070-0137-03 90207-90217 Ops Manual
Contents
1. e SPACELABS Healthcare Ambulatory Blood Pressure Monitors 90207 90217 Operations Manual 070 0137 03 Rev L 90207 90217 Operations Manual 2008 Spacelabs Healthcare Inc All rights reserved Contents of this publication may not be reproduced in any form without the written permission of Spacelabs Healthcare Products of Spacelabs Healthcare are covered by U S and foreign patents and or pending patents Printed in U S A Specifications and price change privileges are reserved Spacelabs Healthcare considers itself responsible for the effects on safety reliability and performance of the equipment only if assembly operations re adjustments modifications or repairs are carried out by persons authorized by Spacelabs Healthcare and the electrical installation of the relevant room complies with the requirements of the stand ard in force and the equipment is used in accordance with the operations manual Spacelabs Healthcare will make available on request such circuit diagrams component part lists descrip tions calibration instructions or other information which will assist appropriately qualified technical personnel to repair those parts of the equipment which are classified by Spacelabs Healthcare as field repairable Spacelabs Healthcare is committed to providing comprehensive customer support beginning with your initial inquiry through purchase training and service for the life of your Spacelabs Healt2. have been corrupted and subsequently recovered Frequent occurrence of this message would indicate a malfunction that requires service ECO5 The individual blood pressure result has been corrupted and cannot be recovered Equipment malfunction Return to Spacelabs Medical for service Monitor failed to initialize Please initialize 90207 At least one of the blood pressures or time readings obtained before the event code is erroneous Interpret all readings with caution 90217 The monitor needs to be reinitialized EC1 EC2 EC35 ECO ECO5 amp O1 EC45 Invalid bleed size The monitor has automatically changed the bleed size to 8 mmHg An unexpected loss of power possibly caused by a removal of the bat teries during a blood pressure measurement b hardware overpressure or c a hardware time out Frequent EC55 messages would indicate a malfunction which requires service 90207 Equipment malfunction Return to Spacelabs Medical for service 90217 Extremely large artifact EC75 Equipment malfunction Return to Spacelabs Medical for service EC85 ECO5 amp EC85 EC85 Equipment malfunction Return to Spacelabs Medical for service EC95 ECO5 amp EC55 EC55 ECO5 amp EC65 EC65 ECO5 amp EC75 ECO5 amp EC85 ECO5 amp EC95 Cuff pressure baseline is out of limits The monitor should correct the baseline automatically within 10 minutes or it can be reset by initializ ing the monit
3. STOP key on the front of the monitor If the cuff slips out of place make certain that the patient knows how to correctly reposition the cuff for successful readings If the cuff is not properly positioned event codes may appear on the monitor Note The patient should make every effort to keep the monitor dry However there is no hazard if the monitor does get wet If this occurs power the monitor OFF and return it to Soacelabs Healthcare for service Data Transfer and Reports After monitoring is complete connect the monitor to either a PC Direct or Base Station interface to transmit patient data and generate blood pressure reports Refer to the 90121 ABP Report Manage ment System P N 070 0137 00 the 92506 ABP Report Management System Client Application P N 070 00932 00 or the 90239 ABP Report Generator P N 070 0399 03 Operations Manuals for more details Note Any pulse rate obtained from the ABP cuff should be used only as a guideline for the heart rate Cleaning Disinfecting Visually inspect the monitor air hose and pressure cuff for dirt debris frayed or worn areas etc prior to patient use Warning e Use only recommended cleaning solutions or you may void the manufacturer s warranty e Harsh chemical agents degrade plastics and will compromise the safety of the device e Disconnect the equipment from the patient and the electrical supply before cleanng e Do not allow liquid to enter the interior
4. arrhythmia Movement artifact at systole Heart rate arrhythmia Movement artifact at diastole Heart rate arrhythmia Movement artifact B Heart rate arrhythmia Systole was found to be above the highest cuff pressure However this result appears to be an error caused by motion artifact Therefore the N EC30 EC40 EC50 EC60 Zz EC70 cuff will not be inflated to a higher pressure on the next measurement at tempt EC80 A Movement artifact B N Heart rate arrhythmia EC90 A Movement artifact B Heart rate arrhythmia ECO ECH EC21 ECO ECO ee EC12 Did not reach initial cuff pressure The cuff may have been improperly ap plied or there may be an air leak EC22 EC32 EC42 EC52 EC62 EC82 Overpressure Overpressure No cuff attached Kinked hose Cuff applied too loosely ECO OD ECO3 Patient canceled reading by pressing STOP key No retry attempt is made following an ECOS code The Office Check mode has been reinstated No retry attempt is made following an EC13 code EC13 EC04 12 90207 90217 Operations Manual Operation EC04 Blood pressure measurement not completed in the maximum time al lowed Occasional EC04 messages may result from excessive patient movement Frequent EC04 messages would indicate an improperly ap plied cuff or a monitor malfunction which requires service ECn4 where n 1 to 9 Indicates that one or more of the blood pressure results
