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instruction manual (english) - Tecno-Gaz

1. P al 2001 G E sn e ST2 0 80 zol PVCs 0 AUTO ds emm Ls Ale 253 MIDE 13 04 nnHg war 118 ss 73 RESP o Manual Atm RR MTT RESP ER E PLETH bi 37 2 5 14 37 1 NAAN UM SP02 CH1 ART 150 SPOZ x a IS Ph f P O9 MEE E CORE Ream CH2 cup 40 IBP 1 2 mmHg IBP1 FL OO PV al 0 2hours 1 0 Em EPA Pu eese cM dM 10 Figure 4 3 28 Trend Screen TECNO GAZ Multi Parameter Monitor MD User Manual n Position of trend graph Trend graph is located to the right of the corresponding waveform in the Waveform area Its color is the same as that of the corresponding parameter n Trend length Dynamic trend length is 2 hours On the trend graph the scale of the right end of the X axis is 0 hour while the left end is 2 hour n Select trend parameter If multiple parameters are located at the same position on the trend graph by selecting the corresponding hot key of a parameter on the trend graph you can have the trend graph of this parameter displayed on the screen For example in ECG trend graph you can select hot keys such as HR ST or PVCs then the system will display their corresponding trend graphs respectively n Close trend screen In the FACE SELECT menu select options of other operating screens to close the Trend Screen 4 4 oxyCRG Screen n Enter oxyCRG SCREEN In the FACE SELECT menu select the oxyCRG SCREEN option to enter the oxyCRG Screen
2. II AUTO DIAGNOSTIC A A m Aes des H s 0 90 S2 0 80 I RUTO PCs 0 PX ss ere ae T ar ee yas A pm RESP TEMP se mer n 37 2 dn WP gio S d 1 4 37 1 m Q 1 SP02 Y IBP 1 2 mmHg 120 93 80 10 AAAAAARIU NIBP 13 04 mig 119 59 73 Manual Amin 45s 1MIN RESP WAVE x x 03 27 2006 13 06 39 Figure 4 4 oxyCRG Screen n Trend graph of oxyCRG screen 29 TECNO GAZ Multi Parameter Monitor MD User Manual Located at the lower part of the screen oxyCRG screen consists of three trends HR Trend SpO2 Trend and RR Trend or Compressed Resp Waveform n Select oxyCRG trend length Three are two hot keys at the bottom part of the oxyCRG Screen which are 4MIN 2MIN 1MIN RR RESP WAVE By using hot keys for trend time you may select to display trend graphs of three different lengths i e 1 min 2 min and 4 min n Select RR trend or Compressed Resp Waveform By using the hot keys for RR RESP WAVE you may select either RR trend graph or compressed Resp Wave They occupy the same position Therefore if select RR the position displays the dynamic trend of RR If select RESP WAVE the position displays the compressed Resp Wave n Close oxyCRG In the FACE SELECT menu select options of other operating screens to close the oxyCRG Screen 30 TECNO GAZ Multi Parameter Monitor MD User Manual 5 Alarm This chapter gives general information about the alarm and measures to be
3. Patient type All patients refers to perform Arr analysis on patients either with pacemakers or without pacemakers Without pacemaker refers to perform Arr Analysis only on the patients without pacemakers With pacemaker refers to perform Arr Analysis only on the patients with pacemakers Prompt message Message Cause Alarm Level 89 TECNO GAZ Multi Parameter Monitor MD User Manual The QRS template building required for ARR LEARNING No alarm Arr Analysis is in process NOTE Arrhythmia name displays in the Alarm Message Area 12 9 Measuring RESP 12 9 1 How to Measure RESP The monitor measures respiration from the amount of thoracic impedance between two ECG electrodes The change of impedance between the two electrodes due to the thoracic movement produces a respiratory waveform on the screen 12 9 2 Setting Up RESP Measurement For RESP monitoring it is not necessary for additional electrodes however it is very important to attach the electrodes to the correct positions Some patients due to their clinical condition expand their chest laterally causing a negative intrathoracic pressure In these cases it is better to place the two RESP electrodes laterally in the right axillary and left lateral chest areas at the maximum point of breathing movement to optimize the respiratory waveform NOTE The RESP monitoring is not recommended to be us
4. Two 8 16 32 second waveforms 50 TECNO GAZ Multi Parameter Monitor MD User Manual ALARM RECALL D TIME SPAN 01 12 2006 14 52 CURRENT TIME 8 EVENT TYPE ALL TIME 01 12 14 54 No 1of 2 8 Ti 37 2 C T2 37 1 C TD 0 1 C C 2 mHg 20 INS wHg 2 ARR 14 n BB D 73 01 12 14 52 D I S 120 93 D 80 Figure 8 5 ALARM RECALL Menu To view all waveforms during the alarming process Pick L RIGHT and turn the knob to view all 8 16 32 second waveforms stored To view other alarm events Events of up to 60 are listed chronologically from the latese to the earliest Pick UP DOWN button and turn the knob to view later or earlier events Recording Pick REC to print our all data and waveform this event 51 TECNO GAZ Multi Parameter Monitor MD User Manual 9 Drug Calculation and Titration Table Optional Multi parameter patient monitor provides Drug calculation and titration table display functions for fifteen drugs and outputs the content of titration table on the recorder 9 1 Drug Calculation The drug calculations that can be performed by the system are AMINOPHYLLINE DOBUTAMINE DOPAMINE EPINEPHRINE HEPARIN ISUPREL LIDOCAINE NIPRIDE NITROGLYCERIN and PITOCIN Besides DRUG A DRUG B DRUG C DRUG D and DRUG E are also provided to flexibly replace any of the drugs Select DRUG CALC in SYSTEM MENU the following DRUG CALC display appears DRUG CALC DRUG NAME AM
5. MW The patient cable consists of 2 parts The cable that connects to the monitor The lead set that connects to the patient M Using a 3 lead set one waveform is displayed on the screen Using a 5 lead set the ECG can derive up to two waveforms from two different leads For requested lead you may choose from the left side of ECG waveform MW The monitor displays the Heart Rate HR ST segment and Arrhythmia analysis ME All of the parameters above can be set as alarm parameters NOTE In the default settings of the monitor the ECG waveforms are the first two waveforms from top in the Waveform Area 12 2 Precautions during ECG Monitoring WARNING A Do not come into contact with the patient table or the monitor during defibrillation WARNING Use only the original ECG cable for monitoring WARNING A When connecting the cables and electrodes make sure no conductive part is in contact with the ground Verify that all ECG electrodes including neutral electrodes are securely attached to the patient but not the conductive part or ground 67 TECNO GAZ Multi Parameter Monitor MD User Manual NOTE Interference from a non grounded instrument near the patient and ESU interference can cause inaccuracy of the waveform EN60601 1 2 protection against radiation is 3v m specifies that the electrical field density exceeding 1v m may cause measurement error in various frequencies It is accordingly suggested t
6. NIBP TIME OUT Problem happens when measuring the curve The perform measurement system cannot analysis or calculation Check the connection of each part and the patient situation Measure again if the failure still exists the for contact manufacturer repair Check the connection of TEMPI TEMPI SENSOR TEMP sensor is not ensor OFF connected correctly sm TEMP2 SENSOR TEMP2 sensor is not Check the connection of TEMP2 OFF connected correctly sensor IBP1 SENSOR OFF IBPI connected correctly sensor is not Check the connection of IBPI sensor 144 TECNO GAZ Multi Parameter Monitor MD User Manual IBP2 SENSOR OFF IBP2 sensor is connected correctly not Check the connection of IBP2 sensor 145 TECNO GAZ Multi Parameter Monitor MD User Manual Appendix III EMC Information Guidance and Manufacture s Declaration A3 1 Electromagnetic Emissions for all EQUIPMENT and SYSTEMS Guidance and manufacture s declaration electromagnetic emission The MD Patient Monitor is intended for use in the electromagnetic environment specified below The customer or the user of the MD Patient Monitor should assure that it is used in such an environment Emission test Compliance Electromagnetic environment guidance RF emissions The MD Patient Monitor uses RF energy only CISPR 11 for its internal function
7. n Signs indicating the operating status of the monitor and the sensors are displayed at the right side of patient name n Alarm message is displayed at the right most area n FREEZE appears when the waveforms are frozen Waveform Area Six waveforms can be displayed at the same time The sequence of waveforms can be adjusted Under the maximum configuration the system can display 2 ECG waveforms SpO2 waveform Respiration waveform can be from ECG module and 2 IBP waveforms In the TRACE SETUP menu all the waveforms are listed The user can select the waveform to be displayed and adjust the display position Refer to Waveform is TECNO GAZ Multi Parameter Monitor MD User Manual Sequence Selection for detail The name of the waveform is displayed on the upper left part of the waveform The name of ECG is user selectable Gain and filter way of this channel are displayed as well A 1 mv scale is marked on the right of ECG waveform The IBP waveform scale can also be selected according to the actual requirement Its range is described in the part IBP Monitoring In the IBP waveform area the waveform scale is displayed The three dotted lines for each IBP waveform form up to down represent respectively the upper limit scale reference scale and lower limit scale The values of these three scales can be set The specific method is given in the part IBP Monitoring When a certain menu is displayed some wave
8. 5 indicates maximum volume 0 indicates no sound PACE ON detected signal will be marked by a I above the ECG waveform OFF for non pacemaking patient NOTE If monitoring a patient with the pacemaker set PACE to On If monitoring a patient without pacemaker set PACE to Off If PACE is on the system will not perform some types of ARR analysis For detailed information please refer to the section ARR ALARM ECG CAL Pick this item to start ECG calibrating process Picking this item again or change lead name on the screen can end calibrating process ADJUST WAVE POS Used to adjust the position of ECG waveform on the screen Pick this item to call up the ADJUST WAVE POS dialog box The user may use CH NAME item to select the channel to be adjusted UP DOWN to adjust the position of the selected channel on the screen BACK TO DEFAULT to let the waveform go back to the default position on the screen ADJUST WAVE POS CH NAME CH1 UP amp DOWN BACK TO DEFAULT Figure 12 9 ADJUST WAVE POS Menu DEFAULT Pick the DEFAULT item to call up the ECG DEFAULT CONFIG dialog box in which you can select the FACTORY DEFAULT CONFIG or the USER DEFAULT CONFIG item After selecting any of the items and exiting the dialog box the system will pop up a dialog box asking for your confirmation 78 TECNO GAZ Multi Parameter Monitor MD User Manual ECG DEFAULT CONFIG E FACTORY DEFAULT CONFIG E USE
9. Freeze When in normal mode press this button to freeze all the waveforms on the screen When in FREEZE mode press to restore the waveform refreshing Main Press to return to the main interface Rotary Knob The user may use the rotary knob to select the menu item and modify the setup It can be rotated clockwise or anticlockwise and pressed like other buttons The user may use the knob to realize the operations on the screen and in the system menu and parameter menu Method to Use the Knob to Operate on the Screen The rectangular mark on the screen that moves with the rotation of the knob is called cursor Operation can be performed at any position at which the cursor can stay When the cursor is in the waveform area the user may immediately modify the current setup When the cursor is in the parameter area the user may open the setup menu of the corresponding parameter module so as to set up the menu items of the module Operating method E Move the cursor to the item where the operation is wanted E Press the knob E One of the following four situations may appear 6 TECNO GAZ Multi Parameter Monitor MD User Manual 1 The cursor with background color may become into the frame without background color which implies that the content in the frame can change with the rotation of the knob 2 Menu or measuring window may appear on the screen or the original menu is replaced by the new m
10. O IS E A VP rar 9 9 3 A A 300 P2 300 IBP Transducer Zero Press the IBP PRESSURE ZERO button on the IBP SELECT menu to call up IBP PRESSURE ZERO menu as shown below IBP PRESSURE ZERO Being Prepared Press ZERO key CH1 ZERO 00 00 0000 00 00 00 CHZ ZERO 00 00 0000 00 00 00 Figure 16 5 IBP PRESSURE ZERO NOTE It is the responsibility of the user to ensure that a zero procedure has recently been done on the transducer otherwise there will be no recent valid zero value for the instrument to use which may result in inaccurate measurement results Zero Calibration of Transducer Select CH1 IBP1 return to zero Select CH2 IBP2 return to zero 126 TECNO GAZ Multi Parameter Monitor MD User Manual CAUTION Y Turn off patient stopcock before you start the zero procedure The transducer must be vented to atmospheric pressure before the zero procedure n The transducer should be placed at the same height level with the heart approximately mid axially line n Zero procedure should be performed before starting the monitoring and at least once a day after each disconnect and connect of the cable The prompt information related to zero calibration take CH1 for example CH1 ZERO SUCCESS Indicate that zero calibration is over so you can turn off the stopcock that was open to atmospheric pressure and turn on the patient stopcock CH1 ZERO FAIL Make sure that the transducer
11. S TECNO GAZ ntal and medical equipment User manual Multiparameter Monitor DM o 600000 ENGLISH Contents DEP OG CULO p TN 1 ll General Information aid ati eodd ou bane sivas A 1 I2 Screen UA bie 2 1 3 Button Functions 1 noe ve ed n eae icc es 5 1 4 Interfaces is re IP AA AA WV IP rara 7 US Label E E T 9 1 6 Built in Chargeable Battery inr tes Aedes eee 9 2 Installation OF Monitores ach o ea ME ORO e sores SR SERE CER CERE EUER PRER EE TRA ERE SER CER 11 2 I Opem the Package and Chek Aart uss eevee tion HUNE AT RM E Hack Ra a tUe 11 2 2 Install Wall Mount for Patient Monitor Optional esee 11 2 9 Connect the Power Cables qui iet tecto t d dee e t dex date deeds 13 2 4 Power on the Monitor iiu edes aida 13 2 3 Connect Patient SenSOf a A E SEN THEN EXC Y uS 14 2 6 Check the Recorder iii ie Pe dace P e esee exi rey 14 3 System ME 15 3 1 Patient Intormation Setups cese AA au desc ea betes 15 A IDE En DSTA h ce EEEE EE E e EE O 17 3 3 Mark EVED ME HDI a aE E E E E EA E E E Ea VE E EEEE 18 a dopace WCE ed E RS 19 3 5 Tim Setup iie I YR Ra OG espe bag E NEEN EXE doe EE haa ORAE VAT Ra 20 3 0 Recorder Setup ui D rp oti ya copre oue ie ed esee eee Deua 20 3 7 Module Setup ete eee ra rebate dae ea deci idee a ied eee ees 22 3 8 Tracing Waveforms Selection 1 eei E reae aee red sede dee tree Musee 23 3 9 Monitor Versiones ecco evan ARA A e prit ees 23 2 10 Alarm VOTUme i oae A A A E
12. ECG lead gain and filter way as the user defined default configuration according to the patient type And the dialog box as shown below will pop up Old user defined config For this patient type vill covered Yes Figure 3 5 Confirm Save Default Config Pick YES to save the current patient type configure as user default configure Pick NO to give up the operation 3 3 Mark Event There are four types of events that you can define Select MARK EVENT item in SYSTEM SETUP to call up the following menu 18 TECNO GAZ Multi Parameter Monitor MD User Manual SYSTEM MARK EVENT B EVENT C EVENT D EXIT Figure 3 6 Mark Event To mark the event Use the rotary knob to select one from event A B C and D There is a signal for the one selected To cancel your selection repress the knob at selected item Press EXIT to return to the previous menu The point of using event function To differentiate the patient events that have impact on parameter monitoring such as dose taking injection therapy status etc Event will be displayed on the Trend Graph Trend Table to assist to analyse patient parameter of the time event happened 3 4 Face Select Select FACE SELECT item in SYSTEM SETUP menu to access FACE SELECT dialog box as shown below in which three selections are available STANDARD SCREEN TREND SCREEN oxyCRG SCREEN Only one selection can be chosen for each time
13. FACE SELECT M STANDARD SCREEN TREND SCREEN E oxyCRG SCREEN Figure 3 7 Face Select 19 TECNO GAZ Multi Parameter Monitor MD User Manual 3 5 Time Setup Select TIME SETUP item in SYSTEM SETUP menu to access the sub menu of TIME SETUP as shown below System time is in format of year month day hour minute and second Pick the item you wish to modify and turn the knob Select EXIT item to return to the previous menu TIME SETUP YEAR MONTH DAY HOUR MINUTE SECOND Figure 3 8 Time Setup 3 6 Recorder Setup Select RECORD in SYSTEM SETUP menu to call up the following menu RECORD REC WAVEZ ECG1 RT REC TIME 8S TIMING REC TIME OFF REC RATE 25 0 CLEAR REC TASK Figure 3 9 Record 20 TECNO GAZ Multi Parameter Monitor MD User Manual In the sub menu the user may select the waveforms to be output in REC WAVE1 and REC WAV E2 items ECGI ECG2 ECGI waveform and ECG2 waveform There will be 7 ECG waveforms on the screen when Full Lead display If no ECG waveform is currently displayed on the screen this item cannot be picked SPO2 SpO2 Plethysmogram If no SpO2 waveform is currently displayed on the screen this item cannot be picked But under ECG Full Lead display mode this item can be picked although no SpO2 waveform is currently displayed on the screen RESP RESP waveform If no RESP waveform is currently displayed on the scree
14. If the hospital or agency that is responding to using the monitor does not follow a satisfactory maintenance schedule the monitor may become invalid and the human health may be endangered NOTE To prolong the life of chargeable battery charging it once every month at least is recommended and it must be done after the electric energy is run out WARNING Replace batteries according to the instruction of our servicing engineer 11 2 General Cleaning 63 TECNO GAZ Multi Parameter Monitor MD User Manual WARNING A Before cleaning the monitor or the sensor make sure that the equipment is switched off and disconnected from the power line The Multi parameter Patient Monitor must be kept dust free Regular cleaning of the monitor shell and the screen is strongly recommended Use only non caustic detergents such as soap and water to clean the monitor shell cAUTION Please pay special attention to the following items 1 Avoid using ammonia based or acetone based cleaners such as acetone 2 Most cleaning agents must be diluted before use Follow the manufacturer s directions carefully to avoid damaging the monitor 3 Don t use the grinding material such as steel wool etc Don t let the cleaning agent enter into the chassis of the system 5 Don t leave the cleaning agents at any part of the equipment m 11 3 Cleaning Agents Examples of disinfectants that can be used on the instrument casing are listed b
15. Therefore its RF Group 1 emissions are very low and are not likely to cause any interference in nearby electronic equipment RF emission PESA The MD Patient Monitor is suitable for use in CISPR 11 all establishments including domestic Harmonic emissions establishments and those directly connected IEC 61000 3 2 id to the public low voltage power supply Voltage fluctuations network that supplies buildings used for flicker emissions Complies domestic purposes IEC 61000 3 3 A3 2 Electromagnetic Immunity for all EQUIPMENT and SYSTEMS 146 TECNO GAZ Multi Parameter Monitor MD User Manual Guidance and manufacture s declaration electromagnetic immunity The MD Patient Monitor is intended for use in the electromagnetic environment specified below The customer or the user of MD Patient Monitor should assure that it is used in such an environment Immunity test IEC 60601 test level Compliance level Electromagnetic environment guidance Electrostatic discharge ESD IEC 61000 4 2 6 kV contact 8 kV air 6 kV contact 8 kV air Floors should be wood concrete or ceramic tile If floor are covered with synthetic material the relative humidity should be at least 30 Electrical fast transient burst t2 kV for power supply lines 1kV for power supply lines Mains power quality should be that of a IEC 61000 4 4 typical commercial or hospital environment S
16. it indicates that the airway may have air leaks In this case the user should check for loose connection After confirming secure connections the user should re perform the pneumatic test If the failure prompt still appears please contact the manufacturer for repair Monitor cylinder Cuff Figure 14 4 Diagram of NIBP Air Leakage Test INTERVAL Interval time for automatic measuring Available selection 1 2 3 4 5 10 15 30 60 90 120 180 240 480 minutes Press START button to start the first auto measuring Pick MANUAL selection in INTERVAL item to set up the measuring mode to MANUAL 14 4 NIBP Alarm Message and Prompt Message Tables below describe the possible physiological alarms technical alarms and prompt messages occurring during NIBP measurement Physiological alarms Message Cause Alarm Level NS TOO HIGH User selectable NIBP SYS measuring value is above upper alarm limit NS TOO LOW User selectable NIBP SYS measuring value is below lower alarm limit 111 TECNO GAZ Multi Parameter Monitor MD User Manual ND TOO HIGH NIBP DIA measuring value is above upper alarm limit User selectable ND TOO LOW NIBP DIA measuring value is below lower alarm limit User selectable NM TOO HIGN NIBP MAP measuring value is above upper alarm limit User selectable NM TOO LOW NIBP MAP measuring value is below lower alarm limit User selectab
17. sss 80 12 8 Arr Monitoring Optronal tii deua dece reae ens 84 12 9 Measuring RESP lt A A A E eg 90 12 9 1 How to Measure RESP tl e cedes 90 12 9 2 Setting Up RESP Measurement oa dios 90 12 9 3 Installing Electrode for RESP Measurement sseses 91 129 4 RESP MOI ecoeotexo ob bres o evadat ret o dee tied tee torpe iodo nada 91 vil 2 0 S RESP Alarm Message xoc codo loepies eva deerat Ny Ex EN perso 93 12 10 Maintenance and Cleaning a 93 13 SpO 2 NOBHOELHBE e 95 13 1 What 15 pOs MORBITOEIIE Ii e e etis 95 13 2 Precautions during SpO Pulse Monitoring see 96 13 3 Monitorimmg Proced te ie ec A eode b nu uode ee UE 97 13 4 Limitations for Measurement o ee a dr 97 13 SPO cM CMW NM PP 98 13 6 Alarm Description ye reso edes eee alarde orbe 100 13 7 Maintenance and C Te aunt na 100 14 NIBPM niltOTPIBg eee eee etas uo nae UIN toss ARA E EU CRR ENTRE S NEEAS TOL S O CR SU LM ER NOUS ERE V NAT 102 14 OCMC EL OTI erede ht UE det e db du coll UT Quas ele deca e 102 14 2 NIBP NODO a Heic re e tbt d A Or Sex E ERR Durex O e 103 14 2T NIBPOMeaSU LH x oer ed epe ethers ace eee to eeepc vectes 103 14 2 2 NIBP Parameter Setup and Adjustment occconcocccnnoncononenoninnonnnenccnnnnns 107 14 3 NIBP SETUP fenus ooh ere usa Ere eae R E Decus tuu apes ue T a 107 14 4 NIBP Alarm Message and Prompt Message ooooccncncncncncnncncncncncncnoncncnononanos 111 14 5 Mainten
