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Model 9454/9456 User`s Manual, English

1. NOTE Each alarm limit may also be selected OFF individually or as a whole Low Limits cannot be set above the associated High Limit High Limits cannot be set lower than the associated Low Limit 21 02 0187 REV 05 3 15 101 Midmark Veterinary Monitors CONTROL PANEL Characteristic Specification Display LCD display of measurement results instructions troubleshooting messages waveforms and signal strength bar Parameters Displayed Heart Rate Respiration Rate ODC Pulse Rate Temperature in Fahrenheit or Celsius OPERATING MODES Characteristic Specification Patient Veterinary ECG Continuous Monitoring History Trend Review of previous measurements Alarm Review of previous alarms SpP0 Continuous Monitoring Temperature Continuous Monitoring POWER Characteristic Specification Source External line or internal battery AC Power Option 100 240 VAC 50 60 Hz 0 5A Fuse Rating T500mAL250V or T1 25AL250V two provided Refer to rear panel monitor labeling for actual fuse rating Battery Nickel Metal Hydride NiMH battery pack user removable Charge Time 3 5 hours Operation on battery Approximately four 4 hours Based on a Model 9454 Leakage Current 100 microamp maximum 102 21 02 0187 REV 04 05 09
2. To acknowledge the alarm depress the SILENCE RESET pushbutton The monitor silences the audible and visual alarms but the message SpOs Error or SpO Module remains on the display Should any of the above problems persist contact CAS Medical Systems Inc 21 02 0187 REV 05 3 15 71 Midmark Veterinary Monitors EEN MONITOR MESSAGES MONITOR Table 7 Monitor Messages MONITOR POSSIBLE CAUSE POSSIBLE SOLUTION MESSAGE Clock Battery The monitor s internal Contact CAS Medical Systems to have the clock battery is almost monitor serviced discharged Dead Battery The battery is fully Recharge the battery for at least 5 hours discharged Low Battery The battery is almost At least 30 minutes of operation is discharged available from when the message first appears Recharge the battery as soon as possible System Error An electronic failure has Contact CAS Medical Systems to have the occurred within the monitor serviced monitors Main Board Power Failure Power was disconnected Depress the SILENCE RESET pushbutton from the monitor to clear the message OR Turn the monitor Off then back On to clear the message Set Clock The monitor s clock The monitor s time and date values are needs to be set incorrect Refer to Page 45 for information to set the Date and Page 46 to set the Time The monitor s internal clock battery needs to be replaced Contact CAS Medical Systems
3. NOTE For temperature monitoring a YSI temperature probe and Adapter are required To take a Temperature measurement 1 Consult proper procedure for application of the probe to the patient 2 Connect the probe to the Temperature Adapter Connect the Adapter to the TEMP connector on the side panel of the monitor 3 Press the ON STANDBY pushbutton to turn ON the monitor 4 Check that the monitor is accurately measuring temperature When the value has been determined it will be displayed on the front panel as F or C 5 Configure the appropriate temperature scale F or C Refer to Page 48 SELECTING THE TEMPERATURE UNITS NOTE When the Temperature value being measured is greater than 43 C 109 4 F the TEMP numeric value will be displayed as gt gt gt gt gt indicating a value above the monitors temperature range NOTE When no Temperature probe is connected the TEMP numeric display will be blank Refer to Section 12 ACCESSORIES for Temperature probe types and part number information Consult instructions enclosed with the sensor for proper application 21 02 0187 REV 05 3 15 31 Midmark Veterinary Monitors EEN 21 02 0187 REV 04 05 09 32 eg Midmark Veterinary Monitors 8 MONITOR OPERATION FRONT PANEL Figure 6 Front Panel View TN 9454 SpOy ECG Bradycardia DISPLAY AREAS The Main display area of the Midmark Monitor can be bro
4. 21 02 0187 REV 04 05 09 72 eg Midmark Veterinary Monitors MONITOR MESSAGES cont ECG RESPIRATION Table 8 ECG Respiration Monitor Messages MONITOR POSSIBLE CAUSE POSSIBLE SOLUTION MESSAGE ECG Error A communication failure Contact CAS Medical Systems to have the has occurred with the monitor serviced monitors ECG Board ECG Module An electronic failure has Contact CAS Medical Systems to have the occurred within the monitor serviced monitors ECG Board Leads OFF The leadwires may be Check the leadwires at the electrode end disconnected and at the patient cable to be sure they are connected securely The patient cable may Check the patient cable jack on the monitor be disconnected to be sure it is plugged in securely The leadwires or patient Replace the leadwires or patient cable cable may be broken The electrodes may be Replace the electrodes old 21 02 0187 REV 05 3 15 73 Midmark Veterinary Monitors EEN MONITOR MESSAGES cont SpO Table 9 SpO2 Monitor Messages MONITOR POSSIBLE CAUSE POSSIBLE SOLUTION MESSAGE Chk SpO Probe The monitor is Verify that the sensor is being used questioning the quality according to the manufacturer s of the signal being recommendations received by the SpO sensor The sensor is receiving Verify that the sensor emitter and detector too much ambient light are parallel to and directly opposing each other
5. 8 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 Figure 5 Sensor to Interface Cable 9 Plug the Interface Cable into the SpO connector on the side panel of the monitor The connector is shaped like a D Line up the D on the Interface Cable with the D on the receptacle Push the cable in until you hear an audible click 10 Press the ON STANDBY pushbutton to turn ON the monitor 11 Verify that the sensor is properly positioned by observing at least ten seconds of a continuous pleth waveform being displayed across the screen When a valid signal is detected the monitor displays the SpO gt and Pulse Rate values Should the perfusion light be at a low level reposition the sensor or try a different sensor If normal operation cannot be achieved call a Midmark representative for assistance 12 If required refer to Page 49 PARAMETERS MENU and configure the appropriate waveform s to be viewed and printed 13 Check the Alarm Limits and configure them appropriately for the patient Refer to Page 61 ALARM LIMIT VALUES for more information 14 If an audio beep is required based on the SpOsz configure the Beep Source to SpO gt in the Audio Visual menu and adju
6. Refer to Page 49 PARAMETERS MENU for more information ALARM LIMITS HISTORY Allows the user to enter set save and restore the monitor s Alarm Limits Refer to Page 58 PATIENT ALARMS for more information Allows the user to review stored patient readings Refer to Page 52 HISTORY for more information 21 02 0187 REV 04 05 09 Midmark Veterinary Monitors AUDIO VISUAL Allows the user to setup and configure the Audio and Visual parameters being monitored Refer to Page 51 AUDIO VISUAL MENU for more information ARROW UP Allows forward Adjustment History Limits and Monitor Setup Menus Depress to cycle through menu selections or depress and hold for quicker advance ARROW DOWN Allows backwards Adjustment History Limits and Monitor Setup Menus Depress to cycle through menu selections or depress and hold for quicker advance NEXT The HISTORY and AUDIO VISUAL pushbutton keys have been programmed to allow the user to advance horizontally to the next parameter selection in the menus PREVIOUS The PARAMETERS and ALARM LIMITS pushbutton keys have been programmed to allow the user to advance horizontally backwards to the previous parameter selection in the menus INFRARED Ir DATA PORT An Infrared Ir output port located on the bottom panel of the monitor s front cover is available to print Waveforms History and Alarm data to the optional external printer or other data collec
7. Turn the printer ON To turn the printer ON press and hold the ON OFF pushbutton for one 1 second The Power LED illuminates Green To turn the printer OFF press and hold the ON OFF pushbutton The Power LED will illuminate Red and change back to Green When the LED illuminates Green remove your finger from the pushbutton 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 Midmark Monitor will periodically send to the printer a wake up message that will disable the Auto Power Off feature NOTE If the printer was powered ON during the monitor s power up sequence the Midmark logo is printed 21 02 0187 REV 05 3 15 77 Midmark Veterinary Monitors Sample printouts of both History Modes are shown below 94XX Series Monitor Figure 20 History Sample Printouts 27 Feb 04 13 33 94XX Series Monitor 27 Feb 04 13 39 Patient Patient Header Notes Notes History Alarm Hist Hr Mn HR RR 02 PR 14 01 Tachycardia 200 BPM 13 57 160 28 98 159 13 59 128 22 98 125 13 59 160 26 98 157 14 00 172 25 98 171 14 01 190 35 98 189 14 02 176 23 98 174 NOTE The monitor s Header information is printed each time the monito
8. twice for one half second and cycled one after the other e The monitor displays for three 3 seconds the current monitor configuration setup The configuration setup consists of the monitor s Model number the version of its main software and a list of installed parameters NOTE If the printer was powered ON during the monitor s power up sequence the Midmark is printed MIDMARIK Once the Power On Self Test is completed the monitor s Main display screen is ready for use Refer to the Setup and Parameters menus to configure the monitor 21 02 0187 REV 04 05 09 42 eg Midmark Veterinary Monitors SETUP MENU WARNING Do not enter the Setup menu while the monitor is connected to a patient The patient is not being monitored while in the menu The monitor s Setup menu allows the user to tailor the Midmark Monitor to your individual needs Once entered the user can Set the Operating Language Make selections for Audio Alarm Silence Set the Date Set the Time Set Daylight Saving Time Options Set the SpO Pulse Rate Alarm Delay Time Select the Temperature Units Select the Trace Background ENTERING THE SETUP MENU To enter the monitor s Setup menu depress and hold the ALARM LIMITS fi and AUDIO VISUAL Pa pushbutton keys while the monitor is being turned ON Figure 13 Setup Menu setup Language English Audio Silence 2 Minute Date 06 Feb 04 Time 08 26 DST OFF O
9. RED Battery Low or Dead Battery 21 02 0187 REV 04 05 09 eg Midmark Veterinary Monitors FRONT PANEL CONTROLS Figure 10 Front Panel Controls On Standby Silence Reset Q ON STANDBY Turns ON the monitor s display SILENCE RESET When depressed during an active patient alarm silences the audio portion of that alarm for fifteen 15 seconds When depressed during an active equipment alarm the alarm condition shall be acknowledged along with the audio and visual shall be removed Used to enable and disable the 2 Minute or Permanent Audio Alarm Silence feature Refer to Page 44 AUDIO ALARM SILENCE SILENCE RESET Pushbutton for more information 21 02 0187 REV 05 3 15 37 Midmark Veterinary Monitors I FREEZE PRINT MAIN PARAMETERS FREEZE When depressed while viewing the Main display screen will freeze the traces The message Traces Frozen appears at the top of the Main Display screen While frozen the numerics continue to update Depress again to un freeze Traces will remain frozen for sixty 60 seconds if no pushbutton is depressed or if the user enters one of the menu selections PRINT Depress and hold for two 2 seconds to print Waveforms History or Alarm History information MAIN When depressed while in a sub menu returns to the Main display screen Allows the user to setup and configure how the Parameters being monitored are viewed on the display
10. 15 seconds the audio alarm is reactivated If the alarm condition continues uninterrupted for the 15 seconds the audio alarm is reactivated RESPIRATION ALARMS During either a Low or High Respiration Alarm Limit Violation the monitor flashes the Respiration Rate RR numeric display and the Patient Alarm LEDs provides a Patient Alarm Limit Violation audible tone and flashes the appropriate message Low RR or High RR in the Patient Alarm Message Window section of the display To acknowledge the alarm and temporarily mute the audio depress the SILENCE RESET pushbutton The monitor silences the audible tone for a maximum of fifteen 15 seconds the parameter in alarm and Patient Alarm LEDs continue to flash on the front panel and the appropriate message will be displayed in the Patient Alarm Message Window section of the display If the current patient alarm condition becomes inactive during the 15 seconds and then recurs OR a different patient alarm condition occurs during the 15 seconds the audio alarm is reactivated If the alarm condition continues uninterrupted for the 15 seconds the audio alarm is reactivated SpO ALARMS During either a Low or High SpO gt Alarm Limit Violation the monitor flashes the SpO gt numeric display and the Patient Alarm LEDs provides a Patient Alarm Limit Violation audible tone and flashes the appropriate message Low SpOz or High SpOz in the Alarm Window section of the display To acknowledg
11. EN 60601 1 EN 60601 1 2 EN 60601 2 30 EN 60601 2 49 EN 865 UL Classified UL 2601 1 CAN CSA C22 2 No 601 1 If so marked Nellcor VetSat and OxiMax are registered trademarks of Mallinckrodt Inc SatSeconds is a trademark of Mallinckrodt Inc YSI is a registered trademark of Yellow Springs Instrument Company CASMED MAXIE um cum Safe Cuff amp SoftCheck UltraCheck and FOR WHAT S VITAL are registered trademarks of CAS Medical Systems Inc All units covered by U S patent 4 796 184 and 5 022 403 Other patents pending Monitors are d d if so marked 104 21 02 0187 REV 04 05 09 eg Midmark Veterinary Monitors 14 PURCHASING RECORD Midmark VITAL SIGNS MONITOR Installed Options ECG Resp amp Temp SpO Model 9454 9456 Serial Number Date of Purchase Distributor Name Representative Phone Number Fax Number Email 21 02 0187 REV 05 3 15 105
12. LL red Left Hind Leg F green Left Hind Leg 5 Lead For a 5 lead system four limb leads can be applied RA LA RL and LL with the exploring lead brown used for diagnostic purposes as needed Otherwise the exploring lead may be left unplugged Refer to Figure 3 and Table 3 for more information NOTE Do not use the 5 Lead Patient Cable for 3 Lead monitoring A Leads OFF message will be displayed Refer to Section 12 ACCESSORIES for the 3 Lead Patient Cable part number information 21 02 0187 REV 04 05 09 20 Midmark Veterinary Monitors Figure 3 5 Lead Placement Table 3 5 Lead Color and Coding USA Standard International Standard LA black Left Foreleg L yellow Left Foreleg RA white Right Foreleg R red Right Foreleg RL green Right Hind Leg N black Right Hind Leg LL red Left Hind Leg V brown explore F green Left Hind Leg C white common LEAD CONTACT Sites where leads are attached to the body must be properly prepared to optimize contact Dogs and cats have enough electrolyte material on their skin and hair so that merely moistening lead sites with 70 isopropyl alcohol is appropriate This will usually be sufficient for ECG recording monitoring for a short time 30 to 60 minutes depending upon the relative humidity For monitoring during longer periods an electrode paste shou
13. MONITOR sennnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnennnnnn 5 INA INSPEGTION eee 5 MONITOR CHECKLIST EE 5 OPTIONALACCESSORIES araia eaa aa a aa ts 5 3 E del 7 4 SAFETY MEASURES AND WARNINGS nnrnnnvvvvvvvvennrnnnnnnnnnvvvvnennnnnnnnnnnnnnen 13 AUTOMATIC SAFETY FEATURES wincinitieisiecsnuacestiviice angi radeon nad 17 5 ECG AND RESPIRATION MONITORING rrnnnnnnvvvnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnen 19 EGG MONITORING eee 19 POSITIONING ANESTHETIZED PATIENTS musvvennvnrvvrrrvvvrnvvnvvrnrvrrrrvversversveevsrernn 19 POSITIONING CONSCIOUS PATIENTS A 19 CEAD ATTAC MEN EE 19 EE EE 21 HEGORDING ae 22 FREEZETRAGES nemes 22 RESPIRATION MONITORING EE 23 DETACHING THE Re 25 REMOVING THE PATIENT GABLE 2 iarcsccsieue itis caskensas gear steden opened 25 6 PULSE OXIMETRY MONITORING rrnnnnnnnnnnnvvvvnnnnnnnnnnnnnnnnvnnnnnnnnnnnnnnnnnennnnnnnn 27 INSTA a 27 SatSeconds ALARM MANAGEMENT uesermesmneseoenesbe dad 29 SENSOR REMOVAL riaa apa nede ea iiaei 29 REMOVING THE INTERFACE CABLE vits EE 30 PERFORMANCE CONSIDERATIONS AAA 30 7 TEMPERATURE MONITORING nnnnvvvvnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnen 31 YELLOW SPRINGS INTERNATIONAL YSI TECHNOLOGY 31 21 02 0187 REV 04 05 09 Midmark Veterinary Monitors EEN 8 MONITOR GBERAHIENRezugrgugeseeegegegeguersgrgekdEEREReEEEeEEeEEENEeEgEERNedEERNECegEe 33 FRONT PANEL sd 33 DISPLAY AREAS se end 33 MAIN DISPLAY AREA Linnie EEN 33 TIME BATTERY AND NUME
14. Stop bits 1 Flow Control None 6 When finished select OK 7 Click on Transfer and select Capture Text Use the Browse button to select a location to save your work Example C My Documents Midmark TXT 8 From the File menu choose SAVE 9 When completed from the File menu choose CLOSE Whenever you need to capture data from the monitor connect the cable from the RS232 connector on the Midmark Monitor to the computer and open the Midmark MONITOR application in the HyperTerminal program Click on Transfer and select Capture Text When the Capture Text box opens click the START pushbutton 1 HyperTerminal by Hilgraeve Monroe Michigan USA Copyright 1999 Hilgraeve Inc 21 02 0187 REV 05 3 15 83 Midmark Veterinary Monitors EEN Refer to Page 52 HISTORY for information on the Trend and Alarm History menus When the Printing message appears on the monitor a data dump can be observed on your PC display All subsequent readings will also be captured when the connection remains active Once you have the file captured the data can be viewed and printed by using a standard Windows application such as Word NOTE Capturing data to an existing file will append new data to the end of the file 21 02 0187 REV 04 05 09 84 eg Midmark Veterinary Monitors 10 CLEANING CLEANING OVERVIEW WARNING Do not under any circumstances perform any testing or maintenance on the monitor while
15. eg Midmark Veterinary Monitors FEATURES Characteristic Specification Self Test System self test is performed each time power is turned on OPERATING ENVIRONMENT Characteristic Specification Operating Temperature 0 C to 50 32 F to 122 Humidity 15 95 non condensing Altitude 10 000 to 1 000 ft 690 1050 hPa Storage Transport Temperature 20 C to 65 C 4 F to 149 F Humidity 15 95 non condensing Altitude 10 000 to 1 000 ft 690 1050 hPa Monitors may not meet performance specifications if stored or used outside temperature and humidity ranges When moving the monitor from a storage location wait at least one hour prior to use to allow the monitor to adjust to room temperature PHYSICAL DIMENSIONS amp WEIGHT Characteristic Specification Base Unit H x W x D 6 75 in x 8 5 in x 4 0 in 17 cm x 21 5 cm x 10 2 cm Weight 4 1 lbs approx 1 4 kg 21 02 0187 REV 05 3 15 103 Midmark Veterinary Monitors SERIAL INTERFACE Characteristic Specification Speed 9600 Interface Bidirectional serial communication Signal Level RS232C Data Length 8 bits Start Bit 1 bit Stop Bit 1 bit Parity None STANDARDS Units comply with the following requirements
