Home

GE Dash 2000 - User manual

1. Parameter Low Limits High Limits Min Max Min Max HR 1 299 0 300 NBP S 99 349 98 350 NBP D 99 349 98 350 NBP M 99 349 98 350 ART S 99 349 98 350 ART D 99 349 98 350 ART M 99 349 98 350 ART R 1 299 0 300 FEM S 99 349 98 350 FEM D 99 349 98 350 FEM M 99 349 98 350 FEM R 1 299 0 300 UAC S 99 349 98 350 UAC D 99 349 98 350 UAC M 99 349 98 350 UAC R 1 299 0 300 PA S 99 349 98 350 PA D 99 349 98 350 PA M 99 349 98 350 CVP 99 349 98 350 RA 99 349 98 350 UVC 99 349 98 350 LA 99 349 98 350 ICP 99 349 98 350 SP 99 349 98 350 SpO2 0 104 1 105 SpO2 R 1 299 0 300 RR 1 199 2 200 RR Apnea ICU 3 ICU 30 OR 3 OR 30 NEO 3 NEO 20 TP 1 0 C 32 2 F 46 9 C 116 5 F 0 9 C 30 3 F 47 0 C 116 6 F Revision B Dash 2000 Patient Monitor 227 499 06 US E 14 23 APPENDICES Technical Specifications Technical Specifications Display Controls Processing Alarms ECG 14 24 Size Type Monochrome Color Resolution Number of traces Number of seconds trace Sweep speed All waveforms Waveform display Information window Display organization Standard Main processor Data acquisition processor Program storage Data storage Classification Notification Setting Silencing Volume Location Visual color modulation Standard leads available Leads analyzed simultaneously Lead
2. Dash 2000 Patient Monitor Revision B 227 499 06 US E NBP NBP Menu Options NBP Limits This option provides an information window that shows the alarm limits for systolic diastolic and mean pressures A new set of menu options is displayed to allow you to adjust these limits Follow this procedure 1 Select NBP LIMITS from theNBP Menu An information window is displayed on the screen and a new set of menu options is displayed in the menu area 21 NOV 1998 16 27 DAK BED 1 NBP LIMITS NBP S mmHg 20 NBP D mmHg 20 NBP M mmHg 40 NBP LIMITS Menu and Information Window 2 Rotate the Trim Knob control to move the pointer gt through the list 3 Pressthe Trim K nob control when the pointer is in front of the parameter for which you want to change default limits The parameter label highlights 4 TurntheTrim K nob control to highlight the low or high limit Press the Trim K nob control again and rotate to change value Press the Trim Knob control to complete the change 6 Rotatethe Trim K nob control to highlight the parameter label and press to unhighlight 7 Select RETURN when all changes are completed The popup menu and information window close Revision B Dash 2000 Patient Monitor 10 9 227 499 06 US E NBP NBP Menu Options Cuff Size This option programs the monitor for the appropriate inflation pressure The cuff size setting is based on the patient s age There are three choices Adult Pediatric
3. RevisionB 227 499 06 US E 1 THE BASICS le Te EE 1 2 The Monitoring Gvstem nn corn nnnnnnnnanns 1 2 Dash 2000 Monitor oconoccccnnncnonanonononininonananano conc n cnc nn nana nono nn cnn nano 1 2 Optional Centralscope Central Station rennen 1 4 Optional Clinical Information Center 1 5 Optional Laser Printer sess 1 6 Operation ie e ieai aa ia eii eas 1 7 EE NEEN 1 7 Trim Knob Control eee nennen 1 8 Control Keys une Pe ie el 1 9 Turning Power Onw E 1 11 AG ROWED o iei eio SEA n da pur dia d ER 1 11 Battery POW E 1 12 Power Indicator Lights ccccececseeeeeeceeeceeeeeeeeeeeeeeeeeeeeteeeeeees 1 13 Battery Conditioning cocccnconccnnnnnnonnnanncannccnn crac 1 14 Battery ii a E T S 1 15 Battery Service Information Window essessss 1 16 Soft War eT e lg 1 17 U RS aUe DEDERE 1 17 Popup Menus ii riti di 1 19 Subordinate Menus eene 1 20 Direct Action Menu OptiONS occoccccocococcnonaconanonanana nano nanonnnccnnns 1 21 Parameter Windows 1 22 Information Windows 1 23 Trim Knob Control Operation When Setting Alarm Limits 1 24 Graphing Printing ssc oe reencuentro 1 25 Ree 1 25 Manual Graphs eet re e be ed 1 25 Pressure Scales nn ed A 1 26 Graphing Messages eene nennen cnn nnne 1 26 Graph Header ie 1 26 Putting the Monitor Into Operation 1 27 Monitor Installation and Conpeclon 1 27 Performance Cheka iii exer ere sinat Pr
4. ALARM CONTROL Alarm Control Menu Alarm Volume To adjust the volume of the alarm tones follow this procedure 1 Select ALARM VOL option from the Alarm Control Menu 2 A popup menu opens displaying all choices ALARM VOL ALARM VOL Popup Menu 3 Rotatethe Trim Knob control to change the selection Each time the control is rotated you hear a tone at that volume ALARM VOL OFF message is displayed at the top of the screen if OFF is selected NOTE When in Neonatal I CU mode alarm volume cannot be turned off The lowest it can be set is 30 4 When you are satisfied with the volume level press the Trim Knob control to close the popup menu Any change made with this menu option is only temporary and will revert to default upon discharge 4 10 Dash 2000 Patient Monitor Revision B 227 499 06 US E ALARM CONTROL Alarm Control Menu Parameter Alarm Parameter alarms are assigned to one of the four patient status alarm categories The PARAMETER ALARM LEVEL option allows you to view and reassign parameter alarms to other levels NOTE Theheart rate limit alarm level cannot be set to the MESSAGE level in Neonatal ICU mode If you want to move a parameter alarm to another level use the PARAM ALARM LEVEL option and follow the same procedure as described for arrhythmia alarm levels Any changes made with this menu option are temporary and will revert to defaults upon discharge DAK BED 1 PARAMETER ALARM LEVELS
5. The parameters listed are only those currently being monitored WARNING ADVISORY ADVISORY ADVISORY MESSAGE MESSAGE MESSAGE PARAMETER ALARM LEVELS Popup Menu and Level 21 NOV 1998 RR APNEA SPO2 RATE Revision B Dash 2000 Patient Monitor Information Window 227 499 06 US E ALARM CONTROL Alarm Control Menu Arrhythmia Alarm Thearrhythmia calls recognized by the monitor are assigned to one of the L l four patient status alarm categories The ARRHYTHMIA ALARM LEVEL eve options allow you to view and reassign parameter alarms to other levels Follow this procedure to display a list of the arrhythmia calls and the alarm level to which each is assigned 1 Select ARRHYTH ALARM LEVEL option from the ALARM CONTROL Menu 2 Aninformation window is displayed on the screen and a popup menu is displayed in the menu area 21 NOV 1998 16 27 DAK BED 1 Aden p de de ARRHYTHMIA ALARM LEVELS gt RETURN ASYSTOLE CRISIS VFIB VTAC CRISIS V TACH CRISIS BRADY CRISIS ARRHYTHMIA ALARM LEVELS Popup Menu amp NRT The information window shows a list of the arrhythmia calls on the left with their corresponding alarm level to the right NOTE V TACH is only found in the Adult mode and Operating Room mode menu BRADY is only found in the Neonatal mode menu 4 12 Dash 2000 Patient Monitor Revision B 227 499 06 US E Revision B ALARM CONTROL Alarm Control Menu If you want to move a call to another level fol
6. 5 mV from dc to 30 Hz Revision B Pulse Oximetry SpO2 Non invasive Blood Pressure NBP Revision B APPENDICES Technical Specifications Accuracy Alarms Parameters monitored SpO2 range calibrated total PPR range Accuracy SpO2 PPR Alarms Measurement technique Displayed parameters Measurement modes Heart rate detection Total cycle time Automatic cycle times Auto zero Tubing length Adult Neonatal Automatic cuff deflation Cuff sizes Disposable Reusable Alarms Dash 2000 Patient Monitor 227 499 06 US E 22 or 1 mmHg in the range of 25 mmHg to 350 mmHg whichever is greater exclusive of transducer User selectable upper and lower limits for systolic diastolic and mean pressures Arterial oxygen saturation SpO2 and peripheral pulse rate PPR 50 10096 0 10096 25 250 beats per minute 3 beats per minute Actual accuracy depends on probe Please reference manufacturer s specifications 2 70 100 SpO2 1 standard deviation 3 50 6996 SpO2 1 standard deviation 3 beats per minute User selectable upper and lower limits for SpO2 and PPR Oscillometric Systolic diastolic and mean pressures pulse rate time of last measurement Manual auto and stat 30 to 300 beats per minute 20 t0 40 seconds typical dependent on heart rate and motion artifact O to 24 hours Zero pressure reference prior to each cuff in
7. Dash 2000 Patient Monitor 227 499 06 US E 14 15 APPENDICES Factory Defaults Neonatal ICU Mode Parameter Limits Low High HR 90 200 NBP S 40 100 NBP D 20 60 NBP M 30 70 ART S 40 100 ART D 20 60 ART M 30 70 ART R 90 200 FEM S 40 100 FEM D 20 60 FEM M 30 70 FEM R 90 200 UAC S 40 100 UAC D 20 60 UAC M 30 70 UAC R 90 200 PA S 99 350 PA D 99 350 PA M 99 350 CVP 99 350 RA 99 350 UVC 99 350 LA 99 350 ICP 99 350 SP 99 350 SpO2 88 100 SpO2 R 90 200 RR 15 100 RR Apnea 15 TP 30 0 C 86 0 F 42 0 C 107 6 F 14 16 Dash 2000 Patient Monitor 227 499 06 US E Revision B APPENDICES Factory Defaults Neonatal ICU Mode Display Defaults BP Filter 12 Hz Patient Age 0 2 years QRS Width Narrow Color Format Transducer Discharge Alert Off Primary ECG I Arrhythmia On Lead Analysis Multi Lead Arterial Rate On Detect Pace Off Lead Analysis Multi Lead Graph Waveform 2 ART Graph Waveform 3 RR Alarm Graph Off Timed Graph Continuous Arterial Scale 100 PA Scale 60 CVP RA UVC Scale 30 LA Scale 30 ICP Scale 30 SP Scale 160 NBP Auto Off NBP Ouff Size Neonatal RR Parameter On RR Lead ll VOA Broadcast Off Alarm Volume 70 Silence Alarm Normal QRS Volume Off Rate
8. Pressure Menu Options Select the BP FILTER option of the SETTINGS menu to open a popup menu Use the Trim Knob control to select a 12 or 40 Hz filter CALIB TRANSDUC BP FILTER Popup Menu The 12 Hz filter is recommended for typical monitoring applications The 40 Hz filter allows higher frequency waveform components to be processed This may result in elevated pressure values The CALIB TRANSDUC option allows you to adjust the monitor for any transducer error NOTE Error is determined when pressure calibration is measured with another instrument such as a mercury manometer 1 Select CALIB TRANSDUC option from the Settings menu A new menu is displayed with two options to adjust for transducer error CALIBRATE TRANSDUCER Menu 2 Select one of the two menu options Adjusting one option automatically adjusts the other CAL 100 Open a popup menu to enter the percentage of error Usethis option when the calibration error is already known NOTE Always make sure the CAL is at 100 when making a new adjustment For example if it is known that this transducer measured 296 high rotate the Trim Knob control to 102 When you dose the popup menu the monitor will now compensate for the error Or if you apply a known pressure such as 100 and the monitor displays 102 for that pressure site adjust the CAL to the number displayed NOTE You must dose the popup menu before a change is displayed in the values window
9. The CHANGE ADMIT INFO option allows you to change or enter information pertinent to the monitored patient 1 Select CHANGE ADMIT INFO option from the Admit Info Menu The RETURN option and a pointer gt are displayed in the Admit Info information window 21 NOV 1998 16 27 DAK BED 1 de en denen MANUAL ADMIT INFORMATION RETURN gt LAST NAME FIRST NAME PATIENT ID SEX BIRTH DATE AGE HEIGHT WEIGHT CHANGE ADMIT INFO Window 2 Rotate the Trim Knob control to move the pointer gt and scroll through the list press to select an item you want to change see below 3 When all information is entered select RETURN A prompt appears giving you the option to SAVE or DO NOT SAVE CHANGES Selecting an option will close the popup and return you to the Change Admit I nfo menu Name enter up to 13 characters for each name The name at least part if not all is displayed on the monitor and central station and printed on all graph headers Patient ID enter up to 13 characters This is important information to enter if you have a MUSE system or a Solar Lab Access Server If not entered the monitor uses a default of all 9 s for MUSE storage Sex select male or female Birth Date enter the patient s birth date AGE is automatically calculated Age automatically calculated when the birth date is entered Age is calculated in years for adults and weeks days or years for neonates weeks if ages is greater than 14 day
10. Y abrasive cleaners or solvents of any kind Y ketone Y alcohol based cleaning agents or Y Betadine Dash 2000 Patient Monitor Revision B 227 499 06 US E Revision B MAINTENANCE General Cleaning To clean the display screen use a soft clean cloth dampened with a glass cleaner Never spray the glass cleaner directly onto the display and never use alcohol or hospital disinfectants like Betadine A Word About Displays The Dash monitors have a special filter for the display Specifically it s a circular polarized filter with an anti reflective coating This type of filter increases the display s contrast while it reduces glare from nearby lights If you look dosely at the display while it s turned off you might notice milky white streaks The streaks don t mean that you need to clean the display They re caused by the circular polarization effect of the filter and they re perfectly normal with this type of filter Dash 2000 Patient Monitor 7 5 227 499 06 US E MAINTENANCE Cleaning Applied Parts Cleaning Applied Parts Cables and CAUTION Leadwires Do not use acetone or ketone solvents for cleaning do not use an autoclave or steam cleaner Cables and leadwires can be cleaned with a warm damp cloth and mild soap or isopropyl alcohol wipes Refer to page 7 4 for safe deaning techniques For more intensive disinfecting near sterile Ethylene Oxide ETO is acceptable but will reduce the useful l
11. and Neonatal This can be set in Monitor Defaults A label showing your choice ADT PED NEO is displayed at the bottom of the parameter window If you need to select a different size follow this procedure 1 Select CUFF SIZE option from the NBP Menu A popup menu opens displaying the three options ADULT PEDIAT NEONATE CUFF SIZE Popup Menu 2 UsetheTrim Knob control to make your selection The change will not be in effect until the Trim Knob control is pressed and the popup menu closed 3 Pressthe Trim K nob control to close the popup menu The cuff size option determines the inflation pressure for the first Cuff Inflation Mor NNNM Pressures Adult 160 mmHg Pediatric 140 mmHg Neonatal 125 mmHg Cuff inflation thereafter is 30 mmH g adult pediatric and 20 mmHg neonatal over last systolic pressure with a maximum inflation pressure of 300 mmHg for adult 250 mmHg for pediatric and 150 mmHg for neonatal Clear NBP Reading If you want to remove the values displayed in the NBP parameter window select this option The values will be replaced with X This action also removes those values from Vital Signs history 10 10 Dash 2000 Patient Monitor Revision B 227 499 06 US E NBP Troubleshooting Troubleshooting NBP Status Messages A status message will be displayed in the NBP values window if a measurement is unable to be completed Following is an alphabetical list of the status messages wi
12. e ADJUST TO MMHG Open a popup menu to change the millimeters of mercury Dash 2000 Patient Monitor Revision B 227 499 06 US E PRESSURES Pressure Menu Options Smart BP Smart BP is a feature found in ART and FEM pressure menus NOTE The Smart BP feature is not available when the monitor is set up for Neonatal I CU mode Smart BP isan arterial femoral artifact rejection program which substantially reduces the occurrences of needless alarms by eliminating most of the alarms associated with zeroing the transducer fast flushing the system and drawing blood When Smart BP is on and the system recognizes one of these events the arterial femoral alarms are deactivated and the systolic and diastolic numerics are replaced with Xs The message ARTIFACT is displayed The mean pressure value is displayed throughout the artifact occurrence Safety Features f zeroing fast flushing or drawing blood is not accomplished within certain time frames alarms will sound When artifact is detected Smart BP begins to search for the return of a pulsatile pressure When 15 20 beats have been detected numerics are displayed and alarms are reactivated If pressure remains below 10 mmHg for more than 14 seconds the alarms will reactivate During sustained high pressure drawing blood you have a maximum of two minutes before alarms reactivate Toturn Smart BP on off select the SMART BP option from the Settings menu This feature can be se
13. e RESP LIMITS display a new menu and an information window to adjust respiration rate and apnea alarm limits e SENSITIV increase or decrease the sensitivity setting CARDIAC ARTIFACT turn the artifact alarm off and on e SIZE displays the SIZE menu with the AUTO SIZE and MANUAL SIZE options e AUTO SIZE automatically size the respiration waveform to fit in a predetermined area on the screen MANUAL SIZE manually increase or decrease the size of the respiration waveform Detailed information on each option is found in this chapter 12 6 Dash 2000 Patient Monitor Revision B 227 499 06 US E RESPIRATION Respiration Menu Options Respiration Menu Options Lead Relearn Respiration Revision B You have two choices for the respiration lead lead and lead II This menu option when selected automatically switches the monitored lead for respiration The label of the lead currently being monitored I or 11 appears in the menu option in the lower left corner of the RR parameter window and with the waveform label Changing leads automatically starts the relearn process NOTE If you are monitoring with a fixed lead 3 lead cable respiration can only be obtained from the lead for which the cable is manufactured For example if your cable is a fixed lead II cable you will see a LD FAIL message in the RR parameter window should you try to change the respiration lead A learning process always take
14. methemoglobin milligrams minute milliliter millimeters millimeters per second millimeters of mercury magnetic resonance image motor milliunits millivolt minute volume nitrogen nitrous oxide noninvasive blood pressure non capture neonatal non real time non sense O oxygen oxygen consumption index oxygen delivery index oxygen extraction ratio operating room P pulmonary artery partial pressure of carbon dioxide in arterial blood pulmonary artery diastolic oxygenation ratio pulmonary artery mean pressure partial pressure of oxygen in arterial blood alveolar pressure pause pulmonary artery wedge pressure barometric pressure partial pressure of arterial carbon dioxide end inspiratory pressure pediatric Revision B 227 499 06 US E APPENDICES Abbreviations and Symbols PEEP positive end expiratory pressure pH hydrogen ion concentration PIP peak inspiratory pressure PO2 partial pressure of arterial oxygen PPLAT plateau pressure PT RR patient respiration rate PULM pulmonary PVC premature ventricular complex PvO2 partial pressure of oxygen in mixed venous blood PVR pulmonary vascular resistance PVRI pulmonary vascular resistance index PWR power Q QA quality assurance QRS interval of ventricular depolarization Qs Qt shunt fraction QTY quantity R R rate right RA right arm right atrial RESP respiration RHb reduced hemoglobin RHY rhythm RL right leg RM respiratory mechanics RT A LM r
15. 05 120H 2 MONITOR recommended for typical monitoring applications 05 40H23 MODERATE used to reduce high frequency interference i e ESU 05 25HZ Moderate ECG filtering is not recommended with pacemaker patients MAXIMUM provides maximum filtering 5 25Hz used to stabilize the ECG baseline Maximum ECG filtering is not recommended with pacemaker patients WARNING The MAXIMUM filter alters ECG morphology Do not rely on ECG morphology for diagnostic purposes when this filter is selected When selected 5 Hz is displayed under the ECG parameter label Dash 2000 Patient Monitor 8 17 227 499 06 US E Lead Analysis Multi Lead Analysis Single Lead Analysis Changing Lead Analysis 8 18 ECG ECG Menu Options With the LEAD ANALYSIS option you can elect to choose single lead analysis or multi lead analysis for ECG analysis Multi lead analysis examines ECG leads II III and V whether they are displayed or not to help eliminate false alarms and improvethe capability of the system to e detect beats which occur isoelectric to a single chest lead e discriminate artifact that appears in one lead compared to the other lead vectors e provide a smart lead fail feature where the failed lead is identified and if available another lead is provided for display continue arrhythmia processing even after a lead change Single lead analysis uses only the lead displayed in thetop
16. 1 1 9 1994 A1 12 95 General requirements for safety Requirements for the safety of medical electrical systems EC Publication 513 1994 Fundamental aspects of safety standards for medical equipment ROY 0 Z Summary of cardiac fibrillation thresholds for 60 Hz currents and voltages applied directly to the heart Med amp Biol Engn amp Computing 18 657 659 1980 Dash 2000 Patient Monitor Revision B 227 499 06 US E Classifications Underwriters Laboratories Inc Revision B SAFETY Classifications The Dash 2000 Patient Monitor is classified according to I E C 60601 1 as Type of protection against electric shock Degree of protection against electric shock CF ECG Temp Resp BP BF NBP SpO2 Degree of protection against harmful ingress of water Ordinary Equipment enclosed equipment without protection against ingress of water Degree of safety of application in the presence of a flammable anesthetic mixture with air or with oxygen or nitrous oxide Not suitable I Class equipment CF Type CF applied part BF Type BF applied part Not suitable Equipment not suitable for use in the presence of flammable anesthetic mixture with air or with oxygen or nitrous oxide ale Classified by Underwriters Laboratories Inc Q with respect to electric shock fire mechanical c US and other specified hazards only in accordance with UL 2601 1 CAN CSA C22
17. 2 No 601 1 IEC 60601 1 and if required I EC 60601 2 27 IEC 60601 2 30 I EC 60601 2 34 EC 60601 1 1 Dash 2000 Patient Monitor 227 499 06 US E Safe Operating and Handling Conditions 2 12 SAFETY Classifications Method s of sterilization or disinfection recommended by the manufacturer Sterilization not applicable Disinfection see Maintenance gt General Cleaning Mode of operation Continuous operation Electromagnetic interference No cordless telephone nearby Electrosurgical interference damage No damage Diathermy instruments influence Displayed values and prints may be disturbed or erroneous during diathermy Defibrillation shocks The monitor specifications fulfill the requirements of EC13 IEC 60601 2 27 30 34 and prEN 865 Auxiliary outputs The system must fulfill the requirements of standard IEC 60601 1 1 Dash 2000 Patient Monitor 227 499 06 US E Revision B SAFETY Classifications Equipment Symbols NOTE Some symbols may not appear on all equipment N ATTENTION Consult accompanying documents CAUTION Toreducetherisk of electric shock do NOT remove cover Refer servicingto qualified service personnel 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 Jet TYPE CF APPLIED PAR
18. Admitting You Must Admit to Activate Alarms Monitors are Used in Different Ways 3 2 ADMIT DISCHARGE About Admitting Admitting a patient to the monitor is important Audiblealarms are off and there will beno alarm graphs and alarm history until the monitor is in the admit mode The following message is displayed near the middle of the screen to alert you to admit your patient ALL ALARMS OFF ADMIT PATIENT TO ACTIVATE ALARMS What you do to admit a patient to the monitor depends on how the monitor is used We have defined four ways in which the monitor is used STANDARD This application uses a monitor mounted in the room It does not accommodate telemetry A network connection is not required unless you have a central station ROVE R With this application you can move or rove the monitor to the patient rather than moving the patient to a monitored room It does not accommodate telemetry A network connection is not required unless you have a central station COMBO This application provides the option to acquire ECG data from either the monitor or from a telemetry receiver cabinet This ECG data acquisition capability enhances basic telemetry monitoring by providing additional access to all of the available parameters from the monitor A network connection is required ROVER COMBO This application combines the mobility feature of Rover monitoring with the telemetry compatibility of Combo monitoring A network is
19. Analysis Settings 8 16 ECG ECG Menu Options Todisplay the ECG Analysis Settings Menu usethe Trim Knob control to select the Analysis Settings label from the ECG Menu T ANEE SETTINGS 08 5 ECG Menu The Analysis Settings Menu is displayed at the bottom of the screen ANALYSIS SETTINGS Menu With the Trim Knob control you can now select any of the displayed options e ECG FILTER select one of four filter settings for the ECG signal e LEADANALYSIS choose single lead or multi lead processing of ECG e DETECT PACE turn pacemaker detection on off or access help e QRS WIDTH choose QRS width normal or narrow or access help ARRHYTH turn arrhythmia detection on off Dash 2000 Patient Monitor Revision B 227 499 06 US E ECG Filter Revision B ECG ECG Menu Options The ECG FILTER option offers you four choices for filtering the ECG waveform data on the display and graph strip NOTE Filters affect the ECG waveform only Arrhythmia analysis is not affected by filter choice 1 Select the ECG FILTER option to open a popup menu ECG FILTER gt DIAGNOST MONITORG MONITORG MODERATE t l MAXIMUM HELP ECG FILTER Popup Menu 2 Rotate the Trim Knob control to move the pointer gt The change will not take effect until the Trim Knob control is pressed and the popup menu closed Press the Trim Knob to close the popup menu DIAGNOSTIC provides the least amount of filtering
20. BASICS Components On the back of the monitor you can find all connectors for equipment and network See the illustration below NOTE Refer tothe service manual for system safety requirements when connecting the monitor to accessory equipment Handle An optional alarm indicator can be built into the handle of the monitor not shown When activated the LED indicator flashes red for CRISIS and WARNING patient status alarms and yellow for all other alarms Aux Port This auxiliary port is non functional at this time Network Connector A cable Defib Sync Connector Provides ECG analog can be connected to this port output signals to user supplied equipment A 5 volt for monitors used in the patient Power Input 2 milisecond artificial pacer spike is added to the monitoring network configuration analog output when PACE is on and detection occurs Refer to the Appendices Analog Output for details on signal output Monitor Back View Revision B Dash 2000 Patient Monitor 1 3 227 499 06 US E Optional Centralscope Central Station THE BASICS Components TheGE Marquette Unity Network Ethernet establishes bed to bed communication and allows patient data to be sent to an optional Centralscope central station and to other monitors on the network All devices must be connected to the network The central station may have a built in writer for graphing printing This built in w
21. COLOR choose a color configuration if you have a color monitor e BACKGRND switch from background white to black monochrome option CONTRAST control how bright the display is GRAPH SETUP select waveforms to be graphed graph speed and where a graph will be printed PARAM ON OFF dear unneeded parameter windows from the display and turn them back on again when needed e SOFTWARE SUMMARY display a list of the software revisions currently installed for the various components of the monitor e SERVICE MODE access a service mode for qualified service personnel Detailed information on each option is found in this chapter 5 2 Dash 2000 Patient Monitor Revision B 227 499 06 US E MONITOR SETUP Monitor Setup Menu Monitor Defaults Alarm levels alarm limits and many of your monitor settings can be set up as Monitor Defaults Monitor Defaults are recalled whenever a discharge procedure is performed The monitor can save only one set of defaults Whenever the monitor mode is changed Adult I CU Neonatal I CU Operating Room any Monitor Defaults you have set up will revert to factory default settings The monitor mode however is usually established at the time of installation and can only be changed in the service menu Monitor Defaults Todisplay the menu to set up your Monitor Defaults select MONITOR DEFAULTS from the Monitor Setup Menu Menu MAIN SETUP ET PREV MONITOR DEFAULTS Menu
22. D 20 120 NBP M 40 140 ART S 80 200 ART D 20 120 ART M 40 140 ART R 50 150 FEM S 80 200 FEM D 20 120 FEM M 40 140 FEM R 50 150 UAC S 80 200 UAC D 20 120 UAC M 40 140 UAC R 50 150 PA S 99 350 PA D 99 350 PA M 99 350 CVP 99 350 RA 99 350 UVC 99 350 LA 99 350 ICP 99 350 SP 99 350 SpO2 90 105 SpO2 R 50 150 RR 5 30 RR Apnea z 20 TP 30 0 C 86 0 F 42 0 C 107 6 F 14 12 Dash 2000 Patient Monitor 227 499 06 US E Revision B APPENDICES Factory Defaults Adult ICU Mode Display Defaults ECG Filter Monitoring Patient Age Adult BP Filter 12 Hz Color Format Transducer QRS Width Normal Primary ECG Il Discharge Alert Off Arrhythmia On Lead Analysis Multi Lead Arterial Rate On Detect Pace Off Graph Waveform 2 ART Graph Waveform 3 Off Alarm Graph On Timed Graph Continuous ART Disconnect On Smart BP On Arterial Scale 160 PA Scale 60 CVP RA UVC Scale 30 LA Scale 30 ICP Scale 30 SP Scale 160 NBP Auto Off NBP Cuff Size Adult RR Parameter Off RR Lead ll VOA Broadcast Off Alarm Volume 70 Silence Alarm Normal QRS Volume Off Rate Volume Off ECG Leads Fail Sys Warning SPO2 Probe Off Sys Warning Display Limits On Display Units Off Units for Height cm Units for Weight kg Temperature Units C NBP Limits Type Systolic Arterial Limits Type Systolic PA Limits Type Diastol
23. Dash 2000 Patient Monitor Revision B 227 499 06 US E PATIENT DATA Patient Data Menu Vital Signs NOTE Vital Signs is called TABULAR TRENDS if your monitor is in the Operating Room mode U pon admit to the system a history of the patient s vital signs is continually being collected Follow this procedure to display this patient data 1 Select VITAL SIGNS TABULAR TRENDS from the Patient Data Menu An information window and new set of menu options are displayed 21 APR 1999 17 10 DAK BED 1 Current Date and Time VITAL SIGNS 27 APR 1999 17 10 16 15 16 30 16 45 17 00 De ee Te oe OFF is displayed if alarms were paused or the monitor was in discharged state Press the GRAPH GO STOP key to print the vital signs information VITAL SIGNS Menu and Information Window For most parameters 24 hours of data is collected For NBP 96 values NBP S NBP D NBP M are collected With a BP interval of 15 minutes 24 hours of NBP data is collected 2 You cannot change any values in the Vital Signs but you can use the menu options to move through all the data collected Refer to the following page for details Revision B Dash 2000 Patient Monitor 6 3 227 499 06 US E View Older View Newer Time Interval Specific Time 6 4 PATIENT DATA Patient Data Menu Described below are the Vital Signs Menu options Each of these direct action menu options will move the data displayed either backward or forward in time
24. HR The parameter label highlights Turn the Trim K nob control to highlight the low or high limit Press the Trim K nob control again and rotate to change value Press the Trim Knob control to complete the change 5 Rotatethe Trim K nob control to highlight the parameter label and press to unhighlight 6 Select RETURN when all changes are completed The popup menu and information window close 8 14 Dash 2000 Patient Monitor Revision B 227 499 06 US E ECG ECG Menu Options QRS Volume The QRS VOLUME option turns on a tone which sounds each time a QRS complex is detected Y ou can adjust how loud you want this tone Follow this procedure NOTE ORS volumeis not 1 Select QRS VOLUME option from the ECG Menu A popup menu opens available from a telemetry displaying all choices transmitter when using combination monitoring Combo Rover Combo gt 100 OLUME OFF QRS VOLUME Popup Menu 2 Rotatethe Trim K nob control Each time the Trim K nob control is rotated you will hear a tone at that volume 3 When you are satisfied with the volume level press the Trim K nob control to close the popup menu NOTE Turning QRS volume on will automatically turn off the SPO2 rate volume if on Refer to SPO2 chapter When in OR mode the 1096 and 2096 volume tone is slightly quieter than the 10 and 20 volume tone in Adult I CU or Neonatal 1 CU modes Revision B Dash 2000 Patient Monitor 8 15 227 499 06 US E
25. NOTE Monitor Defaults can only be changed when the monitor is in a discharged state Changes made are in effect immediately but admit must be done for fully functional alarms e SETUP DEFAULT DISPLAY determine display settings such as Smart BP on color format waveforms graphed etc e PARAM PRIORITY determine the priorities you want for display of parameters e DEFAULT LIMITS set alarm limits for all parameters e PARAM ALARM LEVELS adjust parameter alarm levels to other alarm levels e ARRHYTH ALARM LEVELS adjust arrhythmia alarms to other alarm levels e RECALL DEFAULT recall Monitor Defaults without performing a discharge procedure Revision B Dash 2000 Patient Monitor 5 3 227 499 06 US E 5 4 MONITOR SETUP Monitor Setup Menu Setup Default The arrhythmia calls recognized by the monitor are assigned to one of the four patient status alarm levels ARRHYTH ALARM LEVELS option nn Alarm allows you to view the levels assigned as defaults tothe arrhythmia calls Euer Follow this procedure to display a list of arrhythmia calls and the alarm level to which each is assigned 1 Select ARRHYTH ALARM LEVELS option from the Monitor Defaults Menu 21 NOV 1998 16 27 DAK BED 1 gt RETURN ASYSTOLE CRISIS V FIB VTAC CRISIS V TACH CRISIS ARRHYTH ALARM LEVELS SETUP DEFAULT ARRHYTHMIA ALARM LEVELS Popup Menu and Information Window The information window shows a list of the arrhythmia calls on the left with their cor
26. On OP 5 12 COMER AST LEM 5 13 eo EE 5 14 Backgrnd uc ou oe Ite am nadie deeds 5 14 Timeand Date iii e ren nalts 5 14 SCE D ate 5 15 SI TIME u EE a este 5 15 Graph Setup e ent c nn 5 16 ECG 1 Waveform 2 Waveform 3 sss 5 17 Graph iE OcaLiofi i tin inch ont naaa 5 18 Alarm Graph iege eet meine 5 20 o EE 5 20 Timed Graph EE 5 21 Parameters On On ENEE 5 22 Software Summary 5 23 Service Mode else 5 24 Patient Monitor Tvpe nana nnncnnncnnn 5 25 Admit Mode inae eere tatus tes 5 25 Revision B Dash 2000 Patient Monitor 227 499 06 US E MONITOR SETUP Monitor Setup Menu Monitor Setup Menu Whenever possible we want you to be able to customize your monitor to best suit your unit s and patients needs The Monitor Setup menu allows you to make changes and in some cases to save these changes as monitor defaults to be recalled each time you discharge a patient Follow this procedure to access the Monitor Setup Menu 1 Select MORE MENUS from the Main Menu 2 Select MONITOR SETUP todisplay the Monitor Setup Menu MONITOR SETUP Menu e MONITOR DEFAULTS configure alarms set alarm limits and establish display defaults to be recalled whenever a discharge is performed DISPLAY SETUP selects the DISPLAY SETUP menu for the following adjustments e WAVEFORM ON OFF reassign waveform positions on the Screen or turn some waveforms off
