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Model 750C User`s Manual

1. Figure 11 Audio Visual Menu The cursor position is initially at the first item in the left column e Use the UP and DOWN keys to select the item that needs to be changed e Use the NEXT key to move the cursor to the next column to the right e Use the UP and DOWN key to scroll through the available op tions Note Several changes may be done in one session Use the PREVIOUS key to return the cursor back to the left column and repeat the steps as before e Press the RETURN key when finished All changes will be saved and become immediately effective Page 39 Basic Operation CAS 750C Monitor Auto Dim The CAS 750C Monitor incorporates an Auto Dim feature that when enable turns the display s backlight automatically off after 30 seconds This feature can be helpful when the monitor is being used at night in a patient s room The Auto Dim feature is enabled when the user selects on in the Auto Dim parameter selection of the Audio Visual menu Page 40 21 02 0193 REV 00 08 05 CAS 750C Monitor Alarms 3 Alarms The monitor distinguishes between patient and equipment alarms Patient Alarms Warning Before each use verify that the alarm limits are appro priate for the patient being monitored Note All patient alarms based on continuously monitored pa rameters e g CO2 and SpO etc will clear automatically when the alarm cause is no longer persistent
2. Page 48 21 02 0193 REV 00 08 05 CAS 750C Monitor SpOz Introduction Safety 21 02 0193 REV 00 08 05 SpO Pulse Oximetry The Pulse Oximeter parameter SpO2 determines arterial oxyhe moglobin saturation by measuring the absorption of red and infra red light passing through the tissue Changes in absorption caused by pulsations of blood are used to determine Arterial Satu ration Y SpOz2 and Pulse Rate PR If SoO2 was not selected as a trace to be displayed a SpOz signal bar graph will be displayed indicating the relative signal strength and signal quality at the sensor site Note The bar graph indicator is not proportional to the pulse vol ume An audio beep can be enabled that is generated each time the SpO module detects a pulsation Warning If uncertain about the accuracy of any measurement check the patient s vital signs by alternate means and then make sure the monitor is functioning correctly Warning Accurate oxygen saturation measurements cannot be obtained when the oximeter is not measuring the pulse properly If the SpO2 waveform perfusion bar graph or the Pulse Rate be erratic or inaccurate first examine the patient for any sign of dis tress and only then re examine sensor placement Warning A pulse oximeter should be considered an early warning device As a trend toward patient deoxygenation is indicated blood samples should be analyzed by a laboratory co oximeter
3. Adult 1 or Adult 2 to restore Note Restore options will be Factory Neo 1 and Neo 2 when the monitor is in Neonate mode e Press the LIMITS key to start the restore process The message Restoring appears and the alarm limit values are overwritten with the restored values e Press the RETURN key when finished The monitor returns to the Main screen and the new limit set will become effective immediately Factory Default Alarm Limits Factory Default Alarm Limits are different for Adult and Neonatal patients Adult Neonate Parameter Low High Low High SpO2 88 OFF 88 96 Pulse Rate OFF 220 OFF 220 SatSeconds OFF N A OFF N A ECO OFF OFF OFF OFF FiCO2 N A 3 N A 3 Resp Rate OFF OFF OFF OFF No Resp 30 N A 20 N A Systolic OFF 240 OFF 120 Diastolic OFF 130 OFF 80 Table 1 Factory Default Alarm Limits 1 Factory Set Not user adjustable 21 02 0193 REV 00 08 05 Page 45 Alarms CAS 750C Monitor Alarm Volume Alarm Delays Page 46 The alarm tone volume can be changed but not completely turned off e To change the alarm tone volume follow the steps described in paragraph Audio Visual Menu on page 39 To reduce the number of false positive alarms some patient alarms will be activated after a short delay These are e ECO alarms 10 seconds e FCD alarm 10 sec
4. Note All patient alarms based on discontinuously monitored parameters e g NIBP readings will clear only after acknowl edged by the user Manifestation of Patient Alarms e Numeric display of the alarming parameter flashes e Patient Alarm LED s are activated e Audible tone is generated 3 beeps followed by 2 beeps every 10 seconds e Flashing text in Patient Message Window explains the cause Note When an ongoing patient alarm is acknowledged by press ing the ALARMS key only the audible signal will be silenced for 15 seconds All other alarm indicators will remain active until the alarm condition no longer exists Equipment Alarms Note All equipment alarms will clear automatically when the alarm cause is no longer persistent Manifestation of Equipment Alarms e Alarming parameter display flashes e Equipment Alarm LED s are activated e Audible tone is generated 3 beeps every 25 seconds e Flashing text in Equipment Message Window explains the cause 21 02 0193 REV 00 08 05 Page 41 Alarms CAS 750C Monitor Note When an ongoing equipment alarm is acknowledged by pressing the ALARMS key only the audible signal will be disabled All other alarm indicators will remain active until the alarm condi tion no longer exists Note Low Battery and Dead Battery alarms cannot be silenced Silencing Alarms In case the monitor should temporarily not generate any alarm tone the user can activate a S
5. HxWxD Weight Operating Environment 21 02 0193 REV 00 08 05 Operating Temperature Storage Temperature Humidity Altitude 170 mm x 215 mm x 102 mm 6 75 in x 8 5 in x 4 0 in 2 0 kg 4 4 Ibs 0 to 50 C 32 F to 122 F 20 to 60 C 4 F to 149 F 15 to 95 RH non condensing 10 000 to 1 000 ft 690 to 1050 hPa Monitors may not meet performance specifications if stored or used out side 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 Page 119 Appendix CAS 750C Monitor Page 120 Power External Power AC DC optional Chassis Leakage Current Battery Charge Time Operating Time Serial Interface Standards Interface Type Speed Signal Level Data Length Start Bit Stop Bit Parity Flow Control 100 240 VAC 50 60 Hz 0 5A Fuse Rating TS500mAL250V two provided 12 VDC 7W Fuse Rating Littelfuse Type 154 Slo Blo 5 0A 125VAC or approved equivalent one provided 100 pA maximum NiMH battery pack user removable 3 5 hours 3 hrs minimum Bi directional Serial Communication 9600 RS232C 8 bits 1 bit 1 bit None None Units comply with the following requirements ANSI AAMI SP 10 2002 EN 60601 1 EN 60601 1 2 EN 60601 2 27 EN 60601 2 30 EN 60601 20 49 EN 864 EN 865 UL classified UL
6. Tuff Cuff Blood Pressure Cuffs Reusable Blood Pressure Cuffs Catalog No Type Description 01 01 0308 CR5216 Large Adult 16 cm x 42 cm 01 01 0307 CR5214 Adult 14 cm x 37 cm 01 01 0306 CR5212 Small Adult 12 cm x 30 cm 01 01 0249 CR5209 Child 9 cm x 27 cm 01 01 0248 CR5207 Small Child 7 cm x 21 cm 01 01 0258 CR5206 Infant 6 cm x 18 cm Safe Cuff Blood Pressure Cuffs Single Patient Use Blood Pressure Cuffs Catalog No Type Description 01 01 0245 CD2060 X Large Adult 20 cm x 52 cm 01 01 0243 CD1642 Large Adult 16 cm x 41 cm 01 01 0241 CD1437 Adult 14 cm x 36 cm 01 01 0239 CD1230 Small Adult 12 cm x 31 cm 01 01 0237 CD927 Child 9 cm x 25 cm 01 01 0235 CD618 Infant 6 cm x 16 cm Pedisphyg Blood Pressure Cuffs Single Patient Use Neonatal Blood Pressure Cuffs Catalog No Type Description 01 01 0267 C26 2 5 cm x 9 0 cm 01 01 0268 C39 3 0 cm x 11 5 cm 01 01 0269 C412 4 0 cm x 14 5 cm 01 01 0270 C515 5 0 cm x 17 75 cm Inflation Hoses Catalog No Type Description 01 02 0185 Straight NIBP Hose for Neonatal and Infant applica tions 6 feet 01 02 0131 Coiled NIBP Hose for Adult and Pediatric applica tions 10 ten Page 124 21 02 0193 REV 00 08 05 CAS 750C Monitor Appendix Masimo SpO gt Accessories Catalog No Type Description 01 02 0178 LNOP DCI Adult digit reusable sensor 01 02 0190 LNOP DCIP Pediatric digit reusable sensor 01 02 0191 LNOP YI Multisite reusable sensor 01 02 03
7. Warning Do not connect the CAS 750C Monitor to more than one patient Warning The CAS 750C Monitor is not intended to be used in Oxygen Enriched Atmospheres Warning The CAS 750C Monitor is defibrillator proof It may re main attached to the patient during defib but the readings may be inaccurate during use and less than ten 10 seconds thereafter Warning Do not use the monitor in the presence of Magnetic Resonance Imaging MRI equipment Warning The CAS 750C Monitor is not Category AP or APG Equipment Warning Explosion Hazard Do not use the monitor in the pres ence of a flammable Anesthetic Mixture with Air or with Oxygen or Nitrous Oxide Warning Explosion Hazard Do not use this equipment in the presence of flammable anesthetics vapors or liquids Warning Electromagnetic Compatibility EMC The equipment needs special precautions if it is placed close to a strong transmit ter such as X ray equipment MRI devices TV AM FM radios po lice fire stations a HAM radio operator an airport or cellular phone Their signals could interfere with the monitor which may result in disruption of performance of this device or prevents the clear reception of signals by the monitor 21 02 0193 REV 00 08 05 CAS 750C Monitor Safety 21 02 0193 REV 00 08 05 Caution Qualified biomedical engineering personnel only must in terface monitoring equipment with other types of medical equip ment
8. e Switch the printer off e Disconnect the printer from the monitor and unplug the wall charger cord e Open the battery door by pressing in on the battery cover and pushing upward Figure 24 Opening the Battery Door e Remove the battery cover e Remove the battery pack from the compartment and disconnect its connecting cable 21 02 0193 REV 00 08 05 Page 103 Printer CAS 750C Monitor Installing the new Battery Pack Figure 25 Installing the New Battery e Connect the battery cable into the battery connector e Insert the battery and its connecting cable into the bat tery compartment e 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 po sition after installing the new battery pack Warning Do not disassemble the battery pack or batter ies The batteries contain electrolytes which can cause in jury to eyes skin and clothing Note 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 recy cling options in your area Page 104 21 02 0193 REV 00 08 05 CAS 750C Monitor External Device Interfacing 11 External Device Interfacing RS232 Interface The monitor uses the DB9 connector to interface to the RS232 port on the Citizen CMP 10 Mobile Printe
9. 1 to 13 2 kPa 1 to 13 2 kPa Respiration Rate 5 145 BrPM 5 145 BrPM 5 145 BrPM 5 145 BrPM No Respiration 5 to 30 Sec 5 to 30 Sec 5 to 30 Sec 5 to 30 Sec SYS 35 130 mmHg 35 130 mmHg 35 250 mmHg _ 35 250 mmHg DIA 20 105 mmHg 20 105 mmHg 20 215 mmHg 20 215 mmHg 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 Operating Modes Patient Modes Neonate or Adult Page 118 COz Continuous Monitoring SpOsz Continuous Monitoring NIBP Manual STAT or Automatic at preset inter vals History Trend Review of previous measurements Alarm Review of previous alarms Other Modes Stand by mode and Auto Dim 21 02 0193 REV 00 08 05 CAS 750C Monitor Appendix Display Physical Dimensions and Weight Display Numerics Waveforms Sweep Speeds Trend History Alarm History LCD display of measurement results instruc tions troubleshooting messages waveforms and signal strength bar SpPOz2 PR NIBP Systolic Diastolic and MAP or PR EtCO2 mmHg or kPa RR Up to 3 traces SpOs fixed as trace 1 CO2 fixed as trace 2 3 trace configurable 12 5 25 or 50 mm s for SpOo 3 0 6 25 or 12 5 mm s for CO 480 1 minute entries of all parameters 25 most recent alarms Fully configured unit with battery
10. D YSE D YSPD Sensor Accuracy MAX R 80 100 3 5 digits 1 S D 3 digits every 1 second Plethysmogram fixed for trace 1 12 5 25 or 50 mm sec High and low limits on SpOz adjustable High and low limits on Pulse Rate adjustable SpO gt z SatSeconds Pulse 0 or 10 seconds Page 115 Appendix CAS 750C Monitor Page 116 Capnography Method Patient Range Units Sample Rate System Response Time Rise Time Delay Time Frequency Response Ambient Pressure Range Initialization Time Accuracy Before steady state Steady state Resolution Respiration Rate Waveform Display Sweep Speeds Patient Alarms Sidestream Capnography MicroStream Adult Neonate mmHg or kPa 50 ml min 7 5 ml min 2 9 seconds typical includes delay and rise time Adult and Neonate 190 msec max 2 7 seconds typical EtCO accuracy is maintained up to 80 breaths min For maintaining accuracy for respiration rate over 60 bpm use Neonate mode From 81 to 150 bpm accuracy is 12 if the EtCO is higher than 18 8 mmHg in Neonate mode Compensated internally automatic 0 99 mmHg 0 13 2 kPa and 0 13 0 vol at sea level 30 seconds typical 0 38 mmHg 4 mmHg 39 99 mmHg 12 of reading 0 38 mmHg 2 mmHg 39 99 mmHg 5 of reading 0 08 for every 1 mmHg above 38 mmHg 1 mmHg 0 1 or 0 1 kPa 0 150 breaths min CO waveform fixed f
11. least 30 Electrical fast transient burst 2 kV for power 2 kV common mode 2 kV for power 2 kV common mode Mains power quality should be that of a typical commercial or supply lines supply lines IEC 61000 4 4 1 kV for in 1 kV for in hospital environment put output lines put output 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 hospital environment Voltage Dips short interruptions and volt age variations on power supply input lines IEC 61000 4 11 lt 5 UT gt 95 dip in UT for 0 5 cycle 40 UT 60 dip in UT for 5 cycles 70 UT 30 dip in UT for 25 cy cles lt 5 UT gt 95 dip in UT for 5 lt 5 UT gt 95 dip in UT for 0 5 cycle 40 UT 60 dip in UT for 5 cycles 70 UT 30 dip in UT for 25 cy cles lt 5 UT gt 95 Mains power quality should be that of a typical commercial or hospital environment If user of the model 750C requires contin ued operation during power mains interruptions it is recom mended that the model 750C be powered from an uninterruptible power supply or a battery seconds dip in UT for 5 seconds Power frequency 3 A m 3 A m Power frequency magnetic fields 50 60 Hz should be at levels characteristic magnetic field of a typical location in a typical IEC 61000 4 8 commercial or hospital environ ment 21 02
12. read ings The monitor should be returned to CAS Medical Systems for periodic maintenance every 14 000 operat ing hours Page 85 Maintenance CAS 750C Monitor Maintenance Checks Entering the Service Menu Warning Do not enter the SERVICE menu when the monitor is connected to a patient To enter the monitor s SERVICE menu proceed as fol lows e Press and hold the PARAMETERS and HISTORY keys while the monitor is being turned on Service LeDA Test OFF EtCO2 Check OFF EtCO2 Cal OFF EtCOz CAL Date 06 Feb 04 EtCO2 S N 00234 Service EtCO2 XXXXX Cal EtCO2 XXXX Manometer Mode OFF Pneumatic Test OFF PIC Voltage XX XX Figure 17 Service Menu The cursor is initially positioned at the first item in the left column e Use the UP or DOWN keys to select any other item e Press one of the NEXT keys to move the cursor to the next column to the right e Use the UP or DOWN keys to scroll through the avail able options Exiting the Service Menu e Press the RETURN key to exit the menu and return to the Main screen Note If no key is pressed for 15 minutes the monitor will automatically return to the Main screen Page 86 21 02 0193 REV 00 08 05 CAS 750C Monitor Maintenance IrDA Test The IrDA Test checks the alignment of the monitor and the printer to guarantee communication between their infrared windows To use the Infrared Test proceed as follows e Enter t
13. the monitor will continue to update and display the nu meric values of the parameters being monitored Note The actual displayed information depends on the parameter configuration of the monitor and the user defined screen layout 1 45 6 7 76 55 Cie SpCi2 ee PR NIBP Manual 1 120 80 80 ws 120 80 sl Adult High SpO2 8 9 10 11 12 13 14 Figure 7 Main Screen Equipment Alarm Indicator Main Display Screen Waveform Selections Time 1 2 3 4 5 Heart Beat Icon flashes for every detected pulse beat 6 Battery Indicator 7 Patient Alarm Indicator 8 Silence Indicator 9 CQz size indicator 10 Equipment Message Window 11 Patient Message Window 12 NIBP Mode 13 Bar Graph Indicator for signal strength when traces not dis played 14 Respiration Breath Icon flashes for every detected breath 21 02 0193 REV 00 08 05 Page 33 Basic Operation CAS 750C Monitor Freeze Traces While the Main screen is being display the user can freeze the traces e Press the RETURN key The message Traces Frozen appears at the top of the Main screen While the traces are frozen the numerics continue to up date Traces will automatically un freeze if no key is pressed for 60 seconds or in case any other screen or menu is entered e Press the RETURN key again to manually un freeze traces History Screens Page 34 The monitor collects History data over a 24 hour period Continu ously m
14. 0193 REV 00 08 05 NOTE Ur is the A C mains voltage prior to application of the test level Page 121 Appendix CAS 750C Monitor Guidance and Manufacturer s Declaration Electromagnetic Immunity The Model 750C Monitor is intended for use in the electromagnetic environment specified below The customer or the user of the Model 750C 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 750C Monitor including cables than the recom mended separation distance calculated from the equation applicable to the frequency of the transmit ter Recommended separation distance Conducted RF 3 Vrms 3 Vrms IEC 61000 4 6 150 kHz to 80 MHz d 1 2 P Radiated RF 3 V m 3 V m IEC 61000 4 3 80 MHZ to 2 5 GHz d 1 2VP 80 MHz to 800 MHz d 2 3VP 800 MHz to 2 5 GHz Where P is the maximum output power rating of the transmitter in watts according to the transmitter manu facturer and dis the recommended separation dis tance in meters Field strengths from fixed RF transmitters as deter mined by an electromagnetic site survey should be less than the compliance level in each frequency range Interference may occur in the vicinity of equipment marked with the following symbol NOTE 1 At 80 MHz a
