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BeneVision N1
Patient Monitor
Operator’s Manual
© Copyright 2017-2020 Shenzhen Mindray Bio-Medical Electronics Co., Ltd. All rights reserved.
Release time: June 2020
Revision: 10.0
WARNING
•
Federal Law (USA) restricts this device to sale by or on the order of a physician or other practitioner licensed by U.S. state law to use or order the use of this device.
BeneVision N1 Patient Monitor Operator’s Manual I
II
Intellectual Property Statement
SHENZHEN MINDRAY BIO-MEDICAL ELECTRONICS CO., LTD. (hereinafter called Mindray) owns the intellectual property rights to this Mindray product and this manual. This manual may refer to information protected by copyright or patents and does not convey any license under the patent rights or copyright of Mindray, or of others.
Mindray intends to maintain the contents of this manual as confidential information. Disclosure of the information in this manual in any manner whatsoever without the written permission of Mindray is strictly forbidden.
Release, amendment, reproduction, distribution, rental, adaptation, translation or any other derivative work of this manual in any manner whatsoever without the written permission of Mindray is strictly forbidden.
is the trademark, registered or otherwise, of Mindray in China and other countries. All other trademarks that appear in this manual are used only for informational or editorial purposes. They are the property of their respective owners.
This posting serves as notice under 35 U.S.C.§287(a) for Mindray patents: http://www.mindrayna.com/patents.
Manufacturer’s Responsibility
Contents of this manual are subject to changes without prior notice.
Mindray is responsible for the effects on safety, reliability and performance of this product, only if:
■
■
■ all installation operations, expansions, changes, modifications and repairs of this product are conducted by
Mindray authorized personnel; the electrical installation of the relevant room complies with the applicable national and local requirements; the product is used in accordance with the instructions for use.
WARNING
•
Only skilled/trained clinical professionals should operate this equipment.
•
It is important for the hospital or organization that uses this equipment to perform a recommended service/maintenance plan. Neglect of this may result in machine breakdown or personal injury.
Service
Mindray maintains a network of service representatives and factory-trained distributors. Prior to requesting service, perform a complete operational check of the instrument to verify proper control settings. If operational problems continue to exist, contact Mindray service.
In North America contact the Service Department at (800) 288-2121, ext: 8116 for Technical Support or (201)
995-8000 for assistance in determining the nearest field service location.
Please include the instrument model number, the serial number, and a description of the problem with all requests for service.
Any questions regarding the warranty should be directed to the local sales or service representative.
BeneVision N1 Patient Monitor Operator’s Manual
Company Contact
Manufacturer:
Address:
Website:
E-mail Address:
Tel:
Fax:
Distributor:
Address:
Tel:
Website:
Shenzhen Mindray Bio-Medical Electronics Co., Ltd.
Mindray Building, Keji 12th Road South, High-tech Industrial Park, Nanshan,
Shenzhen 518057, P.R.China
www.mindray.com
+86 755 81888998
+86 755 26582680
Mindray DS USA, Inc.
800 MacArthur Boulevard, Mahwah, New Jersey, 07430 USA
1.800.288.2121, 1.201.995.8000
www.mindray.com
BeneVision N1 Patient Monitor Operator’s Manual III
Preface
Manual Purpose
This manual contains the instructions necessary to operate the product safely and in accordance with its function and intended use. Observance of this manual is a prerequisite for proper product performance and correct operation and ensures patient and operator safety.
This manual is based on the maximum configuration and therefore some contents may not apply to the product.
If you have any question, please contact Mindray.
This manual is an integral part of the product. It should always be kept close to the equipment so that it can be obtained conveniently when needed.
Intended Audience
This manual is geared for clinical professionals who are expected to have a working knowledge of medical procedures, practices and terminology as required for monitoring of patients.
Illustrations
All illustrations in this manual serve as examples only. They may not necessarily reflect the setup or data displayed on the patient monitor.
Conventions
■
■
■
Italic text is used in this manual to quote the referenced manuals, chapters, sections and formulas.
Bold text is used to indicate the screen texts and names of hard keys.
→ is used to indicate operational procedures.
IV BeneVision N1 Patient Monitor Operator’s Manual
Contents
BeneVision N1 Patient Monitor Operator’s Manual 1
2 BeneVision N1 Patient Monitor Operator’s Manual
BeneVision N1 Patient Monitor Operator’s Manual 3
4 BeneVision N1 Patient Monitor Operator’s Manual
BeneVision N1 Patient Monitor Operator’s Manual 5
10 Monitoring Pulse Oxygen Saturation (SpO
2
) ..............................................................................................................10 - 1
Introduction ..................................................................................................................................................................................... 10 - 1
Safety Information ......................................................................................................................................................................... 10 - 2
Measurement Limitations ........................................................................................................................................................... 10 - 3
Display ................................................................................................................................................................................................ 10 - 3
2
Monitoring ............................................................................................................................................................ 10 - 4
2
Settings .................................................................................................................................................................. 10 - 4
Alarm Settings ...................................................................................................................................... 10 - 4
TM
Alarm Management ....................................................................................................................... 10 - 5
Sensitivity (for Masimo SpO
2
) ...................................................................................................................... 10 - 6
10.6.4 Enabling FastSAT (for Masimo SpO
) ................................................................................................................................... 10 - 6
10.6.5 Displaying SIQ (for Masimo SpO
2
) ......................................................................................................................................... 10 - 7
10.6.6 Changing Averaging Time (for Masimo SpO
) ................................................................................................................. 10 - 7
2
and NIBP Simultaneously ...................................................................................................................... 10 - 7
10.8.1 Selecting the Range of each SpO
Section and the Target Section .......................................................................... 10 - 9
Statistics Length .................................................................................................................................... 10 - 9
Troubleshooting ............................................................................................................................................................................. 10 - 9
6 BeneVision N1 Patient Monitor Operator’s Manual
BeneVision N1 Patient Monitor Operator’s Manual 7
14 Monitoring Carbon Dioxide (CO
2
) ................................................................................................................................14 - 1
2
Introduction ....................................................................................................................................................................................... 14 - 1
2
Modules ........................................................................................................................................................................ 14 - 1
2
Safety Information ........................................................................................................................................................................... 14 - 2
2
Measurement Limitations ............................................................................................................................................................. 14 - 2
2
Display .................................................................................................................................................................................................. 14 - 3
Using the Sidestream/Microstream CO
2
Module ........................................................................................... 14 - 3
14.6.1 Preparing to Measure CO
2
Using the Sidestream CO
2
Module .................................................................................. 14 - 3
14.6.2 Preparing to Measure CO
2
Using the Microstream CO
2
Module ............................................................................... 14 - 5
14.6.3 Zeroing the Sidestream/Microstream CO
2
Module ........................................................................................................ 14 - 6
14.7 Changing Settings for All CO
Modules ............................................................................................................................................ 14 - 6
Alarm Settings ................................................................................................................................................ 14 - 6
Waveform ....................................................................................................................................................... 14 - 6
2
Calibration ........................................................................................................................................................................................ 14 - 9
2
Troubleshooting ............................................................................................................................................................................. 14 - 9
14.13.1 Troubleshooting the Sidestream/Microstream CO
Module .................................................................................... 14 - 9
8 BeneVision N1 Patient Monitor Operator’s Manual
BeneVision N1 Patient Monitor Operator’s Manual 9
10 BeneVision N1 Patient Monitor Operator’s Manual
21.5.5 Manually Zeroing the CO
Module .....................................................................................................................................21 - 12
21.5.6 Hiding the Invalid Display after Zeroing the CO
2
Module ..........................................................................................21 - 13
21.5.8 Setting Flow Rate (For Sidestream CO
Module Without O
2
) ....................................................................................21 - 13
BeneVision N1 Patient Monitor Operator’s Manual 11
2
Tone Mode .............................................................................................................................................. 21 - 24
12 BeneVision N1 Patient Monitor Operator’s Manual
BeneVision N1 Patient Monitor Operator’s Manual 13
Accessories ....................................................................................................................................................................................... 25 - 4
RD Set Sensors Available for Purchase .................................................................................................... 25 - 5
LNCS Sensors Also Compatible .................................................................................................................. 25 - 5
Sensors Also Compatible ............................................................................................................................... 25 - 5
2
Accessories .......................................................................................................................................................................................... 25 - 8
2
Accessories Available for Purchase ...................................................................................................... 25 - 8
2
Accessories Intended for Sale .............................................................................................................. 25 - 9
2
Accessories Also Compatible ............................................................................................................... 25 - 9
14 BeneVision N1 Patient Monitor Operator’s Manual
Specifications ....................................................................................................................................................................A - 12
2
Specifications .......................................................................................................................................................................A - 17
2
Default Settings ................................................................................................................................................................................... C - 5
Default Settings ...................................................................................................................................................................................C - 11
BeneVision N1 Patient Monitor Operator’s Manual 15
2
Physiological Alarm Messages ........................................................................................................................................ D - 2
Physiological Alarm Messages ............................................................................................................................................. D - 2
Physiological Alarm Messages .......................................................................................................................................... D - 3
2
Technical Alarm Messages ................................................................................................................................................ D - 4
Technical Alarm Messages .................................................................................................................................................. D - 6
Technical Alarm Messages .............................................................................................................................. D - 7
Sensor Accuracy ....................................................................................................................................................... E - 1
E.1 The Accuracy of Masimo SpO
Sensors ................................................................................................................................................... E - 1
E.2 The Accuracy of Nellcor SpO
2
Sensors .................................................................................................................................................... E - 3
16 BeneVision N1 Patient Monitor Operator’s Manual
1
Safety
1.1
1.1.1
Safety Information
WARNING
•
Indicates a potential hazard or unsafe practice that, if not avoided, could result in death or serious injury.
CAUTION
•
Indicates a potential hazard or unsafe practice that, if not avoided, could result in minor personal injury or product/property damage.
NOTE
•
Provides application tips or other useful information that does not involve patient or user risk.
Warnings
WARNING
•
Patient with a pacemaker – on ventricular paced patients, episodes of Ventricular Tachycardia may not always be detected. Do not rely entirely upon the system’s automated arrhythmia detection algorithm. Keep pacemaker patients under close surveillance.
•
This equipment is used for a single patient at a time.
•
To avoid explosion hazards, do not use the equipment in the presence of oxygen-rich atmospheres, flammable anesthetics, or other flammable agents.
•
Do not touch the equipment’s metal parts or connectors when in contact with the patient; otherwise patient injury may result.
•
Never mix patient electrode types or brands. Dissimilar metals or other incompatibilities may cause considerable baseline drift and may increase trace recovery time after defibrillation.
•
To reduce the hazard of burns during high-frequency surgical procedure, ensure that the monitor’s cables and transducers never come into contact with the electro-surgery unit (ESU).
•
The neutral electrode of the electro-surgery unit (ESU) shall properly contact the patient. Otherwise, burns may result.
•
MR unsafe: the N1 monitor is not intended to be used within the Magnetic Resonance (MR) environment.
•
Before connecting the equipment to the mains power, ensure that the voltage and frequency ratings of the power line are the same as those indicated on the equipment’s label or in this manual.
•
Before putting the system into operation, the operator must verify that the equipment, connecting cables, and accessories are in correct working order and operating condition.
•
To avoid risk of electric shock, the equipment must only be connected to mains power with protective earth, or operated on battery power.
•
Do not touch the patient and live parts simultaneously. Otherwise patient injury may result.
•
Do not touch the patient or metal parts in contact with the patient during defibrillation. Otherwise serious injury or death could result.
•
Do not open the equipment housings. All servicing and future upgrades must be carried out by trained and authorized personnel.
BeneVision N1 Patient Monitor Operator’s Manual 1 - 1
•
Do not rely exclusively on the audible alarm system for patient monitoring. Turning the alarm volume to a low level or off may result in a hazard to the patient. Always keep the patient under close surveillance.
•
Alarm settings should be customized according to patient situations.
•
Do not place the equipment or accessories in any position that might cause it to fall on the patient.
•
Do not start or operate the equipment unless the setup was verified to be correct.
•
To avoid inadvertent disconnection, route all cables in a way to prevent a stumbling hazard. Wrap and secure excess cabling to reduce risk of entanglement by patients or personnel.
•
The physiological data and alarm messages displayed on the equipment are for reference only and cannot be directly used for diagnostic interpretation. The equipment should not be used as the sole basis for medical decisions. It must be used in conjunction with clinical signs and symptom. If any measurement seems questionable, first check the patient’s vital signs by alternate means and then check the equipment for proper functioning.
1.1.2
Cautions
CAUTION
•
Use only parts and accessories specified in this manual.
•
Disposable accessories are not designed to be reused. Reuse may cause a risk of contamination and affect the measurement accuracy.
•
Ensure that the equipment is supplied with continuous electric power during operation from the mains power or batteries. Sudden power failure may cause data loss.
•
When no battery is installed, ensure that the monitor is supplied with continuous electric power during operation. Sudden power failure may lead to data loss.
•
Store and use the equipment in specified environmental condition. The monitor and accessories may not meet the performance specification due to aging, stored or used outside the specified temperature and humidity range.
•
Magnetic and electrical fields are capable of interfering with the proper performance of the equipment. For this reason make sure that all external devices operated in the vicinity of the equipment comply with the relevant EMC requirements. Mobile phones, X-ray equipment, and MRI devices are possible sources of interference as they may emit higher levels of electromagnetic radiation.
•
Always install or carry the equipment properly to avoid damage caused by drops, impacts, strong vibrations or other mechanical forces.
•
Dry the equipment immediately in case of rain or water spray.
•
Some settings are password protected and can only be changed by authorized personnel. Contact your department manager or biomedical engineering department for the passwords used at your facility.
•
Do not loop the patient cabling into a tight coil or wrap around the device, as this can damage the patient cabling.
•
Dispose of the package material as per the applicable waste control regulations. Keep it out of children’s reach.
•
At the end of its service life, the equipment, as well as its accessories, must be disposed of in compliance with the guidelines regulating the disposal of such products. If you have any questions concerning disposal of the equipment, please contact Mindray.
1.1.3
Notes
NOTE
•
The equipment software copyright is solely owned by Mindray. No organization or individual shall resort to modifying, copying, or exchanging it or to any other infringement on it in any form or by any means without due permission.
•
Put the equipment in a location where it can be easily viewed and operated.
1 - 2 BeneVision N1 Patient Monitor Operator’s Manual
1.2
•
The equipment uses a mains plug as isolation means to the mains power. Do not locate the equipment in a place difficult to access the mains plug.
•
During normal use, the operator is expected to face the front of the equipment.
•
Remove the battery before shipping the monitor or if it will not be used for an extended period of time.
•
Remove the battery before transporting the equipment or if the equipment will not be used for a long time.
•
The software was developed in compliance with IEC62304, to minimize the possibility of hazards arising from software errors.
•
This manual is based on the maximum configuration and therefore some contents may not apply to the product. If you have any question, please contact Mindray.
•
Observance of this manual is a prerequisite for proper product performance and correct operation and ensures patient and operator safety.
•
Keep this manual in the vicinity of the equipment so that it can be referenced when needed.
Equipment Symbols
Symbol Description
General warning sign
Symbol Description
Refer to instruction manual/booklet
Serial number
Date of manufacture
USB connector
IP44: protected against ingress of foreign objects no less than 1.0 mm, and against access to hazardous parts with wire; protect against harmful effects of splashing water
Battery indicator
Direct current
Equipotentiality
Catalogue number
Manufacturer
Protected against vertically falling water drops per IEC 60529
IP22: protected against ingress of foreign objects no less than 12.5 mm and against access to hazardous parts with finger; protected against harmful effects of vertically falling water drops with the device tilted at any angle up to 15°
Computer network
Lock; tighten
Alternating current
Defibrillation-proof type CF applied part Defibrillation-proof type BF applied part
BeneVision N1 Patient Monitor Operator’s Manual 1 - 3
1 - 4
Symbol Description
Direction and angle off rotation
Input/output
Locking
NIBP start/stop
Start
Stand-by
Gas outlet
Video output
Dispose of in accordance to local requirements
Pushing prohibited (wheels locked, no pushing)
Symbol Description
Polarity of d.c. power connector
IBP zero key
Unlocking
Calibration
Stop
Menu
Gas inlet
Non-ionizing electromagnetic radiation
Plastic identification symbol
Conforms to ANSI Std. ES60601-1, IEC Std.
60601-1-8, IEC Std. 60601-2-25, IEC Std.
60601-2-26, IEC Std. 60601-2-27, IEC Std.
80601-2-30, IEC Std. 60601-2-34, IEC Std.
60601-2-49, ISO Std. 0601-2-55, ISO Std.
80601-2-56, and ISO Std. 80601-2-61
Certified to CAN/CSA Std. C22.2 No. 60601-1,
No. 60601-1-6, No. 60601-1-8, No. 60601-2-25,
No. 60601-2-26, No. 60601-2-27, No. 80601-2-
30, No. 60601-2-34, No. 60601-2-49, No.
80601-2-55, No. 80601-2-56, and No.
80601-2-61
BeneVision N1 Patient Monitor Operator’s Manual
2
Equipment Introduction
2.1
2.2
2.3
Indications for Use
The BeneVision N1 Patient Monitor is intended for monitoring, displaying, reviewing, storing , alarming, and transferring of multiple physiological parameters including ECG (3-lead, 5-lead, 6-lead or 12-lead selectable,
Arrhythmia Detection, ST Segment Analysis, QT Analysis, and Heart Rate (HR)), Respiration (Resp), Temperature
(Temp), Pulse Oxygen Saturation (SpO
2
), Pulse Rate (PR), Non-invasive Blood Pressure (NIBP), Invasive Blood
Pressure (IBP), Pulmonary Artery Wedge Pressure (PAWP), Carbon Dioxide (CO
2
) and Oxygen (O
2
). The system also provides an interpretation of resting 12-lead ECG.
All the parameters can be monitored on single adult, pediatric, and neonatal patients except for the following:
■ The arrhythmia detection and PAWP is intended for adult and pediatric patients only
The BeneVision N1 monitor is to be used in healthcare facilities. It can also be used during patient transport inside and outside of the hospital environment. It should be used by clinical professionals or under their guidance. It should only be used by persons who have received adequate training in its use. It is not intended for home use.
NOTE
•
This manual is based on the maximum configuration and therefore some contents may not apply to the product. If you have any question, please contact Mindray.
Equipment Features
The monitor is intended to be used in a hospital environment including, but not limited to, ICU, CCU, PICU,
Neonatology, RICU, emergency room, operating room, postoperative observation ward, etc.
The monitor can be used in two ways:
■
■
As a stand-alone patient monitor, or
As a multi-parameter module (MPM) for the Mindray BeneVision N22, BeneVision N19, BeneVision N17,
BeneVision N15, or BeneVision N12 patient monitor, hereafter referred to as “the host monitor”.
In this manual, the N1 is generally referred to as “the monitor” except in the situation describing its use with a host monitor, where it is referred to as “the N1” to distinguish it from the host monitor.
Applied Parts
The applied parts of the monitor are:
■
■
■
■
■
■
ECG electrode and leadwire
SpO
2
sensor
Temp probe
NIBP cuff
IBP transducer
CO
2
sampling line/nasal sampling cannula, water trap, and mask
BeneVision N1 Patient Monitor Operator’s Manual 2 - 1
2.4
2.4.1
Main Unit
Front View
(1) (2)
BeneVision N1
(3)
(4)
(5)
(1)
(2)
(3)
(5)
Alarm lamp:
When a physiological alarm or technical alarm occurs, this lamp lights and flashes corresponding with the alarm priority:
• High priority alarms: the lamp quickly flashes red.
• Medium priority alarms: the lamp slowly flashes yellow.
• Low priority alarms: the lamp lights in cyan without flashing.
Ambient light sensor
When screen brightness is set to auto, the system automatically adjusts screen brightens according to the strength of ambient light.
Display
• Yellow: the battery is being charged.
• Green: the battery is fully charged.
• Flashing green: the monitor runs on battery power.
• Flashing yellow: the battery is malfunctioning.
• Off: no battery is installed, or the monitor is powered off and no external power is connected.
External power supply indicator:
• On: when external power supply is connected.
• Off: when external power supply is not connected.
2 - 2 BeneVision N1 Patient Monitor Operator’s Manual
2.4.2
Left View
(5)
(4)
(1)
(2)
(3) (3)
(1)
(2)
(3)
(4)
(5)
Communication interface: used for communication between the
N1 and host monitor (BeneVision N series monitor).
Infrared filter: used for communication between the N1 and N series monitor if the communication interface does not work.
Contact: used for receiving power supply from the host monitor
(BeneVision N series monitor).
Multi-pin connector: connects the N1 to the Modular Rack or Dock.
External DC power input connector: connects the N1 to the AC adapter
NOTE
•
To ensure good contact, clean the contacts regularly, as dust and dirt may collect on them. When cleaning the contacts, wipe them with cotton, dampened with alcohol. Using forceps is recommended.
•
In the case of water spray, dry the Multi-pin connector of the N1 before connecting the N1 to the
Modular Rack or Dock.
BeneVision N1 Patient Monitor Operator’s Manual 2 - 3
2.4.3
Right View
(1) (2) (3)
(9)
(8)
(4)
(5)
(6)
2.4.4
(7)
(1)
(4)
(7)
(9)
Power switch (2) Sample line connector for sidestream CO
2
ECG cable connector (5) SpO
2
sensor connector
Multifunctional connector: outputs analog ECG, IBP and defib synchronization signals.
Temperature probe connector
(3) Gas outlet
(6)
(8)
NIBP cuff connector
IBP cable connector
Bottom View
(1)
(2)
(1)
2.5
2 - 4
(1)
(2)
Clip: fastens the N1 when N1 is in use with the host monitor, Dock or Modular Rack.
Latch: locks the N1 when the N1 is in use with the host monitor, Dock or Modular Rack. Pressing here releases the N1 so that the N1 can be removed from the host monitor, Dock or Modular Rack.
Modular Rack
The Modular Rack is used to connect an N1 and an external parameter module as well as providing bed rail mounting capability. It can also be connected to the Dock.
BeneVision N1 Patient Monitor Operator’s Manual
2.5.1
Left View
(1)
(2)
2.5.2
(1)
(2)
Release button: pressing this button releases the Modular Rack from the Dock.
Multi-pin connector: connects the Modular Rack and Dock.
Right View
(1)
(2)
(3)
(4)
(1)
(2)
(3)
(4)
Multi-pin connector: connects the Modular Rack and N1.
Pogo pin: used for communication between the Modular Rack and external parameter module.
Infrared filter: used for communication between the Modular Rack and external parameter module.
Contact: power input connector of the external parameter module.
BeneVision N1 Patient Monitor Operator’s Manual 2 - 5
2.6
2.6.1
Dock
The Dock is used to connect the N1 or Modular Rack to provide power, charge the installed battery, and support connection to an external display, USB drive, network cables, and the BeneVision N series patient monitors.
Left View
(1)
(2)
2.6.2
(1)
(2)
Symbol: indicates the direction and angle that Dock can rotate when Dock is fixed onto a transverse or a vertical rod.
Pole mount seat: used to fix the pole mount to the Dock and then to a transverse or a vertical rod.
Right View
(1)
(3)
2 - 6
(2)
(1)
(2)
(3)
Multi-pin connector: power input and communication connector of the N1.
Connection status indicator: it is on when the N1 is properly connected to the Dock.
External power supply indicator: it is on when the external AC power supply is connected.
BeneVision N1 Patient Monitor Operator’s Manual
2.6.3
Rear View
(1) (2) (3) (4) (5) (6)
2.7
(1)
(2)
(3)
(4)
(5)
(6)
AC Power input connector
Equipotential grounding terminal: when using the monitor together with other devices, connect their equipotential grounding terminals together to eliminate the potential difference between them.
VGA connector: connects the external display
Host monitor connector: connects the N1 to the host monitor through a cable.
USB connector: connects USB devices.
Network connector: a standard RJ45 connector which connects the monitor to the CMS. It can also be used to transfer data..
External Parameter Modules
The monitor can connect the following external parameter modules through the Modular Rack.
Sidestream CO
2
module
BeneVision N1 Patient Monitor Operator’s Manual
Microstream CO
2
module IBP module
2 - 7
2.8
2.8.1
Installation
Installing the N1 or External Parameter Module into the Modular Rack
Install the N1, and an external parameter module if needed, to the Modular Rack as indicated below:
Firmly push the N1 or the external module until an audible click is heard indicating that the clip (refer to
) engaged the Modular Rack. To ensure that the N1 or the external module is properly connected, try to pull the N1 or the external module outward. The N1 or the external module has properly engaged the Modular Rack if it cannot be pulled out.
NOTE
•
To prevent the N1 or the external module from falling out of the Modular Rack, after inserting the N1 or the external module into the Modular Rack, always check that the N1 or the external module properly engaged the Modular Rack.
•
When the external module is properly installed, it should be further fasten to the Modular Rack with the lock at the bottom of the module to ensure the engagement.
2.8.2
Removing the N1 or External Parameter Module from the Modular Rack
To remove the N1 or external parameter module, follow this procedure:
1.
Press and hold the latch at the bottom of the N1 or parameter module. If the external module is locked to the Modular Rack, unlock it first.
2.
Pull the N1 or parameter module out as indicated.
1
2
1
2
BeneVision N1 Patient Monitor Operator’s Manual 2 - 8
2.8.3
Installing the Modular Rack to the Dock
The Modular Rack can be installed to the Dock as indicated below:
2.8.4
A click is heard when the Modular Rack is pushed into place.
Removing the Modular Rack from the Dock
To remove the Modular Rack from the Dock, follow this procedure:
.
1.
Press and hold down the release button at the top of the Modular Rack.
2.
Pull the Modular Rack out as indicated.
1
2
CAUTION
•
To prevent the Dock from falling off, do not press the release button while transporting the N1 with the Modular Rack and Dock.
2.8.5
Installing the N1 to the Dock
The N1can also be installed directly to the Dock as shown below:
BeneVision N1 Patient Monitor Operator’s Manual 2 - 9
2.8.6
Dock. To ensure that the N1 is properly connected, try to pull the N1 outward. The N1 has properly engaged the
Dock if it cannot be pulled out.
Removing the N1 from the Dock
To remove the N1 from the Dock, follow this procedure:
1.
Press and hold the latch at the bottom of the N1.
2.
Pull the N1 out as indicated.
2
1
2.9
2.9.1
N1 in Use with a Host Monitor
■
■
■
When the N1 is connected to the BeneVision N series monitor, the N1 works as the parameter module while
The N1 can be connected to the host monitor through the following parts:
The module rack of the host monitor
The Satellite Module Rack (SMR)
The Dock
Connecting the N1 to the Host Monitor through the Module Rack
To connect the N1 to the module rack of the host monitor, follow this procedure:
1.
Insert the N1 to the host monitor’s module rack. Firmly push the N1 until an audible click is heard indicating that the clip (refer to
2.4.4 Bottom View ) engaged the module rack.
2 - 10 BeneVision N1 Patient Monitor Operator’s Manual
2.
To ensure that N1 is properly connected, try to pull N1 outward. The N1 has properly engaged the module rack if it cannot be pulled out.
bottom of the N1 and pull the N1 out.
CAUTION
•
To prevent the N1 from falling out, after inserting the N1 into the module rack, always check that the
N1 properly engaged the module rack.
•
To prevent the N1 from falling, catch it with another hand while pulling it out from the module rack.
NOTE
•
There is no module rack for the BeneVision N22 or BeneVision N19 monitors. The N1 can be connected to the BeneVision N22 or BeneVision N19 monitor through the SMR or Dock.
2.9.2
Connecting the N1 to the Host Monitor through the Satellite Module Rack
(SMR)
To connect the N1 to the host monitor through the SMR, follow this procedure:
1.
Connect the SMR to the host monitor.
2.
Insert the N1 to the SMR. Firmly push the N1 until an audible click is heard indicating that the clip (refer to
) engaged the SMR.
3.
To ensure that the N1 is properly connected, try to pull the N1 outward. The N1 has properly engaged the module rack if it cannot be pulled out.
2.9.3
To remove the N1 from the SMR, lift the latch (refer to
) at the bottom of the N1 and pull the N1 out.
CAUTION
•
To prevent N1 from falling out, after inserting the N1 into the SMR, always check that the N1 properly engaged the SMR.
•
To prevent the N1 from falling, catch it with another hand while pulling it out from the SMR.
Connecting the N1 to the Host Monitor through the Dock
To connect the N1 to the host monitor through the Dock, follow this procedure:
1.
Connect the N1 to the Dock.
2.
Connect the host monitor connector of the Dock with the SMR connector of the host monitor using the dock data cable.
BeneVision N1 Patient Monitor Operator’s Manual 2 - 11
2.10
N1 in Use with the Transport Dock
The N1can be used with the Transport Dock to transport a patient via ambulance, airplane fuselage or helicopter fuselage. For the installation instructions of the N1 and Transport Dock, refer to the Transport Dock Indication for
Use (PN: H-046-011365-00) .
(4)
(3)
(2)
(1)
(1) DC power input
(3) Upper cover
(2) Power supply indicator
(4) Slide block for unlocking the N1
WARNING
•
The monitor must only be connected to mains power with protective earth, and the connection should be performed by qualified service personnel.
•
Ensure that the external power system has secure protective earth when the monitor is used together with the Transport Dock.
•
Verify that the connection of protective earth and the external power system is securely connected when installing the Transport Dock.
2.11
Input Devices
The monitor allows data entry through touchscreen, keyboard, mouse, and barcode reader.
2.12
Printing Devices
Use only Mindray specified printers to output patient information and data.
2 - 12 BeneVision N1 Patient Monitor Operator’s Manual
3
Getting Started
3.1
Equipment Preparation Safety Information
WARNING
•
Use only installation accessories specified by Mindray.
•
Connect only approved devices to this equipment. Devices connected to the equipment must meet the requirements of the applicable IEC standards (e.g. IEC 60950 safety standards for information technology equipment and IEC 60601-1 safety standards for medical electrical equipment). The system configuration must meet the requirements of the IEC 60601-1 medical electrical systems standard. Any personnel who connect devices to the equipment’s signal input/output port are responsible for providing evidence that the safety certification of the devices has been performed in accordance to the IEC 60601-1. If you have any questions, please contact Mindray.
•
The monitor and parameter monitoring accessories are suitable for use within the patient environment. For other equipment and accessories connected to the monitor, consult corresponding manufacturers for the suitability within the patient environment.
•
If it is not evident from the equipment specifications whether a particular combination with other devices is hazardous, for example, due to summation of leakage currents, please consult the manufacturer or an expert in the field. A determination must be made that the proposed combination will not negatively affect the devices themselves or the patient's safety.
CAUTION
•
The equipment should be installed by Mindray authorized personnel.
•
When disposing of the packaging material, be sure to observe the applicable waste control regulations and keep it out of children’s reach.
•
Before use, verify whether the packages are intact, especially the packages of single use accessories.
In case of any damage, do not apply it to the patient.
•
Make sure that the equipment operating environment meets the specific requirements. Otherwise unexpected consequences, e.g. damage to the equipment, could result.
•
Avoid rough handling during transport.
NOTE
•
This manual is based on the maximum configuration and therefore some contents may not apply to the product. If you have any question, please contact Mindray.
•
Put the equipment in a location where it can be easily viewed and operated.
•
Keep this manual in the vicinity of the equipment so that it can be referenced when needed.
•
Save the packing case and packaging material as they can be used if the equipment must be reshipped.
•
Many settings in the patient monitor are password protected. It is recommended to change the default passwords and keep the passwords safe. Passwords should only be changed by authorized personnel. Contact the department manager or biomedical engineering department for the passwords used at the facility.
BeneVision N1 Patient Monitor Operator’s Manual 3 - 1
3.2
3.2.1
3.2.2
Monitor Installation
Unpacking and Checking
Before unpacking, examine the packaging carefully for signs of damage. If any damage is detected, contact the carrier, distributor, or Mindray.
If the packing case is intact, open the package and remove the equipment and accessories carefully. Check all materials against the packing list and check for any mechanical damage. Contact Mindray in case of any problems.
NOTE
•
If the N1 purchased contains the internal CO
2
module, connect the CO
2
adapter to the CO
2
receptacle soon after unpacking the monitor to avoid losing the CO
2
adapter.
Environmental Requirements
The operating environment of the equipment must meet the requirements specified in this manual.
The environment where the equipment is used shall be reasonably free from noises, vibration, dust, corrosive, flammable and explosive substances. Moreover, to maintain good ventilation, the equipment shall be at least 2 inches (5cm) away from around the cabinet.
When the equipment is moved from one place to another, condensation may occur as a result of temperature or humidity difference. In this case, never start the system before the condensation evaporates.
CAUTION
•
Make sure that the equipment operating environment meets the specific requirements. Otherwise unexpected consequences, e.g. damage to the equipment, could result.
3.3
Setting Up the Equipment
Observance of this manual is a prerequisite for proper product performance and correct operation. It ensures patient and operator safety.
3.3.1
Connecting the AC Mains
The monitor can be powered by AC power supply when it is connected to the AC adapter or Dock. Before connecting the equipment to the AC mains, check that the voltage and frequency ratings of the power line are the same as those indicated on the AC adapter or Dock.
3.3.1.1
Connecting the AC Mains through the AC Adapter
To connect the N1 to the AC power source through the AC adapter, follow this procedure:
1.
Connect the N1 to the AC adapter.
2.
Connect the female end of the power cord to the AC adapter, and the male end of the power cord to a wall
AC outlet.
3.
Check that the external power supply indicator is on.
The external power supply indicator lies in the lower right corner of the display. When the AC mains is not connected, the external power supply indicator is off. When AC mains is connected, the external power supply indicator is illuminated in green.
3.3.1.2
Connecting the AC Mains through the Dock
To connect the N1 to the AC power source through the Dock, follow this procedure:
1.
Connect the N1 to the Dock.
2.
Connect the female end of the power cord to the AC power input of the Dock, and the male end of the power cord to a wall AC outlet.
3 - 2 BeneVision N1 Patient Monitor Operator’s Manual
3.3.2
3.3.3
3.4
3.
Check that the external power supply indicator of the N1 and Dock are on.
WARNING
•
Operate the equipment on battery power if the integrity of the protective earth conductor or the protective earthing system in the installation is in doubt.
CAUTION
•
Always use the accompanying power cord delivered with the monitor.
•
Always use the AC adapter specified by Mindray.
•
Before connecting the equipment to the AC mains, check that the voltage and frequency ratings of the power line are the same as those indicated on the AC adapter and Dock.
NOTE
•
Use the cable retainer to secure the power cord to prevent it from falling off.
•
Use AC power source when the N1 is in use with the Dock.
Connecting the Input Devices
Connect the mouse, keyboard, and/or barcode reader to the USB ports on the rear of the Dock if necessary.
Installing the External Parameter Module
If an external parameter module is needed, refer to section 2.8.1 Installing the N1 or External Parameter Module into the Modular Rack for installation.
Turning on the Monitor
Before beginning measurements, turn on the monitor, perform the following inspections:
1.
Check the monitor for any mechanical damage. Make sure that all external cables, plug-ins and accessories are properly connected.
2.
Connect the monitor to the AC power source using AC adapter or Dock. Make sure the battery power is sufficient if the monitor is powered by the battery.
3.
Press the power switch to turn on the monitor.
When the monitor is turned on, the alarms are paused for two minutes. Then the alarm system is activated.
CAUTION
•
Check that visual and auditory alarm signals are presented correctly when the equipment is powered on.
•
Do not use the monitor for any monitoring procedure on a patient if you suspect it is not working properly, or if it is mechanically damaged. Contact the service personnel or Mindray.
NOTE
•
For first use, connect the monitor to the AC power source and then turn on the monitor to activate the battery.
•
The time for the monitor to warm up from the minimum storage temperature between uses until the monitor is ready for its intended use is 10 minutes when the ambient temperature is 20 °C.
•
The time for the monitor to cool down from the maximum storage temperature between uses until the monitor is ready for its intended use is 10 minutes when the ambient temperature is 20 °C.
BeneVision N1 Patient Monitor Operator’s Manual 3 - 3
3.5
3.5.1
Operation and Navigation
Everything needed to operate the monitor is on its screen. Almost every element on the screen is interactive.
Screen elements include parameter values, waveforms, quick keys, information fields, alarms fields, dialogs, and menus. Often you can access the same element in different ways. For example, you can access a parameter dialog by selecting the corresponding numeric area or waveform area, or by selecting the Main Menu quick key
→
from the Parameters column select Setup .
Using the Touchscreen
You can use the touchscreen to select a screen element by pressing directly on the monitor’s screen.
3.5.1.1
Tapping or Swiping across the Screen
■ Tapping the screen
◆ To select an item from menus or lists or select a quick key, tap on it with your finger.
◆ To enter a parameter menu, tap the corresponding numeric area or waveform area. For example, select the ECG numeric area or waveform area to enter the ECG menu.
■
■
Swiping the screen with a single finger
◆
To scroll through a list or a menu, swipe up or down.
◆
If an external display is connected, to show or expand the Minitrends screen or the EWS screen on the external display, swipe right across the corresponding screen.
◆ If an external display is connected, to contract or hide the Minitrends screen or the EWS screen on the external display, swipe left across the corresponding screen.
Swiping across the screen with two fingers
◆
If an external display is connected, to switch to another screen, swipe left or right across the screen.
For example, on the Normal screen, swipe with two fingers from left to right to switch to the
Minitrends screen.
◆
To discharge a patient, swipe from top to bottom.
3.5.1.2
Locking the Touchscreen
To avoid accidental use, the touchscreen is locked in the following situations:
■
■
The touchscreen is not used in 60 seconds when the N1 runs on battery and is not connected to an external display.
Select the Unlock quick key , and swipe the slider up as instructed.
When the touchscreen is locked, the quick key changes to on the touchscreen and swipe the slider up as instructed.
. To unlock the touchscreen, touch anywhere
NOTE
•
Wipe off any water on the touchscreen in case of rain or water spray.
3.5.2
Using the On-Screen Keyboard
The on-screen keyboard enables information entry:
■
■
■
■
Enter the information by selecting one character after another.
Select the Backspace key
Select the Caps Lock key
Select the Enter key
to delete single characters or select
to access uppercase letters.
to delete the entire entry.
to confirm the entry and close the on-screen keyboard.
If a conventional keyboard is connected to the monitor, you can use it instead of, or in combination with, the onscreen keyboard.
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3.5.3
Using the Barcode Reader
The monitor supports both a linear (1D) barcode reader and two-dimensional (2D) barcode reader. The barcode reader is connected to the monitor through the USB connector on the rear of the Dock.
NOTE
•
Use the Mindray custom barcode reader to obtain all the available patient information from both the 2D and 1D barcodes. Using other barcode readers can only output the patient’s medical record number (MRN) and visit number.
3.5.3.1
Clearing Old Data Formats (for the Mindray Custom 2D Barcode Reader)
If you are using the Mindray custom 2D barcode reader (Model HS-1R or HS-1M), before using the it for the first time, clear old data formats and configure the barcode reader. To do so, follow this procedure:
1.
Scan the engineering barcode to clear the previous data format.
2.
Scan the 2D engineering barcode which contains the hospital’s data format.
NOTE
•
Contact the scanner manufacturer or Mindray to obtain the barcodes for clearing data formats and programming the hospital’s data format.
3.6
Screen Display
The following figure shows the normal screen:
(1) (2) (3) (4)
(5) (6)
(10)
(7)
(9)
(8)
(1)
(2)
(3)
(4)
(5)
(6)
Patient information area: displays patient category and gender. The displayed patient information is configurable. Selecting this area enters the Patient Management dialog. For more information, see 5.2.2 Editing
Patient Information .
Patient information area: displays patient information, including department, room number, bed number, and so on. The displayed patient information is configurable. Selecting this area enters the Patient Management dialog. For more information, see 5.2.2 Editing Patient Information .
Technical alarm information area: displays technical alarm message or prompt message.
The current configuration: displays the name of the configuration that can be loaded from the main menu.
Physiological alarm information area: displays physiological alarm message.
System status information area: displays alarm symbol, battery status, network status, currently connected CMS,
and system time. For more information, see 3.6.1 On-screen Symbols .
BeneVision N1 Patient Monitor Operator’s Manual 3 - 5
3.6.1
(7)
(8)
Quick key area: displays quick keys.
Parameter numerics area: displays parameter values, alarm limits, and alarm status. This area can also display the parameter list. For more information, see
3.9.3 Displaying the Parameter List
. Selecting a parameter numeric block enters the corresponding parameter dialog. Selecting the parameter list enters Tabular Trends review.
(9) Parameter waveform/numerics area: unique area of the screen that can be configured to display either parameter numerics or parameter waveforms. Depending on the configuration, the tiles take on the characteristics of either area (8) or area (10).
(10) Parameter waveform area: displays parameter waveforms, measurement ranges, and magnification. Selecting a waveform enters the corresponding parameter dialog.
On-screen Symbols
The following table lists the on-screen symbols displayed on the system status information area:
Symbol Description
Adult, male
Symbol Description
Adult, female
Pediatric, male
Neonate, male
Wireless network is connected. The solid part indicates network signal strength.
Wired network is connected.
Pediatric, female
Neonate, female
Wireless network is not connected.
Wired network is not connected.
All the alarms are paused.
Audible alarm tones are paused.
The alarm system is reset.
The battery has low power and needs to be charged.
The battery is being charged.
Individual physiological alarms are turned off or the monitor is in the alarm off status.
Audible alarm tones are turned off.
The battery is working correctly. The green portion represents the remaining charge.
The battery has critically low charge and needs to be charged immediately. Otherwise, the monitor will automatically shut down soon.
No battery is installed.
Battery fault, battery communication fault, or battery charging fault. Contact service personnel for help.
3 - 6 BeneVision N1 Patient Monitor Operator’s Manual
3.6.2
Dialogs
All dialogs have similar style and structure, see the figure below:
(1)
(2)
(2)
(4)
(5)
(6)
(3)
3.6.3
(4) Exit button: closes the current dialog.
(5) Main body area: includes dialog items and options.
(6) Switch:
◆
Green: the switch is on.
◆
Gray: the switch is off.
Quick Keys of N1
The monitor provides quick keys for you to quickly access some functions. The quick key area is located at the right of the screen. The quick key area displays 5 quick keys.
You can also swipe down on the quick key area for more quick keys.The following table shows available quick keys.
The following table shows available quick keys.
Symbol Label
Main Menu
Function
Enters the main menu.
Symbol Label
Alarm Reset
Function
Resets the alarm system.
Alarm Pause
Screen Setup
Pauses the physiological alarm system (Availability depends on configuration of Pause in Maintenance
→ Alarm → Pause/Reset dialog).
Enters the Screen Setup dialog.
Audio Pause Pauses alarm tone
(Availability depends on configuration of Pause in
Maintenance → Alarm →
Pause/Reset dialog).
Standby Enters the standby mode.
BeneVision N1 Patient Monitor Operator’s Manual 3 - 7
Symbol Label
Manual Event
Function
Manually saves an event into the Events list.
Symbol Label
Function
Starts printing a real-time report.
NIBP Start/
Stop
Lock
Starts an NIBP measurement or stops the current NIBP measurement.
Selects and operates as instructed to unlock the touchscreen
NIBP Measure Opens the NIBP Measure interval options.
Unlock Selects and operates as instructed to lock the touchscreen
3.7
Operating Modes
The monitor provides different operating modes. This section describes the different monitoring modes and standby modes.
3.7.1
3.7.2
3.7.3
Monitoring Mode
The monitoring mode is the most frequently used clinical mode for patient monitoring. When the monitor is turned on, it automatically enters the monitoring mode.
Module Mode
■
■
■
■
■
■
■
When the N1 is connected to the host monitor, the N1 enters the module mode. For connection of the N1 and the host monitor, see section 2.9 N1 in Use with a Host Monitor . The N1 monitor has the following features when it enters the module mode:
■ The patient information, parameter setup, and alarm setup of the N1 and the host monitor will be synchronized. For data transfer strategy, see the operator’s manual of the host monitor.
The N1 can still store the parameter data and the alarm events.
The N1 receives and stores the parameter trends data from the host monitor.
All audible sounds of the N1 are off.
Wired and wireless network of the N1 are not available.
The alarm indications of the battery related alarms of the N1 are given by the host monitor.
Turning on or off the host monitor simultaneously powers on or off the N1.
The main screen of the N1is off when it is connected to the host monitor through the SMR or the module rack of the host monitor.
The N1 resumes to monitor mode when it is disconnected from the host monitor.
Privacy Mode
The privacy mode is a special clinical monitoring mode. In the privacy mode, the monitor does not display patient information and monitoring data. This provides controlled access to patient data and ensures confidentiality.
The privacy mode is only available when the patient admitted by the monitor is also monitored by the CMS. The monitor continues monitoring the patient, but patient data is only visible at the CMS.
3.7.3.1
■
■
Entering the Privacy Mode
To enter the privacy mode, select the Main Menu quick key → from the Display column select Privacy Mode
→
select Ok .
The monitor has the following features after entering the privacy mode:
The screen turns blank.
Except for the low battery alarm, the monitor inactivates alarm tones and alarm lights for all other alarms.
3 - 8 BeneVision N1 Patient Monitor Operator’s Manual
■ The monitor suppresses all system sounds, including heart beat tone, pulse tone, and prompt tone.
WARNING
. •
In the privacy mode, all audible alarms are suppressed and the alarm light is deactivated at the monitor. Alarms are presented only at the CMS. Pay attention to potential risk.
NOTE
•
The privacy mode is not available if the Department is set to OR.
•
You cannot enter the privacy mode if a low battery alarm is active.
3.7.3.2
Exiting the Privacy Mode
The monitor automatically exit the privacy mode in any of the following situations:
■
■
The monitor disconnects from the CMS.
The low battery alarm occurs.
You can also operate the touchscreen, mouse, or keyboard to manually exit the privacy mode.
3.7.4
Night Mode
The night mode is a special clinical monitoring mode. The night mode reduces screen brightness, sound volumes, and pauses NIBP measurements. To avoid disturbing the patient, you can use the night mode.
3.7.4.1
Entering the Night Mode
To enter the night mode, follow this procedure:
1.
Select the Main Menu quick key
→
from the Display column select Night Mode .
2.
Change the night mode settings if necessary.
3.
Select Enter Night Mode .
The night mode settings are as follows by default:
■
■
■
■
■
■
Brightness
Alarm Volume
QRS Volume
Key Volume
NIBP End Tone
Stop NIBP :
: 1
:
:
0
1
Off
:
:
2
Off
CAUTION
•
Verify the night mode settings before entering the night mode. Pay attention to the potential risk if the setting value is low.
3.7.4.2
Exiting the Night Mode
To cancel the night mode, follow this procedure:
1.
Select the Main Menu quick key
→
from the Display column select Exit Night Mode .
2.
Select Ok .
NOTE
•
If the monitor is connected to the CMS, it automatically exits the night mode if disconnected from the CMS.
BeneVision N1 Patient Monitor Operator’s Manual 3 - 9
•
The monitor resumes the previous settings after exiting the night mode.
3.7.5
Standby Mode
You can temperately stops patient monitoring without switching off the monitor by entering the standby mode.
3.7.5.1
Entering the Standby Mode
1.
Select the Standby quick key, or select the Main Menu quick key
→
from the Patient Management column select Standby .
2.
Define where the patient is by selecting a location in the drop down list when the monitor enters the standby mode.
3.
Select Ok .
The monitor behaves as follows after entering the standby mode:
■
■
■
Stops all parameter measurements.
Disables all the alarms and prompt messages, except for the battery low alarm.
Turns screen brightness to the dimmest after entering the standby mode for 30 seconds.
WARNING
•
Pay attention to the potential risk of placing the monitor to standby. In the standby mode, the monitor stops all parameter measurements and disable all the alarm indications, except for the battery low alarm.
3.7.5.2
Changing the Patient Location at Standby
To change the patient’s location, select patient location from the Standby screen.
3.7.5.3
Exiting the Standby Mode
To exit the standby mode, choose any of the following ways:
■
■
Select
Select
Resume Monitor to exit the standby mode and resume monitoring the current patient.
Discharge Patient to discharge the current patient.
If the monitor automatically enters the standby mode after a patient is discharged, choose any of the following ways to exit the standby mode:
■
■
Select
Select
Monitor to exit the standby mode and admit a new patient.
Patient Management to enter the patient information for preparing to admit a new patient.
When the monitor exits Standby mode and resumes monitoring, the alarms are paused for two minutes, after which the alarm system is activated.
3.7.6
Outdoor Mode
The outdoor mode is intended for transferring patients outdoors. The monitor behaves as follows after entering the outdoor mode:
■
■
The parameter color is white and unchangeable.
The screen brightness is automatically changed to 10.
3.7.6.1
Entering the Outdoor Mode
To enter the outdoor mode, select the Main quick key → from the Display column select Enter Outdoor Mode .
NOTE
•
The monitor enters the outdoor mode automatically if the strength of ambient light is greater than the threshold.
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3.7.6.2
■
■
Exiting the Outdoor Mode
When Enter Outdoor Mode is set to Manual , select the Main Menu quick key → from the Display column select Exit Outdoor Mode .
The monitor automatically exits the outdoor mode in the following situation:
The monitor is connected to a host monitor.
The strength of ambient light is lower than the threshold when Enter Outdoor Mode is set to Auto .
3.7.7
Discharge Mode
The discharge mode is a special standby mode after a patient is discharged.
3.8
Configuring the Monitor
Configure the monitor before putting it in use.
3.8.1
Setting the Date and Time
To set the system time, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Time .
2.
Set Date and Time .
3.
Set Date Format .
4.
If you want to use the 12-hour mode, switch off 24 Hour Time .
5.
If you want to use daylight saving time, switch on Daylight Saving Time . You can manually switch on or off the daylight saving time only when the auto daylight saving time function is disabled. For more information, see 21.7 Enabling Auto Daylight Savings Time for details.
If the monitor is connected to a central monitoring system (CMS) or hospital clinical system (HIS), the date and time are automatically taken from the CMS. In this case, you cannot change the date and time on the monitor.
CAUTION
•
Changing the date and time affects the storage of trends and events and may result in loss of data.
3.8.2
3.8.3
3.9
Adjusting the Screen Brightness
To adjust the screen brightness, follow this procedure:
1.
Access Display in either of the following ways:
◆ Select the Screen Setup quick key → select the Display tab.
◆ Select the Main Menu quick key → from the Display column select Display .
2.
Set Brightness . If Brightness is set to Auto , the monitor automatically adjust the screen brightness according to the ambient light.
Adjusting the Key Volume
To adjust the key volume, follow this procedure:
1.
Select the Main Menu quick key
→ from the Display column select Display .
2.
Set the Key Volume .
General Operation
This section describes the operations that are generally used when monitoring a patient.
BeneVision N1 Patient Monitor Operator’s Manual 3 - 11
3.9.1
Switching On or Off a Parameter
You can manually switch on or off a parameter when its module is connected. If setting parameter switches is not password protected, follow this procedure to set parameter switches:
1.
Access Parameters On/Off in either of the following ways:
◆ Select the Screen Setup quick key → select the Parameters On/Off tab.
◆ Select the Main Menu quick key → from the Parameters column select Parameters On/Off .
2.
Switch on or off desired parameters.
When a parameter is switched off, the monitor stops data acquisition and alarming for this measurement.
NOTE
•
When a parameter is manually switched off even, you cannot monitor this parameter if related accessories of this parameter are connected.
3.9.2
3.9.3
3.9.4
Displaying Parameter Numerics and Waveforms
You can configure the parameter numerics, waveforms, and their sequence displayed on the normal screen. To do so, follow this procedure:
1.
Access Tile Layout in either of the following ways:
◆ Select the Screen Setup quick key
→
select the Tile Layout tab.
◆ Select the Main Menu quick key
→ from the Display column select Tile Layout .
2.
Select a parameter numeric area or waveform area, and then from the popup list select an element you want to display in this area. The parameters and waveforms you did not select will not displayed.
Displaying the Parameter List
You can display the trends of HR, SpO
2
, RR, and NIBP/IBP in the parameter numerics area. To do so, follow this procedure:
1.
Access Tile Layout in either of the following ways:
◆ Select the Screen Setup quick key
→
select the Tile Layout tab.
◆ Select the Main Menu quick key → from the Display column select Tile Layout .
2.
Select the parameter numerics area where you want to display the parameter list, and then from the popup list select Parameter List .
Accessing Parameter Setup Dialogs
Each parameter has a setup dialog in which you can adjust the alarm and parameter settings. You can enter a parameter setup dialog by using any of the following methods:
■
■
■
■
Select the parameter numeric area or waveform area.
Press the setup hard key on the module front of the CO
2
module.
Select the Parameters Setup quick key , and then select the desired parameter .
Select the Main Menu quick key
→
from the Parameters column select Setup
→
select the desired parameter .
NOTE
•
In this manual, we always use the first method to enter the setup dialog. But you can use any method you prefer.
3.9.5
Changing Measurement Colors
You can set the color of measurement values and waveforms for each parameter. To do so, follow this procedure:
1.
Select Main Menu quick key → from the Parameters column select Parameter Color .
3 - 12 BeneVision N1 Patient Monitor Operator’s Manual
3.9.6
3.9.7
2.
Select the Current tab and set the colors of the currently monitoring measurement values and waveforms.
3.
Select the All tab and set the colors of measurement values and waveforms for all parameters.
Choosing a Screen
The monitor enters the normal screen after it is powered on. The normal screen is most frequently used for patient monitoring. You can also select other screens. To do so, follow this procedure:
1.
Access Choose Screen in either of the following ways:
◆ Select the Screen Setup quick key.
◆ Select the Main Menu quick key → from the Display column select Choose Screen .
2.
Select the desired screen.
Selecting the Big Numerics Screen
The big numerics screen displays parameter numerics in big font size. You can configure the parameters and their layout on the big numeric screen. Quickly switch between the normal screen and the big numeric screen by swiping left or right on the touchscreen with two fingers. You can also select the big numeric screen by proceeding as follows:
1.
Access Choose Screen in either of the following ways:
◆ Select the Screen Setup quick key.
◆ Select the Main Menu quick key → from the Display column select Choose Screen .
2.
Select Big Numerics .
3.
Select Big Numerics tab.
4.
Select a parameter numeric area or waveform area, and then from the popup list select an element to display in this area.
3.10
Connecting the CMS
■
■
You can connect the monitor to the BeneVision CMS through wired LAN or wireless LAN. When connected to the
CMS, the system provides the following function.
■
■
■
The monitor can transmit parameter values, waveforms, alarms, and events to the CMS. From the CMS, you can check the patient’s monitoring data and alarms.
The monitor can transmit parameter values and alarms from the connected external devices to the CMS.
From the CMS you can check the patient’s monitoring data and alarms obtained from the connected external devices.
Patient information, alarm settings, and alarm status can be synchronized between the monitor and the
CMS.
You can start or stop NIBP measurements from the CMS.
In case of network disconnection, the monitor can transmit the offline data to the CMS when the network is reconnected.
For more information on the CMS, see the operator’s manual of corresponding central monitoring system.
To select a CMS, select the system status information area at the top right corner of the main screen. Select the desired CMS from the popup CMS list.
NOTE
•
You can select CMS only when the Select CMS switch is on. For more information, see
21.12.4 Enabling Selecting a CMS .
BeneVision N1 Patient Monitor Operator’s Manual 3 - 13
3.11
Connecting the eGateway
■
■
You can connect the monitor to the eGateway through wired LAN or wireless LAN to implement interaction between the monitor and external devices. When connected to the eGateway, the system provides the following functions:
■
The monitor can transmit parameter values, waveforms, alarm settings, and events to the eGateway.
The monitor can transmit parameter values and alarm settings received from the BeneLink-connected external devices to the eGateway.
Clock can be synchronized between the monitor and the eGateway.
3.12
Connecting the Wireless Network
You can add up to five wireless networks for the monitor. For more information, see
.
If connecting the current wireless network fails, the monitor automatically connects other wireless networks in the order when they were added.
To manually switch the wireless network, from the system status information area on the top right conner of the screen select , and select the desired wireless network.
3.13
Disconnecting the Wireless Network
To disconnect the wireless network manually, follow this procedure:
1.
Swipe the screen from top down with a single finger.
2.
Select .
To reconnect the wireless network after it is disconnected manually, follow this procedure:
1.
Swipe the screen from top down with a single finger.
2.
Select .
3.14
Turning Off the Monitor
Before turning off the monitor, perform the following check:
1.
Ensure that monitoring of the patient has been completed.
2.
Disconnect the cables and sensors from the patient.
3.
Save or clear the patient data as required.
To turn off the monitor, press and hold the power switch for 3 seconds.
CAUTION
•
Press and hold the power switch for no less than 10 seconds to forcibly shut down the monitor if it could not be shut down normally. This may cause loss of patient data.
NOTE
•
Turning off the monitor does not disconnect the monitor from the AC mains. To completely disconnect the power supply, unplug the power cord.
•
In case of a temporary power failure, if the power is restored within 30 minutes, monitoring will resume with all active settings unchanged. If the monitor is without power for more than 30 minutes, it behaves the same as if it were normally turned off.
3 - 14 BeneVision N1 Patient Monitor Operator’s Manual
4
Using the External Display
4.1
Using the External Display
The N1 can be connected to an external display through the VGA connector of the Dock. When the external display is connected, you can monitor a patient’s condition either through the N1 or through the external display.
The external display can be configured as independent display enabling it to be configured to show different information than the N1. For the configuration of the independent external display, see section 21.15.4 Setting the External Display .
The following screens or functions can be viewed and operated only on the independent external display:
■
■
■
■
■
■
■
■
■
■
Minitrends Screen
OxyCRG Screen
Remote View Screen
ECG Half-Screen
PAWP Screen
Calculations
EWS
GCS
ST Graphic
Targeted Goal
NOTE
•
The external display can share the mouse or keyboard with the monitor. If the mouse or keyboard are needed, connect them to the USB connector of the Dock.
4.1.1
4.1.2
Connecting the N1 to the External Display
To connect the external display, follow this procedure:
1.
Connect the Dock and the external display using the VGA cable.
2.
Connect the Dock and the external display using the USB cable accompanying the external display.
3.
Connect the external display to the AC mains and turn on the display.
4.
Connect the N1 to the Dock.
External Display Troubleshooting
Problem Corrective Actions
Image offset
No image or the image displays abnormally • Check that the external display is properly connected to the AC mains and is powered on.
• Check that the VGA cable is properly connected.
• Remove the N1 from the Dock and reconnect it.
Touchscreen failure
Adjust the external display by using the auto adjust function or adjust the external display manually.
Check that both ends of the USB cable accompanying the external display are connected properly to the Dock and the external display.
BeneVision N1 Patient Monitor Operator’s Manual 4 - 1
4.1.3
CAUTION
•
Use only the specified display. Using unspecified displays may result in unexpected problems.
Quick keys of the independent external display
The following table displays the quick keys that are available for the independent external display.
Symbol Label
Main Menu
Function
Enters the main menu.
Symbol Label
Alarm Reset
Function
Resets the alarm system.
Alarm Pause
Screen Setup
Pauses the physiological alarm system (Availability depends on configuration of Pause in Maintenance
→ Alarm → Pause/Reset dialog).
Enters the Screen Setup dialog.
Manual Event Manually saves an event into the Events list.
NIBP Start/
Stop
NIBP STAT
Alarm Setup
Starts an NIBP measurement or stops the current NIBP measurement.
Starts a five-minute continuous NIBP measurement.
Enters the Alarm dialog.
Zero IBP Enters the Zero IBP dialog.
Parameters
Setup
Enters the Parameters
Setup dialog.
Review
OxyCRG
Enters the Review dialog to review historical data.
Opens the OxyCRG screen.
Privacy Mode Enters the privacy mode.
Audio Pause Pauses alarm tone
(Availability depends on configuration of Pause in
Maintenance → Alarm →
Pause/Reset dialog).
Standby Enters the standby mode.
Print Starts printing a real-time report.
NIBP Measure Opens the NIBP Measure interval options.
NIBP Stop All Stops all NIBP measurements.
More Shows more quick keys.
PAWP Opens the PAWP screen.
Remote View Opens the Remote View screen to view other patients.
Minitrends Opens the Minitrends screen.
ECG Full-
Screen
Opens the ECG full screen.
Night Mode Enters the night mode.
4 - 2 BeneVision N1 Patient Monitor Operator’s Manual
Symbol Label
CPB Mode
Function
Enters the CPB mode.
Volume Enters dialog.
Symbol Label
Intubation
Mode
Function
Enters the intubation mode.
Freeze Freezes waveforms.
Calculations Enters the Calculations dialog.
Patient
Management
Enters the Patient
Management dialog.
Venipuncture Inflates the NIBP cuff to help venous puncture.
GCS Enters the GCS dialog.
Discharge
Patient
Targeted Goal
Enters the Discharge
Patient dialog to discharge the patient and restore pre-configured default settings.
Opens the Targeted Goal screen.
Load Config Enters the Load Config dialog.
ECG Lead/
Gain
Enters the ECG Lead/Gain dialog.
EWS Opens the EWS screen.
SepsisSight Enters the SepsisSight dialog.
Discharged
Patients
Enters the Discharged
Patients dialog and displays previously discharged patients.
End Case
Report
Prints the selected end case reports
4.1.4
4.2
4.2.1
Configuring the Displayed Quick Keys (only available when the N1 is used with the independent external display)
To select the quick keys you want to display, follow this procedure:
1.
Access Quick Keys in either of the following ways:
◆ Select the Screen Setup quick key → Select the Quick Keys tab.
◆ Select the Main Menu quick key → from the Display column select Quick Keys .
2.
Select the Current tab to configure the quick keys you want to display on the screen: From the top of this page, select a block where you want to show a certain quick key, and then select the quick key from the quick key list. For example, if you want to show the Screen Setup quick key at the first block, select the first block, and then select Screen Setup from the list.
3.
Select the More tab to configure the quick keys you want to display when the More quick key is selected.
Minitrends Screen
The Minitrends screen shows the recent graphic trends of parameters.
Entering the Minitrends Screen
Choose one of the following methods to enter the Minitrends screen:
■ Swipe left or right on the touchscreen with two fingers to switch among the Minitrends screen, normal screen, and the big numerics screen.
BeneVision N1 Patient Monitor Operator’s Manual 4 - 3
4.2.2
■
■
■
■
■
■
Select the Minitrends quick key.
Select the Screen Setup quick key → Select the Choose Screen tab → select Minitrends .
Select the Main Menu quick key → from the Display column select Choose Screen → select Minitrends .
For adult and pediatric patients, when the Minitrends screen is hidden as following methods to quickly enter the Minitrends screen.
, you can also choose one of the
Swipe left or right across the touchscreen with two fingers until you switch to the Minitrends screen.
Swipe right across the touchscreen with a single finger.
Select the button .
The Display of Minitrends Screen
The following figure shows the minitrends screen. Your display may be configured to look slightly different.
(3)
(1)
(4)
(5)
4.2.3
(6)
(2)
(1)
(2)
(3)
(4)
(5)
(6)
Scale
Routine Vital button. If the department is set to OR , then the Baseline button is displayed.
Routine Vital/Baseline
Select this button to view the long trends, or contract the long trends screen to the Minitrends screen.
Time line
Alarm statistic area
Viewing the Long Trends
To expand the Minitrends screen to view the long trends, choose either of the following ways:
■
■
Select the button.
Swipe right across the Minitrends screen with a finger.
4 - 4 BeneVision N1 Patient Monitor Operator’s Manual
4.2.4
4.2.5
4.2.6
4.2.7
4.2.8
Setting Minitrends Parameters
To set parameters, follow this procedure:
1.
Enter the Minitrends screen.
2.
Select the Setup button.
3.
Set parameters. If you want to use the default parameters, select Default Parameter .
Setting the Minitrend Length
To set the Minitrend length, follow this procedure:
1.
Enter the Minitrends screen.
2.
Select the Setup button.
3.
Set the Minitrend Length .
Setting the Alarm Statistics Switch
The Minitrends screen can be configured to display the statistic number of physiological alarms in its lower half screen. To set the alarm statistics switch, follow this procedure:
1.
Enter the Minitrends screen.
2.
Select the Setup button.
3.
Switch on or off the Alarm Statistics switch.
Setting the Alarm Statistics Duration
The time length within which the alarms statistics are made is configurable. To set the alarm statistics length, follow this procedure:
1.
Enter the Minitrends screen.
2.
Select the Setup button.
3.
Set Alarm Statistics Duration .
Routine Vital/Baseline
The Routine vital/Baseline function is used for marking the parameter measurements of certain moment for later reference. If the department is set to OR , then the Baseline button is available. For other departments, the
Routine Vital button is available.
