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9403-5 - Veterinary Instrumentation

1. 158 OTHER ACCESSORIES 159 MONITOR CONFIGURATIONS 159 SPECIFICATIONS 161 APPENDIX 171 DEAD SPACE Cause Effect amp Control in Small Animal Anesthesia 171 PURCHASING 173 21 02 0186 REV 08 07 11 21 Of Contents CARDELL Veterinary Monitors FIGURES Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Patient 27 3 Lead Placement 46 5 Lead Placements 2 RU er 47 Detaching the Leadwires 51 Removing the Patient Cable 51 Cat Cuff e S 54 Dog Cuff Placement TU TNT 55 Full Velcro Engagement ene o in eio e 56 Figure 9 NIBP Menu sedent
2. 87 CONNECTOR inne 88 COS SENSOR CONBNEGTDI 88 SCAVENGER EXHAUST PORT 88 MONITOR OPERATING INSTRUCTIONS 89 TURNING THE CARDELL MONITOR 89 21 02 0186 REV 08 07 11 18 Of Contents CARDELL Veterinary Monitors SETUP MENU 90 ENTERING THE SETUP 90 EXIT THE SETUP MENU cians tian 91 SELECTING THE LANGUAGE 91 AUDIO ALARM SILENCE SILENCE RESET Pushbutton 91 2 MINUTE AUDIO ALARM SILENCE nncrntton thun ttp b ries rbd 92 PERMANENT AUDIO ALARM SILENCE eene 92 icu Wl cM DATE 92 SETTING THE TIME C 93 DAYLIGHT SAVING TIME OF 93 SET THE SpO PULSE RATE ALARM 94 SELECTING THE TEMPERATURE 95 TRACE BACKGROUND 95 PARAMETERS MENLE IURE VES 96 AU
3. Of Contents CARDELL Veterinary Monitors The following equipment is required to perform the pressure checks e Assembled P9 Calibration Kit Mercury manometer whose accuracy meets the AAMI ANSI Standard for Non Automated Sphygmomanometers 2002 WARNING Do not place the monitor in the Service menu when a cuff is attached to a patient MANOMETER PRESSURE CHECK 1 Assemble the Calibration Kit according to the diagram provided in the P9 kit 2 Remove the manometer tubing from the inflation bulb Connect the open ended tubing of the T connector to the inflation bulb 3 Connect the female luer fitting to the inflation tube leading to the manometer 4 Connect the male luer fitting to the manometer tubing 5 Enter the monitor s Service menu Refer to Page 144 SERVICE MENU 6 Press the ARROW DOWN pushbutton until the parameter Manometer Mode is highlighted 7 Press one of the NEXT programmed pushbutton keys to select and start the test 8 The Message Window will switch from displaying OFF to mmHg 9 Use the manometer inflation bulb to slowly inflate the system pausing for 30 seconds at the following points and verify calibration according to the following table 0 mmHg 1 mmHg 50 mmHg 4 mmHg 100 mmHg 4 mmHg 150 mmHg 4 mmHg 200 mmHg 5 mmHg NOTE If the monitor does not display the test pressure for the 30 second period deflate to zero
4. Of Contents CARDELL Veterinary Monitors MONITOR MESSAGES cont NIBP Table 12 NIBP Monitor Messages MONITOR POSSIBLE CAUSE POSSIBLE SOLUTION MESSAGE Air Leak Air leak in Check that the cuff hose monitor cuff hose monitor connection is secure pneumatic system Check cuff for leaks Do not use a known leaky cuff Large Cuff mode operating mode Flow Error Stable cuff pressure Check the external tube for kinks cannot be maintained by the NIBP pneumatic Perform a Pneumatic Check as detailed in system the Maintenance section of this manual Replace cuff Cuff applied too loosely Check cuff for proper fit on patient There was too much Measurements can be obtained when there extremity motion for the is limited extremity movement but the monitor to accurately measurement time may be extended complete the NIBP measurement in 150 Measurement time is limited to 150 seconds seconds Restrain patient extremity motion NIBP Cal Pressure calibration data Pressure module needs recalibration corrupted within NIBP module Contact CAS Medical Systems to have the monitor serviced NIBP Error An electronic failure has Turn the monitor Off disconnect the AC occurred within the NIBP Line cord and battery Reconnect the module battery and AC Line cord turn the monitor On If the message still appears contact CAS Medical Systems to have the monitor serviced NIBP Mod
5. 28 2 UNPACKING THE MONITOR 29 INITIAL TNSPECTIOIL 29 MONITOR CHECKLIS eiua dax enc E Dd RN cu EE 29 OPTIONAL ACCESSORIES anni conr HERR MEA M GR 29 4 SYMBOLS CEU HRS 31 4 SAFETY MEASURES AND WARNINGS 37 AUTOMATIC SAFETY FEATURES 42 5 ECG AND RESPIRATION MONITORING 45 MONITORING 45 POSITIONING ANESTHETIZED PATIENTS eene e 45 POSITIONING CONSCIOUS PATIENTS Rr tienne 45 LEAD AT TAC ILS Ee 45 CON apo 47 pie e ibI cm 48 FREEZE TIRAGE situent 48 pies pg sRue ger cR 49 DETACHING grs a tli Sub aene 51 REMOVING THE PATIENT 51 6 BLOOD PRESSURE MONITORING nnne nnn 53 CUFF SELECTION AND 53 SITE SELECTION 54 CUFF PLACEMENT TOR Ras 54 CUFF PLACEMENT FOR n a ud 55
6. Of Contents CARDELL Veterinary Monitors TREND HISTORY Figure 26 History Menu History HR MN HR 02 PR CO2 RR 14 02 176 98 174 38 16 14 01 NIBP 153 91 123 PR 14 01 190 98 189 38 16 14 00 172 98 151 38 16 13 59 NIBP 140 88 125 PR 1 13 59 160 398 157 38 16 13 58 128 98 125 38 16 13 57 NIBP 135 92 114 163 13 57 160 98 159 38 16 Erase No To view Trend History 1 Press the HISTORY pushbutton to enter the Patient History menu The most current measurement values and the time of measurement HR MN are highlighted on the front panel display screen If there were no readings in History the message No History is displayed at the top of the Main display screen when the History pushbutton is first pressed NOTE History data values for NIBP are saved as they occur One 1 minute averages of history data values for Heart Rate HR Respiration Rate RR when enabled 96SpO 02 Pulse Rate PR and CO Respiration Rate RR are saved once a minute NOTE An will appear in the Trend History menu indicating an alarm occurred during that minute 2 Press the ARROW DOWN pushbutton to review preceding measurements The word Oldest Entry will be displayed briefly at the top of the display indicating there are no more readings remaining for review 3 Press the ARROW UP pushbutton to advance the measurements towards the most curre
7. Of Contents CARDELL Veterinary Monitors OTHER ACCESSORIES Catalog No Description 01 02 0395 Replacement Power Cord U S A 01 02 0386 Replacement Power Cord European 01 02 0385 Replacement Power Cord Australian 01 02 0384 Replacement Power Cord U K 03 08 0450 Monitor Battery Pack 7 2 VDC 3700 mAhr 01 01 0047 P9 Calibration Kit includes T connector with tubing and male luer plug 01 02 0248 500 ml Fixed Volume Cylinder 01 02 0172G Roll Stand with Basket 01 02 0269 Carry Bag 01 02 0189 Printer includes Battery RS232 Cable Power Supply One 1 Roll of Paper and Manual 01 02 0181 Printer Bracket Attachment for Roll Stand 01 02 0300 Printer Mount Attachment for Monitor 28 02 0077 Printer Paper One 1 Roll 01 02 0266 Printer Power Supply Adapter Plug European 01 02 0267 Printer Power Supply Adapter Plug UK 01 02 0268 Printer Power Supply Adapter Plug Australian 01 03 0162 Cardell NIBP Inflation Hose Six 6 Feet 01 03 0239 Equine NIBP Inflation Hose Ten 10 Feet 09 01 0002 Fuse 250V 500mA 5x20 mm Slow Blow 2 per monitor 09 01 0034 Fuse 250V 1 25A 5x20 mm Slow Blow 2 per monitor 21 02 0186 Cardell Monitors Model 9403 9404 and 9405 User s Manual MONITOR CONFIGURATIONS Table 15 Monitor Configurations Model Description 9403 ECG Respira
8. Of Contents CARDELL Veterinary Monitors Characteristic Specification Self Test System self test is performed each time power is turned on Auto Zero Zero pressure reference is automatically established after every reading Inflation Initial inflation to 150 mmHg or user selectable Adaptive 80 100 120 140 150 160 180 200 Subsequent inflation to approximately 30 mmHg greater than previous Systolic pressure Deflation Automatic Max Measurement Time Limited to 150 seconds SAFETY LIMITS Characteristic Specification Automatic Cuff Deflation If cuff pressure exceeds 290 mmHg If measurement time exceeds 150 seconds If safety timer detects microprocessor failure OPERATING ENVIRONMENT Characteristic Specification Operating Temperature 0 to 50 32 to 122 Humidity 15 95 non condensing Altitude 10 000 to 1 250 ft 700 1050 hPa Monitors may not meet performance specifications if stored or used outside temperature and humidity ranges When moving the monitor from a storage location wait at least one hour prior to use to allow the monitor to adjust to room temperature 21 02 0186 REV 08 07 11 167 Of Contents CARDELL Veterinary Monitors STORAGE TRANSPORT ENVIRONMENT Characte
9. 149 150 PNEUMATIC PRESSURE CHE GG seu 150 EU TUBE n 150 S00 ml PRESSURE CHECK 151 21 02 0186 REV 08 07 11 20 14 15 16 17 Of Contents CARDELL Veterinary Monitors VOLTAGE aie ie aie 152 SOFTWARE 152 TEMPERATURE CALIBRATION 153 CALIBRATION vetuit rne tee re 153 REPLACING THE MONITOR 154 REMOVING THE BATTERY 154 INSTALLING THE 154 CHANGING THE FUSES 155 STORAGE Li M e EL 156 ACGESSORIES ERES 157 BLOOD PRESSURE CUFFS 22 157 ECG RESPIRATION 0cccccccccccsceceeeeecececeesseeeaueeeeceeceeeseeaueueseeeeesueeaueesuceseeeeaeeanenees 158 OXIMETRY 158 CERE 158
10. eua n pine Kp cpu Hen D E Esa HE 99 Figure 26 History Menu C 102 Figure 27 Alam History 104 Figure 28 Alarm Limits 106 Figure 29 Printer Controls and Indicators 130 21 02 0186 REV 08 07 11 22 Of Contents CARDELL Veterinary Monitors Figure 30 History Sample Printouts eese esee 132 Figure 31 Waveform Sample Printouts 133 Figure 32 Paper 5 cca 134 Figure 33 Opening the Battery 135 Figure 34 Installing the New Battery 136 Figure 35 Service ino m 145 Figure 36 Software Versions 152 Figure 37 Removing the Monitor Battery 154 21 02 0186 REV 08 07 11 23 Of Contents CARDELL Veterinary Monitors TABLES Table T Parts of the System si det na
11. Table Of Contents CARDELL9 Veterinary Vital Signs Monitors Models 9403 9404 and 9405 119 EtCO2 mmHg Manual TEMP F 38 140 88 125 M x Vet1 SmCuff Bradycardia User s Manual Manufactured for Mm e FOR WHAT S VITAL 21 02 0186 REV 08 07 11 Table Of Contents 21 02 0186 REV 08 07 11 Of Contents CARDELL Veterinary Vital Signs Monitors IMPORTANT This manual addresses all parameters of the CARDELL Veterinary Vital Signs Monitor Not all monitors have all the parameters referred to in this manual Read this Manual completely before using this equipment WARNING The CARDELL Monitor is to be operated by qualified personnel only Before use carefully read this manual including accessory directions for use all precautionary information and specifications The user must check that the equipment functions safely and see that it is in proper working condition before being used CARDELL Veterinary Vital Signs Monitors Model Number Installed Parameters 9403 NIBP 5 ECG Temperature 9404 NIBP ECG Temperature 9405 NIBP 5 ECG Temperature 21 02 0186 REV 08 07 11 Of Contents In the U S the following Caution applies CAUTION Federal law restricts this device to sale
12. the Alarm Window section of the display To acknowledge the alarm and temporarily mute the audio press the SILENCE RESET pushbutton The monitor silences the audible tone for a maximum of fifteen 15 seconds the parameter in alarm and Patient Alarm LEDs continue to flash on the front panel and the appropriate message will be displayed in the Patient Alarm Message Window section of the display If the current patient alarm condition becomes inactive during the 15 seconds and then recurs OR a different patient alarm condition occurs during the 15 seconds the audio alarm is reactivated If the alarm condition continues uninterrupted for the 15 seconds the audio alarm is reactivated 21 02 0186 REV 08 07 11 113 Of Contents CARDELL Veterinary Monitors NIBP PATIENT ALARMS During a NIBP Patient Alarm Limit Violation the monitor flashes the NIBP numeric display of the parameter in alarm and the Patient Alarm LEDs provides a Patient Alarm Limit Violation audible tone and flashes the appropriate message Low or High SYS Low or High DIA Low or High MAP in the Alarm Window section of the display To acknowledge the alarm press the SILENCE RESET pushbutton The monitor silences the audible tone the Patient Alarm LEDs and the appropriate alarm message are no longer flashing EQUIPMENT ALARMS During an active Equipment Alarm the monitor displays the alarm parameter in either the
13. WARNING When used with closed suction system do not place the Airway Adapter between the suction catheter and endotracheal tube 4 Press the ON STANDBY pushbutton to turn ON the monitor NOTE While the module is initializing typically 30 to 40 seconds the monitor shall display the message Warm Up and dashes will remain in the numeric section 5 Check that the monitor is accurately detecting CO and Respiration by watching the monitor to see that the lung visual indicator flashes with each corresponding breath Wait for the monitor to determine the initial End Tidal and Respiration Rate values When the values have been determined they will be displayed on the front panel respective as EtCO mmHg and Respiration Rate RR 21 02 0186 REV 08 07 11 71 Of Contents CARDELL Veterinary Monitors 6 If the lung visual indicator is not corresponding to the patient s respiration reposition the sensor until the indicators flash in synch with the patient s breathing This will help to minimize false alarms 7 If required refer to Page 96 PARAMETERS MENU and configure the appropriate waveform s to be viewed and printed NOTE A library of ten 10 CO traces called Library can be selected for viewing in the Trace 3 location of the Parameters menu Once selected use the ARROW UP pushbutton to enter the library Once e
14. WARNING ACCURACY If the accuracy of any measurement does not seem reasonable first check the patient s vital signs by alternate means and then check the CARDELL Monitor for proper functioning APPLICATION This monitor is not designed for direct cardiac connection CABLES Route all cables away from the patient s neck to avoid possible strangulation CONDUCTIVE CONNECTIONS Avoid making any conductive connections to applied parts patient connection which is likely to degrade safety CONDUCTIVE PARTS Ensure that the conductive parts of the lead electrodes and associated connectors do not contact other conductive parts including earth CONNECTIONS The correct way to connect a patient to the monitor is plug the electrode leads into the patient cable which in turn connects to the monitor The monitor is connected to the wall socket by the power cord Do not plug the electrode leads into the power cord a wall Socket or an extension cord DEFIBRILLATION Do not come in contact with patients during defibrillation Serious injury or death could result DISPOSAL Dispose of the packaging material observing the applicable waste control regulations LEAKAGE CURRENT TEST The interconnection of auxiliary equipment including a patient monitor or other patient connected equipment with this device may increase the total leakage current When interfacing with other equipment a test for leakage current must be performed by a qua
15. 5 Slide the second sensor button along the other clip slot until the second sensor pad is fully engaged in its side of the clip NOTE Check that the VetSat optical sensor pads are facing each other directly 6 The sensor is now ready to be applied to the patient The preferred sensor application site for canine feline and equine animals is on the tongue with the sensor s optical components positioned on the center of the tongue Alternatively the sensor and clip may be applied to the animal s lip toe ear prepuce or vulva NOTE If the sensor does not track the pulse reliably it may be incorrectly positioned or the sensor site may be too thick thin or deeply pigmented to permit appropriate light transmission If any of these situations occurs reposition the sensor or try another sensor site If the sensor site is one that is covered with fur try shaving the site and reapplying the sensor 21 02 0186 REV 08 07 11 65 Of Contents CARDELL Veterinary Monitors 7 Be sure that the sensor cable is positioned along the side of the animal s face and body to avoid entanglement with the animal WARNING Do not use supplemental tape to adhere the clip and sensor directly to the site this can restrict blood flow and cause inaccurate measurements For best results secure the sensor cable independently from the sensor 8 Connect the sensor asse
16. CISPR 11 Class B The Model 9403 9404 9405 Monitor is suitable for use in all Harmonic emissions Class B establishments including domestic establishments and IEC 61000 3 2 those directly connected to the public low voltage power Voltage fluctuations Complies supply network that supplies buildings used for domestic flicker emissions purposes 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 floors are covered with synthetic material the relative humidity should be at least 3096 Electrical fast transient burst 2 kV for power supply lines 2 kV for power supply lines Mains power quality should be that of a typical commercial or IEC 61000 4 4 1 kV for input output 1 kV for input output hospital environment lines lines Surge 1 kV differential 1 kV differential Mains power quality should be IEC 61000 4 5 mode mode that of a typical commercial or 2 kV common mode 2 kV common mode hospital environment Voltage Dips lt 5 295 dip in lt 5 gt 95 dip in Mains power quality should be short interruptions for 0 5 cycle for 0 5 cycle that of a typical commercial or and voltage 40 60 dip in 40 60 dip in hospital environment If
17. To view the PIC Voltage level follow the following procedure 1 First enter the monitor s Service menu Refer to Page 144 SERVICE MENU 2 Press the ARROW DOWN pushbutton until the parameter PIC Voltage is highlighted 3 Verify the value on the display to be 12 00 V 0 50 NOTE The information provided is read only No changes can be made 4 When you have completed press the MAIN G pushbutton to exit and return to the Main display screen SOFTWARE VERSIONS The CARDELL Monitor displays the current software revision of its operating system and that of the internal modules being used inside The software versions are displayed in the following order Figure 36 Software Versions Menu Versions DSP Software Lang FLASH BOOT PIC CAS ECG RESP Nellcor SpO2 Oridion EtCO2 CAS ND Unit S N XXXXXXXX NOTE In the Model 9404 monitor the message Nellcor SpO is skipped NOTE In the Models 9403 and 9404 monitor the message Oridion EtCO is skipped 21 02 0186 REV 08 07 11 152 Of Contents CARDELL Veterinary Monitors To view the software Versions menu follow the following procedure 1 First enter the monitor s Service menu Refer to Page 144 SERVICE MENU 2 Press and hold the HISTORY pushbutton for two 2 seconds to display the Versions menu NOTE The information provided in the Versions menu is read only No ch
18. 58 Figure 10 Sensor to Interface Cable 66 Figure 11 70 Figure 12 Attaching the Airway Adapter 71 Figure 13 Front Panel ER RM Ma RS E M 7T Figure 14 Main Display nd erm t esp RU 7T Figure 15 Time Battery and Numeric Status 78 Figure 16 Numerics and 79 Figure 17 NIBP Numeric ANCA iot iones Fas Dudes intemerata aS aub intei Cael fasc 79 Figure 18 Numeric M 80 Figure 19 Front Panel Controls dri Repas ERE 82 Figure 20 Rear Panel VIGW 86 Figure 21 Left Side Panel View 87 Figure 22 Turning the Monitor On 89 Figure 23 Setup lo 90 Figure 24 Parameters Men didnt 96 Figure 25 Audio Visual
19. CARDELL Veterinary Monitors MONITOR MESSAGES cont SpO Table 13 SpO Monitor Messages MONITOR POSSIBLE CAUSE POSSIBLE SOLUTION MESSAGE Chk SpO Probe The monitor is Verify that the sensor is being used questioning the quality according to the manufacturer s of the signal being recommendations received by the SpO sensor The sensor is receiving Verify that the sensor emitter and detector too much ambient light are parallel to and directly opposing each other No SpO Probe The monitor is not The probe was disconnected from either the detecting the 5 Interface Cable or from the monitor probe Pulse Search The monitor is searching Normal at power up as the monitor for a Pulse signal searches for a pulse The probe position may have changed Check the probe site Probe Error The SpO probe being Verify the probe being used is the correct used is not the correct probe one for the monitor s configuration SpO Error An electronic failure has Turn the monitor Off disconnect the AC occurred within the 5 Line cord and battery Reconnect the module battery and AC Line cord turn the monitor On If the message still appears contact CAS Medical Systems to have the monitor serviced 5 Module An electronic failure has Contact CAS Medical Systems to have the occurred within the monitor serviced monitors module 5 Probe OFF The monitor is lo
20. MGE rra n 27 Table 2 3 Lead Color and 46 Table 3 5 Lead Color and ee 47 Table 4 Small Animal Cuff Selection 57 Table 5 Large Animal Cuff 57 Table 6 Specifications for Intubated Consumables Airway 72 Table 7 Alarm Parameters 107 Table 8 Factory Default Alarm Values 108 Table 9 Audible and Visual Indicators 110 Table 10 Monitor Messages 122 Table 11 ECG Respiration Monitor Messages 123 Table 12 NIBP Monitor Messages 124 Table 13 SpO Monitor 126 Table 14 CO Monitor 127 Table 15 Moni
21. parameter currently being used 4 Press either the ARROW UP or ARROW DOWN pushbutton to make a selection 5 Press one of the PREVIOUS programmed pushbutton keys to return back to the parameter selections column 6 Press the ARROW DOWN pushbutton to continue to the next parameter or press the MAIN C2 pushbutton to exit to the Main display screen TRACE BACKGROUND The background area surrounding the monitor s waveforms can be displayed either as a black background with white traces Dark or a white background with black traces Light The default value used by the CARDELL Monitor is Dark To configure the monitor s Trace Background setting follow the following procedure 1 First enter the monitor s Setup menu Refer to Page 90 SETUP MENU 2 Press the ARROW DOWN pushbutton until the parameter Background is highlighted 3 Press one of the NEXT programmed pushbutton keys until the cursor displays the parameter currently being used 4 Press either the ARROW UP or ARROW DOWN pushbutton to make a selection 5 Press one of the PREVIOUS programmed pushbutton keys to return back to the parameter selections column 6 Press the MAIN 2 pushbutton to exit to the Main display screen 21 02 0186 REV 08 07 11 95 Of Contents PARAMETERS MENU CARDELL Veterinary Monitors Figure 24 Parameters Menu Parameters Trace 1 Trace 2 Trace 3 Print Traces Print On Alarm ECG Gain ECG Smoothin
22. A continuously updating Trend History menu or a menu of NIBP event readings can be chosen as Trace 3 Refer to Page 102 TREND HISTORY for more information Print Traces Select the trace and the speed of the trace which will be printed when an alarm occurs Available selections All or ECG The default value is All 50 0 25 0 12 5 6 25 mm Sec The default value is 25 0 Print On Alarm Select whether the monitor will automatically print to the recorder when a patient alarm condition occurs Available selections OFF or ON The default value is OFF ECG Gain Select the gain size of the ECG Trace Available selections Automatic Manual Available selections X 5 X1 X2 X4 X8 X16 The default value is X8 When Automatic is selected the monitors ECG module selects a gain that adjusts the waveform to be at a pleasing level on the display NOTE The gain value will appear in the upper left hand corner of the Main display screen when the ECG waveform is displayed ECG Smoothing Adds Smoothing Filtering to low amplitude ECG traces Manual or Auto Gain at X8 or X16 only to reduce the amount of baseline noise visible on the display and printed traces Available selections OFF or ON The default setting is ON ECG Trigger Select the monitor s ECG Trigger based on the animals size Available selections Small or Large Animal The default value is Small Animal Impedance Resp Configure the Respiration channel
23. Available selections OFF or ON The default value is OFF EtCO Scale Select the scale size of the waveform trace Available selections 0 25 mmHg 0 50 mmHg The default value 0 100 mmHg 21 02 0186 REV 08 07 11 97 Of Contents CARDELL Veterinary Monitors Print Select whether the monitor will automatically print to the recorder a seven 7 second snap shot of the currently selected waveforms when the sensor is connected and when it is disconnected Based on the Print Traces selections Available selections OFF or ON The default value is OFF Trace Select whether the trace will be displayed as a continuous Line or displayed with the area below the line as Filled in The printed Recorder trace shall use the Line selection Available selections Line or Filled The default value is Filled Save Save menu selections into independent veterinary memory locations Vet 1 and Vet 2 Refer to Page 108 for more information Restore Restore a set of menu selections from memory locations Vet 1 and Vet 2 There is also a provision to restore the Factory Defaults if needed Refer to Page 109 for more information To configure a parameter 1 2 3 4 Press the PARAMETERS pushbutton The parameters that are available are listed on the left hand side of the display The monitor will initially highlight the Trace 1 parameter Pre
24. Our obligation under this warranty is limited to repairing or at our option replacing any defective parts or our equipment without charge if such defects occur in normal service and with prompt notification Damage to any part through misuse neglect or accident or by affixing any accessories or attachments other than CAS Nellcor amp Oridion amp and YSI manufactured accessories or attachments is not covered by this warranty ACCESSORIES BATTERIES CUFFS AND CERTAIN COMPONENTS In all cases policy applies from date of purchase from CAS or its authorized distributors or agents Batteries 1 Year Chargers 1 Year not including power cord see other accessories Cuffs all Out of box failure only CO Accessories Out of box failure only Lead Wires Out of box failure only Patient Cable 6 Months SpO Cable and Sensor 6 Months Nellcor SpO Cable and Sensor Temperature Probe 6 Months YSI Temperature Probe Other Accessories Out of box failure only Certain Components 1 Year Printer mechanism but not including Thermal Print Heads Print Heads Out of box failure only THERE ARE NO WARRANTIES WHICH EXTEND BEYOND THOSE EXPRESSLY DESCRIBED IN THIS AGREEMENT AND THE COMPANY MAKES NO WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE 21 02 0186 REV 08 07 11 13 Table Of Contents This page is intentionally left blank 21 02 0186 REV 08
25. or loss of spring tension that would allow slippage or movement of the sensor from its proper position NOTE If defects are noted do not use the sensor or clip Refer to the Directions For Use pamphlet enclosed with the sensor for more information TEMPERATURE PROBES Reusable As necessary the probes should be cleaned with a mild detergent and water to remove excess bioburden When necessary the probes may be disinfected using a soft cloth saturated with a 10 1 10 solution of chlorine bleach in tap water or 70 isopropyl alcohol When all of the surfaces have been disinfected wipe the entire surface of the monitor using a soft cloth dampened with fresh water to remove any trace amounts of residue and or fumes 21 02 0186 REV 08 07 11 142 Of Contents CARDELL Veterinary Monitors 13 MAINTENANCE MAINTENANCE INTERVALS Besides the routine cleaning of the monitor and accessories outlined in the previous section and replacement of accessories due to normal wear and tear calibration of the monitor should not be necessary during the warranty period If the monitor is in need of repair it must be referred to the appropriate service personnel Service performed by unauthorized personnel could be detrimental to the monitor and may void the warranty For service contact CAS Medical Systems Inc Following the warranty period preventative maintenance can be an important fact
