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M9500 Patient Monitor User`s Manual

1. Applicable Prompt Patient Occurring Condition Indication Alarm level Type ASYSTOLE All patients NOORS B eerte ora Ayao User selectable consecutive seconds ASY Without Fibrillatory wave consecutive 4 Ventricular VENT FIB ence seconds 350 to 600 times per fibrillation User selectable P min VFIB PAC Without Single Premature Atrial PAC s tseledtable pacemaker Contractions The number of continuous Vent VENT Without beats is larger than the upper Ventricular TACHY ac emaket limit of cluster Vent beats 5 tachycardia User selectable P The R R interval is less than VTA 600ms UVPB lenis Single UVPB UVPB User selectable pacemaker COUPLET watbout 2 consecutive PVCs CPT User selectable pacemaker Vent BIGEMINY eae Vent Bigeminy Bigeminy User selectable pacemaker BGM Without ene TRIGEMINY deere Vent Trigeminy Trigeminy User selectable P TGM A type of single PVC under the condition that HR lt 100 R R interval is less than 1 3 the RONT Without average interval followed by a RONT Ueeewiceasie pacemaker compensating pause of 1 25 X the average R R interval The next R wave advances onto the previous T wave Single Without Single PVCs not belonging to the Premature ENG pacemaker type of above mentioned PVCs Ventricular Peele Contractions Patient monitor user s manual Applicable Prompt Patient Occurring Condition Indication Alarm level Type
2. Accessory Type Patient Type 2249 Adult ECG Electrode 2248 Pediatric 2258 3 Neonate No 0202001 3 leads ECG CABLE No 0202006 5 leads REK3003B 3 leads M1866A 3 1 5 7cm Neonate NIBP CUFF M1868A 4 3 8 0cm Neonate Disposable M1870A 5 8 10 9cm Neonate M1872A 7 1 13 1cem Neonate 5082 201 3 7 7 10 5cm Infant 5082 202 3 9 8 13 3cm Infant 5082 203 3 12 4 16 8cm Infant 5082 204 3 15 8 21 3cm Pediatric 5082 205 3 20 0 27 0cm Pediatric NIBP CUFF 5082 206 3 25 3 34 3cm Adult Reusable 5082 207 3 32 1 43 4cm Large Adult 5082 208 3 40 7 55 0cm Adult Thigh RNCOOILA 27 35cm Adult RNC002X 275 20 28cm Pediatric RNC 004E 10 18cm Infant RNC OOSN 9 16cm Neonate SpO2 sensor MAX A Adult gt 30kg Disposable MAX P Pediatric 10 50kg Patient monitor user s manual MAX I Infant 3 20kg MAX N Neonate lt 3kg Adult gt 40kg DS 100A Adult OXI A N Adult Neonate OXI P I Pediatric Infant SpO2 sensor RSJO63CA Reusabie A0212 SA125P Adult A0212 SA125PU Adult A0212 SP125P Pediatric Pediatric A0212 SW125PU Extension Cable of SpO2 sensor FEO SERO Temperature 90044 Probe YSI 400 Series IBP Transducer Deltran II DPT 248 Water trap EtCO2 Sidestream Sample line CPT 3 way stopcock IRMA CO2 sensor Adult Pediatric EtCO2 Mainstream Extension cable Adult Pediatric IRMA 7 aot Ai
3. 2 Trend Table Configuration Patient monitor user s manual Page 1 Region Parameter Region 1 HR Region 2 SpO2 Region 3 P1 S D Region 4 P2 M Region 5 CO2 Page 2 Region Parameter Region 1 PR Region 2 NIBP S D Region 3 NIBP M Region 4 Resp Region 5 Tl Region 6 T2 4 Standard Configuration dual IBP EtCOQ GAS 1 Trend Graph Configuration Page 1 Region Parameter Region 1 HR Region 2 SpO2 Region 3 P1 Region 4 P2 Region 5 CO2 Page 2 Region Parameter Region 1 PR Region 2 NIBP Region 3 Resp Region 4 O2 N20 Region 5 AA Region 6 T1 T2 2 Trend Table Configuration Page 1 Region Parameter Region 1 HR Region 2 SpO2 Region 3 P1 S D Region 4 P2 M Region 5 CO2 Patient monitor user s manual Page 2 Region Parameter Region 1 PR Region 2 NIBP S D Region 3 NIBP M Region 4 Resp Region 5 T1 Region 6 T2 Page 3 Region Parameter Region 1 CO2 Region 2 N20 Region 3 AA Region 4 O2 B 2 Alarm Limit 1 Setup of parameters alarm limit for adult Parameter Low limit High limit HR bpm 50 120 SpO2 90 100 PR bpm 50 120 RR rpm 8 30 T1 C 36 0 39 0 T2 36 0 39 0 NIBP SYS mmHg 90 160 NIBP DIA mmHg 50 90 NI
4. Measurement range 10 350 bpm Refreshing time Per 4 pulses Resolution 1 bpm Accuracy 1 or 1 bpm whichever is greater Sensitivity gt 0 2mVpp Alarm range 0 350 bpm continuously adjustable between upper limit and lower limit Alarm indication Sound and light alarming Time to Alarm for Tachycardia Average 4s Tall T Wave Rejection Capability 0 1 mV T Wave amplitude Patient monitor user s manual Response Time of Heart Rate HR change from 80 to 120 bpm Range 6 to 10s Na to Change in Heart HR change from 80 to 40 bpm Range 6 to 10s ST segment Measurement range 2 0mV 2 0mV Accuracy 0 8mV 0 8mV 0 02mV or 10 whichever is greater Over 0 8mV unspecified Resolution 0 01mV Refreshing time 10s Alarm range NIBP 2 00mV 2 00mV continuously adjustable between upper limit and lower limit Way of measurement Automatic oscillometry Range of measurement SYS 30 270 mmHg Adult DIA 10 220 mmHg MEAN 20 235 mmHg SYS 30 235 mmHg Child DIA 10 220 mmHg MEAN 20 225 mmHg SYS 30 135 mmHg Neonate DIA 10 110 mmHg MEAN 20 125 mmHg Range of HYPER measurement SYS DIA MEAN Only for adult 40 300mmHg 10 250 mmHg 20 270 mmHg Cuff pressure range 0 280 mmHg 0 300mmHg at HYPER mode Resolution 1 mmHg Pressure Accuracy Static 2 or 3 mmHg whi
5. Alarm Driver mode Relay Specs lt 60W S2A S36VDC lt 25VAC Isolated voltage 1500VAC Type N C N O ECG analog signal output Signal range 2 5V 42 5V Sensitivity 1V mV Accurancy 5 Signal delay 25ms PACE restrain intensify Non IBP analog signal output Signal range 0 4V 3V Sensitivity 1V 100mmHg Accurancy 5 Signal delay 55ms Level Low medium and high Indication Auditory and visual Setup Default and custom Silence All alarms can be silenced Volume 45 85 dB measured at 1 meter A 3 Measurement Specifications ECG Patient monitor user s manual Lead Mode 1 5 leads ECG input 2 3 leads ECG input 3 12 leads ECG input option Lead selection 1 I II III aVR aVL aVF V 2 1 I MH 3 I Il MI aVR aVL aVF V1 V6 option Gain AUTO 0 25x 0 5x 1 0x 2 0x 4 0x Input impedance gt 5 0 MQ MON gt 105dB CMRR OPS gt 105dB MON 0 5 40Hz Frequency response OPS 1 25Hz Electrode offset potential 500mV d c Leakage Current lt 10 uA ECG signal range 6 0 mV Baseline recovery lt 5s after Defibrillation MON or OPS mode Pacemaker pulses No rejection of pulses with amplitudes of 2mV 700 mV and durations of 0 5 2 0 ms Insulation Breakdown Voltage 4000 VAC 50 60Hz Indication of electrode separation Every electrode exclusive of RL Sweep speed 12 5mm s 25mm s 50mm s HR
6. Nellcor SpO option Measurement Range 0 100 Resolution 1 At 70 100 2 digits Adult At 70 100 3 digits Neonate Accuracy At 70 100 2 digits Low Perfusion At 0 69 unspecified Perfusion Range 0 03 20 Data update period Average 7s 0 100 continuously adjustable between upper Alarm range limit and lower limit PR Measurement Range 20 250 bpm Resolution 1 bpm Accuracy 3 digits Data update period Average 7s 0 300 bpm continuously adjustable between upper Alarm range limit and lower limit TEMP Measurement Range 0 0 50 0 C Accuracy 0 1 C Resolution 0 1 C Unit Celsius C Fahrenheit F Refreshing time Is Self check Every 10 minutes At 45 1 50 0 C 0 2 C exclusive of probe Accuracy At 25 0 45 0 C 0 1 C exclusive of probe At 0 0 24 9 C 0 2 C exclusive of probe Connecting cable Compatible with YSI 400 0 0 50 0 C continuously adjustable between upper Alarm range aie a 8 limit and lower limit Alarm indication Sound and light alarming RESP Method Impedance variation between RA LL R F 7 Patient monitor user s manual Measuring impedance range 0 2 3 Q Excitation frequency 64 8 kHz Excitation current lt 300 u A at 64 8 kHz Base line impedance range 500 4000 Q 50 120 kHz exciting frequency Measurement Range 0 150 rpm
7. 6 8 7 System Alarm and Prompt Technical Alarm Message Cause Alarm Level Battery failure Battery failure or no battery Low Battery low Voltage of battery is too low Medium Key error Keyboard error Low No paper in the recorder when recording or Recorder error the recorder door is open or recorder is Low absent Prompt Message Cause Alarm Level Recording Recorder is in printing operation No alarm 6 8 8 CO2Alarm CPT module Physiological Alarm IRMA module Patient monitor user s manual Message Cause Alarm Level EtCO gt too high EtCO measuring value is above upper alarm limit EtCO too low EtCO measuring value is below lower alarm limit User Selectable Technical Alarm Message Cause Alarm Level CO sensor off CO sensor off patient or off the monitor Low Melis CO module failure or communication CO communication error i Low failure CO2 alarm error Co2 alarm function failure Low Ciecere CO airway adapter disconnected with CO2 eee sensor CO measurement Over CO measurement Over range need verify Medium range Zero CO sensor error CO sensor error Medium 6 8 9 CO2Alarm LoFlo module CAPNOSTATS module Physiological Alarm Message Cause Alarm Level EtCO Hi EtCO measuring value is above upper alarm User Selectable EtCO Lo EtCO measuring valu
8. Patient monitor user s manual 4 3 1 System status The system time and status of battery capacity are displayed on the upper right corner 19 29 Ga Battery capacity Notes on battery capacities Hon Battery capacity is full Ca Battery capacity is half full fs Battery capacity is exhausted Only when the monitor is powered by battery and is recharging the battery the icon for battery capacity is displayed If AC power in current use and the battery capacity is full the icon will not be displayed Note When the battery capacity is exhausted the system produces an alarm sound prompting the user to plug in the AC power for recharging if it is not recharged in time the monitor will be automatically switched off due to insufficient capacity more than 5 minutes g Caution When the energy level of the battery is exhausted plug in the AC power to recharge and then the battery indication may quickly return to Full battery level the AC plug should be plugged in so as to ensure the full capacity of the battery 4 3 2 Info display region The upper region of the screen is the info display region which is used to display the status of alarm sound alarm suspension countdown and alarm info Status of alarm sound X The alarm sound is in Off status and if a new alarm is generated the Off status of alarm sound will be automatically cancelled 4 Pause the alarm and if a new alarm is gener
9. Resolution 1 rpm Accuracy 2 rpm Gain xl x2 x4 Sweep speed 6 25mm s 12 5mm s 25mm s Delay of Apnea Alarm Off 10s 20s 40s 60s Alarm range 0 150 rpm continuously adjustable between upper limit and lower limit Alarm indication Sound and light indication IBP Measurement Range 50 300 mmHg Resolution 1 mmHg Unit mmHg kPa Accu 2mmHg or 2 of the reading whichever is greater Sta ni y exclusive of transducer s 4mmHg or 4 of the reading whichever is greater inclusion of transducer Dynamic 4mmHg or 4 of the reading whichever is greater Sensitivity of transducer 5uV V mmHg 2 Impedance of transducer 300 3000 2 Bandwidth d c 15Hz Transducer sites Arterial Pressure ART Pulmonary Artery Pressure PA Left Atrium Pressure LAP Right Atrium Pressure RAP Central Venous Pressure CVP Intracranial Pressure ICP Patient monitor user s manual ART 0 200mmHg PA 0 300 mmHg CVP 10 20 mmHg LAP Selection of measurement RAP 50 300 mmHg range AUTO ICP Among them the AUTO switches automatically at an interval of 10 mmHg so as to ensure the waveform is at the state most suitable for observation 50 300 mmHg continuously adjustable SYS bed pes between upper limit and lower limit Alarm range DIA 50 300 mmHg continuously adjustable between upper lim
10. 2 Tie the cuff on the arm of patient 3 Set the parameters and modes relevant to NIBP Note Make sure that the air conduit connecting the blood pressure cuff and the monitor is neither blocked nor tangled and avoid compression or restriction of air conduit 5 5 3 Connecting to Patient and the Monitor Plug the connector of air hose on cuff into the socket marked with NIBP and wrap the cuff onto the arm of patient Make sure the mark of on the cuff is placed on the femoral artery of the arm and the air hose should be below the cuff so as to ensure the air hose is not snarled after coming out of the cuff The white line on the cuff should be within the range of lt gt otherwise it will be necessary to replace it with a more suitable cuff smaller or bigger one The cuff should be placed on the same plane with the heart so as to prevent the errors in readings caused by the effects of hydrostatics of the blood column between the heart and the cuff If the position of the cuff is higher than the plane of heart the measured BP readings tend to be smaller in case the position of the cuff is lower than the plane of the heart the measured BP readings tend to be higher Note The accuracy of measurement of BP depends on the suitability of the cuff Select the size of the cuff according to the size of the arm of patient The width of the cuff should be 40 of the circumference of the upper arm or 2 3 of the length of the upper a
11. Monitor has the function of Auto recording To make Auto recording available user can adjust lt Record Interval gt of lt Recorder Setup gt of lt System Setup gt in lt Monitor Setup gt to a necessary interval time All monitoring parameter values and waveforms will be recorded automatically according to the determined period Real Time recording Monitor has the function of real time recording If Q key in the front panel has been pressed over 2 seconds the waveform and data of cardiac electro and SpO2 can be recorded in real time If this key pressed again real time recording will end The lead ECG waveform determined by lt Record Wave gt in lt Recorder Setup gt will be monitoring in emphasis when ECG waveforms are being recorded Note During real time recording three waveforms can be recorded at the same time Users can configure the waveforms according to need Please refer to chapter 4 2 1 Measurement parameter values of individual module have been recorded on the top of waveforms 7 1 Patient monitor user s manual Chapter 8 Other Functions 8 1 Nurse Call Nurse Call is a function that the monitor will send signal to call nurse when the alarm conditions destined are occurred The monitor has a nurse call output socket connect the socket to the nurse call system of the hospital by the nurse call cable provided along with the monitor the nurse call function can be realized The nurse call function
12. Neonatal and Hyperpiesia The selection of objects of measurements during the measuring process will terminate the ongoing measurement Unit Select the unit for the NIBP measurement and options are kPa and mmHg Leakage Air Leakage test NIBP Alarm Click and open the dialog of alarm configuration of NIBP Patient monitor user s manual Adjust Alarm xit Alarm Source NIBP Sys Alarm Switch Previous NIBP Dia NIBP Mean Adjust alarm Select this option to enter the configuration of alarm limits conduct the configurations by turning the trim knob to select high or low limits and exit by selecting EXIT The upper part is the high limit and the lower one is the low limit Alarm Source Select the alarm source for NIBP parameters When the selected parameter or one of the parameter exceed alarm limit the monitor will give out alarm signal The options are as follow S Only Systolic pressure exceeds the alarm limit will trigger the alarm system D Only Diastolic pressure exceeds the alarm limit will trigger the alarm system M Only Mean pressure exceeds the alarm limit will trigger the alarm system S M Systolic pressure or mean pressure exceeds the alarm limit will trigger the alarm system D M Mean pressure or diastolic pressure exceeds the alarm limit will trigger the alarm system S D Systolic pressure or diastolic pressure exceeds the alarm limit will trigger the alarm system S D M Mean pressure
13. IP Net Mask Gateway MacNO RcevAlmLmt Set HID Previous In the interface of network configuration such items as IP address Net mask Gateway Machine number can be configured The configuration is mainly necessary when the monitor connecting to the Central Unit E System info sion Module SN SerialNumber Previous 4 21 Patient monitor user s manual Version It displays the version number of software Module SN It displays the product serial number of module Serial Number It displays the serial number of the machine 4 2 2 Trend Review Trend Graph Trend Table Return to main screen Page Press this option and turn the trim knob to conduct the paging operation Press it again to restore the initial status If more than one page of trend diagrams or trend tables are configured then the paging is switched between the trend diagrams or trend tables between different pages 4 22 Patient monitor user s manual Cursor Press this option turn the trim knob and move the cursor in the trend diagrams or trend tables Press it again to restore the initial status It is possible to move the cursor in the trend diagrams and trend tables In the trend tables it is possible to browse the trend records by moving the cursor and if it moves to the left side or the right side of trend diagram continue moving can roll the trend diagram by 1 4 screen to the left or right Record Press th
14. It is important to set physiological alarm limits properly The monitor can t give medicinal alarm prompt in clinical application with improper setting of physiological alarm limit The physiological alarm occurs when the measurement exceeds the set parameter limits Please refer to above operation for Methods of alarm setup of the other parameters ECG Alarm configuration Adjust Alarm HR Alarm Previous 6 3 Patient monitor user s manual Alarm levels configuration Alarm Level Default Previous Alarm recording configuration Alarm Record All OFF zo sp02 wre Default Setup Ea Ea Previous Alarm indication of physiological parameters Audio when alarm occurs the system generates alarm sound to raise the user s attention audio alarm can be disabled Visual The parameter flashes on the display area of the screen and alarm LED lights Patient monitor user s manual Warning The lower limit and the upper limit of parameter must be set based on clinical practices and general clinical experiences Note When parameter alarm level is off alarm will be disabled even if the measurement results exceed the limits Alarm indicating lamp in the front of the monitor will alarm at the highest level if different levels alarms coexist 6 4 Alarm Cause Alarm of the monitor includes 1 Physiological Alarm 2 Technical Alarm 3 General Prompt Physiological Alarm When th
15. User Selectable alarm limit Technical Alarm Message Cause Alarm Level TEMP sensor off TEMP sensor may be disconnected from i OW user or monitor TEMP sensor off TEMP2 sensor may be disconnected from a OW user or monitor TMEP communication error TEMP measurement error or communication S OW error TMEP alarm error Alarm failure Low TEMP2 alarm error Alarm failure Low T1 over measuring range TEMP over measuring range Low T1 below measuring range TEMP below measuring range Low T2 over measuring range TEMP over measuring range Low T2 below measuring range TEMP2 below measuring range Low TEMP Self checking error TEMP calibration failure Low 6 8 5 IBP Alarm Physiological Alarm Message Cause Alarm Level IBP SYS1 too high SYS measuring value of channel 1 is above upper alarm limit User Selectable IBP SYS1 too low SYS measuring value of channel 1 is below lower alarm limit User Selectable IBP DIA too high DIA measuring value of channel 1 is above upper alarm limit User Selectable IBP DIA too low DIA measuring value of channel is below lower alarm limit User Selectable 6 9 Patient monitor user s manual IBP MAP too high MAP measuring value of channel is above upper alarm limit User Selectable IBP MAP too low MAP measuring value of channel 1 is below lower alarm limit U
16. When in the PAUSE status press the X button again to restore the normal alarm status Besides during PAUSE status newly occurring technical alarm will cancel the PAUSE status and the system will come back to the normal alarm status The symbol EA disappears too Note Whether an alarm will be reset depends on the status of the alarm cause But by pressing X button can permanently shut off audio sound of Lead Off or Sensor Off alarms 6 6 Parameter Alarm The setup for parameter alarm is in their menus In the menu for a specific parameter you can check and set the alarm limit alarm status The setup is isolated from each other When a parameter alarm is off a symbol displays near the parameter If the alarms are turned off individually they must be turned on individually For the parameters whose alarm switch is set to ON the alarm will be triggered when at least one of them exceeds alarm limit The following actions take place 1 Alarm message displays on the screen as described in alarm mode 2 The monitor beeps in its corresponding alarm class and volume 3 If alarm recording is on the recorder starts alarm recording at set interval 6 6 Patient monitor user s manual 6 7 When an Alarm Occurs Note When an alarm occurs you should always check the patient s condition first Check the alarm message appeared on the screen It is needed to identify the alarm and act appropriately accordin
17. and so on It is especially important to check the sensor placement of neonate and patient of poor perfusion or immature dermogram by light collimation and proper attaching strictly according to changes of the skin Check per 2 3 hours the sensor placement and move it when the skin deteriorates More frequent examinations may be required for different patients 5 3 4 Setup of SpO2 Pulse parameters Beep Volume HR Source Scan Speed Fast Mode Alarm Setup Spo2 Mode Back to Main Beep Volume Select the BEEP volume and options are Off 1 2 3 4 5 6 Once an option is selected a testing beep will be produced HR source Select the option of HR source and options are AUTO ECG and PLETH When selecting AUTO the HR source is ECG with the priority and if there is no current ECG the system automatically derives HR from SpO gt Scan speed Select the scanning speed of the SpO2 waveform and options are 12 5mm s 25mm s and 50mm s Alarm Setup Click and open the dialog of SpO gt alarm configuration SpO mode Select the response time mode for SpO2 and options are Common mode and Fast mode It is valid only use the Nellcor SpO2 module Patient monitor user s manual Adjust Alarm SPO2 Alarm PR Alarm Previous Adjust alarm Select this option to enter the configuration of alarm limits conduct the configurations by turning the trim knob to select high and low limits and exit by selecting EXIT The upper part is
18. connecting cables and accessories are in correct working order and operating condition To avoid explosion hazard do not use the equipment in the presence of flammable anesthetics vapors or liquids Do not open the equipment housings electric shock hazard may exist All servicing and future upgrades must be carried out by the personnel trained and authorized by manufacturer only When using the equipment with electrosurgical units ESU make sure the patient is safe Do not come into contact with the patient during defibrillation Otherwise serious injury or death could result Do not rely exclusively on the audible alarm system for patient monitoring Adjustment of alarm volume to a low level or off may result in a hazard to the patient Remember that alarm settings should be customized according to different patient situations and always keeping the patient under close surveillance is the most reliable way for safe patient monitoring The physiological data and alarm messages displayed on the equipment are for reference only and cannot be directly used for diagnostic interpretation To avoid inadvertent disconnection route all cables in a way to prevent a stumbling hazard Wrap and secure excess cabling to avoid risk of entanglement or strangulation by patient or personnel Caution To ensure patient safety use only parts and accessories specified in this manual At the end of its service life the equipment as well as its a
19. signal and the patient clinical feature and symptom as the primary information to medical and nursing staff about the physiological condition of the patient 8 2 Analog Signal Output The monitor has an auxiliary output socket connect to the device such as oscillograph and then perform some settings the analog signal output function can be realized 8 3 SD Card Storage The monitor prepares the SD card to store data in case of power failure or power off This can avoid the data lost in case of power off Trend data and waveforms of patient are stored during monitoring If the monitor is switched off suddenly the monitoring data shall be consistent before and after power off 8 2 Patient monitor user s manual Chapter 9 Maintenance and Cleaning 9 1 System Check An effective maintenance schedule should be established for your monitoring equipment and reusable supplies This should include inspection as well as general clearing on a regular basis The maintenance schedule must comply with the policies of your institution s infection control unit and or biomedical department Check with your biomedical department to be sure preventive maintenance and calibration has been done The User Maintenance Instruction contains detailed information Before using the monitor check the equipment following these guidelines Check the equipment for obvious mechanical damage Check all the outer cables inserted modules and ac
20. systolic pressure or diastolic pressure exceeds the alarm limit will trigger the alarm system Alarm Switch Select lt ON gt to enable parameter over limit alarm select lt OFF gt to disable parameter over limit alarm 5 5 5 Precautions during Measurement If the BP of the patient is above 180mmHg lt HYPER gt measurement mode is recommended When using the STAT measurement or AUTO measurement if the time duration is relatively Patient monitor user s manual long care must be taken to check such abnormalities as purple spots coldness and numbness at the limb end If there are such phenomena the cuff should be relocated or the measurement of NIBP should be halted To neonate mode STAT measurement is unavailable The presence of factors that change the properties of the cardiovascular dynamics of patient will adversely affect the measurement value of the monitor and shock and hypothermia will also affect the accuracy of the measurement When the built in main artery balloon pump is applied on the patient the measurement value of NIBP will be affected For the limb that is on an intravenous drip or in a catheter insertion or if the patient is connected to the heart lung machine or the patient is experiencing shiver or convulsions the measurement of NIBP cannot be conducted When errors occur in the measurement of NIBP the error codes will appear in the parameter displ