15. 4502 880 557 in the US 800 227 4414 Fax 1 203 488 9438 Fax 49 4502 880 559 custsrv casmed com mossa rod t online de sales casmed com techsrv casmed com www casmed com Please contact the distributor in the country of purchase if product information or service should be required Page 2 21 02 0193 REV 00 08 05 CAS 750C Monitor General Information A 21 02 0193 REV 00 08 05 This manual is an integral part of the product and describes its in tended use Observance of the manual is a prerequisite for proper product performance and correct operation and ensures patient and operator safety The symbol means ATTENTION Consult accompanying docu ments The warranty does not cover damages resulting from the use of accessories and consumables from other manufacturers CAS Medical Systems Inc is responsible for the effects on safety reliability and performance of the product only if e Assembly operations extensions readjustments modifica tions or repairs are carried out by persons authorized by CAS Medical Systems Inc e The electrical installation of the relevant room complies with the requirements of the appropriate regulations e The device is used in accordance with the instructions for use e All publications conform to the product specifications and ap plicable IEC publications on safety and essential performance of electro medical equipment as well as with applicable UL re qu
16. 60601 1 CAN CSA C22 2 No 601 1 CE marking according to Directive 93 42 EEC All units covered by U S patent 4 796 184 and 5 022 403 Other patents pending 21 02 0193 REV 00 08 05 CAS 750C Monitor Appendix Certificates Electronic Emissions and Immunity The Model 750C Monitor is intended for use in the electromagnetic environment specified below The customer or the user of the Model 750C Monitor should assure it is used in such an environment flicker emissions purposes Emissions Test Compliance Electromagnetic Environment RF emissions Group 1 The Model 750C Monitor uses RF energy only for its CISPR 11 internal function Therefore its RF emissions are very low and are not likely to cause any interference in nearby electronic equipment Ee Class B The Model 750C Monitor is suitable for use in all estab Harmonic emissions lishments including domestic establishments and those IEC 61000 3 2 Class B directly connected to the public low voltage power sup Voltage fluctuations Complies ply network that supplies buildings used for domestic 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 cov ered with synthetic material the relative humidity should be at
17. Be certain to consult manufacturers specifications to main tain safe operation Caution Leakage Current Test The interconnection of auxiliary equipment with this device may increase the total leakage current When interfacing with other equipment qualified biomedical engi neering personnel must perform a test for leakage current before using it with patients Serious injury or death could result if the leakage current exceeds applicable standards Caution Measurements may be affected in the presence of strong electromagnetic sources such as electro surgery equipment Note The CAS 750C Monitor is designed for continuous opera tion Note The CAS 750C Monitor is suitable for use in the presence of electro surgery Note The CAS 750C Monitor can remain connected to the patient during Cardio Defibrillation All applied parts are Type BF Defibril lation Proof The monitor has been designed to promote 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 Page 15 Safety CAS 750C Monitor Device Handling Warning To ensure patient safety do not place the monitor in any position that might cause it to fall on the patient Warning Do not lift the monitor by any sensor cable or line as they could disconnect from the monitor causing the monitor to fall on the patient Wa
18. Calibration Page 88 To check CO Calibration proceed as follows e Verify that the FilterLine supplied with the Calibration kit is firmly attached to the gas canister e Enter the Service menu as described on page 86 and follow the general instructions given there e Press the DOWN key until the parameter EtCO Check is selected e Press one of the NEXT keys to select the OFF set ting e Change the ECO Check setting from OFF to Con nect Gas e Connect the FilterLine to the monitor e The highlighted section should read Open 5 Gas e When the message Open 5 Gas appears press and hold open for 15 seconds the gas valve until the reading stabilizes e Verify the reading on the display to be 5 0 0 3 vol Note Calibration is not required if the measured value are the same as the concentration of the calibration gas 0 3 vol e Press one of the PREVIOUS keys to cancel the test and return to the EtCO2 Check menu selection e Disconnect the FilterLine from the monitor Should the monitor fail the EtCO2 Check it is recom mended to perform an EtCO Calibration or returning the monitor for service Note Perform the Calibration only after performing the Calibration Check Caution The Calibration must be performed with a manu facturer authorized Calibration Kit containing 5 COz 21 Oz Balance N2 gas tubing adapter and a calibration FilterLine A manufacturer approve
19. Intubated Appltcatons 59 GOs MOnMOri NG DEE 59 Removing the CO Consumables ssssessseseseeseeeseeereereeerreee 60 CO Display WiINdOW ssssssssssesseesseereeererersrerrteerteerterrrterreeerreereent 60 CO related Settings sitccingiiauech wii nciadiiceoas 61 CO Troubleshooting ss sessesssseseessnerrerrreertrerteereerrtterreeereeereeet 61 COz related messages cecceeeceecceeceeeeeeeeeeeeeeeeeeeeeeeeeeereeeeeees 61 6 NIBP 63 idee e OM EE 63 E 63 Pre Paratlons eege tee Steeg deeutadetestedesdernaadeaseeedhetes 65 Patient Mode Selection cccccccccccceccecssseececeesessaeaesseseeeeees 65 NIBP Hose Selection ccccccccccesecccceceeceesesseceeeesessaeaeeseseeeeess 65 Cuff Selecto EE 65 Cuff Appltcatton T E ES 66 NIBP Measurement ascensa ear e EEK 67 Starting a Blood Pressure Readmg 68 Stopping a Blood Pressure Readmg 68 Entering the Cycle Mode ccceseceseccceeeeeeeeeteeeeseteedenneeeeess 69 Terminating the Cycle Mode eeeeeeeeeeeeeeereeeeereeesereeene 69 HK Reie EE 69 Entering STAT dl e EE 70 Exiting SIAT EE 70 NIBP E EE EEN 70 21 02 0193 REV 00 08 05 Page 7 CAS 750C Monitor Page 8 NIBP Menu To enter the NIBP Menu Menu Options 00 e Operating the NIBP Menu NIBP related Settings NIBP Troubleshooting NIBP related Messages Setup Entering the Setup Menu Selecting the Language Selecting Patient Mode Configure Audio Silenc
20. Plug the battery charger s cord into the printer battery charger jack located on the rear panel e Plug the charger into an AC wall outlet of the appropri ate voltage e Verify the Charge LED is lit red Battery charge time is approximately 3 hours Once the battery is fully charged the Charge LED switches to green 21 02 0193 REV 00 08 05 Page 101 Printer CAS 750C Monitor Installing Paper Note A red line appears when the remaining supply of thermal paper becomes low e Switch the printer off e Press the Cover Open button to access the paper compartment Remove any remaining paper before in stalling the new roll e 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 e Close the paper door Figure 23 Paper Installation Note Make sure that the paper is correctly placed If it is tilted in one or another direction and does not come out straight from under the cover open the door and reposition the roll again Warning Do not touch the print head or paper cutter while replacing the printer paper Page 102 21 02 0193 REV 00 08 05 CAS 750C Monitor Printer Removing the Battery Pack Warning Do not operate the printer or connect it to the monitor with the battery pack is removed Warning Never change the battery pack while the battery charger is plugged in and or the monitor is being operated
21. Test 21 02 0193 REV 00 08 05 To perform a Calibration Check proceed as follows e Connect the NIBP inflation hose to the monitor without a cuff connected to the hose e Enter the Service menu as described on page 86 and follow the general instructions given there e Press the DOWN key until the parameter Manometer Mode is selected e Press one of the NEXT keys to move the cursor and begin the test The pressure in the pneumatic system is being displayed At this point it is 0 mmHg e Use the manometer inflation bulb to slowly inflate the system pausing for 30 seconds at the following points and verify calibration according to the following table OmmHg 1mmHg 50 mmHg 4mmHg 100 mmHg 4mmHg 150 mmHg 4 mmHg 200 mmHg 5 mmHg Page 91 Maintenance CAS 750C Monitor To test the Overpressure safety function proceed as fol lows e Inflate the pressure slowly until 290 mmHg 10 mmHg is reached The monitor s NIBP display should stop updating and the message OVER PRESS will be dis played Note The monitor needs to be serviced if it does not meet the test criteria PIC Voltage The monitor displays the DC voltage level being received by the PIC processor from the Power Supply Board To view the PIC Voltage level proceed as follows e Connect the monitor to an external power source AC Line power e Enter the Service menu as described on page 86 and follow the general instructions gi
22. and Neonate modes These sets and the factory defaults can be restored when needed Note Switching between Adult and Neonate mode automatically activates the most recently stored set for patient alarm limits of the appropriate type Alarm Limits Menu The Alarm Limits menu shows the actual settings of all alarm limits and allows changing them e Press the LIMITS key to enter this screen Note The information being displayed depends on the monitor configuration and patient specific data Note The monitor will automatically return to the Main screen if no key is pressed for 30 seconds Adult 1 SSpO2 PR SatSeconds EtCO2 RR No RESP SYS DIA Save Restore Figure 12 Alarm Limits Menu 1 SatSeconds Limit selection only available with Nellcor SpO2 oximetry option 21 02 0193 REV 00 08 05 Page 43 Alarms CAS 750C Monitor Page 44 Changing Alarm Limits The cursor is automatically positioned at the first item in the left column e Use the UP and DOWN keys to select the alarm limit that needs to be changed e Use the NEXT key to scroll to the next Low column or ad vance to the High column by pressing the key again e Use the UP or DOWN keys to increase or decrease the alarm limit value Note Several changes may be done in one session Use the PREVIOUS key to move the cursor back to the left column and re peat the steps as before e Press the RETURN key wh
23. disconnected from the monitor an Equipment Alarm is activated and the message No SpO Probe appears Press the ALARMS key to acknowledge the alarm SpO Display Window Oxygen Saturation SpO 2 and Pulse Rate PR are displayed in the green window at the upper right area of the Main screen Note The bar graph indicator is only presented if the SpO wave form is not displayed in one of the trace windows SpO gt related Settings 21 02 0193 REV 00 08 05 Access the Parameters menu as described on page 38 to review or change the following settings e SpOzTrace Speed selection Access the Alarm Limits menu as described on page 43 to review or change the following settings e SpO Alarm Limits Access the Audio Visual menu as described on page 39 to review or change the following settings e Beep Volume Page 53 GpC CAS 750C Monitor SpO2Troubleshooting Note If the accuracy of any measurement does not seem reason able first check the patient s vital signs by an alternate method Note The SpOz and related Pulse Rate numeric displays will show dashes and the signal strength window will be blank when no SpOz probe is attached to the monitor Note Inaccurate SpoO2 measurements may be caused by Anemia or low hemoglobin concentrations Electro surgical interference Excessive ambient light Excessive patient movement Incorrect sensor application or use Intravascular
24. dyes such as indocyanine green or methylene blue Moisture in the sensor Placement of a sensor on an extremity with a blood pressure cuff arterial catheter or intravascular line Venous pulsations Note The loss of a pulse signal can occur in any of the following situations Page 54 A blood pressure cuff is inflated on the same extremity as the one with the SpO sensor attached Excessive ambient light such as from a surgical lamp a bilirubin lamp or sunlight is present The patient has hypotension severe vasoconstriction severe anemia or hypothermia The patient is in cardiac arrest or is in shock The sensor is too tight There is arterial occlusion proximal to the sensor 21 02 0193 REV 00 08 05 CAS 750C Monitor SpO2 SpO gt 2 related Messages The following SpO related messages may occur Chk SpO2 Probe Note This message relates to Masimo technology only The monitor is questioning the quality of the signal being received by the SpO probe or the probe is receiving too much ambient light e Press the ALARMS key The monitor silences the audio alarm tone but the visual messages remain e Verify that the probe being used is the correct one for the moni tors SpO configuration e Replace a wrong or defective probe e Verify that the probe is being used according to the manufac turer s recommendations e Verify that the probe emitter and detector are parallel to and di rectly
25. e ECO Unit selection mmHg kPa or CO Troubleshooting Note If the accuracy of any measurement does not seem reason able first check the patient s vital signs by an alternate method CO2 related messages e Pressing the ALARMS key will silence the audio alarm tone for the following CO related messages Blocked Line The CO module has attempted to purge the line with no success e Disconnect the FilterLine e Check the FilterLine for kinks and or blockages Cal EtCO z The CO module s calibration timer has reached zero hours e Perform a CO calibration check Clearing Line The CO module has detected an occlusion and is attempting to purge the line e Check the FilterLine tube for kinks and or blockages Chk EtCO Flow The CO module has detected a blockage in the exhaust port e Check the exhaust port and associated tubing for kinks and blockages 21 02 0193 REV 00 08 05 Page 61 CO2 CAS 750C Monitor Page 62 EtCO2 Error A failure occurred on the CO Board e To reset the CO board turn the monitor off and disconnect it from external power AC Line or 12VDC Remove the battery and then reconnect the battery and external power Turn the monitor on e If the message remains the monitor needs to be serviced EtCO Module A failure occurred on the CO Board The monitor needs to be serviced EtCO2 OFF The CO module is no longer receiving a signal from the patient or the Fil
26. high blood pressure reading 21 02 0193 REV 00 08 05 Page 65 NIBP CAS 750C Monitor Length The edge of the cuff is marked with a white arrow It should fall within the white range marking when the cuff is applied to the patient Otherwise the cuff is too long or too short MAKE SURE THAT THIS ARROW IS WITHIN THIS AREA WHEN ON PATIENT Figure 13 Cuff Application Range Marker Note Overlapping the cuff will not affect the measurement results Cuff Application Measurements made above the level of the heart will give reduced blood pressure readings while measurements made below the heart level will give increased readings These errors are mainly due to the weight of the blood Figure 14 Cuff Application Page 66 21 02 0193 REV 00 08 05 CAS 750C Monitor NIBP CAS cuffs do not require an exact placement of the hose over the brachial artery The design of a fully encircling bladder ensures that the artery is properly compressed independent of the hose placement It can be placed in any position e Wrap the cuff for a snug fit to avoid prolonged pumping time Do not wrap a cuff over the patient s clothing e Verify the hook and loop sections of the cuff are fully engaged when it is wrapped around the limb e The limb should be positioned to be at heart level e Do not compress the cuff or the cuff hose The hose must not be kinked or pinched Warning The cuff should not be applied
27. longer function as intended Note When the Low Battery or Dead Battery message ap pears the monitor should be connected to an external power source A depleted battery may be fully recharged in 5 hours Note The monitor can remain in normal operation while the bat tery is charging During charging the case may feel warm to the touch Page 28 21 02 0193 REV 00 08 05 CAS 750C Monitor Basic Operation Connecting the Accessories Connect the various accessories to the appropriate input connec tor at the left side of the monitor Figure 5 Left Side View SpO2 Probe Connector NIBP Hose Connection CO Scavenger Exhaust Is MicroStream CO Input Connector 21 02 0193 REV 00 08 05 Page 29 Basic Operation CAS 750C Monitor Front Panel Controls SILENCE RESET Figure 6 Front Panel Controls Power Indicator Green Yellow Red POWER O On Standby ALARM Reset Silence Monitor operates on external power Monitor operates on battery power Low or dead battery Turns on the monitor e display Switches monitor to standby mode when press ed again When depressed once 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 acknowl edged along with the audio and visual shall be removed Starts
28. of CO at the end of exhalation EtCOz2 and the Respiratory Rate RR are measured The CO measurement is intended for use in any environment where continuous noninvasive monitoring is desired including hospital and mobile use when protected from excessive moisture such as direct rainfall It is intended for use on adult pediatric and infant neonatal patients It is intended for use on intubated and non intubated patients A CO library can be selected for educational viewing Refer to paragraph CO Library on page 39 Warning If uncertain about the accuracy of any measurement check the patient s vital signs by alternate means and then make sure the monitor is functioning correctly Warning When monitoring COz in the presence of flammable gases or anesthetics such as high concentrations of oxygen or ni trous oxide connect the gas outlet to a scavenger system Warning CO readings and respiratory rate can be affected by certain ambient environmental conditions sensor application er rors and certain patient conditions Caution Microstream consumables are latex free non sterile and non pyrogenic Caution During MRI scanning the monitor must be placed out side the MRI suite When the monitor is used outside the MRI suite CO2 monitoring can be implemented using the FilterLine XL Page 57 CO CAS 750C Monitor Preparations Caution Prior to patient monitoring ensure the monitor is confi
