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User Manual - Mennen Medical

1. Table 1 Par Subject Description Specifications Measured Result value Pass Fail 2 3 Connect AC line AC led in Green O K Charger Led is Green Blinking Permanent OK 2 4 Main Battery 3 Years Passed Done Yes Replace Battery 2 5 Fan on CPU Board 3 Years Passed Done Yes Replace Fan Working low noise and air O K direction to out 2 6 CPU Battery 3 Years Passed Done Yes Replace Battery 2 7 Fan on the chassis 4 Years Passed Done Yes Replace Fan Working low noise and air O K direction to out 2 8 Leakage As per standard pass Add Report 2 9 Mounting Check the Mounting O K 3 Trim Knob Leds Esc Switch Touch Screen Configuration 3 1 3 Years passed Replace switch Done Trim Knob test Move the Knob and see O K functions on screen 3 2 Esc key test Chose ecg and esc to O K main screen 3 3 NIBP key test Active NIBP press NIBP O K Verify that the pump start 3 4 Silence key test Press and verify label on O K the screen 3 5 Print key test Press and verify that O K screen Is flashing 3 6 Touch Screen Press on the touch screen O K option and verify function 3 7 Set configuration Record the configuration Saved to the Laptop 4 Software Version 4 1 Main Unit Software Software Version V F 2 Mennen Medical 7 Operating Manual
2. CO CCO SvO2 Table 1 PiCCO Parameters Code Description Units UDC list PVPI Pulmonary Vas No unit PiCCO cular Permeabil ity Index SVV Stroke Volume PiCCO Variation ART Arterial Pressure mmHG Vital Signs SpO2 Oxygen Satura 96 Vital Signs tion Pulse ScvO2 Central Venous 96 Vital Signs Oxygen Satura tion Cardiac Output l min Vital Signs Thermal dilution Cardiac Index l min m2 Hemodynamics SV Stroke Volume CC Hemodynamics SVI Stroke Volume cc m2 Hemodynamics Index SVR Systemic Vascu dyn s cm 5 Hemodynamics lar Resistance SVRI Systemic Vascu dyn s cm 5 m2 Hemodynamics lar Resistance Index vo2 Oxygen Con ml min Oxygenation sumption 21 ml min m2 Oxygenation sumption Index 28 12 Mennen Medica 29 RADICAL 7 MASIMO CO OXIMETER Overview Radical 7 is an Optical device with sensor similar to SpO2 sensor that measures e Oxygen Saturation SpO2 PVI PI e Methemoglobin Saturation SpMet e Carboxyhemoglobin Saturation SpCO e Total Hemoglobin SpHb and e Oxygen Content SpOC Note Refer to Chapter 22 Pulse Oximetry SpO2 to learn about the operation and use of SpO2 measurement This chapter describes the difference between the standard SpO2 measurement and the SpO2 measurement using Radical 7 In addition to the standard SpO2 measurement the Radical
3. Table 1 Par Subject Description Specifications Measured Result val Pass Fail 4 2 CIPAM FE FLASH Software Version V S W 4 3 BEP FLASH S W Software Version V 4 4 SPO2 S W Ver Software Version V sion 4 5 NIBP S W Version Software Version V 4 6 EtCO2 S W Ver Software Version V sion 4 7 BIOS S W Version Software Version V Mennen Default 4 8 SPB S W Version Software Version V 5 9 Wireless Version Software Version V 6 ECG Test Simulator DNI217A or similar 6 1 Without ECG cable Out message cable on the screen 6 3 Connect 5 12 Fault ALL message O K leads cable with out leads wires Verify 5 12 Lead detection O K at ECG WF panel 6 4 Insert 5 12 leads Verify that fault message O K cable disappear Connect all leads wires to the simu Heart Rate 120BPM 120 2bpm lator 120BPM 6 5 Alarm Test Speaker and keys test 6 5 1 QRS Tone test Set the volume 6 5 2 Alarm Tone test Set the volume and ecg out of the limit 6 5 3 Silence key test Press Silence key press Silence the red label remained again after test for next step 6 5 4 Alarm LED test Upper red led should blink RED Set alarm to C1 and make alarm Mennen Medical F 3 7 Operating Manual Table 1 Par Subject Description Specifications Measured Result value
4. 150 COMM ERROR T 10 21 99 12 02 ISMITH ADAM a up Nm 999007 1 2 1 spoz CO2 ES Local bed s 70 Ea ob ors 60 ST Il 0 0 Pd 0 0 gt TEMP CABLE OUT EN 10 21 99 12 02 KAYLOR RONALD ruei ar c rme2 c r2 11 e 150 r ere G hm ECG II 50 v Y Y Y v j ECG VI Remote bed 114 76 88 UN L 35 mmHg 29 9 13 35 5 PULSE S p Min Signal Max pp s 90 _2 Local bed s mies Discharge Quick Admit System Eee Cardiac Data QuicKeys Patient Keys Keys Setup Output Review Figure 7 8 Remote View Display The local bed s ECG and measured values are minimized and appear at the top part of the screen The remote bed s parameters and waveforms appear in the middle of the screen At the bottom appear the local bed s QuicKeys Remote View allows you to temporarily set all alarms to off at the remote bed When exiting Remote View the remote bed alarm setting will automatically revert to the monitor s original selection The local view display includes e Patient global header contains the local bed s device name patient name alarm message area and date time e Waveforms and measured values displays the top displayed ECG lead and measured values
5. Item and Description Part Number P N BP Accessories BP Adapter Cable Single 551 306 011 BP Transducer Kit Model MX860 800 060 580 Pressure Transducer MX860 800 060 582 Pressure Transducer Cable for MX860 800 060 584 Disposable dome for MX860 5 domes pak 800 060 586 Mounting Clamp vertical for MX860 800 060 588 Plate for mounting MX860 800 060 589 Disposable monitoring kit for MX860 10 kits pak 800 060 670 Disposable Transducer MX 950 5 pack 800 060 596 Pressure Transducer Cable for MX 950 800 060 595 TRANSPAC IV Abbott Critical Care Systems Art Line Biometrix Table 3 Cardiac Output Accessories Item and Description Part Number P N Cardiac Output Accessories Close Injected C O Cable Kit 551 306 110 C O Adapter cable CO Set Type 551 306 013 Injected Temperature Probe CO Set Type 800 030 450 Iced Bath C O Cable Kit 551 306 120 C O Adapter Cable Ice Bath Type 551 306 014 Injected Temperature Probe Ice Bath Type 800 060 050 Mennen Medical A 3 Menntor 7 Operating Manual Table 4 Non Invasive BP Accessories Reusable NIBP Accessory Kits Item and Description Part Number P N Non Invasive BP Accessories Reusable NIBP Accessory Kits NIBP Accessory Kit Adult 551 306 370 NIBP Accessory Kit Pediatric 551 306 371 NIBP Accessory Kit Infant 551 306
6. 7 Operating Manual Under Suspension Time you can select the period of time that Alarms Off is in effect when the Alarms Off button is pressed The available options are 30 60 90 and 120 seconds Alarms Off can be configured to be permanent where allowed by law When the Enable Alarms Off checkbox is selected the option Permanent is added to the available options under Suspension Time The factory default suspension time is 60 seconds Silence Time When pressed the Silence key terminates any audio alarms active at that moment for predefined period which you can set under Silence Time The available options are 30 60 90 and 120 seconds The factory default is 30 seconds SpO2 Alarm Tone Defines whether SpO2 alarms are indicated with the same standard tone as other alarms of the same priority or whether they are indicated with a tone unique to SpO2 The available options are Standard or Unique Priority Level Defines the alarm priority level for which you wish to define alarm volume parameters The available priority levels are C1 C2 C3 C4 Low HR High HR T1 T2 and SpO2 When you select an alarm priority level the following fields are enabled File Name Defines the WAV file sound file which supplies the alarm tone for the selected alarm priority The available options are CI WAV C2 WAV C3 WAV T1 WAV T2 WAV and SpO2 WAV Each file corresponds to the default alarm priority of tha
7. Function Page Condition A D T Admission Dis 9 1 charge Transfer Alarm Volume 8 7 Display Controls 7 2 CRG 7 6 Select Monitor Profile 9 20 System Setup Software Version 3 18 Remote View 10 23 HemoCis View 9 16 Option Alarm Watch Setup 7 13 System Setup Shutdown 6 1 System Setup D 1 Appendix D Service Manual 6 18 Mennen Medica SECTION 2 PATIENT MONITORING PROCEDURES This section contains the following chapters 1 Chapter 7 Setting Up the Patient Display 2 Chapter 8 Alarms 3 Chapter 9 Connecting a Patient to Menntor X7 4 Chapter 10 Reviewing Patient Data 5 Chapter 11 Performing Clinical Calculations 6 Chapter 12 Performing Medication Calculations 7 Chapter 13 Recording Vital Sign Data 7 Operating Manual Mennen Medica 7 SETTING UP THE PATIENT DISPLAY Admission Keys Before you connect a patient to the Menntor X7 bedside monitor the main screen display is in idle mode and all that appears on the monitor screen is the Admit as Previous key and some additional Monitor Profile Admission keys Each Monitor Profile key contains the following information e Key name e List of parameters to be monitored e Settings for each of the parameters alarm limits colors etc e Screen format and the location of the monitored parameters on the main screen display The various Monitor Profile Admission keys enable you to quickly connect a pati
8. 15 ARRHYTHMIA Introduction QRS detection and classification uses a proprietary algorithm that recognizes the QRS and eliminates the sensing of P or T waves The algorithm marks the beat as Normal Ventricular or doubtful The Arrhythmia diagnosis is based on the beat classification and the beat to beat intervals Arrhythmia alarms are detected by the ECG algorithm Three levels of Arrhythmia can be monitored according to the configuration of your system None The Arrhythmia option does not appear on the ECG menu Basic Only the basic Arrhythmia types appear on the Arrhythmia Alarms panel Extended All Arrhythmia types appear on the Arrhythmia Alarms panel The following Arrhythmia types are monitored in the Basic Arrhythmia set Mennen Medical Asystole This alarm is activated when no QRS complex is detected within five seconds When an Asystole alarm is detected it overrides any existing Pause alarm VFib Ventricular Fibrillation Ventricular fibrillation is characterized by chaotic uncoordinated ventricular depolarization The alarm is activated when a pseudo sinusiodal shape waveform with a frequency of 2 10 Hz is present for at least four consecutive seconds 15 1 Arrhythmia Menntor 7 Operating Manual e V Tach Ventricular Tachycardia Ventricular tachycardia is characterized by sequence of consecutive ventricular beats with coupling interval of less than 600 ms You can defi
9. Auto 390 1800 300 800 300 E 1 2 comP 120 138 40 40 FiO2 60 60 21 Fraction of tH to Negative mi Plato Compliance Inspiratory O2 Expiratory Inspiratory Resistance Pressure Pressure pressure Activating and Deactivating Ventilator Monitoring Ventilator monitoring can be activated and deactivated in this panel Monitoring can also be discontinued for whatever reason and resumed later To activate and deactivate Ventilator monitoring 1 From the Ventilator menu select Activate The Ventilator Activate panel is displayed 2 Select the Activate checkbox to initiate Ventilator monitoring 3 Press Main Screen to return to the main screen display 26 10 Mennen Medica Menntor 7 Operating Manual QC TKI 4 25 Main ASHER SASON AB Screen VENTIII 2 Activate IT Activate Deactivate Vent Puritan Bennet 7200 Figure 26 6 Parameter Activation Panel Alarm Messages The following technical ventilator alarm messages may appear on the Menntor X7 Screen Technical Alarm Messages Safety Valve Open Disconnect O2 Inlet Air Inlet Low Battery Valve Leak Inoperable Gas Supply Error Communication Error Mennen Medical 26 11 Menntor 7 Operating Manual 26 12 Mennen Medica 27 BIS BISPECTRAL INDEX The Menntor X7 monitor BIS input is an interfa
10. 06 24 36 06 24 42 06 24 48 2 1 0 D Ll D D 1 T 04 15 05 15 06 15 07 15 Admission During Activity 50 EEG RIGHT 50 pV I l 06 24 36 06 24 42 06 24 48 e Figure 30 14 Dual channel aEEG playback gt To open the aEEG History Panel 1 Open the EEG menu 2 Click aEEG History The History panel is displayed 30 16 Mennen Medica Menntor 7 Operating Manual Gain us 06 30 Admission During Activity BAG LENT MW plea A Vie in NN 50 d 07 14 48 07 14 54 Range aEEG Scroll Scroll Roll cursor sen SG Go to posa eet WSS gt gt lt lt gt gt lt lt Cursor slow Event Available data time span 03 04 18 00 04 04 07 15 Figure 30 15 Single channel aEEG playback The following controls are available in the aEEG History Panel see Figure 30 15 aEKG Scroll Scrolls the aEEG in steps of one 1 hour EEG Scroll Scrolls the EEG waveform to the left or to the right in steps of 8 Seconds EEG roll rolls the EEG waveform to the left or to the right in steps of 8 seconds Cursor Slow Fasttoggle Slow movesthecursorin steps of 12 seconds Fast moves the cursor in steps 2 minutes Cursor This enables moving the cursor Activate this key and rotate the Quicknob to move the cursor The raw EE
11. if you are already in another Respiration dialog panel from the drop down menu list below the Respiration title area select Lead Gain Select either RA LL or RA LA as required Only one option can be selected Set the slider bar on the scale to the required gain The available options are Automatic 1 8 1 4 1 2 1 2 4 or 8 Automatic Gain Control AGC sets the range of the displayed waveform AGC response time is 10 seconds for adults and 5 seconds for pediatric or neonatal patients If the respiration waveform shows cardiac pulses click Cardiac to toggle between activating algorithm and eliminating detection of cardiac pulses Press RSP to return to the RSP menu Press Main Screen to return to the main screen display Setting Respiration Alarms Respiration alarm parameters are set in two dialog panels Alarm Limits and Alarm Response Each dialog panel controls a different aspect of Resp alarms Setting Resp Alarm Limits The Alarm Limits dialog panel enables you to set respiration alarm limits and criteria Two types of alarms are monitored 17 4 Respiration Rate Respiration is monitored by impedence pneumography which monitors respiratory effort as reflected by chest or abdominal wall motion The monitor checks that the respiration rate value is within a specific range between 0 150 BPM Any respiration rate outside of the allowed limits triggers an alarm Apnea Apnea is the absence of detected breathin
12. 24 2 Cleaning nendum E eer den eibide 24 3 Calibration on 42 esse eee 24 3 Anesthetic Gas Module e ERR teater 24 5 Patient Connection eo rere rere eee e Pire rere degere RNET 24 5 Alarmi Messages ce net nee Ad Ud retenta tre FH DR SECRET Te EENE EH ne 24 6 AJNCCeSSOFIGS iode e eee estero edes dades e eso ate ee 24 6 Module Specifications eet ten een sne Arne iode east Ped Eee e Po det eio dena 24 7 vi Mennen Medica Menntor 7 Operating Manual Chapter 25 Anesthetic Gas Monitoring OVetVIe Wash ODORE OUR 25 1 Monitoring Procedures been arnested 25 1 EtC02 Monitoring 2 ite i eta ett penc ee iei Dd e e EU 25 2 O2 N2O and Anesthetic Agent Monitoring Procedures eese 25 0 Activating Monitoring at ege eese 25 16 MAC Minimum Alveolar Concentration esses eene entere nnne nnne 25 17 Chapter 26 Ventilator OVERVIEW atte Ree Hte tere inae ede HO I e et Ge e e ORE HER LEUR 26 1 Ventilator Parametets vr cette ete ree 26 2 Monitoring Procedures t a tee ee anole Shieh wel ea inthe wae 26 2 Ventilator eias ate tide ber naui eae pa ce e rien 26 3 Setting Alarms dna epe ome edidi iei ee tene eed 26 4 Setting Ventilator Display Options 26 7 Activating
13. 7 Operating Manual mm mam ercoo Mz ow 66 rn Abo b L4 T i Lie LT TS LLLI HE p RECA aad eds As rev vi Li Ar El J devi Ten boc avn im gt S v febri l el 1 1970 18 15 za 12 17 se 150 50 9 1 ST 4 6 ST vL 9 0 ST v 4 0 T v5 608 ST il a a g 9 STAVF a0 T 49 57 VI 9 0 I va Pateat fe tweet kven z Frot Seug EI II Figure 14 5 Main Screen Displaying 12 ECG Traces Mennen Medical 14 9 Gain Menntor X7 Operating Manual Gain controls the amplitude of the displayed waveform The gain for each lead can be defined individually or all leads can be set to the same gain The following gain values are available 1 4 1 2 1 2 4 and 8 The default gain value is 1 Note The ECG gain effects only the waveform display and does not influence the ORS sensing QRS sensing is effective for QRS amplitude of at least 0 25 mVolt and up to an amplitude of 5 mVolts If you use gain X 4 with an amplitude of about one cm the QRS sensing will not be reliable CAUTION Show Channels To obtain reliable ECG Heart Rate Counting and QRS identification it is recommended to select the ECG lead with an amplitude of 0 5 mVolt and above The monitor specification allows QRS detection for QRS amplitude in the rang
14. Name Last ANDREJKO Name First JOSEPH Sex Female a OCC 5411 HID Patients In Clinibase Patients In Transfer Date of Birth 09 Jun 1933 Doctor Figure 9 15 Patient Occuence ID gt To transfer Menntor X7 clinical data to HemoCis 1 When you discharge a patient from a monitored bed in Cath Lab suite enter the ADT menu 2 Select Save amp Discharge this will send transfer the clinical data from the Menntor X7 to the HemoCis and also store the patient information in the Menntor X7 under a Ready for Transfer file See Figure 9 4 3 If you select the Discharge panel you have the option of either discharge without any storage or Save amp Discharge as above Note The Full Disclosure data will be deleted and only Charts Trends and Event strips are Sent to HemoCis and stored for transfer Note To send transfer Patient Data the patient must be admitted from Clinicase and the ADT panel must include the Occurance ID received during patient admission from the HemoCis 4 If the patient was not admitted from the HemoCis selecting Save amp Discharge opens a modified Save amp Discharge panel Selection of the Discharge panel opens a modified Discharge panel 9 18 Mennen Medica Menntor 7 Operating Manual Mennen Medical lt none gt en370072 Save amp Discharge PLEASE ADMIT PATIENT FROM CLINIBASE Figure 9 16 Save and Discharge 9 19 Connec
15. Figure 18 6 The PCWP Dialog Panel Mennen Medical 18 13 Invasive Blood Pressures Menntor 7 Operating Manual gt measure the Pulmonary Capillary Wedge Pressure 15 Insert Swan Ganz catheter into central and properly situate the distal end of the catheter in the pulmonary artery Do not inflate the balloon From the BP menu or From the drop down menu list below the BP title area in the BP panel select PAP to open the PAP menu select PCWP from and then select Start Procedure The PCWP dialog panel opens and the following message appears in the upper left corner Inflate balloon To automatically scale the PAP waveform press Autoscale To simultaneously change the sweep speed of the PAP and RSP waveforms press Sweep Speed and select a different speed from the drop down list Available options are 6 25 12 5 25 and 50 mm sec The default sweep speed is the same as the current ECG sweep speed Inflate the balloon and wait until the following message appears in the upper left corner of the PCWP dialog panel Catheter Wedged The Menntor X7 automatically calculates the PCWP value and displays it on PCWP dialog panel Press Accept to accept the PCWP value or Press Adjust The PAP waveform is frozen and a red cursor marks the location of the PCWP value Use the QuicKnob to move the red cursor up or down When satisfied press Accept The PCWP dialog panel clo
16. Masimo Technology Use only disposable transducers for neonatal SpO2 monitoring LNCS Neonatal Disposable Probe 10 Kg Recommended monitoring site For infants less than 3 kg Across the foot or alternatively across the palm amp back of hand For infants greater than 3 kg the thumb or the great toe LNCS Neonatal Patient Disposable Probe 1Kg Recommended monitoring site Across the foot or alternatively across the palm and back of hand 1 Remove liner from adhesive side 2 Locate center line a and windows b 3 Position center line on edge of foot hand or toe and position first window on sole of foot 4 Wrap around foot so that windows oppose each other 5 Wrap excess tape loosely around foot 6 Plug into adapter cable 7 Check site every 8 hours Mennen Medical 22 15 Pulse Oximetry SpO2 Menntor X79 Operating Manual Appendix SpO2 Sensors Sensors for SpO2 Masimo technology LNCS DCI Adult Reusable Probe LNCS Adult Disposable Probe 30 Kg LNCS Pediatric Disposable Probe gt 10 50 Kg LNCS Neonatal Disposable Probe 10 Kg LNCS Neonatal Pt Disposable Probe lt IKg Sensors for SpO2 Nellcor technology SpO2 OxiMax Adapter Cable SpO2 OxiMax Reusable Adult Finger Sensor Multi Site OxiMax Dura Y Sensor D YS Ear Clip for OxiMax Dura Y Sensor D YSE Disposable OxiMax Neonatal Foot N 25 24 Case Disposable OxiMax Infant Great Toe 1 20 24 Case Disposable OxiMax
17. lt gt en370072 Main ANDREJKO JOSEPH Screen Main Alarm Volume Display Controls Select Monitor Profile Software Version Remote View Alarm Watch Setup Figure 9 14 HemoCis View 2 If you defined a QuicKey for HemoCis View use the QuicKey to toggle between show and hide 3 If the monitor is in either Discontinue or Discharge the QuicKey is not available and you can only show or hide the HemoCis window via the HemoCis View key in the Setup menu Transfer to HemoCis To transfer patient clinical data to the HemoCis the Menntor X7 has to be defined in System Setup as Cathlab Suite monitor gt To define Menntor X7 monitor as Cathlab Suite monitor 1 Use password to enter System Setup gt gt Network Setup 2 Inthe HemoCis Information area activate Cath Lab Suite monitor Green If the Menntor X7 was defined as Cathlab Suite monitor the function of Save amp Discharge will change to Send Save and Discharge The Menntor X7 will send its clinical patient file to the HemoCis under the patient s Occurance ID provided by the HemoCis when the patient is admitted from the HemoCis Mennen Medical 9 17 Connecting Patient to Menntor X7 Menntor 7 Operating Manual lt none gt en370072 vel Discard Main A D T Patient Identification ANDREJKOJOSEPH F Se Caa Bed Name en370072 Height 180 3 CM Weight 1248 Kg Patient ID BSA M 241
18. 27 24 Use lint free absorbent towels dampened with a 10 bleach solution or a commercial disinfectant e g Lysol Professional Disinfectant Foam Cleaner Spray or PDI Germicidal Disposable Wipes After cleaning dry all areas except the monitor display screen see below with a lint free absorbent paper towel Wipe the BISx and PIC connector ends with alcohol and allow to dry completely WARNING WHENEVER AN EVENT SUCH AS SPILLAGE OF BLOOD OR SOLUTIONS OCCURS RE TEST GROUND LEAKAGE CURRENT BEFORE FURTHER USE DO NOT MIX DISINFECTING SOLUTIONS e g BLEACH AND AMMONIA AS HAZARDOUS GASES MAY RESULT CAUTION Do not autoclave the BISx or Monitor Autoclaving will seriously damage both components CAUTION Avoid liquid ingress to the Patient Interface Cable Contact of fluids with the PIC sensor connectors can interfere with PIC performance Mennen Medical Menntor 7 Operating Manual Maintenance No periodic adjustment or calibration is required for the BISx and BIS Suggested routine maintenance includes periodic checking of cable integrity system checkout CAUTION Service or repairs must be performed only by qualified biomedical technicians Checking Cable Integrity The BIS should be inspected periodically to ensure that all cables are in working order with no cuts in electrical insulation Cables can be flexed during the system checkout to ensure there are no loose wires Service Field repair or cust
19. 4 From CO Color list select the color required for CO parameters You have a choice of 16 colors SvO2 Monitoring Procedures The SvO2 menu provides access to specific dialog panels enabling interaction with all aspects of SvO2 monitoring Each dialog panel enables SvO2 control of different aspects of SvO2 monitoring The available dialog panels are Alarm Limits Use this panel to activate deactivate SvO2 alarms define SvO2 alarm limits See Setting SvO2 Alarm Limits e Alarm Response Use this panel to define the way alarms are heard and displayed on the monitor See Setting SvO2 Alarm Response e Display Options Use this panel to define how SvO2 values appear on the main screen display See Setting SvO2 Display Options e Activate Use this panel to activate deactivate SvO2 monitoring See Activating and Deactivating SvO2 Monitoring Mennen Medical 28 7 CO CCO SvO2 Menntor X79 Operating Manual Accessing the SvO2 Menu The SvO2 menu can be accessed from the Vital Signs menu or from the main screen display gt Toaccess the SvO2 panel from the Vital Signs menu 1 Press the Vital Signs key on the front panel The Vital Signs menu appears SvO2 currently monitored appear on the Vital Signs menu 2 From the Vital Signs menu select SvO2 The appropriate menu is displayed gt Toaccess the SvO2 panel from the main screen display e Turn the QuicKnob until the SvO2 parameter key is hi
20. Alarm Response Respiration Rate Alarm Tones JE Event Strip Apnea Alarm JE Record Tones F Event Strip Figure 17 3 The Respiration Alarm Response Dialog Panel gt To set respiration alarm responses 1 From the Respiration menu if you are already in another respiration dialog panel from drop down list below the title area select Alarm Response The Alarm Response dialog panel is displayed 2 Under Respiration Rate Alarm e Select the Record checkbox to activate or deactivate recording of the patient s ECG during the alarm event e Select the Tones checkbox to activate or deactivate audible alarms By default Tones is activated e Select the Event Strip checkbox to activate or deactivate Event Strip By default Event Strip is deactivated Mennen Medical 17 7 Respiration Menntor 7 Operating Manual Under Apnea Alarm e Select the Record checkbox to activate or deactivate recording of the patient s ECG during the alarm event e Select the Tones checkbox to activate or deactivate audible alarms By default the checkbox is activated e Select the Event Strip checkbox to activate or deactivate Event Strip By default Event Strip is deactivated Press RSP to return to the RSP menu Press Main Screen to return to the main screen display Note Checkboxes appear green when activated and gray when deactivated Setting Resp Display Options By defining Display
21. Figure 27 7 The BIS Display Options Dialog Panel Mennen Medical 27 15 BIS Bispectral Index Menntor 7 Operating Manual gt 27 16 To set display options 1 From the BIS menu if you are already in another BIS dialog panel from the drop down list below the title area select Display Options The Display Options dialog panel is displayed 2 6 From the Display Area drop down list select the area where you want BIS to be displayed on screen Available options are Waveform Secondary VS area and Big Numbers The default is Waveform From the Sweep Speed drop down list select the required sweep speed Available options are ECG Sweep Speed 6 25 mm sec 12 5 mm sec and 25 mm sec The default is 25 mm sec Under Display Features e Select the SQI EMG SR BC checkboxes to activate or deactivate display of the relevant parameters Select the Alarm limits checkbox to activate or deactivate display of this values on screen Select BIS Colors and select the color required for BIS parameters Default color is orange Press BIS to return to the BIS menu Press Main Screen to return to the main screen display Note Checkboxes appear green when activated and gray when deactivated Mennen Medica Menntor 7 Operating Manual Setting EEG Filter BIS 5 1 Filter Figure 27 8 BIS Filter setting panel gt Toset BIS EEG Filter l From the BIS menu if you are already in anot
22. The ECG Alarm Response panel enables you to define how the Menntor X7 responds to ECG heart rate pacemaker and lead fault alarms The Menntor X7 can be set to emit an audible message record monitored vital signs at the time of the detected alarm or both WIRELES VL6B Main Sereen ECG Alarm Response Heart Rate Alarm Response Wi Tones IE Event Strip ECG Lead Fault Response Tones IT Artifact Tones IT Use as 5 Lead Pacemaker Alarm Response Record Tones Figure 14 8 The ECG Alarm Response Panel 14 14 Mennen Medical Menntor 7 Operating Manual gt To set ECG Alarm Response parameters 1 Mennen Medical From the ECG menu or if you are already in another ECG dialog panel from the drop down menu list below the panel title area select ECG Alarm Response The Alarm Response panel appears Under Heart Rate Alarm Response e Select the Record checkbox to activate or deactivate recording of the patient s condition at the time of the heart rate alarm event e Select the Tones checkbox to activate or deactivate audible alarm indication e Select the Event Strip checkbox to activate or deactivate the Event Strip Under ECG Lead Fault Response e Select the Tones checkbox to activate or deactivate audible alarm indication e Select the Artifact Tones checkbox to activate or deactivate audible alarm indication on artifact that prevents HR counting red backgroun
23. To access the Cardiac Output menu 1 From Main menu select the Vital Signs key The Vital Signs menu is displayed 2 From the Vital Signs menu select Cardiac Output Acquiring Data for Determining Cardiac Output This panel leads the user through the process of performing Cardiac Output injections and acquiring the resulting data Two graphs are displayed in the panel Current which presents data on the current injection and Previous which presents an average of the data on the most recent injections up to six Procedure indicators appear in the space between the two graphs These indicators are e Wait for thermal ready state e Ready begin injecting e Injecting in progress e Done process complete After each injection the procedure indicator returns to Wait in anticipation of the next injection After the sixth injection the message Six valid injections already conducted appears If an error occurs during an injection procedure an error message appears below the procedure indicator The possible error messages are e Baseline Temperature Error This message appears if blood temperature has deviated more than 0 067 C within the two second interval immediately preceding the Ready prompt A typical cause of this error is cardiac pumping which causes the baseline temperature to vary e Curve Error This message appears if blood temperature does not change sufficiently to enable C O to be computed T
24. Use this panel to activate or deactivate respiration monitoring See Activating and Deactivating Respiration Monitoring on page 17 12 All the above panels can be accessed from the Resp menu Accessing the Respiraion RSP Menu There are two ways to access the Resp menu 17 2 From the Vital Signs menu From the main screen display Mennen Medica Menntor 7 Operating Manual gt To access the Resp menu from the Vital Signs menu 1 From Main menu select the Vital Signs key The Vital Signs menu appears 2 From the Vital Signs menu select RSP The RSP menu is displayed gt To access the Resp menu from the main screen display Turn the QuicKnob until the RSP parameter key or value if Resp is displayed as secondary vital sign or as big number is highlighted and press to display the RSP menu Setting Respiration Leads and Gain Select the required lead and gain for monitoring respiration in the Lead Gain dialog panel e Lead Selection select RA LL or RA LA Gain Control select either Automatic Gain Control or 1 8 1 4 1 2 1 2 4 or 8 Lead amp Gain Lead Selection RA LA Sensing Mode Normal v Cardiac Gain Control 8 4 2 1 12 Figure 17 1 The Respiration Lead Gain Dialog Panel Mennen Medical 17 3 Respiration gt Menntor 7 Operating Manual To set respiration leads and gain 1 From the Respiration menu
25. e On select this checkbox to activate the menu option The option appears in the appropriate panel and can be accessed e Off select this checkbox to remove the menu option from the appropriate panel The option cannot be accessed e Dimmed select this checkbox when you want the menu option to appear dimmed on the panel The option cannot be accessed C5 System Setup Permission Editor Oxygenation Renal Clearance ull Disclosure verview Selective Recording Reports amp Vital Signs amp Setup ss Dimmed Figure D 44 The Permission Editor Panel gt To define permission for a menu option Discard Main Changes Screen 1 From the System Setup menu select Permission Editor The Permission Editor panel appears displaying menu tree with all Menntor X7 menu options Mennen Medical D 77 7 Operating Manual 2 In the menu tree click the plus icon that appears to the left of a menu item to access the menu level below that listed on the screen Any item from any level can be selected when assigning permission 3 Select the required menu item and then select the permission status for the item 4 Repeat step 3 until defining permission for all the menu option that you want 5 Click Main Screen to apply changes and close the panel Remove Saved Patients Use this panel to view the list of patients with data saved in the Menntor X7 moni
26. gt view an aEEG section 1 From EEG menu select aEEG Sections This displays a table with list of sections selected during the recording 30 18 Mennen Medical Menntor 7 Operating Manual Figure 30 16 Section selection 2 Select a section A window with the following options opens Select Unselect aEEG history Edit Label Edit the section label Delete Delete the section Trend Go to Trend at the start time of the section Chart Go to Chart at the start time of the section Close Mennen Medical 30 19 CerebraLogik and EEG Menntor 7 Operating Manual lt MADB 12248 Medication Started 00 28 48 sums um xem mmu wma x sam mme wa X Matches 4 Page 1 1 Figure 30 17 aEEG Section panel Marking Sections Selected Archived Use this option to mark sections to be exported to the USB e An Xat the Selected column means that the section is selected for export to USB e An Xin the Archived column means that the section has already been exported to the USB aEEG Sections History Use aEEG History to go to aEEG Sections History Panel This panel is almost identical to aEEG History but has keys for viewing Next or Previous sections Selection of section moves the cursor to the start of the Section The start is marked by blue mark and the end of the section by red mark Use the Next Prev
27. gt 8Days gt 8Days Eventstip 7 75 5 _aEEG Sections Not supported 50 50 a EGSaved Patient Notsupported s Mem storagetime sur sur ser memsavedfle 3 3 gt Calculations Host Unit Medications Hemodynamics Respiratory Mechanics Oxigenation Renal Clearance Fick Cardiac Output Heart Rate Variability HRV Time Domain Histogram Default Alarms Host Unit e User defined Fixed or calculated values e Alarm levels 9 Clinical levels C1 C2 C4 Technical levels T1 T2 e Visual and Audible alarm Output Alarms by Analog Switches Recorder Optional Host Unit e Integrated Recorder up to 3 channels Analog Output Host Unit e ECG II 1Volt mV pini 5 Gnd ECG V1 1Volt mV pin2 6 Gnd QRS 5 Volt ART 1Volt 100 mmHg pin4 8 Gnd Output to input delay lt 20 mSec Languages e English Dutch Espanol French Greek Italian Polish Portuguese Russian Spanish Turkish Regulatory Approvals EN 60601 1 EN 60601 1 1 EN 60601 1 2 e Degree of protection against electrical shock 9 RSP IBP CO and TEMP Type CF NIBP SpO2 and EtCO2 Type BF e CE Mark 0473 FDA Clearance K073140 K093766 Pending e WIFI FCC ID XM5 SM2144N1 2 Industrial Canada 8516A SM2144N1 2 mennen Menntor X7 a fj medical Technical Specification MX357 Multi Parameter Module e The MPM when disconnected from the host wi
28. to 40 OC Storage Temperature 400F to 158 OF 400C to 70 OC Relative Humidity 5 TO 95 non condensing Operating Altitude 1 00 ft to 18 00ft 304 m to 5 486 m Mennen Medical 22 17 Pulse Oximetry SpO2 Menntor 7 Operating Manual Covidien Oximax N 65 N560 N600 and N600x 22 18 Accuracy depends on the sensor being used Sensor type SpO2 Range LoStat TM 60 70 to 100 to 80 MAX A MAX AL 3 2 MAX N adult amp neonatal 3 2 MAX P 3 2 MAX I 3 2 MAX FAST 3 2 NeoMAX 2 SC A Adult 2 SC PR Neonatal 2 SC NEO Neonatal 2 MAX R 3 5 Sensor type SpO2 Range OxiMax OciCliqR Single Patient Use 70 to 100 OxiCliq A 2 5 OxiCliq 2 5 OxiCliq N Adult 2 5 OxiCliq N Neonatal 2 5 OxiCliq I 2 5 OxiMax Reusable Sensor 70 to 100 D YS Infant to Adult 3 D YS Neonatal 4 D YS with D YSE Ear Clip 3 5 D YS with D YSPD SpotClip 3 5 DS 100A 3 OXI A N Adult 3 Mennen Medica Menntor 7 Operating Manual Sensor type SpO2 Range OXI A N Neonatal 4 3 Total Optical Power of sensor LEDs less than 15 mW Mennen Medical 22 19 Pulse Oximetry SpO2 Menntor X79 Operating Manual 22 20 Mennen Medica 23 END TIDAL
29. 2 In Tabular Charts enter UDC User Defined Chart to create the list of parameters to be included in the chart 28 10 Mennen Medica Menntor 7 Operating Manual The UDC panel offer several lists of parameters It is possible to create chart from parameters appearing in different lists See also Appendix D Tabular Charts on page D 69 The list of parameters that are specific to PiCCO is labeled PiCCO Note Some of the parameters that are supported by PiCCO may appear in other lists Table 1 shows the list of parameters that are specific to PiCCO and the location of parameters that are supported by the monitor and appear in the UDC in other lists Table 1 PiCCO Parameters Code Description Units UDC list CPO Cardiac Power PiCCO Output CPI Cardiac Power W m2 PiCCO Output Index CFI Cardiac Func 1 min PiCCO tion Index DO2 Oxygen Delivery ml min PiCCO 21 Oxygen Delivery ml min m2 PiCCO Index dPmx Index of Left mmHg s PiCCO Ventricular Con tractility EVLW Extra vascular ml PiCCO Lung Water GEDV Global End Dia ml PiCCO stolic Volume GEDI Global End Dia ml m2 PiCCO stolic Volume Index GEF Global Ejection 96 PiCCO Fraction ITBV Intrathoracic ml PiCCO Blood Volume ITBI Intrathoracic ml m2 PiCCO Blood Volume Index PPV Pulse Pressure PICCO Variation Mennen Medical 28 11 Menntor 7 Operating Manual
30. 7 e Select the Alarm Limits S D M Labels and Units checkboxes to activate or deactivate display of these parameters on the main display screen 5 From the BP Colors list select the color required for BP parameters You have a choice of 16 colors The default colors are ART Pink BP Light Blue Orange Others Grey or Silver 6 Press BP to return to the BP menu Press Main Screen to return to the main screen display Note Checkboxes appear green when activated and gray when deactivated Deriving the PCWP Value The Menntor X7 enables you to monitor the Left Atrium BP using the Wedge Pressure procedure The derived Pulmonary Cappillary Wedge Pressure PCWP value is equal to the Left Atrium BP Note The Wedge Pressure procedure is available only after the PAP transducer has been zeroed Each step of the Wedge Pressure procedure is monitored in the PCWP dialog panel Messages are issued in the upper left hand corner that guide you through the procedure During the procedure the Menntor X7derives the PCWP value by averaging the expiratory and inhalatory values during respiration You can accept this value or manually change the value to better reflect the average value during expiration When the procedure is completed the Menntor X7enters the PCWP value under Hemodynamics and Vital Signs in the patient s chart PCWP 10 Sweep Speed 25 mm sec Autoscale
31. 8 minutes to full accuracy measurement Agent detection threshold solitary agent 0 296 Complete occulsion response time lt 5 seconds at 200 ml min 10 seconds at 120 ml min Agent Detection time 11 sec max at 200 ml min Calibration User selectable automatic or manual zero cali bration Gas calibration check once per year Sample gas flow rate 120 or 200 ml min Input Power 90to 264 Vac 48 to 62 Hz 110 Watts typical On screen Display Waveforms O2 CO2 N20 Anesthetic Agent Derived parameters Inspired End Tidal values of O2 CO2 N2O Anesthetic agent Resp rate Charts and Trends on all derived parameters Size 14 5 cm Hx 18 3 cm W x 43 2 cm D 5 Hx72 Wx17 D Weight 7 6 Kg 16 7 Ib Measurement method CO2 N20 Anesthetic agent NDIR non disper sive infrared O2 Paramagnetic Measured and identified gases O2 CO2 N2O Halothane Isoflurane Desflurane Enflurane Sevflurane Measurement Range 2 0 to 100 Torr N20 0 to 100 Oxygen 0 to 100 Halothane 0 0 to 10 096 solurane 0 0 to 10 0 Enflurane 0 0 to 10 096 Sevoflurane 0 0 to 10 0 Desflurane 0 0 to 2496 Mennen Medical 24 7 Multigas Anesthesia Analyzer Menntor 7 Operating Manual Anesthesia Module Anesthesia Module Measurement Accuracy CO2 0to 40 Torr 2 5 Torr 40 to 60 Torr 2 5 Torr 60 to 80 Torr 4 Torr
32. A N EN Yi N Y EN N E Freeze 30 13 Mennen Medical CerebraLogik aEEG and EEG Menntor 7 Operating Manual gt To view realtime EEG with an hour trend of aEEG 1 In Setup menu select Display Control 2 Onthe Display Control activate WF Trend display 3 From EEG menu select Display Option and in aEEG mode display select EEG Realtime EEG is displayed on the waveform part and the last hour of aEEG is displayed in the trend area EEG LEFT EEG RIGHT Figure 30 12 EEG Ihour aEEG 30 14 Mennen Medica Menntor 7 Operating Manual Very Big Numbers with one EEG and aEEG Display gt To view one EEG and one aEEG in very big numbers display 1 In Setup menu select Display Control 2 the Display Control activate Very Big Numbers 3 In EEG menu select Display Option and in aEEG mode select aEEG One channel of real time EEG aEEG is displayedabove two VBN boxes Figure 30 13 aEEG with Very Big Numbers aEEG History aEEG History is used to playback EEG and aEEG stored by the monitor aEEG History is displayed with one or two channels The EEG waveform at the location of the cursor is displayed under the relevant aEEG panel Mennen Medical 30 15 CerebraLogik and EEG Menntor 7 Operating Manual RD VER 6 1 24 r3 0 04 15 05 15 06 15 07 15 500 EEG LEFT 50 uV
33. Activating and Deactivating BP Monitoring on page 18 16 PCWP from PA Use this panel to derive the PCWP value See Deriving the PCWP Value on page 18 13 This key is dimmed if PAP is not zeroed CVP from PA Use this panel to intermittently measure CVP from the BP channel reserved for PAP See Measuring the Central Venous Pressure on page 18 14 This key is dimmed if PAP is not zeroed Accessing the BP Menu The BP menu can be accessed from the Vital Signs menu or from the main screen display To access the BP panel from the Vital Signs menu 1 From Main menu select the Vital Signs key The Vital Signs menu appears All BPs currently monitored appear on the Vital Signs menu From the Vital Signs menu select the required BP The appropriate menu is displayed To access the BP panel from the main screen display Turn the QuicKnob until the appropriate BP parameter key is highlighted and press to access the BP panel Zeroing BP Transducers Before the Menntor X7 begins taking BP measurements you must zero the BP transducers If the BP transducers are not zeroed waveform data appears but the BP value is not calculated You can zero BP transducers by Pressing one of the Zero buttons on the 2BP and CO 2 TMP to zero the BP transducer connected to the adjacent channel connector Using the Zero Pressure dialog panel to zero the transducer for the BP displayed in the menu title or to zero the transdu
34. Heart Lung Machine It is impossible to take an NIBP reading when a patient is connected to a heart lung machine Arrhythmia An irregular heartbeat caused by cardiac arrhythmia may cause the NIBP reading to be unreliable or impossible to perform Again measurement time is increased Changes in Pressure If a patient s blood pressure changes rapidly over the period of time during which the arterial pressure pulses are being analyzed for the reading the measurement will be unreliable and may be impossible to obtain Patient Movement Patient movement shivering tremors and convulsions may interfere with detection of parterial pressure pulses NIBP measurements may be unreliable or impossible to perform In any case measurement time is increased Heart Rate Extremes An NIBP reading cannot be taken if the patient s heart rate is less than 40 BPM or more than 300 BPM Severe Shock Reduced blood flow to the extremities due to shock or hypothermia causes reduced pulsations of the arteries This causes the NIBP readings taken under such conditions to be unreliable Limitations for Neonates Due to the small size of arteries in premature babies and in neonates it becomes more difficult to sense the arterial pulse To achieve optimal results in Neonatal NIBP 1 Use the shortest practical tube length possible between the NIBP inputs and the Cuff Use approximately 1 5 meters as a practical compromise 2 Do not tighten the Cuff on
35. In the module box select the module a window with a list box containing software versions appears Select the new version and update Press the QuicKnob a message appears requesting you to confirm the upgrade of the software Click Yes to download the software Click Main Screen to close the panel Mennen Medica 7 Operating Manual gt download MPM software 1 Click Update MPM version window with list box containing software versions appears 2 Select the new MPM SW version and Update 3 Press the QuicKnob a message appears requesting you to confirm the upgrade of the software 4 Click Yes to download the software 5 Click Main Screen to close the panel Enmove Interface Setup To use the Menntor X7 with the Ensemble EN Central Station the monitor has to receive a Network Number in the common network of Enmoves and Menntor X7s To set the Network Number enter System Setup gt Enmove Interface Setup and give the monitor a Network Number between 1 and 64 The Network Number is displayed in System Setup gt Network Setup under the heading Menntor X7 to MCS interface CAUTION Each of the monitors Menntor X7 s and Enmove s must have a different Network Number Note All Menntor X7 monitor with software version 3 6 and up can be monitors on Ensemble EN Central Nurse Station Change Password The Change Password option allows you to change the passw
36. T 150 100 100 50 Figure 27 10 BIS Waveform display Real time BIS and its quality bars and parameters are displayed with one or two EEG channels BIS is displayed together will other vital signs Mennen Medical 27 21 BIS Bispectral Index 27 22 BIS enABO04F BIS enABO04F 11 06 11 36 2 0 11 06 11 36 11 06 11 36 50 80 11 06 11 36 6 Wo ao mm md enl ati an Hold wl Pant Munn AW ye Menntor X79 Operating Manual Lead RA LA 40 EN Intr 10 2 o Last Apn 10 1115 11 89 150 100 100 SR BC 68 96 BIS SQL f 6 Minutes 1 Min Division Lead RA LA 40 f R Apn Intr 10 10 150 Last Apn 115 77 89 150 100 100 50 125 SR 80 B 68 EMSQ TP 58 40 68 100 BIS SQL 6 Minutes 1 Min Division Figure 27 12 BIS Waveform Trend display Mennen Medica Menntor 7 Operating Manual This profile shows about 5 seconds of real time EEG together with a Trend of BIS and EMG gt To create BIS waveforms display 1 From the BIS menu select Display Option 2 From the Display Area drop down list select Waveform 3 Press BIS to return to the BIS menu Press Main Screen to return to the main screen display gt To create BIS waveforms Trend display From the BIS menu select Display Option From the Display Area drop down list select Waveform From the Setup menu select Display Control 1 2 3 4
37. Types of Menus and Panels A series of interactive panels enables you to enter data into the Menntor X7 The Menntor X7 works with four panel types e Vertical e Horizontal e Ful Keyboard A description of each type of panel follows For a description of common panel features see Panel Features on page 6 15 Vertical Panels When you select a function from a menu or press a UDK or select an on screen button a dialog panel opens In some cases this panel is a vertical Menu panels and vital sign panels are vertical panels A vertical panel appears on the right side of the screen above the UDKs 6 12 Mennen Medica Menntor 7 Operating Manual The following table identifies common features of vertical panels and their locations Feature Location Back Menu Button Top of panel Menu Title Top of panel directly below Back Menu button Drop down menu Left of panel below Menu Title area Main Screen Button Right corner to the right of the drop down menu Horizontal Panels When you select function from menu press UDK or select an on screen button dialog panel opens In some cases this panel is horizontal Charts and Trends are examples of horizontal panels Vertical panels cover the lower central area of the screen without affecting the main display area The following table identifies common features of horizontal panels and their locations F
38. 0 and Anesthetic Agent Menu 25 10 The N50 and Agent menus can be accessed from the Vital Signs menu or from the main screen display To access the N O and Agent menus from the Vital Signs menus 3 From the main menu select the Vital Signskey The Vital Signs menu is displayed From the Vital Signs menu select NO or the required Agent The appropriate menu appears Select the required menu item to display the associated panel To access the 0 and Agent menus from the main screen display l When 0 or an Agent is displayed in a parameter slot in the primary display area waveform area turn the QuicKnob until the required parameter key is highlighted The parameter key functions as an on screen button Press the QuicKnob to select the parameter key and access the required menu When 0 or an Agent is displayed in the Secondary Vital Sign area or in Big Number format turn the QuicKnob until the required value is highlighted and press to select The appropriate menu appears Mennen Medica Menntor 7 Operating Manual Setting N20 and Anesthetic Agent Alarms 0 and Agent alarm parameters are set in two dialog panels Alarm Limits and Alarm Response Alarm Limits allows you to activate deactivate etO inO etN5O inN5O etAgent inAgent alarms and set high and low alarm limits Alarm Response allows you to define how the Menntor X7 res
39. 1 2 Manual Structure ORO RI UE Es 1 3 Changes in Default Configuration esses E e tnnt a a aaa senes entes 1 4 Intended Uses 1 4 Compliance E 1 5 Network Mennen NEt 54 ain eC EROS ORIS ene E CO MR A Ula 1 6 Chapter 2 Warnings and Precautions Power Failure eoe epi lee ean 2 1 Minimizing Electrosurgical Interference 3 2 2 2 Electrical Shock Hazard i ence eae Naa a wha E dh 2 3 Connection of Other Medical Devices orreee eea e A AEAT E 2 3 Explosion Hazard i mit eee e P tb E e ER Hae bd eei a ace 2 4 Environmental Status 2 2 n oO ORO RE qti quee qu e Hen ee ere us 2 4 Monitor SOFA Be La oto ean teet bee hte nete e eed dep A a ee ee 2 4 Use of Manual m ettet POE etd aet presi obe ee ae 2 4 Responsibility eee oe AU De rr ge e Poe Dea eet D et eade 2 4 Labeling rib bie t ga ae ib e ak 2 5 Electrode and Transducer Protection sss sese eene enne nennen 2 7 Gerneral Use OF ACCeSSOFIGS onere ton uta tede a te iere pfe ad De Pos as aloes 2 8 Disposal of Monitors and Accessories essent tenentes 2 8 Chapter 3 System Description OVeEVIEW RR EORR ER XO EE e gi neal te e te ERE eMe outs 3 1 System Features and
40. 15 or 20 seconds The factory default is set to 0 seconds Units Defines the default units used to measure and display CO2 The available options are or mmHg The factory default is mmHg CO2 Default Color Defines the color in which CO2 values appear on the main screen display You can Mennen Medica 7 Operating Manual choose from 16 available colors QC1 S 5 Extended Alarm Response Units Latching Oft z Alarm Detection Delay 0 sec ue CO2 Default Color cl Figure D 19 The CO2 Dialog Panel gt To set default CO2 parameters 1 From the System Setup menu select Vital Signs Setup The Vital Signs menu is displayed 2 From the Vital Signs menu select CO2 Setup The CO2 Setup dialog panel is displayed 3 Under Extended Alarm Response Set the default priority level for Co2 alarms From the Latching drop down list set default alarm latching to On or Off 4 From the Alarm Detection Delay drop down list select the required delay time in seconds 5 From the Units drop down list select the required default measurement unit or mmHg 6 Select CO2 Default Color A panel displaying all available 7 colors appears Select the required color 8 Select Discard Changes to close the panel without applying any changes Select Main Screen to apply the changes and exit the panel Note When you exit a vital signs setup panel you return to
41. 385gr 0 849 Ib with mounting clip and cable e Interface Cable length 1 2meter 47 2 inch e 5 sockets for DIN safety electrodes cables e Power Consumption 5V 300 mA e Mounting Clip e 2 different amplifiers Left Right Reference e Input Range 400 pV full scale e Input impedance gt 5 MQ e Linearity 2 e DC input offset 2500 mV maximum Common Mode Rejection Ratio 130 dB at 50 60 Hz e Frequency Response 0 5 Hz to 75 Hz 3db e Noise lt 10nV sqrt Hz at 100Hz e Bias Current Less than 7nA per input e Input isolation Double isolation e Sampling rate 640 Hz per channel e A D span 24 bits e Low filter High pass 0 5 1 5 Hz e High filter Low pass 15 35 50 70 Hz e Degree of protection Type BF Applied part e 2 x Differential channel Left Right EEG aEEG channels e 1 Cross Channels Left Right EEG aEEG e Signal Quality Resistance 0 to 5 Arbitrary units e EEG Gain 10 20 50 70 100 200 V cm e aEEG Range 100 200uV e EEG aEEG history duration Up to 7 days recording aEEG panel 3 Hour Display e EEG sweep speed 15 or 30 mm Sec Section marking e Event marking e Built in Recorder Optional e Data printing on recorder Optional e USB for Data output viewer on PC Temperature 5 C to 40 C 41 F to 104 F e Humidity 10 to 93 percent non condensing e Temperature 15C to 68C 5 F to 154 F e Humidity 10 to 93 percent
42. 7 me EN UDC Name ABC Alarm Cardiac Output NIBP Manual PWEDGE _ __ Alarm Automatic Meer Pam dg 10 Minutes Select All Filters Unselect All Filters Figure D 40 Defining the Filters 8 Press Select All Filters for all available filters to be included in the chart Press Unselect All Filters and select only those filters you want to include in the chart 9 Click Accept to apply the changes and return to the Tabular Charts panel The new UDC appears in the User Defined Charts list Clearing a UDC From the UDC List gt To clear a UDC from the UDC List 1 From the System Setup menu select Tabular Charts 2 From the User Defined Charts List select the UDC you want to remove from the list 3 Press Clear UDC The UDC is removed from the User Defined Charts List and the undefined Tabular Chart appears in its place Updating the Software Version The Software Version panel displays the software version of the bedside monitor the MPM BEP and CIPAM the two plug in modules and modules connected via the UIM It also allows you to download the software for the modules D 72 Mennen Medica 7 Operating Manual SARA 10 System Setup BS Version VitaLogik 7 0 19 Aug 2013 15 34 36 Wi Fi ID807b06 MPM Llc CIPAM 3 0b SPB 96 1GB SPOZM4ii NIBP 2 0 Module Rack UIM I UIM 2 Select Vendor Select Ven
43. 7 T T 7 T 1 10 10 10 25 10 40 10 55 1110 07 06 06 Signature 1 Figure 10 18 Trend Report Printing a Report The reports can be printed on network laser printer The printing will occur either upon request or automatically e Ata pre selected time of the day e At the end of one of three shifts of the day for example 07 00 15 00 23 00 e Upon Discharge Note Any report can be printed up to three times every day The reports formats and durations are prepared in System Setup password protected Report Setup see Paragraph 5 12 in Appendix D t To print preview a report 1 Press the Patient Data key orange to display the Patient Data menu The Report panel appears 10 28 Mennen Medica Menntor 7 Operating Manual TEST VL 2 Reports Figure 10 19 Report Panel 2 Select Report name 3 Select the report duration Note The total duration of the report is set in the System Setup Report Setup the duration box enables creating reports for part of the original report duration 4 Select the end date and time for the report Note Pressing either Current Shift or Previous Shift will set the end time of the report to the end of the selected shift 5 Click one of the following Print Report to print the report on the laser printer Report Preview to preview the report on screen Mennen Medical 10 29 Reviewing Patient Data LAST VL 2 15 06 06 11 02 REPORT
44. Amplitude Integrated EEG aEEG and in conjunction with other clinical data WARNING monitoring is intended for use in hospitals only and under the direct supervision of a licensed healthcare practitioner trained in its proper use CAUTION The dual channel EEG monitoring does not replace full EEG examination WARNING CerebraLogik is not defibrillator proof in case of defibrillation disconnect the EEG electrodes from the CerebraLogik Mennen Medical 30 1 CerebraLogik aEEG and EEG Menntor 7 Operating Manual Compliance Menntor X7 bedside monitor is also designed to comply with the international EMC requirements for medical electrical equipment IEC 60601 1 2 CerebraLogik Storage CAUTION If the CerebraLogik is stored for a long period of time it is recommended to store it on it s original packaging Icons The following icons appear on the CerebraLogik adjacent to the electrode input connectors Table 30 1 Icons AY Attention consult accompanying documents Service to be per F M formed by qualified technician Refer to instruction manual booklet Restricts the sale and use of this instrument to qualified Only medical personnel only R Not for use in explosive gas environment Electrical and electronic equipment Dispose according to local regulation Date of manufacture YYYY MM C CE Mark 30 2
45. CALCULATIONS The Menntor X7 Drug Calculation package allows fast and accurate calculation of drug infusion rates drug concentrate and injection amounts based on various clinically specified parameters The Calculation package comes with default list of drugs supplied by Mennen Medical Calculation Formulas Calculating the Infusion Rate The rate of fluid administration for an IV is calculated based on patient weight required medication dose rate drug amount and total fluid volume in the IV bag Formula I If dose rate is given in units of mg Kg min e Total Dose Rate gram hour Dose Rate mg Kg minute x Patient Weight 1000 x 60 e Concentration of infusion fluid gram CC Drug amount added to IV grams IV Fluid volume CC e Infusion Rate CC Hour Total Dose Rate gram hour Concentration of infusion fluid gram CC Formula 2 If dose rate is given in units of gram time e Total Dose Rate gram hour Dose Rate mg minute x 1000 x 60 Mennen Medical 12 1 Performing Medication Calculations Menntor 7 Operating Manual e Concentration of infusion fluid gram CC Drug amount added to IV grams IV Fluid volume CC e Infusion Rate CC hour Total Dose Rate gram hour Concentration of infusion fluid gram CC Calculating the Drug Concentration The amount of medication to be added to the IV bag is calculated based on patient weight dose rate fluid infusion rate and tota
46. High Scale 250 300 and 350 Low Scale 15 10 and 0 BP Default Color Defines the color in which BP vital signs values and waveforms appear on the main screen display You have a choice of 16 colors The factory default colors are as follows ART UA Pink PAP Light Blue CVP Orange All others Grey or Silver D 29 7 VS Setup Figure D 10 The BP Setup Dialog Panel Displaying the Color Selection Panel gt define default BP parameters 1 From the System Setup menu select Vital Signs Setup The Vital Signs menu is dis played 2 From the Vital Signs menu select BP Setup The BP Setup dialog panel is displayed 3 Under Extended Alarm Response From the appropriate drop down list set the default priority levels for BP and Fault alarms From the Latching drop down list set default alarm latching to On or Off 4 From the Alarm Detection Delay drop down list select the required delay time in seconds 5 Under Auto Scale e From the After Zero drop down list select Always Never or Only After First Zero Under Type select Normal or Only Upper Limit D 30 Mennen Medica 7 Operating Manual 6 From the Defaults Per Site Name drop down list select the BP for which you want to set site specific default values 7 From the Units drop down list select the type of units used to measure the selected B
47. Mennen Medical 10 15 Reviewing Patient Data Menntor 7 Operating Manual e intervals between beats in milliseconds e Type of QRS complex e List of alarms that were activated during that time period including the time the alarm started Ten Minute Display Panel The Ten Minute Display panel presents a snapshot of the waveform activity for any selected ECG lead over a specified ten minute period The time period initially displayed depends on the way you access Full Disclosure When Full Disclosure is accessed directly from the Patient Data menu the current system time rounded to the next ten minutes is used as the end time When Full Disclosure is accessed from another Patient Data panel such as Charts the time period under review in that panel is used as the start time When accessing the Ten Minute Display panel for the first time it displays by default the waveform for the top most ECG lead currently shown on the main display screen gt To access the Ten Minute Display panel 1 From the Main menu select the Patient Data key or If a Patient Data function key appears on the main screen turn the QuicKnob until the Patient Data key is highlighted and press to access the Patient Data menu 2 From the Patient Data menu or When the Patient Data panel is already displayed from the drop down menu below the panel title select Full Disclosure to access the Ten Minute Display panel 10 16 Mennen
48. N20 1 5 abs 5 rel Oxygen 2 5 abs 5 rel Halothane 0 7 5 0 2 abs 4 rel Isoflurane 0 7 5 0 1 abs 4 rel Envlurane 0 7 596 0 1 abs 4 rel Sevoflurane 0 996 0 1 abs 4 rel Desflurane 0 2096 0 1 abs 4 rel Preventive Maintenance 24 8 The following procedures should be performed by trained end user personnel 1 Oncea week or as often as required replace the water trap 2 Oncea week clean and remove any excess dust etc using a soft cloth lightly moistened with water 3 Once a year or as often as required clean or replace the ventilation fan filter Recommended Service Personnel Preventive Maintenance should be performed once a year or more often if actual usage requires it Mennen Medica 25 NESTHETIC GAS MONITORING Overview During Anesthesia oxygen is brought to the body s cells from the Anesthetic machine ventilator Carbon dioxide is produced by the body during cellular metabolism When performing anesthesia N5O and anesthetic agent are also delivered into the respiratory system is removed from the body and expelled to the atmosphere by the pulmonary system The concentration of O5 N50 and anesthetic agent are continuously monitored Monitoring Procedures The Menntor X7 monitor can interface with either Andros 4800 gas module Poet IQ or Leon Plus anesthesia machine by Heinen amp Lowenstein The interface is acc
49. Note The above effect is more likely to occur with smaller ET tubes How can I get longer life from my FilterLine Set with Systems When connecting FilterLineQ Sets to an airway that includes an HME the following guidelines are recommended FilterLineQ Sets will perform best when placed on the endotracheal hub closest to the patient in Figure 23 8 providing optimal rise time and accurate EtCO2 waveforms and readings Figure 23 8 FilterLine Sets Connections Mennen Medical 23 19 End Tidal CO2 EtCO2 Microstream MicroPod Menntor 7 Operating Manual 23 20 1 To Patient 2 FilterLine Set 3 HME In environments with heavy secretions which may cause airway adapter blockage it is best to position the airway adapter on the distal dry side of the HME if long duration sampling is required in Figure 23 9 Note In the above case rise time may be slower by 150 300 msec depending on the type of HME used and the length and type of tubing between the humidifier and the patient slower rise time will affect CO2 waveforms and readings relative to the breath rate Fast breathing rates of over 25 bpm usually with infants will cause noticeably rounded waveforms and erroneously low EtCO2 readings proportional to the breath rate Figure 23 9 Positioning the airway adaptor in environments with heavy secretions 1 To Patient 2 HME 3 FilterLine H Set
50. Notification of an equipment related problem Except for the priority level of life threatening alarms the priority level for all parameter alarms can be defined Life threatening alarms are fixed at the highest priority Alarm priority is defined in the Alarm Response panel of each monitored vital sign Alarm Response Priority Level The following table describes the default audible and visual indication associated with each alarm priority Table 8 2 Alarm Response Priority Audible response Visual Response Clinical Level 1 C 1 bbb bb bbb bb repeat every 2 5 Blinking Red Sec Clinical Level 2 C 2 bbb bb repeat every 5 seconds Blinking Red Clinical Level 3 C 3 ec repeat every 15 seconds Blinking Yellow Clinical Level 4 C 4 ec repeat every 20 seconds Continuous Yellow Technical level 1 T 1 Aaa Aa Aaa Aa repeat every10 Continuous Cyan sec Technical level 2 T 2 Eee repeat every 20 sec Continuous Cyan SpO2 unique alarm Hi Lo Hi pause Hi Lo Hi every 5 sec Blinking Yellow Note When an alarm color is the same as the normal display color of the vital sign alarm background and foreground colors are reversed Upgrading of Alarm Priorities In the Menntor X7 when alarms are triggered simultaneously the system responds by upgrading the alarm response to a higher priority level than that of each individual alarm For example if two priority level C 2 alarms are triggered simulta
51. Operating Manual none enA01127 ST Select Lead ST 1 5 om 1 0 OQ ET dO DO gt Auto Set JE STI Alarms Due Figure 16 2 The ST Alarm Setup Panel To set ST alarms 1 From the ST menu or if you are already in another ST panel from the drop down list below the panel title area select Alarm Limits From the Select Lead drop down list select an ECG lead or select All Leads to bring up the corresponding panel Using the QuicKnob move the slide indicator on the high limit slider bar along the alarm limits scale to set the required high limit and move the slide indicator on the low limit slider bar to set the required low limit Press Auto Set to Defaults to set the ST alarm limits to their default values Press ST Alarms to set alarm limits and activate or deactivate all ST alarms Note Checkboxes appear green when activated and gray when deactivated Press ECG to close the panel and return to the ECG menu press Main Screen to close the panel and return to the main screen display Mennen Medica Menntor 7 Setting ST Alarm Responses The Alarm Response panel controls how the Menntor X7 responds to ST alarms Alarm Response Alarm Response JE Tones JE Event Strip Figure 16 3 The ST Alarm Response Panel gt To set ST
52. Operating Manual gt To set SpO2 default parameters 1 From the System Setup menu select Vital Signs Setup The Vital Signs menu is displayed From the Vital Signs menu select BP Setup The BP Setup dialog panel is displayed Under Extended Alarm Response e From the appropriate drop down list set the default priority levels for SpO2 Pulse Rate and Fault alarms e From the Latching drop down list set default alarm latching to On or Off Select the Disable SpO2 Alarms During NIBP checkbox to stop detection of SpO2 alarms if monitored while taking an NIBP reading Clear the checkbox to reactivate SpO2 alarms From the Alarm Detection Delay drop down list select the required delay time in seconds default is 5 sec Set Extreme Delta to set an Extreme SpO2 alarm if SpO2 is below the low alarm setting by more than X X 1 to 10 Default is Off Select SpO2 Default Color A panel displaying all available colors appears Select the required color Select Discard Changes to close the panel without applying any changes Select Main Screen to apply the changes and exit the panel Note When you exit a vital signs setup panel you return to the main screen To continue System Setup you must press the System Setup button again to access the System Setup menu Temperature Setup This dialog panel enables you to set Temperature default parameters These parameters include setting Temperature alarm priority act
53. Patients In Clinibase Show All Figure 9 12 Patients in HemoCis Panel Note Transfer of the full list of patients from the HemoCis to the Menntor X7 takes a long time We therefore recommended that you schedule the patient s for Today on the HemoCis before monitoring starts Mennen Medical 9 15 Connecting Patient to Menntor X7 Menntor 7 Operating Manual HemoCis View To Open HemoCis window on Menntor X7 monitor PAP DIAST LOW ALARM L Name ABEL 0 F Name RICHARD Med Rectt Demo Hx Procs Lab meds Equip Vamoxi c Tree Summary Bill imag 1 I Admit Status x Admitbate Discharge Date Last Name pu 7 Medical Record Nun First Name RICHARD Social Security Numf Middle Name fiw Date of Birth 121942 O fom frep arin 2000 units Gender me City Race Native gt State Insurance Provider NyLCARE Country Insurance Exp Date It 1 Postal Code Height 900 Phone home 12347 Weight 2002115 Phone wot BSA for Location Figure 9 13 HemoCis window displayed on Menntor X7 If the Menntor X7 is a Cathlab Suite monitor with Option 960 OPT 280 or 960 OPT 286 HemoCis Licence show the HemoCis window by doing one of the following 1 In Setup menu select HemoCis View this key will toggle Show and Hide of the HemoCis window 9 16 Mennen Medica Menntor 7 Operating Manual
54. Report 2 etc You can change the name of any report according to what is accepted practice in your hospital or department gt To rename a report 1 In the System Setup menu select Report Setup 2 From the Reports List select a report 3 Select the Report Name textbox The alphanumeric keyboard panel is displayed Enter the new report name and close the panel The new report name now appears on the Reports List Mennen Medica 7 Operating Manual Editing a Report When you edit a report you define its type duration and layout You can select from one of two report types Charts or Trends Charts A chart documents a patient s condition as observed at regular intervals in table format much in the same way as a nurse records data in a bedside chart The Menntor X7 supports the following set of clinical charts for the purpose of data acquisition clinical calculations and review e Hemodynamics e Respiration e Oxygenation e Renal Clearance e User Defined Charts with the name as given in Tabular Charts The format of the User Defined chart can be edited All other charts have a fixed format System Password System Setup Report Setup 5 REPORT 1 Back to reports list I cu 4 Paper Duration is Hr Size Letter Orlentation Landscape Type Vital Signs E Alarm CardiacOutput NIBP Manual PWEDGE m Apnea
55. The Alarm Response panel controls the way the Menntor X7 responds to Ventilator alarms for each parameter type The panel is divided into three areas e Parameter Type selection where the parameter to be set is selected e Alarms where response preferences are set for clinical alarms e Fault where preferences are set for technical alarms QC ENVOL Main Screen VENT 5 1 Alarm Response Vent Alarm Response JE Record Tones JE Event Strip Vent Fault Response Record Tones Figure 26 3 The Ventilator Alarm Response Dialog Panel gt To set alarm response preferences 1 From the Ventilator menu select Alarm Response The Alarm Response panel appears Under Parameter Type Selection choose the parameter to be set 2 Under Ventilator Alarms e Select the Record checkbox to activate or deactivate recording of the patient s condition during the alarm event By default Record is deactivated e Select the Tones checkbox to activate or deactivate audible alarms By 26 6 Mennen Medica Menntor 7 3 default Tones is activated e Select the Event Strip checkbox to activate or deactivate Event Strip By default Event Strip is deactivated Under Ventilator Fault e Select the Record checkbox to activate or deactivate recording of the patient s condition during the alarm event By default the checkbox is deactivated e Select the To
56. The EtCO2 menu appears Setting EtCO2 Alarms EtCO alarm parameters are set in two dialog panels Alarm Limits and Alarm Response Each dialog panel controls a different aspect of EtCO2 alarms Mennen Medical 23 9 End Tidal 2 EtCO2 Microstream MicroPod Menntor X79 Operating Manual Setting EtCO2 Alarm Limits Use this panel to activate deactivate EtCO2 inCO and respiration rate alarms and 23 10 set high and low alarm limits Selecting an option in the Select Type box activates the corresponding panel containing the current high and low alarm limits as well as the currently measured value for the selected option RICU BED Main Screen etCO2 5 Select etco2 25 aa o 83888 ess ss a a LLLI AUN INI 8 Auto Set F All etCO2 Alarms to Defaults Figure 23 3 The EtCO2 Alarm Limits Panel To set EtCO2 alarms 1 From the EtCO2 menu if you are already in another EtCO2 panel from the drop down list below the panel title area select Alarm Limits From the Select Type drop down list select EtCO2 inCO or Resp respiration rate to bring up the corresponding panel Press All inCO2 EtCO2 Resp Alarms to activate or deactivate the alarms Using the QuicKnob move the slide indicator on the high limit slider bar along the alarm limits scale to set the required high limit and move the slide indicator on the low limit slider bar to s
57. The alphanumeric keyboard panel is displayed Enter the new UDC name and close the panel The new chart name now appears in the User Defined Charts List 5 17 2Editing a UDC Editing a User Defined Chart includes the following procedures Defining the parameters to appear in the chart The parameters can be selected from any of the available parameters associated with the Menntor X7 predefined charts Defining the order in which the parameters will appear in the chart Defining an alarm column for display of clinical alarms for the selected parameters Defining filters the conditions according to which entries are added to the chart The available filters are Manual Chart entries based on a manually selected event Alarm Chart entries when an alarm is triggered Cardiac Output A chart entry each time a cardiac output reading occurs PCWP A chart entry each time a pulmonary wedge reading occurs NIBP A chart entry each time a NIBP reading occurs CVP A chart entry each time a VCP reading from the PAP channel occurs Apnea A chart entry each time an apnea event occurs Time Interval Chart entries based on a defined time interval gt To edit a User Defined Chart 1 D 70 From the System Setup menu select Tabular Charts The Tabular Charts panel opens Mennen Medica 7 2 From the User Defined Charts List select chart and click the Edit
58. Vent Color Menntor 7 Operating Manual Figure 26 4 Ventilator Display Options 3 From the Cell Size select the size of the data display numbers The Ventilator data is displayed on the lower part of the displayed on screen The options are Quarter Half and Full Numbers 4 From the Vent Color list select the color required for Ventilator parameters You have choice of 16 colors 5 Press Main Screen to return to the main screen display 26 8 Mennen Medica Menntor 7 Operating Manual QC TKI 4 25 Remote ASHER SASON AB 1111111 NISSIM HR 80 i 21000 11 10 Sp02 97 5002 89 CO IPCVF 50 Q RUN 0 BGM Q STI 9 STU 0 3 ST Uli 0 1 ECG VI STaVR 0 0 STaVL 0 0 STaVF 0 1 ST 0 0 ST V2 0 0 menn SSA 119 DU 31 o 9 3 5 5 MEE 15 11 E 10 0 3 5 10 0 3 5 25 er 20 9 0 620 500 Auto 0210 00 11 56 2016 20 0 4 0 tis 800 300 800 300 02 10 00 11 56 St 02 10 00 11 56 mud jmd 02 10 00 11 56 Figure 26 5 Main Screen with Ventilator Display ECG II lt UPT z See the figure below for an explanation of the abbreviations Mennen Medical 26 9 Menntor 7 Operating Manual Positive Peek Minute Expiratory Respiration Inspiratory Ventilation Tidal Volume Pressure Rate Pressure Mode Volume Last Apn lt
59. Vital Signs Setup Utilities Open Utilities to show a menu of HW key function that can be used to active the functions or to create QuicKeys Record Timer e All Alarms Off e Silence e Freeze Main Screen 6 10 Pressing the Main Screen key saves changes made on open panels closes the panels and returns you to the main screen display Mennen Medica Menntor 7 QuicKnob The QuicKnob permits you to interact with the display screen menus and dialog panels Turn the QuicKnob clockwise or counterclockwise to move through all areas of the main screen display menus and dialog panels As you pass through an area it is highlighted When you reach a required area press the QuicKnob to select it For example if you have begun monitoring a patient but you haven t yet completed entering his demographic data turn the QuicKnob until you highlight the demographic area on the screen and press The Patient Identification panel is displayed Turn and press the QuicKnob to fill out each area on the panel When you have finished turn the QuicKnob until you highlight the Main Screen button Press the QuicKnob to implement your changes and close the panel Note The QuicKnob is also used to set values on a scale such as when setting alarm limits using the slider bar in the Alarms panel In this case turning the knob clockwise or counterclockwise increases
60. and Freeze and by the yellow key to Timer This allows the user to reach these functions without opening the Main menu For a detailed description of the functions and controls of the main processing unit see Main Screen Display Features on page 6 3 Display Features The main screen display is divided into four areas e Global Header Area e Patient Area e Patient Display Area e QuicKeys For a description of all monitor display features and functions see Main Screen Display Features on page 6 3 Input Modules The Vital Signs inputs modules are housed on the left side panel They include e MX57 Multi Parameter Module providing inputs for e 12 Lead ECG RSP Dual BP 4 optional e CO 2TMP e Temp NIBP Mennen Medical 3 3 System Description Menntor 7 Operating Manual e SpO2 2UIM Universal inputs e CerebraLogik EEG amplifier Optional connected via e EtCO2 MicroStream e Spirometry Inputs The Vital Signs inputs are housed on the left side panel They include e 12 Lead ECG RSP e Dual BP e CO 2TMP Temp e e Spo2 e EtCO2 MicroStream Controls and Outputs e Video output for external display e External keyboard and mouse e Remote keypad or Analog output EtCO2 gas outlet 119 80 92 00 05 13 Figure 3 2 Menntor X7 Front Panel 3 4 Mennen Medical Menntor 7 Operating Manual QuicKnob Keypad D type 9 pin connector to MPU Figure 3 3 Menn
61. and the button label changes to Restore Press Restore to restore the selected curve to its active state return it to the central graph and include its associated data in C O calculations The button label changes to Delete Press Clear All Measurements to delete all data acquired so far Press Save and Clear Measurements to save the acquired data and clear the graphs Press CO to close the panel and return to the CO menu Press Main Screen to close the panel and return to the main screen display 19 9 Cardiac Output C O Menntor 7 Operating Manual Cardiac Output Fick Method The Fick method enables calculation of Cardiac Output using a non invasive procedure The Fick method is based on the following parameters SpO5 e Consumption e Hemoglobin These parameters are provided by the Menntor X7 or acquired using other monitoring equipment in which case you must manually enter them The formula for calculation of the Cardiac Output is O Consumption x 10 CardiacOutput Sp04 5v0 x HB x 1 34 Upon calculation of Cardiac Output the Fick method automatically calculates Cardiac Output associated parameters Cardiac Index Stroke Volume Stroke Index Systemic Vascular Resistance Systemic Vascular Resistance Index Pulmonay Vascular Resistance Pulmonay Vascular Resistance Index All values are stored in the patient chart The calculated C O is displayed in the C O display area o
62. appears 6 Press Main Screen to accept the change and restart the monitor Recorder Setup If the Menntor X7 is connected to a network it can be set up to send a recording to an in built optional recorder or a defined list of recorders or printers located on the network The Menntor X7 supports three recording types each of which can be configured to send recordings to different recorders or printers as is convenient for the user These recording types are e Manual Recording A manual recording is initiated by the user at the bedside The user can select a real time or delayed recording and can select from the following recording durations 20 30 45 and 60 sec or Continuous e Alarm Recording A recording triggered by an alarm documenting the ECG waveforms all VS values and the waveform of the clinical parameter which triggered the alarm when not ECG When using a dual channel recorder the first Mennen Medical D 65 7 channel is always ECG1 For the second channel you can select ECG2 or any other parameter that produces waveform e Selective Recording In a selective recording the user defines which waveforms to record The following recording durations can be selected 20 30 45 or 60 sec Each recording type has its own characteristics If the Menntor X7 is on a network and a number of different recorders at different locations are available you can assign sp
63. as well as various types of clinical reports Patient data output to a recorder or a printer if connected You can interact with the Menntor X7 Using interactive panels These panels include menus and dialog panels that enable you to configure system and monitoring parameters Responding to Events Fixed keys on the front panel of the main processing unit enable you to respond quickly to events such as alarms Reviewing Clinical Data Mennen Medica Menntor 7 Operating Manual Charts Trends Full Disclosure and Overview enable you to view and compare data in different formats and over selected time periods Monitor and Main Processing Unit The Menntor X7 can display up to eight traces depending on how the vital sign display is configured For monitor control procedures refer to the User s Manual clinical data collected from the inputs is stored in the main processing unit This data includes waveforms vital signs trends charts and beat to beat data The main processing unit can store at least 4 days of patient waveform and 80 days of numeric data for review purposes The front panel of the main processing unit contains 7 fixed keys and the QuicKnob These features enable you to interact with the system The back panel contains the power connector A remote keypad provides direct access via the orange keys to the menus of Vital signs Patient data and Setup via the green keys to Event Print Record
64. gt gt Available data time span a Ii 20 11 13 50 21 11 08 40 Figure 10 22 Time Domain Graphic Trend Mennen Medical 10 33 Reviewing Patient Data HRV Histogram Menntor 7 Operating Manual Collects NNi interval for user defined interval Minimal interval is 5 minutes into bins in stages of 20mSec 1 50 Sec The Histogram is shown graphically by vertical bars representing the percentage of beats within each interval bin A cursor is provided showing the percentage of beats at the cursor position QC 320 VLO1 Data avallable From 20 11 12 14 01 To 211112 08 35 2011 12 14 01 21 11 12 08 35 18 i 34 Show Histogram 21 11 12 HRY Histogram percent 100 y 90 80 ms 400 600 800 1000 1200 1400 1600 1800 2000 conn RR 1240ms 0 of 58623 Intervals REM gt gt Figure 10 23 HRV Histogram gt To activate HRV Histogram 1 From the Main menu select the Patient Data key to access the Patient Data menu 10 34 Mennen Medica Menntor 7 Operating Manual 2 Inthe Patient Data menu click HRV Histogram Patient Data 3 Set end date and time 4 Select duration 5 Click Show Histogram Note Minimal Histogram time is 5 minutes Mennen Medical 10 35 Reviewing Patient Data Menntor 7 Operating Manual 10 36 Mennen Medica 11 PERFORMING CLINICAL CALCULATIONS The Menntor X7 Clinical Calculation package
65. non condensing e Degree of protection Type BF Applied part EN 60601 1 60601 1 2 60601 2 26 0473 DGM 781 001 Rev 11 2014 5 5 4 INSTALLATION AND SETUP Unpacking and Inspection Before unpacking the Menntor X7 bedside monitor the packaging should be visually inspected for any signs of damage or abuse which may have resulted during shipment If any signs of external damage are visible you should contact your nearest Mennen Medical agent before proceeding to unpack the unit Failure to do so could invalidate the warranty During unpacking each item should be unpacked carefully and should be visually inspected for any signs of damage which may have resulted during shipment All components should be checked against the packing list to confirm their availability Should any damage be apparent or any part found missing contact your Mennen Medical agent immediately Do not attempt to set up the system if any damage to a component is apparent Setting Up the System The Menntor X7 is a modular monitor with integrated display and optional recorder The basic system consists of the host monitor the Multi Parameter Module MPM and optional EtCO2 and Spirometry modules It is supplied with accessories according to the invasive or non invasive model The monitor can be placed either on top of a shelf on a mobile cart or on a wall mount A variety of di
66. or in the letter or number area Capital Letters When pressed letters are in capitals below the numbers Clear Clears the text box center of panel below letter buttons Undo Last Key Clears the last input character below the letters to the left Accept Saves input changes and closed panel bottom right corner of panel Cancel Changes Closes panel without implementing changes to the left of the Accept button Two text boxes One for the name of the field being changed One for the field itself bottom left of panel Moving Between Panels Move between panels by e Selecting navigational keys in the panel that allow you to move to a higher level panel or to access another panel on the same level e Exiting the panel and returning to the main screen display You can then select a new panel by using the on screen buttons or via the Main menu Use the QuicKnob to access the box above the ADT box top left and open the Main menu 6 14 Mennen Medica Menntor 7 Operating Manual Common Panel Features none enODA911 Main Screen Button Menu Title Alarm Limits A lt 4 Drop down menu Slider Bar n LLL li uli dim lim nmm un mmi Checkbox Button Figure 6 8 An Example of a Dialog Panel Each panel except keyboard panels shares the following common features Mennen Medical M
67. or 10 seconds The factory default is set to 5 seconds e Units Defines the default units used to measure and display temperature The available options are mmHg or kPa for Tc PO2 Tc Co2 The factory default is mmHg The sensor temperature unit options are Celsius or Fahrenheit The factory default is Celsius e TcGas Default Color Defines the color in which TcGas values appear on the main screen display You can choose from 16 available colors D 42 Mennen Medica 7 Operating Manual oe EE Extended Alarm Response Priority teGas Clinical C2 Fault T2 teGas Units t 1 Der Hite rH Alarm Detection Delay 5 sec Latching Off es teGas Default Color w Figure D 18 The TcGas Dialog Panel gt To set TcGas parameters 1 From the System Setup menu select Vital Signs Setup The Vital Signs menu is displayed From the Vital Signs menu select TcGas Setup The TcGas Setup dialog panel is displayed Under Extended Alarm Response e Set the default priority level for TeGas alarms e From the Latching drop down list set default alarm latching to On or Off From the Alarm Detection Delay drop down list select the required delay time in seconds From the TeGas drop down list select the required default measurement unit mmHg or kPa Select the required default measurement unit Celsius or Fahrenheit from the Sensor Temperature units d
68. sure that the Menntor X7 is correctly configured for pediatric readings due to the lower overpressure level used CAUTION While in normal use it is not possible to connect the Male Luer Mennen Medical Lock connector of infusion sets into the Female Luer connector of the NIBP hose there are situations and accessories that will enable the possible connection of the female Luer at the end of the NIBP hose to an infusion set inserted into a vein This could deliver air into patient s venous system resulting in a potentially lethal air embolism The NIBP hose has different color and texture to standard infusion sets which are normally clear to allow visibility of the infused fluid Users of NIBP systems are warned to take care and 21 3 Non Invasive Blood Pressure NIBP Menntor 7 Operating Manual instruct the medical staff nurses and doctors about the risk involved 21 4 Mennen Medica Menntor 7 Operating Manual Monitoring Procedures The NIBP menu provides access to all the specific dialog panels enabling interaction with all aspects of NIBP monitoring Each dialog panel enables control of different aspects of NIBP monitoring short description of the panels in the order they appear on the NIBP menu follows Mennen Medical NIBP Start Measurement A Start NIBP button is present in the NIBP menu to begin NIBP measurement This Start NIBP button can also be made into a QuicKey if desired Read