26. the monitor may no longer function as intended The monitor should be plugged into a power source as soon as possible and the battery allowed to charge for five 5 hours NOTE A Low Battery alarm cannot be silenced When the Dead Battery message appears the battery is no longer able to power the monitor During a Dead Battery condition the message Dead Battery is displayed continuously on the Main display screen the Equipment Alarm LEDs are flashing the Battery Power visual indicator is colored Red and three 3 audio beeps followed by two 2 audio beeps once every ten 10 seconds are heard until the power is turned off WARNING Upon the detection of a Dead Battery condition and if the monitor is not turned off by the user the monitor shuts down and turns OFF after three 3 minutes of operations NOTE A Dead Battery alarm cannot be silenced When either of these messages appears it is necessary to recharge the battery A depleted battery may be fully recharged in five 5 hours The monitor can be used to obtain measurements while the battery is charging NOTE Using the monitor while charging may lengthen the time to restore battery charge NOTE During charging of the battery the case may feel warm to the touch 21 02 0186 REV 08 07 11 116 Of Contents CARDELL Veterinary Monitors CHECKING BATTERY S
27. yellow Left Foreleg RA white Right Foreleg red Right Foreleg RL 7 green Right Hind Leg N 7 black Right Hind Leg LL red Left Hind Leg V brown explore F green Left Hind Leg C white common LEAD CONTACT Sites where leads are attached to the body must be properly prepared to optimize contact Dogs and cats have enough electrolyte material on their skin and hair so that merely moistening lead sites with 70 isopropyl alcohol is appropriate This will usually be sufficient for ECG recording monitoring for a short time 30 to 60 minutes depending upon the relative humidity For monitoring during longer periods an electrode paste should be used It is best to first wet the hair at the lead attachment site with alcohol then place paste on the moistened hair and skin It is important that the paste be in direct contact with skin For patients with dense undercoat rub paste with fingers to assure that it has made contact with skin Crocodile clips are supplied with this monitor and they must open wide enough to firmly but gently grasp the skin 21 02 0186 REV 08 07 11 47 Of Contents CARDELL Veterinary Monitors RECORDING 1 Once the electrode clips are in place and the leadwires attached patient cables and leadwires must be kept away from the neck area to minimize entanglement and accidental strangulation 2 Connect the leadwi
28. 07 11 14 Of Contents 05 For Warranty Issues CAS Medical Systems Inc 44 East Industrial Road Branford CT 06405 U S A Phone 800 227 4414 203 488 6056 Fax 203 488 9438 E Mail techsrv casmed com Web www casmed com For Product Usage Information Midmark 10008 N Dale Mabry Hwy Suite 110 Tampa FL 33618 U S A Phone Toll Free 800 Midmark 643 6275 Fax 813 264 6218 E Mail www Midmark com Pages Contactus asp X Web www Midmark com Copyright 2004 CAS Medical Systems Inc All rights reserved No part of this manual may be reproduced without the written permission of CAS Medical Systems Inc CAS reserves the right to make changes to this manual and improvements to the product it describes at any time without notice or obligation 21 02 0186 REV 08 07 11 19 Table Of Contents This page is intentionally left blank 21 02 0186 REV 08 07 11 16 CARDELL Veterinary Monitors TABLE OF CONTENTS 1 INTRODUCTION AND INTENDED USE 25 INTRODUC TION mc 25 INDICATIONS FOR 25 SEIL RIS YE S c 25 BRIEF DEVICE DESCRIP TION 25 PATIENT ENVIRONMENT Un D UE MERE 27 DEFINITION OF PERS
29. 2 audible beeps should be heard when the calibration is completed 10 Verify the EtCO2 CAL Date and the Hours have been updated NOTE The starting hours for Calibration are initially 1200 hours and then 4000 after that This timer is automatically reset to 4000 hours during the Calibration process as long as it has been more than 720 hours from the last calibration If less than 720 hours the timer does not reset 11 Press one of the PREVIOUS programmed pushbutton keys to return to the Cal menu selection and end the Calibration 12 Disconnect the FilterLine from the unit 13 When you have completed press the MAIN pushbutton to exit and return to the Main display screen NOTE Should the monitor fail the Calibration it is recommended the procedure be repeated Prior to repeating the Calibration procedure carefully check all connections Should the monitor continue not to pass the Calibration procedure the monitor should be returned to CAS Medical Systems for service NIBP CALIBRATION CHECK Verify the calibration of the monitor once 1 per year A Calibration Kit product P9 is included with the monitor The kit contains a T connector with a male and a female luer fitting for a Calibration Check and a male luer plug to be used for the Pneumatic Test Manometer Mode e Overpressure Test Pneumatic Test 21 02 0186 REV 08 07 11 148
30. 32 Of Contents CARDELL Veterinary Monitors SYMBOLS CONT These symbols appear on the front panel in the place of text ON STANDBY Pushbutton SILENCE RESET Pushbutton 9 y NIBP START CANCEL Pushbutton FREEZE PRINT MAIN Pushbutton PARAMETERS Pushbutton ALARM LIMITS Pushbutton HISTORY Pushbutton AUDIO VISUAL Pushbutton 21 02 0186 REV 08 07 11 33 Of Contents CARDELL Veterinary Monitors SYMBOLS CONT A Yellow LED visual indicator used along with the SILENCE RESET pushbutton to display the status of the Audio Alarm Silence ARROW UP Pushbutton ARROW DOWN Pushbutton Horizontal bar graph display of the charge level of the battery Heart Rate Icon Flashes once for every detected heartbeat Respiration Breath Icon Flashes once for every detected breath A vertical bar graph display of signal strength is displayed along side the numerics for and 5 When the parameter is not selected as a waveform being displayed 4 When one of the sub menus is being displayed i e Parameters menu Alarm Limits menu 21 02 0186 REV 08 07 11 34 Of Contents CARDELL Veterinary Monitors SYMBOLS CONT I T A tri colored LED used to indicate the status of the monitors power Source These symbols appear on the batt
31. CARDELL Monitor CAS recommends the use of the inflation hose supplied with the monitor or a replacement from CAS The widest cuff that can be placed around the limb should be used A cuff that is too small for the limb will not supply sufficient occlusion pressure to the artery This can cause an erroneously high blood pressure reading Ideally cuff width should be 40 of the limb circumference Substitution of a cuff different from that supplied might result in a measurement error NOTE Overlapping the cuff will not affect the measurement results For best results a cuff should be wrapped for a snug fit and be positioned reasonably close to heart level Measurements made above the level of the heart will give reduced blood pressure readings Measurements made below the heart level will give increased readings These errors are mainly due to the weight of the blood NOTE Avoid compression or restriction of the NIBP Inflation Hose The hose must not be kinked or pinched It can be placed in any position but it should be kept off the table surface to avoid equipment vibrations WARNING The cuff should not be applied on a limb being used for an intravenous infusion Do not place the cuff on any extremity being used for monitoring See Section 14 ACCESSORIES for CAS Medical Systems cuff size and part number information 21 02 0186 REV 08 07 11 53 Of
32. Cuff The default value is Small Cuff e NIBP Cycle Select between Manual and Automatic modes Available selections Manual 1 2 3 4 5 10 15 30 60 or 90 Minutes e Init Inflate Select the Initial Inflation Pressure for the first NIBP measurement Available selections Adaptive 80 100 120 140 150 160 180 or 200 mmHg e STAT Select the STAT mode Available selections OFF or ON The default value is OFF 21 02 0186 REV 08 07 11 58 Of Contents CARDELL Veterinary Monitors e NIBP Numerics Select how the NIBP numerics are displayed in the NIBP window Available selections S D MAP S D PR or MAP S D The default value is S D MAP e Save Save menu selections into independent veterinary memory locations Vet 1 and Vet 2 Refer to Page 108 for more information e Restore Restore a set of menu selections from memory locations Vet 1 and Vet 2 There is also a provision to restore the Factory Defaults if needed Refer to Page 109 for more information LARGE CUFF SMALL CUFF OPERATING MODES NIBP function is affected by changing Large Cuff and Small Cuff operating modes Once the monitor s power is ON a visual indicator located on the front panel of the monitor indicates the current operating mode IMPORTANT Prior to patient monitoring ensure the monitor is configured to the appropriate patient mode Large Cuff or Small Cuff The factory default is Small
33. Cuff mode To select the cuff size 1 Press and hold the START CANCEL pushbutton for two 2 seconds to access the NIBP menu The parameter Cuff Size is highlighted 2 Press one of the NEXT programmed pushbutton keys until the cursor displays the current Cuff Size being used 3 Use either the ARROW UP or ARROW DOWN pushbutton to make a selection 4 Once a Cuff Size has been selected press the MAIN pushbutton to return to the Main display screen The Cuff Size selected will be displayed in the lower left hand corner of the Main display screen MANUAL MODE FOR BLOOD PRESSURE DETERMINATION Select and apply the appropriate sized cuff to the extremity Refer to Page 56 CUFF SIZE SELECTION for more information 1 Connect the cuff to the end of the monitor tubing 2 Connect the monitor tubing to the NIBP connector located on the left side of the monitor 3 The default Initial Inflation Pressure is 150 mmHg for all cuff sizes To select an alternate Initial Inflation Pressure press and hold the START CANCEL pushbutton for two 2 seconds to enter the NIBP menu where the Initial Inflation Pressure can be changed 21 02 0186 REV 08 07 11 59 Of Contents CARDELL Veterinary Monitors IMPORTANT Excessive patient motion can contribute to inaccurate measurements It is important that the animal be kept still during a measurement Make every attempt to alleviate fear anxiety a
34. During a Permanent Audio Alarm Silence period if an alarm patient or equipment occurs except for Low Battery and Dead Battery the audio alarm remains silenced and only a visual indicator is provided SETTING THE DATE The CARDELL Monitor s Date value is set at the factory To configure the monitor s Date follow the following procedure 1 First enter the monitor s Setup menu Refer to Page 90 SETUP MENU 2 Press the ARROW DOWN pushbutton until the parameter Date is highlighted 3 Press one of the NEXT programmed pushbutton keys until the cursor displays the day parameter currently being used 4 Press either the ARROW UP or ARROW DOWN pushbutton to make a selection 5 Press one of the NEXT programmed pushbutton keys until the cursor displays the month parameter currently being used Month of the Year Jan Feb etc 6 Press either the ARROW UP or ARROW DOWN pushbutton to make a selection 7 Follow steps 5 and 6 to set the year parameter Last 2 digits of the year 2004 is displayed as 04 8 Press one of the PREVIOUS programmed pushbutton keys to return back to the parameter selections column 9 Press the ARROW DOWN pushbutton to continue to the next parameter or press the MAIN C pushbutton to exit to the Main display screen 21 02 0186 REV 08 07 11 92 Of Contents CARDELL Veterinary Monitors SETTING THE TIME The CARDELL Monitor s Time value is set for Eastern Time
35. Main display screen Should the monitor fail the Check it is recommended CO Calibration be performed or the monitor be returned to CAS Medical Systems for service CALIBRATION NOTE Perform the Calibration after performing the Calibration Check CAUTION The Calibration must be performed with a manufacturer authorized Calibration Kit containing 596 21 Balance gas tubing adapter and a calibration filter line A manufacturer approved Calibration Kit can be purchased from Scott Medical P N 0304653ORFBD To perform a CO Calibration follow the following procedure 1 Verify that the FilterLine supplied with the Calibration Kit is firmly attached to the gas canister 2 Enter the monitor s Service menu Refer to Page 144 SERVICE MENU 3 Press the ARROW DOWN pushbutton until the parameter EtCO is highlighted 21 02 0186 REV 08 07 11 147 Of Contents CARDELL Veterinary Monitors 4 Press one of the NEXT programmed pushbutton keys to select OFF 5 Press the ARROW UP pushbutton to change the setting from OFF to Connect 6 Connect the FilterLine to the monitor 7 The highlighted section should read Open 5 8 When the message Open 5 Gas appears press and hold the gas valve until the message Remove Gas is displayed 9 The highlighted section should read Passed and two
36. Message Window section of the display The Equipment Alarm LEDs are flashing ECG Heart Beat Low 1 Beep coincides with each Numerics are updated with each received ECG heart rate received heart rate value NIBP Complete Low 1 Beep when blood pressure Numerics are updated with each is completed blood pressure taken 5 Pulse Beat Low 1 Beep coincides with each Numerics are updated with each received SpO pulse rate received SpO pulse rate value Key Click Low 1 Beep associated with each None The message interval time will vary based on what monitor conditions are present If the Equipment Alarm is associated with a selected waveform being viewed the Alarm message appears in the Waveform section of the display NOTE Refer to the Tables starting on Page 122 for a listing of messages that may be displayed on the Main display screen CLEARING ALARMS The CARDELL Monitor provides to the user an audible and visual indication for both patient and equipment alarm conditions WARNING The CARDELL Monitors are equipped with non latching patient alarm s As soon as the monitored parameter s return within the adjusted limits the alarm is silenced and reset automatically without any operator interaction 21 02 0186 REV 08 07 11 111 Of Contents CARDELL Veterinary Monitors ECG HEART RATE ALARMS During either a Low or High ECG Heart Rate
37. NOTE This product contains a rechargeable battery that is recyclable Under various state and local laws it may be illegal to dispose of this battery into the municipal waste stream Check with your local authorities for instructions on recycling options in your area CHANGING THE FUSES The CARDELL Monitor uses a dual fuse power input receptacle The receptacle incorporates fuses in the hot and neutral AC input lines that are user serviceable Refer to Section 14 ACCESSORIES for part number information NOTE Refer to the monitor s rear panel label for the proper fuse rating CAUTION For continued protection against fire hazard replace only with identically rated fuses A fuse may need to be replaced if the monitor is plugged into an electrical outlet but the Battery Power Visual Indicator is not illuminated the color Green WARNING Before changing the fuse unplug the power cord The fuse holder is incorporated into the power input receptacle and located under the power cord input connector To replace the fuses 1 Turn the monitor OFF and disconnect the power cord from the back of the monitor 2 Press down on the locking tab which holds the fuse holder in the power input receptacle 3 While holding down on the tab pull the fuse holder out 4 Remove the fuses 5 Place new fuses directly into the fuse holder 6 Insert the fuse holder into the power input receptacle There sho
38. OFF to ON The message Printing will be displayed in the Equipment Message Window as a status indicator that the test is active The test will continue for sixty 60 seconds or can be terminated by the user 4 When the Infrared windows are properly positioned the printer will begin to print a series of A characters 5 When the test is completed press one of the PREVIOUS programmed pushbutton keys to cancel the test and return to the IrDA Test menu selection 6 Press the ARROW DOWN pushbutton to continue to the next parameter test or press the MAIN 7 pushbutton to exit to the Main display screen CALIBRATION CHECK CAUTION Do not perform a CO Calibration Check from the monitor s measuring mode This mode corrects the CO value for BTPS Body Temperature Pressure Saturation which assumes that alveolar gases are saturated with water vapor The Calibration Check mode disables this correction CAUTION The Calibration Check must be performed with a manufacturer authorized Calibration Kit containing 5 21 Balance gas tubing adapter and a calibration filter line A manufacturer approved Calibration Kit can be purchased from Scott Medical P N 0304653ORFBD NOTE The Calibration Check should be performed only after the CO module has been operating for at least twenty 20 minutes in a normal operating mode and connected to a FilterLine 21 02 0186 REV 0
39. Printer interfaces to the CARDELL Monitor via an Infrared Ir port or by using the direct connect RS232 cable supplied with printer The Infrared ports are located on the top of the printer and on the bottom front panel of the CARDELL Monitor When using the Infrared port it is important to keep the two devices close together less than three 3 Feet one 1 Meter and in line to maintain proper communications The monitor can perform a communication test to verify the Infrared connection Refer to Page 146 IrDA TEST for more information CAUTION For safe and proper usage of the external printer please observe the following When using the printer e Avoid placing monitor in areas where fluid may enter the printer opening accidentally Do not drop or bump the monitor Avoid places subject to high or low temperature extremes Avoid direct sunlight Avoid dusty places and where corrosive gasses are generated Never attempt to dismantle or repair the printer mechanism When handling the thermal paper e Store in a dark cool and dry place Do not place near organic solvents Avoid contact with vinyl chloride films erasers or adhesive tapes for extended periods Avoid exposure to high temperature humidity liquid or sunlight Always use specified thermal paper P N 28 02 0077 21 02 0186 REV 08 07 11 129 Of Contents CARDELL Veterinary Monitors PRINTER CONTROLS AND INDIC
40. RESET pushbutton or properly recycle the monitor s power 21 02 0186 REV 08 07 11 117 Of Contents CARDELL Veterinary Monitors USER MESSAGES WARNING The CARDELL Monitors are equipped with non latching equipment alarm s As soon as the monitored parameter s return within the adjusted limits the alarm is silenced and reset automatically without any operator interaction The CARDELL Monitor displays a variety of messages to aid the user in monitor operation Ifa troubleshooting message is displayed during a measurement follow the actions listed to correct the situation If the monitor does not turn on or exhibits a flashing display and failure to operate the battery is most likely below the Dead Battery point Connect the monitor to an AC wall outlet and allow it to charge for five 5 hours NOTE Refer to the Tables starting on Page 122 for a listing of messages that may be displayed on the Main display screen If the monitor is in need of repair it must be referred to the appropriate service personnel Service performed by unauthorized personnel could be detrimental to the monitor and will void the warranty For service contact CAS Medical Systems Inc ECG RESPIRATION USER MESSAGES If the accuracy of any measurement does not seem reasonable first check the patient s vital signs by an alternate method If one of the leadwires should become disconnected
41. Refer to Page 99 AUDIO VISUAL MENU for more information 21 02 0186 REV 08 07 11 66 Of Contents CARDELL Veterinary Monitors SatSeconds ALARM MANAGEMENT False or nuisance alarms are a common concern with pulse oximetry monitoring Nuisance alarms are often triggered by minor and brief desaturation events that are clinically insignificant Clinicians tend to manage these alarms by ignoring them turning off the alarm or monitor or widening the alarm limits The CARDELL Monitor incorporates Nellcor s SatSeconds Alarm Management feature that offers a better way to manage nuisance alarms without sacrificing patient safety The SatSeconds function can be activated from the Alarm Limits menu by selecting a SatSeconds limit or clock of 10 25 50 100 or OFF SatSeconds Clinicians who choose to employ the SatSeconds function should select a limit suited to their clinical environment and patient conditions Think of SatSeconds as the product of magnitude and time a patient exceeds 5 alarm limits For example points below the alarm limit for 10 seconds equals 30 SatSeconds An alarm is only triggered if a desaturation event occurs that reaches the SatSeconds limit you selected As a safety net when three or more SpO alarm violations occur within 60 seconds an alarm will sound even if the SatSeconds limit has not been reached NOTE When SatSeconds is set to OFF the monitor will
42. The battery is charging whenever the monitor is plugged into the AC wall outlet A Battery Power Visual Indicator located on the front panel indicates the status condition of the monitor s battery Batteries will self discharge when they are not used It is recommended that the battery be maintained at full charge by leaving the monitor connected to the AC wall outlet whenever possible The 7 2 Volt 3700 mAhr battery pack when fully charged is capable of running the monitor for approximately four 4 hours NOTE Operating time on battery power is based on a Model 9403 monitor when the NIBP is set in the 5 Minute Automatic Mode BATTERY MESSAGES When the message Low Battery appears in the Equipment Message Window section of the display at least thirty 30 minutes of battery operation remain and the monitor s battery pack should be charged as soon as possible 21 02 0186 REV 08 07 11 115 Of Contents CARDELL Veterinary Monitors During a Low Battery condition the monitor flashes the Battery Charge Status visual indicator and the Equipment Alarm LEDs provides an Equipment Alarm audible tone and flashes the message Low Battery in the Alarm Message Window section of the display Also the front panel Battery Power visual indicator changes from Orange to Red WARNING Upon the detection of a Low Battery condition and if the battery is not charged by the user
43. To acknowledge the alarm press the SILENCE RESET pushbutton The monitor silences the audible and visual alarms but the message CO Error or CO Module remains on the display Should the above problems persist contact CAS Medical Systems Inc When the message Cal CO appears the CO Hours to Calibration value displayed in the monitors SERVICE menu equals zero 0 The message Cal is displayed in the Equipment Message area of the display and will alternate with the monitor s current operating mode No other audible or visual alarm indications will be made The module will continue to function normally This is an indicator that it is time to Calibrate the module Refer to Page 146 CO CALIBRATION CHECK for more information When the message Service CO appears the Hours to Service value displayed in the monitor s SERVICE menu equals zero 0 The message Service CO is displayed in the Equipment Message area of the display and will alternate with the monitor s current operating mode No other audible or visual alarm indications will be made The module will continue to function normally This is an indicator that it is time to Service the module For more information contact CAS Medical Systems Inc NIBP USER MESSAGES If the accuracy of any measurement does not seem reasonable first check the patient s vital signs by an alternate method If the NIBP Module located inside the CARDELL Monit
44. Waveform section or the Equipment Message Window section of the display flashes the Equipment Alarm LEDs and provides an Equipment Alarm audible tone To acknowledge the alarm press the SILENCE RESET pushbutton The monitor silences the audible and visual alarms and clears the parameter from the display NOTE The Low Battery and Dead Battery alarms cannot be silenced 2 MINUTE AUDIO ALARM SILENCE NOTE Enabling the 2 Minute Audio Silence mode can only be accomplished after all active alarm conditions have been addressed To clear an alarm refer to Page 111 CLEARING ALARMS If the 2 Minute Audio Silence mode is selected in the Audio Silence portion of the Setup menu pressing the SILENCE RESET pushbutton will temporarily deactivate the audio alarms for two 2 minutes The SILENCE visual indicator will illuminate continuously and the message 2 Minute will be displayed in the Equipment Message Window section of the display as a reminder NOTE The 2 Minute message will alternately be displayed with the monitor s current operating mode When the 2 Minute Audio Silence is enabled the monitor will not alarm for patient related High and Low Alarms NIBP Errors and Equipment Alarms The monitor will alarm for Low Battery and Dead Battery To re activate the audio alarm press the SILENCE RESET pushbutton again The visual indicators will go out If the button is not pressed audible alarms will be
45. and is set at the factory To configure the monitor s Time follow the following procedure 1 2 3 4 5 6 7 8 First enter the monitor s Setup menu Refer to Page 90 SETUP MENU Press the ARROW DOWN pushbutton until the parameter Time is highlighted Press one of the NEXT programmed pushbutton keys until the cursor displays the hour parameter currently being used Hour of the Day 0 23 Press either the ARROW UP or ARROW DOWN pushbutton to make a selection Press one of the NEXT programmed pushbutton keys until the cursor displays the minute parameter currently being used Minute of the Hour 0 59 Press either the ARROW UP or ARROW DOWN pushbutton to make a selection Press one of the PREVIOUS programmed pushbutton keys to return back to the parameter selections column Press the ARROW DOWN pushbutton to continue to the next parameter or press the MAIN pushbutton to exit to the Main display screen NOTE Altering the Date and Time will affect the History readings but not erase them DAYLIGHT SAVING TIME OPTION The CARDELL Monitor can be configured to automatically respond to time changes associated with Daylight Saving Time The monitor can be configured to one of five Daylight Saving Time Option settings They are OFF Daylight Saving Time is OFF The user is responsible for changing the time if needed This is the default setting for the CARDELL Monitor N America Daylig
46. by or on the order of a veterinarian First Printing 04 2004 Revised 05 2004 Revised 09 2004 Revised 08 2005 Revised 12 2006 Revised 07 2007 Revised 05 2008 Revised 05 2009 21 02 0186 REV 08 07 11 Table Of Contents QUICK START UP GUIDE PATIENT CONNECTIONS NIBP Refer to Page 53 Select and apply the appropriate cuff Connect cuff tube to monitor hose Connect monitor hose to the NIBP connector on the side panel of the monitor TEMPERATURE Optional Accessory Refer to Page 75 Connect temperature probe to the temperature adapter Connect the adapter to the TEMP connector on the side panel of the monitor CO2 Refer to 69 Attach the FilterLine to the monitor Connect the Airway Adapter to the patient USA Standard um LA 7 black Left Foreleg RA white Right Foreleg LL red Left Hind Leg PULSE OXIMETRY Refer to Page 65 Select the small or large veterinary sensor and attach to the sensor clip Apply sensor clip to the patient s tongue Connect the sensor to the interface cable and lock hinged cover into place Connect the interface cable to the SpO2 connector on the side panel of the monitor ECG Refer to Page 45 Attach the 3 lead or 5 lead patient cable and leads per the diagram Leads may need to be moistened with isopropyl alcohol to op
47. displayed for one second every two to six seconds in the Patient Alarm Message Window section of the display Power Failure High 3 Beeps followed by 2 Beeps every 10 seconds The message is displayed for one second every two to six seconds in the Equipment Message Window section of the display The Equipment Alarm LEDs are flashing Low Battery Alarm Medium 3 Beeps every 25 seconds The message is displayed for one second every two to six seconds in the Equipment Message Window section of the display The Battery Charge Status visual indicator is flashing for one second on one second off on the display The Equipment Alarm LEDs are flashing The Battery Power visual indicator is Red 21 02 0186 REV 08 07 11 110 Of Contents CARDELL Veterinary Monitors AUDIBLE AND VISUAL INDICATORS cont Table 9 Audible and Visual Indicators button action Alarm Condition Priority Audible Indication Visual Indication Level Equipment Alarms Medium 3 Beeps every 25 seconds The appropriate message is displayed for one second on one second off in either the Waveform section or Equipment Message Window section of the display The Equipment Alarm LEDs are flashing NIBP Errors Medium 3 Beeps every 25 seconds The appropriate message is displayed for one second every two to six seconds in the Equipment
