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Reference Guide - Propaq Encore Vital Signs Monitor

1. 4 General information Welch Allyn Propaq Encore Vital Signs Monitor Registration Number signify the device has met all essential requirements of European Medical Device Directive Battery charging when IPX1 Enclosure Protection Drip green indicator proof Classification IPX1 illuminated per IEC Publication 529 The CE Mark and The Canadian C o207 Notified Body aro e StandardsAssociation has evaluated this device according to CSA 601 1 and Underwriters Laboratory Standard UL 2601 1 This symbol is on the Universal Power CE The CE Mark signifies the device has met all essential requirements of European Medical Device Directive 93 42 EEC for a Class 1 product This symbol is on the Universal Power Adapter radiation 93 42 EEC Adapter Input port Temperature sensor input Lo Two way gt Output port Single use only not communication port E reusable Apply the NIBP cuff as 04 shown er Se 4 i NIBP cuff sizes L_ Thigh Large adult Adult Small adult A Child Infant Non ionizing Fuse R electromagnetic E HG Pb Separate lead acid battery from other disposables for recycling Recycle the monitor and battery separately from other disposables www welchallyn com weee Temperature limits Stacking limit by number lt gt gt Altitude limit Humidity limit z Keep away from rain T
2. Fragile This device has been tes ed and certif ied by the Canadian Standards Association International to comply with applicable U S and Canadian medical safety standards Reference Guide General information 5 Propag Encore documentation The documentation set The Propag Encore documentation set consists of documents for the clinician the biomedical technician and the department head or purchaser of accessories for the Propaq Encore monitors This Propag Encore Reference Guide contains important safety and operating information for the clinician Propaq Encore Service Manual 810 0696 XX contains information on how to properly maintain the Propaq Encore through routine calibration inspection and maintenance Welch Allyn Products 8 Accessories 810 0409 XX provides a comprehensive list of accessories recommended for Propaq Encore monitors and options About this reference guide This Reference Guide provides descriptions and operating information for the Propaq Encore models 202EL 204EL and 206EL including all available options at the time of this manual s printing Statement of expectations ofthe reader This Reference Guide was written for the clinician Although this guide may describe some monitoring techniques Welch Allyn expects that you are a trained clinician who knows how to take and interpret a patient s vital signs The Propag Encore has been designed as a quality monitor howe
3. HR PR Allows or prohibits turning off the HR PR alarm limits If CANNOT TURN ALARM OFF is selected the ON OFF button is not displayed on the HR PR LIMITS Alarm Limits Menu CO UNITS Sets the CO display units as mmHg kPa or percent If you change the units the CO2 trends will be cleared and CO2 alarm limit settings change to the factory default settings for the currently used patient mode Note Any time you change the Date Filter Temp F C Decimal HR PR Alarm Limits CAN or CANNOT TURN OFF or CO Units setting the new setting also becomes the powerup default setting Setting the current custom and power up modes The Propag Encore has two sets of patient mode settings e Factory patient modes The powerup settings and alarm limits for these patient modes are preset and cannot be changed They are listed in Factory default settings on page 118 e Custom patient modes You can customize the powerup settings and alarm limits for these patient modes See SAVE on page 24 A WARNING If any alarms are set to OFF and you select SAVE to store the settings for that CUSTOM patient mode those alarms will be OFF whenever the Propaq powers up in that CUSTOM patient mode or when that CUSTOM patient mode is selected Consider carefully before setting CUSTOM patient mode powerup alarms to OFF 24 Getting started Welch Allyn Propag Encore Vital Signs Monitor Note The alarm for apnea cannot be turned off at any time Yo
4. A WARNING Before you use a Propaq on a new patient always turn off the Propaq for a few seconds then turn it on again This clears the prior patient s trend values alarm limit settings and NIBP cuff inflation target 1 If the Propag Encore has been used for a previous patient switch the monitor off then on again The monitor will turn on in the powerup patient mode with the associated settings Note Verify that the powerup tone is produced If the monitor has SpO verify two tones are produced to make sure that both speakers are working 2 Verify the monitor is in the correct patient mode according to the patient s age If the patient mode is not correct change it See Monitor setup on page 20 to change the patient mode WARNING Always check the patient mode when monitoring a new patient The patient mode determines default alarm limits maximum cuff inflation pressure and internal algorithm settings 3 Verify the battery voltage is sufficient for monitoring If it is less than 74 V connect to a power adapter see Power adapter intended use on page 89 for information about the power adapter Powerup equipment alert program fault settings lost If a PROGRAM FAULT SETTINGS LOST TIME DAY RESET equipment alert appears when you turn on the monitor the monitor cannot recall the programmed custom settings and current time and date This can occur if the battery is drained or after new software has been installe
5. AT Difference temperature The difference between T1 and T2 AAMI Association for the Advancement of Medical Instrumentation United States of America AC Power Adapter The device that plugs into the 12 28V dc receptacle on the Propaq Encore s side panel to allow operation and battery charging from ac mains Acuity Welch Allyn s trade name for its central station patient monitoring system Altimeter A sensor internal to the Propaq Encore that measures absolute atmospheric pressure and is used to correct CO numerics for varying altitudes ANSI American National Standards Institute Apnea Condition of no respiration occurring during a prescribed time interval ART Arterial label for an invasive blood pressure channel Arterial Blood Gas Measurements Laboratory value reporting acid base oxygenation and ventilation status Artifact An unwanted disturbance to or by the patient or attached sensors that adds errors usually erratic to the measured parameters e g muscle motion or shivering electrical interference vibration of the cuff etc Auto Interval The interval at which NIBP measurements are initiated when operating in the automatic mode Bell The symbol that appears in a window to indicate alarm limits status If alarm limits have been set a bell appears BP Blood pressure bpm Beats per minute Blood Pressure Numerics Windows The two larger windows below the heart rate These windows can display inv
6. If excessive ambient light is present cover the sensor site with opaque material to block the light Failure to do so may result in inaccurate measurements Light sources that can affect performance include surgical lights especially those with a xenon light source bilirubin lamps fluorescent lights infrared heating lamps and direct sunlight If NIBP will be monitored while using SpO place the NIBP cuff on a different limb than the SpO sensor to help reduce unnecessary SpO alarms For optimal measurements avoid placing the SpO sensor on the same limb as an arterial catheter or intravascular line Loss of pulse signal can occur if the sensor is too tight there is excessive ambient light an NIBP cuff is inflated on the same limb as the sensor there is arterial occlusion proximal to the sensor the patient is in cardiac arrest or shock or the patient has hypotension severe vasoconstriction severe anemia or hypothermia Reference Guide Patient monitoring 53 Perform SpQ monitoring with Masimo option 1 Attach the sensor to the patient according to the sensor manufacturer s instructions observing all warnings and cautions WARNING Use only Masimo accessories and sensors with the monitor with Masimo SpO option as listed in Products and Accessories 810 0409 XX 2 Inspect the Masimo SpO cable Replace it if it shows any signs of wear breakage or fraying Plug the sensor into the cable and plug the cable into the Propaq
7. LOW BATTERY HEATER DISABLED UNCAL appears in the numerics area The Propaq s battery voltage is too low The CO waveform is displayed without range values To continue operation plug the ac power adapter into the Propaq NO MAINSTREAM SENSOR DETECTED SRCH appears in the numerics area The Mainstream CO sensor has been disconnected from the Propaq after providing CO values Disconnect and reconnect the sensor to the Propaq if necessary NON PROTOCOL SENSOR UNCAL appears in the numerics area A CO sensor has been connected that does not match Welch Allyn s specifications The CO waveform is displayed without range values Replace the sensor with a Welch Allyn CO sensor SENSOR FAILURE CALIBRATION ERROR A sensor is defective or out of calibration The sensor will be disabled Replace the sensor SENSOR FAILURE EEPROM The sensor has failed Replace the sensor SENSOR FAILURE HEATER The sensor s temperature control circuit or the Propaq s CO circuitry has failed Try replacing the sensor If the message reappears have the Propaq serviced SENSOR FAILURE MOTOR DRIVE The sensor s motor drive in the sensor head has failed Replace the sensor SENSOR TEMPERATURE TOO HIGH The sensor s temperature is too high The sensor s ambient operating range is 10 to 46 C When the ambient temperature returns to this range this message is automatically removed and operation is restored WARM UP or WARM appears in t
8. no lower limit 1 mmHg Mainstream 0 30 mmHg 3 mmHg 31 99 mmHg 10 of value Sidestream 0 30 mmHg 3 mmHg 31 99 mmHg 10 of value 0 4 1 000 ft 304 8 m Breath rate display Screen Display Breath rate BR source Units Range Resolution Accuracy Alarm Limits Range Numeric When CO is active CO is the BR source Otherwise RESP from ECG is the RR source Breaths Minute Adult Ped0 apnea 2 to 150 breaths min Neonate0 apnea 3 to 150 breaths min 1 breaths min 1 breaths min or 5 whichever is greater Adult Ped2 to 150 breaths min Neonate3 to 150 breaths min CO perormance Specification Per ISO 9918 1993 E EN 864 1996 Apnea alarms and tickets Apnea Ticket Apnea Alarm Accuracy Apnea delay setting Set to auto print after apnea event and after 1 minute continued apnea 2 sec Adult Ped 6 10 15 20 25 30 seconds Neonate 6 10 15 20 seconds Barometric pressure Pressure Compensation Operating Range Screen Display Units Accuracy Automatic 2 000 to 15 000 ft 610 to 4572 m 817 to 429 mmHg Numeric CO Status Window mmHg or kPa 3 mmHg or 2 5 of difference from calibration pressure whichever is greater a Lower if in alarm Based on these airway conditions sensor 42 airway adapter temperature 33 C water vapor pressure 38 mmHg standard gas mixture CO in balance air fully hydrated at 33 C barometric pressu
9. 3 Lift the paper roll from the holder and pull out any paper remaining in the printing mechanism 4 Place the new paper roll onto the holder as shown below and pull out several inches of paper Load the new paper roll onto the Feed the paper through the printer spindle on the door mechanism 5 Slide the end of the paper into the slot of the printing mechanism until it extends out of the paper exit slot 6 Close the paper door 7 Place the monitor on its feet 8 Simultaneously press the START STOP button and the PRINT TRENDS button to produce a test print Reference Guide Care and maintenance 97 VER 2 00 00 Eh Customer services Ordering and customer service For ordering information for the location of your nearest Welch Allyn sales representative or service center or for more information on other Welch Allyn products contact Welch Allyn 8500 SW Creekside Place Beaverton OR 97008 7107 USA Worldwide 503 530 7500 In the USA toll free 800 289 2500 FAX 503 526 4200 Technical service Repacking If you need technical assistance on troubleshooting are interested in customer technical training on Welch Allyn products or help with ordering replacement parts contact Welch Allyn s Technical Services Department at Worldwide 503 530 7500 In the USA toll free 800 535 6663 FAX 503 526 4970 Internet http Awww monitoring welchallyn com service Internet E mail s
10. NIBP and two temperature connectors The Propag Encore 204 left side panel includes one invasive pressure connector and the Propag Encore 206 includes two invasive pressure connectors ECG EKG RESP INV BP P1 ECG EKG RESP INV BP ap CG RESP HS PSM a INV BP P2 Propaq Encore 202 EL Propag Encore 206 EL INV BP Pi ECG EKG RESP AY aa TIBLE A 3 i Oe i COMPATIBLE N SH N HP I I L UNV BP P2 NIBP 202 HP 206 HP On Propags with the Hewlett Packard connector option all models have only one temperature connector the YSI 400 connector 14 Getting started Option connectors EN A Mainstream CO Connector C02 Welch Allyn Propag Encore Vital Signs Monitor Sidestream CD Connector Sp0 gt o gt Tk Cable see Products and Accessories 810 0409 XX lost Masimo SpO Connector motion tolerant NELLCOR SENSORS CAPTEURS Nellcor Sp0 Connector Reference Guide Getting started 15 Propag Encore display The display shows waveforms vital sign numeric values Propag Encore status and alarm information in different windows Different vital sign numeric values such as heart rate and blood pressures have upper and lower range limits If the Propag Encore detects a vital sign value outside of the Propaq s measurable range the mo
11. 40 and 50 minutes past the hour Note however that for intervals 1 2 or 3 minutes measurements begin 1 2 or 3 minutes after the interval is set For example if the 1 minute interval is selected at 10 45 20 the next measurement starts at 10 46 20 The start time may be delayed if the previous measurement ended within 30 seconds of the scheduled start time because the monitor requires that the cuff pressure be below 5 mmHg for a minimum of 30 seconds between measurements to allow time to restore blood flow to the limb NIBP messages The following NIBP messages can appear in the equipment alert window An NIBP caution message also appears in the numerics window If an error number ERR x is listed in an NIBP trend printout or display it indicates that the corresponding NIBP equipment alert occurred AIR LEAK CHECK HOSE ERR 1 The Propag Encore could not properly inflate cuff Check the hose and cuff for obvious leaks such as O rings in the hose connections CUFF NOT DETECTED ERR 2 During cuff inflation the detected pressure did not sufficiently rise Check that the cuff connection is tight and take the measurement again KINKED HOSE CHECK HOSE ERR 3 The Propag Encore could not properly inflate cuff Check for a kinked hose between the monitor and the patient OVERPRESSURE CONDITION ERR 4 The pressure in the cuff exceeded the acceptable limits for patient mode Check the hose and try taking another measuremen
12. 83 printing each shift 83 printing one 83 printing several 83 programmable default 78 RESP 77 specifications 111 status window 77 Symbol and NIBP 78 TEMP 77 TRENDS button 78 TRENDS button 20 78 TURBOCUF button 46 U UA label for umbilical artery 40 Universal Power Adapter voltage selection 89 UV label for umbilical vein 40 V Verifying Patient Mode 11 Verifying powerup tone 11 Voltage battery 11 checking battery 92 Volume heart tone 34 W Waveform Sp02 53 54 Waveforms display priorities 22 ECG 22 scales 40 62 size 34 WAVE SEL button 20 Wave Select Menu 19 window 22 Wave Select Menu INSERV button 19 26 NEXT button 22 NO INSRV button 19 ON OFF button 22 Windows Index 137 Propaq screen 15 Z ZERO P1 P2 buttons 40 Zeroing messages 38 transducers 38 138 Index Welch Allyn Propaq Encore Vital Signs Monitor
13. ECG FAULT This message is displayed in the status message area at the top of the display A problem occurred with ECG If the problem is caused by a defective or disconnected lead the monitor typically displays an additional message that indicates which lead failed such as LL LEAD FAILED Check the ECG lead for proper connection and operation ECG LEAD CHANGED The Propag monitor has automatically changed an ECG lead due to a lead wire or electrode problem LEAD FAIL REPLACE ELECTRODES The cable may not be properly connected to the electrodes or the electrodes may have failed Check for proper connection replace electrodes if needed MULTIPLE LEAD FAIL The monitor displays this message if multiple ECG leads fail Check all ECG leads for proper connection and operation RESP messages RESP FAULT This message is displayed in the status message area at the top of the display A problem occurred with RESP The monitor typically displays an additional message indicating the cause of the problem such as a problem with a RESP lead Check for proper connection replace electrodes if needed LEAD FAIL One or more electrodes are making very poor or no contact Check for proper connection replace electrodes if needed INAPPROPRIATE ECG CABLE ECG cable appears not to contain 1 kW current limiting resistors These resistors are required for RESP operation and to protect the monitor from damage during defibrillation Replace cable with pr
14. also Unfreeze Gas Compensation A correction factor required to obtain accurate CO readings when elevated levels of O or N20 are present in respired gases Heart Rate Source See Heart Rate Pulse Rate Source Heart Rate Pulse Rate The heart rate derived from the heart rate pulse rate source and expressed in units per minute or 1 min See also Heart Rate Pulse Rate Source Heart Rate Pulse Rate Source The source from which heart rate pulse rate is derived This source can be ECG any pressure including NIBP or SpO When the monitor is first turned on the Propag Encore determines the most likely source for heart rate ECG first P1 second SpOz third P2 fourth and NIBP last Highlight The method of identifying a selected item on the display Highlighted selections appear as light characters on a dark background or dark characters on a light background See also Cursor HR An acronym for heart rate and expressed in units per minute or 1 min This is displayed when the heart rate pulse rate source is ECG ICP Intracranial pressure label for an invasive blood pressure channel Impedance Pneumography A method of detecting respiratory effort by measuring the AC impedance between selected ECG leads INCO gt An acronym for inspired CO The amount of CO measured during inhalation 128 Glossary Welch Allyn Propaq Encore Vital Signs Monitor In service Mode A user training aid built into all Propag Encores
15. 01 peak to peak inches at 55 Hz then sloping to 0 0001 peak to peak inches at 2000 Hz Operating 1 hour per axis 3 hours per test Designed to meet RTCA DO 160C Category N IPX1 rating drip proof per EN60529 1991 114 Specifications Welch Allyn Propaq Encore Vital Signs Monitor Monitor physical Characteristic Specification Protection classifications all configurations Type of Protection against Electric Shock Power Power adapter class 1 Adapter Type of Protection against Electric Shock Monitor Protective earth not available in monitor Monitor when connected to power adapter or powered by designed and tested to meet Double Insulation internal battery Requirement Degree of Protection Against Electric Shock for Parts See monitor labels Applied to Patients Recovery time following defibrillator discharge Less than or equal to 10 seconds Electrosurgery interference suppression Suitable for use in the presence of electrosurgery Method of Disinfection Not suitable for autoclaving b Flammable Anesthetics Not suitable for use with flammable anesthetics Monitor only Height 6 65 in 16 9 cm Width 8 25 in 20 9 cm Depth 5 10 in 12 9 cm Weight 6 25 Ib 2 8 kg Monitor with Sp0 module Height 6 65 in 16 9 cm Width 8 25 in 20 9 cm Depth 7 50 in 19 10 cm Weight 9 12 lb 4 10 kg Monitor with expansion module Printer Sp0 C03 Height 9 65 in 24 5 cm Width 8 25 in 20 9
16. 2 PREV MENU Sets the display to Range Mode All invasive pressure waveforms monitored are displayed against the same scale You can select one of five Propaq Encore pressure scales lf two waveforms have a great difference in their pressures the higher pressure waveform may not be visible if it is out of range of the scale Press RANGE until the desired scale appears Sets the display to Rescale Mode Each invasive pressure waveform is displayed against its own scale Each time you press the button the scale is automatically selected based on the highest and lowest pressure levels of each pressure waveform Zeroes the selected pressure channel or cancels zeroing in process The ZERO button changes to CANCEL while zeroing Selects a label for the pressure channel The selectable labels are ART arterial PA pulmonary artery CVP central venous pressure CP intracranial pressure UA umbilical artery and UV umbilical vein You can still use the generic Propaq Encore pressure label P1 or P2 The Propag Encore displays the invasive pressure values in two different numeric formats in the pressure numerics window You can select which pressure value s are most prominently displayed RANGE RESCALE ZERO ARTJZERO CVPI MORE Reference Guide Patient monitoring 4 Invasive pressure messages The following messages can appear in the numerics window NOT ZEROED or NO ZERO No zero reference has been established T
17. Always replace fuses with the fuses rated for the power adapter Part number connector style Rated input Rated serviceable Rated Application voltage fuses output With power switch 503 0054 00 100V 120V ac 1800 mA 250V 16 24V de 25 Watt requirement Without power switch 503 0093 XX 500 mA Time Delay 25VA in countries with 50 60 Hz 5x 20 mm 100V 120V power systems With power switch 503 0054 01 200V 240V ac 1400 mA 250V 16 24V de 25 Watt requirement Without power switch 503 0092 XX 250 mA Time Delay 25VA incountries with 50 60 Hz 5x 20 mm 200V 240V power systems Replacing the power adapter fuses Procedure The Power Adapter contains two fuses that can easily be replaced by service personnel if necessary The adapter can contain spare fuses A Caution Replace each fuse only with the specified type 1 Unplug the power adapter s removable cord from the ac mains outlet and the power adapter 2 Turn the power adapter so you can see the window that indicates the voltage setting 3 Using a small flat blade screwdriver carefully pry the fuse module from the power adapter 4 Replace both fuses with the specified type Note Both fuses should be replaced at the same time even if only one fuse has opened due to an overcurrent situation The unopened fuse may have been stressed and could become unreliable A Caution Spare fuses are contained in housings next to the fuses in the fuse module as shown in the following pi
18. CO be sure to install it according to the manufacturer s instructions The scavenging system should comply with ISO 8835 3 1997 E Sure C02 Watertrap Adapter WARNING Do not connect sample line or patient input to exhaust port Sample line Exhaust Port To cannula Note f you are using a watertrap and sample line instead of the one piece Sure CO2 gas sampling system perform steps above with the following changes attach the watertrap to the monitor then attach the sample line to the watertrap 66 Patient monitoring Welch Allyn Propag Encore Vital Signs Monitor Connect to an intubated patient 1 Connect the gas sampling elbow and elbow connector into the patient s breathing circuit according to the manufacturer s instructions Sure C02 Watertrap Adapter Sample Line WARNING Do not connect sample line or patient input to exhaust port Exhaust Port Elbow Connector A WARNING The exhaust port for Sidestream CO is an output for the expired gases from the patient and any connected breathing apparatus The exhaust port is intended only for connection to gas collection equipment such as gas scavenger devices Do not allow any other connection to the exhaust port Note If you use a gas scavenging system with Sidestream CO be sure to install it according to the manufacturer s instructions The scavenging system should comply with ISO 8835 3 1997 E Note f you are using a watertrap and sample li
19. Central Monitor using the Alarms Setup Window A Note WARNING f you don t set alarm limits Acuity uses preset settings for arrhythmia limits and the powerup default settings for the Propaq Encore When a Propag Encore in Adult or Pediatric Mode is connected to an Acuity System the audio alarms at the bedside Propaq can be delayed up to 4 minutes and 15 seconds The delay time is selected in Acuity software at the time of Acuity installation Visual alarm indications are not delayed Reference Guide Acuity Central Monitoring system 87 Key press route to Acuity menu MAIN MENU NIBP ECG RESP INV PRS SpO2 C02 SETUP SETUP MENU 1 STATSCALE ALARMS WAVE SEL TRENDS MORE ACUITY NET OFF SNAPSHOT PREV MENU ACUITY MENU FRZ PRNT Press NET OFF to disconnect from Acuity When you want to disconnect the monitor from Acuity be sure to use the NET OFF button as described below The NET OFF button is a safety feature to help make sure the patient is not disconnected accidentally If you simply disconnect the Acuity network cable from the monitor without using the NET OFF button the monitor and Acuity both generate equipment alert messages that must be acknowledged by an operator NET OFF When the monitor is connected to Acuity pressing this button disconnects the monitor from the Acuity network FREEZE UNFREEZE When the monitor is NOT connected to Acuity pressi
20. DETECTED This message occurs when the Propag Encore has successfully measured temperature and a probe is then disconnected Reconnect the probe or acknowledge the equipment alert by pressing any menu button PROBE SHORT Verify that the probe is properly inserted in the left side panel If so replace probe CALIBRATION ERROR TEMP DISABLED This message appears when the Propaq Encore has detected that it cannot accurately measure the temperature The monitor should be serviced Malfunction of the temperature probes may result in inaccurate readings Confirm suspect readings 52 Patient monitoring Welch Allyn Propag Encore Vital Signs Monitor Pulse oximetry Sp0 A WARNING Oxygen saturation measurements using pulse oximetry are highly dependent on proper placement of the sensor and patient conditions Patient conditions such as shivering and smoke inhalation may result in erroneous oxygen saturation readings If pulse oximetry measurements are suspect verify the reading using another clinically accepted measurement method such as arterial blood gas measurements on a co oximeter WARNING Tissue damage can be caused by incorrect application or use of a sensor e g wrapping the sensor too tightly applying supplemental tape failing to periodically inspect the sensor site leaving a sensor on too long in one place Refer to the Directions for Use provided with each sensor for specific instructions on application and use and for descri
21. Day window the monitor deletes any patient trend data that is older than five hours for non NIBP trends or older than eight hours for NIBP trends according to the new clock setting However if the monitor has not yet stored the full capacity of trends and you change the hour minute second setting to a time that is within the stored trend period previously stored trends are not erased Changing the day month or year setting does not affect the stored patient trends Reference Guide Getting started 23 Changing the date format filter and units To change the date format ECG filter or some measurement units first make sure you are in the Adult patient mode Then press SETUP MORE MORE SERVICE YES to access the Service Menu MORE MORE SETTINGS The monitor displays the Settings window SETTINGS DATE MO DA YR FILTER 60 Hz TEMP F C C DECIMAL HR PR ALARM LIMITS CAN TURN OFF c02 UNITS mmHg NEXT TP CHANGE Pe Pe REV MENU NEXT Selects the next setting in the status window CHANGE Changes the currently selected display setting DATE Sets the date format Month Day Year Day Month Year or Year Month Day FILTER Sets the ECG filter frequency Make sure it is set to your ac mains frequency TEMP F C Sets the temperature display units either degrees Fahrenheit or Celsius If you change the units the TEMP trends will not be cleared DECIMAL Sets the decimal character as either a period or a comma
22. ECG RESPJINV_PRS and then they change to the smaller characters for 44 minutes The numerics SYS DIA MEAN are removed after 60 minutes B 135 81 103 mmHg TIME SINCE READING If NIBP is the only vital sign being A monitored the numerics are displayed in a a 1 3 5 8 1 1 03 waveform window above a trend window mmHg TIME SINCE READING 10 min 4 EENT a er Sa a NT HND OXYCRG Set the NIBP alarm limits Set the alarm limits according to your hospital s standards NIBP display default settings To select which vital sign waveforms are displayed press MAIN MENU SETUP WAVE SEL tO display the Wave Select window WAVE SELECT ECG ON RESP OFF INE ON Sp02 ON PA OFF NIBP ON c02 OFF A NEXT ON OFF INSERV PREV MENU To enable the display of a waveform or large NIBP numerics select ON ECG cannot be set to OFF The monitor displays the first three active waveforms set to ON in the order of priority listed in the Wave Select window If NIBP is ON and only one or two other waveforms are ON and active the monitor displays large NIBP numerics in a waveform window 48 Patient monitoring Welch Allyn Propag Encore Vital Signs Monitor Important information about automatic measurements A blood pressure measurement will begin when the minute of the time of day clock is evenly divisible by the interval For example if the interval is set to 10 minutes measurements will begin at the hour and at 10 20 30
