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GE B30 Patient Monitor - Frank`s Hospital Workshop

1. 11 9 B30 Patient Monitor Setting PVC alarm limits 11 10 To set the PVC alarm limits 1 Press the ECG key 2 Select ECG Alarms 3 Select PVC Alarm ON 4 Select Adjust Limits You can also adjust the limits through Alarms Setup Adjust Limits For detailed instructions see section Alarms ECG ECG1 Lead aVR ECG Lead Casc ECGS Lead Casc ECG Size 1 0 Adjust ST Relearn ECG Setun ECG Alarms Normal Screen Change high and low HR and ST alarm limits Change PVC alarm limit and arrh alarm settings 49 ECG ADJUST ALARM LIMITS Adjust Limits PYC Alarm ON ST Alarms HR PYC Arrh Alarme Alarms Setup 250 30 Previous Menu 160 TEE 20 E 40 m Amin Amin Push ComWheel to adjust alarm limits manually ECG ST segment analysis Overview The ST value analyzed by the monitor shows the difference of electrical activity between ISO and ST points Myocardial ischemia appears in the ECG as an ST segment deviation from the isoelectric line ISO point The ST segment generally rises above the PQ isoelectric line in the presence of transmural ischemia and is pressed below the isoelectric line in the subendocardial ischemia NOTE ST segment changes may also be affected by such factors as drugs or metabolic and conduction disturbances NOTE The significance of the ST segment changes needs to be determined by a ph
2. Alarms Silencing alarms Silencing audible alarms temporarily NOTES e The bedside alarms can also be silenced and acknowledged from the Central if this feature has been enabled in the Central configuration In this case the message Alarms silenced from Central or Alarms acknowledged from Central is displayed on the bedside monitor display If the monitor is connected to the network and the network connection is lost the silenced alarms are reactivated and the volume level is automatically set to 7 Pressing the Silence Alarms key once e Tosilence all alarms for two minutes press the Silence Alarms side panel key once e Tosilence all alarms for five minutes keep the Silence Alarms key pressed for more than five seconds NOTE NOTE FiO 1896 high Ppeak alarms are always silenced only for 20 seconds Pressing the Silence Alarms key once silences the alarms that are currently active and presilences the upcoming alarms of other measurements If the alarms are not active when you press the Silence Alarms key they are pre silenced for 2 or 5 minutes The crossed bell symbol with a countdown timer is displayed in the upper left hand corner of the screen to indicate that the alarms are silenced and the message field is cleared of all the previous alarm and note messages The visual alarms in the digit and waveform fields remain as long as they are valid During silencing all new alarms for the sam
3. Il LL LA F LL R RA or N RL aVR N RL R RA L LA F LL aVL N RL R RA L LA F LL aVF N RL R RA L LA F LL V5 N RL R RA ULA F LL C5 ECG Color and letter coding IEC standard 3 lead ECG Position 5 lead ECG Position Position on on body on body surface surface surface R red right arm R red right arm right arm L yellow left arm L yellow left arm left arm F green left leg F green left leg left leg N black right leg neutral right leg neutral C white chest 4th intercostal space at right border of sternum AAMI standard 3 leadECG Position 5 lead ECG Position Position on on body on body surface surface surface RA white right arm RA white right arm right arm LA black left arm LA black left arm left arm LL red left leg LL red left leg left leg RL green right leg neutral right leg neutral V brown chest 4th intercostal space at right border of sternum B30 Patient Monitor ECG Setup menu CL ECG ECGL Lead II ECG Lead W5 ECG3 Lead aVL ECG ECG Setup Beat Sound Volume 3 HR Source AUTO Ee See edu Display with HR None Adjust ST Filter Monit Relearn A Pacemaker Hide ECG Alarme El S lead cable Select Normal Screen Vlead V5 Previous Menu HR source filter and acemaker ten sound volume Adjust volume of pulse heart gt beat sound
4. Screen Setup Waveform Fields Field 1 ECGL Field 2 Resp Field 3 Fi Field 4 P2 Field 5 Pleth Field amp CO Combine Pressures NO Previous Menu Change waveform in field 2 select OFF to clear field OFF ECG P1 P2 Pleth coe OFF Check that the measurement is on 1 _ Press the Others key 2 Select Resp Setup 3 Select Measurement and ON Others Sp02 Setup Resp Setup Temp Setup Normal Screen Set size Resp rate source and alarm Enable ordisable Resp measurement Screen Setup Digit Fields Lower Field 1 Resp More Lover Field 2 nee 02 Lower Field 3 T4 T2 Resp Lower Field 4 G02 Temp Previous Menu T1 T2 Ti T2 ErrLog Battery Hore or Change contents of lower digit field 1 Select OFF to clear field Others Resp Setup Size 2 0 Resp Rate Source Imped Measurement OFF Detection limit Resp Rate Alarm Previous Menu JE measurement Select ON to enable impedance respiration 15 5 B30 Patient Monitor Improving waveform readability To improve readability increase the waveform size 1 Press the Others key 2 Select Resp Setup 3 Select Size and adjust the waveform size gt Others Resp Setup Size Resp Rate Source Measurement Detection Limit Resp Rate Alarm Previous Menu The bar on the left side of the waveform al
5. CU The Creighton University Sustained Ventricular Arrhythmia Database Gross results for beat by beat detection AHA Test Gross QRS Sensitivity 99 84 QRS positive preductive 99 88 accuracy VEB sensitivity 95 24 VEB positive predictive 97 24 accuracy VEB false positive rate 0 274 ECG Gross results for sample by sample detection of ventricular fibrillation AHA Test Gross VF Sensitivity duration 99 VF positive preductive accuracy 100 episode The gross results are calculated as overall results of all records Abbreviations VEB Ventricular ectopic beat QRS The waveform presented in an ECG during ventricular depolarization VF Ventricular fibrillation or ventricular flutter ST Segment of the ECG between the end of the QRS complex and the start of the T wave Monitoring pacemaker patients WARNING WARNING The monitor detects and rejects pacemaker pulses see selection Pacemaker in the ECG Setup menu Sometimes this may lead to unnecessary asystole alarms NOTE The shape of QRS complex may be changed because of the pacemaker so much that QRS detection may be affected NOTE If the patient has an atrial pacer ST calculations can be performed if the pacer does not coincide with the ISO point s adjustment range NOTE Pacemaker detector may not operate correctly during the use of high frequency HF surgical equipment The distu
6. Artifacts Some artifacts muscle activity eye e Calm the patient since patient movements etc may disturb certain movements shivering deep measurements breathing arrhythmia or irregular beats may cause some measurements to fail e f applicable start a new measurement Asystole No QRS detected in ECG e Check the patient status e Check the electrodes Battery low About 20 minutes of battery operation e Replace the battery or connect the time left monitor to power outlet Brady HR is equal to or below the lower e Check the patient status alarm limit Calibr error Unsuccessful gas calibration e Perform a new calibration Check D fend The water trap is not attached e Check that the water trap is properly attached to the module If the problem persists contact authorized service personnel 10 2 Troubleshooting Message Explanation What to do Check NIBP NIBP measurement affected by low blood pressure and pulsation or a change in patient s condition e Check the patient status e Check the measurement setup e Check the cuff Check sample gas out Sample gas outlet is blocked e Remove blockage from the sample gas outlet Check SpO2 probe SpO There is no detectable SpO signal the sensor is faulty or it is detached from the patient e Check the sensor and connections Cuff loose Cuff is not attached to the patient or it is too lo
7. Performance WARNING results Operation of the monitor outside the specified values may cause inaccurate Any fluctuations within the specified limits do not affect the performance NOTE Information in this section can be especially useful to clinicians Power supply Rated voltages and frequencies Allowed voltage fluctuations Maximum power consumption Battery operation Batteries Charging time Operation time Environmental conditions Operating temperature normal operation while charging batteries Storage and transport temperature Relative humidity Atmospheric pressure Alarm behavior 100 to 240 V 50 60 Hz 10 150 VA Exchangeable lithium ion 2 pcs max 2 hours per battery pack up to 4 5 hours 5 to 40 C 41 to 104 F 5 to 35 C 41 to 95 F 20 to 60 C 4 to 140 F 10 to 90 noncondensing 670 to 1060 mbar 500 to 800 mmHg The maximum alarm delay of the alarm at the monitor signal output to network 5 seconds If the alarm mode is latched the technical alarms are latched as well This does not comply with the NIBP IEC 60601 2 30 and invasive pressure IEC 60601 2 34 standard requirements Silencing alarms for 5 minutes does not comply with the SpO ISO 9919 standard requirements Defibrillator amp IABP synchronization connector Analog output ECG From first user lead ECG1 Gain Delay DC offset Frequency response Invasive blood pressure From pre
8. Others Resp Setup Size 2 0 Resp Rate Source Imped AUTO Measurement coz Detection limit Resp Rate Alarm Previous Menu ange source of respiration rate AUTO CO or Impedance received from ECG electrodes Of Imped R cr UE 20 5 p Amin Figure 15 3 Impedance respiration waveform and numeric respiration rate value 15 3 B30 Patient Monitor Patient connections The setup is the same as for the ECG measurement For more information see section ECG NOTE Impedance respiration measurement is intended for patients over three years old R RED IEC L YELLOW IEC R RED IEC RA WHITE AAMI LA BLACK AAMI RA WHITE AAMI L YELLOW IEC BLACK AAMI C C WHITE EC c V BROWN AAMI SI F GREEN IEC LL RED AAMI N BLACK IEC RL GREEN AAMI F GREEN IEC LL RED AAMI Figure 15 4 Impedance respiration setup 1 E PSMW or E PSMPW module 2 Multi link 5 lead standard cable 3 Multi link leadwire set 3 or 5 leads ECG electrodes pre gelled electrodes are recommended Check the expiration date NOTE For a comprehensive list of accessories see the Supplies and Accessories catalog Impedance respiration Activating measurement Monito gt Select respiration in a waveform or a digit field otherwise the respiration information is not included in the trends and the alarms are not operative
9. Beat Sound Volume HR Source Adjusts the pulse heart beat sound volume 0 to 10 When the monitor has detected a QRS complex or a pleth or pressure pulse a beep tone is produced You can raise lower or turn off the volume Adjusting beat sound volume affects also the beat sound volume of the HR source ECG Art or Pleth When Pleth is monitored the monitor provides a variable pulse beep so that the tone of the pulse beep rises with increasing oxygen saturation and falls with decreasing saturation This affects also the ECG tone Selects the heart rate source AUTO ECG Art ABP or Pleth When ECG is selected HR is always calculated from ECG Ifthe ECG signal is affected by too much noise for a reliable heart rate calculation pulse rate can be calculated from pressure Art and ABP or plethysmographic pulse waveform The selected heart rate source is displayed above the numerical display of the heart rate The color of the heart rate source indicator is the same as that of the source parameter The AUTO selection priorities for heart rate calculation are ECG pressure Art or ABP plethysmographic pulse waveform The first heart rate source available is selected Display with HRSelect PR PVC or None to display combined heart rate and pulse rate or heart rate and PVC Filter 11 6 rate next to the ECG waveform The current HR source is displayed with bigger font and the heart rate symbol flashes next to the reading ECG ar
10. WARNING WARNING NOTE The ECG parameter conforms to IEC 60601 2 27 with the exception of Sub clause 51 103 2 SILENCE RESET of PHYSIOLOGICAL ALARMS Sub clause 51 104 1 Auditory manifestation of TECHNICAL ALARMS A new alarm only triggers a visual indication not the audible alarm Refer IEC 60601 2 49 item for monitor s performance and warnings NOTE The ECG parameter conforms to IEC 60601 2 27 with the exception of Sub clause 51 103 3 4 New PHYSIOLOGICAL ALARM s beginning after activation of SILENCE RESET resumed the auditory and visual ALARM manifestations Refer IEC 60601 2 49 items for monitor s performance and warnings NOTE The ECG parameter conforms to IEC 60601 2 27 with the exception of Sub clause 51 104 Both non latched and latched alarms are selectable for technical alarms Refer IEC 60601 2 49 items for monitor s performance and warnings e The NIBP parameter conforms to IEC 60601 2 30 EN 1060 1 EN 1060 3 with the exception of Sub clause 22 4 1 51 103 of IEC 60601 2 30 and Sub clause 5 of EN 1060 1 NOTE The NIBP parameter conforms to IEC 60601 2 30 with the exception of Sub clause 22 4 1 In single fault condition the functioning independently of the normal pressure control system does not prevent immediately Prolonged use and frequent blood pressure determinations can lead to venous pooling and congestion Devices that exert pressure on tissue have been associated with p
11. Clears the menu selections from the display so that only 10 minute trends and limits are displayed push the ComWheel to return the selections on the screen Alarms Adjusting alarm limits Adjusting limits 1 2 51 d Press the Alarms Setup side panel key Select Adjust Limits Turn the ComWheel to highlight the measurement If the desired measurement is not displayed in the window select Next Page Push the ComWheel to open an adjustment window Turn the ComWheel to change the limits and accept them by pushing it Move between selections by turning the ComWheel To return to the Alarms Setup menu to select more measurements push the ComWheel until the cursor is in the adjustment menu then select Previous Menu or Alarms Setup Press the Normal Screen key to return to normal monitoring view You can enter the alarm limit adjustment window also through the measurement menus When you are in an XX parameter menu select XX Alarm or enter XX Setup and then select XX Alarm NOTES ST high low alarms will reach the white low priority level only In NIBP measurement the alarm limits change automatically according to the cuff hose type used If the monitor is connected to the network the alarm limits can also be adjusted using the Central if this feature has been enabled in its configuration If alarm limits are adjusted using the Central the message Alarm settings changed from Central is displayed in the be
12. EtCO high 8 low 3 FICO high 3 low Off Carbon dioxide CO Measurement range 0 to 20 vol Resolution 0 01 Measurement rise time lt 300 ms with nominal flow Accuracy 0 to 15 vol 0 2 vol 2 of reading 15 to 20 vol 0 7 vol 2 of reading Valid for respiration rate lt 40 1 min at E ratio of 1 1 Relative error is typically 10 for respiration rate 80 1 min at LE ratio of 1 1 The accuracy is specified in simulated ventilation With higher respiration rates and with varying ventilation methods the specifications may not be met Respiration rate Breath detection 1 change in CO level Measurement range 4 to 80 breaths min Accuracy 1 breath min in the range 4 to 20 breath min 5 in the range 20 to 80 breath min Resolution 1 breath min NOTE CO measurement is intended for patients who weigh over 5 kg 11 Ib Modules with recorder N FREC and N FCREC Power consumption 3W Recorder type Thermal array Print resolution vertical 8 dots mm horizontal 24 dots mm Paper width 50 mm printing width 48 mm Traces Selectable 1 2 or 3 waveforms Print speed 1 6 25 12 5 25 mm s 1 Alarm limits and their adjustment range may vary depending on the mode used 2 35 B30 Patient Monitor Table of contents Table of contents 3 Monitoring basics 3 1 PACE scs tee tetes ketan ita REA GO do 3 1 Modules and module Re en cod ese estet LE NR ANR uS LL 3 1 Patient sds Module EPM a A te
13. ke lt 2 5 ES Figure 12 2 Pulse oximetry setup with OxyTip sensors 1 E PSMW or E PSMPW module with SpO measurement capability 2 OxyTip interconnect cable NOTE The listed sensors are latex free B30 Patient Monitor Connecting the patient WARNING WARNING WARNING WARNING NOTE Use dry and clean sensors only 1 Connect the sensor to the blue connector in the module 2 Clean the application site Remove nail polish artificial fingernails earrings etc clip long fingernails 3 Position the sensor correctly For proper sensor positioning see the Instructions for use accompanying each sensor Attach the sensor to the patient 5 Attach the sensor cable to the wrist or bed clothes to prevent the cable and sensor from moving The message Pulse Search is displayed in the message field After the pulse search is completed the plethysmographic pulse waveform and the SpO reading are displayed on the screen Allow sensor and cable to dry completely after cleaning Moisture and dirt on the connector may affect the measurement accuracy To prevent erroneous readings do not use physically damaged sensors cables or modules Discard a damaged sensor or cable immediately Never repair a damaged sensor or cable never use a sensor or cable repaired by others A damaged sensor or a sensor soaked in liquid may cause burns during electrosurgery Inaccurate SpO data can re
14. ooo pi seed aoe 8 pr OS ais 5 12 Displaying oT ST NISI REESE IR A EAR CLR SERO DRE E RENT 5 12 Changing psrdmstercolols si oL eene a be E Se trea ales b be se tiet eatis 5 12 Changing the recorder and printer settings ad 5 13 Recorder a Oe Rd e RCRUM OA Eae 5 13 Printer SEUNG Ss tain arg e gae pe BEEN ER Sha e a Matos 5 13 CORONA MAS arr lane id 5 14 CORMOUFING end ole of CEE EEN 5 14 Senelle 5 14 Setting trend scales nea mare teeta bib br ken tabe ear vada 5 14 Setting trisidebaulb SRE scine aa ed TE DELEN 5 14 Table of contents Monitor setup 5 Monitor setup Overview The B30 monitor has numerous setup options for screen parameters alarms etc There are two types of settings User mode settings Some of the monitor setup options are preconfigured to be effective The preconfigured default settings so called factory settings form six sets of user modes The monitor starts in the startup mode which is one of the user modes You can change to another user mode see Changing the user mode page 5 6 The changes you make in the user mode settings are valid only temporarily until you discharge the patient or change a mode or until more than 15 minutes has elapsed from the turn off of the monitor The changes need to be saved in the mode to become permanent A Monitor installation settings the monitor installation settings are the same in all user modes The changes are permanent and preserved until changed aga
15. 14 7 B30 Patient Monitor Smart InvBP and flushing Flushing is performed to keep the lines open It prevents blood from clotting and occluding the lines and measurements Infusion that is used for flushing goes through the dome into the patient s artery Two types of flushing are used simultaneously flushing with continuous infusion and manual flushing Flushing with continuous infusion uses a higher pressure than the patient s blood pressure and contains Heparin to prevent blood from clotting Manual flushing is always used after having taken a blood sample and every now and then to ensure that the lines remain open The monitor detects the pressure used for infusion to flush the invasive blood pressure line There is a 40 second time out for performing the flushing The digits change to dashes and there are no alarms After 40 seconds or when flushing is completed and patient s pulse detected the pressure digits are displayed and alarms become active If pressure values are outside the alarm limits an alarm is given The monitor functions the same way when blood samples are taken Checklist 14 8 Check that e Invasive blood pressure transducer cable is plugged to the adapter cable and this is connected to the red connector in the module e Pressure transducer is connected to the cable e Patient catheter is connected to the pressure line e There is no air in the transducer dome or catheter line and trans
16. Module keys The E PSM P W modules have the following direct function keys A For starting or stopping the NIBP me A automatic cycling For starting or stopping the NIBP manual cycling For zeroing pressure channel P1 NOTE with E PSMPW only For zeroing pressure channel P2 NOTE with E PSMPW only 100 2 5 B30 Patient Monitor Extension Module N FC Figure 2 6 Module N FC 1 Module insertion guide for attaching an E PSM P W module 2 Sample gas inlet 3 Water trap 4 Gas outlet 5 Tab for removing the module System description Extension Module N FCREC Figure 2 7 Module N FCREC 1 2 3 4 5 6 7 Recorder Paper compartment lever CO measurement Water trap Tab for removing the module Sample gas inlet Gas outlet Extension Module N FREC Figure 2 8 Module N FREC 1 2 3 Recorder Paper compartment lever Tab for removing the module B30 Patient Monitor General module description The modules are plugged into the monitor They can be removed or inserted during monitoring Inserting and removing a module WARNING 2 8 Figure 2 9 Inserting and removing a module To insert a module 1 Align the module with the insertion guide E PSM P W and N Fx modules are all inserted the same way 2 Pushthe module into the monitor frame until it clicks To remove a module Pull the module out using the
17. ft FVloop GEDI GEDV GEF Graph Hal Hb Hbtot HCO3 Hemo end systolic volume end systolic volume index end tidal concentration end tidal anesthetic agent end tidal balance gas end tidal carbon dioxide end tidal nitrous oxide end tidal oxygen endotracheal tube extravascular lung water extravascular lung water index expiratory foot describing location Fahrenheit degree frontal electromyogram fast Fourier transform fraction of inspired gas fraction of inspired anesthetic agent fibrillation fraction of inspired balance gas fraction of inspired carbon dioxide fraction of inspired N fraction of inspired nitrous oxide fraction of inspired oxygen airway gas flow frequent foot feet flow volume loop Gauss gram global enddiastolic volume index global enddiastolic volume global ejection fraction graphical hour hand describing location halothane hemoglobin total hemoglobin bicarbonate hemodynamic System description Hemo Calcs HHb HME HMEF hPa HR HRdiff ht HW Hz EC E ABP CP CU moped nf nfl nsp nv nv BP rreg SO SO SM TBV VR kcal kJ kPa hemodynamic calculations reduced hemoglobin heat and moisture exchanger heat and moisture exchanger with filter hectopascal heart rate heart rate difference height hardware hertz International Electrotechnical Comission inspiratory expiratory ratio intra aortic balloon pump inspirator
18. onto o sx db o et m PO ev nee eto tuta 11 2 Preparing the patient and placing the electrodes nennen eenen 11 3 Preparing the patent entre een ed ik tee ioo ERG dh es 11 3 Placing the electrodes caca osse EH ERR ANO EERDERE HA GAS 11 3 MN a e Oe 11 4 Colt an SER COM ee tent ede laad Andere 11 5 BESTAAND le Dto real eter e E e MT ad epu s 11 5 a AA A ep Um eked wee 11 5 ECOS a Mada Vinay atts Le P M RR AD 2 11 6 Selecta edid AAA ended uie ies Lb er terc utt 11 7 Se lectina ser leads weten esn Cal doers Lo Ge a do te De ce 11 7 Viewing a cascaded EUG coa otio Gd E Rb HERE ET e ELLAS UE 11 8 Adjusting tS o a rd bd d maius 11 8 Sima Fel HEURE ET A en tore OO Pt bm ded 11 9 Setting heart ratelde HERMES eoa doces A E OR 11 9 A BoA A ciet tuii ene 11 10 ST Se mMentan als Jense irte oran ale pri 11 11 O EEE 11 11 Disparos lnb e es La 11 11 Monitoring the ST segment tete eara ee era E e ar CELLS cog 11 11 Setting the ST measurement points non eneen eneen en 11 12 Setting STOME tet a NN 11 13 Description of the ST segment measurement algorithm on 11 14 Test results of ST segment measurement algorithm testing cece eee ee 11 14 M nitoring PED EEG n rero ee hk 11 15 Adjusting arrhythmia alarm SSDS s us cep ette i C re e VE ER ETHER ARAS 11 15 Detecting the ECG arrhythmia alarms ta 11 16 Selecting leads for the arrhythmia analysis xy Er sace ERR D c RR OPERAE 11 16 Description of the arrhythmia algorithm ter ziii careo GC e Cv O
19. 7 coooo Figure 17 2 N FCREC module Insertion guide for attaching on E PSM P W module Water trap Sampling gas inlet Gas outlet Tab for removing the module Recorder Paper compartment lever CO2 measurement Water trap Sampling gas inlet Tab for removing the module Gas outlet B30 Patient Monitor Display of gases Figure 17 3 Airway gas waveform display 1 30 minute trend for CO selected in the Monitor Setup menu 2 Gas waveforms 3 Message field for gases 4 Gas label 5 Digit field for ET and FI gas values 6 Respiration rate 7 Scale NOTE When the measured CO value is outside the specified measurement range the numeric value is gray 21 15 Figure 17 4 Lower digit field for gases Airway gas CO2 Patient connections WARNING 1 Insert the N FC or N FCREC in the monitor Align the module with the insertion guides and push until it clicks 2 Check visually that the airway adapter connections are tight and that the adapter is operating properly then attach it to the patient 3 Make sure that the water trap container is empty and properly attached The water trap should be changed between patients and emptied whenever it is more than half full Handle the water trap and its contents as you would any body fluid Infectious hazard may be pre
20. Changing the recorder and printer settings Recorder settings 1 2 Printer settings Press Print Record Select Record Waveforms Select Waveform 1 and select a parameter or select OFF Then select Waveform 2 and 3 and their parameters You can record up to three waveforms simultaneously If you wish to record only one waveform select the other waveform fields OFF Select Start on Alarms Yes to start automatic strip chart recording when the following alarms reach the red alarm level NO is the default with L DICUO8 software license bradycardia tachycardia asystole Art high low V Fib V Tachy Select Delay and OFF or 12 s If the recording delay is OFF the recording starts when an event occurs and continues for 30 seconds or until manually stopped or until the recorder runs out of paper If the delay is 12 seconds default the recording starts when an event occurs and the 12 seconds prior to the event are recorded from the recorder memory The recording continues for 18 seconds if the length has been set to 30 seconds or until the recorder runs out of paper Select Paper Speed and 1 6 25 12 5 default or 25 mm s Select Length and choose 30 s default or Cont Select Record Trends Select Trend Resolution and every 1 min 5 min 10 min default or 30 min This setting is for numerical trends Select Num Trend Type and Num default or Tab as the format of the numerical trend recorded Select Graphi
21. Skin temperature 13 3 SpO2 patient connections 12 3 ST display 11 11 monitoring ST segment 11 11 setting alarm limit 11 13 Surface temperature 13 3 Sweep speed changing waveform sweep speed 5 12 Symbols equipment safety symbols 2 15 other equipment symbols 2 16 trend 6 6 System configuration 5 1 messages 10 2 T Temperature changing label 13 3 changing units 13 4 checklist 13 4 cleaning the probes 9 5 combining temperatures 13 4 display 13 2 label 13 3 modules 13 1 patient connections 13 2 testing 13 4 Time setup 5 2 Trend configuring 5 14 graphical pages 6 7 graphical trend view 6 5 printing numerical 6 10 recording numerical 6 10 symbols 6 6 trended parameters 6 1 Troubleshooting 10 1 Tympanic temperature 13 3 U Unit changing for different parameters 5 3 temperature 13 4 User leads 11 7 User mode default modes 5 6 renaming 5 7 V Vapor of water 17 8 Venous stasis 16 8 Volume beat sound from SpO2 12 5 heartbeat 11 6 NIBP 16 4 W Water trap 9 6 care 9 6 emptying 9 6 Waveform 5 9 modifying the field 5 9 WEEE symbol 2 18 Z Zeroing airway gas 17 7 IBP 14 4 World Headquarters European Representative Asian Headquarters GE Medical Systems GE Medical Systems GE Medical Systems Information Technologies Inc Information Technologies GmbH Information Technologies Asia 8200 West Tower Avenue MunzingerStrasse 5 GE China Technology Park Milwaukee WI 53223 USA 79111 Freiburg 1 Huat
22. Starts a single measurement and cancels any measurement Displaying non invasive blood pressure NIBP can be displayed in the digit field Figure 16 2 NIBP digit field display 1 Systolic and diastolic pressure value of non invasive blood pressure 2 Label 3 Mean pressure value of NIBP 4 Time since the last autocycle measurement 5 NIBP autocycle time indicator NOTE When 60 minutes has passed from the latest NIBP measurement the NIBP numeric value digits turn gray When 245 minutes has passed from the latest NIBP measurement the gray numeric value digits are replaced by a dashed line 16 2 Non invasive blood pressure Patient connections Figure 16 3 Cuff positioning 1 E PSMW or E PSMPW module 2 Cuff hose 3 Cuff of correct size Place the arrow 4 over the brachial artery Check that the index line 5 falls within the range markings on the cuff and wrap the cuff around the upper arm For a comprehensive list of accessories see the Supplies and Accessories catalog The listed NIBP cuffs are latex free Selecting a cuff and a cuff hose Two different cuff hoses with different cuff connections are available BLACK hose for adults and children corresponding inflation limits Adult and Child including cuff identification LIGHT BLUE hose for infants corresponding inflation limit Infant without cuff identification The monitor automatically identifies the black h
23. This is only ms quantitative difference that can t be defected by human audition according to the usability study it has no negative effect in clinical use Comformity according to the Council Directive C 93 42 EEC concerning Medical Devices 0459 Table of contents Table of contents 2 System description 2 1 Principles Of AMENONS ne cras hate mU A due hide ot eee 2 1 SUISSE IAD e Pets Aa et A ee ERA 2 1 Components za da e Decus 2 2 Uta A A ed den Vag eN 2 3 Rear pane connect e ot ed se 2 5 Module eri usato cera det rip Nr E erstes 2 4 Patient Side ModbleEcPs MM e E ll E do 2 4 Patient Side Module EPS e Le uH 2 5 Extension Module NE lee Es te Mta o o Buen M dd o Soe ad 2 6 ExtensiorModule N FOREGD srs cue opp irte dup OR 2 7 Extension Module NE FREC hiatu Y ht dua 2 7 General module des CA a ido 2 8 Inserting and removing a module ee a ee ate 2 8 Keyboard etten ard eeen A hont er 2 10 Command Board KEYS a ies ida Maram de 2 10 dd 2 11 BOSNIE ae ana ek Are ee a AAN A 2 12 Bottero MC OR OMS van trant tte Ee Cre eb qe Pto eres 2 13 Replacing the batteries rasnaam wette essent 2 14 Boalo alas dolen ICN 2 15 Sumbois CNG Ko lele 234 iel Te CN 2 15 Equipment safety symbols lao Sac Et RM HM EEN eta d 2 15 OPHEPSUINDOIEE tronen asa 2 16 BbECBUIdHDHe cetur ER EET m A 2 19 os eR RPM PPM 2 30 E O ERROR 2 30 BURRO AA AS A AS AO 2 30 Environmental COMGITIONS nn sa oto vaneen eed tat Ms 2 30 A E aen
24. batteries Monitor Setup Screen Set up Battery Setup Sweep Speeds Previous Menu Display brightness TO Remaining time Time and Date Battery A 02 50 Help Battery B 0238 Total 05 28 Battery Setup a Install Service Normal Screen Battery Quality Battery A OK Battery B oO Show remaining battery time and battery status Return to previous menu gt O lo NOTE When the monitor is battery powered the green battery LED is on When the monitor is mains powered the green mains LED is on If you wish to have the battery charge visible at all times select it in one of the digit fields Monitor Setup Screen Setup Digit Fields Battery You can now see how much charging time is left for each battery separately both in numbers and as symbols and the total charging time in numbers Battery Time 5 20 A B 2 35 2 44 h min Use only manufacturer approved batteries Contact GE service if you need to order new batteries System description Battery indicators The B30 messages screen symbols and front panel LED indicators tell the user about the status of the batteries For screen symbols see page 2 15 For LED indicators consult the table below and for messages see section Troubleshooting Table 2 1 Battery indicators Screen symbol Explanation Front panel battery LED indicators screen Batteries have failed or they are no
25. indications of errors in the gas readings Calibrate the gas measurement with the GE Healthcare calibration gas Do not use any other calibration gases Use the regulator 755534 or equivalent Use the gas 755580 only and set the CO concentration to 20 If you do not use the recommended calibration gases the calibration does not succeed During gas calibration units are always used for CO regardless of selected measuring units Figure 17 5 Attaching regulator to calibration can 1 Attach the regulator to the gas container 2 Attach a new sampling line to the water trap Connect the loose end of the sampling line to the regulator on the gas container Figure 17 6 Connecting sampling line to the gas valve and feeding gas Airway gas CO2 3 _ Turn on the power For maximum accuracy let the monitor warm up for 30 minutes The menu item Gas calibration remains gray as long as the message Calibrating gas sensor is displayed 4 _ Press the Airway Gas key and select Gas calibration 5 Wait until Zero ok and then Feed gas messages are displayed after each gas on the screen 6 Open the regulator and feed calibration gas until the message Adjust is displayed then close the valve If you use an older brass regulator the feeding pressure should be adjusted between 5 and 7 psi 7 Check that the displayed gas values match the values on the calibration gas container NOTE Set the