48. etc If an item is missing or damaged contact CAS Medical Systems Inc Record the monitor model serial number and date of purchase at the back of this manual MONITOR CHECKLIST Qty Description 1 Monitor 9403 or 9404 or 9405 1 Hospital Grade AC Power Cord 1 3 or 5 Lead ECG Respiration Patient Cable based on order 1 1 3 or 5 Lead Wire Set based on order Six 6 Foot Inflation Hose Midmark Blood Pressure Cuffs 7 sizes Nellcor amp Model DOC 10 SpO Interface Cable Nellcor VetSat amp Veterinary Sensor and Clips Oridion FilterLine amp Sets for Model 9405 Electrode Gel 1 Tube P9 Calibration Kit includes T connector with tubing and male luer plug Monitor User s Manual 99 The monitor is shipped with the appropriate line cord for the country and or voltage being used OPTIONAL ACCESSORIES The CARDELL Veterinary Monitor is available with a rolling stand and basket a soft sided carrying case and other optional accessories to fit your needs Refer to Section 14 ACCESSORIES for part number information Contact Midmark for more information 21 02 0186 REV 08 07 11 29 Table Of Contents CARDELL Veterinary Monitors This page is intentionally left blank 21 02 0186 REV 08 07 11 30 Of Contents CARDELL Veter
49. from Group West or equivalent supplied with printer 21 02 0186 REV 08 07 11 27 Of Contents CARDELL Veterinary Monitors DEFINITION OF TERMS In this manual WARNING CAUTION IMPORTANT and NOTE mean the following WARNING Directions that warn of conditions that put the patient or caregiver at risk CAUTION Directions that help you avoid damaging your monitor or losing data IMPORTANT Directions you should be particularly aware of something not readily apparent NOTE Directions that make it easier to use your monitor 21 02 0186 REV 08 07 11 28 Of Contents CARDELL Veterinary Monitors 2 UNPACKING THE MONITOR INITIAL INSPECTION Before unpacking the monitor inspect the packaging for damage If there are any signs of damage to the package a claim should be filed immediately with the shipping agent It is the receiver s responsibility to notify the carrier s local office to arrange for the pickup of the damaged items Save the damaged shipping carton as evidence Contact CAS Medical Systems Inc to report external damage and to arrange for repair or replacement of damaged equipment The shipping carton should contain the items listed below Unpack the monitor and account for each item Inspect each item for signs of external damage dents cracks scratches
50. from the patient the waveform trace s will become blank the message Leads OFF will be displayed in the waveform section of the display the Heart Rate and Respiration Rate numeric displays will show dashes the Equipment Alarm LEDs will flash and three 3 audio beeps are heard every twenty five 25 seconds for as long as the condition continues To acknowledge the alarm press the SILENCE RESET pushbutton The monitor silences the audible and visual alarms and the message Leads OFF remains on the display If the ECG Respiration Module located inside the CARDELL Monitor should fail the message Error Module is displayed the Heart Rate and Respiration Rate numeric displays will show dashes the Equipment Alarm LEDs will also flash and three 3 audio are heard every twenty five 25 seconds 21 02 0186 REV 08 07 11 118 Of Contents CARDELL Veterinary Monitors To acknowledge the alarm press the SILENCE RESET pushbutton The monitor silences the audible and visual alarms but the message ECG Error or ECG Module remains on the display Should the above problems persist contact CAS Medical Systems Inc SpO USER MESSAGES If the accuracy of any measurement does not seem reasonable first check the patient s vital signs by an alternate method NOTE The SpO probe must be kept as motionless
51. immediately alarm for SpOz limit violations based on the selection made in the Alarm Limits menu SENSOR REMOVAL CAUTION For the comfort of the patient and to avoid damaging the sensor do not pull on the cable when removing the sensor and clip from the sensor site When SpO monitoring is completed remove the sensor from the patient To remove the sensor and clip from the patient press the clip open and remove When the probe is removed from the patient the message SpO Probe OFF is displayed the Equipment Alarm LEDs are flashing and an audible alarm sounds indicating a connection has been lost To acknowledge the alarm press the SILENCE RESET pushbutton The monitor silences the audible and visual alarms and the message SpO Probe OFF remains on the display 21 02 0186 REV 08 07 11 67 Of Contents CARDELL Veterinary Monitors To remove the sensor from the clip grasp the end of each sensor pad and pull it through to the inside of the clip The sensor should pop out of the clip easily DO NOT pull on the cable NOTE If either the 2 Minute Audio Silence or Permanent Audio Silence is enabled no audio will be heard but a visual message will appear in the Message Window REMOVING THE INTERFACE CABLE When monitoring is not required disconnect the Interface Cable by squeezing the grey tabs with your thumb and index finger while pulling th
52. individual needs Once entered the user can Set the Operating Language Make selections for Audio Alarm Silence Set the Date Set the Time Set Daylight Saving Time Options Set the SpO Pulse Rate Alarm Delay Time Select the Temperature Units Select the Trace Background ENTERING THE SETUP MENU To enter the monitor s Setup menu press and hold the ALARM LIMITS and 0 AUDIO VISUAL pushbutton keys while the monitor is being turned Figure 23 Setup Menu Setup Language English Audio Silence 2 Minute Date 06 Feb 06 Time 08 26 DST OFF O2 Alarm Delay 10 Sec TEMP Units oF Background Dark NOTE While in the Setup menu if no pushbutton is pressed within 60 seconds the monitor will automatically save all changes made exit the Setup menu and return to the Main display screen 21 02 0186 REV 08 07 11 90 Of Contents CARDELL Veterinary Monitors EXIT THE SETUP MENU When you have completed configuring the monitor press the MAIN G pushbutton to exit and lock in your selection s The monitor exits the Setup menu and returns to the Main display screen SELECTING THE LANGUAGE The CARDELL Monitor can operate in one 1 of nine 9 languages English German French Italian Spanish Dutch Swedish Portuguese or Norwegian To configure the monitor s operating Language follow the following procedure 1 First enter the monitor s Setup men
53. message Set Clock The monitor s clock The monitor s time and date values are needs to be set incorrect Refer to Page 92 for information to set the Date and Page 93 to set the Time The monitor s internal clock battery needs to be replaced Contact CAS Medical Systems 21 02 0186 REV 08 07 11 122 Of Contents CARDELL Veterinary Monitors MONITOR MESSAGES cont ECG RESPIRATION Table 11 ECG Respiration Monitor Messages MONITOR POSSIBLE CAUSE POSSIBLE SOLUTION MESSAGE ECG Error communication failure Turn the monitor Off disconnect the AC has occurred with the Line cord and battery Reconnect the monitors ECG Board battery and AC Line cord turn the monitor On If the message still appears contact CAS Medical Systems to have the monitor serviced ECG Module An electronic failure has Contact CAS Medical Systems to have the occurred within the monitor serviced monitors ECG Board Leads OFF The leadwires may be Check the leadwires at the electrode end disconnected and at the patient cable to be sure they are connected securely The patient cable may Check the patient cable jack on the monitor be disconnected to be sure it is plugged in securely The leadwires or patient Replace the leadwires or patient cable cable may be broken The electrodes may be Replace the electrodes old 21 02 0186 REV 08 07 11 123
54. minute interval with a brief approx ten 10 second pause between determinations to allow venous blood return To choose the STAT mode 1 Press and hold the START CANCEL pushbutton for two 2 seconds to access the NIBP menu 2 Press the ARROW DOWN pushbutton until the parameter STAT is selected 3 Press one of the NEXT programmed pushbutton keys until the cursor displays the current STAT mode being used OFF 4 Use either the ARROW UP or ARROW DOWN pushbutton to change the selection to ON 5 Once the STAT mode has been selected press the MAIN pushbutton to return to the Main display screen The message STAT appears in the NIBP Message Window 6 Press the START CANCEL pushbutton to begin the first measurement NOTE Selecting STAT will override any time interval selected for NIBP Cycle in the NIBP menu The NIBP Message Window will display STAT XXX where is the real time cuff pressure Between readings the NIBP Message Window will display XX S where XX is the 10 second count down until the next measurement After five 5 minutes of determinations the monitor will stop taking measurements exit the STAT mode and return to the Manual NIBP mode 21 02 0186 REV 08 07 11 62 Of Contents CARDELL Veterinary Monitors Pressing the START CANCEL pushbutton during the STAT Mode will terminate the current NIBP measurement and retur
55. ml min CO Range 0 to 99 mmHg 0 to 13 2 kPa and 0 to 13 0 vol at sea level Accuracy 0 to 38 mmHg 2 mmHg 39 to 99 mmHg 5 of reading 0 08 for every 1 mmHg above 38 mmHg Equivalent values for kPa and vol Respiration Rate 0 to 150 breaths min Resolution 1 mmHg Initialization Time 30 seconds typical Frequency Response accuracy is maintained up to 80 breaths min For maintaining accuracy for respiration rate over 60 bpm use the neonatal mode From 81 to 150 bpm accuracy is 12 if the EtCO is higher than 18 8 mmHg in neonatal mode System Response Time 2 9 seconds typical includes the delay time and the rise time Rise Time Adult and Neonate 190 msec max Delay Time 2 7 seconds typical Ambient Pressure Compensated internally automatic PATIENT ALARMS Characteristic Specification Adjustable Alarms High and low alarms for Heart Rate 96SpO Pulse Rate Respiration Rate Systolic and Diastolic Pressure and MAP High alarms for FiCO Low alarms for No Respiration Fixed Alarms Asystole Alarm History 25 most recent alarms Indicators Audible Yellow Equipment Alarm LED s Red Patient Alarm LED s and Text in Patient Message Window 21 02 0186 REV 08 07 11 164 9403 9404 940
56. monitor will automatically save all changes made and exit to the Main display screen The Audio Visual setup menu allows the user to Alarm Volume Adjust the Alarm Volume level The Alarm Volume can be adjusted to one 1 of five 5 volume levels Altering the Alarm Volume will produce a single tone at the selected volume level NOTE The Volume Level cannot be set to OFF Beep Source Select the source of the audio when enabled Available selections or 5 NOTE When SpO is selected the monitor provides a varying pulse beep that will rise with increasing oxygen saturation and fall as saturation decreases e Volume Adjust the Beep Volume level The Beep Volume can be adjusted to one 1 of five 5 volume levels Altering the Beep Volume will produce a single tone at a selected non off volume level 21 02 0186 REV 08 07 11 99 Of Contents CARDELL Veterinary Monitors e Contrast Adjust the Contrast level of the display e Save Save menu selections into independent veterinary memory locations Vet 1 and Vet 2 Refer to Page 108 for more information e Restore Restore a set of menu selections from memory locations Vet 1 and Vet 2 There is also a provision to restore the Factory Defaults if needed Refer to Page 109 for more information To configure a parameter 1 Press the AUDIO VIS
57. on the rear panel of the CARDELL Monitor NOTE When using the IrDA port for printing it is recommended to keep all items clear of the communications path between the monitor and the printer Turn the printer ON To turn the printer ON press and hold the ON OFF pushbutton for one 1 second The Power LED illuminates Green To turn the printer OFF press and hold the ON OFF pushbutton The Power LED will illuminate Red and change back to Green When the LED illuminates Green remove your finger from the pushbutton NOTE If the printer was powered during the monitor s power up sequence the MIDMARK logo is printed The CMP 10 Mobile Printer contains an Auto Power Off feature If the monitor and printer become separated and after ten 10 minutes during which no data has been sent to the printer and the Line Feed LF pushbutton has not been pressed the printer will automatically shutoff The CARDELL Monitor will periodically send to the printer a wake up message that will disable the Auto Power Off feature 21 02 0186 REV 08 07 11 131 Of Contents CARDELL Veterinary Monitors Sample printouts of both History Modes are shown below Figure 30 History Sample Printouts 94XX Series Monitor 94XX Series Monitor 22 Aug 06 13 33 22 Aug 06 13 39 Patient
58. pushbutton again to recall Alarm History Recall list of alarms that have occurred AUDIO VISUAL Refer to Page 99 Press Audio Visual pushbutton Adjust Alarm volume Select source of audio beep Adjust beep volume Adjust screen contrast Silence Reset On Standby NIBP OPTIONS Refer to Page 58 PATIENT ALARMS Refer to Page 106 Press and hold NIBP Start Cancel pushbutton Press Alarm Limits pushbutton Select Cuff Size Change alarm limits values of any parameter Select manual or automatic mode Select Initial Inflation Select STAT mode Select NIBP Numerics 21 02 0186 REV 08 07 11 Table Of Contents This page is intentionally left blank 21 02 0186 REV 08 07 11 10 Of Contents Manufacturers Declaration of Conformity Electronic Emissions and Immunity The Model 9403 9404 9405 Monitor is intended for use in the electromagnetic environment specified below The customer or the user of the Model 9403 9404 9405 Monitor should assure it is used in such an environment Emissions Test Compliance Electromagnetic Environment RF emissions CISPR 11 Group 1 The Model 9403 9404 9405 Monitor uses RF energy only for its internal function Therefore its RF emissions are very low and are not likely to cause any interference in nearby electronic equipment RF emissions
59. re armed automatically after two 2 minutes Refer to Page 91 AUDIO ALARM SILENCE SILENCE RESET Pushbutton for more information 21 02 0186 REV 08 07 11 114 Of Contents CARDELL Veterinary Monitors PERMANENT AUDIO ALARM SILENCE NOTE Enabling the Permanent Audio Silence mode can only be accomplished after all active alarm conditions have been addressed To clear an alarm refer to Page 111 CLEARING ALARMS If the Permanent Audio Silence mode is selected in the Audio Silence portion of the Setup menu pressing the SILENCE RESET pushbutton will deactivate the audio alarms The SILENCE visual indicator will flash at a rate of one 1 second ON and one 1 second OFF and the message Permanent will be displayed in the Equipment Message Window section of the display as a reminder NOTE The Permanent message will alternately be displayed with the monitor s current operating mode When enabled the monitor will not alarm for patient related High and Low Alarms NIBP Application Error and Equipment Alarms The monitor will alarm for Low Battery and Dead Battery To re activate the audio alarm press the SILENCE RESET pushbutton again The visual indicators will go out Refer to Page 91 AUDIO ALARM SILENCE SILENCE RESET Pushbutton for more information BATTERY POWER The CARDELL Monitor is equipped with an internal rechargeable battery
60. recommended separation distance calculated from the equation applicable to the frequency of the transmitter Recommended separation distance Conducted RF 3 Vrms 3 Vrms d212NP IEC 61000 4 6 150 kHz to 80 MHz Radiated RF 3 3 V m 1 2NP 80 MHz to 800 MHz IEC 61000 4 3 80 MHz to 2 5 GHz d 2 3VP 800 MHz to 2 5 GHz Where is the maximum output power rating of the transmitter in watts according to the transmitter manufacturer and d is the recommended separation distance in meters Field strengths from fixed RF transmitters as determined by an electromagnetic site survey should be less than the compliance level in each frequency range Interference may occur in the vicinity of equipment marked with the following symbol 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 effected by absorption and reflection from structures objects and people 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 Model 9403 9404 9405 Monitor is used exceeds t
61. second ON one second OFF Permanent Audio Disable A tri colored LED visual indicator used to display the status of the power source and battery condition The status of the LED is GREEN Monitor is connected to an AC power source ORANGE In Use on Battery Battery Low or Dead Battery 21 02 0186 REV 08 07 11 81 Of Contents CARDELL Veterinary Monitors FRONT PANEL CONTROLS Figure 19 Front Panel Controls EV On Standby Silence Reset NIBP Start Cancel 0 Press amp Hold for NIBP Options ON STANDBY Press once turns ON the CARDELL Monitor s display if it was OFF Press again turns the monitor s display OFF SILENCE RESET When pressed during an active patient alarm silences the audio portion of that alarm for fifteen 15 seconds When pressed during an active equipment alarm the alarm condition shall be acknowledged along with the audio and visual shall be removed Used to enable and disable the 2 Minute or Permanent Audio Alarm Silence feature Refer to Page 91 AUDIO ALARM SILENCE SILENCE RESET Pushbutton for more information 21 02 0186 REV 08 07 11 82 Of Contents CARDELL Veterinary Monitors NIBP START CANCEL START Initiates a blood pressure measurement in the Manual Mode or begins the selected Automatic Cycle CANCEL Cancels any active b
62. seconds Numeric Resolution 1 BPM Accuracy 3 BPM or 3 whichever is greater Numeric Range 0 15 to 300 BPM averaged 1 second update 21 02 0186 REV 08 07 11 161 RESPIRATION Of Contents CARDELL Veterinary Monitors Characteristic Specification Detection Technique Impedance Pneumography Sensing Electrodes LA RA Bandwidth 0 05 to 2 5 Hz Sweep Speed 3 6 25 12 5 mm Sec Sense Frequency 63 kHz Sensitivity Adjustment Automatic Trigger Level Minimum trigger at 0 20 ohm Respiration Rate Numeric 0 to 150 BrPM averaged 1 second update Accuracy 0 to 122 BrPM 1 BrPM 123 to 150 BrPM 2 BrPM Numeric Resolution 1 BrPM Alarms User selectable low and high respiration rate Base Impedance Range 0 to 3 5 K ohms at 63 kHz NIBP MEASUREMENT Characteristic Specification Technique Oscillometric MAXNIBP Technology Microprocessor software eliminates most ambient noise and motion artifact Blood Pressure Range Systolic 25 to 265 mmHg Diastolic 15 to 220 mmHg MAP 20 to 235 mmHg Pulse Rate Range 20 to 300 BPM Accuracy Blood Pressure 5 mmHg with a standard deviation no greater than 8 mmHg See Standards P
63. the CHARGE LED indicator switches to Green CAUTION Once the battery has reached a full charge remove it from the charger Continued charging of the battery may cause its performance to degrade INSTALLING PAPER NOTE A red line appears when the remaining supply of thermal paper becomes low 1 Switch the printer OFF 2 Press the Cover Open button to access the paper compartment Remove any remaining paper before installing the new roll 3 Place the new paper roll as shown on the illustration and pull out enough paper to reach out over the control panel of the printer 4 Close the paper door Figure 32 Paper Installation NOTE Make sure that the paper is correctly placed If it is tilted in one or another direction and does not come out straight from under the cover open the door and reposition the roll again WARNING Do not touch the print head or paper cutter while replacing the printer paper 21 02 0186 REV 08 07 11 134 Of Contents CARDELL Veterinary Monitors REPLACING THE BATTERY PACK WARNING Do not operate the printer or connect the printer to the CARDELL Monitor with the battery pack removed WARNING Never change the battery pack while the battery charger is plugged in and or the CARDELL Monitor is being operated 1 Switch the printer OFF 2 Disconnect the printer from the CARDELL Monit
64. the High or Low extreme value and the time the alarm occurred are also displayed Press and hold the HISTORY pushbutton for two 2 seconds returns to the Trend History list NOTE The History pushbutton can be used at any time during monitoring When the History pushbutton is pressed the waveforms being displayed are replaced with the History menus While in the menus the monitor will continue to update and display the numeric values of the parameters being monitored and a signal bar graph will be displayed indicating the relative signal strength and signal quality at the sensor site NOTE While in the History menus if no pushbutton is pressed within 30 seconds the monitor will automatically exit to the Main display screen NOTE Both Trend and Alarm History data are only available for twenty four 24 hours Data older than twenty four 24 hours is automatically removed from the history lists Once the HISTORY pushbutton has been pressed press and hold the HISTORY pushbutton for two 2 seconds to toggle between the two History screens NOTE If no alarms have occurred the message No Alarm History is displayed at the top of the History menu When completed press the MAIN C pushbutton to exit and return to the Main display screen or after thirty 30 seconds of button inactivity the monitor will automatically return to the Main display screen 21 02 0186 REV 08 07 11 101
65. the cable from the RS232 connector on the CARDELL Monitor to the computer and open the MONITOR application in the Hyper Terminal program Click on Transfer and select Capture Text When the Capture Text box opens click the START pushbutton 1 HyperTerminal by Hilgraeve Monroe Michigan USA Copyright 1999 Hilgraeve Inc 21 02 0186 REV 08 07 11 137 Of Contents CARDELL Veterinary Monitors Refer to Page 100 HISTORY for information on the Trend and Alarm History menus When the Printing message appears on the monitor a data dump can be observed on your PC display All subsequent readings will also be captured when the connection remains active Once you have the file captured the data can be viewed and printed by using a standard Windows application such as Word NOTE Capturing data to an existing file will append new data to the end of the file 21 02 0186 REV 08 07 11 138 Of Contents CARDELL Veterinary Monitors 12 CLEANING CLEANING OVERVIEW WARNING Do not under any circumstances perform any testing or maintenance on the monitor while the monitor is being used to monitor a patient The monitor must be turned OFF Unplug the monitor from the AC power source and remove the internal battery CAUTION Do not open the monitor to clean or repair it Contact CAS Medical System for ser
66. to detect changes in feline blood pressure is also by comparing individual blood pressure readings taken over time Normal feline blood pressure 124 84 Other investigators have reported comparable reference values Feline Reference Values Systolic Diastolic mmHg mmHg 125 11 89 9 Brown et al 1997 123 14 88 15 Curtet 2001 125 12 86 15 Weber et al 2002 1 Adapted from Essential Facts of Blood Pressure in Dogs and Cats Egner Carr amp Brown 2003 21 02 0186 REV 08 07 11 63 Of Contents CARDELL Veterinary Monitors CANINE NORMAL VALUES The normal values for dogs are breed specific Those for Golden Retrievers Labradors and giant breeds tend to be lower than the overall average and those for greyhounds and in general racing hounds tend to be higher The table that follows lists the normal values for common dog breeds using oscillometric blood pressure monitors Average canine blood pressure 133 75 This figure was calculated as the mean of 1782 oscillometric measurement in clinically healthy dogs of different breeds The overall average is therefore serves as a point of reference only The individual or at least breed specific value must be known to most accurately determine whether a given patient s blood pressure deviates from normal Breed Systolic Diastolic Pulse Rate mmHg mmHg Labrador Retriever 118 17 66
67. 13 99 19 Golden Retriever 122 14 70 11 95 15 Great Pyrenees 120 16 66 6 95 15 Yorkshire Terrier 121 12 69 13 120 14 West Highland 126 6 83 7 112 13 131 14 75 12 101 21 Charles Spaniel 131 16 72 14 124 24 German Shepherd 132 13 75 10 108 23 136 16 76 12 104 16 Bullterrier 134 12 77 17 122 6 Chihuahua 134 9 84 12 109 12 Miniature Breeds 136 13 74 17 117 13 136 12 76 13 131 14 Beagle 140 15 79 13 104 16 Dachshund 142 10 85 15 98 17 143 16 88 10 98 22 Greyhound 149 20 87 16 114 28 Pointer 145 17 83 15 102 14 GUIDELINES Mean Arterial Pressure MAP Minimum to adequately perfuse all peripheral tissue beds 60 70 mmHg Hypertension Suspect with systolic pressure greater than 150 mmHg affirmed when above 160 170 mmHg also affirmed in cats when diastolic pressure is above 100 mmHg Hypotension During anesthesia generally maintain systolic pressure above 80 mmHg For more information call Midmark 2 Info per Dr Donald Sawyer Michigan State University 21 02 0186 REV 08 07 11 64 Of Contents CARDELL Veterinary Monitors 7 PULSE OXIMETRY MONITORING Model 9403 and 9405 The Pulse Oximeter parameter SpO determines arterial oxyhemog
68. 39 CLEANING OVER VIEW 139 THE MONITOR M 139 THE DISPLAY n pad RN 140 PATIENT CABLE AND LEADWIRES e RE itia bn 140 m 140 REUSABLE CUFFS nia UE Un nau Gd enn ME 140 DISPOSABLE CUFF Suarri a p a Eaa pa 140 aE 141 COs CONSUMABLES HA RU pin b IA 141 PRINTER qe 141 SpOs INTERCONNECT 141 SENSOR AND OLI S a RU PA buda Rb a 141 TEMPERATURE PROBES ER BR Ran 142 13 MAINTENANCE 143 MAINTENANCE INTERVALS rnit 143 SERVICE MENUS M 144 ENTERING THE SERVICE MENU 144 EXIT THE SERVICE MENU 145 WD AY TEST eH 146 CALIBRATION CHECK 146 COs CALIBRATION 147 NIBP CALIBRATION CHECK 148 MANOMETER PRESSURE GHEQGQNK
69. 5 Of Contents CARDELL Veterinary Monitors Patient Parameters Low Limit High Limit HR 25 to 295 BPM 25 to 295 BPM RR 5 to 145 BrPM 5 to 145 BrPM No RESP 10 to 60 Sec SpO 70 to 95 80 to 99 SatSeconds 10 to 100 SYS 30 to 260 mmHg 30 to 260 mmHg DIA 20 to 215 mmHg 20 to 215 mmHg MAP 25 to 230 mmHg 25 to 230 mmHg Patient Parameters Low Limit High Limit HR 25 to 295 BPM 25 to 295 BPM RR 5 to 145 BrPM 5 to 145 BrPM No RESP 10 to 60 Sec SYS 30 to 260 mmHg 30 to 260 mmHg DIA 20 to 215 mmHg 20 to 215 mmHg MAP 25 to 230 mmHg 25 to 230 mmHg Patient Parameters Low Limit High Limit HR 25 to 295 BPM 25 to 295 BPM 2 70 to 95 80 to 99 SatSeconds 10 to 100 EtCO 1 to 99 mmHg 1 to 99 mmHg FiCO 3 to 30 mmHg RR 5 to 145 BrPM 5 to 145 BrPM No RESP 10 to 60 Sec SYS 30 to 260 mmHg 30 to 260 mmHg DIA 20 to 215 mmHg 20 to 215 mmHg MAP 25 to 230 mmHg 25 to 230 mmHg NOTE Each alarm limit may also be selected OFF individually or as a whole Low Limits cannot be set above the associated High Limit High Limits cannot be set lower than the associated Low Limit 21 02 0186 REV 08 07 11 165 CONTROL PANEL Of Contents CARDELL Vet
70. 8 07 11 146 Of Contents CARDELL Veterinary Monitors To perform a Calibration Check follow the following procedure 1 Verify that the FilterLine supplied with the Calibration Kit is firmly attached to the gas canister 2 Enter the monitor s Service menu Refer to Page 144 SERVICE MENU 3 Press the ARROW DOWN pushbutton until the parameter Check is highlighted 4 Press one of the NEXT programmed pushbutton keys to select OFF 5 Press the ARROW UP pushbutton to change the setting from OFF to Connect Gas 6 Connect the FilterLine to the monitor 7 The highlighted section should read Open 5 Gas 8 When the message Open 5 Gas appears press and hold open for fifteen 15 seconds the gas valve until the reading stabilizes 9 Verify the reading on the display to be 5 0 0 3 vol NOTE Calibration is not required if the measured value is the same as the concentration of the calibration gas 0 3 vol The concentration of the calibration gas used is 596 the measured value should be between 4 7 to 5 396 therefore calibration is not required 10 Press one of the PREVIOUS programmed pushbutton keys to return to the Check menu selection and end the Calibration Check 11 Disconnect the FilterLine from the monitor 12 When you have completed press the MAIN pushbutton to exit and return to the
