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Welch Allyn Connex ® Devices
Directions for use
Software version 2.4X
© 2019 Welch Allyn. All rights are reserved. To support the intended use of the product described in this publication, the purchaser of the product is permitted to copy this publication, for internal distribution only, from the media provided by Welch Allyn. No other use, reproduction, or distribution of this publication, or any part of it, is permitted without written permission from Welch Allyn.
Welch Allyn assumes no responsibility for any injury to anyone, or for any illegal or improper use of the product, that may result from failure to use this product in accordance with the instructions, cautions, warnings, or statement of intended use published in this manual.
Welch Allyn, Connex, SureTemp, FlexiPort, and SureBP are registered trademarks of Welch Allyn.
Vital Signs Monitor 6000 Series and PartnerConnect are trademarks of Welch Allyn.
Integrated Pulmonary Index is a trademark of , and Oridion and Microstream are registered trademarks of, Oridion Medical 1987
Ltd. No implied license. Possession or purchase of this device does not convey any express or implied license to use the device with unauthorized CO2 sampling products 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 products.
Radical-7R, Pulse CO-Oximeter, rainbow Acoustic Monitoring, RRa, and ReSposable are trademarks of, and SET, LNCS, SpHb, rainbow, and Masimo are registered trademarks of, Masimo Corporation. Possession or purchase of a Masimo-equipped 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.
Nellcor SpO2 Patient Monitoring System with OxiMax Technology and Nellcor SpO2 OxiMax Technology are registered trademarks of COVIDIEN LP Covidien Holdings Inc.
Braun and ThermoScan are registered trademarks of Braun GmbH.
Health o meter is a registered trademark of Sunbeam Products, Inc., used under license.
EarlySense is a registered trademark of EarlySense Ltd.
Software in this product is Copyright 2019 Welch Allyn or its vendors. All rights are reserved. The software is protected by United
States of America copyright laws and international treaty provisions applicable worldwide. Under such laws, the licensee is entitled to use the copy of the software incorporated with this instrument as intended in the operation of the product in which it is embedded. The software may not be copied, decompiled, reverse-engineered, disassembled, or otherwise reduced to humanperceivable form. This is not a sale of the software or any copy of the software; all right, title, and ownership of the software remain with Welch Allyn or its vendors.
This product may contain software known as “free” or “open source” software (FOSS). Welch Allyn uses and supports the use of
FOSS. We believe that FOSS makes our products more robust and secure, and gives us and our customers greater flexibility. To learn more about FOSS that may be used in this product, please visit our FOSS website at www.welchallyn.com/opensource .
Where required, a copy of FOSS source code is available on our FOSS website.
For patent information, please visit www.welchallyn.com/patents .
For Nellcor patent information, please visit www.covidien.com/patents .
For information about any Welch Allyn product, contact Welch Allyn Technical Support: www.welchallyn.com/about/company/ locations.htm
.
DIR 80024382 Ver. A
Revision date: 2019-04
This manual applies to
Connex Integrated Wall System.
901060 Vital Signs Monitor and 901028
Welch Allyn, Inc.
4341 State Street Road
Skaneateles Falls, NY 13153-0220 USA www.welchallyn.com
Regulatory Affairs Representative
Welch Allyn Limited
Navan Business Park
Dublin Road
Navan, County Meath
Republic of Ireland
Contents
About warnings and cautions .............................................................. 15
Remove the temperature probe and well .......................................................... 38
Connect the SpO2 cable or the SpO2/RRa dual cable ....................................... 39
Disconnect the SpO2 cable or the SpO2/RRa dual cable .................................. 41
Disconnect the patient movement sensor and cable ........................................ 42
iii
iv Contents Welch Allyn Connex ® Devices
Set up the physical assessment instrument handles and specula dispenser ... 54
Set up the SureTemp® Plus thermometer ........................................................ 55
Set up the Braun ThermoScan® PRO thermometer ......................................... 56
Using the keypad, keyboard, and barcode scanner ........................... 73
Activate the Continuous Monitoring profile ...................................................... 80
Pause continuous monitoring (Pause mode) ..................................................... 81
Saving vital sign measurements (Continuous Monitoring profile) ...................... 87
Saving vital sign measurements (Intervals Monitoring, Spot Check, and Office
Directions for use Contents v
Patient data management .................................................................... 95
Manage patient records (Continuous Monitoring profile) .................................. 99
Manage patient records (Intervals Monitoring, Spot Check, and Office
Adjust ECG and Impedance Respiration alarm limits ....................................... 113
Physical assessment instrument handles ........................................................ 192
Maintenance and service .................................................................... 195
Replace the printer paper (Connex VSM) ......................................................... 196
Remove the wall system from the wall (Connex IWS) .................................... 198
vi Contents Welch Allyn Connex ® Devices
Physical assessment instrument handles ........................................................ 235
Patient data management messages .............................................................. 236
Communications module messages ................................................................ 237
Standards and compliance ................................................................. 267
Guidance and manufacturer's declaration ........................................ 275
Introduction
This directions for use (DFU) covers the following devices:
• the Connex® Vital Signs Monitor 6000 Series (Connex VSM or VSM 6000 series)
• the Connex® Integrated Wall System (Connex IWS)
Most of the content in this directions for use applies to both Connex devices, but some sections present device-specific content. See section titles and parentheses throughout to identify the device-specific content. If your Connex device has an ECG module, see the ECG module DFU for additional instructions regarding its use.
Most of the content in this directions for use applies to both Connex devices, but some sections present device-specific content. See section titles and parentheses throughout to identify the device-specific content.
Connex Vital Signs Monitor 6000 Series
This directions for use describes the capabilities and operation of the monitor. The information, including the illustrations, covers all configuration options. If your monitor configuration lacks any of these options, some information in this manual might not apply.
Before using the monitor, you must familiarize yourself with all warnings and cautions, with the steps to power up the monitor, and with the sections of this directions for use that pertain to your use of the monitor. You must also familiarize yourself with all information that accompanies the accessories you use.
Note Some product features described in this publication might not be available in your country. For the latest information about products and features, please call Welch Allyn Customer Care.
Connex Integrated Wall System
The Welch Allyn Connex Integrated Wall System combines the advanced, easy-to-use monitor capabilities of the Welch Allyn Connex Vital Signs Monitor 6000 Series with the
Welch Allyn 767 Power Handles. This manual (directions for use) is designed to help you understand the capabilities and operation of the wall system. The information in this manual, including the illustrations, is based on a wall system configured with noninvasive blood pressure (NIBP), body temperature, pulse oximetry (SpO2), total hemoglobin concentration (SpHb), pulse rate, ECG, weight scale, and two power handles. If your wall system configuration lacks any of these options, some information in this manual may not apply.
1
2 Introduction Welch Allyn Connex ® Devices
Before using the wall system, read the sections of the manual that pertain to your use of the system.
Note Throughout this directions for use, the Integrated Wall System may be referred to as a wall system or monitor.
Note Some product features described in this publication might not be available in your country. For the latest information about products and features, please call Welch Allyn Customer Care.
Indications for use
The Connex VSM 6000 series of monitors is intended to be used by clinicians and medically qualified personnel for monitoring of neonatal, pediatric, and adult patients for
• noninvasive blood pressure (NIBP)
• pulse rate (PR)
• noninvasive functional oxygen saturation of arteriolar hemoglobin (SpO2)
• body temperature in normal and axillary modes
The most likely locations for patients to be monitored are general medical and surgical floors, general hospital, and alternate care environments. Monitoring can be accomplished on the VSM 6000 series bedside monitor itself, and the VSM 6000 series bedside monitor also can transmit data continuously for secondary remote viewing and alarming (e.g., at a central station). Secondary remote viewing and alarming features are intended to supplement and not replace any patient bedside monitoring procedures.
The optional Masimo rainbow ® SET Pulse CO-Oximeter ™ and accessories are indicated for the continuous noninvasive monitoring of functional oxygen saturation of arterial hemoglobin (SpO2), pulse rate (PR), total hemoglobin concentration (SpHb ® accessories are indicated for use with adult, pediatric, and neonatal patients during both motion and no-motion conditions, and for patients who are well or poorly perfused in hospitals and hospital-type facilities.
), and/or respiration rate (RRa ™ ). The Masimo rainbow SET Radical-7R ™ Pulse CO-Oximeter and
The optional Oridion ® module and accessories are intended for the continuous noninvasive measurement and monitoring of carbon dioxide concentration of the expired and inspired breath (etCO2 and FiCO2) and respiration rate (RR). It is intended for use with neonatal, pediatric, and adult patients in hospitals and hospital-type facilities.
The optional Oridion module also provides the clinician with an Integrated Pulmonary
Index ™ (IPI). The IPI is based on four parameters provided by the monitor: end-tidal carbon dioxide (etCO2), respiration rate (RR), oxygen saturation (SpO2), and pulse rate
(PR). The IPI is a single index of an adult or pediatric patient's ventilatory status displayed on a scale of 1–10, where 10 indicates optimal pulmonary status. IPI monitoring displays a single value that represents the patient's pulmonary parameters and alerts clinicians to changes in the patient's pulmonary status.
The IPI is an adjunct to, and is not intended to replace, vital signs monitoring.
Optional compatible weight scales (e.g., Health o meter ® weight, and BMI input.
) can be used for height,
The optional EarlySense ® (Everon) System is intended for continuous measurement of respiration rate, heart rate, and movement in an automatic contact-less manner, in a hospital or clinic setting. The system is indicated for use in children, adolescents, and
Directions for use Introduction 3 adults. The operation of the EarlySense has been studied in children (weight ≥ 10 Kg) and adults (weight <111 Kg) during sleep and resting condition.
The Welch Allyn ECG/Impedance Respiration module and associated software acquires and analyzes ECG signals from patients. Patients are people with coronary problems, suspected coronary problems, or recent medical procedures that require cardiac monitoring.
This ECG module can be used on adult and pediatric patients.
The ECG module is indicated for use by healthcare professionals whenever there is a need to monitor a patient’s physiological parameters for the following:
• ECG
• ECG with alarms for ventricular tachycardia, ventricular fibrillation, and asystole
• Impedance respiration
This product is available for sale only upon the order of a physician or licensed healthcare professional.
Handle module assembly (Integrated Wall System only)
Handles supply power to Welch Allyn 3.5V instruments.
Contraindications
This system (all configurations) is not intended to be used:
• on patients connected to heart/lung machines
• on patients being transported outside a healthcare facility
• within the controlled access area of MRI equipment
• in a hyperbaric chamber
• in the presence of flammable anesthetics
For contraindications of SpO2 and SpHb sensors, consult the sensor manufacturer's directions for use.
Systems configured with EarlySense are not intended to be used:
• on patients for whom proper positioning cannot be achieved or maintained
• on patients who do not meet the weight limits tested or specified
4 Introduction Welch Allyn Connex ® Devices
Symbols
For information on the origin of these symbols, see the Welch Allyn symbols glossary: www.welchallyn.com/symbolsglossary .
Documentation symbols
WARNING The warning statements in this manual identify conditions or practices that could lead to illness, injury, or death.
CAUTION The caution statements in this manual identify conditions or practices that could result in damage to the equipment or other property, or loss of data. This definition applies to both yellow and black and white symbols.
WARNING Hot surface. Do not touch.
Follow the operating instructions/directions for use (DFU) — mandatory action.
A copy of the DFU is available on this website.
A printed copy of the DFU can be ordered from Welch Allyn for delivery within 7 days.
Power symbols
Power on/Display power-saving
[recent models]
Equipotential terminal
Power on/Display power-saving
[older models]
(on the display) monitor is plugged into Alternating Current power
Battery absent or faulty
5
6 Symbols
(on the monitor, green indicator)
Alternating Current power present, battery fully charged
(on the monitor, amber indicator)
Alternating Current power present, battery is charging
Alternating Current (AC)
Li-ion battery
Connectivity symbols
USB
Wireless signal strength
• Best (4 bars)
• Good (3 bars)
• Fair (2 bars)
• Weak (1 bar)
• No signal (no bars)
• No connection (blank)
Connected to central station
Miscellaneous symbols
CO2 sampling input
Manufacturer
Reorder number
Do not reuse
Welch Allyn Connex ® Devices
Battery charge level
Battery cover
Rechargeable battery
AC input power
Ethernet RJ-45
Nurse call
[recent models]
Nurse call
[older models]
Disconnected from central station
CO2 sampling output/exhaust
Limited rotation/Turn completely to right
Serial number
China RoHS markings for control of pollution caused by electronic information products. XX indicates
Environmentally Friendly Use
Period in years.
Directions for use
Nonionizing electromagnetic radiation
Restrictions for use of wireless device in Europe. European
Community's Class 2 radio equipment.
Defibrillation-proof Type BF applied parts
Atmospheric pressure limitation
Transport and storage temperature range
Maximum safe working load limits
(specific values presented with symbol)
Recycle
Symbols 7
Recycle the product separate from other disposables
Call for maintenance
Defibrillation-proof Type CF applied parts
Not for injection
Authorized Representative of the
European Community
Mass in kilograms (kg)
IPX1
(Vital Signs
Monitor)
IPX0
(Integrated Wall
System)
Degree of protection provided by the enclosure with respect to harmful ingress of liquids
Do not expose to open flame
8 Symbols Welch Allyn Connex ® Devices
Screen elements
Global navigation, controls, and indicators
Select option
Select item from list
Increase or decrease value
Monitoring and connectivity
Connect to the central station and retain patient data
(Monitor tab)
Connected to the central station (Device Status area)
Temporarily pause continuous monitoring but retain patient data
ECG, Heart rate/Pulse rate, and Impedance respiration
Process indicator for activities like acquiring measurements and connecting to a central station
Display lock/unlock
Disconnect from the central station but continue monitoring and retain patient data (Monitor tab)
Disconnected from the central station (Device Status area)
End continuous monitoring session for current patient and clear patient data
ECG lead selector
9
10 Screen elements
ECG, Heart rate/Pulse rate, and Impedance respiration
Heart rate / Pulse rate
Saved waveform icon
(Review tab)
Waveform snapshot button
NIBP
NIBP start
Intervals status indicators
Welch Allyn Connex ® Devices
Beats per minute (to represent heart rate / pulse rate)
Saved waveform icon, alarm condition (Review tab)
NIBP stop
NIBP view toggle
Temperature
Temperature site control
SpO2 and Pulse rate
Pulse amplitude bar
SpO2 view toggle
Beats per minute (to represent pulse rate)
Direct mode selector
SatSeconds timer (Nellcor feature only)
Response mode selector (Fast mode selected)
Directions for use
Total hemoglobin (SpHb)
SpHb view toggle
Capnography (CO2)
CO2 pump start etCO2 view toggle
RRa
Respiration indicator
Patient movement
Bed mode
Patient turn indicator and timer
Patient turn indicator (Review tab)
Screen elements 11
Averaging mode selector
(Long mode selected)
CO2 pump stop
IPI view toggle
IPI graphic indicators
Averaging mode selector
(Fast mode selected)
Bed exit
Bed exit (Review tab)
Exit sensitivity indicator
12 Screen elements
Manual parameters
Welch Allyn Connex ® Devices
Manual parameter selector
Alarm and information messages
Alarm limit control
Multiple alarms toggle
Alarm active
Patient Rest Mode
Patient data management
Diacritical marks key
(available for languages that use diacritical marks; appearance differs based on language)
Send patient data
View tabular trend data
Cancel action
Retrieve patient list from the network
Alarm On/Off toggle
Alarm audio paused
Information message
Symbols key
Print patient data
View graphical trend data
Add patient identifiers
Select patient from List tab
Directions for use
Patient data management
Delete patient from List tab
Forward or backward in
Review tab
Settings
Open keypad to enter Advanced settings password
Save configuration settings (must be enabled in Advanced settings)
Screen elements 13
Clear patient context from
Summary tab
Proceed to the next field to input patient information
Open Lost password dialog
Close Advanced settings
14 Screen elements Welch Allyn Connex ® Devices
About warnings and cautions
Warning and caution statements can appear on the monitor, on the packaging, on the shipping container, or in this document.
The monitor is safe for patients and clinicians when used in accordance with the instructions and the warning and caution statements presented in this manual.
Before using the monitor, you must familiarize yourself with all warnings and cautions, with the steps to power up the monitor, and with the sections of this directions for use that pertain to your use of the monitor. In addition to reviewing the general warnings and cautions presented in the next section, you must also review the more specific warnings and cautions appear throughout the manual in conjunction with setup/startup, device operation, patient monitoring, and maintenance tasks.
• Failure to understand and observe any warning statement in this manual could lead to patient injury, illness, or death.
• Failure to understand and observe any caution statement in this manual could lead to damage to the equipment or other property, or loss of patient data.
General warnings and cautions
WARNING Many environmental variables, including patient physiology and clinical application, can affect the accuracy and performance of the monitor.
Therefore, you must verify all vital signs information, especially NIBP and
SpO2, before treating the patient. If there is any question about the accuracy of a measurement, verify the measurement using another clinically accepted method.
WARNING Inaccurate measurement risk. Do not use the device or accessories in environments affected by extremes of temperature, humidity, or altitude. See "Environmental specifications" for acceptable operating conditions.
WARNING Alarm limits are patient-specific. For alarms to function properly, you must set or verify alarm limits appropriate for each patient.
Each time the monitor is powered on, you must check that the alarm settings are appropriate for your patient before you start monitoring.
WARNING The monitor is not intended for use during patient transport outside of the medical facility. Do not use the monitor to take measurements on any patient in transit.
15
16 About warnings and cautions Welch Allyn Connex ® Devices
WARNING Do not use the monitor as an apnea monitor. Neither the VSM
6000 series monitors, nor any of the integrated or accessory sensor systems used in conjunction with the VSM 6000 series monitors, are intended for use in apnea monitoring.
WARNING Use only Welch Allyn approved accessories, and use them according to the manufacturer’s directions for use. Using unapproved accessories with the monitor can affect patient and operator safety and can compromise product performance and accuracy.
WARNING Inaccurate measurement risk. Do not connect more than one patient to a monitor.
WARNING Inaccurate measurement risk. Dust and particle ingress can affect the accuracy of blood pressure measurements. Use the monitor in clean environments to ensure measurement accuracy. If you notice dust or lint build-up on the monitor's vent openings, have the monitor inspected and cleaned by a qualified service technician.
WARNING Inaccurate measurement risk. Liquids and excessive moisture can damage patient sensors and cause them to perform inaccurately or fail.
WARNING Patient harm risk. Always remove sensors from patients and disconnect them completely from monitors before bathing.
WARNING Liquids can damage electronics inside the monitor. Prevent liquids from spilling on the monitor.
If liquids are spilled on the monitor:
1. Power down the monitor.
2. Disconnect the power plug.
3. Remove battery pack from the monitor.
4. Dry off excess liquid from the monitor.
Note If liquids possibly entered the monitor, remove the monitor from use until it has been properly dried, inspected, and tested by qualified service personnel.
5. Reinstall battery pack.
6. Power on the monitor and verify that the monitor functions normally before using it.
If liquids enter the printer housing:
1. Power down the monitor.
2. Disconnect the power plug.
3. Remove battery pack from the monitor.
4. Remove and discard the paper roll.
5. Clean and dry the inside of the printer housing.
Note The printer housing has a drain tube that directs liquids down and out the bottom of the monitor. If liquids possibly entered other openings in the monitor, remove the monitor from use until it has been properly dried, inspected, and tested by qualified service personnel.
6. Install a new roll of paper.
7. Power on the monitor and verify that the monitor functions normally before using it.
Directions for use About warnings and cautions 17
WARNING Safety risk and potential shock hazard. Cords, cables, and accessories damaged from prior misuse can affect patient and operator safety. Inspect all cords, cables, and accessories for strain relief wear, fraying, or other damage according to the recommendations presented in the Maintenance and service section of this manual. Replace as necessary.
Inspect the AC cord for exposed copper before touching the cord. Unplug the AC cord only by pulling on the plug, never the cord. Never lift the monitor by the power cord or patient connections.
WARNING Fire and explosion hazard. Do not operate the monitor in the presence of a flammable anesthetic mixture with air, oxygen, or nitrous oxide; in oxygen-enriched environments; or in any other potentially explosive environment.
WARNING Fire and shock hazard. Only connect LAN cables contained within the perimeter of a single building. Conductive LAN cables spanning multiple buildings may introduce fire or shock hazards unless they are fitted with fiber optic cables, lightning arrestors, or other applicable safety features.
WARNING The monitor may not function properly if dropped or damaged.
Protect it from severe impact and shock. Do not use the monitor if you notice any signs of damage. Qualified service personnel must check any monitor that is dropped or damaged for proper operation before putting the monitor back into use.
WARNING Defective batteries can damage the monitor. If the battery shows any signs of damage or cracking, it must be replaced immediately and only with a battery approved by Welch Allyn.
WARNING Improper disposal of batteries may create an explosion or contamination hazard. Never dispose of batteries in refuse containers.
Always recycle batteries according to local regulations.
WARNING Electric shock hazard. Do not open the monitor or attempt repairs. The monitor has no user-serviceable internal parts. Only perform routine cleaning and maintenance procedures specifically described in this manual. Never perform maintenance or service tasks while the device is connected to a patient. Inspection and servicing of internal parts shall only be performed by qualified service personnel.
WARNING Electric shock hazard. Never perform maintenance or service tasks while the device is connected to a patient.
WARNING Inaccurate measurement risk. Do not expose to temperatures higher than 122º F (50º C).
WARNING Inaccurate measurement risk. Do not use the monitor on patients who are on heart-lung machines.
WARNING Inaccurate measurement risk. If using patient sensors during full body irradiation, keep the sensor out of the irradiation field. If the sensor is exposed to the irradiation, the reading might be inaccurate or the monitor might read zero during the active irradiation period.
WARNING Inaccurate measurement risk. Do not use the monitor on patients who are experiencing convulsions or tremors.
18 About warnings and cautions Welch Allyn Connex ® Devices
WARNING Use the monitor only as described in this directions for use. Do not use the monitor on patients as described in the Contraindications.
WARNING Personal/patient injury risk. Wall-mounted equipment and accessories must be installed in accordance with accompanying instructions. Improper installation can result in the monitor falling off the wall and injuring someone. Welch Allyn is not responsible for the integrity of any installation not performed by authorized Welch Allyn service personnel. Contact an authorized Welch Allyn service representative or other qualified service personnel to ensure professional installation for safety and reliability of any mounting accessory.
WARNING Do not place the monitor in any position that might cause it to fall on the patient.
WARNING Welch Allyn is not responsible for the integrity of a facility's power. If the integrity of a facility's power or protective earth conductor is in doubt, always operate the monitor on battery power alone when it is attached to a patient.
WARNING Avoid continuously monitoring a patient when the device is operating on battery power. If only battery power is available, you must remain in the room with any patient whose vital signs are being monitored continuously. Actively monitor both patient and battery status to ensure patient safety.
WARNING Patient harm and equipment damage risk. Carefully route patient cabling to reduce the possibility of patient entanglement or strangulation. When transporting the monitor on a mobile stand, properly secure all patient cables and cords to keep them clear of the wheels and to minimize trip hazards.
WARNING For operator and patient safety, peripheral equipment and accessories that can come in direct patient contact must comply with all applicable safety, EMC, and regulatory requirements.
WARNING All signal input and output (I/O) connectors are intended for connection of only devices complying with IEC 60601-1, or other IEC standards (for example, IEC 60950), as applicable to the monitor.
Connecting additional devices to the monitor may increase chassis or patient leakage currents. To maintain operator and patient safety, consider the requirements of IEC 60601-1. Measure the leakage currents to confirm that no electric shock hazard exists.
WARNING Equipment failure and patient harm risk. Do not cover the air intake or exhaust vents on the rear and base of the monitor. Covering these vents could cause overheating of the monitor or muffling of alarms.
WARNING Cross-contamination or nosocomial infection risk. Clean and disinfect the monitor on a routine basis according to your facility's protocols and standards or local regulations. Thorough hand-washing before and after contact with patients greatly reduces the risk of cross-contamination and nosocomial infection.
WARNING For patient safety, do not use the monitor or any accessory during MRI scanning. Induced current could cause burns.
Directions for use About warnings and cautions 19
WARNING When the monitor is not conected to a secondary alarm system during continuous monitoring, check the monitor regularly to receive patient data, alarms, and alerts.
WARNING Patient safety risk. The EarlySense system is not intended for high-risk patients in coronary or respiratory distress who require continuous monitoring of heart function or CO2. For these patients, the most reliable method of patient monitoring involves close personal surveillance and/or equipment suited to that type of monitoring.
WARNING Patient injury risk. The decision to use the NIBP module on pregnant or pre-eclamptic patients is at the discretion of the trained clinician using the equipment.
WARNING Patient injury risk: The decision to use this device with children, or pregnant or nursing women is at the discretion of the trained clinician using the equipment.
WARNING Personal injury risk. The power cord is the disconnect device to isolate this equipment from supply mains. Position the equipment so that it is not difficult to reach to disconnect the cord.
WARNING Patient injury risk. This device is suitable for use with highfrequency surgical equipment but does not provide any additional means of protection.
WARNING Safety risk and potential shock hazard. For accessories that use a USB cable to connect to the monitor, disconnect the USB cable from the monitor when you disconnect the accessory.
WARNING Personal/patient injury risk. Wall Mount must be mounted using the appropriate hardware for the type of wall structure. Your facility may need to provide the appropriate hardware needed to install for your type of wall structure.
WARNING Personal/patient injury risk. Only authorized Welch Allyn service personnel or a Biomedical engineer should attach or remove the device from the wall mount.
WARNING Personal/patient injury risk. Any modification made to a Welch
Allyn mounting solution removes Welch Allyn from responsibility or liability and voids the warranty.
WARNING Personal/patient injury risk. Welch Allyn is not responsible for the integrity of any installation not performed by authorized Welch Allyn service personnel.
WARNING Personal/patient injury risk. Welch Allyn is not responsible for the integrity of any wall structure or wall mounting interface. Welch Allyn recommends that you contact your Biomedical Engineering Department or maintenance service to ensure professional installation, safety, and reliability of any mounting accessory.
CAUTION Position the wall mount so that the screen, controls, and connectors are accessible and support optimal and ergonomic use of the device.
20 About warnings and cautions Welch Allyn Connex ® Devices
CAUTION United States Federal law restricts this monitor to sale, distribution, or use by or on the order of a physician or licensed healthcare professional.
CAUTION Electromagnetic interference risk. The monitor complies with applicable domestic and international standards for electromagnetic interference. These standards are intended to minimize medical equipment electromagnetic interference. Although this monitor is not expected to present problems to other compliant equipment or be affected by other compliant devices, interference issues still may occur. As a precaution, avoid using the monitor in close proximity to other equipment. In the event that equipment interference is observed, relocate the equipment as necessary or consult manufacturer's directions for use.
CAUTION Use only a Class I (grounded) AC power supply cord for powering this monitor.
CAUTION Do not use a long press of to power down the monitor when it is functioning normally. You will lose patient data and configuration settings.
CAUTION Never move the monitor or mobile stand by pulling on any of the cords as this may cause the monitor to tip over or may damage the cord. Never pull on the power cord when removing it from the power outlet. When disconnecting the power cord, always grasp the attachment plug and not the cord. Keep the cord away from liquids, heat, and sharp edges. Replace the power cord if the strain relief or cord insulation is damaged or begins to separate from the attachment plug.
CAUTION Use only the Welch Allyn USB client cable to connect a laptop computer to the USB client port. Any laptop connected to the monitor must be running on a battery, a 60601-1-compliant power supply, or a 60601-1compliant isolation transformer. While monitoring a patient, you can only charge the laptop battery if it is connected to 60601-1-compliant, isolated
AC power.
CAUTION If the touchscreen is not responding properly, refer to the troubleshooting section. If the problem cannot be resolved, discontinue use of the monitor and contact an authorized Welch Allyn service center or qualified service personnel.
CAUTION Verify patient identity on the monitor after manual or barcode entry and before printing or transferring patient records.
CAUTION Keep the monitor outside of MRI suites and any areas marked for high magnetic or electric field strength.
CAUTION Do not use the Suretemp to take or monitor the patient’s temperature during defibrillation or electrosurgery. This may damage the temperature probe.
CAUTION Before weighing a patient on any weight scale connected to the monitor, disconnect all sensors from the patient. Doing so ensures an accurate weight measurement and significantly reduces electrostatic discharges that might disrupt the monitor.
Directions for use About warnings and cautions 21
Integrated Wall System warnings and cautions
In addition to the preceding warnings and cautions, consider the following when using the Integrated Wall System.
WARNING Liquids can damage electronics inside the Connex IWS.
Prevent liquids from spilling on the wall system.
If liquids are spilled on the wall system:
1. Power down the wall system.
2. Disconnect the power plug.
3. Remove the wall system from the wall.
4. Remove battery pack from the wall system.
5. Dry off excess liquid from the wall system.
Note If liquids possibly entered the wall system, remove the wall system from use until it has been properly dried, inspected, and tested by qualified service personnel.
6. Reinstall battery pack.
7. Mount the wall system on the wall.
8. Power on the wall system and verify that it functions normally before using it.
WARNING The physical assessment instruments (handles) are designed for intermittent use. On-time should not exceed 2 minutes. Allow at least
10 minutes off-time between patients.
CAUTION Welch Allyn is not responsible for the integrity of any wall mounting interface. Welch Allyn recommends that you contact your
Biomedical Engineering Department or maintenance service to ensure professional installation, safety, and reliability of any mounting accessory.
CAUTION Do not use the Suretemp to take or monitor the patient’s temperature during defibrillation or electrosurgery. This may damage the temperature probe.
22 About warnings and cautions Welch Allyn Connex ® Devices
ECG module warnings and cautions
In addition to the preceding warnings and cautions, consider the following when using the ECG module.
WARNING Liquids can damage electronics inside the ECG module.
Prevent liquids from spilling on the ECG module.
If liquids are spilled on the ECG module, remove it from service.
Note The module provides no protection against liquid ingress.
WARNING Do not operate the Connex device and ECG module near equipment that emits strong electromagnetic or radio-frequency signals.
Electronic equipment of this type can cause electrical interference with device operation, which can distort the ECG signal and prevent accurate rhythm analysis.
WARNING Patient safety risk. Life-threatening arrhythmias can trigger one of two optional high alarm tones for ventricular tachycardia (V-Tach), ventricular fibrillation (V-Fib), and asystole. If you are monitoring a patient for life-threatening arrhythmias, verify the alarm tone that your facility or floor has chosen.
WARNING Patient injury risk. Do not perform waveform analysis on the
ECG acquisition display as these ECG representations are not true to scale.
Make manual measurements of ECG intervals and magnitudes on printed
ECG reports only.
WARNING The arrhythmia analysis program is intended to detect V-Tach,
V-Fib, and asystole. It is not intended to detect other arrhythmias.
Occasionally it may incorrectly identify the presence or absence of an arrhythmia. Therefore a physician must analyze the arrhythmia information in conjunction with other clinical findings.
WARNING Arrhythmia detection (for V-Tach, V-Fib, and asystole) and impedance respiration are not intended for neonatal patients.
WARNING Computer-assisted ECG data acquisition and interpretation is a valuable tool when used properly. However, no automated interpretation is completely reliable and a qualified physician shall review the interpretations before treatment, or non-treatment, of any patient. The ECG module must be used in conjunction with clinical signs and symptoms. This device is only intended to be an adjunct in patient assessment. Certain arrhythmias or pacemaker signals could adversely affect heart rate indications or alarms.
WARNING Patient injury risk. The data captured from this device should not be used as a sole means for determining a patient’s diagnosis or prescribing treatment.
Directions for use About warnings and cautions 23
WARNING Physiological variations in the patient population generate a nearly infinite range of possible ECG waveform morphologies. In some cases, the Connex device occasionally may not alarm or alarm inappropriately for some arrhythmia (V-Tach, V-Fib and asystole) waveforms. It is the operator 's responsibility to set alarm limits as appropriate for each individual patient. High risk patients must be kept under close surveillance.
WARNING For patients with a pacemaker, maintain a minimum of 6 inches between the device and pacemaker. Power down the ECG module immediately and provide appropriate patient care if you suspect the ECG module has affected the pacemaker.
WARNING Patient safety risk. Use of impedance respiration monitoring can affect the operation of some pacemakers. Keep pacemaker patients under close observation. If pacemaker operation is affected, turn off impedance respiration.
WARNING Impedance respiration must be disabled when using ECG wrist clip electrodes.
WARNING Inaccurate measurement risk. Impedance respiration monitoring is not reliable when ECG electrodes are placed on the limbs.
WARNING Patient safety risk. Correctly set pacemaker detection and keep pacemaker patients under close observation. A pacemaker pulse can be counted as a QRS, which could result in an incorrect heart rate and failure to detect cardiac arrest and some life-threatening arrhythmias (V-
Tach, V-Fib, and asystole). If your patient has a pacemaker, turn pacemaker detection ON to avoid this hazard.
WARNING Inaccurate measurement risk. When an external pacemaker is being used on a patient, arrhythmia monitoring (to detect V-Tach, V-Fib and asystole) is severely compromised due to the high energy level in the pacemaker pulse. This may result in the arrhythmia algorithm’s failure to detect pacemaker non-capture or asystole.
WARNING Patient safety risk. Implantable pacemakers, which are minuteventilation-rate adaptive, can occasionally interact with the impedance respiration measurement of cardiac monitors causing the pacemakers to pace at their maximum. Keep pacemaker patients under close observation.
WARNING Inspect device and accessories before each use. Use only
Welch Allyn approved accessories. Peripheral equipment and accessories that touch the patient must comply with all appropriate safety, EMC, and regulatory requirements.
WARNING Frequently inspect—electrically and visually—all cables, sensors, and electrode wires. Replace any damaged cables, sensors, or wires. Failure to properly inspect and keep in excellent working order all cables, sensors, and electrode wires can result in hazards to patients and to equipment failure and damage.
WARNING Always keep patient motion to a minimum. Motion artifact can cause inaccurate measurement of patient vital signs.
24 About warnings and cautions Welch Allyn Connex ® Devices
WARNING The conductive parts of electrodes and associated connectors for type BF or CF applied parts, including neutral electrode, should not contact other conductive parts including earth.
WARNING Skin irritation may result from the continuous application of the
ECG electrodes. Examine the skin for signs of irritation or inflammation and avoid placing the electrode in those areas. If you observe skin irritation, replace the electrodes or change the location of the electrodes every 24 hours.
WARNING Connect patient lead wires only to the patient electrodes.
WARNING Patient safety risk. The most important aspect of obtaining a quality electrocardiogram is a proper electrode hook-up. Failure to properly apply the electrodes and patient cable may result in noisy signal, false alarms, or sub-optimal electrocardiogram analysis, which could cause patient harm. Any of these events could potentially contribute to patient harm.
WARNING Patient injury risk. Use only accessories approved by Welch
Allyn, including electrodes, lead wires, and patient cables. These approved accessories are required for electrical protection of the patient during cardiac defibrillation. Refer to the accessory list or www.welchallyn.com.
WARNING Patient injury risk. Use only ECG cables supplied or specified by Welch Allyn. Use of any other ECG cables can negate defibrillator protection and can create a risk of patient injury due to shock.
WARNING To avoid serious injury or death, take precautions consistent with good clinical practice during patient defibrillation:
• Avoid contact with the electrocardiograph, patient cable, and patient.
• Place defibrillator paddles properly in relation to electrodes.
WARNING To avoid serious injury or death, take precautions consistent with good clinical practice during patient defibrillation:
• Before defibrillation, verify that patient leads are properly connected to the patient and the ECG module. Loose ECG leads can divert defibrillator current.
• After defibrillation, pull each patient lead out of the patient cable and inspect the tips for charring (black carbon marks). If there is any charring, the patient cable and individual leads must be replaced. If there is no charring, fully reinsert the leads into the patient cable. (Charring can occur only if a lead is not fully inserted into the patient cable before defibrillation.)
WARNING Electric shock hazard. Before cleaning the monitor, disconnect the AC power cord from the mains outlet and the power source.
WARNING This equipment must not be connected to any other equipment that is not compliant with EN60601-1. The combined leakage currents could exceed safe limits.
WARNING Use of accessories, transducers, and cables other than those specified may result in degraded electromagnetic compatibility performance of this device.
Directions for use About warnings and cautions 25
WARNING Do not operate this product with MRI (Magnetic Resonance
Imaging) equipment.
WARNING When using ECG Wrist Clip electrodes, although a normal
Lead I QRS waveform is produced on the monitor, this waveform should not be used for serious clinical interpretation because the electrodes are not properly triangulated around the patient 's heart.
WARNING Inaccurate measurement risk. To use ECG wrist clip electrodes effectively, consider the following:
• The size of ECG wrist clip electrodes is fixed; you cannot adjust it.
• Proper orientation of the clip with the monitor depends on repositioning the clip until you achieve a snug fit.
• The preferred position of the clip is the patient's wrist, but you can move it up the patient's arm toward the torso.
• The clip might not work with patients who have small wrists and arms.
• Exercise caution when placing the clip so that it doesn't impede circulation along the patient's wrist and arm.
• If you cannot achieve a snug fit with the wrist clip, use some other method to monitor ECG.
WARNING Do not pause or turn off an audible alarm if the patient safety might be compromised.
WARNING Always ensure that the appropriate electrode placement is employed for the lead configuration selected.
WARNING The ECG module should not be used on patients who are linked to heart lung machines.
WARNING If an electrosurgical unit is used, place the ECG cable and wires as far as possible from the site of the surgery and from the electrosurgical cables. This will minimize interference and the risk of burns to the patient. Ensure that the electrosurgical return cable (neutral) is well attached and making good contact with the patient.
WARNING Patient injury risk. To prevent cross-contamination and the spread of infection:
• Dispose of single-patient use components (for example, electrodes) after use.
• Regularly clean and disinfect all components that come in contact with patients.
• Reprocess the device accessories (for example, patient cable, leads, and reusable electrodes) between patients.
CAUTION Never use acetone, ether, freon, petroleum derivatives, or other solvents to clean the ECG Module. Never immerse the ECG module or the patient cable in liquid. Never autoclave or steam clean the ECG module or the patient cable. Never pour alcohol directly on the ECG module or the patient cable, and never soak any components in alcohol. If any liquid enters the ECG module, remove the ECG module from service, and have it inspected by a qualified service person before using it again.
26 About warnings and cautions Welch Allyn Connex ® Devices
CAUTION Verify that dates on applicable accessories have not expired.
CAUTION Connect the USB cable to the Connex device in a manner that minimizes entangling.
CAUTION To prevent accidental loosening of the USB cable and the potential loss of ECG connection to the device, you must close the door and tighten the screw on the Connex Vital Signs Monitor and tighten the cable retention screw on the Connex Integrated Wall System to secure the cable in place.
Physical design
Vital Signs Monitor 6000 Series
Standard and extended monitors
The monitor is available in two sizes: standard and extended. The primary difference between these models is the number of parameters they support.
Note Your monitor, based on size or configuration, might not contain all parameters or features illustrated in this section.
In a standard monitor, up to two parameter modules are installed on the left side. You can tell which modules are installed based on the connectors visible on the outside of the device. The following image shows a standard monitor with pulse-oximetry and blood-pressure modules.
Standard monitor left side
27
28 Physical design Welch Allyn Connex ® Devices
The extended version can have a maximum of three modules (such as CO2, pulse oximetry, and blood pressure) on the left side.
Extended monitor left side
If the extended monitor is configured with EarlySense, it has an additional module on the right side.
Extended monitor right side
Equipment setup and basic monitor functions are the same for both models, unless otherwise noted in the directions for use.
Controls, indicators, and connectors
The following diagrams show a full-featured monitor. Your monitor, based on size or configuration, might not contain all of these features.
Directions for use
Top-Left-Front view
Physical design 29
No. Feature
1 Printer
2 Light bar
3 Thermometry
4 Thermometry
5 Thermometry (connector behind cover)
6 LCD screen
7 Battery compartment (behind cover)
8 Blood pressure
9 Pulse oximetry
10 CO2
11 CO2
Description
Printer provides a printout of patient and device information.
Provides a visual alarm with red and amber LEDs.
Temperature probe cover box.
Temperature probe.
Secures the probe connection to the monitor.
1024 x 600 pixels color touchscreen provides a graphical user interface.
Houses the lithium-ion battery.
Supports dual-lumen or single-lumen hoses.
Nellcor or Masimo rainbow SET module.
The Nellcor module measures SpO2 and pulse rate.
The Masimo module measures SpO2, pulse rate, SpHb, and RRa.
Note SpHb and RRa are optional parameters but cannot be configured together.
Note Monitors configured with RRa cannot be configured with CO2.
CO2 sampling exhaust port.
CO2 sampling input connector (behind cover).
30 Physical design
Right-Back-Bottom view
1
Welch Allyn Connex ® Devices
2
3
4
5
6
13
12
11
No. Feature
1 Power switch and LED
10
2 Ethernet RJ-45
3 USB client
4 Nurse call
5 Fan exhaust
6 Ground lug (equipotential terminal)
7 Power connection
8 Mobile stand mounting hardware
9 Recess for mounting plate
10 USB connector door
11 Fan intake
12 Speaker
9 8 7
Description
Power-on/Display power-saving button.
The LED indicates the charging status when the monitor is connected to AC power:
• Green: The battery is charged.
• Amber: The battery is charging.
Provides a hardwired connection to the computer network.
Provides a connection to an external computer for testing and software upgrades.
Provides a connection to the hospital nurse call system.
Exhaust vents cool the monitor.
Provided for electrical safety testing and as a means for connection of a potential-equalization conductor.
Provides an external AC power connection.
Secures the mounting plate to the monitor.
Secures the monitor when the monitor is mounted on the mobile stand or wall.
Provides access to host USB connections for optional accessories.
Fan intake vents draw in air to cool the monitor.
Provides tones.
Directions for use Physical design 31
No. Feature
13 Patient movement
Description
The EarlySense module monitors patient movement, respiration
(RR), and pulse rate.
Note Monitors configured with RRa and CO2 cannot be configured with EarlySense.
Integrated Wall System
Controls, indicators, and connectors
Note
Front view
Your model might not contain all of these features.
No. Feature Description
1 Physical assessment instruments - Handles and handle cradles
Handles will accept any 3.5V Welch Allyn instrument head.
The handle cradles support using one handle at a time. A handle turns on automatically when you remove it from a cradle and turns off when you return it.
2 Rheostat
3 Exhaust vents
4 LCD screen
5 Storage compartment
Located on each handle. Turn clockwise to increase light output; turn counterclockwise to decrease light output.
Exhaust vents cool the monitor.
1024 x 600 color touchscreen provides a graphical user interface.
6 Expansion slots
Provides covered storage for additional probe covers and other small accessories.
Provide space to add modules.
7 SureTemp® Plus thermometer probe covers Support temperature measurements from oral, axillary, and rectal sites.
8 SureTemp® Plus thermometer probe Supports temperature measurements from oral, axillary, and rectal sites.
9 Braun ThermoScan® PRO thermometer and dock
Support temperature measurements from the ear. Dock charges the thermometer battery.
32 Physical design Welch Allyn Connex ® Devices
No. Feature
10 SureTemp® Plus thermometer connector
11 Blood pressure and pulse oximetry
12 Power switch and LED
Description
Secures the probe connection to the wall system.
See front underside view for more detail.
Power-on/Standby switch.
The LED indicates the charging status when connected to AC power:
• Green: The battery is charged.
• Amber: The battery is charging.
13
14
15
16
USB/Comms cover
Light bar
Speaker
Specula dispenser
Houses light bar.
Provides access to host USB connections for optional accessories and some routing for cords and cables.
Provides a visual alarm with red and amber LEDs.
Provides tones.
Dispenses KleenSpec® disposable specula in pediatric (2.75 mm) and adult (4.25 mm) sizes.
Front underside views
(Left: USB/Comms cover attached; Right: USB/Comms cover removed)
1 Retention screws
2 Blood pressure
3 Pulse oximetry
4 USB-to-computer connector
5 Power connection
6 Ground lug (equipotential terminal)
7 USB connectors
Supports removing and attaching USB/Comms cover.
Self-contained module for easy replacement. Supports duallumen or single-lumen hoses.
Optional Nellcor (SpO2) or Masimo Rainbow SET (SpO2 or combined SpO2/SpHb) in a self-contained module for easy replacement.
Provides a connection to an external computer for testing, data transfer, and software upgrades.
Provides an external AC power connection.
Supports electrical safety testing; terminal for connecting a potential equalization conductor.
Provides access to host USB connections for optional accessories.
Directions for use
No. Feature
8 USB cable retainer
Back view
Physical design 33
Description
Reduces strain on USB cables and connectors; helps prevent cables from disconnecting.
1 Recess for mounting bracket
2 Ethernet RJ-45
3 Li-ion battery
4 Nurse call
Accessory bin
Secures the monitor when mounted on the wall.
Provides a hardwired connection to the computer network.
Provides backup power to wall system.
Provides a connection to the hospital nurse call system.
1 Accessory bin
2 SpO2 holder
Stores accessories and organizes cables.
Provides location to wrap SpO2 cable and attach SpO2 finger clip.
34 Physical design
No. Feature
Mounting materials
Description
Welch Allyn Connex ® Devices
1 Wall mounting rail bracket and hardware
2 Accessory bin mounting bracket and hardware
Secures the wall system to the wall.
Secures accessory bin to the wall and provides routing and strain relief for power cord.
Setup
Vital Signs Monitor 6000 Series
Supplies and accessories
For a list of all approved supplies and accessories, see Approved accessories in the
Appendix.
Insert the battery
This procedure applies to first-time setup of the monitor.
WARNING Risk of fire, explosion, and burns. Do not short-circuit, crush, incinerate, or disassemble the battery pack.
1. Turn the monitor upside down to access the battery cover.
2. Locate the battery cover, indicated by .
3. Insert a coin into the slot and push to open. Choose a coin that fits comfortably into the slot.
35
4. Slide in the battery.
36 Setup Welch Allyn Connex ® Devices
Note Do not remove the tab label from the battery. This tab helps you remove the battery from the compartment when you need to replace it.
5. Replace the battery cover by inserting one end into the notched access and then pressing firmly on the opposite end.
Note New batteries are only 30 percent charged. Therefore, connect the monitor to AC power immediately after inserting a new battery.
Mount the monitor
You can install the monitor on a mobile stand or on an interior wall equipped with a
Welch Allyn-approved wall-mount fixture.
Check the mounting bracket
Before you mount the monitor, make sure the stand or wall-mount fixture has the mounting bracket designed for your monitor. Monitors with a standard housing require a small bracket. Monitors with an extended housing require a large bracket.
Small bracket for standard housing Large bracket for extended housing
Note If your monitor has an extended housing but the small bracket is installed on your stand or wall-mount fixture, you must replace the small bracket with the large bracket. Follow the steps presented in the Mounting Bracket
Replacement Install Guide shipped with the large bracket, and then proceed to mount the monitor.
Directions for use Setup 37
Mount the monitor on a stand
1. Align the monitor on the mounting bracket in the center of the stand tray. Slide the monitor into place, catching the bracket in the guides on the bottom of the monitor.
2. Ensure that the monitor is properly seated on the bracket. If you can raise either side of the monitor off the stand, it is not seated properly. Repeat step 1 until the monitor is mounted correctly.
3. Tighten the screw on the bracket into the screw hole on the back of the monitor.
Mount the monitor on the wall
For mounting instructions, see the wall mount manufacturer's assembly instructions.
Attach the probe well
1. Align the probe well with the tabs facing up and down and insert the probe well into the temperature module.
The probe well snaps into place when it is fully seated.
2. Insert the temperature probe into the probe well.
38 Setup Welch Allyn Connex ® Devices
Attach the temperature probe
CAUTION The temperature module only operates with the probe well properly in place.
1. Remove the cover of the temperature module by pressing the tab on the bottom and sliding the cover to the right. The cover is located at the bottom-right of the monitor, below the probe well.
2. Hold the temperature probe cable connector with the spring tab on the right and insert it into the probe port of the temperature module.
3. Push it into place until it clicks.
4. Reattach the cover. Use the alignment tab and slide the cover to the left to click it back into place.
Remove the temperature probe and well
Follow these steps to disconnect the probe cable and remove the probe well.
1. Remove the cover of the temperature module by pressing the tab on the bottom and sliding the cover to the right. The cover is located at the bottom-right of the monitor, below the probe well.
