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1. NIBP SpO2 RESP TEMP IBP CO2 All means all parameters User can select the parameter s alarm event to view EH Choose Alarm User may use button M lt lt and gt lt to choose alarm event By selecting A lt button the previous event will be displayed selecting button the next event will be displayed E Select waveform With the buttons 4 and the operator may move the alarm waveform a page forward or backward EH Record The recorder will output current alarm event if the user pressed button Record 15 4 NIBP Review The monitor may display the recent 1000 pieces of noninvasive blood pressure measurement data in the NIBP review Choosing the NIBP Review in the Review menu will display the results and time of the recent 10 pieces of noninvasive blood pressure measurement just as the following window shows Nbp Review ss pen ie fe 1 120 93 80 2007 01 27 18 07 07 2 120 93 80 2007 01 27 18 05 37 3 120 93 80 2007 01 24 17 43 50 4 120 93 80 2007 01 24 17 43 14 S 120 93 80 2007 01 24 17 42 18 6 120 93 80 2007 01 24 17 39 12 7 120 93 80 2007 01 24 17 39 08 8 120 53 80 2007 01 24 17 39 03 3 120 93 80 2007 01 24 17 38 59 10 120 93 80 l2007 01 24 17 38 55 upowe se rotri n Return Chart 12 4 NIBP measurement review 76 Operation Manual Chapter 15 His
2. 5 record grid Off means non grid output On means grid output Operation Manual 33 Chapter 3 Record 3 2 Record type The monitor can carry on several kinds of types record the continuously real time records 8 seconds real time records Automatic 8 second records E Real time record This means that it starts the real time recording waveform when presses down the recording key and stops the record when press down the recording key again in the recording process EH Auto record The monitor can trigger the record output according to the time interval the recording length is 8 seconds 3 3 Record content The record outputs contents The recording type the patient information the parameter table the record time the waveform name the waveform amplitude and waveforms 34 Operation Manual Chapter 4 Admit Discharge Patient Chapter 4 Admit Discharge Patient 4 1 Admit patient The step of receiving new patient is as follows enter Patient info window by choosing the Admit new patient menu and input the patient information the following chart to show Patient Info E Bed Number 1 Ok Patient Type Adult v Cancel Patint Name Gender Male Date of BirtH1900 Lt CL Height 20cm Weight 2kg MRN Chart 4 1 admit new patient choose the yes button to quit the patient s informations is accepted Operation Manual 35 Chapter 4 Admit
3. 17 1 17 2 17 3 17 4 17 5 17 6 17 7 17 8 17 9 17 10 17 11 17 12 17 13 17 14 17 15 CONTENTS CLASSITICA MOM sta A A A at 82 AGcordant Standard a5 scvcies css dos i E esha vane dengue ov seen tebiiven A E E A EE 82 Power Supply seinninn a A as 82 Battery ed ose dale e e a E e dd ah ee eee 82 ENVIO MEN ii asin asta ib 82 Signal Interface voconananinin atada ina leevicaeeiandisuleevicaveichs dese viegee ESES 82 Elina iaa ado 83 Respiration ae aa a E O E a E ah ee aE AM aa ed 84 NB A A A A N O 85 A RANAS 86 TS A a es actas 86 TBP ptional ii A tas 87 CO2 optional uti A A A a 87 lOG optional ii A AA ee een 88 Recorder optlonal 2 A A ce 88 Operation Manual HE Chapter 1 Overview Chapter 1 Overview 1 1 Overview This monitor is suitable for adult pediatric and neonate patient may monitor the physical parameters such as electrocardiograph ECG noninvasive blood pressure NIBP oxygen saturation SpO respiration rate Resp body temperature Temp invasive blood pressure IBP carbon dioxide CO2 index of cerebral loC and so on can display maximum 11 waveforms and all information of the parameters monitored in the same screen Below shows the monitoring functions of this monitor 1 electrocardiograph ECG including heart rate 6 channels ECG waveforms ST segment analysis arrhythmia analysis 2 oxygen saturation SpO 2 including oxygen saturation pulse rate pulse wave 3 noninvasi
4. Operation Manual 87 Chapter 17 Appendix Product Specifications 17 14 IoC optional EEG sensitivity 475 uV CMRR gt 100 dB Input Impedance gt 50 Mohm IoC 0 100 ESR 0 100 EMG 0 100 17 15Recorder optional Paper width 48 mm speed 25 50 mm s wave channel 2 channels 88 Operation Manual
5. may enter ECG Alarm Limit window Ecg Alarm Limit E Alarm High LimitLow Limit HP MMMM 120 Els 4 ST lan zo 2omv 4 Lo zom El PVCs on fo E Ok Cancel Chart 2 3 Ecg Alarm Limit Following is the adjustment scope of the heart rate Patient type Adult Pediatric Neonate HR high limit 300 350 350 HR low limit 15 15 15 adjustment scope of the ST 2 00mV 2 00mV adjustment scope of the PVCs 0 10 20 Operation Manual E SpO Alarm Limit Chapter 2 Alarms Choosing SpOz Alarm limit may enter SpO2 Alarm Limit window Sp0 Alarm Limit Alarm Spe MM oo so 4 Pulse Ratel On 120 so 2 Ok Chart 2 4 SpOz Alarm Limit The SpO limit adjustment scope is 0 100 The Pulse rate alarm limit adjustment scope are 20 300 E NIBP Alarm Limit High LimitLow Limit Cancel Choosing NIBP Alarm Limit may enter NIBP Alarm Limit window NIBP Alarm Limit Alarm Ok Chart 2 5 NIBP Alarm Limit Cancel The NIBP Alarm Limit adjustment scope as follows ES High LimitLow Limit sustolic MN commie Efon E Mean On f 1 ommHg E some E Diastolic On fomi 4 Sombie 2 Patient type Adult Pediatric Neonate Systolic pressure high limit 280 220 135 Systolic pressure low limit 40 40 40 Diastolic pressure high limit 220 160 100 Diastolic pressure low limit 10 10 10 mean pressure high limit 240 170 110 me
6. 26 Operation Manual Chapter 2 Alarms PA SYS TOO LOW PA systolic pressure is lower than the low limit PA MEAN TOO HIGH PA mean pressure exceeds the high limit PA MEAN TOO LOW PA mean pressure is lower than the low limit PA DIA TOO HIGH PA diastolic pressure exceeds the high limit PA DIA TOO LOW PA diastolic pressure is lower than the low limit PA DIA TOO LOW PA diastolic pressure is lower than the low limit CVP SYS TOO HIGH CVP systolic pressure exceeds the alarm high limit CVP SYS TOO LOW CVP systolic pressure is lower than the low limit CVP MEAN TOO HIGH CVP mean pressure exceeds the high limit CVP MEAN TOO LOW CVP mean pressure is lower than the low limit CVP DIA TOO HIGH CVP diastolic pressure exceeds the high limit CVP DIA TOO LOW CVP diastolic pressure is lower than the low limit LAP SYS TOO HIGH LAP systolic pressure exceeds the alarm high limit LAP SYS TOO LOW LAP systolic pressure is lower than the low limit T AP MEAN TOO HIGH LAP mean pressure exceeds the high limit T AP MEAN TOO LOW LAP mean pressure is lower than the low limit T AP DIA TOO HIGH LAP diastolic pressure exceeds the high limit LAP DIA TOO LOW LAP diastolic pressure is lower than the low limit RAP SYS TOO HIGH RAP systolic pressure exceeds the alarm high limit RAP SYS TOO LOW RAP systolic pressure is lower than the low lim
7. The Resp rate alarm limit adjustment scope is 7 120 The EtCO2 alarm limit adjustment scope is 0 100mmHg The FICO alarm limit adjustment scope is 0 100mmHg Operation Manual 23 Chapter 2 Alarms E IOC Alarm Limit Csm Alarm Limit Alarm High LimitLow Limit CSI TEN Also slo Dk Cancel Chart 2 10 CO Alarm Limit The IoC rate alarm limit adjustment scope is 0 100 Load Default Alarm Limit Choosing Load Default Alarm Limit can enter load default Alarm limit window Load Default Alarm Limit A Current alarm limit setting will lost Are you sure to do this Yes The chart 2 11 Load default Alarm Limit If chooses Yes then the current alarm limit settings will be able to substituted by the default alarm limit settings 24 Operation Manual Chapter 2 Alarms 2 6 Physiology alarm information Below is all physiologies alarm tabulates Alarm Information Trigger Condition ASYSTOLE Over 4 seconds non palpitations signals xk APNEA In a setting time without breath signal NO PULSE Over 15 seconds without pulse signals HR TOO HIGH The heart rate exceeds the alarm high limit HR TOO LOW The heart rate is lower than the alarm low limit ST I TO HIGH the ST value correlate with I surpass the upper alarm limit ST I TOO LOW the ST value correlate with I surpass the lower alarm limit ST TO HIGH the ST value
8. Titration Table ES Height 71 kg Dose hr 200 00mg Amount 500 00mg Inf Rate 100 00m1hr volume250 00m1 Drip Rate 20 00 GTT min Dose Inf Rate Dose Inf Rate DoseType Dose hr Item Dose step E Record Return Chart 13 2 titration table 80 Operation Manual Chapter 16 Drug Calculation 1 Move the cursor to the DoseType option press down the knob to choose dosage unit 2 Move the cursor to the Item option then press down the knob to choose Dose Inf Rate The selection of Dose will calculate the infusion rate taking the dose as the basis of calculation otherwise the dose taking infusion rate as the basis of calculation 3 Move the cursor to the step option press down the knob to choose length of step The optional scope is 1 10 4 With the buttons 4 and P the operator may move the titration table a step backward or forward With the buttons 4 and lt gt the operator may move the table a page forward or backward By selecting the button M the operator may display the minimum titration table data and M gt the maximum 5 The recorder will output current titration table if Record button is pressed 6 Move the cursor to the Return button press down the knob to get back to the Drug Calculate menu Operation Manual 81 Chapter 17 Appendix Product Specifications Chapter 17 Appendix Product Specifications A W
9. if error exceeds the normal voltage still existed contact the scope factory service 12V LOW The 12V voltage examination Restart the machine if error is lower than the normal still existed contact the voltage scope factory service 3 3V HIGH The 3 3V voltage Restart the machine if error examination exceeds the still existed contact the normal voltage scope factory service 3 3V LOW The 3 3V voltage Restart the machine if error examination is lower than the still existed contact the normal voltage scope factory service BAT HIGH The battery voltage Restart the machine if error examination exceeds the still existed contact the normal voltage scope factory service BAT LOW The battery capacity is Meets the alternating current insufficient to carry on the charge immediately to the battery NIBP LOOSE CUFF The cuff has not connected Reconnects the blood pressure cuff NIBP AIR LEAK The cuff has not connected good or the air course leaks air check the pipe connection situation or replace cuff if the breakdown still existed please contact the factory service 30 Operation Manual Chapter 2 Alarms NIBP DEFLATE ERR check the tube connection or When blood pressure replace cuff if the error still measurement deflates has the A see existed please contact the factory service NIBP WEAK SIGNAL Examined the patient type When blood pre
10. the operator may move the time of trend graph a step length forward or backward current period With the buttons gt and B the operator may move the time of trend graph a page forward or backward By selecting the button M the operator may move the time of trend graph 72 hours forward and M the current time 74 Operation Manual Chapter 15 History Review 15 3 Alarm Review When physical alarm occurs the monitor will save all the parameters and 16 seconds waveforms in the alarm event database the monitor can display 200 alarm event in the alarm review Choosing the Alarm Review in the Review menu will display recent alarm event information just as the following chart shows Sequence number format is I N which I means the index of alarm event and N means the total alarm event number in the database as chart 12 4 shown new alarm has smaller number eg No 1 means the closest alarm Alarm event s time Alarm event s type Parameters when alarm occurs 2 channels of waveform 16 seconds for both channels Alarm Review EN 1 12 xHR TOO LOW60 lt 61 2006 07 10 HR 60 Sp02 98 NIBP 120 80 93 RR 20 PR 60 Tempi 36 0 Temp2 36 5 ECG1 a ECG2 d mi 10 54 50 10 54 54 Type TE 4 4 gt Record Return Chart 12 4 NIBP measurement review Operation Manual 75 Chapter 15 History Review Alarm Type There are 8 types of alarm event All ECG
11. Discharge Patient 4 2 Discharge patient Enter the Discharge Patient window by choosing Discharge Patient menu as the following chart to show Discharge patient EN All patient history data will lost Are you sure to do this Yes Chart 4 2 Discharge patient Carry on the following operations to relieve the patient 1 Discharge all patients information 2 Discharge all historical data including trend graph trend table blood pressure review waveform review data A Attention A If do not relieve the patient firstly before receive new patient new patients measurement data would be save in the preceding patient s data The monitor can not distinguish the new patient data from the old one 36 Operation Manual Chapter 5 ECG Monitoring Chapter 5 ECG Monitoring The ECG monitors the heat electricity activity of the body and shows the heart electricity waveform and the heart rate on the monitor 5 1 Connecting ECG electrodes 1 make the patient s skin preparation at first before place the electrode A good signal at the electrode provides the monitor with valid information for ECG data processing Clean the skin with the soap and the water don t use aether and pure alcohol because this can increase skin impedance or scratches the skin dry to increase the blood stream capillary of the organization and remove skin filings and fat If necessary shave the hairs in which the electrode is plac
