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Product Manual - Ardus Medical

1. 88 Opening the Battery Door Pcr M 89 Installing the New Battery FIgillo 22 uices ero E ere eoe iie seen TT 106 Removing the Monitor Battery Pack PIQUIO Ian O 112 DB9 Male Connector Pin Layout 21 02 0171 REV 00 03 03 vii CAS 740 Monitors Error Messages on the Message Window Table 40 sc ea eet tercer DB9 Pin Out Monitor Configurations viii TABLES 21 02 0171 REV 00 03 03 CAS 740 Monitors Section 1 Introduction and Intended Use 21 02 0171 REV 00 03 03 CAS 740 Monitors 21 02 0171 REV 00 03 03 CAS 740 Monitors INTRODUCTION AND INTENDED USE INTRODUCTION The CAS 740 Monitor is multi parameter monitor measuring blood pressure oxygen saturation and temperature Non invasive blood pressure is measured using the oscillometric technique determining systolic diastolic mean arterial pressure and pulse rate The pulse oximeter function continuously monitors and displays values for functional arterial hemoglobin saturation and a pulse rate Temperature is obtained in the normal predictive mode in as little as four 4 seconds A monitoring mode is available for taking axillary temperatures INDICATIONS FOR USE The CAS 740 Monitor is a portable device intended to be used by trained clinicians for multi parameter vital signs monitoring of neonatal pediatric and adult patients in health care bedside applications
2. DS 100A DOC 10 OXI A N OXI P I Description 85001 8000 3 8000Q 8000K2 2 8000JFW 8500VI 8000AA 3 8000AA 1 8000AP 8000K2 8000R 8000J 8000H 8000T 8000TH 9000P 90001 7000N 7000A Adult Reusable Sensor OxiMax Patient Cable 10 FT Neonatal Sensor Pediatric Sensor SpO Extension Cable 1 Meter Pediatric Finger Clip Sensor 9 ft 3 Meter Cable Ear Clip Sensor Adult Finger Clip Sensor 2 Meter Cable Sensor Attachment Tape 25 case SpO Extension Cable 3 Meter Adult Articulated Finger Clip Sensor 9 ft 3 Meter Cable Adult Articulated Finger Clip Sensor 3 ft 1 Meter Cable Pediatric Finger Clip Sensor 3 ft 1 Meter Cable Adult Finger Clip Sensor 3 ft 1Meter Cable Reflectance Sensor Adult Flex Sensor Straight Reflectance Sensor Holder System Sensor Attachment Tape Hydro gel Tape Strips Pediatric Flexi Form Single Patient Use Sensor Infant Flexi Form Single Patient Use Sensor Neonatal Flexi Form Single Patient Use Sensor Adult Finger Flexi Form Single Patient Use Sensor 21 02 0171 REV 00 03 03 CAS 740 Monitors TEMPERATURE Welch Allyn Catalog No 01 02 0095 01 02 0096 01 02 0097 01 02 0103 Description 06137 000 SureTemp Calibration Key 02678 100 Temperature Probe Oral 02679 100 Temperature Probe Rectal 05031 Temperature Probe Covers case of 40 boxes 25 Probe covers box OTHER ACCESSORIES Catalog No 01 01 0047 01 02 0172 01 02 0173 01 02 0174 01 02 01
3. FIGURE 5 Flex Type Adult Application Adult and Pediatric The preferred application site is the index finger however other fingers or toes may be used where the tissue thickness is between 5 and 17 millimeters FIGURE 6 Flex Type Infant Application Infant The preferred application site is the large toe of infants greater than 2 kilograms in weight FIGURE 7 Flex Type Neonatal Application Neonatal The preferred application site is on the foot close to the toes for infants less than 2 kilograms in weight 21 02 0171 REV 00 03 03 32 CAS 740 Monitors NOTE For best results secure the sensor cable independently from the sensor preferably around the base of the finger Tape may be used to secure the cable to the patient Make sure that the tape being used does not restrict the blood flow 2 Once the sensor has been attached to the patient and to the monitor the SpO signal bar graph will illuminate and indicate the relative signal strength and signal quality at the sensor site Wait for the monitor to determine the initial SpO and Pulse Rate values When the values have been determined they will be displayed in their respective SpO and front panel LED display windows NOTE Inspect the pulse oximeter site every 2 to 4 hours or per hospital protocol If there is any skin irritation caused by the sensor remove the sensor and apply it to a different location 3 When SpO monitorin
4. Should the monitor fail the 500 ml Pressure Check it is recommended the monitor be returned to CAS Medical Systems for service TEMPERATURE CALIBRATION CHECK Verify the calibration of the monitor s Temperature circuit once 1 every year To perform a Temperature Calibration Check obtain a Calibration Key This key can be purchased directly from Welch Allyn or CAS Medical Systems Refer to Section 14 ACCESSORIES for part number information The Temperature Calibration Check can be performed at any time once the monitor enters the Configuration Mode To enter the monitor Configuration Mode depress and hold the AUDIO and ALARM LIMITS pushbutton keys while the monitor is being turned ON 1 Remove the temperature probe and its connector completely from the monitor and insert the Calibration Key 2 Re insert and remove the temperature probe from the probe guide to reset the thermometer s electronics 21 02 0171 REV 00 03 03 104 CAS 740 Monitors 3 Wait for the test to complete and observe the display reading in the TEMP display window 4 The display value should read 36 3 0 1 C or 97 3 0 1 F NOTE The monitor will display the Temperature Calibration Key value using the current temperature units selected NOTE The Temperature Calibration Key will only operate while the monitor is in the Configuration Mode If the Calibration Key is inserted during normal monitoring the TEMP display will show three
5. Press and hold the ALARM LIMITS pushbutton for 2 seconds until the message Saving N appears in the Message Window Press the ALARM LIMITS pushbutton to bring up the Recall menu The message RECALL N appears in the Message Window Pressing either the ARROW UP or ARROR DOWN pushbutton will display the message RECALL Y in the Message Window Press the ALARM LIMITS pushbutton The Message Window will display RESTORE and return to the Alarm Limit menu When finished press the CANCEL pushbutton to return to the Ready state ALARM LIMIT VALUES There are two sets of alarm limit parameters one for Adult Pediatric and one for Neonatal The Alarm Limits pushbutton will operate on the parameters for the mode the monitor is currently in ADULT NEO Table 5 lists the Alarm Limit Default Values used by the CAS 740 Monitor ADULT OFF NEONATAL High teo 100 220 TABLE 5 Default Alarm Values NOTE Patient alarms for Systolic Diastolic and MAP values are produced at the time the measurement is taken Alarms for SpO have a ten 10 second delay Alarm for Pulse Rate will be immediate if taken from the NIBP or have a ten 10 second delay if taken from the SpO signal 21 02 0171 REV 00 03 03 63 CAS 740 Monitors AUDIBLE AND VISUAL INDICATORS The CAS 740 Monitor is capable of producing both an audible and a visual indicator for a variety of monitor conditions The following table provides a cross refe
6. Where HH is the hour and is the minute of the measurement taken NOTE If SpO is active the Pulse Rate value will be determined from the SpOs measurement Press the CANCEL pushbutton at any time to stop a measurement and deflate the cuff during the measurement process The monitor s front panel NIBP displays will indicate all dashes and the Message Window returns to Ready The CANCEL pushbutton can be depressed after a measurement is taken to clear the current reading from the displays The monitor s front panel NIBP displays will indicate all dashes and the Message Window returns to Ready 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 displays to all dashes and the Message Window returns to 21 02 0171 REV 00 03 03 57 CAS 740 Monitors AUTOMATIC CYCLE FOR BLOOD PRESSURE DETERMINATION The CAS 740 Monitor can automatically take blood pressure measurements at pre selected time intervals To choose a time interval press the CYCLE TIME pushbutton The Message Window displays the format AUTO XX Where XX is the time interval in minutes Choose the time interval using one of the following methods 1 Depress the CYCLE TIME pushbutton to advance through the available time intervals 2 Depress the ARROW UP or ARROW DOWN pushbutton keys to advance forward or backwards through th
7. FOR A PARTICULAR PURPOSE 21 02 0171 REV 00 03 03 HOW TO CONTACT US Representative in European Union CAS Medical Systems Inc Mossa Consulting GmbH 44 East Industrial Road Branford CT 06405 U S A Phone Bollbr gg 22 23570 L beck Germany Phone 800 227 4414 49 4502 880 557 203 488 6056 Fax Fax 203 488 9438 49 4502 880 559 E Mail E Mail custsrv casmed com mossa rod t online de sales casmed com techsrv casmed com Should service be required contact the dealer in the country of purchase Web www casmed com Copyright 2003 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 0171 REV 00 03 03 CAS 740 Monitors TABLE OF CONTENTS 1 INTRODUCTION AND INTENDED USE 1 INTRODUCTION tenta d O as E 3 INDICATIONS FOR USE cotes tetti tata 3 CONTR ANDICATIONS ic ss nuntia s eu De ek 3 BRIEF DEVICE DESCRIPTION 3 PATIENT ENVIRONMENT 4 2 UNPACKING THE MONITOR 7 INMALINSPECHON Serien donde 9 MONITOR CHECKLIST e Hb oo di D 9 OPTIONAL ACCESSORIES c rascacielos aid 9 3 A ee ee 11 4 SAFETY MEASURES WARNINGS A
8. any remaining paper before installing the new roll 2 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 3 Close the paper door FIGURE 19 Paper Installation 21 02 0171 REV 00 03 03 87 CAS 740 Monitors 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 REPLACING THE BATTERY PACK WARNING DO NOT operate the printer or connect the printer to the CAS 740 Monitor with the battery pack removed WARNING Never change the battery pack while the battery charger is plugged in and or the CAS 740 Monitor is being operated 1 Switch the printer OFF 2 Disconnect the printer from the CAS 740 Monitor and unplug the wall charger cord 3 Open the battery door by pressing in on the battery cover and pushing upward FIGURE 20 Opening the Battery Door 4 Remove the battery cover 5 Remove the battery pack from the compartment and disconnect its connecting cable 21 02 0171 REV 00 03 03 88 CAS 740 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 21 Ins
9. user removable Charge Time 4 hours Operation on battery 100 NIBP readings when set in the 5 minute Automatic Mode 100 microamp maximum System self test is performed each time power is turned on Zero pressure reference is automatically established after every reading Initial inflation to 150 mmHg Adult or 100 mmHg Neonatal or user selectable 100 120 140 160 180 200 Adult 60 80 100 120 Neonatal Subsequent inflation to approximately 30 mmHg greater than previous Systolic pressure Automatic Limited to 120 seconds Adult 90 seconds Neonate If cuff pressure exceeds 290 mmHg Adult 145 mmHg Neonate If measurement time exceeds 120 seconds Adult 90 seconds Neonate If safety timer detects microprocessor failure 21 02 0171 REV 00 03 03 OPERATING ENVIRONMENT Operating Temperature Humidity Altitude Barometric Pressure Storage Transport Temperature Humidity Altitude Barometric Pressure 0 to 50 C 32 F to 122 F for NIBP amp SpO 16 C to 40 C 61 F to 104 F for Temperature 15 95 non condensing 152 4 m to 3048 m 500 ft to 10 000 ft CAS 740 Monitors 1032 hPa to 697 hPa 774 1 mmHg to 522 8 mmHg 20 C to 65 C 4 F to 149 F 15 95 non condensing 152 4 m to 3048 m 500 ft to 10 000 ft 1032 hPa to 697 hPa 774 1 mmHg to 522 8 mmHg Monitors may not meet performance specifications if stored or us
10. 117 OTHER ACCESSORIES an ota deste es 117 15 GLOSSARY Lcd 119 16 SPECIFICATIONS a a 123 CAS 740 MONITOR PURCHASING RECORD n 130 21 02 0171 REV 00 03 03 CAS 740 Monitors FIGURES gis cnn Patient Environment an rj Cuff Application RIUS escis bia HR WERDE Haie nie aiii s Cuff Positioning EQU E SpO Finger Clip Sensor Application EQU Flex Type Adult Application Figure eS A A ae va tere rei a Flex Type Infant Application HERI ea UR Flex Type Neonatal Application gie abia Loading the Probe Cover EREE bitrate taa ar ati Location of Sublingual Pockets Figure 10 acti dos Loading the Probe Cover EQU Td RII den RU d aH uova ai is Loading the Probe Cover cuc rer HE nee n Front Panel View CHE Front Panel Controls FIgUre ld nee aee be E ER Gee eee Rear Panel View T5 its e e nies Left Side Panel View calm Right Side Panel View 21 02 0171 REV 00 03 03 vi CAS 740 Monitors Figure 17 2 84 Printer Controls and Indicators PIQUIO 1 EET 86 Sample Printouts gj cep 87 Paper Installation Figure 20 cree ado aa a eed cm oma a ard
11. 740 Monitors CAUTION When measuring blood pressure on a Pediatric patient using the ADULT mode it is recommended that the Initial Inflation Pressure be set to a lower value of 120 mmHg ADULT MODE NEONATE MODE faOommHg f 0omeHg S TABLE 4 Selectable Initial Inflation Pressures IMPORTANT It is important that the patient be kept still during a measurement Make every attempt to alleviate fear anxiety and pain Press the START pushbutton to begin a measurement For the first measurement the monitor will inflate to the default setting or the Initial Inflation Pressure selected The monitor s front panel NIBP displays will indicate all dashes while the measurement is in progress and the Message Window displays the Inflation Pressure in the format Meas XXX where XXX is the pressure value 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 120 seconds for Adult Pediatric patients and no more than 90 seconds for Neonates When the measurement is completed the cuff will automatically deflate and the monitor will display the Systolic Diastolic MAP if enabled and Pulse Rate values on the front panel displays The Message Window displays a time stamp of the NIBP measurement in the format BP HH MM
12. History mode and returns to the Ready state REAL TIME CLOCK RTC The CAS 740 Monitor uses an internal Real Time Clock to time stamp all entries that are stored in History Changes made to either the time or date settings should be performed in between patients being monitored Refer to Page 56 for displaying the monitors time and Page 72 for setting the time 21 02 0171 REV 00 03 03 61 CAS 740 Monitors PATIENT ALARM MODE WARNING Configuring the CAS 740 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 70 AUDIO ALARMS for more information The CAS 740 Monitor is equipped with patient alarms 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 Systolic High and Low Diastolic High and Low MAP High and Low Pulse High and Low SpO High and Low CHANGING ALARM LIMITS The CAS 740 Monitor incorporates a two 2 step process for reviewing and changing Alarm Limit values Press the ALARM LIMITS pushbutton once and the monitor s front panel displays indicate the current values of all High Alarm Limit values for two 2 seconds then toggles to indicate all Low Alarm Limit values for two 2 seconds This reviewing of all High and Low Alarm Limit values continu
13. Mode and begin a measurement TREND HISTORY TREND Tr NOTE If the CAS 740 Monitor is not equipped for SpO or Temperature monitoring no Trend History menu will be available To review Trend History press the HISTORY pushbutton twice The most current measurement NIBP Predictive or Monitor Temperature or a one 1 minute averaged SpO values and the time of measurement HH MM Tr are displayed on the front panel If there are no readings in the History the message NO TREND is displayed in the Message Window Press the ARROW DOWN pushbutton to review preceding measurements The word Oldest will be displayed briefly on the Message Window when there are no more readings left in the memory The oldest measurement will then be redisplayed Press the ARROW UP pushbutton to advance the measurements towards the most current measurement taken The word Newest will be displayed briefly on the Message Window when there are no more current readings The most recent measurement will then be redisplayed To exit the History Mode and return to Ready press the CANCEL pushbutton If a measurement is desired immediately while in the History Mode simply press START This will exit the History Mode and begin a measurement 21 02 0171 REV 00 03 03 60 CAS 740 Monitors 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
14. OPTION eeeemH mH 72 BATTERY POWER nn ern rime e EI 73 CHECKING BATTERY STATUS eene 74 AUTO OFF FEATURE ER odere ne tree 74 POWER FAIL 75 USER MESSAGES zn ae dea eie Re ele reed 75 USER MESSAGES eese 75 TEMPERATURE FUNCTION USER MESSAGES 77 ERROR MESSAGES ON THE MESSAGE WINDOW 78 EXTERNAL PRINTER deine een iba 81 PRINTER OVERVIEW 5 5er ee Pave oui tee a aes 83 PRINTER CONTROLS AND INDICATORS nieee 84 PRINTER OPERATIONS 24 2 85 CHARGING THE PRINTER BATTERY eene 87 INSTALLING PAPER EE 87 REPLACING THE BATTERY PACK 88 INSTALLING A NEW BATTERY PACK 89 21 02 0171 REV 00 03 03 iii CAS 740 Monitors EMS SWIVEL MOUNT 222 22 22 2 2 222 oe ei aides 91 ASSEMBLING THE SWIVEL MOUNT eem 93 POLARITY OF THE POWER CABLE seem 93 le z cmm 95 CLEANING OVERVIEW ens 97 THE MONITOR een Seed ce rere retra tene 97 THE DISPLAY cies AER 98 CUFFS AND SENSORS 98 PNEUMATIC TUBING 98 EA 98 MAINTENANCE ala ee sede oie 99 MAINTENANCE INTE
15. REV 00 03 03 PATIENT ALARMS CAS 740 with NIBP CAS 740 with NIBP and SpO CAS 740 Monitors low High Low High I low Low High 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 CONTROL PANEL Display Parameters Displayed OPERATING MODES Patient NIBP History SpO Temperature LED display of measurement results instructions troubleshooting messages and signal strength bar Systolic Pressure Diastolic Pressure and Mean Arterial Pressure MAP Pulse Rate 5 Temperature in Fahrenheit or Celsius NIBP function in Neonatal or Adult Manual STAT or Automatic at preset intervals Review of previous measurements Continuous Monitoring Predictive or Continuous Monitoring 21 02 0171 REV 00 03 03 127 CAS 740 Monitors POWER Source AC Power DC Power EMS Option Battery Leakage Current FEATURES Self Test Auto Zero Inflation Deflation Max Measurement Time SAFETY LIMITS Automatic Cuff Deflation 128 External line or internal battery 100 240 VAC 50 60 Hz 0 5A Fuse Rating T500mAL250V two provided 12 VDC 7W Fuse Rating Wickman Type TE5 Time Lag 3 15A 125VAC or approved equivalent one provided Smart Nickel Metal Hydride NiMH battery pack