29. operate on a completely charged battery for 3 to 5 hours depending of its configuration and the use of the NIBP func tion 21 02 0193 REV 00 08 05 Page 27 Basic Operation CAS 750C Monitor Battery Status There are several means to get an indication about the battery charge status e When the monitor is connected to external power and turned off the Main screen displays the Battery Indicator icon with a moving bar from left to right within the indicator signifying the battery is being charged Once charged the moving bar will stop and the battery icon will be completely filled in e When the monitor is being powered from the battery the mov ing bar within the Battery Indicator icon will be moving from right to left signifying the battery is being discharged Caution Under various state and local laws it may be illegal to dispose of the battery into the municipal waste stream Check with your local authorities for instructions on recycling options in your area Battery Conditions The user will be alerted in case the battery charge level gets low e The Low Battery or Dead Battery message is displayed e The Power Indicator changes from orange to red e The Equipment Alarm LEDs are activated e An audible tone is generated Warning After approx 3 minutes in Dead Battery condition the monitor turns off and the patient is no longer being monitored Warning If the battery is not charged the monitor may no
30. opposing each other Low Perfusion Note This message relates to Masimo technology only The perfusion level being received by the SpO probe is low e Determine if an extreme change in the patient s physiology and blood flow at the monitoring site occurred e g an inflated blood pressure cuff a squeezing motion e Try to warm the patient or the probe site e Move probe to a site with better perfusion Low Signal IQ Note This message relates to Masimo technology only The quality of the signal level being received by the SpO probe is in question e Ensure proper probe type and application e Verify that the probe emitter and detector are parallel to and di rectly opposing each other e Clean or replace the probe Note When the message Low Perfusion or Low Signal IQ ap pear and the monitor is displaying valid SpO numerics no au dible or visual alarms will be generated In case the monitor is not displaying valid SpO 2 numerics an audible and visual alarm will be generated 21 02 0193 REV 00 08 05 Page 55 SpO2 CAS 750C Monitor Page 56 No SpO2z Probe The monitor is not detecting the SpO2 probe The probe was dis connected from either the Interface Cable or from the monitor e Press the ALARMS key The monitor silences the audio alarm tone but the visual messages remain e Reconnect probe to monitor Probe Error The SpOz probe being used is not the correct one for th
31. persists after setting the monitors clock then the monitor s internal clock battery needs to be replaced 21 02 0193 REV 00 08 05 Page 111 Appendix CAS 750C Monitor Monitor Configurations CAS 750C Models with AC Power Supply CAS 750C 2MS Oridion COz Masimo SpO gt z CAS 750C 2NL Oridion COz Nellcor SpO2 CAS 750C 3MS Oridion CO2 Masimo SpOz MAXNIBP CAS 750C 3NL Oridion CO Nellcor SpO2 MAXNIBP Table 2 CAS 750C Models with AC Power CAS 750C Models with 12 VDC Power Input CAS 750CM 2MS Oridion CO2 Masimo SpO2 CAS 750CM 2NL_ Oridion COz Nellcor SpO2 CAS 750CM 3MS Oridion CO Masimo SpO MAXNIBP CAS 750CM 3NL_ Oridion COs Nellcor SpO2 MAXNIBP Table 3 CAS 750C Models with DC Power Page 112 21 02 0193 REV 00 08 05 CAS 750C Monitor Appendix Monitor Configuration Record Monitor Model CAS b CAS BOCH Serial Number Installed Option Parameter a NIBP Main Screen Defaults Alarm Limit Defaults Parameters Adult Neonate High Low High Low SpO2 Pulse Rate CO Resp Rate No Resp Systolic Diastolic MAP Date 21 02 0193 REV 00 08 05 Unit Page 113 Appendix CAS 750C Monitor Specifications Oximetry Masimo SET Type Functional Oxygen Saturation Wavelengths Red 660
32. the Adult mode or 90 seconds in the Neonate mode An extremely long measurement can be due to a loose cuff high blood pressure or monitor re pumps e Repeat measurement e Try higher initial cuff pressure e f message consistently reappears try using another means to obtain patient s blood pressure Weak Signal The monitor did not detect any pulses during a NIBP measure ment e Check the fit of the cuff e Repeat measurement Page 74 21 02 0193 REV 00 08 05 CAS 750C Monitor Setup 7 Setup Configuring the Monitor Entering the Setup Menu The Setup menu shows all configuration options in a tabular form To enter the Setup menu proceed as follows e Press and hold the LIMITS and VOLUME keys while the moni tor is being turned on setup Language English Patient Adult Audio Silence 2 Minute Date 21 Mar 05 Time 11 26 DST OFF O2 Alarm Delay 10 Sec EtCO2 Units mmHg Background Dark Figure 16 Setup Menu The cursor is initially positioned at the first item in the left column e Use the UP and DOWN keys to select the item that needs to be changed e Use the NEXT key to move the cursor to the right column e Use the UP and DOWN key to scroll through the available op tions e Press the RETURN key to exit the Setup menu Note If no key is pressed for 60 seconds the monitor automati cally exits the Setup menu All changes will be saved and the monitor returns
33. to completely understand the patient s condition Warning Various patient or mechanical conditions may cause in accurate measurements These conditions include but are not limited to venous pulsations hypotension severe vasoconstric tion severe anemia hypothermia shock cardiac arrest sensor tension sensor placement on the same extremity as a blood pres sure cuff arterial catheter or intravascular line or arterial occlu sion proximal to the sensor Warning MRI Scanning Do not use oximetry sensors during magnetic resonance imaging MRI scanning Conducted current could cause burns Page 49 GpC CAS 750C Monitor SpO Sensors Page 50 Warning Do not expose probe detector to strong ambient light while monitoring a patient A poor signal may result Warning If a probe is damaged in anyway discontinue use im mediately Caution Cardiogreen and other intravascular dyes depending on the concentration may affect the accuracy of the oximeter meas urement Caution Significant levels of dysfunctional hemoglobins such as carboxyhemoglobin or methemoglobin may affect the accuracy of the measurement Caution Certain antibiotics such as the Sulfas can create high levels of methemoglobin Methemoglobin is unable to bind O and will absorb light similarly to reduced hemoglobin thus giving an ar tificially low SpOz Caution Reusable SpO sensors Prolonged monitoring may re quire changing
34. to the Main screen 21 02 0193 REV 00 08 05 Page 75 Setup CAS 750C Monitor Selecting the Language To select the monitor s language proceed as follows e Enter the Setup menu as described on page 75 and follow the general instructions given there e Press one of the NEXT keys to move the cursor to the next column to the right e Use the UP or DOWN keys to select the desired language Note Once a new language is selected all text in the Setup menu and in all other menus and screens will be displayed in that lan guage This may cause difficulties if an unknown language is se lected Selecting Patient Mode Caution Prior to patient monitoring ensure the monitor is config ured to the appropriate Patient mode To select the Patient mode proceed as follows e Enter the Setup menu as described on page 75 and follow the general instructions given there e Press the DOWN key until the parameter Patient is selected e Press one of the NEXT keys to move the cursor to the next column to the right e Use the UP or DOWN keys to select Adult or Neonate mode Or alternatively e Keep the UP keys pressed when the monitor is turned on to set the monitor to Adult mode e Keep the DOWN keys pressed when the monitor is turned on to set the monitor to Neonate mode The Patient mode is being displayed in the Equipment Message Window in the lower left area of the Main screen Note CO and NIBP functions
35. 12 LNOP DC 195 Adult digit reusable sensor 01 02 0251 LNOP Adt Adult single patient adhesive Sensor box of 20 01 02 0252 LNOP Adt Long Adult single patient adhesive Sensor long cable box of 20 01 02 0253 LNOP Pdt Pediatric Slender digit single patient adhesive Sensor box of 20 01 02 0254 LNOP Neo Neonatal single patient adhesive sensor box of 20 01 02 0255 LNOP NeoPt Neonatal preterm single patient adhesive sensor box of 20 01 02 0182 PC 04 Patient Cable 4 feet 01 02 0192 PC 08 Patient Cable 8 feet Nellcor SpO2 Accessories Catalog No Type Description 01 02 0179 DS 100A 01 02 0183 DOC 10 21 02 0193 REV 00 08 05 Durasensor DS 100A adult finger clip sensor OxiMax Patient Cable 10 feet Page 125 Appendix Capnography Accessories Page 126 Catalog No Type Description Microstream CO Consumables for intubated patients 01 02 0338 006324 FilterLine H infant neonate humid environments box of 25 01 02 0392 XS04624 FilterLine H adult pediatric humid environments box of 25 01 02 0290 XS04620 FilterLine adult pediatric box of 25 Microstream CO Consumables for non intubated patients 01 02 0329 007266 Smart CapnoLine pediatric box of 25 01 02 0294 007269 Smart CapnoLine Oz pediatric box of 25 01 02 0387 008177 CapnoLine H adult box of 25 01 02 0388 008178 CapnoLine H pediatric box of 25 01 02 0389 008179 CapnoLine H infant neonate box of 25 01 02 0
36. 2 0193 REV 00 08 05 CAS 750C Monitor NIBP Motion There was too much extremity motion for the monitor to accurately complete the NIBP measurement in 120 seconds Measurements can be obtained when there is limited extremity movement but the measurement time may be extended e Restrain patient extremity motion NIBP Cal Pressure calibration data corrupted within NIBP module Pressure module needs recalibration The monitor needs to be serviced NIBP Error A failure occurred on the NIBP board The monitor needs to be serviced NIBP Module A failure occurred on the NIBP board The monitor needs to be serviced Over Press Cuff pressure exceeded 290 mmHg in the Adult mode or 145 mmHg in the Neonate mode Very rapid squeezing of the cuff can cause this error e Repeat the measurement e If this message repeatedly occurs during normal use the moni tor must be serviced Range Error The systolic reading exceeds the measurement range of 255 mmHg in the Adult mode or 135 mmHg in the Neonate mode e Repeat measurement e If the message is displayed again use another method to measure the patient s blood pressure Signal Sat Signal Saturation or motion pulses too strong e Repeat measurement Limit patient activity the arm must be still and or relaxed 21 02 0193 REV 00 08 05 Page 73 NIBP CAS 750C Monitor Time Out The monitor was unable to complete a measurement within 120 seconds in
37. 390 008180 CapnoLine H O2 adult box of 25 01 02 0391 008181 CapnoLine H O2 pediatric box of 25 01 02 0330 008174 NIV Line nasal adult box of 25 01 02 0331 008175 NIV Line nasal pediatric box of 25 Other 01 02 0295 CO Gas Calibration Kit 21 02 0193 REV 00 08 05 CAS 750C Monitor CAS 750C Monitor Appendix Other Accessories and Options Catalog No Description 01 02 0395 01 02 0386 01 02 0385 01 02 0384 03 08 0386 03 08 0450 01 01 0047 01 02 0248 01 02 0172 01 02 0297 01 02 0173 01 02 0243 01 02 0174 01 02 0189 01 02 0181 01 02 0301 01 02 0188 28 02 0077 01 02 0266 01 02 0267 01 02 0268 21 02 0191 21 02 0193 REV 00 08 05 Replacement Power Cord U S A Replacement Power Cord European Replacement Power Cord Australian Replacement Power Cord U K DC Power Cable Monitor Battery Pack P9 Calibration Kit 500 ml Fixed Volume Cylinder Roll Stand with Basket Domestic Roll Stand with Basket International Swivel Mount Kit Universal Pole Mount Carry Bag Printer including Battery RS232 Cable Power Supply Roll of Paper and Manual Printer Bracket Attachment for 01 02 0172 Roll Stand Printer Bracket Attachment for 01 02 0297 Roll Stand Printer Battery Printer Paper one Roll Printer Power Supply Adapter Plug European Printer Power Supply Adapter Plug UK Printer Power Supply Adapter Plug Australian CAS 750 Service Manual Page 127
38. CAS 750C Multi Parameter Monitor 120 80 2 High SpO2 User s Manual e C 0086 CAS Menca Systems INC TECHNOLOGY APPLIED TO MEDICINE 21 02 0193 REV 00 08 05 CAS 750C Monitor Trademarks Trademarked names appear throughout this document Instead of inserting a trademark symbol with each mention of the trade marked name the publisher states that it is using the names only for editorial purposes and to the benefit of the trademark owner with no intention of improperly using that trademark Masimo SET is a registered trademark of Masimo Inc Possession or purchase of this device does not convey any ex press or implied license to use the device with replacement parts which would alone or in combination with this device fall within the scope of one or more of the patents relating to this device Nellcor and OxiMax are registered trademarks and SatSec onds is a trademark of Mallinckrodt Inc Microstream and FilterLine are registered trademarks of Oridion Medical 1987 LTD Q cas is a registered trademark of CAS Medical Systems Inc MAXNIBP Tuff Cuff Pedisphyg are registered trademarks and Safe Cuff is a trademark of CAS Medical Systems Inc Contact Addresses Corporate Office Representative in Europe CAS Medical Systems Inc mossaConsulting GmbH 44 East Industrial Road Bollbrugg 22 Branford CT 06405 23570 L beck U S A Germany Phone 1 203 488 6056 Phone 49
39. Data Note In between patients the previously stored data should be erased to avoid any potential misinterpretation of data Note Trend and Alarm History data are not erased at the same time Follow these steps to erase Alarm History data e Press the HISTORY key to access the Trend History screen e Then press and hold the HISTORY key for 2 seconds to enter the Alarm History screen e Press the NEXT key to move the cursor to the line labeled Erase No e Use the UP and DOWN key to scroll through the available op tions Select Erase Yes and press the HISTORY key The monitor erases all data in Alarm History and returns to the Trend History screen Note Turning the monitor off or disconnecting it from all power sources does not erase the History data 21 02 0193 REV 00 08 05 Page 37 Basic Operation CAS 750C Monitor Parameters Menu Page 38 The Parameters menu shows the settings of all parameters and al lows changing them e Press the PARAMETERS key to enter this menu Note The information being displayed depends on the monitor configuration and patient specific settings Note The monitor will automatically return to the Main screen if no key is pressed for 30 seconds Parameters mm Sec Trace 1 25 0 Trace 2 12 5 Trace 3 Print Speed 25 0 Print On Alarm tCO2 Scale tCO2 Print tCO2z Trace Figure 10 Parameters Menu The cursor position is initially at the fir
40. EV 00 08 05 CAS 750C Monitor SpOz Preparations Follow the instructions provided by the sensor manufacturer Ma simo or Nellcor and prepare for SpO2 monitoring as follows e Select a sensor that has the appropriate size for the patient s digit or extremity e Clean the surface of the probe before and after each patient use e Correctly position and attach the probe to the patient e Connect the sensor cable to the SpO gt patient cable e Verify a secure connection and gently tug on the patient cable connector e Plug the SpO patient cable into the SpO2 connector on the left side panel of the monitor Note The SpO gt 2 probe must be kept as motionless as possible to make a proper determination To minimize motion artifacts se cure the sensor cable independently from the sensor Tape may be used to secure the cable to the patient e g around the base of the finger Make sure that the tape being used does not restrict the blood flow SpO2 Monitoring Once the sensor has been attached to the patient and the cable to the monitor proceed as follows e Press the POWER key to turn the monitor on e If required configure the appropriate waveform to be displayed on the Main Screen e Verify the signal quality and strength with the help of the SpO2 waveform or the bar graph indicator e Wait for the monitor to determine the initial SpO2 and Pulse Rate values Caution Some sensors may not be approp
41. ITS BIA HISTORY Ge VOLUME Audio Visual 8 21 02 0193 REV 00 08 05 Page 107 Appendix CAS 750C Monitor A V DOWN Screen Indicators e Heart Beat Indicator GP Respiration Breath Indicator Battery Charge Level Indicator A Silence Indicator Bar Graph Indicator Symbols near Accessory Connections 4 x t Patient connections are Type BF K N Communication Port RS232 Connector SpO2 Pulse Oximeter Probe Input Connector MicroStream CO2 Input Connector gt CO Scavenger Exhaust Port MAI NIBP Hose and Cuff Connector Page 108 21 02 0193 REV 00 08 05 CAS 750C Monitor Appendix Symbols on Monitor or Printer A o IPX1 C 0086 J Z m At CAUTION read instructions before using Potential Equalization Post Protection against ingress of water The CE Mark and Notified Body Registration Number signify the device has met all essential requirements of European Medical Device Directive 93 42 EEC Alternating Current Symbol for DC power polarity Symbol for DC power Recycling suggested Class Il equipment Read instructions in Printer Manual Symbols on Packaging 6 D 21 02 0193 REV 00 08 05 Relative Humidity for Storage and Transport Storage and Transport Temperatures Page 109 Appendix CAS 750C Monitor Warranty Policy MONITORS CAS 750C CAS Medical Systems Inc warrants the monitor when new to be free from def
42. Monitor has been tested with specific parts of the system used within the Patient Environment These parts are e The CAS 750C Monitor e Appropriate Accessories as listed in section Accessories at the back of this manual e Line Cord e Citizen CMP 10 Mobile Printer e RS232 Interconnect Cable supplied with printer e AC Adapter Charger Model TRC 09 1100 M from Group West or equivalent Supplied with printer e rte ere ea e wm e e vm o e mm eo Figure 1 Patient Environment Monitor Electronics Classifications The CAS 750C Monitor monitor version with integrated AC Power Supply is a Class device The CAS 750CM Monitor monitor version with external DC Power Supply is a Class II device 21 02 0193 REV 00 08 05 Page 19 Safety CAS 750C Monitor Page 20 21 02 0193 REV 00 08 05 CAS 750C Monitor Basic Operation 2 Introduction 21 02 0193 REV 00 08 05 Basic Operations The CAS 750C Monitor is a pre configured monitor that can in clude the following measurement functions e Capnography CO2 e Pulse Oximetry SpOz e Non Invasive Blood Pressure NIBP The MicroStream Capnography provides continuous monitoring of the EtCO value and the Respiration Rate RR of intubated and non intubated patients The CO signal can be displayed as a waveform The Pulse Oximeter function continuously monitors and displays values for functional arterial hemoglobin satur
