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Multi-parameter Patient Monitor
STAR8000H
User Manual
Shenzhen Comen Medical Instruments Co., Ltd.
Copyright
Version:
1.0
Issued Date: 2010/01/28
Statements
Our company makes no warranty of any kind with regard to this material, including, but
not limited to the implied warranties of merchantability and fitness for a particular
purpose. Our company assumes no responsibility for any errors that may appear in this
document, or for incidental or consequential damage in connection with the furnishing,
performance or use of this material.
No part of this document can be photocopied, reproduced or translated to another
language without prior written consent of our company.
Responsibility of the Manufacturer
Our company 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 personnel authorized by our company, and the electrical installation of the relevant
room complies with safety standards, and the instrument is used in accordance with the
instructions for use.
Note: This device is not intended for home use.
WARNING
: This device is not intended for treatment.
WARNING
A WARNING label advises against certain actions or situations that could result in
personal injury or death.
Note
A NOTE label provides useful information about a function or procedure.
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Contents
CONTENTS .............................................................................................................................................- 2 CHAPTER 1 GENERAL INFORMATION...........................................................................................- 1 -
1.1 General Information.......................................................................................................... - 2 1.2 Button Functions and Basic Operations........................................................................ - 3 1.3 Screen display................................................................................................................... - 4 1.4 External Socket ................................................................................................................. - 8 1.5 Built-in charge battery .................................................................................................... - 10 CHAPTER 2 MONITOR ASSEMBLY ...............................................................................................- 12 -
2.1 Open Package and Check ............................................................................................ - 12 2.2 Connect with AC Cable .................................................................................................. - 12 2.3 Power on .......................................................................................................................... - 12 2.4 Connect with Sensor ...................................................................................................... - 13 2.5 Check Recorder .............................................................................................................. - 13 CHAPTER 3 SYETEM MENU ............................................................................................................- 14 -
3.1 PATIENT MANAGE ........................................................................................................ - 14 3.2 DEFAULT (Default Setting) ........................................................................................... - 16 3.3 WORK INTERFACE SELECTION ............................................................................... - 16 3.4 TREND SCREEN............................................................................................................ - 16 3.5 TREND TABLE (TREND Figure) .................................................................................. - 17 3.6 NIBP RECALL ................................................................................................................. - 18 3.7 MONITOR SETUP (Monitor Setting) ........................................................................... - 19 3.8 SELECTION ................................................................................................................. - 21 3.9 INFO (Monitoring Information) ...................................................................................... - 22 3.10 DRUG CALCULATION & TITRATION LIST ............................................................. - 23 3.11 DEMO (Password: 5188)............................................................................................. - 23 CHAPTER4 SYSTEM WORK INTERFACE..................................................................................- 24 -
4.1.1 STANDARD .................................................................................................................. - 24 4.1.2 TREND SCREEN ........................................................................................................ - 24 4.1.3 OxyCRG SCREEN...................................................................................................... - 25 4.1.4 BIG FONT INTERFACE ............................................................................................. - 26 CHAPTER 5 RECORDING ..............................................................................................................- 28 -
5.1 General Information on the Recorder .......................................................................... - 28 5.2 Record Type .................................................................................................................... - 28 5.3 Operation and Status Information of Recorder........................................................... - 29 CHAPTER 6 TREND............................................................................................................................- 31 -2-
6.1 TREND GRAPH (TREND Diagram) ............................................................................ - 31 6.2 TREND TABLE (TREND Figure) .................................................................................. - 33 6.3 NIBP RECALL ................................................................................................................. - 34 CHAPTER7 DRUG CALCULATION & TITRATION LIST .............................................................- 36 -
7.1 DRUG CALC ................................................................................................................... - 36 7.2 TITRATION ...................................................................................................................... - 38 CHAPTER 8 PATIENT SAFETY .......................................................................................................- 39 CHAPTER 9 ECG MONITORING......................................................................................................- 41 -
9.1 Definition of ECG Monitoring ........................................................................................ - 41 9.2 Attentions during ECG Monitoring................................................................................ - 41 9.3 Monitoring Procedures................................................................................................... - 42 9.4 ECG Hot Key ................................................................................................................... - 45 9.5 ECG Menu ....................................................................................................................... - 46 CHAPTER10 RESP MEASUREMENT .............................................................................................- 52 -
10.1 Measure RESP ............................................................................................................. - 52 10.2 RESP Setting menu (RESTP SETUP) ...................................................................... - 53 10.3 RESP setting in waveform area ................................................................................. - 54 10.4 RESP setting in measurements ................................................................................. - 55 10.5 Maintenance & Cleaning ............................................................................................. - 55 CHAPTER 11 SPO2 MONITORING..................................................................................................- 57 -
11.1 Definition of SpO2 Monitoring ..................................................................................... - 57 11.2 Precautions in SpO2/Pulse Monitoring....................................................................... - 58 11.3 Monitoring Procedures ................................................................................................. - 59 11.4 Measurement restriction .............................................................................................. - 61 11.5 SpO2 Setting menu ....................................................................................................... - 61 11.6 SPO2 setting in waveform area.................................................................................. - 62 11.7 Alarms & Reminders..................................................................................................... - 63 11.8 Maintenance & Cleaning.............................................................................................. - 63 CHAPTER12 NIBP MONITORING....................................................................................................- 64 -
12.1 General Information ..................................................................................................... - 64 12.2 NIBP Monitoring............................................................................................................ - 64 12.3 NIBP setting in parameter area .................................................................................. - 66 12.4 NIBP setting in measurements ................................................................................... - 68 12.5 NIBP alarm information................................................................................................ - 69 12.6 Maintenance & Cleaning ............................................................................................. - 69 CHAPTER13 TEMP MONITORING ..................................................................................................- 70 -
13.1 TEMP Monitoring .......................................................................................................... - 70 13.2 TEMP setting in parameter area ................................................................................ - 71 -3-
13.3 TEMP setting in measurements ................................................................................. - 72 13.4 Alarm information and prompt information................................................................ - 72 13.5 Maintenance & Cleaning ............................................................................................. - 72 -
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Chapter 1 General Information
For information about the monitor, please read the General Information on the Monitor chapter.
For introduction on various information displayed on screen, please read the Screen Display chapter.
For operational methods, please read the Button Functions and Basic Operations chapter.
For locations of various interfaces, please read the External Interfaces chapter.
For notices of using the monitor with power supply from a battery, please read the Built-in Chargeable
Battery chapter.
Warning
This monitor is to monitor clinical patients, only for doctors and nurses’ use.
Warning
Don’t open cover of the equipment to avoid possible risks in electric shock. Any maintenance
or upgrading on the monitor must be conducted by service personnel trained and authorized by
OUR Company.
Warning
Don’t use this monitor where there are flammables such as anesthetic agent, so as to prevent
from explosion.
Warning
Users before starting use should check whether the equipment and its accessories can work
properly and safety.
Warning
Please make sufficient alarming setting for each patient in order to prevent from delayed
therapy and make sure there is voice effect during alarming.
Warning
Don’t use mobile phones around the monitor. Mobile phones will generate strong emission
fields and disturb the monitor.
Warning
During defibrillation don’t touch patients, tables and the machine.
Warning
Equipments inter-connected with the monitor should form an equal-potential body (as
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protective effective earthing).
Warning
Users (doctors or nurses) should ensure safety of patients under monitoring, when the monitor
is used together with electrosurgical equipments.
1.1 General Information
Transport and Storage:
Temperature: -20℃~+40℃
Humidity: ≤80%
Atmospheric Pressure: 50kPa~106kPa
Working:
Temperature: 5℃~+40℃
Humidity: ≤80%
Atmospheric Pressure: 86kPa~106kPa
Voltage:
a.c.100V~250V 50Hz/60Hz
FUSE T 1.6A
The portable multi-parameter monitor is of rich functions, applicable for bedside monitoring on adults,
infants and newborns.
This monitor can monitor main parameters including ECG, RESP, SpO2, NIBP and TEMP. It
integrates parameter measurement modules, display and record output to build such a solid and light
monitor. Its replaceable built-in battery makes convenience for patient movement and it will clearly
display 7 waveforms and all the monitoring parameter information on the high-resolution interface.
′
Attention
IBP and CO2 are optional.
From left to right they are in turn:
(1) ALARM INDICATOR; (2) Charging INDICATOR; (3) Working INDICATOR; (4) ON/OFF
button; (5) SILENCE button; (6) FREEZE button; (7) PRINT button; (8) START button (for blood
pressure); (9) MAIN button (for key frame return); (10)Knob; (11) MENU; (12) Parameter area; (13)
Waveform area; (14) Information area. The Knob has three working methods as turning left, turning
right and pressing to confirm parameters are mainly applied to the operation of menu.
The outlet of the recorder is located on the left side of monitor and AC power line sockets are on the
rear panel of the monitor.
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(14)
(1)
(13)
(12)
(2)
(11)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Figure 1-1 Multi-parameter Monitor
This monitor has rich functions, able to provide various functions such as visual/audio alarming,
TREND storage & output, NIBP measurement save and review, medicine calculation, ST analysis,
pulse analysis, heart rate turbulence analysis, etc.
This monitor has a friendly operation interface, able to provide all functions with the keys and buttons
on the front panel, refer to Function Keys part for details.
1.2 Button Functions and Basic Operations
The monitor can be operated through use of the buttons and knobs. Here are the functions of the
buttons as follows:
(SILENCE button): Press this button and the alarm will be silence for 3
minutes (this item can be set in the “Alarm Setting” menu). Press this button
over 1 second and the alarm sound can be shielded. In the information area
sign. Repress this button again to pause alarm, resume heart beat
appears
sound and cancel some technical alarm (ECG off, SPO2 off), and the
sign
disappears.
(FREEZE button): Press this button and all waveforms on the screen can be
frozen in the normal mode. Press this button once again and the frozen
waveforms can be freed.
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(PRINT button): Press this button to start a real-time recording. The recording
length is determined according to the “real-time recording time” in the
“Recorder” submenu of “Setting” menu. Press this button once again in the
recording process and the recording will stop at once. Each interval of pressing
this button should be greater than 2 seconds and the frequency should not be
excessively high.
(To start/stop NIBP measurement), press to inflate the cuff to start a blood
pressure measurement. When measuring, press to stop the measurement and
deflate the cuff.
(MENU button): Press this button to have the main menu pop up when the
interface is in the state of non-window setting.
(ON/OFF button): Press this button to control the startup and shutdown of the
monitor.
a.c. INDICATOR
Work INDICATOR
JOG-DIAL
JOG-DIAL to select and change the settings. Operation can be performed by
turning it clockwise, counterclockwise or pressing it down. JOG-DIAL is
mainly used in menu and window operation
1.3 Screen display
This monitor has a color LED screen, able to concurrently display collected patient parameters,
waveforms, and alarming information provided by the monitor, bed marks, clocks, monitor status and
other reminder information.