16. guidelines may not apply in all situations Electromagnetic propagation is effected by absorption and reflection from structures objects and people 7 Field strengths from fixed transmitters such as base stations for radio cellular cordless telephones and land mobile radios amateur radio AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy To assess the electromagnetic environment due to fixed RF transmitters an electromagnetic site survey should be considered If the measured field strength in the location in which the Model 9454 9456 Monitor is used exceeds the applicable RF compliance level above the Model 9454 9456 Monitor should be observed to verify normal operation If abnormal performance is observed additional measures may be necessary such as re orienting or relocating the Model 9454 9456 Monitor gt Over the frequency range 150 kHz to 80 MHz field strengths should be less than 3 V m Recommended Separation Distances Between Portable and Mobile RF Communications Equipment and the Model 9454 9456 Monitor The Model 9454 9456 Monitor is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled The customer or the user of the Model 9454 9456 Monitor can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment transmitters and the Model 9454 9456 Monitor as recommen
17. in the Patient Alarm Message Window section of the display If the current patient alarm condition becomes inactive during the 15 seconds and then recurs OR a different patient alarm condition occurs during the 15 seconds the audio alarm is reactivated If the alarm condition continues uninterrupted for the 15 seconds the audio alarm is reactivated EQUIPMENT ALARMS During an active Equipment Alarm the monitor displays the alarm parameter in either the Waveform section or the Equipment Message Window section of the display flashes the Equipment Alarm LEDs and provides an Equipment Alarm audible tone To acknowledge the alarm depress the SILENCE RESET pushbutton The monitor silences the audible and visual alarms and clears the parameter from the display NOTE The Low Battery and Dead Battery alarms cannot be silenced 2 MINUTE AUDIO ALARM SILENCE NOTE Enabling the 2 Minute Audio Silence mode can only be accomplished after all active alarm conditions have been addressed To clear an alarm refer to Page 63 CLEARING ALARMS If the 2 Minute Audio Silence mode is selected in the Audio Silence portion of the Setup menu pressing the SILENCE RESET pushbutton will temporarily deactivate the audio alarms for two 2 minutes The SILENCE visual indicator will illuminate continuously and the message 2 Minute will be displayed in the Equipment Message Window section of the display as a reminder When the 2 Minu
18. mains voltage prior to application of the test level 21 02 0187 REV 05 3 15 Guidance and Manufacturer s Declaration Electromagnetic Immunity The Model 9454 9456 Monitor is intended for use in the electromagnetic environment specified below The customer or the user of the Model 9454 9456 Monitor should insure that it is used in such an environment Immunity Test IEC 60601 Test Level Compliance Electromagnetic Environment Guidance Level Portable and mobile RF communications equipment should be used no closer to any part of the Model 9454 9456 Monitor including cables than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter Recommended separation distance Conducted RF 3 Vrms 3 Vrms d 1 2VP IEC 61000 4 6 150 kHz to 80 MHz Radiated RF 3 V m 3 V m d 1 2 P 80 MHz to 800 MHz IEC 61000 4 3 80 MHz to 2 5 GHz d 2 3VP 800 MHz to 2 5 GHz Where Pis the maximum output power rating of the transmitter in watts according to the transmitter manufacturer and dis the recommended separation distance in meters Field strengths from fixed RF transmitters as determined by an electromagnetic site survey should be less than the compliance level in each frequency range Interference may occur in the vicinity of equipment marked with the following symbol Ur i NOTE 1 At 80 MHz and 800 MHz the higher frequency range applies NOTE 2 These
19. menu Refer to Page 90 SERVICE MENU 2 Press the ARROW DOWN pushbutton until the parameter PIC Voltage is highlighted 3 Verify the value on the display to be 12 00 V 0 50 NOTE The information provided is read only No changes can be made 4 When you have completed press the MAIN pushbutton to exit and return to the Main display screen 21 02 0187 REV 05 3 15 91 Midmark Veterinary Monitors EEN SOFTWARE VERSIONS The Midmark Monitor displays the current software revision of its operating system and that of the internal modules being used inside The software versions are displayed in the following order Figure 26 Software Versions Menu Versions DSP Software XX Lang FLASH XX BOOT XX PIC XX CAS ECG RESP XX Nellcor SpO gt X XX Unit S N XXXXXXXX NOTE In the Model 9456 monitor the selection for Nellcor SpO is skipped To view the software Versions menu follow the following procedure 1 First enter the monitor s Service menu Refer to Page 90 SERVICE MENU 2 Depress and hold the HISTORY pushbutton for two 2 seconds to display the Versions menu NOTE The information provided in the Versions menu is read only No changes can be made 3 When you have completed press the MAIN G pushbutton to exit and return to the Main display screen 21 02 0187 REV 04 05 09 92 eg Midmark Veterinary Monitors TEMPERATURE CALIBRATION CHECK Verify
20. on non disposable accessories and certain components consisting of reusable SpOz sensors and other accessories provided by CAS as part of the original purchase CAS warrants single patient use products for out of box failure only Where the accessory is not a CAS manufactured product the manufacturer s own warranty conditions apply CAS reserves the right to perform warranty service operations in its own factory at an authorized repair facility or at the customers site Our obligation under this warranty is limited to repairing or at our option replacing any defective parts or our equipment without charge if such defects occur in normal service and with prompt notification Damage to any part through misuse neglect or accident or by affixing any accessories or attachments other than CAS Nellcor and YSI manufactured accessories or attachments is not covered by this warranty ACCESSORIES BATTERIES AND CERTAIN COMPONENTS In all cases policy applies from date of purchase from CAS or its authorized distributors or agents Batteries 1 Year Chargers 1 Year not including power cord see other accessories Lead Wires Out of box failure only Patient Cable 6 Months SpO Sensor 6 Months Nellcor SpO Sensor Temperature Probe 6 Months YSI Temperature Probe Other Accessories Out of box failure only Certain Components 1 Year Printer mechanism but not including Thermal Print Heads Print Heads Ou
21. or Norwegian The monitor s display window can display various system alarm messages These messages direct the user to check conditions such as the battery state and measurement problems 21 02 0187 REV 05 3 15 Midmark Veterinary Monitors SSS The ECG parameter is intended for three lead or five lead ECG monitoring The Respiration RESP parameter is intended to measure changes in electrical impedance caused by chest shape changes associated with inspiration and expiration 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 pulse rate numeric values are available for display When selected as a waveform parameter a pulsatile waveform is also available for display When selected on the display as a numeric parameter on each detected pulse a bar graph gives the user a pulse by pulse visual indication of waveform signal quality An audio beep can be enabled that is generated each time the SpO2 module detects a pulse NOTE The bar graph is not proportional to the pulse volume The Temperature parameter TEMP is intended to measure temperature using an attachable probe The temperature value displaye
22. programmed pushbutton keys to return back to the parameter selections column 8 Press the ARROW DOWN pushbutton to continue to the next parameter or press the MAIN G pushbutton to exit to the Main display screen NOTE Altering the Date and Time will affect the History readings but not erase them DAYLIGHT SAVING TIME OPTION The Midmark 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 OFF Daylight Saving Time is OFF The user is responsible for changing the time if needed This is the default setting for the Midmark Monitor e N America Daylight Saving Time North America Use this setting and the monitor will automatically add 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 EU 01 00 Daylight Saving Time European Union EU 02 00 EU 03 00 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 all time zones change at the same moment 21 02 0187 REV 04 05 09 46 eg Midmark Veterinary Monitors Select EU 01 00 if the monitor will be located in Ireland Portugal or the United Kingdom Select EU 03 00 for Finland EU 02 00 can be used for all remaining countries
23. pushbutton to make a selection 5 Press one of the PREVIOUS programmed pushbutton keys to return back to the parameter selections column 6 Press the ARROW DOWN pushbutton to continue to the next parameter or press the MAIN pushbutton to exit to the Main display screen 21 02 0187 REV 05 3 15 47 Midmark Veterinary Monitors SELECTING THE TEMPERATURE UNITS The Midmark Monitor can display Temperature readings in either the Celsius C or Fahrenheit F scales The default value used by the Midmark Monitor is Fahrenheit F To configure the monitor s Temperature setting follow the following procedure First enter the monitor s Setup menu Refer to Page 43 SETUP MENU Press the ARROW DOWN pushbutton until the parameter TEMP Units is highlighted Press one of the NEXT programmed pushbutton keys until the cursor displays the parameter currently being used Press either the ARROW UP or ARROW DOWN pushbutton to make a selection Press one of the PREVIOUS programmed pushbutton keys to return back to the parameter selections column Press the ARROW DOWN pushbutton to continue to the next parameter or press the MAIN G pushbutton to exit to the Main display screen TRACE BACKGROUND The background area surrounding the monitor s waveforms can be displayed either as a black background with white traces Dark or a white background with black traces Light The default value used by the Midmark Monitor is Dark To
24. saved set of limits Restore factory defaults 21 02 0187 REV 05 3 15 21 02 0187 REV 05 3 15 Manufacturers Declaration of Conformity Electronic Emissions and Immunity The Model 9454 9456 Monitor is intended for use in the electromagnetic environment specified below The customer or the user of the Model 9454 9456 Monitor should assure it is used in such an environment Emissions Test Compliance Electromagnetic Environment RF emissions CISPR 11 Group 1 The Model 9454 9456 Monitor uses RF energy only for its internal function Therefore its RF emissions are very low and are not likely to cause any interference in nearby electronic equipment RF emissions CISPR 11 Class B The Model 9454 9456 Monitor is suitable for use in all Harmonic emissions Class B establishments including domestic establishments and IEC 61000 3 2 those directly connected to the public low voltage power Voltage fluctuations Complies supply network that supplies buildings used for domestic flicker emissions purposes Immunity Test IEC 60601 Test Level Compliance Level Electromagnetic Environment Guidance Electrostatic discharge ESD IEC 61000 4 2 6 KV contact 8 KV air 6 KV contact 8 KV air Floors should be wood concrete or ceramic tile If floors are covered with synthetic material the relative humidity should be at least 30 Electrical fast transient bur
25. silences the audible and visual alarms but the message ECG Error or ECG Module remains on the display Should the above problems persist contact CAS Medical Systems Inc SpO USER MESSAGES Model 9454 only 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 waveform display to determine if a strong rhythmic pulse signal is present When no oximeter probe is attached to the monitor the SpO gt and Pulse Rate numeric displays will show dashes and the signal strength window will be blank NOTE If SpO is selected as a waveform parameter no signal strength bar graph is displayed 21 02 0187 REV 04 05 09 70 eg Midmark Veterinary Monitors When the probe is connected to the monitor but is off of the patient the SpO gt and Pulse Rate numeric displays will show dashes The message SpO Probe OFF is displayed the Equipment Alarm LEDs are flashing and three 3 audio beeps are heard every twenty five 25 seconds NOTE If SpO is selected as a waveform parameter the message appears in the waveform section of the display If SpO is not selected as a waveform parameter the message appears in the equipment message window section of the display To acknowledge the alarm d
26. the guidance given NOTE The Midmark Monitor is not equipped with interfaces to remote equipment or network s to duplicate alarms PRINTER OVERVIEW The Citizen CMP 10 Mobile Printer interfaces to the Midmark Monitor via an Infrared Ir port or by using the direct connect RS232 cable supplied with printer The Infrared ports are located on the top of the printer and on the bottom front panel of the Midmark Monitor When using the Infrared port it is important to keep the two devices close together less than three 3 Feet one 1 Meter and in line to maintain proper communications The monitor can perform a communication test to verify the Infrared connection Refer to Page 91 IrDA TEST for more information CAUTION For safe and proper usage of the external printer please observe the following When using the printer e Avoid placing monitor in areas where fluid may enter the printer opening accidentally Do not drop or bump the monitor Avoid places subject to high or low temperature extremes Avoid direct sunlight Avoid dusty places and where corrosive gasses are generated Never attempt to dismantle or repair the printer mechanism When RE the thermal paper Store in a dark cool and dry place Do not place near organic solvents Avoid contact with vinyl chloride films erasers or adhesive tapes for extended periods Avoid exposure to high temperature humidity liquid or sunlight Always us
27. within the European Union NOTE Enabling Daylight Saving Time will affect the History readings but not erase them To configure the monitor s Daylight Savings time setting follow the following procedure 1 First enter the monitor s Setup menu Refer to Page 43 SETUP MENU 2 Press the ARROW DOWN pushbutton until the parameter DST is highlighted 3 Press one of the NEXT programmed pushbutton keys until the cursor displays the parameter currently being used 4 Press either the ARROW UP or ARROW DOWN pushbutton to make a selection 5 Press one of the PREVIOUS programmed pushbutton keys to return back to the parameter selections column 6 Press the ARROW DOWN pushbutton to continue to the next parameter or press the MAIN G pushbutton to exit to the Main display screen SET THE SpO PULSE RATE ALARM DELAY The delay time until an alarm is generated for SpO Pulse Rate can be configured to be either zero 0 seconds no delay or ten 10 seconds The default value used by the Midmark Monitor is ten 10 seconds To change the monitor s SpO Pulse Rate Alarm Delay Time follow the following procedure 1 First enter the monitor s Setup menu Refer to Page 43 SETUP MENU 2 Press the ARROW DOWN pushbutton until the parameter O Alarm Delay is highlighted 3 Press one of the NEXT programmed pushbutton keys until the cursor displays the parameter currently being used 4 Press either the ARROW UP or ARROW DOWN
28. years 21 02 0187 REV 05 3 15 93 Midmark Veterinary Monitors SSS SaaS REMOVING THE BATTERY 1 Turn the monitor OFF and disconnect the power cord from the back of the monitor 2 Push down on the battery latch to unlock the battery door from the rear panel of the monitor 3 Carefully remove the battery pack from the rear panel of the monitor Refer to Figure 27 Figure 27 Removing the Monitor Battery Pack 100 240 NM 5A 50 60Hz FUSE TL25AL250V CAUTION U S FEDERAL LAW RESTRICTS THIS DEVICE TO SALE ON OR BY THE ORDER OF A VETERINARIAN U S PATENT 4 796 184 6 022 403 OTHER PATENTS PENDING INSTALLING THE BATTERY 1 Align the Battery Pack guides with the bottom of the monitor 2 Slowly close the battery door to ensure the connector in the monitor and the connector on the battery pack mate together 3 Lock the battery door closed Refer to Page 66 BATTERY POWER for additional battery information WARNING Do not disassemble the battery pack or batteries The batteries contain electrolytes which can cause injury to eyes skin and clothing NOTE When the battery pack is re inserted the monitor will automatically turn ON 21 02 0187 REV 04 05 09 94 eg Midmark Veterinary 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 m
29. 2 Alarm Delay 10 Sec TEMP Units oF Background Dark NOTE While in the Setup menu if no pushbutton is depressed within 60 seconds the monitor will automatically save all changes made exit the Setup menu and return to the Main display screen 21 02 0187 REV 05 3 15 43 Midmark Veterinary Monitors EEN EXIT THE SETUP MENU When you have completed configuring the monitor press the MAIN G pushbutton to exit and lock in your selection s The monitor exits the Setup menu and returns to the Main display screen SELECTING THE LANGUAGE The Midmark Monitor can operate in one 1 of nine 9 languages English German French Italian Spanish Dutch Swedish Portuguese or Norwegian To configure the monitor s operating Language follow the following procedure 1 First enter the monitor s Setup menu Refer to Page 43 SETUP MENU The monitor will automatically highlight the Language parameter 2 Press one of the NEXT programmed pushbutton keys until the cursor displays the current language being used 3 Press either the ARROW UP or ARROW DOWN pushbutton to make a selection 4 Press one of the PREVIOUS programmed pushbutton keys to return back to the parameter selections column At this time the new language selection shall take effect 5 Press the ARROW DOWN pushbutton to continue to the next parameter or press the MAIN G pushbutton to exit to the Main display screen AUDIO ALARM SILENCE SILENCE RESET
