V SERIES OPS MANUAL
V
V
Operating Instructions
V
Patient Monitors
V
V
Operating Instructions
V
Patient Monitors
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Copyright © Mindray DS USA, Inc., 2011. All rights reserved. Contents of this publication may not be reproduced in any
form without permission of Mindray DS USA, Inc.
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V Series Operating Instructions
Table of Contents
Foreword ................................................................................................................................................................................................................................. xv
Warnings.................................................................................................................................................................................................................................. xvi
Cautions................................................................................................................................................................................................................................... xix
Notes......................................................................................................................................................................................................................................... xxiii
Indications for Use ............................................................................................................................................................................................................... xxiv
Unpacking Information...................................................................................................................................................................................................... xxv
Warranty Statements ......................................................................................................................................................................................................... xxv
Service ...................................................................................................................................................................................................................................... xxvi
Manufacturer’s Responsibility ........................................................................................................................................................................................ xxvi
Symbols and Descriptions................................................................................................................................................................................................. xxvii
General Product Description .....................................................................................................................................1 - 1
General Product Description .............................................................................................................................................................................................1 - 2
V Series Monitoring Platform ..................................................................................................................................................................................1 - 2
Interfacing......................................................................................................................................................................................................................1 - 2
Key Features .............................................................................................................................................................................................................................1 - 3
V 12/V 21 Physical Views......................................................................................................................................................................................................1 - 5
Front View ......................................................................................................................................................................................................................1 - 5
Rear View ........................................................................................................................................................................................................................1 - 7
Left Side Panel ..............................................................................................................................................................................................................1 - 9
Right Side Panel ...........................................................................................................................................................................................................1 - 10
V Dock Physical Views...........................................................................................................................................................................................................1 - 11
Back View........................................................................................................................................................................................................................1 - 11
Right Side View.............................................................................................................................................................................................................1 - 12
Left Side View................................................................................................................................................................................................................1 - 12
VPS Physical Views ......................................................................................................................................................................................................1 - 13
Getting Started ...........................................................................................................................................................2 - 1
Introduction .............................................................................................................................................................................................................................2 - 2
Power On/Off Unit..................................................................................................................................................................................................................2 - 3
Using the V 21 Touch Pad ...................................................................................................................................................................................................2 - 3
Main Display.............................................................................................................................................................................................................................2 - 4
System Status Message .............................................................................................................................................................................................2 - 5
Navigation Area ...........................................................................................................................................................................................................2 - 6
Dialogs........................................................................................................................................................................................................................................2 - 8
List Box ............................................................................................................................................................................................................................2 - 9
Alarm Icons and Messages..................................................................................................................................................................................................2 - 9
Alarm Icons ....................................................................................................................................................................................................................2 - 9
Parameter Messages ..................................................................................................................................................................................................2 - 9
Keyboard Dialog .....................................................................................................................................................................................................................2 - 11
Using the Keyboard ....................................................................................................................................................................................................2 - 11
Digital Keypad Dialog ...........................................................................................................................................................................................................2 - 12
Using the Digital Keypad ..........................................................................................................................................................................................2 - 12
Message Dialogs .....................................................................................................................................................................................................................2 - 13
Audio Levels Dialog...............................................................................................................................................................................................................2 - 13
Configuring Audio Levels .........................................................................................................................................................................................2 - 14
Battery Levels Dialog.............................................................................................................................................................................................................2 - 15
Battery Indicator Colors.............................................................................................................................................................................................2 - 15
Display Setup ..............................................................................................................................................................3 - 1
Introduction .............................................................................................................................................................................................................................3 - 2
Display Options Dialog.........................................................................................................................................................................................................3 - 2
Navigating to the Display Options Dialog..........................................................................................................................................................3 - 2
Configuring Display Presets ....................................................................................................................................................................................3 - 3
Display Preset Configurations .....................................................................................................................................................................3 - 3
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Editing a Display Preset .................................................................................................................................................................................3 - 8
Overlapping Waveform.............................................................................................................................................................................................3 - 10
Changing IBP Waveform Overlap Settings.........................................................................................................................................................3 - 11
Undoing an IBP Waveform Overlap......................................................................................................................................................................3 - 11
Display Modes .........................................................................................................................................................................................................................3 - 12
Privacy Mode.................................................................................................................................................................................................................3 - 12
Screen Lock Mode .......................................................................................................................................................................................................3 - 12
Standby Mode ..............................................................................................................................................................................................................3 - 12
Discharge Mode ...........................................................................................................................................................................................................3 - 12
View All ECG Mode......................................................................................................................................................................................................3 - 13
Changing Lead/Size....................................................................................................................................................................................................3 - 13
Touch Screen Calibration .........................................................................................................................................................................................3 - 13
Display Options Troubleshooting ....................................................................................................................................................................................3 - 15
Mechanical Functions.................................................................................................................................................4 - 1
Introduction .............................................................................................................................................................................................................................4 - 2
V 12 ..............................................................................................................................................................................................................................................4 - 2
V 12 Undocking ............................................................................................................................................................................................................4 - 3
Battery Installation ......................................................................................................................................................................................................4 - 4
Battery Removal...........................................................................................................................................................................................................4 - 6
Battery Charge Checking ..........................................................................................................................................................................................4 - 8
Module Installation.....................................................................................................................................................................................................4 - 9
Module Removal..........................................................................................................................................................................................................4 - 10
V Dock.........................................................................................................................................................................................................................................4 - 11
V Dock Mounting.........................................................................................................................................................................................................4 - 11
V Dock Dismounting ..................................................................................................................................................................................................4 - 13
V 21 ..............................................................................................................................................................................................................................................4 - 14
V 21 Docking .................................................................................................................................................................................................................4 - 14
V 21 Undocking ............................................................................................................................................................................................................4 - 16
V Hub ..........................................................................................................................................................................................................................................4 - 17
V Hub Mounting...........................................................................................................................................................................................................4 - 17
V Hub Dismounting ....................................................................................................................................................................................................4 - 17
Module Installation.....................................................................................................................................................................................................4 - 17
Module Removal..........................................................................................................................................................................................................4 - 18
Module Locking ...........................................................................................................................................................................................................4 - 19
Module Unlocking.......................................................................................................................................................................................................4 - 19
Thermal Recorder...................................................................................................................................................................................................................4 - 20
Installing the Thermal Recorder Paper ................................................................................................................................................................4 - 20
Troubleshooting .....................................................................................................................................................................................................................4 - 22
Module Configuration ................................................................................................................................................5 - 1
Module Status Dialog............................................................................................................................................................................................................5 - 2
Navigating to the Module Status Dialog ............................................................................................................................................................5 - 3
Enabling/Disabling a Module..................................................................................................................................................................................5 - 3
Changing an IBP or Temperature Module Channel........................................................................................................................................5 - 3
VPS Synchronization ..................................................................................................................................................................................................5 - 4
Patient Management..................................................................................................................................................6 - 1
Introduction .............................................................................................................................................................................................................................6 - 2
Patient Info Dialog .................................................................................................................................................................................................................6 - 2
Navigating to the Patient Info Dialog ..................................................................................................................................................................6 - 2
Admitting a Patient.....................................................................................................................................................................................................6 - 3
Patient Demographics ..............................................................................................................................................................................................6 - 3
Patient Room and Bed ...............................................................................................................................................................................................6 - 4
Discharging a Patient.................................................................................................................................................................................................6 - 5
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Clearing Patient History ............................................................................................................................................................................................6 - 6
Placing a Patient in Standby....................................................................................................................................................................................6 - 7
Exiting the Standby Mode........................................................................................................................................................................................6 - 7
Patient Management Troubleshooting..........................................................................................................................................................................6 - 8
Alarm Behavior ...........................................................................................................................................................7 - 1
General Alarm Behavior .......................................................................................................................................................................................................7 - 2
Physiological Alarms .............................................................................................................................................................................................................7 - 2
Alarm Behaviors ...........................................................................................................................................................................................................7 - 2
Alarm Options...............................................................................................................................................................................................................7 - 2
Physiological Alarm Responses ..............................................................................................................................................................................7 - 3
Alarm Levels ......................................................................................................................................................................................................7 - 3
Technical Alarms.....................................................................................................................................................................................................................7 - 4
Alarm Behaviors ...........................................................................................................................................................................................................7 - 4
Alarms .........................................................................................................................................................................8 - 1
Alarms Dialog ..........................................................................................................................................................................................................................8 - 2
Navigating to the Alarms Dialogs..........................................................................................................................................................................8 - 2
Alarm Limits..............................................................................................................................................................................................................................8 - 2
Configuring Alarm Limits..........................................................................................................................................................................................8 - 2
Factory Default Alarm Limits...................................................................................................................................................................................8 - 4
ECG/Resp Tab ....................................................................................................................................................................................................8 - 4
Pressure Tab ......................................................................................................................................................................................................8 - 5
Temp Tab ............................................................................................................................................................................................................8 - 6
SpO2/Gases Tab ...............................................................................................................................................................................................8 - 8
CCO/Hemo Tab .................................................................................................................................................................................................8 - 9
Auto-Set All Alarms Button ..........................................................................................................................................................................8 - 9
Restore All Defaults Button ..........................................................................................................................................................................8 - 9
Alarm Responses ....................................................................................................................................................................................................................8 - 10
Understanding Alarm Levels...................................................................................................................................................................................8 - 10
Factory Default Alarm Priorities between Alarm Types.................................................................................................................................8 - 10
Configuring Alarm Levels .........................................................................................................................................................................................8 - 11
Understanding Alarm Response Settings...........................................................................................................................................................8 - 11
Configuring Alarm Response Settings.................................................................................................................................................................8 - 11
Factory Default Alarm Settings...............................................................................................................................................................................8 - 12
ECG/Resp Tab ...................................................................................................................................................................................................8 - 12
Pressure Tab ......................................................................................................................................................................................................8 - 12
Temp Tab ............................................................................................................................................................................................................8 - 12
SpO2/Gases Group ..........................................................................................................................................................................................8 - 13
CCO/Hemo Tab ............................................................................................................................................................................................................8 - 13
Arrhythmia Alarms.................................................................................................................................................................................................................8 - 14
Understanding Alarm Levels...................................................................................................................................................................................8 - 14
Configuring Arrhythmia Alarm Levels .................................................................................................................................................................8 - 14
Understanding Arrhythmia Alarm Responses ..................................................................................................................................................8 - 16
Configuring the Arrhythmia Alarm Responses ................................................................................................................................................8 - 16
Configuring Arrhythmia Alarm Setup..................................................................................................................................................................8 - 17
Alarm Setup..............................................................................................................................................................................................................................8 - 18
Configuring Alarm Setup..........................................................................................................................................................................................8 - 18
Alarms Troubleshooting ......................................................................................................................................................................................................8 - 19
ECG – Arrhythmia........................................................................................................................................................9 - 1
Introduction .............................................................................................................................................................................................................................9 - 2
ECG Dialog ................................................................................................................................................................................................................................9 - 3
Navigating to the ECG Dialog .................................................................................................................................................................................9 - 3
Configuring the Arrhythmia Tab............................................................................................................................................................................9 - 3
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Configuring Pacemakers...........................................................................................................................................................................................9 - 3
Configuring ECG Setup..............................................................................................................................................................................................9 - 4
Configuring the Arrhy Setup ...................................................................................................................................................................................9 - 6
Relearning .....................................................................................................................................................................................................................9 - 6
Viewing All ECG Waveforms ....................................................................................................................................................................................9 - 7
Arrhythmia Digital Tile Layout...........................................................................................................................................................................................9 - 9
About the Arrhythmia Tile .......................................................................................................................................................................................9 - 9
Arrhythmia Alarms ......................................................................................................................................................................................................9 - 9
Message Area................................................................................................................................................................................................................9 - 9
ECG Waveform Tile Layout..................................................................................................................................................................................................9 - 10
About the ECG Tile ......................................................................................................................................................................................................9 - 10
Arrhythmia Alarms ......................................................................................................................................................................................................9 - 10
Message Area................................................................................................................................................................................................................9 - 10
Preparation and Lead Placement ....................................................................................................................................................................................9 - 12
Skin Preparation...........................................................................................................................................................................................................9 - 12
Electrode Patch Location..........................................................................................................................................................................................9 - 12
Lead Placement............................................................................................................................................................................................................9 - 13
Description .........................................................................................................................................................................................................9 - 13
Setting Lead Naming Standard ..................................................................................................................................................................9 - 13
Lead Placement: Standard 3-wire Lead Sets ..........................................................................................................................................9 - 14
Lead Placement: Standard 5-wire Lead Sets ..........................................................................................................................................9 - 15
Lead Placement: Standard 6-wire Lead Sets ..........................................................................................................................................9 - 16
Lead Placement: Lead II Monitoring ........................................................................................................................................................9 - 17
Lead Placement: Modified Chest Lead (MCL) Monitoring ................................................................................................................9 - 18
12L ECG ...............................................................................................................................................................................................................9 - 19
Lead Placement: Neonates ...........................................................................................................................................................................9 - 20
Lead Placement: Pacemaker Patients ......................................................................................................................................................9 - 21
Arrhythmia Algorithm ..........................................................................................................................................................................................................9 - 23
Arrhythmia Alarms.................................................................................................................................................................................................................9 - 25
Lethal Arrhythmia Alarms.........................................................................................................................................................................................9 - 25
Non-Lethal Arrhythmia Alarms...............................................................................................................................................................................9 - 27
ST Segment Analysis .............................................................................................................................................................................................................9 - 30
ECG-Arrhythmia Troubleshooting ..................................................................................................................................................................................9 - 32
Respiration (Resp) ....................................................................................................................................................10 - 1
Introduction .......................................................................................................................................................................................................................... 10 - 2
Resp Dialog............................................................................................................................................................................................................................ 10 - 2
Navigating to the Resp Dialog............................................................................................................................................................................. 10 - 2
Configuring Resp Alarm Limits............................................................................................................................................................................ 10 - 3
Configuring the Resp Parameter ........................................................................................................................................................................ 10 - 3
Configuring the Resp Waveform ....................................................................................................................................................................... 10 - 4
Configuring Apnea Alarms.................................................................................................................................................................................... 10 - 5
Respiration Tile Layouts .................................................................................................................................................................................................... 10 - 7
Respiration Digital Tile Layout............................................................................................................................................................................. 10 - 7
About the Resp Tile.................................................................................................................................................................................................. 10 - 7
Resp Alarms ................................................................................................................................................................................................................ 10 - 7
Message Area............................................................................................................................................................................................................. 10 - 7
Respiration Waveform Tile Layout ..................................................................................................................................................................... 10 - 8
About the Resp Waveform Tile............................................................................................................................................................................ 10 - 8
Message Area............................................................................................................................................................................................................. 10 - 8
Respiration Troubleshooting .......................................................................................................................................................................................... 10 - 9
Invasive Blood Pressure (IBP) ..................................................................................................................................11 - 1
Introduction .......................................................................................................................................................................................................................... 11 - 2
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IBP Dialog ............................................................................................................................................................................................................................... 11 - 3
Navigating to the IBP Dialog ............................................................................................................................................................................... 11 - 3
Configuring IBP Alarm Limits ............................................................................................................................................................................... 11 - 3
Configuring the IBP Parameter............................................................................................................................................................................ 11 - 3
Configuring the IBP Waveform............................................................................................................................................................................ 11 - 5
Default IBP Waveform Sizes ...................................................................................................................................................................... 11 - 6
Measuring IBP ....................................................................................................................................................................................................................... 11 - 7
IBP Digital Tile Layouts ...................................................................................................................................................................................................... 11 - 8
PA Digital Tile............................................................................................................................................................................................................. 11 - 9
PAWP Digital .............................................................................................................................................................................................................. 11 - 9
Intracranial Pressure (ICP) Digital Tile ............................................................................................................................................................... 11 - 9
Cerebral Perfusion Pressure (CePP) Digital ......................................................................................................................................... 11 - 9
Intraabdominal Pressure (IAP) Digital Tile...................................................................................................................................................... 11 - 9
Abdominal Perfusion Pressure (APP) Digital ...................................................................................................................................... 11 - 9
About the IBP Tile ..................................................................................................................................................................................................... 11 - 10
Message Area............................................................................................................................................................................................................. 11 - 10
IBP Tile Layouts .................................................................................................................................................................................................................... 11 - 11
IBP Digital Tile Layout ............................................................................................................................................................................................. 11 - 11
Inserting the PA Catheter ................................................................................................................................................................................................. 11 - 12
Pulmonary Artery Wedge Pressure (PAWP)............................................................................................................................................................... 11 - 13
Measuring PAWP ...................................................................................................................................................................................................... 11 - 13
Understanding the PAWP Dialog ....................................................................................................................................................................... 11 - 14
PAWP Setup Dialog.................................................................................................................................................................................................. 11 - 14
IBP Troubleshooting........................................................................................................................................................................................................... 11 - 16
Heart Rate (HR)..........................................................................................................................................................12 - 1
Introduction .......................................................................................................................................................................................................................... 12 - 2
HR Dialog................................................................................................................................................................................................................................ 12 - 2
Navigating to the HR Dialog................................................................................................................................................................................. 12 - 2
Configuring Heart Rate Alarm Limits ................................................................................................................................................................ 12 - 3
Configuring the Heart Rate Parameter ............................................................................................................................................................. 12 - 3
Heart Rate Digital Tile Layout ......................................................................................................................................................................................... 12 - 4
About the HR Tile...................................................................................................................................................................................................... 12 - 4
HR Alarms .................................................................................................................................................................................................................... 12 - 4
Message Area............................................................................................................................................................................................................. 12 - 5
HR Troubleshooting ........................................................................................................................................................................................................... 12 - 6
Temperature (Temp) ................................................................................................................................................13 - 1
Introduction .......................................................................................................................................................................................................................... 13 - 2
Temperature Dialog ........................................................................................................................................................................................................... 13 - 3
Navigating to the Temperature Dialog ............................................................................................................................................................ 13 - 3
Configuring Temperature Alarm Limits ........................................................................................................................................................... 13 - 3
Configuring the Temperature Parameter........................................................................................................................................................ 13 - 3
Measuring Temperature ................................................................................................................................................................................................... 13 - 5
Temperature Probes................................................................................................................................................................................................ 13 - 5
Skin Temperature Sensor with 400 Series Thermistor .................................................................................................................... 13 - 5
Esophageal Stethoscope with 400 Series Thermistor Temperature Sensor ....................................................................................... 13 - 6
Esophageal/Rectal Temperature Probe with 400 Series Thermistor ..................................................................................................... 13 - 7
Temperature Digital Tile Layout .................................................................................................................................................................................... 13 - 9
About the Temperature Tile ................................................................................................................................................................................. 13 - 10
Temperature Alarms................................................................................................................................................................................................ 13 - 10
Message Area............................................................................................................................................................................................................. 13 - 10
Temperature Troubleshooting ...................................................................................................................................................................................... 13 - 11
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Non-Invasive Blood Pressure (NIBP) .......................................................................................................................14 - 1
Introduction .......................................................................................................................................................................................................................... 14 - 2
NIBP Dialog............................................................................................................................................................................................................................ 14 - 3
Navigating to the NIBP Dialog ............................................................................................................................................................................. 14 - 3
Configuring NIBP Alarm Limits ............................................................................................................................................................................ 14 - 3
Configuring the NIBP Parameter......................................................................................................................................................................... 14 - 3
Measuring NIBP................................................................................................................................................................................................................... 14 - 5
Measurement Types ................................................................................................................................................................................................ 14 - 5
NIBP Cuff Checklist................................................................................................................................................................................................... 14 - 5
Measuring NIBP ........................................................................................................................................................................................................ 14 - 5
NIBP Interval Measurements ................................................................................................................................................................................ 14 - 6
Pausing/Restarting a Clock or Interval NIBP Measurement ...................................................................................................................... 14 - 6
NIBP Stat Measurements ....................................................................................................................................................................................... 14 - 7
Stopping a Stat NIBP Measurement .................................................................................................................................................................. 14 - 7
General NIBP Information................................................................................................................................................................................................. 14 - 8
Cuff Inflation Time.................................................................................................................................................................................................... 14 - 8
NIBP Pressure Limit Fail Safe ................................................................................................................................................................................ 14 - 8
NIBP Digital Tile Layout..................................................................................................................................................................................................... 14 - 9
About the NIBP Tile.................................................................................................................................................................................................. 14 - 9
NIBP Alarms ................................................................................................................................................................................................................ 14 - 9
Heart Rate (HR) Measurement ............................................................................................................................................................................. 14 - 9
Message Area............................................................................................................................................................................................................. 14 - 10
NIBP List Tile Layout ........................................................................................................................................................................................................... 14 - 11
NIBP Troubleshooting........................................................................................................................................................................................................ 14 - 12
Pulse Oximetry (SpO2) .............................................................................................................................................15 - 1
Introduction .......................................................................................................................................................................................................................... 15 - 2
SpO2 Dialog........................................................................................................................................................................................................................... 15 - 3
Navigating to the SpO2 Dialog............................................................................................................................................................................ 15 - 3
Configuring SpO2 Alarm Limits........................................................................................................................................................................... 15 - 3
Configuring the SpO2 Parameter Setup .......................................................................................................................................................... 15 - 3
Configuring the SpO2 Waveform ...................................................................................................................................................................... 15 - 5
Measuring SpO2 .................................................................................................................................................................................................................. 15 - 7
Taking an SpO2 Measurement............................................................................................................................................................................. 15 - 7
Nellcor® SpO2............................................................................................................................................................................................................. 15 - 8
Masimo SpO2............................................................................................................................................................................................................. 15 - 8
SpO2 Tile Layouts................................................................................................................................................................................................................ 15 - 9
SpO2 Digital Tile Layout ......................................................................................................................................................................................... 15 - 9
About the SpO2 Tile ................................................................................................................................................................................................ 15 - 10
SpO2 Alarms............................................................................................................................................................................................................... 15 - 10
Message Area............................................................................................................................................................................................................. 15 - 10
SpO2 Waveform Tile Layout ................................................................................................................................................................................. 15 - 12
About the SpO2 Waveform Tile........................................................................................................................................................................... 15 - 12
Message Area............................................................................................................................................................................................................. 15 - 12
Performance Considerations........................................................................................................................................................................................... 15 - 13
SpO2 Troubleshooting ...................................................................................................................................................................................................... 15 - 14
ST................................................................................................................................................................................16 - 1
Introduction .......................................................................................................................................................................................................................... 16 - 2
ST Dialog................................................................................................................................................................................................................................. 16 - 2
Navigating to the ST Dialog.................................................................................................................................................................................. 16 - 2
Configuring ST Alarms Limits............................................................................................................................................................................... 16 - 3
Configuring the ST Parameter ............................................................................................................................................................................ 16 - 3
Adjusting the ISO and J/ST Points ...................................................................................................................................................................... 16 - 5
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Reviewing ST Points ................................................................................................................................................................................................ 16 - 7
ST Relearning ............................................................................................................................................................................................................. 16 - 7
ST Tile Layouts ...................................................................................................................................................................................................................... 16 - 9
ST Digital Tile Layout............................................................................................................................................................................................... 16 - 9
About the ST Tile....................................................................................................................................................................................................... 16 - 10
Message Area............................................................................................................................................................................................................. 16 - 10
ST Rep Beat Tile ......................................................................................................................................................................................................... 16 - 11
About the ST Rep Beat Tile.................................................................................................................................................................................... 16 - 11
ST Alarms ..................................................................................................................................................................................................................... 16 - 12
ST Troubleshooting ............................................................................................................................................................................................................ 16 - 13
CO2 Monitoring (optional).......................................................................................................................................17 - 1
Introduction .......................................................................................................................................................................................................................... 17 - 2
CO2 Dialog............................................................................................................................................................................................................................. 17 - 2
Navigating to the CO2 Dialog.............................................................................................................................................................................. 17 - 2
Configuring CO2 Alarm Limits............................................................................................................................................................................. 17 - 3
Configuring the CO2 Parameter Setup............................................................................................................................................................. 17 - 3
Configuring the CO2 Waveform ........................................................................................................................................................................ 17 - 4
Calibrating the CO2 Module................................................................................................................................................................................. 17 - 6
Taking a CO2 Measurement ................................................................................................................................................................................. 17 - 7
CO2 Sensors................................................................................................................................................................................................................ 17 - 8
CO2 Tile Layouts .................................................................................................................................................................................................................. 17 - 9
CO2 Digital Tile Layout........................................................................................................................................................................................... 17 - 9
About the CO2 Digital Tile .................................................................................................................................................................................... 17 - 9
CO2 Alarms ................................................................................................................................................................................................................. 17 - 9
Message Area............................................................................................................................................................................................................. 17 - 10
CO2 Waveform Tile Layout ................................................................................................................................................................................... 17 - 11
About the CO2 Waveform Tile............................................................................................................................................................................. 17 - 11
Message Area............................................................................................................................................................................................................. 17 - 11
CO2 Troubleshooting ........................................................................................................................................................................................................ 17 - 12
Cardiac Output (CO) (optional)................................................................................................................................18 - 1
Introduction .......................................................................................................................................................................................................................... 18 - 2
Cardiac Output Dialog....................................................................................................................................................................................................... 18 - 2