The main screen is divided into 4 sub-areas, i.e., Information Area ①, Waveform Area ②, Parameter
Area ③ and Menu Area④ (As shown in Figure 0-2)
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Information Area
Waveform
Area
Parameter
Area
Menu Area
Figure 1-2 Main screen display
Information Area (①):
Prompt message in the information area appears and disappears together with the reported state.
In accordance with the content, it is divided into:
1.
Network setup: Cursor stops in
sign, press to enter system setup.
„ Network Bed No.: refer to IP address for monitor, The IP is 200.200.200.X,(X is Network
Bed No.:, from 1 to 100)
′ attention ′
Connection state of CMS (central monitoring system) : when displaying
, no connection;
, connection.
when displaying
Network Bed No. should not conflict with other monitors, or there will be unnecessary problems
for the monitor.
If any problem happens because of confliction, unplug network wire, restart the monitor, reset the
Network Bed No. and connect the network wire again.
2. Patient Information: press to enter the Patient Information menu when cursor is in bed No., name
or patient group area.
„ “Bed No.”: Refer to the bed number of the patient being monitored, this area will be blank if
there is no input.
„ Name: Patient name, this area will be blank if there is no input.
„ Sex: Male and Female.
„ Patient Type: neonatal, pediatric, adult
„
„
„
Pacer: pacer state, pacer detected displaying
Height(cm): patient’s height
Weight(kg): patient’s weight
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, otherwise displaying
3.
4.
5.
6.
Time setup: set up local time
„ time: display system time
Technical alarm: display technical alarm, such as ECG lead off.
Physical alarm: display physical alarm, such as T2 too low.
Battery: display capacity of batter.
Full capacity
Not full capacity
Low capacity
7.
Very low capacity, need to chatge soon.
Volume setup: setup alarm volume, heart beat volume, key volume.
„ Alarm volume: there are five Alarm Vol levels, 1, 2, 3, 4 and OFF, where "OFF" level means
the alarm sound is closed.
Alarm volume on, alarm level 4
Alarm volume off
′ Attention ′
Visual alarm and alarm status
Alarm light winks or shines when there is an alarm. The colour of light means the alarm level. Refer
to alarm function chapter for details.
Waveform Area (②)
There are four waveforms in the waveform area, which are respectively from up to down: two-channel
ECG waveform, SpO2 volume graphic waveform and respiratory waveform (possibly from ECG
module).
The name of selected waveform is displayed on the upper left part. For details, please refer to chapter
of ECG Monitoring. Each ECG waveform still shows the gain of this channel and the filtering method
of ECG waveform. A 1-mv rod is on the left of ECG waveform.
When you choose/touch each waveform, submenu of waveform will be pop up, which always
occupies most of space of waveform area, so that some waveforms are invisible. The original image
will come back after the menu exit.
Waveforms are refreshed at the set speed. For adjustment on waveform refresh speed, refer to the
chapter of each Parameter Setting.
Parameter Area(③):
Parameters can display at the fixed position (as shown in ①~○
12 of the following picture), which are
separately:
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②
①
③
④
⑤
⑥
⑦
9
○
8
○
11
○
12
○
10
○
Figure 1-3 Main Screen
ECG
—Heart Rate or Pulse Rate(①,unit:bpm)
—pacer detection (②PACE)
—ST-segment of channel 1 and channel 2 (③, unit: mv)
— PVCs times (④ Unit: times/minute)
SpO2
—SpO2(⑤,unit:%)
—Pulse Rate(unit:bpm)
IBP (optional)
— Invisive Blood Pressure
(From left to right) Systolic, Diastolic, Mean (⑥, Unit: mmHg or kPa)
NIBP
— None-Invisive Blood Pressure
(From left to right) Systolic, Diastolic, Mean (⑦, Unit: mmHg or kPa)
RESP
—Respiration Rate(⑧,unit:bpm)
TEMP —TEMP
—Temperature(⑨,unit: ℃ or℉)
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CO2 (optional)
—end-tidal CO2 (⑩, Unit: mmHg or kPa)
—inspiratory CO2 (1○1, Unit: mmHg or kPa)
—Air Way Respiration Rate (AWRR)(,unit:bpm)
The above monitored results will show in the parameter area.
The parameters are refreshed once per second, but NIBP value, once per measurement.
Users can select the monitoring parameters and the main screen will display the relative content.
Menu Area(○
4)
1.
2.
3.
4.
5.
6.
7.
8.
9.
PATIENT: patient information configuration. Refer to chapter of Patient Informatio for details.
ALARM SETUP: set up alarm type
„ ALARM RECORD TIME: in case of physiological alarm, the system can record the
information before and after the alarm time. The system can give three kinds of time, i.e., 8
seconds, 16 seconds. The seconds in the options are the sum of seconds before and after the
alarm time. For example, 8 seconds mean the information within 4 seconds before the alarm
time and within 4 seconds after such a time.
„ ALM PAUSE TIME (Alarm pause time):“1 minute”, “2 minutes” or “3 minutes”
„ PARA ALM TYPE (Parameter alarming method):“UNLATCH” or “LATCH”, “LATCH”
means the system will raise the alarm until someone interferes it in case of alarm;
“UNLATCH” means the alarm will automatically disappear with the alarm factor vanishing.
„ ALAM LIMIT (Display alarm limits):”ON” and”OFF”
SURVEY SETUP: ECG, RESP, SpO2, NIBP and TEMP setup, refer to each chapter for details
SCREEN CHANGE: STANDARD, LIST FACE, TREND SCREEN, oxyCRG SCREEN, BIG
FONT, AND 7CH MULTI-LEADS DISPLAY. For details,please refer to chapters for each
parameter.
NIBP STARTt: press this button to start/stop NIBP measurement.
FREEZE: the screen freezes when press this button, turn the knob to review all the waveform
stored for the last 4 minutes.
DEFAULT: Select “Yes”, adopt the neonatal configuration, instead of the previous configuration,
Select “NO”, abandon this selecton,and system can continuously keep the original setting. Refer
to chapter 3.
TREND TABLE (TREND Figure): refer to chapter 3 for details.
PRINT: press this button to record waveforms and patient information.
1.4 External Socket
Left Panel
Recorder is optional
1. Open the recorder door.
2. Take away the no-paper rod
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3. Fix the new paper correctly, tip of paper out from the
head of printer.
4. 3mm paper must out of recorder door, close the door.
5. Press PRINT to check if the paper fixed well or not.
If no printing, prease re-fix the paper.
Figure1-4 recorder
Right Panel
On the right side of the monitor are sockets for each transducer
① TEMP 1
② TEMP2
①
②
③ ECG
④ SPO2
④
③
⑤ NIBP
⑥ IBP1(optional)
⑤
6
○
⑦ IBP2(optional)
⑧ CO2(optional)
8
○
7
○
Figure 1-5 Right Side
This symbol means “be careful”; refer to this manual for details.
This symbol means this application part is of CF type, designed with special protection from
electric shock (especially provided with F-type floating insulation apparatus for permissible leakage
current) and suitable for the defibrillation process.
Other symbols will be introduced in the Patient Safety chapter.
this symbol means: BF type
means the equipotential grounding terminal.
A.C. indicator
work indicator
Power-up
Shutdown
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Rear Panel
There are the following soclets
in the rear panel:
①
11
○
②
10
○
③
9
○
8
○
④
1. Handle
2. Speaker
7. Fuse holder 2
3.Label
8.SD card socket
⑤
6
○
7
○
4.Earth line socket 5. AC power socket
9. Network socket
10.Fan
6. Fuse holder 1
11.Place for clamp or hook
Warning
This network port can only be connected with CARL NOVEL’s central monitoring system.
Warning
All the simulated or digital equipments connected with this monitor must be certified under the
designated IEC standards (such as IEC 60950 Date Processing Equipment Standard and IEC
60601-1 Medical Equipment Standard). And all configurations must comply with effective
versions of IEC 60601-1-1 system standards. Persons in charge of connecting additional
equipments with the input/ output signal terminals should configure the medical system and be
responsible for compliance of the system to IEC 60601-1-1 standard. For any enquiries, please
contact the supplier.
Attention
Patient cable interface, network interface and other interfaces connected to different
equipments, the leakage current should not exceed the limit.
1.5 Built-in charge battery
The multi-parameter monitor has a built-in charge battery. When connected with AC power, the
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battery will charge automatically until it is full. On the right side of the screen, there is a “ ”, it
means charging state. Its yellow part means the quantity of the battery. If this monitor has no built-in
battery, the battery state will display “
”, it means no battery or defective battery.
- 11 -
Chapter 2 Monitor Assembly
′
′Attention′
For normal work of the monitor, before use please read this chapter and the Patient
Safety chapter and assemble in accordance with the requirements.
2.1 Open Package and Check
Carefully pick up the monitor and accessories from the package box, and properly keep the package
materials for future transport or storage. Please check the accessories with the package checklist.
„ Check whether there is any mechanical damage;
„ Check all the exposed cables and plug in some accessories for test.
Any problems should be immediately raised to the Sales Department of our Company or our agents.
2.2 Connect with AC Cable
Procedures to connect with AC power cables:
Make sure the AC supply complies with the following specification: 100-250VAC,50/60Hz
Use the power cables provided with the monitor together. Plug in the power cable into power supply
interface of the monitor, while insert the other end of this cable to a 3-phase earthing power socket.
′Attention′
Connect the power cable with the sockets special for hospital use.
If deemed necessary, connect with an equal-potential earthing cable. Refer to the
equal-potential earthing part in the Patient Safety chapter.
′Attention′
In case configured with a battery, the equipment after transport or storage must have the
battery taken for charging. Thus in case of direct booting without connection with AC
power supply, the equipment may not work properly due to insufficient power. With AC
power supply connected, the battery will be charged no matter the monitor is booted or
not.
2.3 Power on
The logo displays when the power is on, and appears the processing screen. After the 3~5 seconds
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checking process, the system enters the monitoring main screen and the users can start operations.
′Attention′
In case of any fatal errors found during the self-detection process, the system will alarm.
′Attention′
Check all the available monitoring functions and make sure they work properly.
′Attention′
If a battery is configured, users must charge the battery after each time of use so as to
ensure sufficient power storage.
′Attention′
If any monitoring functions are found with damage or there are any error reminders,
don’t use this monitor to monitor patients and quickly contact with the biomedical
engineers of your hospital or maintenance engineers of our Company
′Attention′
Reboot the equipment at least 1 minute after shut down.
2.4 Connect with Sensor
Connect the required sensor between the monitor and the monitoring position of a patient.
′Attention′
For correct connection methods and relevant requirements of various sensors, please refer
to Chapters 10-15.
2.5 Check Recorder
If there is recorder in monitor, check the paper. If there is no paper, see reference related in chapter 1.
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Chapter 3 Syetem Menu
The monitor system setting is more flexible. Monitoring, waveform speed, volume and output, all can
be setup by user. Press the “
MENU.