43. Nanometers Infrared 905 Nanometers Radiant Power 0 79mW maximum at 50 mA pulsed Measurement Range SpOz 0 100 Pulse Rate 25 240 BPM Accuracy SpO gt 2 Sensor Accuracy DC 195 70 100 2 digits 1 S D LNOP Adt LNOP Adt Long LNOP DCI LNOP DCSC LNOP DC1P LNOP DC150 LNOP Ear LNOP Padt Sensor Accuracy LNOP Neo 70 100 3 digits 1 S D LNOP Neo PT LNOP NeoPT L LNOP Neo L LNOP Inf L Pulse Rate 3 BPM Update of Numeric every 1 second Waveform Display Plethysmogram fixed for trace 1 Sweep Speeds 12 5 25 or 50 mm sec Patient Alarms High and low limits on SpOz adjustable High and low limits on Pulse Rate adjustable Alarm Delay 0 or 10 seconds Page 114 21 02 0193 REV 00 08 05 CAS 750C Monitor Appendix 21 02 0193 REV 00 08 05 Nellcor OxiMax Type Wavelengths Red Infrared Power Measurement Range Dep Pulse Rate Accuracy SpOsz Pulse Updated of Numerics Waveform Display Sweep Speeds Patient Alarms Alarm Delay Functional Oxygen Saturation 660 Nanometers 890 Nanometers Not exceeding 15 mW 1 100 20 240 BPM Sensor Accuracy MAX A 70 100 2 digits 1 S D MAX AL MAX N MAX P MAX MAX FAST Sensor Accuracy OxiCliq A 70 100 2 5 digits 1 S D OxiCliq OxiCliq N OxiCliq P Sensor Accuracy DS 100A 70 100 3 digits 1 S D D YS OXI A N OXI P I Sensor Accuracy D YS 70 100 3 5 digits 1 S D
44. OWN keys to select the desired row e Move the cursor to the right with the use of the NEXT keys e Use the UP and DOWN keys to select the desired function or setting 21 02 0193 REV 00 08 05 Page 71 NIBP CAS 750C Monitor NIBP related Settings Access the Parameters menu as described on page 38 to review or change the following settings e NIBP History selection for trace 3 Access the Alarm Limits menu as described on page 43 to review or change the following settings e NIBP Alarm limits NIBP Troubleshooting Note If the accuracy of any measurement does not seem reason able first check the patient s vital signs by an alternate method NIBP related Messages Pressing the ALARMS key will cause the following NIBP re lated messages to be removed from the display and silence the audio alarm tone Air Leak Air leak in the cuff the NIBP hose or in the internal pneumatic sys tem of the monitor Check that the cuff hose monitor connection is secure e Check cuff for leaks Do not use a known leaky cuff Appl Error Neonate cuff is detected in Adult Mode Check cuff Replace cuff or change operating mode Flow Error Stable cuff pressure cannot be maintained by the NIBP pneumatic system e Check the external tube for kinks Perform a Pneumatic Pressure Check as described on page 90 e Replace cuff Loose Cuff Cuff applied too loosely e Check cuff for proper fit on patient Page 72 21 0
45. a period of silence when pressed while no alarms are active The duration of the si lence period depends on its previously made configuration Note Press the key twice to enter a silence pe riod while an alarm is active The LED lighting scheme indicates the selected functionality Continuous 2 Minute audio silence Flashing 1s Permanent audio silence Page 30 21 02 0193 REV 00 08 05 CAS 750C Monitor Basic Operation oD 21 02 0193 REV 00 08 05 NIBP Start Initiates a NIBP measurement Stop Terminates any active NIBP measurement and immediately deflates the cuff NIBP Menu Activates the NIBP menu when pressed and held for 2 seconds RETURN Main Screen Returns to the Main screen when pressed while any other screen or menu is being displayed Freeze Freezes all traces when pressed while the Main screen is active Press again to un freeze Traces will un freeze automatically after 60 sec onds Print Activates a print of the actual screen content Traces Trend or Alarm History when key is pressed for 2 seconds Refer to paragraph Main Screen on page 33 for more informa tion PARAMETERS Activates the Parameters menu which provides an overview of parameters and screen layout settings and gives access to change these settings Refer to paragraph Parameters Menu on page 38 for more information LIMITS Activates the Alarm Limits menu which provides an overview o
46. all dashes Stopping a Blood Pressure Reading A blood Pressure Reading can be interrupted for any reason at any time e Pressing the NIBP key during an ongoing NIBP measurement will interrupt the measurement and immediately deflate the cuff 21 02 0193 REV 00 08 05 CAS 750C Monitor NIBP Entering the Cycle Mode If a cycle time is selected the monitor will automatically take blood pressure measurements at pre selected time intervals e Enter the NIBP Menu as described in this section on page 71 e Select the desired cycle time and return to the Main Screen by pressing the RETURN key The selected cycle time will be displayed in the NIBP window e Press the NIBP key to begin the first measurement The measurement results are displayed in the NIBP Numeric Area of the Main Screen until the end of the next Automatic measure ment or the start of the next Manual measurement If applicable the selected cycle time and the remaining time until the next measurement will be displayed as well Note If a measurement is desired between measurement cycles press the NIBP key After this measurement the monitor will con tinue the Automatic Cycle mode Terminating the Cycle Mode To return to the Manual NIBP mode proceed as follows e Enter the NIBP Menu as described in this section on page 71 e Change the NIBP Cycle entry back to Manual STAT Mode The monitor will take a series of automatically sta
47. and hold the ON OFF key for 1 second The Power LED illuminates green e To turn the printer off press and hold the ON OFF key The Power LED will illuminate red and change back to green When the LED illuminates green remove your finger from the key Note If the monitor is turned on and the printer is already on the CAS logo is printed automatically CAS MeDicaAL SYSTEMS Inc TECHNOLOGY APPLIED TO MEDICINE The CMP 10 Mobile Printer has an Auto Power Off feature If the monitor and printer become separated and during 10 minutes no data has been sent and the Line Feed LF key has not been pressed the printer will automatically shutoff The monitor periodically sends a wake up message to the printer that will disable the Auto Power Off feature 21 02 0193 REV 00 08 05 Page 99 Printer CAS 750C Monitor Page 100 Header Sample printouts of both Trend and Alarm Histories are shown below 750X Series Monitor 750X Series Monitor 27 Feb 04 15 48 27 Feb 04 15 48 Patient Patient Notes Notes Trend Hist Alarm Hist HR MN 02 PR CO2 RR HR MN Alarm 13335 98 59 38 16 13 39 High Sp02 98 13 35 NIBP 120 80 90 PR 59 13 36 98 59 38 16 13237 H Sp GG L 13 37 NIBP 112 78 89 PR 61 13 38 98 59 38 16 U3339 98 gt 59 38 L 13 39 NIBP 120 80 90 PR 58 13 40 98 59 38 16 Figure 21 History Sample Printouts Note The header information i
48. are affected by selecting Adult or Neonatal operating modes The factory default is the Adult mode Page 76 21 02 0193 REV 00 08 05 CAS 750C Monitor Setup Configure Audio Silencing The audio signal associated with patient alarms can be silenced by pressing the ALARM key The functionality of this key depends on the selected configuration To configure the monitor es silencing function proceed as follows e Enter the Setup menu as described on page 75 and follow the general instructions given there e Press the DOWN key until the parameter Audio Silence is se lected e Press one of the NEXT keys to move the cursor to the next column to the right e Use the UP or DOWN keys to select the desired option Select 2 Minute when the silence period should automatically terminate after 2 minutes Select Permanent when the silence period should continue per manently until it is terminated manually Warning In Permanent Silence mode the user is responsible to reactivating enabling the audio alarm signal by pressing the ALARMS key again Setting the Date To set the monitor s Date function proceed as follows e Enter the Setup menu as described on page 75 and follow the general instructions given there e Press the DOWN key until the parameter Date is selected e Press one of the NEXT keys to move the cursor to Day Month Year e Use the UP or DOWN keys to increase or decrease the va
49. ation SpOz and the pulse rate PR The dynamic pulse signal can be displayed as a waveform Plethysmogram or as a bar graph indicator The non invasive blood pressure measurement uses the oscil lometric method and applies for neonatal pediatric and adult pa tients The user can select between manual cycle or continuous STAT mode The monitor is equipped with a rechargeable battery pack and can be used independently from an external power source Page 21 Basic Operation CAS 750C Monitor Page 22 Front View NIBP Manual 120 80 uk 90 High SpOz Figure 2 Front View 21 02 0193 REV 00 08 05 CAS 750C Monitor Basic Operation Rear View THIS DEVICE TO SALE ON OR BY THE ORDER OF A PHYSICIAN U S PATENT 4 796 184 5 022 409 OTHER PATENTS PENDING C 0086 Figure 3 Rear View of Monitors M Version shown below Battery Compartment External Device Interface RS232 Receptacle for the AC power cord Fuse Compartment Receptacle for the 12 VDC cable Pe Ber en Bottom View Infrared Communication 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 collection device s Maximum distance is approximately 3 feet direct line of sight operation Serial Number Label The serial number labe
50. ch represents the most recent event e Press the DOWN key to scroll down back in time e Press the UP key to scroll up forward in time Printing Trend or Alarm History Page 36 To print the Trend or Alarm History data proceed as follows e Enter the Trend or Alarm History screen by pressing the HISTORY key e Press and hold the RETURN key for 2 seconds The message Printing appears in the Equipment Message Window Note Refer to section Printer for more information about the printer and a sample printout of the History screen 21 02 0193 REV 00 08 05 CAS 750C Monitor Basic Operation Erase Trend History Data Note In between patients the previously stored data should be erased to avoid any potential misinterpretation of data Note Trend and Alarm History data are not erased at the same time Follow these steps to erase Trend History data e Press the HISTORY key to access the Trend History screen e Press the NEXT key to move the cursor to the line labeled Erase No e Use the UP and DOWN key to scroll through the available op tions Select Erase Yes and press the HISTORY key The monitor erases all data in Trend History and returns to the Main screen Note If the monitor contained Alarm History data the monitor dis plays the Alarm History screen Note Turning the monitor off or disconnecting it from all power sources does not erase the History data Erase Alarm History
51. d Calibration Kit can be purchased from Scott Medical P N 03046530ORFBD 21 02 0193 REV 00 08 05 CAS 750C Monitor Maintenance 21 02 0193 REV 00 08 05 To perform a CO Calibration proceed as follows e Verify that the FilterLine supplied with the Calibration Kit is firmly attached to the gas canister e Enter the Service menu as described on page 86 and follow the general instructions given there e Press the DOWN key until the parameter EtCO Cal is selected e Press one of the NEXT keys to select the OFF set ting e Change the EtCO Cal setting from OFF to Connect Gas e Connect the FilterLine to the monitor e The highlighted section should read Open 5 Gas e When the message Open 5 Gas appears press and hold the gas valve until the message Remove Gas is displayed e The highlighted section should read Passed and two audible beeps should be heard when the calibration is completed e Verify the EtCO CAL Date and the Cal EtCO Hours have been updated The starting hours for Calibration are initially 1200 hours and then 4000 after that This timer is automatically reset to 4000 hours during the Calibration process as long as it has been more than 720 hours from the last calibration If this was less than 720 hours the timer does not reset e Press one of the PREVIOUS keys to cancel the test and return to the EtCO2 Cal menu selecti
52. del 750C Monitor as recom mended 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 d in meters can be estimated using the equation applicable to the frequency of the transmitter where P is the maximum output power rating of the transmitter in watts 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 Page 122 21 02 0193 REV 00 08 05 CAS 750C Monitor Appendix CE Marking Information Compliance The CAS750C patient monitors bear the CE mark CE 0086 indi cating conformity with the provisions of the Council Directive 93 42 EEC concerning medical devices and fulfills the essential requirements of Annex of this directive Exceptions None 21 02 0193 REV 00 08 05 Page 123 Appendix CAS 750C Monitor Accessories
53. e monitor s configuration e Press the ALARMS key The monitor silences the audio alarm tone but the visual messages remain e Verify the probe being used is the correct probe Pulse Search The monitor is searching for a Pulse signal This is normal at power up as the monitor searches for a pulse or the probe position may have changed e Check the probe site SpO2 Error A failure occurred on the SpO board The monitor needs to be serviced e Press the ALARMS key The monitor silences the audio alarm tone but the visual messages remain SpO2 Module A failure occurred on the Go board The monitor needs to be serviced e Press the ALARMS key The monitor silences the audio alarm tone but the visual messages remain SpO2 Probe OFF The monitor is no longer receiving a patient signal from the SpO2 probe The probe is no longer in contact with the patient e Press the ALARMS key The monitor silences the audio alarm tone but the visual messages remain e Check if probe is properly applied to the patient e Check if probe cable is connected to extension cable e Check if cable is attached to monitor e Replace probe and or cable 21 02 0193 REV 00 08 05 CAS 750C Monitor COz Introduction Safety 21 02 0193 REV 00 08 05 CO Capnography The monitor uses Microstream non dispersive infrared NDIR spectroscopy to continuously measure the amount of CO during every breath The amount
54. e quarter turn to make sure the con nection is not leaking This is essential for the test to be performed e Enter the Service menu as described on page 86 and follow the general instructions given there e Press the DOWN key until the parameter Pneumatic Test is selected e Press one of the NEXT keys to move the cursor and begin the test The monitor starts to pressurize the pneumatic system to approximately 180 mmHg and attempts to hold this pres sure The pressure value will be displayed for about 15 seconds At the completion of a successful Pressure Check the message Passed will display and the monitor will beep two times 21 02 0193 REV 00 08 05 CAS 750C Monitor Maintenance If the monitor fails the Pressure Check the message Failed will be displayed and the monitor will beep three times e Press one of the PREVIOUS keys to exit and return to the Pneumatic Test selection Caution Should the monitor fail the Pneumatic Pressure Check the test should be repeated Instead of blocking the inflation hose with the male Luer plug a 500 ml volume should be connected Obtain a fixed volume 500 ml Pres sure Cylinder from CAS part number 01 02 0248 e Remove the LUER plug from the end of the air hose and connect the 500 ml Pressure Cylinder instead Should the monitor fail the Pneumatic Pressure Check with the 500 ml attached it needs to be serviced Calibration Check and Overpressure
55. eal tube Caution Loose or damaged connections may compromise venti lation or cause an inaccurate measurement of respiratory gases Securely connect all components and check connections for leaks Note Ensure the consumable is not twisted or crimped Note During nebulization or suction when not using closed suc tion system in order to avoid moisture buildup and FilterLine oc clusion disconnect the Airway Adapter from the patient s endotra cheal tube CO Monitoring 21 02 0193 REV 00 08 05 Once the appropriate consumable has been applied to the patient proceed as follows e Press the POWER key to turn the monitor on Page 59 CO CAS 750C Monitor Note While the CO module is initializing typically 30 to 40 sec onds the monitor shall display the message CO Warm Up and dashes will remain in the numeric section e Check that the monitor is accurately detecting the CO signal and wait for the monitor to determine the initial EtCO2 and Res piration Rate values e Ifthe lung visual indicator is not corresponding to the patient s respiration reposition the sensor until the indicators flash in synch with the patient s breathing This will help to minimize false alarms Check the alarm limits and configure them appropriately for the patient Refer to paragraph Alarm Limits Menu on page 43 Removing the CO2 Consumables When CO monitoring is no longer required disco
56. eaning solu tion directly onto the monitor e Housing As needed clean the monitor using a soft cloth dampened with a mild dishwashing detergent so lution and gently rub the soiled area until clean Use a clean soft cloth to dry the monitor e Display Clean the display window using a soft lint free cloth sprayed with an alcohol free glass cleaner The use of paper towels is not recommended as it may scratch the surface e Disinfections The monitor surfaces may be disin fected 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 Page 81 Cleaning CAS 750C Monitor 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 Cleaning Cuffs and Pneumatic Hoses Prior to each patient use inspect the blood pressure cuff and the pneumatic hose for damage e Tuff Cuff Clean the cuff using a soft cloth dampened with a 70 Isopropyl Alcohol solution The cuff should be allowed to thoroughly dry before use e Safe Cuff Clean the cuff using a soft cloth dampened with a soap water based detergent or chlorinated disin fectant solution Do not use alcohol e Pedisphyg Cuffs A water based detergent