71. 9405 Monitor is equipped to use Microstream End Tidal EtCO consumables manufactured by Oridion No other manufacturer s consumables should be used NOTE CARDELL 9405 Monitors equipped with Oridion technology will have the Microstream logo imprinted onto the connector s protective cover OVERVIEW OF ORIDION MICROSTREAM EtCO CONSUMABLES CAUTION Microstream consumables are latex free non sterile and non pyrogenic CAUTION Microstream consumables are intended for single patient use only in human medicine but in the veterinary setting may be reused as long as any moisture is allowed to dry between uses Do not attempt to disinfect or flush the consumables as the monitor can be damaged NOTE After use on a patient the sampling line should be hung to allow any moisture to dry before using again Multiple sampling lines are included with the monitor to allow one to use fresh dry lines for each case Sampling lines should be disposed of immediately upon the first occlusion alarm or after 3 4 months of use Additional sampling lines may need to be purchased depending on case load INTUBATED CONSUMABLES The Microstream FilterLine products are comprised of a pre connected sampling line and a tube Airway Adapter There is a FilterLine Set for non humid environments and a FilterLine H Set for humid environments ATTACHING THE INTUBATED CONSUMABLES 1 Slide the protective cover and
72. AC Line cord and battery Reconnect the battery and AC Line cord turn the monitor On If the message still appears contact CAS Medical Systems to have the monitor serviced Contact CAS Medical Systems to have the monitor serviced The consumable is no longer connected to the monitor The monitor will continue to function Contact CAS Medical Systems to arrange for service 21 02 0186 REV 08 07 11 127 Table Of Contents CARDELL Veterinary Monitors This page is intentionally left blank 21 02 0186 REV 08 07 11 128 Of Contents CARDELL Veterinary Monitors 11 EXTERNAL PRINTER The following section is provided as an overview of the Citizen CMP 10 Mobile Printer as it is used with the CARDELL Monitor NOTE For more detailed information on the Citizen Model CMP 10 Mobile Printer refer to the User s Manual that was supplied with the printer WARNING The CARDELL Monitor has been tested with the Citizen CMP 10 Mobile printer to comply with IEC 60601 1 1 and is the only printer that is recommended to be used with the monitor If another printer is to be used the user must read the Warning on Page 39 under LEAKAGE CURRENT TEST and follow the guidance given NOTE The CARDELL Monitor is not equipped with interfaces to remote equipment or network s to duplicate alarms PRINTER OVERVIEW The Citizen CMP 10 Mobile
73. ATORS aoe OoN 3 Figure 29 Printer Controls and Indicators LED Indicators Bicolor Red and Green CHARGE LED Red on Charging Battery Green on Battery is fully charged Power Error LED Green on Device is switched ON or self testing is in progress Red Green blinking fast End of paper Red Green blinking slow Print Head Overheated Controls Infrared IrDA port RS 232 Serial Port Power ON OFF switch Line Feed button press once for one 1 line paper feed press down and hold for continuous paper feed to any length Paper Cover Release Button Press down to open cover Paper Cutting Edge Paper Cover 21 02 0186 REV 08 07 11 130 Of Contents CARDELL Veterinary Monitors PRINTER OPERATION DIRECT CONNECTION The monitor uses the DB9 connector located on the rear panel of the monitor to interface to the RS232 port on the printer Use the cable which is supplied with the printer NOTE When using the direct connect method connect the printer s serial cable to the printer before turning the printer on INFRARED CONNECTION NOTE When using the infrared port disconnect the printer s serial cable from the printer before turning the printer on Position the printer s port window in line with the window of the CARDELL Monitor OR connect the RS232 direct cable from the printer to the 9 pin RS 232 connector located
74. Alarm Limit Violation the monitor flashes the Heart Rate HR numeric display and the Patient Alarm LEDs provides a Patient Alarm Limit Violation audible tone and flashes the appropriate message Bradycardia or Tachycardia in the Patient Alarm Message Window section of the display To acknowledge the alarm and temporarily mute the audio press the SILENCE RESET pushbutton The monitor silences the audible tone for a maximum of fifteen 15 seconds the parameter in alarm and Patient Alarm LEDs continue to flash on the front panel and the appropriate message will be displayed in the Patient Alarm Message Window section of the display If the current patient alarm condition becomes inactive during the 15 seconds and then recurs OR a different patient alarm condition occurs during the 15 seconds the audio alarm is reactivated If the alarm condition continues uninterrupted for the 15 seconds the audio alarm is reactivated RESPIRATION ALARMS During either a Low or High Respiration Alarm Limit Violation the monitor flashes the Respiration Rate RR numeric display and the Patient Alarm LEDs provides a Patient Alarm Limit Violation audible tone and flashes the appropriate message Low RR or High RR in the Patient Alarm Message Window section of the display To acknowledge the alarm and temporarily mute the audio press the SILENCE RESET pushbutton The monitor silences the audible tone for a maximum of fifteen 15 seconds the parameter in
75. Area will be displayed the time remaining until the next measurement as well as the cycle time chosen in the format MM SS CC where is the minutes and SS is the seconds until the next measurement and is the cycle time selected NOTE If a measurement is desired between measurement cycles press the START CANCEL pushbutton After this measurement the monitor will re enter the Automatic Cycle mode and countdown to the next measurement based on the Automatic Cycle time selected To return to the Manual Mode press and hold the START CANCEL pushbutton for two 2 seconds to enter the NIBP menu and change the NIBP Cycle back to Manual 21 02 0186 REV 08 07 11 61 Of Contents CARDELL Veterinary Monitors STAT MODE WARNING Readings obtained during STAT mode may not meet the stated accuracy of this monitor WARNING In some cases rapid prolonged cycling of an oscillometric noninvasive blood pressure monitor cuff has been associated with ischemia Apply the oscillometric cuff appropriately according to instructions and check the cuff site and cuffed extremity regularly when blood pressure is measured at frequent intervals or over extended periods of time NOTE The monitor must be in the Manual NIBP Cycle mode when selecting STAT mode The CARDELL Monitor can automatically take a series of blood pressure measurements for a five 5
76. CE erat 114 PERMANENT AUDIO ALARM SILENCGE tpan sut ink heh tete b rk indc 115 BATTERY POWER 115 BAT TERY MESSIS eee eee eee eee 115 CHECKING BATTERY S PATUS S 117 POWER Q 117 21 02 0186 REV 08 07 11 19 Of Contents CARDELL Veterinary Monitors USER MESSAGES m 118 ECG RESFIRA TION USER MESSAGE S 118 Spo USER MESSAGES pi einen agas 119 Hd minit occ 120 NIBP USER MESSADES da tM MEE ME 121 MONITOR MESSAGES m 122 11 EXTERNAL PRINTER 129 PRIN TER OVERVIEW 129 PRINTER CONTROLS AND INDICATORS 130 PRINTER OPERATION Mu 131 DIREGT CONNEC lI 131 INFRARED CONNECTION 131 CHARGING THE PRINTER BATTERY n oc ni ee 133 INSTALLING PAPER e Ae 134 REPLACING THE BATTERY PAG crier tunt nior bebat boi cera ati 135 INSTALLING A NEW BATTERY PACK 136 PRINTING TO COMPUTER vx race 137 12 cp 1
77. Contents CARDELL Veterinary Monitors SITE SELECTION Place the patient on a padded surface or chair to provide comfort Shivering will inhibit the monitor from making a determination CUFF PLACEMENT FOR A CAT cat may be left in its owner s lap to keep it calm Measurements are best done in an area of the hospital away from noise and bright lights The animal may be held so that the front limbs are free for cuff placement In conscious patients the tail may be the most appropriate location for placement of the cuff Cats may be most comfortable in sternal recumbency making the tail a more preferable site For the median artery on the foreleg place the cuff around the forelimb between the elbow and carpus Hair need not be clipped except when heavily matted In cats less than five 5 pounds when measurements are difficult to obtain place the cuff around the leg above the elbow to obtain measurements from the brachial artery Measurements from the coccygeal artery may be used by placing the cuff around the base of the tail but not in anesthetized patients Figure 6 Cat Cuff Placement N it N E N RN 3 X M Ne NN W 3 Y x 4 X ws NOM X X NN N NINE 21 02 0186 REV 08 07 11 54 Of Contents CARDELL Veterinary Monitors CUFF PLACEMENT FOR A DOG For measurements in dogs it is preferab
78. DIO VISUAL 99 HISTORY ge 100 TREND Y 102 PRINTING TREND TESTOR 103 ERASING TREND BIS TIOECE 103 ALARM HISTORY RT 104 PRINTING ALARM HIST TORY 105 ERASING ALARM HISTORY 105 REAL 106 oll E E iu 106 CHANGING ALARM LIMITS niei 107 ALARM LIMIT VALUES 108 SAVING MENU SEES TIPS 108 RESTORE A PREVIOUSLY SAVED SET OF MENU SELECTIONS 109 RESTORE FACTORY 109 AUDIBLE AND VISUAL INDICATORS 110 CLEARING ALARMS cat Rar ve itas 111 ECG HEART ALARMS 112 RESPIRATION FEcqu 112 pore b i e 112 SpOz PULSE ALARMS 113 EtCOSALARMS 113 NIBP PATIENT pA FS ras cia unu pa 114 ERN QW E lc 114 2 MINUTE AUDIO ALARM SILEN
79. E icuPI E E 56 CUFF SIZE SELECTION 56 NIBP MENU 58 LARGE CUFF SMALL CUFF OPERATING 5 59 MANUAL MODE FOR BLOOD PRESSURE DETERMINATION 59 AUTOMATIC CYCLE FOR BLOOD PRESSURE DETERMINATION 61 STAT MODE 62 BLOOD PRESSURE REFERENCE VALUES 63 21 02 0186 REV 08 07 11 17 Of Contents CARDELL Veterinary Monitors 7 PULSE OXIMETRY MONITORING 65 INSTRUCTIONS USB 65 SatSeconds ALARM MANAGEMENT 67 SENSOR REMOVAL M 67 REMOVING THE INTERFACE ORDBLE eritis tk aen tlt e tir xn ba ti 68 PERFORMANCE CONSIDERATIONS asa sucus nube barra brat 68 8 CAPNOGRAPHY 69 ORIDION TECHNOLOGY a 69 OVERVIEW OF ORIDION MICROSTREAM CONSUMABLES 69 ATTACHING THE INTUBATED CONSUMABLES 69 REMOVING THE 73 9 TEMPERATURE 75 YE
80. IRATION Catalog No Description 01 02 0304 3 Lead Patient Cable 3 meter IEC AAMI Color Coding 01 02 0305 5 Lead Patient Cable 3 meter IEC AAMI Color Coding 01 02 0306 3 Lead Wire set with crocodile clips black white red 01 02 0307 5 Lead Wire set with crocodile clips black white red green brown 01 02 0308 3 Lead Wire set with snap clips 01 02 0309 5 Lead Wire set with snap clips SV 02 0329 Esophageal Interface kit with 12 Fr 18 Fr Probes SV 02 0329TC ECG Esophageal Interface kit with 12 Fr 18 Fr Probes w Temp cable 01 03 0225 Electrode Gel 28 02 0445 Leadwire Detangler OXIMETRY Note Use only with Nellcor amp Pulse Oximeter Accessories Catalog No Description 01 02 0183 Patient Interface Cable DOC 10 10 Feet 01 02 0299 SpO Sensor and Clips MaxFast 1 Reflectance Sensor amp Posey wrap CO Catalog No Description 01 02 0290 FilterLine Set Adult Pediatric box of 25 01 02 0392 FilterLine H Set Regular SV 02 0338 FilterLine H Set Exotic 01 02 0295 Gas Calibration Kit Scott Medical P N 030465 TEMPERATURE Catalog No Description 01 02 0327 Esophageal Rectal Reusable Probe 9 Feet Small 01 02 0379 Esophageal Rectal Reusable Probe 9 Feet Large 28 02 0444 Temperature Adapter Plug 21 02 0186 REV 08 07 11 158
81. LLOW SPRINGS INTERNATIONAL YSI 75 10 77 are az TT DISPLAY AREA 77 MAIN DISPLAY AREA 77 TIME BATTERY AND NUMERIC 5 78 NUMERIC AND TEMPERATURE 79 NIBP NUMERIC AREA e m 79 EtCO NUMERIC SECTION 80 PATIENT ALARM MESSAGE WINDOW eene 80 EQUIPMENT MESSAGE WINDOW lk epe ddr rn ean 80 DISPLAY VISUAL INDICA TOSS 80 FRONT PANEL CONTROLS 82 INFRARED Ir DATA PORT 85 aizadln 86 AC LINE POWER CONNEC 86 FUSE COMPARTIMENT 86 BATTERY COMPARTMENT 86 EQUIPOTENTIALITY GROUND POS T 86 EXTERNAL DEVICE 86 LEFT SIDE VIEW 87 CUFF HOSE CONNECTION ra 87 TEMP ONE CT ORR c Q 87 NELLCOR VET SpO SENSOR
82. METERS MENU and configure the appropriate waveform s to be viewed and printed 12 Check the alarm limits and configure them appropriately for the patient Refer to Page 108 ALARM LIMIT VALUES 21 02 0186 REV 08 07 11 50 Of Contents CARDELL Veterinary Monitors DETACHING THE LEADWIRES To remove leadwires from a patient cable always grasp the strain relief plastic portion of the leadwire Do not pull the wire itself Figure 4 Detaching the Leadwires REMOVING THE PATIENT CABLE To remove the patient cable from the monitor s ECG RESP connector press and hold down the release button to unlock the cable and pull straight back Do not pull on the cable itself Figure 5 Removing the Patient Cable Refer to Section 14 ACCESSORIES for electrode clips and patient cable types and part number information 21 02 0186 REV 08 07 11 51 Table Of Contents CARDELL Veterinary Monitors This page is intentionally left blank 21 02 0186 REV 08 07 11 52 Of Contents CARDELL Veterinary Monitors 6 BLOOD PRESSURE MONITORING CUFF SELECTION AND APPLICATION The use of properly designed and sized cuffs is essential for the accurate non invasive measurement of blood pressure Midmark cuffs are recommended for use with the CARDELL Monitor NOTE CAS recommends the use of Midmark cuffs with the
83. O respiration rate RR functional oxygen saturation of arterial hemoglobin 96SpO pulse rate PR and temperature WARNING The CARDELL Monitor is intended only as an adjunct in patient assessment It must be used in conjunction with clinical signs and symptoms CONTRAINDICATIONS are known at this time BRIEF DEVICE DESCRIPTION The CARDELL Monitor is compact lightweight and portable allowing it to be easily carried and used in a variety of clinical settings The monitor is powered by AC Line Power or by a Nickel Metal Hydride NiMH rechargeable battery pack The internal battery pack charges when the monitor is plugged into the AC wall outlet The CARDELL Monitor can be set to operate in one of nine 9 different languages English German French Italian Spanish Dutch Swedish Portuguese or Norwegian The monitor s display window can display various system alarm messages These messages direct the user to check conditions such as the battery state air leaks and measurement problems The monitor s display window also displays the operational mode of the monitor Large or Small Cuff 21 02 0186 REV 08 07 11 25 Of Contents CARDELL Veterinary Monitors The ECG parameter is intended for three lead or five lead ECG monitoring The Respiration RESP parameter is intended to measure changes in electrical impedance caused by chest s
84. Patient Notes Notes History Alarm Hist HR MN RR 502 PR 2 RR HR MN Alarms 3 57 160 28 98 159 38 29 14 01 Tachycardia 200 BPM 13 57 NIBP 135 92 114 PR 156 3 58 128 22 98 125 38 23 3 59 160 26 98 157 39 26 13 59 NIBP 140 88 125 PR 125 4 00 172 25 98 17 37 24 4 01 190 35 98 189 38 34 4 01 NIBP 153 91 123 PR 191 4 02 176 23 98 174 37 24 NOTE An asterisk appears in the History printout to indicate an Alarm has occurred during that one minute time frame The alarm value shown represents the extreme value during the alarm time NOTE When Respiration is turned OFF no Respiration Rate RR readings will appear 21 02 0186 REV 08 07 11 132 Of Contents CARDELL Veterinary Monitors Figure 31 Waveform Sample Printouts 04 Sep 06 12 35 25 0 mm Sec 121 Sp02 98 PR 120 2 38 mmHg RR 16 140 88 125 PRe119 1 mV r1 SpO2 ECG I 94XX Series Monitor Patient Notes CO2 0 100 mmHg e To print waveforms press and hold for two 2 seconds the FREEZE PRINT MAIN pushbutton C while in the Main display screen The waveforms being displayed will print based on the Print Traces selections in the Parameters menu Refer to Page 96 PARAMETERS MENU for the Print Traces selections When the Print On Alarm setting in the Parameters menu is set to t
85. TATUS There are several means to get an indication about the battery charge status e When the monitor is connected to the AC wall outlet the Battery Charge Status visual indicator will have a moving bar from left to right within the indicator signifies the battery is being charged Once charged the moving bar will stop and the battery icon will be completely filled in e When the monitor is being powered from the battery the moving bar within the Battery Charge Status visual indicator will be moving from right to left signifying the battery is being discharged CAUTION This product contains a rechargeable battery that is recyclable Under various state and local laws it may be illegal to dispose of this battery into the municipal waste stream Check with your local authorities for instructions on recycling options in your area POWER FAIL The CARDELL Monitor incorporates a Power Fail feature Whenever the power is disconnected from the monitor and the monitor is not allowed to shut down in an orderly fashion the monitor when re powered alerts the user The message Power Failure is displayed in the Equipment Message Window the Equipment Alarm LEDs are flashing and three 3 audio beeps followed by two 2 audio beeps are heard every ten 10 seconds During this condition all other pushbuttons are inactive except for the ON STANDBY and SILENCE RESET To clear the Power Fail condition press the SILENCE
86. UAL pushbutton The available items are listed on the left hand side of the display The monitor will initially highlight the Alarm Volume selection 2 Press one of the NEXT programmed pushbutton keys and highlight the selections column 3 Press either the ARROW UP or ARROW DOWN pushbutton to make a selection 4 Press one of the PREVIOUS programmed pushbutton keys to return back to the parameter selections column 5 Press the ARROW DOWN pushbutton to continue to the next parameter or press the MAIN G pushbutton to exit and return to the Main display screen HISTORY The History pushbutton allows the user to recall stored Trend and Alarm History information Patient History is organized in two 2 visually displayed lists Trend History Pressing the HISTORY pushbutton the first time reveals the first viewable list that contains up to 480 entries of Trend History The Trend History contains NIBP readings as they occur along with one 1 minute averages of history data values for Heart Rate HR Respiration Rate RR when enabled 96SpO 02 Pulse Rate PR and CO Respiration Rate RR that are saved once a minute 21 02 0186 REV 08 07 11 100 Of Contents CARDELL Veterinary Monitors Alarm History Once in the History screen press and hold the HISTORY pushbutton for two 2 seconds to reveal the second viewable list that contains up to 25 entries of Alarm History The Alarm Type
87. UTION U S FEDERAL LAW RESTRICTS THIS DEVICE TO SALE ON OR BY THE ORDER OF A VETERINARIAN U S PATENT 4 796 184 5 022 403 OTHER PATENTS PENDING AC Input Connector Fuse Compartment AC LINE POWER CONNECTOR Receptacle for the AC power cord FUSE COMPARTMENT The power input receptacle incorporates dual fuses located in the hot and neutral lines BATTERY COMPARTMENT The CARDELL Monitor is equipped with a 7 2 Volt 3700 mAhr battery pack The monitor will operate on a completely charged battery for 3 to 5 hours depending on its configuration and the use of the NIBP function EQUIPOTENTIALITY GROUND POST This terminal can be used to provide an auxiliary ground for the monitor EXTERNAL DEVICE INTERFACE The CARDELL Monitor comes equipped with a DB9 RS232 serial output connector that is used to interface to the Citizen CMP 10 Mobile Printer or another serial printing device Refer to Section 11 EXTERNAL PRINTER for more information NOTE The serial number label is located on the bottom of the monitor 21 02 0186 REV 08 07 11 86 Of Contents CARDELL Veterinary Monitors LEFT SIDE VIEW Figure 21 Left Side Panel View MAXIE CUFF HOSE CONNECTION The six 6 foot Inflation Hose is connected to the monitor where the MAXNIBP logo is located as shown in Figure 21 The hose must be connected to the cuff prior to us
88. ake pediatric low volume adaptor for smaller patients to avoid any significant impact on total mechanical dead space Avoid the use of positional right angle adaptors in smaller patients e Avoid maintaining anesthesia with a facemask Simply put anesthetized patients should have their end tidal CO2 monitored for maximal patient safety 21 02 0186 REV 08 07 11 172 Of Contents CARDELL Veterinary Monitors 17 PURCHASING RECORD CARDELL VITAL SIGNS MONITOR Installed Options amp Temp SpO NIBP CO Model 9403 9404 9405 Serial Number Date of Purchase Distributor Name Representative Phone Number Fax Number Email 21 02 0186 REV 08 07 11 173 Table Of Contents Midmark Corporation 60 Vista Drive Versailles OH 45380 0286 Phone 937 526 3662 937 526 5542 MIDMARI lt midmark com Because we care Midmark Corporation 2009
89. alarm and Patient Alarm LEDs continue to flash on the front panel and the appropriate message will be displayed in the Patient Alarm Message Window section of the display If the current patient alarm condition becomes inactive during the 15 seconds and then recurs OR a different patient alarm condition occurs during the 15 seconds the audio alarm is reactivated If the alarm condition continues uninterrupted for the 15 seconds the audio alarm is reactivated SpO ALARMS During either a Low or High SpOz2 Alarm Limit Violation the monitor flashes the 5 numeric display and the Patient Alarm LEDs provides a Patient Alarm Limit Violation audible tone and flashes the appropriate message Low SpOz or High 96SpO in the Alarm Window section of the display To acknowledge the alarm and temporarily mute the audio press the SILENCE RESET pushbutton 21 02 0186 REV 08 07 11 112 Of Contents CARDELL Veterinary Monitors The monitor silences the audible tone for a maximum of fifteen 15 seconds the parameter in alarm and Patient Alarm LEDs continue to flash on the front panel and the appropriate message will be displayed in the Patient Alarm Message Window section of the display If the current patient alarm condition becomes inactive during the 15 seconds and then recurs OR a different patient alarm condition occurs during the 15 seconds the audio alarm is reactivated If the alarm condition c
90. amage Contact Midmark for assistance Equipment not suitable for use in the presence of FLAMMABLE ANESTHETICS Equipment is not intended to be used in Oxygen Enriched Atmospheres 21 02 0186 REV 08 07 11 37 Of Contents CARDELL Veterinary Monitors WARNING The use of Accessory equipment not complying with the equivalent safety requirements of this equipment may lead to a reduced level of safety of the resulting system Consideration relating to the choice shall include Use of the accessory in the Patient Environment Evidence that the safety certification of the accessory has been performed in accordance with the appropriate IEC 60601 1 and or IEC 60601 1 1 harmonized national standard Do not gas sterilize or autoclave the monitor Do not use the monitor in the presence of Magnetic Resonance Imaging MRI equipment Do not apply the blood pressure cuff on an extremity being used for an intravenous infusion Do not place liquids on top of the monitor Do not immerse the monitor or power cord in water or any liquid If unit is accidentally wetted it should be thoroughly dried The rear cover can be removed by a qualified service technician to verify absence of water Accurate oxygen saturation measurement cannot be obtained with the Model 9403 when the oximeter is not measuring the pulse properly If the waveform perfusion bar graph or the Pulse Rate be erratic or inac
91. and verify the proper assembly of the calibration set up Re inflate the system If the monitor again fails to hold the pressure it is recommended the monitor be returned to CAS Medical Systems for service 21 02 0186 REV 08 07 11 149 Of Contents CARDELL Veterinary Monitors OVERPRESSURE 1 While still in the Manometer Mode Test inflate the pressure slowly until 290 mmHg 10 mmHg is reached The monitor s NIBP display should stop updating and the message Over Press will be displayed in the Message Window 2 Press the SILENCE RESET pushbutton to exit the Overpressure Test The monitor returns to the Manometer Mode selection 3 Press either the ARROW UP or ARROW DOWN pushbutton key to continue If the monitor does not meet the above specifications it is recommended the monitor be returned to CAS Medical Systems for service PNEUMATIC PRESSURE CHECKS To check the monitor s pneumatic system for air leakage follow the procedure below PLUG TUBE 1 Obtain the male luer plug found in the Calibration Kit product P9 supplied with the monitor 2 Place this plug into the cuff connector at the end of the monitor inflation hose and twist one quarter turn The plug must fit securely into the connector for this test to be performed properly 3 Enter the monitor s Service menu Refer to Page 144 SERVICE MENU 4 Press the ARROW DOWN pushbutton until the parameter Pneumat
92. anges can be made 3 When you have completed press the MAIN G pushbutton to exit and return to the Main display screen TEMPERATURE CALIBRATION CHECK Verify the calibration of the monitor s Temperature circuit once 1 every year To perform a Temperature Calibration Check a Temperature Test Jack is required This Test Jack can be assembled by a service personnel The Temperature Test can be performed at any time CAUTION Do not perform a Temperature Test while the CARDELL Monitor is monitoring a patient To perform a Temperature Test follow the following procedure 1 If installed remove the temperature probe connector completely from the TEMP connector 2 Insert the Temperature Test Jack into the TEMP connector 3 The TEMP display value should read 37 0 0 1 C or 98 6 0 1 F NOTE The monitor will display the Temperature Test Jack value using the current temperature units selected 4 Once completed remove the Temperature Test Jack from the TEMP connector SpO CALIBRATION CHECK The oximeter is factory calibrated to determine the percentage of arterial oxygen saturation of functional hemoglobin No user calibration is required 21 02 0186 REV 08 07 11 153 Of Contents CARDELL Veterinary Monitors REPLACING THE MONITOR BATTERY A part number for the battery can be found in the Accessories section of this manual or on the labe
93. as possible to make a proper determination Use the 5 waveform display to determine if a strong rhythmic pulse signal is present When oximeter probe is attached to the monitor the 5 and Pulse Rate numeric displays will show dashes and the signal strength window will be blank NOTE If SpO is selected a waveform parameter no signal strength bar graph is displayed When the probe is connected to the monitor but is off of the patient the 5 and Pulse Rate numeric displays will show dashes The message SpO Probe OFF is displayed the Equipment Alarm LEDs are flashing and three 3 audio beeps are heard every twenty five 25 seconds NOTE If SpOz is selected as a waveform parameter the message appears in the waveform section of the display If SpO is not selected as a waveform parameter the message appears in the equipment message window section of the display To acknowledge the alarm press the SILENCE RESET pushbutton The monitor silences the audible and visual alarms but the message SpO Probe OFF remains on the display If the message Chk 5 Probe should appear verify that the probe being used is not defective by replacing the defective one and trying a different probe The message Chk 5 Probe is displayed the Equipment Alarm LEDs are flashing and three 3 audio heard every twenty five 25 seco
94. bon dioxide at all Ideally your goal should be to minimize dead space through proper patient planning and to detect excess dead space consequences through end tidal CO2 monitoring Anatomic dead space is comprised of the upper airway structures that do not participate in gas exchange This includes the gases in the nasal passages nasopharynx larynx trachea and in the larger airways Alveolar dead space represents those alveoli that are ventilated with fresh gas but not perfused by the pulmonary circulation Mechanical or equipment dead space is made up of any portion of the endotracheal tube extending beyond the patient s incisors patient monitor adaptors ETCO2 apnea alert etc any adaptors used to facilitate patient system positioning right angle or swivel adaptors used to reduce the risk of tracheal trauma during patient rotation the pace within a mask not occupied by the patient s nose humidification management exchangers HME and the Y piece defined as the terminal end of an F circuit or noncircle system and the inhalation exhalation hose connector in a circle system Exhausted soda lime or malfunctioning one way valves can also contribute to increasing mechanical dead space Dead space also increases in a non rebreathing system when fresh gas flows are inadequate or when certain defects are present in the system for instance when the center tube of a Bain system or F circuit is cracked or broken These dead space contr