Navigating to the Cardiac Output Dialog........................................................................................................................................................ 18 - 2
Configuring TBlood Alarm Limits ....................................................................................................................................................................... 18 - 3
Configuring the CO Parameter ........................................................................................................................................................................... 18 - 3
Measuring CO ....................................................................................................................................................................................................................... 18 - 6
Optimizing CO Measurements ............................................................................................................................................................................ 18 - 6
Auto and Manual CO Measurements ................................................................................................................................................................ 18 - 6
Taking CO Measurements ..................................................................................................................................................................................... 18 - 6
About the Cardiac Output Dialog ........................................................................................................................................................... 18 - 8
Cardiac Output Dialog Messages ............................................................................................................................................................ 18 - 8
CO Digital Tile Layout ........................................................................................................................................................................................................ 18 - 9
About the CO Tile ..................................................................................................................................................................................................... 18 - 9
CO Alarms.................................................................................................................................................................................................................... 18 - 9
Message Area............................................................................................................................................................................................................. 18 - 10
CO Troubleshooting........................................................................................................................................................................................................... 18 - 11
Reports ......................................................................................................................................................................19 - 1
Introduction .......................................................................................................................................................................................................................... 19 - 2
Print Setup ............................................................................................................................................................................................................................. 19 - 2
Navigating to the Print Setup Dialog ................................................................................................................................................................ 19 - 2
Configuring the Print Setup.................................................................................................................................................................................. 19 - 3
Configuring the Waveforms to Print ................................................................................................................................................................. 19 - 4
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Configuring the Print Destination ...................................................................................................................................................................... 19 - 5
Print Queue............................................................................................................................................................................................................................ 19 - 7
Navigating to the Print Queue Dialog .............................................................................................................................................................. 19 - 7
Deleting all Print Requests .................................................................................................................................................................................... 19 - 7
Internal Recorder (Optional)............................................................................................................................................................................................ 19 - 8
Printing to the Thermal Recorder....................................................................................................................................................................... 19 - 8
Printing an ECG Strip............................................................................................................................................................................................... 19 - 8
Laser Printer Reports .......................................................................................................................................................................................................... 19 - 9
Waveform Report ..................................................................................................................................................................................................... 19 - 9
Printing a Waveform Report................................................................................................................................................................................. 19 - 10
12 Lead Report .......................................................................................................................................................................................................... 19 - 11
Printing the 12 Lead Report.................................................................................................................................................................................. 19 - 12
List Trend Report ...................................................................................................................................................................................................... 19 - 13
Printing the List Trend Report.............................................................................................................................................................................. 19 - 14
Disclosure Overview Report ................................................................................................................................................................................. 19 - 15
Printing the Disclosure Overview Report ........................................................................................................................................................ 19 - 16
Disclosure Detail Report......................................................................................................................................................................................... 19 - 17
Printing the Disclosure Detail Report................................................................................................................................................................ 19 - 19
Event List Report....................................................................................................................................................................................................... 19 - 20
Printing the Event List Report .............................................................................................................................................................................. 19 - 21
Event Detail Report.................................................................................................................................................................................................. 19 - 22
Printing the Event Detail Report ......................................................................................................................................................................... 19 - 24
Graphic Trend Report.............................................................................................................................................................................................. 19 - 25
Printing the Graphic Trend Report..................................................................................................................................................................... 19 - 27
Print On Alarm Report............................................................................................................................................................................................. 19 - 28
Printing the Print on Alarm Report .................................................................................................................................................................... 19 - 29
ST Report ..................................................................................................................................................................................................................... 19 - 30
Printing the ST Report............................................................................................................................................................................................. 19 - 32
PAWP Report .............................................................................................................................................................................................................. 19 - 33
Printing the PAWP Report ..................................................................................................................................................................................... 19 - 34
Drug Calculations Report ...................................................................................................................................................................................... 19 - 35
Printing the Drug Calculations Report.............................................................................................................................................................. 19 - 36
Hemodynamic Calculation Report..................................................................................................................................................................... 19 - 37
Printing the Hemodynamic Calculation Report ............................................................................................................................................ 19 - 38
Quick Trend Report.................................................................................................................................................................................................. 19 - 39
Printing the Quick Trend Report ......................................................................................................................................................................... 19 - 40
System Settings Report .......................................................................................................................................................................................... 19 - 41
Printing the System Settings Report ................................................................................................................................................................. 19 - 43
Printing Troubleshooting ................................................................................................................................................................................................. 19 - 44
History Dialogs..........................................................................................................................................................20 - 1
Introduction .......................................................................................................................................................................................................................... 20 - 2
Trends...................................................................................................................................................................................................................................... 20 - 2
Navigating to the Quick Trends Tab.................................................................................................................................................................. 20 - 2
About Quick Trends................................................................................................................................................................................................. 20 - 2
List Trends ................................................................................................................................................................................................................... 20 - 2
Navigating to the List Trends Tab....................................................................................................................................................................... 20 - 3
About the List Trends Tab ..................................................................................................................................................................................... 20 - 3
Navigating in the List Trends Tab....................................................................................................................................................................... 20 - 3
Configuring a List Trends Display Interval....................................................................................................................................................... 20 - 4
Configuring a List Trends Display Group ......................................................................................................................................................... 20 - 4
Configuring a List Trends Time Search ............................................................................................................................................................. 20 - 4
Printing from the List Trends Tab ....................................................................................................................................................................... 20 - 4
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Graphic Trends .......................................................................................................................................................................................................... 20 - 4
Navigating to the Graphic Trends Tab.............................................................................................................................................................. 20 - 4
About the Graphic Trends Tab ............................................................................................................................................................................ 20 - 5
Viewing Event Detail from Graphic Trends ..................................................................................................................................................... 20 - 5
Navigating in the Graphic Trends Tab .............................................................................................................................................................. 20 - 6
Configuring a Graphic Trends Display Interval.............................................................................................................................................. 20 - 6
Configuring a Graphic Trends Display Group ................................................................................................................................................ 20 - 6
Configuring a Graphic Trends Time Search .................................................................................................................................................... 20 - 6
Printing from Graphic Trends............................................................................................................................................................................... 20 - 6
Events Tab.............................................................................................................................................................................................................................. 20 - 7
Navigating to the Events Tab............................................................................................................................................................................... 20 - 7
Events - List View ...................................................................................................................................................................................................... 20 - 7
About the Events - List View Tab ........................................................................................................................................................................ 20 - 7
Navigating in the Events - List View................................................................................................................................................................... 20 - 8
Applying/Removing an Events Filter................................................................................................................................................................. 20 - 8
Tagging Events in the Events - List View.......................................................................................................................................................... 20 - 9
Archiving Events in the Events - List View....................................................................................................................................................... 20 - 9
Changing Leads in the Events - List View ........................................................................................................................................................ 20 - 10
Creating an Events - List View Time Search .................................................................................................................................................... 20 - 10
Deleting Events in the Events - List View......................................................................................................................................................... 20 - 10
Configuring Displayed Parameters for the Events - List View.................................................................................................................. 20 - 10
Printing from the Events - List View................................................................................................................................................................... 20 - 10
Accessing the Events - Detail View..................................................................................................................................................................... 20 - 10
About the Events - Detail View............................................................................................................................................................................ 20 - 11
Navigating in the Events - Detail View.............................................................................................................................................................. 20 - 11
Configuring Displayed Parameters for the Events - Detail View ............................................................................................................. 20 - 12
Printing from the Events - Detail View.............................................................................................................................................................. 20 - 12
Full Disclosure....................................................................................................................................................................................................................... 20 - 13
Navigating to the Full Disclosure - Overview View ...................................................................................................................................... 20 - 13
About the Full Disclosure - Overview View..................................................................................................................................................... 20 - 13
Navigating in the Full Disclosure - Overview View....................................................................................................................................... 20 - 13
Changing Leads in the Full Disclosure - Overview View ............................................................................................................................ 20 - 14
Creating a Full Disclosure - Overview View Time Search ........................................................................................................................... 20 - 14
Printing from the Full Disclosure - Overview View....................................................................................................................................... 20 - 14
Accessing the Full Disclosure - Detail View..................................................................................................................................................... 20 - 14
About the Full Disclosure - Detail View ............................................................................................................................................................ 20 - 14
Navigating in the Full Disclosure- Detail View............................................................................................................................................... 20 - 14
History Dialog Common Functions .............................................................................................................................................................................. 20 - 16
Configuring a Display Interval ............................................................................................................................................................................. 20 - 16
Configuring a Display Group................................................................................................................................................................................ 20 - 17
Configuring Custom Configuration Option.................................................................................................................................................... 20 - 17
Configuring a Time Search.................................................................................................................................................................................... 20 - 19
Changing Leads ........................................................................................................................................................................................................ 20 - 20
Adding/Deleting Event Notes.............................................................................................................................................................................. 20 - 20
Performing ECG Waveform Measurements .................................................................................................................................................... 20 - 21
Configuring Displayed Parameters .................................................................................................................................................................... 20 - 22
Printing from the Historical Dialogs .................................................................................................................................................................. 20 - 22
Historical Events................................................................................................................................................................................................................... 20 - 25
Troubleshooting .................................................................................................................................................................................................................. 20 - 29
Calculators.................................................................................................................................................................21 - 1
Hemodynamics Calculations........................................................................................................................................................................................... 21 - 2
Hemodynamics Dialog ...................................................................................................................................................................................................... 21 - 2
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Table of Contents
Navigating to the Calculator Tab........................................................................................................................................................................ 21 - 2
Configuring the Calculator Tab ............................................................................................................................................................... 21 - 3
About the Calculator Tab ........................................................................................................................................................................... 21 - 4
Navigating to the Log Tab..................................................................................................................................................................................... 21 - 5
About the Log Tab ....................................................................................................................................................................................... 21 - 5
Hemodynamic Calculations Report.............................................................................................................................................................................. 21 - 6
Hemodynamic Calculations Troubleshooting.......................................................................................................................................................... 21 - 7
Drug Calculations................................................................................................................................................................................................................ 21 - 8
Drug Calculator Dialog...................................................................................................................................................................................................... 21 - 8
Navigating to the Drug Calculator Dialog....................................................................................................................................................... 21 - 8
Configuring a Drug Calculation .......................................................................................................................................................................... 21 - 9
Drug List and Requirements ..................................................................................................................................................................... 21 - 10
Weight Requirements ................................................................................................................................................................................. 21 - 11
Drug Amount Requirements .................................................................................................................................................................... 21 - 11
Solution Volume Requirements .............................................................................................................................................................. 21 - 12
Non-Weight Based Dose Requirements ............................................................................................................................................... 21 - 12
Weight Based Dose Requirements ......................................................................................................................................................... 21 - 12
Infusion Rate Requirements ..................................................................................................................................................................... 21 - 13
Concentration Requirements ................................................................................................................................................................... 21 - 13
Previous Drug Calculations................................................................................................................................................................................... 21 - 13
Deleting a Drug from the Previous Calculations List................................................................................................................................... 21 - 14
Navigating to the Drug Titration Table ............................................................................................................................................................ 21 - 14
Titration Table Requirements ................................................................................................................................................................... 21 - 15
Drug Calculations Report ................................................................................................................................................................................................. 21 - 16
Drug Calculator Troubleshooting ................................................................................................................................................................................. 21 - 17
Standard Calculator............................................................................................................................................................................................................ 21 - 18
Navigating to the Standard Calculator............................................................................................................................................................. 21 - 18
Alarm Watch..............................................................................................................................................................22 - 1
Alarm Watch.......................................................................................................................................................................................................................... 22 - 2
Navigating to the Alarm Watch Setup Dialog................................................................................................................................................ 22 - 2
Alarm Watch Bed Status Symbols ...................................................................................................................................................................... 22 - 3
Adding a Bed.............................................................................................................................................................................................................. 22 - 3
Removing a Bed ........................................................................................................................................................................................................ 22 - 4
Adding Alarms to Watched Alarm List.............................................................................................................................................................. 22 - 4
Removing Alarms from the Watched Alarms List......................................................................................................................................... 22 - 4
Alarm Watch Tile.................................................................................................................................................................................................................. 22 - 6
Alarm Watch Notification ................................................................................................................................................................................................. 22 - 6
Acknowledging Watched Alarms ....................................................................................................................................................................... 22 - 7
Alarm Watch Troubleshooting ....................................................................................................................................................................................... 22 - 8
Remote View .............................................................................................................................................................23 - 1
Remote View ......................................................................................................................................................................................................................... 23 - 2
Remote View Setup ................................................................................................................................................................................................. 23 - 2
Configuring the Remote View Display Dialog .............................................................................................................................................. 23 - 3
Managing Alarm Delays from the Remote View Monitor.......................................................................................................................... 23 - 4
Printing from the Remote View Dialog............................................................................................................................................................. 23 - 5
Remote View Troubleshooting....................................................................................................................................................................................... 23 - 6
VAccess ......................................................................................................................................................................24 - 1
Introduction .......................................................................................................................................................................................................................... 24 - 2
Navigating to the VAccess Dialog ...................................................................................................................................................................... 24 - 2
Connecting to a VAccess Location..................................................................................................................................................................... 24 - 2
System Setup ............................................................................................................................................................25 - 1
Introduction .......................................................................................................................................................................................................................... 25 - 2
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Table of Contents
System Dialog....................................................................................................................................................................................................................... 25 - 2
Navigating to the System Dialog........................................................................................................................................................................ 25 - 2
Configuring the General Tab................................................................................................................................................................................ 25 - 4
Configuring the Quick Functions Tab ............................................................................................................................................................... 25 - 4
Configuring the Alarms Tab ................................................................................................................................................................................. 25 - 7
Configuring the Printer Tab.................................................................................................................................................................................. 25 - 8
Configuring the Network Tab .............................................................................................................................................................................. 25 - 9
Configuring VAccess ............................................................................................................................................................................................... 25 - 10
Entering VAccess Addresses................................................................................................................................................................................. 25 - 11
Configuring the Alarm Watch Tab...................................................................................................................................................................... 25 - 11
Adding an Alarm Watch Location ...................................................................................................................................................................... 25 - 12
Removing an Alarm Watch Location................................................................................................................................................................. 25 - 12
Adding Alarms to a Watched Alarm List .......................................................................................................................................................... 25 - 13
Removing Alarms from the Watch Alarm List ................................................................................................................................................ 25 - 13
Alarm Watch Response........................................................................................................................................................................................... 25 - 14
Configuring the System Tab................................................................................................................................................................................. 25 - 14
Restore Factory Defaults ............................................................................................................................................................................ 25 - 15
Change Password ......................................................................................................................................................................................... 25 - 15
Import/Export Configuration Settings .................................................................................................................................................. 25 - 16
Save Dept. Defaults ...................................................................................................................................................................................... 25 - 16
Print System Settings .................................................................................................................................................................................. 25 - 16
Configuration Management............................................................................................................................................................................................ 25 - 16
Product Maintenance ...............................................................................................................................................26 - 1
Introduction .......................................................................................................................................................................................................................... 26 - 2
Care and Cleaning of Monitor, Modules and Racks ................................................................................................................................................ 26 - 2
Monitor Sterilization................................................................................................................................................................................................ 26 - 2
Care and Cleaning of SpO2 Sensors.............................................................................................................................................................................. 26 - 3
Care and Cleaning of Reusable Temperature Probes ............................................................................................................................................ 26 - 3
Care and Cleaning of Reusable Cuffs .......................................................................................................................................................................... 26 - 4
Reusable Cuffs with Bladders............................................................................................................................................................................... 26 - 4
Reusable Bladderless Cuffs ................................................................................................................................................................................... 26 - 4
Care and Cleaning of Lead ECG Cables and Wires .................................................................................................................................................. 26 - 5
Battery Maintenance ......................................................................................................................................................................................................... 26 - 5
Care of CO2 Module ........................................................................................................................................................................................................... 26 - 6
Accessories ...............................................................................................................................................................27 - 1
ECG ........................................................................................................................................................................................................................................... 27 - 2
ECG Electrodes .......................................................................................................................................................................................................... 27 - 2
ECG Cables .................................................................................................................................................................................................................. 27 - 2
ECG Leadsets ............................................................................................................................................................................................................. 27 - 2
SpO2 ........................................................................................................................................................................................................................................ 27 - 4
Masimo SpO2 Module ............................................................................................................................................................................................ 27 - 4
Nellcor® SpO2 Module ............................................................................................................................................................................................ 27 - 5
NIBP .......................................................................................................................................................................................................................................... 27 - 5
Temperature ........................................................................................................................................................................................................................ 27 - 7
Disposable 400 Series Temperature Probes ................................................................................................................................................... 27 - 7
IBP ............................................................................................................................................................................................................................................. 27 - 7
CO2 ........................................................................................................................................................................................................................................... 27 - 8
Oridion Microstream CO2 Module ..................................................................................................................................................................... 27 - 8
CO ............................................................................................................................................................................................................................................. 27 - 9
Miscellaneous Accessories ............................................................................................................................................................................................... 27 - 10
Mounts & Mounting Accessories ................................................................................................................................................................................... 27 - 10
Networking Accessories.................................................................................................................................................................................................... 27 - 11
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Table of Contents
Manuals................................................................................................................................................................................................................................... 27 - 11
Product Specifications..............................................................................................................................................28 - 1
Specifications........................................................................................................................................................................................................................ 28 - 2
Standards Compliance ........................................................................................................................................................................................... 28 - 2
V 12 Safety Designations: ...................................................................................................................................................................................... 28 - 3
V 21 Safety Designations: ...................................................................................................................................................................................... 28 - 4
V Dock Safety Designations:................................................................................................................................................................................. 28 - 5
VPS Safety Designations: ...................................................................................................................................................................................... 28 - 6
V Hub Safety Designations:................................................................................................................................................................................... 28 - 7
12L ECG Safety Designations: .............................................................................................................................................................................. 28 - 7
CO Module Safety Designations: ....................................................................................................................................................................... 28 - 8
CO2 Module Safety Designations:...................................................................................................................................................................... 28 - 8
IBP Module Safety Designations: ........................................................................................................................................................................ 28 - 9
Temp Module Safety Designations:................................................................................................................................................................... 28 - 10
Recorder Safety Designations:............................................................................................................................................................................. 28 - 10
VDI Safety Designations:........................................................................................................................................................................................ 28 - 11
Visual and Auditory Alarm Disclosure............................................................................................................................................................... 28 - 11
Verifying Alarm Functionality .............................................................................................................................................................................. 28 - 12
Self-Test of Alarm System .......................................................................................................................................................................... 28 - 12
ECG Performance...................................................................................................................................................................................................... 28 - 12
Impedance Respiration ..................................................................................................................................................................................................... 28 - 25
Non-Invasive Blood Pressure (NIBP) .................................................................................................................................................................. 28 - 27
Invasive Blood Pressure (IBP)................................................................................................................................................................................ 28 - 30
Temperature............................................................................................................................................................................................................... 28 - 32
Pulse Oximetry (SpO2)............................................................................................................................................................................................ 28 - 33
Analog Output........................................................................................................................................................................................................... 28 - 35
Thermodultion Cardiac Output (CO)................................................................................................................................................................. 28 - 36
Carbon Dioxide (CO2) ............................................................................................................................................................................................. 28 - 37
Drug Calculations ..................................................................................................................................................................................................... 28 - 39
Patient Contacting Materials................................................................................................................................................................................ 28 - 39
Power Specifications ......................................................................................................................................................................................................... 28 - 40
Performance Characteristics ........................................................................................................................................................................................... 28 - 41
ECG Specifications.................................................................................................................................................................................................... 28 - 41
ECG Function and Specifications ............................................................................................................................................................ 28 - 41
ECG Specifications ........................................................................................................................................................................................ 28 - 42
Temperature Performance Characteristics ..................................................................................................................................................... 28 - 42
Recorder Parameter Specifications.................................................................................................................................................................... 28 - 42
Recorder Safety Specifications ................................................................................................................................................................ 28 - 42
Recorder Performance Specifications ................................................................................................................................................... 28 - 42
Continuous Cardiac Output (CCO) Performance Characteristics............................................................................................................ 28 - 43
Continuous Cardiac Output Performance Requirements .............................................................................................................. 28 - 43
Continuous Cardiac Index Performance Requirements ................................................................................................................. 28 - 43
Real-time SVR Performance Requirements ........................................................................................................................................ 28 - 43
SVRI Performance Requirements ........................................................................................................................................................... 28 - 43
SVO2 Output Performance Requirements ......................................................................................................................................... 28 - 43
Safety Designations ........................................................................................................................................................................................................... 28 - 44
Safety Classification ................................................................................................................................................................................................ 28 - 44
Electromagnetic Capability ............................................................................................................................................................................................. 28 - 45
EMC Safety ................................................................................................................................................................................................................. 28 - 45
V 12/V 21...................................................................................................................................................................................................................... 28 - 45
Environmental Conditions ............................................................................................................................................................................................... 28 - 49
Power Supply ............................................................................................................................................................................................................. 28 - 49
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Table of Contents
Sound....................................................................................................................................................................................................................................... 28 - 49
Communication Protocols ............................................................................................................................................................................................... 28 - 49
Connection to Panorama® Central Station................................................................................................................................................................. 28 - 49
Operator Position ................................................................................................................................................................................................................ 28 - 49
Glossary .....................................................................................................................................................................29 - 1
Terms, Acronyms, and Abbreviations .......................................................................................................................................................................... 29 - 2
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xiv
0070-10-0727-02
V Series Operating Instructions
Foreword
Introduction
Foreword
CAUTION:
U.S. Federal Law restricts this device to sale by or on the order of a
physician or other practitioner licensed by U.S. state law to use or order
the use of this device.
NOTE:
Figures in this manual are provided for reference purposes only.
Screens may slightly differ based screen resolution and setup
configuration.
Patents: This device is covered under one or more of the following U.S. Patents: RE 38,492; RE 38,476;
7,221,971; 7,215,986; 7,215,984; 6,850,787; 6,826,419; 6,822,564; 6,816,741; 6,745,060; 6,699,194;
6,684,090; 6,654,624; 6,650,917; 6,643,530; 6,606,511; 6,463,311; 6,430,525; 6,360,114; 6,236,872;
6,229,856; 6,067,462; 6,011,986; 6,002,952; 5,919,134; 5,769,785;5,758,644; 5,685,299; 5,632,272;
5,490,505; 5,482,036; 4,802,486; 4,869,254; 4,928,692; 4,934,372; 4,960,126; 5,078,136;5,485,847;
5,743,263; 5,865,736; 6,035,223; 6,298,252; 6,463,310; 6,591,123; 6,675,031; 6,708,049; 6,801,797;
7,254,433; 6,428,483; 6,997,880; 5,300,859, 6,437,316; 7,530,955 RE 35,122 foreign equivalents; and
Masimo patents (www.masimo.com/patents.htm). Possession or purchase of this device does not
convey any express or implied license to use the device with replacement parts which would, alone,
or in combination with this device, fall within the scope of one or more of the patents relating to this
device.
General knowledge of monitoring and an understanding of the features and functions of the V 12/V
21 are prerequisites for its proper use.
Please read and adhere to all of the warnings and precautions listed throughout this manual.
A WARNING is provided to alert the user to potentially serious outcomes (death, injury or serious
adverse events) to the patient or the user.
A CAUTION is provided to alert the user that special care should be taken for the safe and effective
use of the device. They will include actions to be taken to avoid effects on patients or users that will
not be potentially life threatening or result in serious injury, but about which the user should be
aware.
A NOTE is provided when additional general information is available.
V Series Operating Instructions
0070-10-0727-02
xv
Introduction
Warnings
Warnings
xvi
WARNING:
Possible explosion hazard. Do not operate machine near flammable
anesthetic agents or other flammable substances. Do not use
flammable anesthetic agents (i.e., ether or cyclopropane.)
WARNING:
If liquid is accidentally spilled on equipment, battery, or accessories, or
they have been immersed in liquid, contact service personnel. Do not
operate the equipment before it has been tested and approved for
further use.
WARNING:
Do not connect other equipment to the same MPSO (Multiple Portable
Socket Outlets i.e. Multiple outlet extension cords) with the V 12/V 21,
as it may increase system leakage current. Only use the MPSO to supply
power to the equipment.
WARNING:
Devices connected to the equipment must meet the requirements of
the applicable IEC standards (e.g. IEC 60950 safety standards for
information technology equipment and IEC 60601-1 safety standards
for medical electrical equipment). The system configuration must meet
the requirements of the IEC 60601-1-1 medical electrical systems
standard. Any personnel who connect devices to the equipment’s
signal input/output port is responsible for providing evidence that the
safety certification of the devices has been performed in accordance to
the IEC 60601-1-1. If you have any questions, please contact Mindray.
WARNING:
Use of the V 12/V 21 in the vicinity of explosive anesthetics and in the
presence of electromagnetic interference or power overloads caused
by electrosurgical or diathermy instruments could create a potential
hazard or could damage the monitor.
WARNING:
Fire, explosion or severe burn hazard. Do not disassemble, crush, heat
above 100º C (212º F), or incinerate. Replace only with the Mindray DS
USA, Inc. P/N 0146-00-0091-01. See operator’s manual for safety
instructions. Battery is not fully charged upon delivery. Please charge
battery before initial use.
WARNING:
This device is NOT suitable for use in a magnetic resonance imaging
(MRI) environment.
WARNING:
This device is not intended for direct cardiac application.
WARNING:
Use of the V 12/V 21 is restricted to one patient at a time.
WARNING:
Electrode polarization: some electrodes may be subject to large offset
potentials due to polarization. Use only electrodes as recommended by
Mindray. Recovery time after application of defibrillator pulses may be
especially compromised. Squeeze bulb electrodes commonly used for
diagnostic ECG recording may be particularly vulnerable to this effect.
Electrodes of dissimilar metals should not be used unless the amplifier
can handle polarization potentials as high as 1 volt (V).
WARNING:
To reduce the hazard of burns in the high-frequency surgical neutral
electrode connection, the electrodes should not be located between
the surgical site and the electro-surgical unit return electrode.
WARNING:
Patients with fragile skin, dermal allergies, or a history of skin reactions
to adhesive tapes may show a dermatitis type reaction to ECG
electrodes and SpO2 sensors.
0070-10-0727-02
V Series Operating Instructions
Warnings
Introduction
WARNING:
Reliably attach Potential Equalization connector to the safety ground
when interconnecting V 12/V 21 with other medical or non-medical
electrical equipment to minimize the risk of excessive leakage current
and/or shock hazard.
WARNING:
This unit uses a common isolation path for the ECG leads and the
Invasive Pressure Channels. Ensure that conductive parts of the ECG
electrodes do not contact other conductive parts including earth
ground. Do not connect any non-isolated accessories to the unit or to
the ECG or invasive pressure channel inputs when connected to a
patient. Insure that the total chassis leakage currents of all connected
units does not exceed 100μA in normal conditions and does not exceed
300μA in a single fault condition. Use an IEC 60601-1 approved
isolation / separation transformer if required. Do not operate the
equipment with any cover removed. Do not simultaneously touch the
patient and any piece of electrical equipment if any cover has been
removed from the equipment.
WARNING:
When using the 12 lead ECG device cable, the device is not protected
against Electro Surgical Unit (ESU) interference.
WARNING:
Observe extreme caution when a defibrillator is used on a patient. Do
not touch any part of patient, table, or monitor when a defibrillator is in
use.
WARNING:
Do not use the V 12/V 21 when it is adjacent to or stacked with other
equipment. If adjacent or stacked use is necessary, the V 12/V 21 should
be observed to verify normal operation in the configuration in which
they will be used.
WARNING:
Use of accessories, transducers and cables other than those specified in
the manual may result in increased Electromagnetic Emissions or
decreased Electromagnetic Immunity of the V 12/V 21. It can also cause
delayed recovery after the discharge of a cardiac defibrillator.
WARNING:
Do not put MPSO (Multiple Portable Socket Outlets i.e. Multiple outlet
extension cords) used with the V 12/V 21 or its accessories on the floor.
Connect only V 12/V 21 accessories to the same MPSO as the V 12/V 21.
Do not overload the MPSO.Trace Gas Hazard - When using the optional
CO2 Module, a health hazard exists when trace amounts of vaporized
anesthetic agents are chronically inspired by operating room
personnel. See Appendix A in NFPA 56A on Inhalation Anesthetics.
During any procedure where such agents are employed, the CO2
Module exhaust output should be connected to a medical gasscavenging system.
WARNING:
For safe installation, mount Mindray V Series patient monitoring
equipment only to wall mounts identified with the Mindray V Series
logo.
WARNING:
Do not use a damaged or broken unit or accessory.
WARNING:
Do not use unit if enclosure is damaged.
WARNING:
Do not reuse disposable accessories. Dispose of single use items in
accordance with hospital policy.
WARNING:
CO2 FilterLines® should be treated as biohazardous waste and disposed
of in accordance with local regulations for contaminated and
biologically hazardous items.
V Series Operating Instructions
0070-10-0727-02
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xviii
WARNING:
When using a sampling line for intubated patients with close 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 of the catheter.
WARNING:
Do not cut or remove any part of the sample line. Cutting the sample
line could lead to erroneous readings.
WARNING:
Loose or damaged connections may 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:
SpO2 sensors, SpO2 accessories, and temperature probes should be
disposed of in accordance with local regulations.
WARNING:
To prevent possible electric shock, connect the V 12/V 21 system to a
correctly grounded mains connection.
WARNING:
Pacemaker patients’ rate meters may continue to count the pacemaker
rate during occurrences of cardiac arrest or some arrhythmias. Do not
rely entirely upon rate meter alarms. Keep pacemaker patients under
close surveillance. See the Product Specifications chapter of this
manual for disclosure of the pacemaker pulse rejection capability of
this instrument.
WARNING:
Due to physiologic differences in the patient population, the V 12/V 21
may occasionally not alarm or may sound a false alarm for some
arrhythmia patterns. The arrhythmia analysis feature is intended to
detect ventricular rhythms only. High-risk patients should be kept
under close surveillance.
WARNING:
During procedures employing electro-cautery, use currently
acceptable procedures to minimize conditions of the thermistor and
lead wires functioning as an alternate path for radio-frequency current
to return to ground, causing localized tissue burns. Procedures which
may minimize risk of electro-surgical burns are: keep both active and
ground electrodes of the electro-cautery system in close proximity so
that the temperature sensor is outside the radio-frequency current
field. Keep temperature monitor with its associated cables separated
from electro-cautery systems. Unusual, fast artificial variations in
temperature readings may occur with concomitant applications of the
electro-cautery system.
WARNING:
Temperature probes are sterile unless unit container is opened or
damaged.
WARNING:
A hazard can exist if different alarm presets are used for the same or
similar equipment in any single area.
WARNING:
The clinician should check that the current alarm settings on the V 12/V
21 monitor are appropriate prior to use on each patient.
WARNING:
Setting alarm limits to extreme values can render the alarm system
useless.
0070-10-0727-02
V Series Operating Instructions
Cautions
Introduction
Cautions
CAUTION:
Do not operate the unit with the ventilation or speaker vents
obstructed.
CAUTION:
Do not carry the V 12/V 21 using the integrated grip handle if the unit is
mounted to another item (e.g., a rolling stand or wall mount).
CAUTION:
The V 12 rolling stand is intended for use on horizontal surfaces ONLY.
CAUTION:
The V 21 is intended for mounting only.
CAUTION:
The V 12 is designed for use with specific batteries. To avoid possible
damage to the system, use approved batteries only.
CAUTION:
The SB and MR ports are intended for use with specific Mindray
accessories only. To avoid possible damage to the V 12/V 21, use
approved ECG cables and accessories only.
CAUTION:
The V 12/V 21 monitor system has been validated for use with the
approved accessories listed in ‘‘Accessories’’ on page 27-1. Use of other
accessories not approved for use with the V 12/V 21 monitor may cause
unexpected changes in performance or possible damage to the system.
CAUTION:
The monitor and its components should be serviced by trained and
qualified personnel only. Service is defined as any activity requiring
internal adjustments, parts replacements, repairs, or software
upgrades.
CAUTION:
Route cables and hoses neatly. Ensure cables, hoses and wires are kept
away from patient’s neck to avoid strangulation. Keep floors and
walkways free of cables to reduce risk to hospital personnel, patients
and visitors.
CAUTION:
Do not block the speakers. Set the volume levels so that alarms can be
heard at all times, as described in this Operating Instructions.
CAUTION:
Do not block or affix anything to the display to avoid obstruction.
CAUTION:
Do not use damaged cable connectors.
CAUTION:
Use the power cord provided with the product. If a substitute is
necessary, use only hospital grade power cords.
CAUTION:
To avoid possible device overheating, do not block ventilation or device
vents.
CAUTION:
A blood pressure measurement can be affected by the position of the
patient, and his / her physiological condition as well as other factors,
such as patient movement.
CAUTION:
The V 12/V 21 may not meet its performance specifications if stored or
operated outside of specified temperature and humidity ranges. If
abnormal performance is observed, additional measures may be
necessary, such as reorienting or relocating the V 12/V 21.
V Series Operating Instructions
0070-10-0727-02
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xx
CAUTION:
Observe caution on all patients (Neonates, Pediatrics, and Adults) when
NIBP is set to the Stat mode and when using the 1 minute interval.
When the NIBP Stat is selected, the V 12/V 21 continually takes
continuous blood pressure readings. As a safety precaution, a limit is
placed on NIBP Stat mode. In NIBP Stat mode, after 5 minutes or 10
readings, the NIBP reverts to the previous interval setting. As a safety
precaution in 1 minute mode, a mandatory 30 second deflation period
between measurements is added. Reports have been made of nerve
injury occurring during use of automatically cycled blood pressure
cuffs.
CAUTION:
When equipped with Nellcor® SpO2, use only Nellcor oxygen
transducers including Nellcor Oxisensor® and OxiMax® patient
dedicated adhesive sensors. Use of other oxygen transducers may
cause improper oximeter performance.
CAUTION:
When equipped with Masimo SET® SpO2, use only Masimo SET Oxygen
Transducers including Masimo SET LNOP® and LNCS® Patient Dedicated
Adhesive Sensors and Masimo SET PC Series Patient Cables. Use of
other oxygen transducers may cause improper oximeter performance.
CAUTION:
Replace Li-Ion batteries with P/N 0146-00-0091-01 ONLY.
CAUTION:
Some pacemakers may contain a respiratory sensor that may produce
artifact on an ECG waveform.