21. the configuration range of EtN2O alarm low limit is 0 100 continuously adjustable no higher than the high limit FiN O alarm Select lt ON gt to enable FiN2O over limit alarm select lt OFF gt to disable FiN2O over limit alarm EtN 0 alarm Select lt ON gt to enable EtN2O over limit alarm select lt OFF gt to disable EtN gt O over limit alarm 5 11 6 Precautions during Measurement 1 See 5 8 6 2 The lifetime of the IRMA oxygen sensor cell is up to six months since its leaving factory If it cannot work normally or the parameter cannot be accurate measured due to exceeding time limit please timely change the oxygen sensor cell 3 If the IRMA airway adapter is detached from the sensor or low voltage of oxygen sensor cell or there is something wrong with the sensor the prompting message may pop up on one of above conditions 5 63 Patient monitor user s manual 5 11 7 Maintenance and Cleaning 5 11 7 1 Oxygen sensor replacement Replace the oxygen sensor every four months when indicated by the monitor or whenever the oxygen readings are questionable 5 11 7 2 Zero reference calibration Gas readings should be verified with a reference instrument at regular intervals A zero reference calibration of the IR measurement should be performed whenever an offset in gas readings is discovered or if GAS CONC OUT OF RANGE alarms appear when measuring room air Zero Reference calibration is performed by snapping a new
22. 25 C full specifications within 2 minutes CO2Measurement Range 0 19 7 0 150 mmHg at 760 mmHg ambient temperature of 25 C CO Resolution ImmHg CO Stability Short Term Drift Drift over four hours lt 0 8mmHg Long Term Drift Accuracy specification will be maintained over a 120 hours period unit mmHg kPa CO Accuracy 0 40 mmHg 2 mmHg 41 70 mmHg 5 of reading 71 100 mmHg 8 of reading 101 150 mmHg 10 of reading Above 80 breath per minute 12 of reading Gas temperature at 25 C CO response time lt 3s includes transport time and rise time Respiration Rate Range 2 150 rpm Respiration Rate Accuracy 1 rpm Sample Flow Rate 50 ml min 10 ml min Alarm range 0 0 13 1 0 99 6mmHg continuously adjustable between upper limit and lower limit Alarm indication Sound and light indication Patient monitor user s manual EtCO2 Mainstream CAPNOSTATS Measure method Infrared spectrum Measure mode Mainstream Warm up time Capnogram displayed in less than 15 s At an ambient temperature of 25 C full specifications within 2 minutes CO Measurement Range 0 19 7 0 150 mmHg CO Resolution ImmHg CO Accuracy 0 40 mmHg 2 mmHg 41 70 mmHg 5 of reading 71 100 mmHg 8 of reading 101 150 mmHg 10 of reading Temperature at 35 C CO Stability Sh
23. 5 consecutive QRS complex Tachycardia Tey All patients R R interval is less than 500 ms TAC Escesciee RDI 5 consecutive QRS complex Bradycardia PRADY Al pablents R R interval is longer than 1 5s BRD epale When HR is less than 100 beats min no heartbeat is MISSED Without detected during the period of Missed beats 1 75 times of the average RR User selectable BEATS pacemaker MIS interval or when HR is longer than 100 beats min no heartbeat is detected within 1 second No QRS complex and pacing With pulse are available during the Pacemaker PNP oa period 1 75 times of the average not pulsating User selectable Dae RR interval Only considering PNP patients with pacemaker When pacing pulse is available With no QRS exists during the period Pacemaker PNC emake 1 75 times of the average RR not capturing User selectable p interval Only considering PNC patients with pacemaker Without Depression of ST segment is Depression of P CTPRBERS pacemaker more than 0 2mV DEFAULT ST segment Ueerpelsetibig Without Elevation of ST segment is more Elevation of ce cae pacemaker than 0 2mV DEFAULT ST segment Pserseleetahle NOISE All patients Abnormal ECG wave Noise NOS User selectable 5 1 8 Maintenance and Cleaning If there is any sign that the ECG cable may be damaged or deteriorated replace it with a new one instead of continuing its application on the patient To avoid extended damage to the equipmen
24. 8 1 Patient monitor user s manual 6 12 leads ste te wake 80 1 es 8 60 rons fh sa a E coz E Fico ar ele siii i A L d is talia O 29 B E ee 73 132 w pe e 741 56 w 126 83 95 2 345 264 81 The 12 lead ECG waveforms are displayed in the waveform display zone they are I II III aVR aVL aVF V1 V2 V3 V4 V5 V6 In order to facilitate the diagnosis and analysis of heart disease monitor is especially designed with displaying 12 lead all lead ECG synchronously on screen Select 12 leads in the lt Select Screen gt of the lt Main Setup gt menu The waveform is composed of left and right regions and displayed in the left region are ECG waveforms of limb leads and on the right are the ECG waveforms of chest leads 7 OxyCRG Eom 11 30 ca we ta OO ee Wer wo Oe Ce ee ee ee ee fac 8 0 e C NANANA A men 73 32 w 71 56 62 126 83 5 2 Z T 345 264 81 The trend diagrams of HR SpO 2 and RESP within 8 minutes are displayed under the waveforms 4 4 Patient monitor user s manual 8 Other Bed Eau 11 30 ca WN GON Wan OUR We Ne 2s Rcd Rahs ner Pare 0 fe r z N 3 60 ee J Ye K pi LW J J J K a i S te 9 8 ee coz etig Ficoz iter 29 s wri 4 73 32 50 A 71 56 3 nior m Lee GAS ma N2 rewr e 126 83 5 7 34 5 26 4 81 The info for other beds is showed below the waveforms including one waveform and p
25. Limit ST Low Limit ARR Review Mig Previous ARR Only when ON is selected the monitor will conduct Arrhythmia analysis ST Only when ON is selected the monitor will conduct ST segment analysis Pacemaker Only when ON is selected the monitor will conduct pace making analysis on patient with pacemaker PVCs Only when the times of continuous occurrences is selected from 1 to 10 the monitor will set off the alarm for the frequent occurrences of ventricular premature contractions PACs Only when the times of continuous occurrences is selected between 1 and 10 the monitor will set off the alarm for the times of premature beat ST High Limit ST alarm high limit of arrhythmia analysis and the unit is mV ST Low Limit ST alarm low limit of arrhythmia analysis and the unit is mV In arrhythmia analysis only when the ST segment exceeds the configured high and low limits will be regarded as the elevation or depression of the ST segment They are different from the high and low limit in the configuration of ST alarm limits ARR Review Click and open the dialog of arrhythmia review The user can review the arrhythmia that have occurred and can browse the waveforms 4 seconds before and after the occurrence of arrhythmia alarm 5 9 Patient monitor user s manual e ECG replay lt lt gt gt Select this button and it is possible to roll the waveform block by turning the trim knob back and forth with 5 s
26. Patient monitor user s manual Titration Table DRUG AMOUNT 400 00 mg IQUID VOL 250 00 ml 150 00 mo INF RATE 93 75 ml hr 0 0 kg DRIP RATE 81 25 GTT min INF RATE D INF RATE DOSE INF RATE e 10 20 6 25 ps PAGE UP DOWN RECORD In the titration table turn the trim knob to Base then press the trim knob to select the desired item Options are Dose Trans speed and Drop speed After selecting press the trim knob to confirm the selection Move the cursor to Step and press the trim knob to select the step size the selectable range is 1 10 Move the cursor to Dose Type and press the trim knob to select the dosage unit Move the cursor to Page Up Down press the trim knob and then turn the trim knob to browse the previous page and next page Move the cursor to Record press the trim knob to give the output of the data of the titration table on the currently displayed interface Move the cursor to Exit press the trim knob to return to the window of drug calculation 4 3 Screen Display This Monitor adopts color LCD screen with high brightness which can display parameters waveforms system status and other prompt info The main screen is mainly divided into three regions they are respectively E Display zone of system info and alarm prompt info the uppermost part E Waveform display zone left and It shall vary according to different screen types E Parameter display zone right and lowest part
27. Previous mi Adjust alarm Select this option to enter the configuration of alarm limits conduct the configurations by turning the trim knob to select high and low limits and exit by selecting EXIT The upper part is the high limit and the lower one is the low limit EtAA alarm high limit its configuration range is 0 0 30 0 continuously adjustable no lower than the low limit the configuration range of EtAA alarm low limit is 0 0 30 0 continuously adjustable no higher than the high limit FiAA alarm high limit its configuration range is 0 0 30 0 continuously adjustable no lower than the low limit the configuration range of FiAA alarm low limit is 0 0 30 0 continuously adjustable no higher than the high limit EtAA alarm Select lt ON gt to enable EtAA over limit alarm select lt OFF gt to disable EtAA over limit alarm Patient monitor user s manual FiAA alarm Select lt ON gt to enable FiAA over limit alarm select lt OFF gt to disable FiAA over limit alarm E O alarm Click and open the dialog of O2 alarm Adjust Alarm Fi02 Alarm Et02 Alarm Previous Adjust alarm Select this option to enter the configuration of alarm limits conduct the configurations by turning the trim knob to select high and low limits and exit by selecting EXIT The upper part is the high limit and the low one is the low limit FiO alarm high limit its configuration range is 18 100 continuously adjustable no lower
28. Record Print the ECG waveform of the current screen through the recorder If no recorder is configured this option is invalid Exit Exit the dialog of Arrhythmia Review 4 2 5 Alarm Setup Common Alarm Hig IBP Alarm Mig AG Alarm Mig ST Alarm Mp ARR Alarm Mp ICG Alarm Mig Alarm Record Mp Alarm Volume Previous 4 24 Patient monitor user s manual Common Alarm Click and open the dialog of common parameters alarm It can setup the alarm limits of common parameters Adjust Alarm Default Setup Enable All Previous IBP Alarm Click and open the dialog of IBP alarm It can setup the alarm limits of IBP Adjust Alarm Default Setup Sys IBP1 Mean Enable All Previous AG Alarm Click and open the dialog of AG alarm It can setup the alarm limits of the AG module 4 25 Patient monitor user s manual Adjust Alarm Default Setup Enable All Previous ST Alarm Click and open the dialog of ST alarm If the ST analysis is not configured this option is invalid Adjust Alarm ST AlarmSwitch Lead Previous ARR Alarm Click and open the dialog of ECG analysis alarm It can setup the alarm limits of various Arrhythmias 4 26 Patient monitor user s manual Alarm Setup Default Setup Enable All Previous Alarm Record Click and open the dialog of alarm recording Configure whether the alarm records of various modules are recorded Only when the switch for
29. Use the following procedure to perform a room air calibration of the oxygen sensor 1 Disconnect the IRMA sensor from the airway adapter 2 Wait until the LED starts blinking with red light 3 Snap the IRMA sensor back on the airway adapter 4 Check that the LED turns green 5 Check that the O2 reading on the monitor is 21 5 11 4 Sensor Alarms Indicate Description of the status LED situated on the IRMA sensor head Patient monitor user s manual Steady green light System OK Steady blue light Anesthetic agent present Steady red light Sensor error Blinking red light Check adapter 5 11 5 Setup of AG parameter AA Type Alarm Setup Mig Back to Main AA type Select the types of anesthetic gas and options are AA HAL ENF ISO SEV and DES After the monitor is turn on if no AA types are configured there will be a technical alarm prompting the configuration of AA and need to designate a kind of anesthetic gas Considering safety the configuration will not be saved after the monitor is switched off Label Meanings Label Meanings AA Anesthetic agent ISO Isoflurane HAL Halothane SEV Sevoflurane ENF Enflurane DES Desflurane Alarm Setup Click and open the dialog of anesthetic gas Patient monitor user s manual AA Alarm Mig N20 Alarm Mig 02 Alarm Mig Previous E AAalarm_ Click and open the dialog of AA alarm Adjust Alarm EtAA Alarm FiAA Alarm
30. above upper alarm limit User Selectable EtO too high EtO is above upper alarm limit EtO too low EtO is below lower alarm limit User Selectable FiO too high FiO is above upper alarm limit FiO too low FiO is below lower alarm limit User Selectable Required correct Technical Alarm Message Cause Alarm Level GAS communication error GAS module failure or communication error Medium Check Airway Adapter ean ne Medium Replace O sensor Oxygen sensor disconnected with module Medium O2 sensor low Weak oxygen sensor signal Medium GAS sensor error GAS sensor error Low GAS CONC Out of Range Measurement of GAS module over range Medium Room Air Calibration Measurement of oxygen density is not High Patient monitor user s manual Chapter 7 Recording Monitor carries out the recording function by the built in recorder Alarm recording Monitor provides the function of alarm trigger recording To make alarm recording available Please keep lt Alarm Record gt of lt Recorder setup gt of lt System setup gt in lt Monitor setup gt menu is ON and adjust alarm level of alarm parameter to non close If any monitoring parameter exceeds the limit and lt Alarm Record gt is ON recorder will print all monitoring parameter values in the alarm time Moreover if monitor alarms continuously recorder will print every two minutes Auto recording
31. adapter ensure the windows are dry and residue free and that the adapter has not been damaged during handling or by the cleaning process Patient monitor user s manual 5 11 Measurement of AG IRMA AG module is used to measure respiratory and anesthetic gases of a patient during anesthesia It is applicable for adult and pediatric usage The measuring principle is that anesthetic gas can absorb infrared light Gases that can be measured by AG module are able to absorb infrared light Besides each gas has its own absorption characteristic First the gas is driven into a sample cell Then the optic infrared filter selects the infrared light with special wavelength to penetrate this gas For a given volume the higher the gas concentration is the more infrared light are absorbed We may measure the quantity of the infrared light that have penetrated the gas and then calculate the gas concentration via specialized formula If you desire to measure multiple gases you should install various infrared filters in the AG module MAC is defined as the minimum alveolar concentration at steady state that prevents reaction to a standard surgical stimulus skin incision in 50 of patients at 1 atmosphere i e sea level Note The AG measurement of monitor can only uses PHASEIN IRMA mainstream probe provided by the manufacturer 5 11 1 Preparatory Steps for Measurement of AG 1 See 5 8 1 for preparatory steps 2 A green LED indicates that t
32. an increment or decrement of 1 kg Sex Gender of patient male or female Age Age of patient Turn the trim knob with an increment or decrement of 1 year Room No Number of patient s room Patient s room number can be displayed in the central unit Bed No Number of patient s bed Patient s bed number can be displayed in the central unit Patient monitor user s manual 4 2 7 Drug Dose Calc Drug Dose Calculation DRUG_A v 35 71 00 7 3 EEN This calculation of drug concentration is mainly aimed at facilitating the work of physicians It conducts concentration calculation on some commonly used drugs A content of titration table can be output through recorder In the system the following categories of drugs can be calculated AMINOPHYLLINE DOBUTAMINE DOPAMINE EPINEPHRINE HEPARIN ISUPREL LIDOCAINE NIPRIDE NITROGLYCERIN and PITOCIN In addition it provides DRUG_A DRUG_B DRUG_C DRUG_D and DRUGE to displace any other drugs flexibly The following formulas are used for the calculation of drug dosage Drug concentration equal to total amount of drug divided by liquid volume Liquid velocity equal to drug dosage divided by drug concentration Duration time equal to total amount of drug divided by drug dosage Drug dosage equal to velocity of IV drip multiply drug concentration In the window of drug calculation the operator should first select the name of the drug to be calculated confirm the patient weig
33. change the language it is necessary to restart the monitor Recorder Setup Click and open the dialog of recorder configuration Time Setup Click and open the dialog of time configuration After the time of the system has been configured please restart the monitor Mode Config Click and open the dialog of mode configuration Alarm level Click and open the dialog of alarm level configuration Machine Setup Click and open the dialog of machine maintenance Enter the interface of machine maintenance and it is necessary to enter the password password is 125689 Patient monitor user s manual E Recorder Setup Record Wavel Record Havez Record Wave3 Record Time Interval Delay Time Record Grid Alarm Record Warn Record Previous Record Wavel Select the waveform recording in the first line Select certain waveform to record It cannot be switched off Record Wave2 Select the waveform recording in the second line Select Off close the wave display or select certain waveform to record Record Wave3 Select the waveform recording in the third line Select Off close the wave display or select certain waveform to display Record Time Select the time duration of the waveform for each recording Options are 8s 12s and 16s Record interval Select the time interval for cycle recording Options are Off Imin 2min 3min 4min 5min 10min 15min 20min 25min and 30min Record Grid Enable Disable recording of the grids when the rec
34. discovered or if GAS CONC OUT OF RANGE alarms appear when measuring room air Zero Reference calibration is performed by snapping a new IRMA airway adapter onto the IRMA sensor without connecting the airway adapter to the patient circuit and then using the lt host instrument gt to transmit a calibration command to the IRMA sensor Special care should be taken to avoid breathing into the adapter during the zero reference calibration procedure The presence of ambient air 21 O2 and 0 COz in the IRMA airway adapter is of crucial importance for a successful zero reference calibration Always perform a pre use check after performing zero reference calibration 5 8 7 2 Cleaning and disinfecting E Cleaning Use a piece of clean cloth moistened in water or mild soap solution to clean the sensor E Disinfection Use a piece of clean cloth to wipe the surface of the sensor with a 70 ethanol or 70 isopropyl alcohol 5 45 Patient monitor user s manual 5 9 Measurement of CO2 Microstream LoFlo Use the CO measurement to monitor the patient s respiratory status and to control patient ventilation 5 9 1 Preparing to Measure CO2 1 Attaching the LoFlo Module Cable To attach the LoFlo module cable plug the cable into the CO2 socket on the left panel of monitor by matching the key on the cable to the key on the connector Caution To remove the module cable from the monitor grasp the collar surrounding the cable and pull
35. is valid when the following conditions are concurrent 1 The nurse call function is open 2 An alarm condition destined is occurred 3 The monitor is not in the state of alarm paused or system silence To set up nurse call function 1 Select MENU Monitor Setup gt System Setup gt Nurse Call and configuration the following options Nurse call Select lt ON gt to enable nurse call function select lt OFF gt to disable nurse call function Phy trigger Select the Physiological alarm level that can trigger the nurse call action The options are OFF Low MED and High and select lt OFF gt to disable the trigger action Tech trigger Select the Technical alarm level that can trigger the nurse call action The options are OFF Low MED and High and select lt OFF gt to disable the trigger action 2 Select MENU Monitor Setup System Setup Machine Setup enter the password password is 125689 3 Enter the interface of Nurse call setup and configuration the following options Call mode Select the duration of nurse call signal and options are One second and Continuous Relay type Select the connecting type of nurse call relay Select lt N C gt is normal Close select lt N O gt is normal on 8 1 Patient monitor user s manual Na Warning The nurse call function should not be used as the primary patient alarm inform source It is necessary for combining the auditory and visual alarm
36. methods are basically the same the standard configuration includes 5 lead ECG RESP SpO2 Single TEMP and NIBP modules and the non standard parameter configuration includes Dual TEMP IBP CO and AG modules 4 1 Screen Mode In the lt Select Screen gt of the lt Main Setup gt menu 8 kinds of different screen display modes can be selected namely Standard NIBP Review Big Numerics Short Trend 7 leads 12 leads oxyCRG Other Bed They are respectively showed as follow 1 Standard fmm 11 28 Gi t ECG j l A a el kiakia i adi 80 r 60 a 9 8 x A er pN coz niig Ficoz Mac 29 73 32 us 71 56 a 126 83 95 1 34 5 26 4 8 The ECG waveform of one lead is displayed on the uppermost region above the waveforms this lead is called key monitoring lead and is set by the lt ECG1 gt option in lt ECG gt and the waveforms below are displayed differently according to different configurations 4 1 Patient monitor user s manual 2 NIBP Review 11 28 j a i i 5 i i i ECG Hin i awe aw we ee ee ee i ee ee AR al A jA e p 7002 PR s s P 60 k a he Wa Nm INN Jf MR S JA fesp ze y gt j s x aa COZ stig Ficoz Etoo een U ae oe LR r LC RR rom Mac ae 29 tori w ta 73 32 w9 eR T tpa 71 56 n 126 83 65 IZ Z I 345264 8 The recent groups of NIBP measurement results are displayed below the waveforms an
37. of the above tests the device has to be repaired The synchronism of the defibrillator should be checked by in the frequency described in the hospital regulations At least every 3 months it should be checked by the biomedical engineer of the hospital or qualified service technician All the checks that need to open the monitor should be performed by qualified service technician The safety and maintenance check can be conducted by persons from the manufacturer You can obtain the material about the customer service contract from the local office The circuit diagrams parts lists and calibration instructions of the patient monitor can be provided by the manufacturer Warning If the hospital or agency that is responding to using the monitor does not follow a satisfactory maintenance schedule the monitor may become invalid and the human health may be endangered Note To ensure maximum battery life please ensure that the battery is fully charged when you are keeping the device in storage for an extended period of time and then take out the battery yy Warning Refer the battery replacement only to manufacturer s service technician 9 2 Battery Maintenance A rechargeable and maintenance free battery is designed for Patient Monitor which enables continuous working when AC power off Special maintenance is not necessary in the normal situation Please pay attention to the followings in using for more durable usage and a bett
38. sensor and airway adapter together until they click 3 Wait for the airway adapter and sensor to warm up The monitor will display the Sensor Warm Up message for approximately one minute while the sensor and adapter warm to operating temperature The message disappears when the sensor is ready for use Note Warm up time varies with ambient temperature of the module Patient monitor user s manual 4 Zero Please refer to chapter 5 9 3 5 Attaching the airway adapter to the airway circuit After zeroing attach the airway adapter to the airway circuit as follow Fig 5 10 1 CAPNOSTAT Reusable Adult Airway Adapter To Patient Fig 5 10 1 6 Ensure the airway air proof and ready to measure 5 10 2 Setup of CO2 parameter Please refer to chapter 5 9 2 5 10 3 Zero Please refer to chapter 5 9 3 5 10 4 Safety considerations Warning E Do not use in the presence of flammable anesthetics or other flammable gasses Use of the CAPNOSTATS sensor in such environment may present an explosion hazard E Electrical Shock Hazard Always disconnect the CAPNOSTATS sensor before cleaning Do not use if it appears to have been damaged Refer servicing to qualified service personnel E Do not position the sensor cables or tubing in any manner that may cause entanglement or strangulation E Reuse disassembly cleaning disinfecting or sterilizing the single patient use CO2 airway adapters may compromise functionality and sys
39. setup ADULT CHILD NEONATAL The followings are the detail B 1 System 1 Standard Configuration 1 Trend Graph Configuration Region Parameter Region 1 HR Region 2 SpO2 Region 3 PR Region 4 NIBP Region 5 Resp Region 6 T14 T2 2 Trend Table Configuration Page 1 Region Parameter Region 1 HR Region 2 SpO2 Region 3 PR Region 4 NIBP S D Region 5 NIBP M Region 6 Resp Page 2 Region Parameter Region 1 HR Region 2 Tl Region 3 T2 2 Standard Configuration dual IBP 1 Trend Graph Configuration Page 1 Region Parameter Region 1 HR Region 2 SpO2 Region 3 P1 Region 4 P2 Region 5 Resp Patient monitor user s manual Page 2 Region Parameter Region 1 PR Region 2 NIBP Region 3 T1 T2 Region 4 NIBP 2 Trend Table Configuration Page 1 Region Parameter Region 1 HR Region 2 SpO2 Region 3 P1 Region 4 P2 Region 5 Resp Page 2 Region Parameter Region 1 PR Region 2 NIBP S D Region 3 NIBP M Region 4 Tl Region 5 T2 3 Standard Configuration dual IBP EtCO 1 Trend Graph Configuration Page 1 Region Parameter Region 1 HR Region 2 SpO2 Region 3 P1 Region 4 P2 Region 5 CO2 Page 2 Region Parameter Region 1 PR Region 2 NIBP Region 3 Resp Region 4 T1 T2
40. source And options are AUTO ECG and EtCQ Unit Select the unit for CO2 and options are mmHg and kPa Resp Gain Select the gain of RESP waveform from ECG and options are 1x 2x and 4x Alarm setup Click and open the dialog of CO3 alarm CO setup Click and open the dialog of CO2 setup Back to Main Return to main screen 5 47 Patient monitor user s manual Adjust Alarm EtCO2 Alarm FiCO2 Alarm Resp Alarm Apnea Alarm Previous Adjust alarm Select this option to enter the configuration of alarm limits conduct the configurations by turning the trim knob to select high or low limits and exit by selecting EXIT The upper part is the high limit and the lower one is the low limit EtCO alarm high limit its configuration range is 0 0 13 1 0 99 6mmHg continuously adjustable no lower than the low limit the configuration range of EtCO2 alarm low limit is 0 0 13 1 0 99 6mmHg continuously adjustable no higher than the high limit FiCO alarm high limit its configuration range is 0 0 13 1 0 99 6mmHg continuously adjustable no lower than the low limit the configuration range of FiCO gt alarm low limit is 0 0 13 1 0 99 6mmHg continuously adjustable no higher than the high limit RESP alarm high limit its configuration range is 0 150 rpm continuously adjustable no lower than the low limit the configuration range of RESP alarm low limit is 0 150rpm continuously adjustable no higher than