57. easured parameters as SpO2 PR CO and RR are stored as one minute averages Sporadically measured NIBP readings and alarm events are stored as they occur Note Turning the power off does not clear the stored data The stored data will remain in memory for 24 hours Older data is de leted automatically It is suggested to manually clear History Data between patients Refer to paragraph Erase Trend History Data on page 37 Note The monitor uses an internal Real Time Clock to time stamp all entries Changes made to either the time or date settings should be performed in between patients being monitored Note The information being displayed depends on the monitor configuration and patient specific data History data is presented in two screens the Trend History and Alarm History screen e Once the History screen has been displayed press and hold the HISTORY key for 2 seconds to toggle between the Trend History and the Alarm History screens e Press the RETURN key to exit from the History screen Note If no key is pressed for 30 seconds the monitor will auto matically exit to the Main screen 21 02 0193 REV 00 08 05 CAS 750C Monitor Basic Operation Trend History 21 02 0193 REV 00 08 05 The Trend History screen shows patient data in a tabular form All continuously monitored parameters are listed as 1 minutes aver age values Each line represents one minute Sporadically meas ured NIBP parameter
58. ects 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 ninety 90 days on non disposable accessories and certain components consisting of reusable SpO sensors and other accessories provided by CAS as part of the original pur chase CAS warrants blood pressure cuffs and disposable or single patient use products for out of box failure only Where the accessory is not a CAS manufactured product the manufac turers own warranty conditions apply CAS reserves the right to perform warranty service operations in its own factory at an author ized 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 at tachments other than CAS Masimo Nellcor and Oridion manufactured accessories or at tachments is not covered by this warranty ACCESSORIES BATTERIES CUFFS AND CERTAIN COMPONENTS In all cases policy applies from date of purchase from CAS or its authorized distrib
59. en power on red green blinking fast end of paper red green blinking slow print head overheated Infrared IrDA port RS 232 serial interface Power ON OFF key Line Feed key Paper Cover Release Button press down to open cover Paper Cutting Edge Paper Cover aes ae ee o Printer Operation Direct Connection The monitor uses the DB9 connector located on the rear panel of the monitor to interface to the RS232 port on the Citizen CMP 10 Mobile Printer Use the cable which is supplied with the printer Note When using the direct connect method connect the printer s serial cable to the printer before turning the printer on Page 98 21 02 0193 REV 00 08 05 CAS 750C Monitor Printer Infrared Connection Note When using the infrared port disconnect the printer serial cable from the printer before turning the printer on Position the printer s infrared port window in line with the infrared window of the monitor Note When using the Infrared port it is important to keep the two devices close together less than three feet one meter and in line to maintain proper communications The monitor can perform a communication test to verify the In frared connection Refer to paragraph IrDA Test on page87 Note When using the IrDA port for printing it is recom mended to keep all items clear of the communications path between the monitor and the printer e To turn the printer on press
60. en CPAP Bi PAP or NPPV mask and to avoid intubation during EMS transport Select the appropriate CapnoLine and connect it to the monitor before attaching it to the patient s airway Be sure to follow Micro stream CO Consumables Directions for Use for proper connec tion 21 02 0193 REV 00 08 05 CAS 750C Monitor COz Caution Loose or damaged connections may compromise venti lation or cause an inaccurate measurement of respiratory gases Securely connect all components and check connections for leaks Warning Carefully route the CapnoLine to reduce the possibility of patient entanglement or strangulation Note Ensure the CapnoLine is not twisted or crimped and the cannula tips are in the nostrils Note If the CapnoLine includes an additional oxygen connection connect the oxygen connector to the standard outlet Intubated Applications For intubated patients the continuous gas sampling is taken from the Airway Adapter directly at the intubation tube The following consumables are available e FilterLine set for non humid environments e FilterLine H set for humid environments Select the appropriate FilterLine and connect it to the monitor be fore attaching it to the patient s airway Be sure to follow Micro stream CO2 Consumables Directions for Use for proper connec tion Warning When used with closed suction system do not place the airway adapter between the suction catheter and endotrach
61. en finished The monitor returns to the Main screen all changes will become effective immediately and remain valid until the monitor is turned off Saving Alarm Limits To save the alarm limit changes proceed as follows e Use the DOWN key and move the cursor to the Save posi tion e Use the NEXT key and move the cursor to the No position e Use the UP or DOWN keys and select the appropriate alarm limit set Adult 1 or Adult 2 for saving Note Saving options will be Neo 1 and Neo 2 when the monitor is in Neonate mode e Press the LIMITS key to start the saving process The message Saving appears and the alarm limit values will be stored in memory If a second set of alarm limits is required repeat these steps and save the changes under a different name e g Adult 2 or Neo 2 e Press the RETURN key when finished The monitor returns to the Main screen all changes will become effective immediately and remain valid until alarm limits changed manually or a different set of alarm limits is selected 21 02 0193 REV 00 08 05 CAS 750C Monitor Alarms Restore Alarm Limits To restore a set of alarm limits proceed as follows e Use the DOWN key and move the cursor to the Restore posi tion e Use the NEXT key and move the cursor to the No position e Use the UP or DOWN keys and select the appropriate alarm limit set Factory
62. ess the NIBP key to terminate the current NIBP measure ment e Enter the NIBP Menu as described in this section on page 71 e Select STAT mode OFF NIBP Display Window NIBP Manual mmHg The NIBP numeric values SYS DIA and MAP are displayed in 1 20 80 90 the blue window at the lower center of the Main screen NIBP Manual Note The monitor may be configured to display the Pulse Rate PR instead of the Mean Arterial Pressure MAP Page 70 21 02 0193 REV 00 08 05 CAS 750C Monitor NIBP NIBP Menu To enter the NIBP Menu Press and hold the NIBP key for 2 seconds to access the NIBP menu The following screen will be displayed NIBP nit Inf STAT MAP PR Figure 15 NIBP Menu Note While in the NIBP menu and no key is pressed for 30 sec onds the monitor will automatically save all changes made and re turn to the Main Screen Menu Options The NIBP menu allows the user to e Select the cycle time Available selections are Manual 1 2 3 4 5 10 15 30 60 or 90 Minutes e Select the initial Inflation Pressure for the next NIBP measure ment Available selections are Neonate mode 60 80 85 100 or 120 mmHg Adult mode 80 100 120 140 150 160 180 or 200 mmHg e Select the STAT mode to be OFF or ON e Select MAP or Pulse Rate to be displayed in the NIBP display window Operating the NIBP Menu To change settings proceed as follows e Use the UP and D
63. f all actual limit settings and gives access to change save and restore alarm limits Refer to section Alarms starting on page 41 for more information HISTORY Activates the Trend History and the Alarm History screen Gives access to erase History data Refer to paragraph History Screens on page 34 for more information Page 31 Basic Operation CAS 750C Monitor Gi D so ru A V INDICATORS Activates the Audio Visual menu that allows configure the audio and visual signals the monitor can generate Refer to paragraph Audio Visual Menu on page 39 for more information UP Moves cursor upward or scrolls through menu options press and hold for quicker advance Sets patient mode to Adult when pressed and hold while the moni tor is being turned on DOWN Moves cursor downward or scrolls through menu options press and hold for quicker advance Sets patient mode to Neonate when pressed and hold while the monitor is being turned on NEXT Function In the menus The HISTORY and INDICATORS keys are pro grammed to advance horizontally to the next parameter selection PREVIOUS Function Page 32 In the menus The PARAMETERS and LIMITS keys are pro grammed to move backwards horizontally to the previous pa rameter selection 21 02 0193 REV 00 08 05 CAS 750C Monitor Basic Operation Main Screen Note When switching from the Main screen to any other screen or menu
64. ffice to arrange for the pickup of the damaged items Save the damaged shipping carton as evidence Contact your distributor CAS sales representative or call CAS Medical Systems Inc to report external damage and to arrange for repair or replacement of damaged equipment The shipping carton should contain the items listed below Un pack the monitor and account for each item Inspect each item for signs of external damage dents cracks scratches etc If an item is missing or damaged contact your distributor CAS sales repre sentative or CAS Medical Systems Inc Record the monitor model serial number and date of purchase at the back of this manual Monitor Checklist e 1 CAS 750C Monitor e 1 Hospital Grade AC Power Cord or DC Power Cord Depending on model ordered 1 SpOz Interconnect Cable 1 SpOz Finger Sensor e 2 FilterLine Set Adult Pediatric 2 Smart CapnoLine Adult 1 Ten 10 Foot Coiled Inflation Hose For models with NIBP installed e 1 Tuff Cuff Blood Pressure Cuffs Adult For models with NIBP installed e 1 Tuff Cuff Blood Pressure Cuffs Child For models with NIBP installed e 1 P9 Calibration Kit For models with NIBP installed e 1 CAS 750C Monitor User s Manual Note The monitor is shipped with the appropriate line cord for the country and or voltage being used Page 18 21 02 0193 REV 00 08 05 CAS 750C Monitor Safety Patient Environment The CAS 750C
65. g ured to the appropriate patient mode Neonate or Adult Refer to paragraph Selecting Patient Mode on page 76 Microstream CO2 Consumables Note The Microstream CO technology requires the use of Micro stream consumables No other manufacturer s products should be used Refer to paragraph Capnography Accessories on page 126 for CO consumable types and order information When choosing CO consumables for a particular patient the fol lowing should be considered e Intubated or non intubated e Whether the patient is on mechanical ventilation e Duration of use e Patient s size and weight Caution Before use carefully read the Directions for Use that is enclosed with the Microstream consumable Caution Microstream consumables are designed for single pa tient use and are not to be reprocessed Warning Do not attempt to disinfect or flush the FilterLine as the monitor can be damaged Non Intubated Application Page 58 For non intubated patients the continuous gas sampling is taken from the patient s nose and or mouth The following consumables are available e CapnoLine Cannula with nasal patient adapter e Smart CapnoLine Oral Nasal Cannula for use in procedural sedation Also available with Oz delivery e CapnoLine H for use in ICU for patients receiving hi flow oxygen by mask or on long term CPAP or Bi PAP Also avail able with O delivery e NlIV Line for use under oxyg
66. he Service menu as described on page 86 and follow the general instructions given there e Change the IrDA Test setting from OFF to ON The message Printing will be displayed in the Equipment Message Window When the Infrared windows are prop erly positioned the printer will begin to print a series of A characters The test will continue for 60 seconds or can be terminated by the user e Press one of the PREVIOUS keys to cancel the test and return to the IrDA Test menu selection CO Calibration Check 21 02 0193 REV 00 08 05 The CO Calibration Check is a tool to verify proper calibra tion of the CO parameter Caution Do not perform a CO Calibration Check when the monitor is in normal measuring mode This mode cor rects the CO value for BTPS Body Temperature Pres sure Saturation which assumes that alveolar gases are saturated with water vapor The Calibration Check mode disables this correction Caution The Calibration Check must be performed with a manufacturer authorized Calibration Kit containing 5 COz2 21 O2 Balance N2 gas tubing adapter and a cali bration filter line A manufacturer approved Calibration Kit can be purchased from Scott Medical P N 0304653ORFBD Note The Calibration Check should be performed only af ter the CO module has been operating for at least 20 min utes in a normal operating mode Page 87 Maintenance CAS 750C Monitor CO
67. he new Battery Pack 104 11 External Device Interfacing 105 RS232 EE 105 e leit BE 106 12 Appendix 107 Seege 107 Front Panel Zawtplbele 2 ggegeedegerne oer tierskewenn ae aerer 107 Screen Indicators geckegt eege EES eteacceme eden eee 108 Symbols near Accessory Connections ceeeeeeeeeeeeteeees 108 Symbols on Monitor or Printer s e 109 Symbols on Packaging E 109 Warranty Polity iceri eio aii a Ree E 110 Monitor Error Messages ccccceceeeeeccceeeeeeeeesesseeseeeeeeeeneeeces 111 Monitor Configurations Gerd deEEe geet deer 112 CAS 750C Models with AC Power Gupphy 112 CAS 750C Models with 12 VDC Power Input 112 Monitor Configuration Record 2 ccc ccccecceeeseeeeneecrteeeeeeeeennens 113 21 02 0193 REV 00 08 05 Page 9 CAS 750C Monitor Page 10 el geed TE 114 COPING ALES tai eet tliat ere EE ee 121 Electronic Emissions and IMmunity ssssssssnesseeesrerrrrerrerreeene 121 CE Marking Information 0 cceeceeeeeeeeeeeeeeeeeeeeeeeeeeeeeeees 123 ACCESSOSIES euer gedoen e dE Aeneas 124 Tuff Cuff Blood Pressure Cuffs oeonnnnnesnnusennnnennrnserrrrena 124 Safe Cuff Blood Pressure Cuffe 124 Pedisphyg Blood Pressure Cuffs eceeeeeeeeeeeeeeeeeennenaees 124 Inflatiohs HOSES E AA 124 Masimo SpOz ACcessories 125 Nellcor SpOz Accessories cccccecccceccaeeeeseeceeeeeessaseeeseeeeees 125 Capnography Accessories eeeeeeeeeeieeeeereee rerere
68. ilence Period Note When a Silence Period is being entered the monitor will not generate an audible signal for patient or equipment alarms with the exception of Low Battery and Dead Battery conditions No alarm active Pressing the ALARMS key will immediately activate a Silence Pe riod Alarm is active Pressing the ALARMS key will only acknowledge the active alarm and disable the audio signal for 15 seconds A second keystroke is required to activate a Silence Period Silence Indication The duration of the Silence Period can be selected in the monitors Configuration menu Refer to paragraph Configure Audio Silenc ing on page 77 for more information Depending on the selection made the indication for a Silence Period will be as following Silence Period is set to 2 Minute e The Silence Indicator will illuminate continuously e The message 2 Minute will be displayed in the Equipment Message Window e The Silence Period will be terminated automatically after 2 minutes Silence Period is set to Permanent e The Silence Indicator will flash 1 second on 1 second off e The message Permanent will be displayed in the Equipment Message Window e To re activate the audio alarm the ALARMS key has to be pressed manually Page 42 21 02 0193 REV 00 08 05 CAS 750C Monitor Alarms Alarm Limits The monitor can store two independent sets of alarm limit values for both Adult
69. ing Setting the Date REENEN Setting the Time ee Daylight Saving Time Option Selecting Alarm Delay Selecting CO Units ee Selecting Display Background Cleaning Cleaning the Monitor Cleaning Cuffs and Pneumatic Hoses Cleaning SpO Sensors Cleaning CO Consumables Cleaning the Printer 01aeeeeenn Maintenance Maintenance Intervals Maintenance Checks Entering the Service Menu Exiting the Service Menu WDA T6Sti nif acct Eed CO Calibration Check CO Calibration c 21 02 0193 REV 00 08 05 CAS 750C Monitor NIB Geer 90 Pneumatic Pressure Check 22 ccccceeseeeecccceeeeeeeeteeseneeeee 90 Calibration Check and Overpressure Test 91 PIC VON EE 92 Battery Replacement EE 93 Removing the Battery ccceeceeecececeeeeeeeeeeeeeeneeeeeeeeeeeenees 93 Inserting the eege ge 94 Fuse Replacement ccccccceccceccceccccecceeeceeeceeeeeeeeeeeeeeeesaeeaaeanas 94 eg EE 95 Storage ge ee dereen EE 96 10 Printer 97 Printer Controls and Indicators eeeeeeeeeeeeseeeeeeeeerneeeererrrreneeeeee 98 Printer Operation ccccccccccsccceecceeeeaeeeeeeaaeeaaaeeaaeaaaeeaaeeaaeeaaeeaea 98 RI Connection EE 98 Infrared Connection EE 99 Charging the Printer Battery 2 ccccc eeecneceeeeeseneecereneeeeeeees 101 Installing Pape inann enigni RN E A aaa te 102 Removing the Battery Pack aeeekkEKRRRSEEEREEEEEEEEEEEERRRNE ee 103 Installing t
70. ions Think of SatSeconds as the product of magnitude and time a patient exceeds SpO alarm lim its For example 3 points below the alarm limit for 10 seconds equals 30 SatSeconds An alarm is only triggered if a desatura tion event occurs that reaches the SatSeconds limit you selected As a safety net when three or more SpO gt alarm violations occur within 60 seconds an alarm will sound even if the SatSeconds limit has not been reached To activate the SatSeconds function proceed as follows e Press the LIMITS key to enter the Alarm Limits menu e Use the DOWN key to select SatSeconds e Use the NEXT key to scroll to the next column to the right e Use the UP or DOWN keys to increase or decrease the Sat Seconds value e Press the RETURN key when finished All changes will be saved and become immediately effective Note When SatSeconds is set to OFF the alarm delay for SpOz is based on the current configuration Refer to paragraph Selecting Alarm Delay on page 79 21 02 0193 REV 00 08 05 CAS 750C Monitor SpO2 Disconnecting SpOz2 Accessories When SpOz monitoring is not required disconnect the patient ca ble from the monitor by squeezing the tabs with your thumb and index finger while pulling the connector away from the monitor Note To avoid damage to the Interface Cable always hold it by the connector rather than the cable when connecting or discon necting either end When the probe is