CAUTION:
Tissue damage or inaccurate measurements may be caused by incorrect
SpO2 sensor application or use, such as wrapping too tightly, applying
supplemental tape, failing to inspect the sensor site periodically, or
failing to position appropriately. Carefully read the sensor directions
for use, the V 12/V 21 Operating Instructions, and all precautionary
information before use.
CAUTION:
Inaccurate SpO2 measurements may be caused by:
•
Incorrect sensor application or use
•
Significant levels of dysfunctional hemoglobins, (e.g.,
carboxyhemoglobin or methemoglobin)
•
Intra-vascular dyes such as indocyanine green or methylene blue
•
Exposure to excessive illumination such as surgical lamps
(especially ones with a xenon light source), bilirubin lamps,
fluorescent lights, infrared heating lamps, or excessive ambient
light. In such cases, cover the sensor site with opaque material
•
Excessive patient movement
•
Venous pulsations
•
Electro-surgical interference
•
Placement of a sensor on an extremity that has a blood pressure
cuff, arterial catheter, or intra-vascular line
•
Nail polish or fungus
CAUTION:
In certain situations in which perfusion and signal strength are low,
such as in patients with thick or pigmented skin, inaccurately low SpO2
readings will result. Verification of oxygenation should be made,
especially in pre-term infants and patients with chronic lung disease,
before instituting any therapy or intervention.
CAUTION:
Many patients suffer from poor peripheral perfusion due to
hypothermia, hypovolemia, severe vasoconstriction, reduced cardiac
output, etc. These symptoms may cause a loss in vital sign readings.
0070-10-0727-02
V Series Operating Instructions
Cautions
Introduction
CAUTION:
Prolonged and continuous monitoring may increase the risk of skin
erosion and pressure necrosis at the site of the sensor. Check the SpO2
sensor site frequently to ensure proper positioning, alignment and skin
integrity at least every eight (8) hours; with the Adult and Pediatric reusable finger sensor, check every four (4) hours; for neonates and
patients of poor perfusion or with skin sensitive to light, check every 2 3 hours; more frequent examinations may be required for different
patients. Change the sensor site if signs of circulatory compromise
occur.
CAUTION:
When cleaning SpO2 sensors, do not use excessive amounts of liquid.
Wipe the sensor surface with a soft cloth, dampened with cleaning
solution. Do not attempt to sterilize.
CAUTION:
A functional tester cannot be used to assess the accuracy of the pulse
oximeter probe or a pulse oximeter monitor.
CAUTION:
Temperature probes are for single use only. Destroy after single use. Do
not re-sterilize. Federal (U.S.A.) law restricts this device to sale by or on
the order of a physician.
CAUTION:
Line Isolation Monitor transients may resemble actual cardiac
waveforms, thus inhibiting heart rate alarms. Check lead wires for
damage and ensure good skin contact prior to and during use. Always
use fresh electrodes and follow proper skin preparation techniques.
CAUTION:
When connecting a sampling line to the monitor, screw the sampling
line connector clockwise into the monitor CO2 port until it can no
longer be turned to ensure that it is connected securely to the monitor.
This will assure that there is no leak of gases during measurement at
the connection point and that measurement accuracy is not
compromised.
CAUTION:
If too much moisture enters the sampling line (i.e., from ambient
humidity or breathing of unusually humid air), the message “Clearing
FilterLine” appears in the message area. If the sampling line cannot be
cleared, the message “FilterLine Blockage” appears in the message
area. Replace the sampling line once the “FilterLine Blockage” message
appears.
CAUTION:
Microstream® etCO2 sampling lines are designed for single patient use,
and are not to be reprocessed. Do not attempt to clean, disinfect,
sterilize or flush any part of the sampling line as this can cause damage
to the monitor.
CAUTION:
Before use, carefully read the Microstream® etCO2 sampling lines
Directions for Use.
CAUTION:
Only use Microstream® etCO2 sampling lines to ensure the monitor
functions properly.
CAUTION:
The VDI module enables the V 12/V 21 to display and store data
received from another specialized medical device. The V 12/V 21 can be
set to provide alarms on received data, but the connected medical
device should be regarded as the primary monitor for the parameter it
is monitoring. For patient safety, do not turn off the alarm systems of
connected devices.
V Series Operating Instructions
0070-10-0727-02
xxi
xxii
CAUTION:
The VDI serial port connector is exclusively for connection to
equipment. If the serial port connector contacts the patient while the
VDI module is in an operational system, it can violate requirements of
60601-1-1.
Always keep both ends of a serial cable connected to the VDI module
and the associated equipment while the VDI module is plugged into an
operational system and keep the VDI module out of patient contact.
It may be most convenient to use the VDI module configured in a
stationary external module rack.
CAUTION:
When powering off the unit, do not continue to hold the power button
down after the triple-beep signal is heard. Holding the power button
down for more than three (3) seconds initiates a hard shutdown of the
monitor which may cause unexpected and potentially harmful effects
to the monitor database.
0070-10-0727-02
V Series Operating Instructions
Notes
NOTE:
The comparison testing conducted via the auscultatory method used
both Phase 4 and Phase 5 Korotkoff sounds. Reports of study findings
for both the auscultatory method as well as the intra-arterial methods
are available by contacting Technical Support (800) 288-2121, ext. 8116
or (201) 995-8237.
NOTE:
If the supply mains has been interrupted during SpO2 monitoring, the
V 12 switches power to battery backup if at least one battery has been
installed and charged. If power has been completely interrupted, SpO2
monitoring continues when the supply mains is restored or a fully
charged battery is installed, and power has been recycled to the
monitor.
NOTE:
Pressure transducers are protected against the effects of defibrillation
and electro-cautery.
V Series Operating Instructions
0070-10-0727-02
xxiii
Indications for Use
The V Series Monitoring System is intended for intra hospital use under the direct supervision of a
licensed healthcare practitioner.The Indications for Use for the V 12/V 21 include the monitoring of
the following human physiological parameters:
•
ECG waveform derived from 3, 5, 6 and 12 lead measurements
•
Heart Rate
•
Pulse Oximetry (SpO2)
•
ST Segment Analysis
•
Arrhythmia Detection
•
Non Invasive Blood Pressure (NIBP)
•
Invasive Blood Pressure (IBP)
•
Cardiac Output (CO)
•
Respiratory Gases
•
Respiration Rate
•
Temperature
The V 12/V 21 Monitor has the capability of performing IV Drug and Hemodynamic Calculations and
interfacing with network devices.
The target populations are adult, pediatric and neonate with the exception of:
xxiv
•
Arrhythmia detection and ST Segment Analysis, for which the target populations are adult and
pediatric only,
•
IV Drug Calculations for which the target population is adult only, and
•
Cardiac Output for which the target population is adult and pediatric only.
0070-10-0727-02
V Series Operating Instructions
Unpacking Information
Remove the instrument from the shipping carton and examine it for signs of shipping damage. Save
all packing materials, invoice and bill of lading. These may be required to process a claim with the
carrier. Check all materials against the packing list.
Contact your agents or the Service Department at:
•
(800) 288-2121 or (201) 995-8000 (U.S.A and Canada)
•
(201) 265-8800 (South America and other areas in North America excluding U.S.A and Canada)
•
(86) 755 26582492 or (86) 26582888 (areas other than North and South Americas) for prompt
assistance in resolving any shipping issues.
Warranty Statements
Mindray warrants that components within the monitor unit will be free from defects in workmanship
and materials for the number of years shown on the invoice. Under this extended warranty, Mindray
will repair or replace any defective component at no charge for labor and/or materials. This extended
warranty does not cover consumable items such as, but not limited to batteries, displays, external
cables and sensors.
Recommended preventative maintenance, as prescribed in the Service Manual, is the responsibility
of the user, and is not covered by this warranty.
Except as otherwise provided herein, the terms, conditions and limitations of Mindray’s standard
warranty will remain in effect.
Mindray warrants that its products will be free from defects in workmanship and materials. This
warranty does not cover consumable items such as, but not limited to, batteries, external cables,
sensors, cuffs, hoses, or mounts.
Mindray will not be liable for any incidental, special, or consequential loss, damage, or expense
directly or indirectly arising from the use of its products, liability under this warranty and the buyer’s
exclusive remedy under this warranty is limited to servicing or replacing at Mindrays option at the
factory or at an authorized Distributor, any product which shall under normal use and service appear
to the Company to have been defective in material or workmanship.
No agent, employee, or representative of Mindray has any authority to bind Mindray to any
affirmation, representation, or warranty concerning its products, and any affirmation, representation
or warranty made by any agent, employee, or representative shall not be enforceable by buyer.
This warranty is expressly in lieu of any other express or implied warranties, including any implied
warranty or merchantability or fitness, and of any other obligation on the part of the seller.
Damage to any product or parts through misuse, neglect, accident, or by affixing any nonstandard
accessory attachments or by any customer modification voids this warranty. Mindray makes no
warranty whatever in regard to trade accessories, such being subject to the warranty of their
respective manufacturers.
A condition of this warranty is that this equipment or any accessories which are claimed to be
defective be returned when authorized, freight prepaid to Mindray DS USA, Inc., Mahwah, New Jersey
07430, Mindray's agents or Mindray service centers in your region. Mindray shall not have any
responsibility in the event of loss or damage in transit.
Calibration may be performed without the need to disassemble the instrument. It is the responsibility
of the purchaser to perform calibration as necessary, in accordance with the instructions provided in
this manual.
V Series Operating Instructions
0070-10-0727-02
xxv
Service
Mindray maintains a network of service representatives and factory-trained distributors. Prior to
requesting service, perform a complete operational check of the instrument to verify proper control
settings. If operational problems continue to exist,
•
In North and South Americas contact the Service Department at (800) 288-2121, ext: 8116 for
Technical Support or (201) 995-8000 for assistance in determining the nearest field service
location.
•
In areas other than North and South Americas, contact your agent or Mindray service center in
your region. If Mindray service center is not available in your region, please contact the Customer
Service of Mindray Shenzhen headquarters at (86) 755 26582492 or (86) 26582888 for technical
support or assistance.
Please include the instrument model number, the serial number, and a description of the problem
with all requests for service.
Any questions regarding the warranty should be directed to your agent or the nearest Mindray
location. A list of international offices, along with their phone numbers, is provided at the end of this
manual.
NOTE:
Upon request, Mindray provides circuit diagrams, component part lists,
descriptions, calibration instructions, or other information which assist
the user’s appropriately qualified technical personnel to repair those
parts of the equipment which are designated by Mindray DS USA, Inc.
as repairable.
Manufacturer’s Responsibility
Mindray is responsible for the effects on safety, reliability and performance of the equipment only if:
a. assembly operations, extensions, readjustments, modifications or repairs are carried out by
persons authorized by Mindray; and
b. the electrical installation of the relevant room complies with the appropriate requirements;
and
c. the equipment is used in accordance with the instructions for use.
xxvi
0070-10-0727-02
V Series Operating Instructions
Symbols and Descriptions
SYMBOL
SYMBOL
DESCRIPTION
Attention, Consult Accompanying
Documents / Refer to Manual
Zero all IBP
Equipotentiality
Type BF Equipment
Alternating Current (AC)
Power On/Off
V Series Operating Instructions
DESCRIPTION
Defibrillator Proof Type BF Equipment
Defibrillator Proof Type CF Equipment
Data Input
Alarm Off Icon
Data Output
Alarm Silence Icon
Data Input/Output
Alarm Silence Permanently Icon
Gas Port Input
Separate treatment from general
waste at end of life
Gas Port Output
Locked
Chart Recorder Output
Unlocked
NIBP Connection
Interference may occur in the vicinity
of equipment marked with this
symbol
Battery Charging
Manufacturer’s reference/catalogue
number
Protection against fluid ingress
European Representative
Mindray Medical Netherlands B.V.
Drs. W. van Royenstraat 8
P.O. Box 26, 3870 CA Hoevelaken
The Netherlands
Manufacturer
Serial number
0070-10-0727-02
xxvii
SYMBOL
SYMBOL
DESCRIPTION
DESCRIPTION
Start button
CONFORMS TO UL STD 60601-1, IEC 60601-2-27, IEC 60601-2-25, IEC 60601-2-34, IEC 60601-230, IEC 60601-2-49
CERTIFIED TO CSA STD C22.2 NO 601.1, NO 60601-2-27, NO 60601-2-30, NO 60601-2-34, NO
60601-2-49
Conformité Européenne (CE) Marking of Conformity to European Medical Device Directive.
CEXXXX represents the Notified Body number
A symbol designating compliance of the V 12/V 21 system with the Medical Device Directive
(MDD) 93/42/EEC, as a Class IIb device.
xxviii
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V Series Operating Instructions
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1.0
General Product Description
General Product Description ...................................................................................................................... 1-2
Key Features .......................................................................................................................................................... 1-3
V 12/V 21 Physical Views ............................................................................................................................... 1-5
V Dock Physical Views ..................................................................................................................................... 1-11
V Series Operating Instructions
0070-10-0727-02
1-1
General Product Description
General Product Description
1.1
General Product Description
1.1.1
V Series Monitoring Platform
The V 12/V 21 monitoring platform is a modular patient monitoring system. The system architecture
allows users to customize, by removal or addition of modules, monitored parameters based on a
patients monitoring need or acuity level. The modular design simplifies the addition of monitoring
additional parameters with the addition of parameter modules.
The V 12/V 21 monitoring platform focuses on the philosophy of "Ease of Use" while incorporating
traditionally highly complex monitoring parameters. The user interface minimizes menu layers and
excessive user interaction to simplify patient care. The V Series monitoring platform maximizes the
amount of viewable data through the use of a Portrait display orientation.
The V 12/V 21 monitoring platform consists of the following major components:
1.
V 12/V 21 Monitor - The V 12/V 21 monitor which includes the system processor, display, user
interface and appropriate connectors for communication to peripheral devices. Power the V 12/
V 21 from AC through the V Dock. Up to three (3) removable batteries may also be used to
power the V 12.
2.
V Dock - The V 12/V 21 V Dock is a physical mount for the V 12/V 21 designed to provide quick
connection and release with peripheral devices. The V Dock incorporates multiple connectivity
ports designed to enable quick connection and release for mobility.
3.
V Patient Server (VPS) - The V 12/V 21 VPS is a lightweight parameter acquisition device
designed to acquire and store up to 12 hours of real-time vital sign data including 3/5/6 Lead
ECG including ST and Arrhythmia Analysis, Respiration, two (2) Invasive Blood Pressures, Noninvasive Blood Pressure, Pulse Oximetry, and Temperature. This module is a patient centered
solution that measures the parameter stated and allows it to be moved with the patient
between V 12/V 21 display and control units without removing the patient connections.
4.
V Hub - The V 12/V 21 V Hub hosts several module bays to allow multiple modules to be
connected to the monitor. The V Hub connects to the monitor via a PUSB cable.
5.
12L ECG - The V 12/V 21 12L ECG module monitors 12 lead ECG and Respiration including ST
and Arrhythmia Analysis through the VPS module. The V 12/V 21 12L ECG is used in conjunction
with the VPS by using its ECG port as a connection to the system.
6.
CO Module - The V 12/V 21 CO module acquires thermodultion cardiac output parameter data
from the patient.
7.
CO2 Module - The V 12/V 21 CO2 module acquires carbon dioxide respiration parameter data
from the patient.
8.
Battery - The battery is a lithium smart battery and is used in the V 12 monitor where the V Dock
is not available. When powered on, the self-check feature of the V 12 provides verification of
proper operation.
9.
IBP Module - The IBP module provides two additional IBP channels.
10. Temperature Module - The Temperature module provides an additional temperature channel.
1.1.2
Interfacing
The V 12/V 21 has the capability of interfacing with Panorama Central Stations and Nurse Call
Systems.
1-2
0070-10-0727-02
V Series Operating Instructions
General Product Description
1.2
Key Features
Key Features
FEATURES
STANDARD
Display
- 12.1 inch color touchscreen with up
to 8 waveforms
- 21.3 inch color touchscreen with up
to 12 waveforms
Portable VPS
3/5/6 lead ECG
Respiration
SpO2
NIBP with Stat
Temperature
IBP (2 channels)
2 Analog output/defib sync connectors
ECG
3,5,6 lead
(I, II, III, aVR, aVL, aVF, V)
ST Analysis
Arrhythmia
Analysis
Asystole
Ventricular Tachycardia (V-Tach)
Ventricular Fibrillation (V-Fib)
Bradycardia
R on T PVC
Pause
Pause/Minute
Bigeminy
PVCs/Minute
Couplet
Irregular HR
Multiform PVC
Run
Trigeminy
Ventricular Rhythm
12 Lead
(I, II, III, aVR, aVL, aVF, V-6)
Non-Invasive
Blood Pressure
(NIBP)
VPS contains one NIBP connector
SpO2
VPS contains one SpO2 connector
Nellcor® SpO2, Masimo ®SpO2
Temperature
VPS contains one probe connector
Up to two (2) Temp modules may be installed
Respirations
Lead-selectable impedance
Invasive Blood
Pressure (IBP)
VPS contains two IBP connectors
CO
Thermodultion CO/CI/Tblood
CO2
MicroStream®
Pulmonary Artery
Wedge Pressure
(PAWP)
Uses reference line.
History
12 hours full disclosure in VPS Module
48 hours full disclosure in V 12/V 21
Monitors
Power
V Dock/AC Power
Li-Ion battery
Battery applicable to the V 12 monitor only
External
Interfaces
Ethernet network
Connectivity to Panorama Central Station
V Series Operating Instructions
0070-10-0727-02
OPTIONAL
Requires a VPS and a 12L ECG Module
Up to three (3) dual IBP modules may be
installed
1-3
Key Features
1-4
General Product Description
FEATURES
STANDARD
Calculations
IV drug calculations and hemodynamic
calculations
Other
Soft Grip Handle - Applicable to V 12
only
0070-10-0727-02
OPTIONAL
Arm Mounts
Rolling stand - Applicable to V 12 only
V Series Operating Instructions
General Product Description
V 12/V 21 Physical Views
1.3
V 12/V 21 Physical Views
1.3.1
Front View
The front view contains:
1.
Alarm lights/indicators
2.
Display
3.
Touch Pad
1
1
2
FIGURE 1-1 Example V 12 Front Panel
V Series Operating Instructions
0070-10-0727-02
1-5
V 12/V 21 Physical Views
General Product Description
1
1
2
3
FIGURE 1-2 Example V 21 Front Panel
1-6
0070-10-0727-02
V Series Operating Instructions
General Product Description
1.3.2
V 12/V 21 Physical Views
Rear View
1.
Handle
2.
Integrated module bays
3.
Grips/actuators
4.
V Dock connector
1
2
3
3
4
FIGURE 1-3 Example V 12 Rear Panel
V Series Operating Instructions
0070-10-0727-02
1-7
V 12/V 21 Physical Views
General Product Description
1
3
3
4
FIGURE 1-4 Example V 21 Rear Panel
1-8
0070-10-0727-02
V Series Operating Instructions
General Product Description
1.3.3
V 12/V 21 Physical Views
Left Side Panel
1.
Handle
2.
Side grip/actuator
1
1
2
FIGURE 1-5 Example V 12 Left Side Panel
V Series Operating Instructions
0070-10-0727-02
1-9
V 12/V 21 Physical Views
1.3.4
General Product Description
Right Side Panel
1.
Handle
2.
MR 1 connectors
3.
Side grip/actuator
4.
Battery compartment
5.
Power button
1
2
4
3
5
FIGURE 1-6 Example V 12 Right Side Panel
1 - 10
0070-10-0727-02
V Series Operating Instructions
General Product Description
1.4
V Dock Physical Views
V Dock Physical Views
NOTE:
1.4.1
Use the V Dock for the V 12 and the V 21 monitor.
Back View
1.
Equipotential Lug
2.
AC Receptacle (with an integrated cord retention clip)
3.
V Hub Connector (MR 2-3)
4.
Digital Video Interface (DV 1)
5.
Central Station (CS 1)
1
2
3
5
4
3
FIGURE 1-7 Example V 12 V Dock Back View
V Series Operating Instructions
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1 - 11
V Dock Physical Views
1.4.2
General Product Description
Right Side View
1.
Serial Bus 3 (SB 3)
2.
V Hub Connector (MR 4)
1
2
FIGURE 1-8 Example V 12 V Dock Right View
1.4.3
Left Side View
1.
Serial Bus (SB 1-2)
2.
Nurse Call (NC 1)
1
2
FIGURE 1-9 Example V 12 V Dock Left Side View
1 - 12
0070-10-0727-02
V Series Operating Instructions
General Product Description
1.4.4
V Dock Physical Views
VPS Physical Views
Side View
1.
IBP (P1-P2) connector
2.
Non-invasive blood pressure (NIBP)
3.
SpO2 connector
4.
ECG/EKG connector
5.
Temperature (T1) connector
6.
Release lever
7.
Analog output protective door (2 analog outputs)
1
2
5
3
4
1
FIGURE 1-10 Example Nellcor VPS Side View
V Series Operating Instructions
0070-10-0727-02
1 - 13
V Dock Physical Views
General Product Description
7
6
FIGURE 1-11 Example VPS Release Lever (Nellcor and Masimo)
1 - 14
0070-10-0727-02
V Series Operating Instructions
General Product Description
V Dock Physical Views
Front View
1.
Silence All alarms
2.
Zero IBP transducers
3.
Start/Stop NIBP
4.
Indicator light
4
3
1
2
FIGURE 1-12 Example VPS Front View (Nellcor and Masimo)
V Series Operating Instructions
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1 - 15
V Dock Physical Views
General Product Description
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1 - 16
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V Series Operating Instructions
2.0
Getting Started
Introduction .......................................................................................................................................................... 2-2
Power On/Off Unit ............................................................................................................................................ 2-3
Using the V 21 Touch Pad............................................................................................................................. 2-3
Main Display.......................................................................................................................................................... 2-4
Dialogs...................................................................................................................................................................... 2-8
Alarm Icons and Messages .......................................................................................................................... 2-9
Keyboard Dialog................................................................................................................................................. 2-11
Digital Keypad Dialog ..................................................................................................................................... 2-12
Message Dialogs ................................................................................................................................................ 2-13
Audio Levels Dialog.......................................................................................................................................... 2-13
Battery Levels Dialog ....................................................................................................................................... 2-15
V Series Operating Instructions
0070-10-0727-02
2-1
Introduction
2.1
Getting Started
Introduction
The V 12/V 21 is a modular patient monitoring system. The system architecture allows users to
customize, by removal or addition of modules, monitored parameters based on a patients
monitoring need or acuity level. The modular design simplifies the addition of monitoring additional
parameters with the addition of parameter modules.
The V 12/V 21 platform focuses on the philosophy of “Ease of Use” while incorporating traditionally
highly complex monitoring parameters. The user interface minimizes menu layers and excessive user
interaction to simplify patient care. The V 12/V 21 maximizes the amount of viewable data through
the use of a Portrait display orientation.
2-2
0070-10-0727-02
V Series Operating Instructions
Getting Started
2.2
Power On/Off Unit
Power On/Off Unit
CAUTION:
When powering off the unit, do not continue to hold the power button
down after the triple-beep signal is heard. Holding the power button
down for more than three (3) seconds initiates a hard shutdown of the
monitor which may cause unexpected and potentially harmful effects
to the monitor database.
It is very important that the V 12/ V 21 unit is powered on and off properly. The power on button is
located in the lower right corner of the monitor.
NOTE:
Refer to "Right Side View" on page 1-12 for exact placement of power button.
Power On Unit
To power on unit, press and release power button momentarily.
Power Off Unit
To power off unit, press the power button and release when a triple-beep signal is heard. This initiates
the monitor shutdown process.
NOTE:
2.3
The monitor shutdown process takes approximately one (1) minute,
during which time the monitor cannot be restarted.
Using the V 21 Touch Pad
NOTE:
Only the V 21 is equipped with a touch pad.
•
Move a finger around the touch pad to change the cursor location on the display.
•
Tap the touch pad once the cursor is positioned in the desired position on the display to open
the dialog.
V Series Operating Instructions
0070-10-0727-02
2-3
Main Display
2.4
Getting Started
Main Display
The Main Display shows:
1.
Header Bar
2.
Message Area
3.
Alarm status icon
4.
Date and time
5.
Shortcut icons (Display Setup and Module Status)
6.
Digital tiles
7.
Waveform tiles
8.
Navigation Area
1
3
4
5
5
2
6
7
8
FIGURE 2-1 Example V 12/V 21 Main Display
2-4
0070-10-0727-02
V Series Operating Instructions
Getting Started
Main Display
Selecting the different areas of the Main Display opens various dialogs.
2.4.1
COMPONENT
DESCRIPTION
Header Bar
Accesses the Patient Info dialog where the patient’s demographic
information is changed.
Date and Time
Accesses the Time & Date dialog where the system time and can be
changed.
Display Presets
Accesses the Display Presets dialog where the Main Display
parameters are selected.
Battery Levels
Accesses the Battery Levels dialog where battery status is checked.
Waveform tile
Accesses the respective parameter dialog. For example, selecting
the Resp waveform tile opens the Resp dialog.
Digital tile
Accesses the respective parameter dialog. For example, selecting
the Resp digital tile opens the Resp dialog.
Navigation button
Accesses the respective dialog.
System Status Message
System messages display in the Main Display Header Bar. TABLE 2-1 lists all the system messages. If
there is more than one message to display, the messages scroll.
TABLE 2-1
MESSAGE
DESCRIPTION
Silence
Silences all current alarms at the monitor for a user
configurable time period. The Main Display
contains a message indicating the alarms are
silenced for a designated time period. If a new
alarm occurs, the alarm sounds.
NOTE:
Silence All
The Low Battery audible alarm is
not affected by the Silence.
Silences all current and future alarms at the
monitor for a user designated time period. The
Main Display contains a message indicating the
alarms are silenced for a designated time period.
NOTE:
The Low Battery audible alarm is
not affected by the Silence.
All Alarms Permanently Silenced
Indicates that all alarms are permanently silenced
on the monitor for a designated time period.
Communications Lost
Indicates communication with the central station is
lost.
Fan Failure
Indicates the unit fan is non-functioning.
VPS Synchronized
Indicates VPS synchronization is complete.
NOTE:
View All ECG Mode
Refer to ‘‘VPS Synchronization’’
on page 5-4 or additional
information.
Indicates the Main Display is currently in the All
ECG mode.
Low Battery
Indicates the battery runtime is below 20 minutes.
Demo Mode - Not for Clinical use
Indicates the monitor is in the demonstration
mode.
V Series Operating Instructions
0070-10-0727-02
2-5
Main Display
Getting Started
TABLE 2-1
2.4.2
MESSAGE
DESCRIPTION
Software Download Pending
Indicates software was downloaded and is
pending installation.
Printer Error
Indicates printer management errors.
Navigation Area
The Navigation Area provides access to the monitors functions. This area contains one row of tabs
and two rows of buttons. The buttons below the tabs vary based on the currently selected tab. The
buttons located within the Quick Functions tab are user-configurable and may be modified by
accessing the password protected System dialog. The bottom row of buttons is permanent and
cannot be changed.
NOTE:
Refer to ‘‘Configuring the Quick Functions Tab’’ on page 25-4 for
additional information.
FIGURE 2-2 Example Default View of the Navigation Area (from Quick Functions Tab)
TABLE 2-2 lists the buttons and tabs available in the factory default Navigation Area.
TABLE 2-2
BUTTON
DESCRIPTION
Strip
Initiates a single strip or a continuous strip print request.
Capture Event
Provides ability to capture a current event and save to the event database.
History
Accesses the Trends, Events, and Full Disclosure dialogs.
Silence All
Silences all current and future alarms for the configured time period.
Silence
Silences the current alarms for the configured time period.
Normal Screen
Closes all dialogs and returns to the Main Display.
QUICK FUNCTIONS TAB
2-6
Start/Stop NIBP
Starts/Stops a NIBP measurement in progress. If there is no measurement in progress,
the button reads Start NIBP. If there is a measurement progress, the button reads
Stop NIBP.
NIBP Stat
Starts an immediate NIBP measurement.
Zero All IBP
Sets the current pressure for all invasive pressure channels to zero.
View All ECG
Displays all the ECG waveforms available based on the lead set currently in use.
Lead/Size
Accesses the Lead/Size dialog used to change the ECG waveform height or wave gain.
Standby
Places the monitor in the standby mode.
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V Series Operating Instructions
Getting Started
Main Display
TABLE 2-2 (Continued)
BUTTON
DESCRIPTION
PRINT TAB
Continuous/Abort
Begins/ends strips from printing to the thermal printer.
Print 12-Lead
Prints a 12 Lead Report to the default printer.
Print Setup
Accesses the Print Setup dialog where the clinician can configure which waveforms to
print and where to print them.
Print Queue
Accesses the Print Queue dialog.
SETUP TAB
Patient Info
Accesses the Patient Info dialog.
Audio Levels
Accesses the Audio Levels dialog.
Display
Accesses the Display Setup dialog.
Parameters
Accesses the Parameter dialog.
System
Accesses the System Setup dialog.
TOOLS TAB
Calculators
Accesses the Calculators dialog.
Alarm Watch
Accesses the Alarm Watch dialog.
Remote View
Accesses the Remote View dialog.
System Information
Accesses the System Information dialog.
VAccess
Accesses the VAccess dialog.
NOTE:
The VAccess button is only available in the
Tools tab if it is enabled in System Setup.
NOTE:
These buttons are only available when using
the Adult or Pediatric patient size.
PROCEDURES TAB
C.O. Run
Accesses the Cardiac Output Runs dialog.
PAWP
Accesses the PAWP dialog.
PA Insertion
Accesses the PA Insertion dialog.
Hemo Calculations
Accesses the Hemodynamic Calculations dialog.
ALARMS TAB
Limits
Accesses the Alarm Limits dialog.