4.2.8.1
Manually Marking the Routine Vital/Baseline
To manually mark the Routine Vital/Baseline, follow this procedure:
1.
Enter the Minitrends screen.
2.
Select the Routine Vital button or Baseline button.
NOTE
•
If you do not see the Baseline button or Routine Vital button in the Minitrends screen, you can select the Setup button and switch on the Baseline switch, or set the Routine Vital to Manual or Auto.
4.2.8.2
Configuring Automatic Routine Vital Settings
The monitor can automatically mark the routine vital sign values. To enable this function, follow this procedure:
1.
Enter the Minitrends screen.
2.
Select the Setup button.
3.
Select Auto from the dropdown list of Routine Vital .
4.
Select Time to set the time for marking the first routine vital sign values.
BeneVision N1 Patient Monitor Operator’s Manual 4 - 5
4.3
4.3.1
4.3.2
5.
Select Interval to set the interval for marking the routine vital sign values.
The OxyCRG Screen
The monitor displays the OxyCRG screen by default when the neonatology department is selected. The OxyCRG screen is available in any department setting, but only when the patient size is set to Neo. This screen displays 6minute HR, SpO
2
trends, CO
2
/Resp compressed waveform, ABD parameters, and the latest ABD events.
The OxyCRG function is intended for neonatal patents only.
■
■
■
■
Entering the OxyCRG Screen
To enter the OxyCRG screen, choose any of the following ways:
Swipe left or right on the touchscreen with two fingers to switch to the OxyCRG screen.
Select the OxyCRG quick key.
Select the Screen Setup quick key
→
select the Choose Screen tab
→
select OxyCRG .
Select the Main Menu quick key
→
from the Display column select Choose Screen
→
select OxyCRG .
The Display of the OxyCRG Screen
The following figure shows the OxyCRG screen. Your display may be configured to look slightly different.
(8) (7)
(1)
(6)
(2)
4.3.3
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(3) (4) (5)
HR, SpO
2
trend
Resp/CO
2
compressed waveform
Event time
Event type
Parameter values of ABD events
ABD event list: displays the latest red ABD events. Selecting the ABD event list area enters the OxyCRG review page.
Mark button: opens the Mark dialog to edit the events.
ABD event prompt area: displays parameter values of currently active OxyCRG events.
OxyCRG Events
The following table lists the ABD events and their criteria:
Event type
A
Description
Zero RR event: the zero RR duration exceeds the threshold.
• A20: the zero RR duration is greater or equal to 20 seconds.
• A15: the zero RR duration is between 15 to 20 seconds (excluding 20 seconds).
• A10: the zero RR duration is between 10 to 15 seconds (excluding 15 seconds).
Remarks
A20 is a red event
4 - 6 BeneVision N1 Patient Monitor Operator’s Manual
B
D
BD
AB
AD
ABD
Event type Description
Low Heart Rate event: the duration of low heart rate exceeds the threshold.
Low SpO2 event: the duration of SpO2 Desat exceeds the threshold.
Low Heart Rate and low SpO2 happen at the same time.
Zero RR and Low Heart Rate happens at the same time.
Zero RR and low SpO2 happen at the same time.
Zero RR, Low Heart Rate, and low SpO2 happen at the same time.
Remarks
/
/
/
Red event
Red event
Red event
NOTE
•
The monitor records all ABD events for OxyCRG review, but only red events displays in the ABD list of the OxyCRG screen.
4.3.4
4.3.5
4.3.6
4.3.7
4.4
The Display of the ABD Event Area
The ABD event area displays parameter values of currently active OxyCRG events and lists the latest red ABD events.
Setting OxyCRG Parameters
Select parameter trends or compressed waveform to set parameters and the compressed waveform you want to display. The selected parameters will be used for ABD event calculation.
Setting the Threshold of ABD Events
Select any parameter trend or the compressed waveform to perform the following setup:
■
■
Set the threshold of ABD events.
Set Event Storage Format :
◆ 1 min+3 min : stores data one minute before and three minutes after the event.
◆ 3 min+1 min : stores data three minutes before and one minute after the event.
◆ 2 min+2 min : stores data two minutes before and two minutes after the event.
The stored data includes the trends of the OxyCRG parameters, compressed waveform, alarm thresholds, NIBP, and Temp measurements.
Editing ABD Events
To edit ABD events, follow this procedure:
1.
Select the Mark button to enter the Mark dialog box.
2.
Drag the event list upwards and downwards to select the desired event.
3.
Select the patient’s status when the event happened.
4.
Select Save .
The Targeted Goal Screen
If you are concerned with specific parameters and their trends, you can use the Targeted Goal screen. The
Targeted Goal screen focuses on the target parameter and displays parameter measurements in big numerics.
You can easily identify whether parameter target is reached via a dashboard and review the statistics of the target parameter by sections.
The Targeted Goal screen displays parameter measurements and waveforms of ECG, SpO
2
, IBP, PI, PR, CO
2
, Resp,
NIBP, and Temp. You can define the target parameter and secondary parameters. The measurements of these parameters displays in big numerics.
BeneVision N1 Patient Monitor Operator’s Manual 4 - 7
4.4.1
4.4.2
Entering the Targeted Goal Screen
To enter the Targeted Goal screen, choose any of the following ways:
■
■
Select the Screen Setup quick key
→
select the Choose Screen tab
→
select Targeted Goal screen.
Select the Main Menu quick key
→
from the Display column select Choose Screen
→
select Targeted
Goal Screen.
■ If the Patient Category is set to Neo , swipe left or right on the touchscreen with two fingers to switch to the Targeted Goal screen.
The Display of the Targeted Goal Screen
The following figure shows the Targeted Goal screen. Your display may be configured to look slightly different.
(4)
(1)
(2) (5)
(3)
(6)
4.4.3
(1) Parameter trends area: displays trends of the target parameter and secondary parameters. If the target parameter is Art, this area only lists the trend of arterial pressure.
(2) Target parameter statistics area: displays the statistics of the target parameter by sections.
(3) Other parameter area: displays parameter measurements and alarm limits of parameters other than the target parameter and secondary parameters.
(4) Target parameter area: displays the measurement of the target parameter in big numerics, as well as its target range, and alarm limits.
• If the target parameter is Resp or PR, parameter source is also displayed.
• The dashboard shows the target range in green.
• The
△ pointer below the dashboard indicates the current measurement value.
(5) Secondary parameters area: displays parameter measurement of secondary parameters in big numerics, as well as waveforms and alarm limits. If secondary parameters are Resp and PR, parameter sources are also displayed.
(6) Target parameter waveform area: displays the waveform of the target parameter.
• If the target parameter is Resp or PR, the waveform of the source parameter is displayed.
• If the target parameter is ECG, the fist ECG waveform is displayed by default.
Configuring the Targeted Goal Screen Layout
To configure the parameter numerics, waveforms, and their sequence displayed on the Targeted Goal screen, follow this procedure:
1.
Access the Targeted Goal screen in either of the following ways:
◆ Select the Screen Setup quick key
→
select the Choose Screen tab
→
select Targeted Goal screen.
◆ Select the Main Menu quick key
→
from the Display column select Choose Screen
→
select
Targeted Goal Screen.
2.
Select a parameter numeric area or waveform area, and then from the popup list select an element to display in this area. The parameters and waveforms not selected will not displayed.
4 - 8 BeneVision N1 Patient Monitor Operator’s Manual
4.4.4
4.5
Operating the Targeted Goal Screen
■
■
You can access parameter setup and trends review from the Targeted Goal screen. To do so, follow this procedure:
■
Select the parameter trends area to enter the Tabular Trends review page.
Select the target parameter statistics area to enter the parameter statistics setup dialog. Set the range of each section and the target section.
Select the desired waveform area, parameter numeric area, or dashboard to enter corresponding parameter setup dialog.
Remote View
The patient alarm and real time physiological data of the N1 can be viewed by other networked monitors. When the external display is connected, you can also observe alarm conditions and view real time physiological data from patients on other networked monitoring devices.
A device from a remote site is called a remote device or bed. You can simultaneously watch up to 12 remote devices. You can also view waveforms of one remote device on the external display.
You can watch the remote devices in the Remote View screen, or the alarm watch tiles on the main screen.
In the Remote View screen, you can view real time parameters and waveforms from one specific device, and watch the alarms of other monitored devices at the same time.
NOTE
•
A particular monitor (for example Monitor #1) can be viewed by at most 32 remote devices at the same time, of which eight of those remote devices can watch Monitor #1’s waveforms.
4.5.1
4.5.2
Entering the Remote View Screen
To enter the Remote View screen, choose one of the following ways:
■
■
■
Select the Remote View quick key.
Alarm Watch Tile on the Main Screen .
Select the Screen Setup quick key
→ select the Choose Screen tab
→ select Remote View .
About the Remote View
The following figure shows the Remote View screen.
BeneVision N1 Patient Monitor Operator’s Manual 4 - 9
(1)
(2)
(3)
(1)
(2)
(3)
Alarm watch area
Displays all the monitored remote beds. Each bed displays the room number, bed number, connection status and alarm status. The background color indicates the alarm status on the corresponding bed.
Background Color Description
Green
Red
Yellow
Cyan
Grey
Main area
No alarm is occurring at the bed.
The remote device is disconnected or a high priority alarm is currently the highest alarm level on the bed. If the remote device is disconnected, the icon is displayed.
The medium priority alarm is currently the highest alarm level on the bed.
The low priority alarm is currently the highest alarm level on the bed.
The bed is in the standby mode.
Displays the patient’s information, alarm status and messages, waveforms, measurements, etc. of the selected bed.
This bed is called main bed.
Remote View setup button: select it to enters the Remote View setup menu.
WARNING
•
The data presented in the Remote View screen has a delay. Do not rely on this screen for real time data.
4.5.3
Adding a Bed
After adding the desired remote devices, then the alarms from these devices can be viewed on the monitor. To add a remote device, follow this procedure:
1.
Enter the Select Bed dialog. To do so, choose either of the following ways:
◆ In the Remote View screen, select Select Bed . For more information, see
.
◆
Select the icon at the alarm watch tile if the tile is configured to display on the main screen.
2.
In the Select Bed dialog, select a desired department. All the beds under this department will be listed.
3.
Select a desired tile at the A-W1 or A-W2 areas and then select a bed from the bed list. The selected bed will appear in the tile.
4 - 10 BeneVision N1 Patient Monitor Operator’s Manual
NOTE
•
The added bed is indicated by a check mark (√) at the left of the bed list.
4.5.4
4.5.5
4.5.6
4.5.7
Removing a Bed
To remove a remote device from remote monitoring, follow this procedure:
1.
Enter the Select Bed dialog. Choose either of the following ways:
◆
In the Remote View screen, select Select Bed
. For more information, see 4.5.1 Entering the Remote
.
◆ Select the icon in the alarm watch tile if the tile is configured to display on the main screen.
2.
In the Select Bed dialog, select a bed at the A-W1, A-W2 or A-W3 areas, and then select Clear Bed . If you want remove all beds, select Clear All Beds .
Displaying the Main Bed
In the Remote View screen, you can select a bed in the alarm watch area, then the main body of the Remote
View screen will display the real time monitoring screen of the device.
Saving a Manual Event
You can initiate a manual event on the remote monitor by selecting Manual Event in the Remote View screen.
Managing Alarms from Remote Devices
You can view and manage the alarms coming from remote devices.
If the monitor and remote devices have alarms at the same time, the monitor presents alarms according to the following rules:
■
■
If the alarm tone pattern for the monitor is same as that for the remote devices, the monitor prioritizes all the alarms and sounds the highest alarm tone.
If the alarm tone pattern for the monitor is different from that for the remote devices, the monitor sounds the alarms in their corresponding tone.
The monitor provides the same alarm tone pattern for the remote device alarms as those for the monitor alarms by default. You can change the alarm tone pattern of the remote monitor; see
21.3.5.5 Setting the Tone Pattern for
.
4.5.8
4.5.9
Resetting Alarms for Remote Devices
You can reset the alarms on the remote devices by selecting Alarm Reset in the Remote View screen. This
Selecting Beds By Care Group
If configured, the monitor automatically selects beds in the same care group during the shift of care groups in the CMS. To enable this function, follow this procedure:
1.
Enter the Select Bed window. Choose either of the following ways:
◆ In the Remote View window, select Select Bed . For more information, see
for entering the Remote View window.
◆
Select the icon in the alarm watch tile if the tile is configured to display on the main screen.
2.
In lower left corner of the Select Bed window, select Select Beds By Care Group .
4.5.10
Alarm Watch
The alarm watch function provides the alarm notification by color and sound.
■ The monitor sounds the highest priority alarm tone from all the monitored remote devices.
BeneVision N1 Patient Monitor Operator’s Manual 4 - 11
■ The monitor displays the highest priority alarm in corresponding background color for each bed at the following areas:
◆
At the top of the Remote View . For more information, see
for details.
◆ On the main screen. For more information, see
4.5.10.1 About Alarm Watch Tile for details.
4.5.10.1
About Alarm Watch Tile
The main screen can display two alarm watch tiles, namely A-W1 and A-W2. Each tile can accommodate up to six beds.
The following figure shows the alarm watch tiles.
(1) (1) (2)
(3) (5)
(3) (4)
(1)
(2)
(3)
(4)
(5)
Alarm watch tile label
Disconnection icon: when the remote device is disconnected, this icon displays at the tile, and the tile background color is red.
Select bed icon: select it to enter the Select Bed dialog.
More than one bed tile: when more than one bed is assigned to a tile, the tile displays the alarm status, connection status, etc.
One bed tile: when only one bed is assigned to a tile, the tile displays the parameter value and alarm message from this bed, etc.
The alarm watch tile is similar to alarm watch area in the Remote View.
For more information, see 4.5.2 About the
.
4.5.10.2
Displaying the Alarm Watch Tile on the Main Screen
To configure the alarm watch tile to be displayed on the monitor’s main screen, follow this procedure:
1.
Select the Main Menu quick key → from the Display column select Choose Screen to enter the Screen
Setup dialog.
2.
Select the Tile Layout tab.
3.
Select the numeric area where you want to display the alarm watch tile, and then in the drop-down list, select Alarm Watch → A-W1 or A-W2 .
4.5.11
Auto Displaying the Alarm Bed
The monitor provides the function of automatically displaying the remote alarm bed. If this function is enabled, when a remote bed issues an alarm, the monitor automatically displays the monitoring information from this remote bed.
If multiple remote beds issue alarms, the monitor cyclically displays the alarm beds as per the preset interval and in the order of alarm time.
The auto displaying alarm bed function is disabled by default. To enable this function, follow this procedure:
1.
From the Remote View screen, select to enter the Remote View setup menu.
2.
Switch on Rollup Alarm Beds .
3.
Set Rollup Interval :
4 - 12 BeneVision N1 Patient Monitor Operator’s Manual
4.6
4.6.1
4.6.2
4.6.3
4.6.4
◆ Off : do not cyclically display the remote alarm beds. Once a new alarm is issued, the monitor automatically switches to the new alarm bed.
◆
10 sec , 20 sec , or 30 sec : If multiple remote beds issue alarms, the monitor cyclically displays the alarm beds as per the preset interval and alarm priority in the order of alarm time.
4.
Set Alarm Priority:
◆ High Only: Only when a high priority alarm is issued, the monitor automatically switches to the alarm bed.
◆ High & Med: If Rollup Interval is set to Off and when a high priority alarm or medium priority alarm is issued, the monitor automatically switches to the alarm bed. If Rollup Interval is set to 10 sec , 20 sec , or 30 sec and multiple remote beds issue alarms, the monitor cyclically displays the alarm beds with higher priority in the order of alarm time. For example, if both high priority alarms or medium priority alarm are issued, only beds with high priority alarms are cyclically displayed.
Freezing Waveforms
During patient monitoring, the freeze feature allows you to freeze the currently displayed waveforms on the screen so that you can have a close examination of the patient’s status. Additionally, you can select any frozen waveform for recording.
Freezing Waveforms
■
■
■
■
To freeze waveforms, select the Freeze quick key. Except waveforms of the following screens, all displayed waveforms stop refreshing and scrolling after you select the Freeze quick key:
Minitrends screen oxyCRG screen
Remote View screen
EWS screen
Viewing Frozen Waveforms
To view the frozen waveforms, follow this procedure:
■
■
Select the or button in the Freeze dialog.
Slide the frozen waveform leftward or rightward.
At the lower right corner of the bottom most waveform displays the freeze time. The initial frozen time is 0 s .
With the waveforms scrolling, the freeze time changes at an interval of 1 second. For example, -2 s means the two seconds before the frozen time. This change will be applied for all waveforms on the screen.
NOTE
•
You can view the frozen waveforms of up to 120 seconds.
Unfreezing Waveforms
To unfreeze the frozen waveforms, select the button upper right corner of the Freeze dialog.
Printing Frozen Waveforms
To print the frozen waveforms, select the button at the upper left corner of the Freeze dialog.
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4 - 14 BeneVision N1 Patient Monitor Operator’s Manual
5
Managing Patients
5.1
5.2
Starting Monitoring a Patient
After turning on the monitor, follow this procedure to monitor a patient:
1.
Admit the patient.
2.
Check patient settings. Make sure that alarm limits, patient category and paced status, and so on, are appropriate for the patient. Change them if necessary.
3.
Perform desired measurements. For more information, see corresponding measurement chapters.
Admitting a Patient
The monitor admits a new patient in the following situations:
■
■
■
After a patient is manually discharged, the monitor automatically admits a new patient.
After being switched off for the selected time period, the monitor automatically discharges the previous patient and admits a new patient at startup.
If the monitor has not detected certain patient vital signs (ECG, SpO
2
, PR, RR, NIBP) for 30 minutes, it will prompt whether to start monitoring a new patient if any of the above vital signs are detected again.
Always input patient information as soon as the patient is admitted. For more information, see
Patient Information for details.
WARNING
•
The default Patient Category setting is Adult, and Paced setting is Unspecified. Set Paced and check if the Patient Category setting is correct for the patient.
•
For paced patients, set Paced to Yes. If it is incorrectly set to No, the monitor could mistake a pace pulse for a QRS and fail to alarm when the ECG signal is too weak.
•
For non-paced patients, set Paced to No.
5.2.1
5.2.2
■
■
Entering the Patient Management Dialog
Use any of the following methods to enter the Patient Management dialog:
■
Select the patient information area at the top left corner of the screen.
Select the Patient Management quick key (only available when the N1is used with the independent external display).
Select the Main Menu quick key → from the Patient Management column select Patient Management .
Editing Patient Information
Edit patient information after a patient has been admitted, or when patient information is incomplete, or when it is necessary to change patient information:
To edit patient information, follow this procedure:
1.
Enter the Patient Management
dialog. For more information, see 5.2.1 Entering the Patient Management
2.
Edit patient information as required.
If a barcode reader is connected to the monitor, scanning the patient’s barcode will enter the patient’s information.
BeneVision N1 Patient Monitor Operator’s Manual 5 - 1
5.2.3
5.2.4
NOTE
•
The monitor will reload the configuration if you change the patient category.
Loading Patient Information from the CMS
If the monitor is connected to the central monitoring system (CMS). You can load patient information from the
CMS to the monitor. To do so, follow this procedure:
1.
Enter the Find Patient dialog in either of the following ways:
◆ Select the Main Menu quick key → from the Patient Management column select Find Patient .
◆ From the Patient Management dialog select Find Patient .
2.
Input query criteria.
3.
Select Search . Then a list pops up, including all the patients that meet the query criteria.
4.
Select a patient from the patient list, and then select Admit . Corresponding patient information in the monitor will be updated.
NOTE
•
If ADT Query is switched on, input query criteria from the Discharged Patients page.
Loading Patient Information from the ADT Server
If the monitor is connected with the Admit-Discharge-Transfer (ADT) server through the eGateway. You can load patient information from ADT server to the monitor.
To do so, follow this procedure:
1.
Enter the Find Patient dialog in either of the following ways:
◆ Select the Main Menu quick key → from the Patient Management column select Find Patient .
◆ Select Find Patient from the Patient Management dialog.
2.
Input query criteria.
3.
Select Search . Then a list pops up, including all the patients that meet the query criteria.
4.
Select a patient from the patient list, and then select Admit . Corresponding patient information in the monitor will be updated.
NOTE
•
You can load patient information from the ADT server only when ADT Query is enabled. For more
information, see 21.12.9 Using the ADT Gateway .
•
The monitor can automatically upload the patient information from the ADT server when:
◆
The configured keywords of the monitor and the eGateway are the same.
◆
The IP address of the monitor is added to the eGateway configuration dialog.
•
Loading patient information from the ADT server updates only patient information in the monitor.
The patient’s monitoring data is not changed and the patient is not discharged.
5 - 2 BeneVision N1 Patient Monitor Operator’s Manual
5.3
5.4
5.5
5.6
5.7
Transferring Patient
Patient settings and data can be transferred from an N1 into a host monitor. The patient settings and data includes patient information, trend data, alarm events, and parameter alarm limits. The N1 also allows transfer of full disclosure data.
For detailed information about patient data transfer, refer to the user manual of the host monitor. For the connection of N1 and the host monitor, refer to section 2.9 N1 in Use with a Host Monitor .
WARNING
•
Do not discharge a patient on the bedside monitor before patient information is completely transferred. Discharging the patient during transfer will result in incomplete patient information.
NOTE
•
The system automatically switches on the HR/PR (high, low) alarms and lethal arrhythmia alarms after transferring the patient data.
Exporting Patient Data
To export the data of the current patient and discharged patients, follow this procedure:
1.
Connect the N1 to the Dock.
2.
Connect the USB drive to the Dock’s USB connector.
3.
Access the Discharged Patients dialog box by selecting the Main Menu quick key
→ from the Patient
Management column select Discharged Patients .
4.
From the patient list select desired patients.
5.
Select Export Patient Data .
Deleting Patient Data
To delete the data of discharged patients, follow this procedure:
1.
Access the Discharged Patients dialog box by selecting the Main Menu quick key
→ from the Patient
Management column select Discharged Patients .
2.
From the patient list select desired patients.
3.
Select Delete .
Stopping a Parameter Measurement
To stop monitoring a parameter, follow this procedure:
1.
Remove corresponding sensor from the patient.
2.
Disconnect the sensor from the patient cable.
3.
Disconnect the patient cable from the parameter module.
Discharging a Patient
Before monitoring a new patient, discharge the previous patient. The technical alarms are reset, and monitor
settings return to their defaults. For more information, see 20.3 Setting Default Patient Category
.
After a patient is discharged, the monitor automatically admits a new patient.
WARNING
•
Always discharge the previous patient before starting to monitor a new patient. Failure to do so can lead to data being associated with the wrong patient.
BeneVision N1 Patient Monitor Operator’s Manual 5 - 3
To manually discharge a patient, use any of the following methods to access the Discharge Patient dialog:
■
■
■
■
■
■
■
Swipe down the touchscreen with two fingers.
Select the Discharge Patient quick key (only available when the N1is used with the independent external display).
Select the patient information area at the top left corner of the screen → Discharge Patient .
Select the Patient Management quick key → Discharge Patient (only available when the N1is used with the independent external display).
Select the Main Menu quick key
→
from the
Select a button in the Discharge Patient dialog:
Patient Management column select Discharge .
■
Print End Case Report : prints the end case report when the patient is discharged.
Discharge : clears the waveform data of the current patient. The monitor loads the default configuration and goes to the standby mode. The current patient becomes a discharged patient.
Clear Patient Data : discharges the current patient and clears the waveform data. The monitor still uses the current configuration and does not go to the standby mode. The current patient becomes a discharged patient.
5 - 4 BeneVision N1 Patient Monitor Operator’s Manual
6
Alarms
6.1
6.2
Alarm Introduction
This chapter describes alarm functions and alarm settings.
Alarm Safety Information
WARNING
•
A potential hazard can exist if different alarm presets and default configuration settings are used for the same or similar equipment in the same care area, for example an intensive care unit or cardiac operating room.
•
If the monitor is connected to the central monitoring system (CMS) or other monitors, alarms can be presented and controlled remotely. Remote suspension, inhibition, or reset of monitor alarms via the CMS or other monitors may cause a potential hazard. For more information, see the operator’s manuals for the CMS and the other monitors.
•
The monitors in the care area may each have different alarm settings to suit different patients.
Always check that the alarm settings are appropriate for the patient before starting the monitoring.
Always make sure that necessary alarm limits are active and set according to the patient's clinical condition.
•
Setting alarm limits to extreme values may cause the alarm system to become ineffective. For example, setting the SpO
2
high alarm limit to 100%, is equivalent to switching the alarm off.
•
When the alarm sound is switched off, the monitor gives no alarm tones even if a new alarm occurs.
Be careful when considering to switch off the alarm sound. When the alarms are off or while alarm audio is paused either temporarily or indefinitely, observe the patient frequently.
•
When monitoring patients that are not continuously attended by a clinical operator, properly configure the alarm system and adjust alarm settings as per the patient's condition.
•
Do not rely exclusively on the audible alarm system for monitoring. Adjustment of alarm volume to a low level may result in a hazard to the patient.
6.3
6.3.1
6.3.2
Understanding the Alarms
Alarm Categories
The monitor has two different types of alarms: physiological alarms and technical alarms.
■
■
Physiological alarms are triggered by patient measurement exceeding the parameter limits, or by an abnormal patient conditions.
Technical alarms are triggered by an electrical, mechanical, connectivity, or other monitor abnormal operation, or by failure of a sensor or component. Technical alarm conditions may also be caused when an algorithm cannot classify or interpret the available data.
Apart from the physiological and technical alarms, the monitor can also prompt with some messages describing the system status or patient status.
Alarm Priorities
By severity, the alarms are classified into the following priority levels:
■
■
High priority alarms: indicate a life threatening situation or a severe device malfunction. High priority alarms require an immediate response.
Medium priority alarms: indicate abnormal vital signs or a device malfunction. Medium priority alarms require a timely response.
BeneVision N1 Patient Monitor Operator’s Manual 6 - 1
6.3.3
■
■
Low priority alarms: indicate a discomfort condition, a device malfunction, or an improper operation. Low priority alarms require you to be aware of this condition.
Messages: provides additional information on the patient or the equipment.
Alarm Indicators
When an alarm occurs, the monitor indicates it through visual or audible alarm indications. For more information, see the following table.
Alarm Indicator High Priority
Alarm
Alarm lamp
Audible tone pattern
Red
Flashing frequency: 1.4 -
2.8 Hz
Duty cycle: 20 -
60% on
ISO Repeat pattern of triple + double + triple
+ double beeps
Mode 1 Repeat pattern of high-pitched single beep
Mode 2 Repeat pattern of high-pitched triple beeps
Alarm message White text inside a red box
Medium
Priority Alarm
Yellow
Flashing frequency: 0.4 -
0.8 Hz
Duty cycle: 20 -
60% on
Repeat pattern of triple beeps
Repeat pattern of double beeps
Repeat pattern of double beeps
Black text inside a yellow box
Low Priority
Alarm
Cy a n
No flashing
Duty cycle:
100% on
Single beep
Low-pitched single beep
Low-pitched single beep
Black text inside a cyan box
Message Comments
None
None
None
None
White text
None
None
Alarm priority indicator
Parameter value
*** ** * None
Alarm messages are displayed in the alarm information area at the top of the screen. You can select the alarm messages to show the alarm list.
The indicator appears in front of the corresponding alarm message.
None White text inside a flashing red box
Black text inside a flashing yellow box
Black text inside a flashing cyan box
None
NOTE
•
When multiple alarms of different priority levels occur simultaneously, the monitor selects the highest priority alarm to light the alarm lamp and issue the alarm tone.
•
When multiple alarms of different priority levels occur simultaneously and should be displayed in the same area, the monitor only displays the messages from the highest priority alarm.
•
When multiple alarms of the same priority levels occur simultaneously alarm messages are displayed cyclically.
•
Some physiological alarms, such as Asystole, are exclusive. They have identical alarm tones and alarm lights with normal high level physiological alarms, but their alarm messages are displayed exclusively. That is, when an exclusive physiological alarm and a normal high level physiological alarm are triggered simultaneously, only exclusive physiological alarm message will be displayed.
6 - 2 BeneVision N1 Patient Monitor Operator’s Manual
6.3.4
Alarm Status Symbols
to indicate the alarm status:
Alarm pause: indicates that all the alarms are paused.
Alarm off: indicates that individual measurement alarms are turned off or the system is in the alarm off status.
Audio pause: indicates that audible alarm tones are paused.
Audio off: indicates that audible alarm tones are turned off.
Alarm reset: indicates that the alarm system is reset.
6.4
Accessing On-screen Help for Technical Alarms (AlarmSight)
In the technical alarm list, alarm messages followed by Detail include help messages or pictures to help you identify the problem. This function is called AlarmSight. To access AlarmSight, follow this procedure:
1.
Select an alarm displaying in the technical alarm information area to enter the Alarms dialog.
2.
From the alarm list select the desired alarm.
NOTE
•
If there are no displayed alarms, then selecting the technical alarm area will not open any dialogs.
6.5
6.6
6.6.1
Checking the Physiological Alarms List
If the patient monitor has more than one physiological alarm, you can see the physiological alarm list by selecting the physiological alarm information area to enter the Alarms dialog. If there is only one physiological alarm, selecting the physiological alarm information area enters the Review dialog for the event created by this alarm.
Changing Alarm Settings
Alarms settings can be changed by selecting Main Menu and choosing from the list in the Alarm column.
Setting Parameter Alarm Properties
To set parameter alarm properties, follow this procedure:
BeneVision N1 Patient Monitor Operator’s Manual 6 - 3
1.
Select the Main Menu quick key → from the Alarm column select Limits.
2.
Enter the password if required.
3.
Select a parameter tab and set alarm properties as desired.
You can also change the alarm properties of individual parameter from the corresponding parameter dialog.
6.6.2
NOTE
•
The monitor can be configured to require an password or login to change alarm settings. For more
information, refer to 21.13.3 Selecting Password for User Authentication
.
Changing the Alarm Volume
To change the alarm volume, follow this procedure:
1.
Select the Main Menu quick key
→
from the Alarm column select Setup.
2.
Set Alarm Volume . The alarm volume can be set from X to 10, in which X is the minimum volume allowed by your department, and 10 is the maximum volume.
3.
Select High Alarm Volume to set the volume of the high priority alarm.
4.
Select Reminder Volume to set the volume of the reminder tone.
NOTE
•
When the alarm volume is set to 0, the alarm sound is turned off and the audio off symbol appears on the screen.
•
You cannot set the volume of high priority alarms if Alarm Volume is set to 0.
•
You can set the Alarm Volume to 0 only when your monitor is connected to the CMS. If your monitor is not connected to the CMS, the lowest setting of Alarm Volume is 1.
•
When the monitor is connected to the CMS and Alarm Volume is set to 0, Alarm Volume automatically changes to 2 if the CMS is disconnected.
6.6.3
Setting the Auto Limits for New Patient Switch
If the Auto Limits for New Patient function is enabled, a dialog box can pop up to ask you whether to set alarm limits based on the latest parameter measurements for a newly admitted patient. To set the Auto Limits for
New Patient switch, follow this procedure:
1.
Enter the alarm setup page in any of the following ways:
◆
Select the Alarm Setup quick key
→
select the Setup tab.
◆
Select the Main Menu quick key
→
from the Alarm column select Setup .
2.
Set the Auto Limits for New Patient switch.
6 - 4 BeneVision N1 Patient Monitor Operator’s Manual
■
■
■
■
■
■
■
■
When Auto Limits for New Patient is switched on, the confirmation dialog box pops up if all of the following requirements are met:
Within 10 minutes after the patient is admitted.
Continuous measurements are stable.
An NIBP measurement has been taken.
HR alarm switch is on.
No lethal alarms are triggered.
The patient is not in poor perfusion condition.
Alarm limits of no parameters were manually changed.
The monitor is not in intubation mode, private mode, or CPB mode.
NOTE
•
The Auto Limits for New Patient function is intended for newly admitted patients only.
•
The automatically set alarm limits take effect only after being confirmed.
6.6.4
Initiating Auto Alarm Limits
The monitor provides the auto alarm limits function to automatically adjust alarm limits according to the patient’s vital signs. When auto limits are selected, the monitor calculates safe auto limits based on the latest measured values. To get accurate auto alarm limits, collect a set of measured vital signs as a baseline.
To initiate auto alarm limits, follow this procedure:
1.
Select the Main Menu quick key
→
from the Alarm column select Limits.
2.
From the Limits page, select Auto Limits at the left bottom.
3.
Select Ok from the popup dialog box.
Then the monitor will automatically calculate alarm limits based on the latest measured values. Before applying these automatically created alarm limits, confirm if they are appropriate for the patient from the Limits dialog. If not, you can adjust them manually. These alarm limits will remain unchanged until you select auto limits again or adjust them manually.
The monitor calculates auto limits based on the following rules:
Module
ECG
Resp
SpO
2
Parameter Lower Limit
HR/PR
(bpm)
RR (rpm)
SpO
2
(%)
Upper Limit Auto Limit Range
Adult/ pediatric
Neonate Adult/ pediatric
Neonate
HR × 0.8 or 40
(whichever is greater)
RR × 0.5 or 6
(whichever is greater)
Same as the default alarm limit
(HR - 30) or 90
(whichever is greater)
(RR - 10) or 30
(whichever is greater)
Same as the default alarm limit
HR × 1.25 or
240
(whichever is smaller)
(RR × 1.5) or
30 (whichever is smaller)
Same as the default alarm limit
(HR + 40) or
200
(whichever is smaller)
(RR + 25) or
85 (whichever is smaller)
Same as the default alarm limit
Adult/pediatric: 35 to 240
Neonate: 55 to 225
Adult/pediatric: 6 to 55
Neonate: 10 to 90
Same as the measurement range
BeneVision N1 Patient Monitor Operator’s Manual 6 - 5
6 - 6
Module
NIBP
Temp
(xx refers to temperat ure site)
IBP: ART/
Ao/UAP/
BAP/FAP/
LV/P1-P4
(Arterial pressure)
Txx (°C)
ΔT (°C)
IBP-S
(mmHg)
IBP-D
(mmHg
IBP: PA
IBP: CPP
IBP-S
(mmHg)
IBP-D
(mmHg
IBP-M
(mmHg)
CPP
(mmHg)
Parameter Lower Limit
NIBP-S
(mmHg)
NIBP-D
(mmHg)
NIBP-M
(mmHg)
IBP-M
(mmHg)
Upper Limit Auto Limit Range
Adult/ pediatric
(SYS × 0.68 +
10)
(Dia × 0.68 +
6)
(Mean × 0.68
+ 8)
(Txx - 0.5)
Same as the default alarm limit
Neonate
(SYS - 15) or
45 (whichever is greater)
(Dia - 15) or
20 (whichever is greater)
(Mean - 15) or
35 (whichever is greater)
(Txx - 0.5)
Same as the default alarm limit
Adult/ pediatric
(SYS × 0.86 +
38)
(Dia × 0.86 +
32)
(Mean × 0.86
+ 35)
(Txx + 0.5)
Same as the default alarm limit
Neonate
(SYS + 15) or
105
(whichever is smaller)
(Dia + 15) or
80 (whichever is smaller)
(Mean + 15 or
95)
(whichever is smaller)
(Txx + 0.5)
Same as the default alarm limit
Adult: 45 to 270
Pediatric: 45 to 185
Neonate: 35 to 115
Adult: 25 to 225
Pediatric: 25 to 150
Neonate: 20 to 90
Adult: 30 to 245
Pediatric: 30 to 180
Neonate: 25 to105
1 to 49
Same as the measurement range
SYS × 0.68 +
10
(Dia × 0.68 +
6)
Mean × 0.68 +
8
SYS × 0.75
(SYS - 15) or
45 (whichever is greater)
(Dia - 15) or
20 (whichever is greater)
(Mean - 15) or
35
(whichever is greater)
SYS × 0.75
SYS × 0.86 +
38
(Dia × 0.86 +
32)
Mean × 0.86 +
35
SYS × 1.25
(SYS + 15) or
105
(whichever is smaller)
(Dia + 15) or
80 (whichever is smaller)
(Mean + 15) or 95
(whichever is smaller)
SYS × 1.25
Adult: 45 to 270
Pediatric: 45 to 185
Neonate: 35 to 115
Adult: 25 to 225
Pediatric: 25 to 150
Neonate: 20 to 90
Adult: 30 to 245
Pediatric: 30 to180
Neonate: 25 to 105
3 to 120
Dia × 0.75
Mean × 0.75
Dia × 0.75
Mean × 0.75
CPP × 0.68 + 8 (CPP-15) or
Mean × 0.75
35,
(whichever is greater)
Mean × 0.75
Dia × 1.25
Mean × 1.25
CPP × 0.86 +
35
Mean × 1.25
Dia × 1.25
Mean × 1.25
3 to 120
3 to 120
IBP: CVP/
LAP/
RAP/
UVP/P1-
P4
(Venous pressure)
IBP-M
(mmHg)
(CPP+15) or
95,
(whichever is smaller)
Mean × 1.25
Adult: 20 to 235
Pediatric: 25 to175
Neonate: 25 to 100
3 to 40
BeneVision N1 Patient Monitor Operator’s Manual
Module
CO
2
Parameter Lower Limit
EtCO awRR
(rpm)
2
(mmHg)
FiCO
2
Upper Limit Auto Limit Range
Adult/ pediatric
0 to 32: remains the same
33 to 35: 29
Neonate
0 to 32: remains the same
33 to 35: 29
Adult/ pediatric
0 to 32: remains the same
33 to 35: 41
Neonate
0 to 32: remains the same
33 to 35: 41
Same as the measurement range
36 to 45:
(etCO
2
- 6)
46 to 48: 39
36 to 45:
(etCO
2
- 6)
46 to 48: 39
36 to 45:
(etCO
2
+ 6)
46 to 48: 51
36 to 45:
(etCO
2
+ 6)
46 to 48: 51
>48: remains the same
None
>48: remains the same
None awRR × 0.5 or
6 (whichever is greater)
(awRR - 10) or
30 (whichever is greater)
>48: remains the same
Same as the default alarm limit awRR × 1.5 or
30 (whichever is smaller)
>48: remains the same
Same as the default alarm limit
(awRR+25) or
85 rpm
(whichever is smaller)
Same as the measurement range
Same as the measurement range
Same as the measurement range
Same as the measurement range
Same as the measurement range
Adult/pediatric: 6 to 55
Neonate: 10 to 90
6.6.5
6.6.6
6.6.7
Setting the Zero RR Delay Time
To set the zero respiration rate delay time, follow this procedure:
1.
Select the Main Menu quick key
→
from the Alarm column select Setup.
2.
Select Zero RR Delay to set the zero respiration rate delay time.
Switching On or Off V-Tach Latching
When V-Tach Latching Lock is switched on, you can switch on or off V-Tach Latching . To do so, follow this procedure:
1.
Select the Main Menu quick key → from the Alarm column select Setup.
2.
Switching on or off V-Tach Latching .
For information on the V-Tach Latching function, see
21.3.4 Latching Physiological Alarms .
Restoring the Default Alarm Settings
To reset all alarm settings to the defaults, follow this procedure:
1.
Select the Main Menu quick key
→
from the Alarm column select Limits.
2.
On the Limits page, select Defaults at the bottom.
6.6.8
Setting the Length of Printed Waveforms
You can define the length of printed waveforms when an alarm is triggered. To do so, follow this procedure:
1.
Select the Main Menu quick key
→
from the Alarm column select Setup.
2.
Set Printing Duration On Alarm .
BeneVision N1 Patient Monitor Operator’s Manual 6 - 7
6.7
Pausing Alarms/Pausing Alarm Tones
You can either pause alarms or pause alarm tones. This depends on the pause setting. To set the pause function, refer to
21.3.3 Defining the Pause Function
.
6.7.1
Pausing Alarms
If the Pause function is configured to alarm pause, pressing the Alarm Pause quick key can temporarily disable alarm indicators. For the configuration of the pause function, see
21.3.3 Defining the Pause Function
. When alarms are paused, the following rules are followed:
■
■
■
■
No physiological alarm will be presented.
For technical alarms, alarm sounds are paused, but alarm lamps and alarm messages continue to be presented.
The remaining alarm pause time is displayed in the physiological alarm information area.
The alarm pause symbol is displayed in the system information area.
When the alarm pause time expires, the alarm paused state is automatically deactivated. You can also cancel the alarm paused state by pressing the Alarm Pause quick key again.
6.7.1.1
Prolonging the Alarm Pause Time
If enabled, you can temporarily prolong the alarm pause time after the monitor enters the alarm paused state.
This capability is disabled by default. To prolong the alarm pause time, follow this procedure:
1.
In the physiological alarm information area, select the alarm pause countdown.
2.
Select Pause 5 min, Pause 10 min , or Pause 15 min .
NOTE
•
Prolonging alarm pause time does not affect the setting of alarm pause time.
6.7.1.2
Switching Off All Alarms
■
■
■
■
If Pause Time is set to Permanent
(see section 21.3.3.1 Setting the Alarm Pause Time/Alarm Tone Pause Time ),
pressing the Alarm Pause quick key permanently switches off all alarms. The alarm off state has the following features:
Physiological alarms are switched off. The alarm lamp does not flash and alarm sound is not issued.
Alarm sound of technical alarms is switched off, but alarm lamp flashes and alarm messages are presented.
The message Alarm Off with red background is displayed in the physiological alarm information area.
The alarm off symbol is displayed in the system status information area.
To exit the alarm off state, press the Alarm Pause quick key again.
WARNING
•
Pausing or switching off alarms may result in a hazard to the patient.
6.7.2
Pausing Alarm Sound
■
■
■
If the Pause function is configured to Audio Pause, pressing the Audio Pause quick key pauses alarm tone and sets the quick key to be highlighted. For the configuration of the pause function, see section
. When alarm tones are paused, the following rules are followed:
The sound of all physiological alarms and technical alarms are switched off.
The remaining audio pause time is displayed in the physiological alarm information area.
The audio pause symbol is displayed in the system information area.
When the audio pause time expires, the audio paused state is automatically deactivated. You can also cancel the audio paused state by pressing the highlighted Audio Pause quick key again.
6 - 8 BeneVision N1 Patient Monitor Operator’s Manual
6.7.2.1
Prolonging the Alarm Tone Pause Time
If enabled, you can temporarily prolong the alarm tone pause time after the monitor enters the alarm tone paused state. This capability is disable by default. To prolong the audio pause time, follow this procedure:
1.
In the physiological alarm information area, select the alarm pause countdown.
2.
Select the alarm tone pause time. Options may include Pause 5 min, Pause 10 min , or Pause 15 min .
NOTE
•
Prolonging alarm pause time does not affect the setting of alarm tone pause time.
6.7.2.2
Switching Off Alarm Sound
■
■
If Pause Time is set to Permanent
(see section 21.3.3.1 Setting the Alarm Pause Time/Alarm Tone Pause Time
), pressing the Audio Pause quick key permanently switches off all alarm sound. The audio off state has the following features:
Alarm sound of both physiological alarms and technical alarms is switched off.
The audio off symbol is displayed in the system information area.
To exit the audio off state, press the Audio Pause quick key again.
WARNING
•
Pausing or switching off alarm sound may result in a hazard to the patient.
6.8
Resetting Alarms
Press the Alarm Reset quick key to reset the alarm system. When the alarm system is reset, the alarm reset symbol displays in the system status information area for alarm symbols.
NOTE
•
If a new alarm is triggered after the alarm system is reset, the alarm reset icon will disappear and the alarm light and alarm tone will be reactivated.
6.8.1
6.8.2
6.9
■
■
■
Resetting Physiological Alarms
For physiological alarms, when the alarm system is reset, the following occur:
The alarm sound is silenced.
A √ appears before the alarm message.
The color of the parameter numeric background corresponds with the alarm priority, but the parameter numeric does not flash.
Resetting Technical Alarms
■
■
■
For technical alarms, when the alarm system is reset, the following occur:
Some technical alarms are cleared. The monitor gives no alarm indications.
Some technical alarms are changed to prompt messages.
For some technical alarms, the alarm is silenced and a √ appears before the alarm message.
.
Latching Alarms
The latching setting for physiological alarms defines how alarm indicators behave if you do not reset the alarms.
■ If you do not “latch” physiological alarms, their alarm indications disappear when the alarm condition ends.
BeneVision N1 Patient Monitor Operator’s Manual 6 - 9
■ If you “latch” physiological alarms, all visual and audible alarm indications remain (if configured) until the alarms are reset. For latched alarms the time when the alarm is last triggered is displayed behind the alarm message.
The monitor can be set to separately latch visual indications or simultaneously latch the visual and the audible indications.
■
■
When visual indications are latched, visual indications, including alarm lamp, alarm message and its background remain when the alarm condition ends and the time when the alarm last triggered is displayed behind the alarm message.
When audible indications are latched, the monitor continues to issues alarm sounds when the alarm condition ends.
NOTE
•
Changing alarm priority may affect the latching status of the corresponding alarm. Determine if you need to adjust the latching status for the specific alarm when you have changed its alarm priority.
•
When the alarm system is reset, latched physiological alarms are cleared.
6.10
CPB Mode
The CPB (Cardiopulmonary Bypass) mode is activated only if you set the department to OR .
In the CPB mode, all the physiological alarms and technical alarms are switched off. So when performing CPB, you can put the monitor in the CPB mode to inactivate unnecessary alarms.
6.10.1
Entering the CPB Mode
To enter the CPB mode, select the Main Menu quick key
→
from the Alarm column select CPB Mode .
In the CPB mode, CPB Mode is displayed in the physiological alarm area with a red background color.
NOTE
•
When the CPB mode is entered, the monitor stops all NIBP measurements. You can restart NIBP measurements after entering the CPB mode.
6.10.2
Exiting the CPB Mode
To exit the CPB mode, select the Main Menu quick key
→
from the Alarm column select Exit CPB Mode .
6.11
Intubation Mode
Intubation mode is available for Resp and CO
2
monitoring. When performing intubation during general anesthesia, you can put the monitor in the intubation mode in order to inactivate unnecessary alarms.
In the intubation mode, Resp and CO
2
related physiological alarms are switched off.
6.11.1
Entering the Intubation Mode
To enter the intubation mode, choose either of the following ways:
■
■
From the bottom of the Resp or CO2 dialog, select Intubation Mode .
Select the Main Menu quick key
→ from the Alarm column select Intubation Mode .
6.11.2
Exiting the Intubation Mode
To exit the intubation mode, choose either of the following ways:
■
■
From the bottom of the Resp or CO2 dialog, select Exit Intubation Mode .
Select the Main Menu quick key from the Alarm column
→ select Exit Intubation Mode .
6 - 10 BeneVision N1 Patient Monitor Operator’s Manual
6.12
Testing Alarms
The monitor automatically performs a selftest at startup. Check that an alarm tone is heard, the alarm lamp illuminates, one after the other, in red, yellow, and cyan. This indicates that the visible and audible alarm indicators function correctly.
To further test individual measurement alarms, perform measurements on yourself or using a simulator. Adjust alarm limits and check that appropriate alarm behavior is observed.
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6 - 14 BeneVision N1 Patient Monitor Operator’s Manual
7
Monitoring ECG, Arrhythmia, ST and QT
7.1
ECG Introduction
The electrocardiogram (ECG) measures the electrical activity of the heart and displays it on the monitor as waveforms and numerics. ECG monitoring provides 3-, 5-, 6-, and 12-lead ECG monitoring, ST-segment analysis, arrhythmia analysis, QT/QTc measurements, and optional 12-lead resting analysis via the Glasgow algorithm.
The N1 monitor incorporating ST analysis has the ST label.
The N1 monitor incorporating 12-lead has the 12-lead label.
(1)
(2)
(3)
7.2
(1) 12-lead label (2) ST label (3) Glasgow label
ECG Safety Information
WARNING
•
This equipment is not intended for direct cardiac application.
•
Ensure that the conductive parts of ECG electrodes and associated connectors, including the neutral electrode, do not come into contact with any other conductive parts including earth.
•
Always use defibrillation-proof ECG cables during defibrillation.
•
Do not touch the patient, or metal devices connected to the patient, during defibrillation.
•
To minimize the hazard of burns during high-frequency surgical procedures, ensure that the monitor’s cables and transducers never come into contact with the electrosurgery unit (ESU).
•
To minimize the hazard of burns during use of high-frequency surgical unit (ESU), the ECG electrodes should not be located between the surgical site and the ESU return electrode.
CAUTION
•
Only use parts and accessories specified in this manual. Follow the instructions for use and adhere to all warnings and cautions.
•
Periodically inspect the electrode application sites to ensure skin integrity. If the skin quality changes, replace the electrodes or change the application site.
BeneVision N1 Patient Monitor Operator’s Manual 7 - 1
7.3
•
Interference from an ungrounded instrument near the patient or electrosurgery usage can induce noise and artifact into the waveforms.
ECG Display
The following figures show the ECG waveform and numeric areas. The display may be configured to look slightly different.
(1) (2) (3) (4) (5) (6)
(7)
(1) ECG lead label of the displayed waveform
(3) ECG filter mode
(2) ECG waveform gain
(4) Notch filter status
is displayed. If Paced is set to No , (5) Paced status: If Paced is set to Yes ,
(6) HR/PR alarm message
is displayed.
(7) Pace pulse marker: If Paced is set to Yes , pace pulse markers “|” are displayed corresponding to detected pacer for each beat.
(1)
(2)
(4)
7.4
7.4.1
7.4.2
(3)
(1) Parameter label
(3) HR alarm limits
(2) HR measurement unit
(4) HR value
Preparing for ECG Monitoring
Preparing the Patient Skin
Proper skin preparation is necessary to ensure good signal quality at the electrode sites, as the skin is a poor conductor of electricity. To properly prepare the skin, choose flat areas and then follow this procedure:
1.
Shave hair from skin at chosen electrode sites.
2.
Gently rub skin surface at sites to remove dead skin cells.
3.
Thoroughly cleanse the site with a mild soap and water solution. We do not recommend using ether or pure alcohol, because this dries the skin and increases the resistance.
4.
Dry the skin completely before applying electrodes.
Applying Electrodes and Connecting the Patient
To connect ECG cables, follow this procedure:
7 - 2 BeneVision N1 Patient Monitor Operator’s Manual
1.
Check that electrode packages are intact and the electrodes are not past the expiry date. Ensure the electrode gel is moist. If you are using snap electrodes, attach the snaps to the electrodes before placing electrodes on the patient.
2.
Place the electrodes on the prepared sites. Ensure that all electrodes have good skin contact.
3.
Connect the leadwires to the patient cable if not already connected.
4.
Plug the patient cable into the ECG connector.
CAUTION
•
Never mix patient electrode types or brands. This may lead to impedance mismatches issues.
NOTE
•
When applying the electrodes, avoid bony area, obvious layers of fat, and major muscles. Muscle movement can result in electrical interference. Applying electrodes on major muscles, for example on muscles of the thorax, may lead to erroneous arrhythmia alarms due to excessive muscle movement.
7.4.3
Lead Wire Color Code
The following table lists the color coding of leadwires for AHA standards:
Lead
Right arm
Left arm
Right leg (neutral)
Left leg
Chest 1
Chest 2
Chest 3
Chest 4
Chest 5
Chest 6
Label
V1
V2
V3
V4
RA
LA
RL
LL
V5
V6
Color
White
Black
Green
Red
Brown/Red
Brown/Yellow
Brown/Green
Brown/Blue
Brown/Orange
Brown/Violet
7.4.4
ECG Electrode Placements
In this section, electrode placement is illustrated using the AHA naming convention.
7.4.4.1
3-leadwire Electrode Placement
The following is the electrode configuration when a 3-leadwire cable is used:
■
■
■
RA placement: directly below the clavicle and near the right shoulder.
LA placement: directly below the clavicle and near the left shoulder.
LL placement: on the left lower abdomen.
RA LA
LL
BeneVision N1 Patient Monitor Operator’s Manual 7 - 3
7.4.4.2
■
■
■
5-leadwire and 6-leadwire Electrode Placement
The following is the electrode configuration for a 5-leadwires cables:
■
■
RA placement: directly below the clavicle and near the right shoulder.
LA placement: directly below the clavicle and near the left shoulder.
RL placement: on the right lower abdomen.
LL placement: on the left lower abdomen.
V placement: on the chest in any of the V1 to V6 positions.
For 6-leadwire placement, you can use the position for the 5 leadwire placement but with two chest leads. The two chest leads (Va and Vb) can be positioned at any two of the V1 to V6 positions. For more information, see
7.4.4.3 Chest Electrode Placement
. The Va and
Vb lead positions are configurable. For more information, see
7.5.3.3 Changing Va and Vb Labels
.
V
RL
RA LA
7.4.4.3
■
■
Chest Electrode Placement
The chest electrode can be placed at the following positions:
■
■
■
■
■
V1 placement: on the fourth intercostal space to the right of the sternum.
V2 placement: on the fourth intercostal space to the left of the sternum.
V3 placement: midway between the V2 and V4 electrode positions.
V4 placement: on the fifth intercostal space at the left midclavicular line.
V5 placement: on the left anterior axillary line, horizontal with the V4 electrode position.
V1
VE V2 V3
V6 placement: on the left midaxillary line, horizontal with the V4 electrode position.
V3R-V6R placement: on the right side of the chest in positions corresponding to those on the left.
V6
V5
V4
NOTE
•
For the 5-leadwire and 6-leadwire placement, place the precordial electrode according to the physician's preference.
LL
7 - 4 BeneVision N1 Patient Monitor Operator’s Manual
7.4.4.4
10-leadwire Electrode Placement
12-lead ECG uses 10 electrodes, which are placed on the patient’s four limbs and chest. The limb electrodes should be placed on the limb extremities and the chest electrodes placed according to the physician’s preference. The figure at right illustrates the conventional 10-leadwire electrode placement.
7.4.4.5
Lead Placement for Pacemaker Patients
The recommended lead placement for monitoring a pacemaker patient is as follows.
RA
Pacemaker
LA
LL
RA
V1
RL
Pacemaker
LA
LL
3-leadwire Electrode Placement 5-leadwire Electrode Placement
A pacemaker patient usually requires a different electrode patch placement configuration than a nonpacemaker patient.
Do not place an ECG electrode directly over the pacemaker generator. Place the electrode patches 2 to 3 inches away from the pacemaker generator area. For example, if the pacemaker generator is located in the left subclavian area, relocate the Left Arm electrode closer in towards the center of the chest.
7.4.4.6
Lead Placement for Surgical Patients
The surgical site should be taken into consideration when placing electrodes on a surgical patient. For example, for open-chest surgery, the chest electrodes can be placed on the lateral chest or back. To reduce artifacts and interference from electrosurgical units, you can place the limb electrodes close to the shoulders and lower abdomen and the chest electrodes on the left side of the mid-chest. Do not place the electrodes on the upper arm. Otherwise, the ECG waveform will be very small.
WARNING
•
To reduce the hazard of burns during use of electrosurgical units (ESU), the ECG electrodes should not be located between the surgical site and the ESU return electrode.
•
Never entangle the ESU cable and the ECG cable together.
BeneVision N1 Patient Monitor Operator’s Manual 7 - 5
•
When using ESU, never place ECG electrodes near the grounding plate of the ESU, as this can cause a lot of interference on the ECG signal.
•
When using ESU, ensure proper contact of the ESU return electrode to the patient to avoid burns at monitor measurement sites. Also ensure that the ESU return electrode is near the operating area.
7.4.5
7.4.6
Choosing the ECG Lead Type
To choose ECG lead type, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the Setup tab.
3.
Set Lead Set according to the lead type you are going to use. The default lead type is Auto . In this case, the monitor automatically detects the lead type.
Checking Paced Status
It is important to correctly set the patient’s paced status before you start monitoring ECG. The paced symbol is displayed when Paced is set to Yes . Pace pulse markers “|” are displayed on each ECG waveform whenever a pacer signal is detected. If Paced is set to No or unspecified, the symbol will be shown in the ECG waveform area.
To change the paced status, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the Pacer tab.
3.
Set Paced to Yes or No .
You can also change the patient’s paced status from the Patient Management dialog. For more information, see
5.2.1 Entering the Patient Management Dialog
.
If you did not set the paced status, the monitor issues a prompt tone when pace pulse is detected. At the same time, the paced symbol flashes and the message Please check if the patient has a pacemaker?
appears in the ECG waveform area. Check and set the patient’s paced status.
WARNING
•
For paced patients, you must set Paced to Yes. If it is incorrectly set to No, the monitor could mistake a pace pulse for a QRS complex and fail to alarm when the ECG signal is too weak. On ventricular paced patients, episodes of ventricular tachycardia may not always be detected. Do not rely entirely upon the system’s automated arrhythmia detection algorithm.
•
False low heart rate or false asystole alarms may result with certain pacemakers because of pacemaker artifacts, such as electrical overshoot of the pacemaker overlapping the true QRS complexes.
•
Do not rely entirely on rate meter alarms when monitoring patients with pacemakers. Always keep these patients under close surveillance.
•
The auto pacer recognition function is not applicable to pediatric patients and neonatal patients.
7.4.7
Enabling Pacer Rejection
To eliminate the pacing pulse from the ECG waveform of paced patients, it is recommended to enable the pace pulse rejection function. The pace pulse rejection function is disabled by default. To enable this function, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the Pacer tab.
3.
Switch on Pacer Reject .
7 - 6 BeneVision N1 Patient Monitor Operator’s Manual
NOTE
•
When pace pulses are detected, the pace pulse markers “|” are shown on the ECG waveforms. Pacer
Rejection setting has no impact on the display of pace pulse markers “|”.
•
You can switch on pacer rejection only when Paced is set to Yes. If Paced is set to no, the Pacer Reject function is disabled.
7.5
Changing ECG Settings
7.5.1
7.5.2
Choosing an ECG Screen
When monitoring ECG, several display options are available.
■
■
■
■
For 3-lead ECG monitoring, only normal screen is available.
For 5-lead ECG monitoring, besides the normal screen, you can also choose Full-screen (7-lead).
For 6-lead ECG monitoring, besides the normal screen, you can also choose Full-screen (8-lead).
For 12-lead ECG monitoring, besides the normal screen, you can also choose Full-screen (7-lead), or 12-
Lead (12-lead analysis).
To choose the desired screen configuration, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select Full-Screen or 12-Lead .
To return to the normal screen, press the highlighted button to unselect that screen.
Alternately you can choose the desired screen configuration as follows:
1.
Select the Screen Setup quick key
→
Choose Screen or select the Main Menu quick key
→ from the
Display column select Choose Screen .
2.
Select ECG Full-Screen or ECG 12-Lead .
Setting ECG Alarm Properties
To select the desired ECG alarm options, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the Alarm tab.
3.
Select the desired alarm options.
7.5.3
Changing ECG Wave Settings
7.5.3.1
Selecting the Leads of Displayed ECG Waveforms
To select the desired ECG waveforms to be displayed, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the Setup tab.
3.
Select ECG to set the lead of each displayed ECG waveform.
4.
If more than three ECG waveforms are to be displayed, select the More Leads tab, and then select ECG to set leads of other ECG waveforms.
■
■
■
For optimal ECG analysis, select leads with the following characteristics:
The QRS complex should be either completely above or below the baseline and it should not be biphasic.
The QRS complex should be tall and narrow.
The P waves and T waves should be less than 0.2mV.
BeneVision N1 Patient Monitor Operator’s Manual 7 - 7
CAUTION
•
Ensure that you have selected the optimal leads with the best waveform amplitude and the highest signal-to-noise ratio. Selecting the optimal leads is important for detecting beats, classifying beats, and detecting ventricular fibrillation.
7.5.3.2
Changing ECG Waveform Size
If the ECG waveform is too small or clipped, you can change its size by selecting the appropriate Gain setting. To do so, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the Setup tab.
3.
Select ECG Gain to set the size of each ECG waveform.
4.
If more than three ECG waveforms are displayed, select the More Leads tab, and then select ECG Gain to change the sizes of other ECG waveforms. If you select Auto , the monitor automatically adjusts the size of the ECG waveforms for all the leads.
7.5.3.3
Changing Va and Vb Labels
When monitoring ECG with 6-leadwire. You can change the labels of Va and Vb leads. To do so, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the Setup tab.
3.
Set Va and Vb according to the locations of the Va and Vb electrode sites. Default settings are Va and Vb .
7.5.3.4
Changing ECG Waveform Speed
To change ECG waveform speed, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the Setup tab.
3.
Set the desired Speed .
7.5.3.5
Setting the ECG Filter
To set the appropriate ECG waveform filter mode, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the Setup tab.
3.
Set Filter .
◆ Diagnostic : use when diagnostic quality ECG is required. The unfiltered ECG waveform is displayed so that changes such as R-wave notching or discrete elevation or depression of the ST segment are visible.
◆ Monitor : use under normal monitoring conditions.
◆ Surgery : use when the signal is distorted by high frequency or low frequency interference. High frequency interference usually results in large amplitude spikes making the ECG signal look irregular.
Low frequency interference usually leads to wandering or rough baseline. The surgery filter reduces artifacts and interference from electrosurgical units. Under normal measurement conditions, selecting Surgery may suppress certain features or details of the QRS complexes.
◆ ST : recommended for ST monitoring.
7.5.3.6
Switching On or Off the Notch Filter
The notch filter removes the line frequency interference. To switch on or off the notch filter, follow this procedure:
7 - 8 BeneVision N1 Patient Monitor Operator’s Manual
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the Setup tab.
3.
Switch on or off Notch Filter .
NOTE
•
The notch filter can only be switched on or off when ECG Filter is set to Diagnostic. In other filter modes, the notch filter is always on.
7.5.4
7.5.5
7.5.6
Disabling the Smart Lead Off Function
The monitor provides the smart lead off function. When the lead corresponding to the first ECG wave gets detached but another lead is available, the monitor automatically switches to the available lead to recalculate heart rate, and to analyze and detect arrhythmias. When you reconnect the detached leads, the monitor automatically switches back to the original lead.
The smart lead off function is enabled by default. To disable this function, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the Setup tab.
3.
Switch off Smart Lead .
Adjusting the QRS Volume
To adjust the QRS volume, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the Setup tab.
3.
Set QRS Volume .
When valid SpO
2
measurements are available, the monitor adjusts the pitch of QRS tone based on the SpO
2 value.
Adjusting the Minimum QRS Detection Threshold
To avoid false asystole alarm due to low R wave amplitude, and to avoid tall T waves and P waves being mistaken for QRS complexes, the monitor provides a means to manually adjust the minimum QRS detection threshold.
To adjust the minimum QRS detection threshold, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the Setup tab and set Filter to Monitor .
3.
Select the QRS Threshold tab.
4.
Select up or down arrow buttons to adjust the minimum threshold for QRS detection. Selecting Default resets the QRS threshold to the default value (0.16 mV).
CAUTION
•
The setting of the QRS detection threshold can affect the sensitivity for arrhythmia, ST, QT/QTc detection, and heart rate calculation.
•
If the QRS amplitude is low, the monitor might not be able to detect the beats and false asystole calls may occur.
NOTE
•
The minimum QRS detection threshold can only be adjusted when the ECG filter is set to Monitor.
BeneVision N1 Patient Monitor Operator’s Manual 7 - 9
7.6
7.6.1
Monitoring Arrhythmia
Arrhythmia monitoring is intended for adult and pediatric patients.
Arrhythmia Safety Information
WARNING
•
Heart rate reading may be affected by cardiac arrhythmias. Do not rely entirely on heart rate alarms when monitoring patients with arrhythmias. Always keep these patients under close surveillance.
•
The arrhythmia analysis program may incorrectly identify the presence or absence of an arrhythmia.
Therefore, a physician must analyze the arrhythmia information with other clinical findings.
•
Atrial fibrillation (Afib) detection function is not intended for pediatric and neonatal patients.
CAUTION
•
Since the arrhythmia detection algorithm sensitivity and specificity are less than 100%, it is possible for false arrhythmias to be detected and true arrhythmia events to not be detected. The possibility increases when the signal is noisy.
•
The ECG size and minimum QRS detection threshold settings affect arrhythmia detection and heart rate calculation sensitivity.
•
If QRS amplitude is low, the monitor might be unable to calculate heart rate and thus create false asystole calls. During the learning phase of the algorithm, arrhythmia detection may not be available. It is recommended to closely monitor patient condition during, and for several minutes after, the learning phase to allow the algorithm to reach optimal detection performance.
7.6.2
Arrhythmia Events
This section lists all arrhythmia events and their criteria.
7.6.2.1
Lethal Arrhythmia Events
Arrhythmia message Description
Asystole
V-Fib/V-Tach
V-Tach
No QRS complex detected within the set time interval in the absence of ventricular fibrillation or chaotic signal.