5. forceps are recommended 4 Install the new lithium battery and replace the pry off cover The underside of this cover is divided into two unequal sized compartments Install the cover with the smaller compartment oriented over the lithium battery 5 Gently replace the battery compartment cover and secure the latch Note Please ensure that discharged batteries are disposed of in accordance with local regulations 1 2 90207 90217 Operations Manual Operation Initializing the Monitor The ABP monitors must be initialized prior to the start of patient monitoring Initialization specifies the monitoring period patient information time format measurement interval monitor tone ON OFF dur ing selected periods event code display and whether or not to display pressure values To initialize the monitor connect it to one of the following analysis systems Connecting Directly to a Local Report Generator For a direct connection to the 90207 or to the 90217 monitor place the monitor into the chute on the Report Generator Model 90239A or equivalent as displayed in Report Generator Figure 1 1 Report Generator Connecting Directly to the PC Interface For a direct connection to a PC compatible computer via a Model 90121 or 92506 1 Connect one end of the ABP interface cable to the serial port on the computer where the 90121 or 92506 software is installed 2 Connect the other end of the interface cable to the ABP monitor Re
6. to indicate the reason for the missed blood pressure reading When only a single blood pressure parameter systole diastole or mean arterial pressure is obscured and the other two parameters are measured the obscured parameter may be replaced with a computed value If such a value is computed in the 90217 monitor it appears on the report in angle brackets e g lt value gt On the monitor display dashes are displayed instead of the estimated value The ratio used in the formula is determined by the previous successful measurements of the pressure rather than a fixed ratio Consult a physician for interpretation of pressure measurements After the monitor has been initialized prepare the patient for monitoring as fol lows I Power ON the monitor wait for the monitor to perform self tests When the LCD displays the current time the monitor is ready for operation Strap the monitor to the patient s hip opposite the side on which the cuff is worn Secure the monitor using the patient s own belt or the ABP pouch strapped over the opposite shoulder When using the shoulder strap use the belt supplied with the monitor or the patient s belt to provide additional security Ensure the accuracy of blood pressure measurements through proper cuff selection and ap plication To select the proper cuff first measure the circumference of the limb at the point where the cuff will be applied Match the limb measurement to the range o
7. within one minute to ensure successful resumption of the test 90207 only 1 Power the monitor OFF and remove the door over the battery compartment 2 Replace the AA alkaline or Nicad batteries being careful to observe polarities Caution o The monitor will not operate if the alkaline nickel cadmium or lithium batteries are incorrectly installed If the monitor is going to be stored for an extended period of time remove the batteries to prevent the possibility of leakage or discharge e Spacelabs Healthcare is not responsible for product damage incurred as a result of AA battery leakage In the event your monitor has been damaged by a leaking battery contact the battery manufacturer for any recoverable repair or replacement costs Spacelabs Healthcare will assist you in determining those costs 3 Gently replace the battery cover and secure the latch 4 Power the monitor ON Check that the LCD display is ON If there is no display power the monitor OFF and review the problem solving checklist in Troubleshooting on page 3 1 Lithium Battery Replacement 90207 only The lithium battery is located in the battery compartment under a pry off cover to the right of the AA batteries 1 Power the monitor OFF and remover the door over the battery compartment 2 Remove the pry off cover and note the polarity of the battery and socket indicators 3 Remove the old lithium battery by carefully prying it out Curved