41. started performing calibration Inflate the pneumatic system to 0 50 and 200 mmHg by ball pump separately The difference between the indicated pressure of the reference manometer and the indicated pressure of the monitor will not exceed 3 mmHg Otherwise please contact our customer service Press the ee button on front panel can stop the calibration Monitor Reference Manometer Ball Pump Metal Vessel Fig 5 5 6 Diagram of NIBP calibration Air Leakage check Procedure of the air leakage test 1 2 3 4 5 6 7 Connect the cuff securely with the socket for NIBP air hole Wrap the cuff around the cylinder of an appropriate size Access the NIBP setup window Select the Air Leakage option and press Then the prompt Air Leakage test will appear on the NIBP parameter area indicating that the system has started performing Air Leakage test The system will automatically inflate the pneumatic system to about 180mmHg After 20 seconds or so the system will automatically open the deflating valve which marks the completion of an air leakage test If no error information displays on NIBP parameter area it indicates that the airway is in good situation and no air leaks exist However if the prompt AIR SYSTEM LEAK appears in the place it indicates that the airway may have air Patient monitor user s manual leaks In this case the user should check for loose connection After confirming sec
42. than the low limit the configuration range of FiO alarm low limit is 18 100 continuously adjustable no higher than the high limit FiO alarm cannot be switched off and when lower than 18 it will trigger high alarm EtO alarm high limit its configuration range is 18 100 continuously adjustable no lower than the low limit the configuration range of EtO2 alarm low limit is 18 100 continuously adjustable no higher than the high limit FiO alarm Select lt ON gt to enable FiO over limit alarm select lt OFF gt to disable FiO over limit alarm EtO alarm Select lt ON gt to enable EtO over limit alarm select lt OFF gt to disable EtO over limit alarm Note FiO alarm cannot be switched off Patient monitor user s manual E N Oalarm Click and open the dialog of N20 alarm Adjust Alarm EtN20 Alarm FiN2O Alarm Previous Adjust alarm Select this option to enter the configuration of alarm limits conduct the configurations by turning the trim knob to select high and low limits and exit by selecting EXIT The upper part is the high limit and the lower one is the low limit FiN2O alarm high limit its configuration range is 0 100 continuously adjustable no lower than the low limit the configuration range of FiN2O alarm low limit is 0 100 continuously adjustable no higher than the high limit EtN20 alarm high limit its configuration range is 0 100 continuously adjustable no lower than the low limit
43. the high limit and the lower one is the low limit SpO alarm Select lt ON gt to enable SpO over limit alarm select lt OFF gt to disable SpO over limit alarm PR alarm Select lt ON gt to enable PR over limit alarm select lt OFF gt to disable PR over limit alarm 5 3 5 Maintenance and Cleaning Warning E Do not subject the sensor to autoclaving E Do not immerse the sensor into any liquid E Do not use any sensor or cable that may be damaged or deteriorated Note When disposing the disposable SpO probe or useless SpO2 probe please observe all local state and federal regulations that relate to the disposal of this products or similar products For reusable SpO gt sensor Please unplug the sensor from the monitor before cleaning or disinfection Clean or disinfect the sensor before attaching to a new patient E Cleaning Use a piece of clean cloth moistened in water or mild soap solution to clean the sensor and patient contact surfaces E Disinfection Patient monitor user s manual Use a piece of clean cloth to wipe the sensor and patient contact surfaces with a 10 bleach solution or 70 isopropyl alcohol clean with clear water and wipe it dry 5 3 6 Signal strength prompt The signal strength prompt is used to indicate if the SpO gt signal strength measured is adequacy Prompt Description Weak Signal The invalidation weak signal The low intensity signal i The medium inten
44. to the transmitter manufacturer and d is the recommended separation distance in metres m Field strengths from fixed RF transmitters as determined by an electromagnetic site survey a should be less than the compliance level in each frequency range b Interference may occur in the vicinity of equipment marked with the following symbol gt NOTE 1 At 80 MHz and 800 MHz the higher frequency range applies NOTE 2 These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people a Field strengths from fixed transmitters such as base stations for radio cellular cordless telephones and land mobile radios amateur radio AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy To assess the electromagnetic environment due to fixed RF transmitters an electromagnetic site survey should be considered If the measured field strength in the location in which the Low Frequency Therapeutic Device is used exceeds the applicable RF compliance level above the Low Frequency Therapeutic Device should be observed to verify normal operation If abnormal performance is observed additional measures may be necessary such as reorienting or relocating the Low Frequency Therapeutic Device b Over the frequency range 150 kHz to 80 MHz field strengths should be less than 3 V m 20 Patient monitor user s man
45. 0 4 EtCO mmHg 20 45 FiCO gt mmHg 0 20 EtAA 0 0 3 0 FiAA 0 0 5 0 EtN20 0 82 FiN20 0 82 EtO2 10 100 FiO 18 100 Appendix Patient monitor user s manual C EMC Guidance and manufacture s declaration electromagnetic emissions for all EQUIPMENT and SYSTEMS Guidance and manufacture s declaration electromagnetic emission The Monitor is intended for use in the electromagnetic environment specified below The customer of the user of the Multi parameter Monitor should assure that it is used in such and environment Emission test Compliance Electromagnetic environment guidance RF emissions Group 1 The Monitor uses RF energy only for its internal function CISPR 11 Therefore its RF emissions are very low and are not likely to cause any interference in nearby electronic equipment RF emission Class A The Monitor is suitable for use in all establishments other CISPR 11 than domestic and those directly connected to the public Harmonic emissions Class A low voltage power supply network that supplies buildings IEC 61000 3 2 used for domestic purposes Voltage fluctuations flicker emissions Complies IEC 61000 3 3 Guidance and manufacture s declaration electromagnetic immunity for all EQUIPMENT and SYSTEMS Guidance and manufacture s declaration electromagnetic immunity The Monitor is intended for use in the electroma
46. 40s and 60s RESP alarm Click and open the dialog of RESP alarm configuration Adjust Alarm Resp Alarm Previous Adjust alarm Select this option to enter the configuration of alarm limits conduct the 5 14 Patient monitor user s manual configurations by turning the trim knob to select high or low limits and exit by selecting EXIT The upper part is the high limit and the lower one is the low limit RESP alarm Select lt ON gt to enable RESP over limit alarm select lt OFF gt to disable RESP over limit alarm 5 2 5 Maintenance and Cleaning No special operation demanded Please refer to chapter 5 1 8 5 3 Measurement of SpO Pulse 5 3 1 Principles of Measuring The measurement of degree of blood oxygen saturation also known as pulse oxygen saturation usually shortened as SpO adopts the principles of light spectra and volume tracing The LED emits lights with two specific bandwidths which are selectively absorbed by hemoferrum and desoxyhemoglobin The optical receptor measures the changes in the light intensity after the light passes the capillary network and estimates the ratio of hemoferrum and the total hemoglobin hemoferrum Degree of pulse oxygen saturation X 100 hemoferrum desoxyhemoglobin Abnormal hemoglobin carboxyhemoglobin oxidative hemoglobin are not directly measured for they are not the affecting factors in the measurement of Sp0 The sensor measurement wavelengths are no
47. BP MEAN mmHg 60 110 IBP1 SYS mmHg 90 160 IBP1 DIA mmHg 50 90 IBP1 MEAN mmHg 60 110 IBP2 SYS mmHg 6 14 IBP2 DIA mmHg 4 6 IBP2 MEAN mmHg 0 10 EtCO2 mmHg 20 50 FiCO2 mmHg 0 20 EtAA 0 0 3 0 FiAA 0 0 5 0 Patient monitor user s manual EtN20 0 82 FiN20 0 82 EtO2 10 100 FiO 18 100 Setup of parameters alarm limit for child Parameter Low limit High limit HR bpm 75 160 SpO2 90 100 PR bpm 75 160 RR rpm 8 30 T1 36 0 39 0 T2 36 0 39 0 NIBP SYS mmHg 70 120 NIBP DIA mmHg 40 70 NIBP MEAN mmHg 50 90 IBP1 SYS mmHg 70 120 IBP1 DIA mmHg 40 70 IBP1 MEAN mmHg 50 90 IBP2 SYS mmHg 2 10 IBP2 DIA mmHg 4 2 IBP2 MEAN mmHg 0 4 EtCO2 mmHg 20 50 FiCO2 mmHg 0 20 EtAA 0 0 3 0 FiAA 0 0 5 0 EtN20 0 82 FiN20 0 82 EtO gt 10 100 FiO 18 100 Setup of parameters alarm limit for neonate Parameter Low limit High limit HR bpm 90 200 SpO2 85 95 PR bpm 90 200 Patient monitor user s manual RR rpm 30 100 T1 C 36 0 39 0 T2 C 36 0 39 0 NIBP SYS mmHg 40 90 NIBP DIA mmHg 20 60 NIBP MEAN mmHg 25 70 IBP1 SYS mmHg 40 90 IBP1 DIA mmHg 20 60 IBP1 MEAN mmHg 25 70 IBP2 SYS mmHg 2 10 IBP2 DIA mmHg 4 2 IBP2 MEAN mmHg
48. EC 60601 2 34 The system must fulfill the requirements of Auxili tout ETE SERA standard IEC 60601 1 1 2 6 Patient monitor user s manual Chapter 3 Preparations Before the Use of the Monitor 3 1 Unpacking and Checking Unpack the package Open the package accessories include electrical wire various patient sensors and user s manual this manual warranty card certificate and particular paper and the lower foam case contains the monitor Remove the monitor and accessories p Caution Please place the monitor on level and stable supporting plane not on the places that can easily shock or wake Enough room should be left around the monitor so as to guarantee normal ventilation Keep all the packaging materials for future use in transportation or storage Check the monitor and accessories Check the monitor and its accessories one by one in accordance with the particular paper Check to see if the parts have any mechanical damages In case of problems please contact us or our agent 3 2 Connecting to Power 3 2 1 AC Power Confirm the rated AC current is AC 100 240V 50 60Hz Use the electrical wires provided along with the instrument put its output end plug round headed into the AC current socket on the back of the monitor and the plug of input end into a grounded socket of the mains It must be a special socket of the hospital connect the monitor through the earth one of e
49. ECG cable into the ECG socket and refer to Fig 5 1 5 to place the RA and LL leads onto the body of patient Warning For the sake of safety all the leads on the 5 lead ECG cable must be connected to the body of patient g Caution In order to get the best RESP waveforms when selecting lead II for measuring RESP it is advised to place RA and LL electrodes cornerways Caution For reducing the influence of rhythmic blood flow on Resp electrode pickup impedance changes avoid the liver area and ventricles of heart in the line between RA and LL electrodes This is particularly important for neonates Caution The measurement of RESP is not applicable for patient with excessive motion otherwise it may cause the mistake of RESP alarm Patient monitor user s manual 5 2 4 Setup of RESP parameters Scan Speed Resp Gain Resp Source Apnea Alarm Resp Alarm Back to Main Scan speed Select the scanning speed of RESP waveform and options are 6 25mm s 12 5mm s and 25mm s Resp gain Select the waveform gain and options are 1x 2x and 4x RESP source When the system is configured with CO module RESP source can be selected as AUTO ECG and EtCO2 Only when the monitor that user has bought has CO2 module EtCOQ of RESP source is valid otherwise the RESP source is defaulted as ECG Apnea alarm Suffocation alarm occurs when the time of zero RESP rate has reached this time scale the alarm will be set off Options are Off 10s 20s
50. IBP socket IBP1 and IBP2 NIBP cuff connector TEMP socket TEMP and TEMP2 PE SOW a ee Ce NS Receptacle for Dehydration flask 1 4 3 Rear View 100 240V 1 AC input socket 2 Potential equalization conductor terminal Base on the requirements of safety and anti interference the monitor must be connected with potential equalization system individual Connect the Potential equalization conductor terminal to the potential equalization system with the green and yellow potential equalization cable If the protection earth system is damaged the potential equalization system can take on the safety function of protection earth conductor 3 Auxiliary output connector Connect to the device such as oscillograph to output analog signals It also can be connected to nurse call system in hospital When an alarm occurs outputting the nurse call signal to remind nurse 4 Secondary display socket Connect to standard VGA display for secondary displaying 5 USB socket Connect to USB device Patient monitor user s manual 6 Network connector Standard RJ45 socket It is used for connection with the central monitoring system provided by manufacturer g Caution The AC input socket at the back panel of the monitor can be connected with 100 240V AC power by electrical wires supplied with this instrument Note The Network Connector is a standard RJ45 socket and being used for connection with the central monitoring system pr
51. IRMA airway adapter onto the IRMA probe without connecting the airway adapter to the patient circuit and then using the lt host instrument gt to transmit a calibration command to the IRMA probe Allow the IRMA probe to warm up for at least 15 minutes after power on and 2 minutes after changing airway adapter before transmitting the calibration command Zero Reference calibration is performed by snapping a new IRMA airway adapter onto the IRMA sensor without connecting the airway adapter to the patient circuit and then using the lt host instrument gt to transmit a calibration command to the IRMA sensor Special care should be taken to avoid breathing into the adapter during the zero reference calibration procedure The presence of ambient air 21 O2 and 0 COz in the IRMA airway adapter is of crucial importance for a successful zero reference calibration Always perform a pre use check after performing zero reference calibration Warning Incorrect probe zero calibration will result in false gas readings 5 11 7 3 Cleaning and disinfecting E Cleaning Use a piece of clean cloth moistened in water or mild soap solution to clean the sensor E Disinfection Use a piece of clean cloth to wipe the surface of the sensor with a 70 ethanol or 70 isopropyl alcohol Patient monitor user s manual Chapter 6 Alarm This chapter gives general information about the alarm and corresponding remedies Note The equipment generates all the a
52. M9500 Patient Monitor User s Manual Guangdong Biolight Meditech Co Ltd Address Innovation First Road Technology Innovation Coast Jinding Zhuhai P R CHINA Tel 86 756 3399900 Fax 86 756 3399989 http www blt com cn J M9500 A004 2008A1 Preface Thank you for using M9500 patient monitor In order to enable you to skillfully operate Monitor as soon as possible we provide this user s manual with delivery When you install and use this instrument for the first time it is imperative that you read carefully all the information that accompanies this instrument Based on the need to improve the performance and reliability of the parts and the whole instrument we sometimes will make some amendments to the instrument including the hardware and software As a result there might be cases of discrepancies between the manual and the actual situation of products When such discrepancies occur we will try our best to amend or add materials Your comments and suggestions are welcome Contact Information Address Innovation First Road Technology Innovation Coast Jinding Zhuhai PR CHINA Tel 86 756 3399900 Fax 86 756 3399989 Post code 519085 Toll free consultation hot line 86 800 830 1016 Statement This manual contains exclusive information protected by copyright laws and we reserve its copyright Without written approval of manufacturer no parts of this manual shall be photocopied Xeroxed or translated
53. ables and connectors must be replaced immediately Before using the system the operator must verify that it is in correct working order and operating condition Periodically and whenever the integrity of the product is in doubt test all functions CABLES Route all cables away from patient s throat to avoid possible strangulation TO CLEAR PATIENT DATA When monitoring a new patient you must clear all previous patient data from the system To accomplish this shut down the device and then turn on it Selecting New patient in main setup menu can also clear the previous patient data DISPOSAL OF PACKAGE Dispose of the packaging material please observe the applicable waste control regulations and keeping it out of children s reach EXPLOSION HAZARD Do not use this equipment in the presence of flammable anesthetics vapors or liquids LEAKAGE CURRENT TEST When interfacing with other equipment a test for leakage current must be performed by qualified biomedical engineering personnel before using with patients BATTERY POWER The device is equipped with a battery pack The battery discharges even when the device is not in use Store the device with a fully charged battery and take out the battery so that the service life of the battery will not be shortened DISPOSAL OF ACCESSORIES AND DEVICE Disposable devices are intended for single use only They should not be reused as performance could degrade or contamination c
54. alarm recording of the module and the switch for alarm record in the record setup have been switched on the physiological alarm in the relevant modules will trigger the alarm recording Alarm Record All OFF Default Setup Previous Alarm volume Configure the volume of alarm and options are off 1 2 3 4 5 6 Once a level is selected a testing beep will be produced 4 27 Patient monitor user s manual Note In each dialog of alarm configuration press the button Adjust Alarm and the cursor moves to the adjustment region of alarm limits Press the button Enable All and all the alarms will be opened If the user desires to adjust the alarm parameter of a certain parameter first move the cursor onto the label of that parameter and then press the trim knob to move the cursor up and down to select the parameter to be adjusted for revision 4 2 6 Patient info Case No Name Height Weight Sex Age Room No Bed No Previous Case No The case number of patients It can be configured according to the actual status of the hospital and a maximum of 10 letters can be entered press Del to delete and Clear to clear enter OK to confirm Name Patient name It can be selected among A Z and 0 9 and a maximum of 10 letters can be entered enter OK to confirm Height Body height of patient Turn the trim knob with an increment or decrement of 1 cm Weight Body weight of patient Turn the trim knob with
55. ance for the higher frequency range applies NOTE 2 These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people 21 Product name Patient Monitor Product type M9500 Manufacturer Guangdong Biolight Meditech Co Ltd Address Innovation First Road Technology Innovation Coast Jinding Zhuhai PR CHINA Tel 86 756 3399900 Fax 86 756 3399989 Post code 519085 Toll free consultation hot line 86 800 830 1016 PN 8 22 28 0001 02
56. arts of parameters Among them through lt Bed NO gt the number of online machine can be selected and through lt Bed wave gt the waveform display of other beds can be selected Press lt Run gt to initiate monitoring of other beds and press lt Stop gt to terminate the present monitoring of other beds Switching from monitoring of other beds screen to other screens will automatically terminate the present monitoring of other beds 4 2 Main Menu Select Screen Monitor Setup Mig Trend Review Mig Alarm Review Mig ARR Review Mig Alarm Setup Mig New Patient Mig Patient Info Mig Drug Dose Calc Mig Back to Main Patient monitor user s manual Select Screen Such eight display modes as Standard NIBP Review Big Numerics Short Trend 7 leads 12 leads oxyCRG and Other Bed can be selected And the display mode varies according to different manufacturer configurations Monitor Setup Click and open the dialog of monitor configuration Conduct some configurations of the monitor Trend Review Click and open the dialog of trend browse Browse trend tables or trend diagrams Alarm Review Click and open the dialog of alarm event review Browse alarm events ARR Review Click and open the dialog of arrhythmia review Browse the waveforms and events of arrhythmia Alarm Setup Click and open the dialog of alarm configuration Conduct configuration of alarm parameters New Patient Terminate the monitoring of the current patient an
57. ated the Pause status of alarm sound will be automatically cancelled Patient monitor user s manual Alarm indicating zone Physiological Technical alarm parameter alarm Alarm levels Red base color is high alarm Yellow base color is medium and low alarm The order displayed by the physiological parameter alarm is displayed from left to right in turn according to the alarm levels Parameter alarm The value of that parameter displayed on the upper part of the screen will flash to indicate the alarm of that parameter Patient monitor user s manual Chapter 5 Parameters Measurement 5 1 Measurement of ECG HR 5 1 1 Principles of Measuring Before the mechanical contraction the heart will firstly produce electrization and biological current which will be conducted to body surface through tissue and humors the current will present difference in potential in different locations of the body forming potential difference ECG also known as body surface ECG or regular ECG is obtained by recording this changing potential difference to form a dynamic curve Monitor measures the changes in the body surface potentials caused by the heart of the patient observe the cardioelectric activities record the cardioelectric waveforms and calculate the HR through the multiple electrodes connected to ECG cable 5 1 2 Precautions during ECG Monitoring Warning Before connecting the ECG cables to the moni
58. aturation TEMP Short for Temperature IBP Short for Invasive Blood Pressure NIBP Short for Non invasive Blood Pressure EtCO2 Short for End tidal carbon dioxide AG Short for Anesthetic gas Patient monitor user s manual Chapter 2 Important Safety Notes Warning For pacemaker patients Rate meters may continue to count the pacemaker rate during occurrences of cardiac arrest or some arrhythmias Do not rely entirely upon rate meter alarms Keep pacemaker patients under close surveillance See this manual for disclosure of the pacemaker pulse rejection capability of this instrument Warning Only trained doctors and nurses can use the device Warning The monitor is neither a therapeutic instrument nor a device that can be used at home 2 1 General Safety 1 Safety precautions for safe installation The input socket of monitor can be connected to the electrical wires and common electrical wire can be used Only the power supply type of AC 100 240V 50 60Hz specified by monitor can be used Connect the electrical wire to a properly grounded socket Avoid putting the socket used for it in the same loop of such devices as the air conditioners which regularly switch between ON and OFF Avoid putting the monitor in the locations where it easily shakes or wobbles Enough space shall be left around the monitor so as to guarantee normal ventilation Make sure the ambient
59. ay zone of the NIBP and for the cause of the errors please refer to chapter 6 8 6 Measurement Limitations Measurements are impossible with heart rate extremes of less than 40 bpm or greater than 240 bpm or if the patient is on a heart lung machine The measurement may be inaccurate or impossible 1 Ifa regular arterial pressure pulse is hard to detect 2 With cardiac arrhythmias 3 With excessive and continuous patient movement such as shivering or convulsions 4 With rapid blood pressure changes 5 With severe shock or hypothermia that reduces blood flow to the peripheries 6 With obesity where a thick layer of fat surrounding a limb dampens the oscillations coming from the artery 7 On an edematous extremity 5 5 6 Periodic Check Calibration Warning The calibration of the NIBP measurement is necessary for every two years of as frequently as dictated by your Hospital Procedures Policy The performance should be checked according to the following details Procedure of the Pressure Transducer Calibration 1 Replace the cuff of the device with a rigid metal vessel with a capacity of 500 ml 5 2 3 4 5 6 Patient monitor user s manual Connect a calibrated reference manometer with an error less than 0 8 mmHg and a ball pump by means of a T piece connector and hoses to the pneumatic system Access the NIBP menu Turn the trim knob to the Manometer option and press Then the NIBP module has
60. ble the switch of warning storage When it is enabled it indicates if there is a medium alarm of physiological parameters a record will be stored 4 11 Patient monitor user s manual E Short trend Setup Time Scale IBP2 EtC02 Scale ciscale Previous Time scale Select the time interval of short trend diagram Options are 5min 10min 15min 20min 30min 1h and 2h HR scale Select the scale of heart rate for short trend diagram Options are 0 160 min and 0 300 min SpO gt 2 scale Select the scale of SpO2 for short trend diagram Options are 40 100 60 100 and 80 100 RESP scale Select the scale of respiration rate for short trend diagram Options are 0 8 min 0 24 min 0 50 min and 0 100 min ST scale Select the scale of ST segment for short trend diagram Options are 2 2mm 5 5mm and 9 9mm IBP1 scale Select the scale of IBP1 for short trend diagram Options are 0 300mmHg 0 150mmHg 0 200mmHg 0 100mmHg 20 SOmmHg and 50 300mmHg IBP2 scale Select the scale of IBP2 for short trend diagram Options are 0 300mmHg 0 150mmHg 0 200mmHg 0 100mmHeg 20 SOmmHg and 50 300mmHg EtCO scale Select the scale of EtCO for short trend diagram Options are 0 30mmHg 0 60mmHg and 0 100mmHg Patient monitor user s manual E System Setup Language Recorder Setup Mig Time Setup Mig Mode config Mig Alarm Level Mig Machine Setup Mig Previous Language The categories of languages can be selected To