12. Service button the user may choose to enter the windows of ECG calibration Temp Sensor Type NIBP Pneumatic Test NIBP calibration NIBP Reset IBP Zero IBP Calibration CO2 Calibration Demo mode Version info 39 66 User setting Factory Service and so on Ecg Calibrate Temp Sensor Type NIBP Pneumatic Test NIBP Calibration NIBP reset Ibp Zero Ibp Calibration CO2 Calibration Demo Mode Version Info User Setting Factory Service Chart 1 11 Service 12 Operation Manual Chapter 1 Overview mE ECG calibration Entering the ECG calibration window the user may turning on or turning off of the ECG calibration signal as the following chart shows Ecg Calibrate E Calibrate td Return Chart 1 12 ECG calibration m Temp Sensor Type Entering the Temp Sensor Type window the user may initialize the type of body temperature sensor 10K or 2 25K as the following chart shows Temp Sensor Type sensor Type OK Cancel Chart 1 13 Temp Sensor Type E Air leakage examination of noninvasive blood pressure Selecting the air leakage examination of noninvasive blood pressure the user may examine whether the entire air way of blood pressure measurement leaks air or not When the blood pressure cuff is connected the user may start the air leakage test with this key thus discover whether the airtight condition of gas route is good or not
13. The examination result is If air leakage examination is passed the system will not make any prompt If isn t the corresponding failure prompts will be displayed in the noninvasive blood pressure information section The detailed introductions refer to 10 5 the air leakage examination m NIBP calibration After selecting the noninvasive blood pressure calibration the user enters the calibration mode and at this time the user may calibrate using a pressure gauge or mercury sphygmomanometer with a calibration precision higher than 1 mmHg after calibrated If the measure blood pressure key is presses down during the calibration the system will stop calibrating The detailed introductions refer to 10 4 the blood pressure calibrations Operation Manual 13 Chapter 1 Overview E NIBP reset After choosing the noninvasive blood pressure reset the user may restore the blood pressure module to the initial settings When the blood pressure measurement is abnormal yet the monitor cannot prompt reasons of the problem using this key is suggested Because this causes the blood pressure module to reset the blood pressure module may commit self recovery when the abnormity of work is caused by accidental reasons E IBP Zero Detailed introductions of IBP zero can refer to 12 2 IBP zero m IBP Calibration Detailed introductions of IBP calibration can refer to 12 3 IBP Calibration CO Calibration Detailed introduct
14. connected to the monitor and Lead Off connected then perform zeroing again If the monitor continues to IBP Zero Fail Pressure is not zero give this prompt information contact Customer Service Verify the transducer is connected to the monitor and Over Range the 3 way stopcock is open to the atmosphere then perform zeroing again If the monitor continues to give this prompt information contact Customer Service IBP Zero Fail Pulsatile Pressure is not stable Verify the transducer is connected to the monitor and the 3 way stopcock is open to the atmosphere then perform zeroing again If the monitor continues to give this prompt information contact Customer Service 1 Ensure zero the transducer before A Warning A uncorrect measurement it is used to zero the monitor otherwise will cause 2 Position the transducer at the same level with the patient s heart approximately mid axillary line 3 Perform zeroing before monitoring and between monitoring at least once per day The zeroing should also be conducted once the transducer cable is changed Operation Manual 57 Chapter 12 IBP Monitoring 12 4 IBP Calibration Steps of IBP Calibration 58 1 2 3 4 5 6 Disconnect the pressure transducer from the patient Using a T connector to connect the 3 way stopcock the sphygmomanometer and the inflation orb as Chart 12 5 shown below Perform the
15. correlate with II surpass the upper alarm limit ST TOO LOW the ST value correlate with II surpass the lower alarm limit ST II TO HIGH the ST value correlate with III surpass the upper alarm limit STII TOO LOW the ST value correlate with III surpass the lower alarm limit ST AVR TOO HIGH the ST value correlate with AVR surpass the upper alarm limit ST AVR TOO LOW the ST value correlate with AVR surpass the lower alarm limit ST AVL TOO HIGH the ST value correlate with AVL surpass the upper alarm limit ST AVL TOO LOW the ST value correlate with AVL surpass the lower alarm limit ST AVF TOO HIGH the ST value correlate with AVF surpass the upper alarm limit ST AVF TOO LOW the ST value correlate with AVF surpass the lower alarm limit ST V TOO HIGH the ST value correlate with V surpass the upper alarm limit ST V TOO LOW the ST value correlate with V surpass the lower alarm limit Operation Manual 25 Chapter 2 Alarms PVCs TOO HIGH The PVCs value exceeds the alarm high limit SPO TOO HIGH The oxygen saturation exceeds the alarm high limit SPO2 TOO LOW The oxygen saturation is lower than the alarm low limit Pulse rate TOO HIGH The Pulse rate surpass the alarm high limit Pulse rate TOO LOW The Pulse rate are lower than the alarm low lim
16. interface may communicate with the central station through the ethernet cable to achieve the function of remote monitoring In the top right corner of the screen there is a network icon representing current network status If the network electric cable is disconnected the network condition g icon shows as ESS After the monitor has established connection with the central station the icon shows as ES If the monitor communicates normally with the central monitoring lt A ar system the icon shows as 1518 Operation Manual 15 Chapter 1 Overview 1 7 Rechargeable built in battery The monitor is equipped with a rechargeable built in battery In the top right corner of the screen exists one symbol ca indicating the state of the battery capacity of which the green part denoting electric quantity of the battery When the battery is charged the charging condition is expressed with animation After the battery is full charged the symbol will show as GB When this monitor has not been installed the built in battery the symbol shows as m indicating no battery When running with power supply from battery the monitor detects the volume of the battery and alarms when the battery is insufficient and prompts in the information section BAT LOW At this time the AC power should be plug in and immediately charge battery in time If battery is still used for power supply the monitor will power off automatically w
17. of the P wave and the T wave is smaller than 0 2mV R Chart 5 2 standard ECG waveform E ECGsetting enter the ECG setting window by choosing the ECG setting menu as can be seen from the following chart Pace CO Lead Type s Lead Chi Lead Filter Moni tor Ch2 Lead Heart volune s 8 ch3 Lead Have Speed 2s m s size HR Source auto Notch On ST Switch Of f ia ARR Switch Dff X Ok Cancel Chart 5 3 ECG settings menu 1 Pacemaker When it is turned on the pacing signal which is considered as the pacing 38 Operation Manual Chapter 5 ECG Monitoring symbol is shown as a vertical line above the ECG waveform 1 When it is turned off the pace maker will not be detected 2 channel 1 lead channel 2 lead channel 3 lead There are 7 leads I I II AVR AVL AVE V 3 channel 1 gain channel 2 gain channel 3 lead There are four gains X0 25 X 0 5 X 1 X2 1 millivolt ruler mark is displayed on the right of the ECG waveform the height of which make a direct ratio with the wave amplitude 4 Notch work frequency suppression switch when it is On will filter the AC disturbance of ECG signal 5 Lead mode 5 lead 3 lead 6 Filter mode There are 3 filter modes diagnostic monitor and surgery In diagnostic mode The ECG wave without filtering is displayed In monitor mode the artifact which causes the false alarm is filtered out In s
18. point shows the ECG waveform s baseline The ST point shows the position of the ST section diff IH ST ISO Chart 6 2 the analysis point of ISO and ST Operation Manual 41 Chapter6 ST Monitoring Enter the ST setting window by choosing ST Setting as the following chart can be seen _ Iso soms 2 ST l112m8 2 Ok Cancel Chart 6 3 ST settings ISO baseline point set the baseline point The default setting is 80 milliseconds ms ST measuring point set the measuring point The default setting is 112 milliseconds ms The reference point of setting the ST point is the R wave peak point If the patient s heart rate has changed obviously the ST measuring point must be adjusted A Attention A When the ECG filter mode is monitor or surgery mode ECG waveform can make a distortion possibly causing the ST value to be distorted It is suggested to set ECG filter mode as diagnostic when the ST monitoring works A Attention A When the Pace switch is On ST analysis doesn t work 42 Operation Manual Chapter 7 Arrhythmia Monitoring Chapter 7Arrhythmia Monitoring When the arrhythmia analysis switch in the ECG setting menu is turned on the monitor can carry on arrhythmia analysis The arrhythmia analysis can be used in the clinical examining on the arrhythmia event or producing reports for the alarm Doctor can evaluate the patient s condition according to th
19. pressure transducer zeroing If the zeroing succeeds open the stopcock to the sphygmomanometer Inflate using the inflation orb until the mercury volume of the sphygmomanometer rises to 100 250mmHg In the IBP Calibrate menu set the value for calibration which should be the same with the sphygmomanometer Press IBP1 Calibrate or IBP2 Calibrate to start calibrate After calibration disconnect the blood pressure tubing and the T shape connector Then connect the pressure transducer with the patient for normal monitoring Ibp Calibrate Pressure 1 ommHel E Ibp1 Calibrate Pressure 16ommHg E Ibp2 Calibrate IBP1 Calibrate Not Done IBP2 Calibrate Not Done Return Operation Manual Chapter 12 IBP Monitoring Chart 12 4 IBP Calibrate Dialog Chart 12 5 IBP Calibrate IBP calibrate prompt message Prompt Cause Process Method IBP need zero IBP have not zeroed Start zeroing IBP then calibrate again if the message still exist contact Customer Service IBP calibrate IBP sensor is not Verify the transducer is connected to the monitor fail Lead off connected to the monitor and then perform calibrate again If the monitor continues to give this prompt information contact Customer Service IBP calibrate IBP pressure is too high Verify the transducer is connected to the monitor and fail Over Range the 3 way stopcock is open to the atmosphere then perform zeroing again I
20. the screen the user may visit these menus by rotating the knobs When the cursor chooses anyone of the items sublevel menus will popup When the user presses down the knob once again the corresponding dialog will pop up and the user can change the settings in the dialog 1 3 Alarm When the alarm occurs the warning light will glitter or bright the color represents certain level of the alarm The detailed contents please refer to chapter2 Alarm 1 4 Control panel The control panel is on the front panel The total keys from left to right are listed below 1 Power key key to turning on and turning off of the power 2 Alarm silence key With this key pressed down sound of the alarm will shut down also the ALARM SILENCE will be displayed in the information section and other sounds key sound palpitation sound and so on will not be affected Pressing down the key again will restore all the alarms 3 Alarm pausing key With this key pressed down the alarm may hang up for 2 minutes 1 minute 2 minutes and 3 minutes are optional and the ALARM PAUSE will be displayed in the information section All the alarm will be restored after this key is pressed again 4 Freezing key In the normal mode all the waveforms on the screen will be frozen with this key pressed down Pressing down this key once again will release the frozen waveforms 5 Blood pressure key Pressing down this key will start to c
21. this time should cause the patient peaceful or the replacement measurement SpO2z reduces the influence of moves excessively to the measurement Operation Manual 49 Chapter 10 NIBP Monitoring Chapter 10 NIBP monitoring 10 1 NIBP measurement step 1 Insert the gas tube into the blood pressure socket of the monitor 2 Tie the blood pressure cuff on the patient upper arm or the thigh 3 Use the suitable size cuff for the patient guaranteed the symbol is located above to the suitable artery Guarantee the cuff to twine the body is not too tight otherwise possibly causes the body far end to change color even lacks the blood 4 Inspects the edge of the cuff to fall in the range signed lt gt If it is not this exchange a more appropriate cuff 5 Confirm the cuff deflated completely 6 Cuff and gaseous tube coupling The body which will be measured should put in the same horizontal position with the patient heart If it is unable to achieve must use the following adjustment method to make the revision to the measurement result If the cuff is higher than the heart horizontal position each centimeter disparity should add 0 75mmHg 0 10kPa in the value If the cuff is lower than the heart horizontal position each centimeter disparity should reduce 0 75mmHg 0 10kPa in the value 7 Confirm the patient type whether correct patient type shows in the block of information on the monitor the right side of bed number if needs
