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GE Dash 3000,4000,5000 - Frank`s Hospital Workshop

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1. 3 9 Catheters astuce 12 4 recall defaults 3 9 catlieter size aute tete 12 4 D computation 12 5 Danger 4 2 12 4 Eu He discharge n 5 5 injectate temperature 12 4 sos MANUAL te reete rete gs biter 5 5 injectate volume 12 4 dosage calculations 7 11 2 3 ener tete 12 4 troubleshooting s x i xax 12 7 GO trials a A 12 5 eee eco ENIM E 8 2 8 23 CO 15 2 15 8 12 lead 44 2 1222 8 21 Calibrating adapters 15 7 AB l k ya eren dik ne et Kak tea e dies 8 3 calibrating sample lines 15 7 control settings Ek 8 11 Calibrating 15 6 12 lead 8 11 control settings ARET 15 5 8 11 alarm 15 5 arrhythmia Sy n 8 13 averaglng cet notiert 15 5 beat pause interval 8 14 Calibrate
2. 15 6 clear 8 13 capnogram 15 5 detect pace erepti 8 11 0 compensation 15 5 GIS PLAY ico t ri eia esee 8 11 O2 15 5 eee ene 8 14 units of 15 5 lead analysis 8 13 Z ro Sel SOL cere interit eda 15 6 QRS 8 14 eii m 15 3 QRS iion tane 8 14 troubleshooting lt lt u dk y u xuh 15 8 relearn 8 11 CO2 conirol settings ST analysis Ei ee 8 11 calibrate sample 15 6 View All leads neie nere 8 11 waveform 15 6 waveform 8 12 1 15 1 17 waveform 826 8 11 EMI sz ett D cee reer 1 16 waveform 8 14 a Da M 1 15 custom defaults LOG SAI LIAE aC 1 17 AFIB alarm level 8 18 UL stent etie ens 1 16 IntelliFlata n entere 8 17 connectors rate 8 17 2 6 SOUCO
3. 16 7 12 lead 8 21 clear 5 16 7 ppl M 3 3 CP alarm 16 8 A display 16 7 gas alarm 16 8 admit 5 2 5 5 16 9 Loo uU eer 5 3 MOOG shite 16 7 control Settings 5 3 review gas 16 8 bed qek leka ya 5 4 U na units of measurement 16 8 change patient information 5 4 ECG source 5 5 view other 9 5 5 16 8 SER R N DANEK NAL O WE W HAL rece 16 9 location 5 5 CECI 16 3 print 0 5 5 iroubleshoolin 16 9 request admit information 5 4 aa HII MEE 5 4 B units of 5 4 lo i CE 3 3 IECIT 5 2 batteries ione tie eee 6 14 ER 5 3 Capacity ieai pees eee ie A 9 admit mode charging tee eere Beene A 11 see monitoring 3 3 conditioning 11
4. E 14 Continuous Cardiac E 14 sacer SER 14 5 ayyy rie one E 15 1 E 15 Abbreviations and Symbols 1 Abbreviatlolls ii y cik a ki 1a aa o EC GU DIDE ka ar EY CD XR YU C a a E Y F 2 Symbols s c a an 400 00 enean F 0 Dash 3000 4000 5000 2000966 338A CE Marking Information CE Marking Information C Compliance Exceptions The Dash 3000 4000 5000 patient monitor bears CE mark CE 0459 indicating its conformity with the provisions of the Council Directive 93 42 EEC concerning medical devices and fulfills the essential requirements of Annex I of this directive The product is in radio interference protection class A in accordance with EN 55011 The country of manufacture can be found on the equipment labeling The product complies with the requirements of standard EN 60601 1 2 Electromagnetic Compatibility Medical Electrical Equipment The system meets the requirements of EN 60601 1 2 2001 Medical Electrical Equipment Part 1 General Requirements for Safety 2 Collateral Standard Electromagnetic compatibility Requirements and tests Users should be aware of known RF sources such as radio or TV stations and hand held or mobile
5. Press once to turn the monitor on and off For more Power information refer to Operating Modes on page 2 14 Graph Go Stop Press once to print patient data or an information 3000 4000 window Press again to stop the print job For more information refer to Chapter 6 Print 5000 Press once to startone noninvasive blood pressure NBP Go Stop measurement Press again to stop the measurement For more information refer to Monitoring on page 10 1 2 6 Dash 3000 4000 5000 2000966 338A Equipment Overview 5000 Zero All Press once to zero all invasive pressures lines which are open to the atmosphere For more information refer to Monitoring Invasive Pressures on page 9 1 Admit 4000 5000 DX Silence Alarm Silence Alarm 3000 Press Silence Alarm Admit to quickly admit a patient to the monitor when the monitor is in the discharged state Press Silence Alarm to control audible alarms as configured in the monitor defaults For more information refer to Alarms on page 4 1 Standby Press once to enter the standby mode Press again to return to normal mode For more information refer to Getting Started on page 3 2 Main Display Press once to close all open menus and information windows and return to the main display For more information refer to User Interface Overview on page 2 16 Press once to d
6. 2 2 17 4 Control Settings 17 5 0 17 7 18 Monitoring Bispectral Index BIS 18 1 Introd ctionz cii rei ce cfe ce C e REA ROC 18 2 End dte ex n wena te 18 2 1 18 3 Safety I E ER CU ERAN cb 18 3 Considerations enie ra e doe er ep ROI OR QE ee LR 18 3 erum MITT 18 3 Monitoring isis ennemi 18 4 Control Settings 18 5 Disabling Continuous Lead Detection 18 6 Disabling the Waveform Filter 18 7 Testing 5 18 7 Understanding Displayed Values 18 7 d EE 18 7 18 8 SQ N E Qr aen mdp tud tre taa 18 8 SEF m 18 8 EM Gest tas po RE UC o pe o a vd to ee aaa 18 8 Troubleshooting isse nennen nnns 18 8 A Maintenance BH BON NOB B BB BB BB BB BOB EON EON BOB EON EN BB A 1 a ca iocari a a aya OCURRA CROCO e REC
7. CO INJ TEMP IN LINE CO SIZE 15 CO INJ VOL 10 CO AUTO MODE ON ON OFF B ADA IBO COMPENSATION TO UE RR PARAMETER OFF ON OFF RR LEAD l RR WF SPEED 25 5 2 WF SPEED VIEW ON ALARM VOA BROADCAST OFF VOA ALERT TONE iu ALARM CRISIS ey l FOLUME ENABLE DISABLE ENABLE T ALARM VOLUME 70 70 40 SILENCE ALARM NORMAL QRS VOLUME OFF RATE VOLUME OFF OFF 40 ECG LEADS FAIL SYSTEM SYSTEM SYSTEM WARNING WARNING ADVISORY SPO2 PROBE OFF SYSTEM WARNING Dash 3000 4000 5000 2000966 338A Factory Defaults OPERATING ADULTICU NEONATAL ICU RW P02 PULSE SEAN SYSTEM ADVISORY MONITOR ISO DES ISOFLURANE DISPLAY LIMITS ON ON OFF DISPLAY UNITS OFF UNITS FOR HEIGHT OM UNITS FOR WEIGHT KG TEMPERATURE UNITS C DEO CO2 UNITS MMHG 02 UNITS GAS UNITS NBP LIMITS TYPE ARTERIAL LIMITS SYSTOLIC TYPE PA LIMITS TYPE DIASTOLIC MENU TIMEOUT 5 MINUTES ECG FILTER MONITORING MONITORING MODERATE BP FILTER 12 HZ QRS WIDTH NORMAL NARROW NORMAL C02 DISPLAY MODE AUTO DISCHARGE ALERT OFF VENT WE SPEED 6 25 2000966 338A Dash 3000 4000 5000 C 11 Factory Defaults ADULTICU NEONATAL ICU OPERATING DISPLAY MAC VALUE DISABLE SAM HAL DISABLE SAM ENF TECH ID FIELD OFF ICG PRIMARY PAR C ICG SECONDARY PARI CO ICG SE
8. daney 10 8 control settings 2 9 5 een static detemination 10 8 SIMI 9 7 n custom defaults 2 10 11 alarm 9 5 alarm 5 2 10 11 Calibrate 9 6 cancellation notification 10 11 E 9 5 OPUON PR Pr doaia 10 3 Qa 9 6 i e eee 10 4 ABI Us 9 6 troubleshootin 10 12 WO QO needs 9 7 dd pulse rate cg i es 9 7 O Del Dy DD Db OA 9 5 operating modes eese 2 14 Site lame og ter 9 5 e ecu eee da 2 14 Smart BP oii etes 9 7 in e ote ein aeta oed f URS 2 15 waveform 9 6 Standby eed ee Ee 2 15 zero transducers eese 9 6 optional 2 10 2 14 site 9 3 site values 9 3 PA wed F RU WEQ O e RN EE 9 7 s 2 decerneret 9 7 K manual 9 9 K YE cm ker b ib e s 2 6 parameter windows ai uds 2 7 BIS Assit iti Ai hele itt 18 2 Discharge P 2 7 EE 12 2 M
9. 2000966 338A Dash 3000 4000 5000 D 5 Custom Defaults SV02 RR APNEA TEMP 1 TEMP 2 02 INSP 02 N20 INSP N20 EXP N2 INSP N2 EXP SEV INSP SEV EXP DES INSP DES EXP ENF INSP ENF EXP HAL INSP HAL EXP ISO INSP ISO EXP HE INPS HE EXP AR INP AR EXP CI D 6 Dash 3000 4000 5000 2000966 338A Custom Defaults Display Defaults TFC BIS PATIENT AGE DISPLAY MODE COLOR FORMAT PRIMARY ECG ECG WAVEFORM 2 ARRHYTHMIA DETECT PACE ARTERIAL RATE LEAD ANALYSIS ST ANALYSIS ST TEMPLATES ST V LEAD ST TEMPLATE 1 ST TEMPLATE 2 ST TEMPLATE 3 ADJ UST ST POINT 12 LD ON ST HISTORY ECG WF SPEED PRINT WAVEFORM 2 PRINT WAVEFORM 3 PRINT WAVEFORM 4 2000966 338A Dash 3000 4000 5000 D 7 Custom Defaults PRINT ON ALARM TIMED GRAPH ART DISCONNECT SMART BP ARTERIAL SCALE PA SCALE CVP RA UVC SCALE LA SCALE ICP SCALE SP SCALE BP WF SPEED C02 SCALE C02 WF SPEED NBP AUTO ADULT CUFF PRESSURE PED CUFF PRESSURE NEO CUFF PRESSURE CO CATHETER CO INJ TEMP CO SIZE CO INJ VOL CO AUTO MODE N20 COMPENSATION OR ONLY 02 COMPENSATION
10. 9 7 AUTOM AUCs sc Crete CR doeet OA dike 9 7 9 9 Troubleshooting i i ki saa a a a adana i v oc naa 9 9 10 Monitoring NBP WB NH NH N NH N BB BB NB NOB NE NB NE EON BB NONE HON NON BB BB 10 1 INTODUCHON eese bec s Yo ee Dre a oe OC bata ala T 10 2 OVERVIEW ia ccce ceca aca idco a ee Vr 10 2 te eet oda red pedes Redde Red aeree 10 3 Additional Information 0 0 0 0 c kak kk kak eee 10 4 Safety s ici A tra ay EA ada PRIORA TE ara aa a 10 4 x d rv cv ad ace Ee nn C Le P a Cp av EA 10 7 Control 05 nena 10 7 Custom Defaulls 1 xu asa kak I kal te eat Kaka e aw 10 10 Setup Custom Automatic Measurements 10 10 Auto Cancellation Notification 10 11 Extended Alarm 10 11 Tro bleshooting bi ici ce ey e na rr n e oe ga a a 10 12 11 Monitoring 5 02 s B BB BB BB BB BB B NH NE N E NE ON NONE NON 11 1 Introduction i wad a na dh Wala a E a aac V a VR E 11 2 OVerVleW a ba ket 112 Primary Parameter Monitoring Considerations 11 3 Configura
11. och a da 8 15 ECG Setting Source os RHOD a D Pee ERE ER 8 15 Selecting ECG Setting Source 8 15 ECG Setting Source When Entering COMBO 8 16 ECG Setting Source When Exiting COMBO Mode 8 17 ECG Rate Averaging o dine beaten al aa vee ee Faces X 8 17 ht lliRate 8 17 AFIB AlartmibeVeli zt CERE ORT AC d 0 18 Performing ST 8 18 OvervleW 8 18 Control Settinigs Miata t e at cet coe 8 19 Performing 12 Lead Analysis 8 21 Troubleshooting yana u PA nena 8 23 iv Dash 3000 4000 5000 2000966 338A 2000966 338A 9 Monitoring Invasive Pressures 9 1 Introduction achat e xe OAS ac CR CC Eu eae 9 2 Wis tacere die drm od lg bed dre ero t ordo dte odd 9 2 Pressure Site Names and Values 9 3 Default Site Labels 2 ade at ect Mte odis 9 3 Analog Ss edt Fe eie dame Regi a d na Ea 9 3 Additonal information s i His ay Det a te a Pb i 9 4 MONIDONNG 23 cs na tine ea e sie eoe E C Va ERG Linea iA 9 4 Control Settings eene enn 9 5 Performing PA Wedge Measurements
12. 5 10 SPO2 o ed ae 11 2 UI Ls 5 11 wireless 2 15 MONTON NE 5 11 2000966 338A Dash 3000 4000 5000 Index 5 Index Index 6 Dash 3000 4000 5000 2000966 338A GE Medical Systems Information Technologies gemedical com World Headquarters GE Medical Systems Information Technologies Inc 8200 West Tower Avenue Milwaukee WI 53223 USA Tel 1414 355 5000 1 800 558 5120 US only Fax 1 414 355 3790 European Representative GE Medical Systems Information Technologies GmbH Munzinger StraBe 3 5 D 79111 Freiburg Germany Tel 49 761 45 43 0 Fax 49 761 45 43 233 Asia Headquarters GE Medical Systems Information Technologies Asia GE China Co Ltd 24th Floor Shanghai MAXDO Center 8 Xing Yi Road Hong Qiao Development Zone Shanghai 200336 P R China Tel 86 21 5257 4650 Fax 86 21 5208 2008
13. 8 15 DG POWE ERE 2 5 8 5 reet ees 2 6 Salely es ced ege ee 8 8 eltl ierriGt iss ie een teils 2 5 ST analysis ere 8 18 pate M em 2 3 troubleshooting enis nasi 8 23 control 3 9 equipment 1 14 Drighitness o reote bids 3 11 G POER voee Oto eit 3 11 display colors i e 3 10 7 5 9 5 parameters rone Dee ie ende 3 10 tee edat etiquetas 9 6 EE 3 10 EMT TES 17 2 17 8 decet keke e n eya teres 3 9 control settings 17 5 control setttings beat 17 7 Index 2 Dash 3000 4000 5000 2000966 338A fastlook intct tette aet 17 6 Trends xureka eye Heseke N yey k ux fette eret mete ee Hana 2 7 lead failures esee 17 7 Zero Alle eR 2 7 normal ranges 17 7 L vee tee edi hat 7 9 secondary parameters 17 6 signal quality 17 7 M edet pointe 17 6 monitor defaults 22 3 7 units of 17 6 control 3 7 wave
14. LIrE 15 5 Calibrating isse nmn 15 6 SONSOMS se eec p ditt ne pui petes fae er uri aioe te 15 6 Adapters ace Seneca ROI HER Do EH EE 15 7 Sample WINGS resi AR RET ERR 15 7 Troubleshooting nena 15 8 Monitoring Anesthesia Gases 16 1 Introduction sisse mmm 16 2 felicia 16 2 Options eR ERES p p E 16 3 Guidelines trne EP aR ents 16 3 1 16 3 Safety ade T iy n n kd bbb EUR veda 16 3 Monitoring a i Da DE YAK n R Ka Wa TI 16 6 Control Settings nena 16 6 2 istae E Dar n at Wa n We 16 6 aS cat nan o ees A a KK AA nn dera ice AYE s ar ak Ti See A ported 16 8 Enabling HAL and ENF k cima cece cece Dik nnn 16 9 nennen 16 9 Monitoring Impedance Cardiography ICG 17 1 Introduction co rer E venae e c ar la DE OS a 17 2 OUI METH 17 2 Monitored Parameters si so c ces ROO E cae ea 17 2 Additional Information eee 17 2 Safety Rc FAO CR CR Pd 17 3 Dash 3000 4000 5000 vii 0
15. ECG is turned off SpO2 alarm levels are elevated from advisory to warning Parameter Limits The following are the parameter alarm limit factory defaults To access these options select MORE MENUS gt MONITOR SETUP gt MONITOR DEFAULTS gt SETUP DEFAULT LIMITS ADULT ICU LOW HR 50 PVC MIN 6 6 _ 6 C 4 Dash 3000 4000 5000 2000966 338A Factory Defaults ADULFICU monacu Low HGH Low HGH Low HGH 574 Sr ST II ST V1 ST AVL ST AVF EINE E gt 0 ST AVR 5 2 5 ST V4 ST V5 ST V6 NBP S 80 20 4 100 4 200 NBP D 2 10 2 60 2 m NBP M 4 x 70 4 140 ART S 80 20 40 10 4 200 ART D 2 10 2 60 2 120 ART M 4 x 70 40 140 50 m 90 200 a 150 FEM S 80 200 40 100 40 200 FEM D 20 p 60 20 120 FEM M 40 30 70 40 140 FEM R 50 5 90 20 1 150 UAC S 80 200 40 100 4 200 2000966 338A Dash 3000 4000 5000 C 5 Factory Defaults ADULFICU OFERRING Low HGH Low HGH Low HGH UAC D 20 p 60 20 120 UAC M 40 70 40 140 UAC R 50 5 90 20 1 150 PA S PA D PA M CVP RA 99 350 99 350 99 350 UVC LA ICP SP
16. WARNING ISOFLURANE AND DESFLURANE The SAM module cannot distinguish between isoflurane and desflurane You must use tell the module which agent combination will be used If both are present such as when introducing one and discontinuing the other inaccurate values are displayed for the selected agent isoflurane or desflurane until only the selected agent is present If isoflurane is selected and concentration is greater than 5 0 percent a Desflurane prompt will be displayed suggesting verification of correct selection CAUTION AGENT EXPOSURE Connect exhaust to a scavenging system to prevent exposure to exhaled agents CAUTION ANESTHETIC AGENT VERIFICATION When administering anesthetic agents always verify your anesthetic vaporizer settings CAUTION ETHANOL AND METHANE The presence of ethanol or methane with halogenated agents causes inaccuracy in the agent values Methane even when no halogenated agent is present will cause a halothane value to be displayed CAUTION MULTIPLE CO2 MODULES Do not attempt to use a combination of CO or SAM modules at the same time Only data from the first acquisition source to detect will be displayed 16 4 Dash 3000 4000 5000 2000966 338A Monitoring Anesthesia Gases CAUTION SAMPLE RATE The SAM module continuously withdraws about 250 milliliters per minute nominal from the patie
17. An waveform is also displayed The following examples show a good quality and bad quality waveform Bad quality waveforms display motion artifact The motion at the sensor site is indicated by noise spikes in the normal waveform ESQ RR Good quality waveform 687A 11 2 Dash 3000 4000 5000 2000966 338A Monitoring 5 02 031A Bad quality waveform Primary Parameter Monitoring Considerations When ECG is turned off the SpO parameter becomes the primary patient monitoring parameter The following conditions apply when ECG is turned off m The SpO and SpO Rate parameter patient status alarm levels default to WARNING m The SpO Pulse Search and Probe Off system status alarm levels default to WARNING m SpO becomes the WAVEFORM 1 selection for waveform display and graphing Configuration Options To determine the option running on the monitor look on the right side of the monitor next to the patient connectors There will be a Masimo SET Nellcor OXiMAX or an Ohmeda label This label indicates the technology option installed on the monitor NOTE The patient cable should easily plug into the patient connector Do not use excessive force to connect the cable If the patient cable does not easily fit into the patient connector it is likely that you do not have the appropriate cable for the enabled configuration option Masimo The following measurement guidelines apply to Masimo SET m The ti
18. 2 6 Tim ro a veo abge rat ra s aA e 2 8 Indica NEEDED EE 2 9 Alarni LiNE soe 2 9 P OWG us b ka 2 9 Gener de 2 9 Battery 2 9 Optional 2 10 TRAM RAC 2A Module 0 2 10 Nellcor amp 395 Pulse 2 10 Unity 52 oec ona 2 10 Centralscope Central Station 2 11 Dash 3000 4000 5000 i CIC Pro Clinical Information 2 11 Wireless LAN 2 11 s arcte dus ac a PR crc as 2 12 PRN 50 M Digital 2 12 Remote Control rr aeneis p ener aere d Eg 2 12 Dashi PO ss xx cite mo P o m kart ptem ata 2 14 Remote 5 2 14 Cadex8 5 Two 2 14 Operating Modes cnr HEC pn pe reb e quee 2 14 EEEn EA EEEE AE UT edd reda 2 14 Off Chargintg c oret oe S Oa t ans acl e OR 2 15 eser
19. tre 8 3 gauge ient rate eoe tices A 9 alarm 7 2 recycling A 13 alarms uper 4 2 4 8 S A 12 control settings 1 2 4 5 22 2 14 arrhythmia alarm 4 5 enne A 13 ClO AM i rede ee Nee e pee Oe nds 4 6 Sj ND utut 18 2 18 9 pila 4 6 control 18 5 parameter alarm 4 5 alarm 18 5 parameter alarm limits 4 5 EE Qi SOQ Hin ay n yay tette tea 18 6 PAUSE eR 4 6 EEG 18 6 4 5 FANQCS RE a tein 18 6 patient 4 3 resume monitoring 18 6 GU V SOL xur itis tiet pite E eet 4 3 sensor 18 6 4 3 Setup uie ide i 18 6 message deci 4 3 18 6 4 3 trends en eis 18 6 pause 4 6 waveform smooihing 18 5 EDT 4 4 DSC teSt ssi catia 18 7 SIGN CO cie ee tenete rente 4 6 Salely eite ente ked
20. 5 02 Status messages only zk Baxter Edwards Vigilance SVO2 Yes Gas analyzer Datex Capnomac Ultima GAS CO Yes Ohmeda 5250 RGM GAS CO Yes Ohmeda Rascal Il GAS CO No 2000966 338A Dash 3000 4000 5000 E 5 Interfacing with Non GE Devices 6201 6301 Device Type Manufacturer and Model Parameters Alarms IV pump Abbott LifeCare 5000 NA Status messages Alaris Medical Systems 560M NA Status messages 570 Alaris Medical Systems Gemini NA Status messages PC 1 PC 2 PC 2TX PC 4 Alaris Medical Signature IV Status messages 7130 7230 Baxter Edwards Flowgard NA Status messages Multi parameter monitor Hellige SMU EVO GAS CO Sp0 No Siemens 5 9000 5p02 CO No Pulse oximeter Nellcor Puritan Bennett N 200 5 0 Yes Nellcor Puritan BennettN 395 5 0 Yes Nellcor Puritan BennettN1000 Sp05 CO GAS Yes Pulse oximeter gas analyzer Nellcor Puritan BennettN2500 Sp0 GAS Yes Transcutaneous monitor Novametrix 840 PtcO2 TCO Status messages PtcCO2 TCO2M Radiometer TINA TCM3 Linde MicroGas 7650 Not for sale in the United States Urometer Bard CritiCore UO Status messages E 6 Dash 3000 4000 5000 2000966 338A Interfacing with Non GE Devices Device Type Manufacturer and Model Parameters Alarms Ventilator Bear 1
21. INJECT NOW A stable baseline temperature has been detected and the monitor is ready for the ui This is a normal procedure message injectate 9 INJ ECT WHEN READY A stable baseline temperature has been automatically detected and the monitor is ready for the injectate PLEASE WAIT The monitor is searching for a stable baseline temperature PUSH CO NOW OR TURN AUTO ON A stable baseline temperature has been automatically detected and the monitor is ready for the injectate 2000966 338A Dash 3000 4000 5000 12 7 Measuring Cardiac Output Message Cause Solution CO IS TOO LOW HIGH TO DISPLAY The calculated cardiac output value has exceeded the acceptable range 0 2L to 20L NO CO DUE TO BT SENSOR FAIL NO CO DUE TO IT SENSOR FAIL A cable may be loose or there is equipment failure UNSTABLE BT DETECTED The monitor cannot detect a stable baseline temperature after over 12 seconds of attempts BT TOO LOW HIGH Blood temperature is too high or low to detect or there is an equipment failure IT TOO LOW HIGH Injectate temperature is too high or low to detect or there is an equipment failure Check the patient and catheter If any of these problems persist contact service 12 8 Dash 3000 4000 5000 2000966 338A 13 Monitoring Respiration 2000966 338A Dash 3000 4000 5000 Monitoring Respi
22. BIS Value Patient State 100 Patient is awake responds to normal voice 80 Patient is moderately sedated responds to loud commands or mild prodding shaking 60 Patientis in deep sedation low probability of explicit recall and unresponsive to verbal stimulus 2000966 338A Dash 3000 4000 5000 18 7 Monitoring Bispectral Index BIS SR SQI SEF EMG Troubleshooting BIS Value Patient State 20 Patient is in deep sedation burst suppression 0 No brain activity detected The suppression ratio value identifies the percentage of epochs in the last 63 seconds in which the EEG signal is considered suppressed or the percentage of time the EEG waveform is flat line over the previous minute The range is zero to 100 percent The signal quality index value identifies the percentage of good epochs episodes in the last 60 seconds that could be used to calculate the bispectral index The optimum SQI is 100 The spectral edge frequency is the frequency between zero and 30 Hz at which 95 percent of the total power is a lower frequency and five percent exceeds the spectral edge frequency The electromyograph value measures the absolute power in the 70 to 110 Hz range The power value is in dB decibels This is the measurement of the facial muscle activity or other artifact in the EEG signal within this frequency range The indicator displays up to seven bars the more bars the grea
23. Control Settings To adjust the control settings for the patient admitted to the monitor select MORE MENUS gt VIEW OTHER PATIENTS Then select any of the following options and make the desired changes NOTE All changes are temporary and revert to the factory or custom defaults when the patient is discharged To permanently change the these settings refer to Defining Custom Defaults on page 3 7 5 10 Dash 3000 4000 5000 2000966 338A Managing Patients Option Function VIEW ALARM Select the alarming monitor to display or print patient data or silence alarms VIEW ON ALARM OPTIONS Select how this monitor receives automatic alarm displays m VIEW OTHER BEDS ON ALARM Select ON OFF or AUTO m SEND AUTO VIEWS Select ON or OFF m ALERT TONE Select ON OFF or REPEAT m CONFIGURE AUTO VIEW ON ALARM AutoView XM only Selecta care unit to automatically display on alarm m CURRENT CONFIGURATION AutoView XM only View the current alarm configuration for a care unit SELECT A BED TO VIEW Select the automatic view on alarm level for any monitor on the network Select ALLBEDS to apply to selected beds SELECT ANOTHER CARE UNIT Select any care unit from the network PRINT VIEWED BED Print 20 seconds of the viewed patient data VIEWED PATIENT DATA Display the patient s last event TABULAR TRENDS or GRAPHIC TRENDS Viewing Other Monitor
24. No light The battery is not installed not charging or asleep Or the monitor is using this battery for power Battery Status Indicates the power status of the internal batteries One inside each battery door 2000966 338A Dash 3000 4000 5000 2 9 Equipment Overview m Green The monitor is using this battery for power m No light The monitor is not using this battery for power Optional Components TRAM RAC 24A Module Housing The TRAM RAC 2A module housing supports one single parameter module It has an optional internal power supply that runs the module housing and supports the needed voltages Single Parameter Modules Use the following single parameter modules in the TRAM RAC 2A module housing to acquire the patient s physiological data and view it on the monitor SAM Module The Smart Anesthesia Multi gas SAM module is an infrared based multi gas analyzer module that measures inspired and expired values for patient gases and calculates respiratory rate For more information refer to Chapter 16 Solar ICG Module The Solar ICG impedance cardiography module uses thoracic bioimpedance technology TEB to provide non invasive continuous hemodynamic data For more information refer to Chapter 17 Nellcor 395 Pulse Oximeter The Nellcor 395 pulse oximeter is an external pulse oximeter that sends SpO parameter data including saturation and rate to the monitor for review and print You
25. RR PARAMETER RR LEAD RR WF SPEED D 8 Dash 3000 4000 5000 2000966 338A Custom Defaults 2 WF SPEED VIEW ON ALARM VOA BROADCAST VOA ALERT TONE REMOTE ALARM LEVEL ALARM VOLUME ALARM VOLUME OFF MIN ALARM VOLUME SILENCE ALARM QRS VOLUME RATE VOLUME ECG LEADS FAIL 5 02 PROBE OFF 2 PULSE SEARCH MONITOR ISO DES DISPLAY LIMITS DISPLAY UNITS UNITS FOR HEIGHT UNITS FOR WEIGHT TEMPERATURE UNITS C02 UNITS 02 UNITS GAS UNITS NBP LIMITS TYPE ARTERIAL LIMITS TYPE PA LIMITS TYPE MENU TIMEOUT 2000966 338A Dash 3000 4000 5000 D 9 Custom Defaults ECG FILTER BP FILTER QRS WIDTH C02 DISPLAY MODE DISCHARGE ALERT VENT WF SPEED DISPLAY MAC VALUE DISABLE SAM HAL DISABLE SAM ENF TECH ID FIELD ICG PRIMARY PAR ICG SECONDARY PAR1 ICG SECONDARY PAR2 ICG SECONDARY PAR3 NBP SILENCE ALARM PAUSE BREAKTHRU MASIMO AVERAGING ECG INTELLIRATE ECG PARAMETER DISCONNECTION OPTION NBP CLOCK SYNC AVOA ALARM LEVEL REMOTE SILENCE AVOA SILENCE PERSISTENT CO2 ECG RATE AVERAGING BEAT PAUSE INTERVAL D 10 Dash 3000 4000 5000 2000966 338A Custom Defaults UNIT ROVING DOSE CALCS WT XFER NBP PULSE RATE NBP NO DETERMINAT
26. Remove cuff and contact service Contact service Remove cuff and contact service NO DETERMINATION PUMP TIMEOUT Inflation failure or pressure leak TOTAL TIMEOUT No measurement in over three minutes for adult and pediatrics or 90 seconds for neonatal patients Stops automatic NBP measurement after TWO messages Verify cuff placement and try a manual measurement Check connections between cuff and monitor check for worn connector O rings and try a manual measurement Verify patient is not moving excessively or experiencing an arrhythmia condition and try a manual measurement 10 12 Dash 3000 4000 5000 2000966 338A 11 Monitoring SpO 2000966 338A Dash 3000 4000 5000 Monitoring 5 02 Introduction Overview Non invasive SpO monitoring measures the amount of oxygenated hemoglobin and pulse rate by measuring the absorption of selected wavelengths of light The light generated in the sensor passes through the tissue and is converted into an electrical signal by photodetectors in the sensor The monitor processes the electrical signal and displays digital values for SpO and pulse rate A parameter window displays when a patient cable is connected to the monitor The display updates every two seconds SPO we ro 100 1 Signal strength indicator 719A 2 Derived pulse rate value 3 SpO value
27. V2 V6 Fail message More ECG 2000966 338A Dash 3000 4000 5000 8 13 Monitoring ECG Option Function MORE ECG gt QRS VOLUME Select the alarm tone for QRS complex annunciation If turned on 5 0 Rate volume is turned off In NEONATAL ICU BRADY ALARM option automatically starts a QRS alarm tone when the monitor alarms for bradycardia that is 20 percent louder than the set alarm volume NOTE Not available from a telemetry transmitter when performing combination monitoring MORE ECG gt QRS WIDTH Select one of the following for use in ECG analysis algorithms m NARROW Default for NEONATAL ICU m NORMAL Defaultfor ADULT ICU and OPERATING ROOM MORE ECG gt INTELLIRATE Turn IntelliR ate on or off For more information refer to IntelliR ate on page 8 5 MORE ECG BEAT PAUSE INTERVAL Select the maximum pause between consecutive heart beats before an alarm sounds MORE ECG SPEED Select a sweep speed for the displayed waveform Custom Defaults Turning Off ECG Permanently To permanently turn the ECG parameter off follow this procedure 1 Select MORE MENUS gt MONITOR SETUP gt MONITOR DEFAULTS gt SETUP DEFAULT DISPLAY 2 Locate and select ECG PARAMETER 3 Select OFF 8 14 Dash 3000 4000 5000 2000966 338A Monitoring ECG Constraints When the ECG parameter is turned off the following constraints apply m 5 becom
28. ies 18 3 system Ss u y4 o2 W a Wi W ZA nini kana 4 4 troubleshooting iiu kr 18 8 xiii 4 4 AN ds 18 7 4 4 waveform filter 4 11 18 7 O E 4 4 analog output e calculations tied n k aA a le a AA 7 10 sa rana E 8 7 Cardiac nece Dr 7 10 c 9 3 dosaq 7 41 TN N n en E ca EN 16 2 16 10 rer UHR ea ayi xel aE covet 7 13 control 16 6 EE 3 3 02 16 7 up cardiac calculations sse 7 10 alarm iy n lina en 16 7 cardiopulmonar 3 3 EEU rrr 16 8 P 2000966 338 Dash 3000 4000 5000 Index 1 Index CIO AMIN 26s T 3 5 waveform display Options 3 9 vom 12 2 12 8 CRG trends 7 7 control settings s k n Kul Pa 12 3 custom defaults automatic 12 4 arrhythmia alarm levels 3 8 blood pressure values 12 4 default display 3 8 blood temperature alarm limits 12 4 parameter alarm limits 3 8 cardiac calculations 12 4
29. m This product is protected against the effects of cardiac defibrillator discharges to ensure proper recovery as required by test standards The screen may blank during a defibrillator discharge but recovers within seconds as required by test standards This equipment is suitable for use in the presence of electrosurgery Users should be aware of a possible time discrepancy between the waveforms from the telemetry device and the waveforms hardwired to the monitor Users should not consider these waveforms to be synchronous If absolute synchronicity is desired COMBO mode should be discontinued and the ECG waveforms should be acquired via the hardwired bedside monitor m The ambient conditions specified in the technical specifications of the service manual must be ensured at all times m Connect the power cord supplied with the monitor Use only the original cord or an equivalent one m Formeasurements in or near the heart GE recommends connecting the monitor to the equipotential stud Use the green and yellow potential equalization cable and connect it to the equipotential stud on the back of the monitor Contact customer service engineers to connect monitors to a central station Monitors may be shipped with protective covers to protect unused parameter connector inputs from dust and liquids Do not remove the protective covers the parameter connectors will not function without them 2000966 338A Dash 3000 4000 5000 1 13
30. 450 to 0 Parameters The following parameter values are unique m ECG gain Derived by mV 25 mV to 2 mV and displayed on the primary ECG waveform W Units of measurement Metric only 2000966 338A Dash 3000 4000 5000 3 5 Monitor Setup m Arrhythmia level The default arrhythmia alarm level for ADULT ICU is FULL NEONATAL ICU and OPERATING ROOM are OFF m Heart rate Values under 30 bpm are not displayed The values displayed in the parameter window are replaced with X m SpO saturation Values under 60 percent are not displayed The values displayed in the parameter window are replaced with X Customizing Monitor Setup Monitor Defaults Overview There are three types of monitor defaults m Factory defaults m Custom defaults m Control settings Factory Defaults Factory defaults control alarm levels alarm limits display setup and parameter priority settings Each monitor is programmed with three sets of factory defaults one for each patient monitor type To review the factory defaults on a monitor select MORE MENUS MONITOR SETUP MONITOR DEFAULTS These are persistent settings meaning they are recalled after a patient is discharged from the monitor You cannot change the factory defaults If your care unit requires different settings you can create custom defaults NOTE If you are prompted for a password after selecting this option access to monitor defaults
31. E 14 Dash 3000 4000 5000 2000966 338A Interfacing with Non GE Devices Urometers Additional Information m The monitor does not broadcast alarms m The information displayed varies by device When a urometer interface is connected the following applies m The monitor displays a UO parameter window m The information displayed varies by device m The temperature is displayed and trended as an indicator of core temperature For more information on the intended use safety and setup information for any interface with the Unity Network ID connectivity device refer to the Unity Network ID connectivity device operator s manual 2000966 338A Dash 3000 4000 5000 E 15 Interfacing with Non GE Devices E 16 Dash 3000 4000 5000 2000966 338A F Abbreviations and Symbols 2000966 338A Dash 3000 4000 5000 Abbreviations and Symbols Abbreviations The following abbreviations and symbols that you may encounter while reading this manual are listed below with their meanings 1251 ACI AD AFIB ALRM AMI ANT Arr Arrhy ART Auto Aux A V AVG AVOA BIS BP Brady BT 12 lead ECG analysis A alternating current accelerated acceleration index adult atrial fibrillation alarm acute myocardial infarctions anterior arrhythmia arterial automatic auxiliary arterial venous average automatic view on alarm B bispectral index blood pressure bradycardia blood temperat
32. 2 15 User Interface Overview i n 2 16 DIS Play 5 5 o Cog 2 16 m TEM 2 17 WINdOWS zu en eR EDU E e ODER RSS 2 17 Monitor Setup or oe eene wo E x eR eel Getting Started 3 2 Identifying Your Configuration 3 2 Software Packages 3 2 Software Options 3 3 Monitoring Admit 3 3 PatientMonitor Type 3 4 Langage s es at cta t ao Tat P a Ac ea 3 4 Locale cis es pascit eben nnm sette Tr oie th 3 5 eee nettes ote n ka ak Qtr a Na 3 5 Customizing Monitor 3 6 Monitor Defaults Overview 2 222222 3 6 Factory Defaults eR Ee eb eda 3 6 Custom Defaults sin cwana n ye PPP RAD TER AR ORTA MET REIS 3 6 Control Settings rectas oie dece de aces a eere 3 7 Defining Custom 5 3 7 Defining Control Settings 3 9 Restoring Factory lt 5 3 12 Defining Parameter Window Priority 3 12 Alanis ek reach CR Cc Introd ctio
33. 3000 4000 5000 6 3 Printing Guidelines Type alarm manual or saved Alarm violation if any Unit name bed number and patient name Date and time Patient monitor type Alarm volume Speed Lead failed if any Heart rate Arrhythmia call if any Pace mode if on Arrhythmia mode full lethal off PVC count if arrhythmia mode is on ST value for top displayed lead if on ECG filter Hz range Monitored parameter values Keep in mind the following printing guidelines When printing to a laser printer there may be a slight one minute delay to print the first page of data when any speed slower than 25 mm sec is selected Each page contains 20 seconds of waveforms per page in a cascade format If the selected printer is removed from use you must update the location to an available printer All failed print jobs are saved until a printer is available They print as soon as a functioning printer is selected A one millivolt ECG signal at normal 1X size equals 10 millimeters on the graph paper To convert an arrhythmia alarm to a manual print stop the print job by pressing the Graph Go Stop or Print key and immediately restart by pressing the Graph Go Stop or Print key again Invasive pressure scales print on individual and full scales as follows Displayed Scale Printed Scale 30 0 30 PA CVP LA RA ICP 40 0 45 60 0 60 6 4 Dash 3000 4000 5000 2000966 338A Print
34. Option Function SENSOR CHECK Select to automatically detect sensors and display the impedance value and status of each lead This data is updated every two seconds PASS This lead passed the sensor check LD OFF No impedance value check the lead NOISE No impedance value check the lead HIGH Re prep the sensor BIS SETUP Provides access to the following controls m LEAD DETECT For more information refer to Disabling Continuous Lead Detection on page 18 6 m EEG FILTER For more information refer to Disabling the Waveform F ilter on page 18 7 m BIS TEST For more information refer to Testing the BIS on page 18 7 RESUME BIS Select to initiate a sensor check when the EXPIRED SENSOR message displays EEG WAVEFORM Select ON to display EEG waveform data EEG SCALE Selectthe scale of the displayed waveform The larger the scale the smallerthe waveform The factory default setting is 25 uV DIV BIS RANGES Displays a description of the factory default BIS ranges BIS TRENDS SPEED Display the trended BIS values in the VITAL SIGNS information window Select a sweep speed for the displayed waveform Disabling Continuous Lead Detection By default the BISx continuously checks electrode impedances This 1 nA 128 Hz impedance check signal may interfere with other equipment such as evoked potential To temporarily stop the continu
35. em 6 2 alarm volume i i sele sine n l anek 11 10 6 2 6 5 Dersistent enti tn 11 11 pulmonary calculations 7 13 pulse rate es eee reri hte 11 10 P lse OXIITIBEGT iiir dnte d ia ka kalekal keka kaka ka 11 13 response mode 11 12 R SatSecorids caetero ee b n 11 12 sensitivity 11 13 RET 13 2 13 5 ON gO NREL RE sensor averaging 11 13 control settings eese 13 4 waveform S Z 2 11 10 VE WE 13 4 waveform 11 10 relearn 13 4 ros OD OTI Su s d sa m 11 3 sensor sensitivity 13 4 us reti etn teta 11 3 waveform 926 13 4 11 4 waveform 13 4 Ohmeda 11 5 Safety ase eee ee 13 3 SOI OLY soc aep e diccre dee dest cedex VAN 11 7 troubleshooting eene 13 5 11 9 RR control settings ne troubleshooting eeeeeee 11 16 alarm limits oe 13 4 Gardiac rlifael alar n 13 4 waveforms 11 2 pu IL ST analysis 8 18 S contr
36. on page 15 5 16 6 Dash 3000 4000 5000 2000966 338A Monitoring Anesthesia Gases Option Function 02 LIMITS 02 COMPENSATION NOTE Only available with O sensor Select the high and low alarm limits for inspired expired 0 respiration rate and apnea An alarm sounds when a value occurs outside of these limits NOTE Only available with O sensor Select percentage of O concentration to compensate for 0 gt related decrease of the CO value Obtain the concentration from an oxygen analyzer CLEAR MESSAGE Clear hardware error messages after the condition is corrected MODE Select one of the following m RUN The pump is on m STANDBY The pump is in a low flow state or off C02 DISPLAY MODE NOTE Only available with O sensor Select the value display size m INSP EXP Displays both inspired and expired values at normal size m EXP ONLY Displays the expired value larger no inspired value displayed If an inspired alarm limit is exceeded the display reverts to INSP EXP m AUTO Displays the expired value larger and the inspired value when less than five mmHg CALIBRATE MODULE NOTE Only perform when the patient is discharged Calibrate the module with a special calibration gas cylinder 2000966 338A Dash 3000 4000 5000 16 7 Monitoring Anesthesia Gases Gas To adjust the control settings
37. operator and service manuals The following safety statements apply when interfacing with non GE devices WARNING ACCURACY Patient information transferred by the connectivity device must be qualified by medical personnel before permanent storage in a database WARNING ALARMS The peripheral device s alarms must not be turned off or the volume reduced in any way to diminish the importance of the peripheral device as the primary alarm source for parameters monitored by the peripheral device WARNING CORRECT INTERFACE ADAPTER Use of the wrong interface adapter may cause improper operation of the supported peripheral device Verify that the correct interface adapter on the peripheral device is operational before the device is used on a patient E 2 Dash 3000 4000 5000 2000966 338A Interfacing with Non GE Devices WARNING INSTALLATION Qualified technical personnel must connect the interface adapter to the peripheral device and make any necessary adjustments to the peripheral device baud rate parity etc as described in the specific installation instructions for the interface adapter Insert cabling from the Unity Network ID connectivity device only into specified interface adapters and specified peripheral devices To avoid inadvertent disconnection route all cables in a way to prevent a stumbling hazard Wrap and secure excess cabling to reduce risk of entangle
38. s alarm limits or by an arrhythmia condition There are four levels of patient status alarms m CRISIS Life threatening events CRISIS alarms sound until silenced by the user m WARNING Serious but non life threatening events WARNING alarms sound until the condition is resolved m ADVISORY Events that require monitoring but are not serious or life threatening ADVISORY alarms sound until the condition is resolved m MESSAGE Additional information only no alarms sound The monitor s response to patient status alarms is as follows Indicator CRISIS WARNING ADMSORY MESSAGE Alarm tone Three beeps Two beeps One beep No Alarm light Red Yellow No No On screen message Yes Yes Yes Yes Automatic print Yes Yes No No ALARM HISTORY Yes Yes Yes No Alarm broadcast Yes Yes Yes No Remote alarm terminal Yes Yes Yes No IThe factory default for ADULT ICU is ON NEONATAL ICU and OPERATING ROOM is OFF You can change patient status alarm levels and limits For more information refer to Control Settings on page 4 5 2000966 338A Dash 3000 4000 5000 4 3 Alarms System Status Alarms Safety System status alarms are triggered by mechanical or electrical problems They are of lesser priority than patient status alarms There are three levels of system status alarms m WARNING Serious mechanical or electrical problems m ADVISORY Mechanic
