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Philips V26CT User's Manual

1. The Touchboard Task Window contains a subtitle which references the Task Window from which the Touchboard was accessed Data entry can be performed for one item at a time Press 4 to save edited data Press Nextltem or Previous Item to navigate through the editable items of the Task Window the Touchboard was accessed from Press Back to return to the Task Window the Touchboard was accessed from The CMS and V24 and V26 Patient Monitors 1 31 xe q N gt ne o z o o c T 4 x e es Lnd e E 2 J a e N gt FE s 9 5 Touch or Mouse Trackball Operation o SE N 2 Disabling In order to prevent unintended or uncontrolled operations of the 8 Ls Touch monitor touch operation must be disabled while cleaning the og Mouse touchscreen To disable touch and mouse trackball operation press and e Trackball hold or click and hold the control panel button in the lower right corner Operation of the main screen for at least four seconds A padlock icon over the control panel button indicates when touch and mouse trackball operation is disabled To re enable touch and mouse trackball operation press and hold or click and hold the padlock icon for at least two seconds The control panel button will reappear Note If a task window is opened or the monitor is put in standby mode via the handheld keypad while touch and mo
2. Code Meaning Recording Type 90 Realtime 8A Delayed 0B Alarm 91 Stored 92 Vital Signs Operating Mode M Monitoring D Demo Application Area I ICU O OR Patient Type A Adult P Pediatric N Neonatal Delay Time 10 10 seconds 15 15 seconds 360 360 sec 6 min lFor all waveforms except oxyCRG For oxyCRG waveforms only Recording Functions 6 39 7 c T 5 c 2 LL e xe LS 5 tc Additional Information For example the complete code 8AMIN360 at the beginning of a recording strip means The recording is delayed 8A The monitor is in monitoring mode M The application area is ICU 1 The patient type is neonatal N The delay time is 6 minutes and the recording is an oxyCRG one 360 Realtime and delayed recordings are also annotated with the following information e Date and time time of the alarm for alarm recordings time of request for delayed recordings time data was measured for stored recordings such as cardiac output and time when run for others e Alarm INOP text if applicable e Patient parameters e Recorder speed e Waveform labels e Scale lines and labels e Bed label and patient name if the monitor is attached to the Philips patient care system or if the patient data management option has been purchased Note For recordings made at speeds lower than 6 25 mm s the time is updated every 15 minutes If yo
3. Vital Signs Interval Direction Graph Trends Span 1 minute gt 1 hour 5 minute lt 1 hour 15 minute lt gt 2 hours l hour lt gt 8 hours 2 hour lt gt 16 hours 3 hour gt 24 hours Trends and Calculations 8 9 oe S 2 25 gt c Eg Fo oe og 25 E f E FO Viewing Patient Data For example when you press Graph Trends from a Vital Signs display at one minute resolution the total time the graphs spans is 1 hour Conversely when you go directly from Graph Trends with a 2 hour span to the Vital Signs display the intervals are 15 minute Note If configured for the OR environment the data is stored every 12 seconds Depending on the patient data management configuration and the options purchased the default data time intervals are 1 min 5 min 15 min and 1 hr with a maximum of 4 hours and CMS only 1 min 5 min 15 min 1 hr and 2 hrs with a maximum of 9 hours ICU Adult 31 JAN OO 7 49 Non paced mode so 100 ES inv ABP 120 70 91 31 JAN 6 00 6 15 6 30 6145 PAB 1 30 7 45 EE ry errs c ei a ca cep es E EHR 121 100 112 121 121 98 91 80 fist Ti EST2 8 6 EPULSE 60 FABP S 114 123 97 87 99 107 117 120 FABP D 93 87 66 55 59 57 73 70 FABP M 100 99 76 65 72 73 87 91 FPAP S 45 3f 36 25 28 PAP D 25 25 30 15 15 PAP M 1 29 32 18 21 ECVP M 19 19 14 T 9 E398 i68 FETCO 40 ma Use the arrow keys to view more parameter 4 or more dat
4. c Z Neonatal Event Review 9 9 Viewing Neonatal Events Event The event summary line is located above the graph along the top of the Summary Line task window The user can view at a glance the total number of stored events The events are divided into five categories 1 ACD gt Total Apneas with or without associated Desaturation 2 BCD gt Total Bradycardias with or without associated Desaturation 3 AB D gt Associated Apnea and Bradycardia with or without associated Desaturation 4 D gt Isolated Desaturation 5 M gt Manually captured event 16 Stored Events A D Evnt_sum tif c 7 gt LLI S o 9 10 Neonatal Event Review Event Storage Viewing Neonatal Events Event Review 19 Stored Events A D 4 2 B D 3 0 AB Dy 1 1 D 9 M 2 Example of an Event Summary Line The above example of an event summary line conveys the following information If the number of stored events reaches a total of 44 the following status message is displayed in the Event Review task window If the number of stored events exceeds a total of 48 the oldest events are overwritten and the following status message is displayed in the Event Review task window A total of 19 neonatal events are stored Four Apnea events occurred of which two resulted in a Desaturation Three isolated Bradycardia events occurred none of them resulted in a
5. 4 8 Extended Overview CMS only 0 eee eee 4 15 To View an Extended Other Patients Bed 0 cece eee eee eee 4 16 Alert Notitication neces ek eee eee AREE Rp eR HE guy rese 4 17 Alarm Functions 5 1 Alarm Display osvvert et E ub ES REF od oe s PUE SER SOE OIE bbe CE RES 5 2 Alarm Functions on the Control Panel 0 0 0 cee cc eens 5 2 Suspending Alarms iue xe GI RUE Chas Sena te Res Ae ERA Aa ode 5 3 Silencing and Resetting Alarms 0 0 eee eects 5 4 Alarm Pr OTrities ineen erste okie ba garde RS RSS PROC IR dieu qu ope PRU 5 8 Individual Parameter Alarms 0 cece eee hee 5 10 When an Alarm OCCUIS cu IURI UR BUS IUE UC es 5 11 Alarm Setpa cde ve eb EDU dr PSU Ib Ee pda ub cupa 5 12 Getting into the Alarms Selection Window 0 0 cece eee cece eee 5 12 Changing the Alarm Limits 0 0 0 0 c eee cece eee 5 13 Setting the Volume Control 0 00 ee cee eee tees 5 14 The Nurs Call Relay o bee eb obtuse b eb e PETRO 5 15 Recording Functions 6 1 General Recorder Information 0 0 0 cece cece een teen hr 6 2 Contents 5 Recotrdets eee ePPUUPU Pep UH sene edes eio etn 6 2 Controls and Indicators on the Plug In Recorder 00 0 0 0 eee eee eee ee 6 3 Controls and Indicators on the 4 Channel Recorder CMS only 20 02005 6 4 Recorder Capabilities scs sh eka dete s ER RR RUE SR ER EA 6 5 Types of Recordings
6. diagram ECG Output 3 Fuse Holders 5 La Pd i TD pes J rf I TT T T o d aygo 45 7 fe 4 U z Power ON LED Powe Pok Connecto Connector Maximum Voltages Rack Connector 60 V ECG Output 3 2 V p p Monitor Installation and Patient Safety 11 19 c o9 5 s T a td fa a z and Patient Safety Controls and Connectors Connectors of th 11 20 e M1046B Computer 1 Module 2 3 4 5 The connectors on the front panel of the computer module are Local Power Connector a 3 pin 90 connector is used to input the local line voltage Rack Connector female interface connector used to connect a satellite rack to the computer module ECG Output used to output an ECG wave to synchronize a defibrillator and provide an input for the defibrillator marker signal Power on LED Two fuse holders for the line protection fuses for 200 240V 3 15 amps 250V for 100 120V 3 15 amps 250V Monitor Installation and Patient Safety t gt 3 Controls and Connectors BC aw OE 9 The Rear The rear panel of the M1046A and M1046B computer modules has several Mer Panel of the connectors The connectors and their position depends upon which M1046A B function cards are fitted as the rear panel is made up of small panels that 25 Com puter are attached to certain function cards A typical computer module rea
7. 5 tc To load paper into the central recorders see the operating guide for the instrument Directions for loading paper into the Plug In Recorder are given on the next pages Before starting pull the paper storage door open and remove the remaining paper core Caution For superior performance and top quality recordings it is strongly recommended that you use Philips paper Philips order part number 40477A or 40477B Recording Functions 6 49 7 c T 5 c 2 LL e xe A 5 tc Loading Paper To Replace Paper in the Plug In Recorder 1 Insert new roll with paper feeding from the TOP Pull paper out until it clicks into place 2 Pull out some paper and discard first 2 inches tear or fold front edge of paper at a 45 angle 3 Feed paper UNDER roller using left edge of paper as a guide 6 50 Note To test if paper is loaded correctly initiate a recording If no printing appears paper is loaded backwards Remove and reload Recording Functions Loading Paper If the Paper is If you have loaded the paper backwards to remove the roll do the Loaded following Backwards N S I5 c gt LL 22 c o A o o tc Tear off paper then open recorder door 2 Pinch paper at shelf below roller and pull paper off of roller see illustration below 9 Gently push exce
8. MULTIFORM VPBs HR XXX UUU HR XXX lt LLL IRREGULAR HR Minimum Condition Required for Alarm For HR 100 a VPB with R R interval 1 3 second and 1 3 of the average R R interval followed by a compensatory pause or 2 such Vs without a compensatory pause in 5 min When HR 100 1 3 R R interval is too short for detection Dominant rhythm of SV V SV V Dominant rhythm of SV SV V SV SV V The occurrence of two different shaped VPBs within last 300 beats repeated in the last 60 beats Heart rate gt UUU where UUU is the adjustable bedside high alarm limit The heart rate of XXX is the highest heart rate measured since the alarm was detected HR LLL where LLL is the adjustable bedside low heart rate limit The heart rate of XXX is the lowest heart rate measured since the alarm was detected Irregular SV rhythm Other Patients 4 11 Other Patients o E c o 2 Q o t o Arrhythmia Alarms on th Using Philips Patient Care System with an Arrhythmia Computer e 78560A Arrhythmia Computer Alarm Minimum Condition Required for Alarm RUN VPBs gt X Run of more than X VPB s where X is adjustable from 2 to 9 using the Change Limits display PACER NON FUNCT Missed beat without pace pulse in paced E patient VPBs gt XX min More than XX VPBs per minute where XX is adjustable from 1 to 30 using the Change Limit d
9. Viewing oxyCRG Episodes Operating Controls Selecting an Episode Entering the Event Review Task Window The exact time an event was triggered is indicated by a vertical line which is positioned on the graph according to the monitor s configuration Depending upon the user s requirements the monitor can be configured in Configuration Mode to display and store an oxyCRG Episode in the following way e Two minutes of Pre Event Time Two minutes of Post Event Time the default or e One minute of Pre Event Time Three minutes of Post Event Time Note In both cases manual events are displayed with four minutes Pre Event Time The association of events is determined by the configuration of the post event time The events that occur during the configured two or three minutes of post event time are associated and displayed as one event in the Event Review and oxyCRG Episode Task Window In the oxyCRG task window you can 1 Select the previous episode 2 Select the next episode 3 Return to the Event Review task window 4 Record an episode 5 Print an episode 6 Delete an event Selecting the Previous Episode and or NextEpisode softkeys jumps from one oxyCRG episode to the next in both directions Selecting the Event Review softkey returns you to the Event Review task window The event last selected in the oxyCRG Episode task window will be selected here 9 16 Neonatal Event Review Recording an Episod
10. e For comprehensive details on cleaning agents and their efficacy refer to Guidelines for Prevention of Transmission of Human Immunodeficiency Virus and Hepatitis B Virus to Health Care and Public Safety Workers issued by the U S Department of Health and Human Services Public Health Service Centers for Disease Control Atlanta Georgia February 1989 e Do not use any cleaning agents that corrode or damage Polycarbonate Maintenance 13 5 S el oO c E oO Monitor Maintenance Monitor Maintenance The following is a list of the tasks and procedures to maintain the monitor e Performance Assurance Test e Functional Testing procedures e Preventative Maintenance e Check Accuracy and Calibration of NBP and Temperature The recommended maintenance schedule is shown in the following table Recommended Maintenance Schedule Procedure Frequency Source of Information Testing of all cables and Daily See the following pages of cords this chapter Electrical Safety Tests At least every two years See Testing and after system installation Maintaining the CMS in the after any repairs or as CMS Service Guide or needed Testing and Maintaining the V24 and V26 in the V24 and V26 Service Guide o o c c o 2 Functional Testing Once a year See the following pages of Procedures this chapter or Testing and Maintaining the CMS in the CMS Ser
11. 3 Remove the module from the source monitor and plug it into the destination monitor 4 Press the hardkey on the module and transfer the data to the monitor Note Not all blood analysis results will be presented if the destination monitor is a CMS Release E or F or a V24 Release E o o c e G a 10 12 Data Transfer Types of Transfer e Transferring data from a source monitor via a transit monitor to a destination monitor requires special handling if The source monitor and the destination monitor are CMS Release G or later or V24 or V26 Release A 0 or later and The transit monitor is CMS Release E or F V24 Release E CTS 1 Plug the Data Transfer Module into the rack of the source monitor 2 Press the hardkey on the module and transfer all data to the module 9 Plugthe Data Transfer Module into the rack of the transit monitor 4 Select Collect New Data in the Data to Module task window to collect new data to the module without clearing the module 5 Remove the module from the transit monitor and plug it into the destination monitor 6 Press the hardkey on the module and transfer the data to the monitor Note With specific configurations data loss can occur when transferring data to a V24 or V26 Release B 0 via the Data Transfer module Data Transfer Data Transfer 10 13 o o c e G a Combining Dat
12. and Patient Safety c o9 5 s T a td fa a z 3 V SHIFT this is the vertical shift control used to adjust the vertical position of the displayed video 4 H AMP this is the horizontal amplitude control used to adjust the width of the displayed video 5 EAST WEST this control is used to adjust the pin cushion effect of the displayed video Connectors of 1 There are two fuse holders for the line protection fuses The fuses the M1092A depend on the type of monitor and the power supply as M1094A and summarized below M1094B Displays 200 240V M1094A color monitor 2 5A 250V 200 240V M1094B color monitor 3 15A 250V 200 240V monochrome monitor 2A 250V 100 120V color or monochrome monitor 4A 125V Slow Blow 2 Local Power Connector a 3 pin connector is used to input the local line voltage 3 System Power Connector a 15 pin D type connector is used to output 60V DC 100W max to a similar connector on the DC DC converter in the rear of the computer module 4 Video In Connector a 9 pin D type connector is used to input the video signal to be displayed from the display controller in the computer module DSPC for monochrome or CDSPC Video for color 5 Video Out Connector a 9 pin D type connector is used to output the video signal to be displayed on a duplicate display 11 26 Monitor Installation and Patient Safety Controls and Connectors 6 Human Interface Link Connector this
13. 7 E T 5 c gt LL e Ke A 5 tc 9 JAN 21515 71520 T1535 15 40 15 45 15 50 15 55 16 00 L7 HR 60 60 62 62 63 65 65 65 ST O4 O4 01 0 1 0 1 0 1 0 1 0 1 ST2 O4 0 1 0 1 0 1 Ost 0 1 0 1 0 1 PULSE 62 62 63 64 64 64 ABP 120 120 122 122 122 122 ABP D 78 78 80 80 80 80 ABP M 92 92 94 94 94 94 PAP S 24 24 24 24 PAP D 10 10 12 12 NN PAP M 14 15 16 16 9 JAN 1526 15 30 15 35 1540 15 45 15 50 15 55 16 00 NBP S 123 x NBP D 55 x NBP M 77 Bi 15 42 n C o 4327 x 15 51 M SpO2 98 98 98 99 99 99 x RESP 15 15 15 15 15 9 45 5 15 x Height 170 16 00 x Stripo tif Time line 7 Diastolic Data that has been transferred 8 Mean Date Time setting has been altered during time period Parameter labels Systolic 10 11 12 Time of measurement Questionable value More than one value is available in the time period Value has been entered manually Recording Functions 6 31 4 es S 2 5 E rm fo KJ A 5 1 Trended Vital Signs Recordings Making Trended Vital Signs Recordings Trends Calcs 9 Vital Signs The trended data displayed in the Vital Signs task window can be recorded by selecting the Vitals PLUG IN softkey To stop trended vital signs recordings The recording can be stopped at any time by selecting Stop Recordng _ in the Preset Recording task window
14. LI a c Freezing Waves CMS only Freezing Waves CMS only You can freeze any wave movement on the screen via the Freeze Waves keys Press Start Waves or any other key except or Silence Reset to restart the waves You can also freeze the waves on your Znd and 3rd independent display To restart the waves on an independent display press Start Waves A 2 9 2 ax 22 gt 5 Cc Ez o 3 4 Setting up your Monitor What you Can Configure What you Can Configure Changes and adjustments you make to the settings in Monitor Setup Screens remain active while the system is switched on With the exception of changes to the date and time all settings revert back to their default settings factory defaults or user defaults if the system is switched off for longer than 60 seconds The settings for the date and time are stored by the system when it is switched off Note If necessary these default settings can also be changed This is done in a special configuration mode either by your biomedical engineering department or the Philips service engineer See the Changing Default Settings and Patient Category on page 3 44 for more details EnS 2 e gt ax 22 gt 5 E 72 Setting up your Monitor 3 5 Changes to the Configuration Changes to the Configuration To make changes to the settings you need to get into the Monitor Setup Selection Window
15. c c o 5 o Q o N gt Introduction Control Panel Softkeys Hardkeys The control panel consists of softkeys hardkeys and alarm lamps The softkeys perform multiple functions Their functions correspond to the labels displayed at the bottom of the screen When no softkey labels are on the screen the softkeys do not function The hardkeys have only one function defined by the label on the key The hardkeys are labeled in blue Each one of these keys gets you into a level where adjustments and changes can be made or performs an immediate action The keys are labeled according to their function for example Realtime Record key allows you to start a recording of a waveform Note If you are using the M1167 77A system with the External Alarm Device the handheld keypad can be used to operate the system and to enter data It contains all the hardkeys and softkeys available on the control panel of the other systems 1 8 The CMS and V24 and V26 Patient Monitors Introduction Alarm Lamps The alarm lamps are lit when a red or yellow alarm condition exists ze S 9 atc gt 0 b2 St O s B oc Te gA E gt Alarm Lamps I d Cx contm B us 88 IE 0773 Tana 9 3E lt gt Suspend Aa E hae o DT welotZab tif SILENCE RESET Ala
16. on the recorder itself or e by beginning another procedure recording The time intervals and the time span can be changed by selecting Zoom In Time and e Zoom Out Time EE RM RAMS ICU Adult 16 FEB 99 21 31 ALARMS SUSPENDED WPuLsE 100 Use the up and down arrow keys to view more parameter values Use the Left and right arrow keys to view older and newer data 6 32 Recording Functions Neonatal Event Review Recordings Tabular Neonatal Event Recordings Neonatal Event Review Recordings 7 E S 5 c gt LL e xe D 5 tc You can record the contents of the Event Review task window in a tabular format on an M1116A B plug in recorder The recorder selection must be set to PLUG IN the default in the Procedure Recordings task window before neonatal events can be recorded You can access the Procedure Recordings task window by selecting on the control panel and e Recordng Setup in the Monitor Setup selection window Note Neonatal Event Review recordings can only be made on the M1116B plug in recorder The M1116A plug in recorder the M1117A four channel recorder and the central recorder do not support Neonatal Event Review recordings Header Information Each neonatal event recording begins with general information such as the recording date time patient s name medical record number and the bed label Beneath this comes the Event Summary info
17. 0 0 eee cece eects 3 45 NBP fos Sores eadein II eet a tedrentie e REPE tue eee ER 3 47 NBP Examples i52 ele bx shade ER pU te ia hk EEUU 3 47 lc 3 49 Heart Rate HR Pulse 35 uoces ec C Ceo C RR Rd eed 3 51 RESP oaie i a r Mee teer bebe Ee eed poe ees 3 51 Press UTE nnas she 8 eae Ales Wes Sek got oo Mh tha ea aha by i ae ee aaa 3 51 SPO 2 sa en eem ee RS OE Be ee x ee OAS coe eae LE GPE em 3 51 Contents 4 Changing the Configuration Set 0 0 0 coe e 3 53 Procedure 54 rete e Re ee abo bah seid eodd ie ia eal ated Jae 3 54 Changing Operating Modes 0 0 0 ee Ie 3 55 Returning to Monitoring Mode lslleeeleeeee eh 3 56 Procedu re uero eser EUH Nee eo edt td eR idend ER S 3 57 The Test Signals Function 0 0 0 Ie 3 58 Proced te 4 euet tee e Y RO DG ee RIS PRU LR AN ewes REN 3 59 Analog Output CMS only kc lg ge bh hh RR RR RR pg 3 59 Parameter Settings Transfer sss csser pete esiaine o i eA a o e 3 61 Parameter Settings Transfer Messages 0 00 ccc eee e 3 63 Other Patients 4 1 OVETVIEW gt teret ee er Oe toe intact Gat ete ee ene ebb es S uide Ei ehe 4 2 Philips Patient Care System llle e 4 3 The Other Patients Selection Window 0 ce cece eee eee ee 4 3 Automatic Alarm Other Patients llle 4 4 Configuring the Other Patients Controls 0 0 eee eee eee eee eel 4 7 Using Philips Patient Care System with an Arrhythmia Computer
18. Left Cardiac Work LCW Minute Volume MINVOL 5 E Cardiac Index CT Compliance COMP o Stroke Volume SV Dead Space Vd Oxygenation Percent Shunt Qs Qt Venous Oxygen Content CvO Oxygen Consumption VO 8 20 Trends and Calculations Performing Calculations Performing and Reviewing Calculations Calculations can be performed using automatically entered values or manually entered values If a parameter is being continuously monitored its value is automatically entered Values which are not monitored must be entered manually You can also change any of these values if needed In hemodynamic calculations if the systolic and diastolic pressures are manually entered via the cursor keys or the handheld keypad the mean pressure is calculated marked with an asterisk and stored automatically The following formula will be used to estimate the mean pressure systolic diastolic x 2 3 Both indexed and non indexed values are calculated Calculated and input values are first presented with their associated units If desired the units column for calculated values may be replaced with normal ranges and the input units column may be replaced with the times at which the values were stored in the database Parameters that are sourced in kPa cmH5O or mbar are automatically converted into mmHg to provide consistent indexed and non indexed calculation units Ventilation calculations convert input pressures from mmHg kPa and
19. Philips M1165 66 67 75 76 77A CMS Patient Monitoring System and Philips M1205A V24 and V26 Patient Monitor User s Reference Manual Volume 1 System Information PHILIPS Part Number M1046 9220L Printed 02 2003 Notice This document contains proprietary information which is protected by copyright All Rights Reserved Reproduction adaptation or translation without prior written permission is prohibited except as allowed under the copyright laws Philips Medical Systems Cardiac and Monitoring Systems 3000 Minuteman Road Andover MA 01810 Publication number M1046 9220L Warranty The information contained in this document is subject to change without notice Philips Medical Systems makes no warranty of any kind with regard to this material including but not limited to the implied warranties or merchantability and fitness for a particular purpose Philips Medical Systems shall not be liable for errors contained herein or for incidental or consequential damages in connection with the furnishing performance or use of this material 2003 Philips Medizin Systeme B blingen GmbH All rights are reserved Reproduction in whole or in part is prohibited without the prior written consent of the copyright holder Important United States federal law restricts these devices to sale by or on the order of a physician The M1165 66 75 76A Systems comply with UL544 CSA 22 2 125 IEC 601 1 EN 60601 1 and
20. Sa E gt ov EG bL E Za G oo When the battery voltage cannot be read because of a hardware or battery malfunction the fuel gauge will be replaced by a flashing message HARDWARE MALFUNCTION and an INOP alarm will sound even if the alarms are suspended The key will silence the tone for 3 minutes The alarm will reoccur until the condition is corrected Battery Information V24CT and V26CT only 12 7 External Battery Charger External Battery Charger We suggest that you use the Philips M1278A external battery charger to charge the M1205A batteries This battery charger can charge up to 4 sealed lead acid batteries at one time in two and a half hours LED indicators will indicate the status of each battery during a charging cycle Note Use of other battery chargers may result in shorter battery life and is not recommended c SD 6 Ca E os ES gt Sg Za G mo Refer to the external battery charger operating guide for specific operating instructions 12 8 Battery Information V24CT and V26CT only Battery Care and Maintenance Battery Care and Maintenance Storage The Philips 40488A sealed lead acid batteries used in the V24CT provide optimum performance and battery life when properly cared for Proper handling of batteries is essential to the life of the battery and safety of the user e Store batteries in a cool dry area A refrigerator is an excellent place to store batterie
21. Summary i c 7 gt LLI L d c Z The information displayed in the Event Review task window is presented in a graph format and is divided up into the following four channels 1 The Bradycardia channel with a range from 40 up to 120 bpm 2 The Desaturation channel with a range from 70 up to 90 3 The Apnea Duration channel with a range from 0 to 40 seconds Neonatal Event Review 9 3 Viewing Neonatal Events 4 The Manual Event Channel The graph provides an overview of the total number of events and how they were distributed over the last 24 hours Manual If you would like to capture an event manually press Event followed by Capture Episode Storage m c 7 gt LLI S o 9 4 Neonatal Event Review Graphical Details Event Bar Viewing Neonatal Events The following information is displayed on the graph in the Event Review task window l 2 Event bars Event threshold lines Event time Event numerics Event summary line A neonatal event is indicated by one or more vertical bars which are displayed across one or more graph channels Each event bar can be selected by the graph cursor Isolated Events indicated by one event bar displayed in one graph channel Associated Events indicated by two or three event bars displayed in a vertical line across two or three graph channels Manual Events indicated by one event bar in the m
22. Bed 6 Adult 16 FEB 99 15 54 Non paced mode AB An ood cd A ruse 80 imV 00 cvP tere mi 119 80 96 R 25 10 14 TP 1 Spo 2 024 95 3 Select the bed using More Beds if necessary a View CCU CCU 1 The Extended Overview Task Window will be displayed Note that only beds available on the other Philips monitoring network can be selected 4 16 Other Patients Alert Notification To view an Alarming Bed from Alert Notification Extended Overview CMS only 4 To view another bed in the group select the appropriate group label To select any bed not in the group press Alert Notification provides automatic notification of Alarms and INOPs from other extended Other Patients beds within a single unit of more than 24 beds With one keypress at the bedside you can view the alarming bed waves and numerics If more than one bed is in alarm a 5 second Alert Notification window is provided for each bed in turn Alert notification is not provided between care units The operation of receive send alarm choices and group selections is unchanged for Alert Notification Alarms cannot be reset in Alert Notification other Beds ecu e Alert Notification x ABP 95 gt 80 LEADS OFF II Clear View Bed Bed 1 Select View Bed to display waves Other Patients 2 When done select Clear Bed to return to the Main
23. LI a c LI gt gt Q gt 22 c p o o Displaying Split Screen Trends Displaying Split Screen Trends Split Screen trends display the last 30 minutes of the patient s trend data along with any alarm limits that are set The trend values are updated every minute The trend value itself is calculated as the average of all the values sampled with the previous minute DAVID SCHULTZ ICU AduLt 23 JAN 99 22 22 II HR Non paced mode Asl WeusE 76 imV lavr QO dspo 6 M 00 treo 39 3 mL ee 2 Pmin 3 SpO 2 Pplat 9 p m d 9 0 Pmean 12 ckto 2 PLET SpO come 10 EREE EA 9 6 TP1 Ol 8 Spo SQ rn se 200 RESP J 10hm RESP T2 044 2 0 strz 155 Ti 383 With Split Screen trending you can e Display the preceding 30 minutes of trend data for all vital signs next to their waves e Obtain a clear indication if a patient s vital signs tend towards exceeding the alarm limits Note Split Screen Trends are not available with selected V24 and V26 ICU bundles 3 22 Setting up your Monitor Displaying Split Screen Trends The alarm limits are represented by a rectangle filled with the parameter s color at low intensity When a measurement exceeds an alarm limit it is clearly visible against the screen s black background The limits themselves are displayed on the right side of the trend display next to th
24. O G50VA max L7 C0 Dea TL 6 H 2604 RS 232 D A seaw en Lc 6 2 3 5 1 4 as RS232 System Fuses Local Equipotential Outlet Connector Power Power Grounding Outlet Connector Terminal The rear of the Anesthetic Gas Module has the following connections 1 Local Power connector a 3 pin connector is used to input the local line voltage 2 RS232 Connector RS232 Interface a 25 pin D type connector is used for connection to the ACMS Note Do not apply a voltage greater than 12V to the RS232 connections 3 System Power Outlet restricted use this can be used to output power to the Philips M1165A 66A 75A 76A ACMS 11 30 Monitor Installation and Patient Safety Controls and Connectors Caution and Patient Safety e The System Power Outlet cannot be used to output power to other devices such as the Philips M1167A 77A ACMS c 2 s T D L fa a e The System Power Outlet can only be used to supply power to the ACMS when the total leakage current does not exceed 300 pA 4 Equipotential Grounding Terminal this is used to connect the Anesthetic Gas Module to the hospital s grounding system 5 Line protection fuses T1 6 H 250V 6 Anesthetic Gas Exhaust Caution Make sure that the anesthetic gas exhaust at the rear of the module is connected to the gas extraction system If it is not contact your biomedical engineer in order to mak
25. The key labeled with the parameter name is called the Setup key which gets you directly into the setup screen for that parameter When you press the Setup key on the front of the module and get into the parameter setup window or task window a light appears above the key The connector socket on the front of each module is the same color as the corresponding connector plug on the transducer or patient cable va ECGM1001B T Light for setup key ECG Parameter setup key TS J ei Connector for l 1 patient cable PIN or transducer Note If a T is present on the front of a module certain parameter settings may be transferred with that module when it is moved from one rack to another This behavior is dependent on a setting made in a 1 16 The CMS and V24 and V26 Patient Monitors Parameter Modules special Service Mode either by your biomedical engineering department or the Philips service engineer You can find a description of this behavior called Parameter Settings Transfer in Chapter 3 FE S 9 gt 0 St O s B oc o gA E gt Sym bols to As detailed in the table below some modules used with the M1046A CMS Indicate Key and M1205A V24 26 patient monitors now use symbols instead of words Functions to indicate the function of some keys If the monitor s Reference Manual tells you for examp
26. The Neonatal Event Review application enables the patient monitors to automatically detect store display and document up to 48 neonatal events over a period of 24 hours The neonatal events detected by the monitors are e Apnea e Bradycardia e Desaturations and or a combination of the three In addition events e g breathing patterns can be stored manually The above neonatal events represent the most frequently encountered cardiorespiratory problems in newborn babies The documentation of these events enables the clinician to diagnose and manage the patient s condition more accurately and effectively and determine an appropriate course of treatment V24 and V26 Patient Monitors can only store up to 24 events c 7 gt LLI S o 9 2 Neonatal Event Review Viewing Neonatal Events Viewing Neonatal Events Once an event has been captured and stored by the monitor it is displayed in the Event Review task window You can access the Event Review task window by selecting Alarms Volume on the control panel and Event Review in the Alarms Volume selection window KEVIN AMES ICU Neo 16 FEB 99 22 34 LALLA tt te a ase tes 160 ABP CVP 5 Stored Events ACD 1 1 B D 4 1 ABCD 95 110 22 30 2 30 6 30 10 30 14 30 18 30 22 30 PrevTeus Next exyGRe Pring Reeore i Event Event Eplsade Review
27. The key sequence to get into the Task Windows is shown above the screen figures in this guide The softkeys are indicated in the text like this Display The hardkeys are indicated in the text like this Monitor Setup A 2 9 2 ax 22 gt 5 Cc Ez o 3 6 Setting up your Monitor Making Changes to the Main Display Making Changes to the Main Display The following describes how to change screen A B C D or E and assign a label The description includes Assigning Waves to Screen Channels Selecting a Screen Selecting Screen Labels for Realtime Display Screens Selecting the Number of Waves Selecting the Wave Overlap Configuration Selecting Realtime Wave Speeds Numerics On Off Selecting an Application Window Wave Replace Mode Trace Mode A description is then given for changing a completely separate display Screen hee 2 e gt ax 22 gt 5 E 72 Setting up your Monitor 3 7 Assigning Waves to Screen Channels Assigning Waves to Screen Channels You can assign realtime waves to positions on the screen This defines where the waves appear on the Main Screen Display1 Setup DAVID SCHULTZ ICU Adult 15 FEB 99 17 04 IT HR Non paced mode AL na mln al LA mln ada 80 Wuse 80 1mv spo 97 id ABP 120 80 96 B pla e p ScreenChoice A Screen Label Standard Channel 1 ECG CH1 II BScreenChoice A Channel 2 ECG CH2 aVR E Screen Lab
28. Use of other camcorder type batteries could result in inaccurate estimates of battery capacity remaining or in shorter battery life Warning ee When connecting a non medical device such as a printer to the RS 232 Interface of V24CT the monitor must be properly grounded or the non medical device properly isolated This must be done in order to prevent the possibility of an electrical shock hazard to the user and or patient from excessive ground leakage currents from the non medical device such as a printer and to maintain compliance with IEC 601 1 1 where applicable This hazard is especially prevalent when the V24CT is operated in battery mode c SD 6 Ca E os ES gt Sg Za G mo In normal AC line operation grounding the monitor is accomplished by ensuring that the AC line cord is connected from the monitor to a properly grounded AC receptacle Alternatively and additionally proper grounding may be achieved by attaching a safety grounded wire to the threaded safety ground stud v found on the rear of the monitor Isolation may be achieved by powering the printer through a safety isolation transformer 12 2 Battery Information V24CT and V26CT only Operating Instructions AC and DC Battery Operation The following is a list of AC and battery operating instructions e The batteries continuously charge when the instrument is connected to AC power Charging occurs whether the monitor is turned Off or On Ca
29. What the A Symbol Means When the alarm capability is suspended by using the Suspend Alarms softkey or the hardkey the A sign on the control panel is illuminated If however you have turned the individual parameter alarms off one by one the amp sign on the control panel is not illuminated but a A appears next to the individual parameter numerics on the screen There are four alarms off modes available You configure which one you want at installation of your system The four modes are ALARMS SUSPND 1 MIN ALARMS SUSPND 2 MIN ALARMS SUSPND 3 MIN 4 ALARMS SUSPENDED oN Pr ALARMS SUSPENDED 1 2 3 MIN In these modes the alarm capability can be switched off but is automatically switched on after 1 2 or 3 minutes unless you have switched it on manually beforehand with the SwitchOn Alarms softkey in the Alarms Selection Window or the hardkey ALARMS SUSPENDED In this mode the alarm capability is switched off permanently and must be switched on manually when required using the SwitchOn Alarms softkey in the Alarms Selection Window or the hardkey Note For safety reasons we recommend that you always configure your monitor to ALARMS SUSPND 1 2 or 3 MIN for Intensive Care as well as Operating Room use If you want to avoid nuisance alarms caused by artifacts in the Operating Room configure your alarm limits carefully or switch off individual paramter alarms applying special vigilance to these parameters All monitors w
30. e CHANNEL 2 7 LI gt gt Q gt 22 c p o CHANNELZ3 CHANNEL 4 1 mco 0 NBP 4947 1 Pi awan 37 115 65 81 4 Alarm vol165 THES QRSvoli50 f 3 36 Setting up your Monitor Adjusting the Date and Time Adjusting the Date and Time You can set the date and time to be displayed on the screen Once it has been set the internal clock retains the setting even when the system is turned off If your monitoring system is connected to a central station via a Philips monitoring network the date and time on your monitor is automatically taken from the central station gt DateTime DAVID SCHULTZ ICU Adult 15 FEB 99 17 28 II Non paced mode HR 80 Purse 80 spo 97 ABP 120 80 96 PAP 25 10 16 CVP 12 Spo 2 95 depo 2 Date amp Time Monitor Day Month Hour Minute 15 FEB 17 i 2T LI E gt Q E 22 c o Rdjust the Date and Time Press CONFIRM to validate Ag urat Bay Procedure 1 Change the day month year hour and minute by pressing the corresponding softkeys 2 Press after all the adjustments have been made and a message will appear with the date and time settings Setting up your Monitor 3 37 Adjusting the Date and Time 3 Press to return to the Selection Window or to return to the Main Screen Note If you are using a
31. o o c e G a Combining Data Module Database Monitor Configuration What will be Stored in Monitor 32 param 12 hr 1 min 16 param 4 hr 12 sec 32 param 12 hr 1 min 32 param 12 hr 1 min 32 param 24 hr Ext 1 min 32 param 12 hr 1 min 32 param 12 hr 1 min 16 param 9 hr Ext 12 sec 32 param 4 hr 1 min 32 param 12 hr 1 min 32 param 4 hr Ext 12 sec 32 param 4 hr 1 min 10 16 Data Transfer Vital Signs Blood Review and Graphs Vital Signs Blood Review and Graphs Some functions under Trends and Procedures are unavailable during transfers of patient data To the Monitor Vital Signs Blood Review Graph Trends Discharg Patient or End Case ST Analysis To the Module Discharg Patient or End Case Caution Transferred data is not entered into the module database until up to one minute after it enters the monitoring system Because of this delay during updates to the module some aperiodic data may not be transferred for up to 2 minutes after the actual time it was obtained Time Stamp Transferred data is identified in Patient Data displays by a T placed before the time in the Vital Signs Graph Trends and Calculation Review task windows Transferred data is labeled relative to the time in the destination monitor The Data Transfer module has a clock which ages the data the exact amount of time which has transpired
32. 1 The number of waveforms depends on the waveforms you have selected to have displayed and also on the model of your system The numerics are aligned with the corresponding waveform Attaching the Patient Adjusting V24 and V26 Screen The brightness or contrast of the screen display can be adjusted by using Contrast the dial located behind the edge of the display on the lower right side of the monitor The V24 uses a contrast control V24C V24CT V26C and V26CT are equipped with a brightness control Make sure that all of the screen information is visible o o b S o D c 7 o Screen Brightness Control Model V24C V26C V24CT V26CT Screen Contrast Control Model V24 CMS The brightness and contrast of the screen display can be adjusted by means of the two dials underneath the hardkeys Follow this procedure to achieve the optimum screen display 1 Turn the brightness and contrast controls to their maximum settings 2 Slowly turn the brightness and contrast controls down to the lowest acceptable position where the display can still be seen clearly The most acceptable position will be dependent upon the surrounding light conditions Please ensure that all the screen information is visible Getting Started 2 7 o b fo n o D c 7 o Attaching the Patient Starting Monitoring DAVID SCHULTZ Bed 6 Adult 16 FEB 99 19 27 II HR jon paced mode E PE aha AlL J EY
33. 100 PRESS s 90 160 o E Ej 1 Press Select Parametr to highlight the parameter that you want to adjust 2 Use the On Off Alarms softkey to switch the parameter s alarms on or off When the alarms are turned off a appears next to the parameter alarm limits 3 Use LowLimit and High Limit softkeys if you want to adjust the limits 4 Ifthere are more than 10 alarm bars to review press the Next Page softkey and the remaining alarm bars appear on the Screen 5 Stay in the Task Window if you want to adjust more limits or press to return to the Main Screen Alarm Functions 5 13 o c fa o 5 ra E A S lt x o c fa o 5 ns E A s lt Alarm Setup Setting the The QRS and the alarm tone volume can be set independently Volume Control 1 Press Alarms Volume hardkey 2 Press Volume Control inthe Alarms Selection Window The QRS and alarm tone are each represented by the outline of a triangle which can be filled in When the triangle is completely filled this represents maximum tone volume 9 Press the up and down arrow softkeys to fill each triangle to the required amount If there is no current alarm or INOP two short alarm tones will sound each time the alarm tone keys are pressed so that you can hear the effect of changing the volume 4 Press to return to the Main Screen Note The QRS tone can be derived from other sources than ECG su
34. 16 Graph Trends 8 12 V V24 and V24C Patient Monitor getting started 2 1 3 1 V24 V24C Golden Rules to remember 1 36 Vital Signs Recording 6 39 Volume control 3 35
35. 2 9 screen messages 2 8 Graph Trends 8 12 Installation assembling the monitor 11 36 lifting the monitor 11 36 L Loading paper four channel bedside recorder M1117A 6 53 plug in recorder M1116A 6 50 plug in recorder M1116A B 6 49 Main Screen 1 21 Monitor rear panel 11 34 rear panel connectors 11 35 Monitor Standby with Data Transfer 10 6 monitoring network 4 3 N network arrhythmia alarms 4 10 automatic alarm Other Patients 4 4 multiple incoming alarms 4 5 O Operating levels 1 20 getting into 1 25 highlighting moving 1 26 Main Screen 1 21 selection 1 25 selection window 1 23 task window 1 24 Overpressure 3 47 oxyCRG recording 6 36 P Parameter module rack 1 35 Parameter Modules 1 14 inserting into rack 2 5 parameter settings transfer 3 61 satellite racks 1 18 setting up 2 5 Parameter Settings Transfer 3 61 messages 3 63 Parameters on off 3 33 Patient Care System 4 3 Patient category changing 3 45 differences between categories 3 46 Patient Data see Trends Calcs 8 1 Patient Data Management Calculations Review 8 25 changing input values 8 25 entering input values 8 25 Reports 8 26 Patient Information changing 7 5 deleting previous patient 7 5 Performance Assurance Checks 13 11 Performance Specifications DTM 10 20 Power supply 1 14 Q QRS volume 3 35 R Recorder Capabilities plug in recorder M1116A 6 5 plug in recorder M1116
36. 60 mmHg 8 0 kPa tepCOs 40 mmHg 5 3 kPa CO Simulated square wave ETCOs 40 mmHg 6 0 kPa IMCO 0 mmHg 0 0 kPa AWRR 25 rpm g fa Temperature 40 C 104 F No wave a 7 E Performing Auto Check None the ECG Module and Self Test The ECG and ECG RESP self test may be performed at any ECG RESP time as the lead selector and pace pulse detection are inhibited during the Self Test check The module will produce ECG test signals at the beginning of the processing circuitry and process the test signals in the same way patient signals are processed The test signals last about 30 seconds and then the display returns to the normal monitoring mode TEST Press gt Test Signals RESULT If the module is functioning correctly the following heart rate and respiration are displayed without the alarms being activated ECG 100 bpm in ADULT mode 125 bpm in NEO PEDI mode RESP 15 rpm in ADULT mode 30 rpm in PEDI mode 55 rpm in NEO mode Maintenance 13 15 o o c c o 2 Performance Assurance Checks Performing the Invasive Pressure Module Self Test 13 16 Maintenance Auto Check The check for these modules is started every time the system is switched ON and checks the complete module circuitry including the sensitivity detection circuit Self Test The test signals lasts about 30 seconds and then the display returns to the normal monitoring mode The M1006A Pressure self test may be performed
37. 94 Channel 1 ECG CH1 II BSpeed 7 25 mm sec Channel 2 ECG CH2 aVR E Recorder PLUG IN 2 ch Overlap gt 1 Key Label Mode A SEIR Assign Change Change Select Change hannel Wave Speed Recorder Overlap KeyLabel 1 Select the recorder and layout a Press Change Recorder to select the recorder that will produce the recordings b Press Select Overlap to change the layout of the waves on the recording strip c Press Change Speed to change the recorder speed 2 Select wave for each channel a Press Select Channel to select required recorder channel b Press Assign Wave to highlight the wave for selected channel 3 Press Change KeyLabel to give a name to the mode being configured Modes B and C are configured in the same way Recording Functions 6 21 4 es S 2 5 e rm fo Ke A 5 x Realtime Wave Recordings Making Preset Recordings Making Non Preset Recordings Realtime Record gt Preset Recordng if available ModeA Mode B or Mode C Realtime Record gt Select RecWaves if available DAVID SCHULTZ Bed 6 Adult 16 FEB 99 19 36 II HR jon paced mode A ala allan l Al ES 80 i puse 80 imv STi 00 CvP capes pol _ ABP 120 80 964 25 10 16 PAP IFEGI i Spo 2 Rn fl y EEG2 KAPTA HN 100UV Select Recordin Lm Select the wave s to be recorded Selected waves are identified in the win
38. AMP 8 2 n Maximum Voltages System Power Connector 60 V Local Power Connector 240 V Human Interface Connector 12V Video Out Connector 5V Video In Connector 5V 11 24 Monitor Installation and Patient Safety t gt HE Controls and Connectors Br aw OE S o M1094B Display Module 55 o ct BER oc Ss SS eS ERE ANGE 0 T Local Power Connector 7 5 ism Fuses 6 4 Eauipotential Grounding LOCATED ON RIGHT SIDE OF DISPLAY g g Tenin aiia Fl gas Video Termination Switch z J Video Out Connector 10 ODOOQO i Ht DY 3 Video In Connector 9 TM System ge e VSHIFT H e V d Interface Power 9 Connector Connector t 8 Maximum Voltages System Power Connector 60 V Human Interface Connector 12V Local Power Connector 240 V Video Out Connector 5V Video In Connector 5V Controls of the 1 Video Termination Switch thus switch is used to terminate the M1092A video signal at this display this must be switched to the 75Q M1094A and position if only a master display is used and must be switched to the M1094B HIGH IMP position if a second duplicate display is used Displays Monitor Installation and Patient Safety 11 25 Controls and Connectors 2 V AMP this is the vertical amplitude control used to adjust the height of the displayed video
39. BUN 10 8 9 15 18 8 26 gi Glu 76 70 75 86 92 70 08 mgh AnGap 1 10 12 17 15 10 20 mEg Operld 123456 123456 123456 123456 123456 123456 Blood Review Report Trends and Calculations 8 29 o c o c o c fo 2 s 5 2 o Printing Reports What to Do During normal report printing messages appear in the status message If Your area of the display However sometimes a printing status message may Repo rtDoes alert you to a problem that needs to be corrected The following Not Print information describes printing messages that may appear what they mean and what you may need to do to correct a problem should there be one MESSAGE Printer Malfunction Meaning While printing a report the monitor detected a problem with the printer What You Need to Do Check the printer to be sure it is plugged in turned on and has paper loaded If you are using a printer at the central station be sure the central station is operating If these do not correct the problem call your Philips service representative MESSAGE Report On Printer Has Been Canceled Meaning The report sent to the printer has been stopped because someone has pressed the Cancel Report ge og 25 E f E FO What You Need to Do You don t need to do anything MESSAGE No Printer Available Meaning A report cannot be started on this printer What You Need to Do Check the printer to be sure it