A fibrillatory wave for 6 consecutive seconds.
A dominant rhythm of adjacent PVCs and the ventricular rate is greater than the V-tach rate limit.
The number of consecutive PVCs is greater than or equal to the V-Tach PVCs limit, and the ventricular rate is greater than or equal to the V-Tach rate limit.
7.6.2.2
Nonlethal Arrhythmia Events
Arrhythmia message
Vent Brady
Extreme Tachy
Extreme Brady
R on T
Run PVCs
Couplet
Description
The number of consecutive PVCs is greater than or equal to V brady PVC limit and the ventricular rate is less than the V-Brady Rate limit.
The heart rate is greater than the extreme tachycardia limit.
The heart rate is less than the extreme bradycardia limit.
R on T PVC is detected.
More than two consecutive PVCs, but lower than the V-Brady PVCs limit, and the ventricular rate is lower than the V-Tach rate limit.
A Pair of PVCs detected in between normal beats.
7 - 10 BeneVision N1 Patient Monitor Operator’s Manual
7.6.3
Arrhythmia message
Multiform PVC
PVC
Bigeminy
Trigeminy
Tachy
Brady
Pacer Not Capture
Pacer Not Pacing
Missed Beat
Nonsus V-Tach
Vent Rhythm
Pause
Irr Rhythm
A-Fib (for adult only)
PVCs/min
Pauses/min
Irr Rhythm End
A-Fib End (for adult only)
*N: normal beat; V: ventricular beat
Description
Multiform PVCs detected in Multif. PVC's Window (which is adjustable).
One PVC detected in between normal beats.
A dominant rhythm of N, V, N, V, N, V * .
A dominant rhythm of N, N, V,N, N, V, N, N, V * .
The heart rate is greater than the tachycardia limit.
The heart rate is lower than the bradycardia limit.
No QRS complex detected for 300 ms following a pace pulse (for paced patients only).
No pace pulse detected for 1.75 x average R-to-R intervals following a QRS complex (for paced patients only).
At least 3 consecutive Ns * , and
The current RR interval is greater than 1.5 x previous RR interval, and
The next RR interval is lower than 1.5 x average RR interval, and
HR lower than 100 and the current RR interval is greater than 1.75 x average RR interval , or
HR is greater than or equal to 100 and the current RR interval is greater than 1000 ms.
The number of consecutive PVCs is lower than the V-Tach PVCs limit but greater than 2, and the ventricular rate is greater than or equal to the V-Tach Rate limit.
The number of consecutive PVCs is greater than or equal to the V-Brady PVCs limit, and ventricular rate is greater than or equal to the V-Brady Rate limit but lower than V-Tach Rate limit.
No QRS complex is detected within the set pause time threshold.
Consistently irregular rhythm (N * , irregular RR interval change is greater than 12.5%)
P wave is absent and normal beat RR intervals are irregular.
PVCs/min exceeds high limit.
Pauses/min exceeds high limit.
Irregular rhythm no longer detected for the irregular rhythm end delay time.
Atrial fibrillation no longer detected for the A-Fib end delay time.
Displaying Arrhythmia Information
You can display the arrhythmia information in the numeric area. To do so, follow this procedure:
1.
Access Tile Layout using either of the following ways:
◆ Select the Screen Setup quick key → select the Tile Layout tab.
◆ Select Main Menu quick key → from the Display column select Tile Layout .
2.
Click the numeric area where you want to display the arrhythmia information, and then select ECG →
Arrhythmia .
7.6.4
Changing Arrhythmia Settings
7.6.4.1
Changing Arrhythmia Alarm Settings
To set the arrhythmia alarm properties, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the Arrhythmia tab
→
Alarm tab.
3.
Set alarm properties as desired.
BeneVision N1 Patient Monitor Operator’s Manual 7 - 11
NOTE
•
You can switch off lethal arrhythmia alarms only when the monitor is set to enableLethal Arrh
Alarms Off. For more information, see 21.3.9.1 Setting the Lethal Arrhythmia Alarms Switch
.
•
The priority of lethal arrhythmia alarms is always high. It cannot be altered.
7.6.4.2
Changing Arrhythmia Alarm Threshold Settings
You can change threshold settings for certain arrhythmia alarms. When an arrhythmia exceeds its threshold, an alarm will be triggered. To do so, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the Arrhythmia tab
→
select the Threshold tab.
3.
Enter the password if required. For more information, refer to 21.13.3 Selecting Password for User
.
4.
Set the threshold for the desired arrhythmia alarms.
NOTE
•
The asystole delay time relates to ECG relearning. When heart rate is less than 30 bpm, it is recommended to set Asystole Delay to 10 sec.
7.6.4.3
Arrhythmia Threshold Range
Arrhythmia
Asystole Delay
Tachy (HR High)
Brady (HR Low)
Extreme Tachy
Extreme Brady
Multif PVCs Window
V-Tach Rate
V-Brady Rate
V-Tach PVCs
V-Brady PVCs
PVCs/min
Pauses/min
Pause Threshold
AF/Irr Rhy End Time
Threshold Range
3 sec to 10 sec
60 bpm to 295 bpm
16 bpm to 120 bpm
65 bpm to 300 bpm
15 bpm to 115 bpm
3 beats to 31 beats
100 bpm to 200 bpm
15 bpm to 60 bpm
3 beats to 99 beats
3 beats to 99 beats
1 to 100
1 to 15
1.5 sec, 2.0 sec, 2.5 sec, 3.0 sec
0 min, 1 min, 2 min, 3 min, 4 min, 5 min, 10 min, 15 min, 30 min
7.6.4.4
Setting Thresholds for PVC-Related Alarms
PVC-related alarms are detected on the basis of the current PVC rate and the number of consecutive PVCs.
To set the required thresholds for PVC-related alarms, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the Arrhythmia tab → select the More Threshold tab.
7 - 12 BeneVision N1 Patient Monitor Operator’s Manual
3.
Enter the password if required. For more information, refer to 21.13.3 Selecting Password for User
.
Adjust V-Tach PVCs , V-Tach Rate , V-Brady PVCs , and V-Brady Rate as necessary to set the thresholds for the desired PVC-related alarms.
The following figure illustrates the conditions under which PVC alarms will be generated if V-Tach PVCs is set to
6, V-Tach Rate is set to 130, V-Brady PVCs is set to 5, and V-Brady Rate is set to 40.
7.6.5
■
■
■
■
■
If the number of consecutive PVCs is greater than or equal to the V-Tach PVCs limit (6), and the ventricular rate (Vent Rate) is greater than or equal to the V-Tach Rate limit (130), a V-Tach alarm is generated.
If the number of consecutive PVCs is lower than the V-Tach PVCs limit (6) but greater than 2, and the ventricular rate is greater than or equal to the V-Tach Rate limit (130), a Nonsus V-Tach alarm is generated.
If the number of consecutive PVCs is greater than or equal to the V-Brady PVCs limit (5), and the ventricular rate is lower than the V-Tach Rate limit (130) but greater than or equal to the V Brady Rate limit (40), a Vent
Rhythm alarm is generated.
If the number of consecutive PVCs is lower than the V-Brady PVCs limit (5) but greater than 2, and the ventricular rate is lower than the V-Tach Rate limit (130), a Run PVCs alarm is generated.
If the number of consecutive PVCs is greater than or equal to the V-Brady PVCs limit (5), and the ventricular rate is lower than the V Brady Rate limit (40), a Vent Brady alarm is generated.
Intelligent Arrhythmia Alarm
Normally, an arrhythmia alarm is presented when an alarm condition is detected. However, there are certain situations that can inhibit audible and visible alarm indications even though an alarm condition was detected.
BeneVision N1 Patient Monitor Operator’s Manual 7 - 13
7.6.5.1
Arrhythmia Alarm Chains
If multiple alarms overlap, announcing all of the detected alarm conditions would be confusing, and a more serious condition might be overlooked. So arrhythmia alarms are prioritized by alarm "chains".
Asystole
V Ͳ Fib/V Ͳ Tach
V Ͳ Tach / Vent Brady
PVC Alarm Chain
Nonsus V Ͳ Tach /
Vent Rhythm
Run PVCs
Extreme Tachy/
Extreme Brady
Beat Detection
Alarm Chain
Pauses/min
Rate Alarm Chain
Tachy/Brady
Pause
HR High /
HR Low
Couplet
Pacer not Capture /
Pacer not Pacing /
Missed Beat
R on T
A Ͳ Fib Alarm Chain
A Ͳ Fib/
A Ͳ Fib End
Irr. Rhythm/
Irr.Rhythm End
Bigeminy
Trigeminy
PVCs/min
Multiform PVC
PVC
7.6.5.2
Arrhythmia Alarm Shielding Rules
The following table explains how audible and visual alarms are indicated during arrhythmia alarm shielding period .
Previous alarm
Alarm in high priority chain
Alarm in medium priority chain
Current alarm
Alarm in high priority chain
Alarm in medium priority chain
Alarm indication
Alarm light and alarm tone
During the shielding period, alarm light and alarm tone are disabled. When the shielding period is reached, alarm light and alarm tone are reactivated.
Alarm light and alarm tone
Alarm light and alarm tone
Alarm in high priority chain
Alarm in the same medium priority chain, but with higher priority
The same alarm reoccurs
Alarm in the same medium priority chain, but with lower priority
Alarm in other medium priority chain
During the shielding period, alarm light and alarm tone are disabled. When the shielding period is reached, alarm light and alarm tone are reactivated.
During the shielding period, alarm light and alarm tone are disabled. When the shielding period is reached, alarm light and alarm tone are reactivated.
Alarm light and alarm tone
7 - 14 BeneVision N1 Patient Monitor Operator’s Manual
7.6.5.3
Arrhythmia Alarm Refractory Period
■
■
■
■
■
■
■
■
For the following eight alarms in medium priority chain, there is a 30-second refractory period. That is to say, if the same alarm is not presented within 30 seconds after the previous alarm disappears.
Couplet
R on T
PVCs/min High
Multiform PVCs
PVC
Missed Beat
Pacer not Capture
Pacer not Pacing
7.7
ST Segment Monitoring
ST segment analysis is intended for adult, pediatric and neonatal patients. To use this feature, the N1 must be labeled to support ST analysis, see
7.7.1
ST Safety Information
WARNING
•
ST segment deviation values may be affected by such factors as certain drugs or metabolic and conduction disturbances.
•
ST deviation is often calculated at a fixed offset from the J point. Changes in heart rate may affect ST.
•
The significance of ST segment changes needs to be determined by a physician.
•
This monitor provides information regarding changes in ST deviation levels. The clinical significance of the ST level change information should be determined by a physician.
7.7.2
7.7.3
Enabling ST Monitoring
The ST monitoring function is disabled by default. Before you start ST monitoring, enable the ST function. To do so, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the ST tab → select the Setup tab.
3.
Switch on ST Analysis .
Reliable ST monitoring cannot be ensured under the following situations:
■
■
■
■
You are unable to get a lead that is not noisy.
Arrhythmias, such as atrial fibrillation or atrial flutter, which may cause an irregular baseline.
The patient is continuously ventricularly paced.
The patient has left bundle branch block.
In these cases, you may consider switching off ST monitoring.
Displaying ST Deviation Numerics
To display ST numerics, follow this procedure:
1.
Access Tile Layout by either of the following ways:
◆ Select the Screen Setup quick key → select the Tile Layout tab.
◆ Select Main Menu quick key → from the Display column select Tile Layout .
2.
Click the numeric area where you want to display the ST numerics, and then select ECG → ST .
BeneVision N1 Patient Monitor Operator’s Manual 7 - 15
The ST parameter display area is configured differently according to the ECG cable used:
■
■
■
■
When you are using the 3-lead ECG leadwires, a separate ST numeric area does not appear on the display.
The ST deviation value displays in the ECG numeric area.
When you are using the 5-lead ECG leadwires, the ST numeric area displays 7 ST deviation values: ST-I, ST-II,
ST-III, ST-aVR, ST-aVL, ST-aVF, ST-V.
When you are using the 6-lead ECG leadwires, the ST numeric area displays 8 ST deviation values: ST-I, ST-II,
ST-III, ST-aVR, ST-aVL, ST-aVF, ST-Va, ST-Vb.
When you are using the 12-lead ECG leadwires, the ST numeric area displays12 ST deviation values: ST-I, ST-
II, ST-III, ST-aVR, ST-aVL, ST-aVF, ST-V1, ST-V2, ST-V3, ST-V4, ST-V5, ST-V6.
This example shows the ST numeric area when 5-lead ECG cable is used. The monitor screen may look slightly different:
(4) (5)
(1)
(2)
(3 )
7.7.4
(1) Parameter label
(3) ST alarm off symbol
(2) ST measurement unit
(4) Lead labels
(5) ST numerics: a positive value indicates ST segment elevation, and a negative value indicates ST segment depression.
Displaying ST Segments in the Waveform Area
You can display ST segments in the waveform area. To do so, follow this procedure:
1.
Access Tile Layout by either of the following ways:
◆ Select the Screen Setup quick key → select the Tile Layout tab.
◆ Select Main Menu quick key → from the Display column select Tile Layout .
2.
Select the waveform area where you want to display the ST segments, and then select ECG → ST .
7 - 16 BeneVision N1 Patient Monitor Operator’s Manual
ST segment shows a QRS complex segment for each measured ST lead. The current ST segment is drawn in the same color as the ECG wave, usually green, superimposed over the stored reference segment, drawn in a different color. The information is updated once every ten seconds.
(1) (2)
(3 )
7.7.5
7.7.6
(1) ST lead
(3) Baseline ST deviation value
(4) (5)
(2) Current ST deviation value
(4) 1 mV scale
(5) Current ST segment (green) and baseline ST segment (white)
Entering the ST View
In ST View mode a complete QRS segment for each ST lead is displayed. The color of the current ST segments and ST deviation values is consistent with the color of the ECG waveforms, normally green. The color of the baseline ST segments and ST deviation values is white.
To enter the ST View, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the ST tab.
3.
From the bottom of the dialog, select ST View .
Saving the Current ST Deviation and Segment as Baseline
ST deviation is typically monitored as a relative change from a baseline value. Set an ST baseline when ST deviation values become stable. If you did not set the ST baseline, the monitor automatically saves the baseline when valid ST deviation values appear for 5 minutes. To set the ST baseline, follow this procedure:
1.
From the ST View , select Set Baseline .
2.
From the pop-up dialog box, select Ok to set the current ST segments and values as the baseline.
From the ST View , you can also perform the following operations:
■
■
Display or hide ST baseline by selecting Display Baseline or Hide Baseline
Display or hide the position of ISO point, J point and ST point by selecting
.
Display Marker or Hide Marker .
CAUTION
•
Updating ST baseline affects ST alarms.
BeneVision N1 Patient Monitor Operator’s Manual 7 - 17
7.7.7
Entering the ST Graphic (only available when the N1 is used with the independent external display)
To display ST Graphic , follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the ST tab.
3.
Select ST Graphic .
The following figure shows the ST Graphic when ST Alarm Mode is set to Absolute . The height of the bar indicates the ST deviation value of corresponding ST lead. The color of the bar indicates ST alarm status: green indicates that corresponding ST deviation value is within alarm limits; cyan, yellow and red indicate that the ST deviation value exceeds the alarm limits. The color matches ST alarm priority.
The following figure shows the ST Graphic when ST Alarm Mode is set to Relative . The height of grey bar indicates the baseline ST deviation value and the green bar (cyan, yellow or red if an alarm occurs) indicates relative ST from that baseline.
7.7.8
Changing ST Settings
7.7.8.1
Setting ST Alarm Properties
To set ST alarm properties, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the ST tab → Alarm tab.
3.
Set ST Alarm Mode to Absolute or Relative .
◆ Absolute : you can separately set the alarm properties for each ST alarm for each lead.
◆ Relative : you can set the alarm properties for ST Single and ST Dual alarms.
4.
Set ST alarm properties.
7 - 18 BeneVision N1 Patient Monitor Operator’s Manual
7.7.8.2
Changing Leads for ST Display
The monitor automatically selects the three most deviated leads for ST display. You can also manually select the leads. To do so, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the ST tab → select the Setup tab.
3.
Set ST Segment . You can select up to 3 leads.
7.7.8.3
Showing ISO Point, J Point, and ST Point Markers
In the waveform area, the ISO point, J point, and ST point marker do not display on the ST segments by default.
To display these markers, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the ST tab
→
select the Setup tab.
3.
Switch on Show Markers .
7.7.9
Adjusting ST Measurement Points
7.7.9.1
About ST Point, ISO Point, and J Point
The ST deviation value for each beat is the potential difference between the isoelectric (ISO) point and the ST point. The ISO point provides the baseline. The ST point is located between the J point and the start of the Twave. The J point is the end of the QRS complex. As the ST point is at a fixed distance away from the J point (40,
60, 80 etc msec), manually adjusting the J point helps you correctly position the ST point.
R
P
(1) (2) (3) T (4)
Q
(1) ISO point (2) J point
S
(3) ST point (4) ST deviation
7.7.9.2
Setting ST Point, ISO Point, and J Point
CAUTION
•
If Auto Adjust is Off, or if the patient's heart rate or ECG morphology changes significantly, the ISO and ST points need to be occasionally adjusted because this may affect the QT interval and thus the location of the ST point. False ST segment depression or elevation may occur if the isoelectric point or the ST point is incorrectly set.
•
Always ensure that the locations of ST points are appropriate for the patient.
To set the ST point, ISO point, and J point, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the ST tab → select the Adjust tab.
3.
Set ST Point .
The setting for Auto Adjust defines the method of adjusting the ISO and J point locations. Auto Adjust is enabled by default. In this case, the locations of the ISO point and J point are automatically determined by the
BeneVision N1 Patient Monitor Operator’s Manual 7 - 19
7.8
7.8.1
7.8.2
algorithm. When Auto Adjust is disabled, you need to manually adjust the position of the ISO point and J point using the arrows at the right sides of ISO and J .
■
■
■
The ISO point (isoelectric) location shown is relative to the R-wave peak. Position the ISO point in the middle of the flattest part of the waveform (between the P and Q waves).
The J point location is indicated relative to the R-wave peak. Position the J point at the end of the QRS complex and the beginning of the ST segment.
The ST point is positioned a fixed distance from the J point. Position the ST point relative to the J point at
J+60/80ms , J+40ms , J+60ms or J+80ms . When J+60/80ms is selected, the ST point will be positioned 80 ms (heart rate 120 bpm or less) or 60 ms (heart rate more than 120 bpm) from the J point.
QT/QTc Interval Monitoring
The QT interval is the time between the beginning of the Q-wave and the end of the T-wave. It represents the total duration of the depolarization (QRS duration) and repolarization (ST-T) phases of the ventricles. QT interval monitoring can assist in the detection of long QT syndrome.
The QT interval has an inverse relationship to heart rate. Faster heart rates shorten QT interval and slower heart rates prolong QT interval. Therefore, several formulas are commonly used to correct the QT interval for heart rate. The heart rate corrected QT interval is abbreviated as QTc.
QT/QTc interval monitoring is intended for adult, pediatric, and neonatal patients.
QT/QTc Monitoring Limitations
Some conditions may make it difficult to achieve reliable QT/QTc monitoring, for example:
■
■
■
■
■
■
■
■
R-wave amplitudes are too low
The presence of frequent ventricular ectopic beats
RR intervals are unstable
P-waves tending to encroach on the end of the previous T-wave at high heart rates
The T-wave is very flat or T-wave are not well defined
The end of the T-wave is difficult to delineate because of the presence of U-waves
QTc measurements are not stable
In the presence of noise, asystole, ventricular fibrillation, atrial fibrillation, or ECG lead off
For reliable QT/QTc monitoring, choose lead with good T-wave amplitude and no visible flutter activity, and without a predominant U-wave or P-wave.
Some conditions such as left or right bundle branch block or ventricular hypertrophy can lead to a widened QRS complex. If a long QTc is observed you should verify it to ensure that it is not caused by QRS widening.
Because normal beats followed by ventricular beats are not included in the analysis, no QT measurement will be generated in the presence of a bigeminy rhythm.
If the heart rate is extremely high (over 150 bpm for adults and over 180 bpm for pediatrics and neonates), QT will not be measured. When the heart rate changes, it can take several minutes for the QT interval to stabilize. For reliable QTc calculation it is important to avoid measurements when the heart rate is changing.
Enabling QT/QTc Monitoring
The QT monitoring function is disabled by default. Before you start QT monitoring, enable the QT function. To do so, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the QT tab → select the Setup tab.
3.
Switch on QT Analysis .
7 - 20 BeneVision N1 Patient Monitor Operator’s Manual
7.8.3
7.8.4
Displaying QT Numerics and Segments
To display QT numerics and Segments, follow this procedure:
1.
Access Tile Layout by either of the following ways:
◆ Select the Screen Setup quick key
→
select the Tile Layout tab.
◆
Select Main Menu quick key
→ from the Display column select Tile Layout .
2.
Click the parameter numeric area where you want to display the QT numerics, and then select ECG
→
QT/
QTc .
NOTE
•
QTc values are calculated based on the QT-HR, not the ECG HR. To view the QT-HR, open the QT View.
For more information, see
The following picture shows the QT numeric area. The monitor screen may look slightly different:
(3)
(2)
(4)
(5)
(1 )
(6)
(1) QTc alarm limit (if QTc alarm is off, the alarm off symbol is displayed)
(2) Parameter label (3) QTc value
(4) ΔQTc value (the difference between the current and baseline QTc values)
(5) QT value (6) QT-HR value
Entering
the
QT View
QT View shows the current and baseline QT parameter values and waveforms. To enter QT View, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the QT tab.
3.
Select QT View .
The following picture shows a typical QT view.
■
■
The current waveform is shown in the upper half in green.
The baseline waveform is shown below in white.
BeneVision N1 Patient Monitor Operator’s Manual 7 - 21
7.8.5
■
■
■ The waveform of selected lead is highlighted, while the waveforms of other leads are in light green or light gray.
The start of the QRS complex and the end of the T wave are marked with a vertical line.
In some conditions, no QT measurement can be made. Then the cause of failed QT measurement is shown at the bottom of the QT numerics area and the message “Cannot Analyze QT” is shown in the technical alarm area.
Select the left or right arrow to switch leads, and the corresponding waveform will be highlighted.
Saving the Current QTc as Baseline
In order to quantify changes in the QTc value, you can set a QTc baseline. If no baseline has been set for this patient within the first five minutes after getting valid QT values, the monitor will automatically set a baseline. To set the current values as baseline, follow this procedure:
1.
From the QT View , select Set Baseline .
2.
From the pop-up dialog box, select Ok . This baseline will then be used to calculate ΔQTc.
If you set a new baseline the previous baseline is discarded.
From the QT View , you can also perform the following operations:
■ Select the left or right arrow to select a lead label to highlight corresponding waveform.
■ Select Display Baseline or Hide Baseline to display or hide the baseline waveform.
CAUTION
•
Updating QTc baseline affects the ΔQTc value and alarm.
7.8.6
Changing QT Settings
7.8.6.1
Setting QT Alarm Properties
To set QT alarm properties, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the QT tab
→
select the Alarm tab.
3.
Set QTc and ΔQTc alarm properties.
7.8.6.2
Selecting Leads for QT Calculation
You can select one lead or all leads for QT calculation. To do so, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the QT tab → select the Setup tab.
3.
Set QT Leads . All is selected by default. This means all leads are used for QT calculation.
7.9
7.9.1
ECG Relearning
Changes in ECG beat morphology could result in incorrect arrhythmia alarms and/or inaccurate heart rate. ECG relearning allows the monitor to learn the new dominant beat morphology and thus reduce false arrhythmia alarms and inaccurate HR values. Once learning is complete, the dominant QRS complex is stored as a reference template. The reference template is used as the normal morphology of that patient and it is compared with incoming beats to identify possible arrhythmias.
Auto ECG Relearning
Auto arrhythmia relearning happens in the following situation:
■ The ECG lead type or lead label is changed.
7 - 22 BeneVision N1 Patient Monitor Operator’s Manual
7.9.2
■
■
ECG leads are off and are not reconnected within 60 seconds.
The patient‘s paced status is changed.
Initiating an ECG Relearning Manually
If you suspect that false arrhythmia alarms are presented, you may need to manually initiate an ECG relearn. To do so, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select Relearn .
CAUTION
•
Initiate ECG relearning only during periods of predominantly normal rhythm and when the ECG signal is relatively noise-free. If ECG learning takes place during arrhythmias, the ectopic beats may be incorrectly learned as normal QRS complexes. This may result in missed detection of subsequent arrhythmia events.
7.10
Defibrillation Synchronization Pulse Output
The 12-lead N1 monitor provides an analog out connector to output synchronization pulses for defibrillators. If a defibrillator is connected, it receives a synchronization pulse (100 ms, +5 V) through the multifunction connector each time an R-wave is detected. The 3/5/6 lead N1 monitor does not offer this output.
WARNING
•
According to IEC 60601-2-4: 2010, the peak of the synchronized defibrillator discharge should be delivered within 60 ms of the peak of the R wave. The signal at the ECG output (sync pulse) on the monitor is delayed by maximum of 30 ms. the biomedical engineer should verify that the ECG/
Defibrillator combination does not exceed recommended maximum delay of 60 ms.
•
Before defibrillation, ensure that both defibrillator and monitor have passed the system test and can be safely used together.
7.11
ECG Troubleshooting
This section lists some of the problems that might be encountered during ECG monitoring. If you encounter problems when using the monitor or accessories, check the table below before requesting for services. If the problem persists after you have taken corrective actions, contact the service personnel.
NOTE
•
For the physiological and technical alarm messages, see
.
Problem
Noisy ECG traces
Excessive electrosurgical Interference
Muscle Noise
Corrective Actions
1. Check that the electrodes are not detached or dry. Replace with fresh and moist electrodes if necessary.
2. Check that leadwires are not defective. Replace leadwires if necessary.
3. Check that the patient cable or leadwires are not routed too close to other electrical devices. Move the patient cable or leadwires away from electrical devices and their cables if necessary.
Use ESU-proof ECG cables.
For more information, see
Inadequate skin preparation, tremors, tense subject, and/or poor electrode placement.
1. Perform skin preparation again and re-place the electrodes. For more
.
2. Apply fresh, moist electrodes. Avoid muscular areas.
BeneVision N1 Patient Monitor Operator’s Manual 7 - 23
Problem
Intermittent Signal
Excessive alarms: heart rate, lead fault
Low Amplitude ECG Signal
No ECG Waveform
Base Line Wander
Corrective Actions
1. Check that cables are properly connected.
2. Check that electrodes are not detached or dry. Perform skin preparation again as described in
7.4.1 Preparing the Patient Skin
and apply fresh and moist electrodes.
3. Check that the patient cable or leadwires are not damaged. Change them if necessary.
1. Check that electrodes are not dry. Perform skin preparation again and re-place the electrodes. For more information, see
Patient Skin and 7.4.2 Applying Electrodes and Connecting the Patient
.
2. Check for excessive patient movement or muscle tremor. Reposition the electrodes. Replace with fresh and moist electrodes if necessary.
1. Check that the ECG gain is not set too low. Adjust the gain as required.
For more information, see 7.5.3.2 Changing ECG Waveform Size .
2. Perform skin preparation again and re-place the electrodes. For more information, see
7.4.1 Preparing the Patient Skin
and
Electrodes and Connecting the Patient
.
3. Check electrode application sites. Avoid bone or muscular area.
4. Check that electrodes are not dry or used for a prolonged time. Replace with fresh and moist electrodes if necessary.
1. Check that the ECG gain is not set too low. Adjust the gain as required.
For more information, see 7.5.3 Changing ECG Wave Settings .
2. Check that the leadwires and patient cables are properly connected.
3. Change cable and lead wires if necessary.
4. Check that the patient cable or leadwires are not damaged. Change them if necessary.
1. Check for excessive patient movement or muscle tremor. Secure leadwires and cable.
2. Check that electrodes are not detached or dry and replace with fresh and
.
3. Check for ECG filter setting. Set ECG Filter mode to Monitor to reduce baseline wander on the display.
7 - 24 BeneVision N1 Patient Monitor Operator’s Manual
8
Resting 12-Lead ECG Analysis
8.1
8.2
Resting 12-Lead ECG Analysis Introduction
The monitor can be configured with the Glasgow 12-lead resting ECG analysis algorithm. The monitor incorporating the Glasgow algorithm is labeled with the logo of Glasgow as shown in 7.1 ECG Introduction .
The Glasgow algorithm is intended for adult, pediatric, and neonatal patients.
Entering the 12-Lead Screen
To enter the 12-Lead screen, follow this procedure:
1.
Select the ECG numeric area or waveform area to enter the ECG dialog.
2.
From the bottom of the ECG dialog, select 12-Lead .
You can also enter the 12-Lead screen by following this procedure:
■
■
Select the Screen Setup quick key
→
select the Choose Screen tab
→
select ECG 12-Lead .
Select Main Menu quick key
→ from the Display column select Choose Screen
→
select ECG 12-Lead .
NOTE
•
The ECG 12-Lead screen is available only when the Glasgow algorithm is configured (associated module has the Glasgow label) and Lead Set is set to Auto or 12-Lead.
8.3
8.4
8.4.1
8.4.2
Initiating Resting 12-Lead ECG Analysis
Before initiating 12-lead ECG analysis, check that all electrodes are correctly connected to the lead wires and the
ECG trunk cable is properly connected. Check that patient information is correct. Keep the patient still.
To initiate 12-Lead ECG analysis, select Analyze from the bottom left of the 12-Lead screen.
Changing 12-Lead ECG Analysis Settings
On the ECG 12-Lead screen, you can set the high frequency filter, baseline drift removal (BDR) filter, and the waveform layout.
Setting the High Frequency Filter
The high frequency filter attenuates muscle artifact by restricting the included frequencies. The setting of the high frequency filter is 35 Hz by default. To change the setting, follow this procedure:
1.
On the ECG 12-Lead screen, select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the Setup tab.
3.
Set High-Freq Cut-off .
The high frequency filter is a low-pass filter. That is to say, signal frequencies higher than the set frequency are filtered out. For example, if you set High-freq Cutoff to 35 Hz , then signal below 35 Hz is kept in the signal and signal exceeding 35 Hz is attenuated.
Setting the Baseline Drift Removal Filter
The baseline drift removal (BDR) filter suppresses most baseline drift interference and also is able to preserve the fidelity of the ST-segment level. BDR is switched on by default. To set the BDR, follow this procedure:
1.
On the ECG 12-Lead screen, select the ECG numeric area or waveform area to enter the ECG dialog.
BeneVision N1 Patient Monitor Operator’s Manual 8 - 1
2.
Select the Setup tab.
3.
Switch on or off Baseline Drift Removal as desired. If BDR is switched off, the 0.05 Hz high pass filter is used.
NOTE
•
BDR introduces around 1-second delay. Using BDR is recommended except when the delay is unacceptable.
8.4.3
8.4.4
Setting the 12-Lead Waveform Layout
To set the 12-lead waveform layout, follow this procedure:
1.
On the ECG 12-Lead screen, select the ECG numeric area or waveform area to enter the ECG dialog.
2.
Select the Setup tab.
3.
Set Waveform Layout .
◆ Standard : the waveform sequence is I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6.
◆ Cabrera : the waveform sequence is aVL, I, -aVR, II, aVF, III, V1, V2, V3, V4, V5, V6.
For the Glasgow algorithm, the sequence of the chest leads depends on the setting of V3 Placement . If V3 placement is set to V4R , the sequence of chest leads is V4R, V1, V2, V4, V5, V6.
Editing Patient Information
Some patient information may directly affect ECG analysis. Complete and correct patient information is helpful for accurate diagnosis and treatment of the patient. Enter patient information before starting a resting ECG analysis.
To enter patient information, follow this procedure:
1.
On the ECG 12-Lead screen, select Setup to enter the 12-Lead Setup dialog.
2.
On the Patient Demographics page, input or edit patient information.
NOTE
•
Saving information will also save the information as though it was entered in the Patient
Management dialog.
•
Changes are not saved until you press Save. So changing to another tab without saving and then pressing the exit button “X” will lose any changes.
•
Check that patient information is correct before starting a resting 12-lead analysis.
•
Using pediatric lead placement V4R, V1, V2, V4 - V6 is recommended if the patient is under 16 years of age. Please record V4R using the V3 electrode. Also set V3 Electrode to V4R. This is a normal practice for a patient of this age.
8.4.5
Setting Tachycardia and Bradycardia Thresholds
To set tachycardia and bradycardia thresholds, follow this procedure:
1.
On the ECG 12-Lead screen, select Setup to enter the 12-Lead Setup dialog.
2.
Select the Setup tab.
3.
Set Tachy and Brady .
NOTE
•
The tachycardia threshold only applies to patients whose age exceeds 180 days.
•
The bradycardia threshold only applies to patients whose age exceeds 2191 days (6 years).
8 - 2 BeneVision N1 Patient Monitor Operator’s Manual
8.4.6
8.5
8.6
8.7
Setting the 12-Lead Interpretation Report
To set the 12-lead interpretation report, follow this procedure:
1.
On the ECG 12-Lead screen, select Setup to enter the 12-Lead Setup dialog.
2.
Select the Report tab.
3.
Set the format and items included in the 12-lead interpretation report.
Saving the 12-Lead Interpretation Report
At the completion of 12-lead ECG interpretation, select Save to save the report. You can review the saved 12-
lead interpretation reports. For more information, see 15.2.10 12-Lead ECG Review Page .
Printing the 12-Lead Interpretation Report
At the completion of 12-lead ECG interpretation, select Print to output the report via the printer.
Exiting the ECG 12-Lead Screen
To exit the ECG 12-Lead screen, select Exit on the ECG 12-Lead screen.
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8 - 4 BeneVision N1 Patient Monitor Operator’s Manual
9
Monitoring Impedance Respiration (Resp)
9.1
9.2
Resp Introduction
Impedance respiration is measured across the thorax. When the patient is breathing or ventilated, the volume of air changes in the lungs, resulting in impedance changes between the electrodes. Impedance respiration rate
(RR) is calculated from the signal representing these impedance changes, and a respiration waveform is displayed on the patient monitor screen.
Impedance respiration monitoring is intended for adult, pediatric and neonatal patients.
Respiration may also be measured using a CO
2
module. Refer to 14 Monitoring Carbon Dioxide (CO
2)
for respiration information specific to the CO
2
module.
Impedance Resp Safety Information
WARNING
•
When monitoring the patient’s impedance respiration, do not use ESU-proof ECG cables. The monitor cannot measure impedance respiration with ESU-proof ECG cables.
•
If you do not set the detection level for the respiration correctly in manual detection mode, it may not be possible for the monitor to detect zero respiration rate. If you set the detection level too low, the monitor is more likely to detect cardiac activity, and to falsely interpret cardiac activity as respiratory activity in case of zero respiration rate.
•
The respiration measurement does not recognize the cause of zero respiration rates. It only indicates an alarm if a pre-adjusted time has elapsed without a breath being detected since the last detected breath. Therefore, it cannot be used for diagnostic purpose.
•
If operating under conditions according to the EMC Standard IEC 60601-1-2 (Radiated Immunity 3V/ m), field strengths above 3V/m may cause erroneous measurements at various frequencies.
Therefore, it is recommended to avoid the use of electrically radiating equipment in close proximity to the impedance respiration measurement unit.
•
The current used to measure impedance respiration may cause rate changes in Minute Ventilation
Rate Responsive Pacemakers. If you suspect the patient monitor is affecting the pacemaker rate then replace the ECG cable with an ECG cable that contains ESU filters.
CAUTION
•
Only use parts and accessories specified in this manual.
•
Impedance respiration monitoring is not for use on patients while they are active, as this can cause false alarms.
BeneVision N1 Patient Monitor Operator’s Manual 9 - 1
9.3
Resp Display
(1) (2) (3) (4) (5)
(1) Resp waveform gain
(4) Respiration rate (RR)
(2) Resp lead label
(5) RR source
(3) Alarm limits
NOTE
•
If ESU-proof ECG cables are used, the Resp waveform area will display the message “Check Leads”.
Replace the ECG cable if necessary.
9.4
9.4.1
Preparing for Impedance Resp Monitoring
Preparing the Patient
Follow this procedure to prepare the patient:
1.
Shave hair from skin at chosen sites.
2.
Gently rub skin surface at sites to remove dead skin cells.
3.
Thoroughly cleanse the site with a mild soap and water solution.
4.
Dry the skin completely before applying the electrodes.
CAUTION
•
Proper skin preparation is necessary for good signal quality at the electrode site, as the skin is a poor conductor of electricity.
9 - 2 BeneVision N1 Patient Monitor Operator’s Manual
9.4.2
Placing the Electrodes
Impedance respiration is acquired using standard ECG electrodes and cables. Either lead I (RA-LA) or lead II (RA-
LL) can be used.
For more information, see 7.4.4 ECG Electrode Placements .
(1) (2)
(1) Lead I (2) Lead II
CAUTION
•
Correct electrode placement can help to reduce interference from cardiac related impedance changes: avoid including the liver area and the ventricles of the heart between the respiratory electrodes. This is particularly important for neonates.
•
Some patients with restricted movements breathe mainly abdominally. In these cases, you may need to place the left leg electrode on the left abdomen at the point of maximum abdominal expansion to optimize the respiratory waveform.
•
Some patients (especially neonates) expand their chests laterally, causing a negative intrathoracic pressure. In these cases, it is better to place the two respiration electrodes in the right midaxillary and the left lateral chest areas at the patient’s maximum point of the breathing movement to optimize the impedance respiration waveform.
•
To optimize the impedance respiration waveform, place the RA and LA electrodes horizontally when monitoring respiration with ECG Lead I; place the RA and LL electrodes diagonally when monitoring respiration with ECG Lead II.
•
Periodically inspect electrode application sites to ensure skin integrity. If the skin quality changes, replace the electrodes or change the application site.
NOTE
•
Store the electrodes at room temperature. Open the electrode package immediately prior to use.
•
Check that the electrode packages are intact and that the electrodes are not past the expiration date. Ensure the electrode gel is moist.
BeneVision N1 Patient Monitor Operator’s Manual 9 - 3
9.5
9.5.1
9.5.2
9.5.3
9.5.4
9.5.5
Changing Resp Settings
Setting the Resp Alarm Properties
To set the Resp alarm properties, follow this procedure:
1.
Select the Resp numeric area or waveform area to enter the Resp dialog.
2.
Select the Alarm tab.
3.
Enter the password if required. For more information, refer to
21.13.3 Selecting Password for User Authentication .
4.
Set alarm properties as desired.
Setting the RR Source
To set RR source, follow this procedure:
1.
Select the Resp numeric area or waveform area to enter the Resp dialog.
2.
Select the Setup tab.
3.
Choose RR Source from the dropdown list.
When you select Auto , the monitor automatically selects the RR source following order of priority: first CO2 , and then ECG . When the manually selected RR source is not available, the monitor automatically switches the RR
Source to Auto .
Choosing the Respiration Lead
To set the respiration lead, follow this procedure:
1.
Select the Resp numeric area or waveform area to enter the Resp dialog.
2.
Select the Setup tab.
3.
Set Resp Lead .
If you cannot get an acceptable impedance Resp waveform or you suspect the veracity of the Resp value after choosing the Resp lead, you may need to adjust the electrode placement.
Setting the Resp Waveform Size
To set the Resp waveform size, follow this procedure:
1.
Select the Resp numeric area or waveform area to enter the Resp dialog.
2.
Select the Setup tab.
3.
Set Gain .
Setting the Resp Waveform Speed
To set the Resp waveform speed, follow this procedure:
1.
Select the Resp numeric area or waveform area to enter the Resp dialog.
2.
Select the Setup tab.
3.
Set Speed .
9 - 4 BeneVision N1 Patient Monitor Operator’s Manual
9.5.6
9.5.7
Setting the Auto Detection Switch
To set the auto detection switch, follow this procedure:
1.
Select the Resp numeric area or waveform area to enter the Resp dialog.
2.
Select the Setup tab.
3.
Switch on or off Auto Threshold Detection .
◆ If Auto Threshold Detection is switched on, the monitor automatically adjusts the Resp waveform detection level, or threshold.
◆ If Auto Threshold Detection is switched off, you have to manually adjust the Resp waveform threshold. For more information, see
9.5.7 Adjusting the Resp Waveform Detection Threshold
.
In the auto threshold detection mode, if you are monitoring Resp and the ECG parameter is switched off, the monitor cannot compare the heart rate and Resp rates to detect cardiovascular artifact. The respiration detection level is automatically set higher to prevent the detection of cardiovascular artifact as respiration.
In the manual detection mode (where auto threshold detection is off ), cardiovascular artifact can, in certain situations, trigger the respiration rate counter. This may lead to a false indication of a high respiration or an undetected zero respiration rate condition. If you suspect that cardiovascular artifact is being registered as respiratory activity, raise the detection level above the zone of cardiovascular artifact. If the Resp wave is so small that raising the detection level is not possible, you may need to optimize the electrode placement.
Adjusting the Resp Waveform Detection Threshold
■
■
■
Use the manual detection mode (where auto threshold detection is off ) in the following situations:
The respiration rate and the heart rate are close.
Patients have intermittent mandatory ventilation.
Respiration is weak. Try repositioning the electrodes to improve the signal.
To set the Resp waveform threshold to the desired level, follow this procedure:
1.
Select the Resp numeric area or waveform area to enter the Resp dialog.
2.
Select the Threshold tab.
3.
Select the up and down arrows below Upper Line and Lower Line to define the Resp waveform threshold.
Once set, the detection level will not adapt automatically to different respiration depths. It is important to remember that if the depth of breathing changes, you may need to change the detection level.
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9 - 6 BeneVision N1 Patient Monitor Operator’s Manual
10
Monitoring Pulse Oxygen Saturation (SpO
2
)
10.1
SpO
2
Introduction
Pulse Oxygen Saturation (SpO
2
) monitoring is a non-invasive technique used to measure the amount of oxygenated hemoglobin and pulse rate by measuring the absorption of selected wavelengths of light. The light generated in the emitter side of the probe is partly absorbed when it passes through the monitored tissue. The amount of transmitted light is detected in the detector side of the probe. When the pulsative part of the light signal is examined, the amount of light absorbed by the hemoglobin is measured and the pulse oxygen saturation can be calculated. This device is calibrated to display functional oxygen saturation.
SpO
2
monitoring is intended for adult, pediatric and neonatal patients.
The monitor can be configured with Masimo SpO
2 or Nellcor SpO
2
:
■
■
Masimo SpO
2
: the connector is purple and the logo of Masimo SET is on the monitor.
Nellcor SpO
2
: the connector is grey and the logo of Nellcor is on the monitor.
NOTE
•
The SpO
2
extension cable used must be compatible with the SpO
2 sensor connectors used. For example, only the Masimo SpO
2
extension cable can be connected to the Masimo SpO
2
sensor connectors.
•
Measurement accuracy verification: The SpO
2
accuracy has been verified in human experiments by comparing with arterial blood sample reference measured with a CO-oximeter. Pulse oximeter measurement are statistically distributed and about two-thirds of the measurements are expected to come within the specified accuracy range compared to CO-oximeter measurements.
•
A functional tester or SpO
•
A functional tester or SpO
2
simulator can be used to determine the pulse rate accuracy.
2
simulator cannot be used to assess the SpO
2
accuracy.
BeneVision N1 Patient Monitor Operator’s Manual 10 - 1
10.2
SpO
2
Safety Information
WARNING
•
When a trend toward patient deoxygenation is indicated, analyze the blood samples with a laboratory co-oximeter to completely understand the patient’s condition.
•
Do not use SpO
2
sensors during magnetic resonance imaging (MRI). Induced current could potentially causes burns. The sensor may affect the MRI image, and the MRI unit may affect the accuracy of the oximetry measurements.
•
Prolonged continuous monitoring may increase the risk of undesirable changes in skin characteristics, such as irritation, reddening, blistering or burns. Inspect the sensor site every two hours and move the sensor if the skin quality changes. Change the application site every four hours.
For neonates, or patients with poor peripheral blood circulation or sensitive skin, inspect the sensor site more frequently.
•
If the sensor is too tight because the application site is too large or becomes too large due to edema, excessive pressure for prolonged periods may result in venous congestion distal from the application site, leading to interstitial edema and tissue ischemia.
•
When patients are undergoing photodynamic therapy they may be sensitive to light sources. Pulse oximetry may be used only under careful clinical supervision for short time periods to minimize interference with photodynamic therapy.
•
Setting alarm limits to extreme values may cause the alarm system to become ineffective. For example, high oxygen levels may predispose a premature infant to retrolental fibroplasia. If this is a consideration, do not set the high alarm limit to 100%, which is equivalent to switching off the alarm.
•
SpO
2
is empirically calibrated in healthy adult volunteers with normal levels of carboxyhemoglobin
(COHb) and methemoglobin (MetHb).
•
To protect from electric shock, always remove the sensor before bathing the patient.
•
The pulse oximetry function of the bedside monitor should not be used for apnea monitoring.
•
The pulse oximetry function of the bedside monitor should not be used for arrhythmia analysis.
CAUTION
•
Change the application site or replace the sensor and/or patient cable when a persistent SpO2 Low
Signal Quality message is displayed on the equipment. These messages may indicate that patient monitoring time is exhausted on the patient cable or sensor.
•
Replace the cable or sensor when a “SpO2 Sensor Off”, “SpO2 No Sensor”, or “SpO2 Low Signal
Quality” message is consistently displayed while monitoring consecutive patients after completing troubleshooting steps listed in this manual.
•
Variation in measurements may be profound and may be affected by sampling technique as well as the patient's physiological conditions. Any results exhibiting inconsistency with the patient’s clinical status should be repeated and/or supplemented with additional test data. Blood samples should be analyzed by laboratory instruments prior to clinical decision making to completely understand the patient’s condition.
•
Use only SpO
2
sensors specified in this manual. Follow the SpO
2
sensor’s instructions for use and adhere to all warnings and cautions.
•
Do not place the patient monitor where the controls can be changed by the patient.
•
If using pulse oximetry during full body irradiation, keep the sensor out of the radiation field. If the sensor is exposed to the radiation, the reading might be inaccurate or the device might read zero for the duration of the active irradiation period.
NOTE
•
Additional information specific to the Masimo sensors compatible with the equipment, including information about parameter/measurement performance during motion and low perfusion, may be found in the sensor's directions for use (DFU).
10 - 2 BeneVision N1 Patient Monitor Operator’s Manual
•
Masimo cables and sensors are provided with X-Cal™ technology to minimize the risk of inaccurate readings and unanticipated loss of patient monitoring. Refer to the Cable or Sensor DFU for the specified duration of the patient monitoring time.
10.3
SpO
2
Measurement Limitations
The following factors may influence the accuracy of SpO
2
measurement:
■ Patient physiological characteristics:
◆ Cardiac arrest
◆ Hypotension
◆ Darkly pigmented skin
◆ Shock
◆ Severe vasoconstriction
◆ Hypothermia
◆ Severe anemia
◆ Ventricular septal defects (VSDs)
◆ Venous pulsations
◆ Poor perfusion
◆ Dysfunctional hemoglobin, such as carboxyhemoglobin (COHb) and methemoglobin (MetHb)
◆ Elevated levels of bilirubin
◆ Vasospastic disease, such as Raynaud’s, and peripheral vascular disease
◆ Hemoglobinopathies and synthesis disorders such as thalassemias, Hb s, Hb c, sickle cell, etc.
◆ Hypocapnic or hypercapnic conditions
◆ Birthmark(s), tattoos, skin discolorations, moisture on skin, deformed or abnormal fingers. etc.
■
■
Interfering substances:
◆ Intravascular dyes (such as indocyanine green, methylene blue, indigo carmine, etc.)
◆
Dyes in the measure site, such as nail polish
Environmental conditions:
■
◆ Excessive ambient light
◆
Electrosurgery equipment
◆ Defibrillation (may cause inaccurate reading for a short amount of time)
◆ Excessive patient/sensor motion
◆
Electromagnetic field
◆ Arterial catheters and intra-aortic balloon
Others
◆
Inappropriate positioning of the SpO
2
sensor, or use of incorrect SpO
2
sensor
◆ Cuff or arterial blood pressure measurement device on the same limb as the SpO
2
sensor
10.4
SpO
2
Display
(4)
(5)
(1) (2) (3)
BeneVision N1 Patient Monitor Operator’s Manual 10 - 3
(1) Pleth waveform (Pleth): visual indication of patient’s pulse. The waveform is not normalized.
(2) Oxygen saturation of arterial blood (SpO
2
): percentage of oxygenated hemoglobin in relation to the sum of oxyhemoglobin and deoxyhemoglobin.
(3) Perfusion indicator: the pulsatile portion of the measured signal caused by arterial pulsation.
(4)
(5)
Perfusion index (PI): gives the numerical value for the pulsatile portion of the measured signal caused by arterial pulsation. PI is an indicator of the pulsatile strength. You can also use it to assess the SpO
2
signal strength.
Pulse rate (derived from the pleth wave): detected pulsations per minute.
NOTE
•
PI is displayed for Masimo SpO
2
.
10.5
Preparing for SpO
2
Monitoring
To prepare to monitor SpO
2
, follow this procedure:
1.
Select an appropriate sensor according to the module type, patient category and weight.
2.
Clean the contact surface of the reusable sensor.
3.
Remove colored nail polish from the application site.
4.
Apply the sensor to the patient according to the instruction for use of the sensor.
5.
Select an appropriate extension cable according to the connector type and plug the cable into the SpO
2 connector.
6.
Connect the sensor to the extension cable.
CAUTION
•
Do not apply sensor too tightly as this results in venous pulsation which may severely obstruct circulation and lead to inaccurate measurements.
•
At elevated ambient temperatures, be careful with measurement sites that are not well perfused, because this can cause burns after prolonged application.
•
Avoid placing the sensor on extremities with an arterial catheter, an NIBP cuff or an intravascular venous infusion line.
•
For neonatal patients, make sure that all sensor connectors and adapter cable connectors are outside the incubator. The humid atmosphere inside can cause inaccurate measurements.
10.6
Changing the SpO
2
Settings
NOTE
•
The settings of in the SpO
2
module and SpO
2 b module are linked.
10.6.1
Changing the SpO
2
Alarm Settings
To change the SpO
2
alarm settings, follow this procedure:
1.
Select the SpO
2
numeric area or waveform area to enter the SpO2 dialog.
2.
Select the Alarm tab.
3.
Enter the password if required. For more information, refer to 21.13.3 Selecting Password for User
.
4.
Set the alarm properties as desired.
10 - 4 BeneVision N1 Patient Monitor Operator’s Manual
NOTE
•
The desat alarm is a high level alarm notifying you of potentially life threatening drops in oxygen saturation. When the SpO
2
value is below the desat alarm limit and desat alarm switch is set on, the message “SpO2 Desat” is displayed.
•
You can switch off the SpO
2
Desat alarm only when the SpO
2
Desat Alarm Off is enabled. For more information, see section
21.3.6.6 Setting the Switch of the SpO
10.6.2
Nellcor SatSeconds
TM
Alarm Management
With traditional alarm management, high and low alarm limits are set for monitoring oxygen saturation. During monitoring, once an alarm limit is violated, an audible alarm immediately sounds. When the patient SpO
2 fluctuates near an alarm limit, the alarm sounds each time the limit is violated. Such frequent alarms can be distracting. Nellcor’s SatSeconds alarm management technique is used to reduce these nuisance alarms.
The SatSeconds feature is available with the Nellcor SpO
2
to decrease the likelihood of false alarms caused by motion artifacts. With SatSeconds alarm management, high and low alarm limits are set in the same way as those with traditional alarm management. A SatSeconds limit is also set. The SatSeconds limit controls the amount of time that SpO
2
saturation may be outside the set limits before an alarm sounds.
The method of calculation is as follows: the percentage points of the SpO
2
saturation falling outside the alarm limit is multiplied by the number of seconds remaining outside the limit. This can be stated as the equation:
SatSeconds = Points × Seconds
Only when the SatSeconds limit is reached, the monitor gives a SatSeconds alarm. For example, the figure below demonstrates the alarm response time with a SatSeconds limit set at 50 and a low SpO
2
limit set at 90%. In this example, the patient SpO
2
drops to 88% (2 points) and remains there for 2 seconds. Then it drops to 86% (4 points) for 3 seconds, and then to 84% (6 points) for 6 seconds. The resulting SatSeconds are:
% SpO
2
2×
4×
6×
Total SatSeconds=
Seconds
2=
3=
6=
SatSeconds
4
12
36
52
After approximately 11 seconds, a Sat-Second alarm would sound, because the limit of 50 SatSeconds would have been exceeded.
%SpO
2
BeneVision N1 Patient Monitor Operator’s Manual
Seconds
10 - 5
Saturation levels may fluctuate rather than remaining steady for a period of several seconds. Often, the patient
SpO
2
may fluctuate above and below an alarm limit, re-entering the non-alarm range several times. During such fluctuation, the monitor integrates the number of SpO
2
points, both positive and negative, until either the
SatSeconds limit is reached, or the patient SpO
2
re-enters the non-alarm range and remains there.
NOTE
•
The SpO
2
Too Low or SpO
2
Too High alarm is presented in the case that SpO
2
value violates the alarm limits 3 times within one minute even if the setting of SatSeconds is not reached.
To set the SatSeconds, follow this procedure:
1.
Select the SpO
2
numeric area or waveform area to enter the SpO2 dialog.
2.
Select the Alarm tab.
3.
Set Sat-Seconds .
10.6.3
Setting SpO
2
Sensitivity (for Masimo SpO
2
)
For Masimo SpO
2
, selects the Sensitivity as per signal quality and patient motion.
Normal sensitivity is the recommended for patients who are experiencing some compromise in blood flow or perfusion. It is advisable for care areas where patients are observed frequently, such as the intensive care unit
(ICU).
Adaptive Probe Off Detection (APOD) sensitivity is the recommended sensitivity mode where there is a high probability of the sensor becoming detached. It is also the suggested mode for care areas where patients are not visually monitored continuously. This mode delivers enhanced protection against erroneous pulse rate and arterial oxygen saturation readings when a sensor becomes inadvertently detached from a patient due to excessive movement.
Maximum sensitivity is recommended for use on patients with weak signals (e.g. high ambient noise and/or patients with very low perfusion) and for use during procedures or when clinician and patient contact is continuous such as in higher acuity settings.
To set SpO
2
sensitivity, follow this procedure:
1.
Select the SpO
2
numeric area or waveform area to enter the SpO2 dialog.
2.
Select the Setup tab.
3.
Set Sensitivity to Maximum, Normal, or APOD .
CAUTION
•
When using the Maximum Sensitivity setting, performance of "Sensor Off" detection may be compromised. If the equipment and the sensor becomes detached from the patient, the potential for false readings may occur due to environmental noise such as light, and vibration.
•
Configuring the monitor to “Load Latest Configuration” as the default configuration may result in
Masimo SpO
2
being set to Maximum sensitivity mode on power up or after admitting a new patient.
Maximum sensitivity is recommended for use during procedures or when clinician and patient contact is continuous, such as in higher acuity settings. Maximum sensitivity is not recommended for care areas where patients are not monitored visually as “Sensor Off” detection may be compromised. Refer to
Section 20.4 Setting Default Configuration
for managing configuration.
10.6.4
Enabling FastSAT (for Masimo SpO
2
)
FastSAT enables rapid tracking of arterial oxygen saturation changes as may be required in urgent situations.
When FastSAT is switched on, the averaging algorithm evaluates all the SpO
2
values and provides an averaged
SpO
2
value that is a better representation of the patient’s current oxygen saturation status.
The reliability of FastSAT is dependent on the setting for the averaging time and the input signal. FastSAT is disabled by default. To enable FastSAT, follow this procedure:
1.
Select the SpO
2
numeric area or waveform area to enter the SpO2 menu.
2.
Select the Setup tab.
3.
Switch on FastSAT .
10 - 6 BeneVision N1 Patient Monitor Operator’s Manual
10.6.5
Displaying SIQ (for Masimo SpO
2
)
The signal quality indicator (SIQ) displays below the Pleth waveform. The SIQ is conveyed by vertical bars. The height of the bar provides an assessment of the confidence in the displayed SpO
2
value. The SpO be used to identify the occurrence of a patient ‘s pulse.
2
SIQ can also
The following picture shows the SpO
2
SIQ:
(1)
(1) Signal quality indicator (SIQ)
To show SpO
2
SIQ, follow this procedure:
1.
Select the SpO
2
numeric area or waveform area to enter the SpO2 menu.
2.
Select the Setup tab.
3.
Switch on Display SIQ .
10.6.6
Changing Averaging Time (for Masimo SpO
2
)
The SpO
2
value displayed on the monitor screen is the average of data collected within a specific time. The shorter the averaging time is, the quicker the monitor responds to changes in the patient’s oxygen saturation level. Contrarily, the longer the averaging time is, the slower the monitor responds to changes in the patient’s oxygen saturation level, but the SpO
2
measurement is more stable. For critically ill patients, selecting a shorter averaging time will help with understanding the patient’s state.
To set the averaging time, follow this procedure:
1.
Select the SpO
2
numeric area or waveform area to enter the SpO2 dialog.
2.
Select the Setup tab.
3.
Set Averaging .
10.6.7
Monitoring SpO
2
and NIBP Simultaneously
When monitoring SpO
2
SpO
2
and NIBP on the same limb simultaneously, you can switch on NIBP Simul to lock the
alarm status until the NIBP measurement ends. If you switch off NIBP Simul , low perfusion caused by NIBP measurement may lead to inaccurate SpO
2
readings and therefore cause false physiological alarms.
To set the NIBP Simul , follow this procedure:
1.
Select the SpO
2
numeric area or waveform area to enter the SpO2 dialog.
2.
Select the Alarm tab.
3.
Set NIBP Simul .
10.6.8
Changing the Sweep Speed of the Pleth Waveform
To set the sweep speed of Pleth waveform, follow this procedure:
1.
Select the SpO
2
numeric area or waveform area to enter the SpO2 dialog.
2.
Select the Setup tab.
3.
Set Speed .
10.7
Changing the PR Settings
10.7.1
Changing the PR Alarm Settings
To change the PR alarm settings, follow this procedure:
1.
Select the SpO
2
numeric area or waveform area to enter the SpO2 dialog.
2.
Select the PR tab.
BeneVision N1 Patient Monitor Operator’s Manual 10 - 7
3.
Enter the password if required. For more information refer to 21.13.3 Selecting Password for User
.
4.
Set the alarm properties as desired.
10.7.2
Changing the QRS Volume
If the Alarm Source is set to PR , the QRS tone is derived from PR measurements. To set the QRS volume, follow this procedure:
1.
Select the SpO
2
numeric area or waveform area to enter the SpO2 dialog.
2.
Select the PR tab.
3.
Select the Setup tab.
4.
Set QRS Volume .
If the SpO
2
value is valid, the monitor also adjusts the QRS tone (pitch tone) according to the SpO
2
value. For
information, see 21.15.3 Setting the SpO
.
NOTE
•
Changing the QRS volume settings in the PR Setup page also changes the QRS volume settings in the
Setup page of the ECG dialog.
10.7.3
Setting the PR Source
Current pulse source is displayed in the PR numeric area if current PR source is not SpO
2
. The PR from current pulse source has the following characteristics:
■
■
PR is stored in the monitor’s database and can be reviewed in the graphic and tabular trends.In graphic trends, as the PR curve has the same color as that of current PR source.
PR is sent via the network to the CMS, if available.
To set which parameter is used as a PR source, follow this procedure:
1.
Select the SpO
2
numeric area or waveform area to enter the SpO2 dialog.
2.
Select the PR tab.
3.
Select the Setup tab.
4.
Set PR Source .
The dropdown list of the PR Source displays the currently available PR sources from top to bottom by priority.
When you select Auto , the system will automatically select the first option as the PR source. If the current PR source is unavailable, the system will automatically switch PR Source to Auto . When you select IBP , the system will automatically select the first pressure label as the PR source.
10.7.4
Showing/Hiding PR
You can set whether to display the PR value in the SpO
2
parameter area. To do so, follow this procedure:
1.
Select the SpO
2
numeric area or waveform area to enter the SpO2 menu.
2.
Select the PR tab.
3.
Select the Setup tab.
4.
Switch on or off Display PR.
10.8
Displaying SpO
2
Statistics
You can show SpO
2 statistics for a defined period of time. To do so, follow this procedure:
1.
Access the Tile Layout in either of the following ways:
◆
Select the Screen Setup quick key
→ select the Tile Layout tab.
◆ Select the Main Menu quick key
→ from the Display column select Tile Layout .
10 - 8 BeneVision N1 Patient Monitor Operator’s Manual
2.
Select the parameter numeric area where you want to display SpO
2
statistics, and then from the popup list select SpO2
→
SpO2 Statistics .
The following figure shows the SpO
2
statistics area.
(1)
(2)
(3)
(1) Duration of SpO
2 statistics
(2) Results of SpO
2 statistics
(3) Sections for statistics: The section in green indicates the target range.
10.8.1
Selecting the Range of each SpO
2
Section and the Target Section
To define the SpO
2 range of each section, follow this procedure:
1.
Select the SpO
2
statistics area.
2.
In the To column set the SpO2 value at which each section ends. Changing the value in the To column automatically changes the value in the From column of the next section.
3.
In the Target column select the section to be used as the target section. The target section is highlighted in green in the SpO
2
statistics area.
10.8.2
Selecting the SpO
2
Statistics Length
The time period over which the SpO
2
statistics are calculated is configurable. From the SpO
2
statistics area, select a new duration from the popup menu.
10.9
SpO
2
Troubleshooting
This section lists the problems that might occur. If you encounter the problems when using the equipment or accessories, check the table below before requesting service. If the problem persists, contact your service personnel.
NOTE
•
For the physiological and technical alarm messages, see Appendix D Alarm Messages .
Problem
Do not see SpO
2
numeric area or waveform area on the main screen
Solution
1. Check that the SpO
2 is set to display in the Screen Setup
→ →
Tile Layout
page. For more information, see 3.9.2 Displaying
Parameter Numerics and Waveforms
.
2. Check that the SpO
SpO
2
2 parameter switch is enabled. If not, enable the
measurement .
For more information, see
.
3. Check that the cable connections of the SpO
2
sensor and the extension cable are tight. Replace the SpO
2
sensor or the extension cable if needed.
BeneVision N1 Patient Monitor Operator’s Manual 10 - 9
Problem
Dashes “- -” display in place of numerics
Low amplitude SpO
2
signal
SpO
2
value is inaccurate
Solution
1. Check that the cable connections of SpO
2 sensor and the extension cable are tight. Replace the SpO
2
sensor or the extension cable if needed.
2. Reconnect the SpO
2
sensor if the alarm SpO2 Sensor Off appears.
3. Check the PI value. If the PI value is too low, adjust the SpO
2
sensor, or apply the sensor to a site with better perfusion.
4. Move the sensor to a place with weaker ambient light, or cover the sensor to minimize the ambient light if the alarm SpO2 Too Much
Light appears.
1. The SpO
2
sensor and NIBP cuff are placed on the same limb.
Change the monitoring site if necessary.
2. Check the PI value. If the PI value is too low. Adjust the SpO
2
sensor, or apply the sensor to a site with better perfusion.
1. Check the patient’s vital signs.
2. Check for conditions that may cause inaccurate SpO
2
readings. For more information, see
.
3. Check the monitor, the SpO
2
module or the MPM for proper functioning.
10.10
Nellcor Information
Nellcor Patents
This posting serves as notice under 35 U.S.C.§287(a) for Covidien patents: http://www.covidien.com/patents.
No Implied License
Possession or purchase of this device does not convey any express or implied license to use the device with unauthorized replacement parts which would, alone, or in combination with this device, fall within the scope of one or more of the patents relating to this device.
10.11
Masimo Information
Masimo Patents
This posting serves as notice under 35 U.S.C.§287(a) for Masimo patents: http://www.masimo.com/patents.htm.
No Implied License
Possession or purchase of this device does not convey any express or implied license to use the device with unauthorized sensors or cables which would, alone, or in combination with this device, fall within the scope of one or more of the patents relating to this device.
10.12
Masimo End-User License Agreement
THIS DOCUMENT IS A LEGAL AGREEMENT BETWEEN YOU (“PURCHASER”) AND SHENZHEN MINDRAY. IF YOU DO
NOT AGREE TO THE TERMS OF THIS AGREEMENT, PROMPTLY RETURN THE ENTIRE PACKAGE, INCLUDING ALL
ACCESSORIES, IN THEIR ORIGINAL PACKAGE, WITH YOUR SALES RECEIPT TO SHENZHEN MINDRAY FOR A FULL
REFUND.