Responses
Accesses the Responses dialog.
Arrhythmia
Accesses the Arrthythmia Alarm dialog.
Alarm Setup
Accesses the Alarm Setup dialog.
V Series Operating Instructions
0070-10-0727-02
2-7
Dialogs
2.5
Getting Started
Dialogs
Dialogs may include the following components:
1.
Active tab
2.
Dialog name
3.
Inactive tabs
4.
Selected radio button
5.
Unselected radio button
6.
Selected check box
7.
Unselected check box
8.
Tab specific buttons
9.
Dialog specific buttons
1
2
3
4
6
7
5
8
9
FIGURE 2-3 Example Arrhythmia Alarm Dialog
2-8
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V Series Operating Instructions
Getting Started
2.5.1
Alarm Icons and Messages
List Box
FIGURE 2-4 shows an example of a list box. The list box provides a list of available selections for a
particular dialog button or item.
FIGURE 2-4 Example List Box
2.6
Alarm Icons and Messages
2.6.1
Alarm Icons
FIGURE 2-3 shows the icons that display in the header area of the Main Display related to alarm
sounds.
TABLE 2-3
ICON
DESCRIPTION
Indicates that any active alarms have been temporarily silenced.
Indicates that all alarms have been permanently silenced.
Indicates that the one or more alarms are set to Off.
2.6.2
Parameter Messages
As shown in FIGURE 2-5 and FIGURE 2-6, each digital tile and waveform tile contains an area where
parameter specific messages display.
NOTE:
V Series Operating Instructions
Individual parameter messages are discussed in each respective
chapter.
0070-10-0727-02
2-9
Alarm Icons and Messages
Getting Started
Message Area
FIGURE 2-5 Example Waveform Tile Message Area
Message Area
FIGURE 2-6 Example Digital Tile Message Area
2 - 10
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V Series Operating Instructions
Getting Started
2.7
Keyboard Dialog
Keyboard Dialog
The V 12/V 21 uses an on-screen keyboard which enables the clinician to enter alphanumeric
information such as patient demographics, drug names, and passwords.
T
FIGURE 2-7 Example Keyboard Dialog
2.7.1
Using the Keyboard
The on-screen keyboard functions similarly to a standard PC keyboard.
1.
Using the touch screen, enter the desired alphanumeric text.
2.
To edit the alphanumeric text:
•
Select the
arrow key to move the cursor to the left.
•
Select the
arrow key to move the cursor to the right.
•
Select the Delete button to erase the text to the right of the cursor.
Select the Cancel or Accept button.
3.
V Series Operating Instructions
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
0070-10-0727-02
2 - 11
Digital Keypad Dialog
2.8
Getting Started
Digital Keypad Dialog
The V 12/V 21 uses a digital keypad dialog to enter digital values.
FIGURE 2-8 Example Digital Keypad with
Unit of Measure
2.8.1
Using the Digital Keypad
1.
Using the touch screen, enter a number within the range.
NOTE:
2 - 12
FIGURE 2-9 Example Digital Keypad without Unit
of Measure
To assist with the entry, the allowable range is shown above the text
box.
2.
If shown, select the unit of measure button (inch or cm) as shown in FIGURE 2-8.
3.
Select the Clear button to delete an entry.
4.
Select the Enter key to save the entry and close the dialog.
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V Series Operating Instructions
Getting Started
2.9
Message Dialogs
Message Dialogs
Message dialogs display in response to various actions. They require acknowledgement or
confirmation before continuing. As an example, the message dialog in FIGURE 2-10 requires No to
cancel the operation or Yes to proceed. Not all message dialogs use No or Yes. Other message
dialogs may contain use Cancel or Accept.
FIGURE 2-10 Example of a Confirmation Message Dialog
2.10
Audio Levels Dialog
The Audio Levels dialog (as shown in FIGURE 2-11) provides a means to configure the volume levels
for the physiological and technical alarms and the systole beep.
The Audio Levels dialog contains:
1.
Decrease audio volume button
2.
Audio level indicator
3.
Increase audio volume button
4.
Audio off indicator
1
2
3
4
FIGURE 2-11 Example Audio Levels Dialog
V Series Operating Instructions
0070-10-0727-02
2 - 13
Audio Levels Dialog
2.10.1
Getting Started
Configuring Audio Levels
1.
Select the Setup tab from the Navigation Area.
2.
Select the Audio Levels button to display the Audio Levels dialog.
3.
Adjust the volume levels.
•
Select the
arrow key to decrease the volume level.
•
Select the
arrow key to increase the volume level.
NOTE:
The
icon indicates that the Beep Volume or Technical Volume was
turned off. The Alarm Volume cannot be turned off.
NOTE:
2 - 14
The factory default for all three volume levels is medium.
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V Series Operating Instructions
Getting Started
2.11
Battery Levels Dialog
Battery Levels Dialog
When batteries are installed and the V 12 is functioning on battery power, the battery indicator
provides a visual reference for the approximate charge level of the batteries. The Battery Levels dialog
(as shown in FIGURE 2-12) indicates which batteries are currently installed; which batteries are
currently being charged; and what the charge level is for each battery.
FIGURE 2-12 Example Battery Levels Dialog
NOTE:
2.11.1
The
icon indicates that the battery is charging.
Battery Indicator Colors
•
Red indicates that the battery is charged less than or equal to 25%.
•
Yellow indicates that the battery is charged less than or equal to 50% but greater than 25%.
•
Green indicates that the battery is charged less than or equal to 100% but greater than 50%.
V Series Operating Instructions
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Battery Levels Dialog
Getting Started
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V Series Operating Instructions
3.0
Display Setup
Introduction .......................................................................................................................................................... 3-2
Display Options Dialog .................................................................................................................................. 3-2
Display Modes ..................................................................................................................................................... 3-12
Display Options Troubleshooting ........................................................................................................... 3-15
V Series Operating Instructions
0070-10-0727-02
3-1
Introduction
3.1
Display Setup
Introduction
The chapter describes all the functions in the Display Options dialog (as shown in FIGURE 3-1). This
dialog provides access to display configuration, patient Standby, patient Discharge, and touch screen
calibration among other things.
3.2
Display Options Dialog
The Display Options dialog provides access to display configuration, privacy mode, patient standby,
patient discharge, various display modes, display lead size, and touch screen calibration.
3.2.1
Navigating to the Display Options Dialog
1.
Select the Setup tab from the Navigation Area.
2.
Select the Display button.
The Display Options dialog displays (as shown in FIGURE 3-1).
FIGURE 3-1 Example Display Options Dialog
3-2
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V Series Operating Instructions
Display Setup
Display Options Dialog
3.
Select the buttons described in TABLE 3-1 to configure the tab.
TABLE 3-1
BUTTON
DESCRIPTION / COMMENTS
Display Setup
Opens the Display Setup dialog where the display configurations are set.
NOTE:
Privacy Mode
Screen Lock
Refer to ‘‘Configuring Display Presets’’ on
page 3-3 for additional information.
Hides the patient data and suppresses alarm notification at the monitor.
The purpose of Privacy Mode is to have virtually NO alarm notification at
bedside, unless LED is active at bedside.
NOTE:
This button is only available when the
patient is being monitored at a central
monitoring station.
NOTE:
Refer to ‘‘Privacy Mode’’ on page 3-12 for
additional information.
Disables the touch screen for a 10 second period for cleaning purposes.
NOTE:
Standby
Refer to ‘‘Screen Lock Mode’’ on page 3-12
for additional information.
Places the monitor in the standby mode.
NOTE:
Discharge
Refer to ‘‘Standby Mode’’ on page 3-12 for
additional information.
Discharges the patient.
NOTE:
Lead/Size
Refer to ‘‘Discharge Mode’’ on page 3-12 for
additional information.
Opens the Lead/Size dialog.
NOTE:
Touch Screen Calibration
Refer to ‘‘Changing Lead/Size’’ on page 3-13
for additional information.
Activates touch screen calibration.
NOTE:
3.2.2
Refer to ‘‘Touch Screen Calibration’’ on page
3-13 for additional information.
Configuring Display Presets
Display presets are predefined display configurations or layouts. The V 12/V 21 supports 10 factory
display presets. There are five presets and five empty presets from which to choose. Configure the
presets based on the needs of the individual department or unit, clinicians preference, or the
patient’s condition. This tab and the factory default presets are described in the following section.
3.2.2.1
Display Preset Configurations
Each display preset shows the position of the digital and waveform tiles, if applicable.
Preset 1 - V 12 Monitor
TABLE 3-2 provides the factory default configuration for Preset 1.
TABLE 3-2
WAVEFORM TILE
DIGITAL TILE
II
HR
V Series Operating Instructions
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3-3
Display Options Dialog
Display Setup
TABLE 3-2
V/Vx/V1
Arrhy
Off
Off
IBP1
IBP1
IBP2
IBP2
Resp
Resp
Pleth
NIBP
SpO2
NIBP List
Temp 1
Preset 1 - V 21 Monitor
TABLE 3-3 provides the factory default configuration for Preset 1.
TABLE 3-3
WAVEFORM TILE
NUMERIC TILE
II
HR
V/Vx/V1
Arrhy
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
IBP1
IBP1
IBP2
IBP2
Resp
Resp
Pleth
NIBP
SpO2
NIBP List
Temp 1
Preset 2 - V 12 Monitor
TABLE 3-4 provides the factory default configuration for Preset 2.
TABLE 3-4
WAVEFORM TILE
DIGITAL TILE
II
HR
V/Vx/V1
Arrhy
IBP1
IBP1
IBP2
IBP2
IBP3
IBP3
Pleth
3-4
SpO2
CO
ST
Resp
NIBP
NIBP List
Temp 1
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V Series Operating Instructions
Display Setup
Display Options Dialog
Preset 2 - V 21 Monitor
TABLE 3-5 provides the factory default configuration for Preset 2.
TABLE 3-5
WAVEFORM TILE
NUMERIC TILE
II
HR
V/Vx/V1
Arrhy
Vy/V2
ST
I
Off
III
Off
IBP1
IBP1
IBP2
IBP2
IBP3
IBP3
CO2
CO2
Pleth
SpO2
CO
NIBP
Resp
Off
NIBP List
Temp 1
Preset 3 - V 12 Monitor
TABLE 3-6 provides the factory default configuration for Preset 3.
TABLE 3-6
WAVEFORM TILE
DIGITAL TILE
II
HR
V/Vx/V1
Arrhythmia
IBP1
IBP1
IBP2
IBP2
Pleth
SpO2
Off
Off
Off
CO
ST
Resp
NIBP
NIBP List
Temp 1
Preset 3 - V 21 Monitor
TABLE 3-7 provides the factory default configuration for Preset 3.
TABLE 3-7
WAVEFORM TILE
NUMERIC TILE
II
HR
V/Vx/V1
Arrhy
ST Dev 12 Lead
Off
IBP1
IBP1
IBP2
IBP2
Off
Off
Off
Off
Off
Off
Pleth
SpO2
V Series Operating Instructions
0070-10-0727-02
3-5
Display Options Dialog
Display Setup
TABLE 3-7
Off
Off
Resp
CO
NIBP
Temp 1
Alarm Watch
NIBP List
Temp 2
Preset 4 - V 12 Monitor
TABLE 3-8 provides the factory default configuration for Preset 4.
TABLE 3-8
WAVEFORM TILE
DIGITAL TILE
II
HR
V/Vx/V1
Arrhy
I
NIBP
IBP1
IBP1
IBP2
IBP2
IBP3
IBP3
Pleth
SpO2
Resp
Resp
Preset 4 - V 21 Monitor
TABLE 3-9 provides the factory default configuration for Preset 4.
TABLE 3-9
WAVEFORM TILE
NUMERIC TILE
II
HR
V/Vx/V1
Arrhy
Vy/V2
ST
IBP1
IBP1
IBP2
IBP2
IBP3
IBP3
IBP4
IBP4
Pleth
SpO2
Resp
Resp
CO2
CO2
Off
Off
Off
NIBP
Preset 5 - V 12 Monitor
TABLE 3-10 provides the factory default configuration for Preset 5.
TABLE 3-10
3-6
WAVEFORM TILE
DIGITAL TILE
II
HR
Pleth
SpO2
NIBP
Resp
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V Series Operating Instructions
Display Setup
Display Options Dialog
Preset 5 - V 21 Monitor
TABLE 3-11 provides the factory default configuration for Preset 5.
TABLE 3-11
WAVEFORM TILE
NUMERIC TILE
II
HR
Pleth
SpO2
Off
Off
NIBP
Resp
Empty Presets - V 12 Monitor
TABLE 3-12 provides the factory default configuration for all Empty Presets.
TABLE 3-12
WAVEFORM TILE
DIGITAL TILE
II
HR
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Empty Preset - V 21 Monitor
TABLE 3-13 provides the factory default configuration for the Empty Preset.
TABLE 3-13
WAVEFORM TILE
NUMERIC TILE
II
HR
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
V Series Operating Instructions
Off
Off
0070-10-0727-02
3-7
Display Options Dialog
3.2.2.2
Display Setup
Editing a Display Preset
Edit an existing preset or configure an Empty preset:
1.
Select the Setup tab from the Navigation Area.
2.
Select the Display button, then select the Display Setup button.
The Display Setup dialog displays (as shown in FIGURE 3-2).
FIGURE 3-2 Example Display Setup Dialog
3.
Select a display preset from the list.
4.
Enter a preset password if prompted.
5.
Select the Edit button. The “Select an area from the grid on the left and choose a parameter
from the corresponding list that appears in this area.” message displays.
6.
Select an area on the grid to see a list of available parameters.
A list of digital or waveform parameters displays to the right of the grid (as shown in FIGURE 3-3).
NOTE:
3-8
The available parameters is dependent on whether a waveform tile or a
digital tile was selected in the grid.
0070-10-0727-02
V Series Operating Instructions
Display Setup
Display Options Dialog
FIGURE 3-3 Example Display Setup Grid (Overlap button disabled)
Select a parameter button.
7.
NOTE:
The arrow beside a parameter button (for example,
)
indicates that there is a submenu with additional choices available.
Select a parameter from the list to add it to the grid.
8.
OR
Select the Off button to leave that portion of the grid empty.
NOTE:
The HR parameter tile and the topmost ECG waveform tile cannot be
turned off.
Optional - repeat steps 7 and 8 until edits are complete.
9.
10. Select the Done button.
11. Select the Cancel or Accept button.
V Series Operating Instructions
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
0070-10-0727-02
3-9
Display Options Dialog
3.2.3
Display Setup
Overlapping Waveform
The V 12/V 21 display grid allows up to four IBPs, displayed in pairs of two, to overlap. The following
must occur before the Overlap button enables in the Display Setup dialog.
•
Requires at least two IBP channels
•
Second waveform must added to the waveform area in the grid
•
The IBP channels must be stacked in the grid (one on top of the other)
To add an overlapping IBP waveform to the display grid:
NOTE:
Refer to ‘‘IBP Tile Layouts’’ on page 11-11 for additional information.
1.
Select the Setup tab from the Navigation Area.
2.
Select the Display button, then select the Display Setup button.
3.
Select a preset from the list, then select the Edit button.
4.
Select a waveform area on the grid.
A list of waveform parameters display to the right of the grid (as shown in FIGURE 3-3).
5.
If there are currently no IBP waveform channels in the grid, add one.
6.
Add a second IBP waveform channel to the grid below the first IBP channel.
The Overlap button enables.
7.
Select the Overlap button.
The two waveform channels display in one grid cell instead of two cells.
8.
Optional - If adding a second set of overlapping waveforms, repeat step 7.
9.
Select the Done button.
10. Select the Cancel or Accept button.
3 - 10
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
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V Series Operating Instructions
Display Setup
3.2.4
Display Options Dialog
Changing IBP Waveform Overlap Settings
Change the configuration for either of the two overlapping IBP waveforms from the Main Screen.
Select the overlapping waveforms from the Main Screen to open the Overlapping Waveform
dialog (as shown in FIGURE 3-4).
1.
FIGURE 3-4 Example Overlapping Waveform Dialog
2.
Select one of the IBP channel buttons.
The respective IBP Waveform tab opens.
3.
Make the needed changes in the IBP dialog.
NOTE:
Select the Cancel or Accept button.
4.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Select the Accept button.
5.
3.2.5
Refer to ‘‘Configuring the IBP Waveform’’ on page 11-5 for additional
information.
Undoing an IBP Waveform Overlap
1.
Select the Setup tab from the Navigation Area.
2.
Select the Display button, then select the Display Setup button.
3.
Select the preset from the Display Presets list which contains the overlapping waveforms, then
select the Edit button.
4.
Select the overlapping waveforms tile.
5.
Select the Undo Overlap button.
6.
Select the Done button.
7.
Select the Cancel or Accept button.
V Series Operating Instructions
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
0070-10-0727-02
3 - 11
Display Modes
Display Setup
3.3
Display Modes
3.3.1
Privacy Mode
The Privacy Mode hides the patient data and suppresses alarm notification at the monitor while still
monitoring the patient. This feature is only available when a patient is connected to a central
monitoring system. The central station displays the patient data and provides alarm notification while
the patient monitor is in this mode. If communication with the central station is lost or a module is
added or removed, the monitor automatically exits the Privacy Mode. While in this mode, the display
alarm light or LED, located at the top of the monitor, may be enabled or disabled.
NOTE:
Refer to ‘‘Display Options Dialog’’ on page 3-2 for information.
NOTE:
This button is only available when the patient is being monitored at a central
monitoring station.
To enter Privacy Mode:
1.
Select the Setup tab from the Navigation Area.
2.
Select the Display button.
3.
Check or uncheck the Disable Alarm Light check box in the Display Options dialog.
NOTE:
Select the Privacy Mode button.
The display clears and the screen reads privacy mode.
4.
3.3.2
Selecting the Disable Alarm Light check box disables the alarm lights/
indicators. Refer to ‘‘V 12/V 21 Physical Views’’ on page 1-5 for
additional information.
Screen Lock Mode
The Screen Lock mode disables the touch screen for 10 seconds. Enter this mode if the display is
being cleaned. While in this mode, a timer countdown is shown indicating how much time is
remaining.
To enter Screen Lock mode:
3.3.3
1.
Select the Setup tab from the Navigation Area.
2.
Select the Display button
3.
Select the Screen Lock button.
The display indicates that the screen is locked and counts down the time remaining until it exits
the mode and returns to the Main Screen. The timeout is 10 seconds.
4.
Select the Cancel or Accept button.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Standby Mode
Refer to ‘‘Placing a Patient in Standby’’ on page 6-7 for additional information.
3.3.4
Discharge Mode
Refer to ‘‘Discharging a Patient’’ on page 6-5 for additional information.
3 - 12
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V Series Operating Instructions
Display Setup
3.3.5
Display Modes
View All ECG Mode
The View All ECG mode displays all the ECG waveforms available based on the lead set currently in
use. Enter this mode when using a 5 lead, 6 lead, or 12 lead.
To enter the View All ECG Mode:
3.3.6
1.
Select the Setup tab from the Navigation Area.
2.
Select the Display button, then select the View All ECG button.
The Display Options dialog automatically closes and the first six (6) ECG waveforms populate the
ECG waveforms tiles.
3.
Optional - If using a 12 lead set with the V 12, select the View All ECG button a second time to
view the next six (6) leads.
4.
To return to the display mode, continue to select the View All ECG button until the display mode
displays.
Changing Lead/Size
The Lead/Size dialog provides a vehicle to change the waveform size of the ECG waveforms at the
display when using more than three ECG leads.
NOTE:
The Lead/Size dialog can also be accessed from the Display Options
dialog. Refer to ‘‘Changing Lead/Size’’ on page 3-13.
1.
Select the Setup tab from the Navigation Area.
2.
Select the Display button, then select the Lead/Size button.
The Lead/Size dialog displays.
3.
Select the ECG lead by using the
and
scroll buttons. The leads available are based
and
scroll buttons. The waveform sizes available
on the lead set currently in use.
4.
Select the lead size by using the
are: 0.125 cm/mv, 0.25 cm/mv, 0.5 cm/mv, 1 cm/mv, 2 cm/mv, 4cm/mv.
5.
3.3.7
Select the Done button.
Touch Screen Calibration
NOTE:
Recalibrate the touch screen whenever the touch interface becomes difficult to
maneuver.
1.
Select the Setup tab from the Navigation Area.
2.
Select the Display button, then select the Touch Screen Calibration button.
3.
Touch and hold the areas where indicated. Release the area when indicated (as shown in
FIGURE 3-5).
V Series Operating Instructions
0070-10-0727-02
3 - 13
Display Modes
Display Setup
FIGURE 3-5 Example Calibration Display
Select the Cancel or Accept button.
4.
3 - 14
•
The Cancel button returns to the monitoring display without recalibrating.
•
The Accept button returns to the monitoring display and recalibrates the display.
0070-10-0727-02
V Series Operating Instructions
Display Setup
3.4
Display Options Troubleshooting
Display Options Troubleshooting
MESSAGE/PROBLEM
There is no image on the display.
REASON
SOLUTION
Monitor is off.
Turn monitor on.
Monitor is not properly seated in
V Dock.
Reseat monitor in V Dock.
Monitor is not plugged into
power source.
Plug monitor into power source.
Desired parameters do not
display on monitor.
Parameter(s) not included in
Display Preset.
Refer to ‘‘Configuring Display
Presets’’ on page 3-3 for
instructions on modifying the
preset.
Monitor is blank and reads
“standby mode.”
The Standby button was selected
in the Display Options dialog.
Touch the display to resume
monitoring.
Touch screen is difficult to
maneuver.
Display needs to be calibrated.
Refer to ‘‘Configuring Display
Presets’’ on page 3-3 for
instructions on touch screen
calibration.
Only see ECG leads in the
waveform tiles.
Display is in the View All ECG
mode.
Select the View All ECG button in
the Display Options dialog.
Overlap button in Display Setup
dialog not enabled.
A digital parameter tile is selected.
Select a waveform tile.
A waveform tile is selected but it
is not directly above or below
another IBP waveform channel.
Select a waveform tile that is
directly above or below an existing
IBP waveform channel.
V Series Operating Instructions
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Display Options Troubleshooting
Display Setup
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V Series Operating Instructions
4.0
Mechanical Functions
Introduction .......................................................................................................................................................... 4-2
V 12 ............................................................................................................................................................................. 4-2
V Dock....................................................................................................................................................................... 4-11
V 21 ............................................................................................................................................................................. 4-14
V Hub......................................................................................................................................................................... 4-17
Thermal Recorder .............................................................................................................................................. 4-20
Troubleshooting................................................................................................................................................. 4-22
V Series Operating Instructions
0070-10-0727-02
4-1
Introduction
4.1
Mechanical Functions
Introduction
This chapter describes the docking and undocking the V 12, battery installation, module installation,
the V Hub, and V Dock mounting.
4.2
V 12
1.
Hold the V 12 by the side grips, or top handle, and vertically lower it onto the top of the V Dock,
so that the alignment pins on the bottom of the V 12 engage with the alignment channel on
the top of the V Dock.
2.
Push the V 12 backward onto the V Dock, until the front latching bar moves upward, with a
corresponding audible click.
FIGURE 4-1
OR
4-2
1.
Reposition your hands so that your thumbs or palms press against the front surface of the V 12,
near the lower corners, and other fingers grip around the protrusions on the side of the V Dock.
2.
Squeeze your grip so that the V 12 moves backward onto the V Dock, until the front latching bar
moves upward, with a corresponding audible click.
0070-10-0727-02
V Series Operating Instructions
Mechanical Functions
V 12
FIGURE 4-2
4.2.1
V 12 Undocking
1.
Grab around both sides of the V 12, at the two side grip locations, with your palms firmly
pressing against front edges of the V 12, and your fingers staged to grip the side actuators.
2.
Close your grip against both actuators. The latching bar on the V Dock moves downward, then
the V 12 pushes forward on the V Dock.
3.
Lift the V 12 up and away from the V Dock.
FIGURE 4-3
V Series Operating Instructions
0070-10-0727-02
4-3
V 12
Mechanical Functions
4.2.2
Battery Installation
1.
With one finger, press against the finger grip on the battery door, then slide the door backward.
FIGURE 4-4
2.
With a finger, grab around the front edge of the door and swing it open.
FIGURE 4-5
3.
4-4
Reposition your hand against the inside surface of the door to keep it in the open position.
0070-10-0727-02
V Series Operating Instructions
Mechanical Functions
V 12
FIGURE 4-6
4.
With the other hand, pick up a battery and install it into one of the three revealed battery bays,
pushing it inward until the battery latch engages the battery, with a corresponding audible click.
(Avoid pressing against the circular button on the end of the battery, to avoid inadvertent
checking of battery charge.)
FIGURE 4-7
5.
V Series Operating Instructions
Swing the door toward the closed position, align the three tabs on the front edge of the door
with the three slots in the V 12 housing and, while pressing the door flush to the housing, slide
it forward, until it latches.
0070-10-0727-02
4-5
V 12
Mechanical Functions
FIGURE 4-8
4.2.3
Battery Removal
1.
With one finger, press against the finger grip on the battery compartment door, then slide the
door backward.
FIGURE 4-9
2.
4-6
Reposition your hand against the inside surface of the door to keep it in the open position.
0070-10-0727-02
V Series Operating Instructions
Mechanical Functions
V 12
FIGURE 4-10
3.
With the same or other hand, prepare to receive the desired battery by positioning your fingers
close or against the battery. Press downward against the release button adjacent to the desired
battery. The corresponding battery ejects from the battery bay. Grab it and remove it completely
from the V 12.
FIGURE 4-11
V Series Operating Instructions
FIGURE 4-12
0070-10-0727-02
4-7
V 12
Mechanical Functions
4.
Swing the door toward the closed position, align the three tabs on the front edge of the door
with the three slots in the V 12 housing and, while pressing the door flush to the housing, slide
it forward, until it latches.
FIGURE 4-13
4.2.4
Battery Charge Checking
•
Press the elastomeric button in the battery door that corresponds to the battery that you desire
to check, until the button on the end of the battery is actuated, with a corresponding click. The
charge status LED's on the end of the battery lights according to the amount of charge in the
battery, and is visible through the narrow window in the door.
FIGURE 4-14
4-8
0070-10-0727-02
V Series Operating Instructions
Mechanical Functions
4.2.5
V 12
Module Installation
•
Pick up a module and align it with a group of module bays on the V 12 sufficient to
accommodate the module. (For example, a VPS requires a set of three adjacent module bays.)
modules may be installed in either of two orientations (rotated 180º apart). Push the module
inward until the module latch engages the latching pins on the V 12, with a corresponding
audible click. (Avoid pressing against any circular buttons on the end of the module, to avoid
inadvertent actuation of the button function.)
FIGURE 4-15
V Series Operating Instructions
FIGURE 4-16
0070-10-0727-02
4-9
V 12
Mechanical Functions
4.2.6
Module Removal
1.
Grip around the desired module with your thumb positioned against the module release trigger
and your index finger (and/or other finger(s)) positioned in the large notch on the back of the
module.
2.
Depress the release trigger, and pull the module away from the V 12.
FIGURE 4-17
4 - 10
0070-10-0727-02
V Series Operating Instructions
Mechanical Functions
4.3
V Dock
V Dock
The V 12/V 21 V Dock is a physical mount for the monitor designed to provide a quick connection to
a rolling stand (for the V 12) or to a wall mount (for the V 21). Before mounting to either of these
peripheral devices, the V Dock must be mounted.
4.3.1
V Dock Mounting
1.
Pick up the V Dock, and align the metal mounting plate on the bottom of the V Dock with the
channel on the top of a wall mount or rolling stand, with both the front and the back edges of
the mounting plate beginning to slide sideways underneath the overhanging flanges of the
mounting channel.
NOTE:
The metal mounting plate is already affixed to the V Dock when it ships.
Mounting Plate
FIGURE 4-18
FIGURE 4-19
V Series Operating Instructions
0070-10-0727-02
4 - 11
V Dock
Mechanical Functions
2.
Pull down on the spring-loaded plunger near the front of the mounting channel, and slide the V
Dock sideways, ensuring that the front and back edges remain caught under the flanges of the
channel.
.
FIGURE 4-20
3.
4 - 12
As the V Dock approaches a centered position relative to the wall mount or rolling stand, release
V 21 the spring-loaded plunger. Continue to slide the V Dock sideways until the spring-loaded
plunger engages the notch in the mounting plate, with a corresponding audible click.
0070-10-0727-02
V Series Operating Instructions
Mechanical Functions
4.3.2
V Dock
V Dock Dismounting
1.
If a V 12 or V 21 is docked, undock it.
2.
Pull down on the spring-loaded plunger near the front of the mounting channel.
3.
Firmly grip the V Dock with the other hand and carefully slide it sideways until it is free of the
mounting channel.
V Series Operating Instructions
0070-10-0727-02
4 - 13
V 21
Mechanical Functions
4.4
V 21
4.4.1
V 21 Docking
NOTE:
Mount the V Dock to the wall mount before attempting to mount the
V 21. Refer to ‘‘V Dock’’ on page 4-11 for additional information.
CAUTION:
The V 21 is intended for mounting only.
1.
Hold the V 21 by the side grips, or top handle, and vertically lower it onto the top of the V Dock,
so that the alignment pins on the bottom of the V 21 engage with the alignment channel on
the top of the V Dock.
FIGURE 4-21
2.
4 - 14
FIGURE 4-22
Push the V 21 backward onto the V Dock, until the latch engages, with corresponding audible
click.
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V Series Operating Instructions
Mechanical Functions
V 21
FIGURE 4-23
V Series Operating Instructions
0070-10-0727-02
4 - 15
V 21
Mechanical Functions
4.4.2
V 21 Undocking
1.