23. Guide Alarms and limits 15 A WARNING f a patient s vital sign value falls outside of the upper or lower alarm range limit STAT SET turns off the alarm and the alarm limit except for the following The lower alarm limits for SpO and ETCO are not turned off by STAT SET 2 If HR PR ALARM LIMITS in the Settings window is set to CANNOT TURN OFF STAT SET affects HR PR alarm limits as follows e For an overrange HR PR patient value displayed as the upper alarm limit is set to the maximum alarm limit and the lower alarm limit is unchanged e For an underrange HR PR patient value displayed as the lower alarm limit is set to the minimum alarm limit and the upper alarm limit is unchanged e For an indeterminate HR PR patient value displayed as the alarm limits are unchanged Power up equipment alert program fault settings lost If a PROGRAM FAULT SETTINGS LOST TIME DAY RESET equipment alert appears when you turn on the monitor the monitor cannot recall the programmed custom settings and current time and date This can occur if the battery is drained or after new software has been installed If this occurs the monitor provides a special sequence of display windows to help you regain use of your monitor as quickly as possible Refer to Powerup equipment alert program fault settings lost on page 11 and perform the described steps If you follow these steps and the equipment alert reappears at powerup the
24. If an Apnea or RR BR alarm condition is detected an OxyCRG will be queued to print 75 seconds after the alarm is detected The parameters which have alarmed in the two minute period are indicated by the highlight of the corresponding labels Reference Guide Printing 83 Printing trends Printed trends are useful for reviewing the patient s vital signs over the last several minutes to the last five hours The Propaq enables you to print one trend or several trends with a press of a button or automatically at 4 hour intervals Printing a single trend The best way to print just one trend is with the PRINT button in the Trends Menu When you press the PRINT button the displayed trend is printed If you want to print a trend different from the one displayed press NXT TRND until the desired trend is shown Printing several trends The best way to print several trends at one time is to set up the printer to print the trends you want and then press the PRINT TRENDS button on the expansion module or the PR TREND button in the Printer Menu whenever you want the trends printed 1 From the Main Menu press SETUP MORE PRINTER MORE The printer trend select window appears 2 Using the NEXT and CHANGE buttons select each of the trends you want printed and turn them on Turn off all other trends 3 Now each time you want to print the selected trends press PRINT TRENDS NIBP TREND 02 16 98 This symbol indicates that the NIBP reading wa
25. More charging time may be required before the NIBP COs and printer can be operated Operating times using battery power The amount of time you can operate the Propaq Encore on each battery charge depends upon many variables including active options frequency of NIBP measurements frequency and length of print strips ambient temperature battery age and condition and what information is displayed 92 Power sources Welch Allyn Propag Encore Vital Signs Monitor For monitors without the Expansion Module or SpO option typical monitor operating time is about 2 hours at 25 C for a new fully charged battery This is when all patient channels are active and measurements are taken every 15 minutes For monitors without the Expansion Module but with the SpO option operating time is about 5 hours For monitors with the Expansion Module and printer SoO gt and CO options typical operating time is about 3 hours under the above conditions when print strips are generated every 15 minutes Monitor functions based on battery voltage As battery voltage drops during extended monitor battery operation error messages are displayed and monitor functions are discontinued in order of priority Checking battery voltage The Propaq s battery voltage is displayed on the initial powerup screen The battery voltage is also displayed with the Settings window Replacing the fuse The Propag Encore is protected against power surges by a 3 Ampere fu
26. SpO option Impedance pneumography RESP option The RESP option detects the rate or absence of respiratory effort and is configured with the Pulse Oximetry option Printer option The Expansion Module with Printer EMP provides a lightweight 3 channel recorder Reference Guide Getting started 9 Propaq to Acuity option This option allows communication between the Propag Encore and the Acuity Central Monitoring System by means of an ethernet network system installed in your facility The Acuity System operator can view the patient data and control most of the bedside Propaq functions The Propaq Encore connects to the Acuity System through an Acuity network cable that plugs into the Propag right side panel Modem Propag option This option allows telecommunication between a Propag Encore and the Acuity System by means of external modems This option is configured with the Propaq to Acuity option For more information refer to Modem Propag Reference Guide HP compatible side panel option The HP connectorcompatible option makes the Propag Encore compatible with many Hewlett Packard sensors and accessories used with the Hewlett Packard Component Monitoring System This option replaces the standard Propag Encore left side panel Using the Propag Encore System controls right side panel Defib Sync Connector DEFIB SYNCHRO Contact Welch Allyn technical oY support for information for O specifications see page 101 Rea
27. Thresholds are dependent on ECG cable type 20 ohms 0 06 Hz single pole to 3 2 Hz 2 pole 140 milliohms or 2x CVA whichever is greater Adult Ped 0 apnea 2 to 150 breaths min Neonate 0 apnea 3 to 150 breaths min 2 breaths min or 2 whichever is greater When CO is active CO is the BR source Otherwise RESP from ECG is the RR source 1 second 5 seconds Central apnea only alarm delay is set by the user Adult Ped 6 10 15 20 25 30 Neonate 6 10 15 20 seconds Presence of CVA is detected automatically Breaths will be picked in the presence of CVA unless the Breath Rate is within 5 of the Heart Rate or a sub multiple of the heart rate not rejected not detected Presence of CVA is detected automatically Breaths will be picked in the presence of CVA unless the Breath Rate is within 5 of the Heart Rate or a sub multiple of the heart rate not rejected not detected Reference Guide Invasive pressure Specifications 103 Applies only to models 204 and 206 Characteristic Specification Transducer Type Transducer Excitation Impedance Range Transducer sensitivity Excitation Voltage Connector Bandwidth Zero Drift Zero Adjustment Numeric Accuracy Pressure range Pulse range IBP Alarm Limit Ranges Leakage Current Electrosurgery interference suppression Strain gauge resistive bridge or HP quartz with HP Option 200 to 2000 Q 5 UV V mmHg
28. When only one waveform is selected a trend window automatically appears below the waveform While changing Propaq Encore settings a status window may appear below the waveform Patient waveform and trend information can be simultaneously displayed while numeric values are continuously updated HR PR SpO2 BR_ ETCO2 INCO2 A ETM HH MM Copa 2 6 0 mia ma K Dece TN 5 EAS PRS NXT FAND NRE Propaq Encore buttons The four buttons at the sides of the screen are reserved for the most commonly used functions ALARMS Silences or resumes alarm tone START STOP Starts and stops NIBP measurements The STOP function will automatically vent the cuff NET OFF Disconnects the monitor from the Acuity network if connected FREEZE UNFREEZE Freezes or unfreezes the waveforms If only one or two waveforms are displayed and you press FREEZE the frozen waveform s are shown along with an active waveform so you can continue to monitor the patient s condition MAIN MENU Pressing MAIN MENU always returns the monitor to the top level menu NET OFF WelchAliyn A FREEZE ALARMS MAIN MENU START STOP _ ES ws NIBP q The five labels above the associated buttons The five buttons below the screen and their associated labels located on the screen provide access to the menus Later in this manual the notation A B C is used as a shorter way to say Press Button A then B then C Referen
29. hose connector onto the NIBP connector on the monitor s left side P If motion artifact such as shivering coughing or vehicle motion interferes with NIBP readings do the following Position the patient s limb away from the body so the applied cuff is not in contact with the patient s body or any other object such as a bed rail Try to keep the cuff at the same level as the heart Connect the ECG leads to the patient and perform ECG monitoring during NIBP Set up the NIBP channel Press the NIBP button to display the status window and menu 46 Patient monitoring NIBP values and units of measure Last measurement rotate in and out of this window for up to one hour International Measurement mode Time remaining in Turbocuf Mode or Auto Mode interval Manometer Bar 50 Systolic diastolic and Welch Allyn Propaq Encore Vital Signs Monitor This symbol indicates the NIBP reading was taken in the presence of high motion artifact while monitoring ECG Artifact can affect accuracy To help reduce artifact see page 45 Time of last measurement English only NIBP values are displayed in one of these windows if MODE TURBOCUF a vacant After 16 TIME 4 21 minutes the display SLAMS 2 ON 58 changes to that shown below for 44 minutes mean values are indicated STOP AUTO MANT INTERVAL TURBOCUF SMARTCUF above the manometer as small triangles Alarm Limits Bell START STOP Starts and stops NIBP
30. in the equipment alert window and indicates a probe has been disconnected from the monitor after being plugged in for more than a few seconds SEARCH during the search time the SpO channel tries to detect blood pulsing through the measurement site Once the measurement has been established the oxygen saturation value is displayed in the numeric window STANDBY is displayed in the numeric window when the SpO gt sensor is disconnected from the patient an alarm occurs and you press the STANDBY button STANDBY is also displayed if you first plug the SpO sensor cable into the monitor connector before attaching the SpO gt sensor to the patient DEFECTIVE SpO2 SENSOR If you see the error message DEFECTIVE SpO2 SENSOR either the sensor is not compatible with the monitor or the sensor is not working properly Check Products and Accessories 810 0409 XX to be sure the sensor is compatible If compatibility is not a problem try another sensor Reference Guide Patient monitoring 57 Capnography C03 Intended use The Propaq s Capnography CO option is intended to noninvasively measure the following vital signs or events End tidal CO ETCO Inspired CO INCO gt Breath Rate and Apnea The CO option is available as Mainstream CO Sidestream CO or Dualstream cop Although Dualstream CO provides both Mainstream CO and Sidestream CO monitoring only one method can be used at a time The v option is required for any Pro
31. measurements Any time the Propaq Encore is AUTO MAN INTERVAL TURBOCUF SMARTCUF taking a noninvasive pressure measurement the START button changes to STOP So you can stop the measurement in progress This button initiates the same action as the START STOP button at the left side of the screen Pressing STOP will automatically vent the cuff This button switches the mode between Automatic or Manual Mode The Manual Mode is the default unless you change it by reprogramming your Propaq Measurements can be taken at intervals of 1 2 3 5 10 15 30 and 60 minutes Press START to initiate a measurement Selects the interval at which NIBP measurements are automatically taken The interval you select ranging from one minute to 60 minutes is shown on the display next to the word TIME Automatically starts NIBP measurements and continues to take as many measurements as possible within five minutes Enables or disables the Smartcuf motion artifact filter NIBP measurements can still be taken when Smartcuf is off Artifact may interfere with the accuracy of NIBP measurements with Smartcuf off Reference Guide Patient monitoring 47 NIBP Displayed in Waveform Window By turning on NIBP in the wave select window the NIBP numerics can be displayed in a waveform window The numerics are shown in large 0 characters for 16 minutes for each new A 1 3 5 8 1 1 059 measurement taken P mmHg TIME SINCE READING O min NIBP
32. monitor Note The monitor displays STANDBY in the SpO5 numeric window until it measures and displays the SpO gt value As oxygen saturation increases and decreases the pitch of the heart tone rises and falls The monitor self calibrates the SpO channel whenever the monitor is first turned on or a sensor is first connected to the SpO gt channel 3 From the Main Menu press SpO2 or SpO2 CO2 then SpO2 to display the SpO menu similar to the following Oxygen saturation percentage Spocw eel PREV MENU Pulse amplitude indicator not proportional to pulse volume 4 Press SIZE to adjust the waveform size for best viewing 1x 2x 4x or 8x 5 Adjust the placement of the sensor until a good SpO waveform is displayed A waveform with artifact may cause erroneous oxygen saturation readings 6 Set alarm limits according to your hospital s standards Note To help minimize false alarms the Propaq monitor briefly delays or holds off triggering both audible and visual alarms for limit violations for SoO and Pulse Rate for 10 seconds After the alarm hold off period begins if the monitor detects that the patient s vital sign has returned to acceptable limits the monitor cancels the alarm hold off The next time a vital sign limit is violated the monitor starts a new hold off period The averaging time for SpO measurements is fixed at eight seconds 7 If patient movement interferes with measurements consider
33. monitor may need to be serviced and the battery replaced Contact a qualified service person Troubleshooting system error messages If the monitor detects a system error it will display a message similar to the following ERROR NUMBER 1 123 4567 REMOVE CUFF FROM PATIENT PLEASE NOTIFY YOUR LOCAL SERVICE REPRESENTATIVE OR WELCH ALLYN PROTOCOL INC This type of message indicates that the monitor detected an internal system problem which may require service for the monitor If the monitor displays this message disconnect the monitor from the patient Write down the error number for the service department and send the monitor to your facility s biomedical engineering department Note The message REMOVE CUFF FROM PATIENT as shown above does not imply that the detected error is related to NIBP It is simply a reminder to disconnect the NIBP cuff from the patient if a cuff is connected 76 Alarms and limits Welch Allyn Propag Encore Vital Signs Monitor 11 H Trends Every two minutes the Propaq Encore collects the monitored vital sign numerics and stores them in its trend memory which can save the last five hours of trend information See NIBP Trends on the next page for exceptions All this information can be printed and viewed as a trend print The trend status window and menu There are five trends NIBP RESP P1 P2 and TEMP Except for NIBP all vital signs are continuously monitored from the time monitoring begins
34. noise can cause the displayed heart rate to be erratic even though the ECG trace may look clean with the pacer indicator off Fix the noise problem by using fresh ECG electrodes and an ECG cable whose lead wires make good connections 36 Patient monitoring Welch Allyn Propag Encore Vital Signs Monitor Using the filter to better display a waveform The Propag Encore includes a filter that reduces noise from the ac power signal and produces a much clearer ECG waveform To set the filter press SETUP MORE MORE SERVICE YES to access the Service Menu MORE MORE SETTINGS to display the Settings Menu Select the FILTER function with the NEXT button and press the CHANGE button to change settings Set the filter to the ac mains frequency of your hospital either 60 or 50 Hz Simultaneous equipment alerts MULTIPLE If multiple equipment alerts occur simultaneously the Propaq monitor displays this message In this situation the source of the alert may not be displayed resulting in the message MULTIPLE Look for blank numeric or waveform areas on the display or status messages at the top of the display to identify the source s of multiple alerts Note The monitor can also display MULTIPLE LEAD FAIL if for example there is a problem with an ECG lead and RESP lead at the same time In this case the monitor will alternately display ECG FAULT and RESP FAULT Check all ECG and RESP leads for proper connection and operation ECG messages
35. occurs during the suspend period you can acknowledge dismiss a indications of the alert by pressing any key as usual Reference Guide Alarms and limits 71 Inhibit alarm and alert tones indefinitely ALL ALARMS Note This feature requires access to the Service Menu The Service Menu features are not intended for use during ordinary routine operation You can suspend potential or current alarm and alert tones for an indefinite period of time The tones are disabled until someone re enables them Indefinitely suspend all alarm and alert tones 1 Press MAIN MENU SETUP MORE MORE SERVICE YES MORE MORE SETTINGS ALL ALRM YES WARNING Whenever audible alarm tones are disabled make sure the patient A is closely observed Resume all alarm and alert tone capability 1 Press O Q Indications during an all alarms suspended period At the Propaq Encore Monitor At the Acuity Central Station If an alarm or alert occurs during the suspend period the usual visual alarm and alert indications are displayed Propaq monitors connected to Acuity Central Station Apnea or life threatening arrhythmia alarm tones interrupt Apnea or life threatening arrhythmia alarm tones the suspend period interrupt the suspend period Standalone Propaq monitors Apnea alarms do not interrupt the suspend period and arrhythmias are not detected To resume alarm and alert tone capability press To resume alarm and alert tone capabilit
36. sampling O delivery Disposable single use 90 or 175 ml min user selectable a Based on the following additional airway conditions Sample line 7 ft 0 055 in ID 2 13 m 1 4 mm ID Sample flow rate 175 ml min Welch Allyn watertrap new unused b BTPS Body Temperature and Pressure Saturated ATPS Ambient Temperature and Pressure Saturated STPD Standard Temperature and Pressure Dry Reference Guide Alarms Trends Specifications 111 Characteristic Specification Indicators Tone Frequency Tone Patterns Selectable Tone Volume Limits Control Alarm on Tachycardias Apnea delay setting Flashing red alarm bell light patient alarm s Continuously on red alarm bell light patient alarm silenced or suspended Flashing yellow crossed alarm light equipment alert Continuously on yellow crossed alarm light one or more patient alarm limit s off 900 Hertz Apnea 1 second on 1 second off Patient alarm 1 second on 2 seconds off Equipment alert 1 second on 4 seconds off Low Medium High Settable on all parameters Automatic preset or manual settings Most tachycardias will alarm in less than 8 seconds These include AAMI 3 1 2 1 part f waveforms Certain multifocal tachycardias may initially alarm as low rate Adult Ped 6 10 15 20 25 30 seconds Neonate 6 10 15 20 seconds Alarm Holdoff Time Period HR PR 3 seconds except NIBP PR Sp0 10 seconds RR BR 5
37. that provides simulated signals for all patient parameters so that function of the display alarms and printer can be explored easily The in service mode is activated by the INSERV button Invasive Pressure Label The two or three character label that appears in the Invasive Pressure Numerics Window identifying the source of blood pressure Labels The names appearing above the buttons Mainstream A respiratory CO measurement technique which uses a noninvasive sensor located at the endotracheal tube This technique avoids signal delays and fluid problems associated with other techniques Menu A group of labels above the bottom front row of buttons on a Propag Encore NIBP Status Window The window that appears when the NIBP button is pressed This window displays NIBP information Numerics The numbers that appear along the top and right side of the display for heart rate blood pressure temperature etc OxyCRG An oxygen cardiorespirogram a graph showing heart rate SpO and a condensed respiratory waveform P1 A generic label for invasive pressure channel one P2 A generic label for invasive pressure channel two PA Pulmonary artery label for an invasive blood pressure channel Parameter See Vital Sign Parameter Patient Alarm The condition that exists when a vital sign parameter numeric violates an alarm limit Patient Channel ECG P1 P2 T1 T2 SpO CO NIBP and RESP Patient Mode Selects Adult Pediatr
38. that the patient s HR PR vital sign has returned to acceptable limits the Propag cancels the alarm holdoff The next time an HR PR limit is violated the Propaq starts a new 3 second HR PR alarm holdoff period How ECG RESP is displayed Because of the critical nature of monitoring ECG it is always displayed in the top part of the waveform display area The ECG waveform is the only waveform that cannot be turned off using the Setup Wave Select Menu Respiration rate numerics are sourced from the CO channel and displayed as BR when CO is active Otherwise respiration rate numerics are sourced from the ECG RESP channel and displayed as RR Patient artifact Patient movement and other artifact might cause the waveform to move on the display Most artifact such as this is automatically detected and the waveform is adjusted so that it always remains centered in the waveform window Severe artifact and interference such as interference from defibrillation may cause the waveform to move off the display The Propag Encore will always automatically reposition the waveform in just a few seconds so you can see it again ECG RESP menus and status window A ECG SIZEJECG LEAD RESP SZEJ MORE ECG SIZE Selects the ECG waveform size sizes are shown in millivolts per centimeter 2 5 1 2 or 4 mV cm to the left of the waveform ECG LEAD Selects the ECG lead The available leads are lead Il Ill aVR aVL aVF or V The Propaq s factor
39. the pulse oximeter s systole determination to the R wave to reduce the effects artifact may have on SpO measurements Under some conditions you may find more stable SpO readings with C LOCK set to ON SYNC appears next to the waveform when synchronization to the ECG has been obtained Synchronization takes a few seconds to establish the first time If C LOCK is on and the HR source is SpO the heart rate source is automatically changed to ECG An ECG signal must be present or C LOCK does not activate If you get false SpO gt alarms with patients with low perfusion states or multiple arrhythmias try turning off C LOCK 10 Set alarm limits according to your hospital s standards Note To help minimize false alarms the Propaq monitor briefly delays or holds off 11 triggering both audible and visual alarms for limit violations for SpO and Pulse Rate for 10 seconds After the alarm hold off period begins if the monitor detects that the patient s vital sign has returned to acceptable limits the monitor cancels the alarm hold off The next time a vital sign limit is violated the monitor starts a new hold off period If patient movement interferes with measurements consider the following possible solutions be sure the sensor is secure and properly applied use a new sensor with fresh adhesive backing select a different type of sensor move the sensor to a less active site 56 Patient monitoring Welch Allyn Propag Encore Vital S
40. trend values and alarm limit settings At powerup the Propaq has an NIBP default inflation pressure cuff inflation target based on the patient mode see NIBP on page 104 for the values After each NIBP measurement the Propaq adjusts the target inflation pressure to optimize the next NIBP measurement To avoid possible patient discomfort be sure to turn the monitor off and then on between different patients to reset the cuff inflation target to the default value Place and connect the cuff 1 Squeeze as much air from the cuff as you can before placing it on the patient Reference Guide Patient monitoring 45 Cuff applied evenly and Possible cuff snugly with bottom edge of placements for cuff one inch above neonates antecubital fossa 2 Place the cuff on the limb When you place the cuff it should ideally be placed at the same level as the heart If above the heart add 1 9 mmHg to the NIBP measurement for every inch the cuff is above the heart If below the heart subtract 1 9 mmHg for every inch The cuff should fit snugly but not be uncomfortable The hose must not be kinked or pinched Ensure that the cuff tubing is centered over the brachial artery Note Acuff that is not properly connected to the patient may result in a false reading if the patient and cuff are moved by motion artifact or clinical personnel during the NIBP measurement Always verify the cuff is properly placed on the patient wm Screw the
41. 101 RESP 102 Sp02 106 TEMP 105 trends 111 Sp02 8 Adjust waveform size 53 54 C LOCK 55 Display 53 54 Menu 1 17 Menu 2 17 NIBP and Sp02 53 54 plethysmograph 79 printing waveforms 79 Reducing false alarms 53 55 relative gain 79 Welch Allyn Propaq Encore Vital Signs Monitor Response time selection 54 Sensor selection 53 54 size indicator 79 specifications 106 Sp02 Menus 53 54 Spot Check monitoring 56 Standby Mode 56 Sp02 C02 button 17 Spot Check Sp02 monitoring 56 STANDBY and Sp02 56 Standby Mode Sp02 56 START STOP button NIBP 16 46 START STOP button Printer 26 79 96 STAT SET 74 STAT SET button 74 Status Windows ECG 34 STBY message Sp02 STANDBY 56 Storage battery 95 monitor 95 printer paper 96 SWEEP mm s setting 20 Sweep speed C02 RESP 62 Symbol In NIBP displays and prints 45 78 80 83 Symbols defined 3 Synchronizing R waves C LOCK 55 T Technical service and training 97 Temperature accessories 50 connectors 50 intended use 50 messages 51 preparing for monitoring 50 specifications 105 TEMP F C setting 23 TIME DAY setting 22 Tone HR PR volume 34 powerup 11 Trends clearing data 78 column labels 78 continuous monitoring 77 how to display 78 how to select 78 maximum number of samples 77 Menu 18 77 NIBP 78 NIBP and symbol 78 Reference Guide NXT TRND button 77 78 83 OXYCRG button 77 Pl 77 P2 77 PRINT button 77
42. 2 breaths minute 31 breaths minute P Waveform Arterial Same as Initial Value P Pulse Rate 80 pulses per min 25 pulses per min P Systolic 121 mmHg 120 mmHg P Diastolic 79 mmHg 85 mmHg P Mean 96 mmHg 103 mmHg P2 Waveform Pulmonary Artery Same as Initial Value P2 Pulse Rate 80 pulses per min 125 pulses per min P2 Systolic 25 mmHg 25 mmHg P2 Diastolic 9 mmHg 12 mmHg P2 Mean 15 mmHg 18 mmHg NIBP Mode Manual Auto cancels in service Same as Initial Value NIBP umerics Actual values from patient Actual values from patient TI Numeric 37 0 C 39 1 C T2 Numeric 36 4 C 37 4 C AT Numeric 0 6 C 1 7 C Sp0 Waveform Normal 2x Same as Initial Value Sp0 Rate 80 pulses per min 125 pulses per min Sp02 Numeric 97 88 CO Waveform Normal Hyperventilating CO ETCO Numeric 38 mmHg 60 mmHg CO INCO Numeric 0 mmHg 8 mmHg C0 Breath Rate 12 breaths minute 31 breaths minute Reference Guide EMC compli Spec medi Specifications 121 ance ial precautions concerning electromagnetic compatibility EMC must be taken for all cal electrical equipment The Propaq Encore complies with IEC EN 60601 1 2 2001 e All medical electrical equipment must be installed and put into service in accordance with the EMC information provided in this document and the Propaq Encore Directions for Use or Propaq Encore Reference Guide e Portable and mobile RF communications equipment can affect the behavior of medical elec
43. 23 Default alarm limits Patient Mode 11 Defibrillators use with ECG 30 Defibrillator synchronization specifications 101 Disinfection instructions 93 Display Propag screen 15 specifications 112 Sp02 53 54 waveform priorities 22 Displaying ECG 33 INV PRS 39 NIBP 45 Display trends 78 E ECG accessories 31 artifact 33 connector 31 displaying 33 electrode placement 32 filter 36 Menu 1 17 Menu 2 17 messages 36 pacemaker patients 35 pre gelled electrodes 31 printing waveforms 79 specifications 99 Welch Allyn Propaq Encore Vital Signs Monitor Status Window 34 waveform priorities 22 ECG RESP Menu 1 33 Menu 2 33 ECG RESP button 33 ECG RESP Menu 1 ECG SIZE button 33 34 ECG RESP Menu 2 ECG LEAD button 33 RESP SZE button 34 ECG Bandwidth 30 34 ECG BANDWIDTH setting 34 ECG LEAD button 33 ECG Menu 2 CHANGE button 34 NEXT button 34 ECG SIZE button 33 34 Electrodes placement 32 pre gelled 31 Electrosurgical machines use with ECG 30 32 EMP see Expansion Module with Printer Environmental monitor specifications 113 Environmental limits operating 95 storage 95 Equipment Alerts Printer Fault 26 PROGRAM FAULT 11 75 ESIS 30 Expansion Module C02 8 Printer 8 Sp02 8 Extended Mode 30 34 Extended storage 95 F Factory defaults specifications 118 Factory patient modes 23 False alarms with Sp02 53 55 FILTER setting 23 36 FLOW