26. ECG1 3 ECG3 is displayed below ECG2 4 Selected lead label 5 ECG gain bar 1 mV reference 6 Heart rate HR label 7 Heart rate pulse rate source ECG Art ABP Pleth 8 HR PR value 9 Heart beat detector is flashing with every detected heart beat 10 ST values are always displayed next to ECG2 11 Fourth ST value showing the largest absolute ST value 12 Selected ST leads 13 ST label 14 Message field for parameter messages NOTES You can change the number of ECG waveforms on the screen in the Monitor Setup menu by selecting Screen Setup and Waveform Fields The ECG leads can be chosen in the ECG menu The module input circuits are protected against the effects of electrosurgery and defibrillation However the ECG waveform on the monitor screen may be disturbed during electrosurgery ECG Preparing the patient and placing the electrodes Preparing the patient Prepare the skin properly to ensure optimal signal quality Shave any hair from the electrode site Gently rub the skin surface to increase capillary blood flow and remove dead skin cells and oil Clean the skin using a mild soap and water solution Dry the skin completely before applying the electrodes Pre gelled electrodes are recommended Check that the electrodes are moist and have not dried out during storage Placing the electrodes When placing the electrodes avoid bones close to the skin obvious layers of fat and major muscle
27. FCREC 8 1 N FREC 8 1 NIBP cuff and hose cleaning 9 5 patient connections 16 3 setup 16 4 Normal Screen digit fields 5 10 minitrend length 5 8 waveform fields 5 9 Numerics 5 10 O Oscillometric 16 1 Other equipment symbols 2 16 Oxygen saturation 12 1 P Pacemaker 15 2 Paper recorder paper speed 5 13 Parameter colors 5 12 trended parameters 6 1 Patient connections impedance respiration 15 4 invasive blood pressure 14 2 NIBP 16 3 SpO2 12 3 temperature 13 2 Preparations 3 5 Printing numerical trends 6 10 Printout tabular trend printout 8 7 Problems messages 10 2 other situations 10 8 Pulse rate display 11 6 R Recording delay time 8 4 general 8 1 numerical trend format 8 7 numerical trends 6 10 paper speed 5 13 selecting graphical trend parameter 5 13 selecting graphical trends 8 7 selecting recorded waveforms 5 13 side panel key 8 1 Rectal temperature 13 3 Removing water trap 9 7 Room temperature 13 3 S Sampling line 9 6 Scale pleth 12 5 trendtime scale 5 14 Screen setup digit fields 5 10 parameter colors 5 12 waveform fields 5 9 Setup changing units 5 3 digit field 5 10 ECG 11 6 NIBP 16 4 parameter colors 5 12 SpO2 12 5 temperature 13 3 temperature units 13 4 time and date 5 2 trends 5 14 user mode 5 6 waveforms 5 9 Side panel 2 11 Side panel keys Index recording 8 1 Silencing alarms from Central 4 10 Size ECG 11 8 impedance respiration waveform 15 6
28. Patient Monitor R A taA 5 Other symbols y SN HE HB E E Type CF IEC 60601 1 defibrillator proof protection against electric shock When displayed in the upper left corner of the screen indicates that the alarms are silenced When displayed in the menu or digit fields indicates that the alarm source has been turned off or alarm does not meet the alarm specific activation criteria ESD warning symbol for electrostatic sensitive devices Pins of connectors identified with the ESD warning symbol should not be touched Connections should not be made to these connectors unless ESD precautionary procedures are used For details see ESD precautionary procedures page 1 2 Symbol for non ionizing electromagnetic radiation Interference may occur in the vicinity of equipment marked with this symbol Equipotentiality Monitor can be connected to potential equalization conductor Alternating current Fuse Replace the fuse only with one of the same type and rating Serial Number In the front panel battery Battery operation and remaining capacity The height of the green bar indicates the charging level Battery A charging white bar Battery A failure Both batteries have failed System description Ku re prezzo o Battery A is missing In the front panel mains or external DC power Submenu Selecting an alternative marked with this symbol in a menu opens a new menu The mo
29. Split Screen and Trend Monitor Setup Monitor gt Screen Setup Waveform Fields E None Digit Fields Split Screen Trend Minitrend Length 30 min Previous Menu Minitrends of waveforms are permanently displayed with waveforms 9 You can choose to view trend data from the last five minutes or the last 30 minute period The five minute minitrend is updated every 10 seconds the 30 minute minitrend is updated once every minute To modify the split screen trend view 1 Press the Monitor Setup key 2 Select Screen Setup 3 Select Minitrend Length and choose 5 min or 30 min Minitrend length Removing minitrend To remove the minitrend from the screen 1 Press the Monitor Setup key 2 Select Screen Setup 3 Select Split Screen and None 6 4 Trends Graphical trend view Print Page Cursor Time Scale 20 Art Numerical O Trend Scales Previous Menu Show graphical trends Sp 2 56 STEP DOWN 15 27 Trends ECG Arh hidde analys Severe Scroll Pages HR H 1 F y T n 88 Figure 6 2 Graphical trend page 1 2 3 4 5 6 7 Trends menu Measurement trend field Real time ECG Numeric value of a measurement at the trend cursor point Trend page number Indication of the amount of data gathered and viewed Time and marker field 6 5 B30 Patient Monitor Symbols Ee me Trend bar param
30. The invasive blood pressure parameter conforms to the IEC 60601 2 34 with the exception of Sub clause 51 300 and 51 207 4 NOTE The invasive blood pressure parameter conforms to the IEC 60601 2 34 with the exception of Sub clause 51 300 Both non latched and latched alarms are selectable for technical alarms Refer IEC 60601 2 49 item for monitor s performance and warnings NOTE The invasive blood pressure parameter conforms to the IEC 60601 2 34 with the exception of Sub clause 51 207 4 A new alarm only triggers a visual indication not the audible alarm Refer IEC 60601 2 49 item for monitor s performance and warnings e The ECG parameter conforms to IEC 60601 2 27 with the exception of Sub clause 50 102 8 a 51 103 2 51 103 3 4 51 104 1 and 51 104 NOTE The ECG parameter conforms to IEC 60601 2 27 with the exception of Sub clause 50 102 8 a Frequency response The output signal amplitudes are out of range at Method A 40HZ and Method B The ECG high frequency response limit for monitoring filter and ST filter with 50 Hz power supply frequency is 30 Hz but not 40 Hz according the 60601 2 27 In clinical conditions the high frequency response limit of 30 Hz for monitoring filter and ST filter with 50 Hz power supply frequency is adequately and safe for these lethal arrhythmia identification which are available in B30 The diagnostic filter is recommended for diagnostic purposes Safety precautions
31. against harmful ingress of water In accordance with EU Medical Device Directive The B30 patient monitor is classified as IIb In accordance with CISPR 11 Group 1 Class B e Group 1 contains all ISM Industrial scientific and medical equipment in which there is intentionally generated and or used conductively coupled radio frequency energy which is necessary for the internal functioning of the equipment itself e Class B equipment is suitable for use in domestic establishments and in establishments directly connected to a low voltage power supply network which supplies buildings used for domestic purposes Responsibility of the manufacturer GE Medical Systems Information Technologies Inc is responsible for the effects on safety reliability and performance of the equipment only if assembly extensions readjustments modifications servicing and repairs are carried out by personnel authorized by GE e the electrical installation of the monitor room complies with appropriate requirements e the equipment is used in accordance with the User s Guide Product availability Some of the products mentioned in this manual may not be available in all countries Please consult your local representative for the availability Trademarks Dash Datex Ohmeda S 5 D fend D fend Mini D fend OxyTip ComWheel ComBar EarSat FingerSat FlexSat are trademarks of GE Healthcare All other product and company names are property of the
32. alarm history e Pressthe Pt Data Trends key and select Alarm History This displays a list of the last 20 alarms that have reached the yellow or the red alarm level The time and type of occurrence are displayed next to the alarm list items Alarms Other adjustable features NOTE This section describes the rest of the adjustable features regarding the alarms You can adjust each feature if you know the required password for entering the Install Service menu If you wish to adjust the settings we recommend that you contactthe person responsible for the entire configuration Displaying limits You may select the alarm limits to be displayed next to the numerical parameter value 1 de 3 4 Press the Monitor Setup key Select Install Service and enter the password Select Installation Alarm Options Select Show Limits and YES or NO Installation Setup gt Alarm Options show Limits YES Show Audio QN OFF YES Alarm Light YES Latching Alarms NO Reminder Volume 5 Alarm Tones Previous Menu select NO to disable alarm silencing Silence option in gt Audio ON OFF menu willbe hidden The alarm limits become visible when patient monitoring begins and the monitor receives patient data B30 Patient Monitor Enabling or disabling alarm silencing With this selection you can determine whether the audible alarms can be turned off or not 1 2 3 4 Press the Monitor Setup key S
33. and ID Admit 1 1 be Admit Discharge Select Hode Discharge Normal Screen Give patient s last name first name and ID gt NOTE Always observe the monitor and the patient carefully during start up periods 7 1 B30 Patient Monitor Adding demographics 1 Admit Discharge key 2 Select Admit Patient Demographics 3 Enter patient data Height is adjustable from 15 to 250 cm 5 in to 8 ft 2 in Weight is adjustable from 1 to 250 kg 2 to 555 Ib The body surface area BSA is calculated automatically by using du Bois formula The body surface area is used in calculating index values of some parameters Loading previous data If the patient has already been admitted on the same monitor and this monitor has been restarted the Contin Previous will be appeared Admit Ee gt Contin Previous Yes Select Mode Discharge Normal Screen Admit Discharge admit Patient NO Contin Previous 7 2 Give patient s last name first name and ID OQ 49 Select this to load the most recent patient trends from the monitor memory when less than 15 minutes has elapsed from the turn off If the patient has been discharged but the monitor has been on you can retrieve approximately the last 24 hours NOTE This selection is available if the patient is already admitted on this monitor Patient data management Automatic saving of patient data The monitor continuously and au
34. conditions expired minute volume in STPD conditions inspired minute volume l min spontaneous minute volume myocardiac temperature neutral nitrogen nitrous oxide sodium nasopharyngeal temperature neonate network System description NIBP Ni Cd Ni MH NMT NO NTPD Num O OER O Hb OR Oxy Oxy Calcs P P P BTPS Plg alCO P g ET CO P STPD P1 P2 PA Pa Paced Paco PAO PaO PAOP PA Paw Pbaro PCWP PE pedi PEEP PEEPe PEEPe i PEEPe PEEPi PEEPI PEEPtot PgCO non invasive blood pressure nickel cadmium nickel metal hydride neuromuscular transmission nitric oxide normal temperature and pressure dry gas numerical oxygen oxygen extraction ratio oxygenated hemoglobin operation room oxygenation oxygenation calculations partial pressure pressure pressure in BTPS conditions difference between gastrointestinal carbon dioxide and arterial blood carbon dioxide concentration difference between gastrointestinal carbon dioxide and end tidal carbon dioxide concentration pressure in STPD conditions invasive pressure channel identification on module pulmonary artery Pascal unit of pressure paced beats partial pressure of carbon dioxide in the arteries partial pressure of oxygen in the alveoli partial pressure of oxygen in the arteries pulmonary artery occlusion pressure pulmonary arterial pressure airway pressure barometric pressure pulmonary capillary wedge
35. conditions over a wide range of arterial blood oxygen saturations as compared to arterial blood CO Oximetry Accuracy may depend on the sensor used please refer to the instructions for use in the accessory package The accuracy is expressed as rms This means that approximately two thirds of the data will fall within the accuracy range 2 33 B30 Patient Monitor Default alarm limits SpO high Off low 90 PR high 160 low 40 NOTE For each SpO accessory refer to the instructions for use in the accessory package for patient weight limits and accuracy Modules with CO measurement N FC and N FCREC Sampling rate 150 25 ml min sampling line 2 to 3 m normal conditions Maximum sampling line length 6m Sampling delay 2 1 s typical with a 3 m sampling line Total system response time 2 4 seconds typical with a 3 m sampling line including sampling delay and rise time typically 3 7 seconds with a 6 m sampling line Warm up time 1 min for operation 30 min for full specification Autozeroing interval 4 15 30 and 60 minutes after start up then every 60 minutes Automatic compensation for barometric pressure Gas values are measured in ATPD conditions ambient temperature and pressure dry When CO2 is displayed as a partial pressure kPa mmHg the value can be alternatively shown as wet BTPS body temperature and pressure saturated Non disturbing gases are those with a maximum effect on the CO reading at 5 0 vol9
36. fraction reference respiration rate total set respiration rate total measured radio frequency average root mean square power System description Room RQ RR rtm RV RVEDV RVESV RVP RVSW RVSWI SA SaO S A R SD SE SEF SEMG Sev S Skin SN S N Spiro SpO Spont SQI SR SR SSEP ST ST stat STAT STBY Stfilt STPD Surf SV SVC SVI SvO SVR SVRI room temperature respiratory quotient respiration rate total measured rhythm residual volume right ventricular end diastolic volume right ventricular end sustolic volume right ventricular pressure right ventricular stroke work right ventricular stroke work index second sinoatrial arterial oxygen saturation specific absorption rate standard deviation State Entropy spectral edge frequency spontaneous electromyogram sevoflurane stroke index skin temperature serial number patient spirometry oxygen saturation spontaneous breathing signal quality index suppression ratio sinus rhythm somatosensory evoked potentials single twitch NMT ST segment of electrocardiograph static continuous NIBP cuff inflation for five minutes standby ST filter ECG standard temperature and pressure dry gas surface temperature stroke volume supraventricular contraction stroke volume index mixed venous oxygen saturation systemic vascular resistance systemic vascular resistance index B30 Patient Monitor SW SVV Sys
37. gt ECG ECG1 Lead II ECG Lead V5 ECG3 Lead aVL Adjust ST EI Relearn ECG Setup E ECG Alarms B Normal Screen Change size of ECG waveforms by adjusting scale height gt ECG Starting relearning manually Ce When the patient s ECG pattern changes considerably the monitor should start relearning a new ECG pattern The pattern changes for example when changing the patient s position To start relearning manually 1 Press the ECG key 2 Select Relearn ECG ECG1 Lead I ECG Lead W5 ECG3 Lead aVL ECG Size 1 0 AdustsT IE ECG Setup ECG Alarms E Normal Screen fia Select Relearn to enable monitor to learn new ECG pattern Setting heart rate alarm limits To set the heart rate alarm limits 1 Press the ECG key 2 Select ECG Alarms 3 Select Adjust Limits O 49 You can also adjust the limits through Alarms Setup Adjust Limits For detailed instructions see section Alarms ECG ECG1 Lead awR ECG Lead Casc ECG3 Lead Casc ECG Size 1 0 Adjust ST Relearn ECG Setup ECG Alarms E Normal Screen iil fr ECG Adjust Limits Change high and low HR and ST alarm limits Change PYG alarm limit and arrh alarm settings HR Alarm Of PVC Alarm OFF ST Alarms Arrh Alarme Alarms Setup Previous Menu Push ComMheel to adjust alarm limits manually ADJUST ALARM LIMITS
38. line blocked may result if you attach the sampling line to the water trap after turning the monitor on e Whenthe warning symbol is displayed beside the O value FiO low alarm limit is set below 21 Use only approved accessories For a list of approved supplies and accessories see the Supplies and Accessories catalog delivered with the monitor Other accessories may cause a safety hazard damage the equipment or system result in increased emissions or decreased immunity of the equipment or system or interfere with the measurement Remove the airway sampling line from the patient s airway while nebulized medications are being delivered Do not apply pressurized air to any outlet or tubing connected to the monitor Pressure may destroy sensitive elements Always test the airway adapter for a tight connection and proper operation before attaching it to the patient Airway gas CO2 CO setup menu CL Scale FiO2 Level Unit Airway Gas Airway Gas C02 Setup C02 Setup PN Ps Cale Gas Calibration Fi02 Level 21 40 5 Normal Screen N20 Level 0 40 Unit Resp Rate Source AUTO Measurement ON C02 Alarm Resp Rate Alarm Previous Menu Set scale Resp rate source and alarms Change size of C02 waveform by changing scale height gt Allows you to select the following scales scale options for scale options for kPa scale options for mmHg 0 6 0 6kPa 0 50 mmHg 0 10 0 10
39. modules and keyboards instructions 3 1 B30 Patient Monitor Using menus A menu is a list of functions or commands displayed on the monitor screen To display a menu press one of the Command Board keys STEP DOWN 15 27 N20 Level 0 40 Unit Resp Rate Source AUTO Measurement ON CO2 Alarm Resp Rate Alarm 38 0 20 5 Figure3 1 Example of a menu 1 Menu header 2 List of menu selections 3 Indicates the present selection 4 Adjustment window with other options 5 Short instructions 6 Entry indicator to submenus Monitoring basic Select items in the menus with the ComWheel For example to change what is displayed in the ECG display Select the desired function by pressing the menu key Turn the ComWheel to move the highlight down in the menu to the desired selection c ECG cor Lead JT ECG Lead WB ECGS Lead aVL ECG Size 1 0 Adjust ST Relearn ECG Setup ECG Alarms Normal Screen Change lead displayed as ECG waveform ECG ECG Lead II ECG Lead Wa ECG3 Lead aVL Adjust ST Relearn ECG Setup ECG Alarms Normal Screen Change size of ECG waveforms by adjusting scale height 3 3 B30 Patient Monitor Push the ComWheel to ECG enter an adjustment window or a submenu ECG1 Lead II ECG Lead WO ECGS Lead aVL ECG Size Adjust ST Relearn ECG Setup ECG Alarms Normal Screen Change size of ECG waveforms by adjusting sc
40. must be recycled or disposed of in accordance with local state or country laws Within this system the backlight lamps in the monitor display contain mercury IPX class Degree of protection against harmful ingress of water as detailed in the IEC 60529 IPXO Ordinary equipment IPX1 Protection against vertically falling water drops IPX2 Protection against vertically falling water drops when enclosure tilted up to IPX3 15 IPX4 Protected against spraying water IPX7 Protected against splashing water IPX8 Protected against the effects of temporary immersion in water Protected against the effects of continuous immersion in water 2 18 System description Abbreviations min e F Hg A A a a AO AaDO AA AAMI ABG ABP ADU AEP AirW Alpha Al AM Amp Ant APN Arrh Art ASY ATMP ATPD ATPS AV avF avg aVL aVR aw Axil BAEP Bal bar Beta Be Bigem BIS Blad Blood beats per minute breaths per minute Celsius degree Fahrenheit degree microgram arm describing location alveolar arterial arterio alveolar PO ratio alveolo arterial oxygen difference anesthetic agent Association for the Advancement of Medical Instrumentation arterial blood gases arterial pressure Anesthesia Delivery Unit auditory evoked potential airway temperature alpha frequency band Anesthesia Monitor amplitude anterior apnea arrhythmia arterial pressure asystole atmospheric pressure
41. oe 2 30 Defibrillator amp IABP synchronization connector 6 0 cece cece en ereen enen 2 30 Hemodynamic modules E PSM E PSMP an 0a heathen Oo GUSTO TOU PU IRE 2 31 Modules with CO measurement N FC and N FCREC neee eeen 2 34 Modules with recorder N FREC and N FCREC 0 0 cee cece cece eeen 2 35 Table of contents System description 2 System description Principles of functions The B30 monitor is a modular multiparameter patient monitor The monitor is especially designed for monitoring in PACU ED Wards Step down units ICU CCU and OR in regions where anesthesia gas monitoring is not required It can also be used during transportation within the hospital The modular design makes the system flexible and easy to upgrade System introduction WARNING WARNING WARNING The B30 monitor system may consist of the elements shown below NOTE Your system may not include all these components Consult your local representative for the available components oo o 90 3 Ae ESS N Figure 2 1 B30 patient monitor system 1 B30 with module s 2 Printer network printer only 3 Other monitors in the network NOTE You cannot view other monitors on the B30 with L DICUO8 software NOTE The allowed cables batteries transducers and accessories for the monitor are listed in the Supplies and Accessories catalog deli
42. of them you want to record 1 Press the Print Record key 2 Select Record Waveforms 3 Select Waveform 1 and a parameter for it see the list below or select OFF 4 Select Waveform 2 and 3 and their parameters You can record simultaneously up to three waveforms The following menu figure shows which parameters have recordable waveforms Record amp Print Record Waveforms Record to Net Record to Local Waveform 1 Waveform 2 Waveform 3 Start on Alarms Delay Paper Speed Length Previous Menu Change waveform recorded in upper field gt Select OFF to clear field Changing the paper speed To see the waveforms more clearly or more generally you can change the paper speed The recorder speed can be 1 6 25 12 5 or 25 mm second 1 Press the Print Record key 2 Select Record Waveforms 3 Select Paper Speed Record amp Print Record Waveforms Record to Net Record ta Local 1 Waveform 1 ECGL 6 25 Waveform 2 OFF 12 5 Waveform 3 OFF Start on Alarms NO Delay 125 Paper Speed 25 mm s Length 30 s Previous Menu Change paper speed 1 6 25 12 5 0r25 mm s 2 B30 Patient Monitor Controlling the recording time Print Record You can adjust the recording time to be 30 seconds or continuous which means that the recording continues until the recorder runs out of paper 1 Press the Print Record key 2 Select Record Waveforms 3 Select Lengt
43. once every minute To modify the minitrend length 1 Press the Monitor Setup key 2 Select Screen Setup 3 Select Minitrend Length and choose 5 min or 30 min B30 Patient Monitor Other adjustable screen features Changing the display brightness 1 Press Monitor Setup and select Display brightness 2 Select from 10 to 100 Changing sweep speeds You can change the speed of the waveforms on the screen Selections are Fast 6 25 mm s and Slow 0 625 mm s For hemodynamic parameters the selections are 12 5 25 and 50 mm s Slow waveforms have a sweep speed one tenth of normal for a full screen sweep Slow waveforms show amplitude changes better than fast waveforms 1 Press the Monitor Setup key 2 Select Sweep Speeds select the parameter and adjust the value Displaying pulse rate Combined heart rate and pulse rate can be displayed next to the ECG waveform The current HR source is displayed with bigger font and the heart rate symbol flashes next to it ECG art H 5 8 min 58i 1 Press the ECG key 2 Select ECG Setup 3 Select Display with HR and PR PVC or None Changing parameter colors You can select the color of each parameter to be yellow white green red or blue For some parameters also violet is possible To change the color 1 Press the Monitor Setup key 2 Select Install Service and enter the password 3 Select Colors 4 Selectthe desired parameter and the color Monitor setup
44. pressure polyethylene pediatric positive end expiratory pressure extrinsic positive end expiratory pressure total positive end expiratory pressure ICU total positive end expiratory pressure ICU intrinsic positive end expiratory pressure total positive end expiratory pressure anesthesia gastrointestinal carbon dioxide concentration B30 Patient Monitor pH pHa pHi pHv PIC Pleth PM PM non capt PM non funct Pmax Pmean Pmin Ppeak Pplat PR Prev psi pt PTC pts PVC PVC PVloop PvO PVR PVRI Px QRS Os Qt RAP Raw RCW RCWI RE Rect REF ref Resp Resp Rate RF RMS pH arterial pH intramucosal pH mixed venous pH patient interface cable plethysmographic pulse waveform pacemaker pacemaker non capturing pacemaker non functioning maximum pressure mean pressure minimum pressure peak pressure plateau pause pressure pulse rate previous pounds per square per inch patient post tetanic count NMT patients polyvinylchloride premature ventricular contraction pressure volume loop partial pressure of oxygen in mixed venous blood pulmonary vascular resistance pulmonary vascular resistance index standard pressure label x being 1 2 3 4 5 or 6 QRS complex venous admixture right describing location right atrial pressure airway resistance right cardiac work right cardiac work index Response Entropy rectal temperature right ventricular ejection
45. sets its display scale color filter alarm source and alarm limits The label descriptions are preconfigured To change the label 1 Press the Invasive Pressures key 2 Select P1 Setup 3 Select Label Invasive Pressures Invasive Pressures Zero Pressures P1 Art Setup P1 rt Setup Label art P2 C P Setup Scale 200 mm Digit Format S D Response Normal Filter Frequency 22 Hz HR Source AUTO Pl Art Cursor E Pl rt Alarm B Ventilation Made Contr Normal Screen Previnus Menu Set label scale digit format Change label Scale color HR source and alarm filter alarm source and limits gt return to default settings The labels are the following P1 P2 Standard labels Art Arterial pressure CVP Central venous pressure PA Pulmonary arterial pressure RAP Right atrial pressure RVP Right ventricular pressure LAP Left atrial pressure ICP First intracranial pressure ABP Arterial blood pressure Both Art and ABP labels are available for situations when two arterial lines are desired but you want to use different settings or alarm labels Invasive blood pressure Table 14 1 Invasive blood pressure labels and descriptions LABEL P1 Art P2 CVP RAP LAP ICP PA RVP ABP Scale mmHg kPa 200 30 20 3 20 3 20 3 60 8 60 8 Color Red Blue White White Yellow White Alarm source Sys Mean Off Off Off Off Digit format S D
46. t T BTPS T196 T1 T2 Tab Tachy Tbl Tblood Tcorr Temp Theta Th Tinj TOF TOF Trigem TV TVexp TVinsp Tx Tymp V Q V0 5 V1 0 VA VC VCO Vd Vd Vt Vent Calcs VFib VO VO Calc VO Calcl VO Vol software stroke volume variation systolic pressure time min temperature tesla temperature in BTPS conditions first stimulus as of the reference value NMT temperature channel identification on module tabular tachycardia blood temperature temperature correction temperature theta frequency band injectate temperature train of four NMT ratio of the 4th to the 1st response NMT trigeminy tidal volume expired tidal volume ml inspired tidal volume ml temperature label x being 1 2 3 or 4 or one of the other label choices tympanic temperature venous ventricular volume ventilation perfusion ratio volume expired during the first 0 5 seconds volume expired during the first second alveolar ventilation vital capacity carbon dioxide production dead space dead space ventilation ventilation calculations ventricular fibrillation oxygen consumption calculated oxygen consumption calculated oxygen consumption index oxygen consumption index volume System description V Run V Tachy WLAN wt A Ur Urs with Fick equation ventricular run ventricular tachycardia wireless local area network weight extreme year years B30 Patient Monitor
47. that all use thereof is and shall remain terminated 7 No waiver The failure of GE to enforce any provision of this Software License shall not be considered a waiver of any subsequent breach of that provision or as a waiver of any other provision hereof 8 Amendments This Software License may be modified only by a written instrument expressly agreed to by the parties hereto Warranty This Product is sold by GE Healthcare GE under the warranty set forth in the following paragraphs Such warranty is extended only with respect to the purchase of this Product directly from GE or GE s Authorized Dealers as new merchandise and is extended to the Buyer thereof other than for the purpose of resale For a period of twelve 12 months from the date of original delivery to Buyer this Product other than expandable parts is warranted against functional defects in materials and workmanship and to conform to the description of the Product contained in this manual and accompanying labels and or inserts provided that the same is properly operated under the conditions of normal use that regular periodic maintenance and service is performed and that the replacements and repairs are made in accordance with the instructions provided using genuine parts and performed by a trained person The foregoing warranty shall not apply if the Product has been repaired by anyone other than GE or otherwise than in accordance with written instructions provided b
48. trap Sample line blocked The sampling line inside or outside the monitor is blocked or the water trap is occluded Change the sampling line and water trap Select inflation limits You are using a hose without an automatic identification When you try to start the measurement the monitor goes automatically to the selection NIBP Setup Inflation Limits Select appropriate inflation limits NOTE Auto option is not available for these hoses Sensor INOP The gas measuring sensor is inoperative or the temperature in the module has increased Contact authorized service personnel Small resp curve Signal amplitude is less than 0 4 ohms SpO2 probe off The finger or ear lobe may be too thin or sensor halves are not aligned Check connection between sensor and patient Replace the sensor SRAM error Faulty SRAM circuit on the CPU board e Contact authorized service personnel Tachy HR is equal to or above the higher e Check the patient status alarm limit Temperature error The self check has found an error in the temperature measurement Contact authorized service personnel Unable to measure Dia Accurate diastolic pressure not achieved because of artifacts weak pulsation etc Check the patient status Check the NIBP cuff placement Perform a new NIBP measurement Unable to measure Sys Systolic pressure probably higher than maximum inflation pressur
49. trend data is lost and the monitor returns to the user default settings startup mode Changing fuses Cleaning WARNING WARNING WARNING CAUTION CAUTION CAUTION 1 Remove the power cord if used 2 Remove the fuse holder by pushing the locking pin and pulling the holder gently out 3 Ifa fuse is blown replace it with a fuse of the correct type and rating NOTE Only a qualified medical personnel allow to operate The appropriate cleaning procedure depends on where and how the part or accessory is used and on the patient s condition Before cleaning disconnect the monitor from the power supply After cleaning ensure that every part of the system is dry before reconnecting it to the power supply If liquid has accidentally entered the system or its parts disconnect the power cord from the power supply and have the equipment serviced by authorized service personnel Do not immerse any part of the device in liquids or allow liquid to enter the interior Do not autoclave the device or its parts Do not use hypochlorite acetone phenol or ammonia based cleaners abrasive material or harsh chemicals as they may damage the surfaces of the device Permitted detergents and disinfectants Mild hospital detergents Ethanol Isopropyl alcohol Chlorite compounds Glutaraldehyde Monitor casing e Wipe with mild hospital detergent solution Make sure not to leave any liquid spills on any
50. used for detection is lead or Il The algorithm uses the lead appearing first in user leads The second lead used for detection is one of the precordial leads V1 V6 The algorithm uses the precordial lead appearing first in the user leads To change the user lead 1 Press the ECG key 2 Selecta lead for ECG1 Lead ECG2 Lead ECG3 Lead The monitor starts relearning the new ECG pattern automatically NOTE With the 3 leadwire trunk cable the algorithm uses the only one available lead ECG1 Lead which is Il or Ill depending on the selected user lead Description of the arrhythmia algorithm The bedside arrhythmia algorithm is based on template matching A template is a group of beats matching the same morphologu The algorithm detects QRS complexes generates QRS templates and performs beat labeling Parallel to this process there is an algorithm for detection of ventricular fibrillation Detection of ventricular fibrillation is based on waveform analysis NOTE A physician must analyze the arrhythmia information in conjunction with other clinical findings Test results of arrhythmia algorithm testing 11 16 The algorithm testing has been performed by using the following databases AHA The American Heart Association Database for Evaluation of Ventricular Arrhythmia Detectors MIT BIH The Massachusetts Institute of Technology Beth Israel Hospital Arrhythmia Database NST The Noise Stress Test Database