Directions for use Setup 39
2. Depress the spring tab on the temperature probe cable connector and withdraw it from the probe port.
3. Reattach the cover. Use the alignment tab and slide the cover to the left to click it back into place.
Grasp the probe well and pull it up to remove it from the monitor.
Connect the NIBP hose
1. Place your thumb and forefinger on the hose connector and squeeze the side tabs.
2. Align the hose connector with the hose connector port on the side of the monitor.
3. Insert the hose connector, pressing firmly until it clicks into place.
Disconnect the NIBP hose
1. Place your thumb and forefinger on the hose connector.
Note Always grasp the hose by the connector. Do not pull on the hose itself.
2. Squeeze the side tabs until the connector releases.
3. Pull the connector away from the connector port.
Connect the SpO2 cable or the SpO2/RRa dual cable
WARNING Patient injury risk. Do not use a damaged sensor or pulse oximetry cable or a sensor with exposed electrical or optical components.
Follow these steps to connect the SpO2 cable or the SpO2/RRa dual cable to the SpO2 port on the monitor. The location of the port on your monitor might differ from that shown in the images below.
Note
Note
For monitors configured with SpHb, the sensor used to monitor SpHb also measures SpO2.
SpHb and RRa cannot be configured together.
Connect the SpO2 cable
40 Setup Welch Allyn Connex ® Devices
1. Place your thumb and forefinger on the cable connector and squeeze the side tabs.
2. Align the cable connector with the cable connector port.
3. Insert the cable connector, pressing firmly until it clicks into place.
Connect the SpO2/RRa dual cable
Note Monitors configured to measure acoustic respiration (RRa) require a dual cable as shown below. The dual cable connects to the device with one connector but splits into two separate cables at the other end to support
RRa and SpO2 measurement.
1. Connect the dual cable to the device as shown in the preceding steps. (The connector is the same as for the standard SpO2 cable.)
2. Align the RRa dual cable connector and the RRa acoustic respiration sensor connector so that the arrow labels point toward each other. Insert the RRa dual cable connector into the RRa sensor connector until it locks into place.
3. Open the SpO2 dual cable connector's protective cover and align the arrow on this connector with the arrow on the SpO2 sensor cable connector. Insert the SpO2
Directions for use Setup 41 sensor cable connector into the SpO2 dual cable connector, and then close the protective cover.
Note Arrows appear on the dual connector as well as on the sensor connectors to ensure proper cable connections.
Note Typically, a clinician will connect the single-use RRa sensor to the RRa patient cable at the start of acoustic respiration monitoring. See the sensor manufacturer’s directions for use for more information. Also see the
Acoustic Respiration rate (RRa) section of this directions for use.
Disconnect the SpO2 cable or the SpO2/RRa dual cable
1. Place your thumb and forefinger on the cable connector.
Note Always grasp the cable by the connector. Do not pull on the cable itself.
2. Squeeze the side tabs until the connector releases.
3. Pull the connector away from the connector port.
Connect the patient movement cable
1. Align the EarlySense cable connector with one of the EarlySense ports on the right side of the monitor.
2. Insert the cable connector until it clicks into place. Also check the stress relief connector on the cable to ensure that both parts of the cable are tightly connected.
3. When you are ready to monitor a patient, position the bed sensor (sensing unit) as follows:
• horizontally under the patient's mattress
• the top surface of the sensing unit facing the mattress
• the sensing unit under the patient's chest area
• the sensing unit cable extending toward the head of the bed
42 Setup Welch Allyn Connex ® Devices
Note Typically, a clinician will connect the bed sensor and cable at the start of patient movement monitoring. See the Patient movement section of this directions for use for more information.
Disconnect the patient movement sensor and cable
To disconnect the EarlySense bed sensor, pull the sensor cable connector out of the cable connector port on the device.
Attach a USB accessory
CAUTION Accessories attached to this monitor must run on battery power. Do not use any accessory's external power supply when it is attached to the monitor.
1. On the rear of the monitor, loosen the screw on the USB door and open it.
Note On some monitor stands, the monitor mounting bracket partially overlaps the USB door. If you observe this overlap, loosen the screw on the monitor mounting bracket and shift the monitor forward just enough on the bracket to open the
USB door, then slide the monitor back on the mounting bracket.
2. Attach each accessory's USB cable into an unused USB port on the monitor. See the accessory's directions for use for any special instructions.
CAUTION Connect cables in a manner that minimizes entangling.
3. Close the door and tighten the screw.
Directions for use Setup 43
Note If you loosened the monitor mounting bracket in order to open the USB door, shift the monitor forward on the bracket as you did in step 1, close the door, and then slide the monitor back into its mounted position. Ensure that the monitor is seated firmly on the bracket, then tighten the screw on the bracket into the screw hole on the back of the monitor. (See "Mount the monitor on a stand" in this section for more detail.)
Note Some accessories require a license to enable them for use. These accessories are packaged with an authorization code and instructions for activating the license using the Welch Allyn Service Tool. For more information, refer to the instructions and the service tool installation guide.
Detach a USB accessory
1. On the rear of the monitor, loosen the screw on the USB door and open it.
2. Detach the accessory's USB cable from USB port on the monitor.
3. Close the door and tighten the screw.
Insert a new roll of paper
The printer is located on the top of the monitor. Follow these steps to insert the roll of printer paper:
1. Grasp the two tabs on the printer door and pull up to open.
2. Insert a new roll of paper.
Note The paper roll must be installed so that it unwinds from the bottom of the roll, as illustrated. If the paper roll is not installed correctly, the printer will not print properly.
3. Advance the end of the roll past the roller so that it extends past the printer door, as shown.
44 Setup Welch Allyn Connex ® Devices
4. With one hand, pull lightly on the paper to take up any slack. With the other hand, close the printer door by pushing it down and into place until it clicks.
Be certain that the paper does not catch in the printer door.
Connect AC power
You can use the monitor with AC or battery power (after fully charging the battery).
WARNING Shock hazard. Inspect the AC cord for exposed copper before touching the cord.
CAUTION During continuous monitoring, keep the monitor connected to
AC power at all times. If only battery power is available, you must remain in the room with any patient whose vital signs are being monitored continuously. Actively monitor both patient and battery status to ensure patient safety.
1. Insert the power cord into the AC power connector port on the back of the monitor.
2. Insert the power plug into an electrical outlet to power the monitor and to charge the battery.
Disconnect AC power
Carefully grasp the power plug and disconnect it from the power outlet. To avoid damaging the power cord, do not pull on the cord itself.
Directions for use Setup 45
Integrated Wall System
CAUTION Welch Allyn is not responsible for the integrity of any wall mounting interface. Welch Allyn recommends that you contact your
Biomedical Engineering Department or maintenance service to ensure professional installation, safety, and reliability of any mounting accessory.
Supplies and accessories
For a list of all approved supplies and accessories, see Approved Accessories in the
Appendices.
Unpack the wall system
This procedure applies to first-time setup of the wall system.
CAUTION You must follow these instructions exactly to ensure safety and ease of assembly.
CAUTION Do not remove any packing materials around the wall system until the instructions tell you to do so.
1. Lift the wall system out of the box by the cardboard handles.
2. With the wall system still in its packing material, place it onto a table or flat work surface and remove it from the plastic bag.
3. Turn the wall system over so that back of the wall system faces up.
46 Setup Welch Allyn Connex ® Devices
Insert the battery
This procedure applies to first-time setup of the wall system. Therefore, the wall system is assumed to be shut down.
WARNING Risk of fire, explosion, and burns. Do not short-circuit, crush, incinerate, or disassemble the battery pack.
1. Locate the battery compartment, indicated by .
2. Insert the battery. (The battery is in a pink anti-static bag in the accessory box.)
Directions for use Setup 47
Prepare for mounting
1. Slide the mounting rail bracket out of the packing material and put it aside. Do not discard. Then flip the wall system onto its back.
2
1
2. Remove the cardboard end caps and all foam as shown and put aside for recycling.
CAUTION Do not remove the cardboard securing the handles on the left side of the wall system at this time. The cardboard prevents damage to those instruments during the mounting process.
Mounting hardware inventory
Use these items to mount the wall system.
48 Setup Welch Allyn Connex ® Devices
• Mounting rail bracket
• Accessory bin bracket
• Screws
6 x
Tools list
Use these tools to mount the wall system.
• #2 Phillips screwdriver
• level
• tape measure
• stud finder
• drill
• 1/8-inch (3.17 mm) diameter drill bit
Mounting location
Before mounting the wall system, consider the following recommendations to determine the best mounting location:
• Mount the wall system to studs.
• Mount the wall system within reach of the AC power outlet. The power cord is 8 ft.
(2.44 m) long.
• Avoid brightly lit areas.
• Blood pressure tubing is 8 ft. (2.44 m) long.
• Position the wall system so that all instruments are accessible and in a location that allows for ergonomic examinations.
Sample room layout r
1
2
1.
Connex Integrated Wall System
2.
Examination table
Mount the wall system
1. On the selected wall, find and mark the studs, and choose the system height and corresponding height for the mounting rail bracket.
Directions for use Setup 49
Recommendation: Place the mounting rail bracket 63 in. (1.6 m) from the floor, which places screen center height at approximately 63 in. (1.6 m) from the floor.
CAUTION This drawing shows the physical relationships of the mounting brackets to each other and to the wall system after you complete the mounting instructions. Do not place the wall system on the wall until you have completed all preliminary steps.
2. Affix the mounting rail bracket to three studs at the selected height using the available screws (anchors are provided for additional support).
CAUTION Ensure that the upper "lip" of the bracket sticks out from the wall and that the bracket is level.
3. Route the power cord through the channel in the back of the accessory bin bracket, then mount the bracket on the center stud at least 13 in. (33 cm) below the mounting rail bracket.
50 Setup Welch Allyn Connex ® Devices
4. Before mounting the wall system, remove the cover by loosening the captive retention screws.
5. Hang wall system on the mounting rail bracket.
WARNING Ensure that the ribs on the back of the wall system fully engage the mounting rail bracket. The wall system should be level and flush to the wall.
Directions for use Setup 51
6. Select one of the three available slots at the bottom of the unit that overlaps a stud, and secure the unit to the stud with the remaining screw.
WARNING Failure to install this security screw may result in personal injury and equipment damage.
7. If the wall unit is configured for SpO2 or SpHb, connect the sensor cable and route it through the channel above the security screw you just installed.
52 Setup Welch Allyn Connex ® Devices
8. Re-attach the cover.
a. Thread the sensor cable through the cutouts on the top right and bottom left of the cover.
b. Tighten the two retention screws.
9. Attach the system power cord to the wall unit. Do not plug the cord into an outlet at this time.
Mount the accessory bin
1. Mount the accessory bin on the accessory bin bracket, then loosely wrap the excess power cord around the accessory bin bracket.
Directions for use Setup 53
2. If your wall system is configured for SpO2 (or SpHb), attach the spool to the accessory bin by sliding the spool onto the retention clip.
3. Properly orient and insert the sensor cable into the patient cable connector. (You just connected the opposite end of the sensor cable to the wall system.) Ensure the sensor cable is inserted completely, then close the protective cover. (See the sensor manufacturer's directions for use.)
4. Wrap the excess patient cable around the spool, and place the finger clip in the holder. Also observe the maximum safe working load limit noted here when filling the bin.
54 Setup Welch Allyn Connex ® Devices
Connect the blood pressure (NIBP) hose
1. Align the hose connector with the hose connector port on the bottom of the monitor.
2. Insert the hose connector, pressing firmly until it clicks into place.
3. Attach a blood pressure cuff to the tubing (see the cuff manufacturer's directions for use), then store the cuff in the accessory bin.
Set up the physical assessment instrument handles and specula dispenser
1. Attach the specula dispenser. Ensure that the keyhole locking slots on the back of the dispenser engage the locking screws on the wall system, then push down firmly.
2. Remove cardboard securing instrument handles.
Directions for use Setup 55
3. Attach Welch Allyn 3.5V instrument heads of your choice to the handles. See the directions for use for each instrument head.
Set up the SureTemp® Plus thermometer
If your wall system is configured for a SureTemp Plus thermometer, follow these setup instructions.
1. Align the probe well with the tabs facing up and down and insert the probe well into the temperature module.
The probe well snaps into place when it is fully seated.
2. Hold the temperature probe cable connector with the spring tab on the right and insert it into the probe port of the temperature module. Push it into place until it clicks.
3. Insert the temperature probe into the probe well.
4. Open a box of probe covers and place it in the probe cover box holder.
Note Spare boxes of probe covers can be stored in the compartment on the top of the wall system.
56 Setup Welch Allyn Connex ® Devices
Set up the Braun ThermoScan® PRO thermometer
If your system is configured for the Braun ThermoScan thermometer, follow these setup instructions.
1. Remove the thermometer from the package. Then open a box of probe covers and place it in the dock.
2. Remove the thermometer cover, insert the battery, replace the thermometer cover, then place the thermometer in the dock.
1 1
2
2
3. Charge the Braun thermometer for 24 hours before first use.
4. To switch from Celsius to Fahrenheit, see the thermometer manufacturer's directions for use.
Note The Braun ThermoScan PRO 6000 thermometer does not charge during
ECG monitoring. When ECG monitoring stops, the thermometer automatically resumes charging.
Directions for use Setup 57
Note In monitors with an older version of the Communication module (version 4 or earlier), the Braun ThermoScan PRO 6000 thermometer does not charge during ECG monitoring. When ECG monitoring stops, the thermometer automatically resumes charging. See the Settings > Advanced tab to display the Communication module version in your monitor.
Connect AC power
The wall system uses both battery and AC power. After completing all other setup activities, you can apply power to the wall system.
1. Insert the power plug into an outlet to power the monitor and to charge the battery.
Note New batteries are only 30 percent charged. You must plug the wall system into AC power to fully charge the battery.
Do not plug in the power cord until completing all preliminary steps.
2. Proceed to Startup.
Attach an accessory
1. Shut down the wall system and detach the power cord. Then remove the cover from the wall system by loosening the captive retention screws.
2. Loosen the two screws on the cable retention clamp and remove it. Then connect the USB cable(s) to an available connector and thread the cable(s) through the cable guide(s).
3. Replace the cable retention clamp and tighten the two screws.
58 Setup Welch Allyn Connex ® Devices
4. Re-attach the cover.
a. Thread the SpO2 (or SpHb) cable through the cutouts on the top right and bottom left of the cover.
b. Tighten the two retention screws.
5. Re-attach the system power cord and power up the wall system.
Note Some accessories require a license to enable them for use. These accessories are packaged with an authorization code and instructions for activating the license using the Welch Allyn Service Tool. For more information, refer to the instructions and the service tool installation guide.
Startup
Power
The device operates in one of two power states:
• Device powered on. The device is operating on battery power or AC power. You can utilize the device's features, and the display is active.
• Sleep (Display power-saving) mode. The device is operating on battery or AC power, but the display is off to conserve power. Settings for this mode can be changed in the Display tab in Advanced settings.
Note Battery-powered accessories connected to the device continue to charge while the device is in this mode and connected to AC power. However, if you power down the device or disconnect the device from AC power, batterypowered accessories connected to the device do not charge.
The following actions return the display to the active state:
• Touching the screen
• Removing the temperature probe from the probe well
• Attaching the SpO2 sensor to a patient
• Connecting the patient movement cable and bed sensor (sensing unit) to the device
• Attaching a sampling line to a patient
•
Pressing
59
60 Startup Welch Allyn Connex ® Devices
Power on/Display power-saving button
The Power on/Display power-saving button , located on the device housing, performs the following functions:
• Powers up the device
• Opens an onscreen Power-down dialog with options to Power down, Sleep, or
Cancel (brief press)
• Sets the device into Display power-saving (Sleep) mode (brief press followed by 30 seconds of inactivity)
Note The device will not enter the Sleep (Display power-saving) mode while an alarm condition is active or when NIBP intervals or continuous measurements are in progress. The device also exits this mode if an alarm occurs.
The LED in the center of the power plug symbol indicates the battery charging status:
• Green indicates that AC power is present and that the device's battery is fully charged. It does not indicate the charge level of any accessories.
• Amber indicates that AC power is present and that the device's battery is charging. It does not indicate the charge level of any accessories.
Power up the monitor
The monitor runs a brief diagnostic self-test each time it powers up.
WARNING Equipment failure risk. The monitor includes a fan that circulates air through the device. If the fan does not run when you power up the device, remove it from use and inform qualified service personnel immediately. Do not use the monitor until the problem is corrected.
WARNING To ensure patient safety, listen for an audible indicator and watch for visual alerts at power-up at least once daily. Correct any system errors before using the monitor. In addition to the audible indicator, the monitor LED light bar illuminates to alert you of alarms. Amber indicates a low-level alarm. Flashing amber indicates a medium-level alarm. Flashing red indicates a high-level alarm.
WARNING Always observe the monitor during power-up. If any display fails to illuminate properly, or if an error code displays, inform qualified service personnel immediately, or call your nearest Welch Allyn Customer
Service or Technical Support facility. Do not use the monitor until the problem is corrected.
CAUTION Always use the monitor with an adequately charged and properly functioning battery.
CAUTION During continuous monitoring, keep the monitor connected to
AC power at all times.
CAUTION Use only a Class I (grounded) AC power cord for powering this monitor.
1. Press to power up the monitor.
Directions for use Startup 61
Following a successful self-test, the monitor displays the Welch Allyn logo, the LED light bar (located on the handle) flashes, and a power-up tone sounds. The startup screen then appears with the following banner across the bottom.
Note
Note
If patient data was saved during the most recent power down and the device was in the Continuous Monitoring profile, a Confirm patient and location dialog appears with the following options:
• Same patient and location
• Same patient, new location
• New patient
If "Allow profile change" is enabled in Advanced settings and continuous sensors are attached to the device at startup, the device powers up in the Continuous Monitoring profile, overriding other default profile selections.
2. If the Confirm patient and location dialog appears, select the desired option and touch OK .
If a system error is detected, the monitor becomes inactive until you press or until the monitor shuts down automatically. The monitor displays a system fault message that contains a wrench icon and a system fault code to aid service and engineers in diagnosing the problem.
Set the date and time
1. Touch the Settings tab.
2. Touch the Device tab.
3. Touch the Date/Time vertical tab.
4. To change the date and time values: Touch the up and down arrow keys or touch and enter a value.
Repeat for each value you want to change.
Note The date and time stamps on saved patient measurements will adjust in response to new date and time settings.
Power down the monitor
This power-down method, which places the monitor into Standby mode, ensures that patient measurements are retained in the monitor memory for a maximum of 24 hours.
These saved measurements are available for recall or sending electronically to the network. This method also ensures that any configuration settings you have changed and saved will be maintained at the next startup.
1. Touch the Settings tab.
2. Touch the Device tab.
62 Startup Welch Allyn Connex ® Devices
3. Touch Power down .
If there is a software update available, a system message asks if you want to upgrade the software.
4. If you want to upgrade the software, touch OK .
The monitor continues to charge the battery when in Standby mode.
Reset the monitor
If the monitor stops functioning, you can press and hold for approximately 6 seconds to allow the hardware to completely cycle off and to reset the monitor configuration settings to the last saved default power-up configuration. The button is located on the side of the monitor and on the front of the wall system.
CAUTION Do not use a long press of to power down the monitor or wall system when it is functioning normally. You will lose patient data and configuration settings.
Single sign-on (SSO)
Single sign-on (SSO) technology allows users to sign in just once to a network or server and have access to all of their authorized applications without maintaining or entering multiple passwords. If SSO has been implemented in your facility and extended to your
Connex device, you can log on to the device quickly and securely with a simple scan or tap of your ID.
Note
Note
SSO is only available in the Spot Check and Intervals Monitoring profiles. If
SSO is enabled, the Office profile is disabled.
You can capture patient vitals measurements in the Spot Check profile without a clinician login, but clinician login is required to save those vitals measurements.
The Intervals profile requires a clinician login to start intervals monitoring.
Note
Follow the instructions below that apply to your situation to log on to your Connex device.
Enter clinician information (SSO implemented)
In facilities that have implemented SSO, you can use your badge to log on to the device on either the Home tab or the Clinician tab.
Note Badge-only login is only available to authorized users who are registered in the facility.
Note
Note
Note
Badge-only login is only available during the established grace period.
Attempts to log on to the device anywhere but on the Home tab or
Clinician tab will result in a "Badge not accepted" message.
Manually entering clinician information remains an option in all SSO environments.
Directions for use Startup 63
Note After the established grace period expires, you must enter clinician passwords or PINs manually.
1. Touch either the Home tab or the Settings > Clinician tabs.
2. Using the attached scanner or RFID reader, scan or tap your badge.
If the scan/tap is successful, the device authenticates you as an authorized user and displays your Clinician ID in the Device Status area of the Home tab.
Note If you started the login process on the Clinician tab, the device navigates back to Home tab after you authenticate.
3. If the grace period has expired and authentication is unsuccessful, manually enter your system password or PIN in the Authentication pane as prompted, then touch
OK .
The device authenticates you as an authorized user and displays your Clinician ID in the Device Status area of the Home tab.
Note
Note
Note
Note
Note
Note
If another Clinician is logged in and no unsaved vitals or patient data appear onscreen, scanning/tapping your badge logs out that Clinician and logs you in.
If another Clinician is logged in and unsaved vitals and/or patient data appear onscreen, scanning/tapping your badge opens a dialog stating that the patient data and vitals will be cleared. If you touch OK , you will clear the vitals and log out the other clinician. If you touch Cancel , the other
Clinician remains logged in with patient data and vitals intact.
If another Clinician is logged in and unsaved vitals and/or patient data appear onscreen, manually entering your Clinician ID and password/PIN and then touching OK opens a dialog asking if you want to log out the current user. If you touch OK , the device clears the vitals and logs out the other clinician. If you touch Cancel , the other Clinician remains logged in with patient data and vitals intact.
You can use your RFID badge to log out only if you used your RFID badge to log in. If you manually entered your clinician information to log in and then scan or tap your badge, the device treats the scan as a new Clinician login.
Clinician logout is not permitted during an active intervals program.
SSO is not available during continuous monitoring. If SSO was used when the device was in the Spot Check or Intervals Monitoring profile, applying a continuous monitoring sensor to a patient automatically logs out the current user if no patient or vitals information has been captured on the device. If you apply a continuous monitoring sensor to a patient and patient or vitals information has been captured, a dialog window opens, asking if you want to log out the current user. If you touch OK , the device clears the vitals, logs out the current user, and starts continuous monitoring. If you touch Cancel , the current user remains logged in with patient data and vitals intact, and with the same profile active on the device. You can then save the patient and vitals information before using the continuous monitoring sensor.
64 Startup Welch Allyn Connex ® Devices
Enter clinician information (SSO not available)
1. Go to the Clinician tab using one of these methods:
• On the Home tab, touch the Clinician ID section of the Device Status area (top left corner of the screen).
• Touch the Settings > Clinician tab.
2. To enter the clinician name, touch enter characters.
, located at the right of the text field, and
You can enter up to 32 characters for the clinician's first and last name. Enter only 1 character for the middle initial.
3. To enter the clinician ID, use one of these methods:
• Touch and enter the ID.
• Scan the clinician's barcode with a barcode scanner.
Note If "Require clinician ID match to save measurements" is enabled in Advanced settings, a progress indicator appears in the Device Status area as the device queries an external host system for a matching ID.
• An unsuccessful query results in the message, "Unable to identify clinician."
• A successful query results in clinician data replacing the progress indicator according to preferences configured in Advanced settings.
4. If prompted, enter your system password in the Authentication pane.
5. Touch OK to save your entries and return to the Home tab.
Navigation
Home tab
The monitor screen provides the interface that you use to complete your workflow. You access the monitor's features by touching the screen.
The Home tab includes the following areas:
65
Item
1
2
3
Device Status area
Area
Device Status
Content
Navigation
The Device Status area, located at the top of the Home screen, displays the following monitor information, from left to right:
• Clinician identification. The format can be a name, ID number, or icon. Touch this area to navigate to the Clinician login.
• Device location.
66 Navigation Welch Allyn Connex ® Devices
• Time and date. Touch this area to navigate to date and time settings.
• Current profile. Touch this area to navigate to the Profiles vertical tab (on the Device tab), which displays available profiles.
• Connection status (wired or wireless, and central station). The icons indicate which connections, if any, are currently attempted or active.
Icon Connection type or indicator
Ethernet
USB
Wireless
Wireless signal strength
Attempting to connect to the central station
Connected to central station
Not connected to central station
Blank No connection
• Battery condition. Estimated battery capacity is displayed in hour(s):minute(s) format.
Touch this area to navigate to the Device tab, where you can power down the device.
This area also provides interactive alarm and information messages, including a Demo mode active indicator.
Battery status
The battery status indicator displays the state of the battery.
Note Unplugging the power cord does not interrupt power to the device. Battery power runs the device, and AC power charges the battery.
The battery status is represented by icons in the right corner of the Device Status area:
• The monitor is connected to a power outlet and the battery is charging or is fully charged. The estimated charge rate is displayed as a percentage of capacity.
Directions for use Navigation 67
• The monitor is not connected to a power outlet and is running on battery power. The estimated charge time remaining is displayed in the hour(s):minute(s) format. Each section of the battery status indicator represents a percentage of remaining charge.
Note When the battery switches from AC power to battery power, no charge time is displayed while the device calculates the remaining charge time.
• The monitor is connected to a power outlet but the battery does not maintain a charge or has been removed.
When the battery is not being recharged and power becomes low, a very low-priority alarm appears in the Device Status area.
Note Observe the remaining battery charge in the battery status indicator and plug the monitor into a power outlet as soon as you are able.
If the very low-priority alarm is dismissed or if you take no action to charge the battery, a high-priority alarm appears when battery power is critically low. Plug the monitor into a power outlet immediately to prevent it from powering down.
Failure to plug in the monitor before the remaining charge runs out causes the monitor to power down and lose all unsaved data.
Alarm and information messages
The Device Status area provides alarm and information messages that are either temporary or exist as long as the condition to which the message applies remains. Alarm or information messages may also include controls and/or behavior that you can use to manage alarm and information messages.
When the monitor detects an alarm condition, an alarm message appears. When multiple alarms occur, the device provides options to manually toggle or autoscroll through a stack of messages. You can cycle through each alarm message in sequence of priority by touching the multiple alarm toggle. Alternatively, the autoscroll option displays messages in the stack for approximately 4 seconds. These messages are stacked in order of priority: the monitor displays the highest priority messages first followed by each successive alarm message in order of priority. After presenting the entire stack of alarm messages, the autoscroll feature loops back to the top priority message and repeats the entire stack unless specific alarms auto-dismiss or you reset or cancel specific alarms. In both the manual toggle and autoscroll options, when multiple alarm messages of the same priority exist at the same time, the device displays the most recent of those alarm messages first.
68 Navigation Welch Allyn Connex ® Devices
Information messages instruct you to interact with the monitor in a specific way or provide information that does not require action. You can dismiss an information message by selecting the control associated with the message or waiting for the message to time out. Information messages rank the lowest in priority.
When the monitor is operating in Demo mode, which requires access to Advanced settings, the Device Status area displays an information message indicating that the
Demo mode is active, as shown below.
Any alarm messages that occur in Demo mode include a clear "DEMO MODE:" prefix as well.
Content area
The Content area displays current vital sign measurements and patient identification. It also provides relevant controls.
The Content area includes the following:
• A frame for each available parameter
• The Patient frame
• The Manual parameters frame (height, weight, pain, temperature, respiration, and
BMI, depending on configuration)
In the Office, Spot Check, and Intervals Monitoring profiles, the Content area also includes a Save button, which you use to manually save current measurements to the
Review tab. If your monitor is connected to an external system, you can send these patient measurements to that external system as well. You can configure your monitor to automatically send these measurements any time you press Save, or you can navigate to the Review tab and then select specific records to send to the external system.
In the Continuous Monitoring profile, patient measurement data is automatically saved to the Review tab. Consequently, there is no Save button on the Home tab. (A Pause button appears in its place. See "Pause continuous monitoring (Pause mode)" in the "Host system" section of this directions for use.) If the monitor is connected to the central station, the monitor automatically sends these patient measurements to the central station as well.
Directions for use Navigation 69
Office profile content area
The Content area displays vital sign measurements. It also provides shortcuts to several controls.
The Content area of the Office profile includes the following frames:
• NIBP
• BMI (including weight and height)
• Patient
• Pulse rate
• SpO2
• Temperature
• Pain
The Content area also includes a Save button, which you use to manually save current measurements.
The Clear button deletes current measurements without saving them.
Save patient data
Patient data can be saved to the monitor.
After taking a patient reading, touch Save .
A message appears indicating a successful save or a failed save.
70 Navigation Welch Allyn Connex ® Devices
Note
Navigation area
During an NIBP averaging program, after acquiring an NIBP measurement, the monitor saves all measurements displayed on the Home tab and associated patient identification. To retain an NIBP average, touch Save upon completion of the averaging program.
The Navigation area includes the following tabs:
• Home : Displays vital-sign measurements and provides shortcuts to several controls.
• Patients : Accesses the patient list, patient summary, and manual parameters.
• Alarms : Accesses global alarm response and settings controls, alarm limit settings
(available only in the Intervals Monitoring and Continuous Monitoring profiles), and patient rest mode.
• Review : Prints, deletes, and sends patient data.
• Settings : Accesses device configuration settings.
To navigate to a tab, touch the tab in the Navigation area with the corresponding name.
The active tab is highlighted.
Display lock
The display lock feature blocks the display of patient information and also prevents both screen navigation and data input, which might be useful when cleaning the display. You can activate display lock manually or, depending on the device configuration, set the device to lock automatically after a specific idle period.
The display locks when any of the following occur:
• You touch Lock display now on the Device tab.
• No interaction with the monitor occurs for the period specified on the Display tab in
Advanced settings. (An authorized person can access the Display tab in Advanced settings and set or change the length of the idle period that triggers the display lock.)
Lock the display
Follow these steps to lock the display.
1. Touch the Settings tab.
2. Touch the Device tab.
3. Touch Lock display now .
The following occurs:
Directions for use Navigation 71
• The Home tab appears with a large lock icon on the lower left of the display.
• The following information no longer appears on the screen:
○ Clinician ID
○ Patient ID
○ Manual parameters frame
○ Navigation tabs
• All controls on the display are locked. If you touch the display, you either unlock the display immediately (no security configuration implemented) or receive a prompt to enter credentials (security configuration implemented) to unlock the display.
Unlock the display
1. Touch anywhere on the locked display.
If no security configuration has been implemented, the display unlocks immediately.
2. If a security configuration or single sign-on (SSO) has been implemented on the device, enter the requested credentials (ID number, access code, and/or password) based on your facility's security policy. Where SSO has been implemented, scanning or tapping your badge overrides manual entry of your credentials if you haven't exceeded the established grace period.
The display unlocks when the device authenticates your credentials.
3. If the SSO grace period has expired and authentication is unsuccessful, manually enter your system password or PIN as prompted, then touch OK .
The device authenticates you as an authorized user and displays your Clinician ID in the Device Status area of the Home tab.
Note An authorized person can adjust security configuration and
SSO settings in Advanced settings.
The display also unlocks when the following occur:
• A high- or medium-priority alarm.
• An externally initiated action, such as taking or stopping an NIBP measurement or upgrading software.
72 Navigation Welch Allyn Connex ® Devices
Using the keypad, keyboard, and barcode scanner
Open the numeric keypad
Touch any field that includes the numeric keypad icon .
The numeric keypad appears.
Numeric keypad
73
The numeric keypad includes the following components:
Component Name
Data field
Backspace key
Description
Displays the numbers you enter. The field name appears above and the range of values you can enter appears below this field.
When touched, removes the rightmost number from the data field.
74 Using the keypad, keyboard, and barcode scanner Welch Allyn Connex ® Devices
Component Name
Cancel button
OK button
Description
When touched, the numeric keypad disappears and the selected number does not change.
When touched, the numeric keypad disappears and the entered number appears in the associated frame or data field.
Enter a number
1. With the numeric keypad open, touch a number or numbers.
The value must be within the range that appears below the data field.
2. Touch OK .
• If the value is within the required range and format, the numeric keypad disappears and the entered numbers replace the previous numbers.
• If the number is not within the required range and format, OK remains inactive until you enter a valid number.
Close the numeric keypad
Touch one of the following:
• OK : Exits the numeric keypad and inserts the number.
• Cancel : Exits the numeric keypad without saving entered numbers.
Open the keyboard
Touch any field that includes the keyboard icon
The keyboard appears.
Enter a symbol or special character
.
Note To return to the keyboard's normal layout, touch .
1. With the keyboard open, touch .
Symbols and special characters for the selected language appear.
2. Touch the appropriate symbol or special character.
The keyboard returns to its normal layout.
Directions for use Using the keypad, keyboard, and barcode scanner 75
Close the keyboard
Touch one of the following:
• Next : Accepts the entry for the current field, then clears the field to allow data entry for the next field.
• OK : Exits the keyboard and inserts the data.
• Cancel : Exits the keyboard without saving entered data.
Use a barcode scanner
The monitor enables the scanning of patients’ and clinicians’ barcodes to enter ID information. The barcode scanner supports linear and two-dimensional barcodes.
If you haven't done so already, power down the monitor and attach the barcode scanner.
Use the instructions to attach an accessory.
Note Refer to the manufacturer's directions for use to ensure that the scanner is set to USB Com Emulation mode.
1. Remove the barcode scanner from its holder.
2. Hold the scanner approximately 6 inches (15.4 cm) from the barcode and squeeze the trigger so that the light from the scanner appears on the barcode.
Once the scanner completes a successful barcode reading and any required queries for a matching ID on the device or in an external host system, the ID appears in the targeted area (Patient frame, data field, or Device Status area). See additional notes below.
If the scanner has difficulty reading the barcode, slowly adjust the distance and the angle between the scanner and the barcode while squeezing the scanner trigger. If it continues to have difficulty, verify that the barcode is as flat as possible.
Note
Note
Note
You can scan a patient's barcode from the Home tab or the Summary tab.
The scanned ID appears in the Patient frame on the Home tab and in the
Patient ID field on the Summary tab.
Before you scan a barcode on the Summary tab, touch the keyboard icon in the Patient ID field. To return to the Home tab and begin taking patient measurements, touch OK .
If "Require patient ID match to save measurements" is enabled in Advanced settings, a progress indicator appears onscreen as the device queries an external host system or the device's Patient list for a matching ID.
• An unsuccessful query results in the message, "Unable to identify patient."
• A successful query results in patient data populating fields and appearing onscreen according to preferences configured in Advanced settings.
If "Require clinician ID match to save measurements" is enabled in
Advanced settings, a progress indicator appears onscreen as the device queries an external host system for a matching ID.
• An unsuccessful query results in the message, "Unable to identify clinician."
• A successful query results in clinician data replacing the progress indicator according to preferences configured in Advanced settings.
76 Using the keypad, keyboard, and barcode scanner Welch Allyn Connex ® Devices
Note
Note
Scanning a clinician ID while the Clinician ID pane is open places the scanned ID into the Clinician ID section of the Device Status area. Touch
OK to return to the Home tab and to begin taking patient measurements.
Use the Advanced settings Data Management tab to change the appearance of the Clinician ID if you do not want your ID to appear in the
Device Status area. (This requires the Advanced settings access code.)
However, this information is still retained in the monitor memory for recall, printing, or to send measurements electronically to the network.
Host system
Overview
A monitor can be used as standalone device or be networked to a compatible Welch
Allyn host system or central station. This section describes communication between the monitor and the host system.
Monitors communicate with the host system through hardwired Ethernet and wireless networks. The diagram below shows monitors connected to the host system.
1.
Wired monitors
(Ethernet connection)
2.
Wireless monitors
3.
Wireless access point
4.
Network
5.
host system
The host system provides centralized monitoring of connected monitors. This central monitoring system supports the communication of continuously monitored and intermittently acquired (episodic) data, patient vital-sign alarms, and technical equipment alerts, as well as the review and printing of all stored data.
Communication between the monitor and the host system is bi-directional but varies based on the active profile and selected advanced settings. In all profiles, for example, episodic patient data can be saved and sent to the host system, but in the Continuous
Monitoring profile, patient vital-signs data streams to the host system automatically when the monitor is connected to the host system. You can enable or disable automatic
77
78 Host system Welch Allyn Connex ® Devices connection to the host system in Advanced settings. Furthermore, you can add patients to a patient list on the monitor and then send them to the host system, and you can also retrieve patient lists from a host system. In the Intervals Monitoring and Spot Check profiles, retrieving the patient list requires user action. In the Continuous Monitoring profile, the patient list on the monitor updates automatically when the monitor is connected to the host system.
Once you assign a patient to a monitor and send this information to the host system, you can edit patient information on the monitor as noted in the following table:
Patient type Editable patient information based on profile and host system communication
Spot Check and Intervals profiles
Continuous Monitoring profile, communicating with the host system
Continuous Monitoring profile, not communicating with the host system
Patient ID Patient name
X X
Patient location
X
X
X X
X
X
X
Note In many cases, changing patient information opens an onscreen dialog asking you to confirm the action. These dialogs appear whenever the action results in clearing patient measurement data or patient context.
If a monitor loses its connection to the host system, the device continues to monitor the patient, display patient data, and generate alarms and messages. When connectivity is restored, the monitor resumes sending vital-signs trends and episodic data.
Monitor tab
The Monitor tab provides the following controls related to continuous patient monitoring at the device and the streaming of patient vital-signs data to a host system:
• End Monitoring – Stop continuous monitoring on the current patient and clear patient data on the device.
• Pause – Pause continuous monitoring as well as alarms for a specified period and retain patient data on the device.
• Change pause interval – Increase or decrease the pause interval in 15 minute increments up to 2 hours.
• Connect to host system – Manually connect to a host system and start or resume the streaming of patient vital-signs data when the device does not connect automatically.
• Disconnect from host system – Manually disconnect the device from a host system yet continue monitoring the patient and retain patient vital-signs data on the device.
This control is only available after connecting to a host system.
The sections which follow provide instructions for using these controls.
Note
Note
This tab is visible only when the Continuous Monitoring profile is active. It is not available in the Office, Spot Check, or Intervals Monitoring profiles.
The Continuous Monitoring profile is available only on devices with a
Continuous Monitoring profile license.
Directions for use Host system 79
Connect to the central station
To connect the monitor to a central station over a wireless or Ethernet network connection while in the Continuous Monitoring profile, you must first enable the
Connect to CS option in Advanced setttings. When this control is enabled, the monitor automatically attempts to connect to the central station and continues to do so until a connection is achieved.
If the Continuous Monitoring profile is active but your device has been disconnected from the central station (you will see the can restore the connection manually.
1. Touch the Settings tab.
The Monitor tab appears.
2. Select Connect to central station .
indicator in the Device Status area), you
As the monitor attempts to connect to the central station, a appears in the
Device Status area until a connection is achieved. When the monitor connects to the central station, the indicator appears.
The Connect to CS control described above only impacts the Continuous Monitoring profile, but you can configure Intervals Monitoring and Spot Check profiles to communicate with a central station as well in Advanced settings. In these configurations, if either the Intervals Monitoring or Spot Check profile is active, your device connects to the central station when you retrieve a patient list or load a patient's previously saved records with a barcode scanner. In addition, you can send episodic data to the central station when you touch Send on the Patient Review tab.
Disconnect from the central station
Disconnecting from the central station enables you to stop streaming data to the central station yet continue monitoring your patient, retaining patient vital signs data on the monitor. Select this option when you need to transport a patient yet continue monitoring them.
1. Touch the Settings tab.
The Monitor tab appears.
2. Select Disconnect from central station .
If reasons for disconnecting from the central station have been configured in Connex
CS, a Disconnect dialog appears with a list box of reasons.
3. Select a reason for disconnecting, if applicable, then touch OK .
The Home tab appears.
Continuous patient monitoring
Your device must be configured with the Continuous Monitoring profile to perform continuous patient monitoring.
80 Host system Welch Allyn Connex ® Devices
Key terms
Patient context
Location context
Condition in which a patient ID and patient type have been selected on a device.
Condition in which a room or a room and bed have been selected on a device.
You have the option to continuously monitor patients on the device alone (primary monitoring) or to stream continuous patient data to a central station as well (secondary monitoring).
If Continuous Monitoring has been configured as the default profile, then the device starts up in this profile. If the Continuous Monitoring profile is active, you can proceed with an existing patient and/or location context, or you can assign a patient and location.
Activate the Continuous Monitoring profile
If the Continuous Monitoring profile is not active, follow these steps:
1. Touch the Settings tab.
2. Touch the Device tab.
The Profile vertical tab appears.
3. Select Continuous Monitoring .
When neither patient nor location context are established and no patient measurements have been taken or saved, the Continuous Monitoring profile immediately becomes active. If these conditions do not apply, proceed to step 4.
4. Using the conditions presented in boldface text, select and follow the steps below that apply to your patient and the device.
a.
When patient and/or location context are established but no patient measurements have been taken or saved:
A confirmation dialog appears asking you to confirm the patient and/or location context information or select a new patient. For example, if both patient and location context have been established, the following options appear:
• Same patient, same location
• Same patient, different location
• New patient
Select the desired option and touch OK .
b.
When patient and/or location context are established and patient measurements have been taken or saved:
A confirmation dialog appears with the following message: "Changing to the
Continuous Monitoring profile deletes all measurement data from the device.
Continue anyway?"
1. Touch Yes to confirm or No to cancel the profile change.
Note Selecting No enables you to send captured vitals data on the device before changing profiles. After you complete that task, if applicable, repeat steps 1 to 3.
Directions for use Host system 81
Another confirmation dialog appears asking you to confirm the patient and/or location context information or select a new patient. For example, if both patient and location context have been established, the following options appear:
• Same patient, same location
• Same patient, different location
• New patient
2. Select the desired option and touch OK .
The profile change immediately takes effect.
5. Touch the Home tab.
You can now start monitoring a patient in the Continuous Monitoring profile.
Pause continuous monitoring (Pause mode)
You can temporarily pause continuous monitoring and retain patient data on the device when your patient needs to ambulate, use the restroom, or go off the unit for a test.
Note If a low-battery alarm occurs on the device, Pause mode is not available.
Note While in Pause mode, the device retains previously stored patient data, but it does not display this data or store additional patient measurements until you exit Pause mode.
1. Touch Pause on the Home tab.
A "Pause" dialog appears, indicating that you have paused continuous monitoring.
Controls on this screen provide options to resume or end monitoring. A countdown timer displays the time remaining before continuous monitoring resumes.
Note You can configure the Pause Mode timeout in Advanced settings.
2. To increase the pause interval, repeatedly touch the + symbol until the desired length of time appears.
The pause interval is automatically applied.
82 Host system Welch Allyn Connex ® Devices
Resume continuous monitoring
You can resume continuous monitoring after a pause when patient sensors are connected to a patient. The status of the pause timer determines your next step.
Pause time remaining
If the pause time limit has not expired (time remains on the countdown timer), resume monitoring as follows:
1. Reconnect patient sensors to the patient as needed.
2. Touch Resume monitoring .
The Home tab appears and continuous monitoring resumes.
Pause time limit expired (patient sensors connected)
If the pause time limit has expired and you have already reconnected patient sensors to the patient and/or the device, the Home tab appears and continuous monitoring automatically resumes.
Pause time limit expired (patient sensors disconnected)
If the pause time limit runs out before you resume monitoring, the device exits Pause mode, and alarms might occur.
Reconnect patient sensors to the patient and/or device and acknowledge alarm and information messages as needed.
Continuous monitoring resumes.
End continuous monitoring
When you no longer need to monitor a patient continuously, follow these steps to end monitoring:
1. Touch the Settings tab.
The Monitor tab appears.
2. Touch End monitoring .
An "End monitoring" dialog appears with the following options:
• New patient – Clears patient and location context and review data after you remove patient sensors
• Power down – Clears patient and location context and review data, and powers down the device
• Cancel – Retains patient data and returns to Home tab
3. Select the desired option.
Directions for use Host system 83
Note After approximately 30 seconds of inactivity, the "End monitoring" dialog disappears. If you do not respond to this dialog and continuous monitoring is interrupted, the "Confirm patient and location" dialog appears. You must respond to this dialog before continuous monitoring resumes.
4. If you select New patient, follow the onscreen prompt to remove sensors from your patient (and the device, if applicable), and then touch OK .
The Home tab appears.
Assign a patient and location
You can assign a patient and location after you have begun to monitor a patient's vital signs.
When you start to continuously monitor a patient on a device that has no patient context, the following information message appears in the Device Status area: "Assign patient and location."
1. In the top right corner of the screen, touch Assign .
The List tab appears.
Note When the monitor is connected to a central station, the monitor automatically retrieves the patient list when you navigate to the Patients tab.
2. If you see your patient's name on the patient list, select that patient entry, and then touch Select .
The Home tab appears with patient and/or location information filled in according to your monitor's settings.
Note If patient name or location information is missing, the monitor will prompt you to "Assign patient" or "Assign location" until that information is complete. You can monitor the patient without entering all of these details.
3. If your patient's name does not appear on the patient list, touch Add .
4. In the Patient pane, touch in a field and enter patient information. Touch
Next to cycle through the patient data fields.
Note You can use a barcode scanner to enter a patient ID in the
Note
Patient ID field. Touch the barcode, and touch OK .
in the Patient ID field, scan
If "Require patient ID match to save measurements" is enabled in Advanced settings, a progress indicator appears onscreen as the device queries an external host system or the device's Patient list for a matching ID.
• An unsuccessful query results in the message, "Unable to identify patient."
• A successful query results in patient data populating fields and appearing onscreen according to preferences configured in Advanced settings.
84 Host system Welch Allyn Connex ® Devices
5. In the Location pane, select an available room and bed from the list box.
Note The Location list only presents locations that are not already assigned to a continuous monitoring device.
"No location assigned" appears in the list box until you select a room and bed.
6. Touch OK to return to the Home tab.
The information is saved.
Note You have the option to leave some fields blank on the Patient > Summary tab. However, if patient name or location information is missing, the monitor will prompt you to "Assign patient" or "Assign location" until that information is complete. You can monitor the patient without entering all of these details.
Profiles
Profiles are variations of the Home tab. Each profile gives you access to a different set of features. Choose the profile that best suits your needs.
The monitor offers multiple profiles—including Continuous Monitoring, Intervals
Monitoring, Spot Check, and Office—based on the configuration and any upgrade licenses you purchase.
Continuous Monitoring profile
The Continuous Monitoring profile is designed for continuous patient monitoring.
Monitors configured with Oridion Microstream® Capnography provide continuous monitoring of end-tidal CO2 (etCO2), fraction of inspired CO2 (FiCO2), respiration rate
(RR), pulse rate, and Integrated Pulmonary Index (IPI). Monitors configured with the
Nellcor pulse oximetry option provide continuous monitoring of oxygen saturation of hemoglobin (SpO2) and pulse rate. Monitors configured with the Masimo rainbow SET option may provide continuous monitoring of oxygen saturation of hemoglobin (SpO2), total hemoglobin (SpHb or SpHbv), Acoustic Respiration (RRa), and pulse rate. Monitors configured with EarlySense provide continuous monitoring of respiration rate (RR), pulse rate, and patient movement.
The Continuous Monitoring profile also enables you to take manual temperature or NIBP readings, to use alarms and timed intervals, and to use bi-directional controls to transmit data between the monitor and a central station.
Note
Note
Note
Patient data continuously streams to a central station only in the
Continuous Monitoring profile.
If "Allow profile change" is enabled in Advanced setting, the device attempts to change to the Continuous Monitoring profile automatically when a continuous sensor (CO2, RRa, EarlySense) is attached to the device. (See "Change to the Continuous Monitoring profile: Automatic profile change" later in this section.)
The single sign-on (SSO) feature is not available in the Continuous
Monitoring profile.
85
86 Profiles
Oridion CO2-based Home tab
Welch Allyn Connex ® Devices
Masimo RRa-based Home tab
EarlySense patient movement-based Home tab
Directions for use Profiles 87
Saving vital sign measurements (Continuous Monitoring profile)
In the Continuous Monitoring profile, measurements are automatically saved as follows:
• Continuous measurements (SpO2, SpHb, pulse rate, etCO2, FiCO2, IPI, respiration rate, and patient movement) are saved once per minute.
• When any measurements fall outside of alarm limits, all continuous measurements are saved.