Grab around both sides of the V 21, at the two side grip locations, with your palms firmly
pressing against front edges of the V 21, and your fingers staged to grip the side actuators.
FIGURE 4-24
2.
Close your grip against both actuators. The latch on the V Dock disengages, then the V 21
pushes forward from the V Dock.
3.
Lift the V 21 up and away from the V Dock.
FIGURE 4-25
4 - 16
0070-10-0727-02
V Series Operating Instructions
Mechanical Functions
V Hub
4.5
V Hub
4.5.1
V Hub Mounting
1.
Pick up and hold the V Hub by gripping it around one or both sides, and align the channel in the
mounting plate on the back of the V Hub with the cleat on a wall mount post, or on the front of
a rolling stand, with both the left and the right flanges of the channel beginning to slide
vertically over the flanges of the mounting cleat.
FIGURE 4-26
2.
4.5.2
4.5.3
Continue to slide the V Hub downward, ensuring that the flanges remain engaged, until the
spring-loaded latch engages, with a corresponding audible click.
V Hub Dismounting
1.
Grab the V Hub around both sides and, with the right hand, forcefully squeeze against the lever
of the mounting plate on the back of the V Hub.
2.
Carefully slide the V Hub upward until the mounting plate is free of the mounting cleat on the
wall mount or rolling stand.
Module Installation
1.
Look at the "locked/unlocked" indicator near the top left corner of the V Hub, and confirm that it
is in the unlocked position (with green background). If not, then follow the instructions for
Module Unlocking.
2.
Pick up a module and align it with a group of module bays on the V Hub sufficient to
accommodate the module. (For example, a VPS requires a set of three adjacent module bays.)
Modules may be installed in either of two orientations (rotated 180º apart). Push the module
inward until the module latch engages the latching pins on the V Hub, with a corresponding
audible click. (Avoid pressing against any circular buttons on the end of the module, to avoid
inadvertent actuation of the button function.)
V Series Operating Instructions
0070-10-0727-02
4 - 17
V Hub
4.5.4
Mechanical Functions
Module Removal
1.
Look at the "locked/unlocked" indicator near the top left corner of the V Hub, and confirm that it
is in the unlocked position (with green background). If not, then follow the instructions for
Module Unlocking.
2.
Grip around the desired module with your thumb positioned against the module release trigger
and your index finger (and/or other finger(s)) positioned in the large notch on the back of the
module.
FIGURE 4-27
3.
4 - 18
Depress the release trigger, and pull the module away from the V Hub.
0070-10-0727-02
V Series Operating Instructions
Mechanical Functions
4.5.5
V Hub
Module Locking
•
Insert the edge of a thin coin into the slot on the face of the lock on the bottom of the V Hub, and
turn it clockwise, until the "locked" symbol (with red background) appears. [This prevents any
modules from being installed in or removed from all bays of the V Hub.]
FIGURE 4-28
4.5.6
FIGURE 4-29
Module Unlocking
•
Insert the edge of a thin coin into the slot on the face of the lock on the bottom of the V Hub, and
turn it counterclockwise, until the unlocked symbol (with green background) appears. [This
allows modules to be installed in or removed from all bays of the V Hub.]
FIGURE 4-30
V Series Operating Instructions
FIGURE 4-31
0070-10-0727-02
4 - 19
Thermal Recorder
Mechanical Functions
4.6
Thermal Recorder
4.6.1
Installing the Thermal Recorder Paper
1.
Turn the recorder module upside down. Press the button to open the recorder door (as shown
in FIGURE 4-32).
FIGURE 4-32
2.
Locate the paper guides inside of the recorder (as shown in FIGURE 4-33).
FIGURE 4-33
4 - 20
0070-10-0727-02
V Series Operating Instructions
Mechanical Functions
Thermal Recorder
3.
Place the thermal paper roll between the paper guides and gently press down until the paper is
seated between the guides (as shown in FIGURE 4-34). Once installed, pull the paper to ensure it
rolls out smoothly.
NOTE:
Insert the paper with the shiny side of paper facing upwards.
FIGURE 4-34
4.
Close the recorder door (as shown in FIGURE 4-35).
FIGURE 4-35
5.
V Series Operating Instructions
Optional - insert the recorder in the V Hub or internal module bay.
0070-10-0727-02
4 - 21
Troubleshooting
4.7
Mechanical Functions
Troubleshooting
MESSAGE/PROBLEM
REASON
SOLUTION
Recorder strips are blank
Paper was inserted incorrectly.
Reinsert paper with shiny side of
paper facing upwards.
You can’t select multi same IBP
channel or temperature
channel.
Cannot use the same label twice.
Change the channel label to one
not currently in use.
Module indicator light is orange
Module is only partially seated in
V Hub.
Remove module and insert again
with more force.
Module is resetting or was just
inserted.
Wait until indicator light displays
green.
*
4 - 22
Display messages are shown in bold text.
0070-10-0727-02
V Series Operating Instructions
5.0
Module Configuration
Module Status Dialog...................................................................................................................................... 5-2
V Series Operating Instructions
0070-10-0727-02
5-1
Module Status Dialog
5.1
Module Configuration
Module Status Dialog
Depending on the patient’s needs, different modules will need to be inserted and/or removed from
the V Hubs (integrated V Hub or free standing racks). The V 12 has a integrated V Hub that can hold
up to three (3) 1x modules once the VPS (which is required) is inserted. The number of modules the
rack can hold depends on which modules are in use. For example, 1x modules occupy one V Hub
position. The CO2 module is a 2x module which occupies two V Hub positions. The VPS is a 3x
module and occupies three positions in the V Hub.
NOTE:
The V 12/V 21 allows for a maximum of three racks, including the
integrated rack in the V 12.
FIGURE 5-1 Example Module Status Dialog
The Module Status dialog provides the following functionality:
•
Current state of each V Hub and each module bay
•
Where each module is positioned in the rack
NOTE:
5-2
The order in which the modules display in the Module Status dialog is
exactly how they are positioned in the V Hub.
•
Indicates whether an inserted module is functioning without error
•
Provides ability to disable and enable a module
•
Provides ability to view the assigned channel for an IBP and Temperature module.
•
Provides ability to assign a channel to an IBP and Temperature modules.
0070-10-0727-02
V Series Operating Instructions
Module Configuration
5.1.1
Module Status Dialog
Navigating to the Module Status Dialog
Select the
1.
icon in the upper right corner of the Main Screen to open the Module Status
dialog (as shown in FIGURE 5-1).
2.
Select the Rack 3 and Rack 4 tabs to find the needed module.
3.
Ensure that all the modules needed indicate “On” beside the module identifier.
NOTE:
5.1.2
Active modules are also indicated by a green light indicator in the
upper left corner of the Module Status dialog. Partially installed
modules or modules first inserted are indicated with an orange
indicator light in the upper left corner of the Module Status dialog.
Enabling/Disabling a Module
1.
From the Module Status dialog, select the
A menu displays.
2.
Select On/Off from the menu.
3.
Select the Accept button.
NOTE:
5.1.3
icon beside the module name.
When the module indicator light is green, the module is enabled. When
the module indicator light is amber/orange, the module is disabled.
Changing an IBP or Temperature Module Channel
1.
From the Module Status dialog, select the tab which contains the module requiring a channel
change.
2.
Select the
3.
Select the desired channel.
NOTE:
arrow icon to display a list menu.
The channel number on the module
changes when the
channel number is selected in the Module Status dialog.
NOTE:
Select the Cancel or Accept button.
4.
V Series Operating Instructions
If the message “You can’t select multi same IBP channel or temperature
channel.” displays, this indicates that the selected channel is already in
use.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
0070-10-0727-02
5-3
Module Status Dialog
5.1.4
Module Configuration
VPS Synchronization
The VPS is a device designed to acquire and store up to 12 hours of real-time vital sign data. This
module can easily be moved with the patient between V 12/V 21 displays without removing the
patient connections. When a VPS is moved to a monitor where the patient ID does not match the
patient ID of the VPS, VPS synchronization is required. VPS synchronization ensures that the 12 hours
of patient data, patient settings, and display settings stored on the VPS and the monitor remain
current.
Synchronization is automatic and occurs after the VPS is inserted into the V Hub or V 12 internal
module and a mismatch is identified (as shown in FIGURE 5-2). The dialog provides three choices.
Each is described as follows.
FIGURE 5-2 Patient ID Mismatch Dialog
Monitor
Selecting this button copies 12 hours of patient data, patient settings, and display settings from the
monitor to the VPS clearing any previous data.
VPS
Selecting this button copies 12 hours of patient data, patient settings, and display settings from the
VPS to the monitor clearing any previous data.
New Patient
Selecting the New Patient button clears all previous patient data, patient settings, and patient
settings contained on the monitor and the VPS, and all monitor display settings are reset to the
departmental defaults.
5-4
0070-10-0727-02
V Series Operating Instructions
6.0
Patient Management
Introduction .......................................................................................................................................................... 6-2
Patient Info Dialog............................................................................................................................................. 6-2
Patient Management Troubleshooting ............................................................................................... 6-8
V Series Operating Instructions
0070-10-0727-02
6-1
Introduction
6.1
Patient Management
Introduction
The V 12/V 21 comes with default factory settings which enable a clinician to begin monitoring
without setting any of the waveforms, parameters, alarms, or functions. However, all of these settings
can be changed for specific patient or departmental needs.
NOTE:
6.2
Certain operating characteristics are based on the selected patient size
(e.g. NIBP start pressure). Match the patient size selection to the actual
patient before monitoring begins.
Patient Info Dialog
The Patient Info dialog (as shown in FIGURE 6-1) contains a Demographics tab, Room/Bed tab, and
a Transfer/Discharge tab. A description of each tab follows.
6.2.1
Navigating to the Patient Info Dialog
1.
Select the Header Bar (located above the top waveform).
The Patient Info dialog displays (as shown in FIGURE 6-1).
OR
2.
Select the Setup tab from the Navigation Area.
3.
Select the Patient Info button.
The Patient Info dialog displays (as shown in FIGURE 6-1).
FIGURE 6-1 Example Patient Info Dialog (Demographics Tab)
6-2
0070-10-0727-02
V Series Operating Instructions
Patient Management
6.2.2
Patient Info Dialog
Admitting a Patient
NOTE:
1.
Turn the monitor on using the ON/OFF switch located on the lower right of the monitor.
NOTE:
Refer to ‘‘V 12/V 21 Physical Views’’ on page 1-5 for additional
information and location of ON/OFF switch.
NOTE:
Remove the previous patient’s data by discharging the patient before
admitting the new patient. Refer to ‘‘Discharging a Patient’’ on page 6-5
for additional information.
2.
6.2.3
When connected to a central monitoring system (i.e., central station), a
patient admission at the V 12/V 21 bedside monitor also admits the
patient to the central station. Refer to the central station operating
instructions for additional information.
Connect the patient to the monitor and apply the appropriate accessories such as ECG
electrodes, blood pressure cuff, etc.
Patient Demographics
To enter or edit patient information after admission in the Demographics tab.
1.
Select the Header Bar (located above the top waveform) to display the Patient Info dialog.
By default, the Demographics tab selects.
2.
Select the applicable button to begin entering or editing. Refer to TABLE 6-1 for a description of
each button.
NOTE:
When connected to a central monitoring system (i.e., central station),
the following fields are updated at the central station whenever they
are entered or edited at the V 12/V 21 beside monitor: Patient Size, ID,
Bed, Year, Month, Day (date of birth), Gender, and Height. Refer to the
central station operating instructions for additional information.
TABLE 6-1
BUTTON
SELECTIONS
COMMENTS
Patient Size
Adult
Pediatric
Neonate
Select to enter the patient size.
Verify monitoring settings when the patient size is changed.
NOTE:
The selected patient size remains after power down and discharge.
NOTE:
A confirmation dialog displays if you change patient size. Verify
monitoring settings when the patient size is changed.
ID
None
Select to enter or change Patient ID.
Accepts up to 15 alphanumeric characters.
Last Name
None
Select to enter or change patient’s last name.
Accepts up to 15 alphabetic characters.
Factory default is a blank value.
First Name
None
Select to enter or change patient’s first name.
Accepts up to 15 alphabetic characters.
Factory default is a blank value.
Factory default is a blank value.
*
V Series Operating Instructions
Default values display in bold.
0070-10-0727-02
6-3
Patient Info Dialog
Patient Management
TABLE 6-1 (Continued)
BUTTON
SELECTIONS
COMMENTS
Gender
Unspecified
Male
Female
Select to enter or change patient gender.
Height
Unspecified
Select to enter or change patient’s height.
Factory default is a blank value.
Weight
Unspecified
Select to enter or change patient weight.
Factory default is a blank value.
Year
None
Year choices are from 1891 through current year.
Factory default is a blank value.
Month
None
Factory default is a blank value.
Day
None
Factory default is a blank value.
*
Default values display in bold.
Select the Cancel or Accept button.
3.
6.2.4
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Patient Room and Bed
Enter or edit the patient’s location information using the buttons in the Room/Bed tab.
NOTE:
6-4
Refer to the Chapter 2.0 Getting Started for specific instructions on how
to use the keyboards, keypads, etc.
1.
Select the Header Bar (located above the top waveform).
The Patient Info dialog displays.
2.
Select the Room/Bed tab (as shown in FIGURE 6-2).
0070-10-0727-02
V Series Operating Instructions
Patient Management
Patient Info Dialog
.
FIGURE 6-2 Example Patient Info Dialog (Room/Bed Tab)
Select the applicable button to begin entering or editing. Refer to TABLE 6-2 for a description of
each button.
3.
TABLE 6-2
BUTTON
SELECTIONS
COMMENTS
Room
None
Select to enter the patient’s alphanumeric room
number.
Factory default is a blank value.
Bed
None
Select to enter the patient’s alpha digital bed number.
Factory default is a blank value.
Select the Cancel or Accept button.
4.
6.2.5
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Discharging a Patient
Discontinue monitoring a patient by discharging them from the monitor. Discharging a patient clears
all their historical data from the monitor.
NOTE:
When connected to a central monitoring system (i.e., central station), a
patient’s discharge from the V 12/V 21 bedside monitor also discharges
the patient from the central station. Refer to the central station
operating instructions for additional information.
1.
Select the Header Bar (located above the top waveform).
The Patient Info dialog displays.
2.
Select the Transfer/Discharge tab (as shown in FIGURE 6-3).
V Series Operating Instructions
0070-10-0727-02
6-5
Patient Info Dialog
Patient Management
FIGURE 6-3 Example Patient Info (Transfer/Discharge Tab)
3.
Select Discharge. A confirmation dialog displays the message Are you sure you want to
discharge? This will restore the defaults for all settings and clear history data.
4.
Select No or Yes.
•
Selecting No cancels the operation.
•
Selecting Yes does the following:
•Returns to the Discharge dialog
•Discharge occurs at the local monitor and the central station (if applicable).
•All patient data and trends are cleared.
•Default departmental settings are restored.
6.2.6
Clearing Patient History
To clear a patient’s history without discharging them from the monitor:
6-6
1.
Select the Header Bar (located above the top waveform).
The Patient Info dialog displays.
2.
Select the Transfer/Discharge tab, then select the Clear History button.
3.
A confirmation dialog displays the message Are you sure you want to clear the history data
of this patient?
4.
Select No or Yes.
0070-10-0727-02
V Series Operating Instructions
Patient Management
6.2.7
Patient Info Dialog
Placing a Patient in Standby
NOTE:
When connected to a central monitoring system (i.e., central station),
and a patient is moved or removed from standby at the V 12/V 21
bedside monitor, the patient is moved or removed from standby at the
central station. Refer to the central station operating instructions for
additional information.
To enter the standby mode:
1.
Select the Header Bar (located above the top waveform).
The Patient Info dialog displays.
2.
Select the Transfer/Discharge tab, then select the Standby button.
Placing a patient in the standby mode does the following:
6.2.8
•
Temporarily suspends patient monitoring
•
Places alarms in permanent suspension
•
Places interval NIBP measurements in Pause mode
•
Shuts off the CO2 pump
•
Shuts down the display
Exiting the Standby Mode
•
To exit the standby mode, select the touch screen. When in the standby mode, the message
Touch screen to resume monitoring displays.
When exiting from the standby mode to the monitoring mode, the monitor responds as follows:
V Series Operating Instructions
•
Restores parameter measurement as previously configured.
•
Arrhythmia automatically relearns.
•
NIBP measurement does not automatically start. Restart NIBP measurements via the Start
button.
•
Restores normal data storage.
•
The CO2 pump automatically reactivates provided the sensor is in place.
•
All the alarms are activated.
•
The display settings are maintained during standby mode.
•
The monitor notifies the central station and other monitors when back in monitoring mode.
0070-10-0727-02
6-7
Patient Management Troubleshooting
6.3
Patient Management
Patient Management Troubleshooting
l
MESSAGE/PROBLEM
REASON
SOLUTION
The Month and Day buttons are
disabled in the Patient Info
dialog.
The birth year needs to be
entered first.
Select the Year button to enter the
birth year, then the Month button
enables once entered, followed by
the Day button.
The entered string is invalid.
Only alpha characters may be
entered.
Use the Delete key in the keyboard
dialog to remove the invalid
character(s), then reenter.
Units in weight keypad are set to
kg.
The kg key is selected in the
keypad.
Select the lb key in the keypad to
change units to pounds, then
select the Enter key.
Units in height keypad are set to
cm.
The cm key is selected in the
keypad.
Select the inch key in the keypad
to change units to inches, then
select the Enter key.
Value out of range
An invalid value was entered in
the keypad.
The acceptable range displays
above the text box. Observe the
range, then enter a value within
the range.
*
6-8
Display messages are shown in bold text.
0070-10-0727-02
V Series Operating Instructions
7.0
Alarm Behavior
General Alarm Behavior................................................................................................................................. 7-2
Physiological Alarms ....................................................................................................................................... 7-2
Technical Alarms ................................................................................................................................................ 7-4
V Series Operating Instructions
0070-10-0727-02
7-1
General Alarm Behavior
7.1
Alarm Behavior
General Alarm Behavior
The V 12/V 21 uses alarms to send notification when a patient’s physiological status changes, a
patient has a specific technical issue, or when there is a system violation. When a patient is first
admitted, the default system alarm settings are in effect. Modify individual patient alarm settings by
using the Alarms tab in the individual parameter dialogs. By default, alarm settings send notification
using:
•
Visual indicators
•
Audible indicators
The three alarm types used in this system include physiological, technical, and system.
7.2
Physiological Alarms
Physiological alarms indicate a violation of a monitored patient's physiological alarm thresholds or
arrhythmia analysis settings.
NOTE:
7.2.1
Refer to ‘‘Alarms’’ on page 8-1 for additional information.
Alarm Behaviors
The visual and audio indicators associated with a physiological alarm are:
Visual Indicators
Visual indicators provide visual notification when an alarm threshold is violated. When a physiological
alarm condition is triggered, the digital data portion of the patient tile flashes (if the alarm priority is
set to high or medium), a text message displays in the digital tile, and, if configured, the alarm light
indicators flash, unless it is a low level alarm, in the corresponding alarm response color. The
physiological alarm behavior varies depending on the parameter, and on the alarm priority
associated with the parameter.
Audio Indicators
Audio indicators provide audible notification when an alarm threshold is violated. Audio indicators
may vary depending on the alarm severity, alarm type, system setup and configuration.Audio alarms
are triggered by:
•
The onset of an alarm condition, provided the alarm delay is not active.
•
A configured alarm delay, if alarm delay is active.
Once the alarm condition is resolved and/or silenced, the audible alarm stops, unless the alarm is
latched.
7.2.2
Alarm Options
The alarm options associated with a parameter dictate how the system responds when an alarm
occurs.
Latching
Alarm latching denotes that the audio and visual indicators, associated with an alarm condition, do
not automatically stop after resolving the patient alarm condition. After resolving the condition, it
must be acknowledged or the audio and visual alarm indicators continue.
The Navigator Area’s Silence button temporarily silences the alarm condition for the configured time
period. However, if that latched alarm is not acknowledged during the configured time period, the
alarm indicators resume.
7-2
0070-10-0727-02
V Series Operating Instructions
Alarm Behavior
Physiological Alarms
To acknowledge a latched alarm condition, once the condition is resolved, select the Silence or
Silence All button from the Navigator Area.
Apnea Latching
The conditions for apnea latching follow standard latching procedures, however apnea latching is
associated with an apnea alarm condition. This option can be enabled/disabled in the Respiration
dialog’s Apnea tab. The apnea latching factory default setting is Off.
NOTE:
Refer to ‘‘Configuring Apnea Alarms’’ on page 10-5 for additional
information.
Audio Alarm Delay
Audio Alarm Delay is the configurable time period required before an alarm sound triggers. Alarm
Audio Delay does not effect the Apnea Alarm, ST Alarms, the non-lethal arrhythmia alarms, or the
lethal arrhythmia alarms. When permitted, this option can be enabled/disabled in the Alarm Setup
dialog.
7.2.3
Physiological Alarm Responses
The alarm responses associated with a physiological alarm are as follows:
7.2.3.1
Alarm Levels
The V 12/V 21 supports three alarm levels. When an alarm level is turned on, the choices available are
high, medium, and low. Alarms may be turned off by selecting the All Off button in the respective
parameter dialog’s Alarms tab. Alarm priorities associated with lethal alarms cannot be changed
from their default value of high. However, all other parameters can be modified. The alarm level used
to configure a parameter defines the alarm severity.
When a parameter’s alarm level is turned off, there are no visual or audio alarm indicators associated
with the alarm event, however Nurse Call is still available if it was enabled in the System setup.
NOTE:
Refer to ‘‘Configuring the General Tab’’ on page 25-4 for more
information about Nurse Call.
High Level Alarms
High level alarms are the most severe alarm type. Lethal-arrhythmia alarms (for example, Asystole, VTach, and V-Fib) are automatically configured as high level alarms and cannot be modified. High level
alarm conditions cause the applicable parameter digital tile to flash in red, display a red text message
in the parameter tile message area, use a high level alarm sound, and if configured, the alarm light
indicator flashes in the corresponding alarm response color. A parameters’ alarm limit is configured in
the respective parameter dialog’s Alarms tab.
Medium Level Alarms
Medium level alarms are less severe than high level alarms, and have different visual and audio
indicators. Medium level alarm conditions cause the applicable parameter digital tile to flash in
yellow (for a physiological alarm), display a yellow text message in the parameter tile message area (if
alarm delay is not enabled), use a low level alarm sound, and if configured, the alarm light indicator
flashes in the corresponding alarm response color. A parameters’ alarm limit is configured in the
respective parameter dialog’s Alarms tab.
V Series Operating Instructions
0070-10-0727-02
7-3
Technical Alarms
Alarm Behavior
Low Level Alarms
Low level alarms are the least severe of the three alarm levels. Low level alarm conditions cause the
applicable parameter digital tile to flash in yellow (for a physiological alarm), display a yellow text
message in the parameter tile message area (if alarm delay is not enabled), use a low level alarm
sound, and if configured, the alarm light indicator flashes in the corresponding alarm response color.
A parameters’ alarm limit is configured in the respective parameter dialog’s Alarms tab.
All Off
Any alarm levels can be turned off, including lethal alarms. Parameters configured to use All Off do
not have any visual or audio alarm indicators, however, Nurse Call still functions.
7.3
Technical Alarms
Technical alarms are patient specific and are related to technical issues that occur with cables, leads,
and parameter sensors.
7.3.1
Alarm Behaviors
The visual and audio indicators associated with a technical alarm are as follows:
Visual Indicators
Technical visual indicators display as white text messages in the parameter tile’s message area.
Audio Indicators
Technical alarm sounds are unique to other alarm types.
7-4
0070-10-0727-02
V Series Operating Instructions
8.0
Alarms
Alarms Dialog....................................................................................................................................................... 8-2
Alarm Limits .......................................................................................................................................................... 8-2
Alarm Responses................................................................................................................................................ 8-10
Arrhythmia Alarms ............................................................................................................................................ 8-14
Alarm Setup........................................................................................................................................................... 8-18
Alarms Troubleshooting................................................................................................................................ 8-19
V Series Operating Instructions
0070-10-0727-02
8-1
Alarms Dialog
8.1
Alarms
Alarms Dialog
This chapter discusses how to configure alarms through the Alarms tab. The choices are Limits,
Responses, Arrhythmia, and Alarm Setup. A description of each tab follows.
8.1.1
Navigating to the Alarms Dialogs
1.
Select the Alarms tab from the Navigation Area.
2.
Select one of the buttons to access the respective alarm dialog.
8.2
Alarm Limits
8.2.1
Configuring Alarm Limits
NOTE:
When connected to a central monitoring system (i.e., central station),
entered or edited alarm limits made at the V 12/V 21 are transferred to
the central station. Refer to the central station operating instructions
for additional information.
Use the Alarm Limits tab to set the parameter’s high and low alarm limit thresholds. Alarms are
triggered when the alarm limit is equal to or exceeds the high or low configured alarm limit for the
parameter.
To access the alarm limits dialog from any parameter tile:
1.
Select the respective parameter tile to open the parameter dialog.
2.
Select the Alarms tab.
An alarm limits dialog displays similar to FIGURE 8-1.
FIGURE 8-1 Example HR Alarm Limits Dialog
8-2
0070-10-0727-02
V Series Operating Instructions
Alarms
Alarm Limits
Select the high or low alarm limit button or select the Auto-Set button.
3.
NOTE:
When first entering the dialog, the high limit is selected.
NOTE:
Refer to ‘‘Auto-Set All Alarms Button’’ on page 8-9 for additional
information.
NOTE:
Before setting the alarm limits, refer to ‘‘Factory Default Alarm Limits’’
on page 8-4 for additional information.
Use the keypad to enter the high and low alarm limit button or select Off using the keypad.
TABLE 8-1 describes the keypad button. The Enter key changes to green after a value is entered.
4.
NOTE:
The alarm limit range is indicated in italics above the alarm limit text
box.
TABLE 8-1
BUTTON
DESCRIPTION
Clear
Erases the keypad entry.
Enter
Accepts the keypad entry.
Auto-Set
Auto configures the parameter alarm limit high and low values based on the
individual parameter specifications.
Default
Auto configures all the parameter’s limits to the departmental defaults.
All Off
Turns off all the parameter’s alarm limits.
Select the Enter key to save the alarm limit.
5.
NOTE:
The pop-up message “Value out of range” displays if the entered alarm
limit is outside the alarm limit range.
Select the Cancel or Accept button.
6.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
To access the alarm limits dialog from the Navigation Area:
1.
Select the Alarms tab from the Navigation Area.
2.
Select the Limits button.
The Alarm Limits dialog displays (as shown in FIGURE 8-2).
V Series Operating Instructions
0070-10-0727-02
8-3
Alarm Limits
Alarms
FIGURE 8-2 Example Alarm Limits Dialog (ECG/Resp Tab)
3.
Select the applicable alarm group tab: ECG/Resp, Pressure, Temp or SpO2/Gases. For example,
to change the NIBP alarm limits, select the Pressure tab.
4.
Select applicable parameter button to set the alarm limits for the individual parameter.
5.
Follow steps 3 through 6 in the ‘‘Configuring Alarm Limits’’ on page 8-2.
8.2.2
Factory Default Alarm Limits
8.2.2.1
ECG/Resp Tab
TABLE 8-2 lists the alarm limit ranges for the parameters contained in the ECG/Resp tab.
TABLE 8-2
PARAMETER
HR
Unit of Measure: bpm
Resolution: 1 bpm
Invalid data: “- -”
ALARM
LIMIT
ADULT
PEDIATRIC
NEONATE
High Limit
Off, 50 to 300
Default other: 150
Default France: 120
Off, 50 to 300
Default other: 180
Default France: 150
Off, 50 to 350
Default other: 200
Default France: 175
Low Limit
Off, 25 to 200
Default other: 50
Default France: 30
Off, 25 to 200
Default other: 80
Default France: 50
Off, 25 to 200
Default other: 90
Default France: 70
NOTE:
8-4
When the V 12/V 21 language is configured to French, the Heart Rate
(HR) high/low alarm limit cannot be turned Off.
0070-10-0727-02
V Series Operating Instructions
Alarms
Alarm Limits
TABLE 8-2
ALARM
LIMIT
PARAMETER
ST Single
Unit of Measure: mm
Resolution: 0.1mm
Invalid data: “- -”
ST Dual
Unit of Measure: mm
Resolution: 0.1mm
Invalid data: “- -”
Resp
Unit of Measure: RPM
Resolution: 1RPM
Invalid data: “- -”
Apnea Alarm
ADULT
PEDIATRIC
NEONATE
High Limit
Off, +.5 to +10.0
Default: Off
Off, +.5 to +10.0 Default:
Off
N/A
Low Limit
Off, -.5 to -10.0 Default:
Off
Off, -.5 to -10.0 Default:
Off
N/A
High Limit
Off, +.5 to +10.0
Default: Off
Off, +.5 to +10.0 Default:
Off
N/A
Low Limit
Off, -.5 to -10.0 Default:
Off
Off, -.5 to -10.0 Default:
Off
N/A
High Limit
Off, 10 to 190
Default: Off
Off, 10 to 190
Default:Off
Off, 10 to 190
Default:Off
Low Limit
Off, 5 to 50
Default: Off
Off, 5 to 50
Default:Off
Off, 5 to 50
Default:Off
NOTE:
Apnea Latch
Apnea Delay
Unit of Measure: seconds
Resolution: 1second
8.2.2.2
N/A
Refer to ‘‘Configuring Apnea Alarms’’ on page 10-5 for additional
information.
10 to 60
Default: 30
10 to 20
Default: 15
10 to 20
Default: 15
Pressure Tab
TABLE 8-3 lists the alarm limit ranges for the parameters contained in the Pressure tab.