1.
Grant of License. In consideration of payment of the license fee, which is part of the price paid for this product, Shenzhen Mindray grants to Purchaser a nonexclusive, nontransferable license, without right to sublicense, to use the copy of the incorporated software/firmware, and documentation in connection with
Purchaser's use of the Masimo Products for their labeled purpose. Shenzhen Mindray reserves all rights not expressly granted to Purchaser.
10 - 10 BeneVision N1 Patient Monitor Operator’s Manual
2.
Ownership of Software/Firmware. Title to, ownership of, and all rights and interests in, any Masimo software and/or firmware and the documentation, and all copies thereof, remain at all times vested in
Masimo Corporation, licensor to Shenzhen Mindray, and they do not pass to Purchaser.
3.
Assignment. Purchaser shall not assign or transfer this License, in whole or in part, by operation of law or otherwise, without Shenzhen Mindray's prior written consent; any attempt without such consent, to assign any rights, duties or obligations arising hereunder shall be void.
4.
Copy Restrictions. The software/firmware, mask works, circuit board layouts, and accompanying written materials are copyrighted. Unauthorized copying of the software, including software that has been modified, merged, or included with other software, or other written materials is expressly forbidden. You may be held legally responsible for any copyright infringement that is cause or incurred by your failure to abide by the terms of this license. Nothing in this license provides any rights beyond those provided by 17
U.S.C. §117.
5.
Use Restriction. As the Purchaser, you may physically transfer the products from one location to another provided that the software/firmware is not copied. You may not electronically transfer the software/ firmware from the products to any other device. You may not disclose, publish, translate, release distribute copies of, modify, adapt, translate, reverse engineer, decompile, disassemble, or create derivative works based on the Masimo Product, the software/firmware, or the written materials without the prior written consent of Masimo. Masimo Sensors that are designated for single use are licensed under Masimo patents for use on a single patient only, and are not sold. There is no license, implied or otherwise, that would allow use of single use Masimo Sensors beyond their intended single use. After use of single use Masimo Sensors, there is no further license granted by Masimo to use the sensors and they must be discarded.
6.
Transfer Restrictions. The software/firmware is licensed to the Purchaser, and may not be transferred to anyone, except other end-users, without the prior written consent of Shenzhen Mindray. In no event may you transfer, assign, rent, lease, sell, or otherwise dispose of the software/firmware or the products on a temporary basis.
7.
Beneficiary. Masimo Corporation is a Beneficiary of this Agreement and has the right to enforce its provisions.
U.S. Government Rights: If you are acquiring software (including the related documentation) on behalf of any part of the United States Government, the following provisions apply: the software is deemed to be “commercial software” and “commercial computer software documentation,” respectively pursuant to DFAR Section 227.7202
FAR 12.212, as applicable. Any use, modification, reproduction, release, performance, display or disclosure of the software (including the related documentation) by the U.S. Government or any of its agencies shall be governed solely by the terms of this Agreement and shall be prohibited except to the extent expressly permitted by the terms of this agreement.
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11
Monitoring Temperature (Temp)
11.1
Temperature Introduction
The monitor can continuously monitor the patient’s skin temperature and core temperature. Thermally sensitive resistors (thermistors) are used, and are based on the principle that electrical resistance of the thermistor changes as temperature changes. The resistance change of the thermistors is used to calculate the temperature.
Up to two temperature sites can be monitored simultaneously and the difference between two measured sites is calculated.
Temperature monitoring is intended for adult, pediatric and neonatal patients.
11.2
.
Temperature Safety Information
CAUTION
•
Verify that the probe detection program works correctly before monitoring. Remove the temperature probe cable from the temperature probe connector, and check that the monitor can display the alarm messages and give alarm tones correctly.
11.3
Temperature Display
The following figure shows the Temp numeric area for temperature monitoring with the monitor. Your display may be configured to look different.
(3)
(1)
(2)
(1)
(2) (4)
(3)
(1) Temperature site ( 2 ) Temperature alarm limits (3) Temperature value
(4) Temperature difference (
∆
T): Difference between two temperature sites. It displays only when
∆
T is switched on.
11.4
Preparing for Temperature Monitoring
To prepare temperature monitoring, follow this procedure:
1.
Select an appropriate probe for your patient according to patient category and measured site.
2.
Plug the probe or temperature cable to the temperature connector. If using a disposable probe, connect the probe to the temperature cable.
3.
Follow the probe manufacturer’s instructions to connect the probe to the patient.
BeneVision N1 Patient Monitor Operator’s Manual 11 - 1
11.5
Changing Temperature Settings
11.5.1
Setting the Temperature Alarm Properties
To set the temperature alarm properties, follow this procedure:
1.
Select the temperature numeric area to enter the Temp dialog.
2.
Select the Alarm tab.
3.
Enter the password if required. For more information, refer to 21.13.3 Selecting Password for User
.
4.
Set the alarm properties as desired.
11.5.2
Selecting the Temperature Label
Select the temperature label according to the measurement site. To do so, follow this procedure:
1.
Select the temperature numeric area to enter the Temp dialog.
2.
Select the Setup tab.
3.
Set the temperature label.
Label
T1
T2
T skin
T core
T axil
T naso
T eso
T rect
Description
Temperature of application site 1
Temperature of application site 2
Skin temperature
Core temperature
Axillary temperature
Nasopharyngeal temperature
Esophageal temperature
Rectal temperature
Label
T amb
T airw
T vesic
T blood
T myo
T tymp
T cereb
Description
Ambient temperature
Airway temperature
Vesical temperature
Blood temperature
Myocardial temperature
Tympanic temperature
Cerebral temperature
11.5.3
Displaying the Temperature Difference
To display the temperature difference between two measurement sites monitored by the same temperature module, switch on
∆
T. To do so, follow this procedure:
1.
Select the temperature numeric area to enter the Temp dialog.
2.
Select the Setup tab.
3.
Switch on ∆ T .
11.6
Temperature Troubleshooting
This section lists the problems that might occur. If you encounter the problems when using the equipment or accessories, check the table below before requesting service. If the problem persists, contact your service personnel.
NOTE
•
For the physiological and technical alarm messages, see Appendix D Alarm Messages
.
11 - 2 BeneVision N1 Patient Monitor Operator’s Manual
Problem
Do not see Temp numeric area on the main screen
Measurement fails/’--’ is displayed in the Temp numeric area
Solution
1. Check that if the Temp parameter switch is enabled. If not, enable
the Temp measurement. For more information, see 3.9.1 Switching
.
2. Check that the connections of the temperature probe and the temperature cable are tight.
1. If using a disposable probe, check the connection between the probe and the temperature cable.
2. Try using a known good probe in case the sensor is damaged.
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11 - 4 BeneVision N1 Patient Monitor Operator’s Manual
12
Monitoring Noninvasive Blood Pressure (NIBP)
12.1
NIBP Introduction
The monitor uses the oscillometric method for measuring Non-Invasive Blood Pressure (NIBP). NIBP measurement is based on the principle that pulsatile blood flow through an artery creates oscillations of the arterial wall. The oscillometric device uses a blood pressure cuff to sense these oscillations that appear as tiny pulsations in cuff pressure. The oscillometric devices measure the amplitude of pressure changes in the occluding cuff as the cuff deflates from above systolic pressure. The amplitude suddenly increases as the pulse breaks through the occlusion in the artery. As the cuff pressure decreases further, the pulsations increase in amplitude, reach a maximum (which approximates to the mean pressure), and then diminish. The oscillometric method measures the mean pressure and determines the systolic and diastolic pressures.
NIBP monitoring is intended for adult, pediatric, and neonatal patients.
NOTE
•
Blood pressure measurements determined with this device are equivalent to those obtained by a trained observer using the cuff/stethoscope auscultatory method or an intra-arterial blood pressure measurement device, within the limits prescribed by the American National Standard: manual, electronic, or automated sphygmomanometers.
•
NIBP measurement can be performed during electro-surgery and discharge of a defibrillator.
12.2
NIBP Safety Information
WARNING
•
Be sure to select the correct patient category setting for your patient before NIBP measurement. Do not apply the higher adult settings for pediatric or neonatal patients. Otherwise, it may present a safety hazard.
•
Do not measure NIBP on patients with sickle-cell disease or on the limb where skin damage has occurred or is expected.
•
Use clinical judgment to determine whether to perform frequent unattended blood pressure measurements on patients with severe blood clotting disorders because of the risk of hematoma in the limb fitted with the cuff.
•
Do not use the NIBP cuff on a limb with an intravenous infusion or arterial catheter in place. This could cause tissue damage around the catheter when the infusion is slowed or blocked during cuff inflation.
•
Do not apply cuff on the arm on the side of a mastectomy or lymph node clearance.
•
Continuous cuff pressure due to connection tubing kinking may cause blood flow interference and result in harmful injury to the patient.
•
NIBP reading can be affected by the measurement site, the position of the patient, exercise, or the patient's physiologic condition. If you doubt the NIBP measurements, determine the patient’s vital signs by alternative means, and then verify that the monitor is working correctly.
•
Devices that exert pressure on tissue have been associated with purpura, ischemia, and neuropathy.
Inspect the application site regularly to ensure skin quality and inspect the extremity of the cuffed limb for normal color, warmth and sensitivity. If the skin quality changes, or if the extremity circulation is being affected, move the cuff to another site or stop the blood pressure measurements immediately. Check more frequently when making automatic or STAT measurements. Auto NIBP measurements with one and two minute intervals are not recommended for extended periods of time.
•
Do not modify or replace connectors of the NIBP air hose except with mindray-approved connectors.
Use neonatal and infant cuffs with CM1901 hoses only. Use pediatric/adult cuffs with CM1903 hoses only.
BeneVision N1 Patient Monitor Operator’s Manual 12 - 1
•
Never connect intra-arterial or intra-venous lines, or any other incompatible connectors to the NIBP hose. This can cause serious injury or death.
•
NIBP diagnostic significance must be decided by the hospital’s clinician staff.
CAUTION
•
Measuring NIBP on patients connected to an Intra Aortic Balloon Pump (IABP) machine may result in the NIBP measurement, including PR, to be inaccurate or fail.
•
Only use parts and accessories specified in this manual. Follow the instructions for use and adhere to all warnings and cautions.
•
Using IABP may cause NIBP, including PR, measurements inaccurate or failed.
•
Accuracy of NIBP measurement depends on using a cuff of proper size. It is essential to measure limb circumference and choose a cuff with proper size.
12.3
NIBP Measurement Limitations
■
■
■
■
■
■
■
Measurements are impossible with heart rate extremes of less than 30 bpm or greater than 300 bpm, or if the patient is on a heart-lung machine. The measurement may be inaccurate or impossible in the following situations:
Regular arterial pressure pulses are hard to detect
Excessive and continuous patient movement such as shivering or convulsions
Cardiac arrhythmias
Rapid blood pressure changes
Severe shock or hypothermia that reduces blood flow to the peripheries
On an edematous extremity
Obesity, where a thick layer of fat surrounding a limb dampens the oscillations coming from the artery
NOTE
•
The effectiveness of this sphygmomanometer has not been established in pregnant women, including pre-eclamptic patients.
12.4
Measurement Modes
The monitor provides the following NIBP measurement modes:
■
■
■
■
Manual: measurement on demand.
Auto: repeated measurements at set interval.
STAT: continual rapid series of measurements over a five-minute period.
Sequence: continually automatic measurement at set durations and intervals.
12 - 2 BeneVision N1 Patient Monitor Operator’s Manual
12.5
NIBP Display
The NIBP display shows only numerics.
(3) (4) (5)
(2)
(1)
(6)
(7)
(8)
(11) (10) (9)
(1) Systolic pressure alarm limits
(2) NIBP unit: mmHg or kPa
(3) The last NIBP measurement time
(4) Time to the next measurement (for Auto mode and Sequence mode)
(5) Measurement mode: for Auto NIBP, interval is displayed; for Sequence mode, the current phase and interval are displayed
(6) Diastolic pressure
(7) Diastolic pressure alarm limits
(8) Mean pressure alarm limits
(9) Mean pressure (displayed after measurement completed) or cuff pressure (displayed during the measurement)
(10) Systolic pressure (11) Pulse Rate
NOTE
•
If NIBP measurement fails, “XX” is displayed; if NIBP measurement is not taken or NIBP measurement exceeds its measurement ranges, “--” is displayed.
•
NIBP numerics in black color with a light outline indicate that the measurement is old and exceeds the configured NIBP Measurement Timeout time (see section
21.5.7 Setting Parameter Measurement
Timeout ). These NIBP values are not recommended for reference.
12.6
Preparing for NIBP Measurements
12.6.1
Preparing the Patient for NIBP Measurements
■
■
■
■
In normal use, perform NIBP measurement on a patient who is in the following position:
Comfortably seated
Legs uncrossed
Feet flat on the floor
Back, arm and feet supported
NOTE
•
It is recommended that the patient remains calm and relaxes as much as possible before performing the measurement and that the patient does not talk during the measurement.
•
Other factors that have been shown to result in an overestimation of blood pressure are labored breathing, full bladder, pain etc.
BeneVision N1 Patient Monitor Operator’s Manual 12 - 3
12.6.2
Placing the NIBP Cuff
To place the NIBP cuff, follow this procedure:
1.
Verify that the patient category setting is correct.
2.
Connect the air tubing to the NIBP connector.
3.
Select an appropriately sized cuff for the patient, and then wrap it around the limb directly over the patient’s skin as follows: a Determine the patient
’ s limb circumference.
b Select an appropriate cuff by referring to the limb circumference marked on the cuff. The width of the cuff should be 40% (50% for neonates) of the limb circumference, or 2/3 of the length of the upper arm or the thigh. The inflatable part of the cuff should be long enough to encircle to overlap at least
50% to 80% of the limb. c Apply the cuff to the patient ’ s upper arm or leg and make sure the Φ marking on the cuff matches the artery location. The cuff should fit snugly, but with enough room for two fingers to be placed between the cuff and the patient ’ s arm (on adults), and loosely on neonates with little or no air present within the cuff. Otherwise it may cause discoloration and ischemia of the extremities. Make sure that the cuff index line falls within the range markings on the cuff. If it does not, use a cuff that fits better.
d Middle of the cuff should be at the level of the right atrium of the heart. If it is not, use the measurement correction formula to correct the measurement. For more information, see
12.8.7 Setting the NIBP Display Format
.
4.
Connect the cuff to the air tubing. Avoid compression or restriction of pressure tubes. Air must pass unrestricted through the tubing.
CAUTION
•
Do not touch or apply external pressure against the cuff and air tubing during NIBP measurement.
This may cause inaccurate blood pressure values.
•
Use care when placing the cuff on an extremity used for monitoring other patient parameters.
12.7
Starting and Stopping NIBP Measurements
Start and stop NIBP measurement by selecting the NIBP quick keys or from the NIBP dialog.
Task
Start a manual measurement
By Quick Key
NIBP Start/Stop quick key
Start auto NIBP series
Start NIBP sequence measurement
Start STAT measurement
NIBP Start/Stop quick key
NIBP Measure quick key
Interval
NIBP Measure
Sequence
NIBP Measure
quick key
quick key
Stop the current NIBP measurements
End auto NIBP series or NIBP
Sequence
Stop STAT measurement and end series
NIBP Start/Stop quick key
/
NIBP Start/Stop quick key
→ select
→
→
STAT
From NIBP dialog
Start NIBP button
Setup tab
→
set Interval
→
Start NIBP button
Sequence tab → set NIBP sequence
→ Start NIBP button
STAT button
Stop NIBP button
NIBP Stop All button
Stop NIBP or NIBP Stop All button
12 - 4 BeneVision N1 Patient Monitor Operator’s Manual
12.8
Changing NIBP Settings
12.8.1
Setting the NIBP Alarm Properties
To set the NIBP alarm properties, follow this procedure:
1.
Select the NIBP numeric area to enter the NIBP dialog.
2.
Select the Alarm tab.
3.
Enter the password if required. For more information, refer to 21.13.3 Selecting Password for User
.
4.
Set the alarm properties as desired.
12.8.2
Setting the Initial Cuff Inflation Pressure
To set initial cuff inflation pressure, follow this procedure:
1.
Select the NIBP numeric area to enter the NIBP dialog.
2.
Select Initial Pressure , and then select the appropriate setting.
NOTE
•
For known hypertensive patients, you need to set initial cuff pressure to a higher value to reduce the measurement time.
12.8.3
Setting the NIBP Interval
For auto NIBP measurement, you need to set the interval between two NIBP measurements. To set the NIBP interval, follow this procedure:
1.
Select the NIBP numeric area to enter the NIBP dialog.
2.
Set Interval . Selecting Manual switches to manual mode.
NOTE
•
NIBP Measure dialog gives quick access to starting and setting the interval. Selecting an option from the NIBP Measure dialog will change the NIBP interval to that selection and start the NIBP measurement.
12.8.4
Selecting NIBP Start Mode
Start mode defines how future NIBP measurements are initiated with automatic measurement mode. To set the start mode, follow this procedure:
1.
Select the NIBP numeric area to enter the NIBP dialog.
2.
Select Start Mode .
◆
Clock : after the first measurement, the monitor automatically synchronizes NIBP automatic measurements with the real time clock. For example, if Interval is set to 20 min , and NIBP auto measurement is started at 14:03, the next measurement will be taken at 14:20, and then at 14:40,
15:00, and so on.
◆ Interval : after the first measurement, the monitor automatically repeats measurements at set interval.
For example, if Interval is set to 20 min , and NIBP auto measurement is started at 14:03, the next measurement will be taken at 14:23, and then at 14:43, 15:03, and so on.
12.8.5
Enabling the NIBP End Tone
The monitor can issue a reminder tone at the completion of NIBP measurement. The NIBP End Tone is off by default. To switch on the NIBP end tone, follow this procedure:
1.
Select the NIBP numeric area to enter the NIBP dialog.
BeneVision N1 Patient Monitor Operator’s Manual 12 - 5
2.
Switch on NIBP End Tone .
12.8.6
Setting NIBP Sequence
NIBP sequence measurement can have up to five phases: A, B, C, D, and E. The duration and interval of each phase can be set individually.
To set NIBP sequence, follow this procedure:
1.
Select the NIBP numeric area to enter the NIBP dialog.
2.
Select the Sequence tab.
3.
Set Duration and Interval of each phase.
12.8.7
Setting the NIBP Display Format
To set the NIBP display format, follow this procedure:
1.
Select the NIBP numeric area to enter the NIBP menu.
2.
Select the Setup tab.
3.
Set Display Format .
12.8.8
Setting the NIBP Alarm Limits Display Switch
To set whether to display the alarm limits of diastolic NIBP and mean NIBP, follow this procedure:
1.
Select the NIBP numeric area to enter the NIBP menu.
2.
Select the Setup tab.
3.
Switch on or off Display Alarm Limits.
12.8.9
Showing/Hiding PR
You can set whether to display the PR value in the NIBP parameter area. To do so, follow this procedure:
1.
Select the NIBP numeric area to enter the NIBP menu..
2.
Select the Setup tab.
3.
Switch on or off Display PR.
12.8.10
Correcting the NIBP Measurements
The middle of the cuff should be at the level of right atrium. If the limb is not at the heart level, the measurement should be corrected as follows:
■
■
Add 0.75 mmHg (0.10 kPa) to the displayed value for each centimetre higher.
Deduct 0.75 mmHg (0.10 kPa) to the displayed value for each centimeter lower.
12.9
Assisting Venous Puncture
You can use the NIBP cuff to cause sub-diastolic pressure to block the venous blood vessel and therefore help venous puncture. To assist venous puncture, follow this procedure:
1.
Select the NIBP numeric area → Setup tab.
2.
p Set Venipuncture Pressure .
3.
Select Venipuncture at the bottom of the dialog.
4.
Puncture vein and draw blood sample.
5.
Select the NIBP Start/Stop quick key to deflate the cuff. If the cuff is not manually deflated, the cuff automatically deflates after a fixed period of time (170 seconds for adult and pediatric patient, 85 seconds for neonatal patient).
During venous puncture, pay attention to the cuff pressure and the remaining time displayed in the NIBP numerics area.
12 - 6 BeneVision N1 Patient Monitor Operator’s Manual
12.10
NIBP Troubleshooting
This section lists the problems that might occur. If you encounter the problems when using the equipment or accessories, check the table below before requesting for services. If the problem persists, contact your service personnel.
NOTE
•
For the physiological and technical alarm messages, see Appendix
.
Problem
Cannot see NIBP numeric area on the main screen
Solution
1. Check that the NIBP is set to display in the Screen Setup
→
Tile Layout
page. For more information, see.
3.9.2 Displaying Parameter Numerics and
2. Check that if the NIBP parameter switch is enabled. If not, enable the NIBP measurement. For more information, see
.
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12 - 8 BeneVision N1 Patient Monitor Operator’s Manual
13
Monitoring Invasive Blood Pressure (IBP)
13.1
IBP Introduction
This patient monitor can monitor up to four invasive blood pressures and displays the systolic, diastolic and mean pressures and a waveform for each pressure.
IBP monitoring is intended for adult, pediatric, and neonatal patients. PAWP monitoring is only intended for adult and pediatric patients.
(2) (3)
(1)
(1)
(1)
(1) IBP cable connector (2) IBP dialog hard key (3) Zero IBP hard key
NOTE
•
In order for the N1 to connect to the external IBP module and perform IBP monitoring, the N1system software V01.11 and above is required.
13.2
IBP Safety Information
WARNING
•
Use only pressure transducers specified in this manual. Never reuse disposable pressure transducers. See chapter
25 Accessories for specified pressure transducers.
•
Make sure that the applied parts never contact other conductive parts.
•
To reduce the hazard of burns during high-frequency surgical procedures, ensure that the monitor’s cables and transducers never come into contact with the high-frequency surgical units.
•
When using accessories, their operating temperature should be taken into consideration. For more information, see instructions for use of accessories.
•
All invasive procedures involve risks to the patient. Use aseptic technique. Follow catheter manufacturer's instructions.
•
Mechanical shock to the invasive blood pressure transducer may cause severe shifts in zero balance and calibration, and cause erroneous readings.
•
The neutral electrode of the electro-surgery unit (ESU) shall properly contact the patient. Otherwise, burns may result.
BeneVision N1 Patient Monitor Operator’s Manual 13 - 1
CAUTION
•
Measuring IBP on patients connected to an Intra Aortic Balloon Pump (IABP) machine may result in the IBP measurement, including PR, to be inaccurate or fail.
NOTE
•
PAWP monitoring is available only when using an external display.
13.3
Preparing for IBP Monitoring
13.3.1
IBP Equipment to Patient Connection
(1)
(2)
(4)
(5)
(3)
(5)
(1) Pressure bag
(3) IBP cable
(5) Three-way valve
(2) IBP connector
(4) IBP transducer
13.3.2
Measuring an Invasive Blood Pressure
To monitor IBP, follow this procedure:
1.
Connect one end of the IBP cable to the IBP cable connector, and the other end to the IBP transducer.
2.
Flush the IBP transducer system to exhaust all air from the tubing according to the manufacturer’s instructions. Ensure that the system is free of air bubbles.
3.
Connect the IBP transducer to the patient, making sure that the transducer is at the same horizontal level as the heart.
4.
Select the proper pressure label for currently measured pressure. For more information, see
13.6.2 Changing the Pressure Label .
5.
Zero the IBP transducer. For more information, see.
13.3.3 Zeroing the IBP transducer . After a successful
zeroing, turn off the three-way valve to the air and turn on the three-way valve to the patient.
13 - 2 BeneVision N1 Patient Monitor Operator’s Manual
CAUTION
•
Make sure that all the transducers are zeroed correctly before making IBP measurements.
•
Make sure that all air bubbles have been flushed from the IBP transducer system before making IBP measurements.
•
If measuring intracranial pressure (ICP) with a sitting patient, level the transducer with the top of the patient’s ear. Incorrect leveling may give incorrect values (not applicable if measuring ICP with the
Codman ICP transducer).
NOTE
•
If two invasive blood pressures measurements are needed, use the IBP extension cable with dualreceptacle (PN: 040-001029-00) instead of the IBP cable.
13.3.3
Zeroing the IBP transducer
To avoid inaccurate pressure readings, the monitor requires a valid zero. Zero the transducer in accordance with your hospital policy. The IBP transducer should be zeroed in the following conditions:
■
■
■
■
The IBP transducer or adapter cable is reconnected.
The monitor restarts.
The readings are in doubt.
The monitor displays the prompt message Zero Required .
To zero the transducer, follow this procedure:
1.
Connect the IBP transducer, the IBP adapter cable and the monitor.
2.
Turn off the three-way valve (the one near the transducer) to the patient, in order to vent the transducer to the atmospheric pressure.
3.
Select the numeric area (such as the Art numeric area), and then select Zero button.
4.
After the zero calibration is completed, close the three-way valve to the air and open the three-way valve to the patient.
13.4
Zero calibration may fail in case of pressure fluctuation or pressure exceeding the calibration range. If zero calibration fails, follow this procedure:
1.
Check that the three-way valve (the one near the transducer) is open to the air.
2.
Perform zero calibration again. Do not sway the IBP transducer and tubing during zero calibration.
Measuring ICP Using the Codman ICP Transducer
13.4.1
Zeroing the Codman ICP transducer
The Codman ICP transducer (Model: 82-6653) must be zeroed before use. To zero the ICP transducer, follow this procedure:
1.
Connect the ICP transducer, the ICP adapter cable and the monitor.
2.
Follow the manufacturer’s instructions to prepare the ICP transducer.
3.
Zero the ICP transducer: when the message Zero Reference is displayed in the ICP numeric area, select the
ICP waveform area or numeric area to enter the ICP dialog
→
select the Zero tab
→ select the Zero button.
4.
Record the zero reference value on the blank area of the ICP transducer for reference.
If the ICP transducer zero calibration failed or the zero reference value is in doubt, perform the zero calibration again.
13.4.2
Measuring ICP
To perform the ICP measurement, follow this procedure:
BeneVision N1 Patient Monitor Operator’s Manual 13 - 3
1.
.
2.
Disconnect the ICP transducer and ICP adapter cable. Follow the manufacturer’s instructions to apply the
ICP transducer to the patient.
3.
Reconnect the ICP transducer and ICP adapter cable.
4.
Check that the zero reference value displayed on the monitor is consistent with that recorded on the ICP transducer.
◆ Consistent: select Accept .
◆ Inconsistent: input the zero reference value recorded on the ICP transducer, and select Accept .
If the patient being monitored for ICP must be transported, and N1 is not used for transport, check that the transport monitor supports the Codman ICP transducer. If the transport monitor does not support the Codman
ICP transducer, do not use it for ICP monitoring.
If the transport monitor supports the Codman ICP transducer, follow this procedure to transport the patient:
1.
Disconnect the ICP adapter cable from the N1.
2.
Connect the ICP adapter cable and the transport monitor.
3.
Check that the zero reference value displayed on the monitor is consistent with that recorded on the ICP transducer.
◆ Consistent: select Accept .
◆ Inconsistent: input the zero reference value recorded on the ICP transducer, and select Accept .
CAUTION
•
If monitors of different brands are used to zero the Codman ICP transducer, the zero reference values can be different. Use a Mindray monitor to Zero the Codman ICP transducer if you will take
ICP measurement using a Mindray monitor. Otherwise the ICP measurement could be inaccurate.
13.5
IBP Display
The IBP measurement is displayed on the monitor as a waveform and numeric pressures. For arterial pressure, the IBP numeric area displays systolic pressure, diastolic pressure and mean pressure. For venous pressure, the
IBP numeric area displays only the mean pressure. The figure below shows the waveform and numerics for the
Art pressure.
(1) (2) (3) (4) (5)
(7) (6)
(1) Pressure label
(3) Pressure Unit
(5) Diastolic pressure
(7) PPV measurement
(2) Waveform
(4) Systolic pressure
(6) Mean pressure
For some pressures, the parameter window may show the mean pressure only. For different pressures, their defaults unit may be different. If the Art and ICP pressures are measured simultaneously, the ICP parameter area will display numeric CPP, which is obtained by subtracting ICP from the Art mean.
13.5.1
Overlapping IBP Waveforms
The IBP waveforms can be displayed together. To combine IBP waveforms, follow this procedure:
13 - 4 BeneVision N1 Patient Monitor Operator’s Manual
1.
Access Tile Layout by either of the following ways:
◆ Select the Screen Setup quick key → select the Tile Layout tab.
◆ Select Main Menu quick key → from the Display column select Tile Layout .
2.
Select the waveform area where you want to display the overlapped IBP waveforms, and then select the IBP waves to be overlapped on the left side of the same line.
3.
Repeat step 2 in another waveform area if needed.
4.
Select to save the setting and exit the screen. The main screen will display the overlapped IBP waves.
■
■
Selecting the overlapped IBP waveforms on the main screen opens the Overlapping Waveform Setup dialog, where you can make the following settings:
■ Scale
◆ Set Left Scale for the arterial pressure.
◆ Set Right Scale for the venous pressure.
◆ Set CVP Scale individually if the CVP waveform is combined and CVP unit is different from IBP unit.
◆ Set ICP Scale individually if the ICP waveform is combined and ICP unit is different from IBP unit.
◆ Set PA Scale individually if the PA waveform is combined.
Switch on or off Gridlines to show or hide gridlines in the overlapped waveform area.
Set Speed for the overlapped waveforms.
NOTE
•
The unit of CVP scale is consistent with the CVP parameter unit.
13.6
Changing IBP Settings
13.6.1
Changing the IBP Alarm Settings
To change the IBP alarm settings, follow this procedure:
1.
Select the IBP numeric area or waveform area to enter the corresponding pressure dialog.
2.
Select the Alarm tab.
3.
Enter the password if required. For more information, refer to 21.13.3 Selecting Password for User
.
4.
Set the alarm properties of pressure.
13.6.2
Changing the Pressure Label
The pressure label is a unique identifier for each type of pressure. Therefore, it is recommended to select the proper pressure label for the source of the pressure being monitored.
To select the pressure label, follow this procedure:
1.
Select the IBP numeric area or waveform area to enter the corresponding pressure dialog.
2.
Select the Setup tab.
BeneVision N1 Patient Monitor Operator’s Manual 13 - 5
3.
Set IBP1 Label or IBP2 Label .
Label
Art
Ao
BAP
CVP
RAP
UVP
P1 to P4
Description
Arterial blood pressure
Aortic pressure
Brachial arterial pressure
Central venous pressure
Right atrial pressure
Umbilical venous pressure
Non-specific pressure label
Label
PA
UAP
FAP
LAP
ICP
LV
Description
Pulmonary artery pressure
Umbilical arterial pressure
Femoral arterial pressure
Left atrial pressure
Intracranial pressure
Left ventricular pressure
NOTE
•
The same label cannot be selected for different pressures. When two pressures are detected having the same label, the monitor automatically changes one pressure label to a currently unused one.
13.6.3
Setting the Pressure Type for Display
For the non-specific pressure (P1, P2, P3 or P4), the displayed pressure type is configurable. To set the displayed pressure type, follow this procedure:
1.
Select the numeric area or waveform area of the non-specific pressure to enter the corresponding pressure dialog.
2.
Select the Setup tab.
3.
Set Measure :
◆ If this non-specific pressure is arterial pressure, set the Measure to All . In this case, its corresponding numeric area displays systolic pressure, diastolic pressure and mean pressure.
◆
If this non-specific pressure is venous pressure, set the Measure to Mean Only . In this case, its corresponding numeric area displays only the mean pressure.
13.6.4
Changing the Sensitivity
The IBP value displayed on the monitor screen is the average of data collected within a specific time. The shorter the averaging time is, the quicker the monitor responds to changes in the patient’s blood pressure, and the higher the sensitivity. Contrarily, the longer the averaging time is, the slower the monitor responds to changes in the patient’s blood pressure, the lower the sensitivity, but the measurement accuracy will be improved. For critically ill patients, selecting higher sensitivity will help with understanding the patient’s state.
To set the sensitivity, follow this procedure:
1.
Select the IBP numeric area or waveform area to enter the corresponding pressure dialog.
2.
Select the Setup tab.
3.
Set Sensitivity .
13.6.5
Setting the IBP Waveform
To set the IBP waveform, follow this procedure:
1.
Select the IBP numeric area or waveform area to enter the corresponding pressure dialog.
2.
Select the Setup tab.
3.
Set the following properties of the IBP waveform:
◆ Speed
◆ Scale : if Auto is selected, the size of the pressure’s waveform will be adjusted automatically.
13 - 6 BeneVision N1 Patient Monitor Operator’s Manual
13.6.6
Setting the Display Format of Artery Pressure
To set the display format of the artery pressure, follow this procedure:
1.
Select the numeric area or waveform area of any arterial pressure to enter the corresponding menu.
2.
Select the Setup tab.
3.
Set Display Format .
13.6.7
Showing/Hiding the Alarm Limits of Artery Pressure
To set whether to display the alarm limits of the arterial pressure, follow this procedure:
1.
Select the numeric area or waveform area of any arterial pressure to enter the corresponding menu.
2.
Select the Setup tab.
3.
Switch on or off Display Alarm Limits.
13.6.8
Setting the Use PA-D as PAWP Switch (only available when the N1 is used with the independent external display)
The PA-D value can be configured to replace the PAWP value for hemodynamic calculation. To do so, follow this procedure:
1.
Select the PA numeric area or waveform area to enter the PA dialog.
2.
Select the Setup tab.
3.
Switch on or off Use PA-D as PAWP .
For more information on hemodynamic calculation, see 17.4 Hemodynamic Calculations
.
13.6.9
Enabling PPV Measurement
PPV indicates pulse pressure variation. When measuring the arterial pressure (except PA), the PPV measurement is available. To enable the PPV measurement, follow this procedure:
1.
Select the IBP numeric area or waveform area to enter the corresponding pressure dialog.
2.
Select the PPV Setup tab.
3.
Switch on PPV Measure .
You can select PPV source after enabling the PPV measurement.
WARNING
•
This monitor can calculate PPV from beat-to-beat values of any arterial pulsatile pressure. The circumstances under which the calculation of a PPV value is clinically meaningful, appropriate and reliable must be determined by a physician.
•
The clinical value of the derived PPV information must be determined by a physician. According to recent scientific literature, the clinical relevance of PPV information is restricted to sedated patients receiving controlled mechanical ventilation and mainly free from cardiac arrhythmia.
•
PPV calculation may lead to inaccurate values in the following situations:
◆ at respiration rates below 8 rpm
◆ during ventilation with tidal volumes lower than 8 ml/kg
◆ for patients with acute right ventricular dysfunction (cor pulmonale).
•
The PPV measurement has been validated only for adult patients.
13.7
PAWP (only available when the N1 is used with the independent external display)
Pulmonary Artery Wedge Pressure (PAWP) values, used to assess cardiac function, are affected by fluid status, myocardial contractility, and valve and pulmonary circulation integrity.
BeneVision N1 Patient Monitor Operator’s Manual 13 - 7
Obtain the measurement by introducing a balloon-tipped pulmonary artery flotation catheter into the pulmonary artery. When the catheter is in one of the smaller pulmonary arteries, the inflated balloon occludes the artery allowing the monitor to record changes in the intrathoracic pressures that occur throughout the respiration cycle.
The pulmonary wedge pressure is the left ventricular end diastolic pressure when the airway pressure and valve function are normal. The most accurate PAWP values are obtained at the end of the respiration cycle when the intrathoracic pressure is fairly constant and the artifact caused by respiration is minimal.
WARNING
•
PAWP monitoring is not intended for neonatal patients.
13.7.1
PAWP Equipment to Patient Connection
(2)
(1)
(3)
(4)
(6)
(7)
(8)
(5)
(1) IBP connector
(3) IBP transducer
(5) PA distal port
(7) Thermodilution catheter
(2) Flush bag
(4) Three-way valve
(6) Balloon inflation syringe
(8) Balloon
13.7.2
Preparing to Measure PAWP
To prepare to monitor PAWP, follow this procedure:
1.
Connect one end of the IBP cable to the IBP cable connector, and the other end to the IBP transducer. For more information, see
13.3.2 Measuring an Invasive Blood Pressure .
2.
Follow the manufacturer’s instructions to connect the PA port of the thermodilution catheter and the patient end of the IBP transducer.
3.
Zero the IBP transducer. For more information, see 13.3.3 Zeroing the IBP transducer
.
13 - 8 BeneVision N1 Patient Monitor Operator’s Manual
4.
Set the IBP label to PA
since the PAWP is measured on PA. For more information, see 13.6.2 Changing the
13.7.3
Measuring PAWP
To measure the PAWP, follow this procedure:
1.
Select the PA numeric area or waveform area to enter the PA dialog, and then select PAWP .
2.
Wedge the flotation catheter into the pulmonary artery by observing the PA waveform changes on the screen, referring to the following figure.
3.
Select Start .
4.
Inflate the balloon and pay attention to PA waveform changes on the screen when the prompt message
Ready For Balloon Deflation appears.
5.
Deflate the balloon when the prompt message Ready For Balloon Deflation appears. If the PA waveform is stable, but the monitor is still not showing the prompt message Ready For Balloon Deflation , select
Freeze to freeze the waveform, and deflate the balloon.
6.
Select Accept to save the PAWP value.
7.
If you need to start a new measurement, repeat step 3 to step 6.
BeneVision N1 Patient Monitor Operator’s Manual 13 - 9
■
■
■
If the measurement fails or you need to adjust the PAWP value, you can use the following buttons to adjust the
PAWP waveform and measurement.
Select the up or down arrow button to adjust the PAWP value.
Select the left or right arrow button to view the frozen waveforms of 40 seconds.
Select Accept to save the PAWP value.
WARNING
•
Prolonged inflation can cause pulmonary hemorrhage, infarction or both. Inflate the balloon for the minimum time necessary to get an accurate measurement.
•
If the PAWP is greater than the PA (systolic), deflate the balloon and report the incident in accordance with hospital policy. Because the pulmonary artery could be accidentally ruptured, and the PAWP value derived will not reflect the patient’s hemodynamic state, but will merely reflect the pressure in the catheter or balloon.
•
If the flotation/thermodilution catheter drifts into the wedge position without inflation of the balloon, the PA waveform assumes a wedged appearance. Take appropriate action, in accordance with standard procedures, to correct the situation.
NOTE
•
The PA alarm is turned off automatically when the monitor enters the PAWP screen.
13.7.4
Setting the Waveforms of the PAWP Screen
On the PAWP screen, select Setup to enter the PAWP Setup dialog. In the PAWP Setup dialog, you can make the following settings:
■
■
■
■
Select
Select
Select
Select
Reference Waveform 1
Reference Waveform 2
Speed
Scale to set an ECG lead wave as the first reference wave.
to set a respiration wave as the second reference wave.
to set a sweep speed for the displayed waveforms on the
to set the size of the PA waveform on the PAWP screen.
PAWP screen.
13.7.5
Performing Hemodynamic Calculation (only available when the N1 is used with the independent external display)
On the PAWP screen, select Hemo Calcs to enter the Calculations dialog. For more information, see
17.4 Hemodynamic Calculations .
13.8
IBP Troubleshooting
This section lists the problems that might occur. If you encounter the problems when using the equipment or accessories, check the table below before requesting service. If the problem persists, contact your service personnel.
NOTE
•
For the physiological and technical alarm messages, see Appendix
.
13 - 10 BeneVision N1 Patient Monitor Operator’s Manual
Problem
Cannot see IBP numeric area or waveform area on the main screen
Cannot see systolic pressure and diastolic pressure for P1/P2/P3/P4
IBP readings seem unstable
Zeroing of IBP channel(s) fails.
Solution
1. Check that the IBP is set to display in the Screen Setup dialog. For more information, see.
3.9.2 Displaying Parameter Numerics and Waveforms .
2. Check that if the IBP parameter switch is enabled. If not, enable the IBP measurement. For more information, see
.
3. Check the connection of IBP cable, IBP transducer and module.
4. Check that the three-way valve is turned to the correct position.
5. Check that the IBP transducer has been zeroed. For more information, see
13.3.3 Zeroing the IBP transducer .
Set Measure to All in the P1/P2/P3/P4 setup page. For more information, see
13.6.3 Setting the Pressure Type for Display .
1. Make sure there are no air bubbles in the transducer systems.
2. Check that the transducer is properly fixed.
3. Zero the transducer again.
4. Replace the transducer.
1. Ensure that the channels are open to air.
2. Perform zero calibration again.
Do not sway the IBP transducer and tubing during zero calibration.
For more information, see 13.3.3 Zeroing the IBP transducer .
3. If zero calibration still fails, replace the transducer.
BeneVision N1 Patient Monitor Operator’s Manual 13 - 11
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13 - 12 BeneVision N1 Patient Monitor Operator’s Manual
14
Monitoring Carbon Dioxide (CO
2
)
14.1
CO
2
Introduction
CO
2
monitoring is a continuous, non-invasive technique for determining the concentration of CO
2
in the patient’s airway by measuring the absorption of infrared (IR) light of specific wavelengths. CO
2
has its own absorption characteristic and the amount of light passing the gas probe depends on the concentration of the measured CO
2
. When a specific band of IR light passes through respiratory gas samples, some of IR light will be absorbed by the CO
2
molecules. The amount of IR light transmitted after it has been passed through the respiratory gas sample is measured with a photodetector. From the amount of IR light measured, the concentration of CO
2
is calculated.
CO
2
measurement is used to monitor the patient’s respiratory status. The sidestream/Microstream CO
2 measurement takes a sample of the respiratory gas with a constant sample flow from the patient's airway and analyzes it with a remote CO
2
sensor built into the Sidestream or Microstream CO
2
module.
The sidestream and microstream CO
2
measurement can be used, with specified accessories, with intubated and non-intubated adult, pediatric, and neonatal patients. With intubated patients, a sample of the respiratory gas is drawn from the patient's breathing circuit through an airway adapter and a gas sampling line. With nonintubated patients, the gas sample is drawn through a nasal cannula.
Both sidestream and microstream CO
2
modules have the function of automatic barometric pressure compensation (the system automatically measures the barometric pressure to which the patient monitor is exposed).
CO
2
monitoring is intended for adult, pediatric and neonatal patients.
WARNING
•
The N1 monitor does not support CO
2
measurements when used for transporting patients by rotary or fixed-wing ambulance.
•
It is not recommended to measure O
2
when transporting a patient with the N1 monitor. Shaking the
CO
2
module during O
2
measurement may lead to a distorted O
2
waveform or inaccurate O
2 measurement.
14.2
Identifying CO
2
Modules
To measure CO
2
, use either the internal CO
2
module or the external CO
2
module. The external CO
2
module is connected to the N1 through the Modular Rack. For the connection of the N1 and the external CO
2
module, see
section 2.8.1 Installing the N1 or External Parameter Module into the Modular Rack .
In sequence from left to right, the following are sidestream CO
2
external module, microstream CO
2
external module, and N1 monitor with internal CO
2
module.
BeneVision N1 Patient Monitor Operator’s Manual 14 - 1
(1) (2)
(1) (2)
(6)
(3)
(4)
(5)
(4)
(1) CO
2
dialog hard key
(3) CO
2
watertrap seat
(5) Sample line connector
(2) CO
2
Measure/standby hard key
(4) Gas outlet
(6) Internal CO
2
adapter connector
14.3
CO
2
Safety Information
WARNING
•
Route all tubing away from the patient’s throat to avoid strangulation.
CAUTION
•
Remove the airway sample line from the patient’s airway while nebulized medications are being delivered. Measuring CO
2
during nebulization may lead to inaccurate CO
2
readings.
•
EtCO
2
values measured from the CO
2
module may differ from those from the blood gas analysis.
•
Avoid mechanical shock to the sidestream CO
2
module.
•
Shaking the CO2 module during O2 measurement may lead to a distorted O2 waveform or inaccurate O2 measurement
NOTE
•
The CO
2
module automatically suppresses physiological alarms until breathing waves have been detected. Ensure that the patient is properly connected when using the CO
2
module.
14.4
CO
2
Measurement Limitations
The following factors may influence the measurement accuracy:
■
■
■
■
Leaks or internal venting of sampled gas
Mechanical shock
Cyclic pressure up to 10 kPa (100 cmH
2
Other sources of interference, if any
O)
For more information, refer to A.14.8 CO
.
CAUTION
•
Measurement accuracy of the sidestream CO
2
module may be affected by the breath rate and inspiration/expiration (I/E) ratio.
•
Measurement accuracy of the microstream CO
2
module may be affected by the breath rate.
14 - 2 BeneVision N1 Patient Monitor Operator’s Manual
14.5
CO
2
Display
The CO
2
numeric and waveform areas provide FiCO
2
measurement, EtCO
2
measurement, awRR measurement, and a CO
2
waveform.
(1) (2) (3) (4)
(1) CO
2
waveform
(3) End tidal CO
2
value (EtCO
2
)
(2) Fraction of inspired CO
2
(FiCO
2
)
(4) Airway respiration rate (awRR)
14.6
Measuring CO
2
Using the Sidestream/Microstream CO
2
Module
14.6.1
Preparing to Measure CO
2
Using the Sidestream CO
2
Module
To prepare the CO
2
measurement, follow this procedure:
1.
Select the appropriate gas sample line and watertrap according to the patient category.
2.
Connect one end of the gas sample line to the watertrap or to the CO
2
adapter.
◆
If using the sidestream CO
2
module, connect the watertrap to the CO sample line to the watertrap.
2
module, and connect the gas
(1)
(2)
(3)
(1) Watertrap receptacle
(3) Gas sample line
(2) DRYLINE II watertrap
◆
If using the N1 monitor for CO
2
measurement, connect one end of the gas sample line to the CO
2 adapter. Refer to the CO2 Adapter User Manual (PN: H-046-009994-00) for the connection of the CO
2 adapter and the gas sampling line.
BeneVision N1 Patient Monitor Operator’s Manual 14 - 3
(1)
(2)
(1) CO
2
adapter (2) Gas sample line
3.
Connect the other end of the gas sample line to the patient.
◆ For intubated patients requiring an airway adapter, install the airway adapter between the patient circuit and the ventilator Y-piece.
(1)
(2)
(3)
(4)
(1) Sample line
(3) Airway adapter
(2) Connection to the ventilator
(4) Connection to the patient
◆ For non-intubated patients, place the nasal cannula onto the patient.
14 - 4
4.
Connect the gas outlet to the scavenging system using an exhaust tube.
After the CO
2
module is connected, it enters measure mode by default and the monitor displays CO2 Starting .
CO
2
can be measured after the start-up sequence is complete.
WARNING
•
Do not use the adult or pediatric watertrap with a neonate patient. Otherwise, patient injury could result.
•
Connect the gas outlet to the scavenging system when measuring CO
2
using the sidestream CO
2 module.
CAUTION
•
Check the compatibility of the CO
2
adapter and the sampling line before use. The CO
2
adapter is intended for connecting the Oridion CO
2
sampling line.
BeneVision N1 Patient Monitor Operator’s Manual
•
Leakage in the breathing or sampling system may cause the displayed EtCO
2
values to be significantly low. Always make sure that all components are securely connected.
•
Inspect the airway adapter for a tight connection and proper operation before attaching it to the patient.
•
Squeezing or bending the sample line during sidestream or microstream CO
2
measurement may cause inaccurate CO
2
readings or no reading.
•
To avoid blocking the airway, empty the DRYLINE II watertrap container whenever half full.
Replacing the DRYLINE II watertrap once a month is recommended. Dispose of accumulated fluids in accordance with hospital policy or your local regulations.
•
The DRYLINE II watertrap has a filter preventing bacterium, water and secretions from entering the module. Extended use could destroy the filter in watertrap and fail to stop the bacterium, water and secretions entering the module, result in damaging the gas module and having infection risk.
NOTE
•
It is recommended to replace the CO
2
adapter at least once a year.
•
To extend the lifetime of the watertrap and module, disconnect the watertrap from the module and set the operating mode to Standby mode when CO
2
monitoring is not required.
•
The sample rates are different when different types of watertraps are used.
•
The emptying interval of the DRYLINE II adult/pediatric watertrap is 26 hours @ 120 ml/min, sample gas of 37 °C, room temperature of 23 °C, and 100% RH.
•
The emptying interval of the DRYLINE II neonatal watertrap is 35 hours @ 90 ml/min, sample gas of
37 °C, room temperature of 23 °C, and 100% RH.
14.6.2
Preparing to Measure CO
2
Using the Microstream CO
2
Module
To prepare the CO
2
module for measurement, follow this procedure:
1.
Connect one end of the sample line to the microstream CO
2
module.
(1)
(2)
(1) Sample line connector (2) Sample line
2.
Connect the other end of the sample line to the patient.
◆ For intubated patient requiring an airway adapter, install the airway adapter between the patient circuit and the ventilator Y-piece.
◆
For non-intubated patient, place the nasal cannula onto the patient.
◆ For patient prone to mouth breathing, place the oral-nasal cannula onto the patient.
3.
Connect the gas outlet to the a scavenging system using an exhaust tube.
BeneVision N1 Patient Monitor Operator’s Manual 14 - 5
After the CO
2
module is connected, it enters measure mode by default and the monitor displays CO2 Sensor
Warmup . CO
2
can be measured after the start-up sequence is complete.
WARNING
•
Connect the gas outlet to the scavenging system when measuring CO
2
using the microstream CO
2 module.
NOTE
•
Disconnect the sample line from the module when CO
2
monitoring is not required.
14.6.3
Zeroing the Sidestream/Microstream CO
2
Module
The sidestream and microstream CO
2
modules perform a zero calibration automatically when needed. Once the zero calibration is started, the CO
2
module stops measuring and “ Zeroing ” is displayed in the CO
2
numeric area.
After the zero calibration is completed, the CO
2
module reacquires the CO
2
readings. During the reacquisition period, “ Zero Recovering ” is displayed in the CO
2
numeric area. Valid data will reappear 30 seconds after the zero calibration is started. You can hide the display of the “ Zero Recovering ” message, but values displayed during the reacquisition period may not be accurate. See
21.5.6 Hiding the Invalid Display after Zeroing the CO
The automatic zero calibration will not start under the following conditions:
■
■
■
Physiological alarms related to CO
2
A zero RR alarm is active.
are active.
No breath has been detected for over 30 seconds.
14.7
Changing Settings for All CO
2
Modules
14.7.1
Changing CO
2
Alarm Settings
To change the CO
2
alarm settings, follow this procedure:
1.
Select the CO
2
numeric area or waveform area to enter the CO2 dialog.
2.
Select the Alarm tab.
3.
Enter the password if required. For more information, refer to 21.13.3 Selecting Password for User
.
4.
Set alarm properties as desired.
14.7.2
Setting the CO
2
Waveform
To set the CO
2
waveform, follow this procedure:
1.
Select the CO
2
numeric area or waveform area to enter the CO2 dialog.
2.
Select the Setup tab.
3.
Set Waveform Type , Speed, Scale , or CO2 Scale of the CO
2
waveform.
14.7.3
Setting the RR Source
To set the respiration rate (RR) source, follow this procedure:
1.
Select the CO
2
numeric area or waveform area to enter the CO2 dialog.
2.
Select the Setup tab.
3.
Set RR Source .
14 - 6 BeneVision N1 Patient Monitor Operator’s Manual
When you select Auto , the system automatically selects the RR source according to the priority. The priority of
RR source is first CO
2
, and then ECG. When the current RR source does not have valid measurement, the system automatically switches the RR Source to Auto .
14.7.4
Entering the Standby Mode
Set the CO
2
module to one of the following modes according to the module status:
■
■
Select Measure mode when using the CO
2
module for monitoring.
Select Standby mode to prolong the CO
2
module service life when not using the CO
2
module.
The default operating mode is Measure . When not using the CO
2
module, proceed as follows to enter the
Standby mode:
1.
Select the CO
2
numeric area or waveform area to enter the CO2 dialog.
2.
Select the Setup tab.
3.
Set Operating Mode to Standby .
14.7.5
Entering the Intubation Mode
When performing intubation during general anesthesia, enter the intubation mode to reduce unnecessary alarms. To enter the intubation mode, follow this procedure:
1.
Select the CO
2
numeric area or waveform area to enter the CO2 dialog.
2.
Select Intubation Mode .
To exit the intubation mode, choose either of the following ways:
■
■
From the bottom of the CO2 dialog, select Exit Intubation Mode .
Select the Main Menu quick key
→ from the Alarm column select Exit Intubation Mode .
For the details of the intubation mode, see 6.11 Intubation Mode .
NOTE
•
When the configured intubation period is over, the monitor automatically exits the intubation mode and gives two alert sounds.
14.7.6
Setting the Auto Standby
The monitor enters standby mode automatically if no breath is detected after the configured period of time. To set the auto standby, follow this procedure:
1.
Select the CO
2
numeric area or waveform area to enter the CO2 dialog.
2.
Select the Setup tab.
3.
Set Auto Standby .
14.7.7
Setting Humidity Compensation
Sidestream and microstream CO
2
modules are configured to compensate CO
2
readings for either Body
Temperature and Pressure, Saturated Gas (BTPS), to account for humidity in the patient’s breath, or Ambient
Temperature and Pressure, Dry Gas (ATPD).
■
■
■
ATPD: P
CO2
(mmHg)=CO
2
(vol%) x P amb
/100
BTPS (sidestream): P
CO2
(mmHg)=CO
2
(vol%) x (P amb
- 47)/100
BTPS (microstream): P
CO2
(mmHg)=CO
2
(vol%) x (1- 0.03)x P amb
/100
Where, P
CO2
(mmHg)= partial pressure, vol%=CO
2
concentration, P amb
=ambient pressure, and unit is mmHg.
For the sidestream and microstream CO
2
module, set the humidity compensation on or off according to the actual condition.
To set the humidity compensation, follow this procedure:
1.
Select the CO
2
numeric area or waveform area to enter the CO2 dialog.
BeneVision N1 Patient Monitor Operator’s Manual 14 - 7
2.
Select the Setup tab.
3.
Set BTPS Compensation .
◆ Switch on for BTPS.
◆ Switch off for ATPD.
14.8
Setting the Gas Compensation
The presence of interfering gas affects the CO
2
measurement. To get the best possible measurement result, it is recommended to set the gas compensation. The configured concentration of the interfering gas should be in accordance with its actual proportion.
For the microstream CO
2
module, gas compensations are not required.
CAUTION
•
Make sure to use the appropriate compensations. Inappropriate compensations may cause inaccurate measurement values and result in misdiagnosis.
For the sidestream CO
2
module, follow this procedure to set the gas compensation:
1.
Select the CO
2
numeric area or waveform area to enter the CO2 dialog.
2.
Select the Setup tab.
3.
Set the compensation according to the actual condition.
14.9
Choosing a Time Interval for Peak-Picking
For microstream CO
2
modules, select a time interval for picking the highest CO
2
as the EtCO
2
and the lowest as the FiCO
2
.
To set the time interval, follow this procedure:
1.
Select the CO
2
numeric area or waveform area to enter the CO2 dialog.
2.
Select the Setup tab.
3.
Set Maximum Hold .
4.
Toggle between Single Breath , 10 s and 20 s .
◆
Single Breath : EtCO
2
and FiCO
2
are calculated for every breath.
◆
10 s and 20 s : EtCO
2
and FiCO
2
are calculated using 10 or 20 seconds of data.
14.10
Performing the Leakage Test
When measuring CO
2
using the internal CO
2
module or the external sidestream CO
2
module, the leakage test is required every time before the CO
2
measurement. To perform the CO
2
leakage test, follow this procedure:
1.
Connect the measuring accessories as per section 14.6.1 Preparing to Measure CO
.
2.
Wait until the startup finishes. Completely block the gas inlet on the sidestream CO
2
module or on the N1.
The alarm message “ CO2 Airway Occluded ” will appear on the screen.
3.
Continue to block the gas inlet for another one minute.
4.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
5.
Select the Module tab
→
CO2 tab.
6.
Check that the current flow rate is less than 10ml/min, and the alarm message “ CO2 Airway Occluded ” does not disappear.
This indicates that the module does not leak. If the alarm message disappears, or the flow rate is equal to
10ml/min or greater, it indicates that the module leaks. Perform the leakage test again. If the problem remains, contact your service personnel for help.
14 - 8 BeneVision N1 Patient Monitor Operator’s Manual
14.11
CO
2
Calibration
For sidestream and microstream CO
2
modules, a calibration is needed every year or when the measured values have a great deviation.
To calibrate the CO
2
module, contact your service personnel.
CAUTION
•
Connect the gas outlet to the scavenging system when calibrating the CO
2
module.
14.12
Test Method Used to Determine the Respiration Rate Measuring
Range
To determine the RR measurement range, follow this procedure:
1.
Connect the 5% CO
2
+ N
2
(BAL) gas cylinder, reduction valve, rhythm generator and gas sampling path of a monitor.
2.
Respectively set the rhythm generator to generate a respiration rate of 0 rpm, 6 rpm, 20 rpm, 60 rpm,
120rpm, and 150 rpm.
3.
Verify that it meets the specifications.
NOTE
•
The rhythm generator mentioned above is a sensor/sampling site in Figure 201.101 – Test apparatus for the TOTAL SYSTEM RESPONE TIME of an RGM of ISO 80601-2-55.
14.13
CO
2
Troubleshooting
This section lists the problems that might occur. If you encounter the problems when using the equipment or accessories, check the table below before requesting service. If the problem persists, contact your service personnel.
NOTE
•
For the physiological and technical alarm messages, see Appendix D Alarm Messages .
14.13.1
Troubleshooting the Sidestream/Microstream CO
2
Module
Problem
EtCO
2
measurements too low
Solution
1. Check the patient status.
2. Check the sample line and connectors for leakage.
3. Ventilate the room if the environmental CO
2
concentration is too high.
14.14
Oridion Information
Oridion Patents
This posting serves as notice under 35 U.S.C.§287(a) for Covidien patents: http://www.covidien.com/patents.
BeneVision N1 Patient Monitor Operator’s Manual 14 - 9
No Implied License
Possession or purchase of this device does not convey any express or implied license to use the device with unauthorized CO
2 sampling consumables which would, alone, or in combination with this device, fall within the scope of one or more of the patents relating to this device and/or CO2 sampling consumable.
14 - 10 BeneVision N1 Patient Monitor Operator’s Manual
15
Review
15.1
Review Overview
Trends are patient data collected over time and displayed in graphic, tabular, or other forms to give you a picture of how the patient's condition is developing. The Review dialog also enables access to review the events, 12lead ECG analysis results and waveforms, full disclosure waveforms, and so on.
15.2
Review Dialog
The Review dialog contains tabs to display trend data in tabular, graphic, or other forms.
15.2.1
Accessing the Review Dialog
To enter the review dialog, select the Main Menu quick key → from the Review column select the desired option.
15.2.2
Example Review Dialog
The review pages have a common structure. The graphic trends review page is taken as an example:
(1)
(2)
(5)
(6)
(7)
(3)
(4)
(8)
(9)
(1)
(2)
(3)
(4)
■
■
■
■
Event type indicator: different color blocks match different types of events:
■ Red: high priority alarm event
Yellow: medium priority alarm event
Cyan: low priority alarm event
Green: manual event
White: operation-related event
Current screen time line: indicates the time length of the current screen.
Waveform area: displays trend curves. The color of trend curves is consistent with the color of parameter labels.
■
■
Time line: indicates the entire time length.
■ : indicates the time length of trend data.
: indicates the time length of no trend data.
can be moved within this time length.
cannot be moved within this time length.
Different color blocks along the time line indicate events of different types. See the color definition for the event type indicator.
BeneVision N1 Patient Monitor Operator’s Manual 15 - 1
(5)
(6)
(7)
(8)
(9)
Event area: displays the event of the cursor time. Selecting the event accesses the event list. If there is no event at the cursor time, the cursor time is displayed.
Cursor: this is adjusted by touching different locations. Adjusting this changes the data displayed in the Event area and Numeric area.
Numeric area: displays numeric values at the cursor indicated time. The background color of numeric values matches the alarm priority.
Slider: indicates the position of current screen time in the entire time length. Dragging this button left or right enables you to locate the trend data at a specific time and also refreshes trend data in current screen accordingly.
Button area.
15.2.3
Symbols on Review Pages
The following table lists the symbols on review pages.
Symbol
or
Description
Slider: indicates the position of current screen time in the entire time length. Dragging the slider left or right enables you to locate the trend data at a specific time and also refreshes data in current screen accordingly.
Goes to the previous or next event.
Event list: displays events in a chronological order. The most recent event is displayed at the top. The number of asterisk symbols before an event indicates alarm priority.
Print button: select it to output patient information and data through the printer.
15.2.4
Common Operations
This section describes common operations for all review pages.
15.2.4.1
Browsing Trend Data
Browse trend data in one of the following ways:
■
■
■
Move the cursor.
Move the slider .
Slide your finger on the screen.
15.2.4.2
Viewing Events
You can view the following types of events:
■
■
■
Manually triggered events
Parameter-related operation events and alarm-related events, such as starting NIBP measurement
Operation events not related to parameters, such as system time change
View events in either of the following ways:
■
■
Select
Select
and select the desired event.
or to jump to the previous event or next event.
Events are displayed in a chronological order. The most recent event is displayed at the top. The number of asterisk symbols before an event indicates alarm priority as follows:
■
■
■
***: high priority alarm
**: medium priority alarm
*: low priority alarm
15 - 2 BeneVision N1 Patient Monitor Operator’s Manual
15.2.5
Tabular Trends Review Page
The tabular trends review page displays trend data in a tabular form.
15.2.5.1
Entering the Tabular Trends Review Page
To enter the tabular trends review page, select the Main Menu quick key
→
from the Review column select
Tabular Trends .
15.2.5.2
Changing the Tabular Trend Group
To change the tabular trend group, follow this procedure:
1.
Enter the tabular trends review page.
2.
Set Trend Group .
15.2.5.3
Editing the Tabular Trend Group
The setting of the Trend Group defines the contents of displayed trends. It is possible to edit any trend group except for the All and Standard trend groups. To do so, follow this procedure:
1.
Enter the tabular trends review page:
2.
Select Group Setup → select the desired tab.
◆ Rename the trend group (optional): select the desired name.
symbol at the upper left corner and input the
◆
Add parameters: select desired parameters from the Choices column, and then select Add . Selecting
Add All adds all parameters (up to the maximum of 83).
◆ Delete parameters: select desired parameters from the Selected column, and then select Delete .
Selecting Delete All deletes all parameters except for HR.
◆
Move the position of parameters displayed on the trend page: select desired parameters from the
Selected column, and then select Move up , Move Down , Move to Top , or Move to Bottom .
◆ Display two parameters side by side: select two parameters from the Selected column, and then select Overlap . Then, the symbol appears at the right of the overlapped parameters. The overlapped parameters will be displayed side by side in one numerics area and waveform area.
◆ Unoverlap two parameters: select the overlapped parameters from the Selected column, and then select Unoverlap .
Selecting Default will restore the trend group settings to factory defaults.
NOTE
•
Trend groups labeled All or Standard cannot be edited.
•
The HR parameter and waveform are always displayed in the first row on the trend page. It cannot be deleted or moved.
15.2.5.4
Changing the Resolution of Tabular Trend Data
The interval of tabular trends defines the interval of displaying trend data. A short interval is especially suited for neonatal applications, where the clinical situation may change very quickly. In adult monitoring, where the patient's status typically changes more gradually, a longer interval may be more informative.
To change the interval of trend data, follow this procedure:
1.
Enter the tabular trends review page.
2.
Select Interval .
◆
5 sec or 30 sec : select to view up to 4 hours of tabular trends at an interval of 5 seconds or 30 seconds.
◆
1 min, 5 min, 10 min, 15 min, 30 min, 1 hr, 2 hrs, or 3 hrs : select to view up to 120 hours of tabular trends at selected interval.
◆ Select parameters, such as NIBP, or GCS, to view the tabular trends when these parameter measurements are acquired.
BeneVision N1 Patient Monitor Operator’s Manual 15 - 3
NOTE
•
Changing between intervals does not typically change the position of the slider or cursor except to round it to the nearest interval, however changing intervals to be 30 seconds or less will move any cursor position more than 4 hours ago to the oldest data less than 4 hours ago.
15.2.5.5
Printing a Tabular Trends Report
To print a tabular trends report, follow this procedure:
1.
Enter the tabular trends review page.
2.
Select to enter the Print Setup dialog.
3.
Set the tabular trends report as described in 18.6.3 Configuring Tabular Trends Reports .
4.
Select Print or Print (All) .
◆ Print : the trend data before the above set Time , for the above set Period , and at the above set
Interval will be printed.
◆
Print (All) : all the stored trend data will be printed at the review interval.