” button or use turn-knob to choose main menu, popping up MAIN
MAIN MENU including: PATIENT MANAGE, SURVEY SETUP, SELECTION, MONITOR SETUP,
FACE SELECT, TREND GRAPH, TREND TABLE, NIBP RECALL, INFO, DRUG CALC,
MAINTAIN, DEMO, DEFAULT
3.1 PATIENT MANAGE
Attention′
For deleting the patient’s current data, please refer to the “NEW PATIENT” in this
chapter.
Select the “PATIENT MANAGE” item under the system menu, and then pop up the following menu:
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Figure 3-1 Patient Manage
Users can set the following content:
1. Bed NO.
0-999 for option, for example, 666
2. Name
input patient name to the popping up menu
Lock
3.
4.
5.
6.
7.
Caps Lock
(permanent)
SEX
PAT TYPE
PACE
Height(cm)
Weight(kg)
Shift
Del
Caps shift
delete
(one-off)
Patient gender( female, male)
PATIENT TYPE (Neonate, Pediatric)
Packmaker ON/OFF
0~300, for example, 180
0~200, for example, 100
Clr
Enter
clear
enter
Attention′
PACE: The default setting is OFF after you restart the monitor.
In this menu, user can select the “NEW PATIENT” and select “CONFIRM TO UPDATE PATIENT”
to update patient information.
Warning
Patient type changed, the alarm parameters such as heart beat and NBP may vary, usually
make sure the limits are suitable for the patient.
Pacer detection must be on for pacing patients. If falsely setting OFF, the monitor would
miktake pacing pulse as QRS, and not alarm for heatbeat stop
- 15 -
3.2 DEFAULT (Default Setting)
′ Attention′
After any item is selected in the submenu, the selected one will take the place of the
current system configuration and become the default setting of the system.
After any item is selected in the “Default Setting” menu, the dialog box “Confirm Default Setting”
will pop up. Select “Yes” and you can save all configuration of the current patient type as the user’s
default setting. Select “No” and you can abandon the current operation so that the system can
continuously keep unchanged the original setting.
3.3 WORK INTERFACE SELECTION
In the System Menu, select the “FACE SELECT” to enter the dialog box in the following Figure. Here
there are such six options as “STANDARD”, “LIST FACE” “TREND SCREEN”, “oxyCRG
SCREEN” , “BIG FONT” , “7CH MULTI-LEADS DISPLAY”
Figure3-2 Work Interface
3.4 TREND SCREEN
Trend gragh for the previous 1 hour can be diplayed in the resolution of one data per one second or
one data per five seconds.
Trend gragh for the previous 96 hour can be diplayed in the resolution of one data per minute, per five
minutes or per ten minutes.
Users can select the TREND Diagram Review item under the System menu so as to pop up the
following window:
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Figure 3-3 Trend Graph
Parameter selection: HR、RR、SPO2、PR、TEMP、NIBP、IBP1、IBP2、CO2、INS、AWRR.Y-axis
means measurement value, X-axis means measurement time. “Д is cursor for trend graph, The
measurement values it points to display at the bottome of the graph, corresponding time at the upper
end of the graph: 2009-06-22 09:50:35。
Vertical axis is for measured values and horizontal axis for measurement time. The “ ” symbol is the
cursor for TREND diagrams, and the measured value at the position it arrows is displayed below the
TREND diagram while its corresponding time is displayed above the TREND diagram.
3.5 TREND TABLE (TREND Figure)
TREND Figure data over the previous 96 hours can be displayed in the following resolutions: 1
minute, 5 minutes, 10 minutes, 30 minutes and 60 minutes.
Select “TREND Figure review” under the system menu to pop up the following TREND Figure:
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Figure 3-4 Trend Table
Time corresponding to various groups of TREND data is displayed at the left column, with dates
braced. What are listed is the cases that have once been marked, which corresponds to the time of the
marked cases. Parameters in the TREND Figures can be categorized into the following 9 groups:
HR,
ST1, ST2
RR,
T1,T2,TD
SPO2, PR
NIBP (S/M/D)DATE
IBP1(S/M/D)
IBP2(S/M/D)
CO2 INS AWRR
NIBP TREND data has its own characteristics; besides of measured values, below each “measurement
point” there is time for this NIBP measurement.
3.6 NIBP RECALL
The monitor can display the latest 400 NIBP measurement data in the NIBP review function. After
users select the NIBP Data Review item under the System menu, the windows will display the latest
10 NIBP measurement results and measurement time, as shown in the following:
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Figure3-5 NIBP Recall
Data is sorted in time sequence, from early to late, and each screen can display 10 times of
measurement data, while users can select “Page up/ down” to view later or earlier data. Maximally
400 measurement results can be displayed, and when the measure times are over 400, only the latest
400 will be displayed.
3.7 MONITOR SETUP (Monitor Setting)
Select MONITOR SETUP in MAIN MENU, sub-menu following with figure below, including
Figure3-7 Monitor Setup
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3.7.1 ALARM SETUP (Alarm Setting)
Alarm Setup has the following options:
ALM REC TIME (Alarm Record Time):
In case of physiological alarm, the system can record the information before and after the alarm time.
The system can give three kinds of time, i.e., 4 seconds, 8 seconds, 16 seconds. The seconds in the
options are the sum of seconds before and after the alarm time. For example, 8 seconds mean the
information within 4 seconds before the alarm time and within 4 seconds after such a time.
ALM PAUSE TIME (Alarm pause time):“1 minute”, “2 minutes” or “3 minutes”
PARA ALM TYPE (Parameter alarming method):“UNLOCK” or “LOCK”, “LOCK” means the
system will raise the alarm until someone interferes it in case of alarm; “LOCK” means the alarm will
automatically disappear with the alarm factor vanishing.
ALM LIMIT (Display alarm limits):”ON” and”OFF”
3.7.2 RECORD (Record output setting)
Options for record output:
REC WAVE1/ REC WAVE2: can not change
REC RATE: 25.0/50.0 mm/s, record speed
REC GRID: ON/OFF
RT REC TIME: 3S/5S/8S/CONTINUAL (real-time record time)
CONTINUAL means after pressing PRINT BUTTON
printing parameters and waveform, until press
, monitor will keep
to stop
′ ′Attention′
The recorder is a component for option.
′Attention′
Where two similar waveforms are selected, the system will automatically adjust the other
one into a different one.
3.7.3 TIME SETUP (System Time Setting)
- 20 -
"TIME SETUP" with options below:
Setup year, month, day, hours, minutes and seconds.
Pitch on the content required for correction.
3.7.4 NURSE CALL SETUP
Options in nurse call setting:
Signal Duration: continuous/pulse
Signal type: Normal Open/Normal closed
Alarm level: high, middle, low, low+middle, middle+high, low+middle+high
Alarm type: technical, physical, technical+physical
3.7.5 MODULE SETUP.
Options in module setup:
ECG and SpO2 are not optional.
TEMP: ON/OFF. When it is ON, machine can monitor TEMP, when it is OFF, machine can not
monitor TEMP, and no parameter area of TEMP in main interface.
RESP: ON/OFF. When it is ON, machine can monitor RESP, when it is OFF, machine can not monitor
REST, and no parameter area of RESP in main interface.
NIBP: ON/OFF. When it is ON, machine can monitor NIBP, when it is OFF, machine can not monitor
NIBP, and no parameter area of NIBP in main interface.
3.8 SELECTION
Select the “SELECTION SETUP” in the “MENU MENU” and sub-menu following with Figure below,
including
Figure3-7 Selection Setup
- 21 -
3.8.1 ALARM Volume
In the system there are five levels of Alarm Vol: OFF, 1~4.
"OFF" level means the alarm sound is closed.
WARINING
Where the alarm volume of the system is set at OFF, the monitor will not give alarm sound
in case of alarm, so you should use this function carefully.
3.8.2 HEART BEAT VOLUME
In the “SYSTEM MENU” select the “SELECTION”. Pitch on the “BEAT VOL ” with the cursor and
turn the knob to select the volume from such five options as “OFF”, “1”,“2”、“3” and “4”.
3.8.3 KEY VOL (Keyboard Vol )
Pitch on the “KEY VOL ” with the cursor and select the volume from such five options as “OFF”,
“1”,“2”、“3” and “4”.
3.8.4 LCD Brightness (LCD LIGHT)
In the system there are five Brightness level, i.e. “1~5”, where “5” means the maximum brightness.
3.9 INFO (Monitoring Information)
In the “MAIN MENU” select the “INFO” to look through the version information of the software and
hardware.
Figure3-8 Monitoring Information
- 22 -
3.10 DRUG CALCULATION & TITRATION LIST
The portable-type multi-parameter monitor can provide the computation for 15 kinds of medicines as
well as the Titration List Display Function, and output the content of Titration list on the recorder.
3.11 Maintenance
In the “MAIN MENU” select the “MAINTENANCE”, submenu pop out:
Password: 5188
1. Wave type: SpO2 waveform and RESP waveform has two type to select: LINE and
FILL
2. Wave Mode: Color or not
3. Secreen Adjust: switch on touch screen as monitor indicated
Password: 2016
1. Language Selection
2. Filter Hz: OFF/ON
3.11 DEMO (Password: 5188)
In the “System Menu” select the “Demo” to have the “Input Demo Password” dialog box pop up.
Input the correct password and the system will enter the waveform demonstration state.
Demo Waveform means the simulated one set by the manufacturer for showing the monitor
performance and helping users with training.
In the practical clinical l use it is prohibited to use such a function because it will make the medical
personnel misthink they are the monitored patient’s waveforms and parameters so as to affect patient
monitoring and delay treatment. So this menu is set with the password.
- 23 -
Chapter4
System Work Interface
4.1 Work Interface Selection
In the Main Menu, select the “FACE SELECT” to enter the dialog box in the following Figure. Here
there are such six interfaces to choose:
STANDARD, LIST FACE, TREND SCREEN, oxyCRG SCREEN, BIG FONT, and 7CH
MULTI-LEADS DISPLAY.
4.1.1 STANDARD
In the “FACE SELECT” menu, select the “STANDARD” to enter the standard work interface. The
Standard interface provides us the parameter waveforms under monitoring and displays the parameters
in the parameter area, as shown in the following picture:
Figure 4-1 Standard Interface
4.1.2 TREND SCREEN
Enter the “FACE SELECT” and select the “TREND SCREEN” in the Work Interface Selection
menu to enter such an interface.
- 24 -
Figure 4-2 Trend Sreen Interface
„
Location of trend diagrams
TREND diagrams is located at right side of waveforms, with the same colors to the corresponding
parameters.
„ TREND length
Dynamic trend length is 2 hours; in a trend diagram, the right side of the horizontal axis is 0 hour, and
the left side is 2 hours.
„ End of trend concurrence interface
Out of the “Interface Selection” options, select any other work interface to end the trend concurrence
interface.
4.1.3 OxyCRG SCREEN
In the Work Interface Selection menu, select the “oxyCRG Screen” to enter the oxyCRG work
interface.
- 25 -
Figure 4-3 OxyCRG Screen
„
TREND Diagram in oxyCRG Interface
„
OxyCRG Dynamic Interface is consist of compressed respiratory wave and RR.