TABLE 8-3
PARAMETER
NIBP
Unit of Measure: mmHg
Resolution: 1 mmHg
Invalid data: “- -”
V Series Operating Instructions
ALARM
LIMIT
ADULT
PEDIATRIC
NEONATE
High Systolic
Limit
Off, 40 to 240
Default: Off
Off, 30 to 140
Default: Off
Off, 30 to 100
Default: Off
Low Systolic
Limit
Off, 30 to 150
Default: Off
Off, 20 to 120
Default: Off
Off, 20 to 90
Default: Off
High
Diastolic
Off, 40 to 150
Default: Off
Off, 30 to 120
Default: Off
Off, 30 to 90
Default: Off
0070-10-0727-02
8-5
Alarm Limits
Alarms
TABLE 8-3
ALARM
LIMIT
PARAMETER
IBP 1-8
Unit of Measure: mmHg
Resolution: 1 mmHg
Invalid data: “- -”
8.2.2.3
ADULT
PEDIATRIC
NEONATE
Low
Diastolic
Off, 20 to 140
Default: Off
Off, 20 to 100
Default: Off
Off, 10 to 80
Default: Off
High
Mean
Off, 60 to 200
Default: Off
Off, 30 to 140
Default: Off
Off, 30 to 90
Default: Off
Low
Mean
Off, 20 to 150
Default: Off
Off, 20 to 100
Default: Off
Off,10 to 70
Default: Off
High Systolic
Limit
Off, 5 to 300
Default: Off
Off, 5 to 300
Default: Off
Off, 5 to 300
Default: Off
Low Systolic
Limit
Off, 0 to 150
Default: Off
Off, 0 to 150
Default: Off
Off, 0 to 150
Default: Off
High
Diastolic
Off, 5 to 200
Default: Off
Off, 5 to 200
Default: Off
Off, 5 to 200
Default: Off
Low
Diastolic
Off, 0 to 150
Default: Off
Off, 0 to 150
Default: Off
Off, 0 to 150
Default: Off
High
Mean
Off, 5 to 200
Default: Off
Off, 5 to 200
Default: Off
Off, 5 to 200
Default: Off
Low
Mean
Off, 0 to 150
Default: Off
Off, 0 to 150
Default: Off
Off, 0 to 150
Default: Off
Temp Tab
TABLE 8-4 lists the alarm limit ranges for the parameters contained in the Temp tab.
TABLE 8-4
PARAMETER
Temperature (T1-T3)
Unit of Measure: F°
Resolution: 1 F°
Invalid data: “- -”
8-6
ALARM
LIMIT
ADULT
PEDIATRIC
NEONATE
High Limit
Off, 77 to 113°
Default: Off
Off, 77 to 113°
Default: Off
Off, 77 to 113°
Default: Off
Low Limit
Off, 59 to 104°
Default: Off
Off, 59 to 104°
Default: Off
Off, 59 to 104°
Default: Off
0070-10-0727-02
V Series Operating Instructions
Alarms
Alarm Limits
TABLE 8-4
PARAMETER
Temperature (T1-T3)
Unit of Measure: C°
Resolution: 1 C°
Invalid data: “- -”
Delta Temperature
Unit of Measure: F°
Resolution: 1 F°
Invalid data: “- -”
Delta Temperature
Unit of Measure: C°
Resolution: C°
Invalid data: “- -”
TBlood
Unit of Measure: F°
Resolution: 1 F°
Invalid data: “- -”
TBlood
Unit of Measure: C°
Resolution: 1C°
Invalid data: “- -”
V Series Operating Instructions
ALARM
LIMIT
ADULT
PEDIATRIC
NEONATE
High Limit
Off, 25 to 45°
Default: Off
Off, 25 to 45°
Default: Off
Off, 25 to 45°
Default: Off
Low Limit
Off, 15 to 40°
Default: Off
Off, 15 to 40°
Default: Off
Off, 15 to 40°
Default: Off
High Limit
Off, 1 to10°
Default: Off
Off, 1 to 10°
Default: Off
Off, 1 to10°
Default: Off
Low Limit
N/A
N/A
N/A
High Limit
Off, 0 to 10°
Default: Off
Off, 0 to 10°
Default: Off
Off, 0 to10°
Default: Off
Low Limit
Off, 0 to 10°
Default: Off
Off, 0 to 10°
Default: Off
Off, 77to113°
Default: Off
High Limit
Off, 95 to 110°
Default: Off
Off, 95 to 110°
Default: Off
N/A
Low Limit
Off, 80 to 100°
Default: Off
Off, 80 to 100°
Default: Off
N/A
High Limit
Off, 35 to 43°
Default: Off
Off, 35 to 43°
Default: Off
N/A
Low Limit
Off, 26 to 38°
Default: Off
Off, 26 to 38°
Default: Off
N/A
0070-10-0727-02
8-7
Alarm Limits
Alarms
8.2.2.4
SpO2/Gases Tab
TABLE 8-5 lists the alarm limit ranges for the parameters contained in the SpO2/Gases tab.
TABLE 8-5
PARAMETER
SpO2
Unit of Measure:%
Resolution: 1%
Invalid data: “- -”
CO2 ET
Unit of Measure: mmHg
Resolution: 1 mmHg
CO2 ET
Unit of Measure:%
Resolution: 0.1%
CO2 ET
Unit of Measure: kPa
Resolution: 0.1 kPa
CO2 INS
Unit of Measure: mmHg
Resolution: 1 mmHg
CO2 INS
Unit of Measure:%
Resolution: 0.1%
8-8
ALARM
LIMIT
ADULT
PEDIATRIC
NEONATE
High Limit
Off, 75 to 101
Default: 101
Off, 75 to 101
Default: 101
Off, 75 to 101
Default: 101
Low Limit
70 to 99
Default: 88
70 to 99
Default: 90
70 to 99
Default: 92
High Limit
20 to 80
Default:60
20 to 80
Default:60
20 to 80
Default:60
Low Limit
5 to 50
Default:15
5 to 50
Default:15
5 to 50
Default:15
High Limit
2 to 10
Default:10
2 to 10
Default:10
2 to 10
Default:10
Low Limit
1 to 6
Default:2
1 to 6
Default:2
1 to 6
Default:2
High Limit
2 to 10
Default:10
2 to 10
Default:10
2 to 10
Default:10
Low Limit
1 to 6
Default:2
1 to 6
Default:2
1 to 6
Default:2
High Limit
5 to 30
Default:10
5 to 30
Default:10
5 to 30
Default:10
Low Limit
N/A
N/A
N/A
High Limit
1 to 4
Default: 1
1 to 4
Default: 1
1 to 4
Default: 1
Low Limit
N/A
N/A
N/A
0070-10-0727-02
V Series Operating Instructions
Alarms
Alarm Limits
TABLE 8-5
ALARM
LIMIT
PARAMETER
CO2 INS
Unit of Measure: kPa
Resolution: 0.1 kPa
8.2.2.5
ADULT
PEDIATRIC
NEONATE
High Limit
1 to 4
Default:1
1 to 4
Default:1
1 to 4
Default:1
Low Limit
N/A
N/A
N/A
CCO/Hemo Tab
Refer to the Addendum to V Series Operating Instructions P/N 046-002101-00 for additional
information.
8.2.2.6
Auto-Set All Alarms Button
The Auto-Set All button automatically recalculates high and low alarm limit settings to the percent
indicated in TABLE 8-1 above and below the patient’s current measured value for the selected
parameter.
TABLE 8-1 Auto Set Percent Indicator
ALARM
PERCENT INDICATOR
(APPROXIMATE)
Heart Rate
30%
Respiration
30%
IBP Systolic
20%
IBP Diastolic
20%
IBP Mean
20%
NIBP Systolic
20%
NIBP Diastolic
20%
NIBP Mean
20%
ET CO2 (mmHg)
20%
ET CO2 (%)
20%
INSP CO2 (%)
20%
ET CO2 (kPa)
20%
INSP CO2 (kPa)
20%
Temp (F°)
3%
Temp (C°)
3%
Delta Temp (F°)
25%
Delta Temp (C°)
25%
NOTE:
8.2.2.7
The systolic, diastolic, and mean NIBP values flash in the corresponding
alarm priority color when an alarm is active.
Restore All Defaults Button
Restores all alarm limits to the departmental default values.
V Series Operating Instructions
0070-10-0727-02
8-9
Alarm Responses
8.3
Alarms
Alarm Responses
Use the Responses dialog to set the parameter’s alarm level (or alarm priority) and the alarm
responses. Alarm level is associated with the severity of an alarm condition and determines the audio
and visual indicators that occur during an alarm condition. Alarm responses are used to adjust how
the system reacts or responds during an alarm condition. For example, if Nurse Call is selected, and a
HR alarm occurs, an electronic signal is sent to the Nurse Call system.
NOTE:
Nurse Call is not an available alarm response unless it was enabled in
System Setup.
The Responses dialog contains the following tabs: ECG/Resp, Pressure, Temp and SpO2/Gases. A
description of each tab follows.
8.3.1
Understanding Alarm Levels
Assigning an alarm level or priority is based on the patient’s condition. For example, lethal alarms,
because of their critical nature, are usually the highest priority alarms. The parameter's alarm level
(shown as a colored oval) appears beside the corresponding parameter alarm limits button in the
Alarm Limits dialog (as shown in FIGURE 8-2).
8.3.2
BUTTON
DESCRIPTION
High
Violating the alarm limits of this parameter is life threatening for this patient.
Medium
Violating the alarm limits of this parameter is critical, but not life threatening for
this patient.
Low
Violating the alarm limits of this parameter is neither critical nor life threatening
for this patient.
Factory Default Alarm Priorities between Alarm Types
The V 12/V 21 prioritizes high priority arrhythmia alarms in the following order:
•
Asystole
•
Ventricular Fibrillation
•
Ventricular Tachycardia
•
Bradycardia
•
R-On-T PVC
•
Pause
The V 12/V 21 prioritizes medium priority arrhythmia alarms in the following order:
8 - 10
•
Bradycardia
•
R-On-T PVC
•
Pause
•
Run
•
Ventricular Rhythm
•
Bigeminy
•
Trigeminy
•
Couplet
•
Irregular HR
•
Multiform PVC
0070-10-0727-02
V Series Operating Instructions
Alarms
Alarm Responses
The V 12/V 21 prioritizes low/technical priority arrhythmia alarms in the following order:
8.3.3
•
Pause
•
Ventricular Rhythm
•
Run
•
Bigeminy
•
Trigeminy
•
Couplet
•
Irregular HR
•
Multiform PVC
•
Leads Off
Configuring Alarm Levels
1.
Select the Alarms tab from the Navigation Area.
2.
Select the Responses button.
3.
Select the applicable alarm group tab.
4.
Select the applicable parameter alarm level radio button.
NOTE:
8.3.4
The alarm levels available are based on the parameter. Some
parameters will not have all three levels available, as shown in
FIGURE 8-4.
Understanding Alarm Response Settings
Based on the selected alarm responses, several monitor responses may occur when a parameter
alarm occurs. Configure each parameter to use any of the following responses:
•
Print on Alarm directs the monitor to send the alarm data to the configured printer.
•
Save to Event directs the monitor to mark the event and save it to the events database.
•
Nurse Call directs the monitor to send an electronic signal to the Nurse Call system.
NOTE:
8.3.5
Nurse Call is not an available alarm response unless it was enabled in
System Setup.
Configuring Alarm Response Settings
1.
Select the Alarms tab from the Navigation Area.
2.
Select the Responses button.
3.
Select the applicable alarm group tab.
4.
Select the applicable alarm level.
NOTE:
Before setting the alarm responses, refer to ‘‘Factory Default Alarm
Settings’’ on page 8-12 for additional information.
5.
Optional - select the applicable parameter alarm check boxes under the headings: Print on
Alarm, Save to Event, and Nurse Call.
6.
Select the Cancel or Accept button.
V Series Operating Instructions
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
0070-10-0727-02
8 - 11
Alarm Responses
Alarms
8.3.6
Factory Default Alarm Settings
8.3.6.1
ECG/Resp Tab
TABLE 8-6 lists the available alarm levels for each parameter in the ECG/Resp tab.
TABLE 8-6
FACTORY
DEFAULT ALARM RESPONSES
ALARM LEVELS*
ALARM LEVELS
BUTTON
HIGH
MEDIUM
LOW
PRINT ON
ALARM
SAVE TO
EVENT
NURSE
CALL
HR
X
X
—
Off
On
Off
ST**
X
X
X
Off
On
Off
Resp
X
X
X
Off
On
Off
Apnea
X
X
—
Off
On
Off
*
**
***
8.3.6.2
X indicates available alarm level
Only available when patient size is Adult or Pediatric
The factory default configuration settings are in bold.
Pressure Tab
TABLE 8-7 lists the available alarm levels for the each parameter in the Pressure tab.
TABLE 8-7
FACTORY
DEFAULT ALARM RESPONSES
ALARM LEVELS*
HIGH
MEDIUM
LOW
PRINT ON
ALARM
SAVE TO
EVENT
NURSE
CALL
NIBP
—
X
X
Off
On
Off
IBP 1- 8
—
X
X
Off
On
Off
ALARM LEVELS
BUTTON
*
8.3.6.3
X indicates available alarm level
Temp Tab
TABLE 8-8 lists the available alarm levels for the each parameter in the Temp tab.
TABLE 8-8
FACTORY
DEFAULT ALARM RESPONSES
ALARM LEVELS*
HIGH
MEDIUM
LOW**
PRINT ON
ALARM
SAVE TO
EVENT
NURSE
CALL
T1 - T3
—
X
X
Off
On
Off
Delta Temp
—
X
X
Off
On
Off
T Blood
—
X
X
Off
On
Off
ALARM LEVELS
BUTTON
*
**
8 - 12
X indicates available alarm level
The factory default configuration settings are in bold.
0070-10-0727-02
V Series Operating Instructions
Alarms
8.3.6.4
Alarm Responses
SpO2/Gases Group
TABLE 8-9 lists the available alarm levels for the each parameter in the SpO2/Gases tab.
TABLE 8-9
FACTORY
DEFAULT ALARM RESPONSES
ALARM LEVELS
ALARM LEVELS
BUTTON
HIGH
MEDIUM
LOW
PRINT ON
ALARM
SAVE TO
EVENT
NURSE
CALL
SpO2
X
X
_
Off
On
Off
CO2
X
X
_
Off
On
Off
*
**
8.3.7
X indicates available alarm level
The factory default configuration settings are in bold.
CCO/Hemo Tab
Refer to the Addendum to V Series Operating Instructions P/N 046-002101-00 for additional
information.
V Series Operating Instructions
0070-10-0727-02
8 - 13
Arrhythmia Alarms
8.4
Alarms
Arrhythmia Alarms
Use the Arrhythmia Alarm dialog to set the parameter’s alarm level (or priority) and the alarm
responses for arrhythmia alarms. The alarm level determines the priority at which a parameter’s alarm
violation is actuated. Also use this tab to configure the arrhythmia alarm responses during an alarm
condition.
NOTE:
8.4.1
The Arrhythmia Alarm dialog is only available when the patient size is
Adult or Pediatric.
Understanding Alarm Levels
Refer to ‘‘Understanding Alarm Levels’’ on page 8-10 for additional information.
8.4.2
Configuring Arrhythmia Alarm Levels
1.
Select the Alarms tab from the Navigation Area.
2.
Select the Arrhythmia button.
3.
Select the On/Off check box to turn on/off the alarm (as shown in FIGURE 8-3).
NOTE:
Selecting the On/Off check box enables or disables the alarm responses
radio button.
NOTE:
Through the System button in the Navigator Area, the administrator
can lock Asystole, Ventricular Tachycardia, and Ventricular Fibrillation
settings which controls the ability to enable or disable the lethal
arrhythmias. Refer to ‘‘Configuring the Alarms Tab’’ on page 25-7 for
additional information.
FIGURE 8-3 Example Arrhythmia Dialog (Arrhythmia Tab)
4.
8 - 14
Select an alarm level or select one of the buttons in TABLE 8-11.
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V Series Operating Instructions
Alarms
Arrhythmia Alarms
NOTE:
Before setting the alarm levels, refer to TABLE 8-10 for additional
information.
TABLE 8-10
FACTORY DEFAULT ALARM
LEVELS*
BUTTON
DEFAULT
ON/OFF**
HIGH
MEDIUM
LOW
Asystole
On
X
—
—
Ventricular Tachycardia (V-Tach)
On
X
—
—
Ventricular Fibrillation(V-Fib)
On
X
—
—
Bradycardia
Off
X
—
—
R on T PVC
Off
X
X
—
Pause
Off
X
X
X
Pauses/Minute
Off
X
X
X
Bigeminy
Off
—
X
X
PVCs/Minute
Off
—
X
X
Couplet
Off
—
X
X
Irregular HR
Off
—
X
X
Multiform PVC
Off
—
X
X
Run
Off
—
X
X
Trigeminy
Off
—
X
X
Ventricular Rhythm
Off
—
X
X
X indicates available alarm level, — indicates alarm level not available
The factory default configuration settings are in bold.
*
**
5.
Optional - select the Relearn Arrhythmia button to establish a new base line.
6.
Select the applicable alarm level button or select one of the following buttons.
TABLE 8-11
BUTTON
DESCRIPTION
All On
Configures all arrhythmia alarms to on.
All Off
Configures all lethal arrhythmia alarms to off, except Asystole, Ventricular
Tachycardia, and Ventricular Fibrillation if they were locked by the
administrator.
Lethals Only On
Configures the lethal arrhythmia alarms (Asystole, V-Tach, and V- Fib) to on
and set all non-lethal arrhythmias to off.
Select the Cancel or Accept button.
7.
V Series Operating Instructions
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
0070-10-0727-02
8 - 15
Arrhythmia Alarms
Alarms
8.4.3
Understanding Arrhythmia Alarm Responses
Setting the alarm responses directs the monitor how to manage the alarm. Configure any alarm with
the following alarm responses:
•
Audio On directs the monitor to present an audible alarm.
•
Print on Alarm directs the monitor to send the alarm data to the configured printer.
•
Save to Event directs the monitor to mark the event and save it to the events database.
•
Nurse Call directs the monitor to send an electronic signal to the Nurse Call system.
NOTE:
8.4.4
Nurse Call is not an available alarm response unless it is enabled in
System Setup.
Configuring the Arrhythmia Alarm Responses
1.
Select the Alarms tab from the Navigation Area.
2.
Select the Arrhythmia button.
3.
Select the Responses tab.
4.
Select an alarm response.
NOTE:
Before selecting an alarm response, refer to TABLE 8-12 for additional
information.
TABLE 8-12
FACTORY
DEFAULT ALARM RESPONSES
AUDIO ON
Asystole
**
Off
On
Off
Ventricular Tachycardia (V-Tach)
**
Off
On
Off
Ventricular Fibrillation (V-Fib)
**
Off
On
Off
Bradycardia
On
Off
On
Off
R- on-T PVC
On
Off
On
Off
Pause
On
Off
On
Off
Pauses/Minute
On
Off
On
Off
SAVE TO EVENT
NURSE CALL*
Bigeminy
On
Off
On
Off
PVCs/Minute
On
Off
On
Off
Couplet
On
Off
On
Off
Irregular HR
On
Off
On
Off
Multiform PVC
On
Off
On
Off
Run
On
Off
On
Off
Trigeminy
On
Off
On
Off
Ventricular Rhythm
On
Off
On
Off
*
**
8 - 16
PRINT ON
ALARM
ALARM
Nurse Call is not an available alarm response unless it is enabled in System Setup.
By default, audio for these lethal alarms is on even though there are no Audio On settings shown.
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V Series Operating Instructions
Alarms
Arrhythmia Alarms
Select the Cancel or Accept button.
5.
8.4.5
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Configuring Arrhythmia Alarm Setup
1.
Select the Alarms tab from the Navigation Area.
2.
Select the Arrhythmia button.
3.
Select the Setup button.
4.
Select the buttons described in TABLE 8-13 to configure the tab.
TABLE 8-13
BUTTON
DESCRIPTION/ COMMENTS
SETTINGS
Asystole Delay
Configures how many seconds
should occur between QRS
complexes to be defined as
Asystole.
3 sec, 4 sec, 5 sec, 6 sec, 7 sec, 8 sec, 9 sec,
10 sec
V-Tach Run
Configures how many ventricular
beats must occur in a row in order
to be defined as a V-Tach.
3 to 15 beats in increments of one (1) beat
V-Tach Rate
Configures how fast the ventricular
beat rate must be to be defined as
a V-Tach.
100 bpm - 180 bpm in increments of one
(1) bpm, 120 default
Pause Threshold
Configures the Pause Threshold.
1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9, and 2.0
Pauses Per Minute
Configures the Pauses per Minute
arrhythmia call.
1 to 15 Pause/min in 1 Pause/min steps
Default: 8
PVCs Per minute
Configures the PVCs per Minute
arrhythmia call.
1 to 30 PVC/min in 1 PVC/min steps
Default: 10
*
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
5.
V Series Operating Instructions
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
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8 - 17
Alarm Setup
8.5
Alarms
Alarm Setup
Use the Alarm Setup tab to configure the alarm silence and alarm audio delay settings.
8.5.1
Configuring Alarm Setup
1.
Select the Alarms tab from the Navigation Area.
2.
Select the Alarm Setup button to display the Alarm Setup dialog (as shown in FIGURE 8-4).
FIGURE 8-4 Example Alarm Setup Tab
Select the buttons described in TABLE 8-14 to configure the tab.
3.
TABLE 8-14
FUNCTION
DESCRIPTION
SETTINGS*
Silence
Configures temporary alarm silencing.
1 min, 2 min, 5 min and 10 min
Silence All
The choices displayed here are specified
in the System Setup Alarms tab.
Dependent on the System
configuration. Refer to ‘‘Configuring
the Alarms Tab’’ on page 25-7 for
additional information.
Audio Alarm Delay
Configures whether or not there is a
delay before an alarm sounds.
None, 1 sec, 2 sec, 3 sec, 4 sec, 5 sec,
6 sec, 7 sec, and 8 sec
*
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
4.
8 - 18
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
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V Series Operating Instructions
Alarms
8.6
Alarms Troubleshooting
Alarms Troubleshooting
MESSAGE/PROBLEM
REASON
SOLUTION
No alarm sounds.
The Silence All or Silence button
was selected.
Select the Silence All or Silence
button to hear the alarm sounds.
Audio levels were turned down or
turned off.
Refer to ‘‘Configuring Audio Levels’’
on page 2-14 for additional
information.
Apnea alarms were enabled.
Enable apnea alarms in the Alarm
Limits dialog ECG/Resp tab.
Apnea delay is enabled.
Enable apnea delay alarms in the
Alarm Limits dialog ECG/Resp tab.
Cannot configure Pressure
alarms to high.
Cannot configure Pressure alarms
to high. Only medium and low
settings are available for the
Pressure alarms.
N/A
Cannot configure Temp alarms
to high.
Cannot configure Temp alarms to
high. Only medium and low
settings are available for the Temp
alarms.
N/A
Cannot configure the SpO2/
Gases alarms to low.
Cannot configure SpO2/Gases
alarms to low. Only high and
medium settings are available for
the SpO2/Gases alarms.
N/A
Lethal alarms not being called.
Lethal alarms were disabled in the
Arrhythmia Alarms dialog.
Refer to ‘‘Understanding Alarm
Levels’’ on page 8-10 for additional
information.
All Alarms Permanently
Silenced displays in the Main
Display message area.
The Silence All button was
configured for Permanent.
Select the Silence All button to
hear the alarms.
Would like to remove the
Permanent choice from the
Silence All button configuration
options.
Must remove this configuration
option in the password protected
System Setup dialog.
Refer to ‘‘Configuring the Alarms
Tab’’ on page 25-7 for additional
information.
Lethal alarms are disabled.
Lethal alarms were disabled in the
password protected System
Setup dialog.
Refer to ‘‘Configuring the Alarms
Tab’’ on page 25-7 for additional
information.
Apnea alarms are disabled.
Apnea alarms were disabled in
the password protected System
Setup dialog.
Refer to ‘‘Configuring the Alarms
Tab’’ on page 25-7 for additional
information.
System not calling Apnea alarms.
*
V Series Operating Instructions
Display messages are shown in bold text.
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Alarms Troubleshooting
Alarms
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8 - 20
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V Series Operating Instructions
9.0
ECG – Arrhythmia
Introduction .......................................................................................................................................................... 9-2
ECG Dialog ............................................................................................................................................................. 9-3
Arrhythmia Digital Tile Layout ................................................................................................................... 9-9
ECG Waveform Tile Layout........................................................................................................................... 9-10
Preparation and Lead Placement............................................................................................................. 9-12
Arrhythmia Algorithm..................................................................................................................................... 9-23
Arrhythmia Alarms ............................................................................................................................................ 9-25
ST Segment Analysis........................................................................................................................................ 9-30
ECG-Arrhythmia Troubleshooting........................................................................................................... 9-32
V Series Operating Instructions
0070-10-0727-02
9-1
Introduction
9.1
ECG – Arrhythmia
Introduction
This chapter describes the ECG – Arrhythmia dialogs in detail, including configuring alarm limits,
parameter setup, waveform speed, skin preparation and lead placement, and the arrhythmia
algorithm. ECG is a continuous waveform of a patient's cardiac electrical activity. An ECG waveform
displays in the first waveform area of the V 12/V 21.
The quality of an ECG signal is directly affected by electrode site skin preparation, electrode patch
quality and ECG lead placement. If artifact is present on the ECG waveform, then the arrhythmia
processing, alarm processing, and quality of the monitoring function may be affected. The presence
of artifact can prevent the monitor from establishing an accurate ECG reference waveform, increasing
the difficulty experienced in assessing the ECG rhythm.
Optimizing the ECG signal is imperative for accurate monitoring. Use high quality electrodes,
designed to acquire the ECG with excellent base line stability, recovery from defibrillation and
minimum artifact from patient movement.
With the V 12/V 21, ECG can be obtained by using a 3/5/6/12 lead ECG cable in conjunction with the
matching skin electrodes. For best performance and safety, inspect the ECG cables and electrodes
daily.
Patient Sizes
Intended patient types: Adult and Pediatric.
VPS Connector
The VPS module supports one (1) ECG/EKG connector (shown in FIGURE 9-1).
ECG Connector
FIGURE 9-1 Example VPS ECG Connector (Nellcor)
9-2
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V Series Operating Instructions
ECG – Arrhythmia
ECG Dialog
Display Setup
To be able to see the IBP values, IBP must be configured to display on the Main Screen. Refer to
‘‘Display Options Dialog’’ on page 3-2 for additional information.
9.2
ECG Dialog
The ECG dialog (as shown in 9-2) contains an Arrhythmia tab, Pacer tab, ECG Setup tab, and Arrhy
Setup tab. A description of each tab follows.
9.2.1
Navigating to the ECG Dialog
•
Select the Arrhy digital or ECG waveform tile.
OR
1.
Select the Setup tab from the Navigation Area.
2.
Select the Parameters button.
3.
Select the ECG button to display the ECG dialog (as shown in FIGURE 9-2).
FIGURE 9-2 Example ECG Dialog (Arrhythmia Tab)
9.2.2
Configuring the Arrhythmia Tab
Refer to ‘‘Arrhythmia Alarms’’ on page 8-14 for additional information.
9.2.3
Configuring Pacemakers
1.
Select the Arrhy digital or ECG waveform tile.
NOTE:
V Series Operating Instructions
The current parameter setting displays in bold to the right of the
button.
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9-3
ECG Dialog
ECG – Arrhythmia
Select the Pacer tab (as shown in FIGURE 9-3).
2.
FIGURE 9-3 Example ECG Dialog (Pacer Tab)
Select the buttons described in TABLE 9-1 to configure the tab.
3.
TABLE 9-1
FUNCTION
DESCRIPTION
SETTINGS*
Pacer Enhancement
Configures whether or not to display the
pacer markers in the waveform.
Adult and Pediatric settings:
On, Off
Pacer Blanking**
Configures the pacer blanking filter.
Adult and Pediatric settings:
Off, 20 msec, 40 msec, 60 msec, and
80 msec
*
**
The factory default configuration settings are in bold.
Only available when patient size is Adult or Pediatric.
Select the Cancel or Accept button.
4.
9.2.4
9-4
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Configuring ECG Setup
NOTE:
The ECG Setup tab can also be accessed from the ECG dialog.
NOTE:
The current parameter setting displays in bold to the right of the
button.
1.
Select the Arrhy digital or ECG waveform tile.
2.
Select the ECG Setup tab (as shown in FIGURE 9-4 and FIGURE 9-5).
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V Series Operating Instructions
ECG – Arrhythmia
ECG Dialog
FIGURE 9-4 Example ECG Setup tab Accessed from ECG Waveform Tile
FIGURE 9-5 Example ECG Setup Tab Accessed from Arrhy Digital Tile
3.
V Series Operating Instructions
Select the buttons described in TABLE 9-2 to configure the tab.
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9-5
ECG Dialog
ECG – Arrhythmia
TABLE 9-2
BUTTON
DESCRIPTION/ COMMENTS
SETTINGS*
ECG Leads
Configures the ECG lead that displays in the
selected waveform tile.
Dependent on the lead set
currently in use.
NOTE:
Size
Configures the ECG waveform size for each
unique lead type in all operating modes.
0.125 cm/mv, 0.25 cm/mv, 0.5 cm/
mv, 1 cm/mv, 2 cm/mv, 4cm/mv
Filter
Configures the ECG filter in all operating
modes.
Monitor, ST, Diagnostic
Refer to ‘‘ECG Filters’’ on page 9-31
for additional information.
Color
Configures the ECG waveform color.
16 distinct colors
Note: Default color is green.
Notch Filter
Configures the ECG Notch filter. This menu
item is used to filter out AC line noise from
the ECG waveform.