• NIBP and predictive temperature measurements are saved when acquired.
• Manual parameters are saved when you touch OK on the Manual tab.
• Modifiers are set when you complete parameter setup and return to the Home tab.
These modifiers do not appear on the Review tab.
After 24 hours of data has been saved for the selected patient, any data older than 24 hours is deleted from the monitor.
Note
Note
The monitor does not retain Direct mode temperatures in memory.
Therefore, you must note the temperature before removing the probe from the measurement site and then manually record it in the patient record.
SSO is not available during continuous monitoring. If SSO was used when the device was in the Spot Check or Intervals Monitoring profile, applying a continuous monitoring sensor to a patient automatically logs out the current user if no patient or vitals information has been captured on the device. If you apply a continuous monitoring sensor to a patient and patient or vitals information has been captured, a dialog window opens, asking if you want to log out the current user. If you touch OK , the device clears the vitals, logs out the current user, and starts continuous monitoring. If you touch Cancel , the current user remains logged in with patient data and vitals intact, and with the same profile active on the device. You can then save the patient and vitals information before using the continuous monitoring sensor.
Intervals Monitoring profile
The Intervals Monitoring profile enables you to use alarms and timed NIBP intervals for patient monitoring.
88 Profiles Welch Allyn Connex ® Devices
Note Patient vital signs data streams to a central station only in the Continuous
Monitoring profile.
Note The Intervals profile requires a Clinician login to start intervals monitoring, and SSO is available in this profile.
Clinician logout is not permitted during an active intervals program.
Note
Spot Check profile
The Spot Check profile is optimized for clinicians who take spot-check vitals readings and do not need automatic reading or alarm features.
Note
Note
SSO is available in the Spot Check profile.
You can capture patient vitals measurements in the Spot Check profile without a clinician login, but clinician login is required to save vitals measurements.
Office profile
The Office profile is designed for outpatient clinical settings, such as a physician's office, and has the following features:
• Noninvasive blood pressure (NIBP) averaging programs: These programs display the average of multiple NIBP readings.
• Calculation of body mass index (BMI): The device calculates BMI based on weight and height input entered manually or transferred from a connected weight scale.
You can also take manual NIBP and temperature measurements, monitor pulse rate and
SpO2, and manually enter pain level.
Note The single sign-on (SSO) feature is not available in the Office profile.
Directions for use Profiles 89
Saving vital sign measurements (Intervals Monitoring,
Spot Check, and Office profiles)
In the Intervals Monitoring, Spot Check, and Office profiles, you can manually save vital sign measurements to the monitor. This procedure saves measurements displayed on the Home tab, along with associated patient identification and modifiers.
After taking a patient reading, touch Save .
A message appears indicating a successful or failed save.
Note
Note
Note
Note
Note
During intervals, measurements displayed on the Home tab, along with associated patient identification, are automatically saved after each interval measurement is acquired and when some alarm conditions occur.
Modifiers are automatically saved with the first NIBP reading only but not subsequent readings with NIBP intervals running. Throughout intervals monitoring, you can manually save measurements as well.
The monitor does not retain Direct mode temperatures in memory.
Therefore, you must note the temperature before removing the probe from the measurement site and then manually record it in the patient record.
SSO is only available in the Spot Check and Intervals Monitoring profiles.
You can capture patient vitals measurements in the Spot Check profile without a clinician login, but clinician login is required to save those vitals measurements.
The Intervals profile requires a clinician login to start intervals monitoring.
90 Profiles Welch Allyn Connex ® Devices
Profile feature comparison
The following table compares the features of the profiles.
Feature
Take NIBP, SpO2, temperature, and pulse rate measurements
Configure and use NIBP averaging programs
Take SpHb measurements (Masimo only)
Monitor etCO2, FiCO2, and IPI (Oridion only)
Monitor RR (EarlySense and Oridion only)
Monitor patient movement (EarlySense only)
Monitor RRa (Masimo only)
Configure and use interval timing setting
Observe and configure alarm limits
Observe and respond to physiological alarms
Change patient type (adult, pediatric, neonate)
View and enter manual parameters
Temperature*
Weight
Height
BMI**
Pain
Respiration rate
Save currently displayed vital signs data to device memory
Clear patient data without saving
Review saved vital signs data
Use bi-directional controls between monitor and external systems
Continuous
Monitoring
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Intervals
Monitoring
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Spot Check
X
X
X
X
X
X
X
X
X
X
X
X
X
Office
X
X
X
X
X
X***
X
X
X
X
X
Directions for use Profiles 91
Feature Continuous
Monitoring
Intervals
Monitoring
Spot Check Office
* Braun IR thermometers configured to work with the monitor transfer temperature data automatically to the
Temperature frame. You can enter temperature manually if you take a patient temperature with a thermometer that is not connected to the monitor, and you have selected temperature as one of the four manual parameters to display.
** In the Spot and Office profiles, Body Mass Index (BMI) is calculated based on weight and height values that are either entered manually or transferred from an attached weight scale. The Office profile displays BMI in its own frame.
In the Spot profile, BMI displays in the Manual parameters frame if you have selected it as one of the four parameters to display. In all profiles, BMI is a read-only field that clears or recalculates with changes to height or weight values..
*** The Office profile calculates BMI based on weight and height measurements. You cannot enter or adjust BMI values.
Changing profiles
You can change the active profile on the device to access a different set of features.
Note "Allow profile change" must be enabled in Advanced settings to change profiles.
The steps to change profiles vary based on several conditions:
• Active versus target profile
• Established patient context
• Saved patient measurement data
• Sensors actively collecting patient measurement data
The following table provides an overview of allowed profile changes based on these conditions.
Conditions under which specific profile changes are allowed
Active profile Target profile Established patient context
Saved patient measurement data
Sensors actively collecting patient measurement data
X Continuous
Monitoring
Intervals Monitoring or Spot Check
Intervals Monitoring or Spot Check
Continuous
Monitoring
Spot Check Intervals Monitoring
Intervals Monitoring Spot Check
X
X
X
X
X
X
X
X
X
Note Confirmation dialogs appear onscreen whenever a specific profile change would erase saved Review tab data, erase episodic patient measurements on the display, or potentially require changes to patient or location context.
Change from one non-continuous profile to another non-continuous profile
1. Touch the selected profile indicator in the Device Status area.
92 Profiles Welch Allyn Connex ® Devices
The Profile vertical tab appears.
2. Select the desired profile.
The profile change immediately takes effect.
Note For all of these non-continuous profile changes, saved episodic patient measurements remain on the Review tab, and current measurements remain onscreen. Patient and/or location context, if established, remain onscreen for all noncontinuous profile changes.
Change to the Continuous Monitoring profile
Automatic profile change
If "Allow profile change" has been enabled in Advanced settings, the device attempts to change to the Continuous Monitoring profile automatically when a continuous sensor
(CO2, RRa, EarlySense) is attached to the device. When the profile change occurs, an information message appears in the Device Status area to report that change.
Note The profile change dialogs described in the following Manual profile change section appear onscreen as appropriate based on established patient context and/or patient measurements on the device.
Note An automatic change to the Continuous Monitoring profile occurs only once for each continuous sensor attachment. If the attempted profile change fails, or if you switch to an episodic profile after an automatic change to the
Continuous Monitoring profile, you must disconnect and then reconnect a continuous sensor for another automatic change to occur.
Note If the device cannot change to the Continuous Monitoring profile, a dialog indicating that this profile is unavailable in the current configuration appears.
Manual profile change
To manually change to the Continuous Monitoring profile from any other profile, complete these steps.
1. Touch the selected profile indicator in the Device Status area.
The Profile vertical tab appears. Based on the boldface text presented, select and follow the step and substeps below that apply to your patient and the device.
2.
When no patient and/or location context are established and no patient measurements have been taken or saved, select the desired profile.
The profile change immediately takes effect.
3.
When patient and/or location context are established but no patient measurements have been taken or saved: a. Select the desired profile.
Directions for use Profiles 93
A confirmation dialog appears asking you to confirm the patient and/or location context information or select a new patient. For example, if both patient and location context have been established, the following options appear:
• Same patient, same location
• Same patient, different location
• New patient b. Select the desired option and touch OK .
The profile change immediately takes effect.
4.
When patient and/or location context are established and patient measurements have been taken or saved: a. Select the desired profile.
A confirmation dialog appears with the following message: "Changing to the
Continuous Monitoring profile deletes all measurement data from the device.
Continue anyway?" b. Touch Yes to confirm or No to cancel the profile change.
Note Selecting No enables you to send captured vitals data on the device before changing profiles. After you complete that task, if applicable, repeat steps 1 and 4.
A confirmation dialog appears asking you to confirm the patient and/or location context information or select a new patient. For example, if both patient and location context have been established, the following options appear:
• Same patient, same location
• Same patient, different location
• New patient c. Select the desired option and touch OK .
The profile change immediately takes effect.
5. Touch the Home tab.
You can now start monitoring a patient in the Continuous Monitoring profile.
Change from the Continuous Monitoring profile
To change from the Continuous Monitoring profile to any other profile, complete these steps.
1. Touch the selected profile indicator in the Device Status area.
The Profile vertical tab appears. Based on the boldface text presented, select and follow the step and substeps below that apply to your patient and the device.
2.
When no patient trend data has been stored, select the desired profile.
The profile change immediately takes effect.
3.
When continuous sensors are connected to the patient, or when episodic or continuous data has been stored, no other profile selections are available until you remove patient sensors and end monitoring.
94 Profiles Welch Allyn Connex ® Devices a. Remove continuous sensors from your patient.
b. On the Settings tab, touch the Monitor tab.
c. Touch End monitoring .
An "End monitoring" dialog appears with the following options:
• New patient – Clears patient and location context and review data
• Power down – Clears patient and location context and review data, and powers down the device
• Cancel – Retains patient data and returns to Home tab
Note Ending monitoring deletes all patient measurement data from the device.
d. Select the desired option and touch OK .
The Home tab appears.
e. Repeat step 1 and select the desired profile on the Profile vertical tab.
The profile change immediately takes effect.
4.
When patient and/or location context are established, but no episodic or continuous trend data has been stored: a. Select the desired profile.
A confirmation dialog appears asking you to confirm the patient and/or location context information or select a new patient. For example, if both patient and location context have been established, the following options appear:
• Same patient, same location
• Same patient, different location
• New patient b. Select the desired option and touch OK .
The profile change immediately takes effect.
Note If the device was connected to a central station while the Continuous
Monitoring profile was active, changing to any other profile disconnects the device from the central station.
Patient data management
Patient demographic data is managed on the Patients tab.
From this tab, you can do the following:
• Retrieve a patient list from the network (for example, electronic medical records
(EMR) or a central station).
• Select a patient from the list.
• Manually create patient entries and a patient list.
• Scan a patient ID with the barcode scanner and return a patient name match from your host system.
Note The patient name match could come from EMR or a central station.
• Enter additional patient information such as manual parameters.
• Assign a patient and location to device only or to a central station during continuous monitoring.
CAUTION Verify patient identity on the monitor after manual or barcode entry and before printing or transferring patient records.
Add a patient to the patient list
Note
Note
If the monitor is configured to retrieve the patient list from the network and is in the Spot Check or Intervals Monitoring profile, you cannot manually add a patient to the patient list.
If the monitor is configured to retrieve the patient list from the central station and is in the Continuous Monitoring profile, you can add a patient to the patient list and transfer it to the central station.
1. Touch the Patients tab.
2. Touch Add .
3. Touch and then enter patient information. Touch Next to cycle through the patient data fields.
Note You can use a barcode scanner to enter a patient ID in the
Patient ID field. Touch the barcode, and touch OK .
in the Patient ID field, scan
95
96 Patient data management Welch Allyn Connex ® Devices
4. Touch OK to return to the Home tab.
The information is saved.
CAUTION Verify patient identity on the monitor after manual or barcode entry and before printing or transferring patient records.
Load patient data with a barcode scanner
You can use a barcode scanner to query existing patient records and perform a patient name match with the host system.
Note
Note
If the monitor is connected to the network, the monitor can receive a patient name from patient records associated with a scanned ID number.
If "Require patient ID match to save measurements" is enabled in Advanced settings, a progress indicator appears onscreen as the device queries an external host system or the device's Patient list for a matching ID.
• An unsuccessful query results in the message, "Unable to identify patient."
• A successful query results in patient data populating fields and appearing onscreen according to preferences configured in Advanced settings.
1. Ensure that you are on the Home tab.
2. Scan the patient's barcode with the barcode scanner.
The Patient ID appears in the Patient frame if the patient query is successful.
CAUTION Verify patient identity on the monitor after manual or barcode entry and before printing or transferring patient records.
Select a patient
The options for selecting previously stored patients from the List tab vary based on the following conditions:
• Active profile
• Established patient context
• Connection to a network
• Connection to a central station
Based on the boldface text presented, follow the steps below that apply to your patient and the device.
1.
In all profiles, when patient context has not been established on the device and patient type remains the same: a. Touch the Patients tab.
The List tab appears.
b. If the monitor is connected to the network, touch Retrieve list to update the onscreen patient list.
The monitor retrieves the patient list from the network.
Directions for use Patient data management 97
Note When the monitor is connected to a central station, the monitor retrieves the patient list when you navigate to the Patients tab.
c. Touch the patient's identifier (name, ID number, or location) you want to select.
Note Patient data can be sorted in ascending or descending order by selecting the heading row and touching ▲ or
▼ . If a sort marker does not appear in a column, touch the heading, and the ▲ appears.
d. Touch Select .
The selected patient's identifier appears on the Home tab.
Note As long as you make no change to patient type, any displayed patient measurements remain onscreen and are associated with the selected patient, and patient configuration settings are retained.
2.
In the Intervals Monitoring and Spot Check profiles, when patient context has been established on the device and you want to select a different patient
(change patient context): a. Touch the Patients tab.
The Summary tab appears.
b. Touch the List tab.
c. If the monitor is connected to the network, touch Retrieve list to update the onscreen patient list.
The monitor retrieves the patient list from the network.
Note You can enable the monitor to retrieve the patient list from the network in Advanced settings. When this feature is enabled, a Retrieve list button replaces the
Add button on the List tab.
Note When the monitor is connected to a central station, the monitor automatically retrieves the patient list when you navigate to the Patients tab.
d. Touch the patient's identifier (name, ID number, or location) you want to select.
Note Patient data can be sorted in ascending or descending order by selecting the heading row and touching ▲ or
▼ . If a sort marker does not appear in a column, touch the heading, and the ▲ appears.
e. Touch Select .
The selected patient's identifier appears on the Home tab.
Note All displayed patient measurements and configuration settings are cleared.
3.
In the Continuous Monitoring profile, when patient context has been established on the device and you want to select a different patient (change patient context), you must end monitoring before selecting/assigning a different patient.
98 Patient data management Welch Allyn Connex ® Devices a. Touch the Settings tab.
The Monitor tab appears.
b. Touch End monitoring .
An "End monitoring" dialog appears with the following options:
• New patient – Clears patient and location context and review data after you remove patient sensors
• Power down – Clears patient and location context and review data, and powers down the device
• Cancel – Retains patient data and returns to Home tab c. Touch New patient .
d. Complete step 1.
Note If patient context has been established and you attempt to select a new patient by navigating to the List tab, the device displays the message, "Patient already assigned to device.
To assign a different patient, end monitoring for the current patient."
Office profile
The Office profile supports manual entry of patient information.
Some configurations also enable scanning of patient barcodes. These configurations, specified in Advanced Settings, include the following:
• The "Primary label" setting is Patient ID.
• The "Primary label" setting is Name and the "Search by patient ID" setting is selected.
Manually enter patient information
In the Office profile, you can manually enter patient information in the Patient frame.
1. From the Home tab, touch the keyboard icon in the Patient frame.
The keyboard appears.
2. Enter patient information. Touch patient data fields.
Note
, if displayed, to cycle through the
The "Primary label" setting in Advanced Settings specifies available fields.
3. Touch OK .
The information appears in the Patient frame.
4. To change the patient type, touch the patient type button (located on the right side of the Patient frame).
CAUTION Verify patient identity on the monitor after manual or barcode entry and before printing or transferring patient records.
Directions for use Patient data management 99
Manage patient records (Continuous Monitoring profile)
In the Continuous Monitoring profile, the Review tab enables access to tabular and graphical trend tables of all readings for the currently selected patient. You can configure the time intervals displayed, and you can scroll through the last 24 hours of patient measurements. Trend data can be printed from this tab.
1. Touch the Review tab.
Note Measurements that triggered a physiological alarm are highlighted on this tab.
If your device is configured to monitor patient movement, the Review tab might resemble the following example.
2. Modify the trend interval (the progression of time displayed horizontally in the table) by using the View listbox. Trend interval options are 1, 5, 15, and 30 minutes; 1, 2, 4, or 8 hours; and alarms only. The default trend interval is 1 minute.
100 Patient data management Welch Allyn Connex ® Devices
Note Event data (e.g., physiological alarms, patient movement, manual NIBP or temperature measurements, Manual parameter entries) is displayed in all trend intervals. By modifying the trend interval to one of the longer time spans, you can filter out non-alarming, continuous measurements between the currently selected time intervals to focus more attention on event data. Alternatively, you can modify the trend interval by selecting a shorter time span to display a more comprehensive listing of continuous measurements.
3. Use the scroll bar on the right to view patient measurements for any parameters that do not fit in the display area.
4. Touch the page forward and page backward controls in the table header to view additional measurements for this patient. The most recent measurements appear on the right of the table, with older measurements to the left.
5. Touch the graphical trends button to view a graphical representation of patient measurements recorded in the tabular trends table.
6. Touch the tabular trends button
7. Touch Print to print the patient's record.
to return to the tabular view.
A Print options dialog appears.
8. Select the desired Timespan and touch Print .
Note
Note
Note
If no patient is selected, the Continuous Monitoring profile is not active, and no measurements have been taken, all table cells in the Review tab remain blank.
In the Continuous Monitoring profile, you cannot delete saved patient measurements. Patient measurements older than 24 hours are automatically deleted from the Review tab.
The date and time stamps on saved patient measurements will adjust in response to new date and time settings.
Directions for use Patient data management 101
Note In the Continuous Monitoring profile, the Send option is not available on the
Review tab.
Manage patient records (Intervals Monitoring, Spot
Check, and Office profiles)
Patient records can be sent to the network, printed, or deleted in these profiles.
1. Touch the Review tab.
Note If your device is configured for Custom scoring, the Review tab might resemble the following example.
Note To see the specific parameters and scores that generated the aggregate score in the EWS column (which could have a different name at your facility), touch the score in that column to open the custom score summary.
102 Patient data management Welch Allyn Connex ® Devices
2. Select records by touching the check box.
3. Touch Send to transmit the records to the network, Print to print the records, or
Delete to permanently remove the records as desired.
CAUTION Verify patient identity on the monitor after manual or barcode entry and before printing or transferring patient records.
CAUTION Always visually verify the printed patient records.
Note
Note
Note
Note
The network.
icon indicates the records have been sent to the
You can configure some profiles and settings to automatically send measurements to the network.
Patient measurements older than 24 hours are automatically deleted from the Review tab.
The date and time stamps on saved patient measurements adjust in response to new date and time settings.
Printer
The monitor prints to a strip to create printouts of patient information and data. Controls in Advanced settings enable you to select what patient information (Name and patient
ID, Name only, Patient ID only, None) appears on these printouts.
Note The sample printouts below are English, but the language in the printouts is defined by the language selected on the monitor.
Directions for use Patient data management 103
Intervals Monitoring report Spot Check report
Continuous Monitoring trend data report with capnography
Continuous Monitoring trend data report with patient movement
Delete a patient from the list
1. Touch the Patients tab.
2. From the List tab, touch the patient record you want to delete.
3. Touch Delete .
At the Delete Confirmation window, touch OK to permanently delete the selected patient. Touch Cancel to cancel the deletion.
104 Patient data management Welch Allyn Connex ® Devices
Note
Note
Deleting a patient from the Patients List does not delete saved records. Touch the Review tab to see or delete saved records.
For monitors connected to the network, deleting a patient on the monitor does not affect data on the network.
105
Alarms
The monitor presents physiological alarms and technical alarms. Physiological alarms occur when vital sign measurements fall outside of set alarm limits, but they occur only in the Continuous Monitoring and Intervals Monitoring profiles. Technical alarms occur when there is a problem with the monitor, an accessory connected to the monitor, or the network. Technical alarms occur in all profiles.
The monitor can communicate alarms to the following external systems:
• Nurse Call systems
• Welch Allyn software systems
Note
WARNING The monitor is the primary alarming source for the patient, and any external system (such as a Nurse Call or software system) is a backup alarm source. The external system is only as reliable as its network and can be relied on only as a backup alarming device.
WARNING When the monitor is not connected to a secondary alarm system during continuous patient monitoring, check the monitor regularly to receive patient data, alarms, and alerts.
USB is not intended for remote communication of continuous parameters and continuous alarms. Ethernet and wireless are intended for communication of vital signs parameters, patient data, and alarms
(including continuous and episodic parameters and alarms) to secondary remote viewing and alarming systems.
106 Alarms Welch Allyn Connex ® Devices
Alarm types
Type
• NIBP, SpO2, SpHb, etCO2, respiration, pulse rate, or IPI limit exceeded
• No breath detected
• Some technical alarms
Priority
High
• Patient has exited the bed High
• Temperature or FiCO2 limit exceeded
• Extremely high motion
• Some technical alarms
Medium
• Some technical alarms Low
Color
Red
Red
Amber
Amber
Alarm audio tone
10-pulse tone
Alternate 10-pulse tone
3-pulse tone
• Technical alarms that don't impact patient safety
Very low Cyan
2-pulse tone or 1-pulse tone at
30-second intervals
2-pulse tone or 1-pulse tone at
5-minute intervals
ECG module alarm types
WARNING Patient safety risk. Life-threatening arrhythmias can trigger one of two optional high alarm tones for ventricular tachycardia (V-Tach), ventricular fibrillation (V-Fib), and asystole. If you are monitoring a patient for life-threatening arrhythmias, verify the alarm tone that your facility or floor has chosen.
Priority Color Alarm audio tone Type
Physiological
• Asystole
• Ventricular tachycardia
• Ventricular fibrillation
• High or low respiration.
• High or low heart/pulse rate.
High cardiac Red
High Red
Two available tones
Default: IEC 10-pulse tone
Standard 10-pulse tone
10-pulse tone
Technical
• Searching for respiration, caused by extended period of no respiration signal
High Red 10-pulse tone
• Module reports that it is unable to analyze the ECG signal for V-Tach, V-Fib, and/or
Asystole (Cannot analyze ECG)
Medium Amber 3-pulse tone
Directions for use Alarms 107
Type
• In acquisition mode, the ECG has been unable to detect an ECG waveform for the past 30 seconds. (Cannot measure ECG)
• Module reports that one or more electrodes are off (Electrode(s) off:…)
Priority
• In acquisition mode, the ECG module has not transmitted ECG data for the past 30 seconds. (ECG not functional)
Low
• Data inconsistency (ECG not functional)
• Sensor errors
Very low
Color
Amber
Cyan
Alarm audio tone
2-pulse tone or 1-pulse tone at
30-second intervals
2-pulse tone or 1-pulse tone at
5-minute intervals
Alarm notification locations on the monitor
Recommended operator position: Stand in front of the device within 1 meter. Face the device with the monitor at an angle that allows you to easily view the screen.
WARNING Whenever possible, do not rely on visual alarm notifications alone while monitoring patients. If you must rely on visual alarm notifications, maintain a clear line of sight with the monitor. For audio alarm notifications, set the volume as needed considering the environment and ambient noise levels. Verify that the alarm is audible to a clinician working at the maximum distance from the monitor.
WARNING Patient injury risk. If you are relying on visual alarm notifications, maintain a clear line of sight with the monitor and/or Nurse
Call. Set the volume as needed considering the environment and ambient noise levels.
WARNING Patient injury risk. Do not set the alarm limits to extreme levels, which could render the alarm system useless.
Nurse Call
In facilities with a Nurse Call system, the monitor immediately notifies the Nurse Call when an alarm occurs. The configuration settings for devices at your facility specify
Nurse Call notification settings.
LED light bar
The light bar on the handle of the monitor illuminates as follows:
• Flashing red for high-priority alarms
• Flashing amber for medium-priority alarms
• Constant amber for low-priority and very low-priority alarms
The light bar darkens when the alarm tone is reset.
108 Alarms
Home tab
Welch Allyn Connex ® Devices
Home tab notifications
Notification
Device Status area
Description
The area changes color and displays a message with an accompanying status icon or button. If the alarm tone is in a pause interval, a timer countdown appears.
If multiple alarms are active, the device provides options to manually toggle or autoscroll through the alarms. You can cycle through each alarm message in sequence of priority by touching the multiple alarm toggle. Alternatively, the autoscroll option displays each alarm message in sequence of priority for approximately 4 seconds, and then loops back to the top priority message. In either option, when multiple alarm messages of the same priority exist at the same time, the device displays the most recent of those alarm messages first.
Information messages instruct you to interact with the monitor in a specific way or provide information that does not require action. You can dismiss an information message by selecting the control associated with the message or waiting for the message to time out.
Parameter frame The background color changes. Touch this area to reset (pause or turn off) the alarm tone.
WARNING Do not pause or turn off an audible alarm if patient safety might be compromised.
After the tone is reset, visual indicators remain until the condition is corrected, the next measurement is taken, or the alarm is cancelled.
Alarm Limit control The control appears in each parameter frame.
The icon in this control indicates the status of the alarm limit settings. Red and amber icons indicate measurements that have exceeded alarm limits.
Touch this control to navigate to a parameter-specific tab where you can modify alarm limit settings. The control also displays alarm limits in some device configurations.
Directions for use Alarms 109
Icons on the Home tab
Icons in parameter frames
The icons in the parameter frames indicate alarm notification settings. When alarm limits are on, the icons are black and white until an alarm occurs. Then, the icons change color to indicate the priority of the alarm. Red icons represent high-priority alarms, and amber icons represent medium- or low-priority alarms.
Icons in parameter frames
Icon Name and status
Alarm off.
No visual or audio alarms occur for this parameter.
You are fully responsible for maintaining awareness of the patient’s condition.
Alarm on.
Audio and visual notifications are enabled.
Alarm audio off.
Only visual notifications occur.
If the patient is being monitored continuously, maintain a clear line of sight with the monitor while audio alarms are disabled.
Alarm audio paused.
The audio tone is paused. The icon remains until the paused time counts down to 0.
Icons in the Device Status area
The icons in the Device Status area are black and white, but the background area changes colors to indicate the alarm priority. Messages accompany these icons. These icons can be controls or status indicators.
Icons in the Device Status area
Icon Name and status
Alarm active.
One or more alarms are active. Touch this icon to reset (pause or turn off) the alarm tone.
WARNING Do not pause or turn off an audible alarm if patient safety might be compromised.
Alarm audio off.
Audio signals are disabled, but alarm limits and visual alarm signals remain active.
If the patient is being monitored continuously, maintain a clear line of sight with the monitor while audio alarms are disabled.
110 Alarms Welch Allyn Connex ® Devices
Icons in the Device Status area
Icon Name and status
Multiple alarms toggle.
Touch this icon to cycle through the messages for each active alarm.
Alarm audio paused.
The audio tone is paused. The icon remains until the paused time counts down to 0. Touch this icon to start the user-configured pause interval (set in the Advanced tab).
Patient rest mode
Patient rest mode enables you to turn the audio off and dim the screen of the device when continuous monitoring is enabled and a device is connected to the central station.
The visual alarms indication on the device will display, and audible alarms will sound at a compatible Welch Allyn host with visual indications. The device may still be used for additional vitals capture. Touch the screen to remove the dimming while in use. If a loss of connectivity occurs, certain alarms become audible until connectivity is restored.
Patient rest mode can be enabled and disabled from the central station or from the device.
Patient rest mode location on the monitor
Access the rest mode on the Alarms tab.
CAUTION Loss of power will cause the monitor to return to default settings. Each time you power up the monitor, you must set alarm limits appropriate for your patient.
Turn on patient rest mode
To turn on the patient rest mode from the device:
1. Touch the Alarms tab.
The Alarms screen appears.
2. On the Alarms screen, touch Patient rest mode on .
The patient rest mode is activated.
Turn off patient rest mode
To turn off the patient rest mode from the device:
1. Touch the Alarms tab.
The Alarms screen appears.
2. On the Alarms screen, touch either Alarm audio on or Alarm audio off .
The patient rest mode is deactivated.
Directions for use Alarms 111
Reset (pause or turn off) audio alarms
WARNING Do not pause or turn off an audible alarm if patient safety might be compromised.
Audio alarm characteristics
• After you reset an audio alarm, some tones do not return, but others return after a pause interval if the condition that caused the alarm persists.
• If a new alarm condition occurs during a pause interval, a new audio tone occurs.
• If an audio alarm is not paused or turned off after a period of time, a buzzer accompanies the tone.
Pause or turn off an audio alarm
1. In the Device Status area, touch .
• Visual indications remain in the parameter frame until the condition is corrected, the next measurement is taken, or the alarm is cancelled.
• In the Device Status area, if the icon changes to and the message remains, the timer counts down a fixed pause interval of 60 seconds. The alarm tone returns after the pause interval.
A longer pause interval can be configured in the Advanced tab. You start the configured pause interval by touching .
If you responded to an NIBP alarm and multiple NIBP limits have been exceeded, the alarm tone pauses, the first message clears, and the next NIBP limit message appears with a countdown timer. A new NIBP alarm tone sounds after the countdown unless you touch limit message.
to dismiss each remaining NIBP
2. If multiple alarms are active, a multiple alarm toggle appears in the Device Status area. The monitor will either autoscroll through the alarm messages, displaying each for approximately 4 seconds in order of priority, or you can move through the alarms manually. Respond to multiple alarms manually as follows: a. Touch to pause all audio alarms.
The alarm icon changes to and the timer counts down a fixed pause interval of 60 seconds. The alarm tone returns after the pause interval.
b. Touch in the Device Status area to view each alarm in the stack.
112 Alarms Welch Allyn Connex ® Devices
Note The multiple alarm toggle button displays the number of active alarms inside the alarm icon. A set of dots indicating the display order of alarms from highest (left) to lowest (right) priority (as well as the most recent in the case of multiple alarms of the same priority) appears below it.
Cancel a paused alarm
You can clear a paused alarm from the Home tab. If the condition that caused the alarm persists, a new alarm appears with visual and audio notification.
1. On the Home tab, touch the alarm limits control in the selected parameter frame.
The Alarms tab for that parameter appears.
2. Touch .
The alarm clears.
3. Touch .
4. Touch the Home tab and confirm that
Adjust vital sign alarm limits
appears in the parameter frame.
You can adjust vital sign alarm limits or turn off alarm limit checking for individual parameters.
WARNING Alarm limits are user-adjustable. For alarms to function properly, you must set or verify alarm limits appropriate for each patient, taking into account the patient's condition and acute care needs. Each time the monitor is powered on, you must check that the alarm settings are appropriate for your patient before you start monitoring.
CAUTION Loss of power will cause the monitor to return to default settings. Each time you power up the monitor, you must set alarm limits appropriate for your patient.
1. On the Home tab, touch the alarm limits control in the selected parameter frame. For example, to adjust the NIBP alarm limits, touch
2. Adjust vital sign alarm limits.
.
• To adjust a limit: Enter the desired upper and lower alarm limits using the up/ down arrow keys or the keypad.
Directions for use Alarms 113
• To turn alarm limits off or on for the vital sign: Touch button toggles to display the current alarm state.
or . This
If you turn off alarm limit checking for a vital sign, no visual or audio alarm signals will occur for those limits. If alarm limit checking is off, the icon changes to
on the Home tab in the parameter frame.
Adjust ECG and Impedance Respiration alarm limits
You can adjust vital sign alarm limits or turn off alarm limit checking for individual parameters.
WARNING Alarm limits are patient-specific. For alarms to function properly, you must set or verify alarm limits appropriate for each patient.
Each time the monitor is powered on, you must check that the alarm settings are appropriate for your patient before you start monitoring.
CAUTION Loss of power will cause the monitor to return to default settings. Each time you power up the monitor, you must set alarm limits appropriate for your patient.
1. On the Home tab, touch the alarm limits control in the selected parameter frame. For example, to adjust the ECG alarm limits, touch .
2. Adjust vital sign alarm limits.
• To adjust a limit: Enter the desired upper and lower alarm limits using the up/ down arrow keys or the keypad.
• To turn alarm limits off or on for the vital sign: Touch button toggles to display the current alarm state.
or . This
If you turn off alarm limit checking for a vital sign, no visual or audio alarm signals will occur for those limits. If alarm limit checking is off, the icon changes to
on the Home tab in the parameter frame.
3. Repeat the same steps in the Respiration Rate (RR) frame to adjust Impedance
Respiration alarm limits.
Modify audio alarm notification
You can modify the volume of all audio alarms.
Note If the Allow user to turn off general audio option is selected in Advanced settings, you can turn off audio alarms. Whenever possible, however, do not rely on visual alarm notifications alone while monitoring patients. If the patient is being monitored continuously, maintain a clear line of sight with the monitor while audio alarms are disabled.
114 Alarms Welch Allyn Connex ® Devices
WARNING If you are relying on audio alarm notifications, set the volume as needed considering the environment and ambient noise levels. Verify that the alarm is audible to a clinician working at the maximum distance from the monitor.
As you are working in the Alarms tab, parameter measurements appear across the top of the tab.
1. Touch the Alarms tab.
2. On the General tab, modify audio alarm notification.
• To enable or disable audio alarms, select Alarm audio on or Alarm audio off .
If you turn off audio alarms, visual alarm signals still occur in the LED light bar,
Device Status area, and on the Home tab in parameter frames.
The in the Device Status area indicates alarm audio turned off, and a similar bell appears in the parameter frames . If an alarm condition occurs, the bell is red or amber in the alarming frame, according to the priority of the alarm, as shown here: or .
• To modify the volume of audio alarms: Select a volume level.
An audio tone sounds briefly to indicate the volume level.
Alarm messages and priorities
The following tables list the physiological and technical alarm messages and their priority.
Directions for use
Physiological alarms
Alarm messages
Alarm limit exceeded. etCO2 HIGH.
Alarm limit exceeded. etCO2 LOW.
Alarm limit exceeded. FiCO2 HIGH.
Alarm limit exceeded. IPI LOW.
No breath detected. Exceeded time limit since last breath.
Alarm limit exceeded. Respiration HIGH.
Alarm limit exceeded. Respiration LOW.
Alarm limit exceeded. NIBP systolic HIGH.
Alarm limit exceeded. NIBP systolic LOW.
Alarm limit exceeded. NIBP diastolic HIGH.
Alarm limit exceeded. NIBP diastolic LOW.
Alarm limit exceeded. NIBP MAP HIGH.
Alarm limit exceeded. NIBP MAP LOW.
Alarm limit exceeded. SpO2 HIGH.
Alarm limit exceeded. SpO2 LOW.
Alarm limit exceeded. SpHb HIGH.
Alarm limit exceeded. SpHb LOW.
Alarm limit exceeded. Pulse rate HIGH.
Alarm limit exceeded. Pulse rate LOW.
Alarm limit exceeded. Temperature HIGH.
Alarm limit exceeded. Temperature LOW.
Extremely high motion.
Heart/Pulse rate HIGH.
Heart/Pulse rate LOW.
Respiration HIGH.
Respiration LOW.
Alarms 115
Priority
High
High
High
High
High
High
High
High
High
High
High
High
High
High
Medium
High
High
High
High
Medium
Medium
Medium
High
High
High
High
116 Alarms
Alarm messages
Asystole detected.
Ventricular tachycardia detected.
Ventricular fibrillation detected.
Technical alarms
Alarm messages
Low battery 5 minutes or less remaining.
Searching for SpO2 signal.
Communications module did not power on properly. Power down the device.
Check for occlusion in gas line.
Network not found; check network cable connection.
Battery is absent or faulty.
Battery is absent or faulty. Call for service.
NIBP air leak; check cuff and tubing connections.
NIBP not functional. Call for service.
Unable to determine NIBP; check connections and tubing for kinks.
Incorrect NIBP cuff size; check patient type.
Inflation too quick; check NIBP cuff and tubing connections.
Unable to determine NIBP; check connections; limit patient movement.
Unable to determine NIBP; check inflation settings.
SpO2 not functional. Call for service.
Attach SpO2 sensor to monitor.
Replace the SpO2 sensor.
Set date and time.
Maximum number of patient records saved. Oldest record overwritten.
Connect temperature probe.
Insert correct color-coded probe well.
Welch Allyn Connex ® Devices
Priority
High cardiac
High cardiac
High cardiac
Priority
Very low
Very low
Very low
Very low
Very low
Low
Low
Very low
High
High
High
High
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Directions for use
Alarm messages
Replace temperature probe.
Temperature not functional. Call for service.
Retry temperature measurement.
Temperature time limit exceeded. Retry temperature measurement.
Low battery, unable to print; plug into outlet.
Printer door is open; close to continue.
Printer not functional. Call for service.
Out of paper.
Printer too hot; wait to retry.
Radio not functional. Call for service.
Radio error. Power down and restart.
Radio error. The radio has restarted.
Unable to establish network communications. Radio out of network range.
Unable to establish network communications. Call for service.
Radio software upgrade failed.
Unable to load configuration; using factory defaults.
Functional error. Call for service.
External device not recognized.
Incompatible Welch Allyn device.
USB Communication failure. Call for service.
Low battery 30 minutes or less remaining.
Low SpHb signal quality. Check sensor.
Low SpO2 signal quality. Check sensor.
Low perfusion. Check sensor.
Replace the SpO2 cable.
SpO2 mode only. Check sensor or cable.
SpO2 sensor expires in….
Alarms 117
Priority
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Medium
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
118 Alarms
Alarm messages
Unexpected restart occurred. Call for service.
Weight scale not functional. Call for service.
CO2 not functional. Call for service.
Filter line disconnected.
CO2 module temperature is out of range. CO2 might not be accurate.
Purging filter line.
Calibration is overdue. CO2 might not be accurate.
Factory service is overdue. CO2 might not be accurate.
CO2 auto-zero in progress.
Respiratory freshness timeout expired.
Replace RRa sensor.
RRa background interference detected.
RRa patient interference detected.
File system formatted on first-time startup.
Lost connectivity with host.
The patient has exited bed.
Patient turn overdue.
EarlySense not functional.
The sensor has expired.
The sensor is defective.
Replace the bed sensor.
The bed sensor is disconnected.
The bed sensor is upside down.
Bed sensor expires in <"1 month", "1 week", "1 day", "x hours">
Cannot measure patient. Lost or unstable signal.
Cannot measure respiration.
Cannot measure pulse rate.
Welch Allyn Connex ® Devices
Priority
Very low
Very low
Very low
Very low
Very low
Very low
Low
High
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
Very low
High
High
Directions for use Alarms 119
Alarm messages
Trend change detected. Review patient history.
Time limit exceeded. Unable to complete program.
Searching for respiration.
ECG not functional.
Electrodes off:
Cannot analyze ECG.
Cannot measure ECG.
Configuration is invalid without certificates. Reconfigure and try again.
Failed to authenticate to server.
Nurse call
The monitor can be connected to a Nurse Call system through a cable that connects to the Nurse Call connector.
When the Nurse Call cable is connected and Nurse Call is enabled, the monitor notifies the Nurse Call system when an alarm that exceeds the preset threshold occurs. Nurse
Call notification persists until one of the following occurs on the monitor:
• The alarm clears.
• You reset (pause or turn off) the alarm tone.
For paused alarms, Nurse Call notification returns after the pause interval if the condition that caused the alarm persists.
Nurse Call thresholds are set in the Advanced Settings.
To connect the monitor to a Nurse Call system, you must have a cable that has been adapted to your Nurse Call system (REF 6000-NC), rated 50V DC maximum at 500mA
(DC or ACRMS). For ordering information, see Approved Accessories in the Appendix.
WARNING The monitor is the primary alarming source for the patient, and any external system (such as a Nurse Call or software system) is a backup alarm source. The external system is only as reliable as its components
(e.g., wiring, hardware, light bulbs, connections) and can be relied on only as a backup alarming device.
Priority
Very low
Low
High
Low or
Very low
Medium
Medium
Medium
Very low
Very low
120 Alarms Welch Allyn Connex ® Devices
121
Patient monitoring
This section of the directions for use describes the parameters available on the device, how to modify settings and alarm limits for those parameters, and how to take parameter measurements.
Before focusing on each parameter, the section addresses features that generally apply to the parameters on your device: standard and custom modifiers, and manual overrides.
WARNING When the monitor is not connected to a secondary alarm system during continuous monitoring, check the monitor regularly to receive patient data, alarms, and alerts.
WARNING Whenever possible, do not rely on visual alarm notifications alone while monitoring patients. If you must rely on visual alarm notifications, maintain a clear line of sight with the monitor. For audio alarm notifications, set the volume as needed considering the environment and ambient noise levels. Verify that the alarm is audible to a clinician working at the maximum distance from the monitor.
Configuration tool
The configuration tool is a web-based tool on the Welch Allyn website that enables you to set the device settings for your facility. For more information, see the service manual for your device.
Standard and custom modifiers
Modifiers enable you to save additional information for the measurements for a specific patient. Standard modifiers are the same on all devices. Custom modifiers are specific to a facility or a unit, and they are set up during the initial configuration of your site.
Both standard and custom modifiers appear on the Patients > Manual tab.
Enter modifiers
Follow these steps to enter standard and custom modifiers.
1. Touch the Patients tab.
2. Touch the Manual tab.
3. Scroll through the list to find the parameter(s) you want to modify, then enter or select the modifier(s) as desired.
122 Patient monitoring Welch Allyn Connex ® Devices
4. Touch OK .
The Home tab appears. In the Continuous Monitoring profile, the modifiers are saved with the next set of measurements sent to the network. In the episodic profiles, the modifiers are saved with the next set of measurements you take or with any current, unsaved measurements on the device when you touch Save .
Custom scoring
Custom scoring enables you to configure your device to generate custom scores for specific parameters based on your facility's standards. The device supports both single parameter and aggregate scores, as well as messages to accompany both. These scores and messages are provided only as reminders of a patient's condition. You can configure multiple scoring systems that include several parameters as well as customized protocols to generate custom scores.
WARNING Risk to patient safety. Custom scores and messages serve as guides to your facility's protocols; do not subsitute custom scores for patient physiological alarms . Appropriate alarms settings must be set and maintained to ensure patient safety.
To access these configurable parameters, protocols, and custom scoring options on your device, touch the Manual parameters frame just right of center near the bottom of the
Home tab.
Manual overrides
The manual override feature enables you to do the following:
• input measurements when none have been recorded on the device
• replace the currently displayed measurements with measurements you take manually
Enter a manual override measurement
Follow these steps to enter a manual measurement.
1. Press and hold the selected parameter frame until a keypad appears.
2. Enter the manually acquired measurement on the keypad and touch OK .
The Home tab appears and displays the entered measurement.
Note
Note
Touch Clear to remove all values and correct your entry as needed.
In the Continuous Monitoring profile, measurements entered manually remain on the screen for one minute. In the episodic profiles, the manual measurement remains in the frame until the next measurement is taken.
Patient movement
Monitors configured with the EarlySense™ module continuously monitor patient movement, as well as Respiration rate (RR) and Pulse rate if licensing is enabled for these functions.
Directions for use Patient monitoring 123
Note
Note
Note
Note
Respiration rate and Pulse rate measurements taken by the EarlySense module are displayed in the RR and Pulse rate frames, respectively. The frame remains blank until the sensor acquires its first measurements, which could take 1 to 2 minutes. After the initial measurement, a process indicator appears in the frame if a lost or low signal condition occurs. Lost or low signal conditions that last more than 3 minutes trigger an alarm. See the Respiration rate and Pulse rate sections of this directions for use for more information.
Monitors configured with EarlySense cannot be configured with Masimo rainbow Acoustic Respiration (RRa) or Oridion Microstream capnography.
Patient movement monitoring is not available for neonatal/infant patients.
The EarlySense system has not been studied on any specific patient group, nor has it been studied as a tool to diagnose any specific disease of medical condition. It is an adjunctive tool used to measure respiratory rate, pulse rate, and patient movement.
Movement frame
The Movement frame displays the following data and controls used to monitor patient movement:
• Patient motion level
• Exit sensitivity
• Movement-related alarm conditions
• Patient turn events and status (time overdue or time remaining until next scheduled turn)
• Sensor source indicator
The size of the Movement frame and displayed data varies based on your configuration.
If the patient turn reminder is active, the timer counts down to zero and then displays a reminder in the Device Status area to perform and log a patient turn. If a scheduled patient turn remains overdue, a "Patient turn overdue" alarm message appears in the
Device Status area, and the patient turn control is highlighted based on the priority of the alarm (for example, indicates a very low alarm). The timer displays a negative time until the next patient turn or the timer reaches –99:59.
Exit alarm view
The Exit alarm view is displayed automatically when an exit alarm is triggered. An exit graphic replaces the movement level and exit sensitivity indicators in the frame. The entire frame and alarm icon are highlighted based on the priority of the exit alarm.
124 Patient monitoring Welch Allyn Connex ® Devices
Set up movement
The Movement vertical tab ( Settings > Setup > Movement ) presents information on the status of sensors. Only alarm settings and modifiers can be changed for this parameter. See "Configure movement alarms" to adjust alarm settings. Follow these steps to set up movement modifiers, if applicable.
1. Touch the Patients tab.
2. Touch the Manual tab.
3. Scroll through the list to find the Movement section, then enter or select the
Movement modifier(s) as desired.
Note If no modifiers are associated with this parameter, no
Movement section will appear.
4. Touch OK .
The Home tab appears. In the Continuous Monitoring profile, the modifiers are saved with the next set of measurements sent to the network.
Configure movement alarms and patient turn reminder
Follow these steps to set alarm limits for patient movement.
1. Verify that you are using the Continuous Monitoring profile.
Note If “Allow profile change” is enabled in Advanced settings, the device attempts to shift automatically to the Continuous
Monitoring profile when you connect the sensor cable.
2. Touch the Alarms tab.
3. Touch the Movement vertical tab.
4. Ensure that the Exit alarm and Motion alarm controls are set to ON.
Note If any parameter's alarm limit control is set to OFF, you cannot adjust alarm limits on the Alarm tab, and no visual or audio signals occur for that specific parameter.
5. Adjust the following settings as desired:
• Exit sensitivity . Use the up/down arrow keys or the keypad to choose a sensitivity level ranging from 1 to 6. Setting 1 is the least sensitive, and setting 6 is the most sensitive.
Note Levels 5 and 6 are highly sensitive and might trigger an alarm as a result of minimal movement while the patient is in bed. Correct patient assessment is the key to minimize false alerts.
• Turn reminder . Select the desired turn schedule from the list box.
6. Touch the Home tab.
Directions for use Patient monitoring 125
The new alarm settings take effect immediately.
Monitor patient movement
WARNING Patient safety risk. Do not use heating blankets. Heating blankets could reduce the safety and efficacy of the system and void the warranty.
WARNING Patient safety risk. The EarlySense system is not intended for high-risk patients in coronary or respiratory distress who require continuous monitoring of heart function or CO2. For these patients, the most reliable method of patient monitoring involves close personal surveillance and/or equipment suited to that type of monitoring.
WARNING Patient injury risk. The patient should not have direct contact with the bed sensor. A mattress, mattress pad, or mattress cover should always be placed as a barrier between the sensor and the patient. Check patients regularly to ensure that direct contact with the sensor does not occur.
WARNING Patient safety risk. Provide careful oversight when the
EarlySense System is used with children.
CAUTION Sensor malfunction risk. Do not use EarlySense with patients who weigh more than 200 kg (440 pounds).
CAUTION Sensor malfunction or inaccurate measurement risk. Patients should not share a bed with another person during EarlySense monitoring.
CAUTION Inaccurate measurement risk. The quality of measurements might be affected by cable lengths. Do not shorten or extend the cable.
CAUTION Sensor malfunction risk. Do not allow patients to jump on the bed or the bed sensor.
Note
CAUTION Sensor malfunction risk. For patients with poor bladder function or control, take care when placing the bed sensor under the mattress, mattress pad, or mattress cover to prevent urine from contacting the sensor.
CAUTION Sensor malfunction risk. Do not create sharp bends in the cable to prevent tearing or breaking the shielding.