15.2.6
Graphics Trends Review Page
The graphic trends review page displays trend data in a visual format.
15.2.6.1
Entering the Graphic Trends Review Page
To enter the graphic trends review page, select the Main Menu quick key
→ from the Review column select
Graphic Trends .
15.2.6.2
Changing the Graphic Trend Group
To change the graphic trend group, follow this procedure:
1.
Enter the graphic trends review page.
2.
Select and set Trend Group .
15.2.6.3
Editing the Graphic Trend Group
1.
Enter the graphic trends review page.
2.
Select and select Group Setup.
For more information, see
15.2.5.3 Editing the Tabular Trend Group
for detail on how to edit the group.
15.2.6.4
Changing the Resolution of Trend Data
To change the length of trend data displayed on the current screen, follow this procedure:
1.
Enter the graphic trends review page.
2.
Select Zoom .
◆
8 min: the screen displays eight minutes of trend data. You can view the most recent one hour of data.
◆ 30 min, 1 hr, 2 hrs, 4 hrs : the screen displays 30 minutes, one hour, two hours, or four hours of trend data. You can view the most recent four hours of data.
◆
8 hrs, 12 hrs, 24 hrs, 48 hrs : the screen displays 8 hours, 12 hours, 24 hours, or 48 hours of trend data.
You can view the most recent 120 hours of data.
15.2.6.5
Changing the Number of Waveforms
To change the number of waveforms displayed on the trend review page, follow this procedure:
1.
Enter the graphic trends review page.
2.
Select and set Trend Group .
15 - 4 BeneVision N1 Patient Monitor Operator’s Manual
15.2.6.6
Printing a Graphic Trends Report
To print a graphic trends report, follow this procedure:
1.
Enter the graphic trends review page.
2.
Select to enter the Print Setup dialog.
3.
Set the graphic trends report as described in
18.6.4 Configuring Graphic Trends Reports
.
4.
Select Print to print the graphic trend data before the above set Time and for the above set Period .
15.2.7
Events Review Page
The monitor stores events in real time, including technical alarm events, physiological alarm events, manual events, and operational events. When an event occurs, all the measurement numerics and three event-related waveforms 16 seconds before and after the event are stored.
NOTE
•
Alarms are saved as events and will be maintained if the equipment is powered down. The time of equipment power down is not recorded as an event and cannot be reviewed.
•
Earlier events will be overwritten by later ones if the storage capacity is reached.
•
A total loss of power does not affect the events already stored.
15.2.7.1
Entering the Events Review Page
To enter the events review page, select the Main Menu quick key
→ from the Review column select Events .
The Event page displays the event list. Events are displayed in descending chronological order, with the most recent displayed at the top. The number of asterisk symbols before an event indicate alarm priority as described
.
Different color blocks are displayed on the left of each event to indicate different event types.
■
■
■
■
■
Red: high priority alarm event
Yellow: medium priority alarm event
Cyan: low priority alarm event
Green: manual event
White: operation-related event
The number of currently selected events and the total number of events are displayed at the top right corner of the event list. For example, 2/4 indicates that the selected event is the second event in the filtered events and the total number of filtered events is 4. Total indicates the total number of events. For example: Total : 28 means that there are a total of 28 events.
15.2.7.2
Configuring the Filter
You can filter events to facilitate event review. To configure the filter, follow this procedure:
1.
Enter the Events page.
2.
Select Filter . From the drop-down list, select the desired filter item.
You can create up to two sets of custom filter. To do so, follow this procedure:
1.
From the Filter drop-down list, select Custom 1 or Custom 2 to enter the Filter Setup menu.
2.
Select the Name field to edit the name of the custom filter criterion.
3.
Select the desired items.
If you want to review events which happened around certain time, select the button → set the time → select Ok
.
The cursor then jumps to the event happened closest to the time entered.
15.2.7.3
Editing Events
To edit events, follow this procedure:
1.
Enter the Events page and tick off the desired events.
BeneVision N1 Patient Monitor Operator’s Manual 15 - 5
2.
Select to edit the selected events.
◆ Lock : manually lock the event. Locked events cannot be deleted.
◆ Note : enter comments for the event.
◆ Rename : allow renaming an event name. Only manual events and arrhythmia events can be renamed if enabled by the hospital’s settings.
15.2.7.4
Viewing Event Details
To view waveforms and parameter values at the event time, follow this procedure:
1.
Enter the Events page.
2.
Select Detail .
To display beat labels on the first ECG waveform, switch on Beat Anno . The white beat labels indicate heart beats classification and may explain suspected, missed, or false arrhythmia calls. Heart beats are classified as follows:
■
■
■
■
■
■
■
■
N = Normal
V = Ventricular ectopic
S = Supraventricular premature
P = Paced
L = Learning
? = Insufficient information to classify beat
I = Inoperative (for example, Lead Off )
M = Missed beat
If you switch on Beat Anno on the Events page, beat labels will also be displayed on the Full Disclosure page, and vise versa. Beat labels can be printed out.
15.2.7.5
Printing Event Reports
To print event reports via a printer, follow this procedure:
1.
Enter the events review page.
2.
Select to enter the Print Setup dialog.
3.
Select the desired options.
◆ Print All Event List : print the entire event list.
◆ Print List of Selected Events : print the list of selected events.
◆ Print Detail of Selected Events : print the details of selected events.
◆ Print Displayed Event Detail : print the waveforms and parameters of the currently displayed event.
4.
Select Print .
15.2.8
Full Disclosure Review Page
You can review up to 48 hours of waveform data on the full disclosure review page. You can view both the compressed waveforms and numeric values.
15.2.8.1
Entering the Full Disclosure Review Page
To enter the full disclosure review page, select the Main Menu quick key
→ from the Review column select Full
Disclosure .
15.2.8.2
Selecting Waveforms
You can select the waveforms to be displayed and stored. Up to 48 hours of waveforms for all parameters can be stored. When closing the Select Waveform dialog, a prompt will inform you of the duration of waveforms that can be saved if the amount is less than 48 hours. To save and display the desired waveforms, follow this procedure:
15 - 6 BeneVision N1 Patient Monitor Operator’s Manual
1.
Enter the full disclosure review page.
2.
Select and select Setup to enter the Select Waveform page.
3.
Select the Storage tab and set the desired waveforms to be stored in the monitor. Select the Display
(Maximum: 3) tab and set the desired waveforms to be displayed on the Full Disclosure page.
NOTE
•
Storing more waveforms may shorten the storage time to less than 48 hours. Please adjust the waveforms stored with this consideration.
•
Parameter labels from external devices are prefixed with the plus sign (+).
In case of alarms, the background of the compressed waveform is highlighted with a colored block during the alarm time:
■
■
■
Red: high alarm priority
Yellow: medium alarm priority
Cyan: low alarm priority
15.2.8.3
Setting the Scale and Duration
To set the length and size of displayed compressed waveforms, follow this procedure:
1.
Enter the full disclosure review page.
2.
Select Overview . If there is no Overview button in the Full disclosure page, skip this step.
3.
Set the waveforms scale in either of the following ways:
◆
Select the Scale button. If you do not see Scale , select the
◆
Select the waveform label.
4.
Select Duration to set the length of displayed waveforms.
button to show it.
5.
Select the parameter label beside the waveforms to set scale for each parameter.
15.2.8.4
Viewing Details of Compressed Waveforms
To view the full waveforms and numeric values, follow this procedure:
■
■
■
1.
Enter the full disclosure review page.
2.
Select Detail .
You can perform the following operations on the this page:
Switch on Beat Anno . For more information, see
15.2.7.4 Viewing Event Details
.
Select and , ECG Gain , or Save As Event .
Select Overview to switch to the compressed waveform view.
15.2.8.5
Printing the Full Disclosure Waveform Report
To print a compressed waveform report, follow this procedure:
1.
Enter the full disclosure review page.
2.
Select to enter the Print Setup dialog.
3.
Select waveform type you want to print:
◆ Print Waveform Overview : compressed waveform of selected period will be printed. This option is only available when printing from the Overview or compressed waveform view.
◆
Print Displayed Waveform Detail : parameter values and all stored waveforms around the cursor time will be printed. This option is only available when printing from the Detail view.
4.
Select Print .
BeneVision N1 Patient Monitor Operator’s Manual 15 - 7
NOTE
•
When a parameter label is prefixed with the plus sign (+) on a printout, it indicates that the data is from an external device.
15.2.9
OxyCRG Review Page (available when the N1 is used with the independent external display)
You can review up to 48 hours worth of 4 minute trend curves on the OxyCRG review page. The OxyCRG review functionality is available for neonatal monitoring only.
NOTE
•
OxyCRG Review Page is available only when Patient Category is set to Neo.
15.2.9.1
Entering the OxyCRG Review Page
■
■
Choose one of the following methods to enter the OxyCRG review page:
From the OxyCRG screen, select the ABD events list area.
Select the Main Menu quick key → from the Review column select OxyCRG .
15.2.9.2
The Display of the OxyCRG Review Page
The following figure shows the OxyCRG screen:
(1)
(2) (2)
(3)
(1) Event title area: displays information of the selected event, such as the event type and time.
(2) Event detail area: displays 4 minutes of parameter trends and compressed waveform, and parameter values of the selected event.
(3) Event summary area: displays ABD events within the Zoom period. The selected event is enclosed in a white frame.
(4) Event statistics area: displays the total number of ABD events and the numbers of each event within the Zoom period.
15.2.9.3
Changing the Resolution of Trend Curves
To set the resolution of trend curves, follow this procedure:
1.
Enter the OxyCRG review page.
2.
Set Zoom .
(4)
15 - 8 BeneVision N1 Patient Monitor Operator’s Manual
NOTE
•
If the Zoom is set for a large duration (for example, 8 hrs), the screen may show "No Patient Data" for the first several minutes of data collection (for example, 6 minutes), but data will be shown after enough data has been collected.
15.2.9.4
Printing an OxyCRG Review Report
To print an OxyCRG review report, follow this procedure:
1.
Enter the OxyCRG review page.
2.
Select to enter the Print Setup dialog.
3.
Select Print . The report duration corresponds to the duration of data shown on the screen.
15.2.10
12-Lead ECG Review Page
When 12-lead ECG analysis is performed, you can review the most recent 20 events of 12-lead analysis. For more information, see
8 Resting 12-Lead ECG Analysis
.
15.2.10.1 Entering the 12-Lead Review Page
Choose one of the following methods to enter the 12-lead ECG review page:
■
■
Upon completion of 12-lead ECG analysis, select Review from the 12-Lead Interpretation page. For more
information, see 8 Resting 12-Lead ECG Analysis .
Select the Main Menu quick key → from the Review column select 12-Lead ECG .
15.2.10.2 Switching to Median Complex (for Glasgow Algorithm Only)
The median complex template displays 12-lead ECG waveforms on one page in 4 columns, with 3 lines in each column, and one rhythm lead waveform at the bottom. Additionally, a short vertical bar appears above each waveform, marking the start and end positions of the P-wave and the QRS-wave and the end position of T-wave.
To view Median Complex, follow this procedure:
1.
Enter the 12-lead review page.
2.
Select Median Complex .
Selecting Waveform can return to the 12-lead ECG waveform page.
15.2.10.3 Setting 12-Lead ECG Waveforms
To set the 12-lead ECG waveforms on the review page, follow this procedure:
1.
Enter the 12-lead review page.
2.
Set Speed , Gain , and Layout .
15.2.10.4 Printing the 12-Lead ECG Report
To print the 12-Lead ECG report, follow this procedure:
1.
Enter the 12-lead review page.
2.
Select .
3.
Configure the 12-lead ECG report.
4.
Select Print .
15.3
Reviewing Discharged Patients
For discharged patients, you can review the trend data in the review page. You can also review the events and
12-lead ECG analysis results.
BeneVision N1 Patient Monitor Operator’s Manual 15 - 9
15.3.1
Checking the Data of a Discharged Patient
1.
Access the Discharged Patients dialog box by selecting the Main Menu quick key
→ from the Patient
Management column select Discharged Patients .
2.
From the patient list select the desired patient.
3.
Select Detail .
15.3.2
Checking the Information of a Discharged Patient
1.
Access the data of the discharged patient as described in
15.3.1 Checking the Data of a Discharged Patient
.
2.
Select the icon to enter the Patient Management dialog box.
3.
Select Ok to exit the Patient Management dialog box.
15 - 10 BeneVision N1 Patient Monitor Operator’s Manual
16
Clinical Assistive Applications (CAA) (available when the N1 is used with the independent external display)
The Clinical Assistive Applications (CAA) function integrates some commonly used clinical guidelines and tools into the monitor. It puts the currently monitoring parameter measurements together and provides comprehensive analysis results.
CAA can improve the clinician’s working efficiency. However, it is not directly used for diagnosis and cannot not replace the clinician’s judgement.
16.1
Checking Software Licenses
Licenses are required to run the following CAA functions in the monitor:
■ Early Warning Score (EWS)
■ SepsisSight
To check the licenses, select the Main Menu quick key → select License → Local .
To install the licenses, follow this procedure:
1.
Connect the N1 to the Dock.
2.
Connect the USB drive to the Dock’s USB connector.
3.
Select the Main Menu quick key → select License → select External .
4.
Select Install .
16.2
Early Warning Score (EWS)
The Early Warning Scores (EWS) can help you recognize the early sign of deterioration in patients based on vital signs and clinical observations. It is based on the “Royal College of Physicians (2015) National Early Warning
Score (NEWS2): Standardizing the assessment of acute illness severity in the NHS, Report of a Working Party. RCP,
London. Depending on the score calculated, appropriate recommendations are displayed.
The monitor supports the following scores:
■
■
■
■
MEWS (Modified Early Warning Score)
NEWS (National Early Warning Score)
NEWS2 (National Early Warning Score 2)
Custom Score
A subscore is given for each parameter based on the measured or entered value. When all the required parameters are entered or measured, the subscores are added together to calculate the total early warning score. Each subscore has a color coding to indicate associated level of risk. When the total score is outside of the thresholds, actions are recommended. MEWS, NEWS and NEWS2 can give total scores.
Custom Score is based on user-defined parameters.
MEWS, NEWS and NEWS2 are intended for adult patients only. The patient category applied to the Custom Score is defined by the Mindray Clinical Score Configuration Tool. For more information, see Mindray Clinical Scoring
Config Tool Instruction for Use (P/N: 046-012986-00).
WARNING
•
EWS is not intended for pediatric and neonatal patients
•
The EWS scores and recommended actions are for reference only and cannot be directly used for diagnostic interpretation.
BeneVision N1 Patient Monitor Operator’s Manual 16 - 1
•
EWS cannot be used as an prognosis index. It is not a clinical judgement tool. Clinicians must use their clinical judgement in conjunction with the EWS tool at all times.
•
MEWS and NEWS are intended for adult patients only. NEWS is not applicable to pregnant woman and COPD (Chronic Obstructive Pulmonary Disease) patients.
NOTE
•
The EWS scores does not trigger any alarms and cannot used for continuous monitoring.
16.2.1
Displaying the EWS Numerics Area
To display the EWS numerics area, follow this procedure:
1.
Access Tile Layout in either of the following ways:
◆ Select the Screen Setup quick key → select the Tile Layout tab.
◆ Select the Main Menu quick key → from the Display column select Tile Layout .
2.
Select the parameter area where you want to display the EWS score, and then from the popup list select
EWS .
(2)
(1)
(3)
(8)
(4)
(5)
(6)
(5)
(6)
(7
(8)
(1)
(2)
(3)
(4)
(7)
EWS protocol label
Scoring countdown: time to the next scoring.
Scoring interval
The scoring time
Single parameter whose score reaches 3
Risk level indicator. The level of risk increases from top down. The current level is enclosed by a white square frame.
History total score. The rightmost one is the latest history score.
Total score. The color of the circle indicates the level of risk.
16.2.2
Accessing the EWS Screen
Access the EWS window in any of the following ways:
■
■
■
■
Select the EWS parameter area
Select the EWS quick key.
Select the Screen Setup quick key → select the Choose Screen tab → select EWS .
Select the Main Menu quick key → from the CAA column select EWS .
When the EWS screen is hidden as
EWS screen.
, you can also choose one of the following methods to quickly enter the
■
■
Swipe left or right across the touchscreen with two fingers until you switch to the EWS screen.
Swipe right across the touchscreen with a single finger ,
16 - 2 BeneVision N1 Patient Monitor Operator’s Manual
■ Select the button ,
Take NEWS2 as an example, the EWS screen is shown as follows. Your screen may be slightly different due to the configuration.
(12) (11) (10) (9)
(1)
(2)
(8)
(7)
(6)
(3)
(4)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(5)
Total score. The color of the circle indicates the level of risk.
Risk level indicator. The level of risk increases from top down. The current level is enclosed by a white frame.
Parameter area: display the subscore and parameter value of each parameter. The keyboard symbol indicates that the parameter value is manually entered.
History total scores area: selecting this area or swiping up with one finger can review the trends of total score and each subscore
Selecting this button expands the History Total Scores area where your can review the trends of the total score and each subscore.
Selecting this button or swiping right across the screen with one finger displays the trends of total score and parameter values for scoring.
Clinician ID (displays only when the Clinician ID is enabled): allows inputing the Clinician ID to associate with the
EWS score. For more information, see
21.4.1 Enabling Inputing the Clinician ID .
Select this button to see the clinical response to the current score
Scoring interval
EWS protocol label
Scoring countdown: time to the next scoring.
The scoring time
16.2.3
Performing EWS Scoring
To perform scoring, follow this procedure:
1.
Select Reset to clear the previous score and update values of currently monitored parameters and relevant subscores.
BeneVision N1 Patient Monitor Operator’s Manual 16 - 3
2.
For NEWS2, set the SpO2 Scale .
◆ Scale 1 : for patient without hypercapnic respiratory failure.
◆ Scale 2 : f or patients with a prescribed oxygen saturation requirement of 88–92% (for example, in patients with hypercapnic respiratory failure).
3.
Measure or manually enter other required parameters and observations.
4.
If the clinician ID is enabled, input the clinician information by selecting and manually entering the information, or by scanning the clinician’s barcode.
5.
Select Calculate to get the total score.
6.
If Score Confirmation is enabled, select Confirm to save current scoring, or select Cancel to give up
CAUTION
•
The decision to use Scale 2 of the SpO2 Scale should be made by a competent clinical decision maker and should be recorded in the patient’s clinical notes.
NOTE
•
Before calculating the score, select Reset to clear the previous score.
•
The keyboard symbol at the right of the parameter value indicates that the value is manually entered.
•
You can get the score only when all required parameters have been measured or entered.
16.2.4
Changing EWS Settings
16.2.4.1
Changing the Scoring Protocol
The monitor is configured with a default scoring protocol. To change the scoring protocol, follow this procedure:
1.
From the EWS page select Setup .
2.
Set Score .
16.2.4.2
Setting the Scoring Confirmation Switch
To select if confirmation is required before saving score, follow this procedure:
1.
From the EWS page select Setup .
2.
Set Score Confirmation switch.
◆ Off: the monitor automatically saves the scoring result after the scoring is completed.
◆ On: you need to confirm that whether the scoring result is saved or not after the scoring is completed.
16.2.4.3
Setting the Manual Data Timeout
The manually input parameter data can be configured to become invalid after a preset time. To set the timeout period for the input data, follow this procedure:
1.
From the EWS screen select Setup .
2.
From the Manual Data Timeout area, select a desired parameter and set its timeout period.
NOTE
•
If the data is expired and not updated, the monitor displays the corresponding parameter score in outline font, and gives a timeout alarm.
16.2.4.4
Setting Auto Scoring
The monitor automatically starts scoring at the preset interval. To set auto scoring, follow this procedure:
16 - 4 BeneVision N1 Patient Monitor Operator’s Manual
1.
From the EWS page select Setup .
2.
Set Auto Scoring :
◆ Interval : the monitor automatically starts scoring at the preset interval.
◆ NIBP : the monitor automatically starts scoring at the completion of each NIBP measurement.
◆ Alarm : the monitor automatically starts scoring when an alarm occurs to the parameter for scoring.
◆ If no option is selected, the monitor does not initiate auto scoring.
16.2.4.5
Setting Auto Scoring Interval
1.
From the EWS page select Setup .
2.
Set Interval :
◆ By Score : the monitor automatically starts scoring as per the interval selected for corresponding total score.
◆
5 min - 24 h : If Auto Scoring is set to Interval , the monitor automatically starts scoring as per the selected interval. If Auto Scoring is not set to Interval , the countdown timer of manual scoring is selected.
16.2.5
Viewing Historical Scores
From the EWS screen, you can view the total score or subscores of the past 24 hours. To do so, choose either of the following ways:
■
■
Select the history total score area.
From the history total score area, swipe up with a finger.
To return to the EWS screen, select
from the top of the historical score screen. Refer to 16.2.2 Accessing the
for the position of the history total score area.
16.2.6
Viewing Parameter Trends
From the EWS screen, you can view the 24-hour graphic trends of each parameter used for scoring. To do so, choose either of the following ways:
■
■
Select the button.
Swipe right across the EWS screen with a finger.
From the screen of parameter trends, selecting the button or swiping left across the screen with a finger can return to the EWS screen.
Refer to 16.2.2 Accessing the EWS Screen
for the position of the button.
16.3
Glasgow Coma Scale (GCS)
The Glasgow Coma Scale (GCS) function is based on Teasdale’s Assessment of Coma and Impaired Consciousness-A
Practical Scale (Lancet, 1974) . Three aspects of behavior are independently measured: eye opening, verbal response, and motor response. The scores are added together to indicate that patient’s level of consciousness.
GCS is intended for adults and pediatric patients.
CAUTION
•
GCS is intended as an adjunct in patient assessment and must be used in conjunction with observation of clinical signs and symptoms.
•
GCS is not applied to patients that are sedated, muscularly relaxed, with artificial airway, drunk, hypothermia or in status epilepsies.
•
Please refer to hospital policy regarding acceptable use of GCS.
•
When applied to children younger than five years old or to the elderly, the GCS score may not reflect actual function.
BeneVision N1 Patient Monitor Operator’s Manual 16 - 5
16.3.1
Displaying the GCS Parameter Area
To display the GCS parameter area, follow this procedure:
1.
Access Tile Layout in either of the following ways:
◆ Select the Screen Setup quick key
→
select the Tile Layout tab.
◆
Select the Main Menu quick key
→ from the Display column select Tile Layout .
2.
Select the parameter area where you want to display the GCS score, and then from the popup list select
GCS .
The following figure shows the GCS parameter area. The display may be configured to look slightly different.
(4)
(1)
(5)
(2)
(3)
(1)
(2)
(3)
(4)
(5)
(6)
GCS label
Total score and level of consciousness. The color of the circle indicates the level of risk.
Scoring time
Scoring countdown: time to the next scoring
Scoring interval
Subscores
◆
E: eye opening
◆ V: verbal response
◆
M: motor response
(6)
16.3.2
Accessing the GCS Dialog
Enter the GCS dialog in any of the following ways:
■
■
■
Select the GCS parameter area.
Select the GCS quick key.
Select the Main Menu quick key
→ from the CAA column select GCS .
16 - 6 BeneVision N1 Patient Monitor Operator’s Manual
(1)
(2)
(1) Subscore (2) Total score
16.3.3
Performing GCS Scoring
To perform scoring, follow this procedure:
1.
From the Eye Opening area, Verbal Response area, and Motor Response area, respectively select an item that represents the patient’s status.
2.
Select Ok to accept the total score.
The following table lists the default score range and color of relevant consciousness level.
Level
Mild damage
Moderate damage
Severe damage
Range
13-15
9 - 12
3 - 8
Color
White
Yellow
Red
NOTE
•
The GCS score range is adjustable. Refer to
21.4.4 Setting GCS Threshold for Each Consciousness Level
for the method of changing the high limit and low limit of each consciousness level.
16.3.4
Setting GCS Scoring Interval
From the GCS dialog, select Interval to set GCS scoring interval. When the scoring interval is reached and you do not perform another scoring, the score will be invalidated and displayed as outline fonts.
16.3.5
Reviewing GCS Trend Data
From the GCS dialog, select Review to enter the Review dialog and view the GCS trend data from the Tabular
Trends .
16.4
SepsisSight
TM
The SepsisSight
TM
function is based on Third International Consensus Definitions for Sepsis and Septic Shock
(Sepsis-3) and Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock:
2016 (SSC Guideline 2016). It assists you in recognizing the early signs and symptoms of sepsis by comparing the state of the patient to the defined criteria and then guides you through the recommended treatment protocol.
BeneVision N1 Patient Monitor Operator’s Manual 16 - 7
CAUTION
•
SepsisSight is not a diagnostic or therapeutic tool and is not intended to replace the competent judgment of a clinician.
•
SepsisSight should not be used with intravenous immunoglobulins in adult patients with severe sepsis or septic shock.
•
SepsisSight should not be used with intravenous selenium for the treatment of severe sepsis.
•
SepsisSight should not be used with sodium bicarbonate therapy for the purpose of improving hemodynamics or reducing vasopressor requirements in patients with hypoperfusion-induced lactic acidemia with pH ≥7.15.
NOTE
•
SepsisSight is intended to perform routine screening of potentially infected seriously ill patients for severe sepsis to allow earlier implementation of therapy.
•
SepsisSight is intended to be followed by application of hospital–based performance improvement efforts in severe sepsis.
•
The Surviving Sepsis Campaign recommends to discuss goals of care and prognosis with patients and families.
•
The Surviving Sepsis Campaign recommends to incorporate goals of care into treatment and end-oflife care planning, utilizing palliative care principles where appropriate.
•
The SepsisSight goals of care are intended to be applied in a time defined by the SSC guidelines.
•
Due to space limitations on the screen, the recommendations cannot always be reproduced in the full detail available in the printed and on-line guidelines.
•
SepsisSight is intended for patients suffering from sepsis or suspicion of sepsis.
16.4.1
Accessing the SepsisSight Dialog
■
■
Enter the SepsisSight dialog in any of the following ways:
Select the SepsisSight quick key.
Select the Main Menu quick key → from the CAA column select SepsisSight .
16.4.2
Screening
As per Sepsis-3, SepsisSight supports quick Sepsis-Related Organ Failure Assessment (qSOFA, or quick SOFA) and
Sepsis-Related Organ Failure Assessment (SOFA).
16.4.2.1
Performing qSOFA qSOFA evaluates the patient’s respiration rate, systolic blood pressure and altered mental status.
RR and BP-S being monitored are automatically obtained. You can also manually enter these values by selecting the symbol. Select whether the patient’s mental status is altered. Then qSOFA score is calculated.
If the qSOFA score is greater than or equal to 2, or sepsis is suspected, select SOFA>> to perform SOFA.
To clear the score, select Reset .
NOTE
•
The keyboard symbol indicates that the parameter value is manually entered.
•
The question mark (?) in the score circle indicates that more parameter values are required before a score can be calculated.
16.4.2.2
Performing SOFA
SOFA score is used to identify organ function or the rate of sepsis-related organ failure.
16 - 8 BeneVision N1 Patient Monitor Operator’s Manual
To perform SOFA, enter the value or select a range for each item, SOFA score will be automatically calculated.
To clear the score, select Reset .
If Sepsis criteria is met, make a comprehensive judgement on the clinical features.
16.4.2.3
Changing Screening Settings
■
■
From the Screening page select Setup . You can change the following settings:
In the Screening area, set RR (rpm) high limit and BP-S (mmHg) low limit for qSOFA scoring.
In the Unit area, set the unit of Bilirubin and Creatinine .
16.4.3
Recommendations
As per the SSC Guidelines 2016, SepsisSight provides graded recommendations. Pages Part I and Part II in the
SepsisSight screen list these recommendations.
16.4.3.1
Viewing Detailed Recommendations
Select the icon at the right side of each item to view detailed recommendations of SSC Guideline
2016. The star symbol
★
indicates the grade of recommendation:
■
■
■
★★
: strong recommendation
★
: weak recommendation
No
★ symbol: ungraded strong recommendation
16.4.3.2
Marking Implemented Items
Check off implemented items. Then the time and date are automatically recorded and displayed.
■
■
You can select the symbol to change the date and time.
Select Reset to clear the current results.
16.4.4
Reviewing SepsisSight Trend Data
Select the Graphic Trends tab to view the trend of parameters of resuscitation.
When a recommended treatment is checked off on the Part I page and Part II page, relevant event is marked in the tabular trend. Vertical lines of different colors indicate the event type:
■
■
■
■
White: inspection performed
Blue: medication
Green: goal achieved
Purple: other treatment
BeneVision N1 Patient Monitor Operator’s Manual 16 - 9
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16 - 10 BeneVision N1 Patient Monitor Operator’s Manual
17
Calculation (only available when the N1 is used with the independent external display)
17.1
Calculation Overview
The monitor provides calculation functions. The calculated values, which are not directly measured, are computed based on the values you provide. The calculation function is independent of other monitoring functions and can therefore be used for patients being monitored by other monitors. Any operation in a calculation dialog does not affect the patient monitored by the current monitor.
You can perform the following calculations:
■
■
■
■
■
Drug calculations
Hemodynamic calculations
Oxygenation calculations
Ventilation calculations
Renal calculations
17.2
Calculation Safety Information
WARNING
•
Decisions on the choice and dosage of drugs administered to patients must always be made by the physician in charge. The drug calculations are based on the values input; it does not check the plausibility of the calculation performed.
•
Check that the entered values are correct and the calculated values are appropriate. Mindray assumes no responsibility for any consequences caused by wrong entries and improper operations.
17.3
Drug Calculations
17.3.1
Performing Drug Calculations
To perform drug calculations, follow this procedure:
1.
Access the drug calculator by either of the following ways:
◆ Select the Calculations quick key → select the Drug tab.
◆ Select the Main Menu quick key → from the Calculations column select Drug .
2.
Set Drug Name and Patient Category.
If the dose of drug is weight dependent, you must input the patient’s weight. The dose calculation program has a library of commonly used drugs, while Drug A through Drug E are user defined.
3.
Enter the known values, for example Drug Amount and Solution Volume.
4.
Select Calculate . The calculated values are indicated by red arrows.
NOTE
•
If available, the patient category and weight from the Patient Demographics dialog are automatically entered when you first access drug calculation. You can change the patient category and weight. This will not change the patient category and weight stored in the patient demographic information.
BeneVision N1 Patient Monitor Operator’s Manual 17 - 1
17.3.2
Checking the Titration Table
The titration table shows information on the currently used drugs. Use the titration table to see what dose of a drug your patient will receive at different infusion rates. To access the titration table, follow this procedure:
1.
Access drug calculator by either of the following ways:
◆ Select the Calculations quick key.
◆ Select the Main Menu quick key → from the Calculations column select Drug .
2.
Select the Titration Table tab.
3.
Select Dose Type to set the type of dose unit in the titration table.
4.
Select Interval to set the interval between two adjacent titration table items.
You can select how to display the titration table:
■
■
Dose : the titration table is listed in the sequence of increased drug dose.
Infusion Rate : the titration table is listed in the sequence of increased infusion rate. By default the resolution of the infusion rate is one (1). By selecting Exact Rate the resolution of the infusion rate can reach 0.01 so that you can display the infusion rate more accurately.
17.3.3
Drug Calculation Formula
Description
Dose
Dose (weight based)
Drug Amount
Drug Amount (weight based)
Duration
Duration (weight based)
Concentration
Solution volume
Infusion rate
Infusion rate (weight based)
Unit Formula
Dose/hr
Dose/min
Dose/kg/hr
Dose/kg/min g series: mcg, mg, g unit series: Unit, KU, MU mEq series: mEq g series: mcg, mg, g unit series: Unit, KU, MU mEq series: mEq hr hr mcg/ml, mg/ml, g/ml, Unit/ml,
KU/ml, MU/ml, mEq/ml ml ml/hr g•ml/hr
Dose = Infusion Rate × Concentration
Dose (weight based) = Infusion Rate ×
Concentration/Weight
Drug Amount =Dose × Duration
Drug Amount (weight based) = Dose × Duration ×
Weight
Duration = Amount/Dose
Duration (weight based) = Amount/(Dose × Weight)
Concentration = Drug Amount/Solution Volume
Volume = Infusion Rate × Duration
Infusion Rate = Dose/Concentration
Infusion Rate = Dose × Weight/Concentration
17.3.4
Titration Table Calculation Formula
Description
Infusion Rate
Infusion Rate (weight based)
Dose
Dose (weight based)
Unit ml/hr ml/hr
Dose/hr
Dose/min
Dose/kg/hr
Dose/kg/min
Formula
Infusion Rate = Dose/Concentration
Infusion Rate = Weight × Dose/Concentration
Dose = Infusion Rate × Concentration
Dose (weight based) = Infusion Rate ×
Concentration/Weight
17 - 2 BeneVision N1 Patient Monitor Operator’s Manual
17.4
Hemodynamic Calculations
The monitor provides the hemodynamic calculation function and can save the results of up to 10 calculations, which are displayed in groups.
17.4.1
Performing Hemodynamic Calculations
To perform hemodynamic calculation, follow this procedure:
1.
Access hemodynamic calculation by either of the following ways:
◆ Select the Calculations quick key → Hemodynamics tab.
◆ Select the Main Menu quick key → from the Calculations column select Hemodynamics .
2.
Enter the known values. For a patient who is being monitored, the currently measured values are automatically entered.
3.
Select Calculate .
A calculated value greater than the normal upper limit is indicated by an up arrow “ ↑ ”. A calculated value lower than the normal lower limit is indicated by a down arrow “
↓
”.
You can select Range to show the normal range of each parameter.
17.4.2
Input Parameters for Hemodynamic Calculations
Input Parameter cardiac output heart rate pulmonary artery wedge pressure mean arterial pressure pulmonary artery mean pressure central venous pressure end-diastolic volume height weight
Label
C.O.
HR
PAWP
MAP
PA-M
CVP
EDV
Height
Weight
Unit
L/min bpm mmHg mmHg mmHg mmHg ml cm kg
NOTE
•
If you enable Use PA-D as PAWP, PA-D value will be used to replace PAWP value for hemodynamic
17.4.3
Calculated Parameters and Formulas for Hemodynamic Calculations
Calculated Parameters cardiac index body surface area
Label
C.I.
BSA stroke volume stroke index systemic vascular resistance
SV
SVI
SVR
Unit
L/min/m
2 m
2 ml ml/m
2
DS/cm
5
Formula
C.I. (L/min/m
2
) = C.O. (L/min)/BSA (m
2
)
BSA (m
2
) = Wt
0.425
(kg) × Ht
0.725
(cm) ×
0.007184
SV (ml) = 1000× C.O. (L/min)/HR (bpm)
SVI (ml/m
2
) = SV (ml)/BSA (m
2
)
SVR (DS/cm
5
) = 79.96 × [APMAP (mmHg) -
CVP (mmHg)]/C.O. (L/min)
BeneVision N1 Patient Monitor Operator’s Manual 17 - 3
Calculated Parameters systemic vascular resistance index pulmonary vascular resistance pulmonary vascular resistance index left cardiac work
Label
SVRI
PVR
PVRI
LCW left cardiac work index left ventricular stroke work left ventricular stroke work index right cardiac work
LCWI
LVSW
LVSWI
RCW right cardiac work index right ventricular stroke work right ventricular stroke work index
RCWI
RVSW
RVSWI ejection fraction end-diastolic volume index
EF
EDVI end-systolic volume ESV end-systolic volume index ESVI
Unit
DS•m
2
/cm
5
DS/cm
5
DS•m
2
/cm
5 kg•m kg•m/m
2 g•m g•m/m
2 kg•m kg•m/m
2 g•m g•m/m
2
% ml/m2 ml ml/m
2
Formula
SVRI (DS•m
2
/cm
5
) = SVR (DS/cm
5
) × BSA (m
2
)
PVR (DS/cm
5
) = 79.96 × [PAMAP (mmHg) -
PAWP (mmHg)]/C.O. (L/min)
PVRI (DS•m
2
/cm
5
) = PVR (DS/cm
5
) × BSA (m
2
)
LCW (kg•m) = 0.0136 × APMAP (mmHg) × C.O.
(L/min)
LCWI (kg•m/m
2
) = LCW (kg•m)/BSA (m
2
)
LVSW (g•m) = 0.0136 × APMAP (mmHg) × SV
(ml)
LVSWI (g•m/m
2
) = LVSW (g.m)/BSA (m
2
)
R CW (kg•m) = 0.0136 × PAMAP (mmHg) × C.O.
(L/min)
R CWI (kg•m/m
2
) = RCW (kg.m)/BSA (m
2
)
R VSW (g•m) = 0.0136 × PAMAP (mmHg) × SV
(ml)
R VSWI (g•m/m
2
) = RVSW (g•m)/BSA (m
2
)
EF (%) = 100 × SV (ml)/EDV (ml)
EDVI (ml/m
2
) = EDV (ml)/BSA (m
2
)
ESV (ml) = EDV (ml) –SV (ml)
ESVI (ml/m
2
) = ESV (ml)/BSA (m
2
)
17.5
Oxygenation Calculations
The monitor provides the oxygenation calculation function and can save the results of up to 10 calculations, which are displayed in groups.
17.5.1
Performing Oxygenation Calculations
To perform oxygenation calculations, follow this procedure:
1.
Access oxygenation calculation by either of the following ways:
◆ Select the Calculations quick key
→
Oxygenation tab.
◆ Select the Main Menu quick key
→
from the Calculations column select Oxygenation .
2.
Enter the known values. For a patient who is being monitored, the currently measured values are automatically entered.
3.
Select Calculate .
A calculated value greater than the normal upper limit is indicated by an up arrow “
↑
”. A calculated value lower than the normal lower limit is indicated by a down arrow “ ↓ ”.
In the Oxygenation page, you can also perform the following operations:
■
■
Select OxyCont Unit , Hb Unit , and Pressure Unit . Then corresponding parameter values will be automatically converted and updated accordingly.
Select Range to show the normal range of each parameter.
17 - 4 BeneVision N1 Patient Monitor Operator’s Manual
17.5.2
Input Parameters for Oxygenation Calculations
Input Parameter cardiac output percentage fraction of inspired oxygen partial pressure of oxygen in the arteries partial pressure of carbon dioxide in the arteries arterial oxygen saturation partial pressure of oxygen in venous blood venous oxygen saturation hemoglobin respiratory quotient atmospheric pressure height weight
Label
C.O.
FiO
2
PaO
2
PaCO
2
SaO
2
PvO
2
SvO
2
Hb
RQ
ATMP
Height
Weight
17.5.3
Calculated Parameters and Formulas for Oxygenation Calculations
Unit
L/min
% mmHg, kPa mmHg, kPa
% mmHg, kPa
% g/L, g/dl, mmol/L
None mmHg, kPa cm, inch kg, lb
Calculated Parameters body surface area
Label
BSA alveolar-arterial oxygen difference capillary oxygen content
AaDO
2
CcO
2 venous admixture QS/QT
Unit m
2 oxygen consumption arterial oxygen content venous oxygen content
VO
2
ml/min
CaO
2 ml/L, ml/dL
CvO
2 ml/L, ml/dL arteriovenous oxygen content difference oxygen extraction ratio oxygen transport partial pressure of oxygen in the alveoli
C(a-v)O
2
O
2
ER
DO
2
PAO
2 ml/L, ml/dl
% ml/min mmHg, kPa mmHg, kPa ml/L, ml/dl
% oxygen transport index oxygen consumption
DO
2
I
VO
2
I ml/min/m
2 ml/min/m
2
Formula
BSA (m
2
) = Wt
0.425
(kg) × Ht
0.725
(cm) ×
0.007184
VO
2
(ml/min) = C(a-v)O
2
(ml/L)× C.O. (L/min))
CaO
2
(ml/L) = 10× (0.0134 × Hb (g/dl) × SaO
2
(%)) +0.031× PaO
2
(mmHg)
CvO
2
(ml/L) = 10× (0.0134 × Hb (g/dl) × SvO
2
(%)) +0.031 × PvO
2
(mmHg)
C(a-v)O
2
(ml/L) = CaO
2
(ml/L) - CvO
2
(ml/L)
O
2
ER (%) = 100×C(a-v)O
2
(ml/L)/CaO
2
(ml/L)
DO
2
(ml/min) = C.O. (L/min) × CaO
2
(ml/L)
PAO
2
(mmHg) = [ATMP (mmHg) - 47 mmHg] ×
FiO
2
(%)/100 - PaCO
2
(mmHg) × [FiO
2
(%)/100
+ (1 - FiO
2
(%)/100)/RQ]
AaDO
2
(mmHg) = PAO
2
(mmHg) - PaO
2
(mmHg)
CcO
2
(ml/L) = Hb (g/L) × 1.34 + 0.031 × PAO
2
(mmHg)
QS/QT (%) = 100× [1.34 × Hb (g/L) × (1 - SaO2
(%)/100) + 0.031 × (PAO2 (mmHg) - PaO2
(mmHg))]/[1.34 × Hb (g/L) × (1 - SvO2 (%)/
100) + 0.031× (PAO2 (mmHg) - PvO2
(mmHg))]
DO2I (ml/min/m
2
) = CaO2 (ml/L) × (C.O. (L/ min)/BSA (m
2
))
VO2I (ml/min/m
2
) = C (a-v) O2 (ml/L) ×(C.O. (L/ min)/BSA (m
2
))
BeneVision N1 Patient Monitor Operator’s Manual 17 - 5
17.6
Ventilation Calculations
The monitor provides the ventilation calculation function and can save the results of up to 10 calculations, which are displayed in groups.
17.6.1
Performing Ventilation Calculations
To perform ventilation calculations, follow this procedure:
1.
Access ventilation calculation by either of the following ways:
◆ Select the Calculations quick key → Ventilation tab.
◆ Select the Main Menu quick key → from the Calculations column select Ventilation .
2.
Enter the known values. For a patient who is being monitored, the currently measured values are automatically taken. If the anesthesia machine or ventilator is connected, measured values for ventilation calculation are also automatically entered.
3.
Select Calculate .
A calculated value greater than the normal upper limit is indicated by an up arrow “ ↑ ”. A calculated value lower than the normal lower limit is indicated by a down arrow “
↓
”.
On the Ventilation page, you can also perform the following operations:
■
■
Select Pressure Unit . Then corresponding parameter values will be automatically converted and updated accordingly.
Select Range to show the normal range of each parameter.
17.6.2
Input Parameters for Ventilation Calculations
Input Parameter percentage fraction of inspired oxygen respiration rate partial pressure of mixed expiratory CO2 partial pressure of carbon dioxide in the arteries partial pressure of oxygen in the arteries tidal volume respiratory quotient atmospheric pressure
Label
FiO
2
RR
PeCO
2
PaCO
2
PaO
2
TV
RQ
ATMP
17.6.3
Calculated Parameters and Formulas for Ventilation Calculations
Unit
% rpm mmHg, kPa mmHg, kPa mmHg, kPa ml
None mmHg, kPa
Calculated Parameters Label partial pressure of oxygen in the alveoli
PAO
2 alveolar-arterial oxygen difference oxygenation ratio
AaDO
2
Pa/FiO
2 arterial to alveolar oxygen ratio minute volume a/AO
2
MV
Unit mmHg, kPa mmHg, kPa mmHg, kPa
%
L/min
Formula
PAO
2
(mmHg) = [ATMP (mmHg) - 47 mmHg] ×
FiO
2
(%)/100 - PaCO
2
(mmHg) × [FiO
2
(%)/100
+ (1 - FiO
2
(%)/100)/RQ]
AaDO
2
(mmHg) = PAO
2
(mmHg) - PaO
2
(mmHg)
Pa/FiO
2
(mmHg) = 100 × PaO
2
(mmHg)/FiO
2
(%) a/AO
2
(%) = 100 × PaO
2
(mmHg)/PAO
2
(mmHg)
MV (L/min) = [TV (ml) × RR (rpm)]/1000
17 - 6 BeneVision N1 Patient Monitor Operator’s Manual
Calculated Parameters Label volume of physiological dead space physiologic dead space in percent of tidal volume alveolar volume
Vd
Vd/Vt
VA
Unit ml
%
L/min
Formula
Vd (ml) = TV (ml) × [1 - PeCO
2
(mmHg)/PaCO
2
(mmHg)]
Vd/Vt (%) = 100 × Vd (ml)/TV (ml)
VA (L/min) =[TV (ml) - Vd (ml)] × RR (rpm)/
1000
17.7
Renal Calculations
The monitor provides the renal calculation function and can save the results of up to 10 calculations, which are displayed in groups.
17.7.1
Performing Renal Calculations
To perform renal calculations, follow this procedure:
1.
Access renal calculation by either of the following ways:
◆ Select the Calculations quick key
→
select the Renal tab.
◆ Select the Main Menu quick key
→
from the Calculations column select Renal .
2.
Enter the known values.
3.
Select Calculate .
A calculated value greater than the normal upper limit is indicated by an up arrow “
↑
”. A calculated value lower than the normal lower limit is indicated by a down arrow “ ↓ ”.
You can select Range to show the normal range of each parameter.
17.7.2
Calculated Parameters and Formulas for Renal Calculations
Input Parameter urine potassium urinary sodium urine plasm osmolality urine osmolality serum sodium creatinine urine creatinine blood urea nitrogen height weight
Label
URK
URNa
Urine
Posm
Uosm
SerNa
Cr
UCr
BUN
Height
Weight
Unit mmol/L mmol/L ml/24 hrs mOsm/kgH
2
O mOsm/kgH
2
O mmol/L
μmol/L
μmol/L mmol/L cm kg
BeneVision N1 Patient Monitor Operator’s Manual 17 - 7
17.7.3
Calculated Parameters and Formulas for Renal Calculations
Calculated Parameters urine sodium excretion
Label
URNaEx urine potassium excretion URKEx sodium potassium ratio Na/K clearance of sodium fractional excretion of sodium osmolar clearance
CNa creatinine clearance rate Clcr
FENa
Cosm free water clearance CH2O urine to plasma osmolality ratio blood urea nitrogen creatinine ratio urine-serum creatinine ratio
U/P osm
BUN/Cr*
U/Cr
*: BUN/Cr is a ratio under the unit of mol.
Unit mmol/24 hrs mmol/24 hrs
% ml/24 hrs ml/min
% ml/min ml/hr
None
Mmol/L
Formula
URNaEx (mmol/24 hrs) = Urine (ml/24 hrs) ×
URNa (mmol/L)/1000
URKEx (mmol/24 hrs) = Urine (ml/24 hrs) ×
URK (mmol/L)/1000
Na/K (%) = 100 × URNa (mmol/L)/URK (mmol/
L)
CNa (ml/24 hrs) = URNa (mmol/L) × Urine (ml/
24 hrs)/SerNa (mmol/L)
Clcr (ml/min) = Ucr (μmol/L) × Urine (ml/24 hrs)/[Cr (μmol/L) × (BSA (m
2
)/1.73) × 1440]
FENa (%) = 100 × URNa (mmol/L) × Cr (μmol/
L)/[SerNa (mmol/L) × Ucr (μmol/L)]
Cosm (ml/min) = Uosm (mOsm/kgH
2
O) ×
Urine (ml/24 hrs)/(Posm (mOsm/kgH
2
O) ×
1440)
CH2O (ml/hr) = Urine (ml/24 hrs) × [1 - Uosm
(mOsm/kgH
2
O)/Posm (mOsm/kgH
2
O)]/24
U/P osm = Uosm (mOsm/kgH
2
O)/Posm
(mOsm/kgH
2
O)
BUN/Cr = 1000 × BUN (mmol/L)/Cr (μmol/L)
17 - 8 BeneVision N1 Patient Monitor Operator’s Manual
18
Printing
18.1
Supported Printer
The monitor can output patient reports via a connected network printer. The monitor supports the following printers:
■
■
■
■
■
■
HP LaserJet Pro M202dw
HP LaserJet Pro 400 M401n
HP LaserJet P4015n
HP LaserJet 600 M602
HP LaserJet Enterprise M605
HP LaserJet Enterprise M608n
NOTE
•
For more details about the printer, refer to the document accompanying the printer. With product upgrades, the monitor may support additional printers without prior notice. If you have any doubts about the compatibility of the printer used with this monitor, contact Mindray.
18.2
End Case Reports
18.2.1
Printing the End Case Report
To print the end case report, choose one of the following ways:
■
■
■
Select Print from the End Case Report menu.
Select Print End Case Report when you discharge a patient.
Select the End Case Report quick key (only available when the N1 is used with the independent external display).
18.2.2
Setting a Report as An End Case Report
■
■
■
■
■
■
■
The following reports can be set as end case reports:
Tabular Trends Report
Graphic Trends Report
Event Report
12-lead Interpretation
Alarm Limits Report
Realtime Report
ECG Report
To set a report as an end case report, follow this procedure:
1.
Select the Main Menu quick key → from the Report column select End Case Report .
2.
From the Select Reports page, select the desired report tab, for example ECG Report .
18.2.3
Configuring the End Case Reports
To configure the end case reports, follow this procedure:
1.
Select the Main Menu quick key
→ from the Report column select End Case Report .
BeneVision N1 Patient Monitor Operator’s Manual 18 - 1
2.
From the Report Setup page, set the following end case reports:
◆ Select the Tabular Trends Report , Graphic Trends Report , Realtime Report , and ECG Report tab, and set these end case report by referring to section
◆ Select the Event Report tab, and select the event that needs to be printed.
◆ Select the 12-Lead Interpretation tab, and set the switch of Median Complex , Measurements ,
Interpretation , or Interpretation Summary . For other settings, refer to section
18.2.4
Setting the End Case Report Period
To set the end case report print period, follow this procedure:
1.
Select the Main Menu quick key → from the Report column select End Case Report .
2.
From the Select Reports page, set the Period .
NOTE
•
End case report print period is calculated from the patient discharged time to the configured period.
•
Period setting is applicable to all of the end case reports.
18.3
Manually Starting a Printing Task
This section describes different methods for manually printing a report.
18.3.1
Printing from the Screen
The button will be shown at the top of dialogs that have associated reports. If the button is gray, then there is not enough information to begin the report, or the printer has not been set up.
When the icon is white, pressing it opens a Print Setup dialog or starts printing a report. If the Print Setup dialog is entered, configure the report and press Print to start printing.
18.3.2
Printing Realtime Reports
Select the Print quick key to print a realtime report. You can also print a realtime report from the Report Setup
dialog. For more information, see 18.3.3 Printing Most Common Reports .
18.3.3
Printing Most Common Reports
The following most common reports can be printed:
■
■
■
■
ECG Report
Realtime Report
Tabular Trends Report
Graphic Trend Report.
To print these reports, follow this procedure:
1.
Select the Main Menu quick key
→ from the Report column select Report Setup .
2.
Select the desired report tab.
3.
Check the settings.
4.
Select Print .
18.4
Automatically Printing Reports
When a parameter alarm switch is set to on and an alarm is triggered for this parameter, you can set the monitor to automatically print a Print on Alarm Report.
To do so, follow this procedure:
18 - 2 BeneVision N1 Patient Monitor Operator’s Manual
1.
Access alarm related tabs such as the Alarm tab for a parameter in one of the following ways:
◆ Select the parameter or waveform area of the desired parameter → select the Alarm tab.
◆ Select the Main Menu quick key → from the Parameters column select Setup → select the desired parameter
→
select the Alarm tab.
2.
Switch on Alarm Outputs for desired parameters.
18.5
Stopping a Printing Task
To stop a printing task, follow this procedure:
1.
Select the Main Menu quick key → from the Report column select Print Queue .
2.
Select desired printing tasks and then select Delete . Alternately, select Delete All to stop all the printing tasks.
18.6
Configuring Reports
This section focuses on how to configure ECG reports, realtime reports, tabular trends reports, and graphic trends reports.
18.6.1 Configuring ECG Reports
To configure ECG reports, follow this procedure:
1.
Select the Main Menu quick key → from the Report column select Report Setup .
2.
Select the ECG Report tab.
3.
Set the desired options.
The following table explains some of the less familiar options.
Menu item
Speed
Auto Interval
12-Lead Format
Rhythm Lead 1
Rhythm Lead 2
Rhythm Lead 3
Format Sequence
Function Description
Set the print speed of
ECG waveforms
25 mm/sec : prints 25 mm of ECG waveform per second.
50 mm/sec : prints 50 mm of ECG waveform per second.
Defines the spacing between the ECG waveforms on a printout
On: automatically adjusts the space between waveforms to avoid overlapping.
Off : each waveform area has the same size on a printout.
Note: Auto Interval is only enabled when 12×1 is selected for 12-Lead Format .
Select the format of 12lead ECG waveforms on a printout.
12×1: displays 12-lead ECG waveforms on one page in one column.
6×2 : displays 12-lead ECG waveforms on one page in two columns, with 6 lines in each column.
6×2+1 : displays 12-lead ECG waveforms on one page in two columns, with 6 lines in each column, and one rhythm lead waveform at the bottom.
3×4+1 : displays 12-lead ECG waveforms on one page in 4 columns, with 3 lines in each column, and one rhythm lead waveform at the bottom.
3×4+3 : displays 12-lead ECG waveforms on one page in 4 columns, with 3 lines in each column, and three rhythm lead waveforms at the bottom.
Select the lead that will be used as Rhythm
Lead 1, 2, or 3.
I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6
Note: Rhythm Lead setting is only enabled when 6×2+1 , 3×4+1 , or 3×4+3 is selected for
12-Lead Format .
Select the recording method of ECG report generated by auto measurement
Sequential : 12-lead ECG data are recorded sequentially and displayed in 3 lines and 4 columns with 2.5 seconds of ECG data for each column.
Simultaneous : Record simultaneous 12-lead ECG data.
BeneVision N1 Patient Monitor Operator’s Manual 18 - 3
NOTE
•
When ECG Lead Set is set to 3-Lead, the ECG report cannot be printed.
18.6.2
Configuring Realtime Reports
To configure tabular realtime reports, follow this procedure:
1.
Select the Main Menu quick key → from the Report column select Report Setup .
1.
Select the Realtime Report tab.
2.
Set the desired options.
The following table explains some of the options.
Menu item
Select Waveform
Function
Select the desired waveform to print
Description
Current Waveforms : prints the realtime report for the currently displayed waveforms and all the currently measured parameter values.
Selected Waveforms : prints the realtime report for the waveforms configured in the Select Waveform dialog, accessed by clicking the
Select Waveform button.
18.6.3
Configuring Tabular Trends Reports
To configure tabular trends reports, follow this procedure:
1.
Select the Main Menu quick key
→ from the Report column select Report Setup .
2.
Select the Tabular Trends Report tab.
3.
Set the desired options.
The following table explains some of the options.
Menu Item
Time
Period
Interval
Report Format
Function Description
Select the time before which a tabular trends report will be printed
Select the period during which a tabular trends report will be printed.
/
Select the resolution of the tabular trends printed on a report.
Select the printing principle.
Auto : one page of a tabular trends before the current time will be printed at the selected Interval .
All : all stored tabular trends will be printed at the selected
Interval .
30 min to 96 hrs : 30 min to 96 hrs of tabular trends before the selected Time will be printed at the selected Interval .
NIBP, EWS , GCS : at an interval of acquiring the values of selected parameter (EWS and GCS are only available when the N1 is used with the independent external display).
Auto : using the Interval setting of the Tabular Trends review page.
5 sec to 3 hrs : the tabular trends will be printed at the interval of 5 sec to 3 hrs .
Parameter Oriented : print one page span of report with parameters listed by row and time listed by column when
Interval is set to Auto .
Time Oriented : print one page span of report with time listed by row and parameter listed by column when Interval is set to Auto .
Note that Interval on Auto only limits the number of rows or columns for Time. The report may have multiple pages to accommodate the number of parameters. To limit the parameters, change the Trend Group .
18 - 4 BeneVision N1 Patient Monitor Operator’s Manual
18.6.4
Configuring Graphic Trends Reports
To set graphic trends reports, follow this procedure:
1.
Select the Main Menu quick key
→ from the Report column select Report Setup .
2.
Select the Graphic Trends Report tab.
3.
Set the desired options.
Menu Item
Period
Function
Select the period during which a graphic trends report will be printed.
Description
Auto : one page of a graphic trends before the current time will be printed.
All : all stored graphic rends will be printed..
30 min to 96 hrs : 30 min to 96 hrs of graphic trends before the selected Time will be printed.
18.7
Viewing Printer Status
You can view the status of the most recent ten printing tasks in the Print Queue dialog. To view the status of printing tasks, follow this procedure:
1.
Select the Main Menu quick key
→ from the Report column select Print Queue .
2.
View the status of printing tasks in the Print Queue dialog.
■
■
■
■
Each printing task includes the following information:
Print time
Report title
Printer name (when using the printer server) or IP address (when using the network printer)
Printing status, for example, printing, failed, retrying, and waiting.
18.8
Printer Out of Paper
When the printer runs out of paper, the print request will remain incomplete. If there are too many print jobs that remain incomplete, then a printer error may occur. To resolve the error, install paper. Some print requests may be lost if the incomplete tasks overflow the printer buffer. Missing or lost reports must be recreated and printed.
To reduce risks of printer errors, maintain enough paper in the printer.
18.9
List of Reports
The monitor can output the following reports to the printer:
■ Realtime reports
◆ Realtime Report
◆ Freeze Report
◆ ECG Report (5-lead, 6-lead , 12-lead)
◆ 12-Lead Interpretation Report (realtime)
◆ Print on Alarm Report
◆ Alarm Limits Report
◆ Titration Table Report (only available when the N1 is used with the independent external display)
◆ Hemodynamic Calculation Report (only available when the N1 is used with the independent external display)
◆ Oxygenation Calculation Report (only available when the N1 is used with the independent external display)
◆ Ventilation Calculation Report (only available when the N1 is used with the independent external display)
◆ Renal Calculation Report (only available when the N1 is used with the independent external display)
◆
ST Report (Realtime)
BeneVision N1 Patient Monitor Operator’s Manual 18 - 5
■
■
◆ QT Report (Realtime)
◆
OxyCRG Report (only available when the N1 is used with the independent external display)
◆ PAWP Report (only available when the N1 is used with the independent external display)
History reports
◆ Tabular Trends Report
◆ Graphic Trends Report
◆ Event List Report
◆ Event Detail Report
◆ Full Disclosure Overview Report
◆ Full Disclosure Detail Report
◆ 12-Lead Review Interpretation Report (review)
◆ OxyCRG Report (review, only available when the N1 is used with the independent external display)
◆ OxyCRG review Report (review)
End Case Report
◆ End Case Report Realtime Report
◆ End Case Report ECG Report
◆ End Case Report Tabular Trends Report
◆ End Case Report Graphic Trends Report
18 - 6 BeneVision N1 Patient Monitor Operator’s Manual
19
Using the On-Screen Timers
The monitor has a Timer function to notify you when a preset time period is expired or how much time has elapsed. You can simultaneously display up to four timers.
19.1
Displaying Timers
To display a timer, follow this procedure:
1.
Access Tile Layout in either of the following ways:
◆ Select the Screen Setup quick key → select the Tile Layout tab.
◆ Select the Main Menu quick key → from the Display column select Tile Layout .
2.
Click the numeric tile area where the timer is to be displayed, and then select a timer from the popup list.
19.2
Controlling the Timer
The timer provides the following controls, depending on the state and settings of the timer:
■
■
■
■
Start
Reset
: starts the timer.
Pause : pauses the timer.
Resume : resumes the timer.
: clears the timer.
19.3
Setting the Timer
You can set each timer independently. To set the timer, follow this procedure:
1.
Select the timer area to enter the Timer Setup dialog.
2.
Set Timer Type :
◆
Normal : The timer has a single and defined run time, and stops with a notification beep when the run time is reached.
◆ Advanced : The timer has a single and defined run time. When the run time is reached, the timer makes a notification beep and continuously displays the time beyond the end of run time.
◆
Cycled : The timer has a single and defined run time. When the run time is reached, the timer makes a notification beep and restarts automatically. The number of elapsed cycles is also displayed on the left of the Timer tile.
◆
Unlimited : The timer displays the time elapsed since the timer was started.
◆
Clock : The timer displays the system time.
3.
Set Direction .
◆
Up : the timer counts up, from zero to Run Time.
◆
Down : the timer counts down, from Run Time to zero.
4.
Set Run Time .
5.
Set Reminder Volume .
A progress bar is shown with the run time. When the remaining time is 10 seconds, the monitor issues a reminder tone and the timer flashes in red, prompting you that the run time is about to expire.
NOTE
•
You cannot change timer settings, other than Reminder Volume when a timer is running.
•
You can set Direct, Run Time, and Reminder Volume only for normal, advanced, and cycled timers.
BeneVision N1 Patient Monitor Operator’s Manual 19 - 1
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19 - 2 BeneVision N1 Patient Monitor Operator’s Manual
20
Managing Configurations
20.1
Configuration Introduction
■
■
■
■
■
When performing continuous monitoring on a patient, the clinical professional often needs to adjust the monitor’s settings according to the patient’s condition. The collection of all these settings is called a configuration. The system configuration items can be classified as: parameter configuration items, conventional configuration items, and user maintenance items. Allowing you to configure the monitor more efficiently, the monitor provides different sets of configurations to accommodate the varying patient categories and departments. You can change some settings from a certain set of configuration and then save the changed configuration as a user configuration.
The default configurations provided for your monitor are department-oriented. You can choose either from:
General
OR
ICU
Neonatology
CCU
Each department has three different sets of configurations tailored for adult, pediatric and neonatal patients respectively.
WARNING
•
The configuration management function is password protected. The configuration management tasks must be performed by clinical professionals.
20.2
Changing the Department
If the current department configuration is not the one you want to view, you can change the department by following this procedure:
1.
Select the Main Menu quick key → from the Configuration column select Manage → input the required password
→ select .
2.
Select Change Department .
3.
Select a department.
4.
Select Ok .
CAUTION
•
Changing the department will delete all current user configurations.
20.3
Setting Default Patient Category
To set the default patient category when admitting a new patient, follow this procedure:
1.
Select the Main Menu quick key
→
from the Configuration column select Manage
→ input the required password → select .
2.
Set Default Patient Category .
20.4
Setting Default Configuration
The monitor will load the pre-set default configuration in the following cases:
BeneVision N1 Patient Monitor Operator’s Manual 20 - 1
■
■
■
A patient is admitted.
A patient is discharged.
Patient category is changed.
To set the default configuration, follow this procedure:
1.
Select the Main Menu quick key
→
from the Configuration column select Manage
→ input the required password → Select .
2.
Select Select Default Config .
3.
Select Load the Latest Config or Load Specified Config .
◆ When you select Load Specified Config , the restored configuration is subject to the patient category
(adult, pediatric or neonate). This configuration can be either factory configuration or a saved user configuration. As an example, select Default Adult Config and then select Factory Default or user configuration(s).
◆ When you select Load the Latest Config , the latest configuration is loaded when the monitor is started or a patient is admitted.
20.5
Saving Current Settings
Current settings can be saved as a user configuration. Up to 25 user configurations can be saved.
To save current settings, follow this procedure:
1.
Select the Main Menu quick key → from the Configuration column select Manage → input the required password
→
Select .
2.
Select Save Current Settings .
3.
Input the configuration name.
4.
Select Ok to save current settings as a user configuration.
20.6
Deleting a Configuration
To delete a configuration, follow this procedure:
1.
Select the Main Menu quick key → from the Configuration column select Manage → input the required password
→
Select .
2.
Select Delete Configuration .
3.
Select the configuration you want to delete:
◆ In the Delete Configuration dialog, selecting Local tab shows the existing user configurations on the monitor.
◆ In the Delete Configuration dialog, selecting USB Drive tab shows the existing user configurations on the USB drive.
4.
Select Delete .
5.
Select Ok .
20.7
Transferring a Configuration
When installing several monitors with identical user configurations, it is not necessary to set each unit separately. Use a USB drive to transfer the configuration from monitor to monitor.
20.7.1
Exporting a Configuration
To export the current monitor’s configuration, follow this procedure:
1.
Connect the N1 to the Dock.
2.
Connect the USB drive to the Dock’s USB port.
3.
Select the Main Menu quick key
→
from the Configuration column select Manage
→ input the required password → Select .
20 - 2 BeneVision N1 Patient Monitor Operator’s Manual
4.
Select Export Configuration .
5.
Select the configurations and User Maintenance Settings to export.
6.
Select Export .
20.7.2
Importing a Configuration
To import the configuration from the USB drive to the monitor, follow this procedure:
1.
Connect the N1 to the Dock.
2.
Connect the USB drive to the Dock’s USB port.
3.
Select the Main Menu quick key
→
from the Configuration column select Manage
→ input the required password → Select .
4.
Select Import Configuration .
5.
Select the configurations and User Maintenance Settings to import.