40. Chapter 8 Trends and Calculations for details for the Patient Admit Task Window see Chapter 7 Admit Discharge End Case for details for the ST Analysis Task Window see Chapter 14 ECG and ECG Respiration Module Section for details and for defining screen labels and adjusting the date and time see Chapter 3 Setting up your Monitor for details 1 30 The CMS and V24 and V26 Patient Monitors Alphanumeric Entries Touch or Mouse Trackball Operation A Touchboard can be accessed when alphanumerical data needs to be entered This is an alternative to the entry of data with the handheld keypad The Touchboard can be activated with the Touch Board softkey e g from the Patient Admit Task Window ICU Adult 31 JAN OO 8 00 R Non paced mode M HR o spo 100 MM inV ABP 120 70 91 Patient Information Admitting Physician ee Hn Hag Hee BB HnBdIHBHSEBEURBE ngBm5mmBmmmunmmmuH BBBBBDUEUSENEE EI ES E EI Next Itam Prey ou X nm Beck
41. DO transfer parameter settings They are M1006A M1016A M1006A CO1 M1029A M1006B M1032A M1012A M1012A C10 M1034A Any other module without a 7 does not transfer parameter settings The settings such as alarm limits are stored inside the module You could even unplug a satellite rack full of these modules from one monitor and plug it into another monitor without losing the parameter settings This behavior permits fast and easy transport and is called Parameter Settings Transfer Note The settings that are stored in each module are detailed in the relevant module chapters of this guide LI a c For Parameter Settings Transfer to work on your monitor it must be set ON in a special Service Mode either by your biomedical engineering department or the Philips service engineer LI gt Q gt Le c o After making changes to parameter settings wait about 10 seconds until the new settings are stored in the relevant module before removing the module After plugging in a module wait about 10 seconds to let the monitor read the settings before opening the Task Window After switching on the system or going into Monitor mode from Config mode the first 30 seconds are used to store settings from the system to the modules Modules plugged in after this initial 30 second period are capable of keeping their settings You can change parameter settings either e inthe parameter Task
42. Data Transfer module e A question mark beside a time 7 15 indicates the blood measurement occurred prior to clock changes at the bedside or central station e A question mark preceding a blood measurement value 5 0 indicates that blood measurement has been invalidated by a user e A question mark standing alone in a blood measurement field indicates that no valid result could be derived from the sensor signals e The symbol at the beginning of the blood measurement label BEecf indicates the measurement has been calculated by the blood analysis module e The amp symbol before a label e g amp PCO2 indicates the measurement has been adjusted to the patient s temperature e The gt symbol preceding a blood measurement value gt 3 0 indicates the value is greater than the upper limit of the reportable range e The symbol preceding a blood measurement value lt 3 0 indicates the value is less than the lower limit of the reportable range oe S 2 25 gt c Sg Fo If configured to Enabled in the Blood Analysis configuration task window OZ the Free Fields Field1 Field2 and Field3 and Operator ID of the person performing the blood measurement appear after the last measurement in the order listed Viewing Blood You can compare an adult arterial venous blood result value against a Review corresponding adult arterial venous blood reference range The blood Reference results on the Blood Review
43. Desaturation One associated Apnea and Bradycardia occurred which also resulted in a Desaturation Nine isolated Desaturations occurred Two events were manually captured and stored Event Storage 9096 full c 7 gt LLI L ad c o a Event Storage overflow First events overwritten 1 22 for V24 and V26 Patient Monitors 2 24 for V24 and V26 Patient Monitors Neonatal Event Review 9 11 m c 7 gt LLI S o Viewing Neonatal Events Op erating Controls Selecting an Event Viewing an oxyCRG Episode for the Selected 9 12 Event If the event storage is full the newest 49th event will enter the graph on the right hand side and push the oldest 1st event off the graph on the left hand side This information cannot be retrieved To document the event review before the event storage becomes overfull you should initiate an event summary recording To free up space in the event storage and remove unwanted events from the Event Review graph you can delete events in the oxyCRG Episode task window In the Event Review task window you can 1 Select the previous event 2 Select the next event View an oxyCRG Episode for the selected event Record the event summary Print the event summary Qu OMS UMP ISO Enter the Event Setup Window to change the neonatal event trigger conditions Selecting the Previous Event and or Next Even
44. Docking a second rack by a cable may disrupt module communication The signals from the parameters being monitored are transmitted to the internal computer where they are processed and then displayed on the screen as waveforms and numerical readouts i The CMS and V24 and V26 Patient Monitors 1 35 Operating Rules to Remember Operating Rules to Remember FE S 9 RE gt 0 St Os B oc o gA E gt e Pressing key always returns you to the Main Screen e To get into a Selection Window press a hardkey e What is labeled in yellow and appears pushed in is active e Softkeys function only in the Selection and Task Windows with the exception of the Alarm Volume Control and the QRS Tone Volume Control on the V24 and V26 Patient Monitors e The parameter module Setup key gets you directly into a Task Window e The arrow keys and key are illuminated when available for use 1 96 The CMS and V24 and V26 Patient Monitors Performance Specifications of the Philips Displays Performance Specifications of the Philips Displays M1095A Flatscreen Display M1094A B and M1092A CRT Display M1097A A02 XGA Flatscreen Display Useful Screen 45 unless otherwise noted Pixel Size Storage Time at 25 mm sec Trace Speeds Useful Screen 45 unless otherwise noted Pixel Size Storage Time at 25 mm sec Trace Speeds Useful Screen 45 unless otherwise noted Pixe
45. EN 60601 1 2 and carries C o3g Marking to Council Directive 93 42 EEC European Medical Device Directive MDD The M1167 77A Systems comply with UL2601 1 CSA 22 2 No 601 1 M90 IEC 601 1 EN 60601 1 and EN 60601 1 2 and carries C o36 Marking to Council Directive 93 42 EEC European Medical Device Directive MDD The M1205A Systems comply with UL2601 IEC 601 1 CSA C22 2 no 601 1 EN60601 1 and EN60601 1 2 and carries C 9123 Marking to Council Directive 93 42 EEC European Medical Device Directive MDD Electromagnetic Interference Anomalies due to electromagnetic interference are not unique to the M1165 66 67 75 76 77A or the M1205A but are characteristic of patient monitors in use today This performance is due to the very sensitive high gain front end amplifiers used to display the physiological signals Among the many similarly performing patient monitors already in use by customers interference from electromagnetic sources is rarely a problem in actual use Avoiding Electromagnetic Interference When electromagnetic interference EMI is encountered there are a number of actions that can be taken to mitigate the problem e Eliminate the source Possible sources of EMI can be turned off or moved away to reduce their strength e Attenuate the coupling If the coupling path is through the patient leads the interference may be reduced by moving and or rearranging the leads If the coupling is through the power cord
46. Neo Neo HR PULSE Adult Neo Neo RESP Adult Adult Neo Inv Pressure Adult Neo Neo CO Adult Adult Neo For example The ECG parameter uses the neonatal algorithm if you choose either the Neonatal or Pediatric patient category If you choose the Adult patient category the ECG parameter uses the adult algorithm The following pages describe in detail how the choice of patient category influences monitoring Setting up your Monitor Changing the Patient Category NBP The patient s tolerance for the cuff pressure i e stress when an NBP measurement is made is an important factor to consider when choosing patient category The amount of stress is determined by e the size of the cuff and e the duration of time the cuff pressure is applied Since a neonate can usually tolerate less stress than a pediatric patient and a pediatric patient can tolerate less than an adult the System algorithm has category dependent safety values If the cuff pressure exceeds these values for more than a given time period the cuff immediately deflates and a severe INOP Alarm is given These values are adapted to normal physiological values NBP Examples 5 fe Overpressure Overpressure occurs if the cuff maintains a pressure above the safety A value for more than two seconds The safety values are E E Adult 300 mmHg o Pediatric 300 mmHg e Neonate 150 mmHg Continuous Continuous Pressure occurs if for any reason a safe
47. PU ML dS 8 32 Contents 7 Neonatal Event Review Introduction to Neonatal Event Review lseeeeesese Viewing Neonatal Events 20 0 eee eee ee eee ene Manual Event Storage 0 02 e eee eee eee Graphical Details 0 00 eee ee eee Operating Controls 0 0 0 0 userre rererere eee Viewing oxyCRG Episodes 00 0 0 eee Operating Controls 02 0 0 eee eee eee eee Adjusting Neonatal Event Review Settings Event Criteria s ege Seas weg EE gs Operating Controls cech erred ess esee Data Transfer Data Transfer Module 0 0 0 0 cece eee eee Symbols to Indicate Key Functions What is Transferred 20 0 cece ee ee eee Types of Transfer sd d Rex eR ddd aa eda yn TO Module s red Ier t BEE Cae C PUR To MoOnttot c eee b Reb kegibed bis aa po baea Transferring Blood Analysis Data 00 002 e eee Combining Data fcc rper me dd eens be eee Time Conversion zuo ER Eus BEA Ph BAO MEE REN Database Conversion 0 0 e cece cece eee eens Vital Signs Blood Review and Graphs 0 000 Time Stamp sms Iu ese ek ite dda b e epe REDONS etae e Tec COE NIRE USER MUSS Troubleshooting sseeeeeeee hm Performance Specifications 0 0 cece eee eee Data Transfer Module 0 0 cee ee eee ee Monitor Installation and Patient Safety Introd ction x este dee ecb eer
48. Pacing Next ECG ECG E 1 24 The CMS and V24 and V26 Patient Monitors Getting into the Operating Levels Operating Levels Before you can start to make adjustments or changes to the parameters or perform a procedure you need to know how to get into the operating levels and how to navigate through the selections Follow the procedures below to get into the Selection and Task Windows Selection Window 1 Press the blue labeled hardkey for the function you require 2 When you get into a Selection Window the bottom line is always active Select the line with the parameter or function you require by pressing the same hard key again that got you into the selection window or use the arrow keys if they are illuminated 9 Press either the softkey corresponding to the parameter or function you require or This gets you into the Task Window For example to get into the Noninvasive Blood Pressure NBP Task Window 1 Press the hardkey Module Setup 2 Ifit is not already active select the line containing NBP by pressing Module Setup again 3 Press the softkey NBP to get into the Noninvasive Blood Pressure Task Window Task Window There are two ways to get into a parameter Task Window either via the Selection Window or by pressing the Setup key on the parameter module which gets you directly into the Task Window Getting into other Task Windows for functions like Other Patients or Monitor Setup is only pos
49. Perform Calc the unknown value is calculated and displayed DAVID SCHULTZ ICU Adult 16 FEB 99 21 27 II L B B HR Non paced mode HR 80 Meuse 60 10 Spo ABP PAP CVP DOBUTAMINE Inputs Unknown Value Dose 2 500 mcg kg min Rate 10 50 mehr Amount 250 0 mg Volume 250 0 m Conc 1000 mcg ml Weight vU kg 21 27 l mzn 16 67 mcg min Use Select Item or the arrow keys to select an input value Use the keypad to Change the selected input value Trends and Calculations If you are performing a calculation for a drug that is weight dependent the calculator will retrieve the most recent weight entered either through the Admit task window or one of the physiological calculations task windows If weight is not available you can enter it in the Drug Calculator task window The weight you enter will be stored with the patient s history Trends and Calculations 8 33 Drug Calculator Caution If you use the Drug Calculator for any patient other than the one currently being monitored the current patient s history will be altered when another patient s weight is stored ge og 25 E f E FO 8 34 Trends and Calculations Drug Calculator The Titration Table task window notes the relationship between dose and rate as configured during system installation This table can be printed directly from the Titration Table task window or from the Drug Calculation ta
50. SUSPENDED or ALARMS SUSPND 1 2 or 3 MIN message at the top right corner of the screen depending on the alarm suspended mode which is configured on the monitor The Alarm Suspend symbol on the control panel is also illuminated Note When you switch the monitor on a loudspeaker test is conducted for approximately 3 seconds If there is no sound please check the volume settings If there is more than one red alarm yellow alarm or INOP message you will see an up arrow next to the message The messages are displayed in rotation every 2 seconds If your patient has more than one alarm you can see a list of all these active alarms in the Alarm Messages Task Window To access this Task Window press or followed by Alarm Messages Warning Alarms and INOPs are not active in the configuration and service modes but are active in monitoring and demo modes Aem pad i Al Other M Silence Reset key T essi K eum Patents Sel dAl Wai Ch Suspend key pT_Susend Screen Screen 7 Alarms Suspended Lamp 5 2 Alarm Functions Suspending Alarms Alarm Display Alarm Lamps Red and yellow alarm lamps on the control panel signify the severity of the cause of the alarm One of these lamps is always lit in the event of an alarm sound In the case of more than one alarm the highest severity alarm lamp is always lit
51. Screen or to view next bed s Alert Notification if more than one bed is in Alert Notification T preceding bed name A maximum of 4 beds can be viewed on each Philips monitoring network at one time When the maximum use is exceeded the message CANNOT DISPLAY WAVES AND VITAL SIGNS OTHER BED DISPLAY LIMIT EXCEEDED is displayed for 5 seconds Other Patients 4 17 Extended Overview CMS only Note If the gateway is configured to provide Alert Notification and the gateway is inoperational the message SDN comm error inter network gateway failed will be displayed in the message area of the main screen display The Alert Notification display is removed if is pressed on the source bedside monitor or Silence on the central station All star star and hard INOP alerts will generate alert notification o E c o Q o t o 4 18 Other Patients 5 Alarm Functions This chapter provides general information on alarm functions and what to do if an alarm occurs It includes the following sections e J Alarm Display cesse RA ete ts 5 2 Alam Setup esee eee eee eee eneee 5 12 Alarm Functions 5 1 o c 2 5 ra E A S Alarm Display Alarm Display Alarm Functions on the Control Panel The alarm messages are displayed across the top of the screen When you switch the power on the system alarm capability is switched off This is indicated by an ALARMS
52. To prevent unintentional disruption in monitoring be sure the SDN interface cable is properly secured at both ends when connecting to the Philips monitoring network SDN Setting up the Parameter Modules Setting up the Parameter Modules 1 Decide which parameters you want to monitor 2 Make sure the appropriate modules are plugged into the rack If not insert the module into the rack until the lever on the base of the module clicks into place To remove a module press the lever upwards and pull the module out See diagram below o E n o D c 7 o 3 Check that you have the correct patient cables and transducers plugged into the modules The module connectors are color coded to the patient cables and transducers for easy identification Your monitor may have Parameter Settings Transfer set ON To understand the effect this has when using modules with the 7 label turn to Parameter Settings Transfer in Chapter 3 Getting Started 2 5 o b fo n o D c 7 o Attaching the Patient Attaching the Patient 2 6 Getting Started 1 Attach the electrodes probes transducers and insert pressure catheters as required for monitoring the patient 2 Connectthe electrodes probes and transducers to the appropriate modules After less than 10 or 20 seconds you should see a display on the screen similar to the one under Main Screen in Section
53. V p p The parameter modules are inserted into one or several satellite racks They cannot be attached to the front of the computer module Applies to both the M1046A and M1046B Computer Modules The ECG output and defibrillator marker input connector on the computer module is used during cardioversion to provide an ECG waveform for synchronizing a defibrillator It is also used to receive a marker pulse from the defibrillator for indicating the defibrillator discharge in the ECG waveform on the monitor display If you are using a Philips defibrillator without a built in recorder the marker pulse from the defibrillator is returned to the monitor If the Philips defibrillator has a built in recorder then the marker pulse is returned to that recorder rather than to the monitor The ECG output can also be used for other applications such as synchronizing intra aortic balloon pump systems 1 94 The CMS and V24 and V26 Patient Monitors The V24 and V26 Parameter Module Rack The V24 and V26 Parameter Module Rack FE S 9 gt 0 St O s B oc o LA E gt The V24 and V26 parameter module rack is attached to the display module by a cable to a connector on the left side of the display module In addition the V24CT and V26CT allow you to dock a 6 slot rack directly to the mainframe Warning Do not connect a second rack by a cable when using the V24CT or V26CT with a 6 wide rack docked to the mainframe
54. Xxx Heart Rate yyy greater than the upper HR limit xxx HR yyy lt XXX Heart Rate yyy lower than the lower HR limit xxx IRREGULAR HR Consistently irregular rhythm irregular R R intervals 4 14 Other Patients Extended Overview CMS only Extended Overview CMS only Note The Extended Overview feature is optional and requires the M1272A Inter Philips monitoring network gateway Extended Overview enables you to review the status of patients on another Philips monitoring network either in another care unit or in a care unit larger than 24 beds The Extended Overview Task Window provides display of one wave cascaded into two 4 second segments up to seven parameter numerics including arrhythmia if available and alert status messages Extended Other Patients can be in use at a maximum of eight beds in each Philips monitoring network simultaneously When the maximum use is exceeded the message CANNOT DISPLAY WAVES AND VITAL SIGNS OTHER BED DISPLAY LIMIT EXCEEDED is displayed Other Patients Other Patients 4 15 o L d c o 2 Q o t o Extended Overview CMS only To View an 1 Press Other Patients Extended Other 2 Depending on your monitor s configuration select a group softkey Patients Bed in the following display labeled View CCU to bring up bed labels in another unit or other Beds for bed labels in a unit larger than 24 beds
55. a crack or electrolyte leakage is found on the case or cover e Do not short the battery by directly connecting the positive and negative terminals Shorting can burn out the connections and serious burns or fire may result e Do not dispose of batteries in an incinerator Batteries may explode if put into fire c SD 6 Ca E os ES gt Sg Za G mo e Clean the battery if it is dirty or dusty Wipe the battery with a dry cloth or water dampened cloth Never use oil gasoline thinner or other petrochemicals e If the battery is accidentally broken and electrolyte sulfuric acid leaks out wipe it up with a cloth and neutralize the acid with an alkaline substance such as sodium bicarbonate baking soda e Ifyou need to dispose of the batteries follow local laws for proper disposal Be aware that batteries contain lead Caution In the event electrolyte sulfuric acid contacts the skin immediately flush with water and consult a physician 12 10 Battery Information V24CT and V26CT only Accessories and Ordering Information Accessories and Ordering Information 40488A 12 Volt Lead Acid Batteries M1278A Battery Charger SD 6 Ca E os ES gt Sy Za G oo Battery Information V24CT and V26CT only 12 11 Accessories and Ordering Information c SD 6 Ca E os ES gt Sg Za G mo 12 12 Battery Information V24CT and V26CT only 13 Maintenance This chapte
56. a header page which contains general information such as date time patient s name medical record number and the bed label I 91MIA _ 19 JAN 98 16 16 BED 8 5 John Smith 123456 Vital Signs Table WU strip2 tif 1 Recording code 2 Date and Time Patient s name gt w Recording title 5 Bed label if connected to the Philips monitoring network Recording Functions 6 29 7 c T 5 c 2 LL e xe LS 5 tc Trended Vital Signs Recordings Trend Data 6 Medical record number Depending upon the number of trended parameters the header page is followed by one or more pages of trend data A trend data recording may take from 15 seconds to 50 seconds to complete The recording speed is set by the system and cannot be adjusted The trended parameters are recorded in the same order as those displayed in the Vital Signs task window and the Vital Signs report Please refer to the Trends and Calculations section later in this manual Chapter 8 Volume 1 for further information on the data displayed in the Vital Signs task window and the Vital Signs report Note Blood Analysis parameters are not included in a trended vital signs recording Please consult the Realtime Wave Recordings section of this chapter for further information on recording Blood Analysis data 6 30 Recording Functions D Ws Ue npe ics LAY Qe Q Trended Vital Signs Recordings
57. a report of the data shown in the Task Window you are viewing These reports are available for Patient Information Graphs Blood Review Vital Signs all parameters for the displayed time period Calculations Calculation Review and Drug Calculator Titration Table if available Through Scheduled User defined reports may consist of tables Reports graphs and calculations and blood review v reports These can be printed according to a S 6 configured schedule or you can choose to os print a report before its scheduled time in E 2 the Selection Window under FS Printing In the Graph Trends Blood Review Vital Signs Calculations and Task Calculation Review Task Windows you can print a report of the Window information being presented The data will be printed in the same detail Repo rts same time intervals as shown Note In Tables and Calculations Review the reports will include data for the displayed time period including those parameters which are not displayed In Graph Trends only the displayed graphs are printed Printing The print times and the contents of scheduled reports are chosen during Scheduled the configuration of the monitor However the Print SchedRep key Repo rts in the Selection Window accessed through Trends Calcs enables you to print a report identical to the scheduled report at any time Using this key doesn t interfere with the normal printing of scheduled reports the report will still print again later
58. among V24 and V26 Patient Monitors CMS Patient Monitoring Systems and Component Transport Systems For example if a patient is moved to another location the Data Transfer module can be used to transfer the patient s data along with the patient to the new location During the transport the Data Transfer module can be used to continuously collect the patient s vital sign information When the patient arrives at the new location the Data Transfer module is able to move both the data from the old location as well as the data obtained during transport into the monitor at the new location A typical transfer takes less than one minute When unplugged the module retains data for at least one hour Data Transfer Module CMS a ar LI CMS V24 V26 Data Transfer Data Transfer 10 3 Data Transfer Module Data transfer presents no interruptions to realtime monitoring and provides near continuous trends However some functions under and are not available during the transfer of data The ST Analysis task windows are unavailable during a transfer to the monitor fi T ume i DATA M1235A TRANSFER M1235A V V v y ED A uu J The front of the module has two keys e The Monitor key for initiating a transfer from the module to the monitor e The Mo
59. and additionally proper grounding may be achieved by attaching a safety grounded wire to the threaded safety ground protective earth stud C found on the rear of the monitor 11 8 Monitor Installation and Patient Safety Environ ment Installation Information To ensure a completely safe electrical installation follow the instructions described later in this section The environment where the system will be used should be reasonably free from vibration dust corrosive or explosive gases extremes of temperature humidity and so on and Patient Safety c 2 T D LI fo o For a cabinet mounted installation allow sufficient room at the front for operation and sufficient room at the rear for servicing with the cabinet access door open Approximately 15 minutes after switch on the patient monitor and the Anesthetic Gas Module operate within specifications at ambient temperatures shown in the tables below These specifications do not apply to the plug in modules they are specified for different ambient temperatures Ambient temperatures that exceed these limits could affect the accuracy of these instruments and cause damage to the components and circuits Allow at least 2 inches 5cm clearance around the instruments for proper air circulation Refer to the tables below for a summary of the environmental specifications of the different system combinations Monitor Installation and Patient Saf
60. at any time as the input switch switches the CAL divider to OmmHg and the pressure test signals bypass the sensitivity detection circuit From here the signals are processed in the same way as the patient signals The M1006B Pressure self test may be performed at any time as the signal is output from a microprocessor based controller From here the test signal is processed in the same way as a patient signal testing the complete signal path from the module to the display TEST Press gt Test Signals RESULT If the module is functioning correctly the following systolic and diastolic pressures are displayed without the alarms being activated Systolic 120 mmHg ADULT 60 mmHg PEDI NEO Diastolic 0 mmHg ADULT 0 mmHg PEDI NEO Performing the NBP Module Self Test Performing the SpO Pleth Module Self Test Performing the Cardiac Output Module Self Test Performance Assurance Checks Auto Check The NBP module performs a check periodically during operation Self Test None Auto Check None Self Test The SpOs Pleth module self test may be performed at any time The integral waveform generator in the module produces test signals using the current driver at the beginning of the processing circuitry The test signals are processed in the same way as patient signals are processed The test signals last about 30 seconds and then the display returns to the normal monitoring mode TEST Press gt Test Si
61. begins After the transfer updates continue once per minute until they are manually stopped DAVID SCHULTZ ICU Adult 15 FEB 99 16 45 II HR Non paced mode T J nahn J nA Al d 50 Purse 80 imv spo 97 me PD 18 yc ee ree Eum 2 9p0 2 9b dSp0 2 RESP 20 _ TP1 044 PNIS 165 Monitor content Module content DAVID SCHULTZ BOB JONES 12345678 84847566 Data To Module Press CONFIRM to clear module and transfer all data I oL Lect Dat Transfer All Data to Module 2 Collect New Data Patient demographics plus all data starting at the current time is transferred to the module Clear Yes No Selecting Yes erases any data existing in the module before the transfer begins Clear Yes No Selecting No appends new data to data currently in the module Data Transfer 10 7 Data Transfer Types of Transfer Updates continue once per minute until the transfer is manually stopped o o Co a 10 8 Data Transfer Types of Transfer DAVID SCHULTZ ICU Adult 15 FEB 99 16 48 II HR Non paced mode HR l A JL nA nbn hn 80 rust 80 spo 97 ABP 119 80 96 PAP 25 10 16 a ae Data will be combined and identified under this name in module Module BOB JONES 84847566 Monitor DAVID SCHULTZ 12345678 Press CONFIRM to start the transfer Select Namel Append New Data to the Module Patient not matching DAVID SCHULTZ ICU Ad
62. between when the measurement was obtained and when the data is put into the receiving monitor Data Transfer Data Transfer 10 17 L J o o c Co a Vital Signs Blood Review and Graphs Reports The destination monitor creates the time stamp for transferred data by determining how old each data sample is and subtracting the age of the data from the current monitor time Caution Hemodynamic oxygenation and ventilation calculations result values may show slightly different times before and after being transferred because a different set of valid parameters was used for the calculation at calculation time If there is a time change at the destination monitor for data occurring after the transferred data the T will not be overwritten by a the indicator of time change Although transfers to the module and report printing can occur simultaneously data cannot be transferred to the monitor during the printing of reports If a transfer to the monitor is initiated during printing the printing can be suspended for the duration of the transfer through the Data Transfer Task Window it will continue automatically when the transfer is finished 10 18 Data Transfer Troubleshooting Troubleshooting Caution In a centrally networked system if the previous patient is discharged only at the monitor and a new patient s data is transferred to the monitor the new patient s nam
63. both ends when connecting to the Philips monitoring network SDN 5 Parameter Module Rack Connector this connects the parameter module rack to the monitor 6 Defibrillator sync connector sends an ECG signal out to a defibrillator or other external device or receives a marker pulse from a defibrillator or other external device The marker pulse is processed with the ECG signal and displayed on the monitor Note To filter radiated emissions a core shielding bead Philips P N 9170 1521 must be attached to the defibrillator synchronization cable when a defibrillator is connected to the monitor This filter has no impact on the function of the monitor To attach the core shielding bead a Open the core shielding bead filter b Place the bead around the defib sync cable as close to the jack as possible c Close the bead over the cable and snap shut d Plug the cable into the monitor s defib sync port The bead should be at the monitor end of the cable Monitor Installation and Patient Safety 11 35 Sz ba MA Controls and Connectors aw Of o B Assembling The monitors consist of two individual parts M the V24 and S V26 1 One of two types of Display Modules depending on the particular model monitor you have either a A monochrome display with control panel supporting the V24 or b A color flat panel display with control panel supporting the V24C V24CT V26C and V26CT 2 The Rack with Param
64. e Alarm tones red yellow continuous yellow short e INOP tone Alarm Functions 5 9 o c fa o 5 ra E S lt x o f fo 2 o i 2 ra E ee S lt x Alarm Display Individual Parameter Alarms When you plug in a parameter module and connect the transducer or adapter cable the parameter is automatically switched on ECG RESP and NBP are automatically switched on when you plug in the relevant module Whether the parameter alarms are switched on or off at start up can be selected for each parameter separately in the Configuration Mode The parameter alarms can be switched off individually either in each parameter Adjust Alarms Task Window or in the Alarm Limits Task Window A A symbol appears next to the numeric of any parameter for which the alarms are switched off A parameter without any INOP or alarm capabilities does not show a A If all the alarms have been turned off individually they must be turned on individually There is one exception to this rule when the monitor is set up in Operating Room mode this applies to all ACMSs and V24 and V26 Patient Monitors and others using a Configuration Set with Unit Type OR In this mode all parameter alarms can be switched off with a single key press This enables you for example to quickly switch all alarms off and individually switch on those parameter alarms really needed depending on your monitoring requirements All parameter alarms ca
65. eee SIOTape Siesta eem ee tp bp bs Care and Handling 00 0 0 eee ee Accessories and Ordering Information 0 00 Maintenance General cleaning of the System 0 0 00 e eee eee eee eee General Disinfecting of the System lees Monitor Maintenance sss Inspectthe System everti Oe ERI HORE E RES Perform a Start up Sequence Test of the System Verify the Integrity of the Display 2 0 00 ee ee eee Perform a System Self Test 0 0 0 0 0000 c ee eee eee Performance Assurance Checks 0 0 0 eee eee eee eee Performance Assurance Test 0 0 0 0 cece eee eee eee Functional Testing Procedures 00 0000 eese Performing the ECG Module and ECG RESP Self Test Performing the Invasive 0 0 0 0 cece eee eee eee Contents 9 Pressure Module Self Test 0 00000 ccc RR n 13 16 Performing the NBP Module Self Test 0 0 0 0 cece eee eee eee 13 17 Performing the SpO2 Pleth Module Self Test 00 0 0 00 000005 13 17 Performing the Cardiac Output Module Self Test 0 00 0000 13 17 Performing the tcpO2 tcpCO2 Module Self Test 0 0 00 00 0000 13 18 Performing the CO2 Module Self Test 0 0 0 0 0 0 eee eee eee 13 19 Performing the Temperature Module Self Test 00 0 0 00 00000 13 19 Performing the Blood Analysis Module Self Tes
66. for each graph channel c 7 gt LLI c Z Neonatal Event Review 9 13 Viewing oxyCRG Episodes Viewing oxyCRG Episodes The oxyCRG Episode task window displays a four minute oxyCRG episode for the event currently selected in the Event Review task window It enables you to view the event in context by showing the oxyCRG reading during the Pre and Post Event Time Note Manual Events are only shown with 4 minutes Pre Event Time For further information on the Oxy Cardiorespirography application please consult the Philips Oxy Cardiorespirography Application Note part number 5963 3949L You can access the oxyCRG Episode task window by selecting oxyCRG Episode in the Event Review task window ICU Neo 16 FEB 99 22 36 dE bsc HR Non paced mode 160 Bs ig 16 FEB 99 21 27 95 110 m c 7 gt LLI S o Prey BLE Even Print Recarga zpisoge Episo Review Eglsede EISE The oxyCRG Episode graph is divided up into the following three channels 9 14 Neonatal Event Review Viewing oxyCRG Episodes 1 The btb HR trend channel with a range from 60 up to 220 bpm 2 The SpO trend channel with a range from 60 up to 100 3 The RESP compressed wave channel m c 7 gt LLI el o a Neonatal Event Review 9 15 m c 7 gt LLI S o
67. get the optimum battery life when using the battery power supply Battery e 1or2 lead acid batteries Specifications e 12 Volt e Upto 1 25 hours battery capacity typical on two new fully charged batteries at 25 C depending on modules used in the product Note Charging time is 4 hours to 9096 of full capacity if the monitor is off 16 hours to 9096 of full capacity if the monitor is on f Confirm f J L J L J Y Trends f Module Calc Setp L gt Delayed Record Battery mm Battery AC Charging Charged Power t Note When AC is connected and the monitor is on the Battery Charge LEDs may take some time to cycle to the appropriate charge indication and may underreport battery capacity during this setting period Use the fuel gauge rather than the Battery Charge LEDs during this period to estimate battery capacity or turn the monitor off to accelerate the charge setting time See Chapter 12 Battery Information V24CT and V26CT only for additional information on battery operation and Battery Charge LEDs and indicators The CMS and V24 and V26 Patient Monitors 1 15 xe t N gt o c no o o Rel H o o c L nd o S o Q o N gt Parameter Modules Parameter Modules FE S9 atc gt 0 St O s B oc Te gA E The parameter modules have one or more hardkeys on the front
68. gp i puse 80 imV avr ST1 0 CVP aope uem EODD imv 25 10 16 028 The patient s vital signs are now appearing on the screen The pre configured default settings for the parameters and screen display that were set up at installation or have been stored in the module Parameter Settings Transfer are active If you want to make changes to the screen display see the section Configuring the System If you want to make changes to the parameter settings see the individual parameter sections Switch the system alarms ON by pressing the key so that the Alarm Suspend lamp goes out The patient is now being monitored Screen Two types of messages appear at the top of the display screen Messages e Prompt messages these instruct the user to perform an action e Status messages these give information about the current situation For instance sync output not available plug in ECG module 2 8 Getting Started Reserving a Channel Attaching the Patient this message stays as long as the ECG module is not plugged in Prompt and status messages are displayed either in the appropriate Task Window or at the top of the Main Display screen depending on the operating level On the Main Screen display the prompt and status messages are shown below the alarm and INOP messages Prompt messages appear for 3 seconds Status message are displayed in rotation for 3 seconds each In the Task Window
69. gt LLI c Z 3 Trigger Level Change Note When the patient monitor is connected to the Philips Information Center the Bradycardia threshold line is displayed as a shaded area Neonatal Event Review 9 7 Viewing Neonatal Events Event Time The time at which the event was captured is stored with each event To display the event time move the cursor onto the event you wish to view The event time is displayed immediately in the top right hand corner of the task window Ewnt tmetif 1 Event Time m c 7 gt LLI S o 9 8 Neonatal Event Review Viewing Neonatal Events Event When the cursor is moved onto an event bar specific numerical data for Numerics that event is displayed in the three boxes on the right hand side of the task window The background of one of the three boxes is always highlighted This indicates which one of the parameters triggered the capture of the event Note When an event is captured manually all boxes contain the word Manual and no box is highlighted 73 80 60 85 id Ax eve 39 gt 10 1 B o Evnt num tif 1 This value represents the most severe value during an event 2 This value represents the trigger threshold which was valid at the time that the event was captured The value is defined by an alarm limit or specifically by the user c 7 gt LLI
70. have visual alarms latching and audible alarms non latching You can also configure the alarm reminder function to be on or off Note We recommend that you configure latching alarms for your monitor for Intensive Care use All monitors within a unit should have the same alarm configuration Note Audible alarm indications broadcast over the Philips monitoring network SDN are always treated like visual alarms on the central station or remote systems even if the bedside monitor is configured differently 5 4 Alarm Functions Alarm Display Latching Alarms The alarm continues when the alarm condition is eliminated Latching alarms can be reset by pressing the key Alternatively all latching alarms can be turned off using the Suspend Alarms softkey or the hardkey Latching alarms for individual parameters can be turned off in the Adjust Alarms Task Window or the Alarm Limits Task Window Non latching Alarms These automatically reset when the alarm condition is eliminated INOPs are always non latching Alarm Reminder This only functions with alarms and not INOPs It does not work for arrhythmia alarms It affects the alarm sound lamp nurse call relay and the recorder but not the alarm messages The alarm reminder and reminder time can be configured as follows Alarm Reminder Reminder Time Off Not Applicable On 2 or 3 mins Re alarm 2 or 3 mins If you have acknowledged an alarm by pressing
71. ie a A n ebb Eben a Installation Information 0 0 0 eee eee eee Power Source Requirements 00 00 02 eee Grounding the System 0 0 00 0 02 c eee eee eee Combining Equipment 00 0 0 eee eee Environment 0 cece cece etree eb t hh Condensation esa ceu UU PRODR CIR BARS Contents 8 Explanation of Symbols used 0 000002 esses Maintenance Checks cosins cas 00 eee eee t Patient Cables and Leads 0 0 00 cece eee Controls and Connectors es e 2 0 0 ee eee eee The Front Panel of the M1046A Computer Module The Front Panel of the M1046B Computer Module The Rear Panel of the M1046A B Computer Modules The Rear Panel of the Display Modules 20 The Rear Panel of the M1109A External Alarm Device The Rear Panel of the M1026A Anesthetic Gas Module Assembling the System 0 0 00 0 eee eee eee The V24 and V26 Connectors 0 0 0 0 eee eee eee Assembling the V24 and V26 0 0 e eee ee eee Accessories and Ordering Information 0 00 Battery Information V24CT and V26CT only AC and DC Battery Operation 0 0 00 0 ee eee eee Operating Instructions llle Battery Indicator and Messages 0 eee e eee eee eee eee External Battery Charger lt s eneee cee RR ee tae bes Battery Care and Maintenance 0 0 0 0 cece eee
72. in the connectors of each end to prevent rotation or other strain 5 Flex the patient cable near each end to verify that there are no intermittent faults 13 8 Maintenance Perform a Start up Sequence Test of the System Verify the Integrity of the Display Monitor Maintenance The System automatically starts every time the system is switched ON TEST Turn the System On by pressing the power switch in the lower left hand corner of the display RESULT The system will click and light up the LEDs on the control panel After several seconds the LEDs will go off and the display will start showing waveforms and numerics If the system fails to boot notify your biomedical department or the Philips representative Note the position of the contrast control on the V24 or the brightness control on the V24C V24CT V26C V26CT before starting tests so that they are returned to their previous positions assuming they are correct at the end of the testing procedure 1 2 Set up an ECG signal from a fixed rate simulator on the screen Check the ECG complexes They should be regularly spaced Uneven spacing indicates missing pixels All portions of a simulated ECG waveform should be clear and visible including the P wave and QRS Adjust the contrast control on the V24 or the brightness control on the V24C V24CT V26C V26CT so it is at the maximum setting and then adjust to the minimum setting Check to see if any noise
73. interference is superimposed on the baseline with the ECG simulator attached Baseline interference may be apparent as a thick baseline at high gain settings Apply an external 1 mV pulse The trace should exhibit a leading edge with minimal rounding and a spike or overshoot of less than 10 After 1 second the pulse should have decayed no more than half of its original amplitude Return the contrast control on the V24 or the brightness control on the V24C V24CT V26C V26CT to its previous position assuming it was correct If any problems are identified notify your biomedical department or the Philips representative Maintenance 13 9 S c oO E 5 E Oo Monitor Maintenance Perform a The following lists how to perform the system self test System Self Test 1 Examine all controls for physical condition During the course of this examination ensure that the controls perform their proper function 2 Check that the parameter module LED s light up when first plugged in 3 Confirm that the display lights up and displays a Main Screen 4 Pressthe ECG key on the front of the ECG module in a system that is turned On This brings up the ECG Task Window and verifies that the System board and integral rack are communicating with the plug in module If the ECG module does not respond perform the ECG module Functional self test 5 Ensure correct operation visually and audibly of all alarms using if requi
74. is a Philips HIL connector used to output the information from the keypad and control panel to the Utility CPU function card in the computer module and Patient Safety c 2 T 7 LJ fo c a 7 Equipotential Grounding Terminal this is a grounding stud connector used to connect the system to an equipotential grounding system Monitor Installation and Patient Safety 11 27 c S c T N S td e m and Patient Safety Controls and Connectors Controls of the M1095A Display Connectors of the M1095A Display M1095A Display Module P oS Hes HIE amp mlO95a3c tif Brightness Control Standby Switch Combined Video In Power Connector a male SCSI connector with 25 pin pairs is used to input the video signal and the 60 V dc line voltage Human Interface Link Connector In this is a Philips HIL connector used to connect the handheld keypad Human Interface Link Connector Out this is a Philips HIL connector used to output the information from the keypad and control panel to the Utility CPU function card in the computer module Note The HIL connector cover must be closed when the two HIL connectors are connected 11 28 Monitor Installation and Patient Safety The Rear Panel of the M1109A External Alarm Device Controls and 1 Connectors of
75. is also recorded The recording strip is also annotated with the date time and wedge value ST Recordings of ST waves and their reference waves can be made on the Recordings bedside or central recorders They are initiated from the ST Analysis Task Window An ST recording shows the ST beat s from the cursor spot in the upper channel and the corresponding reference beat s in the lower channel with the measurement values net change and measurement points listed in the annotation ST values transferred by the Philips M1235A Data Transfer Module are indicated by a T after the time Because the ST waveforms are not transferred no waveforms will be recorded 6 18 Recording Functions Procedure Recordings 91MIA 25 mm sec 01 DEC 93 8 35 Ref 01 DEC 8 30 01 DEC 8 35 Change STi 1I 0 2 Il 2 1 2 3 ST2 aVR 0 0 aVR 1 0 1 0 ST3 V 0 0 V 0 5 0 5 Iso 72 ms ST Pt 100 ms Ref Iso 72 ms ST Pt 100 ms IT Bef 1 Recording Functions 6 19 7 E T 5 c gt LL e xe D 5 7 tc Realtime Wave Recordings Realtime Wave Recordings 7 c T 5 c 2 LL e xe LS 5 tc Definitions Realtime Recordings recordings of waveforms from the time of your request There are two types of realtime recordings Preset Record
76. is installed and configured on your monitor CMS only Trends and Calculations 8 11 oe S 2 25 gt S Sg Fo Viewing Patient Data Recording Functions section chapter 6 of this manual for further information Selecting You can select up to 9 parameters to be displayed in the Graph Trends Parameters Task Window by using the On Off Combined softkey The parameters for Graph are placed into the graph channels according to the following rules Trends e Ifthe current parameter is not selected and you press the On Off Combined key the system will try to combine the parameter with any of the selected parameters in one graph channel If this fails a new graph channel will be assigned automatically e Ifthe current parameter is combined with any other parameter in a graph channel and you press the On Off Combined key the system will try to assign this parameter to a new graph channel If this fails the parameter will be unselected e Ifthe current parameter is selected and is the only parameter in one graph channel pressing the On Off Combined key will unselect this parameter from Graph Trends oe og 25 E f E FO In the Vitals Signs Task Window parameters that are selected for Graph Trends are displayed with a sign to the right of the parameter label Parameter is combined A sign appears next to the parameter label Parameter is on A hyphen appears next to the parameter labe