44. 3 N Neonatal Mode 42 Network Fault message 88 NEXT button 20 25 NIBP accessories 44 adult mode 42 Artifact 42 45 50 78 80 83 automatic intervals 48 automatic measurements 48 cardiopulmonary bypass 42 connector 44 cuff placement 44 cuff sizes 44 Welch Allyn Propaq Encore Vital Signs Monitor displaying 45 Menu 17 46 messages 48 49 Motion artifact 42 45 50 78 80 83 neonatal mode 42 pediatric mode 42 preparing for measurements 44 specifications 104 Symbol in display and prints 45 78 80 83 Ticket 80 waveform window displayed in 47 NIBP button 45 47 NIBP Menu AUTO MAN button 46 INTERVAL button 46 START button 46 STOP button 46 TURBOCUF button 46 NIBP TICKET setting 25 NO INSRV button 19 Noninvasive blood pressure see NIBP NXT TRND button 77 78 83 O Options C02 8 HP compatible side panel 9 Printer 8 RESP 8 Sp02 8 Ordering 97 OXYCRG button 77 OXYCRG ON ALARM setting 25 Oxygen saturation display 53 54 P PA label for pulmonary artery pressure 40 Pacemakers detection 35 use with patients 35 PACER DISPLAY setting 34 Paper printer 96 Patient artifact 33 Patient connectors 13 C02 13 ECG 13 HP option 13 INV PRS 13 NIBP 13 Sp02 13 TEMP 13 Patient Mode 31 59 Adult 42 Reference Guide Custom 23 default alarm limits 11 factory default 11 Neonatal 42 Pediatric 42 PATIENT MODE setting 21 Pediatric Mode 42 Physical mo
45. 4 85V Pulsed de 181 Hz ITT Cannon plug MS3106F 14S 6P Std Hewlett Packard compatible 12 pin connector optional Digital filtered de to 20 Hz 1 mmHg without transducer drift 200 mmHg including transducer offset 2 mmHg or 2 of reading whichever is greater plus transducer error 30 to 300 mmHg 25 to 250 beats per minute All patient modes Systolic Diastolic Mean 30 to 300 mmHg Meets ANSI AAMI risk leakage requirements Included in all models a Transducers with 40 pV V mmHg sensitivity are not compatible b Duty factor depends on transducer impedance For 200 to 900 Q duty factor is 11 Above 900 Q the duty factor increases to 91 c At pulse rates exceeding 250 beats per minute refer to the IBP waveforms on the display or printout to determine systolic and diastolic pressures Standard 6 pin IBP connector HP 12 pin IBP connector side panel view side panel view SIGNAL SIGNAL EXC SIGNAL EXC Y ao SHIELD 104 Specifications NIBP Welch Allyn Propaq Encore Vital Signs Monitor Characteristic Specification Method Control Auto Intervals Turbocuf Displayed Pressures Systolic Range Diastolic Range Mean Range Static Manometer Accuracy Minimum Inflation Pressure Maximum Allowable Pressure Default Inflation Pressure Normal Overpressure Limit results in up to 2 retries Single Fault Overpressure Limit Leak Rate Pulse R
46. 5 minutes the channel will briefly deactivate until a new calibration has occurred LOW BATTERY NIBP DISABLED ERR 11 The battery lacks sufficient voltage to be able to operate the NIBP channel Connect the Encore to the ac power adapter SERVICE REQUIRED NIBP DISABLED ERR 12 Have the monitor serviced CUFF TOO LARGE FOR PATIENT MODE ERR 13 The monitor detects a cuff too large for the current patient mode First verify the patient mode If the patient mode is correct make sure the cuff fits snugly If this alert occurs in Neonatal Mode change the patient mode to Pediatric Mode and check alarm limits If the alert occurs in Pediatric Mode change to Adult Mode and check the alarm limits Note that different pressures and retries are used for each mode as stated in NIBP on page 104 KINKED OR NEONATE HOSE ERR 14 This message occurs when the neonate hose is detected in adult patient mode Change the hose or the patient mode selection ARTIFACT PRESENT MINIMIZE ARTIFACT ERR 15 The monitor has detected too much artifact to allow accurate readings Take steps to reduce artifact Position the patient s limb away from the body so the applied cuff is not in contact with the patient s body or any other object such as a bed rail If the Smartcuf motion artifact filter is on make sure that the ECG leads are properly connected to perform ECG monitoring during NIBP If the Smartcuf motion artifact filter is off consider turning
47. 9 Real time ECG analog defib Sync ooo 101 Impedance pneumography RESP 0 0 0 0 eee 102 INvaSiVe Pressure 2 eee 103 A E TA Ada areas ahs ata 104 Temperature id A A AI 105 Pulse oximetry Sp mu A A De ee ee 106 Capnography COs end saves E EA Bees Glen pe aes Gees ee 108 PALAIS recent se Nan ten acs A aes erecta 111 MESA tee ee A e aca ne Ba cb a asec ened oa ane vate 111 Display zs 2 ts A a all ats oe A ey aoe ee 112 Monitor environmental anaana aaan aaae 113 Monitor Physicals as siene dd al page eed a a hatte eae deg eniT 114 Pintelier so eek ds E te e ANAE VE Bila E ti n 115 E ete ee le Le ee oe kay Pad ates Oe 116 POWER AGE DtEIS s a ou fre ya teh shan da A Sued oS 9 he tae 117 Factory detault settingS lt 3 040 444 boat a a ndak e eh ord bhp cal tl ea 118 In service Simulated Values 2 0 0 0 ees 120 EMGscomplidihiG e 21d da clans Sealand ale 121 Glossary yaad pene terres tense eee ys 125 1 General information Safety summary This Safety Summary should be read by all Propag Encore users Specific warnings and cautions will be found throughout the Propaq Encore documentation where they apply A A Caution Federal U S A law restricts this device to sale distribution or use by or on the order of a licensed medical practitioner WARNING This monitor is to be operated by qualified personnel only The operator of this monitor should read this entire manual the monitor reference guide or directions fo
48. CG set for extended bandwidth ST segments may be accurately displayed and printed The Propaq Encore ECG s bandwidth is 0 5 40 Hz in Monitor Mode and 0 05 40 Hz in Extended Mode Monitor Mode is useful to minimize baseline wander due to respiration or other artifact However in Monitor Mode ST segments can be distorted potentially causing underestimation of ST elevation and overestimation of ST depression Always use Extended Mode when observing ST segment morphology on the display or printer The Propaq Encore can be used during procedures using electrosurgical machines and defibrillators However even though the ECG channel contains electrosurgical interference suppression ESIS circuitry noise artifact may be displayed on the ECG trace while an electrosurgical device is in use This will vary depending on ECG electrode placement and the operative site A WARNING High intensity radio frequency RF energy from external sources such as an improperly connected electrosurgical unit can induce heat into electrodes and cables which can cause burns on the patient Reading errors and damage to equipment may also result This hazard can be reduced by 1 avoiding the use of small ECG electrodes 2 selecting ECG electrode attachment points remote from the surgical site and from the electrosurgical return electrode 3 using electrosurgical return electrodes with the largest practical contact area and 4 assuring proper application of the elect
49. CO value actual CO value x 1 03 N20 gt 50 CO value actual CO value x 0 952 Note If the ETCO value is displayed as verify calibration against a known reference gas If the sensor calibration is not accurate return it to Welch Allyn for service Reference Guide Patient monitoring 63 6 Press RESPONSE to select either NORMAL SLOW or FAST The FAST setting is recommended where a sudden step change in ETCO is of concern such as that induced by an air embolus in certain neurosurgical procedures A SLOW response will decrease ETCO false alarms when breath morphology varies considerably from one breath to the next The default setting is NORMAL Response Time Sampling Period Typical Indications for Use Setting FAST 15 seconds During neuroanesthesia NORMAL 30 seconds During routine use SLOW 45 seconds To decrease ETCO false alarms Set alarm limits for ETCO INCO and Breath Rate A WARNING For patient safety it is recommended that the Breath Rate alarm limits always be turned on and set appropriately Motion artifact or other factors can cause false RR BR alarms To help minimize false alarms the Propaq delays or holds off triggering a RR BR alarm for 5 seconds After this holdoff period begins if the Propaq detects that the patient s RR BR vital sign has returned to acceptable limits the Propaq cancels the alarm holdoff The next time a RR BR limit is violated the Propaq starts a
50. Engineer for service DEGRADED WAVEFORM SERVICE REQUIRED Send the Propaq to a Biomedical Engineer for service LACK OF WAVEFORM SERVICE REQUIRED Send the Propag to a Biomedical Engineer for service MOTOR FAILURE SERVICE REQUIRED The sensor hardware has failed Send the Propaq to a Biomedical Engineer for service NO WATERTRAP DETECTED There is no Sidestream CO watertrap or Sure CO watertrap installed Install a watertrap or Sure CO watertrap adapter OCCLUSION CHECK EXHAUST PORT TUBING Blockage has been detected on the pneumatic exhaust port Check the exhaust port and related tubing for occlusions Make sure that the sampling line and any inputs to the patient breathing apparatus are not connected to the exhaust port OCCLUSION CHECK WATERTRAP TUBING Blockage has been detected on the Sidestream CO input Check the watertrap sample line and any connected tubing for occlusion PUMP FAILURE SERVICE REQUIRED The pump is not able to maintain the target flow rate Send the Propag to a Biomedical Engineer for service SIDESTREAM STICK EEPROM FAILURE Send the Propaq to a Biomedical Engineer for service SSP BOARD EEPROM FAILURE Send the Propaq to a Biomedical Engineer for service 69 Alarms and limits Description of alarm and alert tone patterns e Patient alarm tone pattern one second on two seconds off e Apnea alarm tone pattern one second on one second off fastest e Equipment alert tone patt
51. General information caso cases a odds 1 Safely SUMMARY 4 26 00 xa Ad eet ee oe a Pe 1 Propaq Encore documentation o 5 2 Getting started lts OA ee Ves wa Pte Ma OS ee we 7 Introducing the Propag Encore s asana aaaea eee 7 Using the Propaq ENCO Eaa seek a tia G 9 Monitor SETUP i em soleil i gla dnde 20 Printer TUMCTIONS sasea aisle ta ol AS ll A ad es e bas at LAN 25 Learning the Propaq Encore 0002 cc te 26 3 Patient MONITOFING is 2 ada e dale ps a es ake Meas ele die 29 ECG RES ip foes to e gi oe O cae eh kee atc AETA E pte ke 29 INWASIVE PFESSUPE ai Bek hata lee ny edd Gere i a lect E al he 37 NIB Rete A Me ttt AA eh i tN tte IR ES 42 TEM perature oc fn tha lef AG Mes E bh Deh dhe RPS hae dado te aed 50 PUISE OXIMEthY SPO2 3 ost ag ale san dl pe dade 52 CapnoOgraphyiCO2 s cia sconce wel o en at ected te Mota Se iene 57 4 2 Alarms and MMS sta ae eek eee Reese eae eee A 69 Description of alarm and alert tone patterns 0 0202000005 69 Silence an active patient alarm or equipment alert tone for 90 seconds 69 Inhibit alarm and alert tones for four minutes 4 SUSPND 70 Inhibit alarm and alert tones indefinitely ALL ALARMS 0 71 Summary of alarm and alert keys and Acuity Central Station messages 72 Al arity oldom See bat MS arcada a 414 ol o ll kh ate Md Da A e hahah A A 9s 73 settingiala Ime a GEE hee hae Re a ev eee 7A Powerup equipment alert program fa
52. IUM HR PR TONE LOW HR PR SOURCE ECG RR BR Source CO if ON or ECG if CO OFF Patient Mode Adult ECG Bandwidth Monitor ECG Size 1 mV cm ECG Lead ll ECG Filter 60 Hz ECG Pacer ON RESP size 2X RESP lead Ld2 RESP sweep 6 25 mm sec RESP ON OFF ON RESP window ON IBP Range 0 to 180 mmHg IBP Rescale 0 to 140 mmHg IBP Mode RESCALE Invasive Pressure Formats Label dependent NIBP Mode MANUAL NIBP Auto Time 15 min SpO SIZE 2x Sp0 C LOCK OFF SpO Response NORMAL TEMP F C Celsius CO Range 0 to 60 mmHg CO Sweep 6 25 mm sec CO Response NORMAL CO Units mmHg CO Gas Compensation OFF Sidestream CO Flow Rate Adult 90 ml minute Ped 90 ml minute Neonate 90 ml minute The flow rate cannot be programmed to a different value in a Custom Patient Mode See Custom Patient Modes Display Wave Select Trend Group All waves are on except NIBP NIBP Alarm Limits All are ON except P2 HR Limits Adult 50 Ped 50 Neonate 120 beats per minute 50 beats per minute 100 200 beats per minute NIBP Limits Systolic Adult 75 Ped 75 Neonate 220 mmHg 5m 0 1 mhg 00 mmHg NIBP Limits Diastolic 10 Om 0 7 Adult 35 Ped 35 Neonate mmHg g mmHg NIBP Limits Mean 4 5 1 0 3 Adult 50 1 Ped 50 Neonate 20 10m 35 8 mHg g mmHg P1 P2 Limits Systolic Adult 75 220 Ped 75 145 m Neonate 50 100 mmHg mH
53. MENU 20 Getting started Monitor setup Welch Allyn Propaq Encore Vital Signs Monitor Setup Menu 1 is accessed by pressing the SETUP button on the Main Menu STATSCALE ALARMS WAVE SEL TRENDS MORE STATSCALE ALARMS WAVE SEL TRENDS MORE NEXT CHANGE PRINTER MORE CURRENT SOURCE SELECTED SOURCE Automatically readjusts all waveform scales Allows access to the Alarms menu Allows you to turn on and off desired waveforms or NIBP numerics for display Allows access to the Trend settings and display Displays the next setup menu and the following status window SETUP HR PR RR BR CURRENT SOURCE ECG MCO2 SELECTED SOURCE ART SWEEP mm s O 3115 ALARM TONE HIGH HR PR TONE LOW PATIENT MODE E PRINT Selects the next setting in the status window Changes the currently selected display setting Pressing CHANGE at PATIENT MODE allows you to choose between Adult Pediatric and Neonatal in a Patient Mode window Allows access to the Printer Menu Allows access to the Time Day window When the selected HR PR source is no longer available the current source is the active source with highest priority The RR BR source cannot be manually selected It will always be CO if CO is active Otherwise it will be ECG RESP The userselected HR PR source is displayed along with the HR PR source currently being used by the monitor SWEEP mm s The selectable sweep speeds
54. Propaq Encore Vital Signs Monitor Reference Guide Models 202EL 204EL 206EL Software version 2 5X WelchAllyn Advancing Frontline Care ii Welch Allyn Propaq Encore Vital Signs Monitor Copyright 2007 Welch Allyn All rights are reserved No one is permitted to reproduce or duplicate in any form this manual or any part thereof without permission from Welch Allyn Welch Allyn assumes no responsibility for any injury to anyone or for any illegal or improper use of the product that may result from failure to use this product in accordance with the instructions cautions warnings or statement of intended use published in this manual Welch Allyn Propag Propaq Encore Acuity Smartcuf and Flexible Monitoring are registered trademarks of Welch Allyn FlexNet and ParamSet are trademarks of Welch Allyn SETS and Masimo are registered trademarks of Masimo Corporation Possession or purchase of a Masimo SpO equipped monitor does not convey any express or implied license to use the device with unauthorized sensors or cables which would alone or in combination with this device fall within the scope of one or more of the patents relating to this device Nellcor and Oximax are registered trademarks of Nellcor Puritan Bennett Software in this product is copyright by Welch Allyn or its vendors All rights are reserved The software is protected by United States of America copyright laws and international tre
55. RATE button 60 FORMAT P1 P2 buttons 40 FREEZE UNFREEZE button 16 26 Fuses replacing Unversal Power Adapter 90 G GAS COMP button 59 60 62 Reference Guide Gas compensation for C02 57 62 H HP connector compatible option 9 HR PR TONE setting 21 34 ICP label for intracranial pressure 40 Impedance Pneumography see RESP INSERV button 19 26 In service mode 26 simulated trend data 26 using with NIBP 27 what you can do 27 what you cannot do 27 Inspect the monitor 93 INTERVAL button 46 Introduction 7 Intubated patients 57 Invasive pressure accessories 37 connectors 37 displaying 39 intended use 30 37 Menu 1 17 Menu2 17 messages 38 41 numerics 39 numerics formats 40 preparing for monitoring 38 printing waveforms 79 range 37 rezeroing a transducer 39 scales 40 specifications 103 transducer sensitivity 37 transducer zeroing 38 Invasive pressure labels ART arterial 40 CVP central venous pressure 40 ICP intracranial pressure 40 P1 40 P2 40 PA pulmonary artery 40 selecting 39 UA umbilical artery 40 UV umbilical vein 40 INV PRS button 38 39 INV PRS Menu 1 CANCEL button 40 RANGE button 40 RESCALE button 40 ZERO P1 P2 buttons 40 Index 133 INV PRS Menu 2 FORMAT P1 P2 buttons 40 LABEL P1 P2 buttons 40 L LABEL P1 P2 buttons 40 Learning the Propaq 26 Left side panel patient connectors 13 Lights ALARM 10 ALARM S OFF 10 b
56. SLOW 60 Patient monitoring SOURCE Welch Allyn Propag Encore Vital Signs Monitor Changes between Mainstream CO and Sidestream CO monitoring if both options are installed or disables CO monitoring Setting CO2 SOURCE to OFF allows you to disable CO monitoring without removing the sensor When the CO2 SOURCE is set to OFF the Propaq displays OFF for CO numerics SWEEP SPEED The CO and RESP display sweep speed set by the mm s button BAROMETER The ambient barometric pressure Note To change CO units use the Settings Menu under the Service Menus Changing these units will clear CO trends Sidestream CO menu and status window When Sidestream CO is active press MORE from the first CO menu to access the SCO menu and the SCO status window GAS COMPENSATION OFF RESPONSE C02 SOURCE SWEEP SPEED BAROMETER FLOWRATE z NORMAL SIDESTREAM 6 25 mm s 762 0 mmHg 75 ml min GAS COMP RESPONSE SOURCE FLOWRATE JP PREV MENU GAS COMP RESPONSE SOURCE Selects the measurement compensation for CO measurements Sets the response time for CO measurement NORMAL FAST OR SLOW Changes between Mainstream CO and Sidestream CO monitoring if both options are installed or disables CO monitoring Setting CO2 SOURCE to OFF allows you to disable CO monitoring without removing the sensor When the CO2 SOURCE is set to OFF the Propaq displays OFF for CO numerics SWEEP SPEED The CO and RESP display
57. Signs Monitor Recommended Separation Distances Between Portable and Mobile RF Communications Equipment and the Propaq Encore Monitor The Propag Encore monitor is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled The customer or the user of the monitor can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment transmitters and the monitor as recommended below according to the maximum output power of the communications equipment Rated Maximum Output Separation Distance According to Frequency of Transmitter Power of Transmitter m sb 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2 5 GHz d 1 2 JP d 1 2 JP d 2 3 JP 0 01 0 12 0 12 0 23 0 1 0 38 0 38 0 73 1 1 2 1 2 2 3 10 3 8 3 8 7 3 100 12 12 23 For transmitters rated at a maximum output power not listed above the recommended separation distance d in meters m can be estimated using the equation applicable to the frequency of the transmitter where Pis the maximum output power rating of the transmitter in watts w according to the transmitter manufacturer Note 1 At 80 MHz and 800 MHz the separation distance for the higher frequency range applies Note 2 These guidelines might not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people 125 Glossary
58. T A y NXTTRND OXYCRG ALARMS MENU L STATSET 4SUSPND LIMITS PREV MENU RESUME ALARM LIMITS MENU NEXT UP DOWN ON OFF NEXT PAGE ON OFF button is not displayed for HR PR alarm limits if the HR PR ALARM LIMITS setting is set to CANNOT Reference Guide Getting started 19 Key press route to setup menu 2 NIBP ECG RESP INV PRS Sp02 C02 SETUP y SCATSCALE ALARMS WAVE SEL TRENDS MORE gt A Service menu tests are for use by authorized SETUP MENU 2 service personnel only and are available only when in the Adult patient mode NEXT CHANGE WAVE SEL PRINTER MORE TIME DAY MENU NEX UP DOWN ENTER SERVICE PREV MENU Ee CE MENU 1 NIBP TEST IBP TEST Sp02 TST C02 TEST MORE 4 SERVICE MENU 2 TEMP TEST PIXL TST NET TEST MORE SERVICE MENU 3 SETTINGS KEY TEST SYSTEM MORE SETTINGS MENU NEXT CHANGE ALL ALRM PREV MENU PRINTER SETUP MENUS Printer Setup status L o NEXT CHANGE PR TREND MORE PREV MENU A x A Printer Trend Select status window i NEXT CHANGE PR TREND MORE PREV MENU WAVE SELECT MENU PREV MENU gt Patient Mode menu is accessed when CHANGE is pressed for PATIENT MODE NEX ON OFF INSERV NO INSRV PATIENT MODE MENU NEONATAL PED ADULT SETUP PREV MENU MODE SETUP MENU 1 NEXT POWERUP USE NOW SAVE PREV
59. Umbilical artery label for an invasive blood pressure channel Unfreeze Returns the waveforms to active display See also Freeze UV Umbilical vein label for an invasive blood pressure channel Vital Sign Parameter The measurements obtained from patient channels such as heart rate systolic diastolic mean pulse rate SpO COs etc Waveform Window The area in which waveforms are displayed Waveform Status Window See Waveform Window or Status Window Window An area on the display screen in which information is displayed YSI An acronym for Yellow Springs Instrument Company Zeroing The process by which an invasive pressure zero reference is obtained so that pressures can be related to atmospheric pressure This process also nulls out any residual pressure indicated by a transducer with zero pressure applied Index 131 A ac adapter connector 10 Accessories Products amp Accessories book 5 Acuity System 85 Acuity menu 87 connecting 85 Intended use 85 Network Fault message 88 printing at Acuity 87 Adult Mode 42 ALARM S OFF light 10 Alarm Holdoffs 73 111 ALARM light 10 Alarm Limits Menu 18 ALARM PRINT setting 25 81 Alarms limits for CO2 58 Menu 18 setting quickly STAT SET 74 specifications 111 ALARMS button 20 Alarms Menu STAT SET button 74 ALARM TONE setting 20 Apnea 59 alarm limit 63 Ticket 81 APNEA TICKET setting 25 ART label for arterial pressure 40 Artifact affec
60. ammable which trend window comes up first The NIBP trend window is the factory default To clear trend data before connecting a new patient the monitor power must be cycled This will prevent the trend data of a previous patient from being attributed to the new patient NIBP trends A maximum of 128 NIBP readings are collected up to 8 hours NIBP is not measured continuously like other vital sign parameters The numerics on this trend are captured at the time of the NIBP reading a TREND TIME HR PR Sp02 SYS DIA MEAN PA 35 HH mel mg Terr Pe 10 EINT sr When the SEARCH message appears in an NIBP TREND This symbol indicates that the NIBP reading was taken in display or printout it indicates that the monitor was not the presence of high motion artifact while monitoring able to complete an NIBP measurement during that ECG Artifact can affect accuracy To help reduce artifact period see Place and connect the cuff on page 44 01126 85 XK A NX If an error number ERR x is listed in an NIBP TREND printout or display it indicates that an NIBP equipment alert occurred See NIBP messages on page 48 for NIBP alert error numbers and definitions Displaying trends Displayed trends show the last five hours of data Trends are displayed if you are at the main menu and have only one waveform turned on in the wave selection window Trends are also displayed when you press the TRENDS button in the first Setup Menu Se
61. and making appropriate power connections WARNING Make frequent electrical and visual checks on cables and electrode wires 2 General information A Welch Allyn Propag Encore Vital Signs Monitor WARNING Avoid electrosurgery burns at monitoring sites by ensuring proper connection of the electrosurgery return circuit so that the return paths cannot be made through monitoring electrodes and probes WARNING During defibrillation keep the discharge paddles away from ECG and other electrodes as well as other conductive parts in contact with the patient Avoid contact with any accessories connected to the Propaq s left side panel WARNING To ensure patient safety the conductive parts of the ECG electrodes including associated connectors and other patient applied parts should not contact other conductive parts including earth ground at any time WARNING Do not operate this product in the presence of flammable anesthetics or other flammable substance in combination with air oxygen enriched environments or nitrous oxide explosion can result WARNING Within certain governmental jurisdictions all interconnected accessory equipment must be labeled by an approved testing laboratory After interconnection with accessory equipment risk leakage current and grounding requirements must be maintained WARNING To ensure conformance to risk leakage current requirements when operating from an ac mains power source use only a Welch Al
62. asive pressures and NIBP pressures 126 Glossary Welch Allyn Propaq Encore Vital Signs Monitor BR Breath rate expressed in units per minute or 1 min BR is derived from CO See also RR Buttons The five buttons along the bottom front of the Propag Encore A menu appears above each button identifying what each button will do when pressed Capnogram Hard copy of the ETCO waveform over time Capnometer Analyzer used to measure CO specifically ETCO gt Channel See Patient Channel C Lock A processing scheme used in SpO that uses ORS timing to improve the noise tolerance of SpO measurements CO A patient channel indicating the by product of respiration carbon dioxide which is exhaled by the lungs Configuration The patient channels included with each Propaq Encore model A table in Chapter 1 lists the configuration of each Propaq Encore model Cursor The highlighted block in a status window that indicates the selection you make by pressing the NEXT button CVA Cardiovascular artifact CVP Central venous pressure label for an invasive blood pressure channel DC Offset The DC voltage difference between ECG electrodes DC offset is caused by using dried out electrodes or electrodes of dissimilar metal types Difference Temperature The difference between T1 and T2 Also called delta T AT Digital Filter A computer program in the Propaq Encore that removes unwanted noise that can be induced into the ECG s
63. ate Range NIBP Alarm Limit Ranges Maximum Determination Time with retries Maximum Determination Time no retries Typical Determination Time without Artifact Minimum Time between automatic measurements Electrosurgery Interference Suppression NIBP Performance NIBP Safety Oscillometric Automatic and manual measurement control 1 2 3 5 10 15 30 and 60 minutes Maximum measurements allowable in a 5 minute period Systolic Diastolic and Mean plus on screen manometer Adult 30 to 260 mmHg Ped 30 to 160 mmHg Neonate 25 to 120 mmHg Adult 20 to 235 mmHg Ped 15 to 130 mmHg Neonate 10 to 105 mmHg Adult 20 to 255 mmHg Ped 15 to 140 mmHg Neonate 10 to 110 mmHg 3 mmHg Adult 100 mmHg Ped 80 mmHg Neonate 50 mmHg Adult 270 mmHg Ped 170 mmHg Neonate 132 mmHg Adult 160 mmHg Ped 120 mmHg Neonate 90 mmHg Adult 280 mmHg Ped 200 mmHg Neonate 141 mmHg Adult 308 mmHg Ped 220 mmHg Neonate 154 mmHg After a 1 minute settling period leak rate is lt 4 mm Hg over a 3 minute period at 270 mm Hg 30 to 220 beats per minute Neonate Systolic 25 to 120 mmHg Diastolic 10 to 105 mmHg Mean 10 to 110 mmHg Pediatric Systolic 30 to 160 mmHg Diastolic 15 to 130 mmHg Mean 15 to 140 mmHg Adult Systolic 30 to 260 mmHg Diastolic 20 to 235 mmHg Mean 20 to 255 mmHg Adult 4 5 minutes Ped 4 minutes eonate 3 minutes dult 3 minutes ed 2 minutes eonate 1 5 minut
64. atient s limb should be periodically observed to ensure that the circulation is not impaired for a prolonged period of time WARNING The Propaq Encore should never be used to monitor NIBP on one patient while simultaneously monitoring ECG on another patient WARNING If a noninvasive blood pressure measurement is suspect repeat the measurement If you are still uncertain about the reading use another method WARNING Do not attempt to take NIBP pressures on patients during cardiopulmonary bypass WARNING Some or all NIBP safety functions are disabled in the NIBP TEST screen in the Service Menu Do not attempt to conduct NIBP TEST when the cuff is attached to a patient The Propag Encore NIBP channel has been calibrated to agree with a central invasive blood pressure Diastolic pressures may be 5 to 10 mmHg lower than the auscultatory equivalent Systolic pressures may be lower than radial invasive equivalent Neonatal Mode is intended for use on infants of up to about 44 weeks gestational age in neonatal care settings The Neonatal Mode provides the lowest cuff pressure and shortest inflation time limits to ensure patient safety and comfort Pediatric Mode is intended to be used on larger infants and small children up to nine years old in pediatric care settings This mode supports the widest range of cuff sizes and a higher range of patient numerics for the hypertensive infant or child while still restricting the cuff pressure and inflation
65. ation 0 02g2 Hz from 10 to 300 Hz ramping down to 0 002g2 Hz at 500 Hz Operating 1 hour per axis 3 hours per test Water Resistance For ordinary indoor locations only a Per EN 60601 1 unless otherwise stated b See Chapter 8 for cleaning ins tructions Characteristic Specification Universal power adapter 503 0054 00 503 0093 XX Length 5 0 in 12 7 cm Width 3 6 in 9 1 cm Height 3 1 in 7 9 cm Weight 3 1 lb 1 4 kg Rated Input 100V 120V ac 500 mA 50 60 Hz Rated Fuses T800 mA 250V Time Delay 5x20mm Rated Output Continuous 16 24V de 25 VA Additional Features Detachable power cord pilot light Universal power adapter 503 0054 01 503 0092 XX Length 5 0 in 12 7 cm Width 3 6 in 9 1 cm Height 3 1 in 7 9 cm Weight 3 1 lb 1 4 kg Rated Input 200V 240V ac 250 mA 50 60 Hz Rated Fuses T400 mA 250V Time Delay 5 x 20mm Rated Output Continuous 16 24V de 25 VA Additional Features Detachable power cord pilot light Power Adapter connector 118 Specifications Factory default settings Welch Allyn Propaq Encore Vital Signs Monitor Characteristic Specification Date MO DA YR DA MO YR or YR MO DA Decimal Period HR PR Sweep 25 mm sec RR BR Sweep 6 25 mm sec Alarm Tone MED
66. attery charging 10 Loading printer paper 96 Loudness heart tone 34 M Main Menu 17 ECG RESP button 33 INV PRS button 38 39 NIBP button 45 47 SETUP button 20 Sp02 C02 button 17 MAIN MENU button 16 Mainstream Capnography see C02 Mainstream C02 monitoring 61 Maintenance monitor care 95 power adapters 89 printer 96 replacing monitor fuse 92 service intervals 94 Marriott Configuration MCL electrode placement 32 Menus Alarm Limits 1 Alarms 18 CO2 Menu 1 17 59 CO2 Menu 2 1 C02 Menu2 5 ECG RESP 33 ECG Menu 1 17 ECG Menu 2 17 INV PRS Menu 1 17 40 INV PRS Menu 2 17 40 Main 17 NIBP 17 46 Printer Setup 19 Service 19 Setup Menu 1 18 Sp02 53 54 Sp02 Menu 1 17 Sp02 Menu 2 17 co ort 134 Index Trends 18 Wave Select 19 22 Messages ECG 36 INV PRS 41 Mainstream C02 66 NIBP 48 49 Printer Fault 26 RESP 36 Sidestream C02 67 SIMULATING 26 TEMP 51 mm sec button 59 62 Modem Propaq option 9 Monitor buttons FREEZE UNFREEZE button 16 26 MAIN MENU button 16 START STOP button 16 Monitor care 95 fuse replacement 92 Monitor Mode 30 34 Monitor settings ALARM TONE 20 CURRENT SOURCE 20 DATE 23 DECIMAL 23 ECG BANDWIDTH 34 FILTER 23 36 HR PR TONE 21 34 PACER DISPLAY 34 PATIENT MODE 21 RESP ON OFF 34 RESP LEAD 34 SELECTED SOURCE 20 SWEEP mm s 20 TEMP F C 23 TIME DAY 22 MORE button 20 25 Motion artifact and NIBP 42 45 50 78 80 8