1. Verify that you are using the Continuous Monitoring profile.
If "Allow profile change" is enabled in Advanced settings, the device attempts to shift automatically to the Continuous
Monitoring profile when you connect the sensor cable.
2. Touch the patient type control on the right side of the Patient frame.
The Patient Summary tab appears.
3. Select the patient type, then touch OK .
Note Patient movement monitoring is not available for neonatal/ infant patients.
4. If sensor is not plugged into the device, align the EarlySense cable connector with one of the EarlySense ports on the right side of the monitor. Insert the cable
126 Patient monitoring Welch Allyn Connex ® Devices connector until it clicks into place. Also check the stress relief connector on the cable to ensure that both parts of the cable are tightly connected.
5. Position the bed sensor (sensing unit) as follows:
• horizontally under the patient's mattress
• the top surface of the sensing unit facing the mattress
• the sensing unit under the patient's chest area
• the sensing unit cable extending toward the head of the bed
6. Instruct or assist the patient to lie down in bed. Double-check the position of the patient and the sensor (see step 5), and adjust as needed.
Note Careful placement of the sensor is key to getting quality
EarlySense measurements.
7. Wait for a first measurement.
Directions for use Patient monitoring 127
Note
Note
Patient movement, Respiration rate, and Pulse rate measurements taken by EarlySense are displayed in the
Movement, RR, and Pulse rate frames, respectively. Each frame remains blank until the sensor acquires its first measurements, which could take approximately 1 to 2 minutes. After the sensor detects a patient, an initial set of measurements appears in the associated frames.
EarlySense alarms occur only after a good initial measurement.
Low confidence condition
After receiving a valid set of measurements for a specific patient, a low confidence condition occurs whenever the EarlySense module loses or has difficulty acquiring a signal. During low confidence conditions, a process indicator replaces the previous reading in the Respiration rate (RR) and/or Pulse rate frames and remains in the frame until the sensor acquires a valid measurement.
Note A low confidence condition that persists beyond 3 minutes triggers a technical alarm.
Observe and report patient turn events
Based on the Turn reminder schedule configured on the Alarms > Movement tab, the patient turn countdown timer indicates the time remaining until the next scheduled turn.
If turn reminders have been turned off, the patient turn control is disabled and the counter is blank.
Any time the patient turn button is active and the timer is running, you can report a patient turn on the device. You do not have to wait for the timer to expire.
1. On the Home tab, touch Pause .
Note Putting the device in Pause mode prevents triggering a bed exit alarm.
2. Turn the patient.
3. Touch Resume monitoring .
Note The Home tab appears.
4. Touch .
The patient turn button is disabled, and the following confirmation appears in the
Device Status area: "Patient turn logged and counter reset."
The patient turn button remains disabled until the updated turn status is recorded.
128 Patient monitoring Welch Allyn Connex ® Devices
Capnography (CO2)
Monitors configured with Oridion Microstream capnography continuously measure or indicate the following:
• End-tidal CO2 (etCO2): the level of CO2 in a patient's exhaled breath
• Fraction of inspired CO2 (FiCO2): the level of CO2 in a patient's inhaled breath
• Respiration rate (RR)
• Integrated Pulmonary Index (IPI): a numerical value that integrates four parameters
(etCO2, respiration rate, SpO2, and pulse rate) and indicates a patient's overall respiratory status
Note Monitors configured with Oridion Microstream capnography cannot be configured with Acoustic Respiration (RRa).
etCO2 frame
The etCO2 frame displays data and controls used in monitoring the level of CO2 in a patient's breath (etCO2 and FiCO2). Controls to pause or restart the CO2 pump as well as to pause CO2 alarms also appear in the frame.
Note CO2 monitoring is available only with the Continuous Monitoring profile.
The frame provides a numeric view and a waveform view of CO2 data. You can toggle between views by touching the left side of the frame.
etCO2 numeric view
The numeric view displays end-tidal CO2 (etCO2) and fraction of inspired CO2 (FiCO2) in mmHg or kPa. The size of the etCO2 frame and displayed measurements varies based on your configuration.
CO2 waveform view
The CO2 capnogram waveform view displays the CO2 waveform, enabling you to observe a patient's breathing patterns and to determine adequate, hyperventilation, or hypoventilation conditions.
The size of the etCO2 frame and displayed measurements varies based on your configuration.
Directions for use Patient monitoring 129
Set up etCO2
Follow these steps to configure etCO2 parameter settings and to set up etCO2 modifiers.
1. Touch the Settings tab.
2. Touch the Setup tab.
3. Touch the etCO2 vertical tab.
4. Adjust the following settings as desired:
• Sweep speed. Select the desired speed. You can set the default in Advanced settings.
• Waveform scale. Select the scale using the toggle button. You can set the default in Advanced settings.
• Pump standby time. Select the time using the toggle button.
5. Touch the Home tab.
The new settings take effect immediately.
6. To set up modifiers, if applicable, touch the Patients tab.
7. Touch the Manual tab.
8. Scroll through the list to find the etCO2 section, then enter or select the etCO2 modifier(s) as desired.
Note If no modifiers are associated with this parameter, no etCO2 section will appear.
9. Touch OK .
The Home tab appears. In the Continuous Monitoring profile, the modifiers are saved with the next set of measurements sent to the network.
Configure etCO2 and FiCO2 alarms
Follow these steps to set alarm limits for CO2 measurements.
Note FiCO2 appears only if enabled in Advanced settings.
1. Verify that you are using the Continuous Monitoring profile.
Note If “Allow profile change” is enabled in Advanced settings, the device attempts to shift automatically to the Continuous
Monitoring profile when you connect the sensor cable.
2. Touch the Alarms tab.
3. Touch the etCO2 vertical tab.
4. Ensure that the etCO2 and FiCO2 alarm limit controls are set to ON.
Note If any parameter's alarm limit control is set to OFF, you cannot adjust alarm limits on the Alarm tab, and no visual or audio signals occur for that specific parameter.
5. Adjust the following settings as desired:
• etCO2 limits. Enter upper and lower alarm limits for etCO2 using the up/down arrow keys or the keypad next to the Limits control.
130 Patient monitoring Welch Allyn Connex ® Devices
• FiCO2 limit. Enter the desired upper alarm limit for FiCO2, if activated, using the up/down arrow keys or the keypad next to the FiCO2 control.
• High alarm delay. For etCO2 only, select the duration using the list box. This alarm delay specifies the minimum duration of a high alarm condition to activate an alarm signal. You can set the default in Advanced settings.
6. Touch the Home tab.
The new alarm settings take effect immediately.
Measure CO2
Before you begin, read the Microstream CO2 sampling line's directions for use.
WARNING Loose or damaged connections can compromise ventilation or cause an inaccurate measurement of respiratory gases. Securely connect all components and check connections for leaks according to standard clinical procedures.
WARNING When using a sampling line for intubated patients with a closed suction system, do not place the airway adapter between the suction catheter and endotracheal tube. This is to ensure that the airway adapter does not interfere with the functioning of the suction catheter.
WARNING Do not cut or remove any part of the sampling line. Cutting the sampling line could lead to erroneous readings.
WARNING Inaccurate measurement or equipment malfunction risk. If too much moisture enters the sampling line (e.g., from ambient humidity or breathing unusually humid air), the message "Purging filter line" will appear in the Device Status area. If the sampling line cannot be cleared, the message "Check for occlusion in gas line" appears. Replace the sampling line when this message appears.
WARNING The sampling line might ignite in the presence of O2 when directly exposed to lasers or high heat. When performing head and neck procedures involving lasers or high heat, use with caution to prevent combustion of the sampling line or surrounding surgical drapes.
WARNING Microstream CO2 sampling lines are designed for single patient use and are not to be reprocessed. To prevent damage to the monitor, do not attempt to clean, disinfect, or blow out the sampling line.
Reprocessing or reusing CO2 sampling lines could cause crosscontamination and inaccurate readings.
CAUTION Only use Welch Allyn-approved CO2 sampling lines to ensure the monitor functions properly.
CAUTION Dispose of Microstream CO2 sampling lines according to standard operating procedures or local regulations.
1. Touch the patient type control on the right side of the Patient frame.
The Patient Summary tab appears.
2. Select the patient type, then touch OK .
3. Select the appropriate sampling line based on the following considerations:
• Whether the patient is intubated or non-intubated
• Whether the patient is on mechanical ventilation
Directions for use Patient monitoring 131
• Duration of use
• Patient's size and weight
4. Connect the sampling line to the monitor.
a. Slide open the door that protects the sampling line port on the monitor.
b. Connect the sampling line.
Note The CO2 pump starts as soon as the pump sensor recognizes the sampling line. This can occur before you completely connect the sampling line.
c. Turn the connector completely to the right until tight.
An etCO2 sampling line dialog appears on the screen to reinforce this instruction
(unless the dialog is disabled in Advanced settings).
WARNING You must connect the sampling line correctly.
Ensure that the connector is tight to accurately monitor CO2.
WARNING Cross-contamination and nosocomial infection risk. The CO2 sampling exhaust port, located just below the sampling line connection port, is for respiratory exhaust only.
Maintain an open breathing circuit by leaving this port open to vent respiratory gases. Do not attach tubing or reconnect it in any way to the patient's breathing circuit.
Note This secure connection prevents gases from leaking at the connection point during measurement and is essential to ensure accurate measurements.
5. If the etCO2 sampling line dialog appears on your screen, watch the animation and confirm that you have connected the sampling line correctly, then touch OK to dismiss the dialog.
6. Verify that you are using the Continuous Monitoring profile.
Note If "Allow profile change" is enabled in Advanced settings, the device attempts to shift automatically to the Continuous
Monitoring profile when you connect the sensor cable.
132 Patient monitoring Welch Allyn Connex ® Devices
7. Connect the sampling line to the patient as described in the directions for use supplied with the sampling line.
8. Perform the following checks: a. Check that CO2 values appear on the monitor.
b. Check the patient type. Make sure it is correct to ensure accurate sampling.
c. Touch the alarm control to ensure the alarms are set appropriately.
d. Toggle to the waveform view to ensure that a complete waveform appears.
Note
Note
Note
Note
Note
When the cannula is not on the patient, the etCO2 value is blank.
After you connect the sampling line, the monitor immediately searches for breaths, but it does not indicate a No Breath condition before any valid breaths have been detected.
To avoid moisture buildup and sampling line occlusion during suction or nebulization of intubated patients, stop the CO2 pump and remove the sampling line luer connector from the monitor.
Replace the sampling line according to hospital protocol or when a blockage is indicated by the device. Excessive patient secretions or a buildup of liquids in the airway tubing might occlude the sampling line, requiring more frequent replacement.
When the message "Check for occlusion in gas line" appears on the screen, indicating that the sampling line attached to the monitor is blocked, the monitor’s CO2 pump will stop. Follow the instructions in the
Troubleshooting section of this manual to correct the problem.
Stop and restart the CO2 pump
Stopping the CO2 pump prevents the ingress of fluids into the CO2 module during certain patient procedures (such as suction or lavage). In addition, this pump-stop condition pauses the monitoring of all parameters obtained from the CO2 module for a configured period of time or until you restart the CO2 pump.
1. To temporarily pause or stop CO2 monitoring, touch the pump-stop button in the etCO2 frame.
Note This button is a toggle. When you stop the CO2 pump, the
Start button with a countdown timer appears.
2. To resume CO2 monitoring, touch the pump-start button .
The CO2 pump restarts, the current timer clears, and the Stop button appears in the frame.
Respiration rate
RR frame
The RR frame displays the following:
Directions for use Patient monitoring 133
• Respiration rate in breaths per minute (BPM)
• Alarm limit control
Note RR monitoring is available only in the Continuous Monitoring profile.
Set up RR
Only alarm delays and modifiers can be changed for the RR parameter. See "Configure
RR alarms" to adjust alarm settings. Follow these steps to set up RR modifiers, if applicable.
1. Touch the Patients tab.
2. Touch the Manual tab.
3. Scroll through the list to find the RR section, then enter or select the RR modifier(s) as desired.
Note If no modifiers are associated with this parameter, no RR section will appear.
4. Touch OK .
The Home tab appears. In the Continuous Monitoring profile, the modifiers are saved with the next set of measurements sent to the network.
Configure RR alarms
Follow these steps to set alarm limits for RR measurements.
1. Verify that you are using the Continuous Monitoring profile.
Note If "Allow profile change" is enabled in Advanced settings, the device attempts to shift automatically to the Continuous
Monitoring profile when you connect the sensor cable.
2. Touch the Alarms tab.
3. Touch the RR vertical tab.
4. Ensure that the RR alarm limit control is set to ON.
Note If any parameter's alarm limit control is set to OFF, you cannot adjust alarm limits on the Alarm tab, and no visual or audio signals will occur for that specific parameter.
5. Adjust the following settings as desired:
• RR limits. Enter upper and lower alarm limits for RR using the up/down arrow keys or the keypad.
• High alarm delay. Select the duration from the list box. This alarm delay specifies the minimum duration of a high alarm limit condition to activate an alarm signal.
You can set the default in Advanced settings.
134 Patient monitoring Welch Allyn Connex ® Devices
• No breath detected alarm delay. Select the duration from the list box. This alarm delay specifies the minimum duration of a no-breath condition to activate an alarm signal. You can set the default in Advanced settings.
6. Touch the Home tab.
The new alarm settings take effect immediately.
IPI
The Integrated Pulmonary Index (IPI) integrates four parameters and their interactions to provide a numeric value indicating a patient's overall respiratory status. The integrated parameters are etCO2, RR, SpO2, and PR. The additional status information provided by
IPI enables you to intervene before values of individual parameters reach levels of clinical concern.
Note
Note
IPI is available for adult patients as well as three groups of pediatric patients (1–3 years, 3–6 years, and 6–12 years), but it is not available for neonatal/infant patients.
Pediatric patient subtypes appear on the Patient Summary tab and on the
Home tab as a label in the IPI frame, but they do not appear in the Patient frame.
Note IPI is available only with the Continuous Monitoring profile.
The range of IPI is 1–10. These values can be interpreted as indicated in the following table.
Index range Patient status
10
8–9
7
5–6
Normal
Within normal range
Close to normal range; requires attention
Requires attention and may require intervention
3–4
1–2
Requires intervention
Requires immediate intervention
Source: The microMediCO2 Module - OEM Manufacturers' Integration Guide (p. 13), Oridion Medical 1987 Ltd.
Note The interpretation of a patient's IPI value might change in different clinical conditions. For example, patients who have a history of respiratory difficulties might require a lower IPI Low Alert threshold that takes into account their diminished respiratory capacity.
IPI frame
The IPI frame displays a numeric value from 1–10 as well as an alarm threshold and control.
Directions for use Patient monitoring 135
The frame provides a numeric view and a graphical trend view of IPI data. You can toggle between views by touching the left side of the frame.
IPI numeric view
This view displays the numeric value for the integrated parameters.
The numeric view also includes a graphic indicator of the patient's current IPI value. As shown in the examples below, when the IPI value is 8, 9, or 10, the outline of the vertical bar is gray. When the IPI value is 4, 5, 6, or 7, the outline of the bar is yellow, and the middle section of the bar is shaded yellow. When the IPI value is 1, 2, or 3, the outline of the bar is red, and the lowest section of the bar is shaded red.
IPI trend graph view
This view presents a graph of the IPI numeric values over a user-selected period and thus can alert you to changes in the patient's respiratory status. In Advanced settings, you can select the period displayed.
The size of the IPI frame and displayed trend data varies based on your configuration.
The graph shows the IPI value on the y-axis and time on the x-axis (oldest calculations on the left and newest calculations on the right). IPI values update once every second.
Set up IPI
Follow these steps to configure IPI parameter options.
1. Touch the Settings tab.
2. Touch the Setup tab.
3. Touch the IPI vertical tab.
4. Adjust the Trend period as desired. You can set the default in Advanced settings.
5. Touch the Home tab.
The new settings take effect immediately.
6. Touch the patient type control on the right side of the Patient frame.
The Patient Summary tab appears.
136 Patient monitoring Welch Allyn Connex ® Devices
Note
Note
IPI is available for adult patients as well as three groups of pediatric patients (1–3 years, 3–6 years, and 6–12 years), but it is not available for neonatal/infant patients.
If you are monitoring a pediatric patient, the following additional considerations apply when you select patient type:
Pediatric patients fall into one of three types based on their age: Ped 1–3, Ped 3–6, Ped 6–12. Because these age ranges overlap, consider details such as patient size and birth date to select Pediatric patient type.
CAUTION The characteristics of a breath are calculated differently for different patient types. Incorrect patient type selections cause inaccurate monitoring of the patient's respiration rate and affect the patient's IPI value.
7. Touch the Type list box and select patient type.
Note If you select Pediatric as a patient type, an information message prompts you to select a pediatric age range when you monitor IPI on pediatric patients, as shown here.
8. Touch OK .
The Home tab appears.
Note Pediatric patient subtypes appear on the Patient Summary tab and on the Home tab as a label in the IPI frame, but they do not appear in the Patient frame.
Configure IPI alarms
Follow these steps to set alarm limits for IPI.
1. Verify that you are using the Continuous Monitoring profile.
Note If "Allow profile change" is enabled in Advanced settings, the device attempts to shift automatically to the Continuous
Monitoring profile when you connect the sensor cable.
2. Touch the Alarms tab.
Directions for use Patient monitoring 137
3. Touch the IPI vertical tab.
4. Ensure that the Limits control is set to ON.
Note If any parameter's alarm limit control is set to OFF, you cannot adjust alarm limits on the Alarm tab, and no visual or audio signals will occur for that specific parameter.
5. Adjust the IPI limits setting as desired. Enter the desired lower alarm limit for IPI using the up/down arrow keys or the keypad.
6. Touch the Home tab.
The new alarm settings take effect immediately.
Acoustic respiration rate (RRa)
Monitors configured with Masimo rainbow Acoustic Monitoring technology continuously and noninvasively measure respiration rate based on respiratory sounds produced in the upper airway. Respiratory sounds are detected through a sensor applied to the patient's neck.
Note
Note
Note
Note
RRa is available only in the Continuous Monitoring profile.
Masimo SpO2 monitoring is required when monitoring RRa.
RRa monitoring is only for adult patients who weigh more than 66 pounds
(30 kilograms).
Monitors configured with RRa cannot be configured with CO2 or SpHb.
RRa frame
The RRa frame displays the following:
• Respiration rate in breaths per minute (BPM)
• Respiration Indicator
• Alarm limit control
• Averaging control toggle providing the options of slow, medium, fast, trending, and off
Note RRa is available only when the Continuous Monitoring profile and Adult patient type are selected.
Respiration Indicator
The Respiration Indicator displays the level of sound detected by the RRa sensor. A higher level of sound causes more bars to illuminate.
138 Patient monitoring Welch Allyn Connex ® Devices
Averaging selector
The averaging selector enables you to choose the desired visibility of subtle variations in
RRa measurements. You can adjust averaging in the RRa frame by touching the averaging selector . Use this control toggle to select an averaging option (off, slow, medium, fast, or trending) while acquiring readings.
Averaging selector options
Off Fast
~10 seconds
Medium
~20 seconds
Slow
~30 seconds
Trending
~60 seconds
You can set the RRa averaging default in Advanced settings. Averaging is set to default settings when any of the following occurs:
• The device starts up
• You change or clear patient context
Set up RRa
Default settings for the RRa parameter can be changed only in Advanced settings.
Configure RRa alarms
Follow these steps to set alarm limits for RRa measurements.
1. Verify that you are using the Continuous Monitoring profile.
Note If "Allow profile change" is enabled in Advanced settings, the device attempts to shift automatically to the Continuous
Monitoring profile when you connect the sensor cable.
2. Verify that the patient type is Adult.
3. Touch the Alarms tab.
4. Touch the RRa vertical tab.
5. Ensure that the RRa alarm limit control is set to ON.
Note If any parameter's alarm limit control is set to OFF, you cannot adjust alarm limits on the Alarm tab, and no visual or audio signals will occur for that specific parameter.
6. Adjust the following settings as desired:
• RRa limits. Enter upper and lower alarm limits for RRa using the up/down arrow keys or the keypad.
• Alarm delay. Select the duration from the list box. This alarm delay specifies the minimum duration of an alarm limit condition to activate an alarm signal. The
Directions for use Patient monitoring 139 alarm delay you select impacts both upper and lower alarm limits. You can set the default in Advanced settings.
• No breath detected alarm delay. Select the duration from the list box. This alarm delay specifies the minimum duration of a no-breath condition to activate an alarm signal. You can set the default in Advanced settings.
7. Touch the Home tab.
The new alarm settings take effect immediately.
Measure RRa
RRa monitoring is only for adult patients who weigh more than 66 pounds (30 kilograms).
WARNING Inaccurate measurement risk. Use only Masimo rainbow SET sensors and accessories on Masimo-equipped monitors.
WARNING The accuracy of RRa measurements can be affected by any of the following:
• Excessive ambient or environmental noise
• Improper sensor placement
• Failure to properly connect the sensor and cables
WARNING Masimo SpO2 monitoring is required when monitoring RRa.
WARNING Patient injury risk. Do not attempt to reprocess, recondition, or recycle any sensors or patient cables. Doing so might damage electrical components.
WARNING Patient injury risk. The sensor and extension cable are intended only for connection to pulse co-oximetry equipment. Do not attempt to connect these cables to a PC or any similar device. Always follow the sensor manufacturer's directions for care and use of the sensor.
Before you begin, read the RRa sensor directions for use.
1. Verify that the dual cable is connected to the monitor and to the SpO2 cable and the
RRa cable. If a sensor is connected to the RRa cable, disconnect the sensor from the cable.
Note When the RRa sensor is off the patient and is connected to the monitor, the sensor might pick up periodic ambient sounds and report a measurement.
2. Verify that you are using the Continuous Monitoring profile.
Note If "Allow profile change" is enabled in Advanced settings, the device attempts to shift automatically to the Continuous
Monitoring profile when you connect the sensor cable.
3. Verify that the patient type is Adult.
4. Verify that the alarms are set appropriately.
5. Start monitoring SpO2 as described in this directions for use.
6. Attach the RRa sensor to the patient according to the manufacturer's directions for use, observing all warnings and cautions.
140 Patient monitoring Welch Allyn Connex ® Devices
Note
Note
The sensor is for single-patient use only. You can reuse the sensor on the same patient if it is clean and dry, and the adhesive still adheres to the skin. Otherwise, use a new sensor. Do not reuse the sensor on another patient.
Do not use disposable sensors on patients who have allergic reactions to the adhesive.
Note A process indicator appears in the RRa frame until an
RRa measurement is available for display.
7. Connect the RRa sensor to the RRa cable.
8. Confirm that the monitor displays RRa data within approximately 60 seconds of connection to the patient.
WARNING Patient injury risk. Incorrect sensor application or excessive duration of sensor use can cause tissue damage.
Inspect the sensor site periodically as directed in the sensor manufacturer's instructions.
Detaching the sensor during a measurement triggers an alarm.
NIBP
Noninvasive Blood Pressure (NIBP) frame
From the NIBP frame, you can measure blood pressure.
The NIBP frame contains data and features relevant to noninvasive blood pressure measurement. The frame provides different features based on the profile you are using.
NIBP frame in Continuous Monitoring profile
The size of the NIBP frame and displayed measurements varies based on your configuration.
The Continuous Monitoring profile also provides a visual indication of aging episodic measurements (those more than 16 minutes old) and a timestamp indicating the time of the measurement. When a NIBP measurement is displayed for more than 16 minutes, the numerics on the screen change from their current color to gray. After one hour, these measurements are cleared from the frame.
Directions for use
NIBP frame in Intervals Monitoring profile
NIBP frame in Spot Check profile
NIBP frame in Office profile
Patient monitoring 141
NIBP measurement display
In all profiles, the frame can display systolic and diastolic measurements, and MAP calculations. You can configure the default view in Advanced settings.
View indicator
Touch the NIBP frame to toggle between views.
•
NIBP view 1 displays the SYS/DIA measurements as the primary content and the MAP calculation as secondary content.
•
NIBP view 2 displays the MAP calculation as the primary content and the
SYS/DIA as secondary content.
Buttons
The buttons on the right side of the frame enable you to do different tasks depending on the profile you are using. The availability of functions depends on which profile is selected. See the Profiles section for more information.
Button name
Start/Stop
Button image Description
The appearance and function of this button dynamically changes.
Note A process indicator appears in the NIBP frame until the
NIBP parameter has initialized.
142 Patient monitoring
Button name
Welch Allyn Connex ® Devices
Button image Description
Touch to start a manual measurement or a cycle of automatic measurements.
Touch to stop a measurement that is in progress.
In the Office profile,
• Touch to stop a manual NIBP measurement.
• Touch to stop the current measurement and stop an NIBP averaging program.
Interval - Continuous Monitoring, Intervals Monitoring, and Spot Check profiles
This button shows the status of automatic measurements.
Touch the button to display the Intervals tab, where you can configure automatic measurements.
Automatic measurements are off.
Automatic measurements are on.
Interval - Office profile
Alarm Limit control
Touch the button to display the Intervals tab, where you can start an NIBP averaging program.
• Touch to access the Intervals tab, where you can stop the NIBP averaging program.
• Counts down to the next measurement in an
NIBP averaging program.
This button displays alarm status. It also displays alarm limits in some device configurations.
Touch the button to display the Alarms tab.
Select a cuff
WARNING Use only blood pressure cuffs and hoses listed as approved accessories to ensure safe and accurate NIBP measurements.
Directions for use Patient monitoring 143
WARNING Never use an adult or pediatric monitor setting or cuff for an
NIBP measurement on a neonatal patient. Adult and pediatric inflation limits can be excessive for neonatal patients, even if a neonatal cuff is used. Neonates are defined in the AAMI SP10:2002 standard as children 28 days or less of age if born at term (37 weeks gestation or more); otherwise, up to 44 gestational weeks.
CAUTION Correct sizing of the blood pressure cuff is important for accurate blood pressure readings. A cuff that is too small might provide false high readings, while a cuff that is too large might provide false low readings.
The monitor uses the oscillometric method to determine blood pressure; therefore, if the cuff extends to the antecubital fossa (bend in the elbow), you can still acquire an accurate blood pressure reading.
Before taking an NIBP measurement, follow these steps to select the appropriate cuff for the patient.
1. Measure the circumference of the patient's bare upper arm, midway between the elbow and shoulder.
2. Choose the appropriate cuff size based on the circumference measurement. If the circumference of the patient's arm falls between two cuff sizes, use the larger cuff size.
3. Wrap the cuff around the patient's bare upper arm and verify that the artery index marker lies somewhere between the two range markings on the cuff.
Cuff measurements
The following tables provide measurements for Welch Allyn blood pressure cuffs.
One-piece cuff measurements
Cuff Size Circumference (cm) Circumference (in)
Infant
Small child
Child
Small adult
Adult
Large adult
Thigh
9.0 – 13.0
12.0 – 16.0
15.0 – 21.0
20.0 – 26.0
25.0 – 34.0
32.0 – 43.0
40.0 – 55.0
3.5 – 5.1
4.7 – 6.3
5.9 – 8.3
7.9 – 10.2
9.8 – 13.4
12.6 – 16.9
15.7 – 21.7
Neonatal soft disposable cuffs with NeoQuik connectors
Cuff Size Circumference (cm)
NEO 1 3.3 – 5.6
Circumference (in)
1.3 – 2.2
144 Patient monitoring Welch Allyn Connex ® Devices
Cuff Size
NEO 2
NEO 3
NEO 4
NEO 5
Circumference (cm)
4.2 – 7.1
5.4 – 9.1
6.9 – 11.7
8.9 – 15.0
Circumference (in)
1.6 – 2.8
2.1 – 3.6
2.4 – 4.6
3.5 – 5.9
Multi-pack 1 of each 1 of each
For ordering information, see Approved Accessories in the Appendix.
Position the cuff
Note The monitor and cuffs were validated using the bare upper arm site.
WARNING Patient injury risk. Do not use the NIBP for continuous monitoring without frequently checking the patient's limb. When a patient is being monitored frequently or for a prolonged period, regularly remove the cuff to inspect it and to check the cuff site for ischemia, purpura, or neuropathy.
WARNING Inaccurate measurement risk. Do not place the cuff where it can disturb proper circulation. Do not place the cuff on any area where circulation is compromised or on any extremity used for intravenous infusions. Do not use an SpO2 finger clip sensor and a blood pressure cuff simultaneously on the same limb. Doing so may cause a temporary loss of pulsatile flow, resulting in either no reading or an inaccurate SpO2 or pulse rate until the flow returns.
WARNING The blood pressure cuff must be properly positioned to ensure blood pressure accuracy and patient safety. Wrapping the cuff too loosely
(preventing proper inflation) may result in inaccurate NIBP readings.
CAUTION If a site other than the bare upper arm is used, the blood pressure measurements may be different. It is important to document the alternate site on the patient record.
CAUTION To minimize inaccurate measurement, limit patient movement during an NIBP measurement cycle.
Before taking an NIBP measurement, follow these steps to properly attach the cuff to the patient.
1. Check the cuff for residual air from a previous measurement. Squeeze the cuff as needed to completely deflate the cuff.
2. Position the cuff on the patient's bare upper arm midway between the shoulder and the elbow.
3. Wrap the cuff snugly so that there is room for no more than two fingers between the cuff and the patient's bare upper arm.
4. Position the alignment mark on the cuff directly over the brachial artery.
5. Ensure that the blood pressure tubing has no kinks or twists.
Directions for use Patient monitoring 145
Note
Note
In situations where you cannot position the cuff level with the heart, you should adjust the measurements as follows for greater accuracy. For each inch (2.54 cm) that the cuff is above the level of the heart, add 1.8 mmHg to the displayed reading. For each inch (2.54 cm) that the cuff is below the level of the heart, subtract 1.8 mmHg from the displayed reading. It is important to document the adjustment on the patient record.
For additional guidance addressing best practices for taking blood pressure measurements, see " Tips for Taking Accurate Blood Pressure Readings " on the Welch Allyn website.
Set up NIBP
Follow these steps to configure NIBP parameter settings and to set up modifiers.
1. Touch the Settings tab.
2. Touch the Setup tab.
3. Touch the NIBP vertical tab.
4. Adjust the following setting as desired:
• Cuff inflation target. If the monitor is set up for StepBP, enter the Cuff inflation target. You can set the default in Advanced settings.
5. Touch the Home tab.
The new setting takes effect immediately.
6. To set up modifiers, touch the Patients tab.
7. Touch the Manual tab.
8. Scroll through the list to find the NIBP section, then enter or select the NIBP modifier(s) as desired.
• Cuff site. Select the site from the list box.
• Cuff size. Select the size from the list box.
• Patient position. Select the position from the list box.
9. Enter or select other modifier(s), if applicable, as desired.
10. Touch OK .
The Home tab appears. In the Continuous Monitoring profile, the modifiers are saved with the next set of measurements sent to the network. In the episodic profiles, the modifiers are saved with the next set of measurements you take or with any current, unsaved measurements on the device when you touch Save .
Configure NIBP alarms
Follow these steps to set alarm limits for systolic and diastolic measurements, and MAP calculation.
1. Verify that you are using the Intervals Monitoring or Continuous Monitoring profile.
2. Touch the Alarms tab.
3. Touch the NIBP vertical tab.
146 Patient monitoring Welch Allyn Connex ® Devices
4. Ensure that the NIBP and MAP alarm limit controls are set to ON.
Note If any parameter's alarm limit control is set to OFF, you cannot adjust alarm limits on the Alarm tab, and no visual or audio signals will occur for that specific parameter.
5. Adjust the following settings as desired:
• Systolic. Enter upper and lower Systolic alarm limits using the up/down arrow keys or the keypad.
• Diastolic. Enter upper and lower Diastolic alarm limits using the up/down arrow keys or the keypad.
• MAP. Enter upper and lower MAP alarm limits using the up/down arrow keys or the keypad.
6. Touch the Home tab.
The new alarm settings take effect immediately.
NIBP measurement
The monitor enables you to take manual and automatic NIBP measurements. In the
Office profile, you can take manual measurements and use NIBP averaging programs
(see "Office profile" near the end of the NIBP section).
WARNING Many environmental variables, including patient physiology and clinical application, can affect the accuracy and performance of the monitor.
Therefore, you must verify all vital signs information, especially NIBP and
SpO2, before treating the patient. If there is any question about the accuracy of a measurement, verify the measurement using another clinically accepted method.
WARNING Inaccurate measurement risk. Do not use the device or accessories in environments affected by extremes of temperature, humidity, or altitude. See "Environmental specifications" for acceptable operating conditions.
WARNING NIBP readings may be inaccurate for patients experiencing moderate to severe arrhythmia.
WARNING Do not allow a blood pressure cuff to remain on neonatal patients more than 90 seconds when inflated above 5 mmHg. Do not allow a blood pressure cuff to remain on the adult patients more than 3 minutes when inflated above 15 mmHg. Excessive cuff tightness may cause venous congestion, peripheral nerve injury, discoloration of the limb, and patient distress.
WARNING Inaccurate measurement risk. Pulse rate measurements generated through the blood pressure cuff or through SpO2 are subject to artifact and might not be as accurate as heart rate measurements generated through ECG or through manual palpation.
WARNING Use caution when measuring blood pressure using oscillometric blood pressure devices in severely ill neonates and pre-term infants because these devices tend to measure high in this patient population.
Directions for use Patient monitoring 147
WARNING Patient injury risk. Any external compression of the blood pressure hose or cuff or kinked tubing may cause patient injury, system errors, or inaccurate measurements.
WARNING Inaccurate measurement risk. Ensure an airtight seal at all connection points before use. Excessive leaking might affect readings.
WARNING Inaccurate measurement risk. Minimize cuff movement and arm motion during readings. Excessive movement might alter readings.
WARNING Inaccurate measurement risk. Only use the cuff when the artery index marker falls within the printed range indicated on the cuff; otherwise, erroneous readings will result.
WARNING Patient injury risk. Do not place the cuff on the arm on the same side of a mastectomy. If necessary, use the femoral artery in the thigh to take a measurement.
WARNING Patient injury risk. Do not apply the NIBP cuff over a wound.
At the start of a measurement, the monitor inflates the cuff to the appropriate level. In the NIBP frame, the systolic display shows the cuff inflation pressure while the blood pressure measurement is in progress.
The monitor measures blood pressure as the cuff is inflating. If patient movement, excessive noise, or an arrhythmia prevent the monitor from determining the blood pressure while the cuff is inflating, the monitor attempts to measure the blood pressure while deflating the cuff.
When the measurement is complete, the NIBP frame displays the measurement until you save it to the patient's record or you start another NIBP measurement.
Note
Note
Note
The Pediatric and Adult blood pressure modes are supported on patients 29 days and older. The Pediatric mode gives you the option of setting a lower initial inflation pressure when using the StepBP deflation and not SureBP.
Use dual-lumen tubes for adult and pediatric blood pressure measurements and single-lumen tubes for neonate blood pressure measurements.
Mismatching tube types, patient types, and algorithms causes an information message to appear in the Device Status area. For neonate patients, set the NIBP settings as follows: Patient = Neonate, Tube type =
1 tube, Algorithm = Step.
Welch Allyn uses the following definition of Neonate: Children 28 days or less of age if born at term (37 gestation or more); otherwise, up to 44 gestational weeks.
Take a manual NIBP measurement
WARNING Patient injury risk. Never install Luer Lock connectors on Welch
Allyn blood pressure cuff tubing. Using these connectors on blood pressure cuff tubing creates the risk of mistakenly connecting this tubing to a patient's intravenous line and introducing air into the patient's circulatory system.
148 Patient monitoring Welch Allyn Connex ® Devices
WARNING Patient injury risk. Any external compression of the blood pressure hose or cuff or kinked tubing may cause patient injury, system errors, or inaccurate measurements.
1. Properly size the blood pressure cuff and position it around the patient’s bare upper arm.
2. Touch to take a measurement.
Cancel a measurement that is in progress
Follow these steps to cancel any NIBP measurement that is in progress.
On the Home tab, touch .
The monitor rapidly deflates the cuff, and the screen displays the NIBP cancellation message.
Interval NIBP measurement
The monitor can take NIBP measurements automatically based on intervals you choose.
The Intervals tab provides all interval features.
From this tab, you can do the following:
• Configure intervals
• Turn off intervals
• Configure the monitor to print automatic measurements as they are completed
When the measurement is complete, the NIBP frame displays the measurement until the next measurement starts.
Note
Note
Note
If single sign-on (SSO), "Require Clinician ID to save readings," or "Require
Clinician ID match to save measurements" has been enabled in Advanced settings, Clinician login is required before you can save measurements.
In the Intervals Monitoring profile, each time automatic interval measurements are saved, manual parameter and predictive temperature measurements are cleared from the screen. When you manually save any patient measurements in this profile, all patient measurements are cleared from the screen.
In the Continuous Monitoring profile, all patient measurements remain onscreen when automatic interval measurements are saved.
The button changes to a timer ( automatic measurement.
), which counts down to the next
Automatic measurements continue until you turn off intervals.
Directions for use Patient monitoring 149
WARNING Patient harm risk. Do not use intervals on neonates out of earshot. Verify that audio can be heard from where you intend to be.
Set up NIBP intervals
Follow these steps to configure NIBP intervals.
1. Touch the Settings tab.
2. Touch the Setup tab.
3. Touch the Intervals vertical tab.
4. Select Automatic , Program , or Stat , and follow the steps presented in the associated topics that follow.
5. To automatically print patient data at each interval, touch the Automatic print on interval checkbox.
6. To start intervals immediately, touch Start intervals . Otherwise, touch the Home tab.
The new settings take effect immediately.
Automatic intervals
You can configure the monitor to take automatic NIBP measurements at consistent intervals. Use the spin box or keypad to set the desired interval.
Note An alarm does not turn off intervals. Subsequent automatic measurements continue to occur as scheduled.
Start automatic intervals
Follow these steps to configure the monitor to take NIBP measurements at consistent intervals.
1. Properly size the blood pressure cuff and position it around the patient’s bare upper arm.
2. On the Home tab, touch
3. Select Automatic .
.
150 Patient monitoring Welch Allyn Connex ® Devices
4. Use the numeric keypad to enter the length of time between NIBP measurements.
5. Touch Start intervals .
Note Intervals are not available in all profiles. See the Profiles section for more information.
Program intervals
You can configure the monitor to take automatic NIBP measurements at variable intervals. The monitor comes with preset interval programs that can be edited to meet your needs. You can rename selected programs using the keyboard feature. The columns below the selected program name indicate the length of each interval in the cycle (Interval) and the number of intervals you set (Frequency).
Start program intervals
Follow these steps to configure the monitor to take automatic NIBP measurements at variable intervals.
1. Properly size the blood pressure cuff and position it around the patient’s bare upper arm.
2. On the Home tab, touch
3. Select Program .
4. Touch the desired program.
5. Touch Start intervals .
.
Create a new program interval or edit an existing program
Follow these steps to create or edit a program interval.
1. On the Home tab, touch the interval button (
2. Select Program .
or
3. Touch the desired program.
4. Touch the keyboard icon and enter the desired program name.
).
Directions for use Patient monitoring 151
5. Enter the desired interval and frequency settings.
6. Touch Start Intervals .
The new intervals take effect at the start of the next NIBP measurement.
Stat intervals
You can configure the monitor to take NIBP measurements continuously.
When you select the Stat option, the monitor takes repeated NIBP measurements for 5 minutes, starting a new cycle each time the cuff deflates below safe venous return pressure (SVRP) for 2 seconds.
WARNING Patient injury risk. If you use Stat mode repeatedly, periodically observe the patient's limb to ensure that circulation is not impaired and that the cuff remains in place. Prolonged impairment of circulation or improper cuff position can cause bruising.
Current cuff pressures are not dynamically displayed during a Stat reading. The Home tab displays the NIBP reading from the previous cycle until the current cycle finishes.
Note If you are in Stat intervals, you can stop intervals by touching .
Start Stat intervals
Follow these steps to start Stat intervals.
1. Properly size the blood pressure cuff and position it around the patient’s bare upper arm.
2. On the Home tab, touch
3. Select Stat .
4. Touch Start intervals .
.
The Home tab appears with the intervals timer counting down from 0:05:00.
152 Patient monitoring Welch Allyn Connex ® Devices
Stop intervals measurements
Follow these steps to turn off intervals.
1. On the Home tab, touch the interval timer button (
Note
).
The actual time remaining varies based on the length of the selected interval and the time expired.
2. Touch Stop intervals .
Note If you are in Stat intervals, you can also stop intervals on the Home tab by touching .
Office profile
The Office profile enables you to take manual NIBP measurements and use NIBP averaging programs. You need to set up NIBP averaging programs in Advanced settings
(see "Set up an NIBP averaging program").
NIBP averaging programs
An NIBP averaging program displays the average of multiple NIBP readings.
To calculate the average, the program takes a set of readings. The example below shows a program in progress:
4
5
Number
1
2
3
Feature
Numeric
View indicator
History
Program
Stop
Description
Displays the most recent reading.
Touch to toggle between NIBP views.
• Displays completed readings and placeholders for upcoming readings.
• A reading with a line through it is excluded from the average.
Displays the name of the program.
Touch to stop the current reading and terminate the program.
Directions for use Patient monitoring 153
Number
6
Feature
Interval
Description
Counts down to the next reading.
After the program takes all readings, it displays the average reading, as follows:
Number
1
2
3
Feature
Numeric
View indicator
History
Description
Displays the average of the readings.
Displays “NIBP AVERAGED.”
• Displays the readings taken by the program.
• A reading with a line through it is excluded from the average.
Start an NIBP averaging program
To acquire an NIBP average, start an NIBP averaging program from the Intervals tab.
1. Properly size the blood pressure cuff and position it around the patient’s bare upper arm.
2. On the Home tab, touch .
The Intervals tab appears.
3. Confirm that NIBP averaging is selected.
4. Touch the desired program.
The specifications of the program appear in the Summary area.
154 Patient monitoring Welch Allyn Connex ® Devices
5. Read the Summary information to confirm that the specifications are appropriate for your patient:
Setting Action/Description
Total readings
Discard readings
Delay to start
Time between readings
Keep baseline if reading is within + or -
Number of readings that the program takes.
Readings that the program excludes from the average.
For example, "1, 2" indicates that the program excludes the first and second readings.
Period between the start of the program (the moment that the "Start intervals" button is selected) and the start of the first reading.
Period between the end of one reading and the start of the next reading.
Range that the program uses to establish the baseline reading. For more information about how this setting affects the program, refer to the section "Excluded readings" below.
6. Touch Start intervals to start the program.
The Home tab appears.
In the NIBP frame, the timer counts down the “Delay to start” period. The first NIBP reading begins when the timer reaches 0.
After the first reading is acquired, the timer counts down the "Time between readings" period. The next NIBP reading begins when the timer reaches 0.
After taking all readings, the program displays the average.
Note
Note
If a technical alarm condition occurs while a reading is in progress, the reading stops. The timer counts down the
"Time between readings" period. When the timer reaches 0, the program attempts to take the reading again.
During an NIBP averaging program, the monitor saves all
NIBP readings except the average. To retain an NIBP average, touch Save upon completion of the averaging program.
Stop an NIBP averaging program
To stop an NIBP averaging program in progress, touch
The current reading stops, and the program terminates.
Note
on the Home tab.
When a program has been stopped, it cannot be restarted at the point that it was stopped. To start a new NIBP averaging program, select a program in the Intervals tab and touch
Start intervals .
Excluded readings
Directions for use Patient monitoring 155
An NIBP averaging program excludes readings for the following reasons:
• The reading is listed in the "Discard readings" setting of the program.
• The reading precedes the baseline reading.
The program establishes the baseline reading as follows:
• At the start of the program, Reading 1 is the baseline reading.
• The program compares the systolic value of Reading 2 to the systolic value of
Reading 1.
• If the difference between the values is within the "Keep baseline" range, Reading 1 remains the baseline. The program compares the next reading to Reading 1, and so on.
• If a reading is outside the range, that reading becomes the new baseline, and the program excludes from the average all readings that preceded the new baseline.
• After establishing a new baseline, the program compares subsequent readings to the new baseline and applies the rules described above.
BMI frame
The BMI frame displays body mass index (BMI), weight, and height.
Note This frame is available only in the Office profile.
Weight and height measurements can be entered manually or transferred from an attached weight scale. The profile calculates BMI based on weight and height input.
Note When a weight or height measurement is transferred from an attached weight scale to the monitor, the measurement displayed on the monitor is within one decimal place (0.1) of the measurement displayed by the weight scale.
Enter weight and height
The BMI frame enables you to enter weight and height measurements taken manually, and it displays weight and height measurements taken by an attached weight scale.
CAUTION Weight scales attached to this monitor must be running on battery power (battery type is specified in the weight scale manufacturer's directions for use). Do not use the weight scale's external power supply.
1. Verify that you are using the Office profile.
2. From the Home tab, touch the up/down arrow keys or the keypad to manually adjust weight and height.
Note If an approved, battery-powered weight scale is attached to the monitor, weight and height measurements from the weight scale populate fields in the BMI frame.
156 Patient monitoring
The BMI value changes based on weight and height input.
Pain frame
In the Pain frame, you can manually enter the patient's pain level.
Note This frame is available only in the Office profile.
Welch Allyn Connex ® Devices
Enter pain level
1. Verify that you are using the Office profile.
2. From the Home tab, touch the up/down arrow keys or the keypad to manually adjust the pain level.
Temperature
Temperature frame
From the temperature frame you can measure patient temperature.
The temperature frame contains data and features relevant to temperature measurement. The frame provides different features based on the profile you are using.
Temperature frame in Continuous Monitoring profile
The size of the Temperature frame and displayed measurements varies based on your configuration.
The Continuous Monitoring profile also provides a visual indication of aging episodic measurements (those more than 16 minutes old) and a timestamp indicating the time of the measurement. When a temperature measurement is displayed for more than 16 minutes, the numerics on the screen change from their current color to gray. After one hour, these measurements are cleared from the frame.
Temperature frame in Intervals Monitoring profile
Directions for use
Temperature frame in Spot Check profile
Patient monitoring 157
Temperature frame in Office profile
Temperature measurement display
In all profiles, the frame can display temperature in Celsius or Fahrenheit. You can configure the default view in Advanced settings.
Site selection
Note
Note
When taking temperature readings with either the SureTemp or Braun thermometer, the reference site is the measurement site. Therefore, no temperature readings require adjustments.
For additional guidance addressing core temperature and variations in body temperature by measurement site, see the "Normal Body Temperature
Ranges" Quick Reference Card on the Welch Allyn website.
to Remove the temperature probe and touch the Temperature site control toggle between sites.
Pediatric axillary Adult axillary Oral
Note
Rectal
Monitors configured with the temperature module and the red rectal probe well and probe default to the rectal mode.
158 Patient monitoring Welch Allyn Connex ® Devices
Note
Ear
The monitor displays the tympanic mode when it receives a temperature measurement from the ear thermometer.
Temperature buttons
The buttons on the right side of the frame enable you to do different tasks depending on the profile you are using. The availability of functions depends on which profile is selected.
Button name
Temperature alarm
Button image Description
This button displays alarm status. It also displays alarm limits in some device configurations.
Touch the button to display the Alarms tab.
Direct mode Touch the button to enter Direct mode.
Configure temperature alarms
Follow these steps to set alarm limits for temperature measurement.
1. Verify that you are using the Intervals or Continuous profile.
2. Touch the Alarms tab.
3. Touch the Temperature vertical tab.
4. Ensure that the Temperature alarm limit control is set to ON.
Note If any parameter's alarm limit control is set to OFF, you cannot adjust alarm limits on the Alarm tab, and no visual or audio signals will occur for that specific parameter.
5. Adjust the Temperature limits as desired. Enter the desired upper and lower alarm limits for temperature using the up/down arrow keys or the keypad.
6. Touch the Home tab.
The new alarm settings take effect immediately.
SureTemp
®
Plus temperature module
The temperature module uses a thermistor thermometer design and a predictive algorithm to calculate patient temperatures in the Predictive mode.
Directions for use Patient monitoring 159
WARNING Patient injury risk. Do not exceed the recommended temperature measurement durations in Direct mode. Continuous measurement durations of 3 minutes at the oral and rectal sites and 5 minutes at the axillary site are recommended for accurate measurement.