51. user mode To make the changes permanent save them in the user mode through Monitor Setup Install Service Save Modes r Alarms message field M ARA e uus ioo d cg A Waveform gnus digits Digit Field 1 Digit Field 2 Digit Field 3 Digit Field 4 V Figure 5 1 Display fields To change the Normal Screen page 1 Press the Monitor Setup key 2 Select Screen Setup 3 Select Waveform Fields Digit Fields split Screen or Minitrend Length Monito 1 Monitor Setu Screen Setup Digit Fields Split Screen None Minitrend Length 30 min Previous Menu Set waveform fields and related digits displayed on Normal Screen Of NOTE Choosing the same parameter in the waveform and digit field makes the previously chosen field disappear Monitor setup Modifying waveform fields di do hd 1 Press the Monitor Setup key 2 Select Screen Setup 3 Select Waveform Field 40 160 ECG H ht min Arrh analys Severe Up to six waveforms can be displayed at a time Monito Screen Setup Waveform Fields Field 1 Field 2 Field 3 Field 4 Field 5 Field 6 Combine Pressures ECGL OFF Resp ECG PL Pi Pz P2 Pleth coz NO Previous Menu Change waveform in field 2 Select OFF to clear field gt O Lo When waveforms are configured to be displayed they appear and disappear automatica
52. when used again Traces of alcohol or other organic cleaning solutions may affect measurement e Do not force air or oxygen through the water trap Donotallow smoke and dust to enter the water trap e While administering nebulized medication disconnect the gas sampling line from the patient circuit for 30 minutes If the message Sample line blocked alarm occurs e Replace the sampling line e Emptythe water trap container It may be full Cleaning and care Figure 9 1 Emptying the water trap container To remove the water trap push the trigger above the water trap The water trap is spring loaded The message Check D fend is displayed e Detach the container from the water trap cartridge by pulling it carefully downward e Empty and clean the container e Attach the container tightly back into the cartridge e Push the whole unit into its housing on the front panel until the latch is set e _ Press the Normal Screen key to restart monitoring Check that the message Check D fend disappears Other accessories See the accessory package for instructions for how to clean and check them Do not reuse single use disposable accessories 9 7 B30 Patient Monitor 9 8 Table of contents Table of contents 10 Troubleshooting 10 1 OVERVIEW EE 10 1 ERC e eeN ean a ed ee 10 1 POWER ts Lee tte ot e ecce muU 10 1 MESSAGES DEL 10 2 OUS SIEHONOHS certiora dos Bo exeo ete CLP obse RE SN 10 8 Ta
53. 0 Patient Monitor Regular checks 9 2 When you start monitoring check that The module is firmly in place Accessories are intact and properly connected You have selected desired parameters to be displayed in the digit and waveform fields ECG and impedance respiration e Checkthat the message Leads off disappears and the waveforms are displayed when the cable is connected to the patient Pulse oximetry e Checkthatthe red light is lit in the sensor e Check that the SpO value is displayed and the message SpO probe off disappears when the sensor is connected to the patient Temperature e Checkthat the temperature value is displayed when the probe is connected to the patient InvBP e Checkthat the monitor recognizes cable connections activates the display for all the pressure channels used and the pressure values are shown e Make sure all transducers are zeroed correctly NIBP Ensure that you are using correct cuff size and have selected correct inflation limits For children and when using hoses without identification the inflation limit must be set manually e Check that the cuff hose detection works properly e Check that the pressure values are displayed e Startthe Venous Stasis mode and check that the pump is not restarting during the measurement If it does the cuff may be leaking Airway gas CO e Check that the water trap is empty e Occlude the sampling line and
54. 1 Lead avR ECG Lead Casc ECGS Lead Casc ECG Size 1 0 Adjust ST Relearn ECG Setup ECG Alarms Normal Screen Change high and low HR and ST alarm limits Change PYC alarm limit and arrh alarm settings To open the adjustment menu 1 Press ECG Select ECG Alarms Arrh Alarms In the adjustment menu turn and push the ComWheel to select the priority for all alarms except asystole and ventricular fibrillation which are always red high priority and ventricular tachycardia which cannot be selected OFF NOTE Alarm priorities can also be set using the Central depending on its configuration ECG Adjust Limits HR Alarm ON PVC Alarm OFF ST Alarms Alarms Setup Previous Menu Configure arrhythmia gt alarm settings Detecting the ECG arrhythmia alarms Alarm Criteria Asystole Cardiac arrest no QRS complexes for five seconds Brady HR below the HR alarm limit Tachy HR over the HR alarm limit V Fib Fibrillatory waveform caused by ventricular fibrillation V Tachy Five or more consecutive PVCs and rate of successive beats over 100 bpm 11 15 B30 Patient Monitor Selecting leads for the arrhythmia analysis When measuring 5 lead ECG you can affect the selection of the two ECG leads used for detecting beats and ventricular fibrillation The selection of user leads ECG1 ECG2 ECG3 on the monitor affects the leads used for detection The first lead
55. 2 System description Side panel Alarm LED indicators see section Alarms lt q For silencing the alarms 14 For activating the Alarms Setup menu Invasive Pressues m 4 tor zeroing the invasive pressure channels NOTE Functional with the E PSMPW module only For starting the NIBP autocycling 4 amp For starting or stopping the NIBP manual cycling 4 For starting or stopping local recording NOTE Functional with N FREC and N FCREC modules only B30 Patient Monitor Batteries Monitor gt WARNING The monitor can be run either on mains power or batteries Battery operation is initiated when the power cord is disconnected or when the mains power is lost during monitoring NOTE Always use the B30 with batteries inserted Otherwise all trend data and temporary settings are lost if the power cable is detached from the mains NOTE Before using the monitor for the first time charge the batteries to their full capacity Charging time is two hours per battery pack The B30 has two lithium ion batteries at most located in the battery compartment They can be charged separately and screen symbols and monitor frame LEDs indicate their charging level and possible failure see below You can also check the battery status through Monitor Setup Battery Setup The internal battery capacity is up to 4 5 hours with fully charged
56. 6 0 2 vol The effect is valid for specific concentrations shown in parentheses of the non disturbing gas Ethanol C H OH lt 0 3 Acetone lt 0 1 Methane CH 0 296 Nitrogen N2 0 to 100 water vapor 0 to 100 Dichlorofluoromethane lt 1 Tetrafluoroethane lt 1 Disturbing gases and their effect on the CO reading at 5 0 vol CO are shown below Errors listed reflect the effect of specific concentrations shown in parentheses of an individual disturbing gas and should be combined when estimating the effect of gas mixtures Halothane 4 increases lt 0 3 vol Isoflurane 596 increases lt 0 4 vol Enflurane 5 increases lt 0 4 vol Desflurane 24 increases lt 1 2 vol Sevoflurane 6 increases lt 0 4 vol Helium 50 decreases lt 0 3 vol If O compensation is not activated O 40 to 95 decreases lt 0 3 vol If O compensation is activated O 40 to 95 error lt 0 15 vol If N20 compensation is not activated N20 40 decreases lt 0 4 vol If NO compensation is activated N O 40 to 80 error lt 0 3 vol 4 The reported SpO pulse rate accuracy is the product specification SpO pulse rate accuracy tests with a simulator yielded a PR error of less than 2 bpm rms over the whole measurement range 1 Limits are adjustable OFF to 51 for SpO high 50 to 10096 for SpO low 250 to 35 bpm for PR high 30 to 245 bpm for PR low 2 34 System description Default alarm limits
57. CO level according to the gas for example with 755580 set the CO level to 20 NOTE If an error occurs during calibration or if no gas is fed the highlight goes automatically over the item Recalibrate and the text Calibr error is displayed after each gas Push the ComWheel to perform a new calibration If adjustments are required Turnthe ComWheel to highlight the first gas to be adjusted and then push the ComWheel Turnthe ComWheel until the displayed value matches the desired value in the gas bottle and push it again Repeat these two steps for each gas Airway Gas Gas Calibration Coz Previous Menu Last calibration The use of an old regulator with the new aerosol cylinders requires an adapter available from GE Healthcare For ordering details see the Supplies and Accessories catalog If the message Zero error is displayed press the Normal Screen key and repeat the calibration procedure If the problem persists contact authorized service personnel The monitor performs autozeroing after start up The autozeroing intervals are 4 min 15 min 30 min and 60 minutes after start up thereafter every 60 minutes NOTE If you are using separate gas cylinders calibrate each gas separately The time of the last calibration is shown at the bottom of the menu page 17 7 B30 Patient Monitor Interfering gases Non disturbing gases are those with a maximum effect on the C
58. Calibration Check OFF Start Yen Stasis NIEP Setup NIBP Alarm Normal Screen Set ready prompt volume and inflation limits Adjust volume of sound O Lo Previous Menu ial il indicating completion of NIBP measurement Ready prompt gives an audible tone when the NIBP measurement is ready Adjust the volume of the beep tone from 1 soft to 10 loud or to 0 OFF When this selection is Auto the monitor automatically identifies the cuff hose and selects the right inflation pressure and alarm limits for adults For children and when using infant hoses without identification set the limit manually to Child or to Infant This selection allows you to override the automatic safety limit feature for the hose cuff being used The selections are Auto Infant Child and Adult The selection AUTO is not available when using hoses without identification NOTE You cannot select adult limits with an infant cuff hose NOTE When using very large adult cuffs use Adult limits to prevent Cuff loose message from displaying Calibration Check Previous Menu 16 4 Enables the calibration check with an external manometer Remove cuff from the module connector before entering the menu When the menu is displayed attach an external manometer with pump to the connector Pump approximately 200 mmHg and compare the readings of the manometer and screen If the difference is more than 4 m
59. E ECG 3 lead 11 3 5 lead 11 3 adjusting size 11 8 cascaded waveforms 11 8 changing waveform sweep speed 5 12 cleaning of cables 9 5 filter 11 6 monitoring the ST segment 11 11 setup 11 6 starting relearning manually 11 9 user leads 11 7 Electrodes ECG 11 3 Emptying the water trap 9 7 E PSM 13 2 16 1 E PSMP 13 2 16 1 Equipment safety symbols 2 15 ESD warning symbol 2 16 Esophageal temperature 13 3 F Filter ECG 11 6 Functioning of the alarms 9 2 G Gas calibrating 17 6 Graphical trends 6 7 H Half annual maintenance 9 3 Heart rate display 11 2 HR Source 11 6 setting limits 11 9 Hose adult 16 3 children 16 3 color 16 3 infant 16 3 HR 11 6 Impedance respiration measurement patient sage 15 4 module 15 2 patient connections 15 4 infant 16 3 Infants Venous Stasis 16 8 Invasive blood pressure 14 1 horizontal cursor 14 6 module keys 14 1 modules 14 1 patient connections 14 2 setup menu 14 5 L Label ECG lead label 11 7 temperature 13 3 Vleadlabel 11 7 LED alarm 4 1 Light alarm 4 4 Loading modes 5 7 M Main symbol 2 15 Maintenance airway gas 9 2 checking the functioning of the alarms 9 2 Index NIBP 9 2 temperature 9 2 water trap 9 6 Menus 3 2 Messages system 10 2 Module impedance respiration 15 2 invasive blood pressure 14 1 keys 2 5 Monitor installation settings 5 1 Monitoring starting 3 5 Myocardial temperature 13 3 N Nasopharyngeal temperature 13 3 N
60. ECG cable from the connector and reinsert it No P1 transducer Transducer or channel x cable disconnected e Connect the transducer or the cable No SpO2 probe There is no SpO probe e Check connection between the SpO sensor and module No SpO pulse No SpO pulse can be detected e Try other measuring sites Poor signal Signal is not sufficient e SpO Change the measuring site Printer error Printer is not working properly e Check that the network printer is operational Printing Printing network printer has started e Please wait until the printing is finished Printing ready Monitor has completed sending printing data to the printer e Please wait until the printing is finished PVC rate limit changed Limit has changed on the Arrhythmia Workstation e Check the limit 10 4 Troubleshooting Message Explanation What to do RAM error Faulty RAM circuit on the CPU board Contact authorized service personnel Recorder module removed There is no recorder module Reconnect the N FREC or N FCREC module if you need a recorder Replace Battery A Replace Battery B There is hardly any charge left in one of the batteries Also check the symbol on screen Replace the battery as soon as possible Replace D fend Water trap is partially blocked This decreases air flow Replace the water
61. GE Healthcare B30 Patient Monitor User s Reference Manual B30 Patient Monitor English 2039820 001 C Paper 2044678 001 C CD 2009 General Electric Company All Rights Reserved B30 patient Monitor User s Reference Manual Related to software license L DICUO8 Monitoring functions 0459 Conformity according to the Council Directive 93 42 EEC concerning Medical Devices All specifications are subject to change without notice Document no 2039820 001 15th July 2009 GE Medical Systems Information Technologies Inc GE Healthcare 8200 West Tower Avenue 3F Building 1 GE Technology Park Milwaukee WI USA 1 Huatuo Road Zip 53223 Shanghai PRC 201203 Tel 1 414 355 5000 outside US Tel 86 21 3877 7888 800 558 5102 US only Fax 86 21 3877 7451 Fax 1 414 355 3790 www gehealthcare com Copyright 2009 General Electric Company All rights reserved Intended purpose Indications for use The B30 patient monitor is intended for multiparameter patient monitoring The B30 monitor is indicated for continuous monitoring of hemodynamic parameters including arrhythmia and ST segment analysis and respiratory status and creation of limit alarms The B30 monitor is intended for all hospital patients and all hospital departments including intra hospital transport but excluding harsh physical environment like MRI The Patient side module E PSM P W and accessories are indicated for monitoring of hemodynamic paramet
62. J and ISO points The distance between the ST and J point is set according to the heart rate Ifthe heart rate is less than 120 bpm the ST point is set at J 80 ms Ifthe heart rate is more than 120 bpm the ST point is set at J 60 ms Setting the J ST and ISO points manually You can also set the J ST and ISO points manually If any of these points is manually set the other two are set at their current values Select Adjust ST and Set ISO point Set J point or ST point e Setting the J point manually The J point is the point on the ECG trace where the S wave transitions to the ST segment Adjust the J point by turning the ComWheel and confirm by pushing the ComWheel If the J point setting is changed the original point is shown as a dashed line When you adjust the J point also the ST point is set according to the selected ST point setting J 20 J 40 J 60 or J 80 The manually set J point remains until the monitor is turned off or reset After a turn off or reset the J point is set automatically e Setting the ST point manually ST segment is the component of the ECG trace between the end of the QRS complex and the T wave Manual ST point adjustment sets the distance between ST and J points in ms Selection values are J 20 J 40 J 60 J 80 The manually set ST point remains until the monitor is turned off or reset After a turn off or reset the ST point is set automatically according to the heart rate e Setting t
63. Lab Data Menu access is described from top to bottom For example the selection of the Monitor Setup hard key the Screen Setup menu item and the Waveform Fields menu item would be shown as Monitor Setup Screen Setup Waveform Fields File names file paths and text to be entered are written in the following way comm exe Messages alarm messages informative messages displayed on the screen are written inside single quotes Please wait When referring to different sections in this manual or to other manuals manual names and section names are enclosed in double quotes See section Cleaning and care Please refer to Technical Reference Manual Installation This is a WARNING This is a CAUTION This is a NOTE The following symbols are also used to distinguish procedures C Press the menu key described Turn the ComWheel Push the ComWheel Related documentation Software options and default settings are described in the Default Configuration Worksheet delivered with each monitor Available accessories are described in the Supplies and Accessories catalog delivered with each monitor For more information about the Central see the Central User s Reference Manual About this manual Installation and service A separate Technical Reference Manual describes installation interfacing connectors service maintenance and reparation procedures of the monitor Medic
64. Mean Mean CPP S D S D Filter Hz 22 9 9 9 9 9 Response normal normal normal normal normal normal Cerebral perfusion pressure Cerebral Perfusion pressure CPP is calculated by subtracting ICP mean pressure from Art mean pressure CPP mean is displayed next to the ICP value NOTE Set the Label of the channel to ICP and the Digit Format to CPP ICP mmHg 50 6045 CPP 43 Adjusting alarm sources and limits You can adjust or turn off pressure alarm limits in the Alarms Setup Adjust Limits menu Enter the menu by pressing the Alarms Setup key For each pressure channel you can choose as a source Sys Sustolic Dia Diastolic Mean or Off Note that you can choose one or both sources to be active at a time Alarms gt Alarms Setup Adjust Limits Auto Limits Default Limits Cancel Changes Arh Alarms Alarm Volume 5 ALARM LIMITS AND 10 MIN TRENDS Pi Adjust Limits Sys Alarm ON Dia Alarm OFF Mean Alarm OFI a Alarms Setup E Previous Menu Alarm Light 10099 40 Audio ON OFF Resp 38 0 Rate Remove Menu Normal Screen hi Push ComWheel 40 to adjust alarm Temp limits manually jn Push ComWheel to turn alarm ONOFF High ADJUST ALARM LIMITS P1 Sys 2 For more information about alarms and adjusting see section Alarms
65. Minimizing the effects of the line isolation monitor transients Crystal controlled oscillator used as the operating frequency source of the patient isolation power supply The average time and time range to alarm VFib or VTachy for tachycardia waveform are as follows IEC60601 2 27 6 8 2 bb 6 Figure 101 B1 halved amplitude Figure 101 B1 normal amplitude Figure 101 B1 doubled amplitude Figure 101 B2 halved amplitude Figure 101 B2 normal amplitude Figure 101 B2 doubled amplitude 9 9 s 8 4 to 11 5 s 7 1 s 5 8 to 8 2 s 4 4 s 4 2 to 4 6 s 7 0 s 6 1 to 7 5 s 5 8 s 4 5 to 7 4 s 6 1 s 5 1 to 7 0 s A clinician should always confirm the rhythm from the ECG waveform Direct cardiac application The display area reserved for the ECG measurement in the screen may not be adequate for displaying the complete ECG amplitude when measuring ECG direct from the surface of the heart Clipping of the signal can be reduced by adjusting the size of the signal on the screen for example from the default 1 0 to 0 2 in the ECG menu Impedance respiration Respiration range Accuracy 4 to 120 resp min 596 or 5 resp min whichever is greater The conducted RF immunity of the respiration measurement has been tested with 1 Vrms The radiated RF immunity of the respiration measurement has been tested with 1 V m The impedance respiration measurement technology has been optimized so that the measurement is not sensitive to el
66. O reading lt 0 2 vol The effect is valid for specific concentrations shown in parentheses of the non disturbing gas Ethanol C H 0H lt 0 3 Acetone lt 0 1 Methane CH 0 296 Nitrogen N3 water vapor Dichlorofluoromethane 196 Tetrafluoroethane 196 Disturbing gases and their effect on the CO reading at 5 0 vol 96 CO are shown below Errors listed reflect the effect of specific concentrations shown in parentheses of an individual disturbing gas and should be combined when estimating the effect of gas mixtures Halothane 496 increases lt 0 3 vol Isoflurane 596 increases 0 4 vol Enflurane 596 increases 0 4 vol96 Desflurane 2496 increases 1 2 vol Sevoflurane 696 increases lt 0 4 vol Helium 5096 decreases 0 3 vol96 If O compensation is not activated O 40 to 9596 decreases 0 3 vol If O compensation is activated O 40 to 95 error 0 15 vol If N20 compensation is not activated N O 40 increases lt 0 4 vol N O 40 to 80 increases 0 8 vol96 If N2O compensation is activated NO 40 to 80 error lt 0 3 vol Unit conversions Relationship between gas concentration and its partial pressure Reading in mmHg dry gas ambient pressure in mmHg x gas concentration in96 100 Reading in mmHg water vapor saturated gas ambient pressure in mmHg 47 mmHg x gas concentration in96 100 Reading in kPa dry gas ambient pressure i
67. OTE Asystole and ventricular fibrillation alarms are always high priority alarms The priority of an alarm depends primarily on the cause and the duration generally minimum 20 seconds of the alarm condition the priority increasing with the duration and according to the phusiological significance Thus for example brady advances rapidly to high priority whereas apnea is allowed a slightly longer duration The monitor has three options for alarm tones and patterns ISO ISO2 and General The ISO2 and ISO patterns are very similar The difference is the rising sound of the tone pattern The following frame colors and tones identify the alarm categories Table 4 1 ISO pattern Visual Tone pattern Meaning Side panel Alarm light LEDs if enable Red Rising triple double For life threatening red LED flashing red beep every 5seconds situations High flashing except the second tone priority alarm pattern which is produced 1 second after the first one ERG eG es Yellow Triple beep every 19 For serious but not yellow LED flashing seconds life threatening flashing yellow aiga problems Medium priority alarm White Single beep Advisory note It yellow LED lit lit y may be equipment yellow related like Leads off Low priority alarm Table 4 2 ISO2 pattern Visual Tone pattern Meaning Red Rising triple double beep every 5 For life threatening situations High priority
68. RE DIO OT EE Sen FU e Te p REOR ONCE 4 11 Automatic recording AS eene Ie Len raa ce aus et 4 11 Showing ANAIS ceat soni trie deers ued date sho Reo nS EAD LUE ier bei 4 12 Otheradjustable feet Ores osos cuneo y ta enden epe 4 13 PSUS NIMS Do oos qure A URP OF n Ne EVI 4 13 Enabling or disabling alarm silencing ecu pi eat uU RN 4 14 Disabling te dln GE l i eed denti endless eatin 4 14 LSI AGA EIEN Sharer scents ase umes e eco Ned Eee ccs obitu m da ed dd 4 15 FRETTING VOUS coctus tt ridic to ene CoD et od qb educ be Ra oA 4 16 Changing the tone pattern deno Cow rbv eh e or EE UU PC SOS TP OPERE ARAS US 4 16 Table of contents Alarms 4 Alarms Overview When an alarm for the monitored parameter becomes active c Brady E 40 160 CG t e de de LE PI Ad en e 29 min 9 1 Alarm messages appear in the message field in the order of priority 2 The measurement value flashes The color red yellow indicates the alarm category high priority medium priority If the alarm is a low priority white note the measurement value is not flashing 3 In some cases a message in the digit or waveform field gives more detailed information using the color of the parameter An audible alarm is also triggered and the alarm LEDs on the monitor side panel indicate the alarm level If enabled also the alarm light flashes red high prioritu or yellow medium prioritu according to alarm levels Refer to Default C
69. SpO data is removed from the display Every six months Gas calibration Perform gas calibration for airway gas monitoring according to the instructions in the relevant section If gas measurement is in extensive use calibration is recommended every two months NOTE Do not wash or disinfect calibration gas sampling lines Conditioning the batteries Condition batteries regularly to maintain after their useful life This is best done on an external charger Condition a battery every six months or when the message Replace Battery x appears status You can also check the status through Monitor Setup Battery Setup If you do not have an external charger proceed according to the following instructions NOTE You cannot condition batteries during patient monitoring Always disconnect the modules first 1 Continue normal battery use until the green bar of a battery charge indicator is less than 3 4 of the full height After this remove the battery Continue monitoring with one battery until its charge is less than 3 4 of the full capacity 2 Insert both batteries and connect the monitor to the power supply The monitor starts charging both batteries and the capacity indicators scroll accordingly Keep charging the batteries until both capacity indicators are full height 3 Continue charging for another two hours After this check that the orange battery LED in the front panel is no longer on If it is continue charging until it goes
70. Time e Select the alternative with the ComWheel NIBP gt Start Cycling Cycle Time 5 min 2 5min Start STAT Start Manual Start Ven Stasis NIBP Setup NIBP Alarm Normal Screen 1 min 16 6 Non invasive blood pressure Starting a manual measurement To start the measurement do one of the following e Press the Start Cancel module or side panel key or press the NIBP key on the Command Board and select Start Manual Sys Mean ar 2 min ago Canceling a measurement To cancel any NIBP measurement do one of the following Press the Start Cancel module or side panel key or press the NIBP key on the Command Board and select Cancel Starting and stopping a continuous measurement STAT The STAT mode initiates continuous measurement for five minutes A new NIBP measurement starts immediately after the previous one In STAT mode the early systolic value is measured and displayed until the final result is available After five minutes the monitor automatically returns to the previously selected cycling interval or to manual mode To start the measurement do one of the following e Press the NIBP key on the Command Board and select Start STAT Sys Cuff 79 To discontinue the measurement e press the NIBP key on the Command and select Stop STAT 16 7 B30 Patient Monitor Using venous stasis Venous Stasis initiates and holds the pressure in the cuff to help venous can
71. aded into monitor The selected mode is marked with a circle You can return to the previous mode by selecting Return to X Give patient s last name first name and ID During monitoring you can make additional changes to the mode settings and to make the changes permanent save them through the Save Modes menu Monitor setup Changing the startup mode 1 Select Monitor Setup Install Service Save Modes Enter the password 2 Select Startup Mode 1 2 3 4 5 or 6 Renaming a mode 1 Select Monitor Setup Install Service Save Modes Enter the password 2 Select the mode select Name and give a new name Loading modes 1 Select Monitor Setup Install Service Save Modes Enter the password 2 Select Load Modes and one of the following e From Network Loads all modes from network and saves them in monitor s permanent memory To Network Copies all modes from monitor s permanent memory to network This selection is available only if saving modes to network is enabled in Central 5 7 B30 Patient Monitor Changing the Normal Screen layout 5 8 At startup the screen is arranged according to the startup mode definitions Parameters that are not used are not displayed and no space is reserved for them You can decide which waveforms and numerical information are displayed and where on the screen they are arranged You can do this for the duration of monitoring or save the changes in the
72. adwire type is selected in the ECG Setup menu e Pacemaker selection in the ECG Setup menu is Show when a pacemaker is used e ECG is selected for screen through Monitor Setup Screen Setup 11 18 Table of contents Table of contents 12 Pulse oximetry 12 1 O A GE RR RAD be ERR Reel BAe ees 12 1 Mee Ue des CRO TIO Fic ae e Er EA ER Pde doe Mes IN E 12 1 Displatio pulse ORIEN A A ben tud 12 2 PORE AL coc DIOS asas eu acido 12 3 Selecting TNO SEASON nia a ee satt atte eRe ke os oh al i BIE Maa a 12 3 Connecting the DOltlent as i esos transita 12 4 Piles AEN Are Gete 12 5 D ring MONITORING tst tite ete elende da ech 12 6 REMOVING the SENS OP ze eee e d Ae en db ll a edo et oe 12 6 Measurement EO OS io 12 7 3 oe Meee A EN NN 12 7 Table of contents Pulse oximetry 12 Pulse oximetry Overview Oxygen saturation SpO is the percentage of saturated hemoglobin compared to total hemoglobin measured by a two wavelength pulse oximeter also called functional or In Vivo oxygen saturation The SpO value is measured by light absorption technique Red and infrared light is emitted from the emitter side of the sensor The light is partly absorbed when it passes through the monitored tissue The amount of transmitted light is detected in the detector side of the sensor When the pulsative part of the light signal is examined the amount of light absorbed by arterial hemoglobin is discovered and the saturation level can be calcul
73. al electrical equipment needs special precautions regarding EMC and needs to be installed and put into service according to the EMC information provided in the Technical Reference Manual by qualified personnel Service and repairs are allowed for authorized service personnel only B30 Patient Monitor Table of contents Table of contents 1 Safety precautions 1 1 Warning Ss ant edere en ren vant Pad bot bates 1 1 COM A ates A O T TELS D ULT PERRA ela ELA Gal ERRORI ET 1 2 ESD precauti ndry PrOESAUES 2o Belie Peet ete ed 1 3 ESD precautionary procedure training nne aen Ed DEO oa Shee Fe 1 3 POINTS tot IA En de dt ER ee e ot eene 1 3 po A A A nti amen 1 3 Table of contents Safety precautions 1 Safety precautions The following list contains all the general warnings and cautions you should know before starting to use the system Warnings and cautions specific to parts ofthe system can be found in the relevant section Warnings WARNING A WARNING indicates a situation in which the user or the patient may be in danger of injury or death To avoid explosion hazard do not use the monitor in presence of flammable anesthetics Connect only one patient to the monitor at a time Do not use the monitor without manufacturer approved mounting attached Use only hospital grade grounded power outlets and power cord To avoid the risk of electric shock this equipment must only be connected to a supply mains with pr
74. al including earth Cautions CAUTION A CAUTION indicates a situation in which the unit or the devices connected to it may be damaged e Before connecting the power cord to a power supply check that the local voltage and frequency correspond with the rating stated on the device plate e Leave space for air circulation to prevent the monitor from overheating e Donotstoreor use the monitor outside the temperature and humidity ranges specified in Performance in section System description of this manual Refresh the batteries completely every six months ESD precautionary procedures e To avoid electrostatic charges to build up it is recommended to store maintain and use the equipment at a relative humidity of 3096 or greater Floors should be covered by ESD dissipative carpets or similar Non sunthetic clothing should be used when working with the component e Toprevent applying a possible electrostatic discharge to the ESD sensitive parts of the equipment one should touch the metallic frame of the component or a large metal object located close to the equipment When working with the equipment and specifically when the ESD sensitive parts of the equipment may be touched a grounded wrist strap intended for use with ESD sensitive equipment should be worn Refer documentation provided with the wrist straps for details of proper use ESD precautionary procedure training e tisrecommended that all potential users receive an ex
75. ale height m ud Turn the ComWheel to choose the desired option or selection in the window Push the ComWheel to confirm the selection Press the Normal Screen key to return to normal monitoring display Submenus are indicated by a symbol They function just like the main menus and contain less frequently used functions Monitoring basic Starting and ending WARNING Always make sure that necessary alarm limits are active and set according to the patient s clinical condition when you start monitoring a patient WARNING After transferring or reinstalling the monitor always check that it is properly connected and all parts are securely attached Pay special attention to this in case of stacked mounting WARNING Do not use the monitor without manufacturer approved mounting attached WARNING If you accidentally drop the monitor or modules have them checked by authorized service personnel prior to clinical use Preparations 1 Check that the monitor accessories and monitor parts are clean and intact Plug in the desired measurement modules 3 Turnon the monitor from the ON standby key The monitor performs a self test to ensure correct functioning 4 If necessary change the user mode Press the Admit Discharge key and select Select Mode The mode defines what is displayed on screen and in the trends Note that changing the mode also changes settings such as alarm limits The monitor aut