Off, 50 Hz, 60 Hz
Note: The default is 50 Hz when
the monitor is not configured for
the US.
ESU Filter
Configures the ESU filter in all operating
modes. This menu item is used to filter out
high frequency electrosurgical noise from the
ECG waveform.
Auto, Disable
ECG/SpO2 Speed
Configures the speed of ECG/SpO2 waves.
6.25 mm/s, 12.5 mm/s, 25 mm/s,
50 mm/s
ECG Noise Audio
Configures the ECG Noise Alarm in all
operating modes. If turned on, an alarm
sounds when ECG noise is detected on any of
the active ECG leads.
On, Off
Noise Audio Delay
Configures the delay time before the ECG
Noise Alarm is called, if the option is enabled.
3 to 60 seconds in steps of 1
second
Note: Default is V 12/V 21
seconds.
*
9.2.5
The ECG Leads button only displays when the ECG
dialog is accessed from the ECG waveform tile. It is not
shown when accessing the ECG dialog from selecting
the Arrhy digital tile.
The factory default configuration settings are in bold.
Configuring the Arrhy Setup
Refer to ‘‘Configuring Arrhythmia Alarm Setup’’ on page 8-17 for additional information.
9.2.6
Relearning
A relearn can be done for arrhythmia, ST analysis, or for both simultaneously.
The V 12/V 21 initiates the learning process for ST or Arrhythmia analysis after any of the following:
9-6
•
Unit power-up
•
Return to normal monitoring from standby mode
•
Enabling ST or Arrhythmia analysis
•
The lead has been changed in ECG 1 waveform (3 lead only)
•
Patient Size changes
•
Selecting the Relearn button in the ST, ECG, or Arrhythmia tab
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V Series Operating Instructions
ECG – Arrhythmia
ECG Dialog
•
Selecting the Relearn Arrhythmia button or Relearn Both button is recommended after one or
more of the following:
•
ECG electrodes have been repositioned
•
Eight hours have passed since the last relearn
•
Significant changes occurred to the patient QRS complex
•
Significant changes occurred to the patient ECG rhythm
•
A clinician has observed clinically questionable arrhythmia calls
•
“Learning” occurred during a Leads Off condition
Relearning Arrhythmia
To relearn arrhythmia:
1.
Select the Arrhy digital tile.
2.
Select the Relearn Arrhythmia button.
The Arrhythmia Learning message displays in the ECG waveform tile.
Relearning Arrhythmia and ST
To relearn ST:
1.
Select one of the ECG waveform tiles.
2.
Select the Relearn Both button.
The Arrhythmia Learning message displays in the ECG waveform tile.
NOTE:
9.2.7
To relearn ST only, refer to ‘‘Configuring the ST Parameter’’ on page 163 for additional information.
Viewing All ECG Waveforms
Using a V 12 with a 5 or 6 lead wire set:
•
Select the View All ECG button from any of the ECG dialog tabs.
The ECG dialog automatically closes and the seven (7) or eight (8) ECG waveforms populate the
waveform tiles.
Using a V 12 with a 12 lead wire set:
1.
Select the Arrhy digital or ECG waveform tile.
2.
Select the View All ECG button.
The ECG dialog automatically closes and the first six (6) ECG waveforms populate the ECG
waveform tiles.
3.
Select the View All ECG button again to view the next six (6)leads.
Using a V 21 with a 5, 6, or 12 lead wire set:
1.
Select the Arrhy digital or ECG waveform tile.
2.
Select the View All ECG button.
The ECG dialog automatically closes and the six (6), eight (8), or 12 ECG waveforms populate the
waveform tiles.
NOTE:
V Series Operating Instructions
The View All ECG button is also available in the Display Options dialog
Refer to ‘‘View All ECG Mode’’ on page 3-13 for additional information.
0070-10-0727-02
9-7
ECG Dialog
ECG – Arrhythmia
NOTE:
9-8
The View All ECG button may also be Quick Function button. Refer to
‘‘Configuring the Quick Functions Tab’’ on page 25-4 for additional
information.
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V Series Operating Instructions
ECG – Arrhythmia
9.3
Arrhythmia Digital Tile Layout
Arrhythmia Digital Tile Layout
The Arrhythmia digital tile displays:
1.
Tile name
2.
Message area
3.
Units of measure
4.
PVC per minute value
5.
Pauses per minute value
6.
Pauses per minute label
7.
PVCs per minute label
1
9.3.1
9.3.2
2
3
7
4
6
5
About the Arrhythmia Tile
•
The Arrhy tile displays the PVC/Min in a 1 PVC/min resolution.
•
The Arrhy tile displays the Pauses/Min in a 1 Pause/min resolution.
•
If the PVC/Min or Pauses/Min measurement is invalid, “- -” displays in place of digits.
Arrhythmia Alarms
Refer to ‘‘Arrhythmia Alarms’’ on page 9-9 for additional information.
9.3.3
Message Area
The message area provides information about the current state of the Arrhy parameter. If there is
more than one message to display, the messages scroll.
MESSAGE
DETAILS
PVCs Per Minute Alarm
Indicates that the value is either equal to or higher than the set alarm limits.
Pauses Per Minute Alarm
Indicates that the value is either equal to or higher than the set alarm limits.
V Series Operating Instructions
0070-10-0727-02
9-9
ECG Waveform Tile Layout
9.4
ECG – Arrhythmia
ECG Waveform Tile Layout
The ECG waveform tile displays:
1.
ECG Lead
2.
Message area
3.
ECG waveform
4.
ECG filter setting
5.
ECG waveform size
1
2
3
5
4
FIGURE 9-6 Example ECG Waveform Tile
9.4.1
9.4.2
About the ECG Tile
•
The ECG waveform, scale indicator, units, and filter settings display in the configured ECG color.
•
The ECG waveform tile provides scrolling, real-time waveform data and an erase bar to provide a
time indicator of oldest and new data.
•
The ECG waveform tile Scrolls the waveform in the configured sweep speed.
•
The ECG waveform tile rails the top most value when the waveform exceeds the upper scale limit
for real-time waveforms.
•
The ECG waveform tile rails the bottom most value when the waveform exceeds the lower scale
limit for real-time waveforms.
•
The ECG waveform tile indicates the current ECG Filter setting.
•
The ECG waveform tile indicates a Pacer indicator when a paced beat is detected and Pacer
Enhancement is enabled.
Arrhythmia Alarms
Refer to the ‘‘Arrhythmia Alarms’’ on page 9-9 for additional information.
9.4.3
Message Area
The ECG waveform tile message area displays messages indicating the current state of the
Arrhythmia and ECG parameters. Messages only display in the message area of the primary ECG lead,
which occupies the top ECG waveform. If there is more than one message to display, excluding
Asystole, V-Tach, and Ventricular Fibrillation, the messages scroll.
9 - 10
MESSAGE
DETAILS
Asystole
Indicates that an Asystole alarm condition exists.
Ventricular Tachycardia
Indicates that a Ventricular Tachycardia alarm condition exists.
Ventricular Fibrillation
Indicates that a Ventricular Fibrillation alarm condition exists.
0070-10-0727-02
V Series Operating Instructions
ECG – Arrhythmia
ECG Waveform Tile Layout
MESSAGE
DETAILS
NOTE:
Asystole, Ventricular Tachycardia, and Ventricular
Fibrillation messages are mutually exclusive of
each other.
Bigeminy
Indicates that a Bigeminy alarm condition exists.
Bradycardia
Indicates that a Bradycardia alarm condition exists.
Couplet
Indicates that a Couplet alarm condition exists.
Irregular Heart Rate
Indicates that a Irregular Heart Rate alarm condition exists.
Multiform PVC
Indicates that a Multiform PVC alarm condition exists.
Pause
Indicates that a Pause alarm condition exists.
R-On-T PVC
Indicates that a R-On-T PVC alarm condition exists.
Run
Indicates that a Run alarm condition exists.
Trigeminy
Indicates that a Trigeminy alarm condition exists.
Ventricular Rhythm
Indicates that a Ventricular Rhythm alarm condition exists.
Leads Off
Indicates the detection of a single drive lead or other multiple leads are off.
<Lead> Lead Off
Indicates the detection of an event for a single, non-drive lead, where
<Lead> is the ECG lead name.
Check ECG <Lead> Lead
Connection
Indicates the detection of an event for a single where <Lead> is the
problematic lead.
Check Lead Connections
Indicates the detection of an event for multiple leads.
Arrhythmia Learning
Indicates that Arrhythmia is in the learn mode.
ST Learning
Indicates that ST is enabled and is in the learn mode.
ST On
Indicates that ST is enabled and not in the learn mode.
V Series Operating Instructions
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9 - 11
Preparation and Lead Placement
ECG – Arrhythmia
9.5
Preparation and Lead Placement
9.5.1
Skin Preparation
Proper skin preparation is essential in obtaining an accurate ECG reading. Electrode sites should be
clean and dry and should provide a smooth flat surface. Incidental electrical activity and inaccurate
readings may arise from incorrect skin preparation.
The following procedure is recommended for secure electrode patch application:
1.
Shave the chest hair from the electrode sites in a circular area with a diameter of
2 to 4 inches.
2.
Use a dry gauze pad to remove excess skin oils, skin cells and residue from the electrode sites.
Never rub the skin until it is raw or bleeding.
NOTE:
9.5.2
Electrode Patch Location
NOTE:
Store electrode patches at room temperature and open just prior to
use.
NOTE:
Avoid more than one type of electrode on a patient because of
variations in electrical resistance.
NOTE:
Avoid placing electrode patches directly over bone prominences or
over any high activity movement areas such as shoulders or arms
because muscle motion produces electrical activity. If an electrode
patch is placed over a large muscle such as the pectorals, the monitor
may detect this additional muscle activity and could lead to false
arrhythmia calls.
NOTE:
Using a Transcutaneous Electrical Nerve Stimulator (TENS): Since a
TENS unit transmits electrical impulses, avoid placing ECG electrode
patches near the TENS electrodes. ECG electrode patches may need to
be repositioned and the ECG lead viewed may need to be adjusted until
the optimum ECG tracing is obtained.
1.
To prevent evaporation of the contact gel medium, peel the backing off of the electrode patch
only when it is ready for use. Visually inspect the contact gel medium for moistness. If the gel
medium is not moist, do not use the electrode patch. Dry electrode patches are not conductive.
NOTE:
9 - 12
Prepare the electrode site with alcohol only if the skin is extremely
greasy. If alcohol is used as a drying agent, always allow the skin to dry
before placing the electrode patch on the skin.
If using the snap type electrode wires, attach the electrode patch to the
lead wire before placing patch on the patient.
2.
Attach the electrode patch to the skin at the prepared site. Smooth the electrode patch down in
a circular motion to ensure proper skin contact. If using soft gel electrodes, never push down
directly over the contact gel medium as this may displace the gel and cause monitoring artifact.
If using hard gel electrodes, it is recommended that during application, the center of the
electrode should be slightly pressed onto the skin to ensure direct contact. Consult the
electrode patch manufacturer’s instructions for specific use.
3.
Secure the lead wires to the patient according to hospital practice.
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V Series Operating Instructions
ECG – Arrhythmia
9.5.3
9.5.3.1
Preparation and Lead Placement
CAUTION:
Route cables and hoses neatly. Ensure cables, hoses and wires are kept
away from patient’s neck to avoid strangulation. Keep floors and
walkways free of cables to reduce risk to hospital personnel, patients
and visitors.
NOTE:
It is recommended that electrode patches be changed at least every 24 to 36
hours to maintain proper contact with the skin, although some patients may
require more frequent changing. Do not reapply disposable electrode patches.
Try to avoid reusing the exact same electrode site during reapplication. If an
electrode becomes wet with fluid, change the electrode patch.
Lead Placement
Description
For lead placement, the computerized arrhythmia algorithm works best when the patient’s R wave is
significantly larger than the P wave or the T wave. If the R wave is not significantly larger than other
lower voltage waves on the ECG tracing, the monitor may have some difficulty in identifying the
appropriate waves. On some patients, electrode patch placement and/or the viewed ECG lead may
need to be adjusted in order to obtain a significant R wave.
9.5.3.2
Setting Lead Naming Standard
This manual presents lead placement according to the guidelines of the American Heart Association
(AHA) and the International Electro-Technical Commission (IEC).
LEAD NAMING STANDARDS
LEAD POSITION
AHA
IEC
CHEST
V
C
LEFT LEG
LL
F
RIGHT LEG
RL
N
LEFT ARM
LA
L
RIGHT ARM
RA
R
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9 - 13
Preparation and Lead Placement
9.5.3.3
ECG – Arrhythmia
Lead Placement: Standard 3-wire Lead Sets
A 3-wire lead set can monitor one of three ECG vectors (I, II, or III). The recommended 3-wire lead
placement is as follows.
White
Red
Black
RA
Yellow
R
LA
L
Green
Red
F
LL
FIGURE 9-7 3-wire Lead Placement (AHA)
9 - 14
FIGURE 9-8 3-wire Lead Placement
(IEC)
•
Place the RA (white) electrode under the
patient’s right clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the R (red) electrode under the
patient’s right clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the LA (black) electrode under the
patient’s left clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the L (yellow) electrode under the
patient’s left clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the LL (red) electrode on the patient’s
lower left abdomen within the rib cage
frame.
•
Place the F (green) electrode on the
patient’s lower left abdomen within the rib
cage frame.
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V Series Operating Instructions
ECG – Arrhythmia
9.5.3.4
Preparation and Lead Placement
Lead Placement: Standard 5-wire Lead Sets
A 5-wire lead set can monitor seven ECG vectors (I, II, III, aVR, aVL, aVF, and V) simultaneously. The
recommended 5-wire lead placement is as follows.
Black
White
Yellow
Red
Green
RA
LA
Black
Brown
V Lead
(any V positi
R
L
V
White
C Lead
(any C
position)
C
Green
RL
LL
N
F
Red
FIGURE 9-9 5-wire Lead Placement (AHA)
FIGURE 9-10 5-wire Lead Placement
(IEC)
•
Place the RA (white) electrode under the
patient’s right clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the R (red) electrode under the
patient’s right clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the LA (black) electrode under the
patient’s left clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the L (yellow) electrode under the
patient’s left clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the LL (red) electrode on the patient’s
lower left abdomen within the rib cage
frame.
•
Place the F (green) electrode on the
patient’s lower left abdomen within the rib
cage frame.
•
Place the RL (green) electrode on the
patient’s lower right abdomen within the
rib cage frame.
•
Place the N (black) electrode on the
patient’s lower right abdomen within the
rib cage frame.
•
Place the V (brown) electrode in one of the
V-lead positions (V1 to V6) depicted in the
following section.
•
Place the C (white) electrode in one of the
C-lead (C1 to C6) positions depicted in the
following section.
V Series Operating Instructions
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Preparation and Lead Placement
9.5.3.5
ECG – Arrhythmia
Lead Placement: Standard 6-wire Lead Sets
A 6-wire lead set can monitor. The recommended 6-wire lead placement is as follows.
Black
White
Yellow
Red
LA
RA
Brown
Vx
R
Yellow
V Lead
(any V posit
White
C Lead
(any C
position)
L
White
Vy
Cx
Cy
Green
Black
LL
Green
RL
F
Red
FIGURE 9-11 6-wire Lead Placement (AHA)
9 - 16
N
FIGURE 9-12 6-wire Lead Placement
(IEC)
•
Place the RA (white) electrode under the
patient’s right clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the R (red) electrode under the
patient’s right clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the LA (black) electrode under the
patient’s left clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the L (yellow) electrode under the
patient’s left clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the LL (red) electrode on the patient’s
lower left abdomen within the rib cage
frame.
•
Place the F (green) electrode on the
patient’s lower left abdomen within the rib
cage frame.
•
Place the RL (green) electrode on the
patient’s lower right abdomen within the
rib cage frame.
•
Place the N (black) electrode on the
patient’s lower right abdomen within the
rib cage frame.
•
Place the Vx (brown) electrode in one of the
V-lead positions (V1 to V6) depicted in the
following section.
•
Place the Cx (white) electrode in one of the
V-lead positions (V1 to V6) depicted in the
following section.
•
Place the Vy (yellow) electrode in one of the
V-lead positions (V1 to V6) depicted in the
following section.
•
Place the Cy (white) electrode in one of the
C-lead (C1 to C6) positions depicted in the
following section.
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V Series Operating Instructions
ECG – Arrhythmia
9.5.3.6
Preparation and Lead Placement
Lead Placement: Lead II Monitoring
The recommended lead placement for Lead II monitoring is as follows.
White
Black
Red
Red
FIGURE 9-13 Lead II Monitoring (AHA)
Yellow
Green
FIGURE 9-14 Lead II Monitoring (IEC)
•
Place the RA (white) electrode under the
patient’s right clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the R (red) electrode under the
patient’s right clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the LA (black) electrode under the
patient’s left clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the L (yellow) electrode under the
patient’s left clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the LL (red) electrode on the patient’s
lower left abdomen within the rib cage
frame.
•
Place the F (green) electrode on the
patient’s lower left abdomen within the rib
cage frame.
Select ECG Lead II on the monitor. Lead II is the
Select ECG Lead II on the monitor. Lead II is the
direct electrical line between the RA (white)
direct electrical line between the R (red)
electrode and the LL (red) electrode.
electrode and the F (green) electrode.
V Series Operating Instructions
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9 - 17
Preparation and Lead Placement
9.5.3.7
ECG – Arrhythmia
Lead Placement: Modified Chest Lead (MCL) Monitoring
•
The recommended lead placement for MCL monitoring is as follows.
Red
White
Black
Yellow
RA
R
Red
Green
LA
L
LL
FIGURE 9-15 MCL Monitoring with a
3-wire Lead Set (AHA)
9 - 18
F
FIGURE 9-16 MCL Monitoring with a
3-wire Lead Set (IEC)
•
Place the RA (white) electrode under the
patient’s left clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the R (red) electrode under the
patient’s left clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the LA (black) electrode on the right
sternal border, at the fourth intercostal
space within the rib cage frame.
•
Place the L (yellow) electrode on the right
sternal border, at the fourth intercostal
space within the rib cage frame.
•
Place the LL (red) electrode on the patient’s
lower left abdomen within the rib cage
frame.
•
Place the F (green) electrode on the
patient’s lower left abdomen within the rib
cage frame.
•
Select ECG Lead I for MCL1 monitoring.
Lead I is the direct electrical line between
the RA (white) electrode and the LA (black)
electrode.
•
Select ECG Lead I for MCL1 monitoring.
Lead I is the direct electrical line between
the R (red) electrode and the L (yellow)
electrode.
•
Select ECG Lead II for MCL6 monitoring.
Lead II is the direct electrical line between
the RA (white) electrode and the LL (red)
electrode.
•
Select ECG Lead II for MCL6 monitoring.
Lead II is the direct electrical line between
the L (red) electrode and the F (green)
electrode.
0070-10-0727-02
V Series Operating Instructions
ECG – Arrhythmia
9.5.3.8
Preparation and Lead Placement
12L ECG
A 12L ECG utilizes a 10-wire ECG lead set that can monitor 12 ECG vectors (I, II, III, aVR, aVL, aVF, V1, V2,
V3, V4, V5, and V6) simultaneously. The recommended lead placement for a 12L ECG is as follows.
LA
RA
R
L
V6
C6
V5
V1
C1
V4
C5
C4
LL
F
RL
N
C2
V2
V3
FIGURE 9-17 12L ECG
Lead Placement (AHA)
C3
FIGURE 9-18 12L ECG
Lead Placement (IEC)
•
Place RA (white) electrode under the right
clavicle, mid-clavicular line within the rib cage
frame.
•
Place R (red) electrode under the right
clavicle, mid-clavicular line within the rib
cage frame.
•
Place LA (black) electrode under the left
clavicle, mid-clavicular line within the rib cage
frame.
•
Place L (yellow) electrode under the left
clavicle, mid-clavicular line within the rib
cage frame.
•
Place LL (red) electrode on the lower left
abdomen within the rib cage frame.
•
Place F (green) electrode on the lower left
abdomen within the rib cage frame.
•
Place RL (green) electrode on lower right
abdomen within the rib cage frame.
•
Place N (black) electrode on lower right
abdomen within the rib cage frame.
•
Place V1 (brown) chest lead in the fourth
intercostal space, right sternal border.
•
Place C1 (white) chest lead in the fourth
intercostal space, right sternal border.
•
Place V2 (brown) chest lead in the fourth
intercostal space, left sternal border.
•
Place C2 (white) chest lead in the fourth
intercostal space, left sternal border.
•
Place V3 (brown) chest lead midway between
V2 and V4 on a straight line.
•
Place C3 (white) chest lead midway between
C2 and C4 on a straight line.
•
Place V4 (brown) chest lead in the fifth
intercostal space, mid-clavicular line.
•
Place C4 (white) chest lead in the fifth
intercostal space, mid-clavicular line.
•
Place V5 (brown) chest lead in the fifth
intercostal space, anterior axillary line.
•
Place C5 (white) chest lead in the fifth
intercostal space, anterior axillary line.
•
Place V6 (brown) chest lead in the fifth
intercostal space, mid-axillary line.
•
Place C6 (white) chest lead in the fifth
intercostal space, mid-axillary line.
V Series Operating Instructions
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9 - 19
Preparation and Lead Placement
9.5.3.9
ECG – Arrhythmia
Lead Placement: Neonates
Using a 3-wire lead set, ECG lead placement on a neonate is usually directed towards obtaining the
best possible respiration data through the ECG thoracic impedance technique. Thoracic impedance
is usually measured between the Right Arm and Left Arm electrode patches. These patches should
be placed on the chest directly across from each other to optimize the measuring of the neonate’s
chest movement. The recommended lead placement for neonate monitoring is as follows.
Black
Yellow
Red
RA
LA
R
Red
LL
L
Green
F
White
FIGURE 9-19 Neonatal 3-wire Lead
Placement (AHA)
9 - 20
FIGURE 9-20 Neonatal 3-wire Lead
Placement (IEC)
•
Place the RA (white) electrode under the
patient’s right clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the R (red) electrode under the
patient’s right clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the LA (black) electrode under the
patient’s left clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the L (yellow) electrode under the
patient’s left clavicle, at the mid-clavicular
line within the rib cage frame.
•
Place the LL (red) electrode on the patient’s
lower left abdomen within the rib cage
frame.
•
Place the F (green) electrode on the
patient’s lower left abdomen within the rib
cage frame.
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V Series Operating Instructions
ECG – Arrhythmia
9.5.3.10
Preparation and Lead Placement
Lead Placement: Pacemaker Patients
The recommended lead placement for monitoring a pacemaker patient is as follows.
Pacer
White
Pacer
Red
Yellow
Black
Green
Red
FIGURE 9-21 3-wire Lead Placement for a
Pacemaker Patient (AHA)
FIGURE 9-22 3-wire Lead Placement for a
Pacemaker Patient (IEC)
Pacer
White
Red
Green
Vx
Brown
Green
Yellow
V
White
Red
FIGURE 9-23 5-wire Lead Placement for a
Pacemaker Patient (AHA)
White
Pacer
Black
V
Brown
Pacer
Black
Vy
Brown
Red
Black
FIGURE 9-24 5-wire Lead Placement for a
Pacemaker Patient (IEC)
Red
Pacer
Yellow
Cx
White
Black
FIGURE 9-25 6-wire Lead Placement for a
Pacemaker Patient (AHA)
Green
Cy
White
Green
FIGURE 9-26 6-wire Lead Placement for a
Pacemaker Patient (IEC)
A pacemaker patient usually requires a different electrode patch placement configuration than a
non-pacemaker patient.
V Series Operating Instructions
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9 - 21
Preparation and Lead Placement
ECG – Arrhythmia
Do not place an ECG electrode directly over the pacemaker generator. Place the electrode patches 3
to 5 inches away from the pacemaker generator area. For example, if the pacemaker generator is
located in the right subclavian area, relocate the Right Arm electrode closer in towards the center of
the chest.
9 - 22
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V Series Operating Instructions
ECG – Arrhythmia
9.6
Arrhythmia Algorithm
Arrhythmia Algorithm
The V 12/V 21 uses an arrhythmia algorithm to monitor ECG waveform data. During the learning
phase of the algorithm templates of beats including one for the patient’s dominant beat are created.
These templates are then used to analyze newly received data. The algorithm verifies that data is free
from noise and artifact, and that it does not deviate from the patient's normal ECG rhythms.
A normal ECG waveform typically includes consistent spacing between R waves, a sharp and well
defined QRS complex, and an ECG baseline that is free of noise and artifact.
ST Point
J Point
ISO Point
R
T
P
ST deviation
(Depression or Elevation)
Q
40 to 80 msec
S
ST Segment
FIGURE 9-27 Example Waveform
Noise and Artifact
The presence of noise or artifact in an ECG waveform makes the accurate detection and classification
of heart beats difficult. To best optimize performance, all leads should be free of noise.
Some of the causes of ECG noise include poor skin preparation, improperly attached electrodes, dried
electrode gel, defective lead wires, and patient movement. The algorithm uses several techniques to
differentiate a patient’s QRS complexes from noise sources.
If noise levels are too high for a particular lead, a message is posted, and the data is dropped from
analysis until the signal quality is re-established.
If noise levels are too high, the following will occur until the signal quality is re-established:
V Series Operating Instructions
•
Beat detection is suspended
•
All rhythm calls are suspended
•
An ECG Noise message is displayed
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9 - 23
Arrhythmia Algorithm
ECG – Arrhythmia
Heart Rate Meter
Heart Rate is computed using the 16 most recent R-R intervals for heart rates above 48 beats per
minute. If the heart rate calculated using the last 4 beats is less than 48 beats per minute, then this
rate is used. All detected beats are used to compute the heart rate. A separate ventricular rate is used
in the algorithm to determine rhythms like ventricular tachycardia and ventricular run.
Filtering Pacer Signals
In order to prevent pacer pulses from being mistaken for QRS complexes, they are removed from the
ECG data that is sent to the arrhythmia algorithm for analysis. Pacer pulses are shown on the V 12/V
21 as exaggerated vertical lines.
ECG Amplitude
The minimum threshold for QRS detection algorithm is fixed between 0.15 and 0.45 mV to avoid
detecting noise spikes or P-waves as valid beats. Changing the display gain on the monitor does not
affect the amplitude of signal that is used by the algorithm for beat detection. For optimal
performance, the leads selected for monitoring should have amplitudes of 0.5 to 1 mV or more.
Learning
The process of learning is used to establish a dominant beat template for a patient. The learn period is
dependent on the heart rate and the dominant pattern. Learning should not be initiated during a
primarily ventricular rhythm because an ectopic beat may be established as normal.
A learn should be initiated when beats are not being properly detected, or when they are being
erroneously classified. However, if a signal is not strong enough, or lead data is extremely noisy, better
signal quality must be established before a learn can be effective.
Beat Detection and Typing
The following table describes the leads that are used to measure beat detection and beat typing.
DESCRIPTION
3-WIRE LEAD SET
5, 6, 12-WIRE LEAD SETS
Leads used for Beat Detection
Determined by viewed lead
II and V
Leads used for Beat Typing
Determined by viewed lead
II, V, and I
Leads used for V-Fib Detection
Determined by viewed lead
II and V
Once a beat has been detected, the search for the next beat begins after a refractory period to avoid
detecting T- waves as valid QRS complexes. For all patient sizes, the minimum QRS amplitude that
can be detected is between 0.15 and 0.45 mV depending on the width of the QRS complexes.
Beat typing aligns and compares each new heart beat to reference templates that were previously
stored in the system. A beat typing algorithm classifies the beats.
•
If an incoming beat matches a template that has already been classified, it is given the same label
as the template. The template parameters are updated with the features from this new beat.
The real time ECG analysis library incorporates ventricular ectopic beat detection as a part of
arrhythmia analysis.
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V Series Operating Instructions
ECG – Arrhythmia
9.7
Arrhythmia Alarms
Arrhythmia Alarms
Arrhythmia alarms are activated based on the patterns in the patient ECG waveform rhythms. Beat
detection for a 5, 6, or 12-lead wire set is determined by using a combination of leads II and V. When
using a 3-lead wire set, beat detection is determined by using the lead being viewed.
The following lethal and non-lethal arrhythmia alarms may be detected by the arrhythmia algorithm.
NOTE:
9.7.1
Arrhythmia alarms are not available for the Neonate patient size.
Lethal Arrhythmia Alarms
A lethal arrhythmia is an arrhythmia that can be life threatening to a patient if left untreated.
Ventricular Tachycardia (V-Tach), Ventricular Fibrillation (V-Fib), and Asystole alarms are classified as
lethal arrhythmia alarms. These alarms automatically default to a High alarm level.
NOTE:
V Series Operating Instructions
Lethal arrhythmia alarms are latched alarms. Latching indicates that
even after resolving the alarming condition, a the alarm continues until
it is acknowledged by pressing the SILENCE or SILENCE ALL key on the
Navigator Area. If the alarm is acknowledged while the lethal condition
still exists, the audio portion of the alarm is silenced for the configured
duration, but the alarm message remains in message area. If a new
lethal condition occurs while the initial lethal alarm is silenced, the new
lethal alarm breaks through if the SILENCE button was selected. If the
SILENCE ALL button was selected, the lethal alarm will not break
through until the configured duration is expired. If the lethal condition
is resolved while the alarm is silenced, the alarm terminates.
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Arrhythmia Alarms
ECG – Arrhythmia
Asystole Alarm
An Asystole alarm is activated when no QRS complexes are detected for the configured time period
in the absence of Ventricular Fibrillation.
The time period range for an Asystole alarm is user selectable from 3 to 10 seconds.
The Asystole alarm is a High level alarm that produces:
•
High level visual and audio alarm indicators.
•
An Asystole text message above the primary waveform area.