77. it must be in the monitor mode Setting up your Monitor 3 55 Changing Operating Modes Monitor Setup Operatng Modes DAVID SCHULTZ ICU Adult 15 FEB 99 17 32 II HR Non paced mode pA Ld e gp fuse B0 imv spo 97 one poe HAS ues OC MO a e d Spo 2 95 dSp0 2 Operating Mode Monitoring Far authorized persons only Enter password Change 1 a E A E OpMode A 2 o 2 ax 22 gt 5 E o Returning to To exit Config Demo or Service Mode press Monitor Setup Monitoring Resume Monitor This will return you to Monitoring Mode without Mode having to enter a password It is also possible to exit demo mode by powering down and restarting the monitor 3 56 Setting up your Monitor Changing Operating Modes Procedure Enterthe password by pressing the appropriate combination of softkeys which are numbered 1 5 If you enter the password correctly you can proceed with the next step If not exit the Task Window by pressing and try again 2 Pressthe softkey Change Opmode Move the highlighting to the mode you require 3 The prompt message Press CONFIRM to switch to selected mode appears Press the hardkey The instrument goes through the boot up sequence and reverts automatically to default settings and the mode of your choice becomes active Note If you have entered either Config Service or Demo Mode successfully it is possible to return to Monit
78. layout cannot be chosen Time annotation is at the beginning of printout Makes delayed recordings of any waveforms you select Runtime and delay time are configured when the monitor is installed You can choose layout and speed Annotation is along the top edge Recording Functions 6 5 7 c T 5 c 2 LL e xe LS 5 tc General Recorder Information Central e Makes delayed recordings of waveforms broadcast over the Recorder 1 2 Philips patient care system These are waveforms viewed at the or 4 channel central station and other monitors in overview mode recorder Single channel recorder records only the primary wave If ECG is monitored it must be selected as the primary wave It cannot be deselected Dual channel recorder records the primary and secondary wave if the central station supports 2 channel strips See the central recorder operating guide for recording speed runtime and delay time 6 6 Recording Functions Types of Recordings Types of Recordings The monitor produces several different types of recordings Alarm recordings are generated automatically by the monitor when clinical criteria are violated In addition you can make the following types of strip chart recordings from the monitor e Delayed e Monitoring Procedure e Realtime Waves Realtime recordings can either be made from a pre selected set of waves or selected when the recording is initiat
79. may be performed at any time TEST Turn on the system power and plug in the recorder module RESULT The LED on the front panel indicates whether the module has passed the self test by flashing LED flashes twice module has passed check LED flashes once module failed self test Take the module out and try the procedure again to make sure there is a good connection LED does not flash module processors are not working properly and the module should be replaced The data management database is tested during system start up with an SRAM checksum procedure If there is an error found in the SRAM checksum the system will restart cold start and all patient data will be lost Tests for VueLink Module and Anesthetic Gas Module Performance Assurance Checks There are no Self Tests for the M1032A Vuelink Module and the M1026A Anesthetic Gas Module The M1032A Vuelink Module performs automatic checks periodically during operation The M1026A Anesthetic Gas Module performs a 2 minute check automatically when the system is switched on S c oO E 7 E oO Maintenance 13 21 Performance Assurance Checks o o c c o 2 13 22 Maintenance Index of Volume 1 A AC 1 14 operating instructions 12 3 accessories tcpO2 tcpCO2 6 48 Adjusting 2 7 contrast 2 7 volume control 3 35 Admit 7 2 general information 7 1 Alarm functions 5 8 alarm limits review ofl 5 18 alarm remi
80. not apply a voltage of more than 12V to any of the pins on the defibrillator sync parameter module rack Philips monitoring network SDN or equipotential ground connectors The secondary ground complies with IEC 601 1 1 as shown on page 10 4 The connectors on the monitor are 1 AC Power Connector this connector is used to connect the monitor to an AC power source Note If you have a Philips M1026A Anesthetic Gas Module AGM do not daisy chain the AC power through the AGM This configuration may degrade RFI performance 2 Secondary Ground Screw this is a posidrive screw to connect the monitor chassis to earth ground per IEC 601 1 1 standard 3 Equipotential Ground Post this connects the monitor to the equipotential ground system 11 34 Monitor Installation and Patient Safety Controls and Connectors 4 Philips monitoring network connector SDN Interface this is a proprietary Philips system connector used to input output information to a Philips monitoring network and Patient Safety c 2 5 s T sS D LI fa a Warning 0 0 Connecting the Philips monitoring network SDN cable when the product is powered on is not supported Error codes and Philips monitoring network SDN interface lock up may occur Power cycling the product will recover the product No permanent damage will result To prevent unintentional disruption in monitoring be sure the SDN interface cable is properly secured at
81. not use the system for any monitoring procedure on a patient if you identify features which demonstrate impaired functioning of the instrument Contact the hospital biomedical engineer or the Philips Service Engineer Maintenance Frequency Source of Information Full performance checks including safety checks At least every two years after any repairs or as needed See Testing and Maintaining the CMS in the CMS Service Guide or Testing and Maintaining the V24 and V26 in the V24 and V26 Service Guide Synchronization of the monitor and defibrillator Preventive maintenance If defibrillator is used or configured for intended use at least once a year after any repairs or as needed Perform the NBP and Sidestream CO 2 Module Performance test blocks every year Perform the Preventive Maintenance Procedure for the M1180A A01 A02 Wall Mount Assembly every year See the Philips M1722 3 4A Codemaster XL XL XE Defibrillator Service Guide See Testing and Maintaining the CMS in the CMS Service Guide or Testing and Maintaining the V24 and V26 in the V24 and V26 Service Guide 11 14 Monitor Installation and Patient Safety Maintenance Checks Maintenance Frequency Source of Information Electrical Safety Tests At least every two years after system installation after any repairs or as needed See Testing and Maintaini
82. o r 2 LL E A s lt Alarm Setup 5 16 Alarm Functions o c fa o 5 ra E A S lt x 6 Recording Functions This chapter contains information on the recordings that can be made using the patient monitors and the recorders which can produce them It includes the following sections General Recorder Information Lus 6 2 Types of Recordings 0 0 cece eee eee ee 6 7 Delayed Recording 2 0 0 cece eee eee 6 8 Alarm Recording 00 0 c eee ee eee eee 6 12 Procedure Recordings 00 00 eee eee eee 6 16 Realtime Wave Recordings sees 6 20 Realtime Vital Signs Blood Recordings 6 25 Trended Vital Signs Recordings 6 29 Neonatal Event Review Recordings 6 33 oxyCRG Recordings 00 cece eee eee eee 6 36 Additional Information 02 0 000s 6 39 Recording Status Messages 02 2 0000e 6 46 Accessories and Ordering Information 6 48 Loading Paper 00 cece cece eee eens 6 49 Recording Functions 6 1 General Recorder Information General Recorder Information 7 c T 5 c 2 LL e xe LS 5 tc Recorders The following recorders are available for use with the patient monitors Recorder Model Number Plug In MI116A B 4 Channel Bedside M1117A CMS only 2 Channel Bedside 78574
83. of parameters tracked the frequency of measurement capture and the number of hours of database storage are determined in configuration mode prior to monitor use The combinations are Standard Database No of Parameters Resolution Size 16 minute 24 hours 16 12 seconds 4 hours Trends and Calculations 8 3 Viewing Patient Data Extended Database CMS only No of Parameters Resolution Size 16 12 seconds 9 hours 16 minute 48 hours 32 12 seconds 4 hours 32 minute 24 hours If data is stored every minute the values displayed are the stored averaged values of samples taken every 12 seconds for a one minute interval 5 samples per minute If data is stored every 12 seconds the values displayed are the exact values taken at one of the 12 second intervals For example if the database has been configured for 4 hours typical of the OR the data values appear at 12 second intervals In this case the values are exactly as measured not averaged oe og 25 E f E FO An asterisk on the trend or graph indicates 1 a manually entered value 2 a resampled continuously monitored value from the last second or 3 a value more than 10 minutes old at the time of resampling Note When the time in the upper right corner of the Graph Trends Task Window matches the system time time bar at rightmost position on trend the screen will be updated as new data is acquire
84. open or out of paper any alarm recordings will be run or queued at the central station recorder if there is one Otherwise alarm recordings will be lost during the time the Plug In recorder is disabled and an alerting 6 52 Recording Functions Loading Paper into the Four Channel M1117A Recorder CMS only Loading Paper message no alarm recording available will be displayed periodically on the monitor screen 7 E S 5 c gt LL e xe D 5 tc Directions for loading paper into the four channel recorder are given on this page and the next Before starting to load the paper check to see that the power is on Caution To avoid damage to the instrument Make sure hands are clean before loading paper Use only the approved paper Philips order part number 40469A Step 1 Open the door by placing fingertips in the recessed groove and pulling forward Use the Feed key to advance any remaining sheets and paper scraps Recording Functions 6 53 N c 5 i5 c gt IL Le c o LS o tc Loading Paper Step 2 Unfold the first one or two sheets Then place the paper pack in the compartment with the black squares on the left hand side facing up as shown Note No more than one sheet should be left hanging outside of the unit Tear off extra sheets if necessary 6 54 Recording Functions Loading Paper Step 3 Cl
85. or off or set up parameters Keys 1 12 The CMS and V24 and V26 Patient Monitors Introduction The arrow keys consist of up down eft right keys They only function when illuminated The arrow keys allow you to move between areas on operating screens to enable you to change or adjust settings perform procedures or make changes to the screen display Key This key functions only when it is illuminated A prompt message press CONFIRM appears on the screen when you need to use it Airway Gases Ventilation CMS only Press to view airway gases or ventilator waves and numerics The CMS and V24 and V26 Patient Monitors 1 13 xe N gt ne no o o Rel H o o c o 5 o Q o N gt ne q N gt o c on o o T o o c c 5 o oO o N gt V26CT V24CT Power Supply V26CT V24CT Power Supply Battery Power Supply The V24CT and V26CT are powered by an external AC line power or by their own internal battery power supply Your monitoring needs will determine which power source is used We recommend that you plug the monitor into line or AC power whenever the monitor is not being moved or used or for long term bedside monitoring When transporting a patient or when monitoring in a remote area where AC power is not feasible use battery power Warning 00 Do not disconnect th
86. ovs Uer eR ae Shee pede dete deg epe eter eene 6 7 Delayed Recording coc pessier i n ee ee men eus 6 8 Defimtions oe Oe Ue ree SS Ee SEI I e i rere 6 8 Configuring Delayed Recordings 0 0 cece cence eee 6 9 Making Delayed Recordings 0 0 cece ce eens 6 11 Alarm Recording to sug thas pese prep Lupbsr cel Ga ER 6 12 Configuring Alarm Recordings 0 2 0 0 eee eh 6 13 Alarm Recording Priorities ois eisa aaa cee eee enn eee 6 14 Procedure Recordings llle bete eI REIHEN eee cared 6 16 Configuring Procedure Recordings 0 0 2c eee cence 6 16 Making Procedure Recordings 0 0 00 cece ccc eee eee nee 6 17 ST Recordings sacs os seid es I hogs EIE a ORO Soa WE Aaa x D A RU RR REIR 6 18 Realtime Wave Recordings 0 0 0 00 cece e 6 20 Definitions ene ew eae CU hes La eee ps e e RES 6 20 Configuring Preset Recording Modes 0 0c eee eee 6 21 Making Preset Recordings ws csc ek baa Rr x e Rp ed eels hada RE 6 22 Making Non Preset Recordings 6 22 Making Calibrated ECG Recordings 0 0 eee eee 6 23 If the Recorder is BUSy c oen reb Ihre mee eee tb e Sa a 6 23 Realtime Vital Signs Blood Recordings 0 0 0 cece cee eee 6 25 Definitions le a e ea A a RIS ee basing dagen eee Pet 6 25 Making a Single Vital Signs Blood Recording 0 00 eee eee eee ee 6 27 Making Timed Sequences of Vital Signs Blood Recordings less esses 6 27 Trended Vita
87. the Anesthetic Gas Module An electrical input for example video input and 60V dc This symbol is also used for the gas input to the Anesthetic Gas Module Equipotential grounding system o Data out Data in o RS232 input Fuse Off Standby Q On 11 12 Monitor Installation and Patient Safety Installation Information Switch position is on off Contrast Alternating current Protective earth Contains parts to be recycled amp dus Contains parts which may not be put into the normal waste disposal but must be recycled or dealt with as chemical waste Bi Altitude or atmospheric pressure Q Temperature 7 AAA Humidity 1999 07 This symbol identifies the date of manufacture The date format is Year Month e g 1999 07 Monitor Installation and Patient Safety 11 13 c 2 s T a LI fa a and Patient Safety Maintenance Checks Maintenance Checks and Patient Safety c o9 5 s T a td fa a z Before commencing monitoring on a patient carry out the following checks on the system e Check for any mechanical damage e Check all the external leads plug ins and accessories e Check all the functions of the instrument which will be needed to monitor the patient and ensure that the instrument is in good working order Do
88. the M1109A 2 External Alarm Device Controls and Connectors M1109A External Alarm Device and Patient Safety c 2 5 s T a LI fa a Standby Switch Human Interface Link Connector Out this is a Philips HIL connector used to output the information from the handheld keypad to the Utility CPU function card in the computer module Human Interface Link Connector In this is a Philips HIL connector used to connect the handheld keypad Power on off cable this connects to the XGA Display Controller Board C DSPC XGA in the M1046B Computer Module Notes The connector cover must be put back on after all cables have been connected The External Alarm Device should be mounted for maximum visibility of the alarm indicators on the front The device should not be mounted directly against a wall in order to ensure that the alarm Monitor Installation and Patient Safety 11 29 Sz Bee Controls and Connectors awn Oe Q s T loudspeaker is not covered and can be heard The most suitable i location for the External Alarm Device is in close proximity to the oc ITE display Ss 0 The Rear The connections on the rear panel of the Anesthetic Gas Module are Panel of the shown in the following diagram M1026A Anesthetic Gas Module e e e SOOVA max
89. the display if your monitor is configured not to receive silenced alarms the Alarm Bed Task Window is removed from the display An arrow next to the bed label in the Task Window means that there are one or more other beds in the Other Patients group with an unacknowledged alarm See next page Multiple Incoming Alarms If there are one or more beds with unacknowledged alarms superseded by an actual displayed alarm there is an arrow in front of the bed label The unacknowledged alarms are stacked and the beds are viewed in sequence as the alarms arrived If alarms arrive simultaneously they are viewed with the lowest bed number first Each bed in alarm is automatically displayed for 5 seconds When all the alarm beds have been displayed the last bed stays on the display and the softkeys and become active When you have viewed the primary wave for that patient you can press the softkey Show Next Wave to view the next waveform for that patient An arrow next to the bed number signifies that there are one or more beds with unacknowledged alarms in the Other Patients group Press the softkey Clear Alarm Bed This e Acknowledges the alarm of the bed in your own Other Patients Task Window and automatically displays the next alarm bed from the alarm stack Other Patients e If there is no arrow next to the bed number it automatically takes you out of the automatic alarm display Note When an alarm has been acknowled
90. the equipment or accessories contact your biomedical engineering department or the Philips Service Engineer and Patient Safety c E c T 7 S td e m 11 4 Monitor Installation and Patient Safety Installation Information Power Source Require ments Grounding the System Installation Information and Patient Safety c 2 s T J a S LI fa a The CMS systems and the Anesthetic Gas Module can be operated from an AC source of 100 120V 10 or 220 240V 10 50 60Hz Typical input currents for the monochrome and color systems are Monochrome CRT 100 120V 2 2 amps 200 240V 1 2 amps Color CRT 100 120V 2 6 amps 200 240V 1 4 amps Color Flatscreen 110 120V 2 0 amps 200 240V 1 0 amps Typical input current for the Anesthetic Gas Module is 100 240V 1 0 amps Typical input current for the V24 and V26 is 90 250V 150VA To protect the patient and hospital personnel the cabinet of the installed equipment has to be grounded The equipment is supplied with a detachable 3 wire cable which grounds the instrument to the power line ground protective earth when plugged into an appropriate 3 wire receptacle If a 3 wire receptacle is not available consult the hospital electrician Warning Do not use a 3 wire to 2 wire adapter Monitor Installation and Patient Safety 11 5 Installation Information If the computer
91. touchscreen display arrow buttons will appear above and below the date and time fields These can be selected to adjust the date and time instead of pressing the arrow keys ICU Adult 31 JAN 00 8 07 HHR Non paced mode 80 ABP PAP ETCO T2 Day Month Minute 3l JAN i 07 Adjust the Date and Time Press CONFIRM to validate A 2 9 2 ax 22 gt 5 Cc c2 o 3 38 Setting up your Monitor Selecting Waves for Central Recorders Selecting Waves for Central Recorders You can select two waves to be used for delayed alarm recordings at a Philips patient care system central recorder The waves you select can also be displayed at the central station With a single channel recorder you can record the primary wave or with a dual channel recorder you can record the primary and secondary waves The primary wave defines which wave is the default wave at the central station and at other bedsides in the overview screen When ECG is available it must be selected as the primary wave it cannot be deselected The procedures for configuring delayed recordings are described in the section Recording Functions hee 2 e gt ax 22 gt 5 E 72 Setting up your Monitor 3 39 Configuring Module Bedside and Central Recordings Configuring Module Bedside and Central Recordings Note Recordings on a 4 channel bedside recorder are only possib
92. will be referred to as the CMS the ACMS and the NCMS The CMS and V24 and V26 Patient Monitors 1 5 xe N gt ne no o o Rel H V26 Patient Monitors Introduction Display Below are labeled diagrams of the display modules provided by Philips Modules Medical Systems The control panel is described in more detail in the following sections ze 5g dE gt 0 o St O s B oc Te gA E Control panel M1092A M1094B CRT Display Module 1 6 The CMS and V24 and V26 Patient Monitors Introduction V24 and V26 Each V24 and V26 Patient Monitor consists of two individual parts Patient Monitor 1 One of two types of Display Modules depending on the particular model monitor you have purchased either a A monochrome display with control panel supporting the V24 Or b Acolor flat panel display with control panel supporting the V24C the V24CT the V26C and the V26CT 2 The Rack with Parameter Modules The V24 V24C and V26C are powered by connection to an AC power supply The V24CT and V26CT can be powered by rechargeable batteries or by connection to an AC power supply See V26CT V24CT Power Supply on page 1 14 The CMS and V24 and V26 Patient Monitors 1 7 xe N gt ne on o o Rel H V26 Patient Monitors ne q N gt o c on o o T o b
93. 0 to 95 0 to 145 In general use the Adult or Pediatric category if rates below 50 rpm are expected use Neonatal if expected rate is above 100 Pressure The algorithm responsible for respiration artifact suppression is used in all three patient categories for the 10 and 30 scales In the Pediatric and Adult categories the algorithm is also used for the 60 scale SpOs Default for averaging time is 10 seconds for Adult Pedi and Neo Note Default can be changed in Configuration Mode Setting up your Monitor 3 51 A 2 9 2 ax 22 gt 5 Cc c2 o Changing the Patient Category 3 52 CO Adult Pedi Neo AWRR High Range 10 to 100 rpm 30 to 150 rpm AWRR Low Range 0 to 95 rpm 0 to 145 rpm Delay before alarm sounds 20s 20s Note The Apnea alarm delay time cannot be changed Setting up your Monitor Changing the Configuration Set Changing the Configuration Set If you want to change the application of your system for example from Configuration Set 1 adult to Configuration Set 3 neonatal you can do this in monitoring mode by getting into the Monitor Setup setup This procedure will not modify a Configuration Set but will change completely from one Configuration Set to another Note Changing the Configuration Set causes all the monitor s settings to revert automatically to user default settings All patient data is lost Monitor Setup Adult Pedi Ne
94. 100 JW d8p0 0 HR Brady Event settings SpO0 Desaturation Event settings Trigger Mode Brady Alarm Trigger Mode DesatAl XxX Trig Threshold 80 bpm Trig Threshold 80 7 Trigger Time EN sec Trigger Time 20 sec RESP Apnea Event settings Trigger Mode Apnea Alarm Trigger Time 20 sec SEETHE Change Event teem content Review Note An event is only triggered if c 7 gt LLI S o The parameter is switched on The parameter alarms are switched on There are no INOPs The main alarms are switched on 9 18 Neonatal Event Review Event Criteria Apnea Event Settings Adjusting Neonatal Event Review Settings The Event Setup task window enables you to adjust the following items Trigger Mode The trigger mode determines whether an event is triggered by a physiological alarm or by criteria defined specifically by the user Trig Threshold The trigger threshold can be adjusted if the user defined trigger mode setting has been selected Trigger Time The trigger time can be adjusted if the user defined trigger mode setting has been selected The event type Apnea Bradycardia Desaturation determines how a specific event is triggered and stored on the monitor Apnea events are always triggered by a Red Apnea alarm The Apnea alarm is derived from the RESP parameter and occurs whenever breathing ceases for a period exceeding the defined Apnea alarm limi
95. 61 parameters on of 3 33 recordings 3 40 screen display 3 3 screen display selection 3 5 screen display wave overlap 3 14 screen display waveform speeds 3 15 screen display waveforms 3 8 status log function 3 42 test signals function 3 58 the display 3 6 volume control 3 35 what you can configure 3 2 Continuous Pressure 3 A7 Control panel arrow keys 1 13 Confirm key 1 13 hard keys 1 8 softkeys 1 8 D Data Transfer Combining patient records 10 14 Data priorities 10 6 Data that is not transferred 10 5 Data that is transferred 10 5 Database Conversion 10 14 Module description 10 2 Time Conversion 10 14 Time stamps in vital signs and graphs 10 17 Transfers between operating modes 10 6 Types of transfer 10 7 with central monitors 10 19 with Monitor Standby 10 6 Default settings changing 3 44 Delayed Recordings configuring 6 9 6 10 delay time 6 8 making 6 11 runtime 6 8 Discharge drug values 8 32 general information 7 1 Discharging a patient 7 9 Display Screen 1 8 Drug Calculator 8 32 DTM parameter Performance Specifications 10 20 E Editing patient information 7 5 End Case general information 7 1 Ending a Case 7 9 Events marking 8 16 Reviewing 8 16 External battery charger 12 8 G Getting Started attaching the patient 2 6 monitor standby 2 10 parameter modules setting up 2 5 patient information center 2 10 power failure 2 10 reserving a channel
96. 7 PvR ABP 119 80 96 Uelayed Ala Record g Channel 91 btbHR Speed 2 cm min Channel 2 Spo Recorder PLUG IN 3 ch Channel 3 RESP Overlap OXyCRG AlRec Typ OxyCRG Standard Channel and Speed must be changed in oxyCRG Select Assign Change Change Select Change Channel Wave Speed Recorder Overlap RESTYB Pressing the Change AlRecTyp softkey allows you to choose between Standard alarm recording or oxyCRG alarm recording If you select oxyCRG an oxyCRG recording is started when an alarm occurs Six minutes of pre alarm data and two minutes of post alarm data are recorded Any manually initiated recording that is in progress will be interrupted and the oxyCRG recorded instead If a second alarm occurs while an oxyCRG alarm recording is already in progress the recording will be extended to two minutes after the second alarm appears on the strip If you select Standard your selected realtime waves are recorded when an alarm occurs as described earlier in this chapter 6 38 Recording Functions Additional Information Additional Information Annotations Delayed and realtime recordings are annotated with codes which identify The type of recording The monitor operating mode The application area The type of patient The delay time Um ON 7 E T 5 c gt Le e xe D 5 tc The following table shows the annotation codes
97. 7 30 WES oi oo Use the Left and right arrow keys to move vertical time bar Next Select zoom in 400m Out Change Print Greup Graph Time Time Seala Graphs The numbers at the right of the graph indicate the time and parameter numeric values associated with the position of the time bar Trends and Calculations 8 13 oe S 2 25 gt c Sg m Viewing Patient Data The values plotted are the stored averaged values of readings taken every 12 seconds for a one minute interval Invalid data such as a noisy ECG is not plotted on the graph Instead a gap will appear in the graph If you have configured your monitor for the OR up to 4 hours of data at 12 second time intervals is available In this case the values are the stored values for each 12 second reading Up to three graph channels are presented on the screen at once The graph will be blank when a listed parameter is not being monitored Up to five pre configured screens can be displayed using the Next Group softkey The Change Scale softkey allows you to adjust the scaling of the y axis of all graph channels at once To change the scaling of individual graph channels press the Select Graph softkey prior to Change Scale When using a touchscreen select the label of the graph channel instead of pressing select graph The report started with the Print Graphs softkey wi
98. A CMS only a Only the M1116B can be used with the Philips Information Center The Plug In recorder has 2 channels and can also be used at a central location The 4 channel thermal recorder can also be used at a central location The Philips central recorder records the waves you select for transmission over the Philips patient care system This document provides configuration information for the Plug In 4 channel and central recorders The controls and indicators on the Plug In and 4 channel are also described For information about the 2 channel bedside and the central recorder controls please refer to the relevant operating guide 6 2 Recording Functions General Recorder Information Controls and Indicators r on the Plug REC M1116B In Recorder 7 E T 5 c gt LL e Ke A 5 tc f n V D a Continue light Flashes if the currently printing recording is continuous b RUN CONT key Starts a timed delayed recording and or makes a currently printing recording continuous if possible c STOP key Stops the currently printing recording Recording Functions 6 3 General Recorder Information 7 c T 5 c 2 LL e Ke A 5 tc Controls and Indicators on the 4 im Channel E
99. AE PACKARD miza R Recorder 2 La CMS only h L e g f h a j a Power On Off key Switches recorder power on in and off out b Out of paper light Lights when paper is out or recorder door is open c TEST key Initiates a self test to check that the recorder is working properly and prints a test strip d Speed selection Lights to indicate current speed setting lights e Speed selection keys Selects another printing speed while the recorder is running f Feed key Advances paper until key is released g Continue light Lights when the currently printing recording has been made continuous 6 4 Recording Functions Recorder Capabilities Plug In Recorder M1116A B 4 Channel Recorder M1117A CMS only h Cont key Makes currently printing recording i Stop key Stops the currently printing recording General Recorder Information continuous if possible 7 E S 5 c gt LL e Ke A 5 tc Can record up to 3 waveforms if 2 waveforms are overlapped Makes delayed recordings of any waveforms you select Makes realtime vital signs recordings Makes realtime blood measurement recordings Makes trended vital signs recordings Makes neonatal event review recordings M1116B Makes oxyCRG recordings M1116B Runtime and delay time are configured when the monitor is installed You can choose layout and speed except for vital signs recordings With oxyCRG recordings
100. Agent AGT 6 25 S PRESS 3 CVP 25 AG 05 D 6 25 b PRESS 4 P4 25 EEG CH1 EEG 25 Q PRESS 5 P5 i 25 EEG CH2 EEG2 25 o PRESS 6 P fub VueLnk A 25 PLETH PLETH 25 VueLnk B 25 PLETH2 PLETH2 25 VueLnk B 25 C0 CO 6 25 A NEED p 50 Next Select ELEME Global Display Page Parametr SES Speed Setup Procedure To select different speeds for the waveforms 1 Press the softkey Select Parameter repeatedly to select a parameter to which you want to assign a different speed 2 Press Select Speed repeatedly to select the speed you require 3 Repeat steps 1 and 2 for each parameter speed you want to change Setting up your Monitor 3 15 Selecting Realtime Wave Speeds Press the softkey Display Setup to return to the Display Setup Window press to return to the Selection Window or to return to the Main Screen To select the same speed for all the waveforms 1 Press Global Speed repeatedly to select the speed you require 2 Press the softkey Display Setup to return to the Realtime Waves Task Window press to return to the Selection window or to return to the Main Screen Note e The speed of the Resp or COs waves and of the AG waves must always be set individually You cannot alter their speeds by pressing Global Speed e If waves overlap all the waves travel at the speed of the wave in the first overlapping channel If the overlap is then changed to non overlapping waves each wave travels at its
101. B 6 5 Recording Functions 6 1 9 1 annotations 6 39 configuring alarm recordings 6 13 Configuring delayed recordings 6 9 Configuring Monitoring Procedure 6 16 configuring realtime recording modes 6 21 continuing a timed recording 6 43 controls and functions on the M1116A Plug In Recorder 6 3 defining realtime recordings 6 20 extending a recording 6 42 inserting a calibration signal 6 44 loading paper 6 49 making calibrated ECG recordings 6 23 making delayed recordings 6 11 making non preset recordings 6 22 making procedure recordings 6 17 making realtime configured recordings 6 22 messages 6 46 queueing recordings 6 23 recording strip layouts 6 44 using a Patient Information Center 6 23 Recording Types Alarm 6 12 Delayed 6 8 oxyCRG 6 36 Procedure 6 16 realtime 6 20 ST segment 6 18 Vital Signs 6 39 Reports events 8 16 general information 8 26 Scheduled 8 26 through Task Windows 8 26 troubleshooting 8 30 S Scheduled reports Patient Data 8 26 Screen display changing 3 2 configuring 3 3 configuring position of waveforms 3 8 contrast 2 7 selecting a 3 5 Service manuals 13 11 Split Screen Trend 3 5 ST Segment recordings 6 18 Standby 2 10 T tcpOZ tcpCO2 accessories 6 48 Trending Priority 8 5 Trends 8 1 general information 8 1 graphs tables 8 3 Trending Priority 8 5 Trends Calcs Calculations 8 20 Calibration Mark 8 17 Drug Calculator 8 32 Events 8
102. Cs PACER NOT CAPT PACER NOT PACE No QRS for 1 75 x the average R R interval with Pace Pulse paced patient only No QRS and Pace Pulse for 1 75 x the average R R interval paced patient only PAUSE No beat detected for 1 75 x average R R interval for HR lt 120 or no beat for 1 second with HR gt 120 SVT Run of SVPBs gt SVT Run limit and with SVT Heart Rate greater than the SVT HR limit Other Patients 4 13 Other Patients o E c o 2 Q o t o Using Philips Patient Care System with an Arrhythmia Computer Message Minimum Condition Requiring an Alarm R ON T PVCs For HR 100 a PVC with R R interval 1 8 the average interval followed by a compensatory pause of 1 25 x average R R interval or 2 such Vs without a compensatory pause occurring within 5 min of each other When HR gt 100 1 3 R R interval is too short for detection VENT BIGEMINY A dominant rhythm of N V N V N supraventricular beat V ventricular beat VENT TRIGEMINY A dominant rhythm of N N V N N V N supraventricular beat V ventricular beat PVCs gt xxx MIN PVCs within one minute exceeded the PVCs min limit xxx MULTIFORM PVCs The occurrence of two differently shaped Vs each occurring at least twice within the last 300 beats as well as each occurring at least once within the last 60 beats HR yyy gt
103. Gas Module Caution If the Anesthetic Gas Module has been stored at sub zero temperatures it must be left to warm up for a minimum of 4 hours at room temperature before any connection is made to it The Anesthetic Gas Module connects to the ACMS over an RS232 cable to the Computer Module When the system has reached the end of its useful life it should be disposed of in accordance with local regulations for disposal of electronic equipment Plastic parts the housing for the display modules and computer module and sheet metal parts the rear top and bottom of the computer module can be recycled Note The FIO module M1017A and the Blood Analysis Module M1022A contain a Nickel Cadmium battery to be disposed of in accordance with local requirements Monitor Installation and Patient Safety 11 33 c 2 s T a L fa ra a and Patient Safety c o9 5 s T a E LI fa a and Patient Safety Controls and Connectors The V24 and The monitor has several connectors which are shown below V26 AS Connectors p S SMS SS DEFIB SOS SS CONNECTOR I S LS S NS S RACK amp SS CONNECTOR 7 WV RS232 CONNECTOR Rear Housing with Serial Prefix 3608 PROTECTIVE vemm EQUIPOTENTIAL GROUNDING EARTH GROUND S PHILIPS MONITORING NETWORK SDN SINGLE CONNECTOR RS232 CONNECTOR Rear Housing with Serial Prefix 23608 Do
104. If the Desaturation event trigger is switched to OFF the oxygen saturation is still displayed in the oxyCRG Episode task window but the Desaturation events are not captured or displayed in the Event Review task window 24 for V24 and V26 Patient Monitors In the Event Setup task window you can c 7 gt LLI c Z 1 Select items 2 Change the item content Selecting the Select Item softkey enables you to step through the items listed under each event group Neonatal Event Review 9 21 Adjusting Neonatal Event Review Settings Changing Item Selecting the Change Content softkey enables you to change the Contents contents of an item m c 7 gt LLI S o 9 22 Neonatal Event Review 10 Data Transfer This chapter describes the Philips M1235A Data Transfer module It includes the following sections Data Transfer Module 02 0 esses 10 2 Types of Transfer rs crasecrecciseserieicis irese 10 7 Combining Data 0 cece eee ee 10 14 Vital Signs Blood Review and Graphs 10 17 Troubleshooting 00 c eee eee eee eee 10 19 Performance Specifications 10 20 Data Transfer 10 1 o o c e G a Data Transfer Module Data Transfer Module 10 2 Data Transfer The Philips M1235A Data Transfer module allows for rapid convenient and easy transfer of patient data
105. M1278A and Patient Safety c 2 s T 0 LI fa a Six Slot Satellite Rack Eight Slot Satellite Rack Four Meter Satellite Rack Cable 0 91 m 3 ft Local Distribution Cable 1 8 m 6 ft Local Distribution Cable 3 0 m 10 ft Local Distribution Cable 6 1 m 20 ft Local Distribution Cable Defibrillator Sync Cable 12 Volt Lead Acid Batteries Battery Charger Check the parameter module sections of this manual for specific parameter module accessories Monitor Installation and Patient Safety 11 37 Accessories and Ordering Information and Patient Safety S S T N S td e m 11 38 Monitor Installation and Patient Safety 12 Battery Information V24CT and V26CT only The V24CT and V26CT can be operated on AC line or DC battery power This chapter provides information on battery power It includes the following sections AC and DC Battery Operation 12 2 Battery Indicator and Messages 12 6 External Battery Charger 000005 12 8 Battery Care and Maintenance ss 12 9 Accessories and Ordering Information 12 11 Battery Information V24CT and V26CT only 12 1 AC and DC Battery Operation AC and DC Battery Operation You should only use Philips 40488A 12 Volt sealed lead acid batteries obtained from Philips Medical Systems for use with the Philips M1205A V24CT
106. Operation Touch Touch responsive objects and areas of the screen include Responsive Objects e Numerics and Waves When a numeric or wave is selected the respective parameter setup window opens up Alarms INOP messages Selecting an Alarm or INOP Message opens the alarm messages window Task Windows Selection Windows All softkeys displayed in Task Windows and Selection Windows are touch responsive When a Task Window Selection Window is open a selection of any area outside this window except the Silence Reset and Suspend keys will close the task window Selecting the black x in the corner of the Task Window label also closes the Window Closing a Task Window returns you to the Main Screen Items Selections All Items and all Selections within Task Windows can be directly selected by touch or mouse click without the Select Item softkey or the arrow keys Arrow Keys Depending on the application buttons are provided to perform the task of the arrow keys Confirm Button A confirm button is displayed in the lower right corner of the task window every time a confirm is required Application Windows Split Screen oxyCRG and CSA Display contain touch responsive areas which lead to the respective task windows Please refer to Chapter 3 of this manual for further details Application specific buttons Touch Mouse Trackball Operation has special implications for the Vital Signs Graph Trends and Calculation Task Windows see
107. Pediatric if the duration is less than 50 ms Weak signal The signal may be weak due to the patient s constitution the electrode placement or other factors A 1 mV calibration bar at the left side of the ECG channel enables you to estimate the quality of the signal Recommendation e Use the strongest signal on channel 1 and compare the QRS amplitude with the 1 mV bar the height should be at least half of that size If not change the lead or try a different electrode placement Paced Patients Paced pulse rejection is available for patient categories Recommendations e Derive the cardiac rate from pulse o e Look for a lead on channel 1 where the pace pulse amplitude is zero to avoid paced pulses being counted as beats LI gt gt Q gt 22 c p o e Whenever acceptable use the Adult category 3 50 Setting up your Monitor Changing the Patient Category Heart Rate HR Pulse Adult bpm Pedi Neo bpm Cardiotach Range 15 to 300 15 to 350 HR Alarm Limit Range 15 to 250 15 to 300 Pleth Pressure Pulse Alarm Limit 30 to 250 90 to 300 Range The expected range can be estimated by performing a manual pulse count RESP Adult Pedi rpm Neo rpm Respirotach Range 0 to 120 0 to 180 LI c High Alarm Limit Range 10 to 100 30 to 150 LI gt Q gt Le c o Low Alarm Limit Range
108. Pressing stores the resampled values at the current time Pressing Perform Calc also stores the resampled values at the current time and does the calculations using the resampled values Pressing any other softkey except On Off DataTime cancels the resampled values and brings up the database values for the displayed calculation time Resampled values that are not stored or used in calculations will be erased oe og 25 E f E FO When data is transferred with the Data Transfer module values that have been resampled are transferred to the destination monitor Resampled and other manually entered data is annotated with an asterisk at the destination monitor if both the source and destination monitors have software at the Release F level or higher CMS or Release A 0 level or higher V24 and V26 8 24 Trends and Calculations Changing or Entering an Input Value Reviewing Calculations Performing and Reviewing Calculations The arrow keys are used to select a parameter and the keypad is used to enter or change the selected value With a touchscreen you can select a parameter by selecting the touch button in front of the parameter label A numeric touchboard will be included in the task window to enter or change values If you enter a value that has more decimal places than allowed for a particular input the value you enter will be rounded off after you press Numbers 1 to 4 will round the value down and numbers 5 to 9
109. Support Offices is provided at the end of this manual Notice to the User Although there may be products in your area that look similar to the Philips M1165 66 67 75 76 77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors their functionality may not be the same This User s Reference Manual is intended to be used with the Philips M1165 66 67 75 76 77A CMS Patient Monitoring System the M1026A Anesthetic Gas Module and the Philips M1205A V24 and V26 Patient Monitors only This Manual is only applicable for Release C 1 versions of the CMS monitors and for Release D 0 of the V24 and V26 monitors A Release C 1 or Release D 0 monitor can be identified by a the Release C 1 or D 0 label on the monitor or b the suffix of the EPROM pack part number To view this number press Monitor Revision ShowSWRev The suffix of the EPROM pack part number on a Release C 1 CMS is E The Software Revision of a Release D 0 V24 or V26 monitor is M 00 03 Responsibility of the Manufacturer Responsibility of the Manufacturer Philips Medical Systems only considers itself responsible for any effects on safety reliability and performance of the equipment if assembly operations extensions re adjustments modifications or repairs are carried out by persons authorized by Philips and the electrical installation of the relevant room complies with national standards and the instrument is used in accordance w
110. T If the module is functioning correctly the following numerics are displayed without the alarms being activated tcpO 60 mmHg 8 0 kPa tepCO 40 mmHg 5 3 kPa Caution Radiated immunity If operating under conditions according to EN 60601 1 2 up to 1 V m electrical field strength the following deviations in the measurements could occur tcpOs 2 mmHg or less tcpCOs 1 mmHg or less It is recommended to avoid the use of electrically radiating devices in close proximity to a tcpOs tepCO monitor Performing the CO Module Self Test Performing the Temperature Module Self Test Performance Assurance Checks Auto Check None Self Test The self test may be performed at any time The test signals last about 30 seconds and then the display returns to the normal monitoring mode TEST If a transducer is connected to the module the following conditions must be met e The motor in the transducer is running e No heater malfunction is reported Press Monitor Setup 7 Test Signals RESULT If the module is functioning correctly the values will be displayed without the alarms being activated and should read as follows ET CO 40 mmHg 6 0kPa IMCO 0 mmHg 0 0kPa AWRR 25rpm Auto Check None S c oO E 7 E oO Self Test The Temperature module self test may be performed at any time as the switch network switches to the reference resistors for the duration of the check T
111. T T T 28 Jan 01 00 02 00 03 00 04 00 05 00 06 00 07 00 08 00 Graph Trends Report Printing Reports DAVID SCHULTZ Bed CCU 7 Report 28 JAN 1996 17 22 MR 012 34 56789 Adm Phys M MULLER Admit 27 JAN 1996 FOSTO DOB 22 FEB 1945 Att Phys R SCHWARTZ MEMORIAL MEDICAL CENTER BOSTON MA Table Report 27 JAN 10 00 11 00 12 00 13 00 14 00 15 00 16 00 17 00 HR 88 85 87 83 85 84 88 94 ABP S 1145 125 110 T12 11 5 TX 118 125 ABP D 75 90 71 72 75 72 82 90 ABP M 95 100 92 90 95 92 102 100 PAP S 35 28 24 25 23 24 28 27 PAP D 18 T5 11 13 12 19 15 13 PAP M 24 19 15 17 16 17 1 9 17 Tl 37 8 3T 5 37 6 37 8 37 5 37 9 38 0 37 8 C10 543 5d 5 0 52 5 4 2250 6 47 12 54 14 49 17 23 PAWP i IT 10 12 4 2 552 6 49 E2296 14 52 T7925 Vital Signs Report BOBBIE JONES Bed ccu 7 Report 050CT 996 02 00 MR 012 34 5679 Adm Phys M MILLER Admit O30CTI996 08 15 DOB 22FEB 1945 Att Phys R SCHWARTZ FIRST MEDICAL CENTER TALL CITY USA Blood Review Report o50cT O50CT 050CT O50CT ggacTt O50CT 340 T324 547 719 1245 17 45 tet ranges units Sample Art Art Art Art Art Art pH 7 350 7 350 7 390 7 393 7 442 7 35 7 45 PCO2 36 35 39 40 4i 35 45 mmHg HCO3 19 18 20 21 22 18 23 mEq tCo2 20 19 20 21 22 19 24 mEq BEecf 1 E 0 1 0 2 53 mEq Hct 36 38 39 40 Al 42 38 51 PCV Hb 46 12 13 15 47 17 12 17 g al Na 139 138 139 140 141 143 38 446 mEa K 3 7 3 5 3 6 37 39 40 35 4 9 mEgl C 99 98 99 100 101 98 109 mEg
112. Window Setting up your Monitor 3 61 Parameter Settings Transfer or e by resetting all parameter settings to their default values when changing Configuration Sets or operating modes You can find more information about Parameter Settings Transfer in each of the parameter chapters in particular Chapter 20 Pressure Module Section and Chapter 17 Temperature Module Section If Parameter Settings Transfer for your monitor is set OFF parameter settings are NOT transferred with your modules A 2 9 2 ax 22 gt 5 Cc Ez o 3 62 Setting up your Monitor Parameter Settings Transfer Messages Parameter Settings Transfer Messages The following messages related to Parameter Settings Transfer can appear on the display Message Condition Action required Parameter name The indicated parameter Insert a module that has no settings transfer capability module is not a T module a T on the front Parameter name check settings No settings are stored in the module or the settings are incorrectly stored Enter the parameter Task Window and check the settings The settings are automatically stored when you exit the Task Window Check Patient Category and parameter name settings Parameter name unable to store settings in module The patient category stored with the settings in the module is different from that of the monitor The parameter mo
113. a Combining Data Time Conversion Database Conversion In some situations the patient name and or ID in the monitor and module may not match see Append New Data display on previous page In other cases one or both names may be blank The Data Transfer Combine Task Window enables you to combine files when the demographic data is missing or different Data in a monitor can be stored at either 1 minute or 12 second resolution depending on the monitor s configuration Data in a module is stored only at 1 minute resolution Time conversions are done automatically when the resolutions are different When converting data from 12 second to 1 minute resolution that is from a monitor to a module one data sample out of 5 is selected to represent the minute The sample selected is the one on the minute boundary When transferring data from 1 minute to 12 second resolution from a module to a monitor one valid sample and 4 blanks will be used for each minute The valid sample will be placed on the minute boundary Transfers to the Module A module contains enough memory to store 24 hours of data for 16 parameters at 1 minute resolution If the data to be transferred does not fit in the module then the number of hours will be reduced to fit the available memory The following table shows the conversion between the monitor and module databases during a transfer to the module 10 14 Data Transfer Combining Data Database C
114. a Aw Next On Off zoom in Zoom Out Recere Print Page omb Aneel Time T ms Vitals Vitals Up to 13 lines are displayed on the screen at one time Only monitored parameters are shown The continuously monitored parameters are shown in the general order in which their numeric values appear on the Main Screen followed by the aperiodic parameters for example C O Triple valued parameters such as ABP are shown on three separate lines Parameter units for example beats minute are not shown Note If the numeric for a parameter is turned OFF in the Display Setup Numerics On Off Task Window but the parameter is ON the data is still stored and will be shown in the table 8 10 Trends and Calculations Viewing Patient Data Aperiodic parameters parameters which are not monitored continuously such as C O are shown with their collection times below them An up arrow LT beside an aperiodic parameter indicates that more than one value is available for this time column On CMS up to 96 data points for each aperiodic parameter can be stored for 24 hours On a V24 or V26 monitor up to 48 data points for each aperiodic parameter 96 for selected configurations can be stored for 24 hours An asterisk beside the value indicates the value was either manually entered or automatically copied to the time indicated during resampling The time appears along the top of the table in 24 hour for