61. by speaker in the device Physiological alarm information is displayed in the Physiological Alarm area Most of technical alarm information is displayed in the Technical Alarm area Technical alarms related to NIBP measurement are displayed in the NIBP parameter area 6 1 Patient monitor user s manual The Physiological Alarm area is on the upmost right part of the screen The Technical Alarm area is to the left side of the Physiological Alarm area The alarm sound and visual display comply with clause 201 3 2 of the standard IEC 601 1 8 Note The concrete presentation of each alarm prompt is related to the alarm priority Alarm Sound The high medium low level alarms are indicated by the system in following different audio ways Alarm level Audio prompt Mode is DO DO DO DO DO DO DO DO DO DO High S ao ah tents which is triggered once every 10 seconds Medium Mode is DO DO DO which is triggered once every 25 seconds Low Mode is DO which is triggered once every 25 seconds Alarm Lamp light When technical alarm occurs the technical alarm lamp lights on in blue When physiological alarm occurs the physiologic alarm lamp lights according to the alarm level The high medium low level alarms are indicated by the system in following different visual ways Alarm level Visual prompt High Alarm indicating lamp flashes in red with 2 Hz Medium Alarm in
62. ccessories must be disposed of in compliance with the guidelines regulating the disposal of such products If you have any questions concerning disposal of the equipment please contact us Magnetic and electrical fields are capable of interfering with the proper performance of the equipment For this reason make sure that all external devices operated in the vicinity of the equipment comply with the relevant EMC requirements Mobile phone X ray equipment or MRI devices are a possible source of interference as they may emit higher levels of electromagnetic radiation Before connecting the equipment to the power line check that the voltage and frequency ratings of the power line are the same as those indicated on the 1 2 Patient monitor user s manual equipment s label or in this manual Always install or carry the equipment properly to avoid damage caused by drop impact strong vibration or other mechanical force 1 3 Brief Introduction to the Monitor fl 4 M fl fl 0 0 Of Of of FH OQ B fl The monitor has features as follows Multiple measuring functions include 3 lead 7 lead 12 lead ECG HR RESP dual EMP SpO gt 2 Pulse NIBP dual IBP EtCO2 and AG are optional Complete built in module design ensures stable and reliable performance Unique all lead ECG on one screen display which can facilitate the diagnosis and analysis of cardiac disease Can store the trend data for 168 hours and has t
63. cessories for fraying or other damage Qualified service personnel should repair or replace damaged or deteriorated cables Check all the functions relevant to patient monitoring make sure that the monitor is in good condition If you find any damage on the monitor stop using the monitor on patient and contact the biomedical engineer of the hospital or Manufacturer s Customer Service immediately Eg Note Refer to the User Maintenance Instruction for more comprehensive checkout procedures The overall check of the monitor including the safety check should be performed only by qualified personnel once every 6 to 12 month and whenever the monitor is fixed up gt Inspect the safety relevant labels for legibility gt Verify that the device functions properly as described in the instructions for use gt Test the protection earth resistance according IEC 60601 1 1995 Limit 0 lohm gt Test the earth leakage current according IEC 60601 1 1995 Limit NC 500uA SFC 1000uA gt Test the patient leakage current according IEC 60601 1 1995 Limit 100uA BF 10uA CF gt Test the patient leakage current under single fault condition with mains voltage on 9 1 Patient monitor user s manual the applied part according IEC 60601 1 1995 Limit 5mA BF 50uA CF The leakage current should never exceed the limit The data should be recorded in an equipment log If the device is not functioning properly or fails any
64. chever is greater Clinical 5 mmHg average error 8 mmHg standard deviation Unit mmHg kPa Patient monitor user s manual Pulse rate range 40 240 bpm Inflation time for cuff Less than 40s standard adult cuff 20 to 45s typical dependent on heart rate and Total cycle time motion artifact measurement time 2 4 8 hours Overpressure Protection Hardware and software double protections Adult 29743 mmHg Child 252 3 mmHg Neonatal 14743 mmHg SYS 0 300 mmHg continuously adjustable between upper limit and lower limit 0 300 mmHg continuously adjustable glam a ranee ne between upper limit and lower limit MEAN 0 300 mmHg continuously adjustable between upper limit and lower limit Alarm indication Sound and light alarming Adult Manual Auto and STAT Child Manual Auto and STAT Measurement Mode Neonatal Manual Auto HYPER Manual Auto and STAT SpO2 BLT SpO Measurement Range 0 100 Resolution 1 ee At 70 100 2 y At 0 69 unspecified Data update period lt 13s 0 100 continuously adjustable between upper Al ke iy arm range limit and lower limit PR Measurement Range 25 250 bpm Resolution 1 bpm Accuracy 1 or 1 bpm whichever is greater Data update period lt 13s 0 300 bpm continuously adjustable between upper limit and lower limit Alarm range 6 Patient monitor user s manual
65. cording to the usage and configuration of monitor NIBP and SpO monitoring and the usage of the recorder will drain battery power faster than other parameters Note When the monitor is connected to AC power the battery is in a state of being recharged When it is unable to be connected to the AC power the battery can be used to supply power and at this time it is unnecessary to use the electrical wires and the instrument can be switched on directly Note A Battery Low message displaying at the technical alarm information area of screen and an audible system alarm indicate approximate 5 minutes of battery life remaining You should connect the monitor to an AC power source when the message is displayed Wa Note This monitor contains a rechargeable battery The average life span of this type of battery is approximately three years When replacement becomes necessary contact a qualified service representative to perform the replacement 3 2 Patient monitor user s manual Disposal Note Should this product become damaged beyond repair or for some reason its service life is considered to be at an end please observe all local state and federal regulations that relate to the disposal of products that contain lead batteries plastics etc E Install Battery The battery storage is located at the bottom of the monitor following the steps to install a battery 1 Open the battery gate according to the direction marked on the m
66. correct monitoring state and alarm function 2 3 Classifications The Monitor is classified according to IEC 60601 1 1995 as Type of protection against electric shock I Degree of protection against electric shock BF EtCO gt AG CF ECG RESP TEMP IBP NIBP SpO2 Degree of protection against harmful ingress Ordinary Equipment enclosed equipment of water without protection against ingress of water Degree of safety of application in the Not suitable presence of a flammable anesthetic mixture with air or with oxygen or nitrous oxide Mode of operation Continuous operation 2 5 Patient monitor user s manual I Class I equipment BF Type BF applied part CF Type CF applied part Not suitable Equipment is not suitable for use in the presence of flammable anesthetic mixture with air or with oxygen or nitrous oxide 2 4 Safe Operating and Handling Conditions Method s of sterilization or disinfection Sterilization not applicable recommended by the manufacturer Disinfection See Maintenance and Cleaning gt General Cleaning Electromagnetic interference No cellular telephone nearby Electro surgical interference damage No damage Diathermy instruments influence Displayed values and prints may be disturbed or erroneous during diathermy Defibrillation shocks The monitor specifications fulfill the requirements of IEC 60601 1 IEC 60601 2 27 IEC 60601 2 49 I
67. d the measurement records can be browsed by turning the trim knob 3 Big Numerics 11 29 Gi Sever Fag Pao ee asp 126 83 95 3m The main parameters are displayed in big font e g HR SpO2 NIBP RESP and EtCO gt 4 2 4 Short Trend Patient monitor user s manual The short trend diagram relevant to the parameters is displayed on the upper left corner of the waveform 5 7 Leads ww Af amp eS F GE An al sm so A A ii I a Pi Nese sft Na J J f Y mtn wo 2X iw IPL so 1m 5o gt 102 wio nior mg Ti GAS an A m la Muur z fi na 126 83 95 Et ln pem 11 29 80 ECG bpa R 60 spn2 9 8 f f ood my TE es SJ coz miig ae 29 a 73 32 w9 71 56 A A 1 34 5 26 4 8 1 The ECG waveforms of 7 lead are displayed in the waveform display zone they are 426 83 I II II aVR aVL aVF and V respectively S ECG Ladd an alLa n rin a EON E L nh j L a n s PR g w 60 T 0 008 Ad ji l u i f l N i N L Na ah NN wll f ad N wh ah A m ae 9 8 coll ae h _ os A n eie A ae J wn coz etig Ficoz piw Ercoe fat PTET eo pi ba ii aden oaas eeii iaa a Da Bd P RR rom Mac P 29 peal Ar Jen ee A a e sipunin Tk G n we 49 N E A j A f _a Ns f J f A al Na Na A it Na A 71 56 61 MIO ae Tee sas in rene z z A A To Fi n 34 5 26 4
68. d initiate the monitoring of a new patient Pressing the option will delete the monitoring data of the current patient and patient Info and initiate the monitoring of a new patient Patient info Click and open the dialog of patient info It provides the input and browse of patient info Drug Dose Cale Click and open the dialog of drug concentration Open the calculation tool of drug concentration and it provides the calculation and printing of drug calculation and titration tables o Caution After initiating the monitoring of a new patient the data of historical patients will be completely eliminated 4 6 Patient monitor user s manual 4 2 1 Monitor Setup Beep Volume Alarm Volume Have Setup Mig Select Modu ig Trend store Mig Short Trend Hig System Setup Mg System Info Mig Demo Mig Previous Beep volume Set the volume of BEEP and options are Off 1 2 3 4 5 6 After one selection is made a testing beep will be produced Alarm volume Set the alarm volume and options are Off 1 2 3 4 5 6 After one selection is made a testing beep will be produced Wave Setup Click and open the dialog of waveform configuration Conduct the customization of screen waveforms and relevant waveform displays can be selected according to needs Select Module Click and open the dialog of module configuration Some of the modules not in current use can be switched off and after switching off the relevant parameters and waveforms w
69. dicating lamp flashes in yellow with 0 5 Hz Low Alarm indicating lamp lights on in yellow Screen Display Physiological alarm The parameter which triggers the alarm splashes in the frequency of 2Hz on the screen The physiological alarm area on the screen displays alarm message and red indicates high priority alarm yellow indicates medium or low priority alarm When Technical alarm or General alarm occurs the Technical alarm area displays alarm message red indicates high priority alarm yellow indicates medium or low priority alarm cyan indicates general message Note When alarms of different priorities occur at the same time the monitor prompts the one of the highest priority 6 2 Patient monitor user s manual 6 3 Alarm Setup Set Alarm volume Step 1 Select lt Alarm Volume gt item in Menu lt MENU gt gt lt Alarm Setup gt gt lt Alarm Volume gt Step 2 Set lt Alarm Volume gt item to lt Off gt lt 1 gt lt 2 gt lt 3 gt lt 4 gt lt 5 gt lt 6 gt Set alarm limits of physiological parameters The alarm limit of each physiological parameter can be set in its menu and they are continuous in alarm range For example ECG alarm setup Step 1 Select Menu lt ECG gt Step 2 Configure the following parameters related to ECG alarm lt HR LO gt and lt HR HE Please refer to above operation for Methods of Alarm setup of the other parameters
70. e Battery Charge LED 1 Yellow Battery Rechargeable Lithium ion battery 11 1V 4 0AH Charge time lt 6 hours 2 batteries for 12 hours 120 minutes 2 batteries for 240 minutes Operating time under the dorinabise aid full charge New and fully charged battery at 25 C ambient temperature and NIBP work on AUTO mode for 20 minutes interval Operating time after the first Sonate alarm if low battery Battery Type Rechargeable Lead acid cell 12V 2 0AH Charge time lt 10 hours 2 batteries for 20 hours 30 minutes 2 batteries for 60 minutes Operating time under the New and fully charged battery at 25 C ambient normal use and full charge temperature and NIBP work on AUTO mode for 20 minutes interval Operating time after the first alarm if low battery 5 minutes Recorder Option Method Thermal dot array Paper width 50 mm Record width 40 mm Paper Speed 12 5 mm s 25 mm s 50 mm s Traces Maximum 3 tracks Audio indicator Speaker QRS Sound with Pitch Tone Alarm Sound according to the requirement of IEC 60601 1 8 Patient monitor user s manual Interface Power supply 1 AC power socket Network 1 standard RJ45 socket USB 1 standard USB 1 1 socket Auxiliary output 1 standard BNC socket nurse call connector Equipotentiality terminal 1 System output Nurse Call signal
71. e TEMP probes must not be re sterilized or reused Note For protecting environment the disposable TEMP probe must be recycled or disposed of properly Disposal Note Should the TEMP probe become damaged beyond repair or for some reason its useful life is considered to be at an end please observe all local state and federal regulations that relate to the disposal of this products or similar products SB Warning The calibration of temperature measurement is necessary for every two years or as frequently as dictated by your Hospital Procedures Policy When you need calibrate the temperature contact the manufacture please Patient monitor user s manual Note The self test of the temperature measurement is performed automatically once every 10 minutes during the monitoring The test procedure lasts about one second and does not affect the normal measurement of the temperature monitoring Note If Temperature to be measured beyond probe s measuring range over measuring range alarm will display on the screen Check out if probe is on the corresponding patient body site or change it to other site on the patient Note If TEMP self check error display on the screen it is possibly that something is wrong with the temperature capture circuit the operator should stop using the monitor and contact with the company 5 5 Measurement of NIBP 5 5 1 Brief Introduction to Measurement of NIBP Monitor automatically conducts mea
72. e been met disposal should be accomplished following national and local requirements Nitrous oxide elevated levels of oxygen and helium can influence the CO2 measurement Please setup gas compensation according to actual state Barometric pressure compensation is required to meet the stated accuracy of the LoFlo Module Patient monitor user s manual 5 10 Measurement of CO2 Mainstream CAPNOSTATS 5 10 1 Preparing to Measure CO2 1 Attaching the CAPNOSTAT 5 sensor cable To attach the CAPNOSTAT 5 sensor cable plug the cable into CO2 socket on the left panel of monitor by matching the key on the cable to the key on the connector Caution To remove the sensor cable from the monitor grasp the collar surrounding the cable and pull up 2 Selecting a mainstream airway adapter Select an airway adapter based on the patient s size ET tube diameter and monitoring situation For more information refer to the following table or contact manufacturer Airway Adapter Type ET Tube Diameter SPU Pediatric Adult SPU Neonatal Pediatric Neonatal Reusable SPU Single Patient Use 3 Attaching the airway adapter to the CAPNOSTAT 5 sensor Before attaching the airway adapter to the CAPNOSTAT 5 sensor verify that the airway adapter windows are clean and dry Clean or replace the adapter if necessary Follow these steps 1 Align the arrow on the bottom of the airway adapter with the arrow on the bottom of the sensor 2 Press the
73. e fourth line Select Off close the wave display or select certain waveform to display Waveform 5 Select the waveform displayed in the fifth line Select Off close the wave display or select certain waveform to display Waveform 6 Select the waveform displayed in the sixth line Select Off close the wave display or select certain waveform to display Waveform 7 Select the waveform displayed in the seventh line Select Off close the wave display or select certain waveform to display 4 8 Patient monitor user s manual E Select Module Module Module Module Module ij Module cg Module Module Module Previous SpO module Enable Disable the display of SpO2 module After switching off the SpO2 parameters and relevant alarm will not be displayed and the current SpO2 waveform will be automatically switched off After it is open the SpO2 waveform will also be opened NIBP module Please refer to SpO2 module instruction RESP module _ Enable Disable the display of RESP module After switching off the RESP parameters and relevant alarm will no be displayed and the current RESP waveform will be automatically switched off After it is open if there is no CO module the RESP waveform will be opened automatically CO module Enable Disable the display of CO2 module After switching off the CO2 parameters and relevant alarm will no be displayed and the current CO2 waveform will be automatically switched off After it is open the CO2
74. e is below lower alarm User Selectable FiCO Hi FiCO measuring value is above upper alarm User Selectable FiCO Lo FiCO measuring value is below lower alarm User Selectable Apnea No breath detected in the set period User Selectable Technical Alarm Message Cause Alarm Level Sensor Over Temp Sensor over temperature High Sensor Faulty Sensor error High Check Sampling Line Sampling line blockage or damage Low Sampling line is kinked or pinched Exhaust tube is blocked Zero Required Negative CO detected the module needs to High be zeroed CO Out of Range The calculated CO value is out of range Low Check adapter The adapter is removed from the module Low Sensor no initialized Sensor or module is not initialized Low Patient monitor user s manual Prompt Message Cause Alarm Level Zero in Progress Zeroing is in progress No Alarm Sensor Warm Up Module is warming up No Alarm 6 8 10 AG alarm and promotion Physiological alarm FiAA too low FiAA is below lower alarm limit Message Cause Alarm Level EtAA too high EtAA is above upper alarm limit User Selectable EtAA too low EtAA is below lower alarm limit FiAA too high FiAA is above upper alarm limit User Selectable FiN2O too low FiN2O is below lower alarm limit EtN20 too high EtN2O is above upper alarm limit User Selectable EtN20O too low EtN 0 is below lower alarm limit FiN2O too high FiN2O is
75. e measuring value has exceeded the set parameter limit and its lt ALM LEV gt is not lt OFF gt the monitor alarms The monitor wouldn t alarm with absence of either of the two conditions Technical Alarm Once system fault occurs the monitor will alarm immediately and trigger corresponding operations such as stop displaying values and waveforms erase the last screen to avoid misleading The screen displays more than one fault message by alterative General Prompt Sometimes there are alarms similar to Technical Alarms but can be considered as normally The condition which triggers this kind of alarm wouldn t bring danger to the patient 6 5 Silence Suspension SILENCE Press theZ i button and hold for 2 seconds can shut off all sounds until the A X button is pressed again When the system is in SILENCE status any newly generated alarm will cancel the SILENCE status and make the system back to normal status 6 5 Patient monitor user s manual When in the SILENCE status the icon X will be displayed in the left upper of the screen SUSPENSION Press the AX X button once can close all audio and visual prompt and description about all the physiological alarms and to make the system enter ALARM PAUSE status The rest seconds for alarm pause is displayed in the Physiological Alarm area And the symbol r 4 is displayed in the System Prompt area The time for Alarm Suspension is 2 minutes
76. econds each block 1 1 Select this button and it is possible to turn the pages back and forth and the number before shows the current page and the number following shows total page numbers Record Print the enlarged waveform in current selection through the recorder Exit Exit the dialog of ECG replay The states of the filter under various modes of ECG reo ter ECG mode Drift filter HUM filter EMG filter DIAG OFF OFF OFF OPS Drift 2 50Hz 60Hz 25Hz MON Drift 1 50Hz 60Hz 40Hz USER Optional Optional Optional Note Under the mode of DIAG OPS and MON the state of the filter cannot be regulated Only under the state of USER can the state be regulated o Caution When 3 Lead is selected as lt Lead Type gt ECG is in 3 lead input mode and only Lead I II or III can be measured o Caution When 5 Lead is selected as lt Lead Type gt ECG is in 5 lead input mode and Lead I II HI aVR aVL and aVF and one chest lead can be measured at the same time if chest lead ECG cable is connected V1 V6 can be measured at the same time Patient monitor user s manual 5 1 7 Functions of Arrhythmia Analysis Note Arrhythmia Analysis software module may be an optional function in your monitor The function is consisting of ST segment analysis and arrhythmia analysis Arrhythmia analysis can identify more than 18 kinds of abnormal ECG as listed in the following table
77. ect IRMA airway adapter to the breathing circuit Y piece After the monitor is powered up and it functions normally with the CO2 module indicator light turns green The IRMA CO sensor is ready for use and there is no need to start the sample pump 2 Do not place the IRMA airway adapter between the ET tube and an elbow as this may allow patient secretions to block the adapter windows g 5 44 Patient monitor user s manual 3 To keep secretions from pooling on the windows position the IRMA airway adapter with its windows in a vertical position and not in a horizontal position Measuring window 4 To prevent rain out and moisture from draining into the IRMA airway adapter do not place the airway adapter in a gravity dependent position 5 Do not use the IRMA airway adapter with nebulized medications as this may affect the light transmission of the airway adapter windows Never sterilize or immerse the IRMA sensor in liquid Do not apply tension to the sensor cable If error occurs in IRMA sensor the indicate light will keep in red and blink in red means the sensor is check the airway adapter 9 Use apiece of clean cloth and alcohol for IRMA CO cleaning 5 8 7 Maintenance and Cleaning 5 8 7 1 Zero reference calibration Gas readings should be verified with a reference instrument at regular intervals A zero reference calibration of the IR measurement should be performed whenever an offset in gas readings is
78. el Unit Scan Speed Wave Scale Display IBP Alarm Mig IBP Zero Back to Main IBP Label Select the names of IBP labels Options are IBP1 IBP2 ART CVP PA RAP ICP and LAP Unit Select the units of IBP and options are mmHg kPa and cmH 0 Scan speed Select the scanning speed of IBP waveforms and options are 12 5mm s 25mm s and 50mm s Patient monitor user s manual Wave scales Select the scale of IBP waveforms and options are AUTO 0 200mmHg 0 300mmHg 10 20mmHg and 50 300mmHeg Display Select the format of IBP display and options are S D M S D Mean and M S D IBP Zero Conduct zero calibration on IBP IBP Alarm Click and open the dialog of IBP alarm limit configuration IBP1 Sys Previous IBP1 Dia IBP1 Mean Adjust alarm Select this option to enter the configuration of alarm limits conduct the configurations by turning the trim knob to select high and low limits and exit by selecting EXIT The upper part is the high limit and the lower one is the low limit Alarm Source Select the alarm source for NIBP parameters When the selected parameter or one of the parameter exceed alarm limit the monitor will give out alarm signal The options are as follow S Only Systolic pressure exceeds the alarm limit will trigger the alarm system D Only Diastolic pressure exceeds the alarm limit will trigger the alarm system M Only Mean pressure exceeds the alarm limit will trigger the alarm sys
79. ely when the energy converter is not used Note Anytime the user applies a new transducer it should be verified or periodically verified according to the hospital operating rules Warning Disposable pressure transducer should not be reused And it must be used before expired data Do read the expired data on the IBP accessory package bag Patient monitor user s manual Warning When the monitor is used with HF surgical equipment the transducer and the cables must be avoided conductive connection to the HF equipment to protect against burns to the patient The specified transducer is designed to protect against the effects of a discharge of a cardiac defibrillator When the patient is in the defibrillation the waveform of IBP maybe distorted temporarily After the defibrillation the monitoring will go on normally the operation mode and the user configuration are not affected Warning The operator should avoid contact with the conductive parts of the appurtenance when being connected or applied 2 Plug the cable of IBP into the IBP socket on the right panel of the monitor Connect the extension tube of the transducer and blood vessel with the artery needles and secure them then make sure three way valve 1 and three way valve 2 See Fig 5 6 4 are in a state of ON At this moment BP waveforms should appear on the screen of the monitor 3 Set up parameters and modes relevant to IBP 5 6 3 Setup of IBP Parameters IBP Lab