8. Closed Padlock ee 070 0137 03 Rev L 4 3 me mw K gt Appendix Symbols Antenna Mermaid Connector Audio Output Speaker Omni directional Microphone Universal Serial Bus Ale ps Network Connection Ref Oxygen reference gas port Gas Sampling Port Gas Return Port i Nurse Call Low Priority Alarm High Priority Alarm Medium Priority Alarm Alarms Paused Nurse Alert Interface Battery Status Alarm OFF DERE RAL Battery Replace only with the appropriate battery Low Battery All batteries should be disposed of prop erly to protect the environment Lithium batteries should be fully discharged be fore disposal Batteries such as lead ac id Pb and nickel cadmium Ni Cd must be recycled Please follow your internal procedures and or local provincial laws regarding disposal or recycling Replace only with the appropri ate battery signs may be reversed This symbol indicates that the waste of electrical and electronic equip Caution hazardous voltages To reduce ment must not be disposed as un risk of electric shock do not remove sorted municipal waste and must be the cover or back Refer servicing to a collected separately Please contact qualified field service engineer U S A an authorized representative of the DANGER High Voltage International manufacturer for information con cerning the decommissioning of your equipment Ref
9. DIA dia OO o O OO ST Cardiac Output Diastolic O O ECGEcg Electreocardiogram Electroencephalogram Electromyogram Electrosurgical Interface Suppression FECG Fetal Electrocardiogram Multiview Multi Lead Electrocardio gram Nitrous Oxide Synchronous Data Link Con trol EXT External Fetal Heart Rate Channel 1 Fetal Heart Rate Channel 2 hlo High Level Output NIBP Noninvasive Blood Pressure nibp Oxygen RESP resp Respiration SDLC L m Arterial Oxygen Saturation as SVO2 SvO2 Mixed Venous Oxygen Satu M d by Pulse Oximet ration easured by Pulse Oximetry Svo T1 Temperature 1 SYS Buctalie T2 Temperature 2 y T3 Temperature 3 T4 Temperature 4 Uterine Activity or Umbilical Artery UV Unbilical Venous TEMP li 070 0137 03 Rev L 47 Temp LEE lt Temperature VAC Vacuum Connection 90207 90217 Operations Manual 070 0137 03 Rev L www spacelabshealthcare com Spacelabs Healthcare inc Spacelabs Healthcare Ltd 9150 220th Ave SE 1 Harforde Court Issaquah John Tate Road WA 98029 USA Hertford SG13 7NW UK Tel 1 425 657 7200 Tel 44 0 1992 507700 Fax 1 425 657 7212 Fax 44 0 1992 501213 Rx only QD SPACELABS CE F Healthcare 0120
10. NDBY Key Power ON OFF Key Alarm Reset Alarm Audio ON Alarm Audio OFF Alarm Audio Paused Indicator Remote Control ca Indicator Local Control Partial ON OFF Recorder Paper Return to Prior Menu Power Indicator LED Activate Telemetry Recorder PRINT REPORT Key Indicator Out of Paper Normal Screen Clock Time Setting Key TREND TIMER Key Keypad Indoor Use Only Auto Mode NIBP HELP Explain Prior Screen Key Activate Recorder for Graphics START NIBP Key Output Non terminated No Output Terminated Data Input Output Input Output 90207 90217 Operations Manual Input ve Pe gr RCE enr r ep gi N Appendix A Symbols Menu Keys Waveform Parameter Keys HE Monitor Setup gt ta Bo AJ a Set Initial Conditions Menu Select Program Options Return Unit to Monitor Mode 2 Serial Port 2 Access Special Function Menu Serial Port 1 External Marker Push Button 4 Connection I SDLC SDLC Port Electrocardiograph or Defibrilla Arterial Pulse tor Synchronization Gas Exhaust Enlarge Zoom PCMCIA Card Keep Dry Environmental Shipping Stor age Altitude Limitations Foot Switch Fragile Handle with Care This Way Up Environmental Shipping Stor age Humidity Limitations af poe E x D Ko gt i lo Di EI Environmental Shipping Stor age Temperature Limitations Open Padlock
11. chine washable on delicate cycle only Do not wash them in large commercial type washers or with bed linens or gowns Ensure that the carrying pouch is dry before re use Removing Installing the Bladder To remove the bladder follow the steps listed below 1 Using fingers only fold or roll up the bladder inside the cuff Do not use pencils pens or other hard objects because these may damage the bladder 2 Remove the bladder through the hose exit opening Once the bladder is removed mate together the hook and loop surfaces of the velcro attachment before washing Re install the bladder into the cuff wrap in reverse order Make certain that all folds in the bladder are removed and that the long end of the bladder fits into the long end of the cuff refer to Bladder configura tion OPENING FOR OPENING FOR RIGHT ARM LEFT ARM LE F g LTE E a a a a a e e ee ee ef BLADDER shown inserted into cuff wrap for left arm application 25 Da mam map ARTERY a Tor FFF FF FFF FF d d ui res Figure 1 4 Bladder Configuration Note The cuff hose can exit from either opening in the cuff depending on whether you plan a right arm or left arm application 070 0137 03 Rev L 1 11 Operation ECOO S EC10 Excess movement artifact Frequent EC10 messages may indicate an air leak EC20 A Avery large number of movement artifacts B Heart rate arrhythmia Movement artifact at mean arterial pressure Heart rate