69. tor To delete a patient from the list 1 Select the patient row this opens a list of the following options Delete to delete the patient from the list Sort the list or e Close Note The data of a patient that is deleted from the list is LOST and cannot be retrieved Touch Screen Calibration Select the Touch Screen Calibration item A blank screen will appear Follow the instruction and touch the screen corners At the end of calibration press Main Screen Demo Activation D 78 The Menntor X7 monitor has a Demo Mode where signals stores in the system can be viewed and almost all features of the monitor can be demonstrated The following vital signs data will be used in Demo Mode e 12 lead ECG 80 ST 2 0 1 5 Filter ST e Respiration RA LL 19 BPM e PAP waveforms and vital signs e SpO2 96 Pulse 70 76 EtCO2 0 to 5 0 to 39 mmHg Respiration 17 BPM Mennen Medica 7 Operating Manual e Temp Temp 35 C Temp2 31 2C Temp3 36 8C Temp4 37 0 C Temp3 e Temp4 0 2C Not Available Cardiac Output NIBP Arrhythmia Patient Clinical Data Waveforms Vital Signs Bit to Bit amp QRS source will be two minutes of recorded signals data played in continuous loop gt To start Demo Mode Discharge the patient Enter System Setup Select Demo Mode from System setup menu 1 2 3 4 Enter password 517 5 Admit a patient 6 Monitor g
70. 0 monitoring 1 From the N20 or Agent menus or if you are already in another O5 N5O or Agent panel from the drop down list below the title area select Activate The Activate panel opens Select the Activate checkbox to activate or N20 monitoring By default N5O Agent monitoring is activated Press Gas Name O2 N20 or Agent to close the panel and return to the Gas Name menu press Main Screen to close panel and return to main screen display Activating Anesthetic Agent Monitoring You can instruct the Menntor X7 to begin monitoring only when it detects the agent Once the agent is detected its name appears in Agent menu gt To activate or deactivate Agent monitoring 1 25 16 From the Agent menu if you are already in another Agent panel from the drop down list below the title area select Activate The Activate panel opens Select the Activate checkbox to activate Agent monitoring Mennen Medica 7 Operating Manual QC 3 ISMITHADAM Agent 3 1 Activate F Activate Site Name Auto Detect Figure 25 10 Agent Activate Panel 3 Press Gas Name O2 N20 or Agent to close the panel and return to the Gas Name menu or press Main Screen to close the panel and return to the main screen display MAC Minimum Alveolar Concentration The Minimum Alveolar Concentration MAC is the alveolar concentration of an inha
71. 1 Patient Preparation Checklist OR eee CERES EORR ster 22 2 Monitoring Procedures 2 ed tel eat e etate ie OH Pb uL a uode e Pee Lien 22 5 Accessing the SpO2 Menu egeo ied eek 22 6 Setting SpO2 Alarms e ea Pete et P Efe EET Stan 22 6 Setting SpO2 Display Options nte tree net Liebe EE E ese i e eite 22 11 Activating and Setting SpO2 Pulse Tones eese eene nent nennen enne nennen 22 12 Setting SpO2 Response Time eerte eet ertet reris EKO e HRS REPE Qo ee 22 14 Activating SpO2 Monitoring es iei ee OR ge ede ee s eee 22 15 Masimo Technology 5 egeret tate pete RP e ef tede PE RU reru 22 15 Mennen Medical V 7 Operating Manual SpO2 Specification oon user texere Cere ene oak 22 17 Chapter 23 End Tidal CO2 EtCO2 Microstream MicroPod Principles of Operation eee een eee 23 1 Intended Use Are EAST 23 2 Microstream EtCO2 Circuits erc p e i edet n een edere vie e ne be ete edes 23 3 Using the MicroPod M 3 noe per e eM eben mci E HERE e epe to 23 4 Patient Preparation Checklist 1 nhe ue i iae ce heteste 23 5 Cautions and Warnings ergo GI MO einai adi eee aie 23 5 Interfeting Gasses cce een tete oh e Re e t n te RE ee E 23 5 Cleaning es os eed Ld etae Oe ado ett Siete oe e p C E PE rU red een 23 6 Calibration T ert 23 6 Sides
72. 100 mm Hg RAP 0 to 50 Mean 0 to 100 mm Hg LAP 0 to 50 Mean 0 to 100 mm Hg ICP 0 to 100 Mean 0 to 100 mm Hg BPx 0 to 300 Systolic diastolic and mean all 0 to 300 mm Hg Mennen Medical 18 7 Invasive Blood Pressures BP Menntor 7 Operating Manual RICU BED Main Screen BP 1 4 2 eT ET soo 150 275 100 250 225 200 175 150 125 100 75 Tiri dnm Auto Set AILBP Alarms to Defaults Figure 18 3 The BP Alarm Limits Dialog Panel gt To set BP alarm limits 1 From the BP menu or From the drop down list below the BP title area in the BP panel select Alarm Limits 2 From the Select Type drop down list select the type of BP for which you wish to set alarm limits 3 Selectthe BP Alarms checkbox to activate or deactivate both high and low limit alarms When deactivated alarm detection is disabled and the slider is disabled 4 Using the QuicKnob M set the left marker on the slider bar to the required high alarm limit for the current BP then set the right marker to the required low alarm limit These limits are displayed in the High and Low Limit value areas on the panel or Press Auto Set to Defaults to automatically set alarm limits to default values 18 8 Mennen Medica Menntor 7 5 Press BP to return to the BP menu Press Main Screen to return to the main screen display Note Checkboxes appear gr
73. 14 10 14 20 14 25 1430 1311 Duration a EL 30 Minutes ps E SOT Figure 10 2 The Trends Panel gt To operate the Trends Display panel 1 From the Main menu select the Patient Data key to access the Patient Data menu 2 From the Patient Data menu When the Patient Data panel is already displayed from the drop down menu below the panel title select Trends 3 Select up to four or eight vital sign parameters one from each of the colored Parameter drop down lists The selected parameters appear on the graph in the color of the drop down list from which they were selected 4 From the Duration drop down list select duration time for the trend Mennen Medical 10 3 Reviewing Patient Data Menntor 7 Operating Manual 10 11 12 13 14 15 Toggle the 1 Axis button to display up to 4 parameter trends of the vital signs Toggle the 2 Axes button to display up to 8 parameter trends of the vital signs Press the Autoscale button to autoscale the displayed section Press Scroll Right to scroll the trend display forward and Scroll Left to scroll the trend display backward in steps of one third of the trend duration For example if the trend duration is two hours pressing Scroll Right scrolls the trend forward by 40 minutes To hold segment of the trend do the following Enable the cursor and place it at the center of the segment see Step 11 b Use the QuicKnob to sele
74. 20 H20 PLTP 6 cm Minute Volume VE SYSTOLIC DIASTOLIC MEAN Static Pulmonary Compliance SCOMP ART 160 100 130 JmmHs Dynamic Pulmonary Compliance PAP 55 35 45 JmmHg Dead Space val 145 155 CvP 10 PCWP 5 mmHg DeadSpace Tidal Volume vov Alveolar Ventilation VA 0 3 VT 7 ml SP 2 95 40 Limin EtCO2 9 mmHg 8 00 5 mmHg pacal6 mmHg 14224 DATE 06 22 99 Figure 11 3 Respiratory Mechanics Panel 4 Manually enter all missing data and update any existing values if necessary Calculated values appear on the right side of the panel Out of range values appear on red background 11 4 Mennen Medica Menntor 7 Operating Manual Click the Accept button to save calculations and exit the screen The results of the measurement and calculations are saved in the Respiratory Mechanics chart You can access the results from the Charts option in the Patient Data menu Oxygenation Calculations In the Oxygenation panel you can view monitored oxygenation data and perform clinical calculations gt To perform Oxygenation calculations 1 2 3 RSP 12 BPM On the Menntor X7 Main menu press the Patient Data key In the Patient Data menu select Calculations In the Calculations menu select Oxygenation The Oxygenation panel opens displaying the patient s monitored data Calculations Oxygenation Accept i2 1
75. 25 15 zo 07 06 10 42 120 95 108 25 15 20 oros 10 41 120 95 108 zs 15 zo 07 06 10 10 120 95 108 25 15 20 07 06 10 39 120 95 108 25 15 20 07106 10 38 120 95 108 25 15 20 07 06 10 37 120 95 108 zs 15 zo 07 06 10 36 120 95 108 25 15 20 07106 10 35 120 95 108 25 15 20 07 06 10 34 120 95 108 25 15 zo 07106 10 33 120 95 108 25 15 20 07 06 10 32 MISMO 120 95 108 25 15 0706 10 31 120 95 108 25 15 zo 07 06 10 30 120 95 108 25 15 20 07 06 10 29 120 95 108 25 15 zo 07 06 10 28 120 95 108 25 15 20 07 06 10 27 120 95 108 25 15 zo 07 06 10 26 120 95 108 zs 15 zo 07 06 10 25 120 95 108 25 15 zo Signature Figure 10 17 Chart Report Mennen Medical 10 27 Reviewing Patient Data Menntor 7 Operating Manual Trend Report Up to eight graphic trend parameters can be included in each Trend report Any of the vital signs can be shown in the trend graphs Smisth Lohn 007 TEST VL 2 07 06 06 11 02 MM Hospital REPORT 2 HRT BPM STA mmST 50 5 0 00 183 4 0 00 135 4 0 00 78 4 0 00 20 0 00 ART mmHg 300 4 225 4 150 4 75 4 0 iJ 1 1 PAP mmHg 300 5 225 150 75 0 I 1 TMP1 C 45 40 35 30 25 4
76. 3 0 Display Options SpO2 can be displayed in Waveform Big numbers and Secondary other parameters are displayed as Big numbers or Secondary Sensors original Masimo sensors LNOP LNCS and M LNCS work on Radical 7 Sensor categories Mennen Medical 29 3 Radical 7 Masimo CO Oximeter Menntor X79 Operating Manual e Masimo SET adhesive and reusable sensors e Masimo rainbow SET adhesive and reusable sensors e Masimo ReSposable sensor system Note For detailed information contact your Masimo representative 29 4 Mennen Medica CHAPTER 30 CEREBRALOGIK aEEG AND EEG Introduction The CerebraLogik system is Menntor X7 module designed to monitor EEG and display long term Amplitude Integrated EEG aEEG The Menntor X7 monitor uses the CerebraLogik front end amplifier to record two channels of EEG The CerebraLogik is stand alone unit to be attached to basinet or patient bed Its interface cable is connected to the UIM input of the monitor and can be activated via the UIM menu The EEG display shows real time EEG with history of EEG compressed as Amplitude Integrated EEG aEEG showing 3 hours of EEG CAUTION It is not allowed to connect the interface cable to any equipment other than Menntor X7 monitors Indications for Use The intended use of the CerebraLogik is to monitor the state of the brain by acquisition of EEG signals and display the stored EEG in compressed form of
77. 51 7 Operating Manual gt To set default Ventilator parameters 1 oes us m om From the System Setup menu select Vital Signs Setup The Vital Signs menu is displayed From the Vital Signs menu select Ventilator Setup The Ventilator Setup dialog panel is displayed Under Extended Alarm Response Set the default priority level for Ventilator alarms e From the Latching drop down list set default alarm latching to On or Off From the Alarm Detection Delay drop down list select the required delay time in seconds Select Ventilator Default Color A panel displaying all available colors appears Select the required color Select Discard Changes to close the panel without applying any changes Select Main Screen to apply the changes and exit the panel Note When you exit a vital signs setup panel you return to the main screen To continue System Setup you must press the System Setup button again to access the System Setup menu Parameter Hierarchy Note This dialog panel is active only when a patient is being monitored The Parameter Hierarchy panel enables you to set the waveform and big number display on the monitor screen from top for high hierarchy to bottom for lower hierarchy D 52 Mennen Medica 7 Operating Manual Figure D 24 The Parameter Hierarchy Setup Panel gt To set the Parameter Hierarchy panel 1 le oq From t
78. 6 ST analysis Toggle on green if you wish ST to be functional or off to prevent activation of ST measurement 7 From the Alarm Detection Delay drop down list select the required delay time in seconds 8 Select ECG Default Color panel displaying all available colors appears Select the required color The panel closes 9 Select Discard Changes to close the ECG Setup panel without applying any changes or Select Main Screen to apply the changes and exit the panel Note When you exit a vital signs setup panel you return to the main screen To continue System Setup you must press the System Setup button again to access the System Setup menu Respiration Setup D 26 This dialog panel enables you to set Respiration default parameters These parameters include eAlarm priorities for Resp Rate Apnea and alarms Alarm priority affects the order of audible and visual alarm notification See Alarm Priority on page 8 4 for a full description of this feature Resp Rate Apnea and alarm priority can be set at a level of C 1 C 2 or C 3 The factory defaults are as follows Resp Rate C 2 Apnea C 2 eAlarm Latching For a complete description of Alarm Latching see Latched Alarms on page 8 7 The available options are Off Visual latching visual alarms only and On both visual and audible alarms The factory default is Off eAlarm Detection Delay When an alarm is detected a pre defined delay period al
79. 64 Clinicians are also recommended to maintain current knowledge of FDA or other federal based regulatory practice or research information on BIS and related topics 27 2 Mennen Medica Menntor 7 Operating Manual Cautions BISx Read this entire chapter carefully before using the monitor in clinical setting Do not autoclave the BISx Autoclaving will seriously damage the BISx components Do not open BISx for any reason The seal to prevent liquids from entering the BISx may be damaged if opened Service or repairs must be performed only by qualified biomedical technicians The BISx and the Menntor X7 BIS input were designed to operate with BIS sensor The sensor is a silver silver chloride electrode array that utilizes Covidien s patented Zipprep technology and uses proprietary connector Use of other electrodes is not recommended Continuous impedance checking may need to be disabled if the I nanoampere 128 Hz impedance check signal interferes with other equipment e g evoked potential monitors Take care when connecting the BISx to the BIS input to prevent damage to the connectors Before connecting the BISx to BIS input check the BISx and it s cables for any signs of deterioration CAUTION Clinical judgment should always be used when interpreting the BIS in conjunction with other available clinical signs Reliance on the BIS alone for intra operative anesthetic management is not recommended As with any
80. Agent for routine verification recommended mixture is CO2 5 N20 40 balanced with O2 55 This mixture can be supplied in high pressure bottles After performing the test with this gas mixture without an Agent the test should then be performed with a mixture containing an Agent Mennen Medical 24 3 Multigas Anesthesia Analyzer Menntor 7 Operating Manual gt To perform Span Verification Use Pump Speed Adult 120 ml min gas sampling flow Set the flow from the bottle to 150 ml min Connect the span gas bottle to the water trap input Purge for about 30 seconds until measurement has stabilized Compare monitor reading with calibration gas setting Turn off the span calibration gas Pump room air through the sampling gas path to clear the anesthetic gases Sy CON cue Go ee If validation has failed call your service technician Gas Delivery Alternative Methods For alternative methods to the calibration gas delivery system please contact your Mennen Medicalrepresentative Precautionary Environmental Considerations e O2and CO2 at the concentrations required for calibration are non toxic gases that can be spread in the working room e 2 in concentrations above 20 may be flammable prevent contact with oil high temperature such as solder iron smoking or open flame e Anesthetic gases should not be spread in the in house environment Evacuate anesthetic gases out of the building
81. BIS Menu There are two ways to access the BIS menu From the Vital Signs menu From the main screen display 27 10 Mennen Medica 7 Operating Manual gt To access the BIS menu 1 From the main menu select Vital Signs The Vital Signs menu appears 2 From the Vital Signs menu select BIS The BIS menu is displayed gt To access the BIS menu from the main screen display 1 Turn the QuicKnob until the BIS parameter key is highlighted and press to display the BIS menu Setting BIS Leads and Gain Select the required lead and gain for monitoring respiration in the Lead Gain dialog panel e Lead display selection One 1 or two 2 EEG leads can be displayed e Gain Control Select either 5 10 25 50 or 100 u V cm BIS enABOO4F BIS 5 1 Lead amp Gain H ere s 4 1 5 ir Figure 27 4 The BIS EEG Lead Gain Dialog Panel gt To set EEG leads and gain 1 From the BIS menu if you are already in another BIS dialog panel from the drop down menu list below the Mennen Medical 27 11 BIS Bispectral Index Menntor 7 Operating Manual BIS title area select Lead Gain 2 Select either I or 2 EEG leads as required Only one option can be selected 3 Set the required gain The available options are 5 10 25 50 or 100 uV cm 4 Setthe Smoothing Rate 10 15 30 second Default is 15 seconds For ICU it is recommend
82. CO2 ETCO2 MICROSTREAM MICROPOD Overview During respiration oxygen is brought to the body s cells from the atmosphere Carbon dioxide is produced by the body during cellular metabolism It is removed from the body and expelled to the atmosphere by the cardiopulmonary system The concentration of carbon dioxide in respiratory gas is measured to provide a noninvasive means of assessing conditions affecting cellular metabolism and the cardiopulmonary system Two EtCO2 options are available Microstream plug in EtCO2 module and MicroPod external EtCO2 unit connected via the UIM input WARNING Before making decisions on treatment of blood gas check blood gases using a calibrated Gas Blood Analyzer Use the monitor alarms and abnormal value as a indication for further check Principles of Operation The monitor uses Microstream non dispersive infrared NDIR spectroscopy to continuously measure the amount of CO2 during every breath the amount of CO2 present at the end of exhalation EtCO2 and during inhalation FiCO2 and the Respiratory Rate The Microstream EtCO2 circuits deliver a sample of the inhaled and exhaled gases from the ventilator circuit or directly from the patient via an oral nasal cannula into the CO2 measurement sensor Moisture and patient secretions are extracted from the sample while maintaining the shape of the CO2 waveform Mennen Medical 23 1 End Tidal CO2 EtCO2 Microstream MicroPod Mennto
83. Capabilities csie enit tite tede eiTe eie E E PNE EE o reped 3 2 Mennen Medical i 7 Operating Manual System Specifications n odd ein een et eati Dt E n e E samba 3 7 Chapter 4 Installation and Setup Unpacking and Inspection vann n ee ce eee dei eo ede ede dte e dta 4 1 Setting Up the System detecte e ede Re ec dates 4 1 Installation Procedutes des ere etre rm et YER Ee ee be pe 4 1 Chapter 5 Maintenance and Cleaning Cleaning the Menntor X7 Bedside Monitor eese nnne nnne 5 1 Calibration and Preventive Maintenance sese 5 2 Battery Conditiotitig en t e i Ete e e pee poet b bee 5 3 Equipment End of life irre Rer er ete E HE ee Ret pastes 5 3 Chapter 6 Controls and Functions juna ENT 6 1 eR ee LR Re Re ect dre herede Dent 6 2 Power Interruptions eed a tete em Pede eee teet beet Ls ee ts ees 6 2 Mai Screen Display Features eiit eee oe eee ben e ree ote riene 6 3 Mam Proc ssing Unit PL t Peur e ee Pe eerte Heu eite eese d ie boc ien 6 8 Working With Menus and Panels 00 0 0 eterne nennen nennen 6 12 Section 2 Patient Monitoring Procedures Chapter 7 Setting Up the Patient Display Display Controls eee RR RU E ti ee decr E eren 7
84. D 13 The Temperature Dialog Panel gt To set default Temperature parameters 1 From the System Setup menu select Vital Signs Setup The Vital Signs menu is displayed From the Vital Signs menu select Temperature Setup The Temperature Setup dialog panel is displayed Under Extended Alarm Response e From the Temp drop down list set the default priority level for temperature alarms Mennen Medica 7 Operating Manual e From the Latching drop down list set default alarm latching to On or Off 4 From the Alarm Detection Delay drop down list select the required delay time in seconds 5 From the Units drop down list select the required default measurement unit Celsius or Fahrenheit 6 Select Temperature Default Color A panel displaying all available colors appears Select the required color 7 Select Discard Changes to close the panel without applying any changes Select Main Screen to apply the changes and exit the panel Note When you exit a vital signs setup panel you return to the main screen To continue System Setup you must press the System Setup button again to access the System Setup menu CritiCool Setup This dialog panel enables you to set CritiCool Pro default parameters These parameters include neonatal and adult default settings and temperature units Figure D 14 show the CritiCool setup panel C en0F3420 SPEM 1 z Bis 365 p m 330 365 o2 j
85. Delete When you press Delete the curve is removed from the C O calculations and from the central graph and the button label changes to Restore When you press Restore the curve is returned to the central graph and included in the C O calculations and the button label changes to Delete All trials are automatically averaged If the Menntor X7 is connected to a printer the data can be printed out Main Screen GOnth Curve4 7 7 HRT 35 59 60 ART 115 77 89 36 34 149 11 CO 7 8 CI 25 6 PAP 37 89 8 8 HRT BSA 3 04 60 SV 130 0 PVR 51 4 SVI 42 8 156 4 89 ART 115 76 89 60 14 9 11 PCWP 6 Curve 6 tameo HRT 60 ART ART 115 76 amp 1 NUT 89 Measu ent Measurements 89 PAP PAP 149 149 11 11 Figure 19 2 The Cardiac Output Edit Curves Panel Mennen Medica Menntor 7 Operating Manual gt To edit curves 1 Mennen Medical From the Cardiac Output menu or if you are already in another Cardiac Output panel from the drop down menu below the panel title area select Edit Curves or if you are already in the Acquire panel select Edit Curves Press Delete to remove the selected curve from the central graph and remove the associated data from C O calculations The curve is dimmed the graph background is grayed
86. Device IF Mout Baud Rate 19200 Parity None Stop Bit 1 e Data Bit 8 Flow Control 2 Sec 4 Press Return gt Toenter Demo Mode Select the Status box lower left Select Display Setup Turn Demo mode to Enable Enter Patient data Select CO Select Zero Arterial Pressure SJON GE 995 punit Wait several minutes Demo mode starts Mennen Medical E 1 gt To enter Engineering mode 1 Select the Status box lower left 2 Enter Password 8888 Engineering mode starts Menntor X79 Operating Manual Mennen Medica APPENDIX TEST PROCEDURE Serial Number Unit P N Tested By Date Table 1 Par Subject Description Specifications Measured Result value Pass Fail 1 Visual Inspection UUT without Cover Check all connectors Cables screws Dust Connect the UUT to the main power and to display only the cover is open 2 Main power Fans Batteries Leakage Mounting testing 2 1 Connect main led in Green O K power cable amp Bat 1 Led is Green O K Press main power Blinking Permanent switch torlsec System is stating to be O K loaded Led on main switch is O K on 2 2 Disconnect the AC Charger Led is Red O K line AC led is off System is running O K O K Mennen Medical F 1 7 Operating Manual
87. Disposable NeoPT Neonatal Probe for sensitive skin 20 Box 551 339 003 Foam wrap for NeoPT Sensor 12 PKG 551 339 053 Tapes for Neonatal Adhesive Sensor 100 PKG 551 339 054 Table 13 EtCO2 Microstream Accessories Item and Description Part Number P N Filter Line H Set Adult Pediatric 25 Pak 800 060 141 Filter Line H Set Infant Neonatal 25 Pak 800 060 142 CAPNO Nasal Line H Adult 25 Pak 800 060 143 CAPNO Nasal Line H Pediatric 25 Pak 800 060 144 CAPNO Nasal Line H Infant Neonatal 25 Pak 800 060 145 CAPNO Nasal Line H O2 Adult 25 Pak 800 060 146 CAPNO Nasal Line H O2 Pediatric 25 Pak 800 060 147 A 8 Mennen Medica APPENDIX TROUBLE SHOOTING If you have any problems or the setup procedure does not function as described check the appropriate table as follows ECG Respiration Monitoring Table B 1 ECG Respiration Monitoring Problem Probable Cause Corrective Action No display 1 The system is not plugged in and switched on 2 The ECG Resp cable is not inserted correctly 3 The Display is broken 1 Check that the system is plugged in and switched on 2 Check that the ECG cable is correctly inserted 3 Call Mennen Medical Service ECG Cable Out message instead of HR Resp numerics 1 The ECG cable is not connected 1 Check that the ECG cable is connected Lead fault or All lead fault 1 One or more electrodes are
88. Event e Enter Full Disclosure or Overview or Chart or Trend e Exit 15 To display the ST trend starting at a selected time and date do the following Press Go to then Date and the Time and then once again press Go to 16 From the Patient Data drop down menu select Charts Full Disclosure or Overview The ST trends panel closes and the selected panel opens displaying data for time synchronized to the last cursor location in the ST Watch panel 17 Press Main Screen to return to the main screen display STS Area Calculation The ST Watch feature enables the user to measure the Area under the ST Sum ST Ave or STVM Trend Curve Duration of area calculation Use the Scale panel to select the duration of the Area calculation between and 8 hours Mennen Medical 10 11 Reviewing Patient Data Menntor 7 Operating Manual Charts Starting point Set the starting point for Area calculation by creating an Event with name starting with the letters AREA For example AREA or AREA1 or AREA Treatment The Area under the curve will be calculated in units of mm x minute It is possible to mark several area sections not overlapping View Area calculation results To view the Area you have to insert the cursor into the area of integration The value of the Area displayed will be for the whole period of integration either as set in the scale panel or if the integration time has not ended for the
89. Figure 12 1 Medication List gt select a medication Mennen Medical Turn the QuicKnob clockwise or counterclockwise until you reach the required drug The drug is now highlighted Press in the QuicKnob to select the drug A window appears for the drug allowing a choice of function to be performed Infusion Rate calculation Drug Concentrate calculation Injection Amount calculation or the selection of another drug These functions are detailed in the following sections 12 3 Performing Medication Calculations Menntor 7 Operating Manual Using The Medication Calculation Panels For each calculation whether infusion rate drug concentrate or injection amount calculation the Menntor X7 requests that you enter specific parameters relevant for the calculation For example patient weight desired dose rate etc gt To enter the required parameters 1 In the Medication calculation panel turn the QuicKnobTM until you reach the required parameter The area is highlighted Press the QuicKnob to select the area Turn the QuicKnob to set the required value unit of measurement and press again to accept the entry and advance to the next parameter Upon entering all parameters you can execute the calculation operation The following buttons and functions appear in each of the Medication calculation panels Calculate Executes calculations and displays results according to the selected function Drug
90. If ECG is deactivated the following ECG sub parameters is not available ST Arrhytmia PR QT The following ECG related menu items are dimmed and inactive ST Watch entry e ECG Full Disclosure e HRV Histogram The monitor stores Heart Rate from SpO2 or ART in Charts Mennen Medical 14 1 Menntor 7 Operating Manual QRS Detection Mennen Medical QRS detection algorithm is based on the characteristics of the QRS morphology and thus eliminates the sensing of T waves Beats are marked as Normal or Ventricular and these QRS marks are used for arrhythmia detection and alarms ECG LED Indicator The LED indicator on the front panel describes the following functions Status Indication LED is green and blinking QRS detected LED is red and blinking Passive lead fault LED is red and on all fault or active lead fault error detected Patient Preparation Following are the accepted procedures for positioning ECG electrodes Optimal placement sites may vary from patient to patient depending on physiological characteristics and condition In many cases you can improve received ECG signals by repositioning one or more electrodes Chest placement of electrodes provides the best results since there are fewer skeletal muscles to cause artifact When placing the electrodes on the patient take care to avoid areas of pressure Skin breakdown may occur if the patient lies on the ECG electrodes or
91. Lead ECG cable only 551 306 019 Mennen Medical A 1 Menntor 7 Operating Manual Table 1 ECG Accessories Item and Description Part Number P N Set of 10 Lead wires with block Mini Clip 551 306 031 Set of 10 Lead wires with block Grabber Clip 551 306 135 European Color Code 3 Lead ECG Kit Adult Snap 551 306 280 3 Lead ECG Kit Mini Clip Pediatric 551 306 281 3 Lead ECG Kit Grabber Clip 551 306 285 3 Lead ECG Cable only 551 306 216 3 Lead Cable DIN for pre wired electrodes Neonatal 551 306 316 Set of 3 Lead wires with Block Snap 551 306 224 Set of 3 Lead wires with Block Mini Clip Neonatal 551 306 228 Set of 3 Lead wires with Block Grabber Clip 551 306 332 5 Lead ECG Kit Adult Snap 551 306 290 5 Lead ECG Kit Mini Clip 551 306 291 5 Lead ECG Kit Grabber Clip 551 306 293 5 Lead ECG Cable only 551 306 217 Set of 5 Lead wires with Block Snap 551 306 225 Set of 5 Lead wires with Block Mini Clip 551 306 229 Set of 5 Lead wires with Block Grabber Clip 551 306 333 10 Lead ECG Kit MiniClip 551 306 250 10 Lead ECG Kit Grabber Clip 551 306 370 10 Lead ECG cable only 551 306 219 Set of 10 Lead wires with block Mini Clip 551 306 231 Set of 10 Lead wires with block Grabber Clip 551 306 335 A 2 Mennen Medica 7 Operating Manual Table 2 BP Accessories
92. Loop control panel One or two loops can be displayed simultaneously from three options Flow Volume Pressure Volume E Flow Pressure The loops overlap and are refreshed after 1 to 20 respiratory cycles Mennen Medical 34 9 Spirometry Menntor 7 Operating Manual om37020 T Lew Loopi yame 100 1000 vm 0 0 Refs 3 E Loop Figure 34 8 Display Options Loop 2 Select Loop 1 and select the required loop The Default is Flow Volume Set the required scales 4 Set the number of respiratory cycles refresh The Default is 3 Select Loop 2 and select the required loop The Default is Pressure Volume 6 Setthe required scales 7 Set the number of respiratory cycles refresh The Default is 3 Set WF gt Toaccess the Set WF panel 1 Select Set WF from the Spirometry menu in order to display the Set WF control panel 2 Set the sweep speed the default is 6 25 mm s 3 Select the following display features Grid Breath symbol 34 10 Mennen Medica Menntor 7 Operating Manual The color green in the display features indicates active grey indicates inactive 4 Select the number of channels you want to display from 1 to 3 5 Setthe waveform parameters and colors for channels 1 to 3 6 Setthe scales for channels 1 to 3 or use auto scale The following parameters are displayed with the waveform
93. MPM out of host When pulled out of the host Menntor X7 the MPM continues to monitor the patient without interruption and without reconnecting of cables or transducers The MPM is equipped with battery and memory and stores patient vital signs during the transport It provides data continuity by enabling downloading of the stored patient data when returned to Menntor X7 host monitor General Description The MX57 D MPM includes the following e 5 7 LCD display e 5 Hardware keys Silence Start Stop NIBP Zero BP Mark Event ON OFF e Battery charged by the host to cover 180 minutes of use out of the host When returned to the host Menntor X7 the MPM downloads the data collected during the transport back to the host MPM in Host While in the host the MPM stores the following e Patient demographic information e Monitored Vital signs 33 2 Mennen Medica Menntor 7 Operating Manual ECG and respiration leads Alarm limits Alarm response Patient Type Adult Neonatal MPM During Transport For the duration of the transport MPM stores the following Demographics waveforms numeric VS in 1 second resolution Technical and clinical alarms RR intervals and QRS shape identification V b Arrhythmia Event upon alarm per the alarm response Manual Events MPM Service Messages The following service messages are displayed according to the system status Note Themessages and the patient na
94. Medica Menntor 7 Operating Manual Patient Data mmmmmmmmm KAM Vu M L n M n i I M LL HEGEL Ad ku Adda kh kh Ay ud MM AM Ir TR AMAA MAMMA MM n Mi l M AMAA MALLA ni l dd HAMM AAA M m n ALMA M M n MMA RAR AM M M AMA AMA MJ n TY er In Page Overview 7 NY Down Tu data time span 20 11 17 34 zii 15 24 M M AM MA A M i hv mm hk ii m Ay 1 ili i did n M n n MAMMA CG Gain Box Figure 10 10 The Ten Minute Display Panel The waveform for the lead listed in the ECG box is presented over ten lines of one minute each The gain factor for the display appears in the Gain box The waveforms are color coded to help you easily locate areas where alarms were triggered White indicates no alarms were triggered Green indicates a technical alarm and red indicates a clinical alarm The Date and Time boxes present the date and start time of the waveform The time span of the patient s waveform data as stored in the Menntor X7 s memory appears in the bottom right corner of the panel To operate the Ten Minute Display panel 1 Tochange the displayed lead select a different lead from the ECG drop down list 2 To change the gain factor of the display select a differe
95. Mennen Medica Menntor 7 Operating Manual FAQs Why are FilterLine amp H Sets for neonates preferable to other endotracheal tube adapters i e RSP adapters with side port The FilterLine set airway adapter s multiple channel design permits it to be used in any orientation and prevents the sampling line from occluding with water or patient secretions RSP adapters are more prone to occlusion because sampling port is located on the adapter wall FilterLineQ H set for neonates is specially designed to fit all ET tube sizes RSP adapters come in several different sizes for neonates and you need to stock all sizes For neonates that are already intubated I m concerned that when I want to add a sam pling line using an RSP adapter I first have to remove the hub from the ET tube and replace it with the RSP adapter This is an uncomfortable and dangerous procedure for the child Will have that same problem using a FilterLine amp H set No The airway adapter fits easily into the ET tube hub There is no need to disturb the patient Warnings and Precautions WARNING The module should not be used as an apnea monitor WARNING The use of accessories transducers sensors and cables other than those specified may result in increased emission and or decreased immunity of the equipment and or system WARNING CO2 readings and respiratory rate can be affected by sensor application errors certain ambient environmental condit
96. Mennen Medica Menntor 7 Operating Manual Patient Safety Patient safety is assured by double isolation between the EEG input and the electrical power The double isolation prevents summation of leakage between the EEG electrodes and other applied parts CAUTION CerebraLogik is not intended for use during surgery and electro surgery rene 47 medical W ee Figure 30 1 CerebraLogik Module CerebraLogik is equipped with sockets for 5mm DIN connectors for use with disposable cup or needle electrodes with wires Use Grass Safelead Surface or Subdermal needle electrodes or equivalent The sockets are marked as Channel 1 Left Channel 2 Right REF The five sockets build 2 channels of EEG in the following matter The two Left inputs comprise Channel 1 marked as Left and the two Right inputs comprise Channel 2 marked as Right Both channels use the REF as a Reference point Both channels are differential with high common mode rejection thus preventing interference from devices such as pacemakers and peripheral stimulators Each EEG channel can be displayed on the Menntor X7 together with its corresponding aEEG channel Note The DIN connectors have protected female plugs thus preventing the possibility that the plug touchs any conductor other than the CerebraLogik sockets Mennen Medical 30 3 CerebraLogik aEEG and EEG Menntor 7 Operating Manual WARNING Use of electrodes tha
97. Menntor X7 without actually connecting patient set up monitoring parameters and then save them as Monitor profile i Monitor Profiles 52 Main OG ADULT PEDIATRIC ECG ART TEMP 1 TEMP 2 ECG ART PAP NIBP TEMP 1 TEMP 2 ECG ART PAP NIBP TEMP 1 TEMP 2 DELTA T2 T1 SpO2 CO PCWP CVP PAP DELTA T2 T1 SpO2 CO PCWP CVP PAP DELTA T2 T1 SpO2 CO PCWP CVP PAP Save Label Show Hide amp left Right gt Clear Select Key Figure D 25 The Monitor Profiles Setup Dialog Panel Monitor profiles are defined in the Monitor profiles panel which can be accessed from the Setup menu The keys are displayed on the panel in the order in which they appear on the Menntor X7 screen when admitting a patient Any defined Monitor profiles are labeled with their defined name and monitoring parameters To set up a new Monitor profile 1 Set up the monitoring parameters you want according to the instructions in the Vital Signs Monitoring section 2 the main menu select Setup and select Monitor Profiles from the Setup menu The Monitor profile panel is displayed Mennen Medica 7 Operating Manual 3 Press Select Key 4 Select an available key frame appears around the key and the buttons along ICU 859 m D Main System Setup Monitor Profiles Se Monitor Profile 1 Monitor Profile 2 Monitor Profile 43 Monitor P
98. Operating Manual Figure 32 1 Enscribe Network Recorder gt Toinserta paper roll into the recorder 1 Press the grey button top right The recorder door opens Figure 32 2 Enscribe Door Open 32 4 Mennen Medica Menntor 7 Operating Manual 2 Insert the paper roll with the paper coming from the bottom of the roll seret m grt renten MEN citati ral n Figure 32 3 Enscribe Paper roll insertion 3 Pull the paper above the door and close the door Insert fig Enscribe with paper Mennen Medical 32 5 Recording and Printing Menntor 7 Operating Manual Figure 32 4 Enscribe with paper 4 Pull short strip of paper The Enscribe is ready for strip chart recordings Built in Strip Chart Recorder 32 6 The Menntor X7 has an optional Built in strip chart 3 channel recorder It can record three channels of waveforms according to the System Setup Recorder Setup see Recorder Setup on page D 65 To send recordings to the Built in Recorder set the target recorder to the network recorder see Network Setup on page D 64 To activate a Manual Recording 1 Use the hardware Record key or Select Main menu 2 Select the Utilities menu 3 Press Record Note Alternatively you can create a Record Quickey and press it for Manual recording To activate Selective Recording 1 From the Patient Data menu choose Selective Recording Three options are av
99. Patient to Menntor X7 Menntor 7 Operating Manual 2 Press Discharge to stop patient monitoring and erase patient data The Menntor X7 is now ready to admit new patient or Press Cancel to cancel the discharge The Discharge Patient panel closes and you return to the main screen display 3 Press Main Screen to close the Discharge Patient panel and return to the main screen display Discharge erases all stored data Do you wish to Discharge Save amp Discharge Figure 9 3 The Discharge Panel Discharge Patient Discharge erases all stored data Do you wish to Discharge Discharge Figure 9 4 The Save and Discharge Panel To prevent merging data from different patients you must discharge the previous patient before admitting new patient warning message is presented if you try to change patient ID of patient name 9 8 Mennen Medica 7 Operating Manual when trying to admit new patient before the previous was discharged in order to protect from merging data of different patients Patient Identification Height 0 0 Weight 0 0 HIS BSA M 000 Name Last LAST Name First FIRST mip Patients In Transfer Date of Birth Discharge Patient Discharge before Admitting New Patient Rename Figure 9 5 Discharge before admitting new Patient warning message Note You can either Discharge the previous
100. QRS detection gt To get the best results in pacer detection 1 Select the Fixed mode when the pacer is active 2 Check each of the following leads consecutively I IL III V1 Note which lead gives the best pacer spike detection and select it 3 Move to Adaptive I and continue monitoring in this mode Note Use Adaptive 2 only when you have problem with noise Noise is manifested by spurious spikes which are gt To set the Pacemaker Detection panel 1 From the ECG menu Or not related to pacer action if you are already in another ECG dialog panel from the drop down menu list below the panel title area select ECG Pacemaker Detection The Pacemaker Detection dialog panel appears Mennen Medical 14 21 Menntor 7 Operating Manual 2 From the Pacemaker Source drop down list select either Fixed Adaptive 1 or Adaptive 2 The default selection is Adaptive 1 Select either I II III or V1 from Lead 3 Under Pacemaker Features Select the Pacer Spike checkbox to activate or deactivate this feature Select Enable Alarm to activate or deactivate Pacer Alarms 4 From the Pacer Pulse Colors drop down list select either Red or WF color The default color is Red 5 Press Vital Signs to return to the Vital Signs menu Or Press Main Screen to return to the main screen display Note Checkboxes appears green when activated and gray when deactivated Pacer Alarms 14 22 The Mennto
101. Radical 7 are Cable Out and Relocate Probe The alarm warnings of the technical problem appear in the following forms e Cyan background on the numeric vital sign area e Message in the alarm message area Audible alarm Note Relocate Probe is caused by low photo plethysmographic signal Calibration The Masimo sensors are factory calibrated and do not require calibration Monitoring Procedures 29 2 SpO2 refer to Chapter 22 Pulse Oximetry SpO2 for general instructions For all other parameters the menu is built from e Alarm Limits Use this panel to activate deactivate and set low and high alarm limits e Alarm Response Use this panel to define how the Menntor X7 responds to detected alarms Mennen Medica Menntor 7 Operating Manual e Display Options Use this panel to define how a parameter values appear on the main screen display e Activate Use this panel to activate or de active monitoring each parameter Setting SpO2 Alarms limits SpO2 Alarm Limits allows setting the alarm limits for SpO2 Range 0 100 default 90 100 PVI Range 0 100 PI Range 0 20 arbitrary units Setting SpHb Alarm Limits SpHb Alarm Limits allows setting the alarm limits for SpHb Range 0 25 gr dL default 7 0 17 0 SpOC Range 0 100 mL dL Setting SpCO Alarm Limits Spo2 Range 0 100 default 0 10 Setting SpMet Alarm Limits SpMet Range 0 100 96 default 0 0
102. Response and Apnea Alarm Response 4 Press Vital Signs to close the panel and return to the Vital Signs menu press Main Screen to close the panel and return to the main screen display Setting EtCO Display Options The Display Options panel controls how values are displayed on the main screen display Any changes made immediately update the main screen display Vital Signs etCO2 5 1 Display Options E co Display Area Waveform Sweep Speed 6 25 mm sec Display Features JE Grid Resp Rate FinCo2 FT Alarm Limits JE Apnea Information Display Units JE Display Labels etCO2 Color T Figure 25 4 The EtCO Display Options Panel 25 6 Mennen Medica Menntor 7 Operating Manual gt To set display options 1 Mennen Medical From the EtCO menu if you are already in another panel from the drop down list below the panel title area select Display Options From the Display Area drop down list select the area on the main screen display where you want the EtCO data to appear The available options Waveform Secondary VS or Big Numbers By default EtCO values are displayed in the Waveform area From the Sweep Speed drop down list select the required sweep speed Options are ECG Sweep Speed 6 25 mm sec 12 5 mm sec and 25 mm sec The default sweep speed is 6 25 mm sec Under Display Features e Select the Grid checkbox to
103. User configurable 10 15 20 30 45 60 90 Sec Cardiac coincidence alarm 0 Modes Normal Cardiac Data Storage Respiration rate Respiration rate Alarms Apnea alarms Alarm event markers 9 9 9 DGM 781 001 Rev C 11 2014 Page 3 5 Menntor X7 Clinical Specification Invasive Blood Pressure Site Labels BPx ART PAP CVP RAP LAP ICP Input Sensitivity 5 uVolt Volt mmHg IBP waveform synchronized to ECG Dynamic Range 0 Pressure range 50 to 350 mmHg Zero range 150 mmHg Total dynamic range 200 to 450 mmHg Heart rate 20 350 BPM Transducer Excitation Voltage 5 VDC Separate excitation driver for each channel Zero Accuracy 0 2 mmHg Zero Drift Less than 0 2 mmHg in 24 hours at constant temperature Blood Pressure Accuracy 2 mmHg or 2 whichever is greater exclusive of transducer Blood Pressure Linearity within 1 across entire range Waveform Frequency Response 0 40 Hz Sampling Rate 640 Hz Sample Resolution 24 bit Fault Detection Transducer in out Cable out Data Storage Systolic Diastolic and Mean Alarms Pulse Oximetry Sp02 Nellcor Oximax Plethysmograph waveform Saturation Range 0 to 100 Sp02 Extreme Alarm Capability Sp02 Accuracy SpO2 3 digits standard deviation Pulse Rate Range 20 to 250 BPM 3 BPM Saturation alarm limits 0 to 100 Data Storage Heart rate and O2 saturation Alarms Thermo Dilution Cardiac Output Adapter and Co
104. When Fixed Scaling is selected turn the QuicKnob and select the min max scaling values as required e Select or clear the Grid checkbox to activate or deactivate display of the trended data on a grid Select Discard Changes to close the panel without applying any changes select Main Screen to apply your changes and return to the blank screen Clearing a Report From the Reports List 1 gt Tocleara report from the Reports List From the System Setup menu select Report Setup 2 From the Report List select the report you want to remove from the list 3 Press Clear Report The Report is removed from the Reports List and the undefined Report appears in its place Automatic Reports D 62 This function is only available if a printer was selected in Network Setup This panel enables you to activate the automatic printout of reports at a pre selected time daily Mennen Medica 7 Select Report REPORT 1 A Duration Hours Sa Invoke Time Select End Of First Shift 52 Set 15 00 End Of Second Shift 2300 End Of Third Shift 07 00 Figure D 32 The Automatic Reports Setup Panel gt To set Automatic Reports Setup Panel 1 Select System Setup 2 From the System Setup menu select Automatic Reports 3 Select the report for automatic printing 4 Activate the Report Status toggle green dot 5 Select the Invoke Time at
105. activate or deactivate display of a grid By default this option is activated e Select the Resp Rate checkbox to activate or deactivate display of this value on screen By default this option is activated e Select inCO checkbox to activate or deactivate display of Inspired CO values on screen By default this option is deactivated e Select the Alarm Limit checkbox to activate or deactivate display of EtCO alarm limits on the main screen display e Select the Apnea Information checkbox to activate or deactivate display of the last Apnea event and the Apnea Interval Delay on the main screen display By default this option is activated e Select the Display Units checkbox to activate or deactivate display of a mmHg or percentage symbol next to EtCO value which always appears on the main screen display e Select the Display Units and Display Labels checkboxes to activate or deactivate display of these parameters on the main display screen By default these options are deactivated From the EtCO Color drop down list select the display color for all values on the main screen display You can choose from 16 colors The default color is green Press EtCO2 to close the panel and return to the EtCO2 menu press Main Screen to close the panel and return to the main screen display 25 7 Anesthetic Gas Monitoring Menntor 7 Operating Manual Setting the Scale 25 8 The Scale dialog panel defines the
106. alarms By default the checkbox is activated 4 Press Main Screen to return to the main screen display Setting CO Display Options 28 6 The CO Display Options panel enables you to control the way CO values appear on the main screen display You can set the display to suit your hospital s or departments particular needs Any changes made are immediately reflected on screen By setting the parameters on the Display Options panel you can e Instruct the monitor to display CO information in the Waveform area as a Secondary Vital Sign or in Big Number area on screen e Define the color of CO values as they are displayed on the screen Note Values have the same color unless they go into alarm in which case the value takes on the alarm priority color When the alarm condition terminates the original color is restored Mennen Medica Menntor 7 Operating Manual e Configure the following values to be displayed or not as required Alarm Limits and or Units gt To set CO Display Options 1 From the CO menu select Display Options The Display Options panel opens 2 From the Display Area drop down list select the area where you want the CO to be displayed on screen The options are Waveform Secondary VS and Big Numbers The default is Waveform 3 Under Display Features Select the Alarm Limits and Display Units checkboxes to activate or deacti vate display of these parameters on the main display screen
107. and the temperature of the environment such as neonate in an incubator The delta indicates how well the neonate is maintaining body temperature Another example is the difference in temperature between two parts of the same patient s body When measuring toe and core temperature in a post cardiac surgery patient the delta temperature indicates the state of peripheral circulation The patient s body temperature is measured at two sites The temperature measured at the site defined in this panel is used for comparison to the temperature taken at the site defined in the Activate panel Use this panel to define the second site and to set alarm limits for Delta Temperature The current low and high alarm limits as well as the currently measured delta temperature are displayed on the panel gt To set delta temperature alarms Note Delta temperature can be measured on the Menntor X7 by use of a two temperature adapter cable connected to the orange CO 2 Temp socket One pair of delta temperatures ia available T4 T3 Delta temperature can be activated only if both the temperatures of a specific pair are active 1 From the TMP4 TMP3 menu if you are already in another TMP4 TMP3 panel from the drop down list 2 Select the Alarm Limits checkbox to activate or deactivate the low high alarm limit only By default both the low and high alarms are activated 3 Using the QuicKnob move the markers on the low high alarm limits slider bars
108. cables In order to prevent skin irritation follow the hospital procedures for the duration of use and replacement of the ECG electrodes ECG Electrodes 14 2 Use high quality disposable electrodes for patient monitoring Follow the electrode manufacturer instructions for use Use electrodes that are within the use period Discard electrodes that are out of date If the electrodes are supplied in bulk mark the date of package opening Mennen Medica Menntor 7 Operating Manual e Follow manufacturer recommendation for duration of use after opening the packaging CAUTION Using dried electrodes may result in a noisy and unstable ECG waveform ECG Artifact When an artifact is detected in one of the two top displayed leads a warning message Artifact is displayed in red in the ECG area and QRS detection is performed only on the good lead When an artifact is detected in both of the two top displayed leads or when only one lead is displayed and has an artifact then the system shows a severe artifact in white letters on a red background and all ECG analysis is stopped in such a case dashes are displayed instead of the HR Note Excessive noise may prevent or interrupt the reliable detection of the QRS complex in each of the top displayed leads If the level of noise in one of the two top displayed leads is such that it prevents reliable detection of ORS a message entitled Artifact in red le
109. checkbox is deactivated Select the Tones checkbox to activate or deactivate audible alarms By default the checkbox is activated 4 Under ART Pulse Rate Response Select the Record checkbox to activate or deactivate recording of the patient s condition during the alarm event By default Record is deactivated Select the Tones checkbox to activate or deactivate audible alarms By default Tones is deactivated Select the Event Strip checkbox to activate or deactivate Event Strip By default Event Strip is deactivated 5 Press BP to return to the BP menu Press Main Screen to return to the main screen display Note Checkboxes appear green when activated and gray when deactivated 18 10 Mennen Medica Menntor 7 Operating Manual Setting BP Display Options The BP Display Options panel controls how BP waveforms and values appear on the main screen display Use the Display Options panel to Mennen Medical Determine whether the monitored BP appears on screen as waveform in the Secondary Vital Signs area or in Big Number format Define the numeric format for the BP Define whether alarm limits S D M labels and measurement units appears in the display area Detemine if the pulse rate is displayed when the monitored BP is ART Determine if wedge pressure CVP from PAP or Cardiac Output is displayed when the monitored BP is PAP Determine if Cerebral Perfusion Pressure CPP is displayed when the
110. close the panel and return to the main screen display Setting N5O or Agent Alarm Response The Alarm Response panel controls how the Menntor X7 responds to etO inO etN5O inN5O etAgent inAgent alarms QC 01 Tones JE Event Strip inO2 Alarms Record Tones JE Event Strip Figure 25 7 The EtO Alarm Response Panel gt To set O N50 or Agent alarm responses 1 From the 0 or Agent menu or if you are already in another N5O or Agent panel from the drop down list below the panel title area select Alarm Response 25 12 Mennen Medica 7 Operating Manual 2 Under etO etN O etAgent Alarm Response e Select the Record checkbox to activate or deactivate recording of the patient s condition during the alarm event By default Record is deactivated e Select the Tones checkbox to activate or deactivate audible alarms By default Tones is activated e Select the Event Strip checkbox to activate or deactivate Event Strip By default Event Strip is deactivated Repeat the above procedure under inO inN O inAgent Alarm Response Resp Alarm Response and Apnea Alarm Response Press Gas Name 02 N20 or Agent to close the panel and return to the Gas Name menu or press Main Screen to close the panel and return to the main screen display Setting N20 and Anesthetic Agent Display Options The Display Options panel controls
111. connected via a Menntor X7 UIM module to an external ventilator and the Menntor X7 displays the parameters of the Ventilator then it is not possible for the Menntor X7 to display the numeric parameters from the Spirometry module at the same time CAUTION If both the Ventilator interface and the Spirometry module are activated simultaneously then the spirometry waveforms and Mennen Medical 34 15 Spirometry Menntor 7 Operating Manual loops are generated by the Spirometry module while the numeric parameters come from the Ventilator Technical Alarm Messages The following technical alarm messages may appear on the Menntor X7 display screen e Purge Pump On Tubing not connected Note A list of the spirometry clinical alarm messages appears in Chapter 7 of the Menntor X7 User Manual Calibration The Menntor X7 Spirometry module employs pump and purge system to keep the tubing clear allowing for continuous usage No user calibration of the Spirometry module or airway sensor is required 34 16 Mennen Medica Menntor 7 Operating Manual Labels Spirometry Module Symbol Description Location of Symbol Attention Consult accompanying instructions for use On the front panel of the module Type BF Applied part On the front panel of the module Al Date of Manufacture On the label attached to the back of the module 73 CE approval by Notified
112. damage the device Periodic Maintenance Whenever required at least once a year For monitor periodic maintenance see Calibration and Preventive Maintenance on page 5 2 Mennen Medical 30 25 CerebraLogik aEEG and EEG Menntor 7 Operating Manual 30 26 Mennen Medica 31 TRAIN OF FOUR TOF Introduction Overview Menntor X7 monitors can interface with TOF Watch SX by Organon Refer to the TOF Watch SX Operator Manual for instruction on the operation of the Stimulator and twitch sensor The TOF Watch SX is interfaced with the UIM input of the monitor using the TOF Extension Cable Mennen PN 641345092 The Menntor X7 monitor is used for display and storage of the TOF stimulation response Principle of Operation The TOF Watch SX when used in TOF stimulation mode provides as a response to the four 4 nerve stimulation twitches of the thumb If the neuromuscular junction is not affected the four stimulations of the TOF sequence will respond with four full size twitches If however neuromuscular blocking agents are blocking the muscle response the four twitches will gradually decrease or less then 4 twitches will be detected The TOF Watch SX will show and transmit to the monitor either the percentage of the forth response related to the first response or the number of twitches 0 to 3 it less then four twitches are detected Intended use From TOF Watch SX Operating man
113. default parameters and units for each vital sign available for monitoring in the Menntor X7 bedside monitor These include alarm parameters and other parameters specific to the monitored vital sign See Vital Sign VS Setup on page D 22 e Parameter Hierarchy Use this panel to present the Hierarchy of VS parameters See Parameter Hierarchy on page D 52 e Monitor Profiles Use this panel to preset and label monitoring profiles See Monitor Profiles Setup on page D 54 e Admit By Default Use this option to return the Menntor X7 to default parameters See Admit by Default on page D 57 e Report Setup Use this dialog panel to define and edit report formats See Report Setup on page D 58 e Automatic Reports Use this panel to set the time and type of automatic report printout on the network printer See Automatic Reports on page D 62 Mennen Medical D 3 D 4 Menntor X79 Operating Manual e Network Setup Use this panel to configure devices such as monitors printers etc on the network See Network Setup on page D 64 e Recorder Setup Use to define default recording options See Recorder Setup on page D 65 e Trends Setup Use to set the scales of the graphic trend for each vital sign See Trends Setup on page D 67 e QuicKeys Use this panel to prepare QuicKeys for single button access to monitoring functions See QuicKeys Setup on page D 68 e T
114. delay All VS 5 Seconds Menntor X7 Messages MPM is disconnected from the host The response depends on the status of the MenntoX7 at the time of disconnection MPM is pulled out during monitoring Note The same message is displayed on the Ensemble and Enguard MPM is pulled out during discharge MPM returned to host at Discontinue The host monitor switches to Discontinue and retains the patient demographic and stored data The host monitor presents the message Connect MPM The host monitor presents the message Connect MPM The same message is displayedon the Ensemble and Enguard Connect MPM When you insert the MPM into host panel with information of the last patient stored on the MPM is displayed The panel displayes the following information Mennen Medical MPM name Patient Last name Patient First name Patient ID 33 7 MX57 as Transport Monitor Menntor 7 Operating Manual The following figures display the MPM connect information panel under different conditions SARA menntoy MPM Name SARA menntoyT Last Name MPM Name SARA menntoy6T First Name Last Name Patient ID Different Patient or Host on MPM 23 Figure 33 3 a Figure 33 3 b Figure 33 3 c With name No Name Different patient or host You can do one of the following e Ifthe MPM came with a name you can either save the MPM data file or delete it e If the MPM has no na
115. detection is disabled and the slider is disabled or Select the Enable Alarm checkbox located below the Low or High Limit alarm scale to activate detection of that alarm limit Using the QuicKnob set the left marker on the slider bar to the required high alarm limit for the CO then set the right marker to the required low alarm limit These limits are displayed in the High and Low Limit value areas on the panel Press Auto Set to Defaults to automatically set alarm limits to default values Press Main Screen to return to the main screen display 28 5 CO CCO SvO2 Menntor X79 Operating Manual Setting CO Alarm Response The Alarm Response panel controls the way the Menntor X7 responds to CO alarm The panel is divided into two areas e CO alarm e Fault alarms To set alarm response preferences 1 From the CO menu select Alarm Response The Alarm Response panel appears 2 Under CO Alarms Select the Record checkbox to activate or deactivate recording of the patient s condition during the alarm event By default the checkbox is deacti vated Select the Tones checkbox to activate or deactivate audible alarms By default the checkbox is activated 3 Under CO Fault Alarms Select the Record checkbox to activate or deactivate recording of the patient s condition during the alarm event By default the checkbox is deacti vated Select the Tones checkbox to activate or deactivate audible
116. displays the name of the monitored vital sign The key functions as an on screen button When pressed it accesses the relevant parameter menu The ECG slot is generally larger than non ECG slots permitting more than one parameter key to be displayed in the same slot These keys include Arrhythmia and ST Segment Analysis and they provide quick access to the relevant menus The following table presents the vitals signs that the Menntor X7 can monitor including the abbreviations used to identify them on the parameter keys Vital Sign Abbreviation Arrhythmia ARRY Arterial Pressure ART Cardiac Output CO Central Venous Pressure CVP Electrocardiogram ECG End Tidal CO EtCO2 Left Atrial Pressure LAP Left Ventricular Pressure LVP Non Invasive Blood Pressure NIBP Saturation SpO2 Pulmonary Artery Pressure PAP Respiration RSP Right Atrial Pressure RAP Right Ventricular Pressure RVP ST Segment Analysis ST Mennen Medica Menntor 7 Operating Manual Vital Sign Abbreviation Temperature TMP X Temperature Difference TX TY Unnamed Pressure PRX Primary Vital Sign Area The Primary vital sign area appears to the right of the parameter key You can see the numeric values associated with the monitored vital sign in this area The most common values displayed are e Parameter numeric value e Sub parameters values e Measurement units e Alarm lim
117. e An unknown patient starts monitoring He she will get a name further in time This may require additional information stored in Save amp Discharge Note If you attempt to change patient name or ID without discharging the patient a warning message Discharge before admitting new Patient will appear see Figure 9 5 Discontinue Monitoring Use the Discontinue Monitoring option to temporarily stop monitoring a patient When you discontinue monitoring the following occur e All monitoring functions stop e Demographic information and all stored data is saved To temporarily discontinue patient monitoring 1 From the Main menu select the Setup key to display the Setup menu Select ADT and then select Discontinue Monitoring Patient monitoring stops and on the screen appears the Resume button and the patient s name and ID 2 resume monitoring press Resume Note BP transducers must be zeroed after resuming monitoring Save amp Discharge 9 6 The Menntor X7 allows you to save patient clinical data upon discharge for future use in Patient Transfer The saved data includes e Patient demographic information e Numerical Charts e Graphic Trends e Event Strips ECG and Vital signs waveform information Mennen Medica Menntor 7 Operating Manual gt To save patient data for transfer purposes 1 When you discharge a patient from a monitored bed enter the ADT menu 2 Select Save amp Discharge thi
118. event timing depends on the time of button activation and not on the time of the labeling NIBP Leakage Test gt Use the Leakage Test to test the leakage of the NIBP module including the patient cuff To test NIBP Leakage 1 To start the test disconnect the cuff from the patient rap the cuff around itself Mennen Medical D 21 7 Operating Manual Press Leakage Test password panel will open Enter the password The test panel will open The test panel contains warning message Disconnect Patient from Cuff before Testing Be sure that the cuff is not connected to a patient and press Test The module will inflate the cuff to pressure of about 200 mmHg for adult cuff or about 120 mmHg for neonatal cuff After that all internal valves will be closed and the leakage will be tested for total time of 4 minutes The test results are displayed as Pressure after 1 minute of inflation and Pressure Difference that is the pressure drop between the Initial pressure at I minute and the final pressure 3 minutes later Note If you assume that the leakage is in internal parts of the module start the test with a cuff connected and at about I minute close the cuff tube near the pressure outlet using a surgical clamp Vital Sign VS Setup The Vital Signs Setup menus enable you to set default parameters for each vital sign available for monitoring in the Menntor X7 bedside monito
119. from the drop down list The available options are Waveform Secondary VS or Big Numbers By default SpO2 values are displayed in the Secondary VS area Mennen Medical 22 11 Pulse Oximetry SpO2 Menntor 7 Operating Manual Under Display Features Select the Pulse Rate checkbox to activate or deactivate display of SpO2 pulse rate Select the Signal Strength checkbox to activate or deactivate display of SpO2 Waveform bar on the main screen display Notes 1 The Waveform bar does not represent the signal strength or the perfusion index 2 Even though the Waveform bar and the SpO2 waveform are affected by pulse blood volume they cannot be used for measurement of the pulse volume since automatic gain always brings the pulse to an optimal size for display Select the Alarm Limit checkbox to activate or deactivate display of SpO2 alarm limits on the main screen display Select the Pulse Symbol checkbox on or off to activate or deactivate display of the pulse symbol on the main screen display Select the Display units checkbox to activate or deactivate display of a per centage symbol next to the oxygen saturation value which always appears on the main screen display Select the Grid checkbox to activate or deactivate display of the SPO2 wave form on a grid By default the checkbox is deactivated This option is active only if the SPO2 is displayed in the Primary Vital Sign area as a waveform Press SpO2 Color and
120. from the panel that appears select the display color for all SpO2 values on the main screen Press SpO2 to close the panel and return to the SPO2 menu press Main Screen to close the panel and return to the main screen display Activating and Setting SpO2 Pulse Tones 22 12 In the Pulse Tones panel you can define that the Menntor X7 generate an audible tone to indicate pulse rate and saturation and set the tone s volume There are two available options Pulse and Pitch and Pulse When Pulse is selected each time a pulse beat is detected an audible tone is heard When the Pitch and Pulse option is selected the pitch of the tone varies along with Spo2 value indicating changes in saturation As saturation decreases the tone gets lower By default pulse tones are deactivated Mennen Medica Menntor 7 Operating Manual OK 6 Main JOHN SMITH Screen SpO2 5 Pulse Tone w Pitch amp Pulse Pulse Tones Volume 10 10 me h Figure 22 6 The SpO2 Pulse Tones Panel gt To activate and set pulse tones 1 From the SpO2 menu if you are already in another SpO2 panel from the drop down list below the panel title area select Pulse Tones 2 Under Pulse Tone select either Pulse or Pitch and Pulse 3 Set pulse volume with the slider The allowed range is Off 10 When the slider is set to Off SpO2 pulse tones are deactivated 4 Press SPO2 to close the panel and return to the SPO2 menu press Main Scr
121. how N5O and Agent values are displayed on the main screen display Any changes made immediately update the main screen display Mennen Medical QC 3 SMITH ADAM 02 3 1 Display Options Sweep Speed 6 25 mm sec Display Features Fi Grid JE Alarm Limits JE Display Units JE Display Labels JE etO2 Expand x1 A 02 Color Figure 25 8 The Display Options Panel 25 13 Anesthetic Gas Monitoring Menntor 7 Operating Manual gt To set display options 1 From the O5 N50 or Agent menus if you are already in another N5O or Agent panel from the drop down list below the panel title area select Display Options 2 From the Display Area drop down list select the area on the main screen display where you want the N5O or Agent data to appear The available options are Waveform Secondary VS or Big Numbers By default the values are displayed in the Big Numbers area 3 From the Sweep Speed drop down list select the required sweep speed Options are ECG Sweep Speed 6 25 mm sec 12 5 mm sec and 25 mm sec The default sweep speed is 6 25 mm sec 4 Under Display Features e Select the Grid checkbox to activate or deactivate display of a grid By default this option is activated e Select the Alarm Limit checkbox to activate or deactivate display of N5O or Agent alarm limits on the main screen display e Select the Display Units and Display Labels checkboxes
122. iere t ee edel sente 18 2 Preparatory Checklist Rm 18 3 BP Monitoring Procedures uei tum o e ERE HE EE HE PEU ebd te bean das 18 3 Accessing the BP M nu i ica oea SE E eLa EN REE ats dte cde 18 4 Zeroing BP LransducerS deo et eee tee end eder ds lide Fete Re a e ober eate 18 4 selecting the BP Scale ere cie e Ra quie cei ee eee PI D Ee EH LEE rero epe 18 6 Setting eie bte pateat ee es hab eed etui brote e o Pet e ratae rien 18 7 Setting BP Display Options ie hee Rn e ete ete de hse cce EH EE He EHE Pe Hee edet 18 11 iv Mennen Medica Menntor X79 Operating Manual Deriving the PEWP Value l i bte ht eet dede sepe e cede 18 13 Measuring the Central Venous Pressure eese ener nennen rennen nnne 18 14 Activating and Deactivating BP Monitoring sese nnne nete 18 16 Chapter 19 Cardiac Output C O OVER VIC We ERR Ee diee Ge Ie b Ea 19 1 Preparatory Checklist 2 dee oe GS e OH p O eE EEP deer POP t 19 2 Measurimng Procedures cete ette ete tree e othe ae eter 19 2 Cardiac Output Measurement ie oe pe ertt dde dee aes 19 5 Cardiac Output Fick Method 2 eee nee Ee te eee tie e ert iens 19 10 Chapter 20 Temperature OVELVIEW decile M M 20 1 Preparatory Checklist 2 2214 GOGH eH GR Ge eta
123. include Trends ST Watch Charts Full Disclosure and Overview Note The amount of data that can be stored depends on the capacity of the Flash card used Table 10 1 provides information from the Specification Table 10 1 Amount of data stored according to Flash card capacity Storage 8GB 16GB 32GB Tabular Chart 80 days 80 days 80 days Graphic Trend 80 days 80 days 80 days Full discloser 5 Days gt 8 Days gt 8 Days Overview 5 Days gt 8 Days gt 8 Days Event Strip 75 75 75 aEEG Not supported 8 Days 8 Days aEEG Sections Not supported 50 50 Saved Patient 10 10 10 aEEG Saved Patient Not supported 3 8 MPM storage time 5 HR 5 HR 5 HR MPM saved file 3 3 3 CAUTION The duration of patient data storage in Chart and Trend is limited by the size of the processor memory When the memory is full the monitor stops storing data in Chart and Trend and the warning message No Space for Data Storage appears on a red background at the bottom of the monitor panel On the discharge panels a warning panel appears requesting to discharge the patient and re admit Mennen Medical 10 1 Reviewing Patient Data Menntor 7 Operating Manual Trends Use Save amp Discharge to save Trend Chart and Event strips Save amp Discharge deletes all Full Disclosure data Main wee gaze Memory Full Discharge erases all stored data Continue w o storage Figure 10 1 Warn
124. main processing unit Recording duration is set in System Configuration by the hospital System Administrator or Biomedical Engineer Alarm Recording Waveform Selection An alarm recording usually contains two traces the primary ECG and the other parameter in alarm if not ECG When the alarm is triggered by an event whose source is the primary ECG only that trace appears on the recording The following table gives some examples of traces recorded due to an alarm event Table 8 1 Alarm Recording Waveforms Alarm Event Upper Trace Lower Trace HRT 3 cable lead Primary ECG single channel recording format N A Arrhythmia Alarms Primary ECG Secondary ECG ART ART waveform Primary ECG Apnea Alarm Resp waveform Primary ECG Alarm Priority Bedside alarms have different priority levels which affect the order of audible and visual alarm notification The following list is presented in order of descending importance Mennen Medica Menntor 7 Operating Manual Clinical Level 1 C 1 Emergency A life threatening situation requiring immediate response Clinical Level 2 C 2 Abnormal situation requiring prompt response Clinical Level 3 C 3 Notification to make staff aware of the condition Clinical Level 4 C 4 Notification to make staff aware of the condition Technical Level 1 T 1 Notification that monitoring has stopped due to equipment trouble Technical Level 2 T 2
125. monitored BP is ICP Define the color of the vital sign display including waveform and all other information The default colors can be changed at any time in this panel Default display colors are ART Pink BP Light Blue Orange Others Grey or Silver 18 11 Invasive Blood Pressures BP Menntor 7 Operating Manual 18 12 OK 6 Main JOHN SMITH Screen ART 1 1 Numeric Formats Display Area Waveform Display Features Grid F Alarm Limits JE Units 5 0 Labels JE Overlap Expand X1 BP Color Figure 18 5 BP Display Options Panel To set BP Display Options 1 From the menu or From the drop down menu list below the title area in the BP panel select Display Options From the Numeric Formats drop down list select SSS DDD MMM SSS DDD mmm or SSS DDD The default for BPx ART and PAP is SSS DDD The default for LAP RAP and ICP is From the Display Area drop down list select the area where you want the BP to be displayed on screen The options are Waveform Secondary VS and Big Numbers The default is Waveform Under Display Features e Select the Grid checkbox to activate or deactivate display of the BP waveform on a grid By default the checkbox is deactivated This option is active only if the BP is displayed in the Primary Vital Sign area as a waveform Mennen Medica Menntor
126. month and year e Turn QuicKnob until the monthly calendar is highlighted and press Now the calendar is selected e Begin turning the QuicKnob again to move through the days of the month When the correct day is highlighted press the QuicKnobTM e the QuicKnob until one of the arrows the month indicator is Mennen Medical D 9 Menntor 7 Operating Manual highlighted The arrow on the right when selected advances the months the arrow on the left goes back Press to select the correct month e the QuicKnob until the year is highlighted and press to select Turn the QuicKnob clockwise to advance in 10 year steps Press and turn the QuicKnob to advance in one year steps Turn the QuicKnob counter clockwise in the same manner to go back Select Cancel Changes to close the panel without applying the changes Select Accept to apply the changes and return to the Date and Time Setup panel Select the Time area An Hour Minute panel is displayed e Select Hours Minutes and turn the QuicKnob to set the time Turning the QuicKnob clockwise goes forward in time Turning the QuicKnob counter clockwise goes back you have set the minutes hours you must press the QuicKnob again to go on to the next parameter Under Shift End Time select Day Evening or Night The Hour Minute panel is displayed Enter the shift end time in the same way you set the time for the Time
127. normal beats NN50 Number of interval differences between successive beats that are above 50 mSec PNN50 Percentage of successive intervals with more than 50 mSec difference Note References 1 Guidelines Heart Rate Variability Standard of Measurement European Heart Journal 1996 17 354 381 Time Domain Numeric Chart Note The chart was created using simulator with Atrial Fibrillation QC 320 VLO1 21 11 12 C 320 VLO1 Patient Data Charts ChartiHRV Filter Manual Automatic Interval Every 15 Minutes Cardiac Output PWEDG Date Time SDNN RMSSD NN50 pNN50 mSec mSec 211 08 30 SESS 4 Loree 21 11 08 30 343 548 100 21 11 08 15 344 550 100 21 11 08 00 344 550 100 211 344 551 100 21 11 343 549 100 21 11 343 100 2111 345 549 100 2111 343 540 100 2111 545 100 21 11 344 551 100 21 11 343 547 100 21 11 343 549 100 Available data time span 20 11 14 02 21 11 08 39 Find Date Time Find Event Figure 10 21 Time Domain Numeric Chart 10 32 Mennen Medica Menntor 7 Operating Manual Time Domain Graphic Trend Note that the graphic trend shows points every 5 minutes since this is the epoch of the time domain statistics OG 20 Vet 21 11 12 Trends 21 11 06 40 06 55 07 10 07 40 21 11 Duration Autoscale Mark amp Hold Zoom Seroll Cursor Go to 1 Hour Segment Out lt lt
128. of e Scale Use this panel to define the way Anesthetic Agent waveforms are scaled for presentation on the main screen display Accessing the EtCO Menu The EtCO menu be accessed from the Vital Signs menu or from the main screen display gt Toaccess the EtCO menu from the Vital Signs menu 1 From the main menu select the Vital Signs key The Vital Signs menu is displayed 2 From the Vital Signs menu select EtCO3 The EtCO menu appears 3 Select the required menu item to display the associated panel 25 2 Mennen Medica 7 Operating Manual gt To access the EtCO gt menu from the main screen display 1 When EtCO is displayed in a parameter slot in the primary display area waveform area turn the QuicKnob until the parameter key is highlighted The parameter key functions as an on screen button Press the QuicKnob to select the parameter key and access the EtCO menu 2 When EtCO2 is displayed in the Secondary Vital Sign area or in Big Number format turn the QuicKnob until the EtCO value is highlighted and press to select The EtCO menu appears Vital Signs etCO2 5 1 Figure 25 1 EtCO gt Menu EtCO Alarms EtCO alarm parameters are set in two dialog panels Alarm Limits and Alarm Response Each dialog panel controls a different aspect of EtCO alarms Setting EtCO Alarm Limits Use this panel to activate deactivate EtCO inCO and
129. of ST monitoring Following is a short description of each panel in the order they appear on the ST menu Activate Use this panel to activate or deactivate ST monitoring See Activating ST Monitoring on page 16 3 Alarm Setup Use this panel to set ST alarm limits See Setting ST Alarm Limits on page 16 3 Alarm Response Use this panel to define how the viations in ST values from a manually set baseline If space is available the viations in ST values from a manually set baseline If space is available the viations in ST values from a manually set baseline If space is available the viations in ST values from a manually set baseline If space is available the Menntor X7 responds to detected ST deviations See Setting ST Alarm Responses on page 16 5 Display Options Use this panel to configure the way ST values are displayed on the main screen See Setting Display Options on page 16 6 ST Adjustment Use this panel to manually change the ST and ISO measuring points See Manually Determining the ISO an ST Measuring Points on page 16 7 ST Variation Use this panel to define the baseline from which variation in ST values is derived See Determining ST Variations on page 16 8 Accessing the ST Menu The ST menu can be accessed from the front panel or from the main screen display To access the ST menu from the Main menu 1 From Main menu select the Vital Signs key The Vita
130. one or two waveforms in parallel with other vital sign waveforms Note The aEEG History will store the aEEG during this mode of display Mennen Medical 30 11 CerebraLogik aEEG and EEG Menntor 7 Operating Manual AD VER 64 rar en HAMA iit N VAM MGM F EEG LEFT KAIA Ras AA TA ATA AY Am ea y M M y V n EEG RIGHT Figure 30 9 Dual channel EEG waveform EEG Realtime with aEEG gt To view Realtime EEG with aEEG 1 In Setup menu select Display Control 2 In Display Option select aEEG This displays one or two EEG channels together with aEEG Note Due to space limits the display of 2 channels can not be achieved if for example there are two ECG channels and other vital signs in big numbers Note To view two EEG aEEG use a single lead ECG display 30 12 Mennen Medica Menntor 7 Operating Manual RD VER 6 1 EEG LEFT 50 ii AL aaf rv r dv MVA aa era AA raw Were E PN nr EEG RIGHT 50 pv Figure 30 10 Dual channel aEEG real time display LAMA M vw u ANAN A M MM v WW gt t EEG LEFT aEEG Figure 30 11 Single channel aEEG real time display EEG waveforms plus one hour aEEG 94 100 f PULSE 74 N S y V MJ A EY PR NJ V
131. or deactivate Event Strip Note By default Event Strip is deactivated 23 16 Mennen Medica Menntor 7 Operating Manual Setting IPI Display Options The Display Options panel controls how IPI values are displayed on the main screen display gt To set display options 1 From the IPI menu select Display Options Or If you are already in another IPI panel from the drop down list below the panel title area select Display Options 2 From the Display Area drop down list select the area on the main screen display where you want the IPI data to appear The available options are Secondary VS or Big Numbers Note By default IPI values are displayed in the Big Numbers area 3 Select the Alarm Limit checkbox to activate or deactivate display of IPI alarm limits on the main screen display Activating EtCO2 Monitoring Use the Activate panel to activate or deactivate EtCO2 monitoring Note Activating EtCO2 monitoring while monitoring respiration using impedance pneumography causes the pneumograph to deactivate The Menntor X7 then uses EtCO2 data to monitor respiration rate gt To activate or deactivate EtCO2 monitoring 1 From the EtCO2 menu if you are already in another EtCO2 panel from the drop down list below the title area select Activate 2 Select the Activate checkbox to activate or deactivate EtCO2 monitoring By default EtCO2 monitoring is activated 3 Press EtCO2 to close the panel and return
132. or decreases the value by units of five or ten Turning the knob clockwise or counterclockwise while pressing results in an increase or decrease in single units QuicKnob Conventions The following terminology is used when describing QuicKnob procedures Select Used when Accessing a drop down list indicated by an arrow Turn the QuicKnob until the required area is highlighted and press Selecting an option from a list where only one option can be selected These lists are indicated by diamond shaped option buttons Activating or deactivating a checkbox Green indicates that the checkbox is turned on activated gray indicates that the checkbox is turned off deactivated Turn the QuicKnobTM until the required area is highlighted and press Press Used when pushing an on screen button Turn the QuicKnob until the required area is highlighted and press Mennen Medical 6 11 Controls and Functions Menntor 7 Operating Manual Back Panel Connectors e Three wire AC input that connects to hospital grade power supply outlet e Fuse x 2 Fuse assembly under the power cable WARNING Plug assembly power cable must be disconnected to access fuses e Remote control socket e Auxiliary socket Right Panel Connectors e ISO LAN Isolated LAN 5000V main LAN output e Output for external display e PS 2 Mouse keyboard e USB e Compact Flash Working With Menus and Panels
133. period of time to set the alarm and QRS beep permanently to OFF Double click to toggle the QRS beep ON OFF CAUTION There is no Alarm suspension functionality on MPM only Silence Saves an event strip that could later be viewed when the MPM returns to a host monitor Zeros the invasive pressure transducer after opening the stopcock to atmosphere Start Stop NIBP provides manual activation of NIBP measure ment Switches the MPM power ON or OFF Note Power OFF deletes the patient name Power ON starts monitoring with the previous monitor profile but without any name ON OFF Note Power OFF deletes the patient name Power ON starts monitoring with the previous monitor profile but without any name MPM Operation During Transport e ST is not viewed during transport e Arrhythmia alarms are displayed in cases of ASYST VFIB and VTACH e Artifact Alarms will not be restored during MPM merge Alarms off state is not supported by the MPM Each parameter has its own alarm set up Mennen Medical 33 5 57 MPM as Transport Monitor Menntor 7 Operating Manual MPM Modes of Operation 33 6 The MPM works on it s internal battery that is charged when the MPM is inserted into the host Menntor X7 It s battery capacity and data storage while out of host is about 5 hours The displayed operation modes ot the MPM depend on the Menntor X7 status prior
134. previous example if NIBP is activated at 10 23 and the interval is set for Q15 the first reading is taken at 11 00 and the subsequent readings are taken at 11 15 11 30 12 00 etc e Multiple T Interval Up to three time intervals periods of reading can be selected The readings are taken at the selected intervals Mennen Medica Menntor 7 Operating Manual e Multiple Q Interval Up to three time intervals periods of reading can be selected The first readings are taken immediately the next readings are taken according to the selected intervals Note It is possible to simplify the reading intervals control by activating only the Single T mode or Single Q mode in System Setup Refer to the system manager for activating this mode of operation A manual reading can be taken by pressing the Start NIBP button A series of readings taken consecutively during a five minute period can be initiated by activating the Stat Mode option Note In system setup password protected Vital Signs NIBP it is possible to simplify the automatic mode by activating only the Single T or Single Q WARNING Do not monitor patients who demonstrate tremors seizures or other movement disorders in the Automatic mode Limb tremors or movement during a reading may cause excessively elevated cuff pressure for prolonged periods causing venous congestion WARNING Patients in shock in vasodilation or in other states which may cause a v
135. required 9 2 1 Disconnect the Cable out Message 2 4 extension cable O K O K 9 2 2 Connect Xducer not detect Mes O K BP2 BP3 BP4 sage extension cable O K O K 9 2 3 Connect simulator Not Zero Message O K O K O K 9 2 4 Zero BP 2 BP 3 BP 2 3 4 on the display 0 0 0 BP 4 by the key 2mmHg 9 2 5 BP2 BP3 BP4 BP 2 3 4 Rate 200 200 200 200mmHg in 2mmHg 200 200 200 2mmHg 200 200 200 2mmHg 10 Cardiac Output Test Simulator DNI217A and DNI21A or similar 10 1 Disconnect CO Cable out Message O K Cable 10 2 Connect CO 2 Temp 3 4 30 T3 30 0 1 Temp Split cable T4 30 0 1 Temp 3 4 37 T3 37 0 1 T4 37 0 1 11 TEMP Test TEMP Simulator model FOGG TP69 or similar 11 1 Temp 1 2 Temp 1 2 30 T1 30 0 1 2 30 0 1 11 2 Disconnect 1 T1 Probe out Message Mennen Medical 5 7 Operating Manual Table 1 Par Subject Description Specifications Measured Result value Pass Fail 11 3 Disconnect 2 T2 Probe out Message O K 12 SpO2 Test 12 1 Spo2 without Cable out Message O K adapter cable 12 2 Connect adapter Probe out Message O K without the sensor 12 3 Connect the sen Waveform O K sor to the finger SPO2 Value XXX Person test 90 100 12 4 Recheck Spo2 SPO2 Value amp W F O K Disconnec
