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Vital Signs Monitors Operations Manual

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2. Module hose is disconnected Connect internal hose or replace or defective Module cable has become Check connections of NIBP module cable disconnected Module is defective Replace NIBP module Main Board is defective If any of the DC power lines to the NIBP module are not present replace the main board NIBP Initializing Message shown Cause Solution Loss of communication Cycle power OFF wait ten seconds and then power back ON and see if message clears Technicians only Module cable has become Check connections of NIBP module cable disconnected Module is defective Replace NIBP module Main Board is defective If any of the DC voltages to the NIBP module are not present replace the main board 8 5 Abnormal readings If the machine feels that the NIBP measurement could have been influenced by motion vibrations or arrhythmia a is placed to the left of the measurement values shown on the LCD Vibrations such as shivering Please assess the patient s condition then start the Arrhythmia or noises including measurement again bodily contact or motion or Cardiac massage during a measurement Cuff placement or positioning Verify the appropriate cuff is selected for the patient Apply the cuff as specified in the Operations Manual To verify a suspect measurement value initiate another measurement placing your stethoscope under the cuff and watching the cuff pressure shown in the MAP d
3. SYSM CHECK CLOCK RTC potential problem Reset Time through System Setting Screen SYSM BATTERY NEAR Battery below 10 Charge battery EMPTY SYSM BATTERY Internal Temperature gt Cool down unit Replacement battery is TEMPERATURE 50 C needed SYSM FACTORY System returned to None if user selected factory defaults If DEFAULTS factory default settings monitor shows this indication frequently replace main board SYSM FAILURE xxxx ROM Check Sum error Replace Main Board Printer Related Messages Message Shown Action Required ras PRNT PAPER EMPTY Printer paper empty Insert a full roll of printer paper PRNT INTERNAL ERROR Printer Failure Remove any obstacles from printer including paper jams reset power Replace main board or printer as required E Temp Related Messages Message Shown Description Action Required TEMP PROBE FAILURE Defective E Temp Probe Cycle power of unit ON and OFF if failure continues replace probe TEMP PROBE DISCONNECT E Temp Probe is Check connections and hose replace if disconnected or defective necessary TEMP INTERNAL ERROR E Temp Module Failure Contact Life Systems Technical Services 8 10 NIBP Related Messages Message Shown Action Required NIBP CHECK FOR LEAKS Pressure in cuff did not Check cuff and hose connections for air reach specified value leaks within 30 sec within 10 sec for neona
4. Measurements are not displayed Cause Solution Address each condition according to facility protocol Model Wrong Verify selection of Model configuration in the Service Menu Perfusion has reduced Verify appropriate perfusion of sensor site Strong ambient light Drape the sensor site to shield it from light source Probe or Cable are defective Replace and retest Technicians only SpO2 Interface cable is defective Replace cable and retest SpO2 Module is defective Replace SpO2 module Main Board is defective Replace Main Board Unable to measure Cause Solution Assess patient condition Patient may have peripheral circulatory dysfunction caused by shock hypotension or arterial infarction of the probe area Sensor Type The unit is designed to work with Nellcor OXIMAX sensors only Sensor placement Verify appropriate positioning and placement of sensor Sensor is too tight Loosen sensor on site Sensor on same arm as Cuff Move sensor to the other arm Sensor placed on same arm Choose another sensor site as I V or A line 8 8 Readings are unreliable Cause Solution Address each condition according to facility protocol Other pulsations exist Blood alterations other than normal including cardiac massage external noise vein pulsations and convulsions may cause fault in readings Probe applications Verify appropriate probe selection and placement for patient Carbon Monoxide This pulse oximeter ha
5. indicator LED Temperature measurement LED Cuff Start Stop Button Temp unit of measure Pulse Rate measure LED gt Temp Mode indicator LED TIME SYS DIA MBP PR SpO2 TEMP Temperature probe well o N Pulse Level Indicator Up Control Button Power On LED Power ON OFF Control SE AAS yy Battery Charging Indicator OK Select Button Down Control Button LCD screen Soft Keys 25 Front Panel Description clockwise from upper right Cuff Mode Indicator A yellow LED light indicates the mode of operation for the NIBP parameter Adult Pediatric de or Neonatal BP Measurement Large YELLOW LED numbers show the current Systolic Diastolic and Mean blood pressures The cuff pressure is shown in the mean blood pressure MBP window during the measurement cycle and final values appear follow deflation BP Unit of Measure Indicator YELLOW LED light identifies the selected unit of measure of blood pressure values mmHg or kPa Cuff Measurement in Progress Indicator When lit this GREEN LED indicates that a blood pressure measurement cycle is in progress There may be a slight delay up to 30 seconds between the indicator lighting and beginning of cuff inflation Cuff Start Stop Button When pressed this button initiates cuff inflation or stops a blood pressure measurement cycle already in process and deflates the cuff Pulse Rate measurement A RED LED nu
6. Predictive Mode 35 0 41 1 C 95 106 F Monitoring Mode 26 7 42 2 C 80 107 9 F When tested with the thermometer in the Monitoring Mode and using the oral probe Alaris PN 2887A in a calibrated water bath 0 1 C or 0 2 F Selectable from C to F Type BF Defibrillator Protected 12 2 12 5 Recorder Specifications Method Resolution Paper Width Thermal Array Recorder 8 dots mm 58mm 54mm printable Life Systems Technical Services 800 841 1109 12 3 LIFE SYSTEMS INC CORP 7320 CENTRAL AVENUE SAVANNAH GA 31406 800 841 1109 www LifeSystemsonline com Copyright November 2007 12 4
7. SCREEN TOL UPDATE CHANGE gt MAIN 3 3 3 2 1 Setting the Alarm Limits When you enter the Alarms Screen the cursor automatically appears over the Systolic High alarm limit To move the cursor press the OK E Button until the cursor rests over the parameter value you want to change To change the set value press Up or Down Y The possible value ranges for each alarm limit are shown in the table below Parameter Lower Limit Range Upper Limit Range of increments of increments Systolic mmHg OFF 20 160 50 240 OFF 10 10 10 10 10 10 PR bpm OFF 30 295 35 300 OFF 5 5 SpO OFF 50 99 51 100 OFF 1 a Body Temperature F MO 80 0 107 0 OFF 1 The alarm limits must retain their respective relationship that is the lower limit must remain below the upper limit The values will change according to the unit of measure selected a monitor set to show blood pressure in kPa will show alarm limits as a kPa range temperature ranges will be shown in degrees F or degrees C in resolution of 1 degree 3 2 2 Using Pre Set Alarm Limits The Rosie monitor can be set to store alarm protocols determined by your department See section 3 2 to use this feature To use the pre determined alarm limits press the Auto Update Soft Key from the Alarms Screen The tolerances are normally generic tolerances selected by the appropriate personnel
8. used blood infusion protocol for training purposes though it can be modified by following the steps on page 3 6 3 6 Note Resetting Factory Defaults in the Service Screen Mode erases all operator designed dynamic cuff programs and resets program E to the factory pre set blood infusion program Cuff Interval Screen CURRENT ID MIKE WALLACE 123458 INTERVAL 2 MIN CUFF MOTION ARTIFACT 150 11 06 PREV STOP VIEW STAT SAVE SCREEN PROGRM MODIFY gt MAIN Pressing the Cuff Soft Key under the Line List Main screen brings up the Cuff Interval Screen on the LCD display The currently selected cuff interval will appear in the window Press the Up or Down Y Buttons to change the interval To select one of the user designed dynamic timed interval programs A B C D E continue to press the Down Y button past the 1 min interval Press the Save gt Main Soft Key to save the new input and return to the Line Listing screen Pressing the STAT Soft Key from the Cuff Interval Screen the screen will revert back to the Main Line List screen and continuous blood pressure measurements will be taken for five minutes after which time the monitor will automatically revert to 3 minute cuff intervals Pressing the STOP PROGRAM Soft Key inactivates all interval settings and the cursor automatically moves over OFF as shown on the screen above To revi
9. 4 Problems with NIBP Verify against Error Messages for further information 8 5 85 Problems with E Temp Verify against Error Messages for further information 8 7 8 6 Problems with Pulse Oximetry Verify against Error Messages for further information 8 8 8 7 Errors and Other Messages Shown in Message Window 8 10 vi 8 8 ROSIE Error Log Codeso oil je E ka AR A ON ad ie AAA ed Thee eed 8 12 9 General Maintenance ies 9 1 9 1 Battery Care and Replacement dd 9 1 9 2 Tnternal Fuse Replacement sieisen A A Ads tie 9 1 9 3 Clin a llas 9 1 9 3 1 A ON 9 1 9 3 2 Pulse Oximetry Sensors and Cables iii adineradas 9 2 9 3 3 Reusable CUS Sai SSS Q S SOD Aq ee uhu us 9 2 9 3 4 Temperature Probestand Cablesu l u AQ a SD ace Seana day Ge aM aa 9 2 10 Patient ID Bar Code Scanner Instructions id 10 1 11 Supplies and ACCESO ic ii 11 1 ELSE OQ INN MAMMA A II aasawa uw aus 11 1 12 ROSE SPEC LIC ALOIS ies tos 12 1 12 1 Monitor and DISPLAYS DECIAS A AAA Ab 12 1 12 2 NIBP Sp ecificatl ons sasha a atn eren e qua hua E a S a et died EEO aun EOE aeS 12 2 12 3 SPO gt SPECIICGHONS ai 12 2 EZ As E Temp IS DOCH ACTIONS id a a dci 12 2 12 3 Re ord r DECI CAOS saa u A E e AS AALE h ADA ER A A ARE aa 12 3 vii 1 Introduction 1 1 Purpose of Manual This manual describes and supports all of the monitors in the Rosie II series
10. 5 3 2 6 AUD S tn h S SSS E QN aT Sa S u usa eR Aa 3 6 3 2 7 Visual Alanis iii a dci 3 6 3 3 Cuff Interval SCT CCI aus a n O na Siesta tee m taal hh u did 3 6 3 4 System Settings DOTE sca baa hasa lia haqa qaqaqa uama A nama hawa halaq 3 8 3 4 1 Cuff SECTS Screen oi as Say vi seve Sse uc oe aa vata aes ceo ee aha cap asa 3 9 3 4 2 Temperature Configuration Screen idad idad isis 3 11 3 4 3 P int Confis ration Sere i ii 3 11 Donk Print Reg est Sereene usa s e o u G e aa 3 12 30 Patient ID Sereena anan uqu A hae a E EE AEE E EE 3 13 Sef ECD Screen UCI GTDC OTANI u u aaa qaa ce baal A R ai ias 3 16 4 1 Principles of the Oscillometric Tecmqle a ias 4 1 4 2 INIBP Parameter SCUINGS a iaa 4 2 4 2 1 Cuff IntervaliSe reeWu E SSO uu ea 4 2 4 2 2 Cuff Settini S SCRE a er Sumu bip Gers pede um a E A QS SS E ahua Qm E aaa Esq 4 3 4 2 3 Smart Inflation ii adi s 4 3 EI APPS O ARE CHUL Y asta A A ad 4 3 4 3 1 Adult Pediatric Cuff Placement and Positioning 4 4 4 3 2 Neonatal Cuff Placement and Positioning 4 5 Electronic Predictive Temperature E Temp a 5 1 5 1 Principles of Electronic Predictive Temperature is 5 1 5 2 FE Temp S ttino Sereen a SISTEMA TEARS TA TA A
11. 5 SAMOA OS uu Su u um batas asas aint cnica 1 2 E6 Ret mine th Untu aasma ES A sayapayay E sq Seale a cel 1 3 IZo Supping Frocedures us S usual isis chads 1 3 1 8 OSA de UE RECON Ai ea 1 3 Physical A dt pa sas T Saa E passed aus Aon aaa gua C N 2 1 2 1 General Safety Information EIA AA TAE RAE AAA AGE 2 1 2 2 General Operating Precautions aa te ceca 2 1 2 3 Warnmpess and Cautions of Use uzanan a amaya Aca ies AA tiene 2 2 24 Front Panel Callout sosunun i us i SGo una Qasaqa Rusa uma 2 8 25 Front Panel Description clockwise from Upper right 2 8 2 6 Rear Panel Description clockwise from upper right 2 11 27 Recharging the A a ao ca 2 12 28 Installing the Rosie Monitor A A A AA db 2 13 DAS CHSC IS WUC e u tee 3 1 3 1 Line List Display or Main Screen cas 3 1 3 2 Alarms Settings Sree usa O sibs tases AEEA ARO OaE at 3 3 3 2 1 Setting th Alarm Lisa dai E REE E aka pas 3 4 3 2 2 sine Pres Set Alarm MES ainia aa Es 3 4 3 2 3 Removing Alarm Limit CAME A Ir a 3 5 3 2 4 Saving Changes to the Alarm Limits a 3 5 3 2 5 Changing the Auto Update Tolerances ia aia 3
12. CUFF MOTION ARTIFACT j q 50 11 06 PREV ABC 123 BACK SAVE SCREEN SPACE gt MAIN To enter letters press the ABC Soft Key then use the UP or Down buttons to scroll through Alpha characters to select the desired letter Press the OK button to accept that letter and move the cursor to the next space The 123 Soft Key allows integration of numeric ID select the numbers the same way as you did the letters 3 13 Pressing the Back Space Soft Key moves the cursor back one space clearing the last entry Pressing the Prev Screen Soft Key erases any new input and the LCD screen returns to the Patient Select screen Once the Patient ID input is complete press the Save gt Main soft key and the Patient ID Confirmation screen will appear Patient ID Confirmation Screen SELECTED PATIENT ID PLEASE CONFIRM PATIENT ID J DOE 1234567890 CUFF MOTION ARTIFACT 50 11 06 Prev SAVE Screen gt MAIN If the information is incomplete or incorrect press the Prev Screen Soft Key to return to the ID Input Screen and use the Back Space and ABC and 123 Soft Keys to make the desired revisions Once the Patient ID information is complete and correct press the Save Main Soft Key to save the input and return to the Main Screen This ID will be used to identify any measurements taken at this time Note In order to ensure that all
13. Life Systems Technical Services NIBP PROGRAM IN NIBP Interval program is User will get this message if they are PROGRESS running attempting to change from Neonate to Adult while a interval program is running Stop interval program then change modes SPO Related Messages Message Shown Description Action Required SPO2 NO SENSOR Loss of Probe Signal Verify attachment of sensor to extension cable EC 8 and to patient finger SPO2 NO SIGNAL Patient perfusion too Check placement of sensor and if polish is weak on finger Remove polish and reapply sensor SPO2 MOTION ARTIFACT Check placement of sensor strong SPO2 INTERNAL FAILURE SpO gt Module Failure Contact Life Systems Technical Services 8 8 Rosie Error Log Codes I General Service Log Format A General Overview The Rosie stores all warning fatal alarms into its service log The service log allows up to 99 entries within its buffer If more than 99 entries are present the buffer will wrap thus overwriting the oldest entries with new entries as they occur B Format Time Module Error Code Addition if applicable Char Length 8 4 2 4 0 7 Example 12 12 00SPO2TIME Note Any information sent from the modules explaining the error will be added in this area It is up to the user to read the appropriate module specification to understand what the additional info references C Format Definitions Not
14. PULSE and the Unit beeps two times alert before measurement retry to announce a new measurement cycle is about to begin If the monitor incurs a critical error such as loss of internal communication the error code will be displayed in the LCD NIBP TIMEOUT and an audible alarm will sound This alarm will continue until silenced Refer to section 10 6 Error and Other Messages for more information 3 2 7 Visual Alarms When an alarm sounds the LED value of the offending parameter will flash and a message will be shown in brackets on the LCD screen The Alarm Mute Button has no effect on visual alarms which will continue to sound until another measurement is taken and the result once again falls within the set alarm limits All alarms and messages are shown in the message area of the Line List screen with each alarm preceded by its offending parameter Refer to section 3 3 3 3 Cuff Interval Screen The Cuff Interval Setting Screen is accessed by pressing the Cuff Soft Key under the Line List screen The monitor incorporates both static and dynamic cuff intervals The static cuff intervals include 1 2 2 5 3 5 10 15 20 30 60 90 120 and 180 minutes between cuff measurements The dynamic timed interval programs A B C D and E are user designed protocols Programs A through D allow the user to set unit specific protocols with up to five different cuff intervals Program E is pre set to a commonly