71. irements and AHA recommendations valid at the time of printing For complete Warranty information refer to the Warranty Policy located on page 110 The CAS Medical System Inc quality management system com plies with the international standards ISO 13485 and the Council Directive on Medical Devices 93 42 EEC Note The information in this manual applies only to the CAS 750C software version 2 2 It does not apply to earlier software versions Note Due to continuing product innovation specifications in this manual are subject to change without notice In the U S the following caution applies Caution Federal law restricts this device to sale by or on the or der of a physician or properly licensed practitioner Warning Before using the monitor for the first time please read the information given in section Safety starting on page 13 Page 3 CAS 750C Monitor Page 4 About this Manual Manual Purpose Note This manual addresses all parameters a CAS 750C Monitor can have installed It remains suitable for use if the monitor has a sub set of parameters only Please refer to those sections that are applicable for the model in use This manual contains the instructions necessary to operate the CAS 750C monitor safely and in accordance with its functions and intended use Intended Audience Conventions Revision History This manual is written for clinical professionals Clinical profes siona
72. is play the software versions Versions DSP Software Lang Flash BOOT 22 2 PLC 1 0 1 Masimo Sp02 S Oridion EtCO2 2 00 CAS ND 1 0 Unit S N 0503123 Figure 19 Software Versions 1 Installed SpO2z technology may be Masimo SpOz or Nellcor Go 2 The NIBP module is optional in the case when it is not installed no text message is shown 21 02 0193 REV 00 08 05 Page 95 Maintenance CAS 750C Monitor e Press the RETURN key to exit and return to the Main screen Note If no key is pressed for 60 seconds the monitor will automatically exit the Versions menu and return to the Main screen Storage Refer to paragraph Operating Environment on page 119 for storage temperature information Warning If it becomes necessary to store the monitor for longer than 6 months remove the monitor s battery pack and place the monitor in its original packing container if available Note Batteries not charged and left in storage for more than six months could degrade and not recharge to full ca pacity Page 96 21 02 0193 REV 00 08 05 CAS 750C Monitor Printer 10 Printer For more detailed information on the Citizen Model CMP 10 Mobile Printer refer to the User s Manual that was sup plied with the printer Warning The CAS 750C Monitor has been tested with the Citizen CMP 10 Mobile printer to comply with IEC 60601 1 1 and is the only printer that
73. is recommended to be used with the monitor If another printer is to be used the user must read the Caution Leakage Current Test on page 15 and follow the guidance given The Citizen CMP 10 Mobile Printer interfaces to the moni tor via an Infrared 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 monitor Caution For safe and proper usage of the external printer please observe the following e Avoid places where fluid may enter the printer opening accidentally e Avoid places subject to high or low temperature ex tremes e Avoid dusty places and where corrosive gasses are generated e Never attempt to dismantle or repair the printer mecha nism e Do not drop or bump the printer When handling the thermal paper e Store in a dark cool and dry place e Do not place near organic solvents e Avoid contact with vinyl chloride films erasers or adhe sive tapes for extended periods e Avoid exposure to high temperature humidity liquid or sunlight e Always use specified thermal paper Refer to Other Accessories and Options on page 127 for order infor mation 21 02 0193 REV 00 08 05 Page 97 Printer CAS 750C Monitor Printer Controls and Indicators Figure 20 Printer Controls and Indicators 1 Charge LED red charging green fully charged 2 Power LED gre
74. is selected and applied to the patient proceed with the following steps e Connect the cuff to the end of the NIBP hose and make sure the hose is connected to the NIBP connector on left side of the monitor Starting a Blood Pressure Reading Caution Excessive motion can contribute to inaccurate meas urements It is important that the patient be kept still during a measurement Make every attempt to alleviate patient s fear anxiety and pain Note The NIBP key will start a NIBP measurement regardless of the type of screen that is currently displayed The monitor will switch to the Main screen if this is not already on display e To select an alternate Initial Inflation Pressure enter the NIBP menu as described in this section on page 71 e Press the NIBP key to start a measurement The cuff inflation pressure will be displayed until the measurement is completed The measurement typically takes less than 30 seconds to com plete In no case will the cuff remain pressurized for more than 120 seconds for Adult Pediatric patients and no more than 90 sec onds for Neonates When the measurement is completed the cuff will automatically deflate the monitor will provide an audio indication and display the NIBP values Systolic Diastolic and MAP or Systolic Diastolic and Pulse Rate Note If any displayed NIBP measurement were to be left on the screen for up to 24 hours the monitor will automatically blank the NIBP displays to
75. is suitable for wiping the cuff A damp detergent free cloth should then be used to rinse the cuff e Pneumatic Hose Clean the pneumatic tubing using a soft cloth dampened with a germicidal solution Note It is not recommend submersing the cuff or hose Liquid should not be permitted to enter the cuff bladder or hose because instrument damage may occur Cuffs and hoses should be allowed to thoroughly dry before use Cleaning SpO2 Sensors Caution Do not soak or immerse the sensor or its cable in any liquid solution Do not attempt to sterilize it Refer to the Directions For Use pamphlet enclosed with each sensor for more information e Clean the SpO sensors with a soft cloth dampened with 70 Isopropyl alcohol solution Allow the sensor to dry prior to placement on a patient Cleaning CO2 Consumables Microstream CO consumables are designed for single pa tient use and are not to be reprocessed Caution Do not attempt to disinfect or flush the FilterLine as the monitor can be damaged Page 82 21 02 0193 REV 00 08 05 CAS 750C Monitor Cleaning Cleaning the Printer 21 02 0193 REV 00 08 05 Refer to the printer User s Manual for more information Caution Before cleaning the printer disconnect the AC adapter e Wipe with a soft dry cloth To remove extreme dirt buildup e Soak a cloth with mild detergent wring well and wipe Dry by wiping with a soft dry cloth Caution Do not use vola
76. l Information 3 About this Manual 4 Manual Purpose sira e a a a a a 4 Intended Audience uu cece cccecceeeeceeceeeueeeeceseueueeeeueeeeeeseeseanenes 4 ele EN le EE EE 4 PROVISION PISUOM E 4 1 Safety 13 Indications for USE aaae aa a aa iea iaar aeaa Tad 13 ei Elle le TEEN 13 Installation ANd Setup ccccccccccccecccececececeeeeeeeeeeeeeeeeeeeeeeeeeeeeeas 14 Device TUNING E 16 EE 17 IO ele Tei Te DN 17 Initial INSPECUON sects vec erent rsiecteretier es Eed ebgeded ees 18 Monitor Checker 18 Patient Environment 19 Monitor Electronics Classifications cccccccceccseeeseueessuueeeune sees 19 2 Basic Operations 21 little ter e BEE 21 FrONt ViCW ac taki tart E ATATA AAT EE Et ee 22 ROAR VICW EG 23 21011160 EE 23 Infrared Communication Port 23 Serial Number Label 23 Eden E 25 Site Requirements cceccccecccecceeeeeeeeeeeeeeeeeeeeeeeeeeseeeseeeeeees 25 Power Requirements ceceeeeseeeseeeeeeeeeeeneeeseeeseesseesneeees 25 Turning the Monitor Oni scisscc tere eannemnmond 26 Turning the Monitor Off scseccssccxsdecvedecnechacthcartewtabatneteedeiebacineacease 27 Power Fail Message 2 c c ccccereeeeeeeseeseccteeseneeeseneecenee 27 Battery Operation EE 27 Se 28 Battery Conditions ergeet Eeer 28 21 02 0193 REV 00 08 05 Page 5 CAS 750C Monitor Page 6 Connecting the Accessories Front Panel Controls Main Screen cccceeceseceeeeeeeeeees Freeze f
77. l is located on the bottom of the monitor 21 02 0193 REV 00 08 05 Page 23 Basic Operation CAS 750C Monitor Page 24 21 02 0193 REV 00 08 05 CAS 750C Monitor Basic Operation Getting Started Site Requirements Note Put the monitor in a location where you can easily see the screen and access the operating controls Caution 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 Caution Negligence CAS Medical Systems Inc does not as sume responsibility for damage to the equipment caused by im properly vented cabinets improper or faulty power or insufficient wall strength to support equipment mounted on such walls Power Requirements The external power for the CAS 750C Monitor can be either AC mains power or DC power The two different models are e Model CAS 750CM for 12V VDC e Model CAS 750C for 110 to 240 VAC The following applies for the CAS 750C model with AC power sup ply Warning Do not plug the monitor into an outlet controlled by a wall switch or dimmer Warning 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 Warning Isolation of product from mains can only be achieved by removal of external power cord Caution D
78. light Saving Time for all European countries using Greenwich Mean Time EU 02 00 Daylight Saving Time for all European countries 1 hour ahead of Greenwich Mean Time EU 03 00 Daylight Saving Time for all European countries 2 hours ahead of Greenwich Mean Time Note Enabling Daylight Saving Time will affect the History data Page 78 21 02 0193 REV 00 08 05 CAS 750C Monitor Setup Selecting Alarm Delay To change the SpO gt 2 Alarm Delay setting proceed as follows Enter the Setup menu as described on page 75 and follow the general instructions given there Press the DOWN key until the parameter Oz Alarm Delay is selected Press one of the NEXT keys to move the cursor to the next column to the right Use the UP or DOWN keys to select 10 Sec or 0 Sec for the delay Selecting CO Units To select the display unit for CO2 waveform and EtCO values pro ceed as follows Enter the Setup menu as described on page 75 and follow the general instructions given there Press the DOWN key until the parameter EtCO Unit is se lected Press one of the NEXT keys to move the cursor to the next column to the right Use the UP or DOWN keys to select one of the options mmHg kPa or Selecting Display Background To select the display background proceed as follows 21 02 0193 REV 00 08 05 Enter the Setup menu as described on page 75 and follow the general instructions given there Pre
79. ls are expected to have working knowledge of medical pro cedures practices and terminology as required for monitoring of Critically ill patients Caution For continued safe use of this equipment it is necessary that the listed instructions be followed However instructions listed in this manual in no way supersede established medical practices concerning patient care Warning Directions that warn of conditions that put the patient or the caregiver at risk Caution Directions that help to avoid damaging the monitor or losing data Note Directions that make it easier to use the monitor something not readily apparent Figures All illustrations in this manual are provided as examples only They may not necessarily reflect your monitoring setup or data displayed on your monitor This manual has a revision number located at the bottom of each page It changes whenever the manual is updated First Printing 08 2005 Read this manual carefully before patient use of the monitor CAS Medical Systems Inc reserves the right to make changes to this manual and improvements to the product it describes at any time without notice or obligation Copyright 2005 CAS Medical Systems Inc All rights reserved No part of this manual may be reproduced without the written per mission of CAS Medical Systems Inc 21 02 0193 REV 00 08 05 CAS 750C Monitor Contents Bee En E EE 2 Contact Addresses eege hn Ae i ee 2 Genera
80. lues for Day Month Y ear Note Altering the monitors date will affect the History data 21 02 0193 REV 00 08 05 Page 77 Setup CAS 750C Monitor Setting the Time To set the monitor s Time function proceed as follows e Enter the Setup menu as described on page 75 and follow the general instructions given there e Press the DOWN key until the parameter Time is selected e Press one of the NEXT keys to move the cursor to Hours Minutes e Use the UP or DOWN keys to increase or decrease the values for hours or minutes Note Altering the monitors time will affect the History data Daylight Saving Time Option To set the monitor s Daylight Saving Time function proceed as fol lows e Enter the Setup menu as described on page 75 and follow the general instructions given there e Press the DOWN key until the parameter DST is selected e Press one of the NEXT keys to move the cursor to the next column to the right e Use the UP or DOWN keys to select on of the Daylight Saving Time options The possible options have the following meaning OFF Daylight Saving Time is not activated The monitor will not change the time automatically It is up to the user for changing the time if needed This is the monitor s default setting N AMERICA Use this setting and the monitor will automatically change time accordingly to the Daylight Saving Time for countries in North America EU 01 00 Day
81. metric blood pressure monitor the accuracy of the measurements obtained may be ad versely affected by the presence of agents which alter the pa tient s cardiovascular system Caution Do not operate the monitor s NIBP function unless it has been properly calibrated Inaccurate blood pressure readings may result Caution When a patient is experiencing arrhythmias during a measurement the accuracy of the pulse determination may be af fected or the time needed to complete a measurement may be ex tended Caution Do not alter the monitor s air hose CAS Medical Sys tems Inc cannot ensure proper monitor performance if the tubing is altered Modification of the air hose will void the warranty Avoid compression or restriction of pressure tubes Note A patient s vital signs may vary dramatically during the use of cardiovascular agents such as those that raise or lower blood pressure or those that increase or decrease heart rate Note The maximum amount of time allowed completing a NIBP measurement is 120 seconds in Adult mode and 90 seconds in Neonate mode If the measurement has not been completed within that time the cuff is deflated automatically and a message is displayed indicating the problem Note To prevent exposure of the extremity to an inordinately high pressure the cuff is deflated automatically when the pressure in the system is greater than 290 mmHg in the Adult mode or 145 mmHg in the Neonate mode Note In
82. nd 800 MHz the higher frequency range applies NOTE 2 These guidelines may not apply in all situations Electromagnetic propagation is effected by absorption and reflection from structures objects and people Field strengths from fixed transmitters such as base stations for radio cellular cordless telephones and land mobile radios amateur radio AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy To assess the electromagnetic environment due to fixed RF transmitters an electromagnetic site survey should be considered If the measured field strength in the location in which the Model 750C Monitor is used exceeds the applicable RF compliance level above the Model 750C 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 750C 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 750C Monitor The Model 750C Monitor is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled The customer or the user of the Model 750C Monitor can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment transmitters and the Mo
83. ng The position of subject physiological condition and other factors affect the NIBP readings Blood pressure and pulse rate can fluctuate greatly between measurements the monitor cannot alert the user to changes in vital signs occurring between measurement cycles Warning Occasionally Electrical signals at the heart do not pro duce a peripheral pulse If a patient s beat to beat pulse ampli tude varies significantly for example pulsus alternans atrial fibril lation rapid cycling artificial ventilator blood pressure and pulse rate readings can be erratic and an alternate measuring method should be used for confirmation Warning Do not apply external pressure against the cuff while monitoring Doing so may cause inaccurate blood pressure val ues Page 63 NIBP CAS 750C Monitor Page 64 Caution Always be sure to check that there are no signs of pro longed impairment of circulation regardless of automatic safety features that restrict the over all measurement time Caution In shock conditions the low amplitude of the blood pres sure waveform may make it difficult for the monitor to accurately determine the systolic and diastolic pressures Caution The monitor does not operate effectively if a patient is having seizure activity tremors or is connected to a heart lung machine Caution Consult a physician for interpretation of blood pressure measurements Caution As with any non invasive oscillo
84. nician can remove the rear cover Caution To avoid the risk of electrical shock do not remove the back cover Refer all servicing to qualified personnel Note There are no known risks with common disposal of equip ment 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 Page 16 21 02 0193 REV 00 08 05 CAS 750C Monitor Safety Safety Checks Warning Do not under any circumstances perform any testing or maintenance on the monitor or power cord while the unit is being used to monitor a patient Unplug the power cord before cleaning or servicing the monitor The operator should not perform any ser vicing except as specifically stated in this manual Warning The functions of the alarm system for monitoring of the patient must be verified at regular intervals Warning Periodically and whenever the integrity of the product is in doubt test all functions Warning Do not use a frayed or damaged power supply cord or any accessory if you notice any sign of damage Contact CAS Medical Systems for assistance Caution Inspect the monitor patient cables sensors and air hose for damage prior to operation If any damage is noted the monitor should not be used until it has been serviced Only personnel au thorized to do so by CAS Medical Systems Inc should repai