6.
Select Import .
20.7.3
Loading a Configuration
You may make changes to some settings during operation. However, these changes or the pre-selected configuration may not be appropriate for the newly admitted patient. Therefore, the monitor allows you to load a desired configuration to ensure that all the settings are appropriate for your patient.
To load a configuration, follow this procedure:
1.
Select the Main Menu quick key → from the Configuration column select Load .
2.
Select the desired configuration.
◆ Select the configuration on this monitor in the Local page.
◆ Select the configuration on the USB drive in the USB Drive page.
3.
Select Load .
NOTE
•
The monitor may configure some settings by default when you load a configuration of different software version with the current configuration.
20.8
Printing Configurations
To print both factory configurations and user configurations, follow this procedure:
1.
Select the Main Menu quick key
→ from the Configuration column select Manage
→ input the required password → select .
2.
Select Print Configuration .
3.
Select desired configurations.
4.
Select Print .
20.9
Modifying Configuration Password
To modify the configuration password, follow this procedure:
1.
Select the Main Menu quick key
→
from the Configuration column select Manage
→ input the required password → Select .
2.
Select Modify Password .
3.
Respectively input the old password and new password.
4.
Select OK .
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20 - 4 BeneVision N1 Patient Monitor Operator’s Manual
21
Password-protected User Settings
This chapter describes the password-protected functions accessed in the Maintenance dialog.
21.1
Setting the Device Location
21.1.1
Setting Monitor Information
To set monitor information, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Device Location tab.
3.
Input monitor name, facility name and department name.
21.1.2
Setting Monitor Location
If your monitor is installed at a fixed position, or you do not need clinicians to change the room number and bed number, you can set Monitor Location to Fixed . To set the monitor location, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Device Location tab.
3.
Set Location .
◆ Fixed : the Patient Management dialog displays Bed No.
and Room No.
, but you cannot change them.
◆
Unfixed : you can change Bed No.
and Room No.
from the Patient Management dialog.
4.
Input the room number and bed number.
NOTE
•
If Location is set to Unfixed, Bed No.
and Room No.
are cleared from the Device Location tab each time you discharge a patient.
21.1.3
Enabling the Auto Obtain Bed Number Function
If the monitor is connected to the wired network, the monitor can automatically set the patient’s bed number according to the bed number information bonded to the bedside network connector.
To enable this function, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Device Location tab.
3.
Select Unfixed .
4.
Switch on Auto Obtain Bed No..
NOTE
•
The Auto Obtain Bed Number function is available only when the switch connected to the monitor supports the LLDP or CDP protocol, and the corresponding protocol is enabled.
BeneVision N1 Patient Monitor Operator’s Manual 21 - 1
21.2
Changing Patient Management Settings
21.2.1
Selecting Displayed Patient Information
You can define which items can be displayed and edited from the Patient Management tab. To do so, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Patient Management tab.
3.
Select the fields you want to display in the Patient Management dialog.
4.
If necessary, select the customized fields and input names for these fields.
NOTE
•
If the monitor is connected with the CMS, the patient information items and customized fields are loaded from the CMS.
21.2.2
Auto Discharging a Patient after Monitor Power Off
You can let the monitor automatically discharge after the monitor has been switched off for a period of time.
To set the time period of discharging a patient, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Patient Management tab
→ select the Discharge tab.
3.
Select a time for Auto Discharge When Power Off . The monitor will automatically discharge the patient when it is turned off for the designated period of time. The default is Never . That is to say the monitor will not automatically discharge a patient, regardless of how long the monitor has been switched off.
21.2.3
Clearing All Patient Data
You can delete all patient information and data in the monitor. To do so, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password
→
select .
2.
Select the Patient Management tab
→ select the Discharge tab.
3.
Select Clear All Patient Data .
4.
Select OK . Select OK again for confirmation until a message indicating you that all data is cleared.
CAUTION
•
Clearing patient data will discharge the current patient. Make sure there is no patient is being monitored before you clear all data.
21.2.4
Selecting Query Criteria for Searching Patients in ADT Server
You can define which criteria can be used to search patients in the ADT server. To do so, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Patient Management tab → ADT Query tab.
3.
Select the query criteria as desired.
21.2.5
Setting Patient Location Options for the Discharge Screen
To set options for patient location, follow this procedure:
21 - 2 BeneVision N1 Patient Monitor Operator’s Manual
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→
select .
2.
Select the Patient Management tab
→
select the Location tab.
3.
Input or edit patient location options.
21.2.6
Hiding Patient Name
To hide patient name on specific screens, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→
select .
2.
Select the Patient Management tab
→
select the Display tab.
3.
Set the following switches as desired:
◆ Switch off Primary Screen Display Full Name : does not display patient name in the patient information area on the primary display.
◆ Switch off Secondary Screen Display Full Name : does not display patient name in the patient information area on the secondary display, if configured.
◆ Switch off Remote View Display Full Name : does not display patient name in the patient information area on the remote monitors when this monitor is viewed by other monitors.
◆ Switch off Remote View Bedlist Display Full Name : does not display patient name in bed list on the remote monitors when this monitor is viewed by other monitors.
21.2.7
Select Whether a Prompt is Required When Auto Deleting Discharged Patients
The monitor automatically delete earlier discharged patients when the memory is limited. You can select whether an alarm is issued when discharged patients are automatically deleted and the monitor memory is very low.
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Set the Review tab → Discharged Patients tab.
3.
Configure the alarms as needed:
◆ Prompt on patient auto deleted: an alarm is issued when the monitor automatically deletes earlier discharged patients.
◆ Alarm on storage is nearly full : selects whether an alarm is issued when the monitor memory is very low and the priority of this alarm.
21.3
Changing the Alarm Settings
21.3.1
Setting Alarm Tone Properties
21.3.1.1
Setting the Minimum Alarm Volume
To set the minimum alarm volume, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Alarm tab
→
Audio tab.
3.
Set Minimum Alarm Volume .
21.3.1.2
Setting the Audible Alarm Tone Pattern
You can distinguishes the heart beat tone, pulse tone, and keystroke tone by frequency. You can choose any of the three tone patterns: ISO, Mode 1, and Mode 2. For more information, see
To set the alarm tone pattern, follow this procedure:
BeneVision N1 Patient Monitor Operator’s Manual 21 - 3
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password → select .
2.
Select the Alarm tab
→
Audio tab.
3.
Set Alarm Sound to ISO , Mode 1 or Mode 2 .
21.3.1.3
Setting the Interval between Alarm Sounds
If you choose the ISO pattern, you can change the interval between alarm tones. To change the interval between alarm tones, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password → select .
2.
Select the Alarm tab
→
Audio tab.
3.
Set High Alarm Interval , Med Alarm Interval , and Low Alarm Interval .
21.3.1.4
Setting Alarm Volume Escalation
The monitor provides the function of automatically escalating the alarm tone volume. When this function is enabled, if an alarm is not reset within the designated delay time after the alarm occurs, the volume of the alarm tone increases automatically.
To set the alarm volume escalation, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password → select .
2.
Select the Alarm tab
→
Audio tab.
3.
Set Auto Increase Volume .
◆
2 Steps : if an alarm is not reset within the designated delay time after the alarm occurs, the alarm volume automatically increases by two levels.
◆ 1 Step : if an alarm is not reset within the designated delay time after the alarm occurs, the alarm volume automatically increases by one level.
◆
Off : if an alarm is not reset within the designated delay time after the alarm occurs, the volume of the alarm tone does not change.
4.
Select Increase Volume Delay to set the delay time of alarm volume escalation.
NOTE
•
The alarm volume escalation function is not applied to the latched alarms.
21.3.2
Setting Alarm Pausing and Resetting Properties
21.3.3
Defining the Pause Function
You can either pause alarms or pause alarm tones. This depends on the pause setting. To set the pause function, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→
select .
2.
Select the Alarm tab → Pause/Reset tab.
3.
Set Pause to Alarm Pause or Audio Pause .
21.3.3.1
Setting the Alarm Pause Time/Alarm Tone Pause Time
The alarm pause time or alarm tone pause time can be set to 1 min , 2 min , 3 min , or Permanent . The default audio pause time is two minutes.
To set the alarm tone pause time, follow this procedure:
21 - 4 BeneVision N1 Patient Monitor Operator’s Manual
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password → select .
2.
Select the Alarm tab
→
Pause/Reset tab.
3.
Set Pause Time .
21.3.3.2
Setting the Priority of Audio Paused Alarms
To select alarm of what priority can be paused or alarm sound of what priority can be paused, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password → select .
2.
Select the Alarm tab
→
Pause/Reset tab.
3.
Set Pause Priority .
◆
All : pressing the Alarm Pause quick key pauses all alarms.
◆
Med & Low : pressing the Alarm Pause quick key pauses alarms of medium and low priority. The high priority alarms will not be paused.
◆ Disable : the Alarm Pause quick key is disabled.
21.3.3.3
Disabling the Options of Prolonging Alarm Pause Time/Alarm Tone Pause Time
To disable specific options for the clinician when prolonging alarm pause time or the alarm tone pause time, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Alarm tab
→
Pause/Reset tab.
3.
Switch off Pause 5 min , Pause 10 min , or Pause 15 min .
21.3.3.4
Setting Alarm Light Status on Alarm Reset
When the alarm system is reset, the monitor presents the alarm light by default , but you can switch off the alarm light. To change the alarm light setting, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Alarm tab
→
Pause/Reset tab.
3.
Set Alarm Light .
◆
On When Reset : when the alarm system is reset, the alarm tones of the current alarms are switched off, but the alarm lamp remains flashing.
◆ Off When Reset : when the alarm system is reset, both the alarm tone and alarm lamp of the current alarms are switched off.
21.3.3.5
Setting the Reminder Tones
When the alarm volume is set to zero, or the alarm is reset or switched off, the monitor issues a periodical reminder tone. The reminder tone is enabled by default.
To set the reminder tone, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Alarm tab → Pause/Reset tab.
3.
Set Alarm Reset Reminder and Alarm Off Reminder .
◆
On : the monitor issues reminder tones at a designated interval.
BeneVision N1 Patient Monitor Operator’s Manual 21 - 5
◆ Re-alarm : if the alarm condition persists the alarms marked with “√” will be re-generated after the designated reminder tone interval.
◆
Off : the monitor does not issue reminder tones at a designated interval. The alarms marked with “√” will be silenced.
4.
Set Reminder Interval to 10 min , 5 min , 3 min , 2 min , or 1 min .
21.3.4
Latching Physiological Alarms
To latch physiological alarms, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password → select .
2.
Select the Alarm tab
→
Latching tab.
3.
Select how you want to latch the alarms.
■
■
■
■
■
Alarm latching rules are as follows:
You can separately latch visible alarm signals and audible alarm signals.
Latching audible alarm signals simultaneously latches the corresponding visible signals.
Selecting alarms of lower priority simultaneously latches higher priority alarms.
Switching V-Tach Latching Lock off allows you to switch on or off V-Tach Latching .
When V-Tach Latching Lock is switched on, V-Tach latching follows the setting of Lethal alarm latching and you cannot control V-Tach Latching .
21.3.5
Changing Remote Alarm Settings
21.3.5.1
Resetting Alarms for Remote Devices
You can reset the alarms occurring on the remote devices that are viewed on the Remote View screen of the monitor. To enable this function, follow this procedure:
1.
Select the Main Menu quick key
→ from the System column select Maintenance
→ input the required password → select .
2.
Select the Alarm tab → Remote View tab.
3.
Switch on Reset Remote Bed Alarms . Then the Alarm Reset button appears on the bottom left of the
Remote View screen.
To reset any remote device alarms, the clinician may now select the Alarm Reset button at the bottom of the
Remote View screen.
NOTE
•
You can reset remote device alarms only if the Alarm Reset By Other Bed switch is on at the remote devices and alarms are occurring on the remote device.
21.3.5.2
Authorizing the Alarm Reset to Other Devices
Alarms on your monitor can be reset by remote devices if you enable this function. To do so, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Alarm tab
→
Remote View tab.
3.
Switch on Alarm Reset By Other Bed .
21.3.5.3
Selecting the Alarm Reminder for Remote Devices
You can configure what alarm indicators are necessary for the remote devices. To do so, follow this procedure:
21 - 6 BeneVision N1 Patient Monitor Operator’s Manual
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Alarm tab
→
Remote View tab.
3.
Select Alarm Reminder :
◆ Visible + Audible : the monitor provides visual alarm indication, and continuous audible alarm indication if the alarm persists at the remote device.
◆
Visible + Single Tone : the monitor provides visual alarm indication, and a single tone when the alarm occurs at the remote device.
◆ Visible Only : the monitor only provides visual alarm indication.
21.3.5.4
Presenting Alarm Sound for Remote Devices as per Alarm Priority
You can configure what priority of remote device alarms are presented for audible notification. To do so, follow this procedure:
1.
Select the Main Menu quick key
→ from the System column select Maintenance
→ input the required password → select .
2.
Select the Alarm tab → Remote View tab.
3.
Select Alarm Priority :
◆
All : the monitor sounds if an alarm occurs.
◆
High & Med : the monitor sounds if a high or medium priority alarm occurs.
◆
High Only : the monitor sounds only if a high priority alarm occurs.
21.3.5.5
Setting the Tone Pattern for Alarms from Remote Devices
The monitor provides the same alarm tone pattern for the remote device alarms as those for your monitor alarms. For more information on alarm tone pattern, see
To set the alarm tone pattern for the remote device alarms, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Alarm tab
→ select the Remote View tab.
3.
Set Alarm Sound to ISO , Mode 1 or Mode 2 .
21.3.5.6
Switching Off the Remote Device Disconnection Alarm
The monitor can provide an alarm if remote devices, for example, a bedside monitor or a telemetry, are disconnected. By default, the function is enabled. To disable the alarm, follow this procedure:
1.
Select the Main Menu quick key
→ from the System column select Maintenance
→ input the required password → select .
2.
Select the Alarm tab → Remote View tab.
Switch off Remote Disconnected Alarm .
21.3.6
Changing Alarm Priority Settings
21.3.6.1
Setting the Priority of the ECG Lead Off Alarm
To set the priority of the ECG lead off alarm, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Alarm tab
→
select the Other tab.
3.
Set the priority of ECG Lead Off .
BeneVision N1 Patient Monitor Operator’s Manual 21 - 7
21.3.6.2
Setting the Priority of the SpO
2
Sensor Off Alarm
To set the priority of the SpO
2
sensor off alarm, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Alarm tab
→
select the Other tab.
3.
Set the priority of SpO2 Sensor Off .
21.3.6.3
Setting the Priority of the IBP No Sensor Alarm
To set the priority of the IBP no sensor alarm, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Alarm tab
→
select the Other tab.
3.
Set the priority of IBP No Sensor .
21.3.6.4
Setting the Switch of the CMS and eGateway Disconnection Alarm
You can choose whether to issue an alarm when the monitor is not connected or disconnected from the CMS/ eGateway. To do so, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→
select .
2.
Select the Alarm tab → Other tab.
3.
In the Other block, switch on or off CMS/eGW Disconnected Alarm . If CMS/eGW Disconnected Alarm is switched off, the “Offline” alarm is not presented when the monitor is not connected or disconnected from the CMS/eGateway.
21.3.6.5
Setting the Priority of the CMS and eGateway Disconnection Alarm
To set the priority of the CMS and eGateway disconnection alarm, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Alarm tab
→
Other tab.
3.
Set CMS/eGW Disconnected .
21.3.6.6
Setting the Switch of the SpO
2
Desat Alarm Off
You can choose whether switching off the SpO
2
Desat alarm is permissible or not. To do so, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password → select .
2.
Select the Alarm tab
→ select the Other tab.
3.
Set SpO2 Desat Alarm Off .
◆
Disable : the SpO
2
Desat alarm is always on. You cannot switch it off.
◆
Enable : you can switch off the SpO
2
Desat alarm. For more information, see 10.6.1 Changing the SpO
.
WARNING
•
If a clinician switches off the SpO2 Desat alarm, the monitor will not alarm when the patient’s SpO
2
is extremely low. This may result in a hazard to the patient.
21 - 8 BeneVision N1 Patient Monitor Operator’s Manual
21.3.6.7
Setting the Switch of the Zero RR Alarm Off
You can choose whether switching off the zero RR alarm is permissible or not. To do so, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Alarm tab
→ select the Other tab.
3.
Set Zero RR Alarm Off .
◆
Disable : the zero RR alarm is always on. The clinician cannot switch it off.
◆
Enable : the clinician can switch off the zero RR alarm. For more information, see
WARNING
•
If a clinician switches off the zero respiration rate alarm, the monitor will not issue the zero respiration rate alarm when that situation occurs. This may result in a hazard to the patient. Keep the patient under close surveillance.
21.3.7
Changing Alarm Delay Settings
21.3.7.1
Setting the Alarm Delay Time
For continuously measured parameters, you can set the alarm delay time. If the alarm condition is resolved within the delay time, the monitor does not present the alarm.
To set the alarm delay time, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Alarm tab → Other tab.
3.
Set Alarm Delay .
◆ Off : an alarm is presented as soon as the alarm condition occurs.
◆ 1 sec ~ 8sec : for continuously measured parameters, an alarm is not presented if the alarm condition is resolved within the designated delay time.
The setting of Alarm Delay is not applied to the zero respiration rate alarms and the ST alarms. You can set Zero
RR Delay and ST Alarm Delay separately.
WARNING
•
The alarm delay time can be set to a maximum of 8 seconds. Changing this setting to an inappropriate level could result in a hazard to the patient.
21.3.7.2
Setting the ST Alarm Delay Time
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Alarm tab
→
Other tab.
3.
Set ST Alarm Delay .
21.3.8
Adjusting the Alarm Light Brightness
To adjust the alarm light brightness, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password → select .
BeneVision N1 Patient Monitor Operator’s Manual 21 - 9
2.
Select the Alarm tab → Other tab.
3.
From the Alarm Light Brightness area, set Primary Screen (note that you may have to scroll up the dialog to see this option). If you set alarm light brightness to Auto , the monitor automatically adjusts the alarm light brightness according to the ambient light. The stronger the ambient light is, the brighter the alarm light is.
21.3.9
Changing Other Alarm Settings
21.3.9.1
Setting the Lethal Arrhythmia Alarms Switch
To allow a clinician to disable the lethal arrhythmia alarms, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Alarm tab
→
select the Other tab.
3.
From the Other block, set Lethal Arrh Alarms Off as follows.
◆
Lethal Arrh Alarms Off is set to Disable by default. In this case, a clinician cannot switch off lethal arrhythmia alarms.
◆ If you set Lethal Arrh Alarms Off to enable , a clinician can switch off lethal arrhythmia alarms from the ECG
dialog. For more information, see 7.6.4.1 Changing Arrhythmia Alarm Settings .
WARNING
•
If any of lethal arrhythmia alarms are switched off, the ECG waveform area displays a message to indicate that corresponding alarms are off.
•
If a clinician switches off all arrhythmia alarms, the monitor will not present arrhythmia alarms.
Always keep the patient under close surveillance.
21.3.9.2
Setting the Intubation Time
The default intubation time is 2 minutes. To change the intubation time, following this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password → select .
2.
Select the Alarm tab
→
Other tab.
3.
Set the Intubation Mode Period .
21.3.9.3
Setting Arrhythmia Alarm Timeout Period
The arrhythmia algorithm can disable alarm light and alarm tone for designated period of time when certain arrhythmia alarms are detected.
To set the arrhythmia alarm timeout period, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Alarm tab → select the Other tab.
3.
From the Other block, set Arrhy Shield Time .
NOTE
•
For the following alarms, alarm light and alarm tone cannot be disabled: HR high, HR low,
Tachycardia, Bradycardia, Afib End, Irr Rhythm End.
•
The arrhythmia alarm timeout period is only applied to the medium priority chains and atrial fibrillation chain. For the alarms in the high priority chain, alarm tone and alarm light are presented as soon as the alarm condition is detected. Refer to
7.6.5.1 Arrhythmia Alarm Chains for more
information on the arrhythmia alarm chain.
21 - 10 BeneVision N1 Patient Monitor Operator’s Manual
•
Alarm indication rules for alarms in the atrial fibrillation chain are the same with those for the medium priority chains.
21.4
Changing CAA Settings (only available when the N1 is used with the independent external display)
21.4.1
Enabling Inputing the Clinician ID
To display the clinician ID on the EWS screen, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the CAA tab → select the EWS tab.
3.
Switch on Clinician ID .
4.
Select Clinician ID Timeout to set how long the clinician ID will remain valid.
NOTE
•
The EWS tab is only available if a license for EWS is installed in the monitor.
•
When a patient is discharged, or the monitor is turned off, the clinical ID is cleared even if the timeout is not reached.
21.4.2
Selecting the Default Scoring Tool
To set the default scoring tool for different patient category, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the CAA tab → select EWS tab.
3.
From the Select Default Score area, set Default Adult Score , Default Ped Score , and Default Neo Score .
21.4.3
Managing the Scoring Tools
To manage the scoring tool, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the CAA tab
→ select EWS tab.
3.
Select the Manage Score button.
◆ Delete local scoring tools: from the Local page, delete any unnecessary scoring tools.
◆ Import the desired scoring tools to the monitor: from the USB drive page, select the scoring tools on the USB drive, and then select Import .
NOTE
•
The monitor provides MEWS and NEWS by default. You cannot delete them.
21.4.4
Setting GCS Threshold for Each Consciousness Level
You can configure the threshold and color of each consciousness level. To do so, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the CAA tab → select the GCS tab.
3.
Set high limit, low limit for each level.
BeneVision N1 Patient Monitor Operator’s Manual 21 - 11
21.5
Changing Module Settings
21.5.1
Selecting the ECG Standard
Select the ECG standard according to the leadwires you are using. To select the ECG standard, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Module tab → ECG tab.
3.
Set ECG Standard to AHA or IEC .
21.5.2
Changing the QTc Formula
The monitor uses the Hodges correction formula by default to correct the QT interval for heart rate. To select the
QTc formula, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→
select .
2.
Select the Module tab
→
ECG tab.
3.
Set QTc Formula .
◆ Hodges:
QTc = QT + 1.75
× ( HeartRate – 60 )
◆ Bazett:
QTc = QT ×
HeartRate
60
2
◆ Fridericia:
QTc = QT ×
HeartRate
3
◆ Framingham:
QTc = QT + 154 ×
1 –
60
HeartRate
21.5.3
Setting the 12-Lead Order Switch
To set whether to send the order number of 12-lead interpretation report to the hospital information system while saving the report, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → i nput the required password
→ select .
2.
Select the Module tab.
3.
Select the ECG tab.
4.
Set 12-Lead Order .
21.5.4
Calibrating ECG
The ECG signal may be inaccurate due to hardware or software problems. As a result, the ECG waveform amplitude becomes greater or smaller. In that case, you need to calibrate the ECG module. To do so, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→
select .
2.
Select the Module tab
→
ECG tab.
3.
From the bottom left corner of the dialog select Calibrate .
21.5.5
Manually Zeroing the CO
2
Module
To zero the CO
2
module, follow this procedure:
21 - 12 BeneVision N1 Patient Monitor Operator’s Manual
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Module tab
→
CO2 tab.
3.
From the bottom left corner of the dialog select Zero .
21.5.6
Hiding the Invalid Display after Zeroing the CO
2
Module
After the zero calibration is completed, the CO
2
module reacquires the CO
2
readings. During the reacquisition period, “ Zero Recovering ” is displayed in the CO
2
numeric area. Valid data will reappear 30 seconds after the zero calibration is started.
To hide the display of the “ Zero Recovering ” message, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Module tab
→
CO2 tab.
3.
Switch off Zero Recovery for 30s .
Selecting Defaults from the bottom of the dialog can restore this setting to the factory default.
21.5.7
Setting Parameter Measurement Timeout
NIBP measurements become outline fonts after a preset time. This feature prevents older values being misinterpreted as current measurements. To adjust the timeout period for PAWP, C.O., and NIBP, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password → select .
2.
Select the Module tab → select the Other tab.
3.
Set the timeout period for PAWP and NIBP.
21.5.8
Setting Flow Rate (For Sidestream CO
2
Module Without O
2
)
When you are using the sidestream CO
2
module without the O
2
monitoring function to monitor a neonatal patient, you can select flow rate. To do so, follow this procedure:
1.
Ensure that the sidestream module without O
2
is inserted in the monitor.
2.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password
→ select .
3.
Select the Module tab → Other tab.
4.
Set CO2 Flow Rate For Neo .
21.6
Hiding Undesired Review Tabs
If you do not need to review some items, you can hide them. To do so, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Review tab.
3.
From the Tabs page, Event page or Arrh Mark page deselect those that do not need to be available to clinicians during review.
21.7
Setting the Printer
21.7.1
Setting the Printer Properties
To set a network printer, follow this procedure:
BeneVision N1 Patient Monitor Operator’s Manual 21 - 13
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Print tab.
3.
In the Printer tab, select Connection Type to choose whether you want to output patient reports via the print server or a network printer.
4.
If you set Connection Type to Print Server , perform the following settings:
◆ Print Server Address : select
◆ Port : selects to input the print server name or IP address.
to input the print server port. If the CMS is used as the print server, set Port to 6603 .
◆ Set the report type in the Report Type area. For more information, see section
5.
If you set Connection Type to Printer , perform the following settings:
◆ Select Printer IP Address . Select
◆ Select Paper Size .
◆ Select Resolution .
to input the IP address of the desired network printer.
After finishing configurations, you can select the Print Test Page button to verify that the printer works properly.
21.7.2
Setting the Report Type
If the Connection Type is set to Print Server , you need to set the report type:
1.
Select the Main Menu quick key
→ from the System column select Maintenance
→ i nput the required password → select .
2.
Select the Print tab.
3.
Set Connection Type to Print Server .
4.
Select the report you intend to set, for example, General Report .
5.
Set the Print Action :
◆ Paper : outputs paper report.
◆ PDF : outputs the electronic report in PDF format.
◆ Paper And PDF : outputs both the paper report and the PDF report.
6.
For paper report, respectively select Printer and Printer Resolution to set the default printer and the resolution for the default printer.
7.
For PDF report, select the PDF Resolution to set the resolution.
NOTE
•
General reports refer to the reports other than the end case report and realtime alarm report.
21.7.3
Setting the Report Layout
To set the patient information you want to display on general reports, follow this procedure:
1.
Select the Main Menu quick key
→ from the System column select Maintenance
→ input the required password → select .
2.
Select the Print tab.
3.
Select the Report Layout tab.
4.
Select the desired items under Report Name . N/A indicates that this item is not displayed on a report.
21.7.4
Setting Patient Information on 12-lead ECG Reports
To set the patient information you want to display on 12-lead ECG reports, follow this procedure:
1.
Select the Main Menu quick key
→ from the System column select Maintenance
→ input the required password → select .
21 - 14 BeneVision N1 Patient Monitor Operator’s Manual
2.
Select the Print tab.
3.
s elect the ECG Report tab.
4.
On the right of the ECG Report page, select the desired patient information items. Patient ID, Patient
Name, Age, and Gender are displayed on an ECG report by default.
NOTE
•
You can only set the patient information to display on the ECG report from the ECG Report page.
Patient information configured in the Report Layout page is not applied to ECG reports.
21.7.5
Configuring the Name of PDF Files
If you use the print server to output patient reports, you can use the PDF printer to output PDF format reports. To configure the name of PDF files, follow this procedure:
1.
Select the Main Menu quick key
→ from the System column select Maintenance
→ input the required password
→ select .
2.
Select the Print tab → PDF File Name tab.
3.
Select the desired items and their sequence under PDF File Name . N/A refers to no information.
21.7.6
Showing the Second Mark
To set whether you want to show second marks on the report output by the printer, follow this procedure.
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password
→ select .
2.
Select the Print tab
→
Other tab.
3.
Enable or disable Second Mark (Printer) .
21.7.7
Setting Parameter Unit
To set parameter unit, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password
→ select .
2.
Set the Unit tab.
3.
Set unit for each parameter.
21.8
Setting the Time
21.8.1
Setting the Time Synchronization
The monitor can automatically synchronize its time with a time server on which NTP (Network Time Protocol) is implemented. If there are many monitors connected within one network, you can enable the time synchronization to synchronize the time, and make it unnecessary to manually set the time for individual monitors.
21.8.1.1
Setting the Time Server Address
To set the DNS name of the time server address, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Time tab
→
Time Synchronization tab.
3.
Input the name or IP address of the time server.
After configuring the NTP time server, select Network Test to verify that the NTP server is properly connected.
BeneVision N1 Patient Monitor Operator’s Manual 21 - 15
21.8.1.2
Setting the Time Synchronization Interval
To set the time synchronization interval, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Time tab
→
Time Synchronization tab.
3.
Set Interval .
21.8.1.3
Disabling the Time Synchronization Function
To disable the time synchronization function, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Time tab
→
Time Synchronization tab.
3.
Switch off Start NTP Time Sync .
21.8.2
Enabling Auto Daylight Savings Time
By default, daylight savings time is disabled. If this function is needed, you need to manually enable the daylight savings time. To auto start the daylight savings time, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Time tab
→
Daylight Savings Time tab..
3.
Switch on Auto Daylight Savings Time .
4.
Adjust daylight savings time settings as necessary.
NOTE
•
If you enable Auto Daylight Savings Time you cannot manually switch it on or off from the System
Time dialog. For more information, see 3.8.1 Setting the Date and Time.
21.9
Viewing Version Information
To view the system software version, module hardware and software version, and firmware version , follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Version tab.
You can also view the system software version by selecting the Main Menu quick key → from the System column select Version .
21.10
Checking Battery Information
To check the battery information, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Battery Information tab.
21.11
Changing Scanner Settings
For the 2D barcode reader, you can change the scanner settings.
21 - 16 BeneVision N1 Patient Monitor Operator’s Manual
21.11.1
Establish the Relationship between Patient Demographics and 2D Barcode
Fields (for the Mindray Custom 2D Barcode Reader)
To configure 2D barcode reader, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Scanner tab → 2D Barcode tab.
3.
Establish the relationship between the monitor data and hospital’s barcode data for selectable patient demographics. For example, the monitor has an option of Ped for patient category. In your hospital barcode, the text may read as Pediatric . So input Pediatric for the field Ped to establish their relationship.
21.11.2
Setting the Barcode Reader Information
To set the barcode reader information, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→
select .
2.
Select the Scanner tab
→
Scanner Info.
tab.
3.
Set Scanner Type :
◆ 1D Scanner : select this option when using a 1D scanner or a 2D scanner other than the Mindray custom 2D scanner.
◆ 2D Scanner : select this option when using the Mindray custom scanner.
NOTE
•
When you set Scanner Type to 2D Scanner, default settings are applied to Data Encoding Type and
Data Parse Mode. You do not need to change these setting.
21.11.3
Identifying the Barcode Reader (for the non-Mindray Custom 2D Barcode
Reader)
When you are using barcode readers other than the JADAK Flexpoint HS-1R or HS-1M, you should select the barcode reader from the USB device list, so that the monitor can identify the barcode reader. To do so, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Scanner tab → Identify Scanner tab.
3.
From the USB device list, select the barcode reader you are using.
21.11.4
Selecting Patient Information Read by the Barcode Reader (for the Mindray
Custom 2D Barcode Reader)
To select desired patient information that will be read by the barcode reader, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→
select .
2.
Select the Scanner tab
→
Field tab.
3.
Select the patient information. The selected information can be read by the barcode reader.
NOTE
•
The patient information read by the barcode reader is dependent on the patient information encoded in the hospital's barcodes.
BeneVision N1 Patient Monitor Operator’s Manual 21 - 17
21.12
Configuring the Network
You can connect the monitor to the central monitoring system (CMS), eGateway, and other monitors through wired LAN or wireless LAN.
21.12.1
Network Safety Information
CAUTION
•
Wireless network designing, deploying, debugging, and maintenance should be executed by
Mindray service personnel or authorized technicians.
•
Always set the wireless network according to local wireless regulations.
•
Keep network authentication information, for example passwords, safe, to protect the network from being accessed by unauthorized users.
•
Do not connect non-medical devices to the monitor network.
•
If wireless network signal is poor, there may be a risk of CMS-destined data loss.
•
RF interference may result in wireless network disconnection.
•
Disconnecting from the network may result in CMS-destined data loss and function failure. Check the patient in case of network disconnection and solve the network problem as soon as possible.
•
Ensure that the monitor IP address setting is correct. Changing the network settings may result in network disconnection. Contact your service personnel if there are any problems with the IP address.
21.12.2
Setting the Wireless Network
To add and set the wireless network, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Network Setup tab → WLAN tab.
3.
Select Add WLAN . In the popup dialog, input network name, SSID, and password. Set Security .
4.
Select the WLAN IP tab and select how to get the IP address and DNS address.
◆ Obtain IP Address Automatically : the monitor automatically gets the IP address.
◆ Use the Following Address : you need to input the IP address , Subnet Mask , and Gateway .
◆ Obtain DNS Address Automatically : the monitor automatically gets the DNS address.
◆ Use the following DNS Address : you need to input the IP address of Preferred DNS server and
Alternate DNS server .
5.
Select the WLAN Setup tab and set WLAN band and channels. The default is Auto , which means the monitor can automatically identify the WLAN band.
After configuring the wireless network, select Network Test to verify that the wireless network can be properly connected.
If you need to change network settings, select beside the desired wireless network. Selecting deletes the wireless network.
21.12.3
Managing Certifications
You can delete certifications from the monitor, or import certifications from the USB memory device. To do so, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Network Setup tab → WLAN tab.
3.
Select the Certificate Management button from the bottom left corner of the dialog.
◆
From the Local tab, select certifications you want to delete from the monitor, and then select Delete .
21 - 18 BeneVision N1 Patient Monitor Operator’s Manual
◆ From the USB Drive tab, select certifications you want to import from the USB memory device, and then select Import .
21.12.4
Enabling Selecting a CMS
To enable selecting a CMS, follow this procedure:
1.
Select the Main Menu quick key
→ from the System column select Maintenance
→
input the required password → select .
2.
Select the Network Setup tab → Central Station Setup tab.
3.
Switch on Select CMS .
21.12.5
Adding CMSs
You can add up to 30 central monitoring systems (CMS) for your monitor. To add CMSs, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→
select .
2.
Select the Network Setup tab
→
Central Station Setup tab.
3.
Select Add Central Station , and then input the CMS name and IP address of this department.
21.12.6
Setting Multicast Parameters
Multicast helps device discovery between monitors and other devices on the network. Devices in the same multicast group can be mutually discovered.
To set multicast parameters, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Network Setup tab → Device Discover tab.
3.
Set Multicast TTL .
4.
Set Multicast Address .
21.12.7
Setting the Master Server Address
To set the DNS name of the master server, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Network Setup tab
→
Device Discover tab.
3.
Select Master Server Address to input the DNS name or IP address of the master server.
21.12.8
Setting the Network Service Quality Level
To set the quality of service (QoS), follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Network Setup tab → QoS tab.
3.
Select QoS Level For Realtime Monitoring to set the service quality of network connection for realtime monitoring, for example parameter measurements and waveforms, alarms, etc.
4.
Select QoS Level For Others to set the service quality of network connection for non-realtime monitoring, for example history data, printing, etc.
21.12.9
Using the ADT Gateway
The ADT (admit-discharge-transfer) gateway is normally deployed in the eGateway. You can obtain patient information from the hospital ADT server through the ADT gateway.
To configure the ADT gateway, follow this procedure:
BeneVision N1 Patient Monitor Operator’s Manual 21 - 19
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Network Setup tab
→
ADT tab.
3.
Select Server Address to input the host name or IP address of the ADT gateway.
4.
Select Port to input the port of the ADT gateway.
ADT Query is switched off by default. You can load patient information to the monitor from the ADT server only when this function is enabled.
After configuring the ADT gateway, select Network Test to verify that the ADT server is properly connected.
21.12.10 Sending Realtime Data, Waveforms and Alarms via HL7 Protocol
You can send the realtime data, waveforms, and alarms from the monitor to the hospital servers via HL7 protocol. To do so, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Network Setup tab
→
HL7 Configuration tab.
3.
From the Data + Waveforms area, select Server Address to input the name or IP address for the server receiving the realtime data and waveform. Set Port .
4.
Switch on Send Data and Send Waveform , as needed. Set Data Interval .
5.
From the Alarms area, select Server Address to input the name or IP address for the server receiving the alarm data. Set Port .
6.
Switch on Send Alarms as needed.
This page also displays the server connection status.
21.12.11 Selecting Data Encryption Type
To set data encryption type, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Network Setup tab
→
Information Security tab.
3.
Select Encryption Connection Type to set data encryption type when connecting devices:
◆ Only Private Encryption : Mindray private encryption is used to encrypt the transmitted data. You cannot connect devices supporting SSL (secure sockets layer) encryption.
◆ SSL Encryption Priority : for devices supporting SSL encryption, SSL encryption is used when connecting the devices. For devices not supporting SSL encryption, private encryption is used when connecting the devices.
21.12.12 Disabling the Broadcasting Patient Demographics Function
When viewing other patients, device location and patient information of remote devices are displayed in the remote device list by default. To protect patient privacy, you can disable the broadcasting of patient demographics function to prevent the monitor from sending patient information via broadcast. To do so, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→
select .
2.
Select Network Setup tab
→
Information Security tab.
3.
Switch off Broadcast Patient Demographics .
Thus, patient information will not display in the remote device list.
21.13
MLDAP
MLDAP refers to Mindray LDAP (Lightweight Directory Access Protocol). It is an independent process which can be installed on the eGateway or other application server (Windows). MLDAP provides user identity and authentication.
21 - 20 BeneVision N1 Patient Monitor Operator’s Manual
■
■
■
The MLDAP server is connected with the hospital LDAP server. All monitoring devices are connected to the
MLDAP server to implement identity and authentication for the following operations:
Changing alarm settings
Changing arrhythmia settings
Accessing the Maintenance dialog
21.13.1
Setting MLDAP
To access the MLDAP server, you should set your monitor as follows:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Network Setup tab
→
MLDAP tab.
3.
Set Server address and port of the MLDAP server.
21.13.2
Testing MLDAP Server Connection
To test whether the monitor is properly connected with the MLDAP server, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Network Setup tab → MLDAP tab.
3.
Select Network Test .
21.13.3
Selecting Password for User Authentication
You can select what password is used when changing alarm settings, arrhythmia settings, and accessing the
Maintenance dialog. To do so, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Authorization Setup tab.
3.
From the Maintenance area, set User Maintenance to select the password for accessing the monitor’s
Maintenance dialog.
◆ Local Password : the monitor’s password for accessing the Maintenance dialog is required.
◆ User Password : the user name and password saved in the MLDAP server are required.
4.
From the Others area, set Alarm Setup : select the password for changing alarm settings.
◆ No Password : changing alarm settings is not password protected.
◆ Local Password : changing alarm switch, alarm limit, and alarm priority is password protected. The monitor’s password for changing alarm settings is required.
◆ User Password : changing alarm switch, alarm limit, and alarm priority is password protected. The user name and password saved in the MLDAP server are required.
5.
Set Arrhythmia : select the password for changing arrhythmia settings.
◆ No Password : changing arrhythmia settings is not password protected.
◆ Local Password : changing arrhythmia switch, alarm priority, and arrhythmia threshold is password protected. The monitor’s password for changing arrhythmia settings is required.
◆ User Password : changing arrhythmia switch, alarm priority, and arrhythmia threshold is password protected. The user name and password saved in the MLDAP server are required.
From the Maintenance area, selecting Modify Local Password can change the monitor’s password for accessing the Maintenance dialog.
From the Others area, selecting Modify Local Password can change the monitor’s password for accessing alarm settings and arrhythmia settings.
BeneVision N1 Patient Monitor Operator’s Manual 21 - 21
21.13.4
Setting the Password Timeout Period
If you use the password saved in the MLDAP server to access the Maintenance dialog, alarm settings and arrhythmia settings, you can set the password timeout period. Once the timeout period is reached, you will need to re-enter the password. To do so, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Authorization Setup tab.
3.
Set Retention Time .
21.14
Setting the Dock
After the N1 is transferred to the target location, connecting the N1 to a Dock enables N1 to use the settings of the Dock. All the settings in this section are stored in the Dock. When the N1 is disconnected from the Dock, the
N1 uses its own settings and network.
21.14.1
Setting the Work Mode
To set the work mode of the Dock, follow this procedure:
1.
Connect the N1 to the Dock.
2.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→
select .
3.
Select the Dock Setup tab
→ select the Setup tab.
4.
Set the Work Mode . The default work mode is Dock Mode .
◆ Dock Mode : the patient location settings (facility, department, room number, and bed number), printer settings, and authorization settings are from the N1. You can change these settings on Device
Location , Print , or Authorization Setup page from the Maintenance menu.
◆ Host Mode : the patient location settings (facility, department, room number, and bed number), printer settings, and authorization settings are from the Dock. You can change these settings on
Location , Printer , or Authorization Setup tab from the Dock Setup page.
21.14.2
Setting the Net Setting Type
To set the network setting type of the Dock, follow this procedure:
1.
Connect the N1 to the Dock.
2.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
3.
Select the Dock Setup tab → select the Setup tab.
4.
Set the Net Setting Type . The default work mode is Use current N1 net setting .
◆ Use current N1 net setting : the IP and WLAN settings are from the N1. You can change these settings on Network Setup page from the Maintenance menu.
◆ Use current Dock net setting : the IP and WLAN settings are from the Dock. You can change these settings on IP , or WLAN tab from the Dock Setup page.
21.14.3
Setting the Network of the Dock
21.14.3.1 Selecting a Network Type
To select network type, follow this procedure:
1.
Connect the N1 to the Dock.
2.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
3.
Select the Dock Setup tab
→
select the Setup tab.
4.
Set the Work Mode to Host Mode .
21 - 22 BeneVision N1 Patient Monitor Operator’s Manual
5.
Select the IP tab.
6.
Set Network Type to LAN1 IP , or WLAN according to your network type.
21.14.3.2 Setting the Wired Network
Wired networking is available as long as N1 is connected to the Dock. To set the wired network, follow this procedure:
1.
Connect the N1 to the Dock.
2.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
3.
Select the Dock Setup tab
→
select the Setup tab.
4.
Set the Work Mode to Host Mode .
5.
Select the IP tab.
6.
Set Network Type to LAN1 IP .
7.
Select how to get the IP address of wired network.
◆
Obtain IP Address Automatically : the monitor automatically gets the IP address.
◆
Use the Following Address : you need to input the IP address , Subnet mask , and Gateway .
8.
Select how to get the DNS address:
◆
Obtain DNS Address Automatically : the monitor automatically gets the DNS address.
◆
Use the following DNS Address : you need to input the IP address of Preferred DNS server and
Alternate DNS server .
21.14.3.3 Setting the Wireless Network
To set the wireless network of the Dock, follow this procedure:
1.
Connect the N1 to the Dock.
2.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
3.
Select the Dock Setup tab → select the Setup tab.
4.
Set the Work Mode to Host Mode .
5.
Select the IP tab, and set Network Type to WLAN .
6.
Select how to get the IP address of wireless network.
◆ Obtain IP Address Automatically : the monitor automatically gets the IP address.
◆ Use the Following Address : you need to input the IP address , Subnet Mask , and Gateway .
7.
Select how to get the DNS address:
◆ Obtain DNS Address Automatically : the monitor automatically gets the DNS address.
◆ Use the following DNS Address : you need to input the IP address of Preferred DNS server and
Alternate DNS server .
8.
Select the WLAN tab and set SSID , Security , and Password .
After configuring the wireless network, select Network Test to verify that the wireless network can be properly connected.
21.14.4
Setting the External Display
To set the external display, follow this procedure:
1.
Connect the N1 to the Dock.
2.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
3.
Select the Dock Setup tab → select the Setup tab.
4.
Set the External Screen Contents .
BeneVision N1 Patient Monitor Operator’s Manual 21 - 23
◆ Mirrored : the contents of the external display is exactly the same with the monitor.
◆ Independent : separately configure the contents and layout of the monitor and external display.
NOTE
•
The N1’s screen and the independent external display’s screen cannot be viewed simultaneously. To switch the viewing location between the N1's screen and the independent external display, gently press the power switch of the N1, or double click on the screen to be viewed.
•
In the situation that the External Screen Content is set to Independent and the viewing location is switched to the N1, if there is no operation on the monitor within one minute, the viewing location will automatically switch back to the external display.
21.15
Defining Other Functions
21.15.1
Setting Notch Filter Frequency
Set notch filter frequency according to the power line frequency of your country. To set notch filter frequency, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password
→ select .
2.
Select the Other tab.
3.
Set Notch Frequency to 50 Hz or 60 Hz according to the power line frequency.
21.15.2
Setting Mouse Sensitivity
The mouse sensitivity is adjustable. To do so, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password
→
select .
2.
Select the Other tab.
3.
Set Mouse Sensitivity .
21.15.3
Setting the SpO
2
Tone Mode
The monitor adjusts the QRS tone (pitch tone) according to the SpO
2
values. To set the SpO
2
tone mode, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Other tab.
3.
Set SpO2 Tone to Mode 1 or Mode 2 . The pitch changes more rapidly in Mode 2 than in Mode 1, as saturation levels change.
The SpO
2
tone mode chart for SpO
2
between 40% to 100% is as follows:
21 - 24 BeneVision N1 Patient Monitor Operator’s Manual
CAUTION
•
It is highly recommended to use the same SpO
2
tone mode for the same monitors in a single area to prevent issues arising from inconsistent operation.
21.15.4
Selecting the Language
To set the user interface (UI) language, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Other tab
3.
Set Language .
21.15.5
Switching On or Off a Parameter
If there is no Parameters On/Off tab in the Screen Setup dialog then setting parameter switches is password protected. Follow this procedure to set parameter switches:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Other tab.
3.
Select Parameters On/Off .
4.
Enable or disable desired parameters.
When a parameter is switched off, the monitor stops data acquisition and alarming for this measurement.
NOTE
•
When a parameter is manually switched off and the corresponding parameter module is plugged in, you cannot monitor this parameter.
21.15.6
Setting If Setting Parameter Switches is Protected
You can set whether setting parameter switches is password protected. To do so, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Other tab.
3.
Switch on or off Parameters On/Off Protected .
BeneVision N1 Patient Monitor Operator’s Manual 21 - 25
21.15.7
Setting If Parameter Switch is Influenced by Configuration
You can set if the settings of parameter switches are influenced by loading a configuration. To do so, follow this procedure:
1.
Select the Main Menu quick key → from the System column select Maintenance → input the required password
→ select .
2.
Select the Other tab.
3.
Switch on or off Parameters On/Off Config Influenced .
21.15.8
Setting the Outdoor Mode
To set the way of entering the outdoor mode, follow this procedure:
1.
Select the Main Menu quick key
→
from the System column select Maintenance
→
input the required password → select .
2.
Select the Other tab.
3.
Set Enter Outdoor Mode to Manual or Auto .
◆ Manual : The monitor enters the outdoor mode by manually selecting the Main Menu quick key → from the Display column select Enter Outdoor Mode .
◆ Auto : The monitor enters the outdoor mode automatically if the strength of ambient light is greater than the threshold.
21 - 26 BeneVision N1 Patient Monitor Operator’s Manual
22
Battery
22.1
Battery Introduction
This monitor is designed to run on rechargeable Lithium-ion battery power when the external power is not available. The monitor can switch between battery power and the external power without interrupting patient monitoring. If both the external power and the battery power are available, the monitor uses the external power in preference to the battery power.
This monitor is designed to operate on battery power when the mains power is not available. The monitor uses mains power as primary power source. In case of mains power failure, the monitor automatically runs on the battery power.
22.2
Battery Safety Information
WARNING
•
Keep batteries out of the reach of children.
•
Use only Mindray specified batteries. Use of a different battery may present a risk of fire or explosion.
•
Keep the batteries in their original package until you are ready to use them.
•
Do not expose batteries to liquid.
•
Do not crush, drop or puncture the battery. Mechanical abuse can lead to internal damage and internal short circuits. If a battery has been dropped or banged against a hard surface, whether damage is externally visible or not, remove the battery from use and dispose of it properly.
•
If the battery shows signs of damage or signs of leakage, replace it immediately. Use caution in removing the battery. Avoid contacting the leakage.
•
Batteries should be charged only in this monitor.
•
Extremely high ambient temperature may cause battery overheat protection, resulting in monitor shutdown.
•
The lithium-ion battery has a service life. Replace the battery when it reaches the end of its service life. Failure to replace the battery may cause serious damage to the equipment from battery overheating.
•
Do not open batteries, heat batteries above 60 °C, incinerate batteries, or short battery terminals.
They may ignite, explode, leak or heat up, causing personal injury.
CAUTION
•
Remove the battery if it will not be used for an extended period of time.
22.3
Installing the Battery
The battery must only be installed by service personnel trained and authorized by Mindray. To install the battery, contact your service personnel. The battery is installed when the monitor leaves the factory.
22.4
Battery Indications
The battery LED, on-screen battery symbol, battery power indicator, and related alarm messages indicate the battery status.
BeneVision N1 Patient Monitor Operator’s Manual 22 - 1
22.4.1
Battery LED
The battery LED lies on the lower right corner of the monitor front panel.
BeneVision N1
The battery LED indications are as follows:
■
■
■
■
■
Green: the battery is fully charged.
Yellow: the battery is being charged.
Flashing green: the monitor is running on battery power.
Flashing yellow: the battery is malfunctioning.
Off: no battery is installed, or the monitor is powered off and no external power is connected.
22.4.2
Battery symbols
■
■
■
■
■
The on-screen battery symbols indicate the battery status as follows:
■ indicates that the battery is working correctly. The green portion represents the remaining charge.
indicates that the battery power is low and needs to be charged.
indicates that the battery is almost depleted and needs to be charged immediately. Otherwise, the monitor will automatically shut down soon.
indicates that the battery is being charged.
indicates that no battery is installed.
indicates a battery fault, battery communication fault, or battery charging fault. Contact service personnel for help.
22.4.3
Battery Power Indicator
Battery power indicator displays the remaining battery power.
22.4.4
Battery-related Alarms
The capacity of the battery is limited. When the battery level is low, the monitor presents the Low Battery alarm, the alarm lamp flashes, and the monitor produces an alarm sound.
If the battery is almost depleted, the monitor presents the Critically Low Battery alarm. In this case, immediately connect the external power to the monitor and charge the battery. Otherwise, the monitor will automatically shut down soon.
22 - 2 BeneVision N1 Patient Monitor Operator’s Manual
If the battery has been used for a prolonged period of time, the battery will be aged and its runtime may be significantly less than the specification. If the battery is aged, the Battery Service Required alarm is presented each time the monitor is turned on, indicating that the battery has reached its end of life.
For more information on battery-related alarms, see Appendix D Alarm Messages .
22.5
Charging the Battery
To optimize performance, a fully (or nearly fully) discharged battery should be charged as soon as possible. The battery can be charged in any of the following methods:
■
■
■
Method 1: the monitor is connected to the AC adapter or Dock.
Method 2: the monitor is in use with a host monitor.
Method 3: the monitor is in use with the Transport Dock.
For method 1 and method 3, the battery is charged regardless of whether or not the monitor is currently turned on. For method 2, the host monitor must be powered on for the N1 monitor's battery to charge.
22.6
Maintaining the Battery
22.6.1
Conditioning the Battery
The performance of the battery deteriorates over time. You should condition the battery every three months. If the battery is not conditioned for a prolonged time, its charge indication may not be accurate and you may wrongly evaluate the remaining battery runtime.
To condition a battery, follow this procedure:
1.
Disconnect the monitor from the patient and stop all monitoring and measuring procedures.
2.
Turn off the monitor, and connect the monitor to the external power source.
3.
Allow the battery to be charged uninterruptedly until it is fully charged.
4.
Disconnect the monitor from the external power source, and turn on the monitor.
5.
Allow the monitor to run on the battery until the battery is completely depleted and the monitor automatically shuts down.
6.
Fully charge the battery again for use or charge it to 40 - 60% for storage.
NOTE
•
Do not use the monitor to monitor a patient during battery conditioning.
•
Do not interrupt battery conditioning. Interrupting battery conditioning to use the monitor will prevent completion of the conditioning cycle and require repeating the conditioning process completely to properly condition the battery.
22.6.2
Checking Battery Performance
Life expectancy of a battery depends on how frequent and how long it is used. When properly used, the lithiumion battery has a useful life of approximately two years. If improperly used, its life expectancy can be shorter. We recommend replacing the lithium-ion battery every two years.
The performance of a rechargeable battery deteriorates over time. You should check the battery performance every two months or if you question it is meeting the product specifications.
See steps 1 to 5 of
22.6.1 Conditioning the Battery
to check battery performance. The operating time of the batteries reflects their performance directly. If the operating time of a battery is noticeably shorter than that stated in the specifications, the battery may have reached its service life or be malfunctioning. If the battery performance meets the requirement, fully charge the battery again for use or charge it to 40 - 60% for storage.
NOTE
•
Battery operating time depends on equipment configuration and operation. For example, high display brightness or measuring NIBP repeatedly will shorten the battery operating time.
BeneVision N1 Patient Monitor Operator’s Manual 22 - 3
22.7
Storing Batteries
When storing batteries, make sure that the battery terminals do not come into contact with metallic objects. If batteries are stored for an extended period of time, place the batteries in a cool place with a partial charge of
40% to 60% capacity.
NOTE
•
Remove the battery from the equipment if the equipment is not used for a prolonged time (for example, several weeks). Otherwise the battery may overdischarge.
•
Storing batteries at high temperature for an extended period of time will significantly shorten their life expectancy.
•
Storing batteries in a cool place can slow the aging process. Ideally the batteries should be stored at
15 °C.
22.8
Recycling Batteries
Discard a battery in the following situations:
■
■
■
■
The battery has visual signs of damage.
The battery fails.
The battery is aged and its runtime significantly less than the specification.
The battery has been used for more than it service time.
Properly dispose of batteries according to local regulations.
WARNING
•
Do not open batteries, heat batteries above 60 °C, incinerate batteries, or short the battery terminals. They may ignite, explode, leak or heat up, causing personal injury.
22 - 4 BeneVision N1 Patient Monitor Operator’s Manual
23
Care and Cleaning
23.1
Care and Cleaning Introduction
■
■
■
■
■
In this chapter we only describe cleaning and disinfection of the main unit, parameter modules, mounting kits, and certain parameter accessories. For the cleaning and disinfection of the Transport Dock and other reusable accessories, refer to their instructions for use of the corresponding accessories.
Keep your equipment and accessories clean. To avoid damage to the equipment, follow these guidelines:
Always follow the manufacturer’s instructions for each cleaning / disinfecting agent.
Do not immerse any part of the equipment or accessories into liquid.
Do not pour liquid onto the equipment or accessories.
Do not allow liquid to enter the case.
Never use abrasive materials (such as steel wool or silver polish), or erosive cleaners (such as acetone or acetone-based cleaners).
23.2
Care and Cleaning Safety Information
WARNING
•
Be sure to turn off the system and disconnect all power cables from the outlets before cleaning the equipment.
CAUTION
•
If you spill liquid on the equipment or accessories, contact Mindray or your service personnel.
•
Avoid wetting the pins and metal parts of the equipment, mounting kits or accessories during cleaning and disinfection.
•
Use only Mindray approved cleaners and disinfectants and methods listed in this chapter to clean or disinfect your equipment. Warranty does not cover damage caused by unapproved substances or methods.
•
We make no claims regarding the efficacy of the listed chemicals or methods as a means for controlling infection. For the method to control infection, consult your hospital’s Infection Control
Officer or Epidemiologist.
•
The responsible hospital or institution shall carry out all cleaning and disinfection procedures specified in this chapter.
•
Refer to the respective instructions for use of the cleaning agents and disinfectants.
•
Do not mix disinfecting solutions (such as bleach and ammonia) as hazardous gases may result.
NOTE
•
To clean or disinfect reusable accessories, refer to the instructions delivered with the accessories.
BeneVision N1 Patient Monitor Operator’s Manual 23 - 1
23.3
Cleaning and Disinfecting the Equipment and Mounting Kits
Use approved cleaning and disinfecting agents for cleaning or disinfecting the main unit, parameter modules,
Modular Rack, Dock, folding hook, monitor handle, and bedrail hook.
23.3.1
Approved Cleaning and Disinfecting Agents
The following table lists approved cleaning and disinfecting agents:
:
Product Name Product Type Active Ingredients
Liquid Sodium hypochlorite bleach
Hydrogen peroxide
Isopropanol
1-Propanol
Metrex CaviCide1™
Virex® II 256 (1:256)
Virex® TB
Rely+OnTM Virkon® High Level
Surface Disinfectant
Alpet® D2 Surface Sanitizing
Wipes
Powder
Wipes
Sodium hypochlorite bleach 0.5%
Hydrogen peroxide 3%
Isopropanol 70%
1-Propanol 50%
Diisobutylphenoxyethoxyethyl dimethyl benzyl ammonium chloride 0.28%,
Isopropanol 17.2%
Didecyl dimethyl ammonium chloride 8.704%, n-Alkydimethyl benzyl ammonium chloride 8.190% n-Alkyl dimethyl benzyl ammonium chlorides 0.105%, n-Alkyl dimethyl ethylbenzyl ammonium chlorides 0.105%
Used as 1% solution
Biocidal active:
Pentapotassium bis (peroxymonosulphate) bis (sulphate)(500g/ kg),
Contains dipotassium peroxodisulphate.
Isopropyl Alcohol 58.6000%,
Octyl Decyl Dimethyl Ammonium chloride 0.0075%,
Dioctyl Dimethyl Ammonium Chloride 0.0030%
Sodium Hypochlorite 0.65% Clorox Dispatch® Hospital
Cleaner Disinfectant Towels with
Bleach
Clorox Healthcare® Bleach
Germicidal Wipes
Clorox Healthcare® Hydrogen
Peroxide Cleaner Disinfectant
Wipes
Diversey Oxivir® TB Wipes
Metrex CaviWipes™
Sodium Hypochlorite 0.55%
Hydrogen Peroxide 1.4%
Hydrogen Peroxide 0.5%
Diisobutylphenoxyethoxyethyl dimethyl benzyl ammonium chloride 0.28%,
Isopropanol 17.2% n-Alkyl dimethyl ethylbenzyl ammonium chlorides 0.14%, n-Alkyl dimethyl benzyl ammonium chlorides 0.14%
Sodium Hypochlorite 0.63%,other ingredients 99.37%
PDI Sani-Cloth® AF3 Germicidal
Disposable Wipe
PDI Sani-Cloth® Bleach
Germicidal Disposable Wipe
PDI Sani-Cloth® HB Germicidal
Disposable Wipe
PDI Sani-Cloth® Plus Germicidal
Disposable Cloth
PDI Super Sani-Cloth® Germicidal
Disposable Wipe n-Alkyl dimethyl ethylbenzyl ammonium chlorides 0.07%, n-Alkyl dimethyl benzyl ammonium chlorides 0.07% n-Alkyl dimethyl ethylbenzyl ammonium chlorides 0.125%, n-Alky dimethyl benzyl ammonium chlorides 0.125% n-Alkyl dimethyl ethylbenzyl ammonium chlorides 0.25%, n-Alkyl dimethyl benzyl ammonium chlorides 0.25%,
Isopropyl Alcohol 55.0%
23 - 2 BeneVision N1 Patient Monitor Operator’s Manual
Product Name
VIRAGUARD Hospital Surface
Disinfectant Towelettle
Product Type
Wipes
Active Ingredients
Isopropanol 70%,
Other ingredients 30%
NOTE
•
For equipment with the symbol , all the listed cleaning and disinfecting agents are available for use.
23.3.2
Cleaning the Equipment and Mounting Kits
The main unit, parameter modules, Modular Rack, Dock, folding hooks, monitor handle, and bedrail hooks should be cleaned on a regular basis. Before cleaning the equipment and mounting kits, consult your hospital’s regulations for cleaning the equipment.
To clean your equipment, follow this procedure:
1.
Shut down the monitor and disconnect it from the AC power.
2.
Clean the display screen with wipes or a soft cloth moistened with one of the cleaning agents listed in
23.3.1 Approved Cleaning and Disinfecting Agents only.
3.
Clean the exterior surface of the equipment and mounting kits with wipes or a soft cloth moistened with
one of the cleaning agents listed in 23.3.1 Approved Cleaning and Disinfecting Agents
only.
4.
Wipe off all the cleaning agent residue with a dry cloth.
5.
Dry your equipment in a ventilated, cool place.
23.3.3
Disinfecting the Equipment and Mounting Kits
Disinfect the main unit, parameter modules, Modular Rack, Dock, folding hook, monitor handle, and bedrail hook as required in your hospital’s servicing schedule using the disinfecting agents listed in the table above.
Cleaning equipment and mounting kits before disinfecting is recommended.
CAUTION
•
Never use EtO or formaldehyde for disinfection.
23.4
Cleaning and Disinfecting the Accessories
For the NIBP air hose and SpO
2
cable, you should clean and disinfect them using the cleaners and disinfectants and methods listed in this section. For other accessories, you should consult the instructions delivered with the accessories.
CAUTION
•
Fluids entering the NIBP air hose can damage the equipment. When cleaning and/or disinfecting the
NIBP air hose, prevent liquid from entering the hose.
•
Periodically inspect the NIBP air hose and connector for signs of wear or deterioration. Replace the
NIBP air hose if you detect a leak. Dispose of damaged NIBP air hose according to local laws for disposal of hospital waste.
•
Never immerse or soak the accessories in any liquid.
•
Never clean or disinfect the metalic connectors at either end of the accessories.
•
Use only Mindray approved cleaners and disinfectants and methods listed in this section to clean or disinfect the accessories. Warranty does not cover damage caused by unapproved substances or methods.
•
To avoid long term damage, the accessories should be disinfected only when necessary as determined by your hospital’s policy.
BeneVision N1 Patient Monitor Operator’s Manual 23 - 3
23.4.1
Approved Accessories Cleaning and Disinfecting Agents
The following table lists approved NIBP air hose cleaning and disinfecting agents:
:
Product Name Product Type Active Ingredients
Isopropanol
1-Propanol
Metrex CaviCide1™
Virex® TB
Rely+OnTM Virkon® High Level
Surface Disinfectant
Alpet® D2 Surface Sanitizing
Wipes
Liquid
Powder
Wipes
Isopropanol 70%
1-Propanol 50%
Diisobutylphenoxyethoxyethyl dimethyl benzyl ammonium chloride 0.28%,
Isopropanol 17.2% n-Alkyl dimethyl benzyl ammonium chlorides 0.105%, n-Alkyl dimethyl ethylbenzyl ammonium chlorides 0.105%
Used as 1% solution
Biocidal active:
Pentapotassium bis (peroxymonosulphate) bis (sulphate)(500g/ kg),
Contains dipotassium peroxodisulphate.
Isopropyl Alcohol 58.6000%,
Octyl Decyl Dimethyl Ammonium chloride 0.0075%,
Dioctyl Dimethyl Ammonium Chloride 0.0030%
Sodium Hypochlorite 0.65% Clorox Dispatch® Hospital
Cleaner Disinfectant Towels with
Bleach
Metrex CaviWipes™
PDI Sani-Cloth® AF3 Germicidal
Disposable Wipe
PDI Sani-Cloth® Plus Germicidal
Disposable Cloth
PDI Super Sani-Cloth® Germicidal
Disposable Wipe
VIRAGUARD Hospital Surface
Disinfectant Towelettle
Diisobutylphenoxyethoxyethyl dimethyl benzyl ammonium chloride 0.28%,
Isopropanol 17.2% n-Alkyl dimethyl ethylbenzyl ammonium chlorides 0.14%, n-Alkyl dimethyl benzyl ammonium chlorides 0.14% n-Alkyl dimethyl ethylbenzyl ammonium chlorides 0.125%, n-Alky dimethyl benzyl ammonium chlorides 0.125% n-Alkyl dimethyl ethylbenzyl ammonium chlorides 0.25%, n-Alkyl dimethyl benzyl ammonium chlorides 0.25%,
Isopropyl Alcohol 55.0%
Isopropanol 70%,
Other ingredients 30%
:
The following table lists approved Masimo SpO
2
cable cleaning and disinfecting agents:
Product Name Product Type Active Ingredients
Isopropanol Liquid Isopropanol 70%
23 - 4 BeneVision N1 Patient Monitor Operator’s Manual
:
The following table lists approved Nellcor SpO
2
cable cleaning and disinfecting agents:
Product Name Product Type Active Ingredients
Liquid Sodium hypochlorite bleach
Isopropanol
1-Propanol
Virex® TB
Rely+OnTM Virkon® High Level
Surface Disinfectant
Powder
Sodium hypochlorite bleach 0.5%
Isopropanol 70%
1-Propanol 50% n-Alkyl dimethyl benzyl ammonium chlorides 0.105%, n-Alkyl dimethyl ethylbenzyl ammonium chlorides 0.105%
Used as 1% solution
Biocidal active:
Pentapotassium bis (peroxymonosulphate) bis (sulphate)(500g/ kg),
Contains dipotassium peroxodisulphate.