22. to change the patient type please enter the patient information window change the patient type 8 Press down the blood pressure measurement button on the front panel start to measures the blood pressure 10 2 NIBP measurement limits This machine NIBP measuring technique is the vibration mothod this kind of measuring technique basis has the certain limit according to difference metrical object The user should realize at following several situations the observed value changes unreliable or the time measured press increases or the measurement is unable to carry on 1 Patient movement If the patient is moving trembles or the convulsion 2 Arrhythmia the irregular heart beat caused by the arrhythmia 3 Heart lung machine such as the patient uses the heart lung machine connection 50 Operation Manual Chapter 10 NIBP Monitoring 4 Pressure variation such as while in blood pressure measurement the patient blood pressure rapid change 5 Serious shock such as the patient is being in the serious shock or the hypothermia 6 The heart rate exorbitant or lower The heart rate is lower than 40bpm heart beat minute and is higher than 240bpm heart beat minute cannot carry on the blood pressure measurement 7 Obese patient The excessively thick fat stratum can reduce the accuracy of the measurement because the fat can cause the artery pulse signal cannot arrive the cuff 10 3 NIBP settings Eg Mod
23. 0 170 mmHg Neonatal Mode SYS 40 135 mmHg DIA 10 100 mmHg MEAN 20 110 mmHg m Static pressure accuracy 3mmHg E Resolution ImmHg Operation Manual 85 Chapter 17 Appendix Product Specifications E Accuracy Maximum Mean error Maximum Standard deviation E Overpressure Protection Adult Pediatric Neonatal 17 10 SpO 2 E Measurement Range 0 100 E Resolution 1 E Accuracy 70 100 40 69 0 39 E Pulse Rate Measure and Alarm Range Resolution Accuracy 17 11Temperature Channel Measure and Alarm Range Resolution Accuracy no sensor Accuracy include sensor 86 Operation Manual 5mmHg 8mmHg 300 mmHg 240 mmHg 150 mmHg 2 3 unspecified 20 300bpm lbpm 3bpm 2 0 50 C 0 1 C 0 1 C 25 C 45 C 0 2 C other 0 2C 32 42 C 0 3 C other Chapter 17 Appendix Product Specifications 17 12 IBP optional m Sensor reusable sensors OHMEDA P23XL or BD EDWARD compatible once usage OHMEDA DT 4812 or BD EDWARD compatible excitation voltage 5Vdc 2 sensitivity SuV V mmHg E Channels 2 channels E Measuer Range 50 360 mmHg E Resolution ImmHg E Accuracy no sensor 2 or 1mmHg use the greater E Band Width Normal mode DC 40Hz Smooth mode DC 12 5Hz 17 13 CO2 optional E Measuer Range 0 13 E Resolution 1 mmHg E Accuracy 2 mmHg lt 5 0 CO at ATPS E Breath Rate Breath Rate 3 150 bpm
24. 99 99 mcgtug Inf Rate 100 00 ml hr Drip Rate 33 33 lt Herrmin Drop Size 20 00 SeT Inf Time 2 50 CIA Titration Table Return Chart 13 1 Drug Calculate The drug calculation can apply the following formulas Concentrate Amount volume Inf rate Dose Concentrate Durate Amount Dose Dose Inf rate x Concentrate Operation Manual 79 Chapter 16 Drug Calculation 16 2 Operating procedures In the Drug Calculate window first the operator should choose the name of the drug that is to be computed then confirm the patient s weight and input other values that s already known Rotate the knob move the cursor to each calculated item in the formula separately Press down and rotate the knob select the calculated values After the selection value of the calculated item will be displayed in the corresponding place Drug name selection move the cursor to the drug name rotate the knob may choose among the 21 kinds of medicines AMINOPHYLLIN DOBUTAMINE DOPAMINE EPINEPHRINE HEPARIN ISUPREL INOCOR INSULIN INSUPREL LIDOCAINE NIPRIDE NITROGLYCERIN NOREPINEPHRINE PITOCIN PROCAINAMIDE VASOPRESIN DRUG A DRUG B DRUG C DRUG D DRUG E Only one type of medicine can be computed each time 16 3 Titration table Select the Titration Table in the Drug Calculate menu to turn into the interface of titration table The following chart shows the interface of the titration table
25. About the User s Manual The User s Manual serves for operating this instrument only Our company shall not be responsible for any consequences and liabilities caused by using this user s manual for other purposes The User s Manual containing special information is under copyright protection All rights reserved Copy duplication or translation of the whole or any part of the User s Manual is prohibited in case of no prior written consent from our company Based on the need of product technical improvement or the file updates we reserve the right to modify the contents contained in this manual if the change do not involve safety issues the contents are subject to amend without notification Due to technical upgrade or special requirements from users and with the precondition that the performance of the instrument will not be lowered some components may vary from the description of configuration in the User s Manual The explain for tagging in this manual A Warning You should know the information for how to avoid the patients edical staff may suffer injury Note You should know the information for how to avoid possible damage to equipment Version 1 0 2011 01 All rights reserved O Shenzhen Biocare Electronics Co Ltd CONTENTS CONTENTS Chapter Over wnes de seater o ld 1 1 1 OVELVICW IR Aaa 1 1 2 Screen layouts introduction ooooonocccconccnoncnconononnnncnnnnononcnnononcono E EE EAK EE RKS EAE E Esnas 4 L3 Alarm orer
26. Adjust time Miscellaneous ECG setting ST setting SpO2 setting NIBP setting Resp setting Temp setting IBP Setting CO2 Setting IOC Setting or Load Default Alarm Setting Record Setting Screen Layout Adjust Time Miscellaneous ECG Setting Sp02 Setting NIBP Setting Resp Setting Temp Setting IBP Setting COz Setting IoC Setting Load Default Chart 1 5 setting E Alarm setting Detailed introductions can refer to Chapter2 Alarm E Recording setting Detailed introductions can refer to Chapter3 Recording E Screens layout After entering the screen layouts window the user may change the current display interface by selecting the interfaces of 6 types of Standard ECG Full Lead Big Font OxyCRG NIBP Trend Trend Table and choose to turn on or turn off parameter or waveform in the parameter switch and waveform switch The user can change trend resolution from 1 min to 60 min by setting Trend Time if the screen layout is set to Trend Table 8 Operation Manual Chapter 1 Overview The following chart shows the menu of screen layouts Screen Layout ES Trend Time 10min CSM Resolutic 10 Parameter Swit Have Switch M HR M ECG1 M SpDe M ECG2 M RR E M Temp E M NIBP E M IBP1 E M IBP2 Y Pleth M COs Y Resp Y CSM M IBP1 Y IBP2 M COD2 r Ok Cancel C
27. Off ALLE Ok Cancel Chart 13 1 CO Setting 1 Work Mode when Standby is selected CO pump will be closed to lower the power consumption and extend the lifetime of CO2 module 2 Apnea Time set delay time of apnea detection from 10 seconds to 40 seconds If the settings off indicate the apnea alarm is closed 3 Wave Scale wave scale is 30 100mmHg Operation Manual 61 Chapter 13 COz Monitoring 4 Wave Speed 6 25mm s 12 5mm s 25 0mm s 5 Unit mmHg kPa the formula of unit list below CO mmHg CO xPbaro mmHg 100 CO kPa CO2 mmHg 7 5 PCO CO pressure Pbaro barometer pressure standard barometer is 760mmHg 6 Rate set CO pump flow rate 50ml min 100ml min 150m1 min 7 BTPS compensation if On is selected CO2 module will auto compensate BTPS if Off is selected CO2 module will not compensate BTPS BTPS Body temperature and pressure Saturated means the CO is measured at a temperature of 37 C a relative humidity of 95 and a 47mmHg pH20 partial pressure of moisture 8 NzOCompensate Off 20 40 60 9 Oz Compensate Off 40 60 80 13 4 CO calibrate 62 Select CO2 Calibrate menu to enter CO2z Calibrate dialog CO ls 02 Barometer 760 Zero Cal Return Chart 13 2 CO calibrate 1 CO set CO calibration value to 5 10 2 Barometer display current atmosphere pressure 3 Zero press this button to sta
28. The air leakage examination process 1 Connect the cuff and the blood pressure socket on the monitor 2 Wrap the cuff around a suitable cylinder 3 Choose NIBP Pneumatic Test in Service menu the noninvasive blood pressure parameter area diplays Pneumatic test indicated the system starting to carry out leak air examination 5 After about 20 seconds the system will turn on the valve automatically marking leaks air examination is completed 52 Operation Manual Chapter 10 NIBP Monitoring 6 If in the noninvasive blood pressure parameter area does not prompt the information indicate the system does not leak air If Pneumatic leak is displayed indicate the air course possibly leaks air The operator should check loose conditions and carry on the leaks air examination again after confirming all connections are ok A Warning A 1 Can t carry on the noninvasive blood pressure on the patient who have the sickle cell anemia or have the skin disrepair or will have damage 2 To the patient who has the serious hemoglutination machine made barrier must according to the clinically appraise decided whether carries on the automatic blood pressure measurement because the place where the body and the cuff friction will has have the haematoma danger 3 Before start the measurement you must confirm the patient type is correct adult pediatric neonate 4 Do not enwind the cuff to the body have the venou
29. ained it will be stored in the noninvasive trend data the operator may choose the noninvasive blood pressure review to look over the noninvasive blood pressure trend data 15 1 Trend Graph The trend graph permits operator observing the stored trend data in graph mode The recent 72 hours trend data is displayed as a trend curve with a resolution of 1 second 5 second 1 minute 2 minutes 3 minutes 4 minutes or 5 minutes Choosing the Trend Graph in the Review menu will spring out the following window Trend Graph ES bpm 2007 03 27 ES D A ai 8 05 10R05 all bet Parameter HR Period imin Return 7 Chart 12 1 Trend Graph In trend graph window time shows underneath the X axis recent time is displayed on the nearest right side scope value of parameters is displayed on left side of the Y axis E Select parameters By selecting the parameter list box with cursor the operator may choose the parameter trend that is to be displayed After the anticipant parameter appears its trend graph will show in the window by pressing down the revolving button 72 Operation Manual Chapter 15 History Review E Set period By selecting the period option the operator may choose a period of 1 second 5 seconds minute 2 minutes 3 minutes 4 minutes or 5 minutes E Adjust observing time With the button 4 and the operator may move the time of trend graph a second length forward o
30. an pressure low limit 20 20 20 Operation Manual 21 Chapter 2 Alarms E Resp Alarm Limit Choosing Resp Alarm Limit may enter Resp Alarm Limit window Resp Alarm Limit Alarm High LimitLow Limit RR mn feo sf lt Ok Cancel Chart 2 6 Resp Alarm Limit The Resp rate alarm limit adjustment scope is 7 120 Patient type Adult Pediatric Neonate RR high limit 120 150 150 RR low limit 7 7 7 E Temp Alarm Limit Choosing Temp Alarm Limit may enter Temp Alarm Limit window Temp Alarm Limit Alarm High LimitLow Limit channel 1 AR l s9 0c s o 4 Channel 2 fon s9 0 Alls6 0 4 Ok Cancel chart 2 7 Temp Alarm Limit The Temp alarm limit adjustment scope is 0 50 C 32 122 F 22 Operation Manual Chapter 2 Alarms E IBP Alarm Limit Choosing IBP Alarm Limit may enter IBP Alarm Limit window Ibp Alarm Limit E Alarm High LimitLow Limit ART Systolic fon b eonmte E sommg 4 ART Mean On al Lommitg E omg ART Diastolic On some E some CVP Systolic fon ft rms El emng CVP Mean on 12 S omnis S CVP Diastolic On fromme 2 omnis Ok Cancel chart 2 8 IBP Alarm Limit The IBP alarm limit adjustment scope is 50 300mmHg E CO Alarm Limit CO2 Alarm Limit Alarm High LimitLow Limit RR MN lso 2 4 EtCOs On some 4 1 smmbig 4 FiCO2 On anmg 2 omnis 4 Ok Cancel Chart 2 9 CO2 Alarm Limit
31. ar iana a a a e E a devia ents AE I E a E E EE 6 1 4 Control panel haie a ee E 6 1 5 Sensor soketi RN 15 Ee e NT 15 1 7 Rechargeable built in battery oooocnoccnonccnoncncononcnonncnoncncono non a E a A a N 16 Chapter 2 Alarms A 17 2 1 Alarms OVerVI Wisin asalariados 17 2 2 Alarms pausIDE unica 18 23 Alarms SILENCE caco ai A A AA Raia hed 18 ZAS Alarm SO ti A A etalon hehe 19 2 5 LoS a dodo a e dl 20 2 6 Physiology alarm informati0N ooooooccnonocnonncconcnnonenonnnncnon conan cnnononconnncnon non a a nano 25 2 7 Technical alarm information ii A 29 Chapter Record na ns le ae lista le tae ota le dea dea el ven ed co 33 3 1 Record setting nica 33 3 2 Record typkes ies A dad eaten edhe deeded eee 34 3 3 RECOrd CONE td 34 Chapter4 Adimit Discharg Patios a a 35 4 1 NO 35 4 2 Discharge patient ccccccssccssssceeseceeseeceseecesceceeeeenseecsseecseeeeeeaeeeeseeeseeenseeesseeeseaeeseaseseseaeenes 36 Chapter 5 ECG MOonitoring cccccccscccsssceessceeseeesseecesceceeseeesseecsseeescecsessessseecsseecseecnscecseneeesseeecssaeeneseeeaes 37 5 1 Connecting ECG electrodes iio 37 Chapter 6 ST Monti da 41 6 1 O yaaan teh ad eae ated lah sand eal O E Sel rece Seg 41 6 2 SUS SS steak itis tice dee eae Sadek Se ved oie Baek eis eee ea oh ee Sh ces 41 Chapter 7 Arrhythmia Monitoring aseeni nn a e aaa aaa a E E 43 7 1 Arrhythmias PS td daa 43 7 2 PY GS parameter A e e e esa eo ete ta deta da deeds 44 Chapter 8 Resp MOnitoring c