115. abel is selected on the screen 2 Press Change Content to select the key label that you require The choices are Neuro Cardvasc SwanGanz Standard Ventilat Perfusn Surgeon C nOoPROcP Setting up your Monitor 3 11 A 2 9 2 ax 22 gt 5 Cc c2 o Selecting Screen Labels for Realtime Display Screens User Defined Screen Labels 3 12 3 1 2 h Inductn i Non Invasive j OxyCRG3 k Blank No screen label l User Def user defined screen label see below Press to return to the Selection Window or press to return to the Main Screen screen In addition to the pre defined screen labels you can define your own labels for each screen A E To define a screen label Select User Def in the Display Setup Task Window Press Confirm Enter new label using either the handheld keypad the touchboard CMS only or the arrow keys V24 and V26 Press Confirm The user defined labels will also appear in the Change Screen Task Window Setting up your Monitor Selecting the Number of Waves Selecting the Number of Waves You can select how many waves you want displayed on the screen within the capabilities of the model you have ordered Displayi Setup gt Select Item DAVID SCHULTZ ICU Adult 05 FEB 99 10 43 Non paced mode HR pA EE NN do 80 Keuse 80 spo 93 ABP 120 80 97 ScreenChoice A Screen Label Standard Channel ECG CH1 II BScr
116. aced mode NI l ma al d LA ALA 80 WPu se 80 imv spo 97 ABP 120 80 96 acne eel ww PAP 25 10 14 LI a c CVP 12 SpO 2 95 dSp0 2 RESP 20 TPL 020 SEF1 200 TP2 020 LI E gt Q E 22 c o Volume Control QRS Tone Volume Alarm Tone Vol spO02 Tone Mod et ll 120 165 Alarm En GFf Tena Tens renes 1 Increase or decrease the QRS or alarm tone volume by pressing the corresponding softkeys If there is currently no active alarm or INOP two short alarm tones sound at each press of the alarm tone keys so that you can hear the effect of changing the volume Setting up your Monitor 3 35 Adjusting the Volume Control 2 Press to return to the Selection Window or to return to the Main Screen Note Tone Modulation can also be set to On or Off in this window using the On Off Tone Mod key see also SpO Module chapter in Volume 2 Note If the alarm tone volume is set to zero the warning ALARM VOL 0 will appear in the lower right corner of the display V24 and V26 Patient Monitor If not already in the Main Screen press Increase or decrease the QRS or alarm tone volume by pressing the corresponding softkeys directly under the Alarm Volume and QRS Volume indicators ICU Adult 10 JAN 95 20 05 n Weise 70 CHANNEL 1 FHR pol Kn uS 170 fr numerics LAYOUT 1 NON OVERLAP sri 3 ST2 L J 5 ABP
117. and display module of the M1165 66 75 76A Systems and the Anesthetic Gas Module are set up together connect the grounding wire to the equipotential grounding terminal on the display and Patient Safety c 5 s T a td fa a z If the computer and display module of the M1165 66 75 76A Systems and the Anesthetic Gas Module are separated connect one grounding wire to the display one to the computer module and one to the Anesthetic Gas Module Equipotential Protection class 1 instruments are already included in the protective Grounding grounding protective earth system of the room by way of grounding contacts in the power plug For internal examinations on the heart or the brain Computer Module and Display Module of the system and the Anesthetic Gas Module must have separate connections to the equipotential grounding system One end of the equipotential grounding cable potential equalization conductor is connected to the equipotential grounding terminal on the instrument s rear panel and the other end to one point of the equipotential grounding system The equipotential grounding system assumes the safety function of the protective grounding conductor if ever there is a break in the protective grounding system To protect the patient and hospital personnel the cabinet of the installed equipment has to be grounded The equipment is supplied with a detachable 3 wire cable which grounds the instrument to the powe
118. ange C 0 Seale Procedure Recordings HR Non paced mode 80 Weutse 60 so 100 ABP 120 70 91 PAP 28 15 21 CVP 9 Spo 2 100 dSp 0 Sv0 63 ETcO 40 IMCO 0 AWRR 25 o Z f z o 5 ra o L fo o o tc C D Tblood 370 Tinj 00 See Cardiac Output Section for details on cardiac output measurements When a cardiac output measurement has been made the curve in the Measure C O Task Window can be recorded by pressing Record Curve The recording strip shows the curve and is annotated with the date time cardiac output value computation constant blood and injectate temperatures Note Only the most recent cardiac output curve can be recorded Record a curve before including it in an averaging calculation When is pressed all the curves are deleted and cannot be recorded Recording Functions 6 17 Procedure Recordings Wedge Edit Wedge DAVID SCHULTZ ICU Rdult 16 FEB 99 21 39 II L B L HR Non paced mode kb 0 WPuisE 60 spo 100 ABP 120 70 91 RA ane 9 4 es S 2 5 e rm fo Ke p e 5 1 CVP 9PU2 2 100 s dep 0 15 Cursar Recerel Curve See the Pressure Section for details on Pulmonary Artery Wedge Pressure PAWP Measurements When a PAWP measurement has been performed the PAWP waveform can be recorded by pressing the Record Curve softkey If displayed the CO or RESP waveform
119. ansfer 11 Monitor Installation and Patient Safety This chapter contains important information on the installation requirements for the monitor It includes the following sections Introductions eroe ARR ERE ea a DER 11 2 Installation Information ssseses esses 11 5 The Front Panel of the M1046A Computer Module 11 17 The Front Panel of the M1046B Computer Module 11 19 The Rear Panel of the M1046A B Computer Modules 11 21 The Rear Panel of the Display Modules 11 23 The Rear Panel of the M1109A External Alarm Device 11 29 The Rear Panel of the M1026A Anesthetic Gas Module 11 30 The V24 and V26 Connectors 2 0 005 11 34 Accessories and Ordering Information 11 37 Monitor Installation and Patient Safety 11 1 c 5 s T L4 a LI fa a and Patient Safety Introduction Introduction This section contains important information on patient safety and installation requirements for the e CMS e ACMS e NOMS e Philips M1026A Anesthetic Gas Module e V24 and V26 The M1165 66 75 76A Systems are designed to comply with the following international safety requirements for medical electrical equipment e UL544 e CSA22 2 125 e IEC EN 60601 1 e EN 60601 1 2 CISPR 11 Class A The M1167 77A Systems and the M1026A Anesthetic Gas Module are designed to comply with the following international safety requirements for medical electrical equipme
120. ant to set 3 Press the softkey On Off Setup if you want to preset parameter settings when the module is plugged in WITHOUT the transducer Switch this setup off again using On Off Setup or Silence Reset Setting up your Monitor 3 33 Other Functions You Can Configure 4 Press to return to the Main Screen You can also switch OFF parameters in the following ways e Any parameter unplug the module and suspend or silence the alarms e Any parameter except ECG RESP or NBP disconnect the transducer or adapter cable from the module and suspend or silence the alarms If you switch off a parameter you can ONLY enter the parameter s Setup Task Window via the module s hardkey by first pressing Module Setup On Off Setup When you plug in a parameter module and connect the transducer or adapter cable the parameter is automatically switched on ECG RESP and NBP are automatically switched on when you plug in the relevant module A 2 9 2 ax 22 gt 5 Cc c2 o 3 34 Setting up your Monitor Adjusting the Volume Control Adjusting the Volume Control You can adjust the QRS and alarm volume independently The QRS tone is the audible tone produced by the ECG pulse channels to indicate each QRS complex or pulse trigger event picked up Procedure CMS Volume Control or Alarms Volume Volume Control or Volume Control DAVID SCHULTZ ICU Adult 15 FEB 99 17 26 II HR Non p
121. anual channel c 7 gt LLI c Z Neonatal Event Review 9 5 Viewing Neonatal Events Evnt_bar tif 1 Associated Event 2 Isolated Event 3 Cursor The severity of an event is indicated by the length of the event bar the longer the event bar the more severe the event The Bradycardia and Desaturation event bars start at the top of their channels and extend downwards The Apnea event bars start at the bottom of the Apnea channel and extends upwards The Manual Event Bar is only a marker to be selected by the graph cursor c 7 gt LLI S o 9 6 Neonatal Event Review Viewing Neonatal Events Event The patient monitors can be adjusted in monitoring mode so that an event Threshold Line is either triggered by an alarm or by criteria defined specifically by the user The event trigger level is represented in the graph by a threshold line located in each graph channel This line enables the user to see the following 1 Whether a trigger is active This means that the parameter is switched on the parameter alarm is switched on the main alarms are switched on and valid numerical values are available The threshold line is indicated on the graph by an unbroken line At what value it has been set 3 Whether it has been changed during the 24 hour review period MN Ev thres lif 1 Event Threshold Line 2 Non Active Threshold Line c 7
122. any part of the system Que gv o dme ie Do not pour liquid onto the system during cleaning General cleaning of the System 7 Donotallow cleaning agent to remain on any of the equipment surfaces wipe it off immediately with a cloth dampened with water Caution If you want to clean a touch enabled display such as the M1097A A02 Flatscreen Display the touch operation has to be disabled during the cleaning procedure If you use a mouse and want to clean it mouse operation has to be disabled during the cleaning procedure For more detailed information on how to perform these actions please refer to Chapter 1 of this manual Q 3 c 5 E Oo Maintenance 13 3 General Disinfecting of the System General Disinfecting of the System We recommend that you disinfect the product only when necessary as determined by your hospital s policy to avoid long term damage to the product We also recommend that the products being disinfected be cleaned first as described under General cleaning of the System on page 13 2 Use the recommended disinfecting substances listed below Alcohol Ethanol 7096 Isopropanol 7096 based Aldehyde Cidex based Bleach Dilution of sodium hypochlorite laundry bleach concentration ranging from 500ppm 1 100 dilution of household bleach to 5000ppm 1 10 dilution of household bleach Hydrogen peroxide 396 Chlorox 1 10 dilution Da
123. are displayed 2 Press the hardkey to switch to the selected set Wait at least one minute before plugging in or removing any modules from the rack A 2 9 2 ax 22 gt 5 Cc c2 o 3 54 Setting up your Monitor Changing Operating Modes Changing Operating Modes This function will be mainly used by service engineers for configuring the system on installation or for servicing the system Before you can operate in this Task Window you have to use a password There are three levels of password Level 1 password allows you to select Monitor or Config mode only Level2 password allows you to select Monitor or Service mode only Level 3 password allows you to select any of the four operating modes listed below Monitor This is the usual operating mode and fully supports patient monitoring If the system is attached to a patient it must be in this mode LI a c Config This mode is for configuring the monitor for example on installation The settings that are selected in this mode will be the active default settings for when the system is turned on LI E gt Q gt 22 c o Service This mode is used by service personnel Demo This mode can be used for training purposes The data base has 24 hrs of simulated waveform and trend data Warning The Configuration Service and Demo modes do not support patient monitoring When the monitor is attached to a patient
124. arged prior to charging Unlike Ni Cad batteries lead acid battery capacity is not affected by depth of discharge Note If you insert only one battery into the monitor for charging the LED will flash continuously The LED will not light even when the one battery is fully charged This is to remind you that both batteries are not fully charged The one battery will provide enough power to run the monitor However the operating time with one charged battery is less than half the operating time with two charged batteries Note When the unit is not being used for transport connect it to AC power with the monitor turned off This maintains a full battery charge and prolongs battery life Note In the event of AC power failure the instrument s battery is automatically activated so that no data or product information is lost Battery Information V24CT and V26CT only 12 5 f SD 6 Cu E gt ov I M end Sy Za G oo Battery Indicator and Messages Battery Indicator and Messages e The battery fuel gauge located on the lower right of the display indicates the remaining capacity of the batteries in a bar graph form As power discharges from the batteries the number of segments within the battery fuel gauge will decrease When you first switch to battery power the message Battery Measurement in Progress will be displayed for up to 2 minutes before being replaced by the battery fuel gauge e The rate at wh
125. assigned speed A 2 9 2 ax 22 gt 5 Cc c2 o 3 16 Setting up your Monitor Selecting Realtime Wave Speeds Numerics To tailor the numeric display format to specific needs individual On Off numerics can be switched on or off This is possible for each individual screen A E of an independent display When monitoring many parameters switching off the numerics for some of the parameters results in more of the remaining numerics being displayed in large digits Displayi Setup gt Numerics1 On Off DAVID SCHULTZ ICU Adult 15 FEB 99 17 23 I HR Non paced mode I aha ra nba l nla AA 80 Huse 80 imv spo 97 ABP 120 80 96 Numerics 1 ScreenDhoice fi Screen Label Standard PRESS 6 P Un CPP CPP On NBP NBP On PAWP PAWP On c 0 C 0 SpO On SpO 2 On dSp0 On SvO ETCO IMCO AWRR FIO Monitor Setting up your 1 Press the softkey Select Numeric to highlight the required parameter numeric To view parameters which are not displayed press the softkey Next Page 2 Press the softkey On Off Numeric to set the selected numeric display on or off 3 Repeat Steps 1 and 2 for each numeric that requires resetting 4 Press the softkey All Num On Off to switch ALL numerics on or off at the same time 5 Press to return to the Main Screen Setting up your Monitor 3 17 Selecting Realtime Wave Speeds If numerics are switched off the status messa
126. astic housings are intact that all Monitor hardware is present and tight and that there are no spilled liquids or other serious abuse 2 Inspect connectors of the Rack and ensure that the Modules are locked into place and do not slide out without first releasing the locking plate on the bottom of the Module 9 Inspect all accessories external to the system such as transducers referring to the manufacturer s documentation 4 Verify the backlight tube brightness is adequate If the brightness is not adequate notify your biomedical department or the Philips 8 representative Philips recommends replacement of the backlight S tube every 18 months of continuous use 3 s Inspect the Examine the line power plug for damage Ensure that the prongs 2 Cables and of the plug do not move in the casing Cords 2 Inspect the line power cord for signs of damage If damaged replace the entire cord Ensure that any new line power cord or plug is fitted with the same polarity as the old one 3 Inspect the interconnecting cable between the module rack and the mainframe for general condition Examine it carefully to detect breaks in the insulation Ensure that the cable connectors are properly engaged and that any connector screws are fully tightened 4 Inspect the patient cables and leads and their strain reliefs for general condition Examine cables carefully to detect breaks in the insulation and to ensure that they are gripped securely
127. at its scheduled time You can print this report even when the scheduled report capability is turned off 8 26 Trends and Calculations Printing Reports To turn the scheduled report capability on or off press SchedRep On Off in the Patient Data Selection Window This brings you to the Scheduled Reports On Off Task Window The current setting On or Off is indicated and a softkey is highlighted for example if scheduled reports are off the SchedRep On key is highlighted Press the highlighted key to change the setting To cancel a report press Cancel Report in the Selection Window under Trends Calcs This cancels only the report that is currently printing Any reports that have been waiting will then print Refer to What to Do If Your Report Does Not Print on page 8 30 for troubleshooting information Trends and Calculations 8 27 oe S 2 25 gt S Sg Fo o c n i o ie a c fo 2 s 5 2 o Printing Reports 8 28 Trends and Calculations DAVID SCHULTZ Bed CCU7 Report 28 JAN 1987 8 01 MR st 012 34 56789 Adm Phys M MaLLER Admit 27 JAN 198715 DOB 22 FEB 1945 Att Phys R SCHWARTZ MEMORIAL MEDICAL CENTER BOSTON MA Graphs Report 450 1 39 9 esee ER HR 1007 NA WA gt 2 7 to ENS ie eas 95 50 T T T T T T T 1 28 Jan 01 00 02 00 03 00 04 00 05 00 06 00 07 00 08 00 180 py TA PEU VI C Ne PS EUM SEEMS 412 93 73 T 385 Sa 36 35 T T T T
128. ated you must select the size of the ECG wave depending on your recorder sector size To select the size refer to the Switching between EASI and Standard leads on page 14 22 The calibrated ECG wave recording will be 10mm mV Realtime If a delayed recording or any recording from another monitor is in progress at the central station at the time of your request you are alerted with a message on the monitor display and the request is queued When the recorder is free the recording runs It consists of current waveforms not the waveforms from the time the recording was requested If the recorder is busy with a realtime recording and you request another realtime recording from the same monitor the current recording stops and the newly requested recording starts Delayed If the recorder is busy at the time of your request the waveform data and the request are queued When the recorder is free the recording runs The recording shows the waveforms from the time the recording was requested Recording Functions 6 23 Realtime Wave Recordings For central recorders the requests are run and queued according to the priority for that recorder See the operating guide of the recorder for information For the M1116A B Plug In Recorder and the Philips M1117A Bedside Recorder the recording prints when the recorder is free 7 c T 5 c 2 LL e xe LS 5 tc Note If you are using a monitor connect
129. atient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors do not contact the body or tissue of the patient Signals are obtained from accessory electrode transducer and sensor devices Frequency of Use The Philips M1165 66 67 75 76 77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors are indicated for use when prescribed by a clinician Physiological Purpose The Philips M1165 66 67 75 76 77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors are indicated when the purpose is to gain information for treatment to assess adequacy of treatment or to rule out causes of symptoms The Philips M1165 66 67 75 76 77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors are well suited for patient monitoring Patient Population Adult pediatric and neonatal non ambulatory patients vi Indications for Use Prescription Versus Over the Counter The Philips M1165 66 67 75 76 77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors are prescription devices vii Indications for Use Warnings Cautions and Notes Warnings cautions and notes are used throughout this User s Manual to give you additional information about the Philips M1165 66 67 75 76 77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors The warnings and cautions included in this safety section ref
130. ave layout The sector sizes in millimeters and the ECG gain required for 1 mV to equal 1 centimeter on a strip appear below the layout choices c Press Change Speed to change recorder speed 2 Select wave for each channel a Press Select Channel to select channel number b Press Assign Wave to select waveform 3 Press Change AlRecTyp to select the type of recording standard or oxyCRG that will be generated by alarms Recording Functions 6 9 7 E T 5 c gt Le e Ke A 5 tc 4 es S 2 5 E rm fo Ke p 5 tc Delayed Recording For Central System Waves Recorders DAVID SCHULTZ ICU Rdult 15 FEB 99 17 44 II HR lon paced mode an le d d l nd L J Al 80 i Base E imv Sp 97 me PAD 16 sc A a a fe ae ea Ka Sto Spo 2 95 lavi P 2 dSp 2 Primary Wave ECG CH1 II Secondary Wave PRESS 1 ABP EGER CURIE Press 1 Press 2 press 3 ccc BL PETA 0 as Co Ric Pres Press CONFIRM to store new settings Change Cheng Primary 2senel 1 Select the central recorder in the Delayed Alarm Recording Task Window see steps 1 3 for Plug In and 4 Channel Bedside Recorders above 2 Select the waves in the System Waves Task Window a Press Change Primary to select the primary wave The Change Primary key does not function if an ECG wave is available In this case the primary wave
131. bel Standard Channel 1 ECG CH1 II BScreenChoice A Channel 2 PRESS 1 ABP l Screen Label Standard Channel 3 PRESS 2 PAP E NomorOfWaves 8 Waves Channel 4 PRESS 3 CVP E Overlap 1 mon overlap Channel 5 PRESS 4 P4 BApplicWindow Split Trend Channel t PRESS 5 P5 BwWave Replace Disabled Channel 7 PLETH PLETH Trace Mode Fixed trace Channel 8 RESP RESP Salet Change Realt ime Numeric item llContent Speeds on off 3 32 Setting up your Monitor Other Functions You Can Configure Other Functions You Can Configure Parameters On Off Individual parameters can be switched ON or OFF on the monitor No alarms or INOPs are reported for parameters that are switched off and they are not available for display trending or recording on the monitor Module Setup Parametr On Off DAVID SCHULTZ ICU Adult 15 FEB 99 17 22 HR aan ad d A l g B ruse B0 spo 97 ABP 120 80 96 Svoz i BLOODANL PULSE CO ABP FIO PAP 3 RESP Vent IF tcpOs tcpcD EEG TEMP 1 Diff 1 PLETH Diff 2 PLETH2 On Next ESWNENSSMENSEE o Page Perenstr Peramstr Setup Setting up your Monitor 1 Press the softkey Select Parametr to highlight the required parameter To view parameters which are not displayed press the softkey Next Page 2 Pressthe softkey On Off Parametr to set the selected parameter on or off Repeat this procedure for each parameter you w
132. bel Standard 5 Channel 3 PRESS 1 ABP NumbrOfWaves 8 Waves o Channel 4 PRESS 2 PAP Overlap 2 waves 6 ovlp gt ro Channel 5 EEG CH1 EEG ApplicWindow None 2 Channel t EEG CH2 EEG2 Wave Replace Disabled 5 c Channel 7 PLETH PLETH Trace Mode Fixed trace I Channel 8 RESP RESP ES 2 45 1 Lae GLa Select GhengS Realtimel Numeric Item antene ji Speeds Onsorr Procedure 1 Press Selectltem until Overlap is selected on the screen 2 Press Change Content to choose one of the available numbers dependent on model The boxes in the middle of the screen indicate which waves are overlapping 3 Press to return to the Selection Window or to return to the Main Screen 3 14 Setting up your Monitor Selecting Realtime Wave Speeds Selecting Realtime Wave Speeds The same speed can be selected for all the waveforms or different speeds can be chosen for different waveforms You can select the speed for the waveforms from the following 50 mm sec 2b mm sec 12 5 mm sec 6 25 mm sec Displayf Setup gt Realtime Speeds DAVID SCHULTZ ICU Adult 15 FEB 99 17 19 I HR Non paced mode da J J nbn nn 80 Meuse 80 1mv spo 97 ave ABP 120 80 96 Poa e Soeed ScreenChoice A Screen Label Standard o ECG CH1 II 25 RESP RESP 6 25 gt ECG CH2 aVR 25 VentWvl Paw 6 25 Q Q ECG CH3 V 25 VentWve AWV 6 25 3 J PRESS 1 ABP 25 AG CO CO 6 25 oD O PRESS 2 PAP 25 AG
133. c o E If the ECG module does not respond perform the module self test To turn a parameter On press the following key sequence 1 Press Module Setup 2 Parametr On Off 3 Select Parametr 4 On Off Setup Maintenance 13 13 o o c c o 2 Performance Assurance Checks Procedure 1 Choose a patient category Adult Pedi Neo by pressing Overview gt Config Sets gt Change Pat Categ 2 Display 30 seconds of the waveforms and numerics of all connected modules by pressing gt Test Signals 3 Repeat Step 2 as necessary to check the individual test waveforms and numerics for the category 4 Use Step 1 to choose a new patient category and repeat Steps 2 and 3 See the following table for test values System Self test Values Module Test Numeric Test Waveform ECG and ECG RESP ECG 100 bpm in ADULT mode Simulated Square Wave 125bpm in NEO PED mode RESP 15 rpm in ADULT mode Simulated Wave 30 nrpm in PEDI mode 55 rpm in NEO mode Pressure Simulated square wave Systolic 120 mmHg ADULT 60 mmHg PEDI NEO Diastolic 0 mmHg ADULT 0 mmHg PEDI NEO SpO Pleth SpOs 10096 No Wave Pleth Wave on display Simulated wave 13 14 Maintenance Performance Assurance Checks Module Test Numeric Test Waveform Cardiac Output 5 l min 40 1 l min No wave Blood Temp 37 C Inj Temp 0 C tepOs tepCOs No wave tepOe
134. ch as pressure or pleth See Chapter 14 ECG and ECG Respiration Module Section for more details Note Tone Modulation can also be set to On or Off in this window using the On Off Tone Mod key 5 14 A Alarm Functions Alarm Setup The Nurse Note The nurse call relay is not available for the V24CT and V26CT Call Relay The nurse call relay is a paging system which warns the nurse if an alarm occurs on a monitor It becomes active in one of four situations depending on the way it has been configured e Red only alarms e Red and Yellow alarms e Red and INOP alarms e Red and Yellow INOP alarms The nurse call relay is not active when the monitor s alarm capability is switched off Note The delay time to the nurse call relay output is max 1 sec When an alarm has been silenced using the Silence Reset key and the audible 2 or 3 minute alarm reminder is configured to be either On or Re alarm the nurse call relay signals will behave as follows Alarm Reminder Be minder Time Nurse Call Relay Signal Behavior On 2or3mins The nurse call relay signals are repeated for a duration of 6 seconds every 2 or 3 minutes unless the alarm condition is eliminated Re alarm 20r3mins The nurse call relay signals are activated after 2 or 3 minutes The alarm tone and relay signals run continuously until they are interrupted by pressing the Silence Reset key Alarm Functions 5 15 o S fo 92
135. creen The INOPS also have priority levels they are as follows Equipment Related INOPs These are caused by setup or hardware faults for example ABP NO TRANSDUCER You will hear an INOP tone When an equipment related INOP can have a direct effect on the patient for example NBP CUFF OVERPRESS of the noninvasive pressure cuff it is categorized as a severel INOP When a severe INOP occurs the system alarm capability is switched ON by the system if not already on You will hear an INOP tone System alarms cannot be suspended until the cause of the severe INOP has been eliminated Patient Related INOPs These are usually caused by the system being unable to process signals properly for example Noisy ECG You will not hear an INOP tone with this level of INOP Alarm Display Viewing Alarm Messages The monitor alarms are arranged in increasing severity across the screen 1 Press Alarms Volume or Alarms hardkey 2 Press Alarm Messages in the Alarms Selection Window tABP NON PULSATILE txk ST 1 1 621 0 Non paced mode Pulse spo 97 0 25 10 13 12 Spo 2 95 dSpQ 2 RESP 0 TP1 040 SEF1 160 TP2 040 INO ST2 SOURCE STI 1 491 0 APNEA ABP NON PULSAT ILE HR 30 lt 50 ABP DISCONNECT Note When an alarm occurs you should always check the patient s condition first Audible Alarms There are four different tones 3 alarm tones and one INOP tone
136. d trend s will be reserved for it until you change the priority back to normal Note Parameters are displayed in descending priority Multi valued parameters such as all pressures are treated differently from single valued ones A multi valued parameter will not be trended unless a trend is available for each value within the parameter Thus for example a CVP trend would require three available musts ge E 25 gt S Sg Fo Data from devices connected to the monitor via the M1032A VueLink module can be trended and used in calculations Viewing Once blood analysis results have been transmitted in the Blood Analysis Blood Mea task window or automatically if configured you can view a summary of surements those results in the Blood Review task window The Blood Review task window contains only Blood Analysis module parameters No other parameters appear Note If your system is configured for mandatory Operator ID entry you will not be able to access blood analysis results until you have entered an Operator ID 1 If configured with extended database CMS only Trends and Calculations 8 5 o c n i o ie a c fo 2 s 5 2 o Viewing Patient Data You can access the Blood Review task window by selecting Blood Review from the Blood Analysis task window or by selecting Blood Review from the Trends Calcs Selection Window On CMS the Blood Review task window allows you to view bl
137. d Channel PRESS 1 ABP BNumbrOfWaves 8 Waves Channel PRESS 2 PAP BOver lap 1 non overlap Channel EEG CH1 EEGI BApplicWindow OxyCRG Channel EEG CH2 EEG2 H Wave Replace Disabled Channel PLETH PLETH Trace Mode Fixed trace Channel RESP RESP E ETE NSGNS NLIS Select GCnenge LTCTENETS Numeric Item Eonten speeds onsorr 1 Press Selectltem until ApplicWindow is selected on the Screen 2 Press Change Content to choose Split OxyCRG CSA or None no application window to be displayed 3 Press to return to the selection window or to return to the Main Screen 3 20 Setting up your Monitor Selecting an Application Window Note If you have configured a second or third independent display oxyCRG and CSA can only be on one of these displays at a time Split Screen can be configured for all displays simultaneously Special Implications for Touch or Mouse Operation e If Split Screen is active and a split trend is selected the Graph Trends Window opens up displaying the selected parameter in combination with the adjacent parameters e Ifthe oxyCRG display is active and is selected the Neonatal Event Review Window opens up If Neonatal Event Review is not available the Graph Trends Task Window opens up e Ifthe CSA Display is active and is selected the EEG Setup Window opens up Setting up your Monitor 3 21 LI E gt Q gt Le c o
138. d The Vital Signs display does not update automatically when new data becomes available To see new data use the right arrow key Printed copies of the displayed data can be made if a printer is available by pressing the Print Vitals key in the Vital Signs display the Print Review key in the Blood Review display or the Print Graphs in the Graph Trends Trended vital signs can be recorded if an M1116B PLUG IN Recorder is available by selecting Vitals PLUG IN in the Vital Signs task window 8 4 Trends and Calculations Viewing Patient Data Vital Signs and Graph Trends are not functional during a transfer of data from the Philips M1235A Data Transfer Module to the monitor Trending Trending priority enables you to specify which parameters will be Priority trended This is done by assigning a must status to parameters in the Trending Priority Task Window Initially parameters which have been stable for at least one minute are listed with a priority of normal A maximum of 16 32 musts can be chosen Each parameter requires one must except for multi valued parameters where each value in the multi valued parameter requires one must Musts will be trended if the parameter is being monitored After musts normal parameters are trended until the maximum of 16 32 is reached Parameters which are currently being trended are identified by an asterisk If a must parameter is not currently being monitore
139. d F G H i J x 4 5 fe x if DUE eM we Sot E UN ES pee Eos ye Ds SEDES T u vY wW x Y z Ee eT EEE EOE Softkeys and The softkeys and hardkeys on the keypad are in the same relative Hardkeys position and operate in the same manner as the keys on the control panel Data Entry The data entry keys are located on the bottom half of the keypad Keys 1 10 The CMS and V24 and V26 Patient Monitors External Alarm Device Introduction e To enter numbers and arithmetic symbols labeled in white simply press the keys you want e To enter letters and punctuation marks labeled in blue press the key The lamp in the key lights up and remains on until is pressed again The softkeys and hardkeys work as normal CMS only Since the External Alarm Device is used only with commercially available ITE displays that do not have a control panel it contains all the alarm lamps the Alarms Suspended Lamp and the loudspeaker It does not contain any hardkeys or softkeys and therefore can only be used in conjunction with the Handheld Keypad The Handheld Keypad can be mounted onto the External Alarm Device as illustrated below The CMS and V24 and V26 Patient Monitors 1 11 o c N gt o c on o o E H LA o J 7 A E N gt ne q N gt o c on o o E T o b c c o o N gt Introduct
140. d ee ER 2 10 Setting up your Monitor 3 1 Changing Display Screens cr DER ES ERASER AN EREE RITTER EU Ee 3 2 Selecting a Screen obe bap anata tp dd debi aspe eus dep du e Siete acer thy 3 3 Procedu re ede ame etr teles he Sot sey We EOS MUS Subs Dolar d ppt ets 3 3 Freezing Waves CMS Only sa S aaea A a EA EA E Imm 3 4 What you Can Configure ceria es e E Se eee 6 RPSL RASS A ETRE Se 3 5 Changes to the Configuration 0 0c eee II eens 3 6 Making Changes to the Main Display 0 0 0 cece eee eee eee 3 7 Assigning Waves to Screen Channels 0 0 3 8 Procedures iss ote S GRICE RF Ie BRO UOT LR ae Sk Se pa Re ed Bie 3 9 Selecting a Screen seeds bp op Odie a pe Be e ER EEE RAN 3 10 Procedure repns osineen a proe Eques x pus DERI Ib p sass 3 10 Selecting Screen Labels for Realtime Display Screens 0 000000 cee ee eee 3 11 Procedure s vc ve p HENCE RO ertet 3 11 Contents 3 Selecting the Number of Waves 0 0 0 0 cece eee cette I 3 13 Procedure iss eee eR aep p xp p UC BEC ERE Ep eda 3 13 Changing the Wave Overlap sseeeeeeeeeeeeee Ie 3 14 Procedure dm bb e te Up ER CE RU UD Rel En ru 3 14 Selecting Realtime Wave Speeds 00 0 cee cece ee 3 15 Procedures eet eels epe pcr pea p pep s 3 15 Numerics On Ofr eee Sa es ee bte es eret a Sha S 3 17 Additional Information gt ses egos e iera iaei EE cece eens 3 19 Selecting an Application Window sseeeeeeeee
141. dation Task Window will appear automatically on the status display unless you turn it off under Trends Calcs Other Patients Other Patients 4 9 o E c o 2 Q o t o Using Philips Patient Care System with an Arrhythmia Computer 4 10 Arrhythmia Alarms on the 78560A and 78720 Arrhythmia Computers Alarm Minimum Condition Required for Alarm ASYSTOLE VENT FIB TACH HR BRADY XXX lt BBB VENT TACHY VENT RHYTHM PAIR VPBs PACER NON CAPT PACER NOT CAPTURE MISSED BEAT S No QRS for 4 consecutive seconds in absence of V fib or chaotic signal Fibrillatory waveform detected for 4 consecutive seconds Heart rate lt lower HR limit set or 40 bpm whichever is lower Either VENT RHYTHM with average heart rate gt tachy HR limit or RUN VPB s gt tachy run limit with rate for the run gt tachy HR limit Tachy run limit is adjustable from 3 to 9 using the Change Limits display Tachy HR limit is adjustable from 80 bpm to 120 bpm using the Change Limits display Dominant rhythm of adjacent V s and HR lt 120 Two consecutive VPBs between non VPBs Missed beat with pace pulse in paced patient Beat omitted with HR lt 120 or no beat for 1 second with HR gt 120 Other Patients Using Philips Patient Care System with an Arrhythmia Computer Alarm R on T VPBs VENT BIGEMINY VENT TRIGEMINY
142. dditional delayed channels are overwritten by the additional alarming parameter starting at the bottom channel in the following priority e Parameter whose alarm status has escalated in the last second and has alarm recording enabled e Parameter in red alarm with alarm recording enabled e Parameter in yellow alarm with alarm recording enabled e Parameter in red alarm with alarm recording disabled if space is available e Parameter in yellow alarm with alarm recording disabled if space is available On the Plug In 2 channel recorder with respiration recordings disabled an apnea alarm followed by a Pressure 1 limit alarm would produce a strip Channel 1 ECG Channel 2 Pressure 1 provided that P1 has been selected in the Delayed Alarm Recordings Task Window For a 4 channel bedside recorder with a standard delayed recording configured as Channel 1 ECG Channel 2 Pressure 1 Channel 3 Pressure 2 6 14 Recording Functions Alarm Recording Channel 4 Respiration 7 E S 5 c gt LL e Ke A 5 tc A yellow CO alarm would produce a recording ordered as Channel 1 ECG Channel 2 Pressure 1 Channel 3 Pressure 2 Channel 4 COs alarm If ared P3 alarm occurred the recording order would then become Channel 1 ECG Channel 2 Pressure 1 Channel 3 P3 alarm Channel 4 COs alarm For alarm recordings with oxyCRG to document neonatal events without the Neonatal Event capability th
143. ded The waves are selected in the Delayed Alarm Recording Task Window The waves recorded on an alarm strip are also chosen from the list in the Delayed Alarm Recording Task Window If the parameter in alarm is not already selected it will replace the last selected channel Delay Time the maximum time between seeing a waveform on the screen and still being able to record it This is configured when the monitor is installed Choices are 10 or 15 seconds for the Plug In recorder Runtime the length of time the recording runs This is configured when the monitor is installed Choices are 10 15 20 25 or 30 seconds 6 8 Recording Functions Configuring Delayed Recordings For Plug In and 4 Channel Bedside Recorders Delayed Recording gt RecordngSetup gt Delayed amp Alarm DAVID SCHULTZ ICU Adult 15 FEB 99 17 43 II HR Non paced mode Jh ala adn A l nha a0 Weurse 80 imv spo 97 iis ABP 119 80 96 Delayed Ala Record i Channel 1 ECG CH1 II W Speed 25 mm sec Channel 2 ECG CH2 aVR B Recorder PLUG IN 2 ch Channel 3 PRESS 1 ABP Overlap sad d Channel 4 PRESS 2 PAP Channel 5 Blank Channel 6 Blank Channel 7 Blank Channel 8 Blank AlRec Typ Standard SEMI arcu Change Change Select Change hennak Wave Speed Recorder Overlap AlRecTyp 1 Select the recorder and layout a Press Change Recorder to select the recorder b Press Select Overlap to select w
144. dings the M1116B plug in recorder module has to be selected as the procedure recorder The procedures for configuring recordings are described in Chapter 6 Recording Functions 3 40 Setting up your Monitor Other Patients Controls Other Patients Controls If your system is connected via the Philips monitoring network to other bedsides you can choose to send alarms receive alarms and assign your bed to a care group The procedures for setting up the networking system are described in Chapter 4 Other Patients EnS 2 e gt ax 22 gt 5 E 72 Setting up your Monitor 3 41 The Status Log Function The Status Log Function The softkey Status Log is used by service engineers It produces a list of accumulated error codes A 2 9 2 ax 22 gt 5 Cc Ez o 3 42 Setting up your Monitor The Monitor Revision Function The Monitor Revision Function The softkey Monitor Revision is used by service engineers It gives information about the current hardware and software revision of the monitor EnS 2 e gt ax 22 gt 5 E 72 Setting up your Monitor 3 43 Changing Default Settings and Patient Category Changing Default Settings and Patient Category Each system is configured in the factory with the factory default settings The settings are collected together to form Configuration Sets There are 4 Configuration Sets available with uni
145. displaying Details are provided in the following table 3 28 Setting up your Monitor Notes on CSA CSA Display CMS only Main Screen Standard Display CSA Display 4 realtime waves CSA 2 realtime wave 6 realtime waves CSA 3 realtime waves 8 realtime waves CSA 4 realtime waves The CSA information is overlayed on the realtime waves at the bottom of the Main Screen These realtime waves disappear from the display but the parameters are still being monitored and the parameter alarms are still active If CSA covers part of an overlap channel the entire overlap channel disappears from the display If you are using a touchscreen selecting the CSA display via touch or mouse click will open up the EEG Setup Task Window Setting up your Monitor 3 29 LI E gt Q gt Le c o LI a c Wave Replace Wave Replace Wave Replace enables the monitor to fill a currently unused channel which is assigned to a specific wave and replace it temporarily with another wave Monitor Setup gt Displayt Setup gt Select Item DAVID SCHULTZ ICU Adult 15 FEB 99 17 15 II HR Non paced mode nla ada l alan A 80 Wuse 80 1nV spo 97 javR ABP 120 80 96 B pla e p ScreenChoice A Screen Label Standard Channel 1 ECG CH1 II WScreenChoice A Channel 2 ECG CH2 aVR l Screen Label Standard Channel 3 PRESS 1 ABP BNumbrOfWaves 8 Waves Chann
146. does not support Recording Type The recorder configured cannot support the requested application For example an oxyCRG recording that is requested on a recorder other than M1116B Running Recordings Mode A list of running recordings is shown when is pressed Note Recording ink sometimes fades when covered with transparent tape Please avoid covering any part of a recording that is clinically relevant annotation or waveforms when taping a recording strip to a patient record or other patient documentation Recording Functions 6 47 N S 5 i5 c gt iL e c o A o o tc Accessories and Ordering Information Accessories and Ordering Information I i e 5 i 2 LL e c xe A o tc You can order parts and accessories from Philips supplies at www medical philips com or consult your local Philips representative for details Warning Reuse Never reuse disposable transducers sensors accessories and so forth that are intended for single use or single patient use only Philips approval Use only Philips approved accessories Packaging Do not use a sterilized accessory if its packaging is damaged 10 rolls of paper 40477A 80 rolls of paper 40477B 6 48 Recording Functions Loading Paper Central Recorders Loading Paper into the Plug In Recorder Loading Paper 7 E T 5 c gt Tr e xe D
147. dow after the recorder name in the order they were selected Each wave that is selected is also identified below the key label The recording is always continuous running at 25 mm s in non overlapped mode To stop realtime recordings either press Stop Record or press STOP on the recorder All realtime non configured recordings must be stopped manually 6 22 Recording Functions Making Calibrated ECG Recordings If the Recorder is Busy Realtime Wave Recordings Note CMS only The number of recording channels available depends on the recorder If you change from a 4 to a 2 channel recorder only the first two waves are recorded N S 5 I5 c gt iL Le c o A o tc Note Non preset recordings are made on the same recorder as procedure recordings selected in the Procedure Recordings Task Window If the power is off for more than 1 minute a non preset recording automatically reverts to the default waves and recorder for Mode A However the speed 25 mm s waves non overlapped and continuous runtime do not change Note If a realtime recording is requested during an alarm recording it is produced when the alarm recording is finished If a realtime recording is in progress and another parameter goes into alarm an alarm message appears on the realtime recording When the realtime recording is finished the alarm recording is produced If you want your ECG recording to be calibr
148. dule was removed before the settings could be stored or there is a malfunction in the module This message can appear with Settings Transfer On or Off Either change the patient category for the monitor or change the parameter settings Press Silence Reset re insert the module and check adjust the settings in the parameter Task Window Exit the Task Window and leave the module in the rack for about 10 seconds before youremove it Ifthe same message appears replace the module Setting up your Monitor 3 63 LI E gt Q E 22 c o LI c A Oo gt ax 29 i e S2 i N Parameter Settings Transfer Messages Message Condition Action required Parameter name reading settings from plug in module A parameter key has been pressed while parameter settings are being taken from the indicated module Wait for the message to disappear before pressing the key for that parameter Pressure label check zero and transducer level A pressure module has been plugged in with the transducer connected Zero and calibration values will be taken from the module If the transducer has not been recently Zeroed and calibrated or if you are setting up anew measurement do the zero and calibration procedures 3 64 Setting up your Monitor 4 Other Patients This chapter describes the Other Patients function I
149. dule key for initiating a transfer from the monitor to the module The information transferred may consist of up to 24 hours of the database ongoing updates to the database or both Transfers can also be initiated or stopped through During a transfer the module light is on when the corresponding Data Transfer task window is active The light blinks rapidly when a transfer is in progress and at a slower rate during the collection of new data see Types of Transfer on page 10 7 o o c e G a 10 4 Data Transfer Data Transfer Module When the module is unplugged it retains data for at least one hour After data is transferred to the monitor the module is automatically erased This is to ensure that the module is empty when it is used for the next transfer Symbols to As detailed in the table below some versions of this module now use Indicate Key symbols instead of words to indicate the function of some keys If the Functions monitor s Reference Manual tells you for example to select the Monitor key you should press the key marked with the corresponding monitor symbol The design change also means that you will now find the module s product number on the rear of the module s housing not on the front Monitor initiates transfer from module to Data Transfer Module M1235A monitor initiates transfer from monitor to module What is The module is capable of storing and trans
150. e Monitor Installation and Patient Safety 11 7 lt oF o ae Installation Information awn Oe 9 2d B Combining If it is not evident from the instrument specifications whether a Equipment particular instrument combination is hazardous or not for example due oc So to summation of leakage currents the user should consult the manufacturers concerned or else an expert in the field to ensure that the necessary safety of all instruments concerned will not be impaired by the proposed combination Warming 0 0 0 10 0 e Any combination of the Philips M1165 66 67 75 76 77A CMS or the Philips M1205A V24 and V26 Patient Monitor with non medical equipment must comply with IEC 601 1 1 The monitor must be properly grounded or the non medical device e g a printer or an ITE display properly isolated Isolation may be achieved by powering the non medical device through a safety isolation transformer This must be done in order to prevent the possibility of an electrical shock hazard to the user and or patient from excessive ground leakage currents from the non medical device such as a printer V24 and V26 only In normal AC line operation grounding the monitor is accomplished by ensuring that the AC line cord is connected from the monitor to a properly grounded AC receptacle When the V24CT or V26CT is operated in battery mode the possibility of an electrical shock hazard is especially prevalent Alternatively
151. e Printing an Episode Deleting an Event Viewing oxyCRG Episodes Selecting the Record Episode softkey documents the selected oxyCRG episode in a graphical format on the bedside M1116B Recorder Module with fast paper speed Please refer to the Making Recordings section of this manual Chapter 6 for further details on recording neonatal events and associated oxyCRG episodes Selecting the Print Episode softkey starts a print out of the current oxyCRG display Selecting the Delete Event softkey enables you to delete an event This can only be done in the oxyCRG Episode task window after the clinician has identified that the event is invalid and does not need to be stored or documented Once confirmed the event is deleted from the event storage permanently and cannot be retrieved Note As long as the deleted episode is still on the screen it can still be documented c 7 gt LLI c Z Neonatal Event Review 9 17 Adjusting Neonatal Event Review Settings Adjusting Neonatal Event Review Settings The Event Setup task window enables you to adjust event settings to determine how and when an event is detected and stored You can access the Event Setup task window by selecting e Event Setup in the Event Review task window KEVIN AMES ICU Neo 16 FEB 99 22 38 HR Non paced mode Wt Ji n 160 Muse 125 mv spo 100 ABP 120 70 91 PAP 28 15 21 CVP 9 aed Spo 2