15. a limited useful life and using an old sensor may cause measurement errors If the measurement values of an older sensor seem lower than a patient s conditions warrant replace the sensor Measurements are not possible in the following cases Insufficient peripheral circulation acute cases of low blood pressure and or low temperature When the patient is on a cardio pulmonary pump If the sensor is placed on the same limb as the NIBP cuff Accurate measurements may not be possible in the following cases When heart massage is conducted or when there are weak continuous external vibrations spasms CPR and or venous pulsation When the selection and application of an OxiMax sensor is not correct Patients with carbon monoxide poisoning or who are heavy smokers it is impossible to determine differences of functional disorder hemoglobin such as monoxide hemoglobin and metho hemoglobin When there are excessive reagent color elements within the arteries indo cyanine green methylene blue as well as others Under the strong light of a surgical lamp or direct sunlight When the patient is wearing black or bright red fingernail polish The unit may display meaningless measurement values when the sensor is not properly placed on the finger and or when there are lighting changes at the light sensor section of the sensor Measurement sites should be checked at least every 2 3 hours and 8 hours respectively for Reusab
16. eJect probe cover and return the probe to the probe well 5 4 2 Monitoring Temperature Select Monitor in the E Temp Setting screen See section 3 4 2 Remove the oral probe from the probe well and attach a probe cover Have the patient open mouth slightly Holding the probe loosely place the probe tip into the sublingual pocket Hold the probe during the entire temperature measurement process and keep the probe tip in contact either the tissue at all times Observe the display until the value stops changing 3 5 minutes indicating the final temperature Unlike in Predictive Mode there is no audible signal beep to indicate a final temperature reading 6 Pulse Oximetry SpO2 6 1 Principles of Pulse Oximetry Pulse Oximetry provides continuous non invasive information about the percent of oxygen that is combined with the hemoglobin in the patient s blood also referred to as oxygen saturation In combination with the hemoglobin value the SpO gt provides valuable information about arterial oxygen content in the blood 1000 100 600 700 800 900 1000mm Pulse oximeters utilize two light emitting diode LEDs of given wavelength a red light at approximately 660nm and an infrared light at approximately 920nm A photo detector is placed opposite to these LEDs across the vascular bed The difference in the intensity of transmitted versus detected light at each wavelength is caused by the absorption of light by oxy
17. in the screen and the LCD reverts to the System Settings Screen Pressing the Save gt Main Soft Key saves a change and converts the LCD screen to the Main or Line List screen 3 4 3 Print Configuration Screen To have the Rosie monitor print a vital signs record automatically press the Print Options Soft Key under the System Settings Screen and select the Vital Signs Print option Each time a blood pressure SpO2 or temperature measurement is completed the monitor will print the results If measurements are simultaneous or immediately concurrent the Unit will wait until the longest running measurement is complete before printing capturing all the data at one time Note All parameters must be disconnected not in progress for the initiation of a vital sign print If you would prefer to have the unit print a Vital Signs Print upon a violation of the patient alarm limit settings select the Print Upon Alarm option Refer to Section 7 2 for an example of the vital signs record Print Settings Screen PRINT UPON ALARM VITAL SIGNS PRINT Cuff Motion Artifact da 50 11 06 SYSTEM SAVE SCREEN gt MAIN Pressing the System Screen Soft Key saves any changes made in the screen and the LCD reverts to the System Settings Screen Pressing the Save gt Main Soft Key saves all changes and converts the LCD screen to the Main or Line List screen 3 5
18. measurement is taken that falls within the alarm limits The alarm volume is adjusted by modifying the settings through the System Setting screen see section 3 4 on page3 7 The Rosie monitor software allows clinicians 10 volume adjustments within a 15 decibel db range Internal hardware adjustments allow this range to be positioned anywhere from a low of approximately 53 db low to a high of approximately 78db very loud The factory setting is in the lower part of the range low to loud 55 70 db to suit most clinical needs Moving the volume to the higher end of the overall range moderate to very loud requires adjusting an internal potentiometer For details on accessing this hardware please contact your Biomedical Department or Life Systems To silence the alarm press the Alarm Mute button located on the top on the front panel of the monitor The alarm will be silenced for two minutes during which the red Alarm Indicator light will flash slowly Pressing and holding the Alarm Mute button for at least three seconds will silence the offending alarm as well as ALL other alarms for two minutes When all alarms have been silenced the Alarm Indicator LED will flash rapidly If there are no alarms active the LED will remain solid and no flashing will occur If for any reason the monitor is unable to determine the final BP values during a measurement cycle a caution code is displayed on the LCD display for example NIBP WEAK
19. measurements appear under the same ID during Spot Check measurements the following procedure must be used First place the SpO probe onto the patient s finger then apply the BP cuff and initiate a measurement cycle The E Temp measurement can be taken any time during the cuff measurement cycle and as soon as all measurements are complete all the data will be ascribed to that patient To assign an existing Patient ID from the monitor s memory to the next measurements press the UP S button to scroll through the existing patient identifications Once the Patient ID has been located press the Save gt Main soft key and that identification will be used for the measurement and the display will return to the Line List screen To view historical patient measurement information select the appropriate Patient ID as shown above and press the View Pat soft key The following screen will appear allowing the user to view the four most recent measurements The patient s vital signs can be printed by pressing the Print Pat Soft Key refer to section 7 2 The patient ID and vital signs information can also be removed from the Line List memory by pressing and holding the Delete Pat soft key View Patient Screen 7 10 MARK WILLIS 1234745 11 03 120 80 93 83 98 986 7 10 MARK WILLIS 1234745 11 10 120 85 98 75 98 98 4 CUFF MOTION ARTIFACT I H 50 11 06 PREV PRINT DELETE SAVE SCREEN PA
20. pressure measurement mode Adult Pediatric or Neonate Press OK to set the mode and move the cursor to the inflation pressure 3 9 Cuff Settings Screen MEASUREMENT MODE ADULT PEDI INIT INFLATION PRESSURE 180 MMHG MAX INFLATION PRESSURE 300 mmHG BP UPON ALARM SMART CLOCK X SMART INFLATION CUFF MOTION ARTIFACT 50 11 06 SYSTEM SAVE SCREEN gt MAIN INIT INFLATION PRESSURE To select the desired inflation pressure for initial cuff inflation use the UP or Down buttons to bring up the desired setting The selections for inflation pressure vary between modes and are as follows Adult Pediatric mode selections are 80 240 mmHg increments of 20 Neonatal mode selections are 80 140 in increments of 20 Please see note on next page NOTE BP Measurement Mode cannot be changed when a cuff interval has been set To reset Measurement Mode first turn off cuff intervals Pressing the OK E button moves the cursor to the MAX INFLATION PRESSURE function MAX INFLATION PRESSURE To select the desired maximum inflation pressure for the cuff use the UP or Down Y buttons to bring up the desired setting The selections for maximum inflation pressure vary between modes You can not set the maximum inflation pressure lower than the initial inflation pressure If the unit is not able to read the blood pressure on the first
21. probes from the monitor before defibrillator discharge All wire lead patient connected transducer assemblies are subject to reading error local heating and possible damage from high intensity sources or RF energy Electro surgical equipment s capacitively coupled currents may seek alternate paths to ground through probe cables and associated instruments patient burns may result If possible remove the probes from patient contact before activating the surgical unit or other RF source Hazards can be reduced by selecting a temperature monitoring point which is remote from the expected RF current path to ground return pad Appropriate probe selection and application must be determined then applied in the applicable manner Do not operate a cellular phone and or radio trans receiver in the presence of this monitor Only authorized personnel should attempt the operation of this unit Use only authorized accessories and options Read the Operation Manual before using this device Do not use this monitor in the presence of an MRI Inspect the monitor for safe operation before use 2 3 gt Z wi Z gt SAQNL Do not place items on top of the monitor Do not place heavy materials or this device on the AC power cord Do not connect the monitor to devices that do not meet medical safety standards Do not open the cover or disassemble If the monitor fails for any reason turn OFF and unplug the AC cord Failures may i
22. suitably packaged to protect the product If Purchaser ships a product to Life Systems in unsuitable packaging any physical damage present in the product on receipt by Life Systems and not previously reported will be presumed to have occurred in transit and will be the responsibility of the purchaser 1 8 CSA UL Recognition This device has been certified by the Canadian Standards Association to comply with IEC 60601 1 with Amendments 1 amp 2 IEC 60601 2 30 CSA C22 2 No 601 1 M90 CSA C22 2 No 601 151 94 and UL Std No 2601 1 2 edition with accordance to Canadian and US standards The CSA listing master contract number for this product is 216146 1 3 2 Physical Description 2 1 General Safety Information Rosie II monitors should be operated in a location that is free from liquids spillage flammable chemicals or gases vibration shock even during the transportation of the unit and temperature ventilation and humidity extremes To avoid a possible accident place the unit on a firm flat base or mount it securely to a heavy duty stand Do not place items on top of the monitor and keep the cooling path free from obstructions while operating Clean it with a soft damp cloth as directed in section 9 2 do not use solvents or other harsh chemicals Do not autoclave Refer to the Sec 2 3 for other Warnings Cautions and Important Information 2 2 General Operating Precautions e Arrange the power cord and cuff hose so that they
23. temperature connector port on the back of the monitor Insert the probe into the temperature probe well on the front of the monitor To remove the probe cable from the housing s connection depress the connector s release and remove the 5 a b Press to Insert Temperature Probe Connector Press Connector s Release and Pull 5 4 Taking a Temperature It is important to know what type of temperature measurement is required The Rosie Monitor offers a fast predictive measurement as well as a continuous monitoring method Note For oral temperature measurements use the blue probe and for rectal use the red probe 5 1 5 4 1 Predictive Mode Measurements A Select Predictive in the Temperature Setting screen B Insert the appropriate oral or rectal probe completely and firmly into the appropriate probe cover being sure the cover is on securely lt ro UN N MOON NN ae SY Nox A ce s Sa CAUTION Failure to firmly install the probe cover may result in the probe cover becoming loose or disengaged during use Be careful not to press the probe ejection button where the cord exits the probe during use C Have the patient open their mouth slightly Holding the probe loosely place the probe tip into the sublingual pocket Hold the probe during the entire temperature measurement process and keep the probe tip in contact with the tissue at all times Do not allow the patient to reposition or hold the p
24. the System Screen Soft Key saves any changes made in the screen and the LCD reverts to the System Settings Screen Pressing the Save gt Main Soft Key saves all changes and converts the CD screen to the Main or Line List screen SMART INFLATION Smart Inflation can be disabled by pressing the Up or Down buttons For a complete explanation of Smart Inflation see section 4 2 The default is set to ON 3 4 2 Temperature Configuration Screen Pressing the Temp Option Soft Key from the System Setting Screen accesses the E Temp Settings Screen see next page E Temp Settings Screen MEASUREMENT MODE PREDICTIVE CUFF MOTION ARTIFACT j 50 11 06 SYSTEM SAVE SCREEN gt MAIN Use the UP or Down Y buttons to select the Predictive or Monitoring temperature mode The GREEN Temperature Mode LED light on the front of the monitor lights only when the Monitoring mode is selected If the LED is not lit the monitor is set in the E Temp Predictive mode In the Monitoring mode the Unit measures the patient s temperature continuously and displays the temperature constantly in large GREEN LED numbers In the Predictive mode the monitor measures the patient s temperature for approximately 7 seconds then displays the final temperature Refer to section 5 4 1 for more information Pressing the System Screen Soft Key saves a change made
25. the line list format refer to Section 7 2 As the Print Patient and Print List records are printed a Print in Progress screen will appear refer to Section 7 2 1 This screen allows the user to cancel the printing process once the desired records have been printed press the Cancel Print Soft Key 3 12 Print In Progress Screen PRINTING IN PROGRESS NEWEST RECORDS ARE PRINTED FIRST PRESS CANCEL PRINT SOFT KEY TO STOP PRINT OUT PRESS MAIN SOFT KEY ONCE PRINT OUT COMPLETES ERROR MESSAGE SPACE 50 11 06 CANCEL MAIN PRINT If the Cancel Print function is not used and the unit is allowed to continue printing until the print function is completed the User must press the Main Soft Key to return the display to the Line List screen 3 6 Patient ID Screen To enter patient ID information press the ID soft key under the Line List screen and the Initial Patient ID screen will appear If a measurement is started without entering a patient ID the monitor will automatically identify the measurement as patient Unknown Initial Patient ID Screen ERROR MESSAGE SPACE t 50 11 06 PREV VIEW NEW SAVE SCREEN PAT PAT gt MAIN To enter a new patient ID press the New Pat soft key in the Initial Patient ID Screen The following Patient ID Input screen will appear Patient ID Input Screen SELECT PATIENT ID J DOE 12341
26. to AC power A RED light signals the battery is charging GREEN shows the battery is fully charged Note If the battery indicator is GREEN when the monitor is unplugged from AC power it will turn RED when the unit is plugged in again The charging cycle re starts and the indicator will turn GREEN again in 4 6 hours NOTE Life Systems recommends that you continue to leave the unit plugged in even when the light has turned GREEN Power ON OFF Button Pressing this button turns the monitor ON and OFF While the power is ON pressing this button momentarily puts the monitor into sleep mode Pressing and holding the button for three seconds or more turns the unit OFF and sounds an alarm at one second intervals until the unit turns off approx 3 seconds Power ON LED This GREEN LED will light when the power of the device is ON even when the monitor is in the standby or sleep mode Temperature Probe Well The temperature probe is inserted here when not in use Withdrawing the probe initiates a temperature measurement replacing it stops a measurement Temperature Mode Indicator A GREEN LED indicates the monitor is in the Monitoring mode of measurement When the LED is not lit the monitor is in the Predictive mode Temperature Unit of Measure Indicator A GREEN LED light indicates the unit of measure C or F selected for the temperature measurement Temperature Measurement Large GREEN LED numbers show the current tempe