30. 21 02 0187 REV 04 05 09 26 eg Midmark Veterinary Monitors 6 PULSE OXIMETRY MONITORING Model 9454 The Midmark Model 9454 Monitor is intended for animal monitoring by trained personnel It displays numerical values for oxygen saturation and pulse rate The Model 9454 has provisions for alarm settings WARNING Use only Nellcor VetSat veterinary oxygen transducer sensor and clips Use of other oxygen transducers may cause improper oximeter performance Monitors equipped with Nellcor oximetry will have the Nellcor OxiMax logo next to the SpO2 connector For more information refer to the Directions for Use pamphlet included with each Nellcor VetSat sensor INSTRUCTIONS FOR USE NOTE Reusable sensors may be used on the same site for a maximum of four 4 hours provided the site is inspected routinely to ensure skin integrity and correct positioning Because individual skin condition affects the ability of the skin to tolerate sensor placement it may be necessary to change the sensor site more frequently with some patients 1 Select a sensor and clip that is appropriate for the patient There are two 2 sizes of VetSat veterinary sensor clips model VSC S small and model VSC L large 2 Clean the VetSat sensor and sensor clip separately before and after each use Refer to Page 85 CLEANING for more information 3 Open the clip by pressing with the thumb and forefinger 4 Slide one of the senso
31. 4 PURCHASING RECORD E 105 21 02 0187 REV 04 05 09 mn Midrnark Veterinary Monitors FIGURES Figure 1 Patient te ul E EE 2 Figure 2 3 Lead Placement EE 20 Figure 3 5 Lead bilacement 21 Figure 4 Detaching the Leadwires uk ENEE 25 Figure 5 Sensor to Interface Cable mrrrrnnrrrrrsnnrrrrrrnrnrvrrrrrnnrrrrrnrrrrrnnnnnrvennnnnrvnnnnnnannnnen 28 Figure 6 Front Panel Neger Eed enge 33 Figure 7 Main Display Area 33 Figure 8 Time Battery and Numeric Status 0 ccccccce cece eeeneeeeeeeee teense eeneeeeeteeeeneees 34 Figure 9 Numerics and Temperature 35 Figure 10 Front Panel Controls AEN 37 Figure 11 Rear Panel View 40 Figure 12 Left Side Panel View rrrrnrrnnnnrrnnnnrrnnnnrrnnnnnnnnnnnnnnonnnnnnnnnnnennnnsennnnnenvennernnenennnee 41 Figure 13 Setup Menu deele ee ee EE 43 Figure 14 Parameters MenuLuumismandnsisarmuenddernadmnnnstpmdrsnte dt nsiee 49 Figure 15 Audio Visual Menu 51 Figure 16 History Menu iuiausemae kved EENS hee 53 Figure 17 Alarm History Menu 55 Figure 18 Alarm Limits Menu eerrrnnvonnnnnnnnvonnnnnnvnnnnnnnnvnnnnnnnnnvnnnnnnnvnnnnnnnnnnnnnnnnnnnennnnnnenen 58 Figure 19 Printer Controls and Indicators a00annnoonnneeeneneannnnnannsrnrnnerrrrnnernnnnnnrnnnnnnna 76 Figure 20 History Sample Printouts nere nnnrnnvnnsnnrensnnnnee 78 Figure 21 Waveform Sample Printouts cccccccccessececsesseeeceessesececssesececssaeeeeeesneees 7
32. 9 Figure 22 Paper Installation 22 sesrndis aseu snc ned toes le ap eect mane 80 Figure 23 Opening the Battery Door 81 Figure 24 Installing the New Battery AA 82 PIQUIS 25 Service Mentee eelere ege eet 90 Figure 26 Software Versions Menu 92 Figure 27 Removing the Monitor Battery Pack 94 21 02 0187 REV 04 05 09 Midmark Veterinary Monitors TABLES Table 1 Parts TE EE 3 Table 2 3 Lead Color and Codmmg ttnn nttn neren nere nnne 20 Table 3 5 Lead Color and Codimg e 21 Table 4 Alarm Parameters ccccecceeseeceececeeeeeesesecseeaeeeeeeesesacseaeeeceeeeeeeessesenieeeeeeeess 58 Table 5 Factory Default Alarm Values 61 Table 6 Audible and Visual Indicators rrrnnrrrrrnrrrrrrnrnnrnrrnnrrnrrrrrrrrnnnnnnnnenrrrrrrnrnnnnnnennene 62 Table 7 Monitor Messages rrrnarrrrrnronannosnnrnrronernoonannnannrnrrnnennonananannrrnvennennnnnsnnnnnrnnnennennnnnn 72 Table 8 ECG Respiration Monitor Messages rrrrrrnnrnnonnvnnnnvrnnnnvnnnnnvrnnrnrrnnnrrrnnrnrrnnrnrenennn 73 Table 9 SpO Monitor Messages 74 Table 10 Monitor Configurations vennen vennen nennnnnnnrnnrnnnsnnrennn 98 vi 21 02 0187 REV 04 05 09 eg Midmark Veterinary Monitors 1 INTRODUCTION AND INTENDED USE INTRODUCTION The Midmark Monitor is a multi parameter monitor measuring Heart Rate Respiration Oxygen Saturation and Temperature Heart Rate is measured by placing electrodes on either side of the chest that detect electrical
33. ACTORY DEFAULTS To restore the Factory default settings 1 Press the ALARM LIMITS pushbutton to enter the Limits menu 2 Press the ARROW DOWN pushbutton and highlight Restore 3 Press one of the NEXT programmed pushbutton keys to advance onto the parameter value to change No 4 Press either the ARROW UP or ARROW DOWN until the message Factory appears 5 Press the ALARM LIMITS pushbutton the message Restoring appears briefly as a status indicator and the Factory set of Alarm values will be restored into the current memory location 21 02 0187 REV 04 05 09 60 eg Midmark Veterinary Monitors When finished press the MAIN CD pushbutton to exit and return to the Main display screen or after thirty 30 seconds of button inactivity the monitor will automatically return to the Main display screen The Alarm Limit values will be retained in memory even after the monitor s power is turned OFF ALARM LIMIT VALUES Table 5 lists the Alarm Limit Default Values used by the Midmark Monitor Table 5 Factory Default Alarm Values Parameter Limits Low High Heart Rate HR OFF 290 Respiration Rate RR OFF OFF No Respiration Rate No RESP 30 N A SpO gt SpO gt 88 OFF SatSeconds SatSeconds OFF N A NOTE Patient alarms for Heart Rate have a five 5 second delay The alarm for SpO has a zero 0 second or SatSeconds delay The alarm for Pulse Rate wi
34. ENT 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 of 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 GENERAL NOTES There are no known risks with common disposal of equipment or accessories however the disposing of accessories should follow in accordance with local hospital policies The user should ensure these policies do not conflict with any local state or federal guidelines The monitor is suitable for use in the presence of electro surgery The monitor is suitable to be connected to public AC mains power The Midmark Monitor is not Category AP or APG Equipment Th
35. ING THE PRINTER BATTERY rrrvtorsrverrssrrrsssersvsrrnsssrrssssresssrerssernessernessne 79 INSTALLING PA Peen ee encarta K terete arty E 80 REPLACING THE BATTERY PACK ccssessssssssssssssssssscssscscssssessscsessusessnevessuteessens 81 INSTALLING A NEW BATTERY PACK 82 PRINTING TOA COMPUTER ee 83 10 CLEANING EE 85 CLEANING OVERVIEW ee 85 TEN 85 TED NN 86 PATIENT CABLE AND LEADWIRES ccssssessssessssssesssseesessveessseesssseessseeessneeeseees 86 PAINE Ae 86 SENSOR AND CLIPS Senica aiia een tee deet 86 TEMPERATURE PROBES EEN 87 21 02 0187 REV 04 05 09 iii Midmark Veterinary Monitors THe MAINTENANCE icicccaciittiencncacucsasicasinerandntuectadsinansetadaaeaduaaccsaestuaseatudeadeaasaaanaie 89 MAINTENANCE INTERVALS hmm ie kaiene ide den iain 89 SERVIGE MENU vesen 90 ENTERING THE SERVICE MENU A spuseeeereuakae kees kegee dese 90 EXIT THE SERVIGE MENU 1 miin artenes skiene 90 IrDA TES nr 91 PIG VOLTAGE Lua 91 SOFTWARE VERSIONS EE 92 TEMPERATURE CALIBRATION CHECK 93 spOs CALIBRATION CHECK aici cp cccestpnedensendesenn eENECE e AEN 93 REPLACING THE MONITOR BATT ERY wes ciccstectteisccedipacertiseccetauesdigeeeettinaietenes 93 REMOVING THE BATTERY ege SEENEN east 94 INSTALLING THE BATTERY aat 94 CHANGING THE FUSES Leiren EES GAEREN dad eide 95 STORAGE Aetat 96 12 ACCESSORIES Lumet 97 EGG RESPIRAT ON EE 97 OAMETR Tee 97 KS ln RE 97 OTHER ACCESSORIES suse ee 97 MONITOR CONFIGURATIONS E 98 13 e Tei ue LE 99 1
36. ITOR INITIAL INSPECTION Before unpacking the monitor inspect the packaging for damage If there are any signs of damage to the package a claim should be filed immediately with the shipping agent It is the receiver s responsibility to notify the carrier s local office to arrange for the pickup of the damaged items Save the damaged shipping carton as evidence Contact CAS Medical Systems Inc to report external damage and to arrange for repair or replacement of damaged equipment The shipping carton should contain the items listed below Unpack the monitor and account for each item Inspect each item for signs of external damage dents cracks scratches etc If an item is missing or damaged contact CAS Medical Systems Inc Record the monitor model serial number and date of purchase at the back of this manual MONITOR CHECKLIST Q lt Description Monitor 9454 or 9456 Hospital Grade AC Power Cord 3 or 5 Lead ECG Respiration Patient Cable based on order 3 or 5 Lead Wire Set based on order Nellcor Model DOC 10 SpOz Interface Cable for Model 9454 Nellcor VetSat Veterinary SpO gt Sensor and Clips for Model 9454 Electrode Gel 1 Tube Monitor User s Manual sch sch NOTE The monitor is shipped with the appropriate line cord for the country and or voltage being used OPTIONAL ACCESSORIES The Midmark Monitor is av
37. Midmark Veterinary Vital Signs Monitor Models 9454 and 9456 Bradycardia User s Manual Manufactured for CASMED MING 21 02 0187 REV 05 3 15 21 02 0187 REV 05 3 15 Midmark Veterinary Vital Signs Monitors IMPORTANT This manual addresses all parameters of the Midmark Veterinary Vital Signs Monitor Not all monitors have all the parameters referred to in this manual Read this Manual completely before using this equipment WARNING The Midmark Monitor is to be operated by qualified personnel only Before use carefully read this manual including accessory directions for use all precautionary information and specifications The user must check that the equipment functions safely and see that it is in proper working condition before being used 21 02 0187 REV 05 3 15 In the U S the following Caution applies CAUTION Federal law restricts this device to sale by or on the order of a veterinarian First Printing 05 2004 Revised 09 2004 Revised 05 2005 Revised 05 2008 Revised 05 2009 21 02 0187 REV 05 3 15 QUICK START UP GUIDE PATIENT CONNECTIONS TEMPERATURE Optional Accessory Refer to Page 31 Connect temperature probe to the temperature adapter Connect the adapter to the TEMP connector on the side panel of the monitor PULSE OXIMETRY Model 9454 Refer to Page 27 Select the small or large veterinary sensor and attach to the sen
38. NDBY pushbutton to turn ONT the monitor 9 Check that the monitor is accurately detecting the heartbeat and respiration by watching the monitor to see that the heart and lung visual indicators flash with each heartbeat and breath 10 If the heart and lung visual indicators do not correspond to the patient s heart rate and or respiration reposition the electrodes until the indicators flash in synch with the patient s heartbeat and breathing This will help to minimize false alarms 21 02 0187 REV 05 3 15 23 Midmark Veterinary Monitors Or um v 11 If required refer to Page 49 PARAMETERS MENU and configure the appropriate waveform s to be viewed and printed 12 Check the alarm limits and configure them appropriately for the patient Refer to Page 61 ALARM LIMIT VALUES 21 02 0187 REV 04 05 09 24 eg Midmark Veterinary Monitors DETACHING THE LEADWIRES To remove leadwires from a patient cable always grasp the strain relief plastic portion of the leadwire Do not pull the wire itself Figure 4 Detaching the Leadwires REMOVING THE PATIENT CABLE To remove the patient cable from the monitor s ECG RESP connector press and hold down on the release button to unlock the cable and pull straight back Do not pull on the cable itself Refer to Section 12 ACCESSORIES for electrode clips and patient cable types and part number information 21 02 0187 REV 05 3 15 25 Midmark Veterinary Monitors EEN
39. No SpOz Probe The monitor is not The probe was disconnected from either the detecting the SpO Interface Cable or from the monitor probe Pulse Search The monitor is searching Normal at power up as the monitor for a Pulse signal searches for a pulse The probe position may have changed Check the probe site Probe Error The SpO probe being Verify the probe being used is the correct used is not the correct probe one for the monitor s configuration SpO2 Probe OFF The monitor is no longer The probe is no longer in contact with the receiving a patient signal patient from the SpOz probe Check the probe site SpO Error An electronic failure has Contact CAS Medical Systems to have the occurred within the SpO gt monitor serviced module 21 02 0187 REV 04 05 09 74 eg Midmark Veterinary Monitors 9 EXTERNAL PRINTER The following section is provided as an overview of the Citizen CMP 10 Mobile Printer as it is used with the Midmark 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 Midmark Monitor has been tested with the Citizen CMP 10 Mobile printer to comply with IEC 60601 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 16 under LEAKAGE CURRENT TEST and follow
40. PATIENTS Standard position for recording diagnostic ECG in dogs is right lateral recumbency Diagnostic tracings can be obtained in cats in either right lateral or sternal position Limbs should be perpendicular to the spine and parallel with their opposite member In awake cats and dogs it is best to have the patient held by a veterinary technician or veterinary assistant One lead should be applied first to determine comfort level and adjustment made as needed Then the other clamps can be placed in position It is important that the patient be kept still A moving patient may cause clips to saw into skin tissue leading to discomfort and change in position of electrodes LEAD ATTACHMENT 3 Lead Leads should be attached just below the elbow on the front leg and just above the stifle on the hind leg The following lead sequence should be applied for a 3 lead system Right Foreleg RA white Left Foreleg LA black Left Hind Leg LL red Refer to Figure 2 and Table 2 for more information 21 02 0187 REV 05 3 15 19 Midmark Veterinary Monitors Figure 2 3 Lead Placement NOTE In order to pick up ECG and Respiration signals the leads must not be placed on the animal s legs but on the left and right chest areas Table 2 3 Lead Color and Coding USA Standard International Standard LA black Left Foreleg L yellow Left Foreleg RA white Right Foreleg R red Right Foreleg
41. Pushbutton The Midmark Monitor s SILENCE RESET pushbutton can be configured to have the audio associated with patient alarms set to one of the two selections below The selections are e 2 Minute Default e Permanent To configure the monitor s Audio Alarm Silence follow the following procedure 1 First enter the monitor s Setup menu Refer to Page 43 SETUP MENU 2 Press the ARROW DOWN pushbutton until the parameter Audio Silence is highlighted 3 Press one of the NEXT programmed pushbutton keys until the cursor displays the audio mode currently being used 4 Press either the ARROW UP or ARROW DOWN pushbuttons to make a selection 5 Press one of the PREVIOUS programmed pushbutton keys to return back to the parameter selections column 6 Press the ARROW DOWN pushbutton to continue to the next parameter or press the MAIN C pushbutton to exit to the Main display screen 21 02 0187 REV 04 05 09 44 eg Midmark Veterinary Monitors 2 MINUTE AUDIO ALARM SILENCE When the monitor is configured for the 2 Minute Audio Alarm Silence setting use the SILENCE RESET pushbutton to enable or disable audio alarms for a two 2 minute period The SILENCE visual bell indicator located on the front panel of the monitor will be illuminated constantly and the message 2 Minute will be displayed in the Equipment Message Window section of the display as a reminder when enabled At the end of two 2 minutes the monitor will aut
42. RIC STATUS AAA 34 NUMERIC AND TEMPERATURE iinpeet innsamler eden 35 PATIENT ALARM MESSAGE WINDOW A 35 EQUIPMENT MESSAGE WINDOW AAA 35 DISPLAY VISUAL INDICATORS 22tsaassctariic uence iierin meiner eines 36 FRONT PANEL CONTROULS emgeeesskaasreeek engGdeueteuger Sege 37 INFRARED I DATA PORT sunne kender aksen 39 REAR e jaaa 40 AG LINE POWER GONNEGTOR Luger 40 FUSE COMPARTMENT aneian aape AER 40 BATTERY COMPARTMENT ege erme 40 EQUIPOTENTIALITY GROUND POST eessen eneen EEN 40 EXTERNAL DEVICE INTERFACING wisscicicidteieti genistein geed 40 LEFT Sal Eder egene al 41 EGG RESP CONNEC TOR surre aars 41 NELLCOR VET SpO SENSOR CONNECTOR A 41 TEMP GONNEG TOR Liden nn 41 MONITOR OPERATING INSTRUCTIONS AA 42 TURNING THE Midmark MONITOR ONT 42 SETUP MENU EE 43 ENTERING THE SETUP MENU is 43 EXIT THE SETUP MENU eisereen 44 SELECTING THE LANGUAGE 2 agenten gaddien 44 AUDIO ALARM SILENCE SILENCE RESET Pushbutton 44 2 MINUTE AUDIO ALARM SILENGE ici ceeteiacestigecntinetituendicacn vada 45 PERMANENT AUDIO ALARM SILENCE errrervrrrrvvvrvvvnvvrererrvrvvernerrneernrervraeener 45 SETTING THE DATE enda 45 SETTING THEA IME un 46 DAYLIGHT SAVING TIME OPTION 2 ccieacte ie aleetisissiieesettaeenseedes 46 SET THE SpO2 PULSE RATE ALARM DEL AN 47 SELECTING THE TEMPERATURE UNITS sissies ugereegt innan 48 TRACE e ER RE 48 PARAMETERS MENU susen 49 AUDIONTISUAL MENU EE 51 HISTORY EE 52 TREND Ee 53 PRINTING TREND HISTORY La knsssesendsmdensenibde
43. ack cover Refer all servicing to qualified personnel ELECTROCAUTERY PRECAUTIONS To prevent unwanted skin burns apply electrocautery electrodes as far as possible from all other electrodes a distance of at least 15 cm 6 in is recommended ELECTROMAGNETIC COMPATIBILITY EMC The equipment needs special precautions regarding EMC Be aware that strong electromagnetic fields may interfere with monitor operation Interference prevents the clear reception of signals by the monitor If the hospital is close to a strong transmitter such as TV AM or FM radio police or fire stations a HAM radio operator an airport or cellular phone their signals could be picked up as signals by the monitor 21 02 0187 REV 05 3 15 15 Midmark Veterinary Monitors Em EE CAUTION 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 CURR
44. ailable with a rolling stand and basket a soft sided carrying case and other optional accessories to fit your needs Refer to Section 12 ACCESSORIES for part number information Contact Midmark for more information 21 02 0187 REV 05 3 15 Midmark Veterinary Monitors EEN 21 02 0187 REV 04 05 09 Midmark Veterinary Monitors 3 SYMBOLS Units may display the following symbols EN A CE IPX1 Jet 4 x t ECG RESP Alternating Current CAUTION Before using read instructions included The CE Mark signifies the device has met all essential requirements of European Medical Device Directive 89 336EEC Protection against ingress of water Indicates protection against the effects of the discharge of a cardiac defibrillator Patient connections are Type CF isolated for direct cardiac application and protected against defibrillation Indicates protection against the effects of the discharge of a cardiac defibrillator Patient connections are Type BF and protected against defibrillation Equipotentiality Ground Post ECG Respiration Input Connector 21 02 0187 REV 05 3 15 Midmark Veterinary Monitors EEN SYMBOLS CONT SpO Pulse Oximeter Probe Input Connector TEMP Temperature Probe Input Connector Two way Communication Port RS232 Interface Connector These symbols appear on the front panel in the place of text ON STANDBY Pushbutton SILENCE RESET Pushbutton O CH FREEZE PRINT MAIN P