18. such as a button once pressed a menu will pop up for you to further select an option on the front panel and system on the control panel again buttons of MENU n Execute any operation that may trigger the adjustment of the screen or display of a new menu After exiting the Freeze status the system will discharge the Freeze status clear screen waveforms and resume to display real time waveforms In the Screen Refresh mode the system will sweep the waveforms from the left to right in the Waveform Area 6 3 FROZEN Menu Press the FREEZE button on the control panel the FROZEN menu will appear on the bottom part of the screen At the same time the system enters the Freeze status FROZEN RECALL Figure 6 1 Frozen n RECALL used to review frozen waveforms n EXIT after pressed the system closes the FROZEN menu and exits the Freeze status NOTE Pressing the FREEZE button X repeatedly in short time period may result in discontinuous waveforms on the screen 6 4 Reviewing Frozen Waveform By moving the waveform you may review a waveform of 60 seconds before the moment when it is frozen For a waveform less than 60 seconds the remaining part is displayed as a straight line Use the rotary snob on the control panel to move the cursor to the RECALL option on the FROZEN menu Press the knob By turning the knob left or right frozen waveforms on the screen will move left or right corres
19. the electrodes and lead wires i Check the current situation of the Patient suffers from i VT gt 2 patient Check the connection of Arr of VT gt 2 the electrodes and lead wires Patient suffers from Check the current situation of the MISSED BEATS Arr of MISSED patient Check the connection of BEATS the electrodes and lead wires M th lead Ad i e il Check the connection of lead ECG LEAD OFF wire of ECG is not y wires connected correctly ECG LL LEAD OFF The LL lead wire of ECG is not connected correctly Check the connection of LL lead wire ECG LA LEAD OFF The LA lead wire of ECG is not connected correctly Check the connection of LA lead wire ECG RA LEAD OFF The RA lead wire of ECG is not connected correctly Check the connection of RA lead wire ECG V LEAD OFF The V lead wire of ECG is not connected correctly Check the connection of V lead wire SPO2 SENSOR OFF SPO2 connected correctly sensor is not Check the connection of SpO2 sensor The NIBP cuff is not LOOSE CUFF Re connect the NIBP cuff connected correctly The NIBP cuff is not Check the connection of each part connected correctly or or replace with a new cuff If the AIR LEAK there are leaks in the airway failure still exists contact the manufacturer for repair WEAK SIGNAL Problem happens when measuring the curve The perfo
20. ART PA CVP RAP LAP ICP P1 P2 B HI IBP value of High Limit scale the range is the measuring range of the current pressure NOTE The HI value must be higher than the LO value B LO IBP value of Low Limit scale the range is the measuring range of the current pressure NOTE The LO value must be lower than the HI value E VAL IBP value of Reference scale between HI and LO NOTE When change HI scale Low scale or Reference scale of IBP waveform and the corresponding IBP waveforms are displayed under the menu window the waveform will come penetratingly through the menu window for observing 16 5 Alarm Information Tables below describe the possible physiological alarms technical alarms occurring during IBP measurement 130 Physiological alarms TECNO GAZ Multi Parameter Monitor MD User Manual Message Cause Alarm Level IS1 TOO HIGH SYS measuring value of channel 1 is above upper alarm limit User selectable ISI TOO LOW SYS measuring value of channel 1 is below lower alarm limit User selectable ID1 TOO HIGH DIA measuring value of channel 1 is above upper alarm limit User selectable ID1 TOO LOW DIA measuring value of channel 1 is below lower alarm limit User selectable IMI TOO HIGH MAP measuring value of channel 1 is above upper alarm limit User selectable IMI TOO LOW MAP measuring value of channel 1 is below lower alarm limit User
21. Accuracy Mean error Maximum Standard deviation 30 270mmHg 10 220mmHg 20 235mmHg 30 235mmHg 10 220mmHg 20 225mmHg 30 135mmHg 10 110mmHg 20 125mmHg 0 280mmHg ImmHg 5mmHg lt 8mmHg 139 TECNO GAZ Multi Parameter Monitor MD User Manual Entire Measuring Period Overvoltage protection Adult Pediatric Neonatal A1 2 10 SpO2 Measuring Range Alarm Range Resolution Accuracy Adult including Pediatric Neonate Pulse Rate Measuring and Alarm Range Resolution Accuracy Anti low perfusion Anti motion Interference Nellcor module optional Measuring Range Alarm Range Resolution Accuracy Adult and Low perfusion Neonate Pulse Rate Measuring and Alarm Range 20 45s typical depend on HR and motion disturbance Dual Overvoltage protection 315 15mmHg 255 10mmHg 170 15mmHg 0 100 0 100 1 2digits 70 100 SpO2 Undefined 0 70 SpO2 3digits 70 100 SpO2 Undefined 0 70 SpO2 18 254bpm lbpm 3bpm Under Motion Condition 5bpm Strong Anti low perfusion Strong Anti motion Interference Anti electrotome 1 100 1 100 1 96 2digits 70 100 SpO2 Undefined 0 70 SpO2 3digits 70 100 SpO2 Undefined 0 70 SpO2 20 250bpm 140 TECNO GAZ Multi Parameter Monitor MD User Manual Resolution Accuracy Low Perfusion A1 2 11 TEMPERATURE Channel Measuring Range Resolution Accuracy Refresh Time Selftest A1 2 12 IBP Channel Label
22. E A a 23 Se SC DLE M 24 Sal Dr s GIOI ah ua ease ee 29 3 13 Wave Lor DEMOS TAO aid 25 3 14 Mai mte nian Ce eroe concer er eder A Ue Cere Eee esee UN Ee eU 25 4 Race Select eoe eter are aeta en ee Eye ita Dit cee ceeebecateucssoeecesteseeedeess 27 4 1 Select Operating SCEGGTI oe ie iex ns 27 4 2 Standard Screen x uc ee ael NE IA Ier 27 4 3 A 28 AO E RO ONSEN i262 cae A RA E M en Ed eU tri e 29 5A TATTU i ee rese eo ee cea ev ves cree ve ev ceto ew Ai AAA ANA AAA 31 Sel Alarm Modes ise e Dadas 31 5 TL Alarm Level iN A RE E TE ea IPIE RES 31 5 1 2 AlTarm Modes i eL e re ec E 32 5 1 3 Alarm Setup M A A A TETONS 33 5 2 Alarm Causes eer A vend ceeds reed ev od doves A AE eee ra digg 34 5 9 S LE BINGE a MERE en ME IR e De NE E UM E Ren 35 5 4 Parameter Alarm A a ees eeu i des 35 5 5 When an Alarm OCCULS 2 0 ccc ccc cece cece cece eens e e ehe e E esses ese e esee aenea 36 A AEEA T A E A EEE EE 37 Gd sGeme Ball E A AS S EAE PPM EEE E 37 6 2 Enter Exit Freeze Status soie p x as dite eb asad AA A A ER 37 0 3 FROZEN Me nities sc a A ec ele ne o rc cre bg e e E eu ropes gus 38 6 4 Reviewing Frozen Waveform eet em c eee M 38 T Recording Optional consta esce eve nu uon o os qns rape na pv C es ene auae ex rena P Xe epa oar KU YR FA 40 7 1 General Information on Recording aso Io reta dde AS 40 TERA REA A ELI Cu eet m aL ets e Cue iut 40 7 3 Recording Startup idad 42 7 4 Recorder Operations
23. E deas be et 142 Appendix Wisin ap di sedis 146 A3 Electromagnetic Emissions for all EQUIPMENT and SYSTEMS 146 A3 2 Electromagnetic Immunity for all EQUIPMENT and SYSTEMS 146 A3 3 Electromagnetic Immunity for EQUIPMENT and SYSTEMS that are not LEIPESSUPPORLTLINGS sente eere at A A Oda Fre a TR oes eG 148 A94 Recommended Separation Distances ccs eoo be e OR OE RA M DR eaten xed 149 IX TECNO GAZ Multi Parameter Monitor MD User Manual 1 Introduction 1 1 General Information Multi parameter patient monitor monitors parameters such as ECG RESP SpO2 NIBP dual TEMP and dual IBP optional and is adaptable to adult pediatric and neonatal usage The user can select different parameter configuration according to different requirements It centralizes the function of parameter measurement module display record and output to compose a compact portable device Its built in replaceable battery provides convenience for patient movement On the high resolution display screen 6 waveforms and all the monitoring parameters can be displayed clearly The POWER switch is on the left of the front panel Figure 1 10 The POWER indicator lights when the monitor is powered on Figure 1 1 2 The CHARGE indicator shows the charging status Figure 1 1 The ALARM indicator flashes when the alarm is triggered Figure 1 102 The sockets of various sensors are on the le
24. IBP SETUP item to call up the IBP SETUP menu as following 123 TECNO GAZ Multi Parameter Monitor MD User Manual IBP 1 2 SETUP ALM LIMIT SETUP gt gt ALM LEV MED SCALE ADJUST gt gt ALM REC OFF DEFAULT gt gt AMP ADJUST MANUAL SWEEP 25 0 Figure 16 3 IBP SETUP Menu The items to be set up in the menu include ALM select ON to enable alarm prompt during IBP alarm Select OFF to disable audio alarm and prompt the symbol beside IBP numeric A WARNING In order to avoid endangering the patient s life the user should use this function cautiously ALM LEV used to set up the alarm level Three levels are available HIGH MED LOW ALM REC select ON to enable recording during the IBP alarm or to OFF to disable the alarm recording function AMP ADJUST used to adjust waveform amplitude Two selections are available MANUAL AUTO Set it to AUTO the pressure names of IBP become P1 and P2 and the IBP scale is adjusted by system automatically Set it to MANUAL the pressure names of IBP can choose one of ART PA CVP RAP LAP ICP P1 P2 and the IBP scale is adjusted by the user via SCALE ADJUST item SWEEP used to select the scanning speed of the IBP wave Two selections are available 12 5 mm s or 25 mm s UNIT used to select the pressure unit mmHg or kPa ALM LIMIT SETUP used to access the sub menu of IBP ALM LIMIT SETUP in which the user may set up the upper and lower alarm limit of systo
25. Maintenance Select MAINTAIN item in SYSTEM MENU to call up ENTER MAINTAIN PASSWORD dialog box as shown below in which you can enter password and then customize maintenance settings You cannot execute factory maintenance function which is only available for the service engineers of our company ENTER MAINTAIN PASSWORD USER KEY pad CONF IRM Figure 3 14 Enter Maintain Password Input the password into the ENTER MAINTAIN PASSWORD box and press 25 TECNO GAZ Multi Parameter Monitor MD User Manual CONFIRM the USER MAINTAIN menu will pop up in which you can set up following items USER MAINTAIN LANGUAGE ENGLISH Note Please Restart To Change Language LEAD NAMING EURO LOCAL NET NO 1 ALM PAUSE TIME Figure 3 15 User Maintain For the LANGUAGE item you can set the screen language to CHINESE ENGLISH RUSSIAN or Italian NOTE Please restart the monitor after changing the language For the LEAD NAMING item you can select AHA or EURO To know the difference between these two styles refer to Chapter ECG RESP Monitoring For the LOCAL NET NO item please refer to the net No For the ALM PAUSE TIME item you can set up the duration of Alarm Pause status Three options are available 1 minute 2 minutes and 3 minutes 26 TECNO GAZ Multi Parameter Monitor MD User Manual 4 Face Select This monitor h
26. NIBP Calibration n PNEUMATIC This item is used for air leakage test Turn the knob to pick the item to start the air leakage test Then the item will change into STOP PENUM which if picked the system will stop air leakage test A WARNING This pneumatic test other than being specified in the EN 1060 1 standard is to be used by the user to simply determine whether there are air leaks in the NIBP airway If at the end of the test the system gives the prompt that the NIBP airway has air leaks please contact the manufacturer for repair Procedure of the Air Leakage Test 1 Connect the cuff securely with the socket for NIBP air hole 2 Wrap the cuff around the cylinder of an appropriate size 3 Access the NIBP SETUP menu 110 n 4 5 6 7 TECNO GAZ Multi Parameter Monitor MD User Manual Turn the knob to the PNEUMATIC item and press the knob Then the prompt 9 Pneum testing will appear on the bottom of the NIBP parameter area indicating that the system has started performing pneumatic test The system will automatically inflate the pneumatic system to about 180 mmHg After 20 seconds or so the system will automatically open the deflating valve which marks the completion of a pneumatic measurement If no prompt appears on the bottom of the NIBP parameter area it indicates that the airway is in good situation and no air leaks exist However if the prompt PNEUMATIC LEAK appears in the place
27. The patient monitor can be adjusted maximum 15 degree by rotating the black knob 12 TECNO GAZ Multi Parameter Monitor MD User Manual 2 3 Connect the Power Cables Connection procedure of the AC power line n Make sure the AC power supply complies with following specification 100 240 VAC 50 60 Hz n Apply the power line provided with the monitor Plug the power line to INPUT interface of the monitor Socket 4 in Figure 1 6 Connect the other end of the power line to a grounded 3 phase power output NOTE Connect the power line to the jack special for hospital usage n Connect to the ground line if necessary Refer to Chapter Safety Guidance for details NOTE When the battery configuration is provided after the device is transported or stored the battery must be charged Powering on without connecting AC power supply may cause the device out of work Switch on AC power supply can charge the battery no matter if the monitor is powered on 2 4 Power on the Monitor Power on LOGO information will be displayed on the screen NOTE Check all the functions that may be used to monitor and make sure that the monitor is in good status NOTE If chargeable batteries are provided charge them after using the device every time to ensure the electric power is enough A WARNING If any sign of damage is detected or the monitor displays some error messages do not use it on any patient Contact biomedical engineer in the
28. amp Unfreeze n Review Frozen Waveforms 6 1 General When monitoring a patient you may freeze the waveforms of interest so as to view them carefully Generally you can review maximally 60 seconds of a frozen waveform The Freeze function of this monitor has following features n Freeze status can be activated on any operating screen n Atthe same time of entering the Freeze status the system exits all other operating menus Besides the system freezes all waveforms in the Waveform area of the Basic Screen and also freezes Full Lead ECG waveforms and extra waveforms in the Full Lead ECG interface if have Nevertheless the Parameter area refreshes normally n The frozen waveforms can be reviewed 6 2 Enter Exit Freeze Status Enter Freeze Status In the Non Freeze status press the FREEZE button 2 on the control panel of the monitor to let the system exit the Menu being currently displayed if available then enter the Freeze status and display the popup FROZEN menu In the Freeze status all other waveforms are frozen In other words the system will no longer refresh all other waveforms Exit Freeze Status In the Freeze status executing any of the following operations will command the system to exit the Freeze status n Select the EXIT option on the FROZEN menu 87 TECNO GAZ Multi Parameter Monitor MD User Manual Press the FREEZE button 4 Press the non immediate to execute button
29. an alarm occurs during the alarm of another parameter it will be printed out after the current recording is finished 3 If many alarms occur at the same time some of waveforms will be stored for printout in turn n STSegment Alarm The monitor records 2 channel ECG waveforms 4 8 or 16 seconds prior to and after the alarm totally 8 16 or 32 seconds which can be selected in the ECG SETUP menu All parameter values during the alarm will also be recorded n Arrhythgmia Alarm The monitor records 2 channel ECG waveforms 4 8 or 16 seconds prior to and after the alarm totally 8 16 or 32 seconds All measurement results during the alarm will also be recorded Titration Table The monitor can print out the message in the current TITRATION window A TECNO GAZ Multi Parameter Monitor MD User Manual Notes on Recording n Recording types Real time Report Periodic Report Para Alarm Report Titration Table Patient bed number name sex height weight date of birth admission date Parameter name and value Recording time Waveform name Waveform scale for ECG waveform 2D 3 3 3J 2J 2 ECG lead scale filter mode if having ECG waveforms it will be printed out within the first second or when changing the lead gain and filter mode during real time recording n IBP scale the first second of IBP waveform n Date and time 7 3 Recording Startup You can start the recording in the following ways Con
30. and Status Messages ocooccccncncnonononononononcncnoncncncncnnnnnnnns 43 8 Trend and E yent oie eee eese e ees seteenurvececcesssoseeaeveesee c gsee Use a ese OE NN o esos 45 S T Trend rngapbiasoseeses duces su EO lao ii 45 8 2 Trend Tables eed eo edis da och 47 8 3 NIBPRecall xuc ee A e id tel ls 49 VI S Alarm Event Recall odas 49 9 Drug Calculation and Titration Table Optional eee eere een 52 9 1 Drug Calculations e eie eiie es teres body depo ee a neuro a 52 IEA Titration Table duce eo A dt te e e EDU 54 10 Safety GUICANCE dc 56 11 Maintenance Cleaning eoe eee cierne EN Ey EP Uo UE Yo Sue AYERS ONSE A YES aan ea VO uw ES 63 11 1 System Cha 63 MEA oso sott aid cede aveakagawnte Ae olea dde Rees oe p oA 63 LE Ae e pud 64 VAR Sterile Za ico ett e e eMe ME d et Oot 65 11S IDI SINT CEL Os ecu ues deduce a ien e m net elute Aneel tk 65 11 6 Replacement of Fuse amaia 66 12 ECG RESP Monto 67 121 What fs BC GM Omi Corin o iii 67 12 2 Precautions during ECG Monitor sti 67 12 5 MOTHIOILEE Procedure a ae rods sedeat uds O ics dd E 68 12 3 T Preparati omae ieee eee ee ee o oit ere Ltd Iur 68 12 3 2 Installing ECG Larissa 69 I2 HEEE Screen HOt Keys doo eot dex dde aded teste t dan gay t beta dde te TE 74 12 5 ECG Menu id 75 12 6 ECG Alarm Information sce aenea rre reap era pono e qe Van NEN ainia 79 12 6 1 Alarm Message 4 diee vdd adi s 79 12 7 ST Segment Monitoring Optional
31. appropriate 3 wire receptacle If a 3 wire receptacle is not available consult the hospital electrician Connect the grounding wire to the equipotential grounding terminal on the main system If 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 else an expert in the field to ensure that the necessary safety of all instruments concerned will not be impaired by the proposed combination Equipotential Grounding 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 For internal examinations on the heart or the brain the Multi parameter Patient Monitor must have a separate connection to the equipotential grounding system One end of the equipotential grounding cable potential equalization conductor is connected to the equipotential grounding terminal on the instrument rear panel and the other end to one point of the equipotential grounding system The equipotential grounding system assumes the safety function of the protective grounding conductor if ever there is a break in the protective grounding system Examinations in or on the heart or brain should only be carried out in medically used rooms incorporating an equipotential grounding system Check each time before u
32. could potentially cause burns Intravenous dye Excessive patient movement Outside ray radiation 97 TECNO GAZ Multi Parameter Monitor MD User Manual Improper sensor application Sensor temperature maintain between 28 C and 42 C for best operation Placement of the sensor on an extremity that has a blood pressure cuff arterial catheter or intravascular line Significant concentration of dysfunctional hemoglobin such as carboxyhemog lobin and methemoglobin Low SpO Circular perfusion is not well for test part It is recommended to use SpO sensors described in chapter Accessories and Ordering Information 13 5 SpO Menu SPO2 SETUP Menu Pick the SPO2 hot key on the screen to call up the SPO2 SETUP menu as shown below SPOZ SETUP PR ALM LO ALM LEV SWEEP ALM REC PR SOUND SPOZ ALM HI AVG TIME SPOZ ALM LO PITCH TONE OFF PR ALM HI DEFAULT gt gt Figure 13 2 SPO2 Setup WARNING Setting the SpO upper alarm limit to 100 is equivalent to switching off the alarm on upper limit High oxygen levels may predispose a premature infant to retrolental fibroplasia Therefore the upper alarm limit for oxygen saturation must be carefully selected in accordance with commonly accepted clinical practices SpO gt 2 Alarm Setting ALM pick ON to enable prompt message during the SpO alarm pick OFF to disable the alarm function and there will bea 4 amp beside SpO 98 TE
33. gt If it does not use a larger or smaller cuff that fits better Connect the cuff to the air hose The limb chosen for taking the measurement should be placed at the same level as the patient s heart If this is not possible you should apply the following corrections to the measured values If the cuff is placed higher than the heart level add 0 75 mmHg 0 10 kPa for each inch of difference If it is placed lower than the heart level deduct 0 75 mmHg 0 10 kPa for each inch of difference Check whether the patient mode is appropriately selected Access PATIENT SETUP menu from SYSTEM MENU and pick PAT TYPE item and turn the knob to select the required patient type Select a measurement mode in the NIBP SETUP menu Refer to the following paragraphs Operation Hints for details Press the START button on the front panel to start a measurement 104 TECNO GAZ Multi Parameter Monitor MD User Manual Operation Hints 1 To start auto measuring Access NIBP SETUP menu and pick the INTERVAL item in which the user may choose the selections other than MANUAL to set up the time interval for auto measurement After that press START button on the front panel to start the auto measuring according to the selected time interval WARNING Prolonged non invasive blood pressure measurements in Auto mode may be associated with purport ischemia and neuropathy in the limb wearing the cuff When monitoring a patient examine
34. hospital or Customer Service Center immediately NOTE The interval between twice press of POWER should be more than 1 minute ERE TECNO GAZ Multi Parameter Monitor MD User Manual NOTE After continious 360 hour runtime please restart the monitor to ensure the monitor s steady performance and long lifespan 2 5 Connect Patient Sensors Connect all the necessary patient sensors between the monitor and the patient NOTE For information on correct connection refer to related chapters 2 6 Check the Recorder If your monitor is equipped with a recorder open the recorder door to check if paper is properly installed in the slot If no paper present refer to Chapter Recording for details 14 TECNO GAZ Multi Parameter Monitor MD User Manual 3 System Menu New patient enrolment Recording Trend Graph Table System Setup Drug Calculation Maintenance Multi parameter Patient Monitor features flexible configurations You can configure various aspects of the monitor including the parameters to be monitored sweeping speed of the waveforms audio signal volume and output content Press the MENU button on the front panel to call up SYSTEM MENU menu You can perform following operations in this menu SYSTEM MENU PATIENT SETUP gt gt SYSTEM SETUP gt gt DEFAULT gt gt SELECTION gt gt TREND GRAPH gt gt VERSION gt gt TREND TABLE gt gt DRUG CALC gt gt NIBP RECALL gt gt MAINTAIN g