67. aty provisions applicable worldwide Under such laws the licensee is entitled to use the copy of the software incorporated with this instrument as intended in the operation of the product in which it is embedded The software may not be copied decompiled reverse engineered disassembled or otherwise reduced to human perceivable form This is not a sale of the software or any copy of the software all right title and ownership of the software remain with Welch Allyn or its vendors For information about any Welch Allyn product call the nearest Welch Allyn representative USA 1 800 535 6663 Australia 6129 638 3000 1315 685 4560 800 074 793 Canada 1800 561 8797 China 86 216 327 9631 European Call Center 353 46 906 7790 France 331 6009 3366 Germany 49 747 792 7186 Japan 8133 219 0071 Latin America 1 305 669 9003 Netherlands 3115 750 5000 Singapore 656 419 8100 South Africa 2711 777 7555 United Kingdom 44 207 365 6780 Sweden 46 85 853 6551 Caution Changes or modifications not expressly approved by Welch Allyn could void the purchaser s authority to operate the equipment Reorder Part Number 810 1719 XX Manual Part Number 810 0640 04 Rev A 06 2007 oul EC REP Welch Allyn Ltd Welch Allyn Inc avan Business Park 8500 SW Creekside Place Dublin Road Navan Beaverton OR 97008 7107 USA County Meath Republic of Ireland www welchallyn com Printed in USA Gio CE 0297 Welch Altyn Contents 1
68. beats per minute 5 beats per minute When performing Sp02 monitoring the monitor Sp02 channel may not in rare instances initially detect a damaged Sp02 sensor or extension cable as described in EN865 1997 Section 51 109 but may simply display a flat line and no numerics If this occurs try connecting a new Sp02 sensor and extension cable if needed and restart the monitor to resume normal monitoring Minimum difference between upper and lower alarm limits is 2 Refer to Products and Accessories 810 0409 XX for accuracy specifications for all Nellcor SpO probes recommended for use Capnography C03 Welch Allyn Propaq Encore Vital Signs Monitor Characteristic Specification Screen Display Numeric Display Ranges Waveform Scale Maximum Units Sweep Speed Response Modes Gas Compensation Alarm Limit Ranges Resolution Accuracy Altitude Error CO display CO waveform and ETCO and INCO when in alarm numerics ETCO 0 99 mmHg 0 13 2 kPa 0 23 1 INCO 8 25 mmHg 1 12 5 kPa 1 12 5 0 100 mmHg 0 14 kPa 0 14 mmHg kPa user selectable 3 13 6 25 12 5 mm sec user selectable Fast 15 sec sampling time period Normal 30 sec sampling time period Slow 45 sec sampling time period OFF CO value calculated CO value 0 gt 50 No N20C0 value calculated CO value x 1 03 N20 gt 50 CO value calculated CO value x 0 952 ETCO 0 99 mmHg 0 13 2 kPa 0 13 2 INCO 2 25 mmHg 0 2 5 kPa
69. bols on its labeling For definitions of these symbols see Symbols on page 3 A WARNING Place the power adapter where it cannot fall and harm someone A Caution Use of other than Welch Allyn power adapters with the plug rated for your ac mains can damage or compromise the safety of the Propaq Encore monitor and may require fuse replacement in the power adapter Verify that the Power Adapter is set for the proper mains voltage prior to plugging it into the Propaq Caution Do not autoclave the power adapter Do not operate the power adapter with a damaged case mains power cord or plug Verifying proper power adapter configuration Prior to using the power adapter check it for proper voltage selection by looking in the small indicator window on the front end by the power switch If the number in the window does not match your ac mains source voltage 100 120V or 200 240V the adapter should be reconfigured See the illustration on page 91 Your biomedical technician can change the voltage setting and fuses on the power adapter and can verify that your facility is using the correct power cord 90 Power sources Welch Allyn Propag Encore Vital Signs Monitor Poweradapter configurations Poweradapter part numbers are listed with their rated input fuse output and applicable usage Check to be sure you are using the correct power adapter for your mains power source by comparing the part number on the power adapter to the table below
70. ce Guide Getting started 17 Propag Encore menus Menus for some patient vital signs are displayed only if that option is included in your Propaq MAIN MENU NIBP ECG RESP INV PRS Sp02 C02 SETUP gt Sp02 c02 PREV MENU C02 MENU 1 gt RANGE mm s MORE PREV MENU C02 MENU 2A NO C02 SENSORS GAS COMP RESPONSE PREV MENU C02 MENU 2B MAINSTREAM C02 ACTIVE HD GAS COMP RESPONSE SOURCE PREV MENU C02 MENU 2C SIDESTREAM C02 ACTIVE GAS COMP RESPONSE SOURCE FLOWRATE PREV MENU Sp02 MENU 1 SIZE MORE PREV MENU Sp02 MENU 2 4 RESPONSE C LOCK PREV MENU INV PRS MENU 1 Ly RANGE RESCALE ZERO P1 ZERO P2 MORE CANCEL CANCEL NV PRS MENU 2 LABEL P1 FORMAT 1 LABEL P2 FORMAT 2 PREV MENU ECG RESP MENU 1 Lp ECG SIZE ECG LEAD RESP SZE MORE ECG RESP MENU 2 NEXT CHANGE PREV MENU NIBP MENU START AUTO MAN INTERVAL TURBOCUF PREV MENU STOP E DA A 18 Getting started Key press route to setup menu 1 Welch Allyn Propag Encore Vital Signs Monitor TURN OFF NIBP ECG RESP INV PRS Sp02 C02 SETUP SETUP MENU 1 STATSCALE ALARMS WAVE SEL TRENDS MORE MORE button takes you to next Setup Menu TRENDS MENU PRIN
71. cm Depth 7 56 in 19 2 cm Weight with Printer Sp0 and CO 13 5 Ib 6 1 kg a Per EN 60601 1 unless otherwise stated b See Chapter 7 for cleaning instructions Reference Guide Printer Specifications 115 Characteristic Specification Operation Operating Modes Continuous Snapshot Freeze Print Auto Print Auto Trend Tabular Trend Alarm Print NIBP Ticket Apnea Ticket OxyCRG OxyCRG on Alarm Auto Print Intervals 15 min 30 min 1 hour 2 hours 4 hours Auto Trend Shifts Once every 4 hours Number of Waveforms Up to three ECG P1 P2 Sp0 CO RESP Grid 5 mm and 1 mm gradations Annotation Date Time Print Mode Speed Heart Rate Systolic Diastolic Mean SpO Breath Rate ETCO INCO Temperature AT Pacer Status Company Logo ECG Bandwidth Patient Mode scale factors for all traces and if Acuity is connected patient name and identification Printing Speeds 6 25 12 5 25 0 mm sec simulated 6 25 mm sec for CO and RESP in Snapshot mode Printer mechanism Printing Method Dot structure Thermally sensitive dot method 320 dots per line Printing width 53 mm Horizontal Dot Pitch 0 165 mm 6 dots mm Vertical Dot Pitch 0 165 mm Paper Feed Method Friction Feed Paper Feed Precision Paper Width 2 25 C and 60 Relative Humidity 60 mm Reliability 30 million pulses dot Environmental Monitor expan
72. ct the Propag Encore to an Acuity system only Connecting to other networks could damage the monitor or injure the patient If in doubt about the network jacks or devices consult your facility s Biomedical Engineering Department WARNING Make sure the Acuity network cable is not damaged The Acuity network cable is the sole link between the Propag Encore and the Acuity Central Monitor The Acuity system is used as a central monitoring system for Propaq Encore monitors configured to interface with Acuity The Acuity system may be used to monitor all patients For neonatal patients use all Acuity features except the Welch Allyn Cordless Acuity and the arrhythmia detection option The Acuity system is intended to be used in compliance with the instructions in this Propaq Encore Reference Guide the Acuity System Reference Guide and accepted hospital and clinical protocols Connecting to the Acuity system 1 If the Propag Encore has already been connected to the patient save the patient s Trends and Alarm Limit settings by keeping the monitor turned on The Propaq Encore transmits up to five hours of trend information when you connect it to the Acuity network If the Propaq Encore has not been connected to the patient clear any prior patient s trends and alarm limit settings by turning off the Propag Encore and after a few seconds turning it on again 2 Ifthe Propag Encore is not already connected to the patient attach leads and senso
73. cture Between the fuses Is a small printed circuit board PCB that sets the power adapter to the desired ac mains voltage When handling the fuse module the PCB may slide out Caution f the small PCB between the fuses has slipped out of place slide it back into place in the fuse module and verify that the voltage setting indicated in the window on the fuse module is correct If the voltage setting is incorrect simply slide the PCB out of the fuse module rotate it 180 and slide it back into place Reference Guide Power sources 91 Power Switch Fuse Fuse Module Voltage Selector and Indicator Spare Fuse MA Caution Make sure the voltage selector indicates the proper ac input voltage If you change the adapter voltage setting you must replace all fuses to match the appropriate type specified on the bottom of the power adapter The only fuses contained in the power adapter when shipped from the factory are fuses specified for the original adapter input voltage setting Battery care A Caution Leaving the monitor s lead acid batteries in a completely discharged state may result in permanent battery damage The batteries should be kept fully charged Recharging time The battery charges to full capacity within eight hours if the monitor remains off Monitor functions resumed In most instances most monitor functions are usable immediately after plugging in the ac power adapter and cycling the power switch
74. d If this occurs the monitor provides a special sequence of display windows to help you regain use of your monitor as quickly as possible Do the following 1 Connect an ac power adapter to recharge the battery if the battery is drained 12 Getting started Welch Allyn Propag Encore Vital Signs Monitor 2 Press any button below the equipment alert screen to acknowledge the alert The monitor will display the Mode Setup window shown on page 23 3 Press these buttons to select one of the Factory patient modes for use Factory Adult mode POWERUP YES Factory Pediatric mode NEXT POWERUP YES Factory Neonatal mode NEXT NEXT POWERUP YES After you press YES the monitor will display the Time Day window 4 Press NEXT UP and DOWN as needed to set the time and date Then press ENTER to store the new time and date Note These display screens are only displayed in this order if the PROGRAM FAULT equipment alert occurs 5 Turn off the monitor then turn it on again so the settings will take effect The monitor is ready for use If you want to store some customized patient mode program settings refer to page 23 If you follow these steps and the equipment alert reappears at powerup the monitor may need to be serviced and the battery replaced Contact a qualified service person Reference Guide Getting started 13 Patient connections The left side panels differ depending on the Propag Encore model All models have ECG
75. d tubing inspect for damage cracks cuts abrasions extreme wear exposed wires or bent connectors Confirm connectors securely engage Report damage or improper function to your service department Equipment Cleaning instructions Approved cleaning solutions Propag CS Monitor b Wipe with a nearly dry cloth moistened Warm water Coverage with cleaning solution Liquid soap Wex Thoroughly wipe off any excess cleaning T B 0 P lt super gt b cide lt super gt b solution Do not let water or cleaning Hydrogen peroxide solution Windex solution run into connector openings or Ovation crevices NIBP cuff Wipe gently with cloth dampened with Common hospital disinfectants including Clorox cleaning solution liquid bleach 1 10 solution of Clorox water isopropyl Thoroughly wipe off excess cleaning alcohol Lysol solution Phisohex Quatricide solution To avoid harming cuff function Virex and Vesphene do not let enter cuff Cables tubing CO Wipe gen sensor cleaning s olu Masimo Sp0 cables Wipe gen ly with c ly with c Nellcor SpQ cables isopropyl alcohol water or cleaning solution tubing oth dampened with ion Do not immerse the CO sensor in liquid oth dampened with Other accessories Consult manufacturer s instructions Mild detergent solution also consult manufacturer s instructions Isopropyl alcohol Consult manufacturer s instructions a Do not use these cleanin
76. dule with printer Sp02 and CO2 Options 3A 250V Type 2AG 0 57x 0 177 in 2 hours 5 hours 3 hours Battery Recharge Time with instrument on Battery Recharge Time with instrument off Range of 8 hours to 12 hours typical depending upon product configuration Range of 6 hours to 8 hours depending upon product configuration Recharge time until monitor is usable starting with discharged but non faulty battery lt 2 minutes typically longer time required before NIBP printer and CO are available Reference Guide Power adapters Specifications 117 Characteristic Specification Protection classifications all adapters Type of Protection Against Ele Shock ctric Class Protectively Earthed Ingress of Water Degree of Protection Against Harmful For ordinary indoor locations only Method of Disinfection Not suitable for autoclaving Flammable Anesthetics Not suitable for use with flammable anesthetics Environmental specifications all adapters Operating Temperature 0 to 50 C Shipping and Storage Temperature 20 to 60 C Operating Altitude 2 000 to 15 000 feet 610 to 4 572 m Shipping and Storage Altitude 2 000 to 40 000 feet 610 to 12 192 m Operating Relative Humidity 15 to 95 noncondensing Shipping Storage Relative Humidity 15 to 95 noncondensing Shock 50g Vibration Random Vibr
77. e minute clock interval if the apnea alarm does not cease OXYCRG ON When turned on an oxycardiorespirogram will print if an HR PR ALARM SpO or RR BR alarm occurs For more information on OxyCRG see OxyCRG on page 82 26 Getting started Welch Allyn Propag Encore Vital Signs Monitor PRINTER FAULT messages These PRINTER FAULT messages can appear in an equipment alert window LOW BATTERY This message appears when the Propaq s battery voltage is PRINTER DISABLED less than 76 volts To continue operation plug the ac power adapter into the Propaq CHECK DOOR The door on the bottom of the printer is open Close door to remove this message PAPER OUT To add printer paper see Printer maintenance on page 96 OVERHEATING The printer is overheating Service may be required The front panel of the printer lets you control the basic printer functions Manually starts and stops a printout of patient information as it is monitored continuous or real time Hold down top two keys simultaneously to generate a paper feed Hold down top and bottom keys simultaneously to generate a test strip Prints the last 8 seconds of data for nonrespiration waveforms and 32 seconds of compressed waveform history for respiration waveforms PRINT TRENDS Prints all trends that are enabled in the Printer Trend Select Window If you press FREEZE prior to pressing SNAPSHOT the printer prints the 8 seconds of patient i
78. e of motion artifact or diminished pulses Smartcuf synchronizes the NIBP reading with the R wave of the patient s ECG to eliminate noise created by external stimuli such as patient motion or vibration The monitor must perform ECG monitoring while using Smartcuf To enable the Smartcuf filter e Connect the ECG leads to the patient and perform ECG monitoring during NIBP e From the Main Menu press NIBP to display the NIBP Menu and set Smartcuf to ON 18 46 00 122 Wal 102 3F Set SMARTCUF ON MODE TURBOCUF TIME 4 21 SMARTCUF ON 50 STOP AUTO MAN INTERVAL TURBOCUF SMARTCUF If artifact is so severe while Smartcuf is enabled that it affects the accuracy of an NIBP measurement that measurement is marked with a special symbol on the display and on printouts This symbol indicates an NIBP y aug reading taken in the presence of x 1 2 2 high artifact while monitoring ECG ES with Smartcuf enabled Artifact can Numeric Display affect accuracy MEN EXA Coz 11 10 5 Printout There may be some situations where it is desirable to disable Smartcuf This may include situations with very extreme motion artifact certain types of arrhythmias or other situations where it is not possible to obtain a good ECG signal NIBP measurements can still be performed when Smartcuf is disabled a ey To disable Smartcuf from the Main Menu press NIBP to display the NIBP Menu and set Smartcuf to OFF 44 Patie
79. elch Allyn Propag Encore Vital Signs Monitor Some electrodes may be subject to large offset potentials due to polarization This effect is most likely when dissimilar metals are used for different electrodes and may be severe enough to prevent obtaining an ECG trace Furthermore recovery time after application of defibrillator pulses may be compromised when using electrodes of dissimilar metals Squeeze bulb electrodes even if all of the same metal are particularly vulnerable to this effect Stainless steel needle electrodes are prone to having large erratic offset drifts and are not recommended 4 Apply the electrodes to the patient Standard 3 lead LL Configuration se ee A v6 5 lead Configuration Marriott Configuration MCL1 G LA RA LL If using MCL1 select LEAD II on the Propag and use all three electrodes j One of six v lead electrode placement sites for the fifth c lead 5 Support the ECG cable so it does not stress the electrode wires ECG cable connectors or electrodes Note Two RESP leads are available Choose the one that gives you the best signal If neither signal is adequate it may be necessary to experiment with nonstandard electrode placement such as placing the RA and LA electrodes on the respective mid axillary lines just above the level of the nipples 6 If an electrosurgical unit is going to be used place the ECG cable and electrode wires as far as possible fr
80. els the alarm holdoff The next time a vital sign limit is violated the Propaq starts a new alarm holdoff period The following table summarizes the alarm holdoff periods Monitoring Alarm Holdoff Period Function HR PR 3 seconds except NIBP PR Sp0 10 seconds RR BR 5 seconds When the Propaq is connected to the Acuity Central Monitoring System Acuity does not receive any alarm indication from the monitor until this holdoff period expires Propaq audio alarm hold off with Acuity When a Propag Encore in Adult or Pediatric Mode is connected to an Acuity System the audio alarms at the bedside Propag can be delayed up to 4 minutes and 15 seconds The delay time is selected in Acuity software at the time of Acuity installation Visual alarm indications are not delayed Note This audio alarm holdoff does not occur in the Neonatal mode 74 Alarms and limits Welch Allyn Propag Encore Vital Signs Monitor Setting alarm limits Adjust limits with STAT SET When you want to quickly set all alarm limits the Propag Encore can calculate new alarm limits using the patient s current values Press the STAT SET button in the Alarms Menu SETUP ALARMS STAT SET The Propag Encore activates all alarms and calculates the limits for all monitored vital signs except apnea delay The monitor performs a mathematical function addition subtraction or multiplication on the current value of the vital signs to arrive at the new limits The form
81. encompasses 68 of the population b otion for neonates is defined as foot motions at 2 to 4 Hz at an amplitude of 1 to 2 cm against a laboratory co oximeter and ECG monitor This variation equals 1 standard deviation which encompasses 68 of the population Reference Guide Nellcor Specifications 107 Characteristic Specification Saturation Sp03 Range 0 to 100 Resolution 1 Alarm Limits 52 to 100 upper Probe Accuracy saturation levels between 70 and 100 28 to 42 C Adult Pediatric Neonatal Pulse Rate Range Alarm Limits Pulse Rate Accuracy Alarm Hold Off Time Period Circuitry Electrosurgery interference suppression Sensor Compatibility Sensor LEDs RED Wavelength INFRARED IR Wavelength Sensor Energies Radiant Power Electrical Power Optical Power Pulse Rate Accuracy No Motion During Motion 50 to 98 lower Digit accuracy 2 counts Digit accuracy 3 counts 25 to 250 beats per minute 27 to 250 beats per minute upper 25 to 248 beats per minute lower 3 beats per minute 10 seconds resets if the sensor reports levels within limits before 10 seconds elapses Microprocessor controlled Automatic self test of oximeter when powered on Automatic setting of default parameters Automatic alarm messages Yes Compatible only with Nellcor sensors listed in Products and Accessories 660 nm nominal 890 nm nominal 52 5 mW max 15 mW max 3
82. er can cause damage to the battery Even when the Propaq Encore is turned off a very small amount of current is drawn from the battery For long term storage remove the battery from the Propaq See the Propaq Encore Service Manual for procedures on removing the battery Note Removing the battery will cause programmed settings to be lost but they can be reprogrammed when the battery is replaced 96 Care and maintenance Welch Allyn Propag Encore Vital Signs Monitor Printer paper removal A Caution lfa Propag Encore has a battery installed or ac power connected and is stored for an extended period without use the printer paper can cause damage to the printhead Before storing a Propag Encore for more than two months without use remove the roll of printer paper Printer maintenance Paper is loaded through the bottom of the printer A Caution Use only low debris printer paper purchased from or recommended by Welch Allyn Use of other paper can cause unclear printing of patient data damage to printing head and eventual printer failure Store all paper including a monitor loaded with paper in an environment that meets the paper storage specifications listed in Appendix B Failure to properly store paper can result in paper discoloration and damage to the printer 1 Lay the monitor on its back to gain access to the bottom of the printer 2 Squeeze the locks on the paper door toward each other and pull the door toward you to open it
83. ern one second on four seconds off slowest Note Propag monitors connected to an Acuity Central Monitoring System can sound distinct tone patterns for certain alarms such as life threatening Arrhythmia and ST alarms For further information regarding Acuity System alarm tones please consult the Acuity System Directions for Use Silence an active patient alarm or equipment alert tone for 90 seconds You can silence the tone of a patient alarm or equipment alert for a period of 90 seconds Silence an alarm or alert tone for 90 seconds Press either key to silence the alarm or alert tone for 90 seconds 1 Check the patient and provide appropriate care 2 Press A A or the SILENCE key 3 After caring for the patient make sure the appropriate alarm limits are set 70 Alarms and limits Welch Allyn Propaq Encore Vital Signs Monitor Re enable an alarm or alert tone before the 90 second silence period has elapsed 1 Press O Q Indications during a 90 second silence period At the Propaq Encore Monitor At the Acuity Central Station During the silence period the usual visua alarm and alert indications are displayed If a new alarm or alert occurs the new alarm or alert Only life threatening arrhythmia and apnea alarm tones tone interrupts the silence period interrupt the suspend period To re enable an alarm or alert tone before the To resume an alarm or alert tone before the 90 seconds has 90 seconds has elap
84. es 0 to 45 seconds v Z vD Z 30 seconds Auto Mode 2 seconds Turbo Mode Included in all models 202EL 204EL 206EL Per EN 1060 1 EN 1060 3 and ANSI AAMI SP10 1992 Per IEC 601 2 30 Reference Guide Specifications 105 Temperature Characteristic Specification Range 0 to 50 C 32 to 122 F Displays T1 T2 and AT Probes Compatible with YSI Series 400 and 700 probes HP side panel only compatible with YSI 400 and has HP connector Units C and F selectable Channel Accuracy Temperature Range Tolerance 0 to 10 C 0 2 C gt 10 to 50 C 0 1 C 32 to 50 F 0 4 F gt 50 to 122 F 0 2 F Resolution 0 1 C or F Temperature Alarm 32 0 to 122 0 F Limit Range T1 T2 0 to 50 0 C Electrosurgery Included in all models 202EL 204EL 206EL interference suppression 106 Specifications Welch Allyn Propaq Encore Vital Signs Monitor Pulse oximetry SpO0 Masimo Characteristic Specification Saturation Sp02 Range 1 to 100 Resolution 1 Alarm Limits 52 to 100 upper 50 to 98 lower Probe Accuracy 25 to 41 C Adults Pediatrics No motion 0 to 100 2 counts to 69 unspecified ox Neonates No motion 70 to 100 3 counts 0 to 69 unspecified Adults Pediatrics Neonates 70 to 100 3 counts During Motion 0 to 69 unspecified Pulse Rate Range No motion 26 to 239 beats per minute 3 counts Range During motio
85. et the Propaq monitor in alarming Inservice Mode 2 press MAIN MENU SETUP WAVE SEL INSERV wu Within 3 5 seconds the monitor will alarm because the patient s vital signs fall outside of the alarm limit ranges 28 Getting started Welch Allyn Propag Encore Vital Signs Monitor 5 Confirm the following The monitor is sounding an alarm A vital sign numeric is flashing The small red light in the top right corner of the monitor is flashing The SILENCE and LIMITS keys are showing on the screen 6 To silence the alarm tone for 90 seconds press 11 Q or SILENCE Visual alarm indications remain and the alarm tone resets after the 90 second silence period 7 To bring the Propag monitor back into the non alarming Inservice Mode 1 press INSERV 15 The patient s vital sign readings will return to acceptable levels within the alarm limit range 8 Turn off the Propaq monitor Any previously set custom patient mode settings are restored when you turn it on again Under these conditions if the monitor fails to generate visual or auditory alarm indications carefully repeat the above steps If the monitor is still unresponsive remove it from circulation and take it to your facility s biomedical service department for evaluation 29 3 Patient monitoring ECG RESP Intended use impedance pneumography RESP The Respiration channel is intended to detect the rate or absence of respiratory effort derivi
86. for HR PR are 12 5 25 and 50 mm ALARM TONE sec The sweep speeds for RR BR are 3 13 6 25 and 12 5 mm sec Sets the Alarm Tone volume to HIGH MEDIUM or LOW Reference Guide HR PR TONE Getting started 21 Sets the Heart Tone volume to HIGH MEDIUM LOW or OFF PATIENT MODE Pressing CHANGE in this selection displays the following Patient Note Mode window NEO lt 44 WEEKS GEST AGE PED gt 44 WEEKS GEST AGE lt 9 YEARS ADULT gt 9 YEARS NEONATAL PED ADULT If you press NEONATAL PED or ADULT a confirmation window appears requiring you to confirm your selection PATIENT MODE CHANGING SETTINGS AND MODE TO CUSTOM ADULT ADULT ALARM LIMITS WILL BE SET ARE YOU SURE Whenever you change the patient mode the alarm limit settings are automatically changed to the defaults for that mode If Custom settings have been set for that mode the defaults are the Custom mode settings If no Custom settings have been set the defaults are the Factory Mode settings See page 23 for more information about patient modes If you change the patient mode the CO alarm limits in the new mode might vary slightly from the originally programmed CO limits for the new mode Check the CO alarm limits If you press SETUP in the previous Patient Mode window the Mode Setup window appears This allows you to set custom patient modes and powerup defaults as described on page 23 22 Getting started We
87. g 33 023 3 93 Reference Guide Specifications 119 Characteristic P1 P2 Limits Diastolic Specification Adult 35 110 mmHg Ped 35 100 mmHg Neonate 30 70 mmHg P1 P2 Limits Mean Adult 50 120 mmHg Ped 50 110 mmHg Neonate 35 80 mmHg a Any time you change the Date Fil setting Sp0 Limits Adult 85 100 Ped 85 100 Neonate 80 95 RR BR Adult 5 30 BrM Ped 10 45 BrM Neonate 10 60 BrM TEMP Limits 35 0 37 89 C AT Limits 0 0 2 8 C ETCO Limits 25 60 mmHg 3 8 for and kPa INCO Limits N A 5 mmHg 0 7 for and kPa Apnea Delay Adult Ped 20 seconds Neonate 15 seconds PRINTER SETTINGS Printer Alarm Print OFF Printer Auto Print OFF Printer NIBP Ticket OFF Printer Apnea Ticket ON Printer Print Speed 25 mm sec Printer Auto Trend OFF Printer Trend Selections NIBP and P1 ON all others OFF Printer OxyCRG on Alarm OFF er Temp F C Decimal or CO Units setting the new setting also becomes the powerup default 120 Specifications Welch Allyn Propaq Encore Vital Signs Monitor In service simulated values Channel Display Initial value Alternate value ECG Waveform Normal sinus rhythm 1mV Lead Il Normal sinus rhythm ECG Heart Rate 80 beats per minute 125 beats per minute RESP Respiration Rate 1
88. g on the zone immediately appears in the blood pressure numerics window for the invasive pressure channel being used 18 45 28 Transducer pa message ZEROED RANGE RESCALE ZERO P1 ZERO P2 Zeroing the transducer 1 To zero the transducer open the transducer s stopcock to atmospheric air Allow a few seconds for the transducer to settle If the ZERO menu is not displayed press the following Propag Encore buttons INV PRS then ZERO P1 or ZERO P2 The word ZEROING appears in the numerics window during zeroing The button label changes to CANCEL to allow you to cancel the zeroing process if necessary Wait for a tone to briefly sound and the word ZEROED to appear in the blood pressure numerics window You will then see the pressure scale to the left of the waveform and the pressure numerics appear Close the transducer s stopcock If the transducer will not zero the words ZERO REJECTED or NO ZERO depending on zone will appear in the numerics window Press CANCEL and try zeroing again You won t see the pressure values and the scales until an acceptable zero reference is established Check that the transducer is open to atmospheric air and that it is properly connected to the Propag Encore then try zeroing again The Propaq Encore will not allow zeroing to occur if the pressure waveform is pulsatile if there is too much noise in the signal Reference Guide Patient monitoring 39 or if the transducer s offset is
