Up to 240 hours of trend data storage and review Storage of patients history data 72 hour full disclosure physiological waveforms 12 lead ECG display 12 hour short trend data Printing report Monitoring 64 patients simultaneously Connect patient monitor M3 M3A M50 M80 1M50 1M80 iM8 iM8A iM8B elite V8 9 999999 Transfer waveforms parameters alarms etc 53 ENSEMBLE CMS Central Monitoring System User Manual Service Chapter 12 Service If you have any question about maintenance technical specifications or malfunctions of devices contact your local distributor Alternatively you can send an email to MENNEN MEDICAL LTD service department at support Mennen Medical Ltd com cn 54 ENSEMBLE CMS Central Monitoring System User Manual Specifications Appendix Specifications A1 1 Recommended Hardware Configuration The minimum requirements of hardware configuration for the ENSEMBLE CMS are shown as below Components Requirements System Meet the IEC EN control requirements for ITE device PC workstation CPU Intel Core 2 Duo 2 0GHz or above Memory 2G or above Hard disk 320GB or above Display interface 2 LAN port 1 or above USB port more than one OS Windows XP 32 bit Windows 7 Keyboard PS 2 or USB keyb
66. used to modify the display information at the patient section according to the real requirements By using this function you can observe the waveform parameter and the parameter list as your desire To change the display setup click on any area of the patient section the Patient Mgmt Single Bed View Wave Review Alarm Review Trend Review NIBP Review Parameter waveform Setup Alarm NIBP Setup 12 L Review CO Measure Review Review Quick Temp and Calculation items are displayed 4 1 Setting Patient Information There are two ways to modify the patient information Modify the patient information via the monitor For more information please refer to the monitor s operation manual Modify patient information via the ENSEMBLE CMS In the patient management window the user can modify the patient information such as Serial No Patient Name Type Gender Bed No Date of Birth and so on After editing the information click on the Update Monitor button to update the changes on the monitor The patient information can be printed when the user click on Print NOTE If you have changed the patient type via the ENSEMBLE CMS the patient type on the monitor will be changed accordingly 4 2 Hiding Showing Multi lead Waveform After clicking on any area on the patient section the Single Bed View interface is displayed The patient name bed No patient type and monitoring waveform are displayed on the single bed view To view multi lea
67. uter monitors with the resolution of 1028x 1024 or 1440x900 3 Main menu The main menu Figure 10 3 is at the bottom of the screen Click on it to access corresponding windows or perform corresponding functions Figure 10 3 If one patient section is selected for single bed reviewing the button Return Main Screen will appear at the bottom left corner selecting which can return to the main screen 45 ENSEMBLE CMS Central Monitoring System User Manual 3 Control icons Control icon area includes the following icons Icons Operating method Return Main Screen Click on it to return to the main screen System Setup Click on it to enter the system setup menu Logout Click on it to log out of the system Click on it the volume adjustor icon appears Tick the Mute check box the entire system become mute until a new alarm occurs To deselect the silence function tick the Mute check box again Additionally the user can drag the volume adjustor to your desired CMS WEB Observer volume 10 3 Starting Shutting Down the System NOTE Before starting the system make sure the ENSEMBLE CMS has been installed in the computer Otherwise you cannot use the CMS WEB 10 3 1 Starting the System Before starting the system make sure the computer in which the CMS WEB Observer server is installed has been installed with the IIS Internet Information System groupware as well Assume that
68. veforms Set the starting time for printing Print waveforms The system allows you to print the waveform with a maximum time of two minutes If you have not set the starting time the system will output the latest data by default If you have set the starting time the system will start to output data at the point of the set time NOTE The set starting time for printing will be invalid after the data is output For more details about waveform review refer to relevant content for ENSEMBLE CMS in the section 5 2 Wave Review 10 5 4 Alarm Review In the Alarm Review window you can Refresh alarm information Print alarm list Print alarm strip For more details about alarm review refer to relevant content for ENSEMBLE CMS in the section 5 3 Alarm Review 10 5 5 Trend Review In the Trend Review window you can Review trend data Set resolution Select parameters to be reviewed Refresh data Print trend graph and trend list Set the display mode of the trend review window Set the starting time for printing Printing trend graph If you have not set the starting time the system will output the latest data by default If you have set the starting time the system will start to output data at the point of the set time The system allows you to output a maximum of 600 pieces of data 51 ENSEMBLE CMS Central Monitoring System User Manual CMS WEB Observer Printing trend list If
69. veolar arterial oxygen difference CcO2 Capillary oxygen content Qs Qt Venous admixture C O calc Calculated cardiac output Pa F102 PaO2 F102 AaDO2 PaO2 AaDO2 PaO2 Pa AO2 PaO2 PAO2 DO2I Oxygen Delivery Index VO2I Oxygen Consumption Index CaO2 calc Calculated Arterial oxygen content CvO2 calc Calculated Venous oxygen content 9 6 Ventilation Calculation 9 6 1 Input Parameters Abbreviation English Full Name Description FiO2 Percentage fraction of inspired oxygen RR Respiration rate PeCO2 Partial pressure of mixed expiratory CO2 PaCO2 Partial pressure of carbon dioxide in the arteries PaO2 Partial pressure of oxygen in the arteries VT Tidal volume RQ Respiratory quotient ATMP Atmospheric pressure PIP Peak Inspiratory Pressure PEEP Positive End Expiratory Pressure 42 Calculation and Titration Table ENSEMBLE CMS Central Monitoring System User Manual 9 6 2 Output Parameters Abbreviation English Full Name Description Cdyn Compliance dynamic PAO2 Partial pressure of oxygen in the alveoli AaDO2 Alveolar arterial oxygen difference Pa FiO2 PaO2 FiO2 AaDO2 PaO2 AaDO2 PaO2 Pa AO2 PaO2 PAO2 MV Minute volume VD Volume of physiological dead space VD VT Physiological dead space in percent of tidal volume VA Alveolar volume 43 Calculation and Titration Table ENSEMBLE CMS Central Monitoring System User Manua
70. ystem failure please read the user manual in detail and be familiar with the proper operation method The following WARNING and CAUTION must be observed during the operation of the system A WARNING label advises against certain actions or situations that could result in personal injury or death A CAUTION label alerts the user to exercise care necessary for the safe and effective use of the ENSEMBLE CMS WARNING 1 The system should be installed by a qualified service engineer Do not switch on power until all cables have been properly connected and verified 2 The user of this system should get professional training and read this manual thoroughly before using it Do not use it in the presence of flammable anesthetic due to explosion risk To avoid the risk of electric shock do not remove the unit covers Do not move the main unit and monitor while powering on the system Oo a A CO Only the accessories supplied or recommended by the manufacturer can be connected to the system 7 Accessory equipment connected to the analog and digital interfaces must be certified according to the respective IEC EN standards e g IEC EN 60950 for data processing equipment and IEC EN 60601 1 for medical equipment Furthermore all configurations shall comply with the valid version of the standard IEC EN 60601 1 1 Therefore anybody who connects additional equipment to the signal input or output connector to configure a medical system must make sure tha

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