35. immunity The MD Patient Monitor is intended for use in the electromagnetic environment specified below The customer or the user of MD Patient Monitor should assure that it is used in such an environment Immunity IEC 60601 test Compliance Electromagnetic environment test level level guidance Portable and mobile RF communications equipment should be used no closer to any part of the MD Patient Monitor including cables than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter Recommended separation distance Conducted RF 3 Vims 3 Vims IEC 61000 4 6 150 kHz to 80 MHz 3 5 d ZEE 1 Radiated RF 3 V m 3 V m IEC 61000 4 3 80 MHz to 2 5 GHz d Evo 80 MHz to 800 MHz 1 d PAZ 800 MHz to 2 5 GHz 1 Where P is the maximum output power rating of the transmitter in watts W according to the transmitter manufacturer and d is the recommended separation distance in metres m Field strengths from fixed RF transmitters as determined by an electromagnetic site survey should be less than the compliance level in each frequency range Interference may occur in the vicinity of 148 equipment marked with the following symbol a NOTE 1 At 80 MHz and 800 MHz the higher frequency range applies NOTE 2 These guidelines may not apply in all situations Electromagnetic propagation is affected By absorption and reflection fr
36. in the SYSTEM MENU to call up the following menu TREND GRAPH BPM 08 06 2005 11 04 06 100 80 60 40 20 0 T T pm 10358306 11 00 06 11 02 06 11 04 06 H M S HR 60 T1 99 0 ST1 0 10 SP02 99 NS RR 14 T2 98 8 ST2 0 15 PR 3 60 NH PYCs 0 TD 0 2 ND F kPa PARA SELECT RESOLUTION 1S L RIGHT 200M CURSOR Figure 8 1 Trend Graph Menu In the trend graph the y axis stands for the measured value and x axis time Y is the cursor of the trend graph the parameter value of the position pointed by the cursor is displayed below the trend graph and the corresponding time is displayed above the trend graph Other trends except NIBP trend are displayed as continuous curves In NIBP trend graph Y indicates systolic value A indicates diastolic value and indicates mean value 45 TECNO GAZ Multi Parameter Monitor MD User Manual To select trend graph of a specific parameter Pick PARA SELECT item and select a requested parameter name by turning the knob To select 1 hour or 96 hour trend graph Pick RESOLUTION item choose 1 or 5 sec for 1 hour trend graph and 1 5 or 10 min for 96 hour trend graph To view other trend curves When appears on the right part of the screen pick L RIGHT turn the knob clockwise to view later trend curves When appears on the left part of the screen pick the same item turn the knob counterclockwise to view earlier trend curve To ch
37. in the lower left corner of screen to show the 9 TECNO GAZ Multi Parameter Monitor MD User Manual charging status and the green part is the electric energy of battery When the monitor is not equipped with battery the battery status will be showed as the sign mmn which means no battery One battery can support the working of monitor Under the cable connectors is the cover of battery slot See figurel 9 Battery Slot cover Figurel 9 Battery Slot Cover Replace Battery When the lifecycle of battery is over or foul odor and leakage has been detected please contact with manufacturer or local distributor for replacement of battery WARNING A Do not unplug the battery when monitoring WARNING Stop using the battery if abnormal heat odor discoloration deformation or abnormal condition is detected during use charge or storage Keep it away from the monitor 10 TECNO GAZ Multi Parameter Monitor MD User Manual 2 Installation of Monitor Open the package and check Install wall mount for patient monitor Connect the power cables Power on the monitor Connect patient sensors Check the recorder NOTE To ensure that the monitor works properly please read Chapter Safety Guidance and follow the steps before using the monitor 2 1 Open the Package and Check Open the package and take out the monitor and accessories carefully Keep the package for p
38. is switched to a different waveform automatically 3 7 Module Setup Select MODULE SETUP item in SYSTEM SETUP menu to call up the following menu MODULE SETUP Bg HN Figure 3 10 Module Setup You can choose the parameter you wish to monitor from this menu so that you can enhance the display efficiency and avoid interference from other messages 22 TECNO GAZ Multi Parameter Monitor MD User Manual 3 8 Tracing Waveforms Selection Select TRACE SETUP item in SYSTEM SETUP menu to call up the following menu TRACE SETUP ECG1 IBP2 ECG2 RESP SPOZ IBP1 WAVE SEQUENCE gt gt Figure 3 11 Trace Setup You can define the traces displayed on the screen in this menu The waveforms available for selection are those whose modules have been selected in MODULE SETUP menu 3 9 Monitor Version Pick VERSION to show the software version information of this monitor 3 10 Alarm Volume The system provides five levels of alarm volume and an alarm silence function The system will give audio alarm prompt including no alarm sound based on the selection The user may select different level of volume as per clinical requirement The method is listed below Press ALARM SETUP item in SYSTEM SETUP menu to call up ALARM SETUP sub menu as shown below in which the user may set up the alarm volume and other alarm information Refer to Chapter Alarm for detailed information 23 TE
39. patient s arm or leg following the instructions below Figure 14 1 MW Ensure that the cuff is completely deflated E Apply the appropriate size cuff to the patient and make sure that the symbol is over the appropriate artery Ensure that the cuff is not wrapped too tightly around the limb Excessive tightness may cause discoloration and eventual ischemia of the extremities E pa qp A WS e RE NS cd S Figure 14 1 Applying Cuff NOTE The width of the cuff should be either 4096 of the limb circumference 5096 for neonates or 2 3 of the upper arm length The inflatable part of the cuff should be long enough to encircle 50 80 of the limb The wrong size of cuff can cause 103 TECNO GAZ Multi Parameter Monitor MD User Manual erroneous readings If the cuff size is in question then use a larger cuff Size of reusable cuff for neonate children adult Patient Type Limb perimeter Cuff width Hose Infant 10 19 cm 8 cm Child 18 26 cm 10 6 cm Adult 25 35 cm 14 cm 1 5 m or 3 m Large Adult 33 47 cm 17 cm Thigh 46 66 cm 2 cm Size of disposable cuff for neonate children adult Size No Limb perimeter Cuff width Hose 1 3 1 55 7 em 2 5 cm 1l 5mor3 m 2 4 3 8 0 cm 3 2 cm 3 5 8 10 9 cm 4 3 cm 4 7 1 13 1 cm 5 1 cm The lifecycle of cuff is 480mmHg 20000 times 300mmHg 50000 times Make sure that the cuff edge falls within the range of mark lt
40. recording and continuous 8 second recording are automatically set by the monitor usually the first two waveforms displayed on the screen You can also configure it through the menu Refer to related section for details 40 TECNO GAZ Multi Parameter Monitor MD User Manual In RECORD menu the user can choose two waveforms to be printed out The User can setup one waveform off Thus the real time record will print out one waveform If two waveforms are off the real time record will print out measure parameters only NOTE When the system is executing a recording task the system can start executing next alarm recording task only when the current one is finished Auto Recording The monitor starts the recorder for 8 seconds according to interval time set in the TIMING REC TIME of the RECORD menu Refer to Chapter Recorder Setup for details Alarm Recording n Parameter Alarm The monitor records waveforms 4 8 or 16 seconds prior to and after the alarm totally 8 16 or 32 seconds which can be selected in System Menu All parameter values during the alarm will also be recorded When parameter alarm occurs two recorded waveforms can be printed out In order to avoid repeated printout of alarm waveforms D If more than two parameter alarms are switched on and triggered simultaneously the recorder will print out those of the highest level If of the same alarm level the latest alarm will be printed out 2 If
41. screen example To indicate the status of switching on or charging When the monitor is switched on the indictor will flash with green light And then if the battery is charged the light color will turn to orange 1 3 Button Functions All the operations to Multi parameter patient monitor can be finished by several buttons and a knob They are Figure 1 3 Buttons Menu Press to call up the SYSTEM MENU Refer to Chapter System Menu and Chapter Trend and Event for details 2 Start Press to fill gas into cuff and start blood measuring During the measuring process press the button to stop measure and deflate GQ Record Press to start a real time recording The recording time is set in RT REC TIME of RECORD submenu Silence Press this button to enter the status of ALARM SILENCE All the alarm audio will be closed At the 5 TECNO GAZ Multi Parameter Monitor MD User Manual same time Alarm Pause xx s will be displayed in the parameter alarm area When repress it or the pause time is over the system will stop pausing and resume to the normal monitoring status and Alarm Pause XX s will vanish NOTE Whether an alarm will be reset depends on the status of the alarm cause But by pressing SILENCE button suspend alarm can permanently shut off audio sound of the Lead Off or Sensor Off alarms So the user can exit the Alarm Silence Status by Technical Alarm
42. selectable IS2 TOO HIGH SYS measuring value of channel 2 is above upper alarm limit User selectable IS2 TOO LOW SYS measuring value of channel 2 is below lower alarm limit User selectable ID2 TOO HIGH DIA measuring value of channel 2 is above upper alarm limit User selectable ID2 TOO LOW DIA measuring value of channel 2 is below lower alarm limit User selectable IM2 TOO HIGH MAP measuring value of channel 2 is above upper alarm limit User selectable IM2 TOO LOW MAP measuring value of channel 2 is below lower alarm limit User selectable Technical alarms Alarm Message Cause Remedy Level Make sure that cable is IBP1 SENSOR IBP cable of channel 1 LOW properly connected OFF falls off from monitor 131 TECNO GAZ Multi Parameter Monitor MD User Manual IBP2 SENSOR IBP cable of channel 2 LOW Make sure that cable is OFF falls off from monitor properly connected 16 6 Maintenance and Cleaning A WARNING Before cleaning the monitor or the transducer make sure that the equipment is switched off and disconnected from the power line Cleaning of IBP Transducer Reusable After the IBP monitoring operation is completed remove the tubing and the dome from the transducer and wipe the transducer diaphragm with water Soaking and or wiping with soap can clean the transducer and cable and water or clea
43. serious case ALM REC pick ON to enable report printing upon RESP alarm ALM HI used to set up the upper alarm limit ALM LO used to set up the lower alarm limit RESP alarm is activated when the respiration rate exceeds set ALM HI value or falls below ALM LO value RESP alarm limits for default RR HI RR LO Step RESP ADU 30 8 1 RESP PED 30 8 1 RESP NEO 100 30 1 The adjusting range of RESP alarm limits Max RR HI Min RR LO Step RESP ADU 120 0 1 RESP PED 150 0 1 RESP NEO 150 0 1 APNEA ALM to set the standard of judging an apnea case It ranges from 10 to 40 seconds increases decreases by 5 SWEEP Available options for RESP SWEEP are 6 25 12 5 and 25 0 mm s WAVE AMP The user may set up the displaying amplitude of the RESP waveform The selections are Auto 0 5 1 2 4 DEFAULT pick this item to access the RESP DEFAULT CONFIG dialog box in which the user may select whether the FACTORY DEFAULT CONFIG or the USER DEFAULT CONFIG is to be used After selecting any of the items and exiting the dialog box the system will pop up the dialog box asking for the user s confirmation WARNING A The respiration sensitivity will descend after using the defibrillation cable and 92 TECNO GAZ Multi Parameter Monitor MD User Manual the 4 mode is recommended in the WAVE AMP 12 9 5 RESP Alarm Message Tables below describe the possible physiological a
44. the equipment is switched off and disconnected from the power line Reusable TEMP Probes 1 The TEMP probe should not be heated above 100 C 212 F It should only be subjected briefly to temperatures between 80 C 176 F and 100 C 212 F The probe must not be sterilized in steam Only detergents containing no alcohol can be used for disaffection Rw wv The rectal probes should be used if possible in conjunction with a protective rubber cover 5 To clean the probe hold the tip with one hand and with the other hand rubbing the probe down in the direction of the connector using a moist lint free cloth NOTE Wash the probe with clean water after disinfecting and sterilizing to remove any remaining solution The probe can only be reused after being dried thoroughly NOTE Do not disinfect the probe with the means of water boiled NOTE The product has not been disinfected at the factory NOTE Any residue should be removed from the probe before being disinfected and sterilized and avoid contacting corrosive solvent Dip the cable into alcohol or alkalescent solvent for a long time may reduce the flexibility of the scarfskin of the cable Also the connector should not be dipped 119 TECNO GAZ Multi Parameter Monitor MD User Manual NOTE After monitoring disinfect the probe according to the instruction described in the user manual NOTE Disposable TEMP probe must not be re sterilized or reused NOTE
45. the extremities of the limb frequently for normal color warmth and sensitivity If any abnormality is observed stop the blood pressure measurements 2 To stop auto measuring During auto measuring press START button on the front panel at any time to stop auto measurement 3 To start a manual measuring n Access NIBP SETUP menu and pick the INTERVAL item Select the MANUAL selection Then press the START button measurement on the front panel to start a manual n During the idle period of auto measuring process press the START button on the front panel at any time to start a manual measurement Then press the START button system continues executes auto measuring program according to selected time on the front panel to stop manual measurement and the interval 4 To start a manual measuring during the AUTO mode Press START button on the front panel 5 To stop a manual measuring Repress the START button on the front panel again 105 TECNO GAZ Multi Parameter Monitor MD User Manual WARNING Prolonged non invasive blood pressure measurements in Auto mode may be associated with purport ischemia and neuropathy in the limb wearing the cuff When monitoring a patient examine the extremities of the limb frequently for normal color warmth and sensitivity If any abnormality is observed stop the blood pressure measurements 6 To start a continuous measuring Access th
46. the knob to pick STEP item Press and turn the knob to select step 1 10 are available for selection with the increment being 1 Turn the knob to pick DOSE TYPE item Press and turn the knob to select the unit in the pull down list Use UP DOWN item in the table to view the data in previous or following pages Turn the knob to pick REC item After pressing the knob the recorder prints out the data displayed in tne current titration table Turn the knob to pick EXIT to return to DRUG CALC menu Total amount dose volume INF rate drip rate and patient weight and drug name are displayed on the top of the titration table Meaning of each English identifier is AMOUNT drug amount VOLUME liquid volume DOSE min drug dose INF RATE flow rate DRIP RATE drop rate WEIGHT patient weight 55 TECNO GAZ Multi Parameter Monitor MD User Manual 10 Safety Guidance The Multi parameter Patient Monitor is designed to comply with the International National Safety requirements for medical electrical equipment IEC600601 1 EN60601 2 27 and EN60601 2 30 This device has floating inputs and is protected against the effects of defibrillation and electrosurgery If the correct electrodes are used and applied in accordance with the manufacturer instructions see Chapter ECG RESP Monitoring the system can restore screen display within 10 seconds after defibrillation Y This symbol indicates that the instrument is IEC 60601 1 Type CF equipm
47. the patient RESP analysis Check the current situation of the Patient suffers from ASYSTOLE patient Check the connection of Arr Of ASYSTOLE the electrodes and lead wires f Check the current situation of the Patient suffers from VFIB VTAC patient Check the connection of Arr of VFIB VTAC y the electrodes and lead wires Check the current situation of the Patient suffers from i COUPLET patient Check the connection of Arr of COUPLET the electrodes and lead wires Check the current situation of the Patient suffers from i BIGEMINY patient Check the connection of Arr Of BIGEMINY the electrodes and lead wires Check the current situation of the Patient suffers from TRIGEMINY patient Check the connection of Arr of TRIGEMIN Y the electrodes and lead wires Check the current situation of the Patient suffers from RON T patient Check the connection of Arr of RON T the electrodes and lead wires Check the current situation of the PVC Patient suffers from patient Check the connection of Arr of PVC the electrodes and lead wires 142 TECNO GAZ Multi Parameter Monitor MD User Manual Check the current situation of the Patient suffers from TACHY patient Check the connection of TACH Y the electrodes and lead wires i Check the current situation of the Patient suffers from BRADY patient Check the connection of BRADY
48. the screen will display the error message ECG LEAD OFF and the audible alarm is activated NOTE For protecting environment the electrodes must be recycled or disposed of properly 12 3 2 Installing ECG Lead Placing the Electrodes for ECG Monitoring Electrode placement for 3 lead set Figure 12 1 M Red R electrode Be placed near the right shoulder directly below the clavicle MW Yellow L electrode Be placed near the left shoulder directly below the clavicle E Green F electrode Be placed on the left hypogastrium NOTE the following table gives the corresponding lead names used in Europe and America respectively Lead names are represented by R L F in Europe whose corresponding lead names in America are RA LA LL America Euro Lead names color Lead names color RA White R Red LA Black L Yellow LL Red F Green Lewis A L A po R AI Y y S a E om EA AR HAS SY A EI AA wo F Figure 12 1 Electrode Placement for 3 lead Set 69 TECNO GAZ Multi Parameter Monitor MD User Manual Electrode placement for 5 lead set Figure 12 2 Red R electrode Be placed near the right shoulder directly below the clavicle Yellow L electrode Be placed near the left shoulder directly below the clavicle Black N electrode Be placed on the right hypogastrium Green F electrode Be placed on the left hypogastrium White C electrode Be placed on the chest a
49. 06 15 13 01 12 2006 16 13 01 12 2006 16 19 01 12 2006 16 19 01 12 2006 16 13 01 12 2006 16 13 01 12 2006 16 13 01 12 2006 16 19 01 12 2006 16 13 CURSOR WAVE gt gt DELETE RENAME Figure 12 16 ARR Recall Observe other event lists of other page Select the Arr event whose name is displayed in a protruding frame Delete the selected Arr event Rename the selected Arr event whose name is displayed in a sunken frame Switch the knob until the name you want appears To display the Arrhythmia waveform time and parameter value To observe waveforms of other Arrhythmia events To observe 8 second waveform of Arrhythmia events To print out displayed Arrhythmia event To return to ARR RECALL menu of Arrhythmia event 87 TECNO GAZ Multi Parameter Monitor MD User Manual ARR WAVE RECALL x BRADY TIME 01 12 16 20 No 1 of 52 HR B0 RR 14 STi 0 10 ST2 0 15 PVCs 0 Ts 57 2 C Tet 3 41 G TU 0 1 9C SP02 52 PR 60 C 2 mmHg 20 INS lt mmHg 2 RuRR 14 NIBP mmHg S Mi Ho 00 00 00 00 IBP1 mmHg S 120 Mi 93 0 IBP2 mmHg S Mz 10 ECG CH1 II UP DOUN L RIGHT Figure 12 17 ARR Wave Recall ARR ALARM The alarm is triggered when an Arrhythmia occurs If the ALM is ON the alarm sounds and the alarm indicator flashes Physiological alarms Applicable Prompt dd Occurring Condition Alarm Level Patient Type No QRS is detected for 4 ASYSTOLE All patients f User
50. Area The trend can be viewed with table or graphic form Measurement unit of ST segment mv on E E Measurement symbol of ST segment elevating depressing H Measurement range of ST segment 2 0 mv 2 0 mv Pick the ST ANALYSIS item in the ECG SETUP menu to access the ST ANALYSIS sub menu as shown below ST ANALYSIS Menu ST ANALYSIS ST ANAL ALM HI 0 20 ST ALM ALM LO 0 20 ALM LEV DEF POINT gt gt ALM REC Figure 12 11 ST Analysis ST Analysis Alarm Setting B ST ANAL the switch for ST analysis Set it to ON to activate the ST analysis or OFF to disable the ST analysis B ST ALM pick ON to enable prompt message and data record during the ST analysis alarm pick OFF to disable the alarm function and there will be a x beside ST ST alarm is activated when the result exceeds set ST HI value or falls below ST LO value A WARNING In order to avoid endangering the patient s life the user should use this function cautiously B ALM LEV used to set up the ST alarm level There are three selections HIGH MED and LOW B ALM REC pick ON to enable report printing upon ST analysis alarm 81 B ALM HI used to set up the upper limit of ST alarm The max Higher limit is 2 0 TECNO GAZ Multi Parameter Monitor MD User Manual The minimum higher limit must be 0 2 larger than the set lower limit B ALM LOW used to set up the lower limit of ST alarm The minimum lower limit is 2 0 T
51. CNO GAZ Multi Parameter Monitor MD User Manual WARNING In order to avoid endangering the patient s life the user should use this function cautiously ALM LEV used to set up alarm level selectable from HIGH MED and LOW HIGH represents the most serious case ALM REC pick ON to enable report printing upon SpO2 alarm e SpO alarm is activated when the result exceeds set SPO2 ALM HI value or falls below SPO2 ALM LO value Use the knob to pick the SPO2 ALM HI or SPO2 ALM LOW item and turn the knob to select the desired alarm limit e PR alarm is activated when the pulse rate exceeds set PR ALM HI value or falls below PR ALM LO value Use the knob to pick the PR ALM HI or PR ALM LOW item and turn the knob to select the desired alarm limit The adjusting range of SpO alarm limits is 0 100 SpO alarm limits for default Max Upper Limit Min Lower Limit Step ADU 100 90 1 PED 100 90 1 NEO 95 80 1 The adjusting range of PR alarm limits is 0 254 PR alarm limits for default Max Upper Limit Min Lower Limit Step ADU 120 50 1 PED 160 75 1 NEO 200 100 1 E SWEEP Available options for SPO SWEEP are 6 25 12 5 and 25 0 mm s B PR SOUND Pulse beep volume Options are 0 5 B AVG TIME 4S 8S 16S represent times that SpO2 average value is counted B PITCH TONE When ON is enabled the system will provide prompt sound with different tone for clinic un