89. g solutions they may damage the monitor Buty alcohol Denatured ethanol Freon Mild chlorine bleach solution Isopropyl alcohol Trichloroethane Trichloroethylene Acetone Vesphene ll Enviroquat Staphene Misty Glutaraldehyde Fantastik Formula 409 Cidex 94 Care and maintenance Welch Allyn Propag Encore Vital Signs Monitor b The monitor may be disinfected to comply with OSHA requirements for cleaning and decontaminating spills of blood and other body fluids Federal OSHA Standard on bloodborne pathogens 29 CFR 1910 1030 12 6 91 Wex cide Wexford Labs Inc Kirkwood MO and T B Q Calgon Vestal Lab Calgon Corp St Louis MO are disinfectants that meet OSHA requirements and are EPA approved Wipe away disinfectants with a water dampened cloth after the manufacturer s recommended period of time c If liquid gets into the right side panel connectors it will drain out If moisture gets into a left side panel connector dry the connector with warm air then check the monitoring functions for proper operation d The Mainstream CO sensor may also be disinfected with Wex cide Follow the disinfectant manufacturer s instructions Do not leave Wex cide on sensor longer than 30 minutes Thoroughly clean off residue with water dampened cloth Prolonged exposure of the sensor to Wex cide will damage the sensor Caution Do not autoclave this product or its accessories Do not immerse the A monitor in liquid when clean
90. hat the monitor be IEC 61000 4 11 or 5 cycles or 5 cycles powered from an uninterruptible power 70 U 70 U supply or a battery 30 dip in U4 30 dip in U4 or 25 cycles or 25 cycles lt 5 U lt 5 U gt 95 dip in U gt 95 dip in Ur or 5 sec or 5 sec Power frequency 50 3 A m 3 A m Power frequency magnetic fields should be 60 Hz magnetic field at levels characteristic of a typical location in IEC 61000 4 8 a typical commercial or hospital environment Note U is the AC mains voltage prior to application of the test level Reference Guide Specifications 123 Propaq Encore Monitor Guidance and Manufacturer s Declaration Electromagnetic Immunity The Propag Encore monitor is intended for use in the electromagnetic environment specified below The customer or the user of the monitor should assure that it is used in such an environment Immunity Test IEC 60601 Test Level Compliance Electromagnetic Environment Guidance Level Portable and mobile RF communications equipment should be used no closer to any part of the monitor including cables than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter Recommended Separation Distance Conducted RF IVs 3 Vims d 1 2 JP IEC 61000 4 6 150 kHz to 80 MHz Radiated RF 3 V m 3 V m d 1 2 JP 80 MHz to 800 MHz IEC 61000 4 3 80 MHz to 2 5 GHz d 23 P 800 MHz to 2 5 GHz where P
91. he CO channel and alarm limits Note After you connect a Mainstream CO sensor or Sidestream CO watertrap adapter the Propaq displays the waveform briefly without a value range It displays WARM UP for Mainstream or START UP for Sidestream in the CO numerics window After about 20 seconds the Propag displays the CO measurement and waveform range 1 Press SpO2 C02 CO2 to display the first CO Menu 2 Press RANGE until you see the desired waveform scale range on the Propag screen The range choices are shown below Units Waveform Scale Range mmHg 0 100 0 60 default 0 30 setting kPa 0 14 0 8 0 4 0 14 0 8 0 4 Note f an inspired value is displayed indicating patient rebreathing non zero INCO check the patient breathing circuit for proper function Verify the sensor calibration against room air If the Propag continues to display inspired values return the sensor to Welch Allyn for service 3 Press mm s to select either 3 13 6 25 or 12 5 mm sec The default setting is 6 25 mm sec This sweep speed also applies to RESP 4 Press MORE to view the CO status window 5 If either O or N20 is being administered to a patient press GAS COMP to set the proper gas compensation as listed below If no other gas is being administered set GAS COMPENSATION to OFF OFF is the default setting Gas Administration Level ETCO or INCO Value GAS COMP Setting OFF CO value actual CO value 02 gt 50 No N20
92. he monitor displays the pressure waveform but to protect against erroneous readings the pressure waveform scale is not displayed To remove this message zero the transducer ZEROING This message briefly appears as the transducer is being zeroed ZEROED This message appears after the zero value has been accepted It remains for eight seconds and is replaced by the current pressure values ZERO REJECTED or REJECT Unable to establish a zero reference value The message remains until the CANCEL button is pressed CANCELED This message appears if CANCEL is pressed while the channel is zeroing These equipment messages can appear in an equipment alert window TRANSDUCER NOT DETECTED The transducer connection is broken TRANSDUCER SHORT CIRCUIT This message appears when the Propag Encore senses a short in the transducer The transducer should be replaced INCOMPATIBLE TRANSDUCER Check the compatible transducers listed in Products and Accessories to ensure you are using a compatible transducer 42 Patient monitoring Welch Allyn Propag Encore Vital Signs Monitor NIBP Intended use The Propag Encore noninvasive blood pressure channel NIBP indirectly measures arterial pressures using an inflatable cuff If ECG is also monitored the Propaq Encore synchronizes the NIBP measurement process to the occurrences of the R wave increasing accuracy in cases of extreme artifact diminished pulses or some dysrhythmias A WARNING The p
93. he numerics area The sensor heater is warming up Wait 20 to 30 seconds for the sensor to heat Values should appear in the numerics area when the sensor is sufficiently warm Sidestream CO messages Equipment messages for the Sidestream CO option can appear on the display in an equipment alert window ALTIMETER FAILURE RANGE The Propaq is operating at an altitude outside the Sidestream CO option s operating altitude range of 2 000 to 15 000 feet Returning 68 Patient monitoring Welch Allyn Propag Encore Vital Signs Monitor the monitor to within this range automatically cancels this message and restores operation ALTIMETER FAILURE RATE The altimeter has detected that the ambient pressure is changing at a rate greater than 100 mmHg minute When the rate of change Is back within the 100 mmHg minute range disconnect and reconnect the CO sensor to the Propao ALTIMETER NOT CALIBRATED EEPROM The Sidestream CO option has not been calibrated Refer the Propaq to a Biomedical Engineer for calibration AMBIENT TEMPERATURE TOO HIGH The sensor temperature is too high The Sidestream CO option is disabled until the ambient temperature is within the operating range specifications AMBIENT TEMPERATURE TOO LOW The sensor temperature is too low The Sidestream CO option is disabled until the ambient temperature is within the operating range specifications CALIBRATION ERROR SERVICE REQUIRED Send the Propag to a Biomedical
94. ic or Neonatal mode settings for the monitor These settings determine default alarm limits maximum cuff inflation pressure and other internal settings Pinout The signal descriptions for each pin of a connector Polarization The activity that occurs when dissimilar metals between ECG electrodes and leads meet This can cause dc offset and other signal problems PR Pulse rate expressed in units per minute or 1 min This is displayed when the heart rate pulse rate source is from a pressure channel or SpO Reference Guide Glossary 129 Pulse Rate The heart rate determined from either a pressure channel SpO or NIBP expressed in units per minute or 1 min Pushbutton See Buttons Range Mode The method used in invasive pressure display to show two waveforms against the same pressure scale Rescale Mode The method used in invasive pressure display to show each waveform against its own scale The scale is automatically selected for best viewing of the entire waveform Respiration The exchange of oxygen and carbon dioxide in the lungs and with the cells of the body RR Respiration rate a measure of the frequency of respiration See also Impedance Pneumography Sensors The electrodes transducers probes etc used to obtain patient information Serial Number The unique number assigned to the monitor It is located on the rear panel label Sidestream A respiratory CO measurement technique which can be used for in
95. if the transducer case becomes earth grounded A WARNING Although complete disconnections of invasive pressure transducers will be detected by the normal alarm functions partial disconnection will not be detected nor will the use of some incompatible transducers The user must exercise reasonable measures to ensure that approved transducers are used and that pressure transducers are connected properly WARNING Before you use a Propag on a new patient always turn it off for a few seconds then turn it on again This clears the prior patient s trend values alarm limit settings and NIBP cuff inflation target 38 Patient monitoring Preparation Welch Allyn Propag Encore Vital Signs Monitor Preparing for invasive pressure monitoring with the Propag Encore requires you to prepare the transducer zero the transducer set up the pressure channel and set the invasive pressure alarm limits Preparing the transducer 1 Inspect the transducer cable for wear breakage or fraying Replace it if the cable shows signs of any of these Replace the transducer dome if necessary Apply the transducer according to your hospital s procedures Always refer to the transducer manufacturer s Directions for Use If the transducer is a disposable unit with separate cable connect the transducer to the transducer cable Plug the transducer cable into an invasive pressure connector on the left side panel The message NOT ZEROED or NO ZERO dependin
96. ignal from ac mains EL Electroluminescent Display The display screen used in the Propaq Encore EMI An acronym for Electromagnetic Interference Endotracheal Tube Plastic breathing tube placed into the patient s windpipe Equipment Alert Occurs when the Propaq Encore detects an equipment condition requiring operator assistance A message describing the condition is displayed Equipment Alert Window The window that appears during an equipment alert Error Message The message that appears when the monitor detects a malfunction requiring factory service Reference Guide Glossary 127 Error Message Window The window that appears when the monitor detects a malfunction requiring factory service This window contains error messages and numbers Error Number The number that identifies a problem encountered during operation ESD An acronym for Electrostatic Discharge from static electricity ESIS An acronym for Electrosurgery Interference Suppression ETCOQ An acronym for end tidal CO Amount of CO breathed out at the end of an exhalation Factory Default Settings The current values for all Propaq Encore settable functions when the monitor was shipped from the factory Freeze The action taken by the FREEZE button to stop the display If three waveforms are displayed all waveforms are frozen If less than three waveforms are displayed the current waveforms are frozen and the top waveform is also shown in real time See
97. igns Monitor Perform SpQ spot cCheck monitoring The SpO Standby Mode allows you to remove the SpO sensor from a patient without having to disable all alarms or disconnect the SpO sensor cable from the Propaq monitor You can therefore perform intermittent or spot check SpO monitoring 1 While monitoring SpO remove the SpO gt sensor from the patient but leave it connected to the monitor When the monitor detects the lack of a pulsatile waveform it sounds a patient alarm and displays this menu PE STL ENCE PT STANDBY J 2 Press STANDBY to place SpO into the Standby Mode Note The monitor suspends the SpO alarm tone indefinitely and displays STANDBY in place of SpO numerics SpO remains in the Standby Mode until the SpO sensor is reapplied to a patient Other vital sign monitoring is not restricted By contrast if you press SILENCE instead of STANDBY the monitor temporarily suspends all alarm tones however the alarm tone resumes after 90 seconds if the SpO gt sensor is still disconnected from the patient 3 To resume SpO monitoring reapply the SpO sensor to a patient Note The monitor exits the Standby Mode and resumes SpO monitoring The message STBY on the SpO trend display and trend printouts indicates the monitor was in the SpO Standby Mode SpO messages The following status message can appear in the equipment alert window or the SpO numeric display area NO SENSOR DETECTED appears
98. in the presence of high motion artifact while monitoring ECG Artifact can affect accuracy To help reduce artifact see Place and connect the cuff on page 44 NIBP TICKET 02 16 98 TIME HR PR Sp02 SYS DIA MEAN Bl HH MM BPM nmHg 11 46 80 97 120 63 80 12 Reference Guide Printing 81 Printing the apnea ticket The Apnea Ticket documents the length of each apnea episode The Apnea Ticket is printed after the patient and or 60 seconds after the last breath resumes breathing was detected if the patient has not resumed breathing APNEA TICKET BR 02 16 98 APNEA TICKET BR 2 16 98 TIME HR PR Sp02 TIME HR PR __5p02 ae H MIN S BPH i H MIN S BPM z LAST BREATH LAST BREATH 15 45 53 88 OFF 15 45 53 86 OFF RESUMED BREATHING BREATHING NOT RESUMED 15 47 82 88 OFF 15 46 53 80 OFF ELAPSED TIME ELAPSED TIME 86 01 09 60 01 60 ADULT ADULT To set the Propaq to print an Apnea Ticket after an apnea event follow these steps 1 From the main menu press the following buttons SETUP MORE PRINTER 2 Press the NEXT button until APNEA TICKET is highlighted in the Printer Setup window 3 Press the CHANGE button until APNEA TICKET is set to ON Printing when a patient alarm occurs To set up the printer to print on a patient alarm follow these steps 1 From the Main Menu press the following buttons SETUP MORE PRINTER 2 Press the NEXT button to select ALARM PRINT in the printer setu
99. ing Do not immerse accessories in liquid when cleaning unless the accessory manufacturer s cleaning instructions instruct you to do so Maintenance Service interval recommendations At the intervals recommended below verify the Propag Encore for proper operation of all channels and internal circuitry Such checks and verifications should only be carried out by a qualified biomedical service person Other Propag Encore service information including calibration procedures is described in the Propag Encore Service Manual P N 810 0696 XX Refer to it for more information Use the following intervals for a guideline Service may be needed more often in extreme environments heat cold dust etc Recommended interval Service action Six months to two years Minimum every three years Complete functional verification see Propaq Encore Service Manual Inspect the Propag Encore for mechanical and functional damage Inspect safety labels for legibility Inspect the side panel fuse for compliance to specified rating Verify that visual and acoustic alarms are functioning properly Test patient leakage current according to IEC 601 1 1988 Test patient leakage current with mains voltage on patient applied parts according to IEC 601 1 1988 limit 50uA Check battery capacity a NOTE The leakage current should never exceed the 50pA limit The data should be recorded in an equipment log If the device is not functioning p
100. ing Ambient Temperature 10 to 40 C Storage Temperature 20 to 60 C Operating Altitude 2 000 to 15 000 ft 610 to 4 572 m 817 to 429 mmHg Storage Altitude 2 000 to 40 000 ft 610 to 12 192 m 817 to 141 mmHg Operating and Storage Humidity 0 to 95 noncondensing Shock 100 g for 4 msec Vibration 5 35 Hz 0 015 in peak to peak 35 100 Hz 1 g acceleration Drop 36 inches free fall to floor tile over concrete one drop each face one drop each edge corner a not including cable 110 Specifications Sidestream CO Welch Allyn Propaq Encore Vital Signs Monitor Characteristic Specification Sensor Type Principle of Operation Operating Ambient Temperature Startup Time Rise Time Delay Time Total System Response Time Calibration Sampling Chamber Pneumatic and Exhaust System Barometric Pressure Compensation BTPS ATPS STPD Sampling Line Watertrap Flow Rate Sidestream internal Non dispersive infrared single beam single path wavelength ratiometric 5 to 40 C 30 seconds typical 3 minutes maximum 240 ms 10 to 90 at 175 ml min 1 12 seconds maximum 1 36 seconds maximum Rise Time and Delay Time Verify semi annually calibrate only as required Internal replaceable by service technician Integral Automatic CO value calculated CO value x 0 977 7 foot sampling line ID 0 055 in 1 4 mm for use with disposable single use cannula C0 only or CO
101. ion increases and decreases the pitch of the heart tone rises and falls The Nellcor SpO gt option periodically performs an internal adjustment which causes the SpO waveform to appear flat for a brief period 4 From the Main Menu press SpO2 or SpO2 CO2 then SpO2 to display the first SpO menu similar to the following SNS o Y ia Oxygen saturation percentage NO 2 a Pulse amplitude indicator not SIZE of EN PREV MENU proportional to pulse volume 5 Press SIZE to adjust the waveform size for best viewing 1x 2x 4x or 8x Note At high magnification 4x 8x some waveforms may appear truncated To view these waveforms reduce the size until the complete waveform appears 6 Adjust the placement of the sensor until a good SpO waveform is displayed A waveform with artifact may cause erroneous oxygen saturation readings 7 Press MORE to display the second SpO menu RESPONSE C LOCK PoP PREV MENU 8 Press RESPONSE to select the appropriate time required to measure SpO Response Indications for Use NORMAL 5 7 seconds Use for relatively stable patients Reference Guide Patient monitoring 55 Response Indications for Use FAST 2 3 seconds Use when patient movement is minimal SLOW 10 15 seconds Use when patients exhibiting movement are preventing accurate measurement at NORMAL setting 9 If the C LOCK function is desired press C LOCK to set it to ON Note C LOCK synchronizes
102. is the maximum output power rating of the transmitter in watts according to the transmitter manufacturer and d is the recommended separation distance in meters 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 might occur in the vicinity of equipment marked with the following symbol gt Note 1 At 80 MHz and 800 MHz the higher frequency range applies Note 2 These guidelines might not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people a 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 monitor is used exceeds the applicable RF compliance level above the monitor should be observed to verify normal operation If abnormal performance is observed additional measures might be necessary such as reorienting or relocating the monitor b Over the frequency range 150 kHz to 80 MHz field strengths should be less than 3 V m 124 Specifications Welch Allyn Propaq Encore Vital
103. it on and connect ECG if not already connected The following messages can appear in the NIBP status window CALIBRATING The NIBP channel is running an internal calibration DISABLED LOW BATT See LOW BATTERY NIBP DISABLED above NIBP DISABLED SERVICE REQUIRED See SERVICE REQUIRED NIBP DISABLED above RETRY Since the Propag Encore did not receive a valid NIBP reading it will automatically attempt to take another reading NIBP ADULT CALIBRATING MODE MANUAL TIME N A 0 50 100 150 Y v v STOP AUTO MANJINTERVAL TURBOCUF PREV MENU The following message can be displayed if the monitor detects a system error REMOVE CUFF FROM PATIENT See page 75 50 Patient monitoring Welch Allyn Propag Encore Vital Signs Monitor NIBP IN PROGRESS message NIBP IN PROGRESS PLEASE WAIT The monitor displays this message when noise or artifact such as vehicle motion causes a delay while measuring NIBP To remove the message press any button below the screen To cancel the NIBP measurement press STOP Temperature Intended use Propaq Encore monitors provide two temperature channels except for the HP side panel option When both channels are active the difference temperature AT is also displayed You can select C or F Temperature connectors and probes Propags are intended to be used with approved temperature probes listed in Products and Accessories Other temperature probes that do not match the performance
104. ixel Luminance Off Pixel Luminance Refresh Rate 552 x 256 pixels EL display 145 75 mm x 67 56 mm 0 203 mm x 0 203 mm 0 264 mm x 0 264 mm Large 11 03 mm 0 434 in Medium 7 34 mm 0 289 in Small 3 64 mm 0 143 in gt 160 Horizontal and Vertical gt 45 On pixel luminance Off pixel luminance Amber Black gt 9 0 fL area of amber pixel includes protective window lt 0 2 fL black pixel 109 Hz Reference Guide Monitor environmental Specifications 113 Caution The monitor may not meet performance specifications if it is not used or stored within these environmental specifications Characteristic Specification Operating Temperature Shipping and Storage Temperature Operating Altitude Shipping and Storage Altitude Operating Relative Humidity Shipping and Storage Relative Humidity Shock Vibration Random Vibration Sinusoidal Degree of protection against ingress for monitors without CO or printer options 0 to 40 C 20 to 60 C 2 000 to 15 000 ft 610 to 4 572 m 2 000 to 40 000 ft 610 to 12 192 m 15 to 95 noncondensing per MIL STD 810E Procedure 1 natural 15 to 95 noncondensing per MIL STD 810E Procedure 1 natural 50 g 0 02g Hz from 10 to 500 Hz ramping down to 0 002g Hz at 2000 Hz Operating 1 hour per axis 3 hours per test Designed to meet RTCA DO 160C Category C 0 10 peak to peak inches 5 to 17 Hz sloping to 0
105. l time ECG Output Saale Connector cy Speaker On Off Switch Input Fuse Battery Charging Light Connector for Acuity or Power Input Modem Propaq Connector WARNING Safe interconnection between the Propaq Encore and other devices must comply with applicable medical systems safety standards such as IEC 601 1 1 On Off switch This switch turns the monitor on and off The switch is recessed to prevent accidentally turning off the monitor which would result in losing patient data 10 Getting started Welch Allyn Propag Encore Vital Signs Monitor Input fuse The input fuse which protects the Propaq Encore against power surges is a 3 Ampere fuse externally replaceable by qualified service personnel See Replacing the fuse on page 92 for fuse replacement instructions Power input connector This receptacle accepts the Welch Allyn ac power adapter which must be used for ac mains operation and battery charging The Propaq Encore is also designed to operate with other 12 28 volt dc only power sources such as a vehicle battery system Defib sync connector This connector allows connection with a LIFEPAK 5 or LIFEPAK 6s defibrillator for synchronized cardioversion See Real time ECG analog defib sync on page 101 Real time ECG output connector This connector provides a real time analog ECG signal output Battery charging light This green light turns on when a power source ac power adapter or exte
106. lch Allyn Propag Encore Vital Signs Monitor Selecting waveforms for display To select waveforms for display press SETUP WAVE SEL Use the NEXT and ON OFF buttons to turn on the desired waveforms in the wave select window z ON RESP OFF ON Sp02 ON OFF NIBP ON OFF a 92 NEXT ON OFF INSERV PREV_MENU Display priorities You can turn on more than three waveforms but only the first three waveforms listed in the wave select window that are monitored are displayed The patient parameters being monitored are listed in the order they will be displayed if all are turned on Because of the critical nature of the ECG waveform you cannot turn off ECG However if ECG is not monitored another waveform will occupy its place The displayed waveforms are also the ones printed if a printer is attached Setting the time and date To set the time and date from the Main Menu press SETUP MORE MORE The monitor displays the Time Day window TIME DAY BATTERY 9 2 VOLTS TIME H MIN S MO DA YR 07444 gt ERY 06 12 97 a NEXT UP E DOWN ENTER PREV MENU Press NEXT UP and DOWN as needed to set the time and date Then press ENTER to store the new time and date Time day settings and trends WARNING Changing the hour minute second setting for the monitor in the Time Day window can cause the monitor to erase previously stored patient trend data When you change the hour minute second setting for the monitor in the Time
107. lecting a trend NXT TRND Select the trend you want displayed by pressing the NXT TRND button The trend is identified by a label at the top of the table P1 TREND P2 TREND NIBP TREND RESP TREND TEMP TREND Time Time Time Time Time HR PR HR PR HR PR HR PR HR PR Sp0 Sp0 Sp0 Sp03 Sp0 SYS DIA Mean SYS DIA Mean SYS DIA Mean RR or BR T1 RR or BR RR or BR RR or BR ETCO T2 INCO AT 79 Printing Printing patient data Printing waveforms If you have an expansion module set up with your monitor you can print any waveform by pressing either the SNAPSHOT or START STOP button on the expansion module when the waveform is displayed on the monitor You can also set the monitor to print automatically The number of seconds of data shown on the printout depends on the print speed set in the Printer Setup window Patient vital sign numerics are printed above the waveforms The ECG waveform ECG is printed on a grid with major divisions dotted lines every 5 mm and minor divisions single dots every 1 mm The ECG waveform is always printed if ECG is monitored 02 16 08 11 31 43 HR 80_ART 121 70 96 PA 25 9 15 MC02 38 QrmHg BR 12 Sp02 97 NIBP OFFT1 37 8 C 12 36 4 C aT 8 6 C Eslida da dada nal s uusz LOHSdUNS DISPLAY ON ART o ASIN ISI ISI EN A The invasive pressure waveforms Pressure waveforms are printed on a grid with major divisions vertical dotted lines every 5 mm and the press
108. lence 4 SUSPND Inhibits alarm and alert tones for Alarms Suspended Nurse Suspend 4 min four minutes at the Propaq Message Message monitor and Acuity Central Station ALL ALRM Indefinitely inhibits alarm and Alarms Suspended Nurse Suspend Always alert tones at the Propag monitor Message Message and Acuity Central Station until someone resumes tone capability Propaq Encore SUSPEND or Suspends for 90 seconds the Alarms Suspended Alarms Suspended 2 4X capability for patient alarm and Message Message and prior N A equipment alert tones at the Propaq monitor and Acuity Central Station ALL ALRM Turns off all patient vital sign Some Alarms Off Some Alarms Off alarm limits at the Propaq Set Alarm Limits Set Alarm Limits monitor and Acuity Central Message Message Station No visual or auditory alarm indications occur until someone resumes the limits a If connected to the Acuity Central Station life hreatening arrhythmias and apnea alarms interrupt the suspension Reference Guide Alarms and limits 73 Alarm holdoffs Propag audio and visual alarm hold offs Motion artifact or other factors can cause false vital sign alarms To help minimize false alarms the Propaq briefly delays or holds off triggering alarms for certain vital sign limit violations After the alarm holdoff period begins if the monitor detects that the patient s vital sign has returned to acceptable limits the Propaq canc
109. luding earth ground To prevent damage during defibrillation don t use ECG cables without 1K series resistors Preparing for ECG monitoring with the Propag Encore requires you to prepare the monitor prepare the patient set up the ECG channel and then set the ECG alarms Preparing the monitor 1 Inspect the ECG cable for wear breakage or fraying Replace the cable if it shows signs of any of these Plug the ECG cable into the ECG connector on the Propaq s left side panel WARNING Before you use a Propag on a new patient always turn it off for a few seconds then turn it on again This clears the prior patient s trend values alarm limit settings and NIBP cuff inflation target 2 If the monitor is off press the OFF ON switch to turn it on 3 Select the patient mode appropriate for the patient Neonatal Pediatric Adult To change patient modes see Monitor setup on page 20 Preparing the patient 1 Thoroughly clean the skin areas where the electrodes will be attached Attach lead wires to the electrodes before applying them to the patient 2 If you are using pre gelled electrodes use only electrodes that have not expired Make sure there is a generous amount of gel in the electrode and that it has not dried For best results use silver silver chloride electrodes 3 If you are using non gelled electrodes apply a 1 4 to inch mound of gel over the electrode contact area 32 Patient monitoring Note W
110. lyn 503 0054 series power adapter WARNING This monitor should only be repaired by qualified service personnel The operator should not attempt to open the monitor case or perform any maintenance on the monitor except for procedures explicitly described in this manual that can be performed by operators such as inspection and cleaning WARNING To ensure patient safety use only accessories recommended or supplied by Welch Allyn For a list of those accessories see Products and Accessories 810 0409 XX which accompanies this manual Accessories must be used according to your hospital s standards and the manufacturer s recommendations Always refer to the manufacturer s directions for use Use of accessories not recommended by Welch Allyn may result in increased electromagnetic emissions or decreased electromagnetic immunity of the equipment WARNING Safe interconnection between the Propag monitor and other devices must comply with applicable medical systems safety standards such as IEC 60601 1 1 Within certain governmental jurisdictions all interconnected accessory equipment must be labeled by an approved testing laboratory After interconnection with accessory equipment risk leakage current and grounding requirements must be maintained WARNING As with all medical equipment carefully route the patient cabling to reduce the possibility of patient entanglement or strangulation WARNING A product that has been dropped or severely abused sh