27. try it will automatically increase the amount of pressure and retry 2 more times This feature allows you to control the maximum pressure it will inflate during the retries This feature is ideal when working with pediatrics or the elderly The default is 300mmHg for adults and 160mmHg for neonates After you have selected the desired pressure press the OK button move to the cursor to the BP UPON ALARM function BP UPON ALARM BP upon alarm can be activated by pressing the Up or Down buttons If set the monitor will automatically take a blood pressure after an alarm The default is set to off SMART CLOCK When Smart Clock is selected the monitor automatically adjusts the second and all subsequent cuff measurements taken on intervals to major points on the clock making follow up and charting easier Two examples follow 1 Ifa 15 minute interval has been set and the initial measurement is taken at 11 56 then next normal interval would be 12 11 Activating the Smart Clock feature initiates the second measurement at 12 00 then the next at 12 15 then 12 30 etc on the quarter hour marks of the clock 3 10 2 If a5 minute interval has been set and the initial measurement is taken at 11 13 then next normal interval would be 11 18 Activating the Smart Clock feature initiates the second measurement at 11 15 then the next at 11 20 then 11 25 etc on the five minute marks of the clock Pressing
28. underside of the unit passes over the internal components cooling them and rises to escape through vents in the handle The handle will feel warm especially during the battery charging cycle 2 8 Installing the Rosie Monitor Connect the monitor to a properly grounded 3 wire hospital grade AC power source Verify that the Battery Charging Indicator lights allow the unit to fully charge before operating For Adult Pediatric monitoring attach the blood pressure cuff with the light blue cuff hose to the cuff hose connector on the back of the unit Neonatal monitoring requires a neonatal blood pressure cuff identified by its pink cuff hose Select the appropriate sized BP cuff sizes range from neonatal through large adult and thigh and attach it to the cuff hose Connect the Doc10 SpO gt extension cable to the SpOz Connector on the back of the monitor Select the appropriate SpO gt 2 sensor and attach it to the Doc10 extension cable Connect the appropriate E Temp Probe oral rectal by attaching the temperature probe cable to the E Temp Probe Connector on the back of the monitor Insert the probe into the probe well and place a new box of probe covers into the probe cover box receptacle If your Rosie monitor includes a built in printer load the paper by following the instructions in Section 7 1 Loading Paper into the Printer Press the ON OFF switch on the lower left hand corner of the front panel of the monitor Th
29. 0 31vGdn OL N334OS INS MNI MIA AR NIV INR JN INR NRO S MYS IMIS MIA dOls Ud MYS OGNN Olny ZONVHO Add 90 psp OWES 39VSS3N FORT 90 DS Goves 20vssan you 90 b a 3 8 x no 901 Dh 3OV48 39VSS3W YOR 90 OSH OWES 3O SSIN LOW S g 5 338 F96 96 S 86 S9 OZ oww 5 8 202 E l NMONANA ObIZ K OR z a NIN Z WAYENI 96 05 OL 09 06 MO did o A s S ll seo HHO OZ Ob 06 OST YOH SPLPEZL SITIM ANITA OLI 2 2 455 S 8SPEZL 3OVTIVII DIN f s IIR l Il I INRRIIO x _ usag Indu q 11914 wang 1S nbaq Juri uang y 192198 PATOUT nO 199 99 SUL Y enuey ES EN WOJJO SUI JO SUOOUN 409 89 shay JOS lt SAM YOS sen pA palublubly sespalgap usalos sjong lt uonng usoq Usalos SUI Ul JOSINO SUL SSAC lt uonng MO Pe s n DA pajuBruUBly sesparou usas solos lt uonng dN Y w YV w so di INIdd WALSAS dgiN SNaVIv 90 bb os L OWES FOVSSIN VOY v 86 86 SZ 86 98 OZbL OL LL NMONDINN dl ZL Z 9 86 86 ee 6 08 0ZL 0LL SOLDVEZL SITIM NAVIN AI ZL Z dWNSL OCS d VA VIG SAS JNU 192198 um A UIS 1JsrT SurT SOT u9919S AOT JO UOT pwned II ON 3 16 4 NIBP 41 Principles of the Oscillometric Technique Oscillometry or the oscillometric method is a relatively simple quick reliable and comfortable technique to measure blood pressur
30. AX P MAX I MAX FAST MAX R OxiCliq Sensor Models Single Patient Use OxiCliq A OxiCliq P OxiCliq N Adult OxiCliq N Neonate OxiCliq I Reusable Sensor Models D YS Infant to Adult D YS Neonate D YS amp D YSE D YS D YSPD DS 100A OXI A N Adult OXI A N Neonate OXI P I SpO Range 70 100 2 5 2 5 2 5 3 5 2 5 3 4 3 5 3 5 3 3 4 3 The accuracy specification under motion conditions is 3 For a definition of motion contact Nellcor Technical Services or your local Nellcor representative Accuracy Specification Accuracy specifications are based on controlled hypoxia studies with healthy non smoking adult volunteers over the specified saturation SpO range Pulse oximeter SpO readings were compared to SaO values of drawn blood samples measured by hemoximetry All accuracies are expressed as X digits This variation equals one standard deviation 1 SD which encompasses 68 of the population Neonatal Accuracy When sensors are used on neonatal subjects as recommended the specified accuracy range is increased by 1 digit as compared to adult usage to account for the theoretical effect on oximeter measurements of fetal hemoglobin in neonatal blood For example MAX N accuracy on neonates is 3 digits rather than 2 Oxygen saturation accuracy can be affected by certain environmental and pa
31. Care should be taken to allow ventilation of EtO residuals prior to use of the cuff Acceptable methods for determining sterilizer effectiveness should be used such as biological indicators For further information regarding sterilization procedures with your unit contact the sterilizer manufacturer je Virahol Veridien Corporation St Petersburg FL 9 3 4 Temperature Probes and Cables Caution Observe the following precautions when cleaning and sterilizing probes as improper handling easily damages them Avoid contact with strong aromatic chlorinated keytone ether or ester solvents Prolonged immersion in alcohol or mild organic solvents detergent solutions or highly alkaline solutions cause the vinyl cable covers to lose flexibility 9 2 During cleaning or sterilization probes should be handled gently When wiping clean hold the probe at the sensing tip and wipe the probe and lead wire toward the plug Excessive pressure can stretch the covering and break the internal wires destroying the probe Continued flexing of lead wires during use and cleaning can also break the internal wires Failure from this cause is not covered by the warranty Disinfection Probes may be disinfected and sanitized by washing with 3 hydrogen peroxide or an EPA registered disinfectant containing isopropanol 1 e Veridien Corporation s Virahol Dakin s solution sodium hypochlorite in neutral buffer is also suitable Brief immersion o
32. D indicates motion with a mark next to the cuff reading or SpO gt reading this same indication will appear next to their corresponding values on the printout If the LCD indicates the monitor is in the Neonatal mode see section 4 3 2 the notation N will appear next to the printed SYS value Below is an example of the line list printout a a oa o co Lu o u w W mom Fw Ooo Eo R Fo o Fro LNA Not B co N Not N No oar OD ar VO 00 00 or A Ker Q 0 A LO No Do Do DD e 5 5 a gt oy A a Yg m lt oc oc ON a YA A A A a me e E ne em E e co E Q mE AQ 102 NE nes BS LOS 9220948 S c aa o TON 0 2o a DS ai O E oP lt i EM lt i OD i lt i o pert Dor 3 el m aet oe ee eee m gt gaf cO MS nS cO MS oO YS oF gt S gt a O gt s gt s N nr gt n m Or Once this print is initiated the records are printed from the most current to the oldest To stop the printer press the Cancel Print Soft Key on the Print in Progress screen as shown below Print In Progress Screen PRINTING IN PROGRESS NEWEST RECORDS ARE PRINTED FIRST PRESS CANCEL PRINT TO STOP PRINTOUT PRESS MAIN ONCE PRINTOUT COMPLETES CUFF MOTION ARTIFACT 11 06 CANCEL MAIN PRINT Once this print is finished the Main soft key must be pressed to return the screen to the Line List screen 7 2 7 2 2 Vital Si
33. E Temp Printer 12 1 12 2 NIBP Specifications Measurement Method Deflation Method Pressure Detection Inflation Method Pressure Display Range Pressure Accuracy Pulse Accuracy Measurement Accuracy Measurement Range Shock Protection 12 3 SpO gt Specifications Method SpO Display Range SpO Accuracy PR Display Range PR Accuracy Shock Protection Oscillometric Dynamic Linear Deflation Semiconductor Pressure Sensor DC Rolling Diaphragm Pump 0 300 mmHg 1 less than 3 mmHg 2 or 2 bpm Meets or exceeds AAMI SP 10 Adult Pediatric Mode Neonate Mode Systolic 60 250 mmHg 40 120 mmHg MAP 45 235 mmHg 30 100 mmHg Diastolic 40 200 mmHg 20 90 mmHg Pulse 40 200 bpm 40 240 bpm Type BF Defibrillator Protected 2 wave length pulse wave type 0 100 Refer to Sensor Manual of each sensor D 25 Disposable sensor adult 70 100 2 digits 0 69 Unspecified N 25 Disposable sensor NEO 70 100 3 digits Other ranges no accuracy statement 20 250 bpm 3 bpm Type BF Defibrillator Protected 12 4 E Temp Specifications Method Probe Types Modes Display Resol Display Range Accuracy Scale Protection Type Turbo Temp Electronic Predictive Thermometer Oral 2887A Rectal 2888A Predictive Measurement complete within 7 seconds of tissue contact Monitoring Continuous temperature measurement 0 1 C or 0 2 F
34. Fosiel m Vital Signs Monitors Operations Manual Software Ver 11 Foreword Life Systems Inc would like to thank you for your purchase of the Rosie series vital signs monitor Please read this manual carefully before using the monitor Familiarize yourself with the features methods of use cautions and warnings as well as any limitations of the monitor This manual should be kept in a safe convenient place for future reference This manual describes and supports all of the monitors in the Rosie series by discussing the fully configured model that includes NIBP Pulse Pulse Oximetry Temperature and printer It may therefore present information that does not apply to your unit The front and rear panel designs and connection ports may vary according to the parameters that have been built into your monitor No part of this manual should be reprinted or reproduced without permission Life Systems Inc maintains the right to modify the contents of this manual without prior notice If you have any questions about the information presented in this manual or about other Life Systems products please contact us at 111 iv Table of Contents 1 e A aS E E EA A EE ET EEE AT AE ben seeaonecauesesendeesvens 1 1 1 1 Purpose of MATA A ATA EA AI E AA A ah AAA ale RARA 1 1 1 2 General Description seseo nenn a tits 1 1 1 3 WA aqata upan AAA AAA A AAA one wea qaya AA ATA cS 1 1 ff PECTS TOVIS AA A sen Aaa aaa gaa es GIP ean 1 2 1
35. Print Request Screen When the Print Soft Key is pressed from the Line Listing or Main screen the labels of the soft keys change on the screen to reflect the print request Print Request Screen 7 10 MARK WILLIS 1234745 11 03 120 80 93 83 98 98 6 7 10 UNKNOWN 11 10 120 85 98 75 98 98 4 CUFF MOTION ARTIFACT 50 11 06 PRINT PRINT PRINT PRINT MAIN CURRENT SCREEN PAT LIST Pressing the Current Soft Key initiates a printout of the patient s current vital signs in a Vitals Print format Refer to section 7 2 for an example of this printout Pressing the Print Screen Soft Key initiates a line list format printout of the vital signs that on the LCD screen at that time Refer to Section 7 2 for an example of this printout Pressing the Print Pat Soft Key brings up the Patient ID screen refer to section 3 6 where the user will be asked to select the patient ID to be printed Once the appropriate ID has been selected press the View Patient Soft Key to view the measurements Press the Print Pat soft key to print the measurements The information is printed in the order of current to oldest in a line list print format Refer to Section 7 2 for an example of this printout The information is printed Pressing the Print List soft key will initiate a printout of the entire line list memory in the order of most current to oldest The information is printed
36. Replaced batteries should be disposed of in a manner acceptable by local and national recommendations 92 Internal Fuse Replacement The monitor is protected by three fuses Two of the fuses are located internal to the monitor on the line and neutral of the AC Inlet and should only be inspected and replaced by qualified personnel with 250V 2A fast acting fuses The third fuse is a 5 A fast acting fuse located on the internal battery harness 93 Cleaning 93 1 Monitors The exterior of the monitor should be wiped clean with a cloth slightly dampened with mild soap and water solution or ammoniated window cleaner Do not apply large amounts of liquid The monitor front panel should be cleaned carefully to prevent scratches to the displays Dust and dirt particles can be blown off or brushed off using a soft brush Fingerprints and stains may be removed by using a liquid lens cleaner and soft cloth 9 1 e Do not immerse the device e Do not clean with abrasive cleaning agents isopropyl alcohol or other solvents 9 3 2 Pulse Oximetry Sensors and Cables Use a cloth slightly dampened with a mild soap and water solution or other acceptable solution to clean the sensor surface before and after each patient use Then wipe the sensor with a soft dry cloth to ensure all detergent residues have been removed Acceptable Cleaners Dishwashing detergents i e Ivory Joy Procter and Gamble Corp Palmolive Colgate Palmolive Corp Chlorine
37. T PAT gt MAIN 3 14 Caution If cuff intervals or E Temp Monitoring mode are in use or if the SpO gt sensor is connected to the same patient for longer than 5 min the monitor assumes that all measurements taken during that time belong to the same patient and places those values in memory under that patient s ID If no cuff intervals are set and the SpO sensor is not kept on the patient or if no ID information has been entered as additional measurements are taken the monitor will assume the vital signs are for a new patient and the values will be placed under an Unknown patient ID label 3 15 3 7 LCD Screen Structure Diagram NNS N333OS INIdd NIVIN lt N334OS NIWW lt NIJYOS iS Aud NVW HONVO INS INZLSAS Ws WILSAS 9 psp s Govssovssav uous 901 Deh GOWdS J VSSIN YOU 90 14 pS Govds 39VSS3W vor 901 pop 3OWd8 39VSS3A YOR S3I3IWOO LNO INIeld FONO ADI LIOS NIV SS31d 069 99F8Z 300 r Gl IN3IIVd INO IN dOLS OL ADI 1408 INI 13ONVO SS3Ud INIA SNOIS WIN f Said GFINId JAY WATY NOdn INIdd PALOIGId JGOW LNINIUNSVIN WANOD 3SV31d l 1N3IIYd 03103135 SQYOOIY 1SIMIN SSTIOOL NI NIINRId 133195 UOTIPULIJU0O J ed 133109 SS mo1d u Jutid
38. aight line off the end of the roll to make insertion of paper easier See Figure A 2 Press the Power ON OFF switch turning the power ON 3 Open the monitor s paper door on the right side of the monitor and insert the thermal recorder paper so that the end comes from the back over the top of the roll See Figure B 4 Pull the paper s leading edge out 6 10 inches and loop it back into the printer just under the black roller As the paper is placed just under the printer roller the printer will automatically grab and feed the paper See Figure C 5 Once the paper passes the outer edge of the case close the paper door and select a print format The resulting printout will remove any remaining loop in the paper Figure A Figure B Figure C Figure D Tear Straight Line 7 1 7 2 Print Formats 7 2 1 Line List Format The Rosie monitor with printer will print the line list format when the Print Patient soft key is pressed in the View Patient screen and when the Print List soft key is pressed in the Print screen refer to section 3 4 The printed record includes the Current Date Patient s Name Patient s ID number and vital signs information This printout is delayed until the completion of the blood pressure measurement to allow for completion of other parameter measures that may be running concurrently Any values causing alarm signals are shown within a box as shown below If the LC