80. en the amplifier is saturated or overloaded the input signal is medical meaningless then the equipment gives an indication on the screen 5 3 Patient monitor user s manual 2 Location for electrode placement PS 4 EF TH 86 Q Fig 5 1 5 Indicative map of the placement of ECG electrodes The following table shows the lead name to identify each lead wire and its associated color of AHA and IEC standards Label Color Label Color ed 2_ Yellow 4th intercostal space on the left sternum side 3 Green Center of the line connecting V2 and V4 C C C C Red 4th intercostal space on the right sternum side gt 3 4 Node of the left 5th intercostal space and the mid clavicular line Node with the left anterior axillary line at the same C6 Node with the left mid axillary line at the same height with V4 5 4 Patient monitor user s manual When conducting 3 leads ECG monitoring use 3 lead ECG cable The three limb leads of RA LA and LL as shown in Fig 5 1 5 will be placed on the relevant locations This connection can establish the lead of I I III When conducting 7 leads ECG monitoring use 5 lead ECG cable The four limb leads of RA LA RL and LL as shown in Fig 5 1 5 will be placed on the relevant locations This connection can establish the lead of I II HI aVR aVL aVF according to actual needs chest lead C can be placed on any of the locations between C C re
81. er capability Operate the patient monitor in the environment according to the instruction Use AC power for the patient monitor when available Recharge the battery sooner when it is off The volume of battery will not be charged to what it should be when the battery has not been charged for a long time 9 2 Patient monitor user s manual If the monitor is not used for long time the AC power should be plugged in until the battery is fully recharged then take out the battery so that the service life of the battery will not be shortened Avoid exposed and sun shine Avoid infrared and ultraviolet radiation Avoid moist dust and erosion from acid gas For Lithium ion battery A lithium ion battery needs at least two conditioning cycles when it is put into use for the first time A battery conditioning cycle is one complete uninterrupted charge of the battery followed by a complete uninterrupted discharge of the battery A lithium ion battery should be conditioned regularly to maintain its useful life Condition a battery once when it is used or stored for two months or when its run time becomes noticeably shorter To condition a lithium ion battery follow this procedure 1 Disconnect the monitor from the patient and stop all monitoring and measuring procedures 2 Place the lithium ion battery in need of conditioning into battery compartment of the monitor 3 Connect the monitor to the AC main
82. es of equipment Standard sphygmomanometer 3 way stopcock Tubing approximately 25 cm long The Calibration Procedure Warning You must never perform this procedure while patient is being monitored Patient monitor user s manual 1 Close the stopcock that was open to atmospheric pressure for the zero calibration 2 Attach the tubing to the sphygmomanometer 3 Ensure that connection that would lead to patient is off 4 Connect the 3 way connector to the 3 way stopcock that is not connected to the patient catheter 5 Open the port of the 3 way stopcock to the sphygmomanometer 6 Inflate to make the mercury bar rise to 0 50 and 200 mmHg separately The difference between the indicated pressure of the sphygmomanometer and the indicated pressure of the monitor will not exceed 4 or 4 mmHg whichever is greater Otherwise please contact the manufacturer 7 After calibration disassemble the blood pressure tubing and the attached 3 way valve 5 6 8 Maintenance and Cleaning Warning The disposable transducers or domes must not be re sterilized or re used Note For protecting environment the disposable transducers or domes must be recycled or disposable of properly Disposal Note When disposing the disposable transducers or domes and tubing please observe all local state and federal regulations that relate to the disposal of this products or similar products 5 7 Measurement of CO Sidestream CPT Use t
83. figuration Enable All Select this option and configure all the Arrhythmia alarms as low level alarms e ECG Setup Lead Type Scan Speed MODE Resp Lead Display PR ARR Setup Previous Lead Type Select the lead type of ECG input and options are 5 leads 3 leads Auto and 12 leads Scan speed Select the scanning speed of ECG waveforms and options are 12 5mm s 25mm s and 50mm s The output speed of the recorder remains the same as the scanning speed of the ECG lead MODE Select monitoring mode and options are User Diagnosis Monitor and Operation Resp Lead Select the calculation methods of RESP lead and options are RA LL RA LA RL LA and RL LL DRIFT Select the modes of drift filtrations and options are Off Drift 1 and Drift 2 EMG _ Select myoelectric filtration and options are Off 25Hz and 40Hz HUM Select hum frequency filtration and options are Off and on Specific frequencies 50Hz 60Hz are configured in Machine Setup and they must be configured according to the frequency of local power supply 5 8 Patient monitor user s manual Display PR Select to simultaneity display pulse rate If simultaneity display of PR is selected PR will be simultaneity displayed at the lower left corner of the ECG parameter display region ARR Setup Click and open the dialog of Arrhythmia analysis configuration Configure some of the parameters of Arrhythmia analysis ARR ST PACEMAKER PYCs PACs ST High
84. g to the cause of the alarm 1 Check the patient s condition Identify which parameter is alarming or which kind of alarm it is Silence the alarm if necessary 2 3 Identify the cause of the alarm 4 5 When cause of alarm has been over check that the alarm is working properly 6 8 Alarm Description and Prompt 6 8 1 ECG Alarm Physiological Alarm Message Cause Alarm Level HR too high HR measuring value is above the upper User selectable alarm limit HR too low HR measuring value is below the lower User selectable alarm limit Technical Alarm Message Cause Alarm Level ECG RA LA LL V LEAD ECG electrode fall off the skin or ECG TE OFF cables fall off the monitor ECG electrode polarized ECG electrode polarized Low T EE E ad measurement failure or communication hee failure HR alarm error Alarm failure Low 6 8 2 RESP Alarm Physiological Alarm Patient monitor user s manual Message Cause Alarm Level A RR measuring value is above the upper alarm RR too high e User Selectable limit RR measuring value is below the lower RR too low Wa User Selectable alarm limit RESP Apnea No signal for breath in specific interval User Selectable Technical Alarm Message Cause Alarm Level RR alarm error Alarm failure Low 6 8 3 SpO2 Alarm Physiological Alarm Message Cause Alarm Level SpO measuring value is above the u
85. gnetic environment specified below The customer or the user of Low Frequency Therapeutic Device should assure that it is used in such an environment Immunity test IEC 60601 test level Compliance level Electromagnetic environment guidance Electrostatic discharge ESD IEC 61000 4 2 6 kV contact 8 kV air 6 kV contact 8 kV air Floors should be wood concrete or ceramic tile If floor are covered with synthetic material the relative humidity should be at least 30 Electrical fast transient burst 2 kV for power supply lines 2 k V for power supply lines Mains power quality should be that of a typical commercial or hospital IEC 61000 4 4 1 kV for input output 1 kV for input output environment lines lines Surge 1 kV differential mode 1 kV differential mode Mains power quality should be that of IEC 61000 4 5 2 kV common mode 2 kV common mode a typical commercial or hospital environment Voltage dips short interruptions and voltage variations on power supply input lines IEC 61000 4 11 lt 5 UT gt 95 dip in UT for 0 5 cycle 40 UT 60 dip in UT for 5 cycles 70 UT 30 dip in UT for 25 cycles lt 5 UT gt 95 dip in UT for 0 5 cycle 40 UT 60 dip in UT for 5 cycles 70 UT 30 dip in UT for 25 cycles Mains power quality should be that of a typical commercial or hospital environment lt 5 UT lt 5 UT g
86. he AC power supply and options are 50Hz and 60Hz It is mainly configured according to the frequency of local power supply Gas zero Conduct zero calibration on mainstream CO module or anesthesia gas module Press this button the following dialog will pop up Select OK to conduct zero calibration operation If Cancel is selected the zero calibration will not be implemented Patient monitor user s manual Note The zero calibration of Gas is only valid on the mainstream CO module and AG module of IRMA Company Nurse call setup Please refer to chapter 8 for details E System Maintenance Trend Setup Mig Color Mig Network Setup Mig OverPress Manometer NIBP Reset Demo Recorder Cali Previous Trend Setup Click and open the dialog of trend display configuration Conduct configurations of trend diagrams and trend tables Color Click and open the dialog of color configuration and configure colors of parameters and waveforms Network Setup Click and open the dialog of network configuration Conduct network configurations Over press_ Initiate NIBP over pressure test Manometer Initiate NIBP manometer test NIBP reset Reset NIBP module Demo Switch on or switch off demonstration function Recorder cali Conduct speed calibration of the recorder This operation must be conducted when the recorder is changed E Trend Setup The user can define various trend display info according to needs or use the display c
87. he CO2 measurement to monitor the patient s respiratory status and to control patient ventilation The measurement principle is primarily based on the fact that CO molecules can absorb special infrared light where the intensity of infrared light passing the respiratory gas is measured with a photo detector As some of the infrared light is absorbed by the CO molecules the amount of light passing the gas probe depends on the concentration of the measured CO3 5 7 1 Brief Introduction to Measurement of Sidestream EtCO e According to the Fig 5 7 1 snap slantways dehydration flask on the receptacle fixed on the monitor It will click into place when properly seated 5 35 Patient monitor user s manual a Receptacle fixed on the monitor Dehydration flask Fig 5 7 1 The installation sketch map of dehydration flask e According to the Fig 5 7 2 nip slantways the dehydration flask and disconnect from the receptacle fixed on the right panel of monitor It will be remove the dehydration flask Receptacle fixed on the monitor Nip here ff Dehydration flask i QA Fig 5 7 2 Remove sketch map of dehydration flask Nip here According to the Fig 5 7 3 one end of the sampling tube has been connected with screw thread interface of the dehydration flask and the other end of the sampling tube has been connected with the screw thread interface tube 10mm of the patient Anaesthesia machine or Ventilator If not the type
88. he IRMA sensor is ready for use A blue LED indicates that may measurement of AG 3 Always position the IRMA sensor with the O cell pointing upwards And the O cell can be taken out by whirling it Patient monitor user s manual 5 11 2 Pre use check 1 Before connecting the IRMA airway adapter to the breathing circuit verify the O2 calibration by checking that the O2 reading on the monitor is correct 21 See 5 8 3 for instructions on how to perform room air calibration 2 Verify that there has not been any accumulation of gas between the IRMA sensor head and the BLUEYE windows by checking that the CO and Agent readings on the monitor are correct before connecting a patient to the breathing circuit 3 Perform the tightness check of the patient circuit with the IRMA sensor head snapped on the IRMA airway adapter 4 Check that the connections have been made correctly by verifying an actual gas waveform on the monitor display 5 11 3 Room Air Calibration Room air calibration of the oxygen sensor will be performed automatically at regular intervals whenever the IRMA sensor head is disconnected from the IRMA airway adapter If the IRMA sensor is kept in operation for a long time period without being disconnected from the airway adapter or if the operating temperature for the oxygen sensor changes significantly the IRMA sensor will indicate that a new room air calibration is required and a message will appear on the monitor
89. he function of displaying trend data and trend graphs Function of alarm event reviewing can store 1800 pieces of alarm events Function of NIBP measurement reviewing can store 1000 pieces of NIBP easurement data Function of reviewing 30 minutes one important lead s EGC waveform Built in recorder is optional and it supports real time recording trigger printout by arm Parameter display with big character Optional function of Calculator of drug concentration Optional function of Display of oxyCRG Function of Display of short trend 15 authentic color high brightness TFT LCD monitor Portable design stylish and convenient Rechargeable maintenance free battery can continue working when AC power is off Nurse call function guarantee patient alarm draws enough attention Can be connected with the central unit to realize centralized monitoring M Is resistant to high frequency electrotome and is protected against defibrillation effects Patient monitor user s manual 1 4 Appearance and Structure of the Monitor 1 4 1 Front View ESA M9500 12 11 10 9 8 7 6 5 4 1 Physiological alarm indicating lamp 2 Technical alarm indicating lamp 3 Trim Knob The Trim Knob is used for Turn left or turn right to move the cursor Press down to perform an operation such as open the menu dialog or select one option 4 mm Press this button once to open the main menu dialog 5 e ee Press this button in 2 sec
90. he module can be zeroed 5 9 3 Zero Zeroing allows the LoFlo module or CAPNOSTAT 5 sensor to adjust to the optical characteristics in order to obtain accurate readings While zeroing is recommended the first time a LoFlo module or CAPNOSTAT 5 sensor is connected to the unit it is only absolutely necessary when the message Zero Required is displayed 5 49 Patient monitor user s manual Warning E Always ensure that the sample cell is properly connected to the LoFlo module before zeroing E Always ensure that the CAPNOSTATS sensor is properly connected to the airway adapter before zeroing Follow these steps 1 Ensure that the nasal cannula or airway adapter is not connected to the patient or close to any source of CO2 including the patient s your own exhaled breath and ventilator exhaust valves 1 Press the Zero option in CO Setup menu The unit zeroes the module and displays the Zero In Progress message for approximately 15 20 seconds The message disappears upon completion of the zeroing Note E Do not attempt zeroing for 20 seconds after removing the adapter or cannula from the patient s airway This time allows any CO2 remaining in the adapter or cannula to dissipate before zeroing E Do not attempt to zero the module while the adapter or cannula is in the patient s airway E Do not attempt zeroing if the temperature is not stable E Zeroing with CO2 in the adapter or cannula can lead to inaccu
91. ht and then enter other known values E Drug name Move the cursor to Drug name press the trim knob then turn the trim knob to select drug and only one kind of drug can be selected for calculation at one time DRUG _A DRUG _B DRUG C DRUG _D and DRUG E are only codes for drugs rather than their real names The units for these five kinds of drugs are fixed and the operator can select the appropriate units according to the habits of the drugs The rules of the units are as follow DRUG_A DRUG B DRUG C are fixed at the serial units of gram g milligram mg and microgram mcg Patient monitor user s manual DRUG _D is fixed at the serial units of unit k unit and m unit DRUG E is fixed at the unit of mEq E Weight The operator should enter the patient weight first and as independent info the weight is only used in the function of the calculation of drug concentration Turn the trim knob to move the cursor to the positions of the various calculation items in the calculation formula respectively turn the trim knob and select calculation value then press the trim knob and confirm the selected calculation value When the calculation value is selected the value of the calculated item will be displayed at relevant locations There are range limits for the value adoption of each calculation Item if the calculation results exceed the range will be displayed Regarding this function of drug calculation the values for othe
92. ibility of the user to ensure that a zero procedure has recently been done on the transducer otherwise there will be no recent valid zero value for the instrument to use which may result in inaccurate measurement results Procedure of the IBP Transducer Zero 1 2 3 4 5 6 Turn off patient stopcock before you start the zero procedure The transducer must be vented to atmospheric pressure before the zero procedure The transducer should be placed at the same height level with the heart approximately mid axially line Access the Set IBP menu Turn the dial to pick the Zerol item Pick the Zero2 item when zeroing channel 2 IBP and press will start zero the transducer Wait 3 seconds for the Zeroing procedure end and the pressure value that is displayed on screen will approximately return to zero p Caution Zero procedure should be performed before starting the monitoring and at least once a day and whenever after each disconnect and connect of the cable E IBP Calibration Caution gt Mercury calibration should be performed by the biomedical engineering department either whenever a new transducer is used or as frequently as dictated by your Hospital Procedures Policy The purpose of the calibration is to ensure that the system gives you accurate measurements Before starting a mercury calibration a zero procedure must be performed If you need to perform this procedure yourself you will need the following piec
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94. ill not be displayed and no alarm will be made Trend storage Click and open the dialog of configuration of trend storage It provides the configuration function on the mode of trend storage and several modes of trend storage can be defined Short Trend Click and open the dialog of short trend diagram Some scales and time of short trend diagram can be defined System Setup Click and open the dialog of system configuration Conduct the configuration and maintenance of systems System info Click and open the dialog of system info Some info of the system will be displayed such as version info Demo Switch on or switch off demonstration function 4 7 Patient monitor user s manual E Waveform Setup Waveform 1 Waveform 2 Waveform 3 Waveform 4 Waveform 5 Waveform 6 Waveform 7 Previous Waveform 1 Select the waveform displayed in the first line and according to the lead types different ECG waveforms can be selected Note The lead must be the ECG waveform and cannot be switched off At 3 Leads mode it is the key monitoring lead and it is defaulted as Lead II Waveform 2 Select the waveform displayed in the second line and options are Off Cascade and random waveform When selecting lt Cascade gt waveform 2 is the cascade of waveform 1 Waveform 3 Select the waveform displayed in the third line Select Off close the wave display or select certain waveform to display Waveform 4 Select the waveform displayed in th
95. into other languages The contents and version contained in this manual are subject to amendments without notification The version number of this manual Al Manufacturer s Responsibility Only under the following circumstances will manufacturer be responsible for the safety reliability and performance of the instrument All the installation expansion readjustment renovation or repairs are conducted by the personnel certified by manufacturer The electrical safety status at the installation site of the instrument conforms to the national standards The instrument is used in accordance with the operation procedures CE mark Cin EC Representative Name Shanghai International Holding Corp GmbH Europe EC Representative Address Eiffestrasse 80 D 20537 Hamburg Germany Copyright reserved 2008 Guangdong Biolight Meditech Co Ltd II Contents Chapter 1 General Introduction oeessoessoessseossocssoossoossoossssesssosesoossoosssossssesssosssoossoossos 1 1 N 1 mtended O86 cc ciiccsaceuscdesudeccousccscusexe suns sodanccgntetsvsvsesavectovechsshsaiecnssedeReasarscebeubesechvessed 1 1 1 2 About this Manu al s ssssssssssssssssssssossoesssosssssssososoossossostsssooose esios sssssoss oso soise seoesess 1 1 1 3 Brief Introduction to the Monitor seessseoesooessoesssesssesesoosssocssoossoosssoesssesssosssossso 1 3 1 4 Appearance and Structure of the Monitor ssssssesssec
96. is option to record the trend tables of the current page but the trend diagram does not support recording Scale Press this option and the time intervals for one page of trend diagrams can be selected Options are 1h 2h 4h 6h 8h 10h 12h 24h 48h and 72h Graph Press this option to switch to the display of trend diagram Table Press this option to switch to the display of trend tables 4 2 3 Alarm Review 2007 05 24 14 21 42 2007 05 24 14 21 53 ime 2007 05 24 14 21 05 HR 0 Scroll record lt lt gt gt Select this button turn the trim knob to roll the records back and forth 1 1 Select this button turn the trim knob to turn the pages back and forth Record Print the currently selected alarm events through the recorder and if no recorder is configured this option is invalid Exit Exit the dialog of alarm review 4 2 4 ARR Review Patient monitor user s manual ARR RECALL 001 128 2007 05 24 14 22 40 BRADY Exit analysis replay Click and open the dialog of arrhythmia review and the arrhythmia data for 8 seconds are displayed on each screen i e the ECG waveforms 4 seconds before and after the occurrence of the event and a maximum of 128 groups of abnormal data can be stored for search lt lt Turn to the first abnormal waveform record gt gt Turn to the last abnormal waveform record lt lt gt gt Select this button and turn the trim knob to turn the records back and forth
97. it and lower limit MEAN 50 300 mmHg continuously adjustable between upper limit and lower limit Alarm indication Sound and light indication EtCO2 Sidestream CPT Measure method Infrared spectrum Measure mode Sidestream Measurement Range 0 0 13 1 0 99 6 mmHg Resolution 1 mmHg Unit mmHg kPa Acin At lt 5 CO2 0 3 2 0 mmHg y At gt 5 CO lt 10 of reading Range of respiration rate 3 150 rpm measurement ee Offset calibration auto manual Calibration Gain calibration 0 0 13 1 0 99 6mmHg continuously adjustable Alarm range between upper limit and lower limit Alarm indication Sound and light indication EtCO2 Mainstream IRMA Measure method Infrared spectrum Measure mode Mainstream Measurement Range 0 0 13 1 0 99 6 mmHg Resolution 1 mmHg Patient monitor user s manual Alarm range Unit mmHg kPa 0 0 i Aeaiaey 0 5 o 4 0 mmHg or lt 10 of reading which is greater Rise time at 10 L min lt 90 ms Total system response time lt Is Range of respiration rate 0 150 rpm measurement RR Accuracy 1 rpm 0 0 13 1 0 99 6mmHg continuously adjustable between upper limit and lower limit Alarm indication Sound and light indication EtCO2 Microstream LoFlo Measure method Infrared spectrum Measure mode Microstream Warm up time Capnogram displayed in less than 20 s At an ambient temperature of
98. lectrical wires When the indicating light above the power switch on the panel of the monitor is green it means the AC power is on And when the monitor is not connected to AC power and the DC battery is used as the power source the indicating light is orange Warning The monitor must be connected to a properly installed power outlet with protective earth contacts only If the installation does not provide for a protective earth conductor disconnect the monitor from the power line and operate it on battery power 3 1 Patient monitor user s manual Note The equipment has no mains switch The equipment is switched completely only by disconnecting the power supply from the wall socket The wall socket has to be easily accessible Note For measurements in or near the heart we recommend connecting the monitor to the potential equalization system Use the green yellow potential equalization cable and connect it to the pin labeled with the symbol 3 2 2 Battery Power The monitor has a battery pack to provide power to the monitor whenever AC power is interrupted The battery is generally referred to as the battery You must charge the battery before using it There is no external charger The battery is charged when the monitor is connected to AC power To assure a fully charged battery that is ready for use we recommend that the monitor be plugged into AC power whenever it is not in use Run time of the batteries is ac
99. m 1 100 diluted bleaching agent to 5000ppm 1 10 bleaching agents is very effective The concentration of the diluted sodium hypochlorite depends on how many organisms blood mucus on the surface of the chassis to be cleaned E Hydrogen Peroxide 3 Alcohol 70 m Isopropyl alcohol 70 The surface of patient monitor can be cleaned with hospital grade ethanol and dried in air or with crisp and clean cloth The manufacturer has no responsibility for the effectiveness of controlling infectious disease using these chemical agents Please contact infectious disease experts in you hospital for details 9 5 Disinfection To avoid extended damage to the equipment disinfection is only recommended when stipulated as necessary in the Hospital Maintenance Schedule Disinfection facilities should be cleaned first Appropriate disinfection materials for ECG cable SpOz sensor blood pressure cuff TEMP probe CO2 sensor and AG sensor are introduced in the corresponding chapters respectively i Warning Do not use EtO gas or formaldehyde to disinfect the monitor 9 4 Patient monitor user s manual Chapter 10 Accessories This chapter lists the recommendation accessories used in this device Warning The accessories listed below are specified to be used in this device The device will be possibly damaged or lead some harm if any other accessories are used Accessories List
100. minally 660nm for the Red LED and 940nm for infrared LED Monitor adopts FFT filter and signal correlation techniques to deal with SpO2 module s pulse waveform signals Before the measurement of SpO2 the noise produced in the false trace is smoothed so as to the eliminate disturbance in the measurement of saturation In case of weak blood pulse the noise produced by some confinements of electrical properties is greatly reduced The monitor is designed for measurement and recording of functional saturation 5 3 2 Preparatory Steps before the Measurement of SpO2 Pulse 1 Plug the SpO gt sensor cable into the SpO2 socket of the monitor 2 Put the SpO2 sensor onto the finger of the patient and the screen should display SpO2 waveforms and the SpO gt value and pulse rate should be calculated 3 Set up the parameters relevant to SpO2 and pulse monitoring Patient monitor user s manual 5 3 3 Connecting to Patient and Monitor Plug the SpO2 sensor cable into the socket marked with SpOo then put the sensor onto the finger of the patient as shown in Fig 5 3 3 Fig 5 3 3 Connection of SpO2 sensor with the patient After the SpOz sensor is connected to the patient the screen shall display SpO2 waveforms and then it shall calculate the SpO gt value and pulse rate value e Caution In case it is necessary to add a clip to fix the fingertip sensor the cable instead of the sensor itself should be clipped Please note that the cable of