152. e INOPs and alarms quickly so that the alarm reminder function can operate Even when the alarms are suspended or individually switched off the corresponding parameter numeric will blink if an alarm condition occurs and Maintain Visual Alarms is set to Yes in a special Configuration Mode by your biomedical engineering department Note The central stations 78560A M2350A and M2360A can be configured to silence and reset the alarms of the bedside monitors If your system is connected to such a central station you can silence an alarm at the central station The central stations 78504A and 78508A can silence and reset the alarms of the bedside monitor only if configured to do so by a Philips service engineer or hospital biomedical engineer This is then permanent and cannot be altered by the user 5 6 Alarm Functions Summary of Alarm Behavior Alarm Display Non latching alarms Latching alarms Visual Latching Audible Non Latching Silence Reset has NOT been pressed Alarm is given Audible alarm Alarm lamp Alarm message blinking numerics Audible alarm Alarm lamp Alarm message blinking numerics Audible alarm Alarm lamp Alarm message blinking numerics Alarm Automatic reset Audible alarm Alarm lamp situation no Alarm lamp Alarm message longer present Alarm message blinking numerics blinking numerics Audible alarm reset Alarm Audible alarm Audible alarm Audible Alarm has been si
153. e Philips M1205A V24 and V26 Patient Monitors measure and display multiple physiological parameters and waves and generate alarms and recordings They exchange information with compatible devices The Philips M1165 66 67 75 76 77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors are not therapeutic devices Environment The Philips M1165 66 67 75 76 77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors are intended to be used in a clinical environment by trained healthcare professionals They are not intended for home use They communicate with devices such as a central station through network interface ports and a serial I O port The Philips M1165 66 67 75 76 77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors are prescription devices and will carry the following label United States Federal law restricts this device to sale by or on the order of a physician Indications for Use Indications for Use Condition The Philips M1165 66 67 75 76 77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors are generally indicated when the clinician decides there is a need to measure and display multiple physiological parameters and waves to generate alarms and recordings of adult pediatric or neonatal patients Part of Body or Type of Tissue with Which the Device Interacts The Philips M1165 66 67 75 76 77A CMS P
154. e alarm recording items should be set to the following AlRecType oxyCRG All AlarmRec Off Change AlarmRec to red for ECG Resp and SpOs In the event of a Brady Apnea and or Desat alarm the recorder will document an eight minute oxyCRG recording six minutes preceding the event and two minutes following the event Recording Functions 6 15 4 es S 2 5 e rm 2 KJ A 5 x Procedure Recordings Procedure Recordings Recordings can be made during cardiac output measurements Configuring You first select the recorder which will record the curve Procedure Recordings gt Recordng Setup gt Procedur Recordng DAVID SCHULTZ ICU Adult 15 FEB 99 17 49 II Er NH Rie d LA LA HR Non paced mode ue de Puse 80 1mv 80 spo 97 aVR ABP 119 80 96 Recorder PLUG IN 2 ch PRUNE auXLIME Change NEIEBIelsn 1 Press Change Recorder to select the recorder that will produce the recording 2 Press to return to the standard monitoring display Note To generate trended vital signs and neonatal event recordings the recorder selection must be set to PLUG IN in the Procedure Recordings task window 6 16 Recording Functions Making Procedure Recordings Procedures C O DAVID SCHULTZ ICU I Rdult 25 JAN 99 2 11 e m Verify the Computation Constant 1 0 6 Comp Const 0 542 i 10 sec Ready for new measurement Reeerel Curve Start Ch
155. e and ID will be overwritten by the central station s broadcast of the previous patient s name To prevent this situation from occurring the previous patient should be discharged from central station before the transfer The following table outlines the Data Transfer behavior under various events Event Results Power Off 1 min Transfer will restart automatically Power Off 1 min Transfer is stopped Collection of new data must be restarted manually Op Mode Change Transfer is stopped Data in module remains intact Config Mode Change Transfer is stopped Data in module remains intact Patient Discharge or End Transfer is stopped Data in monitor is Case deleted Data in module remains intact Data Transfer Data Transfer 10 19 Performance Specifications Performance Specifications For safety and environmental specifications please refer to Chapter 11 Monitor Installation and Patient Safety Data Transfer Time Transfer A typical transfer time for 24 hours of data is under 30 seconds The Module transfer time could be as high as 60 seconds for highly customized trends Back up Memory Time The Data Transfer Module will store data for a minimum of 1 hour under the following conditions e the module is out of the monitor e the module is in the rack of a powered Off monitor e the monitor has a power failure o o c Co a 10 20 Data Tr
156. e changed For delayed recordings access to the Change Recording Speed window is through the Realtime Record key The new speed is not stored The speed of alarm recordings cannot be changed these recordings always run at 25 mm sec You can change the recorder where alarm delayed preset or realtime non configured recordings are made l Press Monitor Setup 2 Press Recordng Setup 9 Select the recording type Delayed amp Alarm Mode or Procedure 4 Press Change Recorder to choose the appropriate recorder Press CONT on the recorder The recording runs until you stop it by pressing the STOP on the recorder or the Stop Recordng softkey on the display Recording Functions 6 43 7 c T 5 c 2 LL e xe A 5 tc Additional Information Inserting a You can insert a calibration signal into the waveform display on the Calibration monitor and into any actively running recording Calibration signals are Signal automatically generated for calibrated waves The signals can then be used to determine the amplification of the waveform To insert the signal press then Mark Event If you press the Cal Signals softkey at the bottom of the screen when a recording is being run the signal appears on the display and is inserted in the recording Refer to Chapter 3 Setting up your Monitor for further details Recording Layout Choices on Recorder M1116A B Layouts Layo
157. e keys You can access the Control Panel Task Window by touching the Control Panel symbol in the lower right corner of the main screen display 1 28 The CMS and V24 and V26 Patient Monitors General Touch Mouse Trackball Operation CMS only Touch or Mouse Trackball Operation Control Panel Task Window Adult 27 JAN OO 11 30 120 70 91 28 15 21 400 Control Panel 51 lence HALarmS Other gni ear Praesg Panes Mocule Rese Volume Patients Setup cures Cales Setup If a touch responsive object or area of the screen is selected either by touch or by mouse click a white appears and the area is surrounded by a white frame In addition an audible click is issued The white frame disappears automatically when the object is released If an object or area of the screen that is not touch responsive is touched a white x appears in the selected area Note When using a mouse trackball the white and x signs appear wherever the mouse trackball pointer is currently located This indicates touch responsive areas before they are actually selected by mouse click The CMS and V24 and V26 Patient Monitors 1 29 xe q N gt ne o z o o Rel H 4 x e es Lnd e E 2 J a e N gt ne q N gt o c on o o E T o o c c o o N gt Touch or Mouse Trackball
158. e power cord from the monitor and leave it connected to the AC power source This could cause damage to the power cord Instead keep the power cord connected to the monitor and unplug it from the AC power source The power cord must be inspected periodically for cracks or exposed metal parts Replace immediately if there are any cracks exposed metal parts or any other signs of wear and tear The V24CT and V26CT can be powered by 1 or 2 sealed 12 Volt lead acid batteries with capacity The rate of battery discharge is dependent on temperature and power load The power load is a function of the number and type of parameter modules as well as parameter settings being used The battery life for the V24CT and V26CT ranges from approximately 30 minutes for a fully loaded system operating on one new and fully charged battery to e approximately 1 hour for a fully loaded system operating on two new and fully charged batteries when loaded with the following parameter modules ECG Resp NBP SpO Pressure Recorder and e approximately 1 hour 15 minutes for a minimally loaded system operating on two new and fully charged batteries when loaded with the following parameter modules ECG Resp NBP SpO Pressure 1 44 The CMS and V24 and V26 Patient Monitors V26CT V24CT Power Supply Battery life includes the time during the low battery alarm INOP Recharge Batteries until the unit shuts off We recommend you use 2 fully charged batteries to
159. e this connection The module can be operated from an ac power source of 100 240 V 1096 50 60Hz The adjustment is made automatically by the power supply inside the module Assem bling The Systems consist of the following separate parts the System The Display Module with control panel The Parameter Modules with parameter racks The Computer Module The Anesthetic Gas Module optional If the system display module and computer module was delivered as an unpackaged shipment the assembly procedure below does not apply Monitor Installation and Patient Safety 11 31 c o9 5 s T a td fa a z and Patient Safety Controls and Connectors M1167 77A System M1165 66 75 76A System The display module M1095A cannot be attached to the computer module M1046B It is designed for mounting on a horizontal or vertical rail such as an I V pole For further details please refer to the CMS Service Guide chapter 2 Installing CMS The computer module can be attached to the top or bottom of the Anesthetic Gas Module by a locking device This is a lever which is operated from the rear of the monitor and is attached to the bottom of both pieces of equipment To assemble the computer module and Anesthetic Gas Module e Ensure that the locking lever is in the far right position e Place the Anesthetic Gas Module onto the computer module ensuring that its four feet are in their correct gro
160. e waveform s and calibration signals Pressing Cal Signals during a recording produces a calibration pulse on that recording in addition to the calibration wave that routinely appears at the beginning of the recording The calibration pulse does not appear in the Vital Signs or Graphs display 8 18 Trends and Calculations Viewing Patient Data The calibration pulse varies according to the wave type ECG mV square wave RES 1 ohm M shaped wave All Pressures Stepped wave with 30 60 120 and 180 mmHg increments For pressure scales of 240 and 180 all four steps are displayed At lower ranges however not all the steps are displayed since one or more steps exceeds the full scale range Note If you don t want to insert a calibration pulse or mark an event after you have pressed Mark Event press any other hardkey such as Main Screen Trends and Calculations 8 19 oe S 2 25 gt S Sg Fo Performing and Reviewing Calculations Performing and Reviewing Calculations There are two calculation functions available Performcalculations where parameter values can be entered automatically or manually to perform calculations in a specified group Review calculations where previously made calculations can be examined The three calculation groups available are Hemodynamics Ventilation and Oxygenation Examples of values which can be calculated are given below v 2 Hemodynamics Ventilation s
161. eaning the Print head in the Plug In Recorder 0 0 00 00 00 02 ee 6 52 Loading Paper into the Four Channel M1117A Recorder CMS only 6 53 Cleaning the Roller on the Four Channel M1117A Recorder 20 6 55 Admit Discharge End Case 7 1 Admittng a Patient ossi date a ae Ae a date eR a Ta EE pede eRES 7 2 Changing Patient Information e 7 5 Discharging a Patient Ending a Case 0 0 eee ee 7 9 Trends and Calculations 8 1 Introduction to Trends amp Calculations 2 0 0 2 cece eee eae 8 2 Viewing Patient Data sez gen e want RE eh le a eee es 8 3 Trending Priority el ate geht ee ees BIER WE SERRA Shee MEE Sepe eee 8 5 Viewing Blood Measurements e 8 5 Viewing Vital SIGNS dosis SEES eURLPL ERN QE Maca NU EDEN Ce IDEE 8 9 Selecting Parameters for Graph Trends 0 0 00 8 12 Viewing Graph Trends sebo rtr hnekl9erthestreebbesiepBREWS9eq px Ruble ges 8 13 Performing and Reviewing Calculations 8 20 Pertorming Calc lations epe amp Rous ERR NUR ES SAR EERE 8 21 Changing or Entering an Input Value 8 25 Reviewing Calculations sess eposs epee erise er tie eia I eens 8 25 Printing Repotrtsuc c a Ope S E A p Lp mee UE ER e RE 8 26 Printing Task Window Reports leseseeeeeeeeee II 8 26 Printing Scheduled Reports 0 0 eee e 8 26 What to Do If Your Report Does Not Print 0 0 0 eee eee ee 8 30 Drug Calculator repere bn ePi p PI
162. ed e Realtime Vital Signs and Blood Analysis made on a M1116A B Plug In recorder e Trended Vital Signs made on a M1116A B Plug In recorder e Neonatal Event Review made on a M1116B Plug In recorder e OxyCRG recordings can be made only on an M1116B Plug In recorder Note Depending on the configuration of your monitor when you press Realtime Record either the Select Recording Waves window appears where you can choose the waves for a realtime recording or the Preset Recordings window appears where you can initiate delayed preset realtime and vital signs recordings To switch to the other window press Preset Recordng or Select RecWaves Recording Functions 6 7 7 E S 5 c gt LL e xe D 5 tc 7 c T 5 c 2 LL e xe LS 5 tc Delayed Recording Delayed Recording Definitions Delayed Recordings recordings of waveforms that are delayed in time so that if you see a waveform you want to record you can record it even if it has passed off the monitor screen A delayed recording runs for a preset time and begins with delayed waveform from before the recording was initiated Delayed recordings are either manual recordings initiated by the user generally called delayed recordings alarm recordings automatically generated when alarm occurs Depending on the model of your monitor a maximum of 4 delayed waves can be recor
163. ed before a queued request has started to run the queued request is cancelled and the latest request runs The recorder has failed notify your service personnel No Alarm Recording Available There is no Central Recorder operable or configured and the recorder configured for delayed recordings is not available Alarm recordings are lost Recorder Name Recorder Not Available Selected recorder is not operable or has not been installed Procedure Recording Running Trended vital signs recording or neonatal event recording is currently running 6 46 Recording Functions Recording Status Messages Message Meaning Wrong Procedure Recorder Configuration A trended vital signs recording or neonatal event recording has been requested but not supported by the selected procedure recorder Check Paper Door on Recorder Name Recorderl Recorder Name Recorder Stopped The bedside recorder is out of paper or the recorder door is open load new paper and or shut the door An actively running recording has been stopped by pressing on the recorder orthe Stop Recordng softkey on the display or a timed recording has stopped automatically Recording Waves that are being Rec A timed recording is currently running on a Bedside or a Central Recorder Waiting for Recorder Name Recorder A recording has been requested for a recorder that is currently busy Recorder
164. ed to a Patient Information Center 78504 and 78508 and you are using an 78572 recorder please observe the following rule e Always select a valid waveform Do not select Blank as the waveform to be recorded in the Select Recording Waves Task Window as the recorder will not function It will give the prompt Central recorder not available e For the Monitor connected to the a Philips central station realtime recordings must have at least one non blank channel to generate a recording on the central recorder 6 24 Recording Functions Realtime Vital Signs Blood Recordings Realtime Vital Signs Blood Recordings 2 S i5 c gt LL jo c o D o o tc Definitions 1 Realtime Recordings recordings of vital signs blood analysis from the time of your request 2 Automatic Recordings automatic recordings of vital signs blood analysis by an NBP measurement or by a blood analysis measurement The NBP measurement can be taken by the M1008A B module or an NBP monitor connected through VueLink Recordings can also be triggered by a timer when an independent NBP monitor is used 3 Timed Interval Recordings recording of vital signs blood analysis at specific timed intervals Recordings can include e Just vital signs data e Just blood analysis data e Acombination of vital signs and blood analysis data Vital signs blood recordings are made only at the bedside on the M1116A B
165. eeee e 3 20 Procedure ssi ss Sica dee eet Gaeta E te ie a ERE EE eR 3 20 Displaying Split Screen Trends 3 22 oxyCRG Display opi es o RR REED RISO Rx E eo nde ha 3 25 Notes on oxyYCRG elestbepRe bene ReeRECE pe Merge peeTebepee 3 26 CSA Display CMS only i e Ree Ee Lr eS ERE ERE S RR 3 28 Notes on CSA ase EEULA Seb eS Nee tuere A este ou a ON ea 3 29 Wave Replace s eee eee OR E Re uta RC HE 3 30 Proced re seins Leser Ue ERR RES RETPSELR N E aye bebe Each cee oA eo olds 3 30 Trace Mode ys ss sura a eR Ab a PCR E EE C eq ee Rp eR 3 31 Procedure ee Gg Se We ERBEN Ue A NA es EI PN arr 3 31 Configuring a Second Independent Display CMS only 0 00000 2 ee ee 3 32 Other Functions You Can Configure 0 0 eee ene 3 33 Adjusting the Volume Control 2 0 00 cee cece e 3 35 Procedute s eee PRESA bises Aree bo T E SH ee SS 3 35 Adjusting the Date and Time cesse Ree A Rr ERR RA 3 37 Proced te ie tekheee REFERRE ene RENE Rr ED REESE A a 3 37 Selecting Waves for Central Recorders 0 0 ec eee 3 39 Configuring Module Bedside and Central Recordings 0000000000005 3 40 Other Patients Controls lt r sociai in a e RRRLERERICReRDEU E esl ER ae tu 3 41 The Status Log Function hse cide taal d ERROR Nee een 3 42 The Monitor Revision Function 0 0 0 eee e 3 43 Changing Default Settings and Patient Category 0 0 00 eee ee eee 3 44 Changing the Patient Category
166. eenChoice A Channel 2 ECG CH2 aVR l Screen Label Standard Channel 3 PRESS 1 ABP BNumbrOfWaves 8 Waves Channel 4 PRESS 2 PAP BOverlap 1 non overlap Channel 5 EEG CH1 EEG BApplicWindow None Channel 6 EEG CH2 EEG2 H Wave Replace Disabled Channel 7 PLETH PLETH Trace Mode Fixed trace Channel 8 RESP RESP A Bo naves Select GCnenge Realtimel Numeric Item Eonten speeds On off Procedure 1 Press Selectltem until NumbrOfWaves is selected on the screen ps 2 9 gt x 22 gt 5 E 72 2 Press Change Content to choose 4 6 or 8 waves to be displayed depending on your model 3 Press to return to the Selection Window or to return to the main screen Setting up your Monitor 3 13 Changing the Wave Overlap Changing the Wave Overlap The wave overlap refers to the position of particular waves on the Screen You can select to have overlapping and non overlapping waves Overlapping waves allow a larger wave amplitude and you can compare waveforms of various parameters i e pressure waves Display1 Setup gt Select Item DAVID SCHULTZ ICU Adult 15 FEB 99 17 12 II KP EO HPA La xix HR Non paced mode Purse 80 1mV 80 spo 97 avr ABP 120 80 96 B pla a ScreenChoice A Screen Label Standard Channel 1 ECG CH1 II BScreenChoice A Pa Channel 2 ECG CH2 aVR l Screen La
167. eir corresponding boundaries The alarm limit values are always displayed within the rectangle defined by alarm limits if they fit Note Some trends such as vital signs that are received through VueLink do not have alarm limits associated with them In this case no rectangle is displayed for the alarm range Instead the default range scales are displayed with low intensity on the left side of the trend display to distinguish them from alarm limits Trend data is only displayed for those vital signs that are positioned in the left column of the numeric display Viewing Trend Three trend values are displayed for invasive pressure systolic diastolic Data for and mean pressure These three trends are displayed together as shown in Invasive Blood the diagram below Pressure A mA 135 85 invas tif LI c LI E gt Q gt Le c o Display of Trend Data for Invasive Blood Pressure Example The alarm limits can apply to any of the three pressures depending on how they are configured The alarm limits are therefore prefixed with a letter which identifies the pressure to which they are configured These letters are S Systolic pressure D Diastolic pressure M Mean pressure Setting up your Monitor 3 23 LI gt gt Q gt 22 c p o o Displaying Split Screen Trends Viewing Trend Data for Non invasive Blood Pressu
168. el 4 PRESS 2 PAP H overlap 1 non overlap xz Channel 5 EEG CH1 EEGI BApplicWindow None Channel 6 EEG CH2 EEG2 Wave Replace Disabled 9 Channel 7 PLETH PLETH WTrace Mode Fixed trace ro Channel 8 RESP RESP E S S Enabled c E3 2 Select Shenge Real t imel Numeric Item antent Speeds On off Procedure 1 Press Selectitem until Wave Replace is selected on the screen 2 Press Change Content to enable or disable Wave Replace With Wave Replace enabled assigned but currently unused channels will be filled with another wave 3 Press to return to the selection window or to return to the Main Screen 3 30 Setting up your Monitor Trace Mode Trace Mode Trace Mode allows you to choose between fixed and moving traces MoniorSetup Display Setup gt Select item DAVID SCHULTZ ICU Adult 15 FEB 99 17 17 IH als ne NT A x lA NI HR Non paced mode z Wuse 80 1mv 80 spo 97 di ABP 120 80 96 B pla e a ScreenChoice A Screen Label Standard Channel 1 ECG CH1 II l ScreenChoice A Channel 2 ECG CH2 aVR l Screen Label Standard Channel 3 PRESS 1 ABP ll NomorOfWaves 8 Waves Channel 4 PRESS 2 PAP H Overlap 1 non overlap Channel 5 EEG CH1 EEGI BApplicWindow None Channel 6 EEG CH2 EEG2 lave Replace Disabled Channel 7 PLETH PLETH Trace Mode Moving trace Channel 8 RESP RESP E revira 3 gt 22 DS Select Sh
169. el Standard Channel 3 PRESS 1 ABP BNumorOfWaves 8 Waves Channel 4 PRESS 2 PAP H Overlap 1 non overlap Channel 5 EEG CH1 EEGI BApplicWindow None Channel 6 EEG CH2 EEG2 lave Replace Disabled Channel 7 PLETH PLETH Trace Mode Fixed trace Channel 8 RESP RESP E eee AUSSEN Alii RSEN PRESS 1 PRESS Acca A LA CI N RES venti Benth ASC YAS Agent AS os PEG CHT A S ES ES Blank Select Shenge iReal t imel Numer ic Item antent Speeds On orr x c LI gt gt Q gt 22 c p o Notes e You can also return to the Display Setup Task Window from the Realtime Speeds Task Window by pressing the softkey Display Setup 3 8 Setting up your Monitor Procedure Assigning Waves to Screen Channels l Press Select Item repeatedly to select a channel on the Screen 2 Press Change Content to move the selection to the wave you want to place in your selected channel 9 Repeat steps 1 and 2 for each wave position you want to change 4 Press to return to the Main Screen screen Note If one of the assigned waves is not available parameter switched off or unplugged then another wave will use its channel until the assigned wave is reactivated provided Wave Replace Mode is enabled The channel will only remain blank if e Itis assigned to ECG or Blank e Another wave is available but numerics aligned to that wave a
170. elease of your Monitor Types of Transfer The transfer of blood analysis data from one monitor to another will vary depending upon the software level of your monitor Please refer to one of the scenarios on the next pages to transfer blood analysis data To identify the software release of your monitor press Monitor Revision Show SW Rev The software release of CMS can be identified in this task window by the suffix of the EPROM pack part number The software release of a V24 and V26 can be identified in this task window by the prefix of the software release name The following table lists the suffixes and prefixes CMS V24 and V26 Software Release EPROM pack part Software Release Name number suffix Prefix A E n a B F n a C G HorI C D K n a E LorM E F NorP n a G T orU n a A 0 V H B 0 W K C 0 A L C 1 E L D 0 n a M Data Transfer Data Transfer 10 11 Types of Transfer Blood Analysis e Transferring data from a source monitor to a destination Data Transfer monitor where Scenarios The source monitor is CMS Release G or later or V24 and V26 Release A O or later The destination monitor is CMS Release E or later or V24 and V26 Release A 0 or later or V24 Release E 1 Plug the Data Transfer Module into the rack of the source monitor 2 Press the hardkey on the module and transfer all data to the module
171. els on the strip The time the three wave labels and the scales for the oxygen and beat to beat Heart Rate channels are printed periodically on the recording oxyCRG Recordings o Z f z o 5 ra o L fe o o tc Three speeds are available for oxyCRG recording 1 2 or 3 cm min You can choose the speed in the oxyCRG Task Window values at this point recorder speed were taken at Date time recording was initiated Patient Name Current Numerics amp Alarms 2 cm min V05 JUL 9 11 20 8AMIN 05 JUL 94 11 20 180 THOMAS SMITH 123789 RN se EU UN HR 127 PULSE 125 PULSE 125 120 100 109 ABP 80 40 59 goa eu eee PAP PAP ZERO CHECK CAL 8 SpO2 87 SpO2 87 lt 90 NBP 82 41 60 05 JUL 94 10 56 90 ESP AWRR 40 T1 35 2 T2 T2 Note oxyCRG recordings made at slow speeds 1 or 2 cm min can cause deposits of paper debris on the print head over time In this case recordings may appear unevenly faint To correct see Cleaning the Print head in the Plug In Recorder on page 6 52 Then reload the paper and continue recording Recording Functions 6 37 oxyCRG Recordings 4 es S 2 5 E rm fo KJ A e 5 x oxyCRG gt Recordng Setup gt Delayed amp Alarm Alarm x DAVID SCHULTZ ICU Adult 15 FEB 99 17 55 Recording 1 HR Non paced mode hn ala wlan AJL A ala 80 WWpucse 80 1mV spo 9
172. ences in operating the system The following sections contain the instructions specific to touch mouse or trackball operation V24C and V26C monitors with option T01 allow touch operation in addition to the standard operation Mouse and Trackball operation is not available for the V24 and V26 monitors The CMS and V24 and V26 Patient Monitors 1 27 ne q N gt o c on o o E T V26 Patient Monitors Touch or Mouse Trackball Operation Main Screen Control Panel Task Window The layout of the main screen is basically the same as with other CMS V24 and V26 Patient Monitoring Systems with the only exception that it contains three additional buttons the Silence Reset button the Suspend button both in the upper right corner of the display and the Control Panel button in the lower right corner of the display These buttons are touch responsive and can be used alternatively to the hardkeys of the control panel or the handheld keypad Adult 31 JAN OO 8 50 Non paced mode Silence Reset si 10 ST2 06 ABP 120 70 91 Suspend PAP 28 15 21 Control Panel ETCO 40 IMco Q Note Do not remove the keypad from systems with touch or mouse trackball operation as it is still required to perform certain tasks The Control Panel Task Window contains most of the hardkeys found on the control panel of non touch systems See Hardkey Functions on page 1 12 for detailed descriptions of thes
173. enge Real t imel Numeric Item Eentent speeds On off o 2 Procedure 1 Press Selectltem until Trace Mode is selected on the Screen 2 Press Change Content to choose fixed or moving traces 3 Press to return to the selection window or to return to the Main Screen Note Moving Trace is not recommended for flatscreen displays Setting up your Monitor 3 31 A 2 9 2 ax 22 gt 5 Cc c2 o Configuring a Second Independent Display CMS only Configuring a Second Independent Display CMS only The second independent display is normally configured as a true surgeon s display We suggest that Surgeon is the most appropriate key label It does NOT contain any alarm indications blinking messages or or alarm controls or outputs alarm sounds or lamps You can change the screen to have the same display as the main display or you can have a different configuration There are again five separate display screens the default names are Screen A Screen B Screen C Screen D and Screen E To get into the Task Windows press Display2 Setup in the Monitor Setup Selection Window The procedures are then the same as for changing the main display described in Changing Display Screens Monitor Setup Display2 Setup DAVID SCHULTZ ICU Adult 15 FEB 99 17 20 II HR Non paced mode nA La da da d l 90 Purse 80 1mV spo 97 avr ABP 120 80 96 B pla a ScreenChoice A Screen La
174. ength of the power failure Less than 60 seconds Patient Data Management data and all settings retained Less than 3 hours Patient Data Management data retained AII settings revert to user defaults More than 3 hours Patient Data Management data not retained All settings revert to user defaults Time setting may be lost if not networked If the monitor is connected to a Patient Information Center 78504 and 78508 and you select the same lead for ECG channels 1 and 2 the wave is not displayed in channel 2 of the Patient Information Center If you want to stop patient monitoring but keep all settings and Patient Data Management information you can switch the monitor into Monitor Standby 1 Press Alarms Volume or Alarms 2 Press Monitor Standby All waves and numerics disappear from the display and all monitoring is suspended The word Standby appears in big letters on the screen 2 10 Getting Started Attaching the Patient If your monitor is connected to a Philips patient care system while the monitor is in standby no parameter data from your monitor is sent over the system Instead a message indicating that your monitor is in Standby is sent to other beds in the system and is displayed at the central station If your bed is configured to receive alarms and another bed in the system goes into alarm the status message Other Bed in Alarm is displayed on your monitor You will hear the overview prompt t
175. ens 1 33 M1046B Computer Module 1 0 0 cece eens 1 34 Contents 2 ECG Output and Defibrillator Marker Input 0 000000 eene 1 34 The V24 and V26 Parameter Module Rack 1 0 0 0 0 coe eee eee 1 35 Operating Rules to Remember 0 0 0 1 36 Performance Specifications of the Philips Displays 0 0 eee eee eee 1 37 M1095A Flatscreen Display 0 0 0 0 cece III 1 37 M1094A B and M1092A CRT Display 0000 1 37 M1097A A02 XGA Flatscreen Display 0 0 0 2 cece eee eee 1 37 Using an ITE Display e fa ee a Rar e ae Po ahd Be OAR hk c RARE 1 38 Safety ereer hee Sl eget be ope a dd ee ded he he RR eere ene erede a 1 38 EMG 2 251 d n et Loeb bead pcd pede ae tede dd 1 39 Performance Requirements lees 1 39 Getting Started 2 1 Setting up the Monitor V24 and V26 only 0 eee eee eee eee 2 2 Setting up the Parameter Modules 0 0 cece cece ene eee 2 5 Attaching the Patient scs fo aa ete nd Sasha Re Res dr cr e arsi 2 6 Adjusting Screen Contrast 0 ee ee e 2 7 Starting Monitoring sc sis ok p pep hp Ra egre gis 2 8 Screen Messages ccs cesso elemen I Edd Ne eme c etg 2 8 Reserving a Channel i s cia eR Eee eee RARE UR be ee RS 2 9 Power Eail re 02 te ee yiet eee eet eb Eos ROLE pen eb eie estes 2 10 Patient Information Center 0 00 eee cee eee nee 2 10 Monitor Standby osceno ss san eee eels Goes Gee SA eee Bea
176. ent so you can see the change in the patient s condition When a patient goes into an alarm condition an alarm recording is generated automatically according to the monitor s configuration You can determine the alarm severity on a parameter by parameter basis that will cause an alarm recording to run You can also enable and disable alarm recordings for individual parameters With the exception of oxyCRG alarm recordings alarm recordings run at a speed of 25 mm sec regardless of the speed selected in the Delayed Alarm Recording Task Window OxyCRG alarm recordings run at the pre configured oxyCRG speed If oxyCRG is enabled in your monitor s configuration you can select the type of alarm recording standard or oxyCRG refer to Configuring Delayed Recordings on page 6 9 6 12 Recording Functions Configuring Alarm Recordings 7 RecordngSetup AlarmRec On Off 4 Alarm Recording 7 E T 5 c gt LL e Ke A 5 tc DAVID SCHULTZ ICU Adult 23 JAN 99 22 03 II HR Non paced mode HR J A l Pd A gt A 80 Keuse 80 imv spo 96 BYR ABP 120 80 96 Ala Record m m m ECG Red Yellow SpO 2 SpO 2 Yellow ST Yellow SvO2 SvO Yellow PULSE PULSE Yellow CO Red Yellow PRESS 1 ABP Red Yellow FIO Red Yel low PRESS 2 PAP Red Yellow RESP RESP Red Yellow PRESS 3 CVP Red Yellow VentIf Red Yellow PRESS 4 ART Red Yellow AirwyCO Red Yellow PRESS 5 P5 Red Yello
177. er Patients The frame around the softkey for a bed in alarm will blink until the alarm is silenced by that bed If the alarms on a bed in your Other Patients Selection Window are suspended the amp symbol will appear on the respective softkey ref AL er Pouce B0 mv 00 cvP es TDELZI 119 80 96 25110 16 TP 1 Spo 2 024 95 Incoming Alarm If your bed is configured to receive alarms you receive alarms from beds in your Other Patients group which are configured to transmit alarms If such a bed in your group goes into alarm it can be e A totally new alarm e Anew alarm situation on a bed which is already in alarm There are two ways your monitor can react e fitisin Main Screen it reverts automatically to Other Patients mode and enters the Alarm Bed Task Window e fitisina Selection or Task window the message Other bed in alarm is displayed in the status line In both cases you will hear the Other Patients prompt tone consisting of two double beeps Philips Patient Care System The Alarm Bed Task Window shows the bed label of the other bed in alarm the primary wave up to 10 numerics of the parameters being monitored INOP and ALARM messages in a rotating field The alarm parameter numeric will be blinking If the alarm at the other bed has been silenced the message SILENCED appears below the wave If your monitor is configured to receive silenced alarms the Alarm Bed Task Window remains on
178. er to the equipment in general Warning A warning calls attention to the user of imminent hazard to people if proper procedures are not followed viii For continued safe use of this equipment it is necessary that the listed instructions are followed Instructions in this manual in no way supersede established medical procedures Explosion Hazard Do not use this equipment in the presence of flammable anesthetics Alarms Do not rely exclusively on the audible alarm system for patient monitoring Adjustment of alarm volume to a low level or off during patient monitoring may result in patient jeopardy Remember that the most reliable method of patient monitoring combines close personal surveillance with correct operation of monitoring equipment This equipment is only intended for use in healthcare facilities by trained healthcare professionals The product is not intended for outside hospital use such as a helicopters or ambulances This product is not intended for home use To reduce the risk of electrical shock do NOT remove any cover Refer servicing to qualified personnel This equipment may interfere with ultrasound imaging equipment by causing interference on the ultrasound display Try to keep the instruments as far apart as possible Indications for Use e Exposure of electrical contacts or connections to saline or other liquids and gels is dangerous Electrical contacts and connections such as cable connectors
179. ered with the three oxyCRG waveforms The number of realtime waves that you can display simultaneously with oxyCRG is related to the maximum number of realtime waves that your system is capable of displaying Details are provided in the following table Main Screen Standard Display oxyCRG Display 4 realtime waves oxyCRG 1 realtime wave 6 realtime waves oxyCRG 2 realtime waves 8 realtime waves oxyCRG 3 realtime waves Notes on e The oxyCRG information is overlayed on the realtime waves at the oxyC RG bottom of the Main Screen These realtime waves disappear from 3 26 the display but the parameters are still being monitored and the parameter alarms are still active e If oxyCRG covers part of an overlap channel the entire overlap channel disappears from the display e The Freeze Waves softkey has no effect on the oxyCRG section of the Main Screen because the display speed is very low e The beat to beat heart rate btbHR in the oxyCRG display will vary from the heart rate HR numeric on the Main Screen since the HR numeric is an averaged value e Ifthe monitor is switched off for less than 60 seconds oxyCRG data is retained However when the power is switched back on you will see gaps in the oxyCRG display The gaps correspond to the amount of time it takes the monitor to get the first readings after power is restored not the amount of time that the monitor was switched off For this
180. eter Modules To assemble the display module and parameter rack e Connect the parameter module rack with the front end cable to the connector on the left side of the display module e You now have an electrical connection from the rack to the display module and will see monitoring displays Lifting the Display Module The V24 V24C and V26C display module weighs 11 3 lbs 5 1 kg The V24CT and V26CT display module weight 14 8 lbs 6 7 kg without batteries and 16 9 lbs 7 7 kg with batteries Use the monitor s handle when lifting or carrying the monitor You may need to support the bottom of the monitor with your other hand Caution If the monitor falls or is dropped check the display for any cracks If the display is broken contact your biomedical department or local state environmental personnel for proper disposal Note At this time Philips Medical Systems will make available on request and in English only such circuit diagrams component part lists descriptions calibration instructions or other information which will assist the user s appropriate qualified technical personnel to repair those parts of the equipment which are classified by Philips Medical Systems to be repairable 11 36 Monitor Installation and Patient Safety Accessories and Ordering Information Accessories and Ordering Information M1276A M1041A 8120 5236 78599AI J03 78599 AI J06 78599AI J10 78599AI J20 M1181 61625 40488A
181. ety 11 9 c E z c T 7 S td e and Patient Safety Installation Information Philips M1167 77A CMS for Critical Anesthesia and Neonatal Care Operating Storage Temperature Range 5 to 45 C 41 to 113 F 20 to 60 C 4 to 140 F Humidity up to 95 RH at 40 C 104 F up to 85 RH at 50 C 122 F Altitude Range up to 4 600m 15 000 ft up to 4 600m 15 000 ft Philips M1165 66 75 76A CMS for Critical Anesthesia and Neonatal Care Operating Storage Temperature Range 0 to 45 C 32 to 113 F 40 to 70 C 40 to 158 F Humidity up to 95 RH at 40 C 104 F up to 95 RH at 65 C 149 F Altitude Range up to 4 600m 15 000 ft up to 15 300m 50 000 ft ACMS with Anesthetic Gas Module Operating Storage Temperature Range 15 to 40 C 59 to 104 F 40 to 65 C 40 to 149 F Humidity up to 9596 RH at 40 C 104 F up to 9596 RH at 65 C 149 F Altitude Range up to 3 048m 10 000 ft up to 15 300m 50 000 ft Philips M1205A V24 V26 V24C and V26C Operating Storage Temperature Range 5 to 40 C 41 to 104 F 20 to 60 C 4 to 140 F Humidity up to 9596 RH at 40 C 104 F up to 9096 RH at 60 C 140 F Altitude Range up to 4 600m 15 000 ft up to 4 600m 15 000 ft 11 10 Mo
182. ferring up to 24 hours of trend Transferred data and demographic information When a transfer is initiated the following data is transferred Continuously monitored parameters for example ECG Resampled Values Aperiodic measurements for example CO All patient demographic information except bed number The time at which calculations were performed in the Hemodynamic Oxygenation and Ventilation calculation task windows e Marked events e ST events lead changes reference changes The following data is not transferred e Waveforms including ST and CO waveforms e Split Screen trends e Arrhythmia events Data Transfer Data Transfer 10 5 Data Transfer Module The order in which the parameters are listed on the display is relative to the destination monitor not the originating monitor Patient demographics have the highest priority in the order of data being transferred The aperiodic parameters are transferred next before continuously monitored parameters for each hour During a transfer to the monitor aperiodic data obtained by the receiving monitor after the start of the transfer will have higher priority than the aperiodic data from the module Note If the module is unplugged before a transfer is complete some data may not be transferred With the exception of gas parameters if a parameter has different units at the source and destination monitors the data from the source will be converted to the units
183. figured on when the monitor is turned off a vital signs recording will be generated within the 30 seconds after the monitor is turned back on If vital signs blood recordings are configured on when the system clock is changed a recording will be generated immediately Subsequent recordings will be generated based on the configuration choices 6 26 Recording Functions Making a Single Vital Signs Blood Recording Making Timed Sequences of Vital Signs Blood Recordings Realtime Vital Signs Blood Recordings If your monitor is configured to have a VS Blood PLUG IN softkey in the Preset Recordings Task Window you can initiate a single vital signs or blood recording ICU Adult 15 FEB 99 17 46 HR on paced mode ERES NEN WEEDS EIN EAE an 1 Reuse 80 imV STi 00 CvP epo queque Ts An automatic sequence of vital signs blood recordings can be enabled or disabled in monitoring mode in the Vital Signs Blood Recording Task Window under Monitor Setup Recorder Setup You can also determine whether vital signs recordings will be initiated on an NBP measurement a blood analysis measurement at a specific time interval or any combination of the above New configuration choices become effective when you leave the Vital Signs Blood Recording task window Any recordings currently active will be completed using the old choices and the next recording will use the new configuration The settings for vital signs b
184. ge Not all numerics displayed is displayed This message can be disabled in configuration mode by your biomedical engineer or by the Philips service engineer Numeric Parameter numerics on the Main Screen screen are shown as aligned Positioning numerics the numerics are next to the corresponding waveforms Aligned Numerics The monitor controls the position of numerics on the screen and also controls the size of some numerics Numeric Positions Numerics are positioned on the screen in the following order 1 Parameters with waveforms such as Pressure are positioned first The numerics are aligned with the corresponding waveform 2 Numerics which are part of a contiguous block i e CO2 AGM ST BIS HR PULSE are positioned next o 3 Parameters without waveforms which are not part of a contiguous block such as Temperature are positioned in the left column if space is available Otherwise they are placed from bottom to top in a column to the right of the waveform numerics according to their priority as shown in the Numerics On Off Task Window LI gt gt Q gt 22 c p o 3 18 Setting up your Monitor Additional Information Selecting Realtime Wave Speeds Numeric Sizes Parameter numerics on the screen are displayed in 2 sizes big or small When there are too many large numerics to be displayed on the Main Screen display the monitor performs the following act
185. ged the acknowledged bed no longer appears in your Other Bed Alarm stack It is NOT removed from Other Patients 4 5 Philips Patient Care System the alarm stack viewed by other monitors in the Other Patients group No arrow next to a bed number means either there are no more new alarms or all the existing alarms have been acknowledged o c o 2 Q o t o 4 6 Other Patients Configuring the Other Patients Controls Philips Patient Care System With the Other Patients Controls you can place your own bed into one of eight groups A B C D E F G orthe ALL group based on nursing care assignments within a unit The Other Patients Controls Task Window allows you to change the Send Receive alarms configuration for your bed Note When a bed is assigned to the ALL group alarms can be received from and sent to beds in group A G as well as the other beds in the ALL group When a bed is assigned to any group in A G alarms are received from and sent to any bed in the same group and also to beds in the ALL group Note The bed will automatically be assigned to the ALL group if the connection to the Philips monitoring network is interrupted for example if the Philips monitoring network cable at the back of the monitor is disconnected or the central station is switched off and the monitor comes back on a different branch Note Any changes made to Other Patients settings will be stored for up to th
186. gnals RESULT If the module is functioning correctly the following Derived values and waveforms are displayed without the alarms being activated SpO 100 Pleth Wave height after auto gain is 100 of scale height S c oO E 7 E Oo Pleth Pulse Rate 100 bpm in ADULT mode 125 bpm in NEO PEDI mode Auto Check None Self Test The Cardiac Output module test may be performed at any time The test signal lasts about 30 seconds and then the display returns to the normal monitoring mode TEST Press gt Test Signals RESULT If the module is functioning correctly the following derived values will be displayed without the alarms being activated Cardiac Output 5 0 l min 0 1 l min TBlood 37C 0 1C Tinj 0C 0 1C Maintenance 13 17 o o c c o 2 Performance Assurance Checks Performing the tcpO tcpCO5 Module Self Test 13 18 Maintenance Auto Check The check is performed automatically when the system is switched on during calibration and continuously when no transducer is connected When the auto check fails the INOP message Equipment Malfunction is given refer to the Troubleshooting Chapter in the service manual for troubleshooting details Self Test The tcpO tcpCO module self test may be performed at any time The test signal lasts about 30 seconds and then the display returns to the normal monitoring mode TEST Press Test Signals RESUL
187. he Philips M1205A V24 and V26 Service Guide and check the fuses on the battery contact board c Repeat this procedure for the second battery o o c c o 2 13 12 Maintenance Functional Testing Procedures Perform a Quick System Check Performance Assurance Checks The system has a module self test which generates and displays test waveforms and corresponding numerics for all the modules that are connected and turned on The test signals are displayed for about 30 seconds and then the display returns to monitoring mode The test signal will be displayed only if the system self test was successful and the parameter is plugged into the system and turned on Perform the following quick system check to verify that System board integral rack and modules are communication properly before verifying the individual parameter modules You can verify that the System board integral rack and modules are communicating properly by completing the following test TEST Press the ECG key on the front of the ECG module in a system that is turned On RESULT Pressing the ECG key brings up the ECG Task Window and verifies that the System board and integral rack are communicating with the plug in module If the plug in module Task Window waveform or numeric is missing from the display the module may not be turned On Try pushing the key on the plug in to see if the system is communicating with the module o c
188. he system connects the reference resistors to the beginning of the processing circuitry and processes this test value in the same way as the patient values are processed The test signals last about 30 seconds and then the display returns to the normal monitoring mode TEST Press gt Test Signals RESULT If the module is functioning correctly the following temperature will be displayed without the alarms being activated Temp 40 C 0 1C Maintenance 13 19 o o fa c 2 Performance Assurance Checks Performing the Blood Analysis Module Self Test Performing the Recorder Module Self Test Performing the Data Manage ment Data base Self Test 13 20 Maintenance Auto Check The Blood Analysis Module performs a check when the system is switched on Self Test The Self Test with the External Simulator M3634A may be performed at any time TEST Insert the External Simulator into the cartridge slot of the module RESULT Either PASS or FAIL will be displayed on the Monitor to indicate whether the module has passed the self test or not If the module fails the self test try the procedure again If it fails again wait half an hour and then try the procedure again If the module continues to fail the self test the module should be replaced Auto Check The recorder module performs a check when it is plugged into the parameter module rack Self Test The Recorder Module check