136. respiration rate alarms and set high and low alarm limits Selecting an option in the Select Type box activates the corresponding panel containing the current high and low alarm limits as well as the currently measured value for the selected option Mennen Medical 25 3 Anesthetic Gas Monitoring Menntor 7 Operating Manual 25 4 etCO2 4 Alarm Limits Fei End L J i51 27 El EG 1 2 a s 2 2 2 10 0 A d x i Figure 25 2 The EtCO gt Alarm Limits Panel To set EtCO gt alarms 1 From the EtCO menu if you are already in another EtCO panel from the drop down list below the panel title area select Alarm Limits From the Select Type drop down list select EtCO inCO gt or Resp respiration rate to bring up the corresponding panel Press All inCO2 EtCO2 Resp Alarms to activate or deactivate the alarms Using the QuicKnob move the slide indicator on the high limit slider bar along the alarm limits scale to set the required high limit and move the slide indicator on the low limit slider bar to set the required low limit Press Auto Set to Defaults to set the EtCO alarm limits to their default values When you select the Resp option in the Select Type drop down list two additional fields appear on the dialog panel e Apnea Alarms Off Deactivates the Apnea alarm Mennen Medica Menntor 7 Operating Manual e Apnea Delay Interval Sets the apnea
137. return to the BIS menu Press Main Screen to return to the main screen display Note Checkboxes appear green when activated and gray when deactivated Mennen Medica Menntor 7 Operating Manual Setting BIS Display Options You can change the way BIS parameters and EEG waveforms appear on the main screen display to suit your hospital s or department s particular needs by defining Display Options parameters Any changes made are immediately reflected on screen By setting the parameters on the Display Options dialog panel you can e Instruct the monitor to display BIS either in Waveform area Big Number format on screen or as a Secondary Vital Sign e Setthe Sweep Speed e Define the color of BIS value and EEG waveforms as they are displayed on screen All waveforms and values have the same color unless they go into alarm in which case the value takes on the alarm background color When the alarm condition passes the original color is restored e Configure the following Quality values to be displayed or not e SQI EMG SR BC as required e Display of BIS High Low Rate Limits Note When BIS appears in BIG Number area all of the above items can fit into the Big Number display area Note When BIS appears in Secondary area only the BIS value is displayed BIS enABOO4F BIS 5 1 Display Options Dit ref Sweep Spoet 25 mme Display Features E SQI EMG BIS Color l
138. scalp electrodes V sme SUD T9 Secure the CerebraLogik to a convenient location near the patient s head using the attachment clip Electrode Location You can place each pair of electrodes Channel 1 and Channel 2 according to the hospital methodology or follow El Dib recommendation for one left and one right location The two channels are marked as Ch 1 Left and Ch 2 Right You can use either one or both channels providing that a reference electrode is connected on the scalp If two channels are used a third Cross channel that 1s the difference between the Left and Right channel is also available for display Figure 30 4 shows the electrode location for single or dual channel aEEG as recommended by EI Dib et al 2009 Figure 30 4 Electrode location for aEEG El Dib et al 2009 A Single channel electrode 30 6 placement P3 P4 B Dual Channel Placement C3 P3 and C4 P4 Mennen Medica Menntor 7 Operating Manual Technical Alarm If any of the electrodes is not connected a technical alarm is created and the quality bar appears full A label with the faulty electrode is presented to the right of the Realtime or History panels For example EEG Lead L off or EEG Lead for the Left positive electrode or the Right negative electrode failure respectively If more than one electrode is not connected or the reference electrode is not connected the following message is displayed EEG Chec
139. select the required lead SST a calculated Average or Sum ST is displayed together with HRT trend is displayed on the top display area You can select either None STave Average of absolute ST value for all leads STsum Sum of absolute ST value for all leads STVM ST vector magnitude Available only with 12 lead ECG E SST Limits HRT Limits Top ST Limits Middle ST Limits Bottom ST Limits ECG Gain SST Area Time Span Figure 10 5 ST Watch Scale Panel Select the Scale to set the scales for the different trend display areas Press the Autoscale button to autoscale the displayed section Set the SST scale limits Mennen Medica 7 Operating Manual Set the HRT scale limits Set the limits for the Top Middle and Bottom ST leads scale limits Set ECG gain Default I mV cm Nominal Set SST AREA time span between I and 8 hours 10 Mennen Medical E ECG Calibration Scale E ECG Grid Fill SST Area Figure 10 6 ST Watch Display Option Panel Select Display Options A panel with toggle keys is opened ST measurement Points will effect the ECG Waveform area and will show lines at the Isoelectric and ST measuring points ECG Calibration Scale will appear in the ECG Waveform area ECG Grid in the ECG Waveform area Fill SST Area will effect the SST trend curve From the Duration drop down list select a duration time for the ST trend between and 8 hours Press Scroll Ri
140. small internal diameter This provides sharp waveform and an accurate CO2 reading at high breath rate per minute The sample line is not affected by gases and anesthetic agents in the operating room environment Adult Pediatric Infant Neonatal Part Number 800 060 141 800 060 142 Patient Weight gt 2Kg lt 2 Kg Duration of use Up to 72 hours Up to 72 hours Adapter Weight 4 5 gr 3 7 gr Tubing Length 210 mm 210 mm Adapter Dead space lt 6 6 cc 0 5 cc FilterLine Recognition Safeguard When the FilterLine is attached to the monitor the FilterLine Recognition Safeguard FRS identifies the FilterLine and activates the monitor thus enabling measuring Mennen Medical 23 3 End Tidal 2 EtCO2 Microstream MicroPod Menntor 7 Operating Manual Airway Adapter The airway adapter design provides multiple channels for the sampled air from the airway minimizing the possibility of water infiltration or line blockage These multiple channels allow uninterrupted monitoring for all adapter orientations and in all applications The airway adapter provides optimal performance in all directions and is seldom disabled by secretions or liquids Using the MicroPod 23 4 The MicroPod is an external EtCO2 unit that can be connected to the Menntor X7 monitors via the UIM input port It functions the same way as the built in Microstream and uses the same sam
141. supports a set of physiological calculation functions that allow you to calculate set of predefined physiological parameters based on monitored clinical data The following physiological calculation functions are available e Hemodynamics e Respiratory Mechanics e Oxygenation e Renal Clearance Each physiological calculation panel includes fields that display monitored data Since part of the data required for calculations is not monitored by the Menntor X7 you need to manually enter it into the calculation panel in the appropriate fields You can also edit or update monitored data if necessary Once you edit monitored data and manually enter missing data the Menntor X7 automatically recalculates all the derived parameters pertaining to the specific set of physiological functions After viewing the calculated results you can store them for future use in the appropriate chart Viewing the Calculation Panels The physiological calculation panels consist of two types of values e Measured values data automatically monitored by the Menntor X7 or manually entered data e Calculated values data derived and calculated by the Menntor X7 based on the measured values Mennen Medical 11 1 Performing Clinical Calculations gt To access the Calculation panels Menntor 7 Operating Manual 1 Onthe Menntor X7 Main menu press the Patient Data key 2 Inthe Data Review menu select Calculations 3 Inthe Calculat
142. the Event Strip List in the Mark Event panel it turns green Select a Label Select Insert this opens the virtual keyboard on the Menntor X7 screen Prepare a label and press Accept pn de The new label is added above the selected label item 2 gt To Delete a label 1 Select the Event Strip List in the Mark Event panel it turns green 2 Select a Label 3 Select Delete this deletes the label D 20 Mennen Medica 7 Operating Manual Chart gt To Edit a label 1 Select the Event Strip List in the Mark Event panel it turns green 2 Select a Label 3 Select Edit this opens the virtual keyboard on the Menntor X7 screen 4 Edit the label and press Accept 5 The new label will replace selected label To set the response to the Mark Event Key Three response options are available Chart only Chart Strip Chart Strip Label A row of vital signs at the time of Mark Event activation is added to the charts The row is by a green dot Chart Strip In addition to the above an Event Strip is stored in the monitor and is labeled as Manual Event The Event strip starts 10 seconds before the time at which you press the Mark Event Key and ends 10 seconds after the time at which you pressed the above key Chart Strip Label In addition to the above a list of labels is displayed on the monitor screen The user can now select one of the labels for the event The
143. the HemoCis window on the Menntor X7 this requires Option 550 OPT 078 License HemoCis Interface The first function Admit from HemoCis can be performed from any Menntor X7 that is on the same network as the HemoCis The second function Transfer to HemoCis is available only if the Menntor X7 was defined as belonging to Cathlab Suite and if the HemoCis is available on the network See the System Setup for Cathlab Suite This function is available only if the patient was admitted from the HemoCis To open a HemoCis window on the Menntor X7 the Menntor X7 must have Option 55 OPT 078 Licence also you must add to the network a special hardware and software package named System Server 550 OPT 080 This function is available only if the patient was admitted from the HemoCis System Setup for Cathlab Suite gt To define an Menntor X7 monitor as a Cathlab suite monitor 1 Connect the HemoCis system to the same LAN as your suite Menntor X7 monitors 2 Connect a mouse and keyboard to each Menntor X7 3 Enter the System Setup menu of each Menntor X7 with the required password 9 12 Mennen Medica Menntor 7 Operating Manual 4 Enter Network Setup and set Cathlab suite monitor to On Green lt none gt en370072 Network Setup ANDREJKO JOSEPH F Figure 9 9 Network Setup 5 Use the Shutdown function in the Setup menu to restart the Menntor X7 this activates the mouse and the HemoCis window
144. the Scale checkbox to activate or deactivate display of the gain value and calibration pulse in the waveform area By default this option is deactivated e Select the QRS Indicator checkbox to activate or deactivate display in the Primary Vital Sign area on the main screen of a blinking red heart every time a QRS is detected By default this option is deactivated From the ECG Color drop down list select the color required to display ECG waveforms and other parameters The default color is yellow Press Vital Signs to return to the Vital Signs Menu Press Main Screen to return to the main screen display Note Checkboxes appears green when activated and gray when deactivated Setting QRS Tone Volume The monitor can be configured to provide an audible QRS tone whenever a QRS complex or pulse trigger is detected QRS tone volume is set in the QRS Tone Volume panel using a slider bar which can be set on a scale ranging from Off meaning that the QRS tone is deactivated to 10 See Setting ECG Display Options on page 14 17 to activate visual display of the QRS indicator Note It is not necessary to activate a visual QRS indicator in order to activate the 14 18 QRS tone and vice versa Mennen Medica Menntor 7 Operating Manual OK 6 JOHN SMITH ORS Tone Volume Figure 14 11 The ECG QRS Tone Volume Panel gt QRS tone volume 1 Mennen Medical From the ECG menu or if you are already in
145. the baby s limb Leave a space of approximately 5 mm between the Cuff and the limb Mennen Medica Menntor 7 Operating Manual Preparatory Checklist LI Select the correct cuff size for the patient Cuff width should be either 4096 of the arm s circumference or 2 3 the upper arm length If you are unsure whether the cuff is large enough use a larger cuff Connect the fitting at the end of the pressure hose to the corresponding fitting on the cuff and the monitor Ensure that the cuff is not open and that fittings are tight to prevent air leaks No reading can be obtained when cuff is open and the message Air Leak appears on the main screen display Note An incorrect cuff size especially a normal cuff on obese patients may Warnings result in incorrect readings 2 Always take care to avoid compression or restriction of pressure tubes Do not perform NIBP measurements on patients with sickle cell anemia or any condition involving skin damage Do not apply the cuff to a limb where an intravenous infusion or catheter is inserted The infusion is slowed or blocked during cuff inflation and tissue damage may result around the catheter Due to the risk of hematoma in the limb where the cuff is placed use clinical judgment when deciding whether or not to perform automatic blood pressure readings on patients with severe blood clotting disorders It is important when measuring blood pressure in pediatric patients to make
146. the main screen To continue System Setup you must press the System Setup button again to access the System Setup menu Mennen Medical D 45 Menntor 7 02 Setup This dialog panel enables you to set 02 default parameters These parameters include setting O2 alarm priority activating or deactivating alarm latching defining Alarm Detection delay and selecting the default units and color for O2 values e 2 Alarm Priority Alarm priority affects the order of audible and visual alarm notification See Alarm Priority on page 8 4 for a full description of this feature O2 alarm priority can be set to C 1 C 2 or C 3 The factory default is C 2 Alarm Latching For a complete description of Alarm Latching refer to Chapter 7 Alarms in the Menntor X7 Operation Manual The available options are Off Visual latching visual alarms only and On both visual and audible alarms The factory default is Off e Alarm Detection Delay When an alarm is detected a pre defined delay period allows the system to check in order to avoid false alarms The delay can be set to 3 5 10 15 or 20 seconds The factory default is set to 0 seconds e 02 Default Color Defines the color in which O2 values appear on the main screen display You can choose from 16 available colors O2 Setup Figure D 20 The O2 Dialog Panel D 46 Mennen Medical 7 Operating Manual gt s
147. the relevant vital sign panel The following parameters can be set e High and Low Limit Detection Enable Disable High and Low Limit Value Values are entered by setting the limits on a scale with a slider While setting alarm limits the current value is displayed Auto Setting Alarm Limits When activated in System Setup Default Alarm Limits the Auto Set Dynamic Alarm option automatically calculates alarm limits based on the current vital sign value On the alarm limit panel use Auto Set to Defaults to automatically set alarm limits around the patient s vital signs value Note To activate this option the system manager has to set the alarm limits in the System Setup Appendix D Setting Up the System Default Alarm Limits on page D 18 to Dynamic mode See Appendix C for the formula of the Auto Set Dynamic Alarm limits Alarm Limits Off 8 8 You can deactivate alarm processing and detection for any individual vital sign in the relevant vital sign panel All clinical alarm detection stops for the vital sign and any related sub parameters Technical alarms are still detected Setting of any parameter limits to off adds an icon to the vital sign label 7 For example Mennen Medica Menntor 7 Operating Manual Alarm Status The Alarm Status dialog panel lets you review all of the alarm limits set for patient The alarm limits for each monitored vital sign are displayed on the panel You can dea
148. the sub menus 5 Select the function that you wish to assign press the QuicKnob to finish the assignment Tabular Charts A chart documents a patient s condition as observed at regular intervals in table format much in the same way as a nurse records data in a bedside chart The Menntor X7 supports a set of clinical charts for the purpose of data acquisition clinical calculations and review For more details see Report Setup on page D 58 The Menntor X7 also enables to create User Defined Charts UDF customized to specific needs of a unit or patient This is done in the Tabular Charts panel Up to 10 User Defined charts can be defined in System Setup You can define the parameters that appear in the UDC edit the format of a UDC rename it and clear a UDC from the User Defined Charts List All UDCs can be printed and placed in the patient s records Tabular Charts Tabular Chart 0 Figure D 38 The Tabular Charts Dialog Panel Mennen Medical D 69 7 Operating Manual 5 17 1Naming a UDC By default User Defined Charts are named Tabular Chart 1 Tabular Chart 2 etc You can change the name of any tabular chart according to what is accepted practice in your hospital or department gt rename a Tabular chart 1 In the System Setup menu select Tabular Charts The Tabular Charts panel opens From the User Defined Charts List select a tabular chart Select the UDC Name textbox
149. this panel to define how the Menntor X7 responds to calculated IPI see Setting IPI Alarm Responses on page 2 16 e Display Options Use this panel to define how IPI values appear on the main screen display see Setting IPI Display Options on page 2 17 e Activate Use this panel to activate or deactive monitoring of IPI Mennen Medical 23 15 End Tidal CO2 EtCO2 Microstream MicroPod Menntor 7 Operating Manual Accessing the IPI Menu The IPI menu can be accessed from the Vital Signs menu or from the main screen display gt To access the IPI menu from the Vital Signs menu 1 From Main menu select the Vital Signs key The Vital Signs menu is displayed 2 From the Vital Signs menu select IPI The IPI menu appears gt To access the IPI menu from the main screen display 1 When IPI is displayed in parameter slot in the primary display area Big number area turn the QuicKnob until the IPI parameter key is highlighted Select IPI to access the EtCO2 menu Setting IPI Alarm Limits Use the Alarm Limits panel to activate deactivate IPI alarms and set low alarm limits Note Setting IPI Alarm Responses The Alarm Response panel controls how the Menntor X7 responds to IPI alarms gt To set up IPI alarm limits 1 Under IPI Alarm Response Select the Tones checkbox to activate or deactivate audible alarms Note By default Tones is activated Select the Event Strip checkbox to activate
150. to activate or deactivate display of these parameters on the main display screen By default these options are deactivated e Select the etOz etN O etA gent checkbox to activate or deactivate display of end tidal N5O or Agent values on screen 5 From the N50 or Agent Color drop down list select the display color for O N gt O Agent values on the main screen display You can choose from 16 colors 6 Press Gas Name O2 N20 or Agent to close the panel and return to the Gas Name menu or press Main Screen to close the panel and return to the main screen display 25 14 Mennen Medica Menntor 7 Operating Manual Selecting the 0 and Anesthetic Agent Scale The Scale dialog panel defines the way 0 and Anesthetic Agent waveforms are scaled for presentation on the main screen display QC ENVOL Main Screen O2 5 1 Figure 25 9 The Scale Dialog Panel gt Toscale the O N50 and Anesthetic Agent waveform 1 From the NO or Agent menu select Scale 2 Select the required values 3 Press Vital Signs to return to the Vital Signs menu Press Main Screen to return to the main screen display Mennen Medical 25 15 Anesthetic Gas Monitoring Menntor 7 Operating Manual Activating Monitoring Use the Activate panel to activate or deactivate N30 and Anesthetic Agent monitoring Activating O2 and 20 Monitoring gt To activate or deactivate
151. to define an ECG report printout in the format of 3 x 4 rhythm strip Note ECG report has to enabled in System Setup gt gt VS gt gt ECG setup Display Options Panel Use this panel to define the way ECG waveforms and values are displayed on the main screen See Setting ECG Display Options on page 14 17 QRS Tone Volume Use this panel to configure the monitor to provide an audible tone whenever QRS is detected See Setting QRS Tone Volume on page 14 18 Pacemaker Detection Panel Use this panel to control the detection of cardiac pacemaker pulses See Detecting a Pacemaker on page 14 20 Heart Rate Source Panel Use this panel to define the source of the heart or pulse rate See Setting the Heart Rate Source on page 14 23 Filter Panel Use this panel to select a filter to clean any environmental noise from the displayed waveform See Selecting a Filter on page 14 24 Arrhythmia Use this key to open the arrhythmia menu Note This key is available only if the arrhythmia option is enabled in the System Setup ST Analysis Use this key to open the ST menu Note This key is available only if the ST option is enabled in the System Setup PR QT Use this key to open PR QT menu See PR QT Measurement on page 14 28 All ECG Leads Pressing this button will dispaly all ECG leads for a pweriod of 2 minutes Use Main Screen to return to the standard display All ECG panels can be a
152. to reset the Apnea timer 6 Select Respiration Default Color A panel displaying all available colors appears Select the required color The panel closes 7 Select Discard Changes to close the Respiration Setup panel without applying any changes Mennen Medical D 27 7 Operating Manual Select Main Screen to apply the changes and exit the panel Note When you exit a vital signs setup panel you return to the main screen To continue System Setup you must press the System Setup button again to access the System Setup menu BP Setup This dialog panel enables you to set BP default parameters These parameters include general default values applicable to all BPs and default values applicable to specific BP site such as ART etc General BP Default Parameters e Alarm priorities for BP and Fault alarms Alarm priority affects the order of audible and visual alarm notification See Alarm Priority on page 8 4 for a full description of this feature BP alarm priority can be set to C 1 C 2 or C 3 The factory default is C 2 Fault alarm priority can be set to T 1 or T 2 The factory default is T 1 e Alarm Latching For a complete description of Alarm Latching see Latched Alarms on page 8 7 The available options are Off Visual latching visual alarms only and On both visual and audible alarms The factory default is Off Alarm Detection Delay When an alarm is detected a pre define
153. to the EtCO2 menu press Main Screen to close the panel and return to the main screen display Mennen Medical 23 17 End Tidal CO2 EtCO2 Microstream MicroPod Menntor 7 Operating Manual Points to Consider and Possible Causes of Error How can I get longer life from my FilterLine Set During lavage suctioning disconnect the FilterLine or put the monitor in Standby Pump Off mode before starting this procedure in Figure 23 6 illustrates the connections from the intubated patient endotracheal tube to the ventilator Figure 23 6 Connections from the intubated patient to the ventilator 1 To Patient Inline suction 2 3 Airway adaptor 4 FilterLine to capnograph 5 To Ventilator When the patient requires suctioning by saline lavage the position of the airway adapter is not important Whether the airway adapter is positioned vertically or horizontally to the ET tube some of the lavage solution will inevitably flood the airway adapter in Figure 23 7 To avoid the liquid entering and blocking the sample line it is important to either disconnect the FilterLine or place the monitor in Standby Pump Off mode before starting this procedure 23 18 Mennen Medica Menntor 7 Operating Manual Figure 23 7 Lavage solution flooding the airway adapter 1 To Patient 2 Lavage 3 Airway adaptor 4 Liquid in airway adaptor 5 FilterLine to capnograph
154. up to three of the following End of First Second Third Shift e User defined time Upon Discharge Note Each selected report can be printed automatically up to three times every day Mennen Medical D 63 Menntor 7 Operating Manual Network Setup D 64 QC TRO2 The Network Setup panel is used to name device and to name and define which unit each device is associated with You can associate device with each of the units located on the network or you can create new unit and assign to it device The panel also displays the device ID number and IP address as defined during manufacturing If a printer is located on the LAN you can enable the printer for the device If the monitor is connected to a Data Base D B the panel will show the Data Base Device ID and IP address Monitors equipped with Wireless LAN board can be activated from the Network Setup panel Wireless Network ID and WAP Pass Phase can be downloaded from the panel to the wireless board This provides a protected wireless network to Mennen Medical Monitors System Setup Network Setup Network Information Default Printer Device Settings Device Unit Group QC EZ HIS LIS HIS LIS x D B Information HemoCIS Hemocis SE Device ID 0007320da9261800 FI Export data to D B IP Address 172 17 0 53 Device ID 0002554796266000 IP Address 172 17 0 251 Wireless LAN On Enmove Interfac
155. upward in order to minimize moisture and secretions in the adapter and tubing as shown in the figure below Ventilator Croult ond Wye xd d ET nd B Files tubing to patient pp quu ez fies ste wey arum Figure 34 3 Adapter Flow sensor to patient circuit CAUTION During the insertion of the flow sensor into the breathing circuit the patient is not ventilated Perform this procedure as quickly as possible Monitoring Procedures The Spirometry module provides access to the following five monitoring items e Air Flow e Air Volume e Airway Pressure e Loops e Spirometry Calculated parameters Air flow Air volume and Airway pressure are displayed in waveforms plus numeric values Mennen Medical 34 5 Spirometry Menntor 7 Operating Manual Loops include some numeric parameters The Spirometry table shows all or part of the numeric vital signs as selected by the user You can open one or more up to all of the items related to the Spirometry module Screen Captures of Spirometry displays Tr 17 23821 RA QA I H TI 2 san uti rev s j n it 20 10 i al n 119 80 96 23 14 17 s 37 0 141 88 100 HOSPITAL NAME Figure 34 4 Spirometry Loop display on Menntor X7 17 26 fr l Hin p 8 0 WI 20 119 80 96 i 23 898 14 AA 47 n a SEDENS T 37 0 3H 88 100 s pg hesse Figure 3
156. view the beds in alarms 1 From the Patient Data menu select Alarm Watch 2 The Alarm Watch panel will appear Alarm Watch Figure 7 12 Alarm Watch 3 On the panel all the beds that are in Alarm Watch and are in alarm state are listed under the label Beds in Alarm 4 Use the QuicKnob to select the Beds in Alarm panel Select a bed and either set Alarm Off in this case the alarm of the remote bed is off and will not be displayed on the local bed or 6 Select Display Patient to enable remote viewing of the selected bed 7 Press the Refresh list knob to refresh the list in this case you will remove selected beds from their alarm status and add new beds with new alarms 7 16 Mennen Medica Menntor 7 Operating Manual 15 12 01 ALARM WATCH PETTEE TUNES 45 570 alt AA alt JA A Al da an LE A LLLA Lev LEAD V FAULT HOLE J FG c 1 mv n h l x 0 0 STI i1 STU n ley Ecc VI STavR 0 0 ST 0 0 StavF 0 0 ST pio o E an Last Apn 2 108 pes CABLE OUT Figure 7 13 Menntor X7 with Alarm watch Remote view Return to Local View While in Remote View you can return immediately to Local View by pressing Main Screen button on the front panel of the Menntor X7 CPU Note Remote View has automatic timeout with return to Local View This time out
157. waveform displayed in the Ten Minute Display Panel The time span of the patient s waveform data as stored in the Menntor X7 s memory appears in the bottom right hand corner of the panel Statistical data for the ten seconds under review appear below the waveforms including e intervals between beats in milliseconds Time stamps for the beginning middle and end of the ten second period 66 99 e Location and classification of each QRS complex on the waveforms 66 99 indicates a normal QRS complex indicates a ventricular QRS complex indicates a pacemaker induced ventricular QRS complex a indicates a ventricular QRS complex that does not fit into any defined category and 1 indicates a QRS complex detected during the ECG waveform learning stage e List of alarms that were activated during the ten second period with a time stamp for each alarm To operate the Ten Second Display panel To change the gain factor of the display select a different factor from the Gain drop down list Available options are Imv cm and 2mv cm To scroll forward ten seconds press Scroll Right Waveforms and statistical data specific to the new time period appear To scroll back ten seconds press Scroll Left Waveforms and statistical data specific to the new time period appear To view the waveforms and related statistical data for a specific ten second period press Go To and enter the required dat
158. 0 Etco2 Calibration Start Calibration Last Calibration 14 6 10 Next Calibration In 1363 Hours Figure D 16 EtCO2 Calibration panel For Microstream EtCO2 we have to perform span calibration with standard CO2 concentration after 1200 hours of first use and then once every year To perform the calibration use gas mixture 5 21 D2m Bal N2 Scott Medical Products 6141 Easton Road Box 310 Plumsteadville PA 18949 215 766 8861 Fax 215 766 0320 To perform the calibration 1 2 3 4 5 In System Setup select EtCO2 Calibration see Figure D 16 Set the calibration value to 5 0 Open the gas flow and select Start Calibration After several seconds the calibration will end Stop Gas flow Mennen Medica 7 Operating Manual Cardiac Output CO Setup This dialog panel enables you to set the CO default color CO Default Color Defines the color in which CO values appear on the main screen display You can choose from 16 available colors QC1 AAR Discard Main CO Default Color p Figure D 17 The CO Dialog Panel gt Tosetdefault CO parameters 1 From the System Setup menu select Vital Signs Setup The Vital Signs menu is displayed 2 From the Vital Signs menu select CO Setup The CO Setup dialog panel is displayed 3 Select CO Default Color A panel displaying all available colors appears Select the required color 4 Select Discard Changes to close pa
159. 0 156 180 Bath 23 25 10 618 596 628 607 628 5 302 316 288 309 293 309 3 177 188 165 180 170 180 RoomTemp 18 25 10 638 691 629 595 629 Closed 320 342 316 349 309 349 309 gt To enter the computational constant 1 From the Cardiac Output menu select Acquire 2 Select the Computation Constant field Use the QuicKnob to enter the required constant allowed range a decimal point followed by up to three digits Mennen Medica Menntor 7 Operating Manual 3 Press CO to close the panel and return to the CO menu Press Main Screen to close the panel and return to the main screen display Entering Patient Information If cardiac indexes are required the Body Surface Area BSA must be calculated before the C O calculation routine Menntor X7 automatically calculates the BSA from patient height and weight If these parameters were not entered in the Patient Identification Panel when the patient was admitted or at some other time this information can be entered by accessing the Patient Identification panel from the Cardiac Output menu gt To fill out patient height and weight 1 From the Cardiac Output menu or if you are already in another Cardiac Output panel from the drop down menu below the panel title area select Patient Identification The Patient Identification panel is displayed 2 Select Height and Weight e Turn the QuicKnob until the required
160. 00 150 50 100 75 125 S D M 100 150 50 100 75 125 1 0 1 0 NIBP Pulse Rate 50 150 4 40 Figure D 6 The Default Alarm Limits Panel gt To set default alarm limits 1 Turn the QuicKnob until the required vital sign is highlighted and press The appro priate options and scale are displayed on the right side of the dialog panel 2 Under Default Type select Fixed or Dynamic 3 Select Pressure Type for BPs 4 Select the required limit high or low highlight the required slider with the QuicKnob and turn the QuicKnob clockwise or counter clockwise to move the slider to the required alarm limit Press in the QuicKnob to set the limit Mennen Medical D 19 7 5 When done press the Escape button on the front panel to return to the Vital Sign list 6 Repeat steps 1 5 until you have set alarm limits for all required vital signs 7 Select Discard Changes to close the panel without applying any changes Select Main Screen to apply the changes and close the panel Event Setup Use the Event Setup panel to create or modify Event labels and to determine the response to activation of the Mark Event key T o REE 4 Event Strips List Of Labels Insert Admission Edit Delete Mark Event Key x Chart Only sy Chart Strip Chart Strip Label Figure D 7 The Event Setup Panel gt Insert a new label 1 Select
161. 01 Rev A Menntor X7 Operating Manual Location of Symbol On device label On device label On device label The Identification label is located at the back of the monitor The Indentification Label Menntor X7 Mennen Medical Menntor 7 Operating Manual Model MX57 RevA re 751000Xxx x 0000000000000 NNN m l Mennen Medical Ltd D N XO 4 Hayarden Street Yavne PO Box 102 Rehovot 7610002 Israel Rony C EC REP Charter Kontron Limited 0473 Unit 18 Avant Business Centre 21 Denbigh Road Milton Keynes MK1 1DT England 751701002 Rev A Figure 2 2 The Indentification Labels MX57 MPM The labels includes warnings and compliance information as follows e Identification information Part Number P N Serial Number S N and model name e Electrical power information Voltage Current and Frequency e Warnings Disconnect supply before servicing replace fuse as marked Electrode and Transducer Protection The Electrodes and Blood Pressure Transducers recommended for use with the equipment and the equipment itself are provided with protective means against burns to the patient when used with high frequency surgical equipment Immunity requirements of IEC Collateral Standard 60601 1 2 for Electromagnetic Compatibility are met with the transducers recommended for use with the unit see Appendix A Mennen Medical 2 7 Warnings and Precautions Menntor 7 Operating Manu
162. 1 Menntor 7 Operating Manual MM Hospital Date PAPM Sp02 TMPI PCWP To i C mmHg 96 37 0 96 37 0 96 37 0 96 37 0 96 37 1 96 37 0 96 37 1 96 37 1 96 37 0 96 37 0 96 37 0 96 37 0 96 37 0 96 37 1 96 37 0 96 37 0 96 37 1 96 37 0 96 37 1 96 37 0 96 37 0 96 37 1 96 37 0 e e e e e e e e e e e e e e 96 37 0 Eo 248 oOo 1 Print all pages Figure 10 20 Preview Screen Print current page The Preview screen includes Patient name and ID Date amp Time of the Report Hospital Name Unit and Bed number and the buttons listed in the following table Table 10 2 Preview Screen Buttons Button Function Previous Preview the previous report page Next Preview the next report page Print all Pages Print all report pages on a laser printer Print Current Page printer Print the currently displayed report page on a laser Cancel Exit the Report preview 10 30 Mennen Medica Menntor 7 Operating Manual Heart Rate Variability HRV Introduction Heart Rate Variability of the normal ECG contractions non ve
163. 1 Tone 50 I Event Strip Event Strip sinus race Ree Tone I Couplets of PVCs E supraventricular Tachycardia Event Strip Rec MW Tone Event Strip SES om All Event Strip Event Strip On Off Event Strip I Record 1 Record 1 Tone 1 Tone 100 Event Strip Rec _ Tone TJ Event Strip E mutitocal pvcs E Triplets of PVCs 1 Record 1 Tone 5 2 Event Strip Rec MT Tone JE Event Strip GEMI Rec MW Tone EP d NY Event Strip run 1 Record 1 Tone I Event Strip E interpolated PVCs Lo EUM 1 Tone 4 Event Strip Rec MW Tone Garis sv meg non T 1 Record I Record _ Tone _ Tone 12 Event Strip Event Strip Record 1 Tone Event Strip Figure 15 1 The Arrhythmia Alarms Dialog Panel Mennen Medical 15 5 Arrhythmia Menntor 7 Operating Manual 2 Click the ON or OFF All Alarm button to set all arrhythmias alarms on or off 3 Click the ON or OFF All Record button to set the recording response to arrhythmias alarms to on or off 4 Click the ON or OFF All Tone button to set the tone response to arrhythmias alarms to on or off 5 Click the ON or OFF Event Strip button to set the Event Strip alarm response to arrhythmias alarms to on or off Note Setting All Alarms to OFF or ON turns all the arrhythmia boxes off or on Individual arrhythmias can then be set by activating th
164. 14 1 ECG Deactivation doe dee tee be netu etant 14 1 ORS Detect On NE 14 2 ECG LED Indicator eiie at eee tee ET Le Lee trt ce br tet 14 2 Patient Preparation ea OE Dee e OE TERES 14 2 ECG Monitorimsg Checklist dee e Eee o sie besten Le peto Ce t pete utere ce 14 6 ECG Monitoring Procedures ger te etes Pete tt Dee epe tee EU ate hoe 14 6 Setting ECG Leads amp Gain Parameters essent 14 8 Set ng ECCr Alarms ets eet nied icin etiem d e eee 14 12 Mennen Medical iii 7 Operating Manual Setting ECG Report usanne sa nes 14 16 Setting ECG Display Options eere e dese te teet ite eco 14 17 settins ORS Tone Vol m sisne Saat siesta pre EE Ha eee teat er eee D re re ertet ee cte d 14 18 Detecting Pacemaker ege et eere certe tete ede on ee a e ee ee 14 20 Pacer Alaris 3 imet edt dt ERR IIa 14 22 Setting Heart Rate SOUrCE 5 uie entere eee eot tte tee dee ee esee ted 14 23 Selectins a ier ene tutte reete n en etre ete 14 24 BCG Recordin ge use tee Et cte esos ie iE EE Ee uvante 14 26 BCG Report Printm ua Actes ches i e e Pe E t E t EP Led Lot e e deett Renta 14 26 PR OT Measurenient 5 esos ven hme nene ena 14 28 Chapter 15 Arrhythmia nonus EE 15 1 Monitoring Procedures sesamiae nona eue iecit edet 15 4 Accessing the Arrhythmia Menu an eee tte ect Fore he Sn oe p
165. 18 7 Waveform and the From PA Dialog Panel gt measure on a BP channel reserved for PAP 1 Mennen Medical Insert the Swan Ganz catheter into a central vein and properly situate the proximal end of the catheter in the central vein and the distal end of the catheter in the pulmonary artery From the BP menu or From the drop down menu list below the BP title area in the BP panel select PAP to open the PAP menu select from and then select Start Procedure The CVP from PA dialog panel opens and the following message appears in the upper left corner Change stopcock and press Adjust Rotate the stopcock on the Swan Ganz to connect the PAP transducer to the proximal end of the catheter The Menntor X7 automatically calculates the and displays it on the from dialog panel Press Accept to accept the CVP value or Press Adjust The PAP waveform is frozen and a red cursor marks the location of the value Use the QuicKnob to move the red cursor up or down When satisfied press Accept The from PA dialog panel closes and the CVP value appears in the PAP area on the main screen display with a date and time stamp To automatically scale the CVP waveform press Autoscale 18 15 Invasive Blood Pressures Menntor 7 Operating Manual 6 To simultaneously change the sweep speed of the CVP and RSP waveforms press Sweep Speed and select a di
166. 2 Cardio Respiratory Graph CRG rss teet edite cu nere eese pe 7 5 Remote View EE 7 9 Chapter 8 Alarms General Features cea RR rense 8 1 Alarm Notification Gc aste ee oU e t o Pe te ene e eH t He et eret e Le e eb diea 8 2 AlarmrDProfity 5 5p nde ae ores 8 4 Setting Up Alarms c eee ee eet ette es e ieee sten Sued us wen eet oo P ein 8 6 Alarm Controls dx mapas ibo pede om pesce ertet etie eo 8 6 Alarm Status abe bie NE 8 9 What To Do When an Alarm Occurs eerrrennrrenvrneeneneenrnnersnernrsennrnsennnsennnnenrnernrsvensssennenennnneensseersessnseenne 8 10 Alarm Messages iie eee dee ee m Hu EU Be E E deest eR HA ge t ena 8 12 Chapter 9 Connecting a Patient to Menntor X7 dese eem aede eed ene te peto 9 1 Admission Discharge and Transfer Procedures sees rennen 9 1 Setting up Monitoring Profiles tate tt aeta sei e ep repere tip exe rares 9 20 ii Mennen Medica 7 Operating Manual Chapter 10 Reviewing Patient Data Trends TUI 10 2 ST Watch ia iene a ea een 10 5 Charts natta fars 10 12 Full Disclosure 10 15 Overview Panel 80 n tue te EL Ete poe oir pu robe 10 21 Event Sips 21i e eget me ears ce aiv t ater dp pred e 10 23 I
167. 235 Measurement Ranges Neonatal in mmHg Systolic 30 to 135 Diastolic 15 to 110 Mean 20 125 Pressure Transducer Accuracy 3 mmHg or 2 whichever is greater Heart Rate Adult Pediatric 30 to 240 BPM 9 Neonatal 40 to 240 BPM Modes Auto Manual STAT Automatic intervals 1 2 3 4 5 10 15 20 30 60 120 180 240 360 480 minutes Data Storage Measurement time markers S D M Alarm event markers We follow every beat of your heart Mennen Medical Ltd All rights reserved Specification subject to be changed without notice f medical Temperature YSI 400 Series Probes Body temperature 0 to 45 C 32 F to 1139F 0 1 C Temperature Alarm Range 25 C to 45 C 77 F to 113 F Data storage Temperature and Delta temperature Temperature alarms Delta Temperature Range 45 C Delta temp Accuracy 0 1 C End Tidal CO2 Microstream EtCO2 Module Sidestream method Flow rate 50 ml min accuracy 7 5ml min 15ml min Displayed Data Waveform labels and annotations 0 EtCO2 in CO2 and respiration rate values CO2 Display Range 0 99 mmHg Measurement Resolution Typical Accuracy 0 2 mmHg for CO2 range of 0 38 mmHg 0 08 for every 1 mmHg above 38 mmHg 0 5 for CO2 range of 39 99 mmHg Respiration Rate Oto 70 bpm 1 bpm 0 71to 120 bpm 2 bpm 9 121 to 150 bpm 3 bpm e Rise Time 190 msec 10 90 e Delay Time 2 7 Sec 10 90 typical e Start up T
168. 372 NIBP Accessory Kit Adult Pediatric 551 306 373 NIBP Accessory Kit Adult 551 306 370 Reusable Cuff Adult Pediatric Cuff Adult 25 35 cm 800 271 322 Cuff Large Adult 33 47 cm 800 271 329 Cuff Thigh 46 66 cm 800 271 327 Cuff Pediatric 18 25 cm 800 271 328 Cuff New Born Infant 6 11 cm 800 271 324 Cuff Adult 25 35 cm 800 271 322 Reusable NIBP Accessory kits Adult Pediatric CAS NIBP Accessory Kit Adult 551 306 272 NIBP Accessory Kit Pediatric 551 306 271 NIBP Accessory Kit Infant 551 306 270 NIBP Accessory Kit Adult Pediatric 551 306 273 NIBP Accessory Kit Adult 551 306 272 NIBP Accessory Kit Pediatric 551 306 271 Reusable Cuff Adult Pediatric Cuff Adult 23 33 cm 800 261 322 Cuff Large Adult 31 40 cm 800 261 329 Cuff Thigh 38 50 cm 800 261 321 Cuff Small Adult 17 25 cm 800 261 328 Cuff Child 12 19 cm 800 261 323 Cuff Infant 8 13 cm 800 261 324 4 Mennen Medical 7 Operating Manual Table 5 Temperature Accessories Item and Description Part Number P N Dual Temperature Adapter Cable 551 306 023 Temperature Probe General Purpose Adult 800 060 010 Temperature Probe General Purpose Pediatric 800 060 020 Temperature Probe Surface 800 060 030 Table 6 Reusable Cuff Adult Pediatric Item and Description Part Number P N Cuff Adult 23 33 cm 800 261 322 Cuff Large Adult 31 40 cm 800 261 329 Cuf
169. 4 5 Spirometry Loop and Table on Menntor X7 34 6 Mennen Medical Menntor 7 Operating Manual summ 11803 m fane mpm ndr ANE 17 33 sr All hd Ala E fi A A A p 8 H ar YA as 249 89 E 0 4 Ie Y reer p 18 0 ve 249 frir B PF n E 1 22 m 36 ag a 37 015 141 88 100 HOSPITAL HAMP Figure 34 6 Spirometry Waveform and Table display on Menntor X7 m Plu oe fer 17 358 o deni pii ada b Lal EA 8 0 t it UU m 119 80 96 431 34 33 318 9 8 0 4 12 ES SENILE B 1 08 01 14 37 P Figure 34 7 Spirometry Loop and Waveform Display on Menntor X7 gt To start monitoring Air Flow Air Volume or Airway Pressure 1 Connect the patient sensor 2 Enter Vital Sign menu Mennen Medical 34 7 Spirometry Menntor 7 Operating Manual The Spirometry Menu You can access the Spirometry menu from the from the Main Screen display or from the Menntor X7 Vital Signs menu To access the Spirometry panel from the Main Screen display Turn the QuicKnob until the Spirometry parameter key is highlighted and press the QuicKnob in order to access the Spirometry panel gt To access the Spirometry menu from the Vital Signs menu 1 Onthe front panel press the Vital Signs fixed key The Vital Signs menu is displayed 2 From the Vita
170. 6 new item called HemoCis View appears in the Setup menu this key toggles Show and Hide of the HemoCis window Figure 9 10 HemoCis View none en370072 ANDREJKO JOSEPH F Setup Mennen Medical 9 13 Connecting Patient to X7 Menntor 7 Operating Manual Note We recommended that you prepare a QuicKey for HemoCis View to enable opening and hiding of the HemoCis window in one action Admit from HemoCis The Ensemble network system has an option for receiving patient data via the network from the HemoCis Clinical Information System to an Menntor X7 monitor The transferred data includes e Patient Demographic Information e Cath Lab Occurrence ID and e Case ID gt To transfer patient demographic data from the HemoCis to an Menntor X7 mon itor on the network 1 Open the Patient Identification panel from the ADT menu on the target monitor lt none gt en370072 ANDREJKO JOSEPH F Patient Identification Figure 9 11 Patient Identification Panel 2 Select the Patients in HemoCis button on the right side of the panel a panel of Patients in HemoCis opens and a list of patients scheduled for a procedure today is displayed 9 14 Mennen Medica Menntor 7 Operating Manual 3 Either select a patient or use the Look For boxes to find the patient according to the first letters of his name use the Show All Patients button to show the complete list of patients in the HemoCis
171. 6 36 VALUE INDEX NORMVAL NORMIND Alveolar Oxygen Tension PaLO2 100 150 p8 760 mmHg S 98 Arterial Oxygen Content ceo 15 23 HB 220 Venous Oxygen Content 4 Arteriovenous 02 Difference AvDO2 Oxygen Availabili 02Av 1387 2 G9 limi 550 650 svo2 68 x PACOZ 13 mmHg en Avellabiliy FJ o Oxygen Consumption vo 384 VO21 128 250 300 115 165 50 Limin 14 26 Mennen Medical EA 500 Oxygen Extraction Ratio ozer EN 24 28 Alveolar Arterial 02 Difference aa00 89 1 10 15 paca PVO2 I maig 8 Shunt Fraction Qs QT BLUE eu 7 11 Blood O2 Content Capacity CCAPO2 ve Figure 11 4 Oxygenation Panel Manually enter all missing data and update any existing values if necessary Calculated values and indexes appear on the right side of the panel Out of range values appear on a red background Click the Accept button to save calculations and exit the screen The results of the measurement and calculations are saved in the Oxygenation chart You can access the results from the Charts option in the Data Review 11 5 Performing Clinical Calculations Menntor 7 Operating Manual menu Renal Clearance Calculations In the Renal Clearance panel you can view monitored Renal data and perform clinical calculations gt To perform Renal calculations 1 On the Menntor X7 Main menu press the Patient Data key 2 Inthe Pati
172. 7 provides measurement of PVI Pleth Variability Index and PI Perfusion Index The Radical 7 supports the use of standard SpO2 sensor and require special sensors with multi wavelength to measure the additional blood parameters SpMet SpCO SpHb and SpOC See table XX for details WARNING Before making decisions on treatment of blood gas check blood gases using a calibrated Gas Blood Analyzer Use the monitor alarms and abnormal value as a indication for further check WARNING The disposable sensors are attached to the skin with adhesive tape they are contraindicated for patients who exhibit allergicreactions to foam urethane products and or adhesive tape Mennen Medical 29 1 Radical 7 Masimo CO Oximeter Menntor X79 Operating Manual Radical 7 Accuracy Limitations e Inaccurate measurements may be caused by venous pulsations e Inaccurate measurements or loss of pulse signal may be caused by placement of a sensor on an extremity with a blood pressure cuff arterial catheter or intravascular line e Loss of pulse signal can occur when the sensor is too tight e Loss of pulse signal can occur when the patient has hypotension severe vasoconstriction severe anemia or hypothermia e Loss of pulse signal can occur when there is arterial occlusion proximal to the Sensor e Loss of pulse signal can occur when the patient is in cardiac arrest or is in shock Technical Alarms Technical alarm messages for
173. 93 pS9 25 10 114 SpO2 96 p74 350 TMP2 31 1 TMPX 368 TMP4 37 0 ST 076 Hn 097 020 aVR 056 aVL 026 aVF OSR Vi 044 V2 045 VM 126 V4 120 VS 116 075 ST Ave 074 ST Sum 889 STVM 137 55 242 43 16 04 54 I vi va Lip dE peperere dba v2 avF vs LE T DEN FE iran L xL TEN NEN ERGS BEI NEN 750 D 25 mm sec 10 menm Filter ST Signature Figure 14 16 ECG Report on Laser Printer Mennen Medical 14 27 Menntor 7 Operating Manual PR QT Measurement You can measure the PR and QT intervals manually The PR QT results are displayed with a time stamp and QTc defined as QT interval square root of RR interval QT interval Square Root of RR interval gt To manually measure the PR and QRT intervls 1 From the ECG menu choose PR QT 2 From the sub menu choose Measurment A measurement panel opens 2710 10 4 0 06 E Adusi Accept Cancel Figure 14 17 PR QT Measurement Panel 3 Click Adjust PR and using the QuicKnob move the PR line to the beginning of the P wave 4 Click Adjust QT and using the QuicKnob move the QT line to the end of the T wave 14 28 Mennen Medical Menntor 7 Operating Manual 5 Press Accept to accept the results The result is displayed in either Big Numbers or secondary PR i Q T Mennen Medical 14 29 Menntor 7 Operating Manual 14 30 Mennen Medica
174. ARNING If water droplets enter the measuring tubes of the sensor the flow measurement is affected Use the manual purge to remove water from the tubes Yopu can use Purge from the Spirometry menu or create a Purge Quickey Note The vital signs in the waveform areas are duplicates of the values in the table Note Alarm limits ranges and defaults will be the same as in Spirometry PEF and PIF have no alarms and thus no alarm limits If an external Ventilator is in use the dispalyed numeric parameters vital signs are those measured by the Ventilator Use this panel to activate or deactivate spirometry monitoring Monitoring can also be discontinued for whatever reason and resumed later To activate and deactivate Spirometry monitoring 1 From the Spirometry menu select Activate the Spirometry Activate panel is displayed 2 Select the Activate checkbox to initiate Spirometry monitoring Spirometry numeric parameters cannot be monitored together with Ventilator numeric parameters if a Ventilator is active and you try to activate Spirometry a warning message is displayed Ventilator in use at x x activate Spirometry Deactivate Ventilator 3 To activate Spirometry deactivate the Ventilator 4 Press Main Screen to return to the main screen display CAUTION The numeric parameters of the Spirometry module cannot be monitored together with the numeric parameters of the external Ventilator If the Menntor X7 is
175. Adult or Neonatal 3 Press NIBP to close the panel and return to the NIBP menu press Main Screen to close the panel and return to the main screen display Setting NIBP Alarms NIBP alarm parameters are set in the dialog panels Alarm Limits and Alarm Response Each dialog panel controls a different aspect of NIBP alarms NIBP Alarm Limits NIBP alarm limits are activated and set in the NIBP Alarm Limits panel The current low and high alarm limits and the current NIBP value are displayed on the panel RICU BED Main Screen NIBP 5 Select Type Systolic x 150 100 CO ucv et app o Auto Set JE NIBP Alarms Defaults Figure 21 3 The NIBP Alarm Limits Panel 21 10 Mennen Medica Menntor 7 Operating Manual To set NIBP alarm limits 1 Mennen Medical From the NIBP menu if you are already in another NIBP panel from drop down list below the panel title area select Alarm Limits Press Select Type and select either Systolic Diastolic or Mean from the drop down list to set the type of blood pressure monitored Select the Systolic diastolic mean Alarms checkbox to activate or deactivate alarms Using the QuicKnob move the markers on the low high alarm limits slider bars along the displayed scale to set the required limits The right marker sets the low alarm limit and the left marker sets the hig
176. Alarm Automatic Interval Every 1 Hour A Select All Filters Unselect All Filters Figure D 29 Setting Up a Chart Type Report gt To edit the format of a Vital Signs chart type report 1 From the System Setup menu select Report Setup 2 From the Report List select a report 3 Select Edit Report The Edit Report dialog panel is displayed Mennen Medical D 59 10 Chart Vital Signs Time Menntor X79 Operating Manual In the Type drop down list select Chart From the Duration drop down list select the time period during which data is collected for the chart From the Paper Size drop down list select the size of the paper you want the report printed out on Available options are Letter Legal Executive A4 and A3 From the Paper Orientation drop down list select Portrait vertical orientation or Landscape horizontal orientation From the Chart Type drop down list select Vital Signs Press Select Filters for all available filters to be included in the chart Press Unselect Filters and select only those filters you want to include in the chart The available filters are Alarm Manual Cardiac Output PWedge Apnea Alarm NIBP and CVP Select Discard Changes to close the panel without applying any changes select Main Screen to apply your changes and return to the blank screen Data Review 7 Filter Cardiac Output NIBP Manual PWEDGE CVP Apnea Alarm Automati A
177. Big Numbers Note If there is insufficient space to display all of the monitored vital signs waveforms along with the CRG displays then one or more of the vital signs will be relegated to Secondary Vital Sign status according to the defined parameter hierarchy Upon exiting the CRG mode the vital signs will automatically return to their previous waveform format The two CRG displays CRG 1 and CRG 2 are displayed one above the other and are divided into two parts Graphical traces are given on the left parameter values duration selection and grid information are given on the right of the screen Each CRG display is further divided to show up to two parameters The two parameter traces of the CRG display are generated within the same time frame and can thus be overlapped to show point to point time correlation their parameter values and grid information are defined as being left side and right side in the Setup panel according to their position on the display Each trace is accompanied by a vertical scale which can be displayed either on the left or right side of its graph In the following example CRG 1 and CRG 2 displays are shown with each display containing two parameters e Upper Display parameters shown for CRG 1 are HRT BPM Left Param and SpO2 Right Param e Lower Display parameters shown for CRG 2 are RESP BPM Left Param and ARTd mmHg Right Param Traces are shown on the far left of the screen
178. Body On the label attached to the back of the module Mennen Medical 34 17 Spirometry Menntor 7 Operating Manual EZ Flow Flow Airway Adapter Specifications Flow Range Accuracy Dead Space Connections Length Weight Material 2 180 Ipm 33 3000 ml s 5 reading or 0 5 lpm 6 9 ml Airway 15 mm ID 22 mmOD patient end by 15 mm ID ventilator end ISO 5356 1 Monitor Proprietary Smart connector Tri Tubing triple 0 055 inch ID lumen 2 5 inches adapter 6 feet tubing 6 3 grams minus tubing Sensor Polycarbonate Makrolon Tubing Medical grade Polyvinyl Chloride Trouble Shooting Spirometry Problem Cause Solution Monitor measures flow when flow is zero Fluid in measuring tubes Activate Purge to clear the tubes If this fails replace the sensor Negative volume measurement Inverted sensor See Figure 34 3 for the correct sensor direction Negative volume measurement Leakage in the ventilation Check ventilation circuit circuit for leakage and correct Technical Alarm Sensor tubes not properly Reinsert sensor into sensor Cable out inserted socket Technical Alarm Device failure Replace module Contact Device Error Service Technical Alarm Device failure Replace module Contact Calibration Error Service 34 18 Mennen Medica SECTION 6 APPENDIXES This section includes the following Appen
179. CRG On off Figure 7 6 The CRG Panel 5 Select the Grid checkbox to display a grid 6 Select the CRG On off checkbox to activate the CRG Note The settings for Duration Grid and CRG On off apply to both vital signs if two were chosen 7 display parameters for CRG 2 repeat steps 2 to 7 Remote View When monitoring a patient you may want to view simultaneously another patient under your supervision The Remote View feature allows you to view any other Menntor X7 bedside monitor located on the same network When displaying a remote bed you can view on your screen parameters of the remote bed while continuing to monitor basic parameters of the local bed In remote view can only view the remote bed and temporarily set the remote bed all alarms setting to off You cannot change any other settings on the remote bed Note Bed to Bed Remote View is intended for temporary monitoring only while under the direct supervision of the user Mennen Medical 7 9 Setting Up the Patient Display Menntor 7 Operating Manual To remotely view bed 1 From the Main menu select the Setup key The Setup menu is displayed 2 From the Setup menu select Remote View The Remote View panel opens Figure 7 7 Remote View Panel Select the required unit and bed 4 Click Accept The remote bed s waveforms and measured values appears on your screen 7 10 Mennen Medica Menntor 7
180. Description The panel consists of Central trend area and of Frame The Central area has four trend graph areas e SST and HRT trend area Three ST trend areas for three ST leads The area under the trend areas is used for time markers and event information The area on the right is divided into three boxes 1 Area box on top 2 Waveform box that shows reference ECG and ECG at cursor location 3 Reference time box The Frame is divided to the Top strip Left strip and Bottom Strip The Top strip includes e Bed and Patient name e Patient Data menu key e The panel name e Print key e Main Screen key The Left strip includes three ST lead selection keys and SST selection key The Bottom strip is the main control strip and consists of the following keys e Scale e Display Option Duration e Scroll keys e Cursor keys e Reference setting key e Menu key Go to key Mennen Medical 10 7 Reviewing Patient Data Menntor 7 Operating Manual gt To operate the ST Trend Display panel 1 6 From the Main menu select the Patient Data key to access the Patient Data menu From the Patient Data menu or When the Patient Data panel is already displayed from the drop down menu below the panel title select ST Watch Select up to three ST leads The selected ST leads appear each in separate display area Use the QuicKnob to reach the ST lead selection box Press the QuicKnob to get the list of available leads and
181. G appears at the time location of the cursor Mark Event Inserts an event mark and saves an event strip Section Use this key to store sections of aEEG Note Under the above keys the available data time span is shown from the start Mennen Medical of monitoring until the current time 30 17 CerebraLogik aEEG and EEG Menntor 7 Operating Manual e Store Use this key to store a 3 hour section of aEEG e Axis Toggles between I and 2 channels aEEG amp EEG display e Date Displays the date of the historic aEEG displayed e GoTo Use this key to open the Date amp Time panel and select the date and time at which the aEEG display will Start Note This key is dimmed if the history is less than 3 hours EEG Sections You can store aEEG Sections gt To marka section on the aEEG History panel 1 Press Cursor 2 Set the cursor to the required start of the section 3 Select the Section key Use the Quicknob or the Touch screen 4 Rotate the Quicknob This displays Red cursor which provides the end time of the section 5 Click the Quicknob this sets the section between the Cursor and the Red cursor A list of section labels opens 6 Either select a label or Use the Escape key to mark the section as Manual Note In order to be able to display the section labels you need to set the Mark Event key in System Setup gt Event Setup to Chart Strip Label Viewing aEEG Sections
182. History A panel with aEEG History that allows viewing the pre selected sections Activate Use this key to activate or deactivate EEG monitoring Setting EEG Leads and Gain Select the number of EEG channels and the gain for monitoring EEG and aEEG e Channels One 1 or two 2 EEG channels can be displayed e Gain EEG Gain Control Select either 10 20 50 70 100 or 200 uV cm e aEEG Range 100 or 200 uV e 1 aEEG 1 This is the EEG channel that is displayed as the first top lead toggle between Left Right or Cross e 2 aEEG 2 This is the EEG channel that is displayed as the second bottom lead toggle between Left Right or Cross 30 8 Mennen Medica Menntor 7 RD VER 6 1 Channels Gain luVikm Range 1 Lead LR Cross El 2 Lead EEG LEFT EY Figure 30 6 Lead amp Gain panel Setting EEG and aEEG Display Options Set the display options Sweep Speed 15 or 30 mm sec Show Quality toggle between show hide of the Quality scale e Scale toggle between show hide of the EEG scale e Grid toggle between show hide of the EEG grids e aEEG mode choose EEG to display the EEG waveforms only or aEEG to display EEG amp aEEG simultaneously Quality Color choose the color of the Quality waveform A full palette is available EKG color choose the color of the EEG waveform Blue or Black is avail
183. I Note Calculated leads aVR aVL and aVF cannot be selected for pacemaker detection When pacemaker detection is activated the pacemaker pulse is incorporated into all ECG waveforms pacemaker flag in the form of vertical red line is inserted whenever the bedside monitor detects the presence of pacemaker stimulus The default color for this flag is red but the color can be changed to be the same as the waveform color WARNING PACEMAKER PATIENTS Rate meters may continue to count the pacemaker rate during occurrences of cardiac arrest or some arrhythmias Do not rely entirely upon rate meter ALARMS Keep pacemaker patients under close surveillance See the following for disclosure of the pacemaker pulse detection capability of this instrument Note Pacemaker Identification is automatic Pacemaker beats are marked in Full disclosure by P without user action You cannot disable pacemaker beat detection 14 20 Mennen Medical Menntor 7 Operating Manual Pacemaker Pacemaker Source Pacemaker Source Adaptive2 Lead Xd Pacemaker Features IT Pacer Spike FT Enable Alarm FT Enable Alarm Alarm Pacer Pulse Colors Figure 14 12 Pacemaker Detection Panel Recommended practice The pacer spike amplitude in the different ECG leads is not related to the QRS amplitude thus the selection of the optimal lead for pacer detection is independent of the lead selection for
184. If the monitor is equipped with wireless LAN network transceiver the RF energy detected by the monitor is displayed near the antenna icon Lao WARNING If the RF energy is low the monitor will not be viewed by the central nurse station CAUTION Consult hospital Biomed on the area covered by wireless LAN accesses points Leaving this area will not effect the monitor function but the central nurse station will have no display nor control over the monitor Interface with Hospital Network 3 6 Mennen Medical monitors can interface with the Hospital Information System HIS Interfacing with the HIS requires using a Mennen Medical Server to switch between the Mennen Medical LAN and the hospital LAN The interface requires customization and an agreement between Mennen Medical and the hospital IT department To provide this interface contact the Mennen Medical Service department Mennen Medica Menntor 7 System Specifications See the following pages Mennen Medical 3 7 Menntor X7 Specification Menntor X7 is a modular monitor consisting of a Host Monitor Multi Parameter Module and two Single Parameters Modules mennen f medical Menntor X7 Host Monitor Specification Hardware and Parameters Menntor X7 is modular monitor with built in display and battery back up 57 Multi Parameters Module Non Invasive Invasive e 3 5 12 lead ECG e 3 5 12 l
185. Inthe Medication list select a drug 2 Inthe Function list select Injection Amount The Injection Amount panel is displayed Mennen Medical 12 7 Performing Medication Calculations Menntor 7 Operating Manual ASRACURIUM ATROPINE DIAZEPAM DOBUTAMINE DOPAMINE DROPERIDOL EPHEDRINE Calculations Medications 02 03 99 Figure 12 6 Injection Amount Data Entry The display requests information regarding the packaged drug concentration amount the prescribed dose and the method of injection Enter all requested parameters 4 Select the delivery method IV Continuous IV Bolus IM Intramuscular SC Subcutaneous PO Per Os NG ND Nasogastric Nasoduodenal 5 Press the Calculate button The Injection amount is calculated and displayed 12 8 Mennen Medica Menntor 7 Operating Manual Data Review Calculations Medications 087097997 Figure 12 7 Injection Amount Calculation Note The medication delivery method and injection amount are charted in the Medication Chart Mennen Medical 12 9 Performing Medication Calculations Menntor 7 Operating Manual 12 10 Mennen Medica 13 RECORDING VITAL SIGN DATA The vital sign data of monitored patient can be recorded in one of the following ways Waveform recordings vital sign waveforms such as ECG RESP and BP provide continuous indication of a patient s condition They are recorded on a chart
186. Latching refer to Chapter 7 Alarms in the Menntor X7 Operation Manual The available options are Off Visual latching visual alarms only and On both visual and audible alarms The factory default is Off D 47 Menntor 7 e Alarm Detection Delay When an alarm is detected a pre defined delay period allows the system to check in order to avoid false alarms The delay can be set to 3 5 10 15 or 20 seconds The factory default is set to 0 seconds e N20 Default Color Defines the color in which N20 values appear on the main screen display You can choose from 16 available colors N20 Setup Figure D 21 The N20 Dialog Panel gt To set default N20 parameters 1 1 From the System Setup menu select Vital Signs Setup The Vital Signs menu is displayed 2 2 From the Vital Signs menu select N20 Setup The N20 Setup dialog panel is displayed 3 Under Extended Alarm Response Set the default priority level for N2O alarms From the Latching drop down list set default alarm latching to On or Off 4 From the Alarm Detection Delay drop down list select the required delay time in seconds 5 S Select N2O Default Color A panel displaying all available D 48 Mennen Medical 7 Operating Manual colors appears Select the required color 6 Select Discard Changes to close the panel without applying any changes Select Main Screen to apply the changes a
187. List Selects a medication from the list Dosage units Converts current units to the selected units Discard Changes Exits the main screen display without saving selections Main Screen Exits the panel to the Main Display Infusion Rate Calculation The rate of administration for an IV is calculated based on patient weight dose rate desired drug amount and total fluid volume in the IV bag gt Tocalculate the Infusion Rate 1 2 12 4 In the Medication list select drug In the Function list select Infusion Rate The Infusion Rate panel is displayed Mennen Medica Menntor 7 Operating Manual Calculations ASRACURIUM Figure 12 2 Infusion Rate Data Entry The display requests information regarding the drug concentration in the IV bag prescribed dose rate and patient weight 3 Enter all requested information 4 Press Calculate The Infusion Rate calculation is performed A titration chart of fifty infusion rate vs dose rate sets is presented The calculated infusion rate corresponding to the selected dose rate is highlighted 05 09 98 Mennen Medical 12 5 Performing Medication Calculations Drug Concentrate Calculation 12 6 Menntor 7 Operating Manual Figure 12 3 IV Infusion Rate Display Note These results are not charted in the Medications Review Chart The amount of medication to be added to the IV is calculated based on patient weight dose rate fluid infusion rat
188. Main Screen to apply the changes and close the panel When an alarm condition is detected the Menntor X7 automatically records the ECG waveform and the waveform of the vital sign which triggered the alarm condition if other than ECG Multi ECG Recording 13 6 A multi ECG recording contains the waveforms of all monitored ECG leads The ECG leads are recorded in a series of 5 sec waveforms Recording stops automatically at the end of the series You can stop recording at any time by pressing the Stop button on the Chart Recorder To initiate a Multi ECG recording 1 Menntor X7 Main menu press the Patient Data key 2 From the Patient Data menu select Selective Recording Mennen Medica Menntor 7 Operating Manual 3 Select the Multi ECG check box Recording is initiated on the associated chart recorder and message appears on the Selective Recording panel Recording now in progress Selective Recording selective recording allows you to select two waveforms from all those available and record them on dedicated Chart Recorder The recording is continuous meaning that once recording has begun it will continue until you instruct the Menntor X7 to stop recording OK 6 Main JOHN SMITH Screen Patient Data Selective Recording E ECG Multi Lead Waveforms Mi Selective gt gt Paper Speed mm sec 25 t Start Recording Waveform2 Figure 13 2 Performing Selec
189. Mennen Medical service engineer If any deviation from the description provided in this manual is apparent consult your hospital s Biomedical Engineering department or System Administrator Intended Use Menntor X7 is intended for use as a multi parameter physiological patient monitoring system The Menntor X7 is a modular monitor with a Multi Parameter Module MX57 MPM that can monitor ECG heart rate invasive blood pressures temperature pulse oximetry respiration non invasive blood pressure and Cardiac Output The Menntor X7 can also monitor EtCO2 Spirometry and EEG and display aEEG The MPM MX57 is equipped with a battery and can continue monitoring it s vital sign when out of the host Menntor X7 This effectively allows the Menntor X7 to monitor a wide range of adult pediatric and neonatal patient conditions in many different areas of the hospital Functions include display of multi parameter waveforms vital signs alarm amp status messages The Mennen Medical Menntor X7 is intended for sale as a system for monitoring and recording patient information on any in hospital application requiring patient monitoring e Critical Care Patients e Cardiac Step down Units e Emergency Departments ntra operative Anesthesia Monitoring e Post Anesthesia Care e VitaLogik 6000 6500 has full monitoring capacity and includes ECG NIBP SpO2 Temperature 2 4 optional BP and CO 2 Temp with optional EtCO2 1 4 Men
190. Menntor X7 and give also an alert tone and or provide automatic Remote view of the remote bed When displaying remote bed you can view parameters of the remote bed while continuing to monitor basic parameters of the local bed In remote view you can only view the remote bed and temporarily set to off the remote bed all alarms setting You cannot change any other settings on the remote bed SEEK ILL Sereen Alarm Volume Display Controls Select Monitor Profile Software Version Alarm Watch Setup Figure 7 9 Alarm Watch Setup menu Mennen Medical 7 13 Setting Up the Patient Display Menntor 7 Operating Manual To select the beds for alarm Watch From the Main menu select the Setup key The Setup menu is displayed From the Setup menu select Alarm Watch Setup The Alarm Watch Setup panel opens Select the required unit and beds HRT LOW ALARM E 191101 Alarm Watch Setup Alarm Watch Alarm Response BEDS Alarm Watch ICU BED 5 IE Tone ICU BED 7 JE Automatic View ICU BED 8 Alarm Levels ICU BED 9 Clinical 1 Inside INS 5 Clinical 2 OK 10 F Clinical 3 F Clinical 4 Figure 7 10 Alarm Watch Setup Either Unit or Add Bed The selected beds will appear on the Alarm Watch panel To remove beds from the Alarm Watch panel use Remove Bed and Remove Unit keys Set the alarm response to Alarm Watch a
191. O2 Massimo LCD Invasive Monitoring 751010212 MX57 12ECG Resp 2Temp NIBP SpO2 2IBP CO Covidien LCD 751010412 MX57 12ECG Resp 2Temp NIBP SpO2 4IBP CO Covidien LCD 751010222 MX57 12ECG Resp 2Temp NIBP SpO2 2IBP CO Massimo LCD 751010422 MX57 12ECG Resp 2Temp NIBP SpO2 4IBP CO Massimo LCD 751 119 MX57 Wireless Option EU 7510PT219 MX57 Wireless Option UA Table 1 3 Plug in modules Part Number Description ETCO2 module 751142000 Spirometry module 751137000 Manual Structure The manual is divided into four sections e Section 1 introduces the Menntor X7 bedside monitor and provides a general overview of the system including standard operating techniques e Section 2 includes a general discussion of alarms It also provides information about setting up the patient display admission and discharge procedures and reviewing patient data e Section describes vital sign monitoring procedures performed by the Menntor X7 bedside monitor e Section 4 includes appendixes referring to available accessories and troubleshooting Mennen Medical 1 3 What You Should Know Menntor 7 Operating Manual Changes in Default Configuration This manual describes the standard default configuration of all parameter functions in the Menntor X7 bedside monitor as provided by Mennen Medical This configuration can be changed according to your hospital s needs by your Biomedical Engineering department System Administrator or
192. O2 data to appear The available options are Waveform Secondary VS or Big Numbers By default EtCO2 values are displayed in the Waveform area From the Sweep Speed drop down list select the required sweep speed Options are ECG Sweep Speed 6 25 mm sec 12 5 mm sec and 25 mm sec The default sweep speed is 6 25 mm sec Under Display Features e Select the Grid checkbox to activate or deactivate display of a grid By default this option is activated e Select the Resp Rate checkbox to activate or deactivate display of this value on screen By default this option is activated e Select the inCO checkbox to activate or deactivate display of Inspired CO values on screen By default this option is deactivated e Select the Alarm Limit checkbox to activate or deactivate display of EtCO2 alarm limits on the main screen display e Select the Apnea Information checkbox to activate or deactivate display of the last Apnea event and the Apnea Interval Delay on the main screen display By default this option is activated e Select the Display Units checkbox to activate or deactivate display of a mmHg or percentage symbol 96 next to the EtCO2 value which always appears on the main screen display e Select the Display Units and Display Labels checkboxes to activate or deactivate display of these parameters on the main display screen By default these options are deactivated From the EtCO2 Color drop down list select the display co
193. Options parameters the way respiration waveforms and values appear on the main screen display can be changed to suit your hospital s or department s particular needs Any changes made are immediately reflected on screen By setting the parameters on the Display Options dialog panel you can 17 8 Instruct the monitor to display respiration either as a waveform in the Primary Vital Sign area as a Secondary Vital Sign or in Big Number format on screen Set the waveform on a 5x5 mm grid Define the color of respiration waveforms and values as they are displayed on screen All respiration waveforms and values have the same color unless they go into alarm in which case the value takes on the alarm priority color When the alarm condition passes the original color is restored Configure the following values to be displayed or not as required Respiration Rate High Low Rate Limits selected Lead Status messages Apnea alarm limit and last Apnea event When Resp appears in the Primary Vital Sign area all of the above items can fit into the standard display area Set the Sweep Speed Mennen Medica Menntor 7 Operating Manual OK 6 Main JOHN SMITH Screen RSPIII 6 Display Options Display Area Waveform Sweep Speed 6 25 mm sec 52 Display Features JE Grid Alarm Limits Lead Selection JE Apnea Information JE Breath Symbol Resp Color ls A Figure 17 4 The Respiratio
194. P 8 From the Numeric Formats drop down list select the required format in which to display the BP reading 9 Under Manual Scale from the High Low Scale drop down lists select the required upper lower limits for manual scaling 10 Select BP Default Color A panel displaying all available colors appears Select the required color The panel closes 11 Select Discard Changes to close the BP Setup panel without applying any changes or Select Main Screen to apply the changes and exit the panel Note When you exit a vital signs setup panel you return to the main screen To continue System Setup you must press the System Setup button again to access the System Setup menu NIBP Setup This dialog panel enables you to set NIBP default parameters These parameters include setting alarm priority for both NIBP and Pulse Rate alarms defining the default cuff type for the monitor setting reading intervals and specifying the measurement units used to display NIBP values e Alarm priorities for NIBP Alarm priority affects the order of audible and visual alarm notification See Alarm Priority on page 8 4 for a full description of this feature NIBP alarm priority can be set to C 1 C 2 or C 3 The factory default is C 1 e Alarm Latching For a complete description of Alarm Latching refer to Chapter 7 Alarms in the Menntor X7 Operation Manual The available options are Off Visual latching visual alarms only an
195. Pass Fail 6 5 5 Alarm LED test Upper yellow led should Yellow blink Set alarm to C2 and make alarm 6 6 ECG Leads Faults test Disconnect only one on each cycle LEAD RL Lead RL Fault Message O K LEAD RA Lead RA Fault Message LEAD LA Lead LA Fault Message LEAD LL Lead LL Fault Message LEAD V1 Lead V Fault Message LEAD V2 Lead V2 Fault Message O K LEAD V3 Lead V3 Fault Message O K LEAD V4 Lead V4 Fault Message O K LEAD V5 Lead V5 Fault Message O K LEAD V6 Lead V6 Fault Message O K 7 Respiration Test Set the simulator DNI217A to 1000 ohm RL LL V L RA LL 7 1 3 Ohms 20bpm Value 20 BPM 2 Waveform without noise O K 8 IBP Test Simulator DNI217A and TP400 the main board should be calibrated According to the BP Calibration procedure 8 1 IBP 1 8 1 1 Disconnect the Cable out Message BP1 extension cable 8 1 2 Connect BP1 Xducer not detect Mes O K extension cable sage 8 1 3 Connect simulator Not Zero Message 8 1 4 Zero BP 1 BP 1 on the display 0 0 0 2mmHg 8 1 5 BP1 200mmHg in BP 1 Rate 200 200 200 2mmHg F 4 Mennen Medical 7 Operating Manual Table 1 Par Subject Description Specifications Measured Result value Pass Fail 9 2 IBP 2 3 4 Repeat for IBP3 4 if
196. Pediatric Index Finger D 20 24 Case No Implied License 22 16 Possession or purchase of a monitor equipped with Masimo SpO2 does not convey any express or implied license to use the monitor with unauthorized sensors or cables which would alone or in combination with this monitor fall within the scope of one or more of the patents relating to Masimo SpO2 Mennen Medica Menntor 7 Operating Manual SpO2 Specification Masimo SET Range Saturation SpO2 1 100 Pulse rate bmp 25 240 Perfusion 0 02 20 Accuracy Saturation SpO2 During no Motion Condition Adult Pediatric 70 100 2 digits 0 69 unspecified Neonatal 70 100 3digits 0 69 unspecified Saturation SpO2 During Motion Condition Adult Pediatric 70 100 3 digits 0 69 unspecified Neonatal 70 100 3digits 0 69 unspecified Pulse rate bmp During no Motion Condition Adult Pediatric Neonatal 25 240 3digits Pulse rate bmp During Motion Condition Adult Pediatric Neonatal 25 240 5010115 Resolution Saturation SpO2 1 Pulse rate bmp 1 Low Perfusion Performance gt 0 02 Pulse Amplitude Saturation SpO2 2 digits And Transmission gt 5 Pulse Rate 3digits Environmental Operating Temperature 410F to 104 OF
197. QC MENTOR p02 2 CABLE OUT 30 10 13 Menntot Host Battery Status Status Figure 6 3 Global Header Area The Global Header runs along the top of the screen and contains the following information e Hospital or unit name located on the left e Battery Status bars Green for the Menntor host battery and Yellow for the MPM battery CAUTION To ensure battery life service the battery every three months see Battery Conditioning on page 5 3 for battery conditioning procedure e Alarm message area located in the center For a list of all alarm messages see Alarm Messages on page 8 12 e Current date and time located on the right Patient Area Mennen Medical Memorial Hospital 09 28 97 14 11 ac110001 TMP1 uL rz Ti Patient area Secondary Vital Signs area Figure 6 4 Patient Area The Patient area is located directly below the alarm message area and includes Demographic Data Area e Secondary Vital Signs Area e Icons 6 4 Mennen Medical Menntor 7 Operating Manual Demographic Data Area The patient s personal information is displayed here The area also functions as an on screen key enabling access of the Patient Identification panel where relevant patient information can be entered or changed Secondary Vital Signs Area Monitored vital signs are displayed as numeric values in this area A vital sign may be displayed here for one of the following r
198. RSP to return to the RSP menu Press Main Screen to return to the main screen display Note Checkboxes appear green when activated and gray when deactivated Setting the Heart Rate Coincidence Alarm When ECG RSP electrodes are positioned to enhance respiratory monitoring or the patient s breathing signal is slight or non existant the Menntor X7 may count cardiogenic waveforms as respirations due to Cardiavascular artifact CVA This happens because AGC sensitivity increases as the respiration signal decreases The Menntor X7 compares heart and Resp rate values looking for similarities over a period of time A Heart Rate Coincidence alarm is triggered if the respiration rate value remains within 7 of the heart rate for eight consecutive seconds 17 10 Mennen Medica Menntor 7 Operating Manual OK 6 Main JOHN SMITH Screen RSPI II 6 H R Coincidence Heart Rate Coincidence v Off Heart Rate Coincidence Alarm Record Tones Figure 17 5 The Respiration Heart Rate Coincidence Dialog Panel gt To set the heart rate coincidence alarm 1 From the Respiration menu or if you are already in another Respiration dialog panel from the drop down list below the title area select H R Coincidence The panel is displayed Select On or Off to activate or deactivate monitoring of Heart Rate Coincidence Select the Record checkbox to activate or deactivate recording of the patient s respiration wav
199. RTM ARTS ARTD PAPS PAPD PAPM RSP 2 1 02 Pulse E Date 02 12 98 02 12 98 02 12 98 02 12 98 02 12 98 02 12 98 02 12 98 02 12 98 02 12 98 02 12 98 02 12 98 02 12 98 02 12 98 12 08 12 06 12 05 12 04 12 03 12 02 12 01 12 00 11 59 11 58 11 57 11 56 11 55 il lt lt Scroll Lett Find Date Time D 60 mmHg mmHg mmHg mmHg mmHg mmHg Breath Num 121 22 118 19 117 18 116 115 116 117 118 119 120 121 122 123 Scroll Right Find Event Figure D 30 An Example of a Charts Report Showing All Filters Mennen Medica 7 Operating Manual Trends Trends allows you to review data in graphic representation rather than just list of numbers Trends represents changes in vital signs over time Comparing the patterns of change gives an indication of the patient s progress For each trend type report up to four axes can be presented Each axis includes a left vital sign parameter and a right vital sign parameter for 8 parameters in total In the Edit Report panel you can see a preview of the report as you configure it Each parameter appearing in the report can be configured to appear in a different color The available colors are red black green and blue Scaling can be configured as fixed or dynamic You can also define that the data appear on a grid background to make reading the graph easier T oe EE P
200. Recording and Printing Introduction E 32 1 Network Printer te i blat Doe rena te eta cet ERE eee eggs 32 1 Enscribe Network Strip Chart Recorder esses ener enne enne 32 2 Strip Chart Recorder ue ette IR et eee t ee Ee ate 32 6 Chapter 33 MX57 MPM as Transport Monitor Introduction sronto aniei an i HD Us ter UA els 33 1 General Description onto en nette teat te GI Ra Te o acted ree ean 33 2 MPM Service Messages icsi nice treet e ERE EU 33 3 MPM Hardware Keys Functionality eese ener nnne 33 5 MPM Modes of Operation 5 Pe e te Ute dete tee te teeth 33 6 Menntor XI Messages ee dete teinte ledere len e exero e b ude 33 7 Chapter 34 Spirometry Overvekt en de 34 1 Spitometry Module d deter b ded tet rie ee NEU nina 34 4 Monitoring Procedures ei De dt ette e R e ts aner 34 5 Screen Captures of Spirometry displays mronvnrnvrenvonnrannvrrnvnennnenrnenereverenernnnnvnenevasvssnesnnesnvesvraserannene 34 6 viii Mennen Medica Menntor X79 Operating Manual SECTION 6 Appendixes Appendix A Accessories Appendix B Trouble Shooting ECG Respiration Monitoring ss 2 epe eee He en d eU awd Mel B 1 Response to Single Lead Fault EE de PIRE P eet B 2 Invasive Blood Pressure Monitoring eerrrrrnrave
201. Report port setup ECG Report Options Rhythm Lead Gain 3 Print Only lt y Print amp Save on Server x Save on Server Only Figure 14 9 ECG Report Setup Panel 14 16 Mennen Medical Menntor 7 Operating Manual Setting ECG Display Options The ECG Display Options panel enables the user to change the way ECG waveforms and values are displayed on the main screen Any changes made are immediately reflected on the main screen The minimum ECG slot on the main screen display is 30mm The minimum waveform height is also 30mm The ECG default display color is yellow but can be changed to any color available All ECG leads area displayed in the same color The monitor can be configured to display the waveform on a grid The lead ID is displayed next to each trace Calibration Pulse and Gain factor can also be displayed Display Features Scale IE QRS Indicator WF Height Expand Figure 14 10 ECG Display Options panel Mennen Medical 14 17 Menntor 7 Operating Manual gt To set ECG Display Options 1 From ECG menu or if you are already in another ECG dialog panel from the drop down menu list below the panel title area select ECG Display Options The Display Options dialog panel appears Under Display Features e Select the Grid checkbox to activate or deactivate display of the waveform on a grid By default this option is deactivated e Select
202. Select Display Format Waveform Trend 5 Set the Trend Time scale 15 30 60 120 minute 6 Press Main Screen to return to the main screen display gt To create BIS waveforms CRG Trend From the BIS menu select Display Option From the Display Area drop down list select Waveform From the Setup menu select CRG Select CRG 1 Set the Duration 15 30 60 120 minute Select the first Vital Sign BIS Select the second Vital Sign EMG Set CRG On Ce NDA Press Main Screen to return to the main screen display BIS Data Storage BIS data and Quality parameters are stored and can be display in Trend and Chart Refer to chapter 10 Reviewing Patient Data for details Mennen Medical 27 23 BIS Bispectral Index Menntor 7 Operating Manual BIS Cleaning and Preventive Maintenance Introduction This section describes e Care and cleaning procedures e Routine maintenance e Technical documentation e Instrument Identification Care and Cleaning Cleaning the BISx Clean any spillage of blood or solutions on either the monitor or BISx as soon as possible Dried blood is very difficult to remove Use lint free absorbent towels for spill cleanups Dampen the towel with detergent and lukewarm water to aid in cleaning After cleaning wipe the PIC connector ends with alcohol and allow to dry completely Residual moisture inside the connector may affect BISx performance Disinfecting the BISx