76. ally Check skin integrity circulatory status and correct alignment and change sensor site at least every four hours For patients with poor peripheral blood circulation or sensitive skin change the site at intervals of 30 minutes to one hour To confirm the circulatory status observe the size of the plethysmographic waveform with a fixed pleth scale Take special care of this when monitoring small children If possible do not attach the SpO2 sensor on a limb that is used for NMT measurement or for administrating cold infusions NIBP measurement and arterial blood pressure measurement To avoid erroneous readings do not use a blood pressure cuff or arterial blood pressure measurement device on the same limb as the sensor Plethysmographic pulse wave To get an optimal pulse wave use smaller scale indicators when using measuring sites with poor perfusion A small pulse wave may be a sign of impaired circulation that may require increased attention Higher scale indicators together with a well defined pulse wave indicate strong circulation and a relaxed patient Removing the sensor 12 6 e Openthe sensor Do not pull the sensor from its cable Pulse oximetry Measurement limitations Checklist The B30 monitors are designed to minimize the interference of electrosurgery Under some circumstances electrosurgery may cause noise on the screen Therefore be careful in interpreting the results especially the plethysmographic puls
77. and sometimes this may interfere with the respiration measurement Electrical interference Electrical devices such as electrosurgery units and infrared heaters that emit electromagnetic disturbance may cause artifacts or disable the respiration measurement completely Intermittent mechanical ventilation During spontaneous breathing the ventilator may at times support the patient s ventilation with an extra inspiration If these ventilator inspirations are substantially larger than the spontaneous breaths the respiration calculation may mistakenly count only the inspirations and expirations produced by the ventilator You can correct this by adjusting the detection limits manually 1 Press the Others key 2 Select Resp Setup 3 Select Detection limit and adjust the limits Turning off the measurement If the impedance respiration measurement signal interferes with other measurements such as ECG you can turn it off 1 Press the Others key 2 Select Resp Setup 3 Select Measurement OFF gt Resp Setup Size 4 3 Resp Rate Source COZ Measurement Detection Limit Resp Rate Alarm Previous Menu Select ON to enable impedance respiration gt measurement Impedance respiration Checklist Check that Electrode gel is moist Electrodes have good skin contact Electrodes are positioned correctly Correct leadwire set is selected The trunk cable is connected properly Leadwire set is proper
78. ansducer to air 4 During the zeroing process the message Zeroing is displayed After the transducer is zeroed the message Zeroed is displayed in the digit field After each channel is zeroed the time of zeroing is displayed in the menu NOTE Check zero level after power interruptions NOTE Invasive pressures need to be zeroed after reconnecting the pressure transducer or cable and whenever the patient s position is changed If all channels have not been zeroed the message InvBP not zeroed appears However the alarms advance to yellow and red levels regardless of zeroing Invasive blood pressure Invasive Pressures menu Invasive Pressures gt Invasive Pressures P2 Setup Label P2 Scale 50 mm SD Digit Format 5 0 Hean Invasive Pressures Zero Pressures Pl art Setup P2 Setup Ventilation Mode Contrl Response Normal S D M Filter Frequency 9 Hz HR Source AUTO P2 Cursor P2 Alarm Normal Screen E Previous Menu Set label scale digit format HR source and alarm Change formato digit field SD Mean arS D M Forlabel ICP alsa CPP is available Of Zero Pressures Opens a menu to zero both pressures or one of them Ventilation Mode Respiration causes artifacts in invasive pressures At the end of expiration the artifact is at its smallest Select Spont for spontaneous respiration and Contr for co
79. apnea monitor system intended to alarm primarily upon the cessation of breathing In central apnea it indicates an alarm after a pre determined time since the last breath detection Do not attempt to use it for detecting obstructive or mixed apneas since respiration movements and impedance variations may continue in these cases The impedance respiration measurement may cause rate changes in Minute Ventilation Rate Responsive Pacemakers Set the pacemaker rate responsive mode off or turn off the impedance respiration measurement on the monitor The impedance respiration measurement is inherently very sensitive as it measures very small physiologic signals changes of impedance of the patient s chest area Conducted RF current above 1 Vrms may cause erroneous measurements at various frequencies for example interference with the signal waveform leading to respiration rate readings inconsistent with the patient s true respiration rate If you notice this use another form of respiration monitoring For further information see the Technical Reference Manual B30 Patient Monitor Module description E PSMW E PSMPW ECG and impedance respiration connector Figure 15 1 Modules E PSMW and E PSMPW for impedance respiration measurement Respiration detection Respiration The respiration rate is the sum of the respirations that have exceeded the detection limit The dotted lines present the zero li
80. arts in start up modes which is one of the user modes chosen during configuration The default modes are STEP DOWN ED PACU CCU NEURO and PEDIATRIC Please refer to the Default Configuration Worksheet delivered with the monitor for more information For more information about the installation settings and using modes see section Monitor setup Setup monitor before use For more information about the how to setup monitor see section Monitor setup 3 6 Table of contents Table of contents 4 Alarms 4 1 OI Ti weak AA A ITE 4 1 PO A A EES STR EAS A EI RINT Creer Re 4 2 ARCAS o a o Pa A e etes fedt 4 2 AMC o Pedy Sedi acest LL ede ia eatin d Sa tede 4 3 A O 4 4 A spencer ated spec c tq pest EE Feat ax estate s as 4 4 AIG T UCU ciTe o Me RR 4 4 ANS SAUNA oes oot pen dea eost anstelle DONOR RA p iue cepe dea 4 5 Adj sting Arra lAs ete ad ERE ne ERE POPE NODE 4 7 Adiusting Ife sere tnt hone cip eS SO ES plo 4 7 EOSIN CLEC ICC MINIS s tovs stes a a m aL Neg ND nO AE 4 7 Ret rningtodetduib lifts ivo la derde Deed iS 4 7 qa porel AA dp tot Dr MIR ct A It p IE cus 4 8 MEA eee ota eere RR CEA Cer ee het TAa Orb aeta n RR ERR 4 9 Silencing audible alarms temporarily tene kt x teren ae RE REF FREU Sa Eus 4 9 Redctivating DEBITIS et on dau o mir ordini T ome os 4 9 Silencing audible alarms permanently eaa ri DARE ao scene asa haa OS 4 9 Reactivating ONS A A o Pado ee eta Rd Lad 4 10 Deirctivatid AICS as coats de emper e e eh
81. asurement the transducer converts pressure variations into electrical signals The electrical signals are amplified and displayed as numeric pressure values and waveforms WARNING All invasive procedures involve risks to the patient Use aseptic technique Follow catheter manufacturer s instructions Module description E PSMPW Invasive pres sures connector Module keys E PSMPW module has direct function keus to zero both pressure transducers separately e Press the Zero P1 or Zero P2 module key The message Zeroing is displayed After the transducer is zeroed the message Zeroed is displayed Side panel key The monitor has one side panel key for invasive pressures the Zero ALL key You can use this to zero all pressure transducers NOTE Selecting Zero ALL does not zero ICP Zero it separately 14 1 B30 Patient Monitor Display of invasive blood pressure Not zeroed 121 81 Not zeroed 12 15 10 Figure 14 1 InvBP display 1 Invasive blood pressure waveforms with zero and reference lines 2 Selected pressure label 3 Selected pressure scale 4 Field for messages and alarm limit settings 5 Systolic diastolic and mean pressure values of invasive blood pressures You can have a combined display of all those waveforms that are selected on the screen This combined display uses the whole waveform field area and the same zero line for all waveforms To se
82. ata Trends Trends Trend Scales Changing trend length and resolution 1 Press the Pt Data amp Trends key 2 Select Trends Time Scale 3 Select the trend length Table 6 1 Trend length and resolution Trend length on the Resolution Trended time period screen 20 minutes 10 seconds last 30 minutes 1 hour 1 minute last 24 hours 2 hours 1 minute last 24 hours 4 hours 2 minutes last 24 hours 6 hours 3 minutes last 24 hours 8 hours 4 minutes last 24 hours 10 hours 5 minutes last 24 hours 12 hours 6 minutes last 24 hours 24 hours 12 minutes last 24 hours 36 hours 18 minutes last 36 hours 48 hours 24 minutes last 48 hours 72 hours 36 minutes last 72 hours 6 7 B30 Patient Monitor Moving on graphical trend pages To see more parameters on other pages e Select Scroll Pages in the Trends menu Numeric measurement values for trended parameters are displayed next to the cursor The cursor indicates the time when these values have been measured To change the cursor location 1 Inthe Trends menu select Cursor 2 to move the cursor 3 to return to the menu To scroll the time move the cursor past the right or left border of the trend Recording and printing Recording 1 Press the Print Record key 2 Select Record Trends 3 Select Record Graphical The recording time of a trend corresponds to the time scale of the graphical trends You can choos
83. ated The plethysmographic pulse wave is derived from variations of the intensity of the transmitted light and reflects the blood pulsation at the measuring site Thus the amplitude of the waveform reflects the perfusion Module description NOTE In the monitoring system use only one module measuring pulse oximetry E PSMW E PSMPW Pulse oximetry connector B30 Patient Monitor Display of pulse oximetry Figure 12 1 Display of SpO value and pleth waveform 1 Scale of plethysmogram 2 Label 3 Oxygen saturation SpO value 4 Pulse oximetry message field Pulse oximetry Patient connections Selecting the sensor GE Healthcare OxyTip Finger Sensors are recommended for short term patient monitoring with patients weighing more than 20 kg The EarSat sensors are recommended for patients weighing more than 10 kg and patients with compromised peripheral circulation For long term monitoring and during high motion conditions use GE Healthcare OxyTip Adhesive Sensors For pediatric patients weighing more than 3 kg use GE Healthcare OxyTip Adhesive Sensors or Wrap Sensors NOTE For each SpO accessory refer to the instructions for use in the accessory package for patient weight limits OXY E UN n OXY SE 3 2 o o 2 2 OXY F UN o oc OXY W UN E 2 2 X o p 8 OXY AP OXY AF S o o 2 o 7 lt
84. atmospheric ambient temperature and pressure dry gas ambient temperature and pressure saturated gas atrioventricular left foot augmented lead average left arm augmented lead right arm augmented lead airway axillatory temperature brainstem auditory evoked potential balance gas 1 atmosphere beta frequency band bigeminy bispectral index bladder temperature blood temperature C O measurement B30 Patient Monitor Body BP Brady BSA BSR B to B BTPS C C Cla v O C C O CFI Gl CO cal Calc Calcs CAM CaO Casc cc CCCM CCM CcO CCU CEL CFI CISPR cmH O CMRR CO CO COHb Compl Cont Contrl Core Count CPB CPP CSA CT CvO body temperature blood pressure bradycardia body surface area burst suppression ratio beat to beat body temperature and pressure saturated gas calculated derived value chest arteriovenous oxygen content difference continuous cardiac output cardiac function index cardiac index cardiac output calibration calculated derived value calculations Compact Anesthesia Monitor arterial oxygen content cascaded ECG cubic centimeter Compact Critical Care Monitor Critical Care Monitor capillary oxygen content cardiac coronary care unit Celsius degree cardiac function index International Special Committee on Radio Interference centimeter of water common mode rejection ratio carbon monoxide carbon dioxide carboxyhemoglobin compliance continu
85. ature unit to be either degrees Centigrade or degrees Fahrenheit 1 Press the Others key 2 Temp Setup Unit 3 Select the unit C or F with the ComWheel Checklist Check that e Temperature adapter cable is properly inserted into the connector in the module and the probe is inserted into the adapter cable e Temperature probe is positioned correctly e Temperature is selected for screen through Monitor Setup Screen Setup Table of contents Table of contents 14 Invasive blood pressure 14 1 8 1 Soria O ERE AAA A A AA 14 1 MO a DEN EL tu ak RA e 14 1 rs KEUS nnee date tt cae Ue ont Sole enne bed 14 1 Side Dariel kel Zet eren ote ecu LEE E DEE 14 1 Display of invasive blood pressure xvi ectetuer t Coo et EUG REA DIS 14 2 Patient COMEN Sii ade Re LA ane reas Eo CX 14 2 Starting Wicca stenen tee DE AR eee da 14 4 VASE Presses Me dis 14 5 PS etu Men a Merna e o o a lee eer D e 14 5 EGibelitic CAGMMEIS lt li do 14 6 Cerebral perfusion prat Ae Te A ea ote tat ee 14 7 Adjusting alarm sources and limits ri SN aanbaden ie 14 7 SiartipeBPrahd ad EES allo je EN EER 14 8 Checklista o ne Edda c ER ad a a eee 14 8 Table of contents Invasive blood pressure 14 Invasive blood pressure Overview You can measure and monitor two invasive blood pressures at the same time using a dual invasive blood pressure cable To measure invasive blood pressure you need the E PSMPW module During the invasive blood pressure me
86. ave Modes menu The default password for entering the Save Modes menu is 13 20 31 5 1 B30 Patient Monitor Setting time and date The time is shown in the upper right corner of the screen Turning off the monitor does not affect the clock 1 Press Monitor Setup and select Time and date gt Monitor Setup Setu p Time and Date Minutes 4 zero Seconds 16 Day 3 Month Apr Year Previous Menu os 2 Turn and push the ComWheel to set the time and date Hours minutes and seconds Day month and year NOTE If the monitor is connected to the Central the monitor follows the Central s time settings and the Time and date menu is not available Battery setup Through this menu you can check the battery status 1 Press the Monitor Setup key 2 Select Battery Setup Battery information is now available 5 2 Monitor setup Changing monitor installation settings gt Install Service Installation Alarm Options Printer Monitor Settings Previous Menu Set unit of height weight and blood pressure Changing units You can change units for height weight and blood pressure You can change temperature units through Others TempSetup and CO units through Airway Gas CO2 Setup The changes are permanent To change the units 1 Press the Monitor Setup key 2 Select Install Service and enter the password 3 Select Installation Units Installation S
87. be Table 10 10 Other problems related to SpO measurement Symptom Possible cause and solution SpO signal is e Check the sensor and sensor positioning poor A ex Change the averaging time from slow to normal Note that skin pigment causes differences e Make sure that the patient is not shivering Other situations 10 8 The following table lists some other situations that may occur during monitoring and possible explanations Table 10 11 Other operation problems Symptom Possible cause and solution Printing is not possible Printer selection is None change it through Print Record Printer connection Printer is not connected to the network Check printer cable The measured values are not displayed e Check that you have selected the desired parameter to a waveform or digit field The monitor does not start e Check that the power cord is properly connected e Check that all cables are properly connected e Check the fuses and replace them if necessary You cannot perform a measurement or a function Checkthat the measurement module is properly installed e Check that all cables are properly connected e Remove the module and reinstall it Table of contents Table of contents 11 ECG 11 1 OVErVIEW yns IE EE ETE 11 1 Module des CHIDEDEIS 455 ausos cal etta Rr rM ae EL IDEM VM AREA Pe LC M M eae 11 1 DiSplagirq ECG and hedrt Fol e
88. ble of contents Troubleshooting 10 Troubleshooting Overview The troubleshooting section consists of two parts which together should help you resolve the most common monitoring problems The parts are Checklist and Messages Checklist Check the following things before monitoring to ensure that you have remembered to make all essential preparations and if any problems occur during monitoring Parameter specific checklists can be found in the respective parameter sections Check that The monitor and its modules do not have any visual defects such as cracks or loose parts The batteries are inserted and charged The power cord is connected to an electrical wall outlet and to the monitor The modules are pushed properly into the frame and the monitor recognizes the module parameter is displayed on the screen and menu selections are active Patient connection cables are attached to the module connectors Trends of the previous patient are erased Alarm limits are suitable for the patient The desired measurements have been selected for screen through Monitor Setup Screen Setup Waveform Fields or Digit Fields Disposable accessories are not reused Sensors are not expired Power interruption NOTE Always use the B30 with batteries inserted Otherwise all trend data and temporary settings are lost if the power cable is detached from the power supply If the monitor is turned off trend data and the la
89. by law 5 Copy Restrictions The software firmware and the accompanying written materials are copyrighted Unauthorized copying of the software including software that has been modified merged or included with other software or other written materials is expressly forbidden You may be held legally responsible for any copyright infringement that is caused or incurred by your failure to abide by the terms of this license 6 Use Restriction As the Licensee you may physically transfer the products from one location to another provided that the software firmware is not copied You may not electronically transfer the software firmware from the products to any other device You may not disclose publish translate release or distribute copies of the software firmware to others You may not modify adapt translate reverse engineer decompile disassemble or create derivative works based on the software firmware unless and to the extent specifically permitted by local law Your license to the software is not valid for use with any unauthorized data acquisition device When information of the internal structure of the Software is necessary in order to obtain interoperability of the Software with other software programs Licensee shall immediately contact GE The Software contains proprietary and confidential information of GE and its suppliers and is considered by GE and its suppliers to constitute valuable trade secrets Licensee will hold
90. c Trend 1 and select the parameter and then do the same for Graphic Trend 2 These settings define the graphical trends recorded in upper field and lower field You can record graphical trends of two parameters Press Print Record Select Print Graphical Hours Page and select to print 1 2 default 4 6 8 10 12 24 36 48 or 72 hours on one page Select Trend Length and select 1 2 4 6 8 default 10 12 24 36 48 or 72 hours B30 Patient Monitor Configuring trends Configuring trend pages You can change the parameters on the trend fields 2 4 5 Press the Monitor Setup key Select Install Service and enter the password Select Trends and select Graphical Trends Select the trend page that you want to change Select graphical parameters for each field The field numbers start from the top of the screen Select one parameter for each field on the trend page or turn the field OFF When all the fields are OFF the page is displayed with empty fields The time scale and page number appear at the bottom of the page If several similar fields are selected on top of each other they form one higher field Equal fields cannot be defined separate to each other NOTE You cannot make changes in numerical trend page configuration Setting trend length 1 2 Press Pt Data amp Trends Select Trends Graphical Time Scale and select 20min 1h 2h default 4h 6h 8h 10h 12h 24h 36h 48h or 72
91. cal or graphical trends to the screen Select Graphical or Numerical Changing trend scales Select Trend Scales Printing trends To print the currently viewed trend data select Graphical or Numerical and then Print Page To print all the graphical trend data press the Print Record key and select Print Graphical select page Print Graphs Recording trends To record numerical trends press the Print Record key and select Record Trends Record Numerical To record graphical trends press the Print Record key and select Record Trends Record Graphical Erasing trend history Press the Admit Discharge key Select Discharge Yes Selecting minitrend as split screen option Don spo E Press the Monitor Setup key Select Screen Setup and Split Screen Trend Trends Minitrend view STEP DOWN 14 26 aR ECG Arh 4 hidde p 8 8 Severa Amin dn MP Case mm deden i SaR 28 ys Pleth 2 X per 0F 0 0 s RR 15 nin 128 81 91 Figure 6 1 Minitrend view Manual You can split the Normal Screen page so that one fourth of the screen on the left hand side continuously shows graphical minitrends beside waveforms Note that the split screen option is available only when the Normal Screen page shows waveforms 6 3 B30 Patient Monitor To select a split screen view 1 Press the Monitor Setup key 2 Select Screen Setup 3 Select
92. check that the message Sample line blocked appears within 30 seconds and gas waveforms are showing zero at the same time Functioning of the alarms e Set a parameter value outside the alarm limits For example connect the SpO sensor and adjust the SpO High limit under the measured SpO values The alarms go from medium priority Yellow to high priority red according to sequence given in the alarm categories table see section Alarms Check that the yellow and red LEDs function as indicated in the table To check audible alarms and alarm light see section Alarms NOTE Although SpO may not be the best example because it is often off by default it is easy to use for alarm checking If the monitor does not work as described see section Troubleshooting Cleaning and care Safety checks for software The GE Healthcare software design controls include performance of a risk analysis using methods consistent with ISO 14971 Medical devices Application of risk management to medical devices The monitor software employs watchdog timers self monitoring activities memory communication and sensor checks and so on and power on self diagnostics for example memory checksums For example for SpO the software continuously monitors the SpO sensor and if excessive sensor current is detected the message Faulty probe is displayed in the SpO number field and SpO2 Faulty in the monitor message field and the old
93. d Resolution Choices are every 1 minute 5 minutes 10 minutes 30 minutes Tabular trend format Tabular trend printout Parameter Printed values and units HR bpm SpO 96 NIBP or Art sus dia mmHg CO Et mmHg or kPa Selecting graphical trends Print Record You can record graphical trends of two parameters To select the parameters for the graphical trends 1 Press the Print Record key 2 Select Record Trends 3 Select Graphic Trend 1 or Graphic Trend 2 The following figure shows which parameters have graphic trends that you can record Record amp Print Record Trends Record Numerical Trend Resolution 5 min Num Trend Type Record Graphical Graphic Trend 1 Graphic Trend 2 Previous Menu Change graphical trend recorded in upper field 2 8 7 B30 Patient Monitor Inserting recorder paper Figure 8 4 Inserting recorder paper Printing NOTE Before you start printing check that the printer is operational You can print to a laser printer Graphical or numerical trends You can print several pages or trend data through the Print Record menu Printing currently displayed screen contents To print a trend view 1 Press the Pt Data Trends key 2 Select Trends Graphical Numerical 3 Selectthe desired trend page with Scroll Pages 4 Select Print Page Printing all the information To print several pages of graphical tren
94. d data 1 Press the Print Record key 2 Select Print Graphical Changing the printer If you need to change the printer connection 1 Press the Print Record key 2 Select Printer Connection 3 Select the printer from the list The default printer is set during configuration see section Monitor setup Other adjustable features To adjust the ECG printout type default printer connection or default paper size please see section Monitor setup 8 8 Table of contents Table of contents 9 Cleaning and care 9 1 VETO tid GER A AAA AAA ARAS 9 1 Preventive maintenance a A SO 9 1 Daily and between the patients AS etten Gea 9 1 NEIRA coq dc 9 2 VIVE iren e Te T 9 3 EVERY Lo TONS de veces deere darters resaca Presa lla risas rca sees 9 5 POWER ESAT sum aa wares Vo SO AR rm o ANS ES patr cea prar A te 9 4 CRANE e beg bce 9 4 8 ale AM A A ME A ne Der attend A TR 9 4 Permitted detergents and disinfectants enen eeen 9 4 Other accessorie sn eA OR ARE en ee eee EE de 9 7 Table of contents Cleaning and care 9 Cleaning and care Overview WARNING For safe and reliable function and operation of the monitor regular care has to be carried out according to the instructions in this manual and to the maintenance procedures described in the Technical Reference Manual Use only approved accessories including mounts and batteries and defibrillator proof cables and invasive pressure transducers For a list of ap
95. dside monitor Choosing automatic limits To activate automatic patient specific alarm limits enabling close patient control select Auto Limits in the Alarms Setup menu Limits are then calculated from the displayed patient reading at the point of time when auto limits are selected Returning to default limits Select Default Limits to set the alarms to the default alarm limits The factory default alarm limits are listed in the Default Configuration Worksheet 4 7 B30 Patient Monitor Changing alarm sources For NIBP P1 and P2 with E PSMPW you can select which measured values trigger the alarm One or several alarm sources may be active at a time 4 8 Parameters Alarm triggered off by Blood pressure Systolic diastolic and or mean pressure or off NIBP P1 P2 with off there is no 10 minute trend on display 1 Press the Alarms Setup side panel key 2 Select Adjust Limits 3 Select the measurement If the desired measurement is not displayed select Next Page 4 Pushthe ComWheel An adjustment window is displayed 5 In the adjustment window turn the ComWheel to get from the limit setting to the menu 6 selections Select X Alarm and push the ComWheel to change the selection OFF or ON Alarms ADJUST ALARM LIMITS Adjust Limits Mean Alarm ON Sys Alarm ON la arm ON 1 Sys Dia 320 320 Alarms Setup Previous Menu 40 20 5 Push wheel to turn alarm ON OFF
96. ducer is at mid heart level e Pressure transducer is zeroed Invasive blood pressure is selected for screen through Monitor Setup Screen Setup Table of contents Table of contents 15 Impedance respiration 15 1 87 2 PERTH 15 1 MOUSE TE REDE 15 2 Respiration deteccion Anneleen da 15 2 Respiration rate calculation sa ecco oet dcs tC o RN CRGO CER CUP mae pin Sad eade 15 2 Displaying impedance respiration oos eir dai Stu bet deck o tn ee arce Ont 15 3 Patient conne HORS neue oraque so C ride esate EET Lote t EI qu tate ees FE end 15 4 AcUvangmisdsturerellb A RUE TRUE PUO nee fara ea oce te red 15 5 Improving waveform fegdabllitb sus dori ad sd ds 15 6 Correcting the respiration DUITIBBT ere d ee etae e as EN e Der uetus ee Dar de 15 7 Measurement limitations o ober ore pr Ue V PPV bU P E PP QU P EP bie 15 8 Turan ofr the measurements a a a OR Yum S E es 15 8 o EET TERT 15 9 Table of contents Impedance respiration 15 Impedance respiration Overview WARNING WARNING WARNING Impedance respiration is measured across the thorax When the patient is breathing or is ventilated the volume of air changes in the lungs resulting in impedance changes between the electrodes Respiration rate is calculated from these impedance changes and a respiration waveform is displayed on the monitor screen NOTE Impedance respiration measurement is intended for patients over three years old This device is not an
97. e or artifacts interfere in the systolic area Check the patient status Check the inflation limits Perform a new NIBP measurement Unstable zero pressure Pressure is unstable at start of the measurement Calm the patient and retry 10 5 B30 Patient Monitor Message Explanation What to do Weak pulsation Weak or unstable oscillation signal due to improper cuff position or attachment weak or abnormal blood circulation slow heart rate associated with artifacts moving or disturbed patient during measurement small air leak e Check the patient status Check the NIBP cuff position and attachments e Check that the cuff is not damaged x Lead off e Check the leadwires and their connections x measurement s removed Measurement module has been removed e Reconnect the module if you want to restart the measurement x high low e Check the patient status e Adjust the alarm limits Zero error Zeroing during gas calibration failed e Repeat the calibration procedure lt 0 6 displayed in the RQ field Gas exchange measurement out of physiological range e Check the patient status Table 10 2 Other problems related to airway gas measurement Symptom Possible cause and solution are too low Airway gas values e Check the sampling line and connectors for leakage Table 10 3 Other problem
98. e reason and all alarms for a different reason are indicated visually Apnea alarms are activated after five breaths Pressing the Silence Alarms key twice e Tosilence an individual alarm that is currently active press the Silence Alarms key twice This does not pre silence the upcoming alarms The message Alarms acknowledged is displayed to indicate that the alarms that were silenced by pressing the Silence Alarms key twice remain silent whereas other upcoming alarms will have an audible sound Reactivating alarms You can reactivate the alarm sounds of new upcoming alarms by pressing the Silence Alarms key once again during the silencing period The alarms that were active when the key was first pressed will not sound before the original silencing period is over Silencing audible alarms permanently Silencing certain audible alarms entirely may be desirable for special cases 4 9 B30 Patient Monitor NOTES e _ The following silencing selections that is all other selections than Activate Alarms are available only if alarm silencing has been enabled Monitor Setup Install Service Installation Alarm Options Show Audio ON OFF Yes By default it is disabled You need a password to enter the Install Service menu For details see Changing alarm options page 5 4 e lfthe monitor is connected to the network the bedside alarms can also be silenced using the Central if this feature has been enabled in its configura
99. e single use adapter after each patient Areusable adapter can be disinfected with glutaraldehyde or alcohol If you want to clean the adapter before use submerge the adapter in 70 alcohol solution for 30 seconds and rinse carefully with water Make sure that all traces of alcohol or detergent are rinsed away or dried before connecting to the patient Sampling line e Do not reuse the sampling line Reusing a cleaned sampling line may affect measurement results NOTE Do not wash or disinfect calibration gas sampling lines Water trap The water trap is based on a hydrophobic membrane which prevents water and secretions from entering the measuring chamber Condensed water and saliva are collected into a washable container Replace the water trap every 24 hours or when the message Sample line blocked or Replace D fend persists The water trap container can be cleaned with disinfecting solutions or sterilized using cold chemicals or ethylene oxide Do not disinfect or open the water trap cartridge Do not touch the water trap membrane The hydrophobic membrane is damaged if any cleaning is attempted other than rinsing with water To lengthen the lifetime of the monitor and minimize downtime e Empty the water trap container whenever it is more than half full e Donotopen wash or sterilize the water trap cartridge After washing or disinfecting the water trap container make sure there is no alcohol nor detergent left