39. 09 01 56 MAIN SELECT GRAPHIC CARDIAC PULMONARY DOSE MENU ALARM TRENDS CALCS CALCS CALCS LL 0L 1 Up to 36 arrhythmia events and 10 ST events including alarms and references stored Up to 15 events are displayed in the ALARM HISTORY information window at one time When monitoring from telemetry the event is stored at the tower and the last 36 events are viewable from the monitor The ALARM HISTORY contains 10 seconds of the arrhythmia event in a compressed format Due to the display size only eight seconds of waveform data is shown For asystole the first eight seconds of an event is displayed All other arrhythmia events display the last eight seconds of the event WARNING MEASURING DATA STORED IN ALARM HISTORY Waveform data stored in ALARM HISTORY uses compression technology that may not allow perfect reconstruction of the waveform data when subsequently viewed Although differences occur relatively frequently they are usually very minor Users are urged to verify diagnostic waveform measurements with the waveform data from real time graph strips Three leads of ECG are displayed for arrhythmia events If an ART line was monitored at the time of the event two leads of ECG and the ART waveform are displayed with the associated numerics To select an alarm or event position the pointer in front of the option and press the Trim Knob control Selecting an arrhythmia ev
40. 11 SOTING iced uto d o be d ow Cage cag A 12 Waking piscis 13 Recycling ame tcd Eie cer nd dar ea Ge A 13 Troubleshooting eph n ra n na airon hu P k aah k kak A 14 Technical A 15 Salety T65ts NO ECC Oar I E rep m A 15 Generalis euch setis Ane AE AETATEM HP Pot A 15 Temperature 5 A 15 ACCIPERET A 16 Alarm Verification 5 o rx e e RE UC Er CR A 18 B Software Pac kages B EH B NOB NOB BOB BONS NOE NOB B 1 Feature Comparison by Software Package B 2 C Factory Defaults B EB B NOB NOB E OB C 1 Arrhythmia Alarm C 2 Parameter Alarm Levels C 2 Parameter Limits 2 2 4 C 4 Display Defaults C 8 Default Parameter C 13 D C ustom Defaults B EB NB BN BOB HON NOB BOB BB BB BB BOB BN D 1 mirry a an Pe kn COT ee OP EH bc C Pa RE ATI eg D 2 E Interfacing with Non GE Devices 1 Introduction cise cece cece eee eee
41. 13 Equipment Symbols AW kk kk kk kk kk kk kak KK kK kaka kak kaka 1 14 Equipment Compliance Information 1 15 EN 60601 1 Component 55 1 15 Underwriters Laboratories Inc 1 55 1 16 AAMI EMI Environment Recommendations 1 16 FCC Compliance Information 1 17 Manual 1 17 PUIDOSE es aces tal phate ee PO p Od P paa 1 17 Intended Audience kuira 2 m e succedunt ne e qae e a en 1 17 CONVENTIONS 2 o ais oS ott E EO 1 18 2 2 2 4 seh arte eb dade Ale Au b 1 18 U ser Interface us ood screen sten eter nao RR Me fechas 1 18 TON ciun etra d eor eoe Ua Ae Ae 1 19 Illustrations and 1 19 Ordering 5 1 20 Revision History ccc cece eect mmm 1 20 Equipment Overview 2 1 HardWar O V fvl6 W zaxa xa ad dla ennemis 2 2 na DD DK DD 2 2 Mil is ate e tte p a ede db n 2 3 CM Mr natant 2 4 iris QEDE N DD 2 5 Control Panels oss oec tette vi sr ka e Petre aco hed
42. FROM MAINS When disconnecting the system from the power line remove the plug from the wall outlet first Then you may disconnect the power cord from the device If you do not observe this sequence there is a risk of coming into contact with line voltage by inserting metal objects such as the pins of leadwires into the sockets of the power cord by mistake WARNING DISPOSAL Dispose of packaging material observing the applicable waste control regulations and keeping it out of children s reach Dash 3000 4000 5000 2000966 338A Introduction WARNING EXPLOSION HAZARD Do not use this equipment in the presence of flammable anesthetics vapors or liquids WARNING WIRELESS COMMUNICATION INTERFERENCE Wireless LAN equipment contains an intentional RF radiator that has the potential of interfering with other medical equipment including patient implanted devices Before installation and any time new medical equipment is added to the Wireless LAN coverage area complete the following tests m Software version 5 3 or earlier Perform the electromagnetic compatibility test as described in the Wireless LAN Configuration Guide Software version 5 4 or later Perform the ad hoc tests AND the electromagnetic compatibility test as described in the Wireless LAN Configuration Guide WARNING INTERFACING OTHER EQUIPMENT Devices may only be interconnected with each o
43. GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide for the following information BIS sensor placement Patient preparation Clinical level troubleshooting OTE You can also refer to the sensor packaging for instructions on patient preparation and sensor placement m BIS reference literature N Safety Considerations m Clinical judgement should always be used when interpreting BIS in conjunction with other available clinical signs Reliance on BIS alone for intraoperative anesthetic management is NOT recommended As with any monitored parameter artifacts and poor signal quality may lead to inappropriate BIS values Potential artifacts may be caused by poor skin contact high impedance muscle activity or rigidity head and body motion sustained eye movements improper sensor placement and unusual or excessive electrical interference m Due to limited experience in the following applications BIS values should be interpreted cautiously in patients with known neurological disorders those taking psychoactive medications and in children below the age of one General The following safety statements apply when monitoring BIS 2000966 338A Dash 3000 4000 5000 18 3 Monitoring Bispectral Index BIS Monitoring WARNING INTENDED USE BISx is intended for use under the direct supervision of a licensed health care practitioner or by personnel trained in its proper u
44. HAZARD The heart rate reported by the IntelliRate feature may reflect either the electrical or pulsatile heart rate An electrical heart rate may be reported on some pulseless rhythms A pulsatile heart rate may be reported by the IntelliRate feature during ASYSTOLE if the patient is on a cardiac assist device In these situations the monitor will not detect or call an ASYSTOLE patient alarm The user may elect to turn the IntelliRate feature off for patients at risk of these events otherwise patient treatment may be delayed Such patients should always be kept under close observation The IntelliRate algorithm utilizes information contained in multiple physiologic signals for example ECG arterial blood pressure and pulse oximetry to improve the accuracy of the heart rate calculation After assessing the information extracted from each of the physiologic signals the IntelliRate algorithm applies rule based logic to determine which heart rate source has the highest likelihood of being accurate By reporting the most accurate rate the trended heart rate is more accurate and occurrences of false heart rate limit violation alarms are greatly reduced The IntelliRate value replaces the standard heart rate value in the ECG parameter window It also indicates the source of the heart rate SPO or ART when the heart rate source is not ECG To determine if IntelliRate is enabled on this monitor select MORE MENUS gt MONITOR SETUP gt
45. Introduction Equipment Symbols NOTE Some symbols may not appear on all equipment ATTENTION Consult accompanying documents CAUTION To reduce the risk of electric shock do NOT remove cover Refer servicing to qualified service personnel gt gt TYPE CF APPLIED PART Isolated floating applied part suitable for intentional external and internal application to the patient including direct cardiac application Paddles outside the box indicate the applied part is defibrillator proof 7 Medical Standard Definition F type applied part floating isolated complying with the Specified requirements of EN 60601 1 UL 60601 1 CSA 601 1 Medical Standards to provide a higher degree of protection against electric shock than that provided by type BF applied parts TYPE BF APPLIED PART Isolated floating applied part suitable for intentional external and internal application to the patient excluding direct cardiac application Paddles outside the box indicate the applied part is defibrillator proof Medical Standard Definition F type applied part floating isolated complying with the Specified requirements of EN 60601 1 UL 60601 1 CSA 601 1 Medical Standards to provide a higher degree of protection against electric shock than that provided by type applied parts NOTE The rating of protection against electric shock indicated by symbol for CF or BF is achieved only when used with patient applie
46. Laser printers are UL 60950 IEC 60950 certified equipment which may not meet the leakage current requirements of patient care equipment This equipment must not be located in the patient vicinity unless the medical system standard EN 60601 1 1 is followed Do not connect a laser printer to a multiple portable socket outlet MPSO supplying patient care equipment The use of MPSO for a system will result in an enclosure leakage current equal to the sum of all the individual earth leakage currents of the system if there is an interruption of the MPSO protective earth conductor A laser printer can be accessed through a central station For more information refer to Chapter 6 PRN 50 M Digital Writer The built in four channel writer prints on two inch wide paper Remote Control The hand held remote control operates the monitor It connects to the monitor via a communications cable with a DIDCA connector plugged into the Aux port on the monitor or the docking station The remote control is available in three versions m Adult m Neonatal Operating Room 2 12 Dash 3000 4000 5000 2000966 338A Equipment Overview Each version offers a unique set of buttons and a Trim Knob control Button Version Function 12 Lead Adult Opens the 12 LEAD ECG ANALYSIS menu Admit Discharge Adult and Neonatal Opens a menu to admit or discharge a patient Airway Gases 02 Operating Room Opens the CO menu A
47. OPERATING ROOM patient monitor type a summation scale also displays m ST complex Displays current complex for each lead superimposed over the reference complex to show ST segment changes Updates every 16 beats NOTE Trends and complexes are not available from a telemetry transmitter when performing combination monitoring 8 18 Dash 3000 4000 5000 2000966 338A Monitoring ECG Control Settings To adjust the control settings for the patient admitted to the monitor select the ECG parameter window label then ST ANALYSIS Then select any of the following options and make the desired changes NOTE All changes are temporary and revert to the factory or custom defaults when the patient is discharged To permanently change the these settings refer to Defining Custom Defaults on page 3 7 NOTE ST analysis control settings are only available in the CARDIAC software package Option Function TURN ST OFF Turn ST analysis program on or off PRINT ST Print displayed ST trends and complexes NOTE Trends with a scale of 2 or 4mm printon a 3 mm scale 6 or 8 mm print on a 6 mm scale STORE NEW Select a new set of reference complexes REFERENCES 2000966 338A Dash 3000 4000 5000 8 19 Monitoring ECG Option Function ST LIMITS Select the ST deviation limits m ADJUST INDIVIDUAL LIMITS Select the low and high limits for any of the available leads DJ UST ALL LIMITS Select th
48. ROVER COMBO 5 4 Dash 3000 4000 5000 2000966 338A Managing Patients Monitoring Patient Option Mode Monitor Type Function PRINT LOCATION ROVER and All Select writers from the network ROVER COMBO SET LOCATION ID ROVER and All Select the MUSE Cardiology Information System for network ROVER identification COMBO ECG SOURCE COMBO and All Select the monitor or telemetry transmitter to receive ECG data If ROVER you select telemetry you must also select the transmitter number COMBO before you can admit a patient to the monitor includes all four monitoring modes STANDARD ROVER COMBO and ROVER COMBO 2All includes all three patient monitor types ADULT ICU NEONATAL ICU and OPERATING ROOM Discharge Discharging a patient from a monitor clears all patient information while retaining the unit name bed number and factory or custom defaults WARNING DISCHARGE TO CLEAR PATIENT DATA When admitting a new patient to the monitor you must clear all previous patient data from the monitor To accomplish this disconnect all patient cables and discharge the patient from the monitor To manually discharge a patient from the monitor follow this procedure 1 2 Disconnect all patient cables Select MORE MENUS gt ADMIT MENU gt DISCHARGE PATIENT or NEW CASE If in COMBO or ROVER COMBO monitoring modes select on of the following to terminate telemetry monitoring
49. SOFTWARE CONFIGURATION If it is enabled ECG INTELLIRATE is listed under the ENABLED SOFTWARE OPTIONS list 2000966 338A Dash 3000 4000 5000 8 5 Monitoring ECG Combo and Rover Combo Monitoring Guidelines The following are guidelines to remember when monitoring in COMBO or ROVER COMBO monitoring modes m When monitoring ECG from telemetry limits and arrhythmia alarm levels not your monitor defaults but are the telemetry defaults from the central station You can adjust these settings at the monitor The alarm pause feature if available on your transmitter is honored at the monitor You should not turn off the monitor until you have discharged the patient from the monitor Second V lead data is not sent to the monitor from the telemetry transmitter If you wish to see telemetry second V lead data you must view the telemetry patient m When switching ECG monitoring from the monitor to telemetry Arrhythmia alarm histories from the monitor are merged in the telemetry system CD Telemetry LAN software version 5 or later is required Ifyou discharge the monitor the telemetry arrhythmia alarm levels will be the same as the arrhythmia alarm levels supported by the monitor Therefore when the monitor uses the BASIC software package only lethal arrhythmia alarm levels will be detected from telemetry If the monitor has the CARDIAC software package full arrhythmia alarm levels will be
50. Send the report to MUSE system for storage PRINT Print analysis and waveforms to a laser printer or just the analysis to a writer m DELETE Erase the report m RETURN Close the report NOTE You can schedule automatic 12 lead analysis if you have a MUSE system by selecting 2 LEAD AUTO and a time option NOTE You can generate ACI TIPI analysis separately by selecting ACI TIPI ANALYSIS and entering the required patient information 8 22 Dash 3000 4000 5000 2000966 338A Monitoring ECG Troubleshooting Problem For clinical level troubleshooting refer to the GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide Cause Solution Transmitting a 12 lead reportto a MUSE when the report has an invalid ID There are communication problems with the network Aware Gateway or MUSE system Contact service ST numerics only display for the primary top lead If SINGLE LEAD is selected for LD ANALY SIS only the primary lead is used for processing Change LD ANALYSIS selection to MULTI LEAD Printing a 12 lead analysis report fails There is a printer error There are communication problems with the network If you cannot resolve the printer error contact service Contact service ALARM PAUSE or permanently paused Clinician paused the alarms Reactivate the alarms ALL ALARMS OFF The monitor is in a discharged state Admit a patien
51. a gas interface is connected the following applies m The monitor displays and GAS parameter windows 2000966 338A Dash 3000 4000 5000 E 13 Interfacing with Non GE Devices m The information displayed varies by device m For more information refer to Chapter 15 Pulse Oximeter Interface When a pulse oximeter interface is connected the following applies m The monitor displays an pO parameter window m The information displayed varies by device m For more information refer to Chapter 11 Transcutaneous Interface When a transcutaneous pO pCO interface is connected the following applies m The monitor displays a TC parameter window m The information displayed varies by device Ventilator Interface When a ventilator interface is connected the following applies The monitor displays a VENT parameter window The monitor displays up to four ventilator parameters The information displayed varies by device The control settings vary by device Continuous Cardiac Output When a cardiac output interface is connected the following applies The monitor displays a CCO parameter window The monitor may display an additional SvO parameter window The information displayed varies by device For more information refer to Chapter 12 IV Pump When an IV pump interface is connected the following applies m The monitor does not display a parameter window for IV pumps
52. and the alarm will break through m When ECG is turned off the ALARM PAUSE system status message does not display on the central station m FRANCE locale Alarms are paused for no more than three minutes in ADULT ICU and NEONATAL ICU patient monitor types Key Pressed ADULHICU NEONATAL ICU Pees ROOM One 60 seconds Two 5 minutes 3 minutes 5 minutes Three Pause cancelled 15 minutes Four Permanent pause Five Pause cancelled NOTE You can also select Silence Only from the monitor defaults This disables the pause and a second push results in reactivation of alarm versus an extended pause Key Pressed ADULHICU NEONATAL ICU EUER ROOM One 5 minutes 3 minutes 5 minutes Two Pause cancelled 15 minutes Three Permanent pause Four Pause cancelled 2000966 338A Dash 3000 4000 5000 4 7 Alarms Permanently To permanently silence all audible alarms for the patient admitted to the monitor select MORE MENUS gt ALARM CONTROL gt ALARM VOLUME gt OFF NOTE In NEONATAL ICU the alarm volume cannot be turned off The lowest alarm volume can be set to is 10 percent NOTE All changes are temporary and revert to the factory or custom defaults when the patient is discharged To permanently change the these settings refer to Defining Custom Defaults on page 3 7 4 8 Dash 3000 4000 5000 2000966 338A D Managing Patients 2000966 338A Dash 3000 4000 5000 Managing Patients Introduc
53. atrial reference re prepare resistance respiration radio frequency rhythm right leg respiration rate 2000966 338A Dash 3000 4000 5000 F 7 Abbreviations and Symbols sec SEV SIM Sol SP Sp0 ST Stat STR SV 5 02 SVR SVRI Sync 1 2 Temp TMP TP TFC TIR UAC systolic second sevoflurane simulator solution special arterial oxygen saturation pulse oximetry Signal quality index interval of ventricular repolarization right away systolic time ratio stroke volume mixed venous oxygen saturation systemic vascular resistance systemic vascular resistance index synchronized temperature site tachycardia transcutaneous technical temperature thoracic fluid content technical information report U umbilical artery catheter F 8 Dash 3000 4000 5000 2000966 338A Abbreviations and Symbols UO UVC Vent VFib VI VOA Vol VTach WF WFS Symbols urometer umbilical venous catheter V volt version ventrical lead ventilator ventricular fibrillation velocity index view on alarm volume ventricular tachycardia W waveform s X multiplier 2X invalid data and degree s greater than less than minus number percent 2000966 338A Dash 3000 4000 5000 F 9 Abbreviations and Symbols plus or minus inches u micro F 10 Dash 3000 4000 5000 2000966 338A Index Numerics Calibrate
54. battery and store it near the monitor until it is needed for transport When the battery is stored for a long period of time without being charged it will eventually lose all of its charge and fall asleep When the battery is asleep none of the LEDs on the battery will illuminate when the battery s Test button is pressed You must wake up the battery before you can use it again Dash 3000 4000 5000 2000966 338A Maintenance Waking Up The procedure for waking up a battery inside the monitor should only be performed by qualified service personnel For more information refer to the service manual To wake up a battery with the external charger preferred method use the following procedure NOTE A deeply discharged battery will require you to repeat the following steps more than once before the battery will wake up 1 Insert the battery into the battery charger and wait for the RUN LED light to illuminate approximately three minutes 2 Ifthe RUN LED light does NOT illuminate complete the following steps a Remove the battery from the battery charger b Insert the battery into the battery charger and let the battery trickle charge for two to three minutes while the FAIL LED flashes If the RUN LED light illuminates ignore it c Watch the battery charger LEDs and immediately remove the battery from the battery charger when the FAIL LED stops flashing AND remains illuminated OR when both the RUN and
55. by the monitor Refer to the following table for the monitor s factory default parameter alarm levels CRISIS WARNING ADMSORY MESSAGE VENT X SV02 X TC X E 12 Dash 3000 4000 5000 2000966 338A Interfacing with Non GE Devices CRISIS WARNING ADMSORY IVESSAGE CCO X ICG X Alarm Limits You must configure all alarm limits on the monitor The monitor only displays and enunciates the alarm limit violations defined on the peripheral device Parameter Windows and Menus The parameters displayed by the monitor from a peripheral device vary from device to device Anesthesia machines parameter modules gas analyzers and ventilators are capable of sending parameters to the monitor In some cases not all parameters can be displayed at one time To add parameters to the display use the following procedure 1 Select MONITOR SETUP 2 Select PARAMETERS ON OFF All parameters sent to the monitor display in the AVAILABLE PARAMETERS information window 3 Select the parameters you want to display 4 Select RETURN to close the window Peripheral Device Monitoring Guidelines Anesthesia Interface When an anesthesia interface is connected the following applies m The monitor can display up to three parameters GAS and Vent m The information displayed varies by device m For more information refer to Chapter 15 and Chapter 16 Gas Interface When
56. change the selections for USE CATHETER INJECT TEMP SIZE or INJECT VOL during or after beginning a cardiac trial the trials saved in the history are deleted Saved calculations are not deleted or changed All new trials and calculations use the new selected values 2000966 338A Dash 3000 4000 5000 12 3 Measuring Cardiac Output Option Function DELETE CO TRIALS Select and delete trials not wanted Up to four trials are saved when a new trial is made the oldest trial is deleted CARDIAC CALCS Access the cardiac calculations program For more information refer to Cardiac Calculations on page 7 10 CARDIAC OUTPUT NOW Perform one manual cardiac output measurement when the INJ ECT NOW message displays Manual injections may be preferred for patients with extreme blood temperature fluctuations BT LIMITS Selectthe blood temperature alarm limits and unit of measurement An alarm sounds when a value occurs outside of these limits PRINT CO CURVE Printthe displayed real time waveform A PRINTING MANUAL message displays when the waveform is printing AUTO MODE Turn automatic measurements on or off The monitor Searches for a stable baseline by averaging approximately 8 5 seconds of the patient s blood temperature and displays the message INJ ECT WHEN READY when a stable baseline is established USE Before the injection procedure begins select one of the blood pr
57. connected to the monitor The display updates every two seconds 1 3 136 12 70 94 5 2 4 518A 1 Systolic value 2 Pulse rate value ART FEM UAC 3 Diastolic value 4 Mean value There are two BP patient connectors on the monitor Depending on your monitor s capabilities you may be able to use a Y adapter cable to monitor two sites per BP patient connector NOTE When both ART and ICP pressure sites are monitored a CPP values is calculated and displayed in the JCP pressure parameter window The formula for CPP is the mean ART pressure value minus the ICP pressure value 9 2 Dash 3000 4000 5000 2000966 338A Monitoring Invasive Pressures Pressure Site Names and Values The following invasive pressure site names are supported The monitor displays the following labels and pressure values arterial ART systolic diastolic mean and rate femoral FEM systolic diastolic mean and rate umbilical arterial UAC systolic diastolic mean and rate pulmonary artery PA systolic diastolic and mean intracranial ICP CPP and mean umbilical venous UVC mean central venous CVP mean left atrial LA mean right atrial RA mean special SP mean Default Site Labels The BP patient connector default site labels are BP1 ART BP2 PA BP4 LA OTE BP3 CVP The default site labels in OPERATING ROOM are p
58. increasing distance between sources of EMI and susceptible devices Managing removing devices that are highly susceptible to EMI Lower power from internal EMI sources under hospital control such as paging systems Labeling devices susceptible to EMI Educating staff nurses and doctors to be aware of and to recognize potential EMI related problems FCC Compliance Information Statement This device complies with Part 15 of the FCC Rules and with RSS 210 of Industry Canada Operation is subject to the following two conditions This device may not cause harmful interference and This device must accept any interference received including interference that may cause undesired operation WARNING Changes or modifications not expressly approved by the party responsible for compliance could void the user s authority to operate the equipment Manual Information Purpose Intended Audience This manual contains instructions necessary to operate the monitor safely and in accordance with its functions and intended use This manual is intended for clinical professionals Clinical professionals are expected to have a working knowledge of medical procedures practices and terminology as required for monitoring of critically ill patients This manual must be used in conjunction with the GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide This document provides clinical reference informat
59. is always ECG If PARAMETER 2 is set for ECG or ST the ECG parameter window will display the size of two parameter windows You can also define which parameters display on the bottom of the screen by selecting the parameters in the order that you want them to display from the list of parameters on the bottom half of the DEFAULT PARAMETER PRIORITY window The parameters with an asterisk may be displayed in a reduced sized parameter window in order to accommodate 10 parameters The parameter priority also determines which parameters are displayed in GRAPHIC TRENDS and ALL LIMITS menus You cannot select more than 10 parameters The monitored parameters vary by patient monitor type For a complete list of all parameter priority definitions by patient monitor type refer to Factory Defaults on page C 1 NOTE If you are not actively monitoring a parameter the parameter window is not displayed When you begin monitoring the parameter the screen automatically reconfigures to display the parameter in the defined priority and screen position 2000966 338A Dash 3000 4000 5000 3 13 Monitor Setup 3 14 Dash 3000 4000 5000 2000966 338A 4 Alarms 2000966 338A Dash 3000 4000 5000 4 1 Alarms Introduction Overview The monitor notifies you of patient or system status alarms by tone light or on screen messages On screen messages display in the following l
60. manner assume the responsibility for performing the recommended maintenance schedule unless an Equipment Maintenance Agreement exists The sole responsibility rests with the individuals hospitals or institutions utilizing the device General safety tests should be performed every 12 months NBP and temperature measuring devices should be tested every two years Safety tests may only be performed by qualified personnel not subject to directives with respect to these tests If a service contract exists safety tests may be performed by GE service personnel Detailed information about safety tests can be found in the service manual Once the safety tests have been performed no additional regular maintenance is required Only use standards that guarantee sufficient accuracy All such standards must be based upon national or European standards To test temperature use the following procedure and a patient simulator Connect the simulator to the Temp CO patient connector 2000966 338A Dash 3000 4000 5000 A 15 Maintenance 017c 2 Turn on the simulator set the adapter to 400 and set the temperature output to 37 C 3 Check the temperature values in the TEMP parameter window The displayed value must be within 0 4 Cof the simulator setting If the readings fail re calibrate the Temp CO circuit For more information refer to the service manual 4 Repeat the procedure with the simulator adapt
61. menu options Data entry fields screen text Any text that appears on the display screen Text This manual uses the following text styles to identify hardware terms software terms and the correct way to enter data Style Definition bold Indicates hardware items such as Keys labels or connectors italic Indicates software items such as menus menu options or screen text Indicates menu options or control settings to select consecutively Illustrations and Names In this manual all illustrations are provided as examples only They may not necessarily reflect your monitoring setup or data viewed on your monitor All names appearing in examples and illustrations are fictitious The use of any real person s name is purely coincidental 2000966 338A Dash 3000 4000 5000 1 19 Introduction Ordering Manuals Revision History A paper copy of this manual will be provided upon request Contact your local GE representative and request the part number on the first page of the manual Each page of this document has the document part number and revision letter at the bottom of the page The revision letter changes whenever the document is updated Revision Comments A Release of software version 6 1 20 Dash 3000 4000 5000 2000966 338A Equipment Overview 2000966 338A Dash 3000 4000 5000 Equipment Overview Hard
62. monitors in a care unit have the same factory or custom defaults To permanently change the these settings refer to Defining Custom Defaults on page 3 7 The following options control how and when other monitors are viewed on a host monitor Some settings are only available for a specific software option 5 8 Dash 3000 4000 5000 2000966 338A Managing Patients Option Software Option Function VIEW ON ALARM All Select one of the following options m OFF Donotallow this monitor to view other monitors m ON Display alarm messages from alarming monitors in the care unit If running AutoView XM the alarm levels that trigger an automatic display on a host monitor are defined in the AVOA ALARM LEVEL setting m AUTO When running AutoView XM select this option to display alarm messages and enable an automatic split screen view on alarm on a host monitor VOA BROADCAST All Select one of the following options m OFF Donotsend any alarms from this monitor to other monitors on the network m ON Send all ADVISORY WARNING and CRISIS alarms to other monitors on the network Only monitors that have this monitor selected to automatically view on alarm receive the alarms WARNING ALARM NOTIFICATION LIMITATION Ifa viewing bed is configured to auto view a bed that has SEND AUTO VIEWS turned OFF the viewing bed will only receive the alarm line message NOT the split screen view o
63. o eg 7 10 Cardiac Calculations 7 10 Dosage Calculations 7 11 Pulmonary Calculations 7 13 8 Monitoring ECG B NOB NOB EO B N BOB BN U 8 1 Introd ction o eoa oce e e ce C VO A A EAE CA ROC 8 2 1s eret e tette bere Per Td qoe e E 82 en IT 8 3 AFIB Arrhythmia 8 3 2 na n ki dade b n Gad eer Ra bees dass 8 5 Combo and Rover Combo Monitoring Guidelines 8 6 Analog aerated l ka r k ME a w nek kak ees reel 8 7 Additional 1 8 7 Safety sie Oo ec haa e E arx rv a k e hes 8 8 Pacemakers Az eat yh unma Ae envi eio rota A ane 8 8 Arhythimla tad b MA USE Kn 8 9 0 2 8 10 Control Settings Wi CON ES Ka 8 11 Custom 5 aa 8 14 OT E GG 44 4 ERO RR WO W DIT aw kara 8 14 Permanently ur xana naa A Wan UA A a cem a 8 14 ON San Sy
64. of parameters When the maximum number is exceeded the connectivity device ignores all data from the duplicate parameter Two SpO parameters Four temperature parameters Eight BP parameters Eight IV parameters One or Gas parameter One each of all other parameters CO and Gas Parameter Handling The connectivity device requires that CO and Gas parameters originate from the same peripheral device If a device only provides one of the parameters the connectivity device does not recognize the other parameter from any other peripheral device However when the connectivity device is connected to a Dash 3000 4000 monitor the monitor controls which source of and Gas parameter data is used The monitor does NOT require that CO and Gas parameters originate from the same peripheral device E 8 Dash 3000 4000 5000 2000966 338A Interfacing with Non GE Devices Refer to the following table for more information CO and Gas parameter data Setup Connecting the Monitor SAM Module Monitor CO Option Unity Network ID CO Data Source Gas Data Source Yes No No SAM module SAM module Yes Yes No SAM module SAM module Yes No Yes SAM module SAM module Yes Yes Yes SAM module SAM module No Yes No Monitor None No Yes Yes Monitor Unity Network ID No No Yes Unity Network ID Unity Network ID The monitor and the connectivity device much be connected to the same network To connect
65. operation WARNING Before using the monitor for the first time please read the Safety Statements on page 1 2 When the monitor is in normal operating mode press the Standby key to switch to the off charging operating mode All alarms are disabled and the Standby screen displays until you press the Trim Knob control Standby or Admit Discharge key Off charging mode operation only provides one function charging batteries Press the Power key and disconnect the monitor from AC power to turn the monitor off When turned off the monitor does not perform any operations NOTE You cannot turn the monitor off when in COMBO or ROVER COMBO monitoring modes If you disconnect from AC power and press the Power key you are prompted to discharge the patient The monitor receives power from the batteries until the patient is discharged 2000966 338A Dash 3000 4000 5000 2 15 Equipment Overview User Interface Overview Main Display The main display is the primary display It includes all monitored parameter windows and waveforms It also includes monitor information and access to all other monitor and parameter functions and menus The monitor automatically returns to the main display when any other menu is idle for more than five minutes 1 2 3 10 15 15 DEC 2004 ADULT 0 S 0 2 J 60ms 1 02 lula all sal 1107 69 8 5 15 AD
66. placement Clinical level troubleshooting The following safety statements apply when monitoring respiration Monitoring WARNING ELECTRODE CONFIGURATION Impedance respiration monitoring is not reliable when ECG electrodes are placed on the limbs WARNING APNEA The monitor may not detect all episodes of inadequate breathing nor does it distinguish between central obstructive and mixed no breath events To verify that you are ready to monitor respiration follow this procedure 1 2 pale ON Admit the patient to the monitor Verify that respiration is enabled on the monitor Position electrodes on the patient Attach leadwires to the electrodes Connect the patient cable to the leadwires Connect the patient cable to the ECG patient connector on the monitor Verify that patient data displays in the RR parameter window Verify the respiration waveform is regular and even 2000966 338A Dash 3000 4000 5000 13 3 Monitoring Respiration 9 Adjust the control settings as necessary Control Settings To adjust the control settings for the patient admitted to the monitor select the RR parameter window label Then select any of the following options and make the desired changes NOTE All changes are temporary and revert to the factory or custom defaults when the patient is discharged To permanently change the these settings refer to Defining Custom Defau
67. print patient waveforms and most information windows There are three possible printing devices m Built in writer m Writer on the network another monitor or central station m Laser printer on the network There are two printing options m On demand Press the Graph Go Stop or Print key on the monitor to print the data displayed on the monitor The real time print opportunities depend on the monitored parameters and the data tasks or windows displayed m Scheduled automatic Automatically print patient data when a CRISIS or WARNING patient status alarm sounds Once a print job is started press the Graph Go Stop or Print key on the print source monitor or central station to cancel the print job To adjust the control settings for the patient admitted to the monitor select MORE MENUS MONITOR SETUP GRAPH SETUP or PRINT SETUP Then select any of the following options and make the desired changes NOTE All changes are temporary and revert to the factory or custom defaults when the patient is discharged To permanently change the these settings refer to Defining Custom Defaults on page 3 7 Option Function WAVEFORM Select a lead and its associated waveform to print first ECG 1 WAVEFORM 2 Select a lead and its associated waveform to print second 6 2 Dash 3000 4000 5000 2000966 338A Printing Option Function WAVEFORM 3 Select a lead and its associated waveform to print
68. system allows monitors to roam within the access point coverage area and maintain a strong seamless connection to the network Access points connect wireless monitors to the wired network infrastructure within the building The areas covered by each access point overlaps to ensure continuous coverage Wireless monitors perform the same as monitors directly connected to the network Hardwired directly connected to the network with a cable or wireless network communication is transparent to the user It is not indicated on the screen Wireless communication automatically occurs when the network cable is disconnected from a wireless monitor Hardwired communication automatically occurs when the network cable is connected to the wireless monitor and the network Each mode of network communication is established within three seconds of connection or disconnection from the wired network 2000966 338A Dash 3000 4000 5000 2 41 Equipment Overview The hardwired network connection has priority when a monitor is wireless configured but hardwired to the network If you experience any network communication issues try the following Make sure the monitor is in the wireless network coverage area Try moving the monitor to a different access point location in the wireless network m Isolate the monitor from the interfering source or device or remove the interfering source or device Laser Printer WARNING SHOCK HAZARD
69. test for leakage current must be performed by qualified biomedical engineering personnel before using with patients WARNING PATIENT AMBULATION A patient must be assisted if ambulating with a roll stand mounted monitor WARNING POWER SUPPLY The device must be connected to a properly installed power outlet with protective earth contacts only If the installation does not provide for a protective earth conductor disconnect the monitor from the power line and operate it on battery power if possible All devices of a system must be connected to the same power supply circuit Devices which are not connected to the same circuit must be electrically isolated when operated Dash 3000 4000 5000 2000966 338A Introduction WARNING PROTECTED LEADWIRES Only use protected leadwires and patient cables with this monitor The use of unprotected leadwires and patient cables creates the potential for making an electrical connection to ground or to a high voltage power source which can cause serious injury or death to the patient WARNING RATE METERS Keep pacemaker patients under close observation Rate meters may continue to count the pacemaker rate during cardiac arrest and some arrhythmias Therefore do not rely entirely on rate meter alarms WARNING SITE REQUIREMENTS For safety reasons all connectors for patient cables and sensor leads are designed to p