45. alarm for SpOz limit violations based on the selection made in the Alarm Limits menu SENSOR REMOVAL CAUTION For the comfort of the patient and to avoid damaging the sensor do not pull on the cable when removing the sensor and clip from the sensor site When SpOz monitoring is completed remove the sensor from the patient To remove the sensor and clip from the patient press the clip open and remove When the probe is removed from the patient the message SpO2 Probe OFF is displayed the Equipment Alarm LEDs are flashing and an audible alarm sounds indicating a connection has been lost To acknowledge the alarm depress the SILENCE RESET pushbutton The monitor silences the audible and visual alarms and the message SpO Probe OFF remains on the display 21 02 0187 REV 05 3 15 29 Midmark Veterinary Monitors WEEN To remove the sensor from the clip grasp the end of each sensor pad and pull it through to the inside of the clip The sensor should pop out of the clip easily DO NOT pull on the cable NOTE If either the 2 Minute Audio Silence or Permanent Audio Silence is enabled no audio will be heard but a visual message will appear in the Message Window REMOVING THE INTERFACE CABLE When 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 avo
46. ameter value to change Erase No 4 Press either the ARROW UP or ARROW DOWN pushbutton until the message Erase Yes appears 5 Press the HISTORY pushbutton again to erase Patient Alarm History data The monitor erases the memory exits the Alarm History screen and returns to the Patient History display screen if available or returns to the Main display screen REAL TIME CLOCK The Midmark Monitor uses an internal Real Time Clock to time stamp all entries that are stored in either of its History menus Changes made to either the time or date settings should be performed in between patients being monitored Refer to Page 45 for Setting the Date and Page 46 for Setting the Time 21 02 0187 REV 05 3 15 57 Midmark Veterinary Monitors Ki EEE PATIENT ALARMS Figure 18 Alarm Limits Menu Limits High AR 290 RR OFF No RESP SpO gt OFF SatSeconds Save Restore WARNING The Midmark Monitors are equipped with non latching patient alarm s As soon as the monitored parameter s return within the adjusted limits the alarm is silenced and reset automatically without any operator interaction WARNING Configuring the Midmark 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 44 AUDIO ALARM SILENCE SILENCE RESET Pushb
47. and right chest ECG leads LA and RA The monitor detects changes in thoracic impedance that occur as a result in chest movements Impedance normally increases with inspiration and decreases with expiration Electrode placement is crucial to monitoring respiration by the impedance method The sensitivity of the monitor and its ability to accurately detect respiration is greatly enhanced or impeded by the quality of the electrodes and electrode placement The following is a general procedure for respiratory monitoring 1 Check the skin area where the electrodes are to be placed 2 Observe the patient to determine where the greatest breathing movement occurs on the chest 3 The leadwires that attach to the electrode clips are color coded for ease of identification Refer to Table 2 for the lead color based on the lead set being used 4 The third or ground electrode clip LL is placed on the thigh of either rear leg The ground is a reference electrode allowing for better signal detection 5 Once the electrode clips are in place and the leadwires attached patient cables and leadwires must be kept away from the neck area to minimize entanglement and accidental strangulation 6 Connect the leadwires to the ECG patient cable matching the colored end of the leadwire to the corresponding dot on the cable 7 Connect the round end of the ECG patient cable to the ECG RESP connector on the side panel of the monitor 8 Press the ON STA
48. atures This symbol appears on the printer in place of text Ag WARNING Before removing read instructions in Section 9 21 02 0187 REV 05 3 15 11 Midmark Veterinary Monitors EEN 21 02 0187 REV 04 05 09 12 Midmark Veterinary Monitors 4 SAFETY MEASURES AND WARNINGS WARNING The Midmark MODEL 9454 and 9456 monitors are intended for VETERINARY USE ONLY Do not use on human patients The Midmark Monitor is defibrillator proof It may remain attached to the patient during defibrillation but the readings may be inaccurate during use and less than ten 10 seconds thereafter Do not use this instrument for any purpose other than specified in this manual Doing so will invalidate the monitor s warranty Do not connect more than one 1 patient to the monitor Do not plug the monitor into an outlet controlled by a wall switch The position of subject physiological condition and other factors affect the readings Where the integrity of the external protective conductor in the installation or its arrangement is in doubt EQUIPMENT shall be operated from its INTERNAL ELECTRICAL POWER SOURCE Isolation of product from mains can only be achieved by removal of external power cord Do not under any circumstances perform any testing or maintenance on the monitor or power cord while the unit is being used to monitor a patient Unplug the power cord before cleaning or servicing the monitor The operator should not perfor
49. cardia 200 BPM To view Alarm History 1 Press the HISTORY pushbutton to enter the Patient History menu 2 Depress and hold the HISTORY pushbutton for two 2 seconds to enter the Alarm History menu NOTE If no alarms have occurred the message No Alarm History is displayed at the top of the History menu and no Alarm History menu will be displayed 3 The most current alarm type the alarm parameter violated the High or Low extreme value of that alarm and the time of the alarm HR MN are highlighted on the front panel display screen 21 02 0187 REV 05 3 15 55 Midmark Veterinary Monitors BO SSS 4 Press the ARROW DOWN pushbutton to review preceding alarms The word Oldest Entry will be displayed briefly at the top of the display indicating there are no more readings remaining for review 5 Press the ARROW UP pushbutton to advance towards the most current alarm The word Newest Entry will be displayed briefly at the top of the display indicating you have reached the most current reading When completed press the MAIN pushbutton to exit and return to the Main display screen or after thirty 30 seconds of button inactivity the monitor will automatically return to the Main display screen NOTE Turning the power OFF does not clear the Alarm History memory Alarms will remain in memory for up to twenty four 24 hours Any alarm older than twenty four hours is deleted It is suggested t
50. changes produced by the heart The same electrodes for heart rate detection are used to detect respiration through a process called impedance pneumography The pulse oximeter function continuously monitors and displays values for functional arterial hemoglobin saturation and a pulse rate Temperature is obtained using a temperature thermistor probe that can be applied to sites such as esophageal or rectal INDICATIONS FOR USE The Midmark Monitor is a portable device intended to be used by trained clinicians for multi parameter vital signs monitoring of veterinary patients Parameters displayed are heart rate BPM respiration BrPM functional oxygen saturation of arterial hemoglobin SpO gt z pulse rate PR and temperature WARNING The Midmark Monitor is intended only as an adjunct in patient assessment It must be used in conjunction with clinical signs and symptoms CONTRAINDICATIONS e No contraindications are known at this time BRIEF DEVICE DESCRIPTION The Midmark Monitor is compact lightweight and portable allowing it to be easily carried and used in a variety of clinical settings The monitor is powered by AC Line Power or by a Nickel Metal Hydride NiMH rechargeable battery pack The internal battery pack charges when the monitor is plugged into the AC wall outlet The Midmark Monitor can be set to operate in one of nine 9 different languages English German French Italian Soanish Dutch Swedish Portuguese
51. configure the monitor s Trace Background setting follow the following procedure 48 First enter the monitor s Setup menu Refer to Page 43 SETUP MENU Press the ARROW DOWN pushbutton until the parameter Background is highlighted Press one of the NEXT programmed pushbutton keys until the cursor displays the parameter currently being used Press either the ARROW UP or ARROW DOWN pushbutton to make a selection Press one of the PREVIOUS programmed pushbutton keys to return back to the parameter selections column Press the MAIN pushbutton to exit to the Main display screen 21 02 0187 REV 04 05 09 eg Midmark Veterinary Monitors PARAMETERS MENU Figure 14 Parameters Menu Parameters Trace 1 Trace 2 Trace 3 Print Speed Print On Alarm ECG Gain Impedance Resp NOTE The Parameters pushbutton can be used at any time during monitoring When the Parameters pushbutton is depressed the waveforms being displayed are replaced with the Parameters menu While in the menu the monitor will continue to update and display the numeric values of the parameters being monitored and a signal bar graph will be displayed indicating the relative signal strength and signal quality at the sensor site NOTE While in the Parameters menu if no pushbutton is depressed within 30 seconds the monitor will automatically save all changes made and exit to the Main display screen The Parameter setup m
52. cted messages 21 02 0187 REV 05 3 15 21 02 0187 REV 05 3 15 QUICK START UP GUIDE MENUS SETUP Refer to Page 43 Depress and hold ALARM LIMITS and AUDIO VISUAL buttons while turning the monitor on e Set the Operating Language e Make selections for Audio Alarm Silence Set Date Time and Daylight Savings options e Set SpO2 Alarm Delay Time e Select Temperature units e Select Trace Background PARAMETERS Refer to Page 49 HISTORY Refer to Page 52 Press Parameters pushbutton Press the History pushbutton to recall stored Trend e Select and configure the ECG waveform in Trace 1 area History e Select and configure the waveform to be displayed in Trace 2 Recall a list of one minute averages of data values area e Select and configure the waveform or history data in Trace 3 Press and hold History pushbutton again to recall Alarm area History e Select print speed e Recall list of alarms that have occurred e Select Print On Alarm option Select ECG gain Turn Impedance Respiration channel on or off Silence Reset AUDIO VISUAL Refer to Page 51 Press Audio Visual pushbutton Adjust Alarm volume e Select source of audio beep Adjust beep volume e Select audible key click option Adjust screen contrast PATIENT ALARMS Refer to Page 58 Press Alarm Limits pushbutton e Change alarm limits values of any parameter e Save alarm limits for future use Restore a previously
53. d can be viewed in either Fahrenheit or Celsius PATIENT ENVIRONMENT The Midmark Monitor has been tested with specific parts of the system used within the Patient Environment Figure 1 defines the Patient Environment Figure 1 Patient Environment Le en a mm mm mm mm mr ee rm ay Dr wem mm mm e ep om em om ms wm 21 02 0187 REV 04 05 09 eg Midmark Veterinary Monitors The parts of the Midmark Monitor system that can be used in the Patient Environment are defined as Table 1 Parts of the System The Midmark Monitor Appropriate Accessories listed in the ACCESSORIES section of this User s Manual Line Cord Citizen CMP 10 Mobile Printer RS232 Interconnect Cable supplied with printer AG Adapter Charger Model TRC 09 1100 M from Group West or equivalent supplied with printer DEFINITION OF TERMS In this manual WARNING CAUTION IMPORTANT and NOTE mean the following WARNING Directions that warn of conditions that put the patient or caregiver at risk CAUTION Directions that help you avoid damaging your monitor or losing data IMPORTANT Directions you should be particularly aware of something not readily apparent NOTE Directions that make it easier to use your monitor 21 02 0187 REV 05 3 15 Midmark Veterinary Monitors EEN 21 02 0187 REV 04 05 09 eg Midmark Veterinary Monitors 2 UNPACKING THE MON
54. ded below according to the maximum output power of the communications equipment Separation distance according to frequency of transmitter Meters Rated maximum output 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2 5 GHz power of transmitter Watts d 1 2VP d 1 2VP d 2 3vP 0 01 0 12 0 12 0 23 0 1 0 38 0 38 0 73 1 1 2 1 2 2 3 10 3 8 3 8 7 3 100 12 12 23 For transmitters operating at a maximum output power not listed above the recommended separation distance din meters can be estimated using the equation applicable to the frequency of the transmitter where Pis the maximum output power rating of the transmitter in watts according to the transmitter manufacturer NOTE 1 At 80 MHz and 800 MHz the separation distance for the higher frequency range applies NOTE 2 These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people 21 02 0187 REV 05 3 15 WARRANTY POLICY MONITORS CAS Medical Systems Inc warrants the monitor when new to be free from defects in material and workmanship and to perform in accordance with manufacturer s specifications for a period of two 2 years from the date of original purchase from CAS or its authorized distributors or agents except as noted below The same warranty conditions are made for a period of one 1 year with respect to printer and battery and six 6 months
55. e Midmark Monitor is for Continuous Operation The Midmark Monitor with ECG Respiration applied parts is Type CF Defibrillation Proof The Midmark Monitor applied parts are Type BF Defibrillation Proof The Midmark Monitor provides DRIP PROOF level of protection from ingress to moisture Do not expose the Midmark Monitor to extreme moisture levels such as direct exposure to rain Exposure to extreme moisture levels may cause incorrect or inaccurate performance or device failure during or after exposure 21 02 0187 REV 04 05 09 16 eg Midmark Veterinary Monitors AUTOMATIC SAFETY FEATURES The monitor has been designed for patient safety 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 wall 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 Charge LED from Green to either Orange or Red Whenever the power is disconnected from the monitor and the monitor is not allowed to shut down in an orderly fashion the monitor when re powered alerts the user Refer to Page 69 POWER FAIL for more information CAUTION Regardless of these safety features always be sure to check that there are no signs of prolonged impairment of patient circulation and that the monitor is funct
56. e a selection 5 Press one of the NEXT programmed pushbutton keys until the cursor displays the month parameter currently being used Month of the Year Jan Feb etc 6 Press either the ARROW UP or ARROW DOWN pushbutton to make a selection 7 Follow steps 5 and 6 to set the year parameter Last 2 digits of the year 2004 is displayed as 04 8 Press one of the PREVIOUS programmed pushbutton keys to return back to the parameter selections column 9 Press the ARROW DOWN pushbutton to continue to the next parameter or press the MAIN G pushbutton to exit to the Main display screen 21 02 0187 REV 05 3 15 45 Midmark Veterinary Monitors EEN SETTING THE TIME The Midmark Monitor s Time value is set for Eastern Time and is set at the factory To configure the monitor s Time follow the following procedure 1 First enter the monitor s Setup menu Refer to Page 43 SETUP MENU 2 Press the ARROW DOWN pushbutton until the parameter Time is highlighted 3 Press one of the NEXT programmed pushbutton keys until the cursor displays the hour parameter currently being used Hour of the Day 0 23 4 Press either the ARROW UP or ARROW DOWN pushbutton to make a selection 5 Press one of the NEXT programmed pushbutton keys until the cursor displays the minute parameter currently being used Minute of the Hour 0 59 6 Press either the ARROW UP or ARROW DOWN pushbutton to make a selection 7 Press one of the PREVIOUS
57. e specified thermal paper CAS P N 28 02 0077 21 02 0187 REV 05 3 15 75 Midmark Veterinary Monitors PRINTER CONTROLS AND INDICATORS CON OUR 76 Figure 19 Printer Controls and Indicators LED Indicators Bicolor Red and Green CHARGE LED Red on Charging Battery Green on Battery is fully charged Power Error LED Green on Device is switched ON or self testing is in progress Red Green blinking fast End of paper Red Green blinking slow Print Head Overheated Controls Infrared IrDA port RS 232 Serial Port Power ON OFF switch Line Feed button press once for one 1 line paper feed press down and hold for continuous paper feed to any length Paper Cover Release Button Press down to open cover Paper Cutting Edge Paper Cover 21 02 0187 REV 04 05 09 eg Midmark Veterinary Monitors PRINTER OPERATION Position the printer s Infrared port window in line with the Infrared window of the Midmark Monitor OR connect the RS232 direct cable from the printer to the 9 pin RS 232 connector located on the rear panel of the Midmark Monitor NOTE The Midmark Monitor incorporates an IrDA Test The test can be used to establish the proper alignment of the Infrared ports Refer to Page 91 IrDA TEST for more information NOTE When using the IrDA port for printing it is recommended to keep all items clear of the communications path between the monitor and the printer
58. e the alarm and temporarily mute the audio depress the SILENCE RESET pushbutton The monitor silences the audible tone for a maximum of fifteen 15 seconds the parameter in alarm and Patient Alarm LEDs continue to flash on the front panel and the appropriate message will be displayed in the Patient Alarm Message Window section of the display If the current patient alarm condition becomes inactive during the 15 seconds and then recurs OR a different patient alarm condition occurs during the 15 seconds the audio alarm is reactivated If the alarm condition continues uninterrupted for the 15 seconds the audio alarm is reactivated SpO PULSE RATE ALARMS During either a Low or High SpO Pulse Rate Alarm Limit Violation the monitor flashes the SpO Pulse Rate PR numeric display and the Patient Alarm LEDs provides a Patient Alarm Limit Violation audible tone and flashes the appropriate message Low SpO PR or High SpO PR in the Alarm Window section of the display 21 02 0187 REV 04 05 09 64 eg Midmark Veterinary Monitors To acknowledge the alarm and temporarily mute the audio depress the SILENCE RESET pushbutton NOTE For SpO Pulse Rate alarms to be enabled the ECG parameter must be in LEADS OFF condition The monitor silences the audible tone for a maximum of fifteen 15 seconds the parameter in alarm and Patient Alarm LEDs continue to flash on the front panel and the appropriate message will be displayed