12. e the allowed tolerance call your local Service Representative or Spacelabs Medical for servicing At the end of the procedure the monitor displays an event code indicating that no dynamic blood pressure measurements were obtained 4 Disconnect the T tube splitter from the monitor Disconnect the air hose and sohygmoma nometer 2 2 90207 90217 Operations Manual Troubleshooting Problem Solving Checklist ue Data not retained Replace backup battery Check the batteries for a full Low or no power charge if needed replace or recharge the batteries Monitor display is incorrect May be one of the following time out no reading due to air leak in the system improper cuff Isolate cause and correct size cuff not properly attached to the monitor Power OFF the monitor imme diately Replace batteries within 60 seconds after removal to continue monitoring Monitor displays LLL and Low main battery condition alarm sounds Monitor displays event code Lbb during selftesting 90207 Low backup battery condition only Replace backup battery before continuing Cuff placed on the patient too Reposition the cuff tightly Cuff too tight Air pump staying on too long Return monitor to Spacelabs p i Healthcare for service Cuff placed on the patient too Reposition the cuff loosely Cuff too loose Air pump not staying on long Return monitor to Spacelabs enough Healthcare for service Inco
13. e the patient data from the base station e Power ON the modem e When instructed by the base station operator power ON the ABP monitor Note The modem link must be established within 10 to 20 seconds for the 90207 and within 45 sec onds for the 90217 If this does not occur power the monitor OFF and then ON again to retry establishing the link When the transfer of information is complete the ABP monitor will beep Voice communication is re stored after the monitor beeps e Power OFF the monitor and disconnect the monitor from the modem e lfadirectconnection between the monitor and the base station is used power OFF the monitor and then disconnect it from the ABP data interface unit Modem Indicator Lights Modem indicators at the local modem are lit flashing or unlit depending on the stage of operation When the monitor is powered ON the RD Receive Data and SD Send Data lights will flash for several sec onds The OH On Hook indicator becomes lit when the monitor starts communicating with the remote modem When the modems connect the CD Carrier Detect is lit The SD and RD lights flash as data is being transferred After the transmission is complete and the monitor is powered OFF the HS TR and MR indicators will always remain lit at the local modem 070 0137 03 Rev L 1 5 Operation Setup Test Note Verify that the cable connections are secure Power ON the ABP monitor It will display 9999 While t
14. er to manual for further informa tion Use only specified battery type 4 4 90207 90217 Operations Manual gt lt a hipe Appendix A Symbols Protective Earth Ground Replace Fuse Only as Marked Power supply jack polarity signs may be reversed Alternating Current Both Direct and Alternating Cur rent IEC 60601 1 Type B equipment The unit displaying this symbol contains an adequate degree of protection against electric shock IEC 60601 1 Type BF equipment which is defibrillator proof The unit displaying this symbol is an F type isolated floating patient applied part which contains and adequate degree of protection against electric shock and is defibrillator proof EC 60601 1 Type CF equipment The unit displaying this symbol is an F Type isolated floating patient applied part providing a high degree of protection against electric shock and is defibrillator proof Loop Filter ETL Laboratory Approved Risk of Explosion if Used in the Presence of Flammable Anesthet ICS Spacelabs Compatible 070 0137 03 Rev L Functional Earth Fuse Equipotentiality Terminal Direct Current AC DC Input IEC 60601 1 Class Il equipment double isolated The unit display ing this symbol does not require a grounded outlet IEC 60601 1 Type BF equipment The unit displaying this symbol is an F Type isolated floating patient applied part providing an adequate degree of protection again
15. f appropriate circumferences in centimetres specified on each cuff refer to Error Reference source not found Table 2 Cuff Sizes Circumference Ranges and Part Numbers Description Limb Circumference Part Number Part Number Quick Disconnect Luer Lock Pediatric Cuff 12 to 20cm 015 0118 01Q 015 0118 01 Small Adult Cuff 17 to 26cm 015 0067 01Q 015 0067 01 Adult Cuff 24 to 32cm 015 0068 02Q 015 0068 02 Large Adult Cuff 32 to 42cm 016 0077 01Q 016 0077 01 Extra Large Adult 38 to 50cm 016 0109 01Q 016 0109 01 Cuff 070 0137 03 Rev L 1 7 Caution Operation Position the cuff so that the center of the inflatable bladder is directly over the brachial artery The center of the bladder location is marked on the outside of the cuff Once the proper posi tion is determined the cuff must be tightened to ensure that it is equally snug at the top and bottom edges and that it is not kinked This is especially important on larger arms Insert a finger between the cuff and the limb to ensure it is not too tight It may be necessary to wrap the cuff with its tail at an angle to achieve uniform tightness If the cuff is not equally snug at the top and bottom edges the number of readings available will be limited and the monitor may indicate that the cuff is improperly applied e Avoid compression or restriction of pressure in the NIBP patient connector tubes Check that operation of the equipment does not result in prolonged impairment of circ
