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NTS User`s Guide - Central Nursing Station Systems

1. igns report tal s Vi Figure 21 MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide CJPS DL 01008 Rev 1 9 11 9 2 Summary Report To print a summary report for a patient first select the patient s monitor into the primary view area and then select Print Summary Report from the Patient menu You can also print a summary report by pressing the Print Summary button in the trend table dialog box The summary report combines features of a vital signs report and a trend report At the top of the summary report is a 7 second strip which is saved by the monitor automatically when the patient is first admitted The monitor will save this strip when it has noticed two minutes worth of good ECG data that is ECG data that is not interrupted by lead off The middle part of the summary report shows trend values in a tabular format The intervals in the table are the same as the ones you last selected in the trend table screen display The bottom part of the summary report shows another 7 second strip which shows the 7 seconds just prior to when you request the summary report A scanned sample of a summary report is shown on the following page CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 9 12 Figure 22 P Killick I
2. Alarm Silence Note Trends Print Shift Figure 13 Trends button This will bring up the Trends dialog box Trends Room221 P Killick 28 Feb 2003 10 30 10 35 10 40 10 45 10 50 10 55 11 00 11 05 44 10 11 15 Print Print Summary Show table e Show graphs TEMP 6 98 98 6 98 6 98 Interval F 5 minutes NBPs NBPm S E jai E NBPd d gt Al Ll Patient reported minor chest pain a Trend notes 4 gt 28 Feb 10 55 ze Figure 14 NTS Trend dialog box showing trend table The Trend dialog box allows you to view all of the patient s stored trend data in either a tabular or graphical form For tabular trends you can specify the time range shown in the table which indirectly controls the time interval between columns of the table NBP measurements that were taken at times in between the regular column intervals are shown in special columns with a box around the time to show that it was not a regular interval time The Print Summary button provides a way for you to print a Summary Report using the time intervals as set on the trend table display For more details about the summary report please refer to the chapter Printing Reports CJPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 8 2 To view the patient s trend data in a graphical format select the Show graphs option This will cause the Trend dialog box to redraw the trend data as a graph
3. CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 8 6 P Killick Room 221 28 Feb 2003 11 01 ID 7382909 Date of Birth 23 DEC 21 Sex Female Physician Price 200 28 Feb 10 49 HR 80 0 60 RR 29 0 100 Spo 96 50 200 PR 80 0 120 0 TEMP 98 6 oF 80 0 200 NBP 0 28 Feb 10 00 10 15 10 30 10 45 11 00 Figure 16 Trend graph printout CJPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 P Killick ID 7382909 Date of Birth 23 DEC 21 Sex Female Physician Price Room 221 11 10 28 Feb 2003 28 Feb 2003 E 10 30 10 35 10 40 10 45 10 50 10 55 11 00 11 05 11 08 11 10 11 15 HR 80 80 80 80 80 RR 29 29 29 29 40 Sp0O2 96 96 96 96 96 PR 80 80 80 80 80 TEMP 98 6 98 6 98 6 98 6 98 6 SE NBPs 120 NBPm 95 NBPd 80 Figure 17 Trend table printout 8 8 c PS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 8 4 How to Enter Trend Notes To enter a note that will be saved and viewable along with a patient s trend data first select the patient s monitor into the primary view area then press the Note button Note button Patient Configuration Help EN a a 5 Alarm Silence Note Trends Print Shift Figure 18 Note button This brings
4. Trends Boom 231 P Killick x Cancel Print Print Summar Show table C Time range lt Thour SZ Le a Scale range 7 Autoscale NBP 0 Cursor time lt gt 28 Feb 09 57 a Jd Patient reported minor chest pain a Trend notes 4 gt 28 Feb 10 55 v Figure 15 MPC Trend dialog box showing trend graphs You can change the amount of time represented by the graph using the Time range control You can examine a different part of the patient s trend record by using the slider bar just below the graph to select a different time period You can change the scale range used to graph the trends using the Scale range control You can use the Autoscale check box if you want the trend scales to be computed automatically CJPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 8 3 Trend Settings The following table shows the ranges for the controls on in the Trends dialog box value Trend time range 1 hour 1 2 4 8 12 16 24 hours in graphical view Trend time range 100 10 50 100 150 minutes in tabular view minutes 5 10 20 hours Trend HR scale 0 200 bpm 0 150 0 200 0 250 Auto Trend RR scale 0 60 bpm 0 40 0 60 0 80 Auto Trend SpOz scale 50 100 50 100 Auto Trend PR scale 0 200 bpm 0 150 0 200 0 250 Auto 80 0 120 0 degrees F Auto 80 0 Trend TEMP scale 120 0 25 0 50 0 degrees C Auto degrees F Note trends show the curre
5. PRO Monitoring System The VitalPoint NTS connects to a network of bedside patient monitors allowing you to view information or control settings remotely from up to 64 patients at once Alternatively you can Direct Connect each VitalPoint PRO monitor to a computer for printing or to carry out other functions For the sake of brevity e The term NTS is sometimes used in this document to refer to the VitalPoint NTS software e The term PRO is sometimes used in this document to refer to the VitalPoint PRO Note the software itself may sometimes refer to the NTS as the MPC Both terms are interchangeable within the software The VitalPoint PRO is a small lightweight patient monitor designed to acquire physiological waveforms and parameters and to transmit this data to a VitalPoint NTS central monitoring station or directly to a computer Before using the NTS be sure to read carefully and understand all sections of this User s Guide Failure to read and understand the instructions may lead to misuse of the NTS which could result in harm to the patients CJPS Medical Systems includes the following items for use of the NTS software for the NOMAD system PC o VS 950 Desktop o VS 960 Laptop or o VS 970Tablet Speakers Keyboard Mouse Cable o NOMAD Intranet Cable VS 945 or o Direct Connect Cable VS 940 CIPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 2 vi
6. COM15 Room 235 Serial Net Figure 32 Setup COM Ports Dialog Box MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 CIPS 17 7 When you select a COM port from the list and double click on it the following dialog box appears Supcom PER Port COMI Location name Emme Cancel Connect type SERIAL NET e Figure 33 Setup COM Port Dialog Box Through this dialog box you can change the location name associated with the port and also change the connect type In order for the NTS to communicate with a given monitor on this port the connect type must match the connect type shown on the monitor s Setup Biomedical Service menu Other functions available from the Service Setup dialog box include Download Selected monitor Starts downloading new software version to a connected monitor Starts downloading new software version to all connected Downl nn monitor ownload Connected monitors monitors at once Run Windows Explorer Starts the Windows Explorer program on top of the MPC window Exit MPC Stops the MPC program Acquire test values from a connected monitor used by Zoe Get HW Test Values Service personnel CJPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 17 8 When the NTS is configured for Instructional Mode the Configuration Service dialog contains a few different settings compared to normal mode The buttons for downloading
7. ECG and Heart Rate Messages Check the patient and provide any necessary Clinical care Check the ECG lead being used to calculate the heart rate the top displayed lead make sure that the Neen mem QRS amplitude on this lead is at least o etected for last 0 5 mV HR asystole ASY A seconds Change to another ECG lead to get adequate QRS amplitude Reposition or change electrodes if no lead gives adequate QRS amplitudes Remember the importance of good skin preparation techniques Check the patient and provide any necessary Clinical care Check the ECG lead being used to calculate the heart rate the top displayed lead make sure that the QRS amplitude on this lead is at least No organized ventricular 0 5 mV HR ventricular fibrillation rhythm detected Change to another ECG lead to get adequate QRS amplitude Reposition or change electrodes if no lead gives adequate QRS amplitudes Remember the importance of good skin preparation techniques Check to make sure electrodes are still securely attached to the patient and reattach if necessary Remember the importance of good skin preparation Unplugged cable techniques Broken cable Check to make sure all the lead wires Loose lead wire are still connected to the electrodes SRESSen blank i Check to make sure the lead wires are Faulty lead wire i securely connected to the monitor Dried out electrode Check to make sure there are no Inoperable ECG circuit br
8. If you disconnect patient Smith s monitor from the wall jack and patient Jones monitor from the wall jack both patients are still admitted at the NTS and a connection lost alarm will sound if the monitors were not in Standby mode Now if you reconnect patient Smith s monitor to the wall jack in Room 302 the NTS will auto discharge patient Smith from Room 301 auto discharge patient Jones from Room 302 and auto admit patient Smith to Room 302 All of this happens without any need for user interaction so the result is that patient Smith shows up on the NTS screen in the small view area for Room 302 where the patient actually is At this point the small view area for Room 301 top left would be blank showing that the patient in that room had been discharged Since patient data is not deleted when a patient is discharged the auto discharge does not result in any loss of information In the above scenario if you were then to connect patient Jones monitor to the wall jack in Room 301 the system would also re admit patient Jones with no further user interaction required 10 2 Patient Information Storage The basic model for transferring patients is that patient information moves with the monitor Note This feature does not work when using the direct connect method If a monitor has a patient admitted to it when you connect it to the network one of two things will happen If you are connecting it to a wall jack that corresponds to
9. there is no change to the way the NTS handles alarms or to the way you need to respond in order to silence or suspend the alarm tones CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 7 10 7 2 Alarm Conditions The tables in this section contain lists of all the conditions the NOMAD Telemetry System can detect for each parameter along with alarm characteristics of the condition The first row in each table contains the normal condition for the parameter and the other rows contain the alarm conditions for the parameter Columns in these tables have the following meaning e Condition the name of the condition e Display value the value displayed for the parameter when the condition is true applies only to physiological parameters e Alarm grade as defined above e Message the text of a message displayed in the message area when the condition is true e Annunciation type as defined above CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 7 11 VitalPoint Housing temperature conditions gie Display Alarm Annunciation Monitor box temp too high N A Low Monitor overheating Battery conditions Gg Display Alarm Annunciation Battery low N A Low Battery low CIPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 7 12 HR conditions HR within limits Persistent HR Ventr