203. Setup key and select Monitoring Profiles from the Setup menu The Monitoring Profile panel is displayed Press Select Key 4 Select an available key frame appears around the key and the buttons along the bottom of the panel become available 5 Click Save gt To name anew Monitoring Profile 1 Inthe Monitoring Profiles panel press Select Key 2 Turn the QuicKnob and press an available key Mennen Medical 9 21 Connecting Patient to Menntor X7 Menntor 7 Operating Manual 3 Press Label The alphanumeric keyboard panel appears 4 Enter the text for the label and press Accept Showing Hiding the Monitoring Profile on the Main Screen gt Once you have defined Monitoring Profile you can also determine whether it is available for use when admitting a new patient green bullet appears next to those Monitoring Profiles that are set to appear on the main screen To show or hide the Monitoring Profile 1 In the Monitoring Profiles panel press Select Key 2 Select the required Monitoring Profile A frame appears around the key indicating that it is selected e If no bullet appears in the label press Show Hide The green bullet appears and the Monitoring Profile will appear on the main screen the next time you want to admit a patient e green bullet appears in the label press Show Hide The bullet disappears and the Monitoring Profile is removed from the main screen Changing the Posit
204. SpO2 LNCS Adapter Cable 8ft 551 306 321 SpO2 Reusable Adult Finger Sensor with short Cable LNCSDCI 551 339 205 SpO2 Reusable Multisite Sensor Masimo LNCS YI 551 339 207 SpO2 Reusable Ear Sensor LNCS TC I 551 339 208 SpO2 Disposable Adult Finger Sensor Masimo LNCS Adt 20 box 551 339 221 SpO2 Reusable Pediatric Sensor Masimo LNCS DC IP 551 339 206 SpO2 Disposable Pediatric Sensor Masimo LNCS Pdt 20 box 551 339 222 SpO2 Disposable Infant Sensor Masimo LNCS Inf 20 box 551 339 223 SpO2 Disposable Neonatal Sensor Masimo LNCS Neo 20 box 551 339 224 SpO2 Disposable Neonatal Sensor Masimo LNCS NeoPt 551 339 225 Mennen Medical A 7 Table 12 Pulse Oximetry Accessories Masimo LNOP Menntor 7 Operating Manual Item and Description Part Number P N Pulse Oximetry Accessories Masimo LNOP SpO2 LNOP Adapter Cable 8ft 551 306 021 SpO2 LNOP Adapter Cable 12ft 551 306 121 SpO2 LNOP Adapter Cable 12ft 551 306 121 SpO2 Reusable Adult Finger Sensor with short Cable LNOP DCI 551 339 015 SpO2 Reusable Pediatric Finger Sensor with short Cable LNOP 551 339 006 DCIP SpO2 Reusable Ear Sensor LNOP 551 339 735 SpO2 Reusable Multisite Sensor LNOP 551 339 931 SpO2 Disposable Adult LNOP Finger Sensor 20 Box 551 339 001 SpO2 Disposable Pediatric Slender LNOP Digit Probe 20 Box 551 339 025 SpO2 Disposable Neonatal Probe 20 Box 551 339 002
205. SpO2 alarm therefore the unique tone is heard only when an SpO2 alarm exists at a priority level of C 1 or C 2 and no other alarms are active Note Additional wav user defined files are avialable These do not have the characteristics required by the standard Note Specific parameter sounds such as High HR Low HR and SpO2 Unique do not have the characteristics required by the standard since they do not represent Alarm Priority Mennen Medical 8 3 Alarms Menntor 7 Operating Manual Note The following alarm sound levels were measured in room with a surface according to ISO 3744 using test pulse of continuous duration A weighted background noise of 45 dB CI level is 83 dB 2 is 83 dB and is 82 dB Storage Any clinical level alarm is automatically entered in the vital signs and ST charts The entry includes the cause of the alarm listed in the chart s status field and the vital sign which triggered the alarm Recording If the Menntor X7 is connected to an inbuilt recorder optional or to the Enscribe network recorder and network printer an alarm event can be recorded to document the transition from normal state into the alarm condition recording shows several seconds of information prior to the transition and an equal amount of time after that transition taking into account the delay factor used in the parameter This delay factor means that transition actually occurred before the input notified the
206. T measuring points for measuring ST segments These measuring points may be manually adjusted in the ST Adjustment panel ICU Avishai 197 01 15 03 STI 0 0 0 0 STaVF 0 0 ELE und ECG 1 F 1 my ECG III und avR M eS SSE und ECG aVL un ECG aVF Auto TA El ISO ST Automatic Accept Cancel Figure 16 5 The ST Adjustment Panel The ST Adjustment panel includes a waveform area in which the waveform activity of each monitored ECG lead is presented and an adjacent area in which a QRS complex for each monitored ECG lead is presented Each QRS complex is centered on its point The ISO and ST measuring points represented by two red cursors are defined in terms of the point The currently active operating mode is indicated on the toolbar If manual mode is active ST MAN appears under the ST values in the Secondary Vital Signs area of the main screen display Mennen Medical 16 7 ST Segment Analysis Menntor 7 Operating Manual gt determine the ISO and ST measuring points 1 From the ST menu if you are already in another ST panel from the drop down list below the panel title area select ST Adjustment 2 select the automatic operating mode press Auto Mode 3 To adjust the current ISO measuring point press Adjust ISO use the QuicKnob to move the ISO curser to any point within 500 msec to th
207. The NIBP Display Options panel controls how NIBP values are displayed on the main screen display Any changes made immediately update the main screen display OK 6 Main JOHN SMITH Screen 5 Display Options Display Area Big Numbers Display Features IT S D M Labels Alarm Limits IT Units Label NIBP Color Figure 21 5 The NIBP Display Options Panel To set NIBP Display Options 1 From the NIBP menu or if you are already in another NIBP panel from the drop down menu below the panel title area select Display Options Mennen Medical 21 13 Non Invasive Blood Pressure NIBP Menntor 7 Operating Manual 2 Select Display Area and from the drop down list select the area on the main screen display where you want NIBP to appear The available options are Waveform Secondary VS or Big Numbers By default NIBP appears in the Secondary VS area When Waveform is selected an NIBP chart is displayed in the waveform area 21 14 Mennen Medica Menntor 7 Operating Manual Select Numeric Formats and from the drop down list select the format in which you want NIBP values to appear When units are displayed in mmHg the available options are SSS DDD MMM SSS DDD mmm sss ddd and MMM only When units are displayed in KiloPascals KPa the options are SS SS DD DD or MM MM The default numeric format is SSS DDD MMM for Hg mm or SS SS DD DD for KPa Se
208. The remote view display includes e Patient global header contains the remote bed s device name patient name alarm message area and date time e Waveforms and measured values displays the remote bed s monitored parameters up to five waveforms together with measured values Mennen Medical 7 11 Setting Up the Patient Display Menntor 7 Operating Manual Note While remotely viewing a patient the Menntor X7 QuicKnob is disabled Setting Remote Bed Alarms to Off Remote View allows you to temporarily silence the alarms or set all alarms to off at the remote bed When exiting Remote View the remote bed alarm settings will automatically revert to the monitor s original selection e silence alarms occurring at the Remote bed press Silence on the front panel of the Menntor X7 The audible execution of the alarms will be temporarily disabled for 2 minutes The visual display of the alarms will still be present on the display e To set all the alarms off at the Remote bed press Alarms Off on the front panel The audible and visual display of alarms will be disable until the user exits Remote View When exiting Remote View the Remote bed s alarm setting will automatically revert to the monitor s original setting Note Should an audible alarm occur it is always associated with the Local Bed There is no transfer of audible alarm information from the remote site in remote viewing Printing and Recording Da
209. UDC button An editing dialog panel appears displaying all available charts supported by the Menntor X7 and the parameters associated with each nAA2602 snone e System Setup Tabular Charts UDC Name VS Vital Signs ST Medications Hemodynamics Ventilator Oxygenation Renal Clearance HRV Select up to 32 parameters lt lt Move left eter Fenes Anast Gas PR QT Criti Cool PiCCO Figure D 39 Editing a Tabular Chart 3 Click the arrow beneath a category chart name and from the list of parameters available for the category select the required parameters for the UDC The selected parameters appear on the bar above 4 To define the order of parameters in the UDC click on a selected parameter and then click the Move left or Move right buttons until the parameter reach the required location If you want to remove any of the selected parameters select the parameter and click Remove Parameter 5 To display alarms click the Insert alarm button 6 Click Accept to apply your changes and return to the Tabular Charts panel Note If you want to return to the Tabular Charts panel without applying any changes click Back to UDC List If you want to move to the next or to the previous UDC in the list click Next UDC or Previous UDC accordingly 7 To set filters in the Tabular Charts panel click the Define Filter button A window opens displaying all available filters Mennen Medical D 71
210. Use large bore tube or vent Gas Source Calibration Gas can be obtained from the following source Scott Medical Products PA USA Tel 215 766 8861 Fax 215 766 7250 Mixture 1 2 liter at 15 psig of Desflurane 5 CO2 5 N20 42 Balance O2 sufficient for 8 minutes of validation 24 4 Mennen Medical Menntor 7 Operating Manual Anesthetic Gas Module Anesthetic Gas Interface Cable Anesthetic Gas Model Figure 24 2 Anesthetic Gas Module Front Panel The Anesthetic Gas Module consists of e Power ON switch Power ON LED indicator e Water Trap Manifold Patient Connection gt Toconnecta patient 1 1 Power on the module then check alarm limits and flow rate 2 Place tee into the patient breathing circuit 3 Attach the Lurer connector of the sampling line to the exposed end of the watertrap 4 Attach the sampling line to the gas sampling tee 5 Attach a scavenging system to the sidestream sampling exhaust port if desired Note Do not use a scavenging system with a flow rate above that of the sidestream flow rate selected in the Menntor X7 of Adult 120cc min Neonatal 220cc min Mennen Medical 24 5 Multigas Anesthesia Analyzer Alarm Messages Menntor 7 Operating Manual Alarm Message Alarm High Alarm Alarm exceed Low Alarm Alarm exceed Cable Out Cable Out condition Apnea time stamp Apnea detected by CO2 channel No Comm Communication Loss c
211. Within normal range 7 Close to normal range requires attention 5 6 Requires attention and may require intervention 3 4 Requires intervention 1 2 Requires immediate intervention WARNING Before making decisions on treatment of blood gas check blood gases using calibrated Blood Gas Analyzer Use the monitor alarms and abnormal value as an indication for further check Mennen Medica Menntor 7 Operating Manual Age Dependence The IPI algorithm is age dependant It is calculated for either Adult or Neonatal For Neonates it is related to the age according to the Date of Birth entered in the Patient Identification panel Note For babies less than one year old IPI is not calculated and dashes are displayed CAUTION If the patient is defined as Neonate and no birth date is entered IPI assumes it is a newborn and IPI is NOT be calculated Monitoring Procedures Once MicroPod EtCO2 is activated IPI is automatically activated The IPI menu provides access to all the specific dialog panels enabling interaction with all aspects of IPI monitoring Each dialog panel controls different aspects of monitoring the IPI levels present during respiration Following is a short description of the panels in the order they appear on the IPI Alarm Limits Use this panel to activate deactivate IPI alarms and set low alarm limit see Setting IPI Alarm Limits on page 2 16 Alarm Response Use
212. a Menntor 7 Operating Manual Monitoring Procedures The Arrhythmia menu provides access to the specific dialog panels that control all aspects of Arrhythmia monitoring Following is short description of the panels in the order they appear on the Arrhythmia menu Arrhythmia Alarms This panel displays the current status of the individual Arrhythmia alarms Use it to activate deactivate all or individual alarms set alarm responses for all or individual alarms and in certain cases set alarm limits and define where you want alarm data to appear on the main screen display See Activating and Setting Alarms on page 15 5 Activate Use this panel to activate or deactivate Arrhythmia monitoring See Activating Arrhythmia Monitoring on page 15 9 Accessing the Arrhythmia Menu The Arrhythmia menu can be accessed from the front panel or from the main screen display gt Toaccessthe Arrhythmia menu from the Main menu 1 From Main menu select the Vital Signs key The Vital Signs menu appears 2 From the Vital Signs menu select ECG and then select Arrhythmia The Arrhythmia menu appears gt Toaccess the Arrhythmia menu from the main screen display Turn the QuicKnob until the ARR parameter key is highlighted and press The Arrhythmia menu is displayed 15 4 Mennen Medica Menntor 7 Activating and Setting Alarms You can activate and set alarm responses for all or individ
213. able Do not autoclave patient leads transducer components or other sensors Autoclaving permanently damages these instruments If you need to sterilize accessories we recommend EtO gas sterilization 5 1 Maintenance and Cleaning Menntor 7 Operating Manual Calibration and Preventive Maintenance Daily Check interface cables and accessories for deterioration Clean interface cables and accessories with fine lint soaked with mild detergent CAUTION Do not use any cable if it shows signs of deterioration Annualy Once every year perform a full monitor test according to the Menntor X7 field test procedure see Appendix F Test Procedure It is recommended that the Menntor X7 is checked at least once a year by qualified Mennen Medical personnel for proper calibration of the unit The exterior of the unit should be periodically checked for any signs of damage or abuse Units or parts which show any signs of damage should be immediately referred to a qualified technician Before commencing monitoring on a patient e check for any mechanical damage e check all external leads and accessories e check all functions of the instrument needed to monitor the patient and ensure that the instrument is in good working order Do not use the Menntor X7 for any monitoring procedure on a patient if you identify features which demonstrate impaired functioning on the instrument Contact the hospital biomedical engineer or Mennen Medical serv
214. able Mennen Medical 30 9 CerebraLogik aEEG and EEG Menntor 7 Operating Manual Figure 30 7 Display Option Setting EEG Filters e Low pass Filter 15 35 50 70 Hz High pass Filter 0 5 1 5 Hz Figure 30 8 Filter 30 10 Mennen Medica Menntor 7 Operating Manual Alarm Response Tone toggle aEEG History Open the History panel see aEEG History aEEG Section Displays a list of aEEG sections that provides access for section viewing on Section History and export of section to DSD Disk on Key storage device aEEG Section History A panel similar to aEEG History panel with keys to move from section to section Activate Activate or deactivate EEG monitoring CerebraLogik Display Modes Menntor X7 equipped with CerebraLogik can display real time EEG waveforms and historical EEG waveforms in parallel with Amplitude Integrated aEEG real time and history in variety of modes EEG only in real time waveform display EEG real time parallel with aEEG EEG and aEEG History panel Very big numbers with one EEG and aEEG display ECG and two other vital signs EEG waveform plus one hour aEEG EEG only in real time waveform display gt To view one or two EEG waveforms without viewing the stored history of the Amplitude Integrated EEG aEEG 1 2 Select in Display option under mode EEG Use the Lead amp Gain menu to view one or two EEG waveforms This displays
215. able disconnected or device does not transmit CO2 Zero Calibration in Progress Appears during zero calibration when device is in calibration mode CO2 4710 Error Call Service CO2 Error S System Error CO2 Error F Fan Error CO2 Error PS Power Supply Error CO2 Check Sampling Line Sampling delivery system error O2 Error S Device unable to make measurement CO2 Error S Device unable to make measurement N20 Error S Device unable to make measurement CO2 Error Agent 4750 Select Agent Automatic agent ID not functioning must select Agent ID manually Zero Calibration Failure Zero Calibration Failure Intialize Making communication with device Warm up Warm up waiting period Accessories Reference Item 800 060 998 Patient sample line 7ft with Nafion Seletion Zefon ZML 9223 800 060 991 Sidestream Elbow 5 Box Pryon 551 145 507 Water Trap Male Luer 551 145 505 Ventilator Fan Filter 551 145 506 Preventive Maintenance Kit Mennen Medica Menntor 7 Operating Manual Module Specifications Anesthesia Module Anesthesia Module Respiratory rate range 0 to 90 breaths min Response Time CO2 350 msec N20 lt 400 msec Oxygen 300 msec Halothane Isoflurane Enflurane Sevoflurane Desflurane lt 500 msec Repiratory rate accuracy 2 breaths min Warm up time 2 minutes to first measurement
216. able volume QRS Detection Range Height 0 25 or 0 15 mV to 5 0 millivolt Width 70 to 120 milliseconds Heart Rate Counting Range 0 to 350 BPM 0 300 Accuracy 2 BPM 300 350 Accuracy 4 BPM Heart Rate averaging 3 4 of last average 1 4 new beat about 8 beats between 60 to 120 or 120 to 60 Note Values below 20 forced to zero Heart Rate Alarm Settings High and low rate 20 350 BPM non overlapping Leads analyzed for Heart Rate and Arrhythmia Configuration Top two displayed ECG Leads I II III 3 Lead cable 0 I II III aVR aVF V 5 Lead cable O I II III aVR aVF V1 V6 12 Lead cable ST on all leads Automatic or Manual 0 ST range 8 mm to 8 mm 9 ST Alarm Arrhythmia Detection and alarm on 19 Arrhythmias PR and QT measurement and display Data Storage Beat notification RR Interval Heart Rate ST values Arrhythmia Alarms Alarm event markers Respiration Leads RA LA or Leads RA LL Excitation 65 kHz Sinus wave lt 1 mA Input Impedance gt 40 KQ Frequency Response 0 13 to 2 5Hz Impedance Range 100 to 3000 Q Input Sensitivity Range 0 2 to 5 Q Digital Sample Rate 640 Hz Sample Resolution 24 bit Sweep Speed ECG speed 6 25 12 5 mm Sec nominal Gain Automatic or 1 8 to x 8 Respiration Rate Counting Range 0 to 150 breaths min Respiration rate Accuracy 1 per minute Respiration Alarm Settings Low rate 0 150 BPM High rate 0 150 BPM Apnea
217. abular Charts Use this panel to create User Defined Charts customized to the specific needs of a unit or patient See Tabular Charts on page D 69 Software Version The Software Version panel displays the software version of all inputs and manages loading of new software to the vital signs inputs See Updating the Software Version on page D 72 e Change Password Use this panel to define a new password for entering the System Setup menu See Change Password on page D 75 Check Disk Check disk is a technical procedure resets all parameters to factory default settings This panel is for use by authorized service personnel only See Check Disk on page D 76 e Permission Editor Use this panel to define which Menntor X7 menu options are available See Permission Editor on page D 77 e Remove Saved Patients Use this panel to access a list of all the patient data saved by the Menntor X7 and to remove some or all of the saved files See Remove Saved Patients on page D 78 Mennen Medica 7 Operating Manual Touch Screen Calibration Note Monitors and Ensemble equipped with Touch Screen have a key to start Touch screen calibration See Touch Screen Calibration on page D 78 In the System Setup menu some of the dialog panels can be accessed only when the Menntor X7 is not currently monitoring a patient In this case if a patient is being monitored he she must first be dis
218. according to the regulations of the user country Take special care when disposing of batteries Mennen Medical 5 3 Maintenance and Cleaning Menntor 7 Operating Manual 5 4 Mennen Medica CHAPTER 6 CONTROLS AND FUNCTIONS Power On The main power switch is located on the left side of the front panel Turn on to supply power to all the components Power Off Shutdown Use the Shutdown procedure to turn off the power Select the Setup menu and then select Shutdown warning panel called Shutdown appears TEKNOR 2 ARE YOU SURE YOU WANT TO SHUTDOWN THE SYSTEM Figure 6 1 Shutdown Panel You have the following options e Press Cancel to return to the main screen e Press Restart to reset the monitor without power off Mennen Medical 6 1 Controls and Functions Menntor 7 Operating Manual e Press Shutdown A gray screen appears Wait for the message Shutdown System may now be powered down and switch off the power AC Operation The Menntor X7 operates on 115 or 230 VAC line power at 50 60 Hz or on battery Before connecting the unit to the AC line check the identification label on the rear panel of the unit for the appropriate line voltage and frequency The Menntor X7 is supplied with a three wire AC line power cord with ground pin The safety features of the product require that it be connected to a primary power distribution system which provides adequate grounding Installation and
219. actual integration time If more than one Area was defined the display will present the Area of the section were the cursor if located A chart is a tabular representation of the patient s condition The Menntor X7 enables you to review data in the same way as data recorded on chart by nurse The charts can be reviewed printed and placed in the patient s hospital file eliminating the need to copy data from screen or printed page Chart Storage 10 12 The Menntor X7 can store up to 10 days of numeric data It supplies a set of charts for data acquisition clinical calculations and review It adds entries to the charts every minute whenever an event is detected and on request All entries are stored for the entire hospitalization period Once a patient is discharged all stored data is removed Chart entries contain five types of fields e Vital sign values e ST values e Calculated fields e Medication e Ventilator e Anesthetic Gas Date and time are included in each chart entry Mennen Medica Menntor 7 Operating Manual Chart Types The following two types of charts are available 1 Calculation Chart includes the following e Respiration e Oxygenation e Hemodynamics e Renal e Medication Calculation Chart entries can be edited 2 User defined charts Up to 10 User defined charts can be defined in System Setup from the field types above The names of all User defined charts appear in the list of c
220. ailable e Multilead This will result with 5 second strip of each ECG lead e Waveforms This will result with 5 second strip of the top displayed ECG and all active vital signs waveforms e Selective Recording Upon Start this will result with two user selected waveforms recording and will stop by user activating the Stop button To set up recording upon an alarm 1 Select Alarm Response in the relevant vital sign foe example ECG SpO2 or BP 2 In Alarm Response panel activate Record If the alarm is from ECG this results in a two ECG channel recording or for other vital signs in two channel recording the top displayed ECG and the vital sign that created the alarm Mennen Medica 7 Operating Manual Changing the Built in Recorder Paper The Built In recorder is found at the right side of the Menntor X7 4x00 monitor Figure 32 5 Built in recorder closed gt Toinserta paper roll into the recorder 1 Press the green button The recorder door will open Figure 32 6 Built in recorder Door opened 2 Insert the paper roll with the paper coming from the top of the roll Insert fig Paper roll insertion Mennen Medical 32 7 Recording and Printing Menntor 7 Operating Manual Figure 32 7 Paper roll insertion 3 Pull the paper above the door and close the door Figure 32 8 Closed door with paper Closing the door will automatically start the reco
221. ain screen button Implements any changes made and exits the panel panel closes and the standard main screen display appears Menu title Displays the name of the menu to which the panel belongs The Drop down menu Contains a list of panels you can access The selected panel is the current panel Print prints data Does not appear on all panels 6 15 Controls and Functions Menntor 7 Operating Manual Other Panel Features The following features enable you to interact with the panel e Buttons Press a button to perform a specific function For example press the Discard Changes button to close the panel without implementing any changes that might have been made e Labels Text displayed on the panel The text labels active areas such as choice lists or drop down menus e Checkboxes Used to turn an option on and off enable disable If the checkbox appears green the option is enabled If the checkbox appears gray the option is disabled e Option Buttons Used to select an option from a group of mutually exclusive options When you select an option button it appears green The unselected buttons appear gray e Data Entry Controls When you select this feature a keyboard panel opens enabling you to type in the required data Slider Bars Move the indicator along a bar graph to pick a number time or event Drop down lists Presents a list of choices If the list is too long to be displayed in the
222. al From the Vital Signs menu select BP Setup The BP Setup dialog panel is displayed Under Extended Alarm Response e From the appropriate drop down list set the default priority levels for NIBP alarms e From the Latching drop down list set default alarm latching to On or Off Under Cuff Type e Select the Adjustable Cuff Size checkbox to enable user access to the Cuff Type panel Clear the checkbox Adjustable Cuff Type to remove the Cuff Type menu item from the NIBP menu e Select the default cuff type Adult or Neonatal Under Default Reading Intervals set the required parameters for T and Q intervals From the Units drop down list select the type of units used to measure NIBP From the Numeric Formats drop down list select the required format in which to display the NIBP reading Select NIBP Default Color A panel displaying all available colors appears Select the required color Select Discard Changes to close the panel without applying any changes Select Main Screen to apply the changes and exit the panel Note When you exit a vital signs setup panel you return to the main screen To continue System Setup you must press the System Setup button again to access the System Setup menu Note It is possible to simplify the use of NIBP timing by selecting either Single T SpO2 Setup or Single Q If this is selected only single timing mode will be available This dialog panel enables you to set SpO2 defa
223. al General Use of Accessories Useonly Mennen Medical approved accessories with the Menntor X7 This includes but is not limited to those accessories approved for use with the Vital Signs ECG BP CO Temp NIBP SpO2 and EtCO2 e Do not use a damaged accessory Always refer to the instructions for use included with each accessory disposable single patient accessory should not be sterilized or cleaned for reuse e Use care when installing accessories such as adapters and cables Do not use force Do not cause tension in cables when connecting them to the vital signs sockets CAUTION Accessories are connected to the monitor using interface cables Take special care to prevent cable entanglement Take care not to pass the cables around the patient s head and neck in order to prevent possible strangulation Disposal of Monitors and Accessories Dispose of the equipment and its accessories according to the rules and regulations of your country 2 8 Mennen Medica CHAPTER 3 SYSTEM DESCRIPTION Overview The Menntor X7 bedside monitor is standalone bedside unit consisting of main processing unit and built in color monitor The Menntor X7 monitors the patient s vital signs The vital signs data derived by the Menntor X7 is presented on the monitor as waveform and numeric displays The Menntor X7 user interface is especially designed for user friendly operation The fixed buttons and unique QuicKno
224. alarm responses 1 From the ST menu if you are already in another ST panel from the drop down list below the panel title area select Alarm Response 2 Under Alarm Response e Select the Record checkbox to activate or deactivate recording of the patient s condition during the alarm event By default Record is deactivated e Select the Tones checkbox to activate or deactivate audible alarms By default Tones is activated e Select the Event Strip checkbox to activate or deactivate Event Strip upon alarm alarms By default Event Strip is deactivated Note Checkboxes appear green when activated and gray when deactivated Mennen Medical 16 5 ST Segment Analysis Menntor 7 Operating Manual 3 Press ECG to close the panel and return to the ECG menu press Main Screen to close the panel and return to the main screen display Setting Display Options OK 6 Main JOHN SMITH Screen ST Display Options x Displayed Leads Max ST Figure 16 4 The ST Display Options Dialog Panel Set the Display Option of your choice e All Leads Displays ST values for all leads see Figure 16 1 e Displayed Leads Shows ST values only for displayed leads e Max ST Shows maximum ST value and the lead for which the value was obtained 16 6 Mennen Medica Menntor 7 Operating Manual Manually Determining the ISO an ST Measuring Points When a patient is admitted the ST algorithm automatically determines the ISO and S
225. alarms Setting Temperature Alarm Limits Use this panel to set Temperature alarm limits The current low and high alarm limits as well as the currently measured temperature are displayed on the panel The current limits appear in the Low High Limit Value boxes on the panel The current temperature is marked on the scale RICU BED Main Screen TMP1 3 1 Alarm Limits wow d 3 0 N N OQ ow w Vd tn Auto Set All Temp Alarms ic Danie Figure 20 1 The Temperature Alarm Limits Panel Mennen Medical 20 3 20 4 Menntor 7 Operating Manual gt To set the T emperature Alarm Limits panel 1 From the Temperature menu or if you are already in another Temperature panel from the drop down list below the title area select Alarm Limits The panel is displayed Select the TEMP Alarms checkbox to activate or deactivate both high and low limit alarms Using the QuicKnob move the markers on the low high alarm limits slider bars along the displayed scale to set the required limits The right marker sets the low alarm limit and the left marker sets the high alarm limit The allowed range is 25 43 C or Press Auto Set to Defaults to set all temperature alarm limits to their default values Press Temp to close the panel and return to the Temp menu press Main Screen to close the panel and return to the main screen dis
226. all BP waveforms Note Auto Scale All will not affect scales that were set manually 18 6 Mennen Medica Menntor 7 Operating Manual 4 Press BP to return to the BP menu Press Main Screen to return to the main screen display manually scale the BP waveform 1 Select the high and low waveform values from the High Scale and Low Scale drop down lists 2 Press BP to return to the BP menu Press Main Screen to return to the main screen display Setting BP Alarms BP alarm parameters are set in two dialog panels Alarm Limits and Alarm Response Each dialog panel controls a different aspect of BP alarms Setting BP Alarm Limits The Alarm Limits dialog panel controls activation and deactivation of BP alarms and sets BP alarm limits Low and high alarm limits are set separately for systolic diastolic and mean values Low and high limit alarm detection can be enabled or disabled for each of the BP values systolic diastolic and mean or for all three values Alarm limits can automatically be set to the default values set in the System Configuration Default limits differ according to BP type The following table provides a list of BP types and their respective default scale and alarm limits BP Name Scale Alarm Limits ART 0 to 300 Systolic diastolic and mean all 10 to 300 mm Hg PAP 0 to 150 Systolic diastolic and mean all 0 to 200 mm Hg CVP 0 to 50 Mean 0 to
227. along the displayed scale to set the required limits The right marker sets the low alarm limit and the left marker sets the high alarm limit Press Auto Set to Defaults to set delta temperature alarm limits to default values 20 8 Mennen Medica Menntor 7 Operating Manual 4 Press T4 T3 to close the panel and return to the T4 T3 menu press Main Screen to close the panel and return to the main screen display Note The following options are operated in the same way for Delta Temperature as for regular Temperature monitoring refer to the relevant section above in regular Temperature monitoring e Setting the Delta Temperature Alarm Response e Setting the Delta Temperature Display Options e Activating Delta Temperature Mennen Medical 20 9 Temperature Menntor 7 Operating Manual 20 10 Mennen Medica CHAPTER 21 NON INVASIVE BLOOD PRESSURE NIBP Overview Non Invasive blood pressure is measured using a cuff and is derived by the oscillometric method The cuff is automatically inflated and systolic diastolic and mean pressures are derived as the cuff deflates Adults and neonates may be monitored The Menntor X7 bedside monitor can be configured to take NIBP readings in one of three modes manual automatic and stat mode e Inthe manual mode a single NIBP measurement is taken as required e In the automatic mode measurements are repeated at regular pre set intervals e In the stat mode blood pressur
228. an define the default measurement units used for patient s height and weight Height The units of measurement available are CM centimeters or IN inches The factory default is CM Weight Available units of measurement are Kilograms Kg Grams Gr Pounds Lb or Pounds and Ounces Lb amp Oz The factory default is Kg Timeouts Under the Timeouts area you can define the period of time which elapses from the last time an action was performed in a panel or menu to the time it is automatically closed by the system and disappears from the main screen display The timeout can be defined for each type of panel and for menus The following panels can be configured for timeout Vertical Panels Horizontal Panels Full Panels D 12 Mennen Medica 7 Operating Manual Confirmation Panels Keyboard Panels and Menus The available timeout options for all types of panels are None panel or menu will not automatically close I min 2 min 4 min or 10 min The factory default timeout for all panel types is 2 min Hospital Name Under Hospital Name you can enter the name of the hospital This name will then appear in the Header area on the main screen display Setting the General Settings Panel The General Settings panel can be accessed from the System Setup menu or if you are currently in another System Setup panel from the drop down menu list to the right of the back menu button System Setup on th
229. and position The Menntor X7 spirometry module employs a pump and purge system to keep the tubing clear allowing for continuous usage The system is entirely free of any user calibration The Spirometry module produces three waveform signals e Airflow e Air volume e Airway pressure The module measures a set of numeric parameters that evaluate the respiration function The module monitors respiratory mechanic continuously in both spontaneous respiration and during artificial ventilation WARNING Read the following chapters of the Menntor X7 User Manual before using the Spirometry module Chapter 2 Warnings and Precautions Chapter 4 Installation and Setup Chapter 5 Maintenance and Cleaning Chapter 8 Alarms for general information about the Menntor X7 VS Alarms 34 2 Mennen Medical Menntor 7 Operating Manual In particular note the following Caution and Warnings CAUTION Federal law restricts this device to sale by or on the order of qualified medical personnel only WARNING not use this device in the presence of flammable anesthetics WARNING not use this device in the presence of magnetic resonance imaging MRI equipment WARNING The Menntor X7 Spirometry module is intended to be used for the continuous monitoring of pulmonary mechanics of adult and pediatric patients it is not intended to replace a comprehensive diagnosis of pulmonary function WARNING prevent electrical
230. and Deactivating Ventilator Monitoring 26 10 Alarm Messages 1 ine eit p re MT a HERE seder 26 11 Chapter 27 BIS Bispectral Index Introduction MP 27 1 Installation and Preparation for oerte spen 27 4 Operating the Menntor X7 BIS 22 Recte cete ee Lee e 27 8 Monitoring Proced res xe eee tete ee d kuer eevee oats 27 10 BIS Monitors Profile Se eite d HRS he deeded ee EUR ose ee Dee aea 27 21 BIS Cleaning and Preventive Maintenance _ nennen enne nens 27 24 27 25 BIS Lrouble Shooting sk Ar addere ledet dri 27 26 Chapter 28 CO CCO SvO2 OVERVIEW EE 28 1 Input as Vigilance Vigileo PiCCO eese enne E nennen trennen nenne 28 3 CO CCO Monitoring Procedures eee rte eot tette ci ee e e e t DR ee dee Dese 28 4 SvO2 Monitoring Procedures d eet ete RE P te eee re HR ee teen 28 7 Trend aca eere eidem eme oe b e i e hd eis 28 10 Bra RA 28 10 Chapter 29 Radical 7 Masimo CO Oximeter OVeEVIE W ea 29 1 Technical Cla odd ebbet 29 2 D NTT 29 2 Monitoring Procedures dere a teo t tee er et eredi aep i andra 29 2 Setting SpO2 Alarms limits ee eed edes eee OR dee dea 29 3 set ng SpHb Alarm LEtnits irent ertet mete ege
231. and On both visual and audible alarms The factory default is Off eArrhythmia Package Enables you to determine the level of Arrhythmia analysis The available levels are Basic includes Asystole Vfib V tach Run PVC and Pause and Extended includes Bradycardia Supraventricular Tachycardia SV Irregular Rhythm Idioventricular Rhythm Couplets of PVCs Triplets of PVCs Bigeminy Trigeminy on T PVC Vfib V Tach Multifocal PVCs Interpolated PVCs Asystole Run Pause Premature Artrial Contraction and Sinus Tachycardia eArrhythmia Priority Enables you to set default priority levels for all available Arrhythmia alarms The available alarm priorities are as follows D 23 Table D 3 Arrhythmia Alarm Priorities Menntor X79 Operating Manual Arrhythmia C 1 C 2 C 3 Default Priority Asystole X C 1 Ventricular Fibrillation VFIB C 1 Ventricular Tachycardia X C 1 VTACH Runs of PVC beats RUN X X C 2 Bigeminy BGM X X C 2 PVC beats per minute PVC X X C 2 Pause Event PAUSE X X X C 3 Bradycardia BRADY X C 1 Tachycardia TACHY X C 1 Irregular Rhythm IRREGU X X X C 2 LAR Idioventricular Rhythm IDIO X X X C 2 VENT Couplets of PVCs COUPLET X X X C 2 Triplets of PVCs TRIPLET X X X 2 Trigeminy TRIGEM X X X C 2 RonT X X X 2 Premature Atrial Contraction X X X C 2 PAG Atrial Fibrillation AFIB X X 2 Supraventricular Tachy
232. anel between full panel and 1 3 panel e deactivate the fan General Settings Figure D 3 The General Settings Dialog Panel The General Settings panel is divided into five areas General Units Timeouts Hospital Name and and Special Features General Under the General area you can configure the following parameters Patient Name Sequence It is possible to choose between Last First default or First Last Mennen Medical D 11 7 Operating Manual Language Defines the language used for display purposes and as the interface language on the dialog panels You can choose from a provided list of languages currently English and French are supported The factory default language is English CAUTION After changing the Language you need to restart the monitor Frequency Defines the monitor frequency in Hertz Hz You can select either 50 or 60Hz Freeze Time By pressing the Freeze button on the front panel user can stop updating of all waveform information displayed on the main screen for period of time which is defined here The available freeze times are 10 20 or 30 seconds Screen Orientation Defines the location in which numerical values and waveforms are displayed on the main screen There are two options available Right Left or Left Right Remote View Reduced Window Activating this toggle causes Remote View to cover 1 3 of the display Units Under the Units area you c
233. anges Press Main Screen to close the panel implement changes and return to the main screen display In monitoring system equipped with a Mennen Medical Server that connects between the Mennen Net LAN and the hospital LAN Hospital Information System HIS the Server keeps a list of all patients admitted via the HIS and their monitors This list can be used to transfer information from the HIS or Laboratory Information System LIS to the relevant monitor You can either insert the patient ID manually or using the SYMBOL LS 2208 barcode reader initialized by Mennen Medical Mennen Medica Menntor 7 Operating Manual gt To admit via HIS 1 Open the Patient Identification panel 2 Insert the patient ID into the ID box 3 Click on HIS button to the write of the ID box Note The HIS key appears only if the Mennen Net is linked to the HIS The patient demographic information is sent from the HIS to the Patient Identification panel on the monitor 4 Press Main Screen to continue To admit via HIS using barcode reader 1 Place the barcode reader in front of the barcode on the patient card and 2 Press the barcode reader switch This will open the Patient Identification panel and insert the patient ID into the Patient ID box The patient ID will be sent to the HIS and as a result the patient demographics will be returned from the HIS to the monitor s Patient Identification panel During the transfer of demograp
234. another ECG dialog panel from the drop down menu list below the panel title area select ECG QRS Tone Volume The QRS Tone Volume dialog panel appears Turn the QuicKnob until the scale is highlighted and press Turn the QuicKnob clockwise or counterclockwise until the correct volume for the QRS tone is set Set the scale to Off in order to deactivate the QRS tone Press Vital Signs to return to the Vital Signs Menu Press Main Screen to return to the main screen display 14 19 Menntor 7 Operating Manual Detecting a Pacemaker The Pacemaker Detection panel enables you to control the detection of cardiac pacemaker pulses Three options are available for pacemaker detection e Fixed In the Fixed mode the sensitivity of pacer spike detection is fixed at 2 mV for 0 2 to 2 0 mSec pulse width e Adaptive 1 In the Adaptive 1 mode ECG adapts its threshold sensitivity to the spike amplitude It provides lower threshold higher sensitivity down to 0 5 mV for 0 2 to 2 0 mSec pulse width e Adaptive 2 In the Adaptive 2 mode the ECG adapts its threshold sensitivity to the noise amplitude This mode provides the same minimum threshold as the Fixed mode and increases the threshold if noise interferes with the pacer spike detection higher immunity Minimum threshold is 2 0 mV for 0 2 to 2 0 mSec pulse width Lead selection Select one of the following leads to monitor pacemaker pulse detection I or V
235. ar Resistance DYN SEC CM Pulmonary Vascular Resistance pvr NN DyN secicm 20 120 70 40 50 DEE Left Cardiac Work sov vow D cm ovefi5 scwe 20 ur Left Ventricular Stroke Work LVSW 699 LvswrPe WEM Right Cardiac Work row KG M Right Ventricular Stroke Work RYSW PI G M c0 14 0 uM BSAj6 00 4722 DATE 05 22 99 Figure 11 2 Hemodynamics Panel 4 Manually enter all missing data and update any existing values if necessary Mennen Medical 11 3 Performing Clinical Calculations Menntor 7 Operating Manual Calculated values and indexes appear on the right side of the panel Out of range values appear on red background 5 Click the Accept button to save calculations and exit the screen The results of the measurement and calculations are saved in the Hemodynamics chart You can access the results from the Charts option in the Data Review menu Respiratory Mechanics Calculations In the Respiratory Mechanics panel you can view monitored respiratory data and perform clinical calculations gt To perform Respiratory calculations 1 Onthe Menntor X7 Main menu press the Patient Data key 2 Inthe Patient Data menu select Calculations 3 Inthe Calculations menu select Respiratory Mechanics The Respiratory Mechanics panel opens displaying the patient s monitored data Respiratory Mechanics PEEP 60 NORMVAL RSP 22 BPM
236. are in place connect the ECG cable to the green input socket on the front of the monitor ECG Monitoring Checklist Plug the patient cable into the ECG socket Prepare the patient attach clip or snap to electrode and attach to patient Note If you do not receive good ECG waveform and all electrodes are correctly and securely positioned change the lead Note If EtCO2 is active then Respiration Measurement by impedance pneumography is disabled ECG Monitoring Procedures 14 6 Intereaction with all aspects of ECG monitoring is via the ECG menu which provides access to the specific dialog panels Each dialog panel enables control of different ECG monitoring aspects In order of appearance on the ECG menu the available panels are Leads Gain Panel Use this panel to select the monitored ECG leads and gain See Setting ECG Leads amp Gain Parameters on page 14 8 Alarm Limits Panel Use this panel to activate or deactivate ECG alarms and set alarm limits See Activating ECG Alarms and Setting ECG Alarm Limits on page 14 12 Alarm Response Panel Use this panel to define how the bedside monitor responds to ECG alarms See Setting ECG Alarm Response Parameters on page 14 14 Relearn Use this key to cause the QRS detection algorithm to Relearn This is useful if the QRS shape is slightly abnormal but not ventricular ECG Report Mennen Medica Menntor 7 Operating Manual Use this panel
237. area Under Display Format Select Date Format A drop down list is displayed There are three available options ddmmmmyy ddmmyyyy or mmddyy The factory default is mmddyy Select Separator The Keyboard panel is displayed Select a character to be used by the system as a separator between elements of a date such as ee 99 Only a single character can be selected Under Display Leading Zeros select the Date or Time checkbox to activate display of a leading zero for example 01 01 98 or 01 30 Clear the checkbox to deactivate e Select the 24 Hour Display checkbox to activate display of time in a 24 hour format 00 00 24 00 Clear the checkbox to have time displayed in a 12 hour format 12A M AND 12 P M When the 24 Hours Display checkbox is cleared the Suffix am pm checkbox is enabled Select to display the suffix AM or PM after the time when time is displayed in 12 hour format Clear the checkbox to remove the suffix Mennen Medica 7 Operating Manual 8 Select Discard Changes to close the panel without applying any changes Select Main Screen to apply the changes and close the panel General Settings Use this dialog panel to set parameters that e affect general panel behavior timeouts etc e define general information such as the name of the hospital e set the interface language for the panels default measurement units etc e Remote View p
238. area is highlighted and then press The area is selected the QuicKnob clockwise and counterclockwise to increase or decrease the value of the selected parameter on the panel e When you have reached the required value press the QuicKnob again to enter the value into the system Once both height and weight are entered the Menntor X7 automatically calculates BSA and displays the resulting value in the Patient Identification Panel 3 Press CO to return to the CO menu Press Main Screen to return to the main screen display Mennen Medical 19 7 Cardiac Output C O Menntor 7 Operating Manual Editing Curves Up to six accepted trial curve graphs are displayed in the Edit Curves panel along with central graph where all curves are displayed on single axis for comparison Each graph is labelled with the corresponding injection number All graphs included in the central graph are also included in averages computation When graph is removed its associated values are removed from the average Computations appear in the center of the panel below the central graph These computations include Cardiac Output C O Cardiac Index C I Pulmonary Vascular Resistance PVR Stroke Volume SV Pulmonary Vascular Resistance Index PVRI and Stroke Volume Index SVI A toggle button appears next to each graph except the central graph When the displayed curve is included in the computations the button label reads
239. arly irregular This irregular rhythm is generally Mennen Medica Menntor 7 Operating Manual caused by atrial fibrillation but it can also be triggered by random premature atrial or nodal beats e dioventricular Rhythm This alarm is activated when the regular rhythm of at least four ventricular QRS complexes is wider than 120 ms and the RR interval is longer than 1250 ms e Couplets of PVCs This alarm is activated when two PVCs in sequence N V V N N are detected e Triplets of PVCs This alarm is activated when three PVCs in sequence N N V V V N N are detected e Trigeminy This alarm is activated when every third beat in a sequence N N V N N V N N isa PVC e ROnT This alarm 15 activated when a PVC falls on or near the T wave of the preceding beat e Premature Atrial Contraction This alarm is activated when a normal QRS ventricular complex from an abnormal atrial focus emerges earlier than the prevailing RR interval e Supraventricular Tachycardia This alarm is activated when a sequence of at least four normal supraventricular QRS complexes with a rate greater than 120 BPM is detected e Multi Focal PVCs This alarm is activated when PVCs originating from more than one site with different wide QRS shapes are detected e Interpolated PVCs This alarm is activated when at least five PVCs occur each between two normal beats without changing the N N interval Mennen Medical 15 3 Arrhythmi
240. arm default limits are 50 150 BPM A heart rate of less than 20 BPM is displayed as 0 Note For proper QRS detection the upper heart rate alarm limit should not be set to more than 20BPM above the patient s current heart rate 14 12 Mennen Medica Menntor 7 Operating Manual RICU BED Alarm Limits Figure 14 7 ECG Alarm Limits Panel gt To activate ECG alarms and set ECG alarm limits 1 From the ECG menu select ECG Alarm Limits if you are already in another ECG dialog panel in the drop down list below the title area select ECG Alarm Limits The ECG Alarm Limits panel appears 2 Select the All ECG Alarms checkbox to activate or deactivate both high and low limit alarms Note When All ECG Alarms is deactivated the slider bars used for setting alarm limits are disabled Mennen Medical 14 13 Menntor 7 Operating Manual 3 Set the low and high limit values by turning the QuicKnob until the required scale is highlighted Press the QuicKnob and turn in step of 5 min until the correct limit is set Turn the QuicKnob while pressing to set limits in increments of 1 min the limits you have set appear in the Low Limit and High Limit values areas on the panel or Press Auto Set to Defaults to set alarm limits to default values 4 Press Vital Signs to return to the Vital Signs Menu or Press Main Screen to return to the main screen display Setting ECG Alarm Response Parameters
241. arms See Setting SpO2 Pulse Rate Alarms on page 22 8 Alarm Response Use this panel to define how the Menntor X7 responds to detected alarms See Setting SpO2 Alarm Response on page 22 9 e Sensitivity Masimo only Switch between Normal and High sensitivity Note High sensitivity will be better when perfusion is very low but will also be more sensitive to noise and interference Display Options Use this panel to define how SpO2 values appear on the main screen display See Setting SpO2 Display Options on page 22 11 Pulse Tones Use this panel to set SpO2 pulse tone and volume See Activating and Setting SpO2 Pulse Tones on page 22 12 Response Time Use this panel to select a response time interval for updating average SpO2 and pulse rate values See Setting SpO2 Response Time on page 22 14 Activate Use this panel to activate or deactive monitoring of SpO2 See Activating SpO2 Monitoring on page 22 15 Mennen Medical 22 5 Pulse Oximetry SpO2 Menntor X79 Operating Manual Accessing the SpO2 Menu The SpO2 menu can be accessed from the Vital Signs menu or from the main screen display e To access the SpO2 menu from the Vital Signs menu 1 From Main menu select the Vital Signs key The Vital Signs menu is displayed 2 From the Vital Signs menu select SpO2 The SpO2 menu appears 3 Select the required menu item to display the associated panel gt Toaccessthe SpO2 menu from the
242. ars 3 Select the required panel from the menu To access the NIBP menu from the main screen display 1 When NIBP is displayed in a parameter slot in the primary display area waveform area turn the QuicKnob until the NIBP parameter key is highlighted The parameter key functions as an on screen button Press the QuicKnob to select the parameter key and access the NIBP menu 2 When NIBP is displayed in the Secondary Vital Sign area or in Big Number format turn the QuicKnob until the NIBP value is highlighted and press to select The NIBP menu appears Setting Reading Intervals 21 6 The NIBP Reading Intervals panel controls measuring and monitoring of non invasive blood pressure The automatic mode enables taking blood pressure readings at pre set intervals There are five options for selecting automatic intervals e Off disables automatic NIBP reading e Single T Interval A single interval can be selected A reading is taken every selected interval The first reading is taken immediately and the next readings are taken at the selected interval For example if NIBP is activated at 10 23 and the interval is set for T 15 the first reading is taken immediately and the next readings are taken at 10 38 10 53 11 08 etc e Single Q Interval A single interval is selected The first reading is taken at the beginning of the next hour and the next readings are taken according to the selected interval To return to the
243. asured from the ECG electrodes The respiration waveform is displayed in the Primary Vital Sign area and represents inspiration and expiration During inspiration the thorax moves outward raising the average impedance During expiration the inverse occurs The waveform is acquired by impedance pneumography which monitors changes in impedance between two electrodes caused by changes in the bone tissue blood ratio between them An RF reference signal is imposed between the RA and either LA or LL electrodes The modulator reference signal for respiration detection is 65 kHz The corresponding respiration signal caused by the change in patient impedance is modulated by the 65 kHz The actual change is small typically I ohm in an average impedance of 1000 ohm The modulated signal is then amplified and filtered in order to clean environmental noise and to derive the respiration rate The Menntor X7 bedside monitor calculates respiration rate and Breath by Breath time intervals Once every minute trended data is acquired for storage This data includes e Total number of breaths per minute Note In order to allow Respiration monitoring ensure that EtCO gt is not activated Patient Preparation Patient preparatory procedures are the same as for ECG monitoring See Patient Preparation on page 17 2 For optimal results when monitoring both ECG and respiration use the electrode positions described in Figure 14 2 Three Lead Ele
244. asurement of 2 or 4 Invasive blood pressures and Cardiac Output The MX57 MPM will have an optional LCD display 751 OPT 057 that will allow it use the MPM as a transport monitor see chapter 33 Menntor X7 Part Numbers The following tables provide part numbers for Menntor X7 Table 1 1 Menntor X7 host Part Numbers Part Number Description 791000000 Menntor X7 Base Unit Assembly 791OPTXXX Menntor X7main frame 7910PT012 Menntor X7 Touch Screen Option 7910PT014 Menntor X7 Non Touch Screen Option 7910PT010 Menntor X7 Battery Option One Battery 7910PT020 Menntor X7 Battery Option Second Battery 791OPT119 Menntor X7 Wireless Option EU 7910PT219 Menntor X7 Wireless Option UA 7910PT400 Menntor X7 Recorder Option 7910PT008 Menntor X7 Flash Memory 16GB Option Table 1 2 MX57 Multi Parameter Module Part Numbers Part Number Description Non Invasive monitoring 751000010 MX57 3 5ECG Resp 2Temp NIBP SpO2 Covidien 1 2 Mennen Medica Menntor 7 Operating Manual Table 1 2 MX57 Multi Parameter Module Part Numbers Part Number Description 751000012 MX57 12ECG Resp 2Temp NIBP SpO2 Covidien 751000020 MX57 3 5ECG Resp 2Temp NIBP SpO2 Massimo 751000022 MX57 12ECG Resp 2Temp NIBP SpO2 Massimo 751010012 MX57 12ECG Resp 2Temp NIBP SpO2 Covidien LCD 751010022 MX57 12ECG Resp 2Temp NIBP Sp
245. available space a scroll bar appears to enable you to scroll through the list Accessing Menus and Panels From the Main Display Icons The icon located in the upper right corner of the patient area reflects the status of various hardware devices connected with the Menntor X7 Speaker Off Icon If Alarm volume is set to Off or if All Alarm Off button if pressed the icon will show loudspeaker with an X Recorder Status Icon If recordings are sent to the Strip chart recorder and the recorder is not ready or out of paper recorder icon will appear in the icon area 6 16 Mennen Medica Menntor 7 Operating Manual CAUTION When the recorder returns to work all the stacked recordings will be recorded sequentially and lot of recording paper will be wasted In such case it is recommended to Delete All Recordings by using the relevant key in Patient Data Check Printer Message The message CHECK PRINTER appears blinking on the bottom row of the monitor if more than 22 prints were sent by monitor to printer that is not ready or out of paper Use the Silence key to delete the message CAUTION Ifa Check Printer message is received use Delete All Recordings in Patient Data to first clear the stack of prints then check the printer to enable it to resume working Patient ID Area The Patient ID area is located at the top of the main screen display to the left of the speaker recorder icon and funct
246. ay Options panel you can e Instruct the monitor to display SvO2 information in the Waveform area as a Secondary Vital Sign or in Big Number area on screen e Define the color of SvO2 values as they are displayed on the screen Note Values have the same color unless they go into alarm in which case the value takes on the alarm priority color When the alarm condition terminates the original color is restored e Configure the following values to be displayed or not as required Alarm Limits and or Units gt Toset SvO2 Display Options 1 From the SvO2 menu select Display Options The Display Options panel opens 2 From the Display Area drop down list select the area where you want the SvO2 to be displayed on screen The options are Waveform Secondary VS and Big Numbers The default is Waveform 3 Under Display Features Select the Alarm Limits and Display Units checkboxes to activate or deac tivate display of these parameters on the main display screen 4 From the SvO2 color list select the color required for SvO2 parameters You have a choice of colors Trend Up to 8 of the Vigilance Vigileo and PiCCO vital signs and derived parameters can be shown as a graphic trend For use of graphic Trends see Trends on page 10 2 Chart All Vigilance Vigileo and PiCCO vital signs and derived parameters are stored in a chart gt To create a PiCCO chart 1 In System Setup select Tabular Charts
247. ay and extend towards the left side with the farthest righthand point being equal to zero or current time Mennen Medical 7 7 Setting Up the Patient Display Menntor 7 Operating Manual 7 8 Vital Signs Selected Units Duration PULSE 72 90 5 95 HRT BPM r SpO2 3 Minutes 1 MiniDivision 85 gt RESP B min ARTd mmHg 3 Minutes 1 MiniDivision 140 80 9 1 6 00 9 54 Parameters Parameters associated with associated with left scale right scale Figure 7 5 Close up of CRG Display Area To activate CRG 1 From the Main menu select the Setup key and from the Setup menu select CRG The CRG panel appears 2 Select CRG 1 3 In the Duration box set the duration for the selected parameter between 1 5min to 30min 4 Select the vital sign s to appear in the CRG display e Under Left Param in the Vital Sign box select a vital sign from the list of currently active vital signs and define the scale The scale for this parameter will appear on the left of the graph e f you want another vital sign to appear in CRG 1 under Right Param in the Vital Sign box select a vital sign from the list of currently active vital signs and define the scale The scale for this parameter will appear on the right of the graph Mennen Medica Menntor 7 Operating Manual Left Param Se Ea ken SpO2 E ee 100 Fi Grid IE
248. ay pressure is measured in the mouth side of he Pneumotachograph The Menntor X7 Spirometry module uses a disposable Pneumotachograph sensor that is connected to the module via two air tubes There are two transducers in the module Mennen Medical 34 1 Spirometry Menntor 7 Operating Manual e differential transducer that measures the pressure drop on the pneumotachograph and e transducer that measures the airway pressure For long term monitoring the Menntor X7 uses a built in Purge pump for periodic removal of water droplets collected in the two air tubes Principles of Operation The Menntor X7 spirometry module uses OEM flow sensor technology developed by CPT this technology is based upon a fixed orifice differential pressure approach to flow measurement The airway adapter flow sensor creates a slight resistance to the patient s respiratory flows This resistance causes a pressure drop that is relative to the flow rate Both this pressure drop and the overall airway pressure are measured to calculate the numeric parameters and create the graphics loops and waveforms An internal barometric pressure transducer automatically compensates for ambient barometric pressure and altitude changes The pressure transducers are automatically calibrated without user intervention This automatic calibration briefly less than one second interrupts patient monitoring This function is needed due to changes in monitor temperature
249. b control on the front panel of the main processing unit enables quick and direct access to system parameters and functions An optional Touch Screen is available for control of the Menntor X7 setting and menus without the hardware keys and QuicKnob 119 80 92 Figure 3 1 The Menntor X7 Bedside Monitor Mennen Medical 3 1 System Description Menntor 7 Operating Manual System Features and Capabilities 3 2 The Menntor X7 displays wide range of vital sign clinical parameters It includes ECG Respiration multi lead for monitoring ECG and respiration Dual four optional BP inputs for monitoring two invasive blood pressures CO 2TMP connector to measure either thermodilution Cardiac Output or two temperatures Temp connector NIBP input for monitoring non invasive blood pressure using the oscillometric method Pulse Oximetry Microstream End Tidal CO2 EtCO2 for monitoring CO2 during exhalation EtCO2 and inhalation inCO2 and Respiration Rate CerebraLogik dual channel EEG and aEEG Serial Input for communication and interface with an external auxiliary device The Menntor X7 s main monitoring features include Continuously updated vital sign parameter data displayed as numeric values and continuous waveforms Clinical and technical alarm detection as well as alarm notification in audio and visual formats Easy access to collected data in the form of tabular charts and graphical trends
250. by qual ified technician consult service manual before removing cover Off power disconnection from main power supply On power connection to the main power supply Type BF applied part defibrillator proof Type CF applied part direct cardiac application defibrillator proof Fuse Type BF applied part Refer to instruction manual booklet Restricts the sale and use of this instru ment to qualified medical personnel only Not for use in explosive gas environ ment Location of Symbol At the rear of the Processing unit At the rear of the Processing unit On Processing unit On right of Processing unit On the right of the Processing unit On NIBP and SpO2 On ECG and Dual BP and 2 TMP At the rear of Processing unit On CerebraLogik input On device label On device label On device label 2 5 Warnings and Precautions Symbol Description Electrical and electronic equipment Dispose according to local regulation Date of manufacture YYYY C CE Mark Identification Label 2 6 Figure 2 1 Menntor X7 Rev A 791 OPT 008 012 C 0140016 02001190 219 _ 400 0 REF 791000000 SN 0000000000000 Charter Kontron Limited Unit 18 Avant Business Centre 21 Denbigh Road Milton Keynes MK 1 1DT England ul Mennen Medical Ltd 4 Hayarden Street Yavne Box 102 Rehovot 7610002 Israel H Rony C Eo Made in Israel 791 701 0
251. ca 7 Admit by Default This panel enables you to admit patient by factory set default monitor profile You can only use this option after the patient has been discharged System Setup Default Alarm limits Admit By Default Figure D 27 The Admit by Default Setup Panel gt To admit by Default 1 1 Discharge the patient 2 2 Select System Setup 3 3 From the System Setup menu select Admit by Default Mennen Medical D 57 7 Operating Manual Report Setup In order to review patient data the Menntor X7 generates reports You can name and define the format for up to 10 types of reports Reports are configured in the Report Setup dialog panel All available reports appear in the Reports List You can configure and edit the format for each report rename it and clear the report from the Report List All reports can be printed and placed in the patient s records For example if you want to set up report for Hemodynamics you might first name report Hemodynamics and then in Edit Report set up the format for the Hemodynamics report For each report specify whether the report type is Charts or Trends System Password System Setup Reports List REPORT 1 Edit Report Report Name REPORT 1 Figure D 28 The Report Setup Dialog Panel Naming Report D 58 By default reports are named Report 1
252. ca Menntor 7 Operating Manual SpO2 Accuracy Limitations e Inaccurate measurements be caused by venous pulsations e Inaccurate measurements or loss of pulse signal may be caused by placement of a sensor on an extremity with a blood pressure cuff arterial catheter or intravascular line e Masimo MS board pulse oximeter can be used during defibrillation but the readings may be inaccurate for a short time e Loss of pulse signal can occur when the sensor is too tight e Loss of pulse signal can occur when the patient has hypotension severe vasoconstriction severe anemia or hypothermia Loss of pulse signal can occur when there is arterial occlusion proximal to the sensor Loss of pulse signal can occur when the patient is in cardiac arrest or is in shock Technical Alarms Technical alarm messages for SpO2 are as follows Cable Out and Relocate Probe The alarm warns the user of the technical problem in the following ways e Cyan background on the numeric vital sign area e Message in the alarm message area e Audible alarm Recording of a waveform strip triggered by the alarm The last two are user controlled and can be activated or deactivated through the Alarm Response panel see below This enables the user to prevent the audible alarm during periods that the SpO2 sensor is not in use Relocate Probe is caused by low photo plethysmographic signal Before use confirm the alarm activi
253. cardia X X X C 2 SVTACH Multi focal PVCs MULTIFO X X X 2 CAL Interpolated PVCs INTPVC X X X C 2 eAlarm Detection Delay When an alarm is detected a pre defined delay period allows the system to check in order to avoid false alarms The delay can be set to 3 5 10 15 or 20 seconds The factory default is set to 5 seconds D 24 Mennen Medica 7 eDefault Color Defines the color in which ECG vital signs and waveforms appear on the main screen display You have a choice of 16 colors The factory default color is yellow ECG Setup Figure D 8 The ECG Setup Panel gt To define ECG default parameters 1 Mennen Medical From the System Setup menu select Vital Signs Setup The Vital Signs menu is displayed From the Vital Signs menu select ECG Setup The ECG Setup dialog panel is displayed Under Extended Alarm Response e From the appropriate drop down list set the priority levels for Heart Rate Faults and Pacer e From the Latching drop down list set alarm latching to On or Off Under Arrhythmia select the Arrhythmia Package that you want Under Arr Priority From the Arr Name drop down list select the type of arrhythmia for which you want to set alarm priority e From the Priority drop down list select the priority level for the selected D 25 7 Operating Manual type of arrhythmia
254. cause false alarms are filtered out Diagnostic When this filter is selected the monitor displays an unfiltered diagnostic quality waveform You can then detect changes in the ECG such as R wave notching e Exercise This filter implements a narrower bandwidth for situations where there are many movement artifacts or high interference and environmental noise The default option is Monitor When Diagnostic or Exercise is selected a message appears on the main screen display Only one filter can be specified WARNING Do not try to estimate ST when Monitor or Exercise filters are used Only Diagnostic filter and ST mode provide reliable ECG morphology 14 24 Mennen Medical Menntor 7 Operating Manual OK 6 JOHN SMITH Filter Monitor Diagnostic T 5 EXCICISC ST Figure 14 14 The ECG Filter Dialog Panel gt Tosetthe filter 1 From the ECG menu or if you are already in another ECG dialog panel from the drop down menu list below the panel title area select Filter The ECG Filter dialog panel appears 2 Select the required filter 3 Press Vital Signs to return to the Vital Signs menu Press Main Screen to return to the main screen display Note When monitoring ST segment the filter is fixed by default as ST Filter and cannot be changed Mennen Medical 14 25 ECG Menntor 7 Operating Manual ECG Recording Use the ECG built in or network strip chart recorder to recor
255. ccessed from the ECG menu or from the drop down menu list below the title area in any ECG panel Mennen Medical 14 7 Menntor 7 Operating Manual Accessing the ECG Menu Access the ECG menu from the Vital Signs menu or from the main screen display gt To access the ECG menu from the Vital Signs menu From Main menu select the Vital Signs key and select ECG from the Vital Signs menu The ECG menu is displayed gt To access the ECG menu from the main screen display Turn the QuicKnob until the ECG parameter key is highlighted and press The ECG menu is displayed Setting ECG Leads amp Gain Parameters Lead The type of ECG traces displayed on the monitor depends on the type of cable used The 3 lead cable provides a single channel A 5 lead set provides the following choice of leads I II III aVR aVL aVF and V1 A 6 Lead cable provides also V2 A 12 lead set provides I II aVR aVL aVF V1 V2 V3 V4 V5 and V6 The number of leads displayed is configurable but this is limited by the actual space alloted to ECG in Screen Format The displayed leads can be changed at any time The characteristics of a good signal are as follows e R wave should be tall and above or below the baseline e Tall and narrow with no notches e The T wave should be less than 1 3 the height of the R wave e P wave should be much smaller that the T wave 14 8 Mennen Medical
256. ce between Covidien s BISx unit and the Menntor X7 monitor s display and data handling Introduction The Menntor X7 BIS monitoring is user configurable system designed to monitor the hypnotic state of the brain based on acquisition and processing of EEG signals The BISx processes raw EEG signals to produce single number called the Bispectral Index or BIS which correlates with the patient s level of hypnosis The Menntor X7 BIS display consists of The current BIS number Trend graphs of processed EEG parameters in the CRG see Chapter 8 Raw EEG waveforms in real time Various signal quality indicators EMG SQI Suppression Ratio if requested by the user Burst Count number Alarm indicator and messages The BISx performs self tests to ensure that the BISx is functioning properly and that impedance levels of patient sensors are within acceptable limits Easy to use menus allow the user to change the data display and review stored data Mennen Medical 27 1 BIS Bispectral Index Menntor 7 Operating Manual Indications for Use Bispectral Index BIS monitoring is intended for use under the direct supervision of a licensed healthcare practitioner or by personnel trained in its proper use It is intended for use on adult and pediatric patients within a hospital or medical facility providing patient care to monitor the state of the brain by data acquisition of EEG signals The BIS may be used as an aid in monito
257. ce is caused by the way in which this RF electrosurgical signal spreads away from the active electrode Because the spread of the signal is basically symmetrical two sites equidistant from the active electrode will receive basically the same signal or will be at basically the same RF voltage Menntor X7 amplifiers measure the difference in voltage between their positive and negative inputs If the ECG electrodes are placed at equal distances from the active electrode they will have equal RF voltages With no voltage difference between the positive and negative inputs the ECG amplifier will have no RF voltage difference to measure and therefore no interference In actual practice it Mennen Medical Menntor 7 Operating Manual is probably impossible to place the electrodes exactly equidistant from the active ES electrode The effort in attempting to do so however is well spent as it tends to minimize the magnitude of difference mode interference In summary conduction interference can be minimized by 1 Using the lowest possible ES power setting 2 Placing the return plate directly under the surgical site 3 Placing the ECG electrodes as far from the ES site as possible 4 Placing the ECG electrodes equally distant from the ES site 5 Placing ECG electrodes on the frontal or all on the posterior surface Radiation Radio frequency RF voltage always generates an electromagnetic The intensity of the radiate
258. cers for all monitored BPs Mennen Medica Menntor 7 Operating Manual ICU Avishai Main Screen ART 2 1 Zero Pressure Zero All Pressures Figure 18 1 The BP Zero Pressure Dialog Panel gt To zero BP transducers 1 From the BP menu select Zero Pressure 2 Open transducer to atmospheric pressure and press Zero BP to zero transducers for the currently displayed BP Open all transducers to atmospheric pressure and press Zero All Pressures to zero all monitored BP transducers 3 Press BP Site Name to return to the BP menu Press Main Screen to return to the main screen display Mennen Medical 18 5 Invasive Blood Pressures Menntor 7 Operating Manual Selecting the BP Scale The Scale dialog panel defines the way BP waveforms are scaled for presentation on the main screen display You can configure the Menntor X7 to scale waveforms automatically or you can manually set high and low scale limits Scale range depends on the monitored BP OK 7 Main Screen ART IES 1 Scale Auto Scale Auto Scale Auto Scale BP All Manual Scale High Scale 25 Low Scale o Figure 18 2 The BP Scale Dialog Panel gt automatically scale the BP waveform 1 From the BP menu from the drop down menu list below the BP title area in the BP panel select Scale 2 Press Auto Scale BP to automatically scale the current BP waveform 3 Press Auto Scale All to automatically scale
259. charged meaning that monitoring of that patient must be stopped On the other hand some of the dialog panels can be accessed only when a patient is currently being monitored Demo Mode See Demo Activation on page D 78 Build Master Configuration Use this key to store a configuration for future copying to different Envoy monitors Copy Configuration From Use this key to copy a configuration from a master configuration monitor Note See Table D 1 below for the access capabilities in the dialog panel Table D 1 Table D 1 Access Capabilities in the Dialog Panel Patient Discharged Patient Monitored Store Diagnostic File Date amp Time Setup me General Settings EN Enable Touch Screen Alarm Volume amp Controls Sound Event Default Alarm Limits Event Setup Leakage Test CO2 Calibration uM Vital Sign VS Setup DE Parameter Hierarchy Monitor Profiles Admit By Default NM Mennen Medical D 5 7 Operating Manual Table D 1 Table D 1 Access Capabilities in the Dialog Panel Report Setup Automatic Reports Network Setup Recorder Setup Trends Setup QuicKeys M Tabular Charts Software Version __ Change Password Check Disk __ Permission Editor Remove Saved Patient
260. cle activity and artifacts in the 70 110 Hz range Value is in dB with respect to 0 0001 uV SQI 0 100 Signal Quality Index The percentage of good epochs and suppressed epochs in the last 120 epochs collected that could be used in the Bispectral Index calcu lation SR 0 100 Suppression Ratio The percentage of epochs in the past 63 seconds in which the EEG signal is considered suppressed BC 0 30 Burst The number of EEG bursts in the last minute An EEG burst is a momentary Count period of EEG activity among isoelectric or flat EEG Blanked if SR is less than 5 SEF 0 5 30Hz Spectral Edge Frequency The frequency at which 95 of the total Mennen Medical 27 7 BIS Bispectral Index Menntor 7 Operating Manual Operating the Menntor X7 BIS Note Read this section before operating the monitor in clinical setting Introduction This section covers the following e Preparing for operation e sensor check e The monitor screen display e Software menus and menu selections e Reviewing stored data e The EEG display Ending acase Preparing for Operation 27 8 After familiarizing yourself with the safety information in the introductory section of this manual prepared a suitable environment properly connected the BISx and PIC cables prepare the BIS for operation To prepare the BIS for operation 1 Select a BIS monitoring Profile To start the BIS for the first time use the recommended Mo
261. con will appear on the top right corner of the screen When The Selective Recording panel is opened a visual indication of the recorder status is displayed on the panel The following are a list of the different indications e Recording in progress e Designated recorder s not found e Recorder busy e Recorder out of paper e Recorder door open e Recorder fault CAUTION Ifthe recorder is not functioning or out of paper recordings will be stacked in the monitor When the recorder will return to work all the stacked recordings will be recorded sequentially and a lot of recording paper will be wasted In such case it is recommended to Delete All Recordings by using the relevant key in Patient Data Anatomy of the Recorder Strip The length of the chart recorder strip is determined by the length of time a waveform is recorded The strip consists of three major areas a header the waveform area and a footer Header The header contains a single annotation line containing relevant information pertaining to the recording The annotation line appears horizontally along the upper edge of each recording The following information appears in the annotation line Bed Room Name The patient s room number This is proceeded by the Number indicator RM Patient Name The name of the monitored patient This may contain up to 16 characters If the patient s name is longer only the first 16 characters appear on the strip Menn
262. condary Vital Sign area QuicKeys Bar Figure 6 6 QuicKeys Bar The QuicKeys bar is a row of up to 12 user defined function keys that appear on the bottom of the main screen display QuicKeys provide quick access to your most frequently used functions For example if you want to access the Charts panel instead of going through the Main menu to the Patient Data menu and then selecting Charts from the Patient Data menu you can simply turn the QuicKnob until the Charts QuicKeys is highlighted and press to display the Charts panel Any function can be configured as a QuickKey QuicKeys are configured by your hospital biomedical engineer or System Administrator in System Configuration Note Quick Keys disappear from the screen every two minutes To redisplay the QuicKeys simply turn the QuicKnob Main Processing Unit All clinical data collected from the inputs are stored in the main processing unit This data includes waveforms vital signs trends charts and beat to beat data The main processing unit can store at least ten days worth of patient data for review purposes Front Panel The front panel has seven fixed keys and the QuicKnob These features provide the means by which you interact with the Menntor X7 6 8 Mennen Medica Menntor 7 Operating Manual Figure 6 7 Front Panel of the Menntor X7 Fixed Keys Menntor X7 fixed keys are marked by icons and label Table 6 1 M
263. creen display Alarm Limits 34 12 You can set the Spirometry alarm parameters in two dialog panels Alarm Limits and Alarm Response each dialog panel controls different aspect of Spirometry alarms Note See Chapter 8 Alarms for more details on how to set up Alarms in the Menntor X7 e Setting Spirometry Alarm Limits The Alarm Limits dialog panel controls activation and deactivation of Spirometry alarms and defines Spirometry alarm limits Low and high alarm limits are set separately for each parameter selected The Spirometry Module detects alarms and notifies the Menntor X7 accordingly to display the appropriate message By configuring the spirometry parameters on this panel see below for a list of the parameters you can do the following e Activate or deactivate all Spirometry alarms e Set Low and High Spirometry alarms e Set Low and High Spirometry alarms to default values Mennen Medica Menntor 7 Operating Manual Spirometry Parameters The following parameters can be selected RR Respiration Rate VT Tidal Volume MV Minute Volume PIP Peak Inspiration Pressure MAP Mean Airway Pressure PEEP Positive End Expiratory Pressure RES Resistance COMP Compliance PLTP Plateau Pressure CAUTION Airway Resistance is measured by means of the following formula RES PIP Pplat PIF You can measure Pplat with a ventilator procedure that closes the airway at t
264. ct and press Mark Hold Segment a line marking the selected time interval appears on top of the cursor Use the QuicKnob to increase or decrease the marked area d Press the center key H of Mark and Hold to hold the selected section e The graph area splits into two sections The right section contains the whole trend and the left section contains the selected segment The Mark Hold Segment button changes to Clear Hold To release the segment press Clear Hold The graph area returns to normal Use the Zoom in Zoom Out keys to change the duration of the trend around a fixed cursor time Use the QuicKnob to select and press the Cursor button Rotate the QuicKnob to move the Cursor to the left or right Press the QuicKnob to release the Cursor button Press the Grid button to add or remove the grid of the trend panel To display the trend starting at a selected time and date press Go to The Date amp Time panel opens Figure 10 3 Select the date and time and click Accept Mennen Medica 7 Operating Manual Sun Mon Tue Wed Thu Fri Sat 2 S November pes m rj Date 13 11 12 Hour 14 Minute 15 Time 14 15 Figure 10 3 Date amp Time Panel 16 From the Patient Data drop down menu select Charts Full Disclosure or Overview The Trends panel closes and the selected panel opens displaying data fo
265. ction of this manual First disconnect and reconnect the FilterLine If the message still appears disconnect and replace the FilterLine Once a working FilterLine is attached to the module the pump automatically resumes operation After connecting the CO2 sampling line to the monitor and to the patient check that CO2 values appear on the host monitor display EtCO2 Specifications Table 23 2 EtCO2 Specifications Value EtCO2 operating temperature 65 MicroPod operating tempera 40 9C ture CO2 Units mmHg or kPa or Vol resolution 0 1mmHg CO2 Waveform Resolution 0 1 mmHg EtCO2 FiCO2 Resolution 1 mmHg 23 24 Mennen Medica Menntor 7 Operating Manual Table 23 2 EtCO2 Specifications Value Measurement accuracy CO2 Partial Pressure at sea Accuracy level see Note 0 38 mmHg 2 mmHg 39 99 mmHg 5 of reading 0 08 x reading 39mmHg Note Accuracy applies for breath rates of up to 80 bpm For breath rates above 80 bpm accuracy is 4 mmHg or 12 96 of reading whichever is greater for EtCO2 values exceeding 18 mmHg This is tested according to and is compliant with ISO 21647 To achieve the specified accuracies for breath rates above 60 breaths minute the Microstream FilterLineH Set for Infant Neonatal p n 006324 must be used Above 55 C module temperature ImmHg or 2 596 whichever is greater has to be added to the tole
266. ctions on how to download the diagnostic files and send them to the Service dept of Mennen Medical Date amp Time Setup Use this panel to set the date and time and to set time display formats for the Menntor X7 bedside monitor See Date amp Time Setup on page D 8 General Settings Use this dialog panel to define general information such as the hospital name and parameters controlling general panel behavior See General Settings on page D 11 e Disable Enable Touch Screen Monitors and Ensemble equipped with Touch Screen have a toggle to disable the touch screen feature for cleaning Mennen Medica 7 Operating Manual e Alarm Volume amp Controls Use this panel to define general alarm related parameters such as alarm volume color scheme etc See Alarm Volume and Controls on page D 14 Sound Event Use this panel to assign audio messages to various events See Sound Event on page D 17 e Default Alarm Limits Use this panel to set new default alarm limits for all monitored vital signs See Default Alarm Limits on page D 18 Event Strip Use this panel to prepare or modify a list of Event Strip Labels and to define the response of the Menntor X7 to the activation of the Mark Event key e Leakage Test Use this panel to perform Leakage test of the NIBP module and cuff The test is password protected after Event Strip e Vital Sign VS Setup Use this panel to set
267. ctivate CO monitoring See Activating and Deactivating CO Monitoring Accessing the CO CCO Menu The CO menu can be accessed from the Vital Signs menu or from the main screen display gt Toaccess the panel from the Vital Signs menu l Press the Vital Signs key on the front panel The Vital Signs menu appears CO CCO and SvO2 currently monitored appear on the Vital Signs menu 2 From the Vital Signs menu select CO The appropriate menu is displayed 28 4 Mennen Medica Menntor 7 Operating Manual gt To access the CO panel from the main screen display Turn the QuicKnob until the CO parameter key is highlighted and press to access the CO panel Setting CO Alarms CO alarm parameter is set in two dialog panels Alarm Limits and Alarm Response Each dialog panel controls different aspect of CO Note The alarm limit settings should always be set and monitored in the Auxiliary device as the primary setting for the alarms Setting CO CCO Alarm Limits The Alarm Limits dialog panel controls activation and deactivation of CO alarms defines CO alarm limits By configuring parameters on this panel you can Activate or deactivate CCO alarms Set low and high CO alarms gt Toset CO alarm limits 1 2 Mennen Medical From the CO menu select Alarm Limits Select the All CO Alarms checkbox to activate or deactivate both high and low limit alarms When deactivated alarm
268. ctivate individual alarms and adjust alarm limits for all monitored vital signs without having to access each vital signs separately Accessing the Alarm Status Dialog Panel The Alarm Status panel can be accessed from the Vital Signs menu gt To access the Alarm Status panel 1 Onthe Main menu select the Vital Signs menu The Vital Signs menu is displayed 2 From the Vital Signs menu select Alarm Status The Alarm Status dialog panel is displayed Note The Alarm Status panel displays alarm status for all active parameters Non active parameters are not displayed OK 6 JOHN SMITH Alarm Status Figure 8 1 The Alarm Status Dialog Panel Mennen Medical 8 9 Alarms Menntor 7 Operating Manual gt To set alarm limits from the Alarm Status dialog panel 1 Turn the QuicKnob until the vital sign for which you want to adjust alarm limits is highlighted Press the knob The same functions that are available on the Alarm Limits panel for that vital sign are displayed on the Alarm Status panel 2 Select the All HRT Alarms checkbox to activate or deactivate both high and low limit alarms select the Enable Alarm checkbox located below the low and high alarm scales to activate or deactivate either the low or high alarm limit By default both alarms are activated 3 Set the low and high limit values by turning the QuicKnob until the required scale is highlighted Press the QuicKnob and turn until the cor