52. CNO GAZ Multi Parameter Monitor MD User Manual ALARM SETUP ALM SEL COMMON ALM SETUP ALARM VOL 3 ALM REC TIME 83 Figure 3 12 Alarm Setup Pick ALARM VOL to set the volume of alarm sounds by turning the knob The selections are 1 5 WARNING If the alarm volume is off when there is alarm the monitor can t give audio alarm prompt so the user should use this function cautiously 3 11 Key Volume Select SELECTION item in SYSTEM SETUP menu to call up SELECTION sub menu as shown below Select KEY VOL item and set the volume The selections are OFF LOW MED HIGH Figure 3 13 Selection 24 TECNO GAZ Multi Parameter Monitor MD User Manual 3 12 Drug Calculation The patient monitor provide drug calculation and titration table display functions for fifteen different drugs For details please refer to the Chapter Drug Calculation and Titration Table 3 13 Waveform Demonstration Select DEMO item in SYSTEM MENU to call up INPUT DEMO KEY After entering the password the system enters the Demonstration Waveform status The purpose of waveform demonstration is only to demonstrate the machine performance and for training purpose In clinical application this function is not recommended because the DEMO will mislead the hospital workers to treat the waveform and parameter as actual data of the patient which may result in delay of treatment or mistreatment 3 14
53. Cavity temperature probe only suggested to be used inside the recta Recommend to use the disposable cannula to prevent cross infection NOTE For protecting environment the disposable TEMP probe must be recycled or disposed of properly NOTE Do not force the cavity temperature probe against resistance when inserted into human body Also it is not recommended to use it in bleeding part and cankerous part of human body 120 TECNO GAZ Multi Parameter Monitor MD User Manual 16 IBP Monitoring Optional 16 1 Introduction Multi parameter patient monitor measures direct blood pressure SYS DIA and MAP of one selected blood vessel through two channels and displays two BP waveforms measures direct blood pressure SYS DIA and MAP The available pressure labels are Label Definition ART Arterial Blood Pressure PA Pulmonary Artery Pressure CVP Center Arterial Pressure RAP Right Arterial Pressure LAP Left Arterial Pressure ICP Intracranial Pressure P1 P2 Expand Pressure 16 2 Precautions during IBP Monitoring WARNING The operator should avoid contact with the conductive parts of the appurtenance when being connected or applied WARNING A When the monitor is used with HF surgical equipment the transducer and the cables must be avoided conductive connection to the HF equipment to protect against burns to the patient WARNING Disposable IBP transducer or domes should
54. Do not operate the recorder without record paper Paper Out When RECORDER OUT OF PAPER alarm is displayed the recorder cannot start Please insert record paper properly Inserting Paper M Place fingers under the two sides flange of the recorder casing pull outwards directly to release the casing E Insert a new roll of paper into the paper cassette printing side facing upwards MW Ensure proper position and tidy margin M Pull about 2cm of the paper out then close the recorder casing NOTE Be careful when inserting paper Avoid damaging the thermo sensitive print head Unless when inserting paper or shooting troubles do not leave the recorder catch open 43 TECNO GAZ Multi Parameter Monitor MD User Manual Removing Paper Jam When the recorder functions or sounds improperly open the recorder casing to check for a paper jam Removing the paper jam in the following way MW Cut the record paper from the feeding edge M Open the recorder casing MW Re insert the paper A4 TECNO GAZ Multi Parameter Monitor MD User Manual 8 Trend and Event Multi parameter patient monitor provides 96 hour trend data of all parameters storage of 500 NIBP measurement results and 60 alarm events This chapter gives detailed instruction for review of all data 8 1 Trend Graph MW The latest 1 hour trend is displayed every 1 or 5 seconds MW The latest 96 hour trend is displayed every 1 5 or 10 minutes Pick TREND GRAPH
55. INOPHYLLINE INF RATE 60 00 m1 hr WEIGHT 70 0 kg DRIP RATE 20 00 GTI nin AMOUNT 500 00 ng DROP SIZE 20 00 GTI nl VOLUME 500 00 ml DURATION 8 33 hr CONCENTRAT 1 00 mg ml DOSE min 1 00 my Please carefully verify DOSE hr 60 00 ng the input information DOSE kg min 14 29 mcg DOSE kg hr 857 14 mcg TITRATION gt gt EXIT Figure 9 1 DRUG CALC The following formulas are applied for dose calculation Concentrat Amount Volume INF Rate DOSE Concentrat Duration Amount Dose Dose Rate x Concentrat DRIP Rate INF Rate 60 x DROP Size 52 TECNO GAZ Multi Parameter Monitor MD User Manual Operating Method In the Drug Calculation window the operator should first select the name of the drug to be calculated and then confirm the patient weight Afterwards the operator should also enter other known values Turn the knob to select the value of the item to be calculated Turn the knob to change the value When it is the required value press the knob to view the calculation result Each item has its calculation range If the result exceeds the range display NOTE For the drug calculation the prerequisite is that the operator must first of all enter the patient weight and drug name The system first gives a group of random initial values which cannot be used by the operator as the calculation reference Instead he should enter a new group of values at the doctor s instruction NOTE Each d
56. Ordinary equipment sealed equipment without liquid proof Refer to Chapter 12 Chapter 16 for details Continuous running equipment 318mmx152mmx264mm 5 40 C 20 55 C 30 85 30 93 no coagulate 500 to 4 600m 1 600 to 15 000 feet 500 to 13 100m 1 600 to 43 000 feet 100 240 VAC 50 60 Hz 136 TECNO GAZ Multi Parameter Monitor MD User Manual Pmax 80VA FUSE T 1 6AL A1 2 3 Display Device 10 4 inch 12 1 inch optional Multicolour TFT LCD resolution 800 600 1 LED Messages 11 Waveforms Maximum 1 Alarm LED Orange Red Charge LED Green Orange 3 Sound Mode corresponding Alarm Mode A1 2 4 Battery 4A hour 14 8V chargeable Li battery Under normal status the working time with full electric energy is more than 120 minutes A1 2 5 Recorder Optional Record Width 48 mm Paper Speed 25mm S Trace 2 Recording types Continuous real time recording 8 second real time recording Auto 8 second recording Parameter alarm recording Drug Calculation and titration table recording A1 2 6 Recall Trend Recall Short 1 hrs 1 Second Resolution Long 72 hrs 1 Min Resolution NIBP Measurement Recall 500 NIBP measurement data 137 TECNO GAZ Multi Parameter Monitor MD User Manual A1 2 7 ECG Lead Mode 5Leads R L F N C or RA LA LL RL V Lead selection I II III avR avL avF V Waveform 2 ch Lead mode 3 Leads R L F or RA LA LL Lead selection I II III Wa
57. Pressure Sensor Sensitivity Impedance Static Pressure Measuring Range Static Pressure Accuracy Dynamical Pressure Measuring Range Dynamical Pressure Accuracy Frequency Response Measuring and Alarm Range ART PA CVP RAP LAP ICP P1 P2 Resolution IBP Zero Ibpm 3bpm 0 03 20 2 15 45 C 0 1 C 0 1 C excluding probe Everyl 2 Seconds Every about 5 10 Minutes 2 ART PA CVP RAP LAP ICP P1 P2 5 uV V mmHg 300 3000 Ohm 50 300 mmHg Cup to 350 mmHg gt 1 or ImmHg which great excluding probe 4 or 4mmHg which great including probe 50 300 mmHg 4 or 4mmHg which great including probe d c 15 Hz 0 300 mmHg 10 120 mmHg 10 40 mmHg 10 300 mmHg mmHg 2 channel 12 bits DAC Zero Zero Range 50 4300 mmHg 141 Appendix II System Alarm Prompt TECNO GAZ Multi Parameter Monitor MD User Manual PROMPT CAUSE MEASURE XX TOO HIGH XX value exceeds the higher alarm limit XX TOO LOW XX value is below the lower alarm limit Check if the alarm limits are appropriate and the current situation of the patient XX represents the value of parameter such as HR STI ST2 RR SpO2 NIBP IBP etc in the system The respiration signal of the patient is too Check the connection of the RESP APNEA small so that the linking wire and the current systemcannot perform situation of
58. R 76 TECNO GAZ Multi Parameter Monitor MD User Manual W HR CHANNEL CHI to count the heart rate by CH 1 waveform CH2 to count the heart rate by CH 2 waveform LEAD TYPE used to select either 5 LEADS or 3 LEADS SWEEP Available options for ECG SWEEP are 12 5 25 0 and 50 0 mm s B ST ANALYSIS Pick this item to access ST ANALYSIS menu the detailed information about the menu is to be discussed in the following section B ARR ANALYSIS Pick this item to access ARR ANALYSIS menu the detailed information about the menu is to be discussed in the following section B OTHER SETUP Pick this item to access ECG SETUP menu as shown below OTHER SETUP ECG DISPLAY NORMAL DISPLAY BEAT VOL 2 ECG CAL ADJUST WAVE POS gt gt DEFAULT gt gt Figure 12 8 ECG Setup In the sub menu following functions are available ECG DISPLAY Select NORMAL DISPLAY to display 2 ECG waveforms for 5 lead for 3 lead only 1 ECG waveform is displayed Select MULTI LEADS DISPLAY the waveform area on the screen only displays 7 ECG waveforms occupying the area of 7 waveforms Select HALF SCAN MULTI LEADS those 7 ECG waveforms are displayed on the screen occupying the area of 4 waveforms NOTE If 3 LEADS is selected in the ECG SETUP menu only NORMAL DISPLAY can be Js TECNO GAZ Multi Parameter Monitor MD User Manual selected for ECG DISPLAY item in the sub menu BEAT VOL Six selections are available 0 1 2 3 4 5
59. R DEFAULT CONFIG Back to the upper menu Figure 12 10 ECG Default Configure A WARNING For pacemaker patient the pacing impulse analysis function must be switched on otherwise the pacing impulse may be counted as normal QRS complex which results in failure of ECG LOST error detection NOTE When Pacer Switch is On the Arrhythmia events related to PVCs will not be monitored At the same time the ST analysis will not be performed either 12 6 ECG Alarm Information 12 6 1 Alarm Message Alarms occurring in the process of ECG measurement contain two types physiological alarm and technical alarm For the audio and visual features during the appearance of these alarms in the process of ECG measurement please refer to the related description in Chapter Alarm In the screen physiological alarm messages are displayed in the Physiological Alarm area Technical alarms messages are displayed in the Technical Alarm area This section does not describe the content about Arr and ST analysis Tables below describe respectively the possible various alarms those may occur during the measurement Physiological alarms Message Cause Alarm level ECG LOST No ECG signal of the patient is detected HIGH HR HR measuring value is above the upper User selectable TOO HIGH alarm limit 79 TECNO GAZ Multi Parameter Monitor MD User Manual TOO LOW alarm limit HR HR measuring value is below the
60. ance and Cleaning a 113 TS TEMP NODOS eres eee seas ere ERR ONSE a RENTES VON SERRE SUELEN Ae 116 13 1 TEMP OMODIOFIIg euer roe Uttar eere eee aed Oo e ier Edd ets 116 15 2 TEMPS ETT NOTE goer eevee cae Re nies AS 117 5 2 UB MEP Alarm Mass 118 lod C dre unu Cleanin eec sese CER Dd ma Ed 119 16 IBP Monitoring Optional iio to Che re acota 121 16 1 Introduction eoi ris nea boas vec HR E a VR ood ais 121 16 2 Precautions during IBP Monitoring eseeeeememete 121 16 3 Monitoring Proced re edocet dia 122 TOA IBP MENU eenen sa a ia to 123 16 3 Alarm nformati onaren erea ett A A AAA E ere NE 130 VIII 16 6 Maintenance and e arma ve oca ever crede trao ERE e TES aria a o NU vEREN 132 Appendix I eoo O 136 AL Olas SUCIO oot doce ent eapt i tar etus na e ia 136 Pole SPCC leans oos NAAA M pd 136 Ale ze a dE ion con Vu 136 A1 2 2 Environmient iiiee ees icai ero d ee ae e eere exi vn 136 A1 2 3 Display ici siiri sre na EEATT NETAS PE IENA STEA IEN TAES Ss 137 A1 2 4 Balletry coa A A AA 137 A1 2 5 Recorder Optional e cena etate eee ao enne ae E E eases SN EENE 137 EA A ente xd d che wand cued ae HR DO di le BEC RENE 137 PW O A E ARR SIR E TOEREN E AEREA SE EA TEE A ERR 138 AT 2 5 RES PIR ATION cc ciue AAA mS 139 PURUS DUPLI eT 139 AT Oa sicat deans sos rod fades np E Md ke un rV NO E M MD SNMP TUM 140 A211 TEMPERATURE dota Edo E au ei ee 141 ART IS A E drca E UEM nde c aU 141 Appendix Mat A eked dietetic
61. ange the display scale Pick the ZOOM button to adjust the y axis scale and thus change the trend curve in proportion The value beyond maximum value will be represented by the maximum value To obtain trend data of a specific time The time to which the cursor points will change as the knob is turned Parameter at this time is displayed below the x axis When appears on the right part of the screen the trend graph pages down for later trend curve as the cursor moves here When appears on the left part of the screen the trend graph pages up for earlier trend curve as the cursor moves here Mark Event If an event is marked A B C or D then the corresponding event type will display on the axis time of the trend graph such as Al E or B Operation Example To view the NIBP trend graph of the last 1 hour n Pick the MENU key on the lower right of the screen n Pick TREND GRAPH item in the SYSTEM MENU n Select parameter pick the PARA item and turn the knob until NIBP appears 46 TECNO GAZ Multi Parameter Monitor MD User Manual n Select 1S or 5S in the RESOLUTION item n Pick the L Right button and turn the knob to view changes of the trend graph time and trend curve n Stop at requested trend time section for careful review Pick the ZOOM button to adjust the display scale if necessary n For measurement result of a specific time pick CURSOR to move the cursor to the point corresponding tim
62. as three different operating screens which are Standard Screen Trend Screen oxyCRG Screen When required you can select different operating screens for necessary information Let s probe into these three operating screens one by one 4 1 Select Operating Screen In the SYSTEM MENU select the FACE SELECT option in the SYSTEM SETUP menu to call up the dialog box as shown in the figure below There are three options in this dialog box which are STANDARD SCREEN TREND SCREEN oxyCRG SCREEN Only one item can be selected at one time FACE SELECT M STANDARD SCREEN TREND SCREEN M oxyCRG SCREEN Figure 4 1 Face Select 4 2 Standard Screen In the FACE SELECT menu select the STANDARD SCREEN option to enter the Standard Screen The Standard Screen displays to us the parameters in the Parameter area and the waveforms being monitored This screen is the basic operating screen of the monitor 27 TECNO GAZ Multi Parameter Monitor MD User Manual ARR LEARNING AUTO IAGNOSTIC rara ala d A QA Le INZ TOO HIGH 60 TIS 74 07 Namal n urr sm OFF PK OFF gg IBP 1 2 16 012 4 10 7 09 16 2005 09 31 17 Figure 4 2 4 3 Trend Screen n Enter TREND SCREEN Standard Screen In the FACE SELECT menu select the TREND SCREEN option to enter the Trend Screen ARR LEARNING
63. ated to the alarm level How to indicate that the measured parameter has exceeded its alarm limits When physiological alarm of the monitored parameter exceeds the alarm limit besides using the above mentioned three ways to give the alarm prompt the monitor also gives alarm by making the monitored parameter flash in the frequency of 1Hz Screen Display When the measured parameter exceeds its alarm limits and triggers a physiological alarm the corresponding parameter value will flash signal appears on the screen indicating the occurrence of alarm Red indicates high level alarm yellow indicates medium level alarm and yellow indicates low level alarm Technical alarm will not prompts signal Lamp light The high medium low level alarms are indicated by the system in following different visual ways 32 TECNO GAZ Multi Parameter Monitor MD User Manual Alarm level Visual prompt High Alarm indicator flashes in red with high frequency Medium Alarm indicator flashes in orange with low frequency Low Alarm indicator lights on in orange Alarm Sound The high medium low level alarms are indicated by the system in following different audio ways Alarm level Audio prompt Wich Mode is DO DO DO DO DO DO DO DO DO DO i 5 which is triggered once every 10 seconds Maan Mode is DO DO DO which is triggered once every 25 sec
64. ature and humid environment CAUTION Do not immerse transducers in liquid When using solutions use sterile wipes to avoid pouring fluids directly on the transducer CAUTION Y Do not autoclave or gas sterilize the monitor recorder or any accessories CAUTION Y The device and reusable accessories could be sent back to the manufacturer for recycling or proper disposal after their useful lives CAUTION Remove a battery whose life cycle has expired from the monitor immediately CAUTION Avoid liquid splash and excessive temperature The temperature must be kept between 5 C and 40 C while working And it should be kept between 20 C and 55 C during transportation and storage 61 TECNO GAZ Multi Parameter Monitor MD User Manual CAUTION Y Before use the equipment patient cable and electrodes etc should be checked Replacement should be taken if there is any evident defectiveness or aging symptom which may impair the safety or performance Explanation of Symbols in the Monitor TT pagan uan y um u Logo of manufacture e This symbol means BE CAREFUL Refer to the user manual This symbol indicates that the equipment is IEC 60601 1 Type CF equipment The unit displaying this symbol contains an F Type isolated floating patient applied part providing a high degree of protection against shock and is suitable for use during defibrillation mum This symbol con
65. aveform Area 3 Parameter Area ARR LEARNING nz TOO HIGH I AUTO piecnosric dada dra nd gt 60 m e Pts OFF l p 7 u 1 J por EP 49 30 kPa 15 717 9 7 MEM j A T a a x Es A A ET x i sr gt onm CH s T l T 99 f n i j 7 i i IBP C1 2 kPa RN 16 0124 10 7 09 16 2005 09 31 17 O Figure 1 2 Main Interface ES TECNO GAZ Multi Parameter Monitor MD User Manuall Information Area 2 The Information Area is at the top and bottom of the screen displaying operating state of the monitor and status of the patient The information area contains following data Bed number of the monitored patient ADU Type of patient Three options Adult Pediatric Neonate Name Name of the monitored patient When the user input patient name this name will be displayed on the right side of the Patient type If the user doesn t input patient name this position will be vacant 09 16 2005 Current date 09 31 17 Current time Indicates the status of mains power supply means the mains power supply is on Ka means the mains power supply is off EN Indicates the battery and its capacity in the monitor N means there is a battery in the monitor and the green part indicate the battery s charge Emo means there is no battery equipped in the monitor Other information of the Information Area comes up only with respective monitoring status They are
66. ayed on the main interface WARNING A Pulse oximetry can overestimate the SpO value in the presence of Hb CO Met Hb or dye dilution chemicals SpO Pulse Monitoring WARNING ES Electrosurgery equipment wire and SpO2 cable must not be tangled up 95 TECNO GAZ Multi Parameter Monitor MD User Manualanual WARNING A Do not put the sensor on extremities with arterial catheter or venous syringe NOTE Do not perform SpOs measuring and NIBP measuring in same arm at one time because obstruction of blood flow during NIBP measuring may adversely affect the reading of SpO value 13 2 Precautions during SpO2 Pulse Monitoring NOTE Make sure the nail covers the light window The wire should be on the backside of the hand NOTE SpO value always displays at the same position Pulse Rate will display when HR FROM is set at SPO2 No ECG signal when HR FROM is set at Auto NOTE SpO waveform is not proportional to the pulse volume WARNING A Verify sensor cable fault detection before beginning of monitoring phase Unplug the SpO2 sensor cable from the socket the screen will display the error message SpO2 SENSOR OFF and the audible alarm is activated A WARNING If the SpO sensor can t work properly please reconnect the sensor or change a new one A WARNING Do not use the sterile supplied SpO sensors if the packaging or the sensor is damaged and return them to the ve
67. ch the skin is damaged or expected to be damaged For a thrombasthemia patient it is important to determine whether measurement of the blood pressure shall be done automatically The determination should be based on the clinical evaluation Ensure that the correct setting is selected when performing measurements on children It may be dangerous for the children to use an over pressure level NOTE The equipment is suitable for use in the presence of electrosurgery NOTE The equipment can provide protective means to prevent the patient from being burned when used with HF SURGICAL EQUIPMENT NOTE The equipment can protect against the effects of the discharge of a defibrillator NOTE The equipment is suitable for connection to public mains as defined in CISPR 11 102 TECNO GAZ Multi Parameter Monitor MD User Manual 14 2 NIBP Monitoring 14 2 1 NIBP Measuring A WARNING M Before starting a measurement verify that you have selected a setting appropriate for your patient adult pediatric or neonate BI Do not apply the cuff to a limb that has an intravenous infusion or catheter in place This could cause tissue damage around the catheter when infusion is slowed or blocked during cuff inflation WARNING Make sure that the air conduit connecting the blood pressure cuff and the monitor is neither blocked nor tangled Plug in the air hose and switch on the system 2 Apply the blood pressure cuff to the
68. der complex monitoring environment basing on the variance of SpO2 value B DEFAULT 99 TECNO GAZ Multi Parameter Monitor MD User Manual Pick this item to access the SPO2 DEFAULT CONFIG dialog box in which the user may select whether the FACTORY DEFAULT CONFIG or the USER DEFAULT CONFIG is to be used After selecting any of the items and exiting the dialog box the system will pop up the dialog box asking for the user s confirmation 13 6 Alarm Description SpO Alarm Message Tables below describe the possible physiological alarms technical alarms occurring during SpO measurement Physiological alarm Message Cause Alarm Level iv SpO2 measuring value is above upper User selectable TOO HIGH alarm limit poc SpO2 measuring value is below lower User selectable TOO LOW alarm limit PR PR measuring value is above upper alarm User selectable TOO HIGH limit PR PR measuring value is below lower alarm User selectable TOO LOW limit Technical alarms Alarm Message Cause Leve Remedy SpO2 Sensor Make sure that the SPO2 may be disconnected LOW monitor and the patient SENSOR OFF from the patient or are in correct connection the monitor with the cables 13 7 Maintenance and Cleaning Care and Cleaning 100 TECNO GAZ Multi Parameter Monitor MD User Manual WARNING A Before cleaning the monitor or the sensor make sure that the equipment i
69. e NIBP SETUP menu and pick the CONTINUAL item to start a continuous measurement The continuous measurement will last 5 minutes 7 To stop continuous measuring During continuous measuring press START button on the front panel at any time to stop continuous measurement NOTE If you are in doubt about the accuracy of any reading s check the patient s vital signs by an alternative method before checking the functioning of the monitor A WARNING A If liquid is inadvertently splashed on the equipment or its accessories or may enter the conduit or inside the monitor contact local Customer Service Center Measurement Limitations To different patient conditions the oscillometric measurement has certain limitations The measurement is in search of regular arterial pressure pulse In those circumstances when the patient s condition makes it difficult to detect the measurement becomes unreliable and measuring time increases The user should be aware that the following conditions could interfere with the measurement making the measurement unreliable or longer to derive In some cases the patient s condition will make a measurement impossible Patient Movement Measurements will be unreliable or may not be possible if the patient is moving shivering or having convulsions These motions may interfere with the detection of the arterial pressure pulses In addition the measurement time will be prolonged Cardiac Arrhythmia