101. mpletely unwrapped LOOSE CUFF b The cuffis not connected Low c Adult cuff used in neonate mode AIR LEAK Air leak in pneumatics hose or cuff Low AIR PRESSURE ERROR Unable to maintain stable cuff pressure e g Fow kinked hose a Very weak patient signal due to a loosely WEAK SIGNAL wrapped cuff Low b The pulse of patient is too weak RANGE EXCEEDED Measurement range exceeds module iie specification a Too many retries due to interference of motion artifact EXCESSIVE MOTION Low 6 11 Patient monitor user s manual Cuff pressure exceeds the specified upper OVERPRESSURE SENSED safety limit Could be due to rapid squeezing Low or bumping of cuff SIGNAL SATURATED Large noe artifact that saturates the BP Ey amplifier s amplitude handing capability AIR SYSTEM LEAK Module reports Air Leakage failure while in Dow the Pneumatic Test mode SYSTEM FAILURE Module occurs abnormal processor event Low TIME OUT Measurement took more than 120 seconds in Low adult 90 seconds in neonate mode CUFF TYPE ERR Neonate cuff used in adult mode Low Prompt display in description area below NIBP mean arterial pressure value Message Cause Alarm Level NIBP Resetting NIBP measurement module is resetting Over Press Testing NIBP is testing Over Pressure Manometer Testing NIBP is testing Manometer Pneumatic Testing NIBP is testing Pneumatic No alarm
102. ncluding four limb leads RA RL LL LA and six chest leads Ci C2 C3 Ca Cs Co Realize all lead 12 lead ECG monitoring 5 1 5 Connecting the ECG Electrodes to the Patient 1 Connection steps Clean the patient s skin and wipe the oil stains sweat stains on the skin with alcohol If necessary shave body hair at the locations where the electrodes are to be placed or grind off the stratum corneum and clean it with alcohol Check if the buttons on the electrodes are clean and free of damage Place the electrodes on the body of patient Before attaching smear some conducting cream on the electrodes if the electrodes are not electrolyte self supplied Connect the cable leads to the electrodes through the buttons of the electrodes Note For patients who tremble a lot or patients with especially weak ECG signals it might be difficult to extract the ECG signals and it is even more difficult to conduct HR calculation For severely burnt patients it may be impossible to stick the electrodes on and it may be necessary to use the special pin shape electrodes In case of bad signals care should be taken to place the electrodes on the soft portions of the muscle Note Check the irritation caused by each electrode to the skin and in case of any inflammations or allergies the electrodes should be replaced and the user should relocate the electrodes every 24 hours or at a shorter interval Note Wh
103. nd one year 2 The precision of EtCO reading has been doubted by clinical physician 3 After the latest calibration atmospheric pressure or height above sea level varies evidently The apparatus has already been calibrated before leaving factory User can directly apply it to measuring in normal conditions to the exclusion of the previous conditions Gain calibration and manual offset calibration must be carried out if the previous conditions happened The following procedures must be observed 1 In parameter setup please adjust lt VIEW TYPE gt of the CO module to InsCO E When the monitor has been run for 30 minutes one end of the sampling tube has been connected with the module the other end has been exposed in the undefiled atmosphere please adjust lt OFFSET CAL gt to MANU Manual in the CO setup dialog and press the button of lt OFFSET CAL gt to start offset calibration Please connect the adjusting device according to Fig 5 7 4 While the standard gas of pressure CO 5 0 38 0mmHg getting across the sampling tube observe pressure measuring apparatus carefully to ensure that the pressure of standard gas is one standard atmosphere the range of error is 5 Then press the lt GAIN CAL gt of CO parameter setup dialog box a password input box will emerge Please input the password to start gain calibration About five seconds later the reading having calibrated will be shown in the screen Patient monitor user s ma
104. nnections have been made correctly by verifying an actual CO waveform on the monitor display 5 8 3 Room Air calibration Room air calibration of the oxygen sensor will be performed automatically at regular intervals whenever the IRMA sensor head is disconnected from the IRMA airway adapter If the IRMA sensor is kept in operation for a long time period without being disconnected from the airway adapter or if the operating temperature for the oxygen sensor changes significantly the IRMA sensor will indicate that a new room air calibration is required and a message will appear on the monitor 5 8 4 Sensor Alarms Indicate Description of the status LED situated on the IRMA sensor head Steady green light System OK Steady red light Sensor error Blinking red light Check adapter 5 43 Patient monitor user s manual 5 8 5 Setup of CO2 parameters Scan Speed Resp Source Unit Resp Gain Alarm Setup Back to Main Scan speed Select the scanning speed of RESP waveforms and options are 6 25mm s 12 5mm s and 25mm s RESP source Select RESP source Options are AUTO ECG and EtCQ Unit Select the unit for CO Options are mmHg and kPa Resp Gain Select the gain of RESP waveform and options are 1x 2x and 4x Alarm Setup Click and open the dialog of CO alarm Back to Main Return to main screen 5 8 6 Precautions during Measurement 1 Plug IRMA probe into the CO socket on the left panel of monitor then conn
105. nual This end Connects with pressure measurement apparatus Standard CO gas Monitor Sampling tube Three way tap Fig 5 7 4 Gain calibration sketch map Warning The standard gas of which the pressure of CO is 5 0 38 0mmHg must be used during gain calibration Otherwise measurement values will not be accurate Note User may only calibrate the device under the instruction of the technical personnel authorized by company Moreover wrong calibrating procedure may result in false reading Patient monitor user s manual 5 8 Measurement of CO Mainstream IRMA Note You can only use PHASEIN IRMA mainstream EtCO probe provided by the manufacturer to perform EtCO monitoring on the monitor 5 8 1 Preparatory Steps for Measurement of mainstream EtCO 1 Plug the IRMA connector into the CO3 socket on the left panel of the monitor 2 Snap the IRMA sensor head on top of the IRMA airway adapter It will click into place when properly seated 3 A green LED indicates that the IRMA sensor is ready for use 4 Connect IRMA airway adapter 15 mm male connector to the breathing circuit Y piece A 5 42 Patient monitor user s manual 5 Connect the IRMA airway adapter 15 mm female connector to the patient s endotracheal tube 5 8 2 Pre use check Perform the tightness check of the patient circuit with the IRMA sensor head snapped on the IRMA airway adapter Check that the co
106. o Esophageal temperature Rect Rectal temperature Naso Nasopharyngeal temperature Blad Bladder temperature Tymp Tympanic temperature Skin Skin temperature Alarm Setup Click and open the dialog of configuration for TEMP alarm Adjust Alarm T1 Alarm T2 Alarm Previous Patient monitor user s manual Adjust alarm Select this option to enter the configuration of alarm limits conduct the configurations by turning the trim knob to select high or low limits and exit by selecting EXIT The upper part is the high limit and the lower one is the low limit Tl alarm Select lt ON gt to enable T1 over limit alarm select lt OFF gt to disable T1 over limit alarm T2 alarm Select lt ON gt to enable T2 over limit alarm select lt OFF gt to disable T2 over limit alarm 5 4 5 Maintenance and Cleaning Reusable temp probes 1 The temp probe should not be heated above 100 C It should only be subjected briefly to temperatures between 80 C and 100 C 2 Only detergents containing no alcohol can be used for disinfection 3 The rectal probes should be used if possible in conjunction with a protective rubber cover E Cleaning Use a piece of clean cloth moistened in water or mild soap solution to clean the probe E Disinfection Use a piece of clean cloth to wipe the surface of the cable with 70 isopropyl alcohol a 10 bleach solution or 2 Cidex clean with clear water and wipe it dry Warning Disposabl
107. onds to start or stop the NIBP measurement Press and hold this button for 2 seconds to make NIBP module working at STAT measurement mode and perform continuous NIBP measurement within 5 minutes Patient monitor user s manual 6 A X Press this button in 2 seconds to make the monitor alarm paused or cancel the pause Press and hold this button for 2 seconds can silence the monitor s audio system or cancel the silence When the nurse call function is enabled pressing this button can cancel the current nurse call alarm T Press this button in 2 seconds to freeze waveform press again to defreeze waveform Press and hold this button for 2 seconds can start real time recording In case the real time recording is underway pressing this button will terminate real time recording 8 FAA Press this button once to see the Trend Graph and the Trend Table 9 mm Press this button once to exit the present menu and return to main screen 10 Battery charging indicating lamp It is illumined when the battery is being charged It is go out when the battery is fully charged or no battery in monitor 11 Power button 12 Power indicating lamp It is illumined green when the AC power is connected It is illumined orange when the AC power is not connected and monitor is powered by battery It is turned out when the AC power is not connected 1 4 2 Left View Patient monitor user s manual CO AG socket SpO gt socket ECG socket
108. onfiguration for default trend Patient monitor user s manual Trend Graph Mig Trend Graph2 Mig Trend Graph3 Mig Trend Table Mig Trend Table2 Mig Trend Table3 Mig Previous Trend Graphi Configuration of trend diagram There are a total of three pages of trend diagrams and on each page trend diagram can be configured for six regions and options are Off HR SpO2 NIBP PR Resp CO T1 T2 AA N20 O2 P1 P2 ST HR SpO SpO PR Resp CO 2 PR CO T1 T2 IBP1 IBP2 AA CO N O O gt It is possible to have self configurations on the contents of the trend diagrams and at least one page of trend diagrams shall be configured Areal Area2 Area3 Area4 Areab Area6 Previous Patient monitor user s manual Trend Table Configuration of trend tables There are a total of three pages of trend tables and on each page trend table can be configured for six regions and options are HR SpO2 NIBP S D NIBP M IBP1 S D IBP1 M IBP2 S D IBP2 M Resp PR T1 T2 CO2 AA N20 O2 ST It is possible to have self configurations on the contents of the trend tables and at least one page of trend tables shall be configured Areal Area2 Area3 Area4 Area5S Area6 Previous E Color Setup Color Default Previous 4 20 Patient monitor user s manual Enter the interface of color configuration the colors of various parameters and waveforms can be configured E Network Setup
109. onitor 2 Turn the baffle up clockwise 3 Push the battery into the gate with the electrode point to the bottom of the monitor 4 After pushing the battery inside the storage withdraw the baffle turn back to the middle position 5 Close the gate E Uninstall battery 1 Open the battery gate according to the direction marked on the monitor 2 Turn the baffle up clockwise 3 Take out the battery Then close the gate 3 3 Connecting to the Central Monitor System Warning Accessory equipment connected to the analog and digital interface must be certified according to the respective IEC standards e g IEC 60950 for data processing equipment and IEC 60601 1 1995 for medical equipment Furthermore all configurations shall comply with the valid version of the system standard IEC 60601 1 1 Everybody who connects additional equipment to the signal input part or signal output part configures a medical system and is therefore responsible that the system complies with the requirements of the valid version of the system standard IEC 60601 1 1 If in doubt consult the technical service department or your local representative If the user intends to connect the monitor to the central monitoring system plug its connecting electrical cable into the Network Connector at the back of the monitor 3 3 Patient monitor user s manual Note This monitor can only be connected to the central monitoring system provided by manufacturer do not at
110. or Caution Always disconnect the cannula airway adapter or sample line from the sensor when not in use Patient monitor user s manual 5 9 5 Removing Exhaust Gases from the System Warning When using the microstream CO2 measurement on patients who are receiving or have recently received anesthetics connect the outlet to a scavenging system or to the anesthesia machine ventilator to avoid exposing medical staff to anesthetics Use an exhaust tube to remove the sample gas to a scavenging system Attach it to the microstream sensor at the outlet connector 5 9 6 Safety considerations Warning Do not use in the presence of flammable anesthetics or other flammable gasses Use of the LoFlo Module in such environment may present an explosion hazard Electrical Shock Hazard Always disconnect the LoFlo Module before cleaning Do not use if it appears to have been damaged Refer servicing to qualified service personnel Do not position the sensor cables or tubing in any manner that may cause entanglement or strangulation Reuse disassembly cleaning disinfecting or sterilizing the single patient use cannula kits and on airway adapters may compromise functionality and system performance leading to a user or patient hazard Performance is not guaranteed if an item labeled as single patient use is reused Inspect the microstream on airway adapters microstream sampling kits and CO2 airway adapters for damage prior to u
111. order is producing waveforms Alarm Record Enable Disable the alarm recording at the high level of physiological alarm Warn Record Enable Disable the warn recording at the medium level of physiological alarm Delay Time Delayed recordings start documenting on the recorder strip from a preset time before the recording is started This interval is called the Delay Time and can be set to Real time 4s or 8s Patient monitor user s manual E Time Setup Year Month Day Hour Minute Second Previous The user can configure system time The user is advised to set system time before implementing monitoring If the configuration is to be conducted during the process of monitoring the user is advised to switch off the monitor after exiting the current window and then restart it The time for the revision takes effect after the current window is exited E Mode Setup Default Config User Config Save Config Delete Config Back to Main 4 15 Patient monitor user s manual Default Config Select the default configuration defined by the manufacturer and options are Cancel Adult Children and Neonatal select Cancel to abort it User Config Select the mode of user saving Select the previous custom configuration select Cancel to abort it Save Config Save the current configuration info as custom configuration enter the name of the user custom configuration select OK to save the current mode and selec
112. ort Term Drift Drift over four hours lt 0 8 mmHg Long Term Drift Accuracy specification will be maintained over a 120 hours period Rise time lt 60ms unit mmHg kPa Respiration Rate Range 0 150 rpm Respiration Rate Accuracy 1 rpm Alarm range 0 0 13 1 0 99 6mmHg continuously adjustable between upper limit and lower limit Alarm indication Sound and light indication AG IRMA Measure method Measure mode Fi and Et values Resolution Unit Calibration Warm up time Rise time at 10 L min Infrared spectrum CO2 N20 O2 agent HAL ISO ENF SEV DES ImmHg mmHg Room air calibration performed automatically when changing airway adapter lt 5s Concentrations reported in less than 10s full accuracy within 1 min CO lt 90 ms O2 lt 300 ms N20 lt 300 ms Patient monitor user s manual fo end Hal Iso Enf Sev Des lt 300 ms Measurement range of AG e epe Accuracy range 0 0 1 0 10 0 5 or 10 of reading whichever is greater 0 0 1 N 0 100 2 or 10 of reading whichever is greater Gas CO2 20 HAL ISO ENF 0 5 0 15 or 10 of reading whichever is greater SEV 0 8 0 15 or 10 of reading whichever is greater DES 0 18 0 15 or 10 of reading whichever is greater Alarm indication Sound and light indication Patient monitor user s manual Appendix B Default System Setup There are three options of default system
113. osal should be accomplished following national and local requirements Nitrous oxide elevated levels of oxygen and helium can influence the CO2 measurement Please setup gas compensation according to actual state Barometric pressure compensation is required to meet the stated accuracy of the CAPNOSTATS sensor Do not place the combined CO2 sensor between the ET tube and the elbow pediatric or adult circuit as this may allow patient secretions to block the adapter windows Position the combined CO2 sensor with its windows in a vertical and not a horizontal position this helps keep patient secretions from pooling on the windows Patient monitor user s manual 5 10 5 Maintenance and cleaning For CAPNOSTAT 5 Sensor and LoFlo Module The outside of the module or sensor may be cleaned and disinfected by wiping with 70 isopropyl alcohol a 10 bleach solution or mild soap After cleaning wipe with a clean water dampened cloth to rinse Dry before use For Reusable Airway Adapters Reusable airway adapters may be cleaned by rinsing in a warm soapy solution followed by soaking in a liquid disinfectant such as 70 isopropyl alcohol a 10 bleach solution Cidex or System 1 refer to the disinfectant manufacturer s instructions for use Adapters should then be rinsed with sterile water and dried Reusable airway adapters may also be pasteurized or autoclaved Autoclave at 121 C 250 F for 20 minutes unwrapped Before reusing the
114. ossooeessesssesssooessooesoossoosssoesssesssoossoossossssse 6 7 Chapter 7 Recording acaheivcicccasvedesinsscsuncctossseosecsieiasd lt deieosacssselateseuansuchancaevedeninsoeaumcaveeaete 7 1 Chapter 8 Other Fume o ns cssacaecessiscecscncssunstesuvsohsn ces onusssunassecssivenspsveonesdssvosvenssscnavessentaes 8 1 Sol Nurse OE 1I EE nies acescesecbnesuvnescedvuesatessedbiapseneusuoosensctnasseusuedetnatonss 8 1 8 2 Analog Signal Output wicisivadesiessccaccivesssvosessiiciasdedentoseaseceuacedenwnsvchancoovedsatessesuscavensese 8 2 8 3 SD Card Storage inic css ciccscccecscscssscdesnssacensdsesdacsssouspopassnsdesnivudansase chcssulvesgoncesacaeandens 8 2 Chapter 9 Maintenance and Cleaning sesssessseessecssooesoosssoessoesssosssoossoossssssssesssoessoosso 9 1 9 System CHECK sc csccsevcosssticnssesecCccackencenntccacdcbasincesstbecdcosceveayoncoesedonesudunsttpadcssaviusenseers 9 1 9 2 Battery Maintenance sisiccsisscesccsacscacetuacesucdscouedsacneesesepsssecescvsessssedvoeccbssvencanperteceuuaees 9 2 9 3 General Cleaning iesesessccesctscs sacs verusseusccccasudgeasseeciacdosecscebessscadbosucgssoosbeccecvsscguavebuscace 9 3 94 CIC AMIN A CONUS cscsvsiesvuviccusntevessbuarsacdansepuvebtcnsdos csee iese svie vt oegabesusunsseensspesyssbuewencensens 9 4 9 5 Disinfecti n sss soveteinupeaacetsesseasiuiuascsbbavessGeupiastsssndenehpisonbeabeuwusbeuianceiteees 9 4 Chapt r LO A CCOSSONIES sissessicscecsticccscacicccodscccouosvesucdsocasocesducteecssseseussouave
115. ot be into contact with any other conductors including the ground For the sake of patient safety all the leads on the ECG cables must be attached to the patient Cy Warning When conducting defibrillation it is imperative to only use the electrodes recommended by manufacturer Warning Do not come into contact with the patient bed and the monitor during defibrillation Warning The monitor cannot be directly applied to heart and cannot be used or the measurement of endocardio ECG Note When several parts of equipment are interconnected the total leakage current is limited to the safety range according to standards IEC 60601 2 27 5 1 3 Preparatory Steps before the Measurement of ECG HR 1 Plug the ECG cable into the ECG socket of the monitor 2 Place the electrodes onto the body of the patient and connect them to the relevant lead wires of the ECG cables and at this moment ECG waveforms will appear on the screen 3 Set the parameters relevant to ECG monitoring 5 1 4 Connecting the ECG Cables to the Monitor Monitor is provided with three different ECG cables relevant to 3 Lead ECG module 5 Lead ECG module and 12 Lead ECG module 5 2 Patient monitor user s manual 1 3 lead ECG cable Including three limb leads RA LL and LA Realize 3 lead ECG monitoring 2 5 lead ECG cable Including four limb leads RA RL LL LA and one chest lead C C4 Realize 7 lead ECG monitoring 3 12 lead ECG cable I
116. ould be pulled out onto the outlet of the paper on the right panel of the monitor If record paper has been used up following the steps to install recording paper 3 4 Patient monitor user s manual 1 Push down the switch to open recorder 2 Install the paper with the thermal side upwards 3 Close the recorder with a section of paper outside of the storage For detailed operation information refer to Fig 3 6 1 Push Down Outside paper Fig 3 6 1 Install Recording Paper 3 7 Shutting off the Monitor Please follow these steps to shut off the monitor Confirm that the patient monitoring is finished Disconnect the cables and sensors form patient Confirm that the monitoring data is stored or cleared Press the power switch then a dialog will pop up to ask you make sure the shut off operation Select OK to shut off the monitor If the monitor can t be switched off normally forced close the monitor by pressing and holding the power switch more than 5s This may cause some damages to the device 3 5 Patient monitor user s manual Chapter 4 Operation Instructions for the Monitor Note In each menu press Previous to return to the previous menu and press the Main button to return to main screen In all the dialogue windows there is help info to indicate the current operation Note The monitor configuration is consist of standard and non standard parameter configuration and their operation
117. ould occur The service life of this monitor is five years At the end of its service life the product described in this manual as well as its accessories must be disposed of in compliance with the guidelines regulating the disposal of such products If you have questions concerning disposal of products please contact manufacturer or its representatives 2 4 Patient monitor user s manual EMC Magnetic and electrical fields are capable of interfering with the proper performance of the device For this reason make sure that all external devices operated in the vicinity of the monitor comply with the relevant EMC requirements X ray equipment or MRI devices are a possible source of interference as they may emit higher levels of electromagnetic radiation Also keep cellular phones or other telecommunication equipment away from the monitor INSTRUCTION FOR USE For continuous safe use of this equipment it is necessary that listed instructions were followed However instructions listed in this manual in no way can supersede established medical practices concerning patient care LOSS OF DATA Should the monitor at any time temporarily lose patient data close patient observation or alternative monitoring devices should be used until monitor function is restored If the monitor does not automatically resume operation within 60 seconds restart the monitor using the power on off switch Once monitoring is restored you should verify
118. ovided by manufacturer Warning The sensor cable sockets on Monitor can only be connected with the sensor cables supplied with this instrument and no other cables shall be used 1 4 4 Notes on the signs on the monitor Signs Notes on the signs Type CF applied part defibrillation protected j The unit displaying this symbol contains an F Type isolated floating applied part providing a high degree of protection against shock and is defibrillator proof Type BF applied part defibrillation protected j The unit displaying this symbol contains an F Type isolated floating applied part providing a high degree of protection against shock and is defibrillator proof J Attention Consult accompanying documents this manual 9 Non ionizing radiation h Dangerous voltage b Equipotentiality Ne Alternating current AC Patient monitor user s manual Notes on the signs USB socket Network connector Secondary display socket Auxiliary output connector CE mark Symbol for the marking of electrical and electronics devices according to Directive 2002 96 EC The device accessories and the packaging have to be disposed of waste correctly at the end of the usage Please follow local ordinances or regulations for disposal ECG Short for Electrocardiogram RESP Short for Respiration SpO Short for Pulse Oxygen S
119. p Gain Select the gain of RESP waveform and options are 1x 2x and 4x Alarm setup Click and open the dialog of CO3 alarm Start Press this button to start the sampling pump to initiate the measurement of CO2 only valid on sidestream CO2 Stop Press this button to switch off the sampling pump and terminate the measurement of CO only valid on sidestream CO2 Offset cal Select the mode of drift calibration Options are Cancel Automatic and Manual During the common measurements please remain the default configuration as Automatic Only when it is necessary to conduct gain calibration should this option be configured as Manual only valid on sidestream CO which sampling pump has been started Back to Main Return to main screen Patient monitor user s manual Adjust Alarm EtCO2 Alarm FiCO2 Alarm Resp Alarm Apnea Alarm Previous Adjust alarm Select this option to enter the configuration of alarm limits conduct the configurations by turning the trim knob to select high or low limits and exit by selecting EXIT The upper part is the high limit and the lower one is the low limit EtCO alarm high limit its configuration range is 0 0 13 1 0 99 6mmHg continuously adjustable no lower than the low limit the configuration range of EtCO2 alarm low limit is 0 0 13 1 0 99 6mmHg continuously adjustable no higher than the high limit FiCO alarm high limit its configuration range is 0 0 13 1 0 99 6mmHg continuou