111. n 26 to 239 beats per minute 5 counts Resolution 1 beat per minute Alarm Limits 27 to 250 beats per minute upper 25 to 248 beats per minute lower Note Any pulse rate above 239 will activate the pulse rate alarm even if the upper alarm limit is set above 239 If the lower alarm limit is set to 25 a pulse rate of 25 will activate the pulse rate alarm due to the limitation of the displayable numeric range Pulse Rate Accuracy No Motion 3 beats per minute During Motion 5 beats per minute Measurement averaging time 8 seconds Alarm Hold Off Time Period 10 seconds resets if the sensor reports levels within limits before 10 seconds elapses Circuitry Microprocessor controlled Automatic self test of oximeter when powered on Automatic setting of default parameters Automatic alarm messages Electrosurgery interference suppression Yes Sensor Compatibility Compatible only with Masimo sensors listed in Products and Accessories Sensor LEDs RED Wavelength 660 nm nominal INFRARED Wavelength 905 nm nominal Sensor Energies Radiant Power 0 13 mW to 0 79 mW at 50 mA pulsed a Motion for adults and pediatrics is defined as rubbing and tapping motions at 2 to 4 Hz at an amplitude of 1 to 2 cm and a non epetitive motion between 1 to 5 Hz at an amplitude of 2 to 3 cm in induced hypoxia studies in the range of 70 100 SpO against a aboratory co oximeter and ECG monitor This variation equals 1 standard deviation which
112. ncreases or decreases the ECG or RESP waveform size Each time you press a SIZE button the waveform approximately doubles in height When you reach the largest waveform size the next press displays the smallest size Note The ORS detector sensitivity threshold is not affected by changing the ECG display size Likewise the RESP breath detector threshold is not affected by changing the RESP display size RESP LEAD Selects the RESP lead Choices are RA LA and RA LL and choice is independent of ECG lead selection Experiment with placement for best signals RESP Turns impedance pneumography RESP channel on or off Reference Guide Note Patient monitoring 35 The Propag Encore counts as breaths respiratory efforts that are larger than two times background Cardiovascular Artifact CVA Since RESP is derived from the same leads as the ECG channel the Propaq Encore determines which signals are cardiovascular artifact and which signals are a result of respiratory effort If the breath rate is within five percent of the heart rate or a multiple or sub multiple of the heart rate the monitor may ignore breaths and trigger an apnea alarm Using the Propag Encore with pacemaker patients A Pacemaker signals WARNING Pacemaker signals can differ from one pacemaker to the next The Association for Advancement of Medical Instrumentation AAMI cautions that in some devices rate meters may continue to count the pacemaker
113. ne instead of the one piece Sure CO2 gas sampling system perform steps above with the following changes attach the watertrap to the monitor then attach the sample line to the watertrap CO messages Mainstream CO messages Equipment messages for the Mainstream CO option can appear on the display in an equipment alert window and in numeric zones If a sensor is damaged contact Welch Allyn Technical Services Department for information on sensor service options Reference Guide Patient monitoring 67 ALTIMETER FAILURE RANGE The Propaq is operating at an altitude outside the Mainstream CO option s operating altitude range of 2 000 to 15 000 feet Returning the monitor to within this range automatically cancels this message and restores operation ALTIMETER FAILURE RATE The altimeter has detected that the ambient pressure is changing at a rate greater than 100 mmHg minute When the rate of change is back within the 100 mmHg minute range disconnect and reconnect the CO sensor to the Propaq DEGRADED WAVEFORM CHECK ADAPTER UNCAL appears in the numerics area The Mainstream CO adapter is obstructed or the CO sensor has failed The CO3 waveform is displayed without range values Replace the adapter or replace the sensor LACK OF WAVE CHECK ADAPTER SENSOR Either the airway adapter is obstructed or the CO sensor has failed Replace the airway adapter if it is obstructed The sensor must be unplugged and plugged in again
114. new 5 second RR BR alarm holdoff period Set the alarm limit for Apnea Delay this is the maximum time allowed between two successive breaths before an Apnea alarm occurs After the first breath has been detected the Apnea alarm limit setting will be automatically turned on for as long as the CO channel is active The RR BR and Apnea Alarm Limit window is shown below STAT SET does not affect the Apnea limit ALARM LIMITS RR BR Br M 30 APN EA DELAY secs 92 L L NEXT UP DOWN I ON OFF NEXT PAGEJ 64 Patient monitoring Welch Allyn Propag Encore Vital Signs Monitor Sidestream CO monitoring A WARNING If the Sidestream CO option is connected to a ventilatory circuit be sure to adjust appropriate ventilator or anesthesia system settings to compensate for the sampling flow volume 90 or 175 ml min that is aspirated from the ventilatory circuit by the Sidestream CO option WARNING Do not use Sidestream CO if flammable anesthetic gases are in use Setting up for Sidestream CO monitoring requires these major steps 1 Connect the watertrap 2 Set up the CO channel and alarm limits 3 Connect to a non intubated patient OR 4 Connect to an intubated patient Use only accessories provided or recommended in Products and Accessories Always refer to the manufacturer s Directions for Use Note Breath rates greater than 50 breaths minute may reduce the reported ETCO values Select the 175 ml min flow rate to minimize er
115. nformation obtained prior to when you pressed FREEZE Learning the Propag Encore Using in service mode You can practice using the Propag Encore without a patient simulator by using the Propaq s in service mode of operation The in service mode cannot be activated while you are monitoring a patient The message SIMULATING alternates with the time of day and patient mode on the display To begin practicing with your Propag disconnect all patient cables connected to the monitor Leave the cuff connected so you can take NIBP measurements If you have been monitoring a patient turn off the Propag Encore and turn it back on From the Main Menu press SETUP WAVE SEL INSERV The Propaq Encore has two sets of simulated patient information an initial set and an alternate set To change between them press the INSERV button again If you connect a patient cable or set the NIBP channel to automatically take pressure measurements the Propag Encore stops simulating goes through its powerup tests and erases any simulated trend data it might have stored Reference Guide Getting started 27 What you can do with in service mode While using the in service mode you can press any of the Propaq Encore buttons except for the AUTO MAN button in the NIBP Menu to change a function setting You can also NIBP e change the ECG and RESP waveform sizes e set alarm limits and cancel alarms e STAT SET alarms e customize the Propag Encore set
116. ng the signal by measuring the AC impedance between the selected terminals of the ECG electrodes RESP displays a respiration rate and waveforms Two respiration lead selections are available Lead 1 RA LA and Lead 2 RA LL A Note WARNING Impedance pneumography detects respiratory effort via changes in chest volume therefore impedance pneumography can be used to detect central apnea However apnea episodes with continued respiratory effort such as obstructive apnea and mixed apnea may go undetected Always monitor and set alarms for SpO when using impedance pneumography to monitor respiratory function WARNING With any monitor that detects respiratory effort via impedance pneumography artifact due to patient motion apnea mattress shaking or electrocautery use may cause apnea episodes to go undetected Always monitor and set alarms for SoO z when using impedance pneumography to monitor respiratory function WARNING The Propag Encore automatically rejects cardiovascular artifact CVA This function is dependent upon accurate ECG R wave detection Therefore always select the ECG lead with the most prominent ORS complex when monitoring respiration via impedance pneumography WARNING Don t place the Propag Encore monitor with RESP in close proximity with another respiration monitor because the RESP measurement frequencies may interfere with one another WARNING Because pacemaker pulses in some instances may be falsely counted a
117. ng this button freezes or unfreezes the displayed waveforms 1 To disconnect the Propag Encore from the Acuity network press the front panel NET OFF button 2 Within 15 seconds disconnect the Acuity network cable from either the Propaq Encore side panel or the bedside jack If the patient will no longer be monitored with the Propag Encore turn off the monitor to erase trend information If you do not disconnect the Acuity network cable within about 30 seconds the monitor and Acuity attempt to reconnect and prompt you to confirm the patient ID Whenever the monitor is connected to Acuity the NET OFF function overrides the FREEZE UNFREEZE function for the NET OFF front panel button Therefore you cannot freeze the displayed waveforms when the monitor is connected to Acuity Also you cannot initiate a Freeze Print at Acuity when connected to Acuity When the monitor is not connected to Acuity pressing the FREEZE UNFREEZE button freezes or unfreezes the displayed waveforms Printing at Acuity You can print various waveforms from the Propaq Encore to the Acuity system printer To print a waveform shown on the display screen press SETUP ACUITY SNAPSHOT If you press the FREEZE button on the front of the Propag Encore the button changes from SNAPSHOT to FRZ PRNT 88 Acuity Central Monitoring system Welch Allyn Propaq Encore Vital Signs Monitor Network alert message When the Propag Encore is connected to the Acuity system it co
118. nitor specifications 114 Physical inspection 93 Power input connector 10 specifications 116 Power adapters 89 specifications 117 Powerup patient modes 23 Powerup tones expansion module Sp02 module 11 monitor 11 PREV MENU button 25 PRINT button 77 83 Printer 8 loading paper 96 maintenance 96 print speed continuous measurements 25 PRINT TRENDS button 26 83 96 setup 25 SIMULATED DATA 27 SNAPSHOT button 26 79 specifications 115 START STOP button 26 79 96 test strip 26 PRINTER button 20 80 Printer Fault equipment alert 26 Printer Menu CHANGE button 25 MORE button 25 NEXT button 25 PREV MENU button 25 PR TREND button 25 Printer settings ALARM PRINT 25 APNEA TICKET 25 AUTO PRINT 25 CONTINUOUS print speed 25 NIBP TICKET 25 OXYCRG ON ALARM 25 Printer Setup Menus 19 Printing 80 alarm prints 81 Apnea Ticket 81 automatically 79 83 automatic trends 83 C02 waveforms 80 ECG waveforms 79 INV PRS waveforms 79 Index 135 NIBP Ticket 80 NIBP Trend 80 OxyCRG 82 OxyCRG on Alarm 82 PRINT button see a so Trends Menu 83 Printer Setup window 81 PR TREND button 83 RESP waveforms 80 Setup Menu 2 80 speed 79 Sp02 waveforms 79 sweep speeds with SNAPSHOT 80 trends 83 trends according to shift 83 with an expansion module 79 PRINT TRENDS button 26 83 96 Probes temperature 50 Products Accessories book 5 Programmable settings effect of batter
119. nitor displays below the range or above the range instead of the vital sign value A WARNING The Propaq Encore will show for HR numerics between 301 350 beats per minute Above 350 beats per minute it may display incorrectly low heart rates due to intermittent picking of R waves Note Due to differences in software versions and standards required by different countries the displays shown in this reference guide may be slightly different than the display on your Propag Encore Time of day caution and status Temperature values are displayed Bells indicate alarm limit status messages here Noninvasive blood Heart Rate Source Mtra pressure values can HR indicates ECG eart Rate in beats per appear here PR indicates blood pressure minute or SpO 7 GAS COMPENSATION OFF RESPONSE NORMAL C02 SOURCE MAINSTREAM SWEEP SPEED mS BAROMETER Status window ETCO concentration Breath Rate from CO Systolic diastolic and if space permits xygen saturation is a Oxyg mean pressures are displayed percentage value The screenspace is reallocated when vital signs are added or removed By changing the size of the numeric windows below the heart rate the Propaq Encore provides the best possible view of all numerics for vitals signs being monitored 16 Getting started Welch Allyn Propag Encore Vital Signs Monitor You can select up to three waveforms to be shown on the Propag
120. not being monitored variable pitch with SpO option and SpO being monitored 3 9 seconds at 25 mm sec 0 5 to 40 Hz in Monitor Mode 0 05 to 40 Hz in Extended Mode see Real Time ECG Analog Defib Sync specification 364 Hz Electrosurgery and defibrillator protected when used with specified ECG cables All models also include electrosurgery interference suppression 50 nA de for active leads 100 200 nA dc for driven lead depending on number of electrodes attached 1 mV ORS using AAMI test waveform lt 1 mV p p RTI for 10V rms 50 60 Hz input 200 pF source impedance input unbalanced FILTER function OFF lt 0 1 mV p p RTI for 10V rms 50 60 Hz input 200 pF source impedance input unbalanced FILTER function ON gt 2 5 MQ differential 60 Hz 10 mV peak to peak Up to 300 mV lt 30 uV peak to peak R T l with all inputs 47K in parallel with 047 pF Welch Allyn Propaq Encore Vital Signs Monitor Characteristic ORS Detector fal aa eart Rate Range Na R PR Alarm Limit Range oles eart Rate Meter Response Time HR Accuracy Heart Rate Averaging Method Drift Tolerance AAMI Specification EC13 1992 3 2 6 3 Pacer Display Pacer Pulse Rejection Specification Adult or Pediatric Amplitude Range 0 22 to 5 0 mV RTI Neonatal Amplitude Range 0 1 to 5 0 mV RTI Neonatal and Pediatric Width Range Duration 40 to 120 msec Adult Width Range Duration 70 to 120 msec 25 to 350 bea
121. nstantly exchanges information with Acuity If the Propag Encore detects an interruption in this flow of information it displays an alert message NETWORK FAULT CHECK ACUITY DATA COMM CONNECTION If the Propag Encore displays this message check the Acuity network cable to be sure it is plugged in to the side panel and to the bedside jack If the cable is damaged replace the cable If the cable appears undamaged and the Acuity system is operating normally ask your service personnel to check the network and the Propaq Encore Acuity connector 89 Power sources For in hospital operation and recharging from ac mains an ac power adapter plugs into the monitor Use only a Welch Allyn ac power adapter to ensure protection against risk leakage current hazards The Propag Encore can also be powered and recharged from a dc source isolated from ac mains capable of supplying 12 28 Vdc and continuously supplying 25W Caution When a transport vehicle s battery system is used to provide input A power to the Propaq Encore surges caused by a defect in the vehicle s power system may blow a fuse in the Propaq s side panel or cause further damage to the Propaq Power adapter intended use Welch Allyn power adapters are intended to be used only with Propag monitors and Propaq Encore monitors are intended to be recharged using only a Welch Allyn power adapter with a mating plug and rated for your ac mains The power adapter contains sym
122. nt monitoring Welch Allyn Propag Encore Vital Signs Monitor NIBP connector and cuffs Use Propaqs with approved hoses and cuffs listed in Products and Accessories The Propaq Encore uses a single hose cuff Cuffs that conform to AAMI or AHA guidelines should be used Select the proper size of cuff based on the limb circumference Neonate Pediatric Adult Hoses Neonate Infant Adult Adult Cuffs typical cuff Neonate 1 to 5 disposable Newborn infant small child child small adult adult large labeling newborn infant reusable child small adult adult thigh Recommended limb up to 15 cm 7 7 to 25 cm greater than 15 cm circumference A WARNING When monitoring NIBP match the Propaq patient mode to the style of the cuff For neonates set the monitor to Neonatal Mode unless the circumference of the limb is too large for the cuff In that case use the Pediatric Mode In the Pediatric Mode the maximum cuff inflation pressure can exceed 150 mmHg and two retries are allowed For information about patient mode specifications see NIBP on page 104 Preparation Setting up for noninvasive blood pressure monitoring requires three steps place the cuff on the patient and connect the cuff to the monitor set up the NIBP channel and set the NIBP alarm limits WARNING Before you use a Propag on a new patient always turn it off for a few seconds then turn it on again This clears the prior patient s NIBP cuff inflation target
123. olutions monitoring welchallyn com Before returning the monitor for service call Welch Allyn for return authorization and instructions on shipping Repack the Propag Encore in its original shipping container if possible The container is designed to protect the monitor from possible damage during shipment 98 Care and maintenance Welch Allyn Propag Encore Vital Signs Monitor 99 10 Specifications ECG The ECG channel meets all the requirements for Cardiac Monitors Heart Rate Meters and Alarms specified ANSI AAMI EC13 1992 except for Standardizing Voltage section 3 2 9 9 The channel also meets the American National Standard Safe Current Limits for Electromedical Apparatus ANSI AAMI ES1 1993 Characteristic Specification Connector Selectable Leads Lead Fault Indicator ECG Size sensitivity in mV cm Display Sweep Speeds ORS Tone Volume ORS Tone Frequency Freeze Buffer Bandwidth Sample Rate Input Protection Lead Fail Sense Current Tall T wave Rejection Common Mode Rejection Input Impedance Input Range ac Input Range dc System Noise AAMI 6 pin or Hewlett Packard compatible 12 pin style connector optional See the illustration at the bottom of this table 11 Ill aVR aVL aVF V LA LL RA RL C multiple 4 2 1 0 5 0 2 12 5 25 and 50 mm sec High Low Medium Off 900 Hz for Propag Encore without Expansion Module 665 Hertz when equipped with Sp02 but Sp02
124. om the surgical site and from the electrosurgical return electrode and its cables This will minimize interference By now there should be some kind of ECG waveform displayed on the monitor A heart rate should be displayed to the right of the waveform Depending on how the Propag Encore is programmed a beep tone may occur with each detected QRS event Reference Guide Patient monitoring 33 7 f there is no waveform check the electrodes wires cable and the monitor for a possible lead fault If an ECG electrode becomes disconnected or disrupted so that the Propag Encore cannot receive the ECG signal a message and tone are conveyed with an equipment alert Setting up the ECG RESP channel Press ECG or ECG RESP available with the Impedance Pneumography Option to set the selections ECG SIZE ECG LEAD RESP SZE available with Impedance Pneumography The MORE button displays the second ECG RESP menu and a status window with selections for HR PR TONE PACER DISPLAY ECG BANDWIDTH and RESP LEAD available with Impedance Pneumography If the patient being monitored has a pacemaker you may want to turn on the Pacer indicator function Setting ECG RESP alarms Set the alarm limits according to your hospital s standards Motion artifact or other factors can cause false HR PR alarms To help minimize false alarms the Propaq delays or holds off triggering an HR PR alarm for 3 seconds During this holdoff period if the Propag detects
125. ons and the recommended separation distance between the monitor and such equipment refer to the specifications section of this manual The Propag Encore should be serviced only by a Welch Allyn service technician while under warranty Propaq Encore Service Manual 810 0696 XX is available from Welch Allyn to assist the biomedical engineer during post warranty period service The following symbols may appear on the Propaq Encore monitor or accessories or documentation These internationally recognized symbols are defined by the International Electrotechnical Commission IEC 878 and IEC 417A A WARNING Indicates conditions that could lead to illness injury or death A Caution In this manual indicates conditions that could damage equipment or other property AN Caution On the product means Consult the accompanying documentation o Off Standby Patient connections are Transformer meets 19 Type CF isolated for direct requirements of a cardiac application and short circuit proof protected against safety isolating power defibrillation transformer O On Alternating current the specified fuse against defibrillation Caution On the product means Consult accompanying documentation Direct current Patient connections are R Type B ES For continued fire p Patient connections are For indoor use only on protection use only Type BF and protected E power adapter only
126. onstant whose tail amplitudes are 2 5 or 25 2mV maximum whether ventricular only or A V sequential pulses all per AAMI tests 3 1 4 1 and 3 1 4 2 Response to Irregular Rhythm AAMI specification EC13 1992 3 1 2 1 Part e Ventricular Bigeminy VB Slow Alternating VB Rapid Alternating VB Bidirectional Systole 1mV Ventricular Tachycardia 2mV Ventricular Tachycardia 78 to 81 bpm 80 bpm expected 57 to 65 bpm 60 bpm expected 118 to 123 bpm 120 bpm expected 88 to 93 bpm 90 bpm expected 197 to 198 bpm 206 bpm expected 193 to 197 bpm 206 bpm expected R SHIELD LA fo gt LL a fe e n c AAMI 6 pin ECG connector side panel view RA HP 12 pin ECG connector side panel view SHIELD Reference Guide Specifications 101 Real time ECG analog defib sync Special cables are required to interface the defib sync connector to the Physio Control LIFEPAK 5 or LIFEPAK 6s defibrillator Signal Specification Sync Output 0 to 5V pulse 100 5ms wide starts within 35 ms after peak of R wave 15 mA short circuit current Real time ECG Output Range 6V minimum centered about OV Gain 1000X noninverting for lead II inverting for all other leads delay lt 3 msec 0 05 100 Hz going to 5 9V 5 during ECG lead fail V lead has no Real Time analog output Marker Input Defib Sync Normally OV in a pulse either or 3 to 15V for 10 70 ms puts a marker in ECG only race 5 kQ input re
127. oper type Reference Guide Patient monitoring 37 NOISY SIGNAL CHECK ELECTRODES Electrodes are making poor contact and may be dried out Replace electrodes A WARNING f a disconnected lead is in too close proximity to other electrical devices it may cause false heart rate a failure to detect apnea or a failure to display a Lead Fail message Invasive pressure This section applies only to Propaq Encore Models 204EL and 206EL If you don t have one of these models you can skip this section Intended use The Propag Encore invasive pressure channel is intended for measuring arterial venous and intracranial pressures using Invasive transducers with 5 uV V mmHg sensitivity The Propaq Encore can be used with many types of transducers including nondisposable disposable dome and fully disposable Invasive pressure connectors and transducers Recommended transducers for use with the Propaq Encore are listed in Products and Accessories Do not use light sensitive disposable transducers Transducers must be used according to your hospital s standards and the manufacturer s recommendations Always refer to the manufacturer s Directions for Use before using the transducer A WARNING f electrocautery is used always avoid using any transducer with a conductive metal case that is electrically connected to Its cable shield Using a conductive transducer case with such a shield connection risks high frequency burns at the ECG electrodes
128. ould be checked by qualified service personnel to verify proper operation and acceptable risk leakage current values WARNING The pulse oximetry channel should NOT be used as an apnea monitor WARNING If the monitor detects an unrecoverable problem an error message window appears containing an error number and a short message Report such errors to Welch Allyn Reference Guide Symbols General information 3 WARNING When taking NIBP measurements periodically observe the patient s limb to make sure that the circulation is not impaired for a prolonged period of time Also make sure the blood pressure cuff is properly placed according to Propag Encore Directions for Use or Propaq Encore Reference Guide Be especially careful when using the short term automatic mode TURBOCUF Prolonged impairment of circulation or improper cuff placement can cause contusions WARNING The range of values measured by the monitoring parameters is provided in the Specifications section of Propaq Encore Directions for Use or Propaq Encore Reference Guide Operation of the monitor outside the range of specified values is not recommended and may cause inaccurate results WARNING Electronic equipment that emits very strong electromagnetic or radio frequency signals can cause electrical interference with monitor operation including causing the monitor to turn off power Avoid operating this monitor near such equipment For guidance about electromagnetic emissi
129. p window 3 Press the CHANGE button until ALARM PRINT is set to ON PRINTER CONTINUOUS AUTO PRINT 15 minutes ALARM PRINT OFF NIBP TICKET OFF APNEA TICKET OFF OXYCRG ON ALARM OFF 82 Printing OxyCRG Welch Allyn Propag Encore Vital Signs Monitor A 3 second mark Printout continues zi a so 12 SECOND WAJEFORH HISTORY 5 ou 52M El 3 1 0m0 cn PACER DISPLAY ON z a t 1 a NCO2 O ae mnHg i aa eae ax H j E Ldi a AA o Alarm occurred here Alarming vital sign numerics are highlighted a 19 1618 11 50 81 HRAM ART 129 85 189 PA 25 12 18 NCO2 3 drebto BR 12_SpUZ EIZ NIBP 187 64 78 TI E 12 HREI gt C alt PACER DISPLAY ON E ON l a jens The OxyCRG is a graphical printout of two minutes of continuous HR PR and SpO numerics and a condensed respiratory waveform If any of the parameters have been completely inactive for the two minutes prior to the initiation of the print the associated band will be empty DxyCR6 2 Min 02 16 08 Start 19 35 42 HR PR 108 BPH Sp02 SRCH BR SRCH Stop 13 37 42 HR PR 20 BPH Sp02 94 BR 4 Br se a s ao RR BPM A Angy sa Bas E Sp02 8 RUE WY MA OxyCRG on alarm When an alarm condition is detected a print will be initiated if OXYCRG ON ALARM is turned on If an SpO or HR PR alarm condition is detected an OxyCRG will be queued to print 60 seconds after the alarm is detected
130. paq equipped with the CO option CO reading accuracy is affected by the presence of interfering gases and vapors If the CO option is used on patients who are being administered oxygen O3 or nitrous oxide N20 be sure to set the appropriate compensation setting using the GAS COMP button A WARNING Before you use a Propaq on a new patient always turn it off for a few seconds then turn it on again This clears the prior patient s trend values alarm limit settings and NIBP cuff inflation target WARNING Avoid exposing a Propaq with the CO option to non patient sources of CO such as vehicle engine exhaust or smoke When such exposure is possible avoid opening the printer door Exposure to these CO sources can temporarily trap v within the monitor or Mainstream v sensor housing even when monitor power is off This can temporarily cause an erroneous elevated CO3 measurement baseline until the trapped CO leaks out and the baseline returns to zero which can require as long as 3 24 hours A Caution The Mainstream CO and Sidestream CO options are not recommended for use during magnetic resonance imaging MRI procedures The magnetic fields involved will permanently damage the CO sensor Note CO monitoring outside the specified operating temperature range can cause inaccurate CO readings The operating temperature range for the CO option is different than the range of 0 to 40 C for other Propaq Encore functions e Mainst
131. pnea alarm occurs After the alarm ceases the Propaq prints an Apnea Ticket if the Apnea Ticket setting in the Printer Setup window is set to ON Numeric area status messages The following status messages can appear in the numeric display area OFF indicates no CO source is selected SRCH indicates the MCO or SCO sensor is preparing for a measurement UNCAL indicates the monitor has detected a problem such as a lack of calibration an obstruction or a low battery WARM UP indicates Mainstream CO has been activated and is preparing for operation This typically requires 30 seconds at room temperature START UP indicates Sidestream CO has been activated and is preparing for operation This typically requires 30 seconds at room temperature CO display menus and status window To access the first CO menu press SpO2 CO2 CO2 from the Main Menu RANGE mm s MORE PREV MENU RANGE Selects the CO waveform scale range mm s Sets the display sweep speed for CO and RESP Mainstream CO menu and status window When Mainstream CO is active press MORE from the first CO menu to access the MCO menu and the MCO status window GAS COMPENSATION OFF RESPONSE z NORMAL c02 SOURCE MAINSTREAM SWEEP SPEED 6 25 mm s BAROMETER 762 0 mmHg a 92 GAS COMP RESPONSE SOURCE PREV MENU GAS COMP Selects the measurement compensation for CO measurements RESPONSE Sets the response time for CO measurement NORMAL FAST OR