OxyCRG Trend Length Selection
Two hot key at the below part of dynamic interface: TIME and TYPE
„
TREND Diagram for “1 minute” and “2 minute” can be selected through the trend time buttons.
Compressed Respiratory Wave and RR
“The function of “Respiratory Rate/Compressed Respiratory Wave” means the operator can
select the “PR Trend” or “Compressed Respiratory Wave” as needed, under which the displayed
content occupies the same position. Select the “PR Trend” and this position will show the
TREND Diagram of the respiratory rate; select the “Compressed Respiratory Wave” and this
position will show the respiratory wave after compression.
In the Work Interface Selection menu, select other work interface to end the OxyCRG work interface.
4.1.4 BIG FONT INTERFACE
In the Work Interface Selection menu, select the “BIG FONT” to enter the big font interface.
- 26 -
Figure 4-4 Bif Font Interface
4.1.5 7-CH MULTI-LEADS DISPLAY
In the Work Interface Selection menu, select “7-CH MULTI-LEADS SCREEN” to enter the
MULTI-LEADS SCREEN interface. Users could observe seven ECG channels in this screen,
including II, I, III, AVR, AVL, AVF
Figure4-5 7CHANNEL ECG DISPLAY
- 27 -
Chapter 5
Recording
In the Main Menu, select the “MONITOR SETUP”, then to RECORD menu
5.1 General Information on the Recorder
The recorder used with this monitor is a heat-sensitive array recorder, with print width of 50mm.
Recorder capability
1.
Outputted waveforms run at 25mm /sec. or 50mm / sec
2.
Maximally record two waveforms
3.
Grid output function is optional
4.
English output
5.
Real-time record time and waveforms are selected by users through menus
6.
Automatic record interval is selected by users through menus, while waveforms are identical
to real-time records
5.2 Record Type
This monitor generates slip records of the following types:
Real-time continuous record;
Real-time 3, 5, 8-second record;
Automatic alarm record;
Frozen waveform record;
Start recording waveforms from the moment you press the button.
Real-time continuous record for 8-second defaulted by machine system (normally only for two
waveforms) or set by users through menu. Please refer to relevant chapters for details.
′′Attention′
During output process, the next parameter alarming output will be outputted after
completion of the current output.
- 28 -
Frozen waveform record
In case waveforms are frozen, the system can output the designated waveforms on the screen and in
such a way record those unusual waveforms captured by freezing.
Remark record
Real-time record
Alarm parameter, alarming time, and FREEZE time
Bed number
Parameter name and value
Record time
Waveform name
Waveform amplitude (only for ECG waveforms)
ECG lead, ruler, and gain
5.3 Operation and Status Information of Recorder
Requirements on record paper
Only qualified heat-sensitive record paper can be used, otherwise there may be failure or quality
reduction in record, or damage to the heat-sensitive head.
Normal service
Do not pull out paper when the recorder is working.
Do not use recorder without record paper.
Insufficient paper
Don’t boot the recorder when there is a reminder of “add paper to the recorder” in the information
area. Please load qualified heat-sensitive record paper.
- 29 -
Paper loading procedures
Open the recorder door;
Pull up the slide switch at the left rod of the recorder;
Load new paper exactly following the paper inlet, with the print side toward the heat-sensitive
head;
Slightly pull the paper exposed from the other side, and align the paper properly;
Pull back the slide switch at the left rod of the recorder;
Remove the paper from the paper outlet of the recorder;
Close the recorder door.
′Attention′
Paper loading must be done softly so as to avoid heat on the heat sensitive head. Unless
during paper loading or trouble shooting, the recorder door must be kept open.
Solution to paper jam
When the running voice of the recorder sounds improper or paper outputs improperly, users should
open the recorder door to check whether there is paper jam. Procedures to clear paper jam:
Cut the recorder paper at the paper outlet side;
Pull up the slide switch at the left rod of the recorder;
Pull out the recorder paper from the bottom;
Re-load paper.
- 30 -
Chapter 6 Trend
It can store 96 hours trend data, 400 NIBP and 60 alarm events and support recording. Observation
methods are provided in this chapter.
6.1 TREND GRAPH (TREND Diagram)
TREND diagram for the latest 1 hour can be displayed one data per second or one data per five
seconds;
TREND diagram for latest 96 hours can be displayed one data per minute, per 5 minutes, or per 10
minutes.
Select “TREND GRAPH” in the “MAIN MENU” to pop up the following TREND figure:
Figure6-1 Trend Graph
Vertical axis is for measured values and horizontal axis for measurement time. The “ ” symbol is the
cursor for TREND diagrams, and the measured value at the position it arrows is displayed below the
TREND diagram while its corresponding time is displayed above the TREND diagram.
6.1.1 Select trend diagrams for various parameters to be displayed:
Use the cursor to select the Parameter Selection option and revise the displayed contents. Upon
display of the expected parameter, press the knob, then the TREND diagram for this parameter will be
displayed in the window.
- 31 -
6.1.2 Select 1-hour or 96-hour TREND diagrams:
Use the cursor to select the Resolution option, then select 1 seconds or 5 seconds if you want to
observe 1-hour TREND, or select 1 minute, 5 minutes or 10 minutes if you want to observe 96-hour
TREND.
6.1.3 Observe TREND diagrams of later or earlier duration:
Press the “
or
” button or rotate the knob clockwise or anticlockwise so as to observe later or
earlier TREND curves.
6.1.4 Change the display zoom
Use the “
or
” button to change displayed size of the vertical axis, while displayed size of the
TREND curves will follow to change. Values higher than the biggest axis value will be represented by
the biggest axis value.
6.1.5 Obtain the TREND data at certain time in the current TREND
diagram
Select “Cursor” and rotate the knob to control movement of the cursor; with the cursor moves, its
arrowed time also changes, and the parameter value at such time will be displayed below the
horizontal axis. If there is a “ ” indication in the right side of the window, when the cursor moves
onto this indication the TREND diagram will automatically page down to display later TREND curves;
and if there is a “ ” indication in the left side of the window, when the cursor moves onto this
indication the TREND diagram will automatically page up to display earlier TREND curves.
6.1.6 Operation sample
Observe the NIBP TREND diagram within the latest 1 hour:
Press the TREND button on the control panel to pop up the Main menu;
Select the TREND Diagram Review option in the menu;
1. Select the parameter: rotate the knob in the Parameter Selection item until “NIBP” is shown
in the dropdown box;
2.
Select 1 or 5 seconds in the Resolution item;
3.
Press the “
or
” button or rotate the knob, while observing changes in the TREND
diagram time and TREND curves;
4.
Stop at the period to be carefully observed; in case the vertical axis is out of proper size, for
example, some TREND values exceed the highest value of the current vertical axis, select
- 32 -
“Adjust amplitude” to adjust;
5.
If users want to know the measured value at certain time, just select “move cursor” and move
the cursor to where they wants, then time will be displayed above the curve and measured
values below the curve;
6.
If users need output the TREND diagrams to the recorder, just select the “record” button so
as to let the recorder output NIBP TREND of the current review window;
7.
Press “
” to exit observation on TREND diagram.
6.2 TREND TABLE (TREND Figure)
TREND Figure data over the previous 96 hours can be displayed in the following resolutions: 1
minute, 5 minutes, 10 minutes, 30 minutes and 60 minutes.
Select “TREND TABLE” under the “Main Menu” to pop up the following TREND figure:
Figure 6-2 Trend Table
Time corresponding to various groups of TREND data is displayed at the left column, with dates
braced. What are listed is the cases that have once been marked, which corresponds to the time of the
marked cases. Parameters in the TREND Figures can be categorized into the following 9 groups:
HR,
ST1, ST2
RR,
T1,T2,TD
SPO2, PR
- 33 -
NIBP (S/M/D)DATE
IBP1(S/M/D)
IBP2(S/M/D)
CO2, INS, AWRR
NIBP TREND data has its own characteristics; besides of measured values, below each
“measurement point” there is time for this NIBP measurement.
6.2.1 Select TREND Figures in various resolutions
Use the cursor to select a resolution and use the knob to change options so as to change the time
interval for TREND data.
6.2.2 Observe earlier or later TREND curves
Press “
or
” button or rotate the knob clockwise or anticlockwise so as to observe later or earlier
TREND curves.
6.2.3 Observe TREND data of various parameters
Press “
or
” button and select one group of parameters out of 6 available groups.
6.2.4 Operation sample
To observe a NIBP TREND Figure:
Press the TREND button on the control panel to pop up the Main menu;
Select the TREND Figure Review option in the menu;
1.
Press “
2.
Select the resolution: click the left item and select the expected data interval;
3.
Press “
or
or
” button or rotate the knob to select the NIBP (S/M/D)DATE;
” button or rotate the knob, while observing NIBP TREND data over various
time;
4.
Press “
” to exit observation on TREND table.
6.3 NIBP RECALL
The monitor can record the latest 400 NIBP datas. After select the NIBP RECALL in MAIN MENU,
- 34 -
the window will display 10 groups of NIBP records as follows:
Figure 6-3 NIBP RECALL
Data is sorted in time sequence, from early to late, and each screen can display 10 times of
or
” button to view later or earlier data. Maximally
measurement data, while users can Press “
400 measurement results can be displayed, and when the measure times are over 400, only the latest
400 will be displayed.
- 35 -
Chapter7 Drug Calculation & Titration List
The portable-type multi-parameter monitor can provide the computation for 15 kinds of medicines as
well as the Titration List Display Function, and output the content of Titration list on the recorder.
7.1 DRUG CALC
Medicines able to be calculated under this system are: aminophylline, dobutamine, dopamine,
epinephrine, heparin, isuprel, lidocaine, nipride, nitroglycerin and pitocin. Besides, there are Drag A,
Drag B, Drag C, Drag D and Drag E provided to flexibly replace any medicine.
Users can select “Drug Calculation” under the MAIN MENU to pop up the following window:
Figure7-1 Drug Calculation
The following formulae are used for medicine dosage calculation:
Medicine contents = Total medicine volume / Liquid volume
Infusion speed = Medicine dosage / Medicine contents
Continued time = Total medicine volume / Medicine dosage
Medicine dosage = Infusion speed × Medicine contents
7.1.1 Operation method:
In the medicine calculation window, operators should firstly select names of the medicines to be
calculated, and then confirm patient weight, and input other known values. Subsequently, operators
move the cursor to the various calculation items in the calculation formulae, press the knob and rotate
it, so as to select the calculation value. After the calculation value is selected, value of the items to be
calculated will be displayed at the corresponding position. Values for each calculation item have their
limits, if the calculated results exceed such limits, the system will display “---.--”.
- 36 -
′Attention′
Under this medicine calculation function, other menu items are available for input only
after operators input patient weight and medicine names. The values firstly given in the
system are only a random group of initial values, and operators should not take such
values as calculation standard, instead, should re-input a group of values suitable for the
current patient, based on the comments by doctors.
′Attention′
Each kind of medicine is subject with fixed units or unit series, and operators must select
proper unit based on comments by doctors. Under the same unit series, numbering system
of the units will be automatically adjusted with the current input values, and when the
input value exceed out of expression of the relevant unit, the system will display “---”.