100. e the time scale 20 minutes to 72 hours in the trends menu To select the parameters for graphical trend recording 1 Press the Print Record key 2 Select Record Trends 3 Select Graphic Trend 1 and choose the parameter in the opened adjustment menu 4 Select Graphic Trend 2 and choose the parameter in the opened adjustment menu Printing You can print all the graphical trends gathered 1 Press the Print Record key 2 Select Print Graphical 3 Select the page and Print Graphs Factory default parameters 6 8 The default graphical trend setup varies according to mode types For details refer to Default Configuration Worksheet To change these settings see section Monitor setup Trends Numerical trend view STEP DOWN 15 27 Trends eae RA analys Scroll Pages Severe brne D Page 4 Temperatures and saturations Mf rin age Mass Toood_ spo2 ursor Time Scale 20 Graphical O Numerical Trend Scales Previous Menu Spo2 aUR 2 8 y5 I 2 8 28 II 2 8 D 2 Rp Sys Dia 97 128 81 e 13 Mean 91 Mar ual Figure 6 3 Numerical trend page 1 2 3 4 Trend menu Page name and number Real time ECG Real time digit fields if the Normal Screen shows waveforms 6 9 B30 Patient Monitor Numerical trend pages Numerical trends contain four pages of maximum 72 hours trend information real time ECG on top of each page Resol
101. e waveform during electrosurgery The saturation values may be somewhat higher for smokers Special care should be taken with patients who have burns or carbon monoxide CO intoxication When carbon monoxide intoxication is suspected always confirm the pulse oximetry reading with a blood sample measurement Intravascular dyes may cause erroneous readings For example methylene blue indigo carmine indocyanine green or any substances that contain dyes interfere with the SpO measurement Vasoconstrictive drugs such as phenylephrine hydrochloride and dopamine may affect the accuracy of the measurement The pulse oximeter cannot distinguish between oxyhemoglobin and dyshemoglobins for example met or carboxyhemoglobins Poor perfusion may affect the accuracy of measurement when using the ear probe To avoid erroneous readings do not use a blood pressure cuff or arterial blood pressure measurement device or NMT sensor in the same limb as the SpO sensor Check that Only one module with pulse oximetry measurement is inserted Correct SpO sensor is selected for each patient size The sensor is completely dry after cleaning Sensor or interconnect cable is plugged to the blue connector in the module Sensor is properly connected to the interconnection cable if used Sensor is positioned correctly to the patient SpO is selected for screen through Monitor Setup Screen Setup 12 7 B30 Patient Monitor Table of con
102. ectrosurgery equipment which is commonly used in the intended environment for the impedance respiration measurement NOTE Impedance respiration measurement is intended for patients ages three years and up Invasive blood pressure E PSMP module only Measurement range Measurement accuracy Pulse rate Measurement range Accuracy Transducer sensitivity 40 to 320 mmHg 5 5 to 42 6 kPa x5 96 or 2 mmHg 30 to 250 bpm x5 96 or x5 bpm 5 uV V mmHg 1 Theisolation barrier capacitance in the module has been minimized to reduce the hazard of burns in the event of a defect in the ESU return electrode connection 2 32 System description Temperature Measurement range 10 to 45 C 50 to 113 F Measurement accuracy 0 1 C 25 to 45 C Probe type Use only GE Healthcare temperature probes or defibrillator proof YSI 400 series probes Temperature self check At start up and then every 10 minutes Time constant of temperature probes Reusable skin temperature probe 35 Reusable adult central temperature probe 6s Reusable pediatric central temperature probe 4s Disposable skin temperature probe 3to6s Disposable central temperature probe 12F 5to8s Disposable central temperature probe 9F 5to8s NIBP Measurement range adult 25 to 260 mmHg 3 3 to 34 7 kPa child 25 to 190 mmHg 3 3 to 25 3 kPa infant 15 to 140 mmHg 2 0 to 18 7 kPa Typical measuring time adult less than 30 s infant less than 25 s Overal
103. elect Install Service and enter the password Select Installation Alarm Options Select Show Audio ON OFF and YES to enable alarm silencing or NO to disable it Monito Installation Setup gt Alarm Options Show Limits YES Show Audio ON OFF YES Alarm Light YES Latching Alarms NO Reminder Volume 5 Alarm Tones 1502 Previous Menu Select NO to disable alarm U silencing Silence options in gt Audio ON OFF menu are hidden Disabling the alarm light B y default the Alarm Light has been enabled The light flashes red or yellow according to the currently active alarm If several alarms are active at the same time the color follows the h ighest priority alarm To disable the alarm light 1 2 3 4 Monitor gt Press the Monitor Setup key Select Install Service and enter the password Select Installation Alarm Options Select Alarm Light NO Installation Alarm Options show Limits YES Show Audio ON OFF YES YES Latching Alarms NO Reminder Volume 5 Alarm Tones I502 Previous Menu Enahle ar disable the alarm light gt O Lo Alarms Latching alarms If the Latching Alarms selection is active the alarm messages stay on the screen even if the initial alarm condition goes away This enables unattended monitoring You will also hear a reminder beep every 10 seconds To clear the message field of the no longer active alarm me
104. ers of all hospital patients The hemodynamic parameters of the module comprise ECG including ST Segment and arrhythmia impedance respiration oscillometric NIBP sys dia mean temperature SpOz including monitoring during conditions of clinical patient motion and invasive blood pressure Impedance respiration measurement is indicated for patients ages three years and up The NIBP measurement is indicated for patients who weight 5kg 11 Ib or up The E PSMIP W is intended for all hospital departments including intra hospital transport but excluding harsh physical environment like MRI The extension module N FCREC option N FCREC or N FC is indicated for monitoring of COzand respiration rate of all hospital patients CO measurements are indicated for patients who weight over 5 kg 11 Ib The B30 monitor and N F CIREC Extension Module and E PSM P W Patient Side Module are indicated for use by qualified medical personnel only Classifications In accordance with IEC 60601 1 Class and internally powered equipment the type of protection against electric shock Type BF or CF equipment The degree of protection against electric shock is indicated by a symbol on each parameter module Equipment not suitable for use in the presence of a flammable anesthetic mixture with air or with oxygen or nitrous oxide Continuous operation according to the mode of operation Portable Monitor In accordance with IEC 60529 IPX1 degree of protection
105. es 25 mm s default 2x6 50 mm s 2 columns 6 lines 50 mm s or 3x4 25 mm s 3 columns 4 lines 25 mm s e Select Printer Connection and Net1 Net16 None default e Select Paper Size and A4 default or Letter NOTE Network printer only Other printer settings can be changed in the Print amp Record menu To make the changes permanent save them in user modes Changing the monitor settings 5 4 1 Press the Monitor Setup key 2 Select Install Service and enter the password 3 Select Installation Monitor Settings e Select Parameter Settings and select Humidity compensation type CO2 Numbers Dry default Wet Monitor setup Changing the user modes You can change the settings in each user mode to suit your specific needs User modes are predefined combinations of settings that include both general and measurement specific settings A user mode defines for example what is displayed on the screen and in the trends General settings can be changed in the Monitor Setup menu other settings in the parameter setup menus You need a password to make changes through Monitor Setup Install Service menus and to enter the Save Modes menu for details see Configuration and passwords page 5 1 This section describes the following changes that can be saved in user modes Changing the Normal Screen layout on page 5 8 Changing sweep speeds on page 5 12 Displaying pulse rate on page 5 12 Changing
106. eter scale to the left The gap shows the blood pressure mean value except in the Paw field where it indicates Pplat NIBP trend bar Dotted vertical line across the trend field indicates change such as ST relearning or zeroing of an invasive blood pressure channel changing a label A blue white or red line above the marker field indicates the following things Blue line indicates the amount of data on the screen the left end of the line shows the starting point of the trend data gathering The right end of the line shows the last moment the data has been gathered White line indicates which proportion of the data you see on the screen If the line is on the left there is more data to see after the current view If the line is on the right there is more data to see before the current view If the line is in the middle there is more trend data to see towards the beginning and the end of the case Red line indicates the availability of trend data with 10 second resolution available for the last 30 minutes only Trends Graphical trend pages Graphical trends contain Four pages Six fields on each page Five fields are usually visible The lowest sixth field is replaced by digit fields on the screen All six fields are printed Scale label unit and color of the parameter follow the real time waveform setting for each parameter For HR ST PVC CPP SpO and temperature you can select the scale through Pt D
107. etup Units Height cm Weight kg Blood Pressure mmHg Previous Menu Change height unit 4 cmarinch 4 Setthe units for height weight and blood pressure 5 3 B30 Patient Monitor Changing alarm options 1 Press the Monitor Setup key select Install Service and enter the password 2 Select Installation Alarm Options e Select Show limits and YES to show alarm limits in digit fields NO is the default e Select Show Audio ON OFF default and YES to enable alarm silencing Selecting NO disables silencing options in the Audio ON OFF menu in Alarms Setup NOTE The Show Audio ON OFF setting should be changed only by the system administrator e Select Alarm Light and YES default to enable the alarm light or NO to disable it e Select Latching Alarms and YES to keep alarm messages on screen until Silence Alarms key is pressed NO is the default e Select Reminder Volume and adjust the volume of the audible alarm reminder tone e Select Alarm Tones and ISO ISO2 or General Other alarm settings alarm limits alarm light brightness and alarm volume can be changed in the Alarms Setup menu To make the changes permanent save them in user modes see section Saving changes in user modes Changing printer settings 1 Press the Monitor Setup key 2 Select Install Service and enter the password 3 Select Installation Printer e Select ECG Printout Type and 2x6 25 mm s 2 columns 6 lin
108. h Setting trend scales You can change the scale for HR ST PVC SpO and temperature trends 1 2 Press Pt Data amp Trends Select Trends Graphical Trend Scales and adjust the scales Setting the default trend You can select graphical or numerical trends to be displayed by default 1 2 5 4 Press the Monitor Setup key Select Install Service and enter the password Select Trends Select Default Trend and Graph or Num Table of contents Table of contents 6 Trends 6 1 OVETVISW d sek A AAA AA 6 1 Tended parameters o e o UR a de 6 1 MOSCA SS O PE 6 2 A REE EE EE EN 6 3 Mii a BO kahit Se Ok ae NE Se el i oh et De 6 4 asi ale NT 6 4 Graphicaltrend NEW ne EL EN neo Hd 6 5 A leden ea sut 6 6 Cherelle B Ai elo ere sE SS Mee d ot 6 7 Changing trend length and resolution neee eenen 6 7 Moving on graphical trend Cages oss ve eN 6 8 R cording and RM e la dl bn 6 8 Factory default parameters AAA A ei a s ES e i eis 6 8 N mericaltrend e et Md de Eats 6 9 Nurrerical trend PAGES us arresteren EI bere te Aia 6 10 Moving between numerical trend PEES Get lt tier Eh tios e n ae Mel Se A 6 10 Record ond DEBEO A cosi eed eese e ENORMES vC ERU cA mt 6 10 A corren edle ee E ae d t 6 10 Erasingtrend AAR nonsense nen E ENEE RATEN en Rte Ua eo fork qd bac e 6 11 Table of contents Trends 6 Trends Overview The monitor displays two types of trend data graphical and numerical The moni
109. h and choose 30 s or Cont The default setting for the recording time is 30 seconds NOTE When recording is activated by alarms the recording time is always 30 seconds Record amp Print Record Waveforms Record to Net Record Wave Waveform 1 ECGL Cort Waveform 2 OFF Waveform 3 OFF Start on Alarms MO Delay 125 Paper Speed 25 mm Length 50 s Previous Menu Change length of recording 4 30 s or continuous O 2 Selecting the recording delay time 8 4 If the recording delay time is set to OFF the recording starts when an event occurs and continues for 30 seconds or until it is manually stopped or until the recorder runs out of paper see Controlling the recording time on page 8 4 If the delay time is set to 12 seconds default the recording starts when an event occurs and the 12 seconds prior to the event are recorded from the recorder memory The recording continues for 18 seconds if the length has been set to 30 seconds see Controlling the recording time on page 8 4 or until the recorder runs out of paper To change the delay 1 Press the Print Record key 2 Select Record Waveforms 3 Select Delay and OFF or 12 s The recording can be started manually or automatically when certain alarms occur The automatic alarm recording is explained in the following NOTE When recording is activated by alarms the delay is always 12 seconds Printing and recordi
110. he ISO point manually The ISO point is on the isoelectric line Adjust the ISO point by turning the ComWheel and confirm by pushing the ComWheel If the ISO point setting is changed the original point is shown as a dashed line The manually set ISO point remains until the monitor is turned off or reset After a turn off or reset the ISO point is set automaticallu gt gt 3 2o gt E H o Ri El E bb S 9 un Ed T a n lt P R interval QT interval ECG Setting ST alarm limits To set the ST alarm limits 1 Press the ECG key 2 Select ECG Alarms 3 Select ST Alarms 4 Select Adjust Limits You can also adjust the limits through Alarms Setup Adjust Limits Ce ECG ECG1 Lead ave ECG Lead Casc ECGS Lead Casc ECG Size 1 0 Adjust ST Relearn ECG Setup ECG Alarms Normal Screen Change high and low HR and ST alarm limits Change PVC alarm limit and arrh alarm settings ECG Adjust Limits HR Alarm ON PVC Alarm OFF Arth Alarms E Alarms Setup E Previous Menu Change high and low ST alarm limits SI Adjust Limits Lat Alarm ON Inf Alarm OFF Ant Alarm OFF Alarms Setup Previous Menu Push ComMiheel to adjust alarm limits manually ADJUST ALARM LIMITS High Low aYL Y5 11 13 B30 Patient Monitor Description of the ST segment measurement algorithm The ST segment begins at the point w
111. he module that has been most recently connected You can also remove both modules and re connect the new module after five seconds Onthe E PSM P W module indicates that protection against cardiac defibrillator discharge is due in part to the accessories for pulse oximetry SpO j temperature T and invasive pressure P measurement Onthe N FC REC module indicates that airway gases should be calibrated every six months in normal use and every two months in continuous use Ontop of the monitor beside the battery cover Use manufacturer recommended batteries only Follow the regional regulations for disposal Onthe rear panel this symbol indicates the following warnings and cautions Electric shock hazard Do not open the cover or the back Refer servicing to qualified service personnel For continued protection against fire hazard replace the fuse only with one of the same type and rating Disconnect from the power supply before servicing Do not touch the monitor during defibrillation Do not use the monitor without manufacturer approved mounting attached Lithium battery on the CPU board follow the regional regulations for disposal Use manufacturer recommended batteries only Tupe BF IEC 60601 1 protection against electrical shock E Type BF IEC 60601 1 defibrillator proof protection against electric shock Type CF IEC 60601 1 protection against electric shock gt gt B30
112. heit Allows you to adjust temperature alarm limits for two measurement sites measured by T1 or T2 You can choose one or both sources to be active at a time Previous Menu Returns to the previous menu level Changing temperature label 1 Press the Others key 2 Temp Setup T1 Label or T2 Label 3 _ Select the label with the ComWheel Labels are T1 and T2 or Eso Esophageal temperature Naso Nasopharyngeal temperature Tymp Tympanic temperature Rect Rectal temperature Blad Bladder temperature Axil Axillary temperature Skin Skin temperature AirW Airway temperature Room Room temperature Myo Myocardial temperature Core Core temperature Surf Surface temperature 13 3 B30 Patient Monitor Combining different temperatures The monitor displays the difference between different temperatures if they are displayed in the same digit field differences T2 T1 are displayed in the temperature digit field if you choose them in the same digit field For example to display T1 T2 1 Press the Monitor Setup key and select Screen Setup 2 Select Digit Fields 3 Select T1 T2 to one of the lower fields Testing temperature The temperature measurement functioning is automatically tested periodically During the test the message Performing temp test is displayed If the test fails the monitor displays the message Temperature error Changing temperature units You can select the temper
113. here the QRS ends J point Diagnostic criteria of ST segment changes are measured at 60 ms after the J point For monitoring purposes it is important to keep the measurement point fixed during monitoring to notice the ST changes on the respective trends The sophisticated algorithms of B30 monitors search the J and isoelectric ISO points The system learns the ECG and stores the reference QRST complex The algorithm sets the ISO and J points Due to the large variation with QRST complexes the user has possibility to adjust the ST measurement points manually The QRS analysis classifies each beat by using several criteria and rejects distorted complexes from the ST calculation NOTE The ST algorithm has been tested for accuracy of the ST segment data The significance of the ST segment changes needs to be determined by a physician Test results of ST segment measurement algorithm testing 11 14 The algorithm testing has been performed by using The European Society of Cardiology ST T Database ESC DB Average results from ischemic ST detection Episode sensitivity 84 Episode positive predictive accuracy 70 Duration sensitivity 64 Duration positive predictive accuracy 74 ECG Monitoring arrhythmia The Severe arrhythmia analysis mode used by the B30 detects asystole bradycardia tachycardia ventricular fibrillation and ventricular tachycardia Adjusting arrhythmia alarm settings 2 ECG ECG
114. in Before starting to use the monitor check the monitor installation settings and what is configured in the different user modes and make necessary changes You need passwords for making the changes see Configuration and passwords below This User s Reference Manual describes most of the configurable features More detailed lists of the options and also of the factory settings can be found in the Default Configuration Worksheet delivered with each monitor NOTE If you wish to make permanent changes we recommend that you contact the person responsible for the configuration who is familiar with the configuration architecture When new settings are saved they should be marked in the Default Configuration Worksheet Configuration and passwords NOTE If you want to make changes that require a password we recommend you contact the system administrator The default password for entering the Install Service menu is 16 4 34 Press Monitor Setup and select the Install Service menu turn the ComWheel in the opened adjustment window until you hit the desired number then push the ComWheel to accept and select the number Continue until all three numbers are selected After entering the third number the Install Service menu is displayed Most of the modifications are valid only temporarily unless you accept them in the Save Modes menu which is a submenu of the Install Service menu A password is also required for entering the S
115. ir respective owners End User License Agreement THIS DOCUMENT IS A LEGAL AGREEMENT BETWEEN YOU THE LICENSEE AND GE HEALTHCARE GE IF YOU DO NOT AGREE TO ALL THE TERMS OF THIS AGREEMENT PROMPTLY RETURN THE ENTIRE PACKAGE INCLUDING ALL ACCESSORIES IN THEIR ORIGINAL PACKAGE WITH YOUR SALES RECEIPT TO GE FOR A FULL REFUND 1 Grant of License GE grants to Licensee a nonexclusive nontransferable restricted license without right to sublicense to use the copy of the incorporated software firmwarel Software and manuals and documentation related to the Software in connection with Licensee s use of the product for their labeled purpose and only when the instrument is used with authorized accessories and sensors in accordance with this End User License Agreement Software License GE reserves all rights not expressly granted to Licensee 2 Ownership of Software Firmware Title to ownership of and all rights and interests in any software and or firmware and the documentation and all copies thereof remain at all times vested in GE or its partners and they do not pass to Licensee 3 Assignment The rights and obligations of the Licensee under this Software License are personal Accordingly neither this Software License nor any of such rights and obligations are assignable or transferable by merger or by operation of law or otherwise without the prior written consent of GE You may not rent lease sell or otherwise dispose
116. ive blood pressure Impedance respiration Non invasive blood pressure Airway gas CO2 Index Table of contents Table of contents Table of contents About this manual 1 Intended audience eeen About 1 eI MUERE TI ha C8 a dd ae dE ALI Los LAOS gt About 1 IlIustrations and NAMES iia e is About 1 Conventions used in this manual een About 2 Related documentation eeen About 2 Installati n and Seruie snaar daaarna sane Wer edele eie erede About 3 Table of contents About this manual About this manual Intended audience This manual is intended for clinical professionals Clinical professionals are expected to have a working knowledge of medical procedures practices and terminology as required for monitoring critically ill patients Overview This User s Reference Manual describes the functions offered by the B30 patient monitor running the software license L DICUO8 As the monitor setup may vary some menus displays and functions described may not be available in the monitor you are using This manual is an integral part of the product and describes its intended use Keep it always close to the equipment Observance of the manual is a prerequisite for proper product performance and correct operation and ensures patient and operator safety NOTE Before using your monitor please read the User s Guide or this manual thoroughly This User s Reference Manual gives you
117. kPa 0 80 mmHg 0 1596 0 15 kPa 0 100 mmHg 0 2096 0 20 kPa 0 160 mmHg Selects the FiO level The FiO level is used in gas compensations of the CO measurement to increase the measurement accuracy Make sure the level is set if the FiO level is higher than 4096 Selects the CO display unit 96 kPa or mmHg Resp Rate Source CO2 Alarm You can select the rate to be calculated from the ECG leads impedance measurement or the CO measurement If you select AUTO the rate is automatically calculated from the measured CO If impedance measurement is present and the source is AUTO the respiration rate calculation switches back to impedance respiration if you press the Silence Alarms key during an Apnea alarm Opens the CO Alarms Adjustment menu to change the CO alarm limits Resp Rate Alarm Opens the Resp Rate Alarms Adjustment menu to change the respiration rate alarm limits Previous Menu Returns to the previous menu Selecting alarm sources To select alarm sources go to the CO2 Setup menu s submenu CO2 Alarm The selections are Fl or ET as the high and low alarm limit 17 5 B30 Patient Monitor Calibrating NOTE Ensure that the calibration gas and regulator are functioning properly before calibration Perform annual maintenance of the regulator as required NOTE Do not wash or disinfect calibration gas sampling lines The airway module should be calibrated once every six months or whenever there are
118. l You can record numerical graphical or tabular trends Recording numerical trends Since the contents of the numerical trends are preconfigured you cannot choose the parameters or change their order The following parameters are printed in the numerical trend record Parameter Printed values and units HR and SpO2 bpm SpO2 NIBP Sys dia or mean mmHg P1 Art Sys dia or mean mmHg P2 CVP Sys dia or mean mmHg T1 T2 Celsius or Fahrenheit CO2 ET FI 96 kPa or mmHg Resp Rate Breaths per minute Date Unit Time 7 Rug 1995 10 24 HR min SpO2 X EM danken NIBP Sys Dia mmHg 128 81 Pi Art Mean mmHg 93 Po CVP Mean mmHg 14 Ti Ti Tz Ti2 CEL 38 8 720 5 Parameter coz ET FI 33 8 78 8 Parameter value Resp Rate min 15 Figure 8 3 Numerical trend printout For pressures either Sys Dia or Mean are recorded depending on the digit format selected in the pressure setups PCWP is measured from the pressure channel labeled PA 8 6 Printing and recording Selecting the format for the recorded numerical trends You can select the format for the recorded numerical trend to be either Num vertical or Tab horizontal 1 Press the Print Record key and select Record Trends 2 Select Num Trend Type and Num or Tab Changing resolution To select the resolution of a numerical or tabular trend record 1 Press the Print Record key and select Record Trends 2 Select Tren
119. l system accuracy Meets or exceeds SP10 2002 AAMI standards The ESU does not cause a burn hazard through the NIBP cuff because there is no electrical connection between the cuff and the NIBP measuring electronics NOTE NIBP measurement is intended for patients who weigh 5 kg 11 Ib and up NOTE The cuff pressure measurement range is equal to cuff nominal and cuff indication ranges Pulse oximetry SpO Automatic scaling of plethysmographic waveform Measurement and display range Oto 100 96 Calibration range 70 to 100 96 Calibrated against functional oxygen saturation Measurement accuracy 3 100 to 70 96 2 digits 69 to 0 96 unspecified Display resolution 1 digit 196 of SpO Wavelength of SpO probe LEDs Infrared LED 940 nm Red LED 660 nm Maximum energy of SpO probe LEDs Infrared LED 42 uJ pulse Red LED 62 uJ pulse Pulse rate Measurement and display range 30 to 250 bpm Measurement accuracy x5 96 or 5 bpm whichever is greater 1 Theisolation barrier capacitance in the module has been minimized to reduce the hazard of burns in the event of a 2 3 defect in the ESU return electrode connection According to SP10 2002 AAMI 4 4 5 2 B Intra arterial method as the reference standard mean difference of the test system and the comparison system shall be 5 mmHg or less with standard deviation of 8 mmHg or less Accuracy is based on deep hypoxia studies with volunteered subjects during motion and non motion
120. lect 1 Press the Monitor Setup key and select Screen Setup 2 Select Waveform Fields 3 Tocombine all waveforms in one field select Combine Pressures and Yes Patient connections WARNING 14 2 1 Connect the pressure transducer to the transducer adapter cable Connect the cable to the red connector in the module or to the dual invasive blood pressure adapter cable NOTE Invasive pressures need to be zeroed after reconnecting the pressure transducer or cable and whenever the patient s position is changed The transducer is always leveled to the mid right atrium 2 Prepare the transducer kit according to the manufacturer s instructions Mount the kit with the transducer zeroing port at mid heart level 3 Ensure that there is no air in the line Refer to transducer manufacturer s instructions on how to remove trapped air from the transducer 4 Connect the patient catheter to the pressure line 5 Open the dome stopcock to room air 6 Zero the transducer See Starting with accurate values on page 14 4 7 Open the dome stopcock to pressure catheter and check the quality of the waveform Mechanical shock to invasive blood pressure transducer may cause severe shifts in zero balance and calibration and cause erroneous readings Invasive blood pressure WARNING WARNING Figure 14 2 Invasive blood pressure setup 1 2 3 4 5 6 7 E PSMPW module Heparinized fluid bag with
121. lly when modules are connected or disconnected The invasive pressure waveforms are displayed only when the transducer is connected to the module Waveforms are always evenly spread to fill the entire waveform area Whenever there are less than 6 waveforms configured on the screen the remaining waveforms are enlarged Changing the waveform to another also changes the numerical field to the right of the waveform It may also change the digit fields at the bottom if you choose the same measurement in the waveform field that is currently in the digit field the digit field disappears Selecting Combine Pressures in the Waveform Fields menu displays invasive pressures in the same waveform field with individual scales When you use 5 lead ECG measurement up to three different ECG leads can be displayed simultaneously in different fields 5 9 B30 Patient Monitor Modifying digit fields Patient data may be displayed in up to four digit fields located in the lower part of the screen The fields are numbered from left to right Sp02 Ed mmHg Syt Dia 97 128 81 Mean 31 Manual Figure 5 2 Digit fields You may change the contents of each field or turn them off individually Before modifying the digit fields remember to check that the desired parameter module is plugged in 1 Press the Monitor Setup key and select Screen Setup 2 Select Digit Fields and change the field contents gt Screen Setup Digi
122. ly connected to the trunk cable Correct leadwire type is selected in the ECG Setup menu ECG Resp are selected for screen through Monitor Setup Screen Setup B30 Patient Monitor 15 10 Table of contents Table of contents 16 Non invasive blood pressure 16 1 OEI A AA A A IA 16 1 MO A e a eal de 16 1 DitecE TESA RUS A tele te Ge 16 2 Displaying non invasive blood pressure eneen neee eeen 16 2 Patient cornneebllolls draden eee Hea bee aderen 16 3 Selecting a cuff amd G EUROS rover adem erder evana cee ate doctos 16 3 Connecting the cuff hose aee Eoo boom i ene ER E EU ta and 16 4 NIBP Set p tmetil 5 tras dde ad 16 4 SIOEUDO et ad ee wl yi d the Aten ho ca Megan eS Ns o AA 16 5 D ring measurement ton anness reete pH gnd eden ey PN be de Be erheen Be 16 5 AUtTOCYCIMO Acker te Roast EE AN U eN Oe TRUE UN 16 6 SEG SUSE MAS randen eta ane Ga enden eed Nd enten elio Md ene ptr 16 6 Steirtingd miaimidmeasuremelit ters ener NP eto E etie Taede 16 7 Canceling a measurement usa aree LL Ite e eet Cot vet teens 16 7 Starting and stopping a continuous measurement STAT eneen 16 7 Usi g venots Stdsls ceo toh eet Nant a e dd et 16 8 Autormadtuc NIB Prd OU A A TE e ta a end 16 9 Functioning of NIBP measurement during arrhythmias n n a an nnns cece cence eee eee 16 9 GhechliSt 1 ucasalicnea steers sim sata a tbt a Qr vetter aga alte arterie iin 16 9 Table of contents Non invasive blood pressure 16 Non invasive blood p
123. mHg calibration by authorized service personnel may be necessary Returns to the NIBP menu level Non invasive blood pressure Starting WARNING Note that the measurement unit may be mmHg or kPa The unit is selected during configuration through Monitor Setup Install Service Installation Units You can start the NIBP measurement using either the direct function keys on the module or on the side panel or by pressing the NIBP key on the Command Board NIBP d Start Cycling Cycle Time 5 min Start STAT Start Manual Start Yen Stasis NIBP Setup NIBP Alarm Normal Screen Start automatic cuff infla gt tions at cycle time interval In the beginning of the measurement sys and dia labels are replaced by the inflation limit indication Infant Child Adult for five seconds The cuff pressure is displayed in the mean pressure value field If motion artifacts are detected the monitor automatically holds deflation until the motion stops maximum of 30 seconds If the artifacts prevent proper measurement a new measurement starts automatically When the measurement is ready you can hear a short beep and see the result numbers flashing The monitor sets the inflation pressure automatically according to the previous measurement Discharge the patient from the monitor to reset the inflation limit before measuring a new patient During measurement e Observe the cuffed limb frequently Measurement may i
124. metal part e letdry completely before connecting to power source e Checkventilation holes and clean if necessary Cleaning and care WARNING WARNING WARNING Modules e Wipe the front panel as any monitor casing e Donot wash or immerse module in any liquid The internal sampling system of the airway module does no cleaning nor sterilization The water trap functions as a bacteria filter and there is no reverse flow back to the patient If the measuring chamber is suspected to be contaminated for example gas zero error the airway module should be serviced by authorized service personnel Display e Wipe all splashes immediately with a dry cloth e Wipethe LCD display after use with a cloth moisturized with mild detergent solution ECG cables e Wipe the cables with mild detergent solution e _ Avoid excessive use of liquids e Disinfect when necessary e Allow the product to dry completely after cleaning Pulse oximetry sensors The GE Healthcare pulse oximetry sensors are latex free Take possible patient allergies into account also when selecting the cleaning agent 1 Detach the sensor from the patient and the monitor 2 Wipethe sensor with mild detergent solution Allow it to dry completely before use Sensors can be disinfected with chlorite compounds The sensors may be sterilized using an ethylene oxide mixture at 50 to 60 C 120 to 140 F NOTE After ethylene oxide sterilization sensors m