10. Any activity that involves disconnecting any component of the NTS even temporarily or any activity that involves opening the PC case must be performed by the PC manufacturer approved service technicians Configuration Setup The Configuration System dialog box provides a way to change certain aspects of the NTS system configuration that usually only have to be done when the system is installed 6 27 2 29 1 2 EEF 12 13 14 15 16 19 20 21 22 23 2 27 28 29 30 SEs 23 4 5 6 Se ZD Today 3 8 2012 16 57 09 sl E E Test nighttime alarm tone volume 3 00 00 PM 7 SS 7 00 00 AM Ernane MES speaker Gacknp y MES Specken Dackur Gelay minutes A e Figure 30 Configuration System Dialog Box Access to the Configuration System dialog box is password protected The password is given to responsible individual s at each site when the system is installed You can also get the password by contacting CJPS Medical Systems customer support CJPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 17 2 Settings that can be changed via the Configuration System dialog box alarms Sound tones at bed only for Ealse True False RED alarms Daytime alarm tone volume 10 100 Nighttime alarm tone Nighttime end time 07 00 00 00 23 99 Patient Setups Save Restore The buttons in the Patient Setups area allow you to configure the monitors for your particular application Normally when
11. HR gt 75 Figure 11 Alarm Log dialog box CJPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 7 5 AlarmLog Room221 P Killick x Close Curent Alarm Status Acknowledge 28 Feb 2003 10 52 04 Date 02 28 2003 Status Active Message HR gt 75 Alarm History 5 HR Alarm Reports Only Print Date Time Message 28 Feb 2003 10 52 04 HR gt 75 28 Feb 2003 10 52 04 Set HR alarms ON 28 Feb 2003 10 51 51 Set HR alarms OFF 28 Feb 2003 10 50 59 HR gt 75 28 Feb 2003 10 50 49 Set HR upper limit to 75 28 Feb 2003 10 50 23 Set HR upper limit to 80 28 Feb 2003 10 45 34 Set operating mode to Monitoring Mode Figure 12 Alarm Log dialog box with the All Alarm Events option selected If you press the Acknowledge button in the Alarm Log dialog box it has the same effect as if you pressed the Alarm Silence button on the tool bar CJPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 7 6 7 1 6 How to Suspend Alarms Sometimes you may find it helpful or necessary to suspend alarms temporarily for instance when moving or bathing a patient You can suspend the alarms for a monitor by selecting the monitor into the primary view area then selecting Alarm Suspend from the Patient menu This will cause the Suspend icon to appear in the primary view message area and also in the small vi
12. a small view area on the NTS where you had already admitted a patient the first patient is auto discharged and the patient whose information is in the monitor is auto admitted If you are connecting it to a wall jack that corresponds to a small view area on the NTS where you had not already admitted a patient the patient whose information is in the monitor is simply auto admitted If a monitor has no patient admitted to it when you connect it to the network one of two things will happen If you are connecting it to a wall jack that corresponds to a small view area on the NTS where you had already admitted a patient the patient information will be automatically sent from the NTS to the monitor If you are connecting it to a wall box that corresponds to a small view area on the NTS where you had not already admitted a patient the NTS will display a message box informing you that a monitor has been connected and that you need to enter patient information You will still be able to see waveforms and parameters for the monitor but no trend data will be saved since there is no patient ID with which to associate the trend data After you click on the message box to remove it the patient name area will continue to blink until you enter the patient information CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 10 2 11 Standby Mode If you ever have a need to suspend monitoring for a p
13. choose which waveform to display in each of the three display channels in the large view waveform area The waveform you choose for the top display channel will also be the waveform displayed in the small view waveform area for this patient You can also choose the size for the ECG waveforms the other waveforms are scaled automatically to fit the display The Setup Waveforms dialog box also allows you to set the sweep speed for the erase bar to specify whether or not you want to see labels for the waveforms in the large view waveform area and to specify whether or not you want to see beat detect spikes in the waveforms to indicate where the monitor has detected a beat Waveform settings Setting name Default Possible values value Channel 1 Waveform ECGII ECGI ECGII ECGIII ECGV RESP SpOz NBP Channel 2 Waveform ECGI ECGII ECGIII ECGV RESP SpOz NBP Channel 3 Waveform ECGI ECGII ECGIII ECGV RESP SpOz NBP Sweep Speed 25 mm sec 6 25 mm sec 12 5 mm sec 25 mm sec 50 mm sec When you have entered the changes you wanted to make press OK If you press Cancel the dialog box will disappear and the settings will keep the values they had when you first brought up the dialog box All of the settings in the Setup Waveforms dialog box can also be changed via the monitor menus When a monitor is connected the changes you make at either the NTS or at the monitor are copied at the other end so that both the monitor and t
14. electromagnetic compatibility EN 55022 EN 50082 1 The following is a list of actions that should be taken to reduce problems that are caused by electromagnetic interference EMI 1 Only use accessories that are listed in the Parts and Accessories section of the Service Manual 2 Ensure that other products in the area comply to accepted emissions standards EN 55022 3 Maximize the distance between electromedical devices 4 Strictly limit the use of portable radio frequency sources e g cellular phones and radio transmitters 5 Maintain good cable management Try not to route cables over electrical equipment CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 16 3 17 Biomedical Support NTS Hardware All NTS hardware equipment that is used by the NTS operator is composed of standard off the shelf PC components These components are not manufactured by CJPS Medical Systems but CJPS Medical Systems validates the NTS software on each PC platform before it is sent to a customer site for installation The hardware and software is once again tested as a system when the installation is complete Recommendations for storage cleaning and maintenance of the NTS hardware components are supplied by the manufacturer of the PC equipment All the manufacturer s manuals are delivered by CJPS Medical Systems to the NTS user at the time the NOMAD Telemetry System is installed CAUTION
15. following table provides instructions about how to clean the NTS and its accessories Before cleaning please refer to the cautions listed below the table Part Recommended cleaning method NOMAD Telemetry System Materials display case keyboard mouse and speakers e Enzymatic detergent such as ENZOL US or CIDEZYME outside the US e Distilled water e Disinfectant solution such as CIDEX activated dialdehyde or a 10 solution of household bleach 5 25 sodium hypochlorite in distilled water e Soft cloths and soft bristled brushes e Spray bottles Procedure 1 Prepare the enzymatic detergent according to the manufacturer s instructions and also the disinfectant solution in separate spray bottles 2 Spray detergent liberally on product If material is dried on allow to sit for 1 minute 3 Wipe smooth surfaces with a soft cloth 4 Use asoft bristle brush on visibly soiled areas and irregular surfaces 5 Clean detergent from product using cloth dampened in distilled water 6 Repeat as necessary 7 Spray disinfectant solution on affected area until saturated Allow product to sit for 5 minutes 8 Wipe away excess solution and clean product again with cloth dampened in distilled water Allow 2 hours for drying CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 17 12 CAUTION Do not use harsh chemicals for cleaning in particular do not u
16. nee 120 70 P 98 6 sP02 Room 221 P Killick PR Room 222 S Maturin PR HR HR RR RR TEMP base TEMP BK Room 225 A kramden PR Room 226 E Norton PR HR RR d TEMP BK 9g Room 229 H Clay ou Qn Room 230 D Webster PR Qn Figure 29 NTS Instructional Mode In Instructional Mode the Setup Service dialog box contains a setting called Require Passwords When the Require Passwords setting is set to No the Instructional Mode does not require passwords for the Setup System and Setup Service dialog boxes Also the main window can be minimized or closed CIPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 15 2 When the Require Passwords setting is set to Yes the Instructional Mode functions like the regular mode of the NTS passwords are required for the Configuration System and Configuration Setup dialog boxes and the main window cannot be minimized or closed MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 CPS 15 3 16 Troubleshooting The following table is meant to help you solve problems that you may encounter while operating the NTS If you are still experiencing a problem and none of these steps seem to help please contact CJPS Technical Support Email CJPS Info CJPS com Phone 1 248 593 1264 For more information please consult our web site www CJPS MedicalSystems com Trouble Symptom Possible Cause
17. the primary view by clicking on the small view for that monitor Note If using the Direct Connection option you must first connect the VitalPoint PRO monitor to the laptop running the NTS software using the Direct Connect Cable part number VS 940 WARNING Always be sure that you check which patient is selected in the primary view before changing any settings This is to avoid any chance of making changes to settings for one patient while thinking that you are making the changes for another patient Once you have selected the correct monitor into the primary view area you can bring up the Setup Parameters dialog box by clicking on the parameter area of the primary view L Current U m Gi ei GN Auto Set Ali Limits Cancel be HR BPM Iv 45 80 Co S Auto RR RPM lt I E 8 Sp02 100 Auto D lal PR BPM a l l TEMP Degrees F NBPs mmHg Fa NBPm mmHg Fi Fi NBPd mmHg 5 NBP Start NBP Stop Pulse Tone Source OFF e NBP initial inflation pressure mmHg 160 Lele Lele NBF auto mode minutes OFF Figure 8 Setup Parameters Dialog Box The Setup Parameters dialog box allows you to change the alarm limits for all the monitored parameters It also allows you to specify whether or not to disable alarms for a given parameter Note For a discussion of how the alarm limits and the alarms enabled disabled settings affect the alarm behavior of the system plea
18. Alamms EEN 7 7 Telade Alain e E e E 7 8 7 1 8 Alarm Handling at Start up 0 0 0 0 cece esceceecceeeeeeeeessnseeeeeeeeeeeeeeeesnseeeeees 7 8 PA Alarmi REPONS EE 7 9 7 1 10 Audible Alarm Tones While Connected to fbehNl 7 9 7 1 11 Backup Speaker Alarm Tones nn 7 10 7 2 Alarm e ele 7 11 7 3 Manual Self Test of the Alarm Gvstem 7 16 8 Viewing Be E 8 1 8 1 Trend Data Storag E 8 1 8 2 How to EE 8 1 8 3 How to Ee Sesbue eere eeefeeu eeh ege Sein 8 6 8 4 How to Enter Trend Notes oss 8 9 VitalPoint NOMAD eene System User s Guide DL 01008 Rev 2 9 Printing Ge 9 10 Bed Vital Signs Rep rt EE 9 10 9 2 Ne une E 9 12 9 3 Monitor ee 9 14 10 Transferring a TEE 10 1 10 1 Auto admit and Auto diSCharge ccccccceeeeeeeeeeeceeeeeeeeeeeeeeeeeteeeeeeeeeeeeeee 10 1 10 2 Patient Information Storage EE 10 2 11 Standby MOJE esiisa eine eea EE E EEEE NEE EEEE ETE 11 1 12 Wren S DOM ModE mnnn SAE SAAS 12 1 13 Di harging Patient EE 13 1 Th View ele E 14 1 15 Instructional Mode EE 15 2 16 Troubleshooting Seege 16 1 161 R d cmg E 16 3 17 BletregllealEEEER ae edigertieg reege ere eieeEEeeE ege eeieg 17 1 IP SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 General Information This User s Guide provides information for users of the VitalPoint NTS NOMAD Telemetry System Software The VitalPoint NTS serves as a central monitoring station for the VitalPoint