16. fer to the 90121 ABP Report Management System Operations Manual P N 070 0529 xx or the 92506 ABP Report Management System Client Application Operations Manual P N 070 0932 xx for more information on the report management system Computer System with 90121 or 92506 ABP software cable to serial port ABP Monitor Figure 1 2 PC interface direct connect configuration 070 0137 03 Rev L 1 3 Operation Connecting to the Base Station via Modem For a modem connection to a remote IBM XT AT PS2 or equivalent base station refer to Figure 1 3 below cable to serial port to public 7 base 4 telephone modem ABP Station network A Monitor modem Figure 1 3 Modem connection configuration Note The actual initialization procedure is discussed in the 90121 ABP Report Management System Operations Manual P N 070 0529 xx and in the 92506 ABP Report Management System Client Application Operations Manual P N 070 0932 xx Modem Speed and Compatibility Issues The 90207 and 90217 monitors operate Hayes compatible modems only You can identify your model type by plugging the communications cable into your 90207 90217 monitor and looking at the numbers on the display The acceptable modem types and maximum speeds of 90207 90217 monitors are sum marized below Table 1 90207 9021 7 Acceptable Modem Speeds Model Type older 90207 90207 Q older 90217 90217 Q Connection Procedure 1 Set the switches on the
17. hcare equipment CORPORATE OFFICES Spacelabs Healthcare Inc 5150 200th Ave SE Issaquah WA 98029 USA Tel 1 425 657 7200 Fax 1 425 657 7212 Spacelabs Healthcare Ltd 1 Harforde Court John Tate Road Hartford SG13 7NW UK Tel 44 0 1992 507700 Fax 44 0 1992 501213 BirthNet Clinical Browser Data Shuttle Flexport Intesys Mermaid MOM Multiview PCIS PCMS Print Master Quicknet Sensorwatch TRU CAP TRU CUFF TruLink Ultralite Ultraview Ultraview Care Net work Ultraview Clinical Messenger Ultraview Digital Telemetry Ultraview SL Uni Pouch UCW Varitrend and WinDNA are trademarks of Spacelabs Healthcare Inc Brands and product names are trademarks of their respective owners Caution US Federal law restricts the devices documented herein to sale by or on the x only order of a physician A Before use carefully read the instructions including all warnings and cautions CE marked in accordance with the Medical Device Directive 93 42 EEC O m N O 070 0137 03 Rev L ii 90207 90217 Operations Manual Table of Contents Contents Table of Contents Operation Overview ABP Monitor Replacing the Batteries Main Battery Replacement Lithium Battery Replacement 90207 only Initializing the Monitor Connecting Directly to a Local Report Generator Connecting Directly to the PC Interface Connecting to the Base Station via Modem Modem Speed and Compatibility Issues Office C
18. he monitor is being read or initialized the digits will change to indicate that communication is taking place between the monitor and the analysis system When communication is complete the digits will no longer change Office Check Mode The monitor automatically enters an Office Check mode for the first five measurements immediately following initialization This allows you to verify the performance of the monitor on an individual patient without the need for re initialization to reset the display features While in the Office Check mode the monitor operates as follows e Displays the cuff pressure on each bleed step e Displays systole diastole and heart rate at the end of the measurement e Bleeds one step below the diastolic value as determined by the monitor Terminating Office Check Mode For the 90207 monitor versions earlier than 2 14 press the START STOP key twice to cancel each of the remaining readings The Office Check mode is terminated when the sum of the cancelled and suc cessful measurements equals five For the 90217 and the 90207 monitors versions 2 14 and later press the START STOP key twice to cancel a single blood pressure reading The Office Check mode is terminated when a blood pressure reading is cancelled Any event that prevents a successful blood pressure measurement other than a manual cancel is not counted as one of the five Office Check mode readings Reinstating Office Check Mode The Office C
19. he patient becomes comfortable with operation of the monitor and the measurement process 90207 90217 Operations Manual Operation 8 Show the patient how to enter information in the Patient Diary Make sure the patient knows what to do if the cuff becomes very uncomfortable during a measurement if it slips out of place or if event codes are displayed on the monitor screen refer to Patient Instructions Also ensure that the patient knows how to care for the monitor When you are satisfied that the monitor is operating properly the remaining measurements in the Office Check mode may be canceled Refer to Office Check Mode Using Cuff Support Note Keeping the blood pressure cuff in place is very important both for patient comfort and for the accuracy of the readings This becomes particularly challenging when the arm has considerable taper as is often the case with obese patients 1 Put the large loop of the support around the opposite arm Once the cuff is successfully ap plied to the patient adjust the length so that the junction of the straps fits well back on the shoulder towards the neck Fasten the rear short strap to the rear of the armpit Be careful to clip to the material only and not to the bladder Fasten the front strap to the top layer of the cuff material at the location where the hose exits the cuff Adjust the length of these straps to apply a minor amount of tension to hold the cuff in the correct posit