59. eable 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 0187 REV 04 05 09 82 eg Midmark Veterinary Monitors PRINTING TO A COMPUTER The Midmark Monitor uses the 9 Pin connector to interface to the optional Citizen CMP 10 Mobile printer using the cable supplied with the printer or can be connected to a data collection device such as a personnel computer The RS232 serial communication protocol is output only with no polling feature The information provided in this section is made available to allow the user the ability to print the monitor s History data to a personnel computer e Equipment Needed 9 pin female to female RS 232 Null Modem cable e Computer Configuration Create a HyperTerminal Connection 1 From your Desktop choose Start Programs Accessories Communications and select HyperTerminal 2 Open the program Hypertrm exe 3 Enter a new connection e g Midmark_MONITOR in the Name field for this New Connection When finished select OK 4 Choose the appropriate Direct to COMx in the Connect Using dialog box Where X communication port on your computer When finished select OK 5 Set the following settings in the Port Settings dialog box Bits per Second 9600 Data bits 8 Parity None
60. ects a Low Battery condition within itself the message Low Battery is printed and an audio indicator located inside the printer sounds three 3 times WARNING Charge the printer battery using the AC Adapter Model TRC 09 1100 M from GROUP WEST or equivalent included with the printer 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 CHARGE LED indicator is lit Red Battery charge time is approximately three 3 hours Once the battery is fully charged the CHARGE LED indicator switches to Green 21 02 0187 REV 05 3 15 79 Midmark Veterinary Monitors kV u EE v INSTALLING PAPER NOTE A red line appears when the remaining supply of thermal paper becomes low 1 Switch the printer OFF 2 Press the Cover Open button to access the paper compartment Remove any remaining paper before installing the new roll 3 Place the new paper roll as shown on the illustration and pull out enough paper to reach out over the control panel of the printer 4 Close the paper door Figure 22 Paper Installation NOTE Make sure that the paper is correctly placed If it is tilted in one or another direction and does not come out straight from under the cover open the door and reposition the roll again WARNING Do not touch the print head or paper cut
61. ements will remain in memory for up to twenty four 24 hours Any measurement older than twenty four hours is deleted It is suggested to manually clear History between patients Refer to ERASING TREND HISTORY on Page 55 PRINTING TREND HISTORY To Print the Patient History data to the printer 1 Press the HISTORY pushbutton to enter the Patient History menu 2 Depress and hold the PRINT pushbutton for two 2 seconds The message Printing appears at the bottom of the Display Window as a status indicator NOTE Prior to accessing the Print History mode the printer should have paper installed and the power turned ONT Refer to Section 9 EXTERNAL PRINTER for more information about the printer and sample printout of the History screen 21 02 0187 REV 04 05 09 54 eg Midmark Veterinary Monitors ERASING TREND HISTORY To Erase the Patient History data 1 Press the HISTORY pushbutton to enter the Patient History menu 2 Press one of the NEXT programmed pushbutton keys to advance onto the parameter value to change Erase No 3 Press either the ARROW UP or ARROW DOWN pushbutton until the message Erase Yes appears 4 Press the HISTORY pushbutton again to erase History data The monitor erases the memory enters Alarm History if available or exits the History menu and returns to the Main display screen ALARM HISTORY Figure 17 Alarm History Menu Alarm Hist HR MN Alarm 14 01 Tachy
62. enu allows the user to e Trace 1 Select and configure the waveform to be displayed in the Trace 1 area NOTE An ECG trace will automatically be selected as Trace 1 e Trace 2 Select and configure the waveform to be displayed in the Trace 2 area e Trace 3 Select and configure display data in the Trace 3 area Available selections Trace 3 waveform data or History data NOTE A continuously updating Trend History menu consisting of one 1 minute averages for HR RR 0 and PR can be chosen as Trace 3 Refer to Page 53 TREND HISTORY for more information 21 02 0187 REV 05 3 15 49 Midmark Veterinary Monitors Print Speed Select the speed the waveforms selected as Trace 1 2 or 3 will print Available selections 25 0 12 5 6 25 mm Sec Print On Alarm Select whether the monitor will automatically print to the recorder when a patient alarm condition occurs Available selections OFF or ON The default value is OFF ECG Gain Select the gain size of the ECG Trace Available selections Automatic Default value Manual Available selections X1 X2 X4 X8 When Automatic is selected the monitor s ECG module selects a gain that adjusts the waveform to be at a pleasing level on the display NOTE The gain value will appear in the upper left hand corner of the Main display screen when the ECG waveform is displayed Impedance Resp Configure the Respiration channel Available selection
63. ep Speeds 12 5 25 50 mm Sec QRS Tone Volume User selectable 5 settings Off Frequency Response 0 5 to 25 Hz Sensitivity Adjustment Automatic Minimum Signal 0 20 mV peak to peak Common Mode Rejection gt 90dB Loose Lead Threshold 2 0 to 2 5 K ohms Pacemaker Spike Rejection Meets AAMI Standards HEART RATE Characteristic Specification Asystole Detection 4 seconds Alarms User selectable low heart rate and high heart rate Alarm Delay Time 5 seconds Numeric Resolution 1 BPM Accuracy 3 BPM or 3 whichever is greater Numeric Range 0 15 300 BPM averaged 1 second update 21 02 0187 REV 05 3 15 99 Midmark Veterinary Monitors RESPIRATION Characteristic Specification Detection Technique Impedance Pneumography Sensing Electrodes LA RA Bandwidth 0 05 to 2 5 Hz Sweep Speed 3 6 25 12 5 mm Sec Sense Frequency 63 kHz Sensitivity Adjustment Automatic Trigger Level Minimum trigger at 0 20 ohm Respiration Rate Numeric 0 to 150 BrPM averaged 1 second update Accuracy 0 to 122 BrPM 1 BrPM 123 to 150 BrPM 2 BrPM Numeric Resolution 1 BrPM Alarms User selectable low and high respiration rate Base Impedance Ra
64. epress the SILENCE RESET pushbutton The monitor silences the audible and visual alarms but the message SpO2 Probe OFF remains on the display If the message Chk SpO Probe should appear verify that the probe being used is not defective by replacing the defective one and trying a different probe The message Chk SpO Probe is displayed the Equipment Alarm LEDs are flashing and three 3 audio beeps are heard every twenty five 25 seconds NOTE If SpO is selected as a waveform parameter the message appears in the waveform section of the display If SpO is not selected as a waveform parameter the message appears in the equipment message window section of the display To acknowledge the alarm depress the SILENCE RESET pushbutton The monitor silences the audible and visual alarms but the message Chk SpO gt Probe remains on the display If the SpO Module located inside the Midmark Monitor should fail the message SpO gt Error or SpO gt Module is displayed The SpO and Pulse Rate numeric displays will show dashes the Equipment Alarm LEDs are flashing and three 3 audio beeps are heard every twenty five 25 seconds NOTE If SpO is selected as a waveform parameter the message appears in the waveform section of the display If SpO is not selected as a waveform parameter the message appears in the equipment message window section of the display
65. er the power is disconnected from the monitor and the monitor is not allowed to shut down in an orderly fashion the monitor when re powered alerts the user The message Power Failure is displayed in the Equipment Message Window the Equipment Alarm LEDs are flashing and three 3 audio beeps followed by two 2 audio beeps are heard every ten 10 seconds During this condition all other pushbuttons are inactive except for the ON STANDBY and SILENCE RESET To clear the Power Fail condition depress the SILENCE RESET pushbutton or properly recycle the monitor s power USER MESSAGES WARNING The Midmark Monitors are equipped with non latching equipment alarm s As soon as the monitored parameter s return within the adjusted limits the alarm is silenced and reset automatically without any operator interaction The Midmark 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 an AC wall outlet and allow it to charge for five 5 hours NOTE Refer to the Tables starting on Page 72 for a listing of messages that may be displayed on the Main display screen If the monitor is in need of repa
66. er to Page 44 AUDIO ALARM SILENCE SILENCE RESET Pushbutton for more information BATTERY POWER The Midmark Monitor is equipped with an internal rechargeable battery The battery is charging whenever the monitor is plugged into the AC wall outlet A Battery Power Visual Indicator located on the front panel indicates the status condition of the monitor s battery Batteries will self discharge when they are not used It is recommended that the battery be maintained at full charge by leaving the monitor connected to the AC wall outlet whenever possible The 7 2 Volt 3700 mAhr battery pack when fully charged is capable of running the monitor for approximately four 4 hours NOTE Operation time is based on a Model 9454 monitor BATTERY MESSAGES When the message Low Battery appears in the Equipment Message Window section of the display at least thirty 30 minutes of battery operation remain and the monitor s battery pack should be charged as soon as possible During a Low Battery condition the monitor displays the message Low Battery in the Alarm Message Window section of the display flashes the Battery Charge Status visual indicator and the Equipment Alarm LEDs and provides an Equipment Alarm audible tone Also the front panel Battery Power visual indicator changes from Orange to Red 21 02 0187 REV 04 05 09 66 eg Midmark Veterinary Monitors WARNING Upon the detection of a Low Battery condi
67. ers can cause damage to the monitors surface Do not immerse the monitor or power cord in the cleaning solution When necessary the monitor surfaces may be disinfected using a soft cloth saturated with a 10 1 10 solution of chlorine bleach in tap water When 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 to prevent water or cleaning solution to run into connector openings or crevices 21 02 0187 REV 05 3 15 85 Midmark Veterinary Monitors kV 1 u 7 gt K F THE DISPLAY CAUTION Use care when cleaning the display Scratches may occur Occasionally as needed clean the display window using a soft lint free cloth sprayed with an alcohol free glass cleaner Do not use either isopropyl alcohol or solvent to clean the display Use of these cleaners can cause damage to the display The use of paper towels is not recommended as it may scratch the surface PATIENT CABLE AND LEADWIRES Prior to each patient use inspect the patient cable and leadwires for damage As necessary clean the patient cable and leadwires using a soft cloth dampened with a germicidal solution PRINTER When the printer becomes dirty wipe with a soft dry cloth For extreme dirt buildup soak a cloth with mild d
68. es Battery RS232 Cable Power Supply One 1 Roll of Paper and Manual 01 02 0243 Universal Mounting Kit 01 02 0266 Printer Power Supply Adapter Plug European 01 02 0267 Printer Power Supply Adapter Plug UK 01 02 0268 Printer Power Supply Adapter Plug Australian 01 02 0297 Roll Stand with Basket and Quick Release 01 02 9300 No Printer Mount Attachment for Monitor longer available 01 02 0301 Printer Bracket Attachment for Roll Stand 01 03 0225 Electrode Gel 01 04 0016 U S A Power Cord 01 05 0144 International Power Cord IEC320 European Plug 03 08 0450 Monitor Battery Pack 7 2 VDC 3700 mAhr 18 04 0004 Australian Power Cord 18 04 0010 U K Power Cord 21 02 0187 Midmark Monitors Model 9454 and 9456 User s Manual 28 02 0077 Printer Paper 1 Roll 28 02 0445 Leadwire Detangler 21 02 0187 REV 05 3 15 97 Midmark Veterinary Monitors MONITOR CONFIGURATIONS Table 10 Monitor Configurations Model Description 9454 ECG Respiration and Temperature and Nellcor Veterinary SpO 100 240V 50 60HZ AC Power Supply and Battery 9456 ECG Respiration and Temperature 100 240V 50 60HZ AC Power Supply and Battery 98 21 02 0187 REV 04 05 09 eg Midmark Veterinary Monitors 13 SPECIFICATIONS ECG Characteristic Specification Input 3 or 5 leads Selectable Leads I II Ill aVL aVR aVF V Gain X1 X2 X4 X8 Auto Display Swe
69. etergent wring well and wipe Dry by wiping with a soft dry cloth CAUTION Before cleaning the printer disconnect the AC adapter from the printer Do not use volatile chemicals such as thinner benzene etc Never wet the inside of the printer mechanism Refer to the printer User s Manual for more information SENSOR AND CLIPS CAUTION To avoid damage to the VetSat sensor remove it from the clip before cleaning either piece CAUTION Do not sterilize the sensor or clips by irradiation steam or ethylene oxide Do not immerse the sensors in water or cleaning solution When necessary the sensor may be surface cleaned by wiping it with an agent such as 70 Isopropyl Alcohol The clip may be cleaned by either wiping it with or soaking it for ten 10 minutes in 70 Isopropyl Alcohol If the clip is soaked be sure to rinse it with water and air dry it prior to use on the next patient 21 02 0187 REV 04 05 09 86 eg Midmark Veterinary Monitors After each cleaning and prior to each use inspect the sensor and cable for fraying cracking breakage or other damage Inspect the clip for cracking or breakage or loss of spring tension that would allow slippage or movement of the sensor from its proper position NOTE If defects are noted do not use the sensor or clip Refer to the Directions For Use pamphlet enclosed with the sensor for more information TEMPERATURE PROBES Re
70. f the display NOTE Refer to the Tables starting on Page 72 for a listing of messages that may be displayed on the Main display screen CLEARING ALARMS The Midmark Monitor provides to the user an audible and visual indication for both patient and equipment alarm conditions WARNING The Midmark Monitors are equipped with non latching patient alarm s As soon as the monitored parameter s return within the adjusted limits the alarm is silenced and reset automatically without any operator interaction ECG HEART RATE ALARMS During either a Low or High ECG Heart Rate Alarm Limit Violation the monitor flashes the Heart Rate HR numeric display and the Patient Alarm LEDs provides a Patient Alarm Limit Violation audible tone and flashes the appropriate message Bradycardia or Tachycardia in the Patient Alarm Message Window section of the display To acknowledge the alarm and temporarily mute the audio depress the SILENCE RESET pushbutton 21 02 0187 REV 05 3 15 63 Midmark Veterinary Monitors WEEN The monitor silences the audible tone for a maximum of fifteen 15 seconds the parameter in alarm and Patient Alarm LEDs continue to flash on the front panel and the appropriate message will be displayed in the Patient Alarm Message Window section of the display If the current patient alarm condition becomes inactive during the 15 seconds and then recurs OR a different patient alarm condition occurs during the
71. h in synch with the patient s heartbeat and breathing This will help to minimize false alarms NOTE Respiration monitoring by default is set to OFF Should Respiration monitoring be required the feature can be turned ON Refer to Page 49 PARAMETERS MENU for the menu selection 7 If required refer to Page 49 PARAMETERS MENU and configure the appropriate waveform s to be viewed and printed 8 Check the alarm limits and configure them appropriately for the patient Refer to Page 61 ALARM LIMIT VALUES FREEZE TRACES While viewing the Main display screen the user can select to freeze the traces Depress the FREEZE PRINT MAIN pushbutton The message Traces Frozen appears at the top of the Main Display screen While frozen the numerics continue to update Depress again to un freeze Traces will remain frozen for sixty 60 seconds if no pushbutton is depressed or if the user enters one of the menu selections 22 21 02 0187 REV 04 05 09 eg Midmark Veterinary Monitors RESPIRATION MONITORING NOTE The Respiration parameter in the Midmark monitor by default is set to OFF Should Respiration monitoring be required the feature can be turned ONT Refer to Page 49 PARAMETERS MENU for the menu selection The Midmark Monitor determines respiration by impedance pneumography Patient respiration is achieved by applying a low voltage high frequency AC signal across the active left
72. ht or an improperly applied sensor can result in erratic and inaccurate oxygen saturation and or pulse rate measurement Should the SpO waveform or perfusion bar graph be at a low level reposition the sensor or try a different sensor If proper operation cannot be verified remove the sensor from the animal and DO NOT use the oximeter on this animal In the event the sensor becomes dislodged from the animal audible and visual alarms are activated requiring that a veterinary professional investigate the reason for the alarm status The veterinary professional should investigate status and sensor attachment after every sensor alarm indication It is possible when the sensor is dislodged from the animal under certain conditions of light and vibration of the sensor for the pulse oximeter to display normal physiological values ACCURACY If the accuracy of any measurement does not seem reasonable first check the patient s vital signs by alternate means and then check the Midmark Monitor for proper functioning APPLICATION This monitor is not designed for direct cardiac connection CABLES Route all cables away from patient s neck to avoid possible strangulation CONDUCTIVE CONNECTIONS Avoid making any conductive connections to applied parts patient connection which is likely to degrade safety CONDUCTIVE PARTS Ensure that the conductive parts of the lead electrodes and associated connectors do not contact other conductive par