19. D 7382909 Date of Birth 23 DEC 21 Sex Female Physician Price Upper strip ECGII 25 mm sec 1 mV cm Lower strip ECGII 25 mm sec 1 mV cm Room 221 28 Feb 2003 10 47 31 28 Feb 2003 11 10 29 28 Feb 2003 11 10 29 mR Date Time NBP PR RR SO Date Time NBP PR RR SpO2 02 28 09 20 02 28 10 20 02 28 09 25 02 28 10 25 02 28 09 30 02 28 10 30 02 28 09 35 02 28 10 35 02 28 09 40 02 28 10 40 02 28 09 45 02 28 10 45 02 28 09 50 02 28 10 50 80 29 96 02 28 09 55 02 28 10 55 80 29 96 02 28 10 00 02 28 11 00 80 29 96 02 28 10 05 02 28 11 05 80 29 96 02 28 10 10 02 28 11 08 120 80 02 28 10 15 02 28 11 10 80 40 96 Summary report VitalPoint NOMAD Telemetry System User s Guide CJPS MEDICAL SYSTEMS DL 01008 Rev 1 Figure 23 9 3 Monitor Trend Reports The NTS provides a way to print simple trend reports from the monitor If you bring up the trends display on a monitor and press the Print All button the monitor sends a trend report to the NTS A scanned sample of a monitor trend report is shown on the following page CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry Syste
20. IPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 1 4 Main Features of the NTS The VitalPoint NOMAD Telemetry System provides a rich set of features to help you monitor the vital signs of patients respond to alarm conditions and review patient trends and reports The following list identifies the main tasks you will encounter in daily use For each of these tasks you can find detailed information in the corresponding chapter of this User s Guide e Admitting a Patient Section 2 below e Changing Patient Information Section 3 below e Changing Parameter Settings Section 4 below e Changing Waveform Settings Section 5 below e Understanding Messages Section 6 below e Managing Alarms Section 7 below e Viewing Trends Section 8 below e Printing Reports Section 9 below e Transferring a Patient Section 10 below e Standby Mode Section 11 below e Transport Mode Section 12 below e Discharging a Patient Section 13 below e View Only Mode Section 14 below e Instructional Mode Section 15 below e Troubleshooting Section 16 below e Biomedical Support Section 17 below CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 1 8 2 Admitting a Patient Before a patient is admitted to a monitor the small view area for that monitor is blank except for the name area which displays the monitor s Monitor ID In order to
21. Indications for Use The VitalPoint NOMAD is indicated for use in adult and pediatric patient populations in an environment where patient care is provided by healthcare professionals e g Physician Nurse Technician when 1 The professional determines that a device is required to measure any or all of the following patient parameters And Heart Rate Respiration Rate Temperature Systolic Mean and Diastolic Blood Pressure Functional Oxygen Saturation of Arterial Hemoglobin SpO2 Pulse Rate 2 The professional determines that a device is required to issue visible and audible alarms when any or all of the following parameters exceed preset limits Heart Rate Respiration Rate Temperature Systolic Blood Pressure Mean Blood Pressure Diastolic Blood Pressure Oxygen Saturation Percentage Pulse Rate CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 vii Typographical Conventions in this User s Guide This guide contains warnings cautions and notes to help call your attention to the most important safety and operational aspects of the system To help identify these items when they occur in the text they are shown using the following typographical conventions WARNING Statements that call attention to the possibility of injury death or other serious adverse reactions associated with the use or misuse of the device CAUTION Statements that call attention to the pos
22. Mode will suspend central alarm processing and trend data collection for as long as the monitor remains in Transport Mode After you put a monitor into transport mode the words Transport Mode appear in the waveform area Patient Configuration Help Ei A Alarm Silence Note Trends Print Transport Mode Ram P_ Killick Transport Mode RR NBP TEMP SpO2 Room 221 P Killick Room 222 S Maturin Figure 26 Portion of NTS display showing Transport Mode indications While a monitor is in Transport Mode alarm processing at the NTS is suspended To take a monitor out of Transport Mode select the monitor into the primary view by clicking on the small view for that monitor and then select the Patient Transport item from the NTS main menu Normal monitoring operations will resume The monitor will also leave Transport Mode automatically when it is reconnected to the network CJPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 12 2 13 Discharging a Patient When the time comes to discharge a patient you must first select the patient s monitor into the primary view by clicking on the small view for that monitor Note If using the Direct Connection option you must first connect the VitalPoint PRO monitor to the laptop running the NTS software using the Direct Connect Cable part number VS 940 WARNING Always be sure that you check which patient is selected in th
23. Point NOMAD Telemetry System User s Guide DL 01008 Rev 1 7 14 NBP conditions NBPs within limits None NBPd within limits None NBP Pulsations Too Small low NBPweak signal One Time NBP Too Much Motion 1 tow NBPartfact One Time NBP Pinched Hose NBP blocked hose check One Time patient NBP Measurement Time out NBP measurement time 2 minutes tw Size onetime NBP Pump or Valve Failure or NBP Safety Timer Expired or Medium NBP needs service One Time Other H W related problem NBP Bad Profile Shape Po iw NBP cannot measure TEMP conditions spe Display Alarm Annunciation Cremos tw TewPawotaree Les Tew pone sscomesea JL Lagos ow Tne Tew bacatvatonesster tw Jm Poon CIPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 7 3 Manual Self Test of the Alarm System You can manually self test test the alarm system by the following steps e Select a monitor that is being monitored at the NTS and bring it up in the large view area on the NTS e Turn Sp alarms on via the Parameter Setup Menu e At the monitor unplug the SpO gt sensor e After 10 seconds the NTS should sound a low grade alarm tone flash the SpO2 parameter box white and display the message SpO unplugged Note If using the Direct Connection option you must first connect the VitalPoint PRO monitor to the laptop running the NTS software using the Dire
24. VitalPoint NOMAD Telemetry System NTS User s Guide CJPS Medical Systems 2180 Livernois Rd Troy MI 48083 VitalPoint NOMAD Telemetry System NTS User s Guide EC Representative 4 Square Jean Paul Laurens 75016 Paris France CJPS Medical Systems 2013 all rights reserved NOMAD NOMAD Telemetry System and NTS are trademarks of CUPS Medical Systems The information in this document is subject to change without notice This document contains proprietary information that is protected by copyright No part of this document may be reproduced in any manner in whole or in part except for brief excerpts in reviews and scientific papers without the prior written consent of CUPS Medical Systems CJPS Medical Systems makes no warranty of any kind on this material including but not limited to the implied warranties of merchantability and fitness for a particular purpose CJPS Medical Systems shall not be liable for errors contained herein or for incidental or consequential damages concerning the furnishing performance or use of this material Before using any CUPS Medical System monitoring device be sure to read carefully and understand all manuals provided with the device All CUPS Medical System monitoring devices are intended for use only by qualified medical personnel MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 2 CIPS User Assistance If you have a qu
25. Warm the patient s extremities if needed Reattach the sensor on a smaller finger Remove any nail polish that may be interfering with the red light Replace the SpOz2 sensor Check to make sure the SpO2 sensor is securely connected to the SpO2 cable on the monitor Calm the patient Reattach the sensor on another finger with less movement Reattach the sensor on a larger finger Check the patient and provide any necessary Clinical care Change the alarm limit if it is no longer Clinically appropriate Check the patient and provide any necessary Clinical care Change the alarm limit if it is no longer Clinically appropriate VitalPoint NOMAD Telemetry System User s Guide 6 5 Check the patient and provide any The patient s pulse rate necessary clinical care SEH has fallen below the EEN PR lt lower limit number current lower alarm limit Change the alarm limit if it is no longer Clinically appropriate Check the patient and provide any The patient s pulse rate necessary clinical care has risen above the PR gt upper limit number current upper alarm limit Change the alarm limit if it is no longer clinically appropriate CJPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 6 6 6 5 Noninvasive Blood Pressure Messages Check the patient and provide any necessary Clinical care P li fusi SEENEN Check to make sure the cuff is Improper cuff pl
26. a new patient is admitted the patient s parameter and waveform settings are initialized to the factory default values as described in the relevant sections of this User s Guide You can change the values that are used for newly admitted patients to be ones that are tailored for your specific needs To do this select a monitor for display in the primary view area by clicking on the monitor s small view area Next configure the parameter settings and waveform settings for that monitor in the way you prefer Next bring up the Setup System dialog box and press the Save Setup button The settings you have configured for the selected patient will be saved Now any time a new patient is admitted the settings will be initialized to the values you have saved If you have a monitor whose settings have been changed and you want to go back to the saved settings select the monitor into the primary view area by clicking on the monitor s small view area Next bring up the Setup System dialog box and press the Restore Setup button The settings you had previously saved will be applied to the currently selected monitor If you have a monitor whose settings have been changed and you want to go back to the factory default settings select the monitor into the primary view area by clicking on the monitor s small CJPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 17 3 view area Next bring up the Configuration Syste
27. acement wrapped properly with the artery NBP weak signal mark lined up over the brachial artery Cuff size too large for the patient Check the limb circumference against the recommended range as printed on the cuff to insure the cuff is not too big Check the patient and provide any Persistent patient necessary clinical care movement or coughing Calm the patient Hemodynamic Move the cuff to another limb with less interference varying movement NBP artifact pulse amplitudes due to breathing or valvular If no obvious patient motion switching problem to the other limb may still help in the H case of hemodynamic interference ose is clogged or leaking Check the cuff and hose for signs of damage Check for leaks in the cuff or hose and NBP cuff leak P Leaky cuff or hose replace if necessary Check the patient and insure that the cuff is deflated NBP blocked hose Pinched Hose Check for kinks or obstructions in the check patient h ose Replace hose if necessary The measurement time limit 2 4 minutes was See suggestions for NBP artifact exceeded usually due to Repeat the measurement motion artifact Check the patient and insure that the cuff is deflated Monitor has detected a 2 NBP needs service hardware problem Turn the monitor off then on If message persists contact CUPS technical support NBP measurement time exceeded Initial inflation pressure may not have been high enough if patient s Re