20. heck Mode Preparing the Patient and Precautions for Use Correlating with Manual Readings Patient Instructions Data Transfer and Reports Cleaning Disinfecting Cleaning the Cuff and Carrying Pouch Removing Installing the Bladder Event Codes Accuracy Checking Accuracy Accuracy Procedure Troubleshooting Problem Solving Checklist Servicing Appendix A Symbols 070 0137 03 Rev L 2 1 2 2 3 3 3 3 1 6 90207 90217 Operations Manual Operation Overview The Spacelabs Healthcare Models 90207 and 90217 Ambulatory Blood Pressure ABP monitors are small lightweight battery powered monitors designed to take blood pressure and heart rate measure ments for 24 or 48 hours or for longer periods of time These measurements are recorded within the monitors and may be transferred to an ABP Analysis System FT1000A FT2000A or equivalent the personal computer PC interface the base station or in a Remote Connection mode using modems ABP Monitor The monitors have the following features e Four digit liquid crystal display LCD e Battery powered Serial communications port e Power ON OFF switch e Reading START STOP button e Blood pressure cuff The monitors are carried in pouches that are strapped and or belted to the side of the patient Blood pressure and heart rate measurements are taken using a blood pressure cuff attached to the patients arm This information is recorded in the monitors and can be tran
21. heck mode may be reinstated in the 90217 and the 90207 monitors versions 2 14 and later To reinstate the Office Check mode without initialization of the monitor 1 Power ON the monitor 2 Press and hold the START STOP key when the version displays on the LCD 3 Release the START STOP key when ECO3 displays on the LCD An EC13 will be logged to indicate the time at which the Office Check was reinstated The Office Check mode will be enabled for five additional successful measurements 1 6 90207 90217 Operations Manual Operation Preparing the Patient and Precautions for Use Note Blood pressure measurements determined with this device are equivalent to those ob tained by a trained observer using the cuff stethoscope auscultation method within the limits prescribed by the American National Standard Electronic or automated sphyg momanometers The fifth Korotkoff sound was used to determine overall efficiency As in manual auscultatory methods accurate readings may not always be achieved un der some conditions Patient movement the position of the cuff relative to the level of the heart extreme heart rates and blood pressures various arrhythmias and the subject s physiological condition and other factors may hinder an accurate reading Vibration such as that in a moving automobile is an environmental problem that may affect readings When some of the above factors prevent an accurate reading an event code is provided
22. ion Optional Accessories Table 3 Optional Accessories Part Number Cuff Support Harness 015 0070 00 070 0189 02 Quick Disconnect Coupling 712 0794 00 Male Quick Disconnect to Luer Adapter 712 0773 00 Correlating with Manual Readings The monitor bleeds pressure in discrete steps not continuously using the oscillometric method of blood pressure determination If manual pressure readings are taken simultaneously with the monitor readings interpolation is required to accurately correlate monitor systolic and diastolic pressure values with the manual auscultatory pressures e For systole record the first pressure at which a Korotkoff sound is heard Actual systolic pressure is Somewhere between the pressure when the sound is heard and the previous higher pressure where no sound was heard The interval of uncertainty can be reduced by half by adding one half of the bleed step size 4 mmHg to the manual systolic pres sure e For diastole record the cuff pressure at which the last Korotkoff sound was heard Actual diastolic pressure is somewhere between that pressure and the next lower pressure The interval of uncertainty can be reduced by half by subtracting one half of the bleed step size 4 mmHg from the manual diastolic pressure 070 0137 03 Rev L 1 9 Operation Patient Instructions If the cuff becomes uncomfortable during a reading make certain that the patient knows how to termi nate the readings by pressing the