125. mits 11 10 reactivating permanently silenced 4 10 reactivating temporarily silenced 4 9 recording 4 11 reminder volume 4 16 Setup menu 4 5 silencing permanently 4 9 ST limit 11 13 Arrhythmia alarm settings 11 15 arrhythmia algorithm 11 16 detecting 11 15 selecting leads 11 16 Axillary temperature 13 3 B Batteries capacity 2 12 charging indicator 2 14 conditioning 2 15 indicators 2 13 replacing 2 14 test button 2 14 Bladder temperature 13 3 Brightness changing display brightness 5 12 C Calibration airway gas 17 6 NIBP 16 4 Canceling alarm limit changes 4 5 Capacity batteries 2 12 Central setting time 5 2 Changing the water trap 9 7 Charging indicator onthe battery 2 14 Checklist temperature 13 4 Children Venous Stasis 16 8 children 16 3 Cleaning airway adapters 9 6 ECG cables 9 5 NIBP cuff and hose 9 5 parameter cables 9 5 temperature probes 9 5 color 16 3 Colors changing parameter colors 5 12 Command Board 2 10 Configuration digit fields 5 10 installation settings 5 3 splitscreen 5 11 trends 5 14 units 5 3 user modes 5 5 waveform fields 5 9 Index Connecting patients 3 5 Core temperature 13 3 Cuff cuffhose 16 3 Cursor invasive blood pressure 14 6 D Date setup 5 2 Default user modes 5 6 Digit field modifying 5 10 Display airway gases 17 2 ECG 11 2 heartrate 11 2 invasive blood pressure 14 2 SpO2 12 2 ST 11 11 temperature 13 2 Display brightness 5 12
126. mmediately when Manual measurement is selected and after 30 seconds when Auto measurement is selected If the alarm situation persists an alarm is given Functioning of NIBP measurement during arrhythmias The functioning of the NIBP measurement has been tested by using Biotek BP Pump W Non invasive blood pressure monitor tester with wrist cuff in the presence of the following arrhythmias available from the Biotek BP Pump W Tachycardia Bradycardia Premature Atrial Contraction 1 Premature Atrial Contraction 2 Premature Ventricular Contraction and Atrial Fibrillation and PVCs The test results indicate that the presence of some arrhythmias during measurement may increase the time required for the measurement Checklist Check that The hose is correct black NIBP hose for adults and children and light blue for infants The O ring on the hose connector is intact The connector is firmly pushed inside the cuff tube The NIBP hose is properly connected to the module and will not detach if pulled The NIBP cuff is correct for the patient size There are no holes or cracks in the cuff bladder or cuff tube The symbol indicating the center of the bladder is over the artery All residual air is squeezed out of the cuff before wrapping it around the arm The cuff is not loose The cuff is at heart level The cuff tubes or NIBP tube are not kinked or squeezed together If leak is suspected start venous stasis and check tha
127. more specific information about the clinical and technical aspects Pay special attention to WARNING and CAUTION statements The new user of the monitor should begin with sections Safety precautions System description and Monitoring basic These sections describe the system and the basic operation of the monitor The measurement sections describe the measurement technique setup and how to adjust displays and menus for patient monitoring and special views Section Monitor setup gives instructions about setting up the system and making changes in the default settings Section Cleaning and care describes cleaning and daily maintenance procedures Illustrations and names All illustrations in this manual are only examples and may not necessarily reflect your system settings or data displayed in your system If a particular selection is not available in your system the selection is shown grayed in the menu All names used in examples and illustrations are fictitious B30 Patient Monitor Conventions used in this manual To help you find and interpret information easily the manual uses consistent text formats Hard keys Menu items Menu access File names etc Messages References WARNING CAUTION NOTE Names of the hard keys on the Command board side panel and modules are written in the following way Others Software terms that identify window parts or menu items are written in bold italic
128. mpair blood circulation Intervals below 10 minutes and STAT measurements are not recommended for extended periods of time e Make sure that the tubes are not bent pressed or stretched Measurement may be impaired e Blood pressure values may be affected by a change in the patient s position e The presence of some arrhythmias during NIBP measurement may increase the time required for the measurement For details see Functioning of NIBP measurement during arrhythmias on page 16 9 16 5 B30 Patient Monitor Autocucling The Auto On Off key sets automatic NIBP measurement at selected intervals on and off Autocucling is synchronized to real time so that if the first measurement was at 12 02 the next measurement is at 12 05 and again at 12 10 5 min interval To start the autocycling do one of the following e Press the Auto On Off module or side panel key or press the NIBP key on the Command Board and select Start Cycling NIBP mmHg Sys Dia 128 81 Mean 81 Omi 5 min The bar at the bottom of the NIBP field shows the time remaining to the next measurement To stop autocucling e _ Press the Auto On Off module or side panel key or press the NIBP key on the Command Board and select Stop Cycling Setting cycle time The possible intervals for autocycling are 1 2 5 3 5 10 15 30 minutes or 1 2 or 4 hours To set the cucle time e Press the NIBP key on the Command Board and select Cycle
129. n mmHg x gas concentration in 750 Reading in kPa water vapor saturated gas ambient pressure in mmHg 47mmHg x gas concentration in 750 NOTE 47 mmHg is the partial pressure of the saturated water vapor at 37 C Airway gas CO2 Checklist Check that Water trap is locked into the module Water trap container is empty A new sampling line is used after each patient Sampling line is connected to the water trap Monitor is turned on and self check is performed with the sampling line attached Sampling line is connected to the airway adapter The humidification and or bacteria filter are in correct place Breathing circuit or accessories have no residuals of alcohol based disinfectants Desired gas parameter is selected for screen through Monitor Setup Screen Setup B30 Patient Monitor 17 10 Index Index A Abbreviations 2 19 Accessories About 2 Adjusting alarm light brightness 4 6 Admitting 7 1 Adults cuff hose detection 9 2 inflation limit 16 4 Venous Stasis 16 8 Airway adapter cleaning 9 6 Airway gases calibrating 17 6 checklist 17 9 CO2 setup menu 17 5 display 17 2 sampling line 9 6 Airway sampling line 9 6 Airway temperature 13 3 Alarm activation 4 4 AUDIO OFF 5 4 categories 4 3 changing the tone pattern 4 16 changing tone 5 4 deactivating 4 11 displaying limits 4 13 enabling and disabling silencing 4 14 history 4 12 latching alarms 4 15 PVC alarm li
130. ne and the detection limit The signal strength produced by a respiration should thus exceed this minimum limit to be included in the respiration rate calculation Peaks within the grids are not calculated If the detection mode is AUTO the grid lines present the minimum limits The limits in use may be larger The RR value could include fewer respirations than indicated by the gridline rate calculation Respiration rate is calculated automatically when ECG or CO is measured unless the respiration measurement is turned off When CO is measured the respiration rate is automatically calculated from CO Respiration rate calculation switches back to impedance respiration if you press the Silence Alarms key during an Apnea alarm The respiration rate source is displayed above the respiration numeric value Tmped coe if 20 D 18 Figure 15 2 Respiration rate source indication for impedance and CO TH 0o Im ZO om 7a The impedance respiration waveform is displayed next to the RR value also when the RR value is calculated from COs Impedance respiration To manually select impedance respiration as respiration rate source 1 Press the Others key 2 Select Resp Setup 3 Select Resp Rate Source and select AUTO CO2 or Imped Others Sp02 Setup Resp Setup Temp Setup Normal Screen Set size Resp Fate source and alam Enable ordisable Resp measurement Displaying impedance respiration Imned
131. nete a Aa 8 3 Selecting the recording delay time ee s A rnr 8 4 Recording oH Na AA A Shee Dir d pd 8 5 Es de oO E EET VE Ne en DUO TE 8 6 Recording numerical themds a ne de dtes bete VES S 8 6 TOU trend AAA A ae o AI 8 7 Selecting Ard MEA MENOS coe e C ER DEED tacta OS 8 7 Setting recorder DADEN Led E pne iaa S n Ea Sa NOx TIE at So velot e mate aft 8 8 NA tiM tou cum Mol Rr eta teo 8 8 Printing currently displayed screen contents rs 8 8 Printing allithemfrnatoN ai Ea ict ETE Rr ER anes 8 8 Changing the printer il osse rl ltda a uns tasks cee ventana aliens 8 8 Other adjustable features uc vars e PR EE ODDS Meare ee d tQ Nod 8 8 Table of contents Printing and recording 8 Printing and recording Overview You can manage recording and printing via the Print Record menu For recordings you need a module with the built in recorder N FCREC or N FREC and for printouts you need a laser printer PCL5 compatible min 2 MB memory The monitor can be connected to a laser printer via network You can record and print waveforms measurement values If you need to record or print just one view of trends on one page you can do that in the corresponding measurement menu If you need to record or print several pages or all the data gathered and about several parameters you need to enter the Print amp Record menu Recording The recorder records up to three real time waveforms simultaneously displays recordings of nume
132. ng Recording on alarms Print Record An automatic strip chart recording is activated when the following alarms reach the red level Asustole Tachy Brady Art High Art Low V Fib and V Tachy When recording is activated by alarms the recording time is always 30 seconds and the delay always 12 seconds 1 Press the Print Record key 2 Select Record Waveforms 3 Select Start on Alarms and Yes Print amp Record Record Waveforms Record to Met Record Wave Waveform 1 ECG1 Waveform 2 OFF Waveform 3 OFF Start on Alarms YES Delay i25 Paper Speed 25 mm Length 30s Previous Menu Select YES for automatic start of recording when serious arrhythmia occurs O 2 The following alarms start recording Alarm Recorded parameters Asustole ECG1 Art waveforms 25 mm s Tachy Brady ECG1 Art waveforms 25 mm s Art High Low ECG1 Art waveforms 25 mm s V Fib ECG1 Art waveforms 25 mm s V Tachy ECG1 Art waveforms 25 mm s Arrhythmia analysis Alarms which start the recording if the alarm is set on level red Severe Asystole Tachy Brady Art High Low V Fib V Tachy All alarm recordings are marked with the alarm source 8 5 B30 Patient Monitor Recording trends To record trends 1 Press the Print Record monitor key 2 Select Record Trends Record Numerical or Record Graphical 3 Stop recording by selecting Stop Numerical or Stop Graphica
133. nitor is connected to Network A blinking heart next to the heart rate or pulse rate value indicates the beats detected A lung next to the respiration rate value indicates that respiration rate is calculated from the impedance respiration measurement Gas inlet Gas outlet Do not reuse Use by Indicates the last use day Date of manufacture Do not immerse the sensor in liquids 2 17 B30 Patient Monitor This symbol indicates that the waste of electrical and electronic equipment must not be disposed as unsorted municipal waste and must be collected separately Please contact an authorized representative of the manufacturer for information concerning the decommissioning of your equipment The separate collection symbol is affixed to a battery or its packaging to advise you that the battery must be recycled or disposed of in accordance with local or country laws To minimize potential effects on the environment and human health it is important that all marked batteries that you remove from the product are properly recycled or disposed For information on how the battery may be safely removed from the device please consult the service manual or equipment instructions Information on the potential effects on the environment and human health of the substances used in batteries is available at this url http www gehealthcare com euen weeerecucling index html This product consists of devices that may contain mercury which
134. ntrolled ventilation Px Setup menu Label Scale Digit Format Response Start up labels are Art and CVP Other labels are P1 P2 PA RAP RVP LAP ICP and ABP Assigning the appropriate label automatically changes other pressure settings accordingly Scales are assigned by the monitor when the channel is labeled Scales can also be individually adjusted between 10 and 300 mmHg in steps of 10 With the numeric display format you can choose either the Systolic Diastolic numbers S D or the Mean pressure value Mean in large size to the screen You can also choose all values S D M to the screen If the label is ICP also the CPP selection is available see also page 14 7 Use the ComWheel to change the invasive blood pressure averaging time The available values are Normal and B TO B beat to beat With selection Normal normal averaging is used Depending on the label the values are updated approximately every five seconds With selection B TO B no averaging is used and the values of the last detected pulse are displayed These values can change up to three times per second This feature is useful when it is necessary to detect fast pressure changes NOTE This setting affects only the displayed values not the averaging of invasive pressure trends Filter Frequency Measured signal is filtered to remove noise and artifacts Use the ComWheel to adjust the filter HR Source PX Alarm between 4 and 22 Hz If the ECG signal i
135. nulation A constant pressure is maintained in the cuff The value is selected automatically after the inflation limits infant child or adult are set E NIBP Start Cycling Cycle Time 5 min Start STAT Start Manual NIBP Setup NIBP Alarm Normal Screen for venous cannulation Start and hold cuff inflation Of STASIS Cuff 75 Om 2 min To release the pressure before two minutes have expired e Press the Start Cancel key on the module or press the NIBP key on the Command Board and select Stop Ven Stasis The inflation limits venous stasis pressure and venous stasis times are listed in the table below Inflation limit Maximum venous stasis Venous stasis time inflation limit Infant 150 5 mmHg 19 3 0 7 kPa 40 5mmHg 5 3 0 7 kPa 1 min Child 200 10mmHg 26 7 1 3 kPa 60 5mmHg 8 0 0 7 kPa 2 min Adult 280 10 mmHg 37 3 1 3 kPa 80 5 mmHg 10 7 0 7 kPa 2 min Venous stasis pressure may be lower than the values above if the patient has low blood pressure The venous stasis pressure adapts to the measured mean pressure being approximately the same as the mean pressure but always at least the following Infant 20 5 mmHg 2 7 0 7 kPa Child 30 5 mmHg 4 0 0 7 kPa Adult 40 5 mmHg 5 3 0 7 kPa 16 8 Non invasive blood pressure Automatic NIBP double check If the NIBP value exceeds the alarm limits a new measurement takes place automatically i
136. o ect e em 11 17 Test results of arrhythmia algorithm testing eneen eeen 11 17 Monitoring pacemaker patients 5 oro ket leed ete teta 11 18 Other ddjustable features e ad de a 11 18 ECO print OUE UPE vistas o ates p t et Art e td t earn aad 11 18 ECG waveform sweep speed nonnen enen eneen see 11 18 3379 EEE ENE 11 18 Table of contents ECG 11 ECG Overview The electrocardiography ECG reflects the electrical activity generated by the heart muscle ECG monitoring is used for a heart rate measurement for arrhythmia analysis and for detecting pacemaker function and myocardial ischemia In Normal Screen when measuring 5 lead ECG you can simultaneously monitor the waveforms of up to three different ECG leads In 3 lead ECG the monitor displays one ECG lead When monitoring the ECG the monitor simultaneously analyzes ST segment changes Module description NOTE You can use only one E PSM PIW module in the same monitor at a time E PSMW E PSMPW ECG and impedance respiration connector Figure 11 1 Modules for electrocardiographic ECG measurement B30 Patient Monitor Displaying ECG and heart rate PI RN OAT Dt TTT 16 48 ECG a ENS s An Jr R bg vr VI urn vd S avR 2 8 1 28 V2 i li Figure 11 2 Display of ECG and HR 1 ECG1 is displayed first 2 ECG2 is displayed below
137. ode is selected e Check cuff and inflation limits InvBP s not zeroed One or both InvBP channels have not been zeroed Zero the channel indicated or zero both channels 10 3 B30 Patient Monitor Message Explanation What to do Lead changed The monitor automatically switches the ECG1 waveform selection to a measurable ECG Lead I II IIl aVR aVL aVF or V if the current ECG1 is not measurable Note that the ECG waveform changes according to the lead it is measured from e Check the lead Leads off ECG trunk cable or any of the leads is disconnected Offset voltage between two electrodes is too high e ECG Reconnect the disconnected trunk cable electrode or leadwire e ECG Change the trunk cable leadset and module Network down xxx Network cable is not connected The Central is shut down e Check the network cable e Check the Central NIBP manual Autocycling mode is interrupted because of an air leak or loose cuff e Check the NIBP setup and restart autocucling No battery backup Replace the batteries Noise Unreliable HR calculation or distorted waveform possibly during defibrillation or because of motion artifacts e ECG Check the patient status e ECG Check the electrodes e Ensure that the patient is not shivering e Poor electrode quality or wrong positioning e Change the lead e Remove the
138. of the software firmware or the products on a temporary basis GE may assign this Software License and or any rights of Licensor hereunder to any affiliate or to any purchaser of substantially all of the assets used by GE in the performance of this Software License 4 Limitation of liability Other than the attached limited warranty the Software is being licensed to Licensee as is without warranty of any kind express or implied including without limitation the warranties of merchantability fitness for a particular purpose functionality use or performance of the Software and compatibility with particular computer systems computer peripherals or other software packages title or non infringement Some jurisdictions do not allow the disclaimer of implied warranties so the above disclaimer may not apply to Licensee in which case the duration of any such implied warranties is limited to the longer of i minimum required by law or ii thirty 30 days from the date the Software is received by Licensee In no case including without limitation any breach of a fundamental term or a fundamental breach of this Software license shall GE be liable for any damages including but not limited to indirect exemplary special consequential or incidental damages of any kind including without limitation lost profits even if GE has been advised of the possibility of such damages These provisions hereof shall apply to the full extent permitted
139. off 4 Disconnect the monitor from the power supply and leave it on until the batteries run out and the monitor switches off Wait for another 15 minutes 5 Reconnect the monitor to the power supply and turn it on Continue charging the batteries until both capacity indicators are full height and no longer scrolling 6 Keep charging for another two hours After this check that the orange battery LED in the front panel is no longer on If it is continue charging until it goes off to indicate that the battery conditioning is complete Every 12 months Preventive maintenance check The annual check according to detailed instructions of the Technical Reference Manual requires trained service personnel and appropriate testing tools and equipment Calibration check of temperature NIBP and invasive blood pressures Calibration check of temperature NIBP and invasive blood pressures should be performed at least once a year by qualified service personnel as a part of the Planned Maintenance see Technical Reference Manual 9 3 B30 Patient Monitor Power interruption NOTE Always use the monitor with batteries inserted Otherwise all trend data and temporary settings are lost if the power cable is detached from the mains If the monitor is turned off trend data and the latest user made settings remain in the monitor memory for 15 minutes even if the mains power is interrupted If not contact service personnel After 15 minutes
140. omatically reconfigures the display when modules are inserted Reconfiguration of the display may take up to 5 seconds Starting monitoring 1 Prepare the patient connections according to the setup picture in the measurement section Use only approved supplies and accessories see the Supplies and Accessories catalog The alarms and parameter default settings become active 2 Checkthat you have the desired waveforms and digits in the fields If necessary adjust the selections Press the Monitor Setup key Select Screen Setup Select Waveform Fields or Digit Fields 3 Zeroinvasive blood pressure lines Check the alarm limits Press the Alarms Setup side panel key The alarms are operative and the parameter default settings are active when the patient is connected to the monitor 5 Start the measurement according to the instructions in the measurement section For example zero the invasive pressure channels by pressing the Zero PX module keys and start NIBP measurement to get reference values 6 Enterorload patient data see next page 3 5 B30 Patient Monitor Entering and loading patient data Press the Admit Discharge key and do one of the following To continue with a patient already admitted on the same monitor select Contin Previous To admit a new patient select Admit Patient The patient admission also happens automatically when the monitor receives vital signs Always observe
141. on Setup Alarm Options Show Limits YES 150 Show Audio ON OFF YES General Alarm Light YES Latching Alarms N Reminder Volume 5 Alarm Tones 1502 Previous Menu Alarm tones according to gt U ISO 9703 2 standard with rising frequency 4 16 Table of contents Table of contents 5 Monitor setup 5 1 OI E A AA Ad 5 1 Configuration and AS rn eer a on NA EN Lm EE M DA MOM REA 5 1 Setting timeand AAS vaer E eeen etende 5 2 Battery Setup sr annae naden ware Beds da Nees etende ce bees RR ENS eee ace bia 5 2 Changing monitor installation settings stre rs tetteren bte be Ra 5 3 Changing Units ore termen enten EEDE POR pu E S tees ARR 5 3 Changing Alant OPIO S e an eos 5 4 Changing printer setas tie ibid ee denten dateert los 5 4 Changing the monitor settings ura e ten Ol She dd LU A fa 5 4 Changing tbexiset Fredes ern eee hadi dois PIX debo ros 5 5 Saving changes MUS nr Aen At ee ud du 5 5 Chongo MS USAGE c ld dto ine 5 6 ENANA e o nte lia 5 7 Aia E eee 5 7 lading modes EE 5 7 Changing the Normal Screen layout Oet toeten ete 5 8 Modifying waveform fields RR NN 5 9 MSIE digit teld S tete roni a dede ecran obe COP E T EE AAN 5 10 Modifying split SGISB veras ri enea a aa CREER ANE tame aq pd 5 11 Modifying the minitrend length a a EE Oi KE 5 11 Other adjustable screen features ic A e RSS 5 12 Changing the displag Onighttess sr ad Mek ae uec eee lo COS de 5 12 CHANGING SWEED SBBedS i
142. on on arrhythmia alarms please see section ECG B30 Patient Monitor Alarm Volume Alarm Light Audio ON OFF Remove Menu 4 6 Adjusts the volume of the audio alarms The range is from 1 soft to 10 loud NOTE Audible alarms cannot be totally silenced with the Alarm Volume function Adjusts the brightness of the alarm light if the light has been enabled default through Monitor Setup Install Service Installation Alarm Options Alarm Light YES The range is from 5 to 100 The light is on during the adjustment to help determine a suitable brightness Opens a menu to select Silence Apnea Silence ECG Silence Apn amp ECG or Silence All NOTE The silencing selections that is all other selections than the Activate Alarms are available only if alarm silencing has been enabled by selecting Monitor Setup Install Service Installation Alarm Options Show Audio ON OFF Yes By default it is disabled For more details see Enabling or disabling alarm silencing page 4 14 Activate Alarms Activates silenced alarms This selection is always available for activating alarms that have been permanently silenced using the Central Silence Apn Silences apnea and disconnection alarms as well as CO respiration rate Silence ECG Silences arrhythmia alarms and also HR limit alarms Silence Apn amp ECG Silences both of above Silence ALL Silences permanently all alarms except FiO 1896 Ppeak gt 70 cmH O
143. onfiguration Worksheet for more information about priorities and escalating woo wl Figure4 1 View of alarms 4 1 B30 Patient Monitor Points to note WARNING When the alarms are silenced observe the patient frequently WARNING Always make sure that the audio alarm volume level is adequate in your care environment Alarm indications 4 2 When the monitor is turned on you will hear a beep this tells you that the alarm audio signal is working Also the alarm LED indicators are lit up for a few seconds To check them see section Functioning of the alarms You can also check the functioning of the audio signal and alarm light through Alarms Setup Alarm Volume or Alarm Light If alarms are turned off and a power interruption occurs when there is no battery backup or if the monitor is turned off for up to 15 minutes check the alarm status before you start monitoring again If the monitor is connected to the network the alarms can be heard and seen on the Central as well Please consult the iCentral User s Reference Manual Alarms for details If the monitor is connected to the network the alarms can also be silenced using the Central if this feature has been enabled in Central configuration Alarms Alarm categories The alarms are classified into three categories according to the priority HIGH PRIORITY RED ALARM MEDIUM PRIORITY YELLOW ALARM and LOW PRIORITY WHITE NOTE white color N
144. only Selecting a lead OL ECG1 Lead II The following lead selections are possible with 3 leadwire set I Il or III with 5 leadwire set I Il Ill aVL aVF aVR or V For channels ECG2 and ECG3 also a cascaded lead selection Casc is available To select the ECG1 lead e _ Press the ECG key and select ECG1 Lead You can select all leads ECG1 ECG2 and ECG3 in the ECG menu ECG2 Lead V5 I ECG3 Lead aVL ECG Size 1 0 III Adjust ST aL Relearn avr EEG Setup ava ECG Alarms V5 Normal Screen Change lead displayed as first ECG waveform The label of the lead is displayed in the ECG field OL Selecting user leads 1 Press the ECG key 2 Selecta lead for ECG1 3 Lead With 3 lead ECG you can select only one user lead ECG1 Lead With 5 lead ECG you can select three user leads B30 Patient Monitor Viewing a cascaded ECG With a 3 leadwire set ECG2 and ECG3 leads are automatically shown as cascaded The same ECG will be displayed in each waveform field Thus more QRS complexes are displayed at the same time With a 5 leadwire set either a cascaded ECG or different leads can be displayed Select the leads in the ECG menu e Tocascade a lead press ECG and select ECG2 ECG3 Lead Casc Adjusting the ECG size Increasing or decreasing the ECG gain affects the size of the 1 mV bar at the left end of the ECG waveform and the size of the ECG waveform accordingly Cm
145. ormal Screen Select YES to discharge p O Lo current patient Select NO to cancel B30 Patient Monitor Table of contents Table of contents 7 Patient data management 7 1 OVErVIEW a A AAA AAA AR 7 1 Admitting a patemi AAA TC RETO EEE PET 7 1 Adding eMC OA INC Bets eoim Pa NA tale 7 2 stora late ge il re ite NE EE 7 2 COMPE enteren er ex ves IR Tei e dO RA TA Ee 7 2 Automatic saving of patleritdata cres eh cr anal Sede cee tars d eene alte MENSA SEEN 7 3 Discharging the patenta a ee na e Do oe pen ded 7 3 Table of contents Patient data management 7 Patient data management Overview The monitor continuously saves patient data such as trends Saving is activated once the patient is admitted The monitor saves automatically nthe monitor memory the most recent patient data up to 72 hours if the network is not in use nthe network the most recent patient data up to 72 hours from 2 to 90 days depending on the configuration All the data can be printed through network and saved to the network for monitor memory Admitting a patient Monitoring of a new patient is started by admitting the patient After the patient has been admitted you can start monitoring and trend gathering To admit the patient 1 Admit Discharge key 2 Select Admit Patient and enter the patient data Select letters and numbers by turning and pushing the ComWheel max 14 characters or numbers for each name
146. ose The hose is not connected to the module Check cuff and hose Cuff occlusion Tubes or hose are kinked e Check tubes and hose Cuff overpressure Cuff is squeezed during measurement and pressure safety limits are exceeded e Check cuff hose and tubes e Restart measurement measurement off Leads have been disconnected for 15 minutes for impedance respiration check or have just been connected lt 15 seconds ago e Reconnect the leads or wait to continue the measurement EEPROM error or EPROM error Faulty EEPROM circuit on the CPU board or failure in CPU software memory e Call service to replace CPU Faulty ECG cable The ECG cable is defective The ECG cable may be electrically damaged or the connectors are wet e Change the ECG cable and the lead set e Change the ECG module if the module connector is wet Keep the connectors dry e Avoid excessive use of liquids when cleaning cables and connectors Gas measurements removed e Reconnect the N FREC or N FCREC module if you want to restart the CO measurement Identical modules There are two identical modules measuring the same parameter e You are trying to use two or more E PSMIP W modules or two or more N Fx modules at the same time You can only use one E PSM P W and or one N Fx module at a time Remove extra modules Infl limits Check setup Adult or child cuff is used but infant inflation m
147. ose and sets the inflation limits automatically for adults to Adult For children and when using hoses without identification the light blue infant hose the inflation limit must be set manually in the NIBP Setup menu To do this 1 Press the NIBP key and select NIBP Setup Inflation Limits NOTE When using hoses without identification the monitor goes to this selection automatically when you try to start the NIBP measurement With these hoses AUTO option is not available 2 Select the limit according to the hose with the ComWheel For children select Child and for infants select Infant NOTES You cannot select Adult inflation limits when using an infant cuff The NIBP system incorporates a safety circuit to prevent overpressure or prolonged inflation of the cuff Thealarm limits change automatically according to the cuff hose type used Adult Infant To determine the correct cuff size check that the index line on the outer edge of the cuff falls between the range lines If not use a larger or smaller cuff 16 3 B30 Patient Monitor Connecting the cuff hose 1 Connect the cuff hose to the NIBP cuff by placing the opposite connectors in contact and locking them together 2 Plug the NIBP cuff hose to the module NIBP Setup menu OL Ready Prompt Inflation Limits NIBP NIBP Start Cycling NIBP Setup Cycle Time 5 min Ready Prompt 5 Start STAT Inflation Limits AUTO Start Manual
148. otective earth Do not use an additional multiple socket outlet extension cord or adapter of any kind Use only an intact power cord Do not user the power cord for any other product or purpose Do not apply mechanical tension to the power cord otherwise it may be damaged Some equipment malfunctions may not generate a monitor alarm Always keep the patient under close surveillance Never install the monitor so that it is above the patient Do not use the monitor in high electromagnetic fields for example during MRI Do not connect any external devices to the system other than those specified Do not touch the patient table instruments modules or the monitor during defibrillation Pins of connectors identified with the ESD warning symbol should not be touched Connections should not be made to these connectors unless ESD precautionary procedures are used For details see ESD precautionary procedures page 1 2 Use only approved accessories including mounts and batteries and defibrillator proof cables and invasive pressure transducers For a list of approved supplies and accessories see the Supplies and Accessories catalog delivered with the monitor Other cables transducers batteries and accessories may cause a safety hazard damage the equipment or system result in increased emissions or decreased immunity of the equipment or system or interfere with the measurement Protection against cardiac defibrillator discharge is d