28. admit a patient you must first select the patient s monitor into the primary view by clicking on the small view for that monitor If using the Direct Connection option you must first connect the VitalPoint PRO monitor to the laptop running the NTS software using the Direct Connect Cable using part number VS 940 To admit the patient connected to the monitor in Room 233 click on the area assigned to Room 233 on the viewing area Once you have selected the correct monitor into the primary view area you can bring up the Patient Admit Edit dialog box by clicking on the patient name area of the primary view Note You can also bring up the Patient Admit Edit dialog box via the Patient Admit Edit menu selections Patient Admit Edit Room 233 Patient Name ok Patient ID Auto ID Cancel Patient Initials Required Date of Bith Mee F Female Physician Figure 6 Patient Admit Edit Dialog Box In order to admit a patient you need to supply at least the following information patient name patient initials and patient ID The initials are used to display on the monitor in case the patient name is too long Note In order to provide the highest possible quality of patient record you should consider entering all the information requested by the Patient Admit Edit dialog box CJPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 2 9 When you h
29. alarm indicating a technical condition that prevents monitoring e g artifact What the Flashing and Colors Mean If you see It means A flashing red background with white text A high grade alarm indicating an immediately life threatening condition e g asystole or ventricular fibrillation A flashing yellow background with black text A medium grade alarm indicating a physiological condition that may be serious e g physiological parameter limit violations A flashing white background with black text A low grade alarm indicating a technical condition that prevents monitoring e g artifact A solid red background with white text A high grade alarm that has been silenced A solid yellow background with black text A medium grade alarm that has been silenced A solid white background with black text A low grade alarm that has been silenced A solid gray background with black text A condition that is true but is not considered to be an alarm CJPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 What the Icons Mean Icon Icon Name Description Deg Suspend A yellow crossed bell indicates that alarms are suspended for this monitor no alarms will be reported for this monitor while alarms are suspended HR Alarms Off A yellow crossed bell with red heart indicates that HR alarms
30. alarm processing is suspended To take a monitor out of Standby Mode select the monitor into the primary view by clicking on the small view for that monitor and then select the Patient Standby item from the NTS main menu Normal monitoring operations will resume The monitor will also exit Standby Mode if someone presses a key on the monitor front panel CJPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 11 2 12 Transport Mode If you ever have a need to disconnect a patient s monitor from the network without discharging the patient in order to avoid connection lost alarms you can put the monitor into Transport Mode To do this first select the patient s monitor into the primary view by clicking on the small view for that monitor Once you have selected the correct monitor into the primary view area select the Patient Transport item from the NTS main menu Note If using the Direct Connection option you must first connect the VitalPoint PRO monitor to the laptop running the NTS software using the Direct Connect Cable part number VS 940 WARNING Always be sure that you check which patient is selected in the primary view before entering Transport Mode This is to avoid any chance of putting one patient s monitor into Transport Mode while thinking that you are putting another patient s monitor into Transport Mode CAUTION Putting a monitor into Transport
31. are disabled for this monitor Note This icon is only displayed if the HR Alarms Off Icon feature is enabled SpO2 Alarms Off A blue crossed bell indicates that SoO2 alarms are disabled for this monitor Note This icon is only displayed if the SpO2 Alarms Off Icon feature is enabled aS Latched A green check mark indicates that an alarm condition that was true for a while is no longer true to see what the condition was select the monitor into the primary view and click on the message area CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 7 3 7 1 4 How to Silence Alarms You can silence an alarm for a monitor by selecting the monitor into the primary view area then pressing the Alarm Silence button on the NTS tool bar Alarm Silence button teen Help Q VA a 4 Alarm Silence Note Trends Print Shift Figure 10 Alarm Silence button You can also silence an alarm by doing either of the following e Disabling alarms either for the alarming parameter alone using the Parameter Settings dialog box or for the entire monitor using the Suspend button e If the alarm was a limit violation alarm by changing the parameter alarm limits such that the current value is no longer out of limits If the alarm condition that you are acknowledging is still true when you silence it the areas of the screen that were flashing because of the alarm will change t
32. at will directly connect to a local computer CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 1 3 NTS User Interface Note This option is not available with the Direct Connect option using cable part number VS 940 as the direct connection configuration only allows data from one VitalPoint PRO monitor to be displayed at a time Menu Tool bar Large view areas Small view areas Patient Configuration Help x2 120 70 98 6 E Ke Simulated connection 2 i HR I HR o fed 20 07 Ee 98 6 Tom 120 70 98 6 mee CM 120 70 98 6 Room 221 P Killick 8i Room 222 S Maturin 8 Room 223 J rarer 0 0 gt bere 120 70 98 5 ees er 120 70 98 ES bes Se ee 120 70 98 Es a Se P 20107 98 ES a Room 225 A Kramden al Room 226 E Norton Reen Room 227 E Mertz Room 228 B Fife 80 HR 80 me 29 mm A200 a 120 70 ms 96 80 Room 231 J Jay ER 80 Room 232 R Lee 80 zi g cee Room 229 H Clay D 80 PR Room 230 D Webster Figure 1 Sample ofn main NTS display screen The NTS user interface makes use of a keyboard and mouse for input and a display screen and speaker for output You can make selections and changes settings by means of a standard Windows style graphical user interface The NTS display takes up the entire screen with a single window which cannot be minimized cl
33. atient Data Only The main differences between Review Station mode and the NTS normal mode are e the NTS window can be minimized moved or closed e the NTS does not annunciate alarms and always displays crossed bell icons to show this e the NTS does not have any trend functions e the NTS does not support summary reports e there is no way to put monitors into Standby or Transport modes from the NTS e there is no message list dialog box e the NTS automatically discharges the patient when the monitor is disconnected however the patient is not discharged from the monitor Because the NTS Review Only mode can be run with other applications it does not perform alarm monitoring this task is done by the monitor As such there is always an alarm cross bell on the main display indicating that alarms are not annunciated monitor alarm set up is still allowed at the NTS in View Only mode however 15 Instructional Mode The NTS Instructional Mode is designed for training biomedical engineers nurses or other people who are studying how patient monitoring systems work The main differences between a regular NTS and the Instructional Mode NTS are as follows In Instructional Mode the NTS main window title bar contains text indicating that the software is not for use with patients Patient Configuration Help VA E gt Alarm Silence Note Trends Print Shift 24s 120 70 EN S ann Simulated connection HR HR RR RR TEMP D ao
34. atient temporarily for example while bathing the patient or while the patient is temporarily disconnected from the monitor you can put the monitor into Standby Mode To do this first select the patient s monitor into the primary view by clicking on the small view for that monitor Once you have selected the correct monitor into the primary view area select the Patient Standby item from the NTS main menu Note If using the Direct Connection option you must first connect the VitalPoint PRO monitor to the laptop running the NTS software using the Direct Connect Cable part number VS 940 WARNING Always be sure that you check which patient is selected in the primary view before entering Standby Mode This is to avoid any chance of putting one patient s monitor into Standby Mode while thinking that you are putting another patient s monitor into Standby Mode CAUTION Putting a monitor into Standby Mode will suspend alarm processing and trend data collection for as long as the monitor remains in Standby Mode After you put a monitor into standby mode the words Standby Mode appear in the waveform area Patient Configuration Help VA a gt Alarm Silence Note Trends Print Shift Standby Mode Room 221 D Killick Standby Mode NBP TEMP Sp02 Room 221 P Killick Room 222 S Maturin PR Figure 25 Portion of MPC display showing Standby Mode indications While a monitor is in Standby Mode
35. ave entered the information press OK If you press Cancel the patient will not be admitted The patient name area in both the small view and the large view will change to display the patient s name If you want to admit a patient quickly or if you need to admit a patient before complete patient information is available you can press the Auto ID button This will create an automatic ID for the patient based on a combination of the monitor ID and the current date and time and will fill in for the patient name and initials You can change the name ID initials and other fields at a later time The trend data and reports that were stored under the automatic patient ID will automatically be associated with the actual patient ID after you enter it WARNING After admitting a patient you should verify that the name you entered is displayed on the monitor connected to that patient This is to avoid any chance of accidentally admitting a patient for a different monitor than the one to which the patient is actually connected CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 2 10 3 Changing Patient Data If you ever need to change any of the information you entered at the time when a patient was admitted you can bring up the Patient Admit Edit Dialog Box again to make the changes In order to change the information for a patient you must first select the patient s monitor into the primary v
36. ct Connect Cable part number VS 940 CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 7 16 8 Viewing Trends 8 1 Trend Data Storage The NOMAD Telemetry System stores one trend sample per minute for each monitored physiological parameter The term trend sample interval is thus defined to be 1 minute If a parameter has one or more non numeric values such as LEAD OFF during any particular trend sample interval the sample value stored at the end of the interval will be the last non numeric value The only exception to this is that if the HR parameter has the value ASY or VFIB during a trend sample interval this ASY or VFIB value is preserved and stored at the end of the interval regardless of what other values the HR parameter may take on during the rest of the interval If the parameter has only numeric values throughout the trend sample interval the sample value stored will be the average of the numeric values The NTS stores trend samples for up to the past 14 days for up to 64 patients 8 2 How to View Trends You can view the trends for a patient by selecting the patient s monitor into the primary view area then pressing the Trends button Note If using the Direct Connection option you must first connect the VitalPoint PRO monitor to the laptop running the NTS software using the Direct Connect Cable part number VS 940 Trends button Patient Configuration Help Si VA