27. SPO2 will be displayed on the screen when the patient cable is connected to the monitor Numerics are also displayed in the SPO2 parameter windows on the right side of the screen NOTE Visual indication of the patient s pulse is not proportional tothe pulse amplitude Strength of Signal Limits and Units Indicator Pulse SPO2 Value Value 117 SPO2 Parameter Window The current SPO2 value and the derived pulse rate RT are displayed The asterisks indicate the strength of the signal three asterisks indicate the strongest signal The SPO2 measurements are averaged over a 6 second period of time in adult mode and 12 seconds in neonatal mode The different averaging time in neonatal mode is to help decrease false alarms related to patient motion artifact The monitor display is updated every 2 seconds The SPO2 monitoring features are found in the SPO2 menu These features include waveform size alarm limit adjustment display of RATE and RATE volume Dash 2000 Patient Monitor Revision B 227 499 06 US E SPO2 SPO2 Monitoring Features Getting to the SPO2 Todisplay the SPO2 menu usethe Trim K nob control to select the SPO2 parameter label Remember selecting with the Trim Knob control is a two Menu step process rotate to highlight then press to select Selecting the SPO2 Parameter Label The SPO2 menu is displayed at the bottom of the screen SPO2 Menu With the Trim Knob control you now can select any of t
28. Setup Menu Waveform On Off The WAVEFORM ON OFF menu option allows you to reassign waveforms on the display or turn an individual waveform off 1 Select WAVEFORM ON OFF fromthe Display Setup Menu MAIN ECG 1 ucc cum ee MENU LEAD III ART SEE PREV MENU 052 WAVEFORM ON OFF Menu 2 Select WAVEFORM 2 menu option to display a popup menu WAVEFORM 2 Popup Menu The choices in the popup menu indicate which waveforms can be displayed in the second waveform position 3 Rotatethe Trim K nob control to movethe pointer in front of the waveform you would like to display in that position Choose OFF if you want no waveform displayed in that position 4 Press the Trim Knob control to complete the change and close the popup menu Usethis same procedure for the other waveform positions 5 12 Dash 2000 Patient Monitor Revision B 227 499 06 US E MONITOR SETUP Monitor Setup Menu Contrast This option is used to control the brightness of the monitor s screen 1 Select CONTRAST option from the Display Setup Menu A popup menu is displayed with all choices CONTRAST Popup Menu 2 Rotatethe Trim K nob control to change the brightness of the display The change takes place immediately so you can judge the appropriate percentage 3 Pressthe Trim K nob control to close the popup menu Revision B Dash 2000 Patient Monitor 5 13 227 499 06 US E MONITOR SETUP Monitor Setup Menu Color If you have a color
29. TO ENTER THE SERVICE MODE OF OPERATION IF YOU PROCEED YOU MAY LOSE YOUR MONITOR CONFIGURATION SOME OPERATIONS WILL CAUSE A COLD START OF THE MONITOR ENTER THE PASSWORD AND PROCEED AT YOUR OWN RISK SERVICE MODE 07 SERVICE MODE Popup Menu and Information Window 1 When the password is entered and the popup menu closed the Service Mode Menu will be displayed MONITOR IC TIME BATTERY ADMIT AND TYPE SERVICE REVIEW CALIBRATE ADDRESS ERRORS 07 SERVICE MODE Menu 2 The service mode is used by qualified field engineers factory service personnel and hospital biomedical engineers to set up troubleshoot and repair the monitor If you want more details please refer to the appropriate product service manual Dash 2000 Patient Monitor Revision B 227 499 06 US E Patient Monitor Type Admit Mode Revision B MONITOR SETUP Monitor Setup Menu Following is an explanation of two Service M enu options which have been mentioned in other places in the manual In many places throughout the manual the patient monitor typeis mentioned Your monitor is set up for monitoring in one of three modes with the PATIENT MONITOR TYPE option Adult ICU ADLT ICU Neonatal I CU NEO I CU or Operating Room OP ROOM You will know which mode your monitor is set up for by the absence or presence of a label on the date and time line at the top of the display Adult ICU has nolabel Theother labels are NEO ICU
30. US E Alarm Graph Speed 5 20 MONITOR SETUP Monitor Setup Menu This menu option allows you toturn automatic alarm graphs off and on This is a direct action menu option Selecting this option switches back and forth between off and on 060 ALARM GRAPH Option An arrhythmia alarm graph continues to run until a normal sinus rhythm is again detected or until you manually stop it at the writer All other alarm graphs will run for 20 seconds NOTE Toconvert an arrhythmia alarm graph to a manual graph you must stop the graph using the GRAPH GO STOP key on the writer and immediately restart the graph The speed at which a graph strip is printed is controlled with this menu option The slower the speed the more condensed the data will be This option affects manual graphs only and must be selected before starting the graph NOTE Alarm graphs always run at 25 millimeters per second 1 Select the GRAPH TIME SPEED option from the Graph Setup Menu A menu with the two options SPEED and TIMED GRAPH appears 2 Select the SPEED option A popup menu opens displaying all choices SPEED Popup Menu NOTE A laser printer does not support the 0 1 millimeters per second speed 3 Rotatethe Trim K nob control so the pointer is in front of the speed you want 4 Pressthe Trim K nob control to confirm the change and close the popup menu Dash 2000 Patient Monitor Revision B 227 499 06 US E MONITOR SETUP Monitor Set
31. a 9 12 Statt BP Ge a ee See 9 13 Pulse Rate ene EE 9 13 Disconrniect Alartn ias 9 14 Troubleshooting ws dte rte b ed do ac nee ne 9 15 butzege VE 10 2 Checklist ceti e te nie RR DES 10 3 Patient Preparation Renee edt 10 4 NBP Monitoringteatures enne 10 5 NBP Informatio iaa eie dee Ed 10 5 NBP Go Stop K ey een a 10 5 POWE Key ditte ERE RE dee 10 5 Getting to the NBP Menu 10 6 NBP Ment Optio editi dte gaa agen 10 7 VIE ge ME 10 7 NIBP Stat recs iet ted armen terete be notre 10 8 NBP EIMItS cient cnn arin tenis EE 10 9 Cuff Size aa a e ea aaa aai 10 10 Cuff Inflation Preseures nn 10 10 Clear NBP Reading eene 10 10 Troubleshooting ee 10 11 NBP Status Messages AA 10 11 Dash 2000 Patient Monitor Revision B 227 499 06 US E TABLE OF CONTENTS 1 1 SPO2 BERR RRR RRR RRR RRR RRR RRR RRR 11 1 Belge ve del DEE 11 2 Neonates and lntante eene nnne nnns 11 3 ala adiu ge en bad 11 4 Patient Preparation EEN 11 5 Signal and Data Validity sess 11 6 Signal Strength Indicator sss 11 6 Quality of SPO2 Waveform nana nenas 11 6 Stability of GbPOZ3Values non nn nana 11 7 SPO2 Monitoring Features 11 8 SPO2 Info Mati ON asainn niniin aaia nnns 11 8 Getting to the SPO2 Menu nnnnsnnsennnensnennnnnnnnnnnnnnnnnn name 11 9 SPO2 M enu Op OA S ia 11 10 a ZG EE AE E E de 11 10 SPOOZ LM cada 11 11 Rate VU tero eee eee reed eroe e er er e
32. and calibration Dash 2000 Patient Monitor 9 5 227 499 06 US E Getting to the Pressure Menu PRESSURES Pressure Monitoring Features To display a pressure menu use the Trim Knob control to select the pressure parameter label In this example we will use the CVP Menu Remember selecting with the Trim Knob control is a two step process rotate to highlight then press to select 349 99 mmHg 8 e Selecting the CVP Parameter Label The CVP Menu is displayed at the bottom of the screen CVP Menu With the Trim Knob control you now can select any of the displayed options SCALES change the displayed scale for this pressure CURSOR display a new menu for a moveable cursor on the waveform e LIMITS display a new menu and an information window to adjust alarm limits e CHANGE NAME change to another name e ZERO zero reference transducer SETTINGS displays a new menu to adjust BP filter pulse rate transducer calibration smart BP and disconnect alarm feature in the ICU and Operating Room Mode These menu options are found in all pressure menus The only difference is the site name for example CVP Cursor PA Cursor etc More details on each option are found in this chapter Dash 2000 Patient Monitor Revision B 227 499 06 US E PRESSURES Pressure Menu Options Pressure Menu Options Scales Revision B In most cases the CVP menu is used in this section to demonstrate th
33. any of the displayed options NBP AUTO start stop the automatic mode select appropriate time interval NBP STAT start 5 minutes of continuous sequential NBP measurements Not available in Neonatal I CU mode NBP LIMITS display an information window and a new menu to adjust systolic diastolic and mean limits CUFF SIZE select the type of cuff being used adult pediatric neonatal CLEAR NBP READING remove the values from the NBP parameter window Detailed information on each option is found in this chapter Dash 2000 Patient Monitor Revision B 227 499 06 US E NBP NBP Menu Options NBP Menu Options NBP Auto WARNING Periodically check patient limb circulation distal to the cuff Check frequently when using auto NBP in 1 and 2 minute intervals Intervals below 10 minutes are not recommended for extended periods of time This option allows you to program the monitor to automatically take NBP measurements at specific time intervals Follow this procedure 1 Select NBP AUTO option from the NBP Menu A popup menu opens showing all choices 20MINS 3MINS 15MINS 2MINS 10 MINS gt 1 MIN 5 MINS OFF 1HR 30MINS 4MINS NBP AUTO Popup Menu 2 Rotate the Trim Knob control to move the pointer gt to the desired time interval The change will not be in effect until the Trim Knob control is pressed and the popup menu closed NOTE TheNBP AUTO program is a timed cyde If when fir
34. can manually change the size of the respiration waveform 1 Select MANUAL SIZE option from the Respiration Size Menu A popup menu opens displaying the choices available 129A MANUAL SIZE Popup Menu 2 Rotatethe Trim Knob control to highlight another size The change will occur immediately 3 When you are satisfied with the size press the Trim K nob control to close the popup menu NOTE Themanual size you select will be cancelled if you change the lead from which respiration is derived When you change leads the learning process is started and the waveform is automatically Sized Revision B Dash 2000 Patient Monitor 12 11 227 499 06 US E RESPIRATION Troubleshooting Troubleshooting Respiratory Illustrated below is a respiratory waveform which is regular and even The inspiration and expiration markers are identified Waveform Inspiration Marker Expiration Marker 130 Regular and Even Cardiac Artifact In cases wherethere is cardiac artifact if the detection sensitivity percentage is set too low the artifact will be detected as breaths Increase the detection sensitivity percentage until the markers correctly identify each inspiration and expiration Seethe markers in the figures below A artifact B breath A B A A B Incorrect Detection Correct Detection 12 12 Dash 2000 Patient Monitor Revision B 227 499 06 US E Varying Amplitudes Messages Revision B RESPIR
35. cannot accurately compute NBP on patients with these conditions Automatic noninvasive blood pressure monitoring uses the oscillometric method of measurement To understand how this method works we ll compare it to the auscultative method With auscultation the clinician listens to the blood pressure and determines the systolic and diastolic pressures The mean pressure can then be calculated with reference to these pressures as long as the arterial pressure curveis normal Since the monitor cannot hear the blood pressure it measures cuff pressure oscillation amplitudes Oscillations are caused by blood pressure pulses against the cuff The oscillation with the greatest amplitude is the mean pressure This is the most accurate parameter measured by the oscillometric method Once the mean pressure is determined the systolic and diastolic pressures are calculated with reference to the mean Simply stated auscultation measures systolic and diastolic pressures and the mean pressure is calculated The oscillometric method measures the mean pressure and determines the systolic and diastolic pressures Dueto the difference in these methods one cannot be used to check the accuracy of theother Dash 2000 Patient Monitor Revision B 227 499 06 US E Checklist Revision B NBP Introduction d amp mge A T del Eee cop remp Ap NEP NBP Cable Connector Dash 2000 Monitor NBP Connector NOTE TheNBP cable connector is
36. change the lead currently displayed as the primary lead the one in the top trace position This option is useful when you are selecting a lead for pacemaker detection or analog output Follow this procedure 1 Select DISPLAY LEAD option from the ECG Menu A popup menu opens showing all leads available The lead currently displayed is highlighted in the list of options DISPLAY LEAD Popup Menu 2 Rotatethe Trim K nob control to change the displayed lead The change occurs immediately on the screen 3 When you are satisfied with your selection press the Trim K nob control to dose the popup menu NOTE If you are using a standard selectable lead three leadwire patient cable the popup menu only has leads I Il and Ill as available choices The lead displayed in the top trace position is the signal output to the DEFIB SYNC connector on the rear of the monitor Thesoftware provides a defib sync pulse for digital synchronization and places a return marker on the ECG waveform If the defibrillator is to be synchronized with the analog ECG signal review the patient s ECG leads and placethe one with the greatest amplitude in the top position on the monitor Dash 2000 Patient Monitor 8 11 227 499 06 US E ECG ECG Menu Options Smart Lead Fail NOTE Thesmart lead fail feature works only when using a 5 leadwire electrode configuration The smart lead fail feature is continually checking the integrity of the electrodes t
37. fail Alarms Dash 2000 Patient Monitor 227 499 06 US E 5 8 inch diagonal Hi Bright Liquid Crystal Display LCD Liquid Crystal Display LCD 320 by 240 pixels 3 3 8 at 25 mm sec 25 mm sec 20 with erase bar Individual Display of non real time information without obstructing the display of real time information Prioritized by parameter Trim Knob control plus 5 hard keys Silence Alarm NBP Go Stop Graph Go Stop Function and Power MPC 821 32 bit integrated microcontroller 24 MHz MC68332 32 bit integrated microcontroller 15 72 MHz 4 MB flash memory 512 kB battery backed up 4 MB DRAM 4 levels Crisis Warning Advisory and Message Audible and visual Default and individual 1 minute current alarm only Default 70 70 dB measured at 1m Bedside and central station if applicable Red flashing L 11 111 V aVR aVL and aVF 1 11 111 and V multi lead mode Identifies failed lead User selectable upper and lower heart rate limits Revision B APPENDICES Technical Specifications Input specifications Voltage range QRS detection Signal width Heart rate range Response time to change in heart rate Heart rate update Input impedance Common mode Differential Tall T wave rejection amplitude Output specifications Frequency response Display Diagnostic Monitoring Moderate Maximum DDW Direct Digital Writer Diagnostic Monitoring Moderate Ma
38. hose cuffs and tubing The use of single hose cuffs with dual hose tubing can result in unreliable and inaccurate NBP data Cuff selection 1 Identify patient limb size 2 Select appropriate cuff limb width is identified on each cuff Cuff placement 1 Place cuff snugly around extremity being used 2 Marking on cuff should match artery location 3 Cuff should be 2 to 5 cm 1 to 2 inches above the elbow if using brachial artery 4 Theair pad should be exactly over the brachial artery Tubing is immediately to the right or left of the brachial artery to prevent kinking when elbow is bent 10 4 Dash 2000 Patient Monitor Revision B 227 499 06 US E NBP NBP Monitoring Features NBP Monitoring Features NBP Information Thereis no waveform displayed when monitoring with the non invasive blood pressure technique However numerics are displayed in the NBP parameter window on the right side of the screen Limits and Units Systolic Value Diastolic Value Countdown Timer Mean Value Cuff Size Adult NBP Parameter Label and Window The current systolic diastolic and mean values are displayed Limits and the units of measurement may also be displayed The limits displayed are labeled S systolic D diastolic M 2mean The cuff size and time of last measurement are also displayed The time is displayed with a 24 hour clock During a measurement the cuff inflation pressure updated every second is displ
39. is a selection of available options These options are displayed at the bottom of the screen and are accessed with the Trim Knob control Some menus may have some empty spaces These spaces are available for future software enhancements There are two important menu options to note Oneor both of these options is found in every menu with the exception of the Main Menu This option will always take you back to the Main Menu Useit when you are finished making adjustments or accessing stored information PREV MENU This option allows you to back up to the previous menu when a subordinate menu is displayed Think of these as escape or exit options Menu Timeout The monitor automatically returns to the Main Menu refer tothe figure below when you have displayed another menu and have not used the Trim Knob for 5 minutes default time This is a Monitor Defaults setting SETUP DEFAULT DISPLAY which can be set for a longer period of time or no timeout at all Some menus such as Vital Signs and trends are not affected by the timeout setting You must exit them using one of the exit options described above Main Menu TheMain Menu has one menu option MORE MENUS in thelower left corner of the screen With the Main Menu displayed the screen shows all monitored parameters and waveforms 21 NOV 1998 16 27 DAK BED 1 150 50 36 6 17 The Main Menu Fromthe Main Menu you access a parameter menu by selecting the appropriate paramete
40. monitor you can use the COLOR menu option to open a popup menu to select a color format color option 1 Select COLOR option from the Display Setup Menu A popup menu is displayed WAVEFORM C ON OFF CL gt CLINICAL a 054 COLOR Option Popup Menu COLOR version 2 Usethe Trim Knob control to move the pointer to the color format of your choice CLINICAL groups physiological functions by color ECG is amber hemodynamics are green and cardiopulmonary and temperature are blue e TRANSDUC matches a color to a specific transducer ART is red PA is yellow etc all other physiological parameters are green Backgrnd If you have a monochrome monitor this is a direct action menu option which switches the background from white to black and reverse monochrome option Time and Date This menu option is displayed only if no network access is detected and therefore no actual date and time values are available from remote devices Select TIME AND DATE toenter the TIME AND DATE popup menu MAIN MENU PREV MENU TIME AND DATE Popup Menu 5 14 Dash 2000 Patient Monitor Revision B 227 499 06 US E Set Date e Set Time e Revision B MONITOR SETUP Monitor Setup Menu SET DATE opens a popup menu to enter or adjust the current date SET DATE Popup Menu To modify the date follow this procedure 1 Rotate the Trim K nob control to select the item you want to adjust the selected item wil
41. not complying with the equivalent safety requirements of this equipment may lead to a reduced level of safety of the resulting system Consideration relating to the choice shall include e useoftheaccessory in the PATIENT VICINITY and e evidence that the safety certification of the ACCESSORY has been performed in accordance to the appropriate IEC 60601 1 and or IEC 60601 1 1 harmonized national standard BATTERY POWER If a device equipped with an optional battery pack will not be used or not be connected to the power linefor a period of over six months remove the battery 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 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 Dash 2000 Patient Monitor 227 499 06 US E 2 7 SAFETY For Your Safety CAUTIONS DISPOSABLES Disposable devices are intended for single use only They should not be reused as performance could degrade or contamination could occur DISPOSAL At the end o
42. of the desired name The change will not take effect until the popup menu is closed 3 Press the Trim Knob control to confirm the change and close the popup menu This causes a change in the parameter window and the Main Menu is displayed Use the ZERO option to zero the transducer 1 Close the transducer stopcock to the patient 2 Open the venting stopcock to air atmosphere 3 Usethe Trim Knob control to select highlight and press the ZERO option in the pressure menu 4 Verify that zero reference has been established Watch the pressure parameter window messages Close the venting stopcock to air atmosphere Open the transducer stopcock to the patient Within seconds pressure numerics should be displayed in the pressure parameter window Dash 2000 Patient Monitor Revision B 227 499 06 US E Revision B PRESSURES Pressure Menu Options Settings This option provides access to another popup menu that offers special options which influence the processing of the pressure signal The set of options offered varies depending on the pressure site and the selected monitory type BPSET1 BP Settings Menu for pressures sites ART FEM Adult ICU and Operating Room mode BPSET2 BP Settings Menu for pressures sites ART FEM UAC Neonatal ICU mode BPSET3 BP Settings Menu for all other pressures sites Dash 2000 Patient Monitor 227 499 06 US E BP Filter Calibrate Transducer 9 12 PRESSURES
43. pause to reactivate alarms If no alarm is sounding press this key to start an alarm pause If your monitor is set up for Operating Room mode you have three levels of alarm pause e Press once if an alarm is sounding you must press twice to start a 5 minute alarm pause e Press again to start a 15 minute alarm pause Press again to start a permanent alarm pause Pressagain toreactivate alarms Dash 2000 Patient Monitor Revision B 227 499 06 US E THE BASICS Turning Power On Turning Power On AC Power Normal Mode Standby Mode Revision B The Dash 2000 monitor will be powered at all times when using AC power there is no AC power switch The monitor is preset at the factory for a specific AC voltage Before applying power be sure the power requirements match your power supply Refer to the label on the back of the unit for the voltage and current requirements Refer also to Power Requirements in the Safety chapter of this manual When all cables are properly connected press the POWER button toturn the monitor on After approximately 10 seconds you should see a display on the screen The AC indicator on the front panel will light when using AC power Two modes of operation are available when using AC power The monitor will enter NORMAL mode when plugged into AC power and the monitor is turned ON Normal mode operation provides all functional capabilities of the monitor including vital signs monitoring
44. required It is determined at the time of installation which application applies At that time a menu option in the service mode is used to set your monitor for one of the above applications Theinformation that is necessary for successful admission to the monitor and the network is then provided in the Admit Menu Dash 2000 Patient Monitor Revision B 227 499 06 US E ADMIT DISCHARGE About Admitting Guidelines When Doing Combination Monitoring For Which Application is the Monitor Set Revision B Here are some guidelines to remember when doing combi nation Combo and Rover Combo monitoring When monitoring ECG from telemetry ECG limits and arrhythmia alarm levels are not your monitor defaults but arethe telemetry defaults or as modified at the central station You can however adjust these settings at the monitor When monitoring ECG from telemetry the alarm pause feature if available on your transmitter is honored at the monitor e If you switch ECG monitoring from telemetry to monitor the ECG limits arrhythmia alarm levels and display formats will be recalled from Monitor Defaults If you want to know the application for which the monitor is set follow these steps 1 Select MORE MENUS option from the Main Menu 2 Select MONITOR SETUP 3 Select SOFTWARE SUMMARY An information window is displayed See the figure below 21 NOV 1998 16 27 DAK BED 1 SOFTWARE SUMMARY SOFTWARE REVISIONS MAIN 4
45. requirements of Annex I of the Directive 93 42 EEC has been certified by Marquette Hellige GmbH Quality Management and Certification Munzinger Str 3 D 79111 Freiburg Germany Test Report No CE H 024 of 31 August 1999 The medical device has been assigned to class Hb as specified in Annex IX of the Directive 93 42 EEC It bears the mark C 0366 The designated product has been designed manufactured and tested under a quality management system according to EN ISO 9001 EN 46001 and Annex II Section 3 2 of Directive 93 42 EEC concerning medical devices The conformity of the quality management system has been certified by i VDE Testing and Certification Institute Date Freiburg 31 August 1999 Hubert Renc Director Engineering The technical documentation is filed in Marquette Hellige GmbH RA QA Dash 2000 Patient Monitor Revision B 227 499 06 US E
46. sssessss 1 16 Battery Status Messages essen 1 16 Software Features EEN 1 17 Revision B Dash 2000 Patient Monitor 227 499 06 US E TABLE OF CONTENTS Menus a 1 17 Men MEI o VPE 1 17 Main Menu A 1 17 Parameter MenUS coccccoconanconnccnnnnnnnnnannnn nennen nnnnnnannnnnnn ernennen 1 18 More Menus een een leeren 1 18 Popup aU 1 19 Scrolling Popup etin daos tede 1 19 Pointer Rp e teer e neis 1 19 Numeric P OpUp 2 eiie este 1 20 Subordinate Menu 1 20 Direct Action Menu Options seem 1 21 Parameter Windows 1 22 Information Windows 1 23 Trim Knob Control Operation When Setting Alarm L imits 1 24 Graphing Printing een 1 25 Devices HERREN 1 25 Mania Orap S 32 then EE 1 25 Exclusive Graph Contra 1 25 Alarm Graphs nace cenit i Rec nde 1 25 Pressure Scales eie nie 1 26 Graphing Messages nennen 1 26 Graph Ee TEE 1 26 Putting the Monitor Into Operation 1 27 Monitor Installation and Connection 1 27 Performance Check 1 28 For Your Safety cedi en 2 2 Intended Use en sea 2 2 Terminology eie ite ter epe a a ale tia 2 2 Monitor MY ota ehren 2 2 pande A E etre legen 2 2 WarniNgs ie 2 3 eue E 2 7 o 2 10 Reference Literature 2 10 Classifications nee 2 11 Underwriters Laboratories Inc 2 11 Safe Operating and Handling Conditions 2 12 Equipment Symbols seen 2 13 ADMIT DISC HARGE SERRE RRR RRR R
47. the graph header in an abbreviated form when applicable Revision B Dash 2000 Patient Monitor 10 11 Problem Erroneous NBP measurement 10 12 NBP Troubleshooting Solutions 1 gt von au Check for proper cuff size a Toosmall a cuff can give an erroneously high value b Toolarge a cuff can give an erroneously low value Check for residual air left in the cuff from a previous measurement Make sure cuff is not too tight or too loose Make sure cuff and heart are at same level otherwise hydrostatic pressure will offset the NBP value Minimize patient movement during measurement Watch for pulsus paradoxus Check for leak in cuff or tubing Patient may have a weak pulse Calibration may be necessary Dash 2000 Patient Monitor Revision B 227 499 06 US E 11 SPO2 Revision B OEEOQUCELODL os ii eimi een 11 2 Neonates and Infants nennen 11 3 GRecKIISt tue iie th i diee a e ERRARE ain 11 4 Patient Preparation enne 11 5 Signal and Data Validity sss 11 6 Signal Strength Indicator s sse 11 6 Quality of SPO2 Waveform nano 11 6 Stability of GbPOZ3Values nano 11 7 SPO2 Monitoring Features 11 8 SPO2 Inforrmation ze st ted t ree reas 11 8 Getting to the SPO2 Menu nunnsnnsennnnnnnennnnnnnnnnnnnnnnn namen 11 9 SPO2Menu Options iier et beiten 11 10 sj A PETETOER RR E E E 11 10 SPO2 Bir e 11 11 Rate Volume ee ete poene SRK dive ihe 11 12 RCC iste ce
48. time Every non episodic parameter is sampled 30 times a minute A median value is determined and that value is stored for trend display at one minute resolution E pisodic parameters NBP etc are stored every time one occurs Follow this procedure to view graphic trends 1 Select GRAPHIC TRENDS from the Patient Data Menu An information window and new set of menu options are displayed GRAPHIC TRENDS 27 NOV 1998 16 27 The trend data will automatically update while displayed Refer to this chapter Time Period Press the GRAPH GO STOP key to print the displayed trends SE MENU PARAM GRAPHIC TRENDS Menu and Information Window The graphic trends for the last selected parameters are displayed Heart rate is the default if none were previously selected 2 Toselect other parameters for trending follow the procedure on the following page NOTE All trend data that is available at the monitor can be requested by a network device viewing trends e g central station Revision B Dash 2000 Patient Monitor 6 5 227 499 06 US E PATIENT DATA Patient Data Menu Select Parameters 1 Select the SELECT PARAMETERS option from the Graphic Trends Menu A popup menu and the Vital Signs information window are displayed 27 APR 1999 17 10 DAK BED 1 Notice the pointer gt and a RETURN option in this window SELECT PARAMETERS Popup Menu 2 Tomark highlight a parameter for trending rotate the Trim Knob control
49. 14957 006 INT5 020CT1998 MAIN BOOT DAS 414959 005 3B 18FEB97 DAS BOOT 415 002 2A 11JAN96 ETCO2 ETCO2 BOOT DDW ADMIT MENU STANDARD MONITOR TYPE ADLT ICU EE OK OFTWARE SUMMARY 022 SOFTWARE SUMMARY Information Window Dash 2000 Patient Monitor 3 3 227 499 06 US E ADMIT DISCHARGE Getting to the Admit Menu Getting to the Admit Menu 1 Select MORE MENUS from the Main Menu 2 Select ADMIT MENU todisplay one of the following menus MAIN ALARM PATIENT ADMIT MENU CONTROL DATA MENU ONITOR Y kam Operating Room Mode 3 Select ADMIT MENU or NEW CASE SETUP to display the Admit Menu The admit menu displayed depends on how your monitor has been set up The following pages describe the various admit menus 3 4 Dash 2000 Patient Monitor Revision B 227 499 06 US E ADMIT DISCHARGE Standard Admit Menu Standard Admit Menu With the Standard application the monitor is permanently assigned to a room The unit name and bed number are assigned during installation The options you may need to adjust enter are shown in the admit menu below ADMIT XXX INFO PATIENT PREV MENU 025 ICU ADMIT Menu STANDARD application NOTE XXX ADMIT if patient is discharged DISCHARG otherwise MAIN ADMIT NEW MENU INFO CASE MAIN MENU PREV MENU Es 026 OR ADMIT Menu STANDARD Application ADMIT INFO opens the admit information window and popup menu refer to section Admit Info later in this chap
50. 26 ECG Troubleshooting Solution Check ECG signal from patient The chest lead may exhibit polarity changes which may occasionally cause an inaccurate call 1 Check adjust lead placement 2 Check perform skin preparation 3 Check replace electrodes If chest lead is a problem movethe chest lead to another chest position or leg position 4 Relearn ECG a Select ECG parameter label b Select RELEARN IF PROBLEM CONTINUES 1 Select ECG parameter label 2 Select RELEARN Solution Use pacemaker processing 1 Select ECG parameter label 2 Display the lead of ECG with the greatest amplitude in the top waveform position 3 Select ANALYSIS SETTINGS 4 Select DETECT PACE 5 Select either PACE 10r PACE 2 NOTES e ngeneral beawarethat a pacemaker pulse could befalsely counted as a QRS during asystole e Pace 1 mode analyzes the presence of a pacer spike assesses the waveform for residual pacemaker energy and determines the presence of an R wave following the pacer spike If an event occurs during the first few milliseconds following the pacer spike it will be counted Pace 2 mode analyzes waveforms with the added capability of minimizing the chance of counting severe residual pacemaker energy as QRS complexes In relation to the event rejection capability of Pace 2 pace mode certain morphologies may not be detected Arrhythmia calls like asystole or pause may be made with heart rate identified as less t
51. 5 relative humidity 25 C 13 F 500 to 1060 hPa 21 5 mm 8 5 inches 26 0 cm 10 2 inches 20 0 cm 7 9 inches 11 5 lb 5 2 kg EC 60601 1 certified CE Marking for the 93 42 EEC Medical Device Directive UL 2601 classified UL classified for CAN CSA C22 2 No 601 1 Contact the manufacturer sales representative for more information Dash 2000 Patient Monitor 227 499 06 US E 14 29 14 30 APPENDICES EC Declaration of Conformity marquette A GE Medical Systems Company EC Declaration of Conformity Document No 12 99 Marquette Hellige GmbH Munzinger Strasse 3 D 79111Freiburg Germany We herewith declare that the product Compact Monitor DASH 2000 product status Version 2 0 including system components and accessories UMDNS Code 12 636 fulfill the requirements of the following directives standards and normative documents t Council Directive 93 42 EEC of 14 June 1993 concerning medical devices 1 EN 60601 1 1990 A1 1993 A2 1995 IEC 60601 1988 A1 1991 A2 1995 EN 60601 1 1 1993 Al 1996 IEC 60601 1 1 1992 Al 1995 EN 60601 1 4 1996 TEC 60601 1 4 1996 EN 60601 2 27 1994 IEC 60601 2 27 1994 EN 60601 2 34 1995 IEC 60601 2 34 1994 EN 60601 2 30 1995 IEC 60601 2 30 1995 prEN 865 1994 to EN 60601 1 2 1993 TEC 601 1 2 1993 EN 55011 1991 CISPR 11 1990 modified device group class B Compliance of a representative sample of the designated product with the essential
52. 5 mA sinking 10 ms 10 or 100 ms 10 in Service Menu 50 Ohms nominal 15 mA nominal both sourcing and sinking VIH 42 5 V min VIL 241 5 V max 650 mV typical 30 V with respect to ground on pin 2 10 k min for 25 V lt V 25V 1 0 ms min V 2 5 V 100 240 VAC 10 16 W normal use 45 W fast charge Convection 240 BTU hr nickel cadmium NiCd 12 V 2 0 ampere hours 100 240 VAC T2 0A 250 VAC 5x 20 mm Continuous operation not protected against ingress of liquids Battery age will affect operating time SpO2 and NBP monitoring as well as battery age reduce operating time Typical operation time while monitoring ECG is 3 5 hours froma new fully charged battery Typical operation time while monitoring ECG is 3 hours from a new fully charged battery 1 5 hours Revision B Physical Specifications Certification Warranty Revision B APPENDICES Technical Specifications Battery charge time to 9096 Operating conditions Ambient temperature Relative humidty Atmospheric pressure Storage conditions Maximum Minimum Atmospheric pressure Height Width Depth Weight with battery pack and recorder with color monochrome display IEC UL Standard One year Optional Other options are available 1 hour to 3 hours 10 to 40 C 50 to 104 F 30 7096 700 to 1060 hPa 50 C 122 F at 50 relative humidity or 70 C 158 F at 1