32. arning A The patient monitor may not meet its performance specification if stored or used outside the manufacturer s specified temperature and humidity range 17 1 Classification Anti electroshock type Class I equipment Anti electroshock degree CF defibrillation CO2 and IoC are BF defibrillation 17 2 Accordant Standard GB 9706 1 1995 YY0089 92 YY91079 1999 17 3 Power Supply 100 250 VAC 50 60 Hz Pmax 60VA 17 4 Battery 2 6 Ah 12V rechargeable battery Operating time after full charge is more than 1 hours Operating time after the first alarm of low battery will be about 5 minutes Maximum charging time is less than 5 hours 17 5 Environment Temperature Working 0 40 C Storage 20 50 C Humidity Working 15 90 Storage 15 90 no coagulation 17 6 Signal Interface Network interface standard RJ45 Socket 82 Operation Manual Chapter 17 Appendix Product Specifications 17 7 ECG Lead mode 3 Leads RA LA LL lead mode I II III 5 Leads RA LA LL RL V lead mode I IL II AVR AVL AVF V Gain x2 5mm mV 5 0mm mV 10mm mV 20mm mV Heart rate Measure range Adult 15 300 bpm Neonatal Pediatric 15 350 bpm accuracy 11 resolution 1 bpm Sensitivity gt 200 u VP P Differential Input Impedance gt 5M ohm CMRR Diagnostic Mode gt 90 dB Monitor Mode gt 105 dB Surgery Mode gt 105 dB Electrode offset potential 300mV Leakage Current lt 10 HA PACE puls
33. asive blood pressure settings can refer to Chapter10 NIBP monitoring E Temperature setting Detailed introductions of body temperature settings can refer to chapter11 temperature monitoring E IBP setting Detailed introductions of IBP settings can refer to chapter12 IBP monitoring E CO setting Detailed introductions of CO2 settings can refer to chapter13 CO2 monitoring E CO setting Detailed introductions of IoC settings can refer to chapter14 IoC monitoring E Load default setting The following chart shows the window of Apply default settings Load Default E Current configuration data will lost Are you sure to do this MES Chart 1 9 Load default settings If Yes is chosen then the current settings will be replaced with default settings Operation Manual 11 Chapter 1 Overview E Alarm limit By selecting the limits of alarm button the user may choose to enter the windows of ECG Alarm Limit SpO Alarm Limit NIBP Alarm Limit Resp Alarm Limit Temp Alarm Limit IBP Alarm Limit CO2 Alarm Limit IOC Alarm Limit or Load default Alarm Limit the detailed introductions refer to chapter2 alarms ECG Alarm Limit Sp0z Alarm Limit NIBP Alarm Limit Resp Alarm Limit Temp Alarm Limit IBP Alarm Limit CO2 Alarm Limit IoC Alarm Limit Load Default Alarm Limit Chart 1 10 Alarm Limit E Maintenance By selecting the
34. ature settings Temperature unit Choose C or F A Warning A Before start to use the temperature measuring please examine whether the sensor cable is normal Unplug the temperature sensor cable from the socket the screen will display the error message Temp sensor off and sends out the sound alarm 54 Operation Manual Chapter 12 IBP Monitoring Chapter 12 IBP Monitoring 12 1 Steps of IBP measurement 1 Plug the pressure cable into the IBP connector on the monitor and power on the monitor 2 Prepare the flush solution 3 Flush the system to exhaust all air from the tubing Make sure that the transducer and stopcocks are free of air bubbles 4 Connect the pressure line to the patient catheter 5 Position the transducer so that it is level with the heart approximately at the level of the midaxillary line 6 Select IBP channel name 7 Zeroing IBP transducer Following is IBP sensor connection chart pressure sensor 3 way 01004 stopcock Chart 12 1 IBP sensor connection Operation Manual 55 Chapter 12 IBP Monitoring 12 2 IBP Setting Select IBP Setting menu will enter IBP Setting dialog Chi Name ART v Chi High 150mmHg E 3 Ch2 Name CVP y Chi Low OmmHg Gain Manual v Che High 40mmHg 4 Filter Normal Ch2 Low OmmHg Wave Speed 25 mm s v P1 S D M X Unit mmHg P2 S D M z di W Ok Cancel Chart 12 2 IBP Setting 1 Chl Name C
35. aveform speed you can choose the waveform speed at 6 25mm s 12 5mm s 25 0 mm s 3 Amplitude The user may setting the amplitude s enlargement factor has x0 25 x0 5 x x2 x4 altogether 5 levels 4 RR Source when Ecg is selected RR is from ECG leads when CO2 is selected RR is from CO module and AwRR is displayed on parameter area Operation Manual 45 Chapter 8 Resp Monitoring A Attention A Resp monitoring is not recommended on patient who moves a lot because this possibly causes wrong alarm A Attention A Place the RA and the LL electrode in the patient opposite angle of the body in order to obtain the best breath wave Should avoid the liver area and the ventricle at the breath electrode s lines this may avoid the false difference to be caused by the heart beat or pulsing blood stream this is specially important to the neonate 46 Operation Manual Chapter 9 SpOz Monitoring Chapter 9 SpOz Monitoring The Oxygen Saturation SpO 2 parameter measurement the artery blood oxygen saturation it is the percentage of the oxygen gathers hemoglobin For example if in the artery blood red blood cell 97 hemoglobin combine with the oxygen then this blood has 97 oxygen saturation the value reading on the monitor should be 97 this value demonstrated the percent of the carry oxygen hemoglobin molecule which forms the oxygen gathers hemoglobin 9 1 Measurement restrictions In the operating pr
36. cccceccccssscesseeeeseeesseecssneeeesseesseecseeessaecsscecsececesseeesseecsseecseaeessseesessaeeseneeenes 45 8 1 Principles of Respiration Measurement oooooccnoncnnononcnonncnoncnnononcnnnncnnn conan nnnon rn con n nora nnnnnnnnnennnns 45 8 2 Placing the electrodes iii des 45 8 3 Resp setting ash 22st wuts ras hs eee eae ae each A E ee ee en itd eles 45 Chapter 9 SpO s Monitors E a r e r ee ee oae eaa e E eera a doc ehates epaiten 47 9 1 Measurement restrictions cccccsccesccesseeseeesecesceesceeseeesceeseeescecscecseeseecseeceeeeeeeeeseeeeneeeeeeesees 47 CONTENTS 9 2 SpOz SOM aia o an iaa 48 Chapter 10 NIBP monitoring occoooccconccnononcnonncnonnnnoncnnnnoncnnnncnnnnonnnnnonnncnnn E EAEE 50 10 1 NIBP measurement Step oooocooccnonncnoncnoonnncononcnonncnonnnnonnncnn noo n rn can aK sa nn cnn Tr iaro r a daah 50 10 2 NIBP measurement ld viii ies cine shee ie Meee vente 50 103 NIBP SAME hk ila lade hla AA a 51 10 4 Blood pressure calibrations oooononconnonocoooncnonncnonnononcncnnnncnnnncnon conan nn non oncnn nn cnn ncnnnncnnnranannnnnnns 52 10 5 leakage examinatlOO at in nin a 52 Chapter 11 Temperature Monitoring oocoooccnocncoonncnoncnnonnncnnnncnonnononnnnonnncnnnnon nro non nnnnnrnnnnn cnn n cnn rr nan rrrnannnnnnnss 54 11 1 Steps of temperature measureMent ee ccecccccesceceseeeeeceeeeeeeecseecssaecseaeeeseeeeeeesseeeneeeene 54 11 2 Temperatures settings Menu ccccceeccceessceeseeeeseeeeseeesecee
37. ce TOC SENSOR OFF IOC sensor does not Check IOC sensor connected connection IOC SQI LOW IOC sensor does not Check IOC sensor connected or skin dirty connection A Attention A 1 When different level of alarm simultaneously exists the sound of the alarm is the highest level alarm 2 In alarm suspend condition Monitoring will not process any alarm information 32 Operation Manual Chapter 3 Record Chapter 3 Record 3 1 Record setting Record Setting Rec Havel Rec Havez Ecg II Rec Length las Rec Period lost Rec Speed 25mm7s Rec Grid 0n Ok Cancel Chart 3 1 recording settings 1 record waveform 1 record waveform 2 there are five options of the waveform to be choose off ECG1 ECG2 pulse wave respiratory wave IBP1 wave IBP2 wave CO2 wave The user may choose simultaneously two waveforms to record or choose one waveform to record while close another record wave 2 record length there are two options which are continuous 8 seconds continuous means that the record can continuously output the wave until presses down the RECORD key again 3 record period the time interval of two record outputs There are 10 options which are off 10 minutes 20 minutes 30 minutes 40 minutes 50 minutes 1 hour 2 hours 3 hour and 4 hours The recording length is 8 seconds 4 record speed There are two options which are 25 0mm s and 50 0mm s
38. ch devices may greatly affect the monitor performance A Warning A Devices connected to the monitor shall form an equipotential system protectively earthed A Warning A When used with Electro surgery equipment you doctor or nurse must give top priority to the patient safety A Warning A Do not place the monitor or external power supply in any position that might cause it to fall on the patient Do not lift the monitor by the power supply cord or patient cable use only the handle on the monitor A Warning A Consult IEC 601 1 1 for system interconnection guidance The specific requirements for system interconnection are dependent upon the device connected to the monitor and the relative locations of each device from the patient and the relative location of the connected device to the medically used room containing the monitor In all circumstance the monitor must be connected to a grounded AC power supply The monitor is referred to as an IEC 601 F device in the summary of situations table contained in IEC 601 1 1 A Warning A Dispose of the packaging material observing the applicable waste control regulations and keeping it out of children s reach A Warning A Grounding Connect the monitor only to a three wire grounded hospital grade receptacle The three conductor plug must be inserted into a properly wired three wire receptacle if a three wire receptacle is not available a qualified electrician must install one
39. d the main engine communication have the problem Restart the machine if error still existed contact the factory service PARA ALARM LMT ERR The parameter of the alarm limit is modified by the accident contact the factory service RANGE EXEED The parameter observed value has exceed the measurement scope which the system can contact the factory service carry on SpO2 SENSOR OFF SpO 2 sensor does not Check SpO 2 sensor connected connection SpO2 FINGER OFF The finger fall off from SpO 2 sensor Check SpOz sensor connect with the finger SEARCHING PULSE SpO2z sensor connect bad or the patient move the arm Check SpO 2 sensor connection situation and patient s current condition Operation Manual 29 Chapter 2 Alarms WATCHDOG ERR channel 2 sensor do not connect Main engine watch dog self checking defeat Templ SENSOR OFF The body temperature Check temperature sensor channel 1 sensor do not connection connect Temp2 SENSOR OFF The body temperature Check temperature sensor connection Restart the machine if wrong still existed contact the factory service SYSTEM TIME LOST The system clock has not set Change the system time as the current time if error still existed related the factory to carry on the service 12V HIGH The 12V voltage examination Restart the machine
40. e Manual Peroid Ok Cancel Chart 10 1 NIBP settings 1 Pressure unit mmHg or kPa is optional 2 measurements mode have 3 kinds of mode manual automatic STAT Under the manual measurement way presses down the blood pressure measurement button on the control panel then starts the manual measurement once Under the automatic measurement way presses down the blood pressure measurement button on the control panel then starts the automatic measurement once afterwards the monitor can automatic start blood pressure measurement defer to the period Under the STAT measurement way presses down the blood pressure measurement button on the control panel then starts to continuously measure for 5 minutes While the blood pressure measuring the user presses down the blood pressure measurement button on the control panel anytime can stop the current blood pressure measurement 3 The automatic sampling interval If the measurement pattern setting as automatically then the automatic sampling interval button will be available The automatic sampling interval time can be chosen in 1 minute 2 minutes 3 minutes 4 minutes 5 minutes 10 minutes 15 minutes 30 minutes 60 minutes 90 minutes 2 hours 3 hours 4 hours 8 hours Operation Manual 51 Chapter 10 NIBP Monitoring After choose the time interval presses down the blood pressure measurement button will start the first automatic measurement charge in order to fin
41. e arrhythmia analysis result including the heart rate PVCs the frequency of premature ventricular contraction arrhythmia alarm and make a diagnosis or give treatment by this 7 1 Arrhythmias types The monitor may carry on 13 kind of arrhythmias analyzes Arrhythmia e alarm level patient type conditions type have not examined the palpitation High Asystole Al continuously in 4 seconds Ventricular fibrillate wave continue 4 seconds or High fibrillation continuous more than 5 ventricular a No pace maker Ventricular beats and the heart rate more than tachycardia 100 RUN No pace maker More than 3 clusters of PVC medium Pair No pace maker Two continuous PVC medium Bigeminy No pace maker PVC Bigeminy medium Trigeminy No pace maker PVC Trigeminy medium ee No pace maker One type of PVC The R wave lmedium on appears in the T wave s position No pace maker medium VPC not belong to the above types of PVC Ventricular tachycardia the heart rate medium Tachy All is more than 120 Ventricular bradycardia The heart ratemedium Brady All is less than 40 Missed beat Can not detecte the pulselmedium Miss All overl 5 seconds Operation Manual 43 Chapter 7 Arrhythmia Monitoring Pace maker not work No pacing pulselmedium PNF pace maker he ti and the palpitation signal Pace maker not captured In has medium wrestles the pulse in the si