37. dmitted at the monitor the monitor and NTS alarm settings are merged such that the more conservative settings are used That is the narrower alarm limit range is used and a parameter alarm remains enabled if it was enabled at either the monitor or NTS If no patient is admitted at the monitor when the connection is made then the monitor will use the NTS settings without modification In addition to the physiological parameter alarm monitoring the VitalPoint PRO will sound an alarm if the internal temperature of the VitalPoint PRO housing is too high The VitalPoint PRO sounds an alarm when the remaining battery time is too low and when the connection between the monitor and NTS is lost for some reason 7 1 7 1 1 7 1 2 The term silenced in this table means that someone has taken some action in response to the alarm To see what these actions are please refer to the section on How to Silence Alarms 7 2 Alarm Basics What the Alarm Tones Mean If you hear It means Three chime tones separated by 1 second intervals A high grade alarm indicating an immediately life threatening condition e g asystole or ventricular fibrillation Two chime tones separated by 2 second intervals A medium grade alarm indicating a physiological condition that may be serious e g physiological parameter limit violations A single chime tone separated by 3 second intervals A low grade
38. e as pressing the NBP Start Stop key on the monitor when a measurement is in progress The NBP initial inflation pressure control allows you to specify the pressure to which the NBP cuff will be inflated at the beginning of an NBP measurement The monitor inflates the cuff to this pressure the first time it takes a measurement on a patient Once the monitor has made a valid measurement it will use the computed systolic pressure from that measurement when inflating the cuff for subsequent measurements This setting may be helpful if the monitor is having difficulty obtaining blood pressure readings on patients whose systolic pressure may be greater than 200 mmHg The NBP auto mode control allows you to set up the monitor to take NBP measurements automatically at set time intervals The monitor will take the measurements the next time the minute value is a multiple of the setting For example if you select to have measurements every 5 minutes and you do this at 9 12 the automatic measurements will begin at 9 15 then repeat at 9 20 9 25 9 30 and so on To take the monitor out of auto mode change the setting to OFF Note If the monitor loses its connection to the NTS while NBP auto mode is on the monitor will exit auto mode Note For a full discussion of how the NBP measurements work please refer to the VitalPoint PRO User s Manual The NBP settings are as follows Setting name Default Possible values value NBP initial infla
39. e primary view before discharging This is to avoid any chance of discharging one patient while thinking that you are discharging another patient Once you have selected the correct monitor into the primary view area select the Patient Discharge item from the NTS main menu This will cause a message box to appear asking you to confirm that you want to discharge the patient A Discharging will cause the system to stop monitoring for patient P Killick patient ID TEST_7382909 Are you sure you want to continue v Figure 27 Discharge confirmation message box When you have confirmed that this is the patient you want to discharge press Yes If you press No the patient will not be discharged After you discharge a patient the patient s name is removed from the large and small view areas on the NTS and from the monitor display Patient Configuration Help A VA Alarm Silence Note Trends Room 234 TEMP NBP TEMP Danm 2791 P Killick PR an Danm 2799 Q Matiurin PR an Figure 28 Portion of NTS display showing areas where a patient has been discharged MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 CIPS 13 2 14 View Only Mode The NTS Review Station mode provides a way for users of standalone monitors to view patient data without having to use the NTS as a conventional central alarm monitoring station The Review Station mode allows users to View P
40. e small view window i e you cannot change the assignment of monitors to small view windows The large view windows contain four areas a waveform display area a parameter display area which has two segments a patient name area and a message area MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 CJPS Patient Message area Waveform Parameter display area Name area Display area s Configuration Help E a aw gt Alarm Silence Note Trends Print Shift 2 120 70 98 6 Simulated connection Figure 3 Sample of NTS large view window The small view windows contain three areas a waveform display area a parameter display area and a patient name area Waveform display area Parameter display area e 420 80 98 6 Room 222 S Maturin P Patient name area Figure 4 Sample of NTS small view window normal CJPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 1 6 You can select one of the monitors for display in the primary large view window by clicking on the small view window for that monitor Waveform display area Parameter display area 7 80 H 29 e 420 80 98 6 96 WEE o Patient name area Figure 5 Sample of NTS small view window when selected You can copy the monitor display in the primary large view window to the secondary large view window by clicking on the Shift button C
41. estion or need help operating the VitalPoint NTS please contact CJPS Medical Systems Technical Support Email CJPS Info CJPS com Phone 1 248 593 1264 For more information visit our web site www CJPS MedicalS ystems com CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 iii Table of Contents VitalPoint NOMAD Telemetry System i User Assistance tege geed iii General Information EE vi T e EEN 1 1 TAs System Re E E 1 1 1 2 SCONE of this User s Guide a scceewcessesinsnbsnreveenontdvasgosetucabbotinnebiietuausbontwaubneteadts 1 3 1 3 NTS User EE eege 1 4 L Main Features of the NTS gxgetegsgeteekerdetedktegetertegeteikdederedededeeCEdeEedegedeedtet 1 8 2 Admitting a AMIN EE 2 9 3 Changing Patient R E 3 1 4 Changing Parameter Settings Ae 4 1 5 Changing Waveform Settings EE 5 1 6 Understanding Messages 6 1 6 1 Non physiological Messages 6 1 6 2 ECG and Heart Rate MGSSAQES iieieccsieediseuccedveevwendeeeicedeeaveend beeuraniuey ners emeseees 6 2 6 3 ee EE 6 4 6 4 Pulse Oxymetry Messages 6 5 6 5 Noninvasive Blood Pressure Messages 6 7 6 6 Temperature Messages sssssssssirrrreeseerrrrrnrrtresettrrrrtnnnnnseetrrnnnnnnnnneennnnn 6 9 Z Managing E E 7 1 Ka Dune 7 2 7 1 1 What the Alarm Tones Mean en 7 2 7 1 2 What the Flashing and Colors Mean EE 7 2 7 1 3 What the Icons Mean EEN 7 3 7 1 4 HOW to EE EE 7 4 Toles Alarm WOO E 7 5 7 1 6 How to Suspend
42. ew name area for the monitor When you suspend alarms for a monitor a timer starts When the timer expires the monitor goes back to its normal state in which alarms are annunciated You can re enable alarms for the monitor before the timer expires by pressing the Suspend button while the monitor is selected in the NTS primary view WARNING When you suspend alarms for a monitor you will not hear any tones or see any visual indications of alarms from that monitor for as long as the alarms remain suspended The Suspended state is meant to provide a way to avoid nuisance alarms but it also means you need to be especially attentive to the patient s waveforms and parameter values while the NTS is in the Suspended state CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 7 7 7 1 7 Alarm Validation Under the password protected Setup System menu option there is a feature called Alarm Validation that you can either enable or disable When this feature is enabled certain parameter limit violations are not considered to be in alarm until they have existed for a certain time period as listed below Limit Violation Alarm Validation Time HR Upper Limit 10 seconds HR Lower Limit 10 seconds RR Upper Limit 10 seconds SpOz Upper Limit 10 seconds SpO2 Lower Limit 10 seconds PR Upper Limit 10 seconds TEMP Upper Limit 10 seconds TEMP Lower Limit 10 second
43. he NTS are operating with the same setting values The only exception to this is the 50 mm sec sweep speed setting which only applies to the NTS display not the monitor Note All Waveform Settings go back to their default values when you discharge the patient CJPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 6 Understanding Messages This section provides tables that explain all the messages that may appear in the message area of the large patient views 6 1 Non physiological Messages Possible Cause Suggested Action The communication link to the monitor has been interrupted Monitor connection lost Internal temperature of the VitalPoint PRO is too high VitalPoint PRO box temp too high Check to make sure that the Power and Ethernet cable is still securely connected to the monitor Check to make sure that the Ethernet cable is still securely connected to the wall Talk to the NTS operator and check to make sure that the NTS is still operating normally If none of these steps is successful contact CUPS Medical Technical Support Check to see if the VitalPoint PRO has fallen on its side or is covered by a pillow blanket or anything else which could be keeping air from circulating freely around the monitor If this message continues contact Zoe Medical Technical Support Battery low Voie battery is getting Reconnect the monitor to power 6 2
44. ialog box is password protected The password is given to responsible individual s at each site when the system is installed You can also get the password by contacting CJPS Medical Systems customer support CIPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 17 5 Settings that can be changed via the Service Setup dialog box Site name any text up to 100 characters Language English Temperature Units Degrees F Degrees C Notch filter setting 50 Hz 60 Hz Off First COM port COM through COM71 SC Patient Enabled Enabled Disabled onnections Enable MPC second Disabled Enabled Disabled speaker Monitor ID any text up to 100 characters Changing the Monitor ID field will cause the new Monitor ID to be downloaded to the monitor that is connected when you press the OK button CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 17 6 The Setup COM ports button brings up the following dialog box Setup COM Ports COM port configuration Configure Pott Location name Connect type COM1 Room 221 Serial Net COM2 Room 222 Serial Net COM3 Room 223 Serial Net COM4 Room 224 Serial Net COMS Room 225 Serial Net COME Room 226 Serial Net COM Room 227 Serial Net COMS Room 228 Serial Net COM Room 229 Serial Net COM10 Room 230 Serial Net COM11 Room 231 Serial Net COM12 Room 232 Serial Net COM13 Room 233 Serial Net COM14 Room 234 Serial Net