53. 98 16 27 DAK BED 1 150 50 Location of Bed Number on the Monitor Follow this procedure to confirm that the bed number is correct 1 Select SET BED NUMBER from the Admit Menu A popup menu and information window are displayed 21 NOV 1998 16 27 DAK BED 1 CONFIRM BED NUMBER gt CREATE NEW BED BED1 BED2 BED3 BED4 BED5 BED6 SET BED NUMBER Popup Menu and Information Window 2 Usethe Trim Knob control to movethe pointer in front of the correct bed number 3 Ifthe bed number you need is not listed select CREATE NEW BED A text entry popup menu opens which works just like that for setting patient name NOTE Ifthe monitor is not on the network a text entry popup menu will open Set Graph Location This option allows you to choose writers for alarm and manual graphs refer to sections Monitor Setup Graph Setup Set Graph Location for a detailed description 3 14 Dash 2000 Patient Monitor Revision B 227 499 06 US E ADMIT DISCHARGE Admit Menu Options ECG Source This menu option is found in Combo and Rover Combo admit menus This menu option which is unique to those monitors which can obtain parameter data from telemetry or the monitor is used to tell the monitor where to get the parameter information Follow this procedure 1 Select ECG SOURCE option from the Admit M enu A popup menu and an information window are displayed 21 NOV 1998 16 27 DAK BED 1 rl enden Lee N SELECT ECG SOURCE
54. ATION Troubleshooting Some waveforms may show a combination of shallow and deep breaths If the detection sensitivity percentage is set too high the shallow breaths will not be detected Decreasethe detection sensitivity percentage until the markers correctly identify each inspiration and expiration See the markers in the figures below B breath Incorrect Detection Pra WR 132 Correct Detection Below is a list of all the messages which may be displayed in the RR parameter window during respiration monitoring What each of these messages mean as well as action to take is included These messages may appear in abbreviated form if the parameter window is sized smaller due to the number of parameters being monitored The abbreviated form if there is one is shown in parenthesis LEARNING The monitor takes approximately 8 breaths to learn the patient s respiration pattern before displaying a respiration value Learning automatically occurs whenever respiration is turned on and when the lead from which respiration is determined is switched APNEA CHECK THE PATIENT Thisis an alarm condition which requires action Breathing has not been detected for a predetermined period of seconds If necessary the apnea limit can be changed Refer to page 12 8 ARTIFACT CHECK THE PATIENT Thisis an alarm condition which requires action The monitor is unable to successfully determine respiration If it is determine
55. C Power ON O OFF PRESS Indicates where to press to open the door on the DDW Revision B Dash 2000 Patient Monitor 2 13 227 499 06 US E For your notes 2 14 SAFETY Classifications Dash 2000 Patient Monitor 227 499 06 US E Revision B 3 ADMIT DISCHARGE Lee lege une ln EE 3 2 You Must Admit to Activate Alarm 3 2 Monitors are Used in Different Ways oooonoinnniccnincnnncinncnncconnnos 3 2 Guidelines When Doing Combination Monitoring 3 3 For Which Application is the Monitor Get 3 3 Getting to the Admit Menu 3 4 Standard Admit Menu 3 5 Rover Admit MenUu a ek aere AANER det rr anal 3 6 Combo Admit Men 3 7 Rover Combo Admit Men 3 8 Admit Menu Options nsrserseerneennennnnnnnnnnnnnnnnnnnnnnnnnn non n mann 3 9 ACMA gl ul Le ic ao ead Rane 6 0 3 9 Change Admit Info 3 10 Request Admit I nfo esses 3 11 Save Admit Infos sette dde 3 11 Weight and Height AAA 3 11 Age EE 3 11 AdmitPatientari Nee dae bete mete 3 12 Admit Patient 2282 3 12 NEW e Aus ee en a 3 12 Set Unit El ocio ergehen 3 13 Set Bed Number nnn nnn nnn nun 3 14 Set Graph Location uunsennsennsennnnnnennnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nn 3 14 EERE e 3 15 Abo tDischarging ro aam ne ease 3 16 Discharge Patient enne 3 16 Standard and Rover Admit Menu 3 16 Combo and Rover Cor 3 17 NOW AG CIRCE 3 17 Revision B Dash 2000 Patient Monitor 227 499 06 US E About
56. CONTENTS Table of Contents About This Manual ix Manual PU rpose tenet ec tb Ee n expe cus ix Intended Audience ANEREN ix intended U Se tado petu en e EROS IE RR ES ix Product References cesccesceseesseeeseeeeeeeeeeeeaeeeaeeeaaecaaeeeseeeeeeeetaes ix CONVENTIONS ii audae cete te ue te lan er drca Renee dun ix Revision Hit Vivos iste nes Rn A x How ro ReaclUs i ehem ean EE Xi Service Calls and Product Support sssesesss xi Ordering Supplies and Service bart Xi Other Questions or Problems AA xii Monitor Defaults Worksheet AAA xiii 1 THE BASICS SERB RRR RRR RRR 1 1 COMPON GENES PEDE 1 2 The Monitoring System 1 2 Dash 2000 Monitor ue es 1 2 Optional Centralscope Central Station 1 4 Optional Clinical Information Center 1 5 Optional Laser Printer 1 6 Operation anni ETE 1 7 General iiti ie od deet 1 7 Trim Knob Control eic ee 1 8 Control KV Susana id 1 9 POWE WEE 1 9 Graph Go SEOD area tete ee e ee ated e io o tee 1 9 NBP Go Stop eet eet nat 1 10 Function TEE 1 10 Sil nce Alarm ee ette ees 1 10 T rning POWE Oli ad 1 11 AC ROWED ies doit ste diete laica 1 11 Normal Mode x dete e cie e et eb 1 11 Standby Mode iii a 1 11 Battery POWER MEE 1 12 Power Indicator Lights sseeeeeenn 1 13 Battery Conditioning ssseeeeeneeeneennenenes 1 14 Batte y ERE 1 15 Battery Capacity Gauge sse 1 15 Battery Service Information Window
57. Dash 2000 Patient Monitor Operator s Manual Software Version 2 227499 06 GA US E Revision B marquette A GE Medical Systems Company Trademarks NOTE Theinformation in this manual only applies to Dash 2000 software version 2 Due to continuing product innovation specifications in this manual are subject to change without notice Trademarked names appear throughout this document Rather than list the names and entities that own the trademarks or insert a trademark symbol with each mention of the trademarked name the publisher states that it is using the names only for editorial purposes and tothe benefit of the trademark owner with no intention of improperly using the trademark 900 SC ACCUSKETCH AccuVision APEX AQUA KNOT ARCHIVIST Autoseg BABY MAC C Qwik Connect CardioServ CardioSmart CardioSys CardioWindow CASE CD TELEMETRY CENTRA CHART GUARD CINE 35 COROLAN CORO COROMETRICS Corometrics Sensor Tip CRG PLUS DASH Digistore Digital DATAQ E for M EAGLE Event Link FMS 101B FMS 111 HELLIGE IMAGE STORE INTELLIMOTION IQA LASER SXP MAC MAC LAB MACTRODE MARQUETTE MARQUETTE MAC MARQUETTE MEDICAL SYSTEMS MARQUETTE UNITY NETWORK MARS MAX MEDITEL MEI MEI in the circle logo MEMOPORT MEMOPORT C MINISTORE MINNOWS Monarch 8000 MULTI LINK MULTISCRIPTOR MUSE MUSE CV Neo Trak NEUROSCRIPT OnlineABG OXYMONITOR Pres R Cuff PRESSURE SCRIBE OMI QS Quantitative Medicine Quantitative Sentin
58. E 12 11 EE 12 11 Marital Size EE 12 11 Troublechocting AANEREN 12 12 Respiratory Waveform nuerserseersennnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nn 12 12 Cardiac on Ee EE 12 12 Varying Amplitudes sse 12 13 MESSAGES E 12 13 Revision B Dash 2000 Patient Monitor 227 499 06 US E RESPIRATION Introduction Introduction Respiration monitoring can be done with any ECG cable Refer to the ECG chapter for patient preparation and electrode placement This chapter gives guidelines for adjusting respiration setup and problem solving Theillustration below shows the location of the connector on the side of the monitor used for impedance respiration monitoring ap 2p dep Sue cp Teme ga erm 030 999 ECG RESP Cable Connector Dash 2000 Monitor ECG Resp Cable Connector NOTE Thesignal input is a high insulation port and it is defibrillator proof The insulated input ensures patient safety and protects the device during defibrillation and electrosurgery NOTE Respiration monitoring is not adversely affected by the use of a patient cable with ESU filter as listed in the enclosed publication Accessories Dash 2000 3000 12 2 Dash 2000 Patient Monitor Revision B 227 499 06 US E RESPIRATION Introduction General Information WARNINGS APNEA EVENTS The monitor may not detect all episodes of inadequate breathing nor does it distinguish between central obstructive and mixed apnea events ELECT
59. GE Admit Menu Options Set Unit Name This menu option is found in the Rover and Rover Combo admit menus Theunit nameis very important for sending information to central stations and writers Look at thetop of the display The unit name CCU ICU etc is displayed on theright Isthis the unit name which identifies your unit The unit name appears here 36 6 Location of Unit Name on the Monitor If it is not the correct unit name follow this procedure to change it 1 Select SET UNIT NAME option from the Admit Menu An information window is displayed with the available unit names 21 NOV 1998 16 27 DAK BED 1 rede See SELECT A CARE UNIT gt RETURN SET GRAPH LOCATION SET UNIT NAME Popup Menu and Information Window 2 Rotate the Trim Knob control to move the pointer gt in front of the correct unit name 3 PresstheTrim Knob control Theinformation window closes and the new unit name appears at the top of the monitor NOTE If the monitor is not on the network a text entry popup menu will open Revision B Dash 2000 Patient Monitor 3 13 227 499 06 US E ADMIT DISCHARGE Admit Menu Options Set Bed Number This menu option is found in Rover and Rover Combo admit menus Another essential element to recognize the monitor on the network is the bed number Look tothe right of the unit name on the display The bed number assigned to this monitor is displayed Bed number appears here 21 NOV 19
60. Multi Lead Graph Waveform 2 ART Graph Waveform 3 Off Alarm Graph Off Timed Graph 20 seconds ART Disconnect Off Smart BP On Arterial Scale 160 PA Scale 60 CVP RA UVC Scale 30 LA Scale 30 ICP Scale 30 SP Scale 160 NBP Auto Off NBP Cuff Size Adult RR Parameter Off RR Lead II VOA Broadcast Off Alarm Volume 40 Silence Alarm Normal QRS Volume Off Rate Volume 40 ECG Leads Fail Sys Advisory SPO2 Probe Off Sys Warning Display Limits Off Display Units Off Units for Height cm Units for Weight kg Temperature Units C NBP Limits Type Systolic Arterial Limits Type Systolic PA Limits Type Diastolic Revision B Dash 2000 Patient Monitor 14 21 227 499 06 US E APPENDICES Factory Defaults Operating Room Mode Parameter Priority Defaults Thefollowing parameters when monitored will always appear in parameter windows at the right side of the display Parameter 1 ECG Parameter 2 SPO2 Parameter 3 RR The highlighted parameters below appear in parameter windows at the bottom of the display only when there is no room at the side SPO2 CVP TP RA NBP UVC ART LA FEM ICP UAC sp PA RR 4422 Dash 2000 Patient Monitor RevisionB 227 499 06 US E APPENDICES Minimum and Maximum Limits Default Mode Minimum and Maximum Limits Default Mode
61. R SPO2 LIMITS Menu and Information Window Rotate the Trim Knob control to move the pointer gt through the list Press the Trim K nob control when the pointer is in front of the parameter for which you want to change default limits The parameter label highlights 4 TurntheTrim K nob control to highlight the low or high limit Press the Trim K nob control again and rotate to change value Press the Trim Knob control to complete the change 6 Rotatethe Trim K nob control to highlight the parameter label and press to unhighlight 7 Select RETURN when all changes are completed The popup menu and information window close Revision B Dash 2000 Patient Monitor 11 11 227 499 06 US E Rate Volume Rate 11 12 SPO2 SPO2 Menu Options The RATE VOL option turns on a tone which sounds each time an SPO2 pulseis detected This is a variable pitch tone which changes as the patient s saturation level changes as the saturation level decreases the pitch of the tone also decreases The volume of this tone can be adjusted up or down 1 Select RATE VOL option from the SPO2 Menu A popup menu opens displaying all choices RATE VOL Popup Menu 2 Rotatethe Trim Knob control Y ou will hear thetone volume when an option is highlighted Press the Trim Knob control to confirm the change and dose the popup menu NOTE Turningthe rate volume on will automatically turn the QRS volume off When in OR mode the 1096 and 2096
62. R option from the CVP CURSOR Menu Another popup menu opens USE TO POSITION CURSOR ON WAVEFORM 100A CVP Cursor Popup Menu The monitor automatically calculates a scale and the new scale and cursor are displayed with the waveform A numeric cursor valueis displayed to the right of the cursor vA New Scale Cursor Cursor Value M S X CVP2 42 1 101 Cursor on CVP Waveform 3 With the popup menu open rotate the Trim K nob control to move the cursor The cursor value changes as you move the cursor 4 Pressthe Trim K nob control to close the popup menu The cursor remains on the waveform Clear Cursor Toremove the cursor from the waveform select CLEAR CURSOR option from the previous menu This is a direct action menu option 9 8 Dash 2000 Patient Monitor Revision B 227 499 06 US E PRESSURES Pressure Menu Options Limits This option provides an information window that shows the alarm limits for displayed pressures systolic diastolic and or mean A new set of menu options is displayed to allow you to adjust these limits For this example the ART information is used Follow this procedure 1 Select ART LIMITS option from the ART Menu An information window is displayed on the screen and a new set of menu options is displayed in the menu area 21 NOV 1998 16 27 DAK BED 1 ART LIMITS Menu and Information Window Rotate the Trim Knob control to move the pointer gt thro
63. RN REFORM M ART RAI n E GRAPH MENU ON OFF GRAPH SETUP Menu ECG 1 designate the ECG lead graphed as position 1 e WAVEFORM 2 3 designate the other waveforms to be graphed GRAPH LOCATION display a new menu to select writers for manual and alarm graphs e ALARM GRAPH turn automatic alarm graphing on and off GRAPH TIME SPEED control the duration of a manual graph and the speed at which a graph is run SPEEDC choose a speed at which a graph strip is run e TIMED GRAPH control the duration of a manual graph More details on the Graph Setup Menu options follow Dash 2000 Patient Monitor Revision B 227 499 06 US E ECG 1 Waveform 2 Waveform 3 Revision B MONITOR SETUP Monitor Setup Menu Each of these options designates a waveform to be printed on the graph strip You choose the waveforms the system prioritizes them based on the system priority defaults Since all of these options are similar only one WAVEFORM 2 is detailed below Usethis procedure for the other waveform options 1 Select WAVEFORM 2 option from the Graph Setup Menu A popup menu opens displaying all choices Choices available reflect the parameters currently being monitored WAVEFORM 2 Popup Menu 2 Usethe Trim Knob control to move the pointer in front of the waveform you want to be graphed 3 Press the Trim Knob control to confirm the change and close the popup menu Dash 2000 Patient M
64. RODE CONFIGURATION Impedance respiration monitoring is not reliable when ECG electrodes are placed on the limbs Respiration is detected by measuring thoracic impedance When respiration is monitored a small AC signal is applied through ECG lead or ECG lead Il This AC signal appears between the right arm and left arm electrodes or the right arm and left leg electrodes depending on the selected ECG lead Thelead selected is dependent on the type of breather the patient is Seethe figures below NOTE Thefigures below are used to show the relationship between breathing and ECG lead They do not represent an electrode configuration ECG Lead for ECG Lead Il for Upper Chest Breather Abdominal Breather Revision B Dash 2000 Patient Monitor 12 3 227 499 06 US E Checklist 12 4 RESPIRATION Introduction When starting respiration monitoring the monitor learns the patient s respiration pattern Eight breaths are averaged and the average amplitude of the respiration waveform is found Detection sensitivity is automatically set at 4096 of the average amplitude NOTE Themessage LEARNING is displayed in the RR values window during this process Markers displayed on the waveform show this 4096 detection range One marker is at inspiration the other at expiration The detection sensitivity can be manually adjusted by using the SENSITIV option from the respiration menu The waveform size is also set automat
65. RR RRR nana anne 3 1 Lee lege rege Gilet ig ee erlernen 3 2 You Must Admit to Activate Alarms seseseess 3 2 Monitors are Used in Different Ways ssseeses 3 2 Guidelines When Doing Combination Monitoring 3 3 For Which Application is the Monitor Get 3 3 Dash 2000 Patient Monitor Revision B 227 499 06 US E Revision B TABLE OF CONTENTS Getting to the Admit Menu 3 4 Standard Admit Men 3 5 Rover Admit Menu adeo tte ici 3 6 Combo Admit Menu 3 7 Rover Combo Admit Menu 3 8 Admit M enu Options EEN 3 9 AMET repite 3 9 Change Admit Info 3 10 Request Admit Info 3 11 Save Admit Info 3 11 Weight and Height corn nn nnrannna nano 3 11 p 3 11 Admit Patient 3 12 Admit Patata 3 12 NaCl 3 12 Set UJ Ne gl ET ster oce eee nee a 3 13 Set Bed Number 3 14 Set Graph Location EE 3 14 ECO SOUCO EE 3 15 About Discharging essen enne 3 16 Discharge Patient a nem 3 16 Standard and Rover Admit Menu 3 16 Combo and Rover Combo n 3 17 IUNGIT 3 17 ALARM CONTROL 1 eere Anl Smart Alafiris emnt sh ei URP ee 4 2 Alarm Structures ois oue eiat e hu etr dtes 4 3 Patient Status Alarm 4 3 System Status Alarm 4 4 Controlling AudtoAlarme essen 4 5 Silencing an Alarm for One Minute 4 5 Pa using Alarme cn eo ii ee eee 4 5 Turning Alarm Volume Off Permanently 4 5 Alarm Control Menu 4 6 NIB cn 4 7 Viewing an All Limits
66. Revision B PA CVP SPO2 FEM UAC RA UVC LA ICP SP XA XA S SNS SN SN SN SNS SNS SNS S S ART Rate TP SPO2 Rate FEM Rate UAC Rate RR Resp Apnea XA XA SS SN SNS Dash 2000 Patient Monitor 227 499 06 US E 14 19 APPENDICES Factory Defaults Operating Room Mode Parameter Limits Low High HR 1 150 NBP S 40 200 NBP D 20 120 NBP M 40 140 ART S 40 200 ART D 20 120 ART M 40 140 ART R 1 150 FEM S 40 200 FEM D 20 120 FEM M 40 140 FEM R 1 150 UAC S 40 200 UAC D 20 120 UAC M 40 140 UAC R 1 150 PA S 99 350 PA D 99 350 PA M 99 350 CVP 99 350 RA 99 350 UVC 99 350 LA 99 350 ICP 99 350 SP 99 350 SpO2 90 105 SpO2 R 1 150 RR 1 200 RR Apnea 20 TP 0 0 C 32 0 F 42 0 C 107 6 F 14 20 Dash 2000 Patient Monitor 227 499 06 US E Revision B APPENDICES Factory Defaults Operating Room Mode Display Defaults Menu Timeout 5 minutes Patient Age Adult ECG Filter Moderate Color Format Transducer BP Filter 12 Hz Primary ECG Il QRS Width Normal Arrhythmia Off Discharge Alert Off Lead Analysis Multi Lead Arterial Rate On Detect Pace Off Lead Analysis
67. Screen 4 7 Changing a Limit in the All Limits Screen 4 8 Alarm Graphit ec Sid 4 9 Alarm Vollmer ie a 4 10 Parameter Alarm L evel unnennerseerseersennnnnnnnnnnnnnnnnnnnnnnnnnnn 4 11 Arrhythmia Alarm Level sese 4 12 Dash 2000 Patient Monitor 227 499 06 US E TABLE OF CONTENTS 9 MONITOR SETUR eet anne DL Monitor Setup Menu 5 2 Monitor Defaults sci ecd else 5 3 Monitor Defaults Menu 5 3 Setup Default Arrhythmia Alarm Levels 5 4 Setup Default Parameter Alarm Levels 5 6 Setup Default Limite 5 7 Setup Default Display 5 8 Setup Default Parameter Prtoritwv 5 9 Recall Default icono 5 10 Display Setup Menu 5 11 MECA 5 12 Gio adici MM De EE che n 5 13 aoro EA 5 14 Backgrnd tec ad 5 14 Time and Date AEN 5 14 KLEER 5 15 SEE TUTE td iaa 5 15 Graph Setup EE 5 16 ECG 1 Waveform 2 Waveform 3 sss 5 17 Graph Loca 5 18 Alarm Graph ieu e 5 20 o ec re ee sein 5 20 Timed Grp Marie 5 21 Parameters On On ENEE 5 22 Software Summary 5 23 Service Mode cii eder iren Be 5 24 Patient Monitor Tvpe nnns 5 25 AdMmIEM Od EE 5 25 6 PATIENT DATA availa GERE vais GERE T 6 1 Patient Data Menu 6 2 Vital Signs ana ee 6 3 View Older View Newer 6 4 Time Interval os eet terere ete as 6 4 Specific Time cocci ae 6 4 Graphic Trends eh ree an ee tea 6 5 Select Parameters EEN 6 6 View Old
68. T Insulated floating applied part Medical Standard Definition F type applied part floating insulated complying with the specified requirements of IEC 60601 1 UL 2601 1 CSA 601 1 Medical Standards to provide a higher degree of protection against electric shock than that provided by type BF applied parts NOTE Therating of protection against electric shock indicated by symbol for CF or BF is achieved only when used with TYPE BF APPLIED PART Insulated floating applied part patient applied parts AR Je suitable for intentional external and internal application to recommended by GE the patient excluding direct cardiac application Paddles Marquette outside the box indicate the applied part is defibrillator proof Medical Standard Definition F type applied part floating insulated complying with the specified requirements of IEC 60601 1 UL 2601 1 CSA 601 1 Medical Standards to provide a higher degree of protection against electric shock than that provided by type B applied parts 0 TYPE B APPLIED PART Non insulated 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 IEC 60601 1 U L 2601 1 CSA 601 1 Medical Standards to provide protection against electric shock particularly regarding allowable leakage current Fus Xy Equipotentiality IN Alternating current A
69. TUS MESSAGE line if when fully charged the battery reaches only 40 capacity of its design capacity for cell type The BATTERY NEEDS COND system message is displayed when the battery needs to be reconditioned The COND IS RUNNING message is displayed while the battery is being reconditioned The BATTERY DEFECTIVE message is displayed when errors have occurred within the battery management system or the battery The reason of the error can be found in the error logbook MONITOR SETUP gt SERVICE MODE gt REVIEW ERRORS gt VIEW OUTPUT ERRORS Notify Service Environmental Issues GE Marquette strives to produce products that are both user safe and environmentally friendly We sincerely believe that our products and the production methods used to produce them meet these goals Battery Notice This product contains a rechargeable battery The average life span of this type of battery is approximately three years When replacement becomes necessary contact a qualified service representative to perform the replacement Disposal Notice Should this product become damaged beyond repair or for some reason its useful life is considered to be at an end please observe all local state and federal regulations that relate to the disposal of products that contain lead batteries plastics etc Dash 2000 Patient Monitor Revision B 227 499 06 US E THE BASICS Software Features Software Features Menus A menu like the name implies
70. TY For Your Safety The intended use of the monitoring system is to monitor physiologic parameter data on adult pediatric and neonatal patients between all acuity care areas Physiologic data indudes the parameters covered in this manual The monitoring system is also intended to provide physiologic data over the Unity network to clinical information systems This information can be displayed trended stored and printed Theterms danger warning and caution are used throughout this manual to point out hazards and to designate a degree or level of seriousness Familiarize yourself with their definitions and significance Hazard is defined as a source of potential injury to a person DANGER indicates an imminent hazard which if not avoided will result in death or serious injury WARNING indicates a potential hazard or unsafe practice which if not avoided could result in death or serious injury CAUTION indicates a potential hazard or unsafe practice which if not avoided could result in minor personal injury or product property damage NOTE provides application tips or other useful information to assure that you get the most from your equipment 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 statem
71. Volume Off ECG Leads Fail Sys Warning SPO2 Probe Off Sys Warning Display Limits On Display Units Off Units for Height cm Units for Weight kg Temperature Units C NBP Limits Type Systolic Arterial Limits Type Systolic PA Limits Type Diastolic Menu Timeout 5 minutes ECG Filter Monitoring Revision B Dash 2000 Patient Monitor 14 17 227 499 06 US E Parameter Priority Defaults APPENDICES Factory Defaults Neonatal ICU Mode Thefollowing parameters when monitored will always appear in parameter windows at the right side of the display Parameter 1 ECG Parameter 2 SPO2 Parameter 3 RR The highlighted parameters below appear in parameter windows at the bottom of the display only when there is no room at the side 14 18 ART FEM UAC PA RR NBP CVP RA UVC LA ICP sp SPO2 TP Dash 2000 Patient Monitor 227 499 06 US E Revision B Factory Defaults Operating Room Mode APPENDICES Factory Defaults Operating Room Mode Following are the factory set monitor defaults for the Operating Room M ode Y ou can change these using the Monitor Defaults feature Monitor defaults are recalled upon discharge Refer to the Monitor Setup chapter Arrhythmia Alarm Levels Crisis Warning Advisory Message Parameter Alarm Levels Crisis Warning Advisory Message Asystole Y HR Y VFib VTac Y NBP V Tach Y ART
72. al cautery unit and others end tidal carbon dioxide Ethylene Oxide expired Fahrenheit femoral fraction of inspired oxygen French catheter size Revision B 227 499 06 US E APPENDICES Abbreviations and Symbols g GTT CC gtt cc HAL HbO2 HCO3 Hgb HR HT Hz IABP ICP ICU ie IEEE IEC IN Inc INF INIT Inj INJ ECT Insp IRRG ISO ISU IT IV kg KG kPa Revision B G gr drops per cubic centi meter H halothane hemoglobin oxyhemoglobin bicarbonate helium hemoglobin heart rate hour height hertz inspired intra aortic balloon pump intracranial pressure intensive care unit that is Institute of Electrial and Electronics Engineers International Electrotechnical Commission inspired incorporated infusion inferior initialization injectate inspired irregular isoflurane inlet select unit injectate temperature intravenous K kilogram kilopascal L liter left left arm left atrial lateral pounds liquid crystal display lead light emitting diode left leg left ventricular stroke work index Dash 2000 Patient Monitor 14 5 227 499 06 US E APPENDICES Abbreviations and Symbols MM S MRI N2 N20 NBP NEO Neo NRT NS 02 O2CI O2D1 O2R OR PA PaCO2 PAD Pa FiO2 PAM PaO2 PAO2 PAUS PAW PBAR PCO2 PEAKP PED Dash 2000 Patient Monitor M mean minute meter mean arterial pressure mean airway pressure micrograms
73. al professionals are expected to have working knowledge of medical procedures practices and terminology as required for monitoring of critically ill patients This product is intended for use as a hospital patient monitor It is NOT intended for home use The Dash 2000 patient monitor is referred toin this manual as the Dash monitor or simply the monitor The Centralscope central station and the Clinical Information Center are generically referred to as the central station in this manual The Direct Digital Writer is referred to as DDW or writer Thelaser printer is referred to as the printer References to screen text appear throughout this manual in all capital letters for example ECG DISCHARGED SAVING ALARM VOLUME OFF etc This manual refers to keys menus and menu options Keys a labeled button found on the front of the monitor which you press to activate Menus and Menu Options A menu is text which appears at the bottom of the display screen A menu is composed of a set of menu options Each menu option is endosed in a rectangle How can you tell what software package you have Follow this procedure 1 Select MORE MENUS option from the Main Menu 2 Select MONITOR SETUP from the menu displayed 3 Select SOFTWARE SUMMARY from the Monitor Setup Menu An information window is displayed The software package number is displayed in the second line of the title in the information window Illustrations All illus
74. alarm alerts you to the fact that the respiration rate is within 5 of the heart rate over 30 consecutive breaths If this happens the respiration program may be counting heart beat artifact as respiration The cardiac artifact alarm is an Advisory alarm ARTIFACT is displayed in the RR values window and a 1 beep tone sounds There is no adjustable limit for this alarm but you can turn it off and on WARNING If the cardiac artifact alarm is turned off apnea events may not be detected Select CARDIAC ARTIFACT option from the Respiration Menu toturn the alarm off and on This is a direct action menu option Dash 2000 Patient Monitor Revision B 227 499 06 US E RESPIRATION Respiration Menu Options Size The size of the waveform can be changed manually or automatically To perform this operation follow this procedure 1 Select SIZE option from the Respiration Menu a new set of menu options is displayed Respiration Size Menu 2 Select either AUTOSIZE or MANUAL SIZE option Auto Size NOTE Thesize of the waveform has no effect on the detection capability of the program During the learning process the displayed waveform is automatically sized tofit a predetermined area of the screen During monitoring the size may have been changed manually see below Select AUTO SIZE option to automatically resize the waveform to fit the predetermined area Thisisa direct action menu option Manual Size If desired you
75. amages or impaired monitor functions which present a hazard to the patient or the user havethe monitor inspected and repaired before using it again Furthermore the alarm system audio alarms alarm indicators must be checked Dash 2000 Patient Monitor 7 3 227 499 06 US E General Cleaning MAINTENANCE General Cleaning WARNING Disconnect the monitor from the power line before deaning or disinfecting its surface The equipment should be deaned on a regular basis Comply with the policies of your institution s infection control unit and or biomed department The exterior surfaces of the equipment may be cleaned with a dampened lint free cloth Use one of the following approved solutions e ammonia diluted e Cidex sodium hypochlorite bleach diluted or mild soap diluted To avoid damage to the equipment follow these rules CAUTION Failureto follow these rules may melt distort or dull the finish of the case blur lettering on the labels or cause equipment failures Always dilute the solutions according to the manufacturer s suggestions Always wipe off all the cleaning solution with a dry cloth after cleaning Never use wax containing a cleaning substance Never pour or spray water or any deaning solution on the equipment or permit fluids to run behind switches into the connectors or into any ventilation openings in the equipment Never use these cleaning agents
76. analysis e try switching to the other pace detection mode Pacemaker mode In most cases Pace 2 mode will effectively monitor a pacemaker patient However if you are experiencing problems select the Pace 1 mode as an option and observe all cautions as described for the Pace 1 mode of operation Here are some additional guidelines for successful monitoring of pacemaker patients When using the 10 leadwire patient cable with all electrodes attached pace detection occurs on any V lead selected for the top trace position For more information refer to Troubleshooting in this chapter Dash 2000 Patient Monitor 8 21 227 499 06 US E QRS Width Changing QRS width 8 22 ECG ECG Menu Options With the QRS WIDTH option you can choose between normal and narrow QRS widths e QRS normal Use the Normal mode for ECG rhythms that have QRS complex widths of approximately 70 ms or wider This includes almost all adult patients and also any patient with electronic ventricular pacing QRS narrow The Narrow mode is intended for use with all neonatals and pediatric patients who have a QRS complex width of 120 ms or less NOTE Full range of QRS amplitude sensitivity is achieved for QRS x80 ms The QRS WIDTH option opens a popup menu that allows you to specify the QRS width type to NORMAL or NARROW The selected width type will be sent to the monitor for use in the ECG analysis algorithms To change the QRS width fo
77. and OP ROOM The patient must be DISCHARGED to change the patient monitor type Remember when you change the pati ent monitor type any Monitor Defaults you have set will belost and factory defaults will again bein effect Another option in the Service Menu which affects your monitor is the ADMIT MODE The admit mode determines the menu options you will use when admitting a patient to the monitor The admit modes are Standard Rover Combo and Rover Combo ROV COM Dash 2000 Patient Monitor 5 25 227 499 06 US E For your notes 5 26 MONITOR SETUP Monitor Setup Menu Dash 2000 Patient Monitor 227 499 06 US E Revision B 6 PATIENI DATA Patient Data MENU cer eb Ele te Le cro a E ada 6 2 Viet EE 6 3 View Older View Newer 6 4 Timelnterval nennen nnne 6 4 Specific Time eee taa 6 4 Graphic Trends act ee 6 5 Select Parametere 6 6 View Older View Newer 6 7 TIS Perlod EE 6 7 Revision B Dash 2000 Patient Monitor 227 499 06 US E PATIENT DATA Patient Data Menu Patient Data Menu Select PATIENT DATA from the Main Menu to display the following menu MAIN VITAL GRAPHIC MENU SIGNS TRENDS PREV MENU qua quA 073 PATIENT DATA Menu VITAL SIGNS TABULAR TRENDS display the values for the patient s monitored parameters over the last 24 hours e GRAPHIC TRENDS plot trends for selected parameters Detailed information on each option is found in this chapter 6 2
78. and it is defibrillator proof Qe Use only the temperature probes listed in the enclosed publication Accessories Dash 2000 3000 These probes ensure patient safety and protect the device during defibrillation and electrosurgery Checklist 1 Thetemperature probe is correctly positioned on the patient Follow appropriate medical procedures Temperature cable is attached to the monitor 3 Temperature setup is adjusted if necessary Follow detailed procedures within this chapter 13 2 Dash 2000 Patient Monitor Revision B 227 499 06 US E TEMPERATURE Temperature Monitoring Features Temperature Monitoring Features Temperatu re Temperature monitoring provides numerical information only no Inf i waveform As with other parameters numerics are displayed in the nformation temperature TP parameter window on the right side of the screen Temp Limits Units Temp Value Temperature Parameter Window The parameter window displays the current temperature values with the unit of measurement Y ou can monitor a patient s temperature at multiple sites Both internal and external temperature sensors may be used The monitor calculates the monitored temperature and displays its value on the screen The monitor is compatible with YSI series 400 probes listed in the enclosed publication Accessories Dash 2000 3000 The temperature cable is plugged into the TEMP cable connector on the monitor The temperature monitoring feature