269. ctrode Placement in Figure 14 3 Five Lead Electrode Placement and in Figure 14 4 Three Lead Neonatal Electrode Placement Mennen Medical 17 1 Respiration Menntor 7 Operating Manual Note Proper electrode placement is critical when monitoring respiration The slight loosening of an active electrode may be acceptable for ECG monitoring but it will cause Respiration fault If this occurs re attach LA and RA or RA and LL electrodes Monitoring Procedures Respiration monitoring is set up through the Respiration menu dialog panels Each dialog panel enables control of different aspects of Resp monitoring The available panels are Lead Gain Use this panel to select the required lead and gain for monitoring respiration See Setting Respiration Leads and Gain on page 17 3 Alarm Limits Use this panel to set respiration alarm limits and criteria See Setting Resp Alarm Limits on page 17 4 Alarm Response Use this panel to define the way the Menntor X7 responds to respiration alarm events See Setting the Respiration Alarm Response on page 17 6 Display Options Use this panel to configure the way respiration parameters are displayed on the main screen See Setting Resp Display Options on page 17 8 Heart Rate Coincidence Use this panel to set parameters defining the detection and response to Heart Rate Coincidence alarms See Setting the Heart Rate Coincidence Alarm on page 17 10 Activate
270. d 117 63 of the change within 6 seconds change of HR from 80 to 40 BPS will reach 57 63 of the change within 2 seconds The preset delay is set in the System Setup Password protected between 3 5 between 3 5 10 15 and 20 seconds This delay is set by the system manager for each of the vital signs separately Default is 5 second for all vital signs and 0 seconds for arrhythmias The addition of preset delay is provided to reduce the fault alarms due to short term changes in vital signs The total delay is the sum of the above delays and is between 8 and 14 seconds Alarm Notification When an alarm condition is detected the Menntor X7 informs you by providing both visual and audible messages The alarm appears on the Ensemble central nurse station and on the Enguard remote monitor with delay of up to 1 second Alarm Lights Red and yellow lights on top of the monitor will signify the priority of the alarm High priority alarms C1 are identified by a blinking red light Medium priority C2 are identified by a blinking yellow light other alarms are identified by continuous yellow light 8 2 Mennen Medica Menntor 7 Operating Manual Visual Response Identifying the source of an alarm is made easier by the display of alarm messages and change in the color of the vital sign which has generated the alarm Clinical level alarm messages are displayed in the alarm message area and are arranged in order o
271. d On both visual and audible alarms The factory default is Off e Cuff Type Defines the default cuff type to be used by the Menntor X7 The available cuff types are Adult or Neonatal The factory default is Adult Mennen Medical D 31 Menntor 7 e Reading Intervals Use to set defaults for T and Q intervals Refer to Chapter 11 NIBP Monitoring in the Menntor X7 Operation Manual for a complete description of this concept Use Single T Mode or Single Q Mode to simplify the interval selection by showing only one timed mode e Units Determines the units used to measure NIBP The available options are mmHg Kpa and cm H50 The factory default is mmHg Numeric Formats Determines the numeric format in which the NIBP reading is displayed When units are defined as mmHg the available options are SSS DDD MMM SSS DDD mmm and SSS DDD The factory default is SSS DDD MMM When units are defined in Kpa the available options are SS S DD D and MM M The factory default is SS S DD D NIBP Default Color Defines the color in which NIBP values appear on the main screen display You can choose from 16 available colors NIBP Setup EEE EVNENE EEE Figure D 11 The NIBP Setup Dialog Panel gt To set NIBP default parameters 1 From the System Setup menu select Vital Signs Setup The Vital Signs menu is displayed D 32 Mennen Medica 7 Operating Manu
272. d artifact e Select the Use as 3 Lead checkbox to activate or deactivate the feature When activated the monitor uses a reduced ECG set regardless of the lead being used A notification message Only leads RA LA amp LL are used apppears in the message area on the main screen display e For ECG 12 Lead cable Select the Use as 5 Lead checkbox to activate or deactivate the feature When activated the monitor uses a reduced ECG set regardless of the lead being used Under Pacemaker Alarm Response e Select the Record checkbox to activate or deactivate recording of the patient s monitored vital signs at the time of the alarm e Select the Tones checkbox to activate or deactivate audible alarm indication Note Checkboxes appears green when activated and gray when deactivated Press Vital Signs to return to the Vital Signs Menu Press Main Screen to return to the main screen display 14 15 Menntor 7 Operating Manual Setting ECG Report You can now either print a report of 3 x 4 ECG strips plus one rhythm strip or if the Mennen Net is connected to server also save the report to the server gt To print and or save the ECG report 1 From ECG menu select ECG Report The ECG report setup dialog appears Use this panel to select the Rhythm lead and to direct the report either to the printer or if the Mennen Net is connected to server also or only to the server lt none gt enl211AA Main Sereen ECG
273. d delay period allows the system to check in order to avoid false alarms The delay can be set to 3 5 10 15 or 20 seconds The factory default is set to 5 seconds e Auto Scale Automatically sets the range of the BP waveform on the main screen display After Zero enables you to specify if autoscaling is done automatically after the BP is zeroed and in which cases The available options are Always Never and Only After First Zero Under Type you can define the type of autoscaling implemented The available options are Normal and Only Upper Limit meaning that the lower scale limits should be kept BP Site Specific Default Parameters e Defaults per Site Name Defines the site for which the site specific parameters are being set e Units D 28 Mennen Medica 7 Operating Manual Mennen Medical Determines the units used to measure the selected BP The available options are mmHg and cm H 0 The factory default is mmHg Numeric Formats Determines the numeric format in which the selected BP is displayed When units are defined as mmHg the available options are SSS DDD SSS DDD mmm and SSS DDD The factory default is SSS DDD MMM When units are defined in Kpa the available options are SS S DD D and MM M The factory default is SS S DD D MM M Manual Scale Defines the default high and low scale limits for use when implementing manual scaling The available options are as follows
274. d field at any point in space is directly proportional to the source s voltage and inversely proportional to the distance from the source In the case of electrosurgery the active electrode return plate and their cables act as transmitting antennas Electromagnetic fields radiate perpendicular to their associated cables Therefore susceptibility of the ECG cable to this RF is maximum when the ECG cable is parallel to the ES cable Separating or placing cables perpendicular to one another will minimize radiation coupling effects In summary radiation interference can be minimized by 1 Using the lowest possible ES power setting 2 Keeping ECG cables as far from ES cables as possible 3 Keeping ECG cables at right angles to ES cables Electrical Shock Hazard The monitor is designed according to IEC 60601 1 safety standard The front end of all applied parts has double isolation which ensures that the leakage current will not exceed the safety limits Connection of Other Medical Devices Connection of other medical devices to the Menntor X7 unless specifically recommended by Mennen Medical Ltd may compromise the performance and or patient safety of the unit When in doubt contact the company for specific compatibility data Mennen Medical 2 3 Warnings Precautions Menntor 7 Operating Manual WARNING Connection of other medical devices without Mennen Medical approval might jeopardize patient safety Ex
275. d single or multi lead ECG Each strip includes the Bed number Patient name Filter setting ECG leads Gain indicator and sweep speed Default 25 mm sec and Date and time of the recording Numeric Vital signs monitored at the time of recording appear as a list on the top row of the ECG strip The area of the recording includes a 1 mm X Y grid with vertical scale of 20 mm and horizontal grid of 25 boxes per second MANUAL ECG II RCG Vl 10 mm mv 10 mm mv 2 12 13 16 27 52 HRT 80 RSP 19 ART 120 80 m93 1 Figure 14 15 ECG Strip from Strip Chart Recorder ECG Report Printing For monitors that are connected to a LAN network that includes a Laser printer and ECG Report can be printed on the printer The report consists of 3 X 4 sections of the 12 leads with 2 5 seconds of each lead and a Rhythm lead of 10 seconds The vertical area for each lead is 35 mm Under the rhythm lead the RR intervals between beats is shown in mSec Gain indicator of 10 mm 1 mV is added to the left of each row The top row of the report consists of the Patient name Date amp Time and Bed name Below the top row there is a list of all numeric vital signs at the time of the report The bottom row provides information on Sweep speed Gain Filter and place for a signature 14 26 Mennen Medical Menntor 7 Operating Manual MR TEST ICU BEDI 2 12 13 16 04 57 Report 14 50 RSP 20 COD V9 14 ART 120 80 m
276. d to the sensor on patient s forehead 27 6 Mennen Medica Menntor 7 Operating Manual BIS Sensors After the BIS sensor has been placed correctly on the patient s head it is connected to the PIC Cable Connections After you have familiarized yourself with the safety information in the introductory section of this chapter and have prepared a suitable environment prepare the Menntor X7 BIS for operation To prepare the Menntor X7 BIS for operation 1 Connect the BISx to the BIS input 2 Holding the cylindrical connector with the flat side up plug the BISx Interface Cable into the Menntor X7 interface cable and the interface cable to the UIM port on the back or side of the monitor Once connected the BISx need not be disconnected again However if you wish to disconnect the BISx cable from the monitor carefully grasp the connector and pull DO NOT pull on the cable 3 Connect the PIC to the BISx 4 Attach the gray connector of the Patient Interface Cable to the BISx Note Connect with the BIS logo facing up for proper pin alignment To disconnect the PIC grasp the connector housing and pull firmly DO NOT pull apart by the cable wire BIS Parameters Table 27 1 BIS Parameters Parameter Range Description BIS 0 99 Bispectral Index The measure of consciousness of a patient 0 2 no brain activity 100 fully conscious EMG 30 55 dB Electromyography The absolute power of mus
277. damage Ll Select and prepare a sampling tube suitable for the patient O Make sure that the sampling is correctly attached Make sure that all connections are secure air tight and that no lines are subject to tension or extreme bending Be sure to refer to the instructions for use provided with each accessory item to be used with the EtCO2 for specific accessory instructions WARNING Never allow water to enter the sampling tube Disconnect the airway adaptor if you use fluid for cleaning of the tracheal tube Cautions and Warnings e Note that when EtCO2 is active Respiration from ECG is not functioning e Use only Mennen Medical approved airway adapters with the EtCO2 e Single patient disposable airway adapters should not be sterilized or cleaned for reuse Interfering Gasses There is no interference by N5O or NO Mennen Medical 23 5 End Tidal CO2 EtCO2 Microstream MicroPod Menntor 7 Operating Manual Cleaning Airway Adapter and Sampling Lines The airway adapter and sampling lines are intended for use on single patient and should be discarded after use Do not attempt to clean with air or Oxygen WARNING Attempting to clean an airway adapter or sampling line by blowing air or Oxygen will damage the filter and may allow water to enter the module and damage the EtCO2 sensor this damage will require costly module repair Calibration The MicroPod module performs auto zero automat
278. data to calculate and display the numerical values for end tidal carbon dioxide EtCO2 respiration rate inspired carbon dioxide inCO2 inspired and expired N20 O2 anesthetic agent and agent identification Anesthetic Gas Module The Anesthetic Gas module is a stand alone unit connected to a UIM input on the read panel of the Menntor X7 Patient Preparation Checklist O Before using any component inspect it for any signs of damage Make sure that the interface cable is inserted into the UIM socket at the rear of the monitor Select and prepare an airway adapter and sampling tube suitable for the patient Make sure that all connections are secure air tight and that no lines are subject to tension or extreme bending Refer to the instructions for use provided with each accessory item of the anesthetic gas module for specific accessory instructions Cautions and Warnings 24 2 Use only Mennen Medical approval airway adapters Single patient disposable airway adapters should not be sterilized or cleaned for reuse Do not apply tension to the sensor connection cable Do not attempt to remove the sidestream sampling chamber without first removing the watertrap Mennen Medica Menntor 7 Operating Manual Cleaning Airway Adapter The airway adapter is intended for use on a single patient and should be discarded after use Do not reuse Calibration The Anesthetic Gas module is self calibrating and does no
279. delay interval If an apnea event occurs that exceeds the apnea delay interval a message appears displaying the set interval and the time an apnea event occurred The allowed range is 10 to 90 seconds The default is 20 seconds 6 Press EtCO2 to close the panel and return to the EtCO2 menu press Main Screen to close the panel and return to the main screen display Setting EtCO Alarm Responses The Alarm Response panel controls how the Menntor X7 responds to alarms QC ENVOI Main Screen etCO2 6 Alarm Response etCO2 Alarm Response JE Record JE Tones JE Event Strip etCO2 Fault Response JE Record JE Tones Figure 25 3 The EtCO gt Alarm Response Panel gt To set EtCO alarm responses 1 From the EtCO menu or if you are already in another panel from the drop down list below the panel title area select Alarm Response Mennen Medical 25 5 Anesthetic Gas Monitoring Menntor 7 Operating Manual 2 Under EtCO Alarm Response e Select the Record checkbox to activate or deactivate recording of the patient s condition during the alarm event By default Record is deactivated e Select the Tones checkbox to activate or deactivate audible alarms By default Tones is activated e Select the Event Strip checkbox to activate or deactivate Event Strip By default Event Strip is deactivated 3 Repeat the above procedure under inCO Alarm Response Resp Alarm
280. detached 2 No electrolyte gel on the electrodes 3 Strong solvent used for cleaning skin 4 A3 Lead set is used and channels 2 and 3 are not switched off 1 Check that the electrodes are correctly attached 2 Check that there is sufficient gel on the electrodes 3 Change solvents used for cleaning skin in line with your Hospital Procedure Policy 4 Ensure that channels 2 and 3 are switched off or change to 5 lead set ECG waveform is present but the Resp channel shows a flat line 1 One of the Resp electrodes is loose 2 No electrolyte gel on the electrodes 1 Check that the Resp electrodes are properly attached 2 Check that there is sufficient gel on the electrodes Straight line on one or more ECG waveforms Lead fault Reconnect the faulty lead Mennen Medical B 1 Response to Single Lead Fault Menntor X79 Operating Manual Table B 2 Responst to Single Lead Fault Lead Fault Active leads Straight lines LA Il aVR aVL aVF I Ill all V RA Ill aVR aVL aVF I Il all V LL 1 aVR aVL aVF Il Ill all V RL I aVR aVL aVFm V1 V2 to V6 V1 I Il aVR aVL aVFm V1 V2 to V6 Vb b 2 2 to 6 I II HII aVR aVL aVFm Vb V1 to V6 without Vb Invasive Blood Pressure Monitoring Table B 3 Invasive Blood Pressure Monitoring Problem Probable Cause Corrective Action Abnormally low pressure Transd
281. dixes Appendix A Accessories Appendix B Trouble Shooting Appendix C Auto Set Dynamic Alarm Limits Appendix D Setting Up the System Appendix E Setting Up the Interface Between Vigileo and Menntor X7 7 Operating Manual Mennen Medica APPENDIX ACCESSORIES The following cables catheters and electrodes are used to complete the interface between the patient and the Menntor X7 They can be ordered from your nearest representative by specifying the part number Table 1 ECG Accessories Item and Description Part Number P N 551 306 5905 Lead ECG Kit Adult Snap I P USA Color Code 3 Lead ECG Kit Adult Snap 551 306 080 3 Lead Kit Grabber Clip 551 306 085 3 Lead ECG Cable only 551 306 016 3 Lead ECG Cable DIN for pre wired electrodes Neonatal 551 306 116 Set of 3 Lead wires with Block Snap 551 306 024 Set of 3 Lead wires with Block Mini Clip Pediatric 551 306 028 Set of 3 Lead wires with Block Grabber Clip 551 306 132 5 Lead ECG Cable only 551 306 017 Set of 5 Lead wires with Block Snap 551 306 025 Set of 5 Lead wires with Block Mini Clip 551 306 029 Set of 5 Lead wires with Block Grabber Clip 551 306 133 5 Lead ECG Kit Adult Snap 551 306 090 5 Lead ECG Kit Mini Clip 551 306 091 5 Lead ECG Kit Grabber Clip 551 306 093 10 Lead Kit MiniClip 551 306 150 10 Lead ECG Kit Grabber Clip 551 306 170 10
282. dor x Update MPM Software Update CIPAM Software Figure D 41 The Software Version Panel gt To download BEP software 1 Click the Update Software button window with list box containing software versions appears 2 Select the new version to update SARA menntoy System Setup BS Version Eg 7 0 19 Aug 2013 15 34 36 Wi Fi ID807b06 MPM llc CIPAM 30b SPB 96 1GB Select Module and Module Software Version SPOX M 4 1 1 NIBP 20 Module Rack UIM 1 UIM 2 Select Vendor Select Vendor Quit Download Figure D 42 Selecting the Software Version 4 Click the Update CIPAM Software button A window with a list box containing software versions appears 5 Select the new version and update 6 Press the QuicKnob A message appears requesting you to confirm the upgrade of the software 7 Click Yes to download the software Mennen Medical D 73 D 74 8 Menntor 7 Operating Manual Click Main Screen to close the panel gt download UIM vendor software 1 In the UIM box select the vendor a window with a list box containing software versions appears le and Module Sofiware Version Select the new version and update Press the QuicKnob a message appears requesting you to confirm the upgrade of the software Click Yes to download the software Select Main Screen to close the panel gt download plug in module software 1
283. e Current Date amp Time box will show the date amp time but will be dimmed and not accessible D 8 Mennen Medica 7 Operating Manual The Date and Time Setup Panel is divided into 3 major areas note the function Daylight Saving Date is not active Current Date and Time As the name implies the current date and time are set in this area eShift End Time Specify the end times for each work shift according to what is standard in your department or hospital The end time defined for the shift also indicates the start time of the following shift For example if the Day shift ends at 15 00 this indicates that the Evening Shift begins at 15 00 The Date and Time Setup panel provides space for three shifts Day Evening and Night eDisplay Format In the Display Format area you define how the time and the date appear on the main screen display TEKNOR BED1 System Setup Pre d abe Current Date amp Time Time Server Master Display Format M Time server Master Date 09 12 02 Date Format ddmmyy Device ID INSIDE i Time 10 Dvice Name BED2 Z Separators Display Leading Zeros F Date Time 24 Hours Display Shift End Time Night 07 00 Figure D 2 The Date amp Time Setup Panel gt To set the date and time display formats 1 Select the Date textbox calendar panel is displayed 2 Using the QuicKnob select the day
284. e and total fluid volume in the IV bag gt To calculate the drug amount 1 Inthe Medication list select drug 2 Inthe Function list select Drug Concentrate The Drug Concentrate panel is displayed ASRACURIUM ATROPINE DIAZEPAM DOBUTAMINE DOPAMINE DROPERIDOL EPHEDRINE TIME 14 42 DATE 02 05 99 Discard CHANGES Function Drug Concentrate Patient weignt D 00 A bo Kg ASRACURIUM Dose Rate meg KgfHr Fluid Infusi Rate CC Hr Total IV Fluids Volume Calculate cc Drug List Figure 12 4 Drug Concentrate Data Entry The display requests information regarding the infusion rate prescribed dose rate and patient weight Enter all requested information 4 Press Calculate The drug amount that needs to be added to the IV in order to achieve the required dose rate is calculated A titration chart of fifty drug amounts vs dose rate sets is presented The calculated drug amount corresponding to the input data is highlighted Mennen Medica Menntor 7 Operating Manual 08 09 98 Figure 12 5 Drug Concentrate Display Note These results are not charted in the Medications Review Chart Injection Amount Calculation The amount of prepackaged drug to be injected to achieve a desired dose can be calculated based upon the drug concentration or amount and the desired dose gt Tocalculate the injection amount 1
285. e now monitored data Delete deletes the MPM file Close closes the panel with no action Patient Data Chart and MPM When the MPM is pulled out of the host monitor the host goes into Discontinue mode When the MPM is returned to the host the host waits for Resume and then starts monitoring The start and end of the discontinuation on the chart is marked by m Figure 33 5 Figure 33 4 Chart marked for discontinue When MPM merge is performed data stored during the MPM transport between the discontinue and Resume marks is merged 33 10 Mennen Medica Menntor 7 Operating Manual Figure 33 6 Chart after merge Returning MPM to Host at Discharge When Menntor X7 is in Discharge the MPM information panel displays only the MPM patient information MPM data is stored and the Admit keys are displayed as they werebefore the MPM was pulled out IMPORTANT To merge MPM data Menntor X7 must be in Admit mode Mennen Medical 33 11 MX57 as Transport Monitor Menntor 7 Operating Manual 33 12 Mennen Medica 34 SPIROMETRY Overview The Spirometry module P N 751 137 000 of the Mennen Medical Menntor X7 patient bedside monitor enables monitoring of the flow volume airway pressure and lung mechanic parameters The Spirometry module is intended for use in the hospital clinical environment only e g in the RICU The module is used for the continuous mon
286. e BIS alarm detection When deactivated the sliders for setting alarm limits are disabled 5 Press BIS to return to the RBIS menu Press Main Screen to return to the main screen display Setting the BIS Alarm Response Define the way the Menntor X7 visually and audibly responds to BIS alarms in the BIS Alarm Response dialog panel Default response values are set in System Configuration By configuring the parameters on this panel you can e Define whether visual alarm messages audible alarm tones or both signal a triggered alarm e Activate recording of the patient s EEG waveform when an alarm is detected e Create an EEG event strip waveform when an alarm is detected Mennen Medical 27 13 BIS Bispectral Index Menntor 7 Operating Manual 27 14 BIS 5 1 Alarm Response Figure 27 6 The BIS Alarm Response panel To set BIS Alarm responses 1 From the BIS menu if you are already in another BIS dialog panel from the drop down list below the title area select Alarm Response The Alarm Response dialog panel is displayed 2 3 Under BIS Alarm Select the Tones checkbox to activate or deactivate audible alarms By default this checkbox is selected Select the Record checkbox to activate or deactivate recording of the patient s EEG during the alarm event Select the Event Strip checkbox to create an Event Strip of the patient s wave forms during the alarm event Press BIS to
287. e Dura Y Sensor D YS 800 060 930 Nellcor Ear Clip for Dura Y Sensor D YSE 800 060 940 Nellcor Disposable Oxisensor Pediatric Index Finger D 20 24 per 800 060 970 case Nellcor Disposable Oxisensor Neonatal Foot N 25 24 Case 800 060 950 Nellcor Disposable Oxisensor Infant Great Toet I 20 24 Case 800 060 960 SpO2 OxiMax Adapter Cable 551 306 415 SpO2 Adapter Cable 551 306 115 SpO2 OxiMax Reusable Adult Finger Sensor 800 060 731 Multi Site OxiMax Dura Y Sensor D YS 800 060 931 Ear Clip for OxiMax Dura Y Sensor D YSE 800 060 941 Disposable OxiMax Neonatal Foot N 25 24 Case 800 060 951 Disposable OxiMax Infant Great Toe 1 20 24 Case 800 060 961 Disposable OxiMax Pediatric Index Finger D 20 24 C 800 060 971 A 6 Mennen Medical 7 Operating Manual Table 10 Pulse Oximetry SpO2 Accessories Masimo Item and Description Part Number P N Pulse Oximetry SpO2 Accessories Masimo SpO2 Adapter Cable 551 339 000 SpO2 reusable adult Finger Sensor 551 339 004 Adult disposable probe 551 339 001 Neonatal disposable probe 551 339 002 Neonatal disposable probe for sensitive skin 551 339 003 Foam rap for neonatal pt sensor 12 pkg 551 339 053 Tapes for neonatal adhesive sensor 100 pkg 551 339 054 Table 11 Pulse Oximetry Accessories Masimo LNCS and Description Part Number P N Pulse Oximetry Accessories Masimo LNCS
288. e MRI suite When the module is used outside the MRI suite EtCO2 monitoring can be implemented using the FilterLine XL Use of a CO2 sampling line with H in its name indicating that it is for use in humidified environments during MRI scanning may cause interference The use of non H sampling lines is advised In high altitude environments EtCO2 values may be lower than values observed at sea level as described by Dalton s law of partial pressures When using the module in highaltitude environments it is advisable to consider adjusting EtCO2 alarm settings accordingly When using the MicroPod with anesthetics nitrous oxide or high concentrations of oxygen connect the gas outlet to a scavenger system The MicroPod is not suitable for use in the presence of flammable anesthetic mixture with air oxygen or nitrous oxide The FilterLine may ignite in the presence of O2 when directly exposed to laser ESU devices or high heat When performing head and neck procedures involving laser electrosurgical devices or high heat use with caution to prevent flammability of the FilterLine or surrounding surgical drapes Mennen Medica Menntor 7 Operating Manual WARNING WARNING CAUTION WARNING WARNING WARNING WARNING WARNING CAUTION CAUTION CAUTION CAUTION Mennen Medical Operating high frequency electrosurgical equipment in the vicinity of the module can produce interfe
289. e ST algorithm also permits manual adjustment of the ISO and ST measuring points and determines deviations in ST values from a manually set baseline If space is available the viations in ST values from a manually set baseline If space is available the viations in ST values from a manually set baseline If space is available the Menntor X7 plays the ST value for each monitored ECG lead in the Primary area of the main screen display Availability of space depends on how much space on the main screen display is allocated to displaying ECG data and whether or not Arrhythmia monitoring is activated Le ub ab s ul ais 8 0 1 mv ECG Il 50 ee Sle Zu 1 mv ECG V1 STVi 0 7 E G Figure 16 1 Main Screen Display of ST Values for Monitored ECG Leads ST data can be reviewed with other parameter data in Trends and Charts Note To enable accurate measurement of the ST segment ST analysis requires that the ST filter be implemented to provide an expanded ECG bandwidth Due to the expanded bandwidth some increase in artifact may be noticed Proper skin preparation and electrode technique will minimize artifact levels See Patient Preparation on page 16 2 Mennen Medical 16 1 ST Segment Analysis Menntor 7 Operating Manual Monitoring Procedures ST parameters are measured from the ECG signal The ST menu provides access to all the specific dialog panels that control all aspects
290. e Setup Wireless Network ID mennen monitors Download Network WAP Pass Phase connectone IP Address 172 17 0 254 Number 0 gt Figure D 33 The Network Setup Dialog Panel To configure Network Setup 1 In the System Setup menu click Network Setup 2 Click in the Device Name text box and select device or enter the name of the device with the alphanumeric keypad 3 Click in the Device Unit Group text box and select a unit from the list of units located on the network To create new unit select the Manual option and using the alphanumeric keypad type the name of the new unit or group Mennen Medica 7 Operating Manual 4 Click the Printer checkbox if you wish to use the printer and select the printer to be used 5 Select Discard Changes to close the panel without applying any changes Select Main Screen to apply the changes and close the panel IP Address Setup When new monitor is connected to the network it will automatically select free IP address in the format 117 17 0 XX You can select to manually set a different IP address gt manually set a fixed IP Address 1 Discharge the patient 2 Enter System Setup Password protected 3 Select Network Setup 4 Use the QuicKnob to set the focus on the IP Address This opens box with selectable XX number 5 Press and rotate to get the required manually set IP Address A message System Will Restart
291. e Setup menu is displayed 2 From the Setup menu select Display Controls The Display Controls panel appears 3 Under Display Format select the WaveForm Trend checkbox for Waveform and trend display When Waveform amp Trend Format is selected Mennen Medical 7 3 Setting Up the Patient Display Menntor 7 Operating Manual e Both waveforms and trended data are displayed in a split screen format e From the Trend Time Scale drop down list select the time scale for the trended data The available options are 15 30 60 and 120 minutes 4 Clear the checkbox for regular display The screen is divided according to the number of selected parameters 5 Press Main Screen to return to the main screen display Very Big Numbers Display 7 4 Use the Very Big Numbersdisplay mode to view four of the available vital signs SpO2 Temp NIBP or ART pressure Systolic Diastolic and Respiration Rate or EtCO2 Resp Rate with large font in four boxes and two channels of ECG waveforms with HR Figure 7 1 To activate the Very Big Number display 1 Set the Very Big Number toggle in the Setup Display Controls window to ON green Figure 7 1 2 Toggle VBN Select to ON green to select which of the vital signs appears in each box A SLCT select key is added to each of the boxes 18 38 3 Activate the SLCT key This opens the list of Vital Signs and enables selecting the vital sign for each of the four box
292. e System setup menu 3 A panel will all the event labels will open with the following options Insert Edit or Delete labels 4 Selecting Insert or Edit will open an Alphanumeric panel and enable you to write or edit a label e To view a marked event 1 From the Main menu select the Patient Data key 2 Select Event Strip in Patient data menu 3 A panel opens with the list of saved Event strips 10 24 Mennen Medica Menntor 7 Operating Manual Set Event Labels Event Strips Figure 10 14 Panel with List of Saved Event Strips 4 Select the required event window opens with the following options Event Full Disc Event Overview Edit Label Delete Mennen Medical 10 25 Reviewing Patient Data Menntor 7 Operating Manual 5 If you select Event Full Disclosure or Overview a display panel showing 10 seconds of the event will be displayed OK 6 Event Strips Event Full Disclosure Print Am JOHN SMITH Screen aVR aVL aVF Vi 13 25 00 Prev Next 1 mv em lt Seroll Event Overview Right Admission 19 7 01 Figure 10 15 Event Full Disclosure OK 6 Event Strips Event Overview Print JOHN SMITH M s ml EE PAP Spo2 Pm etCO2 Mi Scroll Scroll gt Prev Next 1 mv em lt left Scroll Right gt Admission 197 01 Figure 10 16 Event Overview 6 Use Scroll Left or Right to view event inf
293. e Vital Signs information is shown on the far right of the screen e Selected duration time and Grid Units if configured in the parameter s display options are shown on the far right side just below the vital signs information 7 6 Mennen Medica Menntor 7 Operating Manual Secondary Vital Signs area OK 6 Remote JOHN SMITH 1234567 E _ 19701 15 58 7 E 120 1 5 Minutes 0 5 Min Division c 5 12 7 5 5 165 105 122 E o 18 07 01 11 55 P 18 07 01 11 47 19 07 01 15 43 Patient CRG Software Monitor Network Event Data Version Profiles Setup Strips et 50 38 Apn Intr 20 Last Apn 15 51 2 117 10 66 150 100 100 0 125 30 T SYS mmHq DIA mmHq MEA mmHq III 24 12 mi7 40 20 30 5 35 16 SYS mmHq DIA mmHq mmHg 120 117 f HRT BPM ARTS mmHg 1 5 Minutes 0 5 Min Division 24 R PAPs mmHg SpO2 G N B P Figure 7 4 Viewing a Cardio Respiratory Graph Note Left Param and Right Parm selection given in the Vital Sign box refer to the manner in which the two paramerters are displayed on the far right side of the CRG display as left and right parameters The colors of CRG waveform and labels are those defined for the selected parameter Note the Menntor X7 all displayed traces begin at the righthand side of the displ
294. e and alarm limit EMG and SQI at vertical bars SR BC TP numeric display Alarms High BIS alarm 0 100 0 Low BIS alarm 0 100 DGM 781 001 Rev 11 2014 4 5 Menntor X7 Clinical Specification Anesthetic Gases Module Agent Gas External Module using Poet IQ bench technology with Automatic 5 Agent Identification Size WxDxH 264 x 208 x 96 mm 10 4 x 8 2 x 3 8 in Weight 3 4 kg 7 5 Ibs Power Input Voltage 100 to 240 Vac 48 to 62 Hz Sampling Gas Flow Rate 100 ml min Environment Temperature 15 to 35 C 59 to 95 F 9 Humidity 15 to 95 RH non condensing Barometric Pressure Altitude 525mmHg to 790mmHg 300m to 3 000m 1 000 ft 10 000 ft Gas Specifications Gas Range Accuracy 1 30 BPM 2 0 0 to 30mmHg 1 5mmHg 30 1 to 76mmHg 5 Relative 0 0 to 100 0 2 5 abs plus 2 5 rel To 1 0 0 to 100 1 5 abs plus 5 rel 0 00 to 7 5 0 1 abs plus 4 rel Halothane 0 00 to 7 5 0 1 abs plus 4 rel 0 00 to 7 5 0 1 abs plus 4 rel 0 00 to 9 0 1 abs plus 4 rel 0 00 to 20 0 1 abs plus 4 rel MAC Calculated from N20 Agent Spirometry Module e LED for function indication e For use for patients with tidal volumes greater than 100 ml e Waveforms Air Flow 9 Air Volume Airway Pressure e Loops 9 Flow Volume 9 Pressure Volume Flow Pressure Spirometry Measured Parameters e RR Respirat
295. e immediately update the main screen display OK 6 Main JOHN SMITH Screen TMP2 1 2 Display Options Display Area Secondary VS Units Temp Color p Figure 20 3 The Temperature Display Options Panel gt TosetT emperature Display Options 1 From the Temperature menu if you are already in another Temperature panel from the drop down list below the panel title area select Display Options 2 Press Display Area and select the area on the main screen display where you want temperature to appear from the drop down list The available options are Secondary VS or Big Numbers The default is Secondary VS 3 Select the Units checkbos to activate or deactivate display of measurement units By default the option is activated 4 Press Temp Color and from the panel that appears select the display color for all temperature values on the main screen 20 6 Mennen Medica Menntor 7 Operating Manual 5 Press Temp to close the panel and return to the Temp menu press Main Screen to close the panel and return to the main screen display Note Checkboxes appear green when activated and gray when deactivated Activating Temperature Monitoring Use the Activate panel to activate or deactivate measuring and monitoring temperature gt To activate or deactivate temperature monitoring 1 From the Temperature menu or if you are already in another Temperature panel from the drop down lis
296. e in the Date dialog panel and start time in the Time dialog panel Make sure the required date and start and end times fall within the time span of stored data To exit the Ten Second Display panel and return to the Ten Minute Display panel press Zoom Out The following list of options will open Zoom out Mark event Print e Overview Chart Trend panel Mennen Medica Menntor 7 e Cancel Select Zoom out to return to return to the Ten Minute Display panel 6 Press Print to print the Ten Second page of the Full Disclosure 7 exit the Ten Second Display panel and return to the main screen display press Main Screen Overview Panel The Overview panel enables you to review a patient s waveforms with associated data for at least 6 hours 5 days for extended memory depending on the configuration of your system The Overview panel presents a snapshot of waveform activity for the top most ECG lead and all other vital signs on the main screen display during a selected ten second time frame It also presents the following data for the selected time frame Scales for each vital sign where applicable Numerical vital sign values List of alarms that were triggered during that time period including the time the alarm started To access the Overview panel 1 From the Main menu select the Patient Data key or If a Patient Data function key appears on the main screen
297. e individual arrhythmia checkbox See below Note When Arrhythmia is activated Asystole VFib and Vtach are always ON and have always Tone as an alarm response Only Record and Event Strip response can be set to OFF Activating and Setting Individual Arrhythmia Alarms The Menntor X7 enables you to activate and set alarm responses for individual Arrhythmia alarms Alarm limits can also be set for the following Arrhythmia alarms V Tach Ventricular Tachycardia Runs PVC Pause and BGM Bigeminy Finally the area on the main screen display where you want data to appear can be defined for the following Arrhythmia alarms Runs PVC and BGM There are several types of dialog panels e Dialog panel in which you can set alarm responses Life threatening Arrhythmias Asystole VFib and Vtach These arrhymias are always active when Arrhythmia is ON Their control panel allows to set alarm response to Record or Event Strip Tone response is always on Figure 15 2 shows the Alarm Response panel for Asystole 15 6 Mennen Medica Menntor 7 Operating Manual i Asystole Figure 15 2 Individual Alarm Dialog Panel e Dialog panel in which you can activate the alarm and set alarm responses and alarm limits WE ELI Figure 15 3 Alarm Limit Setting Panel Mennen Medical 15 7 Arrhythmia Menntor 7 Operating Manual e Dialog panel in which you can activate the alarm set alarm responses and alarm limits and de
298. e is measured as many times as possible during a period of five minutes Readings can be logged in the patient s chart Note During NIBP operation isolated readings may be displayed which indicate a significant change in blood pressure values This may have been caused by a change in the patient s actual pressure or by a movement artifact muscle tremors or a weak pulse Take a manual ausculatory blood pressure to verify the patient s pressure before administering any medication Note Inflation pressures used in adult NIBP monitoring are not appropriate for nonates Also neither the pediatric nor the adult cuff is suitable for neonates The width of the cuff for neonates should be 50 of the limb circumferece or 2 3 of the upper arm length The inflation part of the cuff should be long enough to encircle 50 80 of the limb Mennen Medical 21 1 Non Invasive Blood Pressure NIBP Menntor 7 Operating Manual Limitations of the Oscillometric Method The patient s actual condition at the time of measurement has a direct bearing on the reliability of that measurement When taking an NIBP measurement a regular arterial pressure pulse is sought When a patient s condition makes that pulse hard to detect it may take longer to get a reading and the reading may be unreliable In some cases the patient s condition may make it impossible to take a reading The following conditions may interfere with the oscillometric method 21 2
299. e left of the point and then press Adjust ISO 4 To adjust the current ST measuring point press Adjust ST use the QuicKnob to move the ST curser to any point within 500 msec to the right of the point and then press Adjust ST 5 Press Accept to save all changes to the ISO and ST settings close the ST Adjustment panel and return to the main screen display 6 Press Cancel to close the ST Adjustment panel without saving changes and return to the main screen display Determining ST Variations When a patient is admitted the current ST values are automatically displayed in the Secondary Vital Sign area of the main display screen The Menntor X7 offers the option to replace the current ST values in the Secondary Vital Sign area with the difference between current ST values and predetermined ST baseline values It also enables you to set alarms based on these differences For example a patient is admitted with a cardiac condition that has been stabilized at specific ST values Activating ST Variation enables you to define the specific ST values as the baseline You can then view variations in the ST values on the main screen display and set alarms based on the baseline values instead of the current ST values Note If ST Variation is active ST VAR appears under the values displayed in the ST section of the Secondary Vital Signs area on the main screen display ST Variation is activated and baseline values defi
300. e of 0 25 to 5 mVolt QRS amplitude changes with body position and respiration and it is thus not safe to monitor heart rate when the QRS amplitude is just above 0 25 mVolt It is important to note that the display gain does not change the sensitivity of QRS detection Thus an amplitude of 1 cm with a gain of x4 may look good but will provide unreliable sensing and high sensitivity to muscle noise Menntor X7 sense the QRS in the two top displayed leads It is thus recommended wherever practical to use a five lead ECG cable with display of two leads The number of available channels one to seven varies according to which lead cable is used The number of channels depends on available display space Unavailable leads are disabled The default choice list contains channels A and B A for lead II for lead Va with common gain 1 Set All to Same Gain Use this feature to set all leads to the same gain used in trace A 14 10 Mennen Medica 7 Operating Manual OK 6 Main JOHN SMITH Screen ECG II 3 Figure 14 6 ECG Lead Gain Panel Set V Lead to Same Gain Use this feature to set all V leads to the same gain Changing one of the V lead gains will affect all V leads gt Toset ECG leads and gain parameters 1 From the ECG menu or if you are already in another ECG dialog panel from the drop down menu list below the panel title area select ECG Lead Gain The ECG Lead Gain dialog panel a
301. e sensor Read the cleaning instructions of the sensor manufacturer prior to cleaning the sensor Calibration The SpO2 and sensors are factory calibrated to functional saturation and do not require calibration Validation of the calibration can be performed using an SpO2 simulator Use Bio Tek Index 2 SpO2 Simulator or equivalent Set the simulator to the correct Make Nellcor or Masimo Interfering Substances Carboxyhemoglobin may erroneously increase readings The level of increase is approximately equal to the amount of carboxyhemoglobin present Dyes or any substances that contain dyes which change usual arterial pigmentation may also cause erroneous readings SpO2 Sensors The Menntor X7 monitor uses either Nellcor or Masimo SET technology and Masimo sensors see Appendix at the end of this Chapter 22 4 Mennen Medica Menntor 7 Operating Manual Monitoring Procedures The SpO2 menu provides access to all the specific dialog panels enabling interaction with all aspects of SpO2 monitoring Each dialog panel enables control of different aspects of NIBP monitoring short description of the panels in the order they appear on the SpO2 menu follows SpO2 Alarm Limits Use this panel to activate deactivate and set SpO2 low alarm limits See Setting SpO2 Alarm Limits on page 22 6 Pulse Rate Alarms This panel functions similarly to the Alarm Limits panel but activates deactivates and sets pulse rate al
302. e te de e eo ERR e e cer cn 20 1 Temperature Monitoring Procedures essere nent enne netten nennen nnne 20 2 Setting Tempertature A ere olei ete tee Ee Cei eon Ce nie ette etae e eE 20 3 Setting Temperature Display Options rronvnnnvnnnrrenrnenvrnnnnnnnsvrasennsnnnenvernrnsvrasversnvenneneneserassnssnvesnnesnssenn 20 6 Activating Temperature Monitoring sese ene 20 7 Setting Delta Temp rature ux ntes eet ener e Fe D 20 8 Chapter 21 Non Invasive Blood Pressure NIBP rcu ker ARR 21 1 Limitations of the Oscillometric Method essen 21 2 Preparatory Checklist s c cee kan reparere senka Ue tere eoe 21 3 ES 21 3 Monitoring Procedures tte ade nage iure Lee 21 5 Accessing the NIBP Menu iuai a RESquqeedn eer PME 21 6 Setting Reading Intervals Jones Gl oe e te eed ciet iet t Hr pe Detto 21 6 Selecung the Curt Type diee sti ERE erecto in qa enerett 21 9 Setting NIBP Alarms eene erre te Aso es CERTE Tag elie 21 10 Setting NIBP Display Optiotis te detener ei ree Fe 21 13 Activating NIBP Measuring and Monitoring eese eren nennen eren nennen 21 15 Technical Messages x te ec eite etie dus Ie Ven EE tis eee e e DE e ee THEE eae 21 16 Chapter 22 Pulse Oximetry SpO2 OVeLVIEW esee tet Ab c Abt 22
303. e top of the screen gt To define General Settings 1 Under General select the required Language Frequency Freeze Time and Screen Orientation Under Charts select the Default Frequency Under Units select the required default measurement units for the patient s height and weight Under Timeouts select the required timeouts for the various panels and menus Under Hospital Name select the Hospital Name text box The alphanumeric keyboard appears Using the QuicKnob enter the name of the hospital and close the keyboard Select Discard Changes to close the panel without applying any changes select Main Screen to apply your changes and return to the blank screen CAUTION After changing the Language you need to restart the monitor Mennen Medical D 13 Menntor 7 Operating Manual Alarm Volume and Controls lt none gt en096A18 Enable Alarms Off RTT Repeat every sec Play Stop Enable Tones Off Suspension Time 120 EJ Sec End amp Init Vol n nit Volume Silence Time 6o Sec JE Cancel Silence On New Alarm SpO2 Alarm Tone Standard 4 JE Alarm Escalation Use this panel to define general alarm related parameters such as alarm volume color scheme etc These parameters are defined for each alarm priority level enabling the alarm response for each alarm priority to be unique For a more detailed description of Alarms including alarm priority and notif
304. eactivate alarms The default option is activated 11 Press Accept to save the new settings and return to the Arrhythmia Alarms dialog panel Activating Arrhythmia Monitoring Use the Activate panel to activate or deactivate Arrhythmia monitoring gt To activate or deactivate Arrhythmia monitoring 1 From the Arrhythmia menu or if you are already in another Arrhythmia panel from the drop down list below the title area select Activate 2 Select the Activate checkbox to activate or deactivate Arrhythmia monitoring By default Arrhythmia monitoring is activated 3 Press ECG to close the panel and return to the ECG menu press Main Screen to close the panel and return to the main screen display Mennen Medical 15 9 Arrhythmia Menntor 7 Operating Manual 15 10 Mennen Medica 16 ST SEGMENT ANALYSIS ST segment characteristics are indicators of heart muscle ischemia and infarction The level of the ST segments with respect to the isoelectric baseline and the orientation of the ST segments are of special interest to physicians because they indicate the severity and location of ischemia and infarcts caused by heart disease The Menntor X7 bedside monitor provides continuous ST segment analysis The ST algorithm is applied to dominant normal beats as determined by the ECG Analysis algorithm ST values for normal beats are measured and averaged over 30 seconds to reduce the effects of artifact Th
305. ead ECG e Respiration e Respiration e NIBP e NIBP e SpO2 Nellcor e SpO2 Nellcor e 2 Temperatures e 2 Temperatures 4 Temeratures e 2x IBP optional 4 IBP available e CO 2 additional Temperatures Universal Input Module UIM e 2x RS232 ports Interface to other vendor devices Anestheic gases Poet IQ Andros 4800 Leon Plus IRMA Ventilators EVITA Monet Matisse Saturn Evo Stephanie Babylog VN500 Continuous CO Vigilance Vigileo PICCO2 Other BISx CritiCool Micropod Radical 7 CerebraLogik Display Host Unit e LCD 1024x768 15 e Waveform display horizontal area 195 mm Numeric Display horizontal area 95 mm 0 vertical area 23 mm e Very Big Numbers One or Two Lead ECG WF HR height 45 mm 9 Four areas with Waveform height 15 mm Numeric Vital Signs height 35 mm Interface to a Remote Display Waveform Display Standard 7 sec grid 5 boxes sec 25 mm sec nominal up to 8 traces and up to 14 traces during 12 lead ECG Overlapping Pressure Waveforms mode Sweep Speed 6 25 12 5 25 50 100 mm sec nominal Cardio Respiratory Graph CRG up to 4 parameters Big Numbers Waveform Trend Format 2 3 waveforms and 1 3 graphic Trend Very Big Numbers mode Host CPU Details Via X 86 Core Fusion CPU Sound Blaster 2W audio power 89 Mass storage 8 GB 16 GB Operating System QNX 4 25 Window manager Photon SW upgrades via network or memory card Dimensions Weight Me
306. ears around the key indicating that it is selected If no bullet appears in the label press Show Hide The green bullet appears and the Monitor profile will appear on the main screen the next time you want to admit a patient e Ifa green bullet appears in the label press Show Hide The bullet disappears and the Monitor profile is removed from the main screen Changing the Position of an Monitor Profile The Monitor profiles are arranged on the Monitor profile panel in the positions where they will appear on the main screen You can move the keys to the most convenient position gt To move a Monitor profile 1 Inthe Monitor profiles panel press Select Key 2 Turn QuicKnob and press the key you want A frame appears around the key indicating that it is selected 3 Press Right to move the selected Monitor profile clockwise press Left to move the key counterclockwise Clearing a Monitor profile A previously defined Monitor profile may no longer suit your monitoring needs In that case you can simply clear the Monitor profile from the Menntor X7 gt clear a Monitor profile 1 Inthe Monitor profiles panel press Select Key 2 Turn the QuicKnob until you reach the key you want to clear and press A frame appears around the selected key 3 Press Clear The Monitor profile is removed from the Monitor profiles panel and will no longer appear on the main screen when admitting a patient D 56 Mennen Medi
307. easons e t was configured to be displayed without an associated waveform because it was considered to have lower priority than other monitored vital signs e t was configured to be displayed in waveform format but was relegated to Secondary Vital Sign status due to lack of display space Each monitored vital sign has an on screen key that can be used to access the specific vital sign s menu Displayed vital sign information includes the vital sign s name value and the measurement units if configured You can configure how format values are displayed Speaker Icon A Speaker icon appears in the upper left corner of the patient area and displays the status of the speaker It indicates whether the audible alarm is on or off Main Display Area Vital sign waveforms and other information are displayed here Each monitored vital sign appears in a parameter slot parameter slot is the area on the screen set aside for displaying the waveform and data of a specific vital sign The size of the parameter slot is configurable and depends on the system operation mode and the number of vital signs being monitored Each parameter slot contains e Waveform area e Primary vital sign area e Parameter key Mennen Medical 6 5 Controls and Functions Waveform Area Menntor 7 Operating Manual Primary Vital Sign Area Para meter Key Figure 6 5 Typical Parameter Slot Parameter Key 6 6 The parameter key
308. eature Location Back Menu Button Top left of panel Menu Title To the right of the Back Menu button Drop down menu list To the right of the Menu Title area Main Screen Button top right corner of the panel Full Panels full panel appears when function needs more screen space that either horizontal or vertical panel can provide It covers the main display area leaving the area containing the global header the Secondary Vital Signs area and the top ECG waveform visible The following table identifies common features and their locations Feature Location Back Menu Button top left corner of panel Menu Title to the right of the Back Menu Button Drop down menu list to the right of the Menu Title area Main Screen Button top right corner of the panel Mennen Medical 6 13 Controls and Functions Keyboard Panels Menntor 7 Operating Manual The keyboard panel is special type of horizontal panel that appears when you select a text box that entails some kind of alphanumeric input e g the patient name text box in the Patient Identification Panel The following table identifies common keyboard features and their locations Feature Description Location Letter buttons a z letters a z top left area of panel Number buttons 0 9 numbers 0 9 top right area of panel Commonly used symbols Includes symbols such as
309. ecific recorders to specific recording types For example manual alarms can be sent to a local recorder located next to the Menntor X7 while alarm and all waveform recordings can be sent to a Central Nurse Station C TK2 4 25 Q Recorder Setup Selected recorders REC0016 x Duplicate Pool Figure D 34 The Recorder Setup Dialog Panel D 66 Mennen Medica 7 Operating Manual Trends Setup This dialog panel enables you to set the scales to be used in the graphic trend for each vital sign QC TK2 4 25 System Setup Vital Sign Scaling m ml Figure D 35 The Trends Setup Dialog Panel Two scaling options are available Fixed and Dynamic If the Fixed option is selected the scales of the Trend graph will be fixed and independent of the input data In the Dynamic option the scale of the trend graph will depend on the maximal and minimal parameter values from the patient admission gt modify Trends Setup 1 Select Trends Setup from the System Setup menu a large panel will open 2 On the left of the panel open the Vital Sign window a list of vital signs appears Select parameter for example RSP 4 Inthe Scaling window select either Fixed or Dynamic If you select Fixed set the Min minimum and the Max maximum limits of the trend scale 6 If you select Dynamic the Min and Max values will be dimmed and will show the maximal and
310. ed to use 30 seconds 5 Press BIS to return to the BIS menu Press Main Screen to return to the main screen display Setting BIS Alarms BIS alarm parameters are set in two dialog panels Alarm Limits and Alarm Response Each dialog panel controls a different aspect of BIS alarms Setting BIS Alarm Limits The Alarm Limits dialog panel enables you to set BIS alarm limits and BIS BIS is calculated by the BISx and displayed on the monitor The monitor checks that the BIS value is within a specific range between 0 100 Any BIS value rate outside of the allowed limits triggers an alarm BIS enABO04F BIS 5 1 Alarm Limits 69 Mm 2 5 2 EN er SNS a 0 EU E m Ws 5 2 Figure 27 5 The BIS Alarm Limits Dialog Panel 27 12 Mennen Medica Menntor 7 Operating Manual gt To set alarm limits parameters 1 From the BIS menu choose Alarm Limits if you are already in another BIS dialog panel from the drop down menu list below the BIS title area select Alarm Limits 2 Turn the QuicKnob until the low alarm limit scale is highlighted and press 3 Turn the QuicKnob to the required alarm limit and press Repeat the procedure for the high alarm limit The range for each limit is 0 100 The limits are change in steps of one unit Select Auto Set to Defaults to set high and low alarm limits to default values 4 Select the All BIS Alarms checkbox to activate or deactivat
311. ede e ee ee et teste io eat 15 4 Activating and Setting A arms eee itte etre cen ee nee eee e ed ed eee eR ue eens E ZE 15 5 Activating Arrhythmia Monitoring nenne steterit eren 15 9 Chapter 16 ST Segment Analysis Monitoring Procedures 2e ice idee et EE e ie e Pa ee pectet ic eb oe ate cite 16 2 Accessing the S T Menu vasse 16 2 Activating ST Monitoring ge Lente EE CRUEL PE EE Rees 16 3 Setting ST Alarms de eie t dtc d ect ee ob eate gran e oes 16 3 Chapter 17 Respiration OVE VIC We inte geb e e e e eoe 17 1 Patient Pr paration ue eel ee eed eec tet E Gentes ee be AU ott 17 1 Monitoring Procedures ce a dt o m eee 17 2 Setting Respiration Leads and Gain eese nennen ret nennen trennen nenne 17 3 Setting Respiration A larms iuit rt kue ote bn etie d render e e ne ie e eode 17 4 Setting Resp Display Options ate e e ep tu ure Me ee t dU e tet ne Lr pase 17 8 Setting the Heart Rate Coincidence Alarm enne nennen nennen eren 17 10 Activating and Deactivating Respiration Monitoring sese enne 17 12 Chapter 18 Invasive Blood Pressures BP OVERVIEW ioci ec eerte ei dete lop epo ee pee tese an AR EGER EUG ners Pee gates tates 18 1 Caution sukker diced i eed ecd e te eae ee pe Wiel tet 18 2 Warnhilgs ien nz etu tte tige
312. edical D 49 Menntor 7 Operating Manual ws Extended Alarm Response Priority C2 Agent Halothane Latching Off x2 Alarm Detection Delay 0 sec 4 Agent Default Color gt Figure D 22 The Anesthetic Agent Dialog Panel gt Toset default Anesthetic Agent parameters 1 From the System Setup menu select Vital Signs Setup The Vital Signs menu is displayed 2 From the Vital Signs menu select Anesthetic Agent Setup The Anesthetic Agent Setup dialog panel is displayed Under Extended Alarm Response e Set the default priority level for Anesthetic Agent alarms From the Latching drop down list set default alarm latching to On or Off 3 From the Anesthetic Agent drop down list select either one of the 5 Anesthetic Agents or select Automatic for automatic selection of the Agent 4 From the Alarm Detection Delay drop down list select the required delay time in seconds 5 Select Agent Default Color A panel displaying all available colors appears Select the required color 6 Select Discard Changes to close the panel without applying any changes Select Main Screen to apply the changes and exit the panel Note When you exit a vital signs setup panel you return to the main screen To continue System Setup you must press the System Setup button again to access the System Setup menu D 50 Mennen Medica 7 Operating Manual Ventilat
313. edical F 7 8 7 Operating Manual Mennen Medica PPENDIX DECLARATION OF CONFORMITY IEC 60601 2 27 The Menntor X7 monitor ECG complies with IEC 60601 2 27 and the following specific paragraphs 1 Mennen Medical Par 201 7 9 2 9 101 b 4 Heart rate meter accuracy and response to irregular rhythm Par 201 12 1 101 8 Frequency and impulse response The Menntor X7 monitor uses a proprietary QRS detection algorithm that provides Frequency and impulse response per the requirement of the standard Par 201 12 1 101 13 Rejection of pacemaker pulses The Menntor X7 monitor uses a proprietary QRS detection algorithm that provides rejection of pacemaker pulse from the QRS detection Par 201 12 1 101 17 Tall T wave rejection capability The Menntor X7 monitor uses a proprietary QRS detection algorithm that provides rejection of tall T wave per the requirement of the standar G 1 2 7 Operating Manual Mennen Medica
314. een to close the panel and return to the main screen display Mennen Medical 22 13 Pulse Oximetry SpO2 Menntor X7 Operating Manual Setting SpO2 Response Time 22 14 Select a response time interval for updating average SpO2 and pulse rate values Available options are three 3 six 6 and twelve 12 seconds The default response time interval is six 6 seconds OK 6 Main JOHN SMITH Screen SpO2 5 Response Time 6 Sec v 12 Sec Figure 22 7 The 5 2 Response Time Panel gt To select response time 1 From the SpO2 menu or if you are already in another SpO2 panel from the drop down list below the panel title area select Response Time Select 3 sec 6 sec or 12 sec Press SPO2 to close the panel and return to the SPO2 menu press Main Screen to close the panel and return to the main screen display Mennen Medica Menntor 7 Operating Manual Activating SpO2 Monitoring Use the SpO2 Activate panel to activate or deactivate SpO2 monitoring gt To activate or deactivate SpO2 monitoring 1 From the SpO2 menu or if you are already in another SpO2 panel from the drop down list below the title area select Activate 2 Select the Activate checkbox to activate or deactivate SpO2 monitoring By default SpO2 monitoring is activated 3 Press SPO2 to close the panel and return to the SPO2 menu press Main Screen to close the panel and return to the main screen display
315. een when activated and gray when deactivated Setting BP Alarm Response The Alarm Response panel controls the way the Menntor X7 responds to BP alarms The panel is divided into two areas Alarm Response where response preferences are set for clinical alarms Fault Response where preferences are set for technical alarms QC ENVOL ART 5 2 Alarm Response BP Alarm Response JE Tones JE Event Strip BP Fault Response JE Record Tones ART Pulse Rate Response Record Tones JE Event Strip Figure 18 4 The BP Alarm Response Dialog Panel gt To set alarm response preferences 1 From the BP menu or from the drop down menu list below the BP title area in the BP panel select Alarm Response The panel appears immediately 2 Under BP Alarm Response Mennen Medical 18 9 Invasive Blood Pressures Menntor 7 Operating Manual Select the Record checkbox to activate or deactivate recording of the patient s condition during the alarm event By default Record is deactivated Select the Tones checkbox to activate or deactivate audible alarms By default Tones is activated Select the Event Strip checkbox to activate or deactivate Event Strip By default Event Strip is deactivated 3 Under BP Fault Response Select the Record checkbox to activate or deactivate recording of the patient s condition during the alarm event By default the
316. efault Tones is activated Select the Event Strip checkbox to activate or deactivate Event Strip By default Event Strip is deactivated Repeat the above procedure to set the SpO2 Pulse Rate and SpO2 Fault alarm responses Press Vital Signs to close the panel and return to the Vital Signs menu press Main Screen to close the panel and return to the main screen display Note When NIBP and SPO2 are measured simultaneously on the same arm it is recommended to disable the SPO2 alarm response by clicking the Disable SPO2 Alarms during NIBP button Note Checkboxes appear green when activated and gray when deactivated Mennen Medica 7 Operating Manual Setting SpO2 Display Options The Display Options panel controls how SpO2 values are displayed on the main screen display Any changes made immediately update the main screen display OK 6 Main JOHN SMITH Screen 2 5 Display Options Display Features JE Pulse Rate JE Signal Strength JE Alarm Limits JE Pulse Symbol JE Display Units JE Grid Display Area 2 Color Figure 22 5 The 5 2 Display Options Panel e To set SpO2 Display Options 1 From the SpO2 menu or if you are already in another SpO2 panel from the drop down list below the panel title area select Display Options 2 From the Display Area list select the area on the main screen display where you want temperature to appear
317. eform during an alarm event Select the Tones checkbox to activate or deactivate audible alarms By default the checkbox is activated Press RSP to return to the RSP menu Press Main Screen to return to the main screen display Note Checkboxes appear green when activated and gray when deactivated Mennen Medical 17 11 Respiration Menntor 7 Operating Manual Activating and Deactivating Respiration Monitoring Respiration monitoring can be activated or deactivated in the Activate panel You can also temporarily discontinue monitoring for whatever reason and resume monitoring at later time gt To activate deactivate respiration monitoring 1 From the Respiration menu if you are already in another Respiration dialog panel from the drop down list below the title area select Activate The Activate dialog panel is displayed 2 Select the Activate checkbox to activate or deactivate respiration monitoring 3 Press RSP to return to the RSP menu Press Main Screen to return to the main screen display 17 12 Mennen Medica 18 INVASIVE BLOOD PRESSURES Overview Invasive blood pressures BPs are monitored by the Menntor X7 two model 6810001x0 or four model 6810002x0 channels enabling simultaneous monitoring of two or four invasive BPs BP label is selected for monitoring based on site the location on the patient s body where the catheter is inserted Each BP name contains
318. el Note The HIS key appears only if the Mennen Net is linked to the HIS The demographic data in the Patient Identification panel includes Room number e Patient ID e Patient name last first middle initial Note Patient first name and surname are limited to 15 characters each in all monitors using Latin alphabet and to 7 characters each in Monitor with Hebrew name fonts e Date of Birth e Height e Weight e Body Surface Area BSA calculated automatically in the monitor whenever patient height and or weight are changed e Sex e Hospital ID number e Doctor s name Mennen Medical 9 3 Connecting Patient to Menntor X7 Admit via HIS 9 4 Menntor 7 Operating Manual When alphanumeric data is required the keyboard panel opens enabling you to enter the required information DVVO Undo Last Key Figure 9 2 Virtual keyboard on monitor screen gt To fill out the Patient Identification Panel 1 Turn the QuicKnob clockwise or counterclockwise until you reach the required parameter The area is now highlighted Press in the QuicKnob to select the area To enter the patient s height and weight select the area and turn the QuicKnob to set the required value To enter the patient s sex select the Sex field A list appears Select either Male or Female Press Discard Changes to close the panel and return to the main screen display without implementing any ch
319. en Medical 13 3 Recording Vital Sign Data Reason for Recording Waveform Scaling Information Date Time of Recording Vital Signs Numeric Values Waveform Area 13 4 Menntor 7 Operating Manual May be one of the following Manual Alarm Multi ECG Selective Waveforms Some ECG lead and BP waveforms require information about scaling in order to facilitate comprehension of the displayed information Such waveforms will contain this information within triangular parentheses lt and gt A slash serves as a separator between channels ECG leads n mm mv gt where n represents a number BP lt highscale lowscale gt For example when recording ECG with ART 5 mm mv 300 0 The date time when recording started The date time will appear in the format defined in System Configuration Each waveform recording is accompanied by a set of Vital Sign readings taken at the time of recording They are displayed in descending order of importance Each VS is represented by its abbreviated name e g ART for Arterial blood pressure or HRT for heart rate The monitored value appears to the right of the VS name An additional character represents the VS alarm status indicates that the vital sign is in alarm s indicates that the vital sign is in suspended alarm state A waveform recording on Enscribe may include a single grid with one or two ove
320. ence e PiCCO by Pulsion The technology used by each of these devices is different but they measure the same basic vital signs with additional derived parameters that differ from one technology to the other Eduards Vigilance Eduards Vigilance is a device that measures e Cardiac Output CO by thermal dilution with Swan Ganz catheter e Continuous Cardiac Output CCO with special heating catheter introduced into a central vein with sensing thermistor in the Pulmonary Artery e SvO2 by fiber optic catheter Additional stored parameters are e Continuous End Diastolic Volume e Systemic Vascular Resistance SVR e Stroke Volume SV e Ejection Fraction RVEF Mennen Medical 28 1 CO CCO SvO2 Menntor X79 Operating Manual Eduards Vigileo Eduards Vigileo is a device that measures e Cardiac Output CO by thermal dilution with Swan Ganz catheter e Arterial Blood Pressure e From the pulse pressure it derives using the basic physiological principle that pulse pressure is proportional to stroke volume Additional stored parameters are e Cardiac Output Index CCI e Stroke Volume and Stroke Volume Index SV SVI and e Stroke Volume Variations and Index SVR SVRI Pulsion PiCCO PiCCO is a device that measures e Cardiac Output CO using Left Ventricular Thermal Dilution method e Arterial Blood Pressure From the pulse pressure it derives using the basic physiological principle that p
321. enntor 7 Operating Manual Ten Second Display Panel The Ten Second Display panel presents snapshot of the waveform activity for all monitored ECG leads over specified ten second period Statistical data for the ten seconds under review appear below the waveforms To access the Ten Second Display panel 1 From the Main menu select the Patient Data key or If a Patient Data function key appears on the main screen turn the QuicKnob until the Patient Data key is highlighted and press to access the Patient Data menu 2 From the Patient Data menu or When the Patient Data panel is already displayed from the drop down menu below the panel title select Full Disclosure to access the Ten Minute Display panel 3 Press Zoom In and use the QuicKnob to move the cursor to the ten second time period you want to view in detail 4 Press the QuicKnob to access the Ten Second Display Panel Patient Data 13 1112 Go to Mark Event Zo t I mV em ed Cn m ndis Right gt EE Available data time span 13 11 14 00 13 11 14 57 Gain Box Figure 10 11 The Ten Second Display Panel The Ten Second Display panel presents the waveform for each monitored lead over specified ten second period of time The gain factor for the display appears in the Gain box Mennen Medical 10 19 Reviewing Patient Data Menntor 7 Operating Manual 10 20 The Date and Time boxes present the date and start time of the
322. enntor X7 Fixed Keys Fixed Keys Icon Function Alarm Off Pressing Alarm off disable all alarms for predefined KX period for a pre defined period of 60 seconds The alarm condi tion still exists and visual indication of the alarm remains on 21 screen If a new alarm is triggered during the silence period the Silence function is cancelled Silence fA Pressing the Silence key disables any active alarm tones Record Pressing Record will send recording to the inbuilt strip chart recorder If the Menntor X7 is not equipped with inbuilt recorder the recording will be sent to the network Enscribe strip chart recorder Mennen Medical 6 9 Controls and Functions Menntor 7 Operating Manual Table 6 1 Menntor X7 Fixed Keys Fixed Keys Icon Function NIBP Start Stop j Note Pressing NIBP starts stops NIBP measurement 4 Escape When a panel or menu is open pressing Escape allows you to 1 Exit an open list box without implementing any changes 2 Exita panel without implementing any changes 3 When you are in a menu or in an open box use the Escape button to return to the previous step or to the previous menu Note This does not apply to panels in which changes are implemented immediately such as Alarm Settings 4 Escape will bring the focus to the Monitor Name box Top Left Press to get the Main Menu This Menu will include Patient Data
323. ens and requests a patient name 2 Ifno DSD is connected a message No Disk Present appears figure 29 17 Mennen Medical 30 21 CerebraLogik and EEG Menntor 7 Operating Manual No Disk Present Figure 30 18 No Disk Note If a DSD is connected the Export Patient Data panel with Start and Cancel buttons will appear figure 29 18 RD VER 6 1 AMES BOND en E Export Patient Data Figure 30 19 Start Export 3 Press Start This sends the data of the selected section to the DSD and show copying bar with Wait message Fig 29 19 30 22 Mennen Medica Menntor 7 Operating Manual Data Export may take several minutes please wait Start Cancel Figure 30 20 Export Wait message Exporting Saved patients with aEEG to DSD or Network gt To export a Saved patient 1 In Main Menu select Export Saved Patient This opens a panel with a list of patients saved on the local monitor 2 Select a patient A list of options appears Export Selected Sort By xx Close Mennen Medical 30 23 CerebraLogik and EEG Menntor 7 Operating Manual RD VER 6 1 Look For Show All Patient ID Last First Name Matches 3 Page 1 1 Figure 30 21 Export Saved Patients Panel 3 Press Export you are asked toprovide password 4 Enter the password 2334 If no DSD is connected message No Disk Present appears Figure 30 18 I
324. ent Data menu select Calculations 3 Inthe Calculations menu select Renal Clarence The Renal Clearance panel opens displaying the patient s monitored data Calculations Renal Clearance VALUE NORMVAL URV 11 5 URNA 16 meq L Urinary Sodium Excretion UNAEX meg min 0 02 0 15 Urinary Potasium Excretion URKEX ISUE meg min 0 01 0 09 URE Urinay Sodium Potasium Ratio UNA K ig Fractional Excretion of Sodium FENA SERNA 140 SCRE 705 mg DL Creatinine Clearance CRCL mL min 70 160 Osmolar Clearance COSM EA mosm min 17 3 88 5 05 pn Free Vater Clearance CH20 1 mL min 0 5 42 0 NonSaline Loss NSL 5 mL min UROSM 11 mosm Kg POSM 13 mosm Kg Blood Urea Nitrogem Creatinie Ratio BUN C Urine Serum Creatinine Ratio U SCR 15 mg DL 200 Urine Plasma Osmolary Ratio upos 104 0 16 5 14 TIMEN 4 27 DATE 06 22 99 Figure 11 5 Renal Clearance Panel 4 Manually enter all missing data and update any existing values if necessary Calculated values and indexes appear on the right side of the panel Out of range values appear on red background 5 Click the Accept button to save calculations and exit the screen The results of the measurement and calculations are saved in the Renal Clarence chart You can access the results from the Charts option in the Patient Data menu Mennen Medica 12 PERFORMING MEDICATION
325. ent and begin monitoring without having to define all the parameters at the time of admission You always have the option to configure monitoring and display parameters according to the requirement for each specific patient When you initially connect a patient to the bedside monitor you can select either the available Monitor Profile admission keys or Admit as Previous The Menntor X7 turns on the parameters of the selected profile and begins monitoring automatically setting the display according to the configurations defined in the selected Admission key Up to 10 Monitor Profile Admission keys can be configured for the monitor Note See Monitor Profiles Setup on page D 54 for details of creating Monitor Profiles CAUTION To check the functioning of the alarm sound note that the Sound Event upon admission is heard See Sound Event on page D 17 for setting the sound volume Mennen Medical 7 1 Setting Up the Patient Display Menntor 7 Operating Manual Display Controls The Display Controls panel allows you to control the way data is presented on the screen In the Display Controls panel you can set the following Sweep Speed e Special Display Format gt To access the Display Controls panel e From the Main menu select the Setup key and select Display Controls from the Setup menu none enAA004D Main lt none gt enAA004D Main Screen Screen Setup Display Controls Display Controls Spec
326. entries based on a manually selected event e Alarm Chart entries when an alarm is triggered e Cardiac Output A chart entry each time a cardiac output reading occurs e PCWP A chart entry each time a pulmonary wedge reading occurs NIBP A chart entry each time a NIBP reading occurs e CVP A chart entry each time a VCP reading from the PAP channel occurs e Apnea A chart entry each time an apnea event occurs e Time Interval Chart entries based on a defined time interval To operate the Charts panel 1 From the Main menu select the Patient Data key to access the Patient Data menu 2 From the Patient Data menu or When the Patient Data panel is already displayed from the drop down menu below the panel title select Charts Mennen Medica Menntor 7 Operating Manual 3 From the Filters drop down list select filters 4 access specific entry based on when it took place press Find Date Time and enter the required date and time in the Date and Time panels 5 access a specific entry based on event type press Find Event and select an event from the drop down list chart appears containing occurrences of the selected event with the most recent occurrence appearing on the top line Note The following event types are available Manual Automatic Alarms Cardiac Output PCWP NIBP from PAP Apnea Timer Discontinue Resume Press First Page to display the first page of the chart Pr
327. epresentative Mennen Medical B 4 Menntor X79 Operating Manual Mennen Medica PPENDIX AUTO SET DYNAMIC ALARM LIMITS The table below shows the formulas that are used to calculate the alarm limits in the Auto set mode Table C 1 Envoy Menntor X7 Dynamic Alarm Limit Parameter Unit LOW HIGH HRT SPO2 BPM HRT 0 8 5 HRT 0 9 4 34 Pulse ART Pulse ST mm 0 1mV Value 1 Value 1 CVP ICP PAP mmHg RAP LAP BP lt 25 BP 5 5 BP gt 25 BP 0 8 BP 1 2 NIBP mmHg SYS SYS 0 68 11 SYS 0 86 38 DIAS DIAS 0 68 6 DIAS 0 86 32 MEAN MEAN 0 68 8 MEAN 0 86 35 ART SYS mmHg DIAS MEAN BP BP lt 25 BP 5 0 86 BP 32 25 lt BP lt 200 0 68 BP 6 0 86 BP 32 Mennen Medical C 1 2 7 Operating Manual Table C 1 Envoy Menntor X7 Dynamic Alarm Limit BP gt 200 0 68 BP 6 BP 8 TMP DELTA CEL TMP 0 5 TMP 0 5 TMP RSP EtCO2 RSP 2 but not less than 4 RSP 2 but not RSP more than 150 SPO2 VALUE gt 85 Value 5 100 VALUE lt 85 80 90 CO Lt min Value 2 Value 2 ETCO2 mmHg ETCO2 0 8 ETCO2 1 2 INCO2 mmHg INCO2 4 Mennen Medica APPENDIX D SETTING UP THE SYSTEM Note Access to System Setup is password protected Mennen Medical Appendix D includes instructions for configuring the following Menntor X7 pa
328. ery weak pulse are also contraindicated for automatic mode monitoring WARNING Set the interval function to Off and initiate each reading manually after checking to see that the limb is not moving or trembling Mennen Medical 21 7 Non Invasive Blood Pressure NIBP Menntor X7 Operating Manual OK 6 JOHN SMITH Screen 5 Reading Intervals Automatic Reading Readings stiterval T6O 5 Readings stinterva T60 Other readings at intervel T60 Discard Stat Mode Start NIBP Multiple T Figure 21 1 The NIBP Reading Intervals Panel To set the NIBP reading intervals 1 From the NIBP menu if you are already in another NIBP panel from the drop down list below the panel title area select Reading Intervals 2 From the Cuff Type drop down list select the required cuff type Available options are Adult and Neonatal The default option is Adult 3 From the Automatic Reading drop down list select an option for setting measurement intervals The available options are Off Single T Interval Single Q Interval Multiple T Interval and Multiple Q Interval 4 When single interval is selected T or select Single Interval to display the drop down list and select the required interval in minutes The available intervals are T2 T3 T4 T5 T10 T15 T20 T30 T40 T50 and T60 minutes for T intervals Q1 Q2 Q5 Q10 Q15 Q30 Q60 and Q120 minutes for Q intervals 5 W
329. es 4 Setthe VBN Select toggle to OFF to fix the vital signs in the boxes Mennen Medica Menntor 7 Operating Manual ES GS 00 19 39 Figure 7 3 The Very Big Number Screen Cardio Respiratory Graph CRG The Cardio Respiratory Graph is used to display changes in vital signs within a time frame of 1 5 to 30 minutes rather than in seconds as is the case for waveform display Viewing changes over this greater period is especially important in neonatal monitoring where Respiration Heart Rate and SpO2 tend not to be constant The Menntor X7 supports the following time frames e 1 5 min e 3min e 6 min default 12min e 30min Two independent CRG displays can be shown on the Menntor X7 screen as CRG 1 and CRG 2 Each CRG display can present two parameter traces one above the other for a total CRG mode display of up to 4 parameters Each graphical trace is accompanied by a vertical scale The CRG display also supports a grid which can be activated or hidden for all CRG parameters The parameters that can be selected for display in CRG mode are Respiration CO2 Waveform e All Vital Signs Mennen Medical 7 5 Setting Up the Patient Display Menntor 7 Operating Manual The default parameters are Heart Rate Respiration CO2 Waveform and SpO2 Note Only currently monitored parameters can be selected for display CRG Display The two CRG displays appear at the bottom of the screen above the
330. ess Last Page to display the last page of the chart Press Previous Page to display the previous page ne Press Next Page to display the next page 10 Use the scroll bar to move the chart left or right The date and time remains the same while scrolling the data 11 From the Patient Data drop down menu select Trends Full Disclosure or Overview The Charts panel closes and the selected panel opens displaying data for the time displayed on the top line of the Charts panel or Turn the QuicKnob until an entry on the chart is highlighted and press A drop down menu opens Select Trends Full Disclosure or Overview to close the Chart panel and open the selected panel or click Delete to delete the chart entry 12 Press Main Screen to close the panel and return to the main screen display Full Disclosure Full Disclosure enables you to review a patient s ECG waveforms with associated data for at least 6 hours 5 days for extended memory depending on the configuration of your system Full Disclosure features a Ten Minute Display panel that presents a snapshot of the waveform activity for a selected ECG lead over a specified ten minute period Zoom in on any ten second period on the Ten Minute Display panel to open the Ten Second Display panel This panel presents a snapshot of waveform activity for all monitored ECG leads during the selected ten seconds It also presents the following data for the selected time frame
331. essed via the UIM in the Vital Signs menu which provides access to all the specific dialog panels enabling interaction with all aspects of gas monitoring Each dialog panel controls different aspects of monitoring the gas levels present during anesthesia The anesthetic gas modules provide the following signals N5O Anesthetic Agent concentration Anesthetic Agent identification sidestream only and signal Each has its own dialog panel gt To start the interface 1 Open the Vital Signs menu and select This opens with the available vendor devices 2 Select one of the vendor devices and four anesthesia dialog panels open O2 N20 EtCO2 and Agent Note In the case of Leon Plus a Ventilator panel also opens Mennen Medical 25 1 Anesthetic Gas Monitoring Menntor 7 Operating Manual EtCO Monitoring The EtCO menu provides access to all the specific dialog panels regarding monitoring Description of the panels in the order they appear on the EtCO menu is given below e EtCO Alarm Limits Use this panel to activate deactivate EtCO inCO gt and respiration rate alarms and set high and low alarm limits e Alarm Response Use this panel to define how the Menntor X7 responds to detected EtCO inCO respiration rate and apnea alarms e Display Options Use this panel to define how EtCO values appear on the main screen display e Activate Use this panel to activate or deactivate monitoring
332. et default O2 parameters 1 From the System Setup menu select Vital Signs Setup The Vital Signs menu is displayed From the Vital Signs menu select 02 Setup The 02 Setup dialog panel is displayed Under Extended Alarm Response Set the default priority level for O2 alarms e From the Latching drop down list set default alarm latching to On or Off From the Alarm Detection Delay drop down list select the required delay time in seconds Select O2 Default Color A panel displaying all available colors appears Select the required color 6 Select Discard Changes to close the panel without applying any changes Select Main Screen to apply the changes and exit the panel Note When you exit a vital signs setup panel you return to the main screen To continue System Setup you must press the System Setup button again to access the System Setup menu N20 Setup This dialog panel enables you to set N2O default parameters These parameters include setting N2O alarm priority activating or deactivating alarm latching defining Alarm Detection delay and selecting the default units and color for NZO values Mennen Medical N2O Alarm Priority Alarm priority affects the order of audible and visual alarm notification See Alarm Priority on page 8 4 for a full description of this feature N2O alarm priority can be set to C 1 C 2 or C 3 The factory default is C 2 Alarm Latching For a complete description of Alarm
333. et the required low limit Press Auto Set to Defaults to set the EtCO2 alarm limits to their default values Mennen Medica Menntor 7 Operating Manual 5 When you select the Resp option in the Select Type drop down list two additional fields appear on the dialog panel e Apnea Alarms Off Deactivates the Apnea alarm e Apnea Delay Interval Sets the apnea delay interval If an apnea event occurs that exceeds the apnea delay interval a message appears displaying the set interval and the time an apnea event occurred The allowed range is 10 to 90 seconds The default is 20 seconds 6 Press EtCO2 to close the panel and return to the EtCO2 menu press Main Screen to close the panel and return to the main screen display Setting EtCO2 Alarm Responses The Alarm Response panel controls how the Menntor X7 responds to EtCO2 alarms QC ENVOI etCO2 Alarm Response JE Record JE Tones JE Event Strip etCO2 Fault Response JE Record JE Tones Figure 23 4 The EtCO2 Alarm Response Panel gt Toset EtCO2 alarm responses 1 From the EtCO2 menu if you are already in another EtCO2 panel from the drop down list below the panel title area select Alarm Response Mennen Medical 23 11 End Tidal CO2 EtCO2 Microstream MicroPod Menntor 7 Operating Manual 2 Under EtCO2 Alarm Response e Select the Record checkbox to activate or deactivate recording of the patient s condition during the alar
334. ew panel 9 Press Main Screen to close the panel and return to the main screen display Event Strips Full Disclosure and Overview of all ECG and vital signs waveforms are stored in the memory of the Menntor X7 patient monitor for at least 6 hours 5 days for extended memory The user has the option of saving up to 75 important Event strips for the whole duration of patient monitoring until discharge The Event strips can also be transferred with other patient data to another monitor when the patient is transferred from one monitored bed to another monitored bed Event Strips are automatically created upon Clinical Alarms and can also be created manually e To create an Event Strip 1 Enter the Full disclosure or Overview panel Mennen Medical 10 23 Reviewing Patient Data Menntor 7 Operating Manual 2 Locate the event you wish to mark by selecting the following Zoom in in 10 minutes Full disclosure Zoom out in 10 second Full Disclosure 3 window with a list of options will open Zoom out Mark Event Print etc 4 Select Mark Event 5 A list of predefined labels will open 6 Select a predefined label or Select Edit manual to open an alphanumeric panel and create a new label 7 Event Strip of 20 Seconds of all waveforms is stored in the memory of the Menntor X7 under the selected Event label e To create Event strip labels 1 Select System Setup 2 Select Set Event Labels from th