Do not continuously measure beyond 10 minutes in any mode.
WARNING Patient injury risk. Inaccurate measurement risk. Oral/axillary probes (blue ejection button at top of probe) and blue removable probe wells are used for taking oral and axillary temperatures only. Rectal probes
(red ejection button) and red removable probe wells are used for taking rectal temperatures only. Use of the incorrect removable probe well could result in patient cross-contamination. Use of the probe at the wrong site will result in temperature errors.
WARNING Patient injury risk. When taking rectal temperatures, insert the probe tip a maximum of 5/8 inch (approximately 1.5 cm) inside the rectum of adults and a maximum of 3/8 inch (approximately 1 cm) inside the rectum of children to avoid the risk of bowel perforation.
WARNING Inaccurate measurement risk. Always take an axillary temperature with direct contact between the probe cover and the skin.
Carefully place the probe in the axilla, avoiding contact with other objects or material.
WARNING Patient injury risk. Always take a temperature measurement with a Welch Allyn single-use probe cover securely attached. Failure to use a probe cover can cause patient discomfort from a heated probe, patient cross-contamination, and inaccurate temperature readings.
WARNING Inaccurate measurement risk. To ensure optimal accuracy, always confirm that the correct mode and site are selected.
WARNING Never use a damaged temperature probe. The thermometer consists of high-quality precision parts and should be protected from severe impact or shock. Do not use the thermometer if you notice any signs of damage to the probe or monitor. If the thermometer probe is dropped or damaged, remove it from use and have it inspected by qualified service personnel.
WARNING Inaccurate measurement risk. Apply a thin layer of lubricant to probe cover, if necessary, for patient comfort. Use of excessive lubricant may affect reading accuracy.
WARNING Many environmental variables, including patient physiology and clinical application, can affect the accuracy and performance of the monitor.
Therefore, you must verify all vital signs information, especially
Temperature, before treating the patient. If there is any question about the accuracy of a measurement, verify the measurement using another clinically accepted method. If the thermometer configured with the device is unavailable for any reason, use a different thermometer.
WARNING Patient injury risk. Always remain with patient while measuring temperature.
160 Patient monitoring Welch Allyn Connex ® Devices
CAUTION Inaccurate measurement risk. Patient activities such as strenuous exercise, ingesting hot or cold liquids, eating, chewing gum or mints, brushing teeth, or smoking may affect oral temperature measurements for up to 20 minutes.
CAUTION Inaccurate measurement risk. Always use new probe covers taken from the monitor's probe cover box holder to ensure accurate temperature measurements. Probe covers taken from other places or that haven't stabilized in temperature may result in inaccurate temperature measurements.
CAUTION Probe covers are disposable, nonsterilized, and single-use.
Probes are also nonsterilized. Do not autoclave probes and probe covers.
Ensure that probe covers are disposed of according to facility requirements or local regulations.
CAUTION Do not use the Suretemp to take or monitor the patient’s temperature during defibrillation or electrosurgery. This may damage the temperature probe.
Temperature mode selection
The monitor with the temperature module takes a patient temperature in either
Predictive (Normal) or Direct mode. The default setting is the Predictive mode.
WARNING Inaccurate measurement risk. To ensure optimal accuracy, always confirm that the correct mode and site are selected.
WARNING Patient injury risk. Do not exceed the recommended temperature measurement durations in Direct mode. Continuous measurement durations of 3 minutes at the oral and rectal sites and 5 minutes at the axillary site are recommended for accurate measurement.
Do not continuously measure beyond 10 minutes in any mode.
Predictive mode
Is a one-time measurement that takes a temperature in approximately 6 to 15 seconds.
Removing the probe from the probe well, loading a probe cover, and holding the probe tip in place at the measurement site initiates a Predictive mode measurement. The monitor sounds a tone to indicate the end of a predictive measurement.
Direct mode
Provides continual temperature measurements. For oral and rectal measurements, it is recommended to measure temperature until the temperature stabilizes or for 3 minutes.
For axillary measurements, it is recommended to measure temperature until the temperature stabilizes or for 5 minutes. The monitor changes to Direct mode approximately 60 seconds after the probe is removed from the probe well.
Note The monitor does not retain Direct mode temperatures in memory.Therefore, it is important to note the temperature before removing the probe from the measurement site and then manually record it in the patient record.
After 10 minutes of using the Direct mode, the monitor generates a technical alarm condition and clears the measurement.
Directions for use Patient monitoring 161
Take a temperature in the Predictive mode
WARNING Inaccurate measurement risk. To ensure optimal accuracy, always confirm that the correct mode and site are selected.
WARNING Patient injury risk. Prior to taking a temperature, instruct the patient not to bite down on the probe as patient injury and damage to the probe may result.
CAUTION Probe covers are disposable, nonsterilized, and single-use.
Probes are also nonsterilized. Do not autoclave probes and probe covers.
Ensure that probe covers are disposed of according to facility requirements or local regulations.
1. Remove the temperature probe from the probe well.
The monitor sounds a tone as it enters the ready state.
2. Insert the probe into a new probe cover and press the probe handle down firmly.
3. Touch the Temperature site control to choose from these measurement sites: oral, pediatric axillary, or adult axillary.
4. Hold the probe tip in place at the measurement site.
For oral temperatures, place the probe tip under the patient’s tongue on either side of the mouth to reach the sublingual pocket and ask the patient to close his/her lips.
Note Do not hand the probe to patients to place in their mouth.
For axillary temperatures, lift the patient’s arm so that the entire axilla is easily seen and place the probe tip as high as possible in the mid-axilla. Verify that axillary tissue completely surrounds the probe tip and place the arm snugly at the patient’s side.
While the measurement is taking place, the temperature frame displays the process indicator.
162 Patient monitoring Welch Allyn Connex ® Devices
5. The monitor sounds a tone when the final temperature is reached (in approximately
6 to 15 seconds). The temperature frame continues to display the temperature even after the probe is returned to the probe well.
Note To switch to the Direct mode, touch after you acquire the Predictive mode measurement. The temperature frame displays text indicating that the Direct mode is active.
The monitor sounds a tone at the start of a Direct mode measurement.
6. Remove the probe after the temperature measurement is complete and firmly press the eject button on the top of the probe to release the probe cover.
WARNING Patient injury risk. Do not exceed the recommended temperature measurement durations in Direct mode. Continuous measurement durations of 3 minutes at the oral and rectal sites and 5 minutes at the axillary site are recommended for accurate measurement. Do not continuously measure beyond 10 minutes in any mode.
Ensure that probe covers are disposed of according to facility requirements or local regulations.
7. Return the probe to the probe well.
8. Wash your hands to reduce the risk of cross-contamination.
Take a temperature in the Direct mode
Direct mode displays the temperature of the probe as long as the probe tip remains in place at the measurement site and remains within the operating patient temperature range. The patient’s temperature will reach final equilibrium in approximately 3 minutes at the oral and rectal measurement sites and approximately 5 minutes at the axillary site.
The monitor enters Direct mode by the following methods.
•
After you complete a Predictive mode measurement, touch to switch from
Predictive to Direct mode. The temperature frame displays text indicating that the
Direct mode is active.
• Remove the probe from the probe well, load a probe cover, select a temperature site, and expose the probe to ambient air for more than 60 seconds to switch the monitor to Direct mode. The temperature frame displays text indicating that the
Direct mode is active.
• If you have a patient whose body temperature is below the normal temperature range and you follow the previous step, the probe sensor identifies this condition and turns off the probe preheater in order to accommodate the lower body temperature measurement.
Directions for use Patient monitoring 163
WARNING Patient injury risk. Do not exceed the recommended temperature measurement durations in Direct mode. Continuous measurement durations of 3 minutes at the oral and rectal sites and 5 minutes at the axillary site are recommended for accurate measurement.
Do not continuously measure beyond 10 minutes in any mode.
WARNING Inaccurate measurement risk. To ensure optimal accuracy, always confirm that the correct mode and site are selected.
WARNING Patient injury risk. Prior to taking a temperature, instruct the patient not to bite down on the probe as patient injury and damage to the probe may result.
CAUTION Probe covers are disposable, nonsterilized, and single-use.
Probes are also nonsterilized. Do not autoclave probes and probe covers.
Ensure that probe covers are disposed of according to facility requirements or local regulations.
1. Remove the temperature probe from the probe well.
The monitor sounds a tone as it enters the ready state.
2. Insert the probe into a new probe cover and press the probe handle down firmly.
3. Touch the Temperature site control sites: oral, pediatric axillary, or adult axillary.
to choose from these measurement
The temperature frame changes to Direct mode approximately 60 seconds after the probe is removed from the probe well.
The monitor sounds a tone to indicate the start of a Direct mode measurement.
4. Hold the probe tip in place at the oral or rectal measurement site for a total of 3 minutes and for 5 minutes at the axillary site.
5. While the measurements are taking place, the temperature frame displays the patient's continuous temperature measurements.
Note The monitor does not retain Direct mode temperatures in memory. Therefore, it is important to note the temperature before removing the probe from the measurement site and then manually record it in the patient record.
6. Remove the probe after the temperature measurement is complete and firmly press the eject button on the top of the probe to release the probe cover.
7. Return the probe to the probe well to continue taking temperatures in the Predictive mode.
8. Wash your hands to reduce the risk of cross-contamination.
164 Patient monitoring Welch Allyn Connex ® Devices
Take a temperature at the rectal site
WARNING Patient injury risk. When taking rectal temperatures, insert the probe tip only 5/8 inch (approximately 1.5 cm) inside the rectum of adults and only 3/8 inch (approximately 1 cm) inside the rectum of children to avoid the risk of bowel perforation.
WARNING Cross-contamination or nosocomial infection risk. Thorough hand-washing greatly reduces the risk of cross-contamination and nosocomial infection.
WARNING Patient injury risk. Do not exceed the recommended temperature measurement durations in Direct mode. Continuous measurement durations of 3 minutes at the oral and rectal sites and 5 minutes at the axillary site are recommended for accurate measurement.
Do not continuously measure beyond 10 minutes in any mode.
WARNING Inaccurate measurement risk. To ensure optimal accuracy, always confirm that the correct mode and site are selected.
CAUTION Probe covers are disposable, nonsterilized, and single-use.
Probes are also nonsterilized. Do not autoclave probes and probe covers.
Ensure that probe covers are disposed of according to facility requirements or local regulations.
1. Remove the rectal temperature probe from the rectal probe well.
The monitor sounds a tone as it enters the ready state. The Temperature Site
Control defaults to the rectal site.
2. Insert the rectal probe into a new probe cover and press the probe handle down firmly.
3. Separate the patient’s buttocks with one hand. Use the other hand to gently insert the probe tip only 5/8 inch (1.5 cm) inside the rectum of adults and only 3/8 inch
(approximately 1 cm) inside the rectum of children. The use of a lubricant is optional.
4. Insert the probe so that the tip is in contact with tissue. Continue to separate the buttocks and hold the probe in place throughout the measurement process. While the measurement is taking place, the temperature frame displays the process indicator.
5. The monitor sounds a tone when the final temperature is reached (in approximately
10 to 13 seconds). The temperature frame continues to display the temperature even after the probe is returned to the probe well.
Directions for use Patient monitoring 165
Note
Note
To switch to the Direct mode, touch after the
Predictive mode measurement is acquired. The temperature frame displays text indicating that the Direct mode is active.
The monitor sounds a tone to indicate the start of a Direct measurement. Once you are in the Direct mode, continue to separate the buttocks and hold the probe in place throughout the measurement process.
The monitor does not retain Direct mode temperatures in memory. Therefore, it is important to note the temperature before removing the probe from the measurement site and then manually record it in the patient record.
6. Remove the probe after the temperature measurement is complete and firmly press the eject button on the top of the probe to release the probe cover.
7. Return the probe to the probe well.
8. Wash your hands to reduce the risk of cross-contamination.
Braun ThermoScan
®
PRO thermometer and accessory dock
The thermometer and accessory dock enable you to transfer an ear temperature measurement to the monitor. The dock also charges the thermometer battery.
Read the thermometer manufacturer's directions for use before attempting to configure, use, troubleshoot, or maintain the thermometer.
WARNING Liquids can damage electronics inside the thermometer.
Prevent liquids from spilling on the thermometer. If liquids are spilled on the thermometer, dry off the thermometer with a clean cloth. Check for proper operation and accuracy. If liquids possibly entered the thermometer, remove the thermometer from use until it has been properly dried, inspected, and tested by qualified service personnel.
WARNING Many environmental variables, including patient physiology and clinical application, can affect the accuracy and performance of the monitor.
Therefore, you must verify all vital signs information, especially
Temperature, before treating the patient. If there is any question about the accuracy of a measurement, verify the measurement using another clinically accepted method. If the thermometer configured with the device is unavailable for any reason, use a different thermometer.
CAUTION Probe covers are disposable, nonsterilized, and single-use. The thermometer is also nonsterilized. Do not autoclave the thermometer and probe covers. Ensure that probe covers are disposed of according to facility requirements or local regulations.
CAUTION The thermometer has no user-serviceable parts. If service is required, call your nearest Welch Allyn Customer Service or Technical
Support facility.
166 Patient monitoring Welch Allyn Connex ® Devices
CAUTION Store the thermometer and probe covers in a dry location, free from dust and contamination and away from direct sunlight. Keep the ambient temperature at the storage location fairly constant and within the range of 50°F to 104°F (10°C to 40°C).
Take a temperature at the ear site
WARNING Probe covers are single-use only. Re-use of a probe cover may result in spread of bacteria and cross-contamination.
Note
WARNING Inaccurate measurement risk. Use only Braun ThermoScan probe covers with this thermometer.
WARNING Inaccurate measurement risk. Frequently inspect the probe window and keep it clean, dry, and undamaged. Fingerprints, cerumen, dust, and other contaminants reduce the transparency of the window and result in lower temperature measurements. To protect the window, always keep the thermometer in the accessory dock when the thermometer is not in use.
CAUTION Inaccurate measurement risk. Before taking a temperature measurement, make sure that the ear is free from obstructions and excess cerumen build-up.
CAUTION Inaccurate measurement risk. The following factors can affect ear temperature measurements for up to 20 minutes:
• The patient was lying on his or her ear.
• The patient's ear was covered.
• The patient was exposed to very hot or very cold temperatures.
• The patient was swimming or bathing.
• The patient was wearing a hearing aid or an ear plug.
CAUTION Inaccurate measurement risk. If ear drops or other ear medications have been placed in one ear canal, take the temperature in the untreated ear.
A temperature measurement taken in the right ear might differ from a measurement taken in the left ear. Therefore, always take the temperature in the same ear.
Note When the monitor receives an ear temperature measurement, it displays the measurement on the Home tab. If the Home tab already contains a temperature measurement, the new measurement overwrites it.
To take a measurement and transfer it to the monitor:
1. Make sure that the monitor is powered on.
2. Remove the ear thermometer from the accessory dock.
The thermometer turns on automatically when you remove the thermometer from the dock.
Note If the thermometer has been undocked, it turns on after you complete step 4.
3. Locate the probe cover box in the accessory dock.
Directions for use Patient monitoring 167
4. Firmly push the probe tip into the probe cover box.
When the probe cover is in place, previously undocked thermometers turn on automatically.
5. Proceed as follows based on your Braun thermometer model:
• Braun 4000: Wait for the ready beep and three dashes to appear on the thermometer display.
• Braun 6000: Wait for the ready beep, three dashes to appear on the thermometer display, and the ring around the Measure button to turn green.
6. Fit the probe snugly into the ear canal and proceed as follows based on your Braun thermometer model:
• Braun 4000: Push and release the Start button.
• Braun 6000: Push and release the Measure button.
• If the probe is positioned correctly in the ear canal the ExacTemp light flashes.
When the thermometer detects an accurate measurement, the ExacTemp light is continuously on, a long beep signals the end of the measurement, and the display shows the result.
• If the probe is positioned incorrectly in the ear canal or is moved during the measuring process, the ExacTemp light goes out, a sequence of short beeps sounds, and the error message POS (position error) appears.
7. When you are finished taking the temperature, press the ejector button to eject the used probe cover.
8. Return the thermometer to the accessory dock.
After the transfer is complete, the temperature and the temperature scale appear on the Home tab according to the monitor settings.
Note
Note
Only the latest measurement is transferred to the monitor.
Measurements that have already been transferred to the monitor cannot be transferred again.
For more information about thermometer functionality, refer to the thermometer manufacturer's directions for use.
Change the temperature scale on the ear thermometer
To switch from Celsius to Fahrenheit, refer to the thermometer manufacturer's directions for use.
Charge the ear thermometer battery
To charge the battery pack:
• Place the thermometer in the accessory dock.
• Make sure that the monitor is connected to AC power.
• Make sure that the monitor is powered on.
The LED on the dock indicates the charging status of the battery pack.
PRO 6000 model
• Amber: The battery pack is charging.
PRO 4000 model
• Green: The battery pack is charged.
168 Patient monitoring Welch Allyn Connex ® Devices
PRO 6000 model PRO 4000 model
• Blinking green: The battery pack is fully charged.
• Steady green: The battery pack is ready to charge, but dock is empty or thermometer is improperly docked.
• No LED/Off: Not ready to charge. The monitor is not connected to AC power and is not powered on, or the monitor has disabled charging.
• Amber: The battery pack is charging.
• No LED/Off: Not ready to charge. The monitor is not connected to AC power and is not powered on, or the monitor has disabled charging.
Note
Note
The battery pack continues to charge while the monitor is in Display power saving mode.
It is strongly recommended that you use only the Welch Allyn rechargeable battery pack in the thermometer because the dock cannot charge other batteries.
Temperature mode selection
The monitor with the temperature module takes a patient temperature in either
Predictive (Normal) or Direct mode. The default setting is the Predictive mode.
WARNING Inaccurate measurement risk. To ensure optimal accuracy, always confirm that the correct mode and site are selected.
WARNING Patient injury risk. Do not exceed the recommended temperature measurement durations in Direct mode. Continuous measurement durations of 3 minutes at the oral and rectal sites and 5 minutes at the axillary site are recommended for accurate measurement.
Do not continuously measure beyond 10 minutes in any mode.
Predictive mode
Is a one-time measurement that takes a temperature in approximately 6 to 15 seconds.
Removing the probe from the probe well, loading a probe cover, and holding the probe tip in place at the measurement site initiates a Predictive mode measurement. The monitor sounds a tone to indicate the end of a predictive measurement.
Direct mode
Provides continual temperature measurements. For oral and rectal measurements, it is recommended to measure temperature until the temperature stabilizes or for 3 minutes.
For axillary measurements, it is recommended to measure temperature until the temperature stabilizes or for 5 minutes. The monitor changes to Direct mode approximately 60 seconds after the probe is removed from the probe well.
Note The monitor does not retain Direct mode temperatures in memory.Therefore, it is important to note the temperature before removing the probe from the measurement site and then manually record it in the patient record.
After 10 minutes of using the Direct mode, the monitor generates a technical alarm condition and clears the measurement.
Directions for use Patient monitoring 169
SpO2
The SpO2 sensor measures oxygen saturation and pulse rate. Oxygen saturation is displayed as a percentage from zero (0) to 100%. The oxygen saturation and pulse rate are updated and refreshed each second, ± 0.5 seconds.
SpO2 frame
The SpO2 frame displays data and controls used in pulse oximetry measurements.
The frame provides a numeric view and a waveform view of SpO2 data. You can toggle between views by touching the left side of the frame.
SpO2 numeric view
The numeric view indicates the SpO2 saturation percentage and the pulse amplitude.
Features of this view differ based on the type of sensor enabled and the profile selected.
The size of the SpO2 frame and displayed measurements varies based on your configuration.
Nellcor sensor
Intervals Monitoring and Continuous Monitoring profiles Spot Check profile
Masimo sensor
Intervals Monitoring profile, no SpHb license
Intervals Monitoring profile, SpHb license activated
Spot Check profile
170 Patient monitoring Welch Allyn Connex ® Devices
Continuous Monitoring profile
Pulse amplitude
The pulse amplitude bar indicates the pulse beat and shows the relative pulse strength.
More bars illuminate as the detected pulse gets stronger.
Response Mode Control
The Response Mode Control allows you to set the SpO2 measurement time to either
Normal or Fast.
Perfusion Index
Perfusion Index (PI) is an SpO2 feature available only with Masimo-equipped monitors.
PI is a relative reading of pulse strength at the monitoring site. PI display ranges from 0.1
percent (very weak pulse strength) to 20.0 percent (very strong pulse strength). PI is a relative number and varies between monitoring sites and from patient to patient, as physiological conditions vary.
During sensor placement, the PI can be used to evaluate the appropriateness of an application site, looking for the site with the highest PI number. Placing the sensor at the site with the strongest pulse amplitude (highest PI number) improves performance during motion. Monitor the trend of the PI for changes in physiological conditions.
SatSeconds™ alarm management
The SatSeconds feature is an SpO2 alarm management system available only with monitors that are equipped with Nellcor OxiMax Technology.
The SatSeconds feature is the product of the time and magnitude that a patient falls outside of the SpO2 alarm limits. For example, three points below the alarm limit for 10 seconds equals 30 SatSeconds. An alarm is triggered only when a desaturation event reaches the SatSeconds limit. The SatSeconds feature is clinician controlled and can be
Directions for use Patient monitoring 171 set to 0, 10, 25, 50, or 100 SatSeconds. If a desaturation event resolves on its own within the preset time, the clock will automatically reset and the monitor will not alarm.
Note The SatSeconds feature has a built-in safety protocol that sounds an alarm whenever three SpO2 violations of any amount or duration occur within a
1-minute period.
SpO2 waveform view
The waveform view shows the SpO2 plethysmograph waveform. You can select the default SpO2 waveform sweep speed in Advanced settings, but you can change the sweep speed on the Setup tab.
For additional normalization and waveform information, refer to the manufacturer's directions for use.
Set up SpO2
Follow these steps to configure SpO2 parameter settings and to set up modifiers.
1. Touch the Settings tab.
2. Touch the Setup tab.
3. Touch the SpO2 vertical tab.
4. Select the desired Sweep speed.
5. Touch the Home tab.
The new setting takes effect immediately.
6. To set up modifiers, touch the Patients tab.
7. Touch the Manual tab.
8. Scroll through the list to find the SpO2 section, then enter or select the SpO2 modifier(s) as desired.
• SpO2 measurement site. Select the measurement site from the list box.
• O2 flow rate. Enter the flow rate using the keypad.
Note All O2 modifier selections are cleared when the O2 flow rate is changed to 0 and when the O2 method is changed to none.
• O2 concentration. Enter the concentration using the keypad.
• O2 Method. Select the method from the list box.
172 Patient monitoring Welch Allyn Connex ® Devices
9. Enter or select other modifier(s), if applicable, as desired.
10. Touch OK .
The Home tab appears. In the Continuous Monitoring profile, the modifiers are saved with the next set of measurements sent to the network. In the episodic profiles, the modifiers are saved with the next set of measurements you take or with any current, unsaved measurements on the device when you touch Save .
SpO2 alarm signal delays
Configure SpO2 alarms
Follow these steps to set alarm limits for SpO2 measurements.
1. Verify that you are using the Intervals Monitoring or Continuous Monitoring profile.
2. Touch the Alarms tab.
3. Touch the SpO2 vertical tab.
4. Ensure that the SpO2 alarm limit control is set to ON.
Note If any parameter's alarm limit control is set to OFF, you cannot adjust alarm limits on the Alarm tab, and no visual or audio signals will occur for that specific parameter.
5. Enter the desired upper and lower alarms limits for SpO2 using the up/down arrow keys or the keypad.
6. If your monitor is configured with a Nellcor SpO2 sensor, touch select a SatSeconds setting.
7. Touch the Home tab.
The new alarm settings take effect immediately.
Set Response Mode
To set the Response Mode from the Home tab, the monitor must be in the Intervals
Monitoring or Continuous Monitoring profile.
to
Touch in the SpO2 frame.
When Fast mode is selected, either MODE: Fast or : Fast appears in the frame.
Measure SpO2 and pulse rate
WARNING Many environmental variables, including patient physiology and clinical application, can affect the accuracy and performance of the monitor.
Therefore, you must verify all vital signs information, especially NIBP and
SpO2, before treating the patient. If there is any question about the accuracy of a measurement, verify the measurement using another clinically accepted method.
Directions for use Patient monitoring 173
WARNING Inaccurate measurement risk. Use only Masimo rainbow SET sensors and accessories on Masimo-equipped monitors.
WARNING Inaccurate measurement risk. Use only Nellcor sensors and accessories on Nellcor-equipped monitors.
WARNING High-intensity lights (including pulsating strobe lights) directed on the pulse co-oximeter can prevent it from obtaining readings.
WARNING The pulsations from intra-aortic balloon support can increase the pulse rate displayed on the monitor. Verify the patient's pulse rate against the ECG heart rate.
WARNING Inaccurate measurement risk. Venous congestion might cause a low reading of arterial oxygen saturation. Place the sensor on a hand at heart level to ensure proper venous outflow from a monitored site.
WARNING Inaccurate measurement risk. The pulse co-oximeter can be used during defibrillation, but the reading may be inaccurate for up to 20 seconds.
WARNING Patient injury risk. Do not attempt to reprocess, recondition, or modify any sensors or patient cables. Doing so might damage electrical components.
WARNING Pulse rate measurement might not detect certain arrhythmias because it is based on the optical detection of a peripheral flow pulse. Do not use the pulse oximeter as a replacement or substitute for ECG-based arrhythmia analysis.
WARNING Use the pulse co-oximeter as an early warning device. As you observe a trend toward patient hypoxemia, use laboratory instruments to analyze blood samples to better understand the patient's condition.
WARNING Patient injury risk. If the sensor is applied with excessive pressure for prolonged periods, a pressure injury can occur.
WARNING Functional testers cannot be used to assess the accuracy of a pulse oximeter monitor.
174 Patient monitoring Welch Allyn Connex ® Devices
WARNING The accuracy of SpO2 measurements can be affected by any of the following:
• elevated levels of total bilirubin
• elevated levels of Methemoglobin (MetHb)
• elevated levels of Carboxyhemoglobin (COHb)
• hemoglobin synthesis disorders
• low perfusion at the monitored site
• the presence of concentrations of some intravascular dyes, sufficient to change the patient's usual arterial pigmentation
• patient movement
• patient conditions such as shivering and smoke inhalation
• motion artifact
• painted nails
• poor oxygen perfusion
• hypotension or hypertension
• severe vasoconstriction
• shock or cardiac arrest
• venous pulsations or sudden and significant changes in pulse rate
• proximity to an MRI environment
• moisture in the sensor
• excessive ambient light, especially fluorescent
• the use of the wrong sensor
• a sensor misapplied or dislodged
• severe anemia
• venous congestion
1. Verify that the sensor cable is connected to the monitor.
WARNING Patient injury risk. The sensor and extension cable are intended only for connection to pulse co-oximetry equipment. Do not attempt to connect these cables to a PC or any similar device. Always follow the sensor manufacturer's directions for care and use of the sensor.
2. Clean the application site. Remove anything, such as nail polish, that could interfere with sensor operation.
Note Do not use disposable sensors on patients who have allergic reactions to the adhesive.
3. Attach the sensor to the patient according to the manufacturer's directions for use, observing all warnings and cautions.
WARNING Patient injury and inaccurate measurement risk.
Do not use tape to secure the sensor to the patient. This can restrict blood flow, damage the patient's skin, cause inaccurate readings, and damage the sensor.
Directions for use Patient monitoring 175
WARNING Patient injury risk. Exercise caution whe applying a sensor to a patient with compromised skin integrity.
Applying tape or pressure to compromised sites can reduce circulation and cause additional skin damage.
Note If a sterile sensor is required, select a sensor that has been validated for sterilization, and follow the sensor manufacturer's directions for sterilizing the sensor.
Place the sensor and the NIBP cuff on different limbs to reduce unnecessary alarms when you monitor these parameters at the same time.
Note A range of sensors is available for different patient sizes and measurement sites. Consult the sensor manufacturer's instructions for selecting the correct sensor.
4. Confirm that the monitor displays SpO2 and pulse rate data within 15 seconds of connection to the patient.
WARNING Patient injury risk. Incorrect sensor application or excessive duration of sensor use can cause tissue damage.
Inspect the sensor site periodically as directed in the sensor manufacturer's instructions.
While SpO2 is being measured, the displayed pulse rate is derived from the sensor. If
SpO2 is not available, the pulse rate is derived from NIBP.
If SpO2 is being measured continuously on a patient for an extended period, change the sensor location at least every three hours or as indicated by the sensor manufacturer's instructions.
Note In the Intervals Monitoring and Continuous Monitoring profiles, removing the SpO2 sensor from the patient triggers the following responses:
• The last SpO2 saturation measurement captured before the sensor was removed remains on the display for approximately 10 seconds and then is cleared.
• If SpO2 physiological alarm limits are ON, when the saturation measurement is cleared, a "Searching for pulse signal" technical alarm occurs.
• If SpO2 physiological alarm limits are OFF, when the saturation measurement is cleared, no physiological or technical alarms occur.
SpHb
Monitors configured with Masimo total hemoglobin can measure hemoglobin (SpHb),
SpO2, and pulse rate. SpHb monitoring continuously measures blood constituents and anemic status in a patient through a noninvasive SpHb pulse co-oximeter.
SpHb frame
The SpHb frame displays data and controls used in total hemoglobin measurements.
Note SpHb is available only in the Intervals Monitoring and Continuous
Monitoring profiles.
In this frame, one of two labels appears:
176 Patient monitoring Welch Allyn Connex ® Devices
• SpHbv indicates the venous calibrated reference for total hemoglobin measurement.
• SpHb indicates the arterial calibrated reference for total hemoglobin measurement.
You can specify the reference source in Advanced settings.
The frame provides a numeric view and a graphical trend view of total hemoglobin data.
You can toggle between views by touching the left side of the frame.
SpHb numeric view
The numeric view indicates the total hemoglobin level in either grams per deciliter (g/dL) or millimoles per liter (mmol/L). You can select the unit of measure in Advanced settings.
The size of the SpHb frame and displayed measurements varies based on your configuration.
Averaging
The averaging button enables you to select the moving window of time used by the parameter to calculate the SpHb value and update the display: short (approximately 1 minute), medium (approximately 3 minutes), or long (approximately 6 minutes).
SpHb graphical trend view
The graphical trend view presents a trend of the measurements over a user-selected period. You can select the period displayed on the Setup tab. The size of the SpHb frame and displayed trend varies based on your configuration.
The graph shows total hemoglobin level on the y-axis and time on the x-axis (oldest measurements on the left to newest measurements on the right). The entire graph updates every 10 seconds.
To the right of the graph, the frame displays the current measurement in numeric format.
Set up SpHb
Follow these steps to configure SpHb parameter settings.
1. Touch the Settings tab.
2. Touch the Setup tab.
3. Touch the SpHb vertical tab.
4. Select the desired Trend period.
5. Touch the Home tab.
The new settings take effect immediately.
Directions for use Patient monitoring 177
Configure SpHb alarms
Follow these steps to set alarm limits for SpHb measurements.
1. Verify that you are using the Intervals Monitoring or Continuous Monitoring profile.
2. Touch the Alarms tab.
3. Touch the SpHb vertical tab.
4. Ensure that the SpHb alarm limit control is set to ON.
Note If any parameter's alarm limit control is set to OFF, you cannot adjust alarm limits on the Alarm tab, and no visual or audio signals will occur for that specific parameter.
5. Enter the desired upper and lower alarm limits for SpHb using the up/down arrow keys or the keypad.
6. Touch the Home tab.
The new alarm settings take effect immediately.
Set SpHb averaging mode
Touch in the SpHb frame.
The SpHb frame displays the current mode.
Measure SpHb
WARNING Inaccurate measurement risk. Use only Masimo rainbow SET sensors and accessories on Masimo-equipped monitors.
WARNING High-intensity lights (including pulsating strobe lights) directed on the pulse co-oximeter can prevent it from obtaining readings.
WARNING The pulsations from intra-aortic balloon support can increase the pulse rate displayed on the monitor. Verify the patient's pulse rate against the ECG heart rate.
WARNING Inaccurate measurement risk. Venous congestion might cause a low reading of arterial oxygen saturation. Place the sensor on a hand at heart level to ensure proper venous outflow from a monitored site.
WARNING Inaccurate measurement risk. The pulse co-oximeter can be used during defibrillation, but the reading may be inaccurate for up to 20 seconds.
WARNING Patient injury risk. Do not attempt to reprocess, recondition, or modify any sensors or patient cables. Doing so might damage electrical components.
WARNING Pulse rate measurement might not detect certain arrhythmias because it is based on the optical detection of a peripheral flow pulse. Do not use the pulse oximeter as a replacement or substitute for ECG-based arrhythmia analysis.
178 Patient monitoring Welch Allyn Connex ® Devices
WARNING Use the pulse co-oximeter as an early warning device. As you observe a trend toward patient hypoxemia, use laboratory instruments to analyze blood samples to better understand the patient's condition.
WARNING The accuracy of SpHb measurements can be affected by any of the following:
• elevated levels of total bilirubin
• elevated levels of Methemoglobin (MetHb)
• elevated levels of Carboxyhemoglobin (COHb)
• hemoglobin synthesis disorders
• low perfusion at the monitored site
• the presence of concentrations of some intravascular dyes, sufficient to change the patient's usual arterial pigmentation
• patient movement
• patient conditions such as shivering and smoke inhalation
• motion artifact
• painted nails
• poor oxygen perfusion
• hypotension or hypertension
• severe vasoconstriction
• shock or cardiac arrest
• venous pulsations or sudden and significant changes in pulse rate
• proximity to an MRI environment
• moisture in the sensor
• excessive ambient light, especially fluorescent
• the use of the wrong sensor
• a sensor misapplied or dislodged
• severe anemia
• venous congestion
1. Verify that the sensor cable is connected to the monitor.
WARNING Patient injury risk. The sensor and extension cable are intended only for connection to pulse co-oximetry equipment. Do not attempt to connect these cables to a PC or any similar device. Always follow the sensor manufacturer's directions for care and use of the sensor.
2. Verify that you are using the Continuous or Intervals profile.
3. Clean the application site. Remove anything, such as nail polish, that could interfere with sensor operation.
Note Do not use disposable sensors on patients who have allergic reactions to the adhesive.
4. Attach the sensor to the patient according to the manufacturer's directions for use, observing all warnings and cautions.
Directions for use Patient monitoring 179
WARNING Patient injury and inaccurate measurement risk.
Do not use tape to secure the sensor to the patient. This can restrict blood flow, damage the patient's skin, cause inaccurate readings, and damage the sensor.
WARNING Patient injury risk. Exercise caution whe applying a sensor to a patient with compromised skin integrity.
Applying tape or pressure to compromised sites can reduce circulation and cause additional skin damage.
Note If a sterile sensor is required, select a sensor that has been validated for sterilization, and follow the sensor manufacturer's directions for sterilizing the sensor.
Place the sensor and the NIBP cuff on different limbs to reduce unnecessary alarms when you monitor these parameters at the same time.
Note A range of sensors is available for different patient sizes and measurement sites. Consult the sensor manufacturer's instructions for selecting the correct sensor.
5. Confirm that the monitor displays SpHb or SpHbv data after connection to the patient.
WARNING Patient injury risk. Incorrect sensor application or excessive duration of sensor use can cause tissue damage.
Inspect the sensor site periodically as directed in the sensor manufacturer's instructions.
While SpHb is being measured, the displayed SpO2 and pulse rate are derived from the same sensor. If SpO2 is not available, the pulse rate is derived from NIBP.
Detaching the sensor during a measurement triggers an alarm.
If SpHb is being measured continuously on a patient for an extended period, change the sensor location at least every three hours or as indicated by the sensor manufacturer's instructions.
ECG
1. If you haven't done so already, connect the ECG module to the host Connex device.
(See "Mount and connect the ECG module" in the Setup section.)
After the device boots up, if Continuous Monitoring is the default profile, the ECG frame will appear on the Home tab, showing that the device is ready to acquire ECG.
2. If the default profile is something other than Continuous monitoring, follow the instructions in "Change to the Continuous Monitoring profile" before proceeding.
3. Follow the guidance and instructions later in this section for connecting the patient cable, placing leads, and acquiring ECG and Impedance Respiration readings.
Interface overview
These sample screens show how the ECG/Impedance Respiration module displays physiological information on the host Connex device.
180 Patient monitoring
ECG frame
Welch Allyn Connex ® Devices
Item
1
2
3
4
5
6
Respiration Rate frame
Description
ECG frame
Lead toggle and label. Green lead is displayed.
ECG grid
ECG waveform
Gain setting label
Sweep speed label
9
10
11
12
Item
7
8
Description
Filter label
Heart rate/Pulse rate label
Heart rate/Pulse rate alarm limit controls
Heart rate/Pulse rate source label
Start/Stop ECG button
Waveform snapshot button
Item
1
2
3
Description
Respiration Rate frame
Respiration source label
Respiration alarm limit controls
Set up ECG/Impedance Respiration
Follow these steps to configure ECG parameter options.
WARNING Arrhythmia detection (for V-Tach, V-Fib and asystole) and impedance respiration are not intended for neonatal patients.
1. Touch the Settings tab.
2. Touch the Setup tab.
Directions for use Patient monitoring 181
3. Touch the ECG vertical tab.
4. Adjust the following settings as desired:
• ECG Gain. Select the desired gain.
• Sweep speed. Select the desired sweep speed (25 mm/s or 50 mm/s).
Note The display sweep speed matches the printout sweep speed.
• Filter. Touch the selection box to enable or disable Filter.
WARNING Inaccurate measurement risk. In normal measurement conditions, enabling the filter might suppress the QRS complexes too much and thus interfere with ECG analysis.
• Use ECG as the RR source when available. Touch the selection box to enable or disable Impedance Respiration.
WARNING Inaccurate measurement risk. Use of respiration monitoring by impedance pneumography can affect the operation of some pacemakers. If pacemaker operation is affected, turn off respiration pneumography.
5. Set Pacemaker detection as needed. Touch the selection box to enable or disable the display of pacemaker spike markers, as shown here.
Note
WARNING Patient safety risk. Correctly set pacemaker detection. A pacemaker pulse can be counted as a QRS, which could result in an incorrect heart rate and failure to detect cardiac arrest and some life-threatening arrhythmias
(V-Tach, V-Fib, and asystole). If your patient has a pacemaker, turn pacemaker detection ON to avoid this hazard, and keep pacemaker patients under close observation.
The default setting is Pacemaker detection Off. After monitoring a patient with Pacemaker detection On, the device returns to the default before monitoring the next patient. Return to the Settings > Setup > ECG tab to enable
Pacemaker detection for new patients.
6. Touch the Home tab.
The new settings take effect immediately.
182 Patient monitoring Welch Allyn Connex ® Devices
Lead placement overview
WARNING Patient safety risk. To minimize interference and the danger of burns to the patient, use only approved ECG cables. Keep the ECG cable as far away as possible from any electrosurgical cables. Make sure that the electrosurgical return conductor (neutral) is properly attached to the patient and makes a good contact.
Proper lead placement is important for a successful ECG. The most common ECG problems are caused by poor electrode contact and loose leads.
The following table shows the relationships between IEC and AHA leads as well as their placement.
IEC Lead IEC Color AHA Lead AHA Color Placement
R
L
F
C or C1
N
Red
Yellow
Green
White
Black
RA
LA
LL
V or V1
RL
White
Black
Red
Brown
Green
Right arm
Left arm
Left leg
4th intercostal (IC) space at right border of the sternum
Right leg
Directions for use
Lead placement, 3-lead
Lead placement, 5-lead
Patient monitoring 183
IEC
R - Red
L - Yellow
F - Green
AHA
RA - White
LA - Black
LL - Red
IEC
N - Black
R - Red
L - Yellow
C - White
F - Green
184 Patient monitoring Welch Allyn Connex ® Devices
AHA
RL - Green
RA - White
LA - Black
V - Brown
LL - Red
Impedance respiration
In some patients, impedance respiration detection may be inadequate using the standard
ECG electrode placement. In these cases, change the F and R (IEC) or LL and RA (AHA) electrode placement to the mid-axillary line on each side of the chest as shown in the illustrations.
Note Respiration can only be acquired from Lead II.
IEC
N - Black
R - Red
L - Yellow
C - White
F - Green
AHA
RL - Green
RA - White
LA - Black
V - Brown
LL - Red
Directions for use Patient monitoring 185
Attach the leads to the patient
Proper lead attachment is important for a successful ECG. The most common ECG problems are caused by poor electrode contact and loose leads. Follow your local procedures for attaching the leads to the patient. Here are some common guidelines.
WARNING Electrodes can cause allergic reactions. To avoid this, follow the electrode manufacturer’s directions.
WARNING Skin irritation may result from the continuous application of the
ECG electrodes. Examine the skin for signs of irritation or inflammation and avoid placing the electrode in those areas. If you observe skin irritation, replace the electrodes or change the location of the electrodes every 24 hours.
WARNING Connect patient lead wires only to the patient electrodes.
WARNING Patient safety risk. The most important aspect of obtaining a quality electrocardiogram is a proper electrode hook-up. Failure to properly apply the electrodes and patient cable may result in noisy signal, false alarms, or sub-optimal electrocardiogram analysis, which could cause patient harm. Any of these events could potentially contribute to patient harm.
WARNING Patient injury risk. Use only accessories approved by Welch
Allyn, including electrodes, lead wires, and patient cables. These approved accessories are required for electrical protection of the patient during cardiac defibrillation. Refer to the accessory list or www.welchallyn.com.
WARNING Inaccurate measurement risk. Impedance respiration monitoring is not reliable when ECG electrodes are placed on the limbs.
To attach the leads to the patient
1. Prepare the patient.
• Describe the ECG procedure. Explain the importance of holding still during the test. (Movement can create artifact.)
• Verify that the patient is comfortable, warm, and relaxed. (Shivering can create artifact.)
• Put the patient in a supine position.
2. Prepare the electrode locations.
• Shave and gently abrade the areas where you will place the electrodes. Take care not to compromise skin integrity.
186 Patient monitoring Welch Allyn Connex ® Devices
• Thoroughly clean the skin, and lightly rub it dry. You may use soap and water, isopropyl alcohol, or skin preparation pads.
3. Confirm that the patient cable is attached to the module, and then snap the lead wire to each the electrode.
4. Apply the electrodes (disposable or reusable) to the patient according to the "Lead placement overview" presented earlier in this section.
• For reusable electrodes : Use electrode paste, gel, or cream to cover an area the size of each electrode but no larger.
Note Check for buildup of materials on reusable electrodes which can reduce waveform quality.
• For all disposable electrodes : Lightly tug on the connector to ensure that the lead is securely attached. If the electrode comes off, replace it with a new electrode. If the connector comes off, reconnect it.
Note
WARNING Patient injury risk. To prevent crosscontamination and the spread of infection:
• Dispose of single-patient use components (for example, electrodes) after use.
• Regularly clean and disinfect all components that come in contact with patients.
• Reprocess the device accessories (for example, patient cable, leads, and reusable electrodes) between patients.
To maintain the quality of signals during long-term monitoring, replace the electrodes at least every 48 hours.
Over longer periods, the electrode gel can dry out and the patient's skin can be irritated by the gel or adhesive. When replacing the electrodes, do not position the new electrodes on exactly the same locations, but a little to the side of the original position.
Monitor the patient
1. Touch Start in the ECG frame to begin acquiring an ECG waveform. Allow 3 to 5 seconds to pass before the waveform appears onscreen. The Heart Rate also appears in the ECG frame.
2. Locate the ECG lead label in the frame. Look for a list of available leads with the current lead selection highlighted.
3. To display a different lead, touch the screen anywhere on the waveform. The waveform and lead selection label change with each touch.
4. Continue monitoring ECG as needed.
Save and review a waveform snapshot
Non-alarming waveform snapshots
You can save snapshots of non-alarming waveforms to the Review tab. Non-alarming waveform snapshots capture 7 seconds of data before the request.
Directions for use Patient monitoring 187
Note You can capture one waveform snapshot per minute.
1. When you observe a waveform you want to capture, touch in the ECG frame.
A "Snapshot save successful" message appears to confirm a successful waveform capture.
2. Touch the Review tab and observe the saved waveform icon
3. To open and review the waveform snapshot, touch .
4. Touch Print to print the waveform or Cancel to close the snapshot.
Both selections return you to the Review tab.
in the ECG row.
Alarm waveform snapshots
Arrhythmia (V-Tach, V-Fib, and asystole) alarm waveform snapshots are saved automatically to the Review tab. No user action is required.
Note the following:
• If “Print on alarm” has been enabled in Advanced settings, the waveform prints automatically after saving is complete.
• The saved waveform icon for an alarm condition appears red
Review table, indicating a high priority alarm.
in the
• Alarm waveforms capture the 7 seconds before as well as the 7 seconds after an alarm event (V-Tach, V-Fib, and asystole).
• During the 7-second post-alarm save time, you cannot modify any settings
(leads, filter, gain, pacemaker detection, etc.).
Pause continuous monitoring (Pause mode)
You can temporarily pause continuous monitoring and retain patient data on the device when your patient needs to ambulate, use the restroom, or go off the unit for a test. You can also Pause monitoring to replace ECG electrodes on your patient.
Note If a low-battery alarm occurs on the device, Pause mode is not available.
Note While in Pause mode, the device retains previously stored patient data, but it does not display this data or store additional patient measurements until you exit Pause mode.
Resume continuous monitoring
You can resume continuous monitoring after a pause when patient sensors are connected to a patient. The status of the pause timer determines your next step.
Pause time remaining
If the pause time limit has not expired (time remains on the countdown timer), resume monitoring as follows:
1. Reconnect patient sensors to the patient as needed.
188 Patient monitoring Welch Allyn Connex ® Devices
2. Touch Resume monitoring .
The Home tab appears and continuous monitoring resumes.
Pause time limit expired (patient sensors connected)
If the pause time limit has expired and you have already reconnected patient sensors to the patient and/or the device, the Home tab appears and continuous monitoring automatically resumes.
Pause time limit expired (patient sensors disconnected)
If the pause time limit runs out before you resume monitoring, the device exits Pause mode, and alarms might occur.
Reconnect patient sensors to the patient and/or device and acknowledge alarm and information messages as needed.
Continuous monitoring resumes.
Stop ECG measurement
Follow these steps to stop ECG monitoring.
Note You may continue to monitor other parameters when you stop ECG monitoring, or you can stop monitoring all parameters along with ECG.
1. To stop only ECG measurement, touch STOP in the ECG frame.
The ECG module stops collecting data.
2. To stop all parameter measurements, including ECG, touch Pause , and then touch
End monitoring .
3. Detach the electrodes from your patient, and then unsnap the electrodes from the lead wires.
4. Dispose of single-use electrodes. Follow manufacturer's instructions for cleaning reusable electrodes.
Pulse rate frame
The Pulse rate frame displays data, information, and controls used in reading pulse rates.
Pulse rate is derived from one of three sensors based on your configuration: the SpO2 sensor, the NIBP sensor, or the EarlySense sensor. The source of Pulse rate measurements appears in the lower left corner of the frame.
WARNING Inaccurate measurement risk. Pulse rate measurements generated through the blood pressure cuff or through SpO2 are subject to artifact and might not be as accurate as heart rate measurements generated through ECG or through manual palpation.
Note You can specify pulse tone volume in the Pulse rate vertical tab (located in the Settings > Setup tab).
Directions for use
Continuous Monitoring profile
Patient monitoring 189
The size of the pulse rate frame and displayed measurements varies based on your configuration.
The Continuous Monitoring profile also provides a visual indication of aging episodic measurements (those more than 16 minutes old). When a pulse rate measurement derived from NIBP is displayed for more than 16 minutes, the numeric on the screen changes from its current color to gray. (See the timestamp in the NIBP frame for actual time of this measurement.) After one hour, this measurement is cleared from the frame.
Intervals Monitoring profile
Spot Check profile
Set up pulse rate
Follow these steps to configure pulse rate parameter settings.
1. Touch the Settings tab.
2. Touch the Setup tab.
3. Touch the Pulse rate vertical tab.
4. Select the desired Tone volume.
5. Touch the Home tab.
The new settings take effect immediately.
Configure pulse rate alarms
Follow these steps to set alarm limits for pulse rate.