189. ich the batteries discharge is dependent on the power load or the number of modules and type being used c SD 6 Ca E os ES gt Sg Za G mo e tanpears on the display instead of the battery symbol graphics when a battery is unplugged or removed e Ifyou are running the monitor by the batteries the two lead sealed batteries are indicated in the lower right of the display by battery symbol graphics Note Battery 1 is the battery on the right when looking at the back of the monitor This battery corresponds to the 1 battery symbol graphic on the display screen s lt lt PAP m c E 30 17 23 Dee a SpO 100 Turin EE TT FULL Battery Fuel Gauge Battery Symbol Graphics 12 6 Battery Information V24CT and V26CT only Battery Indicator and Messages A low battery alarm INOP tone will sound and the flashing message RECHARGE BATTERIES will replace the battery gauge Remaining monitoring time on the batteries is typically 15 minutes with new batteries at room temperature 25 C The Silence Reset key will silence the tone for 3 minutes When new batteries are inserted or the monitor is plugged into AC line power the low battery condition will be cleared Alarm tones for patient alarms will have higher priority than the low battery INOP tone The battery fuel gauge will be replaced by the message AC POWER ON when the monitor is plugged into AC SD
190. ings the user presses one of the pre configured recording keys to initiate recording of pre selected waveforms on a pre selected recorder The waves are identified above the key labels the recorder name appears on the key label Non Preset Recordings the user selects the waveforms and recorder immediately prior to making the recording Realtime Recording Mode a pre selected set of waveforms will be recorded when one of the pre configured recording keys is pressed Three separate recording modes A B C can be configured The user can choose the waves to be recorded their positions on the recording strip and the recorder to be used Mode B may be reassigned to vital signs blood recordings and Mode C to oxyCRG recordings depending on the monitor s configuration A particular mode might be configured to record a specific procedure performed in a unit Realtime recordings can be produced on Plug In 4 channel bedside and central recorders Remember that realtime recordings are initiated in two Task Windows Preset Recordings and Select Recording Waves depending on the type of realtime recording 6 20 Recording Functions Configuring Preset Recording Modes Realtime Wave Recordings gt Recordng Setup Mode A Recordng 7 E T 5 c gt LL e xe LS 5 as DAVID SCHULTZ ICU Adult 15 FEB 99 17 51 II EP NT ee don AL AL HR Non paced mode Wrurse 80 imv 80 spo 97 me ABP 119 80
191. ion Hardkey Functions Silence Reset press to silence an alarm or alarms that are sounding or if alarms are latching to reset them press to suspend or switch on all alarms The current state is indicated by the Alarm Suspend Lamp press to return to the main monitoring screen CMS only press to change between screen layouts or to access a 2nd or 3rd display You can also freeze any wave movement on the screen INOPs alarms and numerics are not affected Realtime Record press to record pre selected waves onto a system recorder or a bedside recorder Delayed Record press to record pre selected waveforms that are no longer on the monitor screen press to enable you to suspend or switch on alarms set and review alarm limits enter Monitor Standby or set the alarm volume Other Patients press to enable you to view data from other beds in your group press to enable you to pre select certain system characteristics press to enable you to set up and perform procedures such as Cardiac Output Wedge Pressure CMS only ST analysis Drug Calculations admit and discharge patients or end a particular patient case and transfer patient data Trends Calcs press to enable you to view vital signs and graphical trends make and review calculations print reports and mark events to view in graphs Module Setup press to enable you to change or adjust parameter settings switch parameters on
192. ion Window one line at a time For information on how to change the selection see page 1 25 There is also an arrow symbol in the Window that moves along the selected line when the cursor keys are pressed To enter the Task Window to which the arrow is pointing press DAVID SCHULTZ Bed 6 Adult 16 FEB 99 19 27 I HR as M dA Lr n b Lan Meuse BD STi 00 CVvP ce Sa ABP 120 80 96 The CMS and V24 and V26 Patient Monitors 1 23 xe N gt o c o z o o Rel H 4 x fe es Lnd e E 2 J a e N gt procedures Each parameter or procedure has a series of Task Windows FE S9 5 Operating Levels o c aoc N 2 Task This is the second operating level which allows you to make changes or 8 E Window adjustments to the parameters and screen displays or to perform ON E There are two ways to get into the second operating level via the Selection Window or for parameters by pressing the Setup key on the parameter module DAVID SCHULTZ ICU Adult 16 FEB 99 20 55 II HR Non paced mode i L a0 purse 60 inv spo 100 ee RAS 21 Mew 4 cve 9 m QUNM ah eh t eene oU Ee eh E Spo 2 100 is Er j 5 depD Q lel D M HR 80 imv Monitor Mode automatic Alarm Limits 50 120 piod ed a MSN REM rrNTT INE NINNET IE ZUNDT EISETE NECITUEEN Multi Ladl Adjust Leer Size aE
193. ions to make more space available e The large numerics decrease in size starting from bottom to top e If more than one temperature is being monitored the additional temperatures are shown continuously in rotation in the position of the third temperature numeric Invasive pressures are multi numeric parameters because each pressure has numerics for systolic diastolic and mean pressures They are decreased in size Pressure 1 P1 numerics preferably stay big e The ST1 ST2 and ST3 values are shown next to the 2nd ECG channel if present e The NBP numerics are displayed big next to the 2nd or 3rd ECG channels or a blank channel e CO2 AGM and BIS numerics are each preferably kept together as a block Setting up your Monitor 3 19 LI E gt Q gt Le c o LI a c Selecting an Application Window Selecting an Application Window A 2 9 2 ax 22 gt 5 Cc c2 o Procedure One of three application windows can be selected for display in each screen e Split Screen e oxyCRG e CSA They are described in more detail in the following sections Monitor Setup Display1 Setup gt Select Item DAVID SCHULTZ ICU Adult 05 FEB 99 10 48 II Non paced mode bun p E AM A Me 8D ffrurse 80 Sp0 93 ABP 120 80 97 ScreenChoice A Screen Label Standard ECG CH1 II WScreenChoice A Channel ECG CH2 aVR l Screen Label Standar
194. is always ECG CHI b Press Change Second to select secondary wave c Press to store the selected wave d Press to return to the standard monitoring display 6 10 Recording Functions Making Delayed Recordings Delayed Recording To initiate a delayed recording on any recorder press Delayed Record On the Plug In recorder only press RUN CONT 7 E T 5 c gt Le e xe A 5 tc Delayed recordings can also be initiated from the Preset Recordings Task Window Here the waves pre selected for a delayed recording are identified above the Delayed softkey label DAVID SCHULTZ Bed 6 Adult 16 FEB 99 19 22 I HR nb J nn A g 0 Bl Nus B0 STi 00 CVvP TE ABP 120 80 96 _ PAP 25 10 16 TP1 Spo 2 75 PLUS iN ESTERE Note If a delayed recording is configured so that it is produced on a Plug In recorder or a 4 Channel Bedside Recorder alarm recordings are also produced on this recorder If the specified recorder is inoperable for any reason the alarm recording is re routed to the central recorder Remember that arrhythmia alarms are always recorded at the central recorder Recording Functions 6 11 7 c T 5 c 2 LL e xe 5 tc Alarm Recording Alarm Recording Alarm recordings are a type of delayed recording that is the recording includes waveform information from before the alarm ev
195. is plugged in turned on and has paper loaded If you are using a printer at the central station be sure the central station is operating If these do not correct the problem call your Philips service representative MESSAGE Report Complete Meaning A requested report has been printed What You Need to Do You don t need to do anything MESSAGE Report In Progress Meaning A requested report is being printed on a printer What You Need to Do You don t need to do anything 8 30 Trends and Calculations Printing Reports MESSAGE Report Request Accepted Meaning The report has been accepted for printing What Do You Need to Do You don t need to do anything MESSAGE Too Many Reports In Line Please Wait Meaning The printer has reports waiting to print and cannot accept another report request What Do You Need to Do Do not send a new report request to the printer Wait and send your request when the message Report Complete appears MESSAGE Waiting For Printer Meaning A central printer is busy with another report What Do You Need to Do Nothing The requested report will be printed when the copier becomes available Trends and Calculations 8 31 ge E 25 gt S Sg Fo Drug Calculator Drug Calculator The drug calculator provides drug infusion information at the bedside for up to 24 drugs Using the calculator you can determine infusion rate dose amount or volume and display or print a tit
196. isplay Arrhythmia Alarms on th e 78720 Arrhythmia Computer Alarm Minimum Condition Requiring an Alarm EXTREME TACHY Heart rate gt Tachy limit RUN VPBs gt 9 Run of VPB s gt 9 and heart rate escl limit set for VENT TACHY RUN VPB s 3 9 Run of 3 9 VPB s PACER NOT PACE Missed beat without pace pulse in paced patient VPB s gt 23 min More than 23 VPB s minute VPB s gt 11 min VPB s gt 5 min More than 11 VPB s minute More than 5 VPB s minute 4 12 Other Patients Using Philips Patient Care System with an Arrhythmia Computer Arrhythmia Alarms on the 3150A 3153A Arrhythmia Computer Message Minimum Condition Requiring an Alarm ASYSTOLE No QRS for 4 consecutive seconds V FIB TACH Fibrillatory wave for 4 consecutive seconds V TACH Consecutive PVCs gt V Tach Run limit and HR gt V Tach HR limit TACHY yyy gt xxx Heart Rate yyy greater than the Extreme Tachy limit xxx BRADY yyy lt xxx Heart Rate yyy less than the Extreme Brady limit xxx NON SUSTAIN VT A run of Vs having a ventricular HR gt V Tach HR limit but lasting for less than the V Tach Run limit VENT RHYTHM A dominant rhythm of adjacent Vs vent rhythm limit and ventricular HR lt V Tach HR limit RUN PVCs Run of PVCs greater than 2 PAIR PVCs Two consecutive PVCs between non PV
197. isplay which may cause a safety hazard IEC601 1 44 3 The ITE display must be used with an isolation transformer e g Philips M1389A if the enclosure leakage current exceeds the requirements of EN60601 1 IEC601 1 normal and single fault condition The power cable must be secured so that the transformer cannot be disconnected without the use of a tool 2 Atest of the Enclosure Leakage Current normal and single fault condition of the complete system including the display has to be performed and documented 1 38 The CMS and V24 and V26 Patient Monitors Using an ITE Display EMC 1 The display must either fulfill the requirements of the EN60601 1 2 IEC 601 1 2 or it must conform to the requirements of the EMC standard for ITE devices EN50082 1 1997 and EN50081 1 CISPR 22 2 The video cable between M1167A 77A CMS Patient Monitoring System and the ITE display must not exceed a length of 3 0m For cables exceeding 3 0m EMC testing according to IEC 801 4 1988 has to be done Perfor Philips cannot assure compliance with the ANSI AAMI EC 13 Standard for mance Cardiac Monitors Heart rate Meters and Alarms when using ITE displays Require Compliance with the ECG aspect ration and 25 mm s 10 sweep speed ments specifications can only be assured when using the Philips Displays M1092A M1094B and M1095A In addition the following display specifications are recommended Specification Requirement o
198. it Discharge End Case Admitting a Patient Adult 30 JAN 00 13 02 Non paced mode spo 100 B 120 70 91 Patient Name DAVID SCHULZ Date of Admission Height Weight Sex Date of Birth Admitting Physician Attending Physician Other Admit Discharge End Case Soleet Clear Line Line ICU Mode Adult Pediatric Non paced mode spo 100 P 120 70 91 RP Infant s ID Number Mother s Name Date of Admission Gestational Age KEVIN AMES Current Length cm Birth Length cm Current Weight kg Birth Weight kg Sex s Head Circumference cm Date of Birth Admitting Physician Attending Physician Other Soleet Clear Print 0 V Line Line yel amp Board ICU Mode Neonatal Admit Discharge End Case 7 7 D m m E o Ll G lt a 2 e 2 E lt 7 o Admitting a Patient R Adult 30 JAN 00 12 53ALARMS SUSPENDED HR Non paced 0 Spo ABP 120 70 Patient Name Date of Procedure Height Weight Sex Date of Birth Anesthetist Surgeon Diagnosis Procedure Type ASA Category Other DAVID SCHULZ Medical Record mode 100 j 91 Soleet Line Clear Line Print Aami B 7 8 Admit Discharge End Case OR Mode Admitting a Patient Discharging Patient data for the current patie
199. ith the instructions for use To ensure optimum usage we recommend that Philips parts and accessories are used in conjunction with the Philips M1165 66 67 75 76 77A CMS Patient Monitoring System the Philips M1026A Anesthetic Gas Module and the Philips M1205A V24 and V26 Patient Monitors wherever available If non Philips parts are used Philips Medical Systems is not liable for any damage that these parts may cause to the Philips equipment Manufacturer s Address For South America North America and Canada Philips Medical Systems Inc 3000 Minuteman Road Andover MA 01810 1099 For all other countries Philips Medical Systems GmbH Hewlett Packard Str 2 71034 B blingen Germany Xi Responsibility of the Manufacturer xii Contents This book is divided into three volumes This volume contains chapters 1 to 13 see the following table of contents for more details 1 9 10 11 12 13 SDR Fo The CMS and V24 and V26 Patient Monitors Getting Started Setting up your Monitor Other Patients Alarm Functions Recording Functions Admit Discharge End Case Trends and Calculations Neonatal Event Review Data Transfer Monitor Installation and Patient Safety Battery Information V24CT and V26CT only Maintenance Volume 2 contains chapters 12 to 22 see the table of contents of Volume 2 for more details 14 15 16 17 18 19 20 21 22 ECG and ECG Respiration Module Section Noninva
200. ithin a unit should have the same alarm configuration o S fo 92 o r 2 LL E s lt Alarm Functions 5 3 o f fo 2 o i 2 ra E ee S lt x Alarm Display Suspended Alarms during Arrhythmia Monitoring Silencing and Resetting Alarms If all the alarms have been turned off using the Suspend Alarms softkey or the hardkey they can all be turned back on by pressing the SwitchOn Alarms softkey or the hardkey While the alarms are suspended permanently or for 1 2 or 3 minutes INOP messages continue to be displayed but alarm messages lamps and alarm tones are not active The nurse call relay is inactive Notes e While Arrhythmia is assigned the central Arrhythmia Computer takes over the ECG HR alarms e Suspending Alarms switches off all alarms including Arrhythmia alarms e If Arrhythmia is assigned and alarms are suspended the ECG HR alarms are switched off The ON OFF Softkey in the Alarm Limits and ECG Adjust Alarms Task Windows will not be available inactive softkey The ECG HR alarm ON OFF capability can only be reactivated by switching the main Alarms on or unassigning Arrhythmia If an alarm occurs you can silence it by pressing the LSilence Reset key This will silence ALL alarms that are occurring at that moment The alarm messages numeric will continue to blink You can configure your system on installation to have all latching or all non latching alarms or to
201. itor Selecting Screen Labels for Realtime Display Screens Selecting Screen Labels for Realtime Display Screens A screen label may be selected for a realtime display screen There are eleven choices Monitor Setup Displayt Setup gt Select Item ICU Adult 31 JAN 00 8 04 I HHR Non paced mode be DEP PUE per DER e inV ABP 120 70 91 ScreenChoice A Screen Label Channel 1 ECG CH1 I W ScreenChoice A Channel 2 PRESS 1 ABP W Screen Label Channel 3 PRESS 2 PAP E NumbrOfWaves 6 Waves Channel 4 Blank W Overlap 1 non overlap Channel 5 Blank W ApplicWindow None Channel 6 Blank WM Wave Replace Enabled Channel 7 Blank Trace Made Fixed trace 5 Channel 8 Blank e gt standerd f Surgeon vent ilat 2 9 E CxyCRS Blank Busan Der mS E z z Press Confirm to enter screen label edit mode MEESHIMDUNE o ele Change lites eo e anteng need Dn D Procedure 1 Press Select Item until Screen L
202. itor However if data from the previous patient is not erased it will appear in the trends with the new patient s data No distinction will be made between the old and the new patients data Changing At some time you may need to change or add to the patient information Patient entered for your patient If the monitor is connected to a central station Information name and medical record number can only be changed at the central station Otherwise all patient information in the Patient Information Task Window can be changed at the bedside using the cursor keys and the softkeys These keys have the following functions Admit Discharge End Case 7 5 pe wi io o aD lt o 2 e D lt Admitting a Patient Select Line Moves the cursor up and down Clear Line erases the input of a whole line ABC 123 toggle key to switch between Numeric and Alphabetical input The actual input mode is shown above the key ABC or 123 left and right cursor key select the digit on a line to enter or change up and down cursor key V24 and V26 only in numeric mode the selected digit of a number is increased or decreased in alpha mode the selected digit of a string changes in alphabetical order Print Admit prints the patient information confirm key stores the whole line Touch Board on touchscreens only calls up touchboard for alphanumeric data entry 7 6 Adm
203. kin s Solution o o c c o 2 Phenol based Wofasept Sporicidin Caution To avoid damage to the product observe the following general precautions for disinfection You should only deviate when this is explicitly stated in the disinfecting instruction of a specific product 1 Do NOT use Povodine Sagrotan Mucocit disinfecting agents or strong solvents e g acetone 2 Always dilute according to the manufacturer s instructions or use lowest possible concentration 3 Do not allow any liquid to enter the case 4 Never submerge any part of the system 13 4 Maintenance General Disinfecting of the System 5 Do not pour liquid onto the system during cleaning 6 Never use abrasive material such as steel wool or silver polish 7 Do not allow any disinfecting agent to remain on any of the equipment surfaces wipe it off immediately with a cloth dampened with water Caution If you want to disinfect a touch enabled display such as the M1097A A02 Flatscreen Display the touch operation has to be disabled during the cleaning procedure If you use a mouse and want to disinfect it mouse operation has to be disabled during the cleaning procedure Warning Philips makes no claims regarding the efficacy of the listed chemicals or methods as a means of controlling infection Consult your hospital s infection Control Officer or Epidemiologist Notes
204. l Parameter is off No sign next to parameter label 8 12 Trends and Calculations Viewing Graph Trends Viewing Patient Data Patient data can be shown in a graph three minutes after monitoring begins The graph appears in the default time period with the most recent data at the right of the screen The times appear along the X axis horizontal in 24 hour format for example 18 00 means 6 00 p m For all database configurations except 9 hour the default time period is 1 2 8 16 or 24 hours The parameter labels are listed on the Y axis vertical The number of hours of patient data available maximum 24 depends on the data management configuration and the options purchased The vertical line located at the far right of the graph when the display is first presented is called the time bar This bar can be moved along the time axis by using the gt and 4 keys these keys can be held down to move the bar more quickly When using a touchscreen the arrow buttons displayed on the screen perform the same action as the arrow keys To select a time directly it is also possible to select a button underneath that time label ICU Adult 31 JAN 00 7 51 i y HHR Non paced mode IMi M HR EU 80 spo 10D EM inv ABP 120 70 91 HR 140 80 142 120 22 is Mac aM S 62 r r r r r r To 37 FAM 28 PAP er Miu n fan 17 T T T t T T T Events IULII pu 31 JAN 6 00 6 15 6 30 6 45 7 00 7 15
205. l Signs Recordings 00 eee cece cette eee 6 29 Header Information o mesi lice epebtRLDLeREPESRLEDH D Ree Ned eee 6 29 Trend Data 5 extet UR rr eee eI eR e rn 6 30 Making Trended Vital Signs Recordings eese 6 32 Neonatal Event Review Recordings 0 0 00 eee eee ee ee 6 33 Tabular Neonatal Event Recordings 0 0 0 cece cece ee 6 33 oxyCRG Episode Recordings for Neonatal Events 00 000 00000005 6 34 oxyCRG Recotdings eens se ee a ee EEG ATEM NN EC e NU Ron ERE 6 36 oxyCRG Alarm Recording 1 sue RE y RR UR EUER EE ERU 6 38 Additional Information 00 00 eee e e 6 39 Annotations c reg LA ee epi pe eR E Rp ha 6 39 Changing the Recording Length lseleeeeeeee II 6 42 Contents 6 Changing the Recorder Speed 1 0 00 0 ee eee 6 43 Changing the Recorder sessuale eee Meee Rare ee ee ede Sey 6 43 Continuing a Timed Recording eee 6 43 Inserting a Calibration Signal 2 0 eee 6 44 Recording Layouts 0 24 05 2 iia eee be nics GA eb Me dare cad 6 44 Recording Status Messages llle Ie 6 46 Accessories and Ordering Information 0 0 cece cece eee 6 48 Loading Paper ioscan heh si ie eG RR eC tu E ER SR ake Bk AEC 6 49 Central Recorders sic cee ied been ded Ses edo ee E eee ERI de ea 6 49 Loading Paper into the Plug In Recorder unuunu renu e eee eese 6 49 To Replace Paper in the Plug In Recorder 0 0 0 rrun eee eee eee 6 50 Cl
206. l Size 158 mm x 211 mm 6 2 x 8 3 0 33 mm x 0 33 mm 5 5 seconds 6 25 12 5 25 50 mm sec 10 180 mm x 225 mm 7 1 x 8 9 0 22 mm x 0 35 mm 6 seconds 6 25 12 5 25 50 mm sec 10 304 1 mm x 228 1mm 12 x 9 0 297 mm x 0 297 mm The CMS and V24 and V26 Patient Monitors 1 37 ne N gt xe no o o c T o o c Lnd o 5 o Q o N gt Using an ITE Display Using an ITE Display ze S9 90 St O s B oc o gA E gt The M1167A 77A CMS Patient Monitoring System provides means for customers to use ITE displays There are several restrictions associated with this option Since the display is used as part of a medical device within the patient vicinity there are additional requirements to be fulfilled in order to be in compliance with the European Council Directive 93 42 EEC Medical Device Directive and with FDA recognized consensus standards e Safety e EMC e Performance Requirements Safety 1 The display must either comply with the requirements of the EN60601 1 A1 A2 IEC601 1 A1 A2 or it must conform to the requirements of an IEC XXX electrical safety standard and fulfill specific requirements according to the EN60601 1 1 A1 IEC601 1 1 A1 to provide the same level of safety as EN60601 1 IEC601 1 The display must be constructed or protected so that spillage of liquids does not wet parts of the d
207. le to select the START key you should press the key marked with the corresponding start symbol The design change also means that you will now find the module s product number for example M1032A on the rear of the module s housing not on the front Although the new modules do not show the letter T on the housing all modules retain their capability to transfer parameter settings from one monitor to another Symbol Name Function Which Modules c ZERO Zero a pressure transducer Pressure M1006B including option C01 CQ Press pressure outlet connector Pressure M1006B option C01 Out Monitor initiates transfer from Data Transfer Module M1235A module to monitor Module initiates transfer from D monitor to module START start measurement CCO C O M1012A b gt CCO C O including option C10 Cal calibrate SvOe M1021A tcpOs tepCOs X M1018A Mainstream CO M1016A The CMS and V24 and V26 Patient Monitors 1 17 Parameter Modules Parameter modules can be plugged into the following types of rack o o c c o Q o N gt Rack Type Mounting Comments o c q N gt o c on o o E T CMS Patient Monitoring System Integral Rack This is fitted to the front of Cannot be used with the M1046A computer the M1167 77A CMS module Patient Monitoring System 8 slot rack Satellite Rack You can have one
208. le with the CMS The key enables you to configure five types of recordings 1 Delayed and Alarm Recordings on a module bedside or central recorder A maximum of four delayed waves can be recorded depending on the type of recorder Up to four additional waves can be selected for alarm recordings depending on the model of the monitor 2 Realtime Recordings Three recording modes can be configured to record waveforms at your request For each mode you can choose the waves to be recorded their position on the recording strip and the recorder to be used Realtime recordings can be produced on module 4 channel bedside or central recorders o Note To ensure an optimal realtime recording check that the recording configuration is appropriate for your recorder LI gt gt Q gt 22 c p o 9 Monitoring Procedure Recordings on a module bedside or central recorder You can record the curves produced during cardiac output and pulmonary artery wedge pressure measurements 4 Vital Signs Recordings Automatic Vital Signs Recording gives the option of printing out all parameter numerics on the Plug in Recorder Module either at user programmed time intervals or upon completion of an NBP measurement 5 OxyCRG and Neonatal Event Review Recordings You can record the contents of the oxyCRG display and Neonatal Events onto an M1116B plug in recorder module For Neonatal Event Review Recor
209. lect additional screen labels such as Standard or Surgeon for these screens A softkey corresponding to each screen is available in the Change Screen Task Window CMS or the Monitor Setup Task Window V24 and V26 The display screen which is active is identified by an inactive softkey for that screen You can change to one of the other screens at any time by pressing one of the other softkeys o You can reconfigure only the screen which is currently active Once a display screen has been configured the settings remain either until the user changes them or the monitor is switched off When the monitor is switched off the settings automatically revert to the defaults LI gt gt Q gt 22 c p o CMS only If you have a second or third independent display the Next Display softkey is available in the Change Screen Task Window This key is used to configure the second or third display 3 2 Setting up your Monitor Selecting a Screen Selecting a Screen If the screen you want to change is not the currently active screen you must select the required screen for example Screen A Screen B Screen C screen D or Screen E Procedure l Press the hardkey CMS or V24 and V26 2 Pressthe softkey corresponding to the screen you want to change The Main Display appears for the selected screen Setting up your Monitor 3 3 LI E gt Q gt Le c o
210. ll use the current scaling of the graphs displayed ge og 25 E f E FO The number of points plotted for aperiodic parameters depends on the number of values stored Usually every value is plotted On CMS up to 96 data points for each parameter can be stored for 24 hours or for 48 hours if amemory extension is purchased and configured On a V24 or V26 up to 48 data points for each parameter 96 with specific configurations can be stored for 24 hours A below a time label indicates that the time is questionable e g the time may have been altered since that time period A T on the time line denotes that some or all data has been transferred to the monitor from a Philips M1235A Data Transfer Module The Events line below the graphs is for events marked manually A B C D and automatically ST Markers that are more than one line thick indicate multiple events for this time See Marking Events on page 8 16 If a non continuous measured parameter such as C O is trended in graphs a star appears beside each value 8 14 Trends and Calculations Viewing Patient Data If you change a value in Hemodynamics Calculations for example you change ABP from 120 to 140 the new value will be identified in Patient Data graphs by a star Note CMS only For the 9 hour database the default time period is 9 hours with 4 5 hours of information displayed at any one time Data within the other 4 5 h
211. log Output for connection to recorders and other data collection instruments For more information on Analog Output refer to Appendix B Setting up your Monitor 3 59 LI gt Q gt Le c o LI a c A m1 9 gt ax 2g gt 5 Cc 5 i N The Test Signals Function System Self Test Values Module Test Numeric Limits Test Waveforms ECG and ECG RESP ECG 100 bpm in ADULT mode Simulated square wave and numeric 125 bpm in NEO PEDI mode RESP 15 rpm in ADULT mode Simulated Resp wave and numeric 30 rpm in PEDI mode 55 rpm in NEO mode Pressure Simulated square wave and numerics Systolic 120 mmHg ADULT 60 mmHg PEDI NEO Diastolic 0 mmHg ADULT PEDI NEO SpO Pleth SpO 100 Numeric only Pleth Wave on display Simulated Wave tepOs tepCOs Numeric only tcpO 60 mmHg 8 0 kPa tcpCO 40 mmHg 5 3 kPa CO Simulated square wave and numerics ETCO 40 mmHg 6 0 kPa IMCO 0 mmHg 0 0 kPa AWRR 25 rpm Temperature 40 C 104 F Numeric only 3 60 Setting up your Monitor Parameter Settings Transfer Parameter Settings Transfer Parameter modules which are labeled on the front with a small 7 in the upper right hand corner can be transported from one rack to another or from one Philips system to another and still keep their parameter settings Note There are a few modules that may or may not be marked with a T that
212. lood recordings are displayed in the Preset Recordings Task Window above the softkey labels Recording Functions 6 27 7 E T 5 c gt LL e xe 5 tc Realtime Vital Signs Blood Recordings If you are configured for vital signs blood recordings and you are in Mode B selecting the Vital Signs Blood Recording key produces a recording consistent with NBP configuration 4 es S 2 5 e rm fo Ke p 5 tc DAVID SCHULTZ ICU Adult 15 FEB 99 17 52 II HR Non paced mode AES A aa whan Ja ad 80 Weurse 80 imv spo 97 avR ABP 119 80 96 NBP Start No Rec includes Vitals Blood Start Yes Rec includes Blood Timer Start No Rec includes Both Repeat Time NEP ENT Timer Repeat Stare Stere start Time 6 28 Recording Functions Trended Vital Signs Recordings Header Information Trended Vital Signs Recordings 7 E T 5 c gt LL e xe D 5 tc You can record the contents of the Vital Signs display in a tabular format on an M1116A B plug in recorder The recorder selection must be set to PLUG IN the default in the Procedure Recordings task window before trended vital signs can be recorded You can access the Procedure Recordings task window by selecting on the control panel and Recordng Setup in the Monitor Setup selection window Each trended recording begins with
213. mat for example 18 00 means 6 00 p m A beside a time indicates that the time is questionable for example the time date setting may have been altered during that time period A T beside a time indicates that data for that time includes values transferred to the monitor from a Philips M1235A Data Transfer Module Note With specific configurations data loss can occur when transferring data via the Data Transfer Module to a V24 or V26 Release B 0 Monitor The arrow keys can be used to navigate through the parameters and time columns This allows you to view more parameters view older and newer data select a time column for zooming in or out and to select parameters for graph trend display Arrow buttons are displayed to the left and right of the time columns and above and below the parameter rows On touch or mouse trackball operated systems these buttons perform the same functions as the arrow keys on the control panel In addition buttons are displayed above each time column and in front of each parameter row for direct selection of a column or row Note If a parameter which is already highlighted is directly selected the On Off Combined function is performed See Selecting Parameters for Graph Trends on page 8 12 for details Note The data displayed in the Vital Signs task window can be recorded in a tabular format on the M1116A B Recorder Module Please refer to the 1 48 hours if extended database
214. mbar into cmH O before calculating output values Trends and Calculations 8 21 oe S 2 25 gt S Sg Fo Performing and Reviewing Calculations Calculation Task Window DAVID SCHULTZ ICU Rdult 16 FEB 99 21 24 L HR Non paced mode BO M to ABP 120 70 91 units units L min ot L min m2 bpm mL mL m mmHg DS cm5 DSm2 cm5 mmHg DS cm DSm cm5 mmHg kg m kg m m2 mmHg g m g m m mmHg kg m kg m m mmHg g m g m m mmHg mmHg 188 cm Calculation Time kg BSA D m2 16 FEB 99 21 0 I Use the up and down arrow keys to select a parameter value Use the keypad to change the selected value Change Tima Calculation Task Window for Touch Screen oe og 25 E f E FO ICU Adult 31 JAN OO 8 01 Non paced mode M HR so 100 P inv 120 70 91 units units units IC 2 3 14 L min Dd 1 78 L min m IER 88 bpm SV 35 5 m SI 20 3 m m ABP s 120 mhg SVR 2050 ps cms SVRI 3588 DSm 7cm PAeP D 72 mg PVR 17 s cm PVRI 314 psmi cm5 J ABP M 88 mmg LCW 3 2 kg n LEWI 1 8 kg m m IPAP S 26 wg LVSW 36 6 g m LVSWI 20 9 g m m IPAP D 16 mug RCW AT kg m RCWI 27 kg m m IPAP M 19 mug RVSW 5 30 g m RVSWI 3 03 g m m Haa I mum PHeight 170 cs EWeight 65 0 xg BSA D 1 78 m Calculation Time 31 JAN O0 7 41 Use the up and down arrow keys to select a parameter value Use the keypad to cha
215. mmary softkey An oxyCRG episode for a selected neonatal event can be recorded on the M1116B Recorder Module from the oxyCRG Episode task window Header Information Each oxyCRG episode recording begins with general information such as the date time patient s name medical record number and the bed label Beneath this is a tabular list of neonatal event data for the event currently selected in the Event Review task window The trigger event is underlined 6 34 Recording Functions Neonatal Event Review Recordings OxyCRG Episode Data The oxyCRG episode is recorded with the same labels recorder grid and scale labels as those which appear on a standard oxyCRG recording The oxyCRG episode depicts 2 minutes prior and 2 minutes past the captured event alternatively 1 minute 3 minutes configurable For manually captured events 4 minutes prior the captured event are depicted 7 E S 5 c gt LL e xe A 5 tc A typical oxyCRG episode recording takes about 20 seconds to complete The recording speed is set by the system and cannot be adjusted Y oun 91MIN 2 cmfmin 26 NOV 97 14 24 Bed 1 BRADY fo 80 btbHR DESAT 82 lt 89 Spo2 APNEA 30 gt 20 RESP Stripo4 tif Making an oxyCRG Episode Recording Alarms Volume Event Review oxyCRG Episode The data displayed in the oxyCRG task window can be recorded by selecting the Record Episode softkey Recording Fu
216. mputer Module M1046B Computer Module Parameter Modules Satellite Rack The CMS and V24 and V26 Patient Monitors 1 3 FE S9 AS Introduction gt 0 o Se oz M1167 77A System with External Alarm Device 2g O a og Ee XGA Display External Alarm Device Computer Module mu a Parameter 1 epis oer i Modules Display Module ITE Display of choice b Computer Module M1046B Computer Module Parameter Modules Satellite Rack a Philips offers the M1167 77A H05 and H07 XGA Touchscreen display configuration b A 15 flat touchscreen display is also available separately under the order number M1097A A02 A 17 CRT touchscreen display is also available separately under the order number M1098A 1 4 The CMS and V24 and V26 Patient Monitors Model Types Introduction M1165 75A and M1166 76A System Display Module M1094A B 92A 14 CRT Display Computer Module M1046A Computer Module Parameter Modules Integral and or Satellite Rack All system types are also available as a choice of three different model types Full Title Abbreviation The Philips CMS Patient Monitoring System CMS The Philips CMS Patient Monitoring System for ACMS Anesthesia Care The Philips CMS Patient Monitoring System for NCMS Neonatal Care Note In this manual the system
217. mulas for the calculation of body surface area BSA The default configuration for all patients is the Boyd formula All calculation results that use BSA are indexed to the selected formula The Hemodynamics and Oxygenation Calculations Task Windows which display BSA use the label BSA B for the Boyd formula and BSA D for Dubois To change the default for example to use Dubois for adults and keep Boyd for neonates the appropriate selection must be made in the Patient Data Configuration Task Window See your Philips Service Engineer or biomedical engineering department for assistance in making a change Trends and Calculations 8 23 Performing and Reviewing Calculations Resampling Resampling of vital signs enables you to override the values in the Vital Signs Trends database which are stored every 12 seconds or averaged over 1 minute depending on the monitor s configuration Resampling enables you to use the most recent continuously monitored values Resampling sets the calculation time to the current time and displays the corresponding values for the previous second in the calculations task window Resampled values are indicated by a preceding asterisk in Calculations Graph Trends and Vital Signs task windows If no current values exist then the most recent value within 30 minutes will be retrieved The most recent height weight and head circumference for neonatal only are used regardless of how long ago they were entered
218. n be switched off or on using in the Alarm Limits Task Window Note We recommend not to switch off all parameter alarms at once and then switch on individual alarms but rather to switch off individual parameter alarms applying extra vigilance to these parameters If a parameter alarm is turned off INOP messages continue to be displayed but alarm messages lamps and the alarm tones are not active The nurse call relay is inactive Note The heart rate derived from a continuously monitored ECG is a measure of the heart s overall electrical activity The pulse rate is a measure of the heart s mechanical activity pumping blood around the body With the HR PULSE parameter you can select only one of them to be the active alarm source If you choose HR all alarms for PULSE are not active If you choose PULSE all alarms for HR are not active The INOPs for both HR and PULSE are displayed regardless of which one is the alarm source 5 10 Alarm Functions Alarm Display When an The alarm messages appear across the top of the screen You need to Alarm identify the alarm and act appropriately according to the cause of the Occurs alarm e Identify which monitor is in alarm e Check the patient s condition e Identify the cause of the alarm e Silence the alarm if necessary e When alarm condition is eliminated check that the alarm has reset You will find the alarm messages for the individual parameters in the appropriate parameter
219. n by pressing the ON OFF button The monitor should complete the start up after a few moments 3 Observe that there is a screen display and no error codes If any error codes are displayed refer to the chapter Troubleshooting Instruments in the Service Guide If the screen comes up blank check that the external power cable is plugged in If the screen is still blank contact your biomedical engineering department or the Philips representative Maintenance 13 11 Performance Assurance Checks 4 Ifyou are using the V24CT or V26CT make sure the battery Charging and Charged LEDs are behaving consistent with the battery charged The following table describes the LED behavior LED Pattern During Charge Sequence Residual Capacity Charging LED Charged LED Up to 4096 Flashing Off More than 40 Less than 90 Steady Off More than 9096 Off Steady Full Off Steady If the pattern is not correct refer to the troubleshooting chapter of the Service Guide 5 If you are using the V24CT V26CT a Disconnect the AC power cord The V24CT or V26CT will switch to battery power and the display will indicate that a battery measurement is in progress After about 30 seconds a battery gauge and two battery symbols appear in the lower right corner of the screen display b Remove one of the batteries The monitor should continue to operate If the monitor does not continue to operate go to Battery Problems in t
220. n the Arrhythmia In this situation the Bradycardia threshold line is displayed in the Event Review task window as a shaded area and the Brady trigger time and threshold items are set to From Arrhyth in the Event Setup task window 9 20 Neonatal Event Review Desaturation Event Settings Operating Controls Selecting Items Adjusting Neonatal Event Review Settings Alarm Triggered The Desaturation events are derived from the first SpO2 bedside module and triggered either by a Red Desat alarm or a Yellow low limit SpOZ alarm The Desat SpO2 alarms and trigger times can be viewed but not adjusted in the Event Setup task window These settings must be adjusted in Monitoring Mode in the SpO2 task window If the SpO2 alarm related trigger threshold and trigger time items are selected the Change Content key is inactive and the following status message is displayed in the Event Setup task window e SpO2 items must be changed in the SpO2 Setup User Defined For situations where the storage and documentation of an event should be independent of all Desat SpOs alarms you can adjust the Desaturation event threshold and trigger time in Monitoring Mode in the Event Setup task window Desat Trigger Off It is also possible to turn the Desaturation event triggers OFF in cases where the occurrence of Desaturation events are so frequent that the event storage facility risks becoming full a total of 48 events can be stored
221. n the Battery Charge LEDs during this period to estimate battery capacity or turn the monitor off to accelerate the charge setting time 5r e Battery LED Pattern E g Residual Capacity Charging LED Charged LED E o Up to 30 4096 Flashing Off Tw d More than 30 40 Less then 90 Steady Off More than 90 Off Steady Full Off Steady e A fully depleted battery will charge to 90 of full capacity in 4 hours when the monitor is not being used When the monitor is in use it will take approximately 16 hours to charge the batteries to 90 e To preserve battery integrity the battery must be fully charged each time the battery is depleted e Anew battery or one that has been stored for an extended period requires 4 hours of charging before use e To operate on internal battery power only disconnect the power cord from the AC outlet e Batteries should be discarded if there are visual signs of damage e Life expectancy of a battery depends on the frequency and duration of use When properly maintained and stored the life expectancy of a battery is about 1 5 years For more aggressive use models life expectancy may be less Philips recommends replacing sealed lead acid batteries once a year The date of manufacture can be found on the battery It is coded as yymmdd 12 4 Battery Information V24CT and V26CT only AC and DC Battery Operation e The lead acid batteries need not be fully disch
222. nctions 6 35 7 c T 5 c 2 LL e xe A 5 tc oxyCRG Recordings oxyCRG Recordings You can record the contents of the oxyCRG display on an M1116B Plug In recorder Note oxyCRG recordings can only be made on the M1116B Plug In recorder The M1116A Plug In recorder the M1117A four channel recorder and the central recorder do not support oxyCRG recording You can manually request an oxyCRG recording and you can configure an alarm recording of oxyCRG Manual request An oxyCRG recording with a fixed delay of six minutes corresponding to the display content is produced Alarm recording An automatic oxyCRG recording of six minutes of pre alarm data and two minutes of post alarm data is produced The oxyCRG recording is always 6 minutes prior to the most recent data on the screen This enables you to have a hardcopy of events leading up to the current situation When you stop recording the recorder stops immediately with the result that the most recent 6 minutes of patient data will not be recorded Note OxyCRG alarm triggered recordings differ slightly from the oxyCRG episode recordings generated by Neonatal Events All standard oxyCRG recordings are realtime recordings i e when the alarm occurs An oxyCRG episode recording is initiated by the user to document selected events retrospectively 6 36 Recording Functions The oxyCRG is shown in three distinct non overlapping chann
223. nd Calculations Viewing Vital Signs Viewing Patient Data Patient data can be shown in a table three minutes after monitoring begins The table appears in the default data time interval 1 min 5 min 15 min 1 hr 2 hrs or 3 hrs with the most recent data at the right of the screen The number of hours of patient data available maximum 24 hours or 48 hours CMS only depends on the patient data management configuration of the monitor and the options purchased The values shown are for the exact time they are labelled they are the stored averaged value of readings taken every 12 seconds for a one minute interval in 12 second mode only one 12 second sample is shown for each minute A beside a value indicates that the data for that time may not be reliable For example when the message NOISY SIGNAL appears on the screen it often causes a to appear as the HR numeric If the appears in the HR area for 3 out of the 5 samples taken in a minute the value stored for that minute will be If a appears adjust the parameter settings so that they are appropriate for your patient This is done in the parameter s Task Window Check to be sure that any patient cables leads or tubing are not being pulled and that the patient is not lying on them When you go directly between Graphs and Vital Signs Task Windows to view data in a different format the mapping is as follows
224. nd data M2300 only e Review and edit alarms not available for 78720A When arrhythmia ia assigned the monitor automatically goes to Paced mode You cannot change the mode back to Non Paced mode until arrhythmia is unassigned Note The screens that can be seen on the monitor via the ARRHYTHMIA MENU are all similar to screens on the arrhythmia computer or central station For further information on using the arrhythmia monitoring function refer to the operating guide for the arrhythmia computer or central station Using Philips Patient Care System with an Arrhythmia Computer If arrhythmia monitoring for your system is on the heart rate on your screen is that calculated by the arrhythmia computer Alarm messages from the arrhythmia computer are also displayed Within the ECG channel arrhythmia information is displayed on the rhythm and abnormal beat status of the patient In the Delayed ArrhWave Task Window the delayed ECG arrhythmia waveform displays a beat label with each QRS complex See the following table for information on beat labels Beat Label Meaning A Artifact beat N Normal beat S Superventricular beat V Ventricular ectopic beat M Missing beat z Questionable beat P Paced beat l Pace pulse tick mark L Learning ECG pattern U Unknown since pace learning is incomplete If arrhythmia is assigned and an arrhythmia alarm occurs the Arrhythmia Vali
225. nder 5 4 alarm symbol 5 2 Alarms Selection Window 5 12 audible alarms 5 8 INOP priorities 5 8 latching alarms 5 4 non latching alarms 5 4 parameter alarms 5 10 resetting alarms 5 4 SilenceReset key 5 4 summary of alarm behavior 5 7 suspending alarm 5 3 visual display 5 3 volume control 5 14 Alarm messages from arrhythmia computer 4 10 from network 4 10 Alarm recordings configuring 6 13 configuring delayed 6 9 Alarm volume 3 35 Arrhythmia discharge 7 9 end case 7 9 B Battery care and handling 12 9 care and maintenance 12 9 charger 12 8 charging 2 3 charging time 1 15 fuel gauge 12 6 indicator 12 6 inserting 2 8 LEDs 12 3 messages 12 6 operating instructions 12 3 power supply 1 14 specifications 1 14 storage 12 9 symbol 12 6 C Calculations 8 20 Calculations Review Patient Data 8 25 Calibration mark 6 44 8 17 Care and cleaning 13 1 printhead plug in recorder 6 52 Care and handling batteries 12 9 Configuring alarm recordings 6 13 changing default settings 3 44 changing patient category 3 45 configuration setsl 3 45 date and time 3 37 delayed recordings 6 9 delayed recordings on central recorders 6 10 key labels for realtime display screens 3 20 monitor revision function 3 43 Monitor Setup Selection Window 3 2 numeric display on off 3 177 numeric positioning 3 18 operating modes 3 55 other patients controls 3 41 parameter settings transfer 3
226. needed 4 es S 2 5 E rm fo Ke A e 5 x In the example below the recording with a runtime of 12 seconds is extended after it has been running 6 seconds The runtime is reset producing a recording of 18 seconds of waveforms Additional Runtime lt Original Runtime gt _ __ Eee Si alf LI Seconds1 23 4 5 6 7 sd REUTERS Kd d 9 10 11 12 13 14 15 16 17 18 19 20 8 Total length of recording 6 sec 12 sec or 18 sec 6 42 Recording Functions Changing the Recorder Speed Changing the Recorder Continuing a Timed Recording Additional Information The recording speed can be changed for delayed realtime and oxyCRG recordings made on a bedside recorder Changes made in the Change Recording Speed window affect only the last requested and running recording 7 E T 5 c gt LL e xe LS 5 tc Note If more than one bedside recording is running the Change Recording Speed window affects only the last requested and running recording However if the last requested recording is stopped the Change Recording Speed window then affects the recording that started running before the stopped one Because the recorder must complete the annotation at the beginning of the strip before the key to access this window appears there may be a wait of a few seconds before the speed can b