70. e and value will display on above and below respectively n Pick EXIT to return to trend graph display 8 2 Trend Table n The latest 96 trend table data can be displayed at every 1 5 10 30 or 60 minutes Pick TREND TABLE in the SYSTEM MENU to call up the following menu TIME EUENT 06311 06311 06311 06311 06311 06310 06310 06310 06310 06310 06310 06310 RESOLUTION 1MIN UP DOUN L RIGHT 0200000000000o EXIT Figure 8 2 Trend Table Time in response to each group of trend data is displayed at the leftmost list with date in bracket Marked event corresponds to marking time Trend data of each parameter is divided into 7 groups HR PVC STI ST2 RR 47 TECNO GAZ Multi Parameter Monitor MD User Manual T1 T2 TD SPO2 PR NIBP NS NM ND IBP1 IBP2 To choose trend table of different resolution Pick the RESOLUTION item and turn the knob to change its content so as to change the time interval of trend data To view other trend data When 4 appears on the upper part of the screen pick UP DOWN button and turn the knob counterclockwise to view later trend data When 4 appears on the lower part of the screen pick the same item and turn the knob clockwise to view earlier trend data To obtain trend data of different parameter Pick L RIGHT to select one from the 8 groups of parameters A 9 by the rightmost item indicates following page available And by the lef
71. ead Set Recommended ECG Lead Placement for Surgical Patients WARNING When using Electrosurgery ES equipment leads should be placed in a position in equal distance from Electrosurgery electrotome and the ES grounding plate to avoid cautery Electrosurgery equipment wire and ECG cable must not be tangled up Monitoring ECG leads are mainly used for monitoring the patient s vital signs When J1 TECNO GAZ Multi Parameter Monitor MD User Manual using the patient monitor with other Electrosurgery equipments we advice to use the counteracting defibrillation ECG lead The placement of the ECG leads will depend on the type of surgery that is being performed For example with open chest surgery the electrodes may be placed laterally on the chest or on the back In the operating room artifacts may affect the ECG waveform due to the use of ES Electrosurgery equipment To help reduce this you can place the electrodes on the right and left shoulders the right and left sides near the abdomen and the chest lead on the left side at mid chest Avoid placing the electrodes on the upper arms otherwise the ECG waveform will be too small WARNING When using the patient monitor with the defibrillator or other high frequency equipments please use counteracting defibrillation ECG lead to avoid cautery A WARNING When using Electrosurgery ES equipment do not place an electrode near the grounding plate of the Electrosurger
72. ed on patients who are very active as this can cause false alarms Checklist for RESP Monitoring 1 Prepare the patient s skin prior to placing the electrodes 2 Attach snap or clip to the electrodes and attach the electrodes to the patient as described below 3 Switch on the monitor 90 TECNO GAZ Multi Parameter Monitor MD User Manual 12 9 3 Installing Electrode for RESP Measurement Placing the Electrodes for Respiratory Monitoring Red Figure 12 18 Electrodes Placement 5 lead NOTE Place the red and green electrodes diagonally to optimize the respiration waveform Avoid the liver area and the ventricles of the heart in the line between the RESP electrodes so as to avoid cardiac overlay or artifacts from pulsating blood flow This is particularly important for neonates 12 9 4 RESP Menu RESP SETUP Menu Pick RESP hot key on the screen to call up the following menu RESP SETUP ALM LEV MED WAVE AMP AUTO ALM REC OFF DEFAULT gt gt ALM HI 30 ALM LO 8 APNEA ALM 205 Figure 12 19 RESP Setup 91 TECNO GAZ Multi Parameter Monitor MD User Manual RESP alarm setting ALM pick ON to enable prompt message during the RESP alarm pick OFF to disable the alarm function and there will bea 3 beside RESP WARNING In order to avoid endangering the patient s life the user should use this function cautiously ALM LEV selectable from HIGH MED and LOW Level HIGH represents the most
73. elow E Diluted Ammonia Water E Diluted Sodium Hyoichlo Bleaching agent NOTE The diluted sodium hyoichlo from 500ppm 1 100 diluted bleaching agent to 5000ppm 1 10 bleaching agents is very effective The concentration of the diluted sodium hyocihlo depends on how many organisms blood mucus on the surface of the chassis to be cleaned MW Diluted Formaldehyde 35 37 M Hydrogen Peroxide 3 E Alcohol B Isopropanol NOTE Multi parameter Patient Monitor and sensor surface can be cleaned with hospital grade ethanol and dried in air or with crisp and clean cloth 64 TECNO GAZ Multi Parameter Monitor MD User Manual NOTE This company has no responsibility for the effectiveness of controlling infectious disease using these chemical agents Please contact infectious disease experts in your hospital for details 11 4 Sterilization To avoid extended damage to the equipment sterilization is only recommended when stipulated as necessary in the Hospital Maintenance Schedule Sterilization facilities should be cleaned first Recommended sterilization material Ethylate and Acetaldehyde Appropriate sterilization materials for ECG lead blood pressure cuff are introduced in relative chapters respectively WARNING Please sterilize and disinfect timely to prevent the cross infection between patients CAUTION n Follow the manufacturer s instruction to dilute the solution or adopt the lowest pos
74. ent The unit displaying this symbol contains an F Type isolated floating patient applied part providing a high degree of protection against shock and is suitable for use during defibrillation Environment Follow the instructions below to ensure a completely safe electrical installation The environment where the Multi parameter Patient Monitor will be used should be reasonably free from vibration dust corrosive or explosive gases extremes of temperature humidity and so on For a cabinet mounted installation allow sufficient room at the front for operation and sufficient room at the rear for servicing with the cabinet access door open The Multi parameter Patient Monitor operates within specifications at ambient temperatures between 5 C and 40 C Ambient temperatures that exceed these limits could affect the accuracy of the instrument and cause damage to the modules and circuits Allow at least 2 inches Scms clearance around the instrument for proper air circulation Power Source Requirements Refer to APPENDIX 1 Grounding the Multi parameter Patient Monitor To protect the patient and hospital personnel the cabinet of the Multi parameter Patient Monitor must be grounded Accordingly the Multi parameter Patient Monitor is equipped with a detachable 3 wire cable which grounds the instrument to the power 56 TECNO GAZ Multi Parameter Monitor MD User Manual line ground protective earth when plugged into an
75. enu 3 A check mark y appears at the position indicating that the item is confirmed 4 The system immediately executes a certain function 1 4 Interfaces For the convenience of operator interfaces of different function are in different sites of the monitor Right Side of the Monitor Figure 1 4 Right Panel Left Side of the Monitor Connectors for cables and sensors are as shown in Figure 1 5 TEMPI probe connector TEMP2 probe connector IBP2 transducer connector IBP1 transducer connector G9 amp amp O0 ECG cable connector Eris TECNO GAZ Multi Parameter Monitor MD User Manual 9 NIBP cuff connector SpO2 sensor connector os ie e E Figurel 5 Left Panel 00 o 90 o o o9 g g N This symbol means BE CAREFUL Refer to the manual KA Indicates that the instrument is IEC60601 1 Type CF equipment The unit displ aying this symbol contains an F Type isolated floating patient applied part providing a high degree of protection against shock and is suitable for use during defibrillation Rear Panel Figure 1 6 Rear Panel Sockets on the rear panel are shown in Figure 1 6 Rm TECNO GAZ Multi Parameter Monitor MD User Manual Network Interface Standard RJ45 Socket reserved Q Equipotential grounding terminal for connection with the h
76. er Monitor MD User Manual ALARM RECALL CONDITION ALARM RECALL TIME START 2006 1 END C CURRENT TIME E SELF DEF INE ALARM RECALL EVENT ALL ALARM RECALL gt gt Figure 8 4 ALARM RECALL CONDITION In this menu the user may select the conditions for alarm review including 1 Start and End time of review The user may select the start time of review in the item of START Then the user may select the end time of review Two selections are available current time and the user defined time For user defined end time the user can use the knob to select ALARM RECALL EVENT In the pull down list of ALARM RECALL EVENT the user can select the parameter whose alarm events he wants to review The selections include ALL alarm events of all parameters ECG REST SPO2 NIBP IBP TEMP HR_H gt 180 the value of HR is higher than the upper alarm limit HR_L lt 60 the value of HR is below the lower alarm limit SPO2 lt 90 IBP H 200mmHg IBP_L lt 40mmHg RR_H gt 40 RR_L lt 10 TEMP_H gt 40 C TEMP_L lt 34 C After setting up all the review conditions press the ALARM RECALL button to access ALARM RECALL window ALARM RECALL The ALARM RECALL window is as shown below in which following data are displayed Time span Format month day year hour minute month day year hour minu te Event type Serial number Format NO xx of XX The value at the time of alarm NIBP result is with time 066
77. forms become invisible Main display is restored when you exit the menu The user may set up the rate to refresh the waveform The method to adjust the refreshing rate of each waveform is discussed in the setup description of each parameter Parameter Area Parameter area is on the right of Waveform area and parameters are displayed corresponding to waveforms basically They are ECG Heart Rate Unit bpm ST segment analysis of Channel 1 amp 2 ST1 ST2 Unit mV PVCs Premature Ventricular Contraction events Unit times minute Oxygen Saturation SpO2 SpO2 Unit 96 NIBP From left to right Systolic pressure Mean pressure Diastolic pressure Unit mmHg or kPa TEMP Temperature of channell and channel2 and their temperature difference T1 T2 TD Unit C or F RESP Respiration Rate Unit breath minute IBP The blood pressure of channel 1 and 2 From left to right there are Systolic pressure Mean pressure and Diastolic pressure unit mmHg or kPa TECNO GAZ Multi Parameter Monitor MD User Manual Alarm Indicator and Alarm Status Under normal status the alarm indicator won t light When alarming the alarm indicator lights or flashes The color of light represents the alarm level Refer to Alarm Functions for detail Refer to relative content of parameter for Alarm information and prompt Charge Indicator and Charge Status take for monitor with 10 4
78. ft panel Other sockets and power plug in are on the rear panel The recorder is on the right panel Multi parameter patient monitor is a user friendly device with operations conducted by a few buttons and rotary knob on the front panel Figure 1 16 6 Refer to Button Functions sob db 80 21 speed ps So MAMMA o CTOS B CE a O Figure 1 1A Multi parameter Monitor with 10 4 Screen Multi parameter patient monitor can monitor TECNO GAZ Multi Parameter Monitor MD User Manual ECG Heart Rate HR 2 channel ECG waveform Arrhythmia and ST segment analysis optional RESP Respiration Rate RR Respiration Waveform SpO2 Oxygen Saturation SpO2 Pulse Rate PR SpO2 Plethysmogram NIBP Systolic Pressure NS Diastolic Pressure ND Mean Pressure NM TEMP Channel 1 Temperature T1 Channel 2 Temperature T2 Temperature Difference between two channels TD IBP Channel 1 SYS DIA MAP Channel 2 SYS DIA MAP Dual IBP waveforms The patient monitor provides extensive functions as visual amp audible alarm storage for trend data NIBP measurements alarm events and drug dose calculation 1 2 Screen Display Multi parameter patient monitor is equipped with a high resolution multicolor TFT LCD screen The patient parameters waveforms alarm messages bed number time monitor status and other data can be reflected from the screen The screen is divided into three areas 1 Information Area 2 W
79. hands Make certain that your hands are clean and dry before touching a power cord WARNING Accessory equipment connected to the analog and digital interfaces must be certified according to the respective IEC standards e g IEC 950 for data processing equipment and IEC 60601 1 for medical equipment Furthermore all configurations shall comply with the valid version of the system standard IEC 60601 1 1 Everybody who connects additional equipment to the signal input connector or signal output connector configures a medical system and is therefore responsible that the system complies with the requirements of the valid version of the system standard IEC 60601 1 1 If in doubt consult our technical service department or your local distributor WARNING Before using the rechargeable lithium ion battery hereinafter called battery be sure to read the user manual and safety precautions thoroughly WARNING Do not place battery in the monitor with the and in the wrong way around 58 TECNO GAZ Multi Parameter Monitor MD User Manual WARNING A Don t connect the positive and negative terminals with metal objects and don t put the battery together with metal object which can result in short circuit WARNING A Do not unplug the battery when monitoring WARNING Do not heat or throw battery into a fire WARNING Do not use leave battery close to fire or other places where tempera
80. hat do not use equipment generating electrical radiation near ECG RESP monitoring devices NOTE The simultaneous use of cardiac pacemaker or other patient connected equipments does not cause safety hazard 12 3 Monitoring Procedure 12 3 1 Preparation 1 Prepare the patient s skin prior to placing the electrodes MW The skin is a poor conductor of electricity therefore preparation of the patient s skin is important to facilitate good electrode contact to skin B Shave hair from sites if necessary B Wash sites thoroughly with soap and water Never use ether or pure alcohol because this increases skin impedance ME Rub the skin briskly to increase capillary blood flow in the tissues and remove skin scurf and grease 2 Attach clip or snap to electrodes prior to placement 3 Put the electrodes on the patient Before attaching apply some conductive jelly on the electrodes if the electrodes are not electrolyte self supplied 4 Connect the electrode lead to the patient s cable 5 Make sure the monitor is ready with power supply WARNING Placed the electrode carefully and make sure contact good WARNING Check everyday whether there is skin irritation resulted from the ECG electrodes If so replace electrodes every 24 hours or change their sites A WARNING Check if the lead connection is correct before monitoring Unplug the ECG cable 68 TECNO GAZ Multi Parameter Monitor MD User Manual from the socket
81. he Hot Key for ECG D Leads of channel 1 1 The selectable leads are I II III aVR aVL aVF V 2 When the ECG is 5 lead the selectable leads are I II III aVR aVL aVF V when ECG is 3 lead the selectable leads are I II III 3 Leads on the ECG wave must not have the same name Otherwise the system will automatically change the ECG waveform name that has the same name as the waveform being currently adjusted to another name 2 Waveform gain of channel 1 used to adjust the size of ECG waveforms Select gain value for each channel from x0 25 x0 5 x1 x2 and auto Under auto mode the monitor chooses an appropriate level automatically A 1 mv scale displays on each ECG channel s right side The height of 1mV bar is directly proportional to the waveform amplitude NOTE When the input signals are too large the peak of the waveform may be not able to be displayed In this case the user may manually change the setup method of ECG waveform according to the actual waveform so as to avoid the occurrence of the unfavorable phenomena 3 Filter method used for displaying clearer and more detailed waveform 74 TECNO GAZ Multi Parameter Monitor MD User Manual There are three filter modes for selection DIAGNOSTIC MONITOR and SURGE RY modes may reduce perturbance and interference from Electrosurgery equipment The filter method is the item applicable for both channels which is always displayed at the waveform place of t
82. he channel 1 ECG waveform NOTE Only in Diagnosis mode the system can provide non processed real signals In Monitor or Sugery mode ECG waveforms may have distortion of different extent In either of the latter two modes the system can only show the basic ECG and the results of ST analysis may also be greatly affected In Surgery mode results of ARR analysis may be somewhat affected Therefore it is suggested that in the environment having relative small interference you d better monitor a patient in Diagnosis mode Leads of channel 2 refer to D for detailed information Waveform gain of channel 2 refer to for detailed information NOTE Pacemaking signal detected is marked by a above the ECG waveform 12 5 ECG Menu Pick the ECG hot key on the screen and the following menu will popup ECG SETUP HR ALM HR CHANNEL CH1 ALM LEV MED LEAD TYPE 5 LEADS ALM REC OFF SWEEP 25 0 ALM HI 120 ST ANALYSIS gt gt ALM LO ARR ANALYSIS gt gt HR FROM OTHER SETUP gt gt Figure 12 7 ECG Setup B ECG Alarm Setting e HR ALM pick ON to enable prompt message and data record during the ECG 75 TECNO GAZ Multi Parameter Monitor MD User Manual alarm pick OFF to disable the alarm function and there will be a 3 amp beside ECG WARNING In order to avoid endangering the patient s life the user should use this function cautiously ALM LEV selectable from HIGH MED LOW Level HIGH rep
83. he max Lower limit must be 0 2 lower than the set higher limit ST analysis alarm limits for default ST HI ST LO Step ST 0 2 mv 0 2 mv 0 1 mv The adjusting range of ST analysis alarm limits Max ST HI Min ST LO Step ST 2 0 mv 2 0 mv 0 1 mv B DEF POINT pick this item to access the DEF POINT window in which the position of ISO and ST point can be set up amp ISO amp ST Base point Default is 80 ms Measurement point Default is 108 ms DEF POINT IS0 Figure 12 12 80 ms ST 108 ms DEF POINT Window The operator can adjust the position of both ISO and ST measurement points Set the reference point of ST measurement point to be peak point of R wave see Figure 12 13 82 TECNO GAZ Multi Parameter Monitor MD User Manual R Wave ST Value Figure 12 13 DEF POINT The ST measurement for each beat complex is the vertical difference between the two measurement points NOTE The ST measurement point should be adjusted if the patient s HR or ECG morphology changes significantly Adjusting ISO ST These two points can be adjusted turning the knob When adjusting ST measurement point the system will show the ST Measurement Point Window The system displays the QRS complex template in the window It is adjustable of the highlight bar in the window You may select ISO or ST then switch the knob left or right to move the cu
84. he possible physiological alarms occurring during pvcs measurement Physiological alarms Message Cause Alarm Level 85 TECNO GAZ Multi Parameter Monitor MD User Manual PVCs TOO HIGH PVCs measuring value is above upper alarm limit User selectable M ARR RELEARN BE ARR ALARM ASYST UFIB R ON UT 2 COUPL PUC BIGEM TRIGE TACHY BRADY MISSE You can pick ALL ALM ON to enable alarm function of all arrhythmia types and pick ALL ALM OFF to disable this function Likewise you can pick ALL REC ON to enable recording function for all arrhythmia types and pick ALL REC OFF to disable this function Changing the ALM LEV can reset alarm level of all arrhythmia types to the same value B ARR RECALL Pick this item to start a learning procedure Pick this item to access the ARR ALARM dialog box to set arrhythmia alarm parameters ARR ALARM OLE UTAC ALL ALM ON T ALL ALM OFF ET ALL REC ON INY MINY ALL REC OFF ALM LEV D BEATS ON MED Figure 12 15 ARR Alarm Menu Pick this item to review and edit the ARR analysis result The latest arrhythmia events up to 60 are displayed 86 TECNO GAZ Multi Parameter Monitor MD User Manual ARR RECALL BRADY 01 12 2006 16319 BRADY BRADY BRADY BRADY BRADY BRADY BRADY BRADY BRADY UP DOUN UP DOWN CURSOR DELETE RENAME WAVE a X A A UP DOWN L_RIGHT REC EXIT 01 12 20
85. hythmia algorithm can also monitor patients and give proper alarm for arrhythmia MW The arrhythmia monitoring is shutoff by default You can enable it when necessary M This function can call up the doctor s attention to the patient s heart rate by measuring and classifying the arrhythmia and abnormal heart beat and triggering the alarm MW The monitor can conduct up to 11 different arrhythmia analyses Pick the item ARR ANALYSIS in ECG SETUP menu to access the ARR ANALYSIS sub menu AX WARNING This device is not intended for treatment 84 TECNO GAZ Multi Parameter Monitor MD User Manual ARR ANALYSIS Menu ARR ANALYSIS PVCs ALM ON ARR RELEARN ALM LEV MED ARR ALARM gt gt ALM REC OFF ARR RECALL gt gt Figure 12 14 ARR Analysis B ARR ANAL Pick ON during monitoring Default set is OFF B PVCs ALM Pick ON to enable prompt message when alarm occurs pick OFF to disable the alarm function and there will bea zx amp beside PVCs WARNING In order to avoid endangering the patient s life the user should use this function cautiously B ALM LEV Selectable from HIGH MED LOW Level HIGH represents the most serious case B ALM REC pick ON to enable report printing upon PVCs alarm B PVCs alarm is activated when the PVCs exceeds set PVCs ALM HI value PVCs alarm upper limits Max Min Step PVCs 10 il 1 PVCs Alarm and Prompt Message Tables below describe t
86. i Parameter Monitor MD User Manual machine washing close the Velcro fastening Allow the cuff to dry thoroughly after washing then reinsert the rubber bag ur i o Oe esetre m9 ee SS Orel IZIS Linav 9V8 NOLIV I3NI X3 LV1 AddNd MOT Cuervo A 19 9MOUBUInNeg G e s SD A A FEA pp Y 7 C A r j de ra e a gu T m A 7 j i gt J i E Kum j i H b Ma f M Figure 14 5 Replace Rubber Bag in Cuff To replace the rubber bag in the cuff first place the bag on top of the cuff so that the rubber tubes line up with the large opening on the long side of the cuff Now roll the bag lengthwise and insert it into the opening on the long side of the cuff Hold the tubes and the cuff and shake the complete cuff until the bag is in position Thread the rubber tubes from inside the cuff and out through the small hole under the internal flap Disposable Blood Pressure Cuffs Disposable cuffs are intended for one patient use only Do not use the same cuff on any other patient Do not sterilize or use autoclave on disposable cuffs Disposable cuffs can be cleaned using soap solution to prevent infection NOTE For protecting environment the disposable blood pressure cuffs must be 114 TECNO GAZ Multi Parameter Monitor MD User Manual recycled or disposed of properly 115 TECNO GAZ Multi Parameter Monitor MD User Manual 15 TEMP Monitoring 15 1 TEMP Monitoring Two TEMP p