′Attention′
After operators input a certain value, the system will give a clear reminder in the menu,
reminding operators to check correctness of the inputted value; only inputted values are
guaranteed to be correct, the calculated values will be reliable and safe.
′Attention′
In case of newborns, dropping speed and volume of an infusion drop make no sense.
′Attention′
The system gives a reminder for each inputted value, asking operators to confirm.
Operators must be serious with every such reminder, as only valid and correct inputs can
get reliable calculation results.
Select medicine type: move the cursor onto “Medicine name”, rotate the knob and select one
from aminophylline, dobutamine, dopamine, epinephrine, heparin, isuprel, lidocaine, nipride,
nitroglycerin, pitocin, Medicine A, Medicine B, Medicine C, Medicine D and Medicine E,
altogether 15 types. At one time, only one type of medicine can be selected for calculation.
′Attention′
The above introduced A, B, C, D, and E are not actual medicine names but only codes for
medicines. Units for these five types of medicines are fixed, and operators can select
proper units based on general practice of medicines. The expression rules of their units
are as follows:
Medicines A, B, and C are fixed under the “mg” unit series, including g, mg, and mcg;
Medicine D is fixed under the “unit” unit series, including unit, k unit, and m unit; and
Medicine E is fixed under the “mEq” unit.
Patient weight: When entering the medicine calculation window, operators should firstly or
secondly input patient weight, which will be taken as independent information for calculation of
medicine contents.
′Attention′
This function of medicine calculation is only to provide a medicine calculator, while values
in the list should not be related with the patient under monitoring. Thus the patient weight
under this menu is different from the patient weight in the system; when the system
refresh with a new patient, values in this menu will not be affected.
- 37 -
7.2 TITRATION
Enter the Titration list:
In the “Drug Calculation” menu, pitch on the “Titration” to enter the Titration list interface.
The Titration list interface for medicines is shown in the following Figure:
Figure7-2 Titration List
The specific operations are as follows:
In the Titration list, move the cursor to the “Reference Item” with the knob first, and then press the
knob to select the required item. “Dosage” and “Injection Speed” are two options.
Move the cursor to the “Step Length” and press the knob to select the step length in the range of 1~10.
Move the cursor to the “Dosage Type” and press the knob to select the dosage unit.
Move the cursor to the “
pages of the list.
or
” button and press and turn the knob to check the previous and next
Move the cursor to the”Record” and press the knob to output the Titration list data on the current
display interface.
Move the cursor to the” ” and press the knob to return to the “Medicine Calculation” menu.
- 38 -
Chapter 8 Patient Safety
The portable monitor is designed to meet the international safety requirements IEC60601-1,
EN60601-2-27 and EN60601-2-30 formulated for medical electric equipments. It’s furnished with
floating inputted defibrillation resistance and surgery electric knife protection. If correct electrodes
(referring to the ECG and RESP chapters) are installed following supervision of the manufacturer,
screen display will be recovered within 10 seconds after defibrillation.
This symbol means the application part is of IEC 60601-1 type CF equipment, and designed with
special electric shock resistant apparatus (especially with an F-type floating insulation apparatus for
permissible leakage current), especially recommended for use during defibrillation period.
Warning
During defibrillation period don’t touch the relevant patients, beds or equipments.
Environment
Users should follow the following guides to ensure absolute safety of electricity installation. For an
environment where the portable monitor is located, users should reasonably avoid vibration, dusts,
corrosive or explosive gases, extreme temperature and moisture. In case installed inside a chamber,
the front side must be given sufficient space for convenient operations, and while the chamber door is
open, the rear side must be given sufficient space for easy repair. Besides, must make sure of air flow
inside the chamber.
The monitor, when working in an ambient temperature between 0℃~40℃, can meet the technical
indexes, otherwise may have equipment accuracy affected or parts or circuits damaged. Moreover,
there should be at least 2 inch (5 cm) of space reserved surrounding the monitor to ensure air flow.
Power Source
Please refer to the Product Specification chapter.
Monitor earthing
To protect patients and medical staffs, the portable monitor must has its cover connected with the
earth; for such reason the monitor is equipped with a dismountable 3-line cable, which should be
plugged into a matching 3-line socket and further connected with the earth through the ground line of
the power supply cable. In case of no 3-line socket, please consult with the electricity staffs of your
- 39 -
hospital.
Warning
Don’t connect the 3-line cable of this monitor with a 2-line socket.
Connect the ground line with the equal-potential earthing terminal of the monitor. If unaware whether
a certain equipment combination is risky in terms of equipment specification, for example, whether
gathered leakage current is dangerous, users should consult with relevant manufacturers or specialists,
so as to make sure the necessary safety of the relevant equipment will not be damaged by the proposed
combination.
Equal-potential earthing
First level protection on the equipment has been contained in the house protective earthing system
through earthing of the power socket. For heart or head internal check, this portable monitor must be
individually connected with an equal-potential earthing system. One side of the equal-potential cable
(potential balanced cable) should be connected with the equal-potential earthing terminal on the rear
panel of the monitor, while the other side connected with one interface of the equal-potential system.
In case of any damage to the protective earthing system, the equal-potential earthing system will take
the safety function of protecting the earthing cable. Heart or head checks should be conducted within
houses for medical use installed with protective earthing systems. Before each time of use, users
should check whether the equipment is under good work status and pay attention the cable connecting
patients and the equipment must be free from electrolytes pollution.
Warning
If the protective earthing system is instable, the monitor should be applied with internal
power supply.
Condensation
During work period the equipment must be made sure of no condensation. When the equipment is
shifted from one room to another room, condensation may be formed as the equipment is exposed in
moistured atmosphere and different temperature.
Warning
If the monitor is used where there are flammable anesthetic agents, there may be
explosion.
Explanations on Symbols Used in the Monitor
See reference in external interface in chapter 1.
- 40 -
Chapter 9 ECG Monitoring
9.1 Definition of ECG Monitoring
ECG monitoring describes continuous waveforms of cardiac activities of patients so as to accurately
assess the current psychological status of the patients. Thus proper connection of ECG cables must be
ensured in order to obtain correct measurement values. This portable monitor concurrently can display
2 waveforms under normal work status.
A patient cable consists of two parts:
Wire connecting the monitor;
Leads connecting patients
With a 3-lead facility for monitoring, ECG can obtain two waveforms from two different leads.
Users can use the knob, in the left side of the ECG waveforms on the screen, to directly select
the lead to be monitored.
Displayed monitoring parameters include HR, ST segment measurement value and arrhythmia.
All the above parameters can be taken as alarm parameters.
′Attention′
In the ex-factory setting of the monitor the ECG waveform displays at the position of the
first two waveforms in the waveform area.
9.2 Attentions during ECG Monitoring
Warning
Don’t touch patients, tables or the equipment during defibrillation.
Warning
The ECG cable used for ECG signal monitoring by this portable monitor must be
provided by our Company.
Warning
When connecting electrodes or patient cables, users should ensure there is no connection
with other electric conductive parts or the ground, and more importantly, ensure all the
ECG electrodes including neutral electrodes are attached with patient bodies instead of
touching with electric conductive parts or the ground.
′Attention′
Disturbance from non-earthing equipments around a patient or ESU disturbance may
- 41 -
affect waveforms to function improperly.
Where this monitor is operated according to the conditions specified in the EN60601-1-2
(anti-radiation ability: 3V/M) and the electric-field strength above 1V/M may give rise to
the measurement mistakes under various frequencies, it is suggested that the
electroradiant equipment should not be used in the place next to the ECG/Respirometer.
9.3 Monitoring Procedures
9.3.1 Preparation
Take patient skin preparation before installation of electrodes:
1.
Skin is bad conductor, thus to ensure good touch between electrodes and skin it’s very
important to well prepare patient skin.
2.
When necessary, remove body hair surrounding the electrode positions.
3.
Clean thoroughly the skin with soap and water (don’t use ethyl ether or pure alcohol, as they
will increase skin resistance)
4.
Drily sweep the skin so as to increase capillary blood flow as remove skin scraps and oil.
5.
Install spring clamp or snap before installation of electrodes
Put the electrodes on patient body; in case the electrodes contain no conductive paste, coat
the conductive paste before installation.
6.
7.
Confirm power supply.
Warning
Daily check whether the ECG electrode plates stimulate skin; in case of any sensitiveness
phenomenon, change the electrodes or positions every 24 hours.
′Attention′
To protect the environment, used electrode must be recycled or properly treated.
Warning
Before monitoring check whether the leads work properly. After users plug out the ECG
cables, screen will display the error information of “Sensor disconnected” and activate
voice alarming.
9.3.2 Install ECG leads
′ ′Attention′
The following table lists the lead names under the European and US standards (leads are
- 42 -
represented in R, L, N, F and C under the European standard and in RA, LA, RL, LL,
and V under the US standard)
US standard
European standard
Lead name
Color
Lead name
Color
RA
White
R
Red
LA
Black
L
Yellow
LL
Red
F
Green
RL
Green
N
Black
V
Brown
C
White
Three-lead ECG electrodes position (Figure 9-1):
Five-lead ECG electrodes position (Figure 9-2):
- 43 -
′ Attention′
For patient safety, all the leads must be connected with patient body.
For 5-lead device, put the breast (V) electrode at one of the following positions:
V1, around the 4th frame at right side to the breast bone
V2, around the 4th frame at left side to the breast bone
V3, between V2 and V4
V4, around the 5th frame along middle line of the left clavicle
V5, at front line of the left axilla, at the same horizontal position of V4
V6, at middle line of the left axilla, at the same horizontal position of V4
V3R-V7R, at right side of the breast, identical to those positions at left side
VE, at apophysis of the xiphoid process; in case V leads are put on the back, the electrodes must
be put at one of the following position:
V7, around the 5th frame at back line of the left axilla on the back
V7R, around the 5th frame at back line of the right axilla on the back
Figure 9-3 5-lead Chest Electrode Position
9.3.3 ECG lead connection recommended for surgery patients
Warning
When using ES equipments, users should put ECG electrodes at middle of the ES earthing
plate and ES knives to prevent from burns. Cables of ES equipments can not be wrapped
with ECG cables together.
Positioning of ECG leads is up to operation types, for example, for chest operation, electrodes can be
- 44 -
put on breast sides or back. Inside operation rooms using surgery electric knives, sometimes artificial
discrepancy may affect ECG waveforms; to reduce such artificial discrepancy, users may put the
electrodes at the left and right shoulders, near left and right abdomen, with breast lead at left to the
middle breast. No electrodes should be put on left arm; otherwise the ECG waveforms will be very
small.
Warning
During use of ES equipments, don’t put electrodes near the earthing plate of such
equipments, otherwise ECG signals will be much disturbed.
9.4 ECG Hot Key
1
○
4
○
5
○
Figure 9-2 ECG Hot Key
Name of the First ECG Lead ○1 :
ECG using 5-lead, the selectable leads include I, II, III, aVR, aVL, aVF and V;
ECG using 3-lead, the selectable leads include I, II and III. (For neonate)
The leads on the ECG waveform should not have the same name, otherwise the system will
automatically change the similar name into another.