79. atus Alarms Within each dassification there are levels which correlate to how severethe condition is that is causing the alarm Thelevels and how the monitor responds to each are described below Patient status alarms can in most cases be moved from one level to another Refer tothis chapter Arrhythmia Alarm Level and Parameter Alarm L evel Patient status alarms are triggered by patient condition which exceeds parameter limits or by an arrhythmia condition Patient status alarms provide you the highest priority information The levels within the Patient Status Alarm category and how the monitor responds to each is shown in the following chart The chart begins with the most critical type of alarm Crisis and ends with the least critical type of alarm Message NOTE Only for monitors without arrhythmia detection For patients at risk of asystole it is recommended to assign the HR alarm to the Crisis level when assigned to the Warning level the HR alarm will clear automatically after 3 minutes in cases of continued asystole Dash 2000 Patient Monitor 4 3 227 499 06 US E ALARM CONTROL Alarm Structure Alarm Level Monitor Response i N d MAA 7 2 crisis f A E Ka VAN WARNING Tz 200 EXA ZIN i NAA ADvisoRY 200 ZIN SIZ MESSAGE 200 ZO UN Crisis Alarm must be silenced by the user S Alarm Tone oer Flashing Visual Alert 3 2 or 1 beep i Text
80. ayed in place of the mean value If AUTO modeis on a countdown timer is displayed in the lower left corner The NBP values change to X if no NBP monitoring has taken place for 2 hours in ADULT I CU mode 15 minutes in OPERATING ROOM mode and 12 hours in NEONATAL I CU mode TheNBP monitoring features are found in the NBP Menu These features indude AUTO and STAT modes reviewing previous NBP measurements cuff size alarm limits and clearing readings NBP Go Stop Key The NBP GO STOP key on the front of the monitor is a quick way to take one measurement without going into the NBP menu It can also be used to stop a measurement already in progress Power Key If you turn the power off with the POWER key on the front of the monitor NBP is also turned off This applies to both auto NBP if running and manual NBP Turning the power on again enables manual NBP It does not automatically restart auto NBP Revision B Dash 2000 Patient Monitor 10 5 227 499 06 US E NBP NBP Monitoring Features Getting to the NBP Todisplay the NBP Menu usethe Trim Knob control to select the pressure M parameter label Remember selecting with the Trim K nob control is a two enu step process rotateto highlight then press to select 200 80 S mmHg mm 111 71 Sy gt Selecting the NBP Parameter Label The NBP Menu is displayed at the bottom of the screen NBP READING 110 NBP Menu With the Trim Knob control you now can select
81. ays 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 e Thesymbol N means ATTENTION Consult accompanying documents e Information which refers only to certain versions of the product is accompani ed 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 e GE Marquette 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 Marquette Medical Systems the electrical installation of the relevant room complies with the requirements of the appropriate regulations and thedevice is used in accordance with the instructions for use e All publications are in conformity with the product specifications and IEC publications on safety of electromedical equipment as well as with UL and CSA requirements and AHA recommendations valid at the time of printing TheGE Marquette quality management system complies with the standards DI N EN ISO 9001 and EN 46001 and the Council Directive on Medical Devices 93 42 EEC NOTICES 2 Dash 2000 Patient Monitor Revision B 227 499 06 US E TABLE OF
82. can be placed in the 5 lead Multi Link patient cable Standard Molded 3 leadwire Set Rotating Reference e Selectable lead I Il or Ill cable with a rotating reference right arm left arm left leg Operation of the monitor with this standard cable allows you to select one of three leads I I1 or 111 for monitoring When using the standard 3 leadwire configuration the following operating conditions occur DANALYSIS automatically switches to single lead analysis If an attempt is made to change to multi lead analysis a message NOT POSSIBLE WITH 3LEAD CABLE will appear briefly and no change will occur e DISPLAY LEAD choices are limited tol II and III e Any options usually allowing more than one ECG lead selection will be disallowed A message lineis displayed briefly indicating such Dash 2000 Patient Monitor 8 5 227 499 06 US E ECG Electrode Placement e Respiration can be monitored from either lead or Il It is not dependent on the displayed lead Electrode Placement WARNING for Neonates Route cables away from patient s throat to avoid possible strangulation Because of the size of neonatal patients there is usually only enough room for a 3 leadwire electrode configuration A 3 lead neonatal ECG cableis available and a Multi Link DIN adapter is available for the 5 lead Multi Link cable The right arm and left arm or right arm and left leg electrodes are positioned on the right and left
83. city of the type of battery installed will be represented on the gauge by a dashed outline The maxi mum charge level for the cell currently installed in the monitor is represented by a solid outline on the gauge As the battery ages and its charging capacity becomes diminished this line becomes a smaller percentage of the full rated capacity shown by the solid line Refer to the following examples HN ge New battery New battery Old battery Old battery charged fully charged approximately fully charged to approximately 60 charged 75 of its current capacity less than half of its new capacity 008 Revision B Dash 2000 Patient Monitor 1 15 227 499 06 US E Battery Service Information Window Battery Status Messages THE BASICS Battery Power The Battery Service Information window can be accessed using the Trim Knob in the Monitor Setup gt Service Mode menu by selecting the Battery Service softkey The Battery Service Information window includes the following information BATTERY SERVICE INFORMATION BATTERY CAPACITY ACTUAL FULL ACTUAL REMAINING FULL NEW REPLACE BELOW BATTERY TEMPERATURE LAST CONDITIONING 21 NOV 1998 Battery Service Information Window The BATTERY LOW message is displayed in the STATUS MESSAGE line and indicates 10 minutes of battery life remaining You should connect the monitor to an AC power source when the message is displayed The REPLACE BATTERY messageis displayed in the STA
84. communications and battery charging The monitor will enter STANDBY mode when plugged into AC power and the monitor is turned OFF The battery charging function is the only function provided when the monitor is off AC power indicator AC Power Indicator Dash 2000 Patient Monitor 1 11 227 499 06 US E Battery Power THE BASICS Battery Power The monitor has a built in battery pack to provide power to the monitor whenever AC power is interrupted The battery pack is composed of ten nickel cadmium batteries The battery pack is generally referred to as the battery You must charge the battery before using it There is no external charger The battery is charged when the monitor is connected to AC power A fully depleted battery will take 1 hour when the monitor is switched off and up to 3 hours when the monitor is switched on to fully charge To assurea fully charged battery which is ready for use we recommend that the monitor be plugged into AC power whenever it is not in use Depending on usage you can get 2 to 3 hours of battery power on a new fully charged battery on a color monitor and up to 4 hours on a monochrome monitor NBP and SpO2 monitoring and the usage of the recorder will drain battery power faster than other parameters NOTE A Battery Low message at the top of the screen and an audible system alarm indicate 10 minutes of battery life remaining Y ou should connect the monitor to an AC power sou
85. connected to the BP connector on the monitor In conformity to common practice connection of the extracorporeal pressure transducer to the patient is accomplished by tubes with stopcocks located near the transducer dome This chapter gives guidelines for preparation adjusting setup and specialized features for invasive pressure monitoring Detailed operating procedures are given for the CVP pressure site Other pressure sites have menu items just like those in the CVP Menu so you can apply the same principles when monitoring those sites There is one blood pressure connector labeled BP on the right side of the monitor as shown in the illustration below Op 22 RE N BP A gl Ss ee qup Function Zero 004A Location of the ZERO Control Key Dash 2000 Monitor BP Connector NOTE Thesignal input is a high insulation port it is defibrillator pr oof qup and protected against ESU The insulated input ensures patient safety and protects the device during defibrillation and electrosurgery Dash 2000 Patient Monitor Revision B 227 499 06 US E PRESSURES Introduction Assigned BP Names The invasive pressure connector is labeled BP on the monitor However the site name can be changed during the setup procedure Having a name properly reflect the site is important for proper processing of the waveform since different algorithms are used for processing different pressure sites Site names supported and values displayed are arter
86. correct if using a 5 leadwire patient cable ECG setup is adjusted if necessary Follow detailed procedures within this chapter 8 2 Dash 2000 Patient Monitor Revision B 227 499 06 US E Skin Preparation Revision B ECG Skin Preparation The quality of ECG information displayed on the monitor is a direct result of the quality of the electrical signal received at the electrode Proper skin preparation is necessary for good signal quality at the electrode A good signal at the electrode provides the monitor with valid information for processing the ECG data Choose flat non muscular areas to place electrodes then follow the established prep protocol for your unit Following is a suggested guideline for skin preparation 1 2 3 Shave hair from skin at chosen sites Gently rub skin surface at sites to remove dead skin cells Thoroughly clean the site with alcohol or a mild soap and water solution Be sure to remove all oily residue dead skin cells and abrasives Leftover abrasion particles can be a source of noise Dry the skin completely before applying the electrodes Dash 2000 Patient Monitor 8 3 227 499 06 US E ECG Electrode Placement Electrode Placement The chart below shows the label used to identify each leadwire Included also is its associated color code per AHA and IEC standards Leadwire AHA AHA IEC IEC Software Label Color Label Color Label RA right arm wh
87. cquisition Mocdhules AAA 14 2 Abbreviations and Symbols A 14 3 Abbreviations sic ecrit a des e eto Ran 14 3 s riv 14 9 Software back age 14 10 Factory Defaults Adult I CU Mode esses 14 11 Factory Defaults Neonatal I CU Mode 14 15 Factory Defaults Operating Room Mode 14 19 Minimum and Maximum Limits Default Mode 14 23 Technical Specifications oooconocinnnccnncnnnconnccnnccnnccnnccnacrrrnnannnnn 14 24 BIEN 14 24 Bo guys PEE 14 24 ll Le MR 14 24 Pici OP 14 24 EG leise 14 24 Respiration 2 re d et a te ten d tta 14 26 Temperature EMP 14 26 Invasive Blood Pressure Bb 14 26 Pulse Oximetry SpO2 sss 14 27 Non invasive Blood Pressure NBP een 14 27 Analog Output necne nte teet teen Petre oti 14 28 Defibrillator Synchronization Pulse 14 28 Environmental Gpedflcatlonms 14 28 Physical Gpecflcatloms nennen 14 29 Certificati oN ERES 14 29 Warr aney E 14 29 EC Declaration of Conformity sess 14 30 viii Dash 2000 Patient Monitor Revision B 227 499 06 US E PREFACE About This Manual About This Manual Manual Purpose Intended Audience Intended Use Product References Conventions Revision B This operator manual has been prepared by the technical writing staff of GE Marquette Medical Systems It provides operating instructions for the Dash 2000 patient monitor This manual is geared for clinical professionals Clinic
88. ct cect eie e td i tee HH Rer anata c 11 12 Probe Off Patient Condition sese 11 13 Troubleshooting ee te 11 14 IR Ee EE 11 14 Dash 2000 Patient Monitor 227 499 06 US E SPO2 Introduction Introduction WARNING SpO2 monitoring may interfere with MRI operation NOTE SpO2 and SPO2 are used interchangeably in this chapter SPO2 monitoring is a noninvasive technique used to measure the amount of oxygenated hemoglobin and pulse rate by measuring the absorption of selected wavelengths of light functional saturation The light generated in the probe passes through the tissue and is converted into an electrical signal by the photodetector in the probe The monitor processes the electrical signal and displays on the screen a waveform and digital values for SpO2 and pulserate This chapter provides guidelines for successful SPO2 monitoring SPO2 Cable Connector L Jh SC keng Dale 114 Dash 2000 Monitor SPO2 Cable Connector NOTE Thesignal input is insulated and it is defibrillator proof a Theinsulated input ensures patient safety and protects the device during defibrillation and electrosurgery 11 2 Dash 2000 Patient Monitor Revision B 227 499 06 US E SPO2 Neonates and Infants Neonates and Infants Revision B WARNING The display of inaccurate pulse oximetry SPO2 values has been linked to the presence of poor signal strength or artifact due to patient motion during
89. d that patient condition is not the cause it may be necessary to reprep the patient s skin and change the electrodes to resume monitoring of respiration Dash 2000 Patient Monitor 12 13 227 499 06 US E RESPIRATION Troubleshooting LDI FAIL or LD II FAIL CHECK THE PATIENT This is an alarm condition which requires action Thelead monitoring respiration has failed You can manually switch respiration detection to the other lead refer to page 12 7 Or it may be necessary to reprep the patient s skin and change the electrodes LEADS FAIL LDS FAIL CHECK THE PATIENT This is an alarm condition which requires action It may be necessary to reprep the patient s skin and change the electrodes 12 14 Dash 2000 Patient Monitor Revision B 227 499 06 US E 13 TEMPERATURE MEP OGUCEI ON ERES 13 2 Checklist nee 13 2 Temperature Monitoring Features 13 3 Temperature Information 13 3 Getting to the Temperature Men 13 4 Temperature Menu Options sese 13 5 LEES enge eoe ute ted t Ete ltd 13 5 TRIM a 13 5 Troubleshooting essere a enn nnn nnns 13 6 flos ege deed Ee een ee dee Ree Zeie 13 6 Revision B Dash 2000 Patient Monitor 227 499 06 US E TEMPERATURE Introduction Introduction Onetemperature site can be monitored with the Dash monitor gp 8 Dh So A EE ES TEMP Cable Connector Dash 2000 Monitor TEMP Cable Connector NOTE TheTEMP cable connector is a high insulation port
90. e 800 558 5102 U S only 414 521 6856 outside U S Fax 800 232 2599 U S only 414 521 6855 outside U S Service parts GE Marquette Service Parts P O Box 9100 100 Marquette Drive J upiter FL 33468 9100 Telephone 800 321 3251 U S only 561 575 5000 outside U S Fax 800 421 6841 U S only 561 575 5050 outside U S Have the following information handy before calling part number of the defective part or model and serial number of the equipment part number name of the assembly where the item is used item name and where applicable reference designation e g R13 S12 U 32 Ordering Manuals When ordering additional operator manuals be sure toindudethe software version of the product Dash 2000 Patient Monitor xi 227 499 06 US E PREFACE How To Reach Us Other Questions or For additional information contact one of the offices listed below Problems Headquarters GE Marquette Medical Systems Inc 8200 West Tower Avenue Milwaukee Wisconsin 53223 U S A Telephone 414 355 5000 800 558 5120 U S only Fax 414 355 3790 Europe Marquette H ellige GmbH Postfach 60 02 65 D 79032 Freiburg Germany Telephone 49 761 4543 0 Fax 49 761 4543 233 Australia Marquette M edical Systems Australia Pty Ltd Forest Corporate Centre Suite 7 19 Rodborough Road Frenchs Forest NSW 2086 Australia Telephone 61 2 9975 5501 Fax 61 2 9975 5503 Japan Marquette Medical Sy
91. e pressure menu options The SCALES option allows you to change the scale on which the pressure waveform is displayed on the screen Changing the scale changes the size of the waveform Scales can be set in Monitor Defaults Follow this procedure 1 Select CVP SCALES option from the CVP Menu A popup menu opens showing the scale sizes available The scale currently used is designated with the pointer 2 CVP SCALES Popup Menu NOTE The auto scale is only an option once the pressure is zeroed 2 With the Trim Knob control move the pointer to the desired scale size The scale on the display will not change until the Trim K nob control is pressed Pressing the Trim Knob control also closes the popup menu Selecting AUTO will calculate a scale based on the patient s current blood pressure NOTE Auto scaled waveforms will graph on a slightly different scale than displayed Dash 2000 Patient Monitor 9 7 227 499 06 US E PRESSURES Pressure Menu Options Cursor This option takes you to a menu that allows you to place a cursor dashed horizontal line across the pressure waveform The cursor is moveable and is used to give accurate pressure values at selected points on the pressure waveform A numeric value is displayed on the screen tothe right of the cursor Tousethis feature proceed as follows 1 Select the CURSOR option from the Pressure menu The CURSOR menu appears CVP CURSOR Menu 2 Select CVP CURSO
92. e aas 1 28 Revision B Dash 2000 Patient Monitor 227 499 06 US E Components The Monitoring System Dash 2000 Monitor THE BASICS Components The Dash 2000 monitor is a self contained patient transport monitor available with a built in writer optional The monitor can be viewed on a Tramscope monitor an Eagle 4000 monitor a Dash 3000 monitor a Centralscope central station or a Clinical Information Center over the Marquette Unity Network via Ethernet This device is designed to monitor a fixed set of parameters including ECG noninvasive blood pressure impedance respiration SpO2 and temperature Invasive pressure is an optional feature All of the patient cable connectors are located on the right side panel of the monitor The screen displays patient information in a logical easily understood format A Trim Knob control provides single control operation of virtually all monitor functions The monitor is available in both monochrome and color Screen Trim Knob Control Patient Cable Connectors marquette 001 Monitor Front and Side Views Theillustration above shows one invasive pressure connector labeled BP This is an optional feature which your monitor may not have References are made to this optional feature throughout the manual Please ignore such references if this feature was not purchased with your monitor Dash 2000 Patient Monitor Revision B 227 499 06 US E THE
93. e graph will run continuously until GRAPH GO STOP is pressed again Notethat an alarm graph run is usually an automatic 20 second ti med graph This key is also used to print a copy of non real time screens We refer to these as information windows Not all information windows can be printed If a printable information window is displayed press GRAPH GOU STOP to print a copy If a nonprintable information window is displayed pressing the GRAPH GO STOP key prints patient data as if the information window was not displayed Dash 2000 Patient Monitor 1 9 227 499 06 US E NBP Go Stop Function Silence Alarm THE BASICS Operation This key starts one noninvasive blood pressure measurement It can also be used at any time to stop a measurement in process NOTE In Operating Room Mode if an auto mode time is set in monitor defaults pressing the NBP GO STOP key starts the auto mode feature This key zeroes the invasive pressure line The pressure can also be zeroed if desired with a menu option in the pressure menu If your monitor does not have the invasive pressure option this key will be present but will not affect the operation of the monitor This key silences a current audible alarm for 60 seconds Only new alarms of equal or higher level interrupt the silence command Press the key twice during an alarm to start an alarm pause five minutes for Adult I CU 3 minutes for Neonatal ICU Press the key again during the alarm
94. eTrim Knob control to highlight the low or high limit Press the Trim Knob control again and rotate to change value Press the Trim Knob control to complete the change 6 Rotate the Trim Knob control to highlight the parameter label and press to unhighlight 7 Select RETURN when all changes are completed The popup men and information window close 12 8 Dash 2000 Patient Monitor Revision B 227 499 06 US E Sensitivity Revision B RESPIRATION Respiration Menu Options During the learning process the monitor automatically sets the detection sensitivity at 4096 of the average amplitude Markers are displayed on the waveform showing the detection points at inspiration and expiration If you need to change the detection sensitivity because of varying amplitudes or artifact follow this procedure 1 Select SENSITIV ITY option from the respiration menu A popup menu opens showing the choices available Any change is effective immediately The lower the percentage the greater the detection sensitivity gt 40 30 20 10 SENSITIV Popup Menu 2 As you change the sensitivity percentage the markers will move on the waveform This adjustment occurs immediately When you are satisfied with the detection sensitivity press the Trim K nob control to dose the popup menu Dash 2000 Patient Monitor 12 9 227 499 06 US E Cardiac Artifact Alarm 12 10 RESPIRATION Respiration Menu Options The cardiac artifact
95. ection 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 biomed department WARNING Failure on the part of the 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 has been done The service manuals contain detailed information Follow these guidelines when inspecting the equipment e Inspect the equipment for obvious physical damage and replace damaged items e Inspect all cords for fraying or other damage Inspect all plugs and connectors for bent prongs or pins Repair or replacement must be performed by qualified service personnel Inspect all cable insulation Qualified service personnel should repair or replace damaged or deteriorated cables In theUnited States GE Marquette Service is available 24 hours a day by calling 800 558 7044 Outside the United States please contact your sales service office NOTE Refer to the service manuals for more comprehensi ve checkout procedures Check before each use Before each use visually check the monitor the cables and the sensors for signs of mechanical damage Check all functions relevant to patient monitoring Should you detect d
96. ed in the RR parameter window on the right side of the screen R Limits Breath Indicator RR 0 Respiration Rate Lead Monitored 124 RR Parameter Window The parameter window displays the current respiration rate and the ECG lead used to monitor respiration A flashing breath indicator lung symbol is displayed with each breath detection Alarm limits may be displayed for respiration rate and apnea Therespiration monitoring features are found in the RR parameter menu These features include lead relearn sensitivity limits size and cardiac artifact alarm Dash 2000 Patient Monitor 12 5 227 499 06 US E RESPIRATION Respiration Monitoring Features Getting to the Todisplay the Respiration Menu usethe Trim K nob control to select the R irati M RR parameter label Remember selecting with the Trim K nob control is a espiration Menu two step process rotate to highlight then press to select NOTE Ifthe parameter label is not displayed select PARAM ON OFF option in the Monitor Setup Menu toturn respiration on Then select the RR parameter label e Selecting the RR Parameter Label The Respiration Menu is displayed at the bottom of the screen Respiration Menu With the Trim Knob control you now can select any of the displayed options LEAD change the lead from which the respiration rate is derived e RELEARN RESP tell the monitor to examine and relearn the patient s respiration pattern
97. el RAC RAMS RSVP SAM SEER SILVERTRACE SOLAR SOLARVIEW Spectra 400 Spectra Overview Spectra Tel ST GUARD TRAM TRAM NET TRAM RAC TRAMSCOPE TRIM KNOB Trimline UNITY logo UNITY NETWORK Vari X Vari X Cardiomatic VariCath VARI DEX VAS and Vision Care Filter are trademarks of GE Marquette Medical Systems Inc registered in the United States Patent and Trademark Office 12SL 15SL Access AccuSpeak ADVANTAGE BAM BODYTRODE Cardiomatic CardioSpeak CD TELEMETRY amp LAN CENTRALSCOPE Corolation EK Pro EDIC Event Link Cumulus Event Link Cirrus Event Link Nimbus HI RES ICMMS IMAGE VAULT IMPACT wf INTER LEAD LIFEWATCH Managed Use MARQUETTE PRISM MARQUETTE RESPONDER MENTOR MicroSmart MMS MRT MUSE CardioWindow NST PRO NAUTILUS OCTANET O2 SENSOR OMRS PHi Res Premium Prism QUIK CONNECT V QUICK CONNECT QT Guard SMARTLOOK SMART PAC Spiral Lok Sweetheart UNITY Universal Waterfall and Walkmom are trademarks of GE Marquette Medical Systems Inc GE Marquette Medical Systems Inc Marquette Hellige GmbH 8200 West Tower Avenue Postfach 60 02 65 Milwaukee WI 53223 USA D 79032 Freiburg Germany Tel 1 414 355 5000 Tel 49 761 45 43 0 800 558 5120 US only Fax 449 761 45 43 233 Fax 1 414 355 3790 GE Marquette Medical Systems Inc 1999 All rights reserved Dash 2000 Patient Monitor Revision B 227 499 06 US E 6 May 1999 NOTICES CE Marking Information CE Marking Infor
98. emote alarm RMTVID remote video RR respiration rate RTFC artifact RVSWI right ventricular stroke work index S S systolic Sa02 arterial oxygen saturation sec second SOL solution SP special SPEC spectrometer SpO2 arterial oxygen saturation from pulse oximetry SUM summation SV stroke volume SvO2 mixed venous oxygen saturation SVR systemic vascular resistance SVRI systemic vascular resistance index SYNC Sync synchronization SYS systolic Dash 2000 Patient Monitor 14 7 227 499 06 US E APPENDICES Abbreviations and Symbols TI TACH Temp TEMP TGMY TV UAC UVC V V VAC VBRADY VBRD VENT V Fib V FIB VID VNT VT VTAC V Tach V TACH VOL WT Dash 2000 Patient Monitor T temperature site 1 temperature site 2 tachycardia temperature trigeminy temperature tidal volume U umbilical artery catheter umbilical venous catheter V precordial lead volt volts AC alternating current ventricular bradycardia ventricular bradycardia ventilator ventricular fibrillation video ventilator ventricular tachycardia ventricular tachycardia ventricular tachycardia volume Ww weight x multiplier when used with a number 2X denotes invalid data when used in place of a value on the display Revision B 227 499 06 US E Symbols Revision B APPENDICES Abbreviations and Symbols 12SL 12 lead ECG analysis amp and 7 degr ee s gt greater than lt less than minus numb
99. en selected displays neither a popup menu nor a subordinate menu The option either turns a feature on or off or starts a processing function For example selecting the SMART BP ON option from the ART SETTINGS menu turns the Smart BP feature off In ON OFF cases the menu option reflects the current state selecting it switches to the other state SMART BP OFF Other direct action options start a process For example selecting the RELEARN option from the ECG parameter menu tells the monitor to immediately start to relearn the patient s ECG rhythm You can t stop these processes as they are short term and stop automatically therefore the words identifying the menu option do not change as in ON OFF actions Dash 2000 Patient Monitor 1 21 227 499 06 US E THE BASICS Software Features Parameter Windows Parameter windows are displayed on the far right side of the screen and when necessary across the bottom Every monitored parameter has a parameter window Each parameter window has two parts a parameter label and digital values Depending on how you have set your defaults limits and units of measure may be displayed under the parameter label ART Parameter Window 1 22 Dash 2000 Patient Monitor Revision B 227 499 06 US E THE BASICS Software Features Information Windows Another window that is sometimes displayed on the screen is called an information window This large window is superimposed over the middle le
100. ending on how your monitor is set up you will see one of two menu options DISCHARG PATIENT or NEW CASE This menu option indicates that the patient is admitted You select it to discharge the patient To discharge a patient from the Standard and Rover admit menu follow this procedure 1 Select MORE MENUS 2 Select ADMIT MENU todisplay the Admit Menu 3 Select DISCHARG PATIENT option from the Admit Menu A popup menu opens gt ADMITTED PATIENT DISCHARGE 042A Standard and Rover Popup Menu to Discharge 4 Disconnect all patient cables Rotate the Trim Knob control to move the pointer to DISCHARG Press the Trim Knob control The message DI SCHARGED appears at the top of the display and all data is cleared from the system Dash 2000 Patient Monitor Revision B 227 499 06 US E ADMIT DISCHARGE About Discharging Combo and Rover To discharge a patient from the Combo and Rover Combo admit menu Combo follow this procedure 1 Select MORE MENUS 2 Select ADMIT MENU to display the Admit Menu 3 Select DISCHARG PATIENT to display the following popup menu MENU MONO PATIENT TELEMETRY 042B Combo and Rover Combo Popup Menu to Discharge 4 Rotatethe Trim Knob control to move the pointer gt in front of RETURN if you do not want to discharge MONITOR to discharge patient from monitor only If ECG was from telemetry telemetry will remain admitted but will not be monitored by this monitor The central stat
101. ents are presented in no way implies order of importance There are no dangers that refer to the equipment in general Specific Danger statements may be given in the respective sections of this manual Dash 2000 Patient Monitor Revision A 227 499 06 US E Warnings Revision B SAFETY For Your Safety WARNINGS 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 ACCURACY If the accuracy of any value displayed 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 ALARMS Do not rely exdusively 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 BEFORE USE Before putting the system into operation visually inspect all connecting cables for signs of damage Damaged cables and connectors must be replaced immediately Before us
102. er ADMIT PATIENT a direct action menu option that admits the patient DISCHARG PATIENT opens a popup menu to confirm the discharge of the patient Refer tothis chapter Admit Menu Options if you need more details on these menu options Dash 2000 Patient Monitor 3 7 227 499 06 US E ADMIT DISCHARGE Rover Combo Admit Menu Rover Combo Admit Menu With this application you are combining the Rover and the Combo applications into one The monitor may be on a cart which allows you to move it from one room to another and ECG data can be obtained from the monitor or from a telemetry transmitter NOTE A room must have network cable in order to use telemetry T SET RAPH LOCATION 030 ICU Admit Menu Rover Combo Application NOTE XXX ADMIT if patient is discharged DISCHARG otherwise NOTE It is not likely that this application is used when the monitor is set for Operating Room mode H owever the admit menu would look just like this one ECG SOURCE choose either the monitor or a telemetry transmitter from which to receivethe patient s parameter data ADMIT INFO opens the admit information window and popup menu refer to section Admit Info later in this chapter ADMIT PATIENT a direct action menu option that admits the patient DISCHARG PATIENT opens a popup menu to confirm the discharge of the patient SET UNIT NAME verify or change the unit name The correct unit name is essential for recognitio
103. er percent plus or minus Dash 2000 Patient Monitor 227 499 06 US E APPENDICES Software Packages Software Packages Thereis an invasive pressure software package available for the Dash 2000 patient monitor This package can be activated by entering a password in the service mode 14 10 Dash 2000 Patient Monitor Revision B 227 499 06 US E APPENDICES Factory Defaults Adult ICU Mode Factory Defaults Adult ICU Mode Following are the factory set monitor defaults for the Adult I CU Mode You can change these using the Monitor Defaults feature Monitor defaults are recalled upon discharge Refer to the Monitor Setup chapter Arrhythmia Alarm Levels Crisis Warning Advisory Message Parameter Alarm Levels Crisis Warning Advisory Message Asystole Y HR Y VFib VTac Y PA V Tach Y ART Revision B NBP SPO2 FEM UAC CVP RA UVC LA ICP SP XA XA S SNS SN SN SN S SNS SN S S ART Rate RR lt S Resp Apnea lt SPO2 Rate TP FEM Rate UAC Rate GX XA NS Dash 2000 Patient Monitor 227 499 06 US E 14 11 APPENDICES Factory Defaults Adult ICU Mode Parameter Limits Low High HR 50 150 NBP S 80 200 NBP
104. er View Newer 6 7 Time Period EE 6 7 7 MAINTENANCE E ca Biocompati elle EE 7 2 nspection icai ads 7 3 General Cleanimg ENEE 7 4 iv Dash 2000 Patient Monitor Revision B 227 499 06 US E Revision B TABLE OF CONTENTS Cleaning Applied Parts 7 6 Cables and L eadwires sse 7 6 Other cat in enit tuin ie iie tatit Rina ee 7 6 Technical Maintenance 7 7 Technical Inspechons nn cc ronca 7 7 Changing Graph Paper sess 7 8 Built in Writer s end ER Rad 7 8 Thermal Paper Gtorage nan nnn cnn cnn 7 9 INTFOJUCON Laia PTOL 8 2 CHECK Stata ada cata etes 8 2 Skin Preparation esses ener nnn nnns 8 3 Electrode Placement dedere D benc aa 8 4 5 Leadwire Electrode Placement 8 4 3 Leadwire Electrode Placement 8 5 ThreeleachwireConftouration nennen nennen 8 5 Electrode Placement for Neonates esnnneseernesenrnnnennnnnrnnrnnenn 8 6 Electrode Placement for Pacemaker Patients 8 7 Maintaining Quality ECG Signal eese 8 8 Surgical Considerations for Electrode Placement Adults 8 8 ESU EGG Filters aa ciated its 8 8 Electrosurgical Unit ESU Cable ocooconnccccoccccnoconononononnncnonnnonnos 8 8 ECG Monitoring Features sssssssseeeeeeeeneenneeennennn 8 9 ECG Display noh riri aeree neo ire targets 8 9 Getting to the ECG Menu 8 10 ECG Menu Options uralten 8 11 Display Lead ies ndo eti edite dice tede 8 11 Synchron