16. Red and change back to Green When the LED illuminates Green remove your finger from the POWER ON OFF pushbutton 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 depressed the printer will automatically shutoff The CAS 740 Monitor will periodically send to the printer a wake up message that will disable the Auto Power Off feature 21 02 0171 REV 00 03 03 85 CAS 740 Monitors Sample printouts of both History Modes are shown below 740X Series Monitor 740X Series Monitor 04 Oct 02 13 56 04 Oct 02 13 56 Patient Patient Header Notes Notes Events Trends Hr Mn Sys Dia Map Pls 02 Temp Hr Mn Sys Dia Map Pls 02 Temp Leo E12 8 8 979 52 UAE RER 13357 EQ 7 8 4897 ERA KRAK 13599 LES 4 88 60 l2 01 LLY 78 90 70 FAR ORR EK LIDO TI5 260 98 14 101 120 80 100 465 AX 142007 X KAA RER Ae 14503 LIS 78 91 TTV 14 01 117 78 90 TERGA ARTO ARTE oso eoe oe Xp 14 01 120 80 100 65 14 03 118 78 91 77 98 x x 740X Series Monitor TASOA RAA RR AA ER xau OOS 04 Oct 02 15 02 Patient 740X Series Monitor 04 Oct 02 15 02 Notes Patient Notes Events Hr Mn Sys Dia Map Pls 02 Temp 1 1
17. Verify the monitor s operating environment are within its limits and start the procedure from the beginning ERROR ERROR DESCRIPTION NUMBER 09 Probe heated above 112 F Heater watchdog timeout failure PTB resistor temperature out of range Temperature option no longer recognized TABLE 8 Temperature Error Codes Should any of these problems persist contact your dealer or CAS Medical Systems Inc 21 02 0171 REV 00 03 03 77 CAS 740 Monitors ERROR MESSAGES ON THE MESSAGE WINDOW ERROR POSSIBLE CAUSE POSSIBLE SOLUTION MESSAGE Air Leak Air leak in cuff hose monitor Check that the cuff hose monitor connection is pneumatic system secure Check cuff for leaks DO NOT use a known leaky cuff Appl Err Neonate cuff is detected in Adult Check cuff Replace cuff or change operating Mode mode Chk Prb The monitor is questioning the Verify that the sensor is being used according to Masimo quality of the signal being received the manufacturer s recommendations by the SpO sensor The sensor is receiving too much Verify that the sensor emitter and detector are ambient light parallel to and directly opposing each other ChksumEr An electronic failure has occurred Contact CAS Medical Systems to have the within the monitors Main Control monitor serviced Board Dead Bat The battery is fully discharged Recharge the battery for at least 4 hours Flow Err Stable cuff pressure cann
18. as well as for intra facility or inter facility and EMS transport Parameters displayed are the non invasive blood pressure systolic diastolic and mean arterial pressure pulse rate functional oxygen saturation of arterial hemoglobin SpO and temperature CONTRAINDICATIONS e Oral and Rectal Temperature measurements are not intended for neonatal use e Reusable sensor is contraindicated for use for prolonged periods of use It is not intended for long term monitoring It must be removed and repositioned every four 4 hours and if indicated by circulatory condition or skin integrity reapplied to a different monitoring site e Disposable SpO sensors are contraindicated for patients that exhibit allergic reactions to adhesive tape The sensors must be removed and repositioned every eight 8 hours and if indicated by circulatory condition or skin integrity reapplied to a different monitoring site e No other contraindications are known at this time BRIEF DEVICE DESCRIPTION The CAS 740 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 12 VDC or by a Nickel Metal Hydride NiMH rechargeable battery pack The internal battery pack charges when the monitor is plugged into a power source AC Line Power or 12 VDC The CAS 740 Monitor can be set to operate in one of eight 8 different languages English German French I
19. axillary temperatures can only be obtained by using the blue temperature probe The use of the wrong probe will produce temperature errors To take an axillary temperature in Normal Predictive mode follow this procedure 1 Insure that the oral probe is connected to the monitor and that the monitor is in NEO mode Axillary temperatures can only be taken in NEO mode The oral probe has a BLUE probe cover ejection button 2 Remove the probe from the probe holder A short selftest mode will be initiated where every LED segment in the TEMP display window are illuminated briefly Following this selftest the display will show ALy The ALy in the TEMP display window indicates that the axillary algorithm will be used to take a predictive temperature measurement 3 Load a probe cover onto the probe by holding the probe collar with the thumb and forefinger being careful not to hold or press the ejection button Refer to Figure 11 FIGURE 11 Loading the Probe Cover 21 02 0171 REV 00 03 03 43 CAS 740 Monitors When a double dash appears in the TEMP display window the temperature sensor is ready to take a measurement To take a normal predictive temperature simply place the probe as high as possible in the axilla Do not allow the probe tip to come into contact with the patient until it is deliberately placed in the measurement site 4 Be sure that the probe tip is completely surrounded by axillary tissue Clothing o
20. measurement cycles The power supply located inside the CAS 740 Monitor must be protectively grounded If the integrity of the protective earth conductor ground in the AC Line cord is in doubt the CAS 740 Monitor must be operated from its internal electrical power source battery only 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 any accessory if you notice any sign of damage Contact CAS Medical Systems for assistance Equipment not suitable for use in the presence of a FLAMMABLE ANESTHETIC MIXTURE with AIR or with OXYGEN or NITROUS OXIDE Equipment is not intended to be used in Oxygen Enriched Atmospheres DO NOT gas sterilize or autoclave the monitor 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
21. monitor s time and date values are incorrect set Refer to Page 72 for information to set the Time and Date The monitor s internal clock battery needs to be replaced Contact CAS Medical Systems Signal The quality of the signal level being Ensure proper sensor type and application Masimo received by the SpO sensor is in question Verify that the sensor emitter and detector are parallel to and directly opposing each other Clean or replace the sensor Sig Sat Motion pulses too strong Limit patient activity the arm must be still and or relaxed Repeat measurement Time Out The monitor was unable to An extremely long measurement can be due to a complete a measurement within loose cuff high blood pressure or monitor re 120 seconds in the Adult mode or pumps 90 seconds in the Neonatal mode Try measurement again Try higher initial pressure If message consistently reappears try using another means to obtain patient s blood pressure Weak Sig The monitor did not detect any Check the fit of the cuff pulses during a NIBP measurement Repeat measurement TABLE 9 Error Messages on the Message Window 21 02 0171 REV 00 03 03 80 CAS 740 Monitors Section 9 External Printer 21 02 0171 REV 00 03 03 81 CAS 740 Monitors 21 02 0171 REV 00 03 03 82 CAS 740 Monitors EXTERNAL PRINTER The following section is provided as an overview of the Citizen CMP 10 Mobile Printer as it
22. second OFF and the message Perm Aud will be displayed in the Message Window as a reminder NOTE If the Message Window is currently displaying a time stamp from a previously taken NIBP measurement the Perm Aud message will alternately be displayed with the time stamp message When enabled the monitor will not alarm for patient related High and Low alarms NIBP Application Error and SpO Probe Alarm 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 70 AUDIO ALARMS for more information ALARM LIMITS OFF If the Alarm Limits Off mode is selected in the Monitor Configuration menu all alarms associated with patient alarms are DFF except for Low Battery and Dead Battery The visual indicator next to the SILENCE RESET pushbutton will flash at a rate of two 2 second ON and two 2 seconds OFF and the message Alrm Off will be displayed in the Message Window as a reminder NOTE If the Message Window is currently displaying a time stamp from a previously taken NIBP measurement the Alrm Off message will alternately be displayed with the time stamp message To re activate the audio alarms refer to Page 70 AUDIO ALARMS for more information 21 02 0171 REV 00 03 03 67 CAS 740 Monitors MONITOR CONFIGURATION The Monitor Configuration section allows the user to configure the CAS 740
23. 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 OFF When the monitor is configured to the Permanent Audio Alarm Off setting use the SILENCE RESET pushbutton to enable or disable audio alarms The SILENCE visual 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 Perm Aud is displayed on the Message Window as a reminder when enabled During a permanent audio alarm off 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 ALARM LIMITS OFF When the monitor is configured to the Alarm Limit Off setting all alarms associated with patient alarms are OFF This mode is useful for spot check applications or if the monitor is being moved from patient to patient and the user may not want to be disturbed by any audible alarms The SILENCE visual indicator located on the front panel of the monitor will flash at a rate of two 2 seconds ON and two 2 seconds OFF and the message Alrm Off will be displayed on the Message Window as a reminder when enabled During an alarm limit off period if an equipment alarm occurs except for Low Battery and Dead Battery the aud
24. system and that of the internal modules being used inside The software versions are displayed in the following order Software Module Message Window CAS 740 Control Board Boot Loader Power Supply PIC Processor PIC X X CAS NIBP Module CAS X X Nellcor SpO Module NEL X X Masimo Module MAS X X Nonin SpO Module NON XX Welch Allyn Temperature Module TABLE 7 Software Revisions 1 The SpO module is optional in the case when it is not installed the Version text advances to the next Module 2 The Temperature module is optional in the case when it is not installed the Version text advances to the next Module Use the ARROW UP or ARROW DOWN pushbuttons to view the messages Press one of the NEXT programmed pushbutton keys to advance onto the next menu or use the CANCEL pushbutton to Save your changes and exit to the Ready mode SETTING THE LANGUAGE The CAS 740 Monitor can operate in one 1 of eight 8 languages English German French Italian Spanish Dutch Swedish or Portuguese To configure the monitor s operating language first enter the Monitor Configuration menu Once in the menu use one of the NEXT programmed pushbutton keys until the Message Window displays the current language being used Use the ARROW UP or ARROW DOWN pushbuttons to make your selection Press one of the NEXT programmed pushbutton keys to advance onto the next menu or use the CANCEL pushbutton to Save your changes and exit to th
25. the user must read the Caution on Page 21 under LEAKAGE CURRENT TEST and follow the guidance given RS232 The CAS 740 monitor uses the DB9 connector to interface to the Citizen CMP 10 Mobile printer using the cable supplied with the printer The connector information provided in this section is made available to allow the user the ability to print the monitor s History data to an external serial printer Refer to Figure 23 and Table 10 for connection information Refer to Section 16 SPECIFICATIONS for Serial Interface information NURSE CALL INTERFACE The CAS 740 Monitor provides an isolated relay switch closure output connection between two 2 of the pins on the DB9 RS232 output connector The output is compatible with most Nurse Call Systems in that there is no polarity to the connection When properly connected the Nurse Call Interface activates the Nurse Call System each time an alarm is activated on the monitor The delay time for the Nurse Call Interface to activate is less than 0 5 seconds The Nurse Call System s relay contacts are rated at 120 VAC at 0 3A or 30 VDC at 1 0 A The Nurse Call Option is available as a normally open closed on alarm or normally closed open on alarm depending upon how it is wired For normally open N O applications the Nurse Call system needs to be connected to pins 1 and 9 of the RS232 connector For normally closed N C applications the Nurse Call system needs to be connected to pins
26. the Patient Environment are defined as Citizen CMP 10 Mobile Printer RS232 Interconnect Cable supplied with printer AC Adapter Charger Model TRC 09 1 100 M from Group West supplied with TABLE 1 Parts of the System 21 02 0171 REV 00 03 03 CAS 740 Monitors 21 02 0171 REV 00 03 03 CAS 740 Monitors Section 2 Unpacking the Monitor CAS 740 Monitors 21 02 0171 REV 00 03 03 CAS 740 Monitors 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 your distributor CAS sales representative or call 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 etc If an item is missing or damaged contact your distributor CAS sales representative or CAS Medical Systems Inc Record the monitor model serial number and date of purchase at the back of this manual MONITOR CHECKLIST Description CAS 740 Monitor AC Power Cord or DC Power C
27. to prevent water or cleaning solution to run into connector openings or crevices 21 02 0171 REV 00 03 03 97 CAS 740 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 CUFFS AND SENSORS Prior to each patient use inspect the blood pressure cuffs SpO finger sensor and cables for damage The blood pressure cuffs and finger sensors should periodically be cleaned following the manufacturers instructions for the particular item in use CAUTION Do not sterilize the sensors by steam or any other method or solution Do not immerse the sensors in water or cleaning solution NOTE Refer to the documentation enclosed with each accessory for any additional sterilization or disinfection instructions 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 PRINTER When the printer becomes dirty wipe with a soft dry cloth For extreme dirt buildup soak a cloth with mild detergent wring well and wipe Dry by wiping w
28. 23 Be KERE 1509 4415 TT 88 60 99 xx Trends Hr Mn Sys Dia Map Pls 02 Temp los04 112 18 89 WA ewe 15 09 115 77 88 60 98 FIGURE 18 Sample Printouts NOTE When no patient information is stored in the Trend History for consecutive minute storage a break appears in the Trends printout If the 02 reading is then the Pulse value Pls shown is associated with the NIBP reading 21 02 0171 REV 00 03 03 86 CAS 740 Monitors CHARGING THE PRINTER BATTERY The CMP 10 Mobile Printer is equipped with a rechargeable Lithium lon LilON 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 included with the printer Plug the battery charger s cord into the printer battery charger jack located on the rear panel Plug the charger into an AC wall outlet of the appropriate voltage Verify the BATTERY LED indicator is lit Red Battery charge time is approximately three 3 hours Once the battery is fully charged the BATTERY LED indicator switches to Green INSTALLING PAPER NOTE A red line appears when the remaining supply of thermal paper becomes low 1 Turn the printer ON and press the Cover Open button to access the paper compartment Remove
29. 3 flashing dashes and no value will be displayed 5 Remove the Calibration Key and re insert the temperature probe connector 6 Install the temperature probe into the probe holder OXIMETRY CALIBRATION CHECK The oximeter is factory calibrated to determine the percentage of arterial oxygen saturation of functional hemoglobin No user calibration is required REPLACING THE MONITOR BATTERY A part number for the battery can be found in the Accessories section of this manual or on the label 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 21 02 0171 REV 00 03 03 105 CAS 740 Monitors REMOVING THE BATTERY 1 Turn the monitor OFF and disconnect the power cord 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 22 FIGURE 22 Removing the Monitor Battery Pack 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 73 BATTERY POWER for additional battery information WARNING DO NOT disassemble the battery pack or batt
30. 40 BPM 5 mmHg with a standard deviation no greater than 8 mmHg See Standards 2 or 2 BPM whichever is greater Functional Oxygen Saturation 0 100 70 100 2 digits 1 S D Adult 70 100 3 digits 1 S D Neonate Red 660 Nanometers Infrared 905 Nanometers Maximum radiant power at 50 mA pulsed is 0 79mW 25 240 BPM 3 BPM Updated every 50 milliseconds max 21 02 0171 REV 00 03 03 125 CAS 740 Monitors Nellcor amp OxiMaxTM Type Range SpO Accuracy Measurement Wavelengths Power Pulse Rate Range Pulse Rate Accuracy Numerics Nonin amp Type Range SpO Accuracy Measurement Wavelengths Power Pulse Rate Range Pulse Rate Accuracy Numerics Functional Oxygen Saturation 1 100 70 100 2 digits 1 S D Adult 70 100 3 digits 1 S D Neonate Red 660 Nanometers Infrared 890 Nanometers Not exceeding 15 mW 20 240 BPM 3 digits Updated every 50 milliseconds max Functional Oxygen Saturation 0 10096 70 100 2 digits 1 S D Adult 70 100 3 digits 1 S D Neonate Red 660 nanometers Infrared 910 Nanometers 3 mW nominal 18 240 BPM 3 or 1 digit whichever is greater Updated every 50 milliseconds max TEMPERATURE OPTIONAL Temperature Range Accuracy 126 28 9 to 42 2 C 84 0 to 108 0 F 0 1 C 0 2 F Meets or exceeds ASTM Standards 21 02 0171