87. is not attached to the patient CH1 SENSOR OFF FAIL Make sure that transducer is not off then proceed zeroing IN DEMO FAIL Make sure that the monitor is not in DEMO mode Contact service technician if necessary PRESSURE OVER RANGE FAIL Make sure that the stopcock is vented to atmosphere If the problem persists contact service technician IBP Calibration Press the IBP PRESSURE CALIBRATE button on the IBP 1 2 SELECT menu to call up the IBP PRESSURE CALIBRATE menu as shown below IBP PRESSURE CALIBRATE CH1 CAL VALUE CALIBRATE 0 0 00 00 0000 00 00 00 CH2 CAL VALUE 26 7 CALIBRATE 0 0 3 00 00 0000 00 00 00 Figure 16 6 IBP Calibration Menu 127 TECNO GAZ Multi Parameter Monitor MD User Manual Calibrate the transducer Turn the knob to select the item CH1 CAL VALUE press and turn the knob to select the pressure value to be calibrated for channel 1 Then turn the knob to select the item CALIBRATE to start calibrating channel 1 Turn the knob to select the item CH2 CAL VALUE press and turn the knob to select the pressure value to be calibrated for channel 2 Then turn the knob to select the item CALIBRATE to start calibrating channel 2 n The pressure calibration of the portable patient monitor L M E Pressure j S T ansducer is APTA UE la JEN A 3 Way ed a g
88. itch ALM HI higher limit of HR alarm ALM LO lower limit of HR alarm You can move the cursor onto the item to be setup by using the knob and press the knob to make the setup The method for setting the alarm information of other parameters is the same as HR 5 2 Alarm Cause Alarm occurs when 1 Physiological alarm is evoked 2 Alarm for error of the system technical alarm is evoked 3 General alert occurs 34 TECNO GAZ Multi Parameter Monitor MD User Manual n A Conditions that activate the parameter alarms When the measurement value exceeds the alarm limit and the alarm is set ON Alarm will not activate if the alarm is set OFF n B Conditions that activate the system alarms technical alarm Upon the system error the monitor prompts alarm immediately n C General alert In some circumstances alerts will behave as physiological alarm but in normal sense we don t regard them as real patient health related items 5 3 SILENCE n SILENCE Press the SILENCE button on the control panel for more than 1 second the system will shut off all sounds The rest seconds for alarm silence is displayed in the Physiological Alarm area And the symbol 3 is displayed on the left side the Physiological Alarm area The user may set up the time for Alarm Silence in the ALARM SETUP menu Three selections are available 1min 2min and 3min NOTE Whether an alarm will be reset depends on the status
89. ket and check that the monitor is switched on 2 Prepare the pressure line and transducer by flushing through the system with normal saline solution Ensure that the system is free of air bubbles 3 Connect the patient catheter to the pressure line making sure that there is no air present in the catheter or pressure line WARNING A If there are air bubbles in the pressure line or the transducer you should flush the system with the solution to be infused 4 Position the transducer so that it is at the same level with the patient s heart approximately mid axillary line 5 Check if you have selected the correct label name See the next section for details 6 Zero the transducer See the next section for details 122 TECNO GAZ Multi Parameter Monitor MD User Manual ormal Saline B Pressure Transducer 3 Way E Stopcok N Pressure A Transducer Interface Cable Vemm I A le 60 zz E tie 73 i poe i 14 99 2 id ee ana 37 1 0 1 Eus Monitor CD Distal End To Patient Figure 16 1 IBP Monitoring 16 4 IBP Menu Pick the IBP hot key on the screen to access the IBP SELECT menu shown as following IBP 1 2 SELECT IBP SETUP IBP PRESSURE ZERO IBP PRESSURE CALIBRATE Figure 16 2 IBP SELECT Menu Pick the
90. larms messages occurring during resp measurement Physiological alarms Message Cause Alarm Level RR TOO RESP measuring value is above upper alarm HIGH limit User selectable RESP measuring value is below lower alarm RR TOO TM limit User selectable LOW RESP RESP can not be measured within specific HIGH APNEA time interval 12 10 Maintenance and Cleaning Care and Cleaning WARNING Before cleaning the monitor or the sensor make sure that the equipment is switched off and disconnected from the power line If there is any sign that the ECG cable may be damaged or deteriorated replace it with a new one instead of continuing its application on the patient E Cleaning Use fine hair cloth moistened in mild soap liquid or cleaning agent containing 70 ethanol to clean the equipment E Sterilization To avoid extended damage to the equipment sterilization is only recommended when stipulated as necessary in the Hospital Maintenance Schedule Sterilization facilities should be cleaned first Recommended sterilization material Ethylate 70 alcohol 70 isopropanol Acetaldehyde 93 TECNO GAZ Multi Parameter Monitor MD User Manual MW Disinfection To avoid extended damage to the equipment disinfection is only recommended when stipulated as necessary in the Hospital Maintenance Schedule Disinfection facilities should be cleaned first 94 TECNO GAZ Multi Parameter Monit
91. le Technical alarms display in the area below the NIBP value Alarm Remedy Message Cause Level Cuff is no properly LOOSE CUFF wrapped or no cuff LOW Properly wrap the cuff exists Check and replace the leaking AIR LEAK CUM hose or connector LOW pants iS teguited notify is damaged biomedical engineer Or manufacturer s service staff Cuff is too loose or WEAK f Use other method to measure patient pulse is to LOW SIGNAL blood pressure weak After by arm motion E S Make sure that the patient EXCESSIVE signal noise is too large E LOW under monitoring is MOTION or pulse rate is not motionless regular Measure again if failure OVER Pressure has exceeded persists stop using measuring the specified upper LOW function of NIBP module and PRESSURE ME i y y safety limit notify biomedical engineer or manufacturer s service staff ML E i ti LOW Stop th tient f i SATURATED xcessive motion op the patient from moving Check and replace the leaking PNEUMATIC During pneumatic test LOW parts if required notify LEAK leak is detected biomedical engineer Or manufacturer s service staff 112 TECNO GAZ Multi Parameter Monitor MD User Manual Cuff type does not CUFF TYPE f ERR comply with the patient LOW Select appropriate cuff type type Measuring time has NIBP TIME exceeded 120 seconds LOW Measure again or u
92. lic pressure diastolic pressure and mean pressure respectively for channel 1 and channel 2 SCALE ADJUST used to access the sub menu of IBP SCALE ADJUST in which the user may adjust the position of the high reference and low scales for the two waveforms displayed on the screen 124 TECNO GAZ Multi Parameter Monitor MD User Manual B DEFAULT pick this item to access the IBP DEFAULT CONFIG dialog box in which the user may select whether the FACTORY DEFAULT CONFIG or the USER DEFAULT CONFIG is to be used After selecting any of the items and exiting the dialog box the system will pop up the dialog box asking for the user s confirmation m EXIT used to exit the menu and return to the main interface A WARNING Before set the alarm limits confirm to choose the correct label IBP ALM LIMIT SETUP CH1 ART ALM HI CH1 ART ALM LO CH2 CUP ALM HI CH2 CUP ALM LO Figure 16 4 IBP ALM LIMIT SETUP The alarm occurs when the value exceeds the set limits IBP alarm limits for default P1 SYS 90 160 mmHg DIA 50 90 mmHg MAP 70 110 mmHg P2 SYS 90 160 mmHg DIA 50 90 mmHg MAP 70 110 mmHg ART SYS 90 160 mmHg DIA 50 90 mmHg MAP 70 110 mmHg PA SYS 10 35 mmHg 125 TECNO GAZ Multi Parameter Monitor MD User Manual DIA 0 16 mmHg MAP 0 20 mmHg CVP RAP LAP ICP MAP 0 10 mmHg The adjusting range of NIBP alarm limits Max Alarm High Min Alarm Low Step Pressure Label mmHg mmHg ART 300 L
93. lower User selectable Technical alarms take American Standard for example Message Cause Alarm level Remedy ECG LEAD OFF More than one ECG electrodes fall off the skin or ECG cables fall off the monitor ECG LL LEAD OFF ECG electrodes LL fall off the skin or ECG cables fall off the monitor ECG LA LEAD OFF ECG electrodes LA fall off the skin or ECG cables fall off the monitor ECG RA LEAD OFF ECG electrodes RA fall off the skin or ECG cables fall off the monitor ECG V LEAD OFF ECG electrodes V fall off the skin or ECG cables fall off the monitor ECG NOISE ECG measuring signal is greatly interfered LOW Make sure that all electrodes leads and patient cables are properly connected 12 7 ST Segment Monitoring Optional ST Segment Monitoring Optional MW ST segment monitoring function is shutoff by default You can switch it to ON when necessary NOTE When setting ST ANALYSIS on the monitor will select DIAGNOSTIC mode You can set it to MONITOR mode or OPERATE mode as required However at this time ST value has been severely distorted 80 TECNO GAZ Multi Parameter Monitor MD User Manual M It is available to measure the variance of ST segment with ST analysis at the waveform tracks for selected lead The corresponding ST measurement result displays numerically at STI and ST2 in the Parameter
94. may select whether the FACTORY DEFAULT CONFIG or the USER DEFAULT CONFIG is to be used After selecting any of the items and exiting the dialog box the system will pop up the dialog box asking for the user s confirmation 15 3 TEMP Alarm Message Tables below describe the possible physiological alarms technical alarms occurring during TEMP measurement Physiological alarms Message Cause Alarm Level M i l f TI ch li T1 TOO HIGH DRM ne x TET User selectable above upper alarm limit Measuring value of T1 channel is TI TOO LOW dc ad User selectable below lower alarm limit Measuring value of T2 channel is T2 TOO HIGH ee User selectable above upper alarm limit Measuring value of T2 channel is T2 TOO LOW dM User selectable below lower alarm limit Temperature difference of T1 and TD TOO HIGH T2 is above upper temperature User selectable difference limit Technical alarms Alarm Alarm Message Cause Remedy Level Temperature cable of TEMEI STOPOR TEMP channel mte Dose laec a a OFF disconnected from the property connected monitor 118 TECNO GAZ Multi Parameter Monitor MD User Manual Temperature cable of TEMP2 SENSOR TEMP channe2 may be OFF disconnected from the monitor Make sure that LOW the cable is properly connected 15 4 Care and Cleaning WARNING Before cleaning the monitor or the probe make sure that
95. meters You can also modify the alarm level using the method described in this chapter Alarm level of the System Error Message technical alarm is pre set in the system All technical alarm level and general alarm level some of the physiological alarm level are pre set in the system and can not be changed by user 31 TECNO GAZ Multi Parameter Monitor MD User Manual 5 1 2 Alarm Modes When alarm occurs Multi parameter patient monitor may raise the user s attention in at least three ways which are audio prompt visual prompt and description Audio and visual prompt is given by TFT display device the speaker on the display device and the alarm indicator Description is displayed on the screen Physiological alarm is displayed in the Physiological Alarm area Most of technical alarms are displayed in the Technical Alarm area Technical alarms related to NIBP measurement are displayed in the NIBP Technical Alarm area at the bottom of NIBP parameter area NOTE The Physiological Alarm area is on the upper right part of the screen The Technical Alarm area is to the left side of the Physiological Alarm area NOTE If Multi parameter patient monitor is connected to the external alarm prompt system e g the alarm speaker and indicator connected onto the rear panel of the monitor when alarm occurs the external alarm prompt system responds in the same way as the the monitor NOTE The concrete presentation of each alarm prompt is rel
96. n this item cannot be picked But under ECG Full Lead display mode this item can be picked although no RESP waveform is currently displayed on the screen IBP1 IBP2 IBP1 waveform and IBP2 waveform If no IBP waveform is currently displayed on the screen this item cannot be picked But under ECG Full Lead display mode this item can be picked although no IBP waveform is currently displayed on the screen OFF No display for this waveform RT REC TIME represents real time recording time for which two selections are button available CONTINUAL and 8S CONTINUAL means once pressing on the front panel the recorder will continuously print out the waveform or parameter until button is pressed again 21 TECNO GAZ Multi Parameter Monitor MD User Manual TIMING REC TIME represents time interval between two times of timing recording 10 selections are available OFF 10MIN 20MIN 30MIN 40MIN 50MIN 1HOUR 2HOURS 3HOURS and 4HOURS It means that the system will trigger the recording operation according to the selected time interval The recording time is fixed at 8 seconds NOTE REC TIME has the priority compared with TIMING REC TIME REC RATE 25 0 mm s or 50 0 mm s CLEAR REC TASK can be used by the user to stop recorder from printing out too many tasks NOTE The recorder is an optional part NOTE If two same waveforms are selected one of them
97. n distance according to frequency of transmitter m Rated maximum output power of transmitter 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2 5 GHz W d Er d Er d B V 1 E 0 01 0 1167 0 1167 0 2334 0 1 0 3689 0 3689 0 7378 1 1 1667 1 1667 2 3334 10 3 6893 3 6893 7 3786 100 11 6667 11 6667 23 3334 For transmitters rated at a maximum output power not listed above the recommended separation distance d in metres m frequency of the transmitter transmitter in watts W according to the transmitter manufacturer can be estimated using the equation applicable to the where P is the maximum output power rating of the NOTE 1At 80 MHz and 800 MHz the separation distance for the higher frequency range applies NOTE 2These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people 149 lt 7 TECNO GAZ dental and medical equipment TECNO GAZ S p A Strada Cavalli 4 e 43038 e Sala Baganza e Parma e ITALIA Tel 39 0521 83 39 26 r a Fax 39 0521 83 33 91 www tecnogaz com This manual must always be kept with the product in complying with the Directives of European Community TECNO GAZ reserves the right to modify the enclosed document without notice TECNO GAZ reserves the property of the document and forbids others to use it or spread it without its approval
98. nd accessories before use WARNING Be sure that all electrodes have been connected to the patient correctly before operation WARNING A When connecting the cables and electrodes make sure no conductive part is in contact with the ground Verify that all ECG electrodes including neutral electrodes are securely attached to the patient WARNING A Do not touch the patient bed or instrument during defibrillation WARNING A Please set the alarm according to the individual status of patient to avoid delaying treatment Ensure there will be alarm audio prompt when alarming A WARNING Devices connecting with monitor should be equipotential WARNING A When the monitor and electrosurgical device are used together the user physician or nurse should guarantee the safety of patient N WARNING A Please sterilize and disinfect timely to prevent the cross infection between patients 60 TECNO GAZ Multi Parameter Monitor MD User Manual CAUTION Y Electromagnetic Interference Ensure that the environment in which the patient monitor is installed is not subject to any sources of strong electromagnetic interference such as radio transmitters mobile telephones etc CAUTION The device is designed for continuous and is ordinary i e not drip or splash proof CAUTION Keep the environment clean Avoid vibration Keep it far from corrosive medicine dust area high temper
99. ndor WARNING Prolonged and continuous monitoring may increase jeopardy of unexpected change of dermal condition such as abnormal sensitivity rubescence vesicle repressive putrescence and so on It is especially important to check the sensor 96 TECNO GAZ Multi Parameter Monitor MD User Manual Manual placement of neonate and patient of poor perfusion or immature dermogram by light collimation and proper attaching strictly according to changes of the skin More frequent examinations may be required for different patients A WARNING When using the reusable SpOs sensor change the examine position not more than 4 hours every time neonate SpO2 sensor can only be used when it requires to no more than 20 min at a time 13 3 Monitoring Procedure SpO plethysmogram measurement 1 Switch on the monitor 2 Attach the sensor to the appropriate site of the patient finger 3 Plug the connector of the sensor extension cable into the SpO socket on the SpO2 module Figure 13 1 Mounting of the Sensor 13 4 Limitations for Measurement Measurement Limitations In operation the accuracy of oximetry readings can be affected by High frequency electrical noise including noise created by the host system or noise from external sources such as electrosurgical apparatus which is admitted by the host system Do not use oximeters and oximetry sensors during magnetic resonance imaging MRI scanning Induced current
100. ning agents such as those listed below Cetylcide Wavicide 01 Wescodyne Cidex Lysol Vesphene Do not immerse the connector in any liquid After cleaning dry the transducer thoroughly before storing Slight discoloration or temporary increase of surface stickiness of the cable should not be considered abnormal If adhesive tape residue must be removed from the transducer cable double seal tape remover is effective and will cause a minimum of damage to the cable if used sparingly Acetone Alcohol Ammonia and Chloroform or other strong solvents are not recommended because over time the vinyl cabling will be damaged by these agents NOTE The disposable transducers or domes must not be re sterilized or re used NOTE For protecting environment the disposable transducers or domes must be recycled or disposed of properly Sterilization m Liquid Chemical Sterilization Remove obvious contamination by using the cleaning procedure described previously Select a sterilant that your hospital or institution has found to be effective for liquid chemical sterilization of operating room equipment Buffered 132 TECNO GAZ Multi Parameter Monitor MD User Manual gluteraldehyed e g Cidex or Hospisept has been found to be effective Do not use quaternary cationic detergents such as zephiran chloride If the whole unit is to be sterilized immerse the transducer but not the electrical connector into the sterilant for the recommended ste
101. not be reused NOTE Use only the pressure transducer listed in the Chapter Accessories and Ordering information The specified transducer is designed to have the special ability to protect against the 121 TECNO GAZ Multi Parameter Monitor MD User Manual electricity shock especially for the leak current allowed and it is protected against the effects of a discharge of a cardiac defibrillator It can be used in the surgical operation When the patient is in the defibrillation the waveform of the pressure maybe distorted temporarily After the defibrillation the monitoring will go on normally the operation mode and the user configuration are not affected A WARNING Verify transducer cables fault detection before beginning of monitoring phase Unplug the transducer of the channel 1 from the socket the screen will display the error message IBP1 SENSOR OFF and the audible alarm is activated The other channel is the same NOTE Calibrate the instrument either whenever a new transducer is used or as frequently as dictated by your Hospital Procedures Policy WARNING A If any kind of liquid other than solution to be infused in pressure line or transducer is splashed on the equipment or its accessories or may enter the transducer or the monitor contact the Hospital Service Center immediately 16 3 Monitoring Procedure Preparatory steps for IBP measurement 1 Plug the pressure cable into corresponding soc
102. of the alarm cause 5 4 Parameter Alarm The setup for parameter alarms is in their menus In the menu for a specific parameter you can check and set the alarm limit alarm status The setup is isolated from each other When a parameter alarm is off a symbol x displays near the parameter If the alarms are turned off individually they must be turned on individually For the parameters whose alarm is set to ON the alarm will be triggered when at least one of them exceeds alarm limit The following actions take place 1 Alarm message displays on the screen as described in alarm mode 2 The monitor beeps in its corresponding alarm class and volume 35 TECNO GAZ Multi Parameter Monitor MD User Manual 3 Alarm lamp flashes 5 5 When an Alarm Occurs NOTE When an alarm occurs you should always check the patient s condition first The alarm message appears at the top of the screen on the right side It is needed to identify the alarm and act appropriately according to the cause of the alarm Check the patient s condition Identify the cause of the alarm Identify which parameter is alarming or which alarm is happening BR WN When cause of alarm has been over check that the alarm is working properly You will find the alarm messages for the individual parameter in their appropriate parameter chapters of this manual 36 TECNO GAZ Multi Parameter Monitor MD User Manual 6 Freeze n General n Freeze
103. om structures objects and people Field strengths from fixed transmitters such as base stations for radio cellular cordless telephones and land mobile radios amateur radio AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy To assess the electromagnetic environment due to fixed RF transmitters an electromagnetic site survey should be considered If the measured field strength in the location in which the MD Patient Monitor is used exceeds the applicable RF compliance level above the MD Patient Monitor should be observed to verify normal operation If abnormal performance is observed additional measures may be necessary such as reorienting or relocating the MD Patient Monitor Over the frequency range 150 kHz to 80 MHz field strengths should be less than 3 V m A3 4 Recommended Separation Distances Recommended separation distances between portable and mobile RF communications equipment and the MD Patient Monitor The MD Patient Monitor is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled The customer or the user of the MD Patient Monitor can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment transmitters and the MD Patient Monitor as recommended below according to the maximum output power of the communications equipment Separatio