149. ous controlled ventilation core temperature count of responses cardiopulmonary bypass cerebral perfusion pressure compressed spectral array computer tomography mixed venous oxygen content System description CVP d dB DBS DEL Delta De depr Des Dia Diagn DIFF DIS DO DO DSC dyn e ECG ECG1 ECG1 r ECG2 ECG3 ED EDV EDVI EE EEG EEG1 EEG2 EEG3 EEG4 EEMG EEtot elect elev EMC EMG Enf Entr EP ESD ESO central venous pressure day decibel double burst stimulation NMT delete delta frequency band depression desflurane diastolic pressure diagnostic ECG filter difference S 5 Device Interfacing Solution oxygen delivery oxygen delivery index digital signal converter dynamic estimated electrocardiogram first ECG waveform top real time ECG second ECG waveform third ECG waveform emergency department end diastolic volume end diastolic volume index energy expenditure kcal 24h electroencephalogram first EEG waveform second EEG waveform third EEG waveform fourth EEG waveform evoked electromyogram total energy expenditure electrode elevation electromagnetic compatibility electromyogram enflurane entropy evoked potential electrostatic discharge esophageal temperature B30 Patient Monitor ESV ESVI ET Et EtAA EtBal EtCO EtN O EtO ET tube ETT EVLW EVLWI Exp FAH FEMG FFT FI Fi FIAA Fib FiBal FiCO FiN FiN O FiO Flow Freq
150. parameter colors on page 5 12 Changing the recorder and printer settings on page 5 13 Saving changes in user modes The modifications are valid only temporarily unless you accept them by saving them in the modes 1 Select Monitor Setup Install Service Enter the password 2 Select Save Modes Enter the password see page 5 1 3 Select the mode from the list and select Save Temporary modifications are valid until you discharge the patient or change a mode or until more than 15 minutes has elapsed from the turn off of the monitor 5 5 B30 Patient Monitor Changing the user mode The monitor always starts in startup mode The startup mode is one of the user modes and it is chosen during configuration To change from the startup mode to another mode 1 Press Admit Discharge and select Select Mode 2 Select one of the following modes STEP DOWN Mode for intermediate care ED Mode for emergency care PACU Mode for post anesthesia care CCU Mode for ECG and ST care NEURO Mode for neurological monitoring PEDIATRIC Mode for pediatric ICU monitoring Admit Discharge Select Mode Return to STER DOM STERDOWN O 1 Jan 2005 ED 1 Jan 2003 1 PACU O 1 Jan 2003 Kamit Admit Discharge gt Admit Patient Discharge Normal Screen 1 2 3 a ccuje 1 aan 2008 5 NEURO 4 1 Jan 2003 B PEDIATRIC O 1 Jan 2008 Previous Menu Activate mode All preconfigured settings are lo
151. planation of the ESD warning symbol and training in ESD precautionary procedures e Theminimum content of an ESD precautionary procedure training should include an introduction to the physics of electrostatic charge the voltage levels that can occur in normal practice and the damage that can be done to electronic components if they are touched by an operator who is electrostatically charged Further an explanation should be given of methods to prevent build up of electrostatic charge and how and why to 1 2 Safety precautions discharge one s body to earth or to the frame of the equipment or bond oneself by means of a wrist strap to the equipment or the earth prior to making a connection Points to note Disposal Medical electrical equipment needs special precautions regarding electromagnetic compatibility EMC and needs to be installed and put into service according to the EMC information provided in the Technical Reference Manual by qualified personnel Portable and mobile RF communications equipment can affect the medical electrical equipment The equipment is suitable for use in the presence of electrosurgery Please notice the possible limitations in the parameter sections and in Performance on page 2 30 Service and repairs are allowed for authorized service personnel only Dispose of the whole device parts of it its packing material and manuals in accordance with local environmental and waste disposal regulation
152. pressure infusor Flushing set Disposable catheter Transducer Adapter cable for the InvBP transducer Adapter cable for dual InvBP measurement NOTE Patient connections made according to the picture above using approved accessories are defibrillator proof Make sure that no part of the patient connections touches any electrically conductive material including earth Use only defibrillator proof transducers and cables 14 3 B30 Patient Monitor Starting with accurate values Invasive Pressures gt 14 4 Pressure transducers generally produce a small signal even when no pressure is applied to them It is necessary to zero the monitor with the transducer to establish an accurate electrical zero point Also the position of the transducer effects the accuracy of the measurement An error of 10 mmHg of static pressure is introduced for every 13 6 cm 5 4 inches difference in height between the mid heart and the transducer To zero the transducer open the transducer to air and do one of the following e Press the Zero Px module key or the Zero ALL side panel key This starts zeroing immediately NOTE Selecting Zero ALL does not zero ICP Zero it separately e Pressthe Invasive Pressures key on the Command Board and select Zero Pressures Invasive Pressures Zero Pressures Zero ALL Zero Pl art 0 00 zero P2 CYP 0 00 Previous Menu Zero transducer to atmospheric pressure Before starting open tr
153. proved accessories see the Supplies and Accessories catalog delivered with the manual Other cables transducers and accessories may cause a safety hazard damage the equipment or system result in increased emissions or decreased immunity of the equipment or system or interfere with the measurement If the monitor does not function as it should and troubleshooting cannot solve the problem contact your service or sales representative Do not perform any other cleaning or maintenance procedures than those described in the monitor manuals NOTE Refer to the accessory package for detailed cleaning instructions Preventive maintenance Daily and between the patients e Wipe the monitor and module surfaces e Wipe the ECG trunk cable and leadwires NIBP cuff and cables and SpO sensors Avoid excessive use of liquids e Change or sterilize all airway and invasive patient accessories e Clean disinfect or sterilize reusable temperature probes e Empty the D fend water trap whenever half full e Checkthat all accessories cables and monitor parts are clean and intact Cleanthe device as described in the Cleaning part of this section e When you start monitoring check that the module is firmly in place the accessories are intact and properly connected and that you have selected desired parameters to be displayed in digit and waveform fields e Check note the following points regarding different parameters 9 1 B3
154. rbances of HF surgical equipment typically cause false positive pacer detection PATIENTS WITH PACEMAKERS Do not rely entirely upon rate meter alarms when monitoring patients with pacemakers The monitor may count the pacemaker pulses as heartbeats In this case asystole and ventricular fibrillation may go undetected Always keep these patients under close surveillance and monitor their vital signs carefully Impedance respiration measurement may cause rate changes in Minute Ventilation Rate Responsive pacemakers Set the pacemaker rate responsive mode off or turn off the impedance respiration measurement on the monitor 11 17 B30 Patient Monitor Other adjustable features NOTE This section describes the rest of the adjustable features related to ECG measurement To adjust the following features you need a password If you wish to adjust the settings of the features we recommend that you contact the person responsible for the entire configuration ECG printout type See Changing printer settings on page 5 4 ECG waveform sweep speed To change the waveform sweep speed Monitor Setup Sweep Speeds Select Hemodynamics and adjust the value Checklist Check that Electrode gel is moist e Electrodes have good skin contact e Electrodes are positioned correctly e Correct leadwire set is selected e Thetrunk cable is connected properly e leadwire set is properly connected to the trunk cable e Correct le
155. re When the scale changes the message Scale changed is displayed The scale indicator number is displayed on the left side of the waveform Selects the SpO averaging time The selections are Normal 12 seconds default setting Fast 3 seconds Beat Sound Volume HR Source Adjusting the SpO beat volume also affects the beat volume of ECG When SpO is monitored the monitor provides a variable pulse beep so that the tone of the pulse beep rises with increasing oxygen saturation and falls as saturation decreases You can select the volume from 1 soft to 10 loud With selection O there is no audible sound Selects the heart rate source If the ECG signal is affected by too much noise for a reliable heart rate calculation heart rate can also be calculated from invasive pressure Art or plethysmographic pulse waveform Pleth The selected heart rate source is displayed above the numerical display of the heart rate The color of the heart rate is the same as that of the source parameter The AUTO selection priorities for heart rate calculation are ECG the lead with highest R wave pressure Art and plethysmographic pulse waveform 12 5 B30 Patient Monitor During monitoring WARNING Check the sensor site every four hours more frequently if the perfusion is poor Routinely check to ensure adequate circulation distal to the sensor site Patient condition or prolonged use may require changing the sensor site periodic
156. ressure Overview WARNING The non invasive blood pressure NIBP measurement uses the oscillometric measuring principle The cuff is inflated with a pressure slightly higher than the presumed systolic pressure then slowly deflated at a speed based on the patient s heart rate collecting data from the oscillations produced by the pulsating artery Based on this data the unit calculates values for systolic mean and diastolic pressures Blood pressure measurements determined with this device are equivalentto those obtained by an intra arterial blood pressure measurement device Multiple intra arterial sites were used You can set the NIBP module into an automatic cycling mode to make measurements at desired time intervals You can also measure NIBP continuously for five minutes in STAT mode or take separate single measurements NOTE Intervals below 10 minutes and STAT measurements are not recommended for extended periods of time The NIBP measurement is indicated for patients weighing over 5 kg 11 Ib Module description NOTE In the monitoring system use only one module at a time for measuring NIBP E PSMW E PSMPW NIBP connector Figure 16 1 Modules measuring non invasive blood pressure 16 1 B30 Patient Monitor Direct function keys There are two module keys for NIBP on the module and on the monitor side panel Auto Starts and stops autocycling measurements On Off
157. rical information in horizontal and vertical plane prints up to 72 hours or graphical and numerical trend data NOTE Printings on thermal paper may be destroyed when exposed to light heat alcohol and so on Take a photocopy for your archives Recorder description Module with recorder N FREC or N FCREC Figure 8 1 N FREC module with built in recorder 1 Recorder 2 Paper compartment lever Side panel key Use the Start Stop side panel key to start and stop local recording immediately Note that this key is functional only when N FREC or N FCREC modules are used 8 1 B30 Patient Monitor Recording waveforms You can record three waveforms to a local recorder 1 Press the Print Record monitor key and select Record Waveforms Record to Local 2 Stop Waveforms Record amp Print a Record Trends Print Graphical Printer Connection Mone Normal Screen Record waveforms 49 4 5 7Aug95 Tui nu 3 i ponr ECG aVR Q 5mV div IN N zaet i Y Pleth 20x ee o 6 T coz 1 I Spesed l12 5mm s a Figure8 2 Sample of recording ND 0 1 Recorder speed 2 Scale 3 Selected waveform 4 Date 5 Time NOTE Waveform scaling follows the displayed parameter scaling when applicable 8 2 Printing and recording Selecting waveforms for recording Print Record Print Record You can select which waveforms and how many
158. riority alarm You can adjust the brightness of the light in the range 5 to 100 To adjust the brightness of the light 1 Press the Alarms Setup key 2 Select Alarm Light and adjust with the ComWheel During adjustment the red light is on to help you determine a suitable brightness level Alarm activation 4 4 To enable the alarms connect patient cables If the alarm source is selected the alarms are active also when the measurement is not displayed except the impedance respiration alarms When an alarm becomes active messages appear in order of priority See default settings presented in the Default Configuration Worksheet Individual alarms have their own specific requirements before they become active for example Apnea requires five breaths to be activated Invasive pressures need to be within alarm limits for 20 seconds after zeroing Alarms Alarms Setup menu Alarms gt Adjust Limits Auto Limits Default Limits You can view and adjust patient alarm limits in the Alarms Setup menu Alarms Setup ALARM LIMITS AND 10 MIN TRENDS 4Exit Adjust Limits Auto Limits Default Limits HR ST NIBP Art CYF SpO2 CO2 Lat Sys Sys Mean ET 160 2 0 1180 1801 15 T8Q 8 0 8 IB TO Cancel Changes Arrh Alarms Alarm Volume 5 Alarm Light 100 40 2 0 80 so o 90 3 0 a
159. s R RED IEC L YELLOW IEC RA WHITE AAMI LA BLACK AAMI FIL F GREEN IEC LL RED AAMI Figure 11 3 Electrode positioning with 3 lead ECG R RED IEC RA WHITE AAMI L YELLOW IEC LA BLACK AAMI WHITE IEC V BROWN AAMI N BLACK IEC O F GREEN IEC RL GREEN AAMI LL RED AAMI Figure 11 4 Electrode positioning with 5 lead ECG B30 Patient Monitor Patient connection NOTE Keep the ECG cable lead set and connectors dry Avoid excessive use of liquids when cleaning the cables and connectors R RED IEC L YELLOW IEC R RED IEC RA WHITE AAMI LA BLACK AAMI RA WHITE AAMI L YELLOW IEC BLACK AAMI 9 ann e 0 V BROWN AMI W F GREEN IEC LL RED AAM N BLACK IEC o RL GREEN AAM F GREEN IEC LL RED AAMI Figure 11 5 Example of the ECG setup with E PSM P W module 1 E PSMW or E PSMPW module 2 ECG trunk cable or 3 lead ECG cable with integrated leadwires 3 3 or 5 leadwire set ECG electrodes pre gelled electrodes are recommended Check the expiration data NOTE For a comprehensive list of accessories see the Supplies and Accessories catalog Lead measurement The following table lists the electrodes needed to measure different ECG leads Lead Electrodes needed R RA L LA F LL or N RL I R RA F LL L LA or N RL
160. s Product Compliance The B30 Patient Monitor is classified in the following categories for compliance WARNING This equipment is suitable for connection to public mains as defined in CISPR 11 This Monitor conforms to general safety standard for medical devices to IEC 60601 1 This Monitor conforms to EMC safety standard to IEC 60601 1 2 This Monitor conforms to usability safety standard for medical devices to IEC 60601 1 6 Software is developed in accordance with IEC 60601 1 4 The application of risk management analysis to medical device conforms to ISO 14971 The SpO2 Parameter conforms to ISO 9919 The TEMP parameter conforms to EN 12470 4 The CO2 parameter conforms to ISO 21647 This Monitor conforms to particular safety standard for multifunction patient monitoring equipment to IEC 60601 2 49 with the exception of Sub clause 51 103 51 103 1 and 51 102 4 NOTE This Monitor conforms to particular safety standard for multifunction patient monitoring equipment to IEC 60601 2 49 with the exception of Sub clause 51 103 Both non latched and latched alarms are selectable for technical alarms Ifthe Latching Alarms selection is active both technical alarm and physiological alarm messages stay on the screen even if the initial alarm condition goes away The latching alarms function is convenient for the user to analyze and track the old state of the patient This is a advanced function which protected by the pas
161. s N FREC N FCREC and N FC Rear panel connections Figure 2 3 Rear panel connections 1 2 3 4 5 6 7 8 9 10 11 12 Battery compartment Slot for infusion pole mounting Module connector marked with X4 Guide rail for GCX mounting Receptacle for power cord Fuse holder Serial port marked with X9 Network ID connector marked with X8 Connector for future use marked with X7 Accessory Multi I O adapter with connectors 7 9 above Network connector Equipotential connector B30 Patient Monitor Module overview Different modules measure different parameters See below for module descriptions and features Patient Side Module E PSMW Figure 2 4 Module E PSMW 1 Module keys 2 NIBP connector 3 Temperature connector 2 channel measurement 4 SpO connector 5 ECG 3 5 lead and impedance respiration connector 6 Tab for removing the module 2 4 System description Patient Side Module E PSMPW O 9 5 GOGO OC Figure 2 5 Module E PSMPW 1 Module keys 2 NIBP connector 3 Invasive blood pressure connector 2 channel measurement 4 Temperature connector 2 channel measurement 5 SpO connector 6 ECG 3 5 lead and impedance respiration connector 7 Tab for removing the module
162. s affected by too much noise for a reliable heart rate calculation heart rate can be calculated mechanically from the pressure Art or plethysmographic pulse waveform The selected heart rate source is displayed above the numerical display of the heart rate The color of the heart rate is the same as that of the source parameter Auto selection prioritizes the heart rate calculation in a specified order ECG the lead with highest R wave pressure Art and plethysmographic pulse waveform Alarms can be adjusted in this menu or in the Alarms Setup menu which opens by pressing the Alarms Setup keu 14 5 B30 Patient Monitor Determining pressure values visually By moving the horizontal cursor across the pressure waveform you can get accurate pressure values at selected points This may be useful for example if the patient s breathing pattern is irregular The cursor is not available for pressures shown with a combined scale 1 Press the Invasive Pressures key 2 Select Px Setup Px Cursor 3 Move the cursor up or down by turning the ComWheel Every time the cursor is moved the time hours and minutes and pressure values are displayed on the screen This way you can keep track of the changes made 4 You can remove the cursor by selecting Remove cursor Note that if the cursor is not removed it remains visible in the Normal Screen Labeling channels Invasive Pressures gt 14 6 The label of the pressure channel
163. s correctly ECG cables electrodes and setups are correct Thick ECG ECG cable is looped baseline Other electrical power cables are near the ECG leadwires Incorrect ECG filter Incorrect power frequency of the monitor Table 10 6 Other problems related to impedance respiration measurement Symptom Possible cause and solution Respiration e Check the electrode quality and positioning measurement eer l fails Adjust the detection limits During ventilator supported breathing the respiration calculation may count only ventilator produced inspirations and expirations e Other electrical devices may interfere with the measurement Table 10 7 Other problems related to InvBP measurement Symptom Possible cause and solution InvBP readings seem unstable e Make sure there are no air bubbles in the transducer system Flush and zero e Place the transducer on the patient s mid heart level and zero 10 7 B30 Patient Monitor Table 10 8 Other problems related to NIBP measurement Symptom Possible cause and solution NIBP e Check that cuff tubings are not bent stretched compressed or loose measurement doesnotworkor Prevent motion artifacts values seem e Use cuffs of correct size unstable Table 10 9 Other problems related to temperature measurement Symptom Possible cause and solution Temperature e Check that you are using a correct probe measurement fails e Try another pro
164. s related to arrhythmia measurement Symptom Possible cause and solution alarms Extra arrhythmia The morphology of the ECG signal has changed e Start relearning manually through the ECG menu detected Extra Ventricular Fibrillations are Patient s medical condition e Check the patient status Low amplitude signal in some ECG leads e Leads and II Select the one with the largest amplitude to ECG1 e After selecting the leads start relearning manually 10 6 Troubleshooting Table 10 4 Other problems related to batteries Symptom Possible cause and solution Battery operation time is markedly e Condition the batteries according to the instructions in this manual shortened Table 10 5 Other problems related to ECG measurement Symptom Possible cause and solution ECG signal is e Ensure that the patient is not shivering noisy or no QRS is detected Incorrect ECG filter e Check the filter through ECG ECG Setup Filter Poor electrode quality or wrong positioning e Check the electrodes and cables and their placement See section ECG for details e Change the lead e Remove the ECG cable from the connector and reinsert it Pacer markersare le Check that RENS The pacer markers have been selected ON The pacemaker has been adjusted correctly and not above R The pacemaker function
165. second median values Display update time 1s Maximum response time of heart rate meter to change in heart rate Response time 80 to 120 bpm 6 9 s Response time 80 to 40bpm 8 25 Maximum Tall T wave amplitude that does not disturb the heart rate calculation time gt 1 4 mV Input impendance gt 2 5 Mohm The heart rate calculation operates with irregular rhythms of IEC 60601 2 27 6 8 2 bb 4 the heart rate after a 20 second stablization period as follows Figure 101 A1 80 bpm Figure 101 A2 59 bpm Figure 101 A3 122 bpm Figure 101 A4 117 bpm Pacemaker pulse detection detection level 2 to 700 mV pulse duration 0 5 to 2 ms Pacemaker detector may not operate correctly during the use of high frequency HF surgical equipment The disturbances of HF surgical equipment typically cause false positive pacer detection Direct current for leads off detection through an active patient electrode 30 nA 1 Theisolation barrier capacitance in the module has been minimized to reduce the hazard of burns in the event of a defect in the ESU return electrode connection 2 When the heart rate HR changes rapidly the averaging is restarted 2 31 B30 Patient Monitor Direct current for leads off detection through a reference electrode lt 120 nA The normalized respiration sensing current between RA R and LL F or RA R and LA L or LA L and LL L Frequency of respiration sensing current 5 0 pA 31 25 kHz
166. seconds except the second tone alarm pattern which is produced 1 second after the first one IP um Fe Yellow Triple beep every 19 5 seconds For serious but not life threatening problems HOE der cum Medium priority alarm White Single beep Advisory note It may be equipment related like Leads off Low priority alarm 4 3 B30 Patient Monitor Table 4 3 General pattern Visual Tone pattern Meaning Red Continuous beep For life threatening situations High priority alarm Yellow Double beep every 5 seconds For serious but not life threatening problems 5 5 Medium priority alarm White Single beep Advisory note It may be equipment related A like Leads off Low priority alarm There is also a sound for catastrophic situations you hear continuous beep if the FiO is less than 18 or Ppeak is high Alarm LED indicators Alarm light The B30 has several alarm indicators There are two LEDs red and yellow in the side panel beside the Silence Alarms key For their functioning see page 4 3 These indicators can be disabled In addition to the audible and LED indications the B30 has an alarm light located in the upper right corner of the monitor frame The alarm light can be enabled default or disabled see Other adjustable features on page 4 13 When enabled it flashes red high priority or yellow medium priority according to the currently active highest p
167. sent 4 Connect the gas sampling line to the sampling line connector on the water trap 5 Turn on the monitor The monitor performs a self check 6 Before connecting the patient wait until the message Calibrating gas sensor disappears Then make the patient connections as described below and connect the sampling line to the airway adapter 7 Position the adapter with sampling port upwards This prevents any condensed water from entering the sampling line If N FCREC or N FC is used with O and or N O contents higher than 40 make sure that FiO2 Level and N20 Level are set accordingly through Airway Gas CO2 Setup to enable O and or N O compensation Take the gas sample as close to the patient s airway as possible as shown in the illustrations and connect the sampling line to the patient s airway adapter Position the adapter s sampling port upwards to prevent any condensed water from entering the sampling line NOTE The message Sampling line blocked may result if you attach the sampling line to the water trap after turning on the monitor 17 3 B30 Patient Monitor Points to note WARNING CAUTION CAUTION WARNING e You can connect and disconnect airway modules like any other modules e For a comprehensive list of accessories see the Supplies and Accessories catalog e Inthe monitoring system use only one module for measuring airway gases e The message Sampling
168. ssages and to clear the beep press the Silence Alarms key once To clear the message field of all the alarms enabling only new upcoming alarm messages press the Silence Alarms key twice To select latching alarms 1 Press the Monitor Setup key 2 Select Install Service and enter the password 3 Select Installation Alarm Options 4 Select Latching Alarms Yes Monitor Installation Setup Alarm Options Show Limits Show Audio ON OFF Alarm Light Latching Alarms Reminder Yolume Alarm Tones Previous Menu Alarm messages remain on screen until Silence Alarms key is pressed gt O So B30 Patient Monitor Reminder volume 1 Press the Monitor Setup key 2 Select Install Service and enter the password 3 Select Installation Alarm Options 4 Select Reminder Volume and adjust the alarm reminder volume with the ComWheel Monito Installation Setup a Alarm Options Show Limits YES show Audio ON OFF WES Alarm Light YES Latching Alarms NO Reminder Volume 5 Alarm Tones I502 Previous Menu Adjust volume of audible gt reminder tone Changing the tone pattern The monitor has three choices of alarming tone patterns ISO ISO2 and General To change the tone pattern Press the Monitor Setup key 2 Select Install Service and enter the password 3 Select Installation Alarm Options 4 Select Alarm Tones and ISO ISO2 or General Monitor Installati
169. ssure labeled Art Gain Delay DC offset Frequency response 1 V mV 10 lt 15 ms 100 mV max 0 05 Hz to 40 Hz 10 mV mmHg 2 lt 35 ms 20 mV max DC to 30 Hz 2 30 The pacemaker pulses have been replaced with 2 ms 20 fixed digital pulses at the ECG analog output A device that fulfils the requirements of the IEC 60601 1 standard can be connected to the defibrillator IABP synchronization connector There are no other limitations because the signals of the connector are galvanically isolated from patient applied part of the ECG and invasive blood pressure measurements System description Synchronization pulse Pulse width 10 ms positive pulse Delay lt 35 ms R wave peak to leading edge of pulse Amplitude CMOS compatible 3 5 V min at 1 mA sourcing 0 5 V max at 5 mA sinking Output impedance 50 ohm Current limit 10 mA Hemodynamic modules E PSM E PSMP ECG Filter modes With 50 Hz power supply frequency monitoring filter 0 5 to 30 Hz ST filter 0 05 to 30Hz diagnostic filter 0 05 to 150 Hz With 60 Hz power supply frequency monitoring filter 0 5 to 40 Hz ST filter 0 05 to 40 Hz diagnostic filter 0 05 to 150 Hz QRS minimum detection level inimum level 0 5 mV with duration between 40 and 120 ms Defibrillation protection 5000 V 360 J Recovery time 5s Heart rate easurement range 30 to 250 bpm easurement accuracy x5 96 or 5 bpm Displays average of 10
170. sult if a sensor is past its useful life Therefore re evaluate the measurement periodically by performing additional assessment of the patient and equipment including consideration of use of alternate monitoring methods such as direct measurement of arterial oxyhemoglobin SaO Conditions that may cause inaccurate readings and impact alarms include interfering substances excessive ambient light electrical interference ventricular septal defects VSD excessive motion low perfusion low signal strength incorrect sensor placement poor sensor fit and or movement of the sensor on the patient Pulse oximetry Pulse oximetry menu Pleth Scale SpO Response Pulse Oximetry Pleth Scale 20 5p Response Normal Beat Sound Volume 3 HR Source AUTD Sp02 Alarm Normal Screen Change size af Plethysmagraph gt by changing scale To auto scale waveform select AUTO If the pleth scale selection is AUTO the scale of the plethysmographic waveform display is automatically set during Pulse Search The scale is then kept constant throughout the case to enable easy detection of changes in the patient s perfusion To adjust the pleth scale further select one of the following 2 5 10 20 50 Auto With automatic AUTO scaling mode the scale changes automatically if the amplitude of the pleth waveform either exceeds the current scale or falls below the maximum value of the next lower scale by 10 for 30 seconds or mo
171. sword in the monitor This function should be operated by a qualified medical personnel only The latched technical alarms do not affect safety and effectiveness of monitor 1 3 B30 Patient Monitor WARNING WARNING 1 4 NOTE This Monitor conforms to particular safety standard for multifunction patient monitoring equipment to IEC 60601 2 49 with the exception of Sub clause 51 103 1 A new technical alarm only triggers a visual indication not the audible alarm During silencing all new alarms for the same reason and all alarms for a different reason are indicated only visually In clinical conditions caregivers are more likely to silence alarms when they consider these alarms quietly cacophony and may distract and overwhelm the clinicians Appropriate visual textual message indicated in B30 still work to direct the caregiver s attention to the unexpected situation when alarms are silenced However the alarm silence function should be carefully used the clinical practitioner should check the monitor s screen frequently during silencing NOTE This Monitor conforms to particular safety standard for multifunction patient monitoring equipment to IEC 60601 2 49 with the exception of Sub clause 51 102 4 New PHYSIOLOGICAL ALARMIS beginning after the activation of SILENCE RESET resume audio visual ALARM manifestations Refer to the exception of Sub clause 51 103 1 for the same performance and warning e
172. t 58 min 58 ai Filters the ECG signal high frequency noise and slow respiratory artifacts Monit monitor filter effectively filters the artifacts caused by for example the electrosurgery unit and respiration STfilt ST filter permits more accurate information of the ST segment It filters the high frequency artifacts caused by the electrosurgery unit but catches the slow changes in the ST segment The ST filter is more susceptible to baseline wander than the monitor filter ECG Pacemaker Grid 5 lead cable V Lead Diagn diagnostic filter is used if more accurate information of the waveform is needed for example of the P wave or AV block The diagnostic filter is more susceptible to both high frequencies and baseline wander than the monitor filter Selects how to display the pacing spike of cardiac pacemaker The selections are Hide The pacing spike is filtered away from ECG data Show The pacing spike is filtered away from ECG data but the spike is displayed as a constant height marker Sensit This selection uses a more sensitive pacemaker detection Pacing spike is displayed on ECG Selects the ECG gridlines to be displayed or not If you select ON you can view the ECG waveforms over gridlines Selects five or three electrodes Selects the label for V lead according to the placement of the 5th electrode see Placing the electrodes on page 11 3 NOTE Selectable with the 5 lead trunk cable
173. t inserted Y Monitor is battery e green lit powered Batteries are fully charged the size of O orange dark the green bar indicates E the charging level Monitor is battery e oren lit powered Battery A is A t empty battery B charge O orange dark is ok Monitor is battery e green lit powered Battery A S be E failure battery B is full orange flashing NOTE If both batteries fail the green battery LED is dark Monitor is mains green dark powered Battery A is E being charged white o orange lit bar battery B is already charged Monitor is mains green dark no screen symbol powered No battery NY backup message on 7 orange flashing 2 13 B30 Patient Monitor Checking the battery charge when the monitor is turned off When the monitor is turned off you can check the battery charging level by pressing the test button on the battery as indicated in the drawing on the left The charging indicator bar 1 lights up and the number of lit segments indicates the charging level the more lit segments the higher the charging level Y Figure 2 12 Charging indicator on the battery Replacing the batteries Check the monitor indicators regularly to see if either one of the batteries needs to be changed Battery capacity indicators in the upper right corner tell you when you should replace a battery and which one is out of charge missing or not working You can replace one ba