73. id damage to the Interface Cable always hold it by the connector rather than the cable when connecting or disconnecting either end To obtain longer life avoid excessive kinking or coiling the sensor cable When the probe is disconnected from the monitor the message No SpOz Probe is displayed the Equipment Alarm LEDs are flashing and an audible alarm sounds indicating a connection has been broken To acknowledge the alarm depress the SILENCE RESET pushbutton The monitor silences the audible and visual alarms and the message No SpO Probe is removed from the display NOTE If either the 2 Minute Audio Silence or Permanent Audio Silence is enabled no audio will be heard but a visual message will appear in the Message Window See Section 12 ACCESSORIES for Nellcor oximeter probe types and part number information PERFORMANCE CONSIDERATIONS If there is excessive ambient light cover the sensor site with opaque material Failure to do so may result in inaccurate measurements Light sources that can affect performance include surgical lights especially those with a xeon light source bilirubin lamps fluorescent lights infrared heating lamps and direct sunlight 21 02 0187 REV 04 05 09 30 eg Midmark Veterinary Monitors 7 TEMPERATURE MONITORING YELLOW SPRINGS INTERNATIONAL YSI TECHNOLOGY The Midmark Monitor is designed to measure temperature to aid in the assessment of thermoregulation
74. idmark Monitor incorporates a test to check the alignment of the monitor to the printer using the Infrared port To use the Infrared Test follow the following procedure 1 First enter the monitor s Service menu Refer to Page 90 SERVICE MENU The IrDA Test menu selection is highlighted 2 Press one of the NEXT programmed pushbutton keys until the cursor displays the current setting of the IrDA Test 3 Press either the ARROW UP or ARROW DOWN pushbutton to change the setting from OFF to ON The message Printing will be displayed in the Equipment Message Window as a status indicator that the test is active The test will continue for sixty 60 seconds or can be terminated by the user 4 When the Infrared windows are properly positioned the printer will begin to print a series of A characters 5 When the test is completed press one of the PREVIOUS programmed pushbutton keys to cancel the test and return to the IrDA Test menu selection 6 Press the ARROW DOWN pushbutton to continue to the next parameter test or press the MAIN C D pushbutton to exit to the Main display screen PIC VOLTAGE The Midmark Monitor displays the dc voltage level being received by the PIC processor from the Power Supply Board NOTE The monitor must be connected to the AC Line wall outlet to view this voltage level To view the PIC Voltage level follow the following procedure 1 First enter the monitor s Service
75. ilable items are listed on the left hand side of the display The monitor will initially highlight the Alarm Volume selection 2 Press one of the NEXT programmed pushbutton keys and highlight the selections column 3 Press either the ARROW UP or ARROW DOWN pushbutton to make a selection 4 Press one of the PREVIOUS programmed pushbutton keys to return back to the parameter selections column 5 Press the ARROW DOWN pushbutton to continue to the next parameter or press the MAIN pushbutton to exit and return to the Main display screen HISTORY The History pushbutton allows the user to recall stored Trend and Alarm History information Patient History is organized in two 2 visually displayed lists Trend History Pressing the HISTORY pushbutton the first time reveals the first viewable list that contains up to 480 entries of Trend History The Trend History contains one 1 minute averages of history data values for Heart Rate HR Respiration Rate RR when enabled SpPOr 0 gt and Pulse Rate PR that are saved once a minute Alarm History Once in the History screen press and hold the HISTORY pushbutton for two 2 seconds to reveal the second viewable list that contains up to 25 entries of Alarm History The Alarm Type the High or Low extreme value and the time the alarm occurred are also displayed Depress and hold the HISTORY pushbutton for two 2 seconds returns to the Trend History list NOTE The History pushb
76. ioning properly 21 02 0187 REV 05 3 15 17 Midmark Veterinary Monitors EEN 21 02 0187 REV 04 05 09 18 eg Midmark Veterinary Monitors 5 ECG AND RESPIRATION MONITORING ECG MONITORING The Midmark Monitor records heart rate with electrode clips attached to the patient Electrodes detect signals caused by changes of electrical conduction in the heart during the cardiac cycle Heart rate is computed on a beat to beat basis using the R R interval of the QRS complex CAUTION Even though the ECG patient circuit is electrically isolated it has not been designed for direct application on a patient s heart POSITIONING ANESTHETIZED PATIENTS For ECG monitoring during anesthesia it is most important to position patients on the table for the procedure If standard lead placement as described below is not possible leads should be attached to the body where they will be least subject to movement and away from the surgical site It is preferable to view an upright QRS complex for monitoring ECG A heart base to apex lead arrangement will be best if the negative lead is placed at the base point of right shoulder at thoracic inlet and the positive lead at the apex low on caudal left thorax Standard right forelimb lead is negative and standard left hind leg is positive in lead two so if these leads are properly placed and the machine is set to Lead II an upright complex should be the result POSITIONING CONSCIOUS
77. ir it must be referred to the appropriate service personnel Service performed by unauthorized personnel could be detrimental to the monitor and will void the warranty For service contact CAS Medical Systems Inc 21 02 0187 REV 05 3 15 69 Midmark Veterinary Monitors Or um v ECG RESPIRATION USER MESSAGES If the accuracy of any measurement does not seem reasonable first check the patient s vital signs by an alternate method If one of the leadwires should become disconnected from the patient the waveform trace s will become blank the message Leads OFF will be displayed in the waveform section of the display the Heart Rate and Respiration Rate numeric displays will show dashes the Equipment Alarm LEDs will flash and three 3 audio beeps are heard every twenty five 25 seconds for as long as the condition continues To acknowledge the alarm depress the SILENCE RESET pushbutton The monitor silences the audible and visual alarms and the message Leads OFF remains on the display If the ECG Respiration Module located inside the Midmark Monitor should fail the message ECG Error or ECG Module is displayed the Heart Rate and Respiration Rate numeric displays will show dashes the Equipment Alarm LEDs will also flash and three 3 audio beeps are heard every twenty five 25 seconds To acknowledge the alarm depress the SILENCE RESET pushbutton The monitor
78. itored and a signal bar graph will be displayed indicating the relative signal strength and signal quality at the sensor site NOTE While in the Audio Visual menu if no pushbutton is depressed within 30 seconds the monitor will automatically save all changes made and exit to the Main display screen The Audio Visual setup menu allows the user to e Alarm Volume Adjust the Alarm Volume level The Alarm Volume can be adjusted to one 1 of five 5 volume levels Altering the Alarm Volume will produce a single tone at the selected volume level NOTE The Volume Level cannot be set to OFF e Beep Source Select the source of the audio Beep when enabled Available selections ECG or SpO2 NOTE When SpO is selected the monitor provides a varying pulse beep that will rise with increasing oxygen saturation and fall as saturation decreases 21 02 0187 REV 05 3 15 51 Midmark Veterinary Monitors EEN e Beep Volume Adjust the Beep Volume level The Beep Volume can be adjusted to one 1 of five 5 volume levels Altering the Beep Volume will produce a single tone at a selected non off volume level e Key Click Select whether an audible click is heard each time a pushbutton key is depressed Available selections OFF or ON e Contrast Adjust the Contrast level of the display To configure a parameter 1 Press the AUDIO VISUAL pushbutton The ava
79. jden nsditee 54 ERASING TREND HISTORY ssccce sascecevestecdctiacstiveaieehed aectest aetibiaieeetieeenteane 55 ALARM HISTOR EE 55 PRINTING ALARM HISTORY Linnes nts ated eieliotaeladmieentene 56 ERASING ALARM HISTORIKER ege anna 57 REAL MEGA ANE aK ang 57 21 02 0187 REV 04 05 09 mn Midrnark Veterinary Monitors FEN ANA eent 58 CHANGING ALARM LIMITS Lue san kassene arab 59 SAVING ALAR IN INIT eerste de 59 RESTORE A PREVIOUSLY SAVED SET OF LIMITS ccscsccssssssssssssesssesesseeeessees 60 RESTORE FACTORY DEFEAULTS errn eene 60 ALARMEIMIT VALUES ae 61 AUDIBLE AND VISUAL INDICATORS sssessssscscsssesessecesssstesssessssseessssessnteessesens 62 GENIE Kee ea 63 ECG HEART RATE ALARMS EEN 63 RESPIRATION ALARMS ae ees 64 CEET E EEN 64 SpO PULSE RATE ALARMS medstudenten 64 EQUIPMENT AAS 65 2 MINUTE AUDIO ALARM SILENCE 65 PERMANENT AUDIO ALARM SILENCE 66 BATTERY POWER eege Eege 66 BATTERY MESSAGES tee Ae 66 CHECKING BATTERY STATUS cescssescscsscssssssssssssssssssssssessssessssseorsscescetensnerersises 67 AE e eae NG 68 BOWER last 69 USER MESSAGES eege 69 ECG RESPIRATION USER MESSAGES rrtivsrvtrnstrrvsrrtvsnrnevsrrnssernessrnesssrressernenn 70 SpO USER MESSAGES Model 9454 Only cessscssssesssstsssseessesessesssssesseeesseeesseess 70 MONITOR MESSAGES rg 72 9 EXTERNAL PRINTER EEN 75 PRINTER OVERENS 75 PRINTER CONTROLS AND INDICATORS ssssssssesssssecssssveesssesssseessssvesssneesseees 76 PRINTER EECHER 77 CHARG
80. ken down into five 5 sections of information They are MAIN DISPLAY AREA Figure 7 Main Display Area 21 02 0187 REV 05 3 15 33 Midmark Veterinary Monitors EEN During normal operation this section Refer to Figure 7 on the previous page displays the traces that have been selected in the Parameters menu Up to three 3 traces can be selected The names of the traces are also displayed to better identify them The traces are displayed in an erase bar format The Midmark Monitor automatically selects as Trace 1 an ECG waveform trace Included with the ECG trace is the ECG Gain selection This section is also used to display when selected the Audio Visual History Limits Parameters Service and Setup menus TIME BATTERY AND NUMERIC STATUS Figure 8 Time Battery and Numeric Status This section contains the current monitor time and Battery Charge Status icon This section also contains numeric values and flashing visual icons for both Heart Rate and Respiration Rate Also displayed are size markers for both the ECG and Respiration waveforms The size marker for ECG represents a QRS of 1mV and the size marker for Respiration represents a breath of 1 Ohm NOTE When Respiration is turned OFF the RR name numeric and lung icon will be blank 21 02 0187 REV 04 05 09 34 Midmark Veterinary Monitors NUMERIC AND TEMPERATURE Figure 9 Numerics and Temperature This section displays the nume
81. ld be used It is best to first wet the hair at the lead attachment site with alcohol then place paste on the moistened hair and skin It is important that the paste be in direct contact with skin For patients with dense undercoat rub paste with fingers to assure that it has made contact with skin Crocodile clips are supplied with this monitor and they must open wide enough to firmly but gently grasp the skin 21 02 0187 REV 05 3 15 21 Midmark Veterinary Monitors RECORDING 1 Once the electrode clips are in place and the leadwires attached patient cables and leadwires must be kept away from the neck area to minimize entanglement and accidental strangulation Connect the leadwires to the ECG patient cable matching the colored end of the leadwire to the corresponding color on the cable Connect the round end of the ECG patient cable to the ECG RESP connector on the side panel of the monitor Press the ON STANDBY pushbutton to turn ONT the monitor Check that the monitor is accurately detecting the heartbeat and respiration by watching the monitor to see that the heart and lung visual indicators flash with each heartbeat and breath When the values have been determined they will be displayed on the front panel respective as heart rate HR and respiration rate RR If the heart and lung visual indicators do not correspond to the patient s heart rate and or respiration reposition the electrode clips until the indicators flas
82. ll have a zero 0 second or ten 10 second delay when taken from the SpO signal no ECG NOTE When Respiration is turned OFF no Respiration Rate RR Limits will appear 21 02 0187 REV 05 3 15 61 Midmark Veterinary Monitors AUDIBLE AND VISUAL INDICATORS The Midmark Monitor is capable of producing both an audible and a visual indicator for a variety of monitor conditions The following table provides across reference for audible and visual indications Table 6 Audible and Visual Indicators Alarm Condition Priority Level Audible Indication Visual Indication Dead Battery High 3 Beeps followed by 2 Beeps every 10 seconds The message is displayed continuously on the monitor s Main display screen The Equipment Alarm LEDs are flashing The Battery Power visual indicator is Red Patient Alarm Limit Violations High 3 Beeps followed by 2 Beeps every 10 seconds The associated numeric display flashes for one second on one second off for the parameter limit in violation The Patient Alarm LEDs are flashing The message is displayed for one second every two to four seconds in the Patient Alarm Message Window section of the display Power Failure High 3 Beeps followed by 2 Beeps every 10 seconds The message is displayed for one second every two to six seconds in the Equipment Message Window section of the display The Equipment Alarm LEDs a
83. m any servicing except as specifically stated in this manual Do not touch part of non medical electrical equipment in the patient environment after removal of covers connectors etc without the use of a tool which operate at voltages not exceeding 25 VAC or 60 VDC and the patient at the same time Do not use a frayed or damaged power cord or any accessory if you notice any sign of damage Contact Midmark for assistance Equipment not suitable for use in the presence of FLAMMABLE ANESTHETICS Equipment is not intended to be used in Oxygen Enriched Atmospheres Do not gas sterilize or autoclave the monitor Do not use the monitor in the presence of Magnetic Resonance Imaging MRI equipment Do not place liquids on top of the monitor Do not immerse the monitor or power cord in water or any liquid If unit is accidentally wetted it should be thoroughly dried The rear cover can be removed by a qualified service technician to verify absence of water 21 02 0187 REV 05 3 15 13 Midmark Veterinary Monitors KV 1 E 85 EE WARNING Accurate oxygen saturation measurement cannot be obtained with the Model 9454 when the oximeter is not measuring the pulse properly H the SpO waveform perfusion bar graph or the Pulse Rate be erratic or inaccurate first examine the animal for any signs of distress and only then re examine sensor placement Inadequate perfusion thick fur dark skin or foreign matter that blocks lig
84. mark Veterinary Monitors LEFT SIDE VIEW Figure 12 Left Side Panel View Es ECG RESP CONNECTOR The ECG RESP connector is mechanically keyed to accept only CAS Medical Systems 3 Lead or 5 Lead patient cable Connect either the 3 Lead or 5 Lead Patient Cable in this receptacle for ECG and Respiration monitoring NELLCOR VET SpO SENSOR CONNECTOR Model 9454 The SpO connector is compatible only with Nellcor VetSat veterinary sensor Connect the Interface Sensor cable in this receptacle for SpO monitoring TEMP CONNECTOR Connect the adapter and sensor cable in this receptacle for Temperature monitoring 21 02 0187 REV 05 3 15 41 Midmark Veterinary Monitors EJ EEETJJEEEE I V MONITOR OPERATING INSTRUCTIONS TURNING THE Midmark MONITOR ON Press the ON STANDBY pushbutton on the front panel to turn the monitor ON Each time the monitor is turned ON a three 3 second electronic Power On Self Test POST is conducted to ensure that its internal circuits are functioning properly NOTE The user should use the Power On Self Test as a verification tool that all front panel visual indicators and the audio are functioning properly Upon applying power to the monitor verify the following The monitor produces three 3 audio beeps from its internal speaker The two 2 light bars and the Alarm Silence Visual Indicator are turned ON
85. mark Veterinary Monitors EEN STORAGE WARNING If it becomes necessary to store the monitor for longer than six 6 months remove the monitor s battery pack and place the monitor in its original packing container if available WARNING Use of unapproved batteries will invalidate the product s warranty and may result in serious safety consequences for the patient and user See Section 13 SPECIFICATIONS for storage temperature information 21 02 0187 REV 04 05 09 96 eg Midmark Veterinary Monitors 12 ACCESSORIES ECG RESPIRATION Catalog No Description 01 02 0304 3 Lead Patient Cable 3 meter IEC AAMI Color Coding 01 02 0305 5 Lead Patient Cable 3 meter IEC AAMI Color Coding 01 02 0306 3 Lead Wire set w crocodile clips black white red 94 92 0307 No 5 Lead Wire set w crocodile clips black white red green brown longer available OXIMETRY Note Use only with Nellcor Pulse Oximeter Accessories Catalog No Description 01 02 0183 Patient Interface Cable DOC 10 10 FT 01 02 0299 VetSat SpO Sensor and Clips TEMPERATURE Catalog No Description 01 02 0327 Esophageal rectal reusable probe 9 Ft 28 02 0444 Temperature Adapter Plug OTHER ACCESSORIES Catalog No Description 01 02 0174 Carry Bag 01 02 0188 Printer Battery 01 02 0189 Printer includ
86. measurement values and the time of measurement HR MN are highlighted on the front panel display screen If there were no readings in History the message No History is displayed at the top of the Main display screen when the History pushbutton is first depressed 21 02 0187 REV 05 3 15 53 Midmark Veterinary Monitors EES NOTE One 1 minute averages of history data values for Heart Rate HR Respiration Rate RR when enabled SpO2 Oz and Pulse Rate PR are saved once a minute NOTE An will appear in the Trend History menu indicating an alarm occurred during that minute 2 Press the ARROW DOWN pushbutton to review preceding measurements The word Oldest Entry will be displayed briefly at the top of the display indicating there are no more readings remaining for review 3 Press the ARROW UP pushbutton to advance the measurements towards the most current measurement taken The word Newest Entry will be displayed briefly at the top of the display indicating you have reached the most current reading When completed press the MAIN C pushbutton to exit and return to the Main display screen or after thirty 30 seconds of button inactivity the monitor will automatically return to the Main display screen NOTE A continuously updating Trend History menu History can be chosen in the Parameters Setup menu as Trace 3 NOTE Turning the power OFF does not clear the History memory Measur