105. er to section Admit Info later in this chapter ADMIT PATIENT a direct action menu option that admits the patient DISCHARG PATIENT opens a popup menu to confirm the discharge of the patient NEW CASE a direct action option which discharges the patient s information and with no additional steps readies the monitor for the next patient new admission Refer tothis chapter Admit Menu Options if you need more details on these menu options Dash 2000 Patient Monitor Revision B 227 499 06 US E ADMIT DISCHARGE Combo Admit Menu Combo Admit Menu Revision B With the Combo application the monitor is permanently assigned to a room and you have the ability to obtain patient ECG data from a monitor or from a telemetry transmitter NOTE A room must have network cable in order to use telemetry Theunit name and bed number are assigned during installation The options you may need to adjust enter are shown in the admit menu below 029 ICU Admit Menu Combo Application NOTE XXX ADMIT if patient is discharged DISCHARG otherwise NOTE It is not likely that this application is used when the monitor is set for Operating Room mode H owever the admit menu would look just like this one ECG SOURCE choose either the monitor or a telemetry transmitter from which to receivethe patient s parameter data ADMIT INFO opens the admit information window and popup menu refer to section Admit Info later in this chapt
106. ermal chart papers or any other products containing tributyl phosphate dibutyl phthalate or any other organic solvents Many medical and industrial charts contain these chemicals document protectors envelopes and sheet separators containing polyvinyl chloride or other vinyl chlorides Y AVOID CONTACT WITH cleaning fluids and solvents such as alcohols ketones esters ether etc v DO NOT USE mounting forms pressure sensitive tapes or labels containing solvent based adhesives ToassureMAXIMUM TRACE IMAGE LIFE thermal paper should be stored separately in manilla folders polyester or polyimide protectors Plastic document protectors envelopes or sheet separators made of polystyrene polypropylene or polyethylene will not degrade thermal traces in themselves However these materials afford no protection against fading from external causes Use only mounting forms and pressure sensitive tapes made with starch or water based adhesives Paper manufacturers advise us that these thermal products should retain their traces when properly imaged and stored for about 3 5 years If your retention requirements exceed these guidelines we recommend you consider alternate image storage techniques Revision B Dash 2000 Patient Monitor 7 9 227 499 06 US E For your notes 7 10 MAINTENANCE Thermal Paper Storage Dash 2000 Patient Monitor 227 499 06 US E Revision B 8 ECG Revision B uge ele de ar 8 2 Checkliste nei
107. ers Follow the same procedure as described for changing arrhythmia alarm level defaults 21 NOV 1998 16 27 DAK BED 1 PARAMETER ALARM LEVELS gt RETURN WARNING ADVISORY ADVISORY RR APNEA ADVISORY SPO2 RATE MESSAGE MESSAGE MESSAGE PARAM ALARM LEVELS Popup Menu and Information Window 5 6 Dash 2000 Patient Monitor Revision B 227 499 06 US E MONITOR SETUP Monitor Setup Menu Setup Default Limits You can set default limits for all parameters also 1 Select DEFAULT LIMITS from the Monitor Defaults Menu A popup menu and information window are displayed 21 NOV 1998 16 27 DAK BED 1 SETUP DEFAULT LIMITS gt RETURN UNITS HIGH HR 50 5 RR APNEA NBP S 80 NBP D NBP M TP 066A DEFAULT LIMITS Popup Menu and Information Window Rotate the Trim Knob control to move the pointer gt through the list Press the Trim K nob control when the pointer is in front of the parameter for which you want to change default limits The parameter label highlights 4 TurntheTrim Knob control to highlight the low or high limit Press the Trim Knob control again and rotate to change the value Press the Trim Knob control to complete the change 6 Rotatethe Trim K nob control to highlight the parameter label and press to unhighlight 7 Select RETURN when all changes are completed The popup menu and information window close Revision B Dash 2000 Patient Monitor 5 7 227 499 06 US E MONITOR SETUP Mon
108. es not automatically resume operation within 60 seconds power cyde the monitor using the power on off switch Once monitoring is restored you should verify correct monitoring state and alarm function MAINTENANCE Regular preventive maintenance should be carried out annually Technical Inspections You are responsible for any requirements specific to your country Dash 2000 Patient Monitor Revision B 227 499 06 US E Revision B SAFETY For Your Safety CAUTIONS 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 NEGLIGENCE GE Marquette Medical Systems 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 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 POWER REQUIREMENTS Before connecting the device to the power line check that the voltage and frequenc
109. esired 1 Open the HR LOW LIMIT popup menu The number 50 is displayed 2 Rotatethe Trim Knob control until the number reads 45 It will follow this sequence 49 48 47 46 45 Thenext rotation will takethe number to 40 which in this instance is toolow 3 Closethe popup menu when the number is 45 and immediately open it again 4 Rotatethe Trim Knob control to 44 Closing the popup menu and then reopening it allows you to rese again in increments of one The same principle applies when setting limits for other parameters Dash 2000 Patient Monitor Revision B 227 499 06 US E THE BASICS Graphing Printing Graphing Printing Devices Manual Graphs Exclusive Graph Control Alarm Graphs Revision B You can print displayed information using the Dash 2000 monitor s built in writer or via the network using an optional writer and or an optional laser printer This manual refers to a DDW as a writer and a laser printer as a printer The writer may be the Dash 2000 monitor s built in writer or a stand alone writer connected to another monitor Y our system may include one or more central stations Some central stations come equipped with a built in writer A writer can also be connected to the central station The optional laser printer always connects to a central station Patient waveforms and most information windows can be printed Y ou choose which waveforms you want to print to which device you want to pr
110. f 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 products please contact GE Marquette Medical Systems or its representatives ELECTROCAUTERY PRECAUTIONS To prevent skin burns apply electrocautery electrodes as far as possible from all other electrodes a distance of at least 15 cmy6 in is recommended 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 Also keep cellular phones or other tel ecommunication equipment away from the monitor 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 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 funcion is restored If the monitor do
111. flation 12 feet 3 6 m 8 feet 2 4 m Cycle time exceeding 3 minutes 90 seconds neonatal power off or cuff pressure exceeds 300 mmH g 10 adult 150 mmHg 10 neonatal Large adult adult small adult pediatric small pediatric and infant Thigh large adult adult child and infant User selectable upper and lower limits for systolic diastolic and mean pressures 14 27 APPENDICES Technical Specifications ECG Gain DC offset Noise Frequency response Analog Output Defibrillator Marker out Synchronization Time delay Pulse 45 V selection 12 V selection Pulse width Output impedance Current limit Marker in Input threshold Input hysteresis Maximum input voltage Input impedance Pulse width Power requirements AC voltage Power consumption Cooling Heat dissipation Battery Environmental Specifications F uses Design general Battery operation time General Monochrome LCD display Color LCD display Min battery operating time 14 28 Dash 2000 Patient Monitor 227 499 06 US E 1V mV 10 100 mV max 5 mV 0 300 Hz 0 05 Hz to 100 Hz 7 0 Hz 35 ms max R wave peak to leading edge of pulse Amplitude selectable in Service Menu for selection of the Service Menu and adjustments reference the Dash 2000 Field Service Manual 3 5 V min at 1 mA sourcing 0 5 V max at 5 mA sinking 11 0 V max at 1 mA sourcing 0 75 V max at
112. ft portion of the screen The top real time waveform is displayed as are4 parameter windows Information windows are displayed when a HELP option is selected and with certain menu options such as LIMITS Theinformation window contains instructions or other non realtime information Below is an example of an information window Real Time 21 NOV 1998 17 10 150 50 Waveforms NOV ov 21 16 30 16 45 17 00 Information 6o e 6o CH Window luce cae pese tes mut Fe ee v ALARMS 117 46 Rr59 73 021 The Vital Signs Information Window If a popup menu is displayed with the window you must turn the Trim Knob control to scroll to more information Revision B Dash 2000 Patient Monitor 1 23 227 499 06 US E THE BASICS Software Features Trim Knob Control Operation When Setting Alarm Limits Limits which trigger alarms for monitored parameters can be modified Y ou should refer to the specific parameter chapter for details When setting alarm limits the following information is helpful and applies to most parameter s The Trim Knob control will always increase or decrease the displayed number in increments of one for the first five numbers Thereafter it increases or decreases in increments of five There may be situations where the limit you wish to modify does not fall intothis incremental sequence For example the low heart rate limit default is 50 For your patient a limit of 44 is d
113. g 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 DISPOSAL Dispose of the packaging material observing the applicable waste control regulations and keeping it out of children s reach EXPLOSION HAZARD Do not use this equipment in the presence of flammable anesthetics vapors or liquids INTERFACING OTHER EQUIPMENT Devices may only be interconnected with each other 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 standards IEC 60601 1 1 EN 60601 1 1 must be complied with Dash 2000 Patient Monitor Revision B 227 499 06 US E Revision B SAFETY For Your Safety WARNINGS INTRACARDIAC APPLICATION When applying devices intracardially electrically conductive contact with parts connected to the heart pressure transducers meta
114. gauge up to date the battery needs to be conditioned every 3 months or after 250 discharge cycles There are three battery conditioning modes automatic user controlled and manual automatic mode Conditioning starts automatically when the time limit 3 months or the discharge limit 250 cycles is reached The automatic start time for the conditioning cycle is defined with the softkey AUTO START AT Should there bea loss of AC power all the user has to do is plug in the power cord user controlled mode If thetime limit or discharge limit is reached the monitor displays the status message BATTERY NEEDS COND It is up to the user to start the conditioning as a result of this message manual mode In this mode the user is required to manually start the conditioning process The time limit or discharge limit is not observed and has no effect The conditioning process is started from the service menu In the user controlled and manual modes conditioning is started using this menu sequence MONITOR SETUP SERVICE MODE gt BATTERY SERVICE gt START CONDITION notify service Dash 2000 Patient Monitor Revision B 227 499 06 US E THE BASICS Battery Power Battery Battery Capacity The battery capacity gauge or bar graph indicates the battery charge Gauge capacity The gauge is drawn as a vertical rectangular outline which is filled in from bottom to top proportional with the battery charge level The full rated capa
115. gmented lead AVR right arm augmented lead B BE base excess BGMY bigeminy BP blood pressure BPM beats per minute BRAD bradycardia BSA body surface area BT blood temperature C C Celsius CAL calibration CALC calculation CALCS calculations CaO2 arterial oxygen content CARD cardiac CC computation constant cc CC cubic centi meter CCU critical care unit CEd effective dynamic compliance CH channel Dash 2000 Patient Monitor 14 3 227 499 06 US E APPENDICES Abbreviations and Symbols CI cm CM CO CO2 COHb COMM CP CPLT CPP CS CvO2 CVP D DC DDW DEFIB Defib DES DIA DISCH dyn E ea vO2 eCaO2 ECG eCvO2 eg ENF eO2CI eO2DI eO2R eQs Qt Esopho ESU et al EtCO2 ETCO2 ETO EX Exp FEM FiO2 FR Dash 2000 Patient Monitor cardiac index centimeter cardiac output carbon monoxide carbon dioxide carboxyhemoglobin communication cardiopulmonary couplet cerebral perfusion pressure central station mixed venous oxygen content difference central venous pressure D diastolic direct current Direct Digital Writer defibrillator desflurane diastolic discharge dyne expired estimated arterial venous oxygen content difference estimated arterial oxygen content electrocardiograph estimated mixed venous oxygen content for example enflurane estimated oxygen consumption estimated oxygen delivery estimated oxygen extraction ratio estimated shunt fraction esophageal electrosurgic
116. gt MONITOR 331 446 447 783 040 ECG SOURCE Popup Menu and Information Window The information window lists the possible sources from which the parameter data can be obtained Thetransmitter numbers listed are those transmitters assigned to the unit 2 Rotatethe Trim Knob control to move the pointer gt in front of the source of choice Select MONITOR if your patient s ECG cable is connected to the monitor If your patient is wearing a telemetry transmitter select the transmitter number that matches the one on the back of the transmitter 3 Press the Trim Knob control to close the popup menu and information window 4 Select ADMIT PATIENT to admit the transmitter The TTX number now appears in the ECG parameter window Revision B Dash 2000 Patient Monitor 3 15 227 499 06 US E ADMIT DISCHARGE About Discharging About Discharging Discharge Patient Standard and Rover Admit Menu 3 16 WARNING DISCHARGE TO CLEAR PATIENT DATA When admitting a new patient you must dear all previous patient data from the system To accomplish this disconnect patient cables then do a discharge When it is nolonger necessary to monitor a patient a discharge procedure must be done to dear the system of all patient data collected Monitor defaults are always recalled when a discharge is done The last unit name and bed number used are retained Patient name is cleared To discharge a patient select MORE MENUS Dep
117. h one that is compatible LOW QUALITY SIGNAL SPO2 data continues to be displayed but the quality of the signal is questionable Check the patient and the probe PROBE IS OFF THE PATIENT Reusable finger probe is off the patient Check the probe Thefactory default for this alarm is system warning You can set it to be a system advisory alarm in your Monitor Defaults POOR SIGNAL QUALITY The SPO2 signal is too low No SPO2 data is displayed This can be due to a low patient pulse patient motion or some other interference Check the patient and the probe PULSE SEARCH Detection by the monitor of a repeatable pulse has ceased Check the patient and the probe site No SPO2 data is displayed One of the following conditions is indicated defective or damaged probe e defective or damaged cable e probe is off the patient or e detection of a repeatable pulse has ceased Check the probe and cable reposition or replace as needed Dash 2000 Patient Monitor Revision B 227 499 06 US E SPO2 Troubleshooting Thefollowing dinical questions are frequently asked about SPO2 monitoring These may help in troubleshooting when monitoring SPO2 Why does the monitor pulse oximeter sometimes read differently than an ABG How does a pulse oximeter read the various types of hemoglobins What effect can ambient light have on pulse oximetry monitoring Revision B Arterial Blood Gas analyzers calculate the O2 saturati
118. han actual Again pacemaker patients should be kept under close observation The appropriate pace mode may be determined at the time the pacemaker patient is admitted to the monitoring system The Pace 2 mode is recommended for use whenever possible Check ECG signal from patient 1 Check adjust lead placement refer to the Electrode Placement for Pacemaker Patients section in this chapter 2 Check perform skin preparation 3 Check replace electrodes Dash 2000 Patient Monitor Revision B 227 499 06 US E 9 PRESSURES Revision B PERO CE OM BEE 9 2 Assigned BP Names En 9 3 Zero Reference ade ii 9 4 Gl aa dif 9 4 Pressure Monitoring Features 9 5 Pressure Information 9 5 Getting to the Pressure Menu 9 6 Pressure Menu Option 9 7 SCAN GS ie METUIT IEEE 9 7 CUFSOF tee eebe 9 8 ACA MAN EP 9 8 Bleu 9 9 Change N ame cene et tia 9 10 LO EMEN 9 10 SR le cM ER 9 11 BR Eilter u P 9 12 Calibrate Transducer eeeeeeennn nnns 9 12 Sma CBP zu tei e et te lada 9 13 Pulse Rate 22 ts 9 13 Disconnect Alarm 9 14 Troubleshooting esses enne nnn nnns 9 15 Dash 2000 Patient Monitor 227 499 06 US E 9 1 Introduction PRESSURES Introduction NOTE Invasive pressure monitoring is an optional feature that your institution may not have purchased For acquisition of invasive blood pressure a pressure transducer see endosed publication Accessories Dash 2000 3000 is
119. he displayed options e SIZE adjust the size of the displayed SPO2 waveform e SPO2LIMITS display a new menu and an information window to adjust SPO2 percent and rate beats per minute alarm limits RATE VOL turn the rate volume on off adjust the volume when on e RATE turn the displayed rate value off and on Detailed information on each option is found in this chapter Revision B Dash 2000 Patient Monitor 11 9 227 499 06 US E SPO2 SPO2 Menu Options SPO2 Menu Options The SIZE option allows you to change the size of the displayed SPO2 waveform 1 Select SIZE option from the SPO2 Menu A popup menu opens showing all sizes available The current size is highlighted SPO2 LIMITS Size SIZE Popup Menu 2 Rotate the Trim Knob control to change the size The change occurs immediately on the screen 3 When you are satisfied with your selection press the Trim Knob control to close the popup menu Dash 2000 Patient Monitor Revision B 11 10 227 499 06 US E SPO2 SPO2 Menu Options SPO 2 Limits This option provides an information window that shows the alarm limits for SPO2 and pulse rate A new set of menu options is displayed to allow you to adjust these limits Follow this procedure 1 Select SPO2LIMITS option from the SPO2 Menu An information window is displayed on the screen and a new set of menu options is displayed in the menu area 21 NOV 1998 16 27 DAK BED 1 SPO2 LIMITS SPO2 SPO2
120. he main operator control is the Trim Knob control The Trim Knob control rotates in either direction to highlight parameter labels and menu options After highlighting the desired selection press the Trim Knob control to view a new menu or a small popup menu This procedure is referred to as select throughout the manual Remember when using the Trim K nob control rotate to highlight then press to select 003A Trim Knob Control Dash 2000 Patient Monitor Revision B 227 499 06 US E Control Keys Power Graph Go Stop Revision B THE BASICS Operation On theright side of the monitor are five control keys Their functions are described below Press the key to activate the function Beginning with the upper key and reading down the keys are Location of Control Keys The monitor will be powered at all times when plugged into AC power This key turns the monitoring function ON and OFF When the monitor is turned off patient monitoring is discontinued however patient data already accumulated is retained and the battery charging function continues NOTES To avoid unintentional switchoff the POWER key must be pressed at least 0 25 seconds to switch off the monitor In the event of a lockup you can force a switch off by pressing the POWER key for five seconds Press this key onceto start a graph run of the patient s data Press a second time to stop If pressed during an alarm graph run th
121. he parameter reads ON pressing the Trim Knob control turns it off and vice versa The change is in effect immediately The information window remains open so you can select another parameter if desired NOTE ECG cannot be turned off 4 When finished select RETURN to close the information window and popup menu 5 22 Dash 2000 Patient Monitor Revision B 227 499 06 US E MONITOR SETUP Monitor Setup Menu Software Summary Itis important to know how to find out what software revisions versions your system is using Follow this procedure 1 Select SOFTWARE SUMMARY option from the Monitor Setup Menu A popup menu and information window are displayed 21 NOV 1998 16 27 DAK BED 1 ardere dere CTA SOFTWARE SUMMARY gt SOFTWARE REVISIONS MAIN MAIN BOOT DAS DAS BOOT ETCO2 ETCO2 BOOT DDW ADMIT MENU STANDARD MONITOR TYPE ADULT ICU 070 SOFTWARE SUMMARY Popup Menu and Information Window The information in the list is most useful to service personnel 2 Select OK to close the popup menu and information window Revision B Dash 2000 Patient Monitor 5 23 227 499 06 US E Service Mode 5 24 MONITOR SETUP Monitor Setup Menu The service menu is meant for qualified service personnel and therefore is password protected If you select SERVICE MODE option from the Monitor Setup Menu you will see a screen similar to the one shown below 21 NOV 1998 16 27 DAK BED 1 dee deret CAUTION YOU ARE ABOUT
122. high CO levels and thus a high amount of Carboxyhemoglobin Certain antibiotics such as the Sulfas can create high levels of methemoglobin M ethemoglobin is unable to bind O2 and will absorb light similarly to reduced hemoglobin thus giving an artificially low SPO2 Dash 2000 Patient Monitor Revision B 227 499 06 US E What does motion artifact look like what problems can it cause and how can it be corrected What does electrosurgical interference look like and how can it be minimized Revision B SPO2 Troubleshooting Motion artifact occurs with excessive motion of the probe the cable leading to the probe or the cable probe junction In other words anything that causes any of these things to move like the patient moving his hands or the cable laying across the ventilator tubing and being moved with every cycle can cause motion artifact A non arterial often erratic looking waveform and a pulse rate that does not coincide with the HR on the ECG will result The main problem motion artifact can cause is erroneous SPO2 readings Motion artifact can be reduced if not eliminated by selecting a quieter site on the patient An ear probe if he refuses to keep his hands still or an adhesive probe on the toe an adhesive probe on the little finger for an adult or on the sole of the foot in a newborn can help greatly Cable movement can be reduced by applying the probe with the cable leading toward the patient then ta
123. i tte ER ent SH MS 8 23 Aaa 8 23 Arrhythmia Conditions essen 8 24 Troublechoctlng eene nnne nnn nennen nnn nnns 8 25 Dash 2000 Patient Monitor 227 499 06 US E 8 1 ECG Introduction Introduction The information in this chapter will help you to successfully use all the ECG monitoring features of your Dash monitor The ECG connector where the patient cable is plugged into the monitor is shown below O Be qip PO2 A eb Se op So qd Y ECG Connector Dash 2000 Monitor ECG Connector NOTE Thesignal input is a high insulation port and it is defibrillator proof lt Theinsulated input ensures patient safety and protects the device during defibrillation and electrosurgery Use only the electrodes listed in the enclosed publication Accessories Dash 2000 3000 Electrodes for diagnostic use may vastly compromize recovery time and stability after defibrillation Do not connect any electrode to metal parts or ground Checklist 1 Electrodes have been placed on the patient following proper skin preparation NOTE When using snap leadwires attach leadwires to electrodes first then apply electrodes to the patient This prevents the gel from spreading and becoming ineffective as you attach the snaps to the electrodes Leadwires are attached to electrodes on the patient L eadwires are connected to patient cable and patient cable is connected to the monitor 4 Verify the V lead label is
124. ial ART systolic diastolic and mean femoral F EM systolic diastolic and mean pulmonary artery PA systolic diastolic and mean central venous CVP mean left atrial LA mean right atrial RA mean intracranial ICP mean special SP mean Additional site names available in the Neonatal I CU mode are umbilical artery catheter UAC systolic diastolic and mean umbilical venous catheter UV C mean For reference purposes in this manual we refer to the connector as BP Revision B Dash 2000 Patient Monitor 9 3 227 499 06 US E PRESSURES Zero Reference Zero Reference Checklist Zeroing the pressure transducer is very important for accurate pressure measurement Transducers should be zeroed frequently and always before initiating treatment changes based on the pressure data Tozerothe pressure transducer follow this procedure 1 2 3 4 u Close the transducer stopcock to the patient Open the venting stopcock to air atmosphere Press the FUNCTION key on the front panel of the monitor Verify that zero reference has been established Watch the pressure parameter window for messages Close the venting stopcock to air atmosphere Open the transducer stopcock to the patient Within seconds pressure numerics should be displayed in the pressure parameter windows As an alternative select the ZERO option in the pressure menu Patient cable is attached to the BP connecto
125. ic Menu Timeout 5 minutes RevisionB Dash2000PatientMonitor 1448 227 499 06 US E Parameter Priority Defaults APPENDICES Factory Defaults Adult ICU Mode Thefollowing parameters when monitored will always appear in parameter windows at the right side of the display Parameter 1 ECG Parameter 2 SPO2 Parameter 3 RR The highlighted parameters below appear in parameter windows at the bottom of the display only when there is no room at the side 14 14 NBP ART FEM UAC PA CVP RA UVC LA ICP SP SPO2 RR TP Dash 2000 Patient Monitor 227 499 06 US E Revision B Factory Defaults Neonatal ICU Mode APPENDICES Factory Defaults Neonatal ICU Mode Following are the factory set monitor defaults for the Neonatal I CU Mode Y ou can change these using the Monitor Defaults feature Monitor defaults are recalled upon discharge Refer to the Monitor Setup chapter Arrhythmia Alarm Levels Crisis Warning Advisory Message Parameter Alarm Levels Crisis Warning Advisory Message Asystole Y VFib VTac Y Resp Apnea Y V Tach Y HR Revision B UAC UVC SPO2 NBP ART FEM PA CVP RA LA ICP SP XA XA XA SNS S SN SN S SN SN S S UAC Rate RR SPO2 Rate ART Rate FEM Rate N XA XA SN SS TP
126. ically during the learning process but may be adjusted if necessary NOTE Respiration detection is not dependent on the size of the waveform Sizeis for visual purposes only Even though the same electrodes are used for ECG and respiration monitoring it is possible to get a lead fail message for respiration without one for ECG The impedance may be too high for respiration detection but the electrode is still good for ECG Refer to Smart Lead Fail in the ECG Monitoring chapter Since respiration monitoring is so closely linked with ECG monitoring patient preparation and electrode placement are important Please refer to the ECG Monitoring chapter for guidelines 1 Electrodes have been placed on the patient following proper skin preparation L eadwires are attached to electrodes on the patient L eadwires are connected to patient cable and patient cable is connected to the monitor 4 Respiration setup is adjusted if necessary Follow detailed procedures within this chapter Dash 2000 Patient Monitor Revision B 227 499 06 US E RESPIRATION Respiration Monitoring Features Respiration Monitoring Features Respiration Information Revision B When respiration monitoring is on a labeled respiration waveform is displayed when the learning process is complete Refer to this section General Information The label includes the ECG lead used to derive the respiration waveform for example RR II Numerics are display
127. if data is available Select TIME INTERVAL to choose the time interval between each of the displayed columns of data This does not affect data collection only how it is displayed TIME INTERVAL Popup Menu 1 Rotate the Trim Knob control to move the pointer in front of the time interval of choice 2 Press the Trim Knob control to close the popup menu and effect the change Select SPECIFIC TIME option to open a popup menu which allows you to enter a specific time you want to find and display in vital signs SPECIFIC TIME Popup Menu 1 Rotate the Trim Knob control to move the highlight into the date and time The popup menu opens with the current date and time 2 Press the Trim Knob control when an element in the date or timeis highlighted Rotate to make a change 3 Press the Trim Knob control to complete the change and rotate to highlight the next element in the date and time 4 Close the popup menu by rotating the Trim Knob control to highlight SPECIFIC TIME then press the Trim Knob control The specific time you requested or the time closest to it if your TIME INTERVAL is set for other than one minute will appear in the middle column of the information window Dash 2000 Patient Monitor Revision B 227 499 06 US E PATIENT DATA Patient Data Menu Graphic Trends Another way of displaying collected patient data is through trends A trend is a graphic representation of one parameter over a specified period of
128. ifetime of the cable or leadwire CAUTION The decision to sterilize must be made per your institution s requirements with an awareness of the effect on the integrity of the cable or leadwire Other For other applied parts such as temperature sensors catheters pulse oximetry probes and NBP cuffs refer to the documentation supplied with these parts for cleaning sterilization or disinfecting methods 7 6 Dash 2000 Patient Monitor Revision B 227 499 06 US E MAINTENANCE Technical Maintenance Technical Maintenance Technical Inspections Revision B Schematic diagrams specifications and other relevant technical information can be found in the service manuals Comply with the policies of your institution s biomed department or the recommendati ons made within the Preventive Maintenance section of the product s service manual For safety the devices require regular maintenance To ensure functional and operational safety of the Dash 2000 patient monitor technical inspections should be carried out on an annual basis These inspections should be referred to independent persons with adequate training and experience Within the framework of a service agreement GE Marquette service representatives would be pleased to carry out these technical inspections for you Therelevant sections of the Service Manual describe the scope and nature of the technical inspections The Dash 2000 patient monitor does not requi
129. imits Screen 4 7 Changing a Limit in the All Limits Screen 4 8 Alarm Capra oda 4 9 Alarm Volume tc e oie ied 4 10 Parameter Alarm L evel sss 4 11 Arrhythmia Alarm Level nuerserseensennsnnsnnnnnnnnnnnnnnnnnnnnnnnn 4 12 Revision B Dash 2000 Patient Monitor 227 499 06 US E Smart Alarms ALARM CONTROL Smart Alarms Alarm processing is not activated until the monitor has detected valid physiologic data from the patient This allows you to admit a patient and proceed with necessary patient connections without bothersome alarm tones If during monitoring a new parameter is added for example pulse oximetry the alarm processing for that parameter will not be active until valid physiologic data is detected NOTE To properly use the smart alarm feature be sure to remove all patient cables to the monitor prior to discharging This assures that no data is seen after a discharge WARNING After an interruption of the electric power supply e g for an emergency power test it is necessary to check whether the alarm processing is active again and whether asystole has occurred while the power supply was interrupted Dash 2000 Patient Monitor Revision B 227 499 06 US E Alarm Structure Patient Status Alarms Revision B ALARM CONTROL Alarm Structure The alarm structure of the monitor is divided into two classifications e Patient Status Alarms and System St
130. in place of the actual pacemaker spike All pacemaker spikes appear uniform Do not diagnostically interpret pacemaker spike size and shape PATIENT HAZARD A pacemaker pulse can be counted as a QRS during asystole in either pace mode Keep pacemaker patients under close observation RATE METERS Keep pacemaker patients under dose 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 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 indude 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 Dash 2000 Patient Monitor 227 499 06 US E 8 19 Monitoring Pacemaker Patients 8 20 ECG ECG Menu Options NOTE ECG monitoring with patients on non invasive transcutaneous pacemakers may n
131. ing 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 CABLES Route all cables away from patient s throat to avoid possible strangulation CONDUCTIVE CONNECTIONS Extreme care must be exercised when applying medical electrical equipment Many parts of the man machine circuit are conductive such as the patient connectors electrodes transducers lt is very important that these conductive parts do not come into contact with other grounded conductive parts when connected to the insulated patient input of the device Such contact would bridge the patient s insulation and cancel the protection provided by the insulated input In particular there must be no contact of the neutral electrode and ground Dash 2000 Patient Monitor 227 499 06 US E 2 4 SAFETY For Your Safety WARNINGS DEFIBRILLATION Do not come into contact with patients during defibrillation Otherwise serious injury or death could result 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 if you use a Tram module be sure the module is locked in place in the Tram rac housing then do a discharge DISCONNECTION FROM MAINS When disconnecting the system from the power line remove the plu