174. t Fields Lower Field 1 Resp More Lower Field 2 MIEP coz Lower Field 3 T1 T2 Lower Field 4 oo2 Temp Previous Menu T1 T2 Ti T2 ErrLag Battery Hore Change contents of lower digit field 1 Select OFF to clear field OFF More oo2 Resp Temp T14 T2 T1 T2 Changing the digit field may also change the waveform field setup If you choose the same measurement in the digit field that is currently in the waveform field this measurement is removed from the waveform field If a digit field is turned OFF the remaining digit fields are enlarged to fill the space Monitor setup Modifying split screen You can split Normal Screen so that one part continuously displays trend data To select a split screen view 1 Press the Monitor Setup key 2 Select Screen Setup 3 Select Split Screen and choose from the options Trend or None BTEP DOWN 14 26 ECG Arh H analys B 88 Severe min los P886 an 1 iw Slam 28 y5 T I 2 8 28 titan E n 3 Pleth 2 Ali p 2 R Cle Je p min zalk C oer 5 0F 0 0 2 LU i 15 min 4 28 81 91 i 12 12 11 Manual 38 8 20 5 18 3 Figure 5 3 Split screen view Modifying the minitrend length You can choose to view minitrend data from the last 5 minute or 30 minute period next to the parameter s waveform field The 5 minute minitrend is updated every 10 seconds and the 30 minute minitrend
175. t the pressure is stable during stasis Non invasive blood pressureis selected to be displayed through Monitor Setup Screen Setup 16 9 B30 Patient Monitor 16 10 Table of contents Table of contents 17 Airway gas CO2 17 1 eI LI A A ae hah A RA eee 17 1 MA e EL e a e LU DM A MY E 17 1 DISDIGUNGE OASES nr etn Werben we Reen ee ra 17 2 Patientconnectonst ttds eere an re 17 3 A E An 17 4 COZ SELUDIMENU ssa seanae erat aasacatrehiiesesan evr enuis ARA betas taeda Anken pits 17 5 Selecting o een eene ed 17 5 Calibrating adie A A ended deden red 17 6 EEEN GG dass nl cc cedo ds aen le dee lat ene di 17 8 Unit CONVEFSIONS Tran verdere edet as 17 8 CREEKIS ERE o OREN EEEN REE 17 9 Table of contents Airway gas CO2 17 Airway gas CO2 Overview With the N FC and N FCREC modules you can measure and monitor the gases being delivered to the patient and exhaled by the patient The modules are equipped with a water separation system and they measure only CO Respiration rate is the frequency of peak end tidal CO measurements per minute A breath is defined as a change in the CO signal which exceeds 1 8 mmHg All concentrations are measured and displayed breath by breath Module description The airway gas measurement is housed in the N FC and N FCREC modules You can connect and disconnect airway modules like any other modules 1 2 3 4 5 1 2 3 4 5 6
176. tab When detaching modules be careful not to drop them Always support with one hand while pulling out with the other System description Using two modules Figure 2 10 Using two modules NOTE You can use one E PSMIP W and or one N Fx module in the monitor at a time To install an E PSM P W and an N Fx module 1 Insert the N Fx module first see Inserting and removing a module page 2 8 2 Attach the E PSM P W to the N Fx B30 Patient Monitor Keyboards You can control monitoring through the keys on the Command Board and side panel module For more information see section Monitoring basic Command Board keys Normal Screen Figure 2 11 Command Board keys and LED indicators 1 ON standby key 2 Mains power ON lit or OFF dark indicates mains or external DC power 3 For admitting or discharging a patient for selecting user modes 4 For viewing trends and alarm history 5 For activating parameter specific menus NOTE All modules do not measure all of these parameters For more information see Module overview on page 2 4 6 For returning the Normal Screen view to the screen 7 For activating pulse oximetry impedance respiration and temperature setup menus 8 For printing and recording different trends and waveforms 9 For setting up the monitor and for activating the HELP menu 10 Battery operation LEDs see Batteries on page 2 1
177. te 3 1 Patient Side Module E PSMPW one eren En t e RR ER Reo REN woe eat 3 2 Module with built in recorder N FREC s 3 ccrta o te qr te oce Qeon I ada ieee treated 3 2 Module with CO measurement and built in recorder N FCREC 0 cee eee eee 3 3 Module with CO measurement Nori RU VERRE VR EXER EAR 3 4 Command BOE Eerde A A ute 3 4 Command BOA RENS rod de a de dl Mel o e do 3 5 Side panel RENS tse onee A IN oa 3 6 MAS ene a es E RUPEE 3 7 SLE SAE AN ds ela erde Den ede 3 10 preparations At stool LA ue And it ol a ne e E 3 10 starting MOMtOnAG nt zem ae to ek end a a ty 3 10 Entering and loading patient data nnn vereren seal alde paa x 3 11 DURAS MOROS lane te eei tete vu uta 3 11 Automatic discharge of the patients C oa cd ges PRODURRE OC CPGE dae ade 3 11 ate lao ale en 3 11 Table of contents Monitoring basic 3 Monitoring basic Principles You can control monitoring of the B30 patient monitor through the keys on the Command Board side panel and modules Module keys and side panel keys control a set of the most often used functions while the Command Board keys give access to all functions Modules and module Keys The module keys start or end a function immediately They are designed to make the most common monitoring tasks easier and quicker to use The accessories have to be plugged to the respective module before module keys become operative Refer to System description on page 2 1 for detail
178. tents Table of contents 13 Temperature 13 1 CVEIVIBU Suey badd A AAA A AA 13 1 Module descPDEIO Ie ao erri od cce ivt alge A MOM M TA tds coe ee A Lu MU 13 1 Displauird tele atte ss ese eee QURE ISl e og oet 13 2 PORE MECOMMECTIONS ava vac bee Ae oce SO GE Rc de Oe en ice mA RO AG x dieses 13 2 Temp Setup MEA zie dtt de hU E eR a d e Urano Debora 13 3 Changing temperature label series resarcir asa contrarias Bebe er Reda sas 13 3 Combining different temperatures e oe o e le t e Ei 13 4 Testing temperature Puss eth aste de edet eat ome de laden sh ss eer tds 13 4 Chenging temperature HIIS arran dat less y at o Le ies y e Cel ce ettet nn 13 4 vat rai pute ea arg edna entei 13 4 Table of contents Temperature 13 Temperature Overview You can simultaneously measure and monitor temperature of two sites by using one of the hemodynamic multiparameter modules E PSMW or E PSMPW As a measuring probe use only GE Healthcare temperature probes or defibrillator proof YSI 400 series probes You can measure for example esophageal nasopharyngeal rectal and skin temperature NOTE Monitoring of perioperative body temperature is recommended when inducing hypothermia or if unexpected temperature changes occur Module description Temperature measurement is included in the hemodynamic multiparameter modules E PSMW and E PSMPW With a dual temperature adapter cable you get a two channel measurement NOTE Do not use iden
179. test user made settings remain in the monitor memory for 15 minutes even if the power mains or external DC is interrupted After 15 minutes trend data is lost and the monitor returns to the user default settings start up mode 10 1 B30 Patient Monitor Messages Table 10 1 Messages Message Explanation What to do Air leakage Air leak in cuff or hose e NIBP Check all connections and test tightness using Venous Stasis Alarms acknowledged from Central Silenced alarms remain silent New alarms will have an audible sound Can be done using the Central If required turn on the alarms through Alarms Setup Audio ON OFF Activate Alarms Alarm setup changed from Central Alarm limits or arrhythmia alarm priorities have been changed using the Central e Check the alarm limits and the arrhythmia alarm priorities see Alarms and Troubleshooting Alarms silenced from Central Alarms have been silenced using the Central e f required turn on the alarms through Alarms Setup Audio ON OFF Activate Alarms Apnea No breath detected for 20 seconds e Check the patient status e Check the ventilator and breathing circuit Apnea deactivated The case has just been started or the measurement has just been activated and apnea alarm is not active yet It will activate after 5 breaths e The message will disappear after the monitor detects three breaths
180. the Software in confidence and shall protect the Software with at least the same degree of care with which Licensee protects its own similar confidential information but in no event less than a reasonable standard of care Licensee agrees that its officers and employees shall protect the confidentiality of the Software and all confidential and non public information relating thereto and shall not disclose such information to any third party This obligation of confidentiality shall survive the termination of the Software License Licensee agrees to comply with all applicable export and re export restrictions and regulations imposed by the government of the United States or of the country to which the Software is shipped to Licensee Licensee shall not commit any act or omission which will result in a breach of any such export requirements Licensee shall defend indemnify and hold GE and all GE s suppliers harmless from any claims arising out of Licensee s violation of such export control laws Upon termination by GE or its suppliers of this Software License Licensee shall as advised by GE immediately destroy the Software and all copies thereof or return the same to GE and within two 2 business days thereafter certify to GE in writing that in accordance with instructions from GE or its suppliers all copies of the Software have been either destroyed or returned to GE whether same is in tangible or intangible form and Licensee shall further certify
181. the monitor and the patient carefully during start up periods and when inserting modules During monitoring e Ifyou need to avoid audible alarms press the Silence Alarms key e Empty the water trap container of the N FCREC or N FC module whenever it is more than half full Automatic discharge of the patient The monitor will discharge a patient automatically after 24 hours when vital signs for some parameters ECG Art NIBP SpO Resp and CO with N FCREC and N FC only are not available When this happens all trend data will be cleared and alarm limits will be set to default values Ending monitoring 1 Print necessary data Pressthe Print Record key 2 Wait until the printing is finished Then clear patient data and return settings including alarm limits to their defaults by discharging the patient Press the Admit Discharge key Select Discharge and Yes 3 Turn off the monitor from the ON standby key if the monitor will not be used Clean the monitor according to the instructions see section Cleaning and care Using modes The B30 monitor has six user modes These user modes are predefined combinations of settings They determine for example what is displayed on the screen and in trends and what the alarm limits are In other words by choosing a specific mode you get suitable settings on the screen without having to choose all features one by one Modes can be hospital specific The monitor st
182. tical modules in the same monitoring system simultaneously To monitor temperature select E PSMW or E PSMPW module E PSMW E PSMPW Temperature connector Figure 13 1 Modules for temperature measurement B30 Patient Monitor Displaying temperature eC Ti 8 Es 1 38 8 T2 T CE 12 20 5 18 3 Figure 13 2 T1 T2 digit display 1 Labels 2 Temperature measurement value 3 Calculated T2 T1 difference The other options are individual T1 and T2 readings in a digit field Patient connections rex big Figure 13 3 Temperature measurement setup 1 E PSMW or E PSMPW module 2 Adapter cable for temperature probes 3 Reusable temperature probe 4 Adapter cable for disposable temperature probe 5 Disposable temperature probe To connect the patient 1 Attach the temperature probe to the patient 2 Connect the adapter cable to the module connector NOTE For a comprehensive list of accessories see the Supplies and Accessories catalog Temperature Temp Setup menu ones gt Others Sp02 Setup Resp Setup Temp Setup Normal Screen Others Temp Setup T1 Label T2 Label Unit Temp Alarms Previous Menu Set labels and alarms T1 2 Label Allows you to label each temperature measurement site Unit Allows you to select the units to be either degrees Celsius or degrees Fahren
183. tion Alarms Setup ALARM LIMITS AND 10 KIN TRENDS Audio ON OFF Activate Alarms Silence Apnea Silence ECG Silence ALL Previous Menu Silence audible apnea CO2 respiration rate and ECG alarms permanently Select one of the following e Silence Apnea Silences apnea and disconnection alarms as well as CO respiration rate low Ppeak PEEP and minute volume limit alarms permanently e Silence ECG Silences arrhythmia alarms and also HR limit alarms e Silence Apn ECG Silences both of the above e Silence ALL Silences permanently all alarms except FiO 1896 Ppeak gt 70 cmH O A Selecting a choice displays a warning symbol for example AES If an active alarm is silenced the monitor gives a reminder beep every two minutes You can adjust the volume of the reminder beep through Monitor Setup Install Service Installation Alarm Options Reminder Volume a password is required for this operation For more information see Reminder volume page 4 16 Reactivating alarms e Select Alarms Setup Audio ON OFF Activate Alarms to turn on audible alarms Alarms Deactivating alarms You can set the alarm limits temporarily to OFF for the following parameters HR SpO and respiration rate This way you can silence a parameter without having to adjust the alarm limits 1 2 3 4 Press the Alarms Setup key Select Adjust Limits Turn the ComWheel to highlight the measurement and p
184. tomatically collects and saves patient data such as trends Saving is activated once the patient is admitted or the monitor receives vital data If the monitor is not connected to the network patient data is saved to the monitor memory If the monitor is connected to the network patient data is automatically saved to the network The network saves data from up to 2 to 90 days The amount depends on the network configuration Discharging the patient When you end monitoring discharge the patient The monitor erases screen layout trend data and alarm and parameter settings that were active during monitoring and returns to the starting mode and its settings 1 Press the Admit Discharge key 2 Select Discharge Yes NOTE Please wait the message discharged appear in the screen then turn off the monitor if you need and please wait about 30 seconds at least to power on 7 3 B30 Patient Monitor 7 4 Table of contents Table of contents 8 Printing and recording 8 1 CIUGIVIBU o ess d peribit NOE AAA AS dede tee ded a 8 1 RECOrdINO RM CE Se fex Ee EN RT EMR TE O e de E O LU NUT AM td 8 1 RECO PUES OA A tet nen Cactus a acte anie C o dm MALA E RE M 8 1 Side Dahel Reese sd Cr s tete s ou Oo sc EE t E pru ee 8 1 Recording ANS rene PME Fr 8 2 Selecting waveforms for recording uou ane patet ot eto Had SERERE MU Op 8 2 Changing The ppl sped secutus iiim et aS ens AD A EE UR MM ASESOR ae 8 3 Controlling the recording U
185. tor collects graphical and numerical trend data automatically from trended variables You can select the trend time between 20 minutes and 72 hours You can view the trends through Pt Data Trends Trends or you can select graphical minitrends to be displayed continuously next to the waveform fields Monitor Setup Screen Setup Split Screen Trended parameters Electrocardiography HR ST nvasive pressures Non invasive blood pressure Oxygen saturation Pleth SpO Gases CO Resp Impedance respiration Resp Temperatures Trend data is stored in the memory for 15 minutes after the power has been turned to standby 6 1 B30 Patient Monitor Most common tasks 6 2 Displaying trends and activating the Trends menu Press the Pt Data Trends key and select Trends The most recently displayed trend graphical or numerical is displayed together with the Trends menu Scrolling time with trend cursor i Turn the ComWheel to move the cursor to the time you want Numeric measurement values of that time are displayed in the graphical trend next to the cursor Push the ComWheel to return to the menu Scrolling pages to see more parameters Select Scroll Pages and turn the ComWheel to move from one page to the other Changing the time scale Select Time Scale Select the trend time 20 min or 1 2 4 6 8 10 12 24 36 48 72 hours Selecting numeri
186. ttery at a time To replace a battery Figure 2 13 Inserting a battery 1 Open the lid of the battery compartment located behind the handle by sliding it to the left 2 Lift up the battery you want to change Check the indicators and messages on screen to make sure that you change the battery with lower charge 3 Push in the new battery Make sure that the charging indicator is facing forward and push the battery down all the way Check the monitor indicators CAUTION After replacing a battery always make sure to close the battery compartment by sliding the lid back to the right until it clicks System description WARNING Do not incinerate a battery or store at high temperatures as it will explode Conditioning a battery Batteries should be conditioned regularly to maintain their useful life Condition a battery every six months when its run time becomes noticeably shorter or when the message Condition Battery x appears on the screen Conditioning a battery is best done on an external charger Please refer to instructions provided with the charger If you do not have an external charger see section Cleaning and care Conditioning a battery Symbols and abbreviations Equipment safety symbols Attention consult accompanying documents N Onthe modules or frames indicates that modules with identical measurements should not be used in the same monitor If such modules have been inserted remove t
187. udio ON OFF Resp eg 0 Remove Henu ps GQ Normal Screen Push Comheel 34 0 gt to adjust alarm Temp limits manually 4 Tl 1 List of selections 2 Exit from the alarm limit adjustment area back to Alarms Setup menu 3 Parameter box with high and low limit values and a 10 minute trend showing the current status Adjusts individual measurement alarm limits You can also access the adjustment menu through each parameter menu NOTE If the monitor is connected to the network the alarm limits can also be changed using the Central if this feature has been enabled in its configuration Auto limits are calculated from the displayed patient reading at the time when auto limits are selected Sets the alarms to the default alarm limits NOTE Default limits can be changed and saved to modes For more information see the Default Configuration Worksheet Cancel Changes Returns all the limits to the ones set before entering the Alarms Setup menu if you have not Arrh Alarms exited the menu uet Opens a menu to select and adjust Severe arrhythmia analysis Alarm priorities can be configured in this menu Adjust defines the alarm priorities red yellow white off NOTE You can only set the priority for V Tachy NOTE V Tachy alarm cannot be selected OFF NOTE Alarm priorities can also be set using the Central depending on its configuration To redisplay the Alarms Setup menu select Alarms Setup For more informati
188. ue in part to the accessories for pulse oximetry SpO temperature T and invasive pressure P measurement Single use accessories are not designed to be re used Re use may cause a risk of contamination and affect the measurement accuracy The monitor or its components should not be used adjacent to or stacked with other equipment If adjacent or stacked use is necessary the monitor and its components should be observed to verify normal operation in configuration in which it will be used B30 Patient Monitor e When detaching modules be careful not to drop them Always support with one hand while pulling out with the other e _ If you accidentally drop the monitor or modules have them checked by authorized service personnel prior to clinical use e Ifthe integrity of the external protective earth conductor arrangement is in doubt use the monitor with battery operation e Vibrations during intrahospital transport may disturb SpO ECG impedance respiration InvBP and NIBP measurements e Ifthe unit fails to respond as described do not use the monitor until tested and repaired by authorized service personnel e The system is intended for use by qualified medical personnel only e When using the electrosurgery unit ensure proper contact of the ESU return electrode to the patient to avoid burns at monitor measurement sites e Make sure that the leadwire set clips or snaps do not touch any electrically conductive materi
189. uo Road Tel 1414 355 5000 Germany Shanghai 201203 P R China 1800 558 5120 US only Tel 86 21 3877 7888 Fax 1414 355 3790 Fax 86 21 3877 7451 GE Medical Systems Information Technologies Inc 8200 West Tower Avenue Milwaukee WI 53223 USA GE Medical Systems Information Technologies a General Electric Company going to market as GE Healthcare www gehealthcare com 0459
190. urpura skin avulsion compartmental syndrome ischemia and or neuropathy To minimize these potential problems especially when monitoring at frequent intervals or over extended periods of time make sure the cuff is applied appropriately and examine the cuff site and the limb distal to the cuff regularly for signs of impeded blood flow NOTE The NIBP parameter conforms to IEC 60601 2 30 with the exception of Sub clause 51 103 Both non latched and latched alarms are selectable for technical alarms Refer IEC 60601 2 49 item for monitor s performance and warnings NOTE The NIBP parameter conforms to EN1060 1 with the exception of Sub clause 5 Abbreviations Mean used instead M or MAP The word Mean is used in monitor instead of M or MAP as the value for the NIBP pressure mean average The clinical practitioner can understand Mean is the abbreviation of NIBP pressure mean average The B30 monitor is intended for use by qualified medical personnel only e The alarm systems of the Monitor conform to IEC 60601 1 8 with the exception of Sub clause 6 3 3 1a NOTE 1 5 B30 Patient Monitor 1 6 The alarm systems of the Monitor conform to IEC 60601 1 8 with the exception of Sub clause 6 3 3 1a An ALARM SYSTEM provided with auditory ALARM SIGNALS shall have at least one set of ALARM SIGNALS The characteristics of auditory alarm signals are different from IEC 60601 1 8 requirement
191. ush the ComWheel to change the selection Off The symbol yd appears in the digit field When you select the alarm limit ON again the previous alarm limits will be active Automatic recording on alarms An automatic local recording is possible when Asystole Tachy Brady Art High Low V Fib or V Tachy alarms reach the red alarm level When the red alarm level is reached the recorder prints the ECG Art waveforms T3 2 3 Press the Print Record key Select Record Waveforms Select Start on Alarms and Yes Record amp Print Record Waveforms Record to Met Record ta loca Waveform 1 Waveform 2 Waveform 3 Start on Alarms Delay Paper Speed Length Previnus Menu Select YES for automatic start of recording when serious arrhythmias occur B30 Patient Monitor Recording time is 30 seconds consisting of 12 seconds recording from the recorder memory and 18 seconds real time recording The alarm source is always marked to the alarm recordings The following alarms start the recording Alarm Recorded parameters Asustole ECG1 Art waveforms 25 mm s Tachy Brady ECG1 Art waveforms 25 mm s Art High Low ECG1 Art waveforms 25 mm s V Fib ECG1 Art waveforms 25 mm s V Tachy ECG1 Art waveforms 25 mm s V Run gt 3 ECG1 Art waveforms 25 mm s Alarming level Alarms which start the recording Severe Asystole Tachy Brady Art High Low V Fib V Tachy Showing
192. ust be well aerated in a ventilated place A damaged sensor or a sensor soaked in liquid may cause burns during electrosurgery To prevent erroneous readings do not use physically damaged sensors or sensor cables Discard a damaged sensor or sensor cable immediately Never repair a damaged sensor or cable never use a sensor or cable repaired by others Allow the sensor and cable to dry completely after cleaning Moisture and dirt on the connector can affect the measurement accuracy Temperature probes e Clean with mild detergent solution and rinse with water e Disinfect or sterilize when necessary NIBP cuff hose e The cables and hose can be wiped with mild detergent solution e Disinfect when necessary NIBP cuff The NIBP cuffs listed in the Supplies and Accessories catalog are latex free Take possible patient allergies into account also when selecting the cleaning agent 9 5 B30 Patient Monitor WARNING CAUTION 9 6 e Clean only when necessary Wash the cuff in mild detergent solution Do NOT use alcohol Invasive blood pressure cables e Wipe the cables with sterile alcohol based detergent After cleaning rinse surfaces by wiping them with a cloth damped with sterile water Dry with a dry cloth Invasive blood pressure transducer Mechanical shock to the invasive blood pressure transducer may cause severe shifts in zero balance and calibration and cause erroneous readings Airway adapter e Replace th
193. ution is five minutes Moving between numerical trend pages Use the ComWheel to scroll the trend in vertical direction When the highlight reaches the top or the bottom of the view next five minutes of information appear Recording and printing Recording Parameters for recording are chosen during configuration To change the parameters see section Monitor setup 1 Press the Print Record key 2 Select Record Trends 3 Select Record Numerical Printing 1 Press the Pt Data Trends key and select Trends 2 To print all the numerical trend data select Numerical Print Page Factory default parameters You cannot change the contents of numerical trend fields The parameter units follow the real time waveform settings of each parameter Page 1 Vital parameters Mark Time HR SpO2 NIBP NIBP Art Art CVP CO2 sys dia mean sys dia mean mean ET Page 2 Hemodynamics Mark Time P1 P2 C O REF PCWP Art CVP Page 3 Gases Mark Time CO2 RR ET FI Page 4 Temperatures and saturations Mark Time T1 T2 Tblood SpO2 SvO2 Trends Erasing trend data Trends are erased when you discharge the patient 1 Press the Admit Discharge key 2 Select Discharge 3 In the opened window select Yes to erase the trends and to discharge the patient gt Admit Discharge Admit Patient Select Mode Discharge N
194. vered with the monitor If you accidentally drop the monitor modules or frames have them checked by authorized service personnel prior to clinical use Connect only one patient to the monitor at a time Do not use the monitor without manufacturer approved mounting attached 2 1 B30 Patient Monitor WARNING Before starting to use the system ensure that the whole combination complies with the international standard IEC 60601 1 1 and with the requirements of the local authorities Do not connect any external devices to the system other than those specified CAUTION The monitor display is fragile Ensure that it is not placed near a heat source or exposed to mechanical shocks pressure moisture or direct sunlight Components The main components of the B30 are the monitor frame and the interchangeable modules Figure 2 2 B30 monitor front panel 1 Battery compartment 2 Transportation handle 3 Alarm light 4 Alarm LED indicators 5 Side panel keys 6 The ComWheel 7 Command Board keys 8 Guide rail for GCX mounting 9 Mains power and battery LEDs 10 ON standby key 11 Defibrillator amp IABP synchronization connector marked with X5 12 Measurement modules see page 2 4 You can use one E PSM PJW and or one N Fx module in the monitor at a time System description Optional components Optional components are Patient Side Modules E PSMW and E PSMPW Extension Module
195. ways indicates a 1 Q reference Impedance respiration Correcting the respiration number Normally we recommend the use of the AUTO detection limit However in some specific cases you may wish to adjust the limits manually When the respirations are weak you can manually adjust the detection limits measurement sensitivity closer to each other to ensure that all respirations are included in the RR value In this case the dotted line represents the absolute detection limits When there are lots of artifacts the grids can be adjusted further apart to separate smaller artifacts from larger true respiration peaks The small peaks fall within the grids and are not calculated while the bigger peaks cross the grids and are calculated as true respirations To ensure the correct respiration number adjust the limits closer to each other 1 Press Others 2 Select Resp Setup Detection Limit and adjust the limit gt Others Resp Setup Size 4 3 Resp Rate Source AUTO Measurement OFF Detection Limit AUTO Resp Rate Alarm Previous Menu Select detection limit of impedance respiration b AUTO will adjust to sianal The percentage is the ratio to the 1 Q reference bar which is 100 15 7 B30 Patient Monitor Measurement limitations Movement artifacts Changing position moving the head moving the arms or shivering may result in movement artifacts Also the heart may cause noticeable movement
196. y GE or altered by anyone other than GE or if the Product has been subject to abuse misuse negligence or accident GE s sole and exclusive obligation and Buyer s sole and exclusive remedy under the above warranty is limited to repairing or replacing free of charge at GE s option a Product which is telephonically reported to the nearest GE office or GE s Authorized Dealers office and which if so advised by GE is thereafter returned with a statement of observed deficiency not later than seven 7 days after the expiration date of the applicable warranty to the GE office or GE s Authorized Dealers office during normal business hours transportation charges prepaid and which upon GE s examination is found not to conform to the above warranty GE shall not be otherwise liable for any damages including but not limited to incidental damages consequential damages or special damages There are no express or implied warranties which extend beyond the warranty hereinabove set forth GE makes no warranty of merchantability or fitness for particular purpose with respect to the product or parts thereof Table of contents Table of contents About this manual O OANA NKWN ES e e e O PRPrPPP nom UI NM 17 Safety precautions System description Monitoring basic Alarms Monitor setup Trends Patient data management Printing and recording Cleaning and care Troubleshooting ECG Pulse oximetry Temperature Invas
197. y capacity intracranial pressure intensive care unit identification impedance impedance respiration inch inferior inflation limit inspiratory invasive invasive blood pressure irregular isoflurane International Standards Organisation Industrial Scientific and Medical intrathoracic blood volume idioventricular rhythm joule kelvin kilocalorie kilojoule kilopascal leg describing location left describing location liter liters minute laboratory local area network left atrial pressure B30 Patient Monitor Lat LCD LCW LED LVEDP LVEDV LVSW LVSWI MAC Max mbar mcg Mean mEq MetHb MF mg min Min ml MLAEP mmHg mol Monit MRI Mult Multif PVCs MV MVexp MVexp BTPS MVexp STPD MVinsp MVspont Myo N2 N0 Na Naso neo Net lateral pound liquid crystal display left cardiac work light emitting diode left ventricular end diastolic pressure left ventricular end diastolic volume left ventricular stroke work left ventricular stroke work index minimum alveolar concentration maximum millibar microgram mean blood pressure milliequivalent methemoglobin median frequency milligram minute minimum milliliter middle latency auditory evoked potential millimeters of mercury mole monitoring ECG filter magnetic resonance imaging multiple multifocal PVCs minute volume expired minute volume l min expired minute volume in BTPS
198. ysician Display of ST pan i Fay 1 3 Ta it A P Keun S aVR S v T 28 ji ILI 6 v y w l 4 1 3 j Figure 11 6 ST number field 1 Message field 2 ST values of ECG1 ECG2 and ECG3 3 Fourth ST value showing the largest absolute ST value 4 Lead label NOTE ST segment deviations are not displayed if the patient has a ventricular pacemaker in use Monitoring the ST segment The monitor analyzes ST for all measured leads and gives ST trends separately for each lead Numerical ST data is shown to the right of the second real time ECG waveform field You can also select numerical ST data to the lower digit field Press the Monitor Setup key and select Screen Setup Digit Fields Select ST data to the field you prefer The ST analysis starts automatically after the leads have been connected and the QRS detection has started During a learning period of 32 accepted beats the median ST values are displayed Also when the cable or the V lead is changed or when an electrode is removed or relearning is started manually the monitor starts to learn the ST segment NOTE If the patient has an atrial pacemaker ST calculations can be performed if the pacer spike does not coincide with the ISO point s adjustment range 11 11 B30 Patient Monitor Setting the ST measurement points 11 12 Automatic setting of the J ST and ISO points The ST algorithm automatically searches for the

GE B30 Patient Monitor - Frank`s Hospital Workshop

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