42. e detect range 4 700mV width 0 1 2ms rise time 10 100us PACE pulse rejection range 2 700mV width 0 1 2ms rise time 10 100us Operation Manual 83 Chapter 17 Appendix Product Specifications Baseline Recovery lt 3s After defibrillation Signal Range 8 mV p p Bandwidth Surgery 1 20 Hz Monitor 0 5 35 Hz Diagnostic 0 05 130 Hz Calibration Signal 1mVp p 5 accuracy ST measurement range 2 0 2 0 mV Accuracy 0 8mV 0 8mV 0 02mV or 10 which is greater Other range unspecified 17 8 Respiration Method Impedance between RA LL Differential Input Impedance gt 2 5 M ohm Respiration Impedance Range 0 3 3 Q Base Impedance Range 200 2 4000 Q Bandwidth 0 3 2 5 Hz Gain x0 25 x0 500 x1 x2 x4 Respiration Rate Measurement Range Adult 0 120 BrPM Neonatal Pediatric 0 150 BrPM Resolution 1 BrPM 84 Operation Manual Accuracy Inspiriting current Chapter 17 Appendix Product Specifications 0 6 BrPM unspecified 7 150 BrPM 2 BrPM or 2 use the greater lt 300 pA RMS max EW Apnea Alarm 10 40s 17 9 NIBP E Method Oscillometry E Measure mode Manual Auto STAT Measure Interval in AUTO Mode 1 2 3 4 5 10 15 30 60 90 120 180 240 480 min NW Measure Period in STAT Mode 5 min NW Pulse Rate Range 40 240 bpm m Measure and Alarm Range Adult Mode SYS 40 280 mmHg DIA 10 220 mmHg MEAN 20 240 mmHg Pediatric Mode SYS 40 220 mmHg DIA 10 160 mmHg MEAN 2
43. e patient cable in figure 14 1 is connected to the monitor at the patient cable connector while the other end with three leads red yellow and green is connected to the electrodes S lt on the skin of the patient see figure 14 2 Figure 14 1 patient cable The cable is of a design especially prepared for measuring the EEG with low levels of interference Among its characteristics are accentuated 1 Each lead of the cable is shielded individually until the yoke 2 Short terminals that permit better rejection of both capacitive and inductive interference 3 Long main cable The connections have different colors to assist in the correct placement Care should be taken when positioning the electrodes as they are identical except for the colors The device will not work properly if the electrode leads are interchanged Operation Manual 65 Chapter 14 IoC Monitoring Center of the forehead Right side of the forehead Cheek bone Figure 14 2 Application of the electrodes 14 3 Skin preparation and connections In order to obtain a correct measurement of the EEG signal it is especially recommended to prepare the skin in order to reduce the contact impedance that exists in normal conditions For this purpose it is advised to use fine sandpaper dedicated to remove the surface layers of the skin in the areas where the electrodes are to be placed 3 3 1 Application of the electrodes The patient cable possesses three co
44. e same place 3 Do not place the sensor at the body has the ductus arteriosus or the vein syringe 4 Guarantees the nail to block the lights Sensor should at the back of hand 5 Do not place SpO2 or the blood pressure oversleeve blood pressure measurement on the same body because in the blood pressure measurement process the blood stream unenlightened can affect the oxygen saturation reading 6 Continually the excessively long time monitor possibly can increase do not hope danger that the skin characteristic change occurs for example exceptionally sensitive changes red bubbles or pressure necrosis specially in the neonate or has pour barrier as well as the change or juvenility skin kind sickness person 7 In the long time continuous monitoring process about every 2 hours inspects the measurement SpOz the end circulation situation and the skin situation if discovered changes not good should change the measurement SpOz promptly simultaneously should periodical inspection the sensor fastness situation avoids the sensor fastness situation change caused by the moving and so on the factors affect the accuracy of the measurement 8 If the test SpOz and the sensor cannot locate accurately possibly causes the oxygen saturation reading inaccurate even unable to search the pulse wave result in unable to carry on the blood oxygen monitor this time should relocate 9 Measurement SpO2 move excessively possibly creates measurements inaccurate
45. ed 2 place the electrode on the patient s body 3 Connect the ECG lead with the patient cable E ECG electrode placement The position of the ECG electrode is as follows The RA right arm electrode place under the subclavian approaching the right shoulder The LA left arm electrode places under the subclavian approaching the left shoulder The LL left leg electrode places under the left abdomen The RL right leg electrode places under the right abdomen The V chest electrode places on the chest Chart 5 1 The position of electrode Operation Manual 37 Chapter 5 ECG Monitoring Connecting ECG leads recommended for surgical patients The position of ECG electrode is decided by the type of the operation For example regarding the chest operation the electrode may be put on the chest side or the back Sometimes in the operating room because of using surgical equipment the artifact possibly can affect the ECG waveform In order to reduce the artifact place the electrode on the left or right shoulder approaching the left or right side of the abdomen however the chest leads can be placed on the center of the chest left side Avoid to place the electrode on the upper arm otherwise ECG signal can be very weak A good characteristic of the ECG waveform the QRS wave height is great and narrow with no notchs The R wave height is big and located completely above the baseline or under The amplitude
46. eeseeenseeeeseecssaecseaeeeesseeeseeeneeesseeene 54 Chapter 12 TBP MOnitorii es A rakes AGS et eae LEAS Heke AS Ai ig i 55 12 1 Steps of IBP measurement lt 25 329 2c A KU eR ete Re a aa 55 12 2 DA o A 56 12 37 I BP Zeroing Cut ita io See heen ee eee ad 56 24 gt LBP Calt bration it A ad 58 Chapter 13 CO Monitoring oc ccecccecccsssccesseceseeesseeesscecsseecssseeesseeesseecssaecsceeseseeesseeseseeeseeeessaeeesesenseees 61 TS Hy A NON 61 13 2 COMES ocios 61 33 COP AA a 61 DA NN 62 Chapter 14 ToC Monitoring aaa A aR a E E Ei 64 14 1 DIS ripttOn cuca aaa 64 14 2 Thepatientale ii end cas is 65 14 3 Skin preparation and connections oococoonccoonncoonncnoncnnoncnnononcnnn non nnononnnnon rn can nn cnn n rca nrnnannnnnenonns 66 144 TOC Moda AA oe See es 67 14 5 Patient monitor STi nica A Ad 71 14 6 JOC Stma a chs eee pai 71 Chapter 15 History REVIEW aia a CA a IS a a AA a aa 72 ISE Trend Graph at AA A A 72 15 2 Trenditableven atun ada rara crasas 73 15 3 Alarm Revie Wena aaea a a e aaea aa E a aN EE i secede idealista 75 154 NIBP REVIEW inon eee a ea ar E Ea aid aia 76 15 5 Wave IV Wisin A AA 77 Chapter 16 Drus Calculation nas 79 161 Drus Calculations a aaa 79 16 2 Operating procedures e A See ee eevee 80 16 32 tration tablet dd e stk 80 Chapter 17 Appendix Product Specifications oooooonococoooncnonncnoncnnonononnnncnon conan nnconnncnnn nono nrcnon rn nannnannncnnnnss 82 IE Operation Manual
47. f the monitor continues to give this prompt information contact Customer Service IBP calibrate IBP pressure is not stable Verify the transducer is connected to the monitor and Fail Pulsatile the 3 way stopcock is open to the atmosphere then perform zeroing again If the monitor continues to give this prompt information contact Customer Service Operation Manual 59 Chapter 12 IBP Monitoring A Warning A 1 Ensure zero the transducer and perform zeroing before it is used to calibrate the monitor 2 Calibration should be performed before using a new pressure transducer 60 Operation Manual Chapter 13 CO Monitoring Chapter 13 CO Monitoring 13 1 Introduction The monitor can measure CO of patient s air way displays 1 channel CO wave form and EtCO End Tidal CO FiCO Fraction of Inspired CO2 AwRRCAwWRR Air Way Respiration Rate 13 2 CO Measurement 1 Connect the water trap to the socket and power up the monitor 2 If prompt CO STANDBY enter CO Setting and change work mode to RUN 3 After monitor is power up CO2 waveform and values will be displayed 13 3 CO Setting Choose CO setting menu to enter CO Setting dialog C0e Setting A oo Hork Mode Run 4 4 Apnea Time 208 Have Scale 50 mmHg Have Speed 25 mm s v 4 Unit mmHg Rate 100m1 min BTPS Compensatiol Off N20 Compensation Off O2 Compensation
48. h2 Name set name of IBP channel 1 and 2 ART PA CVP LAP RAP ICP P1 P2 2 Gain when Manual is selected the measure range is set by channel high or low gain mark when Auto is selected when name is P1 or P2 the measure range is auto adjusted otherwise is set by channel high or low gain mark 3 Filter when normal is selected the IBP wave bandwidth is 40Hz when Smooth is selected the IBP wave bandwidth is 12 5Hz 4 Wave Speed 12 5mm s or 25mm s can be selected 5 Unit mmHg or kPa 6 Chl High Chl Low Ch2 High Ch2 Low set channel 1 or channel 2 wave display range 7 Pl P2 if S D M is selected systolic mean and diastolic pressure are measured if MEAN is selected only mean pressure is measured 12 3 IBP Zeroing Steps of IBP zeroing 1 Turn off the stopcock to the patient 2 Vent the transducer to the atmospheric to compensate for the static and atmospheric pressure exceed on the transducer 3 Enter IBP Zero dialog push IBP1 Zero or IBP2 Zero button to start zeroing 56 Operation Manual Chapter 12 IBP Monitoring 4 When zeroing finished turn the stopcock to the patient Ibp 2ero Ibpi Zero Ibp2 Zero ES IBP1 Zero Not Done IBP2 zero Not Done Return Chart 12 3 Prompt information of IBP zeroing IBP Zero Dialog Prompt Cause Process Method IBP Zero Fail IBP sensor not Verify the transducer is
49. harge the cuff with gas and to measure the blood pressure Pressing down the key once again can cancel the measurement 6 Record Stop key If the monitor has a recorder pressing down this key will start recording the real time waveforms Pressing the key again may stop recording 7 Main menu key press this key to returning to the main menu 6 Operation Manual Chapter 1 Overview 8 Knob key With this key the user may enter the menus and windows and change the monitor settings E Patients management By pushing the patient button the user may choose to enter the window of Admit new patients Discharge Current Patient or Dose Calculation the detailed introductions may refer to chapter4 Admit and Discharge Patient Admit New Patient Discharge Current Patient Dose Calculation Patient i Chart 1 3 patient management E History review By selecting the Review button the user may choose to enter the window of Trend Graph Trend Table Alarm Review NIBP review or Wave review The detailed introductions may refer to chapter12 History Review Trend Graph Trend Table Alarm Review NIBP Review Wave Review Review Chart 1 4 history review Operation Manual 7 Chapter 1 Overview E Setting By selecting the Setting button the user may choose to enter the window of Alarm setting Record setting Screen layout
50. hart 1 6 screen layouts E Screen layout 120 80 gt justa Y Big font Trend table NIBP trrend Operation Manual 9 Chapter 1 Overview E Adjust Time By entering the adjust time window the user may choose the date format and adjust the current date and time as the following chart shows Adjust Time Format YY MM DD Year 2008 g Month l g Day p 9 5 Hour lis 2 Minute 24 2 Second 28 Ok Cancel Chart 1 7 adjust time E Miscellaneous By entering the miscellaneous windows the user may change the key volume and the screen brightness The adjusting scope of key volume is 0 10 0 means volume closure The adjusting scope of screen brightness is 1 10 10 means the highest brightness If Wave Smooth switch is On the wave will be displayed as smooth mode Miscellaneous Brightness 10 Key Volume 5 4 Wave Smooth Off Ok Cancel Chart 1 8 miscellaneous setting E ECG setting Detailed introductions of ECG settings can refer to Chapter5 ECG monitoring E ST setting Detailed introductions of ST settings can refer to Chapter6 ST monitoring E Resp setting Detailed introductions of RESP settings can refer to Chapter8 RESP monitoring 10 Operation Manual Chapter 1 Overview E SpO setting Detailed introductions of oxygen saturation settings can refer to Chapter9 SpO 2 monitoring E NIBP setting Detailed introductions of noninv