70. was password protected during installation For a complete list of the factory defaults for each patient monitor type refer to Factory Defaults on page C 1 Custom Defaults Custom defaults are a set of modified factory defaults You can create up to five custom default profiles for each patient monitor type used in your care unit 3 6 Dash 3000 4000 5000 2000966 338A Monitor Setup Control Settings Custom defaults are retained when any of the following events occur A parameter cable is disconnected from the patient A parameter cable is disconnected from the monitor A parameter cable is disconnected from a single parameter module A parameter was turned off then turned on again CAUTION Ifa patient cable is disconnected from the monitor and the parameter window disappears from the display alarm limits may revert to the factory defaults when the cable is reconnected These are persistent settings meaning they are recalled when a patient is discharged from the monitor You cannot create or adjust custom defaults while a patient is admitted to the monitor If you change the patient monitor type all custom defaults are erased and the monitor returns to the factory default settings If you create custom defaults record your changes in Appendix D Control settings are temporary adjustments you can make to parameter settings or basic monitor functions for the patient admitted to the monitor
71. 000 VNT Yes Bird 6400ST 8400ST VNT Yes Drager E vita VNT Yes Drager Evita XL VNT CO Yes Drager Fabius GS VNT Yes Drager Savina VNT Yes Hamilton Amadeus Veolar VNT Yes Hamilton Galileo VNT Yes Nellcor Puritan Bennett Adult VNT Yes Star Adult Star 1500 2000 Nellcor Puritan Bennett VNT Yes 72005 E Puritan Bennett 840 VNT Yes with the following exceptions Ve Vre MAND Vie SPONT Vu SPONT Respironics Espirit VNT Yes Stephan Christina Stephanie VNT Yes Not for sale in the United States Siemens Servo i VNT Yes Siemens SV900C 900D 900E VNT No Ventilator adult neonatal Siemens 5 300 VNT Yes Ventilator neonatal Nellcor P uritan Bennett Infant VNT Yes Star Infant Star 500 950 Bird VIP VNT Yes Dr ger Babylog 8000 VNT No 2000966 338A Dash 3000 4000 5000 E 7 Interfacing with Non GE Devices Limitations Duplicate Devices Duplicate Parameters The connectivity device can support a pre defined number of each device type and up to eight total devices including the monitor When the maximum number is exceeded on any device type the connectivity device ignores all data from the duplicate device One ventilator anesthesia machine or gas analyzer Seven IV pumps One transcutaneous monitor One urometer One continuous cardiac output monitor One multi parameter monitor Two pulse oximeters One auto association device GE monitor The connectivity device can support a pre defined number
72. 00966 338A Dash 3000 4000 5000 A 9 Maintenance Battery Status Menu To display the BATTERY STATUS menu select MORE MENUS gt BATTERY STATUS BATTERY STATUS BATTERYA BATTERY B SLOT STATUS IDLE IN USE CHARGE LEVEL 100 65 TIME TO EMPTY H M 01 55 01 12 TIME TO FULL n a FAULT STATUS DURING USE OK OK DURING CHARGE OK OK TEMPERATURE OK OK BATTERY QUALITY CONDITION MAIN BATTERY MENU HELP PREVIOUS MENU 6378 Select BATTERY HELP for more information on batteries m SLOT STATUS Definitions of the information presented in the BATTERY STATUS information window m TIMES Definitions of the information presented in the BATTERY STATUS information window FUEL GAUGES Explains the battery capacity gauges ALARMS Lists the battery messages and solutions Installation Guidelines Position the monitor in a location that does not artificially increase the operating temperature of the battery m To optimize battery life and performance select a location that does NOT artificially increase the ambient temperature surrounding the monitor m Do not place the monitor near a heat vent or near heat generating equipment such as computer monitors m Avoid placing the monitor in corners where the airflow may be restricted A 10 Dash 3000 4000 5000 2000966 338A Maintenance Battery Care Charging Conditioning Charging a battery takes appr
73. 0V the source must be a center tapped 240V single phase circuit This equipment is suitable for connection to public mains as defined in CISPR 11 CAUTION RESTRICTED SALE U S federal law restricts this device to sale by or on order of a physician CAUTION SINGLE PATIENT USE This equipment is designed for use on one patient at a time Using this equipment to monitor different parameters on different patients at the same time compromises the accuracy of data acquired CAUTION SUPERVISED USE This equipment is intended for use under the direct supervision of a licensed health care practitioner Dash 3000 4000 5000 2000966 338A Introduction CAUTION VENTILATION REQUIREMENTS Set up the device in a location which affords sufficient ventilation The ventilation openings of the device must not be obstructed The ambient conditions specified in the technical specifications must be ensured at all times Notes Note statements provide application tips or other useful information The following note statements apply to this monitoring system m Put the monitor in a location where you can easily see the screen and access the operating controls m This product is not likely to cause abnormal operation of other patient connected equipment such as cardiac pacemaker or other electrical stimulators Exceptions are noted in the pacemaker monitoring section if applicable
74. 2000966 338A Monitoring Anesthesia Gases If a third agent is detected with a concentration greater than 0 60 percent the N O values will be removed to make room for the third agent You can adjust the control settings to display the N5O values with the primary and secondary agents NOTE Halothane and enflurane are identified and quantified in a mixture with desflurane if desflurane is less than seven percent Options There are two models of the SAM module one with an sensor and one without The module without the sensor is identified by a SAM 80 label on the top of the module and the words No O2 Sensor on the front panel label Operating instructions are similar for both modules Guidelines Use the following guidelines when monitoring anesthesia gases with an external gas analyzer Configure alarm limits at the gas analyzer Configure and adjust alarm levels at the monitor Review or adjust control settings from the CO or GAS menus The settings you may view or adjust are dependent upon the connected device and may vary between devices Additional Information Refer to the GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide for the following information m Patient tube connections m Patient gas exhaust Safety The following safety statements apply when monitoring anesthesia gases with a SAM module 2000966 338A Dash 3000 4000 5000 16 3 Monitoring Anesthesia Gases
75. 2000966 338A Monitoring ECG ECG Setting Source When Exiting COMBO Mode ECG Rate Averaging IntelliRate When discharging from telemetry but remaining admitted to the monitor exiting COMBO mode the ECG setting source monitor or telemetry depends on the COMBO DEFAULT SOURCE selection m TELE DEFINED When exiting COMBO mode the ECG settings return to the monitor s ECG custom defaults m USER DEFINED When exiting COMBO mode the ECG settings for the current patient persist until the patient is discharged from the monitor For both the TELE DEFINED and USER DEFINED options when discharging from the monitor exiting COMBO mode but remaining admitted to telemetry the ECG settings for the current patient persist until the patient is discharged from telemetry To select the number of heart beat intervals used to generate an average heart rate follow this procedure The factory default is eight beats 1 Select MORE MENUS gt MONITOR SETUP gt MONITOR DEFAULTS gt SETUP DEFAULT DISPLAY 2 Locate and select ECG RATE AVERAGING 3 Select one of the following m amp BEATS Averages the eight most recent heart beat intervals This is the default setting m 4 BEATS Averages the four most recent heart beat intervals to get a faster response to the changes in a patient s heart rate To turn IntelliRate on follow this procedure When this option is enabled the factory default setting is on 1 Selec
76. 338A Monitor Setup NOTE Special characters that are sent over the network in alarm broadcasts patient status or system status messages patient bed or care unit names cannot be displayed by networked equipment that does not support these languages Locale The monitor is set to one of two locale options when installed DEFAULT or France If the monitor is set to FRANCE the following functionality varies from the standard default monitor functions France Alarms m Alarm pause Lasts no more than three minutes when in ADULT ICU or NEONATAL ICU patient monitor types m Alarm volume Alarms can not be turned off in NEONATAL ICU patient monitor type The lowest possible setting is 10 percent When turned off the monitor alarms every three minutes to remind you alarms are silenced The volume resets to the monitor default setting when a patient is admitted alarm pause breakthrough occurs or the monitor is turned on m Discharge alarms The monitor alarms every three minutes when a patient is discharged m Alarm levels All parameter patient status message level alarms except ECG are automatically increased to a patient status advisory level alarm The following monitor default alarm limits are also unique NBP S NBP D NBP M ADULT ICU and OPERATING ROOM 35010 25 NBP S NBP D NBP M NEONATAL ICU 150 to 25 ART 300 to 30 HR 300 to 30 SPO2 105 to 60 SPO2 R 235 to 40 TEMP
77. 966 338A Monitoring ECG Option Function INITIATE 12 LEAD ON ST HISTORY Enable automatic initiation of 12 lead analysis when an ST event is stored in history ADJ UST ST POINT Change ST measurement point J 0 MS to 80 MS NOTE Upon initialization of ST analysis regardless of which IDENTIFY V LEAD option is selected the V lead s ST alarm limits will always be the default limits set for V1 When the identified V lead s position or label is changed the previous identified V lead s ST alarm limits will be retained For example if you change the V lead s ST alarm limits to 3 and then change the identified V lead s position and label the ST alarm limits will remain at 3 regardless of the default ST alarm limits for the new identified V lead This functionality occurs in both hard wired and COMBO mode during 5 lead ECG monitoring Performing 12 Lead Analysis To analyze 12 lead ECG data follow this procedure WARNING This device uses a computerized 12 lead ECG analysis program which can be used as a tool in ECG tracing interpretation This computerized interpretation is only significant when used in conjunction with clinical findings All computer generated tracings should be overread by a qualified physician To ensure accuracy use only computer generated tracings and not the display for physician interpretation The intended use of this device is to recor
78. A 7 Maintenance LED Illuminated Flashing READY and CONDITION Conditioning is complete Conditioning is required pass target FAIL Battery fault Charger fault FAIL and CONDITION Conditioning is complete fail target Safety NOTE WARNING PHYSICAL INJURY Do NOT install the monitor above a patient Make sure the batteries are completely inserted and battery doors are completely closed Falling batteries could seriously or fatally injure neonatal or other vulnerable patients WARNING EXPLOSION OR FIRE Using non recommended batteries could result is injury burns to the patients or users Only use batteries recommended or manufactured by GE The warranty can be voided if non recommended batteries are used WARNING PHYSICAL INJURY Do NOT install the monitor above a patient The potential exists for a battery to leak a chemical on the patient if the monitor is mounted above the patient Leaks from battery cells can occur under extreme conditions The liquid is caustic to eyes and skin If the liquid comes in contact with eyes or skin flush with clean water and seek medical attention For optimal performance and safety use only batteries supplied by GE A 8 Dash 3000 4000 5000 2000966 338A Maintenance Identifying Capacity One new fully charged battery lasts about 3 5 hours Two new fully charged batteries last about 5 hour
79. A Dash 3000 4000 5000 7 13 Patient Data 7 14 Dash 3000 4000 5000 2000966 338A 0 Monitoring ECG 2000966 338A Dash 3000 4000 5000 Monitoring ECG Introduction Overview ECG is the primary patient monitoring parameter It measures heart rate analyzes arrhythmia detects pacemaker function and detects myocardial ischemia A parameter window and waveform display when a patient cable is connected to the monitor The display updates every two seconds The The parameter window varies by software package and the control settings 1 2 3 Pk TECG 4 PVC 0 Ph 5 j J 0ms 02mm ANT INF LAT ll 0 2 0 0 111 0 0 AVL 0 0 AVF 0 0 V5 0 1 6 655A 1 QRS indicator 2 Heart rate 3 Paced beat detection indicator Pacemaker detection enabled 4 PVC count full arrhythmia only 5 ST measurement point 6 ST analysis data ST analysis only When the quality of an electrode signal degrades to an inadequate monitoring level a lead failure message displays and monitoring automatically switches to another lead as described in the following table 8 2 Dash 3000 4000 5000 2000966 338A Monitoring ECG Message New Lead Monitored RA FAIL Lead Ill LL FAIL Lead LA FAIL Lead II V FAIL Lead II LEADS FAILED No waveforms displayed when RL or all leads fail If more than one lead fails a s
80. AIN MENU or RETURN Wm AVOA Perform any one of the following actions Select MAIN MENU or RETURN Silence the alarming monitor at the host monitor or central station 2000966 338A Dash 3000 4000 5000 5 13 Managing Patients Resolve the alarm condition at the alarming monitor all alarm levels except CRISIS Silence the remote alarm This also prevents new alarms from sounding even if a new alarm is of higher priority m AutoView XM Perform any one of the following actions Select MAIN MENU or RETURN Silence the alarming monitor at the host monitor or central station Resolve the alarm condition at the alarming monitor all alarm levels except CRISIS Silence the remote alarm when the host monitor s AVOA SILENCE setting is set to SILENCED This also prevents new alarms from sounding even if a new alarm is of higher priority more recent higher priority alarm is received at the host monitor when the host monitor s AVOA SILENCE setting is set to NEW ALARM NOTE To remove a non alarming monitor display from the host monitor select MORE MENUS VIEW OTHER PATIENTS SELECT A BED TO VIEW The viewed bed is indicated with the word VIEW Selecting that bed again will remove from the host monitor 5 14 Dash 3000 4000 5000 2000966 338A Printing 2000966 338A Dash 3000 4000 5000 6 1 Printing Introduction Overview Options Control Settings You can
81. B Paena ter a a 9 7 CRG high resolutior 7 7 software configuration 3 11 e ls To n on 7 5 Kay Ltd E vital S GI lc cy n pb pae bias tend 2724 Index 4 Dash 3000 4000 5000 2000966 338A Trim i tte tes 2 8 view alat m ive acer ninen e aec Erb n 5 11 troubleshooting view 2 022 1 5 11 anesthesia 16 9 custom defaults 5 8 batteries enter tt iet A 14 alarm level esee 5 10 Li npn 18 8 alert lO i eren reed er aede nd 5 9 12 7 broadcast 5 9 02 sete ett 15 8 remote 5 10 MEE 8 23 itat east teas 5 10 ccm 17 7 view on 5 9 9 9 5 7 eee 10 12 OPON S a ani a 5 6 Doy HEU E 13 5 split view 5 12 SPO2 sitet mete date ek DK 11 16 MAN 7 4 T Sera Ye i eom E iot E 14 3 valsi tri ew KAK e ERR 7 4 V W view other 5 6 5 14 waveforms control settings 2
82. CO2 EXP E 50 J 50 E 50 CO2 INSP 2 5 5 5 CO2 RESP 5 30 15 100 1 200 NO BREATH E 20 15 30 SP02 10 1 90 105 SP02 R 50 5 90 20 1 150 BT 30 0 c 42 0 30 0 c 42 0 c oci 42 0 86 0 F 107 6 F 86 0 F 107 6 F 32 0 F 107 6 F 5 02 60 80 60 80 60 80 RR 5 30 15 100 1 200 RR APNEA 5 20 15 20 TEMP 1 30 0 c 42 0 30 0 c 42 0 c oci 42 0 86 0 F 107 6 F 86 0 F 107 6 F 32 0 F 107 6 F C 6 Dash 3000 4000 5000 2000966 338A Factory Defaults ADULFICU OFERRING Low HGH Low HGH Low HGH TEMP 2 30 0 c 42 0 30 0 c 42 0 c oci 42 0 86 0 F 107 6 F 86 0 F 107 6 F 32 0 F 107 6 F 02 INSP 18 19 18 19 18 19 02 m 02 a 02 a 102 N20 INSP 80 0 80 0 80 0 N20 EXP 80 0 80 0 80 0 N2 INSP 85 0 85 0 85 0 N2 EXP 85 0 85 0 85 0 SEV INSP 70 70 70 SEV EXP 70 70 70 DES INSP 12 0 12 0 12 0 DES EXP 12 0 12 0 12 0 ENF INSP 1 0 10 10 ENF EXP HAL INSP HAL EXP HE INSP 7 0 10 10 HE EXP ISO INSP ISO EXP AR INP AR EXP CI 1 5 5 0 15 5 0 15 5 0 TFC 10 60 10 60 10 60 BIS 4 100 2000966 338 Dash 3000 4000 5000 C 7 Factory Defaults Display Defaults The following are the display factory defaults To access these options sele
83. CONDARY PAR2 SVR ICG SECONDARY PAR3 TFC NBP SILENCE ALARM NORMAL PAUSE BREAKTHRU CRISIS MASIMO AVERAGING 8 SECS SAT SECONDS OFF 5 02 RESPONSE MODE NORMAL ECG INTELLIRATE ECG PARAMETER ON DISCONNECT OPTION TO DEFAULT NBP CLOCK SYNC OFF AVOA ALARM LEVEL WARNING Dash 3000 4000 5000 2000966 338A Factory Defaults OPERATING ADULTICU NEONATAL ICU REMOTE SILENCE CRISIS AVOA SILENCE SILENCED PERSISTENT SP02 OFF ECG RATE AVERAGING 8 BEATS BEAT PAUSE INTERVAL 3 SEC UNIT ROVING ON DOSE CALCS WT XFER OFF ON ON NBP PULSE RATE OFF NBP NO DETERMINATION SYS ADVISORY TRENDS HARDKEY TABULAR ALL COMBO DEFAULT SOURCE TELE DEFINED CLOCK DISPLAY ON W SEC BIS SMOOTH 15 SEC RATE EEG WF SCALE 25 EEG WF SPEED 25 Default Parameter Priority The following are the parameter priority factory defaults To access these options select MORE MENUS gt MONITOR SETUP gt MONITOR DEFAULTS gt SETUP DEFAULT PARAMETER PRIORITY Dash 3000 4000 5000 C 13 Factory Defaults The following parameters when monitored always appear in the parameter window auma NEoNATAL ICU PARAMETER 1 ECG ECG ECG PARAMETER 2 ECG UAC NBP PARAMETER 3 ART UVC ART PARAMETER 4 PA RR PA PARAMETER 5 SP02 SP02 SP02
84. CONDITION LEDs flash d Wait for one to two seconds then reinsert the battery into the battery charger The RUN and CONDITION LEDs will flash for five to ten seconds while the charger initializes the battery If the FAIL LED illuminates remove the battery and reinsert it into the battery charger e Watch the battery charger LEDs The RUN LED should stop flashing and remain illuminated for approximately one minute then the CONDITION LED should stop flashing At this time the battery is awake and being charged Recycling WARNING EXPLOSION HAZARD DO NOT incinerate the battery or store at high temperatures Serious injury or death could result When the battery no longer holds a charge it should be replaced The battery is recycleable Remove the old battery from the monitor and follow your local recycling guidelines 2000966 338A Dash 3000 4000 5000 A 13 Maintenance In the United States and Canada the Rechargeable Battery Recycling Corporation RBRC can help you locate your nearest rechargeable battery collection site You can contact RBRC by telephone 1 800 8 BATTERY or by accessing their internet web site www rbrc org Troubleshooting There are three conditions that activate battery alarms Wm Low battery m Battery failure m Charger failure Refer to the following table for solutions to alarm messages that display in the ECG waveform area Message Solution BATTERY LO
85. Care Monitoring Clinical Reference and Troubleshooting Guide provides the following information 12 2 Dash 3000 4000 5000 2000966 338A Measuring Cardiac Output Measuring Cardiac output washout curve information Clinical techniques that can help obtain an accurate cardiac output Patient preparation bath probe setup and in line setup Cardiac calculations program information Clinical level troubleshooting To verify that you are ready to measure CO follow this procedure 1 2 Control Settings Admit the patient to the monitor Connect the patient cable to the Temp CO patient connector on the monitor Position the patient Verify the in line sensor is connected to the tubing or that the bath probe is correctly sensing injectate temperature Verify that patient data displays in the CO parameter window Verify the monitor is ready for cardiac output trials Verify that a good quality waveform displays Adjust the control settings as necessary Verify that the swan catheter vendor size and constant are correct To adjust the control settings for the patient admitted to the monitor select the CO parameter window label Then select any of the following options and make the desired changes NOTE All changes are temporary and revert to the factory or custom defaults when the patient is discharged To permanently change the these settings refer to Defining Custom Defaults on page 3 7 NOTE If you
86. Communication When properly connected the monitor and the connectivity device automatically identify each other and the connected peripheral device You can determine the connection status for each serial port with the following connectivity device status indicators 2000966 338A Dash 3000 4000 5000 11 Interfacing with Non GE Devices Green Indicator Yellow Indicator Serial Port Status Description off off No connection Nothing is connected to this serial port or the interface connector is not operational on Pending communication The cable and interface adapter are connected but communication with the peripheral device is not established yet Slow flash Communication error The peripheral device is connected but there is a communication error fast flash Other errors Use the following guidelines to identify the error m Too many devices of one type are connected m Device software is not compatible with monitor software m Interface adapter is not supported by the monitor software on Communicating Communication with the device is working Customizing Data Display Default Parameter Alarm Levels Configure all alarm levels on the monitor When connected to a monitor the connectivity device follows the alarm levels defined in the MONITOR DEFAULTS menu The peripheral device does not determine the alarm level displayed or broadcast
87. Dash 3000 4000 5000 Patient Monitor Operator s Manual 2023896 026 Revision A GE Medical Systems Information Technologies gemedical com NOTE T 2 Due to continuing product innovation specifications in this manual are subject to change without notice The information in this manual supports software versions 5 4 or later Listed below are GE Medical Systems Information Technologies trademarks used in this document All other trademarks contained herein are the property of their respective owners CD TELEMETRY CRG PLUS DASH DINAMAP EAGLE MARS MUSE RESPONDER SAM SOLAR TRAM NET TRAMSCOPE TRAM RAC TRIM KNOB UNITY and UNITY NETWORK are trademarks of GE Medical Systems Information Technologies registered in the United States Patent and Trademark Office 12SL CENTRALSCOPE CIC PRO DASH PORT EK PRO IMPACT INTELLIRATE MENTOR PRISM PRN 50 M and SUPERSTAT are trademarks of GE Medical Systems Information Technologies 2005 General Electric Company All rights reserved Dash 3000 4000 5000 2000966 338A 10 May 2005 2000966 338A Contents Introduction siio xax YR xaxa 1 Equipment 2 1 2 intended eoa 12 S afety Statemients tace cd A wan d ea b ted 12 EE 12 97 e c toa de ae i eo ot hes 12 Cautiofis Pide tea cadet d 1 8 nr 1
88. Defaults on page 3 7 Monitoring Patient Option Mode Monitor Type Function CHANGE ADMIT INFO All Select the patient information NOTE When monitoring ECG entering the sex and age of the patient provides information needed for the 12SL with Gender Specific Analysis or ACI TIPI algorithms NOTE If you change any patient information requested from a Lab Access Server notify the appropriate hospital personnel REQUEST ADMIT INFO All All Request patient information from a Lab Access Server with an interface to hospital information NOTE Use the VIEW MANUAL ADMIT INFO menu option to review the manually entered information separately from the automatically populated information RECALL DEFAULT A All Recall factory defaults ADMIT HELP A ADULT ICU and Review the patient information required to admit a patient for the NEONATAL ICU current monitoring mode ADMIT PATIENT A ADULT ICU and Admita patient to the monitor with the information entered on the NEONATAL ICU MANUAL ADMIT INFORMATION information window NEW CASE A OPERATING Discharge the existing patient data and ready the monitor for the ROOM next patient admission UNITS OF MEASURE A All Select the units of measure for the patient s age height and weight SET UNIT NAME ROVER and All Select the unit name for network identification ROVER COMBO SET BED NUMBER ROVER and All Select the bed number for network identification
89. E OPTIONS list 2000966 338A Dash 3000 4000 5000 8 3 Monitoring ECG When a network device does not support AFIB arrhythmia identification the following conditions apply m The network device displays the ATRIAL FIB message in the message line m The network device does not display the ATRIAL FIB message in the ALARM HISTORY GRAPHIC TRENDS or VITAL SIGNS information windows Alarm levels display on network devices that do not support AFIB arrhythmia identification as follows Network Device Actual Displayed Text Central station lt 14 gt Dash 3000 4000 version 3B or earlier No textis displayed Eagle 4000 patient monitor SplitView No textis displayed Solar 7000 8000 patient monitor Full View SplitView No textis displayed Solar View OctaView Solar 8000M patient monitor Full View Split View No textis displayed Unity View Solar 9500 information monitor View Other Patient No textis displayed Tramscope patient monitor Full View Split View No textis displayed Unity Network IS Information Suite AVOA 8 4 Dash 3000 4000 5000 2000966 338A Monitoring ECG IntelliRate Network Device Actual Displayed Text Unity Network IS Information Suite Impact Pager MARS PC workstation The AFIB arrhythmia alarm text does not appear in the MARS Event window WARNING PATIENT RISK
90. EEEE ANE EELEE DE E 2 2000966 338A Dash 3000 4000 5000 ix General ERA EE nt a Pa eat E 2 Sdlely D METUO E 2 Non GE Device E 3 Displayed Data ec eder ved aote dd E 3 Compatible Devices speech S Wan REDE Rn tee E 4 Limitations ec ee o oce kdo me A E 8 Duplicate rei si keh lk Wiy kekan de Tuer ede d E 8 Duplicate 8 ED ELTE TENET E 9 Connecting the Monitor E 9 Connecting Peripheral Devices E 10 Establishing Communication 11 Customizing Data 5 12 Default Parameter Alarm E 12 Alam o etr CER Oe d Pc end eden se E 13 Parameter Windows and E 13 Peripheral Device Monitoring Guidelines E 13 Anesthesia E 13 ae gara cere ORE wen n E 13 Pulse Oximeter Interface W kk kk kk kK kK E 14 Transcutaneous pO2 pCO2 E 14 Ventilator Interface
91. ERIOD SELECT MENU TRENDS OLDER NEWER 90 MINS PARAMETERS PREVIOUS MENU 611A Use the following options to review GRAPHIC TRENDS Option Function PRESET TRENDS Select one ofthe preset parameter groups to trend VIEW OLDER View the previous trend VIEW NEWER View the next trend 7 6 Dash 3000 4000 5000 2000966 338A Patient Data Option Function TIME PERIOD Select one of the following time periods to for the trends Displayed trends automatically update while displayed in the GRAPHIC TRENDS information window according to the following cycle for each time period 24 hours Updates every six minutes 12 hours Updates every four minutes Eight hours Updates every two minutes Four hours Updates every minute Two hours Updates every minute One hour Updates every minute 30 minutes Updates every minute 15 minutes Updates every minute Six minutes Updates every 10 seconds SELECT PARAMETERS Select up to three parameters to trend HR is the default parameter NOTE NBP and invasive pressure with the associated systolic diastolic and mean values are considered one selection and will generate one trend If you do not want all three pressure parameters included in the trend unmark the parameters you do not want This is also true for inspired and expired NOTE You cannot view older or newer trends when viewin
92. ERVICE CO2 The SAM module failed Contact service CP BYPASS The alarms are deactivated for bypass This is a normal procedure message DESFLURANE Desuflurane is selected but isoflurane is Change the gas agent selection detected ISOFLURANE Isoflurane is selected but desoflurane is detected CONNECT AQUA KNOT The Aqua Knot water trap is disconnected Connector replace the Aqua Knot water trap LOW TEMP Gas cells are liquefied Apply power and wait for the module to warm up 30 minutes to one hour NO BREATH DETECTED No breath detected or sample line disconnected Check the patient and the sensor AIR CAL IN PROGRESS Room air calibration in progress This is a normal procedure message SERVICE UNKNOWN ERROR Unknown hardware failure Contact service WARMING UP The SAM module is warming up If the message displays for more than four minutes replace module or contact service 16 10 Dash 3000 4000 5000 2000966 338A 17 Monitoring Impedance Cardiography ICG 2000966 338A Dash 3000 4000 5000 Monitoring Impedance Cardiography ICG Introduction Overview The monitor uses an ICG module to acquire impedance cardiography data When the ICG module is installed into the TRAM RAC 2A module housing the CG parameter window displays one primary ICG parameter and up to three secondary ICG parameters The display updates every two seconds The ICG parameter
93. For clinical level troubleshooting refer to the GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide Message Cause Solution LEARNING The monitor is relearning the patient s This is a normal procedure message respiration pattern APNEA No breath detected Check the patient and the sensor ARTIFACT The monitor cannot determine respiration Check the patient and sensor LD Il FAIL The monitor cannot detect patient data Check the patient and replace or switch from the current lead the sensor LEADS FAIL The monitor cannot detect patient data Check the patient and replace or switch from any lead the sensor 2000966 338A Dash 3000 4000 5000 13 5 Monitoring Respiration 13 6 Dash 3000 4000 5000 2000966 338A 14 Monitoring Temperature 2000966 338A Dash 3000 4000 5000 14 1 Monitoring Temperature Overview Monitoring Because the temperature patient connector on the monitor is also used for cardiac output you cannot monitor temperature and cardiac output at the same time A parameter window displays up to two temperature sites when a patient cable is connected to the monitor The display is updated every two seconds There is no waveform 36 7 34 5 Tee 1270 764A 1 Temperature value 2 Temperature site and unit of measurement You can monitor temperature from both internal and external temperature sensors from the Y
94. G 2 Locate and select COMBO DEFAULT SOURCE 3 Select one of the following m TELE DEFINED Use the telemetry ECG settings This is the factory default m USER DEFINED Use the monitor s ECG settings if telemetry is NOT admitted Use the telemetry ECG settings if telemetry IS admitted ECG Setting Source When Entering COMBO Mode The following tables indicate the source monitor or telemetry of ECG settings when entering COMBO mode Tele Defined Monitor Telemetry Entering COMBOMode ECG Setting Source Not admitted Not admitted gt Admitted Not admitted gt Telemetry Not admitted Admitted gt User Defined Monitor Telemetry Entering COMBOMode ECG Setting Source Not admitted Not admitted gt Monitor Admitted Not admitted gt Not admitted Admitted gt Telemetry Notice that selecting Tele Defined means the ECG setting source is always telemetry when entering COMBO mode while the ECG setting source for User Defined depends on whether the patient is admitted to the monitor or telemetry when entering COMBO mode NOTE It is possible but not a normal operation to admit a patient to both a telemetry bed and a hardwired bed before entering COMBO mode For example bed101 telemetry AND bed101 monitor are two separate beds for the same patient When you enter COMBO mode in this situation the ECG setting source is always telemetry 8 16 Dash 3000 4000 5000
95. IEW VIEW SPECIFIC e MENU OLDER NEWER 15 MINS TIME ALL DATA PREVIOUS PAGE PAGE MENU DOWN UP 607C 74 Dash 3000 4000 5000 2000966 338A Patient Data Graphic Trends Use the following options to review VITAL SIGNS Option Function VIEW OLDER View the previous event VIEW NEWER View the next event TIME INTERVAL Select the desired time interval for the patient data display SPECIFIC TIME Select a specific time period of collected patient data to display in the information window SORT DATA Select one of the following episodic parameters to sort the collected patient data The data prints in the same order displayed m NBP m Cardiac calculations m Pulmonary calculations PAGE DOWN View the next page PAGE UP View the previous page GRAPHIC TRENDS allows you to create a graphic representation of a parameter over a specified period of time It uses median values from the collected patient data to create a one minute resolution trends Episodic parameters are stored every time an event occurs Non episodic parameters are sampled 30 times a minute To display GRAPHIC TRENDS select MORE MENUS PATIENT DATA GRAPHIC TRENDS 2000966 338A Dash 3000 4000 5000 7 5 Patient Data GRAPHIC TRENDS 25 FEB 1999 14 38 150 ml enne 50 13 08 13 38 14 08 h min MAIN PRESET VIEW VIEW TIME P
96. ION TRENDS HARDKEY COMBO DEFAULT SOURCE CLOCK DISPLAY BIS SMOOTH RATE EEG WF SCALE EEG WF SPEED Parameter Priority Defaults Indicate which parameters you want to have priority in the first six positions on the display PARAMETER 1 ECG PARAMETER 2 PARAMETER 3 PARAMETER 4 PARAMETER 5 PARAMETER 6 Circle the other parameters you want to have priority after position 6 Size of the parameter window determines how many selections you can make three full size five reduced size or combination thereof The software prevents you from selecting more parameters than allowable GAS RA TEMP NBP UVC ALARMS ART LA FEM ICP 2000966 338A Dash 3000 4000 5000 Custom Defaults UAC Sp PA SPO2 C02 0 CVP RESP May be displayed as reduced size determined by software Dash 3000 4000 5000 2000966 338A Interfacing with Non GE Devices 2000966 338A Dash 3000 4000 5000 Interfacing with Non GE Devices Introduction General Safety When connected to a Unity Network Interface Device ID connectivity device the monitor can interface with up to seven non GE peripheral bedside devices at the same time The connectivity device is intended for use on one patient at a time For more information on the Unity Network ID connectivity device refer to the
97. ISCONNECT displays in the parameter window PULSE RATE NOTE Only available with ART FEM and UAC parameter Sites Turn the feature on or off to display pulse rate values in the parameter window PA WEDGE NOTE Only available with PA parameter site and in the CARDIO PULMONARY software package Make a PA wedge measurement to emphasize the PA waveform For more information refer to Performing PA Wedge Measurements on page 9 7 Performing PA Wedge Measurements Automatic To perform an automatic PA wedge measurement follow this procedure 1 Select the PA parameter window label 2000966 338A Dash 3000 4000 5000 9 7 Monitoring Invasive Pressures From the PA menu select PA WEDGE A single beep sounds and the message INFLATE BALLOON displays in the PA parameter window Inflate the balloon according to your unit s policy and procedure The message WEDGE PROCESSING displays To add a cursor to the real time wedged waveform select PA CURSOR Deflate the balloon after three or four respiratory cycles no more than 20 seconds The PA WEDGE REVIEW information window displays 20 seconds of compressed waveform data with horizontal and vertical cursors identifying the end exhalation point PAW value and time of measurement PA WEDGE REVIEW 35 PA2 Mh Jil o WAP T PA WEDGE 15 13 31 MAIN CARDIAC MOVE WEDGE MENU OUTPUT CURSOR 705B To cha
98. LAN equipment Article 3 2 Protection of the Radio Spectrum the product complies with ETSI EN 300 328 2003 Radio Equipment and Systems RES Wideband transmission systems Technical characteristics and test conditions for data transmission equipment operating in the 2 4 GHz ISM band and using spread spectrum modulation techniques This manual is an integral part of the product and describes its intended use It should always be kept close to the equipment Observance of the manual is a prerequisite for proper product performance and correct operation and ensures patient and operator safety The symbol means ATTENTION Consult accompanying documents Information which refers only to certain versions of the product is accompanied by the model number s of the product s concerned The model number is given on the nameplate of the product The warranty does not cover damages resulting from the use of accessories and consumables from other manufacturers GE is responsible for the effects on safety reliability and performance of the product only if assembly operations extensions readjustments modifications or repairs are carried out by persons authorized by GE theelectrical installation of the relevant room complies with the requirements of the appropriate regulations and the device is used in accordance with the instructions for use All publications conform with the product specifications and applica
99. LARM WINDOW ALARM HISTORY NOTE CARDIAC software package only View ST references stored arrhythmia waveforms and ST alarm eventfor CRISIS WARNING and ADVISORY alarms For more information refer to Alarm History on page 7 2 WARNING Alarms do not sound alarm histories are not stored alarm graphs do not print and alarms are not sent to the central station during an alarm pause To silence alarms press the Silence Alarm key A SILENCED message displays and alarms will not sound The length of time alarms are silenced depends on m The patient monitor type m The number of times the Silence Alarm key is pressed m Whether any alarms are active when the Silence Alarm key is pressed Alarms remained paused unless a CRISIS patient status alarm occurs Alarm pause breakthrough allows any CRISIS patient status alarm to interrupt an alarm pause Only CRISIS alarms breakthrough other patient status alarms will not sound When the monitor is in alarm pause 4 6 Dash 3000 4000 5000 2000966 338A Alarms Active Alarm No Active Alarms m Countdown timer Displays time left in the alarm pause when in ADULT ICU or NEONATAL ICU patient monitor types NBP alarms Silenced until the next measurement is taken ECG or arrhythmia alarms If a patient condition of equal or greater priority occurs the alarm pause is cancelled
100. MONITOR Discharge from monitor only If ECG was acquired from telemetry telemetry will be monitored by the central station TELEMETRY Discharge from telemetry only ECG monitoring automatically switches to the monitor BOTH Discharge from monitor and telemetry 2000966 338A Dash 3000 4000 5000 5 5 Managing Patients 4 Ifthe monitor is setup to view other monitors the following events occur when the host monitor is discharged m When running the VOA or AVOA software option the viewed bed is removed from the display and the monitor reverts to the factory or custom defaults m When running the AutoView XM software option the viewed bed is removed from the display the monitor reverts to the factory or custom defaults All monitors from other care units are removed from the list of watched monitors All monitors in the same care unit are retained and monitored according to the VIEW ON ALARM control settings NOTE To automatically discharge a patient from the monitor in ADULT ICU or NEONATAL ICU press the Silence Alarm Admit or Admit Discharge key View Other Patients There are three ways to view patients admitted to other monitors on the network m Select another monitor on the network m Select an alarming monitor on the network m Automatically view an alarming monitor on the network How and when monitors display on a host monitor varies by software option There are three software options that