132. insulated and it is defibrillator proof Gk p Use only the BP cuffs listed in the endosed publication Accessories Dash 2000 3000 These cuffs ensure patient safety and protect the device during defibrillation and electrosurgery A cuff appropriate for limb size has been selected Cuff is properly placed on patient Patient cableis connected to monitor NOTE Do not connect more than one NBP patient cable Tubes between the cuff and the monitor are not kinked or blocked Correct CUFF SIZE has been selected from the NBP menu Start an NBP reading following auto or stat mode procedures as detailed in this section or usethe NBP GO STOP control key The measurement should be performed on the left arm Roll up sleeve before measurement Only very thin fabrics will not impair the measurement Check that rolled up sleeve does not constrict the vessels The arm should be placed on a surface that is level with the heart The palm of the hand should face up Dash 2000 Patient Monitor 10 3 227 499 06 US E NBP Patient Preparation Patient Preparation Cuff selection and application are important Inappropriate selection or improper application of the cuff will result in erroneous measurements WARNING The cuff size selected in the NBP menu and the cuff size used must be correct to obtain reliable NBP data and to prevent overpressure in neonatal or pediatric use WARNING The system is designed for use with dual
133. int a duration time and the speed at which manual graphs are printed These menu options are all found in the Graph Setup menu Refer to the Monitor Setup chapter for details Waveforms and information windows are printed when the GRAPH GO STOP key is pressed The message GRAPHING MANUAL or PRINTING WINDOW is displayed when a manual graph is requested There is a setting in the Graph Setup Menu which allows you to set a time for how long a manual graph runs e g continuous 20 seconds etc NOTES A one millivolt ECG signal at normal 1X size equals 10 millimeters on the graph paper All waveforms on a graph strip begin with 10 seconds of delayed data The header information printed with the waveforms is real time data Once a manual graph is started it can only be stopped from the same source from which it was started or from the Graph Stop key on the writer This is to prevent two people at different sources starting a graph at the same time which results in one turning the graph on and the other turning the graph off A graph strip is automatically printed when a Crisis or Warning alarm occurs An arrhythmia alarm graph will run until a normal sinus rhythm is again detected or you manually stop the graph Any other alarm graph runs for 20 seconds or until you manually stop it NOTE Toconvert an arrhythmia alarm graph to a manual graph you must stop the graph using the Graph Stop key on the writer and immediately resta
134. ion will continue to monitor the telemetry TELEMETRY to discharge patient from telemetry only ECG will automatically switch to the monitor BOTH to discharge patient from telemetry and monitor If ECG was from the monitor BOTH will only affect the monitor 5 PresstheTrim Knob control to complete the discharge New Case This menu option is displayed only when the monitor is set for Operating Room mode and is found in Standard and Rover admit menus This menu option clears patient information from the monitor With no additional steps the monitor is ready for the next patient new admission 1 Select MORE MENUS 2 Select NEW CASE SETUP todisplay the Admit Menu 3 Disconnect patient cables 4 Select NEW CASE from the Admit Menu 5 Press the Trim Knob control Patient information clears and the monitor is automatically put in the admit state ready for the next patient You will never see the DISCHARGE D message displayed Revision B Dash 2000 Patient Monitor 3 17 227 499 06 US E For your notes 3 18 ADMIT DISCHARGE About Discharging Dash 2000 Patient Monitor 227 499 06 US E Revision B 4 ALARM CONTROL SMA EE 4 2 Alarm Str cture ars sea Sena ORE d 4 3 Patient Status Alarm 4 3 System Status Alarm 4 4 Controlling AudtoAlarme essen 4 5 Silencing an Alarm for One Minute 4 5 Pausing Ala domes 4 5 Turning Alarm Volume Off Permanently 4 5 Alarm Control Menu 4 6 AI Bin he 4 7 Viewing an All L
135. ite RA red R LA left arm black LA yellow L RL right leg green RL black N LL left leg red LL green F V1 precordial brown V1 white C1 V2 precordial yellow V2 yellow C2 V3 precordial green V3 green C3 V4 precordial blue V4 brown C4 V5 precordial orange V5 black C5 V6 precordial purple V6 purple C6 5 Leadwire Electrode Following is a suggested configuration when using five leadwires Placement AHA Configuration IEC Configuration Right arm and left arm electrodes should be placed just below the right and left davide Right leg and left leg electrodes should be placed on a non muscular surface on the lower edge of the rib cage The chest electrode should be placed according to the physician s preference 8 4 Dash 2000 Patient Monitor Revision B 227 499 06 US E ECG Electrode Placement 3 Leadwire Electrode When a 5 leadwire electrode configuration is not desirable a 3 leadwire Placement electrode configuration can be used 348A 348B AHA Configuration IEC Configuration Three leadwire Configuration Revision B NOTE Electrode configuration will vary depending on the type of leadwire set you are using Refer to Three leadwire Configuration below Right arm and left arm electrodes should be placed just below the right and left davide L eft leg electrode should be placed on a non muscular surface on the lower edge of the rib cage The molded 3 leadwire sets
136. itor Setup Menu Setup Default Display d menu option allows you to set up certain aspects of the display as efaults 1 Select SETUP DEFAULT DISPLAY option from the Monitor Defaults Menu A popup menu and information window open 21 NOV 1998 16 27 SETUP DISPLAY gt RETURN PATIENT AGE COLOR FORMAT PRIMARY ECG DETECT PACE ARTERIAL RATE LEAD ANALYSIS GRAPH WAVEFORM 2 GRAPH WAVEFORM 3 DAK BED 1 ADULT TRANSDUC I OFF OFF SINGLE ART OFF SETUP DEFAULT DISPLAY Popup Menu and Information Window 2 Usingtherotate and press technique with the Trim Knob control select a display item and makethe desired change 3 Select RETURN when finished to dose the popup menu and information window 5 8 Dash 2000 Patient Monitor 227 499 06 US E Revision B MONITOR SETUP Monitor Setup Menu Setup Default This menu option allows you to select how the parameter windows are 2 ioriti the display Parameter Priority prigritzedon ie ls pay 1 Select PARAM PRIORITY option from the Monitor Defaults Menu A popup menu and information window open 21 NOV 1998 16 27 DAK BED 1 RETURN PARAMETER 1 PARAMETER 2 PARAMETER 3 NBP ART All parameters which can be monitored are listed illustration shown includes BP option PARAM PRIORITY Popup Menu and Information Window 2 Usingtherotate and press technique with the Trim K nob control select parameters for positions on the display The PARAMETER selectio
137. itor displays a message and a prompt asking whether the user wishes to continue operation WARNING If this 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 with this unit should continue only in extremely urgent cases and under the supervision of a physician The unit must be repaired before being used again on a patient If this message appears after power up the unit must be repaired before being used on a patient WARNING After connecting the monitor to a central station and or nurse call system verify the function of the alarm system This can be done for instance by temporarily changing one of the alarm limits to initiate an alarm Dash 2000 Patient Monitor Revision B 227 499 06 US E 2 SAFETY For Y out Safety E 2 2 Intended U SG termed eese ete tto RD t ve er e DEO 2 2 i r 2 2 Monitor Safety x tei tete tene ei eH sacas 2 2 Blue 2 2 Mat nIngs sd oe tt Renee cedens at t e edendo rt 2 3 Caut OFISzzcia diana EE 2 7 D Ko SS PR RU M HET M 2 10 Reference Literature 2 10 e EE tege EE 2 11 Underwriters Laboratories Inc 2 11 Safe Operating and Handling Conditions 2 12 Equipment Symbols seen 2 13 Revision B Dash 2000 Patient Monitor 227 499 06 US E For Your Safety Intended Use Terminology Monitor Safety Dangers SAFE
138. ized Cardioversion sese 8 11 Smarts Gad Falo ai 8 12 Leads Fail Patient Condition ococcccnnnccccnnonooncnnononncnnononoos 8 12 Se EE 8 13 ECGLIMIES ais een Oe ie rre dead Eo DE E 8 14 Peart Rate ensi po aan 8 14 ele T LEE 8 15 Analysis Settings iii e nere 8 16 EGG Filter inte SS 8 17 Lead AnalyslS 2 iet een 8 18 Multi L ead Analvsls seen 8 18 Single Lead Analysis essen 8 18 Changing Lead Analvelz eene 8 18 DetecbP dce EE 8 19 Safety Considerations sess 8 19 Monitoring Pacemaker Patiente 8 20 ORS Widih iiber dre t pn tene a da rh ias 8 22 Changing QRS width 8 22 Dash 2000 Patient Monitor 227 499 06 US E vi 10 TABLE OF CONTENTS Arrhythmia cer ete ge 8 23 ENEE 8 23 Arrhythmia Conditions sse 8 24 Troubleshooting ee 8 25 PRESSURES erre rrr D Belge ve de BEE 9 2 Assigned BP Names nnnsennsennsennnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn 9 3 Zero Refererice oe een ate ee 9 4 ChieckllSE 25 m eut E ate LoS es ao Seale dete aa oat gaa eee eene dni 9 4 Pressure Monitoring Features 9 5 Pressure Information 9 5 Getting to the Pressure Menu 9 6 Pressure Menu Option REENEN 9 7 le EE 9 7 SIT zo OMIM ed 9 8 Clear GUISOF 2s ER 9 8 E IA 9 9 Change Name des iii 9 10 Vg ETE 9 10 SettIhigs c secre t tee p emt etur 9 11 BRP iter RE a ofa e eoo sete dete 9 12 Calibrate Transducer eeee
139. ker spike when pacemaker detection is on Usethe ECG parameter menu to make changes during monitoring Dash 2000 Patient Monitor 8 9 227 499 06 US E ECG ECG Monitoring Features Getting to the ECG Todisplay the ECG Menu use the Trim Knob control to select the ECG M parameter label Remember selecting with the Trim Knob control is a two enu step process rotate to highlight then press to select 150 50 DU 084 Selecting the ECG Parameter Label The ECG Menu is displayed at the bottom of the screen DISPLAY ECG LEAD II LIMITS ANALYSIS eck SETTINGS 085 ECG Menu With the Trim Knob control you can now select any of the displayed options DISPLAY LEAD change the top displayed primary ECG lead e ECG SIZE change the size of all ECG waveforms displayed and graphed e ECG LIMITS display a new menu and an information window to adjust heart rate alarm limits RELEARN relearn the patient s QRS pattern to enable more accurate monitoring e QRS VOLUME turn the QRS tone on off and adjust volume when on e ANALYSIS SETTINGS displays a new menu to adjust single or multi lead analysis pace detection and filter settings Detailed information on each option is found in this chapter 8 10 Dash 2000 Patient Monitor Revision B 227 499 06 US E ECG ECG Menu Options ECG Menu Options Display Lead Synchronized Cardioversion Revision B This option enables you to
140. l be displayed Service on the monitor is required SENSOR Thetemperature sensor has failed Dash 2000 Patient Monitor Revision B 227 499 06 US E 14 APPENDICES Revision B Defib Sync Analog Output 14 2 ECG Acquisition Mochules AAA 14 2 Abbreviations and Symbols A 14 3 Abbreviations Lente dete o p de Bao 14 3 Symbols hav nas iat Rae EE 14 9 Software back age 14 10 Factory Defaults Adult I CU Mode sese 14 11 Factory Defaults Neonatal I CU Mole 14 15 Factory Defaults Operating Room Mode 14 19 Minimum and Maximum Limits Default Mode 14 23 Technical Specifications oocooocnncnnnncnnncnnncconcnnccnnncnrrnnnranrnrnnnnno 14 24 Display a nee 14 24 Soa do MEER 14 24 Processi NOn cas tiie tht ada 14 24 Al ERREUR 14 24 occ 14 24 RespiratiONa ein Ue eb i re E SR EROR 14 26 Temperature TEMP nennen nnns 14 26 Invasive Blood Pressure BP eene 14 26 Pulse Oximetry SpO2 sees 14 27 Non invasive Blood Pressure NBP eee 14 27 Analog OUtDUL 3 1 n inet ai 14 28 Defibrillator Synchronization Pulse 14 28 Environmental Gpedflcatlonms 14 28 Physical Gpecflcattoms nn n nn 14 29 Cadde ie VE 14 29 IgM 14 29 EC Declaration of Conformity sese 14 30 Dash 2000 Patient Monitor 227 499 06 US E APPENDICES Defib Sync Analog Output Defib Sync Analog Output ECG Acquisition Modules 14 2 The configuration f
141. l be highlighted Press the Trim Knob control to let the item be changed Rotate the Trim Knob control until the item shows the desired value press the Trim Knob control to set the value Rotate the Trim K nob control to select another item and proceed as in steps 2 and 3 to change the day month or year If an implausible value is entered the monitor will not accept this value and display a message To complete the procedure select the SET DATE option again and press the Trim Knob control SET TIME opens a popup menu to enter or adjust the current time Thetimeis displayed in the 24 hour format SET TIME Popup Menu To modify the time follow this procedure 1 Rotate the Trim K nob control to select the item you want to adjust the selected item will be highlighted Press the Trim Knob control to let the item be changed Rotate the Trim Knob control until the item shows the desired value press the Trim Knob control to set the value Rotate the Trim K nob control to select another item and proceed as in steps 2 and 3 To complete the procedure select the SET TIME option again and press the Trim Knob control Dash 2000 Patient Monitor 5 15 227 499 06 US E Graph Setup 5 16 MONITOR SETUP Monitor Setup Menu This menu option displays a new menu from which you can change certain aspects of your graphing capabilities Select GRAPH SETUP from the Monitor Setup Menu A new menu is displayed ER G RETO
142. l tube connections and stopcocks guide wires etc must be avoided in all cases To prevent electrical contact we recommend the following e always wear isolating rubber gloves e keep parts that are conductively connected to the heart isolated from ground e if possible 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 LEAKAGE CURRENT TEST When interfacing with other equipment a test for leakage current must be performed by qualified biomedical engineering personnel before using with patients PATIENT AMBULATION A patient must be assisted if ambulating with a roll stand mounted monitor 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 electrically isolated RS232 interface 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 grou
143. larm Control Menu Changing a Limit in the f you want to change one or more limits follow the procedure below Any changes made with this menu option are temporary and will revert to defaults upon discharge All Limits Screen 1 2 Rotate the Trim Knob control to move the pointer gt When the pointer is in front of the parameter you wish to change press the Trim Knob control The parameter label highlights Rotate the Trim Knob control to highlight the low or high limit Press then rotate the Trim Knob control to change the limit value Press the Trim Knob control again to complete the change The new limit is in effect immediately Rotate the Trim Knob control to highlight the parameter label then press to unhighlight You can now move to another parameter if you want When finished with all changes move the pointer to RETURN and press the Trim Knob control to close the All Limits information window Dash 2000 Patient Monitor Revision B 227 499 06 US E Alarm Graph Revision B ALARM CONTROL Alarm Control Menu To adjust the automatic alarm graphing to on or off follow this procedure 1 Select ALARM GRAPH option from the Alarm Control Menu 2 Pressing the Trim Knob control alternately changes the state to on or off the actual setting is always displayed Any change made with this menu option is only temporary and will revert to default upon discharge Dash 2000 Patient Monitor 4 9 227 499 06 US E
144. layed to allow you to adjust these limits Follow this procedure 1 Select TP LIMITS option from the Temperature Menu An information window is displayed on the screen and a new set of menu options is displayed in the menu area 21 NOV 1998 16 27 DAK BED 1 TP LIMITS gt RETURN 138 TP LIMITS Menu and Information Window Rotate the Trim Knob control to move the pointer gt through the list TP LIMITS 3 Press the Trim Knob control when the pointer isin front of TP The parameter label highlights 4 TurntheTrim Knob control to highlight the low or high limit Press the Trim K nob control again and rotate to change value Press the Trim Knob control to complete the change 6 Rotatethe Trim K nob control to highlight the parameter label and press to unhighlight 7 Select RETURN when all changes are completed The popup men and information window close Revision B Dash 2000 Patient Monitor 13 5 227 499 06 US E Troubleshooting Messages 13 6 TEMPERATURE Troubleshooting If you experience some problems with temperature monitoring one of the following messages may be displayed in the TP parameter window CHECK There is a 0 1 9C deviation between the temperature value and the internal calibration Notemperature value will be displayed Service on the monitor is required CAL FAIL There is a 19C deviation between the temperature value sensed and the internal calibration Notemperature value wil
145. led An alarm pause tells the monitor that you do not want any alarms to sound for several minutes see below To start an alarm pause press the SILENCE ALARM key on the front of the monitor Press the key twice if an alarm is sounding when you want to start an alarm pause ADULT ICU mode If your monitor is set up for this mode a five minute alarm pause occurs and a count down timer is displayed on the screen Pressthe SILENCE ALARM key again to reactivate alarms before the five minute period elapses NEONATAL ICU mode If your monitor is set up for this mode a three minute alarm pause occurs with a count down timer displayed Press the SILENCE ALARM key again to reactivate alarms before the three minute period elapses OPERATING ROOM mode If your monitor is set up for this mode press the key once for a 5 minute pause press again for a 15 minute alarm pause press again for a permanent alarm pause message will read ALARMS PAUSED Also arrhythmia is switched off and the alarm limits are set to the Operating Room factory defaults Press the SILENCE ALARM key again toturn alarms back on Refer tothis chapter Alarm Volume for a procedure whereby you can permanently turn the alarm volume off Dash 2000 Patient Monitor 4 5 227 499 06 US E ALARM CONTROL Alarm Control Menu Alarm Control Menu Follow these steps to access the Alarm Control Menu 1 Select MORE MENUS from the Main Menu 2 Select ALARM CONTROL
146. llow this procedure 1 Select QRS WIDTH from the Analysis Settings menu DETECT PACE NORMAL OFF a NARROW NORMAL 093A QRS WIDTH Popup Menu 2 Rotatethe Trim K nob control to placethe pointer in front of your choice The change will not take effect until the Trim Knob control is pressed and the popup menu closed 3 Press the Trim Knob control to confirm the change and close the popup menu Dash 2000 Patient Monitor Revision B 227 499 06 US E Arrhythmia NOTE Arrhythmia messages will be displayed when ALARM PAUSE ALL ALARMS OFF or DISCHARGED is displayed but there are no alarm tones Lethal NOTES The message ARR OFF appears in the ECG parameter window when arrhythmia is turned OFF This message is not displayed when the monitor is in Operating Room mode Turning arrhythmia on automatically starts a relearn procedure Revision B ECG ECG Menu Options WARNINGS VENTRICULAR ARRHYTHMIAS The arrhythmia analysis program is intended to detect ventricular arrhythmias It is not designed to detect atrial or supraventricular arrhythmias Occasionally it may incorrectly identify the presence or absence of an arrhythmia Therefore a physician must analyze the arrhythmia information in conjunction with other clinical findings SUSPENDED ANALYSIS Certain conditions suspend arrhythmia analysis When suspended arrhythmia conditions are not detected and alarms associated with ar
147. low this procedure In this example we will change V TACH from a Crisis level to a Warning level Any changes made with this menu option are temporary and will revert to defaults upon discharge NOTE Aystole and ventricular fibrillation V FIB VTAC cannot be moved when in ICU Adult and Neonatal Mode 1 Rotatethe Trim Knob control to move the pointer in front of V TACH 2 PresstheTrim Knob control Thelevel for the V TACH call highlights 3 Rotatethe Trim Knob control until WARNING is displayed 4 Press the Trim K nob control to complete the change Theinformation window is reorganized to indude V TACH as a WARNING alarm and the change is in effect The information window remains open for you to make any other changes 5 When you have completed all changes move the pointer toRETURN and press the Trim Knob control to close the information window Dash 2000 Patient Monitor 4 13 227 499 06 US E For your notes 4 14 ALARM CONTROL Alarm Control Menu Dash 2000 Patient Monitor 227 499 06 US E Revision B o MONITOR SETUP Monitor Setup Menu EEN 5 2 M onitor Defaults u a 5 3 Monitor Defaults Menu 5 3 Setup Default Arrhythmia Alarm Levels 5 4 Setup Default Parameter Alarm Levels 5 6 Setup Default Limite 5 7 Setup Default Display 5 8 Setup Default Parameter Prtoritwv 5 9 Recall Default ocios ee tiefe 5 10 Display Setup Menu 5 11 Waveform
148. m K nob control must be pressed The popup menu doses and the change is in effect Dash 2000 Patient Monitor 1 19 227 499 06 US E Numeric Popup Subordinate Menus THE BASICS Software Features ECG LIMITS RETURN UNITS LOW HIGH gt HR BPM 50 LIMITS Numeric Popup Menu The available selections are many therefore only the current selection is displayed The arrows are highlighted indicating the Trim Knob control can be rotated Rotating the Trim Knob control will change the displayed value in the popup menu Likethe Pointer Popup the change will not bein effect until the Trim Knob control is pressed Whenever possible short popup menus are displayed when selecting menu options n some cases however a whole new menu is displayed This is a menu within a menu or a subordinate menu Many but not all subordinate menus have the PREV MENU option to allow you to return tothe previously displayed menu Following is an example of a subordinate menu Display the ECG Menu ECG SIZE les 1X QRS Sai ANALYSIS RELEARN Vsus SETTINGS 016 ECG Parameter Menu From the ECG Menu select ANALYSIS SETTINGS the entire ECG Menu is replaced with the subordinate ANALYSIS SETTINGS Menu ANALYSIS SETTINGS Menu Select PREV MENU toredisplay the ECG Menu Dash 2000 Patient Monitor Revision B 227 499 06 US E Direct Action Menu Options Revision B THE BASICS Software Features A direct action menu option wh
149. mation Compliance C The Dash 2000 patient monitor bears CE mark CE 0366 or 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 of this directive The radio interference emitted by this device is within the limits specified in EN 55011 for class B equipment For devices manufactured in the United States the CE mark is applied under the authority of Notified Body GMED 0459 For devices manufactured in Germany the CE mark is applied under the authority of Notified Body VDE 0366 The product complies with the requirements of standard EN 60601 1 2 Electromagnetic Compatibility Medical Electrical Equipment The safety and effectiveness of this device has been verified against previously distributed devices Although all standards applicable to presently marketed devices may not be appropriate for prior devices i e electromagnetic compatibility standards this device will not impair the safe and effective use of those previously distributed devices See user s information Declarations of Copies of applicable EC Declarations of Conformity can be found at the end Conformity of the appendices chapter Revision B Dash 2000 Patient Monitor NOTICES 1 227 499 06 US E NOTICES General Information General Information e This manual is an integral part of the product and describes its intended use It should alw
150. n 1X is used the size is displayed on the left side of the screen next to the ECG waveform Size 2X and greater will lower the QRS detection threshold This may be helpful for low amplitude QRS waveforms Use with caution since baseline artifact may be detected as a QRS Follow this procedure 1 Select ECG SIZE option from the ECG Menu A popup menu opens showing all sizes available The current size of all displayed ECG waveforms is highlighted ECG SIZE Popup Menu 2 Rotatethe Trim K nob control to change the size The change occurs immediately on the screen and affects all displayed ECG waveforms 3 When you are satisfied with your selection press the Trim K nob control to dose the popup menu NOTE For QRS complexes 1 mV use size 2x or 4x Dash 2000 Patient Monitor 8 13 227 499 06 US E ECG ECG Menu Options ECG Limits This option provides an information window that shows the heart rate alarm limits A limits menu is displayed to allow you to adjust these limits Follow these procedures 1 Select ECG LIMITS from the ECG Menu An information window is displayed on the screen and a related set of menu options is displayed in the menu area 21 NOV 1998 16 27 DAK BED 1 eem SN LIMITS RETURN UNITS HIGH E ECG LIMITS Menu and Information Window Heart Rate 1 Rotate the Trim Knob control to move the pointer gt through the list Press the Trim K nob control when the pointer is in front of
151. n 8 2 Skin Preparation miccional 8 3 Electrode Placement 8 4 5 Leadwire Electrode Placement 8 4 3 Leadwire Electrode Placement 8 5 ThreeleachwireConftouration ernennen nen 8 5 Electrode Placement for Neonates AAA 8 6 Electrode Placement for Pacemaker Patients 8 7 Maintaining Quality ECG Signal sees 8 8 Surgical Considerations for Electrode Placement Adults 8 8 ESU ECG Filters nenne 8 8 Electrosurgical Unit ESU Cable ooooconncccciccccnocnnononnnnonnnconnnonnos 8 8 ECG Monitoring Features sesssseeeeeneeeneeenenneennn 8 9 SEET LEE 8 9 Getting to the ECG Menu 8 10 AA enne 8 11 Display Lead iini pte net Een 8 11 Synchronized Cardioversion eee 8 11 Smiart LEead F ail nase dee endende 8 12 Leads Fail Patient Condition oonocicnnccnincnnncnnccocnnacnnannnnns 8 12 RE 8 13 EGG Limit res dos doo N Re ecrire etre in Bears vate encase 8 14 Heart R te ipinia ses 8 14 ORS VOLUME cia Seda cece ae dete 8 15 Analysis Settings cia ehe oO ie ERE ge 8 16 ECG Eilter aan cited Zeg gier di atlas 8 17 Lead Analysis ee a 8 18 Multi L ead Analvsls sse 8 18 Single Lead Analysis sse 8 18 Changing Lead Analvelz sese 8 18 Detect P ace oe oe e eine ee e e be eet 8 19 Safety Considerations essen 8 19 Monitoring Pacemaker Patiente 8 20 QRS WILD teet ce tn eer rhe ERR er ana 8 22 Changing QRS width 8 22 EENEG teet t
152. n at a central station and other network devices SET BED NUMBER verify or change the assigned bed number The correct bed number is essential for recognition at a central station and other network devices SET GRAPH LOCATION display a new menu to select writers for manual and alarm graphs Refer tothis chapter Admit Menu Options if you need more details on these menu options 3 8 Dash 2000 Patient Monitor Revision B 227 499 06 US E ADMIT DISCHARGE Admit Menu Options Admit Menu Options Admit Info This menu option is found in all the admit menus It opens the Admit I nfo information window and popup menu The Admit Info popup menu allows you to view change request or save information pertinent to the monitored patient Below is an example of the Admit Info information window 21 NOV 1998 16 27 DAK BED 1 rode de de dn CTI MANUAL ADMIT INFORMATION RETURN gt LAST NAME FIRST NAME PATIENT ID SEX BIRTH DATE AGE HEIGHT WEIGHT 034 ADMIT INFO Information Window The RETURN option appears after selecting CHANGE ADMIT INFO Then two additional items LOCATION ID and SITE NUMBER areaccessible when scrolling through the window not functional in Dash 2000 Depending on the monitor setup different Admit Info popup menus are displayed ADMIT INFO Menu Neonatal ICU Revision B Dash 2000 Patient Monitor 3 9 227 499 06 US E Change Admit Info 3 10 ADMIT DISCHARGE Admit Menu Options
153. nd or to a high voltage power source which can cause serious injury or death to the patient e ei Unprotected Leadwire Protected Leadwire 002A Dash 2000 Patient Monitor 227 499 06 US E SAFETY For Your Safety WARNINGS RATE METERS Keep pacemaker patients under dose 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 SITE REQUIREMENTS For safety reasons all connectors for patient cables and sensor leads with the exception of temperature are designed to prevent inadvertent disconnection should someone pull on them Do not route cables in a way that they may present a stumbling hazard For devices installed above the patient adequate precautions must be taken to prevent them from dropping on the patient Dash 2000 Patient Monitor Revision B 227 499 06 US E Cautions Revision B SAFETY For Your Safety CAUTIONS ACCESSORIES SUPPLIES To ensure patient safety use only parts and accessories manufactured or recommended by GE Marquette Medical Systems Parts and accessories used must meet the requirements of the applicable IEC 60601 series safety standards and essential performance standards and or the system configuration must meet the requirements of the IEC 60601 1 1 medical electrical systems standard ACCESSORIES EQUIPMENT The use of ACCESSORY equipment
154. ne WARNING The Dash 2000 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 For measurements in or near the heart we recommend connecting the monitor to the potential equalization system Use the green and yellow potential equalization cable and connect it to the pin labeled with the symbol Our customer service engineers can be called in to connect the Dash 2000 to a central station and to the nurse call system WARNING For safety reasons all connectors for patient cables and sensor leads with the exception of temperature are designed to prevent inadvertent disconnection should someone pull on the leads Do not route cables in a way that they may present a stumbling hazard Do not install the monitor in a location where it may drop on the patient All consoles and brackets used must have a raised edge at the front Dash 2000 Patient Monitor 1 27 227 499 06 US E Performance Check THE BASICS Putting the Monitor Into Operation Turnon the device with the power switch at the front The green AC ON indicator lights up page 1 11 The monitor display appears after approximately 10 seconds After power up and during operation the Dash 2000 runs automatic self tests When a malfunction is detected the mon
155. nitoring using the following steps 1 Be aware of the following general safety precautions when using SPO2 Choose the probe that is best suited to your patient ear finger disposable reusable etc NOTE Nellcor s RS 10 reflective probe is not recommended for use Use only the probes listed in the enclosed publication Accessories Dash 2000 3000 Contact your sales service representative for other probe options Clean the surface of the probe before and after each patient use probes WARNINGS DATA VALIDITY Do not expose probe detector to strong ambient light while monitoring a patient A poor signal may result DATA VALIDITY Do not allow tape to block the probe light detector DATA VALIDITY Check that the SPO2 waveform is physiological in shape PATIENT SAFETY Prolonged monitoring may require changing the probe site periodically Move the probe if there is any sign of skin irritation or impaired circulation Change the probe 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 PATIENT SAFETY If a probe is damaged in any way discontinue use immediately Be sure to read all literature accompanying probes for specific safety information Revision B Dash 2000 Patient Monitor 227 499 06 US E Following the instructions provided with the
156. nnels Input specifications Probe type Temperature range Resolution Output specifications Parameter displayed Linearity Error Alarms Number of channels Transducer sites Transducer requirements Excitation voltage Transducer output Input specifications Range Offset Input impedance Common mode Differential Output specifications Gain Frequency response Gain stability Zero balance range Zero balance accuracy Zero balance drift Common mode rejection Noise Dash 2000 Patient Monitor 227 499 06 US E Impedance variation detection 1 200 breaths per minute 100 to 1000 Ohms at 52 5 kHz excitation frequency 0 4 to 10 Ohms variation 0 1 to 1 8 Hz 3 dB User selectable upper and lower respiration rate limits and user selectable apnea limit 1 YSI Series 400 0 C to 45 C 32 F to 113 F 30 1 C TP lt 1 from 30 C to 42 C independent of source 0 1 C for Y SI series 400 probes User selectable upper and lower limits for TP 1 Arterial ART femoral artery FEM pulmonary artery PA central venous CVP right atrial RA left atrial LA intracranial ICP and special SP 22 5 V 30 1 96 50 uV V cmHg 25 mmHg to 300 mmHg 150 mmHg 2100 k at 50 50 Hz gt 100 k from dc to 60 Hz 976 1 96 dc to 50 Hz 40 3 dB lt 0 1 C and 40 196 over any 24 hour period 150 mmHg 1 mmHg 1 mmHg over 24 hours gt 60 dB at 60 Hz
157. ns in thetop half of the window arethe ones displayed as full size windows on the right side of the screen Y ou control the order of these when you designate a parameter for each position The parameters in the lower half of the window will be displayed at the bottom of the screen only when there is no room at the side Y ou cannot control the order of parameters displayed across the bottom of the screen The system prioritizes these for you See the next page for additional information which may be helpful to you when prioritizing parameters Revision B Dash 2000 Patient Monitor 5 9 227 499 06 US E Recall Default 5 10 MONITOR SETUP Monitor Setup Menu Hereis some additional information regarding parameter priorities The first parameter cannot be changed It must always be ECG e If only four parameters are being monitored then the window will occupy the four positions on the right side of the screen These windows are always the normal size windows If monitoring more than four parameters some will occupy space at the bottom of the screen e You can display a maximum of six parameters The software will not allow you to pick more parameters than can be displayed e If you are not monitoring a designated parameter the space is not left blank but filled with the next prioritized parameter Should you begin monitoring the designated parameter the screen reconfigures so the parameter occupies its designated space Whene