31. 40 Monitors 4 When a double dash appears in the TEMP display window the temperature sensor is ready to take a measurement To take a normal predictive temperature simply insert the probe tip gently into the patient s slightly opened mouth Carefully slide the probe under the tongue on either side of the mouth to reach the sublingual pocket Refer to Figure 9 To take a direct read temperature monitor mode wait 1 minute until a temperature value appears in the TEMP display The decimal point associated with the temperature value will flash at a rate of one 1 second ON and one 1 second OFF as a reminder that you are in monitor mode Insert the probe tip into the patient s mouth as described above NOTE Accurate temperatures can only be obtained in this location Temperatures in other mouth locations can vary by as much as 2 F or 1 Sublingual Pockets FIGURE 9 Location of Sublingual Pockets 5 The probe should be held by the clinician during the entire temperature measurement process to insure the probe tip maintains tissue contact 6 During the predictive temperature measurement cycle walking segments will appear in the TEMP display window indicating that a predictive measurement is in process 7 When the final temperature has been reached the temperature value will be displayed in the TEMP display window and an audible tone will be generated The time of the measurement and the measured temperatur
32. 6 and 9 Refer to Figure 23 and Table 10 for more information WARNING The connection to the Nurse Call Interface should only be installed by a qualified service personnel WARNING The interconnection of auxiliary equipment to the Nurse Call Interface may increase the total leakage current The user must read the Caution on Page 21 under LEAKAGE CURRENT TEST and follow the guidance given 21 02 0171 REV 00 03 03 111 CAS 740 Monitors NOTE Even though the Nurse Call Interface allows remote alarm indication it does not replace appropriate bedside surveillance by trained clinicians Pin 1 Pin 5 FIGURE 23 DB9 Male Connector Pin Layout PinNumber Signal Description Nurse Call N O Isolated Ground Nurse Call N C Nurse Call common TABLE 10 DB9 Pin Out 21 02 0171 REV 00 03 03 112 CAS 740 Monitors Section 14 Accessories 21 02 0171 REV 00 03 03 113 CAS 740 Monitors 21 02 0171 REV 00 03 03 114 ACCESSORIES BLOOD PRESSURE CUFFS Tuff Cuff Reusable Blood Pressure Cuffs single tube Catalog Number CR 5216 CR5214 CR5212 CR5209 CR5207 CR5206 Safe Cuff Single Patient Use Blood Pressure Cuffs single tube Catalog Number CD2060 CD1642 CD1437 CD1230 CD927 CD618 Pedisphyg Description Large Adult Adult Small Adult Child Small Child Infant Description X Large Adult Large Adult Adult Small Adult
33. 76 01 02 0181 01 02 0188 01 02 0189 01 02 0248 01 04 0016 03 08 0386 03 08 0415 03 08 0450 09 01 0002 18 02 0063 18 04 0004 18 04 0010 21 02 0171 21 02 0173 21 02 0175 21 02 0176 21 02 0177 21 02 0178 21 02 0179 21 02 0180 21 02 0174 28 02 0077 Description P9 Calibration Kit includes T connector with tubing and male luer plug Roll Stand with Basket Swivel Mount Kit Carry Bag RS232 Nurse Call Interface Printer Bracket Attachment for Roll Stand Printer Battery Printer includes Battery RS232 Cable Power Supply One 1 Roll of Paper and Manual 500 ml Fixed Volume Cylinder U S A Replacement Power Cord DC Power Cable Monitor Battery Smart Pack 7 2 VDC 3700 mAhr Monitor Battery Pack 7 2 VDC 3700 mAhr Fuse 250V 500mA 5 x 20mm Slow Blow 2 per monitor European Power Cord Australian Power Cord U K Power Cord CAS 740 User s Manual English CAS 740 User s Manual Spanish CAS 740 User s Manual German CAS 740 User s Manual French CAS 740 User s Manual Italian CAS 740 User s Manual Dutch CAS 740 Users Manual Portuguese CAS 740 Users Manual Swedish CAS 740 Service Manual Printer Paper One 1 Roll 21 02 0171 REV 00 03 03 117 CAS 740 Monitors MONITOR CONFIGURATIONS CAS 740 1 MAXNIBP 100 240V 50 60HZ AC Power Supply and Battery CAS 740M 1 MAXNIBP M 12VDC Power input with Battery Mount included MAXNIBP and Masimo SpO 100 240V 50 60HZ AC Power Supply an
34. Child Infant CAS 740 Monitors Size 16 cm x 42 cm 14 x 37 5 cm 12 cm x 30 cm 9 cm x 27 cm 7 cm x 21 cm 6 cm x 18 cm Size 20 cm x 50 cm 16 cm x 40 cm 14 cm x 35 cm 12 cm x 30 cm 9 cm x 22 5 cm 6 cm x 15 cm Single Patient Use Neonatal Blood Pressure Cuffs single tube Catalog Number C26 C39 C412 C515 INFLATION HOSES Catalog Number 01 02 0185 01 02 0131 Description 2 5 cm 3 0 cm 4 0 cm 5 0cm Description Size 2 5 cm x 9 0 cm 3 0 cm x 11 5 cm 4 0 cm x 14 5 cm 5 0 cm x 17 75 cm Six 6 FT Straight NIBP Hose Neonatal and Infant Ten 10 FT Coiled NIBP Hose Adult and Pediatric 21 02 0171 REV 00 03 03 115 CAS 740 Monitors OXIMETRY Masimo Note Use only with Masimo Pulse Oximeter Catalog No Description 01 02 0178 LNOP DCI Adult Reusable Sensor gt 30kg 01 02 0182 4 Patient Cable 4 FT 01 02 0190 LNOP DCIP Pediatric Sensor 01 02 0191 LNOP YI Multisite Sensor 01 02 0192 PCO8 Patient Cable 8 FT 01 02 0246 NR 125 Adult Reusable Sensor gt 30kg Nellcor Note Use only with Nellcor Pulse Oximeter Catalog No 01 02 0179 01 02 0183 01 02 0193 01 02 0194 Nonin Note Use only with Nonin Pulse Oximeter Catalog No 01 02 0100 01 02 0106 01 02 0108 01 02 0123 01 02 0244 01 02 0136 01 03 0117 01 03 0120 01 03 0121 01 03 0122 01 03 0123 01 03 0124 01 03 0125 01 03 0126 01 03 0127 01 03 0129 01 03 0137 01 03 0138 01 03 0166 116 Description
35. Directive 93 42 EEC Class ll equipment if applicable The CAS 740 Monitor is normally a Class device The CAS 740 Monitor becomes a Class II device when it is mounted in an ambulance and connected to a DC power source 740M Symbol used on the rear panel of the CAS 740M to indicate the polarity of the DC power input Direct Current Indicates protection against the effects of the discharge of a cardiac defibrillator Patient connections are Type BF and protected against defibrillation NIBP Hose and Cuff Connector Pulse Oximeter Probe Connector 21 02 0171 REV 00 03 03 13 CAS 740 Monitors SYMBOLS CONT Two way Communication Port RS232 and Nurse Call Interface Connector Temperature Probe Connector These symbols appear on the front panel in the place of text ON OFF STANDBY Turns ON the Monitors display NOTE At a later date symbol will become _ SILENCE RESET ovo START STAT CANCEL vni CYCLE TIME HISTORY 21 02 0171 REV 00 03 03 A CAS 740 Monitors SYMBOLS CONT ii VOLUME ANM ALARM LIMITS A ARROW UP ARROW DOWN Bar graph display of SpO signal strength A BPM Pulse Rate Display ADULT A lighted LED used to indicate NIBP operating in Adult Mode NEO A lighted LED used to indicate NIBP operating in Neonatal Mode TEMP A lighted LED used to indicate the Temperature Option is installed A tri colored LED used to indicate the status of the
36. ITORING The CAS 740 Monitor features a wide variety of SpO technology that is ideal for every application TAKING A SpO MEASUREMENT IMPORTANT Prior to patient monitoring ensure the monitor is configured to the appropriate patient mode Neonate or Adult The following is a general procedure for taking a SpO measurement 1 Select a sensor based on the patient size and monitoring conditions and properly attach the sensor to the patient FINGER CLIP SENSORS The finger clip sensor is designed for spot check monitoring of pediatric and adult patients or continuous monitoring of less than 30 minutes where patient movement is not expected and the patient s finger is large enough for the sensor to be attached securely NOTE If patient movement is occurring or the finger size is inappropriate select a different sensor that is appropriate for the patient and the monitoring environment FIGURE 4 SpO Finger Clip Sensor Application Insert the finger preferably left or right index finger completely into the sensor Place the sensor with the LEDs positioned on the nail side The thumb is specifically not recommended for use with the finger clip sensor 21 02 0171 REV 00 03 03 31 CAS 740 Monitors DISPOSABLE FLEX TYPE SENSORS These types of sensors are designed for patients as a single patient use sensor and is intended for use where moderate patient movement is expected or cross contamination is possible
37. Monitor to your individual needs Once entered the user can Review the monitor s internal Software Revisions Set the Operating Language Select the Patient Mode Select the Temperature Scale Make selections for Audio Alarms Choose to display the MAP value Set the Date Set the Time Set Daylight Saving Time Option Perform System Checks Refer to Page 102 CALIBRATION CHECK Manometer Mode Leak Check ENTERING THE MONITOR CONFIGURATION MENU To enter the monitor s Configuration Menu depress and hold the AUDIO and ALARM LIMITS pushbutton keys while the monitor is being turned ON Once in the menu use one of the NEXT HISTORY AUDIO or PREVIOUS CYCLE TIME ALARM LIMITS programmed pushbutton keys to advance onto the next or go back to the previous parameter in the Configuration Menu NOTE While in the Configuration Menu if no pushbutton is depressed within 60 seconds the monitor will automatically save all changes made and exit the Monitor Configuration menu The Message Window will briefly display Saving and return to the Ready mode SAVING YOUR CHANGES When you have completed configuring the monitor press the CANCEL pushbutton to exit and lock in your selection s The Message Window will briefly display Saving and return to the Ready mode 21 02 0171 REV 00 03 03 68 CAS 740 Monitors SOFTWARE REVISIONS The CAS 740 Monitor displays the current software revision of its operating
38. N Unplug the monitor from the AC power source and remove all the accessories from the monitor before cleaning The monitor must be turned off and not running on the internal battery Never clean the monitor when it is being operated 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 any water or cleaning solution directly onto the monitor Every three 3 months or 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 1096 1 10 solution of chlorine bleach in tap water 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 NOTE Thoroughly wipe off any excess cleaning solutions Care should be taken
39. ND PRECAUTIONS 17 AUTOMATIC SAFETY FEATURES 22 5 BLOOD PRESSURE MONITORING 23 CUFF SELECTION AND APPLICATION 25 vocc NEUE ERU UID 27 6 PULSE OXIMETRY MONITORING 29 TAKING AN SpO MEASUREMENT 81 FINGER CLIP 81 DISPOSABLE FLEXTYPE SENSORS 32 MASIMOIOXIMETRYS Mnt ee i fos ee hee 33 ATTACHING THE CABLES 33 REMOVING THE INTERFACE CABLE 34 MASIMO MESSAGES 2 diria lata aries tac 34 NELLCOR OXIME TEN a d ADM AU LE e 35 ATTACHMENT PROCEDURE 35 REMOVING THE INTERFACE CABLE 85 21 02 0171 REV 00 03 03 CAS 740 Monitors NONINOMMETRY a een ens ice dot tee ld 36 ATTACHING THE SENSOR CABLE 36 REMOVING THE SENSOR CABLE 36 7 TEMPERATURE MONITORING 37 WELCH ALLYN TEMPERATURE 39 TAKING AN ORAL TEMPERATURE sete 39 TAKING A RECTAL TEMPERATURE 41 TAKING AN AXILLARY TEMPERATURE 43 8 MONITOR OPERATION tentent 45 FRONTPANEEL as clem a de lla 47 DIGITAL DISPLAY AND INDICATORS 47 FRONT PANEL se
40. RVALS seseeeenenem mener 101 TEST MODE He TREES 101 EXIT THE TEST MODE coca 101 PED CHECK Cum 102 CALIBRATION CHECK eerta eren nce ret Race a 102 SYSTEM PRESSURBE teilte i ee gain eS 102 OVERPRESSURE iia 103 PNEUMATIC PRESSURE CHECK seem 103 PLUG TUBE ra roe eec ie 103 500 ML PRESSURE conocia 104 TEMPERATURE CALIBRATION CHECK 104 OXIMETRY CALIBRATION CHECK 105 REPLACING THE MONITOR BATTERY sese 105 REMOVING THE BATTERY ir e thes 106 INSTALLING THE BATTERY 106 GHANGING THE FUSES rss een een 107 STORAGE O 107 EXTERNAL DEVICE INTERFACING 109 OVERVIEW rie o e dH dente e dde 111 c 111 NURSE CALL INTERFACE 111 21 02 0171 REV 00 03 03 CAS 740 Monitors 14 ACCESSORIES una once ut ea lacta De aa 118 BLOOD PRESSURE CUFFS ii 115 INFLATION HOSES un es tt a dede dos sa EROR A ae sl 115 DIA ictu toe tui oun bte ee 116 TS A tua ican Ute AT Pi De Rec ATCP 116 a Uti EA dan 116 NONIN ka a ee coa 116 TEMPERATURE Noch aid obit 117 WELCH A Metal DEAE
41. STING THE AUDIO ALARM VOLUME The Alarm Volume can be adjusted to one 1 of five 5 volume levels Depress the AUDIO pushbutton The Message Window displays the current value of the Audio Alarm Volume ALARM 21 02 0171 REV 00 03 03 65 CAS 740 Monitors Use the ARROW UP and ARROW DOWN pushbuttons to adjust the volume level desired Altering the Alarm Volume will produce a single tone at the selected volume level Press the CANCEL pushbutton when completed NOTE The Volume Level cannot be set to OFF NOTE No Key Click will be heard when the Audio Volume is set to a MINIMUM setting ADJUSTING THE SpO BEEP VOLUME available if SpO is installed The Volume for the SpO Beep can be adjusted to one 1 of five 5 levels OFF This setup menu follows directly after the Audio Alarm Volume Depress the AUDIO pushbutton until the Message Window displays the SpO Volume message SpO2 Use the ARROW ARROW DOWN pushbuttons to adjust the volume level desired Altering the Volume will produce a single tone at a selected non off volume level Press the CANCEL pushbutton when completed 2 MINUTE AUDIO SILENCE NOTE Enabling the 2 Minute Audio Alarm Off mode can only be accomplished after all active alarm conditions have been addressed To clear an alarm refer to section CLEARING ALARMS If the 2 Minute Audio Off mode is selected in the Monitor Configuration menu pressing t
42. WELCH ALLYN TEMPERATURE if so equipped WARNING During use single use disposable temperature probe covers supplied by CAS Medical Systems or Welch Allyn will limit patient cross contamination The use of any other probe cover or the failure to use a probe cover may produce temperature errors and will invalidate the monitors warranty Temperature probe covers are required to ensure the safety of the patient and user TAKING AN ORAL TEMPERATURE CAUTION Never use the Temperature Probe without a probe cover Accurate oral temperatures can only be obtained by using the blue temperature probe The use of the wrong probe will produce temperature errors To take an oral temperature in either Predictive or Monitor mode follow this procedure 1 Insure that the oral probe is connected to the monitor The oral probe has a BLUE probe cover ejection button 2 Remove the probe from the probe holder A short self test mode will be initiated where every LED segment in the TEMP display window are illuminated briefly Following this selftest the display will show OrL The OrL in the TEMP display window indicates that the oral algorithm will be used to take a predictive temperature measurement 3 Load a probe cover onto the probe by holding the probe collar with the thumb and forefinger being careful not to hold or press the ejection button Refer to Figure 8 FIGURE 8 Loading the Probe Cover 21 02 0171 REV 00 03 03 39 CAS 7
43. a male and a female luer fitting for a Calibration Check and a male luer plug to be used for the Pneumatic Check Obtain a mercury manometer whose accuracy meets the AAMI ANSI Standard for Non Automated Sphygmomanometers 1994 SYSTEM PRESSURE Assemble the Calibration Kit according to the diagram provided in the P9 kit 1 Remove the manometer tubing from the inflation bulb Connect the open ended tubing of the T connector to the inflation bulb 2 Connect the female luer fitting to the inflation tube leading to the manometer 3 Connect the male luer fitting to the manometer tubing 4 Enter the Test Mode The Message Window will briefly display TEST MODE followed by 0 mmHg 5 Use the manometer inflation bulb to slowly inflate the system to 200 mmHg The monitor display should read 200 mmHg 5 mmHg Hold the pressure at that point for 30 seconds NOTE If the monitor does not display the test pressure for the 30 second period deflate to zero 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 0171 REV 00 03 03 102 CAS 740 Monitors Inflate the system pausing at the following points to verify calibration 0 mmHg 1 mmHg 50 mmHg 4 mmHg 100 mmHg 4 mmHg 150 mmHg 4 mmHg 200 mmHg 5 mmHg OVERPRESSURE Inflate the pressure sl
44. acle Push the cable in until you hear an audible click 21 02 0171 REV 00 03 03 33 CAS 740 Monitors 5 Press the POWER pushbutton to turn ON the monitor 6 Check the Alarm Limits and configure them appropriately for the patient Refer to Page 62 PATIENT ALARM MODE for more information REMOVING THE INTERFACE CABLE When SpO monitoring is not required disconnect the Interface Cable by squeezing the grey tabs with your thumb and index finger while pulling the 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 When the probe is disconnected from the monitor the message No Probe appears in the Message Window and an audible alarm sounds indicating a connection has been broken Press the SILENCE RESET pushbutton to silence the visual and audible alarm NOTE If either the 2 Minute Audio Off or Permanent Audio Off is enabled no audio will be heard but a visual message will appear in the Message Window See Section 14 ACCESSORIES for Masimo oximeter probe types and part number information Consult instructions enclosed with each sensor for proper application MASIMO MESSAGES When the message Low Perf or Low Sig appear in the Message Window and the monitor is displaying valid SpO gt numerics no audible alarm will be heard When the message Low Perf or Low Sig appear in th