51. hen the battery exhausted 16 Operation Manual Chapter 2 Alarms Chapter 2 Alarms 2 1 Alarms overview E Types of the alarms The alarms can be divided into two types physiology alarms and technical alarms Physiology alarms triggered by some of patient s physiological parameters exceed the limits taking the body temperature exceeding temperature alarm limit as an example Technical alarms triggered by the abnormality of certain monitoring function or distortion of monitoring results caused by failure of system or sensors taking ECG lead off as an example E Level of alarms The alarms have three levels high medium and low The monitor has set levels for technical alarms and physiology alarms E Modes of the alarms When alarming the monitor gives alarm prompts by three ways sound alarm light alarm and alarm message description The prompts of sound and light come from the speaker the alarm indicator light and alarm message description The alarm message description is displayed on the screen The physiology alarm is displayed in the patient alarm information section while the technical alarm displayed in the monitor alarm information section When the physiology alarm occurs which is caused by the measurement parameters exceeding the alarm limit the color of high limit and low limit would change from dark to bright besides the three means of alarm prompting mentioned above When there is before technical or
52. illating 2 In order to ensure the patient safety all leads must be connected to the patient 3 When the electricity surgical ES equipment is used lay the ECG lead in the middle of both the ES ground plate and ES to avoid burning The cable of the electricity surgical equipment cannot twist with the ECG cable 4 When the electricity surgical ES equipment is used don t place the electrode on the ground plate near the electricity surgical equipment Otherwise the ECG signal will be disturbed 6 Regarding the pacemaker patient the pacing switch must be On otherwise it is possibly to consider the pacing pulse as the normal QRS 40 Operation Manual Chapter6 ST Monitoring Chapter 6 ST Monitoring The monitor can use the ST section monitoring of the channel 2 ECG waveform and the measure according to the raise and fall of the ST section the correlative ST measurement result will be shown and presented in the trend graph and the trend table in the parameter area The user can watch the trend data of the ST by opening Trend Graph and Trend Table 6 1 ST display When ST analysis in the ECG setting menu is On the value of 2 channels ST can be shown It means ST raise when the value is more than 0 it means ST pulls down when the value is less than 0 Chart 6 1 the ST display 6 2 ST settings The ST value means the vertical height difference between the ISO point and the ST point The ISO
53. in accordance with the governing electrical code Do not under any circumstances remove the grounding conductor from the power plug 2 Operation Manual Chapter 1 Overview Do not use extension cords or adapters of any type The power cord and plug must be intact and undamaged If there is any doubt about the integrity of the protective earth conductor arrangement operate the monitor on internal battery power until the AC power supply protective conductor is fully functional A Warning A For continued safe use of this equipment it is necessary that the listed instructions be followed However instructions listed in this manual in no way supersede established medical practices concerning patient care Do not rely only on audible alarm system to monitor patient When monitoring adjusting the volume to very low or completely muting the sound may result in the disaster to the patient The most reliable way of monitoring the patient is at the same time of using monitoring equipment correctly manual monitoring should be carried out This multi parameter patient monitor is intended for use only by medical professionals in health care institutions To avoid electrical shock you shall not open any cover by yourself Service must be carried out by qualified personnel Use of this device may affect ultrasonic imaging system in the presence of the interfering signal on the screen of ultrasonic imaging system Keep the distance between the mon
54. ions of CO2 Calibration can refer to 12 2 CO2 Calibration E Demo mode The user input the correct password the monitor will enter demo mode and in the centre of the screen a big DEMO label will be shown The demo mode is a particular state just for demonstrating performance of the machine helping user carry out trainings In the actual clinical use this function is forbidden because it can possibly cause the medical staffs to take demo waveforms as the patient waveforms and parameters by mistake to affect patient monitoring EH Version information Choosing the version information the user may look over the version information of the software installed in the monitor E User settings The user may carry out user maintenance in the user settings menu by inputting the password This item is merely open to the serviceman appointed by the factory E Factory service The user cannot implement functions of maintenance This item is merely open to the serviceman appointed by the factory 14 Operation Manual Chapter 1 Overview 1 5 Sensor socket we no O Tl T2 Sp02 A ry NBP Ye c Chart 1 14 sensor socket The following shows sensor socket T1 temperature channel 1 sensor socket T2 temperature channel 2 sensor socket SpO Oxygen saturation sensor socket NIBP non invasive blood pressure cuff socket ECG ECG cable socket 1 6 Networks The network port of the monitor is the standard RJ45 network
55. ish the automatic measurement should choose the manually returns to the manual pattern while in sampling interval period 10 4 Blood pressure calibrations Using the precision of the pressure gauge or mercury sphygmomanometer is higher than 1 mmHg after the calibration carries to carry on the calibration choose noninvasive blood pressure calibration in the the maintenance menu to start to carry on the calibration if presses down the blood pressure measurement button while calibrating then the system will stop calibrating Connect the pressure gauge the cuff through a 3 way tube to the blood pressure trachea jack on the monitor setting the monitor as the calibration pattern then charge the cuff using a air pump first make the pressure to 250 mmHg then slowly deflates when the monitor display 200 150 and 50 mmHg the disparity between the standard pressure gauge value and the monitor pressure value should in 3 mmHg If the value exceeds 3 mmHg please contact our company s attendant Attention The cuff must entangle in the suitable big and small pillars 10 5 leakage examination When the cuff is connected may use this function to start air course charge process thus to discover whether the air way s airtight condition is good or not If the test passes the system will not make any prompt If do not passed then in the noninvasive blood pressure parameter area will have the corresponding wrong prompt
56. it NIBP SYS TOO HIGH NIBP systolic pressure exceeds the alarm high limit NIBP SYS TOO LOW NIBP systolic pressure is lower than the lower alarm limit NIBP MEAN TOO HIGH NIBP mean pressure exceeds the alarm high limit NIBP MEAN TOO LOW NIBP mean pressure is lower than the alarm low limit NIBP DIA TOO HIGH NIBP diastolic pressure exceeds the alarm high limit NIBP DIA TOO HIGH NIBP diastolic pressure is lower than the alarm low limit RR TOO HIGH The Breath rate exceeds the alarm high limit RR TOO LOW The Breath rate is lower than the alarm low limit TEMP1 TOO HIGH The body temperature channel 1 exceeds the alarm high limit TEMP1 TOO LOW The body temperature channel 1 is lower than the alarm low limit TEMP2 TOO HIGH The body temperature channel 2 exceeds the alarm high limit TEMP2 TOO LOW The body temperature channel 2 is lower than the alarm low limit ART SYS TOO HIGH ART systolic pressure exceeds the alarm high limit ART SYS TOO LOW ART systolic pressure is lower than the low limit ART MEAN TOO HIGH ART mean pressure exceeds the high limit ART MEAN TOO LOW ART mean pressure is lower than the low limit ART DIA TOO HIGH ART diastolic pressure exceeds the high limit PA DIA TOO LOW PA diastolic pressure is lower than the low limit PA SYS TOO HIGH PA systolic pressure exceeds the alarm high limit
57. it RAP MEAN TOO HIGH RAP mean pressure exceeds the high limit RAP MEAN TOO LOW RAP mean pressure is lower than the low limit RAP DIA TOO HIGH RAP diastolic pressure exceeds the high limit RAP DIA TOO LOW RAP diastolic pressure is lower than the low limit ICP SYS TOO HIGH ICP systolic pressure exceeds the alarm high limit ICP SYS TOO LOW ICP systolic pressure is lower than the low limit TCP MEAN TOO HIGH ICP mean pressure exceeds the high limit TCP MEAN TOO LOW ICP mean pressure is lower than the low limit TCP DIA TOO HIGH ICP diastolic pressure exceeds the high limit TCP DIA TOO LOW ICP diastolic pressure is lower than the low limit Operation Manual oy ee Chapter 2 Alarms P SYS TOO HIGH P SYS TOO LOW P1 systolic pressure exceeds the alarm high limit P1 systolic pressure is lower than the low limit P MEAN TOO HIGH P1 mean pressure exceeds the high limit P MEAN TOO LOW P1 mean pressure is lower than the low limit P DIA TOO HIGH P1 diastolic pressure exceeds the high limit P DIA TOO LOW P1 diastolic pressure is lower than the low limit P2 SYS TOO HIGH P2 systolic pressure exceeds the alarm high limit P2 SYS TOO LOW P2systolic pressure is lower than the low limit P2 MEAN TOO HIGH P2mean pressure exceeds the high limit P2 MEAN TOO LOW P2mean pressure is lower than the low lim
58. it P2 DIA TOO HIGH P2diastolic pressure exceeds the high limit P2 DIA TOO LOW P2diastolic pressure is lower than the low limit EtCO2TOO HIGH EtCO exceeds the high limit EtCO2 TOO LOW EtCO2 is lower than the low limit FICO2 TOO HIGH FiCOzexceeds the high limit FICO2 TOO LOW FiCO2 is lower than the low limit AwRR TOO HIGH AwRR exceeds the high limit AwRR TOO LOW AwRR is lower than the low limit ToC TOO HIGH IoC is higher than the low limit ToC TOO LOW IoC is lower than the low limit 28 Operation Manual Chapter 2 Alarms 2 7 Technical alarm information Below is all technical alarm tabulates Alarm Information Trigger Condition Process Method ECG LEAD OFF RL or more than 2 ECG leads check the ECG lead falls off connection ECG LEAD RA OFF RA lead fall off check the ECG lead connection ECG LEAD LA OFF LA lead fall off check the ECG lead connection ECG LEAD LL OFF LL lead fall off check the ECG lead connection ECG LEAD V OFF V lead fall off check the ECG lead connection MODULE INIT ERR Module self checking Restart the machine if error mistake still existed contact the MODULE COMM STOP The module and the main engine communication have the problem factory service Restart the machine if error still existed contact the factory service MODULE COMM ERR The module an
59. itor and the ultrasonic imaging system as far as possible It is dangerous to expose electrical contact or applicant coupler to normal saline other liquid or conductive adhesive Electrical contact and coupler such as cable connector power supply and parameter module socket inlet and frame must be kept clean and dry Once being polluted by liquid they must be thoroughly dried If to further remove the pollution please contact your biomedical department or Factory A Warning A It is important for the hospital or organization that employs this equipment to carry out a reasonable maintenance schedule Neglect of this may result in machine breakdown or injury of human health A Caution A If you have any doubt to the grounding layout and its performance you must use the built in battery to power the monitor Operation Manual 3 Chapter 1 Overview 1 2 Screen layouts introduction The screen is divided into four sections 1 information section 2 waveform section 3 parameters section 4 menu section as chart 1 1 shows Tempi Temp2 36 0 36 5 Patient A Review setting Alarm Limit A service e 3 A 0 E_I z E __ _A __ E E E 2 Chart 1 1 monitor demo interface E Information section The information section is on top of the screen displays current conditions of monitor and patient The information in turn from left to right on the top is patient info
60. m Bluetooth EMG bar 4 lo Index SQI bar p EEG Supresion Trend_o curyes i IoC signal Trend scale EMG signal ESR signal Figure 9C Index trends Figure 14 9 Main screen3 70 Operation Manual Chapter 14 IoC Monitoring 14 5 Patient monitor screen EMG 25 60min 4min a S NIBP 00 00 mmHg 120 80 2s Manual Tenp1 Teno Temp amp 36 0 36 5 IW Patient Y Review setting Pt alarm Limit X service 160 Figure 14 10 Patient monitor screen EEG and 4 IoC trend waves include IoC SQI BS EMG are displayed on wave area 4 IoC parameters include IoC SQI BS EMG and white lead black lead value are displayed on parameter area 14 6 IoC setting Choose IoC Setting in Setting menu will enter IoC Setting dialog ES EEG Have sizd Have Speed 25 mms Ok Cancel Figure 14 11 loC setting 1 EEG Wave Size 10uV 20uV 40uV 80uV 100uV 150uV 200uV 2 Wave Speed 6 25mm s 12 5mm s 25 Omm s Operation Manual 71 Chapter 15 History Review Chapter 15 History Review The monitor can storage 72 hours trend data of the whole monitored parameters and 1000 noninvasive blood pressure measurement data The monitor collects data of parameter every minute and preserves it in trend data the operator may choose trend graph or trend table to examine the trend data Every time the noninvasive blood pressure measurement data is obt