190 Patient monitoring Welch Allyn Connex ® Devices
1. Verify that you are using the Intervals Monitoring or Continuous Monitoring profile.
2. Touch the Alarms tab.
3. Touch the Pulse rate vertical tab.
4. Ensure that the Pulse rate alarm limit control is set to ON.
Note If any parameter's alarm limit control is set to OFF, you cannot adjust alarm limits on the Alarm tab, and no visual or audio signals will occur for that specific parameter.
5. Enter the desired upper and lower alarm limits for pulse rate using the up/down arrow keys or the keypad.
6. Touch the Home tab.
The new alarm settings take effect immediately.
Manual parameters frame
The Manual parameters frame, located in the lower right of the Home tab, supports manual entry of parameters and displays measurements taken by some accessories.
Note
Note
Note
Note
In the Continuous Monitoring and Interval Monitoring profiles, Body mass index (BMI) is only available with an attached weight scale that calculates
BMI and transfers it to the monitor. In the Spot and Office profiles, BMI is calculated based on weight and height values that you enter manually on the device or that an attached weight scale transfers to the monitor.
When a measurement is transferred from an attached weight scale to the device, the measurement displayed on the device is within one decimal place (0.1) of the measurement displayed by the weight scale.
You cannot manually enter temperature in this frame on a device configured with a SureTemp Plus temperature module.
You cannot manually enter respiration rate in this frame on a device configured with CO2, RRa, or EarlySense.
Enter manual parameters
Note The Manual parameters frame enables you to enter measurements taken manually and displays measurements taken by some accessories. You can select and configure the parameters in Advanced settings. Only four parameters appear in the Manual parameters frame.
CAUTION Weight scales attached to this device must be running on battery power (battery type is specified in the weight scale manufacturer's directions for use). Do not use the weight scale's external power supply.
CAUTION Before weighing a patient on any weight scale connected to the device, disconnect all sensors from the patient. Doing so ensures an accurate weight measurement and significantly reduces electrostatic discharges that might disrupt the device.
1. From the Home tab, touch anywhere within the Manual parameters frame.
Directions for use
The Manual tab appears.
Patient monitoring 191
2. Touch the keypad icon in selected fields to open the numeric keypad, and then manually adjust height, weight, pain level, temperature, respiration rate, or other parameters.
Note If an approved, battery-powered weight scale is attached to the device, the device behaves as follows:
• In the Office profile, the device calculates BMI based on weight and height input transferred from the scale and displays those values in the
BMI frame of the Home tab. You can adjust weight and height measurements in this frame, and BMI will recalculate based on those changes.
• In the Spot profile, the device calculates BMI based on weight and height transferred from the scale and displays those values on the
Patients > Manual tab and in the Manual parameters frame of the Home tab if BMI is selected for display. If the scale calculates BMI, that value is transferred to the device. You can adjust weight and height measurements on the Manual tab, and BMI will recalculate based on those changes.
• In the Continuous Monitoring and Intervals Monitoring profiles, the device receives height and weight values from the scale and displays those values on the Patients > Manual tab and in the Manual parameters frame of the Home tab if BMI is selected for display. If the scale calculates BMI, the scale transfers that value to the device. You can adjust weight and height measurements on the Manual tab, but if you do, the read-only BMI field will clear.
Note Ensure that the current patient ID is correct before saving.
3. Touch OK to confirm settings and return to the Home tab.
Note In the Intervals Monitoring and Spot Check (episodic) profiles, manual parameters clear from the Home tab after a successful save.
192 Patient monitoring Welch Allyn Connex ® Devices
Note When the device is connected to a central station and in the
Continuous Monitoring profile, all manual parameters except temperature will be sent to the central station when you touch OK .
Physical assessment instrument handles
Use the physical assessment instrument handles
The handles supply power to Welch Allyn 3.5V instruments. This section focuses on operation of the handles only. Refer to the directions for use for each instrument head to use it properly.
Note Handle modules are available only in the 84- and 85-series models.
Ensure the wall system is plugged in.
1. Lift the handle you want to use from the handle cradle.
The instrument will automatically power on when you remove it from the handle cradle. Only one handle is powered at a time.
2. Attach a specula to the end of the instrument head if appropriate.
3. Adjust light output by turning the rheostat on the handle.
• Turning the rheostat clockwise increases the light output.
• Turning the rheostat counterclockwise decreases the light output.
Note The rheostat does not power down the instrument when you turn it counterclockwise as far as it will go.
4. Follow the directions for use for the instrument head when examining a patient.
CAUTION Do not overstretch the cords on these handles to prevent damage. Always examine patients within a comfortable reach of the wall system to protect the cords.
CAUTION To minimize the external housing temperature of the diagnostic instrument heads, on-time should not exceed
2 minutes, and off-time should be a minimum of 10 minutes.
Directions for use Patient monitoring 193
5. Return the handle to the handle cradle.
Placing the handle in the cradle disengages the OptiSense™ optical sensor and powers down the instrument.
Note The handles continue to receive power as long as the wall system is plugged in, has a charged and functioning battery, and is powered on. You can power down the handles by powering down the entire wall system.
See the Startup section for details.
194 Patient monitoring Welch Allyn Connex ® Devices
195
Maintenance and service
Perform periodic checks
Welch Allyn recommends that each facility conduct periodic checks of each monitor.
1. Check the following at least daily:
• Audio, especially at startup
• Fan, especially at startup
• Touchscreen alignment
• Date
• Time
2. Visually inspect the following at least weekly:
• The monitor for any damage or contamination
• The AC cord for exposed copper
• All cables, cords, and connector ends for damage or contamination
• All mechanical parts, including covers, for integrity
• All safety-related labeling for legibility and adhesion to the monitor
• All accessories (cuffs, tubing, probes, sensors) for wear or damage
• Documentation for current revision of the monitor
3. Do the following at least monthly:
• Test the speaker by selecting each alarm volume level and listening for the different tones
• Visually inspect the mobile stand wheels for wear and faulty operation
• Visually inspect the mounting screws on the wall or cart for looseness and wear
Update settings, replace items, or call for service as necessary based on results of visual inspection. Do not use the monitor if you see any signs of damage. Qualified service personnel must check any monitor that is damaged for proper operation before putting the monitor back into use.
WARNING Electric shock hazard. Never perform maintenance or service tasks while the device is connected to a patient.
CAUTION Wall system components shall be replaced by Welch Allyn service centers or qualified service personnel.
196 Maintenance and service Welch Allyn Connex ® Devices
Replace the printer paper (Connex VSM)
The printer is located on the top of the monitor. Follow these steps to replace the roll of printer paper:
1. Grasp the two tabs and pull up to open the printer door.
2. Remove the empty core.
WARNING Hot surface. Do not touch the printer mechanism.
3. Insert a new roll of paper.
Note The paper roll must be installed so that it unwinds from the bottom of the roll, as illustrated. If the paper roll is not installed correctly, the printer will not print properly.
4. Advance the end of the roll past the roller so that it extends past the printer door, as shown.
5. With one hand, pull lightly on the paper to take up any slack. With the other hand, close the printer door by pushing it down and into place until it clicks.
Be certain that the paper does not catch in the printer door.
Directions for use Maintenance and service 197
Change the battery (Connex VSM)
Before removing the battery, shut down the monitor.
1. Turn the monitor upside down to access the battery cover.
2. Locate the battery cover, indicated by .
3. Insert a coin into the slot and push to open. Choose a coin that fits comfortably in the slot.
4. Pull the battery out by pulling the battery label, which is visible when you open the battery cover.
5. Slide in the new battery. Ensure that you insert the new battery in the same orientation as the old battery.
6. Replace the battery cover by positioning the end below firmly on the opposite end.
and then pressing
198 Maintenance and service Welch Allyn Connex ® Devices
Note New batteries are only 30 percent charged. Therefore, connect the monitor to AC power immediately after inserting a new battery.
WARNING Risk of fire, explosion, and burns. Do not short-circuit, crush, incinerate, or disassemble the battery pack. Never dispose of batteries in refuse containers. Always recycle batteries according to local regulations.
Remove the wall system from the wall (Connex IWS)
For maintenance or service activities that require access to the back of the wall system, follow these steps to remove the wall system from the wall.
1. Touch the Settings tab.
2. Touch the Device tab.
3. Touch Power down .
4. Remove all instrument heads, detach all accessible cords and cables, and unplug the power cord from the outlet.
5. Remove the cover by loosening the captive retention screws.
6. If USB accessories are connected, loosen the two screws on the cable retention clamp and remove it, then disconnect all USB cables.
7. If the wall system is configured with SpO2, disconnect the SpO2 cable and remove it from the channel on the bottom of the wall system.
Directions for use Maintenance and service 199
8. Remove the security screw at the bottom of the wall system.
9. Carefully lift the wall system off the mounting rail bracket and place it onto a table or flat work surface.
Change the battery (Connex IWS)
Before removing the battery, follow the instructions to remove the wall system from the wall.
1. Place the wall system on a table or flat work surface so that the back of the wall system faces up.
2. Locate the battery, indicated by
3. Remove the battery.
.
4. Insert the new battery. Ensure that you insert the new battery in the same orientation as the old battery.
200 Maintenance and service Welch Allyn Connex ® Devices
5. Mount the wall system on the wall using the instructions presented in the Setup section of this directions for use.
Note
WARNING Risk of fire, explosion, and burns. Do not short-circuit, crush, incinerate, or disassemble the battery pack. Never dispose of batteries in refuse containers. Always recycle batteries according to local regulations.
New batteries are approximately 30 percent charged. Therefore, connect the battery to AC power immediately after inserting a new a battery.
Clean the monitor
WARNING Electric shock hazard. Before cleaning the device, disconnect the AC power cord from the power outlet and the device.
WARNING Electric shock hazard. DO NOT autoclave the device or accessories. The device and the accessories are not heat-resistant.
WARNING Electric shock hazard. Do not open the monitor or attempt repairs. Only perform routine cleaning and maintenance procedures specifically described in this manual. Inspection and servicing of internal parts shall only be performed by qualified service personnel.
WARNING Liquids can damage electronics inside the device. Prevent liquids from spilling on the device.
If liquids are spilled on the device:
1. Power down the device.
2. Disconnect the power plug.
3. Remove battery pack from the device.
4. Dry off excess liquid from the device.
Note If liquids possibly entered the device, remove the device from use until it has been properly dried, inspected, and tested by qualified service personnel.
5. Reinstall battery pack.
6. Power on the device and verify device functions normally before using it.
If liquids enter the printer housing (Connex VSM only):
1. Power down the device.
2. Disconnect the power plug.
3. Remove battery pack from the device.
4. Remove and discard the paper roll.
5. Clean and dry the inside of the printer housing.
Note The printer housing has a drain tube that directs liquids down and out the bottom of the device. If liquids possibly entered other openings in the device, remove the device from service until it has been properly dried, inspected, and tested by qualified service personnel.
6. Install a new roll of paper.
7. Power on the device and verify that the device functions normally before using it.
Directions for use Maintenance and service 201
CAUTION Sterilizing the monitor could damage the device.
Note Disinfect according to your facility's protocols and standards or local regulations.
Note See separate instructions for cleaning accessories.
Prepare to clean the equipment
CAUTION Some cleaning agents are not appropriate for all components of the device. Use only approved cleaning agents. Using unapproved cleaning agents may cause damage to components.
CAUTION Do not use bleach solutions of any kind when cleaning metal electrical contacts. They will damage the device.
CAUTION When cleaning the device, avoid using cloths or solutions that include quaternary ammonium compounds (ammonium chlorides) or glutaraldehyde-based disinfectants.
Select an approved cleaning agent from the following tables.
Section 1. Approved for the Connex Vital Signs Monitor except the Braun
ThermoScan PRO dock
Additional information Cleaning agent
Clorox HP
Dispatch Hospital Cleaner Disinfectant Towels with
Bleach (Clorox Healthcare®)
CleanCide Wipes (Wexford Labs)
70 percent isopropyl alcohol solution
10 percent bleach solution
Applied to a clean cloth
(.5% - 1% sodium hypochlorite) applied to a clean cloth
Section 2. Approved for the Connex Integrated Wall System except the Braun
ThermoScan PRO dock
Cleaning agent Additional information
10 percent bleach solution
70 percent isopropyl alcohol solution
(.5% - 1% sodium hypochlorite) applied to a clean cloth
Applied to a clean cloth
Section 3. Approved for the Braun ThermoScan PRO dock
Cleaning agent Additional information
Clorox HP
202 Maintenance and service Welch Allyn Connex ® Devices
Cleaning agent
70 percent isopropyl alcohol solution
Clean the accessories
Additional information
Applied to a clean cloth
1. Wipe the NIBP hose and any reusable cuffs with a damp cloth moistened in a mild detergent solution.
2. Wipe the temperature probe with a cloth dampened with alcohol, warm water, or an appropriately diluted, nonstaining disinfectant solution.
3. Clean the pulse oximetry sensors with a cloth dampened with 70 percent isopropyl alcohol or 10 percent chlorine bleach solution.
4. Clean the RRa cable and the SpO2/RRa dual cable with a cloth dampened with 70 percent isopropyl alcohol.
5. Clean the EarlySense sensor by gently wiping with a soft, slightly damp cloth or wipes containing antiseptic substances (alcohols, Chlorohexidine, and bleach material up to 5% concentration). Ensure that the sensor is dry before re-use. Avoid excessive liquids.
6. To clean the ECG module, follow the instructions provided in the ECG module directions for use.
7. (Connex IWS only) To clean Welch Allyn 3.5V instrument heads attached to the physical assessment handles, follow the instructions provided in their directions for use.
CAUTION Never immerse any monitor accessories.
Advanced settings
The Advanced tab provides password-protected access to the monitor's Advanced settings (or Admin mode), enabling nurse administrators, biomedical engineers, and/or service engineers to configure specific features. The Advanced tab also presents readonly information about the monitor.
Note
Note
You cannot enter Advanced settings if sensors or physiological alarms are active or if vital sign measurements are displayed.
If you lose your Advanced settings password, review the instructions to reset passwords in the service manual for your device.
203
General
Specify the language
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears, displaying the Language tab.
2. Select a language.
3. Do one of the following:
• To continue in the Advanced settings, touch another tab.
204 Advanced settings Welch Allyn Connex ® Devices
• To exit the Advanced settings and return to the Home tab, touch Exit .
Specify date and time settings
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. On the General tab, touch the Date / Time tab.
3. Specify settings.
Setting Action/Description
Date format
Time zone
Automatically adjust clock for daylight saving time, reported by host
Allow users to change date and time
Display date and time
Select a date format for display.
Select your time zone offset from Coordinated Universal
Time (UTC).
Select this to adjust the displayed time by +/- one hour when the connected host reports daylight savings time.
Select this to allow clinicians to set the date and time from the Settings tab.
Select this to display the date and time on the Home tab in the Device Status area.
4. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
Specify advanced alarm settings
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. Touch the Alarms tab.
3. Specify settings.
Option
General
Allow user to disable alarms
Nurse call threshold
Description
(vertical tab)
Select to allow clinicians to turn off or turn on all alarm limits for each vital sign. The control is on each parameter-specific tab on the Alarms tab.
Select the minimum priority alarm that activates a nurse call relay. If you select High , only high-priority alarms activate a nurse call relay. If you select Medium , medium- or high- priority alarms activate a nurse call
Directions for use
Audio
Allow user to turn off general audio
Minimum alarm volume
Audio pause time
Enable audio for low priority alarms
Enable audio for very low priority alarms
Allow user to turn on patient rest mode
Allow host to turn on patient rest mode
Enable cardiac high priority tone
Delays
SpO2 alarm condition delay
SpO2 pulse rate alarm condition delay
Motion pulse rate alarm condition delay
SpHb alarm condition delay
Motion respiration alarm condition delay
Motion pulse rate low confidence alarm delay
Advanced settings 205 relay. If you select Low , high-, medium-, and lowpriority alarms activate a nurse call relay.
(vertical tab)
Select to allow clinicians to turn off all audio notification for alarms. This control is on the Alarms tab (on the
General tab).
Select the minimum alarm volume available. If you select
High , then Medium and Low are not available to the clinician.
Specify the amount of pause time that is added to the
60-second pause time. When a clinician pauses an audio alarm tone, the tone is paused for the combined amount of time.
Select to enable the alarm to sound for low priority alarms. If this setting is disabled, the audio for very low priority alarms is automatically disabled.
Select to enable the alarm to sound for very low priority alarms. This setting is available only when "Enable audio for low priority alarms" is selected.
Select to allow the user to turn off or turn on this option on the Alarms tab. This option is only available in the
Continuous Monitoring profile and when the user has enabled night mode.
Select to allow the host to turn off or turn on this option on the Alarms tab. This option is only available in the
Continuous Monitoring profile and when the device is connected to the Central Station.
Select to enable an alternate alarm tone for ECG LTA alarms.
(vertical tab)
Note Alarm delays are available only for the parameters supported by your configuration.
Specify the minimum amount of time that an SpO2 alarm condition must be active before audio and visual signals occur.
SatSeconds is available with Nellcor SpO2 sensors. If you select Off, 10-, 15-, or 30-second delay, SatSeconds is disabled, and it is removed from the SpO2 tab in the
Alarms tab.
Specify the minimum amount of time that a Pulse rate alarm condition measured by the SpO2 sensor must be active before audio and visual signals occur.
Specify the minimum amount of time that a Pulse rate alarm condition measured by the patient movement sensor must be active before audio and visual signals occur.
Specify the minimum amount of time that an SpHb alarm condition must be active before audio and visual signals occur.
Specify the minimum amount of time that a respiration alarm condition must be active before audio and visual signals occur (EarlySense configuration).
Specify the minimum amount of time that a pulse rate low confidence alarm condition must be active before
206 Advanced settings Welch Allyn Connex ® Devices
Motion respiration low confidence alarm delay etCO2 alarm condition delay
Respiration alarm condition delay
No breath detected alarm delay
Adult no breath detected alarm delay
Pediatric no breath detected alarm delay
Neonate no breath detected alarm delay
ECG HR alarm delay audio and visual signals occur (EarlySense configuration).
Specify the minimum amount of time that a respiration low confidence alarm condition must be active before audio and visual signals occur (EarlySense configuration).
Specify the minimum amount of time that an etCO2 alarm condition must be active before audio and visual signals occur.
Specify the minimum amount of time that an RR alarm condition must be active before audio and visual signals occur.
If configured with a CO2 module, specify the amount of time for the device to wait after receiving a "valid breath" message before activating the "No breath detected" physiological alarm.
If configured for RRa, specify the time that the Masimo module will wait before sending a respiration pause event, which will result in a "No breath detected" physiological alarm.
Specify the time that an adult no breath detected condition must be active in an Oridion CO2 configuration before audio and visual signals occur.
Specify the time that a pediatric no breath detected condition must be active in an Oridion CO2 configuration before audio and visual signals occur.
Specify the time that a neonate no breath detected condition must be active in an Oridion CO2 configuration before audio and visual signals occur.
Specifies the time that an ECG heart rate alarm condition must be active before audio and visual signals occur.
4. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
Specify advanced display settings
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. Touch the Display tab.
3. Specify settings.
Setting
Display power saver
Action/Description
Specify the required period of monitor inactivity before the display turns off.
Clinician interactions, new vital sign measurements, or alarm conditions automatically turn on the display.
Directions for use Advanced settings 207
Device power down
Display lock
Require device access code
Device access code
Require clinician authentication
Specify the required period of monitor inactivity before the monitor turns off.
Specify the required period of monitor inactivity before the touchscreen locks.
Note If the single sign-on (SSO) feature has been enabled on this device, the display lock idle period defaults to 2 minutes but remains configurable. In addition, all of the remaining controls described in this section disappear from the display, but the Require clinician authentication control remains active as part of the SSO feature.
Enable to require entering a code to unlock the display.
Enter the 4-digit code to unlock the display. Note You must enable Require device access code to enable this option.
Enable to require clinician authentication (scanning badge or entering ID) to unlock the display. Note You must enable Search by clinician ID to enable this option.
4. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
Specify advanced device settings
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. Touch the Device tab.
3. Specify settings.
Option Description
Location ID
Enable Save as default
Pause Mode timeout
Power line frequency
Available profiles
Allow profile change
Touch characters.
and enter up to 20 alphanumeric
Select to enable display of the Save as default control.
Specify the default timeout used when entering Pause mode in the Continuous Monitoring profile.
Specify power line frequency for AC power supplied to the device.
Specify the profiles to be available for selection.
Select to enable manual selection of different profiles and the automatic shift to the Continuous Monitoring profile when a continuous sensor is connected to a patient.
When disabled, the current profile selection in the
Settings tab is locked in. No other profile selection buttons are available, and the device does not
208 Advanced settings Welch Allyn Connex ® Devices automatically shift to the Continuous Monitoring profile when a continuous sensor is connected to a patient.
Specify the default profile to be used at startup.
Default profile
4. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
Set and start the demo mode
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. Touch the General tab.
3. Touch the Demo tab.
4. Specify settings.
Setting
Type
Start
Action/Description
Select a type of demonstration mode.
Touch Start to put the monitor in demonstration mode.
Navigate to the Home tab to begin Demo mode.
5. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
Parameters
Specify advanced IPI settings
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. Touch the Parameters tab.
3. Touch the IPI tab.
4. Specify settings.
Setting
Display IPI
Default view
Action/Description
Select to display the IPI frame on the Home tab.
Select a numeric view or trend graph view as the primary
IPI display on the Home tab.
Directions for use Advanced settings 209
Trend period default Select a default time period for the trend graph display of IPI.
5. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
Specify advanced RRa settings
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. Touch the Parameters tab.
3. Touch the RRa tab.
4. Specify settings.
Setting
RRa averaging
Freshness timeout
Action/Description
Select the default averaging option that provides the desired visibility of subtle variations in RRa measurements.
Select the period of time the device should wait before alarming while it attempts to obtain a valid RRa reading.
5. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
Specify advanced SpO2 settings
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. Touch the Parameters tab.
3. Touch the SpO2 tab.
4. Specify settings.
Setting
Default view
Default response
Action/Description
Select a numeric view or a waveform view as the default primary SpO2 display on the Home tab.
Select the default speed of response to changes in SpO2 measurements.
210 Advanced settings Welch Allyn Connex ® Devices
Sweep speed default Select the default waveform sweep speed for the SpO2 display in the Home tab.
Select to enable Masimo low perfusion alarm.
Allow low perfusion alarm
5. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
Specify advanced pulse rate settings
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. Touch the Parameters tab.
3. Touch the Pulse rate tab.
4. Specify settings.
Setting
Display source
Action/Description
Select this to show the source of pulse rate measurements (NIBP or SpO2) on the Home tab.
5. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
Specify advanced etCO2 settings
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. Touch the Parameters tab.
3. Touch the etCO2 tab.
4. Specify settings.
Setting
Default view
Display FiCO2
Waveform scale default
Unit of measure
Action/Description
Select a numeric view or a waveform view as the primary etCO2 display on the Home tab.
Select to display FiCO2 on the Home tab.
Select the default waveform scale in etCO2 measurements.
Select primary units of measure for the etCO2 display on the Home tab.
Directions for use Advanced settings 211
Check calibration
Calibrate
Sweep speed default
Enable sampling line dialog
BTPS compensation
Calibration due hours
Maintenance due hours
Last calibration
Select to start CO2 calibration check.
Select to start CO2 calibration.
Select the default waveform sweep speed for the CO2 waveform view on the Home tab.
Select to enable the sampling line dialog to be displayed when connecting a sampling line to the device.
Select to enable automatic adjustments for BTPS (body temperature pressure saturated) to improve the accuracy of CO2 measurements.
Displays time remaining until CO2 sensor calibration is required.
Displays time remaining until CO2 periodic sensor maintenance is required.
Displays date (XX/XX/XXXX) and time (00:00:00) of last calibration.
Displays anniversary date (XX/XX) of annual calibration.
Annual calibration
• For more calibration information, see the Service manual.
5. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
Specify advanced SpHb settings
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. Touch the Parameters tab.
3. Touch the SpHb tab.
4. Specify settings.
Setting
Default view
Unit of measure
Default averaging
Reference
Action/Description
Select a numeric view or a trend graph view as the primary SpHb display on the Home tab.
Select the primary unit of measure for the SpHb display on the Home tab.
Select the default moving window of time used by the parameter to calculate the SpHb value and update the display: short (approximately 1 minute), medium
(approximately 3 minutes), or long (approximately 6 minutes).
Select arterial or venous as the calibrated reference source.
5. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
212 Advanced settings Welch Allyn Connex ® Devices
Specify advanced NIBP settings
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. Touch the Parameters tab.
3. Touch the NIBP tab.
4. Specify settings.
Setting
Default view
Unit of measure
Tube type
Algorithm default
Action/Description
Select primary and secondary views.
Select Display MAP to display mean arterial pressure (MAP) in the NIBP frame on the Home tab.
If Display MAP is selected, specify which numerics are primary in the NIBP frame. On the Home tab, clinicians can touch the NIBP frame to toggle between views.
Select the NIBP unit of measure for display.
Select the number of tubes that are connected to the
NIBP cuff used with this monitor. If you select the only algorithm available for selection is
1 tube ,
Step .
Select the default algorithm used to determine NIBP measurements.
Cuff inflation target
Allow interval program changes
If you select the
Clinicians can change the CITs from the default CITs that you set here on the tab.
Step algorithm, touch a default cuff inflation target for each type of patient.
Settings > Setup >
and enter
NIBP
Select to enable user to modify interval program selections in the tab.
Settings > Setup > Intervals
5. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
Set up an NIBP averaging program
In Advanced settings, set up NIBP averaging programs to make them available for use.
To set up a program:
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
Directions for use
The General tab appears.
2. Touch the Parameters tab.
3. Touch the Programs tab.
4. Touch the button of the program you want to set up.
The keyboard icon appears in the button.
Advanced settings 213
5. (Optional) Change the name of the program: a. Touch the keyboard icon.
b. Enter the name of the program and touch OK .
6. Specify the settings for this program.
Setting Action/Description
Readings to average
Delay to start
Time between
Keep if + or –
Select readings to include in the average. You must select at least two readings.
The last reading you select is the final reading of the program. For example, if you select Readings 3, 4, and 5, the program takes five readings.
Unselected readings—in this example, Readings 1 and 2
—are excluded ("discarded") from the average.
Enter the period between the start of the program (the moment that the "Start intervals" button is selected) and the start of the first reading.
Enter the period between the end of one reading and the start of the next reading.
Enter the range that the program uses to establish the baseline reading. For more information about how this setting affects the program, refer to "Excluded readings" in the "NIBP averaging programs" section of this manual.
The settings you selected appear in the Summary area.
7. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
The program is now available for use.
214 Advanced settings Welch Allyn Connex ® Devices
Specify advanced temperature settings
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. Touch the Parameters tab.
3. Touch the Temperature tab.
4. Specify settings.
Setting
Unit of measure
Display temperature conversion
Default SureTemp Plus site
Anti-theft return timeout
Mode
Enable pulse timer
Enable Celsius only selection
Action/Description
Select primary units of measure for the temperature display on the Home tab
Select to display primary units of measure and secondary units of measure for the temperature display on the
Home tab.
Select the default site for SureTemp measurements. The default site applies when clinicians power up the monitor and each time clinicians remove the temperature probe from the well.
Select Last site to set the default to the site selected for the last measurement.
Select "Disabled" or a timeout value in hours for the
Braun 6000 to lock after being removed from the dock.
Select None , Technique Compensation , or
Unadjusted as the Braun 6000 compensation mode.
Technique Compensation improves reading accuracy by detecting placement of the probe in the ear canal.
Unadjusted places thermometer in mode to detect raw ear temperature only.
Select to enable pulse timer on the Braun 6000 handle.
Select to enable Celsius only mode, thus disabling the C/
F button on the Braun 6000 handle as well as the hardware switch.
5. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
Specify advanced ECG settings
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
Directions for use Advanced settings 215
2. Touch the Parameters tab.
3. Touch the ECG tab.
4. Specify settings.
Setting
Cable selection
Electrode configuration
Allow impedance respiration
Enable V-Tach, V-Fib, Asystole detection
Automatic print on ECG alarm
Default lead
V-Tach threshold
Action/Description
Select either a 3-lead or 5-lead cable option. The current selection appears as a secondary label on the ECG vertical tab.
Select either AHA or IEC .
Select to enable the selection of impedance respiration as a source for respiration on the ECG settings tab. If not selected, this option is disabled, and impedance respiration is not displayed as an option on the ECG settings tab.
Select to enable detection of these LTA alarms.
Select to enable automatic printing of an ECG waveform when an LTA alarm occurs.
Select the lead to be displayed when the device is powered up.
Use the keypad to enter the V-Tach threshold used by the ECG module (Range: 100-150 bpm).
5. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
Specify the manual parameters
The Manual Parameters frame is in the lower right corner of the Home tab. You can manually enter values for parameters in the frame. In Advanced settings, you can specify which parameters appear in the frame and enable manual overrides of other parameter measurements displayed on the device.
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. Touch the Parameters tab.
3. Touch the Manual tab.
216 Advanced settings Welch Allyn Connex ® Devices
4. Select up to four parameters and associated units of measure for display in the
Manual Parameters frame.
Note If the monitor has the SureTemp Plus temperature module, the Temperature parameter is not available here or in the
Manual Parameters frame.
Note If the monitor is configured with CO2 or RRa, and you select the Continuous Monitoring profile before you enter
Advanced settings, the respiration rate (RR) parameter is not available here or in the Manual Parameters frame. If any other profile is selected when you enter Advanced settings, the respiration rate (RR) parameter remains available for selection on this screen and is displayable in the Manual parameters frame.
5. Enable manual overrides of selected parameter measurements displayed on the device as desired.
6. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
Specify advanced custom scores settings
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. Touch the Parameters tab.
3. Touch the Custom scores tab.
4. Specify settings.
Directions for use Advanced settings 217
Setting
Default score summary view
Incomplete score save options
Action/Description
Select either a patient record.
Condensed or Expanded view of custom scores information to display after saving a
Select the desired response when a user presses Save before an aggregate score is complete:
Allow : The device saves the record with incomplete scores.
Warn user : The device displays a message that the score is incomplete and a prompt to save the incomplete record or cancel.
Block : The device displays a message that the score is incomplete and that values for all required parameters must be entered before saving.
•
5. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
Data management
Specify patient settings
Patient identification appears on the Home tab in the Patient frame, and it is listed in various tabs, such as the Patient tab and the Review tab.
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. Touch the Data Management tab.
3. Touch the Patient tab.
4. Specify settings.
Setting
Default patient type
Name format
Primary label
Secondary label
Action/Description
Select a default patient type for this monitor. The patient type shows in the Patient frame on the Home tab.
In the Summary tab on the Patients tab, clinicians can change the displayed patient type from the default patient type that you set here.
Select a format for all displayed patient names: Full name or Abbreviation .
Select the primary identification label for all displayed patients.
Select a secondary identification label for patients. A secondary label displays only on the Home tab, after the primary label.
218 Advanced settings Welch Allyn Connex ® Devices
Printout label
Require patient ID to save readings
Search by patient ID
Clear patient information on manual save
Retrieve list
Select which patient identifier(s) appear on printouts:
Name and patient ID , Name , Patient ID ,
None .
Make entering a patient ID a prerequisite for saving measurements. If the clinician fails to enter an identifier, the monitor prompts the clinician when they try to save.
Enable clinicians to enter a patient ID to query for the patient's information. If clinicians scan the ID onto the
Home tab or the Summary tab, the monitor queries the patient list and the network. Returned patient information populates the Patient frame on the Home tab and fields on the Summary tab.
Select Require patient ID match to save measurements to require that the selected patient ID matches a patient ID in the Patient list of the device or an external host system before you can save measurements.
Specify that the monitor clears the selected patient after a clinician manually saves measurements from the Home tab. Patient information clears from the Patient frame and the Summary tab.
Note This setting does not take effect when intervals are in progress.
Enable the monitor to retrieve the patient list from the network. When this option is selected, a Retrieve list button replaces the Add button on the List tab.
Information from the network populates the List tab when clinicians touch the Retrieve list button. Since the Add button is not available, clinicians cannot add a patient to the patient list.
5. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
Specify clinician settings
Clinician identification appears next to the medicine symbol in the Device Status area on the Home tab.
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. Touch the Data Management tab.
3. Touch the Clinician tab.
4. Specify settings.
Setting
Label
Action/Description
Select a type of clinician identification label for display on the Home tab: Full name , Abbreviation ,
Directions for use Advanced settings 219
Enable single sign-on
Require clinician ID to save readings
Clear clinician information on manual save
Search by clinician ID
Store clinician information for ___ hours
Clinician ID , Masked Clinician ID , or
Symbol only .
Select to enable the single sign-on (SSO) feature on the device.
Note When SSO is enabled, all of the remaining controls described in this section are removed from the display, but most remain in effect as part of the SSO feature.
Two items are disabled: Clear clinician information on manual save and Store clinician information for (__ hours). In addition, Display lock defaults to 2 minutes, three Display tab controls disappear from the display
(see "Specify advanced display settings" for details), and the Office profile is disabled.
Make entering a clinician ID a prerequisite for saving measurements. If they fail to enter identification, the monitor prompts them when they try to save measurements. Clinicians can enter clinician identification on the Clinician tab.
Specify that the monitor clears the selected clinician after a clinician manually saves measurements from the
Home tab. Clinician information clears from the Clinician tab and the Device Status area.
Enable the monitor to query the network for clinician information based on ID. The monitor initiates the search when the clinician enters or scans the ID from the
Clinician tab. Returned clinician information populates the Device Status area and fields on the Clinician tab.
Select Require password to require clinicians to enter their password, in addition to ID, on the Clinician tab. The monitor uses the ID and password combination to query the network for clinician information.
Select Require clinician ID match to save measurements to require that the selected clinican ID matches a clinician ID in an external host system before you can save measurements.
Select to enable a local cache of clinician login information to speed up and simplify future clinicial logins. Use the keypad to enter the number of hours to store this clinician cache.
5. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
Specify clinical data settings
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. Touch the Data Management tab.
3. Touch the Clinical Data tab.
220 Advanced settings Welch Allyn Connex ® Devices
Network
4. Specify settings.
Setting
Automatically send on manual save
Delete readings after successful send
Emulate Spot Vital Signs LXi
Connect to CS
Enable clear button on Home tab
Action/Description
Select this option to specify that measurements are sent to the network when a clinician saves measurements on the Home tab.
Note When the device is in the Continuous Monitoring profile, this setting is grayed out.
Note When the monitor is not connected to the network, measurements saved on the monitor are sent to the network with the first successful send after reconnecting to the network.
Select this option to specify that measurements are deleted from the monitor after they are successfully sent to the network. Sent measurements do not appear in the
Review tab.
Select this option to specify that clinical data sent to the network appears as Spot Vital Signs LXi data at the network.
Select to enable connection to the Connex central station.
Select to enable the Clear button on the Home tab in
Intervals Monitoring, Office, and Spot Check profiles.
When not selected (disabled), the Clear button does not appear on the Home tab.
5. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
View advanced monitor information
The Status tab shows the monitor's software version, MAC and IP addresses, network, server and access point information, session information, and more.
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. Touch the Network tab.
3. Touch the Status tab.
4. View the information.
5. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
Directions for use Advanced settings 221
Specify radio settings (Newmar)
This task applies only to devices with a Newmar radio card installed. Distinguishing features of devices with this radio card are the following:
• In Advanced settings, the Session frame on the Network > Status tab includes Tx packets dropped , Rx packets dropped , and Rx multicast packets .
• In Advanced settings, the left pane on the Network > Radio tab includes an Enable dynamic frequency option.
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. Touch the Network tab.
3. Touch the Radio tab.
4. Specify settings.
Setting
Enable radio
Enable radio network alarms
Enable dynamic frequency
Action/Description
Enable the radio for device communications. When disabled, the radio is not available.
Activate radio network alarms when an alarm condition occurs. When disabled, radio network alarms are not available.
Enable dynamic frequency selection when the radio is enabled. This might be required to prevent disrupting other technologies and services that share the same frequency.
SSID
Radio band
Authentication type
Touch and enter the service set identifier
(SSID). SSIDs that are longer than 16 characters may be truncated in the user view. Enter a maximum of 32 characters.
Select the radio band.
Select an authentication scheme. Then specify any additional settings that appear.
Method
Security protocol
EAP type
Identity
Password
Key number
Select a method. Then touch and enter characters: Network key (64 characters), or
Passphrase (8 to 63 characters).
Note The characters you enter for Network key and
Passphrase appear as asterisks on the keyboard and then on the Radio pane.
Select the security protocol.
Select the EAP type.
Enter the EAP identity (maximum of 32 characters).
Enter the EAP password (maximum of 32 characters).
Select the WEP key number.
222 Advanced settings Welch Allyn Connex ® Devices
Key
Roam Type
Server validation
Inner EAP setting
Allow anonymous identity
PAC Provisioning
Configure radio
Enter the WEP key (10 characters for WEP 64, or 26 characters for WEP 128).
Select roam type.
Select to enable server validation.
Select inner EAP setting.
Select to enable the use of an anonymous identity.
Select PAC provisioning option.
Touch Configure radio to activate all new radio settings not selected previously.
Note None of the changed radio settings take effect until you touch Configure radio .
5. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
Specify radio settings (Lamarr)
This task applies only to devices with a Lamarr radio card installed. Distinguishing features of devices with this radio card are the following:
• In Advanced settings, the Session frame on the Network > Status tab includes
Dir. Rx packets , Dir. Tx packets , and Signal-to-noise ratio .
• In Advanced settings, the left pane on the Network > Radio tab includes only
Enable radio and Enable radio network alarms options (no Enable dynamic frequency option).
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. Touch the Network tab.
3. Touch the Radio tab.
4. Specify settings.
Setting
Enable radio
Enable radio network alarms
Action/Description
Enable the radio for device communications. When disabled, the radio is not available.
Activate radio network alarms when an alarm condition occurs. When disabled, radio network alarms are not available.
SSID
Radio band
Touch and enter the service set identifier
(SSID). SSIDs that are longer than 16 characters may be truncated in the user view. Enter a maximum of 32 characters.
Select the radio band.
Directions for use Advanced settings 223
Authentication type Select an authentication scheme. Then specify any additional settings that appear.
Method
Security protocol
EAP type
Identity
Password
Key number
Key
Configure radio
Select a method. Then touch and enter characters: Network key (64 characters), or
Passphrase (8 to 63 characters).
Note The characters you enter for Network key and
Passphrase appear as asterisks on the keyboard and then on the Radio pane.
Select the security protocol.
Select the EAP type.
Enter the EAP identity (maximum of 32 characters).
Enter the EAP password (maximum of 32 characters).
Select the WEP key number.
Enter the WEP key (10 characters for WEP 64, or 26 characters for WEP 128).
Touch Configure radio to activate all new radio settings not selected previously.
Touch OK in the confirmation popup telling you to power down the monitor.
Touch the
Touch
Settings tab. Touch the Device tab.
Power down .
The radio will reboot.
Note None of the changed radio settings take effect until you touch Configure radio .
5. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
Specify server settings
1. Access the Advanced settings.
a. Touch the Settings tab.
b. Touch the Advanced tab.
c. Touch Enter password .
d. Enter your password and touch OK .
The General tab appears.
2. Touch the Network tab.
3. Touch the Server tab.
4. Select the method used to identify the IP address of the server with which the device will communicate.
5. Specify settings.
Setting Action/Description
Manual entry Enable the device to connect to a Continuous, Episodic, or Service server at a fixed IP address or with a specified
DNS name. Touch the desired server field and enter the
224 Advanced settings Welch Allyn Connex ® Devices
Service
NRS IP
DNS name
DHCP
Data encryption
Authentication
Restore defaults
Test
IP address host name. Touch the Port field and enter the port number. The range of entry is 0 to 65535.
This option supports server Authentication, which you can enable or disable. The Authentication option is disabled by default and only applies to the Episodic server. Authentication is not available when Data encryption is disabled.
Enable the device to connect to a Network Rendezvous
Service (NRS) at a fixed IP address. Touch the keypad in the Network rendezvous service IP address fields and enter the IP address. Touch the keypad in the Port entry field and enter the port number. The range of entry is 0 to 65535. The device will always use this IP address to contact the NRS server.
Enable the device to connect to a Network Rendezvous
Service (NRS) by entering a host name to be sent to a
Domain Name Server (DNS) to retrieve the NRS IP address. Touch the keypad in the Network rendezvous service DNS name field and enter the DNS name. Touch the keypad in the Port entry field and enter the port number. The range of entry is 0 to 65535.
The device displays the NRS IP address as well as the
Connex server address and port returned by the DNS.
Note The DNS name option is only available in the following conditions:
– The version of the installed radio is 3.00.02 or greater
– The radio is disabled
– No radio is installed
Enable the device to connect to a Network Rendezvous
Service (NRS) by entering a port number and then connecting at an address provided by the DHCP43 response. Touch the keypad in the Port entry field and enter the port number. The range of entry is 0 to 65535.
After you touch Test and successfully connect to the server, the device displays the NRS IP addresses.
Enable data encryption for all network connection methods.
Enable authentication with an Episodic server. This option is disabled by default and is only available when
Data encryption is enabled.
Touch Restore defaults to restore settings for the selected option to the default values.
Touch server.
Test to test the connection to the configured
6. Do one of the following:
• To continue in the Advanced settings, touch another tab.
• To exit the Advanced settings and return to the Home tab, touch Exit .
The Service tab presents numerous settings and controls typically accessed by authorized service or biomedical engineering personnel to configure, maintain, test, and update the device. For example, the Service tab enables authorized users to save device
Directions for use Advanced settings 225 configurations to a USB flash drive and then load saved configurations to other devices.
Systems and devices configured with the PartnerConnect™ service feature also have access to remote diagnostics, troubleshooting, and software upgrades.
For a description of service-related advanced settings, see the service manual for this product.
226 Advanced settings Welch Allyn Connex ® Devices
227
Troubleshooting
This section presents tables of technical alarm and information messages, as well as problem descriptions that do not generate messages, to help you troubleshoot issues on the monitor.
Note Problem descriptions without messages appear at the end of this section.
When the monitor detects certain events, a message appears in the Device Status area at the top of the screen. Message types include the following:
• Information messages, which appear on a blue background.
• Very low-priority alarms, which appear on a cyan background.
• Low- and medium-priority alarms, which appear on an amber background.
• High-priority alarms, which appear on a red background.
Technical alarm messages are low or very low priority unless noted in the Message column.
You can dismiss a message by touching the message on the screen, or, for some messages, you can wait for the message to time out.
To use these tables, locate the message that displays on the monitor in the left column of the table. The remainder of the row explains possible causes and suggests actions that can resolve the issue.
Note Instructions to "Call for service" in the following tables mean that you should contact qualified service personnel in your facility to investigate the issue.
Patient movement messages
Message Possible cause
Replace the bed sensor.
The sensor is faulty or expired
The cable is faulty or expired
The bed sensor is disconnected.
The bed sensor is disconnected from the monitor
The bed sensor is disconnected from the extension cable
Suggested action
Replace the bed sensor.
Replace the cable.
Check the bed sensor cable to ensure that connections to the monitor and the extension cable are tight.
228 Troubleshooting Welch Allyn Connex ® Devices
Message Possible cause
The bed sensor is upside down.
The bed sensor was not placed properly under the mattress, mattress cover, or mattress pad
Cannot measure patient. Lost or unstable signal.
The sensor is not under the patient's chest
(Low confidence condition)
The sensor is turned 90 degrees, placed vertically (Low confidence condition)
Cannot measure respiration.
Cannot measure pulse rate.
EarlySense not functional.
Bed sensor expires in ...
The sensor has expired.
There is excessive patient movement (Low confidence condition)
An unqualified mattress type is in use
The sensor is not under the patient's chest
(Low confidence condition)
The sensor is turned 90 degrees, placed vertically (Low confidence condition)
There is excessive patient movement (Low confidence condition)
An unqualified mattress type is in use
The sensor is not under the patient's chest
(Low confidence condition)
The sensor is turned 90 degrees, placed vertically (Low confidence condition)
There is excessive patient movement (Low confidence condition)
An unqualified mattress type is in use
A module error occurred
The bed sensor expires soon
The bed sensor has expired
Suggested action
Turn the sensor right-side up.
Reposition the sensor under the patient's chest.
Place the sensor horizontally under the patient's mattress, with the cable extending toward the head of the bed.
Check the patient.
Replace the bed sensor.
Switch to a qualified mattress type.
Adjust the position of the sensor under the patient's chest.
Place the sensor horizontally under the patient's mattress, with the cable extending toward the head of the bed.
Check the patient.
Replace the bed sensor.
Use an alternative sensor to monitor respiration.
Switch to a qualified mattress type.
Adjust the position of the sensor under the patient's chest.
Place the sensor horizontally under the patient's mattress, with the cable extending toward the head of the bed.
Check the patient.
Replace the bed sensor.
Use an alternative sensor to monitor pulse rate.
Switch to a qualified mattress type.
Call for service.
Replace the bed sensor before it expires.
Replace the sensor.
Directions for use Troubleshooting 229
Message
The sensor is defective.
Trend change detected. Review patient history.
CO2 messages
Possible cause Suggested action
A sensor error occurred Replace the sensor.
Patient measurements have changed enough to require attention
Check the patient and patient history.
Message Possible cause Suggested action
CO2 not functional. Call for service. A nonrecoverable communications error has occurred
Filter line disconnected.
Call for service.
The sampling line is not connected to the monitor Connect a sampling line to the monitor.
Check for occlusion in gas line.
Check to ensure that the sampling line plug is tightly connected to the monitor.
The purge cycle failed to clear a blockage in the sampling line
Replace the sampling line.
CO2 temperature out of range. CO2 might not be accurate.
CO2 module temperature is out of range Wait for the module temperature to return to normal and the module to reset before calibrating CO2.
Move to a location where the ambient temperature enables the module temperature to return to normal and the module to reset before calibrating CO2.
Connect or clear filter line.
Calibration failed because sampling line is blocked or kinked
Check sampling line for obstruction or kinks. Replace the filter line if necessary.
Module is not ready for calibration because the sampling line is not connected to the monitor
Check to ensure that the sampling line plug is tightly connected to the monitor.
Purging filter line.
Check calibration gas concentration.
Check calibration gas flow.
An occlusion was detected in the sampling line, which automatically initiated a purge cycle
Wait for the purge cycle to clear the blockage and the module to be reset.
The calibration gas is not flowing Check that the calibration gas is turned on.
The calibration gas has the wrong CO2 concentration
The calibration gas flow is unstable
Check that the calibration gas has the correct concentration.
Check the sampling line for kinks or obstructions.
Check all tubing connections for leaks.
230 Troubleshooting Welch Allyn Connex ® Devices
Message Possible cause Suggested action
Check that the gas source is not running out.
Call for service.
Check exhaust port for obstruction. The exhaust port is blocked
Calibration overdue. CO2 might not be accurate.
Internal flow problem
The due date for calibration has passed Perform CO2 calibration or call for service.
Factory service overdue. CO2 might not be accurate.
The due date for factory service has passed
Calibration failed. Error message here.
The calibration failed for the reason named in the error message
Call for service.
Check the error message and take corrective action presented.
Resume using the monitor.
Calibration completed successfully. An uninterrupted, error-free calibration took place
Calibration aborted.
You or some other user interrupted the calibration
RRa messages
Resume or retry calibration.
Message
Respiratory freshness timeout expired.
Possible cause
Excessive ambient or environmental noise
Poor sensor placement on the patient
Suggested action
Reduce the level of noise in the room.
Remove the sensor from the patient and reapply.
The patient cable or sensor is defective
Replace RRa probe.
The sensor is faulty
No sensor is connected
The cable is faulty
RRa patient interference detected. Poor sensor placement on the patient
The patient is talking
Replace the patient cable or sensor.
Replace the sensor.
Connect the sensor.
Replace the cable.
Remove the sensor from the patient and reapply.
Ask the patient to limit talking.
The patient is snoring Gently adjust the patient's position to reduce snoring.
Awaken and ask the patient to adjust their position to reduce snoring.
Directions for use Troubleshooting 231
Message Possible cause
Excessive ambient or environmental noise RRa background interference detected.
NIBP messages
Message Possible cause
NIBP air leak; check cuff and tubing connections.
The NIBP module has an air leak
Suggested action
Reduce the level of noise in the room.
Suggested action
NIBP not functional. Call for service.