39. ameter combinations Model Configuration Rosie II 1 NIBP only Rosie II 1P NIBP with Printer Rosie II 2 NIBP Nellcor Pulse Oximetry Rosie II 2P NIBP Nellcor Pulse Oximetry with Printer Rosie II 3 NIBP E Temp Rosie II 3P NIBP E Temp with Printer Rosie II 4 NIBP Nellcor SpO E Temp Rosie II 4P NIBP Nellcor SpO gt E Temp Printer 1 3 Warranty LIFE SYSTEMS INC is committed to distributing the highest quality products by manufacturing devices that are equipped with unsurpassed speed accuracy reliability quality and comfort Every Rosie monitor purchased through Life Systems Inc includes our Gold Standard warranty The monitor is warranted to be free from defects in material and workmanship for a period of three 5 years The pulse oximeter electronic predictive thermometer and printer when purchased with the Rosie are warranted for a period of three 3 years Accessories and the rechargeable battery are warranted for a 1 1 period of ninety 90 days from date of purchase If an extended warranty was purchased at time of sale it will cover only the Life System components not the pulse oximeter electronic predictive thermometer or printer 14 Exclusions This warranty does not extend to any warranted products or parts thereof that have been subject to misuse neglect or accident that have been damaged by causes external to the Warranty including but not limited to failure of or faulty electrical p
40. an the affected time span Each Interval Program allows up to five possible measurement periods that can be used Two examples of Interval Programs are presented below Program A Run Time Program B Run Time Start 1 00 5 Start 1 00 10 1 00 2 00 15 1 00 2 00 30 2 00 4 00 30 2 00 4 00 30 4 00 5 00 60 4 00 5 00 60 5 00 6 00 60 5 00 6 00 60 If an Interval program is in process when the user enters the screen the cursor will identify the current point in time in that program If there is no program running when entering the screen the cursor will appear next to the first time frame Once a program has been set up or changes have been made to an existing program pressing the Save gt Main Soft Key accepts saves and implements the program and the LCD reverts to the Main Line List screen Pressing the Prev Screen Soft Key changes the screen back to the Cuff Interval screen without saving any changes Program modifications cannot be made while an Interval Program is in process If any attempt is made to modify the program while one is in progress the program in process will stop However the monitor will allow you to revert to any of the standard cuff intervals or re start a program in which modifications were made and saved While a cuff interval protocol is running the letter A B C D or E identifying that protocol and a number identifying the current cuff interval appears on the MAIN Li
41. ana 5 1 5 3 Connecting the Temperature Probe to the Uhilt a 5 1 5 4 Taking a Temperature s anan AAA a uma bale li um uha ld 5 1 5 4 1 Predictive Mode Measuremetnts a 5 2 5 4 2 MARA Lemperat re io cake is cae ase retest A oan sQ atu cad ada 5 4 Pulse CRIME EY COD Os edit O tedaas Wee 055 a aa 6 1 6 1 Principles of Pulse OxImelry maaa naa diac lad AA AA ku 6 1 6 2 TODD ELE CTO AE apuq A AAA A Gas uu da hated lt Nuu 6 2 6 3 OxiMax Sensor Accuracy Specification A RA 6 3 6 4 Connecting the SpO2 Probe Cable to the Uhil a 6 4 65 Applying The Probe Attachment eens ase a ed 6 4 66 Applying Disposable OxiMax Sensors E A E A 6 5 PEINCer Opepati riise uncata a ll e 7 1 7 1 Loading Paper into Me a a 7 1 Z P iint FOrmMAtS A ua APG ap Sq aa hs 7 2 ool Line LISO s ha Da aaa Saam TR De a le Ga es ta ea tale ee Te 7 2 722 Wala Signs Formatie nansl s AS Sa T N S a q ms sis saan 7 3 Z 3 Using the Printed Oscillometric Profile a iaa sad 7 4 Rosie Lroublesho0 IN 8 1 8 1 TroubleshootIma Gu1d A a ita 8 1 8 2 Problems with the Monitor Verify against Error Messages for further information 8 1 8 3 Problems with Printer da AAA A o 8 4 8
42. ances To modify the pre set alarm values press the CHANGE TOL Soft Key from the Alarms Screen and the display will change to the Auto Update Tolerance screen shown below Auto Update Tolerance Screen ALARM TOLERANCE SCREEN High 50 50 50 50 50 OFF Low 20 20 20 20 20 CUFF MOTION ARTIFACT 50 11 06 PREV SAVE SCREEN gt MAIN The alarm tolerances have a range of 1 to 100 and OFF for the high alarm limits and a range of 1 to 50 and OFF for the low alarm limits When the Auto Update Soft Key is pressed from the previous alarm screen the current measurement value patient s baseline blood pressure is multiplied against the High and Low alarm tolerances the product of this multiplication is added to the current baseline value to set a high alarm limit value and subtracted from the current value for the low alarm limit value Pressing the Prev Screen Soft Key causes the screen to revert to the Alarms Screen and no changes are saved Pressing the Save to Main Screen Soft Key saves the changes activates the new limits and returns the display to the Line List Display Main Screen 3 5 3 2 6 Audible Alarms The Rosie monitors sound an alarm when set limits for Systolic Mean Diastolic Pulse Rate SpOo or Temperature are surpassed The audible alarm is a high pitched tone that sounds at one second intervals until a new
43. anufacturers in general and to manufacturers of the product category to which the product belongs 1 5 Service Limitations Maintenance and repair services performed by user personnel on the equipment covered in this manual apply only to products that are out of warranty All warranty repairs should be performed only by qualified service technicians authorized by Life Systems A comprehensive technical service manual for the Rosie containing specific information about operation calibration parts listing and schematics can be obtained by contacting Life Systems Technical Service Department 1 2 1 6 Returning the Unit Prior to returning a unit for any reason please Call Technical Services at 1 800 841 1109 Ext 105 for the most efficient and effective troubleshooting you will need to have the unit in front of you and be knowledgeable of the problem in the unit is experiencing If it is determined that the unit needs servicing a Return Authorization RA number will be assigned and the Life Systems technician will instruct you on how to return the unit Life Systems will not accept any package without a valid RA 1 Contact Technical Services ALWAYS 2 Send Back once Technical Services issues RA Ship to Life Systems Inc 7320 Central Ave Savannah Ga 31406 Write Attn RA Number the number provided when you called on the address label 1 7 Shipping Procedures Products shipped by Purchaser under this warranty shall be
44. ation indications other than parameter measurements are also shown In front of the SYS value indications for Neonatal N or motion artifact may be indicated Motion artifact may also appear in front of the SpO value Any time a parameter has fallen outside of an alarm limit that value will be placed in a box The Patient Name and ID information is entered through the use of the ID screens see section 3 6 If no patient information is entered prior to a spot check measurement the patient ID will be displayed as ID Unknown The monitor automatically adds updates information into the Line Listing memory Upon the completion of a blood pressure measurement Upon the violation of a set patient alarm limit Upon the completion of an E Temp measurement At the user selected memory intervals see System Settings page 3 7 Upon receipt of first measurement following application of the SpO sensor Services A 3 2 Data is saved added to the Line List at user selected intervals or on completion of a blood pressure or temperature measurement Parameters being measured concurrently will be saved to the Line List at the end of the longest running measurement The maximum Line List memory is 400 lines Each memory listing presents patient ID the date current time and the vital signs values If the memory listing has 400 measurements stored and an additional measurement is made the memory will automatically remove th
45. bleach 5 25 0 75 cup gal Germicidal detergents i e Hi Tor Plus Huntington Corp 9 3 3 Reusable Cuffs Neonatal cuffs and all other disposable cuffs are supplied for single patient use and should be discarded if they become soiled For all other cuffs Remove the bladder from the cuff All parts of the cuff and bladder can be cleaned with an alcohol wipe or a damp cloth or they may be disinfected with an EPA registered low level disinfectant wipe spray Care should be exercised to ensure that no fluid enters the cuff hose at any time If immersion is necessary insert cuff hose caps into the ends Should water enter the cuff hose the hose may be dried by passing air through it A more thorough hand washing of the cuff will enhance the service life After removing the bladder hand wash the cuff in warm soapy water then rinse thoroughly Allow the cuff to air dry and then reinsert the bladder If machine washing be sure that the hook and loop fasteners are engaged so that the hooks do not collect lint or other fibers If ironing or pressing the cuff ensure that the temperature does not exceed 325 F 162 C The cuff may be sterilized by exposure to EtO Since the cuff is used as an external accessory only the desired sterility assurance level SAL of 10 should be achieved Due to variations in hospital sterilizing technique precise instructions cannot be given however maximum exposure and aeration times should be employed
46. by discussing the fully configured model that includes NIBP Pulse Pulse Oximetry Temperature and a printer It may therefore present information that does not apply to your unit s The front and rear panel designs and connection ports will vary according to the parameters that have been built into your monitor s 1 2 General Description The Rosie II monitor is a portable adult pediatric and neonatal vital signs monitor It non invasively and automatically measures systolic mean and diastolic blood pressures pulse rate oxygen saturation SpO gt and temperature depending on the parameters incorporated into the specific model Please Note The Rosie monitor is designed for Single Patient Use only Do not attempt to place the sensors on multiple patents simultaneously The monitor incorporates large colored LEDs to display all current parameters with each parameter having its own unique color to increase readability A large LCD screen displays historical information and is used to set up the operation of the unit The monitor uses Colin s dynamic linear deflation blood pressure technology and features a full array of alarm settings for each displayed parameter Its memory holds up to 400 lines of information that can be viewed or printed in several print formats The monitor has been designed to operate on AC power properly grounded hospital grade outlet or on a 6 volt internal battery The Rosie series offers several par
47. connector AC Plug Receptacle RS232 Interface Connector 2 6 Rear Panel Description clockwise from upper right Handle Allows the user to move or carry the monitor The handle area may feel warm because it is also used as an exhaust port for the unit E Temp Probe Connector Configuration dependent this port is used to connect the Alaris Turbo Temp temperature probe cable Push the cable connector of probe in until a positive latch is made SpO2 EC Cable Connector Configuration dependent this port is used to connect the Doc 10 extension cable to the monitor When connecting the Doc 10 extension cable you will have a positive lock on the cable when inserted correctly RS232 Interface Connector Allows for RS232 or other communication interface with other systems AC Plug Receptacle Standard inlet for AC cord plug Biomed Ground Lug An additional ground point for Biomed or when external grounding is needed Printer Paper Door Allows easy access to the paper roll compartment Refer to Section 7 1 for more information BP Cuff Connector To connect the cuff hose insert the connector and rotate clock wise to lock in place Battery Cover on the bottom of the unit not shown Allows quick access to the battery compartment It is secured with screws as access is intended for trained professionals only 2 7 Recharging the Battery The battery of the Rosie monitor recharges automatically any time the power
48. cord is plugged into an appropriate AC power source Recharging from a fully drained battery to a fully charged battery may take up to four hours The Battery Charging Indicator LED on the front of the monitor shows the charging status when the unit is plugged in A RED light indicates the battery is charging GREEN indicates battery power has reached at least 90 of capacity A fully charged battery greater than 90 of capacity will generally last more than six hours at 15 minute spot check measurement frequencies NOTE Life Systems doesn t recommend that you let the battery discharge completely P Battery Charging Indicator Life Systems recommend that when the monitor is stationary it should be connected to an appropriate AC power supply to help ensure maximum battery power accessibility and life Refer to Section 9 1 and 9 2 for further information regarding battery removal and replacement Note If the unit is stored or will not be used for an extended period of time Life Systems recommends that the main battery be removed from the monitor Note Always verify that the Battery Charging Indicator LED lights when the unit is connected into an AC outlet A monitor that is plugged in but shows no Battery Charging light indicates a problem with the charging of the monitor Refer to the troubleshooting section for assistance Note The Rosie employs the chimney effect to cool the monitor ambient air enters vents in the
49. curate measurements can also occur during e External motion artifact as in patient movement CPR or bed movement e Serious episodes of shock hypotension or decreased body temperature e Frequent episodes of arrhythmia When the measurement has failed or if a measurement value is questionable always verify the patient s blood pressure using another technique 5 Electronic Predictive Temperature E Temp 5 1 Principles of Electronic Predictive Temperature Life Systems E Temp temperature measurement technique is based on Alaris Turbo Temp predictive temperature technology that uses a temperature thermistor that changes it s output depending upon the temperature of the contacting tissue In the Monitoring mode the monitor continuously updates and displays the temperature values as long as the temperature probe is in contact with the patient s In the Predictive mode the monitor looks at the rate of change from a given starting temperature and within 7 seconds predicts and displays the final temperature and sounds a tone signifying completion of measurement 5 2 E Temp Setting Screen To select the temperature measurement mode Predictive or Monitoring press the Systems Soft Key from the Line List screen then the Temp Settings Soft Key See section 3 4 2 for setting instructions 5 3 Connecting the Temperature Probe to the Unit Connect the temperature probe cable to the