101. OU ay Kera coisas to vai ena ex ant ce rene 2 7 Ri idea Ra vids 15 2 16 2 2 6 tcm RE 8 2 go 2 6 16 2 niter 2 6 EE 9 2 Silence Alarm 2 7 pce 13 2 Standby ete eiie breed edd 2 7 SPOZ 11 2 2000966 338 Dash 3000 4000 5000 Index 3 Index e 14 2 FOVISION td 3 11 patient information 2 5 2 3 3 patient status 4 3 ECG n aime Cree fats 3 3 patient monitor type 3 4 high resolution 3 3 pressures see IP Unity Network nennen 3 3 print software 3 2 control settings ad n lt l ase ken kk kk yak 6 2 yek ke sec y P eR Ae 3 3 locationis eei v eiie 6 3 o teet een 3 3 Ort alarm iicet te ees 6 3 3 3 SPCC ERAI NIRE 6 3 565 2 422 44 011 11 2 11 17 UME iin ciet nae en tein 6 3 control settings lt cA 5k ka t 11 10 Aw kaynak o ek ka ka KEWE eker 6 2 alarm lT s Ay eee re aka lala et 11 10
102. PARAMETER 6 C02 NBP C02 lWhen ECG is turned on it is first and cannot be changed If turned off SPO2 is first and cannot be changed The following highlighted parameters parameter windows may display on the bottom of the screen when there is no room on the right side of the screen The parameters preceded with an asterisk may display in reduced size Adult ICU GAS CVP CO BIS NBP RA CCO ART UVC RESP FEM LA TEMP UAC ICP TC PA SP UO C02 SV02 ICG VENT 5 02 ALARMS C 14 Dash 3000 4000 5000 2000966 338A Factory Defaults Neonatal ICU VENT NBP SVO2 BIS ART CVP TC FEM RA TEMP UAC UVC CO PA LA CCO C02 ICP UO GAS SPA ICG RESP SPO2 ALARMS Operating Room C02 FEM ICP BIS GAS UAC SP SPO2 PA SVO2 CO VENT RESP CCO CVP TC TEMP RA UO NBP UVC ICG ART LA ALARMS Dash 3000 4000 5000 C 15 2000966 338A Factory Defaults C 16 Dash 3000 4000 5000 2000966 338A D Custom Defaults 2000966 338A Dash 3000 4000 5000 Custom Defaults Overview Use this worksheet to record the custom defaults used in your care unit Keep it ina prominent place You may want to make additional copies of the worksheet for future use before filling it out General Information Custom Default Name Unit Name Patient monitor type Arrhy
103. ROLS Then select any of the following options and make the desired changes NOTE All changes are temporary and revert to the factory or custom defaults when the patient is discharged To permanently change the these settings refer to Defining Custom Defaults on page 3 7 Option Function ALL LIMITS Select the high and low alarm limits for all monitored parameters ARRHYTHMIA ALARM LEVEL Select the alarm level for arrhythmias PARAMETER ALARM LEVEL Select the alarm level for all monitored parameters NOTE In NEONATAL ICU the heart rate limit alarm level cannot be set to MESSAGE ALARM VOLUME Select the alarm tone volume NOTE In NEONATAL ICU the alarm volume cannot be turned off The lowest alarm volume can be set to is 10 percent ALARM HELP Select to learn about alarms levels and hear alarm tones 2000966 338A Dash 3000 4000 5000 4 5 Alarms Silencing Alarms Temporarily Option Function DISPLAY OFF ALARM Select one of the following options to temporarily pause PAUSE patient and system status alarms m MONITOR CENTRAL PAUSE Preserve the collected patient data turn off the display and alarm light and pause alarms at the central station m MONITOR PAUSE Turn off the display and alarm light print local alarms and send patient data and alarms to the central station CLEAR ALARMS Clear all alarm information displayed in the A
104. SECONDARY ID Select a secondary identification number up to 13 characters REF PHYSICIAN Select the patient s referring physician s name telephone number up to 16 characters 3 When finished select SAVE 4 To admit a patient to the monitor with a custom default follow this procedure a Select RECALL DEFAULT b Select the desired custom default name from the RECALL DEFAULT window 5 Select ADMIT PATIENT To quickly admit a patient to the monitor select MORE MENUS gt ADMIT MENU gt ADMIT PATIENT or NEW CASE without entering any patient information When time permits add the patient s information by selecting MORE MENUS gt ADMIT MENU gt CHANGE ADMIT INFO NOTE Only available in software version 6 or later Not available in the OPERATING ROOM patient monitor type To automatically admit a patient to the monitor press the Silence Alarm Admit or Admit Discharge key When time permits add the patient s information by selecting MORE MENUS ADMIT MENU gt CHANGE ADMIT INFO To adjust the control settings for the patient admitted to the monitor select MORE MENUS gt ADMIT MENU Then select any of the following options and make the desired changes 2000966 338A Dash 3000 4000 5000 5 3 Managing Patients NOTE All changes are temporary and revert to the factory or custom defaults when the patient is discharged To permanently change the these settings refer to Defining Custom
105. SI series 400 and 700 To verify that you are ready to monitor temperature follow this procedure 1 Admit the patient to the monitor 2 Position the sensor on the patient 3 If you are using a dual temperature cable select 400 or 700 on the cable switch 700 400 766A 4 Connect the patient cable to the Temp CO patient connector on the monitor 5 Verify that patient data displays in the TP parameter window 6 Adjust the control settings as necessary 14 2 Dash 3000 4000 5000 2000966 338A Monitoring Temperature Control Settings To adjust the control settings for the patient admitted to the monitor select the parameter window label Then select any of the following options and make the desired changes NOTE All changes are temporary and revert to the factory or custom defaults when the patient is discharged To permanently change the these settings refer to Defining Custom Defaults on page 3 7 Option Function T1 Selectthe T1 temperature site to acquire patient data When off no patient data is acquired or displayed T2 Selectthe T2 temperature site to acquire patient data When off no patient data is acquired or displayed UNITS Select the unit of measurement TEMPERATURE LIMITS Selectthe high and low alarm limits for each temperature site An alarm sounds when a value occurs outside of these limits Troubl
106. Start five minutes of automatic continuous sequential NBP measurements When initiated cuff inflation begins a measurement is taken and the systolic diastolic and mean pressure values are displayed Thereafter the systolic value displays after the measurement starts but before the other pressure values are complete The monitor beeps when all values are complete Press the NBP Go Stop key to stop the measurements REVIEW NBPS Review the previous 96 NBP measurements less than 24 hours old in the VITAL SIGNS information window NBP LIMITS Select the high and low alarm limits for systolic diastolic and mean pressures An alarm sounds when a value occurs outside of these limits 10 8 Dash 3000 4000 5000 2000966 338A Monitoring NBP Option Function CUFF SIZE Select the type of NBP cuff used on the patient ADULT PEDIATRIC or NEONATAL WARNING The correct cuff size must be selected to obtain reliable NBP data and to prevent overpressure in neonatal or pediatric use NOTE You must select CLEAR NBP READINGS after changing this setting for the target pressure to take affect CLEAR NBP READINGS Remove all values from the NBP parameter window remove NBP messages from the display and remove all NBP information from the VITAL SIGNS history SETUP CUSTOM AUTO CAUTION Changes made to these control settings are persistent They are rec
107. These settings are erased when the patient is discharged from the monitor For more information on permanently changing monitor settings refer to Custom Defaults on page 3 6 Defining Custom Defaults To define a new set of custom defaults follow this procedure NOTE All custom defaults are effective immediately but you must admit the patient to the monitor for fully functional alarms NOTE If you do not define a custom default name and make any changes to the monitor default settings the custom default name displays with an asterisk For example ADULT 0 1 Discharge the patient from the monitor 2000966 338A Dash 3000 4000 5000 3 7 Monitor Setup Select MORE MENUS gt MONITOR SETUP gt MONITOR DEFAULTS gt CUSTOM DEFAULTS 3 create a name for a custom default set select DEFAULTS 4 Select the default name from the CUSTOM DEFAULTS window There are five default names for each patient monitor type m ADULT ICU ADULT 0 to ADULT 4 m NEONATAL ICU NEO 0 to NEO 4 m OPERATING ROOM OR 0 to OR 4 umo SUA Select RETURN Use the Trim Knob control to define a unique name up to 12 characters Select NAME DEFAULTS to save the new name 8 Select PREVIOUS MENU 9 Select any of the following menus and make the desired changes Option Function SETUP DEFAULTS ARRHYTHMIA ALARM LEVELS SETUP DEFAULT PARAMETER ALARM LEVELS Select the default ala
108. UT 87 M 0 rate 70 041 9 33 15 0 mmHg 50 1 00 15 B79 100 C02 RSP HI 29 NO BREATH 6 10 15 45 7 MENUS 15 DEC 2004 8 ALARMS BED3 HR LOW Main Display ALRM RR INSP EXP CO2 19 3 38 2 5L 9 809B 1 Time date and factory or custom default name 2 Care unit and bed name Patient name 4 Parameter windows 2 16 Dash 3000 4000 5000 2000966 338A Equipment Overview 5 Parameter waveforms 6 MORE MENUS 7 Large Clock Date 8 Message line 9 Battery gauge Menus There are three types of menus Popup menus A small menu that displays over the original menu All popup menus require some action by the user There are three types of action Scrolling Use the Trim Knob control to scroll and select an option from a list Pointer Use the Trim Knob control to move a pointer gt and select an option from a list Numeric Use the Trim Knob control to scroll though a range of numbers and make a selection Subordinate menus A complete set of menu options Direct action menus A menu that allows you to select a status for example ON or OFF or start a process for example RELEARN Windows There are two types of window parameter and information A parameter window for ever
109. W When this system WARNING sounds and displays only 10 minutes of battery run time is remaining Replace the battery or connect the monitor to AC power POWERING DOWN When this system WARNING sounds and displays there is no battery run time left The monitor will power off unless connected to AC power CHECK BATT STATUS When this system message displays the battery is not functioning Remove and insert or replace the battery BATTERY ERROR When this system WARNING sounds and displays the battery cannot be charged in the monitor Attempt charging in the external battery charger or replace the battery CHECK BATT STATUS When this system message displays the external charger failed to charge the battery Attempt charging the battery again or replace the battery A 14 Dash 3000 4000 5000 2000966 338A Maintenance Technical Maintenance Safety Tests General Temperature Testing Diagrams technical specifications and other relevant technical information can be found in the service manual supplied with this equipment Comply with the policies of your institution s biomedical department and the preventive maintenance recommendations in the service manual WARNING Failure on the part of all responsible individuals hospitals or institutions employing the use of this device to implement the recommended maintenance schedule may cause equipment failure and possible health hazards The manufacturer does not in any
110. We Wara abroad eran 5 8 Control Settings Lo b h ra N pO ea 5 10 Viewing Other 5 11 Selecting a 5 11 Understanding the Split View 5 5 12 Removing a Viewed Monitor 5 13 PHNGNG vii dn d wikia dr s Ond Introd ction eee ew o Ced RR E ead 6 2 OVeIVIBW lt gt xiya kal C o CER e CR A E RICE 6 2 OPUONS 23ye kaya Wi K e Kuna do eR betreten s 6 2 Control Settings nan 6 2 Printed N N 6 3 Guidelines o ree Rn eb ea 6 4 Patient Data w ERE Introduction 7 2 Reviewing Patient 7 2 Alarm HIStO Y dae Kir n fena 1 2 Vital SIGNS 5 7 4 Graphic Trends oi areari Se n n E CUP ROTER K ED a Ah h Wel y y 1 5 Dash 3000 4000 5000 iii TENS o e eU RC e RICE CER rade 7 1 Enn EUST 7 9 Customizing the Trends 7 10 Calculations iscsi eroe rye e c o e a e cC a e
111. Wedge Adult and Operating Room Opens the PA WEDGE menu QRS Volume Neonatal Opens a menu to adjust the QRS volume tone Resp Relearn Neonatal 2000966 338A Dash 3000 4000 5000 2 13 Equipment Overview Button Version Function Silence Alarm Adult Neonatal and Operating Room Silences sounding alarms 5 02 Operating Room Opens the SPO menu View Other Adult and Neonatal Opens the VIEW OTHER PATIENTS menu Vital Signs Adult and Neonatal Opens the VITAL SIGNS menu Zero All Adult Neonatal and Operating Room Zeroes all invasive pressure lines open to the atmosphere Dash Port Remote Display The Dash Port is a docking station for a monitor It gives the monitor easy connect disconnect access to AC power the network remote display and auxiliary devices For more information refer to the docking station operating instructions The remote display provides a larger display or display in a separate room The remote display must be located within 150 feet of the patient monitor It also requires a docking station a monitor running software version 5 or later and a network connection Cadex SMart Two Charger Operating Modes Normal GE recommends using the Cadex SMart Two Charger software version 1 1 or later to care for all batteries used in this monitor For more information refer to Batteries on page A 6 Press the Power key to begin the normal operating mode Normal mode pr
112. a arta A 2 Bidcompatibility eoa o one eke ed abe ete YT erates A 2 AE TA PROS 2 Disposal ic c e mb zm A 2 0 2 2 3 50 8 6 gt a s n nn ear bread 3 Display ida rta i AR a CAR ae c A 4 Applied cosciente Even fnere ter Eee en A 4 Cables and A 4 Capnostat Sensor and A 4 C ff and Hose akla y ra c eec eec a eee mca A 5 uM A 5 viii Dash 3000 4000 5000 2000966 338A 5 Changing Whiter P aper 5 ea neon a Re eT SUR RO DAR e BO A 6 acea NCC tar oe aa Me nd a teres d A 6 ecl A 6 Lithium lon 7 Cadex SMart Two Battery A 7 era E ISO queres A 8 Identifying Capacity s u Xak a y n O N pa ank Ea PER REENER 9 Installation Guidelines A 10 Battery Care s ice pek p n radere ure fev d tan bist A 11 CHANING ede rod UE SUN Eat ERROR Racca am A 11 Conditionilig zt epos ek Tan e Rec wegen A
113. a monitor to a connectivity device follow this procedure 1 Turn off the monitor and connectivity device 2 Connect one end of the purple interconnect cable to the AUX connector on the monitor or docking station 3 Connect the other end of the purple interconnect cable to the serial port labeled 1 on the connectivity device 2000966 338A Dash 3000 4000 5000 E 9 Interfacing with Non GE Devices 4 Connect one end of the network cable to the Ethernet connector on the connectivity device 5 Connect the other end of the network cable to the Ethernet connector on the monitor or docking station 6 Turn on the monitor and connectivity device Connecting Peripheral Devices A unique factory programmed interface adapter is required for each peripheral device Refer to the instructions provided with the interface adapter for setup and installation instructions To assure proper operation GE recommends permanently connecting interface adapters to peripheral device cables To connect peripheral devices to the connectivity device follow this procedure 1 Connect the interface adapter to the peripheral device cable E 10 Dash 3000 4000 5000 2000966 338A Interfacing with Non GE Devices amp 2 Connect the interface adapter in any of the remaining serial ports labeled 2 8 Serial port 1 is reserved for the monitor 3 Turn on the connectivity device and peripheral devices Establishing
114. ains an integrated electronic fuel gauge and a safety protection circuit The following are the key points you should know about lithium ion battery technology m The battery will discharge on its own even when it is not installed in a monitor This discharge is the result of the lithium ion cells and the bias current required for the integrated electronics m the nature of lithium ion cells the battery will self discharge The self discharge rate doubles for every 10 C 18 F rise in temperature The capacity loss of the battery degrades significantly at higher temperatures As the battery ages the full charge capacity of the battery will degrade and be permanently lost As a result the amount of charge that is stored and available for use is reduced Cadex SMart Two Battery Charger NOTE To extend the life of batteries GE recommends using the external Cadex SMart Two battery charger to perform all battery care functions To use the external battery charger the monitor must be running software version 2A or later and the charger must be running software version 1 1 or later The following LEDs appear on the battery charger The combination of LEDs and their meaning change by illumination type solid or flashing LED Illuminated Flashing RUN Charging in progress Initializing the battery RUN and CONDITION Conditioning in progress READY Charging is complete 2000966 338A Dash 3000 4000 5000
115. al or electrical problems m MESSAGE Additional information only The monitor s response to system status alarms is as follows terminal Indicator WARNING ADMSORY MESSAGE Alarm tone Repeating foghorn Single foghorn No Alarm light Yellow No No On screen Yes Yes Yes message Alarm broadcast Yes No No Remote alarm Yes No No You cannot change system status alarm levels and limits WARNING ALARM ACTIVATION No alarms sound or display on the monitor until a patient is admitted to the monitor The monitor will NOT alarm if an unadmitted patient enters an alarm condition You must admit the patient to activate alarms automatic alarm printing and the ALARM HISTORY WARNING After an interruption of the electric power supply verify the alarm processing is active and verify that no arrhythmia occurred 4 4 Dash 3000 4000 5000 2000966 338A Alarms CAUTION GErecommends that monitors without arrhythmia detection monitoring patients at risk of asystole should define the HR alarm as CRISIS If the HR alarm is set to WARNING the alarm clears after three minutes of continued asystole NOTE Always remove all patient cables from the monitor prior to discharging a patient to clear all alarm data from the monitor Control Settings To adjust the control settings for the patient admitted to the monitor select MORE MENUS gt ALARM CONT
116. alled when a patient is discharged from the monitor NOTE Only available in software version 6 or later Create a custom series of automatic NBP measurements including the time interval between measurements and the number of measurements to perform For more information refer to Setup Custom Automatic NBP Measurements on page 10 10 2000966 338A Dash 3000 4000 5000 10 9 Monitoring NBP Option Function INITIAL INFLATION PRESSURE Select the target inflation pressure for the first NBP measurement The choices vary by cuff size NOTE You must select CLEAR NBP READINGS after changing this setting for the target pressure to take affect NOTE SuperS briefly over inflates beyond the initial inflation pressure and then steps down to the correct pressure To benefit patient comfort lower the default initial inflation pressure PULSE RATE NOTE Only available in software version 6 or later Turn the feature on or off to display pulse rate values in the parameter window when the display setting is INDV 3 WFS Custom Defaults Setup Custom Automatic NBP Measurements To define up to four individual automatic NBP measurement series follow this procedure CAUTION Changes made to these control settings are persistent They are recalled when a patient is discharged from the monitor NOTE Only available in software version 6 or later 1 S
117. also displays a waveform The ICG waveform is not synchronized with any parameter A message DELAYED displays with the waveform due to an approximately four second patient data delay Monitored Parameters The following measured parameters are available for display Thoracic Fluid Content TFC Acceleration Index ACT Velocity Index Heart Rate HR The following calculated parameters are available for display Additional Information Cardiac Output CO Cardiac Index Stroke Volume SV Stroke Index ST Systemic Vascular Resistance SVR Systemic Vascular Resistance Index SVRI Left Ventricular Stroke Work Index LVSWT Left Cardiac Work Index LCWI Systolic Time Ratio STR Estimated Delivered Oxygen Index eDO2I Pre Ejection Period PEP Left Ventricular Ejection Time LVET Refer to the GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide for the following information 17 2 Dash 3000 4000 5000 2000966 338A Monitoring Impedance Cardiography ICG ICG formulas Patient preparation Sensor and cable placement ICG reference literature Clinical level troubleshooting Safety For important information about monitoring pacemaker patients refer to Pacemaker on page 8 8 and the GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide WARNING The ICG module is designed for use on adult patients in the resting posi
118. and position on the display right R or left L CURSOR Display a horizontal line with a numeric value over the waveform to indicate a pressure value at specific position on the waveform CLEAR CURSOR Remove the cursor from the waveform LIMITS Select the high and low alarm limits for heart rate systolic diastolic and mean pressures An alarm sounds when a value occurs outside of these limits NOTE Adjusting the HR limits affects the pressure tracing not the primary ECG HR alarm level CHANGE NAME Select the site name for the monitored pressure site for accurate waveform processing for example if monitoring the femoral pressure site select FEM 2000966 338A Dash 3000 4000 5000 9 5 Monitoring Invasive Pressures Option Function ZERO Zero a Single transducer To zero all transducers press the Zero All key BP FILTER Select one of the following filter options m 12 7 Recommended for typical monitoring m 40HZ Recommended for higher frequency waveform component processing May result is elevated pressure values CALIBRATE TRANSDUCER Adjustthe monitor to compensate for transducer errors Measurement errors can be identified when pressure calibration is measured with other instruments for example a manometer m CAL 100 Select the percentage of error when the calibration error is known for example 102 if the transducer measured two percent hig
119. aneous multi lead ECG acquisition X 3 lead or 5 lead ECG cable compatibility X Selectable beat pause interval X Selectable heart rate averaging Pacemaker detection rejection Smart lead fail All ECG display format gt lt lt gt Lethal arrhythmia detection package Asystole VTach and VFib alarms Full arrhythmia package w alarm level adjust X Multi lead arrhythmia storage and recall X B 2 Dash 3000 4000 5000 2000966 338A Software Packages Capability or Feature Basic Cardiac Cardio pulmonary High Resolutio nCRG Trends Gender Specific 12SL amp Multi lead ST segment measurement 7 leads 12 lead ST segment monitoring 12 leads Multi lead ST segment template and trending Multi lead ST segment history storage Selectable ST points gt lt gt lt gt lt gt 12SL ECG Analysis Automatic 12 lead on ST alarm Respiration monitoring and apnea detection Invasive BP measurement cursor Arterial disconnect alarm Arterial Smart BP function gt lt gt lt gt lt gt Intra aortic balloon pump BP algorithm PA wedge measurement program PA insert wedge measurement program Non invasive BP NBP measurement NBP clock sync NBP cuffs measurement for adult pediatric neonate NBP manual automatic and stat me
120. arameter window and a system status alarm will sound To set the system status alarm level select MORE MENUS MONITOR SETUP MONITOR DEFAULTS NBP NO DETERMINATION and select SYSTEM ADVISORY or SYSTEM WARNING This monitor default controls both no determination and pump timeout Extended NBP Alarm Silence To extend the alarm silence follow this procedure 1 Discharge the patient 2 Select MORE MENUS MONITOR SETUP MONITOR DEFAULTS SETUP DEFAULT DISPLAY 3 From the SETUP DISPLAY information window locate the NBP SILENCE ALARM option and SELECT 1 MINUTE 2000966 338A Dash 3000 4000 5000 10 11 Monitoring NBP Troubleshooting Problem CUFF INFLATION OVER 5 MINS 4 Press the Silence Alarm Admit key The NBP alarm is silenced until you change the NBP SILENCE ALARM setting to NORMAL or discharge the patient All patient status alarms that occur while alarms are silenced are stored in ALARM HISTORY as a patient status MESSAGE For clinical level troubleshooting refer to the GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide NOTE The following messages display until the next measurement is initiated or manually cleared Monitor Response DEFLATION FAIL REMOVE CUFF Stops automatic NBP measurement after NBP HARDWARE MALFUNCTION ONE message OVER PRESSURE Solution Make sure there is no air in the cuff and try a manual measurement
121. as m TRANSDUCER Match transducers to a color Blue CVP RA and UVC Green ECG SP and all other parameters Red Highest priority arterial line ART FEM or UAC POC and alarms White LA ICP non highest priority arterial line ART FEM or UAC CO and gas data Yellow BIS and PA m CRGPLUS NOTE Blue 5 0 Green ECG Red Alarms MAP and highest priority arterial line ART FEM or UAC White All other pressures Yellow BIS CO and RR The TRANSDUCER and CRG PLUS pressure colors are based on the priority set as monitor defaults The arterial line ART FEM and UAC setatthe highest priority is red all others are white Selectthe parameters to display When turned off the parameter window and waveform does not display alarms do not sound and data is not collected in trends PRINT SETUP Select the print locations content and timing For more information refer to Chapter 6 MONITOR DEFAULTS Select the custom defaults for any patient monitor type 3 10 Dash 3000 4000 5000 2000966 338A Monitor Setup Option Function CLOCK DISPLAY Select the type of clock display m OFF Remove the clock display from the reduced parameter window location and display the smaller clock on the upper left of the screen m ON W SEC Display the military time in hours minutes and second
122. asurement modes Pulse oximetry monitoring Pulse oximetry desaturation tones Pulse oximetry Masimo probe compatibility Pulse oximetry Nellcor probe compatibility Pulse oximetry factory probe compatibility Temperature monitoring support gt lt lt lt gt lt lt gt lt gt gt lt 2000966 338 Dash 3000 4000 5000 B 3 Software Packages High Gender Capability or Feature Basic Cardiac lid b a i 5 Trends Thermodilution cardiac output support X Cardiac computation constants stored for major manufacturers X Cardiac calculations X lex LF Sidestream X SAM Smart Anesthesia Multi gas module interface X Vital Signs 24 hr X Graphic trending 24 hr X Pulmonary calculations w fick CO calculation X Dose calculations adult neonate X High low alarms all parameters X Alarm window X Multi level user programmable graded alarms package X Laser printer support X Two or four inch direct digital writer DDW support X View other patient float X View on alarm X Auto view on alarm requires Prism Information Server X LAN COMBO telemetry hardwire monitoring X B 4 Dash 3000 4000 5000 2000966 338A C Factory Defaults 2000966 338A Dash 3000 4000 5000 Factory Defaults Arrhythmia Alarm Le
123. be made per your institution s requirements with an awareness of the effect on the integrity of the cables or leadwires Use a warm damp cloth and mild soap to clean cables and leadwires For more intensive disinfecting near sterile you can use Ethylene Oxide ETO however this method will reduce the useful lifetime of the cable or leadwire Capnostat Sensor and Adapter To clean the sensor use a damp cloth to wipe clean and dry including the sensor windows Do not immerse or sterilize the sensor A 4 Dash 3000 4000 5000 2000966 338A Maintenance NBP Cuff and Hose Other Printer Writer s To clean the reusable adapters rinse in warm soapy solution then soak in a liquid disinfectant pasteurized or cold sterilized such as glutaraldehyde Rinse and dry well with sterile water To clean adult and low volume dead space adapters sterilize with the ETO gas method or a steam autoclave Using the steam autoclave may reduce the useful lifetime of the adapter Before reusing any adapter make sure the sensor windows are dry and residue free Also ensure the adapter was not damaged during handling cleaning or sterilization To clean an NBP cuff consult the manufacturer for the correct cleaning information Make sure cleaning fluid used does not enter the valves Fluid trapped in the valves can enter the monitor and may result in damage to the monitor For other applied parts such as temperature sensors catheter
124. ble EN publications on safety and essential performance of electromedical equipment as well as with applicable UL and CSA requirements and AHA recommendations valid at the time of printing The quality management system complies with the international standards ISO 9001 and ISO 13485 and the Council Directive on Medical Devices 93 42 EEC CE 2 Dash 3000 4000 5000 2000966 338A 1 Introduction 2000966 338A Dash 3000 4000 5000 Introduction Equipment Information Intended Use Safety Statements Dangers Warnings The intended use of this device is to monitor physiologic parameter data on adult pediatric and neonatal patients within a hospital or facility providing patient care Physiologic data includes the parameters covered in this manual The monitoring system is also intended to provide physiologic data over the optional network to clinical information systems This information can be viewed trended stored and printed The safety statements presented in this chapter refer to the equipment in general and in most cases apply to all aspects of the monitor There are additional safety statements in the parameter chapters which are specific to that monitored parameter The order in which safety statements are presented in no way implies order of importance Danger statements identify an imminent hazard which if not avoided will result in death or serious injury No danger statements apply to this mo
125. bservation Rate meters may continue to count the pacemaker rate during cardiac arrest and some arrhythmias Therefore do not rely entirely on rate meter alarms 8 8 Dash 3000 4000 5000 2000966 338A Monitoring ECG Arrhythmia WARNING SURVEILLANCE Maintain close surveillance of pacemaker patients Heart rate errors can occur CAUTION FDA POSTMARKET SAFETY ALERT The United States FDA Center for Devices and Radiological Health issued a safety bulletin October 14 1998 This bulletin states that minute ventilation rate adaptive implantable pacemakers can occasionally interact with certain cardiac monitoring and diagnostic equipment causing the pacemakers to pace at their maximum programmed rate The FDA further recommends precautions to take into consideration for patients with these types of pacemakers These precautions include disabling the rate responsive mode and enabling an alternate pace mode For more information contact Office of Surveillance and Biometrics CDRH FDA 1350 Piccard Drive Mail Stop HFZ 510 Rockville MD 20850 U S A NOTE ECG monitoring with patients on non invasive transcutaneous pacemakers may not be possible due to large amounts of energy produced by these devices Monitoring ECG with an external device for example a defibrillator may be needed Remember that there are no ECG alarms at the monitor if you are monitoring with an external devices The fol
126. c pulses at each pressure step are relaxed while supplementing the criteria with additional information from ECG NOTE Adult Pediatric only When ECG is monitored SuperSTAT NBP is able to determine blood pressure in the presence of irregular heart rhythms At the beginning of a SuperSTAT NBP determination the coefficient of variation from the previous 120 ECG R R intervals is used to determine if an irregular rhythm is present Additional Information The GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide provides the following information Oscillometric versus auscultation measurement methods m Patient preparation m NBP monitoring features m Clinical level troubleshooting Safety The following safety statements apply when monitoring NBP WARNING The NBP parameter will not measure blood pressure effectively on patients who are experiencing seizures or tremors 10 4 Dash 3000 4000 5000 2000966 338A Monitoring NBP WARNING Devices that exert pressure on tissue have been associated with purpura skin avulsion compartmental syndrome ischemia and or neuropathy To minimize these potential problems especially when monitoring at frequent intervals or over extended periods of time make sure the cuff is applied appropriately and examine the cuff site and the limb distal to the cuff regularly for signs of impeded blood flow WARNING The system is design
127. can connect this device to the monitor the docking station or both For more information refer to Nellcor 395 Pulse Oximeter on page 11 13 Unity Network The Unity Network is a purchased software option that must be enabled in order use a central station remote display wireless LAN system or any other networked device 2 10 Dash 3000 4000 5000 2000966 338A Equipment Overview Centralscope Central Station The Centralscope central station accepts patient data from monitors and allows bed to bed communication via a network connection The central station may have a built in two inch writer or a laser printer For more information refer to the Centralscope central station operator s manual CIC Pro Clinical Information Center Wireless LAN System The CIC Pro central station accepts patient data from monitors and allows bed to bed communication via a network connection For more information refer to the CIC Pro clinical information center operator s manual CAUTION DATA LOSS Operation of an access point or wireless LAN device in close proximity to microwave ovens may cause gaps in waveforms loss of waveforms or NO COMM at the central station due to radio frequency RF interference Isolate the monitor from the interfering source or device or remove the interfering source or device NOTE Wireless monitors moved from room to room must be configured as ROVER or ROVER COMBO The wireless LAN
128. ce PROBE OR MODULE MALFUNCTION No data displayed due to hardware failure Replace the cable and sensor Masimo SET only or unrecognized sensor 2000966 338A Dash 3000 4000 5000 11 17 Monitoring 5 02 11 18 Dash 3000 4000 5000 2000966 338A 12 Measuring Cardiac Output 2000966 338A Dash 3000 4000 5000 Measuring Cardiac Output Introduction Overview NOTE This parameter is only available with the CARDIO PULMONARY software package The cardiac output CO program allows measurement of cardiac output by use of a thermodilution catheter A numeric value and a real time cardiac output washout curve are displayed A parameter window displays when a patient cable is connected to the monitor The display updates every two seconds The waveform does not display unless you are performing an injection procedure 36 12 LAST AVG 30 0 3 06 31 15 25 C 2 520A 1 Blood temperature value 2 Lastsaved calculation time stamp 3 Lastsaved calculation average Performing a cardiac trial allows you to perform multiple measurements and to delete those not wanted Up to four measurements are retained and included in the average value The program automatically averages these and when saved enters the average value into cardiac calculations and GRAPHIC TRENDS The monitor can save up to 20 calculations Additional Information The GE Critical
129. control how you can select and view other monitors on the network m View On Alarm VOA m Auto View On Alarm AVOA m AutoView XM Software Option Comparison NOTE GE recommends using ONE software option per care unit All monitors outside the care unit have all automatic view on alarm functionality disabled View On Alarm VOA Auto View On Alarm AVOA AutoView XM Host monitor software version Monitor source of alarm software version Dash 3000 4000 5000 Patient Monitor V1 or later Dash 3000 4000 5000 V5 or lat Solar 8000M Patient Monitor V4 or later arer Solar 9500 Information Monitor 5 6 Dash 3000 4000 5000 2000966 338A Managing Patients Monitors you can view All monitors in the care unit All monitors in the care unit with SEND AUTO VIEW turned on View On Alarm VOA Auto View On Alarm AVOA AutoView XM Number of monitors viewable 40 or 10 100 40 or 10 on a host monitor Unity Network Information Not required Required Not required Server V1 or greater Network connection Continuous Automatic split screen display No Yes Yes All monitors on the network from the host monitor and have SEND AUTO VIEW turned on View on alarm functionality Manually select the alarming monitor Up to four alarming monitors are available Automatically displays the most recent highest priority alarming monitor in the care unit Automatically di
130. ct MORE MENUS gt MONITOR SETUP gt MONITOR DEFAULTS gt SETUP DEFAULT DISPLAY ADULTICU NEONATALICU PATIENT AGE ADULT 0 2 ADULT DISPLAY MODE INDV 6 WFS COLOR FORMAT TRANSDUCER PRIMARY ECG 1 ECG WAVEFORM m m MIN ARRHYTH OFF LEVEL ARRHYTHMIA FULL LETHAL OFF DETECT PACE OFF ARTERIAL RATE ON LEAD ANALYSIS MULTI LEAD ST ANALYSIS OFF OFF ON ST TEMPLATES OFF OFF TRENDS ST V LEAD V5 ST TEMPLATE 1 1 ST TEMPLATE 2 V5 ST TEMPLATE 3 ADJ UST ST POINT 60MS J 30 MS J 60 5 oF ECG WF SPEED 25 C 8 Dash 3000 4000 5000 2000966 338A Factory Defaults OPERATING ADULT ICU NEONATAL ICU ROOM PRINT WAVEFORM 2 ARI PRINT WAVEFORM 3 OFF RR Or PRINT WAVEFORM 4 oT PRINT ON ALARM ON OFF OFF TIMED PRINT CONTINUOUS CONTINUOUS 20 SECONDS ART DISCONNECT ON SES SMART BP ON ON ARTERIAL SCALE 160 100 160 PA SCALE 60 CVP RA UVC SCALE LA SCALE 30 ICP SCALE SP SCALE 160 BP WF SPEED 25 C02 SCALE 50 CO2 WF SPEED 6 25 NBP AUTO OFF ADULT CUFF PRESSURE LU PED CUFF PRESSURE AUG NEO CUFF PRESSURE HUNG CO CATHETER BAXTER EDWARDS 2000966 338A Dash 3000 4000 5000 C 9 Factory Defaults auma NEONATAL ICU
131. d electrocardiograms and vectorcardiograms from surface ECG electrodes not for positioning floating temporary pacemaker leadwires performing pericardiocentesis or other internal applications 2000966 338A Dash 3000 4000 5000 8 21 Monitoring ECG NOTE When monitoring ECG entering the sex and age of the patient will provide information needed for using the 12SL Algorithm with Gender Specific Analysis or the ACI TIPI algorithm The 12SL Algorithm with Gender Specific Analysis improves the detection of acute myocardial infarctions AMI for adult women under the age of 60 If the date of birth is not entered the system will set the date of birth to the current month and day but the year will be set to 1948 ACI TIPI analysis cannot be performed on patients less than 16 years of age 1 From the ECG menu select 2 LEAD ECG ANALYSIS All 12 leads of ECG display 2 Define the following information if required If ACI TIPI is enabled you may have to define additional information m TECHNICIAN ID Select up to four characters m OPTION FIELD Select up to two digits m ORDER NUMBER Select up to nine digits 3 Select 2 LEAD ECG NOW The PERFORMING ANALYSIS PLEASE WAIT message displays for approximately 30 seconds until the analysis report displays 4 Select one of the following options m TRANSMIT PRINT Send the report to MUSE system for storage and print to local printer TRANSMIT
132. d parts recommended by GE TYPE B APPLIED PART Non isolated applied part suitable for intentional external and internal application to the patient excluding direct cardiac application Medical Standard Definition Applied part complying with the specified requirements of EN 60601 1 UL 60601 1 CSA 601 1 Medical Standards to provide protection against electric shock particularly regarding allowable leakage current Dash 3000 4000 5000 2000966 338A Introduction Fuse Equipotential Stud A ground wire from another device can be tied here to ensure the devices share a common reference point Alternating current AC Power Indicates where to press to open the writer door This symbol indicates that the waste of electrical and electronic equipment must not be disposed as unsorted municipal waste and must be collected separately Please contact an authorized representative of the manufacturer for information concerning the decommissioning of your equipment De d Equipment Compliance Information EN 60601 1 Component Classification The following components meet EN 60601 1 classification standards 2000966 338A Dash 3000 4000 5000 1 15 Introduction Type of ae Degree of protection against electrical electrical shock shock Monitor BF 5p05 CO CF ECG Resp IP Temp CO ICG Module BF N A SAM Module B PRN 50 Write