87. nge 0 to 3 5 K ohms at 63 kHz TEMPERATURE Characteristic Specification Input YSI 400 compatible Temperature Range 28 to 43 C 82 4 to 109 4 F Accuracy 0 1 C 0 2 F Resolution 0 1 or 0 1 F 100 21 02 0187 REV 04 05 09 eg Midmark Veterinary Monitors SpO2 MEASUREMENT Characteristic Specification Nellcor OxiMax Type Functional Oxygen Saturation SpO Range 0 100 SpO Accuracy 70 100 2 digits 1 S D Adult 70 100 3 digits 1 S D Neonate Measurement Wavelengths Red 660 Nanometers Infrared 890 Nanometers Power Not exceeding 15 mW Pulse Rate Range 20 300 BPM Pulse Rate Accuracy 3 digits Numerics Updated every one 1 second NOTE Accuracy is specified for adult human hemoglobin measured at the fingertip Although animal hemoglobin has similar optical characteristics other types of hemoglobin may affect the accuracy PATIENT ALARMS 9456 9454 Patient Parameters Low Limit High Limit Low Limit High Limit Heart Rate 25 295 BPM 25 295 BPM 25 295 BPM 25 295 BPM Respiration Rate 5 145 BrPM 5 145 BrPM 5 145 BrPM 5 145 BrPM SpOv 70 95 80 99 SpO gt Pulse 25 295 BPM 25 295 BPM
88. o manually clear Alarm History between patients Refer to ERASING ALARM HISTORY on Page 57 PRINTING ALARM HISTORY To Print the Alarm History data to the printer 1 Press the HISTORY pushbutton to enter the Patient History menu 2 Depress and hold the HISTORY pushbutton for two 2 seconds to enter the Patient Alarm History menu NOTE If no alarms have occurred the message No Alarm History is displayed at the top of the History menu and no Alarm History menu will be displayed 3 Depress and hold the PRINT pushbutton for two 2 seconds The message Printing appears at the bottom of the Display Window as a status indicator NOTE Prior to accessing the Print History mode the printer should have paper installed and the power turned ON Refer to Section 9 EXTERNAL PRINTER for more information about the printer and sample printout of the History screen 21 02 0187 REV 04 05 09 56 eg Midmark Veterinary Monitors ERASING ALARM HISTORY To Erase the Alarm History data 1 Press the HISTORY pushbutton to enter the Patient History menu 2 Depress and hold the HISTORY pushbutton for two 2 seconds to enter the Patient Alarm History menu NOTE If no alarms have occurred the message No Alarm History is displayed at the top of the History menu and no Alarm History menu will be displayed 3 Press one of the NEXT programmed pushbutton keys to advance onto the par
89. omatically exit the 2 Minute Audio Alarm Silence period and return to normal operation During a 2 Minute Audio Alarm Silence period if an alarm patient or equipment occurs except for Low Battery and Dead Battery the audio alarm remains silenced for the remainder of the two minutes and only a visual indicator is provided PERMANENT AUDIO ALARM SILENCE When the monitor is configured to the Permanent Audio Alarm Silence setting use the SILENCE RESET pushbutton to enable or disable audio alarms The SILENCE visual bell indicator located on the front panel of the monitor will flash at a rate of one 1 second ON and one 1 second OFF and the message Permanent is displayed in the Equipment Message Window section of the display as a reminder when enabled During a Permanent Audio Alarm Silence period if an alarm patient or equipment occurs except for Low Battery and Dead Battery the audio alarm remains silenced and only a visual indicator is provided SETTING THE DATE The Midmark Monitor s Date value is set at the factory To configure the monitor s Date follow the following procedure 1 First enter the monitor s Setup menu Refer to Page 43 SETUP MENU 2 Press the ARROW DOWN pushbutton until the parameter Date is highlighted 3 Press one of the NEXT programmed pushbutton keys until the cursor displays the day parameter currently being used 4 Press either the ARROW UP or ARROW DOWN pushbutton to mak
90. pack the following applies 1 When the monitor is connected to the AC wall outlet the Battery Charge Status visual indicator will have a moving bar from left to right within the indicator signifies the battery is being charged Once charged the moving bar will stop and the battery icon will be completely filled in 2 When the monitor is being powered from the battery the moving bar within the Battery Charge Status visual indicator will be moving from right to left signifying the battery is being discharged 21 02 0187 REV 05 3 15 67 Midmark Veterinary Monitors SSS If your Midmark 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 the AC wall outlet and is powered OFF the Main display screen will display the charge of the battery pack XXX where XXX represents the percent 0 to 100 of the full charge condition of the battery and the Battery Charge Status visual indicator 2 When the monitor is powered ON the Battery Charge Status visual indicator is located in the upper right hand corner of the Main display screen The icon is filled to correspond with the level of battery charge 3 The Midmark Monitor s Smart Battery pack contains on board electronics which can be
91. pect the monitor 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 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 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 BATTERY POWER If the monitor will not be used or not connected to AC line power for a period over six 6 months remove the battery ELECTRICAL SHOCK To reduce the risk of electrical shock do not remove the b
92. r s alignment buttons along the clip slot until the sensor pad is fully engaged in the clip 5 Slide the second sensor button along the other clip slot until the second sensor pad is fully engaged in its side of the clip NOTE Check that the VetSat optical sensor pads are facing each other directly 6 The sensor is now ready to be applied to the patient The preferred sensor application site for canine feline and equine animals is on the tongue with the sensor s optical components positioned on the center of the tongue Alternatively the sensor and clip may be applied to the animal s lip toe ear prepuce or vulva NOTE If the sensor does not track the pulse reliably it may be incorrectly positioned or the sensor site may be too thick thin or deeply pigmented to permit appropriate light transmission If any of these situations occurs reposition the sensor or try another sensor site If the sensor site is one that is covered with fur try shaving the site and reapplying the sensor 21 02 0187 REV 05 3 15 27 Midmark Veterinary Monitors WEEN 7 Be sure that the sensor cable is positioned along the side of the animal s face and body to avoid entanglement with the animal WARNING Do not use supplemental tape to adhere the clip and sensor directly to the site this can restrict blood flow and cause inaccurate measurements For best results secure the sensor cable independently from the sensor
93. r is turned ON An asterisk appears in the History printout to indicate an Alarm has occurred during that one minute time frame The alarm value shown represents the extreme value during the alarm time NOTE When Respiration is turned OFF no Respiration Rate RR readings will appear 78 21 02 0187 REV 04 05 09 eg Midmark Veterinary Monitors Figure 21 Waveform Sample Printouts 120 D S D 53 Se 26 n Cha CC o g By wa a ST m amp E xs E y E E SZ E g L S 0 S32 2 I amp To print waveforms depress and hold for two 2 seconds the FREEZE PRINT MAIN pushbutton while in the Main display screen The waveforms being displayed will print based on the Print Trace selections in the Parameters menu Refer to Page 49 PARAMETERS MENU for the Print Trace selections When the Print On Alarm setting in the Parameters menu is set to ON the type of alarm is printed on the printout and the trace is annotated with an arrow marker to mark the point of the alarm ECG II X2 Bradycardia al ke AK di SJ AE Je JE AE SE ix JE RESP 26 98 PR 120 5p02 121 RR SpO2 94XX Series Monitor 18 Aug 04 16 46 25 0 mm Sec Patient Notes HR CHARGING THE PRINTER BATTERY The CMP 10 Mobile Printer is equipped with a rechargeable Lithium lon LIION battery pack When the printer det
94. re flashing Low Battery Alarm Medium 3 Beeps every 25 seconds The message is displayed for one second every two to six seconds in the Equipment Message Window section of the display The Battery Charge Status visual indicator is flashing for one second on one second off on the display The Equipment Alarm LEDs are flashing The Battery Power visual indicator is Red 62 21 02 0187 REV 04 05 09 eg Midmark Veterinary Monitors AUDIBLE AND VISUAL INDICATORS cont Table 6 Audible and Visual Indicators Alarm Condition Priority Audible Indication Visual Indication Level Equipment Alarms Medium 3 Beeps every 25 seconds The appropriate message is displayed for one second on one second off in either the Waveform section or Equipment Message Window section of the display The Equipment Alarm LEDs are flashing ECG Heart Beat Low 1 Beep coincides with each Numerics are updated with each received ECG heart rate received heart rate value SpO Pulse Beat Low 1 Beep coincides with each Numerics are updated with each received SpO gt pulse rate received SpO gt pulse rate value Key Click Low 1 Beep associated with each None button action The message interval time will vary based on what monitor conditions are present If the Equipment Alarm is associated with a selected waveform being viewed the Alarm message appears in the Waveform section o
95. red To change an Alarm Limit 1 Press the ARROW UP or ARROW DOWN pushbuttons to select a parameter value 2 Press one of the NEXT programmed pushbutton keys to advance onto the parameter value to change Low or High 3 Press either the ARROW UP or ARROW DOWN pushbutton to change the parameter s value 4 Press one of the PREVIOUS programmed pushbutton keys to return back to the parameter selections column 5 Press either the ARROW UP or ARROW DOWN pushbutton to select the next parameter limit to change When finished press the MAIN pushbutton to exit and return to the Main display screen or after thirty 30 seconds of button inactivity the monitor will automatically return to the Main display screen The alarm value s set will now be used until power is turned OFF SAVING ALARM LIMITS The Midmark Monitor has the ability to save two 2 independent sets of Alarm Limit values Vet 1 or Vet 2 To save the Alarm Limit values to non volatile memory 1 Press the ALARM LIMITS pushbutton to enter the Limits menu 2 Press the ARROW DOWN pushbutton and highlight Save 3 Press one of the NEXT programmed pushbutton keys to advance onto the parameter value to change No 21 02 0187 REV 05 3 15 59 Midmark Veterinary Monitors EEN 4 Press either the ARROW UP or ARROW DOWN pushbutton and select the appropriate Alarm set to save Vet 1 5 Press the ALARM LIMITS pushbutton the message Saving appears b
96. ric information for SpO gt and Pulse Rate as well as the Temperature value PATIENT ALARM MESSAGE WINDOW The text section directly below the bottom trace and to the right in Figure 6 displays any patient related alarm messages example Bradycardia Tachycardia EQUIPMENT MESSAGE WINDOW The text section directly below the bottom trace and to the left in Figure 6 displays the current status of the Audio Alarm Silence 2 Minute or Permanent as well as other Equipment type alarm messages 21 02 0187 REV 05 3 15 35 Midmark Veterinary Monitors DISPLAY VISUAL INDICATORS 36 Two 2 light bar visual indicators One on the left side of the monitor and one on the right side of the monitor are used for alarm indications The Yellow light bar on the left side is lit indicating an equipment alarm The Red light bar on the right side is lit to indicate a patient alarm A Yellow LED visual indicator used along with the SILENCE RESET pushbutton to display the status of the Audio Alarm Silence feature Refer to Page 65 for more information The status of the LED is e ON continuously 2 Minute Audio Disable e Flash one second ON one second OFF Permanent Audio Disable A tri colored LED visual indicator used to display the status of the power source and battery condition The status of the LED is e GREEN Monitor is connected to an AC power source e ORANGE In Use on Battery
97. riefly as a status indicator and the current values will be saved in memory When finished press the MAIN pushbutton to exit and return to the Main display screen or after thirty 30 seconds of button inactivity the monitor will automatically return to the Main display screen The Alarm Limit values will be retained in memory even after the monitor s power is turned OFF If a second set of Alarm Limits is required re enter the Alarm Limits menu make your changes and save the set as Vet 2 RESTORE A PREVIOUSLY SAVED SET OF LIMITS To restore a previously saved set of Alarm Limit settings ex From Vet 2 to Vet 1 1 Press the ALARM LIMITS pushbutton to enter the Limits menu 2 Press the ARROW DOWN pushbutton and highlight Restore 3 Press one of the NEXT programmed pushbutton keys to advance onto the parameter value to change No 4 Press either the ARROW UP or ARROW DOWN pushbutton and select the appropriate set of Alarm Limits that the monitor will use 5 Press the ALARM LIMITS pushbutton the message Restoring appears briefly as a status indicator The restored values will be saved to memory When finished press the MAIN pushbutton to exit and return to the Main display screen or after thirty 30 seconds of button inactivity the monitor will automatically return to the Main display screen The Alarm Limit values will be retained in memory even after the monitor s power is turned OFF RESTORE F
98. s OFF or ON The default value is OFF To configure a parameter 50 Press the PARAMETERS pushbutton The parameters that are available are listed on the left hand side of the display The monitor will initially highlight the Trace 1 parameter Press one of the NEXT programmed pushbutton keys and highlight the selections column Press either the ARROW UP or ARROW DOWN pushbutton to make a selection If Trace 1 2 or 3 is being configured press one of the NEXT programmed pushbutton keys to select the speed mm Sec the trace will be viewed at Press either the ARROW UP or ARROW DOWN pushbutton to make a selection Press one of the PREVIOUS programmed pushbutton keys to return back to the parameter selections column Press the ARROW DOWN pushbutton to continue to the next parameter or press the MAIN pushbutton to exit and return to the Main display screen 21 02 0187 REV 04 05 09 eg Midmark Veterinary Monitors AUDIO VISUAL MENU Figure 15 Audio Visual Menu Audio Visual Alarm Volume Beep Source Beep Volume Key Click ON Contrast PTET TTT NOTE The Audio Visual pushbutton can be used at any time during monitoring When the Audio Visual pushbutton is depressed the waveforms being displayed are replaced with the Audio Visual menu While in the menu the monitor will continue to update and display the numeric values of the parameters being mon
99. sor clip Apply sensor clip to the patient s tongue Connect the sensor to the interface cable and lock hinged cover into place Connect the interface cable to the SpO2 connector on the side panel of the monitor USA Standard LA black Left Foreleg RA white Right Foreleg LL red Left Hind Leg ECG Refer to Page 19 Attach the 3 lead or 5 lead patient cable and leads per the diagram Leads may need to be moistened with isopropyl alcohol to optimize contact Connect lead wires to patient cable by matching colored ends with colored block on cable Connect round end of patient cable to the ECG RESP connector on the side panel of the monitor 21 02 0187 REV 05 3 15 QUICK START UP GUIDE MONITOR OPERATIONS MAIN DISPLAY AREA TOP RIGHT SECTION Up to 3 traces can be selected in the Current monitor time and battery charge Parameters Menu Trace 1 is automatically status are displayed an ECG waveform e Trace 1 and 2 waveform names numeric This section also displays various menus values and flashing visual icons are displayed when selected LOWER RIGHT SECTION e Trace 3 waveform name numeric value and flashing visual icon are displayed s Temperature if in use is displayed Bradycardia EQUIPMENT MESSAGES PATIENT ALARM MESSAGES Displays the current status of the Audio e Text section displays any patient related alarm Alarm Silence when sele
100. st 2 kV for power supply lines 2 kV for power supply lines Mains power quality should be that of a typical commercial or IEC 61000 4 4 1 kV for input output 1 kV for input output hospital environment lines lines Surge 1 kV differential 1 kV differential Mains power quality should be IEC 61000 4 5 mode mode that of a typical commercial or 2 kV common mode 2 kV common mode hospital environment Voltage Dips lt 5 Ur gt 95 dip in lt 5 Ur gt 95 dip in Mains power quality should be short interruptions Ur for 0 5 cycle U for 0 5 cycle that of a typical commercial or and voltage 40 Ur 60 dip in 40 Ur 60 dip in hospital environment If users of variations on power supply input lines IEC 61000 4 11 Ur for 5 cycles 70 Ur 30 dip in Ur for 25 cycles lt 5 U gt 95 dip in Ur for 5 seconds Ur for 5 cycles 70 Ur 30 dip in Ir for 25 cycles 5 Ur gt 95 dip in t for 5 seconds EA C the Model 9454 9456 Monitor requires continued operation during power mains interruptions it is recommended that the Model 9454 9456 Monitor be powered from an uninterruptible power supply or a battery Power frequency 50 60 Hz magnetic field IEC 61000 4 8 3 A m 3 A m Power frequency magnetic fields should be at levels characteristic of a typical location in a typical commercial or hospital environment NOTE U is the A C
101. st the Beep Volume to the desired level Refer to Page 51 AUDIO VISUAL MENU for more information 21 02 0187 REV 04 05 09 28 eg Midmark Veterinary Monitors SatSeconds ALARM MANAGEMENT False or nuisance alarms are a common concern with pulse oximetry monitoring Nuisance alarms are often triggered by minor and brief desaturation events that are clinically insignificant Clinicians tend to manage these alarms by ignoring them turning off the alarm or monitor or widening the alarm limits The Midmark Monitor incorporates Nellcor s SatSeconds Alarm Management feature that offers a better way to manage nuisance alarms without sacrificing patient safety The SatSeconds function can be activated from the Alarm Limits menu by selecting a SatSeconds limit or clock of 10 25 50 100 or OFF SatSeconds Clinicians who choose to employ the SatSeconds function should select a limit suited to their clinical environment and patient conditions Think of SatSeconds as the product of magnitude and time a patient exceeds SpO alarm limits For example 3 points below the alarm limit for 10 seconds equals 30 SatSeconds An alarm is only triggered if a desaturation event occurs that reaches the SatSeconds limit you selected As a safety net when three or more SpO alarm violations occur within 60 seconds an alarm will sound even if the SatSeconds limit has not been reached NOTE When SatSeconds is set to OFF the monitor will immediately