50. do not create a hazard and are not moved during operation e Always follow approved technique when using each parameter Refer to the section s in this manual pertaining to the parameter s included in your monitor e Always press front panel switches with a fingertip not a fingernail or other pointed objects 2 1 2 3 Warnings and Cautions of Use Safety Symbols and Terms for Safety Throughout this manual and on the actual products safety symbols and terms are shown for safe and proper use of the products The meanings of these symbols are shown below Please familiarize yourself with these symbols before proceeding with this manual DANGER WARNING CAUTION NOTE ANS Other Symbols HSD DANGER indicates an imminently hazardous situation which if not avoided may result in serious injury or death WARNING indicates a potentially hazardous situation which if not avoided may result in serious injury or death CAUTION indicates a potentially hazardous situation which if not avoided may result in minor or moderate injury NOTE presents helpful information about the operation of the unit Indicates a warning defined or described by its contents Specific DMA information or cautions are included within or nearby the symbol In this case the symbol warns of the possibility of electrical shock O Indicates a prohibited behavior Specific instructions are included within or nearby the symbol in this case prohibit
51. e When a module sends over an error code that is not defined by the Rosie it will store that error for troubleshooting purposes though the user must consult the respective module specification document to translate the error Time format Modules Error Code Def MM DD YY SYSM M2 Warning Battery near empty M3 Fatal Battery Empty M5 Warning Run Time Clock Error M10 Fatal RAM ROM error MII Warning Factory Defaults reset 8 12 M13 Fatal System Overheat M14 Fatal System Overheat NIBP TIME Warning Comm Timeout E09 Warning M2600 E09 error E08 Warning M2600 E08 error E07 Warning M2600 E07 error NR3 Warning No read after 3 tries other Warning check M2600 spec SPO2 TIME Warning Comm Timeout S03 Warning No Sensor Detected S04 Warning Monitoring No Signal other Warning check SpO2 spec TEMP TIME Warning Comm Timeout TA6 Warning Probe Failure TA7 Warning Probe Disconnect other Warning check Temp spec PRNT P02 Warning Plat is up P03 Warning Paper empty other Warning check Printer spec POO Warning Communication Timeout 8 13 9 General Maintenance This manual describes and supports all of the monitors in the Rosie series by discussing the fully configured model model 2240P that includes NIBP Pulse Pulse Oximetry temperature and printer It may therefore present information that does not apply to your moni
52. e non invasively automatically The fundamentals of the technique are easily explained An inflatable cuff is placed around a limb usually the upper arm When the cuff is inflated and the pressure in the cuff exceeds systolic blood pressure blood ceases to flow through the brachial artery Though the inflated cuff stops blood flow each time the heart contracts a very small pulse can be observed superimposed upon the cuff pressure signal These small pulses are called oscillometric pulses Slowly relieving the pressure in the cuff allows the blood to penetrate further and further under the cuff slightly increasing the amplitude of the pulses until the cuff pressure eventually becomes equal to the systolic blood pressure and blood can start to flow through the brachial artery The increased surface area of the cuff that comes in contact with the blood as it passes under it causes sudden large increases in the amplitude of the oscillometric pulses Measured M Measured Systolic ean Diastolic Pressure Time As the pressure in the cuff continues to decrease more cuff surface area is affected and the amplitude of the oscillometric pulses continue to increase until the cuff pressure reaches mean arterial blood pressure and the amplitude of the oscillometric pulses peak Then as the cuff pressure decreases further the oscillometric pulse amplitude decreases continuously until the cuff pressure reaches the diastolic blood pres
53. e oldest stored listing and add the current one The Line Listing memory is automatically saved each time the unit is powered OFF When the unit is powered back ON the entire Line Listing will again be available To clear all the data on a specific patient Press the ID Soft Key from the Main Screen Press the Up or Down button until the ID or the patient name appears on the screen and then press the View Pat Soft Key Verify that the selected patient is the appropriate patient you wish to delete from the listing and push and hold the Delete Pat Soft Key To clear the entire Line List memory enter the System Settings screen using the Soft Keys move the cursor over the Line List Clear selection then press and hold the Delete Soft Key for at least one full second A beep sounds two times confirming the process 3 22 Alarms Settings Screen The Rosie monitors contain fully functional alarm parameters High low values can be set for Systolic Mean Diastolic Pulse Rate SpO2 and Temperature HI only These alarms may be set manually for each use or automatically as a protocol The alarms screen shown below is accessed by pressing the Alarms Soft Key from the Line List screen It allows the user to view the current alarm settings Alarms Screen High 150 90 110 120 OFF 103 5 Low 90 50 70 50 95 CUFF MOTION ARTIFACT C5 50 11 06 PREV CHANGE AUTO UNDO SAVE
54. e unit will initialize and perform a self test During this process 888 appears in all of the LED displays As each parameter is initialized the displays change from 888 to and the Line List or Main Screen appears on the LCD screen Once this verification is complete for all parameters about 10 seconds the monitor is ready for use Note Life Systems recommends that the user has a clear understanding of the Rosie Monitor its intended use warnings precautions and the other information found in this manual before using this device for patient monitoring 3 LCD Screen Structure The screens in the liquid crystal display LCD of the Rosie monitor have been designed so that all models use the same screen structure regardless of the parameter configuration This section describes each of those screens and the selections that are available for and through them Selections are parameter dependent that is you only see screens that apply to the parameters within your monitor The OK Button moves the cursor through the settings on the screen The UP and Down V Buttons increase or decrease the values highlighted by the cursor or toggle between two settings Adult or Neonatal BP mode for instance Time Sys Dia MBP SpO2 E Temp UP Button LCD OK Button Down Button RTEZ AAA 2 Soft Keys LCD screen Buttons and Soft Keys The Soft Keys AAA ALL select the functions you wish t
55. ew and or modify one of the user designed cuff interval programs select the desired program A B C D E then press the View Modify Soft Key the interval program will appear on the LCD screen as shown in the following example INTERVAL PROGRAM A RUN TIME 4 00 TIME hh mm INTERVAL START i gt 0 30 5 MIN 0 30 2 30 15 MIN Wa 3 00 15 MIN 3 00 3 30 15 MIN 3 30 4 00 15 MIN CUFF MOTION ARTIFACT 50 11 06 PREV SAVE SCREEN gt MAIN Interval Program identifies the selected program in this case A Run Time hh mm indicates the overall time period of the program If the last period is left open ended through the user s selection of the Run Time will also indicate this selection 3 7 From Column This column indicates the beginning time of each period The values found in this column are automatically linked to the ending time of the previous period To Column This column indicates the end time of each period The possible selections for this value are this selection indicates that this period will continue for eternity and 0 05 12 00 a time selection in five minute increments Interval Column shows the cuff measurement interval selected for that time period Any of the manual selection cuff intervals ST 1 2 2 5 3 5 10 15 20 30 60 90 120 180 minutes can be selected as long as they are shorter th
56. f the probe in detergent solutions is not harmful and is recommended before disinfection if soiled material is noted on the probe Activated dialdehyde solutions are also effective Probe plugs should not be immersed Sterilization Ethylene oxide EtO sterilization is the preferred method After sterilization probes must be safely and thoroughly ventilated before handling Storage and Handling Handle all probes and cables with care When not in use probes and leads should be formed into loose loops If wires are stretched or wrapped tightly around instrument cases stresses sufficient to cause mechanical failure may occur Store probes at temperature below 50 C preferably at room temperature Recommended EtO cycle Temperature Humidity Gas Concentration Exposure Aeration Cycle 125 F 5 F 50 650 mg liter 2 hrs 24hrs 9 3 10 Patient ID Bar Code Scanner Wi Dsi Y Barcode ee Instructions Mounting and integrating the scanner Connect the bar code scanner interface cable to the back of the Rosie Monitor on the IO connector Secure the cable in place by tightening the top and bottom retaining screws in the connector Attach the scanner s mounting arm to the Rosie stand just below the unit so that the scanner is held To one side of the unit Tighten the arm s mount by tightening the two allen bolts with the appropriate wrench Attach the enclosed Reset Bar Code Reader label t
57. fter STAT measurements Short Term have been initiated the cuff interval will automatically revert to a 5 minute interval 4 2 4 2 2 Cuff Settings Screen The Cuff Setting Screen refer to 3 4 1 page 3 9 allows the clinician to set up the overall parameters of the NIBP cuff measurements Cuff Mode The user must select from the Adult Pediatric or Neonatal mode to match the patient If the Adult Pediatric mode is selected use the BLUE cuff hose and the appropriate size BP cuff If Neonatal is selected use the PINK cuff hose and a disposable neonate cuff of the correct size Initial Pressure Setting the initial cuff inflation pressure allows the user to select a range inflation values from 120 mmHg to 220 mmHg in increments of 20 mmHg in the Adult Pediatric mode and 80 mmHg to 120 mmHg in increments of 20 mmHg in the Neonatal mode Settings are saved when the monitor is turned off and become the default when the monitor is powered up BP Upon Alarm When this alarm is activated the monitor will automatically take a second blood pressure measurement upon an alarm limit violation to aid in verifying an alarm condition Smart Clock By selecting the Smart Clock feature the unit automatically synchs the second and subsequent cuff interval measurements with the major points on the clock making trending of the information easier for the clinician it can also ensure recent vital signs during the nurses rounds 4 2 3 Smart Inflat
58. genated and deoxygenated hemoglobin within the vascular bed The determination of arterial hemoglobin oxygen saturation is automatically computed from the relative amounts of light transmitted to the photo detector light sources photodetector Pulse Oximetry uses the two wavelength technology to determine functional oxygen saturation Functional saturation is the ratio of oxygenated hemoglobin over that of total possible hemoglobin available for oxygen transport The formula for that equation is as follows SpO2 100 x Hb02 Hb02 Hb 6 1 6 22 Probe Selection The monitor uses Nellcor OxiMax sensors Only Nellcor OxiMax sensors are recommended for use with the Press Mate Prodigy monitor It is important to select the appropriate sensor for use with each patient to obtain accurate measurement results Please select one of the following OxiMax sensors available from Nellcor Dura Sensor DS 100A This reusable sensor should be applied to adults weighing over 40 kg MAX A This disposable adhesive sensor should be applied to adults weighing over 30 kg MAX AL This disposable adhesive sensor is the same as the MAX A OxiMax sensor however it has a longer 36 cable MAX P This disposable adhesive sensor should be applied to pediatric patients weighing from 10 50 kg MAX I This disposable adhesive sensor should be applied to infants weighing from 3 20 kg MAX N This disposable adhesive sensor
59. gns Format The Rosie monitor with printer can be set to print out vital sign automatically after each measurement Print Options screen section 3 4 3 This print format is also used when the Print Upon Alarm selection has been made Print Options screen section 3 4 3 and a patient alarm occurs generating the alarm condition If the Current Soft Key is pressed in the Print screen see section 3 4 a printed record will be made of the last measurement taken and stored in memory The printed record includes the Current Date Patient s Name Patient s ID number and vital signs information This printout is delayed until the completion of the blood pressure measurement to allow for completion of other parameter measures that may be running concurrently Any values causing alarm signals are shown within a box as shown below If the LCD indicates motion with a mark next to the cuff reading or SpO gt reading this same indication will appear next to their corresponding values on the printout If the BP Mode is set to neonatal the indication of N will appear next to the SYS printed value Below is an example of the vital signs print gt On D BS EPES p 32 E u LO lo s 2 o N cO Va SIS SS Y os V2 a CO e Na Na ao Im cu QA sa uN o a gt lt Ci sS OAZA Q S Tearing off the Printout For best results the operator sh
60. he current time Note If an interval of 1 minute Short Term is selected after 12 measurements the monitor will automatically change its interval measurement to 5 minutes To access the Cuff Interval screen press the Cuff Soft Key from the Line List screen Then choose one of the timed measurement intervals from a selection of STAT continuous 1 2 2 5 3 5 10 15 20 30 45 60 90 120 and 180 minutes Pressing the STOP Soft Key can halt a cuff interval already in progress Once a value has been chosen pressing the Main screen button saves that setting the display returns to the Line Listing or Main format and the interval measurement begins Continuous measurements are initiated when STAT is selected in the Cuff Interval screen and the Start Stop button is pressed To interrupt the measurement press the Start Stop button during the measurement When the continuous measurements are interrupted in this manner the word ANI in the CUFF soft key will appear reversed on the LCD screen and the measurements will cease Note When STAT continuous measurements are specified a rapid estimation of systolic blood pressure is displayed upon second and subsequent BP measurements A single beep alerts the user of the displayed Quick Estimated Systolic value On completing the measurement two beeps sound and the actual BP values are displayed Caution Five minutes a
61. in the user s department Refer to section 3 2 5 to learn how to set these tolerances Once the User uses the Auto Update to adjust the alarm limits the new limits are displayed on the Alarm screen At this time the user can agree with the values or make any modifications to the settings using the manual Alarm Soft Key All active parameter alarm limit values can be adjusted using the tolerances found in the Auto Alarm Tolerance Screen The new alarm limits will be shown on the screen and the user will be given the opportunity to adjust limits if required NOTE In the Adult mode the Rosie monitor will sound an alarm at a systolic pressure below 70 mmHg even if a lower limit is set Neither the feature nor the alarm can be overridden The range remains adjustable for use in the Neonatal mode where lower limits can be set 3 4 3 2 3 Removing Alarm Limit Changes Pressing the Undo Change Soft Key erases any changes made and the alarms settings return to their previous values and status 3 2 4 Saving Changes to the Alarm Limits Pressing the Save gt Main Soft Key saves the changes the new alarm limits are activated and the LCD screen returns to the Line List Display Caution When the measured value reaches or exceeds the high limit or falls below the low limit settings its measurement LED display will flash If the audible alarm has been set the alarm will sound 3 2 5 Changing the Auto Update Toler