45. adio operator an airport or cellular phone their signals could be picked up as signals by the monitor If you feel interference is affecting the monitor contact your CAS Medical Systems representative to check the monitor in your environment 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 other 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 LEAKAGE CURRENT TEST The interconnection of auxiliary 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 qualified biomedical engineering personnel before using with patients Serious injury or death could result if the leakage current exceeds applicable standards 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 o
46. airment of circulation and that the monitor is functioning properly 21 02 0171 REV 00 03 03 22 CAS 740 Monitors Section 5 Blood Pressure Monitoring 21 02 0171 REV 00 03 03 23 CAS 740 Monitors 21 02 0171 REV 00 03 03 24 CAS 740 Monitors BLOOD PRESSURE MONITORING CUFF SELECTION AND APPLICATION The use of properly designed and sized cuffs is essential for the accurate measurement of blood pressure Safe Cuff adult single patient use cuffs or Tuff Cuff amp reusable cuffs or Pedisphyg are recommended for use with the CAS 740 Monitor The widest cuff that can be placed around the upper arm or thigh should be used A cuff that is too small for the arm will not supply sufficient pressure to the artery This can cause an erroneously high blood pressure reading Substitution of a cuff different from that supplied might result in a measurement error NOTE Overlapping the cuff will not affect the measurement results RECOMMENDED RANGE MAKE SURE THAT THI amp EDGE 18 YEN ON THIS ARRA WHEN ON PATIENT FIGURE 2 Cuff Application As an example the end of the Tuff Cuff is marked with a white arrow To insure that the proper cuff size has been selected wrap the cuff around the patient s extremity the arrow should point between the white markings on the cuff Verify the hook and loop sections of the cuff are fully engaged when it is wrapped around the limb Measurements made above the level of th
47. al quality An audio beep can be enabled that is generated each time the SpO sensor detects a pulse NOTE The bar graph is not proportional to the pulse volume The temperature parameter has the capability of taking temperature in either normal predictive or monitor mode In the normal mode the thermometer s microprocessor predicts body temperature in about four 4 seconds for oral temperatures about ten 10 seconds for axillary temperatures and in about fifteen 15 seconds for rectal temperatures Monitor mode is normally used for longer term monitoring and when difficult situations prevent accurate temperature from being taken in the predictive mode In monitoring mode the probe must be in contact with tissue for at least three 3 minutes for accurate oral rectal temperature measurement and five 5 minutes for accurate axillary temperature measurement The default setting used by the CAS 740 Monitor for temperature determinations is the normal predictive mode NOTE Axillary temperature readings may only be taken in the Neonate monitoring mode PATIENT ENVIRONMENT The CAS 740 Monitor has been tested with specific parts of the system used within the Patient Environment Figure 1 defines the Patient Environment PE Edi dien 6 a X c o m mom FIGURE 1 Patient Environment 21 02 0171 REV 00 03 03 CAS 740 Monitors The parts of the CAS 740 Monitor system that can be used in
48. character 2 describes how many parameters are installed in the monitor The monitor in our example is configured for NIBP and SpO Installed Parameter Codes include gt 1 2 NIBP and SpO or Temperature 3 NIBP SpO and Temperature e third set of characters MS describes the type of module installed The monitor in our example is configured for Masimo oximeter Configuration Codes are gt MS Masimo NL Nellcor NN Nonin T Temperature 21 02 0171 REV 00 03 03 55 CAS 740 Monitors The four 4 second Power On SelfTest consists of e All equipped parameter segments are lit for one 1 second e All High Alarm Values are displayed for one 1 second in their corresponding numeric display window and an audible tone is emitted from the monitor s internal speaker The Message Window indicates HI LIMS e All Low Alarm Values are displayed for one 1 second in their corresponding numeric display window and an audible tone is emitted from the monitor s internal speaker The Message Window indicates LO LIMS e The monitors current time is displayed for 1 second Once the test is completed the monitor indicates that it is Ready for use FRONT PANEL INTENSITY CONTROL The CAS 740 Monitor utilizes Super Bright LED displays in its front panel for better viewing in a variety of environments If the displays are too bright or should the need come to operate the monitor in a dimly lit environment the mo
49. connected from the monitor AUTOMATIC SAFETY FEATURES The monitor has been designed to promote patient safety The maximum amount of time allowed to complete a blood pressure measurement is 120 seconds in adult mode and 90 seconds in neonate mode 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 in the adult mode or 145 mmHg in the neonatal mode 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 Should the AC or DC power be interrupted coming into the monitor the monitor automatically runs off battery power An indication of this would be a change in color of the Battery Power Visual Indicator 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 75 POWER FAIL for more information CAUTION Regardless of these safety features always be sure to check that there are no signs of prolonged imp
50. d Batter MAXNIBP and Masimo SpO 12VDC Power input with Battery Mount included MAXNIBP and Nellcor SpO 100 240V 50 60HZ AC Power Supply and Batter CAS 740M 2NL MAXNIBP M and Nellcor SpO 12VDC Power input with Battery Mount included MAXNIBP and Nonin SpO 12VDC Power input with Battery Mount included MAXNIBP and Temperature 100 240V 50 60HZ AC Power Supply and Batter MAXNIBPTM and Temperature 12VDC Power input with Battery Mount included MAXNIBPTM Masimo SpO and Temperature 100 240V 50 60HZ AC Power Supply and Batter MAXNIBP Masimo SpO and Temperature 12VDC Power input with Battery Mount included MAXNIBP Nellcor SpO and Temperature 100 240V 50 60HZ AC Power Supply and Batter MAXNIBP M Nellcor SpO and Temperature 12VDC Power input with Battery Mount included MAXNIBP Nonin SpO and Temperature 100 240V 50 60HZ AC Power Supply and Batter MAXNIBP M Nonin SpO and Temperature 12VDC Power input with Battery Mount included TABLE 11 Monitor Configurations CAS 740 2NN MAXNIBP and Nonin SpO 100 240V 50 60HZ AC Power Supply and Batter 21 02 0171 REV 00 03 03 118 CAS 740 Monitors Section 15 Glossary 21 02 0171 REV 00 03 03 119 CAS 740 Monitors 21 02 0171 REV 00 03 03 120 CAS 740 Monitors GLOSSARY Diastolic The Diastolic pressure is the bottom lower number given in a blood pressure reading This number represent
51. e 3 times and the return to the Calibration Check function after five 5 seconds 21 02 0171 REV 00 03 03 103 CAS 740 Monitors Due to the volume differences of the hoses offered with the CAS 740 Monitor the monitor may incorrectly fail the Plug Tube check Should the monitor fail the Plug Tube Pressure Check obtain a 500 ml Pressure Oylinder and follow the 500 ml Pressure Check 500 ml PRESSURE CHECK 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 securely onto the connector for this test to be performed properly Enter the Test Mode The Message Window will briefly display TEST MODE followed by 0 mmHg Press the START pushbutton to begin the Pressure Check The Message Window will display Chk Prs will inflate to approximately 160 mmHg and attempt to hold this pressure The pressure value will be displayed in the SYSTOLIC display window This test takes about fifteen 15 seconds At the completion of a successful Pressure Check the Message Window will display Passed the monitor will beep two 2 times and will return to the Calibration Check function after five 5 seconds If the monitor fails the Pressure Check the Message Window will display Leak the monitor will beep three 3 times and the return to the Calibration Check function after five 5 seconds
52. e Ready mode SELECTING THE PATIENT MODE The CAS 740 Monitor can be used on patients from Neonates to Adults To configure the monitor s operating mode first enter the Configuration Menu Once in the menu use one of the NEXT programmed pushbutton keys until the Message Window displays PATIENT 21 02 0171 REV 00 03 03 69 CAS 740 Monitors Use the ARROW UP or ARROW DOWN pushbuttons to select the patient mode The front panel display will illuminate with the patient mode selected ADULT Adult Pediatric NEO Neonate NOTE Altering the patient mode automatically sets the parameter High and Low Limits to the appropriate patient default limits and affects the NIBP mode Refer to Table 5 Default Alarm Values for more information Press one of the NEXT programmed pushbutton keys to advance onto the next menu or use the CANCEL pushbutton to Save your changes and exit to the Ready mode SELECTING THE TEMPERATURE SCALE available if Temperature is installed The CAS 740 Monitor can display Temperature readings in either the Celsius or Fahrenheit scales To select the operating Temperature scale used by the CAS 740 Monitor enter the Monitor Configuration menu Once in the menu use one of the NEXT programmed pushbutton keys until the Message Window displays the Temperature setup menu F or Use the ARROW UP or ARROW DOWN pushbuttons to make your selection Press one of the NEXT programmed pushbutto
53. e Message Window and the monitor is not displaying valid SpO numerics an audible alarm will be heard Press the SILENCE RESET pushbutton The monitor silences the audio alarm tone but the message remains 21 02 0171 REV 00 03 03 34 CAS 740 Monitors NELLCOR OXIMETER if so equipped The CAS 740 Monitor can be equipped to use Nellcor OxiMax sensors No other manufacturer s sensors should be used NOTE CAS 740 Monitors equipped with Nellcor oximetry will have the Nellcor OxiMax logo next to the SpO connector ATTACHMENT PROCEDURE 1 Select and apply a sensor that is the appropriate size for the patient s digit or extremity according to the instructions provided by Nellcor 2 Connect the sensor assembly 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 c Lock the plastic hinged cover to prevent accidental cable disconnection 3 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 4 Press the POWER pushbutton to turn ON the monitor 5 Check the Alarm Limits and configure them appropriately for the patient Refer to Page 62 PATIENT ALARM MODE for more information REMOVING THE INTERFACE CABLE W
54. e Monitor Configuration menu An Infrared IrDA output port located on the bottom panel of the monitor s front cover is available to print the SpO and Temperature History data to the optional external printer or other data collection device s 21 02 0171 REV 00 03 03 51 REAR PANEL CAUTION US FEDERAL LAW RESTRICTS THIS DENCE 10 SALE ON OR BY THE ORDER OF A PHYSICIAN US PATENT OM 134 5 422 405 OTHER PATENTS PEMOING Fuse 2501 FIGURE 14 Rear Panel View CAS 740 Monitor without Temperature Module AC DC CONNECTION Receptacle for the AC power cord when the CAS 740 Monitor is purchased with an AC Line Power option and built in battery When the CAS 740 Monitor is purchased as an EMS monitor equipped with a Swivel Mount the ambulance DC power cord is attached here FUSE COMPARTMENT When the CAS 740 Monitor is purchased for AC Line power the power input receptacle incorporates dual fuses located in the hot and neutral lines BATTERY COMPARTMENT The CAS 740 Monitor is equipped with a 7 2 Volt 3700 mAhr battery pack that when fully charged is capable of taking 100 NIBP readings when the monitor is set in the 5 minute Automatic Mode NOTE The serial number label is located on the bottom of the monitor 21 02 0171 REV 00 03 03 52 CAS 740 Monitors LEFT SIDE VIEW FIGURE 15 Left Side Panel View MAXIT CUFF HOSE CONNECTION The inflation hose is connected to th
55. e available time intervals Once a time interval has been selected press the START pushbutton to begin the first measurement Between each measurement the Message Window will display 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 CC is the cycle time selected The measurement results are displayed on the front panel until the start of the next measurement cycle NOTE If a measurement is desired between measurement cycles press the START pushbutton After this measurement the monitor will re enter the Automatic Cycle mode and countdown to the next measurement based on the Cycle time selected In the Automatic Mode while during a measurement or in the idle time between measurements pressing the CANCEL pushbutton will cause the monitor to exit the Automatic mode and return to the Manual mode The monitor s front panel NIBP numeric displays will indicate the reading of the previous measurement taken and the Message Window will display the time stamp of that reading STAT MODE CAUTION Readings obtained during STAT mode may not meet the stated accuracy of this monitor The CAS 740 Monitor can automatically take a series of blood pressure measurements for a five 5b minute interval with a brief approx ten 10 second pause between determinations to allow venous blood return Pres
56. e functions are affected by changing between ADULT and NEONATE operating modes IMPORTANT Prior to patient monitoring ensure the monitor is configured to the appropriate patient mode Neonate or Adult Refer to Page 69 SELECTING THE PATIENT MODE for more information Once power has been applied a visual indicator located on the front panel of the monitor indicates the current operating mode TURNING THE CAS 740 MONITOR ON Press the ON OFF STANDBY pushbutton on the front panel to turn the monitor ON Upon applying power to the monitor the CAS 740 Monitor displays a one 1 second Configuration Setup Test and conducts a four 4 second electronic Power On Self Test POST 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 The one 1 second Configuration Setup Test is a visual indication of the CAS 740 Monitor s current configuration It consists of the monitors Model number and a description of its power source 740 or 740M an Installed Parameter Code 1 2 3 and a one 1 or two 2 character module configuration code As an example upon power up the CAS 740 Monitor displays 740 2MS e first set of characters indicates the Model number and the source of its power supply 740 Internal AC Line Power or 740M DC connection e The second
57. e heart will give reduced blood pressure readings while measurements made below the heart level will give increased readings These errors are mainly due to the weight of the blood The CAS cuff is very easy to use because it does not require exact placement over the brachial artery The fully encircling bladder ensures that the artery is properly compressed every time 21 02 0171 REV 00 03 03 25 CAS 740 Monitors Do not compress the cuff or the cuff hose The hose must not be kinked or pinched It can be placed in any position For best results a cuff should be wrapped for a snug fit and the limb should be positioned to be at heart level Do not wrap a cuff over the patient s clothing inaccuracies could be introduced into the measurement FIGURE 3 Cuff Positioning NOTE Remember that there may be a marked difference between readings taken from the left and the right arms Be consistent with each patient 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 SpO monitoring WARNING When monitoring over an extended period 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 21 02 0171 REV 00 03 03 26 CAS 740 Monitors Use the following tables as a guide to select the correct size cuff Pedisphyg Neonatal Cuff
58. e is completed temperature is completed button action TABLE 6 Audible and Visual Indicators The message interval time will vary based on what monitor conditions are present NOTE Refer to Table 9 on Pages 78 80 for a listing of messages that may be displayed in the Message Window 21 02 0171 REV 00 03 03 64 CAS 740 Monitors CLEARING ALARMS The CAS 740 Monitor provides to the user an audible and visual indication for both patient and equipment alarm conditions NIBP PATIENT ALARMS During a NIBP Patient Alarm Limit Violation the monitor flashes the LED display of the parameter in alarm and provides a Patient Alarm Limit Violation audible tone To silence the alarm depress the SILENCE RESET pushbutton The monitor silences the audible tone and the parameter in alarm continues to flash To clear the flashing parameter perform one of the following e If the CAS 740 Monitor was in the Automatic NIBP Mode pressing the CANCEL pushbutton will cause the monitor to exit the Automatic mode and return to the Manual mode The monitor s front panel NIBP numeric displays will indicate the reading of the measurement taken the parameter in alarm will continue to flash and the Message Window will display the time stamp of that reading e fthe CAS 740 Monitor was in the Manual mode pressing the CANCEL pushbutton will clear the flashing parameter from the display The monitor s front panel NIBP displays will ind