61. meter has alarm 4 Para Alarm 2 items LATCH or Unlatch LATCH means that once alarm occurs the system will give alarm all the time until manual intervention such as push the SILENCE button on the panel UNLATCH means that the system will stop giving alarm once the alarm condition does not exist 5 Alarm Record If On is selected the recorder will record the alarm event when physical alarm occurs otherwise 1t will not record 6 Voice Alarm If On is selected and alarm event occurs a human voice alarm will continuously notify the user otherwise it will not notify by human voice Alarm Setting Alarm Volume 5 Suspend Time 2min i Flash Off y Para Alarm Non Latch di Alarm Record Off Voice Alarm Off v Ok Cancel Chart 2 1 alarm setting Operation Manual 19 Chapter 2 Alarms 2 5 Limits of the alarms Physiology alarm is triggered according to the settings limits Various parameters limits are showed by the dark color in the parameter area of the upper corner on the left side If the parameter exceeds the limits then triggers the physiology alarm at this parameter by the bright color For example the low limit of the heart rate is 80 if at this time the heart rate is 60 pieces then triggers HR TOO LOW the low limit of the heart rate 80 will be a bright color the following chart will show Chart 2 2 Alarm Limit E ECG Alarm Limit Choosing ECG Alarm Limit
62. nnections that should be connected to the electrodes placed on the surface of the patient s previously prepared skin The three electrodes should be placed as indicated in figure 3 The coloured spots correspond to the colours of the ends of the patient cable red yellow reference and green Always follow the instructions provided by the manufacturer of the electrodes AY Warning A 1 If skin rash or other unusual symptoms develop remove sensors from patient 2 It is important to take specially care of patients with skin problems 3 Do not place the electrodes on wounds 66 Operation Manual Chapter 14 IoC Monitoring 14 4 IoC module Morpheus Medical Charge Patient Lead battery Figure 14 3 loC module m 14 4 1 There are 2 buttons on IoC View module Button 1 On off Change screen this button on the left side of the monitor is generally used to turn on turn off enter the Main Menu and exit from all other menus Press the button during 3 seconds will switch on the loC view Button 2 Confirm value this button on the right side of the monitor is used to move from one selection to another inside the same screen or to another menu It is also used for certain procedures such as the sensor check and confirms the different options Operation Manual 67 Chapter 14 IoC Monitoring m 14 4 2 Graphic user interface When the user switches on the loC View mod
63. ocess following factors may affect the accuracy of the oxygen saturation measurement 1 High frequency electrical jam such as the disturbance which is produced by monitor system oneself or comes from such as the electricity surgery instrument disturbance which connected with the system 2 In magnetic resonance image formation scanning MRI period do not use the blood oxymeter and the blood oxygen sensor the induced current possibly can cause the burn 3 In vein dye 4 Patient too frequently migration 5 Outside ray radiation 6 Sensor installment inappropriate or contact the improper position with the object 7 Body temperature best body temperature should in 28 C 42 C 8 Lay aside the sensor in the body has the blood pressure cuff in the ductus 9 arteriosus or the cavity on the pipeline body 10 The density of the non function hemoglobin like carbon oxygen hemoglobin COHb and blood and iron hemoglobin MetHb and so on 11 Oxygen saturation lowly To be circular poured is not good at the test part Shock anemia the low temperature and applies the vasoconstriction medicine and so on all possibly cause the artery blood stream to be reduced to the level which was unable to measurement Operation Manual Berg ee Chapter 9 SpOz Monitoring 12 Measurement is also decided on the oxygen gathers hemoglobin and the absorption situation of the return oxygen gathers hemoglobin to the special wave length light If othe
64. ons 4 and lt lt the operator may move the waveform one minute forward or backward By selecting the button M the operator may move the waveform time one hour backward and A the current time A Attention A The trend data can be preserved for 72 hours after the turning off of the monitor If the monitor is turned on after 72 hours power off the trend data would be eliminated The waveform review data can be preserved for 1 hour after the turning off of the monitor If the monitor is turned on after 1 hour s power off the waveform review data would be deleted 78 Operation Manual Chapter 16 Drug Calculation Chapter 16 Drug Calculation This monitor provides the function of computation for 21 kinds of medicines and the titration table 16 1 Drug Calculation The kinds of medicine that can be computed include AMINOPHYLLIN DOBUTAMINE DOPAMINE EPINEPHRINE HEPARIN ISUPREL INOCOR INSULIN INSUPREL LIDOCAINE NIPRIDE NITROGLYCERIN NOREPINEPHRINE PITOCIN PROCAINAMIDE VASOPRESIN DRUG A DRUG B DRUG C DRUG D DRUG E have been provided in addition to replace any kind of the medicine nimbly Selecting the Drug Calculate in the menu will spring out window as the following chart shows Dose Calculation Drug Name Height 2 00 Akg Amount 500 00 mg volume 250 00 7 ml Dose min 3333 33 mcg ug Dose hr 200 00 mg Dose kg min 1666 66 mcg ug Dose kg hr 39
65. r substances which absorb the same wave length light exist they can cause the measurement to appear pseudo or the low oxygen saturation value For example Carbonizes the hemoglobin the blood and iron hemoglobin the methylene blue indigo carmine 9 2 SpOz setting Chooses SpO2 settings menu and enters SpO2 setting window Sp0 Setting Pulse Volume 5 2 Sensitivity Low S Have Speed 25 mm s v Pulse Rate Of f de Have Mode Line Pitch Tone Off X Ok Cancel Chart 9 1 SpO settings 1 Pulse volume the volume choice scope is the 0 10 0 denotes closure pulse sound 10 denotes maximum volumes 2 Sensitivity the sensitivity for computing oxygen saturation value has high medium low three options 3 Wave speed the waveform scanning velocity has 12 5 and 25mm s two levels may choose 4 Pulse rate setting as On in parameter area will show Pulse rate otherwise the Pulse rate will not be displayed 5 Wave Mode when Line is selected will use line mode to draw pleth wave when Fill is selected will use fill mode to draw pleth wave 6 Pitch Tone on and off 48 Operation Manual Chapter 9 SpOz Monitoring A Warning A 1 If it has the carbon oxygen hemoglobin metahemoglobin or dye dilution chemicals then the oxygen saturation value can have the deviation 2 Electricity surgical department equipment electric cable cannot twine with the sensor cable in th
66. r backward current period With the button M gt and gt gt the operator may move the time of trend graph a page forward or backward By selecting the button M the operator may move the time of trend graph 72 hours forward and to current time 15 2 Trend table The trend graph permits operator observing the trend data in tabulate mode The recent 72 hours trend data is displayed as a trend curve with a resolution of 1 minute 2 minutes 3 minutes 4 minutes 5 minutes 10 minutes 15 minutes 30 minutes or 60 minutes Choosing the Trend Graph in the Review menu will spring out the following window Trend Table Period Chart 12 2 trend table menu In the window of trend table the time shows underneath the parameter tabulates the recent time is displayed on the nearest right side the parameter name and the unit are displayed in the first column The alarm events may also be observed in the trend table The alarm time of parameter is saved in the trend data if the parameter alarm the trend data in the correspond alarm time period would be displayed with a yellow background color Operation Manual 73 Chapter 15 History Review E Set period By selecting the period option with cursor the operator may choose a period of 1 minute 2 minutes 3 minutes 4 minutes 3 minutes 10 minutes 15 minutes 30 minutes or 60 minutes E Adjust observing time With the buttons 4 and
67. rmation technical alarm information physiological alarm information date and time network state and battery state 1 Patient information Bed number refers to the hospital bed number of patient monitored Type of patient Adult Pediatric or Neonate Name of patient if operator doesn t input patients name this position will displays NO NAME 2 Technical alarm information Reporting current condition of monitor or sensors this section will display alarm information 4 Operation Manual Chapter 1 Overview 3 Physiological alarm information If patient s physiological parameters exceed the alarm limit this section will display alarm information 4 Date and time Updating current date and time every second 5 Network connection state 6 Battery state current battery capacity or its condition E Parameters section Heart rate heart rate unit beats per minute bpm ST ST segment unit millivolt mV PVCs times of premature ventricular constriction unit times minute NIBP From right to left is systolic pressure diastolic pressure mean pressure unit millimeter mercury column mmHg or kilopascal kPa SpO oxygen saturation SpO2z unit Pulse rate unit pulses minute Respiration rate respiration rate unit Breaths Minute BrPM Temperature body temperature unit centigrade C or Fahrenheit F invasive blood pressure IBP Sy
68. rt zeroing CO2 module 4 calibrate press this button to start calibrating CO2 module Operation Manual Chapter 13 CO Monitoring m CO zero procedure 1 Power on the monitor for 30 minutes 2 Disconnect the filter line from the patient and make sure that the air in filter line have no CO gt 3 Press Zero button in CO2 Zero dialog E CO calibrate procedure 1 Power on the monitor for 30 minutes 2 Connect a gas bottle with a 3 way connector to the monitor as shown below 3 Setthe CO valuein COzcalibrate dialog the same with the CO gas bottle 3 way connector 5 0 10 0 CO2 Chart 13 3 CO calibrate Operation Manual 63 Chapter 14 IoC Monitoring Chapter 14 IoC Monitoring 14 1 Discription The index of cerebral IoC has been designed to be used in the monitoring of the level of consciousness of a person during the application of general anaesthesia or in intensive care This is accomplished by registering the electroencephalographic signal EEG bymeans of surface electrodes which is then analyzed by a digital process As a result of the applied calculation an index IoC is obtained which serves as guidance to the experts who use it to determine the level of consciousness of the patient during surgery ToC Clinical state 90 100 Awake 80 90 Drowsy 60 80 Light anaesthesia 40 60 Range consider as adequate for surgical anaesthesia Deep anaesthesia in mos
69. s transfusion or inserted the drive pipe while cuff charging period when the transfusion reduces speed or stops up possibly causes damage around the drive pipe 5 If the time of the automatic pattern noninvasive blood pressure measurement pull too long then the body connected with the cuff possibly have the purpura lack the blood and the neuralgia When guarding patient must inspect the luster the warmth and the sensitivity of the body far end frequently Once observes any exception please immediately stop the blood pressure measurement 6 The calibration of the noninvasive blood pressure measurement is supposed to be carried on one time every year Or according to the maintenance regulation of your hospital 7 The cuff width should be 40 size of the body perimeter Neonate is 50 or the 2 3 of the upper arm length The length of the cuff charging part should long enough surround 50 80 of the body the inappropriate size cuff can have the wrong reading If the cuff size has the question should use the bigger cuff to reduce the mistake Operation Manual 53 Chapter 11 Temperature Monitoring Chapter 11 Temperature Monitoring 11 1 Steps of temperature measurement 1 Insert temperature sensor directly into the socket 2 Power on patient monitor 11 2 Temperatures settings menu Chooses Temperature setting menu and enters Temp setting window Temp Setting Unit C Ok Cancel Chart 11 1 Temper
70. spend state The suspension countdown time is displayed in the area of the technical alarm Three options can be set about the alarm suspension time 1 minute 2 minute and 3 minutes The user must enter the window of the alarm setting chooses correspondingly the suspension time After presses down of PAUSE key again the system may restore to the normal state 2 3 Alarms SILENCE Presses SILENCE key on the control panel then may close the sound and the light alarm when presses down SILENCE key again will quit from alarm silence condition and reactivated correspondingly sound alarm returns to normal alarm condition If the alarm still exists under the condition of the silence state then the information section display this alarm information If there is no alarm exists under the condition of the silence state then all the alarm will be eliminated A Attention A When the system is under the SILENCE condition any newly triggered alarm will terminate the silence condition and then makes the system to restore to the normal alarm condition 18 Operation Manual Chapter 2 Alarms 2 4 Alarm Setting Enter the alarm setting window the options below may be set 1 Alarm Volume The scope is 1 10 10 is the highest volume 2 Suspend Time 1 minute 2 minutes 3 minutes 3 Flash if On is selected and there is physical alarm corresponding parameter digit will flash to indicate that the para