Unable to determine NIBP; check connections; limit patient movement.
A module error occurred
The ambient temperature is out of range
The NIBP module detected a motion artifact
Call for service.
Use the monitor in the specified temperature range.
Check connections; limit patient movement.
Clear the alarm and retry NIBP.
Unable to determine NIBP; check connections and tubing for kinks.
The NIBP tubing on the outside of the device has a kink
Check the connections and tubing for kinks.
Clear the alarm and retry NIBP.
The NIBP module needs to be calibrated
Check the cuff, tubing, and connections for leaks. If no leaks are found, clear the alarm and retry NIBP.
If the message reappears, call for service to replace the NIBP module.
Incorrect NIBP cuff size; check patient type.
Inflation too quick; check NIBP cuff and tubing connections.
Tubing inside the NIBP module is kinked
The cuff size is not correct for the selected patient type
NIBP inflation was too quick
Call for service to calibrate the
NIBP module.
Call for service to replace the
NIBP module.
Check the patient type and cuff size.
Clear the alarm and retry NIBP.
Check the connections and tubing for kinks.
Clear the alarm and retry NIBP.
Unable to determine NIBP; check inflation settings.
Target pressure is too low
Excessive patient movement.
The NIBP module detected a motion artifact
Check inflation settings and change as necessary.
Clear the alarm and retry NIBP.
Change the cuff inflation target
(CIT).
Touch OK to dismiss.
Limit patient movement and retry
NIBP.
232 Troubleshooting Welch Allyn Connex ® Devices
Message Possible cause Suggested action
Tube type does not match device configuration.
(NIBP measurement is available)
The tube connected to the NIBP sensor does not match the monitor's configuration
Touch OK to dismiss.
Use the tube type specified for the monitor.
Tube type does not match device configuration.
(NIBP measurement is not available)
User is using a single-lumen tube with the following Advanced settings:
1.
Patient type is Pediatric or Adult
2.
Tube type is 2
3.
Algorithm is SureBP
Clear message. Modify settings or tube use to match patient type.
Time limit exceeded. Unable to complete program.
The averaging program could not be completed within the system time limit
Check connections; limit patient movement.
Clear the alarm and retry the program.
SpO2 and SpHb messages
Message
SpO2 not functional. Call for service.
Possible cause
A module error has occurred
Suggested action
Try a new cable/sensor pair.
Call for service.
Searching for pulse signal. (Highpriority alarm)
The SpO2 sensor is not attached to the patient's finger
Touch the alarm icon or the SpO2 frame to dismiss the alarm.
Set SpO2 alarm limits to OFF.
Reattach the SpO2 sensor to the patient's finger.
Attach SpO2 sensor to monitor.
Replace the SpO2 sensor.
Replace the SpO2 cable.
The sensor was not detected
The SpO2 sensor is faulty or expired
No SpO2 sensor is connected
The cable is faulty or expired
The cable is faulty or expired
Check the sensor connection.
Replace the SpO2 sensor.
Replace the SpO2 sensor.
Connect an SpO2 sensor.
Replace the cable.
Replace the cable.
Low SpO2 signal quality. Check sensor.
Low SpHb signal quality. Check sensor.
Low perfusion. Check sensor.
Poor sensor placement on the patient
The patient cable or sensor is defective
Remove the sensor from the patient and reapply.
Call service to test or replace the module.
The SpO2 module is faulty Remove the sensor from the patient and reapply.
SpO2 mode only. Check sensor or cable.
The sensor is operating as an SpO2-only sensor because it failed to calibrate properly
Reattach the cable to the monitor.
Directions for use Troubleshooting 233
Message Possible cause Suggested action
Remove the sensor from the patient and reapply.
Replace the SpO2 sensor.
SpO2 sensor expires in….
Note This message only appears on devices configured with SpHb.
The SpO2 sensor will expire soon
Temperature messages
Message
Connect temperature probe.
Possible cause
No probe is connected
The probe is faulty
The temperature module returned a connect probe message
Suggested action
Connect a temperature probe and retry.
Replace the temperature probe.
Connect a temperature probe and retry. If a probe is already connected, replace the probe.
Insert a temperature probe well.
Insert correct color-coded probe well.
Replace temperature probe.
The probe well is missing
The probe is faulty
Temperature not functional. Call for service.
A module error occurred
Temperature time limit exceeded.
Retry temperature measurement.
The direct mode timed out
Tissue contact lost.
The probe has lost contact with the patient's tissue
Retry temperature measurement.
Note This message often accompanies other temperature messages.
A probe heater or data error occurred
User settings require adjustment
The ambient temperature is out of range
The SureTemp temperature module is faulty
Replace the temperature probe.
Call for service.
Remove the probe from the measurement site.
Touch OK to dismiss the message. Return the probe to the probe well and retry patient temperature measurement.
Ensure that the probe makes proper contact with the patient's tissue.
Retry the temperature measurement. If the problem persists, replace the probe.
Adjust the user settings and retry.
Operate the monitor within the specified temperature range.
Retry patient temperature measurement.
Call for service.
234 Troubleshooting Welch Allyn Connex ® Devices
Message Possible cause Suggested action
Unable to detect new temperature.
Retry measurement.
The Braun thermometer is removed from the dock or not seated properly in the dock
Return the thermometer to the dock or adjust the thermometer in the dock.
The Braun dock is disconnected from the device Connect the USB cable for the
Braun dock to the device.
Thermometer might be docked improperly. Check contacts and connections.
The Braun thermometer is removed from the dock or not seated properly in the dock
Return the thermometer to the dock or adjust the thermometer in the dock.
The Braun dock is disconnected from the device Connect the USB cable for the
Braun dock to the device.
ECG messages
Message
Alarm
Electrodes off:
Possible cause Suggested action
IEC electrodes (N, F, R, L, C)
AHA electrodes (RA, LA, LL, V)
Electrode x off displayed with list of applicable electrodes
ECG not functional.
Device configured for 5 leads, but only
3 leads are used
Use 5-lead cable.
(RA, LA, LL, V) disconnected Connect (RA, LA, LL, V) lead.
(N, F, R, L, C) disconnected
Trunk cable disconnected
Connect (N, F, R, L, C) lead.
Connect trunk cable.
Cannot analyze ECG.
Cannot measure ECG.
ECG module error, WACP error, Data failure
ECG module has not transmitted ECG data for the past 30 seconds
ECG module disconnected
Replace the ECG module.
Unexpected alarm compatibility bits
Check ECG connection to
Connex device.
Restart Connex device and
ECG module; if error persists, replace ECG module.
Module unable to analyze the ECG signal for V-Tach, V-Fib, and/or asystole
Check electrodes and leads, and replace as needed.
Replace the ECG module.
ECG module has been unable to detect and ECG waveform for the past 30 seconds
Check electrodes and leads, and replace as needed.
Directions for use Troubleshooting 235
Message
Searching for respiration.
Respiration alarm limits changed.
Possible cause Suggested action
Replace the ECG module.
Good ECG readings no longer available Check electrodes and leads, and replace as needed.
Replace the ECG module.
Attempting to acquire ECG/Impedance respiration
Check electrodes and leads, and replace as needed.
Replace the ECG module.
Respiration physiological alarm limits were modified because the respiration source changed
Reset alarm limits.
Weight scale messages
Message Possible cause
Weight scale not functional. Call for service.
The weight scale is not operating properly.
Physical assessment instrument handles
Symptom
The lamp does not illuminate
The lamp is too dim
The lamp is too bright
Suggested action
Call for service.
Possible cause Suggested action
There is no lamp in the handle head Install a lamp in the handle head.
The lamp is burned out
The other handle is off the cradle
Install a new lamp.
Place the other handle in the cradle.
The system is not powered up Power up the system.
The platform handle controller PCBA is defective
Call service.
The handle assembly is defective
The rheostat setting is too low
Call service.
Increase the rheostat setting.
The platform handle controller PCBA is defective
Call service.
The handle assembly is defective Call service.
The rheostat setting is too high Decrease the rheostat setting.
The platform handle controller PCBA is defective
Call service.
236 Troubleshooting Welch Allyn Connex ® Devices
Symptom Possible cause Suggested action
The handle assembly is defective Call service.
The lamp brightness does not adjust The platform handle controller PCBA is defective
Call service.
The handle assembly is defective Call service.
The handle becomes very hot to the touch
The lamp has been on for an extended period of time
Return the handle to the cradle.
Patient data management messages
Message
Maximum number of patient records saved. Oldest record overwritten.
No data saved.
Possible cause Suggested action
The maximum number of patient records in the monitor's memory has been exceeded
No patient data is available
On the Review tab, delete old records to prevent the alarm from appearing when new records are saved.
Take or enter vital signs before saving.
Patient ID required to save data.
The configuration requires a patient ID to save data
Call for service to modify advanced settings.
Clinician ID required to save data. The configuration requires a clinician ID to save data
Call for service to modify advanced settings.
Patient ID required to send data.
The configuration requires a patient ID to send data
Patient list is full. Delete some patients to add more.
Add a patient ID.
The maximum number of patients was exceeded Delete a patient from the list to add a new patient.
Stop intervals to select new patient.
No connection for send.
The monitor is set to take interval readings Stop intervals before changing the patient.
No connectivity is available to support sending data manually or automatically sending data on manual save
Call for service to check the network connection or wireless settings.
Unable to retrieve list.
The monitor is unable to retrieve a patient list from the network
Unable to identify clinician.
Unable to identify patient.
Touch Clear to delete all data.
The clinician ID or password is incorrect
The patient ID does not match an ID in the patient list or network
Call for service to check the network connection or wireless settings, or to verify that the server is available.
Confirm the clinician ID and password (if applicable), and retry.
Re-enter the patient ID.
To delete all unsaved data, touch
Clear .
Directions for use Troubleshooting 237
Message
Unable to identify clinician.
Touch Clear to delete all data.
Possible cause
The clinician ID does not match an ID in the network
Suggested action
Re-enter the clinician ID.
To delete all unsaved data, touch
Clear .
Communications module messages
Message
Communications module did not power on properly. Power down the device. (High-priority alarm)
Radio messages
Possible cause
Communication failure
Suggested action
Call for service.
Message Possible cause Suggested action
Radio not functional. Call for service.
Radio error. Power down and restart.
Unable to establish network communications. Radio out of network range.
A hardware failure occurred
The radio has the wrong software
The device and the radio failed to establish communication with each other
The radio is no longer communicating with the access point
Call for service to update the radio software or replace the radio.
Power down and restart. If problem persists, call for service.
Call for service to verify that the device is within the radio coverage area and is configured to the network.
Unable to establish network communications. Call for service.
The radio is unable to get an IP address from the
DHCP server
Call for service to verify that the server is available.
Configuration is invalid without certificates. Reconfigure and try again.
The configuration is invalid for installed radio certificates and/or PAC file
Restore factory defaults for radio settings to clear out the certificate. Then configure the radio appropriately.
You attempted to load corrupted radio certificates
Reload a valid certificate package into the radio.
Ethernet messages
Message Possible cause
Network not found; check network cable connection.
A network cable is unplugged
A network connection is broken elsewhere
Suggested action
Check the network cable connection. If problem persists, call for service.
238 Troubleshooting Welch Allyn Connex ® Devices
USB and USB flash drive messages
Message Possible cause Suggested action
USB Communication failure. Call for service.
External device not licensed for use.
External device not recognized.
An internal or external device is connected but failed enumeration
Power down and restart.
Check USB connections.
If problem persists, call for service.
Disconnect the unlicensed device.
A license for an external device (e.g., barcode scanner) has not been activated
Call for service to obtain the authorization code from Welch
Allyn to activate the license.
An unrecognized external device is connected Disconnect the unrecognized device.
Incompatible Welch Allyn device. A communication protocol failure has occurred Call for service.
USB accessory disconnected.
The USB cable between an external device and the monitor is disconnected
Confirm that the USB cable is connected to the device and the monitor.
Save not successful.
Unable to save configuration to
USB.
System messages
Missing, improperly inserted, or incompatible
USB flash drive
Missing, improperly inserted, or incompatible
USB flash drive
Dismiss message and insert a compatible USB flash drive.
Dismiss message and insert a compatible USB flash drive.
Message
Set date and time.
Possible cause
The date or time is not set
The date or time is not set properly
Suggested action
Set the date and time.
Reset the date or time.
Device shutdown is not available at this time.
Device cannot perform an immediate shutdown Touch OK , wait, and retry.
Advanced settings unavailable.
Sensors are taking measurements Stop continuous measurements.
A physiological alarm condition is active Respond to or reset the alarm.
Spot Check measurements have not been saved Save the measurements.
Unexpected restart occurred. Call for service.
A system error caused the monitor to restart.
Call for service.
Directions for use Troubleshooting 239
Battery power manager messages
Message
Low battery 5 minutes or less remaining. (High-priority alarm)
Low battery 30 minutes or less remaining.
Possible cause
Battery power is extremely low
Battery power is low
Battery is absent or faulty.
There is no battery in the monitor
Battery is absent or faulty. Call for service.
The battery is faulty
Device is operating in battery mode.
The AC power cord has been disconnected
Configuration Manager messages
Message Possible cause
Unable to load configuration; using factory defaults.
A configuration load error occurred
Functional error. Call for service.
A critical configuration load error occurred
No connection for send.
Printer messages
The monitor is not configured to the network
Message Possible cause
Low battery, unable to print; plug into outlet.
The monitor's battery voltage is too low to support printing
Printer door is open; close to continue.
The printer door is open
Out of paper.
The paper is not properly loaded
Printer too hot; wait to retry.
External device not recognized.
Suggested action
Connect the monitor to AC power. (If not connected to AC power, the monitor powers down when battery power is depleted.)
Touch the alarm icon to dismiss or connect the monitor to AC power.
Insert a battery.
Replace the battery.
Touch OK to dismiss or connect the monitor to AC power.
Suggested action
Call for service.
Call for service.
Call for service.
Suggested action
Connect the monitor to AC power.
Close the printer door.
The paper sensor does not detect paper
The print head overheated
An external printer is plugged into a USB port
Align the paper with the print head. If the problem persists, call for service.
Replace the paper. If the problem persists, call for service.
Wait for the print head to cool down and retry. If the problem persists, call for service.
Unplug the external printer.
240 Troubleshooting Welch Allyn Connex ® Devices
Message Possible cause Suggested action
Printer not functional. Call for service.
The printer motor is broken
The detection switch malfunctioned
A hardware failure occurred in the power supply
The printer does not identify itself correctly
Call for service.
The printer does not enumerate
Printing records:
Note The number of records requested appears in the message and counts down during printing.
The monitor is printing the records selected on the Review tab
Acknowledge the number of records printing or touch to interrupt printing.
Cancel
Printing report; please wait.
The printer needs more time to complete a print job when the Automatic print on interval control has been enabled
Wait for the print job to print completely.
Disable Automatic print on interval in Intervals settings.
Network messages
Message
Lost connectivity with host.
Failed to authenticate to server.
Possible cause Suggested action
The central station or other host application has stopped running or is not operating properly
Confirm that the host application is running properly.
Device is configured for server authentication, but server authentication failed for one of the following reasons:
• the domain name of the server does not match the one reported in the server certificate
• the certificate is expired (no longer within the validity period)
• the certificate has not been verified
• the certificate has been revoked
Make sure server certificates are valid.
Make sure the correct CA certificate file exists on the device to authenticate the server certificate.
Check the server configuration.
Make sure authentication is configured correctly.
The server is not configured for authentication
Disable the server authentication option on the device.
Problems and solutions
The problems addressed in this table do not generate alarm or information messages on the monitor.
Directions for use Troubleshooting 241
Problem
No SpHb value is displayed
Possible cause Suggested action
An SpO2-only cable is connected to the monitor Replace the SpO2-only cable with an SpO2/SpHb (Masimo rainbow) cable.
The SpO2/SpHb reusable sensor has expired
Note A technical alarm appears.
Replace the sensor.
No weight measurement is transferred from the scale to the monitor
No BMI value is displayed in the
Office profile
Poor sensor placement on the patient Remove the sensor from the patient and reapply.
The monitor may have the SpHb license, but the
SpO2 module does not
Contact Welch Allyn to verify that the SpO2 module contains the SpHb license.
The scale is not connected
The scale setting is incorrect
The weight measurement is out of range
The height measurement is out of range
Inspect the USB cables from the device to the adapter to the scale to ensure that they are connected properly.
Ensure that the scale settings are enabled for transfer.
Manually adjust the measurement.
The Office profile does not appear in the Profiles tab
The Office profile license is not installed
Use the attached weight scale to retake the measurement.
Purchases a license and install the license using the service tool.
Lead-quality problems
Artifact or noisy waveform
Artifact is signal distortion that makes it difficult to accurately discern the waveform morphology.
Causes
• The patient was moving.
• The patient was shivering.
• There is electrical interference.
Actions
See actions for wandering baseline, muscle tremor, and AC interference.
Wandering baseline
Wandering baseline is an upward and downward fluctuation of the waveforms.
242 Troubleshooting Welch Allyn Connex ® Devices
Causes
• Electrodes are dirty, corroded, loose, or positioned on bony areas.
• The electrode gel is insufficient or dried.
• The patient has oily skin or used body lotions.
• Rising and falling of chest during rapid or apprehensive breathing.
Actions
• Clean the patient’s skin with alcohol or acetone. Take care not to irritate the skin.
• Reposition or replace the electrodes.
• Verify that the patient is comfortable, warm, and relaxed.
Muscle tremor
Causes
• The patient is uncomfortable, tense, nervous.
• The patient is cold and shivering.
• The exam bed is too narrow or short to comfortably support arms and legs.
• The arm or leg electrode straps are too tight.
Actions
• Verify that the patient is comfortable, warm, and relaxed.
• Check all electrode contacts.
• If interference persists, turn on the filter. If interference still persists, the problem is probably electrical in nature. See the suggestions for reducing AC interference.
AC interference
AC interference superimposes voltage on the waveforms.
Causes
• The patient or technician was touching an electrode during recording.
• The patient was touching a metal part of an exam table or bed.
• A lead wire, patient cable, or power cord are broken.
Directions for use Troubleshooting 243
• Electrical devices in the immediate area, or lighting, or wiring concealed in walls or floors are interfering.
• An electrical outlet is improperly grounded.
Actions
• Verify that the patient is not touching any metal.
• Verify that the USB cable is not touching the patient cable.
• Verify that the AC filter is selected.
• Verify that the AC filter is set to proper frequency.
• If interference persists, the noise may be caused by other equipment in the room or by poorly grounded power lines.
Lead alert or square wave
One or more leads might appear as a square wave.
Causes
• The signal from an electrode has not yet stabilized after placing it.
• Electrodes are dirty, corroded, loose, or positioned on bony areas.
• The electrode gel is insufficient or dried.
• The patient has oily skin or used body lotions.
Actions
• Verify that the patient’s skin has been properly prepared.
• Verify that electrodes have been properly stored and handled.
• Replace the electrode.
• Replace the patient cable.
Analysis errors
Condition
Incorrect heart rate
Possible cause Suggested action
Low amplitude signal causes misdetection and creates long coupling interval.
Artifact prevents QRS detections, creating long coupling interval.
Reposition electrode to increase signal amplitude.
Excessively noisy trace causes false interpolated beats.
Excessively noisy trace causes distortion of original QRS signal.
Prematurity threshold in clinical settings is set too low.
Excessively noisy trace causes false interpolated beats, artificially elevating heart rate.
Improve preparation for patient hookup.
244 Troubleshooting
Condition
Low heart rate
High heart rate
Low respiration rate
High respiration rate
False pacer detection
Welch Allyn Connex ® Devices
Possible cause
Low amplitude signal causes no detection.
Suggested action
Low amplitude signal causes no detection.
Low heart rate threshold is set too high.
Excessively noisy trace causes false interpolated beats.
High heart rate threshold is set too low.
Improve preparation for patient hookup.
Check that low heart rate threshold is set to desired threshold.
Improve preparation for patient hookup.
Check that high heart rate threshold is set to desired threshold.
Low amplitude signal causes no detection.
Low respiration rate threshold is set too high.
Improve preparation for patient hookup.
Check that low respiration rate threshold is set to desired threshold.
Excessively noisy trace causes false interpolated beats.
High respiration rate threshold is set too low.
Improve preparation for patient hookup.
Check that high respiration rate threshold is set to desired threshold.
Excessively noisy trace causes false pacer detections.
Disable pacer detection if patient does not have a pacemaker.
Specifications
Physical specifications
Protection classifications, all monitor configurations
Characteristic
Electrical rating
Specification
100 – 240 V AC, 50 – 60 Hz, 0.8 –1.5 A
Duty cycle Continuous operation
Duty cycle – physical assessment handles 2 minutes on, 10 minutes off
Type of protection against electric shock Class I equipment (protectively earthed) with double insulation
Degree of protection against electric shock, for parts applied to patients
Type BF defibrillator proof
IEC EN 60601-1
Less than or equal to 10 seconds Recovery time following defibrillator discharge
Flammable anesthetics
WARNING Not suitable for use with flammable anesthetics.
Degree of protection provided by the enclosure with respect to harmful ingress of liquids
IPX1 (Vital Signs Monitor)
IPX0 (Integrated Wall System)
Vital Signs Monitor 6000 Series
Height Standard chassis: 10 in. (25.4 cm)
Extended chassis: 10 in. (25.4 cm)
Width Standard chassis: 11.4 in. (28.96 cm)
Extended chassis: 11.4 in. (28.96 cm)
Depth Standard chassis: 6 in. (15.3 cm)
Extended chassis: 7.5 in. (19.1 cm)
245
246 Specifications
Protection classifications, all monitor configurations
Weight (including battery) Standard chassis: 9.5 lb (4.3 kg)
Extended chassis: 10.4 lb (4.7 kg)
Integrated Wall System
Height
Width
Depth
Weight (including battery)
Graphical display resolution
10.5 in. (26.8 cm)
39.9 in. (101.4 cm)
7.5 in. (19.1 cm)
14.1 lb. (6 kg)
Display area
Pixels
Pixel arrangement
Color depth
8 in. (H) x 4 in. (V) (19.5 [H] cm x 11.3 [V] cm)
1024 (H) x 600 (V)
RGB (red, green, blue)
16 bits per pixel
Speaker volume
Vital Signs Monitor 6000 Series
High priority alarm sound pressure level 47-92 dBA at 1.0 meter
Medium priority alarm sound pressure level
45-82 dBA at 1.0 meter
Integrated Wall System
High priority alarm sound pressure level 42-78 dBA at 1.0 meter
Medium priority alarm sound pressure level
42-75 dBA at 1.0 meter
Alarm and pulse tones per IEC 60601-1-8
150 – 1000 Hz Pulse frequency (f
0
)
Number of harmonic components in the range 300 Hz to 4000 Hz minimum of 4
Effective pulse duration (t d
) high priority: 75 –200 ms medium and low priority: 125 – 250 ms
Rise time (t r
)
Fall time a (t f
)
10 – 40% of t d t f
< t s
– t r
Welch Allyn Connex ® Devices
Directions for use Specifications 247
Protection classifications, all monitor configurations
Maximum delay for lost connection with host notification
4 seconds
Note The relative sound pressure level of the harmonic components should be within 15 dB above or below the amplitude at the pulse frequency.
See the "Alarm delays" table later in this section.
Note a Prevents overlap of pulses.
Battery specifications 3 cell (Integrated Wall
System)
9 cell (Vital Signs Monitor)
Rating
Composition
Charge time to 90% capacity
Charge time to 100% capacity
Patient exams per charge 1
Age to 70% capacity 2
10.8V 1.9 Ah (20 Wh)
Lithium-ion
Always plugged in
Always plugged in
N/A
N/A
11.1V 6000mAh (66Wh)
Lithium-ion
2 hr 45 min
4 hr
47
300
Operating time per charge for continuous monitoring 3, 4
N/A 2 hr (only if clinician remains in the room)
1 A patient exam includes NIBP, Temperature, and SpO2 measurements at the rate of one patient every 10 minutes with a 2-minute display time out setting and a new battery.
2 After this many full charge and discharge cycles, the battery has aged to where its total capacity has been reduced to
70% of its rating.
3 This specification is based on a monitor with the following characteristics:
• A new, fully charged 9-cell battery
• CO2, SpO2, SpHb and the radio operating continuously
• One blood pressure measurement every 10 minutes
• One printout every 10 minutes
As batteries age, their capacity diminishes. Replace the battery when a noticeable decrease in operating time is observed or when total capacity is below 70% (as described in Note 2 above).
4 If battery power supplied to the monitor falls below the specified lower limit, the monitor powers down. There is no impact on monitor performance or accuracy as the battery charge runs down. A high-priority alarm occurs when a charge of 5 minutes or less remains on the battery. Plugging the monitor into a power outlet starts recharging the battery immediately and prevents the monitor from powering down.
Ethernet connection specifications
Ethernet Communicates using 10base-T and 100-base T
248 Specifications Welch Allyn Connex ® Devices
Nurse Call connection specifications
Nurse Call 50V DC maximum at 500mA (DC or ACRMS)
Handle specifications
Handle output 3.00 - 3.90 V, .700 - 1.5 A
Leakage current is less than 10 microamps from any exposed metal part.
NIBP specifications
Units of measure
Cuff pressure range
Systolic range
Systolic, diastolic, MAP: mmHg, kPa; user-selectable
Pulse rate: beats per minute
Meets or exceeds ANSI/AAMI SP10:2002 standards for cuff pressure range
Adult: 30 to 260 mmHg (4.0 to 34.7 kPa) (StepBP, SureBP)
Pediatric: 30 to 260 mmHg (4.0 to 34.7 kPa) (StepBP, SureBP)
Neonate: 20 to 120 mmHg (2.7 to 16.0 kPa) (StepBP)
Diastolic range Adult: 20 to 220 mmHg (2.7 to 29.3 kPa) (StepBP, SureBP)
Pediatric: 20 to 220 mmHg (2.7 to 29.3 kPa) (StepBP, SureBP)
Neonate: 10 to 110 mmHg (1.3 to 14.7 kPa) (StepBP)
Cuff Inflation Target Adult: 160 mmHg (21.3 kPa) (StepBP)
Pediatric: 140 mmHg (18.7 kPa) (StepBP)
Neonate: 90 mmHg (12.0 kPa) (StepBP)
Maximum Target Pressure Adult: 280 mmHg (37.3 kPa) (StepBP, SureBP)
Pediatric: 280 mmHg (37.3 kPa) (StepBP, SureBP)
Neonate: 130 mmHg (17.3 kPa) (StepBP)
Blood pressure determination time Typical: 15 seconds
Maximum: 150 seconds
Blood pressure accuracy Meets or exceeds ANSI/AAMI SP10:2002 standards for noninvasive blood pressure accuracy, ±5 mmHg (0.7 kPa) mean error, 8 mmHg (1.1 kPa) standard deviation
Mean Arterial Pressure (MAP) range
The formula used to calculate MAP yields an approximate value.
Adult: 23 to 230 mmHg (3.1 to 30.7 kPa) (StepBP, SureBP)
Pediatric: 23 to 230 mmHg (3.1 to 30.7 kPa) (StepBP, SureBP)
Neonate: 13 to 110 mmHg (1.7 to 14.7 kPa) (StepBP)
Pulse rate range (using blood pressure determination)
Adult: 30 to 200 beats per minute (StepBP, SureBP)
Pediatric: 30 to 200 beats per minute (StepBP, SureBP)
Neonate: 35 to 220 beats per minute (StepBP)
Directions for use Specifications 249
NIBP specifications
Pulse rate accuracy (using blood pressure determination)
±5.0% (±3 beats per minute)
Overpressure cutoff Adult: 300 mmHg ±15 mmHg (40.0 kPa ±2.0 kPa)
Pediatric: 300 mmHg ±15 mmHg (40.0 kPa ±2.0 kPa)
Neonate: 150 mmHg (20.0 kPa) maximum
Note NIBP performance can be affected by extremes of humidity, temperature, and altitude.
SureTemp Plus temperature module specifications
Units of measure
Temperature range
Temperature measurement range
Less than 37.0 °C
°F, °C; user-selectable
80° F to 110° F (26.7° C to 43.3° C)
Accuracy
±0.2 °C
37.0 °C to 39.0 °C
Greater than 39.0 °C
Less than 96.4 °F
96.4 °F to less than 98.0 °F
98.0 °F to 102.0 °F
102.0 °F to 106.0 °F
Greater than 106.0 °F
±0.1 °C
±0.2 °C
±0.4 °F
±0.3 °F
±0.2 °F
±0.3 °F
±0.4 °F
Braun ThermoScan PRO thermometer specifications (refer to manufacturer's directions for use for additional information)
Units of measure
Temperature range
Calibration accuracy
°F, °C; user-selectable
68° F to 108° F (20° C to 42.2° C)
• ±0.4° F (±0.2° C) for temperatures ranging from 95.9° F to 107.6° F
(35.5° C to 42° C)
• ±0.5° F (±0.3° C) for temperatures outside of this range
Display resolution 0.1° F or 0.1° C
250 Specifications Welch Allyn Connex ® Devices
SpO2
WARNING Functional testers cannot be used to assess the accuracy of a pulse oximeter monitor.
Some models of commercially available bench-top functional testers and patient simulators can be used to verify the proper functionality of Nellcor and Masimo pulse oximeter sensors, cables and monitors. See the individual testing device's operator's manual for the procedures specific to the model of tester being used.
While such devices may be useful for verifying that the pulse oximeter sensor, cabling, and monitor are functional, they are incapable of providing the data required to properly evaluate the accuracy of a system's SpO2 measurements. Fully evaluating the accuracy of the SpO2 measurements requires, at a minimum, accommodating the wavelength characteristics of the sensor and reproducing the complex optical interaction of the sensor and the patient’s tissue.
These capabilities are beyond the scope of known bench-top testers. SpO2 measurement accuracy can only be evaluated in vivo by comparing pulse oximeter readings with SaO2 measurements obtained from simultaneously sampled arterial blood made using a laboratory CO-oximeter.
Many functional testers and patient simulators have been designed to interface with the pulse oximeter's expected calibration curves and may be suitable for use with Nellcor and Masimo monitors and/or sensors. Not all such devices, however, are adapted for use with the Nellcor OXIMAX or Masimorainbow SET digital calibration system. While this will not affect use of the simulator for verifying system functionality, displayed SpO2 measurement values may differ from the setting of the test device. For a properly functioning monitor, this difference will be reproducible over time and from monitor to monitor within the performance specifications of the test device.
Nellcor specifications (for additional information, refer to the directions for use that accompanies each accessory)
SpO2
Note
Note
Contact the sensor manufacturer for further SpO2 clinical testing information.
Refer to sensor manufacturers’ directions for use for further accuracy information.
Unit of measure
Measurement range
Nellcor sensor accuracy guide
%
1% to 100%
SpO2 measurement accuracy can only be evaluated in vivo by comparing pulse oximeter readings with SaO2 measurements obtained from simultaneously sampled arterial blood made using a laboratory CO-oximeter. SpO2 accuracy was validated through breathe-down-equivalent testing by Covidien using electronic measurements to prove equivalence to the Nellcor N600x predicate device. The
Nellcor N600x predicate device was validated by performing human-subject, “breathe-down” clinical trials.
Accuracy
Note Saturation accuracy varies by sensor type.
The worst case accuracy range of the module or the attached sensor will apply.
Saturation accuracy (module) ±3 digits
70% to 100%
Adult, Pediatrics: ± 2 digits
Neonate: ± 3 digits
Directions for use Specifications 251
Nellcor specifications (for additional information, refer to the directions for use that accompanies each accessory)
Low Perfusion: 0.02% to 20% ± 2 digits
Saturation accuracy (sensors)
60% to 80%
70% to 100%
Sensor Accuracy
MAX-AI, MAX-
PI, MAX-II
±3 digits
DS-100A
D-YS
±3 digits
Infants, Pediatrics, Adults: ±3 digits
Neonates: ±4 digits
Electrical/Optical Specifications
D-YSE
D-YSPD
±4 digits
±4 digits
MAX-AI, MAX-
PI, MAX-II
±2 digits
OXI-A/N Adults: ±3 digits
Neonates: ±4 digits
OXI-P/I ±3 digits
Nellcor pulse oximetry sensors contain light-emitting diodes
(LEDs) that emit red light at a wavelength of approximately
660 nm, and infrared light at a wavelength of approximately
900 nm. The total optical output power of the sensor LEDs is less than 15 mW. This information might be useful to clinicians, such as those performing photodynamic therapy.
Pulse rate
Unit of measure
Measurement range
Accuracy beats per minute
20 to 250 beats per minute
±3 digits
Masimo specifications (for additional information, refer to the directions for use that accompanies each accessory)
SpO2
Note
Note
Contact the sensor manufacturer for further SpO2 clinical testing information.
Refer to sensor manufacturers’ directions for use for further accuracy information.
Unit of measure
Measurement range
%
0% to 100%
252 Specifications Welch Allyn Connex ® Devices
Masimo specifications (for additional information, refer to the directions for use that accompanies each accessory)
Masimo SpO2 sensor accuracy guide Accuracy specified when used with Masimo SET pulse oximetry monitors or with licensed Masimo SET pulse oximetry modules using PC series patient cables, during no motion. Numbers present ±1 standard deviation. Plus or minus one standard deviation represents 68% of the population.
Accuracy 1
Note Saturation accuracy varies by sensor type.
For additional sensor accuracy information, refer to the DFU that accompanies the sensor.
70% to 100%
Resolution
Electrical/Optical Specifications
Adults, Infants, Pediatrics (no motion 2 ): ±2%
Neonates (no motion 2 ): ±3%
Adults, Infants, Pediatrics, Neonates (motion 3 ): ±3%
Adults, Infants, Pediatrics, Neonates (low perfusion 4 ): ±2%
1%
Masimo pulse oximetry uses multi-wavelength sensors that contain light-emitting diodes (LEDs) that emit visible light and infrared light at wavelengths from approximately 500 nm to approximately 1000 nm. The maximum radiant power of the strongest light is less than or equal to 25 mW. This information might be useful to clinicians, such as those performing photodynamic therapy.
Perfusion Index
Measurement range
Pulse rate
Unit of measure
Measurement range
Accuracy 5
0.1% to 20.0% beats per minute
25 to 240 beats per minute
Adults, Infants, Pediatrics, Neonates (no motion): ±3 beats per minute
Adults, Infants, Pediatrics, Neonates (motion): ±5 beats per minute
Adults, Infants, Pediatrics, Neonates (low perfusion 4 beats per minute
): ±3
1 beat per minute Resolution
SpHb
Units of measure
Measurement range g/dL, mmol/L; user-selectable
0.0 to 25.0 g/dL (0.0 to 15.5 mmol/L)
Directions for use Specifications 253
Masimo specifications (for additional information, refer to the directions for use that accompanies each accessory)
Accuracy 6
Resolution
RRa
Unit of measure
Body weight
Measurement range
Adults, Pediatrics (no motion): 8 to 17 g/dL ±1 g/dL
0.1 g/dL or mmol/L breaths per minute
Adult >66 pounds (30 kilograms)
0 to 70 breaths per minute
Accuracy 7
Resolution
Adults: 4 to 70 ±1 breath per minute
1 breath per minute
1 SpO2 accuracy was determined by testing on healthy adult volunteers in the range of 60% to 100% SpO2 against a laboratory CO-Oximeter. SpO2 accuracy was determined on 16 neonatal NICU patients ranging in age from 7 to 135 days old and weighing between 0.5 and 4.25 kg. Seventy-nine (79) data samples were collected over a range of 70% to 100%
SaO2 with a resultant accuracy of 2.9% SpO2. Contact Masimo for testing specifications.
2 The Masimo sensors have been validated for no-motion accuracy in human blood studies on healthy adult male and female volunteers with light to dark skin pigmentation in induced hypoxia studies in the range of 70% to 100% SpO2 against a laboratory CO-Oximeter and ECG monitor. This variation equals ±1 standard deviation which encompasses
68% of the population.
3 The Masimo sensors have been validated for motion accuracy in human blood studies on healthy adult male and female volunteers with light to dark skin pigmentation in induced hypoxia studies while performing rubbing and tapping motions, at 2 to 4 Hz at an amplitude of 1 to 2 cm and a 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 ±1 standard deviation which encompasses 68% of the population.
4 The Masimo rainbow SET CO-Oximeter module has been validated for low-perfusion accuracy in bench-top testing against a Fluke Biotek Index 2 simulator and Masimo's simulator with signal strengths of greater than 0.02% and transmission of greater than 5% for saturations and pulse rates within the stated accuracy specifications. This variation equals ±1 standard deviation which encompasses 68% of the population.
5 The Masimo sensors have been validated for pulse rate accuracy for the range of 25 to 240 beats per minute in benchtop testing against a Biotek Index 2 simulator. This variation equals ±1 standard deviation which encompasses 68% of the population.
6 SpHb accuracy has been validated on healthy adult male and female volunteers and on surgical patients with light to dark skin pigmentation in the range of 8 g/dL to 17 g/dL SpHb against a laboratory CO-Oximeter. The variation equals ±1 standard deviation which encompasses 68% of the population. The SpHb accuracy has not been validated with motion or low perfusion.
7 Respiration rate accuracy for the RRa sensor and instrument has been validated for the range of 4 to 70 breaths per minute in bench-top testing. Clinical validation for up to 30 breaths per minute was also performed with the RRa sensor and instrument.
254 Specifications Welch Allyn Connex ® Devices
CO2 specifications (for additional information, refer to the directions for use that accompanies each accessory)
Capnography is a non-invasive method for monitoring the level of carbon dioxide in exhaled breath (etCO2) to assess a patient’s ventilatory status.
Capnostream uses Microstream non–dispersive infrared (NDIR) spectroscopy to continuously measure the amount of
CO2 during every breath, the amount of CO2 present at the end of exhalation (etCO2), the amount of CO2 present during inhalation (FiCO2), and the Respiratory Rate. Infrared spectroscopy is used to measure the concentration of molecules that absorb infrared light. Because the absorption is proportional to the concentration of the absorbing molecule, the concentration can be determined by comparing its absorption to that of a known standard.
The Microstream etCO2 consumables deliver a sample of the inhaled and exhaled gases from the ventilator consumable or directly from the patient (via an oral/nasal cannula) into the monitor for CO2 measurement. Moisture and patient secretions are extracted from the sample, while maintaining the shape of the CO2 waveform. The 50 ml/min. sampling flow rate reduces liquid and secretion accumulation, decreasing the risk of obstruction in the sample pathway in humid
ICU environments. Once inside the Microstream CO2 sensor, the gas sample goes through a micro-sample cell (15 microliters). This extremely small volume is quickly flushed, allowing for fast rise time and accurate CO2 readings, even at high respiration rates. The Micro Beam IR source illuminates the micro-sample cell and the reference cell. This proprietary IR light source generates only the specific wavelengths characteristic of the CO2 absorption spectrum.
Therefore, no compensations are required when different concentrations of N2O, O2, anesthetic agents and water vapor are present in the inhaled and exhaled breath. The IR that passes through the micro-sample cell and the IR that passes through the reference cell are measured by the IR detectors. The microprocessor in the monitor calculates the CO2 concentration by comparing the signals from both detectors.
Accuracy 1 0 to 38 mmHg: ±2 mmHg
39 to 150 mmHg: ±(5% of reading + 0.08% for every 1 mmHg above 38 mmHg)
Flow rate
Initialization time
System response time
Compensation
Cyclical pressure
Sampled gas return/disposal
50 (42.5 ≤ flow ≤ 65) ml/min, flow measured by volume
40 seconds (typical, includes power-up and initialization time)
7 seconds (typical, includes module response time and host monitor system response time)
Pressure
The CO2 module is equipped with a barometric pressure transducer and compensation is triggered at startup or during other events (significant changes in temperature, ambient pressure, etc.).
BTPS (standard correction used by Microstream capnography during all measurement procedures for body temperature, pressure, and saturation).
Gases
The Microstream emitter radiates a focused beam of infrared energy characterized by the narrow region (0.15 µm wide) of the spectrum where CO2 molecules absorb infrared radiation. Because MCS™ is highly accurate with all gas samples, there is no need to create special algorithms within the monitor to correct for high concentrations of oxygen or anesthetic gases.
≤ 10 kPa (100 cmH
2
O); module operates within specification with overpressure up to 100 cmH
2
O
Sampled gases are not returned to the breathing circuit.
Exhaled gas is exhausted from the monitor's exhaust port.
Directions for use Specifications 255
CO2 specifications (for additional information, refer to the directions for use that accompanies each accessory)
Dispose of sampled gases according to facility requirements or local regulations.
Sampling rate 20 samples per second
Calibration interval Initial: After 1200 operating hours
Subsequent: After 4000 operating hours or annually
(whichever comes first)
After 30,000 operating hours Periodic service etCO2
Units of measure
Display range
Resolution
Frequency response mmHg, kPa; user-selectable
0 to 150 mmHg (0.0 to 20.0 kPa)
1 mmHg, 0.1 kPa
The device maintains etCO2 accuracy up to 80 breaths/min.
From 81 to 150 bpm, accuracy is ±12%.
FiCO2
Units of measure
Display range
Resolution
IPI
Display range
RR
Unit of measure
Display range
Accuracy mmHg, kPa; user-selectable
0 to 150 mmHg (0.0 to 20.0 kPa)
1 mmHg, 0.1 kPa
1 to 10 breaths per minute
0 to 150 breaths per minute
0 to 70 breaths per minute: ±1 breath per minute
71 to 120 breaths per minute: ±2 breaths per minute
121 to 150 breaths per minute: ±3 breaths per minute
Resolution 1 breath per minute
1 For breath rates above 80 bpm, accuracy is 4 mmHg or ±12% of reading (whichever is greater) for etCO2 values exceeding 18 mmHg when measured in accordance with ISO 80601-2-55.
256 Specifications
EarlySense specifications
Sensor
Dimensions
Weight
Material
Connector
Sensor power supply
300 mm x 210 mm x 2.5 mm
160 g
Polycarbonate + ABS
RS232 (S11M03-P04M500-5260(ODU))
Electrical absolute maximum current, DC in Minimum: –0.3 V
Maximum: 5.5 V
Operating current Minimum: 4.9 V
Typical: 5.0 V
Maximum: 5.2 V
Power consumption at 5V operating current Minimum: 1 mA
Maximum: 4 mA
Module
Dimensions
Weight
Host connection
135 mm x 75 mm x 1 0mm
800 g
USB Mini-B
Module power supply
Electrical absolute maximum current, DC in Minimum: –0.3 V
Maximum: 5.5 V
Operating current Main power supply:
Minimum: 4.9 V
Typical: 5.0 V
RTC backup battery voltage:
Minimum: 2.5 V
Typical: 3.0 V
Maximum: 3.2 V
Power consumption at 5V operating current Minimum: 4 mA
Maximum: 400 mA
Patient movement
Movement during defined period (1.5
minutes)
0 = 0%
L = Up to 40%
M = 40% to 60%
H = 60% to 80%
Welch Allyn Connex ® Devices
Directions for use
EarlySense specifications
Accuracy
EH = 80% to 100%
Adult:
0 = 100%, L = 100%, M = 81%, H = 100%, EH = 96%
Pediatric:
0 = 100%, L = 100%, M = 81%, H = 86%, EH = 94%
Averaging period
Respiration rate
Unit of measure
Measurement range
Accuracy 2
15 seconds breaths per minute
6 to 45 breaths per minute 1
Averaging period
Pulse rate
Unit of measure
Measurement range
Accuracy 2
±4% or ±1.5 breaths per minute, whichever is greater
1 minute beats per minute
30 to 170 beats per minute 1
Averaging period
±4% or ±5 beats per minute, whichever is greater
1 minute
1 The system detects pulse rate that is > 1.8 times the respiration rate.
2 Total system accuracy including undetected signals equals 90%.
ECG specifications
Module
Length
Width
Height
Weight
Protection against the ingress of water
Device classification
EMC Class
IEC Type
101.6 mm (4.00 in.)
57.15 mm (2.25 in.)
27.94 mm (1.10 in.)
73.71 g (2.60 oz.)
IPX0 = No protection against water ingress.
Class IIB
Type CF
Specifications 257
258 Specifications Welch Allyn Connex ® Devices
ECG specifications
Heart rate detection range
Heart rate accuracy
QRS detection amplitude
Tall T wave rejection
Heart rate meter accuracy and response to irregular rhythm
Response time of heart rate meter to change in heart rate
20 to 300 beats per minute
±3 beats per minute or ±3%, whichever is greater
≥ 0.3 mV and ≤ 5.0 mV with QRS width of between 40 ms and 120 ms
Rejects Tall T waves less than 1.4 mV
The Heart Rate shall stabilize within 20 seconds and report the following
Heart Rates for data sets A.1 to A.4 with accuracy of ± 5 BPM:
A.1 Ventricular bigeminy 80 BPM
A.2 Slow alternating ventricular bigeminy 60 BPM
A.3 Rapid alternating ventricular bigeminy 120 BPM
A.4 Bidirectional systoles 90 BPM
Increasing from 80 to 120 beats/minute: 10 sec
Decreasing from 80 to 40 beats/minute: 10 sec
Time to alarm for tachycardia Waveform B1
Amplitude – Average time to alarm:
• 0.5 mV – 10 seconds
• 1.0 mV – 10 seconds
• 2.0 mV – 10 seconds
Waveform B2
Amplitude – Average time to alarm:
• 1.0 mV – 10 seconds
• 2.0 mV – 10 seconds
• 4.0 mV – 10 seconds
Data storage capacity
Pacemaker detection
A/D bit resolution
Dynamic range
Sampling rate
Sweep speed
Mains filter
24 hours
±2 mV to ±700 mV amplitude; 0.5 ms to 2.0 ms pulse width per EN
60601-2-27: 2011.
Rejects pacemaker signals, including double-paced signals, with over/ undershoot with the exception of pacemaker signals having an overshoot with a time constant from 4 ms to 100 ms.
Note For leads I, II, III only. The module does not detect or display pacemaker pulses on lead V.
0.5 μ V
±300 mV (95% gain accuracy)
250 ±2% samples per second
25 mm/sec, 50 mm/sec
50 Hz, 60 Hz, off (default = 60 Hz)
Directions for use Specifications 259
ECG specifications
Frequency range
Power source
Digital data interface
Monitoring period
ECG channels
Resolution
Lead-off detection
Applied currents
0.5 to 70 Hz
USB (4.5 V to 5.5 V)
Serial (USB – Full Speed)
Continuous
Supports 3-lead or 5-lead
14 bit ECG data, 30 mV peak-to-peak dynamic range minimum
3-lead or 5-lead
Lead connection failures are detected by a bias current with respect to the reference electrode.
See Alarms User-adjustable parameters
ECG cable specifications
Connector at ECG module
ECG cables
Patient cables
Impedance respiration specifications
Impedance Respiration accuracy
Range
Breath detection range
Respiration lead source
Respiration, leads-off sensing and active noise suppression (applied currents)
80 in. ± 1 shielded cable to a 24 in. ± 1 lead fan-out to electrode connection
3-lead or 5-lead to snap connection
Conforms to ANSI/AAMI EC53
±2 breaths per minute or ±2%, whichever is greater
5 to 100 breaths per minute
0.4 ohms to 3.0 ohms
Lead II (right arm and left leg)
Respiration – Excitation signal characteristics Less than 25 uA RMS at
31 kHz pseudo sine wave
Lead off – DC current of 50nA max for RA ,LA, LL, V; 200nA max for RL
Noise suppression – DC current of 200nA max for RL
Alarm limits
Systolic
Upper limit range of entry Lower limit range of entry
Adult: 30 to 258 mmHg (4.0 to 34.4 kPa). Factory default: 220 mmHg (29.3 kPa).
Pediatric: 32 to 160 mmHg (4.3 to 21.3 kPa).
Factory default: 145 mmHg (19.3 kPa).
Neonate: 27 to 120 mmHg (3.6 to 16.0 kPa).
Factory default: 100 mmHg (13.3 kPa).
Adult: 28 to 256 mmHg (3.7 to 34.1 kPa). Factory default: 75 mmHg (10.0 kPa).
Pediatric: 30 to 158 mmHg (4.0 to 21.1 kPa).
Factory default: 75 mmHg (10.0 kPa).
Neonate: 25 to 118 mmHg (3.3 to 15.7 kPa).
Factory default: 50 mmHg (6.7 kPa).