23. modem if you are using an older 90207 monitor with a 1200 modem as follows Switch Number Setting at Monitor Site 6 om ES II 1 4 90207 9021 7 Operations Manual Operation 2 Connect the serial port cable P N 012 0096 00 between the monitor and the modem Note If call waiting or call forwarding are options on a telephone used to transfer data ensure that both are deactivated Otherwise modem communications may be interrupted In addition telephone systems such as CBX or PBX can cause interference with the modem or the modem can cause interference with the switching system To initialize the monitor for remote connection 1 Contact the base station by telephone for remote operation only 2 Ask the base station operator to initialize the monitor Give the following information to the operator e Patient s name e Patient ID number e Whether monitor display is to be active or not e Time of day 12 or 24 hour format e Whether to display measurement systolic diastolic and heart rate e Multiple or single cycle times If using a single cycle for the 24 hour monitoring period indicate the cycle interval and whether the tone is ON or OFF For multiple cycle times specify each cycle interval and whether the tone is ON or OFF for each cycle e Any other information the base station operator may request The base station operator will enter the patient information in the computer 3 Prepare the monitor to receiv
24. of the module or monitoring equipment e Do not immerse the equipment or cables in water or cleaning solutions Do not autoclave To clean the exterior of monitors modules and cables e Prepare the cleaning solution according to the manufacturer s instructions e Weta clean cloth with the selected cleaning solution e Remove excess liquid from the cloth and squeeze dry e Wipe exposed surfaces of the equipment and cables e Remove any soap residue by gently wiping with a clean damp cloth e Wipe dry with a clean dry cloth 1 10 90207 90217 Operations Manual Operation Use only the following recommended cleaning solutions e Mild soap and water solution e U S Pharmacopoeia USP green soap e Sodium hypochlorite solution 1 10 dilution of household chlorine bleach in water e Phenolic germicidal detergent 1 aqueous solution e Glutaraldehyde 2 4 Cidex e Isopropyl alcohol 70 solution Note Over time repeated use of a chlorine bleach solution may cause some colors to fade Tape adhesive can be removed with Spacelabs Healthcare adhesive tape remover pads P N 392196 001 Questions and concerns about cleaning issues should be directed to a Spacelabs Healthcare field serv ice engineer Cleaning the Cuff and Carrying Pouch Small soiled or stained areas may be cleaned by gentle scrubbing with a sponge or cloth soaked in a mild soap and water solution The cuff wrap with the air bladder removed and the pouch are ma
25. or If initialization does not correct the condition the monitor must be returned to Spacelabs Medical for calibration ECO7 EC78 Clogged connector filter ECO EC18 Too few data entries to accurately determine blood pressure This mes sage may indicate that the cuff is not being worn by the patient taken off but left connected to the monitor The message may also indicate that motion artifacts cause the majority of the incomplete data EC28 EC38 EC48 iastole above 200 mmHg ulse pressure less than 16 mmHg Movement artifact at mean arterial pressure Heart rate arrhythmia y m O IN OI Ol O1 EC58 A Movement artifact at diastole B Heart rate arrhythmia E068 ECO9 ___ EC19 Contradictory instructions sent to hardware e g pump ON and valve open CO 070 0137 03 Rev L 1 1 Operation EC29 Diastolic pressure value cannot be obtained from the data available 90207 systolic pressure cannot be obtained from the data available 90217 Algorithm could not process input data quickly enough resulting in an input queue overflow 90207 Mean arterial pressure cannot be obtained from the data available 90217 This monitor must be initialized The report does not print an event code for this condition which is a low backup battery Contact Spacelabs Medical for replacement of the bat tery 1 14 90207 90217 Operations Manual Accuracy co Checking Accuracy Accuracy of the monito
26. r pressure readings should be checked annually Recalibration is necessary only if the monitor is not within the accuracy limits Required Equipment e A full size mercury sohygmomanometer or aneroid gauge Note Ensure the mercury sohygmomanometer or aneroid gauge is calibrated and indicates 0 with no pressure e T tube P N 016 0040 00 e A pressure cuff and a rigid cylinder sized to fit the pressure cuff 070 0137 03 Rev L 2 1 Accuracy Accuracy Procedure To check the accuracy of the monitor 1 Disconnect the cuff hose from the monitor Connect the T tube splitter to the monitor pneu matic connector and the sphygmomanometer 2 Wrap the pressure cuff around the rigid cylinder and then fasten the cuff Connect the cuff hose to the remaining connection on the T tube splitter The test setup should appear as shown in the following figures Fo us elle SAT 0 car ba Cac Co orc Caden Pai ee ee lee File gy LP rue Ler berii RSR rs CON ARR ia er ati ep EPST eus lu et eva Pr a ar E MUR n vai Figure 2 1 712 0039 01 Calibration Kit 3 Press START STOP on the monitor the monitor should read approximately 165 mmHg Compare the readings on the monitor and the manometer as the pressure bleeds down The monitor reading should be within three millimeters or 2 of the manometer reading whichever is greater the accuracy of the manometer Note If the monitor pressure values fall outsid