335. f Thigh 38 50 cm 800 261 321 Cuff Small Adult 17 25 cm 800 261 328 Cuff Child 12 19 cm 800 261 323 Cuff Infant 8 13 cm 800 261 324 Table 7 Reusable NIBP Accessory kits Adult Pediatric CAS Item and Description Part Number P N NIBP Accessory Kit Adult 551 306 272 NIBP Accessory Kit Pediatric 551 306 271 NIBP Accessory Kit Infant 551 306 270 NIBP Accessory Kit Adult Pediatric 551 306 273 NIBP Accessory Kit Adult 551 306 272 NIBP Accessory Kit Pediatric 551 306 271 Mennen Medical A 5 Menntor 7 Operating Manual Table 8 Neonatal NIBP Accessories Item and Description Part Number P N NIBP Accessory Kit Neonatal Disposable Cuffs 551 306 274 Disposable Cuffs Box of 10 Disposable Cuffs Neonatal 1 3 6 cm 800 260 332 Disposable Cuffs Neonatal 2 3 8 cm 800 260 333 Disposable Cuffs Neonatal 3 6 11 cm 800 260 334 Disposable Cuffs Neonatal 4 7 14 cm 800 260 335 Disposable Cuffs Neonatal 5 8 15 cm 800 260 336 Air Hose Without LUER Connection Single Lumen Adult Pediatric Inflation tube 800 260 326 Single Lumen Neonatal Inflation tube 800 260 337 Table 9 Pulse Oximetry SpO2 Accessories Nellcor Item and Description Part Number P N SpO2 Adapter Cable 551 306 015 SpO2 Finger Sensor 800 306 730 Nellcor Multi Sit
336. f a DSD is connected the Export Patient Data panel with Start or Cancel procedures appear Figure 30 19 5 Press Start The data of the selected patient is sent to the DSD and a copying bar with Wait message is displayed Figure 30 20 aEEG Viewer The DSD data can be viewed on PC equipped with aEEG Viewer software that is provided to CerebraLogik users to enable them to view EEG and aEEG data in parallel with the numeric vital signs stored on the DSD Recording Monitors equipped with built in strip chart recorder enable recording 3 hour aEEG history and 6 or 12 seconds raw EEG at the time of the cursor gt To activate recording 1 Open the History panel 2 Select any 3 hours panel of interest and click Record The recording consists of four parts 2 for each channel 30 24 Mennen Medica Menntor 7 Operating Manual The record label includes Bed number Patient ID and name the EEG channel and the date and time of the recording Printing To print the history panel on network laser printer click print on the History panel Routine Maintenance Care and Cleaning Before each use check the interface cable Integrity CAUTION Do not use the CerebraLogik if the cable has deteriorated Cleaning Use soft linen soaked with mild detergent to clean the CerebraLogik CAUTION Do not allow fluids to enter the sockets of the CerebraLogik WARNING not autoclave CerebraLogik Autoclaving will seriously
337. f priority see Alarm Priority on page 8 4 Alarms of a technical nature are displayed in the primary vital sign area Alarm messages displayed in the alarm message area appear as white text on a red background If more than one alarm is generated at the same time the highest priority alarm appears on screen The Alarm priority will be marked on each of the alarm messages by x for High priority C1 for Medium priority C2 for lower priority You can scroll through a list of alarms by using the pull down list If more that one alarm having the same priority level is generated at the same time they are sorted in chronological order first generated first displayed Audio Response Five alarm levels are available in the Menntor X7 The High C1 Medium C2 and Low C3 priority audible alarm sounds are according to the requirements of the ISO 60601 1 8 Audio response to alarms can be disabled in the Alarm Response dialog panel of each monitored vital sign Each alarm priority level is represented by a different alarm tone Each tone can be adjusted to suit you working environment or personal needs A set of tones is supplied with the system For SpO2 Low HR and High HR alarms can have either a standard clinical alarm C1 C2 C3 or a unique tone This tone can be modified in system configuration but it remains unique in comparison to other alarm tones Any other alarm with the same priority overrides an
338. fferent speed from the drop down list Available options are 6 25 12 5 25 and 50 mm sec The default sweep speed is the same as the current ECG sweep speed Activating and Deactivating BP Monitoring BP monitoring can be activated and deactivated in this panel Monitoring can also be discontinued for whatever reason and resumed later gt To activate and deactivate BP monitoring 1 From the BP menu From the drop down menu list below the BP title area in the BP panel select Activate The BP Activate panel is displayed 2 Press Activate to initiate BP monitoring From the Site Name drop down list select the required site for monitoring 4 Press BP to return to the BP menu Press Main Screen to return to the main screen display 18 16 Mennen Medica 19 CARDIAC OUTPUT Overview Cardiac Output is measured using the thermodilution method in which one or more injections of cold saline solution is introduced into central vein The resulting temperature variation in the pulmonary artery is then measured Each injection results in the display of a thermodilution curve representing blood temperature deviation Up to six injections can be compared for thermodilution response curves and corresponding data The Menntor X7 Bedside Monitor guides you through the procedure and notifies you of invalid injections or other procedural problems The results of all completed injections can be stored in patient charts f
339. fferent types of wall mounts can be used Select the wall mount or cart according to your hospital s individual requirements Wall mounts obtained from Mennen Medical are supplied with detailed instructions Installation Procedures Proper installation of the Menntor X7 is divided into three phases Site survey physically mounting the monitor and cable interconnection If your hospital has Mennen Medical 4 1 Installation and Setup Menntor 7 Operating Manual special installation requirements these may call for special planning and materials that must be furnished by your hospital and are not covered by this manual Site Survey Performing a site survey ensures that all environmental electrical and cabling requirements are taken into consideration This ensures that the actual installation proceeds as smoothly as possible and that the installed equipment will run reliably site survey should be performed every time an Menntor X7 bedside monitor is installed The hospital Biomedical Engineer and Facilities Engineer should participate in any discussion which must include e Reviewing details and drawings of hospital layout and architecture e Planning of all cable ducts raceways runs wall plates pull boxes and other interconnection details e Establishing length of cable runs e Reviewing AC power requirements locations and types of outlets e Discussing the type of emergency backup AC power supply to be used time
340. fine where you want the Arrhythmia data to appear on the main screen display DAP ECG E Area In ECG Ex Alarm Response JE Record Tones Figure 15 4 Individual Alarm Dialog Panel gt Toactivate and set individual Arrhythmia alarms 1 From the Arrhythmia menu if you are already in the Arrhythmia Activate panel from the drop down list below the title area select Arrhythmia Alarms The Arrhythmia Alarms dialog panel opens 2 Select an individual Arrhythmia panel if you are already in an Arrhythmia dialog panel from the drop down list below the title area select an Arrhythmia type to open the corresponding dialog panel 3 Selectthe Record checkbox to activate or deactivate recording of the patient s ECG during the alarm 4 Select the Tones checkbox to activate or deactivate the audible alarm Select the Event Strip checkbox to activate or deactivate Event Strip By default Event Strip is deactivated 6 Select the Alarm checkbox to activate or deactivate the alarm 15 8 Mennen Medica Menntor 7 Operating Manual 7 Press Accept to return to the Arrhythmia Alarms dialog panel 8 When alarm limits are user defined use the QuicKnob to move the slide indicator on the slider bar to set the required limit 9 When the main screen display area is user defined select the area where you want data to appear from the Display Area drop down list 10 Select the Alarm checkbox to activate or d
341. for setting alarm limits are disabled 22 8 Mennen Medica Menntor 7 Operating Manual 3 Using the QuicKnob move the markers on low high alarm limits slider bars along the displayed scale to set the required limits The right marker sets the low alarm limit and the left marker sets the high alarm limit The allowed range is 0 300 BPM Press Auto Set to Defaults to set all Pulse Rate alarm limits to their default values 4 Press Spo2 to close the panel and return to the Spo2 menu press Main Screen to close the panel and return to the main screen display Setting SpO2 Alarm Response The Alarm Response panel controls how the Menntor X7 responds to SpO2 alarms QC ENVOL Tones JE Event Strip SpO2 Pulse Rate Alarms JE Record Tones F Event Strip SpO2 Fault Alarms JE Record Tones Disable SpO2 Alarms During NIBP Figure 22 4 The SpO2 Alarm Response Panel Mennen Medical 22 9 Pulse Oximetry SpO2 Menntor X79 Operating Manual 22 10 gt To set SpO2 alarm response 1 From the 2 menu if you are already in another SpO2 panel from drop down list below the panel title area select Alarm Response Under SpO2 Alarms Select the Record checkbox to activate or deactivate recording of the patient s condition during the alarm event By default Record is deactivated Select the Tones checkbox to activate or deactivate audible alarms By d
342. from the main screen display gt To access the Ventilator panel from the Vital Signs menu 1 From the main menu select Vital Signs The UIM module key will appear All the devices that the Menntor X7 can be currently connected to will appear on the Vital Signs menu 2 Select the UIM and press the QuickKey Mennen Medical 26 3 Menntor 7 Operating Manual 3 A list of all available auxiliary device communication software will appear including ventilators supported by the Menntor X7 4 From the Vital Signs menu select the Ventilator device that you wish to connect to the Menntor X7 The appropriate menu is displayed gt To access the Ventilator panel from the main screen display 1 Turn the QuicKnob until the Ventilator parameter key is highlighted and press to access the Ventilator panel Setting Alarms Ventilator alarm parameters are set in two dialog panels Alarm Limits and Alarm Response Each dialog panel controls a different aspect of Ventilator alarms Note The alarm limit settings should always be set and monitored in the Auxiliary device as the primary setting for the alarms Setting Ventilator Alarm Limits The Alarm Limits dialog panel controls activation and deactivation of Ventilator alarms and defines Ventilator alarm limits Low and high alarm limits are set separately for each parameter selected The Ventilator Module detects alarms and notifies the Menntor X7 acco
343. g Profiles on page 9 17 gt To connect a patient and initiate monitoring 1 Prepare the patient 2 Attach the electrodes probes transducers and insert pressure catheters as required for monitoring the patient 3 Menntor X7 main screen click the Monitoring Profile that most closely matches the monitoring needs of the patient or click the Admit as Previous key to admit the new patient according to the settings used for the previous patient monitored 4 Monitoring begins and the main screen display appears 5 If you wish to change settings for vital sign monitoring or to the screen display see the relevant chapter in this manual Note Default configuration may have been reconfigured by your hospital biomedical engineering department or System Administrator to suit the particular needs of your hospital or department If the default configurations described in this manual differ from what you see on the screen consult the relevant department in your hospital 9 2 Mennen Medica Menntor 7 Operating Manual gt To access the Patient Identification Panel e Select the Patient Demographic area on the main screen display From the Main menu select the Setup key to display the Setup menu Select ADT and then select Patient Identification The Patient Identification panel appears ee Patient Identification vos D ETT Figure 9 1 The Patient Identification Pan
344. g SvO2 Alarm Response The Alarm Response panel SvO2ntrols the way the Menntor X7 responds to SvO2 alarm The panel is divided into two areas e SvO2 alarm e SvO2 Fault alarms gt To set alarm response preferences 1 1 From the SvO2 menu select Alarm Response The Alarm Response panel appears 2 Under SvO2 Alarms Select the Record checkbox to activate or deactivate recording of the patient s condition during the alarm event By default the checkbox is deacti vated Select the Tones checkbox to activate or deactivate audible alarms By default the checkbox is activated 3 Under SvO2 Fault alarms Select the Record checkbox to activate or deactivate recording of the patient s condition during the alarm event By default the checkbox is deacti vated Select the Tones checkbox to activate or deactivate audible alarms By default the checkbox is activated Select the Event Strip checkbox to activate or deactivate Event Strip By default the checkbox is deactivated 4 Press Main Screen to return to the main screen display Setting SvO2 Display Options The SvO2 Display Options panel enables you to control the way SvO2 values appear on the main screen display You can set the display to suit your hospital s or departments particular needs Any changes made are immediately reflected on screen Mennen Medical 28 9 CO CCO SvO2 Menntor X79 Operating Manual By setting the parameters on the Displ
345. g a new printer refer to Appendix D for printing options e Screen capture Print the display as viewed on the monitor display e Patient data Chart Trend ST Watch Calculation Full Disclosure Overview Event Strip e Recordings Use the Laser printer to print waveforms instead of a Strip Chart recorder Mennen Medical 32 1 Recording and Printing Menntor 7 Operating Manual gt Note To print Screen Capture 1 Select Main 2 Select Utilities 3 Press Print single page is printed Alternatively you can create Print Quickey and press it for Screen capture To print Patient data 1 top of each patient data panel use the Print key to print the relevant panel One page print will result for Chart Trend ST Watch Calculation Full Disclosure Overview 20 second print two or four pages will result for Strip Chart Full Disclosure to print waveform recording 1 Inthe System Setup menu choose Recorder Setup see Recorder Setup on page D 65 2 Set Output to printer This sends recordings to the Laser printer whenever recording is initiated either by Recorder key or as an alarm response The number of printed pages depends on the definitions in Recorder setup see Recorder Setup on page D 65 Enscribe Network Strip Chart Recorder 32 2 The Enscribe records one or two channels of waveforms as set in when selecting the Recorder Setup from System Setup men
346. g for a defined period of time Impedence pneumography counts breaths by counting cycles of impedence change one cycle equals one breath Whenever the number of breaths defined in System Configuration is detected an apnea timer is reset If no breath is detected an apnea alarm is triggered after a pre defined time limit runs out The currently monitored respiratory rate appears on the panel Mennen Medica Menntor 7 Operating Manual By configuring the parameters on this panel you can e Activate or deactivate all respiratory alarms e Set low and high respiratory rate alarm limits ranging from 0 150 BPM e Set an apnea duration after which the apnea alarm is triggered Options are 10 15 20 30 and 45 seconds Default duration is 20 seconds e Set high and low respiratory alarms to default values RICU BED Main Screen RSP 1 apnea menn JE Apnea Alarm Auto Set JE All Resp Alarms to Defaults Figure 17 2 The Respiration Alarm Limits Dialog Panel gt To set alarm limits parameters 1 From the Respiration menu if you are already in another Respiration dialog panel from the drop down menu list below the Respiration title area select Alarm Limits 2 Select the Enable Alarm checkboxes located below the scales for High and Low Apnea alarm limits to activate or deactivate the respective sliders Mennen Medical 17 5 Respiration Menntor 7 Operating Manual 3 Tu
347. ge the number 4 will appear instead of the percentage Physiologically it is expected that the first twitches will be larger that the following beats If however following twitches are larger than the first one they will appear in red Mennen Medica Menntor 7 Operating Manual Alarms TOF does not produce clinical alarms If there is a communication with the TOF Watch technical alarms initiated by the TOF Watch are also displayed on the monitor Table 31 1 Alarms Alarm Alarm message Source TOF Watch not connected No Cable Monitor TOF Watch not functional or off No Comm Monitor Battery empty Battery low TOF Flashing acceleration transducer symbol Relocate sensor TOF Normal mode Acceleration transducer has been Relocate sensor TOF removed Calibration mode Unstable or too low acceleration Relocate sensor TOF transducer signal Flashing bad surface electrode connection symbol Relocate electrod TOF All modes Missing or bad electrode connection Relocate electrod TOF Flashing surface electrode symbol Relocate electrod TOF Flashing bad needle electrode connection symbol Relocate electrod TOF All modes Missing or bad electrode connection Relocate electrod TOF Flashing needle electrode symbol Relocate electrod TOF All modes Skin resistance too high Resistance too high TOF Both symbols flashing simultaneously Connect stimulation TOF Mennen Medical 31 3 T
348. ges Menntor 7 Operating Manual The following table lists all Menntor X7 alarm messages Table 8 4 Alarm Messages Vital Sign Alarm Alarm Message All Vital Signs name of parameter High Alarm name of parameter Low Alarm name of parameter Fault name of parameter Artifact name of parameter Cable Out ECG RL or more than one lead fault RL Fault V1 lead fault Lead V Fault when only 1 lead is used Lead Va Fault when 2 leads are used Lead V1 Fault when more than two V leads are used V2 Lead Fault Lead Vb Fault when only two V leads are used Lead V2 Fault when more than two V leads are used Lead V3 Fault Lead V4 Fault Lead V5 Fault Lead V6 Fault Lead RA Fault Lead LA Fault Lead LL Fault All Leads Fault PVC Bigeminy Trigeminy Couplet Triplet Interpolated PVCs Multifocal PVCs Ron Idioventricular rhythm Pause 8 12 Mennen Medica Menntor 7 Operating Manual Table 8 4 Alarm Messages Continued Vital Sign Alarm Alarm Message Supraventricular rhythm Extreme Tachycardia Extreme Bradycardia Asystole V Tachycardia V Tach V Fibrillation V Fib Run Irreg
349. ghlighted and press to access the SvO2 panel Setting SvO2 Alarms SvO2 alarm parameter is set in two dialog panels Alarm Limits and Alarm Response Each dialog panel SvO2 controls a different aspect of SvO2 Note The alarm limit settings should always be set and monitored in the Auxiliary device as the primary setting for the alarms Setting SvO2 Alarm Limits The Alarm Limits dialog panel Controls activation and deactivation of SvO2 alarms defines SvO2 alarm limits By SvO2 configuring parameters on this panel you can e Activate or deactivate SvO2 alarms Set low and high SvO2 alarms gt To set SvO2 alarm limits 1 From the SvO2 menu select Alarm Limits 2 Select the All SvO2 Alarms checkbox to activate or deactivate both high and low limit alarms When deactivated alarm detection is disabled and the slider is disabled Or Select the Enable Alarm checkbox located below the Low or High Limit alarm scale to activate detection of that alarm limit 3 Using the QuicKnob set the left marker on the slider bar to the required high alarm limit for the SvO2 then set the right marker to the required low alarm 28 8 Mennen Medica Menntor 7 limit These limits are displayed in the High and Low Limit value areas on the panel Or Press Auto Set to Defaults to automatically set alarm limits to default values 5 Press Main Screen to return to the main screen display Settin
350. ght to scroll the trend display forward and Scroll Left to scroll the trend display backward in steps of one third of the trend duration For example if the trend duration is two hours pressing Scroll Right scrolls the trend forward by 40 minutes Use the QuicKnob to select and press the Cursor button The cursor will enable you to View the ST values at the Cursor point 10 9 Reviewing Patient Data Menntor 7 Operating Manual e Set references and Events including setting of start point for Area measurement e Show the ECG waveform at the Cursor point Note the ECG waveform is taken from the Full Disclosure and thus will be available only if the cursor is set on a point of time at which Full Disclosure is available Note that the Full Disclosure is limited to 6 hours 5 days for extended memory Set Reference Figure 10 7 ST Watch Reference Panel 11 Rotate the QuicKnob to move the Cursor to the left or right 12 Either fast or slow movement are available for the Cursor movement 13 Reference key will enable you to select up to three reference ECG waveforms e Set Reference at the location of the Cursor The ECG reference waveform will appear in color in the ECG waveform box e Clear Reference e Exit 10 10 Mennen Medica Menntor 7 Figure 10 8 ST Watch Menu Panel 14 Menu key will open menu with the following functions e Print the ST Watch Panel e
351. h alarm limit The allowed range is 0 300 or Press Auto Set to Defaults to set all NIBP alarm limits to their default values Press NIBP to close the panel and return to the NIBP menu press Main Screen to close the panel and return to the main screen display 21 11 Non Invasive Blood Pressure NIBP Menntor 7 Operating Manual Setting NIBP Alarm Response The NIBP Alarm Response panel controls how the Menntor X7 responds to NIBP alarms NIBP 4 Alarm Response NIBP Alarm Response JE Tones JE Event Strip Figure 21 4 The NIBP Alarm Response Panel To set NIBP Alarm Response 1 From the NIBP menu if you are already in another NIBP panel from the drop down list below the panel title area select Alarm Response 2 Under NIBP Alarm Response e Select the Record checkbox to activate or deactivate recording of the patient s condition during the alarm event By default Record is deactivated e Select the Tones checkbox to activate or deactivate audible alarms By default Tones is activated e Select the Event Strip checkbox to activate or deactivate Event Strip By default Event Strip is deactivated 21 12 Mennen Medica Menntor 7 Operating Manual 3 Press NIBP to close the panel and return to the NIBP menu press Main Screen to close the panel and return to the main screen display Note Checkboxes appear green when activated and gray when deactivated Setting NIBP Display Options
352. harts in the Charts panel Viewing Charts Any chart appearing on the list of available charts can be viewed in the Charts panel Chart types OK 6 JOHN SMIT Charts oe EE Figure 10 9 The Charts Panel Mennen Medical 10 13 Reviewing Patient Data Menntor 7 Operating Manual 10 14 Chart entries are sorted by date and time The most recent entries appear first You can set the time resolution to one of the following values I min 2 min 5 min 10 min 15 min 30 min 1 hr and 2 hr The default time resolution is 10 minutes Each chart entry contains time stamp and status field as well as other relevant data The time stamp appears in date and time format The time is displayed in hours and minutes The status field contains the reason the event is being entered on the chart i e alarm event manual entry etc Entries made at pre configured time intervals are displayed with an empty status field Each field may be displayed in particular color or may be underlined These features represent different attributes Feature Attribute Blue Normal value Red Value during a clinical alarm Green Value during a technical alarm Black User modified field Underlined Part of deleted entry T Value out of range Each chart entry includes all vital sign values at the time of entry Entries are added to a chart according to the following filters e Manual Chart
353. he System Setup menu select Parameter Hierarchy The Parameters list menu is displayed From the Parameters list menu select parameter To promote parameter select Promote To demote parameter select Demote When the required hierarchy is obtained select main screen The display will then be reorganized according to the new hierarchy Mennen Medical D 53 7 Operating Manual Monitor Profiles Setup D 54 When admitting patient the admitting staff member must define which vital signs to monitor and how those parameters appear on the main screen display In order to simplify this process the monitor can be configured with pre defined monitor profiles which include all definitions necessary for admitting various types of patients such as adult pediatric geriatric etc Monitor profiles make it possible to prepare standard patient monitoring profiles allowing staff to connect patient quickly without having to first configure the Menntor X7 or at least to reduce configuration to minimum Up to 12 Monitor profiles can be configured for use in the Menntor X7 This includes 11 user defined monitor profiles and one default Admit as previous key that saves the settings defined for the previous patient monitored by the unit Only those Monitor profiles defined for use in the unit appear on the display screen You can set up Monitor profiles while monitoring an actual patient or you can start the
354. he end of the inspirium If this procedure is not performed Pplat will be equal to zero Pplat 0 The spirometry module will estimate the airway resistance by applying the same formula with the Pplat value equal to zero The resultant formula is thus RES PIP PIF The user should note that under this condition RES is an estimate and not a correct value gt To access Spirometry Alarm Limits 1 2 4 Mennen Medical Select Alarm Limits from the Spirometry menu From the Select Type drop down list select the type of Spirometry parameter for which you want to set alarm limits Select the All Alarms checkbox to activate or deactivate both high and low limit alarms When deactivated the alarm detection is disabled and the slider is disabled Select the Enable Alarm checkbox located below the Low or High Limit alarm scale to activate detection of that alarm limit Using the QuicKnob set the left marker on the slider bar to the required high alarm limit for the current Spirometry parameter then set the right marker to 34 13 Spirometry Menntor 7 Operating Manual the required low alarm limit These limits are displayed in the High and Low Limit value areas on the panel Press Auto Set to Defaults to automatically set alarm limits to default values 5 Press Main Screen to return to the main screen display Alarm Response Purge 34 14 The Alarm Response panel controls the way
355. he right of the EEG waveform The historical quality is shown on the aEEG panel by superimposed quality line with an arbitrary scale of 0 to 5 where zero 0 represents good quality and 5 worst quality or faulty electrode Note The quality units are equivalent to the effect of electrode impedance used by other vendors as follows dl very pe P NUN MH UM TT fe i de Pu M eats TA TT 2 v vr repr ad P Ww nie bias AI tow EEG RIGHT Figure 30 3 aEEG EEG real time CerebraLogik Full Disclosure CerebraLogik records the EEG and aEEG during the entire time the patient is connected to the Menntor X7 and to the CerebraLogik electrodes You can export the full data at the end of the procedure or if desired sections of CerebraLogik recording can be exported before the patient is dismissed You can choose the sections manually See aEEG History Viewing of the exported data is done on any PC using the CerebraLogik Viewer software by Mennen Medical Mennen Medical 30 5 CerebraLogik aEEG and EEG Menntor 7 Operating Manual Operating Menntor X7 Monitor with CerebraLogik Preparing for Operation gt To prepare the CerebraLogik for operation 1 Connect the CerebraLogik to one of the UIM inputs of the Menntor X7 monitor From the Vital Signs menu select the relevant UIM channel Select CerebraLogik and activate Attach the EEG
356. he unit in an atmosphere with flammable anesthetic mixtures The system is designed to have special protection against electric shocks and is defibrillator proof WARNING Do not touch the patient bed or instrument during defibrillation CAUTION Connect the monitor to the main power whenever available Note that when the monitor works on battery a Battery label appears on the display WARNING The use of the ME EQUIPMENT is restricted to one patient at a time Power Failure The monitor is equipped with battery backup to ensure continuous monitoring in case of a power failure However if a prolonged power failure is expected it is strongly recommended to use Un Interrupted Power Supply UPS to ensure continuous monitoring in case of power failure Mennen Medical 2 1 Warnings and Precautions Menntor 7 Operating Manual Minimizing Electrosurgical Interference How Electrosurgery Interference Affects Patient Monitoring An electrosurgery ES device uses voltages which may interfere with the monitored ECG Radio Frequency RF voltages ranging from hundreds to thousands of volts generated by these ES devices are present at the active electrode and are transferred directly to the patient s body during electrosurgery This produces ES interference in one or both of two possible modes The most important is conduction in which case the RF signal is carried on and through the patient s body The other radiatio
357. hen multiple interval is selected or select Multiple Interval to display the drop down list and select the required interval in minutes The available intervals the same as for single intervals 21 8 Mennen Medica Menntor 7 Operating Manual 6 Press Start NIBP to initiate manual NIBP reading The button label changes to Stop Press to stop the measurement and depress cuff reading is not performed 7 Select the Stat Mode checkbox to activate a series of readings performed consecutively during a five minute period Start NIBP is disabled during this time At the end of the Stat Mode period the checkbox is automatically deactived and the Start NIBP button is re enabled 8 Press NIBP to close the panel and return to the NIBP menu press Main Screen to close the panel and return to the main screen display Note Checkboxes appear green when activated and gray when deactivated Selecting the Cuff Type The cuff type used for the currently monitored patient is defined in this panel as Adult ICU Avishai Main Screen NIBP II 2 Cuff Type Cuff Type Adult v Neonatal Figure 21 2 The NIBP Cuff Type Panel Mennen Medical 21 9 Non Invasive Blood Pressure NIBP Menntor 7 Operating Manual To select a cuff type 1 From the NIBP menu if you are already in another NIBP panel from the drop down list below the panel title area select Cuff Type 2 Select the required cuff type for either
358. her BIS dialog panel from the drop down list below the title area select Filter The Filter dialog panel is displayed 2 3 Under Filter Set the Low pass limit By default the Low Pass limit is 70 Set the High pass limit By default the High Pass limit is 1 Set the Noth filter By default the Notch filter is On Set Smoothing Rate 10 15 20 seconds Press BIS to return to the BIS menu Press Main Screen to return to the main screen display Mennen Medical 27 17 BIS Bispectral Index Menntor 7 Operating Manual Sensor Check The Sensor Check tests the impedance of each electrode on the BIS sensor to verify that it is within an acceptable range for monitoring A Sensor Check is initiated automatically by the user by pressing the Sensor Check key The screen shows a sensor with each electrode numbered Colors indicate the status of each electrode e White hollow circle No status is available Lead is off e Green circle The electrode impedance is within the acceptable range Monitoring can begin e blinking circle The electrode impedance is not within the acceptable range Figure 27 9 The Sensor Check Graphic Screen Sensor Type At the top of the panel you will find the sensor type Electrode Check 27 18 Below in this display the impedance value for each electrode in kilo ohms appears on the screen along with its status PASS An electrode passes if the im
359. hic data from the HIS to the monitor progress bar appears on top of the panel The patient information box top left receives green background if demographic data was received from the HIS 3 Press Main Screen to continue Note During the transfer of demographic data from the HIS to the monitor progress bar appears at the top of the panel The patient information box top left has a green background if the demographic data was received from the HIS Note The patient s first name and surname are limited to 15 characters each in all monitors using Latin alphabet and to 7 characters each in monitors with Hebrew name fonts Mennen Medical 9 5 Connecting Patient to Menntor X7 Menntor 7 Operating Manual Change Patients CAUTION Always discharge before admitting monitoring new patient Starting to monitor new patient without discharging can cause various problems e Ifa patient is not discharged from the monitor before admitting a new patient all future patient data will be stored under the name of the FIRST admitted patient e If then a patient will be called by TRANSFER from the list of saved patients without discharging the previous patient the data of from the first patient will be stored under the name of the transferred patient e If patients are monitored without inserting a name and without discharging between patients The first patient with a name will have all the history under his her name
360. ial Display Format Display Format JE WaveForm Trend JE Very Big Numbers JE Very Big Numbers JE VBN Select JE VBN Select Figure 7 1 A Display Controls Panel Figure 7 1 B Display Control Very Big Numbers Adjusting Sweep Speed The common sweep speed for all cardiovascular parameter waveforms can be set in the Sweep Speed box Sweep Speed may be set to any of the following values 6 25 12 5 25 50 and 100 mm sec The system default speed is 25 mm sec Note Respiration sweep speed is set separately in the Respiration Display Options panel 7 2 Mennen Medica Menntor 7 Operating Manual gt To adjust sweep speed 1 Inthe Display Controls panel under Sweep Speed select from the list the required speed The system default is 25 mm sec 2 Press Setup to return to the Setup menu Press Main Screen to return to the main screen display Selecting a Special Display Format Select one of the following display formats e Waveforms and Trend Format displays waveforms and trended data in a split screen format e Regular Format the screen display is divided automatically according to the number of selected parameters 6 Remote etCO2 RSP APNEA ee frue 24 4 37 1 ME pl 15 38 15 53 IA I mm 7 5 165 105 122 I 115 Figure 7 2 Waveforms and Trend Special Display Format gt Toselecta Special Display format 1 From the Main menu select the Setup key Th
361. ical 19 11 Cardiac Output C O Menntor 7 Operating Manual 19 12 Mennen Medica 20 TEMPERATURE Overview Temperature is detected either through the Temp input or from the CO 2 Temp input when Cardiac Output CO is not being monitored Preparatory Checklist If the CO 2Temp input is used insert the 2Temp adapter cable in the CO 2Temp socket Connect the temperature probe Attach the probe to the patient making sure that the probe is secure In the Activate panel make sure that temperature monitoring is activated Change temperature monitoring settings if necessary Temperature monitoring procedures are described in detail in the following paragraph Mennen Medical 20 1 Temperature Menntor 7 Operating Manual Temperature Monitoring Procedures The Temperature panel provides access to the specific dialog panels enabling interaction with all aspects of Temperature and Delta Temperature monitoring Each dialog panel enables control of different aspects of Temperature monitoring The available dialog panels are e Alarm Limits Use this panel to activate and set limits for high and or low limit alarms See Setting Temperature Alarm Limits on page 20 3 e Alarm Response Use this panel to define the way the Menntor X7 visually and audibly responds to a detected alarm See Setting Temperature Alarm Response on page 20 5 e Display Options Use this panel to defi
362. ically typically for 10 seconds approximately once an hour in addition autozero occurs when corrections for changes in temperature and altitudr are required The MicroPod module requires calibration after 1200 hours from first use and then once every 4000 hours or annually whichever comes first The calibration procedure is described in Chapter 5 System Setup of the Service manual Sidestream Monitoring for Intubated Patients Airway adapter and sampling tube sets for both adult pediatric and infant neonatal intubated patients are available gt To perform sidestream monitoring for intubated patients 1 Select the appropriate FilterLine 2 Slide open the FilterLine input connector shutter on the MicroPod and connect the appropriate FilterLine 3 Screw the FilterLine connector into the MicroPod clockwise until it can no longer be turned 4 Connect the FilterLine to the patient according to the Directions for Use supplied with the FilterLine 23 6 Mennen Medica Menntor 7 Operating Manual Sidestream Monitoring of Non Intubated Patients WARNING When delivering O2 to a non intubated patient while monitoring with the MicroPod use a Microstream sampling line with O2 tubing gt To perform sidestream monitoring for non intubated patients 1 2 4 Check or clean the nostrils from secretion Check EtCO2 alarm limits and alarm response Attach the connector of the CO2 sampling line to the
363. ication refer to Chapter 7 Alarms in the Menntor X7 Operating Manual System Setup Alarm Volume amp Controls publ Psi Priority Level EN File Name ciwy 10 20 30 40 50 60 20 10 0 Delay sec Step vol JE Increase Intensity Jnd imn Mmm dd UH HH jun OD ovvonnnnnponnt Figure D 4 The Alarm Volume amp and Controls Panel The panel is divided into two major areas Parameters common to all alarms are located on the left of the panel These parameters include Alarm Color Scheme Suspension Time Silence Time and SpO2 Alarm Tone On the right side of the panel parameters specific to each alarm priority are set These fields include File Name Repeat Every sec End and Init Volume Delay Step and Increase Intensity These parameters remain disabled until an alarm priority is selected description of each Alarm Volume and Control panel field follows Enable Alarm Off Depending on the regulation of each country or institution the option to be able to turn off alarms can be allowed by activating Enable Alarm Off or can be prevented by not activating Enable Alarm Off When the Alarms Off key on the Menntor X7 front panel is pressed all detection of clinical alarms is disabled for pre defined period Technical alarms are still detected and visually displayed in the appropriate area on the main screen Mennen Medica
364. ice engineer Full performance checks including safety checks must be performed by qualified service personnel at least once a year and after every repair The synchronization of the monitor and defibrillator should be checked as often as required by the Hospital Procedures Policy and must be tested at least every three months by qualified service personnel The grounding and equipotential resistances of the monitor and power cables must be tested at least every 3 months checks which require the instrument to be opened must be made by qualified service personnel Safety and maintenance checks can also be made by Mennen Medical personnel Your local Mennen Medical agent will be glad to give you information about service contracts 5 2 Mennen Medica Menntor 7 Operating Manual Battery Conditioning To ensure long battery life condition the battery every three 3 months gt To condition the battery in the monitor 1 Check the battery indicators see Figure 6 3 to confirm that the batteries are fully charged 2 Disconnect the monitor from the AC mains and let the monitor work on battery for at least 2 5 hours or until the battery is fully discharged and the monitor switches itself off 3 Connect the monitor back to the AC mains and wait for the battery to be fully charged Equipment End of life CAUTION Disposal of old equipment that is out of service must take into account the environmental requirement
365. ich triggered the alarm has corrected itself When alarm latching is deactivated the alarm message is removed from the message area once the condition which triggered the alarm no longer exists A latched alarm can be unlatched by pressing either the Silence or Alarms Off key on the front panel Alarm latching is set in System Configuration Default configuration specifies that alarm latching is deactivated Consult your hospital biomedical engineer to see if any alarms are latched on your system Note Only clinical alarms can be latched Alarm Volume Control The master volume for all alarms can be set in the Alarm Master Volume panel which can be accessed from the Setup menu Note The sound pressure level of the high priority C1 and Medium Priority C2 is 83dB CAUTION Set the alarm volume to a level that overcomes the background noise Alarm volumes that are less than ambient levels can impede operator recognition of alarm conditions Mennen Medical 8 7 Alarms Menntor 7 Operating Manual To set alarm master volume 1 From the main menu select Setup The Setup menu is displayed 2 From the Setup menu select Alarm Master Control 3 Select 1 10 to set alarm volume to the required level 4 Select Off to disable audible alarm 5 Press Main to return to the Main menu 6 Press Main Screen to return to the main screen display Alarm Limits Alarm limits for each vital sign being monitored are defined in
366. iest D 72 Enmove M Interface Setup ne e ERR RU ee ele e ost a eae ue ee e PUR D 75 Change Password erans eee ku eee RR e nte edens D 75 Check Disk unus ee HR Ree RN ERR D 76 Permission BEGIOE ette pent tee teste le d ep tei ett eite regne D 77 Remove Saved Patients eate ted e EHE een D 78 Touch Screen Calibration uie dea tiet iter if ae C pe OR M HER Lo let epe epo Lid D 78 Dernio ActVation ie ges debated dandi D 78 Copy Configuration Utility 1 eee Ie ret e ete ete e ete ee ee a Dee Dee D 79 Appendix E Setting Up the Interface Between Vigileo and Menntor X7 Mennen Medical ix 7 Operating Manual Appendix F Test Procedure Appendix G Declaration of conformity to 60601 2 27 x Mennen Medical SECTION 1 INTRODUCTION This section contains the following chapters 1 What You Should Know 2 Warnings and Safety Precaution 3 System Description 4 Installation 5 Maintenance and Cleaning 6 Controls and Functions 7 Operating Manual Mennen Medica 1 WHAT YOU SHOULD KNOW Training Mennen Medical or it s authorized distributer will provide training for the system user as per the intended use of the device or system The training may be personal or by training the trainers The scope of the training is part of the agreement between Menne
367. ime 30 sec typical e Automatic Compensation At least once per hour e Ambient Temperature 0 65 C Humidity 10 9596 non condensing e Barometric Pressure 430 795 mmHg 1250 to 15 000 ft 380 to 5200 meter e Calibration required Initially after 1200 operating hours and then once a year or 4000 operating hours e CO2 Alarm Limits 0 to 100 mmHg 0 to 10 0 to 15 kPa e Respiration Rate Alarm Limits Neonatal 0 to 150 BMP Adult 0 to 50 BPM e Data Storage EtCO2 inCO2 and Respiration Rate values Alarms Apnea Alarm e Exhaust Gas Outlet BIS Interface BISx Technology Bispectral Index BIS 0 to 100 0 no brain activity 100 fully conscious Electromyographic Strength EMG 25 to 100 dB where 1uV 40dB Signal Quality Index SQI 0 to 10096 Suppression Ratio SR 0 to 10096 Spectral Edge Frequency SEF 0 5 to 30 0 Hz Total Power TP 40 to 100 dB 10V2 RMS 40dB Burst Count BC 0 to 30 with an Extend Sensor only EEG Two channel real time EEG waveform Noise EEG Waveform lt 0 3 uV RMS 2 0uV peak to peak BIS Numeric Update Frequency Once per second Band width 0 25 to 100 Hz 3dB Filters High Pass 0 25 1 2 Hz 0 Low Pass 30 50 70 Hz Notch 50 or 60 Hz Impedance Measurement Range 0 to 999 kOhm Data Storage Numeric Chart Graphic Trend and EEG waveform full disclosure CRG trend Display features 0 EEG waveforms EEG waveform Trend of BIS and EMG BIS valu
368. ime delay in seconds until the alarm increases in volume Delay is set on a scale of 10 60 Step vol Sets the increase in alarm volume after each delay Step is set on a scale of 0 20 in units of 4 Increase Intensity Select this checkbox to enable increase in alarm volume If this option is disabled the alarm tone remains at its initial level of volume Setting the Alarm Volume amp Control Panel You can access the Alarm Volume amp Control panel from the System Setup menu To set Alarm Volume and Controls 1 Select the required Alarm Color Scheme D 16 Mennen Medica 7 Operating Manual 2 Selector clear the Enable Alarm Off checkbox as required 3 From the drop down menu select the required Suspension Time for the alarm 4 From the Silence Time drop down menu select the alarm silence time 5 From the SpO2 Alarm Tone drop down menu select the type of alarm tone for SpO2 alarms 6 From the Priority Level drop down menu select the alarm priority level to be configured 7 Print the Message you would like to receive in the event of an external device alarm and press accept 8 From the File Name drop down menu select the alarm tone WAV file for the selected priority level 9 Set the Repeat Every sec scale by moving the slider to the required time period Select Play to hear a sample of the alarm tone Select Stop to end the playback of the alarm tone 10 Under End and Ini
369. ing Intervals Use this panel to control measuring and monitoring of non invasive blood pressure You can specify that a reading be taken at pre set intervals and define those intervals and you can also manually initiate a blood pressure reading See Setting Reading Intervals on page 21 6 Cuff Type Use this panel to define the cuff size used on the monitored patient See Selecting the Cuff Type on page 21 9 Alarm Limits Use this panel to activate deactivate and set NIBP low and high alarm limits You can enable either low or high limits alarms or both See NIBP Alarm Limits on page 21 10 Alarm Response Use this panel to define how the Menntor X7 visually and audibly responds to detected alarms See Setting NIBP Alarm Response on page 21 12 Display Options Use this panel to define how NIBP values appear on the main screen display See Setting NIBP Display Options on page 21 13 Activate Use this panel to activate or deactive monitoring of NIBP See Activating NIBP Measuring and Monitoring on page 21 15 21 5 Non Invasive Blood Pressure NIBP Menntor 7 Operating Manual Accessing the NIBP Menu The NIBP menu can be accessed from the Vital Signs menu or from the main screen display To access the NIBP menu from the Vital Signs menu 1 From Main menu select the Vital Signs key The Vital Signs menu is displayed 2 From the Vital Signs menu select NIBP The NIBP menu appe
370. ing an actual patient or you can start the Menntor X7 without actually connecting a patient set up monitoring parameters and then save them as an Monitoring Profile OK 6 T Monitor Profile 1 Q Co Co Baxter ECG SpO2 CO2 O2 N2O Halothane VENT EEG ECG RSP SpO2 PCWP CVP PAP Monitor Profile 11 Art Pap Alarms ee Eo nsP 102 Monitor Profile 10 No Alarms ECG SpO2 CO2 02 0 Halothane VENT ART ROG Sue MEE Monitor Profile 9 Bussy setup ECG RSP ART PAP ICP SpO2 SvO2 CO ECG ART PAP SpO2 SvO2 TMP1 2 PCWP CVP PAP TMP3 TMP4 CO PCWP CVP PAP tcGas Monitor Profile 8 Monitor Profile 7 ECG ART PAP NIBP SpO2 SvO2 CO PCWP CVP PAP ECG RSP ART 5p02 Label Show Hide Left Right gt Clear Select Key Figure 9 18 The Monitoring Profiles Panel Monitoring Profiles are defined in the Monitoring Profiles panel which can be accessed from the Setup menu The keys are displayed on the panel in the order in which they appear on the Menntor X7 screen when admitting a patient Any defined Monitoring Profiles are labelled with their defined name and monitoring parameters gt To set up new Monitoring Profile 1 Set up the monitoring parameters you want according to the instructions in the Vital Signs Monitoring section 2 From the Main menu select the
371. ing on Memory Full The Trends feature enables you to review data as a graphic representation Trends represent changes in vital signs over time Comparing the patterns of change gives an indication of the patient s progress All vital sign data are available for trending Up to eight vital signs can be trended and displayed at one time on two axes The vital signs can be selected individually or as a related group from the total set available The Menntor X7 can store up to 80 days of trend data Trend display duration times available for selection are 30 min 1hr 2 hrs 3 hrs 4 hrs 6 hrs 8 hrs 12 hrs and 24 hrs time on trend can be selected and the actual readings reviewed The Menntor X7 enables you to zoom in and out of a segment of any length trend condensing or expanding the time displayed You can also select segment of trend and hold and compare it to the other segments of the trend Mennen Medica Menntor 7 Operating Manual The Trend Display panel displays markers in the three top lines of the Trend panel as follows Top line ECG Artifact Marked by a violet pixel Middle line Alarm of any of the parameters is marked in red ECG Alarms Off is marked in blue Lower line Event Manual C O NIBP and PCWP Marked by a blue pixel Note The above markers will be activated only when the HTR trend is active QC320 VLA Moin Patient Data wr Screen Spo2z ART LYL 14 00
372. ing red Replace sensor Blinking red Incompatible sensor Blinking red Artifact Blinking Green BISx and Sensor OK Green Mennen Medical 27 9 BIS Bispectral Index Menntor 7 Operating Manual Monitoring Procedures BIS monitoring is set up through the BIS menu dialog panels Each dialog panel enables controling different aspects of BIS monitoring The available panels are Lead Gain Use this panel to select the required lead and gain for monitoring EEG For details see Setting BIS Leads and Gain on page 27 11 Alarm Limits Use this panel to set BIS alarm limits and criteria For details see Setting BIS Alarm Limits on page 27 12 Alarm Response Use this panel to define the way the Menntor X7 responds to BIS alarm events See Setting the BIS Alarm Response on page 27 13 Display Options Use this panel to configure the way BIS and Quality parameters are displayed on the main screen For details see Setting BIS Display Options on page 27 15 Filter Use this panel to set filter selected for the EEG signal For details see Setting EEG Filter on page 27 17 Sensor Check Use this panel to activate and view the results of the BIS Sensor check Activate Use this panel to activate or deactivate BIS monitoring For details see Activating and Deactivating BIS Monitoring on page 27 20 the above mentioned panels can be accessed from the BIS menu Accessing the
373. input port of the monitor Position the or oral nasal cannula on the patient Intubated Sidestream Monitoring 1 2 3 Check EtCO2 alarm limits and alarm response Place the sampling tube into the patient breathing circuit Attach the connector of the CO2 sampling line to the input port of the monitor Monitoring Procedures The EtCO2 menu provides access to all the specific dialog panels enabling interaction with all aspects of EtCO2 monitoring Each dialog panel controls different aspects of monitoring the levels present during respiration A short description of the panels in the order they appear on the EtCO2 menu follows Mennen Medical EtCO2 Alarm Limits Use this panel to activate deactivate EtCO2 inCO and respiration rate alarms and set high and low alarm limits See Setting EtCO2 Alarm Limits on page 23 10 Scale Select between 0 50 0 75 0 100 mmHg Display Options Use this panel to define how EtCO2 values appear on the main screen display See Setting EtCO2 Display Options on page 23 12 23 7 End Tidal CO2 EtCO2 Microstream MicroPod Menntor 7 Operating Manual Alarm Response Use this panel to define how the Menntor X7 responds to detected EtCO2 inCO respiration rate and apnea alarms See Setting EtCO2 Alarm Responses on page 23 11 e Adult Neonatal Select between Adult and Neonatal Note In System Setup Vital Sign setup NIBP Setup it is possible t
374. inuously the concentration of CO2 N20 and anesthetic agent in a sample respiratory gas The O2 concentration is measured by paramagnetic O2 sensor From these measurements the inspiratory and end tidal end expiratory levels of the gases are derived Changes in gas levels are displayed graphically and the inspired and end expiratory levels are presented numerically CO2 is displayed in either percentages or mmHg Other gases are given in percentages 4 1 0 0 14 TT Apnea Int 20 Apnea Event PL LL A Figure 24 1 Main Screen Display of Anesthetic Agent Waveform The module uses Sidestream monitoring in which a tube is attached to the patient s airway circuit Respiratory and anesthetic gases are then drawn into the tube and sent to IR and paramagnetic sensors in the measuring devices The unit performs automatic barometric pressure compensation to adjust the reading for changes due to pressure fluctuations The system incorporates an internal pressure transducer that measures barometric pressure continuously Mennen Medical 24 1 Multigas Anesthesia Analyzer Menntor 7 Operating Manual The pressure transducer also compensates for pressure changes caused by the sampling pump The effects of humidity are eliminated by passing the air through water trap filter and Nafion drier Intended Use The Menntor X7 s anesthetic gas module is intended for use during anesthesia procedures The module uses real time
375. iod e List of alarms during the ten second period with a time stamp for each alarm 10 22 Mennen Medica Menntor 7 Operating Manual e To operate the Overview panel 1 change the cursor resolution select a different resolution from the Cursor drop down list Available options are 1 sec 500 msec 250 msec 125 msec 62 5 msec and 31 25 msec 2 Tochange the gain factor of the ECG display select a different factor from the Gain drop down list Available options are Imv cm and 2mv cm 3 To scroll forward five seconds press Move Right Waveforms and data specific to the new time period appear 4 To scroll back five seconds press Move Left Waveforms and data specific to the new time period appear 5 To scroll continuously through the waveforms press Scroll and use the QuicKnob to move the cursor forwards or backwards Data related to the on screen waveforms appear 6 To view the waveforms and related statistical data for a specific ten second period press Go To and enter the required date in the Date dialog panel and start time in the Time dialog panel Make sure the required date and start and end times fall within the time span of stored data 7 To print the Overview panel press Print Key on the top of the panel 8 From the Patient Data drop down menu select Charts Trends or Full Disclosure The Overview panel closes and the selected panel opens displaying data for the time frame displayed in the Overvi
376. ion Rate e VT Tidal Volume e MV Minute Volume e PIP Peak Inspiration Pressure e MAP Mean Airway Pressure e PEEP Positive End Expiratory Pressure e RES Resistance e COMP Compliance e PLTP Plateau Pressure EZ Flow TM Flow Airway Adapter Specifications e Flow Range 2 180 Ipm 33 3000 ml s e Accuracy 5 reading or 0 5 Ipm e Dead Space 6 9 ml e Flow L min Range Adult 2 0 to 180 Accuracy Greater of 0 5 LPM or 3 of reading e Tidal Volume ml Range Adult 200 to 3000 Resolution Adult 1 ml o Volume Accuracy Greater of 10 ml or 3 of reading e Respiration Rate breaths min Range Adult 2 to 120 Accuracy Adult 1 e Airway Pressure cm H20 Range Adult 120 to 120 Resolution Adult 0 1 cm H20 Accuracy Adult 2 of reading Mennen Medical Ltd All rights reserved Specification subject to be changed without notice We follow every beat of your heart f medical since 1963 CerebraLogik Specification The CerebraLogik is dual channel EEG amplifier with Amplitude Integrated EEG aEEG recording and display capability It is used as front end EEG amplifier interfaced to Menntor X7 Monitors where EEG and aEEG can be displayed and stored simultaneously with all patient vital signs monitored on the Menntor X7 CerebraLogik Module CerebraLogik interface to Menntor X7 with Monitor mass storage 16GB e HxWxD 140 95 mm 5 5 3 7 1 2 inc e Weight
377. ion of a Monitoring Profile The Monitoring Profiles are arranged on the Monitoring Profile panel in the positions where they will appear on the main screen The keys can be moved to any position that is most convenient for you To move an Monitoring Profile 1 In the Monitoring Profiles panel press Select Key 2 Turn QuicKnob and press the key you want A frame appears around the key indicating that it is selected 3 Press Right to move the selected Monitoring Profile clockwise press Left to move the key counterclockwise Clearing a Monitoring Profile 9 22 A previously defined Monitoring Profile may no longer suit your monitoring needs In that case you can simply clear the Monitoring Profile from the Menntor 7 To clear Monitoring Profile 1 In the Monitoring Profiles panel press Select Key Mennen Medica Menntor 7 Operating Manual 2 Turn the QuicKnob until you reach the key you want to clear and press A frame appears around the selected key 3 Press Clear The Monitoring Profile is removed from the Monitoring Profiles panel and will no longer appear on the main screen when admitting patient Mennen Medical 9 23 Connecting Patient to Menntor X7 Menntor 7 Operating Manual 9 24 Mennen Medica 10 REVIEWING PATIENT DATA The Patient Data menu contains options that enable you to review patient data stored in the Menntor X7 in different formats These options
378. ions and certain patient conditions WARNING If calibration does not take place as instructed the monitor might be out of calibration monitor that is out of calibration might provide inaccurate results CAUTION To ensure accurate performance and prevent device failure do not expose the module to extreme moisture such as rain CAUTION If the MicroPodTM sustains structural damage so that its internal components are visible it should not be used Mennen Medical 23 21 End Tidal 2 EtCO2 Microstream MicroPod 23 22 CAUTION CAUTION Menntor X7 Operating Manual An extension cable should not be used with either the USB version or the RS 232 version of the MicroPod M Exercise care when removing the MicroPod from a mount so that your finger does not get caught in the clip during removal Note When disconnecting a sampling line from the device hold the CO2 input connector door open while removing the sampling line to avoid catching the sampling line on the connector door Note During use the MicroPod should be mounted with the CO2 connector facing upwards or to the side WARNING CAUTION CAUTION CAUTION WARNING WARNING WARNING Do not use the FilterLine H Set Infant Neonatal during magnetic resonance imaging MRI scanning Using the FilterLine H Set Infant Neonatal during MRI scanning could harm the patient During MRI scanning the module must be placed outside th
379. ions as an on screen key Select the Patient ID area to access the Patient Identification panel Parameter Keys Parameter keys display the name of the vital sign being monitored The key also functions as an on screen button Select a parameter key to access the relevant parameter menu QuicKeys If a QuicKey has been configured for a function press on the QuicKey to display the relevant menu or dialog panel From the Main Menu Vital Signs Select Vital Signs to access the Vital Signs menu The Vital Signs menu enables you to access the dialog panels of all monitored Vital Signs and to view the Alarm Status panel see page 8 9 The Vital Signs menu displays the available vital signs supported by the Menntor X7 The Vital Signs menu also displays inputs such as CO Temp The user can assign names to the Blood Pressures and Temperatures For example the unassigned BP is marked as follows BP1 Unassigned This changes from Mennen Medical 6 17 Controls and Functions Menntor 7 Operating Manual BP1 to ART when the user assigns the ART location to input 1 Zero All Pressure key appears at the end of the vital signs list TEKNOR BEDI Main ART 4 1 7 T1 234 BP UNASSIGNED 4 2 Figure 6 9 Vital Signs Menu Setup Select Setup to display the Setup menu panel This menu panel gives you access to the following setup functions Table 6 2 Setup Functions
380. ions menu select the required physiological panel e Hemodynamics e Respiratory Mechanics e Oxygenation e Renal Clearance The required panel opens displaying the patient s monitored data Measured values monitored and manually entered data Calculated values Ranges of and indexes normal values Calculations HRT 70 BPM TM21 37 0 RSP 19 BPM TM22 37 0 C Cardiac Index Stroke Volume SYSTOLIC DIASTOLIC MEAN GENE ise aw ns foo duo ee Systemic Vascular Resistance Pulmonary Vascular Resistance PAP 170 40 50 eee cardiac Work cv is rcwe l20 Left Ventricular Stroke Work Right Cardiac Work Right Ventricular Stroke Work Co 4 0 uM BSA16 00 TIVE 14 22 DATE 05 22 99 Hemodynamics INDEX NORMVAL NORMIND 30 40 V157 1 095 mi 35 70 TSR 2200 TSR 13200 bvw secicw SVR pvw sEcicM 110 1500 20 120 Low LVSWJ699 LvswI WA row 1 90 row ETE KG M Figure 11 1 Example of Physiological Calculation Panel The left side of the panel displays the Measured values monitored by the Menntor X7 Here you can manually enter any missing data or edit and update existing values Once you enter or edit data the right side of the panel displays the Calculated values The Hemodynamics Oxygenation and Renal Clearance calc
381. ious keys to move from one section to other Data Storage and Export CerebraLogik data can be exported to external PC software dedicated for viewing data In addition to CerebraLogik data also all data stored in all Menntor X7 monitors can be exported Waveforms Full disclosure and Overview Event Strips numeric Vital signs chart and Alarms 30 20 Mennen Medica Menntor 7 Operating Manual Exporting to DSD It is possible to Export patient data to DSD Disk on Key via the USB port For Monitored patients it is possible to Export sections of the EEG aEEG with the numeric Vital Signs HR BP BMP etc at the time of the cursor Saved and Discharged patient data Export can be performed during monitoring of another patient or when the monitor is at Discontinue or Discharge mode CAUTION The DSD disk on key must be dedicated to CerebraLogik and Menntor X7 data Do not keep on this DSD any other files such as data taken from Window PC systems Word files images video etc Exporting aEEG Sections to DSD or Network gt To export aEEG sections 1 From EEG menu select aEEG Sections A list of available sections is displayed 2 Use the Quicknob to click on a section and use Select Unselect to select the section or sections for Export or Press Export All to send all sections This requires entering a password 2334 Notes 1 You need a patient name to Export If Patient Information is missing a panel op
382. is set by the System Administrator under the Timeouts panel and is the same setting as for any Full Panel namely 1 2 4 or 10 minutes The default timeout setting of the factory is 2 minutes It is possible to manually select continuous display of the remote bed no timeout To do so go to System Setup General Settings Timeouts and select none To remove the continuous remote display press the Main Screen button on the front panel Mennen Medical 7 17 Setting Up the Patient Display Menntor 7 Operating Manual 7 18 Mennen Medica CHAPTER 8 ALARMS General Features Alarms are detected by each Menntor X7 input according to pre configured alarm settings The information is sent to the main processing unit for verification to avoid false alarms When an alarm is triggered the following occurs e An audio signal and a visual display on the main screen are generated e An alarm event entry is automatically stored in the charts e Peripheral devices such as recording an event are activated When the condition which triggered the alarm has passed the monitor immediately sends a stop alarm message to the main processing unit The monitor then removes alarm notification depending on the latched status of the particular alarm See Latched Alarms on page 8 7 Alarms can also be documented and stored in the monitor for future reference and or printed out WARNING Patient monitor alarms do not treat the patient s co
383. itoring of mechanically ventilated adult and pediatric patients or for adult and pediatric patients able to breathe spontaneously In both cases breathing is via a tracheal tube or mask The module is to be used only for patients with tidal volumes greater than 100 ml The basic application of the Spirometry module is to provide a display of the Respiratory Mechanics waveforms and loops on the Menntor X7 patient monitor if they are not displayed on an external Ventilator In addition the Menntor X7 can store the spirometry parameters and clinical data in Charts and Trends together with the patient data of other vital signs measured by the Menntor X7 monitor The user can thereby determine the correlation between the respiration mechanics data and the data of other vital signs Note The user has the choice of activating or disabling alarms for the Spirometry module The user can set the alarm limits and the alarm response via the alarm limits and the alarm response panels of the Spirometry module Spirometry is measured by means of a device called Pneumotachograph that converts air flow into pressure gradient and enables the recording of air flow to and from the lungs For continuous Spirometry monitoring we use a disposable plastic tube with some resistance to air flow The pressure drop on the resistance is related to the air flow The air volume signal is received by integration of the air flow signal In parallel also the airw
384. its For certain vital signs this area may display special information such as e Heartbeat symbol e Plethysmograph indications Timer indicating when the next measurement is due e Date and time stamps for periodic measurements The values that appear for each vital sign are described in the section devoted to the individual vital sign Extended Primary Vital Sign Area When the height of the parameter slot is more than the minimum 30mm for ECG 20mm for non ECG parameters the extra space created is called the Extended Primary Vital Sign Area This space is used to display additional information such as sub parameters calculated values etc Waveform Area In this area waveforms and waveform related data is displayed Up to eight waveforms can be displayed The display area for ECG waveforms is larger than that allocated to non ECG vital signs This allows the Menntor X7 to display more than one ECG waveform In special cases other continuous data display formats such as charts or trends can be presented in this area Mennen Medical 6 7 Controls and Functions Menntor 7 Operating Manual Big Numbers Feature The Big Numbers display option is an intermediate level between the waveform display and the Secondary Vital Sign display When Big Numbers is selected the parameter appears in the Primary Vital Sign area without the waveform The value appears much larger and more apparent to the viewer than values displayed in the Se
385. ivating or deactivating alarm latching defining Alarm Detection delay and selecting the default color for Temperature values Mennen Medical Temperature Alarm Priority Alarm priority affects the order of audible and visual alarm notification See Alarm Priority on page 8 4 for a full description of this feature Temperature alarm priority can be set to C 1 C 2 C 3 or C 4 The factory default is C 4 D 35 D 36 Menntor 7 Operating Manual Alarm Latching For a complete description of Alarm Latching refer to Chapter 7 Alarms in the Menntor X7 Operation Manual The available options are Off Visual latching visual alarms only and On both visual and audible alarms The factory default is Off Alarm Detection Delay When an alarm is detected a pre defined delay period allows the system to check in order to avoid false alarms The delay can be set to 3 5 10 15 or 20 seconds The factory default is set to 5 seconds Units Defines the default units used to measure and display temperature The available options are Celsius or Fahrenheit The factory default is Celsius Temperature Default Color Defines the color in which Temperature values appear on the main screen display You can choose from 16 available colors VS Semp Mate Extended Alarm Response Priority Temp GE B i Units Celsius ES T2 Latching Off Alarm Detection Delay 5 sec Temp Defuakt Color Figure
386. k Electrodes Monitoring Procedures EEG monitoring is set up through the EEG menu dialog panels Each dialog panel enables controlling different aspects of EEG monitoring Display Options Filter Alarm Response aEEG History aEEG Sections aEEG Sections History Activate Figure 30 5 EEG menu 1 El Dib M Change T Tsuchida TN Clancy RR Amplitude Integrated electroenceph alograpy in neonates Pediatr Neurol 2009 41 315 326 Mennen Medical 30 7 CerebraLogik aEEG and EEG Menntor 7 Operating Manual The available panels are listed in the following table Table 30 2 Menu Option Description Lead Gain Use this panel to select the required lead and gain for moni toring EEG See Setting EEG Leads and Gain Display Options Use this panel to configure the way EEG and aEEG are dis played simultaneously on the main screen See Setting EEG and aEEG Display Options Filter Use this panel to set selected filter for the EEG signal See Setting EEG Filters Alarm Response Use this panel to define the way the Menntor X7 Series responds to technical alarm events aEEG History Use this panel to view the historical aEEG and EEG at the cursor location Note Itis recommended to create a Quickey for aEEG History aEEG Sections A list of aEEG sections that provides access to section viewing in aEEG Section History and export of sections to a USB storage device aEEG Sections
387. l carbon dioxide EtCO2 inspired carbon dioxide inCO2 and Respiration Rate The LED indicator on the front panel of the monitor describes the functional status of the EtCO2 Status Indication LED is green and on EtCO2 is fully functional and monitoring LED is red and blinking EtCO2 is warming up LED is red and on Technical fault i e cable connected incorrectly Mennen Medica Menntor 7 Operating Manual Microstream EtCO2 Circuits FilterLine The FilterLine has four active elements that work together to offer solution to the problems that have previously posed challenges to capnography in ICU emergency and transport applications These elements are described below Hydrophobic filter The hydrophobic filter is located at the end of the sample line that is closest to the capnograph This filter strips the remaining water vapor from the gas sample while keeping laminar flow of the gas This laminar flow minimizes distortion of the CO2 waveform This filter is made of 0 45u hydrophobic porous media that reduces biological contaminants Drying Element The drying element is tube made of synthetic material that is chemically stable and has high water absorption This material allows the water vapor to pass outside the tube thereby adjusting the humidity inside the FilterLine close to the level of humidity in the ambient air Sample Line The sample line has low dead space due to its
388. l Signs menu select Spirometry The Spirometry menu appears with the following items Show Loop Use this key to show or hide Spirometry loops Show WF Use this key to show or hide Spirometry waveforms Show Table Use this key to show or hide Spirometry VS Table VS Vital signs Note If the Ventilator interface is activated then the Show Table key is dimmed and cannot be used e Full Panel Loop Use this key to display a Full Panel loop e Set Loop Use this key to set the loops to be displayed e Set WF Use this key to set the waveforms to be displayed e Set Table Use this key to set the Spirometry Table Alarm Limits Use this key to activate deactivate Spirometry alarms and define Spirometry alarm limits 34 8 Mennen Medical Menntor 7 Operating Manual Alarm Response Use this panel to define alarm response by tone or recording e Purge Use this key to activate the purge pump e Activate Use this key to activate deactivate Spirometry monitoring Acessing the Spirometry Menu Items Full panel Loop gt To access the Full panel loop 1 Select Full panel loop from the Spirometry menu in order to display the spirometry loops on the full panel 2 The display has a time out of two minutes or 3 Press Main Screen to return to close the Full panel loop Set Loop To access the Set Loop panel 1 Select Set Loop from the Spirometry Display Option menu in order to display the
389. l Signs menu appears 2 From the Vital Signs menu select ECG and then select ST The ST menu appears Mennen Medica Menntor 7 Operating Manual gt To access the ST menu from the main screen display Turn the QuicKnob until the ST parameter key if available is highlighted and press The ST menu is displayed Activating ST Monitoring Use the Activate panel to activate or deactivate ST monitoring gt To activate or deactivate ST monitoring 1 From the ST menu if you are already in another ST panel from the drop down list below the title area select Activate 2 Select the Activate checkbox to activate or deactivate ST monitoring By default ST monitoring is activated Note The checkbox appears green when activated and gray when deactivated 3 Press ECG to close the panel and return to the ECG menu press Main Screen to close the panel and return to the main screen display Setting ST Alarms ST alarm parameters are set in two dialog panels Alarm Limits and Alarm Response Each dialog panel controls a different aspect of ST alarms Setting ST Alarm Limits Use the Alarm Limits panel to activate deactivate ST alarms and set high and low alarm limits Selecting an ECG lead in the Select Type box activates the corresponding panel containing the current high and low alarm limits as well as the currently measured value for the selected lead Mennen Medical 16 3 ST Segment Analysis Menntor 7
390. l fluid volume in the IV bag Formula 1 If dose rate is given in units of mg Kg min e Total Dose Rate gram hour Dose Rate gram Kg minute x Patient Weight x 60 e Required Concentration gram CC Total Dose Rate Gram hour Infusion rate CC Hour e Amount of Medication gram Required Concentration Gram CC x Fluid Volume CC Formula 2 If dose rate is given in units of gram time e Total Dose Rate gram hour Dose Rate mg minute x 1000 x 60 e Required Concentration Gram CC Total Dose Rate Gram hour Infusion rate CC hour Amount of Medication Gram Required Concentration gram CC x Fluid Volume CC Calculating the Injection Amount 12 2 The amount of prepackaged drug that should be injected in order to achieve the desired dose can be calculated based upon the drug concentration or amount and the desired dose ntect Volume CC Desired Drug dose mg Package Drug concentration mg CC Mennen Medica Menntor 7 Accessing Medications gt To access Medication Calculation functions 1 2 3 On the Menntor X7 Main menu press the Patient Data key In the Patient Data menu select Calculations In the Calculations menu select Medications The Medication panel appears displaying a list of drugs The QuicKnob may now be used to select the medication to be acted upon mme 0 TIME 14 36 paTE 02 03 99
391. lect the Current Interval S D M Label and or Units checkboxes to activate or deactivate display of these values as required Each can be activated or deactivated separately Press NIBP Color and from the panel that appears select the display color for all NIBP values on the main screen Press NIBP to close the panel and return to the NIBP menu press Main Screen to close the panel and return to the main screen display Note Checkboxes appear green when activated and gray when deactivated Activating NIBP Measuring and Monitoring NIBP measurement and monitoring is activated or deactivated in the NIBP Activate panel To set the Activate panel 1 From the NIBP menu or from the drop down list below the NIBP panel title area select Activate Select the Activate checkbox to activate or deactivate NIBP monitoring By default monitoring is activated Press NIBP to close the panel and return to the NIBP menu press Main Screen to close the panel and return to the main screen display Checkboxes appear green when activated and gray when deactivated Mennen Medical 21 15 Non Invasive Blood Pressure NIBP Menntor 7 Operating Manual Technical Messages Technical Message Code Reason for Message 3 Zero pressure detected 9 Hardware failure 11 Pump failure adult cuff used in neonatal mode 12 Diastolic BP too low to measure 13 Motion artifact 14 Inflation not sufficie
392. led anesthetic at one atmosphere that prevents skeletal muscle movement in response to a noxious pain stimulus in 5046 of patients MAC represents a relative measure of depth of anesthesia It can be used to compare inhaled anesthetics and is a useful index of anesthetic potency Approximately 1 3 MAC prevents skeletal muscle movement in nearly all patients during surgery Mennen Medical 25 17 Anesthetic Gas Monitoring Menntor 7 Operating Manual 25 18 The MAC is Calculated by the Formula EX AA 96 EtN20 MAC AA Hut Where x AA is parameter defined in the System Setup of Vital Signs for Agent Setup With the following default values X AA Hal 0 75 Enf 1 7 Iso 1 15 Sev 2 05 and Des 6 0 The parameters can be changed by entering the System Setup password protected MAC value is displayed in the N20 and Anesthetic Agent big numbers area MAC Calculation example Ex Hal 1 2 EtN20 60 MAC 1 2 0 75 60 100 2 2 Mennen Medica 26 VENTILATOR Overview The Menntor X7 Patient Monitor connects to the auxiliary Ventilator device via the Uniport Input UIM on the back panel of the Menntor X7 monitor The UIM plugs are equipped with a serial data input for receiving patient data and waveform information from the ventilator device for direct display by the Menntor X7 Monitor The Menntor X7 is able to display data from the ventilator including status and
393. ll serve as a stand alone trans port monitor e Monitor Profile and alarm setting are fixed as received from the host e Upon return to the host the data collected during the transport will merge with the data collected by the host CPU Detail Arm Cortex A8 AC97 Sound Card 2W audio power 8 ohm Mass storage 2 GB Operating System Linux and TI CCD Dimension Weight HxWxD 170 x 80 x 225 mm 6 7 x 3 0 x 8 8 inches Weight 1 4 Kg 3 08 Ib Display optional LCD 640 x 480 5 7 optional ECG One Waveform display horizontal area 82 mm o HR height 20 mm Power Battery operated e Lithium Ion 16 8 VDC 2 6 e Operation Time 5 Hours e Charge Time 4 Hours from host Environmental Operating Conditions e Temperature 5C to 40C 41 F to 1049F Humidity 10 to 93 percent non condensing User Controls 5 Fixed keys Silence Event Mark IBP Zero NIBP On Off Data Storage Storage time Demographic Data Numerical Vital Sign Full Disclosure All leads ECG waveform Overview All Waveforms with top ECG Event Strips for each event 20 Seconds of all ECG and Vital signs waveforms 10sec pre amp post event Alarms Alarm levels 9 Clinical levels C1 C2 C3 C4 9 Technical levels T1 T2 e Visual and Audible alarm e Battery Status Alarm Numeric Display e 4areas Big Numbers boxes 9 horizontal area 58 mm 0 vertical area 30 mm e Vital Signs Wavefor
394. lor for all EtCO2 values on the main screen display You can choose from 16 colors The default color is green Select units Unit can be selected between mmHg and KPa 23 13 End Tidal 2 EtCO2 Microstream MicroPod Menntor 7 Operating Manual IPI 23 14 7 Press EtCO2 to close the panel and return to the EtCO2 menu press Main Screen to close the panel and return to the main screen display IPI the Integrated Pulmonary IndexTM is numerical value which integrates four major patient parameters to provide simple indication of the patient s overall ventilatory status The integrated parameters are EtCO2 RR SpO2 and PR Since the IPI uses data from the monitoring of both CO2 and SpO2 it is only available when both parameters are available and RR and PR are being calculated from these parameters IPI is calculated using the current values of these four parameters and their interactions based on known clinical data IPI can thus provide an early indication of change in ventilatory status which may not be shown by the current value of any of these four parameters individually The IPI is designed to summarize information regarding patient status possibly before EtCO2 RR SpO2 or PR values reach levels of clinical concern IPI values range from 1 to 10 values should be understood according to the following table Table 23 1 IPI Index Values Index Patient Status 10 Normal 8 9
395. lows the system to check in order to avoid false alarms The delay can be set to 3 5 or 10 seconds The factory default is set to 5 seconds eApnea Reset Defines the default number of breaths the system uses to reset the apnea timer The available options are 2 breaths 3 breaths and 4 breaths Mennen Medica 7 Operating Manual eDefault Color Defines the color in which Respiration vital signs values and waveforms appear on the main screen display You have choice of 16 colors The factory default color is green Respiration Setup Extended Alarm Response Priority Resp C3 Apnes C2 0000 Y Emm _ Latching Alarm Detective Delay 5 ser s Ex IH bei Rap Default Coloc MENS Figure D 9 The Respiration Setup Panel gt To define Respiration default parameters 1 From the System Setup menu select Vital Signs Setup The Vital Signs menu is displayed 2 From the Vital Signs menu select Respiration Setup The Respiration Setup dialog panel is displayed 3 Under Extended Alarm Response From the appropriate drop down list set the default priority levels for Resp Rate and Apnea From the Latching drop down list set default alarm latching to On or Off 4 From the Alarm Detection Delay drop down list select the required delay time in seconds 5 From the Apnea Reset drop down list select the number of breaths required
396. m event By default Record is deactivated e Select the Tones checkbox to activate or deactivate audible alarms By default Tones is activated e Select the Event Strip checkbox to activate or deactivate Event Strip By default Event Stripis deactivated 3 Repeat the above procedure under inCO Alarm Response Resp Alarm Response and Apnea Alarm Response 4 Press EtCO2 to close the panel and return to the EtCO2 menu press Main Screen to close the panel and return to the main screen display Note Checkboxes appear green when activated and gray when deactivated Setting EtCO2 Display Options The Display Options panel controls how EtCO2 values are displayed on the main screen display Any changes made immediately update the main screen display none enAAI4BF Main Screen e CO2 Display Options Display Are GE Sweep Speed 6 25mm ser Units nung Display Features F Grid M Resp Rate H inco2 Alarm Limits Apnea Information Display Units F Display Labels eco2 Color 4 Figure 23 5 The EtCO2 Display Options Panel 23 12 Mennen Medica Menntor 7 Operating Manual gt To set display options 1 Mennen Medical From the EtCO2 menu or if you are already in another EtCO2 panel from the drop down list below the panel title area select Display Options From the Display Area drop down list select the area on the main screen display where you want the EtC
397. m height 11 mm 9 Numeric Vital Signs height 15 mm Sweep Speed 6 25 12 5 25 50 100 mm sec nominal Single parameter modules e EtCO2 e Spirometry Dimension Weight HxWxD 95 x 40 x 120 mm 3 7 x 1 6 x 4 7 inches Weight 0 3 Kg 0 6 Ib 57 MPM Mounting Optional DGM 781 001 Rev C 11 2014 Page 2 5 mennen f medical G 3 5 12 Lead Leads ECG cables for 3 5 12 lead surface ECG with defibrillation protection in the cable Input Dynamic Range 5 mV peak to peak Input DC Offset 530 mV Baseline Correction Automatic recovery of waveform within 100 msec Notch Filtering 50Hz or 60Hz Frequency Response Diagnostic 0 05 to 150Hz Monitoring 0 5 to 40Hz 0 ST 0 05 to 40Hz 0 Exercise 1 to 25Hz Sensitivity 0 25 0 5 1 0 2 0 4 0 8 0 mV cm nominal Common Mode Rejection 120 dB minimum Noise 30 Input Impedance 2 5 megaQ Defibrillator Pulse Protection Yes Baseline Recovery lt 8 sec Lead Fault Sense Based on impedance with driven lead Sense current lt 90 nA DC Digital Sample Rate 640Hz Sample Resolution 24 bit Pacemaker Detection and Rejection of Pacer Artifact Amplitude 2 mV to 700 mV Width 0 1 ms to 2 0 ms Pacer Detection Flag inserted into ECG waveform 3 Detection Modes 1 Fixed Threshold 2mV 2 Adaptive 1 Threshold YamV High Sensitivity 3 Adaptive 2 Threshold 2mV High Immunity Auto Cable Detection e Audio Indicator QRS Beep Adjust
398. m the drop down list below the title area select Sensor check The sensor check will start 2 Atthe end of the check procedure the measured impedance will be displayed on the panel with Green color for Pass and Red color for fail See Figure 27 9 3 Press BIS to return to the BIS menu Press Main Screen to return to the main screen display Mennen Medical 27 19 BIS Bispectral Index Menntor 7 Operating Manual ICU Mode Recommended Setting When the ICU Mode is used use the following settings 1 Set BIS Smoothing Rate to 30 Second 2 BIS Trend interval is set to 60 minutes on both Waveform Trend and or CRG Activating and Deactivating BIS Monitoring 27 20 BIS monitoring can be activated or deactivated in the Activate panel You can also temporarily discontinue monitoring for whatever reason and resume monitoring at a later time To activate deactivate BIS monitoring 1 From the BIS menu if you are already in another BIS dialog panel from the drop down list below the title area select Activate The Activate dialog panel is displayed 2 Selectthe Activate checkbox to activate or deactivate BIS monitoring 3 Press BIS to return to the BIS menu Press Main Screen to return to the main screen display Mennen Medica Menntor 7 Operating Manual BIS Monitoring Profile Following are some examples of recommended Monitoring Profiles used to display BIS parameter BIS enABO04F 120 81 93
399. main screen display 1 When SpO2 is displayed in a parameter slot in the primary display area waveform area turn the QuicKnob until the SpO2 parameter key is highlighted The parameter key functions as an on screen button Press the QuicKnobTM to select the parameter key and access the SpO2 menu 2 When SpO2 is displayed in the Secondary Vital Sign area or in Big Number format turn the QuicKnob until the SpO2 value is highlighted and press to select The SpO2 menu appears Setting SpO2 Alarms SpO2 alarm parameters are set in three dialog panels Alarm Limits Pulse Rate Alarms and Alarm Response Each dialog panel controls a different aspect of SpO2 alarms Setting SpO2 Alarm Limits Use this panel to activate deactivate and set low limit SpO2 alarms The current low alarm limit as well as the currently measured SpO2 value are displayed on the panel The current SpO2 saturation value is marked on the scale 22 6 Mennen Medica Menntor 7 Operating Manual RICU BED Main Screen SpO2 6 High Limit Low Limit 100 os 90 E 85 75 n s lt 50 All SpO2 Alarms EE Figure 22 2 The SpO2 Alarm Limits Panel gt To set SpO2 alarm limits 1 From the SpO2 menu or if you are already in another SpO2 panel from the drop down list below the panel title area select Alarm Limits 2 Using the QuicKnob move the slider bar on the alarm limit slider bars al
400. maintenance must be performed in accordance with Mennen Medical specifications Power Interruptions 6 2 In the case of a power failure the monitor will automatically convert to battery power The Menntor X7 will work on battery power for up to 3 hours 6 hours with optional dual battery If power is switched off the system retains the parameter setup for the monitored patient When power is restored Menntor X7 resumes monitoring according to the patient s setup Alarm Limits and Alarm Response are restored automatically Note All stored data Chart trend Full disclosure and alarm notes are recovered after power interrupts Note Check all monitor settings after any power off Mennen Medica Menntor 7 Operating Manual Main Screen Display Features E 6202 15 308 tet 60 50 PVC RUN BGM STN 09 STVI ev Kc vt Lend RA LL Lest Aga NARR 118 79 91 2 138 100 m 3 123 75 I I n 2418 d ad br 5 ogi 2 17 e 70 MN NBG A 050800 1528 E E E ER Figure 6 2 Main Screen Display d v Econ E The main screen display is divided into four areas e Global Header e Patient e Patient Display e QuicK Keys Mennen Medical 6 3 Controls and Functions Menntor 7 Operating Manual Global Header Area Hospital or unit name Alarm message area Date