133. d revert to the factory or custom defaults when the patient is discharged To permanently change the these settings refer to Defining Custom Defaults on page 3 7 Option Function CHANGE VALUE Select a new value for any monitored value NOTE When a change is made the date on the information window changes to the current date and any applicable calculated values display SAVE CALC Selectto save the displayed data REVIEW CALC Select to review the saved calculation WEIGHT Select the units of measurement for the patient s weight HEIGHT Select the units of measurement for the patient s height Dosage Calculations The dosage calculations program is used to determine appropriate doses and flow rates of intravenous medications NOTE If you are using a drug that is not in the list select one of the generic drug names DRUG A B C or D Make a note of the drug assigned to each generic drug name For more information on dosage calculations refer to the GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide 2000966 338A Dash 3000 4000 5000 7 11 Patient Data To adjust the dosage calculations for the patient admitted to the monitor select MORE MENUS gt PATIENT DATA gt DOSE CALCS Then select any of the following options and make the desired changes Option Function CHANGE VALUE Select a drug name and values for the patient monitoring situation and dr
134. dentification inches individual infusion inferior injectate inspired interior inferior isoflurane injectate temperature intravenous J ST measurement point K kilogram L ead eft iter eft arm eft atrial ocal area network ateral pounds 2000966 338A Dash 3000 4000 5000 F 5 Abbreviations and Symbols LCWI LD LED LIS LL LVET LVSWI MAC MAP Min mm mmHg MPSO MRI ms mV N A No0 NBP NIBP Neo 0 0 OR eft cardiac work index ead ight emitting diode ab information system eft leg eft ventricular ejection time eft ventricular stroke work index M mean minimum alveolar concentration mean arterial pressure minimum millimeters 3 illimeters of mercury multiple portable socket outlet magnetic resonance image milliseconds millivolt N not applicable nitrous oxide non invasive blood pressure neonatal oxygen oxygen consumption index operating room F 6 Dash 3000 4000 5000 2000966 338A Abbreviations and Symbols PA PAD Par PAW PC pC05 p0 PED PEP PVC QRS Qty R R RA RA REF Reprep RES Resp RF RHY RL RR pace pulmonary artery pulmonary artery diastolic parameter pulmonary artery wedge personal computer partial pressure of arterial carbon dioxide pediatric pre ejection period premature ventricular contractions Q interval of ventricular depolarization quantity right rate right arm right
135. detected from telemetry m When switching ECG monitoring from telemetry to the monitor Telemetry is automatically discharged and the most recent 36 alarm histories are transferred to the monitor The ECG limits arrhythmia alarm levels and display defaults are recalled from the monitor defaults NOTE It is not likely that the COMBO or ROVER COMBO monitoring modes are used when the patient monitor type is OPERATING ROOM NOTE Users should be aware of a possible time discrepancy between the waveforms from the telemetry device and the waveforms from the monitor Users should not consider these waveforms to be synchronous If absolute synchronicity is desired COMBO mode should be discontinued and the ECG waveforms should be acquired via the hard wired monitor 8 6 Dash 3000 4000 5000 2000966 338A Monitoring ECG Analog Output The ECG analog output includes the top trace position lead and augmented leads It provides the following signals A five volt two millisecond artificial pacer spike to the analog output when pacemaker detection is on and detection occurs A defibrillator synchronization marker to determine the peak of the R wave In the event of a lead failure the following output occurs Lead Failed ECG Analog Output Right arm Lead Ill Left arm Lead Il Chest Lead Il Right leg buzz leg fled ECG outputs are one volt per millivolt of input NOTE Additional Infor
136. device sends to the connectivity device The parameters sent vary with each external device and are subject to change without notice by the manufacturer If the peripheral device manufacturer changes any parameters or information sent the connectivity device will not send any of the new parameter information over the network The following peripheral devices are compatible with the monitor at the time this document was published NOTE These devices are compatible with Dash 3000 4000 5000 software version 3 or later and Unity Network Interface Device software version 1 or later E 4 Dash 3000 4000 5000 2000966 338A Interfacing with Non GE Devices Device Type Manufacturer and Model Parameters Alarms Anesthesia machine Dr ger J VNT CO GAS Yes Drager Cato PM8050 VNT CO GAS Yes Drager Cicero EM VNT CO GAS Yes Drager PM8060 VNT CO GAS Yes Drager Primus Notforsalein VNT CO GAS Yes the United States North American Dr ger All versions VNT Yes NADIE 3 4 6000 VNT CO gt GAS 2B 2C GS Ventonly 3 4 6000 Vent Gas CO Ohmeda 7800 7810 VNT Yes Ohmeda 7900 VNT Yes Ohmeda Aestiva 3000 VNT Yes Ohmeda Engstrom VNT Yes Ohmeda Aisys VNT Yes Ohmeda Avance VNT Yes Continuous cardiac output Abbott Q Vue CCO Status messages only Pulsion Picco Picco Plus CCO Status messages only Continuous cardiac output with Abbott Q 2
137. diation steam or ethylene oxide CAUTION MASIMO SET CABLES AND SENSORS Tissue damage can be caused by incorrect application or use of an LNOP sensor for example by wrapping the sensor too tightly Inspect the sensor site as directed in the sensor s directions for use to ensure skin integrity and correct positioning and adhesion of the sensor Do not use damaged LNOP sensors Do not use an LNOP sensor with exposed optical components Do not immerse the sensor in water solvents or ethylene oxide Refer to the cleaning instructions in the directions for use for reusable Masimo LNOP sensors The following measurement guidelines apply to Nellcor Dash 3000 4000 5000 2000966 338A Monitoring 5 02 The time period for acquiring a measurement average is adjustable The pulse oximetry is calibrated to display functional saturation The signal strength indicator is not proportional to pulse amplitude Zero asterisks means no signal three asterisks means a strong signal m The waveform corresponds to but is not proportional to the arterial pressure waveform Use the following guidelines when using OxiMAX SpO accessories and sensors WARNING Intravascular dyes such as indocyanine green mythylene blue etc and darkly pigmented skin can adversely affect SpO readings WARNING Oximetry performance may be impaired when patient perfusion is low or signal attenuation i
138. djust the control settings as necessary To adjust the control settings for the patient admitted to the monitor select the parameter window label Then select any of the following options and make the desired changes NOTE All changes are temporary and revert to the factory or custom defaults when the patient is discharged To permanently change the these settings refer to Defining Custom Defaults on page 3 7 2000966 338A Dash 3000 4000 5000 17 5 Monitoring Impedance Cardiography ICG Option Function ICG PATIENT INFORMATION Select the required patient information When monitoring the following parameters additional information is required m MAP Select NBP or Arterial Line m CVP Select invasive or enter a specific value for SVR and SVRI calculations m PAW Select invasive PAW or enter a specific value for LVSWI and LCWI calculations m Enter a specific value for eDO gt monitoring This value is retained for 12 hours and may be used in other calculations for example pulmonary calculations FAST LOOK Select one of the following options for viewing and printing parameter data m NORMAL RANGES Display data with normal parameter ranges A plus 4 or minus indicates values outside the normal range m UNITS OF MEASURE Displays data with units of measurement SECONDARY PARAMETERS Select three parameters from the available parameters t
139. e range to trigger an arm for all of the groups DJ UST INF LIMITS Select the range to trigger an arm for INF group only DJ UST LAT LIMITS Select the range to trigger an arm for LAT group only m ADJUST ANT LIMITS Select the range to trigger an alarm for ANT group only When any monitored lead has a deviation greater or less than the defined limit an alarm sounds and the ST eventis stored in the ALARM HISTORY n gt gt gt gt Only the first lead in each group to exceed the alarm limit is stored in ALARM HISTORY Subsequent alarms in the same group will not be stored until all leads in a group return to the normal range IDENTIFY V LEAD Locate the V lead being used for ECG and ST analysis For 5 Leadwire Cables Verify the V Lead used in ST and arrhythmia analysis is selected This V Lead is also used for ST trends and complex displays For 10 Leadwire Cables Since ST measurement is performed with a different V lead than arrhythmia analysis any changes made to this selection only apply to the V lead used for arrhythmia analysis This V lead is not used for ST trend and complex displays NOTE Changing the V lead changes the displayed waveform analog output network data ST trend and template graphing and histories TREND SCALE Selecta ST trend scale ST DISPLAY Select up to three leads for trend or complex display 8 20 Dash 3000 4000 5000 2000
140. eat averaging begins at 10 20 30 and 60 beats The averaging remains at 60 beats unless a new value is selected The smaller the number selected the more likely the data will be affected by artifact The higher the number selected the more the beat average will be smoothed out with minimum fluctuation CHANGE NORMALS Select the normal range for the parameters CHECK LEADS Check for lead failures For clinical level troubleshooting refer to the GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide 2000966 338A Dash 3000 4000 5000 17 7 Monitoring Impedance Cardiography ICG Message Cause Solution ENTER REQUIRED ICG PATIENT INFO ENTER PATIENT WEIGHT ENTER PATIENT HEIGHT ENTER PATIENT AGE ENTER PATIENT SEX PATIENT WEIGHT OUT OF RANGE PATIENT HEIGHT OUT OF RANGE PATIENT AGE OUT OF RANGE Required patient information missing or incorrect Enter the required patient information SERVICE MODULE RIGHT THORACIC LEAD FAIL LEFT THORACIC LEAD FAIL RIGHT NECK LEAD FAIL LEFT NECK LEAD FAIL Hardware failure Lead failure CABLE DISCONNECTED SIGNAL SEARCH Hardware or lead failure Contact service Check patient and sensor 17 8 Dash 3000 4000 5000 2000966 338A 18 Monitoring Bispectral Index BIS 2000966 338A Dash 3000 4000 5000 Monitoring Bispect
141. ed The monitor deflates the cuff one step each time it detects two pulsations of relatively equal amplitude The time between deflation steps depends on the 10 2 Dash 3000 4000 5000 2000966 338A Monitoring NBP Options DINAMAP Classic DINAMAP SuperSTAT frequency of these matched pulses pulse rate of the patient However if the monitor is unable to find any pulse within several seconds it will deflate to the next step The process of finding two matched pulses at each step provides artifact rejection due to patient movement and greatly enhances the accuracy In stat mode some steps only require one pulse NOTE Values change to X when no monitoring has taken place for more than 15 minutes OPERATING ROOM two hours ADULT ICU or 12 hours NEONATAL ICU The monitor supports two blood pressure technologies To determine the technology on this monitor select MORE MENUS gt MONITOR SETUP gt SOFTWARE CONFIGURATION The technology is listed under NBP The first determination initially pumps up to a target cuff pressure of about 160 mmHg for adult pediatric patients or 110 mmHg for neonates depending on initial target pressure preset The first determination initially pumps up to a target cuff pressure of about 135 mmHg for adults or 110 mmHg for neonates depending on initial target pressure preset To allow for rapid setting of cuff pressure the monitor will momentarily inflate to a higher pressure then immediat
142. ed for use with dual hose cuffs and tubing The use of single hose cuffs with dual hose tubing can result in unreliable and inaccurate NBP data WARNING Do not place the cuff on a limb being used for A V fistulas intravenous infusion or on any area where circulation is compromised or has the potential to be compromised WARNING Do not apply external pressure against the cuff while monitoring Doing so may cause inaccurate blood pressure values WARNING Use care when placing the cuff on an extremity used to monitor other patient parameters WARNING Arrhythmias will increase the time required by the NBP parameter to determine a blood pressure and may extend the time beyond the capabilities of the parameter 2000966 338A Dash 3000 4000 5000 10 5 Monitoring NBP WARNING For SuperSTAT NBP Adult Pediatric Only It takes one to three minutes for the NBP parameter to establish irregular rhythm after ECG is connected The NBP parameter will relearn the rhythm in the event of a lead fault disconnect or lead switch In patients with irregular rhythm wait three minutes after ECG has been connected and ECG heart rate is present on the monitor screen before performing an NBP determination CAUTION Accuracy of NBP measurement depends on using a cuff of the proper size It is essential to measure the circumference of the limb and select the p
143. eet and are not recommended for use on monitoring equipment equipped with the Wireless LAN option CAUTION DEFIBRILLATOR PRECAUTIONS Patient signal inputs labeled with the CF and BF symbols with paddles are protected against damage resulting from defibrillation voltages To ensure proper defibrillator protection use only the recommended cables and leadwires Proper placement of defibrillator paddles in relation to the electrodes is required to ensure successful defibrillation 2000966 338A Dash 3000 4000 5000 1 9 Introduction CAUTION DISPOSABLES Disposable devices are intended for single use only They should not be reused as performance could degrade or contamination could occur CAUTION DISPOSAL At the end of its service life the product described in this manual as well as its accessories must be disposed of in compliance with the guidelines regulating the disposal of such products If you have questions concerning disposal of the product please contact GE or its representatives CAUTION ELECTROCAUTERY PRECAUTIONS To prevent unwanted skin burns apply electrocautery electrodes as far as possible from all other electrodes a distance of at least 15 cm 6 in is recommended CAUTION ELECTRODES Whenever patient defibrillation is a possibility use non polarizing silver silver chloride construction electrodes for ECG monitoring Polarizing elect
144. elect the NBP parameter window label 2 Select Setup Custom Auto The Setup Custom Auto window displays There are four BP SERIES sections 3 define the first measurement series follow this procedure a Select JST BP SERIES 10 10 Dash 3000 4000 5000 2000966 338A Monitoring NBP b Select the time interval between measurements from the available options 1 minute to 4 hours c Select REPEAT d Select the number of times to repeat the measurement 1to 25 times or continuously until manually stopped 4 Repeat step 3 for each series 2ND 3RD and 4TH 5 begin the automatic measurement cycle select START CUSTOM AUTO The measurement cycle begins with the first series completes each measurement the defined number of times then proceeds to the second third and fourth series If any series is not defined or is turned off it is skipped and the next series in the cycle is started 6 Tochange a series while in progress select the NBP parameter window label and select SETUP SERIES m Tostop one of the defined series select the SERIES OFF m Tostop measurements for one of the defined series select REPEAT OFF Auto NBP Cancellation Notification NOTE Only available in software version 6 or later If the monitor is set to acquire measurements automatically VBP AUTO and a time out or no determination occurs automatic measurement is cancelled the message AUTO OFF displays in the NBP p
145. ely deflate to the target pressure As a determination is taken the monitor stores the pattern of the patient s oscillation size as a function of pressure In any subsequent determination as few as four pressure steps may be necessary to complete the process When employing fewer pressure steps the system uses the stored information from the previous blood pressure determination to decide the best pressure steps to take The monitor measures the consistency of pulse size to tell if the oscillations taken at a step are good and if more steps are needed If the current blood pressure reading is similar to the previous reading the monitor may use some information from the previous blood pressure in the current determination The monitor constantly evaluates data during a measurement and tries to perform a blood pressure determination in the shortest possible time providing greater comfort to the patient 2000966 338A Dash 3000 4000 5000 10 3 Monitoring NBP If it has been 16 minutes or less since the last determination and the current blood pressure is similar to the previous reading the monitor will try to make an accelerated determination of blood pressure During irregular rhythms only pulses from the current determination are used in calculating the blood pressure values In order to ensure adequate artifact rejection capability and optimal SuperSTAT NBP performance several criteria used to match and qualify the oscillometri
146. en the RUN LED light is flashing m When the CONDITION LED is flashing 3 Remove the battery when the READY LED illuminates Internal Method WARNING PATIENT RISK Never condition a battery while the monitor is connected to a patient Serious injury or death could result To condition a battery use the following procedure 1 Remove all batteries from the monitor 2 Insert one battery in slot A 3 Disconnect the monitor from AC power Select MORE MENUS BATTERY STATUS 4 5 Allow battery to discharge to less than 90 percent CHARGE LEVEL 6 Connect the monitor to AC power and fully charge the battery 7 Disconnect the monitor from AC power again 8 Allow the monitor to run on battery power until the BATTERY LOW message displays or until the monitor shuts down 9 Connect the monitor to AC power again and allow the battery to fully charge Store the battery outside of the monitor at a temperature between 20 C and 25 C 68 F to 77 F m When the battery is stored inside a monitor that is powered by an AC power source the battery cell temperature increases by 15 C to 20 C 27 F to 36 F above the room s ambient temperature This reduces the life of the battery m When the battery is stored inside a monitor that is continuously powered by an AC power source and is not powered by battery on a regular basis the life of the battery may be less than 12 months GE recommends that you remove the
147. ening blistering skin discoloration ischemic skin necrosis and skin erosion may warrant changing the site frequently or using a different style of sensor Check the sensor site every four hours more frequently of the perfusion is poor Routinely check to ensure adequate circulation distal to the sensor site WARNING DATA VALIDITY Conditions that may cause inaccurate readings and impact alarms include interfering substances excessive ambient light electrical interference excessive motion low perfusion low signal strength incorrect sensor placement poor sensor fit and movement of the sensor on the patient Do not use a blood pressure cuff or arterial blood pressure measurement device on the same limb as the sensor It is possible for any device to malfunction therefore always verify unusual data by performing a formal patient assessment The GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide provides the following information Factors contributing to inaccurate measurements Patient preparation Masimo SET information Nellcor Sat Seconds alarm management information Clinical level troubleshooting Dash 3000 4000 5000 2000966 338A Monitoring 5 02 Safety General The following safety statements apply when monitoring SpO gt WARNING DATA VALIDITY Do not expose sensor detector to strong ambient light while monitoring a patient A poor signal
148. ent displays the applicable waveform and new menu options 2000966 338A Dash 3000 4000 5000 7 3 Patient Data Vital Signs When viewing an ST alarm or reference a QRS complex of all available leads except AVR is displayed If viewing an ST alarm an asterisk is displayed next to each lead in violation of ST limits Use the following options to review the ALARM HISTORY Option Function VIEW OLDER ALARM View the previous event VIEW NEWER ALARM View the next event DELETE ALARM Delete the selected event VITAL SIGNS displays the patient s monitored parameter values for the last 24 hours including the last 20 cardiac calculations and the last 10 pulmonary calculations NOTE If alarms were paused or the monitor was discharged the word OFF displays in the ALARMS field of the VITAL SIGNS information window during the time either of these events occurred To review vital signs select MORE MENUS gt PATIENT DATA gt VITAL SIGNS VITAL SIGNS 25 FEB 1999 13 10 25 FEB 25 FEB 25 FEB 25 FEB 25 FEB 12 00 12 15 12 30 12 45 13 00 HR 68 68 68 68 70 PVC 0 0 0 0 0 AR1 S 132 132 132 132 132 AR1 D 70 70 70 70 71 AR1 M 92 92 92 92 91 1 68 68 68 68 70 PA2 S 31 31 31 31 30 PA2 D 13 13 13 13 13 PA2 M 20 20 20 20 19 RR 5 2 SPO2 R TP 1 1 1 2 ALARMS OFF TMP C MAIN V
149. ential performance standards and or the system configuration must meet the requirements of the EN 60601 1 1 medical electrical systems standard CAUTION ACCESSORIES EQUIPMENT The use of ACCESSORY equipment not complying with the equivalent safety requirements of this equipment may lead to a reduced level of safety of the resulting system Consideration relating to the choice shall Dash 3000 4000 5000 2000966 338A Introduction include m use of the accessory in the PATIENT VICINITY and m evidence that the safety certification of the ACCESSORY has been performed in accordance to the appropriate EN 60601 1 and or EN 60601 1 1 harmonized national standard CAUTION BATTERY POWER If a device equipped with an optional battery pack will not be used or not be connected to the power line for a period of over six months remove the battery CAUTION BEFORE INSTALLATION Compatibility is critical to safe and effective use of this device Please contact your local sales or service representative prior to installation to verify equipment compatibility CAUTION CO PARAMETER INTERFERENCE Capnostat sensors with a serial number 26104 or greater require a separation distance of 0 25 meters 10 inches from the Wireless LAN device to minimize potential interference sensors with a serial number less than 26104 require a separation distance of 2 5 meters 8 2 f
150. er or anesthesia machine 02 COMPENSATION Select the percentage of O concentration to compensate for O related decrease of the CO value Obtain the concentration from an oxygen analyzer C02 AVERAGING Select a time interval for averaging CO 2000966 338A Dash 3000 4000 5000 15 5 Monitoring End Tidal CO2 Option Function CAL SENSOR TO ZERO CELL NOTE Only available with a Mainstream setup Zero the sensor each time a sensor is connected to the monitor CALIBRATE SAMPLE LINE NOTE Only available with a Sidestream setup Calibrate the module each time a module is connected to the monitor CALIBRATE ADAPTER NOTE Only available with a Mainstream setup Calibrate the airway adapter each time a adapter is connected to the monitor SPEED Selectthe sweep speed for the displayed waveform Calibrating Sensors To calibrate a sensor follow this procedure 1 Remove the adapter from the sensor 2 Verify the sensor cable is attached to the CO patient connector on the monitor 3 Place the sensor on the cell marked 0 4 Select the CO parameter window label 15 6 Dash 3000 4000 5000 2000966 338A Monitoring End Tidal CO2 Adapters From the CO menu select CAL SENSOR TO ZERO CELL Select READY The message CALIBRATING displays in the CO parameter window When calibration is complete the EXP value change
151. er set to 700 NBP Testing To test NBP use the following procedure and a digital pressure or calibrated mercury manometer for example Sensym PDM200M or Diptron Plus 3 WARNING When the NBP cuff is used in this procedure it must be tightly wrapped around a rigid cylinder or pipe Do not place the NBP cuff around a human limb during this procedure due to the potential for injury A 16 Dash 3000 4000 5000 2000966 338A Maintenance 1 Connect the manometer to the NBP cuff 2 Connect the manometer to the BP 1 3 patient connector 3 Press the Power key to turn the monitor on 4 Verify the parameter window waveform label and other parameter information display 5 Turn the manometer on and set range switch to 1000 mmHg 6 Wrap the NBP cuff around rigid cylinder or pipe at least six inches in diameter 0218 7 Verify the calibration a Select MORE MENUS gt MONITOR SETUP gt SERVICE MODE b Select CALIBRATE gt CALIBRATE NBP gt CHECK CALC OFF gt START c Verify the readings in the NBP parameter window and the readings on the manometer are within 1 mmHg for at least one full minute If the readings fail re calibrate the NBP circuit For more information refer to the service manual 2000966 338A Dash 3000 4000 5000 A 17 Maintenance d Select CHECK CALC IN PROGRESS gt STOP to deflate the NBP cuff 8 Repeat procedure for the BP 2 4 patient connector Alarm Ver
152. ersistent meaning they are retained after the patient is discharged from the monitor Analog Output All pressure outputs are 10 mV mmHg when zeroed NOTE A buzz signal is sent to the analog output if the pressure is not zeroed m The pressure labeled ART is sent to the analog output m If both pressure sites are labeled ART is sent to the analog output 2000966 338A Dash 3000 4000 5000 9 3 Monitoring Invasive Pressures Additional Information If no pressure sites are labeled ART BP1 is sent to the analog output The GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide provides the following information IABP feature Smart BP feature Monitoring Clinical level troubleshooting To verify that you are ready to monitor pressure follow this procedure 1 2 Admit the patient to the monitor Connect a patient cable to the BP patient connector on the monitor Level transducers according to unit policy GE recommends the LA RA level Remove trapped air from the hydraulic system For more information refer to the manufacturer s instructions Zero transducers a Remove all excess tubing between the transducer and the patient NOTE GE recommends zeroing invasive lines at the transducer stopcock only Zeroing invasive pressures with excessive amounts of tubing between the transducer and the stopcock can cause error messages This will cause a delay in obtain
153. es the primary parameter for patient monitoring The patient s heart rate is determined from pulse oximetry The SpO and SpO Rate parameter alarm levels become WARNING m The SpO pulse search and probe off system status alarm levels become WARNING m Connecting the ECG cable to the monitor will NOT automatically turn the ECG parameter on m When the monitor is connected to a Dash Responder defibrillator the ECG parameter will either automatically turn on or remain turned on m When the monitor alarms are paused AND the ECG parameter is turned off the following network devices will NOT display an ALARM PAUSE text message for that monitor clinical information center using software version 3 0 or earlier Centralscope central station using any version of software ECG Setting Source Selecting ECG Setting Source When the monitor is in COMBO mode you can select whether the monitor uses its own ECG settings or the telemetry ECG settings The following ECG settings are affected when you select an ECG setting source Arrhythmia alarm levels HR PVC and ST parameter alarm levels ECG SIZE DETECT PACE ARRHYTHMIA ST ANALYSIS LEAD ANALYSIS HR HIGH LIMIT and HR LOW LIMIT PVC LIMIT and PVC state To select the source of ECG settings follow this procedure 1 Select MORE MENUS gt MONITOR SETUP gt MONITOR DEFAULTS gt SETUP DEFAULT DISPLAY 2000966 338A Dash 3000 4000 5000 8 15 Monitoring EC
154. ese conditions include but are not limited to venous pulsations hypotension severe vasoconstriction severe anemia hypothermia shock cardiac arrest sensor tension sensor placement on the same extremity as a blood pressure cuff arterial catheter or intravascular line or arterial occlusion proximal to the sensor WARNING INTERFERING SUBSTANCES Carboxyhemoglobin may erroneously increase SpO readings The level of increase is approximately equal to the amount of carboxyhemoglobin present Dyes or any substance containing dyes that change usual arterial pigmentation may cause erroneous readings WARNING MRI INTERFERENCE Do not monitor or use SpO probes during magnetic resonance imaging MRI scanning Induced current could potentially cause burns SpO monitoring may affect the MRI image and the MRI unit may affect the accuracy of the oximetry measurements Read all literature accompanying sensors for specific safety information Dash 3000 4000 5000 2000966 338A Monitoring 5 02 Neonates and Infants The following precautions apply when monitoring neonate and infant patients WARNING The display of inaccurate pulse oximetry values has been linked to the presence of poor signal strength or artifact due to patient motion during signal analysis This condition is most likely to be encountered when the monitor is used on neonates or infants These same conditions i
155. eshooting Message Cause Solution CAL CHECK The monitor detects a 0 1 C deviation between the temperature value and the SENSOR The monitor does not detect a sensor 2000966 338A Dash 3000 4000 5000 14 3 Monitoring Temperature 14 4 Dash 3000 4000 5000 2000966 338A 15 Monitoring End Tidal CO 2000966 338A Dash 3000 4000 5000 Monitoring End Tidal 02 Introduction Overview End tidal monitoring is a continuous non invasive technique that determines the concentration of carbon dioxide in respiratory gas by measuring the absorption of specific wavelengths of infrared light The light generated in the analyzer bench is passed through respiratory gas The amount of absorption by is measured and digitized by the photodectector The monitor processed the electrical signal and displays a parameter window and a waveform 1 2 3 RR INSP EXP 12 1 35 mmHg 773A 1 Respiration rate value 2 Inspired CO value 3 Expired CO value It may take up to two minutes after the sensor is connected to the monitor to display patient data and a waveform The message WARMING UP displays in the CO parameter window and is replaced with patient data when available The display updates every two seconds Compatible Devices Sensors Patients can be monitored whether intubated or non intubated m Intubated patients Use the SAM m
156. essure values to be factored in the cardiac calculation CATHETER Before the injection procedure begins select the correct catheter type The monitor guides you through the INJ ECT TEMP SIZE and INJ ECT VOL options to assure correct setup If you select OTHER you must select a value for COMPUTATION CONSTANT Refer to the literature provided by the catheter manufacturer for the correct value INJ ECT TEMP Select the injectate probe type SIZE Select the catheter French size INJECT VOL Select the injectate volume 12 4 Dash 3000 4000 5000 2000966 338A Measuring Cardiac Output Option Function COMPUTATION Select a computation constant for a catheter manufacturer CONSTANT If you selected a specific manufacturer for the CATHETER the correct value for the manufacturer is automatically selected for you If you selected OTHER for the CATHETER you must select a value or you will not be able to complete a trial Refer to the literature provided by the catheter manufacturer for the correct value CARDIAC OUTPUT HELP Display troubleshooting information Performing the CO Procedure To perform a CO procedure follow this procedure Before you begin this procedure verify you are ready by reviewing Measuring on page 12 3 1 2 Select the CO parameter window label If the monitor is configured for automatic measurements the INJECT WHEN READY
157. evice via a ground wire attached to the stud 4 DC power connector Provides connection for DC power cable The internal power supply converts the AC current to DC power The monitor is preset at the factory for a specific AC voltage Refer to the label on the back of the unit for the voltage and current requirements Before applying power verify the power requirements match your power supply 5 Wireless transmitter label Identifies monitors that contain an internal wireless transmitter for network communication 6 Ethernet connector Provides network connections to other monitors and devices used in the patient monitoring network 2000966 338A Dash 3000 4000 5000 2 5 Equipment Overview Control Panel 3000 4000 and 5000 7 Aux connector Provides serial connection to compatible auxiliary devices including Remote control TRAM RAC housing Remote display m Nellcor 395 pulse oximeter m Aspect BISx module 8 Defib Sync Provides analog output signals to other equipment For connector more information refer to Analog Output on page 8 7 9 Voltage and current Identifies the voltage and electrical current requirements requirements for proper and safe operation of this monitor 10 Speaker Provides an audible announcement of patient and system status alarms For more information refer to Chapter 4 The following keys are on the monitor s control panel
158. f the accompanying audible alarm To avoid this limitation verify that all viewing beds in the watch list have SEND AUTO VIEWS turned ON VOA ALERT TONE All Select one of the following options m OFF Notone sounds at host monitor m Tone sounds once at host monitor m REPEAT Tone sounds the host monitor until the condition is resolved 2000966 338A Dash 3000 4000 5000 5 9 Managing Patients Option Software Option Function AVOA ALARM LEVEL AutoView XM Select the lowest alarm level to automatically view on the host monitor All alarm levels of higher priority will also display NOTE If the monitor is not running AutoView XM all patient status warnings system warnings and CRISIS alarms in the care unit display in the alarm message window REMOTE SILENCE All Select the highest alarm level that can be silenced at the host monitor All alarm levels of lesser priority can also be silenced Alarms cannot be silenced in OPERATING ROOM AVOA SILENCE AutoView XM Select when the split view of the alarming monitor is removed after an alarm is silenced at the host monitor m SILENCED Split view of silenced monitor displays until RETURN or MAIN MENU is selected even if another monitor is alarming m NEW ALARM Split view of silenced monitor replaced when another monitor alarms Tall software options include View On Alarm VOA Auto View On Alarm AVOA and AutoView XM
159. for the patient admitted to the monitor select the GAS parameter window label Then select any of the following options and make the desired changes NOTE All changes are temporary and revert to the factory or custom defaults when the patient is discharged To permanently change the these settings refer to Defining Custom Defaults on page 3 7 Option Function UNITS Select the units of measure for gas parameters VIEW OTHER GASES Select one of the following to select the gases displayed m N20 Display just N0 m MIX Displays the primary and secondary agents if a mix of three agents are detected REVIEW GAS DATA Review GRAPHIC TRENDS information MONITOR Select one ofthe following to select the agent combination for analysis m 50 Isoflurane halothane enflurane and sevoflurane m DES Desflurane halothane enflurane and sevoflurane GAS LIMITS Selectthe high and low alarm limits for gas parameters An alarm sounds when a value occurs outside of these limits CP BYPASS Selectto deactivate alarms when the patientis on bypass Alarms are automatically reactivated when three minutes of uninterrupted ventilation is detected 16 8 Dash 3000 4000 5000 2000966 338A Monitoring Anesthesia Gases Option Function CLEAR MESSAGE Clear hardware error messages after the condition is corrected MAC VALUES Display the MAC value until the patient is discharged The MAC value is the minimum alveolar concent
160. form 17 7 custom defaults 0222222222 3 6 waveform 17 6 parameter alarm levels 3 8 Safety otim te da ele I eei 17 3 factory defaults 3 6 troubleshooting eene 17 7 monitoring 3 3 indicators COMBO e 3 4 2 9 3 4 battery 2 2 2 9 3 4 charging status 2 9 Standard eed beue 3 4 POWE 2 9 N IntelliRate shied LESE 8 5 10210 12 interfaced devices keka 2 control 10 7 compatible E 4 E alarm 10 8 defaults nele r kesaye ker E 12 LM automatic detemination 10 8 displayed E 3 GIS AN sino tede 10 9 guidelines ein Ei E 13 GUTf SIZO ioi e eode tees 10 9 installation s c oia E 9 custom determination 10 9 Dan lela eie etae eet ei rete is E 8 MAD initial inflation pressure 10 10 ler TI 9 2 9 9 p lse tfate y 1an iie 10 10 analog 9 3
161. g a six minute time period CRG Trends CRG TRENDS allows you to create high resolution trends for up to three CRG parameters including HR SpO MAP RESP CO To view CRG TRENDS select MORE MENUS PATIENT DATA CRG TRENDS NOTE The primary ECG lead and parameters windows remain displayed 2000966 338A Dash 3000 4000 5000 7 7 Patient Data 18 OCT 2001 14 16 NEO 0 6 HOUR SUMMARY 18 OCT 2001 14 16 806C The CRG TRENDS information window displays a directory of up to six stored CRG events Each event has an associated number a minimum and maximum alarm value and an event start time An asterisk indicates that you cannot access the trend trace data for this event usually because the event just occurred and the data is not available yet The directory holds up to 100 of the most recent events Only resolved alarms with an alarm level above MESSAGE are stored The directory automatically updates when a valid alarm is resolved When the directory is full the oldest event in the directory is removed to make room for a new event Trend traces are stored for 24 hours It is possible that trends may not be available for events that occurred more than 24 hours ago There may be a two minute delay before data can be displayed when the system is first connected or when admitting a patient Data is displayed on an even minute boundary in either two minute or six hour segments The display automatically u
162. gas readings It may also cause serious damage to the module or monitor s internal components 2000966 338A Dash 3000 4000 5000 15 3 Monitoring End Tidal CO2 Monitoring CAUTION INFECTIOUS DISEASE To avoid the spread of infectious disease do not allow the exhaust to discharge in the direction on the patient or the user CAUTION VACUUM SOURCE Do not connect the exhaust to an unregulated high vacuum source Pressures may cause inaccurate gas readings It may also cause serious damage to the module or monitor s internal components To verify that you are ready to monitor follow this procedure 1 2 8 9 Admit the patient to the monitor Attach the sensor to the patient Attach the patient cable to the patient connector on the monitor Setup the monitoring method sidestream or mainstream For more information refer to the GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide NOTE Not required with CapnoFlex LF CO module Select MORE MENUS gt MONITOR SETUP gt PARAMETERS ON OFF gt CO2 Calibrate the sensor when using mainstream sidestream or SAM modules For more information refer to Sensors on page 15 6 If using a sidestream setup calibrate the sample line For more information refer to Sample Lines on page 15 7 If using a mainstream setup calibrate the airway adapter For more information refe
163. h m ADJUST TO MMHG Select the millimeters of mercury SPEED Select a sweep speed for the displayed waveform The smaller the speed value the slower the speed greater number of complexes IABP NOTE Only available in the CARDIAC software package with ART and FEM parameter sites NOTE Not available when in the NEONATAL ICU patient monitor type NOTE The maximum ECG analog output delay specification with diagnostic ECG filter is less than 35 milliseconds Turn the feature on or off Measures the arterial ART pressure site and displays both pressure waveforms and numerical pressure values It compensates for irregularities in the pressure waveforms caused by the use of an intra aortic balloon pump 9 6 Dash 3000 4000 5000 2000966 338A Monitoring Invasive Pressures Option Function SMART BP NOTE Only available with ART and FEM parameter sites NOTE Not available when in the NEONATAL ICU patient monitor type Turn the feature on or off This is an arterial ART artifact rejection program that substantially reduces alarms associated with zeroing the transducer fast flushing the system and drawing blood DISCONNECT ALARM NOTE Only available with ART and FEM parameter sites Turn the feature on or off This detects potential catheter disconnections When on if the mean pressure falls below 25 mmHg a Warning patient status alarm sounds and the message D