The 1st-ECG Waveform Gain ○2 : used to adjust the amplitude of ECG waveform.
- 45 -
The gain of each calculation channel can be selected, which has such columns as ×0.25, ×0.5,
×1 and ×2 as well as auto mode. Auto mode means that the monitor can automatically adjust the
gain. On the right side of each ECG waveform there is a 1-mv rod of which height and amplitude
are proportional.
′
Attention′
The input signal being too strong, the wave crest may be truncated. At this time users can
manually change the gain column of ECG waveform by reference to the actual waveform
for fear of incompleteness of waveform.
Filtering Mode ○3 : The cleaner or precise waveform can be obtained through filtering.
There are three filtering modes for option. The unfiltered ECG waveform is shown in
diagnostic mode; the monitoring mode will possibly lead to the artifact filtering;
operation mode used in the surgery can reduce the artifact and interference from
electrosurgery unit. The filtering mode can be used in two channels and displayed on
upper part of the first ECG waveform.
the
the
the
the
Warning
Only in the diagnostic mode can the system provide the real signal that has not been
treated. In the filtering modes such as “Monitoring” and “Operation”, the ECG waveform
will abnormally occur to the different extents. At this time the system can only provide the
basic ECG status, and will produce greater influence on the analysis result of ST Segment.
The analysis result of ARR may partially be affected in the operating mode, so it is
suggested that efforts are made to monitor patients in the diagnostic mode when the
interference is small.
The Name of 2nd-ECG Waveform Gain: for details, please refer to ○1 。
The 2nd-ECG Waveform Gain: for details, please refer to ○2 。
′ Attention′
The detected pacing signal displays on the upper part of the ECG waveform in the
waveform area, which is expressed as “ ”.
9.5 ECG Menu
- 46 -
9.5.1 ECG setting menu
Use turn knob and move cursor on the main screen to the ECG hot keys in the parameter area, then
press the knob to pop up the ECG Setting menu:
Figure 9-3 ECG Setup
„
Alarm: Select “ON” to give alarm prompt and storage when the heart rate alarm happens.
will be prompted beside ECG.
„
Alarm level: three options: High, MED and Low, and high is for the most serious alarm.
„
Alarm record: Users can select “On” to print HR alarms when they happen
„
Alarm upper limit: used for users to set the upper limit for HR alarms
„
Alarm lower limit: used for users to set the lower limit for HR alarms
Alarms will happen once the HR values exceed the upper or lower limit.
Adjustable ranges for HR alarm upper & lower limits are as follows:
Highest upper limit
Lowest lower limit
Adjustment
length
1
1
1
step
HR adult
300
15
HR infant
350
15
HR newborn
350
15
′Attention′
Users should set the alarm upper & lower limits based on the clinical conditions of every
patient. Setting of the HR alarm upper limit is very important, and users should not set it
too high but consider fluctuation factors. The set HR alarm upper limit should not be over
20 beats/ minutes than patient HR.
9.5.2 ECG setting in waveform area
Turn the knob to waveform area,press the knob to enter ECG waveform setting
- 47 -
Figure 9-4
ECG Setup
„
Lead Name:
ECG using 5-lead, the selectable leads include I, II, III, aVR, aVL, aVF and V;
ECG using 3-lead, the selectable leads include I, II and III.
„
Gain: used to adjust the amplitude of ECG waveform. The gain of each calculation channel
can be selected, which has such columns as ×0.25, ×0.5, ×1 and ×2 as well as auto mode.
Auto mode means that the monitor can automatically adjust the gain. On the right side of
each ECG waveform there is a 1-mv rod of which height and amplitude are proportional.
„
Sweep: ECG Waveform scanning wave has four levels for option, such as 6.25, 12.5, 25.0
and 50.0mm/s.
„
Filtering Mode: The cleaner or precise waveform can be obtained through filtering. There are
three filtering modes for option. The unfiltered ECG waveform is shown in the diagnostic
mode; the monitoring mode will possibly lead to the artifact filtering; the operation mode
used in the surgery can reduce the artifact and interference from the electrosurgery unit. The
filtering mode can be used in two channels and displayed on the upper part of the first ECG
waveform.
„
Wave Color: green, cyan, red, yellow, white, blue, violet.
- 48 -
9.5.3 ECG setting in measurements
Figure 9-5
ECG Setting menu
1. When the heart rate alarm happens. Select “OFF”
will be prompted beside ECG.
2.
Alarm level: three options: High, MED and Low, and High is for the most serious alarm.
3.
Alarm record: Users can select “On” to print HR alarms when they happen
4.
Lead type: 5-lead or 3-lead
5.
6.
Selection of HR calculation channel
“Channel 1” means the HR is calculated according to the first ECG waveform data.
“Channel 2” means the HR is calculated according to the second ECG waveform data.
“Auto” means the monitor will automatically select the channel of calculating HR.
HR Source
7.
Users can select to check HR through ECG or PLETH (blood-oxygen volume recording
waveform); if users select “Automatic”, the monitor will decide HR source based on signal
quality; if users select “All”, the monitor will concurrently display HR and PR. In case PLETH
is taken as the HR source, the PULSE reminder will be displayed together with pulse voice.
In case PLETH is taken as HR source, no alarm judgment on HR but alarm judgment on PR
will be conducted. In case “All” is selected, PR measurement values will be displayed in the
right to SpO2 on the main screen, and HR & PR make alarms at the same time. Pulse voice will
give priority to HR, as long as there is HR data, voice reminder will be there; only when there is
no HR data, voice reminder will be subject with PR.
ST Segment Analysis Select this item and enter the “ST Segment Analysis” menu.
Arrhythmia Analysis
Press SURVEY in main interface, one submenu pop up; choose ECG SETUP, Arrhythmia analysis
information inside.
- 49 -
Arrhythmia analysis is used in clinically monitoring the ECG of patients, detecting the HR change and
PVB, saving the arrhythmia events and producing alarm messages. Besides, it can be used to monitor
the patients with or without the pacemaker. The qualified personnel can evaluate the patient’s status
(such as HR, PVCS (PVB), frequency, rhythm and abnormal HB) according to arrhythmia analysis
and make a diagnosis and give treatment. In addition to detect the ECG change, arrhythmia analysis
can monitor patients and give a suitable alarm.
The default of arrhythmia monitoring function is off. Users can start this function as needed.
Arrhythmia monitoring can arouse the doctor’s attention to the patient’s cardiac rhythm and give an
alarm through test and classification of arrhythmia and HB abnormality.
This monitor can support 13 kinds of arrhythmia analysis.
In arrhythmia analysis, the system will save the latest 60 alarm events (the single-channel ECG
waveform four seconds before and after alarm). The operator can edit the arrhythmia events through
this menu.
Arrhythmia Analysis
In the “ECG SETUP” menu, select the “Arrhythmia Analysis” to enter the following submenu
(1)Arrhythmia Analysis: During monitoring it can be set at “ON” and during default, “OFF”
(2)Alarm Switch: Select the “ON” and the alarm prompt and saving will proceed; select the
“OFF” and PVCs alarm won’t start, but prompting
do beside PVCs in the screen parameter
area.
(3)Alarm Level: There are such three options as “high”, “middle” and “low”. “High” means the
most serious PVCs alarm.
(4)Alarm Record: Select the “ON” and the recorder will output during PVCs alarm.
(5)Alarm Upper Limit: PVCs alarm is based upon the set alarm upper limit. The alarm will
happen when PVCs exceeds the upper limit.
(6)ARR self-learning: Press this button to trigger a learning course and the screen information
area will show “Learning ARR”
(7)ARR Alarm Setting: Set the Arrhythmia Alarm.
(8)Arrhythmia Recall: Select this option and you can view and edit the patient’s arrhythmia
information.
The latest saved arrhythmia events are listed in the window (one page can show 10 events and at most
6 pages can display).
1. Press
or
to observe the list of arrhythmia events in other pages.
- 50 -
2. Cursor Movement: to move the cursor to select the arrhythmia events in the list.
Figure 9-6 Arrhythmia Events Review
Figure 9-7 Arrhythmia Waveform Review
′ Attention′
In the event that the number of arrhythmia event is more than 200, the monitor will retain
the latest instead of the earliest. As for the monitor with the power-fail saving function, it
can save 200 arrhythmia events with power-fail.
PVCs Alarm Message and Prompt Message:
When the alarm record switch in the related menu is turned on, the physical alarm arising out of that
the parameters exceeds the alarm limit will make the recorder automatically output the alarm
parameter values and related waveforms.
- 51 -
Chapter10 RESP Measurement
10.1 Measure RESP
10.1.1 How to measure RESP
This monitor measures RESP values from the breast impedance values at two electrodes; impedance
change between such electrodes (due to breast activities) will generate a RESP waveform on the
screen.
10.1.2 Setting of RESP monitoring
For RESP monitoring, no additional electrodes are required, but how to install electrode is critical. For
some patients, especially with clinical condition that negative breast internal pressure will be
generated if their breast is horizontal expanded. In that case, users should put the two RESP electrodes
respectively at middle line of the right axilla and left side to the breast, where there are largest
activities during respiration, so as to obtain the best RESP wave.
′ ′Attention′
RESP monitoring is not applicable for patients with active activities otherwise may
generate wrong alarms.
RESP monitoring checks:
Take patient skin preparation before installation of electrodes;
Install spring clamp or snap for electrodes, and follow the later-introduced method to install
electrodes on patient body;
Turn on power supply for the monitor system.
Install electrodes for RESP monitoring
- 52 -
′Attention′
Install the white and red electrodes in a diagonal line so as to obtain the best RESP wave.
Need keep the liver and heart area out of the line formed by such electrodes, so as to avoid
artificial discrepancy generated from heart cover or pulsatile blood, which is very
important for newborns.
10.2 RESP Setting menu (RESTP SETUP)
Users can rotate the knob and move the cursor to the RESP hotkey on the parameter area of the main
screen, then press the knob to enter the RESP Setting menu.
Figure10-1 RESP Setup
1.
Alarm Switch: select the “ON” and the alarm prompt and saving will proceed during RR alarm;
select the “OFF” and “ ” will be prompted beside RESP in the screen parameter area.
- 53 -
2.
Alarm record: If users select “On”, upon RESP alarming, the recorder will output the alarm.
3.
Alarm levels: High, MED or Low to be selected, and High for the most serious alarm.
4.
Alarm HI: used to be set with the upper limit for RR alarm.
5.
Alarm LO: used to be set with the alarm lower limit.
RESP alarming takes the set upper & lower limits as standard, and once the RESP values exceed such
limits there will be alarms.
Adjustable range of RESP alarm upper & lower limits:
Max upper limit
Min lower limit
Adjusted amount
per time
RR adult
120
6
1
RR infant/ newborn 150
6
1
Choke alarm: Users can set the time to judge patient choke; 10-40 seconds are optional, each rotation
of knob will increase/ decrease 5 seconds.