158. o allow uninterrupted monitoring Should the quality of an electrode signal degrade to an inadequate level a lead fail message will be displayed If the lead fail affects the ECG waveform monitored in the top trace position on the screen monitoring will automatically switch to another lead Refer to the chart below Message IEC Label New lead monitored RA FAIL R Lead III LL FAIL F Lead LA FAIL L Lead II V FAIL C L ead II LEADS FAIL No waveform displayed right leg fail or multiple leads fail Individual lead fail messages will not be displayed when using single lead analysis but lead switching will occur Leads Fail Patient There is a system alarm to alert you when more than one lead fails In OR Condition mode the monitor defaults this leads fail patient condition as a system ADVISORY alarm You can however set it as a CRISIS alarm in Monitor Defaults In Adult I CU and Neonatal I CU modes this alarm defaults to a system WARNING alarm but can also be set to a CRISIS alarm Refer to Setup Default Display section in Chapter 5 Monitor Setup 8 12 Dash 2000 Patient Monitor Revision B 227 499 06 US E ECG Size Revision B ECG ECG Menu Options This option enables you to change the size of all the ECG waveforms displayed on the screen This may be necessary when diagnosing or problem solving Normal size 1X is recommended unless circumstances require otherwise NOTES If a size other tha
159. omatically start a relearn procedure Dash 2000 Patient Monitor Revision B 227 499 06 US E ECG Troubleshooting Troubleshooting Problem Solution Inaccurate heart rate Check ECG signal from patient and or false asystole 1 Check adjust lead placement 2 Check perform skin preparation 3 Check replace electrodes Check amplitude of ECG waveform 1 Select ECG parameter label 2 Select DISPLAY LEAD 3 Scroll through all ECG leads and check for 0 5 mV amplitude at normal 1X size At least 0 5 mV amplitude is required for QRS detection For borderline signals validate on a graph 4 f amplitudes are low electrodes may need to be repositioned or replaced Relearn arrhythmia 1 Select ECG parameter label 2 Select RELEARN IF PROBLEM CONTINUES AND ECG AMPLITUDE IS LOW Select ECG parameter label Select ECG SIZE Select 2X or higher Close the popup menu Select RELEARN IF PROBLEM CONTINUES Change to single lead ECG detection and processing Select ECG parameter label Select ANALYSIS SETTINGS Select LEAD ANALYSIS Select SINGLE LEAD Goto PREV MENU Select DISPLAY LEAD Assess all the ECG leads and change top ECG waveform to display lead with greatest amplitude At least 0 5 mV amplitudeis required for QRS detection UBWNE NaUPWNH Revision B Dash 2000 Patient Monitor 8 25 227 499 06 US E Problem False ventricular calls Problem Inaccurate pacemaker detection 8
160. on based on normal values for pH PaCO2 Hb temperature etc i e a normal oxyhemoglobin dissociation curve Depending on the patient s physiologic and metabolic status his curve and all his values may be shifted away from normal Thus the oximeter which measures O2 saturation may not agree with the ABG A CO Oximeter is an analyzer which also measures O2 saturation The saturation of hemoglobin may be much closer to a pulse oximeter in these cases All pulse oximeters utilize two wavelength absorption This is because reduced hemoglobin RH b and oxyhemoglobin H bO2 absorb these two wavelengths differently The hemoglobin saturation is then figured from the measured amounts of the hemoglobins SpO2 HbO2 H bO2 RHb Carboxyhemoglobin COH b absorbs similarly to HbO2 and thus can raise the SpO2 Normal levels of COHb are 1 2 Methemoglobin M etHb usually represents less than 196 total H b but in cases such as some IV dyes antibiotics etc this level may go up sharply MetHb absorbs similarly to RHb and thus could lower the SpO2 reading Fetal Hb absorbs like adult Hb thus the oximeter has the same accuracy with neonates and adults Ambient light can have numerous effects In the newborn ICU bili lights can affect the readings of the oximeters Outside light striking the probe detector can give poor waveform and inaccurate readings Sunlight or bright indoor lights can have the same effect in other areas of the hospital u
161. onitor 5 17 227 499 06 US E Graph Location 5 18 MONITOR SETUP Monitor Setup Menu The GRAPH LOCATION option displays a menu which allows you to choose writers for alarm and manual graphs This menu is shown in the figure below MANUAL ALARM PRINT GRAPH GRAPH WINDOW LOCATION LOCATION LOCATION ICU1 ICU CS1 WRITER GRAPH LOCATION Menu MANUAL GRAPH LOCATION designate to which writer a graph strip with patient waveforms will be printed A manual graph is started and stopped with the GRAPH GO STOP key on the front of the monitor e ALARM GRAPH LOCATION designate to which writer an alarm graph strip with patient waveforms will be printed An alarm graph is automatically started when a Crisis or Warning alarm occurs e PRINT WINDOW LOCATION designate to which writer the data from an information window will be printed You can designate a different writer for each type of graph Described on the following page is the procedure for selecting a manual graph location Use the same procedure when selecting an alarm graph location and print window location NOTE TheGraph Location Menu is also accessible via the Admit Patient Menu when the Rover or Rover Combo application is selected Dash 2000 Patient Monitor Revision B 227 499 06 US E MONITOR SETUP Monitor Setup Menu Revision B 1 Select MANUAL GRAPH LOCATION option from the Graph Location Menu A popup menu and information window are displa
162. or Parameter Value E Automatic Graph 043 Patient Status Alarms Chart NOTE The automatic alarm graph feature can be set on or off as a Monitor Default Refer to Monitor Setup chapter System status alarms are triggered by mechanical or electrical problems System Status and are of lesser priority than patient status alarms Thelevels within the Alarms System Status Alarm category and how the monitor responds to each are shown in the following chart NOTE The optional built in handle alarm indicator is activated flashes yellow when a system status alarm occurs Alarm Level Monitor Response NIZ WARNING A Alarm Text IF EN NY ADVISORY A Alarm Text ZAIN Warning sounds continuously Advisory sounds only once Fog horn 17 Flashing A tone Alarm Text text 044 System Status Alarms Chart Unlike patient status alarms system status alarms cannot be moved from one level to another 4 4 Dash 2000 Patient Monitor Revision B 227 499 06 US E ALARM CONTROL Controlling Audio Alarms Controlling Audio Alarms Silencing an Alarm for One Minute Pausing Alarms Turning Alarm Volume Off Permanently Revision B To silence an alarm tone when it sounds press the SILENCE ALARM key on the front of the monitor The current alarm will be silenced for 60 seconds and the message SI LE NCED is displayed on the screen Any new alarm at an equal or greater level will sound and the silence command is cancel
163. or the analog output from the ECG acquisition modules is detailed below Analog output is obtained through the Defib Sync connector on the rear of the monitor ECG ANALOG OUTPUT Top displayed lead including augmented leads If pace is on there is an enhanced pacer pulse 5 volts at 2 milliseconds when pacemaker triggering is detected In the event of a LEAD FAIL refer tothe following Lead Failed ECG Analog Out Right arm II Left arm II Left leg Chest I Right leg Buzz A right leg lead fail causes an all LEADS FAIL on the screen and a buzz is output NOTES 1 All ECG outputs are 1 volt per millivolt referred to input 2 Insingle lead mode if the specified lead is not available a buzz will be output Dash 2000 Patient Monitor Revision B 227 499 06 US E Abbreviations and Symbols Abbreviations Revision B APPENDICES Abbreviations and Symbols Abbreviations and symbols which you may encounter while reading this manual or using the monitor are listed below with their meaning A A amps AaDO2 alveolar arterial oxygen gradient ABG arterial blood gas AC alternating current ACCV accelerated ventricular ACC VENT accelerated ventricular ADT adult AHA American H eart Associati on ANT anterior AO2 aO2 arterial oxygen saturation AR argon ARR arrhythmia ART arterial ASYS asystole Auto AUTO automatic a v02 arterial venous oxygen content difference AVF left foot augmented lead AVG average AVL left arm au
164. ot be possible due to large amounts of energy produced by these devices Monitoring ECG with an external device may be needed The DETECT PACE option enables disables the pacemaker detection program It must be used whenever the monitored patient has a pacemaker Pace detection choices are Pace 1 Pace 2 and Off NOTE Moderate and maximum ECG filtering is not recommended with pacemaker patients Refer to this chapter ECG Filter There are two pacemaker processing modes Pace 1 and Pace 2 ThePace 1 and Pace 2 modes use different algorithms for pacemaker artifact rejection The dinician must bethe judge as to which mode is better for each patient The pacemaker detection program defaults off so if you have a patient with a pacemaker you will haveto turn the program on Follow this procedure 1 Select DETECT PACE option from the Analysis Settings menu A popup menu opens DETECT PACE Popup Menu 2 Rotatethe Trim K nob control sothe pointer is in front of your choice The Pace 2 mode is much more conservative in recognizing paced QRS morphologies and is recommended for use whenever possible It is designed to minimize the possibility of counting pacemaker artifact as QRS complexes during ASYSTOLE If the monitor does not adequately detect paced beats in the Pace 2 mode then the user may wish totry the Pace 1 mode Please observe all cautions as described when choosing the Pace 1 mode of operation The Pace 1 mode allows succe
165. p monitor defaults etc The service menu is accessed here also Each of these options is covered in more detail in following chapters Dash 2000 Patient Monitor Revision B 227 499 06 US E Popup Menus Scrolling Popup Pointer Popup Revision B THE BASICS Software Features When some menu options are selected a small menu pops up around the selected menu option These are called popup menus There are different types of popup menus Those most commonly used are described below Notethat with all popup menus the original menu remains on the screen but the options are dimmed The popup menu must be dosed before you can select other options from the original menu Scrolling Popup Menu All available selections appear with the current selection highlighted The arrows are also highlighted indicating that the Trim Knob control can be rotated scrolled to change the selection When the Trim Knob control is rotated the new selection is highlighted and the change occurs immediately on the screen so that the user can see if the selection is appropriate before exiting the popup Press the Trim Knob control to close the popup menu ECG REO len MONITORG Pointer Popup Menu All available selections appear and a pointer gt is displayed The arrows are highlighted indicating that the Trim Knob control can be rotated to move the pointer to another selection However before the change is actually implemented the Tri
166. p cup E E e Revision B Dash 2000 Patient Monitor xiii 227 499 06 US E PREFACE Monitor Defaults Worksheet Parameter Limits xiv Dash 2000 Patient Monitor Revision B 227 499 06 US E PREFACE Monitor Defaults Worksheet Display Defaults PATIENT AGE pu ESI T MN eee qp X ee as ARRHYTHMIA PO BR NN eg LEAD ANALYSIS EE pove E DN smt E TIMED GRAPH ART DISCONNECT SMART BP ARTERIAL SCALE PA SCALE CPV RA UVC SCALE LA SCALE ICP SCALE SP SCALE NBP AUTO RUmN WE meor ES RATE VOLUME ECG LEADS FAIL Revision B DISPLAY LIMITS DISPLAY UNITS TEMPERATURE UNITS NBP LIMITS TYPE ARTERIAL LIMITS TYPE PA LIMITS TYPE MENU TIMEOUT ECG FILTER BP FILTER DISCHARGE ALERT QRS WIDTH color display monochrome display not in NEO I CU mode Dash 2000 Patient Monitor 227 499 06 US E XV PREFACE Monitor Defaults Worksheet Parameter Priority Defaults Indicate which parameters you want to have priority in the first 3 positions on the display ECG always appears first and cannot be changed Parameter 1 ECG Puer o0 puero 0 Circle the other parameters you want to have priority after position 3 Size of the parameter window determines how many selections you can make The software prevents you from selecting more parameters than allowable NBP UVC ART LA FEM ICP UAC SP PA SPO2 CVP RR RA TP XE 77 Dash 2000 Patient Monitor
167. ping the cableto the side of the hand or foot In the case of the butterfly probe the tape was designed to secure the cable to the finger Electrosurgical interference will be most obvious on the displayed waveform It is a very spiky erratic looking waveform caused by the electrosurgical unit s overwhelming interference in the OR It can result in grossly inaccurate pulse oximeter parameters Electrosurgical interference can be minimized by 1 Making sure the pulse oximeter probe is as far away from the return pad and operating site as possible Making sure the probe is not between the return pad and operating site 3 Keeping the power cord and probe cable away from the power cord of the electrosurgical unit 4 Plugging the electrosurgery unit into a separate set of outlets from the monitor Dash 2000 Patient Monitor 11 17 227 499 06 US E SPO2 Troubleshooting For your notes 11 18 Dash 2000 Patient Monitor Revision B 227 499 06 US E 12 RESPIRATION lis roro Ulutea RERO ER PEST 12 2 General Information essen 12 3 aedi M 12 4 Respiration Monitoring Features nnennsennsennnnnnnnnnnnnnnnnnnnann 12 5 Respiration Information eene 12 5 Getting to the Respiration Menu 12 6 Respiration M enu Optlons sess 12 7 RE WEE 12 7 Relearn Respiration ssssseeeeeneenen nens 12 7 Respiration Limite 12 8 IER 12 9 Cardiac Artifact Alarm 12 10 SI
168. position on the screen to process ECG and arrhythmia information When monitoring an adult single lead analysis would be beneficial when using an external temporary pacemaker with a Zoll interface cable e troubleshooting pacemaker detection and or arrhythmia detection NOTE ECGisrelearned whenever lead analysis is changed To changethe lead analysis follow this procedure 1 Select LD ANALYSIS option from the Analysis Settings menu A popup menu opens displaying the two options LEAD ANALYSIS Popup Menu 2 Rotatethe Trim K nob control to placethe pointer in front of your choice The change will not take effect until the Trim Knob control is pressed and the popup menu closed 3 Press the Trim Knob control to confirm the change and close the popup menu NOTE Because of the lead configuration used when monitoring neonates single lead analysis defaults on with lead II in the top trace position when the monitor is set up for Neonatal I CU monitoring mode Dash 2000 Patient Monitor Revision B 227 499 06 US E Detect Pace Safety Considerations Revision B ECG ECG Menu Options WARNINGS FALSE CALLS False low heart rate indicators or false asystole calls may result with certain pacemakers because of electrical overshoots MONITORING PACEMAKER PATIENTS Monitoring of pacemaker patients can only occur with the pace program activated PACEMAKER SPIKE An artificial pacemaker spike is displayed
169. probe correctly position and attach the probe to your patient SPO2 Signal and Data Validity Signal and Data Validity Signal Strength Indicator Quality of SPO2 Waveform It is extremely important to determine that the probe is attached to the patient correctly and the data is verifiable To make this determination three indications from the monitor are of assistance signal strength indicator quality of the SPO2 waveform and the stability of the SPO2 values It is critical to observe all three indications simultaneously when ascertaining signal and data validity The signal strength indicator is displayed within the SPO2 values window This indicator consists of 0 1 2 or 3 strongest asterisks depending on the strength of the signal Proper environmental conditions and probe attachment will help to ensure a strong signal Under normal conditions the SPO2 waveform corresponds to but is not proportional to the arterial pressure waveform Thetypical SPO2 waveform indicates not only a good waveform but helps the user find a probe placement with the least noise spikes present The figure below represents an SPO2 waveform of good quality N N NN N NZN Good Quality SPO2 Waveform If noise artifact is seen on the waveform because of poor probe placement the photodetector may not be flush with thetissue Check that the probe is secured and the tissue sample is not toothick Pulse rateis determined from the SPO2 wavefo
170. r label or you can access other menus not related to a specific parameter by selecting the MORE MENUS option Revision B Dash 2000 Patient Monitor 1 17 227 499 06 US E Parameter Menus More Menus THE BASICS Software Features Each parameter has its own menu from which to access features Below is an example of the ECG parameter menu LIMITS NALYSIS SETTINGS 01 ECG Parameter Menu TheMain Menu must be displayed to access a parameter menu 1 To access a parameter menu highlight a parameter label for example ECG and then press the Trim Knob control Each parameter menu is discussed in detail in the specific parameter chapter In the lower left corner of the Main Menu is the MORE MENUS option Select this option to display the following menu MONITOR SETUP MORE MENUS Menu e ALARM CONTROL This option displays a menu which allows you to view and modify all alarm limits change alarm levels and adjust alarm volume PATIENT DATA This option displays a menu which allows you to view patient data vital sign history and graphic trends e ADMIT MENU This option displays a menu to enter necessary patient information and admit and discharge the patient to from the monitor In OR mode this menu item reads NEW CASE SETUP MONITOR SETUP This option displays a menu which allows you to set up the monitor to suit your needs waveforms displayed color Scheme parameters on off graph setu
171. r on the monitor Transducers are level according to unit policy Recommended standard is level of right left atrium The transducer is zeroed Any entrapped air is removed from the system NOTE Refer to the transducer manufacturer s instructions for suggested means of removing entrapped air from the hydraulic system Pressure setup is adjusted if necessary Details are provided in this chapter Dash 2000 Patient Monitor Revision B 227 499 06 US E PRESSURES Pressure Monitoring Features Pressure Monitoring Features Pressure Information A labeled pressure waveform will be displayed when the patient cable is Revision B connected to the monitor if enabled from the Display Setup Menu After a zero reference procedure is done numerics are displayed in the pressure parameter windows on the right side of the screen Limits and Units S denotes systolic limits Systolic Diastolic Value Value Pulse Mean Rate Value Value CVP Pressure Parameter Window The current systolic diastolic and mean values are displayed Some pressures only display a mean value Limits and the units of measurement may also be displayed For pressures with multiple values the limits are labeled S systolic D diastolic M 2mean For sites labeled ART FEM and UAC a pulserate value can be turned on The pressure monitoring features are found in the pressure menu All pressure menus include scales cursor site name limits zero
172. rce when the message is displayed Dash 2000 Patient Monitor Revision B 227 499 06 US E Power Indicator Lights Revision B THE BASICS Battery Power There arethree power indicator lights on the front of the monitor The illustration below identifies these indicator lights AC Power LED Battery Power LED Charging status indicator NBP Go Stop 007 Power Indicator Lights These indicators when lit denote a power condition Conditions may be designated with a single indicator or a combination of indicators The chart below details these power conditions and their indicators In the chart below an X indicates that the indicator light shown at the top of the column is lit Conditions Indicated by Power Indicator Lights Battery Charging Status Unit is AC X yellow powered battery X is being charged Unit is AC X green powered battery X is fully charged Unit is battery X powered Conditioning X X battery is being discharged n this condition the battery can be used but be aware it is not fully charged so usage time is unpredictable The system message COND IS RUNNING is displayed NOTE Ifthe Charging Status LED is blinking yellow this indicates a malfunction in the battery management system Please contact Service Dash 2000 Patient Monitor 1 13 227 499 06 US E Battery Conditioning To obtain the greatest possible battery performance and to keep the fuel
173. re other regular maintenance checks Dash 2000 Patient Monitor 7 7 227 499 06 US E MAINTENANCE Changing Graph Paper Changing Graph Paper Built in Writer 1 Open the door by pressing on the top of the writer as indicated below 2 Removethe old paper spool and install a new paper roll The paper contains a special coating on one side and must be installed correctly Install the paper so it unrolls from the bottom 4 Testthe writer by initiating a graph strip refer to The Basics chapter Graphing Printing for directions Be sureto tear downward when removing a graph strip from the writer NOTE Ifthe graph strip is blank the paper is probably installed upside down Turn the spool over so the paper unwinds from the other direction 7 8 Dash 2000 Patient Monitor Revision B 227 499 06 US E MAINTENANCE Thermal Paper Storage Thermal Paper Storage To avoid deterioration or fading of traces follow these precautions NOTE These precautions apply to both unused paper as well as paper that has already been run through the writer Y Storein cool dark locations Temperature must be below 80 F 27 C Relative humidity must be between 40 and 65 Y Avoid exposure to bright light or ultraviolet sources such as sunlight fluorescent and similar lighting which causes yellowing of paper and fading of tracings Y DO NOT STORE THERMAL PAPER WITH ANY OF THE FOLLOWING e carbon and carbonless forms e non th
174. responding alarm level to the right NOTE VTACH is only found in the Adult ICU and Operating Room mode BRADY is only found in the Neonatal CU mode see also page 4 6 Alarm Control Menu Dash 2000 Patient Monitor Revision B 227 499 06 US E Revision B MONITOR SETUP Monitor Setup Menu If you want to move an arrhythmia call to another level for your Monitor Default follow this procedure In this example we will change V TACH from a Crisis to a Warning level NOTE Asystole and VFIB VTAC can only be moved when in Operating Room M ode 1 Rotate the Trim Knob control to move the pointer gt up and down the list Stop when the pointer isin front of V TACH 2 Press the Trim Knob control Notice that the level for the V TACH call is highlighted Rotate the Trim Knob control until WARNING is displayed Press the Trim Knob control to complete the change The information window is reorganized to include V TACH as a WARNING alarm The information window remains open for you to make any other changes 5 When you have completed all changes move the pointer to RETURN and press the Trim Knob control to close the information window Dash 2000 Patient Monitor 5 5 227 499 06 US E MONITOR SETUP Monitor Setup Menu Setup Default You can set default alarm levels for all parameters supported by the itor Parameter Alarm bios Levels Usethe PARAM ALARM LEVELS option to view and adjust default alarm levels for paramet
175. rhythmias do not occur The messages which alert you to the conditions causing suspended arrhythmia analysis are ARR OFF ARRHY SUSPEND LEADS FAIL ALARM PAUSE ALL ALARMS OFF and DISCHARGED The EK Pro algorithm simultaneously uses leads I II III and V for ECG and arrhythmia analysis The software package detects lethal arrhythmias Lethal arrhythmias are Asystole VFib VTac and V Tach unless in Neonatal I CU mode Then Asystole VFib VTac and Brady are the lethal arrhythmias Refer tothis chapter Arrhythmia Conditions for arrhythmia definitions To manually turn arrhythmia analysis off and on follow this procedure 1 Select ANALYSIS SETTINGS from the ECG Menu A popup menu opens 2 Select ARRHYTH from the Analysis Settings menu A popup opens 093B ARRHYTHMIA ON OFF Popup Menu 3 Rotatethe Trim K nob control to placethe pointer in front of your choice then press The change will not take effect until the Trim Knob control is pressed and the popup menu closed Dash 2000 Patient Monitor 8 23 227 499 06 US E Arrhythmia Conditions ECG ECG Menu Options Following is an alphabetical list of the arrhythmia messages which will be displayed when arrhythmia is on and the condition occurs A definition of each arrhythmia condition is included How the monitor responds to each condition is determined by the alarm level to which the arrhythmia has been assigned Refer to Alarm Control section Arrhythmia Ala
176. riter uses 2 inch wide graph paper 012A Centralscope Central Station The Centralscope Central Station is generically referred to as the central station throughout this manual Refer to the Centralscope central station operator s manual for instructions on operation Dash 2000 Patient Monitor Revision B 227 499 06 US E THE BASICS Components Optional Clinical TheUnity Network Ethernet establishes bed to bed communication and Inf ti Cent allows patient data to be sent to an optional Clinical Information Center nrormation Genter and to other monitors on the network All devices must be connected to the network AD E Clinical Information Center The Clinical Information Center is generically referred to as the central station throughout this manual Refer tothe Clinical Information Center operator s manual for instructions on operation Revision B Dash 2000 Patient Monitor 1 5 227 499 06 US E Optional Laser Printer THE BASICS Components An optional laser printer not shown connects to the central station It is identified on the Dash monitor as LASER when choosing a graph location Refer to the Monitor Setup chapter for more details When you choose the laser printer as the print window location it can print any printable information window when it is displayed and the GRAPH GO STOP key is pressed When you choose the laser printer as the manual graph location it will print
177. rm L evel to view the alarm level settings for arrhythmias ASYSTOLE BRADY Ventricular asystole occurs when a QRS has failed to be detected for 6 seconds and the heart rateis less than 30 beats per minute Bradycardia is the average of the most recent eight R to R intervals at a heart rate less than the set low heart rate limit NOTE TheBrady limit matches the low heart rate limit If the low heart rate limit is changed the Brady limit changes VFIBNTAC V TACH Ventricular fibrillation occurs when the instantaneous heart rate is less than 30 beats per minute and indicates a chaotic ventricular rhythm Adult Ventricular tachycardia occurs when arun of six or more ventricular beats is detected with an average heart rate greater than or equal to 100 beats per minute 0 2 years Occurs when a run of six or more ventricular beats is detected with an average heart rate greater than or equal to 160 beats per minute 3 10 years Occurs when arun of six or more ventricular beats is detected with an average heart rate greater than or equal to 140 beats per minute 11 13 years Occurs when a run of six or more ventricular beats is detected with an average heart rate greater than or equal to 130 beats per minute NOTES The message ARR OFF appears in the ECG parameter window when arrhythmia is turned OFF This message is not displayed when the monitor is in Operating Room mode Turning arrhythmia detection on will aut
178. rm which can be disrupted by a cough or other hemodynamic pressure disturbances Motion at the probe site is indicated by noise spikes in the normal waveform See the figure below It has been noted that letting the patient view the SPO2 waveform enables them to assist in reducing motion artifact AA Ny SPO2 Waveform with Artifact 6 Dash 2000 Patient Monitor Revision B 227 499 06 US E Stability of SPO2 Values Revision B SPO2 Signal and Data Validity The stability of the displayed SPO2 values can also be used as an indication of signal validity Although stability is a relative term with a small amount of practice one can get a good feeling for changes that are artifactual or physiological and the speed of each Messages are provided in the SPO2 values window to aid you in successful SPO2 monitoring Refer tothis chapter Troubleshooting WARNING In the monitoring of patients the coincidence of adverse conditions may lead to a disturbed signal going unnoticed In this situation artifacts are capable of simulating a plausible parameter reading so that the monitor fails to sound an alarm In order to ensure reliable patient monitoring the proper application of the probe and the signal quality must be checked at regular intervals Dash 2000 Patient Monitor 11 7 227 499 06 US E SPO2 SPO2 Monitoring Features SPO2 Monitoring Features SPO2 Information A waveform labeled
179. rt as 11 12 Rate iu iet a 11 12 Probe Off Patient Condition eseeee ne 11 13 s e E le e le DEE 11 14 SPO2 Messages EE 11 14 1 2 RE SPI RATI ON BERR RRR RRR RRR RRR RRR RRR 12 1 feld Te Ne cuca at lia idad 12 2 General Information eee nennen 12 3 Checkliste 12 4 Respiration Monitoring Features 12 5 Respiration Information esses 12 5 Getting to the Respiration Menu 12 6 Respiration Menu OptiONS sse 12 7 Re EE 12 7 Relearn Respiration eesssee ene 12 7 Respiration Limite 12 8 SensikiV3 ae nod atc Ae iio EE 12 9 Cardiac Artifact Alarm 12 10 SILO A MR RIS E 12 11 AUTO Zi 12 11 Manual SiZ iio tias 12 11 Troubleshooting 12 12 Respiratory Waveform nn 12 12 Exa A ee eis EE 12 12 Varying Amplitudes c oocooocccciccconccnncnoncnccnnnann nara naro narran 12 13 MESS c 12 13 Revision B Dash 2000 Patient Monitor 227 499 06 US E vii TABLE OF CONTENTS 1 3 TE MPE RATURE BERBER RR RRR RR RRR RRR 13 1 Introduction ee ceci c tet ei iecur erue ba e Da eene 13 2 Checklist e tires ceret dee ias 13 2 Temperature Monitoring Features 13 3 Temperature Information 13 3 Getting to the Temperature Menu 13 4 Temperature Menu Options uussessennnsnnnnennnennnnnnnnnnnnnnnnnnnnnnann 13 5 Blue ee TEIL ME 13 5 EPA TEEN 13 5 ProubleshootiN EE 13 6 Messages edi e 13 6 1 4 APPENDICES SRR RRR RRR RRR 14 1 Defib Sync Analog Output 14 2 ECG A
180. rt the graph In Operating Room mode and N eonatal I CU mode the alarm graphing default is off in Adult ICU mode it is on There is a menu option in the Graph Setup menu ALARM GRAPH toturn this feature on and off This can be saved as a Monitor Default Dash 2000 Patient Monitor 1 25 227 499 06 US E THE BASICS Graphing Printing Pressure Scales Graphing Messages Graph Header Invasive pressures will always graph on individual scales as follows Displayed Scale Graph Scale 30 0 45 CVP LA RA ICP PA 40 0 45 60 0 60 100 0 90 160 0 150 200 300 0 300 Auto 0 150 ART FEM UAC SP 0 45 PA CVP UVC RA LA ICP Following is a list of all graphing messages and what they indicate SAVING the device to which you want to print is busy or for some reason inoperable If it is an alarm graph 20 seconds of data is saved until it can print or another alarm graph occurs The monitor only saves for print the most recent alarm data A manual graph is saved until you press the GRAPH GO STOP key or an alarm graph occurs GRAPHING MANUAL a manual graph is in progress GRAPHING ALARM a crisis or warning alarm has occurred An automatic graph is run PRINTING WINDOW a manual graph of a printable information window is in progress PAPER OUT the writer printer needs paper or a writer door is open The graph header which is printed with all patient waveforms includes type of graph alarm or man
181. s are found in the Temperature Parameter Menu WARNINGS When the probe becomes disconnected the temperature monitoring function is disabled but no alarm is submitted In order to ensure reliable patient monitoring the proper application of the probe and the connection must be checked at regular intervals Do not route cables in a way that they may present a stumbling hazard Revision B Dash 2000 Patient Monitor 13 3 227 499 06 US E Getting to the Temperature Menu 13 4 TEMPERATURE Temperature Monitoring Features Todisplay the Temperature menu usethe Trim Knob control to select the TP parameter label Remember selecting with the Trim Knob control is a two step process rotate to highlight then press to select Selecting the TP Parameter Label The Temperature menu is displayed at the bottom of the screen MAIN UNITS TP MENU CELSIUS LIMITS 137 Temperature Menu With the Trim Knob control you now can select any of the displayed options e UNITS switch the units of measurement between Celsius and Fahrenheit e TPLIMITS display a new menu and an information window to adjust alarm limits for the temperature site Dash 2000 Patient Monitor Revision B 227 499 06 US E TEMPERATURE Temperature Menu Options Temperature Menu Options Units This direct action menu option switches the units of measure between Celsius C and Fahrenheit F TP Limits A new set of menu options is disp
182. s but less than 2 years If you enter an age the birth date is calculated with current day and month and appropriate year Height Weight enter the patient s height and weight Location ID enter the location identification for your MUSE system if you have one not used in current SW version Site Number if your institution has multiple buildings a site number may be necessary A Muse system may be used for site numbering not used in current SW version Dash 2000 Patient Monitor Revision B 227 499 06 US E Request Admit Info Save Admit Info Weight and Height Age Revision B ADMIT DISCHARGE Admit Menu Options If your monitoring system includes a Lab Access Server with an interface to hospital information selecting this option will display patient information that was entered Seethe figure below If your system does not have this equipment a message is displayed below the menu when you attempt to select this option AUTOMATIC ADMIT INFORMATION LAST NAME DINAKO Name ID Sex and Birth Date FIRST NAME RAY come from hospital information PATIENT ID 333 33 333 SEX MALE BIRTH DATE 14 JAN 1948 Age is calculated if a birth date HEIGHT has been entered WEIGHT LOCATION ID The remaining information will SITE NUMBER be displayed if previously entered If necessary you can add to or change the information displayed 034A REQUEST ADMIT INFO Information Menu Verify the accuracy of any displa
183. s place for a few seconds whenever respiration monitoring is started If your patient s breathing pattern changes after the initial learning process has taken place it may be necessary to relearn Select RELEARN RESP option from the respiration menu This is a direct action menu option The message LEARNING will be displayed in the RR values window There is norespiration rate displayed during the learning process When learning is complete the message will dear and the respiration rate will be displayed NOTE Sensitivity is reset at 4096 and the waveform is automatically sized Dash 2000 Patient Monitor 12 7 227 499 06 US E RESPIRATION Respiration Menu Options Respiration Limits This option provides an information window that shows the alarm limits for respiration rate and apnea A new set of menu options is displayed to allow you to adjust these limits Follow this procedure 1 Select RESP LIMITS option from the Respiration Menu An information window is displayed on the screen and a new set of menu options is displayed in the menu area 21 NOV 1998 16 27 DAK BED 1 RESP LIMITS gt RETURN UNITS E RR min RR APNEA RESPIRATION LIMITS Menu and Information Window 2 Rotate the Trim Knob control to move the pointer gt through the list 3 Press the Trim Knob control when the pointer is in front of the parameter for which you want to change default limits The parameter label highlights 4 Turnth