45. icular Fibrillation Persistent HR Lead off after start up standby Persistent HR Lead off after leads applied Low One Time HR Artifact Po Low Persistent RR conditions RR gt 120 breaths min po Low RR out of range too high Persistent HR Asystole ASY HR esyt Lead off after leads applied Low RR lead off One Time Resp Artifact p Low RR artifact CJPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 SpO gt 2 conditions SpOz Bad Probe Po Low One Time SpOz2 Cannot regulate LED intensity after start up standby Blank None N ng Persistent SpOz2 Pulsations Too Weak po Low SpO2 weak signal Persistent Se La Le ler Les SpOz Probe is disconnected nen Low Spor unplugged One Time SpOz motion artifact Po Low Sp artifact Persistent PR conditions PR Bad Probe po Low One Time PR Cannot regulate LED intensity after start up standby SpO2 Cannot regulate LED Low Sp check sensor Persistent intensity after finger in probe placement PR Cannot regulate LED Low SpOz2 check sensor Persistent intensity after finger in probe placement PR Pulsations Too Weak fo Low SpOz weak signal Persistent PR Probe is disconnected lt Blank gt None None Persistent after start up standby PR Probe is disconnected after finger in probe Low Sp unplugged One Time PR motion artifact Po Low Sp artifact Persistent CJPS MEDICAL SYSTEMS Vital
46. iew by clicking on the small view for that monitor Note If using the Direct Connection option you must first connect the VitalPoint PRO monitor to the laptop running the NTS software using the Direct Connect Cable part number VS 940 WARNING Always be sure that you check which patient is selected in the primary view before changing any information This is to avoid any chance of making changes to information for one patient while thinking that you are making the changes for another patient Once you have selected the correct monitor into the primary view area you can bring up the Patient Admit Edit dialog box by clicking on the patient name area of the primary view Note You can also bring up the Patient Admit Edit dialog box via the Patient Admit Edit menu selections Patient Name P Killick 0K Patient ID 7382909 Auto ID Cancel Patient Initials PK Required Date of Bith 23DEC21 Male Female Physician Price Figure 7 Patient Admit Edit Dialog Box When you have entered the changes you wanted to make click OK or to exit without making any changes to the patient information click Cancel If you change the patient ID the trend data and reports that were stored under the original patient ID will automatically be associated with the new patient ID 4 Changing Parameter Settings In order to change parameter settings for a patient you must first select the patient s monitor into
47. k the patient and provide any necessary Clinical care Change the alarm limit if it is no longer Clinically appropriate Check the patient and provide any necessary Clinical care Change the alarm limit if it is no longer Clinically appropriate 6 9 7 Managing alarms You can configure the VitalPoint NOMAD Telemetry System to sound an alarm when a patient s physiological parameter goes beyond a predetermined limit For example you can configure the system to sound an alarm when the patient s heart rate goes above 150 bpm or goes below 50 bpm Alarm monitoring can be individually configured for each physiological parameter In the NOMAD system alarm monitoring is supported both at the NTS and at the bedside monitor When the monitor and NTS are connected they use the same alarm monitoring settings If a setting is changed at either the monitor or the NTS then the setting is updated at both the monitor and the NTS This is also true for alarm silencing For example if you silence an alarm at the monitor it is also silenced at the NTS Note If using the Direct Connection option only the VitalPoint PRO monitor will alarm An alarm will only show in the NTS software if the VitalPoint PRO is alarming when connected to the NTS using the Direct Connect Cable part number VS 940 When the monitor and NTS are initially connected there is special handling to merge the alarm settings of the two devices If a patient is a
48. l Monitoring Station NTS Multi port Serial to Ethernet Hub Ethernet Serial Connections Up to 64 PRO monitors As shown above all VitalPoint PRO monitors are connected to the NTS software at the central station Alternately if using the NOMAD Direct Connect Cable the diagram below illustrates the main components and setup Central Monitoring Station Direct Connect Cable CIPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 1 2 1 2 Scope of this User s Guide This User s Guide provides information for operators of the NTS For information about how to use the VitalPoint NOMAD Telemetry System please consult the VitalPoint NOMAD User s Guide The NTS service manual provides information related to the connection process for the VitalPoint NOMAD Monitor to the NTS system Once again NOMAD has two possible configurations which require a different connection cable 1 A distributed system which requires one NTS computer laptop desktop or tablet configured and provided by CJPS at the Central Nursing Station This configuration also requires a cable part number VS 945 for each of up to 64 VitalPoint PRO monitors VS 101 to talk to that NTS computer via the user s Intranet network 2 A direct monitor to PC system which requires the NOMAD Direct Connect cable part number VS 940 for each VitalPoint PRO monitor th
49. le the NTS and be sure not to interrupt the start up sequence when it is coming back on If the NTS does not start working normally after this contact CUPS Medical Systems Technical Support The NTS keyboard or mouse is not working right Keyboard or mouse failure Contact CUPS Medical Systems Technical Support for a replacement The NTS display is not working right Display failure Contact CUPS Medical Systems Technical Support for a replacement The NTS displays a message stating that it is unable to get disk free space The NTS disk is too full and needs to be cleaned up Contact CUPS Medical Systems Technical Support The NTS displays a message stating that the disk space is getting low The NTS disk is too full and needs to be cleaned up Contact CUPS Medical Systems Technical Support The NTS displays a message stating that the memory space is getting low The NTS memory is too full The condition may be due to an inadequate amount of memory installed in the PC Contact CUPS Medical Systems Technical Support The NTS displays a message stating that the CPU is too busy Internal system failure Contact CUPS Medical Systems Technical Support CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide 16 2 DL 01008 Rev 1 16 1 Reducing EMI The VitalPoint NOMAD Telemetry Systems complies with regulatory standards regarding
50. m User s Guide DL 01008 Rev 1 9 14 Figure 24 P Killick Room 221 20 May 2003 15 29 37 ID TEST_7382909 Date of Birth 23 APR 21 Sex Female Physician Date Time NBP PR RR SpO02 19 May 2003 16 31 48 120 80 80 z 19 May 2003 16 36 37 120 80 80 D Se 19 May 2003 17 42 43 120 80 80 ss 19 May 2003 17 59 58 120 80 80 CG 19 May 2003 18 12 11 120 80 80 SES 20 May 2003 12 31 11 120 80 80 20 May 2003 12 32 11 120 80 80 D Ss 20 May 2003 14 47 29 120 80 80 15 96 20 May 2003 14 52 15 120 80 80 17 96 20 May 2003 15 27 33 120 80 80 23 96 Monitor trend report MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 CJPS 10 Transferring a Patient 10 1 Auto admit and Auto discharge Once a patient has been admitted to a monitor you can transfer the patient to another place on the network simply by unplugging the monitor from the first location and plugging it into the second location The system accomplishes this through its auto admit and auto discharge capabilities Note This feature does not apply to the direct connect method For example assume that patient Smith is connected to a monitor in Room 301 and that patient Jones is connected to a monitor in Room 302 Assume that in the network configuration Room 301 shows up as the top left small view on the NTS and that Room 302 shows up just to the right of Room 301
51. m dialog box and press the Restore Factory Defaults button The factory default settings will be applied to the currently selected monitor Note At this point if you were to press the Save Setup button you would effectively go back to the situation where factory default settings would be applied to any newly admitted patient Each of these buttons will prompt you for a confirmation before the desired action takes effect You can also restore settings for a monitor by selecting Restore Setup from the Configuration menu this does not require a password Selecting this restores the monitor settings to the last saved settings CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 17 4 Configuration Setup The Configuration Setup dialog box provides a way to change additional aspects of the NTS system configuration that usually only have to be done when the system is installed Site Configuration Sitename Cancel Temperature units C DegreesC e Degrees F System Maintenance Notch filter setting C 50Hz 60Hz C Off Run Windows Explorer First COM port COM1 S Exit MPC Number of COM ports 15 Setup COM Potts Simulate patient connections V gi 4 Place Monitors in Transport Mode 4 Manage Folders Monitor Configuration Monitor Diagnostics Download Monitor ID Get HW Test Values Figure 31 Configuration Setup Dialog Box Access to the Configuration Setup d
52. me interesting details you can zoom in on this section To do this just left click and drag the mouse in either the time scale area or the parameter scale area As you do this the part of the graph that will be zoomed in appears as a white region When you release the left mouse button the white region will expand to fill the whole graph Trend Notes At the bottom of the Trends dialog box are several controls that allow you to see the trend notes that have been entered for the patient You can use the arrow controls to scroll backwards and forwards through the notes or you can use the pull down list to select a specific note for review For information about how to enter the trend notes please refer to the section on How to Enter Trend Notes CJPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 8 5 8 3 How to Print Trend Data To print a paper copy of the trend data first get the data you want into view using either the trend graph view or the trend table view Then just press the Print button The printed report will show the same information you see on the screen Note If using the Direct Connection option you must first connect the VitalPoint PRO monitor to the laptop running the NTS software using the Direct Connect Cable part number VS 940 The following pages show scanned samples of printed trend data Scanned samples of the trend hard copy output are shown on the following pages
53. nt system display units Trend NBPs scale Gates 0 150 0 200 0 250 Auto mmHg 0 150 Trend NBPd scale 0 150 0 200 0 250 Auto mmHg 0 150 Trend NBPm scale 0 150 0 200 0 250 Auto mmHg CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 8 4 How to use the Trend Cursor By left clicking anywhere on the graph you can bring up a cursor which is drawn on the graph as a one pixel wide vertical white line When the cursor is showing you can see the exact values each parameter had at the time represented by the current cursor position These values are displayed to the right of the graphs If you hold down the left mouse button and drag the cursor across the graph you can see the parameter values for any time on the graph You can also use the cursor time arrow controls to move the cursor by slight increments For time periods when a parameter did not have a numerical value that can be graphed the graph shows a gap When you move the cursor over this gap you may see the symbol in the area that tells what the parameter values were at the cursor time To get more information about what the parameter value was you can move the mouse cursor over the symbol which causes a text message explaining the parameter value to appear temporarily in the Trend Notes window at the bottom of the Trends dialog box How to Zoom in on a Trend Graph If there is a section of the graph that contains so