10.3 RESP setting in waveform area
Users can rotate the knob and move the cursor to the RESP hotkey on the parameter area of the
main screen, then press the knob to enter the RESP Setting menu.
Figure10-2 RESP Setup
Waveform speed: Three optional speeds, 6.25mm/s, 12.5mm/s and 25.0mm/s
Waveform amplitude: Users can set enlarged display of RESP waveforms under five optional
enlargement rates: 0.25, 0.5, 1, 2 and 4.
Wave Color: green, cyan, red, yellow, white, blue, violet.
- 54 -
10.4 RESP setting in measurements
Users can rotate the knob and move the cursor to the RESP hotkey on the parameter area of the
main screen, then press the knob to enter the RESP Setting menu.
Figure 10-3
1.
2.
3.
4.
5.
RESP Alarm Setup
ALM: see reference in RESP Setting menu
ALM LEV: see reference in RESP Setting menu
ALM REC see reference in RESP Setting menu
SWEEP: Waveform speed, Three optional speeds, 6.25mm/s, 12.5mm/s and 25.0mm/s
RR Gain: Users can set enlarged display of RESP waveforms under four optional enlargement
rates: 0.25, 0.5, 1.0, 2.0 and 4.0.
10.5 Maintenance & Cleaning
Note and Cleaning
Warning
Before cleaning the monitor or sensor, users must turn of the equipment and break the
AC power supply. In case of any appearance of ECG cable damage or aging, users should
change with new cables.
Cleaning
Surface of the monitor and sensor can be swept by medical alcohol, naturally dried or cleaned
- 55 -
by clean and dry clothes.
Disinfection
To avoid long-term damage to the equipment, we recommend you to disinfect the products only
when deemed as necessary under the maintenance plan of your hospital. We also recommend
you to clean the products before disinfection.
Recommended disinfection materials for the monitor:
1.1.2 Ethanol: 70% alcohol, 70% isopropyl
1.1.3 Glyoxyl
Sterilization
To avoid long-term damage to the equipment, we recommend you to sterilize the products only
when deemed as necessary under the maintenance plan of your hospital. We also recommend
you to clean the products before sterilization
- 56 -
Chapter 11 SpO2 Monitoring
11.1 Definition of SpO2 Monitoring
The SpO2 volume recording parameter is used to measure arterial SpO2, i.e., percentage of
oxyhemoglobin. For example, if there are 97% of hemoglobin molecules combining with oxygen out
of the arterial red blood cells, the blood will be described as SpO2 97%, and the SpO2 reading on the
monitor will be 97%. SpO2 values thus can show the percentage of oxygen-attached hemoglobin
molecules (will form oxyhemoglobin), meanwhile, SpO2 volume recording parameters can also
provide the PR signals and volume recording waves.
11.1.1 Principle for Measurement of SpO2 Volume Recording Parameter
BOS (blood oxygen saturation) is measured and determined in the method of pulse oximetry, which is
a method of measuring and determining the oxyhemoglobin saturation continuously and without any
hurt, mainly used to measure and determine how many rays from the light source of the sensor
penetrate the patient’s tissue (such as fingers or ears) and reach another receiver.
As for the wave length measurable by the sensor, generally the red LED is 660nm and the infrared
LED, 940nm. The maximum selectable output power of LED is 4mW.
The number of penetrated rays rests with many factors where most are constant, but one of these
factors means the arterial flow changes through time because it is pulsant. The arterialized blood’s
BOS can be obtained through measurement of absorbed rays during pulsation. A “volume recording”
waveform and PR signal can be given through detection of pulsation.
“SpO2” value and “Volume Recording” waveform can display on the main screen.
Warning
Where there is carboxyhemoglobin, ferrihemoglobin ordye dilution chemicals, SpO2 value
will have a deviation.
11.1.2 BOS/Pulse Monitoring
Warning
The cable for the equipment of electrosurgery can’t be twisted together with the sensor
cable.
- 57 -
Warning
Please don’t place the senor on the limb with arterial duct or vein injection syringe.
′Attention′
Please don’t place SpO2 detector and cover on the same limb for measurement of blood
pressure, because in the course of measuring blood pressure the vascular obstruction will
affect the BOS reading.
11.2 Precautions in SpO2/Pulse Monitoring
′ Attention′
Guarantee the nail can shut out the light.
The detector cable should be fixed on the back of hand.
′Attention′
SpO2 value always displays at the fixed place.
Only in the following cases PR will appear:
‹ In ECG menu, set “HR Source” as SPO2 or all.
‹ In ECG menu, set “HR Source” as “AUTO” and there is no ECG signal at this time.
′Attention′
SpO2 waveform and pulse are out of proportion.
Warning
Prior to monitoring, the first inspection should be given to whether the sensor cable is
normal. SpO2 sensor cable being pulled out of the jack, the screen will display the “Sensor
Off” mistaken information, and trigger the sound alarm.
Warning
Where the sensor packing or the sensor has the sign of damage, please don’t use this SpO2
sensor, but return it to the manufacturer.
Warning
Continuous and overlong monitoring may increase the undesirable dangers that skin
features change, such as extraordinary sensitivity, reddening, blistering or pressure
necrosis, which are especially easy to happen to the newborns or the patients with
perfusion disorder or immature skin. In such a case special attention should be given to
aiming the correct beam path at detection of sensor position according to the change of
skin quality. Regular inspection should also be given to the laid-on position of sensor and
the change of such a position when the skin quality goes worse. It is possible to require for
the more frequent inspection due to different patient status.
- 58 -
11.3 Monitoring Procedures
SpO2 volume recording measurement:
Turn on the monitor;
Paste the sensor on a proper position of the patient finger;
Insert the connector at the other side of the sensor cable into the SpO2 hole of the SpO2 module.
Figure 11-1 placement of senseor
Neonate SPO2 measurements
The measurement method for neonate is almost the same with adult, the sensor is introduced
below.
1. neonate SPO2 sensor
Neonate SPO2 sensor includes Y type SPO2 sensor and SPO2 sensor jacket, put the LED end of Y type
SPO2 sensor into the SPO2 sensor jacket, refer to the Figure below
Y type sensor
SPO2 sensor jackte
Figure 11-2
neonate SPO2 sensor(1)
- 59 -
Figure 11-3
2.
neonate SPO2 sensor(2)
The placement for the neonatal SPO2 sensor
Put the neonatal SPO2 sensor on hand or foot of neonate patients (Figure11-4). Fix the SPO2 sensor in
the right position.
Figure 11-4 The placement for the neonatal SPO2 sensor
Nellcor SpO2 (option)
NELLCOR SpO2 transducer is consist of Nellcor SpO2 connection cable, Nellcor infant SpO2
sensor, and wraps, as picture shown:
Consist of Nellocr SpO2
Connection between extension cable and sensor
- 60 -
Fix Nellcor SpO2 sensor
11.4 Measurement restriction
Measurement restriction
During operation, the following factors may affect accuracy of SpO2 measurement:
High-frequency electric disturbance, such as disturbance generated from the system itself or
electrosurgery equipments connected with the system;
A photo-oximeter and SPO2 sensor are used during MRI process, as the inductive current may
cause burns;
Intravenous Dye;
Frequent movement by patient;
Light radiation from outside;
Improper installation of the sensor or improper touching position with objects;
Improper sensor temperature (ideal temperature should be 28℃-42℃);
The sensor is put onto body with blood pressure cuff, arterial duct or vein tube;
Contents of non-functional Hb such as COHb and MetHb;
SPO2 over low;
Bad microvascular perfusion at the test position;
Shock, anemia, low temperature and application of vessel shrinking medicines, which all can
reduce the arterial blood flow to a non-measurable level;
Measurement is also up to absorption of lights with special wavelengths by oxyhemoglobin and
deoxygenated hemoglobin. Existence of other materials that absorbs the same wavelengths,
such as carbonated hemoglobin, hemoglobin, methylene blue and indi carmine, will make
artificial or low SPO2 values.
SPO2 sensor introduced in the accessory is recommended.
11.5 SpO2 Setting menu
Users can rotate the knob and move the cursor onto the SPO2 hotkey in the parameter area, then press
the knob to enter the SpO2 Setting menu.
- 61 -
Figure11-5 SPO2 Setup
Warning
Setting the SpO2 alarm upper limit to be 100% means to release the upper limit. However,
high SpO2 level will make early-born infants infected with retrolental fibroplasias, thus
the SpO2 alarm upper limit must be carefully selected based on common acknowledged
clinical practice.
Alarm Switch: Where “ON” is selected, the alarm prompt and saving will proceed when SpO2 (BOS)
is alarmed; where “OFF” is selected, alarming will not happen, but
will be prompted beside
SpO2 in the screen parameter area.
Alarm level: used to set alarm levels and, during SpO2 alarming, for alarm reminder and saving.
Options include “High”, “Middle”, and “Low”; “High” for the most serious alarm.
Alarm record: If “On” is selected, the recorder will output during SpO2 alarming.
SpO2 Alarm Upper/Lower Limit: according to the set upper/lower limit, alarm will happen when SpO2
is higher than upper limit or lower than lower limit.
PR Alarm Upper/Lower Limit: according to the set upper/lower limit, alarm will happen when PR is
higher than upper limit or lower than lower limit.
SpO2 & PR adjustable limits:
Parameter
SpO2
PR
Max upper limit
Min lower limit
100
254
0
0
Adjustable amount
each time
1
1
11.6 SPO2 setting in waveform area
Users can rotate the knob and move the cursor onto the SPO2 hotkey in the parameter area, then press
- 62 -
the knob to enter the SpO2 Setting menu.
Figure11-6 SPO2 Setting
SWEEP: Waveform Speed, the scanning speed of SpO2 volume recording waveform is provided with
12.5 and 25.0mm/s for option.
Waveform Colour: green, cyan, red, yellow, white, blue, violet.
1
11.7 Alarms & Reminders
SpO2 alarm information
When the alarm record function under certain menus is on, those physical alarms caused because
relevant parameters exceed the specified alarm limits will automatically output alarm parameter
values and relevant measurement waveforms.
11.8 Maintenance & Cleaning
Warning
Users must turn off the equipment and shut down the AC power supply before cleaning
the monitor or the connected sensor.
Careful
Please don’t sterilize the senor with pressure.
Please don’t soak the sensor in the liquid.
Use of the senor or cable is prohibited if they are damaged or degenerated.
Cleaning:
Having cleansed the surface of the sensor with the cotton ball or cotton cloth soaked with medical
alcohol, dry it with the dry cloth. The luminotron and receiver of the sensor can be cleaned in the same
method. The cable can be cleaned and sterilized with 3% of hydrogen peroxide or 70% of isopropyl
alcohol. Active reagent can also be used for this purpose. However, the joint can’t be soaked in the
above solution.
- 63 -
Chapter12 NIBP Monitoring
12.1 General Information
NIBP measurement can be performed in the oscillation method;
It can be used in adults, children and newborns;
Measurement mode: manual, automatic and continuous measurement. Each mode can show NS, NM
and ND.