62. ing disassembly Indicates necessary action or gives instructional information Specific instructions are included within or nearby the symbol in this case pulling the power cord by its connector This mark indicates that an alarm is sounded Once the alarm sounds appropriate actions must be taken This mark indicates that these components meet Type BF electrical safety requirements for Difibrillation Proof applied parts This mark indicates the potential equalization terminal 2 2 DANGER a D i l l ll li i l i 88 DO NOT USE THE ROSIE II MONITOR IN THE PRESENCE OF A FLAMMABLE ANESTHETIC MIXTURE WITH AIR OR WITH OXYGEN OR NITROUS OXIDE WARNING HN Only operate the equipment at the rated voltages and frequencies To ensure proper grounding connect the monitor only to a properly grounded 3 wire hospital grade receptacle Do not use extension cords If any doubt exists as to the grounding connection do not operate the unit from the AC power source the monitor must be operated on the internal battery power Servicing other than that described in the Operation Manual should be performed by qualified service personnel only Accessory equipment connected to the analog and digital interfaces must be certified according to the respective IEC standards Do not modify this device without appropriate authorization This device can be damaged by energy discharged from a defibrillator Please disconnect the SpO and temperature
63. ion Smart Inflation is set to ON when shipped from the factory This selection will enable the monitor to automatically inflate the cuff to a required inflation pressure above arterial occlusion The inflation pressure will customize itself to each patient s individual requirements For example monitors typically inflate to 180 mmHg and then deflate In some patients that can be very uncomfortable and they may even become agitated during test Smart Inflation is monitoring for arterial occlusion during inflation and stops when necessary not to a preset pressure NOTE It is important to understand that if a patient is moving shacking or agitated during the blood pressure measurement Smart Inflation might misinterpret the movement as a pulse If it mistakes a pulse while inflating it could potentially inflate to pressures over 180 mmHG When you have patient that is unable to stay still we recommend that you disable Smart Inflation To disable Smart Inflation first press the SYSTEM button then press the CUFF OPTION button Move the curser to the SMART INFLATION choice and un check the X When Smart Inflation is disabled the monitor will first inflate to the maximum pressure setting in the INIT INFLATION PRESURE setting However the monitor will also retry two more times at an increased pressure as normal The default for INIT INFLATION PRESURE from the factory is 180 mmHG 43 Applying of the Cuff When ap
64. ire may be present Where ambient temperature is below 10 C 14 F or the humidity exceeds 95 If condensation is present on the unit disconnect the monitor from AC power and dry the unit with a cloth Condensation could lead to electric shock and other mechanical problems with the monitor Do not use a ball point pen or other sharp objects to push the switches This could lead to mechanical problems 2 4 WARNINGS and CAUTIONS During NIBP Monitoring 88 If the NIBP measurement is unsuccessful or when there are doubts about the measurement values assess the patient s condition immediately Their condition may have deteriorated to the point where measurement limits are exceeded Always verify that the cuff and cuff hoses are applied and or attached appropriately and are not bent or blocked If the display shows 0 the monitor s pressure may be 0 but if the cuff hose is blocked or bent there may be air remaining in the cuff At this time disconnect the hose from the cuff to ensure that blood flow is not restricted Do not apply the cuff to the same arm where IV or blood transfusions are being conducted Measurements are not possible for patients With insufficient peripheral circulation acute cases of low blood pressure or low temperature With a high frequency of arrhythmia Using cardio pulmonary pumps Accurate measurements may not be possible When heart massage is conducted when there are continuous exte
65. isplay The clinician s measured values fall normally within 5 mmHg of the monitor s displayed values at the measurements completion Technicians only Extreme leak in unit or cuff Verify location of leak Replace defective connectors hoses or modules as needed to correct leak Use the appropriate Service Mode tests to locate leaks NIBP Module is defective Replace NIBP module Unreliable NIBP readings Cause Solution Cuff Placement and Verify appropriate cuff placement and positioning Positioning as indicated in Operation Manual Cuff limb is not at Heart Level Verify and place cuff limb at patient s heart level Unstable blood pressure Verify patient for reciprocal pulsations or respiratory alterations Patient Movement or Check for patient movement or anxious state Anxiousness nervous movements 8 6 8 5 Problems with E Temp Verify against Error Messages for further information No temperature measurement Cause Model Wrong Disconnected probe or cable Probe out of well on power up Defective Probe Technicians only Temp Cable disconnected Main Board is defective Temp Internal Error shown Cause Defective Probe Technicians only Temp Cable disconnected Main Board is defective Temperature reading unreasonable Cause Solution Verify selection of Model configuration in the Service Menu Connect probe or change if defective Insert probe into probe well try mea
66. lace power supply Main Board is defective Replace the main board 8 1 Cannot turn ON power to the monitor Displays comes on and Power cycles Cause Solution Battery is defective Allow battery to Charge for a period of 10 minutes Then turn ON again Verify battery voltage is above 6 0 V as power cycles Technicians only Main Board is defective Replace with known good board The unit overheats Cause Solution The unit will normally get warm as it charges a fully depleted battery It will normally start to cool down after 2 hours of charging Airflow to the Move the monitor or remove objects that are too close to it Monitor is impeded Technicians only Battery is defective If after charging for several hours the unit remains hot especially the battery on the bottom of the unit replace the battery Battery Power does not last Cause Solution The unit has been designed to provide a minimum of 4 hours of battery power with spot check measurements taken every 15 minutes Life Systems recommends the battery be replaced at least once a year to maintain sufficient battery power Technicians only Battery is defective Replace Battery Main Board is defective Replace Main Board The main board determines the remaining battery power and if the AD converter has failed the board can notify the user of a depleted battery with sufficient power still exists Monitor does not respond to button press Verify that the u
67. laced when manual measurements are taken Note Be aware of the actual location of the Brachial Artery It is located on the inside of the upper arm The end of the cuff should fall inside the range marks clearly identified on the inside of the BP cuff B in diagram below If the end of the cuff does not fall within this range increase or decrease the size of the cuff so that the new cuff fits correctly Note Life Systems offers a wide range of blood pressure cuffs to meet your patient requirements refer to the accessory portion of this manual for more information about cuffs THIS SIDE TO PATIENT loc A B Wrap the cuff snugly so that two fingers can be placed between the cuff and the arm above and below the cuff If the cuff is wrapped too loosely it cannot be inflated properly there may be errors in measured values and the patient is likely to be uncomfortable It is best to wrap the cuff around a bare arm as clothing may cause errors in measured values Figure C Figure D Figure E Keep the cuffed part of the arm at the same level as the heart The arm should also be resting on a level surface to reduce muscle tension that may cause an increase in blood pressure measurements Note If the arm is above the level of the heart the blood pressure measurement may be lower than the actual value if the arm is below the heart level the b
68. le and Disposable OxiMax sensors If any abnormality is found the measurement site must be changed Without changing the site inflammation and low temperature burns may occur 2 6 WARNINGS and CAUTIONS During Temperature Monitoring AAA Do not use temperature probes with damaged wire coverings Their use may lead to patient harm Use only IVAC P850 Probe Covers for the E Temp thermometer The size shape and thermal characteristics of the probe cover can affect the temperature reading WARNINGS and CAUTIONS During Cleaning Ill Always disconnect the monitor from the AC power source before cleaning the monitor with a wet or damp cloth Avoid using any solvents like thinners or benzene as cleaning with these agents may cause damage to the monitor s exterior See section 9 3 for cleaning instructions 2 7 2 4 Front Panel Callouts This manual describes and supports all of the monitors in the Rosie series by discussing the fully configured model 2240P which includes NIBP Pulse Pulse Oximetry Temperature and Printer It may therefore present information that does not apply to your unit The front and rear panel designs and connection ports vary according to the parameters that have been built into your monitor Alarm Mute Button Alarm Indicator LED Cuff mode indicator LED SpO measurement LED _ BP measurement LED Temperature probe cover BP unit of measure box receptacle BP measurement in progress
69. leep Mode The Biomedical Technical Department must implement this setting 3 1 Patient Information TIME SYS 2M_ MBP PR SoO2 TEMP 7 9 MARK WILLIS 1234 11 03 120 80 93 83 98 7 9 Unknown 10 120 85 98 75 D Message Selection Area Battery Power 9 Indication Current Time CUFF MOTION ARTIFACT Soft Key Labels Pressing the soft keys below the display will yield more information about that setting set up listed in the box above each key and the screen will change accordingly Within the Line List screen if the UP or Down Y buttons are pressed the information on the display will change in steps page turn while pushing and holding the buttons causes the Line List information to scroll quickly If the Down Y button is pressed the Line Listings scroll toward the most recent listing while if the UP button is pressed the Line Listing will scroll toward previous measurements NOTE As you view any historical information please refer to the date and time stamp of each measurement If the user is reviewing historical information and the unit places a current listing to the memory the view will remain where selected rather than automatically presenting the recent data If the screen is left at an historical site for longer than 30 seconds and no buttons are pressed the screen will revert to current the latest information Within the Line List inform
70. lood pressure may be higher than the actual value due to the physical weight of the blood 4 3 2 Neonatal Cuff Placement and Positioning Note Make sure the Neonatal measurement mode is selected in the Cuff Setting screen Check the cuff site if long term monitoring will be required Check the patient s arm thigh frequently for cuff site irritation Reliable measurements can be obtained by following the guidelines listed on the next page A Be sure the disposable cuff is fully deflated before applying it to the neonate s arm or thigh B Wrap the disposable cuff snugly to the arm or thigh C Position the limb and cuff at heart level to avoid a pressure reading error due to hydrostatic pressure D After applying the cuff wait until the patient relaxes before initiating a measurement the patient needs to be reasonably still to avoid motion artifact E Check hose connections and cuff placements routinely for folds kinks cracks or any pressure being applied to the outside of the hose casings By pressing the CUFF START STOP Button the cuff is inflated to 120 mmHg in the Neonatal mode Unless an initial cuff inflation pressure was pre set in the Cuff Option screen the cuff will inflate to the 120 mmHg default WARNING Inaccurate measurements can occur if the neonate s systolic blood pressure is over 130 mmHg due to the 150 155 mmHg maximum inflation pressure of the monitor in the neonate mode Inac
71. mber shows the current pulse rate in beats per minute bpm Pulse Level Indicator This eight segment LED bar indicates the strength of the pulse signal The pulse strength determined from the SpO is shown in red while that determined by the BP cuff is shown in green The SpO 2 measurement is triggered by each pulse The Blood Pressure pulse measurement is triggered by the cuff cycle and remains displayed on the monitor until the next cuff cycle Up Control Button Moves the screen back in the Line List memory or increases the value of a number highlighted by the cursor in the LCD screen OK Select Button Moves the cursor through the LCD screen when adjusting the setup Down Control Button Moves the screen forward in the Line List memory or decreases the value of a number highlighted by the cursor in the LCD screen Soft Keys Are used to control the operational settings of the monitor Their function depends on the screen that appears in the LCD window Refer to the Screen Description section of this manual for more information LCD Screen A high contrast backlit LCD screen used to set monitor variables to input patient information and to access information from the line list The backlight of the LCD automatically turns off after 5 minutes as the unit enters its sleep mode Refer to Section 3 0 Battery Charging Indicator This light shows the status of the battery charge It is lit only when the monitor is connected
72. nclude smoke or odor emission e Dropped units should be considered failed until they have been checked for proper operation e Units into which liquids have seeped should be considered failed until thoroughly dry and they have been checked for proper operation If the monitor fails as mentioned above 1 Confirm that the AC plug is unplugged Do not pull on the cord Unplug by holding and pulling the plug 2 Disconnect the monitor from the patient Place a Do not use Out of Order sign onto the front of the monitor 4 Contact the appropriate personnel according to your facility s procedures or instructions pa A gt E _ Z SOO e The unit should be installed in a location that provides A level and stable surface for the unit to sit on Space required for adequate airflow Ambient temperature between 0 40 degrees Centigrade 32 104 F and a humidity less than 75 Appropriate grounding for the unit If the AC wall plug does not supply ample ground potential connect a grounding strap to the potential equalization conductor on the back of the unit then to an appropriate ground The following locations are not suitable for installing the unit Where direct sunlight is on the unit for an extended period of time Deterioration of the liquid crystal display will occur Where the unit may be splashed with liquids Where extreme shock and vibrations may damage the unit Where gas and f
73. ne List screen under the word Cuff for example A 5 indicates program A running and a cuff interval of 5 minutes is in process 3 4 System Settings Screen Pressing the System Setting Soft Key from the Line List screen brings up the Systems Setting Screen that is used to make changes to the main system Date Time Alarm volume etc Press the OK button to move the cursor and the Up and Down keys to adjust the highlighted values Using the Soft Keys under the screen gives access to the cuff temperature or print set up screens as shown on next page 3 8 System Setting Screen LINE LIST INPUT _5 MIN LINE LIST MEMORY CLEAR DATE 04 21 2000 TIME 11 06 VOLUME ALARMS PULSE CUFF MOTION ARTIFACT 4 50 11 06 CUFF TEMP PRINT SAVE OPTION OPTION OPTION gt MAIN Pressing Save gt Main saves the revisions and returns the LCD screen to the Main screen Line List Input is the rate at which the device stores patient information into the line list memory While the Rosie monitor automatically stores data after each BP measurement and upon alarm activation this option allows the user to store information at a rate not related those cycles The possible selections are CUFF Only 30 sec 1 2 2 5 5 10 20 30 60 minutes Activating Line List Memory Clear erases the entire line list To activate this feature move the cursor