227. ng the CMS in the CMS Service Guide or Testing and Maintaining the V24 and V26 in the V24 and V26 Service Guide Testing of all cables and cords Daily See Testing and Maintaining the CMS in the CMS Service Guide or Testing and Maintaining the V24 and V26 in the V24 and V26 Service Guide Calibration of the measurement modules where appropriate For EU EFTA countries only User Tests Every 2 years Module dependent Please refer to chapter 13 Maintenance of this manual or chapter 3 of the CMS Service Guide Maintaining the CMS for details See individual module chapters in Volume 2 of this manual for details See chapter 13 Maintenance of this manual for details This recommendation does not supersede any local procedures or legal requirements Monitor Installation and Patient Safety 11 15 c 2 s T a L fa a z and Patient Safety c o9 5 s T a E LI fa a and Patient Safety Maintenance Checks Patient Cables and Leads Inspect the patient cables and leads and their strain reliefs for general condition Examine cables carefully to detect breaks in the insulation and to ensure that they are gripped securely in the connectors of each end to prevent rotation or other strain To ensure operation of the Anesthetic Gas Module within specified limits e calibrate the Anesthetic Gas Module at lea
228. nge the selected value INNEN Change On Br t Print Revie Cale Vitales Pater ime Time ReEnges Cale 8 22 Trends and Calculations Performing and Reviewing Calculations Notes e Ifyou plan to use monitored parameter values in Calculations be sure that when you are configuring parameters you assign the parameter the same label that is used in Calculations For example ABP should be used instead of ART because ABP is the label used by Calculations e When you enter the Task Window the Calculation time will be the last C O time or the current time depending on how the monitor is configured If C O time is used values stored more than one minute before that time are automatically entered Values up to and including 30 minutes before the calculation time will be used The most recent values occurring before the calculation time will be used for height weight and head circumference calculations e Displayed values may have been automatically stored or manually entered using the keypad or Resample Vitals e You must verify that all input values are appropriate for your patient prior to performing calculations e Ifyou enter pressure values manually you must enter all three parts systolic diastolic and mean in order for calculations to be performed for that pressure reading oe S 2 25 gt c Sg Fo BSA Formula The patient monitors provide both the Boyd and Dubois for
229. nitor Installation and Patient Safety EA Installation Information sii awn Oe o Philips M1205A V24CT and V26CT 5 T ea To Operating Storage 26 Temperature Range 5 to 35 C 41 to 95 F 15 to 40 C 5 to 104 F Humidity up to 95 RH at 35 C 95 F up to 90 RH at 40 C 104 F Altitude Range up to 4 600m 15 000 ft up to 4 600m 15 000 ft Condensa tion Make sure that during operation the instruments are free of condensation Condensation can form when equipment is moved from one building to another thus being exposed to moisture and differences in temperature Warning Possible explosion hazard if used in the presence of flammable anesthetics Warning Do not use cellular phones in the vicinity of the system Cellular phones may generate excessive radiated fields which can disturb the specified function of the system Monitor Installation and Patient Safety 11 11 62 g keg Installation Information awn Oe Eo BE Explanation o f Symbol JE of Symbols FE used Attention Consult accompanying documents This symbol appears next to certain connectors located on the front and or rear of the instrument It indicates that the connectors are designed to have special protection against electric shocks and are defibrillator proof An electrical output This symbol is also used to indicate the gas output on the ssCOs module and
230. nt UL 2601 1 CSA 22 2 No 601 1 M90 IEC EN 60601 1 EN 60601 1 2 CISPR 11 Class A JIS T 1001 1992 JIS T 1002 1992 11 2 Monitor Installation and Patient Safety Sz o Introduction Fay aw Of 9 The M1205A V24 and V26 Patient Monitors and compatible modules and i T accessories are designed to comply with the following international safety requirements for medical electrical equipment E S e UL2601 1 e CSA C22 2 No 601 1 e JEC 601 1 e TEC 601 1 1 Classification IEC 601 1 Class 1 type CF continuous operation IP20 indicates ordinary protection against the ingress of liquids Note If you have the M1205A option 020 022 024 or 025 versions of the V24 and V26 Patient Monitor refer to the Declaration of Conformity DOO for a complete list of international safety requirements for medical electrical equipment The patient leakage current is less than 10 1A All systems and the Anesthetic Gas Module have floating inputs and are protected against the effects of defibrillation and electrosurgery ak 2s This symbol appears next to certain connectors located on the front and or rear of the instrument It indicates that the connectors are designed to have special protection against electric shocks and are defibrillator proof Warnin Do not touch the patient table or instruments during defibrillation Monitor Installation and Patient Safety 11 3 Introduction Caution If liquid is spilled on
231. nt can be erased in the Patient a Patient Information Task Window under gt Discharge Patient Ending a ICU configuration sets or the End Case Task Window under Case gt End Case OR configuration sets Discharge Patient in ICU Configuration Sets erases the entire patient database You must press for the discharge to take effect The system returns to the Admit Patient Task Window End Case in OR Configuration Sets also erases the entire database Additionally the monitor resets all settings to the user defaults and then returns to Monitor Standby You must press for the discharge to take effect If configured a scheduled report is printed prior to ending the case 7 o Note In ICU configuration not all settings are automatically reset to user defaults To do this manually press Adult Pedi Neo gt Change ConfSet Do not change the selection and then press If the monitor is connected to a Philips Documentation Center and arrhythmia is assigned arrhythmia must be unassigned under Arrhyth Functns If the monitor is connected to a Philips central station discharge must be performed at central as well The discharge procedure is not complete until the patient s information is erased from all parts of the system and the system is available for a new patient pe ui gt 22 X o D e E lt During a transfer to or from the M1235A Data Transfer Module the Discharge Patien
232. o Change ConfSet DAVID SCHULTZ Bed 6 Adult 16 FEB 99 19 39 LI HR Non paced mode H adn Ln J Al J 80 Purse 80 1mV spo 97 pn ABP 120 80 96 hr Sn Dy PAP 25 10 16 inv CVP 12 LU voligut C an lae eio ko D ee e cruris Spa 2 95 as id eg dm Me cs Socom dSpB 2 Active Set Hl New Set 4 Patient Categ Adult Patient Categ Neonatal Unit Type ICU Unit Type ICU EL Lae adjusts all settings to defaults for selected Config Set WARNING Monitoring will be interrupted and database erased Press CONFIRM to switch to new Config Set Change Change ontset llPatcateg Note If you are using the ACMS you will not have a choice of Unit Type as this is automatically set to OR Note If you do not want to store the default settings in the plug in modules do one of the following Setting up your Monitor 3 53 LI E gt Q gt Le c o LI a c Changing the Configuration Set e Remove the plug in modules from the rack before starting the procedure e Ask your biomedical engineering department or Philips service engineer to set Parameter Settings Transfer to OFF Procedure The current Configuration Set for the monitor is highlighted and the universal settings are displayed at the top of the Task Window l Pressthe softkey Change ConfSet to select the Configuration Set you require The universal settings for the selected Configuration Set
233. of the destination For gas parameters there is no unit conversion between volume96 and pressure mmHg kPa and vice versa To transfer gas parameters using a Data Transfer Module the gas units at the source monitor must match the default units at the destination monitor So for example if the CO9 units are configured for volume at the source and for mmHg at the destination ETCOs and IMCO values will not be transferred If the monitor is put in Monitor Standby during a transfer all processing in the monitor will stop but the transfer will continue until it has completed or the module is unplugged The module keys will be disabled in Monitor Standby When the monitor comes out of standby regular updates to the module will continue at a rate of once per minute Transfers can occur in both Monitoring and Demo modes Transfers between modes can only be made from a module in Monitoring Mode to a monitor in Demo mode Resampled and other manually entered data is annotated with an asterisk at the destination monitor only if both source and destination monitors have software for Release F or higher CMS or Release A 0 or higher V24 and V26 o o c e G a 10 6 Data Transfer Types of Transfer Types of Transfer There are two types of transfer to the module and one type of transfer to the monitor To Module l Transfer All Data Any data existing in the module is erased before the transfer
234. on is not accessible during a transfer to the monitor Admit Discharge End Case 7 1 Admitting a Patient Admitting a Patient The patient monitors provide you with a display of demographic information on your patient Patient name and medical record number will appear if the monitor is connected to a central station the patient must be admitted at the central station or patient demographic information transferred with the Data Transfer module M12354A Alternatively the information can be entered at the bedside with the cursor keys The following tables list the patient information fields for ICU and OR configuration sets pe wi o aD lt o 2 e D lt 7 2 Admit Discharge End Case Admission Information ICU mode Admitting a Patient Items Required 9r Instructions Optional Patient Name Recommended Enter up to 18 characters Medical Record No Recommended Enter up to 12 characters Date of Admission Optional Enter up to 14 characters in any form Height Required for Enter a value either cm or in calculations Weight Required for Enter a value g kg or Ib calculations Sex Optional One character allowed use either F or M Date of Birth Optional Enter up to 14 characters in any form Admitting Physician Optional Enter up to 18 characters Attending Physician Optional Enter up to 18 characters Other Comments Op
235. one two double beeps but the Alarm Bed Task Window will not be displayed To resume monitoring simply press one of the keys except Suspend on the control panel on the front of the display or on the handheld keypad CMS only The changes and adjustments that you made to the settings before going into Monitor Standby are retained Patient Data Management information collected before going into Monitor Standby is also retained o b fo o D c 7 o As all monitoring is suspended no patient data is collected while the monitor is in Monitor Standby The hardkey operates as usual when you are in Monitor Standby so you can prepare the monitor alarm capability before you resume monitoring Getting Started 2 11 Attaching the Patient o o b S S o o fa 7 o 2 12 Getting Started 3 Setting up your Monitor This chapter describes the characteristics of your system that can be changed during monitoring using the key It includes the following sections Changing Display Screens 000 eee eee 9 2 Selecting aScreen lesus 3 3 What you Can Configure 00 0 c eee eee 3 5 Changes to the Configuration 04 3 6 Assigning Waves to Screen Channels 3 8 Selecting the Number of Waves 3 13 Changing the Wave Overlap 2 065 9 14 Selecting Realtime Wave Speeds 9 15 Di
236. onversion Transfers to Module Monitor Database What will be Stored in Module 16 param 24hr 1 min 16 param 24 hr 1 min 16 param 4 hr 12 sec 16 param 4 hr 1 min CMS Only 16 param 48 hr ext 1 min 16 param 24 hr 1 min 32 param 24 hr ext 1 min 32 param 12 hr 1 min 16 param 9 hr ext 12 sec 16 param 9 hr 1 min 32 param 4 hr ext 12 sec 32 param 4 hr 1 min Transfers to the Monitor The following table shows the mapping for transfers to the monitor when the data in the module has come from a monitor with a different configuration Database Conversion Transfers To Monitor Module Database Monitor Configuration What will be Stored in Monitor 16 param 24 hr 1 min 16 param 24 hr 1 min 16 param 24 hr 1 min 16 param 24 hr 1 min 16 param 48 hr Ext 1 min 16 param 24 hr 1 min 16 param 24 hr 1 min 16 param 4 hr 12 sec 16 param 4 hr 1 min 16 param 24 hr 1 min 32 param 24 hr Ext 1 min 16 param 24 hr 1 min 16 param 24 hr 1 min 16 param 9 hr Ext 12 sec 16 param 9 hr 1 min 16 param 24 hr 1 min 32 param 4 hr Ext 12 sec 16 param 4 hr 1 min 32 param 12 hr 1 min 16 param 24 hr 1 min 32 param 12 hr 1 min 32 param 12 hr 1 min 16 param 48 hr Ext 1 min 32 param 12 hr 1 min Data Transfer Data Transfer 10 15
237. ood results up to 48 hours old or a maximum of 96 data points for each blood parameter On a V24 or V26 the Blood Review task window allows you to view blood results up to 24 hours old or a maximum of 48 data points for each blood parameter 96 in specific configurations The blood results that appear in the Blood Review task window can be older than other standard database displays and reports for example Vital Signs Trends Graphs and Calculations which can only be 24 hours old Adult 31 JAN OO 7 48 HHR Non paced mode Zo 80 sw 100 E PBP 120 70 91 31 JAN Unspec 7 330 4 27 16 3 26 53 112 5 4 153 4 0 110 Use the left and right arrow keys to select another time Use the up and down arrow keys to view more parameter values Next Soleet Renges Print B Page 3 Column Unite Review liana The Blood Review task window displays blood results in chronological order with the most recent appearing on the right hand side of the screen The time at which the blood measurements were completed appears in 24 hour format along the top of the task window 8 6 Trends and Calculations Viewing Patient Data Qualifying indicators which have specific meaning appear in the Blood Review task window The following list identifies and defines all indicators used to qualify blood analysis results in the Blood Review task window e A T next to the time indicates that the data was transferred to the monitor using the
238. or more Can be used with all satellite racks attached to CMS Patient an LV pole bedside or Monitoring System wall Available as 6 slot or 8 slot rack V24 and V26 Patient Monitor 8 slot Satellite Same as Satellite Rack for Only one Satellite Rack CMS Rack can be used Standard with a V24 and V26 Patient Monitor 6 slot Satellite Same as Satellite Rack for Rack CMS Optional This can also be mounted to the back of the M1205A V24CT and V26CT Monitors Caution When the rack is mounted in close proximity to any intravenous infusion equipment do not let saline solution get onto the rack or parameter modules Severe damage to the equipment can result if saline solution leaks into the connectors at the rear of the modules You can plug the parameter modules into the rack and remove them as you require them The number of modules you can plug in depends on the type of rack and the model of monitor you have ordered 1 18 The CMS and V24 and V26 Patient Monitors Parameter Modules For most types of parameter modules the system allows only one of each type per patient ECG for example Other types of modules allow more than one per patient Invasive Pressure for example If too many modules or an unsupported module are plugged in a message detailing where the extra module is appears in the system message field Currently ignored module in rack position R P where R is the number of
239. oring Mode without entering a password by pressing Resume Monitor I 2 o gt x 22 gt 5 E 72 Setting up your Monitor 3 57 The Test Signals Function The Test Signals Function The Test Signals function allows a check of the way signals are processed from the parameter module to the screen The aim of the function is to identify broken lines and cables in the signal processing areas Note While the Test Signals function is active no patient monitoring is supported parameter values are not collected Alarms will occur depending on the test values as part of the monitor s self test procedure They are patient alarms See for individual tests for each module A 2 9 2 ax 22 gt 5 Cc c2 o 3 58 Setting up your Monitor Procedure Analog Output CMS only The Test Signals Function l Press hardkey 2 Presssoftkey Test Signals in the Instrument Configuration Selection Window The monitor returns to Main Screen Test waves for each parameter being monitored are generated for 30 seconds to test the processing abilities of the monitor The message Test Signals active no monitoring appears on the screen After 30 seconds the monitor automatically switches back to Monitoring Mode If you want to go back to Monitoring Mode before 30 seconds have elapsed press Monitor Setup then Stop Signals The Analog Output function provides eight channels of Ana
240. orphology of the ECG Changing the Patient Category NBP Safety Values for Differing Patient Categories Safety Value Patient Category Adult Pedi Neo Max deflation time 80s 80s 60s Max measurement time 100s 100s 60s Overpressure protection 300 mmHg 300 mmHg 150 mmHg Cuff Size AtoE Any Cuff 1to4 amp A Default Inflation Pressure 165 mmHg 125 mmHg 100 mmHg The figure given for overpressure protection is the maximum pressure the cuff can reach for 2 seconds before it deflates NBP Recommendations Philips Medical Systems makes the following recommendations when selecting a patient category for NBP 1 Choose the category with the most appropriate safety values for your patient 2 Reduce the stress on the patient by choosing the appropriate cuff size a cuff that is too large prolongs inflation time 9 Usearepetition time appropriate to the patient The following factors can cause the cardiotach to calculate an incorrect heart rate e Morphology of the ECG e Weak signal e Paced patients Philips offers two different ECG algorithms to allow for differing morphologies Setting up your Monitor 3 49 LI E gt Q gt Le c o LI a c Changing the Patient Category Recommendation Choose the patient category according to the QRS morphology rather than the patient s age Use Adult if the duration of the QRS base is 50 to 70 ms use Neonate
241. orts Reports will also provide the date of birth and physician names if available Patient name and medical record number will appear automatically if they are being transmitted by the central station You cannot change the 7 4 Admit Discharge End Case Admitting a Patient name and medical record number at the bedside monitor you can only change these at the central station For the patient s name to appear on the display recordings and reports the patient must be admitted to the monitor Before you admit a new patient existing data demographic and monitored from the current patient must be cleared from the monitor in order to avoid combining information from two patients in one record Depending on the monitor s configuration either the Discharge Patient or End Case Task Window is displayed Press to clear data Additionally if the previous patient was initially admitted at the central station you must also discharge the patient from the central station before a new patient can be admitted at central station or at the bedside When a new patient is admitted at the central station the name and medical record number will appear automatically in the Review Admit Task Window The Review Admit Task Window is not accessible during a data transfer to the monitor xe e Ww m 7 97 G o o d 2O a m E xe E Note Data begins to be collected within one to two minutes after the patient is connected to the mon
242. ose the door The paper should feed automatically Note The first sheet will come out folded as shown Cleaning the If the paper doesn t move through the roller properly a possible cause is Roller on that the roller needs to be cleaned Be sure your hands are clean before the Four touching the roller Channel M1117A Recorder Equipment e Lint free cloths or wipes Required e Alcohol solvent that is low in water content We recommend either reagent grade denaturated ethanol or isopropanol 9096 rather than 70 Directions 1 Turn the power off 2 Open the door and remove any paper from the recorder 3 Wipe the visible part of the roller with a saturated but not dripping cloth Rotate the roller with clean fingertips to expose the entire surface and wipe the other side 4 Remove any excess liquid by wiping with a dry cloth Caution The roller must be completely dry before using the recorder or you can permanently damage the recording mechanism Recording Functions 6 55 Loading Paper 6 56 Recording Functions 7 Admit Discharge End Case This chapter describes the procedures for reviewing patient admit information entering height and weight and deleting patient records using the Admit Discharge and End Case functions These functions are accessible under the key Discharge and End Case are not operational during a transfer to or from the Philips M1235A Data Transfer module the Admit functi
243. our monitoring system is connected to the monitoring network you can have 7 waves transmitted to the central station Only the primary wave is displayed on the main screen at the central station Each Other Patients screen of any device connected to the monitoring network starts with the primary wave If you have ECG turned on it is always selected as the primary wave If it is not turned on you can select a primary wave in the System Waves Task Window under Monitor Setup If EASI 12 Lead ECG is configured ON only 5 waves can be transmitted to the central station The softkeys in the Other Patients Selection Window contain the bed labels of the beds currently available for viewing on your monitor Pressing a softkey leads you into the Other Bed Task Window for that particular bed This task window contains detailed patient information including alarms and INOPs Other Patients If your bed is configured to receive alarms and the beds in your Other Patients group are configured to transmit alarms the softkeys in the Other Patients Selection Window contain alarm information under the bed label Alarm severity is indicated in the second line of the softkey label by for a yellow alarm and by for a red alarm Additionally the softkey will have a red or a yellow frame if a bed is in alarm Other Patients 4 3 o L d c o 2 Q o t o Philips Patient Care System Automatic Alarm Other Patients 4 4 Oth
244. ours can be viewed by scrolling with the arrow keys Trends and Calculations 8 15 oe S 2 25 gt S Sg Fo Viewing Patient Data Marking The Mark Event function enables you to mark events and then review Events them in Graph Trends Events are labelled A B C or D You decide for your unit what each letter means for example A drug administration B out of bed C suctioning etc For instance you may want to mark an event such as drug administration Pressing the event key with the appropriate label for example Event A stores the event time and label On the Graph Trends the event will be shown by a tick mark for that time Events are shown on one line at the bottom of the Graph Trends and if configured on five lines as part of a graph group In addition to the events that have been manually marked Events A through D events that have been automatically marked through ST Segment monitoring ST Adjust are also shown Event trends are included in reports both scheduled reports and those initiated from the Trends or Trends Calcs Task Window When events is selected as part of a graph group during configuration graphical events trends are shown on reports whenever that group is printed If events is not configured as part of a graph group then an event trend is printed below the graph group oe og 25 E f E FO Reviewing Events can be reviewed and correlated with other graph data in two form
245. oves e Push the locking lever from right to far left The equipment is now secure To dismantle the computer module and Anesthetic Gas Module e Push the locking lever from left to far right e Lift the Anesthetic Gas Module off the computer module The display module M1094B 92A can be attached to the computer module M1046A by a locking device This is a lever which is operated from the rear of the monitor and is attached to the bottom of the display module To assemble the computer module and display module e Ensure that the locking lever is in the far right position e Place the display module onto the computer module ensuring that its four feet are in their correct grooves e Push the locking lever from right to far left The equipment is now secure To dismantle the computer module and display module e Push the locking lever from left to far right e Lift the display module off the computer module 11 32 Monitor Installation and Patient Safety Disposal of the System Controls and Connectors Lifting the Display Module The M1092A display module weighs 26 lbs 12kgs The M1094A display module weighs 42 Ibs 19kgs The M1094B display module weighs 43 Ibs 19 5kgs When carrying the display module hold it firmly from underneath For safety reasons it is strongly recommended that at least two people should lift the display unit One person on their own should not attempt to do so Connecting the Anesthetic
246. pdated every two seconds With the color model the numeric appears in the same color that you have assigned to the corresponding waveform The hardkey always returns you directly to the Main Screen DAVID SCHULTZ Bed 6 Adult 16 FEB 9 20 00 Non paced mode WPuise 80 120 80 96 PAP 25 10 16 CVP 2 gt 020 Note The Main Screen of the V24 and V26 Patient Monitors include Alarm Volume Control and QRS Volume Control Bars see figure below The CMS and V24 and V26 Patient Monitors 1 21 xe N gt o c no o o Rel H V26 Patient Monitors Ks eg Oo q4 e 5 Operating Levels o SE dp o O ou o E ICU Adult 10 JAN 95 20 05 Meuse 70 E gt CHANNEL 1 uR deo pol bs a ns Jo 170 T i NUMERICS LAYOUT 1 NON OVERLAP stt 3 ST2 0 2 ABP CHANNEL42 J 35 72 94 PAP CHANNEL 3 CHANNEL 4 1 mco 0 NBP 19 47 m 7 eal awmR 37 115 65 81 4 Alarmvoli65 THY aRsvoli50 f 1 22 The CMS and V24 and V26 Patient Monitors Selection Window Operating Levels This is the first operating level where you can choose a specific activity or function You get into a Selection Window by pressing one of the blue labeled hardkeys on the control panel When you get into the Selection Window the bottom line is always active This is indicated by a bar below the keys and the yellow labeling The selection can be changed within the Select
247. phs or tables Mark and review clinical events in Graph Trends Perform hemodynamic ventilation and oxygenation calculations Print reports of patient information calculations and patient data graphs and tables through Task Windows and at scheduled times Calculate drug infusion values To enter the displays for trends and calculations press the or Trends Calcs key The Selection Window for Trends Calcs will appear You can choose the task you want to perform from this window Note It depends on the monitor option purchased whether all of the tasks described are available on your monitor 8 2 Trends and Calculations Viewing Patient Data Viewing Patient Data There are two ways to view patient data In graphs where parameter values are points plotted on a graph along a time axis In tables where parameter values and the times the values were collected are listed in a table In either form the most recent data is displayed at the right of the screen unless entered through the Graph Trends where you may have moved the time bar The patient data will be presented in the default resolution level of detail and time span The number of parameters available to be viewed depends on the patient data management configuration and the options purchased Data is stored and appears in tables and graphs if configured even though the numeric is not displayed on the Main Screen oe S 2 25 gt c E The number
248. plug in recorder this type of recording is not rerouted to a central recorder if the bedside recorder is not available Annotation Code Bed Label Record Patient ab Patient ID Separator 92MIA BED 23 NPB Date Time L 06 JUN 94 11 52 3146 ABP 120 70 91 i JOHN DOE i I ALARMS SUSPENDED CHECK STATUS LOG E PULSE 60 P4 120 70 91 P4 REDUCE SIZE i HR 80 RESP 15 Current C O SpO2 SpO2 NON PULSATILE E Al Tblood 37 0 T1 40 0 E Bm ETCO2 40 ST1 0 9 Lead II amp Numerics IMCO2 0 ST2 0 9 Lead V Iso 80 ms ST Pt 108 ms AWRR 25 FIO2 0 21 Recording Functions 6 25 Realtime Vital Signs Blood Recordings Annotation 7 c T 5 c 2 LL e xe LS 5 tc Sample pH 7 450 T PCO2 d PE HCo3 User ICO2 23 DN 24 BEecf 3 c Patient N Bed Label usd ode atient Name ed Label T T Patient ID seve talor ate Time E Te eoMIA BOBBIE JONES 52 3146 7 Het 54 1 06 OCT 96 21 15 BED 23 Hb 7 x i Na 146 i Date Blood K 49 X Anaylsis BLOOD ANALYSIS 060CT96 21 10 BUN 26 E was Complete ART r Glu 100 B x PERATOR ID 12345 AnCap 45 i x x x x Leading Symbol signifies Parameters calculated value Depending on the number of parameters being monitored a vital signs blood recording may take up to 15 seconds to complete The recording speed is set by the system and cannot be adjusted Note If vitals signs blood recordings are con
249. plugging the patient monitor into a different circuit may help e Reduce the sensitivity of the system In all of the EMC testing the patient monitor was adjusted to maximum sensitivity For the ECG amplifier the gain was four times what is normally required By reducing the gain of the system receiving the EMI the interference can often be eliminated e Add external attenuators If EMI becomes an unusually difficult problem external devices such as an isolation transformer or a transient suppressor may be of help A Philips Customer Engineer can be of help in determining the need for external devices Electromagnetic Compatibility M1205A Only The electromagnetic compatibility EMC validation of the M1205A included testing performed according to international standards for EMC with medical devices See the Manufacturer s Declaration for details EMC Testing During the test program the M1205A was subjected to many EMC tests both international standard and Philips proprietary tests There were no anomalies observed during this testing Intended Use Intended Use Description The Philips M1165 66 67 75 76 77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors are network connectable bedside patient monitoring devices The Philips M1205A Models V24CT and V26CT may powered by either AC line power or by battery power Purpose The Philips M1165 66 67 75 76 77A CMS Patient Monitoring System and th
250. power supplies parameter module plug in connections and rack connections must be kept clean and dry Thoroughly dry any electrical connections that become contaminated with liquids If additional decontamination is required please contact your biomedical department or Philips Medical Systems Response Center e Although this equipment is shielded against Electromagnetic Interference EMI it is recommended to avoid the use of electrically radiating devices in close proximity to this equipment e Connecting the Philips monitoring network SDN cable when the product is powered on is not supported Error codes and Philips monitoring network SDN interface lock up may occur Power cycling the product will recover the product No permanent damage will result To prevent unintentional disruption in monitoring be sure the SDN interface cable is properly secured at both ends when connecting to the Philips monitoring network SDN e Do not connect a second rack by a cable when using a module rack docked to the back of the V24CT or V26CT Using a second rack connected by a cable may disrupt module communication Caution A caution calls attention to a condition or possible situation that could cause injury to the user e Ventilation Requirements Failure to meet ventilation requirements may cause equipment failure and in turn jeopardize the functions of automated monitoring Do not locate equipment in an enclosed area which could
251. r 3 1 Monitor Installation and Patient Safety 11 17 sz LEA Controls and Connectors awn Oe o Sa S g Maximum Voltages 1 Rack Connector 60 V 2 ECG Output 32 V p p 3 Module Connectors 60 V Connectors of The connectors on the front panel of the computer module are the M1046A Computer 1 Rack Connector female interface connector used to connect a Module satellite rack to the computer module 2 ECG Output used to output an ECG wave to synchronize a defibrillator and provide an input for the defibrillator marker signal 3 Plug in Module Connectors female plug in module connectors used to input the information from the plug in modules to the integral rack 11 18 Monitor Installation and Patient Safety The Front Panel of the M1046B Computer Module The M1046B Computer Module is a component of the M1167A 77A System The M1046B has a detachable front panel which must be removed to view the connectors except for the ECG Output connector which is also visible when the front panel is attached The connectors on the front panel of the M1046B Computer Module are shown in the following Controls and Connectors and Patient Safety c 2 s T sS a LI fa a z
252. r CDSPC Video or DSPO this is a connector used to output information to be displayed on the display module 10 PS ON OFF connector DSPC FLAT this is left open 11 Video Out Connector Flatscreen this is a connector used to output information to be displayed on the Flatscreen Display Module and also to output 60V DC to the Flatscreen Display Module The Rear The system can have one of the following displays Panel of the Display the M1092A Monochrome display Modules the M1094A Color display the M1094B Color display the M1095A Flatscreen Color display The rear panel of each display module is shown below The back of the display module should only be removed by qualified service personnel Monitor Installation and Patient Safety 11 23 Controls and Connectors M1092A M1094A Display Module and Patient Safety S z c T S 7 S LI e m ie o O o o wosan LLL O O04AO0 O o o 9 I9 Human Interface G 2 O 90 Connector SC voso Video Out a O 9 S Gana SATE a Connector 05959 tio 959 iara Di E ECH Video Termination S0529 La Video IN Switch a O T oO a o EX 3 Connector n Oo Oo o I9 9 OGG o vfurr o 0 vive paves Equipotential Fuses V SHIFT EAST WEST Grounding e 3 5 Terminal System 12 Local Power Connector Power Connector V AMP H
253. r Modules panel is shown below Equipotential Human Analog Flatscreen Grounding Interface Interface HDLC Remote Power Supply Terminal Connector Connector Connector On Off 2 4 6 8 10 System Nurse Power SDN Paging RS232 Connector Connectors Connector Connectors Video Out Video Out 1 3 5 7 9 en E ebvoc 2 EA nn 5 Br 1 RS232 2 SON IF UTIL CPU JANALOG_IF RS23241F HDLC IF cosro woeo M82 66501 MIo59 G 501 MiO84 G6501 M1085 66501 Mosen MIo72 66501 DSPC_AAT M1047 6660 ER re q AIA hH mar6e tif Maximum Voltages System Power Connector 60 V SDN Connectors 5V Human Interface Connector 12 V Nurse Paging Connector 24 V Monitor Installation and Patient Safety 11 21 c o9 5 s T a td fa a z and Patient Safety Controls and Connectors 11 22 Maximum Voltages RS232 Connectors 12 V HDLC Connector 5V Video Out 9 5V Flatscreen Remote Power Supply On Off 15V Video Out 11 60 V Note Do not apply a voltage of more than x 12V to any of these outputs The connectors on the rear panel of the computer module together with their connecting function cards are 1 System Power Connector on the M1046A Computer Module thi
254. r line ground protective earth when plugged into an appropriate 3 wire receptacle If a 3 wire receptacle is not available consult the hospital electrician Warning Do not use a 3 wire to 2 wire adapter with these instruments If the computer and display module of the M1165 66 75 76A Systems and the Anesthetic Gas Module are set up together connect the grounding wire to the equipotential grounding terminal on the display 11 6 Monitor Installation and Patient Safety Safety Ground Protective Earth V24 and V26 only Installation Information Additional Protective Earth Secondary Ground Wire Hazardous leakage currents can be caused when other equipment is interconnected with either monitor and Patient Safety c 2 s T a td fa a A secondary ground wire is provided with the CMS V24 and V26 to comply with IEC 601 1 1 This additional protection ensures against excessive chassis leakage current in the event of a single fault in the health care facility s primary grounding means It is recommended that the secondary ground wire be connected to a ground source separate from the primary grounding source found in the instruments power source This cord should be permanently attached to either monitor mainframe rear panel attachment screw Check each time before use that the monitor is in perfect working order The cable connecting the patient to the instrument must be free of electrolyt
255. r Value Units Resolution pixel addressability 1024 x 768 Dots x lines Vertical Refresh Rate 60 Hz non interlaced Red Green and Blue Video Inputs 0 7 V p p Vertical amp Horizontal Multi Sync Inputs 5 V TTL Video Cable Connector HD15male The CMS and V24 and V26 Patient Monitors 1 39 Using an ITE Display 1 40 The CMS and V24 and V26 Patient Monitors 2 Getting Started Now that you have been introduced to the monitor you are probably ready to start using it This chapter will help you get started It contains the following sections e Setting up the Monitor V24 and V26 only 2 2 e Setting up the Parameter Modules 2 b e Attaching the Patient lsslsleeeleeeeeeeenl 2 6 Getting Started 2 1 Setting up the Monitor V24 and V26 only Setting up the Monitor V24 and V26 only 1 Attach the parameter module rack to the display module by a cable to the connector on the left side of the display module If you 5 are using the V24CT or V26CT you can attach the 6 slot rack to the E back of the mainframe display without the need for a cable The amp two components will snap or dock together e va oe 7 74 o ae o rd mmm WO TTT MIDI 2 2 Getting Started Setting up the Monitor V24 and V26 only 2 Ifyou are using the V24CT and V26CT and the batteries are not already in place insert 2 Philips 40488A 12 Volt 2 3 Amp ho
256. r details the cleaning and maintenance procedures for the monitor It includes the following sections e General cleaning ofthe System 4 13 2 e Monitor Maintenance 0 0 00 cee eee es 13 6 e Performance Assurance Checks sues 13 11 Maintenance 13 1 o o c c o 2 General cleaning of the System General cleaning of the System 13 2 Maintenance The patient monitor should be kept free of dust and dirt Exterior cleaning of the case and screen is recommended Clean it with a lint free cloth moistened with either warm water 40 C 104 F max and soap a diluted non caustic detergent or one of the approved cleaning agents listed below Soaps mild soaps Tensides dishwasher Edisonite Schnellreiniger Alconox detergents Ammonias Dilution of Ammonia lt 3 Window cleaner Alcohol Ethanol 70 Isopropanol 70 Window cleaner Caution To avoid damage to the product observe the following general precautions for cleaning You should only deviate when this is explicitly described in the cleaning instruction for the individual transducer or accessory 1 Do not use strong solvents such as acetone or trichloroethylene 2 Always dilute according to the manufacturers instructions or use lowest possible concentration Never use abrasive material such as steel wool or silver polish Do not allow liquid to enter into the product Never submerge
257. ration table for each drug The drug calculator is accessed through the Trends Calcs key and the Drug Calc softkey The first window Drug Selection lists the drugs available for use with the calculator These drugs have been configured for use in your unit during system installation In this window you can select the drug you wish to work with DAVID SCHULTZ ICU Adult 16 FEB 99 21 25 Non paced mode p o e mee ABP PAP sp0 2 100 dSpQ 0 RESP 15 TP1 009 inui mansus ce SEF L 150 n o U L O 7 Wo ANY DOSE MCG KG MIN DOPAMINE NITROGLYCERINE ANY DOSE MCG MIN EPINEPHRINE NITROPRUSS I DE ANY DOSE MG HR HEPARIN PROCA INAM1DE ANY DOSE MG KG HR INSULIN AMINOPHYLL INE ISOPROTERENOL AMRINONE LACTATE LEVARTERENOL BRETYL IUM LIDOCAINE DOBUTAMINE MORPHINE SULPHATE Use Select Drug or the arrow keys to select a drug name Select Brug oe og 25 E f E FO 8 32 Trends and Calculations Drug Calculator By pressing Perform Calc you will enter the Drug Calculation task window for the selected drug In this window the input values and units configured for the selected drug are listed on the left The unknown value and the concentration are shown on the right Here you can enter or change values for the inputs using the keypad or the up and down arrow keys You can also select a different unknown value to calculate When youpress
258. re In addition to this the trend to which the alarm limits apply is displayed with a thicker line than the other trends Because the NBP is not a continuously measured parameter a special symbol is used to display the trend values as shown in the diagram below S i NBP Systolic value WM 126 85 Diastolic value s aperio tit Display of Trend Data for Non invasive Blood Pressure Example 3 24 Setting up your Monitor oxyCRG Display oxyCRG Display The oxyCRG oxygen CardioRespiroGram display provides a simultaneous presentation of the following three waveforms overlayed on the Main Screen e Beat to beat heart rate trend e An oxygen parameter trend e Compressed respiration wave Approximately the last six minutes of information is displayed for each parameter KEVIN AMES Bed 6 Neo 16 FEB 99 20 39 HR en mode Darren 160 Weuse 160 II imVv 69 70 80 19 12 dSpD 15 CVP 10 959 7 150 TP2 oq 28 SEF2 60 Main Screen Display with oxyCRG The oxyCRG display can help you to make early detections of respiratory regulation problems in neonates by comparing trend patterns or finding interrelationships among the three parameters Setting up your Monitor 3 25 Setting up your Monitor LI gt gt Q gt 22 c p o o oxyCRG Display Approximately the bottom two thirds of the Main Screen area are cov
259. re switched off Setting up your Monitor 3 9 LI E gt Q gt Le c o LI a c Selecting a Screen Selecting a Screen You can switch between the five available screens A E in the Display Setup Task window Monitor Setup Display Setup gt Select Item DAVID SCHULTZ ICU Adult 15 FEB 99 17 07 II HR Non paced mode AJLA nl nll AlL l Al 80 Wuse 80 1mv spo 97 ave ABP 120 80 96 B pla e a ScreenChoice A Screen Label Standard Channel 1 ECG CH1 II l ScreenChoice A Channel 2 ECG CH2 aVR l Screen Label Standard Channel 3 PRESS 1 ABP E NumbrOfWavses 8 Waves Channel 4 PRESS 2 PAP H Overlap 1 non overlap Channel 5 EEG CH1 EEGI BApplicWindow None Channel 6 EEG CH2 EEG2 lave Replace Disabled Channel 7 PLETH PLETH Trace Mode Fixed trace Channel 8 RESP RESP EE GIN E E E o LI gt gt Q gt 22 c p o Select Shenge iReal t imel Numeric Item antent Speeds Onsorr Procedure 1 Press Select ltem until Screen Choice is selected on the screen 2 Press Change Content to select a screen A E The selected screen choice and its screen label will appear at the top of the Task Window The other items on the screen will change depending on the configuration of the different screens 3 Press to return to the Main Screen 3 10 Setting up your Mon
260. reason you cannot properly measure the time difference between an event which occurs before power Setting up your Monitor oxyCRG Display is switched off and one which happens after the power is restored e Ifyou are using a touchscreen selecting the oxyCRG display either via touch or mouse click will open up the Neonatal Event Review Task Window or the Graph Trends Window if Neonatal Event Review is not available You can find information about oxyCRG recording in Chapter 6 EnS 2 e gt ax 22 gt 5 E 72 Setting up your Monitor 3 27 CSA Display CMS only CSA Display CMS only The CSA Compressed Spectral Array is a format presenting the processed EEG It compresses a large amount of data into a compact easy to read trend and consists of 30 complete spectral lines DAVID SCHULTZ OR Adult 30 JAN 99 13 45 II HR Non paced mode lanl d Ao 8 0 sn imv ST2 ABP Keuse 80 i zT 8 80 26 TP1 ETCO 39 IMCO 3 60 002 Epoch B 30sec Filter 0 5 30 CSA2 SEF2 Sp0z urges A RRaw Pmax Pmin Pplat Pmean cktO COMP SEF1 SEF2 o LI gt gt Q gt 22 c p o The bottom half of the Main Screen area is covered with the CSAs The number of realtime waves that you can display simultaneously with CSA is related to the maximum number of realtime waves that your system is capable of
261. red the User Guide and a patient simulator 6 If possible connect the ECG parameter module of the unit to an ECG simulator and verify that an adequate trace is received at each patient lead selection 7 Press Monitor Setup Monitor Revision Show H W Rev In this screen press Show H W Rev This provides a realtime list of the modules in the rack Remove a module and observe the list changes to delete the module you removed Re insert the module and observe the list changes to include the module o o c c o 2 13 10 Maintenance Performance Assurance Checks Performance Assurance Checks The following performance assurance checks are designed to be completed to verify proper operation when e The monitor has been installed e An assembly has been repaired e To verify the operation any time the unit is suspect The performance assurance checks fall into two parts 1 Verification of overall operation by completing the Performance Assurance Test 2 Verification of plug in module operation by completing the Functional Test procedures You can perform any of the checks in any order you choose They are broken up here for organizational sake Performanc To verify your monitor works properly perform the following e Assurance performance assurance test Test o c c o E 1 Connect the power cord to the monitor and plug it in to an AC power source 2 Turn the monitor o
262. ree hours after the monitor is switched off Other Patients 4 7 Other Patients o E c o 2 Q o t o Using Philips Patient Care System with an Arrhythmia Computer Using Philips Patient Care System with an Arrhythmia Computer 4 8 Other Patients Note The patient monitors perform analysis on the patient s ECG waveform This includes triggering alarms on asystole bradycardia ventricular fibrillation and tachycardia conditions Enhanced arrythmia monitoring is available when the patient monitor is connected to one of Philips arrhythmia systems via the Philips monitoring network interface see below If your monitor is connected via the Philips patient care system to an arrhythmia computer 78720A or you have a central station with arrhythmia channels such as the 78560A or 2300 or you have a M3150A M3153A Philips Information Center you are able to display a delayed arrhythmia wave Using the 78720A or the M3150A M3153A the arrhythmia monitoring for your monitor must be turned on or off at the computer display Using the 78560A or M2300 this can be done from the central station or from the monitor itself Arrhythmia monitoring is most easily assigned in SELECT BED at the central station or arrhythmia computer or from the ARRHYTHMIA MENU at the monitor The ARRHYTHMIA MENU enables you to e Setup arrhythmia monitoring on a patient not available for 78720A e Tabulate trends and review tre
263. restrict heat dissipation e Maintenance Failure on the part of the responsible individual hospital or institution employing the use of this equipment to implement a satisfactory maintenance schedule may cause undue equipment failure and possible health hazards e Do not spray cleaning solutions directly onto the patient monitor Moisture droplets may enter the internal components and cause equipment malfunction or failure Cleaning solutions should be applied to a cloth and the cloth used to wipe the monitor clean The monitor should be turned off during cleaning Indications for Use e Replacement Parts It is highly recommended that only Philips Medical Systems recommended parts and accessories be used with this equipment Failure to do so may result in the degradation of performance Accessories and parts for individual modules and components are listed at the back of the appropriate section in this manual Note A note gives special instructions to highlight an operating procedure or practice Notes may precede or follow the applicable text At this time Philips Medical Systems will make available on request and in English only such circuit diagrams component part lists descriptions calibration instructions or other information which will assist the user s appropriate qualified technical personnel to repair those parts of the equipment which are classified by Philips Medical Systems to be repairable A list of Philips Sales and