102. t of box failure only THERE ARE NO WARRANTIES WHICH EXTEND BEYOND THOSE EXPRESSLY DESCRIBED IN THIS AGREEMENT AND THE COMPANY MAKES NO WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE 21 02 0187 REV 05 3 15 21 02 0187 REV 05 3 15 HOW TO CONTACT US For Warranty Issues CAS Medical Systems Inc 44 East Industrial Road Branford CT 06405 U S A Phone 800 227 4414 203 488 6056 Fax 203 488 9438 E Mail custsrv casmed com Web www casmed com For Product Usage Information Midmark 10008 N Dale Mabry Hwy Suite 110 Tampa FL 33618 U S A Phone Toll Free 800 Midmark 643 6275 Fax 813 264 6218 E Mail www Midmark com Pages Contactus aspx Web www Midmark com Copyright 2004 CAS Medical Systems Inc All rights reserved No part of this manual may be reproduced without the written permission of CAS Medical Systems Inc CAS reserves the right to make changes to this manual and improvements to the product it describes at any time without notice or obligation 21 02 0187 REV 05 3 15 21 02 0187 REV 05 3 15 mn Midrnark Veterinary Monitors TABLE OF CONTENTS 1 INTRODUCTION AND INTENDED USE eevvvnnnnnnnnnnnnnnnnvvnnnnnnnnnnnnnnnnnvnnnnnnnnnnnnn 1 MIO DC HON E 1 INDICATIONS FORUSE un keen 1 GONTRAINBIGATIONS dine eesecek a dad caine Aessnah ai are tedaecdeaser el teat 1 BRIEF DEVICE DESO RIP TION EE 1 SCENE 2 DEFINITION OF TERMS EE 3 2 UNPACKING THE
103. te Audio Silence is enabled the monitor will not alarm for patient related High and Low Alarms and Equipment Alarms The monitor will alarm for Low Battery and Dead Battery To re activate the audio alarm press the SILENCE RESET pushbutton again The visual indicators will go out If the button is not pressed audible alarms will be re armed automatically after two 2 minutes Refer to Page 44 AUDIO ALARM SILENCE SILENCE RESET Pushbutton for more information 21 02 0187 REV 05 3 15 65 Midmark Veterinary Monitors kV u m PERMANENT AUDIO ALARM SILENCE NOTE Enabling the Permanent Audio Silence mode can only be accomplished after all active alarm conditions have been addressed To clear an alarm refer to Page 63 CLEARING ALARMS If the Permanent Audio Silence mode is selected in the Audio Silence portion of the Setup menu pressing the SILENCE RESET pushbutton will deactivate the audio alarms The SILENCE visual indicator will flash at a rate of one 1 second ON and one 1 second OFF and the message Permanent will be displayed in the Equipment Message Window section of the display as a reminder When the Permanent Audio Silence is enabled the monitor will not alarm for patient related High and Low Alarms and Equipment Alarms The monitor will alarm for Low Battery and Dead Battery To re activate the audio alarm press the SILENCE RESET pushbutton again The visual indicators will go out Ref
104. ter while replacing the printer paper 21 02 0187 REV 04 05 09 80 eg Midmark Veterinary Monitors REPLACING THE BATTERY PACK WARNING Do not operate the printer or connect the printer to the Midmark Monitor with the battery pack removed WARNING Never change the battery pack while the battery charger is plugged in and or the Midmark Monitor is being operated 1 Switch the printer OFF 2 Disconnect the printer from the Midmark Monitor and unplug the wall charger cord 3 Open the battery door by pressing in on the battery cover and pushing upward Figure 23 Opening the Battery Door 4 Remove the battery cover 5 Remove the battery pack from the compartment and disconnect its connecting cable 21 02 0187 REV 05 3 15 81 Midmark Veterinary Monitors Ki EEE 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 24 Installing the New Battery 3 Replace the battery cover by sliding it in from the back of the printer and pushing down to lock it in place CAUTION Be sure to place the battery cover firmly in its position after installing the new battery pack WARNING Do not disassemble the battery pack or batteries The batteries contain electrolytes which can cause injury to eyes skin and clothing NOTE This product contains a recharg
105. the monitor is being used to monitor a patient The monitor must be turned OFF Unplug the monitor from the AC power source and remove the internal battery CAUTION Do not open the monitor to clean or repair it Contact CAS Medical System for service needs CAUTION Disconnect all accessories from the monitor before cleaning Do not immerse any part of the electrical connector of the cable or accessories in the cleaning or disinfection solution at any time Do not use an abrasive cloth or cleaner on the accessories Immersing the patient cable or leadwires in any liquid may result in moisture entering This may cause internal damage and reduce the product life Alcohol and organic solvents may cause stiffness and brittleness THE MONITOR On a daily basis examine the monitor s case for any damages and check the AC power cord for bent or broken prongs cracks or fraying Neither the monitor nor the power cord should be used if damaged If any damage is noted contact the appropriate service personnel CAUTION Do not spray or pour any water or cleaning solution directly onto the monitor As needed clean the monitor using a soft cloth dampened with a mild dishwashing detergent solution and gently rub the soiled area until clean Use a clean soft cloth to dry the monitor Do not use abrasive cleaners on the monitor Do not use either isopropyl alcohol or solvent to clean the monitor Use of these clean
106. the calibration of the monitor s Temperature circuit once 1 every year To perform a Temperature Calibration Check obtain a Temperature Test Jack This Test Jack can be purchased directly from CAS Medical Systems or assembled by a service personnel Refer to Section 12 ACCESSORIES for part number information The Temperature Test can be performed at any time CAUTION Do not perform a Temperature Test while the Midmark Monitor is monitoring a patient To perform a Temperature Test follow the following procedure 1 If installed remove the temperature probe connector completely from the TEMP connector 2 Insert the Temperature Test Jack into the TEMP connector 3 The TEMP display value should read 37 0 0 1 C or 98 6 0 19F NOTE The monitor will display the Temperature Test Jack value using the current temperature units selected 4 Once completed remove the Temperature Test Jack from the TEMP connector SpO2 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
107. the monitor is in need of repair it must be referred to the appropriate service personnel Service performed by unauthorized personnel could be detrimental to the monitor and may void the warranty For service contact CAS Medical Systems Inc 21 02 0187 REV 05 3 15 89 Midmark Veterinary Monitors EEN SERVICE MENU WARNING Do not enter the Service menu while the monitor is connected to a patient The patient is not being monitored while in the menu The monitor s Service menu allows the user to perform basic preventative maintenance and testing to the Midmark Monitor Once entered the user can e Perform a IrDA Print Test e Verify the monitor s operating power supply voltage level e Review the monitor s operating and internal modules software levels ENTERING THE SERVICE MENU To enter the monitor s Service menu depress and hold the PARAMETERS Ar and HISTORY Tat pushbutton keys while the monitor is being turned ON Figure 25 Service Menu Service LEDA TESt PIC Voltage NOTE While in the Service menu if no pushbutton is depressed within 15 minutes the monitor will automatically exit the Service menu and return to the Main display screen EXIT THE SERVICE MENU When you have completed testing the monitor press the MAIN C pushbutton to exit and return to the Main display screen 21 02 0187 REV 04 05 09 90 eg Midmark Veterinary Monitors IrDA TEST The M
108. tion 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 five 5 hours NOTE A Low Battery alarm cannot be silenced When the Dead Battery message appears the battery is no longer able to power the monitor During a Dead Battery condition the message Dead Battery is displayed continuously on the Main display screen the Equipment Alarm LEDs are flashing the Battery Power visual indicator is colored Red and three 3 audio beeps followed by two 2 audio beeps once every ten 10 seconds are heard until the power is turned off WARNING Upon the detection of a Dead Battery condition and if the monitor is not turned off by the user the monitor shuts down and turns OFF after three 3 minutes of operations NOTE A Dead Battery alarm cannot be silenced When either of these messages appears it is necessary to recharge the battery A depleted battery may be fully recharged in five 5 hours The monitor can be used to obtain measurements while the battery is charging NOTE Using the monitor while charging may lengthen the time to restore battery charge NOTE During charging of the battery the case may feel warm to the touch CHECKING BATTERY STATUS If your Midmark Monitor is equipped with the standard battery
109. tion device s Maximum distance is approximately three 3 Feet direct line of sight operation 21 02 0187 REV 05 3 15 39 Midmark Veterinary Monitors REAR PANEL Figure 11 Rear Panel View Battery Compartment Equipotentiality External Device Interface Ground Post 100 240 VA 5A 50 60Hz FUSE T12SAL250V j r gt CAUTION U S FEDERAL LAW RESTRICTS THIS DEVICE TO SALE ON OR BY THE ORDER OF A VETERINARIAN U S PATENT 4 796 184 5 022 403 PATENTS PENDING AC Input Connector Fuse Compartment AC LINE POWER CONNECTOR Receptacle for the AC power cord FUSE COMPARTMENT The power input receptacle incorporates dual fuses located in the hot and neutral lines BATTERY COMPARTMENT The Midmark Monitor is equipped with a 7 2 Volt 3700 mAhr battery pack when fully charged is capable of running the monitor for approximately four 4 hours NOTE Based on a Model 9454 monitor EQUIPOTENTIALITY GROUND POST This terminal can be used to provide an auxiliary ground for the monitor EXTERNAL DEVICE INTERFACING The Midmark Monitor comes equipped with a DB9 RS232 serial output connector that is used to interface to the Citizen CMP 10 Mobile Printer or another serial printing device Refer to Section 9 EXTERNAL PRINTER for more information NOTE The serial number label is located on the bottom of the monitor 21 02 0187 REV 04 05 09 40 eg Mid
110. ts including earth CONNECTIONS The correct way to connect a patient to the monitor is plug the electrode leads into the patient cable which in turn connects to the monitor The monitor is connected to the wall socket by the power cord Do not plug the electrode leads into the power cord a wall socket or an extension cord DEFIBRILLATION Do not come in contact with patients during defibrillation Serious injury or death could result DISPOSAL Dispose of the packaging material observing the applicable waste control regulations SITE REQUIREMENTS For safety reasons all connectors for patient cables and sensor leads are designed to prevent inadvertent disconnection should someone pull on them Do not route cables in a way that they may present a stumbling hazard For devices installed above the patient adequate precautions must be taken to prevent them from dropping on the patient 21 02 0187 REV 04 05 09 14 eg Midmark Veterinary Monitors CAUTION Before each use make sure that the monitor default alarm settings are appropriate for the specific patient being monitored Pressing the front panel keyswitch with a sharp or pointed instrument may permanently damage the keyswitch Press the keyswitch using only your finger Even though the ECG patient circuit is electrically isolated it has not been designed for direct application on a patient s heart A calibration check is recommended once every year Ins
111. unicipal waste stream Check with your local authorities for instructions on recycling options in your area CHANGING THE FUSES The Midmark 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 Midmark Monitor are each rated at 250V 500mA or 1 25A 5 x 20 mm Slow Blow CAS p n 09 01 0002 or 09 01 0034 respectively Refer to rear panel monitor labeling for actual fuse rating CAUTION For continued protection against fire hazard replace only with identically rated fuses A fuse may need to be replaced if the monitor is plugged into an electrical outlet but the Battery Power Visual Indicator is not illuminated the color Green WARNING Before changing the fuse unplug the power cord The fuse holder is incorporated into the power input receptacle and located under the power cord input connector To replace fuses 1 Turn the monitor OFF and disconnect the power cord from the back of the monitor 2 Depress down on the locking tab which holds the fuse holder in the power input receptacle 3 While holding down on the tab pull the fuse holder out 4 Remove the fuses 5 Place new fuses directly into the fuse holder 6 Insert the fuse holder into the power input receptacle There should be an audible click when it is secure 21 02 0187 REV 05 3 15 95 Mid
112. usable As necessary the probes should be cleaned with a mild detergent and water to remove excess bioburden When necessary the probes may be disinfected using a soft cloth saturated with a 10 1 10 solution of chlorine bleach in tap water or 70 isopropyl alcohol When all of the surfaces have been disinfected wipe the entire surface of the monitor using a soft cloth dampened with fresh water to remove any trace amounts of residue and or fumes 21 02 0187 REV 05 3 15 87 Midmark Veterinary Monitors EEN 21 02 0187 REV 04 05 09 88 eg Midmark Veterinary Monitors 11 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 The Midmark Monitor e Replace the Battery Pack once every two 2 years ECG Respiration e No user calibration is required e Perform a Bench Test once 1 per year or when there is doubt about the validity of the ECG and or Respiration readings For monitors with SpO gt e No user calibration is required e Perform a SpO Simulator Check once 1 per year or when there is doubt about the validity of the SpO readings Temperature e No user calibration is required e Perform a Temperature Calibration Check once 1 per year or when there is a doubt about the validity of the temperature readings If
113. used to check the status of battery charge remaining when not connected to the monitor 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 your area STAND BY The Midmark Monitor can be placed into a Stand by mode This mode can be used just prior to connecting the monitor to a patient but all the monitor s cables are connected This mode is enabled by depressing and holding for two 2 seconds the SILENCE RESET pushbutton When enabled all Equipment alarms are silenced and the message Stand By is displayed on the Main display screen For the Stand by feature to work properly the following conditions must apply e The monitor cannot be actively monitoring any patient parameter NOTE Temperature monitoring is not effected by the Stand By mode To return the monitor to normal operation connect any of the patient leads to the patient 21 02 0187 REV 04 05 09 68 eg Midmark Veterinary Monitors POWER FAIL The Midmark Monitor incorporates a Power Fail feature Whenev
114. ushbutton PARAMETER Pushbutton 21 02 0187 REV 04 05 09 Midmark Veterinary Monitors SYMBOLS CONT ALARM LIMITS Pushbutton HISTORY Pushbutton AUDIO VISUAL Pushbutton ARROW UP Pushbutton ARROW DOWN Pushbutton A Yellow LED visual indicator used along with the SILENCE RESET pushbutton to display the status of the Audio Alarm Silence Horizontal bar graph display of the charge level of the battery 21 02 0187 REV 05 3 15 Midmark Veterinary Monitors EEN SYMBOLS CONT Heart Rate Icon Flashes once for every detected heartbeat O Respiration Breath Icon Flashes once for every detected breath Vertical bar graph display of SpO gt signal strength 1 A tri colored LED used to indicate the status of the monitors power source These symbols appear on the battery pack in place of text gs Recycling suggested see General Notes I al es rater Den 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 67 CHECKING BATTERY STATUS for more information 21 02 0187 REV 04 05 09 Midmark Veterinary Monitors SYMBOLS CONT 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 Temper
115. utton for more information The Midmark 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 Table 4 Alarm Parameters Parameter Value Heart Rate Low High BPM The Midmark Monitor is also equipped with the ability to save two 2 independent sets of Alarm Limit values for both Vet 1 and Vet 2 modes that can be recalled There is also a provision to Recall the Factory defaults if needed 21 02 0187 REV 04 05 09 58 eg Midmark Veterinary Monitors NOTE The Alarm Limits pushbutton can be used at any time during monitoring When the Alarm Limits pushbutton is depressed the waveforms being displayed are replaced with the Limits menu While in the menu the monitor will continue to update and display the numeric values of the parameters being monitored and a signal bar graph will be displayed indicating the relative signal strength and signal quality at the sensor site NOTE While in the Limits menu if no pushbutton is depressed within 30 seconds the monitor will automatically save any changes made and exit to the Main display screen CHANGING ALARM LIMITS Press the ALARM LIMITS pushbutton and the monitor s front panel displays the currently used set of alarm setting of all Low and High Alarm Limit values along with the numeric values of the parameters currently being monito
116. utton can be used at any time during monitoring When the History pushbutton is depressed the waveforms being displayed are replaced with the History menus While in the menus the monitor will continue to update and display the numeric values of the parameters being monitored and a signal bar graph will be displayed indicating the relative signal strength and signal quality at the sensor site 21 02 0187 REV 04 05 09 52 eg Midmark Veterinary Monitors NOTE While in the History menus if no pushbutton is depressed within 30 seconds the monitor will automatically exit to the Main display screen NOTE Both Trend and Alarm History data are only available for twenty four 24 hours Data older than twenty four 24 hours is automatically removed from the history lists Once the HISTORY pushbutton has been depressed depress and hold the HISTORY pushbutton for two 2 seconds to toggle between the two History screens NOTE If no alarms have occurred the message No Alarm History is displayed at the top of the History menu When completed press the MAIN G pushbutton to exit and return to the Main display screen or after thirty 30 seconds of button inactivity the monitor will automatically return to the Main display screen TREND HISTORY Figure 16 History Menu To view Trend History 1 Press the HISTORY pushbutton to enter the Patient History menu The most current

Model 9454/9456 User`s Manual, English

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