164. he GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide pU sov eA Insert the BIS sensor paddle into the patient interface cable Admit the patient to the monitor Verify that patient data displays in the B S parameter window 8 Verify that the SOI value indicates a strong signal 9 Verify that a good quality waveform displays 10 Adjust the control settings as necessary Control Settings To adjust the control settings for the patient admitted to the monitor select the BIS parameter window label Then select any of the following options and make the desired changes NOTE All changes are temporary and revert to the factory or custom defaults when the patient is discharged To permanently change the these settings refer to Defining Custom Defaults on page 3 7 Option Function SMOOTHING Selectthe averaging time used to calculate BIS The factory default setting is 15 seconds m 15SEC Select for operating room or sedation patient monitoring to increase the responsiveness to changes in the patient s state m 30SEC Select for intensive care patient monitoring to provide a smoother BIS trend with less variability and sensitivity to artifact BIS LIMITS Select the high and low alarm limits for BIS parameter An alarm sounds when a value occurs outside of these limits 2000966 338A Dash 3000 4000 5000 18 5 Monitoring Bispectral Index BIS
165. he message displays for more than four minutes replace sensor or contact service 15 8 Dash 3000 4000 5000 2000966 338A 16 Monitoring Anesthesia Gases 2000966 338A Dash 3000 4000 5000 Monitoring Anesthesia Gases Introduction Overview The monitor uses a SAM module to monitor anesthesia gases The SAM module is an infrared based multi gas analyzer It measures inspired and expired values for patient gas and calculates respiratory rate When all connections are made and the module has warmed up the CO and GAS parameter windows display The display updates every two seconds There is no waveform 02 C02 RR 45 20 QS 02 E 4 39 002E N20 GAS 60 1 0 E38 0 8 1 2 The module detects the following gases 803B Oxygen 02 Carbon dioxide CO2 Nitrous oxide N20 Enflurane ENF Halothane AL Isoflurane 150 Desflurane DES Sevoflurane SEV The monitor can detect a mixture of anesthetic agents A gas mixture is made up of two or more anesthetic agents each greater than 0 30 percent in concentration A third gas agent is displayed if its concentration is greater than 0 60 percent If two agents are detected the primary and secondary agents are displayed with The primary agent is always displayed on the left The primary agent 15 defined as the agent with the greatest inspired value 16 2 Dash 3000 4000 5000
166. ification To verify the system alarm functions use the following procedure 1 Raise the heart rate limit until it is higher that the patient s current heart rate 2 Verify the following The audible alarm sounds the correct tone The heart rate in the ECG parameter window flashes in the correct color The alarm light flashes the correct color An alarm graph printed 3 Silence the alarms and verify they react correctly 4 Return the heart rate alarm settings to the original monitoring levels NOTE For more information on alarms refer to Chapter 4 A 18 Dash 3000 4000 5000 2000966 338A B Software Packages 2000966 338A Dash 3000 4000 5000 Software Packages Feature Comparison by Software Package High Gender Cardio Resolutio Specific pulmonary nCRG 1251 amp Trends Capability or Feature Basic Cardiac 6 trace color display On screen invasive BP site labels Common scale and individual scale BP displays gt lt lt lt gt lt Persistent SPO parameter window display Right left overlapping BP scale display Waveform and numeric alignment MENTOR on screen operational support Adult neonate and operating room customization gt lt gt lt gt lt gt lt gt User programmable monitor default monitor setup Storage of up to 100 CRG events X Storage of up to 24 hours of CRG trend data X Simult
167. ing Displayed Scale Printed Scale 100 0 90 160 0 150 200 300 0 300 Auto 0 150 ART FEM UAC SP 0 45 PA CVP UVC LA RA ICP 2000966 338A Dash 3000 4000 5000 6 5 Printing 6 6 Dash 3000 4000 5000 2000966 338A Patient Data 2000966 338A Dash 3000 4000 5000 Patient Data Introduction Working with patient data includes the following tasks Reviewing ALARM HISTORY Reviewing VITAL SIGNS Reviewing GRAPHIC TRENDS Reviewing CRG TRENDS Customizing the Trend key Reviewing lab data Managing cardiac calculations Managing pulmonary calculations Managing dose calculations Reviewing Patient Data Alarm History When running the CARDIAC software package the ALARM HISTORY information window displays CRISIS WARNING and ADVISORY alarm level arrhythmia and ST events in chronological order beginning with the most recent event No parameter information is stored in ALARM HISTORY NOTE In ADULT ICU and NEONATAL ICU patient monitor types events are not stored during an alarm pause or when the patient is discharged To review ALARM HISTORY select MORE MENUS gt PATIENT DATA gt ALARM HISTORY 7 2 Dash 3000 4000 5000 2000966 338A Patient Data ALARM HISTORY ALARM TIME RETURN gt BRADY 16 FEB 13 58 49 BRADY 13 30 07 VFIB IVTAC 13 17 12 BRADY 12 54 31 ST LIMIT ALARM 10 15 00 VFIB IVTAC 10 09 55 ST REFERENCE
168. ing invasive parameter information For more information refer to Troubleshooting on page 9 9 Place the transducer at the LA level phlebostatic axis Close the transducer stopcock s to the patient Open the venting stopcock s to the air atmosphere Press the Zero All key Verify that the zero reference is established Close the venting stopcock s to the air atmosphere Open the transducer stopcock s to the patient 9 4 Dash 3000 4000 5000 2000966 338A Monitoring Invasive Pressures 6 Position the catheter in the patient 7 Verify that patient data displays in the pressure parameter window 8 Verify that a good quality waveform displays 9 Adjust the control settings as necessary Control Settings To adjust the control settings for the patient admitted to the monitor select the pressure parameter window label Then select any of the following options and make the desired changes NOTE All changes are temporary and revert to the factory or custom defaults when the patient is discharged To permanently change the these settings refer to Defining Custom Defaults on page 3 7 Option Function SCALES Select the size of displayed waveforms The higher the scale value the smaller the waveform scale m AUTO Adjusts the scale to patient s ART pressure Auto scaled waveforms print at a slightly different scale than the display scale m FULL Allows you to select the scale size
169. ing settings control pulse oximetry monitoring for the Masimo configuration option 11 12 Dash 3000 4000 5000 2000966 338A Monitoring 5 02 Option Function SENSITIVITY Select the sensor sensitivity m NORMAL Select for normal patient monitoring m MAXIMUM Select for improved low perfusion performance and faster tracking of S pO saturation changes CAUTION The MAXIMUM setting delays PROBE IS OFF THE PATIENT detection alarms AVERAGING CAUTION An increased averaging time may result in delayed startup erroneous detection of minimum parameter values missed alarms and desaturation and resaturation detection delays Select the sensor averaging time The higher the setting the more stable the reading The default setting is eight seconds NOTE Forthe two and four second settings the actual averaging time may range from two to four and four to Six seconds Nellcor 395 Pulse Oximeter Connecting Use the following diagram to connect one pulse oximeter to the AUX port on the monitor 2000966 338A Dash 3000 4000 5000 11 13 Monitoring 5 02 401A Power cable 0000 Standard category 5 cable Nellcor 395 DIDCA cable kit AC power source Use the following diagram to connect two pulse oximeters to the AUX ports on the monitor and docking station 11 14 Dash 3000 4000 5000 2000966 338A Mon
170. ion such as ECG electrode placement for GE patient monitors 2000966 338A Dash 3000 4000 5000 1 17 Introduction Conventions Equipment This manual uses the following terms to simplify common equipment names Term Equipment Name acquisition device m SAM module m ICG module m Non GE interfaced devices central station m CIC Pro Clinical Information Center m Centralscope central station docking station monitor Dash Port docking station Dash 3000 4000 5000 P atient Monitor printer m Direct digital writer DDW m Laser printer writer PRN 50 M digital writer User Interface This manual uses the following terms to identify common monitor user interface Definition A labeled key found on the keypad or remote A pad containing multiple buttons The main monitoring display that includes the parameter windows patient data and access to menus controls Term key keypad main display menu A menu is composed of a set of menu options 1 18 Dash 3000 4000 5000 2000966 338A Introduction Term Definition menu option A choice found in a menu that performs one or more of the following functions m Views another window m Completes an action m Views a report window A window contains one or more of the following items Patient waveform and parameter data Parameter specific controls List of
171. irway Gases Gas Operating Room Opens the GAS menu Alarm Volume Neonatal Opens the ALARM VOL menu All Limits Adult and Neonatal Opens the ALL LIMITS menu Cardiac Calcs Adult and Operating Room Opens the CARDIAC CALCS menu Relearns the patient s respiration Cardiac Output Adult and Operating Room Opens the CARDIAC OUTPUT menu CRG Events Neonatal Opens the DOCUMENT CRG EVENTS window CRG Print Neonatal Prints the CRG waveforms CRG Recall Neonatal Opens the CRG TRENDS menu at the most recent CRG event Defaults Adult Neonatal and Operating Room Opens the MONITOR DEFAULTS menu Display On Off Adult Neonatal and Operating Room Turns the display alarms and NBP off but remaining on AC or battery power and active at the central station Dose Calcs Neonatal Opens the DOSE CALCS menu Graph Go Stop Adult Neonatal and Operating Room Prints the current patient data Press again to stop Print Graphic Trends Adult and Operating Room Opens the GRAPHICS TRENDS menu Main Menu Adult Neonatal and Operating Room Returns to the main display NBP Auto Adult and Operating Room Opens the NBP AUTO menu NBP Go Stop Adult Neonatal and Operating Room Begins an NBP measurement Press again to stop NBP Stat Adult and Operating Room Starts five minutes of continuous sequential NBP measurements New Case Operating Room Discharges and admits a patient PA
172. isplay patient trends The type of trend displayed depends on the factory or custom default setting For more information refer to Customizing the Trends Key on page 7 10 NBP Auto O M 2 Press once to view the NBP AUTO menu Select one of the 13 pre defined time intervals or select CUSTOM to create a new automatic measurement interval cycle for the patient or begin a predefined custom interval cycle 3 L 4 Admit Discharge Press once to admit the patient Press again to access the DISCHARGE PATIENT option and discharge an admitted patient F or more information refer to Automatic Admit on page 5 3 or Discharge on page 5 5 2000966 338A Dash 3000 4000 5000 2 7 Equipment Overview Trim Knob Control Use the Trim Knob control to select menus and options Selecting Menus or Parameter Window Labels 1 2 Rotate the Trim Knob control in either direction to highlight a parameter window label or menu Press the Trim Knob control to make your selection Selecting Options from Lists 1 2 Rotate the Trim Knob control to scroll the pointer gt up and down the list When the pointer is in front of the desired option press the Trim Knob control to select the option If there are multiple options turn the Trim Knob control until the desired option is highlighted Press the Trim Knob control again to make your selection To exit the menu p
173. itoring SpO2 Guidelines 402 When acquiring patient data from this external pulse oximeter keep the following guidelines in mind The monitor uses the SpO rate and saturation alarm levels as defined in the PARAMETER ALARM LEVELS information window SETUP DEFAULT PARAMETER ALARM LEVELS menu The monitor sounds and display alarms for external alarm limit violations probe off and pulse search Any alarm settings for the monitor do not apply to the external device The central station displays alarm messages and highlights the single view and multi view window displaying the alarm condition SpO data from the pulse oximeter can be viewed on alarm via the monitor Nellcor Oxismart XL GE Nellcor R Cal compatible or other Nellcor R Cal compatible sensors are supported The following table identifies what conditions apply to the monitor and to other network devices when SpO data is acquired from an external oximeter 2000966 338A Dash 3000 4000 5000 11 15 Monitoring 5 02 Troubleshooting External Parameter Conditions S pO trend data The monitor displays external S pO rate and saturation trend data with the following labels to identify whether the information is from the first or second external oximeter m SPOX1 or SPOX2 saturation m SPOX1 R or SPOX2 R rate 5 0 parameter block The cen
174. ividual events and associated traces more than 24 hours old or all events more than 24 hours old PRINT EVENT Print all events in the event directory DOCUMENT CRG When in the NEONATAL ICU patient monitor type you can EVENTS review edit and save CRG events associated with the patient s condition NOTE The display and menu do not time out To exit the display select MAIN MENU If your monitoring system includes a Lab Access Server and an interface to a lab information system LIS you can access the patient s laboratory data at a monitor While monitoring you may also receive an alert when new lab data is available for the patient The alert is displayed at the top of the screen as the lab data icon To review lab data information select MORE MENUS gt PATIENT DATA gt LAB DATA 2000966 338A Dash 3000 4000 5000 7 9 Patient Data The LAB DATA information window displays all the available lab data for the patient in the LIS database How information is display in the window varies by report type Use the following options to review LAB DATA reports Option Function VIEW OLDER View the previous report VIEW NEWER View the next report PAGE DOWN View the previous page of reports PAGE UP View the next page of reports VIEW RANGES AND View the high and low ranges and the units of measure UNITS OF MEASURE used in the selected report Customizi
175. lies This should include inspection as well as general cleaning on a regular basis The maintenance schedule must comply with the policies of your institution s infection control unit and or biomedical department WARNING Failure on the part of responsible hospital or institution employing the use of this monitoring equipment to implement a satisfactory maintenance schedule may cause undue equipment failure and possible health hazards Check with your biomedical department to be sure preventive maintenance and calibration is complete Refer to the service manual for detailed maintenance and repair information Follow these guidelines when inspecting the equipment Locate obvious physical damage replace all damaged items Inspect cords and plugs for any damage schedule repair or replacement with qualified service personnel Disposal WARNING PACKAGING DISPOSAL Dispose of all packaging material observing all applicable waste control regulations and keeping out of children s reach A 2 Dash 3000 4000 5000 2000966 338A Maintenance Cleaning Exterior Surface WARNING DISPOSAL At the end of its service life the product described in this manual as well as its accessories must be disposed of in compliance with the guidelines regulating the disposal of each product If you have any questions concerning disposal of a product please contact GE or its representatives WARNING Disconnect the monito
176. llcor The following settings control pulse oximetry monitoring for the Nellcor configuration option 2000966 338A Dash 3000 4000 5000 11 11 Monitoring SpO2 Option Function SAT SECONDS NOTE Only available in software version 6 or later Select the amount of time that the saturation values can fall outside the saturation limits before an alarm sounds m OFF Any alarm limit violation instantly alarms m 105 5 Triggers an alarm when the saturation iolates the limits for more than 10 seconds SECS Triggers an alarm when the saturation ates the limits for more than 25 seconds 5 io 0 SECS Triggers an alarm when the saturation iolates the limits for more than 50 seconds 00 SECS Triggers an alarm when the saturation violates the limits for more than 100 seconds NOTE When Sat Seconds is turned on the signal strength indicator is not displayed In this event check the amplitude of the waveform to determine signal strength Be sure the SIZE waveform scale setting is 1X n e lt lt N lt RESPONSE NOTE Only available in software version 6 or later Select the averaging time speed of response to changes in a patient s 5 0 measurements m Normal Reports changes within four to six seconds under motion free conditions m Fast Reports changes less than four seconds under motion free conditions Masimo The follow
177. lowing safety statements apply when monitoring arrhythmia patients 2000966 338A Dash 3000 4000 5000 8 9 Monitoring ECG WARNING VENTRICULAR ARRHYTHMIAS Occasionally the arrhythmia analysis program may incorrectly identify the presence or absence of an arrhythmia Therefore a physician must analyze the arrhythmia information in conjunction with other clinical findings WARNING SUSPENDED ANALYSIS Certain conditions suspend arrhythmia analysis When suspended arrhythmia conditions are not detected and alarms associated with arrhythmias do not occur The messages which alert you to the conditions causing suspended arrhythmia analysis are Arr Off Arrhy Suspend and Leads Fail NOTE Arrhythmia processing is suspended during an Artifact condition Should the artifact condition persist for 20 seconds out of 30 seconds an audible system WARNING alarm will sound and the message Arrhy Suspend will be displayed in the top waveform window until the condition is resolved NOTE Monitoring The EK Pro algorithm simultaneously uses leads I II and the V VA lead for ECG and arrhythmia analysis To verify that you are ready to monitor ECG follow this procedure 1 2 Admit the patient to the monitor Position the electrodes on the patient Connect the patient cable to the electrodes NOTE When using snap leadwires attach leadwires to the electrodes first then apply
178. lts on page 3 7 Option Function LEAD Select the lead to derive the respiration rate RELEARN RESPIRATION Relearn the patient s respiration pattern over the next eight breaths While in process the message LEARNING displays When complete the respiration rate value displays at 40 percent sensitivity and the waveform is automatically sized SENSITIVITY Select the detection sensitivity of the average amplitude The lower the value the greater the detection sensitivity RESPIRATION LIMITS Select the high and low alarm levels for respiration rate and apnea An alarm sounds when a value occurs outside of these limits AUTO SIZE Select the size of the displayed waveform to fit as factory intended on the display The waveform size has no effect on detection MANUAL SIZE Select the size of the displayed waveform The waveform size has no effect on detection CARDIAC ARTIFACT ALARM Turn this patient status ADVISORY alarm on or off It alerts you when the respiration rate is within five percent of the heart rate over 30 consecutive breaths because the monitor may be counting heart beat artifact as respiration It displays the message ARTIFACT in the RR parameter window and sounds a one beep tone SPEED Select a sweep speed for the displayed waveform 13 4 Dash 3000 4000 5000 2000966 338A Monitoring Respiration Troubleshooting
179. mation In a single lead mode if the lead is not available a buzz signal occurs The buzz signal can be either a zero volt flat line or a 60 Hz sine wave The buzz signal option is set in the SERVICE MODE gt CALIBRATE gt CAL ECG ANALOG OUT For more information refer to the service manual The GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide provides the following information Skin preparation Electrode placement Pacemaker detection Arrhythmia detection and analysis Clinical level troubleshooting 2000966 338A Dash 3000 4000 5000 8 7 Monitoring ECG Safety Pacemaker The following safety statements apply when monitoring pacemaker patients WARNING FALSE CALLS False low heart rate indicators or false asystole calls may result with certain pacemakers because of electrical overshoots WARNING MONITORING PACEMAKER PATIENTS Monitoring of pacemaker patients can only occur with the pace program activated WARNING PACEMAKER SPIKE An artificial pacemaker spike is displayed in place of the actual pacemaker spike All pacemaker spikes appear uniform Do not diagnostically interpret pacemaker spike size and shape WARNING PATIENT HAZARD A pacemaker pulse can be counted as a QRS during asystole Keep pacemaker patients under close observation WARNING RATE METERS Keep pacemaker patients under close o
180. may result WARNING DATA VALIDITY Do not allow tape to block the sensor photodetectors WARNING PATIENT SAFETY Prolonged monitoring may require changing the sensor site periodically Move the sensor if there is any sign of skin irritation or impaired circulation Change the sensor site at least every four hours to prevent ischemic skin necrosis Be particularly careful when monitoring neonates If required reduce the application periods to half the times recommended above If a sensor is damaged in any way discontinue use immediately WARNING APNEA A pulse oximeter should NOT be used as an apnea no breath monitor WARNING CABLES Route all cables away from the patient s throat to avoid possible strangulation 2000966 338A Dash 3000 4000 5000 11 7 Monitoring SpO2 WARNING EARLY WARNING A pulse oximeter should be considered an early warning device As a trend toward patient deoxygenation is indicated blood samples should be analyzed by a laboratory co oximeter to completely understand the patient s condition WARNING EXPLOSION HAZARD Do not monitor SpO in the presence of flammable anesthetics or other flammable substance in combination with air oxygen enriched environments or nitrous oxide WARNING INACCURATE MEASUREMENTS Inaccurate measurements may be caused by various patient or mechanical conditions Th
181. me period for acquiring a measurement average is adjustable m The default setting for all patient monitor types is eight seconds m The pulse oximetry is calibrated to display functional saturation 2000966 338A Dash 3000 4000 5000 11 3 Monitoring 5 02 Nellcor The signal strength indicator denotes perfusion quality Zero asterisks means no signal three asterisks indicate high perfusion level Only Masimo LNOP sensors are supported Masimo LNOP sensors non invasively measure pulse rate and the amount of oxygenated hemoglobin Possession or purchase of this device does not convey any express or implied license to use the device with unauthorized replacement parts which would alone or in combination with this device fall within the scope of one or more of the patents relating to this device NOTE With motion the plethysmographic waveform is often distorted and may be obscured by the artifact With Masimo SET technology SpO waveform is not an indication of signal quality or validity Even with an SpO waveform obscured by artifact Masimo SET technology is able to read through the noise and locate the arterial pulsation Use the following guidelines when using Masimo LNOP sensors WARNING MASIMO SET CABLES AND SENSORS Do NOT immerse sensors or patient cables in water solvents or cleaning solutions Do NOT reuse sensors intended for single patient use Do NOT sterilize sensors or patient cables by irra
182. ment by patients and personnel Do not install in a location where the device may drop on a person WARNING SINGLE PATIENT USE All eight serial ports on the connectivity device must only be used by ONE patient CAUTION INSTALLATION To avoid accidental ingress of liquids always mount the connectivity device in a vertical position with the connectors at the bottom CAUTION TREATMENT Do not treat a patient based solely on the alarm messages and or numerics presented via the connectivity device to the monitor You must verify the accuracy of the alarm message and or numerics at the peripheral device itself before initiating treatment Treatment should be based on the information presented at the peripheral device Non GE Device Information Displayed Data The peripheral device data that displays on the monitor varies by device as shown in the following table 2000966 338A Dash 3000 4000 5000 E 3 Interfacing with Non GE Devices Device Waveform Wa Trends arid t Graphing Anesthesia machines Yes Yes Yes Yes Yes Continuous cardiac output No Yes Yes Yes Yes Gas analyzers Yes Yes Yes Yes Yes IV pumps No No No Yes No Pulse oximeters No Yes Yes Yes Yes Transcutaneous monitors No Yes Yes Yes Yes Urometers No Yes Yes No Yes Ventilators Yes Yes Yes Yes Yes Compatible Devices The monitor only displays the information the peripheral
183. message and CARDIAC OUTPUT information window displays Watch for the Inject Now message and select CARDIAC OUTPUT NOW to calculate the cardiac output The information window displays the current cardiac trial information a review CO curve the derived CO value the average CO value between stored trials the patient s heart rate and other vital signs at the time of the trial It also includes cardiac disturbances RHY the patient s height and weight and calculated parameters 2000966 338A Dash 3000 4000 5000 12 5 Measuring Cardiac Output INJECT WHEN READY MENU CO TRIALS CALCS OUTPUT NOW LIMITS CO CURVE ON MAIN DELETE CARDIAC CARDIAC BT PRINT AUTO MODE USE CATHETER INJECT TEMP SIZE INJ VOL COMPUTATION CARDIAC PAW EDWARDS IN LINE 75 10CC CONSTANT OUTPUT HELP 7308 If the monitor is configured for manual measurements the PUSH CO NOW OR TURN AUTO ON message displays If this message displays select CARDIAC OUTPUT NOW and watch for the INJECT NOW message If the message UNSTABLE BT DETECTED displays refer to Troubleshooting on page 12 7 Make sure the values for computation constant CC injectate temp T and blood temperature BT in the lower left of the display are correct If they are not adjust the control settings before you perform the injection Perform the injection The washou
184. meters lethal arrhythmia detection dose calculations and other features required by clinicians caring for acutely ill patients CARDIAC Focuses on cardiac conductivity Includes full arrhythmia analysis and storage adjustable ST measurement point and ST segment trending storage and templates CARDIO PULMONARY Focuses on cardiac and pulmonary hemodynamics Includes cardiac and pulmonary calculations PA insert and wedge algorithms intra aortic balloon pump algorithm and a thermodilution cardiac output algorithm that includes predefined computation constants for major catheter manufacturers To determine the software running on a monitor select MORE MENUS gt MONITOR SETUP gt SOFTWARE CONFIGURATION The software package is listed under ENABLED SOFTWARE OPTIONS For more information on the features and functionality of each software package refer to Appendix B There are three software options These options can be purchased separately and used with any software package or in combination with other software options High Resolution Trends Provides storage of up to 100 CRG events and up to 24 hours of CRG trend data 12SL ECG Provides an analysis program that includes the Gender Specific Criteria and the Acute Cardiac Ischemia Time Insensitive Predictive Instrument ACI TIPI It uses recorded ECG data to produce a numerical score which is the predicted probability of acute cardiac ischemia In addition the gender s
185. n adults do not impact the values to the same extent Use the following criteria when measuring SpO on neonates and infants Monitoring The peripheral pulse rate PPR as determined by the SpO function must be within ten percent of the ECG heart rate The SpO signal strength indicator must have two or three asterisks displayed To verify that you are ready to monitor follow this procedure 1 Admit the patient to the monitor 2 Connect the patient cable to the SpO patient connector on the monitor 3 Position the sensor on the patient Refer to the manufacturer s instructions for placement information 4 Verify that patient data displays in the 5 parameter window 5 Verify the signal and data validity a The signal strength indicator displays a strong signal b Verify a good quality waveform displays 6 Adjust the control settings as necessary NOTE If the measurements do not seem reasonable check the patient s vital signs by alternate means then check the monitor for proper SpO functioning 2000966 338A Dash 3000 4000 5000 11 9 Monitoring SpO2 Control Settings To adjust the control settings for the patient admitted to the monitor select the SpO parameter window label Then select any of the following options and make the desired changes NOTE All changes are temporary and revert to the factory or custom defaults when the patient is discharged To permanently change the
186. n i iii ovre rr Ead wa P P EE EA Wa ae E eat 4 2 OVETVIEW eint Sea e etai ac Sh dt a t t Cs 4 2 Alam fe vici eta et bees fpecie aw Eee dus 4 3 Patient Status Alarms 2 0 ccc cece Hee 4 3 System Status Alarms bere RETE ER hen rev s 4 4 aA caua RA ema lea 4 4 Dash 3000 4000 5000 2000966 338A 2000966 338A Control Settings 4 5 Silencing 5 2 4 6 Tempotarily 4 6 Permanently esne aee vos ER EON seers UD ER 4 8 Managing 5 9 1 Introd ction 2 ca he ao ERA 5 2 a oi vance ain Peat iar a rx e YA aad a GE Dee 5 2 circiter a PA ON 5 2 Standard Admits c cse ces trece pre pes freti eb ew teen fps 5 2 Quick Admit corno enr ter HEY Uer eA S d 5 3 Automatic Admits sariren igana Ka tae enti a 5 3 Control Settings coc bred vo a ER eee eases 5 3 Discharge Sat WEN EA WT V n 5 5 View Other Patients 5 6 Software Option Comparison 5 6 al ee Y n ERECTUS gren XQ SER 5 Custom Defaulls ceste n kun bh Ka Ya h
187. ng Patients 9 FEB 1999 10 00 SICU BED2 SICU BEDS MARTIN ECG x ECG Bd 68 150 EN TO ES a7 136 7241 rate 70 94 33 15 23 100 32 4 p MAIN VIEW ALARM VIEW ALARM VIEW ON ALARMS MENU BED 2 OPTIONS PREVIOUS SELECT A BED SELECT ANOTHER PRINT VIEWE MENU TO VIEW CARE UNIT VIEWED BED PATIENT DATA 5928 The viewed monitor displays until you select MAIN MENU or view another monitor The host monitor is completely functional and two seconds of waveforms data continue to display The menus still control the host monitor and any changes you make do not affect the function of the viewed monitor Information windows will also display over the viewed monitor Keep in mind the following guidelines when viewing a split view u Admit a patient to view If the monitor is discharged the parameter windows display no waveforms with a DISCHARGED message m To maintain CO monitoring on the host monitor while viewing another monitor change the position of CO to the sixth position The slower CO sweep speed will block all other waveforms adjacent or below the position m CO waveform and parameter windows not sent to the host monitor ST trends and complexes are not sent to the host monitor CRG display is not sent to the host monitor Removing a Viewed Monitor Display To remove an alarming monitor display from the host monitor m VOA Select M
188. ng the Trends Key NOTE Only available in software version 6 or later To select the default trend type select MORE MENUS gt MONITOR SETUP gt MONITOR DEFAULTS gt SETUP DEFAULT DISPLAY gt TRENDS HARDKEY and select one of the following options m TABULAR ALL Displays the VITAL SIGNS information window sorted by parameter priority This is the factory default setting TABULAR NBP Displays the VITAL SIGNS window sorted by NBP GRAPHIC Displays the GRAPHIC TRENDS information window CRG Displays the CRG TRENDS information window Calculations Cardiac Calculations NOTE Only available in the CARDIO PULMONARY software package The cardiac calculations program displays monitored and calculated hemodynamic parameter values that are used in cardiac output measurement 7 10 Dash 3000 4000 5000 2000966 338A Patient Data The calculated parameter values are computed with input values The input values are obtained from available monitored patient data The patient s height and weight are required to compute cardiac calculations For more information on calculation parameters and formulas refer to the GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide To adjust the control settings for the patient admitted to the monitor select MORE MENUS PATIENT DATA CARDIAC CALCS Then select any of the following options and make the desired changes NOTE All changes are temporary an
189. nge the calculated PA wedge value select MOVE WEDGE CURSOR Adjust the value and select main display to save the new cursor value To save this PA wedge value in the cardiac calculations and VITAL SIGNS select CARDIAC OUTPUT NOTE To change the displayed waveform sweep speed select SPEED and select an option 9 8 Dash 3000 4000 5000 2000966 338A Monitoring Invasive Pressures Manual Troubleshooting To manually begin a PA wedge measurement when the balloon does not automatically inflate follow this procedure The monitor cannot detect a PA wedge with certain patient conditions for example valvular disease respiratory variation during an automatic PA wedge measurement 1 Select the PA parameter window label 2 From the PA menu select PA INSERT WEDGE The message MANUAL WEDGE displays in the PA parameter window 3 Inflate the balloon according to your unit s policy and procedure 4 To adda cursor to the real time wedged waveform select PA CURSOR 5 Deflate the balloon after three or four respiratory cycles no more than 20 seconds 6 Select REVIEW WEDGE to review the last 20 seconds of data 7 To change the calculated PA wedge value select MOVE WEDGE CURSOR Adjust the value and select MAIN MENU to save the new cursor value 8 Tostart a new PA wedge measurement select NEW WEDGE NOTE To change the scale of the displayed pressure waveform select FULL SCALE and select a scale o
190. nitoring system Warning statements identify a potential hazard or unsafe practice which if not avoided could result in death or serious injury The following warning statements apply to this monitoring system WARNING ACCIDENTAL SPILLS To avoid electric shock or device malfunction liquids must not be allowed to enter the device If liquids have entered a device take it out of service and have it checked by a service technician before it is used again Dash 3000 4000 5000 2000966 338A Introduction WARNING ACCURACY If the accuracy of any value viewed on the monitor central station or printed on a graph strip is questionable determine the patient s vital signs by alternative means Verify that all equipment is working correctly WARNING ALARMS Do not rely exclusively on the audible alarm system for patient monitoring Adjustment of alarm volume to a low level or off during patient monitoring may result in a hazard to the patient Remember that the most reliable method of patient monitoring combines close personal surveillance with correct operation of monitoring equipment After connecting the monitor to the central station and or nurse call system verify the function of the alarm system The functions of the alarm system for monitoring of the patient must be verified at regular intervals WARNING BEFORE USE Before putting the system into operation visually ins
191. ns 7 12 Dash 3000 4000 5000 2000966 338A Patient Data Pulmonary Calculations All aspects of oxygen uptake transport and delivery are necessary in the assessment of critically ill patients These parameters cannot be directly measured but are derived from monitored cardiopulmonary variables The input values are obtained from available monitored patient data The patient s height and weight are required for these calculations The calculated parameter values are figured using the input values For more information on pulmonary calculation parameters and formulas refer to the GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide To adjust the pulmonary calculations for the patient admitted to the monitor select MORE MENUS gt PATIENT DATA gt PULMONARY CALCS Then select any of the following options and make the desired changes Option Function CHANGE VALUE Select a new value for any monitored value NOTE When a change is made the date on the information window changes to the current date and any applicable calculated values display SAVE CALC Select to save the displayed data REVIEW CALC Select to review the saved calculation WEIGHT Select the units of measurement for the patient s weight HEIGHT Select the units of measurement for the patient s height CALCULATED Select O2CI requires 0 value or FICK CO requires CO value 2000966 338
192. nt airway The SAM 80 module has a withdrawal rate of about 150 milliliters per minute Do not use the module on any patient who may be adversely affected by this sampling rate CAUTION AQUA KNOT WATER TRAP USE An Aqua Knot water trap must always be used when the unit is running Failure to use the water trap can result in contamination of the internal gas measurement instruments and may cause subsequent inaccurate gas analysis data CAUTION AQUA KNOT WATER TRAP REPLACEMENT Replace and dispose of the Aqua Knot water trap weekly or when occluded whichever occurs first Do not reuse Reusing the water trap may cause incorrect readings to be displayed and may damage the equipment CAUTION CONTAMINANT PREVENTION Always keep an Aqua Knot water trap or filter on the gas sample inlet when not in use This will prevent dust particles from being drawn into the system which may damage the equipment NOTE Always position the Luer Lok connection and patient sample line in an upright position to avoid aspiration of fluids into the patient sample line which will cause premature blockage of the Aqua Knot water trap NOTE Delivery of bronchodilators mucolytics via aerosol and meter dose inhalers will cause premature blockage of the Aqua Knot water trap Discontinue gas analysis prior to treatment by removing the airway adapter from the ventilator circuit or by disconnecting the sample line from the A
193. o display in the parameter window The default selections are CO SVR and TFC LIMITS Selectthe high and low parameter alarm limits An alarm sounds when a value occurs outside of these limits TRENDS Display the GRAPHIC TRENDS information window All ICG parameters display with an i preceding the parameter label for example iHR iMAP iCO2 etc HELP Display the HELP information window for help with patient preparation proper sensor placement and troubleshooting issues WAVEFORMS Select one of the following options for waveform display m ICG Reflects beat to beat changes in the impedance consistent with events of the cardiac cycle m DZ DT Reflects the rate of change at the first derivative of the waveform 17 6 Dash 3000 4000 5000 2000966 338A Monitoring Impedance Cardiography ICG Troubleshooting Option Function SPEED Select a sweep speed for the displayed waveform SIGNAL QUALITY Select one of the following options for signal quality This overrides the automatic signal selection made by the module for data acquisition and processing m AUTO SEARCH Search all leads for optimum signal Displays the message Signal Search in the parameter window m SIGNAL 1 to SIGNAL 4 Select to switch the vector designation to a specific lead BEAT AVERAGE Select the number of heart beats that are averaged When monitoring begins b