132. ption warnings cautions and specifications WARNING Sensors exposed to ambient light while not applied to a patient can exhibit semi normal saturation readings Be sure the sensor is securely placed on the patient and check its application often to ensure accurate readings WARNING Inaccurate measurements may be caused by venous pulsations WARNING The pulse oximetry option can be used during defibrillation but the readings may be inaccurate for a short time WARNING A very sudden and substantial change in pulse rate can result in erroneous pulse rate readings Be sure to validate the patient data and patient condition before intervention or change in patient care WARNING Interfering Substances Carboxyhemoglobin may erroneously increase readings the level of increase is approximately equal to the amount of carboxyhemoglobin present Methemoglobin may also cause erroneous readings Dyes or any substances containing dyes that change usual arterial pigmentation may cause erroneous readings WARNING Before you use a Propag monitor on a new patient always turn off the monitor for a few seconds then turn it on again This clears the prior patient s trend values alarm limit settings and NIBP cuff inflation target Each SpO sensor is designed for application to a specific site on the patient within a certain size range To obtain optimal performance use an appropriate sensor and apply it as described in the sensor s directions for use
133. r use and all accessory directions for use before operating the monitor WARNING Place the Propag monitor and accessories in locations where they cannot harm the patient if they fall from their shelf or mount Lift the monitor only by its handle do not lift it by any attached cables WARNING Do not connect more than one patient to a monitor Do not connect more than one monitor to a patient WARNING Do not use the Propag Encore in an MRI suite or a hyperbaric chamber WARNING Do not autoclave the Propaq Autoclave accessories only if the manufacturer s instructions clearly approve it Many accessories can be severely damaged by autoclaving WARNING Inspect the power adapter cord periodically for fraying or other damage and replace the adapter as needed Do not operate the apparatus from mains power with a damaged power adapter cord or plug WARNING When using a power adapter with this monitor be sure to connect the power adapter to a three wire grounded hospital grade receptacle Do not under any circumstances attempt to remove the grounding conductor from the power plug of the power adapter Do not plug the power adapter into an extension cord If there is any doubt about the integrity of the protective earth ground of the receptacle for the power adapter do not plug in the power adapter operate the monitor only on battery power Contact your biomedical engineering department for assistance in identifying the proper power receptacle
134. rate during occurrences of cardiac arrest or some arrhythmias Do not rely entirely upon rate meter alarms All pacemaker patients should be kept under close or constant observation If the patient being monitored has a pacemaker the Propag Encore detects and can indicate the occurrence of pacemaker signals With the Propag pacemaker signals are not counted as heart beats as long as the pacemaker signal meets the pulse amplitude pulse width and overshoot undershoot specifications listed in Appendix B Pacer display On the Propag Encore display vertical dashed lines indicate each time a pacemaker signal is detected when the Propag Encore PACER function is turned on The waveform spike produced by the pacemaker will also be displayed if it contains sufficient energy Whether the pacer is atrial ventricular or both the indicator and the spike appear If the PACER function is turned off only the pacemaker spike is displayed 18 45 28 5 11 Turn the pacemaker indicator on and off The status of the pacer display is shown in the ECG status window Turn PACER DISPLAY on or off using the NEXT and CHANGE buttons Noise on the signal Noise on the ECG signal may be detected as pacer signals causing the pacer indicator to appear on the display If you don t need to indicate pacemaker signals you may want to turn off the pacemaker indicator for a better display of the ECG waveform A WARNING The presence of much pacerlike
135. re 760 mmHg and flow 60 ml min c Based on the following additional airway conditions Sample line 7 ft 0 055 in ID 2 13 m 1 4 mm ID Sample flow rate 175 ml min Welch Allyn watertrap new unused Respiratory rate lt 50 bpm stable to 3 breaths min Inspired Expired time ratio 1 2 Barometric pressure 760 mmHg d For Sidestream C02 this applies only for BR lt 50 Reference Guide Specifications 109 Mainstream CO Characteristic Specification Mainstream CO sensor Sensor Type Mainstream Principle of Operation Non dispersive infrared single beam single path wavelength ratiometric Warm up time CO sensor and 45 sec typical 3 min maximum monitor Response Time 30 ms typical 60 ms maximum Waveform Rise Time lt 120 ms to 90 after step change Calibration Verify semi annually calibrate only as required Sensor Housing Temperature 42 C nominal Mainstream CO sensor and cable dimensions and weight Sensor Height 1 003 in Sensor Width 1 036 in Sensor Depth 0 78 in Sensor Weight lt 39 oz Cable Length 10 ft 3 05 m nominal Mainstream CO airway adapter Type Per ISO 3040 single use Size 15 mm ID meets ISO specifications Material clear polycarbonate with sapphire windows Added Deadspace lt Bcc 37 cubic inches for adult model lt 0 6 cc 037 cubic inches for low deadspace model Mainstream CO sensor environmental specifications Operat
136. ream CO operating temperature 10 to 40 C e Sidestream CO operating temperature 5 to 40 C Mainstream CO option The Mainstream CO option measures the carbon dioxide content of a patient s inhaled and exhaled breath A mainstream sensor is attached to an airway adapter in series with a ventilator s patient breathing circuit Patients using Mainstream CO must either be intubated or breathing through a well fitting face mask connected to a breathing system such as an anesthesia circle system 58 Patient monitoring Welch Allyn Propag Encore Vital Signs Monitor Sidestream CO option The Sidestream CO option measures the carbon dioxide content of a patient s inhaled and exhaled breath A sidestream sensor Is located within the Propaq monitor The patient s expired gas is aspirated from the airway and sent through a sampling line and sidestream watertrap to the internal sensor Patients using Sidestream CO can either be intubated or non intubated using a CO Sampling cannula or a combination CO Sampling Oxygen Delivery nasal cannula CO measurements and display The measured CO levels are normally displayed as a waveform and an ETCO gt numeric value The CO waveform can be viewed when it is selected for display and the higher priority IBP waveforms are not displayed If the INCOs numeric value is at an alarm level greater than 7 5 mmHg or 1 kPa or 1 it is also displayed If Mainstream CO is active the Propaq di
137. rnal dc source is connected and the battery is charging Although the monitor may be turned off battery charging continues when an external power source is connected Connector for Acuity or Modem Propaq This connector allows either direct connection to an Acuity System or connection to an external modem for telecommunication to an Acuity System For more information about the Acuity System see Acuity Central Monitoring system on page 85 For more information about the Modem Propag refer to Modem Propag Reference Guide Alarm lights Alarms and limits are described in detail beginning on Alarms and limits on page 69 ALARM light When an alarm limit is violated the red ALARM light turns on ALARM S OFF light When any alarm limit is turned off the yellow ALARM S OFF light turns on Reference Guide Getting started 11 Power up screen WELCH ALLYN When you first turn on the monitor the power up screen displays information about the Propag Encore MODEL PROPAQ 204 and the monitor runs diagnostic tests to ensure proper DIAGNOSTICS IN PROGRESS functioning BATTERY 8 3 VOLTS SOFTWARE VERSION 2 50 00 c WELCH ALLYN PROTOCOL INC 1988 2007 A few seconds later the top two lines of the screen are PEDIATRIC MODE replaced with text indicating the current patient mode adult pediatric or neonatal DIAGNOSTICS IN PROGRESS BATTERY 8 3 VOLTS SOFTWARE VERSION 2 50 00 c WELCH ALLYN PROTOCOL INC 1988 2007
138. roperly or fails any of the above tests do not attempt to repair the device Please return the device to the manufacturer or to your distributor for any required repairs Reference Guide Care and maintenance 95 Recycling monitor components Within the European Union or separate collection as specified by Directive 2002 96 EC of the European Parliament and the Council of the European Union on Waste Electronic and Do not dispose of this product as unsorted municipal waste Prepare it for reuse K Electrical Equipment WEEE p Note f the monitor or the battery is contaminated this directive does not apply For more specific disposal information see www welchallyn com weee or contact Welch Allyn Customer Service Outside the European Union When the monitor or the battery reaches end of life recycle it locally according to national state and local regulations or return it to Welch Allyn Monitor care Environmental operating and storage limits Whenever possible store the Propaq Encore at room temperature in a dry environment For environmental operating instructions see Monitor physical on page 114 WARNING The monitor may not meet its performance specifications if stored or used outside the specified temperature and humidity ranges Extended storage precautions Battery removal MA Caution Storing the Propag Encore for extended periods more than three months without being connected to the ac power adapt
139. rors at higher breath rates The 175 ml min flow rate is recommended for intubated adult patients When monitoring a small child with a rapid respiratory rate Mainstream CO can provide a more accurate representation of the expired CO waveform Connect the water trap Sidestream CO Connector Sure C02 water trap adapter WARNING Do not connect sample line or patient input to exhaust port Exhaust Port 1 Firmly insert the Sidestream CO watertrap adapter into the Sidestream CO connector on the Propag left side panel Set up the CO channel and alarm limits 1 Follow the steps described on page 62 Reference Guide Patient monitoring 65 Connect to a nonintubated patient 1 Position the cannula on the patient according to the manufacturer s instructions A WARNING The cannula is disposable and should only be used for a single patient Do not reuse the cannula for another patient WARNING If oxygen is being delivered while using Sidestream CO be sure to use a CO Sampling and O Delivery Cannula Using a different type of cannula could obstruct oxygen delivery WARNING The exhaust port for Sidestream CO is an output for the expired gases from the patient and any connected breathing apparatus The exhaust port is intended only for connection to gas collection equipment such as gas scavenger devices Do not allow any other connection to the exhaust port Note f you use a gas scavenging system with Sidestream
140. rosurgical return electrode to the patient WARNING Verify patient mode Incorrect patient mode may result in inaccurate heart rates and inappropriate alarm settings Even though the Propag Encore contains fully isolated patient connected circuitry it has not been specially designed for direct cardiac application The Propaq Encore can be used on patients with pacemakers See Using the Propaq Encore with pacemaker patients on page 35 Reference Guide Patient monitoring 31 ECG connector and applicable accessories Use only with accessories provided or recommended by Welch Allyn Refer to Products and Accessories To prevent injury use the provided garment clips to route the ECG cables away from the patient s head A WARNING Use of ECG cables with loose or faulty detachable lead wires may cause erratic behavior of the ECG waveform SpO C Lock and NIBP due to intermittent ECG lead wire connections Caution To protect the Propaq Encore from damage during defibrillation for A accurate ECG information and for protection against noise and other interference use only ECG electrodes and cables namely ones with internal current limiting resistors specified or supplied by Welch Allyn and follow recommended application procedures Preparation A WARNING Use only ECG safety cables that are designed so that they cannot accidently be plugged into an AC mains outlet or make contact with other hazardous electrical potentials inc
141. rs to the patient as described in Chapter 2 of this reference guide 86 Acuity Central Monitoring system Welch Allyn Propaq Encore Vital Signs Monitor 3 Plug in the Acuity network cable to the Acuity network jack on the Propaq Encore side panel shown in the following figure Plug in the other end of the cable to the bedside Acuity network jack Power Connector Right Side Panel Acuity Connector networks ACUITY MODEM _ Caution Accessory equipment connected to the analog and digital interfaces must be certified according to the respective IEC standards e g EN 60950 for data processing equipment and EN 60601 1 for medical equipment Furthermore all configurations shall comply with the system standard IEC 601 1 1 Anyone connecting additional equipment to the signal input or output connectors is configuring a medical system and is therefore responsible that the system complies with the requirements of the system standard IEC 601 1 1 If in doubt consult your Biomedical Engineering Department 4 Connect the AC adapter to the Propag Encore and the wall outlet to charge the battery Check to see that the battery charging light on the monitor s right side panel is on 5 Confirm the patient identification at the bedside or enter the patient information at the Acuity Central Monitor using the Patient ID Setup Window 6 If alarm limits have not been set do so at the Propag Encore or at the Acuity
142. s Shield Common terminal for other signals The sync and real time ECG outputs do not operate during In service mode SHIELD SHIELD ane a GROUND En A i MARKER IN Wed N C Da E NE Defib Sync connector side panel view N C Real time ECG Output connector side panel view 102 Specifications Welch Allyn Propaq Encore Vital Signs Monitor Impedance pneumography RESP Characteristic Specification Display Characteristics Sweep speed Amplitude range 3 13 6 25 12 5 mm sec user selectable 1x 2x 4x 8x 16x Performance Characteristics Excitation signal characteristics Sensing electrodes Base impedance in addition to 1K resistors in ECG cables Impedance dynamic range Signal bandwidth after detection Breath detection threshold Respiration rate range Respiration rate accuracy Respitation rate source RR Apnea alarm delay accuracy Resolution Apnea alarm delay settings Cardiovascular artifact rejection CVA Motion artifact rejection Obstructive apnea Cardiovascular artifact rejection CVA Motion artifact rejection Obstructive apnea 65 pA RMS 5 at 63 0 kHz pseudo sine wave User selectable RA LA or RA LL 100 to 1200 ohms is normal monitoring range approx 1200 1500 ohms range produces a NOISY SIGNAL CHECK ELECTRODES equipment alert Above approx 1500 ohms produces a RESP FAULT LEAD FAIL equipment alert
143. s SAVE YES Reference Guide Getting started 25 Printer functions Press SETUP MORE PRINTER to display the printer menu and setup window CONTINUOUS AUTO PRINT ALARM PRINT NIBP TICKET APNEA TICKET OXYCRG ON ALARM 25 0 mm s 15 minutes BROF F OFF OFF OFF a 92 NEXT CHANGE PR TREND MORE PREV MENU NEXT Selects the next setting in the status window CHANGE Changes the currently selected display setting PR TREND Prints all trends turned on in the Printer Trend Select Window MORE Pressing the MORE button displays another menu and status window PREV MENU Returns you to the previous menu CONTINUOUS Sets the print speed for real time continuous measurements to 6 25 12 5 or 25 mm sec This sets the print speed for a printout obtained by pressing the START STOP button on the printer AUTO PRINT Automatically prints 8 seconds of patient information every 15 minutes 30 minutes 1 hour 2 hours or 4 hours This is the latest patient information real time The print speed is automatically set to 25 mm sec ALARM PRINT Automatically prints upon an alarm The Propag Encore prints 20 seconds of patient information The first 12 seconds contain information prior to the alarm The print speed is automatically set to 25 mm sec NIBP TICKET Automatically prints an NIBP Ticket when the measurement is taken APNEA TICKET When turned on an Apnea Ticket is printed at the conclusion of an apnea alarm and at the on
144. s breaths impedance pneumography is not recommended for use on paced patients Impedance pneumography is not recommended for use with high frequency ventilation Since RESP is derived from the same leads as the ECG channel the Propaq Encore determines which signals are cardiovascular artifact and which signals are a result of respiratory effort If the breath rate is within five percent of the heart rate or a multiple or sub multiple of the heart rate the monitor may ignore breaths and trigger an apnea alarm 30 Patient monitoring Welch Allyn Propag Encore Vital Signs Monitor Intended use ECG The Propaq Encore is intended for ECG monitoring of either a five lead or three lead configuration including the Marriott configuration 1 MCL1 requires all three electrodes The five lead configuration can derive one of seven user selected signals Lead Il Ill aVR aVL aVF or V The monitor will automatically determine if only three lead wires are connected and will automatically reduce the number of selectable leads to three I II III If fourwire ECG cables are used they will be handled as if they were three wire cables WARNING The Propag Encore monitor does not have automated arrhythmia analysis therefore some ventricular tachycardias and ventricular fibrillation may not be interpreted correctly and may display an inaccurate heart rate The Propag Encore 200 series does not have automated ST segment monitoring although with E
145. s taken in the presence of high motion artifact while monitoring TIME HR PR Sp02 SYS DIA MEAN BR ECG Artifact can affect accuracy To help reduce artifact Ste thee E nea A ica see Place and connect the cuff on page 44 10 46 86 97 114 67 81 10 45 88 97 1168 6 10 44 80 97 118 68 x 81 12 Automatic trend prints To automatically print trends at 4 hour intervals activate AUTO TREND and select the print times Use the CHANGE button to set the trend print times according to the start time clock hour of each shift or to OFF Once the Propaq is set up it will print all the selected trends at each 4 hour interval You can place the printouts in the patient s record at the end of each work shift Starting times are selectable for the 4 hour interval printouts PRINTER AUTO TREND 03 07 11 15 19 23 NIBP OFF JAS ON ART OFF PA ON TEMP_ OFF D NEXT CHANGE PR TREND MORE _ PREV MENU 84 Printing Welch Allyn Propag Encore Vital Signs Monitor Intended use A 85 l Acuity Central Monitoring system WARNING Use of equipment accessories and parts not recommended or supplied by Welch Allyn could result in inaccurate patient information or damage to the system WARNING When Acuity is inoperable be sure to keep Acuity patients under close surveillance especially those prone to arrhythmias Use Acuity only in conjunction with close surveillance by trained clinicians WARNING Conne
146. se which can easily be replaced in the right side panel Fuse replacement should only be performed by a qualified service person Note f the green Battery Charging lamp does not light when an ac adapter is connected this fuse may be blown 1 Disconnect the Propag Encore from the patient re A ES E o 2 28V 3A 2 Disconnect the ac power adapter from the Propaq Encore s power input connector 3 Using a small screwdriver or similar device unscrew the fuse carrier by turning it counterclockwise 4 Remove the fuse holder and replace the fuse with a 3 Ampere 2AG 250V fast or slow acting fuse This fuse can be ordered from Welch Allyn or its service centers using part number 503 0058 00 93 9 Care and maintenance Avoid electrostatic discharge When humidity in the working environment decreases the human body and other insulators can become charged with static electricity due to friction To prevent unwanted electrostatic discharge ESD follow these standard guidelines e Maintain the recommended humidity of 40 to 60 in the work environment e Dissipate electrostatic charge before performing routine operator maintenance Inspect and clean the monitor and accessories Before cleaning thoroughly inspect the monitor and all accessories for any signs of damage cracks or improper mechanical function of keypads switches connectors and printer paper door While gently bending and flexing cables an
147. seconds Audio Alarm Holdoff with When a Propag Encore in Adult or Pediatric Mode is connected to an Acuity System the Acuity audio alarms at the bedside Propag can be delayed up to 4 minutes and 15 seconds The delay time is selected in Acuity software at the time of Acuity installation Visual alarm indications are not delayed a Alarm holdoff time period is reset if the vital sign returns to acceptable limits before an alarm occurs Characteristic Model 202 Parameters Model 204 Parameters Model 206 Parameters Duration Resolution Specification NIBP T1 T2 AT HR heart rate pulse rate Sp0y End tidal CO Inspired CO Breath Rate NIBP P1 T1 T2 AT HR heart rate pulse rate Sp0 End tidal CO Inspired CO Breath Rate NIBP P1 P2 11 T2 AT HR heart rate pulse rate SpO2 End tidal CO Inspired CO Breath Rate 5 hours for non NIBP trends up to 150 readings A maximum of 128 readings up to 8 hours for NIBP trends All channels except NIBP sample data at 2 minute intervals For NIBP trends a new entry is placed in the table each time an NIBP determination is made a Assumes Sp0 and CO functions are present 112 Specifications Display Welch Allyn Propaq Encore Vital Signs Monitor Characteristic Specification Matrix Active Viewing Area Pixel Size Pixel Pitch Character Height Viewing Angle Contrast Ratio Display Color Display Background Color On P
148. sed press Q elapsed press RESUME If an equipment alert occurs during the silence period you can acknowledge dismiss a indications of the alert by pressing any key as usual If the original alarm or alert condition still exists after 90 seconds the alarm or alert tone sounds again Inhibit alarm and alert tones for four minutes 4 SUSPND As you perform patient care there might be occasions when you want to suspend potential or current alarm and alert tones for a period of four minutes Initiate a four minute suspend period 1 Press MAIN MENU SETUP ALARMS 4 SUSPND Resume alarm and alert tone capability before the four minute period has elapsed 1 Press N A Indications during a four minute suspend period At the Propaq Encore Monitor At the Acuity Central Station If an alarm or alert occurs during the suspend period the usual visual alarm and alert indications are displayed Propaq monitors connected to Acuity Central Station Apnea or life threatening arrhythmia alarm tones interrupt the Apnea or life threatening arrhythmia alarm tones suspend period interrupt the suspend period Standalone Propaq monitors Apnea alarms do not interrupt the suspend period and arrhythmias are not detected To resume alarm and alert tone capability before the To resume alarm and alert tone capability before the 4 4 minutes has elapsed press A A minutes has elapsed press RESUME If an equipment alert
149. sion module Operating Temperature 5 to 40 C Shipping and Storage Temperature 20 to 60 C Operating Relative Humidity 35 to 85 noncondensing Shipping Storage Relative Humidity 15 to 90 noncondensing Operating Altitude 2 000 to 15 000 ft 610 to 4 572 m Shipping and Storage Altitude 2 000 to 40 000 ft 610 to 12 192 m Shock 309 Vibration Random 0 02g Hz from 10 to 500 Hz ramping down to 0 002g Hz at 2000 Hz Operating 1 hour per axis 3 hours per test Electromagnetic Compatibility EMC Per IEC 601 1 2 which is a collateral standard of IEC 601 1 for electromagnetic compatibility Paper Short term Storage Environment up to 7 days 20 to 40 C 5 to 80 noncondensing Long term Storage Environment up to 5 years 25 C optimal 65 noncondensing 116 Specifications Power Welch Allyn Propaq Encore Vital Signs Monitor Characteristic Specification Mode of Operation Continuous Battery Pack Type Sealed gel type lead acid Battery Pack Capacity Monitor only 8 volts 3 Ampere Hours Monitor with Expansion Modules 8 volts 6 Ampere Hours Battery Recharger Circuitry Internal powered by external power adapter DC Input Power Required 12 to 28 Volts 25 Watts Input Fuse Rating Operating Times on Battery Monitor only Monitor and Sp02 Baqpaq Monitor with Expansion Mo
150. specifications of these approved probes may produce incorrect temperature readings Preparation WARNING Application and use of metal jacketed temperature probes that come in contact with conductive objects or clinical personnel during electrocautery may cause burns at the patient probe electrode contact points 1 Place the probe on the patient and plug it into one of the connectors on the Propaq s side panel Within a few seconds the Propaq Encore will display the temperature 2 To select the temperature units C or F press SETUP MORE MORE SERVICE YES to access the Service Menu MORE MORE SETTINGS Use the NEXT and CHANGE buttons to select and set the temperature units as desired The Propaq Encore automatically updates the temperature display to show the newly selected units Changing units does not clear Temperature trends 3 Set the alarm limits according to your hospital s standards Reference Guide Patient monitoring 51 How temperature is displayed Temperature is displayed as a numeric only in a window at the top of the Propaq Encore screen in C or F This area displays all temperature measurements T1 T2 AT one ata time 18 45 28 Ss 135 102 3F IIa a Ved Temperature messages The following messages can appear in an equipment alert window A temperature caution message will also appear in the temperature numeric window when one of these messages appears except PROBE NOT DETECTED PROBE NOT
151. splays MCOZ2 If Sidestream CO is active the Propaq displays SCO2 The Propag displays CO2 if either or both the mainstream sensor and sidestream watertrap are installed in the Propag but neither are active Mainstream CO is active Example of INCO Sidestream CO is we active NOTH NOON OZ L NIBP ECG RESPI INV PRS Sp02 C02 SETUP Displayed values of ETCO gt and INCO are the highest and lowest values respectively of CO measured during the time interval set by the RESPONSE setting on the CO Menu You can set upper and lower alarm limits for ETCO and an upper alarm limit for INCO The monitor only displays the numeric value for inspired CO INCO2 if it is in alarm or if it is greater than or equal to 75 mmHg or gt 1 kPa or 1 Refer to the CO specifications in the Propag Encore Reference Guide for more information Breath rate measurements Breath Rate BR is determined from the CO sensor The Propaq displays a numeric BR value next to the CO values You can set upper and lower alarm limits for BR Reference Guide Patient monitoring 59 Apnea events In the Adult and Pediatric Mode you can set the apnea delay to 6 10 15 20 25 or 30 seconds In the Neonatal Mode you can set the apnea delay to 6 10 15 or 20 seconds The Propag initiates an alarm in response to each apnea event longer than the apnea delay setting When an apnea event is detected the BR numeric automatically goes to O and an a
152. sweep speed set by the mm s button BAROMETER The ambient barometric pressure FLOWRATE Sets the sampling flow rate to either 90 or 175 ml min You can change the flow rate while Sidestream CO is active Note To change CO units use the Settings Menu under the Service Menus Changing these units will clear CO trends Reference Guide Patient monitoring 61 Mainstream CO monitoring 1 Select the appropriate airway adapter Use only accessories provided or recommended in Products and Accessories Always refer to the manufacturer s Directions for Use for instructions about operation cleaning and replacement A WARNING Do not attempt to verify operation of the CO sensor by blowing through it directly Always blow through an attached airway adapter Otherwise a small amount of CO from your breath may enter the CO sensor housing and cause a small shift in the measured CO values It may take 3 24 hours for the sensor to return to proper calibration WARNING Do not clean and or reuse a single patient use airway adapter When a single patient use airway adapter becomes occluded replace it 2 Connect the adapter ventilator circuit and CO sensor according to the manufacturer s instructions Adult airway adapter Low dead space airway adapter Window Window A WARNING Prior to using an airway adapter always look through the window lumen and inspect the adapter for inadvertently lodged obstructions and for window integri
153. t WEAK PULSES CAN T FIND SYS DIA ERR 5 There are not enough pulses to determine the systolic or diastolic pressures but a mean pressure is available Try reapplying the cuff after squeezing as much air from it as you can ARTIFACT CAN T FIND SYS DIA ERR 6 The systolic or diastolic pressures are unreliable due to artifact but a mean pressure is available May be caused by patient motion NO PULSES DETECTED ERR 7 The cuff may not be properly applied to the patient or the patient may not have detectable pulses due to shock or arrhythmias WARNING The Propag Encore cannot differentiate between physiologic and cuff application causes of the NO PULSES DETECTED message Always evaluate the patient for presence of life threatening conditions whenever this message occurs CONNECT ECG TO REDUCE NIBP ARTIFACT ERR 8 NIBP artifact prevents a valid reading Connect ECG electrodes to improve NIBP measurements NO VALID BLOOD PRESSURE FOUND ERR 9 This message can occur due to motion artifact the Propaq Encore being set in the wrong patient mode or the wrong hose or cuff being used in relation to the patient mode Reference Guide Patient monitoring 49 CALIBRATING PLEASE WAIT ERR 10 The Propag Encore periodically recalibrates the NIBP channel to ensure it can properly make NIBP determinations Normal monitor operation continues while the NIBP channel is calibrating If the NIBP channel has not updated its calibration in 1