264. rmation including the total number of stored events and their respective event categories See the Neonatal Event Review section of this manual Chapter 9 Volume 1 for further details on event categories Neonatal Event Data A tabular recording of neonatal event data includes the following information 1 The date and time the event was captured 2 The event labels Brady Desat and Apnea Duration For reference purposes the event labels are reprinted after every 8 columns For filing purposes the recording strip can be cut after every 8 columns and attached to a standard sized sheet of paper 3 The trigger event which is underlined Recording Functions 6 33 7 c T 5 c 2 LL e xe LS 5 tc oxyCRG Episode Recordings for Neonatal Events Neonatal Event Review Recordings Depending upon the number of events stored a neonatal event recording may take from 15 seconds to 40 seconds to complete The recording speed is set by the system and cannot be adjusted 91MIN O7 JAN 98 O7 JAN 98 07 JAN 98 08 JAN 98 9 226 TEL 1 14 35 14 38 14 42 BRADY 106 120 9 STORED EVENTS AD 200 DESAT 52 92 BD 300 ABD 2 0 D 2 APNEA 60 gt 20 26 gt 20 DURAT n Strip03 hpg Making a Tabular Neonatal Event Recording Alarms Volume 9 Event Review The data displayed in the Event Review task window can be recorded in a tabular format by selecting the Record Su
265. rms Suspended Sign key CMS Control Panel Alarm Lamps N d L UE xui outre oes lt gt Silence Alarms Other Monitor Module Reset i Patients Setup Procedures toe Setup Suspend Main Realtime Reve 3 Screen Record Rem m O A Alarms Suspended Lamp V24 and V26 Patient Monitor Control Panel Note Earlier versions of the V24 feature a key instead of the Trends Calcs key The CMS and V24 and V26 Patient Monitors 1 9 z2 s 9 aS Introduction gt 0 o c ac no 2 The CCMS only fae Handheld M Keypad The handheld keypad consists of the same softkeys and hardkeys that S are available on the control panel In addition the keypad provides data entry keys which enable you to enter letters numbers punctuation marks and arithmetic symbols Note The handheld keypad is the main means of operating the M1167 77A System with External Alarm Device Do not remove the keypad from systems with touch or mouse trackball operation as it is still required to perform certain tasks J N 7 X f x E pica Amer Other Monitor Procedures Tronds Module gt Volume Patients Setup Cale Setup j Main Change J f miami f Delayed fre Gases Screen Screen Record Record A Ventilation Sere ara oir at a io Suspen
266. s The Events line at the bottom of all Graph Trends shows all events A D and ST If configured you can review events on five separate lines as part of a graph group A tick mark on the line indicates that an event was recorded for that time When the time bar is positioned on the tick mark the corresponding event letter is displayed in the box below the numerics at the right of the graphs 8 16 Trends and Calculations Viewing Patient Data DAVID SCHULTZ ICU Adult 16 FEB 99 21 21 L L HR Non paced mode 80 Purse 60 spo 100 ABP 120 70 91 Graph Trends 30 140 Lome a O U U 80 20 T T T Event A H Event B kf pi pi HP 4 I I Event C pe s eft Event D E H ST Adjust l T T T T T T Events s INTE Hu A 16 FEB 19 30 17 45 20 00 20 15 20 30 20 45 21 00 21 15 Use the Left and right arrow keys to move vertical time bar Neaxt Select zoom in oom Cut Change Print Groug Graph Time Time Seale Graphs Inserting a The Mark Event function also enables you to insert a calibration Calibration reference into displayed waves Mark oe S 2 25 gt S Sg Fo When checking the magnitude of a displayed wave it can be useful to have a reference or standard to compare against The CalSignals key momentarily interrupts the displayed ECG RESP and pressure waves and inserts the cal pulse s for reference This calibra
267. s Allow batteries to return to room temperature before charging or use c SD 6 N E gt ov ES gt Sg Za G oo e The charge in the batteries gradually deteriorates even during storage They will self discharge 4 5 for each month in storage at 25 C e Batteries should be stored in a fully charged state e A stored battery loses capacity over time To minimize loss of capacity recharge battery at least once every 6 months Batteries can be charged in the monitor or by using a battery charger Note Recharge the batteries after using them It is especially important to avoid allowing the batteries to stay in a fully discharged state for long periods of time Simply plug the monitor into AC line power after transporting a patient or when the monitor is not in use If possible avoid discharging the battery completely e Replace batteries with known charged batteries in the following conditions Batteries discharge quickly when being used Batteries runtime after first RECHARGE BATTERIES alarm is less than ten minutes Batteries do not charge to full capacity indicated by the monitor s battery fuel gauge Battery Information V24CT and V26CT only 12 9 Battery Care and Maintenance Care and e Do not disassemble the battery Strong acid electrolyte may burn Handling your skin or clothes e Check the batteries for any sign of irregularities in appearance Replace the battery if any damage such as
268. s is a connector used to input the 60V dc power supply from the CRT display module It is not for use on the M1046B Computer Module but is instead fitted with a stub connector Equipotential Grounding Terminal this is used to connect the computer module to the hospital s grounding system Philips monitoring network connectors Philips Network Interface these are Philips monitoring network connectors used to input output information to from a Philips monitoring network Human Interface Connector Utility CPU this is a Philips HIL connector used to input information from the keypad in the display module Nurse Paging Relay output this is a mini phone jack used to connect to the hospital s Nurse Paging System Analog Interface Connector a 37 pin D type connector is used to output information to analog devices RS232 Connectors RS232 Interface these are 25 pin D type connectors used to output information to printers or computers Monitor Installation and Patient Safety Controls and Connectors or receive inputs from the Ohmeda 7800 7810 Ventilator or the Anesthetic Gas Module and Patient Safety c 2 s T a fa a z Make sure all devices connected to the RS232 connectors are isolated Consult your biomedical engineer who will verify this for you 8 HDLC Connector this is used to connect to a STRIP recorder such as the Philips M1117A 9 Video Out Connecto
269. sections of the Manual Alarm Functions 5 11 o S fo 92 o r 2 ra E s lt o c 2 O 5 ra E A amp Alarm Setup Alarm Setup In the Alarm Limits Task Window you are able to review all of the alarm limits that have been set for a patient In this Task Window you are able to turn off individual parameter alarms and adjust the limits This means that if you just want to adjust an alarm limit you do not have to get into the individual parameter setups Getting into Press the hardkey Alarms Volume or Alarms the Alarms Selection DAVID SCHULTZ ICU Adult 15 FEB 99 16 18 1 II HR on paced mode Window 4B Ln AJL wn NE alla A 80 wee xn O sT2 Bi imv WPuse 80 112 80 26 25 10 16 dSpO 2 TP 1 The first two softkeys Suspend Alarms and SwitchOn Alarms function in the Selection Window If you select one of these softkeys its function is performed and you are returned to the Standard Display Remember you can also suspend the alarms and switch them back on by using the hardkey 5 12 Alarm Functions Alarm Setup Changing Alarms Volume Alarm Limits the Alarm DAVID SCHULTZ ICU Adult 15 FEB 99 16 18 Limits II Non paced mode lA L l 4 nln wha mn 80 Puse 80 1mV spo 97 Alarm Limits 50 120 BE cP Mm 30 mm a 350 4 Ea NIE MM NE ENS GF NN 2 0 2 0 80 Kid 5 10 RUNG 2 0 m 7 0 CO 3
270. sible via the Selection Window In the Task Window there are separate keys The selections that are currently active for the parameter or function you have chosen are indicated by yellow labeling In addition the selected keys appear to be pushed in on the screen The CMS and V24 and V26 Patient Monitors 1 25 xe N gt o c o z o o c T V26 Patient Monitors Operating Levels There are two reasons for changing the selection in the Task Windows you will either want to move to the next Task Window or make an adjustment to a setting FE Sg RE gt 0 St O s B oc Te LA E gt 1 To move to the next Task Window press the softkey for the function you require for example Filter Mon Diag This gets you into the Filter Mon Diag Task Window where you can make any necessary adjustments 2 To make an adjustment change the selection by pressing the softkey for that window again until the adjustment or change you want is active or use the arrow keys if they are illuminated 1 26 The CMS and V24 and V26 Patient Monitors Touch or Mouse Trackball Operation Touch or Mouse Trackball Operation FE 89 atc gt 0 St O s B oc o gA E The M1167A 77A systems also allow connection of XGA displays enabling touch requires touchscreen displays mouse or trackball operation of the monitor Since these displays do not contain a control panel there are slight differ
271. sive Blood Pressure Module Section SpO2 PLETH Module Section Temperature Module Section CO2 Module and Sidestream Module Section FIO2 Module Section CMS only Pressure Module Section Cardiac Output Module Section VueLink Module Section Volume 3 contains chapters 23 to 29 and appendices A to E see the table of contents of Volume 3 for more details 23 24 25 mUADPFSais SvO2 Module Section CMS only tcpO2 tcpCO2 Module Section Ventilator Interfaces and Respiratory Loops CMS only Anesthetic Gas Module Section Option A05 C03 Blood Analysis EEG Module Section CMS only BIS Module Section Summary of Formulas Used in Calculations Analog Output Section CMS Only Calibrating the Pressure System SpO2 Transducer Information Main Sales and Support Offices Contents 1 Descriptions oru need exu PCR Ee e te PCR AU ei s l v lui EE l v Envitonment si e ei a e wide RS RA C go e O e o Cubs 1 v Indications Tor Use ier UR NES ae eae UM ere Ree eicere bent 1 vi Condition sie so sci eLe tpe Gi rep RD D a RE 1 vi Part of Body or Type of Tissue with Which the Device Interacts 4 1 vi Frequency of Uses ee e a Rc a ec eR EORR SORT RD 1 vi Physiological Purpose 0 cece cect m ences vi Patient Population evt e ear an enel e RR UR OR e eR vi Prescription Versus Over the Counter 0 0 00 eee eee ee 1 vii Responsibility of the Manufacturer lle ene 1 xi Manufac
272. sk window DAVID SCHULTZ ICU Adult 16 FEB 99 21 29 II HR Non paced mode HR T LL L LL LL 80 purse 60 imv spo 100 ABP 120 70 91 Titration Table a Amount Volume Weight DOBUTAMINE 250 0 mg 250 0 mt 70 0 kg Dose Rate Dose Rate Dose Rate mcg kg min ml hr mcg kg min mL hr mcg kg min mL hr 5 500 23 10 50 44 15 50 25 11 00 46 16 00 27 11 50 48 16 50 27 12 00 50 17 00 il 12 50 52 17 50 39 14 50 60 18 42 15 00 63 20 Use Scroll or arrow keys to select another SEE En sees 22222 6 6 7 7 8 33 13 00 54 18 00 8 1 oe S 2 25 gt S Sg Fo When a patient is discharged any modifications made to the inputs or in the unknown value for the discharged patient will be discarded and the configured defaults will be re initialized for the next patient Trends and Calculations 8 35 Drug Calculator ge og 25 E f E FO 8 36 Trends and Calculations 9 Neonatal Event Review This chapter contains information on how to view and interpret Neonatal Events and oxyCRG Episodes for an individual Event Introduction to Neonatal Event Review 9 2 Viewing Neonatal Events 0 0 00s ee eens 9 3 Viewing oxyCRG Episodes 0 00002 eee 9 14 Adjusting Neonatal Event Review Settings 9 18 Neonatal Event Review 9 1 Introduction to Neonatal Event Review Introduction to Neonatal Event Review
273. splaying Split Screen Trends 3 22 oxyCRG Display ise errit ome eneg eee eee eee ee 3 25 CSA Display CMS only 00 02 cee eee eee 3 28 Configuring a Second Independent Display CMS only 3 32 Adjusting the Volume Control suus 3 35 Adjusting the Date and Time 4 3 37 Selecting Waves for Central Recorders 9 39 Configuring Module Bedside and Central Recordings 3 40 Other Patients Controls 2 200 3 41 The Status Log Function 02 0 0000 9 42 The Monitor Revision Function 3 43 Changing Default Settings and Patient Category 3 44 Changing the Patient Category 3 45 Changing the Configuration Set 3 53 Changing Operating Modes 2 005 3 55 The Test Signals Function 200 005 3 58 Parameter Settings Transfer 004 3 61 Setting up your Monitor 3 1 Changing Display Screens Changing Display Screens A display screen is a pre selected arrangement of realtime waveforms numerics and overlayed application windows A particular display screen can for instance be created to monitor a patient during a specific procedure in a department or unit There are five separate display screens which can be configured The default names of these screens are Screen A Screen B Screen C Screen D and Screen E You can se
274. ss paper back onto paper roll 4 With paper rolled loosely pinch several thicknesses of the loose paper with your fingers at front of roll and pull roll out from recorder Tear off any damaged paper before attempting to reload see illustration below Recording Functions 6 51 7 c T 5 c 2 LL e Ke A 5 tc Loading Paper Cleaningthe Print head in the Plug In Recorder If very slow speed 1 or 2 cm min recordings are run for extended periods of time deposits of paper debris may collect on the print head Symptoms of this are recordings that are unevenly fainter in horizontal stripes To clean the print head remove the recorder from the rack Open the recorder door and un thread the paper from behind the rubber roller Tear off or roll up the excess paper into the roll chamber to be out of the way Thread the cloth cleaning strip instead of paper around the rubber roller until the leader exits from the top of the roller by about 2 inches Close the recorder door with both ends of the strip aligned over the top of the door Grasp the top end of the cleaning strip between thumb and forefinger and pull the strip through and out of the recorder Open the door and ensure that the paper cavity is free of dust Re thread the paper and plug the recorder back into the rack Caution When the Plug In recorder is disabled by removal from the rack door
275. st once every 12 months or whenever the validity of the readings is in doubt e check the ventilator fan in the Anesthetic Gas Module for proper operation every 6 months All checks which require the instrument to be opened must be made by qualified hospital service personnel Safety and maintenance checks can also be made by Philips personnel Warning Failure on the part of the responsible individual hospital or institution employing the use of this equipment to implement a satisfactory maintenance schedule may cause undue equipment failure and possible health hazards 11 16 Monitor Installation and Patient Safety Controls and Connectors The Front Panel of the M1046A Computer Module Controls and Connectors and Patient Safety c 2 s T a LI fa a This section describes the various controls and connectors on the front and or rear panels of the Computer Modules the Display Modules the External Alarm Device the Anesthetic Gas Module the V24 and V26 Patient Monitor The M1046A Computer Module is a component of the M1165A 66A 75A 76A Systems The front of the M1046A Computer Module can be mounted with an integral plug in module rack or a blank rack The connectors on the front panel of the M1046A Computer Module are shown in the following diagram ECG Output 2 C front_pl tif Module Rack Connectors Connecto
276. t 00 00 0000 13 20 Performing the Recorder Module Self Test 0 0 00 eese 13 20 Performing the Data Management Database Self Test 0 0 13 20 Tests for VueLink Module and Anesthetic Gas Module 00 13 21 Contents 10 1 The CMS and V24 and V26 Patient Monitors This chapter provides an overview of the CMS Patient Monitoring Systems and V24 and V26 Patient Monitors It includes the following sections Introduction 42e banged nanie a aac SUR 1 2 Parameter Modules 0000 c eee eee eee 1 16 V26CT V24CT Power Supply 2 2 000 1 14 Operating Levels 00 cece eee eee eee 1 20 Touch or Mouse Trackball Operation 1 27 The CMS Computer Modules 1 33 The V24 and V26 Parameter Module Rack 1 35 Operating Rules to Remember 1 36 The CMS and V24 and V26 Patient Monitors 1 1 ne q N gt o c on o o T o b c J c 5 o oO o N gt Introduction Introduction CMS Patient Monitoring System The Philips M1165 66 67 75 76 77 CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors hereafter referred to as the patient monitor are modular patient monitors with networking and data management capabilities All the systems can have modules added or removed at a later
277. t usually 20 seconds The Apnea alarm limit and trigger time can be viewed but not adjusted in the Event Setup task window These settings must be adjusted in Monitoring Mode in the RESP task window c 7 gt LLI c Z Neonatal Event Review 9 19 m c 7 gt LLI S o Review Adjusting Neonatal Event Review Settings Bradycardia Event Settings Alarm Triggered The Bradycardia event is triggered by a Red Brady alarm The Bradycardia alarm limit can be viewed but not adjusted in the Event Setup task window The alarm limit must be adjusted in Monitoring Mode in the HR PULSE or Alarm Limits task window and the trigger time must be adjusted in Configuration Mode in the HR PULSE task window If the Bradycardia alarm related trigger threshold and trigger time items are selected the Change Content key is inactive and the following status message is displayed in the Event Setup task window e Brady items must be changed in the HR PULSE Setup User Defined For situations where the storage and documentation of an event should be independent of all Bradycardia alarms you can adjust the Bradycardia event threshold and trigger time in Monitoring Mode in the Event Setup task window Note When the patient monitor is connected to an Arrhythmia System the Bradycardia alarms are generated by the latter and not the former The alarm limits can only be viewed and adjusted o
278. t and End Case Task Windows are not available Admit Discharge End Case 7 9 D m m E o Ll G lt a 2 e 2 E lt 7 o Admitting a Patient DAVID SCHULTZ ICU Adult 15 FEB 99 18 38 II HR lon paced mode alla da A aL ala ae 90 i Base 9D mV Spo 97 ABP 119 80 96 Patient Information WARNING ALL data for this patient will be erased all reports will be canceled DAVID SCHULTZ 12345678 Press CONFIRM to erase data and cancel reports Press MAIN SCREEN to Leave without erasing data 7 10 Admit Discharge End Case 8 Trends and Calculations This chapter gives you information on the patient data trends and calculations of the patient monitors It includes the following sections e Introduction to Trends amp Calculations 8 2 e Viewing Patient Data 8 3 e Performing and Reviewing Calculations 8 20 e Printing Reports 00 0 e cece eee eee 8 26 e 6Drug Calculator eternan die e a E eee 8 32 Note Your system may not include all the functions described in this chapter Trends and Calculations 8 1 oe og 25 E f E FO Introduction to Trends amp Calculations Introduction to Trends amp Calculations The patient monitors provide you with several tools to manage and present patient data These tools are available in the Trends or Trends Calcs displays You can View patient vital signs in gra
279. t includes the following sections UOVeEVIGW c vue ERE ER ER Der ee E eee Rs 4 2 e Philips Patient Care System 2 00 005 4 3 e Using Philips Patient Care System with an Arrhythmia Computer ocd ete ere eka A AER EK tae ee 4 8 Other Patients 4 1 o E c o 2 Q o t o Overview Overview 4 2 Other Patients If you are connected to a Philips patient care system the Other Patients function allows you to put your bed into groups send and receive alarms between beds in the groups and view data from other beds in your group If you require information about the automatic alarm Other Patients function see the next section If you have an arrhythmia computer attached to your monitor or a central station equipped with arrhythmia channels refer to the Using Philips Patient Care System with an Arrhythmia Computer on page 4 8 Philips Patient Care System Philips Patient Care System The Other Patients Selection Window The Philips Patient Care System is a network which transports information If your system is connected to such a monitoring network you can send information to other systems or central stations and receive information from them One aspect of this information transmission capability is called Other Patients The Other Patients setup based on nursing care assignments allows you to view data from another bed in your group or the ALL group If y
280. t softkeys moves the cursor from one event to the next in both directions Alternatively the arrow keys on the control panel can also be used Once the cursor has been positioned on an event the date and event time is shown and the event values specific to that event are displayed in the three boxes located on the right hand side of the task window Selecting the oxyCRG Episode softkey enters the oxyCRG Episode task window where you can review the oxyCRG episode for the event currently selected At this point and not before an event can be deleted permanently from the event storage 1 25th for V24 and V26 Patient Monitors Neonatal Event Review Recording the Event Summary Printing the Event Summary Changing the Neonatal Event Trigger Conditions Viewing Neonatal Events Note The oxyCRG Episode softkey is only active if at least one event is stored Selecting the Record Summary softkey documents in tabular form the numerical data not graphical of all events displayed in the Event Review task window for the last 24 hours on the bedside M1116B Recorder Module Please refer to the Making Recordings section of this manual Chapter 6 Volume 1 for further details on recording neonatal events Selecting the Print Review softkey starts a print out of the current Event Review display Selecting the Event Setup softkey enters the Event Setup task window where you can change the trigger conditions currently selected
281. task window can be within the reference Ranges range or outside the reference range You can view reference ranges by selecting the Ranges Units key on the Blood Review task window display The reference ranges correspond to the rightmost time displayed in the Blood Review task window The reference range information that appears corresponds to the last measurement The out of range indication refers to the reference range at the time of the measurement Trends and Calculations 8 7 oe og 25 E f E FO Viewing Patient Data The table below describes how reference ranges appear on monochrome and color displays Status Monochrome Display Color Display Printout Inside Range Full intensity White Normal print Outside Range Inverse full intensity Yellow Bold print Cross Connection to Vital Signs When the Vital Signs key is pressed in the Blood Review Task Window the Vital Signs Task Window opens up and the column closest in time to the column selected in the Blood Review Task Window is selected This allows viewing of vital signs stored at the time with the best fit to the time of the blood analysis A Blood Review softkey is also available in the Vital Signs window to return to the Blood Review Task Window If you select another column in the Vital Signs Task Window before returning to the Blood Review Task Window the cursor is positioned on the time column closest to your selection 8 8 Trends a
282. the Silence Reset key and the alarm condition continues then the system will behave according to the following configurations Alarm Reminder i i Alarm Behavior Reminder Time Off No alarm reminder On 2 or 3 mins Alarm reminder tone Alarm lamp No new alarm recording Nurse call relay signals The alarm tone is reannounced for a duration of 6 seconds every 2 or 3 minutes unless the alarm condition is eliminated Alarm Functions 5 5 a c fo 2 o fa 5 LL E s lt o c fo 2 o fa 2 ra E Ee S lt x Alarm Display Alarm Reminder Berinder Time Alarm Behavior Re alarm 2or3mins Full alarm tone Alarm lamp New Alarm Recording Nurse call relay signals A full alarm tone is reannounced after 2 or 3 minutes The alarm tone will sound continuously until it is silenced by pressing the Silence Reset key The alarm reminder clock starts counting from the beginning again every time the key is pressed If an alarm has been acknowledged by pressing the key and during the next 3 minutes a new alarm of whatever priority occurs and is silenced the alarm reminder will sound 3 minutes later for the highest priority alarm The alarm reminder always functions for the highest priority acknowledged alarm The alarm reminder will not sound if there is an active INOP or alarm present For maximum safety when monitoring patients you must resolve activ
283. the prompt and status messages remain until the appropriate user action is performed A parameter module may be turned OFF but left in the rack The empty channel where the waveform should be still appears on the Main Screen There is no waveform waveform label or numeric Another wave may use its screen channel temporarily but will be discarded as soon as the assigned wave is reactivated This ensures that particular waveforms can always be allocated to the same place on the Main Screen and avoids inconsistencies in the waveform display of different patients in the same department Note If trend data for this patient is to be collected old data from a previous patient should be deleted The old data will be automatically deleted if the monitor has been shut off for three hours or more See Discharging a Patient Ending a Case on page 7 9 for more information Getting Started 2 9 o b fo o D c 7 o o b fo n o D c 7 o Attaching the Patient Power Failure Patient Information Center Monitor Standby If a power failure occurs any alarm conditions that were stored in the monitor will NOT be retained when power is restored Settings such as alarm limits stored in 7 modules ARE retained see Parameter Settings Transfer on page 3 61 Caution You are advised to check all the monitor settings after any power failure The monitor reacts according to the l
284. the rack e g 1 integral rack 2 first satellite rack or 1 first satellite rack 2 second satellite rack P is the slot number in that rack counted from left to right The message Unrecognized module in rack position R P is displayed if an unknown module is plugged into the rack Note Since the V24 and V26 Patient Monitors only support one module rack R will always be 1 The CMS and V24 and V26 Patient Monitors 1 19 xe N gt xe o z o o c H o o c o 5 o Q o N gt Operating Levels Operating Levels FE S 9 RE gt 0 St Os B oc o gA E gt There are three types of screens which you will see on the display module The three types of screen and the interconnections between them are shown below Standard Display 2P R Control E Panel Selection 1st Level Window 2nd Level Task ERE Window Lco COC3ZACOCOCOCo go Q c3 1 20 The CMS and V24 and V26 Patient Monitors Main Screen Operating Levels This display shows the waveforms and numerical readouts of the parameters you have chosen to monitor alarms INOP messages bed label date and time and arrhythmia messages when assigned You can configure the number and position of the waveforms on the display screen The numerics are aligned with the corresponding waves The numeric information is u
285. time as needed or you can interchange the modules between systems in your unit Note Some features explained in this manual are not available for both the CMS and for the V24 and V26 Monitors The respective sections are marked throughout the manual with either CMS only or V24 and V26 only The following system types are available The CMS Patient Monitoring System is available as a choice of three system types Each system consists of three individual parts a display module a computer module and parameter modules 1 M1167 77A Color Flatscreen Display and Computer Module with Satellite Module Rack Note This system is also available with an External Alarm Device and an XGA compatible display controller to drive commercially available ITE Information Technology Equipment displays XGA Type 2 M1165 75A Monochrome CRT Display and Computer Module with Integral Module Rack 9 M1166 76A color CRT Display and Computer Module with Integral Module Rack 1 2 The CMS and V24 and V26 Patient Monitors xe eg oO t Introduction MSIE gt 0 o2 c Lnd Gt M1167 77A System oz J aa e es Display EF Module BBC A Aaa Computer Cz py ER Tess ue RED 7 odule p t pai Deeper mam is mE er odules Eis paaa D H Display Module M1095A 10 4 Flatscreen Display Co
286. tion wave is in addition to the calibration reference bar that is always displayed on the ECG and RESP waves Since these calibration pulses momentarily become the waveform signal they are also communicated over the Philips monitoring network SDN and appear on system displays and recorders The RS232 and analog output interfaces also carry these pulses If a recording is in progress the calibration wave also appears on the recording in addition to the recorder calibration wave at the start of the recording Trends and Calculations 8 17 Viewing Patient Data Procedure to Insert a Calibration Pulse Trends Calcs Mark Event Cal Signals DAVID SCHULTZ ICU Adult 16 FEB 99 22 53 HR adandana da lan reuse BD STi 00 CvP mie are ores apo ppl 119 80 96 II imv oe og 25 E f E FO When you press Cal Signals you ll hear a beep as the calibration pulse appears in the displayed waves The event label softkeys and the Cal Signals softkey disappear In the time period between the Cal Signals softkey being pressed and it disappearing from the Screen parameter numeric values are not collected and alarms are not active The calibration pulse will stay on the screen for the length of time it takes a waveform to move across the screen If the waveform is fixed the calibration pulse will be overwritten The Freeze Waves key under can be used to freeze the screen to allow close examination of th
287. tional Enter up to 2 lines of 40 characters Mother s Name Optional Enter up to 18 characters Gestational Age Optional Enter up to 2 characters Birth Weight Optional Enter a value g kg or Ib Birth Length Optional Enter a value either cm or in Head Optional Enter a value either cm or in Circumference INeonatal only Admit Discharge End Case 7 3 To es Lu u 7 co LA 1 Ee 5 2 e E xe lt Admitting a Patient Admission Information OR Mode Required or Items Instructions Optional Patient Name Recommended Enter up to 18 characters 3 AT Medical Record No Recommended Enter up to 12 characters E S Date of Procedure Optional Enter up to 14 characters in 3 any form a Height Required for Enter a value either cm or in calculations o a Weight Required for Enter a value g kg or lb calculations Sex Optional One character allowed use either F or M Date of Birth Optional Enter up to 14 characters in any form Anesthetist Optional Enter up to 18 characters Physician Surgeon Optional Enter up to 18 characters Diagnosis Optional Enter up to 40 characters Procedure Type Optional Enter up to 40 characters ASA Category Optional Enter up to 4 characters Other Optional Enter up to 40 characters Patient name will appear on the Main Screen Name and medical record number will appear on recordings and rep
288. tuation still silenced silenced silenced pressed present Alarm lamp off Alarm lamp off Alarm lamp off Audible alarm Audible alarm Audible alarm reminder every 3 reminder every 3 reminder every 3 minutes if minutes if minutes if configured configured configured Alarm message Alarm message Alarm message blinking numerics blinking numerics blinking numerics Alarm Automatic reset Automatic reset Automatic reset situation no longer present Alarm Functions 5 7 o S fo 92 o i 2 LL E s lt o f fo 2 o i 2 ra E ee S lt x Alarm Display Alarm Priorities 5 8 Alarm Functions Red alarms Highest priority alarms displayed in the top right corner of the display screen These are marked with three asterisks next to the alarm message for example EFASYSTOLE Yellow alarms displayed in the top center of the display screen There are two types of yellow alarms continuous yellow alarms and short yellow alarms The continuous yellow alarms are associated with preset alarm limits The short yellow alarms are active from the arrhythmia computer Both types of yellow alarms are marked with two asterisks next to the alarm message for example HR 56 60 but the alarm tone is shorter with the alarms from the arrhythmia computer For both the short and continuous yellow alarm the yellow lamp is lit INOPs displayed in the top left corner of the display s
289. turer s Address ccce ee dl ede ceeds 1 xi The CMS and V24 and V26 Patient Monitors 1 1 Introduction 2o ee e ER hola Sine SS RR CR ERG RR ud Ae eae 1 2 CMS Patient Monitoring System leleeeeeeeeeee e 1 2 V24 and V26 Patient Monitor llle ee 1 7 Control Panel eee euer P eee E Fere TE Eu dde 1 8 The Handheld Keypad sso Ree er E e ho 1 10 External Alarm Device tee ep eene S ER en 1 11 Hardkey Functions iste eee e t pcne e p OR p etg 1 12 V26CT V24CT Power Supply cce eee eee ie ve e Isa b p Res Ws 1 14 Battery Power Supply cec cR RR e RR E ERR ERE Ee gps 1 14 Parameter Modules noo LEV i eU mee pibe eee 1 16 Symbols to Indicate Key Functions 0 00 eee eee ee 1 17 Operating Levels iiec 25 cates sed Hs ee Decus HE es 2 Et ee 1 20 Main Screen s sa cana ete bool eb NC RR MR C Ad e ai ERR RA 1 21 Selection WindOW Jobs nbLelnh9seshbUD eMe ER CHR eie eee S deben 1 23 Task Window uoc LED Lu bp ae eee REC Rep tegis 1 24 Getting into the Operating Levels 00 0 0c eee ee 1 25 Touch or Mouse Trackball Operation ee 1 27 Main Scree nen ui uai eai e a shady Abd URSUS 1 28 Control Panel Task Window 0 cece cee teenies 1 28 General Touch Mouse Trackball Operation CMS only 000005 1 29 Disabling Touch Mouse Trackball Operation 0 00 1 32 The CMS Computer Modules 00 0 0 eee ccc eee eee eens 1 33 M1046A Computer Module 0 0 eee cece e
290. ty pressure value is Pressure maintained in the cuff for more than a safety period dependent on the patient category Adult if over 15 mmHg for more than 180 seconds Pediatric if over 15 mmHg for more than 180 seconds Neonate if over 5 mmHg for more than 90 seconds Setting up your Monitor 3 47 Changing the Patient Category These safety values effect the measurement range of each category The Adult category has the greatest range systolic 30 to 270 mmHg and the Neonate has the smallest systolic 30 to 130 mmHg Therefore you cannot use Neonate or Pediatric if the expected pressure values are outside the measurement range for that category The following tables list the measurement ranges and safety values for each patient category NBP Measurement Range in mmHg for Differing Patient Categories Measurement Range Patient Category Adult Pedi Neo Systolic 30 to 270 30 to 180 30 to 130 3 Mean 20 to 255 20 to 160 20 to 120 A E Diastolic 10 to 245 10 to 150 10 to 100 Cuff Size AtoE Any Cuff 1to4 amp A Default Inflation Pressure 165 mmHg 125 mmHg 100 mmHg NBP Safety Values for Differing Patient Categories Safety Value Patient Category Adult Pedi Neo Continuous Pressure 15 mmHg 5 mmHg 5 mmHg for for 120s for 120s 60s Time to inflate 40s 20s 20s from 0 to 60 mm Hg Max inflation time 60s 40s 30s 3 48 Setting up your Monitor ECG M
291. u are making a continuous realtime recording at these speeds on the 4 channel recorder the recording is started at 25 mm s for the calibration marks and annotations then switched to the configured speed No re annotations are made Recordings made at speeds greater or equal to 6 25 mm s are annotated every 60 seconds on the Plug In and 4 channel recorders There is no re annotation on central station recorders A calibration pulse scale is included for ECG pressure COs EEG and VueLink waveforms This annotation appears above the waveform For cardiac output recordings the calibration annotation takes the form 6 40 Recording Functions CAL DEG C BY 5 SEC where is the signal value as follows Additional Information Cal Pulse Scale 0 25 0 5 0 50 1 0 1 00 2 0 90DIA HARVEY SMITH 25 mm sec 09 AUG 91 18 04 BED 18 ALARMS SUSPENDED CHECK STATUS LOG PULSE 60 HR 80 ETCO2 40 IMCO2 0 AWRR 25 FIO2 0 21 ABP 120 70 91 PAP 28 15 21 Scalp 0 40 0 80 0 140 Recording Functions 6 41 7 E T 5 c gt LL e Ke LS 5 tc Additional Information Changing Delayed and realtime recordings can be extended or continued the Recording Extending a timed recording resets the runtime You can extend a Length recording as many times as
292. ult 15 FEB 99 16 53 II HR Non paced mode LHR Al aa J A d ay 80 Purse 80 1mV spo 97 ev 26 40 Ld E a p ME cee z Spo 2 95 dSp0 2 RESP 20 TP1 036 aeea a SER 185 Monitor content Module content DAVID SCHULTZ DAVID SCHULTZ 12345678 12345678 Clear module before starting No Press CONFIRM to append new data to module L Append New Data to the Module Patient matching Data Transfer Data Transfer 10 9 Types of Transfer To Monitor Whena Datato Monitor transfer is selected all the module contents will be transferred to the destination monitor If patient information exists in the monitor the message Discharge monitor patient before transfer gives you the option of erasing the previous patient s data before transferring After a transfer to the monitor the module contents are automatically erased DAVID SCHULTZ ICU Adult 15 FEB 99 16 50 II HR Non paced mode PMB nha Ji d J nh 80 purse 80 spo 97 ABP 119 80 96 PAP 25 10 16 mmo mets EAE TP1 030 Loc cM sei 160 Data To Monitor Monitor content Module content DAVID SCHULTZ BOB JONES 12345678 84847566 Discharge monitor patient before transfer Yes Press CONFIRM to start the transfer BISESS YagNa Transfer Data to the Monitor L J o o c Co a 10 10 Data Transfer Transferring Blood Analysis Data Identifying the Software R
293. ur sealed lead acid batteries into the spring loaded battery door in the back of the monitor The batteries should be inserted with the grey Philips battery label facing upwards and the contacts pointing into the monitor The batteries will snap or click into place when properly inserted o b fo o D c 7 o Caution Philips Medical Systems recommends you fully charge the batteries before using the V24CT or V26CT for the first time Plug the monitor into an AC power supply line power for an initial charging cycle When the monitor is plugged in and the power is off it takes approximately four hours for the batteries to reach a charge of 9096 capacity and nine hours for the batteries to be fully charged If the monitor is plugged in and the power and external battery charger is on it takes approximately 16 hours to charge the batteries 3 Ifusing an AC power supply plug the power cord into the power Source Getting Started 2 3 o b fo n o D c 7 o Setting up the Monitor V24 and V26 only 2 4 Getting Started 4 Switch on the system using the power On Off switch A self test is then performed Warning Connecting the Philips monitoring network SDN cable when the product is powered on is not supported Error codes and Philips monitoring network SDN interface lock up may occur Power cycling the product will recover the product No permanent damage will result
294. use trackball operation is disabled touch any area of the screen to return to the main screen The padlock icon will be displayed 1 32 The CMS and V24 and V26 Patient Monitors The CMS Computer Modules The CMS Computer Modules The signals from the parameters being monitored are transmitted to the computer module where they are processed and then displayed on the Screen as waveforms and numerical readouts M1046A The M1046A Computer Module is for use with the Philips M1165 66A and Com puter the Philips M1175 76A CMS Patient Monitoring System Module Maximum Voltages ECG Output and Defib Marker Input 32 V p p Connector for satellite rack 60 V The parameter module rack can be attached to the computer module or a blank panel can be fitted to the computer module if you want to use a satellite parameter module rack The CMS and V24 and V26 Patient Monitors 1 33 ne q N gt xe no o o c T o o c Lnd o 5 o Q o N gt ne q N gt o c on o o T V26 Patient Monitors The CMS Computer Modules M1046B Computer Module ECG Output and Defibrillator Marker Input The M1046B Computer Module is for use with the Philips M1167 77A CMS velot da tif Computer Module ECG Output and Defib Marker Input Satellite rack with parameter modules Maximum Voltage ECG Output and Defib Marker Input 3 2
295. ut Sector 1 Sector 2 1 20 mm 20 mm Wave 1 Wave 2 2 40 mm Wave 1 2 3 20 mm 20 mm Wave 1 Wave 2 3 4 40 mm Waves 1 3 lAlarm recordings always use layout 1 even if the delayed recordings are configured with layout 2 3 or 4 6 44 Recording Functions Layout Choices on Recorder M1117A Additional Information Layout Sector 1 Sector 2 Sector 3 Sector 4 1 25 mm 25 mm 25 mm 25 mm Wavel Wave 2 Wave 3 Wave 4 2 25 mm 75 mm Wavel Wave 2 4 3 25 mm 25 mm 50 mm Wavel Wave 2 Wave 3 4 4 50 mm 50 mm Wave 1 Wave 2 4 Recording Functions 6 45 7 E T 5 c gt LL e kej EN 5 tc 7 c T 5 c 2 LL e xe LS 5 tc Recording Status Messages Recording Status Messages When a recording is running you get a message in the top center of the monitor display telling you which parameters are being recorded In addition the following messages provide information on the status of your recording request Message Meaning Continuous Recording Mode Waves Being A continuous recording is currently running on a Bedside or Central Recorder Recorded Delayed Recording A delayed recording has been accepted and Waves Being Recorded runs if recorder is free or is queued if recorder is busy Earlier Recording Cancelled Recorder Name Recorder Failurel A new recording has been request
296. ution Philips Medical Systems recommends you fully charge the batteries before using the V24CT for the first time Plug the monitor into AC power line power for an initial charging cycle f SD 6 Sa E os ES gt Sg ea G oo e AC power is indicated by the green LED indicator e Battery charging is indicated by the amber LED The LED indicator flashes when the batteries first start charging and continues flashing until the batteries are 30 4096 charged e When the batteries are 30 4096 charged the indicator goes from flashing to continuously on The indicator will be on steady until the batteries are 9096 charged The indicator will turn off when both batteries are 9096 charged or when the line power is disconnected e The green LED illuminates when the battery charging function has reached 9096 charged and will stay on steady even when the batteries are fully charged If the line power is disconnected this LED indicator will be turned off LJ UL UA UACLA mecs Modul Senp Delayed Record Battery me Battery AC rn Charging Charged Power f Battery Information V24CT and V26CT only 12 3 AC and DC Battery Operation Note When AC is connected and the monitor is on the Battery Charge LEDs may take some time to cycle to the appropriate charge indication The V24CT or V26CT may under report battery capacity during this setting period Use the fuel gauge rather tha
297. versal settings Configuration Set 1 is for adult intensive care unit application Configuration Set 2 is for adult operating room application Configuration Set 3 is for neonatal intensive care unit application Configuration Set 4 is for neonatal operating room application The Configuration Sets also include parameter default settings If your hospital requested it these Configuration Sets will have been customized at installation to your specific requirements In this case those new settings are the user default settings if the settings were not changed at installation the user default settings and the factory default settings are the same A 2 9 2 ax 22 gt 5 cS Z o You can change the patient category within a Configuration Set during normal monitoring However if after delivery of your system you want to change any of the other parameters or universal settings you will need to contact your Philips service engineer or your biomedical engineering department as this procedure has to be done in a special Configuration Mode Changes can be made to a Configuration Set to suit an individual clinician s needs for example or to provide optimal settings for a particular medical procedure 3 44 Setting up your Monitor Changing the Patient Category Changing the Patient Category The monitor processes patient signals in different ways using different algorithms depending on the patient categor
298. vice Guide or Testing and Maintaining the V24 and V26 in the V24 and V26 Service Guide 13 6 Maintenance Monitor Maintenance Procedure Frequency Source of Information Preventative Maintenance Replace backlight tube assembly Cleaning procedures 2 5 years of continuous use or as needed Perform the Preventive Maintenance Procedure for the M1180A A01 A02 Wall Mount Assembly every year See Testing and Maintaining the CMS in the CMS Service Guide or Testing and Maintaining the V24 and V26 in the V24 and V26 Service Guide Full performance checks including safety checks At least every two years after any repairs or as needed See Testing and Maintaining the CMS in the CMS Service Guide or Testing and Maintaining the V24 and V26 in the V24 and V26 Service Guide Check Calibration of NBP amp Once a year See chapter 3 of the CMS Sidestream CO Service Guide Maintaining the CMS Check Calibration of all Every 2 years See chapter 3 of the CMS parameters except NBP amp Sidestream CO Service Guide Maintaining the CMS Maintenance 13 7 Q S c 7 E Oo Monitor Maintenance Inspect the The following lists what to look for when inspecting the system System Inspect the 1 Examine the exterior of the unit for cleanliness and general Exterior of the physical condition Ensure that pl
299. w AirwyAGT Yellow PRESS 6 P Red Yellow RirwyO Red Yellow CPP CPP Yellow AirwyN 0 Yellow NBP NBP Yellow tcpO Yellow c D Yellow tcpCO Yellow SpO SpO Yellow TEMP 1 TI Yellow Next Select Change ALL Paga Parametr ALarnReac o Press Select Parametr to highlight a parameter to change Press Change AlarmRec to select the severity Red Red Yellow Yellow Off Press All Rec On to enable recordings for all red and yellow conditions Press All Rec Off for no alarm recordings Note If delayed alarm recordings are being sent to the central recorder the ECG alarm recording setting is displayed in the Alarm Recording On Off Task Window as RED YELLOW This setting cannot be changed unless you choose a bedside recorder either a Plug In or 4 channel bedside Note The AlarmRec On Off function must be enabled in Configuration Mode Recording Functions 6 13 7 c T 5 c 2 LL e Ke A 5 tc Alarm Recording Alarm Recording Priorities Alarm Recording Examples In a delayed recording waves are recorded in the order assigned in the Delayed Alarm Recording Task Window and the number of waves recorded is determined by the recorder configured for delayed recordings In alarm recordings the alarming parameters replace the waves in the lower channels In the default alarm recording the top channel contains the first delayed wave usually ECG A
300. will round the value up For example if you enter 6 55 as an input for a value where only one decimal place is allowed 6 6 will be the value used in the calculation and displayed If you enter 6 54 6 5 will be used in the calculation and displayed If you enter a value which cannot be stored the message Parameter value input range X Y OUT OF RANGE will appear The value for X will be either the upper limit if the value entered is greater than the upper limit or the lower limit if the value entered is less than the lower limit Y is the value you entered Enter a new value The Hemodynamics Ventilation and Oxygenation Review displays enable you to review all calculations made in these groups within the last 24 hours 48 hours if a memory extension is purchased and configured Calculated parameter values both indexed and non indexed are presented with the values used to calculate them The calculation times are indicated along the top of the display The normal ranges for the parameters can also be shown Additional calculation or input values are available by using the Next Page key To select another time column either use the arrow keys or the lt Select Column softkey Trends and Calculations 8 25 oe S 2 25 gt c Sg Fo Printing Reports Printing Reports You can print reports manually through task windows or automatically through pre scheduled printing Through Task Windows You can print
301. y The patient category within a Configuration Set can be changed during normal monitoring gt Adult Pedi Neo Change PatCateg DAVID SCHULTZ ICU Adult 15 FEB 99 17 29 II HR Non paced mode na A adn d nda 4l 80 puise 80 1mV spo 97 A m WW qose EVI uie Fi a Re A eck RR a Spo 2 95 z 23 dSp0 2 Active Set 1 Patient Categ Adult Unit Type ICU Neonate LI a c adjusts the behaviour of algorithms if changing Patient Category review Alarm Limits Change Change ConFSet Pescetag LI gt gt Q gt Le c o In general all the parameter settings and patient data management information are kept if you change the patient category without changing Configuration Set Possible exceptions occur because measurement ranges and alarm limit ranges for some parameters are different for each patient category see the following list If active alarm limits are no longer within range after you change patient category the alarm limits are automatically adjusted to the closest possible values within the new range Setting up your Monitor 3 45 A 2 9 2 ax 22 gt 5 Cc c2 o Changing the Patient Category 3 46 The following table details the differences between the patient categories for those parameters where differences occur Patient Category Parameter Adult Pedi Neo NBP Adult Pedi Neo ECG Adult

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