95. curate first examine the animal for any signs of distress and only then re examine sensor placement Inadequate perfusion thick fur dark skin or foreign matter that blocks light or an improperly applied sensor can result in erratic and inaccurate oxygen saturation and or pulse rate measurement Should the SpO waveform or perfusion bar graph be at a low level reposition the sensor or try a different sensor If proper operation cannot be verified remove the sensor from the animal and DO NOT use the oximeter on this animal In the event the sensor becomes dislodged from the animal audible and visual alarms are activated requiring that a veterinary professional investigate the reason for the alarm status The veterinary professional should investigate status and sensor attachment after every sensor alarm indication It is possible when the sensor is dislodged from the animal under certain conditions of light and vibration of the sensor for the pulse oximeter to display normal physiological values When monitoring End Tidal with non flammable anesthetics halothane enflurane isoflurane sevoflurane and desflurane connect the gas outlet from the monitor to a scavenger system readings and respiratory rate readings can be affected by certain ambient environmental conditions and certain patient conditions 21 02 0186 REV 08 07 11 38 Of Contents CARDELL Veterinary Monitors
96. d be a change in color of the Battery Charge LED from Green to either Orange or Red Whenever the power is disconnected from the monitor and the monitor is not allowed to shut down in an orderly fashion the monitor when re powered alerts the user Refer to Page 117 POWER FAIL for more information CAUTION Regardless of these safety features always be sure to check that there are no signs of prolonged impairment of patient circulation and that the monitor is functioning properly 21 02 0186 REV 08 07 11 43 Table Of Contents CARDELL Veterinary Monitors This page is intentionally left blank 21 02 0186 REV 08 07 11 44 Of Contents CARDELL Veterinary Monitors 5 AND RESPIRATION MONITORING ECG MONITORING The CARDELL Monitor records heart rate with electrode clips attached to the patient Electrodes detect signals caused by changes of electrical conduction in the heart during the cardiac cycle Heart rate is computed on a beat to beat basis using the R R interval of the QRS complex CAUTION Even though the patient circuit is electrically isolated it has not been designed for direct application on a patient s heart POSITIONING ANESTHETIZED PATIENTS For ECG monitoring during anesthesia it is most important to position patients on the table for the procedure If standard lead placement as described below is n
97. d of time or at frequent intervals periodically observe the patient s limb to make sure that the circulation is not impaired for a prolonged period of time CUFF SIZE SELECTION The widest cuff that can be placed on the patient without extending beyond the joint should be selected Appropriate sized cuffs may be selected based on published guidelines that cuff width should be 40 60 of limb circumference The cuff should be wrapped for a snug fit Overlapping the cuff will not affect measurement results Make sure the hook and loop sections of the cuff are fully engaged when it is wrapped around the limb If not fully engaged the cuff will detach during bladder inflation If that happens select the next size bigger cuff Adhesive tape or other material should not be used to secure the cuff Figure 8 Full Velcro Engagement 21 02 0186 REV 08 07 11 56 Of Contents CARDELL Veterinary Monitors Use the following table as a guide to select the correct size Table 4 Small Animal Cuff Selection Cuff Model Bladder Size Limb Circumference Number Width Range 2 0 cm 0 8 in 3 6 1 2 2 4 SV1 2 5 cm 1 0 in 3 0 cm 1 2 in in 4 0 cm 1 6 in 7 13 cm 2 8 5 1 5 0 cm 2 0 in 8 15 cm 3 1 5 9 in Table 5 Large Animal Cuff Selection Cuff Model Bladder Size Limb Circumference Numb
98. e TEMP CONNECTOR Connect the adapter and sensor cable in this receptacle for Temperature monitoring NELLCOR VET SpO SENSOR CONNECTOR The SpO connector is compatible only with Nellcor amp VetSat veterinary sensor Connect the Interface Sensor cable in this receptacle for SpO monitoring 21 02 0186 REV 08 07 11 87 Of Contents CARDELL Veterinary Monitors ECG RESP CONNECTOR The ECG RESP connector is mechanically keyed to accept only CAS Medical Systems 3 Lead or 5 Lead patient cable Connect either the 3 Lead or 5 Lead Patient Cable in this receptacle for ECG and Respiration monitoring CO SENSOR CONNECTOR The consumable is connected to the monitor where the Microstream logo imprinted onto the connector s protective cover is located SCAVENGER EXHAUST PORT To the left of the TEMP connector is the Scavenger Exhaust Port The exhaust port is an output intended only for connection to gas collection equipment such as gas scavenger devices WARNING Do not connect sample line or patient input to the exhaust port 21 02 0186 REV 08 07 11 88 Of Contents CARDELL Veterinary Monitors MONITOR OPERATING INSTRUCTIONS TURNING THE CARDELL MONITOR ON Press the ON STANDBY pushbutton the front panel to turn the monitor ON Figure 22 Turning the Monitor On On Standby _Silence Re
99. e PREVIOUS programmed pushbutton keys the message Restoring appears briefly as a status indicator and the Factory Default values will be restored into the current memory location When finished press the MAIN G pushbutton to exit and return to the Main display screen or after thirty 30 seconds of button inactivity the monitor will automatically return to the Main display screen The values will be retained in memory even after the monitor s power is turned OFF 21 02 0186 REV 08 07 11 109 Of Contents CARDELL Veterinary Monitors AUDIBLE AND VISUAL INDICATORS The CARDELL Monitor is capable of producing both an audible and a visual indicator for a variety of monitor conditions The following table provides a cross reference for audible and visual indications Table 9 Audible and Visual Indicators Alarm Condition Priority Level Audible Indication Visual Indication Dead Battery High 3 Beeps followed by 2 Beeps every 10 seconds The message is displayed continuously on the monitor s Main display screen The Equipment Alarm LEDs are flashing The Battery Power visual indicator is Red Patient Alarm Limit Violations High 3 Beeps followed by 2 Beeps every 10 seconds The associated numeric display flashes for one second on one second off for the parameter limit in violation The Patient Alarm LEDs are flashing The message is
100. e Print History mode the printer should have paper installed and the power turned Refer to Section 11 EXTERNAL PRINTER for more information about the printer and sample printout of the History screen ERASING TREND HISTORY To Erase the Patient History data 1 Press the HISTORY pushbutton to enter the Patient History menu 2 Press one of the NEXT programmed pushbutton keys to advance onto the parameter value to change Erase 3 Press either the ARROW UP or ARROW DOWN pushbutton until the message Erase Yes appears 4 Press the HISTORY pushbutton again to erase History data The monitor erases the memory enters Alarm History if available or exits the History menu and returns to the Main display screen 21 02 0186 REV 08 07 11 103 Of Contents CARDELL Veterinary Monitors ALARM HISTORY Figure 27 Alarm History Menu Alarm Hist HR MN Alarm 14 01 Tachycardia 200 BPM To view Alarm History 1 Press the HISTORY pushbutton to enter the Patient History menu 2 Press and hold the HISTORY pushbutton for two 2 seconds to enter the Alarm History menu NOTE If no alarms have occurred the message No Alarm History is displayed at the top of the History menu and no Alarm History menu will be displayed 3 The most current alarm type the alarm parameter violated the High or Low extreme value of that alarm and the time
101. e START CANCEL pushbutton at any time to stop a measurement and deflate the cuff during the measurement process The monitor s front panel NIBP numeric displays will indicate all dashes NOTE If any displayed NIBP measurement were to be left on the display for up to twenty four 24 hours the monitor will automatically blank the NIBP displays to all dashes 21 02 0186 REV 08 07 11 60 Of Contents CARDELL Veterinary Monitors AUTOMATIC CYCLE FOR BLOOD PRESSURE DETERMINATION The CARDELL Monitor can automatically take blood pressure measurements at pre selected time intervals To choose a time interval 1 Press and hold the START CANCEL pushbutton for two 2 seconds to access the NIBP menu 2 Press the ARROW DOWN pushbutton until the parameter NIBP Cycle is selected 3 Press one of the NEXT programmed pushbutton keys until the cursor displays the current NIBP Cycle mode being used 4 Use either the ARROW UP or ARROW DOWN pushbutton to make a selection 5 Once a time interval has been selected press the MAIN pushbutton to return to the Main display screen The time value selected will be displayed in the NIBP Message Window 6 Press the START CANCEL pushbutton to begin the first measurement The measurement results are displayed on the front panel until the start of the next measurement cycle Between each measurement within the NIBP Numeric
102. e connector away from the monitor NOTE To avoid damage to the Interface Cable always hold it by the connector rather than the cable when connecting or disconnecting either end To obtain longer life avoid excessive kinking or coiling the sensor cable When the probe is disconnected from the monitor the message No SpO Probe is displayed the Equipment Alarm LEDs are flashing and an audible alarm sounds indicating a connection has been broken To acknowledge the alarm press the SILENCE RESET pushbutton The monitor silences the audible and visual alarms and the message No SpO Probe is removed from the display NOTE If either the 2 Minute Audio Silence or Permanent Audio Silence is enabled no audio will be heard but a visual message will appear in the Message Window See Section 14 ACCESSORIES for Nellcor oximeter probe types and part number information PERFORMANCE CONSIDERATIONS If there is excessive ambient light cover the sensor site with opaque material Failure to do so may result in inaccurate measurements Light sources that can affect performance include surgical lights especially those with a xeon light source bilirubin lamps fluorescent lights infrared heating lamps and direct sunlight 21 02 0186 REV 08 07 11 68 Of Contents CARDELL Veterinary Monitors 8 CAPNOGRAPHY MONITORING Model 9405 ORIDION TECHNOLOGY The CARDELL
103. e cuff bladder because instrument damage may occur The cuff should be allowed to thoroughly dry before use DISPOSABLE CUFFS CAS is aware that in certain situations the cuff may become soiled during its use In these situations a water based detergent is suitable for wiping the cuff As necessary the preferred method for cleaning the cuff is to wipe it down with a damp soapy cloth A damp detergent free cloth should then be used to rinse the cuff NOTE CAS does not recommend submersion of the cuff Liquid should not be permitted to enter the cuff bladder because instrument damage may occur The cuff should be allowed to thoroughly dry before use 21 02 0186 REV 08 07 11 140 Of Contents CARDELL Veterinary Monitors PNEUMATIC TUBING Prior to each patient use inspect the NIBP Inflation Hose for proper connection cracks and kinks As necessary clean the pneumatic tubing using a soft cloth dampened with a germicidal solution CO CONSUMABLES Microstream consumables are intended for single patient use in human medicine but in the veterinary setting may be reused as long as any moisture is allowed to dry between uses Do not attempt to disinfect or flush the FilterLine as the monitor can be damaged Refer to the manufacturer s instructions enclosed with each sensor for more information PRINTER When the printer becomes dirty wipe with a soft dry clot
104. enu selection has been changed in either the Audio Visual NIBP Parameters or Limits menu an asterisk will be displayed until a Save has been performed 21 02 0186 REV 08 07 11 Table Of Contents This page is intentionally left blank 21 02 0186 REV 08 07 11 Go Table Of Contents J Next QUICK START UP GUIDE MENUS SETUP Refer to Page 90 Press and hold ALARM LIMITS and AUDIO VISUAL buttons while turning the monitor on Set the Operating Language Make selections for Audio Alarm Silence Set Date Time and Daylight Saving Time options Set SpO2 Alarm Delay Time Select Temperature units Select Trace Background PARAMETERS Refer to Page 96 Press Parameters pushbutton Select and configure the ECG waveform in Trace 1 area Select and configure the waveform to be displayed in Trace 2 area HISTORY Refer to Page 100 Select and configure the waveform or history data in Press the History pushbutton to recall stored Trend History Trace 3 area Recall list of NIBP readings as they occur along with one Selection for Print Traces minute averages of data values for other parameters Select Print On Alarm option Select ECG Gain Select ECG Smoothing Select ECG Trigger Turn Impedance Respiration channel on or off Select EtCO2 Scale Select EtCO2 Print Option Select EtCO2 Trace Type Press and hold History
105. er Width Range SV8 8 cm 3 1 in 13 20 cm 5 1 7 9 in SV10 10 2 cm 4 0 in 18 26 cm 7 1 10 2 in References Pedersen KM Butler MA Ersboll AK Pedersen HD 2002 Evaluation of an oscillometric blood pressure monitor for use in anesthetized cats JAVMA 221 646 650 Sawyer DC Guikema AH Siegel EM 2004 Evaluation of a new oscillometric blood pressure monitor in isoflurane anesthetized dogs Vet Anaesth Analg 31 27 39 21 02 0186 REV 08 07 11 57 Of Contents CARDELL Veterinary Monitors NIBP MENU The NIBP menu can be accessed by pressing and holding the START CANCEL pushbutton for two 2 seconds Figure 9 NIBP Menu NIBP Cuff Size Small Cuff NIBP Cycle Manual Init Inflate Adaptive STAT OFF NIBP Numerics S D MAP Save No Restore No NOTE When the NIBP menu is displayed the waveforms being displayed are replaced with the NIBP menu While in the menu the monitor will continue to update and display the numeric values of the parameters being monitored and a signal bar graph will be displayed indicating the relative signal strength NOTE While in the NIBP menu if no pushbutton is pressed within 30 seconds the monitor will automatically save all changes made and exit to the Main display screen The NIBP menu allows the user to e Cuff Size Select the NIBP Cuff Size Available selections Small Cuff or Large
106. erinary Monitors Characteristic Specification Display LCD display of measurement results instructions troubleshooting messages waveforms and signal strength bar Parameters Displayed Systolic Pressure Diastolic Pressure and Mean Arterial Pressure MAP or Systolic Pressure Diastolic Pressure and Pulse Rate Heart Rate Respiration Rate 5 Pulse Rate EtCO mmHg Temperature in Fahrenheit or Celsius OPERATING MODES Characteristic Specification Patient Veterinary ECG Continuous Monitoring NIBP Manual STAT or Automatic at preset intervals History Trend Review of previous measurements Alarm Review of previous alarms 2 Continuous Monitoring Continuous Monitoring Temperature Continuous Monitoring POWER Characteristic Specification Source External line or internal battery AC Power Option 100 240 VAC 50 60 Hz 0 5A Fuse Rating T500mAL250V or T1 25AL250V two provided Refer to rear panel monitor labeling for actual fuse rating Battery Nickel Metal Hydride NiMH battery pack user removable Charge Time 3 5 hours Operation on battery Approximately four 4 hours Leakage Current 100 microamp maximum 21 02 0186 REV 08 07 11 166 FEATURES
107. ery pack in place of text These symbols appear on the packaging in place of text Recycling suggested see General Notes LOT Lot Number Symbol used to indicate where Relative Humidity information concerning storage and transport can be located Single Patient Use Do Not Reuse Storage and Transport Temperatures Use By Date yyyy mm EE 21 02 0186 REV 08 07 11 35 Of Contents CARDELL Veterinary Monitors SYMBOLS CONT This symbol appears on the printer in place of text v WARNING Before removing read instructions in Section 11 21 02 0186 REV 08 07 11 36 Of Contents CARDELL Veterinary Monitors 4 SAFETY MEASURES AND WARNINGS WARNING The CARDELL monitors are intended for VETERINARY USE ONLY Do not use on human patients The CARDELL Monitor is defibrillator proof It may remain attached to the patient during defibrillation but the readings may be inaccurate during use and less than ten 10 seconds thereafter Do not use this instrument for any purpose other than specified in this manual Doing so will invalidate the monitor s warranty Do not connect more than one 1 patient to the monitor Do not plug the monitor into an outlet controlled by a wall switch Before each use verify that the alarm limits are appropriate for the patient being monitored The position of subject physiological condit
108. eturns to the Main display screen 21 02 0186 REV 08 07 11 105 Of Contents CARDELL Veterinary Monitors REAL TIME CLOCK The CARDELL Monitor uses an internal Real Time Clock to time stamp all entries that are stored in either of its History menus Changes made to either the time or date settings should be performed in between patients being monitored Refer to Page 92 for Setting the Date and Page 93 for Setting the Time PATIENT ALARMS Figure 28 Alarm Limits Menu Limits Low High HR OFF 290 SSpO2 88 OFF SatSeconds OFF EtCO2 OFF OFF FiCO2 7 RR OFF OFF No RESP 30 SYS OFF 240 DIA OFF 130 MAP 70 140 Save No Restore No WARNING The CARDELL Monitors are equipped with non latching patient alarm s As soon as the monitored parameter s return within the adjusted limits the alarm is silenced and reset automatically without any operator interaction WARNING Configuring the CARDELL Monitor s alarm settings to OFF will disable all audible and visual alarms This mode should only be selected for spot check applications where the patient is receiving bedside surveillance by a trained clinician Refer to Page 91 AUDIO ALARM SILENCE SILENCE RESET Pushbutton for more information 21 02 0186 REV 08 07 11 106 Of Contents CARDELL Veterinary Monitors The CARDELL Monitor is equipped with patient alarms
109. g ECG Trigger Impedance Resp ECCO2 Scale EtCO2 Print EtCO2 Trace Save Restore ECG SpO2 CO2 All OFF 8 ON Small Animal OFF 0 50 mmHg OFF Filled No No NOTE The Parameters pushbutton can be used at any time during monitoring When the Parameters pushbutton is pressed the waveforms being displayed are replaced with the Parameters menu While in the menu the monitor will continue to update and display the numeric values of the parameters being monitored and a signal bar graph will be displayed indicating the relative signal strength NOTE While in the Parameters menu if no pushbutton is pressed within 30 seconds the monitor will automatically save all changes made and exit to the Main display screen The Parameter setup menu allows the user to e Trace 1 Select and configure the waveform to be displayed in the Trace 1 area NOTE An trace will automatically be selected as Trace 2 Select and configure the waveform to be displayed in Trace 2 area NOTE When is selected as Trace 2 or 3 a library of ten 10 CO traces called CO Library can be selected for viewing 21 02 0186 REV 08 07 11 96 Of Contents CARDELL Veterinary Monitors Trace 3 Select and configure display data in the Trace 3 area Available selections Trace 3 waveform data or History data NOTE
110. h For extreme dirt buildup soak a cloth with mild detergent wring well and wipe Dry by wiping with a soft dry cloth CAUTION Before cleaning the printer disconnect the AC adapter from the printer Do not use volatile chemicals such as thinner benzene etc Never wet the inside of the printer mechanism Refer to the printer User s Manual for more information SpO INTERCONNECT CABLE Prior to each patient use inspect the Interconnect cable for damage As necessary clean the cable using a soft cloth dampened with a germicidal solution SENSOR AND CLIPS CAUTION To avoid damage to the VetSat sensor remove it from the clip before cleaning either piece CAUTION Do not sterilize the sensor or clips by irradiation steam or ethylene oxide Do not immerse the sensors in water or cleaning solution When necessary the sensor may be surface cleaned by wiping it with an agent such as 7096 Isopropyl Alcohol The clip may be cleaned by either wiping it with or soaking it for ten 10 minutes in 7096 Isopropyl Alcohol If the clip is soaked be sure to rinse it with water and air dry it prior to use the next patient 21 02 0186 REV 08 07 11 141 Of Contents CARDELL Veterinary Monitors After each cleaning and prior to each use inspect the sensor and cable for fraying cracking breakage or other damage Inspect the clip for cracking or breakage
111. hape changes associated with inspiration and expiration The Non Invasive Blood Pressure NIBP parameter automatically inflates an occluding cuff and using the oscillometric measurement technique determines systolic and diastolic pressure and mean arterial pressure Measurement results along with operator prompts and error messages are displayed on the front panel The frequency of NIBP determination can be selected by the operator in varied times between one and ninety minutes The auto and manual operating modes cover a variety of clinical uses The Pulse Oximeter parameter SpOz2 determines arterial oxyhemoglobin saturation by measuring the absorption of red and infrared light passing through the tissue Changes in absorption caused by pulsations of blood in the vascular bed are used to determine arterial saturation and pulse rate The oximeter requires no routine calibration or maintenance Oxygen saturation and pulse rate numeric values are available for display When selected as a waveform parameter a pulsatile waveform is also available for display When selected on the display as a numeric parameter on each detected pulse a bar graph gives the user a pulse by pulse visual indication of waveform signal quality An audio beep can be enabled that is generated each time the SpO module detects a pulse NOTE The bar graph is not proportional to the pulse volume The Capnography parameter is a noninvasive method for continu
112. he applicable RF compliance level above the Model 9403 9404 9405 Monitor should be observed to verify normal operation If abnormal performance is observed additional measures may be necessary such as re orienting or relocating the Model 9403 9404 9405 Monitor Over the frequency range 150 kHz to 80 MHz field strengths should be less than 3 V m Recommended Separation Distances Between Portable and Mobile RF Communications Equipment and the Model 9403 9404 9405 Monitor The Model 9403 9404 9405 Monitor is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled The customer or the user of the Model 9403 9404 9405 Monitor can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment transmitters and the Model 9403 9404 9405 Monitor as recommended below according to the maximum output power of the communications equipment Separation distance according to frequency of transmitter Meters Rated maximum output 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2 5 GHz power of transmitter Watts 1 24P d 1 2 2 3 0 01 0 12 0 12 0 23 0 1 0 38 0 38 0 73 1 1 2 1 2 2 3 10 3 8 3 8 7 3 100 12 12 23 For transmitters operating at a maximum output power not listed above the recommended separation distance d meters be estimated using the equation applicable to the fre
113. he type of alarm is printed on the printout and the trace is annotated with an arrow marker to mark the point of the alarm 04 Sep 06 12 35 25 0 mm Sec HR 121 5 02 98 PR 120 EtCo2 38 mmHg RR 16 NIBP 140 88 125 119 Bradycardia 1 mV Pa SpO2 ECGII 94XX Series Monitor Patient Notes 2 0 100 mmHg LT NOTE If the Print selection is ON and the Print Traces selection is ECG and if the CO connector is installed or removed all traces shall be printed overriding the ECG selection CHARGING THE PRINTER BATTERY The CMP 10 Mobile Printer is equipped with a rechargeable Lithium lon battery pack When the printer detects a Low Battery condition within itself the message Low Battery is printed and an audio indicator located inside the printer sounds three 3 times WARNING Charge the printer battery using the AC Adapter Model TRC 09 1100 M from GROUP WEST or equivalent included with the printer 1 Plug the battery charger s cord into the printer battery charger jack located on the rear panel 2 Plug the charger into an AC wall outlet of the appropriate voltage 21 02 0186 REV 08 07 11 133 Of Contents CARDELL Veterinary Monitors 3 Verify the CHARGE LED indicator is lit Red Battery charge time is approximately three 3 hours Once the battery is fully charged
114. ht Saving Time North America Use this setting and the monitor will automatically change time accordingly to the Daylight Saving Time for countries in North America EU 01 00 Daylight Saving Time for all European countries using Greenwich Mean Time EU 02 00 Daylight Saving Time for all European countries 1 hour ahead of Greenwich Mean Time EU 03 00 Daylight Saving Time for all European countries 2 hours ahead of Greenwich Mean Time 21 02 0186 REV 08 07 11 93 Of Contents CARDELL Veterinary Monitors NOTE Enabling Daylight Saving Time will affect the History readings but not erase them To configure the monitor s Daylight Savings time setting follow the following procedure 1 First enter the monitor s Setup menu Refer to Page 90 SETUP MENU 2 Press the ARROW DOWN pushbutton until the parameter DST is highlighted 3 Press one of the NEXT programmed pushbutton keys until the cursor displays the parameter currently being used 4 Press either the ARROW UP or ARROW DOWN pushbutton to make a selection 5 Press one of the PREVIOUS programmed pushbutton keys to return back to the parameter selections column 6 Press the ARROW DOWN pushbutton to continue to the next parameter or press the MAIN pushbutton to exit to the Main display screen SET THE SpO PULSE RATE ALARM DELAY The delay time until an alarm is generated for Pulse Rate can be co
115. ibutors can all be controlled through proper system inspection and maintenance Mechanical dead space gas is the first gas inhaled at the beginning of the each respiratory cycle As the mechanical dead space volume increases less fresh gas moves into the patient s alveoli limiting gas exchange Anesthetic System Norman Elbow Jackson Rees Bain Ped circle Adult circle Adult F Ped F Dead space 1 ml 3 ml 4 ml 4 ml 8 ml 8 ml 15 ml Adaptors ET tube Monitor ped Monitor adult Positional amp Moisture Exchanger Dead Space 2ml 2ml 7ml 8 2 5 to 90 ml 21 02 0186 REV 08 07 11 171 Of Contents CARDELL Veterinary Monitors The consequences of excessive mechanical dead space can be substantial and potentially fatal As dead space volume from any cause increases effective alveolar ventilation decreases In patients breathing 100 oxygen there may be negligible initial effect on arterial oxygen tension Arterial CO2 however can reach impressive levels It is possible to have an end tidal CO2 level greater than 110 mmHg in patients with a normal pulse oximeter reading e Increased arterial CO2 causes o Respiratory acidosis o Sympathetic stimulation o Cardiac arrhythmias mix of sympathetic stimulation and hypoxemic effects o Variable peripheral vasoconstriction sympathetic effect followed b
116. ic Test is highlighted 5 Press one of the NEXT programmed pushbutton keys to select and start the test 6 The monitor will inflate to approximately 180 mmHg and attempt to hold this pressure The pressure value will be displayed in the Pneumatic Test section of the Service menu This test takes about fifteen 15 seconds 7 At the completion of a successful Pressure Check the Message Window will display Passed and the monitor will beep two 2 times 8 Press one of the PREVIOUS programmed pushbutton keys to exit and return to the Pneumatic Test selection 21 02 0186 REV 08 07 11 150 10 11 Of Contents CARDELL Veterinary Monitors If the monitor fails the Pressure Check the Message Window will display Failed and the monitor will beep three 3 times Press one of the PREVIOUS programmed pushbutton keys to exit and return to the Pneumatic Test selection Due to the volume differences of the hoses offered with the CARDELL Monitor the monitor may incorrectly fail the Plug Tube check Should the monitor fail the Plug Tube Pressure Check obtain a 500 ml Pressure Cylinder and follow the 500 ml Pressure Check 500 ml PRESSURE CHECK 1 2 3 4 5 7 8 9 10 Obtain a fixed volume 500 ml Pressure Cylinder CAS p n 01 02 0248 Place the end of the monitor s inflation hose securely onto the luer fitting at the top of the pressure cylinder The hose must fit