194. o the monitor select MORE MENUS gt MONITOR SETUP Then select any of the following options and make the desired changes Option Function WAVEFORMS ON OFF Select the desired lead option for each waveform or select OFF to remove this waveform from the display NOTE When the ECG parameter is turned off the first waveform option displays the primary parameter monitoring the patient The option cannot be changed until the ECG parameter is turned on DISPLAY Select the number of waveforms on the display m INDV 6 WFS Display up to six waveforms with independent scales The waveforms automatically align with their associated parameter window m INDV 3 WFS Display up to three waveforms with independent scales The waveforms automatically align with their associated parameter window m FULL Display up to five waveforms The first two waveforms are individual scales the next two are full scale common and the final is an individual scale m FULL GRID Display the FULL mode waveforms with additional graticules The graticules do not print 2000966 338A Dash 3000 4000 5000 3 9 Monitor Setup Option Function COLOR PARAMETERS ON OFF Select one of the display color options m CLINICAL Group physiological functions by color Amber ECG Green Hemodynamics Blue Cardiopulmonary temperature and all other parameters Red Alarms White G
195. ocations on the main display m Alarming parameter waveform area m Alarming parameter window m ALRM parameter window m Message line For more information on how and where you receive alarm notification refer to A arm Types on page 4 3 10 15 15 DEC 2004 ADULT 0 SICU BED5 MARTIN Px 70 LEADS FAIL PVC 0 m J 60ms Il 0 2 110 69 5 14 08 E ADULT 87 136 172 2005 70 94 8 33 7 155 2005 23 mmHg SPO2 PROBE IS OFF 105 5 02 THE PATIENT CO2 RSP 29 55 10 15 45 eue e peye 1 15 DEC 2004 ALARMS BED3 HR LOW ACL 810A For ADULT ICU and NEONATAL ICU patient monitor types the alarm parameter window automatically displays when a patient is admitted to the monitor It records any patient status alarms set to CRISIS WARNING and ADVISORY Active alarms display in red Resolved alarms are the designated color for that parameter 4 2 Dash 3000 4000 5000 2000966 338A Alarms The four most recently resolved alarms are displayed in chronological order with the extreme parameter value and timestamp The extreme numerical value for all active displayed parameters is continuously updated To remove the alarm parameter window from the main display select MORE MENUS gt MONITOR SETUP gt PARAMETERS ON OFF gt ALRM gt OFF Alarm Types Patient Status Alarms Patient status alarms are the highest priority alarms They are triggered by a patient condition which exceeds a parameter
196. odule or a direct connection to the CO patient connector on the monitor m Non intubated patients Use the CapnoFlex LF module 15 2 Dash 3000 4000 5000 2000966 338A Monitoring End Tidal CO2 Additional Information Safety The GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide provides the following information Mainstream and sidestream setup Clinical level troubleshooting The following safety statements apply when monitoring WARNING DEVICE PROXIMITY Capnostat sensors should not be used in close proximity to wireless networking equipment to strong electromagnetic fields for example radio station transmitters citizen s band radios cellular phones etc Using these sensors under these conditions may cause on or all of the following to occur Noise may be induced on the capnogram The CO parameter values may be replaced by Xs m The message CHECK ADAPTER CAL may display m The message CALIBRATE SAMPLE LINE may display Normal operation will resume when the source of interference is removed CAUTION CO SOURCE Do not attempt to use a combination of gas monitoring modules for example end tidal and SAM at the same time Only data from one acquisition source is displayed CAUTION GAS EXHAUST LINE Do not allow the gas exhaust line to become kinked or blocked Back pressure may cause inaccurate
197. ol settings u eee 8 19 Ca EI E 2 12 lead analysis 8 21 CIE 4 4 display xuyan itt t tt e 8 20 anesthesia 16 3 identify 2 2 2 2 2 2 8 20 arhiythimlgo yn uyan l roti ceca 8 9 Ip ED 8 20 Sj O ZM MN DI ya MN e O M 18 3 DM a 8 19 15 3 POINT en 8 21 EC Gianne 8 8 eje vi ES 8 19 gerieral ee ees 1 2 1 13 store references 8 19 CAUTIONS ates eite RE 1 8 trend scale 8 20 dangers 1 2 SUANODY 2 15 NOTES n ba nanan a ninan 1 13 System staus alarms 4 4 8 Giyane 1 2 T CO MESE SS SR N 4 2 interfaced E 2 iG ZWE Y qe dal eae 14 2 14 3 IN REY suite mue brit 10 4 control settings esee 14 3 2 2 edem erede 8 8 sr dee alarm 14 3 respiration nte 13 3 temperature sites 14 3 SPO A E 11 7 1 units of measurement 14 3 SAM see anesthesia gases troubleshooting i kk 14 3 service MOG xy 3 11 trends Sman
198. ons are starting points to access and adjust the monitor s settings Option Function ALARM CONTROL View and modify alarm limits change alarm levels and adjust alarm volume For more information refer to Control Settings on page 4 5 VIEW OTHER PATIENTS View other GE monitors on the network For more information refer to Chapter 5 PATIENT DATA View patient data and access the calculation programs For more information refer to Chapter 7 MONITOR SETUP Access menu options to customize the monitor to meet your needs For more information refer to Customizing Monitor S etup on page 3 6 ADMIT MENU Access the menu options to admit and discharge patients For more information refer to Admit on page 5 2 NOTE The menu name changes in OPERATING ROOM patient monitor type to NEW CASE SETUP GO TO STANDBY NOTE Only available in software version 6 or later Select to temporarily suspend monitoring All patient monitoring alarms and trending stop until the Trim Knob control the Standby key or Admit Discharge key is pressed or the monitor is rebooted BATTERY STATUS Review battery information For more information refer to Batteries on page A 6 Identifying Your Configuration Software Packages There are three software packages 3 2 Dash 3000 4000 5000 2000966 338A Monitor Setup Software Options BASIC Includes standard of care para
199. oring Respiration 13 1 Introduction 5a kis a tees Rake dared eth En CREER CEDE d RE 13 2 2 i Sta 13 2 Additional 1 13 3 Safety coe metes er Ya PE Y a 13 3 Monitoring lt y akla ya la a b a alay kK 13 3 Control Settings kik ak IDEN 13 4 0 bala 13 5 Monitoring Temperature 14 1 OVvelvVieW 22 anc P pee OCC DA e P EA c E LC PP c RE RTI ag 14 2 Monhitofifigi ixx a cil aa aa a saya aya ea e e CORR e 14 2 Control Settings adil 14 3 Dash 3000 4000 5000 2000966 338A 15 16 17 2000966 338A Troubleshooting enne nnns 14 3 Monitoring End Tidal 15 1 Introduction eiie eva ex cn e RD OC Kya RU 15 2 ONEVIEW e B e n Ste nd e d 15 2 Compatible Devices Sensors 15 2 1 15 3 Safety ut mans Wet T puree nee 15 3 Monitoring a Za KE na a K A R raa Dn EK kj 15 4 Control Settings 5i ci bedi cece
200. osition the pointer in front RETURN and press the Trim Knob control Selecting High Low Values from Lists 1 2 E uw Rotate the Trim Knob control to scroll the pointer up and down the list When the pointer is in front of the desired option press the Trim Knob control to highlight the parameter Turn the Trim Knob control to highlight the low or high limit Press the Trim Knob control and rotate to change the value Press the Trim Knob control to select the value Press the Trim Knob control to move to the next parameter Rotate the Trim Knob control to highlight the parameter To exit the menu position the pointer in front RETURN and press the Trim Knob control 2 8 Dash 3000 4000 5000 2000966 338A Equipment Overview Indicators Alarm Light Indicates an alarm condition An optional alarm light indicator is built into the handle or the display bezel m Flashing red CRISIS patient status alarms m Flashing yellow WARNING patient status and system status alarms Power Indicates the monitor s power source 820A Power Indicator m AC illuminated The monitor is running on AC power m Battery illuminated The monitor is running on battery power Charging Status Indicates the battery charging status of the internal batteries One indicator for each battery A and B 821A Charging Status Indicator Yellow The battery is charging Green The battery is fully charged
201. ould be carried out annually You are responsible for any requirements specific to your country CAUTION MPSO The use of a multiple portable socket outlet MPSO for a system will result in an enclosure leakage current equal to the sum of all individual earth leakage currents of the system if there is an interruption of the MPSO protective earth conductor Do not use an additional extension cable with the MPSO as it will increase the chance of the single protective earth conductor interruption CAUTION NEGLIGENCE GE does not assume responsibility for damage to the equipment caused by improperly vented cabinets improper or faulty power or insufficient wall strength to support equipment mounted on such walls 2000966 338A Dash 3000 4000 5000 1 11 Introduction CAUTION OPERATOR Medical technical equipment such as this monitor monitoring system must only be used by persons who have received adequate training in the use of such equipment and who are capable of applying it properly CAUTION POWER REQUIREMENTS Before connecting the device to the power line check that the voltage and frequency ratings of the power line are the same as those indicated on the unit s label If this is not the case do not connect the system to the power line until you adjust the unit to match the power source In U S A if the installation of this equipment will use 240V rather than 12
202. ous lead detect signal select the BIS parameter window label BIS SETUP LEAD DETECT OFF 18 6 Dash 3000 4000 5000 2000966 338A Monitoring Bispectral Index BIS Disabling the Waveform Filter Testing the BIS The monitor uses an EEG filter to modify the raw EEG waveform with a combination of low pass high pass and notch filters This produces waveform data display between 2 and 70 Hz To temporarily remove filters and display only the raw waveform for troubleshooting purposes select the BIS parameter window label gt BIS SETUP gt EEG FILTER gt OFF When the filter is removed the waveform data between 0 25 and 100 Hz displays BISx uses an internal DSC to filter and transmit data to the monitor To test the function of the DSC select the BIS parameter window label gt BIS SETUP gt BIS TEST gt ON The message BIS TEST IN PROGRESS displays until the evaluation is complete A PASS message displays if BISx is functioning within normal operating parameters A FAIL message displays if BISx did not meet the noise gain high and low pass normal values If BISx fails contact service Understanding Displayed Values BIS BIS is a processed EEG parameter which corresponds to the patient s level of consciousness The resulting BIS values range from 100 patient is wide awake to 0 Since BIS is an absolute value baseline information about the patient is not required for monitoring patients
203. ovides all functional capabilities of the monitor including vital signs monitoring network communication and battery charging During the power up sequence a splash screen displays and the control panel and alarm light indicators illuminate After approximately 20 seconds the Main Menu displays Before admitting a patient to the monitor complete each of the following tasks to verify that the monitor is ready for use 2 14 Dash 3000 4000 5000 2000966 338A Equipment Overview Off Charging Off Verify the power network and patient cables are connected to the monitor Press the Power key to turn the monitor on Verify the wireless network communication is functional if applicable Approximately one minute after power up perform one of the following actions to verify network communication m From the wireless monitor s main display select MORE MENUS gt VIEW OTHER PATIENTS gt SELECT A BED TO VIEW Select a bed from the network View the wireless monitor from a central station on the network Perform a LIST NETWORK from a central station on the network and verify the wireless monitor appears in the list For more information refer to the central station s operator s manual Verify monitor is functioning correctly After power up and during operation the monitor automatically self tests When a malfunction is detected the monitor displays a message and a prompt asking whether the user wishes to continue
204. oximately 9 hours for both the external and the internal charging method External Charger Method Preferred The Cadex SMart Two charger maintains a lower battery cell temperature during the charge cycle than the monitor This reduction in temperature will extend the life of the battery To charge a battery use the following procedure 1 Insert the battery into the battery charger The RUN LED illuminates 2 Leave the battery in the charger until the READY LED illuminates 3 Ifthe FAIL LED illuminates remove and reinsert the battery This will correct any battery charger time out errors Internal Method To charge a battery use the following procedure 1 Insert battery into the monitor The battery CHARGING STATUS indicator illuminates yellow 2 When the battery CHARGING STATUS indicator illuminates green the battery is fully charged Condition the battery every six months or whenever the BATTERY STATUS information window displays CONDITION in the BATTERY QUALITY field External Charger Method Preferred Remove the battery from the monitor every six months and condition it using the SMart Two charger This condition cycle recalibrates the electronic fuel gauge To condition a battery use the following procedure 1 Insert the battery into the battery charger 2 Press the CONDITION button when one of the following conditions occur 2000966 338A Dash 3000 4000 5000 A 11 Maintenance Storing m Wh
205. package only Displays all six leads of ECG RELEARN Relearn the patient s ECG pattern to correct arrhythmia calls and heart rate value restore ST measurements and enable more accurate monitoring ST ANALYSIS Turn the ST analysis program on or off For more information refer to Performing ST Analysis on page 8 18 12 LEAD ECG ANALYSIS Displays 12 leads of ECG For more information refer to Performing 12 Lead Analysis on page 8 21 2000966 338A Dash 3000 4000 5000 8 11 Monitoring ECG Option Function ECG FILTER Select a ECG waveform signal filter to improve the waveform display and graphs Does not affect ST and arrhythmia analysis m DIAGNOSTIC Provides the maximum available ECG signal information Recommended for high fidelity recordings in low noise environments m MONITORING Provides modest reduction of high frequency interference Recommended for typical monitoring applications m MODERATE Provides significant reduction of high frequency interference Recommended for high noise environments for example electrosurgical units m MAXIMUM Provides significant reduction of high frequency interference plus maximum stabilization of the ECG baseline This mode alters the displayed QRS morphology but does not affect automated analysis Do not rely upon the displayed QRS morphology for diagnostic purposes when this mode is selec
206. pdates every two minutes when the most recent data segment is displayed NOTE When the monitor is set for the VEONATAL ICU patient monitor type and an apnea brady or desaturation alarm occurs within 30 seconds of the first alarm the monitor groups the alarms in one text line in the event directory When more than one alarm is grouped in a text line each alarm counts as a single event Each event can be viewed separately and three separate events are recorded in the event directory The respiration trend data for the two minute display is the respiration waveform The respiration trend data for the six hour summary varies by patient monitor type 7 8 Dash 3000 4000 5000 2000966 338A Patient Data Lab Data m NEONATAL ICU Apnea per five minutes printing as apnea per minute m ADULT ICU and OPERATING ROOM Respiration rate Use the following options to review CRG TRENDS Option Function LOCATE CURSOR Select a specific time on the display and display the associated parameter values ZOOM IN Selecta specific two minute trend from a six hour summary and display the associated trace ZOOM OUT Display the six hour summary VIEW OLDER View the previous event VIEW NEWER View the next event SELECT PARAMETERS Select the parameters to display as trends SELECT EVENT Select and view a single two minute trend event from the six hour summary DELETE EVENT Select and delete ind
207. pecific criteria improves the detection of acute myocardial infarctions AMI for adult women under the age of 60 Unity Network Enables you to view other patients on the network interface with a central station and other network devices and perform COMBO or ROVER COMBO monitoring To determine the software options running on a monitor select MORE MENUS gt MONITOR SETUP gt SOFTWARE CONFIGURATION The software options are listed under ENABLED SOFTWARE OPTIONS Monitoring Admit Modes There are four monitoring or admit modes The mode determines how patients are admitted to the monitor and how the monitor functions within a network environment It is defined during installation via the password protected SERVICE MODE menu 2000966 338A Dash 3000 4000 5000 3 3 Monitor Setup Patient Monitor Type Language m STANDARD Permanently mount a monitor in a room This mode does not accommodate telemetry and does not require a network connection unless central station communication is needed m ROVER Move or rove the monitor to the patient rather than moving the patient to a monitored room This mode does not accommodate telemetry and does not require a network connection unless central station communication is needed m COMBO Acquire ECG data from a monitor or a telemetry receiver cabinet and access all the available parameters from the monitor A network connection is required m ROVER COMBO Combines
208. pect all connecting cables for signs of damage Damaged cables and connectors must be replaced immediately Before using the system the operator must verify that it is in correct working order and operating condition Periodically and whenever the integrity of the product is in doubt test all functions WARNING CABLES Route all cables away from patient s throat to avoid possible strangulation 2000966 338A Dash 3000 4000 5000 1 3 Introduction WARNING CONDUCTIVE CONNECTIONS Extreme care must be exercised when applying medical electrical equipment Many parts of the human machine circuit are conductive such as the patient connectors electrodes transducers It is very important that these conductive parts do not come into contact with other grounded conductive parts when connected to the isolated patient input of the device Such contact would bridge the patient s isolation and cancel the protection provided by the isolated input In particular there must be no contact of the neutral electrode and ground WARNING DEFIBRILLATION Do not come into contact with patients during defibrillation Otherwise serious injury or death could result WARNING DISCHARGE TO CLEAR PATIENT DATA When admitting a new patient you must clear all previous patient data from the system To accomplish this disconnect patient cables then do a discharge WARNING DISCONNECTION
209. ption To change the displayed waveform sweep speed select S WEEP SPEED and select an option For clinical level troubleshooting refer to the GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide 2000966 338A Dash 3000 4000 5000 9 9 Monitoring Invasive Pressures 9 10 Dash 3000 4000 5000 2000966 338A 10 Monitoring NBP 2000966 338A Dash 3000 4000 5000 Monitoring NBP Introduction Overview Automatic non invasive blood pressure monitoring uses the oscillometric measurement method The oscillometric method uses a sensitive transducer which measures cuff pressure and minute pressure oscillations within the cuff to determine the mean pressure and calculate the systolic and diastolic pressures A parameter window display updates every second There is no waveform 111 71 auto 87 708B 1 Systolic value 2 Diastolic value 99 Pulse rate value 4 Time of last measurement 24 hour clock Cuff size 6 Automatic determination message 7 Mean value or cuff inflation pressure during a measurement The reference blood pressure is the intra arterial blood pressure for neonatal pediatric and adult populations After inflating the cuff the monitor begins to deflate and the oscillations in the cuff is measured Finally systolic mean and diastolic pressure are calculated and the display is updat
210. qua Knot water trap 2000966 338A Dash 3000 4000 5000 16 5 Monitoring Anesthesia Gases Monitoring To verify that you are ready to monitor anesthetic gases follow this procedure 1 oy m Control Settings Install the SAM module into TRAM RAC 2A module housing You will hear a click when the module is fully inserted Connect one end of the TRAM NET communication cable into the Auto or TRAM NET port on the back of the module housing Connect the other end of the communication cable into the Aux port on the back of the monitor Turn on the power switch on the back of the module housing Turn on the monitor Admit the patient to the monitor Position the sensor on the patient Verify that patient data displays in the CO and GAS parameter windows Adjust the control settings as necessary To adjust the control settings for the patient admitted to the monitor select the CO parameter window label Then select any of the following options and make the desired changes NOTE All changes are temporary and revert to the factory or custom defaults when the patient is discharged To permanently change the these settings refer to Defining Custom Defaults on page 3 7 NOTE The following options are additional CO control settings These are only available when using a SAM module The other CO control settings are defined in the CO chapter For more information refer to Control Settings
211. r Remote Control N A Not Marked TRAM RAC 2A powered The class of equipment or N A not applicable The type of applied part B BF CF Not Marked or none no applied parts Degree of protection against harmful ingress of water Ordinary 30rdinary equipment enclosed equipment without protection against the ingress of water Equipment not suitable for use in the presence of a flammable anesthetic mixture with air oxygen or nitrous oxide Underwriters Laboratories Inc Classification pile US Medical Equipment Degree of safety of application in the presence of a flammable anesthetic mixture with air or with oxygen or nitrous oxide Not Suitable Method of sterilization disinfection recommended by the manufacturer N A Mode of Operation Continuous With respect to electric shock fire and mechanical hazards only in accordance with UL 60601 1 and CAN CSA C22 2 NO 601 1 AAMI EMI Environment Recommendations Review the AAMI EMC Committee technical information report TIR 18 titled Guidance of electromagnetic compatibility of medical devices for clinical biomedical engineers Part 1 Radiated radio frequency electromagnetic energy This TIR provides a means to evaluate and manage the EMI environment in the hospital The following actions can be taken Dash 3000 4000 5000 2000966 338A Introduction m Managing
212. r from AC power before cleaning or disinfecting its surface CAUTION Failure to follow these rules may melt distort or dull the exterior surface finish blur lettering on labels or cause equipment failure Clean the exterior surface on a regular basis in compliance with your institution s infection control and or biomedical department Use any of the following approved solutions to dampen a clean lint free cloth m Diluted ammonia m Cidex m Diluted sodium hypochlorite bleach m Diluted mild soap NOTE Always dilute solutions according to the manufacturer s suggestions and wipe all the cleaning solution from the exterior surface with a dry cloth 2000966 338A Dash 3000 4000 5000 A 3 Maintenance NOTE Always avoid the following Cleaning solutions containing wax Pouring or spraying water or cleaning solution directly on the exterior surface connectors or ventilation openings Abrasive cleansers or solvents Acetone ketone or alcohol based cleansers m Betadine Display Dampen a soft clean lint free cloth with a glass cleaner NOTE Do not spray cleaner directly on the screen Do not use alcohol based cleansers or hospital disinfectants like Cidex or Betadine Applied Parts Cables and Leadwires CAUTION Do not use acetone or ketone solvents an autoclave or steam cleaner to clean cables and leadwires CAUTION The decision to sterilize must
213. r to Adapters on page 15 7 Verify that patient data displays in the CO parameter window Verify that a good quality waveform displays 10 Adjust the control settings as necessary 15 4 Dash 3000 4000 5000 2000966 338A Monitoring End Tidal CO2 Control Settings To adjust the control settings for the patient admitted to the monitor select the CO parameter window label Then select any of the following options and make the desired changes NOTE All changes are temporary and revert to the factory or custom defaults when the patient is discharged To permanently change the these settings refer to Defining Custom Defaults on page 3 7 Option Function UNITS C02 SCALE C02 LIMITS N20 COMPENSATION Select the units of measure of inspired and expired CO NOTE Respiration is measured in breaths per minute no breath is measured in seconds Select a scale for the displayed CO capnogram The larger the scale the smaller the displayed waveform A waveform scale that exceeds the defined display area is flattened on top Select high and low alarm limits for inspired expired CO respiration rate and apnea An alarm sounds when a value occurs outside of these limits NOTE Only available when in the OPERATING ROOM patient monitor type Select the percentage of N20 concentration to compensate for N50 related elevation of the CO value Obtain the concentration from an analyz
214. ral Index BIS Introduction Overview NOTE Only available in software version 6 or later NOTE Although the external Aspect BISx can monitor EEG the monitor does not support EEG monitoring The external BISx uses an internal digital signal converter DSC The DSC uses EEG amplifiers and analog filters and digitizes the resulting waveforms for transmission and processing by the monitor It also amplifies and digitizes the EEG signal close to the patient to limit the effect of ambient noise sources When connected to the monitor BISx computes the BIS value and other processed EEG parameters in real time using three steps m The raw EEG signal is broken down second by second and the segments that have artifact are identified and removed m BISx calculates the BIS value by combining EEG features associated with the anesthetic effect m The index is modified to reflect the amount of suppressed EEG signal in the raw waveform The monitor displays the digital values in a parameter window The display is updated every two seconds 1 4 BIS SR 54 100 3 E saio 100 30 EMG 900A 1 Electromyograph EMG value 2 Suppression ratio value 3 Signal quality index value 4 Bispectral index value 18 2 Dash 3000 4000 5000 2000966 338A Monitoring Bispectral Index BIS The monitor also displays a single raw EEG waveform Additional Information Refer to the
215. ration Introduction Overview Respiration rate is detected by measuring thoracic impedance changes through ECG lead I or lead II m Lead I provides good thoracic upper chest breath detection However lead I is more susceptible to cardiogenic artifact m ead II provides good thoracic breath detection and abdominal lower chest breath detection However lead II is more susceptible to both cardiogenic artifact and motion head neck or arm artifact To enable respiration monitoring select MORE MENUS MONITOR SETUP PARAMETERS ON OFF RR A parameter window and waveform display when a patient cable is connected to the monitor and respiration monitoring is enabled The display is updated every two seconds 752A 1 Respiration rate 2 Breath indicator 3 Monitored lead NOTE Using an ESU ECG filter will not adversely affect respiration monitoring NOTE When monitoring a respiration rate is always measured and displayed in the CO parameter window Using the respiration rate measurement from CO should be the preferred measurement method as an impedance respiration rate can be disrupted by many conditions 13 2 Dash 3000 4000 5000 2000966 338A Monitoring Respiration Additional Information The GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide provides the following information Safety ECG skin preparation Respiration lead
216. ration of an agent needed to produce an anesthetizing effect in 50 percent of the population WARNING values correspond to healthy adults Other factors such as age and physical condition need to be accounted for NOTE The displayed value reflects the expired MAC value NOTE If N50 and two other agents are displayed the MAC value does not display in the GAS parameter window Enabling HAL and ENF When using a SAM module you can enable the monitor to detect and display low values of halothane and enflurane greater than one percent due to non analyzed gases in the circuit in the GAS parameter window To enable the HAL and ENF display follow this procedure 1 Select MORE MENUS gt MONITOR SETUP gt MONITOR DEFAULTS gt SETUP DEFAULT DISPLAY 2 In SETUP DISPLAY locate DISABLE SAM HAL and DISABLE SAM ENF and select ON Troubleshooting For clinical level troubleshooting refer to the GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide 2000966 338A Dash 3000 4000 5000 16 9 Monitoring Anesthesia Gases GAS LIQUEFIED WARMING UP Due to extreme temperature change gas in one or more of the internal cells is liquefied Message Cause Solution BLOCKED LINE The sample or exhaust line blocked Clean or replace sample or exhaust line CALIBRATE The SAM module is not calibrated Calibrate the module MODULE CELL S
217. revent inadvertent disconnection should someone pull on them Do not route cables in a way that they may present a stumbling hazard For devices installed above the patient adequate precautions must be taken to prevent them from dropping on the patient 2000966 338A Dash 3000 4000 5000 1 7 Introduction Cautions WARNING If an error message appears DURING operation it is the physician s responsibility to decide whether the unit is still suitable for patient monitoring As a general rule monitoring should only continue in extremely urgent cases and under the direct supervision of a physician The unit must be repaired before being used again on a patient If an error message appears AFTER power up the unit must be repaired before being used on a patient WARNING If connecting a monitor to a central station verify the alarm system is functional by temporarily changing one of the alarm limits to initiate an alarm Caution statements identify a potential hazard or unsafe practice which if not avoided could result in minor personal injury or product property damage The following caution statements apply to this monitoring system CAUTION ACCESSORIES SUPPLIES ensure patient safety use only parts and accessories manufactured or recommended by GE Parts and accessories used must meet the requirements of the applicable EN 60601 series safety standards and ess
218. rify the tubes between the cuff and the monitor are not kinked or blocked Verify the correct cuff size is selected in the NBP menu Start an NBP reading Verify that patient data displays in the NBP parameter window Adjust the control settings as necessary To adjust the control settings for the patient admitted to the monitor select the NBP parameter window label Then select any of the following options and make the desired changes NOTE All changes are temporary and revert to the factory or custom defaults when the patient is discharged To permanently change the these settings refer to Defining Custom Defaults on page 3 7 2000966 338A Dash 3000 4000 5000 10 7 Monitoring NBP Option Function NBP AUTO NBP STAT Turn automatic determination off or select the time interval to take automatic NBP measurements The default setting is five minutes A countdown timer displays in the NBP parameter window when the time interval is less than 60 minutes To synchronize NBP measurements with actual clock times change the MONITOR DEFAULTS gt SETUP DEFAULT DISPLAY gt NBP CLOCK SYNC option to ON WARNING Periodically check patient limb circulation distal to the cuff Check frequently when using Auto NBP in one or two minute intervals Intervals below 10 minutes are not recommended for extended periods of time NOTE Not available when in the NEONATAL ICU patient monitor type
219. rm level for arrhythmias The arrhythmias listed are determined by the software package patient monitor type and whether arrhythmia is Set for lethal or full m BASIC software package Only the V TACH alarm level can be changed m ADULT ICU patient monitor type The V FIB and V TAC alarm levels cannot be changed m NEONATAL ICU patient monitor type The V FIB and V TAC alarm levels cannot be changed Select the default alarm level for all monitored parameters SETUP DEFAULT LIMITS Select the default high and low alarm limits for all monitored parameters SETUP DEFAULT DISPLAY Select the display defaults for the current patient monitor type and software package 3 8 Dash 3000 4000 5000 2000966 338A Monitor Setup Option Function SETUP DEFAULT PARAMETER PRIORITY Select how parameter windows are prioritized on the display For more information refer to Defining Parameter Window Priority on page 3 12 RECALL DEFAULT Select one of the factory or custom default names Once selected any changes you make to the settings are automatically saved Defining Control Settings NOTE All control settings are temporary and revert to the factory or custom defaults when the patient is discharged from the monitor To permanently change these settings refer to Defining Custom Defaults on page 3 7 To define control settings for the patient admitted t
220. rocedure NOTE Discharge patients from the monitor before restoring factory defaults 1 Select MORE MENUS gt MONITOR SETUP gt MONITOR DEFAULTS 2 Select CUSTOM DEFAULTS gt RESTORE FACTORY DEFAULTS 3 Position the pointer in front of the desired custom name 4 Press the Trim Knob control Defining Parameter Window Priority The number of parameter windows that display on the screen depends on the display mode No more than six full sized parameter windows can display on the right side of the monitor No more than 10 automatically sized parameter windows can display in total six on the right side and four on the bottom of the screen NOTE The large CLOCK DISPLAY option uses the space of one parameter window If the maximum number of parameter windows are needed for patient monitoring turn this option off You can define which parameters display as full sized parameter windows in the DEFAULT PARAMETER PRIORITY window by selecting the parameters in priority order in the PARAMETER 2 to PARAMETER 6 fields DEFAULT PARAMETER PRIORITY gt RETURN PARAMETER 1 ECG PARAMETER 2 ECG PARAMETER 3 ART PARAMETER 4 PA PARAMETER 5 SPO2 PARAMETER 6 co2 GAS CVP BIS KERI RA cco ART UVC FEM LA TEMP UAC ICP UO co2 SVO2 VENT 5 2 ALARMS MAY BE DISPLAYED AS REDUCED SIZE 579 3 12 Dash 3000 4000 5000 2000966 338 Monitor Setup NOTE PARAMETER 1 cannot be changed It
221. rodes stainless steel or silver constructed may cause the electrodes to retain a residual charge after defibrillation A residual charge will block acquisition of the ECG signal CAUTION EMC Magnetic and electrical fields are capable of interfering with the proper performance of the device For this reason make sure that all external devices operated in the vicinity of the monitor comply with the relevant EMC requirements X ray equipment or MRI devices are a possible source of interference as they may emit higher levels of electromagnetic radiation Dash 3000 4000 5000 2000966 338A Introduction CAUTION INSTRUCTIONS FOR USE For continued safe use of this equipment it is necessary that the listed instructions are followed However instructions listed in this manual in no way supersede established medical practices concerning patient care CAUTION LOSS OF DATA Should the monitor at any time temporarily lose patient data the potential exists that active monitoring is not being done Close patient observation or alternate monitoring devices should be used until monitor function is restored If the monitor does not automatically resume operation within 60 seconds power cycle the monitor using the power on off switch Once monitoring is restored you should verify correct monitoring state and alarm function CAUTION MAINTENANCE Regular preventative maintenance sh
222. roper size cuff CAUTION The pulse rate derived from an NBP determination measurement may differ from the heart rate derived from an ECG waveform because the NBP parameter measures actual peripheral pulses not electrical signals or contraction from the heart Differences may occur because electrical signals at the heart occasionally fail to produce a peripheral pulse or the patient may have poor peripheral perfusion Also if a patient s beat to beat pulse amplitude varies significantly for example because of pulsus alternans atrial fibrillation or the use of a rapid cycling artificial ventilator blood pressure and pulse rate readings can be erratic and an alternate measuring method should be used for confirmation CAUTION For SuperSTAT NBP Adult Pediatric Only Simultaneously monitoring ECG will enhance SuperSTAT NBP performance in irregular rhythm A patient s vital signs may vary dramatically during the use of cardiovascular agents such as those that raise or lower blood pressure or those that increase or decrease heart rate 10 6 Dash 3000 4000 5000 2000966 338A Monitoring NBP Monitoring Control Settings To verify that you are ready to monitor NBP follow this procedure 1 Admit the patient to the monitor Connect a patient cable to the NBP patient connector on the monitor Select a cuff appropriate for the limb size Position the cuff on the patient Ve
223. s The following terms are used to define the battery capacity m Design capacity The theoretical capacity of the battery cells when the battery is new m Full charge capacity The actual amount of charge the battery can store and deliver to the monitor m Remaining charge capacity The amount of full charge capacity currently remaining in the battery This is a percent of the full charge capacity Battery Gauges The battery gauge for each battery displays on the screen when installed in the monitor The example shows a battery that has lost about 20 percent of its design capacity and has about 50 percent remaining charge capacity approximately 1 4 hours 1 2 3 859B 1 Filled white area Remaining charge capacity 2 Empty black area Full charge capacity 3 Dotted outline area Design capacity If the message ERROR displays in the battery gauge refer to Battery Status Menu on page A 10 Battery Charger When you select the Target Capacity switch on the charger the charger compares the battery s performance to a 60 70 or 80 percent target capacity set on the battery charger If the battery fails to meet the target performance the battery charger will prompt you to condition the battery If after the condition cycle has been completed the battery does NOT meet the target performance then the battery charger will illuminate a fail light 20
224. s Selecting a Monitor If more than one monitor is alarming the bed with the most recent and highest priority alarm is displayed first Up to three other alarming monitors display in order of decreasing priority 2000966 338A Dash 3000 4000 5000 5 11 Managing Patients WARNING Due to space limitations in the alarm message line it is possible that the alarm line will only display the beds that are in alarm but not the alarm reason Or the alarm reason may be abbreviated to the point where the reason is not immediately obvious to the user To view alarm reason select VIEW ALARM for the bed you wish to view To select an alarming monitor follow this procedure 1 2 4 Select MORE MENUS gt VIEW OTHER PATIENT Select the alarming monitor from the associated VIEW ALARM menu Select one or more of the following functions GRAPH PRINT SILENCE 60 seconds LAST EVENT VITAL SIGNS GRAPHIC TRENDS Select RETURN PREVIOUS MENU or MAIN MENU to exit Understanding the Split View Display When viewing another monitor the split view divides the display in half Each side displays one monitor s patient information Right Host monitor patient information Left Viewed monitor patient information including the first six parameter windows and up to four waveforms The VIEWED PATIENT message displays on the bottom of the split view 5 12 Dash 3000 4000 5000 2000966 338A Managi