120. patient It is not intended to be used in outdoor transport applications and used on neonate when using IRMA mainstream EtCO and AG monitoring 1 2 About this Manual This manual contains the instructions necessary to operate the product safety and in accordance with its function and intended use Observance of this manual is a prerequisite for proper product performance and correct operation and ensures patient and operator safety This manual is based on the maximum configuration and therefore some contents may not apply to your product If you have any question please contact us This manual is an integral part of the product It should always be kept close to the equipment so that it can be obtained conveniently when needed The manual is geared for clinical professionals who are expected to have a working knowledge of medical procedures practiced and terminology as required for monitoring patients All illustrations in this manual serve as examples only They may not necessarily reflect the setup or data displayed on your product Signs in this manual i Warning Means it must be strictly followed so as to prevent the operator or the patient from being harmed p Caution Means it must be followed so as not to damage the instrument Note Important information or indications regarding the operation or use 5 a Patient monitor user s manual Warning Before putting the system into operation verify that the equipment
121. pper Medium High SpO gt too high A alarm limit User Selectable SpO measuring value is below the lower Medium High SpO gt too low alarm limit User Selectable PR measuring value is above the upper alarm monitor PR too high fy User Selectable limit PR measuring value is below the lower alarm PR too low ae User Selectable limit Technical Alarm Message Cause Alarm Level SpO gt sensor off SpO sensor may be disconnected from the i ow patient or the monitor SpO communication error SpO measurement failure or communication i ow error SpO gt alarm error Alarm failure Low PR alarm error Alarm failure Low SpO gt sensor failure SpO sensor failure Low SpO2 pulse timeout Search pulse too long High Prompt Message Cause Alarm Level Search pulse SpO module is searching for pulse No alarm Motion interference Patient movement too much No alarm Disconnected SpO2 sensor may be disconnected form the No alarm 6 8 6 8 4 TEMP Alarm Physiological Alarm Patient monitor user s manual Message Cause Alarm Level TEMP too high TEMPI measuring value is above upper alarm limit User Selectable TEMP too low TEMPI measuring value is below lower alarm limit User Selectable TEMP2 too high TEMP2 measuring value is above upper alarm limit User Selectable TEMP too low TEMP2 measuring value is below lower
122. r individual items can only be entered after the weight and drug name have been entered In the system the values that are given initially are only a group of random initial values and the operator shall not take this value as the calculation standard and a group of values appropriate to the patient must be reentered according to the physicians comments Each kind of drugs has a fixed unit or unit series and the operator must select the appropriate units according to the physicians comments In the unit series of the same unit the addition of the units will be automatically adjusted in accordance with the current entered value When the expressed range that can be expressed by this unit is exceeded the system will display When the operator has entered the value of a certain item the system will give a prompt in the menu so as to remind the operator to verify the correctness of the entered value Only by ensuring the correctness of the entered values the calculated values can be reliable and safe In case of neonatal drip velocity and volume per drip are invalid The values in the table may not be related to the patient monitored on this bed Therefore the weight of this menu and the weight in the patient info are two different values The values in this menu item are not affected by the values in the patient info E Titration table Select Titration in the menu of drug calculation to enter the interface of titration table
123. r should not come into direct contact with the monitoring electrodes Please ensure the monitor is reliably grounded and the electrodes used repeatedly should be kept clean Warning When conducting defibrillation do not come into contact with the patient the bed and the monitor Otherwise serious injury or death could be resulted in 5 To guarantee the safe operation of the monitor Monitor is provided with various replaceable parts accessories and consuming materials such as sensors and their cables electrode pads Please use the products provided or designated by the manufacturer 6 Monitor only guarantees its safety and accuracy under the condition that it is connected to the devices provided or designated by manufacturer If the monitor is connected to other undesignated electrical equipment or devices safety hazards may occur for causes such as the cumulating of the leakage current 7 To guarantee the normal and safe operation of the monitor a preventive check and maintenance should be conducted for the monitor and its parts every 6 12 months 2 2 Patient monitor user s manual including performance check and safety check to verify the instrument can work in a safe and proper condition and it is safe to the medical personnel and the patient and has met the accuracy required by clinical use e Caution The monitor does not contain any parts for self repair by users The repair of the instrument must be conducted by
124. ransducer they must be rinsed by physiological salt solution Warning If liquid not the liquid which used to douche the tubes and pressure transducers spills on equipment or accessories especially when the liquid is likely to enter the equipment or transducer contacting with the maintenance department of the hospital immediately Patient monitor user s manual Saline water Sterilization container Extension tube Three way valve 2 Artery needle Ea Roller clip Three way valve 1 Extension pol Pressure transducer Free valve Air vent Socket for connecting IBP Fig 5 6 4 Schematic diagram for installation of IBP sensor 5 6 6 Setup of Range The setup of IBP module range can provide you with the best waveforms and the best measurement results Based on different contents of measurement there are two ranges for selection and each group has five options e Arterial Pressure ART AUTO 0 50mmHg 50 150mmHg 100 240mmHg 0 300mmHg e Pulmonary Artery pressure PA Left Atrium Pressure LAP Right Atrium Pressure RAP Central Venous Pressure CVP Intracranial Pressure ICP AUTO 0 20mmHg 0 30mmHg 0 50mmHg 0 80mmHg Note AUTO will adjust the scale on which the pressure waveform is displayed on the screen automatically for the best observation status 5 6 7 IBP Transducer Zero and Calibration E IBP Transducer Zero Patient monitor user s manual Warning It is the respons
125. rate measurements or other error conditions If you attempt zeroing while CO2 remains in the adapter or cannula the time required to zero the module may be increased 5 9 4 Applying Microstream airway adapter or cannula For intubated patients requiring an airway adapter Install the airway adapter at the proximal end of the circuit between the elbow and the ventilator Y section Fig 5 9 3 Patient monitor user s manual For intubated patients with an integrated airway adapter in the breathing circuit Connect the male connector on the straight sample line to the female port on the airway adapter Fig 5 9 4 Fig 5 9 4 For non intubated patients Place the nasal cannula onto the patient Fig 5 9 5 Ar Fig 5 9 5 For patients prone to mouth breathing use an oral nasal cannula Trim the oral sampling tip if necessary to fit the patient It should extend down past the teeth and be positioned in the mouth opening Remove the cannula from the patient if the tip needs to be trimmed Fig 5 9 6 Fig 5 9 6 For nasal or oral nasal cannulas with oxygen delivery place the cannula on the patient as shown then attach the oxygen supply tubing to the oxygen delivery system and set the prescribed oxygen flow amp Warning Always connect the airway adapter to the sensor before inserting the airway adapter into the breathing circuit In reverse always remove the airway adapter from the breathing circuit before removing the sens
126. ration of alarm limits and configure the limits by turning the trim knob to select the high limits and low limits and exit by selecting EXIT The upper part is the high limit and the lower part is the low limit HR alarm Select lt ON gt to enable HR over limit alarm select lt OFF gt to disable HR over limit alarm 5 6 Patient monitor user s manual ST alarm Click and open the dialog of ST alarm Adjust Alarm ST AlarmSwitch Lead Previous Adjust alarm Select this option to enter the configuration of alarm limits by turning the trim knob select the high limits and low limits for configuration and exit by selecting EXIT The upper part is the high limit and the lower part is the low limit ST Alarm Select lt ON gt to enable ST over limit alarm select lt OFF gt to disable ST over limit alarm Lead Select the ECG lead for calculating ST ARR alarm Click and open the dialog of Arrhythmia analysis alarm Alarm Setup Default Setup Enable All Previous In the interface it is possible to configure the alarm levels of various Arrhythmia or switch off the Arrhythmia alarm 5 7 Patient monitor user s manual Alarm Setup Select this option to enter the configuration of ECG alarm levels select the alarm levels of different Arrhythmia by turning the trim knob and exit by selecting lt EXIT gt Default Setup Select this option and configure the Arrhythmia alarm as the manufacturer s default con
127. rm Ye Warning E You must not perform NIBP measurements on patients with sickle cell disease or under any condition that the skin is damaged or expecting to be damaged E For a thrombasthemia patient it is important to determine whether measurement of the blood pressure shall be done automatically The determination should be based on the clinical evaluation E Prolonged non invasive blood pressure measurements in Auto mode are Patient monitor user s manual associated with purport ischemia and neuropathy in the limb wearing the cuff When monitoring a patient examine the extremities of the limb frequently for normal color warmth and sensitivity If any abnormality is observed stop the blood pressure measurements 5 5 4 Setup of NIBP Parameters Auto Time Mode Object Unit NIBP Alarm Leakage Back to Main Auto Time Configure the cycle intervals of BP measurement and options are 1min 2min 3min 4min 5min 10min 15min 30min 60min 90min 2Hour 4Hour and 8Hour During measurements it cannot be altered Mode Configure the measurement mode of NIBP and options are Manual Auto and STAT If STAT mode is configured after measurement the system will be automatically configured as the previous measurement mode There is no STAT mode for neonatal If STAT is selected the rapid measurement will be initiated once it is confirmed Object Objects of measurements shall be configured and options are Adult Children
128. rway adapter Adult Pediatric EtCO2 LoFlo Module MicroStream LoFlo Sample line EtCO2 CAPNOSTATS CO2 Sensor MainStream CAPNOSTATS Airway Adapter IRMA OR sensor Adult Pediatric IRMA OR sensor Adult Pediatric AG IRMA IRMA AX sensor Adult Pediatric Extension cable Adult Pediatric Airway adapter Adult Pediatric Patient monitor user s manual Appendix A Product Specifications A 1 Environmental Specifications Environment Ambient Temperature Operating temperature 0 40 C Operating temperature 10 35 C If use IRMA OR sensor Transportation and storage temperature 20 55 C Transportation and storage temperature 2 8 C If use IRMA O sensor Relative humidity Working lt 85 Transportation and storage lt 93 Atmospheric pressure Working 860 1060 hPa Transportation and storage 500 1060 hPa Power supply Power Voltage AC 100 240V 50 60Hz Power Input lt 100VA Fuse T2AL 250V 5X20 mm Safety class Category I A 2 Hardware Specifications Size and weight Size 335mm H X 366mm W X 172mm D Weight 5 5kg Display LCD Size 15 Type Color TFT LCD Resolution 1024 X 768 pixels or higher Indicators Physiological alarm LED 1 Yellow Red Patient monitor user s manual Technical alarm LED 1 Blue AC Power LED 1 Green Orang
129. s Allow the battery to be charged uninterruptedly for above 6 hours 4 Remove the AC mains and allow the monitor to run from the battery until it shuts off 5 Reconnect the monitor to the AC mains Allow the battery to be charged uninterruptedly for above 6 hours Now the battery is conditioned and the monitor can be returned to service 9 3 General Cleaning Warning Before cleaning the monitor or the sensors make sure that the equipment is switched off and disconnected from the power line The Patient Monitor must be kept dust free Regular cleaning of the monitor shell and the screen is strongly recommended Use only non caustic detergents such as soap and water to clean the monitor shell Please pay special attention to the following items 1 Avoid using ammonia based or acetone based cleaners such as acetone 2 Most cleaning agents must be diluted before use Follow the manufacturer s 9 3 Patient monitor user s manual directions carefully to avoid damaging the monitor Don t use the grinding material such as steel wool etc 4 Don t let the cleaning agent enter into the chassis of the system Don t leave the cleaning agents at any part of the equipment 9 4 Cleaning Agents Examples of disinfectants that can be used on the instrument casing are listed below E Diluted soap solution E Diluted Ammonia Water E Diluted Sodium Hypochlorite Bleaching agent Note The diluted sodium hypochlorite from 500pp
130. screw thread interface tube please connect the requirement type tube the sampling tube s port can also been fixed on the naris of patient with adhesive plaster Patient monitor user s manual This end connected with this Sampling tube This end connected with the mask of patient Fig 5 7 3 Connected with dehydration flask Select lt CO Setup gt button in Main Screen then select the lt Start gt and press this button to start sampling pump begin measuring EtCO gt Pay attention to the water level of dehydration flask If the highest water level reaches Please replace the dehydration flask in time to prevent the module from soaking by water When air is getting across the sampling tube a period of time will cost So a delay time will appear from starting measure to showing waveform in the screen and measuring result Please keep the sampling tube clean and prevent the tube from clogging by dust Note Dehydration flasks and sampling tubes are disposable please use products provided or designated by manufacturer Patient monitor user s manual 5 7 2 Setup of CO parameters Scan Speed Resp Source Unit Resp Gain Alarm Setup Mig START Back to Main Scan speed Select the scanning speed of RESP waveforms and options are 6 25mm s 12 5mm s and 25mm s RESP source Select RESP source And options are AUTO ECG and EtCQ Unit Select the unit for CO2 and options are mmHg and kPa Res
131. se Do not use the microstream on airway adapters microstream sampling kits and CO2 airway adapters if they appear to be damaged or broken Replace the microstream on airway adapters microstream sampling kits and CO2 airway adapters if excessive secretions are observed Monitor the CO2 waveform Capnogram If you see changes or abnormal appearance check the airway adapters and the sampling line Replace it if needed Do not operate the LoFlo Module when it is wet or has exterior condensation Do not apply excessive tension to any cable Do not use device on patients that can not tolerate the withdrawal of 50 ml min 10 ml min from the airway or patients that can not tolerate the added dead space to the airway Do not connect the exhaust tube to the ventilator circuit Patient monitor user s manual g Caution Use only accessories provided by manufacturer Do not sterilize or immerse the LoFlo Module in liquids Do not clean the LoFlo Module and accessories except as directed in this manual Remove the LoFlo sampling kit sample cell from the receptacle when not in use Do not stick appendage into sample receptacle Always insert sample cell before inserting the on airway adapter into the ventilated circuit Always remove the on airway adapter from the ventilated circuit before removing the sample cell Note This product and its accessories are latex free After the life cycle of the LoFlo Module and its accessories hav
132. secseceees 5 35 5 8 Measurement of CO Mainstream IRMA ssssesssccsssssoossesooesesooecesssoossssoossesoo 5 42 5 9 Measurement of CO2 Microstream LOFIO cscsccccssssssccsssssccsssssescesees 5 46 MI 5 10 Measurement of CO2 Mainstream CAPNOSTATS cssccccsssssssseseeeeesees 5 54 5 11 Measurement of AG T RMA cccccsssccssssrsccssscssccssscssccsssssssccsssssseccssscssssssees 5 58 Chapter GABE ses casaicatecesiccsccecstcsseducseshuatouuyies susdvoede spans asncsdaecsssyonececdpniens isss esos eS ss 6 1 6 1 Alarm Category and levell c ccisccsiccescccceasosconsssccnescessssoocsassectoescqnsnenssesecdancectuacoenases 6 1 6 2 Alarm MOUS escscsscsvsudeccbcasososesnsceesnsuues chee cuvndcesheacebnastepsnelbesuhcausaesstnaudetstacensaesansieeyes 6 1 6 3 Alarm SOUP sccciesspccesiesscdsssessecavausiacceenspsesvoudacdossopnusse cede scobesshecteoatescsobespecssenioncessonyeds 6 3 6 4 Alarm C MUSE sccscoeseies wchineccusdetadsiusensaveboes So sdscddenaeteuetestesiea senudeaetoes titsceceluietettatsesiendes 6 5 6 5 Silence Suspension Liicediscacecscauessesancssvesssrcandinnsdsscedpessuebsneanscvonenssclanssecdssnesssedancavesens 6 5 6 6 Parameter Alar iniscs jecicsiezsetssdeccussecessescidevoniiacetstvedsicussedestessad ccoususcossuteniacoesbececsnsebss 6 6 6 7 When an Alarm OCCU rs dssecisessinccccdscesetussessnntsincsentsaesctndeosssnndsrencnsobenccunessouseessonesesis 6 7 6 8 Alarm Description and Prompt se sseeeso
133. sensor should not be pulled with force Note Frequent movements of the sensor may result in errors in the readings of the monitor Warning In case NIBP and SpO are measured at the same time please do not place the SpO sensor and the NIBP cuff on the same end of the limb for the measurement of NIBP will block blood flow affecting the measurement of SpO2 Warning Do not conduct SpO measurement on the finger smeared with fingernail oil otherwise unreliable measurement results might be produced Note When using SpO 2 sensor care should be taken to shield external light sources such as light of thermo therapy or ultraviolet heating light otherwise the measurements may be disturbed Under such conditions as shock hypothermia anemia or the use of blood vessel activating drugs and with the existence of such substances as carboxyhemoglobin methemoglobin methylene blue the result of the SpO measurement will be possibly not accurate Note E Make sure the nail faces to the light window E The wire should be on the backside of the hand E SpO waveform is not proportional to the pulse volume Patient monitor user s manual Warning Do not use the sterile supplied SpO2 sensors if the packing or the sensor is damaged and return them to the vendor Warning Prolonged and continuous monitoring may increase jeopardy of unexpected change of dermal condition such as abnormal sensitivity rubescence vesicle repressive putrescence
134. ser Selectable IBP SYS2 too high SYS measuring value of channel 2 is above upper alarm limit User Selectable IBP SYS2 too low SYS measuring value of channel 2 is below lower alarm limit User Selectable IBP DIA2 too high DIA measuring value of channel 2 is above upper alarm limit User Selectable IBP DIA2 too low DIA measuring value of channel 2 is below lower alarm limit User Selectable IBP MAP2 too high MAP measuring value of channel 2 is above upper alarm limit User Selectable IBP MAP too low MAP measuring value of channel 2 is below lower alarm limit User Selectable Technical Alarm Message Cause Alarm Level IBP1 sensor off IBP cable of channel 1 falls off from monitor Low IBP2 sensor off IBP cable of channel 2 falls off from monitor Low IBP communication error IBP communication error Low IBP1 alarm error Alarm failure Low IBP2 alarm error Alarm failure Low Prompt Message Cause Alarm Level IBP1 Checking IBP1 zero calibration is in progress IBP1 Errlose IBP1 zero calibration failed for IBP1 cable falls off IBP1 Errtimeout IBP1 zero calibration failed for time is out IBP1 Check OK IBP1 zero calibration succeed IBP2 Checking IBP2 zero calibration is in progress IBP2 Errlose IBP2 zero calibration failed for IBP2 cable falls off IBP2 Errtimeout IBP2 zero calibra
135. sity signal nae The high intensity signal 5 4 Measurement of TEMP 5 4 1 Brief Introduction to Measurement of TEMP Monitor measures TEMP with TEMP sensors The TEMP module of Monitor uses TEMP cable compatible with YSI 400 The minimum time to get accurate temperature measuring value is 3 minutes The monitor has two ports for body TEMP measurement and can measure the temperature of two channels at the same time 5 4 2 Preparatory Steps of the Measurement of TEMP 1 Plug the TEMP cables into the TEMP sockets of the monitor 2 Place the TEMP sensors on body of patient and the screen will show the value of TEMP measurement 3 Set the parameters relevant to TEMP 5 4 3 Connecting Patient and Monitor Plug the TEMP cable into the sockets marked with TEMP either of TEMP1 and TEMP2 and then stick the TEMP sensor securely onto the body of patient o Caution The TEMP sensor and cables should be handled with care When not in use the sensor and the cable should be rounded into loose ring shape Patient monitor user s manual 5 4 4 Setup of TEMP Parameters Unit T1 Label T2 Label Alarm Setup Back to Main Unit Select the unit of TEMP and options are C and F T1 label Select the labeling name for TEMP 1 and options are T1 Eso Naso Tymp Rect Blad and Skin T2 label Select the labeling name for TEMP 2 and options are T2 Eso Naso Tymp Rect Blad and Skin Label Meanings Label Meanings Es
136. sly adjustable no lower than the low limit the configuration range of FiCO gt alarm low limit is 0 0 13 1 0 99 6mmHg continuously adjustable no higher than the high limit RESP alarm high limit its configuration range is 0 150 rpm continuously adjustable no lower than the low limit the configuration range of RESP alarm low limit is 0 150rpm continuously adjustable no higher than the high limit EtCO alarm Select lt ON gt to enable EtCO gt over limit alarm select lt OFF gt to disable EtCO gt over limit alarm FiCO alarm Select lt ON gt to enable FiCO gt over limit alarm select lt OFF gt to disable FiCO over limit alarm RESP alarm Select lt ON gt to enable RESP over limit alarm select lt OFF gt to disable RESP over limit alarm Apnea alarm when the time of zero RESP rate has reached this time scale the alarm will be set off Options are Off 10s 20s 40s and 60s Patient monitor user s manual Note EtCO alarm cannot be switched off GO Caution When the monitor is powered on the pump in the CO module is set off as default configuration Since long time running of sampling pump could shorten the life of CO module please start sampling pump manually and stop the sampling pump after monitoring has been finished 5 7 3 Gain Calibration Please carry out gain calibration and manual offset calibration when the following conditions happened 1 The module has been used for between half a year a
137. spectively making one lead of Vi V established When conducting 12 leads ECG monitoring use 12 lead ECG cable and all the leads are placed on the relevant locations respectively as indicated by Fig 5 1 5 This kind of connection realizes the establishment of such 12 leads as I H HI aVR aVL aVF V V6 5 1 6 Setup of ECG HR parameters ECG1 EcG2 ECG3 ECG Gain HR Source Beep Volume Alarm Setup Mig ECG Setup Mig ECG Replay Mig Back to Main ECGI1 Select the first lead ECG waveform and this lead is the key monitoring lead ECG Select the second lead ECG waveform ECG3 Select the third lead ECG waveform ECG gain Select the gain item of ECG waveform and options are AUTO 0 25x 0 5x 1 0x 2 0x and 4 0x HR source Select HR source item and common options are AUTO ECG PLETH When select ART for IBP measurement the option ART is appeared in HR source Beep Volume Select the volume of BEEP and options are Off 1 2 3 4 5 6 Once an option is selected a testing beep will be produced Alarm setup Click and open the dialog of alarm setup 5 5 Patient monitor user s manual ECG setup Click and open the dialog of ECG setup ECGreplay Click and open the dialog of ECG replay e Alarm setup ECG Alarm Mig ST Alarm Mig ARR Alarm Previous ECGalarm Click and open the dialog of HR alarm Adjust Alarm HR Alarm Previous ea Adjust alarm Select this option to enter the configu
138. ssoossoossoossssesssesssocesoossossess 1 4 Chapter 2 Important Safety Notes soessoesssesssecssoossoossooessoesssocesoossoossssssssesssosssoossosssos 2 1 ZA General Sate ty sossscts lt askvscctassesuvstesuwssesniessocnseseusopssusesaensoasnoustoousdsnavosdvannenovcheesecssesase 2 1 2 2 Some Important Notes for Safety ccscccscssscssssecsssccscssccssssesssesssscessessessesees 2 3 2 3 Classifications igo c6s cs cccaracenscssctscicsxncdosatssscobiseudasacseskcobssondecsasontaehosinsvenuteckccsdivecseatsis 2 5 2 4 Safe Operating and Handling Conditions ccccccccssscccssccscsscsscesesssesesees 2 6 Chapter 3 Preparations Before the Use of the Monitor scssssssssssssssseeseesseees 3 1 3 1 Unpacking and Checking ccs cccncsnsssessseissnccsessssoosuosvessseseenbonedbascceuessvestedsiasnesssevenstc 3 1 3 2 Connecting to PO WEN oiccssciscccicscnscasnsesasscesucs sconsdsadossecssabobesoscsosmspadesbassecteasegesbeddstacs 3 1 3 3 Connecting to the Central Monitor System ccccccccsssccssscccssscscsssescessssees 3 3 3 4 Starting the Monitor vices csisscccnsscccescssceandsosstecetedsteecsessucussbvavsecnnsovencseeeucetensdeceusaseeune 3 4 3 5 Connecting to Various Kinds Of Sensors sccccccccssscccssscccsssccscsscscssssssesseseees 3 4 3 6 Preparation of ReECOL der scssesasissicsuvaseovesssvenssovicsosnsvesepucesossnsesbosvnoevesdvensstouvoseutecsenans 3 4 3 7 Shutting off the Monitor ssc ceccewssscotecs