… “Manual” mode: measurement can only be done once.
… “Auto” mode: measurement can be repeated. The interval time can be set as
1/2/3/4/5/10/15/30/60/90/120/180/240/480 minutes.
… “Continuous” mode: measurement can continuously be done within 5 minutes.
Warning
Don’t apply NIBP measurement onto a patient with sickle cell disease or any skin damage
or expected to have skin damage.
For patients with serious DIC, users should decide whether to apply NIBP measurement
based on clinical assessment, as there may have blood tumor at the touching area between
body and cuff.
In case of measurement on infants and newborns, users must ensure to select the correct
mode setting (refers to Patient Information Menu setting). A wrong mode may threaten
patient safety, as adult blood pressure levels are too high to be applied on infants and
newborns.
12.2 NIBP Monitoring
12.2.1 NlBP Measurement
Warning
Before measurement, users must make sure the selected monitoring mode is applicable for
the patients (adult, infant or newborn).
Don’t install a cuff on a body part with vein duct or other tubes. During cuff pumping,
slow infusion or infusion blocking may cause damage to the surrounding body area.
Warning
The pumping pipe connecting blood pressure cuff and the monitor must be smooth,
- 64 -
without any entanglement.
1. Insert the pumping pipe into the interface of a blood pressure cuff and turn on the power
supply.
2. In accordance with the following method (Pic 14-1), tie the blood pressure cuff on upper
arm of upper leg of a patient.
z Confirm the cuff is fully vented.
Select a cuff in proper size for the patient, and make sure the mark is just along the proper vein and
cuff tie the body non-toughly, otherwise remote body part may have color change or even ischaemia.
Figure12-1 Use of a Cuff
Measurement restriction
Vibration measurement has its restriction subject with patient conditions. This measurement method
looks for regular pulse waves generated from arterial pressure, so when patient conditions make this
wave detection method hard to work, measured values are no more reliable and measurement time last
longer. Users must understand the following cases will disturb the measurement method, making
measured press unreliable or measurement time extended. In such cases, patient conditions disable
measurement to be continued.
„ Patient movement
In case a patient is moving, shaking or convulsing, measurement will be unreliable or even
impossible; as such scenarios will disturb detection of arterial pulse and extend measurement
time.
„ Arrhythmia
In case a patient shows irregular heartbeats resulted from arrhythmia, measurement will be
unreliable or even impossible, while measurement time will also be extended.
„ Heart-lung machine
If a patient is connected with an artificial heart-lung machine, measurement can’t be realized.
- 65 -
„ Pressure change
Within certain time if the patient blood pressure immediately changes while users are analyzing
arterial pulse so as to obtain measurement values, measurement will be unreliable or even
impossible.
„ Serious shock
In case a patient is under serious shock or extreme low temperature, measurement will be
unreliable as reduction in blood flowing peripherally will result reduction in arterial pulse.
„ HR limits
In case of HR lower than 40bpm or higher than 240bpm, no blood pressure measurement can be
done.
12.2.2 NIBP Parameter Setting & Adjustment
NIBP measurement results and relevant information are laid on screen as follows:
Measurement Time
Measured Value
NIBP
16: 50 mmHg
108
84 70
BP Unit
NS
160
90
NS
160
90
Manual
Measuring Mode
NS Alarm Limit
Present cuff with pressure
Prompt Area
Manual Measurement…
Cuff with Pressure: 100
12.3 NIBP setting in parameter area
Rotate the knob, move the cursor onto the NIBP hotkey in the parameter area, and then press
the knob to enter the NIBP Setting menu.
- 66 -
Figure12-2 NIBP Setup
■
Alarm switch: Where “ON” is selected, the alarm prompt and saving will proceed when
the pressure is alarmed; where “OFF” is selected, alarming will not happen, but
will be prompted beside NIBP in the screen parameter area.
■
Alarming levels: Optional levels are “High”, “Middle” and “Low” , where “High” is
the highest alarm.
■
Alarm record: Users can select “On” to output through recorder when blood pressure
alarms happen
■
Waveform Colour: green, cyan, red, yellow, white, blue, violet.
■
NS, ND, NM upper/lower limits
Adult:
NS: upper limit: 42-270 mmHg
ND: upper limit:12-210 mmHg
NM: upper limit:22-230 mmHg
Pediatric:
NS: upper limit: 42-200 mmHg
ND: upper limit:12-150 mmHg
NM: upper limit:22-165 mmHg
lower limit: 40-268 mmHg
lower limit:10-208 mmHg
lower limit:20-228 mmHg
lower limit: 40-198 mmHg
lower limit:10-148 mmHg
lower limit:20-163 mmHg
Neonate:
NS: upper limit: 42-135 mmHg lower limit: 40-133 mmHg
ND: upper limit:12-95mmHg lower limit:10-93 mmHg
NM: upper limit:22-110 mmHg lower limit:22-108 mmHg
- 67 -
12.4 NIBP setting in measurements
Users can rotate the knob and move the cursor onto the SPO2 hotkey in the parameter area,
then press the knob to enter the NIBP Setting menu.
Figure12-3 NIBP Setup
■
Alarm switch: Where “ON” is selected, the alarm prompt and saving will proceed when
the pressure is alarmed; where “OFF” is selected, alarming will not happen, but
will be prompted beside NIBP in the screen parameter area.
■
Alarming levels: Optional levels are “High”, “Middle” and “Low” , where “High” is
the highest alarm.
■
Alarm record: Users can select “On” to output through recorder when blood pressure
alarms happen
■
Unit: mmHg/kPa
■
Time interval: Time interval (Unit: minute) for automatic measurement: 1, 2, 3, 4, 5,
10, 15, 30, 60, 90, 120, 180, 240, 480 minutes, Manual, and Continuous. After users select an
interval, there will be a display of “Please press the ‘START/STOP’ button” in the NIBP
reminder area, then users just press the button to start pumping for the first time of automatic
measurement. To end the automatic measurement and return to the manual mode, users need
only select “Manual” during the measurement interval.
■
Waveform Colour: green, cyan, red, yellow, white, blue, violet.
Calibration
The manufacturer recommends to use pressure meter or mercurial sphygmomanometer with calibrated
precision higher than 1mmHg for calibration. Users can select the Calibration item to start calibration,
while this item turns to be “Stop calibration”; if at such moment press the button, the system will stop
calibration.
- 68 -
Warning
Calibration for NIBP measurement should be done every two years (or conducted
following the maintenance plan of your hospital). Please follow the following details to
check its performance.
12.5 NIBP alarm information
Provided that the alarming record function under relevant menu is turned on, those physical alarms
activated because parameters exceed alarming limits may activate the recorder to automatically output
alarming parameter values and the relevant measurement waveforms. The following table lists various
possible alarms during NIBP measurement process.
12.6 Maintenance & Cleaning
Warning
Don’t compress the rubber pipe on a cuff.
Keep water or cleaning liquids out of the connector socket in the front of the monitor,
otherwise the equipment may be damaged.
During monitor cleaning, users need only sweep the outer surface of the connector socket
instead of its inner surface.
In case a recyclable cuff is disconnected with the monitor or being cleaned, users should
locate the cover cap above the rubber pipe so as to prevent any liquids from entering the
rubber pipe and being absorbed into the module.
One-time blood pressure cuff
Cuffs for one-time use can only be used for one patient. Don’t use the same cuff with different
patients. Don’t take one-time cuffs for disinfection or high-pressure vapor sterilization. However,
users can use soap to clean one-time cuffs for infection control purpose.
′Attention′
To protect the environment, one-time blood cuffs after use must be recycled or properly
treated.
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Chapter13 TEMP Monitoring
13.1 TEMP Monitoring
The monitor has two TEMP measuring channels. The temperature data can be measured with the
TEMP detector. Teperature is not a standard configuration for the neonatal monitor.
TEMP measurement setting
For one-time TEMP detectors, users must insert the TEMP cables into slots and then connect the
detectors with such cables; for reusable TEMP detectors, users can directly insert them into slots.
Closely paste TEMP detectors with patient body.
Turn on the system power supply.
Warning
Before monitoring users should check status of detector cables by plugging out the TEMP
detector cable from the hole, then the screen will display the error information “T sensor
disconnected” and make voice alarming.
′Attention′
A one-time TEM detector can only be used once.
Warning
Be careful to use or store TEMP detector and cables; spare detectors and cables should be
wrapped into loose rolls. Tough wires inside the detector and cables, if any, may cause
mechanical injury.
Warning
Calibration of a TEMP detector must be done for every two years or comply with your
hospital’s specified schedule. When requiring calibration, please contact the
manufacturer.
′Attention′
During monitoring process a TEMP detector will self-detect once per hour; such
self-detection last for 2 seconds and will not affect normal work of the TESP monitor.
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13.2 TEMP setting in parameter area
Users can use the knob to move the cursor onto the TEMP hotkey in the parameter area and press the
knob to enter the TEMP Setting menu.
Figure13-1 TEMP setting
Alarm Switch: Select “ON” and the alarm prompt and saving will proceed when TEMP is
„
will be prompted beside TEMP in the
alarmed; select “OFF” and no alarm will happen, but
screen parameter area.
„
Alarming levels: High, Middle or Low to be selected by users to set alarming levels.
Alarm Record: it is mainly used in starting/closing the output function of TEMP alarm
„
record. If “On” is selected, the present TEMP alarm will be outputted through the recorder.
„
Disp Color: green, cyan, red, yellow, white, blue, violet.
„
T1\T2\TD ALM HI/LO
„
TEMP unit: ℃ or ℉
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13.3 TEMP setting in measurements
Figure13-2 TEMP setting
■ TEMP unit: ℃ or ℉
■ Default Setting: Please refer to the “ECG Default Setting” in the “ECG/TEMP
Monitoring”.
13.4 Alarm information and prompt information
In case the alarm record function under relevant menus is enabled, those physical alarms caused
because relevant parameters exceed relevant alarming limits will activate the recorder to automatically
output alarming parameter values and relevant measurement waveforms. The physical alarms,
technical alarms and reminders possible happening during TEMP measurement are listed as follows:
13.5 Maintenance & Cleaning
Warning
Users must turn off the equipment and shut down the AC power supply before cleaning
the monitor or the connected sensor.
This monitor is compatible with YSI400 series TEMP detectors, whose cleaning procedures are as
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follows:
Reusable TEMP detectors:
Heating onto a TEMP detector can not be over 100oC (212.F), as such detector can only
undertake 80oC (176.F) --100oC (212.F) within short period.
Detectors can not be vapor disinfected.
Only cleaning agents with alcohol can be used for disinfection.
During use of straight detectors, users should cover them with protective adhesive.
When cleaning detectors, users should use one hand to hold on one end and the other hand to
downward hold wet lint-free cloth to wash detectors towards the connector direction.
′Attention′
If you are using a one-time TEMP detector, this detector is allowed to be re-disinfected or
reused.
′Attention′
To protect the environment, one-time TEMP detectors should be recycled or properly
treated.
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