104. ompt message during the NIBP alarm pick OFF to disable the alarm function and there will be a 3 amp beside NIBP A WARNING A In order to avoid endangering the patient s life the user should use this function cautiously e ALM LEV selectable from HIGH MED to LOW HIGH represents the most serious case ALM REC pick ON to enable report printing upon NIBP alarm e SYS ALM HI SYS ALM LO MAP ALM HI MAP ALM LO DIA ALM HI DIA ALM LO are for the user to set up the alarm limit for each type of pressure NIBP alarm is activated when the pressure exceeds set upper alarm limits or falls below lower alarm limits The adjusting range of NIBP alarm limits is 10 300mmHg NIBP alarm limits for default 108 TECNO GAZ Multi Parameter Monitor MD User Manual ADU PED NEO Lower Upper Lower Upper Lower Upper Limit Limit Limit Limit Limit Limit SYS 90 160 70 120 40 90 DIA 50 90 40 70 20 60 MAP 60 110 50 90 25 70 The adjusting range of NIBP alarm limits Adult Mode SYS 40 270 mmHg DIA 10 215 mmHg MAP 20 235 mmHg Pediatric Mode SYS 40 200 mmHg DIA 10 150 mmHg MAP 20 165 mmHg Neonatal Mode SYS 40 135 mmHg DIA 10 100 mmHg MAP 20 110 mmHg RESET Restore measurement status Pick this item to restore initial settings of the pressure pump When the pressure does not work properly and the system fails to give message for the problem pick this item to activate self te
105. onds Low Mode is DO which is triggered once every 30 seconds NOTE When alarms of different levels occur at the same time the monitor prompts the one of the highest level 5 1 3 Alarm Setup The setup of the alarms can be realized in the alarm menu Press the ALARM SETUP button on the SYSTEM SETUP menu to call up ALARM SETUP menu default menu as shown below In the ALM SEL item the user may set up the information about common alarm setup and the alarm setup of each parameter 533 TECNO GAZ Multi Parameter Monitor MD User Manual ALARM SETUP ALM SEL COMMON ALM SETUP ALARM VOL 3 ALM REC TIME 83 Figure 5 1 Alarm Setup n COMMON ALM SETUP Select COMMON ALM SETUP selection in ALM SEL item This operation may call up the dialog box as the default one ALARM VOL which has five selections 1 2 3 4 and 5 ALM REC TIME which has three selections 8S 16S 32S n Alarm setup of each parameter In the ALARM SETUP menu select the ALM SEL item to set up the alarm information for following parameters They are HR ST PVCs SPO2 NIBP IBP 1 2 RESP and TEMP For example Method to set up HR alarm information Step 1 Select the HR ALM SETUP option in the ALM SEL item Then the menu only displays HR setup items Step 2 You can set up five items in this menu which are HR ALM on off of the alarm switch ALM LEV alarm level ALM REC alarm recording sw
106. onitor MD User Manual 15 2 TEMP SETUP Menu Pick the TEMP hot key on the screen to call up the TEMP SETUP menu shown as below TEMP SETUP TZ ALM HI ALM LEV MED T2 ALM LO ALM REC OFF TD ALM HI T1 ALM HI 39 0 TEMP UNIT T1 ALM LO DEFAULT gt gt Figure 15 1 TEMP Setup n ALM pick ON to enable prompt message during the TEMP alarm pick OFF to disable the alarm function and prompt the z amp symbol beside TEMP numeric WARNING In order to avoid endangering the patient s life the user should use this function cautiously n ALM LEV used to set up the alarm level selectable from HIGH MED or LOW n ALM REC used to start stop recording TEMP alarms Pick ON to enable report printing upon TEMP alarm n Alarm for T1 T2 TD occurs when the measured temperature exceeds set alarm high limit or falls below alarm low limit T1 represents the TEMP of Channell T2 represents the TEMP of Channel2 TD represents the TEMP difference of T1 and T2 The adjusting range of T1 T2 FI TD alarm limits is 0 50 C T1 and T2 alarm limits for default Max TEMP HI Min TEMP LO Step ADU PED NEO 39 C 36 C 0 1 117 TD alarm limits for default TECNO GAZ Multi Parameter Monitor MD User Manual TEMP HI Step ADU PED NEO 2 C 0 1 n UNIT To set temperature unit C or F DEFAULT Pick this item to access the TEMP DEFAULT CONFIG dialog box in which the user
107. or MD User Manual 13 SpO2 Monitoring 13 1 What is SpO2 Monitoring SpO2 Plethysmogram measurement is employed to determine the oxygen saturation of hemoglobin in the arterial blood If for example 97 hemoglobin molecules in the red blood cells of the arterial blood combine with oxygen then the blood has a SpO2 oxygen saturation of 97 The SpO2 numeric on the monitor will read 97 The SpO2 numeric shows the percentage of hemoglobin molecules which have combined with oxygen molecules to form oxyhemoglobin The SpO2 PLETH parameter can also provide a pulse rate signal and a plethysmogram wave How the SpO PLETH Parameter Works MW Arterial oxygen saturation is measured by a method called pulse oximetry It is a continuous non invasive method based on the different absorption spectra of reduced hemoglobin and oxyhemoglobin It measures how much light sent from light sources on one side of the sensor is transmitted through patient tissue such as a finger or an ear to a receiver on the other side MW The amount of light transmitted depends on many factors most of which are constant However one of these factors the blood flow in the arteries varies with time because it is pulsating By measuring the light absorption during a pulsation it is possible to derive the oxygen saturation of the arterial blood Detecting the pulsation gives a PLETH waveform and pulse rate signal M The SpO value and the PLETH waveform can be displ
108. ospital s grounding system Fuse box used to put fuse in Power supply socket AC100 240 V 50 60 Hz 1 5 Label Patient Monitor B Model XXXX Serial No YYYY C Date of Manufacture ZZZZ 0123 Product Information AS Type Class v EC Representative a Shanghai International Holding Corp GmbH Europe Addr Eiffestrasse 80 D 20537 Hamburg Germany Tel 49 40 2513175 Fax 49 40 255726 Manufactured by Shenzhen Edan Instruments Inc Manufacturer Address ma 4 F New Energy Building 2009 Nanhai Road Nanshan District Shenzhen 518054 P R China N Tel 86 755 26062220 Fax 86 755 26062022 E Figurel 7 Label on the Rear Panel Equipment name Model amp Serial No SeialNo o lt Date Manufacturing Date EC Representative Shanghai Intemational Holding Corp GmbH Europe Addr Eiffestrasse 80 D 20537 Hamburg Germany C Tel 49 40 2513175 Fax 49 40 255726 0123 Manufactured by Edan Instrum ents Inc EDAN tdar4iF NewEnergy Building 2009 Nanhai Road y IEMIZUHSM Nanshan District 51 8054 Shenzhen P R China Information Tel 86 755 26062220 Fax 86 755 26062022 Manufacturer Figurel 8 Label on the Package 1 6 Built in Chargeable Battery Multi parameter Patient Monitor is equipped with a built in chargeable battery When switch on AC power supply the battery will be charged automatically until full electric energy There is a sign REE
109. ossible future transportation or storage Check the components according to the packing list n Check for any mechanical damage n Check all the cables modules and accessories If there is any problem contact the distributor immediately 2 2 Install Wall Mount for Patient Monitor Optional Plastic Nut and Screw g Figure2 1 11 TECNO GAZ Multi Parameter Monitor MD User Manual Device Holding Plate SS Fixing Hole Fixing Screw Black Knob Manual Screw screw Duplexing Piece am Figure2 3 Installation Steps l 2 Outline along the part1 edge against the wall with the desired location Drill 4 holes of 6mm diameter in the wall then knock the plastic nuts in the holes complately Knock 4 screws in the plastic nuts when tightened secure the channel part1 at the desired location of the wall as shown in Figure 2 1 Slide the arm part2 into channel partl as Figure2 2 shown to the desired location Tighten the manual screw and secure the arm part2 at the desired position within the channel part1 Face the side with duplexing piece of the device holding plate to the underside of the patient monitor fix it with M4x25mm screw as shown in Figure 2 3 Pull out the fixing screw from the fixing hole At the same time put the arm part2 into the patient monitor with the device holding plate and secure the fixing screw totally through the fixing hole
110. pondingly There is an arrow indicating upward under the right side of the last waveform There is 38 TECNO GAZ Multi Parameter Monitor MD User Manual also a time scale beside the arrow 0S is used to mark the moment when waveforms are frozen With waveforms moving right this time mark will in turn change into 1S 2S 3S These time marks are applied to all waveforms on the screen 39 TECNO GAZ Multi Parameter Monitor MD User Manual 7 Recording Optional n General information on recording n Instructions for configuring and recording n Recording messages 7 1 General Information on Recording A thermal dot matrices recorder with 48mm wide printout paper is used for Multi parameter Patient Monitor Performance of the Recorder Waveform record is printed out at the rate of 25 mm s or 50 mm s It can record up to 2 waveforms English printout User selectable real time recording time and waveform 3 2 22 2 Auto recording interval is set by the user the waveform is in accordance with the real time recording 7 2 Recording Type Multi parameter patient monitor provides several stripe recording types Continuous real time recording 8 second real time recording Auto 8 second recording Alarm recording 2 3 3 J 5 Drug calculation titration recording Real time Recording Real time recording starts as you press the RECORD button on the recorder The waveforms for continuous real time
111. resents the most serious case ALM REC pick ON to enable report printing upon ECG alarm e ALM HI used to set up the upper limit of ECG alarm ALM LO used to set up the lower limit of ECG alarm ECG alarm is activated when the heart beat exceeds set ALM HI value or falls below ALM LO value The adjusting range of ECG alarm limits is 15 350 ECG alarm limits for default ALM HI ALM LO Step HR ADU 120 50 1 HR PED 160 75 1 HR NEO 200 100 1 The adjusting range of ECG alarm limits Max ALM HI Min ALM LO Step HR ADU 300 15 1 HR PED 350 15 1 HR NEO 350 15 1 NOTE Please set the alarm limits according to clinical condition of individual patient The upper limit shall not exceed 20 beat min higher than the patient s heart rate BE HR FROM ECG SpO2 AUTO and BOTH may detect heart rate AUTO distinguishes heart rate source according to the quality of signal When the quality of ECG signal and SpO signal is the same ECG takes priority over SPO2 By picking ECG the monitor prompts HR and activates HR beep By picking SpO2 the monitor prompts PULSE and activates pulse beep BOTH mode displays HR and PR simultaneously when this item is picked PR parameter is displayed to the right side of SpO2 As for the sound of HR or PR in BOTH mode HR is given the priority i e if HR is available whose sound will be sent out but if HR is not available then the sound will be for P
112. rilizing period Be sure that the dome is removed Then rinse all transducer parts except the electrical connector with sterilized water or saline The transducer must be thoroughly dried before storing W Gas Sterilization For more complete asepsis use gas sterilization Remove obvious contamination by using the cleaning procedure described previously To inhibit the formation of ethylene glycol when ethylene oxide gas is used as the disinfectant the transducer should be completely dry Follow the operating instructions provided by the manufacturer of the gas disinfectant WARNING The sterilize temperature must not exceed 70 C 158 F Plastics in the pressure transducer may deform or melt above this temperature 133 TECNO GAZ Multi Parameter Monitor MD User Manual 134 TECNO GAZ Multi Parameter Monitor MD User Manual 135 TECNO GAZ Multi Parameter Monitor MD User Manual Appendix I Product Specification A1 1 Classification A1 A1 Anti electroshock type EMC type Anti electroshock degree Harmful liquid proof degree Disinfection sterilizing method Working system 2 Specifications 2 1 Size and Weight Size Weight 5kg A1 2 2 Environment Temperature Working Transport and Storage Humidity Working Transport and Storage Altitude Working Transport and Storage Power Supply Class equipment and internal powered equipment Class A ECG RESP TEMP SpO2 NIBP IBP CF
113. rm measurement system cannot analysis or calculation Check if the setup of patient type is correct Check the connection of each part or replace with a new cuff If the failure contact the manufacturer for repair still exists 143 TECNO GAZ Multi Parameter Monitor MD User Manual EXCESSIVE MOTION The patient arm moves Check the connection of each part and the patient situation Measure again if the failure still exists the for contact manufacturer repair OVER PRESSURE Perhaps folds exist in the airway Check for the smoothness in the airway and patient situation Measure again if the failure still exists contact the manufacturer for repair SIGNAL SATURATED Problem happens when measuring the curve The perform measurement system cannot analysis or calculation Check the connection of each part and the patient situation Measure again if the failure still exists the for contact manufacturer repair PNEUMATIC LEAK NIBP airway has leaks Check the connection of each part or replace with a new cuff If the contact the failure still exists manufacturer for repair CUFF TYPE ERR Perhaps the used cuff does not fit the setup patient type Check if the patient type is set up correctly Check the connection of each part or replace with a new cuff If the failure still exists contact the manufacturer for repair
114. robes can be used simultaneously to measure two TEMP datas and get the temperature difference TEMP Monitoring Setup n If you are using disposable TEMP probes you need to plug the TEMP cable into the monitor and then connect the probe to the cable With a reusable TEMP probe you can plug the probe directly into the monitor n Apply the TEMP probe s securely to the patient Switch on the system WARNING Verify probe cables fault detection before beginning of monitoring phase Unplug the temperature probe cable of the channe1 from the socket the screen will display the error message TEMP1 SENSOR OFF and the audible alarm is activated The other channel is the same NOTE Disposable TEMP probe can only be used once for one patient WARNING The calibration of the temperature measurement is necessary for every two years or as frequently as dictated by your Hospital Procedures Policy When you need calibrate the temperature measurement contact the manufacture please WARNING Take the TEMP probe and cable carefully If not use you should coil up the probe and cable into a loose circle If the wire inside the cable is tensely pulled it may cause mechanical damage to the probe and the cable WARNING A The TEMP module shall be calibrated once every two years or as required by your hospitals regulation When calibration is required contact the manufacture please 116 TECNO GAZ Multi Parameter M
115. rsor line When the cursor is at the required position you may select the base point or the measurement point NOTE Abnormal QRS complex is not considered in ST segment analysis ST Alarm Message NOTE The alarm limits for two ST measurements are identical No setting of alarm limits can be made only for one channel Tables below describe the possible physiological alarms Physiological alarms Message Cause Alarm Level 83 TECNO GAZ Multi Parameter Monitor MD User Manual STI TOO ST measuring value of channel 1 HIGH is above the upper alarm limit User selectable STI TOO ST measuring value of channel 1 LOW is below the lower alarm limit User selectable ST2 TOO ST measuring value of channel 2 HIGH is above the upper alarm limit User selectable ST2 TOO ST measuring value of channel 2 LOW is below the lower alarm limit User selectable 12 8 Arr Monitoring Optional Arrhythmia Analysis The arrhythmia algorithm is used to monitor ECG of neonate and adult patient in clinical detect the changing of heart rate and ventricular rhythm and also save arrhythmia events and generate alarming information Arrhythmia algorithm can monitor paced and non paced patients Qualified personnel can use arrhythmia analysis to evaluate patient s condition such as heart rate PVCs frequency rhythm and ectopic beat and decide the treatment Besides detecting changing of ECG arr
116. rug has its fixed unit or unit series Operator must select the proper unit at the doctor s instruction If the result exceeds the system defined range it will display NOTE After entering a value a conspicuous prompt will appear in the menu warning the operator to confirm the correctness of the entered value The correct value is the guarantee for the reliability and safety of the calculated results NOTE For each entered value the system will always give a dialog box asking for the user s confirmation You must be careful when answering each box The calculated result is reliable only after the entered value is confirmed to be correct Select the Drug Name Turn the knob to pick the DRUG NAME item in DRUG CALC menu The user may select the drug name in the pull down list including AMINOPHYLLINE DOBUTAMINE DOPAMINE EPINEPHRINE HEPARIN ISUPREL LIDOCAINE NIPRIDE NITROGLYCERIN PITOCIN Drug A Drug B Drug C Drug D and Drug E Calculation for only one type can be generated each time NOTE A B C D E are only codes for drugs instead of their real names The units for these five drugs are fixed The operator may select the appropriate units 53 TECNO GAZ Multi Parameter Monitor MD User Manual according to the convention of using these drugs The rules for expressing the units are mg series units are fixedly used for drug A B and C g mg mcg unit series units are fixedly used for drug D uni
117. s Measurements will be unreliable and may not be possible if the patient s cardiac arrhythmia has caused an irregular heartbeat The measuring time thus will be prolonged 106 TECNO GAZ Multi Parameter Monitor MD User Manual Heart lung Machine Measurements will not be possible if the patient is connected to a heart lung machine Pressure Changes Measurements will be unreliable and may not be possible if the patient s blood pressure is changing rapidly over the period of time during which the arterial pressure pulses are being analyzed to obtain the measurement Severe Shock If the patient is in severe shock or hypothermia measurements will be unreliable since reduced blood flow to the peripheries will cause reduced pulsation of the arteries Heart Rate Extremes Measurements can not be made at a heart rate of less than 40 bpm and greater than 240 bpm 14 2 2 NIBP Parameter Setup and Adjustment NIBP measurement result and corresponding message are displayed as follows Measurement Time NIBP 16 50 mmHg BPunit Measurement value 108 84 70 Measurement mode gt MANUAL 14 3 NIBP SETUP menu Pick the NIBP hot key on the screen to call up the NIBP menu shown as below 107 TECNO GAZ Multi Parameter Monitor MD User Manual NIBP SETUP INTERVAL 1 MIN RESET CONT INUAL CALIBRATE PNEUMATIC DEFAULT gt gt Figure 14 2 NIBP Setup n NIBP alarm setting e ALM pick ON to enable pr
118. s switched off and disconnected from the power line WARNING A Do not subject the sensor to autoclaving Do not immerse the sensor into any liquid Do not use any sensor or cable that may be damaged or deteriorated For cleaning n Use a cotton ball or a soft mull moistened with hospital grade ethanol to wipe the surface of the sensor and then dry it with a cloth This cleaning method can also be applied to the luminotron and receiving unit n The cable can be cleaned with 3 hydrogen dioxide 7 isopropanol or other active reagent However connector of the sensor shall not be subjected to such solution 101 TECNO GAZ Multi Parameter Monitor MD User Manual 14 NIBP Monitoring 14 1 Introduction IA IA IA The Non invasive Blood Pressure NIBP module measures the blood pressure using the oscillometric method It is applicable for adult pediatric and neonatal usage There are two modes of measurement available manual automatic Each mode displays the diastolic systolic and mean blood pressure In the MANUAL mode only one measurement is conducted for each time In the AUTO mode the measurement is cycled you can set the interval time to 1 2 3 4 5 10 15 30 60 90 120 180 240 480 minutes In the CONTINUAL mode the system executes NIBP measurement continuously within five minutes N WARNING 1 You must not perform NIBP measurements on patients with sickle cell disease or under any condition whi
119. s illustrated in the Figure 12 3 NOTE the following table gives the corresponding lead names used in Europe and America respectively Lead names are represented by R L N F and C respectively in Europe whose corresponding lead names in America are RA LA RL LL and V America Euro Lead names color Lead names color RA White R Red LA Black L Yellow LL Red F Green RL Green N Black V brown C White Yellow N F Black Green Figure 12 2 Electrode Placement for 5 lead Set NOTE To ensure patient safety all leads must be attached to the patient 70 TECNO GAZ Multi Parameter Monitor MD User Manual For 5 lead set attach the C V electrode to one of the indicated positions as below Figure 12 3 Vi V2 V3 v4 V5 V6 V3R V7R VE V7 V7R On the 4th intercostal space at the right sterna margin On the 4th intercostal space at the left sterna margin Midway between V2 and V4 electrodes On the 5th intercostal space at the left clavicular line On the left anterior axillary line horizontal with V4 electrode On the left middle axillary line horizontal with V4 electrode On the right side of the chest in positions corresponding to those on the left Over the xiphoid position On the 5th intercostal space at the left posterior axillary line of back On the 5th intercostal space at the right posterior axillary line of back Figure 12 3 C electrode Placement for 5 l
120. se other OUT adult or 90 seconds measuring method neonatal Prompt message display in the prompt area below NIBP value Message Cause Alarm Level Manual measuring During manual measuring mode Auto measuring During automatic measuring mode Measurement over Measurement over Calibrating During calibrating Calibration over Calibration over No alarm Pneum testing During pneumatic test Pneum test over pneumatic test over Resetting NIBP module in resetting Reset failed NIBP module reset failed 14 5 Maintenance and Cleaning A WARNING Do not squeeze the rubber tube on the cuff Do not allow liquid to enter the connector socket at the front of the monitor Do not wipe the inner part of the connector socket when cleaning the monitor When the reusable cuff is not connected with the monitor or being cleaned always place the cover on the rubber tube to avoid liquid permeation Reusable Blood Pressure Cuff The cuff can be sterilized by means of conventional autoclaving gas or radiation sterilization in hot air ovens or disinfected by immersion in decontamination solutions but remember to remove the rubber bag if you use this method The cuff should not be dry cleaned The cuff can also be machine washed or hand washed the latter method may prolong the service life of the cuff Before washing remove the latex rubber bag and for 113 TECNO GAZ Mult