54. o solid color backgrounds Sometimes an alarm condition will have gone away before you have a chance to silence it When this happens the alarm is said to be latched You can tell when this is the case because the Latched icon will appear in the small view for the monitor To see what the alarm condition was select the monitor into the primary view area then click on the message area CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 7 4 7 1 5 Alarm Log When you click on the primary view message area the system displays the Alarm Log dialog box This dialog box has three main sections one for showing the current alarm status one for showing the alarm history and one for showing the ECG strip associated with stored alarm events You can use the mouse or keyboard to scroll through the list of stored alarm events and print a hard copy if desired You can also select the All Alarm Events option which lists not only the HR alarms but also alarms for other parameters along with any setting changes or other user interactions that affect the system alarm behavior AlarmLog Room221 P Killick x Close 28 Feb 2003 10 52 04 Current Alarm Status Date 02 28 2003 _Time Message Status 10 52 04 HR gt 75 Active Alarm History All Alarm Events Ze HR Alarm Reports Only Print Date Time Message 28Feb 2003 10 52 04 HR gt 75 28Feb 2003 10 50 59
55. o the time when you press the button A scanned sample of a vital signs report is shown on the following page CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 9 10 28 Feb 2003 11 Room 221 80 HR RR P Killick ID 7382909 02 05 29 96 80 SpO2 PR Date of Birth 23 DEC 21 Sex Female Operator Request 98 6 F TEMP NBP ECGIl 25 mm sec 1 mV cm 15 45 120 80 Physician Price
56. oken lead wires Turn monitor off then back on If message persists contact CJPS technical support CJPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 6 2 Calm the patient Patient movement Isolate the patient from auxiliary equipment if possible ee noise torm Check to make sure electrodes are still i auxiliary equipment HR artifact y equip securely attached to the patient and Bad electrode contact reattach if necessary Remember the importance of good skin preparation techniques Check the patient and provide any The patient s heart rate necessary clinical care has fallen below the HR lt lower limit number current lower alarm limit Change the alarm limit if it is no longer clinically appropriate Check the patient and provide any The patient s heart rate necessary clinical care Sch has risen above the HR gt upper limit number current upper alarm limit Change the alarm limit if it is no longer Clinically appropriate CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 6 3 Respiration Messages The patient s respiration rate has risen above the maximum value the monitor can accurately detect RR out of range Electrical noise from auxiliary equipment Monitor confused by signal artifact Unplugged cable Broken cable Loose lead wire RR lead off Faulty lead wire Dried out electrode Inoperable respi
57. onger clinically appropriate Check the patient and provide any necessary Clinical care Change the alarm limit if it is no longer clinically appropriate VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 6 4 6 4 Pulse Oxymetry Messages SpOz replace sensor SpOz2 check sensor placement SpO2 weak signal SpOz2 unplugged SpOz artifact SpO2 lt lower limit SpOz gt upper limit Bad SpO sensor Incorrect set up within the monitor Sensor has become detached from patient Sensor not fully inserted on patient s finger Excessive ambient light Bad sensor no red light coming from sensor Poor perfusion Large tissue mass Nail polish Bad SpOz sensor SpOz sensor not connected to SpOz cable Patient movement or coughing Hemodynamic interference Small tissue mass The patient s oxygen saturation has fallen below the current lower alarm limit The patient s oxygen saturation has risen above the current upper alarm limit CPS MEDICAL SYSTEMS DL 01008 Rev 1 Replace the SpOz2 sensor Contact CJPS technical support Check to make sure the sensor is attached fully and securely to the patient Cover the sensor with opaque material such as a towel to reduce ambient light Reattach the sensor possibly on a smaller or larger finger Replace sensor if there is no red light coming from it Check the patient and provide any necessary clinical care
58. osed resized or moved CAUTION Since the NTS software runs on a Windows platform it can be interrupted by pressing CTRL ALT DEL This will suspend monitoring for all the connected monitors Take care not to press these keys JPS SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 1 4 The window title includes the text CJPS Medical Systems VitalPoint NTS along with a display of the current time The window contains a menu at the top with menu items for Patient Configuration and Help Below this menu is a tool bar consisting of a row of buttons for common tasks Alarm Silence Note Trends Print and Shift Patient Configuration Help A VA M Alarm Silence Note Trends Print Shift ll f Figure 2 Close up view of NTS menu and tool bar buttons The main display window contains two large view windows the primary view on the left and the secondary view on the right The main display window contains up to 64 small view windows Each of the small view windows displays information from a single connected monitor Every monitor in the NOMAD Telemetry System is assigned a Monitor ID which may be simply a number such as Monitor 12 or some text that identifies where the monitor is located such as Room 302 Every monitor is also assigned to a specific small view area of the NTS display The information from a monitor is always displayed in the sam
59. peat the measurement monitor will systolic pressure is automatically adjust to using a higher above 200 mmHg initial inflation pressure if needed NBP cannot measure Patient movement CJPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 6 7 NBPs lt lower limit NBPs gt upper limit NBPm lt lower limit NBPm gt upper limit NBPd lt lower limit NBPd gt upper limit 6 8 The patient s systolic pressure has fallen below the current lower alarm limit The patient s systolic pressure has risen above the current upper alarm limit The patient s mean pressure has fallen below the current lower alarm limit The patient s mean pressure has risen above the current upper alarm limit The patient s diastolic pressure has fallen below the current lower alarm limit The patient s diastolic pressure has risen above the current upper alarm limit CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 Check the patient and provide any necessary Clinical care Change the alarm limit if it is no longer Clinically appropriate Check the patient and provide any necessary Clinical care Change the alarm limit if it is no longer Clinically appropriate Check the patient and provide any necessary Clinical care Change the alarm limit if it is no longer Clinically appropriate Check the patient and
60. provide any necessary clinical care Change the alarm limit if it is no longer clinically appropriate Check the patient and provide any necessary Clinical care Change the alarm limit if it is no longer Clinically appropriate Check the patient and provide any necessary clinical care Change the alarm limit if it is no longer Clinically appropriate 6 6 Temperature Messages blank TEMP unplugged TEMP out of range TEMP needs service TEMP lt lower limit TEMP gt upper limit Temperature probe disconnected The patient s temperature has risen above the maximum value the monitor can accurately detect There is a problem with the connections or with the hardware Monitor has detected a hardware problem The patient s temperature has fallen below the current lower alarm limit The patient s temperature has risen above the current upper alarm limit CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 Check to make sure the temperature probe is connected to the temperature cable Check to make sure the temperature cable is connected to the monitor Check the patient and provide any necessary clinical care Check the temperature cable connections Turn the monitor off then on If message persists contact CUPS technical support Turn the monitor off then on If message persists contact CUPS technical support Chec
61. r Note All Parameter Settings go back to their default values when you discharge the patient MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 CPS 4 5 5 Changing Waveform Settings In order to change waveform settings for a patient you must first select the patient s monitor into the primary view by clicking on the small view for that monitor Note If using the Direct Connection option you must first connect the VitalPoint PRO monitor to the laptop running the NTS software using the Direct Connect Cable part number VS 940 WARNING Always be sure that you check which patient is selected in the primary view before changing any settings This is to avoid any chance of making changes to settings for one patient while thinking that you are making the changes for another patient Once you have selected the correct monitor into the primary view area you can bring up the Setup Waveforms dialog box by clicking on the waveform area of the primary view Note You can also bring up the Setup Waveforms dialog box via the Configuration then Waveforms menu selections Room 221 _ P Killick Waveform Size Sweep Speed Channel1 II v 10 mm m e 6 25 mm sec Cancel C 12 5 mm sec Channel2 RESP xl Auto E e 25 mm sec Channel3 SP02 x Auto A SE Show beat detect spikes I Figure 9 Setup Waveforms Dialog Box The Setup Waveforms dialog box allows you to
62. ration detection circuit Patient movement Electrical noise from RR artifact auxiliary equipment Bad electrode contact The patient s respiration rate has fallen below the RR lt lower limit number current lower alarm limit The patient s respiration rate has risen above the RR gt upper limit number current upper alarm limit CPS MEDICAL SYSTEMS Check the patient and provide any necessary Clinical care Isolate the patient from auxiliary equipment if possible Check to make sure electrodes are still securely attached to the patient and reattach if necessary Remember the importance of good skin preparation techniques Check to make sure electrodes are still securely attached to the patient and reattach if necessary Remember the importance of good skin preparation techniques Check to make sure all the lead wires are still connected to the electrodes Check to make sure the lead wires are securely connected to the monitor Check to make sure there are no broken lead wires Turn monitor off then back on If message persists contact Zoe technical support Calm the patient Isolate the patient from auxiliary equipment if possible Check to make sure electrodes are still securely attached to the patient and reattach if necessary Remember the importance of good skin preparation techniques Check the patient and provide any necessary clinical care Change the alarm limit if it is no l
63. s The purpose of this feature is to reduce nuisance alarms in which parameter values may go out of limits for a very short time 7 1 8 Alarm Handling at Start up When the monitor is initially powered up or brought out of standby alarms will not be annunciated for a given parameter until the lead set or probe has been applied to the patient This prevents nuisance alarms for parameters that are not being monitored on a given patient CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 7 8 7 1 9 Alarm Reports When the monitor is connected to the NTS an alarm report is stored at the NTS for each medium and high grade alarm that is annunciated for the HR parameter This includes upper and lower limit violations Asystole and Ventricular Fibrillation These reports include a snapshot of the monitor s physiological parameters and an ECG waveform strip When the monitor is disconnected from the NTS the 10 most recent alarm reports are stored within the monitor The reports are stored even if power is cycled When the monitor is reconnected to the NTS the reports are transferred to the NTS Manually generated reports via the monitor s print key are also stored while in Transport Mode and are counted as part of the 10 reports See the discussion on the Alarm Log for more details on alarm reports 7 1 10 Audible Alarm Tones While Connected to the NTS When the monitor is connected to