27. rrect time displayed PAANO 1 moved AT MOTE NaN Re initialize monitor play one minute 90207 only Servicing There is a 12 month warranty on this product Field service for the ABP monitor is limited to replacing batteries and accessories If other repair is required return the monitor to Spacelabs Healthcare Contact your Spacelabs Healthcare Customer Service Representative for shipping details Caution Any attempt to perform service or repair to the monitor will result in cancellation of the warranty 070 0137 03 Rev L 3 3 90207 90217 Operations Manual Appendix Symbols The following list of international and safety symbols describes all symbols used on Spacelabs Health care products No one product contains every symbol GS HELP Key ea Keyboard Connection SPECIAL FUNCTIONS Key Mouse Connection START STOP Key RECORD Key NORMAL SCREEN Key START STOP MONITOR SETUP Key ALARMS Key PREVIOUS MENU Key STOP or CANCEL Key CONTINUE Key ENTER Key OFF Power Disconnection from MONITOR SETUP PREVIOUS HENU ON Power Connection to Mains Mains OFF Position for Push Button Power Switch ON OFF Video Output OFF Part of the Instrument On Direction ON Position for Push Button Power Switch Television Video Display ON Part of the Instrument Only Only oele oli x eao 070 0137 03 Rev L 4 1 Appendix A Symbols Standby D l STA
28. sferred over a modem link or by direct connection between the monitors and one of the ABP analysis systems The monitors can be programmed to either activate or deactivate the following features e Display the cuff pressure at each bleed step e Display the systole diastole and heart rate at the end of each measurement e Bleed to 40mmHig rather than stopping at the diastolic value e Beep before and after each reading Front Panel The 90207 and 90217 monitor front panels include the LCD display cuff hose connector and a START STOP switch Rear Panel The rear panels of both monitors contain program input and output communication ports On the 90207 the power ON OFF switch is located on the rear panel On the 90217 the ON OFF switch is located on the top panel 070 0137 03 Rev L id Operation Replacing the Batteries AA batteries provide the main power source for both monitors The 90202 monitor uses four batteries and the 90217 uses three batteries These batteries should be replaced or recharged before the start of each patient monitoring session Use either alkaline or Nicad batteries The 90207 monitor uses a lithium battery P N 146 0008 xx to back up the monitor memory and should be replaced periodically The 90217 monitor backup battery should not require replacement Main Battery Replacement Note If the main AA batteries must be replaced during patient monitoring this replacement must be accomplished
29. st electric shock IEC 60601 1 Type CF equipment The unit displaying this symbol is an F Type isolated floating patient ap plied part providing a high degree of protection against electric shock Adult NIBP Canadian Standards Associa tion Approved Operates on Non Harmonized Radio Frequencies in Europe CE Mark 4 5 Appendix Symbols Attention Consult Operations Note or Service Manual for Descrip tion W Warning About Potential Danger Caution About Potential Danger arning to Human Beings to a Device VQ A gt Noninvasive Blood Pressure Fetal Monitor Connection Fetal Monitor Connection Physiological Monitor Connec tion RS 232 Digital List of Rooms Service Message RS 232 Digital File Cabinet Arrows Non Sterile PVC Free Radio Transmitting device elevat Reusable ed levels of non ionizing ragiation Catalog Number Catalog Number recognized component in a and United States Nell Novametrix Compatible cor OxiMax Compatible I gt SN TZ Nellcor OxiMax Compatible Trulia Spacelabs TruLink Compatible Masimo SET Compatible om Nellcor OxiMax Compatible 90207 90217 Operations Manual Appendix Symbols Access Codes 1 Through 32 ANT 1 Diversity Antenna System 1 ANT 2 Diversity Antenna System 2 EEG EMG or ECG Channel ECG Channels CH1 CH2 CH3 CH4 Arrhythmia Net 1 Arrhythmia Net 2 Centimeters of Water EMG Channel CH5
30. ulation e Do not apply cuff to areas of breached or injured skin e This product contains natural latex rubber components to which some people may be allergic These components include the bladder and the first four inches of tubing extending from the cuff Note 5 6 ig 1 8 e Use only Spacelabs Healthcare cuffs with this monitor Using other manufacturer s cuffs may result in inaccurate readings even if the manufacturer s recommended size is ob served e Ifthe cuff is too small pressure readings may be falsely high if a cuff is too large it pro duces a falsely low reading The bladder can be positioned in the cuff for either the left or right arm Once the cuff is applied the arm should be relaxed at the patient s side To avoid reading errors due to hydrostatic pressure differences the level of the cuff on the arm should be near the level of the heart Lead the hose up the arm with the cuff and place it across the back of the patient Drape the hose so it does not cause the patient discomfort and is not pinched shut by too tight a radius The following graphic displays the most common positions for the cuff hose f ALTERNATIVE 1 ti j j T A Connect the hose to the monitor Verify proper monitor operation by taking one or more blood pressure readings Push the START STOP key to begin a measurement Spacelabs Medical recommends taking three readings in the office so that t
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