401. mary monitoring display for the Auxiliary Device The Auxiliary Device should always be considered the primary monitoring source Should any discrepancy arise between the Auxiliary Device and the Menntor X7 Monitor the Auxiliary Device always takes priority UIM Input as Vigilance Vigileo PICCO The input can detect and provide the following e CO and value e Vigileo amd PiCCO e SvO2 value e Clinical Alarm Processing e Technical Alarm Notification e Storage of all additional parameters Mennen Medical 28 3 CO CCO SvO2 Menntor X79 Operating Manual CO CCO Monitoring Procedures The CO menu provides access to specific dialog panels enabling interaction with all aspects of CO CCO monitoring Each dialog panel enables control of different aspects of CO CCO monitoring The available dialog panels are Aquire Note Dimmed not in use Edit Curve Note Dimmed not in use Alarm Limits Use this panel to activate deactivate CO alarms define CO alarm limits See Setting CO Alarm Limits Note that CO alarm is only relevant for Continuous Cardiac Output Alarm Response Use this panel to define the way alarms are heard and displayed on the monitor See Setting CO Alarm Response Patient Identification Dimmed not in use Display Options Use this panel to define how CO values appear on the main screen display See Setting CO Display Options Activate Use this panel to activate dea
402. me appears alternately in the same area Message Status Alarm Tone Off All Alarm Off Storage Full Memory reached storage limit Low Battery Battery is nearly empty Note In the battery nearly empty status the LED at the bottom right flashes red in Mennen Medical addition to the Low Battery message 33 3 MX57 as Transport Monitor Menntor 7 Operating Manual MPM Display Configuration If the host is in VBN the vital signs display is duplicated to the MPM see Figure 33 1 If the host is in Linear display mode the VS numeric and waveform are entered in the VBN boxes according to the Vital Signs hierarchy in the following sequence Top Right Top Left Bottom Right Bottom Left Note It is not possible to change Vital Signs Display option ECG lead or alarm limits on the MPM MPM Display Rotation Rotating the MPM changes the display from the horizontal display shown in Figure 33 1 to a vertical display A d Figure 33 2 MPM out of host Vertical View Note It is possible to disable MPM rotation in System Setup this fixes the horizontal view see Figure 33 1 33 4 Mennen Medica Menntor 7 Operating Manual MPM Hardware Keys Functionality Table 33 1 Key Functionality Key Function Press for a short period to silences the alarm for the duration set on the host Menntor X7 and or toggle the alarm back to sound Press for a long
403. me but came from the same host it is possible to enter a name or delete e If the MPM came from a different host or has a name different from the host a warning message appears Save starts the MPM downloads and stored data is copied from the MPN into the host memory the following message is displayed on the host MPM in transfer Do not remove MPM MPM in transfer Do not remove MPM If the transfer fails the message Transfer failed MPM cleared appears and the MPM memory is cleared Transfer Failed MPM Cleared 33 8 Mennen Medica Menntor 7 Operating Manual The data collected on the MPM is stored in the Host under Patient MPM Merge Up to three files of MPM data can be saved in the monitor Loading additional files erases the precious files in Fist in First Out FIFO loop gt To access the Merge panel 1 From the Main menu select the Setup key to display the Setup menu Select ADT and then select Patient Identification The Patient Identification panel appears BBBBBBB LALI PAP Figure 33 4 Patient MPM Merge 3 Select the file you want to merge with the monitored patient Mennen Medical 33 9 57 as Transport Monitor Menntor 7 Operating Manual 4 You have now three available options Merge Delete Close Merge merges the MPM save data with the monitored patient data This overrides the patient name with the saved MPM name and merges the MPM data with th
404. menne Menntor X7 Modular Patient Monitors USER MANUAL DDM 781 001 Rev C Nov 2014 Cc 0473 Conformity according to the Council Directive 93 42 EEC concerning Medical Devices Manufacturer s Name i Mennen Medical Ltd 4 Hayarden Street Yavne 8122804 P O Box 102 Rehovot 7610002 Israel Tel 972 8 9323333 Fax 972 8 9328510 European Representative Charter Kontron Limited Unit 18 Avant Business Centre 21 Denbigh Road Milton Keynes MK1 1DT England Tel 01908 646070 Fax 01908 646030 US Representative Mennen Medical Corp 290 Andrews Road Feasterville Trevose PA 19053 3480 Phone 215 259 1020 Fax 215 357 2010 Publication No DDM 781 001 Ver 7 0 Revision C November 2014 Copyright O Mennen Medical Ltd 2014 All RIGHTS RESERVED Registered trademarks are the intellectual property of their respective holders TABLE OF CONTENTS Table of Contents Section 1 Introduction Chapter 1 What You Should Know 1 1 SetVICe c etm ntm etiem ee pe E S E ENT 1 1 Prescription NOUCe i5 oibus Eg Re OR I eee 1 1 User Capability ce rere tee e te ee enden 1 1 General Description e e eere ire qe RS UAE IEEE E Y ce ee oa 1 2 Menntor X7 Part Numbers edet erede ceo bI Poe r qe De Dep ea
405. minimal limits of the dynamic scaling 7 Click on Accept to accept the selected settings Mennen Medical D 67 Menntor 7 QuicKeys Setup Note This dialog panel is active only when patient is being monitored The QuicKeys bar is a row of up to 12 user defined function keys that appear on the bottom of the main screen display This panel provides you with quick access to your most frequently used functions and menus For example if you want to access the Charts panel instead of pressing the Data Review fixed key on the front panel and then selecting Charts from the Data Review menu you can simply turn the QuicKnob until the Charts QuicKey is highlighted and press to display the Charts panel Any function can be configured as a QuicKey QuicKeys are configured by your hospital biomedical engineer or System Administrator in System Configuration Note QuicKeys disappear from the screen every two minutes To redisplay the QuicKeys simply turn the QuicKnob Figure D 36 The QuicKeys Bar Figure D 37 The QuicKeys Setup Panel gt To assign QuicKey 1 Select System Setup 2 From the System Setup menu select QuicKeys D 68 Mennen Medica 7 Operating Manual 3 Use QuicKnob to select one of the QuicKeys this opens a menu with a green background 4 Press and rotate the QuicKnob to open the menu item and open
406. monitored parameter artifacts and poor signal quality may lead to inaccurate BIS values CAUTION Potential artifacts may be caused by poor skin contact high impedance muscle activity or rigidity head and body motion sustained eye movements improper sensor placement and unusual or excessive electrical interference CAUTION Due to limited clinical experience in the following applications BIS values should be interpreted cautiously in patients with known neurological disorders and patients taking other psychoactive medications WARNING Explosion Hazard Do not use the BISx system in a flammable atmosphere or where concentration of flammable anesthetics may occur Ensure that the BISx does not come into prolonged contact with the patient s skin as it may generate heat and cause discomfort The conductive parts of electrodes or sensor and connectors Mennen Medical 27 3 BIS Bispectral Index Menntor 7 Operating Manual including the natural electrode should not come in contact with other conductive parts including earth To reduce the hazard of burns in the high frequency surgical neutral electrode connection the sensor or electrodes should not be located between the surgical site and the Electro Surgical unit return electrode The sensor must not be located between defibrillator pads when defibrillator is used on patient connected to the Menntor X7 via the BIS sensor To minimize the risk of pa
407. mpatibility Cables 0 CO Set interface cable 0 Ice Bath YSI 400 cardiac output interface cable o Dual temperature interface cable YSI 400 Temperature Range 0 Blood temperature 27 C to 45 C 81 F to 113 F 0 Injectate temperature 0 to 25 C 32 F to 77 F Body temperature 0 C to 45 C 32 F to 113 F Accuracy 0 19C over the entire range Digital Sample Rate 160 Hz Sample Resolution 24 bit Frequency Response 0 to 15 Hz Cardiac Output Determination Range 0 to 20 liters per minute Injectate Volumes 1 3 5 and 10cc Displayed Data Cardiac Output Cardiac Index Stroke Volume Stroke Volume Index Blood Temperature Injectate Temperature Trial Number Data Storage In Cardiac Output mode Cardiac Output Hemodynamic Calculation results Measuring time In Two Temp mode Temperatures and Delta Temp Temperature Alarms Non Invasive Blood Pressure Oscillometric Method Displayed Parameters Systolic Diastolic Mean pressure values Time of last measurement and next measurement Cuff Size Adult Pediatric Infant Neonatal Inflation Rate Within 5 sec Initial inflation target 150 mmHg Adult Pediatric Initial inflation target 100 mmHg Neonatal Over pressure limit 290 mmHg Adult Pediatric Over pressure limit 145 mmHg Neonatal Cycle Times Deflation time typical 30 sec BP time out 60 180 sec Measurement Ranges Adult in mmHg Systolic 30 to 255 Diastolic 15 to 220 Mean 20 to
408. n occurs when RF noise is transmitted through the air and induced in the monitoring devices and their cables Suppose that an ES device is set so that the voltage at the active electrode in 100 volts approximately the minimum setting Assuming a reduction attenuation of the signal by 100 000 times through the body s natural impedance and by electrical filtering the ES signal at the ECG lead connection would still be 1 millivolt just equal to the magnitude to the ECG signal Complicating the situation is the fact that some electrosurgery devices are designed to superimpose other signals on the RF to generate different cutting or coagulating effects These superimposed signals are often at the same frequencies as ECG components making it difficult to separate the unwanted interference from the ECG signal with electronic filters Good monitoring techniques however may be used to enhance the quality of the signal reducing the burden on the filtering Conduction 2 2 The electrosurgery RF signal flows through the patient from the active electrode to the return plate If the return plate is directly opposite the active electrode most but not all of the energy goes directly to the return plate The stray ES voltage spreads out over and through the body becoming smaller as it moves away from the active electrode Sites farther from the active electrode have smaller RF signals than those which are close Another aspect of interferen
409. n Display Options Dialog Panel gt display options 1 From the Respiration menu or if you are already in another Respiration dialog panel from the drop down list below the title area select Display Options The Display Options dialog panel is displayed 2 Fromthe Display Area drop down list select the area where you want Resp to be displayed on screen The options are Waveform Secondary VS area and Big Numbers The default is Waveform 3 From the Sweep Speed drop down list select the required sweep speed Options are ECG Sweep Speed 6 25 mm sec and 12 5 mm sec Mennen Medical 17 9 Respiration Menntor 7 Operating Manual 4 Under Display Features Select the Grid checkbox to activate or deactivate display of a grid By default this option is deactivated and is available only when Respiration is displayed in the Primary Vital Sign area as waveform Select the Alarm limits checkbox to activate or deactivate display of this value on screen Select the Lead Selection checkbox to activate or deactivate display of this value on screen Select the Apnea Information checkbox to activate or deactivate display of this value on screen Select the Breath Symbol checkbox to activate or deactivate display of this value on screen 5 Select Resp Colors and select the color required for Resp parameters from the panel that appears You can choose from 16 colors The default color is green 6 Press
410. n Medical or it s authorized distributer and the end user It is the responsible of the hospital management that only users that were trained to use the equipment efficiently and safely should operate the equipment Service Only Service Engineers trained and approve by Mennen Medical are allowed to perform service to Mennen Net equipment Monitor configuration is password protected and is allowed to users that have received permission by the hospital System Manager or administrator Menntor X7 Service manual will be provided to Service Engineers trained and approve by Mennen Medical Prescription Notice CAUTION Federal law restricts this device to sale by or on the order of qualified medical personnel only User Capability Patient monitors are used by nurses under the supervision of physicians System Setup is password protected and should be modified only by the System Manager authorized by the department director a Physician Mennen Medical 1 1 What You Should Know Menntor 7 Operating Manual General Description Menntor X7 is a modular patient monitor with a Multi Parameter Module MX57 that serves as a front end amplifier and signal conditioner for the commonly used vital signs and two additional plug in modules The MX57 MPM will be offered for either Non Invasive monitoring or Invasive monitoring In the Non Invasive option it will measure ECG Resp 2Temp NIBP SpO2 In the Invasive option it will add me
411. n audio message 3 Under the File Name list appear all sound files including technical and clinical alarms Select the sound file that will supply the sound for the selected event 4 Under Volume set the required volume and click Play to test the sound file 5 Click Main Screen to save settings and close the dialog box Note Factory default setting is for Volume 60 for Inject Now and Deflate Balloon and Volume 0 for all other events Default Alarm Limits Each vital signs available for monitoring appears as a button on the Default Alarm Limits panel The current alarm limits for each vital sign are also displayed on the D 18 Mennen Medica 7 Operating Manual button Select a vital sign The appropriate scale is displayed where you can set new default alarm limits for the selected vital sign You can select Fixed or Dynamic Alarm Limits When Dynamic Alarm Limits is selected the alarm limits change according to the patient s vital signs when Set to Default is activated System Setup Default Alarm Limits 7 0 pc 50 150 30 40 0 99 Vtach Beats 5 4 f s S E m 99 BGM Sp02 Pulse Rate 1 i 50 150 0 20 ICP lt a High Limit t S D M 100 150 50 100 75 125 LAP end E T ART S D M S D M 100 150 50 100 75 125 100 150 50 100 75 125 BP M S D M 2 20 40 10 30 14 34 1
412. n the screen gt To activate the Fick Method 1 From the Cardiac Output menu select Fick Method The Fick Method panel opens QC3 waa Discard Cardiac Output Fick Method Fl Accept VALUE NORMVAL HRT 160 BPM 160 awa Consumption vor 250 300 SP02 95 svor 8 Cardiac Output 8 0 LIMIN 4 8 AGE 69 years BSA 2 24 DATE 10 21 99 Figure 19 3 Cardiac Output Fick Method Panel 19 10 Mennen Medica Menntor 7 Operating Manual Indication of Fick Method N results 2 On the left area of the panel enter all missing parameters Parameters are either provided by the Menntor X7 or acquired using other monitoring equipment in which case you must manually enter them HART provided by the Menntor X7 HB enter manually SpO2 calculated by the Menntor X7 enter manually SvO2 provided by the Menntor X7 enter manually Age provided by Menntor X7 BSA calculated by the Menntor X7 Update any value if necessary 3 When all values are entered Consumption and Cardiac Output values appear on the right side of the panel Values that are out of range appear on a red background 4 Click Accept The Hemodynamics chart opens displaying the Cardiac Output result and associated parameters Fick Method results are indicated by the icon Charts Figure 19 4 Hemodyancis Chart displaying Fick Method Calculations Mennen Med
413. natal should be entered via the System Setup This should be performed by the System Administrator or requested as a Factory Setup Table 4 1 Recommended Setup Parameters Parameters Low Alarm High Alarm Display ECG 100 200 Waveform 1 lead Respiration 30 100 Waveform Apnea 20 sec In Respiration NIBP Sys Dia M 50 20 20 mmHg 90 60 70 Big Numbers BP Art Sys Dia M 50 20 30 mmHg 90 60 70 Wavefrom option BP PAP Sys Dia M 24 4 12 mmHg 60 4 26 Waveform option BP CVP Mean 2 10 Waveform option BP ICP Mean 2 10 Waveform option 4 4 Mennen Medical Menntor 7 Operating Manual Table 4 1 Recommended Setup Parameters Parameters Low Alarm High Alarm Display SpO2 80 95 Waveform option EtCO2 35 mmHg 45 mmHg Temperature 36 0 C 96 8 F 39 0 C 102 2 F Big Numbers 1 TcpO2 TcpCO2 60 35 mmHg 90 45 mmHg Big Numbers Opt Recommended Display m Options for CRG CRGI S HRI Resp CRG 2 SpO2 BP Note Optimal parameters will be included in Neonatal Admit key only if they are included in Neonatal Admit key and only if they are included in the purchased monitor configuration Height Select cm or inch Weight Select gram or ounce Mennen Medical Installation and Setup 4 6 Menntor 7 Operating Manual Mennen Medica 5 MAINTENANCE AND CLEANING Cleaning the Menntor X7 Bedside Monitor The Menn
414. nd exit the panel Note When you exit vital signs setup panel you return to the main screen To continue System Setup you must press the System Setup button again to access the System Setup menu Anesthetic Agent Setup This dialog panel enables you to set Anesthetic Agent default parameters These parameters include setting Anesthetic Agent alarm priority activating or deactivating alarm latching defining Alarm Detection delay and selecting the default units and color for Anesthetic Agent values Anesthetic Agent Alarm Priority Alarm priority affects the order of audible and visual alarm notification See Alarm Priority on page 8 4 fr a full description of this feature Anesthetic Agent alarm priority can be set to C 1 C 2 or C 3 The factory default is C 2 Alarm Latching For a complete description of Alarm Latching refer to Chapter 7 Alarms in the Menntor X7 Operation Manual The available options are Off Visual latching visual alarms only and On both visual and audible alarms The factory default is Off Alarm Detection Delay When an alarm is detected a pre defined delay period allows the system to check in order to avoid false alarms The delay can be set to 3 5 10 15 or 20 seconds The factory default is set to 10 seconds Anesthetic Agent Default Color Defines the color in which Anesthetic Agent values appear on the main screen display You can choose from 16 available colors Mennen M
415. nd than set response to Tone and or Automatic View Select the alarm level at which you wish the Alarm Watch to function Click Main Screen to exit the panel and accept the Alarm Watch settings 10 Click on Discard Changes to discard changes and exit to the main screen Mennen Medica Menntor 7 Operating Manual Alarm Watch Function If Automatic View was set to green then upon alarm activation of the selected level on the remote bed a remote view panel is superimposed on 34 of the Menntor X7 screen The local bed s ECG and measured values are minimized and appear at the top part of the screen The remote bed s parameters and waveforms appear in the middle of the screen The local bed s QuicKeys appear at the bottom Remote View allows you to temporarily set all alarms to off at the remote bed When exiting Remote View the remote bed alarm setting will automatically revert to the local monitor s original selection The remote view will stay on the screen for the timeout default of 2 minutes of Large panel or until you press Main Screen If Automatic View was set to off gray then upon alarm in one of the remote beds a message with or without tone will appear on the top right corner of the local Menntor X7 screen Patient Data Figure 7 11 Patient data menu Mennen Medical 7 15 Setting Up the Patient Display Menntor 7 Operating Manual gt
416. ndition It is the responsibility of the medical team to always be at a location where the alarm can be detected either around the bedside or at the Central Nurse Station WARNING The alarm limits for each vital sign should be set to the limits of the normal range of each parameter Alarm efficiency will be lost if the limits are set to a wide range that is not clinically logical CAUTION User nurse or physician should set the alarm limits of each parameter according to the patient s clinical state and confirm that out of limit values produce alarms Alarm Distribution Monitors connected to the LAN network send the alarm status repeatedly along the network every 10 seconds The alarm appears on the Ensemble Central station the Mennen Medical 8 1 Alarms Menntor 7 Operating Manual Enguard remote monitor and any monitor on the network that has activated the Alarm Watch Alarm Watch on page 7 13 Alarm Delay Clinical Alarms are delayed after change of the vital sign due to two factors e monitoring delay due to signal averaging e The preset alarm delay The monitoring delay is the delay between the time the vital sign has changed to the moment the new value is displayed on the monitor screen This delay is a result of the averaging character of each of the vital signs This delay is between 4 to 8 seconds For example change of HR from 80 to 120 BPS will reach 106 37 of the change within 3 seconds an
417. ne the number of consecutive ventricular beats which if exceeded activates the alarm range 5 12 When VTach alarm is detected it overrides any existing Run alarm Note The V Tach alarm does not fail when QRS morphology is Ventricular Note The alarm is activated within I second after the selected number of ventricular beats Note Asystole Vfib and Vtach have the clinical priority of C1 and cannot be disabled when arrhythmia is activated e Runs This alarm is activated when the consecutive number of Premature Ventricular Contraction PVC beats exceeds defined limit range 2 12 e PVC This alarm is activated when the number of PVCs in minute exceeds defined limit range 1 15 e Pause This alarm is activated if no QRS is detected for defined period of time range 1 3 seconds The alarm stays on for one minute In addition to the basic Arrhythmia types the following Arrhythmia types are monitored in the Extended Arrhythmia set e Bigeminy BGM Bigeminy is indicated when every other heart beat is a PVC N V N V N V You can define the number of consecutive N V sequences that activates the alarm e Bradycardia This alarm is activated when the monitored heart rate falls below 50 BPM e Sinus Tachycardia This alarm is activated when the monitored heart rate exceeds 100 BPM e SV Irregular Rhythm This alarm is activated when the rhythm for the last seven normal ventricular QRS complexes is irregul
418. ne how temperature values appear on the main screen display See Setting Temperature Display Options on page 20 6 e Activate Use this panel to activate or deactivate discontinue and resume Temperature monitoring and to define the location of the probe See Activating Temperature Monitoring on page 20 7 All the above panels are accessed from the Temperature menu Accessing the Temperature Menu The Temperature menu can be accessed from the Vital Signs menu or from the main screen display gt Toaccess the Temperature menu from the Vital Signs menu 1 From Main menu select the Vital Signs key The Vital Signs menu is displayed 2 From the Vital Signs menu select Temperature The Temperature menu appears 3 Select the required menu item to display the associated panel 20 2 Mennen Medica Menntor 7 Operating Manual gt To access the Temperature menu from the main screen display When the temperature is displayed in Big Number format or when temperature appears in the Secondary Vital Signs area turn the QuicKnob until the Temperature value is displayed In either case the area where the temperature value is displayed functions as an on screen button Press the QuicKnob to select The Temperature menu appears Setting Temperature Alarms Temperature alarm parameters are set in the Alarm Limits and Alarm Response panels Each dialog panel controls a different aspect of Temperature
419. ned in the ST Variation panel 16 8 Mennen Medica Menntor 7 Operating Manual OK 6 JOHN SMITH ST Variation 16 29 23 su 2 7 s m 07 5 13 stav 0 1 sr avr 12 OM stv 11 s 16 OM st vs 25 OM srv 22 st vs 17 se 12 l Figure 16 6 The ST Variation Panel gt To activate ST Variation 1 From the ST menu if you are already in another ST panel from the drop down list below the panel title area select ST Variation 2 Select the ST Variation checkbox to activate or deactivate ST Variation By default the checkbox is deactivated Note The checkbox appears green when activated and gray when deactivated 3 Press ECG to close the panel and return to the ECG menu press Main Screen to close the panel and return to the main screen display Mennen Medical 16 9 ST Segment Analysis Menntor 7 Operating Manual gt To set the ST baseline 1 From the ST menu or if you are already in another ST panel from the drop down list below the panel title area select ST Variation 2 Press Set BaseLine to define the current ST values as the baseline values 3 Press ECG to close the panel and return to the ECG menu press Main Screen to close the panel and return to the main screen display 16 10 Mennen Medica 17 RESPIRATION Overview Respiration Resp is me
420. nel without applying any changes Or Select Main Screen to apply the changes and exit the panel Note When you exit a vital signs setup panel you return to the main screen To continue System Setup you must press the System Setup button again to access the System Setup menu Mennen Medical D 41 7 Operating Manual Transcoutaneous Gas TcGas Setup This dialog panel enables you to set TcGas default parameters These parameters include setting TcGas alarm priority activating or deactivating alarm latching defining Alarm Detection delay and selecting the default units and color for TcGas values TcGas Alarm Priority Alarm priority affects the order of audible and visual alarm notification See Alarm Priority on page 8 4 for a full description of this feature TcGas alarm priority can be set to C 1 C 2 or C 3 The factory default is C 2 TcGas technical fault priority can be set as T1 or T2 The factory default is T2 The Sensor Temperature alarm priority is set T2 e Alarm Latching For a complete description of Alarm Latching refer to Chapter 7 Alarms in the Menntor X7 Operation Manual The available options are Off Visual latching visual alarms only and On both visual and audible alarms The factory default is Off e Alarm Detection Delay When an alarm is detected a pre defined delay period allows the system to check in order to avoid false alarms The delay can be set to 3 5
421. nen Medical Menntor 7 Operating Manual Compliance The Menntor X7 bedside monitor is designed to comply with the international safety requirements for medical electrical equipment IEC 60601 1 IEC 60601 1 8 IEC 60601 2 27 IEC 60601 2 49 and AAMI voluntary performance standards for cardiac monitors The Menntor X7 bedside monitor is also designed to comply with the international EMC requirements for medical electrical equipment IEC 60601 1 2 European Directive 93 42 EEC as amended by 2007 47 EC classifies the Menntor X7 bedside monitor as a Class IIb device The NIBP and SpO2 are classified as Type BF equipment The ECG and Dual BP and CO 2 Tmp are classified as Type CF equipment for direct cardiac application See page 2 5 for the relevant symbols used on the inputs The inputs are floating inputs and are protected against the effects of defibrillation and electrosurgery If the correct electrodes are used and applied in accordance with the manufacturer s instructions the screen display will recover within 5 seconds of defibrillation The Menntor X7 is designed as a Type CF equipment to have special protection against electric shocks particularly regarding leakage current and is defibrillator proof Mennen Medical 1 5 What You Should Know Menntor 7 Operating Manual Network Mennen Net Menntor X7 and all other Mennen Medical monitors can be connected to Local Area Network LAN by wired or wireless connecti
422. neously the monitor upgrades the response to priority level C 1 Table 8 3 summarizes the alarm response priority for multiple alarms Mennen Medical 8 5 Alarms Menntor 7 Operating Manual Table 8 3 Alarm Priorities Upgrade Scheme Alarm Alarm B Response Level 2 2 1 C 3 C 3 C 2 C 3 C 2 C 2 C 4 C 4 C 3 Normal priority response is restored when the system returns to single alarm condition Setting Up Alarms Setting up alarms for each monitored vital sign is divided into two functions alarm limits and alarm response The high and low limits that can trigger an alarm are set in the Alarm Limits panel The way the alarm is visually and audibly manifested on the system is set in the Alarm Response panel dialog panel for each of these functions exists in the menu for the appropriate parameter For description of alarm setup procedures refer to the section for each vital sign Alarm Controls Alarm Silence 8 6 The Silence button fixed key on the front panel of the CPU is a toggle button pressing it stops all audible alarms and pressing it again enables all audible alarms The silence time can be defined in System Setup Alarm Volume amp Control from between 30 300 seconds The System Setup enables you to set when to terminate the silence period occurs When time out expires e When a new alarm occurs Note Pressing the silence button affects only the l
423. nes checkbox to activate or deactivate audible alarms By default the checkbox is activated 4 Press Main Screen to return to the main screen display Setting Ventilator Display Options The Ventilator Display Options panel enables you to control the way Ventilator values appear on the main screen display You can set the display to suit the hospital s or department s particular needs Any changes made are immediately reflected on screen By setting the parameters on the Display Options panel you can Select Cell Size to instruct the monitor to display Ventilator information in the as Quarter Half or Full size Define the color of Ventilator values as they are displayed on the screen All values and associated parameters have the same color unless they go into alarm in which case the value takes on the alarm priority color When the alarm condition terminates the original color is restored Select the cells to be displayed By default all ventilator parameters will be displayed gt To set Ventilator Display Options 1 Mennen Medical From the Ventilator menu select Display Options The Display Options panel opens From the Display Options panel select the parameters you wish to display and press Done 26 7 Ventilator QC TKI 4 25 ASHER SASON AB VENT 2 Display Options Display ArexfBig Numbers Display Features Alarm Limits Show Cells Expand x1
424. ng examinations in or on the heart or brain the conductive parts of electrodes and associated connectors including the neutral electrode should not contact other conductive parts including earth Mennen Medical 4 3 Installation and Setup Menntor 7 Operating Manual Electrosurgery Diathermy and Defibrillation Protection Neither electrosurgery and diathermy instruments nor defibrillation will damage the monitor If the correct electrodes are used and applied according to the manufacturer s instructions the screen display will recover within 5 seconds of defibrillation or RF interference The inputs are floating and are defibrillator proof For most efficient monitoring when electrosurgery is in use see Minimizing Electrosurgical Interference in Warnings and Precautions WARNING DO NOT TOUCH THE PATIENT BED OR INSTRUMENT DURING DEFIBRILLATION Accidental Wetting of the Equipment If for whatever reason the equipment accidentally gets wet remove all patient connections and turn the unit off Thoroughly wipe all wet areas and then allow sufficient time to ensure that the equipment is completely dry before proceeding Patient Connections All patient connections on the Menntor X7 Vital Signs have special keys to prevent user error CAUTION The rear panels of the Processor have no patient connections Recommended Setup for Neonatal Applications The following setup is recommended for Neonatal Setup for Neo
425. nitoring Profiles Page page 27 21 See Appendix D Setting Up the System to create the required monitoring profiles 2 Attach BIS Sensor to Patient 3 Prepare sensor site and place the BIS sensor on the patient in accordance with the instructions included on the sensor package CAUTION The Menntor X7 BIS was designed to operate with a BIS sensor The sensor is a silver silver chloride electrode array that utilizes Covidien s patented Zipprep technology and uses a proprietary connector Use of other electrodes is not allowed 4 Secure the BISx 5 Using the attachment clip secure the BISx to a convenient location near the patient s head Mennen Medica Menntor 7 Operating Manual 6 Attach the BIS Sensor to the PIC To insert the sensor into the PIC line up as shown and insert the sensor tab into the PIC sensor connector until an audible click is heard The blank side of the sensor tab i e the side without the computer chip should be facing up Figure 27 3 Connecting the PIC The Sensor Integrity Check is initiated each time a sensor is connected to the PIC It checks to make certain that a valid unexpired sensor is in use The LED on the front panel of the BIS will display the status of BISx and Sensor connection Table 27 2 BISx and Sensor connection status State Color Alarm Bisx disconnected Red Par 18 BISx fault Red Sensor not connected Blinking red Sensor fault Blink
426. nntor X7 with MX57 MPM Module HxWxD 361x392x215 mm 14 2x15 4x8 4 inches Weight 8 5Kg 18 7 Ib for basic configuration with battery Power requirement 100 120 VAC 2A 50 60 Hz e 230 240 VAC 1A 50 Hz Environmental Operating Conditions e Temperature 5 C to 40 41 F to 104 F e Humidity 10 to 93 percent non condensing e Barometric Pressure 430 795 mmHg 1250 to 15 000 ft 380 to 5200 meter Environmental Storage Conditions e Temperature 15C to 68 0 59F to 154 F e Humidity 10 to 93 percent non condensing DGM 781 001 Rev C 11 2014 Page 1 5 Network LAN Physical IEEE 802 3 Ethernet interface 10 100 BaseT Protocol TCP IP Serial Interface RS232 optional Connectivity to Ensemble CNS Enguard Enscribe recorder and network printer e Wireless LAN optional includes Utilizes an industry standard 802 11b g IEEE compliant radio card 9 Dual diversity dipole antenna 0 Signal strength indicator WPA security and encryption User Controls Host Unit 6 Fixed Keys Quicknob Remote Control Keypad optional Touch Screen ELO IT optional Barcode Reader optional Patient Data storage Host Unit Demographic Data Charts Numerical Trend Graphic Full Disclosure All leads ECG waveform Overview All Waveforms with top ECG Event Strips 20 Seconds of all ECG and Vital signs waveforms 10 sec pre amp post event Storage 868 1608 Overview TS Days
427. nrrvennrnennnneenrneersnesnenennrssensnsennnnensneenrssenrssnnrsesnnssennessensesenn B 2 mne B 3 Appendix C Auto Set Dynamic Alarm Limits Appendix D Setting Up the System Introduction 9 32 ee ott ettet e e he tet eletto K D 2 D te amp Time Setup o e eta ere te Led RE EE p rcd eese conecte bud eee D 8 General Sete gs teu Hue hin Ep te e Reb Le Ee eter ei eu e ertet Eo ies D 11 Alarm Volume nd Controls ecdesia aaa D 14 Sound Ev nt sexe Hee RR RE dee ee Re e d eee D 17 Detault Alarm Limits uiu e e egre reete t esee aE E E E On Unete D 18 Iu E D 20 Vital Sign VS Setup 6 een eei Ee tete etes fiac e Hines tes D 22 Parameter Hierarchy xvid HR eee dett ite A erii der cete D 52 Monitor Profiles Setup aus secrete rr eem Ht be iuter te ee qi rr deti dede D 54 Admit by Default gere et erit e i Sob acie CLIE E o ee quede iecit D 57 Report Set ps zm etae pe Es a e PE I P e RE cerent doo oo Dee a D 58 Network Setup edem ie me EORR Been D 64 IP Address Setup oeste MC tetto tie A R D 65 Recorder Setup doi coe teet HE roe restet tdeo sin os eH Per eb pre tpe E reet venas D 65 Trends Setup E PERDU RC cett ent EF D 67 QuicKeys M Setup ede fuste oce ite e de Pate eet a ede rrt beet ine D 68 Tabular Charts us 35e ee e ei e eec REL e e E reddas D 69 Updating the Software Version 45 nn tne rettet ere eee Pte feels tote eas
428. nt factor from the Gain drop down list Available options are Imv cm and 2mv cm 3 scroll forward ten minutes press Page Up 4 To scroll back ten minutes press Page Down Mennen Medical 10 17 Reviewing Patient Data Menntor 7 Operating Manual 10 10 18 To view the waveform of a specific ten minute period press Go To and enter the required date in the Date dialog panel and start time in the Time dialog panel Make sure the required date and start and end times fall within the time span of stored data To zoom in on specific ten second period either press Zoom In and use the QuicKnob to move the cursor forwards or backwards or use the QuicKnob to select one of the minute keys on the left of the Full Disclosure panel The cursor appears as rectangle framing ten seconds of the displayed waveform When the desired ten second period is located press the QuicKnob The following list of options will open e Zoom in e Mark event e Print e Overview e Chart Trend e Cancel To access the Ten Second Display panel select it and press Zoom in From the list above or from the Patient Data drop down menu select Charts Trends or Overview The Ten Minute Display panel closes and the selected panel opens displaying data for the time frame displayed in the Ten Second Display panel To exit the Ten Minute Display panel and return to the main screen display press Main Screen Mennen Medica M
429. ntains chapters describing monitoring procedures for all vital signs available for monitoring on the Menntor X7 monitor These vital signs are O I 0 t A WO N Chapter 14 Chapter 15 Chapter 16 Chapter 17 Chapter 18 Chapter 19 Chapter 20 Chapter 21 Chapter 22 ECG Arrhythmia ST Segment Analysis Respiration Invasive Blood Pressures BP Cardiac Output C O Temperature Non Invasive Blood Pressure NIBP Pulse Oximetry SpO2 10 Chapter 23 End Tidal CO2 EtCO2 Microstream MicroPod 7 Operating Manual Mennen Medica 14 ECG Overview The Menntor X7 monitor uses 12 Lead ECG Resp technology via electrodes attached to the patient s chest Monitoring the ECG produces continuous waveform of cardiac electrical activity to enable an accurate assessment of patient s current physiological condition You can use ECG cables with 3 5 6 or 12 lead electrode to display up to twelve selectable ECG leads Alas dn dr alu 50 G v my ECG VI Figure 14 1 Continuous Monitored ECG Waveform Display Note If one or more leads is disconnected from the patient a Lead Fault message is displayed within I second in the ECG area and a Technical Alarm is issued ECG Deactivation As a general rule ECG is always the top displayed vital sign
430. ntly above systolic point 15 Abnormal oscillometric waveform detected may be due to motion 16 Arrhythmic pulse detected 17 Measurement time out may be due to motion 18 Pulse rate too fast may be due to motion 19 Cuff over pressure sensed 20 Loose cuff 21 Neonatal cuff used in adult mode Note Please note the above technical message codes Should the code appear on the unit during a NIBP measurement then the reason for the code is indicated in the above table User action should be to correct for the cause of failure or notify your service technician of the code indicated and the circumstances under which it occurred 21 16 Mennen Medica CHAPTER 22 PULSE OXIMETRY SPO2 WARNING Before making decisions on treatment of blood gas check blood gases using a calibrated Gas Blood Analyzer Use the monitor alarms and abnormal value as a indication for further check CAUTION The monitor supports either Nellcor Covidien or Masimo SpO2 technology Use only accessories of the SpO2 manufacturer Overview SpO2 is measured to determine a monitored patient s arterial oxygen saturation and pulse rate Arterial oxygen saturation is the percentage of oxygenated hemoglobin in relation to the total hemoglobin For example if 95 percent of the hemoglobin molecules in the arterial red blood cells combine with oxygen the blood has an oxygen saturation of 95 percent The SpO2 numeric value represents the percentage of hem
431. ntricular QRS is assumed to provide information on the parasympathetic activity and to have some predictive value for the fate of cardiac patients There are three ways to review HRV Time Domain e Frequency Domain e Histogram Mennen monitors provide HRV in Time Domain and as a Histogram In the Time Domain HRV is performed in 5 minute epochs time periods Features HRV includes the following e Histogram of normal QRS complexes R R intervals for a user selected time interval e Chart of Time domain HRV calculated parameters see Table 10 3 e Graphic trend of Time domain of HRV calculated parameters HRV Time Domain gt To operate the HRV Time Domain 1 display the Interval histogram use HRV histogram key in Patient Data menu 2 In System Setup gt Tabular chart see Tabular Charts on page 7 69 prepare a chart that includes the HRV parameters The minimal time interval is 5 minutes 3 In Trend the HRV parameters are available for graphic display with a 5 minute resolution see Trends Setup on page 7 67 Table 10 3 HRV Parameters Abbreviation Definition ANN Mean RR interval of normal beats SDNN Standard Deviation of RR intervals of normal beats Mennen Medical 10 31 Reviewing Patient Data Menntor 7 Operating Manual Table 10 3 HRV Parameters Abbreviation Definition RMSSD Root Mean Square RMS of differences of successive intervals of
432. nts you require up to six you can edit the results in the Edit Curves panel The procedures that can be performed using the panels available from the Cardiac Output menu are more fully explained in the following paragraphs Measuring Procedures Cardiac Output measurement is set up through the Cardiac Output menu dialog panels Each dialog panel enables control of different aspects of C O monitoring The available panels are Acquire Use this panel during the injection procedure in order to acquire the necessary data for computing cardiac output See Acquiring Data for Determining Cardiac Output on page 19 3 Catheter Information Use this panel to view and change the computational constant for the catheter used in the procedure See Defining Catheter Information on page 19 6 Patient Identification Use this panel to enter the patient s height and weight in order to compute the Body Surface Area BSA if this information was not entered previously See Entering Patient Information on page 19 7 Edit Curves Use this panel to view up to six accepted trial curve graphs along with central graph where all curves are displayed on a single axis for comparison See Editing Curves on page 19 8 All panels can be accessed from the Cardiac Output menu Mennen Medica Menntor 7 Operating Manual Accessing the Cardiac Output Menu The Cardiac Output menu is accessed from the Vital Signs menu gt
433. o enable or disable changing of the patient type The change affects all parameters Use Disable change for units with a single patient type such as Premature Unit The selected patient type Adult or Neonatal appears in the top row of the display e Activate Use this panel to activate or deactive monitoring of EtCO2 See IPI on page 23 14 Accessing the EtCO2 Menu The EtCO2 menu can be accessed from the Vital Signs menu or from the main screen display 23 8 Mennen Medica Menntor 7 gt To access the EtCO2 menu from the Vital Signs menu 1 From Main menu select the Vital Signs key The Vital Signs menu is displayed 2 From the Vital Signs menu select EtCO2 The EtCO2 menu appears QC 8GB VL6B Vital Signs Scale Display Options Alarm Response Adult Neonatal Activate Figure 23 2 EtCO2 Menu 3 Select the required menu item to display the associated panel gt To access the EtCO2 menu from the main screen display 1 When EtCO2 is displayed in a parameter slot in the primary display area waveform area turn the QuicKnob until the EtCO2 parameter key is highlighted The parameter key functions as an on screen button Press the QuicKnob to select the parameter key and access the EtCO2 menu 2 When EtCO2 is displayed in the Secondary Vital Sign area or in Big Number format turn the QuicKnob until the EtCO2 value is highlighted and press to select
434. ocal Menntor X7 bedside monitor The Enguard or Ensemble Nurse Stations do not silence a remotely viewed Menntor X7 Parameters which are measured periodically such as NIBP are handled differently In this situation the alarm is not reinstated after the 60 second silence period Only a new alarm triggers a new audible response This prevents a situation in which the vital sign is no longer being measured but the alarm is still active Mennen Medica Menntor 7 Operating Manual Silence applies to both clinical and technical level alarms CAUTION In monitoring systems with Enguard and Ensemble central nurse station it is not possible to silence the alarm remotely Alarms Off When pressed the Alarms Off key disables all detection of clinical alarms for a pre defined period of 60 seconds Technical alarms are still detected and visually displayed in the appropriate area on the main screen CAUTION In monitoring systems with Enguard and Ensemble central nurse station it is possible to set alarm to off remotely The alarm will return when the Time out expires Latched Alarms Sometimes a vital sign parameter goes into alarm and then returns to normal range on its own The alarm is removed from the screen before it is noticed by the staff The Menntor X7 uses the latched alarm feature to inform you of the alarm event When alarm latching is activated the alarm message remains in the message area even after the condition wh
435. oes into Demo Mode gt To exit Demo Mode e Discharge Copy Configuration Utility The Copy Configuration utility enables transferring monitor configurations from one Menntor X7 monitor to other Menntor X7 monitors on the same network CAUTION You can transfer configurations between monitors only when they are of the same software version CAUTION You can only transfer configurations between monitors which are the same model Menntor X7 to Menntor X7 not from Menntor X7 to Envoy or to VitaLogik or vice versa Copying a configuration includes the following steps 1 Building a reference monitor configuration 2 Storing the configuration on the reference monitor 3 Copying the configuration to each monitor you want to copy the configuration to gt To build the reference monitor configuration 1 Admit a patient without inserting a name or any demographic information 2 Set the monitoring profiles the alarm limits and display options Mennen Medical D 79 7 Operating Manual 3 Discharge the patient gt To store the configuration on the reference monitor 1 Enter System Setup 1 Select Build Master Configuration from System Setup menu The monitor will restart and store the configuration files gt To copy the configuration to a monitor 1 On Main menu select gt Setup A T gt Discharge Patient 2 On Main menu select gt Setup gt System Setup gt Copy Configuration fr
436. of appropriate fasteners and the proper installation of the same Cable Interconnection Connect the power cable to hospital grade power outlet Grounding the System To protect the patient and hospital personnel the Menntor X7 system must be grounded Accordingly the system is equipped with a detachable 3 wire cable which grounds the instrument to the power line ground protective earth when plugged into an appropriate 3 wire receptacle If a 3 wire receptacle is not available consult the hospital electrician WARNING Do not use a 3 wire to 2 wire adapter with this instrument If the monitor is connected to another device make sure that both are connected to an equipotential grounding terminal WARNING lf it is not evident from the instrument specifications whether a particular instrument combination is hazardous or not for example due to summation of leakage currents the user should consult the manufacturers concerned or an expert in the field to ensure that the necessary safety of all instruments concerned will not be impaired by the combination Equipotential Grounding x Protection class 1 instruments are already included in the protective grounding protective earth system of the room by way of grounding contacts in the power plug Check each time before use that the instrument is in perfect working order The cable connecting the patient to the instrument must be dry and clean CAUTION When performi
437. of transfer periodic test degree of transient introduced into the power line how long is power interrupted frequency and voltage of emergency power e Reviewing environmental considerations such as ambient temperature humidity control potential static charge and expected tolerances in the area planned for the Menntor X7 Measure AC power disturbances over a period of at least 24 hours with a power line analyzer It is important to perform this test over the period of emergency power transfer to measure the severity of transients during the transfer Environmental Requirements The location selected for the Menntor X7 should be out of direct sunlight and in a clean air atmosphere Avoid dusty areas or areas where there are airborne dirt particles Avoid static build up and discharge which may result in disruptions of operation and loss of data Reasonable environmental parameters are e Temperature 5 to 40 C 41 to 104 F e Relative Humidity 10 to 93 non condensing Note See System Specifications on page 3 7 for environment limits Mennen Medica Menntor 7 Operating Manual Wall Mounting Instructions To properly mount your Menntor X7 bedside monitor refer to the wall mounting instructions supplied with your wall mounting kit It is the responsibility of the hospital its consultants and or contractors to determine that the wall is adequate to safely mount instrumentation This includes the selection
438. oglobin molecules that have combined with oxygen molecules to form oxyhemoglobin The Menntor X7 bedside monitor measures oxygen saturation using the Pulse Oximetry method This continuous non invasive method measures the light absorption in the patient s tissue for example a finger to a receiver on the other side Absorption by tissue and venous blood is constant However the blood flow in the arterioles is pulsatile and therefore varies with time Oxygen saturation of the arterial blood can be derived by measuring light absorption during pulsation To achieve the measurement in two wavelengths 660 nm and 905 nm in energy ranges of 0 13 mW min to 0 79 mW max light is emitted The Menntor X7 provides continuous monitoring of arterial oxygen functional saturation expressed as a percentage Moment to moment variations in capillary filling are presented as a continuous pulse waveform The pulse rate is derived from the pulse waveform SpO2 is detected by the SpO2 algorithm Mennen Medical 22 1 Pulse Oximetry SpO2 Menntor 7 Operating Manual N PULSE 77 N 94 Figure 22 1 WARNING CAUTION CAUTION Main Screen Display of SpO2 Pulse Waveform The Menntor X7 SpO2 is not intended for use in the magnetic field of MRI The magnetic field may interfere with SpO2 measurement and the sensor may cause artifact in the MRI image A pulse oximeter should NOT be used as an apnea monito
439. om 3 Choose the source reference monitor s unit 4 Choose the source reference monitor from the list Are you Sure panel will appear 5 Select Copy The monitor will restart and will come up with the new configuration 6 Verify that all the changes including the new profiles permissions QuicKeys are displayed CAUTION If Alarm Watch was part of the configuration be sure to remove the target monitor watching itself and if required to add the reference monitor to the watched monitors list Example The reference monitor was BED 1 and it was watching BED 2 Upon transfer BED 2 is part of the list of beds watched by BED 2 which means that BED 2 watches itself while BED 1 is not watched by BED 2 You need to remove BED 2 from the list of beds watched by BED 2 and to add BED 1 to the watched bed list Note If Enmove interface is used enter Enmove Interface Setup panel of each of the target monitors and set it to the proper Enmove network number D 80 Mennen Medica APPENDIX SETTING UP THE INTERFACE BETWEEN VIGILEO AND MENNTOR X7 The interface between Vigileo and Menntor X7 supports the transfer of the following parameters to the Vital Signs chart CO and SvO2 The following parameters are not transferred CI SV SVI SVR SVV SVRI gt Toset up the serial port on Vigileo to interface with Menntor X7 1 Select the Status box lower left 2 Select Serial Port Setup 3 Enter the following
440. omer repairs are limited by design to replacement of major component assemblies such as the Patient Interface Cable PIC BISx the BIS Instrument Identification BIS Part Numbers The BISx identification information is permanently marked on the rear panel of the BISx Software Revision Numbers Software revision numbers are displayed in the Software version panel of the Menntor X7 monitor Sensors The BIS with the BISx can be used with the following sensors e Quarto Pediatric 4 lead Extend SRS e Quarto Sensor Aspect Part number 186 0106 e Pediatric Sensor Aspect Part number 186 0200 Recommended for routine pediatric use SRS sensor Aspect Part number 186 0164 This kit consists of a semi reusable cable and disposable electrode set Mennen Medical 27 25 BIS Bispectral Index Menntor 7 Operating Manual Note The BIS sensor are supplied by Aspect or its distributors and not by Mennen Medical To locate the Covidien distributor in your area contact Mennen Medical or directly Aspect http www aspectmedical com contact BIS Trouble Shooting Table 27 3 Error Messages and what to do Message Problem What to do Isoelectric EEG Detected No discernible EEG activity is detected for sixty three seconds SR 100 Note This message notifies user of flat line EEG This is a normal condition when Sensor Simulator or Test Sensor is connected If unintended 1 Check patient vital signs do
441. on optional The Network enables the Ensemble Central Nurse Station and the Enguard Remote Monitor to view patient data at the central station or doctor s room It also enables each monitor to view remote monitors that are on the Mennen Net Interface to Hospital Information System HIS is also available via server router QD Mennen Medical Wireless LAN rene VitaLogik 6000 VitaLogik 6000 Menntor X7 VitaLogik 4000 VitaLogik 4000 A 4 L V i E g e Access Point mm Network Switch ti Access Point Mennen Monitor Network Wired Devices VitaLogik 6000 VitaLogik 6000 VitaLogik 6000 Ensemble Enguard Central Nurse Station Remote Workstation Figure 1 1 Mennen Net 1 6 Mennen Medica 2 WARNINGS AND PRECAUTIONS The terms Warning Caution and Note have specific meanings in this chapter WARNING advises against certain actions or situations that could result in personal injury or death CAUTION advises against actions or situations that could damage equipment produce inaccurate data or invalidate procedure although personal injury is unlikely NOTE provides useful information regarding function or procedure The Menntor X7 bedside monitor is designed to comply with international safety requirements for medical electric equipment and AAMI voluntary performance standards for cardiac monitors WARNING Do not use t
442. ong the low alarm limits scale to set the required limit Allowed range 85 100 96 or Press Auto Set to Defaults to set SpO2 alarm limits to their default values Note Factory default alarm limits for SpO2 are Low limit 85 High limit 2 100 The default SpO2 alarm limits can be modified in System Setup Password protected within the full range of 50 to 100 Mennen Medical 22 7 Pulse Oximetry SpO2 Menntor X7 Operating Manual 3 Press Spo2 to close the panel and return to the Spo2 menu press Main Screen to close the panel and return to the main screen display Setting SpO2 Pulse Rate Alarms Use this panel to set SpO2 pulse rate alarms The current low and high alarm limits as well as the currently measured SpO2 pulse rate value are displayed on the panel The current SpO2 saturation value is also marked on the scale none enA01127 Main Screen SpO2 High Limit Low Limit 330 aso 22 50 Emi Fi E tai 10 4 110 CDL All Pulse Rate Auto Set Alarms to Defaults Figure 22 3 The SpO2 Pulse Rate Alarms Panel gt To set SpO2 pulse rate alarms 1 From the SpO2 menu or if you are already in another SpO2 panel from the drop down list below the panel title area select Pulse Rate Alarms 2 Select the All Pulse Rate Alarms checkbox to activate or deactivate all Pulse Rate alarms When Pulse Rate Alarms is deactivated the slider bars used
443. oo Figure D 14 CritiCool Setup Note For instruction for use of the Menntor X7 to control the CritiCool Thermoregulation System refer to the MTRE CritiCool Pro User Manual Mennen Medical D 37 7 Operating Manual EtCO2 Setup This dialog panel enables you to set EtCO2 default parameters These parameters include setting EtCO2 alarm priority activating or deactivating alarm latching defining Alarm Detection delay and selecting the default units and color for EtCO2 values e EtCO2 Alarm Priority Alarm priority affects the order of audible and visual alarm notification See Alarm Priority on page 8 4 for a full description of this feature EtCO2 alarm priority can be set to C 1 C 2 or C 3 The factory default is C 2 e Alarm Latching For a complete description of Alarm Latching refer to Chapter 7 Alarms in the Menntor X7 Operation Manual The available options are Off Visual latching visual alarms only and On both visual and audible alarms The factory default is Off e Alarm Detection Delay When an alarm is detected a pre defined delay period allows the system to check in order to avoid false alarms The delay can be set to 0 3 5 10 15 or 20 seconds The factory default is set to 0 seconds e Units Defines the default units used to measure and display EtCO2 The available options are or mmHg The factory default is e EtCO2 Default Color Defines the color in which E
444. or Setup This dialog panel enables you to set Ventilator default parameters These parameters include setting Ventilator alarm priority activating or deactivating alarm latching defining Alarm Detection delay and selecting the default units and color for Ventilator values QC1 Ventilator Alarm Priority Alarm priority affects the order of audible and visual alarm notification See Alarm Priority on page 8 4 for full description of this feature Ventilator alarm priority can be set to C 1 C 2 or C 3 The factory default is C 2 Alarm Latching For a complete description of Alarm Latching refer to Chapter 7 Alarms in the Menntor X7 Operation Manual The available options are Off Visual latching visual alarms only and On both visual and audible alarms The factory default is Off Alarm Detection Delay When an alarm is detected a pre defined delay period allows the system to check in order to avoid false alarms The delay can be set to 3 5 10 15 or 20 seconds The factory default is set to 5 seconds Ventilator Default Color Defines the color in which Anesthetic Agent values appear on the main screen display You can choose from 16 available colors VS Setup VENT Setup ERE Extended Alarm Response Priority Vent ca A Fault T1 Latching Off z Alarm Detection Delay 5 sec SG Vent Default Color Pb Mennen Medical Figure D 23 The Ventilator Dialog Panel D
445. or later review When the patient s height and weight have been entered in the Patient Identification panel upon admission or at any other time preceding the Cardiac Output procedure the computed Body Surface Area BSA is used to calculate cardiac indexes If the patient s height and weight have not as yet been entered the Patient Identification panel can be accessed from the Cardiac Output menu and the information entered Clinical Precautions The accuracy of C O calculations depends on the proper placement of the Swan Ganz catheter Advancing the distal lumen too far into the pulmonary artery may result in an insufficient thermodilution curve Respiratory artifact may also prevent an accurate C O calculation Retracting the distal lumen too far toward the pulmonary valve may also cause calculation errors due to catheter whip Mennen Medical 19 1 Cardiac Output C O Menntor 7 Operating Manual Preparatory Checklist Plug the C O interface cable into the socket Make sure that all connectors injectate probe connector catheter thermistor connector are properly connected to the C O interface cable In the Acquire panel make sure that the computational constant is correct for the catheter and amount of injectate used in the procedure Make sure that the patient s height and weight appear in the Patient Identification panel Access the Acquire panel and begin the procedure When you have taken all the measureme
446. ord that enables access to the System Setup menu Access to the System Setup menu is limited to authorized personnel such as a System Administrator or Hospital Biomedical Engineer gt To change the password 1 Inthe System Setup menu click Change Password The Change Password panel opens Mennen Medical D 75 Menntor 7 Change Password Please enter your new password Figure D 43 Changing the Password 2 Enter the new password 3 digits and click Accept 3 A panel appears requesting you to type the password again Type the password again and click Accept Check Disk When running Check Disk all patient information on the disk is erased Warning Avoid using this option gt Check Disk e Inthe System Setup menu select Check Disk D 76 Mennen Medica 7 Operating Manual Permission Editor In the Permission Editor panel you can define which Menntor X7 functions are available By default access to all functions is available However you can configure certain functions to be unavailable For example you can decide that at a certain station recording of vital signs data cannot be performed The Permission Editor displays the entire Menntor X7 menu in tree format and allows you to define for each menu option whether it is available or unavailable for the current Menntor X7 The following modes can be set for each menu option
447. ormation for a period of 20 seconds 7 Use the Prev Next keys at the low left side corner of the Event strip panel to view other Event strips 8 Use the key on low right side of the Event strip panel to toggle between Overview and ECG Full disclosure of the same event 10 26 Mennen Medica Menntor 7 Operating Manual Reports The Mennen Medical monitors have a reporting tool within the monitor Two types of reports can be created e Chart e Trend Each report includes e Hospital Name As set in the System Setup gt gt General setting e Patient name amp ID e Date and time e Chart or Trend Up to ten reports can be created in System Setup see Appendix D Chapter 5 Paragraph 5 12 Chart Report Any of the User define charts that are created in the monitor can be used for a Chart Report The user can set the chart filter to be used in the report independently from the chart filter on the monitor Smisth Lohn 007 TEST VL 2 07 06 06 10 46 MM Hospital REPORT 1 Dee Time MRI ARTS ARTD ARTM PAPS PAPD PAPM mmz 07706 10 48 120 95 108 25 15 20 07 06 10 47 120 95 108 zs 15 zo 07 06 10 46 120 95 108 25 15 20 07 06 10 45 120 95 108 25 15 20 07 06 10 44 120 95 108 25 15 20 07106 10 43 120 95 108
448. orrective Action Resonating arterial waveform 1 Small air bubbles to the in or very close transducer 2 Tubing too long 1 Carefully flush the transducer and tubing when setting up system De bubble carefully after each flush 2 Shorten tubing EtCO2 Table B 4 EtCO2 Problem Probable Cause Corrective Action Airway Adapter occluded Dirty foggy adapter 1 Check adapter for cleanliness and fog An intubated patient Incorrect adapter sensor airway adapter may fog when placed in a connection warm circuit Wait few minutes for the Sensor on top of circuit fogging to disappear 2 Check that the adapter sensor are correctly connected Sidestream occlusion Kinks in line Watertrap obstructed Check for kinks in the sampling line If no kinks are evident disconnect the sampling line from the water trap If message clears replace the sampling line If message remains replace the watertrap If message persists contact your service representative Error message Device fault detected If Mainstream is being activated check that the sensor in use is the correct sensor recommended for use with the unit Repeat start up procedure If the error message persists contact your service representative Exhaust occluded Kinked exhaust line kinked internal pneumatics bad pump Disconnect the exhaust port con nection If message persists contact your service r
449. osition the transducer correctly in the patient It should be level with the heart The correct position depends on the type of pressure line Zero the transducer If the transducer is not zeroed there will be no valid zero value for the instrument to use Zero the transducer whenever a new transducer is used or as frequently as dictated by hospital policy BP Monitoring Procedures The BP menu provides access to specific dialog panels enabling interaction with all aspects of BP monitoring Each dialog panel enables control of different aspects of BP monitoring The available dialog panels are Mennen Medical Zero Pressure Use this panel to zero BP transducers See Zeroing BP Transducers on page 18 4 Scale Use this panel to define the way BP waveforms are scaled for presentation on the main screen display See Selecting the BP Scale on page 18 6 Alarm Limits Use this panel to activate deactivate BP alarms and set BP alarm limits See Setting BP Alarm Limits on page 18 7 Alarm Response Use this panel to define the way alarms are heard and displayed on the monitor See Setting BP Alarm Response on page 18 9 Display Options Use this panel to define how BP waveforms and values appear on the main screen display See Setting BP Display Options on page 18 11 18 3 Invasive Blood Pressures BP Menntor 7 Operating Manual Activate Use this panel to activate deactivate BP monitoring See
450. ous VT t s Peak Inspiration Pressure Mean Airway Pressure PIP MAP Positive End Expiratory Pressure PEEP Auto PEEP Compliance Static and Dynamic COMP St Dy Resistance Static and Dynamic RES St Dy Ratio I E Plateau Pressure PLTP Negative Inspiratory Pressure NIP Fractional and Inspiratory O2 FiO2 e Oscillatory pressure Stephanie only Posc Airway temperature Stephanie only TEMP Rapid Shallow Breathing Index Babylog only RSB Tidal Volume for High Frequency Ventilation Babylog VThf only Note Not every ventilator covers all the derived parameters Monitoring Procedures The Ventilator menu provides access to dialog panels which enablinVThf g interaction with all aspects of Ventilator monitoring The following dialog panels are available e Alarm Limits Use this panel to activate deactivate Ventilator alarms and define Ventilator alarm limits Alarm Response 26 2 Mennen Medica Menntor 7 Operating Manual Use this panel to define alarm response by tone or recording e Display Options Use this panel to define how Ventilator values appear on the main screen display e Activate Use this panel to activate deactivate Ventilator monitoring OK NOLOG Main Screen VENT 3 2 Alarm Limits Alarm Response Display Options Activate Figure 26 1 Ventilator Vital Signs Menu Selection Ventilator Menu The Ventilator menu can be accessed from the Vital Signs menu or
451. panels enabling interaction with all aspects of O2 NO and Agent monitoring Each dialog panel controls different aspects of monitoring of N5O and Agent levels present during anesthesia Five anesthetic agents are available e Haloten HAL e Isoflurane ISO e Enflurane ENF e Sevoflurane SEV e Desflurane DES Note The term Agent refers to all agents The folowing panels appear in the NO and Agent menus e Alarm Limits Use these panels to activate deactivate etO etN5O etAgent inN5O inAgent and set the high and low alarms limits Mennen Medical 25 9 Anesthetic Gas Monitoring Menntor 7 Operating Manual Alarm Response Use these panels to define how the Menntor X7 responds to detected etO inO etN5O inN5O exAgent inAgent alarms Display Options Use these panels to define how N5O and Agent values appear on the main screen display Scale Use this panel to define the way Anesthetic Agent waveforms are scaled for presentation on the main screen display Activate Use these panels to activate or deactivate monitoring of N5O and agent Note Although 0 and the Anesthetic Agenst have their own menus and dialog panels the menus and panels are identical except for the Activate panel For this reason a single procedure is given below for however the procedure is identical for NO and the Anesthetic Agents unless otherwise noted Accessing the O5
452. patient or to Rename if patient ID or name were entered with a mistake Patient Transfer The Ensemble network system provides the option for the transfer of patient data across the network when the patient is transferred from one monitored bed to another Transfer can be done from and to an Envoy Vitalogik monitor or another Menntor X7 The transferred data includes Patient demographic information Numerical Charts Graphic Trends Event Strips ECG and Vital signs waveform information gt Tosave patient data for transfer purposes 1 When you discharge a patient from a monitored bed enter the ADT menu 2 Select Save amp Discharge this will store the patient information under a ready for transfer file See Figure 9 4 3 If you select the Discharge panel you have the option of either discharge without any storage or Save amp Discharge as above Mennen Medical 9 9 Connecting Patient to Menntor X7 Menntor 7 Operating Manual Note The Full Disclosure data will be deleted and only Charts Trends and Event strips are stored for transfer Note To save Patient Data the ADT panel must include at least a Patient ID or a Patient Name The Data of up to 3 10 with extended memory option patients can be saved on each individual monitor If you save data for more than 3 10 with extended memory option patients the saved data will be replaced on the basis of First in First out FIFO g
453. pedance for that electrode is less than 7 5 kilo ohms Note The ground electrode element 2 must be less than 30 kilo ohms to pass Mennen Medica Menntor 7 Operating Manual HIGH An electrode is labeled HIGH if its impedance value is above 7 5 kilo ohms s long as the combined impedance of electrodes 1 and 3 and the combined impedance of electrodes 1 and 4 are less than 15 kilo ohms the sensor check will be considered successful If the combined impedance is over the 15 kilo ohms limit you will need to re prep the electrodes and check all connections The monitor will continue to check impedance until it is acceptable NOISE If the signal from the electrode goes beyond the measurable range the label NOISE displays Re prep the electrodes and check all connections LEAD OFF If the impedance check indicates that the electrode is not in contact with the patient the label LEAD OFF displays Re prep the electrodes and check all connections The monitor continues updating the values until all impedance values are acceptable To end the impedance test press EXIT The Sensor Check impedance test must be successfully completed before normal processing resumes Sensor Parameters On the lower part of the Sensor Check panel there is a display of e Lot code e Serial Number e Connection Count gt To start BIS sensor check 1 From the BIS menu if you are already in another BIS dialog panel fro
454. play Note Checkboxes appear green when activated and gray when deactivated Mennen Medica Menntor 7 Operating Manual Setting Temperature Alarm Response The Alarm Response panel controls how the Menntor X7 responds to temperature alarms QC ENVOL Main Screen TMP1 5 1 Alarm Response Temp Alarms JE Tones JE Event Strip Temp Fault Alarms JE Record IT Tones Figure 20 2 The Temperature Alarm Response Panel gt To set alarm responses 1 From the Temperature menu if you are presently in another Temperature panel from the drop down list below the panel title area select Alarm Response 2 Select the Record checkbox to activate or deactivate recording of the patient s ECG during the alarm event By default Record is deactivated 3 Select the Tones checkbox to activate or deactivate audible alarms By default Tones is activated 4 Select the Event Strip checkbox to activate or deactivate Event Strip By default Event Strip is deactivated 5 Press Temp to close the panel and return to the Temp menu press Main Screen to close the panel and return to the main screen display Note Checkboxes appear green when activated and gray when deactivated Mennen Medical 20 5 Menntor 7 Operating Manual Setting Temperature Display Options The Display Options panel controls how temperature values are presented on the main screen display Any changes mad
455. pling tubes The MicroPod has an interface cable that fits the UIM input The sampling tube input is protected by window The LED on the MicroPod indicates the following e During startup the LED blinks slowly e During normal operation the LED remains continuously on e During a communication failure malfunction or disconnection of the MicroPod the LED is turned off Note The MicroPod can be used only on Menntor X7 monitors that are not equipped with a built in EtCO2 technology To connect the MicroPod to the monitor 1 Connect the MicroPod interface cable into one of the UIM inputs 2 In the Vital Signs list select the relevant Unassigned UIM input 3 From the UIM Device list select MicroPod The EtCO2 vital sign is activated A technical alarm EtCO2 tube Disconnected appears in the ETCO2 area To connect the sampling tube 1 Shift the window and screw the sampling tube into the input port CAUTION Use only Oridion sampling tube CAUTION Secure the module to prevent it from falling Mechanical shock may damage the module Mennen Medica Menntor 7 Operating Manual Note Ittakes about 30 seconds of initialization from the connection of the MicroPod to the UIM till it is ready for CO2 measurement gt To disconnect the sampling tube 1 Shift the window and unscrew the sampling tube Patient Preparation Checklist Ll Before using any component inspect it for any signs of
456. plosion Hazard This device is not intended for use in the presence of flammable anesthetic agents Environmental Status When the Menntor X7 is working on battery the environmental temperature should not exceed 40 C The battery should be stored separated from the monitor at a temperature that does not exceed 25 C Monitor Storage CAUTION If the monitor is stored for a long period remove the battery and store it separately Use of Manual The instructions for use presented in this manual should in no way supersede established medical protocol concerning patient care Responsibility Mennen Medical Ltd considers itself responsible for the effects on safety reliability and performance of the equipment only if e Repairs are carried out by authorized Mennen Medical personnel only e Electrical installation of the relevant room complies with the appropriate requirements e The equipment is used in accordance with instructions for use WARNING Do not modify this equipment without the authorization of the manufacturer 2 4 Mennen Medical 7 Operating Manual Labeling Symbols The following is short description of the meaning of the various symbols which appear on the Menntor X7 and their location on the equipment Symbol R AN Rony Mennen Medical Description Alternating Current Equipotential Attention consult accompanying docu ments Service to be performed
457. ponds to detected etO inO etN5O inN5O etAgent inAgent alarms Setting N5O and Agent Alarm Limits Use this panel to activate deactivate etO inO etN5O inN5O etAgent inAgent alarms and set high and low alarm limits Selecting an option in the Select Type box activates the corresponding panel containing the current high and low alarm limits as well as the currently measured value for the selected option Alarm Limit Auto Set 202 Alarms Figure 25 6 The O Alarm Limits Panel gt To set 0 and Agent alarms 1 From the O5 N20 or Agent menu if you are already in N5O or Agent panel from the drop down list below the panel title area select Alarm Limits 2 From the Select Type drop down list select etO3 1 or etN5O inN5O or etAgent inAgent to bring up the corresponding panel Mennen Medical 25 11 Anesthetic Gas Monitoring Menntor 7 Operating Manual 3 Press O2 N20 Agent Alarms to activate or deactivate alarms 4 Using the QuicKnob move the slide indicator on the high limit slider bar along the alarm limits scale to set the required high limit and move the slide indicator on the low limit slider bar to set the required low limit Press Auto Set to Defaults to set the N5O or Agent alarm limits to their default values 5 Press Gas Name 02 N20 or Agent to close the panel and return to the Gas Name menu or press Main Screen to
458. ppears 2 From the Show Channels drop down list select the number of channels to be displayed The corresponding data appears on the panel Mennen Medical 14 11 Menntor 7 Operating Manual 3 From the Lead drop down list select the lead to be displayed Only those available for use are displayed The selected lead immediately appears on the main screen display If lead displayed in another trace is selected the leads and respective gains are exchanged 4 From the Gain drop down list select the required gain 5 Select the Set All to Same Gain checkbox to set all lead gains to that selected in trace When activated the checkbox appears green 6 Press Vital Signs to return to the Vital Signs menu Press Main Screen to return to the main screen display Setting ECG Alarms ECG alarm parameters are set in two dialog panels Alarm Limits and Alarm Response Each dialog panel controls a different aspect of ECG alarms ECG alarms are activated and alarm limits are set in the Alarm Limits panel Set alarm limits according to the patient s clinical condition Activating ECG Alarms and Setting ECG Alarm Limits The Alarm Limits panel contains a slider bar with two markers for setting low and high alarm limits Limit values can be set between 20 and 350 beats per minute BPM You can also configure the monitor to automatically set default alarm limits Default values are defined in System Configuration Heart Rate al
459. r A pulse oximeter is an early warning device Use lab co oximeter to completely understand the patient s condition Patient Preparation Checklist 22 2 verify data reliability by checking that the pulse rate displayed on the monitor approximately corresponds to the patient s palpated pulse rate SpO2 readings should not fluctuate more than one digit per second WARNING Pulse rate measurement is based on the optical detection of a peripheral flow pulse and therefore may not detect certain arrhythmias The pulse oximeter should not be used as a replacement or substitute for ECG based arrhythmia analysis Excessive motion at the probe site may result in the display of invalid data To prevent excessive patient movement stabilize the site Ll Select and prepare a probe or sensor suitable for the patient Make sure that the selected probe or sensor is correctly attached and the detector is flush with the skin If not inaccurate SpO2 readings may result Refer to attachment instructions for the selected probe sensor WARNING The disposable sensors are attached to the skin with adhesive tape they are contraindicated for patients who exhibit allergic reactions to foam urethane products and or adhesive tape Dress the cable away from sources of electrical interference Electronic noise emitted from electrosurgery and other electrical devices such as fans can interfere with the signal from the probe Mennen Medi
460. r 7 Operating Manual E The 50 ml min sampling flow rate reduces liquid and secretion accumulation decreasing the risk of obstruction in the sample pathway in humid ICU environments Once inside the Microstream CO2 sensor the gas sample goes through a microsample cell 15 microliters This extremely small volume is quickly flushed through an outlet tube at the back of the monitor allowing for fast rise time and accurate CO2 readings even at high respiration rates An IR source illuminates the microsample cell and the reference channel This IR light source generates only the specific wavelengths characteristic of the CO2 absorption spectrum Therefore no compensations are required when different 4 1 0 0 14 1 17 Apnea Int 20 Apnea Event soos LZ 2 4 AR Figure 23 1 Main Screen Display of EtCO2 Waveform CAUTION The End tidal CO2 is intended to represent the venous CO2 Partial Pressure To achieve this goal the EtCO2 has to represent the Alveolar CO2 get this requirement the CO2 wave has to reach a plateau At high respiration rates the CO2 wave ends before the plateau is reached and the EtCO2 may not represent the alveolar CO2 or the clinical CO2 Intended Use 23 2 The Menntor X7 s End Tidal CO2 EtCO2 Microstream is intended for use with both intubated and non intubated patients It uses real time data to calculate and display the numerical values for End tida
461. r These include alarm parameters and other parameters specific to the monitored vital sign D 22 The Vital Signs Setup menu enables you to access the following dialog panels ECG Setup Respiration Setup BP Setup NIBP Setup SpO2 Setup Temperature Setup CritiCool Setup EtCO2 Setup CO Setup cGas Setup CO2 Setup O2 Setup N20 Setup Agent Setup Ventilator Setup Mennen Medica 7 Operating Manual SvO2 Accessing the Vital Signs Setup Dialog Panels A dialog panel is provided for each available vital sign You can access these dialog panels from the Vital Sign Setup menu gt To access the Vital Sign Setup menu 1 2 Setup In the System Setup menu select Vital Signs Setup The menu is displayed Select the vital sign for which you want to set defaults The appropriate dialog panel is displayed This dialog panel enables you to set ECG default parameters These parameters include Mennen Medical eAlarm priorities for Heart Rate Fault and Pacemaker alarms Alarm priority affects the order of audible and visual alarm notification See Alarm Priority on page 8 4 for a full description of this feature Heart Rate alarm priority can be set at a level of either C 1 or C 2 The factory setting is C 1 eAlarm Latching For complete description of Alarm Latching see Latched Alarms on page 8 7 The available options are Off Visual latching visual alarms only
462. r X7 activates Pacer alarms when the patient status is defined as Paced A Paced condition occurs when 5 Paced beats are detected within one minute over the last 10 minutes Note The Menntor X7 issues Pacer alarms on the assumption that the pacemaker is a Demand Pacemaker To cancel the definition of a patient as Paced select the Relearn function in the ECG menu Three Pacer alarm messages may occur e Pacer Non Capture ineffective stimulation Pacer spike is not followed by QRS e Pacer Non Function QRS rate is lower than the Pacer rate Spikes are expected but not detected e Pacer Non Sense Demand pacemaker does not sense QRS Early pacing occurs after normal or premature QRS The Alarm continues for 1 minute after the last non function beat Mennen Medica Menntor 7 Operating Manual Setting the Heart Rate Source The heart rate derived from continuously monitored ECG is measure of the heart s overall electrical activity The pulse rate is a measure of the heart s mechanical activity pumping blood around the body In certain situations e g due to excessive ECG artifact or the inability to place electrodes on burn patients it may be impossible to derive an accurate heartrate from the ECG and an alternate heartrate source is required If a pulsatile pressure pulse rate is being monitored Arterial Blood Pressure or SpO2 this can be selected as the alternate heart rate source The
463. r panel of the Enscribe chart recorder is the on off switch The front of the recorder includes two buttons e Paper advance press to advance paper e Stop record press to stop recording A LED indicator lights when the recorder is on Timed Vs Continuous Recording Depending on how your Menntor X7 is configured a waveform may be printed out as a timed or continuous recording timed recording terminates after a pre defined time period which is configured in System Setup by your system administrator or hospital Biomedical Engineer In a continuous recording once begun recording continues until it is instructed to stop Depending on the recording type you can stop a recording by pressing a button on a dialog panel or by pressing the Stop button on the Chart Recorder itself Real Time Vs Delayed Data Recording Depending on how your Menntor X7 is configured a waveform may be printed out in real time or as a delayed recording Real time data is continuously generated by the bedside monitor and passed for review and documentation purposes to various peripheral equipment such as the Central Station Recorders or other display stations Delayed data is data previously acquired intended to capture patient s events that occured seconds before the recording started Mennen Medica Menntor 7 Operating Manual Recorder Status Indication Upon initiating recording if the recorder is not ready or out of paper the recorder i
464. r time synchronized to the last cursor location in the Trends panel 17 Click Main Screen to return to the main screen display ST Watch ST Watch panel enables you to review ST data as a graphic representation ST Watch represent changes in ST trend over time Comparing the QRS patterns of change gives an indication of the patient s progress ST leads are available for trending Up to three ST leads and one calculated ST average or sum value can be trended and displayed at one time on four axes The ST leads for each of the axes can be selected individually The Menntor X7 can store up to 10 days of ST trend data Trend display duration times available for selection are 30 min 1hr 2 hrs 3 hrs 4 hrs 6 hrs 8 hrs 12 hrs and 24 hrs A time on a trend can be selected and the actual readings reviewed The actual ECG waveform at each time point can be viewed and compared with up to three reference waveforms The user can mark events on the ST trend curves and calculate the area under the calculated ST average or sum curve for periods of one or more hours Mennen Medical 10 5 Reviewing Patient Data Menntor 7 Operating Manual INSIDE 5 ART PULSE LOW ALARM 35 9198053 114 77 92 ST Watch SST 64 15 20 02 20 1 Eme lt lt gt gt D owe vamp ios dor Figure 10 4 ST Watch Panel 10 6 Mennen Medica Menntor 7 Operating Manual Panel
465. rain Of Four Menntor 7 Operating Manual 31 4 Mennen Medica SECTION 5 MODULES This section contains the following chapters 1 Chapter 32 Recording and Printing 2 Chapter 33 MX57 MPM as Transport Monitor 3 Vendor Device Interface cable P N Andros 4800 Gas Analyzer 641 345 080 Drager Evita 4 ventilator 641 345 058 Leon Plus 641 345 080 PICCO 641 345 060 Poet IQ 641 345 085 Radical 7 641 345 058 Chapter 34 Spirometry 7 Operating Manual Mennen Medica 32 RECORDING AND PRINTING Introduction Three devices provide the Menntor X7 printing and strip chart recording capabilities e Network printer e Enscribe network strip chart recorder Built in strip chart recorder optional To use the first two the monitor has to be connected to the LAN The Built in recorder provides recording capabilities to a stand alone monitor Activation of recording or printing can be performed from the bedside monitor or sent from the Ensemble Central Nurse Station to the bedside monitor to initiate recording or printing Network Printer Mennen Medical monitors supports the following Laser printers HP Laser Jet network printers models 4050N 4200N 4100N 4014N and 4015N To use a Network Printer use the Network setup sub menu of System Setup to choose the printer to be used by the monitor see Network Setup on page D 64 When installin