85. nnect the con sumable by carefully removing the connector from the CO input receptacle When the consumable is disconnected from the monitor the mes sage ECO OFF is displayed the Equipment Alarm LEDs are flashing and an audible alarm sounds indicating a connection has been broken Note If CO is selected as a waveform messages appear in the CO waveform window otherwise messages appear in the Equip ment Message Window of the Main screen e To acknowledge the alarm press the ALARMS key Caution Dispose of Microstream consumables according to stan dard operating procedures or local regulations for the disposal of contaminated medical waste GO Display Window 0 07 uua eE End Tidal CO EtCO and Respiration Rate RR are displayed in the yellow window at the lower right area of the Main screen Note The bar graph indicator is only presented if the CO wave form is not displayed in one of the trace windows Page 60 21 02 0193 REV 00 08 05 CAS 750C Monitor CO2 CO related Settings Access the Parameters menu as described on page 38 to review or change the following settings e EtCO gt Trace speed selection e ECO Scale selection e ECO Print selection e ECO Trace Type selection Access the Alarm Limits menu as described on page 43 to review or change the following settings e ECO Alarm Limits Access the Monitor Setup menu as described on page 79 to change the following settings
86. o 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 Note The monitor is suitable to be connected to public AC mains power 21 02 0193 REV 00 08 05 Page 25 Basic Operation CAS 750C Monitor Turning the Monitor On Press the POWER key on the front panel to turn the monitor on POWER ALARMS SILENCE RESET Figure 4 Turning the Monitor On Each time the monitor is turned on an internal self test is con ducted to ensure that all circuits are functioning properly Verify the following e The monitor produces 3 one second audio beeps e Both the Equipment and the Alarm Indicators are lit for one half second and cycled one after the other e The monitor displays temporarily its current configuration data e Model number 750C e Power source C External AC CM External DC e Number of installed parameters e Brand of installed parameters MS Masimo NL Nellcor C Oridion Warning The monitor must be briefly turned off and back on once every 24 hours of continuous operation to exercise the start up self test function of the optional NIBP module Note If after the Power On Self Test is completed the monitor displays NIBP Cal in the Equipment Message area the monitor should be returned to CAS Medical Systems for service Once the Power On Self Test is completed the monitor
87. on e Disconnect the FilterLine from the monitor Note Should the monitor fail the EtCO 2 Calibration it is recommended the procedure be repeated Prior to repeat ing the Calibration procedure carefully check all connec tions Should the monitor continue not to pass the Calibration procedure the monitor should be returned for service Page 89 Maintenance CAS 750C Monitor NIBP Checks To guarantee correct NIBP measurements it is recom mended to perform the following checks at least once per year All checks can be done in one session beginning with the Pneumatic Pressure Check then continue with the Calibration Check and finally perform the Over Pressure Test Note The monitor must be in the Adult mode to perform the following pressure checks The following equipment is required to perform the NIBP pressure checks e A Calibration Kit P9 which is included with the moni tor e A Mercury manometer or equivalent whose accuracy meets the AAMI ANSI Standard for Non Automated Sphygmomanometers 2002 Warning Do not activate the Service menu when a cuff is attached to a patient Pneumatic Pressure Check Page 90 To perform the Pneumatic Pressure Check proceed as fol lows e Connect the NIBP inflation hose to the monitor without a cuff connected to the hose e Obtain the male luer plug from the Calibration Kit and use it to close the open end of the NIBP inflation hose Twist the plug on
88. on a limb being used for an intravenous infusion Do not place the cuff on any extremity being used for SpO monitoring Note Remember that there may be a marked difference between readings taken from the left and the right arms Be consistent with each patient NIBP Measurements 21 02 0193 REV 00 08 05 Warning When monitoring over an extended period of time or at frequent intervals periodically observe the patient s limb to make sure that the circulation is not impaired for a prolonged period of time Caution Make sure the monitor is set to the correct Patient Mode Refer to page 30 or to paragraph Selecting Patient Mode on page 76 to change the patient mode Note The cuff target pressure must be higher than the patient s systolic pressure to obtain an accurate systolic and diastolic read ing The initial cuff inflation pressure is 150 mmHg in Adult mode and 85 mmHg in Neonate mode After the first measurement the monitor will adapt the cuff inflation pressure automatically based on the previously measured systolic value approximately 30 mmHg above This will continue until the monitor is turned off and on again or the inflation pressure is selected manually Caution When measuring blood pressure on a pediatric patient using the Adult mode it is recommended that the Initial Inflation Pressure be set to a lower value e g 120 mmHg Page 67 NIBP CAS 750C Monitor Page 68 Once the cuff
89. onds e RRalarms 10 seconds When the monitor incorporates Nellcor Go e SpOz alarms 0 or SatSeconds configurable To change the alarm delay follow the steps described in para graph Changing Alarm Limits on page 44 e SpO Pulse Rate alarms 0 or 10 seconds configurable To change the alarm delay follow the steps described in para graph Selecting Alarm Delay on page 79 When the monitor incorporates Masimo SpOz e SpO and Pulse Rate alarms 0 or 10 seconds configur able To change the alarm delay follow the steps described in para graph Selecting Alarm Delay on page 79 Note All other alarms are generated without any delay 21 02 0193 REV 00 08 05 CAS 750C Monitor Alarms Stand By mode 21 02 0193 REV 00 08 05 This mode can be used just prior to connecting the monitor to a patient but all the monitor e cables are connected e Depress and holding for two 2 seconds the SILENCE RESET pushbutton When enabled all Equipment alarms are silenced and the mes sage Stand By is displayed on the Main display For the Stand by feature to work properly the following conditions must apply e The monitor cannot be actively monitoring any patient parame ter Note Temperature monitoring is not effected by the Stand By mode To return the monitor to normal operation connect any of the pa tient leads to the patient Page 47 Alarms CAS 750C Monitor
90. or trace 2 Line or Filled 3 6 25 12 5 mm sec High and low limits on EtCO adjustable FiCO fixed 21 02 0193 REV 00 08 05 CAS 750C Monitor Appendix NIBP Measurement Technique Patient Range Self Test Auto Zero Inflation Deflation Max Measurement Time Overpressure Measurement Range Accuracy Blood Pressure Pulse Rate Patient Alarms Oscillometric MAXNIBP Technology Adult Neonate System self test is performed each time power is turned on Zero pressure reference is automatically es tablished after every reading Initial inflation to 150 mmHg Adult or 100 mmHg Neonatal or user selectable 100 120 140 160 180 200 Adult 60 80 100 120 Neonatal Subsequent inflation to approximately 30 mmHg greater than previ ous Systolic pressure Automatically after measurement If cuff pressure exceeds 290 mmHg Adult If cuff pressure exceeds 145 mmHg Neo nate If measurement time exceeds 120 seconds Adult 90 seconds Neonate If safety timer detects microprocessor failure Limited to 120 seconds Adult 90 seconds Neonate If cuff pressure exceeds 290 mmHg Adult 145 mmHg Neonate Adult Neonate 30 255 mmHg 30 135 mmHg 15 220 mmHg 15 110 mmHg 20 235 mmHg 20 125 mmHg Pulse Rate Range 30 240 BPM 40 240 BPM 5 mmHg Standard deviation no greater than 8 mmHg 2 or 2 BPM whichever is greater High and low limits for Sy
91. orities for instructions on recycling options in your area Fuse Replacement Note The CAS 750CM monitor models have a single fuse located inside the monitor This fuse is not user replace able The CAS 750C monitor has a dual fuse power input recep tacle Both AC lines are fused Caution For continued protection against fire hazard re place only with identically rated fuses Refer to paragraph Power on page 120 A fuse may need to be replaced if the monitor is plugged into an electrical outlet but the Battery Power Visual Indica tor is not illuminated green Warning Before changing the fuse unplug the power cord Page 94 21 02 0193 REV 00 08 05 CAS 750C Monitor Maintenance To replace fuses proceed as follows Turn the monitor off and disconnect the power cord Press down on the locking tab which holds the fuse holder in the power input receptacle While holding down on the tab pull the fuse holder out Remove the fuses Place new fuses directly into the fuse holder Insert the fuse holder into the power input receptacle There should be an audible click when it is secured Software Versions The monitor displays the current software revision of its operating system and that of the internal modules being used inside To view the software versions proceed as follows Enter the monitor s Service menu as described on page 86 Press and hold the HISTORY key for 2 seconds to d
92. ositioned every four 4 hours and if indicated by circulatory condition or skin integrity reap plied to a different monitoring site e Disposable SpO sensors are contraindicated for patients that exhibit allergic reactions to adhesive tape The sensors must be removed and repositioned every eight 8 hours and if indi cated by circulatory condition or skin integrity reapplied to a different monitoring site e No other contraindications are known at this time 21 02 0193 REV 00 08 05 Page 13 Safety CAS 750C Monitor Installation and Setup Page 14 Follow the instructions given in paragraph Site Requirements on page 25 and Power Requirements on page 25 Warning Do not come into contact with patients during defibrilla tion Otherwise serious injury or death could result Warning The CAS 750C Monitor is intended only as an adjunct in patient assessment It must be used in conjunction with clinical signs and symptoms Warning Do not rely exclusively on the audible alarm system for patient monitoring Adjustment of alarm volume to a low level dur ing patient monitoring may result in a hazard to the patient Re member that the most reliable method of patient monitoring com bines close personal surveillance with correct operation of monitor ing equipment Warning Do not use the CAS 750C Monitor for any purpose other than specified in this manual Doing so will invalidate the monitor s warranty
93. r Use the cable which is supplied with the printer The RS232 interface may be used for data collection or service purposes Refer to the documentation provided with each applica tion Note The CAS 750C Monitor is not equipped with interfaces to remote equipment or network s to duplicate alarms 5 Signal Reserved Serial Receive In Serial Transmit Out No Connection Isolated Ground Reserved No Connection No Connection Reserved Pin 1 Pin 6 o0ooo 0o 4 Pin 9 Le e e Ee Pin 5 Figure 26 DB9 Connector 21 02 0193 REV 00 08 05 Page 105 External Device Interfacing CAS 750C Monitor Mounting There are several mounting devices e g roll stand or swivel mount available for the monitor In all cases the 4 screw threads at the back are used to attach the monitor to the mounting device Figure 27 Mounting Threads 1 Screw Thread one of four Note Follow the instructions provided with each specific mounting solution Page 106 21 02 0193 REV 00 08 05 CAS 750C Monitor Appendix 12 Appendix Symbols The following is a summary of all symbols used on the monitor and accessories Symbols may occur on the product or on its packag ing Front Panel Symbols Power Indicator POWER On Standby ALARM Silence Reset ae NIBP Start Stop Menu Ep RETURN Main Screen Freeze Print PARAMETER LIM
94. r the monitor Caution If the monitor fails to respond do not use it until the situation has been corrected by qualified personnel Monitoring Warning Conductive Connections Extreme care must be exer cised when applying medical electrical equipment Many parts of the human machine circuit are conductive such as the patient connectors electrodes and transducers It is very important that these conductive parts do not come into contact with other grounded conductive parts when connected to the isolated patient input of the device Such contact would bridge the patient s isola tion and cancel the protection provided by the isolated input In particular there must be no contact of the neutral electrode and ground Warning If the accuracy of any value displayed on the monitor or printed on a graph strip is questionable determine the patient s vi tal signs by alternative means Verify that all equipment is working correctly Caution Use only CAS approved accessories and sensors to en sure patient safety and to preserve the integrity accuracy and the electromagnetic compatibility of the monitor 21 02 0193 REV 00 08 05 Page 17 Safety CAS 750C Monitor Initial Inspection Before unpacking the monitor inspect the packaging for damage If there are any signs of damage to the package a claim should be filed immediately with the shipping agent It is the receiver s responsibility to notify the carrier s local o
95. races History Screens aee Trend History cccee Alarm History na sa Printing Trend or Alarm History Erase Trend History Data Erase Alarm History Data Parameters Men COs Library tage Audio Visual Menu Auto Dim Alarms Patient Alarms aaeanoa Manifestation of Patient Alarms Equipment Alarms sseenaaeeaaeeaaa Manifestation of Equipment Alarms Silencing AlarMs cceeeeeee No alarm aciive Alarm is active Silence Indication 0 Silence Period is set to 2 Minute Silence Period is set to Permanent Alarm Limits cccceeceseceeeeeeeeees Alarm Limits Menu Changing Alarm Limits Saving Alarm Limits Restore Alarm Limits Factory Default Alarm Limits Alarm Volume Alarm Delays n Stand By mode n SpO Introduction 0 ceeceeeceeeeeeeeeeeeeeeees 21 02 0193 REV 00 08 05 CAS 750C Monitor SPOs Monitoring RES 51 SatSeconds Alarm Management 52 Disconnecting SpO ACcessortes 53 SpOd2 Display Wimdow 53 SpOdc related Gettngs ccc cceeeeeseeeeeeeeeeeeeeeeeeeeseeeseeeseeeeeeeneees 53 SpO2Troubleshooting c cceeseeeeeeeseeeeeeeeeeeeseeeeeeeeeesseeseeeeeeeees 54 SpOz related Messages 55 5 CO 57 Introduchon EAE E E E ET 57 Safety EE 57 Preparations pire aine eee eer eae EEE EEN EEEa NEEE AEE E e 58 Microstream CO Consumables 58 Non Intubated Applcation eneee eenen enneren 58
96. re 126 Other Accessories and Options 0 eeeeeeeeeeeeeeeeeeees 127 21 02 0193 REV 00 08 05 CAS 750C Monitor Figures Tables 21 02 0193 REV 00 08 05 Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Figure 13 Figure 14 Figure 15 Figure 16 Figure 17 Patient Environment 19 Front View EEN EEN REENEN SEENEN Bed quneth 22 Rear View of Monitors sssesseenneenneenneernrnnnennnn nnr nn nrnna 23 Turning the Monitor On seessseesseserreessssseerrreesrererene 26 RE AE 29 Front Panel Controle nenn tnn nenn r nenn nnn nenna 30 Main Green 33 Trend History Eet ege 35 Alarm History Screenn 2 cccceeeeeseeseseceeeeeeeeeeseseeeees 36 Parameters Men 38 Audio Visual Men 39 Alarm Limits Men 43 Cuff Application Range Marker sesseeeeeeneeeseeesneeseeen 66 Cuff Application a a t e e ar aa nai paiete dna eT 66 NIBP Men arinrin tenana den aa 71 Setup Men 75 Service MGS AU enrm ne a a dE EEN 86 Figure 18 Removing the Battery Pack 93 Figure 19 Software Versions cccccceeseeseeecceeeeeeeeeeeesenenenes 95 Figure 20 Printer Controls and Indicators eee 98 Figure 21 History Sample Printouts eeeeeeeeeeeeeeeeeeeeneaes 100 Figure 22 Waveform Sample Prntout 101 Figure 23 Paper Installation ccccceeeeeeeseeecceceneeeseeeeeeceees 102 Figu
97. re 24 Opening the Battery Doorr ececseecteeeeeeeeeeeeeeees 103 Figure 25 Installing the New Batter 104 Figure 26 DBS COnme EE 105 Figure 27 Mounting Threads 2 ccccceeeeeeseceeceeeeeeeseneeeneees 106 Table 1 Factory Default Alarm Lime 45 Table 2 CAS 750C Models with AC Power 112 Table 3 CAS 750C Models with DC Power 112 Page 11 CAS 750C Monitor Page 12 21 02 0193 REV 00 08 05 CAS 750C Monitor Safety 1 Safety The following Warnings Cautions and Notes have to be obeyed to guaranty a safe operation of the monitor Additional Warnings Cautions and Notes which apply to specific parameters are listed in the related sections for each parameter Indications for Use The 750C monitor is intended to continuously calculate and display the following physiological vital signs end tidal carbon dioxide respiration rate capnograph waveform functional arterial oxygen saturation pulse rate plethysmograph waveform and an optional non invasive blood pressure measurement of systolic diastolic mean arterial pressures along with pulse rate derived from a NIBP pressure waveform The 750C is intended for monitoring of adult pediatric and neona tal patients in the care of health care professionals Contraindications e Reusable Go sensors are contraindicated for use for pro longed periods of use It is not intended for long term monitor ing It must be removed and rep
98. riate for a particular patient If at least ten seconds of one bar pulses cannot be ob served for a given sensor change sensor location or sensor type until this condition is achieved e Check the alarm limits and configure them appropriately for the patient 21 02 0193 REV 00 08 05 Page 51 GpC CAS 750C Monitor Page 52 Note Inspect the SpO sensor site every 2 to 4 hours or per hos pital protocol If there is any skin irritation caused by the sensor remove the sensor and apply it to a different location SatSeconds Alarm Management Note The SatSeconds alarm management feature is only avail able in monitors with Nellcor s Oximax technology False or nuisance alarms are a common concern with pulse oxi metry monitoring Nuisance alarms are often triggered by minor and brief desaturation events that are clinically insignificant Clini cians tend to manage these alarms by ignoring them turning off the alarm or monitor or widening the alarm limits The CAS 750C Monitor incorporates Nellcor s SatSeconds Alarm Management feature that offers a better way to manage nuisance alarms with out 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 0 SatSeconds Clinicians who choose to employ the SatSeconds function should select a limit suited to their clinical environment and patient condit