117. inary Monitors 3 SYMBOLS Units may display the following symbols Alternating Current CAUTION Before using read instructions included The CE Mark signifies the device has met all essential requirements of European Medical Device Directive 89 336EEC This symbol appears here instead of on the unit The first two digits of the unit s serial number indicate the year of manufacture in the 21 century Indicates this monitor is subject to the Waste Electrical and Electronic Equipment Directive in the European Union Indicates protection against the effects of the discharge of a cardiac defibrillator Patient connections are Type CF isolated for direct cardiac application and protected against defibrillation Indicates protection against the effects of the discharge of a cardiac defibrillator Patient connections are Type BF and protected against defibrillation 21 02 0186 08 07 11 31 Of Contents CARDELL Veterinary Monitors SYMBOLS CONT Equipotentiality Ground Post IPX1 Protection against ingress of water ECG RESP ECG Respiration Input Connector MAXI NIBP Hose and Cuff Connector SpO2 Pulse Oximeter Probe Input Connector CO2 MicroStream CO Input Connector Scavenger Exhaust Port TEMP Temperature Probe Input Connector Two way Communication Port RS232 Interface Connector 21 02 0186 REV 08 07 11
118. ion and other factors affect the readings Blood pressure and pulse can fluctuate greatly between measurements the monitor cannot alert the user to changes in vital signs occurring between measurement cycles Occasionally electrical signals at the heart do not produce a peripheral pulse If a patient s beat to beat pulse amplitude varies significantly for example pulsus alternans atrial fibrillation rapid cycling artificial ventilator blood pressure and pulse rate readings can be erratic and alternate measuring method should be used for confirmation Where the integrity of the external protective conductor in the installation or its arrangement is in doubt EQUIPMENT shall be operated from its INTERNAL ELECTRICAL POWER SOURCE Isolation of product from mains can only be achieved by removal of external power cord Do not under any circumstances perform any testing or maintenance on the monitor or power cord while the unit is being used to monitor a patient Unplug the power cord before cleaning or servicing the monitor The operator should not perform any servicing except as specifically stated in this manual Do not touch part of non medical electrical equipment in the patient environment after removal of covers connectors etc without the use of a tool which operate at voltages not exceeding 25 VAC or 60 VDC and the patient at the same time Do not use a frayed or damaged power cord or any accessory if you notice any sign of d
119. ion directly below the NIBP information in Figure 13 displays any patient related alarm messages example Bradycardia Tachycardia EQUIPMENT MESSAGE WINDOW The text section directly below the End Tidal information in Figure 13 displays the monitor s current memory location being used Vet1 or Vet2 current NIBP operating mode SmCuff or LgCuff and will also display when selected the current status of the Audio Alarm Silence 2 Minute or Permanent as well as other Equipment type alarm messages If a menu selection has been changed in the NIBP Parameters Limits or Audio Visual menus an asterisk will be displayed example Vet1 SmCuff It will continue to be displayed until all changes have been saved to a memory location DISPLAY VISUAL INDICATORS Two 2 light bar visual indicators One on the left side of the monitor and one on the right side of the monitor are used for alarm indications The Yellow light bar on the left side is lit indicating an equipment alarm The Red light bar on the right side is lit to indicate a patient alarm 21 02 0186 REV 08 07 11 80 Of Contents CARDELL Veterinary Monitors A Yellow LED visual indicator used along with the SILENCE RESET pushbutton to display the status of the Audio Alarm Silence feature Refer to Page 114 for more information The status of the LED is continuously 2 Minute Audio Disable Flash one
120. k the patient s vital signs by an alternate method When the message High FiCO appears the base line level has shifted above the default level set the CARDELL Monitor The message High is displayed the Patient Alarm LEDs are flashing and three 3 audio beeps followed by two 2 audio beeps are heard every ten 10 seconds NOTE If CO is selected as a waveform parameter the message appears the waveform section of the display If CO is selected as a numeric parameter the message appears in the equipment message window section of the display To acknowledge the alarm press the SILENCE RESET pushbutton The monitor silences the audible and visual alarms but the message High remains on the display 21 02 0186 REV 08 07 11 120 Of Contents CARDELL Veterinary Monitors If the Module located inside the CARDELL Monitor should fail the message CO Error or CO Module is displayed The and Respiration Rate numeric displays will show dashes the Equipment Alarm LEDs are flashing and three 3 audio beeps are heard every twenty five 25 seconds NOTE If is selected as a waveform parameter the message appears in the waveform section of the display If CO is selected as a numeric parameter the message appears in the equipment message window section of the display
121. l located on the inside panel of the battery pack When the battery fails to hold a charge it will need to be replaced CAS Medical Systems recommends the battery be changed every two 2 years REMOVING THE BATTERY 1 Turn the monitor OFF and disconnect the power cord from the back of the monitor 2 Push down on the battery latch to unlock the battery door from the rear panel of the monitor 3 Carefully remove the battery pack from the rear panel of the monitor Refer to Figure 37 Figure 37 Removing the Monitor Battery Pack 100 240 V y 5A 50 60Hz FUSE TL25AL250V CAUTION U S FEDERAL LAW RESTRICTS THIS DEVICE TO SALE ON OR BY THE ORDER OF VETERINARIAN U S PATENT 4 796 184 5 022 403 OTHER PATENTS PENDING INSTALLING THE BATTERY 1 Align the Battery Pack guides with the bottom of the monitor 2 Slowly close the battery door to ensure the connector in the monitor and the connector on the battery pack mate together 3 Lock the battery door closed Refer to Page 115 BATTERY POWER for additional battery information 21 02 0186 REV 08 07 11 154 Of Contents CARDELL Veterinary Monitors WARNING Do not disassemble the battery pack or batteries The batteries contain electrolytes which can cause injury to eyes skin and clothing NOTE When the battery pack is re inserted the monitor will automatically turn ON
122. l of the surfaces have been disinfected wipe the entire surface of the monitor using a soft cloth dampened with fresh water to remove any trace amounts of residue and or fumes NOTE Thoroughly wipe off any excess cleaning solutions Care should be taken to prevent water or cleaning solution to run into connector openings or crevices 21 02 0186 REV 08 07 11 139 Of Contents CARDELL Veterinary Monitors THE DISPLAY CAUTION Use care when cleaning the display Scratches may occur Occasionally as needed clean the display window using a soft lint free cloth sprayed with an alcohol free glass cleaner Do not use either isopropyl alcohol or solvent to clean the display Use of these cleaners can cause damage to the display The use of paper towels is not recommended as it may scratch the surface PATIENT CABLE AND LEADWIRES Prior to each patient use inspect the patient cable and leadwires for damage As necessary clean the patient cable and leadwires using a soft cloth dampened with a germicidal solution CUFFS Prior to each patient use inspect the blood pressure cuff and its hose for damage REUSABLE CUFFS As necessary for normal cleaning with mild detergents dilute bleach solution 1 2 wipe the cuff with the cleaning solution rinse with water and dry NOTE CAS does not recommend submersion of the cuff Liquid should not be permitted to enter th
123. larm LEDs are flashing and an audible alarm sounds indicating a connection has been broken To acknowledge the alarm press the SILENCE RESET pushbutton The monitor silences the audible and visual alarms and the message CO OFF is removed from the display NOTE If either the 2 Minute Audio Silence or Permanent Audio Silence is enabled no audio will be heard but a visual indication will appear on the display CAUTION Dispose of Microstream consumables according to standard operating procedures or local regulations for the disposal of contaminated medical waste Refer to Section 14 ACCESSORIES for Oridion consumable types and part number information Consult instructions enclosed with each consumable for proper application 21 02 0186 REV 08 07 11 73 Table Of Contents CARDELL Veterinary Monitors This page is intentionally left blank 21 02 0186 REV 08 07 11 74 Of Contents CARDELL Veterinary Monitors 9 TEMPERATURE MONITORING YELLOW SPRINGS INTERNATIONAL YSI TECHNOLOGY The CARDELL Monitor is designed to measure temperature to aid in the assessment of thermoregulation NOTE For temperature monitoring a YSI temperature probe and Adapter are required To take a Temperature measurement 1 Consult proper procedure for application of the probe to the patient 2 Connect the probe to the Tempe
124. le to use the right lateral sternal or dorsal recumbent positions That is not a problem in anesthetized patients but it may be difficult to get large dogs to cooperate for proper positioning If the dog is in a sitting position place the front paw on the operator s knee and take measurements from the metacarpus Sites for cuff placement are the metacarpus metatarsus and anterior tibial In anesthetized patients most surgeries are done on the posterior part of the body so the metacarpal area of the forelimb is most convenient In situations where this is not possible the cuff should be wrapped around the metatarsus just proximal to the tarsal pad or around the hind leg just distal to the hock The tail site should not be used for cuff placement during anesthesia If the hair over the artery site is too thick or matted for good contact it should be clipped Figure 7 Dog Cuff Placement NOTE Use metacarpus or metatarsus To achieve the most accurate readings it is important to keep the cuff on a horizontal plane with the heart 21 02 0186 REV 08 07 11 55 Of Contents CARDELL Veterinary Monitors LARGER ANIMALS A large animal such as a horse should be in a stock standing still or lying down For horses and cows the cuff can be wrapped around the base of the tail using the coccygeal artery on the ventral surface WARNING When monitoring over an extended perio
125. lified biomedical engineering personnel before using with patients Serious injury or death could result if the leakage current exceeds applicable standards SITE REQUIREMENTS For safety reasons all connectors for patient cables and sensor leads are designed to prevent inadvertent disconnection should someone pull on them Do not route cables in a way that they may present a stumbling hazard For devices installed above the patient adequate precautions must be taken to prevent them from dropping on the patient 21 02 0186 REV 08 07 11 39 Of Contents CARDELL Veterinary Monitors CAUTION Before each use make sure that the monitor default alarm settings are appropriate for the specific patient being monitored Pressing the front panel keyswitch with a sharp or pointed instrument may permanently damage the keyswitch Press the keyswitch using only your finger Even though the ECG patient circuit is electrically isolated it has not been designed for direct application on a patient s heart A calibration check is recommended once every year As with any non invasive oscillometric blood pressure monitor the accuracy of the measurements obtained may be adversely affected by the presence of agents which alter the patient s cardiovascular system Do not alter the monitor s air hose CAS Medical Systems cannot ensure proper monitor performance if the tubing is altered Modificati
126. lobin saturation by measuring the absorption of red and infrared light passing through the tissue Changes in absorption caused by pulsations of blood are used to determine Arterial Saturation SpO2 and Pulse Rate PR WARNING Use only Nellcor amp VetSat veterinary oxygen transducer sensor and clips Use of other oxygen transducers may cause improper oximeter performance Monitors equipped with Nellcor oximetry will have the Nellcor OxiMax logo next to the connector For more information refer to the Directions for Use pamphlet included with each Nellcor VetSat sensor INSTRUCTIONS FOR USE NOTE Reusable sensors may be used on the same site for a maximum of four 4 hours provided the site is inspected routinely to ensure skin integrity and correct positioning Because individual skin condition affects the ability of the skin to tolerate sensor placement it may be necessary to change the sensor site more frequently with some patients 1 Select a sensor and clip that is appropriate for the patient There are two 2 sizes of VetSat veterinary sensor clips model VSC S small and model VSC L large 2 Clean the VetSat sensor and sensor clip separately before and after each use Refer to Page 139 CLEANING for more information 3 Open the clip by pressing with the thumb and forefinger 4 Slide one of the sensor s alignment buttons along the clip slot until the sensor pad is fully engaged in the clip
127. lood pressure function and immediately deflates the cuff NIBP OPTION MENU Press and hold for two 2 seconds to activate FREEZE PRINT MAIN FREEZE When pressed while viewing the Main display screen will freeze the traces The message Traces Frozen appears at the top of the Main Display screen While frozen the numerics continue to update Press again to un freeze Traces will remain frozen for sixty 60 seconds if no pushbutton is pressed or if the user enters one of the menu selections PRINT Press and hold for two 2 seconds to print Waveforms History or Alarm History information MAIN When pressed while in a sub menu returns to the Main display screen PARAMETERS Allows the user to setup and configure how the Parameters being monitored are viewed on the display Refer to Page 96 PARAMETERS MENU for more information 21 02 0186 REV 08 07 11 83 Of Contents CARDELL Veterinary Monitors ALARM LIMITS Allows the user to enter set save and restore the monitor s Alarm Limits Refer to Page 106 PATIENT ALARMS for more information HISTORY Allows the user to review stored patient readings Refer to Page 100 HISTORY for more information AUDIO VISUAL Allows the user to setup and configure the Audio and Visual parameters being monitored Refer to Page 99 AUDIO VISUAL MENU for more information ARROW UP Allows forward Adjustment Aut
128. mbly to the Interface Cable a Place the plastic hinged cover in the unlocked position perpendicular to the connector b Connect the sensor assembly to the Interface Cable Lock the plastic hinged cover to prevent accidental cable disconnection Figure 10 Sensor to Interface Cable 9 Plug the Interface Cable into the SpO connector on the side panel of the monitor The connector is shaped like a D Line up the D on the Interface Cable with the D on the receptacle Push the cable in until you hear an audible click 10 Press the ON STANDBY pushbutton to turn ON the monitor 11 Verify that the sensor is properly positioned by observing at least ten seconds of a continuous pleth waveform being displayed across the screen When a valid signal is detected the monitor displays the 5 and Pulse Rate values Should the perfusion light be at a low level reposition the sensor or try a different sensor If normal operation cannot be achieved call a Midmark representative for assistance 12 If required refer to Page 96 PARAMETERS MENU and configure the appropriate waveform s to be viewed and printed 13 Check the Alarm Limits and configure them appropriately for the patient Refer to Page 108 ALARM LIMIT VALUES for more information 14 If an audio is required based on the SpO2 configure the Beep Source to SpO2 in the Audio Visual menu and adjust the Beep Volume to the desired level
129. n 10 second delay The alarm for SpOz has a zero 0 second or SatSeconds delay The alarm for Pulse Rate will have a zero 0 second or ten 10 second delay when taken from the SpO signal no SAVING MENU SELECTIONS The CARDELL Monitor can save menu selections from the NIBP Parameters Limits and Audio Visual menus into two independent memory locations Vet 1 or Vet 2 To save menu selections to non volatile memory 1 Enter the NIBP Parameters Limits or Audio Visual menus 2 Press the ARROW DOWN pushbutton and highlight Save 3 Press one of the NEXT programmed pushbutton keys to advance onto the parameter value to change No 4 Press either the ARROW UP or ARROW DOWN pushbutton and select a memory location to save Vet 1 21 02 0186 REV 08 07 11 108 Of Contents CARDELL Veterinary Monitors 5 Press one of the PREVIOUS programmed pushbutton keys the message Saving appears briefly as a status indicator and the current values will be saved in memory Verify the asterisk is no longer being displayed in the Equipment Message Window When finished press the MAIN C pushbutton to exit and return to the Main display screen or after thirty 30 seconds of button inactivity the monitor will automatically return to the Main display screen The menu selections will be retained in memory even after the 5 power is turned OFF If a second
130. n the monitor to the STAT mode The user will then be allowed to exit the STAT mode OFF or change the NIBP Cycle to Manual WARNING When monitoring blood pressure over an extended period of time or at frequent intervals 1 cycle per minute periodically check the patient s limb to make sure that the circulation is not impaired beyond the measurement site BLOOD PRESSURE REFERENCE VALUES Which Blood Pressure is Normal in Dogs or Cats It is essential to know the reference range of blood pressure in a given species in order to properly evaluate the animal s blood pressure and detect hypertension or hypotension When using different measurement techniques oscillometry or direct blood pressure measurements one must also remember that methodological factors influence results Therefore technique specific reference values should be known Species specific breed specific and individual differences in normal blood pressure ranges can be observed The most accurate assessments are made by comparing different blood pressure readings over time using serial measurements made at regular intervals at least once yearly This makes it possible to detect the initial signs of related disease e g cardiovascular and renal disease more sensitively and at an earlier stage The normal values for dogs and cats are not identical FELINE NORMAL VALUES The blood pressure values for cats are not breed specific However the most sensitive way
131. nd pain Stroking the animal before and during the measurement or having the animal held by an assistant may be helpful Since fear and anxiety may affect the blood pressure it is advisable to take at least three measurements to allow the animal to relax Taking five measurements will allow you to discard the upper and lower values and average the middle three 4 Press the START CANCEL pushbutton to begin a measurement For the first measurement the monitor will inflate to the default setting or the Initial Inflation Pressure selected Within the monitor s front panel NIBP Numeric Area the NIBP numeric displays Systolic Diastolic and MAP or Pulse Rate lt will indicate all dashes while the measurement is in progress and the Inflation Pressure will be displayed in the format Meas XXX where XXX is the pressure value NOTE The selection between MAP or Pulse Rate is made the NIBP menu For subsequent measurements the monitor will inflate approximately 30 mmHg higher than the previously determined Systolic pressure The measurement typically takes less than 30 seconds to complete In no case will the cuff remain pressurized for more than 150 seconds When the measurement is completed the cuff will automatically deflate the monitor will provide an audio indication and display the NIBP values Systolic Diastolic and MAP or Systolic Diastolic and Pulse Rate lt Press th
132. nds NOTE If SpOz is selected as a waveform parameter the message appears in the waveform section of the display If SpO is not selected as a waveform parameter the message appears in the equipment message window section of the display 21 02 0186 REV 08 07 11 119 Of Contents CARDELL Veterinary Monitors To acknowledge the alarm press the SILENCE RESET pushbutton The monitor silences the audible and visual alarms but the message Chk SpO Probe remains on the display If the 5 Module located inside the CARDELL Monitor should fail the message SpO Error or SpO Module is displayed The 96SpO and Pulse Rate numeric displays will show dashes the Equipment Alarm LEDs are flashing and three 3 audio beeps are heard every twenty five 25 seconds NOTE If SpOs is selected as a waveform parameter the message appears in the waveform section of the display If SpO is not selected as a waveform parameter the message appears in the equipment message window section of the display To acknowledge the alarm press the SILENCE RESET pushbutton The monitor silences the audible and visual alarms but the message SpO Error or SpO Module remains on the display Should any of the above problems persist contact CAS Medical Systems Inc CO USER MESSAGES If the accuracy of any measurement does not seem reasonable first chec
133. nfigured to be either zero 0 seconds no delay or ten 10 seconds The default value used by the CARDELL Monitor is ten 10 seconds To change the monitor s SpO Pulse Rate Alarm Delay Time follow the following procedure 1 First enter the monitor s Setup menu Refer to Page 90 SETUP MENU 2 Press the ARROW DOWN pushbutton until the parameter O Alarm Delay is highlighted 3 Press one of the NEXT programmed pushbutton keys until the cursor displays the parameter currently being used 4 Press either the ARROW UP or ARROW DOWN pushbutton to make a selection 5 Press one of the PREVIOUS programmed pushbutton keys to return back to the parameter selections column 6 Press the ARROW DOWN pushbutton to continue to the next parameter or press the MAIN G pushbutton to exit to the Main display screen 21 02 0186 REV 08 07 11 94 Of Contents CARDELL Veterinary Monitors SELECTING THE TEMPERATURE UNITS The Cardell Monitor can display Temperature readings in either the Celsius C or Fahrenheit F scales The default value used by the Cardell Monitor is Fahrenheit F To configure the monitor s Temperature setting follow the following procedure 1 First enter the monitor s Setup menu Refer to Page 90 SETUP MENU 2 Press the ARROW DOWN pushbutton until the parameter TEMP Units is highlighted 3 Press one of the NEXT programmed pushbutton keys until the cursor displays the
134. nger The probe is no longer in contact with the receiving a patient signal patient from the SpO probe Check the probe site 21 02 0186 REV 08 07 11 126 Of Contents MONITOR MESSAGES cont CO MONITOR MESSAGE CARDELL Veterinary Monitors Table 14 Monitor Messages POSSIBLE CAUSE POSSIBLE SOLUTION Blocked Line Cal Chk Flow Clearing Line Module OFF Service CO The module has attempted to purge the line with no success The module s calibration timer has reached zero hours The module has detected a blockage in the exhaust port The module has detected an occlusion in its input and is attempting to purge the line A communication failure has occurred with the monitors Board An electronic failure has occurred within the monitors Board The monitor is no longer receiving a patient signal from the consumable The module s service timer has reached zero hours Disconnect the consumable Check the consumable tube for kinks and or blockages Replace the consumable Perform a calibration check Refer to Page 146 CALIBRATION CHECK Check the exhaust port and tubing for kinks and or blockages Check the consumable tube for kinks and or blockages Turn the monitor Off disconnect the
135. nt measurement taken The word Newest Entry will be displayed briefly at the top of the display indicating you have reached the most current reading 21 02 0186 REV 08 07 11 102 Of Contents CARDELL Veterinary Monitors When completed press the MAIN G pushbutton to exit and return to the Main display screen or after thirty 30 seconds of button inactivity the monitor will automatically return to the Main display screen If a NIBP measurement is desired immediately while in either of the History menus simply press the START CANCEL pushbutton This will exit the History menu and begin a measurement NOTE A continuously updating Trend History menu History or a menu of NIBP event readings NIBP History can be chosen in the Parameters Setup menu as Trace 3 NOTE Turning the power OFF does not clear the History memory Measurements will remain in memory for up to twenty four 24 hours Any measurement older than twenty four hours is deleted It is suggested to manually clear History between patients Refer to ERASING TREND HISTORY on Page 103 PRINTING TREND HISTORY To Print the Patient History data to the printer 1 Press the HISTORY pushbutton to enter the Patient History menu 2 Press and hold the PRINT pushbutton for two 2 seconds The message Printing appears at the bottom of the Display Window as a status indicator NOTE Prior to accessing th
136. ntered select a trace to view using the ARROW UP or ARROW DOWN pushbutton The trace data is displayed at 3 mm Sec and will remain on the display for 30 seconds before blanking out 8 Check the alarm limits and configure them appropriately for the patient Refer to Page 108 ALARM LIMIT VALUES Consumables Endotracheal Dead Space With Tube Adapter Tube Bore FilterLine Set Regular orange gt 4 5 lt 7 3 FilterLine Set Regular yellow 24 5mm 7 3 cc FilterLine H Set Exotic yellow 4 0 mm 0 5 cc Table 6 Specifications for Intubated Consumables Airway Adapters NOTE For more information on what to consider when choosing between airway adapters refer to Page 171 Dead Space Cause Effect amp Control in Small Animal Anesthesia by Dr Robert Stein founder of the Veterinary Anesthesia Support Group www VASG org 21 02 0186 REV 08 07 11 72 Of Contents CARDELL Veterinary Monitors REMOVING THE CONSUMABLE When monitoring is not required disconnect the consumable by carefully removing the connector from the input receptacle NOTE To avoid damage to the consumable always hold it by the connector rather than the tubing when connecting or disconnecting either end When the consumable is disconnected from the monitor the message CO2 OFF is displayed the Equipment A
137. o Cycle History Inflation Pressure Limits and Monitor Setup Menus Press to cycle through menu selections or press and hold for quicker advance ARROW DOWN Allows backwards Adjustment Auto Cycle History Inflation Pressure Limits and Monitor Setup Menus Press to cycle through menu selections or press and hold for quicker advance 21 02 0186 REV 08 07 11 84 Of Contents CARDELL Veterinary Monitors NEXT The HISTORY and AUDIO VISUAL pushbutton keys have been programmed to allow the user to advance horizontally to the next parameter selection in the menus PREVIOUS The PARAMETERS and ALARM LIMITS pushbutton keys have been programmed to allow the user to advance horizontally backwards to the previous parameter selection in the menus INFRARED Ir DATA PORT An Infrared output port located on the bottom panel of the monitor s front cover is available to print Waveforms History and Alarm data to the optional external printer or other data collection device s Maximum distance is approximately three 3 Feet direct line of sight operation 21 02 0186 REV 08 07 11 85 Of Contents CARDELL Veterinary Monitors REAR PANEL Figure 20 Rear Panel View Battery Compartment Equipotentiality External Device Interface Ground Post 100 240 5A 50 60Hz FUSE TI25AL280V r CA