260 Specifications Welch Allyn Connex ® Devices
Alarm limits
Diastolic
MAP
SpO2
SpHb
Pulse rate (NIBP,
SpO2)
Pulse rate
(EarlySense)
Temperature etCO2
FiCO2
IPI
RR (CO2)
Upper limit range of entry Lower limit range of entry
Adult: 22 to 235 mmHg (2.9 to 31.3 kPa). Factory default: 110 mmHg (14.7 kPa).
Pediatric: 17 to 130 mmHg (2.3 to 17.3 kPa).
Factory default: 100 mmHg (13.3 kPa).
Neonate: 12 to 105 mmHg (1.6 to 14.0 kPa).
Factory default: 70 mmHg (9.3 kPa).
Adult: 20 to 233 mmHg (2.7 to 31.1 kPa). Factory default: 35 mmHg (4.7 kPa).
Pediatric: 15 to 128 mmHg (2.0 to 17.1 kPa).
Factory default: 35 mmHg (4.7 kPa).
Neonate: 10 to 103 mmHg (1.3 to 13.7 kPa).
Factory default: 30 mmHg (4.0 kPa).
Adult: 22 to 255 mmHg (2.9 to 34.0 kPa). Factory default: 120 mmHg (16.0 kPa).
Pediatric: 17 to 140 mmHg (2.3 to 18.7 kPa).
Factory default: 110 mmHg (14.7 kPa).
Neonate: 12 to 110 mmHg (1.6 to 14.7 kPa).
Factory default: 80 mmHg (10.7 kPa).
Adult: 20 to 253 mmHg (2.7 to 33.7 kPa). Factory default: 50 mmHg (6.7 kPa).
Pediatric: 15 to 138 mmHg (2.0 to 18.4 kPa).
Factory default: 50 mmHg (6.7 kPa).
Neonate: 10 to 108 mmHg (1.3 to 14.4 kPa).
Factory default: 35 mmHg (4.7 kPa).
Adult, Pediatric, Neonate: 52% to 100%. Factory default: 100%.
Adult, Pediatric, Neonate: 50% to 98%. Factory default: 90%.
Adult, Pediatric, Neonate: 1.5 to 24.5 g/dL (1.5
to 15.0 mmol/L). Factory default: 17.0 g/dL (11.0
mmol/L).
Adult, Pediatric, Neonate: 1.0 to 24.0 g/dL (1.0
to 14.5 mmol/L). Factory default: 7.0 g/dL (4.0
mmol/L).
Adult: 27 to 300 beats per minute. Factory default: 120 beats per minute.
Pediatric: 27 to 300 beats per minute. Factory default: 150 beats per minute.
Neonate: 27 to 300 beats per minute. Factory default: 200 beats per minute.
Adult: 25 to 298 beats per minute. Factory default: 50 beats per minute.
Pediatric: 25 to 298 beats per minute. Factory default: 50 beats per minute.
Neonate: 25 to 298 beats per minute. Factory default: 100 beats per minute.
Adult, Pediatric: 37 to 150 beats per minute.
Factory default: 130 beats per minute.
Adult: 35 to 148 beats per minute. Factory default: 40 beats per minute.
Adult, Pediatric, Neonate: 87.1 to 110.0°F (30.6
to 43.3°C). Factory default: 101.0°F (38.3°C).
Adult, Pediatric, Neonate: 85.1 to 108.0°F (29.5
to 42.2°C). Factory default: 94.0°F (34.4°C).
Adult: 2 to 150 mmHg (0.3 to 20.0 kPa). Factory default: 60 mmHg (8.0 kPa).
Pediatric: 2 to 150 mmHg (0.3 to 20.0 kPa).
Factory default: 60 mmHg (8.0 kPa).
Neonate: 2 to 150 mmHg (0.3 to 20.0 kPa).
Factory default: 50 mmHg (6.7 kPa).
Adult: 0 to 148 mmHg (0.0 to 19.7 kPa). Factory default: 15 mmHg (2.0 kPa).
Pediatric: 0 to 148 mmHg (0.0 to 19.7 kPa).
Factory default: 15 mmHg (2.0 kPa).
Neonate: 0 to 148 mmHg (0.0 to 19.7 kPa).
Factory default: 20 mmHg (2.7 kPa).
Adult: 0 to 150 mmHg (0.0 to 20.0 kPa). Factory default: 8 mmHg (1.1 kPa).
Pediatric: 0 to 150 mmHg (0.0 to 20.0 kPa).
Factory default: 8 mmHg (1.1 kPa).
Neonate: 0 to 150 mmHg (0.0 to 20.0 kPa).
Factory default: 5 mmHg (0.7 kPa).
None
None Adult, Pediatric: 1 to 10. Factory default: 4.
Adult: 5 to 150 breaths per minute. Factory default: 50 breaths per minute.
Adult: 0 to 145 breaths per minute. Factory default: 3 breaths per minute.
Directions for use Specifications 261
Alarm limits Upper limit range of entry
Pediatric: 5 to 150 breaths per minute. Factory default: 50 breaths per minute.
Neonate: 5 to 150 breaths per minute. Factory default: 80 breaths per minute.
Lower limit range of entry
Pediatric: 0 to 145 breaths per minute. Factory default: 3 breaths per minute.
Neonate: 0 to 145 breaths per minute. Factory default: 12 breaths per minute.
RR (EarlySense) Adult, Pediatric: 9 to 44 breaths per minute.
Factory default: 32 breaths per minute.
RRa Adult: 5 to 150 breaths per minute. Factory default: 50 breaths per minute.
Patient movement Exit sensitivity: 1 to 6. Factory default: 3
EH > 1 minute
Adult, Pediatric: 8 to 43 breaths per minute.
Factory default: 8 breaths per minute.
Adult: 0 to 145 breaths per minute. Factory default: 3 breaths per minute.
Off
Alarm delays
Physiological parameter Default delay
(seconds)
Configurable range
(seconds) 1
Sum of default delays
(seconds) 2
Sum of configurable delays
(seconds)
Pulse rate
SpO2
SpHb
SpO2
Motion (EarlySense)
ECG etCO2 etCO2 no breath detected
Motion low confidence RR/PR alarm delay
Respiration rate
180
Off
10
3
3
10
15
Adult: 30
Pediatric: 20
Neonate: 15
RRa (Masimo)
CO2
ECG
10
10
10
0–60
0–60
0–60
3–120
3–120
0–120
0–30
0–10
0–30
10–60
10–60
10–60
180–1800
21
16
16
31
181
1
11
4
4
11
11
11
11
1–61
1–61
1–61
4–121
4–121
1–121
1–31
1–11
1–31
11–61
11–61
11–61
181–1801
262 Specifications Welch Allyn Connex ® Devices
Physiological parameter Default delay
(seconds)
Configurable range
(seconds) 1
Sum of default delays
(seconds) 2
Sum of configurable delays
(seconds)
181 11–181 Motion (EarlySense) 180 10–180
1 These delays are configurable in Advanced settings.
2 When the device determines the alarm condition, it generates alarm signals (visual and auditory) and notifies any system to which it is connected within one second.
Note The maximum alarm signal generation delay of a technical alarm when connected to a central station is 4 seconds.
Note There are no inherent alarm condition delays in the system for temperature or blood pressure alarms.
Consider ALL of these alarm delays when setting up your monitor and remote alarm system.
ECG software and alarm specifications
Characteristic
Ventricular tachycardia threshold default
Variable ventricular tachycardia settings
Asystole threshold default
Ventricular fibrillation threshold default
Configurable mains filter
Data stream bytes output
Tall T wave rejection per IEC 60601-2-27:
2011 clause 201.12.1.101.17
Heart rate averaging method per IEC
60601-2-27:2011 Clause 201.7.9.2.9.101
Specification
120 beats per minute ±3 beats per minute for 6 consecutive beats
100 beats per minute to 150 beats per minute ±3 beats per minute for 6 consecutive beats
No detectable beat for greater than 4 seconds
A fibrillatory waveform persisting for greater than 4 seconds
ON or OFF; 50 Hz or 60 Hz
Maximum latency < 100 ms
Rejects Tall T waves through 1.4 mV
Number of consecutively detected beats:
>10: Heart rate = 60/(average of last 10 detected consecutive R-R intervals)
> 2 and <10 : Heart rate = 60/(average of the detected consecutive R-R intervals)
Response to change in Heart rate per IEC
60601-2- 27:2011 Clause 201.7.9.2.9.101
Increasing from 80 to 120 beats per minute: 6.0 sec
Decreasing from 80 to 40 beats per minute: 16.0 sec
Directions for use Specifications 263
Protection against defibrillation
Defibrillation protection per EN60601-2-27:2011. ECG device will resume according to the table below.
Parameter Note
HR value
Initial report after defibrillation
Acquiring
Maximum time to recover
3 sec +5 beats Depends on patient heart rate
ECG waveform
Respiration value
Waveform
Acquiring
≤ 5 sec
3 sec +5 breaths Depends on patient respiration rate
Pacer detect
Arrhythmia
Pacer marker in waveform ≤ 5 sec
Acquiring or
Cannot analyze
5 sec +5 beats Depends on patient heart rate
Protection against electrosurgical
Electrosurgical protection per EN60601-2-27:2011. ECG device will resume as per the table below.
Parameter Note
HR value
Initial report after defibrillation
Acquiring
Maximum time to recover
10 sec +5 beats Depends on patient heart rate
ECG waveform
Respiration value
Waveform
Acquiring
≤ 10 sec
10 sec +5 breaths Depends on patient respiration rate
Pacer detect
Arrhythmia
Pacer marker in waveform ≤ 10 sec
Acquiring or
Cannot analyze
10 sec +5 beats Depends on patient heart rate
Device classification
ECG device will operate per table below after startup and after changes to parameter configurations (e.g., filter on/off) or lead off recovery.
Parameter Note
HR value
Initial report after defibrillation
Acquiring
Maximum time to recover
10 sec +5 beats
264 Specifications Welch Allyn Connex ® Devices
Parameter Initial report after defibrillation
Maximum time to recover
Note
Depends on patient heart rate
ECG waveform
Respiration value
Waveform
Acquiring
≤ 3 sec
10 sec +5 breaths Depends on patient respiration rate
Pacer detect
Arrhythmia
Pacer marker in waveform ≤ 3 sec
Acquiring or
Cannot analyze
10 sec +5 beats Depends on patient heart rate
Environmental specifications
Operating temperature
Transport/storage temperature
Operating altitude
Operating humidity
Transport/storage humidity
50°F to 104°F (10°C to 40°C)
-4°F to 122°F (-20°C to 50°C)
-557 to 10,000 ft. (-170 m to 3,048 m)
15 to 95% noncondensing
15% to 95% noncondensing
Device radio
The device's radio operates on 802.11 networks. For information regarding the configuration of network connections and recommended settings, see the best practices documents at www.welchallyn.com/promotions/
Network_Installation_Best_Practices.htm.
Wireless network interface
IEEE 802.11 a/b/g/n
Frequency
Channels
Authentication/
Encryption
Antenna
2.4 GHz frequency bands
2.4 GHz to 2.483 GHz
2.4 GHz channels
Up to 14 (3 non-overlapping); countrydependent
5 GHz frequency bands
5.15 GHz to 5.35 GHz, 5.725 GHz to 5.825Ghz
5 GHz
Up to 23 non overlapping; country-dependent
Wireless Equivalent Privacy (WEP, RC4 Algorithm); Wi-Fi Protected Access (WPA); IEEE 802.11i
(WPA2); TKIP, RC4 Algorithm; AES, Rijndael Algorithm; Encryption Key Provisioning; Static (40bit and 128-bit lengths); PSK; Dynamic; EAP-FAST; EAP-TLS; EAP-TTLS; PEAP-GTC 1
MSCHAPv2; PEAP-TLS;
PEAP-
Ethertronics WLAN_1000146
Directions for use Specifications 265
Wireless data rates 802.11a (OFDM): 6, 9, 12, 18, 24, 36, 48, 54 Mbps
802.11b (DSSS, CCK): 1, 2, 5.5, 11 Mbps
802.11g (OFDM): 6, 9, 12, 18, 24, 36, 48, 54 Mbps
Protocols
Data transfer protocols
802.11n (OFDM,HT20,MCS 0-7): 6.5,13,19.5, 26, 39,52, 58.5, 72.2 Mbps
UDP, DHCP, TCP/IP
UDP/TCP/IP
Output power 39.81mW typical, country-dependent
Ancillary IEEE standards
802.11d, 802.11e, 802.11h, 802.11i, 802.1X
1 One-time passwords are not supported.
Wireless network interface
Frequency
IEEE 802.11 b/g, 802.11a
802.11 b/g: 2.402 GHz to 2.4835 GHz
802.11a: 5.125 GHz to 5.875 GHz
Channels Up to 14 in 802.11b/g, up to 24 in 802.11a; country-dependent
Security/encryption/authentication WPA2/AES (either EAP or PSK authentication)
Antenna
Wireless data rates
Internal multiband PIFA
802.11b: 1Mbps or higher during vitals transmission only
802.11a/g: 6Mbps or higher during vitals transmission only
(approximately 2 seconds per reading)
Protocols
Data transfer protocols
Modulation
Output power
Ancillary IEEE standards
Configuration options
UDP, DHCP, TCP/IP
UDP, TCP/IP
OFDM (802.11a/g), DSSS/CCK (802.11b)
40mW typical, country-dependent
802.11e, 802.11h, 802.11i, 802.11X
Vital Signs Monitor 6000 Series
The monitor is available in multiple configurations.
266 Specifications Welch Allyn Connex ® Devices
Monitors capable of supporting a combination of NIBP, SpO2, SpHb, pulse rate,
ECG, and temperature
Model
6400
6500
Description
Standard. Includes nurse call, Ethernet, and USB connectivity. The radio is optional.
Wireless. Includes all Standard features plus an internal 802.11 a/b/g radio.
Monitors capable of supporting a combination of CO2/RR or RRa or EarlySense
(patient movement), NIBP, SpO2, SpHb, pulse rate, ECG, and temperature
Model
6700
6800
Description
Standard. Includes nurse call, Ethernet, and USB connectivity. The radio is optional.
Wireless. Includes all Standard features plus an internal 802.11 a/b/g radio.
Integrated Wall System
The wall system is available in the following configurations.
Model
Prefix
Description
84 series
85 series
Standard. Includes nurse call, Ethernet, and USB connectivity.
Wireless. Includes all Standard features plus an internal 802.11 a/b/g radio.
Standards and compliance
General compliance and standards
The monitor complies with the following standards 1 :
IEC 60601-1
IEC 60601-1-2
IEC 60601-1-6
IEC 60601-1-8
IEC 60601-2-27 2
IEC 80601-2-30
IEC 60601-2-49
ISO 80601-2-55
ISO 80601-2-56
ISO 80601-2-61
ISO 10993
IEC 62304
IEC 62366
1 Standards are essentially the IEC 60601-1 series of standards plus the listed country's National Deviations (e.g., AS/
NZ, CAN/CSA, EN Harmonized version, etc.).
2 Alarms might display and sound during an Electrosurgery Interference event.
267
268 Standards and compliance Welch Allyn Connex ® Devices
Directive 2002/96/EC-WEEE:
Disposal of noncontaminated electrical and electronic equipment
This product and its accessories must be disposed of according to local laws and regulations. Do not dispose of this product as unsorted municipal waste. Prepare this product for reuse or separate collection as specified by Directive 2002/96/EC of the
European Parliament and the Council of the European Union on Waste Electronic and
Electrical Equipment (WEEE). If this product is contaminated, this directive does not apply.
For more specific disposal or compliance information, see www.welchallyn.com/weee, or contact Welch Allyn Customer Service at +44 207 365 6780.
General radio compliance
The wireless features of this monitor must be used in strict accordance with the manufacturer’s instructions as described in the user documentation that comes with the product.
This device complies with Part 15 of the FCC rules and with the rules of the Canadian
ICES-003 as described below.
Federal Communications Commission (FCC)
This device complies with part 15 of the FCC Rules. Operation is subject to the following two conditions:
• This device may not cause harmful interference.
• This device must accept any interference received, including interference that may cause undesired operation.
This equipment has been tested and found to comply with the limits for a Class B digital device, pursuant to Part 15 of FCC Rules. These limits are designed to provide reasonable protection against harmful interference in a residential installation. This equipment generates, uses, and can radiate radio frequency energy. If not installed and used in accordance with the instructions, it may cause harmful interference to radio communications. However, there is no guarantee that interference will not occur in a particular installation. If this equipment does cause harmful interference to radio or television reception, which can be determined by turning the equipment off and on, the user is encouraged to try and correct the interference by one or more of the following measures:
• Reorient or relocate the receiving antenna
• Increase the distance between the equipment and the receiver
• Connect the equipment to an outlet on a circuit different from that to which the receiver is connected
• Consult the dealer or an experienced radio/TV technician for help
The user may find the following booklet prepared by the Federal Communications
Commission helpful:
The Interference Handbook
Directions for use Standards and compliance 269
This booklet is available from the U.S. Government Printing Office, Washington, D.C.
20402. Stock No. 004-000-0034504.
Welch Allyn is not responsible for any radio or television interference caused by unauthorized modification of the devices included with this Welch Allyn product, or the substitution or attachment of connecting cables and equipment other than specified by
Welch Allyn.
The correction of interference caused by such unauthorized modification, substitution, or attachment will be the responsibility of the user.
Radio compliance/approvals
Newmar radio
This table applies only to devices with a Newmar radio card installed. Distinguishing features of devices with this radio card are the following:
• In Advanced settings, the Session frame on the Network > Status tab includes Tx packets dropped , Rx packets dropped , and Rx multicast packets .
• In Advanced settings, the left pane on the Network > Radio tab includes an Enable dynamic frequency option.
US SQG-WB45NBT
FCC Part 15.247 Subpart C, FCC Part 15.407 Subpart E
Europe 2014/53/EU Radio Equipment Directive
Canada (IC) RSS-210 standard. IC 3147A-WB45NBT based on FCC testing
Australia and New
Zealand
Australian Communications and Media Authority (ACMA) Radio Compliance Mark (RCM)
Brazil
Mexico
Singapore
South Africa
New Zealand maintains a Mutual Recognition Agreement (MRA) with Australia.
Este equipamento opera em caráter secundário, isto é, não tem direito a proteção contra interferência prejudicial, mesmo de estações do mesmo tipo, e não pode causar interferência a sistemas operando em caráter primário.
ANATEL Model No. 01130-15-08547
Instituto Federal de Telecomunicaciones
(Federal Telecommunications Institute—
IFETEL)
This product contains an Approved module,
Model No. WB45NBT IFETEL No.
RCPLAWB14-2006
Infocomm Development Authority of Singapore
(IDA) ( 新加坡 资讯 通信 发 展管理局 )
This product contains an IDA approved device.
Independent Communications Authority of
South Africa
This product contains an ICASA-approved device.
TA-2016/2122
270 Standards and compliance Welch Allyn Connex ® Devices
South Korea Korea Communications Commission ( 대한민
국 방송통 신위원 회 ) - KCC
Certification number:
MSIP-CRM-LAI-WB45NBT
This device complies with Article 58-2 Radio
Waves Act of Korea Communications
Commission. This equipment is Industrial (Class
A) electromagnetic wave suitability equipment and seller or user should take notice of it, and this equipment is to be used in the places except for home.
Class A Equipment (Industrial Broadcasting &
Communication Equipment) A 급 기기 ( 업무
용 방 송통신기자재 )
이 기기는 업무용 (A 급 ) 전자파적합기
기로서 판 매자 또는 사용자는 이 점을
주의하시기 바라 며 , 가정외의 지역에
서 사용하는 것을 목적으로 합니 다 .
To ensure compliance with local regulations, be sure the correct country in which the access point is installed is selected. This product can be used with the following restriction(s):
Norway - Does not apply for the geographical area within a radius of 20 km from the center of Ny-Ålesund.
France - Outdoor use is limited to 10 mW EIRP within the band 2454 to 2483.5 MHz.
Note
Note
Effective Isotropic Radiated Power (EIRP).
Some countries restrict the use of 5-GHz bands. The 802.11a radio in the device uses only the channels indicated by the access point with which the radio associates. The hospital IT department must configure access points to operate with approved domains.
Lamarr radio
This table applies only to devices with a Lamarr radio card installed. Distinguishing features of devices with this radio card are the following:
• In Advanced settings, the Session frame on the Network > Status tab includes
Dir. Rx packets , Dir. Tx packets , and Signal-to-noise ratio .
• In Advanced settings, the left pane on the Network > Radio tab includes only
Enable radio and Enable radio network alarms options (no Enable dynamic frequency option).
US
Argentina
PGUWA11ABG09
FCC Part 15.247 Subpart C, FCC Part 15.407 Subpart E
Europe
Canada
2014/53/EU Radio Equipment Directive
(IC) RSS-210 standard. IC 4168A-WA11ABG09 based on FCC testing
Australia and
New Zealand
Australian Communications and Media Authority (ACMA) Radio Compliance Mark (RCM)
New Zealand maintains a Mutual Recognition Agreement (MRA) with Australia.
Autoridad Federal de las Tecnologias de la
Informacion y las
Contiene Modulo CNC I.D. C-10142
Directions for use Standards and compliance 271
Brazil
Mexico
Singapore
South Africa
South Korea
Comunicaciones
(AFTIC)
Agência Nacional de
Telecomunicações
(ANATEL)
ANATEL Model No. 2997-11-07373
“Este equipamento opera em caráter secundário, isto é, não tem direito a proteção contra interferência prejudicial, mesmo de estações do mesmo tipo, e não pode causar interferência a sistemas operando em caráter primário.”
Instituto Federal de
Telecomunicaciones
(Federal
Telecommunications
Institute—IFETEL
This product contains an Approved module, Model No. Welch Allyn 802.11a/b/ g, IFETEL No. RCPWEWE10-0521
Infocomm
Development
Authority of Singapore
(iDA)
新加坡 资讯 通信 发
展管理局
Singapore: Complies with IDS standard
Independent
Communications
Authority of South
Africa
This product contains an ICASA-approved device.
TA-2010/782
Korea
Communications
Commission ( 대한민
국 방송통 신위원
회 ) - KCC
Certification number:
KCC-CRM-BVT-
WA80211ABG
Class A Equipment
(Industrial Broadcasting
& Communication
Equipment)
A 급 기기 ( 업무용 방
송통신기자재 )
This equipment is Industrial (Class A) electromagnetic wave suitability equipment and seller or user should take notice of it, and this equipment is to be used in the places except for home.
이 기기는 업무용 (A 급 ) 전자파적합기기로서
판 매자 또는 사용자는 이 점을 주의하시기
바라 며 , 가정외의 지역에서 사용하는 것을
목적으로 합니다 .
To ensure compliance with local regulations, be sure the correct country in which the access point is installed is selected. This product can be used with the following restriction(s):
France - Outdoor use is limited to 10 mW EIRP within the band 2454 to 2483.5 MHz.
Norway - Does not apply for the geographical area within a radius of 20 km from the center of Ny-Ålesund.
Note
Note
Effective Isotropic Radiated Power (EIRP).
Some countries restrict the use of 5-GHz bands. The 802.11a radio in the monitor uses only the channels indicated by the access point with which the radio associates. The hospital IT department must configure access points to operate with approved domains.
272 Standards and compliance Welch Allyn Connex ® Devices
Industry Canada (IC) emissions
This device complies with RSS 210 of Industry Canada.
Operation is subject to the following two conditions: (1) this device may not cause interference, and (2) this device must accept any interference, including interference that may cause undesired operation of this device.
L’utilisation de ce dispositif est autorisée seulement aux conditions suivantes: (1) il ne doit pas produire de brouillage et (2) l’ utilisateur du dispositif doit étre prêt à accepter tout brouillage radioélectrique reçu, même si ce brouillage est susceptible de compromettre le fonctionnement du dispositif.
This Class B digital apparatus complies with Canadian ICES-003.
Cet appareil numérique de la classe B est conform à la norme NMB-003 du Canada.
European Union
Czech
Danish
Dutch
English
Estonian
Finnish
French
German
Greek
Hungarian
Italian
Latvian
Lithuanian
Welch Allyn tímto prohlašuje, ze tento RLAN device je ve shod ě se základními požadavky a dalšími p ř íslušnými ustanoveními sm ě rnice 2014/53/ES.
Undertegnede Welch Allyn erklærer herved, at følgende udstyr RLAN device overholder de væsentlige krav og øvrige relevante krav i direktiv 2014/53/EF
Bij deze verklaart Welch Allyn dat deze RLAN device voldoet aan de essentiële eisen en aan de overige relevante bepalingen van Richtlijn 2014/53/EC.
Hereby, Welch Allyn, declares that this RLAN device is in compliance with the essential requirements and other relevant provisions of Directive 2014/53/EC.
Käesolevaga kinnitab Welch Allyn seadme RLAN device vastavust direktiivi 2014/53/EÜ põhinõuetele ja nimetatud direktiivist tulenevatele teistele asjakohastele sätetele.
Welch Allyn vakuuttaa täten että RLAN device tyyppinen laite on direktiivin 2014/53/EY oleellisten vaatimusten ja sitä koskevien direktiivin muiden ehtojen mukainen.
Par la présente, Welch Allyn déclare que ce RLAN device est conforme aux exigences essentielles et aux autres dispositions de la directive 2014/53/CE qui lui sont applicables
Hiermit erklärt Welch Allyn die Übereinstimmung des Gerätes RLAN device mit den grundlegenden
Anforderungen und den anderen relevanten Festlegungen der Richtlinie 2014/53/EG. (Wien)
ΜΕ ΤΗΝ ΠΑΡΟΥΣΑ Welch Allyn ΔΗΛΩΝΕΙ ΟΤΙ RLAN device ΣΥΜΜΟΡΦΩΝΕΤΑΙ
ΠΡΟΣ ΤΙΣ ΟΥΣΙΩΔΕΙΣ ΑΠΑΙΤΗΣΕΙΣ ΚΑΙ ΤΙΣ ΛΟΙΠΕΣ ΣΧΕΤΙΚΕΣ ΔΙΑΤΑΞΕΙΣ ΤΗΣ
ΟΔΗΓΙΑΣ 2014/53/ ΕΚ
Alulírott, Welch Allyn nyilatkozom, hogy a RLAN device megfelel a vonatkozó alapvetõ követelményeknek és az 2014/53/EC irányelv egyéb elõírásainak.
Con la presente Welch Allyn dichiara che questo RLAN device è conforme ai requisiti essenziali ed alle altre disposizioni pertinenti stabilite dalla direttiva 2014/53/CE.
Ar šo Welch Allyn deklar ē , ka RLAN device atbilst Direkt ī vas 2014/53/EK b ū tiskaj ā m pras ī b ā m un citiem ar to saist ī tajiem noteikumiem.
Šiuo Welch Allyn deklaruoja, kad šis RLAN device atitinka esminius reikalavimus ir kitas 2014/53/EB
Direktyvos nuostatas.
Directions for use Standards and compliance 273
Malti
Portuguese
Slovak
Slovene
Spanish
Swedish
Hawnhekk, Welch Allyn, jiddikjara li dan RLAN device jikkonforma mal-htigijiet essenzjali u ma provvedimenti ohrajn relevanti li hemm fid-Dirrettiva 2014/53/EC
Welch Allyn declara que este RLAN device está conforme com os requisitos essenciais e outras disposições da Directiva 2014/53/CE.
Welch Allyn týmto vyhlasuje, ze RLAN device sp ĺň a základné požiadavky a všetky príslušné ustanovenia Smernice 2014/53/ES.
Šiuo Welch Allyn deklaruoja, kad šis RLAN device atitinka esminius reikalavimus ir kitas 2014/53/EB
Direktyvos nuostatas.
Por medio de la presente Welch Allyn declara que el RLAN device cumple con los requisitos esenciales y cualesquiera otras disposiciones aplicables o exigibles de la Directiva 2014/53/CE
Härmed intygar Welch Allyn att denna RLAN device står I överensstämmelse med de väsentliga egenskapskrav och övriga relevanta bestämmelser som framgår av direktiv 2014/53/EG.
274 Standards and compliance Welch Allyn Connex ® Devices
275
Guidance and manufacturer's declaration
EMC compliance
Special precautions concerning electromagnetic compatibility (EMC) must be taken for all medical electrical equipment. This device complies with IEC 60601-1-2:2014.
• All medical electrical equipment must be installed and put into service in accordance with the EMC information provided in the referenced IEC standard and this directions for use.
• Portable and mobile RF communications equipment can affect the behavior of medical electrical equipment.
The monitor complies with all applicable and required standards for electromagnetic interference.
• It does not normally affect nearby equipment and devices.
• It is not normally affected by nearby equipment and devices.
• It is not safe to operate the monitor in the presence of high-frequency surgical equipment.
• However, it is good practice to avoid using the monitor in extremely close proximity to other equipment.
Emissions and immunity information
For information about electromagnetic compatibility (EMC), see the Welch Allyn website: http://www.welchallyn.com/emc-CVSM-CIWS
You can order a printed copy of the Emissions and immunity information from Welch
Allyn for delivery within 7 calendar days.
276 Guidance and manufacturer's declaration Welch Allyn Connex ® Devices
Appendix
Approved accessories
The following tables list approved monitor and wall system accessories and documentation. For information about options, upgrades, and licenses, refer to the service manual.
FlexiPort cuffs (not made with natural rubber latex)
Part Number
Neo-1-1
Neo-2-1
Neo-3-1
Neo-4-1
Neo-5-1
Reuse-08-2MQ
Reuse-09-2MQ
Reuse-10-2MQ
Reuse-11-2MQ
Reuse-11L-2MQ
Reuse-12-2MQ
Reuse-12L-2MQ
Reuse-13-2MQ
Model
Reusable
Reusable
Reusable
Reusable
Reusable
Reusable
Reusable
Reusable
Disposable
Disposable
Disposable
Disposable
Disposable
Description
Cuff, reuse, SM CHILD, 2-tube, MQ
Cuff, reuse, CHILD, 2-tube, MQ
Cuff, reuse, SM AD, 2-tube, MQ
Cuff, reuse, ADULT, 2-tube, MQ
Cuff, reuse, AD LONG, 2-tube, MQ
Cuff, reuse, LG AD, 2-tube, MQ
Cuff, reuse, LG AD LONG, 2-tube, MQ
Cuff, reuse, THIGH, 2-tube, MQ
Cuff, soft, NEO 1, 1-TUBE, NQ (box of 10)
Cuff, soft, NEO 2, 1-TUBE, NQ (box of 10)
Cuff, soft, NEO 3, 1-TUBE, NQ (box of 10)
Cuff, soft, NEO 4, 1-TUBE, NQ (box of 10)
Cuff, soft, NEO 5, 1-TUBE, NQ (box of 10)
277
278 Appendix Welch Allyn Connex ® Devices
Blood pressure accessories (not made with natural rubber latex)
Part Number
4500-30
4500-31
4500-32
6000-30
6000-31
7000-33
Model
BP
BP
SureBP
SureBP
SureBP
BP
Description
Double tube blood pressure hose (5 ft)
Double tube blood pressure hose (10 ft)
Double tube blood pressure hose (8 ft)
Single tube blood pressure hose (5 ft)
Single tube blood pressure hose (10 ft)
Neonatal blood pressure hose (10 ft) with NeoQuik connector
Masimo pulse oximetry (for use with devices with SpO2)
Part Number
LNCS-DCI
LNCS-DCIP
LNCS-ADTX
LNCS-PDTX
RED-LNC-10
LNCS-YI
LNCS-TC-I
LNCS-Neo-L-3
Neo-Wrap-RP
LNCS-Inf-3
Inf-Wrap-RP
YI-AD
YI-FM
LNCS
LNCS
LNCS
LNCS
LNCS
LNCS
LNCS
Model
LNCS
LNCS
LNCS
LNCS
LNCS
LNCS
Description
Reusable finger sensor - Adult
Reusable finger sensor - Pediatric
Disposable adhesive finger sensor - Adult (20 per case)
Disposable adhesive finger sensor - Pediatric (20 per case)
10-foot cable with sensor connector
Multisite reusable sensor (1 sensor, 6 adhesive wraps)
Reusable ear sensor
Disposable adhesive finger sensor - Neonate/Adult (20 per case)
Replacement wrap for neonatal adhesives (100 per case)
Disposable adhesive finger sensor - Infant (20 per case)
Replacement wrap for infant adhesives (100 per case)
Multisite adhesive wrap adult/pediatric/neonatal for YI sensor
(100 per case)
Multisite foam wrap adult/pediatric/neonatal for YI sensor (12 per case)
Masimo rainbow set (for use with devices with SpO2 and SpHb)
Part Number
724322
Model rainbow
Description
DCI SC-400 Adult SpHb sensor and 3-foot cable
Directions for use
Part Number
104149
Model rainbow
Masimo RRa
Part Number
104771
104772
Nellcor pulse oximetry
Part Number
DS-100A
DOC-10
D-YS
D-YSE
D-YSPD
MAX-AI
MAX-PI
MAX-II
OXI-A/N
OXI-P/I
SureTemp Plus thermometry
Part Number
02895-000
02895-100
02894-0000
02894-1000
05031-101
05031-110
Model rainbow rainbow
Model
OxiMax
OxiMax
OxiMax
OxiMax
OxiMax
OxiMax
OxiMax
OxiMax
OxiMax
OxiMax
Appendix 279
Description
RC-12, 12-foot extension cable, 20 pin, for M-LNCS sensors
Description
RAS-125 sensor (box of 10)
Patient cable
Description
Durasensor adult oxygen transducer
Extension cable (10 feet)
Dura-Y oxygen transducer (1 sensor, 40 wraps)
Ear clip (use with Dura-Y sensor)
PediCheck pediatric spot check (use with Dura-Y sensor)
OxiMax adult sensor (single use, case of 24)
OxiMax pediatric sensor (single use, case of 24)
OxiMax infant sensor (single use, case of 24)
Oxiband adult/neonatal transducer (1 sensor, 50 wraps)
Oxiband pediatric/infant transducer (1 sensor, 50 wraps)
Description
Oral probe and well kit (9ft., 2.7M)
Rectal probe and well kit (9ft., 2.7M)
Oral probe well (blue)
Rectal probe well (red)
Disposable probe covers (1,000 covers, packaged 25/box)
Disposable probe covers (10,000 covers, packaged 25/box)
280 Appendix Welch Allyn Connex ® Devices
Part Number
01802-110
06138-000
Description
9600 Plus calibration tester
Temperature calibration key
Braun ThermoScan PRO 6000 thermometer and accessory dock
Part Number
06000-900
106743
106744
106745
Description
Dock with thermometer
Dock without thermometer
Wall mount kit
Mobile stand kit
EarlySense RR, pulse rate, and patient movement
Part Number
105481
MSH-00033
MSH-00033A
MSH-00033B
AME-00970
105637
Description
Contact-free sensor
Metallic plate for beds
Metallic plate for beds with .78" length hooks for spring pan bed frames
Metallic plate for beds with 1.18" length hooks for spring pan bed frames
Bed sensor wall mount hanger
Pigtail cable
Oridion CO2
Oridion Microstream etCO2 filter lines (sampling lines) have been tested for biocompatibility in accordance with ISO 10993 and are the only accessories approved by
Welch Allyn for CO2 monitoring. They are available only from Oridion. To find an Oridion distributor, please refer to www.oridion.com
.
Physical assessment instruments
Part Number
Otoscopes
23810
Description
MacroView™ otoscope
Directions for use
Part Number
23820
23814
23824
25020
25021
20201
20200
20250
20251
21700
21701
Specula and specula dispensers
52432-U
52434-U
52100-PF
52400-PF
Ophthalmoscopes
11810
11820
11710
11720
11730
11735
Illuminators
41100
41101
Appendix 281
Description
MacroView™ otoscope with throat illuminator
MacroView™ otoscope with insufflation bulb
MacroView™ otoscope with throat illuminator and insufflation bulb
Diagnostic otoscope with specula
Diagnostic otoscope with insufflation bulb
Pneumatic otoscope without specula
3.5V pneumatic otoscope with specula
3.5V pneumatic otoscope with 12-diopter lens and specula
Pneumatic otoscope with 12-diopter lens
3.5V operating otoscope with specula
3.5V operating otoscope without specula
2.75 mm Universal KleenSpec® disposable ear specula (case of
10 bags, 850/bag)
4.25 mm Universal KleenSpec® disposable ear specula (case of
10 bags, 850/bag)
Dispenser (full), large ear specula
Dispenser (full), small ear specula
Panoptic ophthalmoscope
Panoptic ophthalmoscope with cobalt blue filter and add-on corneal viewing lens
Standard ophthalmoscope
Coaxial ophthalmoscope
AutoStep® coaxial ophthalmoscope
Prestige coaxial-plus ophthalmoscope
Finnoff ocular transilluminator
Finnoff ocular transilluminator with cobalt blue filter
282 Appendix
Part Number
Lamps
03100-LED
06500-LED
04900-LED
03800-LED
03100-U
26038
27000
27050
28100
43300
26535
26538
26035
06500-U
04900-U
03800-U
Mounting options
Part Number
4800-60
4900-60
104645
4700-60
4701-62
Welch Allyn Connex ® Devices
Description
Curved all-purpose transilluminator
Nasal illuminator (section only)
Complete nasal illuminator
Bivalve nasal speculum
Bivalve nasal speculum with illuminator
Larynx illuminator
Nasopharynx illuminator
Tongue blade holder
LED replacement lamp
LED replacement lamp
LED replacement lamp
LED replacement lamp
Halogen replacement lamp
Halogen replacement lamp
Halogen replacement lamp
Halogen replacement lamp
Description
Accessory Cable Management (ACM) stand — organized mobile stand with bin, standard housing
Accessory Cable Management (ACM) stand — organized mobile stand with bin, extended housing
Mounting plate (bracket), ACM mobile stand, extended housing
Note Use only with the ACM stand, not the MS2 stand.
Economy mobile stand with basket, standard housing
Wall mount with basket, standard housing
Directions for use
Part Number
008-0834-01
4900-62
104644
105430
105341
105342
ECG
Part Number
6000-CBL3I
6000-CBL3A
6000-CBL5I
6000-CBL5A
6000-ECG3I
6000-ECG3A
6000-ECG5I
6000-ECG5A
106512
106550
6200-11
Miscellaneous items
Part Number
BATT99
BATT33-R
BATT33
6000-101H
6000-100S
Appendix 283
Description
GCX wall mount with channel, standard housing
GCX wall mount with channel, extended housing
Mounting plate (bracket), GCX wall mount, extended housing
Office LPC monitor mounting kit
CP150/CP250 office cart
CP150/CP250 hospital cart
Description
Patient cable 3L IEC
Patient cable 3L AHA
Patient cable 5L IEC
Patient cable 5L AHA
Module + USB + Patient cable 3L IEC
Module + USB + Patient cable 3L AHA
Module + USB + Patient cable 5L IEC
Module + USB + Patient cable 5L AHA
USB cable for ECG module
ECG mounting accessory, stand or wall
Electrode pads (30 pads/pack, 20 packs/box)
Description
Lithium-ion battery 9 cell — Extended life
Replacement battery (Connex IWS)
Replacement battery (Connex IWS)
Carrying case, hard sided
Carrying case, soft sided
284 Appendix Welch Allyn Connex ® Devices
4500-925
660-0320-00
660-0321-00
104384
660-0138-00
715270
104279
Part Number
6000-40
PWCD-B
PWCD-C
PWCD-K
PWCD-Z
PWCD-2
PWCD-4
PWCD-6
PWCD-7
6000-NC
6000-916
6000-916HS
6000-916HSR
6000-910
Description
Printer paper (10 per pack)
Line cord B, North America
Line cord C, China, 8'
Line cord K, South Korea, 8'
Line cord Z, Brazil, 8'
Line cord 2, Europe, 8'
Line cord 4, United Kingdom, 8'
Line cord 6, Australia/New Zealand,8'
Line cord 7, South Africa, 8'
Nurse Call cable
1900 2D barcode scanner
HS1-M 2D barcode scanner
2D barcode scanner/RFID reader
Mounting arm for HS1-M barcode scanner (use with Economy mobile stand with basket only)
Cable for wired connectivity
Patch cable, 100', RJ45 M/M CAT5E
Patch cable, 50', RJ45 M/M CAT5E
Patch cable, 25', green
Patch cable, 5', RJ45 T568B
Box set — packaging — empty
Connex IWS shipping box
Service, Vital Signs Monitor 6000 Series
Part Number
S1-6000
S1-6000-C
S1-6000-2
S1-6000-2C
Description
Comprehensive partnership program, 1 year
Comprehensive partnership program, 1 year, with calibration
Comprehensive partnership program, 2 years
Comprehensive partnership program, 2 years, with calibration
Directions for use
Part Number
S1-6000-5
S1-6000-5C
S1-6000-O2
S1-6000-O2-2
S1-6000-O2-5
S1-6000-O2-C
S1-6000-O2-2C
S1-6000-O2-5C
S1-6000-ES
S1-6000-ES-2
S1-6000-ES-5
S1-6000-ES-C
S1-6000-ES-2C
S1-6000-ES-5C
S2-6000
S2-6000-2
S2-6000-5
S2-6000-O2
S2-6000-O2-2
S2-6000-O2-5
S2-6000-ES
S2-6000-ES-2
S2-6000-ES-5
PRV-ESS
PRV-001
Appendix 285
Description
Comprehensive partnership program, 5 years
Comprehensive partnership program, 5 years, with calibration
Comprehensive partnership program, 1 year, with CO2
Comprehensive partnership program, 2 years, with CO2
Comprehensive partnership program, 5 years, with CO2
Comprehensive partnership program, 1 year, with CO2, with calibration
Comprehensive partnership program, 2 years, with CO2, with calibration
Comprehensive partnership program, 5 years, with CO2, with calibration
Comprehensive partnership program, 1 year, with EarlySense
Comprehensive partnership program, 2 years, with EarlySense
Comprehensive partnership program, 5 years, with EarlySense
Comprehensive partnership program, 1 year, with EarlySense and calibration
Comprehensive partnership program, 2 years, with EarlySense and calibration
Comprehensive partnership program, 5 years, with EarlySense and calibration
Biomed partnership program, 1 year
Biomed partnership program, 2 years
Biomed partnership program, 5 years
Biomed partnership program, 1 year, with CO2
Biomed partnership program, 2 years, with CO2
Biomed partnership program, 5 years, with CO2
Biomed partnership program, 1 year, with ES
Biomed partnership program, 2 years, with ES
Biomed partnership program, 5 years, with ES
Preventive annual sensor replacement program (selected countries)
Preventive Welch Allyn bench service, per unit (selected countries)
286 Appendix
Part Number
PRV-002
S4-6000
S4-6000-2
S4-6000-5
S4-6000-O2
S4-6000-O2-2
S4-6000-O2-5
S4-6000-ES
S4-6000-ES-2
S4-6000-ES-5
Service, Integrated Wall System
Part Number
103371
Partnership Programs for Global Use
S1-CIWS
S1-CIWS-2
S2-CIWS
S2-CIWS-2
Technical Training
CIWSSERREPW-TRN
CIWSSERREP-TRN
International Only
PRV-001
PRV-002
S4-CIWS
S4-CIWS-2
Welch Allyn Connex ® Devices
Description
Preventive onsite service, per unit (selected countries)
CVSM, Warranty extension, 1 year (selected countries)
CVSM, Warranty extension, 2 years (selected countries)
CVSM, Warranty extension, 5 years (selected countries)
CVSM with CO2, Warranty extension, 1 year (selected countries)
CVSM with CO2, Warranty extension, 2 years (selected countries)
CVSM with CO2, Warranty extension, 5 years (selected countries)
CVSM with EarlySense, Warranty extension, 1 year (selected countries)
CVSM with EarlySense, Warranty extension, 2 years (selected countries)
CVSM with EarlySense, Warranty extension, 5 years (selected countries)
Description
Barcode license
One-year Comprehensive Partnership Program
Two-year Comprehensive Partnership Program
One-year Biomed Partnership Program
Two-year Biomed Partnership Program
Technical online training for Biomeds
Technical onsite training for Biomeds
Preventive SVC WA bench per unit
Preventive SVC planned onsite per unit
One-year Extended Warranty
Two-year Extended Warranty
Directions for use
Literature/Documentation
Part Number
107404
4600-90E
Service Manuals
80024005
80024006
80024007
80024008
80024009
80024010
80024011
80024012
80024013
80024014
Appendix 287
Description
Connex Devices CD, Directions for Use, Quick Reference Cards,
Multi-language
Blood Pressure Accuracy and Variability Card-English
Service manual, Connex VSM 2.4X, English
Service manual, Connex VSM 2.4X, French
Service manual, Connex VSM 2.4X, Italian
Service manual, Connex VSM 2.4X, German
Service manual, Connex VSM 2.4X, Spanish
Service manual, Connex IWS 2.4X, English
Service manual, Connex IWS 2.4X, French
Service manual, Connex IWS 2.4X, Italian
Service manual, Connex IWS 2.4X, German
Service manual, Connex IWS 2.4X, Spanish
288 Appendix Welch Allyn Connex ® Devices
Warranty
Vital Signs Monitor 6000 Series
Welch Allyn warrants the product to be free of defects in material and workmanship and to perform in accordance with manufacturer's specifications for the period of two years from the date of purchase from Welch Allyn or its authorized distributors or agents.
The warranty period shall start on the date of purchase. The date of purchase is: 1) the invoiced ship date if the device was purchased directly from Welch Allyn, 2) the date specified during product registration, 3) the date of purchase of the product from a
Welch Allyn authorized distributor as documented from a receipt from said distributor.
This warranty does not cover damage caused by: 1) handling during shipping, 2) use or maintenance contrary to labeled instructions, 3) alteration or repair by anyone not authorized by Welch Allyn, and 4) accidents.
The product warranty is also subject to the following terms and limitations: Accessories are not covered by the warranty. Refer to the directions for use provided with individual accessories for warranty information.
Shipping cost to return a device to a Welch Allyn Service center is not included.
A service notification number must be obtained from Welch Allyn prior to returning any products or accessories to Welch Allyn's designated service centers for repair. To obtain a service notification number, contact Welch Allyn Technical Support.
THIS WARRANTY IS IN LIEU OF ALL OTHER WARRANTIES, EXPRESS OR IMPLIED,
INCLUDING BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF
MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. WELCH ALLYN'S
OBLIGATION UNDER THIS WARRANTY IS LIMITED TO REPAIR OR REPLACEMENT
OF PRODUCTS CONTAINING A DEFECT. WELCH ALLYN IS NOT RESPONSIBLE FOR
ANY INDIRECT OR CONSEQUENTIAL DAMAGES RESULTING FROM A PRODUCT
DEFECT COVERED BY THE WARRANTY.
Integrated Wall System
Welch Allyn warrants the product to be free of defects in material and workmanship and to perform in accordance with manufacturer's specifications for the period of one year from the date of purchase from Welch Allyn or its authorized distributors or agents. The coiled cords carry a special 10-year warranty against breakage during normal usage.
The warranty period shall start on the date of purchase. The date of purchase is: 1) the invoiced ship date if the device was purchased directly from Welch Allyn, 2) the date specified during product registration, 3) the date of purchase of the product from a
Welch Allyn authorized distributor as documented from a receipt from said distributor.
This warranty does not cover damage caused by: 1) handling during shipping, 2) use or maintenance contrary to labeled instructions, 3) alteration or repair by anyone not authorized by Welch Allyn, and 4) accidents.
The product warranty is also subject to the following terms and limitations: Accessories are not covered by the warranty. Refer to the directions for use provided with individual accessories for warranty information.
Directions for use Appendix 289
A service notification number must be obtained from Welch Allyn prior to returning any products or accessories to Welch Allyn's designated service centers for repair. To obtain a service notification number, contact Welch Allyn Technical Support.
THIS WARRANTY IS IN LIEU OF ALL OTHER WARRANTIES, EXPRESS OR IMPLIED,
INCLUDING BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF
MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. WELCH ALLYN'S
OBLIGATION UNDER THIS WARRANTY IS LIMITED TO REPAIR OR REPLACEMENT
OF PRODUCTS CONTAINING A DEFECT. WELCH ALLYN IS NOT RESPONSIBLE FOR
ANY INDIRECT OR CONSEQUENTIAL DAMAGES RESULTING FROM A PRODUCT
DEFECT COVERED BY THE WARRANTY.
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