225. s m ON W OUT SEC Display the military time in hours and minutes NOTE This option uses the space of one parameter window If the maximum number of parameter windows are needed for patient monitoring turn this option off BRIGHTNESS Select the screen brightness LEARN THE MONITOR Select any of the MENTOR educational program options for basic monitor function instructions SOFTWARE Select to view the monitor s software configuration ADMIT CONFIGURATION menu type PATIENT MONITOR TYPE enabled software options and NBP configuration REVISION AND ID Select to view the monitor s software version and hardware configuration SERVICE MODE Access password protected monitor settings These features are intended for qualified service personnel to set up troubleshoot and repair the monitor The following settings are controlled in this menu m PATIENT MONITOR TYPE m Application monitoring mode m MONITOR DEFAULTS password protection For more information refer to the service manual NOTE You can also change parameter settings from the main display by using the Trim Knob control to select the parameter window label For more information on specific parameter control settings refer to the appropriate parameter chapter in this manual 2000966 338A Dash 3000 4000 5000 3 11 Monitor Setup Restoring Factory Defaults To restore the factory default settings for the patient monitor type follow this p
226. s pulse oximetry probes and NBP cuffs consult the manufacturer for cleaning sterilization or disinfecting methods Changing Writer Paper 1 Press the button on the top of the writer to open the writer door 638A 2 Remove the old spool and install a new paper roll Install the paper so it unrolls from the bottom 2000966 338A Dash 3000 4000 5000 A 5 Maintenance 639A 3 640A 4 Test the writer by initiating a graph strip 5 Remove the test graph by tearing downward Batteries Overview General A complete battery management system provides maximum battery performance Depending on usage the run time per battery for new fully charged batteries is up to 3 5 hours Monitoring and SpO drains battery power faster than other A 6 Dash 3000 4000 5000 2000966 338A Maintenance Lithium lon Technology parameters The display brightness graphing and connection to a wireless network can also alter battery run times Audible and visual alarms alert you when loss of power is imminent and on screen capacity gauges indicate battery charge condition and capacity A BATTERY LOW message at the top of the screen warns you prior to complete loss of battery power You should replace the battery or connect the monitor to an AC power source when the message is displayed The batteries used in this monitor are rechargeable batteries containing lithium ion cells Each battery cont
227. s high NOTE The Sat Seconds feature has a safety net designed for patients whose saturation is frequently outside the limits but does not remain outside the limits long enough for the Sat Seconds limit to be reached When three or more limit violations occur within 60 seconds an alarm sounds even if the Sat Seconds limit has not been reached NOTE Sat Seconds is only available when the SpO parameter block is full sized m Periodically inspect extension cables and sensors for damage and discontinue use if damage is found Do not immerse sensors Do not use NBP or constricting instruments on the same appendage as the SpO Sensor Ohmeda The following measurement guidelines apply to GE Ohmeda oximetry Adult measurements are averaged over a six second time period Neonate measurements are averaged over a 12 second time period This longer averaging time decreases false alarms from patient motion artifact m The pulse oximetry is calibrated to display functional saturation 2000966 338A Dash 3000 4000 5000 11 5 Monitoring 5 02 The signal strength indicator is not proportional to pulse amplitude Zero asterisks means no signal three asterisks means a strong signal Ohmeda OxyTip sensors and Nellcor R Cal technology compatible sensors are supported Use the following guidelines when using OxyTip sensors Additional Information WARNING PATIENT SAFETY Patient conditions such as redd
228. s to 0 Remove the sensor from the cell marked 0 and attach to the cell marked REP The EXP value should update to 38mmHg 2 If the value is not within this range the sensor is out of tolerance Replace the sensor To calibrate an airway adapter follow this procedure 1 2 Sample Lines Verify the sensor is connected to the adapter Verify the sensor cable is connected to the patient connector on the monitor Verify the airway adapter is clean and free of foreign matter Place the sensor and adapter away from all sources of CO including the patient s exhaled breath your exhaled breath and ventilator exhaust valves Select the parameter window label From the CO menu select CALIBRATE ADAPTER Select READY The message CALIBRATING displays in the parameter window When calibration is complete the message clears To calibrate sample lines follow this procedure 1 Connect the sample line to the Capnoflex module but not to the patient NOTE A spike may display when attaching the sample line Wait for the spike to finish its cycle before continuing Select the CO parameter window label From the CO menu select CALIBRATE SAMPLE LINE Select READY The message CALIBRATING displays in the parameter window When calibration is complete the message clears 2000966 338A Dash 3000 4000 5000 15 7 Monitoring End Tidal CO2 5 Connect
229. se It is intended for use on adult and pediatric patients within a hospital or medical facility providing patient care to monitor the state of the brain by data acquisition of EEG signals The BISx may be used as an aid in the monitoring of certain anesthetic agents Use of BIS monitoring to help guide anesthetic administration may be associated with the reduction of the incidence of awareness with recall in adults during general anesthesia and sedation WARNING CABLES Route all cables away from the patient s throat to avoid possible strangulation WARNING The BISx may remain connected to a patient during defibrillation as long as the sensor is not located between the defibrillator pads CAUTION Due to elevated surface temperature do not place in prolonged direct contact with the patient CAUTION Continuous impedance checking may need to be disabled if the impedance check signal interferes with other equipment To verify that you are ready to monitor BIS follow this procedure Verify BISx is securely mounted to an IV pole bedrail or clipped to a bedsheet 2 Connect the BISx communication cable in the AUX connector on the back of the monitor 18 4 Dash 3000 4000 5000 2000966 338A Monitoring Bispectral Index BIS 3 Connect BISx to an AC power source 4 Position the sensor on the patient For more information refer to the sensor packaging or t
230. splays the oldest highest priority alarming monitor Monitors without an installed wireless card and software version 5 or greater can send data to up to 40 other monitors or ne Limitations twork devices CAUTION ALARM NOTIFICATION A maximum of four monitors can be displayed in the message line at one time even if more than four monitors are alarming Because of this limitation automatic view on alarm should not be used in place of a central station The following conditions prevent an alarming monitor from automatically displaying on another monitor m If any of the following menus are active CHANGE ADMIT INFO or UNITS OF MEASURE Any automatic view on alarm configuration m If any of the following information windows are open Any LEARN THE MONITOR ECG SOURCE COMBO UNIT NAME BED NUMBER and CONFIRM BED NUMBER ROVER ALL LIMITS ARRHYTHMIA ALARM LEVEL PARAMETER ALARM LEVEL or any parameter alarm limit 2000966 338A Dash 3000 4000 5000 5 7 Managing Patients Custom Defaults SELECT A BED TO VIEW SELECT A BED TO AUTOVIEW SELECT A CARE UNIT m If any of the following functions are being performed or updated NOTE PA WEDGE PA INSERT WEDGE CARDIAC OUTPUT CARDIAC CALCS PULMONARY CALCS DOSE CALCS If an alarming monitor is blocked text alarm messages are still available and you can manually access the alarm event All
231. ss firmly on each sensor electrode for five seconds If the impedance check fails reposition or replace the sensor PIC cable or BISx SENSOR CHECK IN PROGRESS SENSOR ERROR A self test is in progress Sensor failure This is a normal procedure message Replace the sensor SERVICE BIS Hardware failure Contact service SIM CONNECTED A BIS demonstration device is connected to the patient interface cable This is a normal procedure message SQI BELOW 50 The signal quality is low SQI TOO LOW The signal quality is low The system is unable to attain high quality EEG signal Run sensor self test to confirm sensor impedances are in range If not re prep or replace the sensor or the PIC cable 2000966 338A Dash 3000 4000 5000 Monitoring Bispectral Index BIS 18 10 Dash 3000 4000 5000 2000966 338A A Maintenance 2000966 338A Dash 3000 4000 5000 Maintenance Overview Biocompatibility When used as intended the parts of the product described in this operator s manual including accessories that come in contact with the patient during the intended use fulfill the biocompatibility requirements of the applicable standards If you have questions about this matter please contact GE or its representatives Inspection An effective maintenance schedule should be established for your monitoring equipment and reusable supp
232. t 155 kg 341 165 Aortic balloon pump insertion Patient movement including shivering Signal interference caused by cable and or power cord Open chest surgery in which the normal patterns of blood flow or electrical current flow of the thorax are altered CAUTION Hemodynamic parameter calculations are dependent on accurate patient height weight sex and age values Ensure that these values have been properly entered To verify that you are ready to monitor ICG follow this procedure Install the ICG module into the TRAM RAC 2A module housing You will hear a click when the module is fully inserted 17 4 Dash 3000 4000 5000 2000966 338A Monitoring Impedance Cardiography ICG Control Settings S 11 12 13 14 Connect one end of the TRAM NET communication cable into the Auto or TRAM NET port on the back of the module housing Connect the other end of the communication cable into the Aux port on the back of the monitor Turn on the power switch on the back of the module housing Turn on the monitor Verify the status light on the front of the module illuminates green Position the sensors on the patient Connect the ICG cable to the sensors Connect the ICG cable to the module Admit the patient to the monitor Enter the required patient information Verify that patient data displays in the CG parameter window Verify that a good quality waveform displays A
233. t MORE MENUS gt MONITOR SETUP gt MONITOR DEFAULTS gt SETUP DEFAULT DISPLAY 2 Locate and select ECG INTELLIRATE 3 Select ON or OFF 2000966 338A Dash 3000 4000 5000 8 17 Monitoring ECG AFIB Alarm Level To adjust the AFIB arrhythmia patient status alarm level follow this procedure When this option is enabled the factory default alarm level setting is MESSAGE 1 Select MORE MENUS gt MONITOR SETUP gt MONITOR DEFAULTS gt SETUP DEFAULT ARRHYTHMIA ALARM LEVELS 2 Locate and select ATRIAL FIB 3 Select the patient status alarm level Performing ST Analysis Overview ST analysis begins at the end of the QRS complex and ends with the onset of the T wave The point at which the QRS complex meets the ST segment is referred to as the J point The ST numeric that displays in the ECG parameter window indicates the greatest positive or negative deviation from the isoelectric reference I point Numerics update every two seconds If ST is the second priority parameter ECG is the first the ST values display in three groups m Anterior ANT to V4 m Inferior INF Lead II III and AVF m Lateral LAT Lead I AVL V5 and V6 The default ST display shows three 30 minute ST trends and three ECG complexes for leads I II and V To change the display default settings refer to Control Settings on page 8 11 m ST trends Displays 30 minute real time trends for each lead When in
234. t curve displays within a few seconds of the injection and the message COMPUTING CO displays When the message COMPLETE displays the CARDIAC OUTPUT information window is populated with the relevant values for this trial and the values update in the CO parameter window Perform another injection when prompted up to four The average value displays in the information window and parameter window To print the displayed waveform and information window select PRINT CO CURVE NOTE The washout curve cannot be printed during calculation You can print the CO curve once when calculation is complete To save this trial average select CARDIAC CALCS The CARDIAC CALCULATIONS information window displays 12 6 Dash 3000 4000 5000 2000966 338A Measuring Cardiac Output Troubleshooting 10 For information on adjusting the displayed calculation refer to Cardiac Calculations on page 7 10 11 Select SAVE CALC 12 To view the saved calculation select REVIEW CALCS to display the calculation in the VITAL SIGNS information window For clinical level troubleshooting refer to the GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide Message Cause Solution CO COMPLETE COMPUTING CO The cardiac output waveform has been The numeric value of the cardiac output has been calculated and displayed on the screen displayed and the monitor is preparing for numeric results
235. t to the monitor PERFORMING ANALYSIS PLEASE WAIT The monitor is analyzing the ECG data This is a normal procedure message LEADS FAIL LA FAIL Reapply electrode using electrode LL FAIL Poor electrode signal quality manufacturer s application recommendations RA FAIL V FAIL ARR OFF Arrhythmia detection is turned off This is a normal procedure message V2 V6 FAIL Five ofthe 10 leadwires were removed Clear the message by selecting the ECG parameter label gt CLEAR V2 V6 FAIL DISCHARGED The monitor is in a discharged state Admit a patient to the monitor LEARNING The monitor is learning a new ECG pattern This is a normal procedure message 2000966 338A Dash 3000 4000 5000 8 23 Monitoring ECG 8 24 Dash 3000 4000 5000 2000966 338A 9 Monitoring Invasive Pressures 2000966 338A Dash 3000 4000 5000 Monitoring Invasive Pressures Introduction Overview Detailed operating procedures are given for the CVP pressure site Other pressure sites function essentially the same except for the PA pressure site which may include the optional PA Wedge feature Invasive blood pressure monitoring uses a transducer to convert the pressure variations into electrical signals The electrical signals are amplified and displayed as numeric pressure values and waveforms A pressure parameter window and labeled waveform display when a patient cable is
236. ted WARNING The MAXIMUM filter alters displayed ECG morphology Do not rely on ECG morphology for diagnostic purposes when this filter is selected NOTE MODERATE and MAXIMUM filters are not recommended for pacemaker patients 8 12 Dash 3000 4000 5000 2000966 338A Monitoring ECG Option Function LD ANALYSIS Select one of the following for ECG and arrhythmia processing m SINGLE LEAD Uses the top trace position lead Recommended for adults using an external temporary pacemaker with a Zoll interface cable or for troubleshooting pacemaker or arrhythmia detection NOTE ECG is relearned when the lead changes m MULTI LEAD Uses leads Il Ill and V lead to eliminate false alarms and improve the ability to Detect beats which occur isoelectric to a single chest lead Discriminate artifact that appears in one lead compared to the other lead vectors Allow failed leads to automatically switch to another lead Continue arrhythmia processing after a lead change ARRHYTHMIA Select the level of EK Pro arrhythmia detection and relearns the patient s ECG pattern m FULL CARDIAC software package only detects and identifies all types of arrhythmia m LETHAL Detects and identifies only lethal arrhythmia m OFF Does not detect or identify arrhythmia NOTE You cannot select an arrhythmia level lower than the MIN ARRHYTH LEVEL monitor default CLEAR V2 V6 FAIL Clear the
237. ter the EMG activity No bars display when EMG values are less than 30 dB Seven bars display when the EMG values are 55 dB For clinical level troubleshooting refer to the GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide 18 8 Dash 3000 4000 5000 2000966 338A Monitoring Bispectral Index BIS Message Cause Solution CHECK SENSOR RESET BIS Sensor failure Reposition or replace the sensor PIC cable or BISx CHECK BIS RESET BIS Hardware failure Reconnect BIS x COMM ERROR Communication failure Reinstall BIS x CONNECT SENSOR Connection or communication failure Reposition or replace the sensor PIC cable or BISx BIS FAILURE Over current electrical condition Contact service BIS TEST IN PROGRESS A self test is in progress This is a normal procedure message EXPIRED SENSOR The current time and date exceeds the recommended usage date of the sensor Select Resume BIS to initiate a sensor check If the sensor check passes BIS monitoring will begin Then Re prep or replace the sensor PIC cable or BIS x INCOMPATIBLE SENSOR The sensor is not compatible Reconnect or replace the sensor PIC cable or BISx BIS ERROR Hardware failure Contact service PATIENT ISOELECTRIC No EEG activity detected for several minutes Check the patient and sensor REPREP SENSOR Sensor impedance status failure Pre
238. the electrodes to the patient If using a 5 or 10 leadwire patient cable verify the V lead labels are correct Connect the patient cable to the ECG patient connector on the monitor Verify that patient data displays in the ECG parameter window Verify the ECG baseline is stable and the waveforms are noise free 8 10 Dash 3000 4000 5000 2000966 338A Monitoring ECG 8 Print atest graph strip 9 Adjust the control settings as necessary Control Settings To adjust the control settings for the patient admitted to the monitor select the ECG parameter window label Then select any of the following options and make the desired changes NOTE All changes are temporary and revert to the factory or custom defaults when the patient is discharged To permanently change the these settings refer to Defining Custom Defaults on page 3 7 Option Function DISPLAY Select the primary top trace lead The V lead choice is determined by the V lead identified in the ST menu ECG SIZE Select the waveform size m 1X Recommended for standard monitoring m 2 4 Recommended for low amplitude QRS waveforms However this lowers the QRS detection threshold and baseline artifact may be detected as a QRS DETECT PACE Turn pacemaker detection on or off ECG LIMITS VIEW ALL ECG Select the alarm limits for heart rate and PVCs NOTE PVC Limit is available in the CARDIAC software
239. the mobility of ROVER mode and the telemetry compatibility of COMBO mode To determine the mode running on a monitor select MORE MENUS MONITOR SETUP SOFTWARE CONFIGURATION The monitoring mode is listed under ADMIT MENU TYPE There are three patient monitor types The patient monitor type controls the monitor defaults and monitor settings It is defined during installation via the password protected SERVICE MODE menu m ADULT ICU m NEONATAL ICU m OPERATING ROOM To determine the patient monitor type running on a monitor select MORE MENUS MONITOR SETUP SOFTWARE CONFIGURATION The patient monitor type is listed under PATTENT MONITOR TYPE For more information on the monitor default settings for each patient monitor type refer to Factory Defaults on page C 1 The monitor language is set to one of 14 options when installed In most cases the language does not affect the monitor functionality or usability However in a few languages you may experience the following conditions m HUNGARIAN POLISH and RUSSIAN Special characters may appear as blanks asterisks or square boxes due to the inability to display Cyrillic Russian characters as well as certain Polish and Hungarian characters m CHINESE and JAPANESE All text for alarm broadcast sent over the network is in English All text input for example unit name bed name patient information etc is also in English 3 4 Dash 3000 4000 5000 2000966
240. the sample line to the patient Troubleshooting For clinical level troubleshooting refer to the GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide NOTE Sidestream setup messages only display on the monitor not at the central station Message Cause Solution CHECK SAMPLE LINE The sample line is blocked loose or not connected Connect or replace the sample line CALIBRATE SAMPLE LINE CAL SENSOR TO ZERO CELL The sample line is not calibrated The sensor is not calibrated Calibrate the sample line Calibrate the sensor CANNOT CALIBRATE The calibration process failed Calibrate the sensor again CHECK ADAPTER ADAPTER CAL The adapter is not calibrated Calibrate the adapter INCOMPATIBLE SENSOR The sensor is not compatible with the monitor Replace the sensor NO BREATH DETECTED The sensor is not connected to the patient Check the patient and sensor placement NOT CALIBRATED The sensor signal is out of tolerance Calibrate or replace the sensor SERVICE CO2 MODULE The module failed Contact service SERVICE C02 MODULE TMP SERVICE CO2 SENSOR SERVICE C02 SENSOR SENSOR TEMP The CO module is overheated The CO sensor failed The CO sensor is overheated Replace module or contact service Replace sensor Replace sensor or contact service WARMING UP The sensor is warming up If t
241. ther or to parts of the system when it has been determined by qualified biomedical engineering personnel that there is no danger to the patient the operator or the environment as a result In those instances where there is any element of doubt concerning the safety of connected devices the user must contact the manufacturers concerned or other informed experts for proper use In all cases safe and proper operation should be verified with the applicable manufacturer s instructions for use and system standard EN 60601 1 1 must be complied with WARNING Before using the monitor for the first time please read the Safety Statements on page 1 2 2000966 338A Dash 3000 4000 5000 1 5 Introduction WARNING INTRACARDIAC APPLICATION When applying devices intracardially electrically conductive contact with parts connected to the heart pressure transducers metal tube connections and stopcocks guide wires etc must be avoided in all cases To prevent electrical contact we recommend the following Always wear isolating rubber gloves Keep parts that are conductively connected to the heart isolated from the ground m Do not use tube fittings or stopcocks made of metal During intracardiac application of a device a defibrillator and pacemaker whose proper functioning has been verified must be kept at hand WARNING LEAKAGE CURRENT TEST When interfacing with other equipment a
242. these settings refer to Defining Custom Defaults on page 3 7 Ohmeda Nellcor and Masimo The following settings control pulse oximetry monitoring for all configuration options Option Function SIZE Select the size of the displayed waveform NOTE When using Nellcor Sat Seconds select 1X RATE Turn the feature on or off to display pulse rate values in the parameter window RATE VOL Select the volume of the pulse rate tone to sound when an 5 0 pulse is detected This is a variable pitch tone The tone pitch decreases as the patient s saturation level decreases The lower the setting the quieter the tone NOTE Turning the pulse tone volume off also automatically turns off the ECG QRS volume 5 02 LIMITS Select the high and low alarm limits for 5 pO percentage and pulse rate beats per minute An alarm sounds when a value occurs outside of these limits SPEED Select a sweep speed for the displayed waveform 11 10 Dash 3000 4000 5000 2000966 338A Monitoring 5 02 Ohmeda and Masimo The following settings control pulse oximetry monitoring for the Ohmeda and Masimo configuration options Option Function PERSISTENT Turn the feature on or off When on a PROBE IS OFF THE PATIENT system status WARNING displays in the 5 0 parameter window when the patient cable is disconnected The parameter window and waveform still display Ne
243. third WAVEFORM 4 Selecta lead and its associated waveform to print fourth GRAPH LOCATION PRINT LOCATION Select the writer or printer for the following m Manual printing m Automatic printing on alarm m Specific patient date parameter or calculation information printing ALARM GRAPH PRINT ON ALARM Select whether alarms print automatically SPEED Select the print speed The slower the speed more condensed the data NOTE Alarms print at 25 mm sec Laser printers do not support 0 1 mm sec print speed TIMED GRAPH TIMED PRINT Selectthe amount of time to print for each manual print job NOTE Arrhythmia alarms run until a normal sinus rhythm is detected or the print job is manually stopped All other alarms run for 20 seconds or until the print job is manually stopped GRAPH BP INVASIVE PRINT BP INVASIVE Selectthe blood pressure waveforms When selected BP waveforms are the only parameters that can be printed They print on one scale on the full grid space NOTE You cannot switch BP selections while a print job is in progress To selecta different BP you must stop the current job If a different parameter is printing the BP print job is ignored Printed Output All waveforms begin with 10 seconds of delayed data The header information printed with the waveforms is real time data Print output contains the following basic information in the header 2000966 338A Dash
244. thmia Alarm Levels Crisis Warning Advisory Message ASYSTOLE VFIBVTAC V TACH VT gt 2 V BRADY COUPLET BIGEMINY ACC VENT PAUSE TRIGEMINY RONT PVC TACHY BRADY IRREGULAR ATRIAL FIB D 2 Dash 3000 4000 5000 2000966 338A Custom Defaults Parameter Alarm Levels Crisis Warning Advisory Message HR 02 BREATH PVC MIN ST ART PA C02 NBP FEM UAC GAS CVP RA UVC LA ICP SP SV02 TC 5 02 ART RATE BT ICG RR RESP APNEA 2000966 338A Dash 3000 4000 5000 D 3 Custom Defaults Parameter Limits FEM RATE UAC RATE SPO2RATE TMP HR PVC MIN ST I ST Il ST III ST V1 ST AVL ST AVF ST AVR ST V2 ST V3 ST V4 ST V5 ST V6 NBP S NBP D NBP M ART S ART D ART M D 4 Dash 3000 4000 5000 2000966 338A Custom Defaults ART R FEM S FEM D FEM M FEM R UAC S UAC D UAC M UAC R PA S PA D PA M CVP RA UVC LA ICP SP 02 CO2 INSP CO2 RESP NO BREATH 5 02 SPO2 R BT RR
245. tion Admit Overview Standard Admit Managing patients includes the following tasks m Admitting patients to the monitor m Discharging patients from the monitor m Viewing other patients You can admit a patient to the monitor from the bedside or a central station There are three ways to admit a patient to the monitor from the bedside The information required to admit patients to the monitor varies by the monitoring mode and patient monitor type To manually admit a patient to the monitor follow this procedure 1 Select MORE MENUS gt ADMIT MENU 2 Usethe Trim Knob control to select the following patient information LAST NAME Select the patient s last name up to 16 characters FIRST NAME Select the patient s first name up to 10 characters PATIENT ID Selecta patient identification number up to 13 characters for a MUSE Lab Access Server The default is 9999999999999 SEX Select male or female BIRTH DATE Selectthe patient s birth date to automatically calculate the age from today s date and year If a birth date is not entered the default is 1948 AGE Age is calculated in years for adults months weeks and days for neonates HEIGHT Select the patient s height 5 2 Dash 3000 4000 5000 2000966 338A Managing Patients Quick Admit Automatic Admit Control Settings WEIGHT Select the patient s weight RACE Select the appropriate race
246. tion 0 11 3 MiaSIMO A asi ith doa ee anon pra av r da ib dg B 11 3 deo donee S big chu nee 114 Olhimedaz audeas tet ec o e Gee o ed 11 5 Additional Information 0 0 0 0 ccc eem 11 6 Dash 3000 4000 5000 V vi 12 13 14 Safety sat oet md ra at pt esp t p or VERE E FE 11 7 Generalis dme MS UOTA 11 7 Neonates and infants a x ecc t e a ae d m ades 11 9 0 2 11 9 Control Settings 2 11 10 Nellcor 395 Pulse 11 13 Corinecting i u scribe kw del l s kayan GAB MET 11 13 201961115 OEC E UR CER tS E P CARE RR 11 15 Troubleshooting isse 11 16 Measuring Cardiac 12 1 12 2 een ib 12 2 Additional Informations i de k na hu l k rered akan B l a dn 12 2 MeasUurilid icici anka Ha ea aya aya oe CREE KO ra RR xar 12 3 Control 05 a an i 12 3 Performing the CO Procedure 12 5 Trot ble hOOtlU i so yay su ya alaya a a ke K Wa nay ya a r 12 7 Monit
247. tion meeting the following height and weight criteria m Patient heights between 120 230 cm 48 90 in m Patient weights between 30 155 kg 67 341 Ibs WARNING The ICG module and its components are not designed sold or intended for use except as described in this document WARNING Use only GE approved ICG module accessories WARNING ICG sensors are intended for skin application only and are not for direct cardiac application WARNING The conductive gel of the ICG sensors should not contact any other conductive materials during patient monitoring 2000966 338A Dash 3000 4000 5000 17 3 Monitoring Impedance Cardiography ICG Monitoring WARNING ICG sensors are specified for single patient use WARNING The patient cables specified and included with the ICG module are specifically designed for protection against the effects of cardiac defibrillators and radio surgery equipment CAUTION Impedance cardiography is a theoretical model of blood flow and is subject to inaccuracies in cases where the model does not fit an individual patient s clinical profile Conditions which may impede the accuracy of the ICG data are as follows Septic shock Aortic valve regurgitation Severe hypertension MAP gt 130 mmHg Patient heights lt 120 cm 48 in or gt 230 cm 90 in Patient weights lt 30 kg 67 lbs or g
248. tral station does not display the SpO parameter block The monitor displays the S pO rate and the oxygen saturation level 5 0 parameter menu The monitor does not display 5 0 parameter menu or selectable menu options SpO waveform display The monitor does not display an external S pO parameter waveform Secondary monitoring parameter The monitor does not allow the external S pO parameter to be the primary monitoring parameter Secondary parameter display priority The monitor does not allow the external 5 0 parameter to have a higher display priority than the internal 500 parameter As a result the monitor displays the internal primary SpO parameter before an external secondary SpO parameter For clinical level troubleshooting refer to the GE Critical Care Monitoring Clinical Reference and Troubleshooting Guide 11 16 Dash 3000 4000 5000 2000966 338A Monitoring 5 02 Message Cause Solution SPO2 PULSE SEARCH Searching for a valid pulse for the purpose of computing saturation when a valid sensor is connected PROBE IS OFF THE PATIENT No data is displayed because the sensor is unplugged invalid or no longer on the patient Check the patient and sensor LOW QUALITY SIGNAL Data is displayed but signal quality is questionable POOR SIGNAL QUALITY DETECTED No data displayed due to low patient pulse patient motion or other interferen
249. two way radios and consider them when installing a medical device or system Be aware that adding accessories or components or modifying the medical device or system may degrade the EMI performance Consult with qualified personnel regarding changes to the system configuration Radio and Telecommunication Terminal Equipment Directive The monitor contains a transmitter The transmitter bears a CE mark indicating conformity with the essential requirements specified in Article 3 of the Council Directive 1999 5 EC of 9 March 1999 concerning Radio Equipment and Telecommunications Terminal Equipment R amp TTE The essential requirements are as follows Article 3 1 a Health Safety the product complies with the particular medical device safety standards specified in the Medical Device Directive 93 42 EEC EN 60601 1 1990 A1 1993 A2 1995 Medical electrical equipment General requirements for safety Article 3 1 b EMC the product complies with 2000966 338A Dash 3000 4000 5000 CE 1 CE Marking Information General Information EN 60601 1 2 2001 Medical electrical equipment Part 1 General requirements for safety 2 Collateral standard Electromagnetic compatibility requirements and test ETS 300 826 1997 Electromagnetic compatibility and Radio spectrum Matters ERM ElectroMagnetic Compatibility EMC standard for 2 4 GHz wideband transmission systems and HIgh PErformance Radio Local Area Network HIPER
250. ug use indications m WEIGHT m SOL VOLUME solution volume m DRUG QTY drug quantity Calculated the dose based on concentration from solution volume dose and rate If entered in milligrams the DOSE KG MIN is in micrograms m DOSE MIN DOSE HR OR DOSE KG MIN Calculated from volume quantity and rate m INF RATE Infusion rate How long the bag takes to infuse cc hr m DRIP RATE When administrating medication with a pump that counts drops and the pump s drop size is NOT 60 gtt cc m DROP SIZE m INF TIME infusion time Calculated from volume quantity and rate SAVE CALC Save all complete calculations displayed on the screen You can save up to four calculations You cannot save incomplete calculations If you modify an existing calculation for a specific drug name the new calculation over writes the old calculation RECALL SAVED CALC DELETE CALC Display all saved calculations by drug name Delete the selected calculation TITRATION TABLE Display the titration table for the selected calculation WEIGHT Select the correct patient weight DRUG UNITS Select the correct dosage unit for each of the generic drug DRUG QTY RANGE Select the correct dosage quantity range for each of the generic drug names you are using RESUSCITATION MEDICATIONS When in the NEONATAL ICU patient monitor type select the concentration and dose for resuscitation medicatio
251. ure C celsius F 2 Dash 3000 4000 5000 2000966 338A Abbreviations and Symbols Cal calibrate Calc calcs calculation s Cc Cubic centimeter CC computation constant CCO continuous cardiac output CD compact disc CI cardiac index CIC Clinical Information Center cm centimeter CO cardiac output CO carbon monoxide C0 carbon dioxide comm communication CP cardiopulmonary CPP cerebral perfusion pressure CRG cardiorespirogram CSA Canadian Standards Association CVP central venous pressure D D diastolic DDW direct digital writer DES desflurane DIDCA direct interface device connection adapter DSC digital signal converter E E expired e g for example 2000966 338A Dash 3000 4000 5000 F 3 Abbreviations and Symbols ECG 0021 ESU et al etc ETO EXP FEM gHz gtt HAL Hb HR Hz IABP electrocardiograph estimated delivered oxygen index electroencephalograph electromagnetic compatibility electromagnetic interference enflurane electrosurgical cautery unit and others end tidal carbon dioxide etcetera ethylene oxide expired Fahrenheit femoral gram gigahertz drops halothane hemoglobin heart rate hertz inspired intra aortic balloon pump F 4 Dash 3000 4000 5000 2000966 338A Abbreviations and Symbols Inject INSP kg LA LA LAN LAT LBS impedance cardiography intracranial pressure intensive care unit i
252. vels The following are the arrhythmia alarm level factory defaults To access these options select MORE MENUS gt MONITOR SETUP gt MONITOR DEFAULTS gt SETUP DEFAULT ARRHYTHMIA ALARM LEVELS ADULTICU NEONATAL ICU OPERATING ASYSTOLE VFIB VTAC V TACH VT gt 2 V BRADY CRISIS CRISIS COUPLET BIGEMINY ACC VENT PAUSE TRIGEMINY RONT PVC TACHY BRADY IRREGULAR ATRIAL FIB MESSAGE ADVISORY CRISIS Parameter Alarm Levels The following are the parameter alarm level factory defaults To access these options select MORE MENUS gt MONITOR SETUP gt MONITOR DEFAULTS gt SETUP DEFAULT PARAMETER ALARM LEVELS Dash 3000 4000 5000 2000966 338A Factory Defaults ADULTICU NEONATAL ICU OPERATING ROOM HR C02 NO BREATH WARNING VENT WARNING ADVISORY PVC MIN ST ART PA C02 NBP FEM UAC GAS CVP RA UVC LA ICP SP 5 02 TC spo ADVISORY ADVISORY ADVISORY 2000966 338A Dash 3000 4000 5000 C 3 Factory Defaults ADULTICU NEONATAL ICU OPERATING ART RATE BT ICG RR RESP APNEA CRISIS FEM RATE MESSAGE MESSAGE UAC RATE CCO SPO2 RATE TMP ICG MESSAGE MESSAGE
253. ware Overview Front 1 Alarm light indicator Provides a visual alarm for patient status alarms 2 Control panel Provides quick function keys and the Trim Knob control to navigate menus and select options 2 2 Dash 3000 4000 5000 2000966 338A Equipment Overview Right 4000 1 Patient connectors Allows patient cables to connectto the monitor 2 Enabled option labels Identifies the options enabled on the monitor NOTE All patient connectors with the applied part symbol CE i are high insulation ports and defibrillator proof to ensure patient safety and protect the device during defibrillation and electrosurgery 2000966 338A Dash 3000 4000 5000 2 3 Equipment Overview Left 1 2 Built in writer Prints on two inch wide paper Battery doors Holds up to two batteries to provide power during patient transport or whenever AC power is interrupted For more information refer to Batteries on page A 6 2 4 Dash 3000 4000 5000 2000966 338A Equipment Overview Back 10 1 Line voltage selector Matches the line voltage and frequency rating for your country 2 Product code label Identifies the product code for this monitor for identification and service needs 3 Equipotential stud Provides a common reference to an auxiliary d
254. y monitored parameter displays on the right side and bottom of the screen Where and how each parameter window displays depends on the priority set in MONITOR DEFAULTS For more information refer to Defining Parameter Window Priority on page 3 12 1136 2m RATE TO 4 mmHg 4 518A Parameter Window 2000966 338A Dash 3000 4000 5000 2 17 Equipment Overview 1 Digital values 2 Parameter window label 3 Alarm limits 4 Units of measurement An information window is a large popup window that displays over most of the screen It contains help and other non real time information Up to six parameter windows and the last two seconds of real time waveforms remain visible 25 FEB 1999 13 10 25 FEB 25 FEB 25 FEB 25 FEB 12 15 12 30 12 45 13 00 68 68 70 94 ap duct d 33 15 23 TS SPQ2 kkk RANAY ep 1091 RU o asa 3 CO 6 3L 1525 6 1 20 VIEW NEWER 15 MINS he INTERVALI SPECIFIC TIME SORT DATA PREVIOUS MENU UP ALL DATA Information Window 522D 2 18 Dash 3000 4000 5000 2000966 338A 3 Monitor Setup 2000966 338A Dash 3000 4000 5000 Monitor Setup Getting Started The main display has one menu option MORE MENUS The following menu opti
255. ystem alarm will sound The alarm is ADVISORY in OPERATING ROOM patient monitor type and a WARNING in ADULT ICU and NEONATAL ICU patient monitor types You can change the alarm levels For more information refer to Alarms on page 4 1 Options AFIB Arrhythmia Detection NOTE This option is only available in the CARDIAC software package in software versions 3B or later and for the ADULT ICU and OPERATING ROOM patient monitor types The AFIB atrial fibrillation identification option uses an algorithm to identify atrial fibrillation arrhythmias AFIB arrhythmias are characterized by random chaotic low amplitude deflections of the supraventricular component of the ECG waveform This results in irregular timing of QRS complexes and the absence of uniform P waves preceding the QRS complex When an AFIB arrhythmia is detected a patient status alarm is triggered An ATRIAL FIB message displays in the message line on both the monitor and the central station AFIB arrhythmia alarms can take up to 90 seconds to display while the algorithm verifies the event When set for an alarm level of ADVISORY or greater all AFIB alarms are displayed on the monitor in the ALARM parameter window and recorded in the ALARM HISTORY VITAL SIGNS and GRAPHIC TRENDS information windows To determine if AFIB is enabled on this monitor select MORE MENUS MONITOR SETUP SOFTWARE CONFIGURATION If it is enabled ATRIAL FIB is listed under the ENABLED SOFTWAR

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