138. of the alarm HR MN are highlighted on the front panel display screen 4 Press the ARROW DOWN pushbutton to review preceding alarms The word Oldest Entry will be displayed briefly at the top of the display indicating there are no more readings remaining for review 5 Press the ARROW UP pushbutton to advance towards the most current alarm The word Newest Entry will be displayed briefly at the top of the display indicating you have reached the most current reading When completed press the MAIN pushbutton to exit and return to the Main display screen or after thirty 30 seconds of button inactivity the monitor will automatically return to the Main display screen If a measurement is desired immediately while in either of the History menus simply press the START CANCEL pushbutton This will exit the History menu and begin a measurement NOTE Turning the power OFF does not clear the Alarm History memory Alarms will remain in memory for up to twenty four 24 hours Any alarm older than twenty four hours is deleted It is suggested to manually clear Alarm History between patients Refer to ERASING ALARM HISTORY on Page 105 21 02 0186 REV 08 07 11 104 Of Contents CARDELL Veterinary Monitors PRINTING ALARM HISTORY To Print the Alarm History data to the printer 1 Press the HISTORY pushbutton to enter the Patient History menu 2 Press and hold the HISTORY pu
139. on of the air hose will void the warranty Avoid compression or restriction of pressure tubes If the cuff is applied on a limb being used for oxygen saturation monitoring SpO gt results will be altered during each blood pressure measurement due to the occlusion of blood flow Inspect the monitor air hose and sensors for any damage prior to operation If any damage is noted the monitor should not be used until it has been serviced The monitor should be repaired only by personnel authorized to do so by CAS Medical Systems Inc Use only CAS Medical Systems approved accessories and sensors to preserve the integrity accuracy and the electromagnetic compatibility of the monitor Consult a physician for interpretation of blood pressure measurements The oximeter is factory calibrated to determine the percentage of arterial oxygen saturation of functional hemoglobin Significant levels of dysfunctional hemoglobins such as carboxyhemoglobin or methemoglobin may affect the accuracy of the measurement Cardiogreen and other intravascular dyes depending on the concentration may affect the accuracy of the oximeter measurement 21 02 0186 REV 08 07 11 40 Of Contents CARDELL Veterinary Monitors CAUTION Some sensors may not be appropriate for a particular patient If at least ten seconds of one bar pulses cannot be observed for a given sensor change sensor location or sensor type un
140. ontinues uninterrupted for the 15 seconds the audio alarm is reactivated SpO PULSE RATE ALARMS During either a Low or High SpO Pulse Rate Alarm Limit Violation the monitor flashes the 5 Pulse Rate PR numeric display and the Patient Alarm LEDs provides a Patient Alarm Limit Violation audible tone and flashes the appropriate message Low PR or High SpO PR in the Alarm Window section of the display To acknowledge the alarm and temporarily mute the audio press the SILENCE RESET pushbutton NOTE For Pulse Rate alarms to be enabled ECG parameter must be in LEADS OFF condition The monitor silences the audible tone for a maximum of fifteen 15 seconds the parameter in alarm and Patient Alarm LEDs continue to flash on the front panel and the appropriate message will be displayed in the Patient Alarm Message Window section of the display If the current patient alarm condition becomes inactive during the 15 seconds and then recurs OR a different patient alarm condition occurs during the 15 seconds the audio alarm is reactivated If the alarm condition continues uninterrupted for the 15 seconds the audio alarm is reactivated EtCO ALARMS During either a Low or High End Tidal Alarm Limit Violation the monitor flashes the numeric display and the Patient Alarm LEDs provides a Patient Alarm Limit Violation audible tone and flashes the appropriate message Low or High
141. or and unplug the wall charger cord 3 Open the battery door by pressing in on the battery cover and pushing upward Figure 33 Opening the Battery Door 4 Remove the battery cover 5 Remove the battery pack from the compartment and disconnect its connecting cable 21 02 0186 REV 08 07 11 135 Of Contents CARDELL Veterinary Monitors INSTALLING A NEW BATTERY PACK 1 Connect the battery cable into the battery connector 2 Insert the battery and its connecting cable into the battery compartment Figure 34 Installing the New Battery 3 Replace the battery cover by sliding it in from the back of the printer and pushing down to lock it in place CAUTION Be sure to place the battery cover firmly in its position after installing the new battery pack WARNING Do not disassemble the battery pack or batteries The batteries contain electrolytes which can cause injury to eyes skin and clothing NOTE This product contains a rechargeable battery that is recyclable Under various state and local laws it may be illegal to dispose of this battery into the municipal waste stream Check with your local authorities for instructions on recycling options in your area 21 02 0186 REV 08 07 11 136 Of Contents CARDELL Veterinary Monitors PRINTING TO A COMPUTER The CARDELL Monitor uses the 9 Pin connector to in
142. or in ensuring the monitor s continuing accurate and reliable performance The next section of this manual details how the user can perform preventative maintenance and testing Alternatively the following program is offered by CAS Medical Systems and it is recommended that it be performed every two 2 years following the warranty period CUSTOMER CARE PLAN Flat rate list price Preventative maintenance includes the following Visual inspection of unit inside and out Update hardware and software as required through ECN changes Battery Replacement Calibration and or adjustments to monitor All Accessories sent in are evaluated Pneumatic Check ECG and Respiration Functional Check 5 Functional Check Calibration and Checks 10 Pressure Calibration Check 11 Temperature Calibration Check 12 Monitor Safety Leakage Check Hi Pot Test 13 Update labeling where needed 14 Final Factory Test Procedure using Auto test station 15 Cleaning 16 QA Inspection 17 One new large adult cuff Or one VET cuff which ever applies See ASS Parts replaced if needed at no additional charge Parts replacements to be determined by repair technician 1 Front panel key switch 2 Front housing 3 Rear housing Any circuit boards which need to be replaced due to malfunction will have an additional charge on the PM Price Customers will be provided with an estimate prior to repairs PM Price also does not ap
143. or should fail the message NIBP Error or NIBP Module is displayed the NIBP and MAP numeric displays will show dashes the Equipment Alarm LEDs are flashing and three 3 audio beeps are heard every twenty five 25 seconds To acknowledge the alarm press the SILENCE RESET pushbutton The monitor silences the audible and visual alarms but the message NIBP Error or Module remains on the display Should the above problems persist contact CAS Medical Systems Inc 21 02 0186 REV 08 07 11 121 Of Contents CARDELL Veterinary Monitors MONITOR MESSAGES MONITOR Table 10 Monitor Messages MONITOR POSSIBLE CAUSE POSSIBLE SOLUTION MESSAGE Clock Battery The monitor s internal Contact CAS Medical Systems to have the clock battery is almost monitor serviced discharged Dead Battery The battery is fully Recharge the battery for at least 5 hours discharged Low Battery The battery is almost At least 30 minutes of operation is discharged available from when the message first appears Recharge the battery as soon as possible System Error An electronic failure has Contact CAS Medical Systems to have the occurred within the monitor serviced monitors Main Board Power Failure Power was disconnected Press the SILENCE RESET pushbutton to from the monitor clear the message OR Turn the monitor Off then back On to clear the
144. ot possible leads should be attached to the body where they will be least subject to movement and away from the surgical site It is preferable to view an upright QRS complex for monitoring ECG A heart base to apex lead arrangement will be best if the negative lead is placed at the base point of right shoulder at thoracic inlet and the positive lead at the apex low on caudal left thorax Standard right forelimb lead is negative and standard left hind leg is positive in lead two so if these leads are properly placed and the machine is set to Lead an upright complex should be the result POSITIONING CONSCIOUS PATIENTS Standard position for recording diagnostic in dogs is right lateral recumbency Diagnostic tracings can be obtained in cats in either right lateral or sternal position Limbs should be perpendicular to the spine and parallel with their opposite member In awake cats and dogs it is best to have the patient held by a veterinary technician or veterinary assistant One lead should be applied first to determine comfort level and adjustment made as needed Then the other clamps can be placed in position It is important that the patient be kept still A moving patient may cause clips to saw into skin tissue leading to discomfort and change in position of electrodes LEAD ATTACHMENT 3 Lead Leads should be attached just below the elbow on the front leg and just above the stifle on the hind leg The following lead sequence sh
145. ould be applied for a 3 lead system Right Foreleg RA white Left Foreleg LA black Left Hind Leg LL red Refer to Figure 2 and Table 2 for more information 21 02 0186 REV 08 07 11 45 Of Contents CARDELL Veterinary Monitors Figure 2 3 Lead Placement NOTE In order to pick up ECG and Respiration signals the leads must not be placed on the animal s legs but on the left and right chest areas Table 2 3 Lead Color and Coding USA Standard International Standard LA black Left Foreleg L yellow Left Foreleg RA white Right Foreleg red Right Foreleg LL red Left Hind Leg F green Left Hind Leg 5 Lead For a 5 lead system four limb leads can be applied RA LA RL and LL with the exploring lead brown used for diagnostic purposes as needed Otherwise the exploring lead may be left unplugged Refer to Figure and Table for more information NOTE Do not use the 5 Lead Patient Cable for 3 Lead monitoring A Leads OFF message will be displayed Refer to Section 14 ACCESSORIES for the 3 Lead Patient Cable part number information 21 02 0186 REV 08 07 11 46 Of Contents CARDELL Veterinary Monitors Figure 3 5 Lead Placement Table 3 5 Lead Color and Coding USA Standard International Standard LA black Left Foreleg L
146. ously measuring the amount of during every breath the amount of CO present at the end of exhalation EtCO2 and during inhalation and the Respiratory Rate RR These parameters are useful to assess a patient s ventilatory status End Tidal and respiratory rate numeric values are available for display When selected as a waveform parameter a CO waveform is also available for display When selected on the display as a numeric parameter on each exhaled breath a visual indicator provides a breath by breath indication of the patient s breathing The Temperature parameter TEMP is intended to measure temperature using an attachable probe The temperature value displayed can be viewed in either Fahrenheit or Celsius 21 02 0186 REV 08 07 11 26 Of Contents CARDELL Veterinary Monitors PATIENT ENVIRONMENT The CARDELL Monitor has been tested with specific parts of the system used within the Patient Environment Figure 1 defines the Patient Environment Figure 1 Patient Environment PILLE Ed The parts of the CARDELL Monitor system that can be used in the Patient Environment are defined as Table 1 Parts of the System The CARDELL Monitor Appropriate Accessories listed in the ACCESSORIES section of this User s Manual Line Cord Citizen CMP 10 Mobile Printer RS232 Interconnect Cable supplied with printer AC Adapter Charger Model TRC 09 1100 M
147. ply to units and accessories that have been misused or damaged Note Pricing can change without notice 21 02 0186 REV 08 07 11 143 Of Contents CARDELL Veterinary Monitors SERVICE MENU WARNING Do not enter the Service menu while the monitor is connected to a patient The patient is not being monitored while in the menu The 5 Service menu allows the user to perform basic preventative maintenance and testing to the CARDELL Monitor Once entered the user can Perform a IrDA Print Test Perform a CO Calibration Check e Perform a Calibration Verify the monitor s last Calibration Date Review the CO module s Serial Number View the hours remaining until the module will require Service This value is set to 20 000 at the time the module is manufactured by Oridion View the hours remaining until the CO module will require Calibration This value is initially set to 1 200 at the time the module is manufactured by Oridion Perform NIBP System Checks Manometer Mode Overpressure Test Pneumatic Leak Test Plug Tube e Verify the monitor s operating power supply voltage level Review the monitor s operating and internal modules software levels ENTERING THE SERVICE MENU To enter the monitor s Service menu press and hold the PARAMETERS and HISTORY WS pushbutton keys while the monitor is being
148. quency of the transmitter where P is the maximum output power rating of the transmitter in watts according to the transmitter manufacturer NOTE 1 At 80 MHz and 800 MHZ the separation distance 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 02 0186 REV 08 07 11 12 Of Contents WARRANTY POLICY MONITORS CAS Medical Systems Inc warrants the monitor when new to be free from defects in material and workmanship and to perform in accordance with manufacturer s specifications for a period of two 2 years from the date of original purchase from CAS or its authorized distributors or agents except as noted below The same warranty conditions are made for a period of one 1 year with respect to printer and battery and six 6 months on non disposable accessories and certain components consisting of reusable SpO sensors and other accessories provided by CAS as part of the original purchase CAS warrants blood pressure cuffs and disposable or single patient use products for out of box failure only Where the accessory is not a CAS manufactured product the manufacturer s own warranty conditions apply CAS reserves the right to perform warranty service operations in its own factory at an authorized repair facility or at the customers site
149. r NIBP Options DISPLAY AREAS The Main display area of the CARDELL Monitor can be broken down into seven 7 sections of information They are MAIN DISPLAY AREA Figure 14 Main Display Area 21 02 0186 REV 08 07 11 77 Of Contents CARDELL Veterinary Monitors During normal operation this section Refer to Figure 14 on the previous page displays the traces that have been selected in the Parameters menu Up to three 3 traces can be selected The traces are displayed in an erase bar format The CARDELL Monitor automatically selects as Trace 1 an ECG waveform trace Included with the ECG trace is the ECG Gain selection This section is also used to display when selected the Audio Visual History Limits Parameters Service and Setup menus TIME BATTERY AND NUMERIC STATUS Figure 15 Time Battery and Numeric Status This section contains the current monitor time and Battery Charge Status icon In the models 9403 and 9405 this section displays the numeric values and flashing visual icons for the Heart Rate and Respiration Rate when enabled In the model 9404 this section displays the numeric value and a flashing visual icon for the Heart Rate Also displayed are size markers for both the ECG and Respiration waveforms The size marker for ECG represents a QRS of 1 and the size marker for Respiration represents a breath of 1 Ohm NOTE When Re
150. r the ARROW UP or ARROW DOWN pushbutton to change the parameter s value Verify an asterisk appears in the Equipment Message Window Vet1 SmCuff as an indicator that a parameter value has been changed 4 Press one of the PREVIOUS programmed pushbutton keys to return back to the parameter selections column 5 Press either the ARROW UP or ARROW DOWN pushbutton to select the next parameter limit to change 21 02 0186 REV 08 07 11 107 Of Contents CARDELL Veterinary Monitors When finished press the MAIN G pushbutton to exit and return to the Main display screen or after thirty 30 seconds of button inactivity the monitor will automatically return to the Main display screen The alarm value s set will now be used until power is turned OFF ALARM LIMIT VALUES Table 8 lists the Alarm Limit Default Values used by the CARDELL Monitor Table 8 Factory Default Alarm Values Parameter Limits Low High Heart Rate HR 60 180 SpO2 5 2 90 SatSeconds SatSeconds OFF N A EtCO2 EtCO2 20 70 FiCO2 FiCO2 N A 10 Respiration Rate RR 5 90 No Respiration No RESP 20 N A Systolic SYS 80 150 Diastolic DIA 40 100 Mean Arterial MAP 70 140 Patient alarms for Systolic Diastolic and MAP values are produced at the time the measurement is taken Alarms for Heart Rate have a five 5 second delay Alarms for EtCO have a te
151. rature Adapter Connect the Adapter to the TEMP connector on the side panel of the monitor 3 Press the ON STANDBY pushbutton to turn ON the monitor 4 Check that the monitor is accurately measuring temperature When the value has been determined it will be displayed on the front panel as F or C 5 Configure the appropriate temperature scale F or C Refer to Page 95 SELECTING THE TEMPERATURE UNITS NOTE When the Temperature value being measured is greater than 43 109 4 F the TEMP numeric value will be displayed as gt gt gt gt gt indicating a value above the monitors temperature range NOTE When no Temperature probe is connected the TEMP numeric display will be blank Refer to Section 14 ACCESSORIES for Temperature probe types and part number information Consult instructions enclosed with the sensor for proper application 21 02 0186 REV 08 07 11 75 Table Of Contents CARDELL Veterinary Monitors This page is intentionally left blank 21 02 0186 REV 08 07 11 76 Table Of Contents CARDELL Veterinary Monitors 10 MONITOR OPERATION FRONT PANEL Figure 13 Front Panel View CARDELL Veterinary Monitor 9405 mmHg Manual e 3 140 88 25 D Vet1 SmCuff Bradycardia On Standby Silence Reset NIBP Start 9 Press amp Hold fo
152. re Do not expose the CARDELL Monitor to extreme moisture levels such as direct exposure to rain Exposure to extreme moisture levels may cause incorrect or inaccurate performance or device failure during or after exposure AUTOMATIC SAFETY FEATURES The monitor has been designed for patient safety The maximum amount of time allowed to complete a blood pressure measurement is 150 seconds If the measurement has not been completed within that time the cuff is deflated automatically and a message is displayed indicating the problem To prevent exposure of the extremity to an inordinately high pressure the cuff is deflated automatically when the pressure in the system is greater than 290 mmHg The cuffs used by the CARDELL Monitor are designed without transducers for patient safety The transducers used for NIBP measurement are located inside the monitor on the NIBP board and are isolated from the patient In the event of a microprocessor failure the cuff will be deflated automatically within ten 10 seconds All equipment parts are protected against the effects of the discharge of a defibrillator No separate actions are required when using this equipment with a defibrillator 21 02 0186 REV 08 07 11 42 Of Contents CARDELL Veterinary Monitors Should the AC wall power be interrupted coming into the monitor the monitor automatically runs off battery power An indication of this woul
153. res to the ECG patient cable matching the colored end of the leadwire to the corresponding color on the cable 3 Connect the round end of the ECG patient cable to the ECG RESP connector on the side panel of the monitor 4 Press the ON STANDBY pushbutton to turn ON the monitor 5 Check that the monitor is accurately detecting the heartbeat and respiration by watching the monitor to see that the heart and lung visual indicators flash with each heartbeat and breath When the values have been determined they will be displayed on the front panel respective as heart rate HR and respiration rate RR 6 If the heart and lung visual indicators do not correspond to the patient s heart rate and or respiration reposition the electrode clips until the indicators flash in synch with the patient s heartbeat and breathing This will help to minimize false alarms NOTE Respiration monitoring by default is set to OFF Should Respiration monitoring be required the feature can be turned ON Refer to 96 PARAMETERS MENU for the menu selection 7 If required refer to Page 96 PARAMETERS MENU and configure the appropriate waveform s to be viewed and printed 8 Check the alarm limits and configure them appropriately for the patient Refer to Page 108 ALARM LIMIT VALUES FREEZE TRACES While viewing the Main display screen the user can select to freeze the traces Press the FREEZE PRINT MAIN pushbutton The mes
154. ristic Specification Storage Transport Temperature 20 C to 65 C 4 F to 149 F Humidity 15 95 non condensing Altitude 10 000 to 1 250 ft 700 1050 hPa PHYSICAL DIMENSIONS amp WEIGHT Characteristic Specification Base Unit HxWxD 6 75 in x 8 5 in x 4 0 in 17 x 21 5 cm x 10 2 cm Weight 4 1 lbs approx 1 4 kg SERIAL INTERFACE Characteristic Specification Interface Bidirectional serial communication Speed 9600 for Printer 115200 for CAS Serial Protocol Signal Level RS232C Data Length 8 bits Start Bit 1 bit Stop Bit 1 bit Parity None Flow Control None 21 02 0186 REV 08 07 11 168 Of Contents CARDELL Veterinary Monitors STANDARDS Units comply with the following requirements IEC 60601 1 EN 60601 1 2 IEC 60601 2 30 EN 60601 2 49 EN 865 UL Classified UL 2601 1 CAN CSA C22 2 No 601 1 If so marked CARDELLO is a registered trademark of Midmark CASMED MAXIIE r i cutie Safe Cuff SoftCheck UltraCheck and FOR WHAT S VITAL are registered trademarks of CAS Medical Systems Inc Microstream and FilterLine are registered trademarks of Oridion Medical 1987 LTD Nellcor VetSat and OxiMax are registered trademarks of Mallinckrodt Inc SatSeconds is a trademark of Mallinck
155. rodt Inc Velcro is a registered trademark of Velcro USA Inc YSI is a registered trademark of Yellow Springs Instrument Company All units covered by U S patent 4 796 184 and 5 022 403 Other patents pending Monitors are if so marked 21 02 0186 REV 08 07 11 169 Table Of Contents CARDELL Veterinary Monitors This page is intentionally left blank 21 02 0186 REV 08 07 11 170 Of Contents CARDELL Veterinary Monitors 16 APPENDIX DEAD SPACE Cause Effect amp Control in Small Animal Anesthesia Robert M Stein D V M DAAPM Founder www VASG org Dead space is an often misunderstood and overlooked aspect of veterinary anesthesia patient management Dead space is always present as a component of the patient s airway and to a variable degree as a component of the anesthetic system Ignoring the harmful consequences of system dead space can lead to potentially fatal patient outcomes This is especially worrisome when managing small patients There are three different types of dead space anatomic alveolar and mechanical equipment Dead space ventilation involves that component of the respiratory gases that does not participate in gas exchange Simply said there is no patient benefit from dead space ventilation If mechanical dead space volume equals or exceeds alveolar ventilation volume the patient will not be able to clear car
156. s the MAIN C2 pushbutton to exit to the Main display screen 21 02 0186 REV 08 07 11 91 Of Contents CARDELL Veterinary Monitors 2 MINUTE AUDIO ALARM SILENCE When the monitor is configured for the 2 Minute Audio Alarm Silence setting use the SILENCE RESET pushbutton to enable or disable audio alarms for a two 2 minute period The SILENCE visual bell indicator located on the front panel of the monitor will be illuminated constantly and the message 2 Minute will be displayed in the Equipment Message Window section of the display as a reminder when enabled At the end of two 2 minutes the monitor will automatically exit the 2 Minute Audio Alarm Silence period and return to normal operation During a 2 Minute Audio Alarm Silence period if an alarm patient or equipment occurs except for Low Battery and Dead Battery the audio alarm remains silenced for the remainder of the two minutes and only a visual indicator is provided PERMANENT AUDIO ALARM SILENCE When the monitor is configured to the Permanent Audio Alarm Silence setting use the SILENCE RESET pushbutton to enable or disable audio alarms The SILENCE visual bell indicator located on the front panel of the monitor will flash at a rate of one 1 second ON and one 1 second OFF and the message Permanent is displayed in the Equipment Message Window section of the display as a reminder when enabled
157. sage Traces Frozen appears at the top of the Main Display screen While frozen the numerics continue to update Press again to un freeze Traces will remain frozen for sixty 60 seconds if no pushbutton is pressed or if the user enters one of the menu selections 21 02 0186 REV 08 07 11 48 Of Contents CARDELL Veterinary Monitors RESPIRATION MONITORING NOTE The Respiration parameter in the CARDELL monitor by default is set to OFF Should Respiration monitoring be required the feature can be turned ON Refer to Page 96 PARAMETERS MENU for the menu selection The CARDELL Monitor determines respiration by impedance pneumography Patient respiration is achieved by applying a low voltage high frequency AC signal across the active left and right chest ECG leads LA and RA The monitor detects changes in thoracic impedance that occur as a result in chest movements Impedance normally increases with inspiration and decreases with expiration Electrode placement is crucial to monitoring respiration by the impedance method The sensitivity of the monitor and its ability to accurately detect respiration is greatly enhanced or impeded by the quality of the electrodes and electrode placement The following is a general procedure for respiratory monitoring 1 Check the skin area where the electrodes are to be placed 2 Observe the patient to determine where the greates
158. securely onto the connector for this test to be performed properly Enter the monitor s Service menu Refer to Page 144 SERVICE MENU Press the ARROW DOWN pushbutton until the parameter Pneumatic Test is highlighted Press one of the NEXT programmed pushbutton keys to select and start the test The monitor will inflate to approximately 160 mmHg and attempt to hold this pressure The pressure value will be displayed in the Pneumatic Test section of the Service menu This test takes about fifteen 15 seconds At the completion of a successful Pressure Check the Message Window will display Passed and the monitor will beep two 2 times Press one of the PREVIOUS programmed pushbutton keys to exit and return to the Pneumatic Test selection If the monitor fails the Pressure Check the Message Window will display Failed and the monitor will beep three 3 times Press one of the PREVIOUS programmed pushbutton keys to exit and return to the Pneumatic Test selection Should the monitor fail the 500 ml Pressure Check it is recommended the monitor be returned to CAS Medical Systems for service 21 02 0186 REV 08 07 11 151 Of Contents CARDELL Veterinary Monitors PIC VOLTAGE The CARDELL Monitor displays the dc voltage level being received by the PIC processor from the Power Supply Board NOTE The monitor must be connected to the AC Line wall outlet to view this voltage level