71. ssure set whether correctly check measurement the pulse signal the tube connection or too weak is unable to replace cuff if the error still calculate the blood pressure existed please contact the factory service NIBP OUT OF RANGE When blood pressure measurement the blood check he tube connection or pressure or the pulse signal replace cuff if the error still exceeds the normal range is existed please contact the unable to carry on the factory service measurement NIBP MOVEMENT Patient arm move Check the patient situation or replace cuff if the error still existed please contact the factory service NIBP OVER PRESSURE The pressure value exceeds check the pipe connection the measurement scope situation or replace cuff if the error still existed please contact the factory service NIBP SATURATE When blood pressure Check the patient situation NIBP PNEUMATIC FAIL measurement the pulse signal exceeds the normal range is unable to carry on_ the measurement The cuff has not connected good or the air course leaks air or replace cuff if the error still existed please contact the factory service check the pipe connection situation or replace cuff if the error still existed please contact the factory service NIBP SYSTEM ERR Blood pressure system Restart the machine if the self check defeat error still existed please contact the factory service NIBP TIME OUT Blood pressure mea
72. stolic pressure diastolic pressure mean pressure carbon dioxide CO 2 Breath rate Et CO2 and FICO Index of Cerebral IoC IoC EMG SQI ESR The user may change the settings of above monitored parameters which will be introduced in later chapters in detail E Waveform section The waveform section displays 7 waveforms in standard screen layout which from top to bottom respectively are ECG1 waveform ECG2 waveform pulse wave respiration waveform 2 channels of IBP waveforms CO waveform standard interface Total 11 waveforms can be displayed if in ECG Full Lead screen layout The name appears in upper left side of each waveform The ECG waveform gain and filter mode will be also displayed besides the ECG wave name On the right side of the ECG waveform stands a mark with the unit of 1 mV The gain of breathing waveform is displayed on the right side of the name of breathing wave The ruler mark of IBP waveform is displayed on the right side of the name of IBP wave The ruler mark of CO waveform is displayed on the right side of the name of CO wave Operation Manual 5 Chapter 1 Overview When user push the keys of patient monitor a window may pop up in the waveform section The waveform section will restore demo after the window is retreated E Menu section On the bottom of the screen there are 5 menu item Patient Review Setting Alarm Limit and Service When no window displays on
73. surement Restart the machine if the overtime error still existed please Operation Manual 31 Chapter 2 Alarms contact the factory service IBP1 NEED ZERO BP NEED ZERO CO2 STANDBY IBP1 has not been zeroed IBP2 has not been zeroed CO is on standby mode NIBP CUFF TYPE WRONG Patient type for adult when Check the patient type or has used the neonate cuff replace cuff if the error still existed please contact the factory service NIBP MEASURE FAIL This blood pressure Check the patient situation measurement has not been or replace cuff if the error able to calculate the blood still existed please contact pressure the factory service NIBP RESET ERR When blood pressure Restart the machine if the measurement exceptionally error still existed please reset contact the factory service IBP1 SENSOR OFF IBP sensor does not Check IBP sensor connected connection IBP2 SENSOR OFF IBP sensor does not Check IBP sensor connected connection Zero IBP channel sensor Zero IBP channel 2 sensor Set CO to run mode C02 COMM STOP CO 2 module and the main engine communication have the problem Restart the machine if error still existed contact the factory service TOC COMM STOP IOC module and the main engine communication have Restart the machine if error still existed contact the the problem factory servi
74. t cases accompanied by BS 10 40 Burst Suppression Close to coma BS greater than 75 When loC is below 0 10 3 the EEG is practically iso electric A Warning A 1 Not to be used in the presence of flammable gases explosion risk 2 When used with High Frequency HF surgery please note the positioning of the sensors In order to reduce the hazard of burns the sensors should not be located between the surgical site and the electro surgical unit return sensor 3 Pay attension if the monitor is connected to a patient connected to other equipment The total of leakage current may exceed the allowable llimit and cause a possible hazard to the patient 4 The conductive parts of sensors and ther connectors incuding the neutral sensor should not contact other conductive parts including earth 5 The monitor will not accurate readings when used on patients with severe neurological disordersand patients under 2 years of age 6 The use of pacemakers might cause either long periods of artifacts or elevated IoC values 64 Operation Manual Chapter 14 IoC Monitoring A Cautions AN 1 The monitor should be used in conjuction with other patient monitoring parameters and clinical signs This will ensure the optimum balance of the anaesthesia sedation administration 2 Do not use IoC monitor when cardiac defibrillator is used 3 Patient cable are not protected against defibrillation 14 2 The patient cable Th
75. the physiology information section it means low level alarm means medium level alarm and the information bottom color will turn yellow means high level alarm and information bottom color will turn red For example The HR TOO HIGH is the expression of medium alarm Physical alarm has 2 kind of alarm mode LATCH or Unlatch LATCH means that once alarm occurs the system will give alarm all the time until manual intervention such as push the SILENCE button on the panel UNLATCH means that the system will stop giving alarm once the alarm condition does not exist Operation Manual 17 Chapter 2 Alarms There are three levels of the alarm high midium low by using the different light and the sound The following table shows in order Alarm level alarm light sound characteristic of the alarm High alarm light glitters red the The pattern as honk honk flicker frequency is quick honk honk honk honk honk honk honk honk each 8 seconds occur once medium alarm light glitters yellow the The pattern as honk honk honk flicker frequency is slow each 25 seconds emit sound once Low alarm light is bright and The pattern as honk each 25 seconds always show yellow emit sound once 2 2 Alarms pausing Presses PAUSE key on the control panel all alarm sound and light and the alarm message are closed Then the system enters alarm su
76. tory Review The data is arranged in order according to the time the recent measurement data is displayed on the topside 10 measurement data can be displayed on the screen each time The buttons 4 and can display the pre or the next measurement data With the buttons M gt and gt the operator may move the time of trend graph a page forward or backward By selecting the button M the operator may see the earliest measurement data and MM the most recent 15 5 Wave review The monitor can display 1 hour waveform data in the waveform review Choosing the wave review in the history review menu will display the recent measurement waveform just as the following chart shows Have Review E 25mm s 2007 03 27 14 06 54 HR 60 Sp02 98 NBP RR 20 PR 60 Temp1 36 0 Temp2 36 5 Ecg1 Amv Ecge dm 14 06 50 14 06 54 Havez Ecg2 Return Chart 12 5 waveform review Above the waveform shows the interrelated information waveform scanning velocity current review time the currently reviewed parameter measurement tabulate E Select waveform By selecting waveform 1 and waveform 2 with cursor the operator may choose the waveform that he wants to observe ECG1 ECG2 pulse wave and resp wave Operation Manual 77 Chapter 15 History Review E Adjust observing time With the buttons 4 and the operator may move the waveform a page forward or backward With the butt
77. tuation not PNC pace maker a no palpitation signal in the condition of pacing pulse suitable patient type All Include Patients taking the pacemaker or not No pace maker The patient without the pacemaker Pace maker The patient with the pacemaker 7 2 PVCs parameter The PCVs parameter means the frequency of appearing PVC in 1 minute When PCVs value is over the range of the alarm settings the monitor can alarm PVCs Too High 44 Operation Manual Chapter 8 Resp Monitoring Chapter 8 Resp Monitoring 8 1 Principles of Respiration measurement When the human body breathes the chest impedance will change along with the breath the monitor gets the breath signal through the chest impedance value from the RA and the LL electrodes at the chest After amplify the signal of the impedance between the electrodes as a result of the thorax activity the breath wave will be displayed on the screen 8 2 Placing the electrodes Connect the electrodes like the way that connect the heart electrodes at 5 1 8 3 Resp settings Choose the Resp settings menu and enters Resp setting window Resp Setting Apnea Time Wave Size Have Speed E mm s J RR Source co Da Ok Cancel Chart 8 1 RESP settings 1 Apnea alarm Setting the judgment time while the patient is asphyxiating between 10 seconds and 40 seconds if switch the settings off indicate the asphyxiation alarm is closed 2 W
78. ule the screen of welcome will be displayed figure 7 After the device has been turned on for three seconds the electrodes test screen appears This shows the estimation of the impedance of every electrode There are three different screens showing the clinical information see fig 14 7 14 8 and 14 9 each one will be described below To change between them press button 2 as in the upper part of figure 10 In the same figure pressing 1C leads to the main menu The procedure to change between windows or choose the main menu is shown in figure 14 4 ESR OOO EMG 057 Figure 14 4 loC Mainscreens 68 Operation Manual Chapter 14 IoC Monitoring m 14 4 3 Display mode A Welcome screen When the monitor is turned on the welcome screen figure 7 is shown for 2 seconds after that the electrodes test screen is shown figure 8 Morpheus Medical Figure 14 5 Welcome screen E 14 4 4 Display mode B Electrode test Figure 14 6 Electrode test screen mW 14 4 5 Display mode C1 main screenl Time 10 00 00 HH MM SS Large loC EEG Supression ratio 7 JESR OOOJEMG 057 EMG Figure 14 7 Main screen1 Operation Manual 69 Chapter 14 IoC Monitoring E 14 4 6 Display mode C2 main screen2 Alarm Battery indicator dd EMG bar loC Index SQI bar Title loC ESR EEG signal EEG scale l J Figure 14 8 Main screen2 E 14 4 7 Display mode C3 main screen3 Battery Alar
79. urgery mode the artifact and the disturbance caused by the electricity surgical equipment can be reduced The filter modes can be displayed above the heart electricity waveform 7 heart volume the range is from 0 to10 0 means that the sound of heartbeat is shuted 10 means it is on the maximum volume 8 wave speed There are three levels of the ECG waveform tracing speed to be chosen 12 5 25 0 and 50 0 mm s 9 HR source there are Auto Ecg SpO2 When Ecg is selected HR and heart sound are from ECG when SpO2 is selected HR and heart sound are from SpO2 when Auto is selected patient monitor will auto detect the ECG and SpO signal HR will from ECG when ECG signal exist otherwise is from SpO2 10 ST switch When it is On the ST analysis is carried on otherwise it isn t 11 arrhythmia switch When it is On the arrhythmia analysis is carried on which shows the PVCs parameter in the parameter area Otherwise the arrhythmia analysis isn t carried on and the PCVs parameter is not shown Operation Manual 39 Chapter 5 ECG Monitoring A Attention A When the Pace analysis is turned on the arrhythmia which is related to PVC Premature Ventricular Contractions including the PVCs computation will not be detected simultaneously the ST section analysis is not carried on A Warning A 1 Don t touch the patient or the monitor in the period of defibr
80. ve blood pressure NIBP including Systolic pressure diastolic pressure mean pressure 4 body temperature Temp 2 channels body temperature data 5 respiration Resp Breath rate breath waveform 6 invasive blood pressure IBP 2 channels IBP waves and Systolic pressure diastolic pressure mean pressure 7 carbon dioxide CO2 1 channel CO wave and Breath rate Et CO2 FiCO2 8 Index of Cerebral loC 1 channel EEG wave and IoC EMG SQI ESR A Warning A Monitor can only monitoring one patient at a time A Warning A There could be hazard of electrical shock by opening the monitor casing All servicing and future upgrading to this equipment must be carried out by personnel trained and authorized by Factory A Warning A You must verify if the device and accessories can function safely and normally before use A Warning A Possible explosion hazard if used in the presence of flammable anesthetics or other flammable substance in combination with air oxygen enriched environments or nitrous oxide A Warning A You must customize the alarm setups according to individual patient situation and make sure that alarm sound can be activated when alarm occurs Operation Manual 1 Chapter 1 Overview A Warning A Do not touch the patient table or the device during defibrillation A Warning A Do not use cellular phone in the vicinity of this device High level electromagnetic radiation emitted from su

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