64. s Things to Try The NTS PC will not run after power cycling There was an internal Windows operating system error Contact CUPS Medical Systems Technical Support No waveforms or parameters appear from the monitor No connection to monitor Verify that the monitor is powered on and that the Ethernet cable is securely connected to the monitor No waveforms or parameters appear from any of the monitors There was an internal Windows operating system error Power cycle the NTS and be sure not to interrupt the start up sequence when it is coming back on If the NTS does not start working normally after this contact CUPS Medical Systems Technical Support The patient name on the monitor does not match the name on the NTS The patient was admitted to the wrong small view area Verify that the patient is admitted into the correct small view area for the monitor The connection cabling to the monitor has been changed Stop using the monitor contact NTS Technical Support to re check the system installation The display is flashing but there is no sound The speaker volume has been turned down Verify that the NTS speaker volume is not turned down The speakers have been disconnected Verify that the speakers are connected to the NTS The NTS PC is displaying an error message or has reset and is displaying a blue screen There was an internal Windows operating system error Power cyc
65. se disinfectants that contain phenol as they can spot plastics Do not steam autoclave gas sterilize irradiate subject to intense vacuum or immerse in water or cleaning solution Be careful to avoid getting cleaning liquids into connectors If liquid does get into a connector allow the unit to dry in warm air for 2 hours then check to make sure all monitoring functions are still working properly CAUTION The user has the responsibility to validate any deviations from the recommended method of cleaning and disinfection CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 17 13
66. se refer to the Managing Alarms chapter The alarm limits can be changed within the following boundaries Setting name Default Possible values value HR upper alarm limit 160 bpm 20 300 bpm HR lower alarm limit 45 bpm 15 295 bpm RR upper alarm limit 40 bpm 6 120 bpm NBPd lower alarm limit TEMP upper alarm limit 32 1 42 0 degrees C Note depends on user setting for TEMP units 89 7 107 6 degrees F TEMP lower alarm limit 32 0 41 9 degrees C Note depends on user setting for TEMP units 89 6 107 5 degrees F Note regarding limits settings the upper limit must always be higher than the lower limit in addition to the ranges listed in the table above The Auto Set All Limits button along with the individual Auto buttons provides a quick way of setting alarm limits When you press the Auto button for a given parameter if it has a current value that is numeric the NTS automatically computes alarm limits based on the current value When you press the Auto Set All Limits button the NTS automatically computes alarm limits for CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 4 2 all the parameters that have numeric values just as if you hit the Auto button for each parameter separately The rules the NTS uses for computing the alarm limits automatically are as follows Parameter Lower limit adjustment Upper limit adjustment HR RR PR NBPs Changed to 80 of
67. sibility of a problem with the device associated with its use or misuse Such problems include device malfunction device failure damage to the device or damage to other property Note Statements that provide supplemental information CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 2 viii 1 Overview This chapter provides an overview of the NTS including a diagram showing how the NTS fits into the VitalPoint NOMAD Telemetry System and a description of how this User s Guide relates to other VitalPoint NOMAD Telemetry System documents This chapter also provides a basic overview of the NTS user interface and a list of the NTS main features NOMAD has two possible configurations which require a different connection cable 1 A distributed system which requires one NTS computer laptop desktop or tablet configured and provided by CJPS at the Central Nursing Station This configuration also requires a cable part number VS 945 for each of up to 64 VitalPoint PRO monitors VS 101 to talk to that NTS computer via the user s Intranet network 2 A direct monitor to PC system which requires the NOMAD Direct Connect cable part number VS 940 for each VitalPoint PRO monitor that will directly connect to a computer 1 1 System Diagrams The main components of the VitalPoint NOMAD Telemetry System are shown in the following diagram Hospital Rooms Centra
68. the NTS central station it can be configured to sound an alarm tone for high grade alarms only e g Asystole This may be especially helpful at night when the patient is sleeping If the communications link between the monitor and NTS is broken the monitor will once again generate an alarm tone for all alarms CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 7 9 7 1 11 Backup Speaker Alarm Tones The backup speaker for the NOMAD Telemetry System enhances the alarm functionality by providing a completely independent backup to the NTS main speakers The way the backup speaker works is very simple Whenever the NTS starts sounding an audible tone for an alarm condition it starts a timer If the alarm tone is still going after a certain length of time normally two minutes the backup speaker will also start sounding When you silence the alarm both the main speakers and the backup speaker if it was sounding are silenced The amount of time delay between when the main speakers start sounding and when the backup speaker starts sounding can be set anywhere between 0 to 600 seconds via the Configuration System menu Since the backup speaker has a slightly different sound than the main speakers it also serves to provide you with an indication of when a given alarm has been sounding for longer than the pre set delay time Other than starting the backup speaker after the pre set delay time
69. the current Changed to 125 of the current NBPm NBPd parameter value or the nearest parameter value or the nearest allowable value given the alarm limit allowable value given the alarm limit settings rules settings rules SpO2 Changed to 95 of the current Set to 100 parameter value or the nearest allowable value given the alarm limit settings rules Temp Changed to 95 of the current Changed to 105 of the current parameter value or the nearest parameter value or the nearest allowable value given the alarm limit allowable value given the alarm limit settings rules settings rules WARNING Be sure to verify that that the alarm limits are set to appropriate values before exiting the Setup Parameters dialog box especially if you are using the automatic limit setting feature The Pulse Tone Source control tells the monitor to generate an audible tone for each beat that is detected during monitoring Either ECG or SpO2 can be selected as the source for pulse tones Setting name Pulse Tone Source Off Default Possible values value Off ECG SpOz CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 4 3 The NBP Start button provides a way for you to complete an NBP measurement for a patient remotely It functions the same as pressing the NBP Start Stop key on the monitor The NBP Stop button provides a way for you to stop an NBP measurement remotely It functions the sam
70. tion 160 mmHg 100 270 mmHg in pressure steps of 10 mmHg NBP auto mode OFF OFF 3 5 10 15 30 60 120 minutes When you have entered the changes you wanted to make press OK If you press Cancel the dialog box will disappear and the settings will maintain the values as set when you first brought up the dialog box All of the settings in the Setup Parameters dialog box can also be changed via the monitor menus When a monitor is connected the changes you make at either the NTS or at the monitor are copied at the other end so that both the monitor and the NTS are operating with the same setting values CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 4 4 When a monitor is disconnected from a user at either the NTS or the monitor may make setting changes These setting changes need to be reconciled at the time when the monitor is reconnected The basic rule at connect time is that setting values stored in the monitor take precedence over the ones stored at the NTS In other words the setting values are uploaded from the monitor to the NTS when the monitor reconnects The only exception to this general rule is that the NTS checks to see if the setting changes from the monitor would create a more hazardous situation for example if alarms were turned off or if alarm limits were made wider In these cases the setting values from the NTS are used instead and override the ones at the monito
71. to PRO monitors are removed and a new check box is added that controls whether or not password access is enabled this check box also controls whether or not the main window can be minimized or closed Service Setup Figure 34 Setup Service Dialog Box Instructional Mode CJPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 17 9 Configuration Factory The Configuration Factory dialog box provides a way to change additional aspects of the NTS system configuration that usually only have to be done when the system is installed Factory section is only to be used by CJPS personnel or contractors MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 CPS 17 10 Maintenance The following table shows the recommended maintenance procedure for the NOMAD Telemetry System These procedures should be carried out every 12 months and can be performed by the biomedical staff If there is a failure in one of the checks please contact CJPS Medical Systems Customer Service for help Email CJPS Info CJPS com Phone 1 248 593 1264 NTS Function Procedure Speaker Use the System Setup dialog box to check the NTS speaker and verify that the volume is appropriate for the place where the NTS is being used CPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 17 11 Cleaning The
72. up the Note dialog box Note Room221 P Killick Patient reported minor chest pain Cancel Figure 19 Note dialog box You can type in any text you want and then press OK If you press Cancel the note will not be saved in the patient s record WARNING Always be sure that you check which patient is selected in the primary view before entering a patient note This is to avoid any chance of entering information in a patient note for one patient while thinking that you are entering the note for another patient There is no way to go back and remove or change a note once it is stored To help avoid mistakes the name of the patient for whom the note will be stored is displayed at the top of the Note dialog box CJPS MEDICAL SYSTEMS VitalPoint NOMAD Telemetry System User s Guide DL 01008 Rev 1 8 9 9 Printing Reports 9 1 Vital Signs Report To print vital signs report for a patient first select the patient s monitor into the primary view area and then press the Print button on the NTS tool bar Print button Patient Configuration Help A A Ww Alarm Silence Note Trends Print Shift Figure 20 Print button The vital signs report prints whichever ECG lead is currently the top ECG lead on the NTS display or ECGII if no ECG lead is on the NTS display The report shows 35 seconds of data 5 strips of 7 second s worth each on a single page The time for the data is the 35 seconds previous t

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