59. e monitor where the MAXNIBP logo is located as shown in Figure 15 The hose must be connected to the cuff prior to use NOTE An optional six 6 foot inflation hose is available when monitoring in the NEO mode Refer to Section 14 ACCESSORIES for part number information SENSOR CONNECTION if equipped Connect the sensor cable in this receptacle for SpO monitoring 21 02 0171 REV 00 03 03 53 CAS 740 Monitors RIGHT SIDE VIEW FIGURE 16 Right Side Panel View CAS 740 Monitor with Temperature and RS232 Module Installed TEMPERATURE PROBE ELECTRICAL CONNECTION if equipped Connect the Temperature cable in this receptacle for Temperature monitoring Leave the probe connection in place The Temperature function is OFF until the probe is removed from the holder Refer to Section 7 TEMPERATURE MONITORING for more information TEMPERATURE HOLDER if equipped Store the Temperature Probe and Temperature Probe Covers in their holder locations when it is not in use EXTERNAL DEVICE INTERFACING The CAS 740 Monitor is available with a combined optional DB9 RS232 output and Nurse Call Interface The RS232 output maybe used to interface to the Citizen CMP 10 Mobile Printer or another serial printing device Refer to Section 13 EXTERNAL DEVICE INTERFACING for more information 21 02 0171 REV 00 03 03 54 CAS 740 Monitors MONITOR OPERATING INSTRUCTIONS ADULT NEONATE OPERATING MODE NIBP and Temperatur
60. e will be stored in the monitor s history memory 21 02 0171 REV 00 03 03 40 CAS 740 Monitors NOTE If the probe tip did not maintain tissue contact during the entire predictive measurement the final temperature displayed in the TEMP display window will flash If this occurs it is recommended that a new temperature be taken Depress the SILENCE RESET pushbutton or after waiting for two 2 minutes the monitor will automatically blank the display 8 After the temperature measurement is complete remove the probe from the patient s mouth and eject the probe cover by firmly pressing the ejection button on the probe Properly dispose of the used probe cover per protocol 9 Insert the probe into the probe holder before attempting to take another temperature measurement 10 Following a completed temperature measurement the current temperature measurement is displayed for thirty 30 seconds after which time the TEMP display will go blank TAKING A RECTAL TEMPERATURE CAUTION Never use the Temperature Probe without a probe cover Accurate rectal temperatures can only be obtained by using the red temperature probe The use of the wrong probe will produce temperature errors To take a rectal temperature follow this procedure 1 Insure that the rectal probe is connected to the monitor The rectal probe has a RED probe cover ejection button 2 Remove the probe from the probe holder A short self test mode will be ini
61. ed 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 PHYSICAL DIMENSIONS amp WEIGHT Base Unit HxWxD Weight OPTIONAL ACCESSORIES Infrared Printer 6 75 in x 8 5 in x 3 0 in 17 cm x 21 5 cm x 7 5 cm 3 lbs approx 1 4 kg Swiveled Hard Mount for ambulance applications Roll Stand and Basket Protective Carrying Case SERIAL INTERFACE Speed Interface Signal Level Data Length Start Bit Stop Bit Parity 9600 Bidirectional serial communication RS232C 8 bits 1 bit 1 bit None 21 02 0171 REV 00 03 03 129 CAS 740 Monitors STANDARDS Accuracy complies with that given in American National Standard for Electronic or Automated Sphygmomanometers ANSI AAMI SP10 1992 Adult blood pressure measurements determined with this device are equivalent to those obtained by an auscultatory blood pressure measurement device and neonatal ones are equivalent to those obtained by an intra arterial blood pressure device within the limits prescribed by the American National Standard for Electronic or Automated Sphygmomanometers The 4 Korotkoff sound was used to determine Diastolic pressure Study findings are available Units comply with the following requirements EN 60601 1 EN 60601 1 2 EN 865 EN 60601 2 30 EN 60601 2 49 ETL Listed UL 2601 CAN CSA C22 2 No 601 1 CE marking acc
62. ensors reusable temperature probes 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 manufacturers 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 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 Masimo Nellcor Nonin and Welch Allyn 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 Accessories Ninety 90 Days Masimo Nellcor and Nonin Sensors Welch Allyn Temperature Probes Batteries Ore 1 Year Cuffs all Out of box failure only External Printer Ore 1 Year Other Accessories 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
63. eries The batteries contain electrolytes which can cause injury to eyes skin and clothing 21 02 0171 REV 00 03 03 106 CAS 740 Monitors 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 CAS 740 Monitor uses a dual fuse power input receptacle The receptacle incorporates fuses in the hot and neutral AC input lines that are user serviceable The two 2 fuses for the CAS 740 Monitor are each rated at 250V 500mA 5 x 20 mm Slow Blow Refer to Section 14 ACCESSORIES for part number information 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 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 fuses k Turn the monitor OFF and disconnect the power cord N Depress down on the locking tab which holds the fuse holder in the power input receptacle gt Remove the fuses al 3 While holding down on the tab pull the fuse holde
64. es allow the user to recall previously taken measurements The measurement results and the time the measurement was taken are also displayed Patient History is organized in two visually displayed lists Event History Pressing the HISTORY pushbutton the first time reveals the first viewable list that contains up to 480 entries of Event driven data NIBP and Predictive Temperature if installed along with the corresponding SpO results if installed Trend History Pressing the HISTORY pushbutton again reveals the second viewable list that contains up to 480 entries of Trend History at one 1 minute intervals The Trend History contains all the events from the Event History log combined with readings that are saved every minute consisting of a one 1 minute average of the 5 values if installed and Monitor Mode Temperature values if installed NOTE Both Event and Trend 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 depressed use the HISTORY pushbutton to toggle between the two History menus When completed press the CANCEL pushbutton to return to Ready or after thirty 30 seconds of button inactivity the monitor will automatically return to Ready NOTE History data values for NIBP and Predictive Temperature are saved as they occur History data values for one 1 min
65. es for thirty 30 seconds if no other pushbutton is depressed To change the value of an Alarm Limit press the ALARM LIMITS pushbutton again The Alarm Limit value is displayed in its corresponding display window and the Message Window will display the limit s name Use the ARROW UP or ARROW DOWN pushbuttons to change the limit value Use the ALARM LIMITS pushbutton key to advance onto the next parameter value Press the CANCEL pushbutton to return to Ready or after thirty 30 seconds of button inactivity the monitor will automatically return to Ready The alarm value s set will now be used until power is turned OFF SAVING ALARM LIMITS To save the Alarm Limit values to non volatile memory press and hold the ALARM LIMITS pushbutton for two 2 seconds while in the Alarm Limits set value mode The Message Window will display SAVE N Press either the ARROW UP or ARROW DOWN pushbuttons will display SAVE Y in the Message Window Depress the ALARM LIMIT pushbutton a final time The Message Window will display Saving and the current value s will be saved in memory When finished press the CANCEL pushbutton to return to the Ready state These values will be retained in memory even after the monitor is turned OFF 21 02 0171 REV 00 03 03 62 CAS 740 Monitors RESTORE FACTORY DEFAULTS To restore the factory default settings press the ALARM LIMITS pushbutton to enter the Alarm Limits mode
66. f the accessory in the patient vicinity and evidence that the safety certification of the accessory has been performed in accordance with the appropriate IEC 601 1 and or IEC 601 1 1 harmonized national standard 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 Read this manual carefully before patient use of the monitor 21 02 0171 REV 00 03 03 21 CAS 740 Monitors GENERAL NOTES If the accuracy of any measurement does not seem reasonable first check the patient s vital signs by alternate means and then check the CAS 740 Monitor for proper functioning The monitor is suitable for use in the presence of electro surgery The monitor is suitable to be connected to public AC mains power 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 CAS 740 Monitor is not Category AP or APG Equipment The CAS 740 Monitor is for Continuous Operation The CAS 740 Monitor applied parts are Type BF Defibrillation Proof The CAS 740 Monitor provides only ordinary protection from ingress to moisture To completely remove AC Mains power from the CAS 740 Monitor the power cord must be dis
67. g is completed remove the sensor from the patient When the probe is removed from the patient the message Prb OFF appears in the Message Window and an audible alarm sounds indicating a connection has been lost Press the SILENCE RESET pushbutton The monitor silences the audible alarm tone but the message remains NOTE If either the 2 Minute Audio Off or Permanent Audio Off is enabled no audio will be heard but a visual message will appear in the Message Window MASIMO OXIMETER if so equipped The CAS 740 Monitor can be equipped to use SpO sensors manufactured by Masimo No other manufacturer s sensors should be used NOTE CAS 740 Monitors equipped with Masimo oximetry will have the Masimo SET logo next to the SpO connector ATTACHING THE CABLES 1 Select and apply a sensor that is the appropriate size for the patient s digit or extremity according to the instructions provided by Masimo 2 Orient the connecting tab of the sensor so that the shiny contacts are pointed up Mate the logo on the sensor to the logo on the patient cable 3 Insert the tab of the sensor into the patient cable connector until there is a tactile or audible click connection Verify a secure connection and gently tug on the patient cable connector 4 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 recept
68. h time the TEMP display will go blank See Section 14 ACCESSORIES for Welch Allyn temperature probe types and part number information Consult instructions enclosed with each probe for proper application 21 02 0171 REV 00 03 03 44 CAS 740 Monitors Section 8 Monitor Operation 21 02 0171 REV 00 03 03 45 CAS 740 Monitors 21 02 0171 REV 00 03 03 46 CAS 740 Monitors MONITOR OPERATION FRONT PANEL CAS 740 AAD aV FIGURE 12 Front Panel View DIGITAL DISPLAY AND INDICATORS SYSTOLIC mmHg Red colored LEDs indicate the Systolic pressure measurement in mmHg DIASTOLIC mmHg Red colored LEDs indicate the Diastolic pressure measurement in mmHg MAP mmHg Red colored LEDs indicate the Mean Arterial Pressure in mmHg if enabled TEMP A Yellow LED indicator with Red colored LEDs indicates temperature value if installed 21 02 0171 REV 00 03 03 47 CAS 740 Monitors 96 SpO2 BPM ADULT NEO TEMP Ready 48 Green colored LEDs indicates the SpO gt value if installed Red colored LEDs indicate the Pulse Rate in BPM beats per minute Green colored LEDs provide a visual indication of the SpO signal strength in a bar graph form if installed A yellow LED indicator used to inform the user that the NIBP is operating in the Adult Mode A yellow LED indicator used to inform the user that the NIBP is operating in the Neonatal Mode A yellow LED indicator used to inform the
69. he SILENCE RESET pushbutton will temporarily deactivate the audio alarms for two 2 minutes The visual indicator next to the SILENCE RESET pushbutton will illuminate continuously and the message 2Min Aud will be displayed in the Message Window as a reminder NOTE If the Message Window is currently displaying a time stamp from a previously taken NIBP measurement the 2Min Aud message will alternately be displayed with the time stamp message When the 2 Minute Audio Off is enabled the monitor will not alarm for patient related High and Low alarms NIBP Application Error and SpO Probe Alarm 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 re armed automatically after two 2 minutes Refer to Page 70 AUDIO ALARMS for more information 21 02 0171 REV 00 03 03 66 CAS 740 Monitors PERMANENT AUDIO ALARM SILENCE NOTE Enabling the Permanent Audio Alarm Off mode can only be accomplished after all active alarm conditions have been addressed To clear an alarm refer to section CLEARING ALARMS If the Permanent Audio Off mode is selected in the Monitor Configuration menu pressing the SILENCE RESET pushbutton will deactivate the audio alarms The visual indicator next to the SILENCE RESET pushbutton will flash at a rate of one 1 second ON and one 1
70. he monitor The connector is shaped like a D Line up the on the sensor cable with the on the receptacle Push the connector in completely 3 Press the POWER pushbutton to turn ON the monitor 4 Check the Alarm Limits and configure them appropriately for the patient Refer to Page 62 PATIENT ALARM MODE for more information REMOVING THE SENSOR CABLE When SpO monitoring is not required disconnect the Sensor Cable by carefully removing the connector from the SpO input receptacle NOTE To avoid damage to the Sensor Cable always hold it by the connector rather than the cable when connecting or disconnecting either end When the probe is disconnected from the monitor the message No Probe appears in the Message Window and an audible alarm sounds indicating a connection has been broken Press the SILENCE RESET pushbutton to silence the visual and audible alarm NOTE If either the 2 Minute Audio Off or Permanent Audio Off is enabled no audio will be heard but a visual message will appear in the Message Window Refer to Section 14 ACCESSORIES for Nonin oximeter probe types and part number information Consult instructions enclosed with each sensor for proper application 21 02 0171 REV 00 03 03 36 CAS 740 Monitors Section Temperature Monitoring 21 02 0171 REV 00 03 03 37 CAS 740 Monitors 21 02 0171 REV 00 03 03 38 CAS 740 Monitors TEMPERATURE MONITORING
71. hen SpO monitoring is not required disconnect the Interface Cable by squeezing the grey tabs with your thumb and index finger while pulling the 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 When the probe is disconnected from the monitor the message No Probe appears in the Message Window and an audible alarm sounds indicating a connection has been broken Press the SILENCE RESET pushbutton to silence the visual and audible alarm NOTE If either the 2 Minute Audio Off or Permanent Audio Off 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 Consult instructions enclosed with each sensor for proper application 21 02 0171 REV 00 03 03 35 CAS 740 Monitors NONIN OXIMETER if so equipped The CAS 740 Monitor can be equipped to use SpO sensors manufactured by Nonin No other manufacturer s sensors should be used NOTE CAS 740 Monitors equipped with Nonin oximetry will have the Nonin logo next to the SpO connector ATTACHING THE SENSOR CABLE 1 Select and apply a sensor that is the appropriate size for the patient s digit or extremity according to the instructions provided by Nonin 2 Plug the sensor assembly into the SpOs connector on the side panel of t
72. ht Saving Time North America Use this setting and the monitor will automatically aad one 1 hour the first Sunday in April at 2 a m and subtract 1 hour the last Sunday in October at 2 a m e DSTEU1 2 3 Daylight Saving Time European Union In the European Union Daylight Saving Time begins and ends at 1 a m Universal Time Greenwich Mean Time It starts the last Sunday in March and ends the last Sunday in October In the EU alltime zones change at the same moment 21 02 0171 REV 00 03 03 72 CAS 740 Monitors Select EU 1 if the monitor will be located in Ireland Portugal or the United Kingdom Select EU 3 for Finland EU 2 can be used for all remaining countries within the European Union NOTE Enabling Daylight Saving Time will affect the History readings but not erase them Press one of the NEXT programmed pushbutton keys to advance onto the next menu or use the CANCEL pushbutton to save your changes and exit to the Ready mode BATTERY POWER The CAS 740 Monitor is equipped with an internal rechargeable battery The battery is charging whenever the monitor is plugged into a power source AC Line Power or 12 VDC 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 a power source whenever po
73. i nest decebat 49 INFRARED DATA PORT en ee sra ee 51 O 52 ACDO CONNECTOR eis cured Eee acti Mane ata 52 FUSE COMPARTMENT eigene 52 BATTERY COMPARTMENT a einen 52 LEET SIDE RANEI coii ee 53 MAX NIBP CUFF HOSE CONNECTION 53 SpO SENSOR CONNECTION 53 RIGHT SIDE PANEL ae De red 54 TEMPERATURE PROBE ELECTRICAL CONNECTION 54 TEMPERATURE HOLDER i ticos etm credatis centies 54 EXTERNAL DEVICE INTERFACING 54 MONITOR OPERATING INSTRUCTIONS 55 ADULT NEONATE OPERATING MODE eet 55 TURNING THE CAS 740 MONITOR 55 FRONT PANEL INTESITY CONTROL 56 DISPLAYING THE TIME ae 56 MANUAL MODE FOR BLOOD PRESSURE DETERMINATION 56 AUTOMATIC CYCLE FOR BLOOD PRESSURE DETERMINATION 58 A 58 HISTORY MODES see LI DL DL LL 59 EVENT EIS TORY iei eet es et 60 TREND HISTORY one ee 60 PRINT HISTOR Vei a ee ern 61 CLEARING HISTORY a ee 61 REAL TIME CLOCK nette ee 61 21 02 0171 REV 00 03 03 CAS 740 Monitors PATIENT ALARM enne 62 CHANGING ALARM LIMITS 62 SAVING ALARM LIMITS mH 62 RESTORE FACTORY DEFAULTS eem 63 ALARM LIMIT VALUES cussions enoei ite