154. the ZERO REJECTED message is overriding the invasive pressure numerics no invasive pressure numerics will flash to indicate invasive pressure is in alarm To remove the ZERO REJECTED message and to restore the invasive pressure numerics during an invasive pressure alarm you must return to the invasive pressure menu and press CANCEL This will restore the invasive pressure numerics How invasive pressure Is displayed From the invasive pressure signal the Propaq Encore displays both a pressure waveform and pressure numeric values systolic diastolic and mean The waveform is displayed in a waveform window if the waveform is turned on in the wave select window The numerics are displayed in the blood pressure numerics windows The Propag Encore allows you to identify the pressure measurement with a selectable label and the numerics can be displayed in different formats The pressure waveform scales are not displayed until you zero the transducer Once the zero reference has been established the scales automatically appear 40 Patient monitoring Rescale Mode In this mode there are two scales and two labels for these pressure waveforms RANGE RESCALE ZERO CANCEL LABEL FORMAT In this mode there is one scale and one label for both pressure waveforms Range Mode Welch Allyn Propag Encore Vital Signs Monitor Numeric formats 0 RANGE JRESCALE ZERO ART ZERO CVPI MORE LABEL P1 FORMAT 1 LABEL P2 FORMAT
155. the following possible solutions e be sure the sensor is secure and properly applied e use anew sensor with fresh adhesive backing e select a different type of sensor e move the sensor to a less active site 54 Patient monitoring Welch Allyn Propag Encore Vital Signs Monitor Perform SpQ monitoring with Nellcor option 1 Attach the sensor to the patient according to the sensor manufacturer s instructions observing all warnings and cautions WARNING Use only Nellcor accessories and sensors with the monitor with Nellcor SpO gt option as listed in Products and Accessories 810 0409 XX 2 When using a sensor extension cable inspect the cable before use Replace it if it shows any signs of wear breakage or fraying Plug the sensor into the cable and plug the cable into the Propaq monitor or plug the sensor directly into the monitor 3 If the monitor SpO receptacle has a locking ring lock the connector in place by turning the locking ring clockwise until it stops For other connectors make sure the plug is all the way in A Caution f you see the error message DEFECTIVE SpO2 SENSOR either the sensor is not compatible with the monitor or the sensor is not working properly Check Products and Accessories 810 0409 XX to be sure the sensor is compatible If compatibility is not a problem try another sensor Note The monitor displays STANDBY in the SpO numeric window until it measures and displays the SpO value As oxygen saturat
156. times to limits lower than those allowed for adults Adult Mode provides the full range of patient numerics and cuff pressures but limits the cuff sizes available to the standard child cuff and larger NIBP measurements are affected by normal physiological pressure variations from reading to reading Normal respiration may affect pressure by as much as 10 to 20 mmHg Patient s emotional state body position and cuff fit may also adversely affect NIBP measurements In some individuals the act of taking blood pressure readings may alter the blood pressure Successive readings on the same patient may vary for the above reasons The static accuracy of the Propaq s internal manometer can be verified by a qualified biomedical engineer using a mercury column manometer refer to the Propaq Encore Service Manual The accuracy of the Propaq s determination of systolic diastolic and mean pressures in a clinical setting can only be assessed by careful statistical analysis of controlled clinical trials of representative patient populations Reference Guide Patient monitoring 43 Improve NIBP accuracy with Smartcuf NIBP measurements can be adversely affected by many factor such as cardiac arrhythmias sudden changes in blood pressure body motions such as convulsions or shivering bumping the cuff vibration vehicle motion or weak pulses The patented Smartcuf software filtering technology greatly increases NIBP measurement accuracy in the presenc
157. ting ECG 33 Artifact reduction with C LOCK Sp02 55 Artifact with NIBP 42 45 50 78 80 83 AUTO MAN button 46 Automatic intervals NIBP 48 Automatic NIBP measurements 46 48 Automatic trend prints 83 AUTO PRINT setting 25 B Battery care and maintenance 91 charging light 10 removal effect on programmable settings 95 replacement 94 storage 95 voltage 11 92 Breath rate measurements 58 Buttons menu 17 monitor 16 C CANCEL button 40 CHANGE button 20 25 Changing printer paper 96 Cleaning instructions 93 C LOCK Sp02 measurement 55 C02 8 accessories 61 64 alarm limits 58 and intubated patients 57 66 and N20 62 gas compensation 57 intended use 57 Mainstream C02 61 Mainstream C02 messages 66 measurements 58 Menu 1 17 Menu2 17 N20 57 printing waveforms 80 Sidestream C02 64 Sidestream CO2 messages 67 specifications 108 sweep speed 62 CO2 Menu 1 mm sec button 59 62 RANGE button 59 62 CO2 Menu 2 FLOWRATE button 60 GAS COMP button 59 60 62 RESPONSE button 59 60 63 SOURCE button 60 Connectors 132 Index ac adapter 10 ECG 31 INV PRS 37 NIBP 44 patient 13 power input 10 temperature probes 50 CONTINUOUS print speed setting 25 Cuff NIBP placement 44 sizes 44 CURRENT SOURCE setting 20 Customer services 97 Custom patient modes 23 CVP label for central venous pressure 40 D DATE setting 23 dc power source 10 DECIMAL setting
158. tings e change from F to C e simulate invasive pressure zeroing For noninvasive pressure measurements keep the Propaq Encore in manual NIBP operating mode and take pressure measurements by pressing the START button You can also press the NIBP Menu s TURBOCUF button to consecutively take pressure measurements for five minutes Printer message Simulated data can be printed on the Propag Encore Printer All printouts include the message SIMULATED DATA every four inches to prevent simulated data from being mistaken for actual patient data What you cannot do with in service mode You cannot use in service mode to calibrate the monitor You cannot set the Propaq Encore to take automatic noninvasive pressure measurements except Turbocuf while using in service mode You cannot use Defib Sync or Real time ECG output while using in service mode You cannot activate in service mode if you have been monitoring a patient Confirm and learn alarm behavior in the in service mode To confirm that a Propaq monitor is properly generating patient alarms and to learn the alarm behavior of the Propaq Encore monitor perform the following steps 1 2 Disconnect all patient cables from the Propaq monitor To temporarily remove customized alarm settings press the MAIN MENU key then SETUP MORE CHANGE SETUP USE NOW YES To put the Propaq monitor in non alarming Inservice Mode 1 press MAIN MENU SETUP WAVE SEL INSERV To s
159. to the time it ends Each trend shows the time of the reading the HR PR measurements the SpO value if configured and other values The three blood pressure trends show systolic diastolic and mean pressures and all but the TEMP trend show respiration rate if it s available Columns on the trend table show the word OFF for the vital signs not being monitored RESP TREND L 8 HR PR Spo2 BR_ ETCO2 INCO2 PA BPM Br m mmHg mmHg PSA 101 98 11 30 3 k Numerics that have alarmed are highlighted 30 2 PA 92 EXT TRNDL OXYCR The Trend Menu allows you to select trended data for display and print the displayed trend if a printer is attached PRINT Prints the displayed trend The Up Arrow button allows you to scroll up to the most current reading 4 y and the Down Arrow lets you scroll down to the oldest reading four readings at a time NXT TRND Allows you to cycle through the current display of each trend group OXYCRG Prints an oxycardiorespirogram For more information on OxyCRG see OxyCRG on page 82 How trends are accumulated For each of the four continuous trends numerics are sampled every two minutes to a maximum of 150 samples up to five hours When the maximum is reached the trending continues but the older data is no longer stored The readings are displayed in descending order most recent first 78 Trends Welch Allyn Propag Encore Vital Signs Monitor The following is progr
160. too great Once the channel is zeroed the pressure scale appears next to the waveform If the transducer still does not zero try another transducer or another cable Setting up the pressure channel Press INV PRS to set the invasive pressure channel selections RANGE RESCALE and ZERO P1 ZERO P2 Press MORE to set LABEL P1 LABEL P2 and FORMAT 1 FORMAT 2 Setting the invasive pressure alarms Set the alarm limits according to your hospital s standards Rezeroing a transducer You can rezero a transducer at any time after again opening the transducer stopcock to atmospheric air If the transducer has already produced pressure readings rezeroing provides a new zero reference for the Propaq If the zero value is not accepted the Propaq Encore continues to use the previous zero reference and displays the pressure values and waveforms based on that value If the new zero value is accepted the new pressure values based on the new zero value are displayed and the waveform is adjusted according to the new scale A WARNING If a ZERO button is pressed after an invasive pressure channel has been successfully zeroed and is currently monitoring a pressure waveform the message ZERO REJECTED will display in the invasive pressure numerics window This message will preempt the valid invasive pressure numerics until the CANCEL button in the Invasive Pressure Menu is pressed WARNING If the invasive pressure channel enters an alarm condition while
161. tor Guidance and Manufacturer s Declaration Electromagnetic Immunity The Propag Encore monitor is intended for use in the electromagnetic environment specified below The customer or the user of the monitor should assure that it is used in such an environment Immunity Test IEC 60601 Test Level Compliance Level Electromagnetic Environment Guidance Electrostatic discharge 6 kV contact 6 kV contact Floors should be wood concrete or ceramic ESD 8 KV air 8 KV air tile If floors are covered with synthetic IEC 61000 4 2 material the relative humidity should be at least 30 Electrical fast 2 kV for power supply 2 kV for power Mains power quality should be that of a transient burst lines supply lines typical commercial or hospital environment IEC 61000 4 4 1 kV for input output 1 kV for input output lines lines Surge 1 kV differential mode 1 kV differential Mains power quality should be that of a IEC 61000 4 5 2 kV common mode mode typical commercial or hospital environment 2 kV common mode Voltage dips short lt 5 U lt 5 U Mains power quality should be that of a interruptions and gt 95 dip in U gt 95 dip in Ur typical commercial or hospital environment voltage variations on or 0 5 cycle or 0 5 cycle If the user of the monitor requires continued power supply input 40 U 40 U operation during power mains interruption it lines 60 dip in U4 60 dip in Ur is recommended t
162. trical equipment Propag Encore monitors comply with all applicable and required standards for elect romagnetic interference It does not normally affect nearby equipment and devices It is not normally affected by nearby equipment and devices It is safe to operate the monitor in the presence of high frequency surgical equipment However it is good practice to avoid using the monitor in extremely close proximity to other equipment Propaq Encore Monitor Guidance and Manufacturer s Declaration Electromagnetic Emissions The Propag Encore monitor is intended for use in the electromagnetic environment specified below The customer or the user of the monitor should assure that it is used in such an environment Emissions Test Compliance Electromagnetic Environment Guidance RF emissions Group 1 The monitor uses RF energy only for its internal CISPR 11 unction Therefore its RF emissions are very low and are not ikely to cause any interference in nearby electronic equipment RF emissions Class B The monitor is suitable for use in all establishments CISPR 11 including domestic establishments and those directly P connected to the public low voltage power supply network Harmonic emissions Class A hat supplies buildings used for domestic purposes IEC 61000 3 2 Voltage fluctuations flicker Complies emissions IEC 61 000 3 3 Welch Allyn Propaq Encore Vital Signs Monitor Propaq Encore Moni
163. ts per minute measurement 25 to 300 beats per minute display 25 to 250 beats per minute Responds to change in heart rate within 5 to 9 seconds depending on physiological waveform As measured per AAMI standard EC 13 1992 clause 4 1 2 1 f including 3 1 2 1 parts f and g waveforms Includes 1 second readout update interval 3 beats per minute or 3 whichever is greater NOTE AAMI Test 4 1 4 part f Accuracy is affected i e rate drops when ORS and pacer spikes are nearly simultaneous as occasionally is the case during this AAMI test Heart rate 60 latest average interval in seconds For higher heart rates latest average interval 7 8 of previous average interval 1 8 of latest interval For lower heart rates latest average interval 3 4 previous average interval 1 4 atest interval Transition rates for choice of formula include hysteresis and are 70 and 80 beats per minute 80 beats per minute indicated for 80 beats per minute ECG plus drift waveform Pacer indicator shown on screen if PACER function turned on pacer spike always shown if of sufficient amplitude Pacer detection range i e will show the dashed vertical marker for 0 1 ms pulses is 3 mV to 700 mV and drops linearly to 2 mV to 700 mV for 0 2 to 2 ms pulses Will not count as heartbeats approximately 95 of pacemaker pulses within pacer detection range with or without AAMI EC13 1992 tails of 4 25 50 75 or 100 ms decay time c
164. tubated or non intubated patients Software Version Number The unique number assigned to the version of the Propaq Encore s internal programming This number appears in the Startup window SpO The standard term assigned to measuring oxygen saturation using a pulse oximeter The SpO gt patient channel noninvasively measures oxygen saturation of arteriolar hemoglobin at a peripheral measurement site such as a finger toe or the bridge of the nose Startup Window The information window that appears while the monitor performs its powerup test just after you turn on the Propag Encore This information includes the Propaq Encore model number and software version number Status Window A window that appears and contains information about the Propaq Encore SYNC Synchronization Two uses apply A digital output pulse from the right side panel that starts within 35 msec of the peak of a ORS complex and is used for cardioversion A message in the SpO display indicating successful C Lock Temporary Patient Alarm An alarm limit violation that occurred and was corrected without operator intervention 130 Glossary Welch Allyn Propaq Encore Vital Signs Monitor Trend The accumulation of several hours of data at two minute intervals Trend Parameter Heart Rate Pulse Rate P1 P2 SpO INCO ETCO temperature NIBP and RR Turbocuf Mode The mode used to acquire as many NIBP measurements as possible in five minutes UA
165. ty WARNING f the sensor does not easily slide onto the adapter do not attempt to force these components together They fit together in only one way Take care not to damage the glass windows WARNING After attaching the sensor to the adapter check the adapter again for proper placement of the sensor and for window integrity WARNING When attaching the airway adapter position the adapter so the sensor is on top to avoid fluid collection in the sensor airway slot Any concentration of fluids here can cause inaccurate CO readings WARNING Always check to make sure there are no leaks in the breathing circuit Check all of the connections 3 Plug in the CO sensor cable to the Mainstream CO connector on the Propag left side panel 4 Set up the CO channel and alarms Follow the steps described on page 62 WARNING When disconnecting the CO sensor from the tracheal or endotracheal tube check the sensor to determine how hot it is If it is too hot for patient comfort do not allow it to come into contact with the patient 62 Patient monitoring Welch Allyn Propag Encore Vital Signs Monitor Note When disconnecting the airway adapter from the ventilator circuit always detach the CO sensor from the airway adapter before removing the airway adapter from the ventilator circuit How to set up the CO channel and alarm limits After you connect the Mainstream CO sensor or Sidestream CO watertrap adapter follow these steps to set up t
166. u can program the Propaq Encore to power up in any of the Factory patient modes or the Custom patient modes You can also change the current patient mode during operation Note Whenever you change the patient mode the alarm limit settings automatically change to the settings for that mode From the Main Menu press SETUP MORE CHANGE SETUP The Mode Setup window appears MODE SETUP BATTERY 9 3 VOLTS ZEROED INS E ADULT PED NEO CUSTOM ADULT PED NEO PATIENT MODE ON POWERUP x 91 NEXT POWERUP _USE NOW PREV_MENU The asterisk indicates which patient mode is currently selected for powerup NEXT Selects the next setting in the status window POWERUP Selects the highlighted patient mode and its associated settings as the powerup mode The selected powerup mode is marked by an asterisk This does not change the current patient mode USE NOW Selects the highlighted patient mode and its associated settings as the current patient mode This does not affect the powerup mode SAVE Use this button to reprogram the settings of Custom patient mode 1 Make sure the patient mode you want to reprogram ADULT PED or NEO is currently used To change patient modes highlight the desired mode and press USE NOW YES 2 Exit the Mode Setup window then use other menus and buttons to set the monitor settings and alarm limits as desired 3 Re enter the Mode Setup window highlight the desired Custom mode and pres
167. ulas for these calculations are shown in the table Vital sign If the patient s vital sign Then calculated new lower Then calculated new upper value is limit is limit is Heart Rate HR lt 99 HR x 0 8 HR x 1 2 100 250 HR 20 HR 20 HR gt 251 Unchanged 250 Pulse Rate PR lt 99 PR x 0 8 PRx 1 2 PR gt 100 PR 20 PR 20 Invasive Inv Prs lt 25 Inv Pressure 5 Inv Pressure 5 Pressure 26 99 Inv Pressure x 0 8 Inv Pressure x 1 2 Inv Prs gt 100 Inv Pressure 20 Inv Pressure 20 NIBP NIBP lt 25 NIBP 5 NIBP 5 26 99 NIBP x 0 8 NIBP x 1 2 NIBP gt 100 NIBP 20 NIBP 20 Respiration Rate RR BR lt 25 RR BR 5 RR BR 5 Breath Rate 26 99 RR BR x 0 8 RR BR x 1 2 RR BR gt 100 RR BR 20 RR BR 20 Temperature Temp gt 0 C Temp 0 5 Temp 0 5 Sp0 Sp0 gt 0 SpO0 5 100 adult and pediatric min limit 50 mode SpO 5 neonate mode ETCO ETCO gt 0 mmHg ETCO 5 mmHg ETCO 10 mmHg min 15 mmHg ETCO gt 2 0 or kPa ETCO 0 7 or kPa min 2 0 ETCO 1 4 9 or kPa or 2 0 kPa INCO NCO gt 0 mmHg Not affected by STAT SET INCO 5 mmHg NCO gt 0 or kPa INCO 0 7 or kPa Apnea Delay Not affected by STAT SET a New alarm limits calculated by STAT SET cannot be outside the allowable alarm limit range If a new limit is calculated to be above or below the allowable alarm limit range it defaults to the maximum or minimum alarm limit allowed for that vital sign Reference
168. ult settings lost 75 Troubleshooting system error MESSAGES 1 2 eee 75 Be LENA iaa ee aus ae sete a mate alin Bes Qs Reade eS 77 The trend status window and menu 0002000 eee 77 How trends are accumulated o oooooooooooo 77 NIB P TFENdS luv a tags td payable oe det SA 78 Displaying trends as y oie ede Gan ee arene E T EEA 78 GASPING ewan ne A Relat Sie tek ERAN 79 Printing palentina ee 79 Printing trends 3 dt a US OARS OOS BO Se eed 83 7 Acuity Central Monitoring systemM 0 0 0 e eee eee 85 AA EN 85 iv Contents Welch Allyn Propaq Encore Vital Signs Monitor Connecting to the Acuity system s an eee 85 Press NET OFF to disconnect from Acuity 0 00 0000 cece eee eee 87 PRIATIMG cats AA A IA ss te tng DEA 87 Network alert Message 00 ee 88 8 Power SourceS eeina nane de Pied cena ee ede ee eat ie ees 89 Power adapter intended USO o ooooocooo 89 Battery Care vniacy do id da AS 91 9 Care and maintenance vnVnvtios cra a ia wee 93 Avoid electrostatic discharge oooooooccooo 93 Inspect and clean the monitor and accessories 0 00000 93 MaintenanGesn 4 47 altas bs bet tte rd lea m8 ett AOR clad 94 Recycling monitor components ooo 95 M nitor carea atra ts 95 Printer MaAINteNANCE ro 82 44 aeons aa a a a iia 96 CUSTOMERSERVICES cdta td e aa ett dal ene debida 97 10 SpeciticationS serrana EE apra 99 ESA ae e A te de ie od ae ia Di OL es 9
169. ure scale grids are printed horizontally The SpO plethysmograph The plethysmograph is printed without a horizontal grid The size is printed on the printout Although no vertical scale is displayed for the SpO waveform a size indicator is displayed to show the relative gain of the waveform 80 Printing Welch Allyn Propag Encore Vital Signs Monitor CO and RESP waveforms CO waveforms are printed on a grid with major divisions vertical dotted lines every 5 mm and the pressure scale grids are printed horizontally The waveforms and numerics are labeled as MCO for Mainstream CO and SCO for Sidestream COs If neither CO option is active the label is simply CO2 On the SNAPSHOT command only the CO and RESP waveforms will be printed with different sweep speeds than the other waveforms 6 168 11 39 86 HR 88 ART 121 79 96 PA 25 9 15 NC02 38 0mebg__ BR 12 Sp02 97 NIBPAOFF 11 37 8 C 123 4 aT 0 6 C no bakuak ban DISPLAY w S uugz p La T in Abt wa naa is aa S uugZ Printing NIBP measurements You can print the results of an NIBP measurement each time one occurs This printout is called the NIBP Ticket The NIBP Ticket must be turned on in the Printer Setup window 1 To turn on NIBP TICKET press SETUP MORE PRINTER The printer setup window appears 2 Use the NEXT and CHANGE buttons to select and turn on the NIBP TICKET This symbol indicates that the NIBP reading was taken
170. ve Pressure Pulse Oximetry Sp02 Capnography CO available only with SpO Mainstream Capnography MCO Sidestream Capnography SCO Dualstream Capnography Both MCO and SCO Impedance Pneumography RESP available only with SpO Printer HP compatible side panel 8 Getting started Welch Allyn Propag Encore Vital Signs Monitor Expansion module The Propag Encore Expansion Module attaches to the monitor and houses additional capabilities The Expansion Module can be fitted with the SpO CO and Printer options ALARM S OFF Light PROPAQcnore 3 Sp0z Option Expansion Mainstream i Module CO Option Printer Option Sidestream CO Option Propaq Encore pulse oximetry option SpD The Propaq Encore Pulse Oximetry option SpO is installed in the Expansion Module or in a smaller unit that attaches to the rear of the monitor Masimo Pulse Oximetry option Nellcor Pulse Oximetry option Capnography C03 options The Propaq Encore CO options allow carbon dioxide monitoring The Mainstream CO option and Sidestream CO option allow CO monitoring directly in the breathing circuit of a ventilator The Sidestream CO option also allows CO monitoring of non intubated patients through a cannula The CO options can be installed separately or together as Dualstream CO in the Expansion Module These options require the Pulse Oximetry
171. ver inherent limitations require that good clinical judgment always prevails 6 General information Welch Allyn Propag Encore Vital Signs Monitor 2 Getting started Introducing the Propag Encore Intended use Before using the Propag Encore on a patient be sure you understand the Safety Summary at the front of this book It provides important information about safely using the Propag Encore The Propag Encore monitor is intended to be used by skilled clinicians for multiparameter vital signs monitoring of neonatal pediatric and adult patients in health care facility bedside applications as well as for intra and interfacility transport Propaq Encore monitors that do not include CO or printer options are able to withstand light rain exposure over short periods of time uniform distribution of approximately 1 mm of water minute for 10 minutes or less Propag Encore models and options Three models of Propag Encore monitors are available Features common to all models 206EL 204EL 202EL Options available for each model ECG 3 lead or 5 lead configurations 0 05 40 0 5 40 Hz NIBP with neonatal pediatric and adult modes Temperature 2 channels YSI 400 and 700 series compatible connectors Defibrillator Synchronization Real time Analog output of ECG Electrocautery noise suppression on all channels except Impedance Pneumography Two Invasive Pressure Channels One Invasive Pressure Channel No Invasi
172. y press RESUME A A If an equipment alert occurs during the suspend period you can acknowledge dismiss a indications of the alert by pressing any key as usual 72 Alarms and limits Welch Allyn Propaq Encore Vital Signs Monitor Summary of alarm and alert keys and Acuity Central Station messages The following table summarizes Silence and Suspend behaviors and Acuity Central Station messages for different combinations of current and previous Propaq monitor and Acuity software versions Note When your facility uses both older and newer Propag monitors and Acuity software versions be aware that messages vary at Acuity Central Station Some Acuity Central Station messages do not identify specific alarm alert tone silence or suspension states However visual alarm indications still continue as usual at the Acuity Central Station and at the Propag monitors Propag Monitor Propaq Result of Propaq monitor key At Acuity Central Station result of Propaq version Monitor key press monitor key press Acuity 6 30 and prior Acuity 6 31 and later Propaq Encore SILENCE or Silences active alarm and alert Alarms Suspended Alarms Suspended 2 5X tones for 90 seconds at the Message Message N A Propaq monitor and Acuity Central Station All new alarms and alerts Only life threatening Only life threatening interrupt the silence arrhythmia and apnea arrhythmia and apnea alarms interrupt the alarms interrupt the silence si
173. y default lead setting is Lead Il 34 Patient monitoring Welch Allyn Propag Encore Vital Signs Monitor Impedance pneumography selections If your Propag Encore includes the Impedance Pneumography Option the following selection is also available RESP SZE Selects the RESP waveform size The Size function increases and decreases the ECG or RESP waveform size Each time you press a SIZE button the waveform approximately doubles in height When you reach the largest waveform size the next press displays the smallest size When you press MORE in the first ECG RESP Menu a status window appears showing you the current ECG RESP settings and additional selections 18 45 28 102 3 iF Selected ECG lead ee Sensitivity factor ye ECG RESP Bandwidth Selection HR PR TONE LOW PACER DISPLAY ON ECG BANDWIDTH MONITOR 0 5 40Hz RESP LEAD Ld1 CRA LA Available with the Impedance 333 z ON a 92 Pneumography Option NEXT CHANGE PREV_MENU HR PR TONE Sets the heart tone loudness to LOW MEDIUM HIGH or OFF If SpO is monitored the pitch of the tone varies with the SpO gt value PACER Turns on and off the pacer indicator in the ECG waveform DISPLAY ECG This selection allows you to determine the bandwidth for the data BANDWIDTH sent to the display and the printer If the selection is Extended the bandwidth is 0 05 40 Hz If the selection is Monitor the bandwidth is 0 5 40 Hz The Size function i
174. y removal 95 lost 11 75 Propaq buttons 16 documentation set 5 screen display 15 Propaq CS Physical inspection 93 Propaq to Acuity option overview 9 PR TREND button 25 83 Pulse oximetry see Sp02 R RANGE button 40 59 62 Real time ECG analog specifications 101 REMOVE CUFF FROM PATIENT 49 75 REMOVE CUFF FROM PATIENT message 75 RESCALE button 40 RESP 8 intended use 29 messages 36 printing waveforms 80 specifications 102 sweep speed 62 RESP LEAD setting 34 RESPONSE button 59 60 63 RESPONSE time Sp02 54 RESP setting 34 RESP SZE button 34 Returning monitor for service 97 Rezeroing a transducer 39 Right side panel fuse replacement 92 system controls 9 136 Index S Safety summary 1 Screen display 15 SELECTED SOURCE setting 20 Service intervals 94 Service Menu 19 SETUP button 20 Setup Menu 1 18 ALARMS button 20 MORE button 20 TRENDS button 20 Setup Menu 2 CHANGE button 20 MORE button 20 NEXT button 20 PRINTER button 20 WAVE SEL button 20 Side panels left patient connectors 13 right system controls 9 Sidestream C02 64 SIMULATING on monitor display 26 Size waveforms 34 SNAPSHOT button 26 79 SOURCE button 60 Specifications alarms 111 C02 108 defibrillator synchronization 101 display 112 ECG 99 environmental 113 factory defaults 118 INV PRS 103 NIBP 104 physical 114 power 116 power adapters 117 printer 115 real time ECG analog

Reference Guide - Propaq Encore Vital Signs Monitor

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