466. rameters Store Diagnostic File Date amp Time Setup General Settings Alarm Volume amp Controls Disable Touch Screen in Touch screen option Sound Event Default Alarm Limits Event Setup NIBP Leakage test Vital Sign VS Setup Parameter Hierarchy Monitor Profiles Admit by Default Report Setup Automatic Reports Network Setup Recorder Setup Trends Setup QuicKeys Tabular Charts D 1 7 Operating Manual e Software Version e Change Password e Check Disk e Permission Editor e Remove Saved Patients e Touch Screen Calibration e Demo Mode e Master Configuration e Copy Configuration From Introduction System Setup enables configuration of global controls such as setting the date and time or defining the default language for the Menntor X7 It is also used to define default values for all monitored vital signs The Menntor X7 is configured at the factory with factory default values which can be changed as needed by your hospital or department Access to the System Setup menu is limited to authorized personnel such as System Administrator or Hospital Biomedical Engineer possessing pre defined password Accessing the System Setup Menu D 2 From the System Setup menu you can access the following dialog panels e Store Diagnostic File Use this panel to store diagnostic file in the event of malfunction or failure of the Menntor X7 See Service Manual for instru
467. rance of the accuracy specs Accuracy in the presence of interfering gases Accuracy in the presence of interfering gases The accuracy specification is as described below in the presence of interfering gases as defined in the MicroPod Product Specification Oridion document D006643 0 38 mmHg 2 mmHg 4 of the expected reading in mmHg 39 150 mmHg 9 of expected reading in mmHg 0 08 x expected reading in mmHg 39mmHg Respiration Rate Range 0 150 bpm Waveform Sampling 20 samples s Initialization Time 40 s typical includes power up and initialization time System Response Time 3 6 Second Compensation BTPS standard correction used by Microstream capnography dur ing all measurement procedures for body temperature pressure and satu ration Mennen Medical 23 25 End Tidal 2 EtCO2 Microstream MicroPod Menntor 7 Operating Manual Patents Patents covering the module should be listed in the host monitor s Operator s Manual as follows The capnography component of this product is covered by one or more of the following US patents 6 428 483 6 997 880 6 437 316 7 488 229 7 726 954 and their foreign equivalents Additional patent applications pending 23 26 Mennen Medica SECTION 4 UNIVERSAL INPUT MODULE UIM Two UIM connectors are available under the MX57 MPM Note The UIM inputs are only functional when the MPM is inse
468. rd operating procedures or local regulations for the disposal of contaminated medical waste Before use carefully read the Microstream EtCO2 sampling lines Directions for Use Use only Microstream EtCO2 sampling lines to ensure the monitor functions properly 23 23 End Tidal CO2 EtCO2 Microstream MicroPod TM Note Note Note Note Note Menntor 7 Operating Manual During nebulization or suction for Intubated patients remove the sampling line luer connector from the module in order to avoid moisture buildup and sampling line occlusion Replace the sampling line according to hospital protocol or when a blockage is indicated by the host monitor screen Excessive patient secretions or build up of liquids in the airway tubing may occlude the sampling line requiring more frequent replacement When connecting sampling line to the module screw the sampling line connecter clockwise into the module CO2 port until it can no longer be turned to ensure that it is connected securely to the module This assures that there is no leak of gases during measurement at the connection point and that measurement accuracy is not compromised When the Caution message Blockage appears on the screen indicating that the FilterLine which is attached to the module is blocked the module s CO2 pump stops pumping the patient s breath into the module for testing Follow the instructions that appear in the Troubleshooting se
469. rder motor and a short strip of paper will come out Recorder Status Messages The following Recorder Status messages appear on the monitor display until a corrective action is taken or for 2 minutes if no action is taken 32 8 Mennen Medica Menntor 7 Operating Manual Recording in Progress Recorder Door is Open Recorder is Out of Paper Recorder is Busy Pressing the Silence key deletes the message Mennen Medical 32 9 Recording and Printing Menntor 7 Operating Manual 9 32 10 Mennen Medica 33 MX57 MPM AS TRANSPORT MONITOR Introduction The Multi Parameter Module MPM has two models e 57 which is a front end Multi Parameter Module MPM that provides all routinely used vital signs e MPM which is an MPM equipped with an LCD display see Table 1 2 page 1 2 When pulled out of the host Menntor X7 MPM continues monitoring according to the host setup The MPM monitor profile is similar to the Very Big Number display mode of the host monitor independently of the prior monitor profile of the host The vital signs alarm limits and alarm response are duplicated from the host monitor Note MPM does not allow changing the profile of the monitored vital signs Figure 33 1 shows the display of the MPM after it has been pulled out of the host Menntor X7 Mennen Medical 33 1 MX57 as Transport Monitor Menntor 7 Operating Manual Figure 33 1 MX57 D
470. rdingly to display the appropriate message By configuring parameters on this panel you can e Activate or deactivate all Ventilator alarms e Set low and high Ventilator alarms e Set low and high Ventilator alarms to default values 26 4 Mennen Medica Menntor 7 Operating Manual RICU BED Main Screen 6 ES High Limit Law Limit FE 14 amp aS 3 6 EUN gt 54 o 2 4 is m 0 5 5i 222 WF me Auto Set Vent Alarms to Defaults Figure 26 2 Ventilator Alarm Limits Panel gt set Ventilator alarm limits 1 From the Ventilator menu select Alarm Limits 2 From the Select Type drop down list select the type of Ventilator parameter for which you want to set alarm limits 3 Select the All Alarms checkbox to activate or deactivate both high and low limit alarms When deactivated alarm detection is disabled and the slider is disabled 4 Using the QuicKnob set the left marker on the slider bar to the required high alarm limit for the current Ventilator parameter then set the right marker to the required low alarm limit These limits are displayed in the High and Low Limit value areas on the panel Press Auto Set to Defaults to automatically set alarm limits to default values 5 Press Main Screen to return to the main screen display Mennen Medical 26 5 Ventilator Menntor 7 Operating Manual Setting Ventilator Alarm Response
471. recorder in the form of 40mm strips Chart recorder strips serve as the printed patient record for overall documentation indication of unexpected events notification and general off line patient status review Alarm recordings When Record is enabled in the Alarm Response panel for a monitored vital sign a waveform of the vital sign is recorded whenever there is an alarm event Charts and Trends All vital sign data for a patient can be collected and presented in the form of charts or trends reports These reports are printed out on laser printers connected to the Menntor X7 through a network This chapter deals mainly with waveform and alarm recordings For more information about charts and trends see Chapter 10 Reviewing Patient Data Waveform Recording The Menntor X7 has optional inbuilt chart recorder If no inbuilt recorder is installed it supports output to the Enscribe chart recorder The external chart recorder can print 40mm strips displaying one or two annotated waveforms with pertinent patient information The inbuilt recorder can print one two or three waveforms The Menntor X7 can be connected directly to a dedicated chart recorder or when connected to a network can share chart recorders with other bedside monitors on the same network Mennen Medical 13 1 Recording Vital Sign Data Menntor 7 Operating Manual 13 2 Paper advance Figure 13 1 The Enscribe Chart Recorder On the rea
472. rect limit is set Turn the QuicKnob while pressing to set limits in smaller increments The limits you have set appear in the Low and High Limit values areas on the panel or Press Auto Set to Defaults to set alarm limits to default values 4 Press Vital Signs to return to the Vital Signs menu or Press Main Screen to return to the main screen display What To Do When an Alarm Occurs When an alarm is generated an alarm message appears in the Global Message area on the main screen display and or an audible alarm can be heard Note When an alarm occurs you should always first check the condition of the patient Alarm Checklist Identify the alarm and act appropriately according to the cause of the alarm Ll Identify the monitor in alarm Check the condition of the patient Identify the cause of the alarm Silence alarm if necessary When the cause of the alarm has resolved itself make sure that all settings are correct for further alarm detection See Alarm Messages page 8 12 for a list of all alarm messages 8 10 Mennen Medica Menntor 7 Operating Manual Sound Events The Monitor provides several Sound Events that should not be confused with alarms In System Setup Appendix Sound Event on page D 17 there is description of the available sound events and the sound and amplitude can be monitored prior to activation Mennen Medical 8 11 Alarms Alarm Messa
473. rence in the module and cause incorrect measurements Do not use the module with nuclear spin tomography MRT NMR NMT as the function of the module may be disturbed A strong magnetic field located 1 cm or less from the MicroPod might temporarily affect performance of the MicroPod M Do not modify this equipment without authorization of the manufacturer If this equipment is modified appropriate inspection and testing must be conducted to ensure continued safe use of the equipment Loose or damaged connections may compromise ventilation or cause an inaccurate measurement of respiratory gases Securely connect all components and check connections for leaks according to standard clinical procedures Do not cut or remove any part of the sample line Cutting the sample line could lead to erroneous readings If too much moisture enters the sampling line i e from ambient humidity or breathing of unusually humid air the message Clearing FilterLine appears in the message area If the sampling line cannot be cleared the message FilterLine Blockage appears in the message area Replace the sampling line once the FilterLine Blockage message appears Microstream EtCO2 sampling lines are designed for single patient use and are not to be reprocessed Do not attempt to clean disinfect sterilize or flush any part of the sampling line as this can cause damage to the module Dispose of sampling lines and packaging according to standa
474. revious Next gt gt REPORT TREND Back to reports ist Number Of Axis 4 EH Left Parameter Vital Sign HRT EG Parameter colar Red v Green Blue Black ES Min 20 Max 250 Grid Figure D 31 The Report Setup Dialog Panel Displaying Trend Report gt To edit the format of a trends type report 1 From the System Setup menu select Report Setup 2 From the Report List select a report 3 Select Edit Report The Edit Report dialog panel is displayed 4 Inthe Type drop down list select Trends 5 From the Duration drop down list select the time period during which data is collected for the chart Mennen Medical D 61 10 7 Operating Manual From the Paper Size drop down list select the size of the paper you want the report printed out on Available options are Letter Legal Executive A4 and A3 From the Paper Orientation drop down list select Portrait vertical orientation or Landscape horizontal orientation Select the number of axes to appear in the trend report Up to eight axes can be presented Each axis contains a left parameter and a right parameter Select an axis and define its left and right parameters From the Vital Sign drop down list select the vital sign for the left or right parameter e Under Parameter Color select the required color From the Scaling drop down list select Fixed or Dynamic e
475. ring the effects of certain anesthetic agents The use of BIS monitoring to help guide anesthetic administration may be associated with the reduction of the incidence of awareness with recall in adults during general anesthesia and sedation e Bispectral Index is a complex technology intended for use only as an adjunct to clinical judgment and training e In addition the clinical utility risk benefit and application of this device have not undergone full evaluation in the pediatric population WARNING This Menntor X7 patient monitor uses a component modular device in deriving the Bispectral Index BIS purchased from Covidien it is important to recognize this index is derived using solely that company s proprietary technology It is recommended that clinicians review applicable information on its utility and or risks in published articles and literature web site information from Covidien or contact said company if they have clinical based BIS questions relating to this portion of the Menntor X7 Patient Monitor Failure to do so could potentially result in the incorrect administration of anesthetic agents and or other potential complications of anesthesia or sedation We recommend that clinicians also review the following practice advisory that includes a section on BIS monitoring the American Society of Anesthesiologists Practice Advisory for Intraoperative Awareness and Brain Function Monitoring Anesthesiology 2006 104 847
476. rlapping waveforms or a dual grid where the maximum excursion of a waveform is 20mm On the inbuilt recorder it may include one two or three non overlapping waveforms Mennen Medica Menntor 7 Operating Manual Footer The footer appears along the lower edge of the recording strip and contains the following information maintained by the recorder time markers elapsed time and current paper speed Assigning a Chart Recorder to the Menntor X7 If the Menntor X7 is not equipped with an inbuilt strip chart recorder a network chart recorder can be assigned to the Menntor X7 in one of three ways Dedicated Recorder single pre defined Chart Recorder is selected from list of available recorders All waveform recordings will be sent to this recorder only Pooled Recorders Up to three pre defined recorders The waveform is printed on the first available recorder Duplicated Recorders list of up to three pre defined recorders When recording is initiated the recording is sent to all the recorders simultaneously Such recording can be cancelled only on specific chart recorder by pressing the Stop button on the active recorder Chart recorders are assigned to the Menntor X7 in System Setup by authorized personnel only Note If an inbuilt recorder is available all recordings will be performed on the inbuilt recorder and or Enscribe network recorders Recording Types The system supports different
477. rn QuicKnob until the low alarm limit scale is highlighted and press Turn the QuicKnob to the required alarm limit and press Repeat the procedure for the high alarm limit The range for each limit is 0 150 BPM When the QuicKnob is not pressed while turned it increases or decreases the limit in units of 5 BPM When the QuicKnob is pressed while being turned it increases or decreases the limit one BPM at a time or Select Auto Set to Defaults to set high and low alarm limits to default values 4 Select the All Resp Alarms checkbox to activate or deactivate Resp alarm detection When deactivated the sliders for setting alarm limits are disabled 5 Press RSP to return to the RSP menu Press Main Screen to return to the main screen display Setting the Respiration Alarm Response 17 6 Define the way the Menntor X7 visually and audibly responds to respiration alarms inthe Resp Alarm Response dialog panel Default response values are set in System Configuration By configuring the parameters on this panel you can e Define whether visual alarm messages audible alarm tones or both signal a triggered alarm e Activate recording of the patient s respiration waveform when an alarm is detected CAUTION The recorder paper speed is fixed on 25 mm Sec and is not related to the sweep speed setting for ECG or respiration waveforms The respiration waveform will thus look Mennen Medica Menntor 7 Operating Manual
478. rofile 11 Monitor Profile 4 Monitor Profile 10 Monitor Profile 5 Monitor Profile 49 Monitor Profile 46 Monitor Profile 8 Monitor Profile 47 Save Label Show Hide 4 Lett Right Gear Select Key Figure D 26 The Monitor Profiles Selection Setup gt To set up new Monitor profile 1 Set up the monitoring parameters you want according to the instructions in the Vital Signs Monitoring section 2 On the main menu select Setup and select Monitor profiles from the Setup menu The Monitor profile panel is displayed Press Select Key 4 Select an available key frame appears around the key and the buttons along the bottom of the panel become available 5 Click Save gt To name anew Monitor profile 1 Press Select Key in the Monitor profiles panel 2 Turn the QuicKnob and press an available key 3 Press Label The alphanumeric keyboard panel appears 4 Enter the text for the label and press Accept Showing Hiding the Monitor Profile on the Main Screen Once you have defined Monitor profile you can also determine whether it is available for use when admitting a new patient green bullet appears next to those Monitor profiles that are set to appear on the main screen gt To show or hide the Monitor profile 1 Inthe Monitor profiles panel press Select Key Mennen Medical D 55 7 Operating Manual 2 Select the required Monitor profile A frame app
479. rop down list Select TcGas Default Color A panel displaying all available colors appears Select the required color Select Discard Changes to close the panel without applying any changes Select Main Screen to apply the changes and exit the panel Note When you exit a vital signs setup panel you return to the main screen To Mennen Medical continue System Setup you must press the System Setup button again to access the System Setup menu D 43 D 44 Menntor X79 Operating Manual CO2 from Anesthetic Gas Setup This dialog panel enables you to set CO2 default parameters These parameters include setting CO2 alarm priority activating or deactivating alarm latching defining Alarm Detection delay and selecting the default units and color for CO2 values CO2 Alarm Priority Alarm priority affects the order of audible and visual alarm notification See Alarm Priority on page 8 4 for a full description of this feature CO2 alarm priority can be set to C 1 C 2 or C 3 The factory default is C 2 Alarm Latching For a complete description of Alarm Latching refer to Chapter 7 Alarms in the Menntor X7 Operation Manual The available options are Off Visual latching visual alarms only and On both visual and audible alarms The factory default is Off Alarm Detection Delay When an alarm is detected a pre defined delay period allows the system to check in order to avoid false alarms The delay can be set to 3 5 10
480. rted into the Menntor X7 Menntor X7 supports interface to other vendor devices This section contains chapters describing relevant information for these devices Chapter 24 Multigas Anesthesia Analyzer Andros or Poet IQ Chapter 25 Anesthetic Gas Monitoring Leon Plus Chapter 26 Ventilator Leon Plus Saturn EVO Evita Babylog Chapter 27 BIS Bispectral Index Chapter 28 CO CCO SvO2 Vigilance Vigileo PiCCO Chapter 29 Radical 7 Masimo CO Oximeter Chapter 30 CerebraLogik aEEG and EEG Chapter 31 Train Of Four TOF OO Svo Ne LG cr s Vendor Device Interface cable P N Andros 4800 Gas Analyzer 641 345 080 Drager Evita 4 ventilator 641 345 058 Leon Plus 641 345 080 PICCO 641 345 060 Poet IQ 641 345 085 Radical 7 641 345 058 7 Operating Manual Mennen Medica 24 MULTIGAS ANESTHESIA ANALYZER Overview The Menntor X7 Monitor can connect to the Mennen Medical Multigas Anesthesia Analyzer 551 145 500 via the Anesthesia kit The Menntor X7 supports Anesthetic Analyzer Model 4800 and Poet IQ 8500AC side stream analyzers Note This is a Note Model 4800 Principle of Operation Menntor X7 s anesthetic agent module uses Non Dispersive Infrared Spectroscopy NIDS with single beam single detector and fully chopped ratiometric measurement with spinning gas cell The module uses infrared IR light to measure cont
481. rver The Date and Time setting of the Menntor X7 monitor can be set on each monitor individually or if the monitors are connected to a LAN by one device defined as the Time Server Only ONE device on the network can function as the Time Server If one of the devices is set to become the Time Server then the Date and Time setting on all other devices will be disabled and the time can be changed only on the Server device The Time Server sends a time signal every 30 seconds to all the devices on the network Monitors that are in the Discharge mode reset their time to the time sent by the server Monitors that are in the process of monitoring a patient will not respond to the Time Server The Enguard always responds to the Time Server and resets its own time but this will not affect the device that the Enguard is viewing The Ensemble always responds to the Time Server and will reset its own time but this will not affect the device s it is viewing gt To create a Time Server 1 Select System setup password protected in the Setup menu 2 Select Date amp Time Setup in the System setup menu 3 In the Time Server Master set the Time server Master to ON Green 4 Use the Current Date amp Time box to change the time and or date Note If there is a Time Server Master on the network then All other devices will show the Device ID and the Device name of the Time Server Master on the Date amp Time panel Th
482. s RR Air Flow Numeric PEF PIF Air Volume Numeric VT MV Airway Pressure Numeric PIP PEEP he gt en3a7020A Alain Screen SPIRO 4 1 Wf Scale amp Color Figure 34 9 Waveform Scale and Color Display Set Table Setting the parameters on the VS Table panel enables you to do the following 1 To select the cell size for display of Spirometry information in one of the following sizes Quarter Half or Full size Mennen Medical 34 11 Spirometry Menntor 7 Operating Manual 2 To define the color of Spirometry values as they are displayed on the screen values and associated parameters have the same color unless they go into alarm in which case the value takes on the alarm priority color When the alarm condition terminates the original color is restored 3 To select the cells to be displayed by default all Spirometry parameters are displayed To access the Set Table 1 Select Set Table from the Spirometry menu the VS Table panel opens 2 From the VS Table panel select the parameters that you wish to display and press Done 3 From the Cell Size select the size of the data display numbers The spirometry data is displayed on the lower part of the displayed on screen The options are Quarter Half and Full Numbers 4 From the Vent Color list select the color required for Spirometry parameters You have choice of 16 colors 5 Press Main Screen to return to the main s
483. s gu Touch Screen Calibration Demo Mode z Build Master Configuration Copy Configuration From gt discharge a patient 1 2 Press the Setup key to access the ADT menu and select Discharge Patient A window appears informing you that all patient data will be erased and asking you to confirm patient discharge Press Discharge to stop patient monitoring and erase patient data The Menntor X7 bedside monitor is now ready to admit a new patient Press Cancel to cancel the discharge close the panel and return to the main screen display Once the patient has been discharged all defined Monitor Profile Admit Keys appear on the now blank display screen You are now ready to access the System Setup menu gt To access the System Setup menu 18 2 Press Setup button the Setup menu is displayed Turn the QuicKnob until the System Setup button is highlighted and press The System Password panel appears requesting the password Mennen Medica 7 System Password Password is Required Please enter password Figure D 1 The System Password Dialog Box 3 Enter the correct password The System Setup menu is displayed Mennen Medical D 7 7 Operating Manual Date amp Time Setup This panel enables you to set the date and time and to set time display formats for the Menntor X7 bedside monitor Time Se
484. s will store the patient information under a ready for transfer file See Figure 9 4 If you select the Discharge panel you have the option of either discharge without any storage or Save amp Discharge as above Note the Full Disclosure data is deleted and only Charts Trends and Event strips are stored for transfer Note to save Patient Data the ADT panel must include at least a Patient ID or a Patient Name The data of up to 3 10 with extended memory option patients can be saved on each individual monitor If you save data for more than 3 10 with extended memory patients the saved data will be replaced on the basis of First in First out FIFO gt Toremove saved patient data 1 Enter System Setup on the monitor in which the data was saved 2 Select Remove Saved Patient a list of the saved patients is displayed 3 Select the patient and delete Discharging a Patient Use the Discharge Patient panel to discharge a patient When you discharge a patient the following actions occur e monitoring functions stop e data stored in the monitor is erased e main screen display is cleared and Monitoring Profiles are displayed in preparation for admitting a new patient gt Todischarge a patient 1 From the Main menu select the Setup key to display the Setup menu Select ADT and then select Discharge Patient The Discharge Patient panel appears Mennen Medical 9 7 Connecting
485. sage etc 2 Check leads for proper connection and possible shorts 3 Verify Sensor Check passes 4 Verify DSC Self test passes 5 Verify PIC Use Test Sensor or Sen sor Simulator and Sensor Check Sensor Negative Ground or Sensor Positive Ground Problem is detected relating to sen sor ground element 1 Disconnect and examine sensor connection Clean any contamination present 2 Replace sensor if necessary 3 Replace PIC 4 Replace BISx Sensor Over current Sensor is using too much current 1 Disconnect and examine sensor connection Clean any contamination 2 Replace sensor if necessary 3 Replace PIC 4 Replace BISx No more Uses for this Sen sor Sensor has been connected and disconnected too many times Replace the sensor Sensor Invalid Poor or contaminated connection between sensor and PIC Connect clean connection between sensor and PIG An incorrect or defective sensor has been connected to the PIC Replace the sensor Defective PIC Replace the PIC Defective BISx Replace the BISx 27 26 Mennen Medica 28 CO CCO SvO2 Overview The Menntor X7 monitor has interface capability to other vendor devices that measure Continuous Cardiac Output CCO and venous Oxygen saturation SvO2 via it s Universal Input UIM Three devices are supported e Vigilance by Eduards Lifesience Vigileo By Eduards Lifesi
486. ses and the PCWP value appears in the PAP area on the main screen display with a date and time stamp Deflate the balloon Note If approximately 20 seconds elapses after inflating the balloon and you have not accepted a PCWP value the following message appears in the upper left corner of the PCWP dialog panel Deflate balloon Deflate the balloon immediately to allow blood flow into the lungs The Menntor X7 freezes the PAP waveform at the point the catheter was wedged Measuring the Central Venous Pressure The Menntor X7 enables you to intermittently measure the Central Venous Pressure CVP on a BP channel reserved for measuring Pulmonary Arterial Pressure PAP if you are measuring PAP with a Swan Ganz catheter 18 14 Mennen Medica Menntor 7 Note This method of measuring is available only if no other BP channel is used for measuring CVP The Menntor X7 derives the CVP by averaging the expiratory and inhalatory values during respiration and displays it in the CVP from PA dialog panel You can accept this value or manually change the value to better reflect the average value during expiration The Menntor X7 enters the accepted value under Vital Signs in the patient s chart 25 mmHg Change stopcock and press Adjust CVP from PA 11 Ar o A AP v i NS S Va ea A yide 7 Autoscale lt gt Accept Cancel Figure
487. ses or vapors e Temperature 10 C to 40 C Humidity Relative humidity of 15 to 95 Non condensing e Pressure 360 mmHg to 800 mmHg Site preparation e Mount BISx firmly on the bedside or operating table Equipment and Supplies e BISx e Monitor Interface cable e Menntor X7 Interface cable e Patient Interface cable e BIS Sensors Figure 27 1 The BISx Mennen Medical 27 5 BIS Bispectral Index Menntor 7 Operating Manual BISx Features The BISx receives filters and processes patient s EEG signals It is located close to the patient s head where the EEG signal is less subject to interference from other medical equipment The BISx is shown Figute 27 1 Its long flexible Monitor Interface Cable connects to the front of the Menntor X7 BIS input The Patient Interface Cable PIC connects the BIS sensor to the BISx The attachment clip on the BISx is used to secure it in convenient location near the patient s head WARNING Ensure that the BISx does not come into prolonged contact with patient s skin as it may generate heat and cause discomfort CAUTION Do not open BISx for any reason The seal to prevent liquids from entering the BISx may be damaged if opened Service or repairs must be performed only by qualified biomedical technicians Patient Interface Cable PIC BIS Sensor Patient Interface Cable PIC see Figure 27 2 connects the BISx to the BIS sensor Figure 27 2 BISx connecte
488. shock hazard only qualified service personnel should open the module and or the Menntor X7 patient monitor WARNING Do not submerse the Menntor X7 Spirometry module at any time Appropriate cleaning is done by wiping the unit down with disinfectant solution WARNING Useofthe Menntor X7 Spirometry module in the presence of high concentrations of oxygen helium oxygen mixtures and anesthetic agents may cause errors in the reported flow measurement CAUTION The flow sensor airway adapter is disposable and for single patient use only CAUTION The Menntor X7 monitor can display respiration numeric parameters from the Spirometry module or from a UIM Universal Interface Module that interfaces with an external OEM Ventilator If both the Spirometry module and the Ventilator interface are activated simultaneously then the spirometry waveforms and loops are generated by the Spirometry module while the numeric parameters come from the Ventilator In this case the table of parameters is marked as Vent and not as Spiro Mennen Medical 34 3 Spirometry Menntor 7 Operating Manual Spirometry Module The single width Spirometry module continuously monitors the respiratory mechanics of the patient Connector for Sensor Figure 34 1 Front Panel of the Spirometry Module Monitor and Patient Connection single patient disposable flow sensor 15 mm airway adapter made of plastic connects the patient to the Menn
489. source for the Heart Rate value to be displayed is set in the Heart Rate Source panel The available options are Heart Rate ECG Pulse Rate SpO2 or Pulse Rate ABP Arterial BP Only one source can be specified Note When the heart rate is derived from the SpO2 pulse rate the heart rate displayed in the ECG waveform appears in the color of its source the SpO2 display color Heart Rate Source Figure 14 13 The ECG Heart Rate Source Dialog Panel Mennen Medical 14 23 Menntor 7 Operating Manual gt To select a heart rate source 1 From the ECG menu or if you are already in another ECG dialog panel from the drop down menu list below the panel title area select Heart Rate Source The ECG Heart Rate Source dialog panel appears 2 Select the required source 3 Press Vital Signs to return to the Vital Signs menu Press Main Screen to return to the main screen display Note If Auto Heart Rate source is activated the heart rate will be taken from the first available reliable source with the following priority ECG SpO2 ART Selecting a Filter A filter that changes the bandwidth a measure of electrical frequencies contained within an electrical signal can be selected to clean any environmental noise or baseline drift from the displayed waveform The available options are Monitor Diagnostic and Exercise e Monitor This filter is used in normal monitoring conditions Artifacts which may
490. spital LAN Hospital Information System HIS you can use the HIS information to get the patient demographics from the HIS to the monitor see Admit via HIS on page 9 4 These two stages can be performed independent of each other Generally patient information is entered into the Patient Identification Panel after the patient has been physically connected to the monitor In cases where a patient is expected the Mennen Medical 9 1 Connecting Patient to Menntor X7 Menntor 7 Operating Manual information can be entered before the patient arrives This procedure is known as pre admission When you first turn on the Menntor X7 a series of defined Monitoring Profile keys appears on the screen By selecting Monitoring Profile you start monitoring the patient according to default monitoring parameters After you have monitored patient the parameters set for the patient are saved and can be used to monitor other patients The Admit as Previous key allows you to use the monitoring setting of the patient monitored previously by the unit The Menntor X7 makes it possible to save different monitoring parameters under different names thereby creating user defined admit Monitoring Profiles You can create up to 12 user defined Monitoring Profiles which include all definitions necessary for admitting various types of patients such as adult pediatric geriatric etc For more about creating Monitoring Profiles see Setting up Monitorin
491. t To remove saved patient data 1 Enter System Setup on the monitor in which the data was saved 2 Select Remove Saved Patient a list of the saved patients is displayed 3 Select the patient and delete Patient ID Last Name First Name Matches 10 Page 1 1 Figure 9 6 The Remove Patient Data Panel gt To transfer patient data from any monitor on the network 1 Open the ADT panel on the target monitor 9 10 Mennen Medica Menntor 7 Operating Manual Figure 9 7 ADT Panel 2 Select Patient in Transfer key on the right side of the panel Patients in Transfer panel opens Select the Unit from which the patient was released 4 A List of patients that have data stored for transfer on all monitors in the unit is displayed 5 Either select a patient or use the Look For boxes to find the patient Note if you insert one or more letters into the name box a sub list with all patients with the name beginning with the selected letters will be displayed wmm us e fr at ne uim Lo ee mn m de T T 1 Figure 9 6 Patients in Transfer Panel Mennen Medical 9 11 Connecting Patient to Menntor X7 Menntor 7 Operating Manual Menntor X7 to HemoCis Interface Introduction The Menntor X7 to HemoCis interface has three main functions e To Admit a patient from HemoCis Transfer patient clinical data to HemoCis upon Discharge e To open
492. t below the panel title area select Activate 2 Select the Activate checkbox to activate or deactivate temperature monitoring By default Temperature monitoring is activated 3 Press Temp to close the panel and return to the Temp menu press Main Screen to close the panel and return to the main screen display e To assign a temperature name Use the activate panel to assign or unassign a temperature name for each temperature input and to activate or de activate a temperature input connector gt To activate an unassigned Temp 1 Open the Vital Signs menu 2 Select a Temp unassign 3 Select a Site Name the alternatives are TMP2 TMP3 TMP4 TMP5 TMP6 TMP7 TMP8 4 The selection assigns and activates two temperature parameters simultaneously gt To de activate an active Temp 1 Select a TMPNum key and open the TMPNum menu the active button is green 2 Press on the Active button to de activate and save the asignment Mennen Medical 20 7 Temperature Menntor 7 Operating Manual 3 Press Unassign Temp to de activate and unassign pair of temperatures related to the common input Setting Delta Temperature In certain clinical situations measuring temperature at two different sites on the patient and comparing the difference between them is important The detected difference between the temperatures is called the Delta This can be the difference between the patient s body temperature
493. t Volume set the left slider to the maximum alarm volume and the right slider to the initial alarm volume 11 Set the Delay slider to the required delay in seconds 12 Set the Step slider to the required number of steps for each alarm volume increase 13 Select the Increase Intensity checkbox to activate this function Clear the checkbox to deactivate 14 Press Discard Changes to close the panel without applying any changes made Press Main Screen to apply the changes and exit to the main screen Sound Event Sound events are audio messages that are heard when certain events occur Sound files are supplied for the following events Mennen Medical When performing cardiac output the message Inject now is heard at injection time CO Inject wav When performing Wedge Pressure procedure PCWP the audio message Deflate balloon is heard when it is time to deflate the balloon PCWPTimeOut wav When starting up the computer StartUp wav Menntor 7 e NIBP Success NIBP Success wav e NIPB Fail NIPB Fail wav e Use Sound Event panel to assign sound files to events at the Menntor X7 and to define the volume of the sound Sound Event T Figure D 5 The Sound Event Panel gt To configure sound events 1 From the System Setup menu select Sound Event The Sound Event panel is displayed 2 Inthe Event list select the event to which you want to assign a
494. t cable and connect again 13 NIBP Test if replacing OEM Module add the CAS NIBP test results 13 1 Warp the cuff on NIBP SYS XXX Person the hand NIBP DIAS XXX Person NIBP MEAN XXX Person 14 EtCO2 Test 14 1 One Year Passed YES Need Calibration Done 14 2 EtCO2 without Tube not connected mes tube sage should be displayed 14 3 Connect tube and Waveform O K test the Waveform 15 Recorder Built in Test 15 1 Open Recorder Verify O K door 1 Recorder doesn t print In Utilities Activate 2 In Selective Recording Record button option the following mes sage is displayed Recorder door is opened 3 In the upper right corner of the screen appears the icon REG F 6 Mennen Medica 7 Operating Manual Table 1 Par Subject Description Specifications Measured Result val ame Pass Fail 15 2 Remove the Chart Verify paper from the 1 Recorder doesn t Recorder and print close the door 2 In Selective Recording option the following mes sage is displayed Recorder is out of paper 3 In the upper right corner of the screen appears the REC icon 15 3 Insert into the Verify Recorder the chart 1 Recorder starts to print paper and close 2 In Selective Recording the door option no message is dis played 3 In the upper right corner of the screen the REC icon disappears after printing has finished Tested by Date Mennen M
495. t do not use DIN connectors is forbidden and may jeopardize the patient safety CAUTION Conductive parts of ELECTRODES including the NEUTRAL ELECTRODE should not come in contact with other conductive parts including earth CerebraLogik Label CerebraLogik A ut 8 681138010 RevA J 681701138 Rev A 000000000001 RICE e 0473 is Charter Kontron Limited Unit 18 Avant Business Centre 21 Denbigh Road Milton Keynes MK1 1DT England wi Mennen Medical Ltd 4 Hayarden Street Yavne PO Box 102 Rehovot 76100 Israel Made in Israel Figure 30 2 CerebraLogik label CerebraLogik Waveforms and Display Modes Menntor X7 equipped with CerebraLogik can display two sections for each channel in parallel real time EEG and aEEG waveforms The real time EEG is shown under the correlating aBEG of each channel The aEEG shows up to 3 hours with the current time at the right side of the panel During the recording you can see the historical EEG waveforms in parallel as full disclosure of the specific patient in a special History panel The display can be configured in a variety of modes e EEG real time waveform display e EEG real time with aEEG e Very big numbers with one EEG and aEEG display e EEG waveform plus one hour aEEG e EEG and aEEG History panel 30 4 Mennen Medica Menntor 7 Operating Manual Quality Bar and Graph The EEG signal quality is shown by vertical quality bar to t
496. t name Additional WAV are available for user selection CAUTION If you select for C1 C2 C3 C4 a different wav file than the default it is recommended to use the Inter burst Interval per the following standard requirement Table D 2 Priority Standard Priority Inter burst Interval C1 0 to 5 sec C2 2 5 sec to 30 sec C3 2 5 sec to 30 sec C4 gt Mennen Medical D 15 7 Operating Manual Repeat Every sec Defines the time period after which an alarm is repeated every 10 seconds every 20 seconds etc The available options are 10 20 30 40 50 and 60 seconds You can press the Play button to sample the selected alarm tone The factory default values are as follows C1 C2 and C4 20 seconds T1 30 seconds T2 60 seconds SpO2 5 seconds Note Note A repeat time of 0 seconds indicates that the alarm tone is continuous End and Init Volume Sets the volume of the alarm tone when the alarm is first triggered Initial Volume and the maximum volume the alarm can reach until responded to End Volume The alarm volume gets progressively louder until it reaches the maximum level then remains at that maximum level until someone responds End and Init Volume is set on a scale of 0 100 Sliders are provided to set the volume The left slider controls the end maximum volume and the right slider controls the init initial volume Delay sec Sets the t
497. t require pre setup calibration However the Service Calibration Check should be performed to validate the unit for proper calibration approximately once every 12 months Zero calibration is performed automatically at intervals depending on thermal stability During zero calibration measurement is temporarily deactivated for number of seconds and an appropriate message appears on the screen Recommended Anesthetic Gas Verification Procedure The Anesthetic Gas module measures the concentration of the gases in the inspired and expired air for the following 02 CO2 N20 Anesthetic Agent It also provides identification of the following five agents Halothane Isoflurane Enflurane Sevoflurane Desflurane Calibration can be verified by measuring two known gas mixtures one for zero or low level the other for high or span value Zero Calibration Zero calibration is performed automatically by the AnaGas technology using room air as the calibration gas No user intervention is required Span Verification It is recommended to perform Span verification once year Verification can be performed with the following mixture CO2 5 N20 40 Agent 3 not Halothane balanced with 02 52 Note Sincecalibrated gas that includes an Anesthetic agent cannot be kept in high pressure bottles the gas mixture normally comes in small bottles that are easily used up For this reason it is recommended to first use gas mixture without an
498. tCO2 values appear on the main screen display You can choose from 16 available colors D 38 Mennen Medica 7 Operating Manual Qc1 oe EE Extended Alarm Response iv a ome Latehing Off Alarm Detection Delay 0 sec etCo2 Deft Color SEN gt Figure D 15 The EtCO2 Dialog Panel gt To set default EtCO2 parameters 1 From the System Setup menu select Vital Signs Setup The Vital Signs menu is displayed 2 From the Vital Signs menu select EtCO2 Setup The EtCO2 Setup dialog panel is displayed 3 Under Extended Alarm Response e Set the default priority level for EtCO2 alarms e From the Latching drop down list set default alarm latching to On or Off 4 From the Alarm Detection Delay drop down list select the required delay time in seconds 5 From the Units drop down list select the required default measurement unit or mmHg 6 Select EtCO2 Temperature Default Color A panel displaying all available colors appears Select the required color 7 Select Discard Changes to close the panel without applying any changes Select Main Screen to apply the changes and exit the panel Note When you exit a vital signs setup panel you return to the main screen To continue System Setup you must press the System Setup button again to access the System Setup menu Mennen Medical D 39 Menntor 7 Operating Manual EtCO2 Calibration D 4
499. ta While in remote view you can print and record data of the remote bed only To print or record data from the remote bed press the Print or Record buttons Main menu Utilities menu To exit the remote view e the local bed s front panel press the Main Screen button The remote bed disappears from your screen and the local bed is redisplayed Returning to Local Viewing 7 12 While in Remote View you can return immediately to Local View by pressing Main Screen button on the front panel Note Remote View has automatic timeout with return to Local View This time out is set by the System Administrator under the timeout panel and is the same setting as for any full panel namely 1 2 4 or 10 minutes or for no timeout Note When Remote View is used on a display with Touch Screen it is possible to return to the Main Screen by touching the Remote View area Mennen Medica Menntor 7 Operating Manual Alarm Watch When monitoring a local patient you may want to simultaneously view the clinical data of remote patient under your supervision that enters alarm status The Alarm Watch feature allows you to view any other Menntor X7 bedside monitor located on the same network that enters alarm status To view the alarms of remote bed you must first set the local monitor for Alarm Watch in the Setup menu Any remote bed set for Alarm watch that enters alarm status will send message to the watching
500. tars 10 27 Heart Variability eee tete tie tee eanet 10 31 11 Performing Clinical Calculations Viewing the Calculation Panels 5 e te e epe e eta e 11 1 Hemodynainics Calculations tii oett Rte Re ene o ea EE A e bte be ere Pen 11 3 Respiratory Mechanics Calculations rerrrronnrnennrnvennnrenrnnenresnnrneesnsennnnennnneenssersssnnrsennrnsenensensssenssensesee 11 4 Oxygenation Calculations e e aat Ce tete ert te Praet 11 5 Renal Clearance Calculations tee inns EE TP EOS is 11 6 Chapter 12 Performing Medication Calculations Calculation Formulas i erre tote rre ere e reae tee gere ne 12 1 Accessing Medications eden ie dc teu REN E pte Ree Pt et eh te ces 12 3 Using The Medication Calculation Panels eese 12 4 Infusion Rate Calculation ranite et eee eei e pee entes eet eei 12 4 Drug Concentrate Calculation esed deena en ie e We pe SEE eo LE AERE EET HE OO 12 6 Injection Amount Calculation 1 itt the tote eee iet Ce Ite aC Re EE beet AP e Code pt Lees 12 7 Chapter 13 Recording Vital Sign Data Wavetorm Recording ci DG et et re imber eer eate ense edes aaa E ete eere tute 13 1 Recording ep Cet orta 13 5 Section 3 VITAL SIGNS MONITORING Chapter 14 ECG OVERVIEW io oerte i Re ER HH rere fea ET
501. technical alarm messages Adjustment of alarms limits on the vital signs is also available The values are memorized in Charts and Trends and are sent to reports These values may also be used to perform various calculations The data and alarm messages are transmitted to the central stations through the network Note The display by the Menntor X7 Patient Monitor of an Auxiliary Device Junction should be regarded as secondary duplication of the functions This secondary duplication should be used for user convenience in comparing data and registering events for data management purposes The Menntor X7 monitor should not be considered the primary monitoring display for the Auxiliary Device The Auxiliary Device should always be considered the primary monitoring source In the event of discrepancy between the Auxiliary Device and the Menntor X7 monitor the Auxiliary Device always takes priority Note Menntor X7 auxiliary ventilators supported are e Drager Evita ventilator Leon Plus by Heinen amp Lowenstein e Ventilator Saturn EVO Stephanie Ventilator by Stephan e Babylog VN 500 ventilator by Drager Mennen Medical 26 1 Menntor 7 Operating Manual Ventilator Parameters Depending on the Ventilator device in use the parameters that maybe selected include e Respiration Rate total and spontaneous RR t s Minute Volume total and spontaneous MV t s Tidal Volume total and spontane
502. tee te eot atn 29 3 Mennen Medical vii 7 Operating Manual Setting SpCO Alarm Limits ce n cep e ea reed nie 29 3 Setting SpMet Alarm Limits 11 uideo lee eto esed eed dece cet eta dee dea aree e dede iren 29 3 Display Options usa sure see evt 29 3 REA M 29 3 Chapter 30 CerebraLogik Introduction 12er dete eter tereti ete e eiet 30 1 eto Re p e tre o pe AE 30 4 CerebraLogik Waveforms and Display Modes eese eene ren nnne 30 4 Operating Menntor X7 Monitor with CerebraLogik eese nene enne 30 6 Technical Alarm o RR ee Ae tete Y pe ne utt des 30 7 Monitoring Procedures SD e de t A eite e 30 7 Cerebrabogik Display Modes i Eti ere oL SHOE EHE E PSP Leere rtis 30 11 eR MU 30 15 EEG eet dete Heide eet te ata ee 30 18 Data Storage and Export nte Een tee Pete 30 20 Recording De nde e eR Re RP LO E sku ont eA ne 30 24 Printing oi nie Re P ete ee peto e eee de ecce 30 25 Routine Maintenance mno ette ose tet elTe OO a RAA Greide 30 25 Chapter 31 Train Of Four TOF Introduction deoa inmediato 31 1 Interfacing with ne re e OE Re eode Cere este aes ted tte odd 31 2 Section 5 Modules Chapter 32
503. the Menntor X7 responds to Spirometry alarms for each parameter type The panel is divided into three areas Parameter Type selection where the parameter to be set is selected Alarms where response preferences are set for clinical alarms Fault where preferences are set for technical alarms To access the Alarm Response panel 1 Select Alarm Response from the Spirometry menu The Alarm Response panel appears Under Parameter Type Selection choose the parameter to be set 2 Under Spirometry Alarms Select the Record checkbox to activate or deactivate recording of the patient s condition during the alarm event By default the checkbox is deactivated Select the Tones checkbox to activate or deactivate audible alarms By default the checkbox is activated 3 Under Spirometry Fault 1 Select the Record checkbox to activate or deactivate recording of the patient s condition during the alarm event By default the checkbox is deactivated ii Select the Tones checkbox to activate or deactivate audible alarms By default the checkbox is activated 4 Press Main Screen to return to the main screen display The purge pump is automatically activated every 5 minutes You can also manually activate the purge pump Mennen Medica Menntor 7 Operating Manual gt Activate To access the Purge pump Select Purge from the Spirometry menu in order to activate the purge pump W
504. the distal end is inflated the Menntor X7 automatically calculates the Pulmonary Capillary Wedge Pressure PCWP value and then permits you to modify the derived value The final PCWP value is equal to the Left Atrium BP Similar procedures are provided for measurement of PAP and CVP from the same transducer by rotating the stopcock of the Swan Ganz catheter between the catheter s distal for PAP or proximal for CVP ends Mennen Medical does not manufacture pressure transducers See Appendix A for Mennen Medical recommended transducers and accessories Appendix A Accessories on page A 1 Other pressure transducers and accessories may be used for invasive blood pressure measurement however they must comply with IEC 60601 2 34 standard Warnings e Do not re use disposable devices e Transducers or accessories which are supplied as sterile must by identified as sterile e operator must avoid conductive connection to applied parts parts which come in contact with the patient such as metal cocks which could degrade the electrical safety of the system Mennen Medica Menntor 7 Operating Manual Preparatory Checklist LI LI Insert the pressure cable into the input Prepare the pressure line and transducer using your routing hospital procedure Make sure that there are no air bubbles Connect the catheter to the pressure line Make sure that no air is present in either the catheter or the line P
505. the name of the site e g CVP or LAP BPx Generic Blood Pressure ART Arterial Pressure AO Aortic Pressure PAP Pulmonary Arterial Pressure CVP Central Venous Pressure RAP Right Atrial Pressure LAP Left Atrial Pressure ICP IntraCranial Pressure CPP Cerebral Perfusion Pressure Mennen Medical 18 1 Invasive Blood Pressures Menntor 7 Operating Manual Caution BP waveforms are filtered to clean environmental noise 12 Hz low pass filters BP rates are calculated and displayed in mmHg units Systolic diastolic and mean values are calculated for each BP channel every second and are included in the beat by beat data for each heartbeat Once a minute the Menntor X7 Series collects trended data including the minimum maximum and mean BP values for each monitored BP channel The Menntor X7 checks the cables and transducers If a cable or a transducer is not properly plugged in or if a transducer is short circuited a technical priority alarm is displayed When an alarm on a monitored BP is detected the normal display color for the values of that BP changes to the alarm priority display color When the alarm condition passes normal display color is restored The Menntor X7 also enables you to monitor Left Atrium BP by using the Wedge Pressure procedure A Swan Ganz catheter is inserted into a central vein and the distal end of the catheter is situated in the pulmonary artery After the balloon lumen surrounding
506. this panel The Menntor X7 automatically determines the injectate temperature by using either a separate bath probe or the COSetTM injectate probe Enter the catheter computation constant in the Catheter Information panel The Menntor X7 uses the Computation Constant to determine the correct K factor for catheter and the injectate volume which are used in the calculation of cardiac output The K factor adds coefficient based on catheter French size injectate volume and injectate temperature This compensates for the warming of the injectate as it passes through the catheter lumen The Menntor X7s allows manual entry of the Computation Constant for the catheter being used When entering or accepting Computation Constants verify that Computation Constant are being used and not K Factors which some manufacturers provide with the catheter To convert K factor to computational constant see Table 19 19 1 Table 19 1 K Factor Conversion Inj Method Inj Vol 2 5F 4 5F 7F 7 5F Temp ml STD Spectra STD Spectra STD Spectra STD Spectra med med med med Ice Bath 0 5 10 576 542 566 563 566 5 272 279 247 270 257 270 3 153 160 132 151 143 151 Closed Inj 6 12 10 623 561 579 574 579 System 8 16 5 310 368 291 259 281 287 281 Room Temp 19 22 10 599 578 628 582 628 292 316 274 309 277 309 3 188 154 18
507. tient strangulation the Patient Inter face Cable PIC must be carefully placed and secured Note Bispectral Index BISx BISx logo BIS the BIS logo and Zipprep are trademarks of Covidien Inc and are registered in the U S A E U and other countries Installation and Preparation for Use This section provides installation instructions for the Menntor X7 Monitor BIS BISx and accessories It includes Installation checklist Environmental considerations Required equipment and supplies Cable connections Start and shutdown procedures Initial menu settings Installation Checklist Ll Open packages and inspect all components Menntor X7 BIS interface cable p n 681 304 027 BISx P N 186 0195 SF BISx P N 186 0195 SF PIC Patient Interface Cable connects BISx to patient BIS Sensor Basic set of 5 sensors are supplied with BISx and BIS Additional Sensors are sold separately For a list of available sensors please contact Covidien or your local distributor O Activate the BIS Connect BISx to PIC and sensor 27 4 Mennen Medica Menntor 7 Operating Manual Attach sensor to the patient s forehead L Perform sensor check Environment Considerations Shipping and storage environment BISx e Temperature 10 C to 60 C e Humidity 15 to 95 non condensing e Pressure 360 mmHg to 800 mmHg Operating environment BISx The BISx is not designed for use in areas containing flammable ga
508. ting Patient to Menntor X7 lt none gt en370072 A D T PLEASE ADMIT PATIENT FROM CLINIBASE Cancel Discharge Figure 9 17 Discharge Panel Get CliniBase Id Menntor X79 Operating Manual 5 You now have the option to return to the ADT panel by pressing Get HemoCis ID or Discharge or Save amp Discharge without transfer to the HemoCis Setting up Monitoring Profiles When admitting a patient the admitting staff member must define which vital signs to monitor and how those parameters appear on the main screen display In order to simplify this process the monitor can be configured with pre defined Monitoring Profiles which include all definitions necessary for admitting various types of patients such as adult pediatric geriatric etc Monitoring Profiles make it possible to prepare standard patient monitoring profiles allowing staff to connect a patient quickly without having to first configure the Menntor X7 or at least to reduce configuration to a minimum Up to 12 Monitoring Profiles can be configured for use in the Menntor X7 This includes 11 user defined Monitoring Profiles and one default Admit as Previous key that saves the settings defined for the previous patient monitored by the unit Only those Monitoring Profiles defined for use in the unit appear on the display screen 9 20 Mennen Medica 7 Operating Manual You can set up Monitoring Profiles while monitor
509. tive Recording gt To perform a selective recording On the Menntor X7 Main menu select the Patient Data key From the Patient Data menu select Selective Recording Select the Selective check box In the Paper Speed list select the required paper speed In the Waveform1 list select the first waveform In the Waveform2 list select the second waveform With an Inbuilt recorder select Waveform3 list 9o m Qv ME PN Press Start Recording Recording begins and the button changes to Stop Recording Press Stop Recording to stop the continuous recording All Waveform Recording An Waveform recording contains all displayed clinical waveforms Waveforms are recorded in a series of 5 sec waveforms The recording shows several seconds Mennen Medical 13 7 Recording Vital Sign Data Menntor 7 Operating Manual of information prior to initiating the recording Recording stops automatically at the end of the series You can stop recording at any time by pressing the Stop button on the Chart Recorder gt To perform an All Waveforms recording 1 Menntor X7 Main menu select the Patient Data key 2 From the Patient Data menu select Selective Recording 3 Select the All Waveforms check box Recording is initiated on the associated chart recorder and message appears on the Selective Recording panel Recording now in progress 13 8 Mennen Medica SECTION 3 VITAL SIGNS MONITORING This section co
510. to MPM being pulled out of the host e MPM is pulled out during monitoring If pulled out during patient monitoring the MPM continues monitoring with Demographic patient type Adult Neonatal and monitoring profile set by the host e MPM is pulled out during Discontinue If pulled out during Discontinue the MPM starts monitoring with Patient Demographic patient type Adult Neonatal taken from the host and MPM Default monitoring profile e MPM is pulled out during Discharge If pulled out during Discharge the MPM starts monitoring with patient type Adult Neonatal taken from the host and MPM Default monitoring profile e MPM is pulled out during Menntor X7 power off The MPM remains in Power OFF mode Upon Power ON the MPM restarts using the default monitoring profile Table 33 2 MPM Default Profile Vital Sign Alarm Limit Color Setting ECG lead II 50 150 Yellow ECG Filter Monitoring HR source Top Right SpO2 90 100 Light purple Spo2 Sensitivity SpO2 response time Top Left Respiration 10 40 Green Resp lead Apnea Non Function Bottom Right NIBP Sys 100 150 Blue Dia 50 100 Mean 75 125 Bottom Left Temp 1 36 0 38 0 OC Purple Mennen Medica Menntor 7 Operating Manual Table 33 2 MPM Default Profile Vital Sign Alarm Limit Color Setting Adult Neonatal Adult Alarm Response Tone or Event strip Alarm
511. tomatically Mennen Medica Menntor 7 Operating Manual 3 Press Discard Last Measurement to clear data on the last injection in the Current graph 4 Press Clear All Measurements to clear the average and all data in the Previous graph 5 Press Save and Clear Measurements to save the average CO and clear all graphs The data is accepted and will be displayed as the last measured CO 6 Press CO to close the panel and return to the CO menu Press Main Screen to close the panel and return to the main screen display Note During the Cardiac Output thermal dilution procedure the CVP alarms are disabled to prevent alarms during the cold saline injection into the central vein Cardiac Output Measurement Sources of Errors Physiological Reasons Patient movement during the procedure e Anxious patient Variations in cardiac rate and rhythm Cardiac abnormalities for example incompetent valves M Catheter related Errors Balloon inflated during measurement Catheter not positioned properly Damaged catheter HM Injection Errors Use of the wrong catheter injection port Poor timing of injection ncorrect volume of injectate naccurate injectate temperature M Instrument Errors ncorrect computation constant nstrument failure Mennen Medical 19 5 Cardiac Output C O Menntor 7 Operating Manual Defining Catheter Information The Computation Constant can be viewed and defined in
512. tor X7 Remote Keypad Menntor X7 Analog Output The back DB9 connector can be defined during PO with following options e AUX e MCU Remote The table below provides the DB9 pin out for the AUX option Table 3 1 9 PIN on the UUT rear panel AUX Connector option Pin Signal Amplitude 1 pin 5 ground ECG II 1 Volt p p 1 mV 2 pin 6 ground ECG V1 1 Volt p p 1 mV 3 pin 7 ground ECG Sync Square pulse 5v 100 mSec 40 4 6 ground ART Pressure 1 Volt 100mHg Monitors Network The Menntor X7 can be used as part of LAN network on which all Mennen Medical monitors and devices are connected The network uses Multiport managed layer 3 switch between all Mennen Medical devices The LAN network enables Bed to Bed communication as well as connections to Ensemble Central Nurse Station Mennen Medical 3 5 System Description Menntor 7 Operating Manual e Enguard Remote monitor e Strip chart recorder Laser network Printer Wireless Network optional Monitors equipped with the wireless network option can interface with the monitors LAN without a hardwire connection Note No change in functionality will occur as long as the wireless connection is functioning The wireless technology uses a protected wireless network To prevent loss of data or alarms due to interference numeric vital signs and alarms are sent to the network every second
513. tor X7 bedside monitor can be cleaned with most common hospital cleaning solutions and detergents Be careful not to use caustic detergents or ammonia or acetone based cleaning solutions These may damage the bedside monitor gt clean the Menntor X7 bedside monitor and accessories 1 2 Mennen Medical Switch the monitor off and disconnect from the power supply before cleaning Dust the monitor regularly Clean with a lint free cloth or sponge dampened with cleaning solution Abrasive scouring powders and pads should be avoided to prevent damage to the monitor Clean the display screen with non abrasive glass cleaners such as Ajax or Windex Use a lint free cloth A paper towel may damage the screen Before cleaning a Touch Screen disable the Touch functionality To disable Touch enter System Setup password protected and press the Touch Screen key At the end of the cleaning re activate the Touch functionality Clean patient cables and all exposed surfaces with mild soap solution only Using alcohol or any type of concentrated cleaning solution may impair patient cable flexibility Remove any adhesive used to attach the cable to the patient To remove adhesive residue use a plaster remover solution made up of one third alcohol two thirds water or use a commercial tape remover such as Scholl Double Seal tape remover Do not use strong solvents acetone straight alcohol ammonia etc These will damage the c
514. tor X7 spirometer module Mennen Medical uses an OEM sensor with the trade name EZ Flow flow sensor Note The term flow sensor is used interchangeably with airway adapter The spirometry sensor depicted below consists of the Pneumotachograph and a triple tube that connects the sensor to the module Figure 34 2 Flow sensor air adapter The sensor is classified as a fixed orifice differential pressure device The EZ Flow flow sensor is connected in series to the ventilation tubing and the 34 4 Mennen Medical Menntor 7 Operating Manual patient tubing and is joined to the module via set of three tubes There is no conductive connection between the patient and the Menntor X7 Spirometry module Flow sensor to monitor Connect the sensor tubing to the Spirometry module before placing the airway adapter in the patient ventilation circuit The end of the triple lumen tube of the sensor fits into the triple connector of the module shown in Figure 34 1 Insert the blue tube in the larger port for proper tubing placing Once the tubing is aligned correctly firmly press tubing into the connector Flow Sensor to patient circuit gt To start monitoring the pulmonary mechanics spirometry of a ventilated patient 1 Disconnect the flex tube of the patient from the wye tube of the ventilator 2 Insert the flow sensor between the patient tube and and the ventilator tube 3 Orient the tubing of the airway adapter
515. tream Monitoring for Intubated Patients 00 le eese nennen 23 6 Sidestream Monitoring of Non Intubated Patients eese 23 7 Titub ted Sidestream Monitoring eerte edidere i re pete Yes e tre tee ales 23 7 Monitoring Procedures ie eee eee ete oce tenete Cette P e rd da Te eL Rte echte e a 23 7 Accessing the BtCO2 Menu i eet EE RE ime ette ie edes 23 8 Setting EtCO2 Alarms vete eee epe ee e Ree a e Ee tL URL Red 23 9 Setting BtCO2 Display Options ree teret ete ridet eee e eee RE eg eue 23 12 uU 23 14 Activating EtCO2 MOnItOFIDg eii e E Po e i IER te ELE er oes rot Lr te E hae aet aeia 23 17 Points to Consider and Possible Causes of Error sees ener nennen 23 18 Warnings and Precautions oio tete eee Ense retenu dee t Re HERE 23 21 EtCO2 Specifications Ire Pa We eee HEREDI EE ROMs 23 24 legna E 23 26 Section 4 Universal Input Module UIM Chapter 24 Multigas Anesthesia Analyzer OVEN CPI sees 24 1 Model 4800 Principle of Operation srernvnnvrnonennvvnnvervrnnenrrnvnnnvennrasrasennsnnnsnvernensvrasnvrsnensnenenessnssevsssnne 24 1 Intended Use in se E 24 2 Anesthetic Gas e PEE rive 24 2 5 Warnings drei eire ti gehe
516. trode Placement 14 4 Mennen Medical Menntor 7 Operating Manual 1 If necessary shave the area where the electrode is to be placed 2 If necessary rub the area with a gauze pad or fine sandpaper to lower skin resistance 3 Clean the area with an alcohol pad to remove residue and skin oils 4 Dry the skin Snap the lead wires to the electrodes before placing them on the patient s chest 6 Place the electrodes on flat bony areas avoiding fat or muscle 7 Tape wires to provide strain relief After preparatory procedures are completed and the electrodes are in place connect the ECG cable to the green input socket on the front of the monitor Neonatal Electrode Placement ELECTRODE PLACEMENT 3 LEAD CABLE ine of Maximum Respiration bigr al Transthoracic Lead I ph Line of Maximum Respirg Signal Transabdominal Ras RA White Right mid auxiliary line about one inch below the nipple LA Black Left mid auxiliary line about one inch below the nipple LL Red Anterior surface of the left thigh preferrably mid thigh Figure 14 4 Three Lead Neonatal Electrode Placement Mennen Medical 14 5 1 2 3 4 Menntor 7 Operating Manual Clean the area where the electrode is to be placed Dry the skin Attach the lead wires to the electrode prior to placement Place electrodes over flat bony areas not over fat After preparatory procedures are completed and the electrodes
517. tters on a black background will be displayed and Heart Rate counting will continue on the unaffected lead If the level of noise in both of the two top displayed leads is such that it prevents reliable detection of ORS a message entitled Artifact in white letters on a red background will be displayed and Heart Rate counting will stop The Heart Rate numerical area will be displayed in dashes Mennen Medical 14 3 Menntor 7 Operating Manual Adult Electrode Placement THREE LEAD Three Lead Cable Electrode Placement RA white Midclavicular on Right LA black Midclaviculat on Left LL red Ground 6th or 7th intercostal space on left midclavicular line Figure 14 2 Three Lead Electrode Placement FIVE LEAD Five Lead Cable Electrode Placement RA white Right midclavicular line V1 Fourth intercostal space at right directly below clavicle sternal margin LA black Left midclavicular line V2 Fourth intercostal space at left directly below clavicle sternal margin RL green 6th or 7th intercostal space V3 Midway between V2 and V4 on right midclavicular line V4 Fifth intercostal space at LL red 6th or 7th intercostal space midclavicular line on the left midclavicular line V5 Same level as V4 on anterior axillary line C brown On the patient s chest Place V6 Same level as V4 on mid axillary line on one of the V positions Figure 14 3 Five Lead Elec
518. turn the QuicKnob until the Patient Data key is highlighted and press to access the Data Review menu 2 From the Patient Data menu or When the Patient Data panel is already displayed from the drop down menu below the panel title select Overview to open the Overview panel Mennen Medical 10 21 Reviewing Patient Data Menntor 7 Operating Manual ECG Patient Data 14 55 05 14 55 10 Scroll Sew SAS Full Disclosure Mark Event 1mV em left Cursor fast Right gt Available data time span 13 11 14 00 13 11 14 57 Gain Box Figure 10 12 The Overview Panel The waveform for each vital sign is displayed in the same color as the vital sign on the main screen display scale for each vital sign appears on the left side of the panel Calculated vital sign values appear above each waveform For arterial and pulmonary artery blood pressure three values appear Systolic diastolic and mean Where applicable the vital sign value current at the point where the cursor intersects the waveforms appears in parentheses The Date and Time boxes present the date and start time of the waveforms currently displayed The time span of the patient s waveform data stored in the Menntor X7 s memory appears in the bottom right corner of the panel Statistical data for the ten seconds under review appear below the waveforms including Time stamps for the beginning middle and end of the ten second per
519. ty by disconnecting the sensor cable and by removing the sensor from the patient s finger Common causes of a low signal are Probe site too thick A large distance between the emitter LED and the detector can reduce the signal strength and result in a poor signal Select a thinner site Poorly perfused site Select an alternate site or rub site to improve perfusion Mennen Medical 22 3 Pulse Oximetry SpO2 Menntor X79 Operating Manual Dark pigmentation Very dark skin pigmentation may result in low signal strength Move the probe to a site with less pigmentation Artificial fingernails or heavy nail polish Select a different probe site or have patient remove nail polish Bright sunlight bright operating room lighting infrared heaters and bilirubin lights may interfere with measurement If such a problem should arise shield probe or sensor with opaque material such as a towel to prevent a poor signal CAUTION Do not apply tension to the probe cable Probe damage may result Cleaning Disposable sensors are for single patient use only and should not be cleaned or disinfected To clean a re usable sensor first remove the sensor from the patient and disconnect it from the patient cable Clean the sensor by wiping it with a 70 96 isopropyl alcohol pad Allow the sensor to dry before placing it on a patient CAUTION Do not soak or immerse the cable in any liquid solution Do not attempt to sterilize th
520. types of recording Mennen Medical Manual Alarm Multi ECG Selective All Waveforms 13 5 Recording Vital Sign Data Menntor 7 Operating Manual Manual Recording waveform recording can be made at any time by selecting the Main menu from the Main menu selecting Utility and then pressing the Record key The recording is sent to chart recorder as defined in the Menntor X7 system setup Pressing again the Record key while recording is in progress terminates the recording successfully Consult your System Administrator or Hospital Biomedical Engineer for the locations of your assigned chart recorders Vital Sign Alarm Recording When connected to a chart recorder the Menntor X7 can record alarm events to document the transition from normal state into the alarm condition The recording shows several seconds of information prior to the transition and an equal amount of time after that transition When Record is enabled in the Alarm Response panel for a monitored vital sign a waveform of the vital sign is recorded whenever there is an alarm event To enable recording of a vital sign alarm 1 In the menu of the appropriate vital sign select Alarm Response 2 Select the Record check box If there is more than one alarm for example in Respiration there are two alarms available Respiration Rate and Apnea select the check box for each alarm or only for the alarm that you want to be recorded 3 Click
521. u see Recorder Setup on page D 65 To send recordings to the Enscribe set the Network recorder as the target recorder To activate a Manual recording 1 Use the hardware Record key or c Select Main menu 2 Select Utilities menu 3 Press Record Mennen Medica Menntor 7 Operating Manual Note Alternatively you can create a Record Quickey and press it to activate Manual recording gt To activate Selective Recording 1 In Patient Data menu select Selective Recording Three options are available e Multilead To record a 5 second strip of each ECG lead e Waveforms To record a 5 second strip of the top displayed ECG and all active vital signs waveforms e Selective Recording Recording of two user selected waveforms starts when the Start button is pressed Recording stops when the the Stop button is pressed gt To set up recording upon an alarm 1 Select Alarm Response in the relevant vital sign foe example ECG SpO2 or BP 2 In Alarm Response panel activate Record If the alarm is from ECG this results in a two ECG channel recording or for other vital signs in a two channel recording the top displayed ECG and the vital sign that created the alarm Changing the Enscribe Recorder Paper The Enscribe network Recorder is connected to the LAN network and can record waveforms sent from monitors on the network Mennen Medical 32 3 Recording and Printing Menntor 7
522. ual The TOF Watch SX is an instrument for monitoring the neuromuscular transmission during surgery or in the intensive care unit by means of acceleromyography Mennen Medical 31 1 Train Of Four Menntor 7 Operating Manual Interfacing with TOF Watch 31 2 The interface to the Menntor X7 monitors enables displaying and storing the TOF response in parallel with the other vital signs monitored by the monitor The TOF menu provides access to following panels e Display Options Use this panel to define if TOF values appear Big Numbers Secondary or None e Alarm Response Use this panel to define alarm response by tone e Activate Use this panel to activate deactivate TOF monitoring To connect to TOF Watch 1 Connect the TOF Watch interface cable to the UIM socket of the Menntor X7 monitor 2 Inthe Vital Sign menu select UIM unassigned 3 From the UIM list of devices select TOF Watch The TOF menu provides access to following dialog panels TOF Display Time 18 48 Figure 31 1 TOF Display The TOF display consists of four vertical bars showing the relative strength of the four twitches using the first twitch as reference The strength of the forth twitch relative to the first one is presented as percentage If less than 4 twitches are detected number between 0 and 3 will be presented in place of the value If 4 twitches are detected but they are too small to calculate percenta
523. ual Arrhythmia alarms In some cases you can also set alarm limits and specify where you want Arrhythmia data to be displayed on the main screen The Arrhythmia Alarms dialog panel contains buttons that display the current status of the individual Arrhythmia alarms Note If your system is configured to monitor basic Arrhythmias only those Arrhythmia types included in the basic Arrhythmia set appear on the Arrhythmia Alarms dialog panel If your system is configured to monitor extended Arrhythmias all the Arrhythmia types appear A green checkbox to the left of an Arrhythmia alarm name indicates that the alarm is activated A green checkbox to the left of an alarm response record or tone indicates that it is activated In cases where alarm limits are user defined the panel also presents the currently monitored value and alarm limit To activate and set all Arrhythmia alarms 1 From the Arrhythmia menu or if you are already in the Arrhythmia Activate panel from the drop down list below the title area select Arrhythmia Alarms The Arrhythmia Alarms dialog panel opens Alarm and alarm response keys for all arrhythmias are located in the top right corner of the arrhythmia alarm panel Arrhythmia Arrhythmia Alarms Ree I Tone Event Strip Awa on on om All Tones gt B raioventricular Rhythm B Premature Atrial Contraction 1 Record 1 Record 1 Tone
524. ucer level higher than heart Loose connections Check patient and transducer positions Check and tighten connections No Pressure If the monitor is switched on and there is no pressure a transducer or connector wire may be broken 1 Replace transducer and cable 2 Check stopcocks Noise or fling in the pressure waveform 1 Movement of PAP catheter tip 2 Motion of pressure tubing 1 Reposition catheter according to hospital procedures policy 2 Make sure the patient or ventilator tubing is not touching the pressure tubing Dampened arterial waveform 1 Thrombus formation or blood left in catheter following blood sampling 2 Large air bubble in tubing 3 Catheter tip against the vessel wall 4 Catheter kinking or arteriospasm 5 Tubing too long or pliant 6 Improper sequence of stopcock operation 7 Defective transducer and or amplifier Use syringe to withdraw air or particles in catheter then flush the line with fresh solution Use syringe to withdraw air in tubing then flush line with fresh solution Reposition the catheter to relieve spasm Shorten the tubing recommended length 3 4ft or replace with large diameter stiff tubing Flush line re zero and recalibrate Replace transducer and have the monitor checked B 2 Mennen Medica 7 Operating Manual Table B 3 Invasive Blood Pressure Monitoring Problem Probable Cause C
525. ular Rhythm Pacer not sensed Pacer non function Pacer non capture BP High Systolic Alarm High Diastolic Alarm High Mean Alarm Low Systolic Alarm Low Diastolic Alarm Low Mean Alarm Not Zeroed Zero in progress Zero Failure Unstable transducer Transducer failure Transducer Fault NIBP High Systolic Alarm High Diastolic Alarm High Mean Alarm Low Systolic Alarm Low Diastolic Alarm Low Mean Alarm NIBP No Systolic NIBP Air Leak NIBP Over Pressure Mennen Medical 8 13 Alarms Menntor 7 Operating Manual Table 8 4 Alarm Messages Continued Vital Sign NIBP cont Alarm Alarm Message NIBP Communication Error NIBP Device Error NIBP Unit Error Inflate time exceeds 3 minutes Inflation Time Out Difficulty in making measurements due to weak pulse tremors movement etc Measurement Fault RESP Apnea Alarm Hi Apnea Alarm Low Apnea Alarm Apnea Alarm Off RSP ECG Coincidence SpO2 Low O2 Sat Hi Pulse Rate Low Pulse Rate SpO2 Relocate Probe SpO2 Wrong Probe SpO2 Check Probe Site SpO2 Probe Disconnected SpO2 Replace Probe SpO2 Low Signal SpO2 Lo
526. ulation panels also display Indexes Indexes are values calculated per unit of body surface BSA Mennen Medica Menntor 7 Operating Manual For comparison a range of normal values NORM VAL and normal indexes NORMIND is presented Values that are not within the normal range appear on red background Upon changing measured field all the calculated fields are automatically recalculated and updated The following buttons and functions appear in each of the charts e Discard Changes exits the main screen display without saving changes e Accept saves calculations in the appropriate chart and exits the screen Hemodynamics Calculations In the Hemodynamics panel you can view monitored hemodynamic data and perform clinical calculations gt Toperform Hemodynamics calculations 1 On the Menntor X7 Main menu press the Patient Data key 2 Inthe Patient Data menu select Calculations 3 Inthe Calculations menu select Hemodynamics The Hemodynamics panel opens displaying the patient s monitored data Calculations Hemodynamics Accept HRT 70 BPM TMP1 37 0 ec VALUE INDEX NORMVAL NORMIND Cardiac Index 30 40 RSP 19 BPM 2 370 57 1 Stroke Volume 35 70 Total Systemic Resistance TSR 2200 TSRI 13200 SYSTOLIC DIASTOLIC MEAN Systemic Vascular Resist sverge 5 110 1500 arT 135 100 110 mmtg ystemic Vascul
527. ulse pressure is proportional to stroke volume e SvO2 by fiber optic catheter Additional stored parameters are e Cardiac Index CI e Stroke Volume SV e Stroke Volume Index SVI e Pulse Pressure Variation PPV e Stroke Volume Variation SVV e Systemic Vascular Resistance SVR e Systemic Vascular Resistance Index SVRI e Global End Diastolic Volume e Global End Diastolic Volume Index e Global Ejection Fraction GEF e Lung Water EVLW e Intrathoracic Blood Volume ITBV 28 2 Mennen Medica Menntor 7 Operating Manual e Intrathoracic Blood Volume Index ITBI e Pulmonary Vascular Permeability Index PVPI e Index of Left Ventricular Contractility dPmx e Cardiac Power Output CPO e Cardiac Power Output Index CPI e Cardiac Function Index CFI PiCCO2 has also optional SpO2 measurement This will add the following parameters e SpO2 e Oxygen Delivery 002 e Oxygen Delivery Index 0021 The Menntor X7 UIM input allows the user to display and store CO CCO and SvO2 and set alarm limits which when violated trigger clinical alarms Note The display by the Monitor of an Auxiliary Device function should be regarded as secondary duplication of the functions This secondary duplication should be used for user convenience in comparing data and registering events for data management purposes The Menntor X7 Monitor should not be considered the pri
528. ult parameters These parameters include setting alarm priority for SpO2 Pulse Rate and Fault alarms activating or deactivating alarm latching defining Alarm Detection delay and disabling SpO2 alarms during NIBP readings Mennen Medical D 33 7 e Alarm priorities for SpO2 Pulse Rate and Fault alarms Alarm priority affects the order of audible and visual alarm notification See Alarm Priority on page 8 4 for a full description of this feature SpO2 and Pulse Rate alarm priority can be set to C 1 C 2 or C 3 The factory default for both parameters is C 1 Fault alarm priority can be set to T 1 or T 2 The factory default is T 1 e Alarm Latching For a complete description of Alarm Latching refer to Chapter 7 Alarms in the Menntor X7 Operation Manual The available options are Off Visual latching visual alarms only and On both visual and audible alarms The factory default is Off e Alarm Response Time When an alarm is detected a pre defined response time allows the system to check in order to avoid false alarms The delay can be set to 3 6 or 12 seconds The factory default is set to 6 seconds SpO2 Default Color Defines the color in which SpO2 values appear on the main screen display You can choose from 16 available colors none en2B90CA e es Figure D 12 The SpO2 Setup Dialog Panel D 34 Mennen Medica 7
529. w Light SpO2 C Lock mode EtCO2 Device Error Apnea Very low signal Check Adaptor Watertrap not found No Watertrap only for Sidestream monitoring Watertrap occluded Replace Watertrap only for Sidestream monitoring Exhaust occluded Check Exhaust Line only for Sidestream monitoring Noisy signal Signal saturation Check Adaptor for Mainstream monitoring or Device Error for Sidestream monitoring Upstream pneumatic leak Device Error only for Sidestream monitoring 8 14 Mennen Medica 9 CONNECTING PATIENT MENNTOR X7 Patient Preparation Procedures for preparing the patient for monitoring of vital signs can be found in the section for each relevant vital sign Admission Discharge and Transfer Procedures The ADT menu provides access to panels that deal with administrative procedures These panels include e Patient Identification e Discontinue Monitoring e Save and Discharge e Discharge Patient Admitting a Patient The admission process is divided into two stages e Physically connecting the patient to the monitor and initiating monitoring of physiological parameters e Hilingin an admission form the Patient Identification panel with the relevant demographic data Note If the monitoring system is equipped with a Mennen Medical Server that connects between the Mennen Net LAN and the ho
530. way waveforms are scaled for presentation on the main screen display You can set the scale in mmHg units or in percentages For mmHg three scales are available e 0 50 mmHg e 0 75 mmHg 0 100 mmHg For percentages three scales are available e 0 6 e 0 10 0 15 Figure 25 5 EtCO Scale Panel gt Toscale EtCO waveform 1 From the EtCO menu choose Scale 2 Select the required values 3 Press Vital Signs to return to the Vital Signs menu Press Main Screen to return to the main screen display Mennen Medica Menntor 7 Operating Manual Activating EtCO Monitoring Use the Activate panel to activate or deactivate EtCO monitoring Note Activating EtCO gt monitoring while monitoring respiration using impedance pneumography causes the impedance pneumography to deactivate The Menntor X7 then uses EtCO gt data to monitor respiration rate gt To activate or deactivate EtCO monitoring 1 From the EtCO menu or if you are already in another EtCO panel from the drop down list below the title area select Activate 2 Select the Activate checkbox to activate or deactivate ECCO monitoring 3 Press EtCO2 to close the panel and return to the EtCO2 menu press Main Screen to close the panel and return to the main screen display N5O and Anesthetic Agent Monitoring Procedures The N5O and Anesthetic Agent menus provide access to all the specific dialog
531. ypical causes are false starts small amount of injectate less than volume shown in data field or injection is performed too slowly When this is the case no C O calculation is attempted e Delta Temperature Exceeds 10 This message indicates that the injectate temperature for COSet or the injectate bath temperature for separate bath injectate probes is outside the Mennen Medical 19 3 Cardiac Output C O Menntor 7 Operating Manual acceptable range for calculation Acceptable temperature ranges are shown on page 19 6 Injected Temperature Probe Out This message appears if the injectate bath temperature probe is not connected or is defective Body Temperature Probe Out This message appears if the body temperature probe is not connected or is defective ICU Avishai Main Screen CO 2 3 Computation Constant 0 574 Previous i 8 8 Ti Tb gt Start Do Not Inject Save amp Clear Discard Last Edit Curves Clear All Figure 19 1 The Cardiac Output Acquire Panel gt Toruna C O trial 1 2 Prepare the injectate When the Ready procedure indicator appears press Start wait for message Start Injection green light and voice message and then begin injecting You have 12 seconds to complete the injection Inject smoothly and rapidly Any problems that might arise are indicated by error messages Values appear in the graphs and the average is updated au

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