74. icate all dashes and the Message Window returns to Ready e Depress the START or STAT pushbutton to begin a new measurement HIGH LOW SpO ALARMS During either a High or Low SpO Alarm Limit Violation the monitor flashes the SpO LED display provides a Patient Alarm Limit Violation audible tone and displays the appropriate message SpO2 Hi or SpO2 Lo in the Message Window To silence the alarm depress the SILENCE RESET pushbutton The monitor silences the audible tone the parameter in alarm continues to flash on the front panel and the appropriate message will be displayed in the Message Window This will continue until the alarm condition no longer exists SpO PULSE RATE ALARM During a SpO Pulse Rate Alarm Limit Violation the monitor flashes the A BPM LED display and provides a Patient Alarm Limit Violation audible tone To silence the alarm depress the SILENCE RESET pushbutton The monitor silences the audible tone and the parameter in alarm continues to flash This will continue until the alarm condition no longer exists EQUIPMENT ALARMS During an Equipment Alarm the monitor displays the alarm parameter in either the Message Window or flashes the LED display of the alarmed parameter and provides an audible Alarm Tone To clear the alarm depress the SILENCE RESET pushbutton The monitor silences the audible tone and clears the parameter NOTE The Low Battery and Dead Battery alarms cannot be silenced ADJU
75. io alarm remains silenced and only a visual indicator is provided MAP VALUE ENABLE DISABLE During a blood pressure reading the user can elect to display or not to display the MAP value Enter the Monitor Configuration menu and use one of the NEXT programmed pushbutton keys until the Message Window displays the current setting for the MAP value MAP On or MAP Off Use the ARROW UP or ARROW DOWN pushbuttons to make your selection NOTE When MAP Off is selected MAP values are omitted from History Display and Printing as well All alarms associated with MAP values are also disabled Press one of the NEXT programmed pushbutton keys to advance onto the next menu or use the CANCEL pushbutton to Save your changes and exit to the Ready mode 21 02 0171 REV 00 03 03 71 CAS 740 Monitors SETTING THE DATE The CAS 740 Monitor s Date value is set at the factory Should it need to be changed enter the Monitor Configuration menu and use one of the NEXT programmed pushbutton keys until the Message Window displays the monitor s date using the following format DDMMMYY Where DD Day of the Month MMM Month of the Year Jan Feb etc and YY Last 2 digits of the year 2002 is displayed as 02 The flashing parameter indicates the parameter that can be changed Use the ARROW UP or ARROW DOWN pushbuttons to make your selection Press one of the NEXT programmed pushbutton keys to advance to the next parameter to set within the Date
76. ion Therefore its RF emissions are very low and are not likely to cause any interference in nearby electronic equipment RF emissions CISPR 11 Group 1 RF emissions CISPR 11 Harmonic emissions IEC 61000 3 2 sais Voltage fluctuations flicker Complies emissions The CAS 740 is suitable for use in all establishments including domestic establishments and those directly connected to the public low voltage power supply network that supplies buildings used for domestic purposes Immunity Test IEC 60601 Test Compliance Electromagnetic Environment Level Level Guidance 6 kV contact 8 kV air Electrostatic discharge ESD IEC 61000 4 2 Electrical fast transient burst IEC 61000 4 4 2 kV for power supply lines 1 kV for input output lines 1 kV differential mode 2 kV common mode lt 5 Ur gt 95 dip in Ur for 0 5 cycle 40 Ur 60 dip Surge IEC 61000 4 5 Voltage Dips short interruptions and voltage variations on power supply input lines IEC 61000 4 11 70 Ur 30 dip in Ur for 25 cycles lt 5 Ur gt 95 dip in Ur for 5 seconds Power frequency 50 60 Hz magnetic field IEC 61000 4 8 in Ur for 5 cycles 6 kV contact 8 kV air 2 kV for power supply lines 1 kV for input output lines 1 kV differential mode 2 kV common mode 5 Ur gt 95 dip in Ur for 0 5 cycle 40 Ur 60 dip in Ur for 5 cycles 70 Ur 30 dip i
77. is used with the CAS 740 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 CAS 740 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 Caution on Page 21 under LEAKAGE CURRENT TEST and follow the guidance given PRINTER OVERVIEW The Citizen CMP 10 Mobile Printer interfaces to the CAS 740 Monitor via an infrared IrDA port or by using the direct connect RS232 cable supplied with printer The IrDA ports are located on the top of the printer and on the bottom front panel of the CAS 740 Monitor When using the IrDA port it is important to keep the two devices close together and irdine to maintain proper communications CAUTION For safe and proper usage of the external printer please observe the following When using the printer Avoid placing monitor 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 Store a dark cool and dry place Do not place near organic s
78. ith a soft dry cloth CAUTION Before cleaning the printer disconnect the AC adapter from the printer Do not use volatile chemicals such as thinner benzine etc Never wet the inside of the printer mechanism Refer to the printer User s Manual for more information 21 02 0171 REV 00 03 03 98 CAS 740 Monitors Section 12 Maintenance 21 02 0171 REV 00 03 03 99 CAS 740 Monitors 21 02 0171 REV 00 03 03 100 CAS 740 Monitors MAINTENANCE MAINTENANCE INTERVALS Preventive maintenance of the monitor is an important function that should be performed routinely by the user to ensure safe and efficient monitor operation CAS Medical Systems recommends that you do the following e Perform a pneumatic check every six 6 months e Perform a calibration check once per year or when there is doubt about the validity of the pressure readings e Replace the battery pack every two 2 years 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 your dealer or CAS Medical Systems Inc TEST MODE The monitor must be in the Configuration Mode in order to perform the following functions e AI LEDs ON Check e Calibration Check System Pressure Over Pressure e Pneumatic Pressure Checks e Temperature Calibration Check To enter the mon
79. itor Configuration Menu depress and hold the AUDIO and ALARM LIMITS pushbutton keys while the monitor is being turned ON Once in the menu depress one of the PREVIOUS CYCLE TIME ALARM LIMITS programmed pushbutton keys until the Message Window briefly displays Test Mode followed by 0 mmHg NOTE While in the Test Mode if no pushbutton is depressed within 15 minutes the monitor will automatically terminate the Monitor Configuration menu and return to the Ready mode WARNING DO NOT place the monitor in the TEST MODE when a cuff is attached to a patient EXIT THE TEST MODE When you have completed with the Test Mode press the CANCEL pushbutton to exit The Message Window will briefly display Saving and return to the Ready state 21 02 0171 REV 00 03 03 101 CAS 740 Monitors LED CHECK The CAS 740 Monitor incorporates an all lights ON check to verify the functionality of the front panel LED displays and indicators Enter the Test Mode The Message Window will briefly display TEST followed by 0 mmHg Depress and hold either the ARROW UP or ARROW DOWN pushbuttons The monitor will illuminate all appropriate 7 segment displays bar graph bell icon and patient mode indicators for as long as the button is depressed 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
80. menu Press one of the NEXT programmed pushbutton keys to advance onto the next menu or use the CANCEL pushbutton to save your changes and exit to the Ready mode SETTING THE TIME The CAS 740 Monitor s Time value is set for Eastern Time and is set at the factory Should it need to be changed enter the Monitor Configuration menu and use one of the NEXT programmed pushbutton keys until the Message Window displays the monitor s time using the following format HH MM Where HH Hour of the Day 0 23 and MM Minute of the Hour 0 59 The flashing parameter indicated the parameter that can be changed Use the ARROW UP or ARROW DOWN pushbuttons to make your selection Press one of the NEXT programmed pushbutton keys to advance to the next parameter to set within the Time menu NOTE Altering the Date and Time will affect the History readings but not erase them Press one of the NEXT programmed pushbutton keys to advance onto the next menu or use the CANCEL pushbutton to save your changes and exit to the Ready mode DAYLIGHT SAVING TIME OPTION The CAS 740 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 e DST OFF Daylight Saving Time is OFF The user is responsible for changing the time if needed This is the default setting for the CAS 740 Monitor e DSTNAM Daylig
81. monitors power source 21 02 0171 REV 00 03 03 15 CAS 740 Monitors SYMBOLS CONT These symbols appear on the battery pack in place of text uy Recycling suggested see General Notes Kae Located on the Smart Pack batteries a set of four 4 LEDs used to indicate the approximate amount of charge remaining in the battery pack See Page 74 CHECKING BATTERY STATUS for more information These symbols appear on the packaging in place of text Symbol used to indicate where Relative Humidity information concerning storage and transport can be located Symbol used to indicate the minimum and maximum storage and transport Temperatures This symbol appears on the printer in place of text N d WARNING Before removing read instructions in Section 9 21 02 0171 REV 00 03 03 16 CAS 740 Monitors Section 4 Safety Measures Warnings and Precautions 21 02 0171 REV 00 03 03 CAS 740 Monitors 21 02 0171 REV 00 03 03 18 CAS 740 Monitors SAFETY MEASURES AND WARNINGS WARNING DO NOT use this instrument for any purpose other than specified in this manual Doing so will invalidate the monitors warranty DO NOT connect more than one 1 patient to the monitor The position of subject physiological condition 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
82. n Ur for 25 cycles lt 5 U gt 95 dip in Ur for 5 seconds Floors should be wood concrete or ceramic tile If floors are covered with synthetic material the relative humidity should be at least 30 Mains power quality should be that of a typical commercial or hospital environment Mains power quality should be that of a typical commercial or hospital environment Mains power quality should be that of a typical commercial or hospital environment If user of the model 740 requires continued operation during power mains interruptions it is recommended that the model 740 be powered from an uninterruptible power supply or a battery Power frequency magnetic fields should be at levels characteristic of a typical location in a typical commercial or hospital environment NOTE Ur is the A C mains voltage prior to application of the test level 21 02 0171 REV 00 03 03 WARRANTY POLICY MONITORS CAS 740 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 printers and battery and ninety 90 days on non disposable accessories and certain components consisting of reusable SpO s
83. n electronic failure has occurred Contact CAS Medical Systems to have the within the NIBP module monitor serviced No Probe The monitor is not detecting the The probe was disconnected from either the SpO probe Interface Cable or from the monitor OverPres Cuff pressure exceeded 290 mmHg Very rapid squeezing of the cuff can cause this in the Adult mode or 145 mmHg in error the Neonatal mode Repeat the measurement If this message repeatedly occurs during normal use the monitor must be serviced P Search The monitor is searching for a Pulse Normal at power up as the monitor searches for a signal pulse The probe position may have changed Check the probe site Prb OFF The monitor is no longer receiving a The probe is no longer in contact with the patient patient signal from the SpO probe Check the probe site Pwr Fail Power was disconnected from the Depress the SILENCE RESET pushbutton to clear monitor the message Re cycle the monitor s RangeErr The systolic reading exceeds the Repeat measurement measurement range of 255 mmHg in the Adult mode or 135 mmHg in If the message is displayed again use another the Neonatal mode method to measure the patient s blood pressure TABLE 9 Error Messages on the Message Window 21 02 0171 REV 00 03 03 79 CAS 740 Monitors ERROR MESSAGES ON THE MESSAGE WINDOW cont ERROR POSSIBLE CAUSE POSSIBLE SOLUTION MESSAGE SetClock The monitor s clock needs to be The
84. n keys to advance onto the next menu or use the CANCEL pushbutton to Save your changes and exit to the Ready mode AUDIO ALARMS SILENCE RESET Pushbutton The CAS 740 Monitors SILENCE RESET pushbutton can be configured to have the audio associated with patient alarms set to one of three selections The selections are 2 Minute Audio Alarm Off Default e Permanent Audio Alarm Off e Alarm Limits Off To configure the alarms first enter the Monitor Configuration menu Once in the menu use one of the NEXT programmed pushbutton keys until the Message Window displays the current value of the Audio Alarms menus Use the ARROW UP or ARROW DOWN pushbuttons to make your selection Press one of the NEXT programmed pushbutton keys to advance onto the next menu or use the CANCEL pushbutton to save your changes and exit to the Ready mode 2 MINUTE AUDIO ALARM OFF When the monitor is configured for the 2 Minute Audio Alarm Off setting use the SILENCE RESET pushbutton to enable or disable audio alarms for a two 2 minute period The SILENCE visual indicator located on the front panel of the monitor will be illuminated constantly and the message 2Min Aud will be displayed on the Message Window as a reminder when enabled At the end of two 2 minutes the monitor will automatically exit the 2 Minute Audio Alarm Off setting and return to normal operation 21 02 0171 REV 00 03 03 70 CAS 740 Monitors During a two minute
85. nitor incorporates a user selectable Intensity Control Depress and Hold the front panel AUDIO pushbutton for two 2 seconds The monitors front panel LED displays will toggle from their bright to their dim intensity level Continue to depress the AUDIO pushbutton and every two 2 seconds the monitor s front panel LED displays will toggle dim to bright bright to dim etc Release the AUDIO pushbutton and select the intensity level required The CAS 740 Monitor remembers this setting and will power up the next time to the intensity level selected DISPLAYING THE TIME The CAS 740 Monitor can be used to display the current Time of day as set by the user at any time Depress and Hold the CYCLE TIME pushbutton for two 2 seconds The monitor displays the Time in 24 Hr format in the Message Window for as long as the pushbutton is depressed MANUAL MODE FOR BLOOD PRESSURE DETERMINATION Select and apply the appropriate sized cuff for the patient being monitored to the extremity Refer to Section 5 BLOOD PRESSURE MONITORING for more information Connect the cuff to the end of the monitor tubing Connect the monitor tubing to the NIBP connector located on the left side of the monitor To select one of the Initial Inflation Pressures shown in TABLE 4 press either the ARROW UP or the ARROW DOWN pushbutton or accept the default Initial Inflation Pressure of 150 mmHg Adult or 85 mmHg Neonate 21 02 0171 REV 00 03 03 56 CAS
86. nni nnne 63 AUDIBLE AND VISUAL INDICATORS eee 64 CLEARING ALARMS enne emen ene nn nennen 65 NIBP PATIENT ALARMS 222 65 HIGH LOW 96SpO ALARMS 65 5 PULSE RATE ALARM see emen 65 EQUIPMENT ALARMS eseeee emen enne 65 ADJUSTING THE AUDIO ALARM VOLUME 66 ADJUSTING THE SpO BEEP VOLUME 66 2 MINUTE AUDIO SILENCE sseeeenm mm 66 PERMANENT AUDIO ALARM SILENCE eee 67 ALARM LIMITS Geek Bese Eee 67 MONITOR CONFIGURATION seem mener 68 ENTERING THE MONITOR CONFIGURATION MENU 68 SAVING YOUR CHANGES esee meme 68 SOFTWARE REVISIONS i arian eaire aaeei edea e ape aT ea a Rn iea 69 SETTING THE LANGUAGE 69 SELECTING THE PATIENT MODE 69 SELECTING THE TEMPERATURE SCALE eee 70 AUDIO ALARMS SILENCE RESET PUSHBUTTON 70 2 MINUTE AUDIO ALARM OFF sssseseeeeeenemm eene 70 PERMANENT AUDIO ALARM OFF see 71 ALARM LIMIT OFF 2 71 MAP VALUE ENABLE DISABLE 71 SETTING THE DATE ea een 72 SETTING THE TIME orti iei ee se ei 72 DAYLIGHT SAVING TIME
87. not ensure proper monitor performance if the tubing is altered Modification of the air hose will void the warranty Avoid compression or restriction of pressure tubes DO NOT use the monitor during an MRI scan The monitor may affect the MRI image and the MRI unit may affect the accuracy of blood pressure measurements The monitor does not operate effectively if a patient is having seizure activity or is connected to a heart lung machine In shock conditions the low amplitude of the blood pressure waveform may make it difficult for the monitor to accurately determine the systolic and diastolic pressures When a patient is experiencing arrhythmias during a measurement the accuracy of the pulse determination may be affected or the time needed to complete a measurement may be extended The monitor will not make a determination beyond 120 seconds If the cuff is applied on a limb being used for oxygen saturation monitoring SpO 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 phy
88. o Ready depress the SILENCE RESET pushbutton or recycle the monitor s power USER MESSAGES The CAS 740 Monitor displays a variety of messages to aid the user in monitor operation If a 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 a power source AC Line Power or 12 VDC and allow it to charge for four 4 hours Refer to TABLE 9 ERROR MESSAGES ON THE MESSAGE WINDOW for more information 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 your dealer or CAS Medical Systems Inc SpO USER MESSAGES available if SpO is installed 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 as possible to make a proper determination Use the SpO strength bar graph to determine if a strong rhythmic pulse signal is When no oximeter probe is attached to the monitor the SpO gt window and signal strength window will be blank When no SpO pulse data is available the monitor will display the last NIBP pulse When the probe i