Sodium Hypochlorite 0.65% Clorox Dispatch® Hospital
Cleaner Disinfectant Towels with
Bleach
Clorox Healthcare® Bleach
Germicidal Wipes
Clorox Healthcare® Hydrogen
Peroxide Cleaner Disinfectant
Wipes
Diversey Oxivir® TB Wipes
PDI Super Sani-Cloth® Germicidal
Disposable Wipe
Wipes
VIRAGUARD Hospital Surface
Disinfectant Towelettle
Sodium Hypochlorite 0.55%
Hydrogen Peroxide 1.4%
Hydrogen Peroxide 0.5% n-Alkyl dimethyl ethylbenzyl ammonium chlorides 0.25%, n-Alkyl dimethyl benzyl ammonium chlorides 0.25%,
Isopropyl Alcohol 55.0%
Isopropanol 70%,
Other ingredients 30%
23.4.2
Cleaning the Accessories
You should clean the accessories (NIBP air hose and SpO
2
cable) on a regular basis. Before cleaning the accessories, consult your hospital’s regulations for cleaning the accessories.
To clean the accessories, follow this procedure:
1.
Clean the accessories with wipes or a soft cloth moistened with one of the cleaning agents listed in
23.4.1 Approved Accessories Cleaning and Disinfecting Agents
only.
2.
Wipe off all the cleaning agent residue with a dry cloth.
3.
Allow the accessories to air dry.
23.4.3
Disinfecting the Accessories
We recommend that the accessories (NIBP air hose and SpO
2
cables) should be disinfected only when necessary as determined by your hospital’s policy, to avoid long term damage to the accessories. Cleaning the accessories before disinfecting is recommended.
23.5
Sterilization
Sterilization is not recommended for this equipment, related products, accessories, or supplies unless otherwise indicated in the Instructions for Use that accompany the products, accessories or supplies.
BeneVision N1 Patient Monitor Operator’s Manual 23 - 5
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23 - 6 BeneVision N1 Patient Monitor Operator’s Manual
24
Maintenance
24.1
Maintenance Introduction
Regular maintenance is essential to ensure that the equipment continues to function properly. This chapter contains information on periodic testing and maintenance.
24.2
Maintenance Safety Information
WARNING
•
To avoid electric shock, stop using the equipment if you find the housing is damaged, and contact the service personnel.
•
Failure on the part of the responsible individual hospital or institution using this equipment to implement a recommended maintenance schedule may cause undue equipment failure and possible health hazards.
•
No modification of this equipment is allowed.
•
This equipment contains no user serviceable parts.
•
The safety checks or maintenance involving any disassembly of the equipment should be performed by professional service personnel. Otherwise, undue equipment failure and possible health hazards could result.
•
Do not open batteries, heat batteries to above 60 °C, incinerate batteries, or short the battery terminals. Batteries may ignite, explode, leak or heat up, causing personal injury.
•
The service personnel must be properly qualified and thoroughly familiar with the operation of the equipment.
CAUTION
•
The equipment and accessories shall not be serviced or maintained while in use on a patient.
•
If you discover a problem with any of the equipment, contact your service personnel or Mindray.
•
Use and store the equipment within the specified temperature, humidity, and altitude ranges.
•
When disposing of the packaging material, be sure to observe the applicable waste control regulations and keep it out of the reach of children.
•
At the end of its service life, the equipment, as well as its accessories, must be disposed of in compliance with the guidelines regulating the disposal of such products. If you have any questions concerning disposal of the equipment, please contact Mindray.
BeneVision N1 Patient Monitor Operator’s Manual 24 - 1
24.3
Maintenance and Testing Schedule
Follow the maintenance and testing schedule or local regulations to perform testing and maintenance such as defined in section
24.5 Testing Methods and Procedures
. Follow your hospital policy on cleaning and disinfecting the equipment before testing and maintenance.
The following table lists the maintenance and testing schedule:
Test/Maintenance Item
Performance Tests
Visual inspection
Measurement module performance test and calibration
Analog output test
Defibrillation synchronization test
Electrical Safety Tests
Electrical safety tests
Other Tests
Power-on test
Network printer tests
Battery check Functionality test
Performance test
Recommended Frequency
Every day, before first use.
1. If you suspect that the measurement values are incorrect.
2. Follow any repairs or replacement of relevant module.
3. Once a year for CO
2
tests.
4. Once every two years for other parameter module performance tests.
If you suspect that the analog output function does not work properly.
If you suspect that the defibrillation synchronization function does not work properly.
Once every two years.
Before use
1. When first installed.
2.Follow any repair or replacement of the printer.
1. When first installed.
2. When battery is replaced.
Every three months or if the battery runtime is reduced significantly.
24.4
Checking System Software Version
To view system software version information, select the Main Menu quick key
→
from the System column select
Version .
You can check the detailed system software version, module hardware and software version, and firmware version only from the Maintenance dialog.
24.5
Testing Methods and Procedures
Except for the following maintenance tasks, all other test and maintenance tasks should be performed by
Mindray-qualified service personnel only.
■
■
■
Regular checks, including visual inspection and power-on test
Printer tests
Battery check
If your monitor needs a safety test and performance test, contact the service personnel.
24.5.1
Performing Visual Inspection
Visually inspect the equipment before its first use every day. If you find any signs of damage, remove the monitor from use and contact the service personnel.
24 - 2 BeneVision N1 Patient Monitor Operator’s Manual
Verify that the equipment meets the following requirements:
■
■
■
■
■
Environment and power supply specifications are met.
The monitor housing and display screen are free from cracks or other damage.
The power cord is not damaged and the insulation is in good condition.
Connectors, plugs, and cables are not damaged or kinked.
Power cord and patient cables are securely connected to the equipment and modules.
24.5.2
Performing Power-on Test
The monitor automatically performs a power-on test at startup. Verify the following items for the power-on test:
■
■
■
The equipment powers on properly.
The alarm system works properly, denoted by alarm sounds and display of all 3 alarm light colors.
The monitor displays properly.
24.5.3
Testing the Network Printer
To check the printer, follow this procedure:
1.
Start a printing task to print waveforms and reports.
2.
Check that the printer is properly connected and functions correctly.
3.
Check that the printout is clear with no missing information.
24.5.4
Checking the Battery
For information on battery check, see 22.6.2 Checking Battery Performance
.
24.6
NIBP Maintenance
24.6.1
NIBP Leakage Test
The NIBP leakage test checks the integrity of the system and of the valve. The NIBP leakage test should be performed once every two years or when you doubt the NIBP measurements. The NIBP leakage test should be performed by Mindray-qualified service personnel only.
24.6.2
NIBP Accuracy Test
The NIBP accuracy test should be performed once every two years or when you doubt the NIBP measurements.
The NIBP accuracy test should be performed by Mindray-qualified service personnel only.
24.7
Disposing of the Monitor
Dispose of the monitor and its accessories when its service life is reached. Follow local regulations regarding the disposal of such product.
WARNING
•
For disposal of parts and accessories, where not otherwise specified, follow local regulations regarding disposal of hospital waste.
BeneVision N1 Patient Monitor Operator’s Manual 24 - 3
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24 - 4 BeneVision N1 Patient Monitor Operator’s Manual
25
Accessories
The accessories listed in this chapter comply with the requirements of IEC 60601-1-2 when in use with the patient monitor. The accessory material that contacts the patients has undertaken the bio-compatibility test and is verified to be in compliance with ISO 10993-1. For details about the accessories, refer to the instructions for use provided with the accessory.
WARNING
•
Use accessories specified in this chapter. Using other accessories may cause damage to the patient monitor or not meet the claimed specifications.
•
Single-use accessories are not designed to be reused. Reuse may cause a risk of contamination and affect the measurement accuracy.
CAUTION
•
The accessories may not meet the performance specifications if stored or used outside the specified temperature and humidity ranges. If accessory performance is degraded due to aging or environmental conditions, contact your service personnel.
•
Check the accessories and their packages for any sign of damage. Do not use them if any damage is detected.
•
Use the accessories before the expiration date if an expiration date is indicated.
•
Discard disposable accessories according to hospital regulations.
NOTE
•
This manual describes all the accessories that are validated for use. Not all accessories are available in every market.
25.1
ECG Accessories
25.1.1
ECG Electrodes Available for Purchase
Model Part No.
31499224 0010-10-12304
1050NPSMKittycat 0681-00-0098-01
1051NPSMKittycat 0681-00-0098-02
Description
Electrode, Kendall, pkg of 10
NEO pre-wired electrode radio
Opaque, pkg of 100
NEO pre-wired electrode radio
Translucent, pkg of 100
25.1.2
ECG Electrodes Also Compatible
Model
2245-50
Part No.
9000-10-07469
Description
ECG electrode, 3M, pkg of 50
Usage
Disposable
Disposable
Disposable
Applicable patient
Adult
Neonate
Neonate
Usage
Disposable
Applicable patient
Pediatric
BeneVision N1 Patient Monitor Operator’s Manual 25 - 1
25.1.3
12-Pin Trunk Cables Available for Purchase
Model
EV6206
EV6207
EV6216
EV6217
EV6208
Part No.
009-005266-00
009-005267-00
009-005268-00
009-005269-00
040-003528-00
Description
ECG cable, 10' (3.1 m), defibrillation-proof, for N/T
ECG cable, 20' (6.2 m), defibrillation-proof, for N/T
ECG cable, 10' (3.1 m), ESU-proof, for N/T
ECG cable, 20' (6.2 m), ESU-Proof , for N/T
ECG cable, 10' (3.1 m), 12-lead, defibrillation-proof, for N/T 5-lead leadwires
Note: 040-003528-00 uses 5-Lead N/T leadwires for the limb leads.
Usage
Reusable
Reusable
Reusable
Reusable
Reusable
25.1.4
12-Pin Trunk Cables Also Compatible
Applicable patient
Adult/Pediatric
Adult/Pediatric
Adult/Pediatric
Adult/Pediatric
Adult/Pediatric
EV6211
EV6212
EV6222
/
/
Model
EV6201
EV6202
EV6203
Part No.
0010-30-42719
0010-30-42720
0010-30-42721
0010-30-42723
0010-30-42724
040-000754-00
040-001416-00
009-003652-00
Description
12Pin 3/5-Lead ECG trunk cable, defibrillation-proof
12Pin 3-Lead ECG trunk cable, defibrillation-proof
12Pin 12-Lead trunk cable, defibrillation-proof
12Pin 3/5-Lead ECG trunk cable,
ESU-proof
12Pin 3-Lead ECG trunk cable, ESUproof
12Pin 3-Lead trunk cable, defibrillation-proof, DIN Conn
12Pin 3/5-Lead ECG trunk cable, defibrillation-proof
12Pin 3/5-Lead ECG trunk cable,
ESU-proof
Usage
Reusable
Reusable
Reusable
Reusable
Reusable
Reusable
Reusable
Reusable
25.1.5
3-lead ECG Leadwires Available for Purchase
Model
EY6316B
EY6305B
EY6316A
EY6305A
EY6310B
EY6310B
Part No.
009-004765-00
009-004766-00
009-004771-00
009-004772-00
009-004777-00
115-032954-00
Description
3-Lead, N/T, AHA, snap, 24’’
3-Lead, N/T, AHA, snap, 36’’
3-Lead, N/T, AHA, clip, 24’’
3-Lead, N/T, AHA, clip, 36’’
3-Lead, N/T, AHA, snap, 24’’
3-Lead, N/T, AHA, snap, 24’’, pkg of
20
Usage
Reusable
Reusable
Reusable
Reusable
Disposable
Disposable
Applicable patient
Adult/Pediatric
Adult/Pediatric
Adult/Pediatric
Adult/Pediatric
Adult/Pediatric
Adult/Pediatric
Applicable patient
Adult/Pediatric
Pediatric/Neonate
Adult/Pediatric
Adult/Pediatric
Pediatric/Neonate
Pediatric/Neonate
Adult/Pediatric
Adult/Pediatric
25 - 2 BeneVision N1 Patient Monitor Operator’s Manual
25.1.6
3-lead ECG Leadwires Also Compatible
Model
EL6305A
EL6303A
EL6301B
EL6311B
EL6311A
/
/
/
/
Part No.
0010-30-42896
0010-30-42731
0010-30-42734
040-000146-00
040-000148-00
0012-00-1503-05
0012-00-1503-06
0012-00-1514-05
0012-00-1514-06
Description Usage
3-Lead leadset, AHA, clip
3-Lead leadset, AHA, clip, Long
3-Lead leadset, AHA, snap
3-Lead leadset, AHA, snap
3-Lead leadset, AHA, clip
3-Lead leadset, snap, 24" (61.0 cm),
AAMI
3-Lead leadset, snap, 36" (101.6 cm), AAMI
3-Lead leadset, clip, 24" (61.0 cm),
AAMI
3-Lead leadset, clip, 36" (101.6 cm),
AAMI
Reusable
Reusable
Reusable
Disposable
Disposable
Reusable
Reusable
Reusable
Reusable
Applicable patient
Neonate
Adult/Pediatric
Adult/Pediatric
Pediatric/Neonate
Pediatric/Neonate
Adult/Pediatric
Adult/Pediatric
Adult/Pediatric
Adult/Pediatric
25.1.7
5-lead ECG Leadwires Available for Purchase
Model
EY6511B
EY6512B
EY6511A
EY6512A
EY6507B
EY6507B
Part No.
009-004782-00
009-004783-00
009-004786-00
009-004787-00
009-004790-00
115-032955-00
Description
5-Lead, N/T, AHA, snap, 24’’
5-Lead, N/T, AHA, snap, 36’’
5-Lead, N/T, AHA, pinch, 24’’
5-Lead, N/T, AHA, pinch, 36’’
5-Lead, N/T, AHA, snap, 24’’
5-Lead, N/T, AHA, snap, 24’’, pkg of
20
Usage
Reusable
Reusable
Reusable
Reusable
Disposable
Disposable
Applicable patient
Adult/Pediatric
Adult/Pediatric
Adult/Pediatric
Adult/Pediatric
Adult/Pediatric
Adult/Pediatric
25.1.8
5-lead ECG Leadwires Also Compatible
/
/
Model
EL6503A
EL6501B
EL6501A
/
/
Part No.
0010-30-42729
0010-30-42735
0010-30-42727
0012-00-1503-02
0012-00-1503-03
0012-00-1514-02
0012-00-1514-03
Description Usage
5-Lead leadset, AHA, clip, Long
5-Lead leadset, AHA, snap
5-Lead leadset, AHA, clip
5-Lead leadset, snap, 24" (61.0 cm),
AAMI
5-Lead leadset, snap, 36" (101.6 cm), AAMI
5-Lead leadset, clip, 24" (61.0 cm),
AAMI
5-Lead leadset, clip, 36" (101.6 cm),
AAMI
Reusable
Reusable
Reusable
Reusable
Reusable
Reusable
Reusable
Applicable patient
Adult/Pediatric
Adult/Pediatric
Adult/Pediatric
Adult/Pediatric
Adult/Pediatric
Adult/Pediatric
Adult/Pediatric
BeneVision N1 Patient Monitor Operator’s Manual 25 - 3
25.1.9
6-lead ECG Leadwires Available for Purchase
Model
EY6601B
EY6602B
EY6601A
EY6602A
Part No.
009-004794-00
009-004795-00
009-004798-00
009-004799-00
Description
6-Lead, N/T, AHA, snap, 24’’
6-Lead, N/T, AHA, snap, 36’’
6-Lead, N/T, AHA, pinch, 24’’
6-Lead, N/T, AHA, pinch, 36’’
25.1.10
12-lead ECG Chest Leadwires Available for Purchase
Usage
Reusable
Reusable
Reusable
Reusable
Model
EL6803A
EL6803B
Part No.
0010-30-42904
0010-30-42908
Description
12-Lead leadset, chest, AHA, clip
12-Lead leadset, chest, AHA, snap
Usage
Reusable
Reusable
25.1.11
12-lead ECG Leadwires Also Compatible
Applicable patient
Adult/Pediatric
Adult/Pediatric
Adult/Pediatric
Adult/Pediatric
Applicable patient
Adult/Pediatric
Adult/Pediatric
Model
EL6801A
EL6801B
Part No.
0010-30-42902
0010-30-42906
Description
12-Lead leadset, limb, AHA, clip
12-Lead leadset, limb, AHA, snap
Usage
Reusable
Reusable
25.2.2
Extension Cables and Adapter Cables Also Compatible
Model
582A
Part No.
115-020768-00
Description
8-pin SpO2 extension cable, Masimo
Usage
Reusable
Applicable patient
Adult/Pediatric
Adult/Pediatric
25.2
SpO
2
Accessories
Wavelength emitted by the sensors is between 600 nm and 1000 nm. The maximum photic output consumption of the sensor is less than 18 mW.
The information about the wavelength range and maximum photic output consumption can be especially useful to clinicians, for example, when photodynamic therapy is performed.
25.2.1
Extension Cables and Adapter Cables Available for Purchase
Model
572A
583A
4089
4092
Part No.
0010-20-42712
040-003310-00
040-003381-00
040-003426-00
Description
8-pin SpO2 extension cable, Nellcor
8 pin, RD SET, Masimo
RD to LNCS adapter cable, Masimo
LNCS to RD adapter, Masimo
Usage
Reusable
Reusable
Reusable
Reusable
Applicable patient
/
/
/
/
/
Applicable patient
25 - 4 BeneVision N1 Patient Monitor Operator’s Manual
25.2.3
Masimo SpO
2
RD Set Sensors Available for Purchase
4002
4003
4004
4005
Model
4050
4051
4053
4000
4001
Part No.
040-003376-00
040-003377-00
040-003380-00
040-003382-00
040-003383-00
040-003384-00
040-003385-00
040-003386-00
040-003387-00
Description Usage
SpO2 sensor, RD SET DCI
SpO2 sensor, RD SET DCI
SpO2 sensor, RD Set TC-I, tip-clip ear sensor, 3ft
SpO2 sensor, RD SET Adt, adhesive, pkg of 20
SpO2 sensor, RD SET PDT, adhesive, pkg of 20
SpO2 sensor, RD Set Inf, adhesive, pkg of 20
SpO2 sensor, RD Set Neo, adhesive, pkg of 20
SpO2 sensor, RD Set NeoPt, adhesive, pkg of 20
SpO2 sensor, RD Set NeoPt-500, nonadhesive, pkg of 20
Reusable
Reusable
Reusable
Disposable
Disposable
Disposable
Disposable
Disposable
Disposable
Applicable patient
Adult (> 30 kg)
Pediatric (10-50 kg)
Adult (> 30 kg)
Adult (> 30 kg)
Pediatric (10 to 50 kg)
Infant (3 to 20 kg)
Neonatal /Adult
(<3Kg or >40Kg)
Neonate (<1 kg)
Neonate (<1 kg)
25.2.4
Masimo SpO
2
LNCS Sensors Also Compatible
Model
LNCS Adtx
LNCS Pdtx
LNCS DCI
LNCS DCIP
LNCS NeoPt
LNCS Neo-L
Part No.
0600-00-0121
0600-00-0122
0600-00-0126
0600-00-0127
0600-00-0156
0600-00-0157
Description
SpO2 sensor, finger-clip, 20 pcs/box
SpO2 sensor, finger-clip, 20 pcs/box
SpO2 sensor, finger-clip
SpO2 sensor, finger-clip
SpO2 sensor, finger-clip
SpO2 sensor, 20 pcs/box
Usage
Disposable
Disposable
Reusable
Reusable
Disposable
Disposable
Disposable
Applicable patient
Adult (>30 kg)
Pediatric (10-50 kg)
Adult (>30 kg)
Pediatric (10-50 kg)
Neonate (<1Kg)
Neonate /Adult
(<3 kg or > 40 kg)
Infant (3-20 kg) LNCS Inf 0600-00-0158 SpO2 sensor, 20 pcs/box
25.2.5
Nellcor SpO
2
Sensors Also Compatible
Model
DS100A
D-YS
OXI-P/I
OXI-A/N
MAXAI
MAXPI
MAXII
Part No.
9000-10-05161
0010-10-12476
9000-10-07308
9000-10-07336
0010-10-12202
0010-10-12203
0010-10-12204
Description
SpO2 sensor, finger-clip
SpO2 sensor, with wraps
SpO2 sensor, finger, band
SpO2 sensor, finger/foot, band
SpO2 sensor, 24 pcs/box
SpO2 sensor, 24 pcs/box
SpO2 sensor, 24 pcs/box
Usage
Reusable
Reusable
Reusable
Reusable
Disposable
Disposable
Disposable
Applicable patient
Adult
/
Pediatric/Infant
Adult/Neonate
Adult (>30 kg)
Pediatric (10-50 Kg)
Infant (3-20 kg)
BeneVision N1 Patient Monitor Operator’s Manual 25 - 5
Model
MAXNI
Part No.
0010-10-12205
Description
SpO2 sensor, 24 pcs/box
Usage
Disposable
Applicable patient
Adult/Neonate
(<3 kg or >40 kg)
25.3
Temp Accessories
25.3.1
Temp Cable Available for Purchase
Model
MR420B
Part No.
040-001235-00
25.3.2
Temp Cable Also Compatible
Description
2-pin Temperature adapter cable
Usage
Reusable
Model
MR420B
Part No.
0011-30-37391
Description
2-pin, extension cable
25.3.3
Temp Probes Available for Purchase
Usage
Reusable
/
Applicable patient
/
Applicable patient
MR411
/
/
/
/
/
MR412
MR412
Model
MR401B
MR402B
MR403B
MR404B
MR411
Part No.
0011-30-37392
0011-30-37394
0011-30-37393
0011-30-37395
040-003292-00
040-003294-00
040-003293-00
040-003295-00
0206-03-0112-02
0206-03-0118-02
0206-03-0209-02
0206-03-0212-02
0206-03-0300-02
Description Usage
Temperature probe, endocavity
Temperature probe, endocavity
Temperature probe, skin surface
Temperature probe, skin surface
Temperature probe, esophageal/ rectal, 9FR
Temperature probe, esophageal/ rectal, 9FR, pkg of 20
Reusable
Reusable
Reusable
Reusable
Disposable
Disposable
Temp probe, skin surface Disposable
Temp probe, skin surface, pkg of 20 Disposable
PROBE,D TEMP,ES400-12 (box of 20) Disposable
PROBE,D TEMP,ES400-18 (box of 20) Disposable
PROBE,D TEMP,ER 400-9 (box of 20) Disposable
PROBE,D TEMP,ER400-12 (box of 20) Disposable
PROBE,D TEMP,STS-400 (box of 20) Disposable
Applicable patient
Adult
Pediatric/Infant
Adult
Pediatric/Infant
Adult/Pediatric
Adult/Pediatric
All
All
Adult
Adult
Adult
Adult
Adult
25.3.4
Temp Probes Also Compatible
Model
MR411
MR412
Part No.
0011-30-90446
0011-30-90447
Description
Disposable temperature probe, esophageal
Disposable temperature probe, skin
Usage
Disposable
Disposable
Applicable patient
All
All
25 - 6 BeneVision N1 Patient Monitor Operator’s Manual
25.4
NIBP Accessories
25.4.1
NIBP Hoses Available for Purchase
Model
CM1903
CM1901
Part No.
6200-30-09688
6200-30-11560
Description
NIBP hose, inbuilt connector, 3m
NIBP hose, inbuilt connector, 3m
Usage
Reusable
Reusable
25.4.2
Cuffs Available for Purchase
Applicable patient
Adult/Pediatric
Neonate
CM1504
CM1505
CM1506
CM1507
CM1500A
CM1500B
CM1500C
CM1500D
/
Model
CM1301
CM1302
CM1303
CM1304
CM1305
CM1306
CM1307
CM1501
CM1502
CM1503
115-027566-00
115-027567-00
115-027568-00
115-027569-00
001B-30-70692
001B-30-70693
001B-30-70694
001B-30-70695
115-031807-00
Part No.
115-027713-00
115-027714-00
115-027715-00
115-027716-00
115-027717-00
115-027718-00
115-027719-00
115-027563-00
115-027564-00
115-027565-00
Description
Cuff, 10-19 cm, bladderless
Cuff, 18-26 cm, bladderless
Cuff, 25-35 cm, bladderless
Cuff, 33-47 cm, bladderless
Cuff, 46-66 cm, bladderless
Cuff, 24-35 cm, bladderless
Cuff, 33-47 cm, bladderless
Cuff, 10-19 cm, bladderless, pkg of
10
Cuff, 18-26 cm, bladderless, pkg of
10
Cuff, 25-35 cm, bladderless, pkg of
10
Cuff, 33-47 cm, bladderless, pkg of
10
Cuff, 46-66 cm, bladderless, pkg of
5
Cuff, 25-35 cm, bladderless, pkg of
10, long
Cuff, 33-47 cm, bladderless, pkg of
10, long
Cuff, 3.1-5.7 cm, pkg of 20
Cuff, 4.3-8.0 cm, pkg of 20
Cuff, 5.8-10.9 cm, pkg of 20
Cuff, 7.1-13.1 cm, pkg of 20
Cuff starter kit, bladderless
Usage
Reusable
Reusable
Reusable
Reusable
Reusable
Reusable
Reusable
Disposable
Disposable
Disposable
Disposable
Disposable
Disposable
Disposable
Disposable
Disposable
Disposable
Disposable
Reusable
Large adult
Adult thigh
Adult
Large adult
Neonate
Neonate
Neonate
Neonate
Child/Small adult/
Adult/Adult thigh
Applicable patient
Infant
Small Adult
Adult
Adult
Adult thigh
Adult
Adult
Child
Small adult
Adult
BeneVision N1 Patient Monitor Operator’s Manual 25 - 7
25.5
IBP Accessories
25.5.1
IBP Accessories Available for Purchase
Model
IM2202
IM2201
IM2204
/
Part No.
001C-30-70757
001C-30-70759
040-001029-00
125-000123-00
Description
12 Pin IBP cable, Argon
12 Pin IBP cable, ICU Medical
IBP extended cable with dualreceptacle
12 Pin IBP cable, Edwards (not for transportation)
Usage
Reusable
Reusable
Reusable
Reusable
Applicable patient
/
/
/
/
25.5.2
ICP Accessories Available for Purchase
Model
82-6653
CP12601
Part No.
040-002336-00
009-005460-00
Description
Codman ICP sensor kit, Johnson &
Johnson, pkg of 1
12-pin ICP cable
Usage
Disposable
Reusable
Applicable patient
/
/
25.6
CO
2
Accessories
25.6.1
Sidestream CO
2
Accessories Available for Purchase
Model
4000
4100
4200
60-15200-00
60-15300-00
60-14100-00
040-001187-00
040-001187-00
60-14200-00
100-000080-00
100-000081-00
Part No.
115-043001-00
115-043002-00
115-043003-00
115-043017-00
115-043018-00
115-043020-00
040-001187-00
115-043019-00
115-043021-00
115-058733-00
115-058734-00
Description
CO2 Nasal sample cannula, 7'’ line, pkg of 25
CO2 Nasal sample cannula, 7'’ line, pkg of 25
CO2 Nasal sample cannula, 7'’ line, pkg of 25
Sampling line, 2.5 m, pkg of 25
Sampling line, 2.5 m, pkg of 25
Dryline airway adapter, straight, pkg of 10
Airway Adapter
Airway Adapter pkg of 10
Dryline airway adapter, elbow pkg of 10
Watertrap, DRYLINE II, pkg of 10
Watertrap, DRYLINE II, pkg of 10
Usage
Disposable
Disposable
Disposable
Disposable
Disposable
Disposable
Disposable
Disposable
Disposable
Reusable
Reusable
Applicable patient
Adult
Pediatric
Neonatal
Adult/Pediatric
Neonatal
Adu/Ped
Neonatal
Neonatal
/
Adult/Pediatric
Neonatal
25 - 8 BeneVision N1 Patient Monitor Operator’s Manual
25.6.2
Microstream CO
2
Accessories Intended for Sale
Model
/
Part No.
045-003134-00
Description
CO2 adapter
25.6.3
Microstream CO
2
Accessories Also Compatible
Model
009822
007269
009826
007743
008177
008178
008179
008180
XS04620
XS04624
006324
007768
007737
007738
009818
007266
008181
008174
008175
25.7
External Modules
Part No.
0010-10-42560
0010-10-42561
0010-10-42562
0010-10-42563
0010-10-42564
0010-10-42565
0010-10-42566
0010-10-42567
0010-10-42568
0010-10-42569
0010-10-42570
0010-10-42571
0010-10-42572
0010-10-42573
0010-10-42574
0010-10-42575
0010-10-42576
0010-10-42577
0010-10-42578
Description Usage
FilterLine Set Disposable
FilterLine H Set Disposable
FilterLine H Set
FilterLine Set, long
Disposable
Disposable
FilterLine H Set, long
FilterLine H Set, long
S CapnoLine Plus
Smart CapnoLine
Disposable
Disposable
Disposable
Disposable
S CapnoLine Plus O2
Smart CapnoLine O2
S CapnoLine Plus O2, long
S CapnoLine O2, long
CapnoLine H
CapnoLine H
CapnoLine H
CapnoLine H O2
CapnoLine H O2 Disposable
NIV-Line Disposable
NIV-Line Disposable
Disposable
Disposable
Disposable
Disposable
Disposable
Disposable
Disposable
Disposable
Part No.
115-053711-00
115-049134-00
6800-30-50820
Description
Sidestream CO2 module, with neonatal accessories
Sidestream CO2 module, with adult and pediatric accessories
Microstream CO2 module, with accessories
Usage
Reusable
Applicable patient
Pediatric
Adult
Pediatric
Adult
Pediatric
Neonate
Adult
Pediatric
Adult
Pediatric
Adult, pediatric
Neonate
Adult, pediatric
Adult, pediatric
Neonate
Adult
Pediatric
Adult
25.8
Mount and Mounting Accessories
Part No.
115-028320 -00
Description
Monitor handle
BeneVision N1 Patient Monitor Operator’s Manual 25 - 9
Part No.
115-048378-00
115-054849-00
115-054851-00
115-048990-00
045-001229-00
045-001230-00
045-002198-00
045-003427-00
045-001228-00
034-000454-00
034-000457-00
034-000456-00
045-000934-00
045-000924-00
115-050757-00
Description
Modular Rack kit
Dock and pole mount kit
Modular Rack and folding hook kit
Bedrail hook kit
LCD wall-mount bracket
Pole mounting kit
Dock wall mount bracket
GCX M series wall mount with quick release
N1/T1 docking station wall-mount (for LCD)
GCX M series arm, 16", with 6” riser
GCX M series 12” pivot arm
GCX VHM variable height arm
Keyboard wall-mount bracket
Rolling stand with quick release mount
Hook kit
25.9
Miscellaneous Accessories
Part No.
009-009766-00
009-006594-00
009-005123-00
009-006593-00
115-048379-00
115-048384-00
009-005391-00
023-001788-00
023-001566-00
115-048139-00
115-049427-00
DA8K-10-14452
115-048417-00
023-000524-00
023-000525-00
023-000247-00
023-000248-00
115-039575-00
115-039635-00
Description
N Series to N1/T1 docking station cable, 20 m
N Series to N1/T1 docking station cable, 10 m
N Series to N1/T1 docking station cable, 4 m
N Series to N1/T1 docking station cable, 2 m
Dock, with power cord
Transport Dock
MPM analog output and defib sync cable
External display, 21.5”
HP LaserJet Enterprise M608n, black and white
AC adapter kit
Lithium battery kit
Power cord
N1 Accessories Storage Box
Wireless keyboard and mouse set
Wired keyboard and mouse set
Keyboard, wired USB connector, black
Mouse, wired USB connector, black
2D Barcode reader, HS-1M, JADAK
2D Barcode reader, HS-1R, JADAK
25 - 10 BeneVision N1 Patient Monitor Operator’s Manual
Part No.
042-007382-00
Description
Cable management hook
BeneVision N1 Patient Monitor Operator’s Manual 25 - 11
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25 - 12 BeneVision N1 Patient Monitor Operator’s Manual
A
Product Specifications
A.1
A.2
A.3
Monitor Safety Specifications
The monitor is classified, according to IEC 60601-1: 2005:
Degree of protection against electrical shock
Type of protection against electrical shock
Degree of protection against harmful ingress of water
Type CF defibrillation proof for ECG, RESP, TEMP, IBP, SpO
2 , and NIBP
Type BF defibrillation proof for CO
2
Class I
Degree of safety of application in the presence of flammable anesthetic mixture with air or with oxygen or nitrous oxide
Mode of operation
N1 monitor: IP44 (protected against ingress of foreign objects no less than 1.0 mm, and against access to hazardous parts with wire; protect against harmful effects of splashing water)
Dock/Modular Rack/AC Adapter: IPX1 (protected against harmful effects of vertically falling water drops)
Transport Dock: IP22 (protected against ingress of foreign objects no less than
12.5 mm and against access to hazardous parts with finger; protected against harmful effects of vertically falling water drops with the device tilted at any angle up to 15°)
The equipment is not suitable for use in the presence of a flammable anesthetic mixture with air or with oxygen or nitrous oxide
Continuous
Physical Specifications
Item
N1 main unit
N1 main unit
Modular Rack
Dock
Transport Dock
Transport Dock
Microstream CO
2 module
Sidestream CO
2
module
IBP module
Maximum
Weight (kg)
2.51
1.80
0.40
0.52
0.26
0.95
1.17
0.60
0.97
W × H × D (mm) Comments
148.5 × 103 × 81
148.5 × 103 × 81
165 ×130×168
190×125×155
162.4×253×195.5
162.4×113×195.5
136.5 × 40 × 102
136.5 × 40 × 102
136.5 × 40 × 102 without internal CO
2
module with internal CO
2
module
/
/ with cable box without cable box
/ without O
2
/
Environmental Specifications
WARNING
•
The monitor may not meet the performance specifications if stored or used outside the specified temperature and humidity ranges. If the performance of the equipment is degraded due to aging or environmental conditions, contact your service personnel.
•
The monitor cannot be transported in the temperature lower than -30ºC.
BeneVision N1 Patient Monitor Operator’s Manual A - 1
A.4
A.4.1
•
When the monitor and related products have differing environmental specifications, the effective range for the combined products is that range which is common to the specifications for all products.
NOTE
•
The environmental specification of unspecified parameter modules are the same as those of the main unit.
Components
Main Unit/
Transport Dock/
AC Adapter
Property (unit)
Temperature (°C)
Relative humidity
(noncondensing) (%)
Barometric (mmHg)
Operating Condition
0 to 40
5 to 95
Storage Condition
-30 to 70
5 to 95
Modular Rack/
Dock
Microstream CO
2 module
Sidestream CO
2 module
Temperature (°C)
Relative humidity
(noncondensing) (%)
Barometric (mmHg)
Temperature (°C)
Relative humidity
(noncondensing) (%)
Barometric (mmHg)
Temperature (°C)
Relative humidity
(noncondensing) (%)
Barometric (mmHg)
427.5 to 805.5
0 to 40
15 to 95
427.5 to 805.5
0 to 40
15 to 95
430 to 790
5 to 40
15 to 95
375 to 805.5 (with CO
2
)
120 to 805.5 (without CO
2
)
-20 to 60
10 to 95
120 to 805.5
-20 to 60
10 to 95
430 to 790
-20 to 60
10 to 95
430 to 790 375 to 805.5
Transient operating conditions
The monitor is operated in normal use for a period not less than 20 minutes when moved from room temperature ( 20 °C ± 2 °C) to an environment of a temperature range from - 20 °C to 50 °C, and relative humidity range from 15% to 95% (non-condensing).
The monitor is operated in normal use for a period not less than 20 minutes when moved from storage temperature (range from - 30 °C to 70 °C) to room temperature ( 20 °C ± 2 °C), and started up within 10 minutes after the movement.
Power Supply Specifications
External Power Supply Specifications
N1 main unit
Input voltage
Input current
AC Adapter
Input
Output
Dock
Input voltage
12VDC (±10%)
2 A
100 to 240 VAC (-15%, +10%), 50/60 Hz (±3 Hz), 1.0A to 0.6A
12VDC (±10%), 2.5A
100 to 240VAC (±10%)
A - 2 BeneVision N1 Patient Monitor Operator’s Manual
N1 main unit
Input voltage
Input current
Frequency
Transport Dock
Input
Output
A.4.2
Battery Specifications
Battery type
Voltage
Run time
A.5
12VDC (±10%)
0.65A to 0.35A
50/60Hz (±3Hz)
100 to 240 VAC (-15%, +10%), 50/60 Hz (±3 Hz), 1.0A to 0.6A
AC waveform: sine
12VDC (±10%), 2.5A
Charge time
Rechargeable lithium-Ion battery
7.2 VDC
At least 8 hours when the monitor without internal CO
2
module is powered by two new fully-charged batteries at 25°C ± 5°C with factory default screen brightness, Wi-Fi disabled, ECG and SpO
2
cable connected, and auto NIBP measurements at an interval of 15 minutes.
At least 3 hours when the monitor with internal CO
2
module is powered by one new fully-charged battery at 25°C ± 5°C with factory default screen brightness, Wi-Fi enabled, CO
2 sampling line connected, Temp, IBP, ECG and
SpO
2
cable connected, and auto NIBP measurements at an interval of 15 minutes.
Shutdown delay: at least 15 minutes after the low battery alarm first occurs.
For the monitor without internal CO
2
module: no more than 6 hours to 90% when the monitor is off.
no more than 10 hours to 90% when the monitor is on.
For the monitor with internal CO
2
module: no more than 3 hours to 90% when the monitor is off.
no more than 5 hours to 90% when the monitor is on.
Display Specifications
N1 main unit
Screen type
Screen Size (diagonal)
Resolution
Pixel per inch (PPI)
External display
Screen type
Screen Size (diagonal)
Resolution
Color TFT LCD
5.5 inches
1280 x 720 pixels
269
Medical-grade color TFT LCD
19 inches, 22 inches
1280 x 720 pixels
BeneVision N1 Patient Monitor Operator’s Manual A - 3
A.6
Touchscreen Specifications
Screen type Capacitive, multi-point touch
A.7
A.7.1
LEDs
Main Unit
Alarm lamp
Power-on LED
External power LED
Battery LED
1 (three color-coded: red, yellow, and cyan)
1 (green)
1 (green)
1 (two color-coded: yellow and green)
A.7.2
Dock
Connection status LED
External power supply LED
A.7.3
Transport Dock
Power-on LED
A.7.4
AC Adapter
Power-on LED
1 (green)
1 (green)
1 (green)
1 (green)
A.8
Audio Indicator
Speaker Give alarm tones (45 to 85 dB), reminder tones, key tones, QRS tones; support
PITCH TONE and multi-level tone modulation; alarm tones comply with IEC
60601-1-8:2012.
A.9
A.9.1
Monitor Interface Specifications
Interface Specifications of the Main Unit
DC power input connector
Multifunctional connector
Multi-pin connector
Communication interface
Infrared filter
Contact
Power switch
Sample line connector of the Sidestream
CO
2
1
1
1
2
1
4
1
1
A - 4 BeneVision N1 Patient Monitor Operator’s Manual
Gas outlet
ECG cable connector
SpO
2
sensor connector
NIBP cuff connector
IBP cable connector
Temperature probe connector
1
1
1
1
1
2
A.9.2
Interface Specifications of the Modular Rack
Multi-pin connector
Infrared filter
Pogo pin
Contact
3
2
2
1
A.9.3
Interface Specifications of the Dock
Network connector
Equipotential grounding terminal
AC power input connector
VGA connector
Host monitor connector
USB connector
Multi-pin connector
1
1
1
1
1
2
1
A.10
Signal Outputs Specifications
ECG Analog Output
Bandwidth
(-3dB; reference frequency: 10Hz)
Maximum QRS delay
Gain (reference frequency 10Hz)
Pace enhancement
Diagnostic mode: 0.05 to 150 Hz
Monitor mode: 0.5 to 40 Hz
Surgical mode: 1 to 20 Hz
ST mode: 0.05 to 40 Hz
25 ms (in diagnostic mode, and non-paced)
1V/mV (±5%)
Signal amplitude: V oh
≥2.5V
Pulse width: 10ms±5%
Signal rise and fall time: ≤100μs
IBP Analog Output
Bandwidth (-3dB; reference frequency:1Hz)
Maximum transmission delay
Gain (reference frequency 1 Hz)
Defib Sync Pulse
Output impedance
Maximum time delay
0 to 40 Hz
30 ms
1 V/100 mmHg, ±5%
≤100 Ω
35 ms (R-wave peak to leading edge of pulse)
BeneVision N1 Patient Monitor Operator’s Manual A - 5
Amplitude
Pulse width
Video Output
Video signals
Alarm output
Alarm delay time from the monitor to remote equipment
Alarm signal sound pressure level range
High level: 3.5 to 5 V, ±5%, providing a maximum of 10 mA output current;
Low level: < 0.5 V, receiving a maximum of 5 mA input current.
100 ms ±10%
VGA signal
The alarm delay time from the monitor to remote equipment is ≤2 seconds, measured at the monitor signal output connector.
45 dB(A) to 85 dB(A) within a range of one meter
A.11
Data Storage
Trends
Events
NIBP measurements
Interpretation of resting 12-lead ECG results
Full-disclosure waveforms
OxyCRG view
A minimum of 120 hours of trend data for trend interval as low as 1 minute.
1000 events
1000 sets
20 sets
48 hours at maximum. The specific storage time depends on the waveforms stored and the number of stored waveforms.
A maximum of 48 hours of oxyCRG events
A.12
Out-Of-Hospital Transport - Standards Compliance
■ Shock Tests according to IEC TR 60721-4-7, Class 7M3. Test procedure according to IEC/EN60068-2-27
(peak acceleration up to 100g).
■
■
■
■
■
■
■
■
■
■
■
Random Vibration according to IEC TR 60721-4-7, Class 7M3. Test procedure according to IEC/EN 60068-2-
64 (RMS acceleration 5g).
Sinusoidal Vibration according to IEC TR 60721-4-7, Class 7M3. Test procedure according to IEC/EN 60068-
2-6 (acceleration up to amplitude 2g).
Bump Test according to IEC/EN60068-2-29 (peak acceleration 15 g, 1000 bumps).
Free Fall Test according to EN 60068-2-32 (height 1.2 m).
EN 1789:2007+A2:2014 Medical vehicles and their equipment - Road ambulances.
EN 13718-1:2008 Medical vehicles and their equipment-Air ambulances-Part 1: Requirements for medical devices used in air ambulances.
IEC 60601-1-12:2014 Medical electrical equipment -Part 1-12: General requirements for basic safety and essential performance -Collateral Standard: Requirements for medical electrical equipment and medical electrical systems intended for use in the emergency medical services environment.
RTCA DO-160G Environmental Conditions and Test Procedures for Airborne Equipment.
◆ Section 7 Operational Shocks and Crash Safety
◆ Section 8 Vibration (Category S for fixed wing and Category U2 for rotary wing)
MIL-STD-810G Environmental engineering considerations and laboratory tests
◆ Method 514.6 Category 13 - Fixed Wing Propeller Aircraft
◆ Method 514.6 Category 14 Category 14 Helicopter, General, UH-60
◆ Method 514.6 Category 20 - Ground vehicles - ground mobile
◆ Method 514.6 Category 24 - Helicopter minimum integrity test
Radiated susceptibility 20 V/m according to IEC 80601-2-30: 2018 (NIBP), ISO80601-2-55: 2018 (CO
2
),
ISO80601-2-56: 2017 (TEMP), ISO 80601-2-61: 2017 (SpO
2
).
Extended radiated susceptibility tests
A - 6 BeneVision N1 Patient Monitor Operator’s Manual
■
■
◆ TETRA 400: 27V/m
◆ GMRS 460; FRS 460; GSM 800/900; TETRA 800; iDEN 820; CDMA 850; LTE Band 5; GSM 1800; CDMA
1900; GSM 1900; DECT; LTE Band 1, 3,4, 25; UMTS; Bluetooth; WLAN; 802.11 b/g/n; RFID 2450; LTE Band
7: 28V/m
◆ LTE Band 13, 17; WLAN 802.11 a/n: 9V/m
Magnetic Field emission according to MIL STD 461F, Chapter RE101: Radiated emissions, magnetic field,
30Hz to 100KHz. Limit class: Army.
Magnetic Field susceptibility : Radiated susceptibility, magnetic field, 50 and 60 Hz, 30 A/m.
A.13
Wi-Fi Specifications
A.13.1
Wi-Fi Technical Specifications (MSD45N)
Protocol
Modulation mode
Operating frequency
Channel spacing
Wireless data rate
Output power
Operating mode
Data security
IEEE 802.11a/b/g/n
DSSS and OFDM
IEEE 802.11b/g/n (at 2.4 GHz)
ETSI: 2.4 GHz to 2.483 GHz
FCC: 2.4 GHz to 2.483 GHz
MIC: 2.4 GHz to 2.495GHz
KC: 2.4 GHz to 2.483 GHz
IEEE 802.11a/n (at 5 GHz)
ETSI: 5.15 GHz to 5.35 GHz, 5.47 GHz to 5.725 GHz
FCC: 5.15 GHz to 5.35 GHz, 5.725 GHz to 5.85 GHz
MIC: 5.15GHz to 5.35 GHz
KC: 5.15 GHz to 5.35 GHz, 5.47 GHz to 5.725 GHz,
5.725 GHz to 5.85 GHz
Not support the DFS channels
IEEE 802.11b/g: 5 MHz
IEEE 802.11n (at 2.4 GHz): 5 MHz
IEEE802.11a: 20 MHz
IEEE802.11n (at 5 GHz): 20 MHz
IEEE 802.11b: 1 Mbps to 11 Mbps
IEEE 802.11g: 6 Mbps to 54 Mbps
IEEE 802.11n: 6.5 Mbps to 72.2 Mbps
IEEE 802.11a: 6 Mbps to 54 Mbps
<20 dBm (CE requirements, detection mode: RMS)
<30 dBm (FCC requirements, detection mode: peak power)
Infrastructure
Standards: WPA-PSK, WPA2-PSK, WPA-Enterprise, WPA2-Enterprise, WPA/WPA2 CCKM
EAP method: EAP-FAST, EAP-TLS, EAP-TTLS, PEAP-GTC, PEAP-MSCHAPv2, PEAP-TLS, LEAP
Encryption: AES
A.13.2
Wi-Fi Performance Specifications
WARNING
•
All network functions of data communication are designed to operate on a private network.
A.13.2.1
System Capacity
Number of the monitors supported by a single AP: ≤ 16
■
■
■
■
Testing conditions are as follows:
Each monitor can communicate with the CMS.
Two monitors are used to view other monitors.
Only one monitor can transmit history data.
The weakest strength of the AP signal where the monitor is located cannot be less than -65 dBm.
BeneVision N1 Patient Monitor Operator’s Manual A - 7
A.13.2.2
Resistance to Wireless Interference
The distance between the interfering devices and the monitor is greater than 20 cm. A Wi-Fi interference (no greater than -85 dBm) in the same channel and a Wi-Fi interference (no greater than -50 dBm) in an adjacentchannel are presented synchronously. The interfering devices include, but are not limited to, 2.4 GHz wireless devices, cellular mobile networks, microwave ovens, intercoms, cordless phones, and ESU equipment. The interfering devices do not include Wi-Fi devices.
■
■
■
■
The monitoring network must support the following requirements:
The total delay of data transmission from the monitor to the CMS: ≤ 2 seconds.
The delay for monitor-related settings configured at the CMS to be effective: ≤ 2 seconds.
The total delay of data transmission from one monitor to the other: ≤ 2 seconds.
The delay for the monitor to reset alarms of another to be effective: ≤ 2 seconds.
A.13.2.3
Wi-Fi Network Stability
The ratio of the communication data loss on the CMS from any monitor does not exceed 0.1% over a 24-hour period (12 of the 16 monitors connected to the network roam for 30 times).
Testing conditions are as follows:
■
■
■
■
■
Number of the monitors supported by a single AP: ≤ 16.
Each monitor can communicate with the CMS.
Two monitors are used to view other monitors.
Only one monitor can transmit history data.
The weakest strength of the AP signal where the monitor is located cannot be less than -65 dBm.
A.13.2.4
Line of Sight Distance
The line of sight distance between the monitor and the AP is no less than 50 meters.
A - 8 BeneVision N1 Patient Monitor Operator’s Manual
A.14
Measurement Specifications
The adjustable range of alarm limits is the same with the measurement range of signals unless otherwise specified.
A.14.1
ECG Specifications
ECG
Standards
Lead set
ECG standard
Display sensitivity
Sweep speed
Bandwidth (-3dB)
Common mode rejection ratio
Notch filter
Differential input impedance
Input signal range
Accuracy of signal reproduction
Electrode offset potential tolerance
Lead-off detection current
Input offset current
Defibrillation protection
Patient leakage current
Calibration signal
ESU protection
Meets the requirements of IEC 60601-2-27: 2011 and IEC 60601-2-25: 2011
3-lead: I, II, III
5-lead: I, II, III, aVR, aVL, aVF, V
6-lead: I, II, III, aVR, aVL, aVF, Va, Vb
12-lead: I, II, III, aVR, aVL, aVF, V1 to V6
AHA, IEC
1.25 mm/mV (×0.125), 2.5 mm/mV (×0.25), 5 mm/mV (×0.5), 10 mm/mV (×1),
20 mm/mV (×2), 40 mm/mV (×4), Auto, less than 5% error
6.25 mm/s, 12.5 mm/s, 25 mm/s, 50 mm/s, less than 5% error
Diagnostic mode:
Monitor mode:
Surgery mode:
ST mode:
High frequency cut-off (for 12lead ECG analysis):
0.05 to 150 Hz
0.5 to 40 Hz
1 to 20 Hz
0.05 to 40 Hz
350 Hz (0.05 to 350 Hz), 150 Hz (0.05 to 150
Hz), 35 Hz (0.05 to 35 Hz), 20 Hz (0.05 to 20
Hz) selectable
Diagnostic mode, monitor mode, surgery mode, ST mode, High Freq Cut-off:
>90 dB (with notch filter off )
Monitor mode, surgery mode, ST mode: >105 dB (with notch filter on)
50/60 Hz
Monitor, surgical, and ST mode: notch filter turns on automatically
Diagnostic mode and High Freq Cut-off: notch filter is turned on/off manually
≥5 MΩ
±8 mV (peak-to-peak value)
Use A and D methods based on IEC 60601-2-25: 2011 to determine frequency response.
±500 mV
Measuring electrode: <0.1 μA
Drive electrode: <1 μA
≤0.1 μA, (drive lead≤1μA)
Withstands 5000V (360 J) charge without data loss or corruption
Baseline recovery time: <5 s
Polarization recovery time: <10 s
Defibrillation energy absorption: ≤10% (100 Ω load)
<10 uA
1mV (peak-to-peak value) ±5%
Cut mode: 300 W
Coagulate mode: 100 W
Recovery time: ≤10 s
In compliance with the requirements in clause 202.6.2.101 of IEC 60601-2-27:
2011
Pace Pulse
BeneVision N1 Patient Monitor Operator’s Manual A - 9
A - 10
Pace pulse markers
Pace pulse rejection
Pace pulses meeting the following conditions are labelled with a PACE marker:
Amplitude:
Width:
Rise time:
No overshoot
±2 mV to ±700 mV
0.1 ms to 2 ms
10 μs to 100 μs (< 10% of pulse width)
When tested in accordance with the IEC 60601-2-27: 2011: 201.12.1.101.13, the heart rate meter rejects all pulses meeting the following conditions.
Amplitude:
Width:
Rise time:
No overshoot
±2 mV to ±700 mV
0.1 ms to 2 ms
10 μs to 100 μs (< 10% of pulse width)
HR
Measurement range
Resolution
Accuracy
Sensitivity
Minimum QRS detection threshold
HR averaging method
Response to irregular rhythm
Response time to heart rate change
Time to alarm for tachycardia
Tall T-wave rejection capability
Neonate: 15 to 350 bpm
Pediatric: 15 to 350 bpm
Adult: 15 to 300 bpm
1 bpm
±1 bpm or ±1%, whichever is greater.
200 μV (lead II)
Adult and pediatric: 0.16 – 0.48 mV
Neonate: 0.12 – 0.40 mV
In compliance with the requirements in Clause 201.7.9.2.9.101 b) 3) of IEC
60601-2-27: 2011, the following method is used:
If the last 3 consecutive RR intervals are greater than 1200 ms, the 4 most recent RR intervals are averaged to compute the HR. Otherwise, heart rate is computed by subtracting the maximum and minimum ones from the most recent 12 RR intervals and then averaging the remaining 10 RR intervals.
The HR value displayed on the monitor screen is updated no more than one second.
In compliance with the requirements in Clause 201.7.9.2.9.101 b) 4) of IEC
60601-2-27: 2011, the heart rates for the specified test signals after 20 seconds of stabilization are:
Ventricular bigeminy (waveform A1): 80±1 bpm
Slow alternating ventricular bigeminy (waveform A2): 60±1 bpm
Rapid alternating ventricular bigeminy (waveform A3): 120±1 bpm
Bidirectional systoles (waveform A4): 90±2 bpm
Meets the requirements of IEC 60601-2-27: 2011: Clause 201.7.9.2.9.101 b) 5).
From 80 to 120 bpm: less than 11 s
From 80 to 40 bpm: less than 11 s
Meets the requirements in Clause 201.7.9.2.9.101 b) 6) of IEC 60601-2-27: 2011.
Waveform
B1h-range:
B1-range:
B1d-range:
B2h-range:
B2-range:
B2d-range:
<11 s
<11 s
<11 s
<11 s
<11 s
<11 s
When the test is performed based on Clause 201.12.1.101.17 of IEC 60601-2-27:
2011, the heart rate calculation is not affected for QRS of 1 mV amplitude and
100 ms duration, T-wave duration of 180 ms and amplitude lower than 1.2 mV, and QT interval of 350 ms.
BeneVision N1 Patient Monitor Operator’s Manual
Arrhythmia Analysis Classifications Asystole, V-Fib/V-Tach, V-Tach, Vent Brady, Extreme Tachy, Extreme Brady, Vent
Rhythm, PVCs/min, Pauses/min, Couplet, Bigeminy, Trigeminy, R on T, Run
PVCs, PVC, Tachy, Brady, Missed Beat, Pacer Not Pacing, Pacer Not Capture,
Multiform PVC, Nonsus V-Tach, Pause, Irr Rhythm, A-Fib
ST Segment Analysis
Measurement range
Accuracy
Resolution
QT/QTc Analysis
Measurement range
-2.0 mV to +2.0 mV RTI
-0.8 mV to +0.8 mV: ±0.02 mV or ±10%, whichever is greater
Beyond this range: not specified
0.01mV
Accuracy
Resolution
12-lead ECG Interpretation
Sampling rate
Amplitude quantisation
QT: 200 to 800 ms
QTc: 200 to800 ms
QT-HR: 15 bpm to 150 bpm for adult, 15 bpm to 180 bpm for pediatric and neonate
QT: ±30 ms
QT: 4 ms
QTc: 1 ms
1000 samples/s (waveform)
500 samples/s (ECG algorithm)
24 bits
Alarm limit
HR High
HR Low
ST High
ST Low
QTc High
ΔQTc High
A.14.2
Resp Specifications
Technique
Lead
Respiration excitation waveform
Minimum respiration impedance threshold
Baseline impedance range
Bandwidth
Range
HR≤40bpm: (low limit + 2 bpm) to 40 bpm
HR > 40 bpm: (low limit + 5 bpm) to 295 bpm (Adult/Pediatric)
(low limit + 5 bpm) to 300 bpm (Neonate)
HR≤40bpm: 16 bpm to (high limit - 2 bpm) (Adult/Pediatric)
15 bpm to (high limit - 2 bpm) (Neonate)
HR > 40 bpm: 40 bpm to (high limit - 5 bpm)
(low limit + 0.2 mV) to 2.0 mV (ST alarm mode: Absolute)
0 mV to 2.0 mV (ST alarm mode: Relative)
-2.0 mV to (high limit - 0.2 mV) (ST alarm mode: Absolute)
-2.0 mV to 0 mV (ST alarm mode: Relative)
200 ms to 800 ms
30 ms to 200 ms
Step
HR≤40bpm: 1 bpm
HR > 40 bpm: 5 bpm
0.05 mV
10 ms
Trans-thoracic impedance
Options are lead I, II, and Auto.
<300 μA RMS, 62.8 kHz (±10%)
0.3Ω
200 to 2500 Ω (using an ECG cable with 1kΩ resistance)
0.2 to 2.5 Hz (-3 dB)
BeneVision N1 Patient Monitor Operator’s Manual A - 11
Sweep speed
Respiration Rate
Measurement range
Resolution
Accuracy
Zero RR alarm delay
Alarm limit
RR High
RR Low
3mm/s, 6.25 mm/s, 12.5 mm/s, 25 mm/s or 50 mm/s, less than 10% error
Adult: 0 to 120 rpm
Pediatric, neonate: 0 to 150 rpm
1 rpm
7 to 150 rpm: ±2 rpm or ±2%, whichever is greater
0 to 6 rpm: not specified
10 s, 15 s, 20 s, 25 s, 30 s, 35 s, 40 s
Range (rpm)
Adult, pediatric:
RR≤20
RR>20
Neonate:
RR≤20
RR>20
RR≤20:
RR>20:
(low limit + 2) to 20
(low limit + 5) to 100
(low limit + 2) to 20
(low limit + 5) to 150
0 to (high limit - 2)
20 to (high limit - 5)
Step (rpm)
RR≤20: 1
RR>20: 5
A.14.3
SpO
2
Specifications
Refer to Appendix F SpO
2
Sensor Accuracy for the clinical study results of SpO
2
sensor accuracy.
Alarm limit
SpO
2
High
SpO
2
Low
SpO
2
Desat Low
Range (%) Step (%)
(low limit + 2) to 100
Masimo: (Desat+1) to (high limit - 2)
Nellcor: (Desat+1) or 20 (whichever is greater) to (high limit - 2)
0 to (SpO2 low limit - 1)
1
Masimo SpO
2
Module
Standards
Measurement range
Resolution
Response time
Accuracy
1
Refresh rate
SpO
2
averaging time
Low perfusion conditions
Low perfusion SpO
2
accuracy
2
PI measurement range
Meets the requirements of ISO 80601-2-61: 2017
1 to 100%
1%
≤20 s (normal perfusion, no disturbance, SpO2 value sudden change from 70% to 100%)
70 to 100%: ±2%ABS (adult/pediatric, without motion)
70 to 100%: ±3%ABS (adult/pediatric, with motion)
70 to 100%: ±3%ABS (neonate)
1% to 69%: Not specified.
≤ 1 s
2-4 s, 4-6 s, 8 s, 10 s, 12 s, 14 s, 16 s
Pulse amplitude: >0.02%
Light penetration: >5%
±2%
0.02 to 20%
A - 12 BeneVision N1 Patient Monitor Operator’s Manual
1
The Masimo pulse oximeter with sensors have been validated for no motion accuracy in human blood studies on healthy adult volunteers in induced hypoxia studies in the range of 70% to 100% SpO2 against a laboratory co-oximeter and ECG monitor. This variation equals plus or minus one standard deviation. Plus or minus one standard deviation encompasses
68% of the population. One percent was added to the accuracies for neonatal sensors to account for accuracy variation due to properties of fetal hemoglobin.
The Masimo pulse oximeter with sensors has been validated for motion accuracy in human blood studies on healthy adult volunteers in induced hypoxia studies while performing rubbing and tapping motions at 2 to 4 Hz. At an amplitude of 1 to
2 cm and non-repetitive motion between 1 to 5 Hz. At an amplitude of 2 to 3 cm in induced hypoxia studies in the range of
70% to 100% SpO2 against a laboratory co-oximeter and ECG monitor. This variation equals plus or minus one standard deviation. Plus or minus one standard deviation encompasses 68% of the population.
2
The Masimo pulse oximeter has been validated for low perfusion accuracy in bench top testing against a Biotek Index 2 simulator and Masimo's simulator with signal strengths of greater than 0.02% and a % transmission of greater than 5% for saturations ranging from 70 to 100%. This variation equals plus or minus one standard deviation. Plus or minus one standard deviation encompasses 68% of the population.
Nellcor SpO
2
Module
Measurement range
Resolution
Refresh rate
Response time
0 to 100%
1%
≤1 s
≤30 s (normal perfusion, no disturbance, SpO
2
value sudden changes from
70% to 100%)
Accuracy 70 to 100%: ±2%ABS (adult/pediatric)
70 to 100%: ±3%ABS (neonate)
0 to 69%: Not specified.
When the SpO
2
sensor is applied for neonatal patients as indicated, the specified accuracy range is increased by ±1%, to compensate for the theoretical effect on oximeter measurements of fetal hemoglobin in neonatal blood.
A.14.4
PR Specifications
Alarm limit
PR High
PR Low
Range (bpm)
PR≤40: (low limit + 2) to 40
PR > 40: (low limit + 5) to 295 (Adult/Pediatric),
(low limit + 5) to 300 (Neonate)
PR≤40: 16 to (high limit - 2) (Adult/Pediatric),
15 to (high limit - 2) (Neonate)
PR > 40: 40 to (high limit - 5)
PR from Masimo SpO
2
Measurement range
Resolution
Response time
Accuracy
Step (bpm)
PR≤40: 1
PR>40: 5
25 to 240 bpm
1 bpm
≤20 s (with normal perfusion, no disturbance, and a PR value transition from
25 to 220 bpm)
±3 bpm (without motion)
±5 bpm (with motion)
≤1 s Refresh rate
PR from Nellcor SpO
2
Measurement range
Resolution
20 to 300 bpm
1 bpm
BeneVision N1 Patient Monitor Operator’s Manual A - 13
Response time
Accuracy
Refresh rate
PR from NIBP
Measurement range
Resolution
Accuracy
PR from IBP
Measurement range
Resolution
Accuracy
≤30 s (with normal perfusion, no disturbance, and a PR value transition from
25 to 250 bpm)
20 to 250 bpm: ±3 bpm
251 to 300 bpm: not specified
≤1 s
30 to 300 bpm
1 bpm
±3 bpm or ±3%, whichever is greater
25 to 350 bpm
1 bpm
±1 bpm or ±1%, whichever is greater
A.14.5
Temp Specifications
Standard
Technique
Operating mode
Measurement range
Resolution
Accuracy
Minimum time for accurate measurement
Alarm limit
Txx High (xx refers to temperature site)
Txx Low (xx refers to temperature site)
ΔT High
Meets the requirements of ISO 80601-2-56: 2017
Thermal resistance
Direct mode
0 to 50 °C (32 to 122 °F)
0.1°C
±0.1 °C or ±0.2 °F (excluding probe error)
Body surface: <100 s
Body cavity: <80 s
Range
(low limit +1.0) to 50.0 °C
(low limit +2.0) to 122.0 °F
0.1 to (high limit - 1.0) °C
32.2 to (high limit - 2.0) °F
0.1 to 50.0 °C
0.2 to 90.0 °F
Step
0.1 °C
0.1 °F
A.14.6
NIBP Specifications
Standard
Technique
Mode of operation
Auto mode repetition intervals
STAT mode cycle time
Max measurement time
Heart rate range
Meets the requirements of IEC 80601-2-30: 2018
Oscillometry
Manual, Auto, STAT, Sequence
1, 2, 2.5, 3, 5, 10, 15, 20, 30, 60, 90, 120, 180, 240 or 480 min
5 min
Adult, pediatric: 180 s
Neonate: 90 s
30 to 300 bpm
A - 14 BeneVision N1 Patient Monitor Operator’s Manual
Measurement ranges
(mmHg)
Accuracy
Resolution
Initial cuff inflation pressure range
(mmHg)
Default initial cuff inflation pressure
(mmHg)
Software overpressure protection
Static pressure measurement range
Static pressure measurement accuracy
Alarm limit
NIBP-S High
NIBP-S Low
NIBP-M High
NIBP-M Low
NIBP-D High
NIBP-D Low
Adult
25 to 290 Systolic:
Diastolic:
Mean:
Max mean error: ±5 mmHg
Max standard deviation: 8 mmHg
1mmHg
10 to 250
15 to 260
Adult: 80 to 280
Pediatric: 80 to 210
Neonate: 60 to 140
Adult: 160
Pediatric: 140
Neonate: 90
Adult: 297±3 mmHg
Pediatric: 297±3 mmHg
Neonate: 147±3 mmHg
0 mmHg to 300 mmHg
±3 mmHg
Range (mmHg)
Adult: (low limit + 5) to 285
Pediatric: (low limit + 5) to 235
Neonate: (low limit + 5) to 135
26 to (high limit - 5)
Adult: (low limit + 5) to 255
Pediatric: (low limit + 5) to 210
Neonate: (low limit + 5) to 120
16 to (high limit - 5)
Adult: (low limit + 5) to 245
Pediatric: (low limit + 5) to 195
Neonate: (low limit + 5) to 110
11 to (high limit - 5)
Pediatric
25 to 240
10 to 200
15 to 215
Step (mmHg)
NIBP ≤ 50: 1
NIBP > 50: 5
Neonate
25 to 140
10 to 115
15 to 125
BeneVision N1 Patient Monitor Operator’s Manual A - 15
NIBP-S Extreme High
NIBP-S Extreme Low
NIBP-M Extreme High
NIBP-M Extreme Low
NIBP-D Extreme High
NIBP-D Extreme Low
NIBP-S high limit < 50
Adult: (NIBP-S high limit + 1) to 290
Pediatric: (NIBP-S high limit + 1) to 240
Neonate: (NIBP-S high limit + 1) to 140
NIBP-S high limit ≥ 50
Adult: (NIBP-S high limit + 5) to 290
Pediatric: (NIBP-S high limit +5) to 240
Neonate: (NIBP-S high limit +5) to 140
NIBP-S low limit ≤ 50
25 to (NIBP-S low limit - 1)
NIBP-S low limit > 50
25 to (NIBP-S low limit - 5)
NIBP-M high limit < 50
Adult: (NIBP-M high limit + 1) to 260
Pediatric: (NIBP-M high limit + 1) to 215
Neonate: (NIBP-M high limit + 1) to 125
NIBP-M high limit ≥ 50
Adult: (NIBP-M high limit + 5) to 260
Pediatric: (NIBP-M high limit + 5) to 215
Neonate: (NIBP-M high limit + 5) to 125
NIBP-M low limit ≤ 50
15 to (NIBP-M low limit - 1)
NIBP-M low limit > 50
15 to (NIBP-M low limit - 5)
NIBP-D high limit < 50
Adult: (NIBP-D high limit + 1) to 250
Pediatric: (NIBP-D high limit + 1) to 200
Neonate: (NIBP-D high limit + 1) to 115
NIBP-D high limit ≥ 50
Adult: (NIBP-D high limit + 5) to 250
Pediatric: (NIBP-D high limit + 5) to 200
Neonate: (NIBP-D high limit + 5) to 115
NIBP-D low limit ≤ 50
10 to (NIBP-D low limit - 1)
NIBP ≤ 50: 1
NIBP > 50: 5
NIBP-D low limit > 50
10 to (NIBP-D low limit - 5)
*Measurement accuracy verification: In adult and pediatric modes, the blood pressure measurements measured with this device are in compliance with the Standard for Non-invasive sphygmomanometers (ISO 81060-2: 2013) in terms of mean error and standard deviation by comparing with intra-arterial or auscultatory measurements
(depending on the configuration) in a typical patient population. For auscultatory reference, the 5th Korotkoff sound was used to determine the diastolic pressure.