121. se that the instrument is in perfect working order The cable connecting the patient to the instrument must be free of electrolyte WARNING If the protective grounding protective earth system is doubtful the monitor must be supplied by inner power only Condensation Make sure that during operation the instrument is free of condensation Condensation can form when equipment is moved from one building to another thus being exposed to moisture and differences in temperature Safety Precautions WARNING and CAUTION messages must be observed To avoid the possibility of injury observe the following precautions during the operation of the instrument 2575 TECNO GAZ Multi Parameter Monitor MD User Manual WARNING A The patient monitor is provided for the use of qualified physicians or personnel professionally trained And they should be familiar with the contents of this user manual before operation WARNING A Only qualified service engineers can install this equipment WARNING EXPLOSION HAZARD Do not use the device in a flammable atmosphere where concentrations of flammable anesthetics or other materials may occur A WARNING SHOCK HAZARD the power receptacle must be a three wire grounded outlet A hospital grade outlet is required Never adapt the three prong plug from the monitor to fit a two slot outlet A WARNING SHOCK HAZARD Do not attempt to connect or disconnect a power cord with wet
122. selectable consecutive seconds Fibrillation wave for consecutive 4 seconds or The number of continuous Vent VFIB VTAC bones beats is larger than the upper limit User selectable BOSE of cluster Vent beats 25 The RR interval is less than 600ms Without 3 the number of cluster VT gt 2 User selectable pacemaker PVCs lt 5 Without COUPLET 2 consecutive PVCs User selectable pacemaker 88 TECNO GAZ Multi Parameter Monitor MD User Manual BIGEMINY Without Vent Bigeminy User selectable pacemaker Without j TRIGEMINY Vent Trigeminy User selectable pacemaker A type of single PVC under the condition that HR 100 R R interval is less than 1 3 the Without average interval followed by a RONT User selectable pacemaker compensating pause of 1 25X the average R R interval the next R wave advances onto the previous T wave Without Single PVCs not belonging to the PVC User selectable pacemaker type of above mentioned PVCs 5 ti RS lex RR TACHY All patients depo aue RE User selectable interval is less than 0 5s 5 consecutive QRS complex RR BRADY All patients User selectable interval is longer than 1 5s When HR is less than 100 beats min no heart beat is tested during the period 1 75 times of the MISSED Without f User selectable average RR interval or BEATS pacemaker When HR is larger than 100 beats min no beat is tested with second
123. sible density Do not let liquid enter the monitor No part of this monitor can be subjected to immersion in liquid Do not pour liquid onto the monitor during sterilization Use a moistened cloth to wipe up any agent remained on the monitor 2 DD 5 11 5 Disinfection To avoid extended damage to the equipment disinfection is only recommended when stipulated as necessary in the Hospital Maintenance Schedule Disinfection facilities should be cleaned first Appropriate disinfection materials for ECG lead SpO2 sensor blood pressure cuff TEMP probe IBP sensor are introduced in relative chapters respectively CAUTION Do not use EtO gas or formaldehyde to disinfect the monitor 65 TECNO GAZ Multi Parameter Monitor MD User Manual 11 6 Replacement of Fuse Unscrew the fuse cap anticlockwise replace the fuse protector tube and screw down the fuse cap clockwise Fuse size 5x20 Rated value T1 6AL 250V NOTE Switch off the power switch of the patient monitor before examining the fuse 66 TECNO GAZ Multi Parameter Monitor MD User Manual 12 ECG RESP Monitoring 12 1 What Is ECG Monitoring Monitoring the ECG produces a continuous waveform of the patient s cardiac electric activity to enable an accurate assessment of his current physiological state Only proper connection of the ECG cables can ensure satisfactory measurement On the Normal Display The monitor provides display of 2 channel ECG waveforms
124. sisting of two parts see below A It indicates that the equipment should be sent to the special agencies according to local regulation for separate collection after its useful life It indicates that the equipment is put on the market after 13 August 2005 Equipotential grounding system Stand by It designates that the switch or switch position which one part of the device has been switched on while the device is at the status of stand by 62 TECNO GAZ Multi Parameter Monitor MD User Manual 11 Maintenance Cleaning 11 1 System Check Before using the monitor do the following M Check if there is any mechanical damage MW Check if all the outer cables inserted modules and accessories are in good condition M Check all the functions of the monitor to make sure that the monitor is in good condition If you find any damage on the monitor stop using the monitor on patient and contact the biomedical engineer of the hospital or Customer Service immediately The overall check of the monitor including the safety check should be performed only by qualified personnel once every 6 to 12 month and each time after fix up All the checks that need to open the monitor should be performed by qualified customer service technician The safety and maintenance check can be conducted by persons from this company You can obtain the material about the customer service contract from the local company s office WARNING A
125. st procedure thus restore the system from abnormal performance CONTINUAL Start continuous measuring When this item is picked the menu will disappear automatically UNIT Pick this item to set measurement unit Option mmHg or kPa CALIBRATE Calibrate the cuff pressure reading with a calibrated reference manometer Pick the CALIBRATE item to start the calibration and the item will change into STOP CAL which if picked the system will stop calibration 109 TECNO GAZ Multi Parameter Monitor MD User Manual WARNING The calibration of the NIBP measurement is necessary for every two years or as frequently as dictated by your Hospital Procedures Policy The performance should be checked according to the following details Procedure of the Pressure Transducer Calibration Replace the cuff of the device with a rigid metal vessel with a capacity of 500 ml 5 Connect a calibrated reference manometer with an error less than 0 8 mmHg and a ball pump by means of a T piece connector and hoses to the pneumatic system Set the monitor in CALIBRATE mode Inflate the pneumatic system to 0 50 and 200 mmHg by ball pump separately The difference between the indicated pressure of the reference manometer and the indicated pressure of the monitor will not exceed 3 mmHg Otherwise please contact our customer service Monitor Reference Manometer NIBP Ball Pump Metal Vessel Figure 14 3 Diagram of
126. sure value 8 Adjust repeatedly until the value in the menu is equal to the pressure value shown by the mercury calibration 9 Press the Start button the device will begin calibrating 10 Wait for the calibrated result You should take corresponding measures based on the prompt information 11 After calibration disassemble the blood pressure tubing and the attached 3 way valve The prompt information related to calibration take CH1 for example m CHI CAL SUCCESS Indicate that CH1 works normally you can use CH1 to monitor the patient m CH1 CAL FAIL Make sure that pressure value shown by hydrargyrum pressure meter is change less m CH1 SENSOR OFF FAIL Make sure that sensor is not off then proceed calibration m IN DEMO FAIL Make sure that the monitor is not in DEMO mode Contact service technician if necessary m PRESSURE OVER RANGE FAIL Make sure that you have selected transducer value in IBP CAL then proceed calibration IBP SCALE ADJUST Submenu 129 TECNO GAZ Multi Parameter Monitor MD User Manual IBP SCALE ADJUST CH1 ART CH2 CUP Figure 16 8 IBP SCALE ADJUST Menu The waveform and corresponding scale appears in the IBP Waveform Area with 3 dotted lines representing High Limit Scale Reference Scale and Low Limit Scale from the top to the bottom Values of the three scales can be user set according to the instruction given below E IBP label selectable from
127. t VA Stopcock gt Pressure H Em 3 W TT Transducer ll Connector Interface Cable Jl uyarargyrum EN Ji Pressure Meter V X len Figure 16 7 IBP Calibration CAUTION n Mercury calibration should be performed by the biomedical engineering department either whenever a new transducer is used or as frequently as dictated by your Hospital Procedures Policy n The purpose of the calibration is to ensure that the system gives you accurate measurements n Before starting a mercury calibration a zero procedure must be performed n If you need to perform this procedure yourself you will need the following pieces of equipment Standard sphygmomanometer 3 way stopcock Tubing approximately 25 cm long The Calibration Procedure SEE Figure 16 7 128 TECNO GAZ Multi Parameter Monitor MD User Manual WARNING A You must never perform this procedure while patient is being monitored Close the stopcock that was open to atmospheric pressure for the zero calibration Attach the tubing to the sphygmomanometer Ensure that connection that would lead to patient is off we e Connect the 3 way connector to the 3 way stopcock that is not connected to the patient catheter Nn Open the port of the 3 way stopcock to the sphygmomanometer 6 Select the channel to be calibrated in the menu and select the pressure value to which the IBP is to be adjusted Inflate to make the mercury bar rise to the setup pres
128. t gt ALARM RECALL gt gt DEMO gt gt Figure 3 1 System Memu Review of trend graphs tables and NIBP measurements will be described in Chapter Trend and Event 3 1 Patient Information Setup NOTE To clear current patient data refer to New Patient for details 15 TECNO GAZ Multi Parameter Monitor MD User Manual Pick PATIENT SETUP in SYSTEM MENU to call up the following menu PATIENT SETUP PAT NO III B IRTH BED NO HEIGHT cn DOCTOR 0 WEIGHT kg NAME BLOOD SEX NEU PATIENT PAT TYPE ADU c p E F 1 k m n IR s T x v z e 1 2 3 4 5 e 8 EXIT Figure 3 2 Patient Setup You can setup the following patient information DEPT Department in which the patient receives treatment PAT NO Patient No BED NO Patient bed number Range 1 254 DOCTOR Name of the doctor NAME Patient name Valid characters A Z 0 9 Max length 12 characters SEX Patient gender Available options F for Female M for Male PAT TYPE Patient type Available options ADU PED and NEO ADMIT Hospitalization starting date format year month May BIRTH Patient date of birth format yearimonth May HEIGHT cm inch Patient height Increase decrease by 0 5 cm or 0 5 inch per switch 16 TECNO GAZ Multi Parameter Monitor MD User Manuall WEIGHT kg Ib Patient weight Increase decrease by 0 5 kg or 0 5 Ib per switch BLOOD Pa
129. t k unit m unit mEq is fixedly used for drug E Patient Weight After accessing the DRUG CALC window the operator should enter the patient weight into the first or the second item The entered weight will be used as the independent data only for the calculation of drug concentration NOTE This drug calculation function acts only as a calculator That means the patient weight in Drug Calculation menu and the patient weight in Patient Information menu are independent from each other Therefore if the Weight in Drug Calcu lation changes the Weight in Patient Information does not change In this way we can say the Drug Calculation menu is independent from other menus in the system Any change of it will not affect other information about the patient being currently monitored 9 2 Titration Table Access Titration Table Select TITRATION item in DRUG CALC menu to enter titration table display Titration table display for drug is as following 54 6 TECNO GAZ Multi Parameter Monitor MD User Manual TITRATION DRUG fi AMOUNT 400 00 my VOLUME 250 00 ml DOSE min 2500 00 mcg INF RATE 93 75 nl hr WEIGHT 70 00 kg DRIP RATE 31 25 GTT min INF RATE BASIC STEP 1 DOSE TYPE DOSE min UP DOUN REC Figure 9 2 TITRATION Method to operate the titration table In the TITRATION table turn the knob to pick BASIC item Press and turn the knob to select either INF RATE or DOSE or DRIP RATE Then turn
130. taken accordingly Alarm setup and prompt messages are provided in respective parameter setup sections 5 1 Alarm Modes 5 1 1 Alarm Level Each alarm either technical or physiological has its own level For alarm of higher level when it occurs the system will give prompt in various ways Some alarm s level can be set by the user via software Others can not be changed once defined by the system Alarms in Multi parameter patient monitor are divided into three levels that is high medium and low High level alarm indicates the patient s life is in danger or the monitor under using has serious problem in technical respect It is the most serious alarm Medium level alarm means serious warning Low level alarm is a general warning Alarms are classified into three categories which are physiological alarm technical alarm and general alarm Physiological alarm refer to those alarms triggered by patient s physiological situation which could be considered dangerous to his or her life such as heart rate HR exceeding alarm limit parameter alarms Technical alarm refer to system failure which can make certain monitoring process technically impossible or make monitoring result unbelievable Technical alarm is also called System Error Message General alarm belongs to those situations that can not be categorized into these two cases but still need to pay some attention Multi parameter patient monitor has preset the alarm level for the para
131. tient blood type Pick A B O AB or N N represents unknown blood type NEW PATIENT Admission of new patient Also in this menu the user may select NEW PATIENT item to access CONFIRM TO UPDATE PATIENT dialog box as shown below in which the user decide whether to monitor a new patient CONFIRM TO UPDATE PATIENT All data of currently monitored patient will be deleted Yes Figure 3 3 Confirm to Update Patient Pick YES to delete all information of the patient being currently monitored and exit the menu Pick NO to give up updating the patient and the system will keep the information of the current patient and exit the menu NOTE Selecting YES will delete all information about the currently monitored patient 3 2 Default Setup NOTE Select any item in this sub menu to cancel the current setup and use the selected default setup 17 TECNO GAZ Multi Parameter Monitor MD User Manual DEFAULT FACTORY DEFAULT ADU CONFIG FACTORY DEFAULT PED CONFIG FACTORY DEFAULT NEO CONFIG USER DEFAULT ADU CONFIG USER DEFAULT PED CONFIG USER DEFAULT NEO CONFIG SAVE CURRENT AS USER CONFIG Figure 3 4 Default Menu In this sub menu you can select both the factory default and the user defined default Also in this sub menu you can save the current configuration as the user defined default configuration At this time the system will automatically save all the setups in the parameter menu
132. tinuous real time recording Press RECORD button 4 to start stop the recording 8 second real time recording Press RECORD button 4 to start recording It will automatically stop in 8 seconds Auto recording Record the two waveforms selected in RECORD menu according to the setup time interval in RECORD menu It will automatically stop in 8 seconds Alarm recoding When alarm recording is set ON it automatically starts when alarm occurs Titration table recording Access the DRUG CALC menu from the SYSTEM MENU menu Pick the TITRATION button in the menu to access the TITRATION window Pick the REC button to print out the titration currently displayed in the window 42 TECNO GAZ Multi Parameter Monitor MD User Manual NOTE You can press RECORD button recording process Access the RECORD menu from the SYSTEM SETUP menu Then pick the CLEAR REC TASK button to stop all recording tasks on the control panel to stop the current 7 4 Recorder Operations and Status Messages Record Paper Requirement Only standard thermosensitive record paper can be used otherwise the recorder may not function the recording quality may be poor and the thermosensitive printhead may be damaged Proper Operation E When the recorder is working the record paper goes out steadily Do not pull the paper outward with force otherwise the recorder may be damaged E
133. tmost item indicated previous page available Mark Event If an event is marked A B C or D the corresponding event type will display on the axis time of the trend table Operation Example To view a NIBP trend table n Pick MENU hot key on the lower right of the screen to access SYSTEM MENU Pick TREND TABLE Pick L RIGHT and switch to NIBP by turning the knob Pick RESOLUTION to select requested time interval Pick UP DOWN and turn the knob to view NIBP trend data of different time Pick EXIT to return to SYSTEM MENU 2 2 2 2 2 48 TECNO GAZ Multi Parameter Monitor MD User Manual 8 3 NIBP Recall The Multi parameter patient monitor can review the latest 500 NIBP measurement data Pick NIBP RECALL in the SYSTEM MENU to invoke the result and time of the latest 15 measurements as shown in the figure below NIBP RECALL ND 2005 08 07 09 03 09 NUM 1 UNIT mmHg UP DOUN Figure 8 3 NIBP Recall Data is listed chronologically from the latest to the earliest 15 measurements can be displayed in one screen Pick UP DOWN to view other trend curve up to 500 results When you press the RECORD button the recorder will pint out the metrical data of current window 8 4 Alarm Event Recall The Multi parameter patient monitor can display the latest 60 alarm events n Select ALARM RECALL in the SYSTEM MENU to access ALARM RECALL CONDITION menu as shown below 49 TECNO GAZ Multi Paramet
134. ture may be above 60 WARNING Do not immerse throw and wet battery in water seawater A WARNING Do not destroy the battery Do not pierce battery with a sharp object such as a needle Do not hit with a hammer step on or throw or drop to cause strong shock Do not disassemble or modify the battery WARNING Use the battery only in the MD multi parameter patient monitor Do not connect battery directly to an electric outlet or cigarette lighter charger WARNING A Don t solder the leading wire and the battery terminal directly WARNING A If liquid leaking from the battery gets into your eyes do not rub your eyes Wash them well with clean water and go to see a doctor immediately WARNING If liquid leaks of the battery onto your skin or clothes wash well with fresh water immediately WARNING Keep away from fire immediately when leakage or foul odor is detected 59 TECNO GAZ Multi Parameter Monitor MD User Manual WARNING A Stop using the battery if abnormal heat odor discoloration deformation or abnormal condition is detected during use charge or storage Keep it away from the monitor WARNING Do not use a battery with serious scar or deformation WARNING A Only patient cable and other accessories supplied by TecnoGaz can be used Or else the performance and electric shock protection can not be guaranteed A WARNING The user should check the monitor a
135. urge t1 kV differential t1 kV differential Mains power quality IEC 61000 4 5 mode mode should be that of a 2 kV common 2 kV common mode typical commercial or mode hospital environment Power frequency 3A m 3A m Power frequency 50 60Hz magnetic fields should magnetic field be at levels 1EC61000 4 8 characteristic of a typical location in a typical commercial or hospital environment Voltage dips lt 5 Uy lt 5 Uy Mains power quality short gt 95 dip in Ur gt 95 dip in Uy should be that of a interruptions and for 0 5 cycle for 0 5 cycle typical commercial or voltage variations hospital environment If on power supply 40 Uy 4096 U1 the user of the MD input lines 6096 dip in Uy 6096 dip in Uy Patient Monitor requires IEC 61000 4 11 for 5 cycles for 5 cycles continued operation during power mains 7096 Ur 7096 Ur interruptions it is 30 dip in Ur for 25 cycles 30 dip in Ur for 25 cycles recommended that the MD Patient Monitor be powered from an 147 TECNO GAZ Multi Parameter Monitor MD User Manual lt 5 Ur gt 95 dip in Ur for 5 sec 596 U1 uninterruptible power gt 95 dip in Ur supply or a battery for 5 sec NOTE Uris the a c mains voltage prior to application of the test level A3 3 Electromagnetic Immunity for EQUIPMENT and SYSTEMS that are not LIFE SUPPORTING Guidance and manufacture s declaration electromagnetic
136. veform ch Waveform 7 waveforms displayed in one screen Gain x2 5mm mV x5 0mm mV x10mm mV x20mm mV auto HR Measuring and Alarm Range Adult 15 bpm 300bpm Neo Ped 15 bpm 350bpm Accuracy 1 or 1bpm which great Resolution bpm Sensitivity 200 uV P P Differential Input Impedance 25MQO CMRR Monitor gt 105 dB Surgery gt 105 dB Diagnosis gt 85 dB Electrode offset potential 300mVd c 600mVd c Leakage Current lt 10uA Working Mode Monitor Surgery Diagnosis ECG Signal Range 6 mV Vp p Amplitude frequency Characteristic Bandwidth Monitor 0 5 40 Hz Surgery 1 25 Hz Diagnosis 0 05 120 Hz ST Segment Monitoring Range Measure and Alarm 2 0 2 0 mV 138 TECNO GAZ Multi Parameter Monitor MD User Manual A1 2 8 RESPIRATION Method Measuring Sensitivity Base line Impedance Range Resp Rate Measuring and Alarm Range Adult Neo Ped Resolution Accuracy Gain Selection A1 2 9 NIBP Method Mode Impedance between R F RA LL 0 2 3 0Q 500 40000hms excitation frequency 64 8kHz 0 rpm 120rpm 0 rpm 150rpm 1 rpm t2 rpm X0 5 x1 x2 x4 Auto Oscillometric Manual Auto Measuring Interval in AUTO Mode Measuring Type 1 2 3 4 5 10 15 30 60 90 120 240 480 720 Min Systolic Pressure Diastolic Pressure Mean Pressure Measuring Rang Adult Mode SYS DIA MAP Pediatric Mode SYS DIA MAP Neonatal Mode SYS DIA MAP Cuff Pressure measuring Range Pressure Resolution Pressure
137. y device otherwise there will be a great deal of interference with the ECG signal Using 5 lead ECG Set You can set the leads on ECG CH1 and ECG CH2 according your needs The lead label is displayed on the upper left part of the waveform You can set them to correspond to any two from I II HI AVR AVL AVF and V If you set both to the same value one of them will be adjusted to another option automatically Figure 12 4 MEM e Figure 12 4 ECG Lead 72 TECNO GAZ Multi Parameter Monitor MD User Manual NOTE If an ECG waveform is not accurate while the electrodes are tightly attached try to change the lead NOTE Interference from a non grounded instrument near the patient and ESU interference can cause inaccuracy of the waveform Normal QRS complex should be o G0 eG Tall and narrow with no notches With tall R wave completely above or below the baseline With pacer spike no higher than R wave height With T wave less than one third of the R wave height With P wave much smaller than the T wave Figure 12 5 Standard ECG Waveform e TECNO GAZ Multi Parameter Monitor MD User Manual 12 4 ECG Screen Hot Keys ARR LEARNING REY DIAGNOSTIC EC G Wr All tl A tl LA Be STL 0 10 ST2 0 15 D PCs 0 BS ine aha PA rm NIBP i mmHg es T wc x Y my Manual RESP 14 IVAN 99 TEMP 37 2 08 07 2005 10 04 16 37 1 0 1 Figure 12 6 T

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