89. o recharge the battery A depleted battery may be fully recharged in four 4 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 0171 REV 00 03 03 73 CAS 740 Monitors CHECKING BATTERY STATUS NOTE If your CAS 740 Monitor is not equipped with a Smart Pack battery the monitor when connected to a power source AC Line Power or 12 VDC and is powered OFF will display CHARGING in the Message Window until the battery reaches a full charge condition Once the battery reaches full charge the monitor is capable of supplying battery charge information as described in items 1 and 2 below If your CAS 740 Monitor is equipped with a Smart Pack battery the following applies The monitor s Main Board receives information from electronics enclosed within the battery pack The status of the battery pack can be verified using one of the following methods 1 When the monitor is connected to a power source AC Line Power or 12 VDC and is powered ON depress and hold the SILENCE RESET pushbutton for two 2 seconds The monitor will display in the Message Window for as long as the button is depressed XXX CHG where XXX represents the percent 0 to 100 of the full charge condition of the battery 2 When the m
90. olvents 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 CAS P N 28 02 0077 21 02 0171 REV 00 03 03 83 CAS 740 Monitors PRINTER CONTROLS AND INDICATORS DEA 84 FIGURE 17 Printer Controls and Indicators LED Indicators Bicolor Red and Green Battery Status Red on Charging Battery Green on Battery is fully charged Device Status 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 0171 REV 00 03 03 CAS 740 Monitors PRINTER OPERATION Position the printers IrDA port window in line with the IrDA window of the CAS 740 Monitor OR connect the RS232 direct cable from the printer to the 9 pin RS 232 connector located on the rear panel of the CAS 740 Monitor Turn the printer ON To turn the printer ON press and hold the POWER ON OFF pushbutton for one 1 second To turn the printer DFF press and hold the POWER ON OFF pushbutton The Status LED will illuminate
91. onitor is connected to a power source AC Line Power or 12 VDC and is powered OFF the Message Window will display XXX 96 CHG where XXX represents the percent 0 to 100 of the full charge condition of the battery 3 When the monitor is running on battery power and is powered ON depress and hold the SILENCE RESET pushbutton for two 2 seconds The Message Window will display the Estimated Battery Run Time remaining for as long as the button is depressed a If less than one half hour is available the Message Window will display lt 5 hrs b If greater than one half hour is available the Message Window will display time in hours 5 1 1 5 2 2 5 etc If more than ten 10 hours is available the Message Window will display gt 10 hrs 4 The CAS 740 Monitor s Battery Pack may contain on board electronics which can be used to check the status of battery charge remaining when not connected to the monitor If available depress the pushbutton located on the inside panel of the battery pack Once depressed four 4 LED indicators will illuminate to display the status of battery charge remaining each LED lit is equivalent to approximately 25 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 y
92. ord depending on model ordered Ten 10 Foot Coiled Inflation Hose Tuff Cuff Blood Pressure Cuffs Adult Tuff Cuff amp Blood Pressure Cuffs Child SpO Interconnect Cable For models with SpO installed SpO Finger Sensor For models with SpO installed SureTemp Oral Probe and a box of Probe Covers For models with Temperature installed 2 l la cl cl O P9 Calibration Kit includes T connector with tubing and male luer plug 1 CAS 740 Monitor Users Manual CAS 740 Monitors configured with Nonin SpO ship with a 2 meter sensor cable assembly Read this Manual completely before using this equipment OPTIONAL ACCESSORIES The CAS 740 Monitor is available with several mounting configurations to fit your needs They consist of Swiveled Hard Mount GCX Roll Stand and Basket Carrying Case Universal Mount Refer to Section 14 ACCESSORIES for part number information Contact CAS Medical Systems Customer Service Department or your local distributor for more information 21 02 0171 REV 00 03 03 CAS 740 Monitors 21 02 0171 REV 00 03 03 10 CAS 740 Monitors Section 3 Symbols CAS 740 Monitors 21 02 0171 REV 00 03 03 12 SYMBOLS CAS 740 Monitors Units may display the following symbols gt Alternating Current CAUTION Before using read instructions included Signifies the device has meet all essential requirements of European Medical Device
93. ording to Directive 93 42 EEC Masimo SET a registered trademark of Masimo Inc Possession or purchase of this device does not convey any express or implied license to use the device with replacement parts which would alone or in combination with this device fall within the scope of one or more of the patents relating to this device Nellcor is a registered trademark and OxiMax is a trademark of Nellcor Puritan Bennett Inc NONIN NONIN Finger Clip Sensor and Flexi Form Sensors are registered trademarks of Nonin Medical Inc SureTemp Temperature Probe is a trademark of Welch Allyn Inc MAXNIBP is a trademark of CAS Medical Systems Inc CAS gs is a registered trademark of CAS Medical Systems Inc All units covered by U S patent 4 796 184 and 5 022 403 Other patents pending Monitors are C marked 21 02 0171 REV 00 03 03 130 CAS 740 Monitors CAS 740 VITAL SIGNS MONITOR PURCHASING RECORD Installed Options NIBP SpO2 Temperatue RS232 amp Nurse Call Model Serial Number Date of Purchase Dealer Name Representative Phone Number Fax Number Email 21 02 0171 REV 00 03 03 131
94. ot be Check the external tube for kinks maintained by the pneumatic System Perform a Pneumatic Check as detailed in the Maintenance section of this manual Replace cuff LooseCuf Cuff applied too loosely Check cuff for proper fit on patient Low Batt The battery is almost discharged At least 30 minutes of operation is available from when the message first appears Recharge the battery as soon as possible Low Perf The perfusion level being received Determine if an extreme change in the patient s Masimo by the SpO sensor is low physiology and blood flow at the monitoring site occurred e g an inflated blood pressure cuff a squeezing motion Try to warm the patient or sensor site Move sensor to a site with better perfusion TABLE 9 Error Messages on the Message Window 21 02 0171 REV 00 03 03 78 CAS 740 Monitors ERROR MESSAGES ON THE MESSAGE WINDOW cont ERROR POSSIBLE CAUSE POSSIBLE SOLUTION MESSAGE Motion There was too much extremity Measurements can be obtained when there is motion for the monitor to accurately limited extremity movement but the measurement complete the NIBP measurement in time may be extended 120 seconds Measurement time is limited to 120 seconds Restrain patient extremity motion NBP Cal Pressure calibration data corrupted Pressure module needs recalibration within NIBP module Contact CAS Medical Systems to have the monitor serviced NIBP Err A
95. our area AUTO OFF FEATURE The CAS 740 Monitor incorporates an Auto OFF feature to preserve battery life The Auto Off feature is enabled automatically when the user selects the Alarm Limits Off option in the Configuration Menu When the monitor is in this mode and if accidentally left powered ON for ten 10 minutes without any key presses or any parameters active the monitor will beep for five 5 seconds prior to automatically shutting itself down to preserve battery life 21 02 0171 REV 00 03 03 74 CAS 740 Monitors For the Auto OFF feature to work properly the following conditions must apply e Alarms Off is selected in the Configuration Menu e The CAS 740 Monitor is operating on battery power e SpO or Temperature readings were taken in the past ten 10 minutes e No key presses were made in the past ten 10 minutes e The monitor cannot be in the Automatic NIBP cycle mode POWER FAIL The CAS 740 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 Pwr Fail is displayed in the Message Window 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 POWER and SILENCE RESET To clear the Power Fail condition and return t
96. owly until 220 mmHg 10 mmHg is reached The Message Window should stop updating and display the message OverPres Press the CANCEL pushbutton to exit the Overpressure Test The monitor returns to the Calibration Check function 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 Check the monitor s pneumatic system for air leakage every six 6 months PLUG TUBE Obtain the male luer plug found in the Calibration Kit product P9 supplied with the monitor 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 Enter the Test Mode The Message Window will briefly display TEST MODE followed by 0 mmHg Press the START pushbutton to begin the Pressure Check The Message Window will display Chk Prs will inflate to approximately 180 mmHg and attempt to hold this pressure The pressure value will be displayed in the SYSTOLIC display window This test takes about fifteen 15 seconds At the completion of a successful Pressure Check the Message Window will display Passed the monitor will beep two 2 times and will return to the Calibration Check function after five 5 seconds If the monitor fails the Pressure Check the Message Window will display Leak the monitor will beep thre
97. r any other material touching the probe tip may cause inaccurate readings 5 Place the arm close to the patient s side Hold the arm in this position without movement of the arm or probe during the measurement cycle 6 During the predictive temperature measurement cycle walking segments will appear in the TEMP display window indicating that a predictive measurement is in process 7 When the final temperature has been reached the temperature value will be displayed in TEMP display window and an audible tone will be generated The time of the measurement and the measured temperature will be stored in the monitor s history memory NOTE If the probe tip did not maintain tissue contact during the entire predictive measurement the final temperature displayed in the TEMP display window will flash If this occurs it is recommended that a new temperature be taken Depress the SILENCE RESET pushbutton or after waiting for two 2 minutes the monitor will automatically blank the display 8 After the temperature measurement is complete remove the probe from the patient s axilla and eject the probe cover by firmly pressing the ejection button on the probe Properly dispose of the used probe cover per protocol 9 Insert the probe into the probe holder before attempting to take another temperature measurement 10 Following a completed temperature measurement the current temperature measurement is displayed for thirty 30 seconds after whic
98. r out Place new fuses directly into the fuse holder 6 Insert the fuse holder into the power input receptacle There should be an audible click when it is secure NOTE The CAS 740M EMS Monitor uses a single fuse located on the inside of the monitor This fuse is not user replaceable If you suspect a defective fuse the Battery Power Visual Indicator is not illuminated it is recommended to contact CAS Medical for service STORAGE If it becomes necessary to store the monitor for an extended length of time place the monitor in its original packing container if available See Section 16 SPECIFICATIONS for storage temperature information 21 02 0171 REV 00 03 03 107 CAS 740 Monitors 21 02 0171 REV 00 03 03 108 CAS 740 Monitors Section 13 External Device Interfacing 21 02 0171 REV 00 03 03 109 CAS 740 Monitors 21 02 0171 REV 00 03 03 110 CAS 740 Monitors EXTERNAL DEVICE INTERFACING OVERVIEW The CAS 740 Monitor is capable of interfacing to an external Serial printer or have the ability to interface to a Nurse Call System if the DB9 RS232 option is available Both connections are made through the DB9 connector located on the rear panel of the monitor WARNING The CAS 740 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
99. removed by a qualified service technician to verify absence of water During use and testing single use disposable temperature probe covers will limit patient cross contamination and ensure the safety of the patient user and device The use of any other probe covers or failure to use a probe cover may produce temperature errors and will invalidate the monitor s warranty A pulse oximeter should be considered an early warning device As a trend toward patient deoxygenation is indicated blood samples should be analyzed by a laboratory co oximeter to completely understand the patient s condition 21 02 0171 REV 00 03 03 19 CAS 740 Monitors WARNING Accurate oxygen saturation measurements cannot be obtained when the oximeter is not measuring the pulse properly If the perfusion LED is erratic or the PULSE RATE display is erratic or inaccurate first examine the patient for any sign of distress and only then re examine sensor placement CAUTION 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 operate the monitor unless it has been properly calibrated Inaccurate blood pressure readings may result A calibration check is recommended once every year A pneumatic check is recommended once every six 6 months DO NOT alter the monitor s air hose CAS Medical Systems can
100. rence for audible and visual indications Alarm Condition Audible Indication Visual Indication Level Dead Battery High 3 Beeps followed by 2 Beeps The message is displayed every 10 seconds continuously in the Message Window The Battery Power Visual Indicator is Red Patient Alarm Limit 3 Beeps followed by 2 Beeps The associated 7 segment LED Violations every 10 seconds flashes for one second on one second off for the parameter limit in violation SpO2 Alarm Limit The message is displayed for one Violations second every two to six seconds in the Message Window Power Fail High 3 Beeps followed by 2 Beeps The message is displayed for one every 10 seconds second every two to four seconds in the Message Window Low Battery Alarm Medium 3 Beeps every 25 seconds The message is displayed for one second every two to six seconds in the Message Window The Battery Power Visual Indicator is Red NIBP Application Medium 3 Beeps every 25 seconds The message is displayed for one Error Second every two to six seconds in the Message Window Probe Alarms Medium 3 Beeps every 25 seconds The message is displayed for one second every two to six seconds in the Message Window completed blood pressure taken SpO Pulse Low 1 Beep coincides with each Numerics are updated with each received SpO pulse rate received SpO pulse rate value Temperature Low 1 Beep when final temperature Numerics are updated when a final Complet
101. rocess 6 During the predictive temperature measurement cycle walking segments will appear in the TEMP display window indicating that a predictive measurement is in process 7 When the final temperature has been reached the temperature value will be displayed in the TEMP display window and an audible tone will be generated The time of the measurement and the measured temperature will be stored in the monitor s history memory NOTE If the probe tip did not maintain tissue contact during the entire predictive measurement the final temperature displayed in the TEMP display window will flash If this occurs it is recommended that a new temperature be taken Depress the SILENCE RESET pushbutton or after waiting for two 2 minutes the monitor will automatically blank the display 21 02 0171 REV 00 03 03 42 CAS 740 Monitors 8 After the temperature measurement is complete remove the probe from the patient s rectum and eject the probe cover by firmly pressing the ejection button on the probe Properly dispose of the used probe cover per protocol 9 Insert the probe into the probe holder before attempting to take another temperature measurement 10 Following a completed temperature measurement the current temperature measurement is displayed for thirty 30 seconds after which time the TEMP display will go blank TAKING AN AXILLARY TEMPERATURE CAUTION Never use the Temperature Probe without a probe cover Accurate
102. s Cuff Model Number Bladder Size Limb Circumference Width Range 2 5 cm 1 0 in 5 0 9 0 cm 2 0 3 5 in 3 0 cm 1 2 in 6 5 11 5 cm 2 5 4 5 in C412 4 0 cm 1 6 in 9 0 14 5 cm 3 5 5 7 in C515 5 0 cm 2 0 in 11 0 17 75 cm 4 3 7 0 in TABLE 2 Neonatal Cuff Size Selection Adult and Infant Cuffs Patient Application Bladder Size Limb Circumference Width Range 2 Small Child 7 cm 2 8 in 15 24 cm 6 0 9 4 in Child 9 cm 3 5 in 18 28 cm 7 1 11 0 in 14 65i 24 37 om 941461 Large Adult 16 cm 6 3 in 26 42 cm 10 2 16 5 in TABLE 3 Adult Infant Cuff Size Selection NIBP HOSES CAS Medical offers two 2 NIBP Inflation Hoses For Adult and Pediatric patient monitoring using the ADULT NIBP mode and Cuffs the coiled ten 10 foot NIBP hose CAS p n 01 02 0131 is recommended For Neonatal and Infant patient monitoring using the NEO NIBP mode and Neonatal cuffs the Neonatal six 6 foot NIBP hose CAS p n 01 02 0185 is recommended See Section 14 ACCESSORIES for CAS Medical Systems cuff size and part number information NOTE Avoid compression or restriction of NIBP hoses 21 02 0171 REV 00 03 03 CAS 740 Monitors 21 02 0171 REV 00 03 03 28 CAS 740 Monitors Section 6 Pulse Oximetry Monitoring 21 02 0171 REV 00 03 03 29 CAS 740 Monitors 21 02 0171 REV 00 03 03 30 CAS 740 Monitors PULSE OXIMETRY MON