159. set Each time the monitor is turned a brief electronic song will play while the Power On Self Test POST is conducted to ensure that its internal circuits are functioning properly NOTE The user should use the Power On Self Test as a verification tool that all front panel visual indicators and the audio are functioning properly Upon applying power to the monitor verify the following e The monitor plays its start up song from the internal speaker e The two 2 light bars and the Alarm Silence Visual Indicator are turned ON twice for one half second and cycled one after the other e The monitor displays for three 3 seconds the current monitor start up screen The start up screen consists of the monitor s Model number and the version of its main DSP software NOTE If the printer was powered during the monitor s power up sequence the MIDMARK logo is printed Once the Power On Self Test is completed the monitor s Main display screen is ready for use Refer to the Setup and Parameters menus to configure the monitor 21 02 0186 REV 08 07 11 89 Of Contents CARDELL Veterinary Monitors SETUP MENU WARNING Do not enter the Setup menu while the monitor is connected to a patient The patient is not being monitored while in the menu The monitor s Setup menu allows the user to tailor the CARDELL Monitor to your
160. set of menu selections is required re enter one of the menus make your changes and save the set as Vet 2 RESTORE A PREVIOUSLY SAVED SET OF MENU SELECTIONS To restore a previously saved set of menu selections ex From Vet 2 to Vet 1 1 Enter the NIBP Parameters Limits or Audio Visual menus 2 Press the ARROW DOWN pushbutton and highlight Restore 3 Press one of the NEXT programmed pushbutton keys to advance onto the parameter value to change No 4 Press either the ARROW UP or ARROW DOWN pushbutton and select the appropriate memory location the monitor will use 5 Press one of the PREVIOUS programmed pushbutton keys the message Restoring appears briefly as a status indicator The restored values will be saved to memory When finished press the MAIN C pushbutton to exit and return to the Main display screen or after thirty 30 seconds of button inactivity the monitor will automatically return to the Main display screen The values will be retained in memory even after the monitor s power is turned OFF RESTORE FACTORY DEFAULTS To restore the Factory default settings 1 Enter the NIBP Parameters Limits or Audio Visual menus 2 Press the ARROW DOWN pushbutton and highlight Restore 3 Press one of the NEXT programmed pushbutton keys to advance onto the parameter value to change No 4 Press either the ARROW UP or ARROW DOWN until the message Factory appears 5 Press one of th
161. shbutton for two 2 seconds to enter the Patient Alarm History menu NOTE If no alarms have occurred the message No Alarm History is displayed at the top of the History menu and no Alarm History menu will be displayed 3 Press and hold the PRINT pushbutton for two 2 seconds The message Printing appears at the bottom of the Display Window as a status indicator NOTE Prior to accessing the Print History mode the printer should have paper installed and the power turned Refer to Section 11 EXTERNAL PRINTER for more information about the printer and sample printout of the History screen ERASING ALARM HISTORY To Erase the Alarm History data 1 Press the HISTORY pushbutton to enter the Patient History menu 2 Press and hold the HISTORY pushbutton for two 2 seconds to enter the Patient Alarm History menu NOTE If no alarms have occurred the message No Alarm History is displayed at the top of the History menu and no Alarm History menu will be displayed 3 Press one of the NEXT programmed pushbutton keys to advance onto the parameter value to change Erase 4 Press either the ARROW UP or ARROW DOWN pushbutton until the message Erase Yes appears 5 Press the HISTORY pushbutton again to erase Patient Alarm History data The monitor erases the memory exits the Alarm History screen and returns to the Patient History display screen if available or r
162. spiration is turned OFF the RR name numeric and lung icon will be blank 21 02 0186 REV 08 07 11 78 Table Of Contents CARDELL Veterinary Monitors NUMERIC AND TEMPERATURE Figure 16 Numerics and Temperature In the models 9403 and 9405 this section displays the numeric values for 5 and Pulse Rate and a flashing visual icon for the Pulse Rate In the model 9404 this section displays the numeric information and a flashing visual icon for the Respiration Rate Also displayed is the Temperature value when in use NIBP NUMERIC AREA Figure 17 NIBP Numeric Area NIBP Manual 140 88 5 This section displays the operating mode for NIBP Automatic Manual or STAT and the numeric information for the last NIBP reading taken The information supplied is in the format Systolic Diastolic and MAP mmHg values or Systolic Diastolic mmHg and Pulse Rate V The selection between MAP or Pulse Rate can be made in the NIBP Options menu 21 02 0186 REV 08 07 11 79 Of Contents CARDELL Veterinary Monitors EtCO NUMERIC SECTION Figure 18 EtCO2 Numeric In the model 9405 this section displays the numeric values for both EtCO and Respiration Rate and a flashing visual icon for the Respiration Rate Also displayed in this example is a vertical bar graph of relative signal strength PATIENT ALARM MESSAGE WINDOW The text sect
163. ss one of the NEXT programmed pushbutton keys and highlight the selections column Press either the ARROW UP or ARROW DOWN pushbutton to make a selection If Trace 1 2 or 3 is being configured press one of the NEXT programmed pushbutton keys to select the speed mm Sec the trace will be viewed at Press either the ARROW UP or ARROW DOWN pushbutton to make a selection Press one of the PREVIOUS programmed pushbutton keys to return back to the parameter selections column Press the ARROW DOWN pushbutton to continue to the next parameter or press the MAIN pushbutton to exit and return to the Main display screen 21 02 0186 REV 08 07 11 98 Of Contents CARDELL Veterinary Monitors AUDIO VISUAL MENU Figure 25 Audio Visual Menu Audio Visual Alarm Volume Beep Source ECG Beep Volume Contrast Save No Restore No NOTE The Audio Visual pushbutton can be used at any time during monitoring When the Audio Visual pushbutton is pressed the waveforms being displayed are replaced with the Audio Visual menu While in the menu the monitor will continue to update and display the numeric values of the parameters being monitored and a signal bar graph will be displayed indicating the relative signal strength NOTE While in the Audio Visual menu if no pushbutton is pressed within 30 seconds the
164. t breathing movement occurs on the chest 3 The leadwires that attach to the electrode clips are color coded for ease of identification Refer to Table 2 for the lead color based on the lead set being used 4 The third or ground electrode clip LL is placed on the thigh of either rearleg The ground is a reference electrode allowing for better signal detection 5 Once the electrode clips are in place and the leadwires attached patient cables and leadwires must be kept away from the neck area to minimize entanglement and accidental strangulation 6 Connect the leadwires to the ECG patient cable matching the colored end of the leadwire to the corresponding dot on the cable T Connect the round end of the ECG patient cable to the ECG RESP connector on the side panel of the monitor 8 Press the ON STANDBY pushbutton to turn ON the monitor 9 Check that the monitor is accurately detecting the heartbeat and respiration by watching the monitor to see that the heart and lung visual indicators flash with each heartbeat and breath 10 If the heart and lung visual indicators do not correspond to the patient s heart rate and or respiration reposition the electrodes until the indicators flash in synch with the patient s heartbeat and breathing This will help to minimize false alarms 21 02 0186 REV 08 07 11 49 Table Of Contents CARDELL Veterinary Monitors 11 If required refer to Page 96 PARA
165. terface to the optional Citizen CMP 10 Mobile printer using the cable supplied with the printer or can be connected to a data collection device such as a personnel computer The RS232 serial communication protocol is output only with no polling feature The information provided in this section is made available to allow the user the ability to print the monitor s History data to a personnel computer e Equipment Needed 9 pin female to female RS 232 Null Modem cable e Computer Configuration Create a HyperTerminal Connection 1 From your Desktop choose Start Programs Accessories Communications and select Hyper Terminal 2 Open the program Hypertrm exe 3 Enter a new connection e g CARDELL_MONITOR in the Name field for this New Connection When finished select 4 Choose the appropriate Direct to the Connect Using dialog box Where X communication port on your computer When finished select 5 Set the following settings in the Port Settings dialog box Bits per Second 9600 Data bits 8 Parity None Stop bits 1 Flow Control None 6 When finished select OK 7 Click on Transfer and select Capture Text Use the Browse button to select a location to save your work Example CAMy Documents Cardell TXT 8 From the File menu choose SAVE 9 When completed from the File menu choose CLOSE Whenever you need to capture data from the monitor connect
166. ther methods Do not use extension cords of any type Do not connect the monitor to an electrical outlet controlled by a wall switch or dimmer INTERFACING OTHER EQUIPMENT Monitoring equipment must be interfaced with other types of medical equipment by qualified biomedical engineering personnel Be certain to consult manufacturers specifications to maintain safe operation STACKING Where monitor is used adjacent to or stacked with other equipment the monitor should be observed to verify normal operation in the configuration in which it will be used 21 02 0186 REV 08 07 11 41 Of Contents CARDELL Veterinary Monitors GENERAL NOTES There are no known risks with common disposal of equipment or accessories however the disposing of accessories should follow in accordance with local hospital policies The user should ensure these policies do not conflict with any local state or federal guidelines The monitor is suitable for use in the presence of electro surgery The monitor is suitable to be connected to public AC mains power The CARDELL Monitor is not Category AP or APG Equipment The CARDELL Monitor is for Continuous Operation The CARDELL Monitor with ECG Respiration applied parts is Type CF Defibrillation Proof The CARDELL Monitor applied parts are Type BF Defibrillation Proof The CARDELL Monitor provides DRIP PROOF level of protection from ingress to moistu
167. til this condition is achieved If the monitor fails to respond do not use it until the situation has been corrected by qualified personnel ACCIDENTAL SPILLS the event that fluids are accidentally spilled on the monitor take the monitor out of operation and inspect for damage BATTERY POWER If the monitor will not be used or not connected to AC line power for a period over six 6 months remove the battery ELECTRICAL SHOCK To reduce the risk of electrical shock do not remove the back cover Refer all servicing to qualified personnel ELECTROCAUTERY PRECAUTIONS To prevent unwanted skin burns apply electrocautery electrodes as far as possible from all other electrodes a distance of at lease 15 cm 6 in is recommended ELECTROMAGNETIC COMPATIBILITY EMC The equipment needs special precautions regarding EMC Be aware that strong electromagnetic fields may interfere with monitor operation Interference prevents the clear reception of signals by the monitor If the hospital is close to a strong transmitter such as TV AM or FM radio police or fire stations a HAM radio operator an airport or cellular phone their signals could be picked up as signals by the monitor ELECTROSURGERY Measurements may be affected in the presence of strong electromagnetic sources such as electro surgery equipment GROUNDING Do not defeat the three wire grounding feature of the power cord by means of adaptors plug modifications or o
168. timize contact Connect lead wires to patient cable by matching colored ends with colored block on cable Connect round end of patient cable to the ECG RESP connector on the side panel of the monitor 21 02 0186 REV 08 07 11 EN Table Of Contents This page is intentionally left blank 21 02 0186 REV 08 07 11 LX Of Contents QUICK START UP GUIDE MONITOR OPERATIONS MAIN DISPLAY AREA TOP RIGHT SECTION Up to 3 traces can be selected in the Current monitor time and battery Parameters Menu Trace 1 is automatically charge status are displayed an ECG waveform ECG heart rate information 9403 amp 9405 Respiration information if in use This section also displays various menus when selected CARDELL Veterinary Monitor SpO2 RESP SECTION 9403 amp 9405 SpO2 information 9404 Respiration information Temperature if in use is displayed NIBP SECTION NIBP information including operating mode and previous results is displayed EtCO2 SECTION PATIENT ALARM MESSAGES including Respiration Text section directly below NIBP section rate EQUIPMENT MESSAGES displays any patient related alarm messages Displays the current memory location Vet1 or Vet2 NIBP operating mode Small Cuff or Large Cuff and when selected the current status of the Audio Alarm Silence If a m
169. tion and Temperature MAXNIBP and Nellcor Veterinary 100 240 50 60HZ AC Power Supply and Battery 9404 ECG Respiration and Temperature and MAXNIBP 100 240V 50 60HZ AC Power Supply and Battery 9405 ECG Respiration and Temperature MAXNIBP Nellcor Veterinary SpO and Oridion 100 240 50 60HZ AC Power Supply and Battery 21 02 0186 REV 08 07 11 159 Table Of Contents CARDELL Veterinary Monitors This page is intentionally left blank 21 02 0186 REV 08 07 11 160 Of Contents CARDELL Veterinary Monitors 15 SPECIFICATIONS ECG Characteristic Specification Input 3 or 5 leads Selectable Leads I aVL aVR aVF V Gain X 5 X1 X2 X4 X8 X16 Automatic Display Sweep Speeds 12 5 25 50 mm Sec QRS Tone Volume User selectable 5 settings Off Frequency Response 0 5 to 25 Hz Sensitivity Adjustment Automatic Minimum Signal 0 20 mV peak to peak Common Mode Rejection gt 90dB Loose Lead Threshold 2 0 to 2 5 K ohms Pacemaker Spike Rejection Meets AAMI Standards HEART RATE Characteristic Specification Asystole Detection 4 seconds Alarms User selectable low heart rate and high heart rate Alarm Delay Time 5
170. to warn the user if any measurement parameter is outside the range of a user set value This feature will allow the user to set values for Table 7 Alarm Parameters Parameter Units Heart Rate Low High BPM Pulse Oximetry SatSeconds Low End Tidal CO2 mmHg 96 kPa FiCO2 Respiration Rate No Respiration Systolic Blood Pressure Diastolic Blood Pressure Mean Arterial Pressure NOTE The Alarm Limits pushbutton can be used at any time during monitoring When the Alarm Limits pushbutton is pressed the waveforms being displayed are replaced with the Limits menu While in the menu the monitor will continue to update and display the numeric values of the parameters being monitored and a signal bar graph will be displayed indicating the relative signal strength NOTE While in the Limits menu if no pushbutton is pressed within 30 seconds the monitor will automatically save any changes made and exit to the Main display screen CHANGING ALARM LIMITS Press the ALARM LIMITS pushbutton and the monitor s front panel displays the currently used set of alarm setting of all Low and High Alarm Limit values along with the numeric values of the parameters currently being monitored To change an Alarm Limit 1 Press the ARROW UP or ARROW DOWN pushbuttons to select a parameter value 2 Press one of the NEXT programmed pushbutton keys to advance onto the parameter value to change Low or High 3 Press eithe
171. tor Configurations 159 21 02 0186 REV 08 07 11 24 Of Contents CARDELL Veterinary Monitors 1 INTRODUCTION AND INTENDED USE INTRODUCTION The CARDELL Monitor is a multi parameter monitor measuring Heart Rate Respiration Blood Pressure Oxygen Saturation Carbon Dioxide and Temperature Heart Rate is measured by placing electrodes on either side of the chest that detect electrical changes produced by the heart The same electrodes for heart rate detection are used to detect respiration through a process called impedance pneumography Non invasive blood pressure is measured using the oscillometric technique determining systolic diastolic and mean arterial pressure The pulse oximeter function continuously monitors and displays values for functional arterial hemoglobin saturation and a pulse rate Capnography continuously monitors and displays the concentration of exhaled carbon dioxide Temperature is obtained using a temperature thermistor probe that can be applied to sites such as esophageal or rectal INDICATIONS FOR USE The CARDELL Monitor is a portable device intended to be used by trained clinicians for multi parameter vital signs monitoring of veterinary patients Parameters displayed are heart rate BPM respiration BrPM non invasive blood pressure systolic diastolic and MAP pressure end tidal carbon dioxide EtC
172. turned ON 1 The CO module is optional in the case when it is not installed no text messages are shown 21 02 0186 REV 08 07 11 144 Of Contents CARDELL Veterinary Monitors Figure 35 Service Menu Service IrDA Test OFF Check OFF Cal OFF Cal Date 06 Feb 04 S N 00234 Service EtCO2 Hours Cal Hours Manometer Mode OFF Pneumatic Test OFF PIC Voltage XX XX V NOTE While in the Service menu if no pushbutton is pressed within 15 minutes the monitor will automatically exit the Service menu and return to the Main display screen EXIT THE SERVICE MENU When you have completed testing the monitor press the MAIN G pushbutton to exit and return to the Main display screen 21 02 0186 REV 08 07 11 145 Of Contents CARDELL Veterinary Monitors IrDA TEST The CARDELL Monitor incorporates a test to check the alignment of the monitor to the printer using the Infrared port To use the Infrared Test follow the following procedure 1 First enter the monitor s Service menu Refer to Page 144 SERVICE MENU The IrDA Test menu selection is highlighted 2 Press one of the NEXT programmed pushbutton keys until the cursor displays the current setting of the IrDA Test 3 Press either the ARROW UP or ARROW DOWN pushbutton to change the setting from
173. twist the large end female luer connector into the CARDELL 9405 Monitor s Microstream input connector Refer to Figure 11 on the following page 21 02 0186 REV 08 07 11 69 Of Contents CARDELL Veterinary Monitors Figure 11 Connection 2 Firmly connect the small end male of the Microstream Airway Adapter to the female end of the ventilation source 3 Firmly connect the patient s endotracheal tube connector into the large female of the Microstream Airway Adapter For a closed suction system firmly connect the patient s endotracheal tube connector into the large end female of the Microstream Airway Adapter Refer to Figure 12 on the following page NOTE Ensure the consumable is not twisted or crimped 21 02 0186 REV 08 07 11 70 Of Contents CARDELL Veterinary Monitors ventilation endotracheal tube source Airway Adapter Connector Figure 12 Attaching the Airway Adapter NOTE During nebulization or suction when not using closed suction system in order to avoid moisture buildup and FilterLine occlusion disconnect the Airway Adapter from the patient s endotracheal tube CAUTION Loose or damaged connections may compromise ventilation or cause an inaccurate measurement of respiratory gases Securely connect all components and check connections for leaks
174. u Refer to Page 90 SETUP MENU The monitor will automatically highlight the Language parameter 2 Press one of the NEXT programmed pushbutton keys until the cursor displays the current language being used 3 Press either the ARROW UP or ARROW DOWN pushbutton to make a selection 4 Press one of the PREVIOUS programmed pushbutton keys to return back to the parameter selections column At this time the new language selection shall take effect 5 Press the ARROW DOWN pushbutton to continue to the next parameter or press the MAIN C pushbutton to exit to the Main display screen AUDIO ALARM SILENCE SILENCE RESET Pushbutton The CARDELL Monitor s SILENCE RESET pushbutton can be configured to have the audio associated with patient alarms set to one of the two selections below The selections are e 2 Minute Default e Permanent To configure the monitor s Audio Alarm Silence follow the following procedure 1 First enter the monitor s Setup menu Refer to Page 90 SETUP MENU 2 Press the ARROW DOWN pushbutton until the parameter Audio Silence is highlighted 3 Press one of the NEXT programmed pushbutton keys until the cursor displays the audio mode currently being used 4 Press either the ARROW UP or ARROW DOWN pushbuttons to make a selection 5 Press one of the PREVIOUS programmed pushbutton keys to return back to the parameter selections column 6 Press the ARROW DOWN pushbutton to continue to the next parameter or pres
175. uld be an audible click when it is secure 21 02 0186 REV 08 07 11 155 Of Contents CARDELL Veterinary Monitors STORAGE WARNING If it becomes necessary to store the monitor for longer than six 6 months remove the monitor s battery pack and place the monitor in its original packing container if available WARNING Use of unapproved batteries will invalidate the product s warranty and may result in serious safety consequences for the patient and user NOTE Batteries not charged and left in storage for more than six months could degrade and not recharge to full capacity See Section 15 SPECIFICATIONS for storage temperature information 21 02 0186 REV 08 07 11 156 Of Contents CARDELL Veterinary Monitors 14 ACCESSORIES BLOOD PRESSURE CUFFS Reusable Blood Pressure Cuffs single tube Catalog Number Width Range SV8 8 0 cm 13 20 cm SV10 10 2 cm 18 26 cm Disposable Blood Pressure Cuffs single tube Catalog Number Width Range SV1 2 0 cm 3 6 cm SV2 2 5 cm 4 8 cm SV3 3 0 cm 6 11 SVA 4 0 cm 7 13 cm 5 5 0 8 15 SV600 Box of 5 one each SV1 SV5 21 02 0186 REV 08 07 11 157 Of Contents CARDELL Veterinary Monitors ECG RESP
176. ule The NIBP Module Contact CAS Medical Systems to have the installed is not monitor serviced compatible with the monitor 21 02 0186 REV 08 07 11 124 Of Contents CARDELL Veterinary Monitors MONITOR MESSAGES cont NIBP cont Table 12 NIBP Monitor Messages ERROR POSSIBLE CAUSE POSSIBLE SOLUTION MESSAGE Over Press Cuff pressure exceeded Very rapid squeezing of the cuff can cause 290 mmHg this error Repeat the measurement If this message repeatedly occurs during normal use the monitor must be serviced Range Error The systolic reading Repeat measurement exceeds the measurement range of If the message is displayed again use 265 mmHg another method to measure the patient s blood pressure Signal Sat Motion pulses too strong Limit patient activity the arm must be still and or relaxed Repeat measurement Time Out The monitor was unable An extremely long measurement can be due to complete a to a loose cuff high blood pressure or measurement within 150 monitor re pumps seconds Try measurement again Try higher initial pressure If message consistently reappears try using another means to obtain patient s blood pressure Weak Signal The monitor did not Check the fit of the cuff detect any pulses during a NIBP measurement Repeat measurement 21 02 0186 REV 08 07 11 125 Of Contents
177. ulse Rate 2 or 2 BPM whichever is greater 21 02 0186 REV 08 07 11 162 SpO MEASUREMENT Of Contents CARDELL Veterinary Monitors Characteristic Specification Nellcor OxiMax Type Functional Oxygen Saturation 5 Range 0 to 100 SpO Accuracy 70 to 10096 2 digits 1 S D Adult 70 to 100 3 digits 1 S D Neonate Measurement Wavelengths Red 660 Nanometers Infrared 890 Nanometers Power Not exceeding 15 mW Pulse Rate Range 20 to 300 BPM Pulse Rate Accuracy 3 digits Numerics Updated every one 1 second NOTE Accuracy is specified for adult human hemoglobin measured at the fingertip Although animal hemoglobin has similar optical characteristics other types of hemoglobin may affect the accuracy TEMPERATURE Characteristic Specification Input YSI 400 compatible Temperature Range 28 to 43 C 82 4 to 109 4 F Accuracy 0 1 0 2 F Resolution 0 1 C or 0 1 F 21 02 0186 REV 08 07 11 163 CAPNOGRAPHY Of Contents CARDELL Veterinary Monitors Characteristic Specification Oridion MicroStream Units mmHg Sampling Rate 50 ml min 7 5
178. users of variations on power supply input lines IEC 61000 4 11 for 5 cycles 70 30 dip in for 25 cycles lt 5 gt 95 dip in for 5 seconds for 5 cycles 70 30 dip in for 25 cycles lt 5 Ur gt 95 dip in for 5 seconds the Model 9403 9404 9405 Monitor requires continued operation during power mains interruptions it is recommended that the Model 9403 9404 9405 Monitor be powered from an uninterruptible power supply or a battery Power frequency 50 60 Hz magnetic field IEC 61000 4 8 3 A m 3 A m Power frequency magnetic fields should be at levels characteristic of a typical location in a typical commercial or hospital environment NOTE U is the mains voltage prior to application of the test level 21 02 0186 REV 08 07 11 11 Of Contents Guidance and Manufacturer s Declaration Electromagnetic Immunity The Model 9403 9404 9405 Monitor is intended for use in the electromagnetic environment specified below The customer or the user of the Model 9403 9404 9405 Monitor should insure that it is used in such an environment Immunity Test IEC 60601 Test Level Compliance Electromagnetic Environment Guidance Level Portable and mobile RF communications equipment should be used no closer to any part of the Model 9403 9404 9405 Monitor including cables than the
179. vice needs CAUTION Disconnect all accessories from the monitor before cleaning Do not immerse any part of the electrical connector of the cable or accessories in the cleaning or disinfection solution at any time Do not use an abrasive cloth or cleaner on the accessories Immersing the patient cable or leadwires in any liquid may result in moisture entering This may cause internal damage and reduce the product life Alcohol and organic solvents may cause stiffness and brittleness THE MONITOR On a daily basis examine the monitor s case for any damages and check the AC power cord for bent or broken prongs cracks or fraying Neither the monitor nor the power cord should be used if damaged If any damage is noted contact the appropriate service personnel CAUTION Do not spray or pour any water or cleaning solution directly onto the monitor As needed clean the monitor using a soft cloth dampened with a mild dishwashing detergent solution and gently rub the soiled area until clean Use a clean soft cloth to dry the monitor Do not use abrasive cleaners on the monitor Do not use either isopropyl alcohol or solvent to clean the monitor Use of these cleaners can cause damage to the monitors surface Do not immerse the monitor or power cord in the cleaning solution When necessary the monitor surfaces may be disinfected using a soft cloth saturated with a 10 1 10 solution of chlorine bleach in tap water When al
180. y peripheral vasodilation as a direct effect on peripheral vessels o CNS depressant effect and eventually narcosis PaCO2 levels above 100 mmHg have an anesthetic effect o Increased cerebral blood flow and intracranial pressure o Tachypnea and an increased work of breathing which can negatively impact a debilitated patient Arterial O2 levels may eventually decrease enough to cause hypoxemia especially in a patient breathing room air e Inadequate ventilation interferes with adjustments in anesthetic levels Controlling mechanical dead space is a simple matter e Mechanical dead space is most concerning for patients under 6 kg body weight o Minimize the connectors attached to the endotracheal tube particularly in small patients example a 6 kg patient under anesthesia the patient s alveolar ventilation volume would be 31 5 ml Using a pediatric F circuit with adult ETCO2 monitor and right angle adaptor or apnea alert adaptor could create 30 ml of mechanical dead space effectively eliminating 9596 of normal spontaneous alveolar ventilation e Make sure you regularly inspect all anesthetic machines and systems paying particular attention to valve function and inner hose integrity e Make sure that the ET tube is not excessively long Select your anesthetic system carefully o Do not use a pediatric F circuit as a substitute for conventional pediatric circle hoses or a noncircle system Using no more than one monitor adaptor o M

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