184. sides of the chest Thethird electrode right leg can be placed on either the right or left side of the abdomen Lead II Lead I Lead II Lead I AHA Configuration IEC Configuration NOTE Usethe neonatal patient cable 8 6 Dash 2000 Patient Monitor Revision B 227 499 06 US E ECG Electrode Placement Electrodes need to be repositioned to modify detection of the electrical Electrode Placement E dete signals generated by the pacemaker Following is a suggested for Pacemaker configuration Patients NOTE When using this configuration display Lead Il as your primary ECG lead AHA Configuration IEC Configuration The right arm electrode is moved down tothe 5th intercostal space and the left leg electrode is moved up tothe 5th intercostal space NOTE After all electrodes are in place ensure minimum of 1 2 mV of signal is present on each lead I II III V Dash 2000 Patient Monitor 8 7 Revision B 227 499 06 US E Maintaining Quality ECG Signal Surgical Considerations for Electrode Placement Adults ESU ECG Filters Electrosurgical Unit ESU Cable 8 8 ECG Electrode Placement Regardless of patient age electrodes should be replaced at least every 48 hours to maintain quality signals during long term monitoring Over the course of 48 hours the electrode gel will start to dry out and the adhesive will age After a long period of time the patient s sensitive skin also may be irritated by
185. signal analysis This condition is most likely to be encountered when the monitor is used on neonates or infants These same conditions in adults do not impact the pulse oximetry values to the same extent When using pulse oximetry on neonates and infants always observe the following precautions PRECAUTIONS We recommend the application of the following criteria when using the pulse oximetry function on neonates and infants 1 The peripheral pulse rate PPR as determined by the pulse oximetry function must be within 10 of the heart rate and 2 the pulse oximetry signal strength indicator must have 2 or 3 asterisks displayed and 3 six seconds of artifact free waveform must be present or 4 stable pulse oximetry values are displayed for six seconds Procedures or devices previously applied in your facility for pulse oximetry monitoring should be used in the event that the pulse oximetry value from the Dash monitor cannot be validated by the above criteria Dash 2000 Patient Monitor 11 3 227 499 06 US E SPO2 Checklist Checklist 1 SPO2 probe is correctly positioned on the patient Follow instructions provided with the probe of choice Patient cable is connected to the monitor 3 SPO2setup is adjusted if necessary Follow detailed procedures within this chapter 11 4 Dash 2000 Patient Monitor Revision B 227 499 06 US E Patient Preparation SPO2 Patient Preparation Prepare the patient for SPO2 mo
186. sing oximetry Error messages of PROBE IS OFF THE PATIENT or PULSE SEARCH etc are possible Shielding the probe with opaque tape the posey wrap or other material can thus increase oximetry accuracy verified by good waveform and signal strength Dash 2000 Patient Monitor 11 15 227 499 06 US E What things can create inaccurate pulse oximeter readings 11 16 SPO2 Troubleshooting Certain IV dyes such as methylene blue can affect the readings Methylene blue will give falsely low readings due to excess absorption of the red wavelength Nail polish especially violets and blues can also reduce the reading dueto the same absorption Removal of the polish is always recommended Long nails and artificial or acrylic nails can interfere with good LE D detector opposition through the tissue Patients with deeply pigmented skin may be tough to monitor although finger pigmentation is usually less than the rest of the body Patients with Sickle Cell Anemia undergoing a sickling crisis may have erroneous readings due to the absorption spectrum of H bS being different than for normal adult H b Severely jaundiced patients have high levels of bilirubin in their blood A product of bilirubin metabolism is CO and thus high levels of carboxyhemoglobin can be formed causing the oxi meter to read artificially high SPO2 Patients with severe anemia can have low SPO2 readings Patients with heavy smoke inhalation can have transiently
187. ssful detection of the largest variety of paced QRS morphologies As a direct consequence this mode does have a higher risk of counting pacemaker artifact as QRS complexes during ASYSTOLE For this reason it is imperative that the user keep patients with pacemakers under close observation It is also recommended that the user set the low heart rate limit on the monitor doseto the minimum pacing rate and that the BRADY arrhythmia alarm level be elevated to a WARNING or CRISIS level 3 Press the Trim Knob control to confirm the change and close the popup menu When either pace mode is enabled the software places an artificial spike on the waveform whenever the pacemaker triggers When pacemaker detection is on it is indicated by a P in the patient s ECG parameter window Dash 2000 Patient Monitor Revision B 227 499 06 US E Revision B ECG ECG Menu Options For successful monitoring of pacemaker patients follow these suggestions Use recommended electrode placement Refer to the Electrode Placement section in this chapter Brady Pause and Low Heart Rate are additional alarms available for use when monitoring pacemaker patients Problems you may experience are heart rate double counting e inaccurate alarms for low heart rate or asystole e pacemaker spikes not recognized by the software Possible solutions to above problems are relearn arrhythmia e try an alternate electrode placement try single lead
188. st turned on it is set to run at 5 minute intervals the cuff inflates immediately and then every 5 minutes thereafter If you change the timing interval i e 15 minutes without turning AUTO off the timing cycle does not start over The next cuff inflation will occur 15 minutes after the last inflation and every 15 minutes thereafter Turning AUTO off and then on again restarts the timing cycle with an immediate cuff inflation 3 Pressthe Trim K nob control to confirm the change and close the popup menu A count down timer is displayed in the NBP parameter window when the time interval set or remaining is 60 minutes or less The last minute will count down in seconds If the set or remaining time interval is morethan 60 minutes the symbol AUT is shown instead NOTE Operating Room Mode If an auto mode time is set in monitor defaults pressing the NBP GO STOP key starts the auto mode feature Revision B Dash 2000 Patient Monitor 10 7 227 499 06 US E NBP Stat NBP NBP Menu Options NOTE TheNBP STAT feature is not available when the monitor is set up for Neonatal I CU mode NBP STAT enables 5 minutes of continuous sequential automatic NBP measurements Follow this procedure Activate the NBP STAT option of the NBP menu to start 5 minutes of continuous sequential NBP measurement Press OFF todiscontinue the STAT process before the 5 minute period is up or simply press NBP GO STOP key on the front of the monitor
189. static axis placement of transducer Rezero pressure Close transducer stopcock to patient Open the venting stopcock to air Press FUNCTION ZERO Close the venting stopcock to air Open transducer stopcock to patient UBWNE Solution Turn Smart BP OFF then ON If problem persists you may need to disable Smart BP by turning it off for that pressure Use Alarm Pause feature prior to drawing blood to reduce unnecessary alarms if Smart BP is disabled Dash 2000 Patient Monitor 9 15 227 499 06 US E For your notes 9 16 PRESSURES Troubleshooting Dash 2000 Patient Monitor 227 499 06 US E Revision B 10 NBP Revision B MEP OGUCEI ON EE 10 2 Checklist vivia cs 10 3 Patient Preparation enne 10 4 NBP Monitoringteatures enne 10 5 NBP Information 10 5 NBP Go Stop Key ununsnennsnnnnannnnnannnnnnnnnnannnnannnnnannnnnanenanrn 10 5 Power Key arena 10 5 Getting to the NBP Menu 10 6 NBP Menu Options ENEE 10 7 NIBP Autor Ren 10 7 NBP Static ida 10 8 NBP Limits cion a 10 9 Cuff SIZe ar e KE 10 10 Cuff Inflation Preseures 10 10 Clear NBP Reading seen 10 10 BN e le e Le DEE 10 11 NBP Status Messages AA 10 11 Dash 2000 Patient Monitor 227 499 06 US E Introduction NBP Introduction WARNING Noninvasive blood pressure monitoring is not recommended for patients with hypotension hypertension arrhythmias or extremely high or low heart rate The software algorithm
190. stems J apan Waseda Hirai Building 7th Floor 1 18 9 Nishi Waseda Shinjuku K uTokyo J apan Telephone 81 3 3203 1631 Fax 81 3 3202 1626 Hong Kong Marquette Medical Systems HK 26 F Catic Plaza 8 Causeway Road Causeway Bay Hong Kong Telephone 852 2804 2320 Fax 852 2804 1776 Southeast Asia Marquette Electronics SEA Pte 2 Leng Kee Road 04 04A Thye Hong Centre Singapore 0315 Telephone 65 471 2133 Fax 65 471 1540 xii Dash 2000 Patient Monitor Revision B 227 499 06 US E PREFACE Monitor Defaults Worksheet Monitor Defaults Worksheet You can customize alarm limits and levels as well as d Date Unit numerous display options Y our settings can be set EE up as Monitor Defaults to be recalled with each Patient Monitor Type circle one discharge procedure Refer to the Monitor Setup chapter of this manual for details ADULT ICU NEONATAL ICU OPERATING ROOM We have provided this worksheet as an optional NOTE Changing patient monitor type after setup reference tool Fill it out and keep it in a prominent erases your monitor defaults and reinstates place to refer to your setup You may want to make monitor defaults additional copies of the worksheet for future use before filling it out Parameter Alarm Levels Arrhythmia Alarm Levels Gris Warning Advisory Message Brady res ART Rate SPO2 Rate MEN mee UR III pa A A ee O O
191. t in Monitor Defaults Another special featureis PULSE RATE Thisfeatureis found in ART FEM and UAC neonatal mode only pressure sites When turned on a Rate value is displayed in the appropriate parameter values window Pulse Rate Pulse Rate Displayed in ART Parameter Window Toturn the pulse rate value on and off simply select PULSE RATE in the applicable Settings menu Revision B Dash 2000 Patient Monitor 9 13 227 499 06 US E Disconnect Alarm 9 14 PRESSURES Pressure Menu Options The DISCONN ALARM feature is found in ART and FEM Settings menus NOTE Thisfeature is not available when the monitor is set up for Neonatal ICU mode If the mean pressure falls below 25 mmHg and the disconnect alarm is on a Warning alarm sounds and the message DISCONNECTED is displayed in the values window Check your patient immediately in the event the catheter has dislodged Toturn this feature off and on select DISCONN ALARM option from the appropriate Settings menu This feature can be set off or on in Monitor Defaults You cannot change the alarm level It will always be a warning alarm Dash 2000 Patient Monitor Revision B 227 499 06 US E Troubleshooting Problem Displayed pressure values are different than expected Problem Smart BP is on Artifact is sensed without flush draw or zero Revision B PRESSURES Troubleshooting Solution Check tubing for bubbles Remove excessive tubing Check phlebo
192. ter ADMIT PATIENT a direct action menu option that admits the patient DISCHARG PATIENT opens a popup menu to confirm the discharge of the patient NEW CASE a direct action option which discharges the patient s information and with no additional steps readies the monitor for the next patient new admission Refer tothis chapter Admit Menu Options if you need more details on these menu options Revision B Dash 2000 Patient Monitor 3 5 227 499 06 US E ADMIT DISCHARGE Rover Admit Menu Rover Admit Menu With the Rover application the monitor may be on a cart which allows you to move it from one room to another Theunit name and bed number in Some cases may need to be changed so they are included as options in the admit menu ICU ADMIT Menu Rover Application NOTE XXX ADMIT if patient is discharged DISCHARG otherwise 028 OR ADMIT Menu Rover Application SET UNIT NAME verify or change the unit name The correct unit name is essential for recognition at a central station and other network devices SET BED NUMBER verify or change the assigned bed number The correct bed number is essential for recognition at a central station and other network devi ces SET GRAPH LOCATION option displays a menu which allows you to choose writers for alarm and manual graphs refer to sections Monitor Setup Graph Setup Set Graph Location ADMIT INFO opens the admit information window and popup menu ref
193. th monitor response and action to take STATUS MESSAGE MONITOR RESPONSE SOLUTION CUFF INFLAT System status alarm Auto mode Check cuff if no air is in cuff try OVER 5MINS will shut off another measurement If air is in cuff remove cuff and contact service DEFLATION System status alarm Auto mode Remove cuff and contact service FAIL will shut off INFLATION FAIL System status alarm Check cuff connections and CHECK CUFF tubing try another measurement MAXIMUM CUFF PRESS EXCEED System status alarm Auto mode will shut off Remove cuff and contact service MEASURE TIME System status alarm Possible excessive patient 227 499 06 US E EXCEEDED movement or arrhythmia condition Check patient try another measurement HARDWARE System status alarm Auto mode Contact service FAIL will shut off PULSE System status alarm Check patient and cuff placement TOO WEAK try another measurement SYSTEM System status alarm Check connections between cuff LEAK and monitor try another measurement Check for worn connector O rings Contact service f problem persists contact service Any two consecutive NBP status messages will shut Auto mode off if it is running A message will clear when the next measurement is initiated or a message can be cleared manually with the CLEAR NBP READING option in the NBP menu An NBP status message will also be included in
194. the gel or adhesive causing discomfort Stabilize the electrode and leadwire with a leadwire stress loop near the electrode Tape the stress loop to the patient A secured stress loop prevents leadwire rotation about the electrode snap leadwire tugging at the electrode and ECG artifact Thorough skin preparation is very important to help keep ESU interference to a minimum Do a thorough skin prep to the skin next to the grounding pad as well Place the right leg electrode close to the ESU grounding pad The Multi Link ESU ECG patient cable is recommended when using the monitor in the presence of an electrosurgical unit This cable with a built in ESU filter helps reduce electrosurgical noise detected on the ECG signal Dash 2000 Patient Monitor Revision B 227 499 06 US E ECG ECG Monitoring Features ECG Monitoring Features ECG Display Revision B An ECG waveform is always displayed at the top of the display Depending on the defaults more may be displayed Displayed also is an ECG parameter window Y our software package and parameter settings determine the information displayed in the window Heart Rate Alarm Limits QRS Indicator Heart Rate Pace Detector Indicators ECG Parameter Window The parameter window displays the current heart rate pacemaker indicators and the heart rate limit Also displayed are a QRS indicator flashing heart and a large flashing asterisk for each detected pacema
195. the waveforms as selected in Graph Setup when the GRAPH GO STOP key is pressed It prints 20 seconds of waveforms per pagein a cascade format when the graph speed is set for 25 millimeters per second There will be a delay of approximately one minute until the first page is printed then it will run until all patient data is printed NOTE The one minute delay does not mean the data printed is delayed It just takes that long for the information to be processed by the laser printer The amount of data printed will increase and the delay will be longer if a speed slower than 25 mns is chosen When you choose the laser printer as the alarm graph location it will provide 20 seconds of waveforms per page in a cascade format but again there will be a delay of one minute until the first page is printed Dash 2000 Patient Monitor Revision B 227 499 06 US E Operation General Revision B THE BASICS Operation Below isan illustration of the front of the monitor with a waveform display The parts of the monitor and display which are involved in the operation of the monitor are labeled Each of these is described in more detail on the following pages Power Parameter Windows Graph Go Stop NBP Go Stop Function Zero Trim Knob Control marquette Silence Alarm Operating the Dash 2000 Patient Monitor Dash 2000 Patient Monitor 1 7 227 499 06 US E Trim Knob Control THE BASICS Operation T
196. to display the Alarm Control M enu ALARM CONTROL Menu e ALLLIMITS view a screen of all currently monitored parameters and their alarm limits Included also is the unit of measure for each Alarm limits can also be changed e ALARM GRAPH turn automatic alarm graphing on and off e ALARM VOL adjust the volume of the alarm tone e PARAM ALARM LEVEL view parameter alarm levels Can adjust parameter alarms to other alarm levels e ARRHYTH ALARM LEVEL view arrhythmia alarm levels Can adjust arrhythmia alarms to other alarm levels Dash 2000 Patient Monitor Revision B 227 499 06 US E ALARM CONTROL Alarm Control Menu All Limits TheALL LIMITS menu option allows you to view the high and low alarm limits and unit of measurement for each parameter currently monitored You can change the limits for any monitored parameter without having to go into each individual parameter menu Viewing an All Limits 1 Select ALL LIMITS option from the Alarm Control Menu Screen 2 Aninformation window is displayed on the screen and a popup menu is displayed in the menu area 21 NOV 1998 16 27 DAK BED 1 RR APNEA NBP S NBP D NBP M ALL LIMITS Popup Menu and Information Window The information window shows a list of the patient parameters currently monitored the units by which they are measured and the high and low limits currently in effect Revision B Dash 2000 Patient Monitor 4 7 227 499 06 US E ALARM CONTROL A
197. to move the pointer and then press the Trim Knob control In this example HR is highlighted because that is the default Up to two parameters can be selected Selecting a third will unmark the first selection chosen NOTE NBP or an invasive pressure with a systolic diastolic and mean value is considered one selection For example if you select ART S the other two parameters ART D and ART M will also highlight However the trends for these parameters will appear in only one trend window If you only want to plot one of the three pressure parameters simply unmark those you don t want 3 When the parameters you want to plot as trends are highlighted move the pointer to RETURN and press the Trim K nob control The popup menu doses and the information window reconfigures to display the trends 6 6 Dash 2000 Patient Monitor Revision B 227 499 06 US E View Older View Newer Time Period Revision B PATIENT DATA Patient Data Menu Use these options to move backward and forward in time These options do not function when viewing in the 6 minutetime period Usethis option to open a popup menu to select a time period for viewing the displayed trends 24 HRS 60 MINS 12 HRS 30 MINS 6 HRS gt 15 MINS 3 HRS 6 MINS 90 MINS t TIME PERIOD Popup Menu Displayed trends will automatically update The frequency of the update is based on the time period selected 6 MINS updates every 10 seconds not for NBP 15 30MINS
198. trations in this manual are provided as examples only They may not necessarily reflect your monitoring setup or data displayed on your monitor Dash 2000 Patient Monitor ix 227 499 06 US E Revision History PREFACE Revision History This manual has a revision letter located at the bottom of each page This revision letter changes whenever the manual is updated Revision Date A J uly 1999 B September 1999 Dash 2000 Patient Monitor 227 499 06 US E Comments This document corresponds with the Dash monitor software version 2 UL mark added ECO 063 296 Revision B How To Reach Us Service Calls and Product Support Ordering Supplies and Service Parts Revision B PREFACE How To Reach Us To open a service call or obtain product support call the numbers below Service calls All products 800 558 7044 U S amp Canada 561 575 5000 outsideU S Product support Monitors 800 558 7044 U S amp Canada 561 575 5000 outsideU S Cardiology 800 558 5120 U S 414 355 5000 outside U S or contact your local sales and service representative Name Telephone For other product information please contact one of the offices listed on the next page Order supplies leadwires electrode paste thermal paper etc or service parts manuals circuit boards cables software etc from Supplies GE Marquette Supplies 2607 North Grandview Blvd Mail Code SN 471 Waukesha WI 53188 Telephon
199. ual alarm violation if any unit name bed number and patient name date and time patient monitor type label ICU has no label alarm volume level 96 graph speed lead failed if any heart rate arrhythmia call if any and arrhythmia is on pace mode if on arrhythmia mode off or lethal ECG filter Hz range values for all other monitored parameters Dash 2000 Patient Monitor Revision B 227 499 06 US E THE BASICS Putting the Monitor Into Operation Putting the Monitor Into Operation Monitor Installation and Connection Revision B WARNING Before using the monitor for the first time please read the information given in chapter 2 Safety The operating position does not influence the performance of the monitor in any way Choose a location which affords an unobstructed view of the monitor Screen and easy access to the operating controls Set up the device in a location which affords sufficient ventilation The ventilation openings of the device must not be obstructed by external equipment walls or blankets for instance The ambient conditions specified in the Technical Specifications chapter must be ensured at all times The Dash 2000 monitor is designed to comply with the requirements of IEC 60601 EN 60601 Using the power cord supplied with the monitor connect it to the power line the illustration on page 1 3 shows the power input Use only the original cord or an equivalent o
200. ugh the list Press the Trim K nob control when the pointer is in front of the parameter for which you want to change limits The parameter label highlights 4 TurntheTrim Knob control to highlight the low or high limit Press the Trim K nob control again and rotate to change value Press the Trim Knob control to complete the change 6 Rotatethe Trim K nob control to highlight the parameter label and press to unhighlight 7 Select RETURN when all changes are completed The popup menu and information window close Revision B Dash 2000 Patient Monitor 9 9 227 499 06 US E Change Name Zero 9 10 PRESSURES Pressure Menu Options This option allows you to change the designated name for the pressure connector Remember the monitor has preset the name for the pressure connector Refer to this chapter Assigned BP Names Having the name properly reflect the site is important for proper processing of the waveform since different algorithms are used for different pressure sites NOTE Thepressure site name cannot be set in Monitor Defaults however upon discharge the pressure site name will remain as last selected Follow this procedure to change a name 1 Select CHANGE NAME option from the pressure menu A popup menu opens showing all choices The name presently assigned is designated with the pointer 2 CHANGE NAME ART CHANGE NAME Popup Menu 2 Rotatethe Trim K nob control to placethe pointer in front
201. up Menu Timed Graph The duration at which a manual graph is printed is controlled with this menu option 1 Select the GRAPH TIME SPEED option from the Graph Setup Menu A menu with the two options SPEED and TIMED GRAPH appears 2 Select the TIMED GRAPH option A popup menu opens displaying all MAIN SPEED MEP 10 SEC MENU 25 20 SEC 30 SEC choices 60 SEC PREV TIMED GRAPH Popup Menu 3 Rotate the Trim Knob control so the pointer is in front of your choice Press the Trim K nob control to confirm the change and close the popup menu Revision B Dash 2000 Patient Monitor 5 21 227 499 06 US E MONITOR SETUP Monitor Setup Menu Parameters On Off This menu option allows you to turn off and on specific parameters Turning a parameter off will remove the waveform as well as the parameter windows Alarms for that parameter are off and data is not collected in vital signs 1 Select PARAM ON OFF option from the Monitor Setup Menu A popup menu opens and an information window is displayed listing all parameters that have cables connected 21 NOV 1998 16 27 DAK BED 1 AVAILABLE PARAMETERS RETURN ECG NBP ART PARAM ON OFF Popup Menu and Information Window The first column in the information window shows the parameter name and the second column shows whether this parameter is on or off 2 Rotate the Trim Knob control to move the pointer to the desired parameter 3 Press the Trim Knob control If t
202. updates every minute 60 MINS 90 MINS 3HRS updates every minute 6HR updates every 2 minutes 12 HRS updates every 4 minutes 24 HRS updates every 8 minutes Dash 2000 Patient Monitor 6 7 227 499 06 US E For your notes 6 8 PATIENT DATA Patient Data Menu Dash 2000 Patient Monitor 227 499 06 US E Revision B MAINTENANCE Biocompatlbility z 32 enr tcn e ett ho eit n o e E Un Pf a e InspecklOn a coti t E edit an A eS rhone General Cleaning na Cleaning Applied Parts Cables and Leadwires A Technical Maintenance Technical Inspechons nara naro narran cnn cnn Changing Graph Paper cncccncccnoconocononanonanonanancnancnnnc non ccon cnn n enne Built in Writer asii hte etes Thermal Paper Storage sse Revision B Dash 2000 Patient Monitor 227 499 06 US E 7 1 Biocompatibility MAINTENANCE Biocompatibility When used as intended the parts of the product described in this operator 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 in this matter please contact GE Marquette Medical Systems or its representatives Dash 2000 Patient Monitor Revision B 227 499 06 US E Inspection Revision B MAINTENANCE Inspection An effective maintenance schedule should be established for your monitoring equipment and reusable supplies This should include insp
203. ver possible waveforms will align with their parameter window You can override waveform alignment with the WAVEFORMS ON OFF option The RECALL DEFAULT option is a direct action menu option used to recall the monitor defaults while monitoring an admitted patient In some cases you may have to temporarily override a default For example it may be necessary to set different alarm limits for the needs of a specific patient The alarm limits you set are in effect until you change them again or discharge the patient If you have made changes while monitoring a patient and then want to recall the monitor defaults WI THOUT discharging the patient use the RECALL DEFAULT option NOTE If you are actually changing Monitor Defaults this option will not recall any prior defaults If you made changes to defaults that you didn t want to make you will have to change them manually Refer to your Defaults Worksheet at the front of this manual or refer to the Appendix Factory Defaults to see the factory defaults Dash 2000 Patient Monitor Revision B 227 499 06 US E MONITOR SETUP Monitor Setup Menu Display Setup Menu The Display Setup Menu contains a subset of options to customize display settings MAIN WAVEFORM MENU ON OFF 051A DISPLAY SETUP MENU monochrome version NOTE TheTIME AND DATE option is displayed only if no network is available Revision B Dash 2000 Patient Monitor 5 11 227 499 06 US E MONITOR SETUP Monitor
204. volume tone is slightly quieter than the 10 and 20 volume tone in Adult ICU and Neonatal I CU modes A pulse rate is derived from the SPO2 signal and is displayed in the parameter window You can turn this displayed rate off and on Simply select the RATE option from the SPO2 Menu This is a direct action menu option Dash 2000 Patient Monitor Revision B 227 499 06 US E SPO2 Probe Off Patient Condition Probe Off Patient Condition Revision B When using a reusable finger probe there is a system alarm to alert you when the probe is off the patient The monitor defaults this probe off patient condition as a System Warning alarm You can however set it as a System Advisory alarm in Monitor Defaults Refer to Setup Default Display section in Chapter 5 Monitor Setup It is identified as SPO2 PROBE OFF in the Setup Default Display information window Dash 2000 Patient Monitor 11 13 227 499 06 US E Troubleshooting SPO2 Messages 11 14 SPO2 Troubleshooting Below is a list of system status alarm messages which may be displayed in the SPO2 parameter window during monitoring SPO2 messages will appear in abbreviated form in graph headers If you are unable to resume SPO2 monitoring call GE Marquette service at 1 800 558 7044 US only Outside the U nited States please contact your sales service office INCOMPATIBLE PROBE TYPE Thetype of probe connected is not compatible with this software Replace the probe wit
205. ximum Common mode rejection Linearity deviation Noise L eads off sensing Pacemaker detection rejection Input voltage range Input pulse width Rise time Over under shoot Baseline drift Timeto alarm for tachycardia for cardiac standstill Response to irregular rhythm Dash 2000 Patient Monitor 227 499 06 US E Revision B 30 5 mV to 35 mV amplitude 0 5 to 5 mV with size 2x or 4x below 1 mV and with QRS time duration Adult ICU 70 to 120 ms Neonatal ICU 40 to 80 ms 40 ms to 120 ms Q to S 30 to 300 BPM accuracy 1 BPM 12 s 2 s HR averaging 2s gt 10 MOhms at 50 60 Hz 22 5 MOhms from dc to 60 Hz 1 2 mV max 0 05 to 120 Hz 0 05 to 40 Hz 0 05 to 25 Hz 5to25Hz 0 05 to 120 Hz 0 05 to 40 Hz 0 05 to 25 Hz 5to25 Hz 90 dB minimum at 50 Hz or 60 Hz 3 lt 30 uV RTI referred to input For each electrode 1 25 V 62 M Ohms referred to RL 2 mV to 700 mV 0 1 toto 2 ms 10 ms to 100 us 2 mV max with Diagnostic or Monitor filter setting and size 1x or 0 5x 0 5 mV hour with a 700 mV 2 ms pacemaker pulse applied 12s Ys 7S 15 acoustic alarm EK PRO used for optimized results with learning function 14 25 Respiration Temperature TEMP Invasive Blood Pressure BP 14 26 APPENDICES Technical Specifications Measurement technique Range Respiration rate Base impedance Detection sensitivity Waveform display bandwidth Alarms Number of cha
206. y 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 120V the source must be a center tapped 240V single phase circuit RESTRICTED SALE U S federal law restricts this device to sale by or on the order of a physician SUPERVISED USE This equipment is intended for use under the direct supervision of a licensed health care practitioner 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 Dash 2000 Patient Monitor 227 499 06 US E 2 9 Notes Reference Literature 2 10 SAFETY For Your Safety e Putthe monitor in a location where you can easily see the screen and access the operating controls 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 Medical Device Directive 93 42 EEC EN 60601 1 1990 A1 1993 A2 1995 Medical electrical equipment General requirements for safety EN 60601
207. yed information U se the CHANGE ADMIT INFO option if any information needs to be corrected or additional information entered NOTE If you change any information which was supplied automatically you may have to notify the appropriate hospital personnel This option is displayed only if your monitoring system includes a Lab Access Server with an interface to hospital information Selecting this option will save patient information entered at bedside WEIGHT and HEIGHT these options change the units of measure for weight and height AGE this option only appears when the monitor is set for Neonatal I CU mode Select it to switch age between weeks days or years Dash 2000 Patient Monitor 3 11 227 499 06 US E ADMIT DISCHARGE Admit Menu Options Admit Patient Depending on how your monitor is set up you will see either ADMIT PATIENT or NEW CASE Admit Patient This menu option is a direct action menu option which admits the patient to the monitor Simply select the key to admit the patient New Case This menu option is found only when the monitor is set for Operating Room mode and Standard or Rover admit menu Itis a direct action menu option which when selected does both a discharge and immediate admit All patient data from the previous patient is erased the screen blanks for a few seconds and then the monitor is ready for the next patient 3 12 Dash 2000 Patient Monitor Revision B 227 499 06 US E ADMIT DISCHAR
208. yed with a list of writers available on your network 21 NOV 1998 16 27 DAK BED 1 a rn MANUAL GRAPH LOCATION WRITER WRITER WRITER WRITER WRITER MANUAL PRINT GRAPH WINDOW LOCATION LOCATION ICU1 ICU1 CS1 CS1 WRITER WRITER 059 MANUAL GRAPH LOCATION Popup Menu and Information Window 2 Rotate the Trim Knob control so the pointer is in front of the writer you want your manual graphs to goto Thechange will not bein effect until theTrim Knob control is pressed and the popup menu closed 3 Press the Trim Knob control to confirm the change and close the popup menu The menu option displays the name of the writer where the graph strip will print NOTE Graph locations cannot be set as Monitor Defaults however upon discharge the graph location designations will remain as last selected If the selected writer printer is removed from use this menu option will continue to show that removed device even though it is no longer available You will have to change it to another available device The SAVING message is displayed when attempting to graph to an unavailable device The first column in the list shows the unit where the writer is located The second column shows the bed number or central station number to which the writer is attached The third column shows the type of writer WRITER means it is a Direct Digital Writer LASER means it is a laser printer Dash 2000 Patient Monitor 5 19 227 499 06

GE Dash 2000 - User manual

Contents

Download Pdf Manuals

Related Search

Related Contents