74. ngs of Volume Verify user selects the appropriate volume selections in the In System Screen SYSTEM configuration screen Technicians only VR2 settings Adjust VR2 on the top of the main board so that the volume becomes acceptable Speaker defective or Check connections to speaker or replace speaker disconnected Main Board is defective Replace main board 8 3 8 3 Problems with Printer Paper Jams Cause Solution If a paper jam occurs turn off unit remove AC power lift up the platen release lever on the left side of the printer and slowly pull on the paper to remove it from the printer Incorrect width paper Verify that the paper is Colin paper users have a tendency to use whatever paper they find if too wide or narrow paper is used the printer can jam Paper inserted wrong If the paper is inserted into printer at a harsh angle to the front or back the printer can jam Technicians only Alignment of printer Verify that the printer bracket is placed up against the paper door spindles Once the bracket is in the appropriate position tighten the two screws on the bottom of the unit to retain the bracket position Printer Does Not Print Cause Solution A paper Jam Occurred Turn off unit remove AC power lift up the platen release lever on the left side of the printer and slowly pull on the paper to remove it from the printer As power is again turned on the printer will reset allowing printing to continue M
75. nit is not functioning clinicians sometimes call trying to operate the unit in a manner that the device was not intended to operate Technicians only Sheet Switch connector Reconnect Sheet Switch connector to main board and verify appropriate Connection Sheet Switch is defective Verify the appropriate pins are pulled low as the buttons are pressed if not replace sheet switch Main board is defective Replace the main board 8 2 Unit forgets settings and continuously says Factory Defaults Cause Solution The message SYS Factory Defaults are only shown on the screen the first time the unit is powered up after the Factory Defaults have been initiated If the unit senses the saved memory has become corrupt the unit will initiate a Factory Default Technicians only Clock Battery Defective Replace Clock battery Main Board is defective Verify Solder of U2 U3 U18 and other components Replace main board Display is not complete or missing segments Cause Solution Model Wrong Verify selection of Model configuration in the Service Menu Technicians only VR setting Adjust VR so that contrast of LCD is acceptable LCD Defective Replace LCD LED Defective Replace LED or main board as required Main Board is defective Replace main board Display shows Garbage while unit off and charging Cause Solution Technicians only LCD Defective Replace LCD Speaker Volume is not appropriate Cause Solution Setti
76. nsors Please read the instructions attached to the OxiMax before using Remove the protective film on the adhesive surface of the probe If the OxiMax is used on the finger make sure the wire is located over the nail Wrap the sensor over the finger so that the light source and the photo detector are in the same line ensuring accurate readings are obtained Light Source Photo Detector CAUTION Apply to a clean dry site Avoid applying additional tape over the sensor to reduce the risk of venous pulsation and inaccurate saturation measurements as well as the potential for pressure damage at the site Applying tape over the cable however may help prevent the sensor from becoming dislodged Check sensor site and circulation distal to the sensor at least every 8 hours and change the sensor site as required Remove the sensor carefully from the patient for use on another site OxiMax sensors may be reused on the same patient if the adhesive tape attaches without slipping Replace the sensor when its adhesive quality is depleted 6 5 7 Printer Operation 7 1 Loading Paper into the Printer The Rosie series monitors use an automatic paper loading system If your unit has a printer follow the instructions listed below to load the paper Verify the appropriate paper roll orientation Only one side of the paper is printable Use your fingernail to rub the paper if the paper marks the correct side is up 1 Tear a str
77. o the scanner s mounting arm for easy access when needed This label can be used to reset the scanner when it qopeqrs the scanner is no longer reading the patient s bar code correctly Scanning a patient s ID At this point you can use the scanner to read the patient s Identifi cation bar code Turn the unit on once the Self Test is complete simply pull the scanner s trigger and with the scanner approximately six 6 inches from the patient s wrist aim the red scanning light at the patient s bar code As the unit Beeps the ID code is recorded into the monitor s memory Verify that the ID displayed on the monitor s LCD screen matches that on the patient s wrist then press the Save gt Main soft key Now you can begin measur ing the patient s vitals signs which will be recorded into memory identified by the patient s ID If the scanner will not read the patient s ID slowly move the scanner away from the bar code starting at a distance of 3 inches moving away to a distance of 12 inches If the scanner still does not read the bar code verify that the bar code is not damaged then scan the Reset Bar Code Reader bar code presented below and try again Scan for John Doe Demonstration ID Demo Joh n Scan to Reset a Cae penne Scanner Reset 10 1 11 Supplies and Accessories 11 1 Ordering Information Contact Life Systems Customer Service Department for information part numbers and pricing of the foll
78. o view or revise The two exceptions are PREV SCREEN rejects any changes made and returns to the previous screen and SAVE gt MAIN accepts saves and initiates any changes and returns to the Line List or Main Screen 3 1 Line List Display or Main Screen The Line List Display screen is the main screen of the monitor s LCD It will appear once the initialization process of the monitor is complete The labels on the housing across the top of the screen identify the columns of patient information presented as shown in the illustration above The Line List Display on the next page is an example of the basic data presented It shows the basic set up selected for this monitor ranges have been set for alarms a cuff interval has been established it shows the battery status 50 of capacity 1t presents the vital signs values for the last two measurement cycles and patient ID information If the monitor is ON not in monitoring mode but is not in use for five minutes it enters a sleep mode In this mode all parameters are suspended in order to decrease power discharge when on battery and to speed charging when plugged in Pushing ANY button will power up the unit and begin the initialization process see above and parameters will be active in approximately 10 seconds While Sleep Mode is a default setting if the Rosie Monitor is to remain on AC power or you want it to just turn off the unit can be set to bypass the S
79. odel Wrong Verify selection of Model configuration in the Service Menu Incorrect paper Verify that the paper is Colin paper users have a tendency to use whatever paper they find Verify paper comes off the roll in the back of the paper door Non Thermal paper If the paper is not thermal paper it will not print Touch the paper with an alcohol wipe and the paper ink should come to the surface if no ink appears get the appropriate paper Technicians only Cable disconnect Verify the interface cables connecting the printer are connected on both ends firmly Printer Defective Replace printer Main Board Defective Replace Main Board 8 4 8 4 Problems with NIBP Verify against Error Messages for further information LED s don t change from 888 to Cause Solution Incorrect Model setting Have BioMed Technician reset the correct Model Number in the Service Mode Cuff does not inflate Cause Solution Faulty cuff hose connection Check all connections and check hoses for damage or leaks Leak in the cuff Check and replace if faulty Cuff Mode selection If the Mode selection in the Cuff Configuration Screen is inappropriate for the patient s cuff being used the unit will not inflate the cuff and alarm Cuff Hose kinked Verify the cuff hose is not kinked or occluded Technicians only Sheet Switch is defective Verify that the Cuff LED is lit as the Cuff Start Stop button is pressed
80. ould pull the strip UP and TOWARD or UP and AWAY from themselves SD G I 7 3 7 3 Using the Printed Oscillometric Profile When a vital signs printout is recorded the printout includes the oscillometric profile A Normal oscillometric profile is a bell shaped curve and variances from this shape indicate possible problems with the measurement s accuracy 100 150 200 I A 50 mmHg mmHg Normal Spikes Due to Patient Movement I ll A T T ill T 50 50 100 150 200 100 150 200 0 mmHg mmHg Plateau due to Patient Movement Missing Oscillations Due to Arrhythmia or Patient Movement N 50 100 150 200 0 0 7 4 8 Rosie Troubleshooting 81 Troubleshooting Guide Warning Should the monitor fail for any reason follow the procedures below immediately 1 Check the patient s condition 2 Read this Troubleshooting section to search for the problem and possible solutions 3 Ifthe problem remains unsolved a Remove the cuff and or probe from the patient b Turn the power OFF and if plugged into an AC source unplug the monitor c Indicate with a sign Out of Order Do not use d Contact the appropriate personnel for service When the unit does not operate properly please check the following troubleshooting guidelines before consulting Life Systems Technical Service Dept at 800 841 1109 This Guide has been written in an order from mo
81. ower that have been in violation of Life System s instructions that have been affixed to any nonstandard accessory attachment on which the serial number has been removed or made illegible or that have been modified or improperly disassembled serviced or reassembled by anyone other than Life System s unless authorized by Life Systems Life Systems makes no warranty a with respect to any disposable products that are not warranted products b with respect to any product purchased from a person other than Life Systems or a Life Systems Authorized distributor or c with any respect to any product sold under a brand name other than Life Systems Life Systems will not be responsible for the effect of safety reliability and or performance of the product if a assembly operations extension readjustments modifications or repairs are carried out by persons other than Life Systems or persons authorized by Life Systems to perform repair service on Life System s behalf or b the electrical installation does not comply with the requirements of the applicable national and international standards including requirements of the IEC or c the Product is not used in accordance with Life System s instruction for use In the event of a defect in the product Life Systems will be liable for injury or death of any actual person or damage to property to the extent but only to the extent that such liability is mandated under laws applicable to m
82. owing accessories Probe Covers Neonatal Cuff Hose Doc 10 Extension Service Manual DS100A Finger Probe Patient ID Bar Code Scanner 12 Rosie Specifications 12 1 Monitor and Display Specifications Monitor Protection Type Class I Internal Power device Dimension 240 W x 238 H x 250 D mm Weight Approx 8 5 lbs including internal battery Power Supply AC 100 V 120 V 220V 240V 50 60 Hz Power Consumption Max 180VA AC Max 40W Battery Internal Battery 6V 5Ah Sealed Tin Acid Battery Charge Time Full in 4 hours Battery Usage Life 6 hours with cuff interval taken once every 15 min This device is rated for Continuous Operation as per IEC 601 1 clause 5 6 regulations Environment Operation Temperature 32 104F 0 40C Humidity 30 85 non condensing Atmospheric Pressure 700 1060hPa Shipping and Storage Temperature 4 140F 20 60C Humidity 10 95 non condensing Atmospheric Pressure 500 1060hPa This device is rated as Drip Proof as per IEC 601 1 clause 5 3 regulations Display Type backlit monocolor LCD and LED Size 3 H x 4 5 W Resolution 240 x 128 dots Configuration Rosie II 1 NIBP only Rosie II 1P NIBP with Printer Rosie I1 2 NIBP Nellcor Pulse Oximetry Rosie II 2P NIBP Nellcor Pulse Oximetry with Printer Rosie II 3 NIBP E Temp Rosie II 3P NIBP E Temp with Printer Rosie II 4 NIBP Nellcor SpO E Temp Rosie I1 4P NIBP Nellcor SpO2
83. plying the cuff to the patient there are many things that must be considered especially size 4 3 1 Adult Pediatric Cuff Placement and Positioning Proper cuff size and placement is essential to assure accurate blood pressure measurements The American Heart Association recommends cuff sizes should be at a length to width ratio of about 2 1 ensuring that if the bladder width is 40 percent the arm circumference the bladder length will encircle 80 percent of the arm If the cuff is too small the bladder width may be so small that the full cuff pressure is never applied to the artery see figure C and erroneously high pressure reading results If the cuff is too large the extra width lengthens the time it takes for the blood to pass completely under the cuff creating an erroneously low systolic measurement In Figure D on page 4 4 the bladder width is adequate for the arm and the full cuff pressure is applied to the brachial artery Cuffs for the thigh are available for large patients or those where neither arm is available for cuff placement Blood pressure measured at the thigh is typically 20 30 mmHg higher than blood pressure measured at the upper arm The artery mark on the center of the cuff bladder A in diagram below should be placed over the brachial artery Make sure not to twist or kink the hose The brachial artery is located on the inside of the upper arm it is NOT located directly above the location where the stethoscope is p
84. rature measurement Temperature Probe Cover Box Receptacle Insert the box of probe covers here Use only Rosie approved Probe Covers SpO gt Measurement RED LED numbers show the current Oxygen Saturation measurement saturation value Alarm Mute Button Pushing this button silences an audible alarm for two minutes and activates the alarm indicator LED If after two minutes the violating parameter is still outside acceptable limits the alarm will reactivate To silence ALL alarms for two minutes whether sounding or not push and hold for at least three seconds Alarm Indicator This light indicates the current status of the alarm function No light no alarms a slow flashing light indicates that an alarm has sounded and has been silenced A fast flashing light indicates all alarms have been silenced The alarm will remain silenced for two minutes This Manual describes and supports all of the monitors in the Rosie series by discussing the fully configured model that includes NIBP Pulse Pulse Oximetry Temperature and a printer as well as the most current software revisions It may therefore present information that does not apply to your unit The front and rear panel designs and connection ports vary according to the parameters that have been built into your monitor 2 10 Rear Panel Callouts Handle BP Cuff Hose Connector Printer Paper Door k E TEMP probe connector Biomed Ground Lug w E SpO EC cable