99. rning To avoid electric shock or device malfunction liquids must not be allowed to enter the device If liquids have entered a device take it out of service and have it checked by a service tech nician before it is used again Warning The CAS 750C Monitor provides DRIP PROOF level of protection from ingress to moisture Warning Do not place liquids on top of the monitor Do not im merse the monitor or power cord in water or any liquid Warning Do not gas sterilize or autoclave the monitor Warning 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 Warning 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 Warning Isolation of product from mains can only be achieved by removal of external power cord Warning Route all cables away from patient s throat to avoid pos sible strangulation Caution Pressing the front panel keys with a sharp or pointed in strument may permanently damage the switch membrane Press the keys using only your finger Caution If the monitor is accidentally wetted take it out of opera tion It should be thoroughly dried To verify the absence of water a qualified service tech
100. rted blood pres sure measurements for a period of 5 minutes when STAT mode is activated Each measurement is followed immediately by the next one after a 10 seconds pause that allows venous blood to return Warning Readings obtained during STAT mode may not meet the stated accuracy of this monitor Warning In some cases rapid prolonged cycling of an oscil lometric noninvasive blood pressure monitor cuff has been asso ciated with any or all of the following ischemia purpura or neu ropathy Apply the oscillometric cuff appropriately according to instructions and check the cuff site and cuffed extremity regularly when blood pressure is measured at frequent intervals or over ex tended periods of time 21 02 0193 REV 00 08 05 Page 69 NIBP CAS 750C Monitor Entering STAT Mode To activate the STAT mode proceed as follows e Enter the NIBP Menu as described in this section on page 71 e Move the cursor to STAT and then select ON e Return to the Main Screen by pressing the RETURN key The message STAT appears in the NIBP window e Press the NIBP key to begin the first measurement Between readings the NIBP window will display the remaining seconds until the next measurement Note Selecting STAT mode will override any time interval se lected for the NIBP measurement cycle Exiting STAT Mode The monitor will stop the STAT mode automatically after 5 minutes and returns to the Manual NIBP mode e Pr
101. s Main screen is activated and the monitor is ready for use Page 26 21 02 0193 REV 00 08 05 CAS 750C Monitor Basic Operation Turning the Monitor Off When the monitor is not being used press the POWER key can turn it off The display will turn blank and the unit is no longer monitoring the patient Note The internal power supply is not switched off It remains connected to the external power source AC or DC to enable bat tery charging Power Fail Message During the internal self test the monitor checks whether it was pre viously turned off correctly or if it was disconnected from power in any other way The user will be alerted about such a power loss after the monitor is turned on again The message Power Failure is displayed in the Equipment Mes sage Window the Equipment Alarm LEDs are activated and 3 beeps followed by 2 beeps are heard every 10 seconds e Press the SILENCE RESET key to clear the Power Fail condi tion Note Only the SILENCE RESET and the ON STANDBY keys are operable all other keys are disabled while the message is dis played Battery Operation The monitor is equipped with a rechargeable battery The battery is charging whenever the monitor is connected to an external power source AC Line Power or 12 VDC Batteries will self discharge when they are not used It is recom mended leaving the monitor connected to an external power source whenever possible The monitor will
102. s are displayed in an additional row posi tioned at the time of occurrence e Press the HISTORY key to enter this screen Note If there is no data available the message No Trend History is displayed at the top of the screen History T DO s AO 2 39 NI EE Be 238 2 37 NI 37 236 35 13 13 13 13 13 JS 13 13 13 735 MN 02 98 BP 120 98 98 BP 112 98 98 98 Erase No PR C02 59 59 59 59 59 IBP 120 59 38 80 38 38 78 38 38 80 38 RR 16 90 PR 59 16 16 89 PR 61 16 16 90 PR 58 16 Figure 8 Trend History Screen The cursor position is initially set to the first line of data which is the most recent data e Press the DOWN key to scroll down back in time e Press the UP key to scroll up forward time Page 35 Basic Operation CAS 750C Monitor Alarm History The Alarm History screen shows patient alarms in a tabular form as they occurred Each line represents one alarm event e Press the HISTORY key to access the Trend History screen first e Then press and hold the HISTORY key for 2 seconds to enter the Alarm History screen Note If there is no data available the message No Alarm History is displayed at the top of the screen Alarm Hist HR MN Alarm 13s3 Eliot oz 98 Figure 9 Alarm History Screen The cursor position is automatically set to the first alarm whi
103. s printed each time the monitor is turned on Note An asterisk appears in the History printout to indi cate an Alarm has occurred during that one minute inter val To print waveforms e Press and hold the RETURN key for 2 seconds while in the Main display screen The waveforms being displayed will print at the speed as previously selected Refer to paragraph Parameters Menu on page 38 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 21 02 0193 REV 00 08 05 CAS 750C Monitor Printer 1 N O a 77 2 Qon 2 De x a AS bi H D By Ss S aud ZS y SAT E xd S S 20a Do o S KK r n D z SS Uu N Figure 22 Waveform Sample Printout 1 Header 2 Numeric Information 3 Print Speed and Alarm Event Type only printed when Print on Alarm is activated 4 Alarm Event Marker Charging the Printer Battery The CMP 10 Mobile Printer is equipped with a recharge able Lithium lon LilON battery pack When the printer de tects a Low Battery condition the message Low Battery is printed and an audio indicator sounds three times Warning Charge the printer battery using the AC Adapter Model TRC 09 1100 M from GROUP WEST or equivalent included with the printer e
104. ss the DOWN key until the parameter Background is se lected Press one of the NEXT keys to move the cursor to the next column to the right Use the UP or DOWN keys to select Dark or Light Page 79 Setup CAS 750C Monitor Page 80 21 02 0193 REV 00 08 05 CAS 750C Monitor Cleaning 8 Cleaning Warning Do not under any circumstances perform any cleaning while the monitor is being used to monitor a pa tient The monitor must be turned off Unplug the monitor from the AC or DC power source and disconnect all acces sories Caution Do not open the monitor to clean it Caution Do not immerse any part of the electrical connec tor of the cable or accessories in the cleaning or disinfec tion solution at any time This may cause internal damage and reduce the product life Caution Do not use abrasive cleaners isopropyl alcohol or organic solvent for cleaning Use of these cleaners can cause damage stiffness and brittleness to the monitors surface and to cables and wires Cleaning the Monitor 21 02 0193 REV 00 08 05 Caution Disconnect all accessories from the monitor be fore cleaning Examine the monitor s case for damages and check the AC power cord for bent or broken prongs cracks or fray ing Neither the monitor nor the power cord should be used if damaged If any damage is noted contact the ap propriate service personnel Caution Do not spray or pour any water or cl
105. st item in the left column e Use the UP and DOWN keys to select the item that needs to be changed e Use the NEXT key to move the cursor to the next column to the right e Use the UP and DOWN key to scroll through the available op tions Note Several changes may be done in one session Use the PREVIOUS key to return the cursor back to the left column and repeat the steps as before e Press the RETURN key when finished All changes will be saved and become immediately effective Note A continuously updating Trend History or a menu of NIBP event readings can be chosen in the Parameters Setup menu as Trace 3 21 02 0193 REV 00 08 05 CAS 750C Monitor Basic Operation CO Library If CO is selected as Trace 2 or 3 a library of 10 CO traces can be selected for educational viewing Use the UP key to enter the library and then select other traces by using the UP or DOWN keys Traces are displayed at 3 mm Sec The CO Library will be displayed for 30 seconds and then automatically return to the Main screen Audio Visual Menu 21 02 0193 REV 00 08 05 The Audio Visual menu shows the actual settings and allows changing them e Press the VOLUME key to enter this menu Note The monitor will automatically return to the Main screen if no key is pressed for 30 seconds Audio Visual Alarm Volume TT Beep Volume Key Click ON Contrast TT TTT Ty Auto Dim OFF
106. stolic Pressure ad justable High and low limits for Diastolic Pressure adjustable Accuracy complies with that given in American National Standard for Electronic or Automated Sphygmomanometers ANSI AAMI SP10 2002 Adult blood pressure measurements determined with this device are equivalent to those obtained by an auscultatory blood pressure meas urement device and neonatal ones are equivalent to those obtained by an intra arterial blood pressure device within the limits prescribed by the American National Standard for Electronic or Automated Sphygmoma nometers The 4th Korotkoff sound was used to determine Diastolic pressure Study findings are available 21 02 0193 REV 00 08 05 Page 117 CAS 750C Monitor Appendix Patient Alarms Adjustable Alarms Fixed Alarms Alarm Indicators High and low alarms for SpOz Pulse Rate EtCO Respiration Rate Systolic Pressure Diastolic Pressure No Respiration Asystole FCO Audible Red Patient Alarm LED s Yellow Equipment Alarm LED s Text in Patient Message Window Patient Parameter Neonatal Limit Range Adult Limit Range Low High Low High SpO2 70 95 80 99 70 95 80 99 SpOz Pulse 25 235 BPM 25 235 BPM 25 235 BPM 25 235 BPM End Tidal CO 1 to 99 mmHg 1 to 99 mmHg 1 to 99 mmHg 1 to 99 mmHg 1 to 13 2 1 to 13 2 1 to 13 2 1 to 13 2 1 to 13 2 kPa 1 to 13 2 kPa
107. terLine is no longer connected to the monitor The consum able is no longer connected to the monitor e Press the ALARMS key The monitor silences the audio alarm tone but the visual messages remain e Check the external tubing for disconnections Service EtCO2 The CO module s service timer has reached zero hours The monitor will continue to function e Arrange for service as soon as possible 21 02 0193 REV 00 08 05 CAS 750C Monitor NIBP Introduction Safety 21 02 0193 REV 00 08 05 NIBP Non Invasive Blood Pressure The Non Invasive Blood Pressure NIBP parameter is using the oscillometric measurement technique It automatically inflates an occluding cuff and then releases the cuff pressure step by step It determines systolic diastolic and mean arterial pressure The NIBP function is suitable for neonatal pediatric and adult patients Warning If uncertain about the accuracy of any measurement check the patient s vital signs by alternate means and then make sure the monitor is functioning correctly Warning Do not place the cuff on a limb being used for A V fistu las intravenous infusion or on any area where circulation is com promised or has the potential to be compromised Warning When monitoring over an extended period of time or at frequent intervals periodically observe the patient s limb to make sure that the circulation is not impaired for a prolonged period of time Warni
108. the event of a microprocessor failure the cuff will be de flated automatically within 10 seconds 21 02 0193 REV 00 08 05 CAS 750C Monitor NIBP Preparations Patient Mode Selection Caution Prior to patient monitoring ensure the monitor is config ured to the appropriate patient mode Neonate or Adult Refer to paragraph Selecting Patient Mode on page 76 Select the Neonate mode when measuring on newborn patients and for all babies where the systolic pressure is expected to be below 120 mmHg Use the Adult mode for infant and adult pa tients Switch from Neonate to Adult mode if one or more of the following conditions occur e Systolic pressure is expected to be above 120 mmHg e Acuff width of 6 cm or larger is required NIBP Hose Selection Two different inflation hoses are available e The coiled ten foot NIBP hose is recommended for adult and pediatric patients e The straight six foot NIBP hose is recommended for neonatal patients and small infants Cuff Selection The use of the correct size of cuff is essential for the accurate measurement of the blood pressure Note CAS recommends the use of its Tuff Cuff reusable cuffs Safe Cuff disposable cuffs and Pedisphyg neonatal cuffs Width The widest cuff that can be placed around the upper arm or thigh should be used A cuff that is too small for the arm will not supply sufficient pressure to the artery This can cause an erro neously
109. the probe site periodically The sensor must be removed and repositioned every 4 hours and if indicated by circu latory condition or skin integrity reapplied to a different monitoring site Caution Disposable SpOz2 sensors Prolonged monitoring may require changing the probe site periodically The sensors must be removed and repositioned every 8 hours and if indicated by circu latory condition or skin integrity reapplied to a different monitoring site This sensor type should not be used with patients that exhibit allergic reactions to adhesive tape Caution Masimo LNOP probe Tissue damage can be caused by incorrect application or use of an LNOP probe for example by wrapping the probe too tightly Inspect the probe site as directed in the probe s directions for use to ensure skin integrity and correct positioning and adhesion of the probe The monitor can be equipped to use SpO sensors manufactured by Masimo or Nellcor The appropriate manufacturer s logo is shown next to the SpOz input connector Note No other manufacturer s sensors should be used Select a sensor based on the patient size and monitoring condi tions and properly attach the sensor to the patient Note Consult instructions enclosed with each sensor for proper application There are a variety of SpO 2 sensors designs for a specific clinical application Please refer to the Instructions of Use which are sup plied with each type of sensor 21 02 0193 R
110. tile chemicals such as thinner benzine etc Caution Never wet the inside of the printer mechanism Page 83 Cleaning CAS 750C Monitor Page 84 21 02 0193 REV 00 08 05 CAS 750C Monitor Maintenance 9 Maintenance Warning Do not under any circumstances perform any testing or maintenance on the monitor while the monitor is being used to monitor a patient The monitor must be turned off Unplug the monitor from the AC or DC power source and remove the internal battery Caution Service performed by unauthorized personnel could be damaging to the monitor and may void the war ranty For service contact your CAS Representative Maintenance Intervals 21 02 0193 REV 00 08 05 Preventive maintenance of the monitor is an important function that should be performed routinely to ensure safe and efficient monitor operation The following maintenance intervals are recommended e Battery Pack Replace the battery every 2 years e SpO No user calibration is required Perform a SpO2 Simulator Check once per year or when there is doubt about the validity of the SpO2 readings e NIBP Perform a Pneumatic Pressure check every 6 months and a NIBP Calibration Check once a year or when there is doubt about the validity of the pressure readings e COz Perform a CO Calibration Check once per year after 4000 operating hours whichever comes first or when there is doubt about the validity of the CO
111. utors or agents Batteries 1 Year Chargers 1 Year not including power cord see other accessories Cuffs all Out of box failure only SpOz2 Sensors 90 Days for Masimo and Nellcor SpO2 Sensors CO Accessories Out of box failure only for Oridion Sample Lines Other Accessories Out of box failure only Certain Components 1 Year Printer mechanism but not including Thermal Print Heads Print Heads Out of box failure only THERE ARE NO WARRANTIES WHICH EXTEND BEYOND THOSE EXPRESSLY DESCRIBED IN THIS AGREEMENT AND THE COMPANY MAKES NO WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE Page 110 21 02 0193 REV 00 08 05 CAS 750C Monitor Appendix Monitor Error Messages Clock Battery The monitor s internal clock battery is almost discharged e The monitor needs to be serviced Dead Battery The battery is fully discharged e Recharge the battery for at least 5 hours Low Battery The battery is almost discharged At least 30 minutes of operation is available from when the message first appears e Recharge the battery as soon as possible System Error A failure has occurred on the Main Board e The monitor needs to be serviced Power Failure Power was disconnected from the monitor e Press the ALARM key to clear the message OR e Turn the monitor off and on again SET CLOCK Time and date values are incorrect e Set the monitor s clock e If the condition
112. ven there Verify the voltage being displayed is 12 00V 0 50V If this is not the case the monitor needs to be serviced Page 92 21 02 0193 REV 00 08 05 CAS 750C Monitor Maintenance Battery Replacement Removing the Battery e Turn the monitor off and disconnect the power cord e Push down on the battery latch to unlock the battery door from the rear panel of the monitor e Carefully remove the battery pack from the rear panel of the monitor Figure 18 Removing the Battery Pack 21 02 0193 REV 00 08 05 Page 93 Maintenance CAS 750C Monitor Inserting the Battery e Align the Battery Pack guides with the bottom of the monitor e Slowly close the battery door to ensure the connector in the monitor and the connector on the battery pack mate together e Lock the battery door closed Note When the battery pack is re inserted the monitor will automatically turn on Warning Use of unapproved batteries will invalidate the product s warranty and may result in serious safety conse quences for the patient and user Warning Do not disassemble the battery pack or batter ies The batteries contain electrolytes which can cause in jury to eyes skin and clothing Note This product contains a rechargeable battery that is recyclable Under various state and local laws it may be il legal to dispose of this battery into the municipal waste stream Check with your local auth

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