103. s and Hold the START STAT pushbutton for two 2 seconds to activate this feature The Message Window will display STAT XXX where XXX is the real time cuff pressure Between readings the Message Window will display 0 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 and exit the STAT mode The monitor will return to the Manual mode and the Message Window will return to the Ready message 21 02 0171 REV 00 03 03 58 CAS 740 Monitors In the STAT Mode while during a measurement or in the idle time between measurements pressing the CANCEL pushbutton will cause the monitor to exit the STAT mode and return to the Manual mode The monitor s front panel NIBP numeric displays will indicate the reading of the previous measurement taken and the Message Window will display the time stamp of that reading NOTE Pressing the CYCLE pushbutton during the Manual Automatic or STAT Modes will terminate the current NIBP measurement if active and place the monitor in the Automatic Cycle mode The user will then be allowed to alter the Cycle time if necessary and begin a new NIBP measurement WARNING When monitoring over an extended period 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 HISTORY MODES The History Mod
104. s connected to the monitor but is off of the patient the message is displayed in the SpO gt and Pulse Rate windows The Message Window flashes the message Pro OFF and three 3 audio beeps are heard every twenty five 25 seconds 21 02 0171 REV 00 03 03 75 CAS 740 Monitors Depress the SILENCE RESET pushbutton The monitor silences the audible alarm tone but the message remains If the message Prb should appear in the SpO gt 2 window verify that the probe being used is the correct one for the monitor s SpO configuration Masimo Nellcor Nonin or that the probe is not defective Depress the SILENCE RESET pushbutton The monitor silences the audio alarm tone but the message remains Remove the defective probe and replace it with a working probe Each sensor is designed for a specific clinical application NOTE Inaccurate measurements may be caused by anemia or low hemoglobin concentrations electrosurgical interference excessive ambient light excessive patient movement incorrect sensor application or use intravascular dyes such as indocyanine green or methylene blue moisture in the sensor placement of a sensor on an extremity with a blood pressure cuff arterial catheter or intravascular line venous pulsations NOTE The loss of a pulse signal can occur in any of the following situations a blood pressure cuff is inflated on the same extremity as the one with the SpO sensor attached e
105. s the amount of pressure present in the system between heartbeats Mean Arterial Pressure MAP The MAP pressure represents the mean pressure in the artery during one cardiac cycle NIBP Non Invasive Blood Pressure Abbreviation used when a blood pressure reading is taken externally using a non invasive procedure SpO 5 Abbreviation used when oxygen saturation level of the blood is measured with a pulse oximeter Systolic The Systolic pressure is the upper top number given in a blood pressure reading This number represents the maximum pressure present in the artery 21 02 0171 REV 00 03 03 121 CAS 740 Monitors 21 02 0171 REV 00 03 03 122 CAS 740 Monitors Section 16 Specifications 21 02 0171 REV 00 03 03 123 CAS 740 Monitors 21 02 0171 REV 00 03 03 124 SPECIFICATIONS NIBP MEASUREMENT Technique Patient Range Blood Pressure Range Systolic Diastolic MAP Pulse Rate Range Accuracy Blood Pressure Pulse Rate OXIMETRY OPTIONS Masimo SET amp Type Range Accuracy Measurement Wavelengths Power Pulse Rate Range Pulse Rate Accuracy Numerics CAS 740 Monitors Oscillometric MAX NIBPTM Technology Microprocessor software eliminates most ambient noise and motion artifact Neonate Adult NEO ADULT 30 135 mmHg 30 255 mmHg 15 110 mmHg 15 220 mmHg 20 125 mmHg 20 235 mmHg 40 240 BPM 30 2
106. s the user to select a time interval for Automatic blood pressure measurement Automatic measurement cycles of 1 2 3 4 5 10 15 30 60 or 90 minutes may be chosen Also used to read the monitor s current time depress and hold for two 2 seconds Allows the user to review stored patient readings Refer to Page 59 HISTORY MODES for more information Used to set the volume level of the Alarms and the SpO Beep if installed Use the Up and Down Arrows to change Also used to adjust the brightness of the front panel displays depress and hold for two 2 seconds Allows the user to enter and set the monitor s Alarm Limits 21 02 0171 REV 00 03 03 A ARROW UP V ARROW DOWN NEXT PREVIOUS INFRARED IrDA DATA PORT CAS 740 Monitors Allows forward Adjustment Auto Cycle History Inflation Pressure Limits and Monitor Configuration Depress to cycle through menu selections or depress and hold for quicker advance Allows backwards Adjustment Auto Cycle History Inflation Pressure Limits and Monitor Configuration Depress to cycle through menu selections or depress and hold for quicker advance The HISTORY and AUDIO pushbutton keys have been programmed to allow the user to advance forward to the next selection in the Monitor Configuration menu The CYCLE TIME and ALARM LIMITS pushbutton keys have been programmed to allow the user to advance backwards to the previous selection in th
107. sician 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 0171 REV 00 03 03 20 CAS 740 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 until 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 In the event that fluids are accidentally spilled on the monitor take the monitor out of operation and inspect for damage ELECTRICAL SHOCK To reduce the risk of electrical shock do not remove the back cover Refer all servicing to qualified personnel 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 r
108. ssible The standard 7 2 Volt 3700 mAhr battery pack when fully charged is capable of taking 100 NIBP readings when the monitor is set in the 5 minute Automatic Mode When the message Low Batt appears in the Message Window at least thirty 30 minutes of battery operation remain The Low Batt message will alternate continuously with the Ready message to indicate that the battery should be charged as soon as possible Also the monitor s front panel Battery Power Visual Indicator will change from Orange to Red and three 3 audio beeps are heard every twenty five 25 seconds WARNING Upon the detection of a Low Battery condition and if the battery is not charged by the user 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 four 4 hours When the Dead Bat message appears the battery is no longer able to power a measurement The message Dead Bat is displayed continuously in the Message Window 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 When either of these messages appears it is necessary t
109. t the remaining plate to the ambulance as desired Ensure a firm connection 5 Attach the monitor to the wall mount by reconnecting the swivel mount clamping fixture Ensure thumbscrew is tightened 6 Connect the un terminated end of the power cord to a 12 VDC power source from the ambulance connecting the other end to the backside of the monitor POLARITY OF THE POWER CABLE To insure proper polarity follow this color code Clear wire positive Black wire negative Shield wire un terminated CAUTION Connection to the monitor and ambulance shall be completed by a qualified electrical installer technician When the CAS 740 Monitor is installed with the EMS swivel mount the following applies e Power Cord none is provided e Battery Power Visual Indicator will only illuminate Green indicating a connection to a main power source NOTE Periodically check thumbscrew to ensure a tight connection 21 02 0171 REV 00 03 03 CAS 740 Monitors 21 02 0171 REV 00 03 03 94 CAS 740 Monitors Section 11 Cleaning 21 02 0171 REV 00 03 03 95 CAS 740 Monitors 21 02 0171 REV 00 03 03 96 CAS 740 Monitors CLEANING CLEANING OVERVIEW CAUTION Do not open the monitor to clean or repair it Contact CAS Medical System for service needs WARNING Do not under any circumstances perform any testing or maintenance on the monitor while the monitor is being used to monitor a patient CAUTIO
110. talian Spanish Dutch Swedish or Portuguese The message 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 message window also displays the operational mode of the monitor automatic or manual The nor invasive blood pressure NIBP parameter automatically inflates an occluding cuff and using the oscillometric measurement technique determines systolic diastolic and mean arterial pressure and pulse rate 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 21 02 0171 REV 00 03 03 CAS 740 Monitors The pulse oximeter parameter SpO 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 heart rate are displayed on light emitting diode LED digital displays On each detected pulse the perfusion LED does indicate patient perfusion signals This bar graph gives the user a pulse by pulse visual indication of waveform sign
111. talling 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 0171 REV 00 03 03 89 CAS 740 Monitors 21 02 0171 REV 00 03 03 90 CAS 740 Monitors Section 10 EMS Swivel Mount 21 02 0171 REV 00 03 03 91 CAS 740 Monitors 21 02 0171 REV 00 03 03 92 CAS 740 Monitors EMS SWIVEL MOUNT The CAS 740 Monitor can be configured to utilize the F A M mounting system for attachment to the inside of an ambulance The system allows several configurable mounting possibilities ASSEMBLING THE SWIVEL MOUNT 1 Disassemble the swivel mount by turning the thumbscrew 2 Position the rubber gasket on the monitor s case back Place the mounting plate over the gasket being careful to align the holes on the gasket mounting plate and monitor rear panel 3 Attach the assembly using the four 4 screws provided 4 Moun
112. than twenty four hours is deleted It is suggested to manually clear History between patients See CLEARING HISTORY on Page 61 PRINT HISTORY The stored Event History and Trend History data are printed individually Press and Hold the HISTORY pushbutton for two 2 seconds while in either the Event or Trend History screens The message PRINT N appears in the Message Window Use either the ARROW UP or ARROW DOWN pushbutton until the message PRINT Y appears in the Message Window Depress the HISTORY pushbutton again to start printing the History data The message PRINTING appears in the Message Window as a status indicator NOTE Prior to accessing the Print History mode the printer should have paper installed and the power turned ON Refer to Section 9 EXTERNAL PRINTER for more information about the printer and sample printouts of both History screens CLEARING HISTORY The History data can be manually cleared by pressing and holding for two 2 seconds the HISTORY pushbutton while in either of the History modes The message PRINT N appears in the Message Window Depress the HISTORY pushbutton again and the message ERASE N appears in the Message Window Use either the ARROW UP or ARROW DOWN pushbutton until the message ERASE Y appears in the Message Window Depressing the HISTORY pushbutton a final time and the message ERASING appears in the Message Window The monitor erases the memory exits the
113. tiated where every LED segment in the TEMP display window are illuminated briefly Following this selftest the display will show rEC The rEC in the TEMP display window indicates that the rectal algorithm will be used to take a predictive temperature measurement 3 Load a probe cover onto the probe by holding the probe collar with the thumb and forefinger being careful not to hold or press the ejection button Refer to Figure 10 21 02 0171 REV 00 03 03 41 CAS 740 Monitors FIGURE 10 Loading the Probe Cover 4 When a double dash appears in the TEMP display window the temperature sensor is ready to take a measurement To take a normal predictive temperature separate the buttocks with one hand Apply a thin coat of water based lubricant when necessary Using the other hand gently insert the probe ONLY 1cm 3 8 inch ONLY inside the rectal sphincter To take a direct read temperature monitor mode wait 1 minute until a temperature value appears in the TEMP display The decimal point associated with the temperature value will flash at a rate of one 1 second ON and one 1 second OFF as a reminder that you are in monitor mode Insert the probe tip into the patient s rectal sphincter as described above WARNING Extreme caution should be used to avoid risk of bowel perforation in children 5 Tilt the probe to insure good tissue contact and continue to keep the buttocks separated while the measurement is in p
114. user that the Temperature Option is installed Message Window area used to display various messages that aid the user in monitor operation A tri colored visual indicator used to display the status of the power source and battery condition e GREEN Charging e ORANGE In Use on Battery RED Battery Low or Dead Battery A visual indicator used along with the SILENCE RESET pus hbutton to display the status of the Audio Alarms 21 02 0171 REV 00 03 03 CAS 740 Monitors FRONT PANEL CONTROLS AAD 4 vp FIGURE 13 Front Panel Controls a ON OFF STANDBY Turns ON the Monitor s display NOTE At a later date symbol will become _ SILENCE RESET Used to enable and disable the two 2 Minute Audio Off or Permanent Audio Off feature Refer to Page 62 PATIENT ALARM MODE for more information Allows the user to clear SpO and Temperature messages from the front panel display 21 02 0171 REV 00 03 03 49 CAS 740 Monitors START STAT Y CANCEL HISTORY AUDIO EN ALARM LIMITS 50 START Initiates a blood pressure measurement in the Manual Mode or begins the selected Automatic Cycle STAT Starts a series of NIBP measurements depress and hold for two 2 seconds Continues for five minutes Cancels any active blood pressure function and immediately deflates the cuff Also used to cancel out of a menu and return to Ready Allow
115. ute averages and Monitor Temperature are saved once a minute 21 02 0171 REV 00 03 03 59 CAS 740 Monitors 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 See CLEARING HISTORY on Page 61 EVENT HISTORY EVENT Ev To review History based on Event readings press the HISTORY pushbutton The most current measurement NIBP or Predictive Temperature and the time of measurement HH MM Ev are displayed on the front panel along with their corresponding SpO values If there are no readings in the History the message NO EVNTS is displayed in the Message Window Press the ARROW DOWN pushbutton to review preceding measurements The word Oldest will be displayed briefly on the Message Window when there are no more readings left in the memory The oldest measurement will then be redisplayed Press the ARROW UP pushbutton to advance the measurements towards the most current measurement taken The word Newest will be displayed briefly on the Message Window when there are no more current readings The most recent measurement will then be redisplayed To exit the History Mode and return to Ready press the CANCEL pushbutton If a measurement is desired immediately while in the History Mode simply press START This will exit the History
116. www ardusmedical com CAS 740 Vital Signs Monitor User s Manual CAS Menca Systems Inc TECHNOLOGY APPLIED TO MEDICINE 21 02 0171 REV 00 03 03 21 02 0171 REV 00 03 03 THE CAS 740 VITAL SIGNS MONITOR FEATURES CAS 740 1 Non Invasive Blood Pressure and Pulse Rate CAS 740 2 Non Invasive Blood Pressure Pulse Rate and Pulse Oximeter or Non Invasive Blood Pressure Pulse Rate and Temperature CAS 740 3 Vital Signs Monitor with Non Invasive Blood Pressure Pulse Rate Pulse Oximeter and Predictive Temperature IMPORTANT This manual addresses all parameters of the CAS 740 Vital Signs Monitor You may have purchased a model that does not have all the parameters referred to in the manual THIS MANUAL REMAINS SUITABLE FOR USE Please refer to sections of the manual and the Quick Reference Guide that are applicable for the model purchased 21 02 0171 REV 00 03 03 In the U S the following Caution applies CAUTION Federal law restricts this device to sale by or on the order of a physician or properly licensed practitioner 21 02 0171 REV 00 03 03 Manufacturers Declaration of Conformity Electronic Emissions and Immunity The CAS 740 Monitor is intended for use in the electromagnetic environment specified below The customer or the user of the CAS 740 Monitor should assure it is used in such an environment The CAS 740 uses RF energy only for its internal funct
117. xcessive ambient light such as from a surgical lamp a bilirubin lamp or sunlight the patient has hypotension severe vasoconstriction severe anemia or hypothermia the patient is in cardiac arrest or is in shock the sensor is too tight there is arterial occlusion proximal to the sensor If the SpO Module located inside the CAS 740 Monitor should fail the message Err will appear in the SpO display window Depress the SILENCE RESET pushbutton The monitor silences the audio alarm tone but the message remains Should any of the above problems persist contact your dealer or CAS Medical Systems Inc 21 02 0171 REV 00 03 03 76 CAS 740 Monitors TEMPERATURE FUNCTION USER MESSAGES If the probe becomes unattached to the CAS 740 Monitor s rear panel connector the message Prb is shown in the TEMP display window NOTE Depress the SILENCE RESET pushbutton to clear the TEMP display When an attached probe is removed from the probe holder the message OrL ALy or rEC is shown briefly in the TEMP display window indicating the predictive algorithm is being used by the Temperature function When the message Err XX where XX is an Error Number is displayed in the TEMP display window an error condition has occurred and a reliable temperature reading could not be obtained NOTE Depress the SILENCE RESET pushbutton to clear the TEMP display Refer to TABLE 8 Temperature Error Codes for more information

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