85. rnal vibrations CPR or motion artifact due to patient movement When improper cuff sizes are used When the cuff position is above or below the heart level by 10 cm or more When the patient moves or talks during a measurement When the cuff is placed over thick clothing When arolled up sleeve is adding pressure on the arm Cuff placement and positioning should be checked at least every 8 hours for patients being continuously monitored If any abnormality is found such as redness or bruising of the skin or if the cuff is poorly positioned the cuff positioning and placement should be changed If the cuff positioning is not changed inflammation due to perspiration or internal hemorrhaging may occur 2 5 WARNINGS and CAUTIONS During SpO Monitoring M If SpO measurements do not register or when there are doubts about those measurements please assess the patient s condition immediately The patient s condition may have deteriorated to the point where measurement limits have been exceeded Applicable patient weight and measurement locations should be observed for each OxiMax sensor When the manufacturer s instructions are not observed measurement errors could occur Do not use sensors with defective or damaged wire covering This could lead to patient harm Avoid applying the sensor too tightly Also do not secure the sensor with tape This could diminish blood flow and or cause edema Reusable sensors have
86. robe Oral While the patient s temperature is being taken the E Temp LED readout will show a moving pinwheel indicating tissue contact If tissue contact is broken the pinwheel will stop moving until contact is reestablished A beep will sound when the measurement is completed and the display will show the temperature in large GREEN numbers The value will remain on the screen for five minutes or until another temperature is initiated Note A long delay from the time the probe is removed from the temperature probe well until it makes contact with the patient s tissues may cause a break in the measurement cycle causing the monitor to switch from Predictive Mode to Monitoring Mode If this occurs eject the probe cover insert the probe back into the temperature probe well and begin the process again Note If an unusually high or low temperature reading is obtained confirm the reading using another temperature measuring device before beginning any treatment 5 2 Once the measurement is completed hold the probe as you would a syringe and press the probe eject button at the base of the probe to release the used cover into a waste container and return the probe into the probe well to prepare for the next measurement Note If the probe tip temperature is higher than 92 F 33 3 C when taken out of the temperature probe well the monitor will be unable to quickly predict the patient s temperature In
87. s no capability to identify hemoglobin such as carbon monoxy hemoglobin or methemoglobin which cause functional damage Therefore faulty readings may result when measuring Carbon Monoxide intoxicated patients or patients who are heavy smokers Consult Blood Gas Reagent Chromocyte Readings may have been influenced by the presence of reagent chromocytes such as indosian green and methyene blue when heavily concentrated in the artery Check patient condition and past procedures Ambient Light Shield the sensor from the light No SpO gt measurement Cause Solution Address each condition according to facility protocol Perfusion has declined Verify appropriate perfusion of sensor site Strong ambient light Drape the sensor site to shield it from light source Probe or Cable is defective Replace and retest SpO Internal Error Cause Solution Address each condition according to facility protocol SpO gt Probe or Cable is defective Replace and retest Contact Life Systems Technical Support 8 9 8 7 Errors and Other Messages Shown in Message Window Monitor Related Messages Message Shown Description Action Required SYSM BATTERY LOW Battery is below 20 Connect monitor to suitable AC power power capacity outlet SYSM BATTERY EMPTY Battery is empty Connect unit to suitable AC outlet before monitor turns off SYSM INTERNAL FAILURE Contact Life Systems Technical Services
88. should be applied to neonates weighing less than 3 kg Use on the leg or arm This sensor may also be used on the forearm of an adult weighing over 40 kg MAX R This disposable adhesive nasal sensor should be applied to adult patients weighing more than 50 kg k MAX FAST This disposable adhesive forehead sensor should be applied to D ap patients weighing more than 40 kg Dura Y D YS This reusable multisite sensor can be applied to patients weighing more than 1 kg If used with the D YSE ear clip the sensor can only be used on patient s weighing more than 30 kg Warning Carefully read the directions for use provided with Nellcor sensors for complete description instructions warnings cautions and specifications Caution Use ofany sensor other than the above designated OxiMax sensors is not allowed Such sensors may not operate normally and could lead to patient injury If reusable sensors are used the monitoring site must be checked at least once every four hours as directed The Nasal OxiMax sensor cannot be reused Other disposable sensors may be reused only on the same patient and as long as the adhesive properties of the tape is not depleted Note Please contact Life Systems about any accessories for use with the above mentioned sensors 6 2 63 OxiMax Sensor Accuracy Specification Sensor Models OXIMAX Sensor Models Single Patient Use MAX A MAX AL MAX N Adult MAX N Neonate M
89. st common to least common problem 8 2 Problems with the Monitor Verify against Error Messages for further information Cannot turn power ON to the monitor Display is blank Cord is unplugged or loose Check the power input cord connections Verify AC power through AC Cord Or damaged When this problem occurs the user will not see the charging LED lit Battery is discharged Plug the monitor into a hospital grade AC power outlet and recharge the battery for at least 10 minutes Then turn ON again Internal AC Fuse is bad The AC DC converter has auto resetting fuses that can be reset by removing AC power for 30 sec Battery Fuse is bad If the unit operates on AC power but will not function on battery power the 5A fuse on the battery may be blown Remove battery from bottom of unit check fuse Technicians only Internal AC Fuse is bad The AC DC converter has auto resetting fuses that can be reset by removing AC power for 30 sec IF the problem still exists open left side printer of monitor and check and replace defective fuse on the AC input connector 250V 2A Sheet Switch is defective Before replacing check if sheet switch connector bottom is connected to main board appropriately Verify pin 2 is pulled low as the power button is pressed if it is pulled low the sheet switch is OK AC DC Power supply is Disconnect the DC power supply wires from the main board with AC applied 7 defective 8V DC should be found if not rep
90. stead it will automatically go into the Monitoring Mode M will appear below the E Temp indication on the screen which may require 3 minutes or longer The monitor will not beep at a final temperature it will continue to monitor the patient s temperature until the probe is returned to the temperature probe well To take a rectal temperature use the optional red thermometer probe Install a disposable cover as described for oral use and insert the probe into the patient s rectum To insure proper tissue contact angle the probe slightly after insertion as shown in the accompanying illustration Recommended insertion depth is 1 2 to 3 4 for adults and 4 to 1 2 for children A lubricant may be used if desired The measurement will proceed similarly to the oral measurement and the final reading will replace the pinwheel pattern in the LED window Rectal 5 3 For axillary temperature measurements remove probe from temperature probe well and attach probe cover Place the probe in the patient s axilla making sure the tip of the probe is in contact with the skin and positioned as close as possible to the axillary artery and with the patient s arm held close to their side Leave the probe in place according to the timeframe set by your facility s protocol for taking an axillary temperature sss a sss SS Once the patient s temperature is taken remove the probe
91. sure and the amplitude of the oscillometric pulse drops off suddenly Rosie II applies an oscillometric technique that uses dynamic linear deflation to measure blood pressure This technique adjusts the deflation rate according to the patient s heart rate ensuring consistent accurate patient specific readings Patient comfort is greatly enhanced because the pressure in the cuff is released constantly over the least amount of time necessary to assure accuracy Some measurement artifacts such as exaggerated patient motion arrhythmia and hypovolemia make any blood pressure measurement impossible However the proprietary algorithms of the Rosie II will reject several types of artifacts to obtain an accurate measurement However in some instances the artifact may be so severe that an accurate reading is simply not possible In this situation an alarm when properly set will notify of the clinician of the situation and the monitor will attempt another measurement cycle 4 2 NIBP Parameter Settings There are two setting menus that affect the function of the NIBP operation The first is the Cuff Interval Setting screen and the second is the CUFF setting screen within the System Settings 4 2 1 Cuff Interval Screen The cuff interval screen refer to section 3 3 page 3 5 allows the clinician to select the appropriate cuff interval or interval program The active cuff interval or program is displayed on the Line Listing screen to the left of t
92. surement again If Temp Probe Disconnected message is shown this normally indicates a defective probe Replace probe and place new probe into and out and back into probe well to reset message If unit was dropped or disassembled verify the cables are connected to the temperature module Replace main board Solution If this message is shown this normally indicates a defective probe Replace probe and place new probe into and out and back into probe well to reset message If unit was dropped or disassembled verify the cables are connected to the temperature module Replace main board Solution Normally if one of the problems is the cause the user will also notice slow temperature measurement times as well as the tissue contact pinwheel interrupting its spin Patient s mouth was open Improper probe placement Ask patient to keep mouth closed during measurement Verify placement of probe as shown in the manual Unlike slower temperature measurement techniques this fast measurement requires the user to make sure the probe is placed directly against the sublingual artery in the back center of the tongue 8 7 Parameter LED s don t change from 888 to Cause Solution Incorrect Model setting Have BioMed Technician reset the correct Model Number in the Service Mode 8 6 Problems with Pulse Oximetry Verify against Error Messages for further information
93. tal modes NIBP CHECK Pressure dropped to 10 Check cuff position and placement verify CUFF PATIENT mmHg without no patient movement occurred completing a measurement NIBP MOTION ARTIFACT Air was not discharged Check for patient movement or presence for 15 sec because of of arrhythmia patient movement NIBP RE INFLATION Cuff pressure did not Automatic re inflation of cuff pressure exceed arterial occlusion no action required and cuff will inflate again NIBP IRREGULAR PULSE Abnormal oscillometric Check for patient movement or presence waveform of arrhythmia NIBP WEAK PULSE Impossible to measure BP Check for patient movement or presence because of arrhythmia of arrhythmia patient movement or the pulse signal was too weak a measurement retry will occur Verify appropriate cuff is used and applied correctly NIBP TIMEOUT Measurement took over Check for extreme patient movement or 160 seconds or more than obstruction of air discharge 160 heartbeats measured during cuff deflation NIBP OVERPRESSURE Cuff pressure rose above Check cuff placement or kink in cuff or 325 mmHg cuff hose NIBP CHECK CUFF SIZE Neonatal cuff used in Verify and correct measurement mode Adult Mode and cuff hose selections NIBP INITIALIZING Possible NIBP Module System is trying to verify problem No problem found user action required NIBP INTERNAL FAILURE Contact
94. tient physiological conditions as discussed in the operator s manual of the monitor Use only Nellcor sensors with this device The MAX N and the OxiCliq N were tested on patients gt 40kg The accuracy specification has been determined between saturations of 80 100 6 3 6 4 Connecting the SpO Probe Cable to the Unit Plug the extension cable into the SpO2 connector on the rear panel of the unit and press firmly to lock it in place SpO Connector Port Back of Unit T Doc 10 6 5 Applying the Probe Attachment The Dura Sensor 100A probe is for adult patients whose weight is more than 40kg Put the DS 100A on the forefinger placing the finger far enough into the sensor that the nail comes in contact with the back Make sure that the clamping strength of the probe is not so tight that perfusion is affected CAUTION Dura Sensor S 100A is only for adult more than 40Kg fingers This probe is only for use on the finger The DS 100A is for spot check measurements only If the probe is be used for an extended time relocate the sensor to a different finger every 2 3 hours Tf the finger is put into the probe too far the tip of the finger may be compressed and may cause necrosis Never use surgical tape to secure the probe in place Be alert to low thermal burns on peripheral circulation disorder patients who are monitored continuously for extended periods 6 6 Applying Disposable OxiMax Se
95. to select Clear then press and hold the Delete Soft key for three seconds the monitor will beep three times while the button is being pressed and held NOTE Data deleted from the Line List Memory CANNOT be retrieved The Date selection is arranged in the order of month day and year the Time selection is in the 24 hour military time format To set these data use the OK Button to move the cursor to the intended data and use the UP amp Down Buttons to change the values The selections for Volume allow the user to select the preferred volume for Alarms and Pulse sounds If OFF is selected for the Pulse sound no pulse tone will be heard Once again use the OK Button to select the data set to be revised and the Up and Down Buttons to change the Volume Settings The selection for Pulse volume does not change the pitch of the pulse tone its pitch is controlled by the SpO value Pressing the Save gt Main Soft Key saves any changes and switches the display to the MAIN Line List screen Pressing the Cuff Options Temp Options and Print Options Soft Keys access those respective displays to allow changes in those values 3 4 1 Cuff Settings Screen Access the Cuff Settings Screen by pressing the Cuff Settings Soft Key from the System Settings Screen See next page MEASUREMENT MODE Use the UP F or Down Y buttons to select the appropriate blood
96. tor 9 1 Battery Care and Replacement The battery of the monitor may be recharged at any time by connecting the monitor s power cord to a properly grounded 3 wire hospital grade AC power source The battery indicator on the front of the monitor will light indicating the charging state of the battery The battery may require up to four to six hours to bring the charge from a completely discharged state to above 90 of capacity As the unit charges and the battery s power increases the charge indicator shows the status of the battery charge whenever the unit is plugged into AC power A RED light signals a battery charge below 90 and a GREEN light indicates the battery is fully charged and ready to use When the monitor is ON and AC is removed the Battery Indicator located in the lower right quadrant of the Line List or Main Screen on the LCD also indicates current battery power levels NOTE If the battery is fully charged and the unit is unplugged and plugged back into AC power the charging cycle starts over again and the light turns to RED This is normal Life Systems recommends that when the monitor is stationary it be connected to an appropriate AC power supply to help ensure maximum battery power accessibility and life The battery is accessible from the bottom of the unit and should only be replaced by qualified personnel Life Systems recommends this battery be replaced once every two years to guarantee optimum battery life

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