In neonatal mode, the blood pressure measurements measured with this device are in compliance with the
American National Standard for Non-invasive sphygmomanometers (ISO 81060-2) in terms of mean error and standard deviation by comparing with intra-arterial measurements (depending on the configuration) in a typical patient population.
A.14.7
IBP Specifications
Standard
Technique
Meets the requirements of IEC 60601-2-34: 2011
Direct invasive measurement
A - 16 BeneVision N1 Patient Monitor Operator’s Manual
IBP
Measurement range
Resolution
Accuracy
PPV
Measurement range
Pressure transducer
Excitement voltage
Sensitivity
Zero adjustment range
Impedance range
Volume displacement
Alarm limit
Sys High
Mean High
Dia High
Sys Low
Mean Low
Dia Low
Art-S Extreme High
Art-M Extreme High
Art-D Extreme High
Art-S Extreme Low
Art-M Extreme Low
Art-D Extreme Low
-50 to 300 mmHg
1 mmHg
±2% or ±1 mmHg, whichever is greater (excluding sensor error)
0% ~ 50%
5 VDC, ±2%
5 μV/V/mmHg
±200 mmHg
300 to 3000Ω
<0.04 mm
3
/100 mmHg
Range (mmHg)
IBP ≤ 50: (low limit + 2) to 50
IBP > 50: (low limit + 5) to 295
IBP ≤ 50: -49 to (high limit - 2)
IBP > 50: 50 to (high limit - 5)
High limit < 50: (High limit+ 1) to 300
High limit ≥ 50: (High limit+ 5) to 300 low limit ≤ 50: -50 to (low limit- 1) low limit > 50: -50 to (low limit- 5)
Step (mmHg)
IBP ≤ 50: 1
IBP > 50: 5
IBP ≤ 50: 1
IBP > 50: 5
A.14.8
CO
2
Specifications
Measurement mode
Technique
Zero RR delay
Alarm limit
Sidestream, microstream
Infrared absorption
10 s, 15 s, 20 s, 25 s, 30 s, 35 s, 40 s
Range
EtCO
2
High
EtCO
2
Low
FiCO
2
High
Sidestream CO
2
Module
(low limit + 2) to 99 mmHg
1 to (high limit - 2) mmHg
1 to 99 mmHg
Standard
CO
2
Measurement range
Meets the requirements of ISO 80601-2-55: 2018
0 to 150 mmHg
Step
1 mmHg
BeneVision N1 Patient Monitor Operator’s Manual A - 17
A - 18
CO
2
absolute accuracy* Full accuracy mode:
0 - 40 mmHg: ±2mmHg
41 - 76 mmHg: ±5% of reading
77 - 99 mmHg: ±10% of reading
100 - 150mmHg: ±(3mmHg + 8% of reading
ISO accuracy mode: Add ±2mmHg to the full accuracy mode
Accuracy specifications are affected by the breath rate and I:E. The EtCO
2
accuracy is within specification for breath rate ≤
60 rpm and I/E ratio ≤ 1:1, or breath rate ≤ 30 rpm and I/E ratio ≤ 2:1.
CO
2 resolution
Accuracy drift
Sample flowrate
1 mmHg
Meets the requirements for measurement accuracy within 6 hours
Using internal CO
2
module: 50 ml/min
Using the external CO
2
module
Adult, pediatric: 120 ml/min
Neonatal: 70 ml/min, 90 ml/min
Sample flowrate tolerance
Start-up time
Rise time
±15% or ±15 ml/min, whichever is greater.
Maximum: 90 s
Typically: 20 s
For CO
2 measurements (using external CO
2 moduler):
Measured with a DRYLINE II neonatal watertrap and a 2.5-meter neonatal sampling line:
≤250 ms@70 ml/min.
Measured with a DRYLINE II neonatal watertrap and a 2.5-meter neonatal sampling line:
≤250 ms@90 ml/min.
Measured with a DRYLINE II adult watertrap and a 2.5-meter adult sampling line:
≤300 ms@120 ml/min
For CO
2 measurements (using internal CO
2 module):
Measured with a standard Oridion sampling line:
≤250 ms@50 ml/min
Measured with a prolonged Oridion sampling line:
≤280 ms@50 ml/min
Response time awRR measurement range awRR measurement precision awRR resolution
Data sample rate
For CO
2 measurements (using external CO
2 module):
Measured with a DRYLINE II neonatal watertrap and a 2.5-meter neonatal sampling line:
≤5.0 s @ 70 ml/min
Measured with a DRYLINE II neonatal watertrap and a 2.5-meter neonatal sampling line:
≤4.5 s @ 90 ml/min
Measured with a DRYLINE II adult watertrap and a 2.5-meter adult sampling line:
≤5.0 s @ 120 ml/min
For CO
2 measurements (using internal CO
2 module):
Measured with a standard Oridion sampling line:
≤5.0 s@50 ml/min
Measured with a prolonged Oridion sampling line:
<6.5 s@50 ml/min
0 to 150 rpm
<60 rpm: ±1 rpm
60 to 150 rpm: ±2 rpm
1 rpm
50 Hz
BeneVision N1 Patient Monitor Operator’s Manual
Effect of interference gases on CO
2 measurements
Gas Concentration (%) Quantitative effect*
N
2
O
Hal
Sev
Iso
≤60
≤4
≤5
≤5
±1 mmHg
Enf
Des
≤5
≤15 ±2 mmHg
*: means an extra error should be added in case of gas interference when CO
2
measurements are performed between 0 to
40mmHg.
Microstream CO
2
Module
Standard
CO
2
Measurement range
Accuracy*
Meets the requirements of ISO 80601-2-55: 2018
0 to 99 mmHg
0 to 38 mmHg:
39 to 99 mmHg:
±2 mmHg
±5% of the reading (0.08% of the reading increased in error for every 1 mmHg if the reading is more than 38 mmHg)
Accuracy drift Meets the requirements for measurement accuracy within 6 hours
* Accuracy applies for respiration rate up to 80 rpm. For respiration rate above 80 rpm and EtCO
2
exceeding 18 mmHg, the accuracy is 4 mmHg or ±12% of the reading, whichever is greater. For respiration rate above 60 rpm, the above accuracy can be achieved by using the CapnoLine H Set for Infant/Neonatal. In the presence of interfering gases, the above accuracy is maintained to within 4%.
Resolution
Sample flow rate
1 mmHg
50 (- 7.5/+15) ml/min
Initialization time
Response time awRR measurement range awRR measurement accuracy awRR resolution
Data sample rate
Maximum 180 s
≤2.9 s
(The response time is the sum of the rise time and the delay time when using a FilterLine of standard length)
Rise time: <190ms@50%
Delay time: ≤2.7 s
0 to 150 rpm
0 to 70 rpm:
71 to 120 rpm:
121 to 150 rpm:
1 rpm
40 Hz
±1 rpm
±2 rpm
±3 rpm
BeneVision N1 Patient Monitor Operator’s Manual A - 19
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A - 20 BeneVision N1 Patient Monitor Operator’s Manual
B
EMC and Radio Regulatory Compliance
B.1
EMC
The device meets the requirements of IEC 60601-1-2: 2014.
WARNING
•
Use of accessories, transducers and cables other than those specified or provided by the manufacturer of this equipment could result in increased electromagnetic emissions or decreased electromagnetic immunity of this equipment and result in improper operation.
•
The non-ME EQUIPMENT (e.g. information technology equipment (ITE)) that is a part of an ME
SYSTEM may be disrupted by the electromagnetic interference of nearby equipment. It may be necessary to take mitigation measures, such as re-orienting or relocating the non-ME EQUIPMENT or shielding the location.
•
Use of this equipment adjacent to, or stacked with, other equipment should be avoided because it could result in improper operation. If such use is necessary, this equipment and the other equipment should be observed to verify that they are operating normally.
•
This equipment is intended for use in professional healthcare facility EMC environment and home healthcare EMC environment. If it is used in a special environment, such as a magnetic resonance imaging environment, the equipment/system may be disrupted by the operation of nearby equipment.
•
Portable RF communications equipment (including peripherals such as antenna cables and external antennas) should be used no closer than 30 cm (12 inches) to any part of the this device, including cables specified by the manufacturer. Otherwise, degradation of the performance of this equipment could result.
Guidance and Declaration - Electromagnetic Emissions
The device is intended for use in the electromagnetic environment specified below. The customer or the user of the device should assure that it is used in such an environment.
Emission tests Compliance Electromagnetic environment - guidance
Conducted and radiated RF
EMISSIONS CISPR 11
Conducted and radiated RF
EMISSIONS
CISPR 11
Conducted and radiated RF
EMISSIONS
CISPR 11
Harmonic distortion
IEC 61000-3-2: 2014
Voltage fluctuations and flicker
IEC 61000-3-3: 2013
Group 1
Class B
Class A
(Used with Dock)
Class A
Complies
The device uses RF energy only for its internal function.
Therefore, its RF emissions are very low and are not likely to cause any interference in nearby electronic equipment.
The device is suitable for use in all establishments, including domestic establishments and those directly connected to the public low-voltage power supply network that supplies buildings used for domestic purposes.
The device is suitable for use in all establishments other than domestic and those directly connected to the public low-voltage power supply network that supplies buildings used for domestic purposes.
The device is suitable for use in all establishments, including domestic establishments and those directly connected to the public low-voltage power supply network that supplies buildings used for domestic purposes.
If the system is operated within the electromagnetic environment listed in Table Guidance and Declaration -
Electromagnetic Immunity, the system will remain safe and provide the following essential performance:
■ Operating mode
BeneVision N1 Patient Monitor Operator’s Manual B - 1
B - 2
■
■
■
■
■
■
Accuracy
Function
Accessories identification
Data stored
Alarm
Detect for connection
NOTE
•
If the essential performance is lost or degraded, it may be necessary to take mitigation measures, such as re-orienting or relocating the ME EQUIPMENT or ME SYSTEM or shielding the location.
During this time, the user should stop using the monitor and contact the service personnel.
•
The device needs special precautions regarding EMC and needs to be installed and put into service according to the EMC information provided below.
•
Other devices may interfere with this device even though they meet the requirements of CISPR.
•
When an input signal is below the minimum amplitude provided in technical specifications, erroneous measurements could result.
•
The EMISSIONS characteristics of this device make it suitable for use in industrial areas and hospitals
(CISPR 11 class A). If it is used in a residential environment (for which CISPR 11 class B is normally required) this device might not offer adequate protection to radio-frequency communication services. The user might need to take mitigation measures, such as relocating or re-orienting the device.
Guidance and Declaration - Electromagnetic Immunity
The device is intended for use in the electromagnetic environment specified below. The customer or the user of the device should assure that it is used in such an environment.
Immunity test IEC60601test level Compliance level Electromagnetic environment - guidance
Electrostatic discharge (ESD) IEC
61000-4-2: 2008
Electrical fast transient/burst IEC
61000-4-4: 2012
Surge IEC 61000-4-5:
2014
Voltage dips and voltage interruptions
IEC 61000-4-11: 2004
±8 kV contact
±15 kV air
±2 kV for power supply lines
±1 kV for input/ output lines
(length greater than 3 m)
±1 kV line(s) to line(s)
±2 kV line(s) to earth
0 % U
T
for 0.5 cycle: at
0°, 45°, 90°, 135°, 180°,
225°, 270° and 315°
0 % U
T
for 1 cycle and
70 % U
T
for 25/30 cycles: at 0°
±8 kV contact
±15 kV air
±2 kV for power supply lines
±1 kV for input/ output lines
(length greater than 3 m)
±1 kV line(s) to line(s)
±2 kV line(s) to earth
0 % U
T
for 0.5 cycle: at
0°, 45°, 90°, 135°, 180°,
225°, 270° and 315°
0 % U
T
for 1 cycle and
70 % U
T
for 25/30 cycles: at 0°
Floors should be wood, concrete or ceramic tile. If floors are covered with synthetic material, the relative humidity should be at least 30%.
Mains power quality should be that of a typical commercial or hospital environment.
Mains power quality should be that of a typical commercial or hospital environment. If the user of our product requires continued operation during power mains interruptions, it is recommended that our product be powered from an uninterruptible power supply or a battery.
RATED power frequency magnetic fields
IEC 61000-4-8: 2009
0 % U
T
for 250/300 cycle
30 A/m
50 Hz/60 Hz
0 % U cycle
T
30 A/m
for 250/300
50 Hz/60 Hz
Note: U
T
is the AC mains voltage prior to application of the test level.
Power frequency magnetic fields should be at levels characteristic of a typical location in a typical commercial or hospital environment.
BeneVision N1 Patient Monitor Operator’s Manual
Guidance and Declaration - Electromagnetic Immunity
The device is intended for use in the specified electromagnetic environment. The customer or the user of the device should assure that it is used in such an environment as described below.
Immunity test IEC60601 test level Compliance level
Conducted disturbances induced by RF fields
IEC61000-4-6: 2013
3 Vrms
150 kHz to 80 MHz
6 Vrms in ISM bands and amateur radio bands a between 0.15 MHz and 80 MHz
3Vrms
6 Vrms
Electromagnetic environment - guidance
Portable and mobile RF communications equipment should be used no closer to any part of the system, including cables, than the recommended separation distance calculated from the equation appropriate for the frequency of the transmitter. Recommended separation distances: d = 1.2
P
Radiated RF EM fields
IEC61000-4-3
10 V/m
80 MHz to 2.7 GHz
20V/m
80 MHz to 2.5 GHz
(IEC80601-2-30: 2018,
ISO80601-2-55: 2018,
ISO80601-2-56: 2017,
ISO80601-2-61: 2017)
10 V/m
20V/m
Recommended separation distances:
80 MHz to 800 MHz: d = 1.2
P
800MHz - 2.7GHz: d = 2.3
P
Where, P is the maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer and d is the recommended separation distance in meters
(m) b
.
Field strengths from fixed RF transmitters, as determined by an electromagnetic site survey a
should be less than the compliance level in each frequency range b
.
Interference may occur in the vicinity of equipment marked with the following symbol:
Proximity fields from
RF wireless communications equipment
IEC61000-4-3:
2006+A1:2007+A2:20
10
27 V/m
380 - 390 MHz
28 V/m
430 - 470 MHz,
800 - 960 MHz
1700 - 1900 MHz,
2400 - 2570 MHz
27 V/m
28 V/m
/
9 V/m
704 - 787 MHz,
5100 - 5800 MHz
9 V/m
Note 1: At 80 MHz and 800 MHz, the higher frequency range applies.
Note 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from structures, objects and people.
a
The ISM (industrial, scientific, and medical) bands between 150 kHz and 80 MHz are 6.765 MHz to 6.795 MHz; 13.553 MHz to 13.567 MHz; 26.957 MHz to 27.283 MHz; and 40.66 MHz to 40.70 MHz. The amateur radio bands between 0,15 MHz and
80 MHz are 1,8 MHz to 2,0 MHz, 3,5 MHz to 4,0 MHz, 5,3 MHz to 5,4 MHz, 7 MHz to 7,3 MHz, 10,1 MHz to 10,15 MHz, 14 MHz to 14,2 MHz, 18,07 MHz to 18,17 MHz, 21,0 MHz to 21,4 MHz, 24,89 MHz to 24,99 MHz, 28,0 MHz to 29,7 MHz and 50,0 MHz to 54,0 MHz.
b
: Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy. To assess the electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey should be considered.
If the measured field strength in the location in which the ME EQUIPMENT or ME SYSTEM is used exceeds the applicable
RF compliance level above, the ME EQUIPMENT or ME SYSTEM should be observed to verify normal operation. If abnormal performance is observed, additional measures may be necessary, such as re-orienting or relocating the ME EQUIPMENT or
ME SYSTEM .
c
: Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3V/m.
BeneVision N1 Patient Monitor Operator’s Manual B - 3
WARNING
•
The device is configured with a wireless network connector to receive wireless signal. Other devices may interfere with this device even though they meet the requirements of CISPR.
B.2
Recommended separation distances between portable and mobile RF communications equipment and the device
The device is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled. The customer or the user of the device can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment (transmitters) and the device as recommended below, according to the maximum output power of the communications equipment.
Separation distance in meters (m) according to frequency of the transmitter
Rated maximum output power of transmitter (W)
150 kHz to 80 MHz d = 1.2
P
80 MHz to 800 MHz d = 1.2
P
800 MHz to 2.7 GHz d = 2.3
P
0.01
0.1
1
10
0.12
0.38
1.20
3.80
0.12
0.23
0.38 0.73
1.20 2.30
3.80
7.30
100 12.00
12.00 23.00
For transmitters rated at a maximum output power not listed above, the recommended separation distance d in metres
(m) can be estimated using the equation applicable to the frequency of the transmitter, where P is the maximum output power rating of the transmitter in Watts (W) according to the transmitter manufacturer.
Note 1: At 80 MHz and 800 MHz, the higher frequency range applies.
Note 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from structures, objects and people.
Radio Regulatory Compliance
This device complies with Part 15 of the FCC Rules and RSS-210 of Industry Canada. Operation is subject to the following two conditions: (1) this device may not cause harmful interference, and (2) this device must accept any interference received, including interference that may cause undesired operation.
Any changes or modifications to this equipment not expressly approved by Mindray may cause harmful radio frequency interference and void your authority to operate this equipment.
The maximum antenna gain permitted complies with the e.i.r.p. limits as stated in RSS-210.
The maximum antenna gain permitted complies with the e.i.r.p. limits specified for point-to-point operation, as stated in RSS-210.
WARNING
•
Changes or modifications not expressly approved by the party responsible compliance could void the user’s authority to operate the equipment.
B - 4 BeneVision N1 Patient Monitor Operator’s Manual
C
Default Settings
C.1
C.1.1
ECG, Arrhythmia, ST and QT Default Settings
ECG Default Settings
Item
HR Alarm switch
High limit
Priority
Alarm Outputs
Alarm Source
ECG1
ECG2 (5-lead, 6-lead, 12-lead)
Va (for 6-lead only)
Vb(for 6-lead only)
ECG Gain
Speed
Filter
Notch Filter
Lead Set
Smart Lead
QRS Volume
Baseline Drift Removal (for 12-lead only)
Waveform Layout (for 12-lead only)
QRS Threshold
Paced
Pacer Reject
Low limit
Default Setting
On
Adult: 120 bpm
Pediatric: 160 bpm
Neonate: 200 bpm
Adult: 50 bpm
Pediatric: 75 bpm
Neonate: 100 bpm
Med
Off
Auto
II
V (for 5-lead).Va (for 6-lead), V1 (for 12-lead)
Va
Vb
×1
25 mm/sec
OR: Surgery
CCU: Diagnostic
Other departments: Monitor
On
Auto
On
General and OR: 2
Other departments: 0
On
Standard
0.16 mV
Adult: Unspecified
Pediatric/neonate: No
Off
BeneVision N1 Patient Monitor Operator’s Manual C - 1
C.1.2
Arrhythmia Default Settings
C.1.2.1
Arrhythmia Alarm Default Settings
Item Alarm Switch
Asystole
V-Fib/V-Tach
V-Tach
Vent Brady
Extreme Tachy
Extreme Brady
R on T
Run PVCs
Couplet
Multiform PVC
PVC
Bigeminy
Trigeminy
Tachy
Brady
Pacer Not Capture
Pacer Not Pacing
Missed Beat
Nonsus V-Tach
Vent Rhythm
Pause
Irr Rhythm
A-Fib
PVCs/min
Pauses/min
On
On
On
On
On
On
CCU: On
Other departments: Off
Off
Off
Off
Off
CCU: On
Other departments: Off
CCU: On
Other departments: Off
Off
Off
Off
Off
Off
CCU: On
Other departments: Off
CCU: On
Other departments: Off
Off
Off
Off
CCU: On
Other departments: Off
CCU: On
Other departments: Off
Med
Low
Prompt
Prompt
Med
Med
Low
Prompt
Med
Prompt
Med
Med
Med
Med
Prompt
Prompt
Prompt
Med
Priority
High, unadjustable
High, unadjustable
High, unadjustable
High, unadjustable
High, unadjustable
High, unadjustable
Med
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Alarm Outputs
Off
Off
Off
Off
Off
Off
Off
C - 2 BeneVision N1 Patient Monitor Operator’s Manual
C.1.2.2
Arrhythmia Threshold Default Settings
Item Default Setting
Asystole Delay
Tachy
Brady
Extreme Tachy
Extreme Brady
Multif PVCs Window
PVCs/min
Pauses/min
Pause Threshold
AF/Irr Rhy End Time
V-Tach Rate
V-Brady Rate
V-Tach PVCs
V-Brady PVCs
Adult
5 sec
120 bpm
50 bpm
160 bpm
35 bpm
15 beats
10
8
6
5
2.0 sec
2 min
130 bpm
40 bpm
C.1.3
ST Default Settings
Item
ST Alarm Mode
ST Alarm Mode set to Absolute :
ST-I, ST-II, ST-III, ST-aVR, ST-aVL, ST-aVF, ST-V1, ST-
V2, ST-V3, ST-V4, ST-V5,ST-V6, ST-Va, ST-Vb
ST Alarm Mode set to
ST Single,
ST Dual
Relative :
Alarm switch
High limit
Low limit
Priority
Alarm Outputs
Alarm switch
High limit
Low limit
Priority
Alarm Outputs
ST Analysis
ST Segment
Show Marker
ST Point
Auto Adjust
J
ISO
Default Setting
Auto
Off
J+60
On
-0.1 mV
Med
Off
Off
48
-80
Absolute
Off
0.2 mV
-0.2 mV
Med
Off
Off
0.1 mV
Pediatric
5 sec
160 bpm
75 bpm
180 bpm
50 bpm
15 beats
10
8
6
5
2.0 sec
2 min
130 bpm
40 bpm
BeneVision N1 Patient Monitor Operator’s Manual C - 3
C.1.4
C.1.5
QT Default Settings
Item
QTc
ΔQTc
QT Analysis
QT Lead
Alarm switch
High limit
Priority
Alarm Outputs
Alarm switch
High limit
Priority
Alarm Outputs
Default Setting
Med
Off
Off
All
Off
Adult: 500
Pediatric: 480
Neonate: 460
Med
Off
Off
60
Glasgow 12-lead ECG Algorithm Default Settings
Item
High Freq Cut-off
Baseline Drift Removal
Tachy
Brady
Waveform Layout
Median Complex
Measurements
Interpretation
Interpretation Summary
Default Setting
35 Hz
On
On
On
On
100
50
Standard
Off
C.2
Respiration Default Settings
Item
RR
Zero RR
Alarm switch
High limit
Low limit
Priority
Alarm Outputs
Alarm switch
Priority
Alarm Outputs
Default Setting
On
Adult: 30
Pediatric: 30
Neonate: 100
Adult: 8
Pediatric: 8
Neonate: 30
Med
Off
On
High, unadjustable
Off
C - 4 BeneVision N1 Patient Monitor Operator’s Manual
Item
Zero RR Delay
RR Source
Resp Lead
C.3
Gain
Speed
Auto Threshold Detection
SpO
2
Default Settings
Item
SpO
2
High limit
Low limit
Priority
Alarm Outputs
Alarm switch SpO
2
Desat
Low limit
Priority
Alarm Outputs
Satsecond (for Nellcor SpO
2
)
NIBP Simul
FastSAT (for Masimo SpO
2
)
Display SIQ (for Nellcor SpO
2
)
Display PI (for Masimo SpO
2
)
Speed
Default Setting
Adult: 20 sec
Pediatric: 20 sec
Neonate: 15 sec
Auto
Adult: Auto
Pediatric: Auto
Neonate: II
×2
6.25 mm/s
On
Default Setting
80%
High
Off
Off
Off
Off
Off
On
25 mm/s
On
Adult: 100%
Pediatric: 100%
Neonate: 95%
90%
Med
Off
On
BeneVision N1 Patient Monitor Operator’s Manual C - 5
C.4
C.5
Item
PR Alarm switch
High limit
Low limit
Priority
Alarm Outputs
Alarm Source
PR Source
Display PR
QRS Volume
Default Setting
On
Adult: 120
Pediatric: 160
Neonate: 200
Adult: 50
Pediatric: 75
Neonate: 100
Med
Off
Auto
Auto
On
General, OR: 2
Other departments: 0
Temperature Default Settings
Item
Txx
(xx refers to temperature site)
Alarm switch
High limit
Low limit
Priority
Alarm Outputs
High limit
Priority
Alarm Outputs
NIBP Default Settings
Item
Default Setting
On
38.0 °C
35.0 °C
Med
Off
On
2.0 °C
Med
Off
High limit
Low limit
Priority
Alarm Outputs
Default Setting
On
Adult: 160 mmHg
Pediatric: 120 mmHg
Neonate: 90 mmHg
Adult: 90 mmHg
Pediatric: 70 mmHg
Neonate: 40 mmHg
Med
Off
C - 6 BeneVision N1 Patient Monitor Operator’s Manual
Item
NIBP-M
High limit
Low limit
Priority
Alarm Outputs
Alarm switch
High limit
Low limit
NIBP-S Extreme
Priority
Alarm Outputs
Alarm switch
High limit
Low limit
NIBP-D Extreme
Priority
Alarm Outputs
Alarm switch
High limit
Low limit
NIBP-M Extreme
Priority
Alarm Outputs
Alarm switch
High limit
Low limit
Priority
Alarm Outputs
Default Setting
Adult: 75 mmHg
Pediatric: 60 mmHg
Neonate: 35 mmHg
High
Off
Off
Adult: 105 mmHg
Pediatric: 80 mmHg
Neonate: 65 mmHg
Adult: 35 mmHg
Pediatric: 30 mmHg
Neonate: 15 mmHg
High
Off
Off
Adult: 125 mmHg
Pediatric: 100 mmHg
Neonate: 75 mmHg
Adult: 45 mmHg
Pediatric: 40 mmHg
Neonate: 20 mmHg
High
Off
On
Adult: 90 mmHg
Pediatric: 70 mmHg
Neonate: 60 mmHg
Adult: 50 mmHg
Pediatric: 40 mmHg
Neonate: 20 mmHg
Med
Off
On
Adult: 110 mmHg
Pediatric: 90 mmHg
Neonate: 70 mmHg
Adult: 60 mmHg
Pediatric: 50 mmHg
Neonate: 25 mmHg
Med
Off
Off
Adult: 175 mmHg
Pediatric: 130 mmHg
Neonate: 95 mmHg
BeneVision N1 Patient Monitor Operator’s Manual C - 7
Item
Initial Pressure
Interval
C.6
Start Mode
NIBP End Tone
Venipuncture Pressure
Display Format
Display Alarm Limits
Display PR
IBP Default Settings
Item
IBP-S Alarm switch
High limit
Default Setting
Adult: 160 mmHg
Pediatric: 140 mmHg
Neonate: 90 mmHg
OR: 5 min
Neonatology: 30 min
Other departments: 15 min
Clock
Off
Auto
Sys/Dia (Mean)
Off
Off
Low limit
Priority
Alarm Outputs
Default Setting
On
■ Art/Ao/UAP/BAP/FAP/LV/P1-P2 arterial pressure
Adult: 160 mmHg
Pediatric: 120 mmHg
Neonate: 90 mmHg
■ PA
Adult: 35 mmHg
Pediatric and neonate: 60 mmHg
■ Art/Ao/UAP/BAP/FAP/LV/P1-P2 arterial pressure
Adult: 90 mmHg
Pediatric: 70 mmHg
Neonate: 55 mmHg
■ PA
Adult: 10 mmHg
Pediatric and neonate: 24 mmHg
Med
Off
C - 8 BeneVision N1 Patient Monitor Operator’s Manual
Item
IBP-D
IBP-M
Alarm switch
High limit
Low limit
Priority
Alarm Outputs
Alarm switch
High limit
Low limit
Priority
Alarm Outputs
Default Setting
On
■ Art/Ao/UAP/BAP/FAP/LV/P1-P2 arterial pressure
Adult: 90 mmHg
Pediatric: 70 mmHg
Neonate: 60 mmHg
■ PA
Adult: 16 mmHg
Pediatric and neonate: 4 mmHg
■ Art/Ao/UAP/BAP/FAP/LV/P1-P2 arterial pressure
Adult: 50 mmHg
Pediatric: 40 mmHg
Neonate: 20 mmHg
■ PA
Adult: 0 mmHg
Pediatric and neonate: -4 mmHg
Med
Off
On
■ Art/pArt/Ao/UAP/BAP/FAP/LV/P1-P2 arterial pressure
Adult: 110 mmHg
Pediatric: 90 mmHg
Neonate: 70 mmHg
■ PA
Adult: 20 mmHg
Pediatric and neonate: 26 mmHg
■ CVP
Adult: 14 cmH
2
O
Pediatric and neonate: 5 cmH
2
O
■ ICP/RAP/LAP/UVP/P3-P4 venous pressure
Adult: 10 mmHg
Pediatric and neonate: 4 mmHg
■ Art/Ao/UAP/BAP/FAP/LV/P1-P2 arterial pressure
Adult: 70 mmHg
Pediatric: 50 mmHg
Neonate: 35 mmHg
■ PA
Adult: 0 mmHg
Pediatric and neonate: 12 mmHg
■ CVP
Adult: 0 cmH
2
O
Pediatric and neonate: 0 cmH
2
O
■ ICP/RAP/LAP/UVP/P3-P4 venous pressure
Adult: 0 mmHg
Pediatric and neonate: 0 mmHg
Med
Off
BeneVision N1 Patient Monitor Operator’s Manual C - 9
C - 10
Item
Art-S Extreme Alarm switch
High limit
Low limit
Art-D Extreme
Priority
Alarm Outputs
Alarm switch
High limit
Low limit
Art-M Extreme
Priority
Alarm Outputs
Alarm switch
High limit
CPP
Low limit
Priority
Alarm Outputs
Alarm switch
High limit
Low limit
Measure (for P1, P2)
Measure (for P3, P4)
Sensitivity
Speed
Priority
Alarm Outputs
Default Setting
Adult: 55 mmHg
Pediatric: 40 mmHg
Neonate: 30 mmHg
High
Off
On
Adult: 130 mmHg
Pediatric: 100 mmHg
Neonate: 90 mmHg
Adult: 50 mmHg
Pediatric: 40 mmHg
Neonate: 30 mmHg
Med
Off
All
Mean Only
Med
25 mm/sec
Off
Adult: 175 mmHg
Pediatric: 130 mmHg
Neonate: 95 mmHg
Adult: 75 mmHg
Pediatric: 60 mmHg
Neonate: 50 mmHg
High
Off
Off
Adult: 105 mmHg
Pediatric: 80 mmHg
Neonate: 65 mmHg
Adult: 35mmHg
Pediatric: 30 mmHg
Neonate: 15 mmHg
High
Off
Off
Adult: 125 mmHg
Pediatric: 100 mmHg
Neonate: 75 mmHg
BeneVision N1 Patient Monitor Operator’s Manual
Item
Scale
Default Setting
0- 20 mmHg ICP/RAP/LAP/UVP venous pressure
Art/Ao/BAP/FAP/LV/P1/
P2 arterial pressure
UAP/P3/P4 venous pressure
CVP/PA
0-160 mmHg
0-80 mmHg
CVP: 0-30 cmH2O
PA: 0 - 30 mmHg
Sys/Dia (Mean)
Off
Off
Display Format
Display Alarm Limits
Use PA-D as PAWP (only available for independent external display)
PPV Measure
PPV Source
PAWP Reference Waveform 1
Reference Waveform 2
Speed
PA Scale
Overlapping
Waveform Setup
Left Scale
Right Scale
CVP Scale
ICP Scale
PA Scale
Speed
Gridlines
Off
Auto
II
Resp
12.5 mm/sec
0-30 mmHg
0-160 mmHg
0-20 mmHg
0-30 cmH2O
0-20 mmHg
0-30 mmHg
25 mm/sec
Off
C.7
C.7.1
CO
2
Default Settings
General Settings
Item
EtCO
2
Alarm
High limit
Low limit
Priority
Alarm Outputs
Default Setting
On
Adult and pediatric: 50 mmHg
Neonate: 45 mmHg
Adult and pediatric: 25mmHg
Neonate: 30mmHg
Med
Off
BeneVision N1 Patient Monitor Operator’s Manual C - 11
Item
FiCO
2
Zero RR Delay
RR Source
Speed
Scale
Waveform Type
High limit
Priority
Alarm Outputs
Default Setting
On
4 mmHg
Med
Off
Adult and pediatric: 20 s
Neonate: 15 s
Auto
6.25 mm/s
50 mmHg
Draw
C.7.2
Sidestream CO
2
Default Settings
Item
EtO
2
FiO
2
High limit
Low limit
Priority
Alarm Outputs
High limit
Low limit
Priority
Alarm Outputs
BTPS Compensation
O
2
Compensation (for CO
2
module without
O
2
measurement)
N
2
O Compenation
AG Compenation
Auto Standby
Operating Mode
Default Setting
On
88%
18%
Med
Off
On
Adult and pediatric: 100%
Neonate: 90%
18%
Med
Off
Off
OR: 100%
Other departments: 21%
0%
0%
60 min
Measure
C.7.3
Microstream CO
2
Default Settings
Item
BTPS Compen
Maximum Hold
Auto Standby
Operating Mode
Default Setting
Off
20 sec
Off
Measure
C - 12 BeneVision N1 Patient Monitor Operator’s Manual
C.8
C.9
Alarm Default Settings
Item
Alarm Volume
High Alarm Volume
Reminder Volume
Zero RR Delay
Printing Duration on Alarm
Auto Limits for New Patient
Default Setting
2
Alarm Volume + 2
2
Adult/Pediatric: 20 sec
Neonate: 15 sec
20 sec
On
Display Default Settings
Item
Choose Screen
Display
Night Mode
Brightness
Key Volume
Brightness
Alarm Volume
QRS Volume
Key Volume
NIBP End Tone
Stop NIBP
Default Setting
2
1
0
Off
Off
2
1
Normal Screen
5
BeneVision N1 Patient Monitor Operator’s Manual C - 13
This page intentionally left blank.
C - 14 BeneVision N1 Patient Monitor Operator’s Manual
D
Alarm Messages
D.1
D.1.1
This chapter lists only the physiological and technical alarm messages. Some messages appearing on your monitor may not be included. In the “Cause and solution” column, corresponding solutions are given instructing you to troubleshoot problems. If the problem persists, contact your service personnel.
Physiological Alarm Messages
General Physiological Alarm Messages
D.1.2
Alarm messages
XX High
XX Low
Default priority
Med
Med
Cause and solution
XX value has risen above the high alarm limit or fallen below the low alarm limit. Check the patient’s condition and check if the patient category and alarm limit settings are correct.
Note: XX represents a measurement or parameter label, such as HR, NIBP, PVCs, RR, SpO
2
, PR, etc.
Arrhythmia Alarm Messages
Alarm message
Asystole
V-Fib/V-Tach
V-Tach
Vent Brady
Extreme Tachy
Extreme Brady
R on T
Run PVCs
Couplet
Multiform PVC
PVC
Bigeminy
Trigeminy
Tachy
Brady
Pacer Not Pacing
Pacer Not Capture
Missed Beats
Nonsus. Vtac
Vent Rhythm
Pause
Default priority
Prompt
Med
Prompt
Med
Med
Med
Med
Prompt
High
High
Med
Low
High
High
High
High
Prompt
Prompt
Med
Med
Low
BeneVision N1 Patient Monitor Operator’s Manual D - 1
D.1.3
Alarm message
Irr Rhythm
PVCs/min
Pauses/min
A-Fib
Default priority
Prompt
Med
Med
Prompt
Note: When arrhythmia alarms occur, check the patient’s condition and the ECG connections.
Resp Physiological Alarm Messages
Alarm message
Resp Artifact
Zero RR
Default priority
High
High
Cause and solution
The patient’s heartbeat has interfered with the impedance respiration measurement. Check the patient’s condition and the ECG connections.
The respiration signal is so weak that the monitor cannot perform respiration analysis. Check the patient’s condition, module and patient connections.
D.1.4
SpO
2
Physiological Alarm Messages
Alarm message
SpO2 Desat
Default priority
High
Cause and solution
The SpO
2
value falls below the desaturation alarm limit. Check the patient’s condition and check if the alarm limit settings are correct.
D.1.5
PR Physiological Alarm Messages
Alarm message
No Pulse
Default priority
High
Cause and solution
The pulse signal is so weak that the monitor cannot perform pulse analysis. Check the patient’s condition and the source of the PR, such as
IBP or SpO2 sensor, and measurement site.
D.1.6 NIBP Physiological Alarm Messages
Alarm message
NIBP-S Extremely
High/NIBP-D
Extremely High/NIBP-
M Extremely High
NIBP-S Extremely
High/NIBP-D
Extremely High/NIBP-
M Extremely Low
Default priority
High
High
Cause and solution
The NIBP value is higher than the NIBP Extreme alarm high limit. Check the patient’s condition and check if the alarm limit settings are correct.
The NIBP value is lower than the NIBP Extreme alarm low limit. Check the patient’s condition and check if the alarm limit settings are correct.
D.1.7 IBP Physiological Alarm Messages
Alarm message
Art-S/Art-D/Art-M
Extremely High
Default priority Cause and solution
High The Art value is higher than the Art Extreme alarm high limit. Check the patient’s condition and check if the alarm limit settings are correct.
D - 2 BeneVision N1 Patient Monitor Operator’s Manual
Alarm message
Art-S/Art-D/Art-M
Extremely Low
Default priority Cause and solution
High The Art value is lower than the Art Extreme alarm low limit. Check the patient’s condition and check if the alarm limit settings are correct.
D.1.8
CO
2
Physiological Alarm Messages
D.2
Alarm message
FiO2 Shortage
Default priority
High
Cause and solution
FiO
2
concentration is less than 18%. Check the patient’s condition, the ventilated O
2
content and the airway connection.
Technical Alarm Messages
This section lists technical alarms, their default priority, responses on alarm reset, and the actions that can be taken when an alarm occurs. Some of alarms may not be included.
Various technical alarms respond differently when the alarm system is reset. For easy clarification, in this section the technical alarms are classified into three categories of response when the alarm system is reset:
■
■
■
A: technical alarms are cleared. The monitor gives no alarm indications.
B: technical alarms are changed to the prompt messages.
C: the alarm is silenced and a √ appears before the alarm message.
In the following tables A, B, and C are used to refer to the responses on alarm reset.
D.2.1
General Technical Alarm Messages
D.2.2
Alarm message Default priority
Indication on alarm reset
C
Cause and solution
XX Module Error High XX module does not work properly. Reinsert the module, if the alarm persists, contact your service personnel.
Note: XX represents a measurement or parameter label, such as HR, RR, SpO2, or EtCO2, etc.
ECG Technical Alarm Messages
Alarm message
ECG Noisy
ECG Amplitude Too Small
ECG (XX) Lead Off
ECG Signal Invalid
ECG Learning
Default priority
Low/Prompt
Indication on alarm reset
A
Low
Low
Low
Prompt
C
B
A
/
Cause and solution
The ECG signal is noisy. Check for any possible sources of signal noise around the cable and electrode, and check the patient for excessive motion.
The ECG amplitude does not reach the detected threshold. Check for any possible source of interference around the cable and electrode.
The electrode has become detached from the patient or the lead wire has become disconnected from the adapter cable. Check the connections of the electrodes and leadwires.
Patient skin impedance is too high. Check ECG electrode application.
ECG learning is manually or automatically triggered.
BeneVision N1 Patient Monitor Operator’s Manual D - 3
D.2.3
Alarm message Default priority
Indication on alarm reset
/
Cause and solution
Cannot Analyze QT Prompt /
Note: XX represents ECG lead name, for example RL, LL, V, Va, Vb, etc.
Resp Technical Alarm Messages
Alarm message
Resp Interference
Electrode Poor Contact
Default priority
Prompt
Indication on alarm reset
/
Prompt /
Cause and solution
The respiration circuit is disturbed. Check for any possible sources of signal noise.
Check the electrode application. Reposition or replace the electrodes if necessary.
D.2.4
SpO
2
Technical Alarm Messages
Alarm message
SpO2 Sensor Off Sensor
Off
Default priority
Low
Indication on alarm reset
B
SpO2 No Sensor No
Sensor
SpO2 Excess Light
SpO2 No Pulse
SpO2 Sensor
Incompatible
SpO2 Low Signal Quality
SpO2 Interference
SpO2 Sensor Error
SpO2 Searching Pulse
SpO2 Low Perfusion
Low
Low
Low
Low
Low
Low
Low
Prompt
Prompt
A
C
C
C
C
C
C
/
/
Cause and solution
The SpO
2
sensor has become detached from the patient or the module. Check the sensor connection. If the alarm persists, replace the sensor.
The SpO
2
extension cable is detached from the
SpO
2
module, or the SpO
2
sensor is detached from the SpO
2
extension cable. Check the SpO cable and the sensor connection. If the alarm
2 persists, replace the sensor.
Ambient light is too strong. Move the sensor to a place with lower level of ambient light or cover the sensor to minimize the ambient light.
The SpO
2
sensor failed to obtain pulse signal.
Check the patient’s condition and replace the sensor application site. If the alarm persists, replace the sensor.
Incompatible or an unspecified SpO
2
sensor is used. Use specified sensors.
1. Check the sensor and sensor position.
2. Make sure the patient is not shivering or moving.
3. The patient’s pulse may be too low to be measured.
The SpO
2
signal has interference. Check for any possible sources of signal noise and check the patient for excessive motion.
Replace the sensor and measure again.
SpO
2
is searching for pulse.
The SpO
2
sensor is not properly placed or the patient’s perfusion index is too low.
1. Check the sensor and sensor position.
2. Reposition the sensor if necessary.
D - 4 BeneVision N1 Patient Monitor Operator’s Manual
D.2.5
Temp Technical Alarm Messages
Alarm message
T1/T2 Sensor Off
Default priority
Low
Indication on alarm reset
A
Cause and solution
Check the sensor connection and reconnect the sensor.
D.2.6
NIBP Technical Alarm Messages
Alarm message
NIBP Loose Cuff
NIBP Air Leak
NIBP Airway Error
NIBP Weak Signal
NIBP Overrange
NIBP Excessive Motion
NIBP Cuff Overpress
NIBP Timeout
NIBP Cuff and Patient
Mismatch
NIBP Airway Leak
Default priority
Low
Indication on alarm reset
A
Low
Low
Low
Low
Low
Low
Low
Low
Low
A
A
A
A
A
A
A
A
A
Cause and solution
There is a leak in the cuff or air tubing. Use a cuff of correct type based on the patient size. Apply the cuff and connect the air tubing as instructed in the manual.
Check the NIBP cuff and pump for leakages.
The air tubing may be occluded. Check the air tubing for an occlusion or kinking. If the alarm persists, contact your service personnel.
The patient’s pulse is weak or the cuff is loose.
Check the patient’s condition and replace the cuff application site.
The measured NIBP value exceeds the module measurement range. Check the patient’s condition.
Check the patient’s condition and reduce patient motion.
The NIBP airway may be occluded. Check the airway and measure again. If the alarm persists, contact your service personnel.
The measurement time exceeds 120 seconds in the adult or pediatric mode, or exceeds 90 seconds in the neonatal mode, and the BP value cannot be obtained. Check the patient’s condition and NIBP connections, or replace the cuff and measure again.
The cuff type mismatches the patient category.
Verify the patient category or replace the cuff if necessary. If patient category is correct, check that the tubing is not bent and the airway is not occluded.
Airway leakage is found during the NIBP leakage test. Check the NIBP cuff and pump for leakages.
D.2.7
IBP Technical Alarm Messages
Alarm message
XX Sensor Error
XX No Sensor
Default priority
Med
Med
C
A
Indication on alarm reset
Cause and solution
The IBP sensor fails. Replace the sensor.
The IBP patient cable and/or corresponding IBP sensor is not connected or detached. Check the cable and sensor connection.
BeneVision N1 Patient Monitor Operator’s Manual D - 5
D.2.8
Alarm message Default priority
Indication on alarm reset
A
Cause and solution
XX No Pulse
XX Disconnected
Low
High
Host Monitor Version Low Low
C
A
The catheter may be occluded. Please flush the catheter.
The tubing is disconnected from the patient, or the three-way valve is open to the air. Check the connection of the tubing, or check the valve is open to the patient. If the alarm persists, contact your service personnel.
The N Series system software version is too low.
In order for the N Series monitor to connect to the N1 which connects to the external IBP module and perform IBP monitoring, the system software of N 1 and N series monitor should be
V01.11 and above.
Note: XX represents an IBP label, for example PA, CVP, FAP, P1, etc.
CO
2
Technical Alarm Messages
Alarm message
CO2 Module High Temp
Default priority
Low
Indication on alarm reset
C
CO2 Module Low Temp
CO2 Zero Failed
CO2 No Watertrap
CO2 No Adaptor
CO2 High Airway Press.
CO2 Low Airway Press.
Low
Low
Low
Low
Low
Low
C
C
B
B
C
C
Cause and solution
Ambient temperature is too high or there is a module failure.
1. Lower the operating temperature.
2. Reinsert the module.
3. If the alarm persists, the CO
2
module may have failed, contact your service personnel.
Ambient temperature is too low or there is a module failure.
1. Raise the operating temperature.
2. Reinsert the module.
3. If the alarm persists, the CO
2
module may have failed, contact your service personnel.
Reinsert the module. If the alarm persists, contact your service personnel.
Check the watertrap connections.
Check the adaptor connections.
1. Check the airway pressure settings of the ventilator/anesthesia machine.
2. Disconnect the module from the ventilator/ anesthesia machine.
3. Reinsert the module.
4. If the alarm persists, contact your service personnel.
1. Check the airway pressure settings of the ventilator/anesthesia machine.
2. Disconnect the module from the ventilator/ anesthesia machine.
3. Reinsert the module.
4. If the alarm persists, contact your service personnel.
D - 6 BeneVision N1 Patient Monitor Operator’s Manual
Alarm message
High Barometric
Low Barometric
CO2 Airway Occluded
CO2 No Filterline
CO2 Calibration Required
CO2 Airway Error
CO2 Adapter Error
CO2 No Sensor
CO2: Change Watertrap
CO2 Watertrap Mismatch
Default priority
Low
Indication on alarm reset
C
Low
Low
Low
Low
Low
Low
Low
Low
Low
C
C
A
C
C
A
A
C
C
Cause and solution
The ambient pressure exceeds the operating pressure range or CO
2
module fails.
1. Make sure that the ambient pressure meets the specifications, and check for sources that affect the ambient pressure.
2. Reinsert the module. If the alarm persists, contact your service personnel.
The ambient pressure exceeds the operating pressure range or CO
2
module fails.
1. Make sure that the ambient pressure meets the specifications, and check for sources that affect the ambient pressure.
2. Reinsert the module. If the alarm persists, contact your service personnel.
1. Check if the sample line is kinked or occluded.
2. Replace the sample line.
3. Reinsert the module.
4. If the alarm persists, contact your service personnel.
Make sure that the filterline is connected.
Perform a calibration.
1. Check if the sample line is kinked or occluded.
2. Replace the sample line.
3. Reinsert the module.
4. If the alarm persists, contact your service personnel.
Check, clean or replace the airway adapter.
Perform a zero calibration.
Make sure that the CO
2 transducer is connected.
Replace the watertrap.
Check the patient category and use a correct watertrap.
D.2.9
Power Supply Technical Alarm Messages
Alarm message
Low Battery
Critically Low Battery
Battery Service Required
Default priority
Med
Indication on alarm reset
C
High
Low
C
B
Power Board Comm Error
Battery Err
Battery Charging Error
High
High
High
C
C
C
Cause and solution
Connect the monitor to an AC power source and allow the batteries to charge.
Connect the monitor to an AC power source and allow the batteries to charge.
The battery has reached its lifetime. Contact the service personnel.
Shutdown and restart the monitor. If the alarm persists, contact your service personnel.
The battery may have failed. Contact your service personnel.
The charging circuit fails or the battery fails.
Contact your service personnel.
BeneVision N1 Patient Monitor Operator’s Manual D - 7
Alarm message Default priority
Indication on alarm reset
C Battery Temperature Too
High
Battery Off
High
High C
RT Clock Need Reset
RT Clock Not Exist
XX V Too High
XX V Too Low
High
High
High
High
Note: XX represents 2.5, 3.3, 5, or 12.
C
C
C
C
Cause and solution
Stop using the monitor after this alarm appears, and contact your service personnel.
Shutdown and restart the monitor. If the alarm persists, contact your service personnel.
Contact your service personnel.
Contact your service personnel.
There is a problem with the system power supply.
Shutdown and restart the monitor.
D.2.10
Printer Technical Alarm Messages
Alarm message
Printer Buffer Full
Printing Failed
Printing Stopped
Printer Unavailable
PDF storage space is nearly full
Error storing PDF file
Change the print server language to be consistent with this monitor
Default priority
Prompt
Indication on alarm reset
/
Prompt
Prompt
Prompt
Prompt
/
/
/
/
Prompt
Prompt
Print Server Disconnected Prompt
/
/
/
Cause and solution
The printer buffer is full. Wait until the printer finishes the printing task.
The printer ran out of paper or cannot be found on the network. Check the printer.
Printing was manually stopped.
The printer may have failed. Check the printer.
Delete the files saved under the PDF file path to release storage space. Otherwise you cannot save new PDF files.
The PDF file path settings on the print server and the PDF Creator are not consistent or the PDF storage space is full. Check the PDF file path settings for consistency, or delete the files saved under the PDF file path to release storage space.
Verify that the language settings of the print server and the monitor are consistent, Otherwise you cannot perform printing.
Check that the monitor is properly connected with the print server.
D.2.11
Technical Alarm Messages Related to Networked Monitoring
Alarm message
CMS/eGW Disconnected
Default priority
Low
Indication on alarm reset
B
View Bed XX YY-ZZ,
Network Disconnected.
Low A
Viewed by Bed XX YY-ZZ,
Network Disconnected.
Low
WLAN IP Address Conflict Low
A
C
Cause and solution
The monitor is disconnected from the CMS.
Check the network connection.
The network is interrupted when the monitor is viewing the remote device. Check the network connection.
The network is interrupted when the monitor is viewed by another remote device. Check the network connection.
There is a wireless network IP address conflicts.
Check the network settings.
D - 8 BeneVision N1 Patient Monitor Operator’s Manual
Alarm message Default priority
Indication on alarm reset
C
Cause and solution
LAN1 IP Address Conflict
Fail To Get WLAN IP
Address
Fail To Get LAN1 IP
Address
Low
Low
Low
C
C
There is a wired network IP address conflicts.
Check the network settings.
Unable to automatically obtain the wireless network IP address. Check the network settings.
Unable to automatically obtain the wired network IP address. Check the network settings.
Note: XX refers to the department name, YY refers to the room number, and ZZ refers to the bed number.
D.2.12
Other System Technical Alarm Messages
Alarm message
Storage Error
Loading Default Config
Failed
Read dock E2PROM error!
Default priority
High
Indication on alarm reset
C
Low
High
XX Conflicts
(XX refers to the module label)
XX Measurement has been closed
(XX refers to the module label)
The display setup for XX is disabled.
(XX refers to the parameter label)
Prompt
Prompt
Prompt
The patient data storage space is nearly full. Please delete some discharged patients.
Med
A
C
/
/
/
B
Cause and solution
The storage card failed or files are damaged.
Shutdown and restart the monitor. Format the storage card (CAUTION: this will clear all patient data stored on this monitor). If the alarm persists, contact your service personnel.
The default configuration was not correctly loaded. The monitor will restore to the factory default configuration for the current patient category.
1. Check if you’re using the specified external display.
• If you’re using the specified external display, remove the N1 from the Dock, and reconnect the N1 and the Dock.
• If you’re not using the specified external display, replace current external display with the specified external display. Then remove the N1 from the Dock, and reconnect the N1 and the Dock.
2. If the alarm persists, contact your service personnel.
The same type of corresponding module being used exceeds the supported number. Remove the conflict module.
The parameter module is disabled. Switch on the module if you want to use it. For more information, see
.
The parameter of the newly inserted module is not displayed on the screen. Select a desired area to display the parameter numerics and waveforms. For more information, see
3.9.2 Displaying Parameter Numerics and
.
The storage space of the monitor is full. Delete unnecessary discharged patients.
BeneVision N1 Patient Monitor Operator’s Manual D - 9
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D - 10 BeneVision N1 Patient Monitor Operator’s Manual
E
SpO
2
Sensor Accuracy
E.1
The Accuracy of Masimo SpO
2
Sensors
Table information for the plots below show A
RMS
values measured with Masimo SET Oximetry Technology in a clinical study.
Adtx/Pdtx/4000/4001
Inf/Neo/NeoPt/4002/4003/4004/4005
BeneVision N1 Patient Monitor Operator’s Manual E - 1
DCI/DCIP/4050/4051
LNCS YI
4053
E - 2 BeneVision N1 Patient Monitor Operator’s Manual
E.2
The Accuracy of Nellcor SpO
2
Sensors
SpO
2
Accuracy for Nellcor Sensors vs. Co-Oximeters (Arms)
SpO
2
Range
DS-100A
D-YS, OXI-P/I, OXI-A/N
MAXAI, MAXPI, MAXII
MAXNI
100% to 70%
1.64%
2.41%
1.62%
1.85%
100% to 90%
1.16%
1.38%
1.49%
1.71%
90% to 80%
1.67%
2.50%
1.57%
1.51%
80% to 70%
2.25%
3.60%
2.50%
1.59%
Modified Bland-Altman for SpO
2
- MAXAI, MAXPI, MAXII, MAXNI Sensors: (SpO
2 vs.SaO
2
- SaO
2
)
Modified Bland-Altman for SpO
2
- DS-100A Sensors: (SpO
2
- SaO
2
) vs.SaO
2
BeneVision N1 Patient Monitor Operator’s Manual E - 3
Modified Bland-Altman for SpO2 - D-YS, OXI-A/N, OXI-P/I Sensors: (SpO
2
- SaO
2
) vs.SaO
2
E - 4 BeneVision N1 Patient Monitor Operator’s Manual
F
Units, Symbols and Abbreviations
F.1
Units
Abbreviation mEq mg min ml mm m mAh
Mb mcg
L lb kg kPa in k h
Hz
°F g
GHz
GTT cc cm dB
DS
Ah bpm bps
°C
μs
A
μA
μV
BeneVision N1 Patient Monitor Operator’s Manual
In Full hour hertz inch kilo kilogram kilopascal litre pound meter milliampere hour mega byte microgram milli-equivalents milligram minute milliliter millimeter microampere microvolt microsecond
Ampere
Ampere hour beat per minute bits per second
Celsius cubic centimeter centimeter decibel dyne second
Fahrenheit gram gigahertz gutta
F - 1
F.2
Abbreviation s
V
VA
Ω
W mW
MΩ nm rpm mmHg cmH2O ms mV
Symbols
Symbol
–
%
/
＝
＜
～
＋
＞
≤
×
©
≥
±
In Full millimeters of mercury centimeters of water millisecond millivolt milliwatt megaohm nanometer breaths per minute second volt volt ampere ohm watt
Explanation negative, minus percent per; divide; or to plus equal to less than greater than less than or equal to greater than or equal to plus or minus multiply copyright
F - 2 BeneVision N1 Patient Monitor Operator’s Manual
F.3
Abbreviations
Abbreviation
C.I.
CIS
CISPR
CMOS
CMS
C.O.
CO
2
COHb
CAA
CaO
2
CCI
CCO
CCU
CE
CFI
Compl
CPI
CPO
CVP
DC
Des
BAP
BSA
BT
BTPS aVF aVL aVR awRR
AaDO
2
AC
Adu
AG
AHA
Ao
Art
ATMP
BeneVision N1 Patient Monitor Operator’s Manual
In Full alveolar-arterial oxygen gradient alternating current adult anaesthesia gas
American Heart Association aortic pressure arterial barometric pressure left foot augmented lead left arm augmented lead right arm augmented lead airway respiratory rate brachial arterial pressure body surface area blood temperature body temperature and pressure, saturated
Clinical Assistive Application arterial oxygen content continuous cardiac index continuous cardiac output cardiac (coronary) care unit
Conformité Européenne cardiac function index cardiac index clinical information system
International Special Committee on Radio Interference complementary metal oxide semiconductor central monitoring system cardiac output carbon dioxide carboxyhemoglobin compliance cardiac power index cardiac power output central venous pressure direct current desflurane
F - 3
F - 4
Abbreviation
FAP
FCC
FDA
Fi
FiAA
EtO
2
EVLW
ELWI
EWS
EtDes
EtEnf
EtHal
EtIso
EtSev
EtCO
2
EtN
2
O
EtO
ESVI
ESU
Et
EtAA
EMG
EMI
Enf
ESV
EDV
EEC
EEG
EMC
Dia dpi dPmx
DVI
DO
2
DO
2
I
ECG
In Full diastolic dot per inch left ventricular contractility digital video interface oxygen delivery oxygen delivery index electrocardiograph end-diastolic volume
European Economic Community electroencephalogram electromagnetic compatibility electromyograph electromagnetic interference enflurane end systolic volume end systolic volume index electrosurgical unit end-tidal end-tidal anesthetic agent end-tidal anesthetic agent end-tidal carbon dioxide end-tidal nitrous oxide ethylene oxide end-tidal oxygen extravascular lung water extravascular lung water index
Early Warning Score femoral arterial pressure
Federal Communication Commission
Food and Drug Administration fraction of inspired inspired anesthetic agent
BeneVision N1 Patient Monitor Operator’s Manual
Abbreviation
Iso
ITBI
ITBV
LA
I:E
IEC
IEEE
IP
ICP
ICT/B
ICU
ID
HIS
HR
IBP
IBW
LAP
LCD
LCW
LCWI
LDAP
LED
GEF
Hal
Hb
Hct
FV
GCS
GEDV
GEDI
FiDes
FiEnf
FiHal
FiIso
FiSev
FiCO2
FiN
2
O
FiO
2
FPGA
BeneVision N1 Patient Monitor Operator’s Manual
In Full inspired anesthetic agent fraction of inspired carbon oxygen fraction of inspired nitrous oxide fraction of inspired oxygen field programmable gate array flow-volume
Glasgow Coma Scale global end diastolic volume global end diastolic volume index global ejection fraction halothane hemoglobin haematocrit hospital information system heart rate invasive blood pressure ideal body weight intracranial pressure intracranial catheter tip pressure transducer intensive care unit identification inspiratory time: expiratory time ratio
International Electrotechnical Commission
Institute of Electrical and Electronic Engineers internet protocol isoflurane intrathoracic blood volume index intrathoracic blood volume left arm left atrial pressure liquid crystal display left cardiac work left cardiac work index
Lightweight Directory Access Protocol light emitting diode
F - 5
F - 6
Abbreviation
MEWS
MLDAP
MRI
MV
MVe
MVi
N/A
N
2
N
2
O
Neo
NEWS
NIBP
LL
LVET
LVSW
LVSWI
MAC
MAP
Mb
MetHb
Ped
PEEP
PEF
PEP
PIF
PIP
Pleth
Pmean
PO
2
Pplat
PPV
NIF
O
2
O
2
%
OR
OxyCRG
PA
Paw
PAWP
In Full left leg left ventricular ejection time left ventricular stroke work left ventricular stroke work index minimum alveolar concentration mean arterial pressure myoglobin methemoglobin
Modified Early Warning Score
Mindray LDAP, Mindray lightweight directory access protocol magnetic resonance imaging minute volume expiratory minute volume inspiratory minute volume not applied nitrogen nitrous oxide neonate
National Early Warning Score noninvasive blood pressure negative inspiratory force oxygen oxygen concentration operating room oxygen cardio-respirogram pulmonary artery airway pressure pulmonary artery wedge pressure pediatric positive end expiratory pressure peak expiratory flow pre-ejection period peak inspiratory flow peak inspiratory pressure plethysmogram mean pressure oxygen supply pressure plateau pressure pulse pressure variation
BeneVision N1 Patient Monitor Operator’s Manual
Abbreviation
TFT
TI
TRC
UAP
Sys
TB
TD
Temp
UPS
USB
SV
SVI
SVR
SVRI
SR
SSC
SSI
STR
SVV
SvO
2
Sync
RR
RSBI
RVEF
SOFA
SpO
2
SQI
Raw
Rec
Resp
RL
PR
PVC
PVPI
PVR
PVRI qSOFA
RA
RAP
BeneVision N1 Patient Monitor Operator’s Manual
In Full pulse rate premature ventricular contraction pulmonary vascular permeability index pulmonary vascular resistance pulmonary vascular resistance index quick Sepsis-Related Organ Failure Assessment right arm right atrial pressure airway resistance record, recording respiration right leg respiration rate rapid shallow breathing index right ventricular ejection fraction
Sepsis-Related Organ Failure Assessment arterial oxygen saturation from pulse oximetry signal quality index suppression ratio
Surviving Sepsis Campaign signal strength index systolic time ratio stroke volume stroke volume index systemic vascular resistance systemic vascular resistance index stroke volume variation venous oxygen saturation synchronization systolic pressure blood temperature temperature difference temperature thin-film technology injectate temperature tube resistance compensation umbilical arterial pressure uninterruptible power supply universal serial bus
F - 7
Abbreviation
UVP
VAC
VEPT
VPB
In Full umbilical venous pressure volts alternating current volume of electrically participating tissue ventricular premature beat per minute
F - 8 BeneVision N1 Patient Monitor Operator’s Manual
P/N: 046-011405-00(10.0)
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