139. stunssvonsestckaccstacs 10 1 Appendix A Product Specification S csessssecosesssosssovesseescssonssstonssecensssesanssensncrencaedentecs 1 A 1 Environmental Specifications s lt acssseocsssssonssovessseenessonssstonsdecenssscasssernscsenasosentess 1 A 2 Hardware Specifications s ciccssssocscssscssecssscvonssovoseecoassooesssscveccsocsvecenvictencsesceenssoucseentes 1 A 3 Measurement Specifications cccccsccccssscccssscccssscccsssscssscscssssssesssccesssssessesesees 3 Appendix B Default System Setup esssesssesssoossooessoossosesssesssocesoossoosssssssoesssoessoossosssssssssee 13 BB PS YS COMM esis ss ius cssiecedivhs casscacice sean tc adiccaUicunesiedn cose ocd soes aosa eoponasesudoosessesbocceseannte 13 B52 Alarm LAM ssccccsssesssseuenseccessssusctetendscuanseccenszshededansnenadsuced speadectansessnctedaecsesteuubiabess 16 Appendix CEMC x ssscnschscessonsssssbenuisivenssnunsbusvundecessessubucesavsacendelucassasnspecvandegeassbevbaceasussenaxe 19 IV Patient monitor user s manual Chapter 1 General Introduction 1 1 Intended Use The Monitor is used to monitor patient s physiological parameters such as ECG RESP SpO2 NIBP IBP TEMP EtCO2 and AG continuously It is intended to be used in various hospital rooms such as Coronary Care Unit Intensive Care Unit Neonatal Intensive Care Unit and Operating Room to provide additional information to medical and nursing staff about the physiological condition of the
140. surement of NIBP with the method of shockwave The method of shockwave indirectly estimates the systolic and diastolic pressures within the blood vessels by measuring the change of the pressure within blood pressure cuff along with the volume of the arteries and calculates the average pressure The measurement time of BP on a calm patient is less than 40s and when each measurement ends the cuff automatically deflates to zero The monitor applies to any standards of the cuffs for neonate child and adult including the cuffs used for arms and legs The monitor measures the blood pressure during the time of deflation Monitor automatically conducts the second and third inflation measurements in case during the first inflation it is unable to measure the value of BP and gives out the information for measurement failures The longest cuff pressure maintaining duration is 120 seconds 90 seconds in neonate mode and when the time is exceeded the air will be deflated automatically The monitor has been designed with hardware protection circuit regarding overpressure errors of microprocessors and the occurrence of power failure 5 5 2 Preparatory Steps of Measurement of NIBP Patient monitor user s manual 1 Plug the air hose of cuff into the NIBP socket of the monitor and tighten it clockwise to ensure secure contact of the plug and the socket Please note that the plug should be loosened by turning counterclockwise first before unplugging
141. t Cancel to cancel saving Delete Config Delete the previous data of custom configuration select the custom configuration that needs to be deleted press the selected mode to delete the mode and press Cancel to cancel deleting g Caution The mode name cannot be black when saving current configuration otherwise the custom configuration will not be save E Alarm level Setup Alarm Level Default Previous Alarm levels of all the parameters can be configured Press lt Set Alarm level gt option the cursor will move to the region of configuring alarm levels If the alarm level of a certain parameter is to be configured first move the cursor to the alarm level of that parameter press the option and then select the alarm level Options are low med and high Patient monitor user s manual E Machine Setup Maintenance Mig Factory Mig HUM GAS ZERO c02 CaliMode Previous Maintenance Click and open the dialog of system maintenance Factory Manufacturer maintenance is not an operation option for users and it must be operated by the technical and maintenance personnel authorized by manufacturer CO Gain Cal Conduct gain calibration on the sidestream CO2 module This function is only valid on sidestream CO and when the sampling pump has been started CO Cal Mode Open or close the CO calibration mode When conducting calibration on sidestream COz set the CO2 cal mode to ON HUM Select the frequency of t
142. t disinfection is only recommended when stipulated as necessary in the hospital maintenance schedule disinfection facilities should be cleaned first E Cleaning Use a piece of clean cloth moistened in water or mild soap solution to clean the ECG cable E Disinfection Use a piece of clean cloth to wipe the surface of the cable with a 10 bleach solution or 2 Cidex clean with clear water and wipe it dry Patient monitor user s manual 5 2 Measurement of RESP 5 2 1 Principles of Measuring Monitor measures RESP with the method of impedance When a patient exhales and inhales changes will take place in the size and shape of the thoracic cavity causing consequent changes in the impedance between the two electrodes installed at the patient s chest Based on the cycle of impedance changes the respiration rate can be calculated 5 2 2 Preparatory Steps of the Measurement of RESP 1 Plug the 5 lead ECG cable into the ECG socket of the monitor 2 Place the various pads of the electrodes onto the body of patient and connect them to the relevant lead cables At this moment the screen will show RESP waves and the RESP rate will be calculated 3 Set the parameters relevant to RESP monitoring 5 2 3 Connect the ECG Cable with Patient and the Monitor To measure RESP parameters it is unnecessary to use other cables and it is only necessary to use the two RA and LL leads in the 5 lead ECG cable So please plug the 5 lead
143. t 95 dip in UT gt 95 dip in UT for 5 sec for 5 sec Power frequency 3A m 3A m Power frequency magnetic fields 50Hz magnetic field should be at levels characteristic of a IEC 61000 4 8 typical location in a typical commercial or hospital environment NOTE UT is the a c mains voltage prior to application of the test level 19 Patient monitor user s manual Guidance and manufacture s declaration electromagnetic immunity for EQUIPMENT and SYSTEMS that are not LIFE SUPPORTING Guidance and manufacture s declaration electromagnetic immunity The Monitor is intended for use in the electromagnetic environment specified below The customer or the user of Low Frequency Therapeutic Device should assure that it is used in such an environment Immunity test IEC 60601 test level Compliance level Electromagnetic environment guidance Portable and mobile RF communications equipment should be used no closer to any part of the patient monitor including cables than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter Recommended separation distance Conducted RF 3 Vrms 1 Vrms d 3 5 JP IEC 61000 4 6 150 kHz to 80 MHz V gales p E Radiated RF 3 V m 3 V m BARE 80 MHz to 800 MHz IEC 61000 4 3 80 MHz to 2 5 GHz 7 d E JP Lvl 800 MHz to 2 5 GHz Where P is the maximum output power rating of the transmitter in watts W according
144. tem S M Systolic pressure or mean pressure exceeds the alarm limit will trigger the alarm system D M Mean pressure or diastolic pressure exceeds the alarm limit will trigger the alarm system S D Systolic pressure or diastolic pressure exceeds the alarm limit will trigger the alarm system S D M Mean pressure systolic pressure or diastolic pressure exceeds the alarm limit will trigger the alarm system Alarm Switch Select lt ON gt to enable parameter over limit alarm select lt OFF gt to disable parameter over limit alarm Patient monitor user s manual 5 6 4 Calibration of Zero point Start the unit and preheat it for 3 minutes If it is in a stable state turn off three way valve 2 and turn on three way valve 1 and then select option in lt IBP Zero gt of lt IBP Setup gt then it can be seen on the screen that the scanning baseline has returned to zero baseline Note In the course of zeroing should turn off the three way valve near artery needle don t connect artery needle with patient and make sure there is no air inside the whole tube 5 6 5 Connecting to Patient As shown in Fig 5 6 4 Note The pressure measuring side of the transducer should be on the same plane as the heart of the patient in the process of zero setting and measurement and the user should make sure there is no air inside the whole tube in order to assure the correctness of the measured results If air is found in tube or in pressure t
145. tem performance leading to a user or patient hazard Performance is not guaranteed if an item labeled as Patient monitor user s manual single patient use is reused Inspect the CO2 airway adapters for damage prior to use Do not use the CO2 airway adapters if they appear to be damaged or broken Replace the CO2 airway adapters if excessive secretions are observed If the CO2 waveform Capnogram appears abnormal inspect the CO2 airway adapters and replace if needed Monitor the CO2 waveform Capnogram for elevated baseline Elevated baseline can be caused by sensor or patient problems Periodically check the CAPNOSTATS sensor and tubing for excessive moisture or secretion buildup Do not operate the CAPNOSTATS sensor when it is wet or has exterior condensation Caution Use only accessories provided by manufacturer Do not sterilize or immerse the CAPNOSTATS sensor in liquids Do not clean the CAPNOSTATS sensor and accessories except as directed in this manual It is recommended that the CO sensor be removed from the circuit whenever an aerosolized medication is delivered This is due to the increased viscosity of the medications which may contaminate the sensor windows causing the sensor to fail prematurely Do not apply excessive tension to the CAPNOSTATS sensor cable a Note This product and its accessories are latex free After the life cycle of the CAPNOSTATS sensor and its accessories have been met disp
146. temperature and humidity are stable and avoid the occurrence of condensation in the work process of the monitor Warning Never install the monitor in an environment where flammable anesthetic gas is present 2 Monitor conforms to the safety requirements of IEC 60601 1 1995 This monitor is protected against defibrillation effects 2 1 Patient monitor user s manual 3 Notes on signs related to safety Type CF applied part defibrillation protected 1 The unit displaying this symbol contains an F Type isolated floating applied part providing a high degree of protection against shock and is defibrillator proof The type CF applied parts provide a higher degree of protection against electric shock than that provided by type BF applied parts AN Attention Please refer to the documents accompanying this monitor this manual l Type BF applied part defibrillation protected The unit displaying this symbol contains an F Type isolated floating applied part providing a high degree of protection against shock and is defibrillator proof 4 When a defibrillator is applied on a patient the monitor may have transient disorders in the display of waveforms If the electrodes are used and placed properly the display of the monitor will be restored within 10 seconds During defibrillation please note to remove the electrode of chest lead and move the electrode of limb lead to the side of the limb The electrode of the defibrillato
147. tempt to connect this monitor to other central monitoring system 3 4 Starting the Monitor Press the power button The alarm indicating lamps flash and then go out The fl system gives a beep and displays the startup screen The startup screen disappears and the monitor enters the main screen T N Warning In case the monitor is found to be working abnormally or indication of errors appears please do not use this monitor for monitoring and should contact the after sale service center as soon as possible 3 5 Connecting to Various Kinds of Sensors Connect sensor cables to the relevant sockets on the monitor and put sensors on the monitored locations on the body of the patient Refer to the relevant content of Chapter 5 for details Na Warning For safety reasons all connectors for patient cables and sensor leads with the exception of temperature are designed to prevent inadvertent disconnection should someone pull on the leads Do not route cables in a way that they may present a stumbling hazard Do not install the monitor in a location where it may drop to the patient All consoles and brackets used must have a raised edge at the front 3 6 Preparation of Recorder If the monitor you use has been provided with a recorder before starting of monitoring please check if the recorder has had recording thermal paper installed The thermal side that is the smoother side should face upwards and a small section sh
148. the cover to use again Patient monitor user s manual Warning E Clean the bladder frequently will cause the bladder scathed except the necessary do not clean the bladder E Do not dry the bladder and cover with high temperature E If need the high level disinfecting please selecting the disposable cuff 5 6 Measurement of IBP 5 6 1 Brief Introduction to Measurement of IBP The method of IBP measurement is direct measuring the BP of artery or veins on the pressure sensor mainly through liquid coupling so as to obtain the pressure curve of the continuous BP The IBP parameters of Monitor can select Arterial Pressure ART Pulmonary Artery pressure PA Left Atrium Pressure LAP Right Atrium Pressure RAP Central Venous Pressure CVP Intracranial Pressure ICP Monitor has two measurement channels for IBP and the IBP of two channels can be measured at the same time 5 6 2 Preparatory Steps for Measurement of IBP 1 Plug the cable of IBP into the IBP socket either CH1 or CH2 and connecting cable to the pressure transducer Fill the pressure transducer and extension tube with saline water mixed with heparin Press the flexible valve to expel the saline water from the air outlet to expel air bubbles and then reset it to zero Note The method of touching test is to touch slightly the surface with finger Waveforms should appear on the screen of the main unit The blue ball cover should be put on the surface immediat
149. the high limit EtCO alarm Select lt ON gt to enable EtCO gt over limit alarm select lt OFF gt to disable EtCO over limit alarm FiCO alarm Select lt ON gt to enable FiCO gt over limit alarm select lt OFF gt to disable FiCO over limit alarm RESP alarm Select lt ON gt to enable RESP over limit alarm select lt OFF gt to disable RESP over limit alarm Apnea alarm When the time of zero RESP rate has reached this time scale the alarm will be set off Options are Off 10s 20s 40s and 60s 5 48 Patient monitor user s manual Note EtCO alarm cannot be switched off Gas Temp Barometric EtCO2 Period Zero Gas Compensation Balance gas Anesthetic ZERO Previous Gas Temp Select the temperature of gas Turn the trim knob with an increment or decrement of 1 C Barometric Select the Atmospheric pressure Turn the trim knob with an increment or decrement of 1mmHg EtCO Period Select the response time of EtCO the options are 1 breath 10s and 20s Zero Gas Select the gas type of zeroing the options are Air and N2 Compensation Select the concentration of oxygen Turn the trim knob with an increment or decrement of 1 Balance gas Select the balance gas type the options are Air N20 and Helium Anesthetic Select the concentration of balance gas Turn the trim knob with an increment or decrement of 0 1 Zero Press the button to start zeroing It is only valid when the system detects that t
150. the technical personnel been authorized by manufacturer 2 2 Some Important Notes for Safety PATIENT NUMBER The monitor can only be applied to one patient at one time INTERFERENCE Do not use cellular phone in the vicinity of this equipment High level of electromagnetic radiation emitted from such devices may result in strong interference with the monitor performance ACCIDENTAL SPILLS To avoid electric shock or device malfunction liquids must not be allowed to enter the device If liquids have entered the device take it out of service and have it checked by a service technician before it is used again ACCURACY If the accuracy of any value displayed on the monitor or printed on a printout paper is questionable determine the patient s vital signs by alternative means Verify that all equipment is working correctly ALARMS Do not rely exclusively on the audible alarm system for patient monitoring Adjustment of alarm volume to a low level or off during patient monitoring may result in a hazard to the patient Remember that the most reliable method of patient monitoring combines close personal surveillance and correct operation of monitoring equipment The functions of the alarm system for monitoring the patient must be verified at regular intervals BEFORE USE 2 3 Patient monitor user s manual Before putting the system into operation please visually inspect all connecting cables for signs of damage Damaged c
151. tion failed for time is out IBP2 Check OK IBP2 zero calibration succeed No alarm Patient monitor user s manual 6 8 6 NIBP Alarm Physiological Alarm Message Cause Alarm Level NIBP SYS too high NIBP SYS measuring value is above upper User Selectable alarm limit NIBP SYS too low NIBP SYS measuring value is below lower alarm limit User Selectable NIBP DIA too high NIBP DIA measuring value is above upper alarm limit User Selectable NIBP DIA too low NIBP DIA measuring value is below lower alarm limit User Selectable NIBP MAP too high NIBP MAP measuring value is above upper alarm limit User Selectable NIBP MAP too low NIBP MAP measuring value is below lower alarm limit User Selectable Technical Alarm 1 display in description area Message Cause Alarm Level NIBP measurement failure or NIBP communication error cGunmnuniention failure Low NIBP SYS alarm error Alarm failure Low NIBP DIA alarm error Alarm failure Low NIBP MAP alarm error Alarm failure Low Technical Alarm 2 display in description area below NIBP mean arterial pressure value b Signal is too noisy during measurement e g patient has severe tremor c Irregular pulse rate e g arrhythmia Message Cause Alarm Level SELF TEST FAILED Transducer or other hardware failure Low a Cuff is co
152. tor please check if the lead wires and cables have been worn out or cracked If so they should be replaced Warning It is imperative to only use the ECG cables provided with the instrument by manufacturer Warning The equipment is capable of displaying the ECG signal in the presence of pacemaker pulses without rejecting pacemaker pulses Warning To avoid burning when the electrotome operation is performed the electrodes should be placed near the middle between ESU grounding pad and electrotome and the electrotome should be applied as far as possible from all other electrodes a distance of at least 15 cm 6 in is recommended Warning When the electrotome operation is performed the ECG leadwires should be intertwisted as much as possible The main unit of the instrument should be placed at a distance from the operation table Power wires and the ECG lead cables should be partitioned and should not be in parallel 5 1 Patient monitor user s manual Warning The monitor is protected against defibrillation effect When applying defibrillator to the patient the monitor will experience transient disorderly waveforms If the electrodes are used and placed correctly the display of the monitor will be restored within 5 seconds During defibrillation the chest leads such as V V should be removed and such limb electrodes as RA LA RL LL should be moved to the side of the limbs Warning All the electrodes and conducting part shall n
153. ual Recommended separation distances between portable and mobile RF communications equipment and the EQUIPMENT or SYSTEM for EQUIPMENT or SYSTEM that are not LIFE SUPPORTING Recommended separation distances between portable and mobile RF communications equipment and the Low Frequency Therapeutic Device The Monitor is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled The customer or the user of the Low Frequency Therapeutic Device can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment transmitters and the Low Frequency Therapeutic Device as recommended below according to the maximum output power of the communications equipment Separation distance according to frequency of transmitter m Rated maximum APDO NOT O 150 KHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2 5 GHz transmitter W E Behe ge Behe d Z JP 1 1 1 0 01 0 35 0 12 0 23 0 1 1 1 0 38 0 73 1 3 5 1 2 2 3 10 11 3 8 7 3 100 35 12 23 For transmitters rated at a maximum output power not listed above the recommended separation distance d in metres m can be estimated using the equation applicable to the frequency of the transmitter where P is the maximum output power rating of the transmitter in watts W according to the transmitter manufacturer NOTE 1 At 80 MHz and 800 MHz the separation dist
154. uditory and visual alarms through speaker LED and screen 6 1 Alarm Category and level There are two kinds of alarms defined as physiological alarm and technical alarm Physiological alarms refer to those alarms triggered by patient s physiological situation which could be considered dangerous to his or her life such as SpO2 exceeding alarm limit parameter alarms Technical alarms refer to system failure which can make certain monitoring process technically impossible or make monitoring result unbelievable General alarm belongs to those situations that cannot be categorized into these two cases but still need to pay some attention Each alarm either technical or physiological has its own priority Alarms in the monitor are divided into three priorities that is high level medium level and low level E High level alarm indicates the patient s life is in danger It is the most serious alarm E Medium level alarm means serious warning E Low level alarm is a general warning Only alarm level of parameters exceeding limits alarm can be modified by the user the other alarm level of physiological and technical alarms are preset by the system and they can not be changed by the user 6 2 Alarm Modes When alarm occurs the monitor may raise the user s attention in two ways which are auditory prompt visual prompt and description Visual prompt is given by alarm indicating lamp and screen of the monitor auditory prompt is given
155. up 2 Attaching the Sample Cell Follow these steps 1 Insert the LoFlo sample cell into the LoFlo sample cell receptacle A click will be heard when the sample cell is properly inserted Fig 5 9 1 Fig 5 9 2 Fig 5 9 1 Exhaust P Tube eee PaPa SS a8 Sample Cell pegs Module Cable Receptacle Wor f i Y gt LoFlo Module Fig 5 9 2 Note E Inserting the sample cell into the receptacle automatically starts the sampling pump Removal of the sample cell turns the sample pump off E To remove the sample cell from the sample cell receptacle press down on the locking tab and pull the sample cell from the sample cell receptacle 5 46 Patient monitor user s manual 2 If the sampling pump fails to turn on or runs intermittently perform a Zero procedure Refer to the chapter 5 9 3 3 Ensure that the LoFlo module exhaust tube vents gases away from the module environment 4 Wait for the CO2 module to warm up The monitor will display the Sensor Warm Up message for approximately one minute while the module warms up to operating temperature The message disappears when the module is ready for use Note Warm up time varies with ambient temperature of the module 5 9 2 Setup of CO2 parameters Scan Speed Resp Source Unit Resp Gain Alarm Sctup Mig my Back to Main Scan speed Select the scanning speed of RESP waveforms and options are 6 25mm s 12 5mm s and 25mm s RESP source Select RESP
156. ure connections the user should re perform the air leakage test If the failure prompt still appears please contact the manufacturer for repair 8 Press the amp s 2 button on front panel can also stop the test Cylinder Metal Vessel Monitor Cuff Fig 5 5 7 Diagram of air leakage check 5 5 7 Maintenance and Cleaning Warning Do not squeeze the rubber hose on the cuff Do not allow liquid to enter the connector socked at the front of the monitor Do not wipe the inner part of the connector socked when cleaning the monitor Warning If liquid is inadvertently splashed on the equipment or its accessories or may enter the conduit or inside the monitor contact local customer service center Warning Disposable blood pressure cuff must not be re sterilized or reused Disposal Note Should the blood pressure cuff become damaged beyond repair or for some reason its useful life is considered to be at an end please observe all local state and federal regulations that relate to the disposal of this products or similar products For Reusable Blood Pressure Cuff E Cleaning 1 Please clean the cuff termly 2 Take down the cuff from the connector take out the bladder from the cover of the cuff 3 Use a piece of clean cloth moistened in water or mild soap solution to clean the bladder and the tube 4 Clean the cover of the cuff with the mild soap solution 5 Dry the cover and the bladder then take the bladder into
157. waveform will be automatically open if there is an RESP waveforms the RESP waveform will be switched off AG module Please refer to SpO2 module instruction TEMP module Click and open the dialog of TEMP module setup 4 9 Patient monitor user s manual Templ Module Temp2 Module Previous TEMP 1 module Enable Disable the display of TEMP 1 module TEMP 2 module Enable Disable the display of TEMP 2 module IBP module Click and open the dialog of IBP module setup IBP1 Module IBP2 Module Previous IBP1 module Enable Disable the display of IBP1 module After switching off no IBP1 parameters and relevant alarm will be displayed and the current IBP1 waveform will be automatically switched off After it is open the IBP1 waveform will also be opened IBP2 module Please refer to IBP1 module instruction Patient monitor user s manual E Trend Storage Setup Interval Time NIBP storage Alarm storage Warn storage Previous Interval time Select the cycle intervals of trend storage and options are Off 1min 2min 3min 4min 5min 10min 15min 20min 25min and 30min NIBP storage Enable Disable the switch of NIBP storage When it is enabled it indicates after NIBP measurement completed a record will be stored Alarm storage Enable Disable the switch of alarm storage When it is enabled it indicates if there is a high alarm of physiological parameters a record will be stored Warn storage Enable Disa

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