Ventricular-Fibrillation (V-Fib) Alarm
A V-Fib alarm is activated when a fibrillated waveform (P, QRS or T waves can no longer be identified)
is detected. V-Fib is defined as “irregular, disorganized electrical activity of the heart”. The V-Fib
detection algorithm runs in parallel to the beat detection algorithm and continuously examines the
incoming data.
The V-Fib alarm is a high level alarm that produces:
•
High level visual and audio alarm indicators.
•
A Ventricular Fibrillation message above the primary waveform area.
Ventricular Tachycardia (V-Tach) Alarm
A V-Tach alarm is activated when the following conditions are met:
•
The V-Tach rate is between 100 or more to 180 or more beats per minute.
AND
•
The V-Tach lethal arrhythmia alarm is activated when the configured number of consecutive
PVCs is reached. The range for the V-Tach threshold is 3 to 15 beats per minute.
A V-Tach alarm is a high level alarm that produces:
9 - 26
•
High level visual and audio alarm indicators.
•
A Ventricular Tachycardia text message above the primary waveform area.
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V Series Operating Instructions
ECG – Arrhythmia
9.7.2
Arrhythmia Alarms
Non-Lethal Arrhythmia Alarms
A Non-Lethal Arrhythmia is an arrhythmia that is most likely not life threatening to a patient. The
following are classified as non-lethal arrhythmia alarms:
•
Bigeminy
•
Bradycardia (Brady)
•
Couplet
•
Irregular Heart Rate
•
Pause
•
Multiform PVC
•
PVC/minute
•
Run
•
Trigeminy
•
Ventricular Rhythm (V-Rhythm)
•
Multiform PVC
•
R-On-T PVC
NOTE:
Non-lethal arrhythmia alarms are not latched alarms and can be
acknowledged at any time. To acknowledge a non-lethal arrhythmia
alarm, press the SILENCE or SILENCE ALL key in the Navigation Area.
Bigeminy
The Bigeminy alarm is activated when three or more cycles of one PVC coupled to one normal beat
are detected.
The Bigeminy alarm is a Low level alarm event that produces:
•
Low level visual and audio alarm indicators.
•
A Bigeminy text message above the primary waveform area.
Bradycardia (Brady)
The Brady alarm is activated when the heart rate falls to a value 10% lower than the user selected
value for low heart rate alarm.
The Brady alarm is a Medium level alarm event that produces:
•
Medium level visual and audio alarm indicators.
•
A Bradycardia text message above the primary waveform area.
Couplet
The Couplet alarm is activated when two consecutive PVCs are detected between normal beats.
The Couplet alarm is a Medium level alarm event that produces:
V Series Operating Instructions
•
Medium level visual and audio alarm indicators.
•
A Couplet text message above the primary waveform area.
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Arrhythmia Alarms
ECG – Arrhythmia
Irregular Heart Rate
The Irregular Heart Rate alarm is activated when the measured variations in the R-R interval over a
period of time exceeds a preset limit established by the arrhythmia algorithm.
The Irregular Heart Rate alarm is a Low level alarm event that produces:
•
Low level visual and audio alarm indicators.
•
An Irregular HR text message above the primary waveform area.
Pause
The Pause alarm is activated when no beats are detected during 1.8 times or more of the current R-R
interval and the next beat is NOT a PVC.
The Pause alarm is a Medium level alarm event that produces:
•
Medium level visual and audio alarm indicators.
•
An Pause text message above the primary waveform area.
Multiform PVC
The Multiform PVC alarm is activated when the over the last 15 beats two or more ventricular beats
with different morphologies are detected and no V-Tach, V-Rhythm, or V-Fib are detected.
The Multiform PVC alarm is a Low level alarm event that produces:
•
Low level visual and audio alarm indicators.
•
An Multiform PVC text message above the primary waveform area.
PVC/minute
The High PVC alarm is activated when the number of PVCs detected per minute exceeds the
configured threshold. The PVC limit can be set to Off, or 1 to 30 PVCs per minute.
The High PVC alarm is a Medium level alarm event that produces:
•
Medium level visual and audio alarm indicators.
•
An PVCs/Minute text message above the primary waveform area.
NOTE:
During periods of Ventricular Rhythms, V-Tach, V-Fib and Asystole,
PVC/mins are not shown.
Run
The Run alarm is activated when the number of consecutive PVCs occur at a rate that equals or
exceeds the user defined V-Tach Rate. The number of consecutive PVCs that constitute a Run is one
beat less than the minimum used to identify V-Tach.
The Run alarm is a Medium level alarm event that produces:
•
Medium level visual and audio alarm indicators.
•
A Run text message above the ECG1 waveform area.
Trigeminy
The Trigeminy alarm is activated when three or more cycles of one PVC coupled to two normal
beats are detected. This rhythm could also cause an Irregular HR alarm.
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V Series Operating Instructions
ECG – Arrhythmia
Arrhythmia Alarms
The Trigeminy alarm is a Low level alarm event that produces:
•
Low level visual and audio alarm indicators.
•
A Trigeminy text message above the primary waveform area.
Ventricular Rhythm (V-Rhythm)
The V-Rhythm alarm is activated when more than 2 consecutive PVCs occur at a rate that is less than
the user defined V-Tach Rate.
The V-Rhythm alarm is a Medium level alarm event that produces:
•
Medium level visual and audio alarm indicators.
•
A Ventricular Rhythm text message above the primary waveform area.
R-On-T PVC
The R-On-T PVC alarm is activated when the following occurs:
•
A beat is detected as a PVC and previous beat is not a PVC and
•
Current BTB heart rate is > 120 bpm and
•
Current RR-interval is < previous RR-interval
The R-On-T PVC alarm is a Medium level alarm event that produces:
V Series Operating Instructions
•
Medium level visual and audio alarm indicators.
•
A R-On-T PVC text message above the primary waveform area.
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9 - 29
ST Segment Analysis
9.8
ECG – Arrhythmia
ST Segment Analysis
The ST segment of an ECG waveform (as shown in FIGURE 9-27) represents the period from the end
of ventricular de-polarization, to the beginning of ventricular re-polarization, or the end of the QRS
complex (the J point) and the beginning of the T-wave. ST Segment analysis is used to monitor the
oxygen supply and the viability of the heart muscle.
ST deviation is the vertical distance between the isoelectric (ISO) point level and signal level at ST
point.
The ISO point is located between the end of the P-wave and the onset of the QRS complex. The ISO
point provides the baseline for this measurement.
The ST point is a fixed distance from the J point at the end of the QRS complex. The ST point can be
configured to 40, 60, or 80 milliseconds past the J-point, independent of the heart rate. By default, the
ST point is positioned as follows:
•
at 80 milliseconds for heart rates less than or equal to 120 beats per minute
•
at 60 milliseconds for heart rates greater than 120 beats per minute
ST segments are typically calculated on graph paper with a scale of 1cm/mV, and measured in
millimeters where one millimeter is equivalent to 0.1 mV. The reliability of ST measurements is
lowered with the presence of atrial fibrillation, flutter, and erratic baseline changes.
Selecting leads that contain the least amount of baseline flutter will improve measurement accuracy,
but accurate ST deviation measurement is dependent on the correct location of the ISO and ST
points.
All available ECG leads are analyzed to measure deviations in the ST segment.
The displayed ST data is updated approximately every 10 seconds.
Learning
The process of learning is used to establish normal beat templates or a stable baseline for accurate ST
analysis. To establish this baseline, the system evaluates the first sixteen normal beats based on
readings from leads II, V, and I.
To establish an accurate baseline, it is recommended that learning be done when the patient is in
stable condition, not moving, and has an ECG rhythm that is free of artifact. Learning should not be
initiated during a primarily ventricular rhythm or other ECG rhythm irregularity because an ectopic
beat may be established as normal.
Learning automatically occurs when:
9 - 30
•
Arrhythmia analysis is turned on
•
ST analysis is turned on
•
Patient monitoring resumes and patient is removed from the standby mode
•
A 3-wire lead set is in use and the current ECG lead is changed
0070-10-0727-02
V Series Operating Instructions
ECG – Arrhythmia
ST Segment Analysis
ECG Filters
The ST segment of an ECG waveform often contains low amplitude signals with low frequency
content. To preserve low frequency signal content, the high pass filter is set to 0.05 Hz when ST
analysis is turned on.
TABLE 9-3
FILTER SETTING
FILTER BANDWIDTH
PURPOSE
Monitor
0.5 Hz to 40 Hz
Used for routine cardiac rhythm
monitoring. Limits display of artifact and
baseline wander due respectively to
power line interference and patient
movement. Unless intentionally set
otherwise, the Monitor filter is selected by
default.
ST
0.05 Hz to 40 Hz
Allows ST segments to be accurately
measured. If the Monitor filter is in use
when the ST analysis feature is enabled,
the V 12/V 21 monitor automatically
selects the ST filter.
Diagnostic
0.05 Hz to 150 Hz
This is the widest bandwidth available.
Effective for diagnostic examination of ECG
wave when patient is not moving. (Patient
movement affects the ECG waveform.) The
Diagnostic filter may also be used with the
ST analysis feature.
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ECG-Arrhythmia Troubleshooting
9.9
ECG – Arrhythmia
ECG-Arrhythmia Troubleshooting
The Arrhythmia tile ECG waveform area displays messages indicating the current state of the
Arrhythmia and ECG parameter. If there is more than one message to display, the messages scroll.
MESSAGE/PROBLEM
REASON
SOLUTION
Noisy ECG traces
Loose or dry electrodes.
Apply fresh, moist electrodes.
Defective electrode wires.
Replace wires as necessary.
Patient cable or leads are routed
too close to other electrical
devices.
Eliminate 50-60 Hz interference.
Excessive Electro-surgical
Interference
Wrong ECG cable used.
Use ESIS ECG cable with internal
filter block.
NOTE: Respiration monitoring via
the ECG electrodes will not be
available when using the cable.
Muscle Noise
Inadequate skin preparation prior
to application of electrode,
tremors, tense subject, and/or
poor electrode placement.
Repeat skin preparation and
electrode location procedures.
Apply fresh, moist electrodes.
Avoid areas of the torso that are
very muscular.
Intermittent Signal
Connections not tight and/or
properly secured.
Ensure proper connection.
(Electrode to lead, lead to cable,
cable to monitor).
Electrodes dry or loose.
Re-prep skin and apply fresh, moist
electrodes.
Cable or lead wires damaged.
Check with continuity tester.
Electrodes dry.
Re-prep skin and apply fresh, moist
electrodes.
Alarm limits set too close to
patient's normal heart rate.
Readjust.
R-wave wrong size.
Must have a higher amplitude
than the other ECG waves, like the
P and T waves.
Excessive patient movement or
muscle tremor.
Reposition electrodes and secure
with tape, if necessary.
Gain set too low.
Readjust as required (Set via the Waveforms tab).
Electrodes dry / old.
Apply fresh, moist electrodes.
Skin improperly prepared.
Abrade skin.
This could be the patient’s normal
QRS complex.
Verify with a 12-lead electrocardiogram.
Electrode could be positioned
over a bone or muscle mass.
Move ECG patches closer towards
each other.
Gain set too low.
Readjust as required.
Lead wires and patient cable not
fully or properly inserted.
Check for proper insertion.
Cable or lead wires damaged.
Check with lead continuity tester.
Excessive alarms: heart rate, lead
fault
Low Amplitude ECG Signal
No ECG Waveform
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V Series Operating Instructions
ECG – Arrhythmia
ECG-Arrhythmia Troubleshooting
MESSAGE/PROBLEM
REASON
SOLUTION
Base Line Wander
Patient moving excessively.
Secure lead wires and cable to
patient.
Patient's respiration.
Reposition electrodes.
Electrodes dry or loose.
Re-prep skin and apply fresh, moist
electrodes.
Static build up around patient.
Check with local biomedical
personnel.
ECG Filter set to ST or Diagnostic
mode.
Set ECG Filter to “Monitor” mode.
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ECG-Arrhythmia Troubleshooting
ECG – Arrhythmia
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V Series Operating Instructions
10.0
Respiration (Resp)
Introduction .......................................................................................................................................................... 10-2
Resp Dialog............................................................................................................................................................ 10-2
Respiration Tile Layouts ................................................................................................................................. 10-7
Respiration Troubleshooting ...................................................................................................................... 10-9
V Series Operating Instructions
0070-10-0727-02
10 - 1
Introduction
10.1
Respiration (Resp)
Introduction
This chapter describes the Resp parameter in detail including how to configure Resp alarm limits,
enabling/disabling respiration, and how to configure the Resp parameter.
Respirations, or the amount of breaths per minute, are measured using two (2) methods:
•
Thoracic impedance via ECG
•
CO2 exchange via Microstream® CO2
The first method is thoracic impedance through the ECG signal. The respiration signal is measured
between two ECG electrodes:
• RA and LA of ECG Lead I, or
• RA and LL of ECG Lead II
The second is by CO2 exchange via internal CO2 module. Refer to ‘‘CO2 Monitoring (optional)’’ on
page 17-1 for additional information.
NOTE:
The respiration source is automatic. When the CO2 parameter is
detected, the system automatically uses CO2 as the source for
respiration. When CO2 is not present, ECG is automatically used as the
respiration source.
Patient Sizes
Intended patient types: Adult, Pediatric, Neonatal.
VPS
The VPS module supports the Respiration parameter when ECG is the respiration source.
Display Setup
To be able to see the Resp values, Resp must be configured to display on the Main Screen. Refer to
‘‘Display Options Dialog’’ on page 3-2 for additional information.
10.2
Resp Dialog
The Resp dialog (as shown in FIGURE 10-1) contains an Alarms tab, Setup tab, Waveform tab and an
Apnea tab. A description of each tab follows.
10.2.1
Navigating to the Resp Dialog
•
Select the Resp digital or waveform tile.
OR
10 - 2
1.
Select the Setup tab from the Navigation Area.
2.
Select the Parameters button.
3.
Select the Resp button.
The Resp dialog displays (as shown in FIGURE 10-1).
0070-10-0727-02
V Series Operating Instructions
Respiration (Resp)
Resp Dialog
FIGURE 10-1 Example Resp Dialog (Alarms Tab)
10.2.2
Configuring Resp Alarm Limits
Refer to ‘‘Configuring Alarm Limits’’ on page 8-2 for additional information.
10.2.3
Configuring the Resp Parameter
1.
Select the Resp digital or waveform tile.
2.
Select the Setup tab (as shown in FIGURE 10-2).
NOTE:
V Series Operating Instructions
The current parameter setting displays in bold to the right of the each
button.
0070-10-0727-02
10 - 3
Resp Dialog
Respiration (Resp)
FIGURE 10-2 Example Resp Dialog (Setup Tab)
Select the buttons described in TABLE 10-1 to configure the tab.
3.
TABLE 10-1
BUTTON
DESCRIPTION / COMMENTS
CHOICES*
ECG Resp
Configures whether respiration is enabled or
disabled.
On, Off
ECG Resp Color
Configures the Resp parameter digital tile and
waveform color.
16 distinct colors
Note: Default color is blue.
ECG Resp Lead
Configures which lead the respiration
parameter uses to calculate the
measurement when ECG is the respiration
source.
Lead I, and II
*
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
4.
10.2.4
10 - 4
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Configuring the Resp Waveform
1.
Select the Resp digital or waveform tile.
2.
Select the Waveform tab (as shown in FIGURE 10-3).
0070-10-0727-02
V Series Operating Instructions
Respiration (Resp)
Resp Dialog
FIGURE 10-3 Example Resp Dialog (Waveform Tab)
Select the buttons described in TABLE 10-2 to configure the tab.
3.
TABLE 10-2
FUNCTION
DESCRIPTION
SETTINGS*
Scale
Configures the Resp waveform gain.
1, 2, 3, 4 and 5
Speed
Configures the Resp waveform speed.
3.125 mm/sec, 6.25 mm/sec, 12.5
mm/sec, 25 mm/sec
*
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
4.
10.2.5
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Configuring Apnea Alarms
1.
Select the Resp digital or waveform tile.
2.
Select the Apnea tab (as shown in FIGURE 10-4).
NOTE:
V Series Operating Instructions
The Apnea alarm options in the Resp dialog are only enabled in the
dialog when Apnea Alarms are unlocked in the System Setup Alarms
tab. Refer to ‘‘Configuring the Alarms Tab’’ on page 25-7 for additional
information.
0070-10-0727-02
10 - 5
Resp Dialog
Respiration (Resp)
FIGURE 10-4 Example Resp Dialog (Apnea Tab)
Select the buttons described in TABLE 10-3 to configure the tab.
3.
TABLE 10-3
FUNCTION
DESCRIPTION
SETTINGS*
Apnea Alarm
Configures whether the apnea alarm is
on or off.
On, Off
Apnea Delay
Configures the number of seconds
before the apnea alarm is called.
Adult: 10-60 seconds, 30
Pediatric: 10-20 seconds, 15
Neonate: 10-20 seconds, 15
Apnea Latch
Configures whether the apnea alarm is
latched or unlatched. Refer to‘‘Apnea
Latching’’ on page 7-3 for additional
information.
On, Off
*
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
4.
10 - 6
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
0070-10-0727-02
V Series Operating Instructions
Respiration (Resp)
10.3
Respiration Tile Layouts
Respiration Tile Layouts
The Respiration parameter is shown in a digital and a waveform tile layout.
10.3.1
Respiration Digital Tile Layout
The Resp digital tile displays:
1.
Message area
2.
Unit of measure
3.
Respiration source
4.
Respiration value
5.
High and low alarm limits
1
2
5
4
3
FIGURE 10-5 Example Resp Digital Tile
10.3.2
10.3.3
About the Resp Tile
•
The Resp tile displays all respiration in units of RPM with a resolution of 1 RPM.
•
If the measurement is invalid, “- -” displays in place of digitals.
•
Displays all non-alarming text in the configured respiration color when the respiration source is
ECG.
•
Displays all non-alarming text in the configured CO2 color when the respiration source is CO2.
•
Replaces the digital value with an Apnea message when an apnea alarm conditions exists.
Resp Alarms
Refer to the ‘‘Factory Default Alarm Limits’’ on page 8-4 for additional information.
10.3.4
Message Area
The message area provides information about the current state of the Resp parameter. If there is
more than one message to display, the messages scroll.
MESSAGE
DETAILS
Resp High Alarm Violation
Indicates that the current value is either equal to or higher
than the set alarm limits.
Resp Low Alarm Violation
Indicates that the current value is either equal to or lower
than the set alarm limits.
High Impedance - Check Leads
Displays when a high impedance conditions exists.
V Series Operating Instructions
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10 - 7
Respiration Tile Layouts
10.3.5
Respiration (Resp)
Respiration Waveform Tile Layout
The Resp waveform tile displays:
1.
Tile name
2.
Resp waveform
3.
Resp waveform size
1
2
3
FIGURE 10-6 Example Resp Waveform Tile
10.3.6
10.3.7
About the Resp Waveform Tile
•
The Resp waveform tile displays the waveform and the wave gain setting in the configured
respiration color.
•
Provides a scrolling, real-time waveform and an erase bar to provide a time indicator of oldest and
new data.
•
The Resp waveform tile rails the top most value when the waveform exceeds the upper scale limit
for real-time waveforms.
•
The Resp waveform tile rails the bottom most value when the waveform exceeds the lower scale
limit for real-time waveforms.
•
The Resp waveform tile displays the waveform at the configured waveform sweep speed.
Message Area
No messages display in the Resp waveform tile message area.
10 - 8
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V Series Operating Instructions
Respiration (Resp)
10.4
Respiration Troubleshooting
Respiration Troubleshooting
The Resp tile message area displays messages indicating the current state of the Resp parameter. If
there is more than one message to display, the messages scroll.
ISSUE
REASON
SOLUTION
Do not see Resp parameter
tiles in display.
Parameter not configured to display.
Refer to ‘‘Display Options Dialog’’ on
page 3-2 for additional information.
Resp waveform too large
Scales set inappropriately.
Change lead selection.
Change respiration scale.
Resp waveform too small
Patient breathing is shallow or
patient is turned on side.
Change lead selection.
Scale set inappropriately.
Change respiration scale.
False apnea alarm
Apnea delay may be improperly set.
Choose another apnea delay.
Patient may be having frequent
episodes of CVA.
Reposition electrodes to better
detect respirations.
Scale size may be too low.
Change Respiration scale
Resp is turned off.
Turn Resp on.
Patient connected using ESIS choke
cable.
Check that proper patient cable is
used. Use approved non-ESIS
patient cable.
Cable not connected.
Check cable.
No Resp waveform or rate
displayed in the tile
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10 - 9
Respiration Troubleshooting
Respiration (Resp)
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V Series Operating Instructions
11.0
Invasive Blood Pressure (IBP)
Introduction .......................................................................................................................................................... 11-2
IBP Dialog................................................................................................................................................................ 11-3
Measuring IBP ...................................................................................................................................................... 11-7
IBP Digital Tile Layouts.................................................................................................................................... 11-8
IBP Tile Layouts.................................................................................................................................................... 11-11
Inserting the PA Catheter.............................................................................................................................. 11-12
Pulmonary Artery Wedge Pressure (PAWP) ....................................................................................... 11-13
IBP Troubleshooting......................................................................................................................................... 11-16
V Series Operating Instructions
0070-10-0727-02
11 - 1
Introduction
11.1
Invasive Blood Pressure (IBP)
Introduction
This chapter describes the Invasive Blood Pressure (IBP) parameter in detail, including step-by-step
instructions on how to configure alarm limits, rename IBP channels, establish filter settings, configure
the IBP waveform scale and speed, and initiate an IBP parameter measurement.
Invasive Blood Pressure (IBP) is a direct measurement of the patient's arterial or venous blood
pressure. IBP utilizes a catheter that is inserted directly into a vein, artery or other pressure access
areas, and is connected to a transducer for interpretation of Systolic (Sys), Diastolic (Dia), and Mean
blood pressures.
The V 12/V 21 calculates the systolic pressure, diastolic pressure and mean pressure values for each
IBP channel.The V 12/V 21 supports up to eight (8) invasive blood pressures measurements. It
provides systolic pressure, diastolic pressure and mean pressure values for each IBP channel.
Patient Sizes
Intended patient types: Adult, Pediatric, Neonatal.
VPS Connector
The VPS module supports two (2) IBP connectors (as shown in FIGURE 11-1). Refer to ‘‘Measuring IBP’’
on page 11-7 for additional information.
IBP
Connectors
FIGURE 11-1 Example VPS IBP Connectors (VPS on Left, Standalone Module on Right)
11 - 2
0070-10-0727-02
V Series Operating Instructions
Invasive Blood Pressure (IBP)
IBP Dialog
Display Setup
To be able to see the IBP values, IBP must be configured to display on the Main Screen. Refer to
‘‘Display Options Dialog’’ on page 3-2 for additional information.
11.2
IBP Dialog
The IBP dialog (as shown in FIGURE 11-2) contains an Alarms tab, Setup tab, and Waveform tab. A
description of each tab follows.
11.2.1
Navigating to the IBP Dialog
•
Select the IBP digital or waveform tile.
OR
1.
Select the Setup tab from the Navigation Area.
2.
Select the Parameters button.
3.
Select the IBP button.
The IBP dialog displays (as shown in FIGURE 11-2).
.
FIGURE 11-2 Example IBP Dialog (Alarms Tab)
11.2.2
Configuring IBP Alarm Limits
Refer to ‘‘Configuring Alarm Limits’’ on page 8-2 for additional information.
11.2.3
Configuring the IBP Parameter
1.
Select the IBP digital or waveform tile.
2.
Select the Setup tab (as shown in FIGURE 11-3).
V Series Operating Instructions
0070-10-0727-02
11 - 3
IBP Dialog
Invasive Blood Pressure (IBP)
NOTE:
The current parameter setting displays in bold to the right of each
button.
FIGURE 11-3 Example IBP1 Dialog (Setup Tab)
3.
Select the buttons described in TABLE 11-1 to configure the tab.
TABLE 11-1
BUTTON
DESCRIPTION / COMMENTS
CHOICES*
Label**
Configures the IBP label.
IBPx, ART1, ART2, UA, LV, PA, CVP, ICP,
IAP, LA, RA
Color**
Configures the IBP parameter color.
16 distinct colors
Channel 1/ART1-2/UA/LV: Red
Channel 2/PA: Yellow Channel 3/CVP/
RA: Blue
Channel 4: Green
Channel 5- 8/ICP/LA/IAP: White
Filter
Configures the IBP filter frequency for
each channel.
8 Hz, 12 Hz, 16 Hz
Display APP
Configures if APP displays in the digital
tile.
On, Off
NOTE:
Display CePP
Configures if CePP displays in the digital
tile.
NOTE:
*
**
11 - 4
This button only displays in the Setup tab when
the IBP channel is labeled IAP.
On, Off
This button only displays in the Setup tab when
the IBP channel is labeled ICP.
The factory default configuration settings are in bold.
Refer to glossary for acronym definitions
0070-10-0727-02
V Series Operating Instructions
Invasive Blood Pressure (IBP)
IBP Dialog
Select the Cancel or Accept button.
4.
11.2.4
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Configuring the IBP Waveform
1.
Select the IBP digital or waveform tile.
2.
Select the Waveform tab (as shown in FIGURE 11-4).
FIGURE 11-4 Example IBP1 Dialog (Waveform Tab)
3.
V Series Operating Instructions
Select the buttons described in TABLE 11-2 to configure the tab.
0070-10-0727-02
11 - 5
IBP Dialog
Invasive Blood Pressure (IBP)
TABLE 11-2
BUTTON
DESCRIPTION / COMMENTS
CHOICES*
Scale
Configures the waveform height and width.
-10 to 10 mmHg
0 to 20 mmHg
0 to 40 mmHg
0 to 60 mmHg
0 to 80 mmHg
60 to 140 mmHg
0 - 160 mmHg (when labeled an
IBP <channel> number)
0 to 225 mmHg
0 to 320 mmHg
Speed
Configures the waveform sweep speed.
6.25 mm/sec.
12.5 mm/sec.
25 mm/sec
50 mm/sec
*
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
4.
11.2.4.1
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Default IBP Waveform Sizes
The default IBP waveform size is 0 - 160 mmHg for all of the generic IBP<channel> labels. The other
IBP labels also have default waveform sizes. TABLE 11-3 outlines these defaults.
TABLE 11-3
11 - 6
LABEL
DEFAULT WAVEFORM SIZE
ART
0 to 160 mmHg
UA
0 to 80 mmHg
LV
0 to 160 mmHg
PA
0 to 40 mmHg
CVP
0 to 20 mmHg
ICP
0 to 20 mmHg
LA
0 to 20 mmHg
RA
0 to 20 mmHg
IAP
0 to 20 mmHg
0070-10-0727-02
V Series Operating Instructions
Invasive Blood Pressure (IBP)
11.3
Measuring IBP
Measuring IBP
1.
Plug the pressure transducer cable into one of the IBP connectors (as shown in FIGURE 11-1).
2.
The IBP1 and IBP2 waveforms display with their associated data to the right of the waveforms.
NOTE:
Do not use the arterial pressure catheter on a limb that is being utilized
for any other medical procedure. For example, an IV Catheter, NIBP Cuff
or an SpO2 sensor.
3.
Connect catheter line with flushing device to a pressure transducer.
4.
Zero pressure transducer as follows:
a. Open transducer vent to atmosphere.
b. Press the Zero All IBP button in Quick Functions menu, or individually zero pressure lines by
opening individual IBP Setup dialog.
c. Close the pressure transducer vent from atmosphere.
After the automatic zero process is complete, the pressure display should indicate zeros.
5.
Select the desired pressure scale in the IBP Menu.
NOTE:
Zero and flush the pressure line at regular intervals per standard
hospital procedure.
NOTE:
Pressure transducers are protected against the effects of defibrillation
and electro-cautery.
V Series Operating Instructions
0070-10-0727-02
11 - 7
IBP Digital Tile Layouts
11.4
Invasive Blood Pressure (IBP)
IBP Digital Tile Layouts
The IBP digital tile displays:
1.
Tile name
2.
Systolic values
3.
Message area
4.
Diastolic values
5.
Unit of measure
6.
Diastolic alarm limits
7.
Mean alarm limits
8.
Mean value
9.
Systolic alarm limits
NOTE:
When displaying a pulsatile pressure, the format will be SYS/DIA
(MEAN) (as shown in FIGURE 11-5). When displaying a non-pulsatile
pressure, the format will be MEAN (SYS/DIA) (as shown in FIGURE 11-6).
1
2
3
4
5
9
6
7
8
FIGURE 11-5 Example IBP Digital Tile (Pulsatile)
1
8
2
4
FIGURE 11-6 Example IBP Digital Tile (Non-Pulsatile)
11 - 8
0070-10-0727-02
V Series Operating Instructions
Invasive Blood Pressure (IBP)
IBP Digital Tile Layouts
11.4.1
PA Digital Tile
11.4.2
PAWP Digital
To use the current PA diastolic value as the PAWP value, the Accept PAWP button was selected in the
PAWP dialog box, and the PAWP timeout was not exceeded.
NOTE:
11.4.3
Intracranial Pressure (ICP) Digital Tile
When displaying ICP, the format is MEAN CePP
•
11.4.3.1
To display the PAWP value and timestamp in the digital tile, the Accept
PAD as PAWP button must configured to On. Refer to “Configuring the
IBP Parameter” on page 11-3 for additional information.
Cerebral Perfusion Pressure (CePP) Digital
The system calculates the CePP value by subtracting the Mean Arterial Pressure (MAP) from the IntraCranial Pressure (ICP).
NOTE:
To obtain the MAP digital value, the other IBP tile must be configured
as an ART line.
NOTE:
To display the CePP value in the digital tile, the CePP button must
configured to On. Refer to “Configuring the IBP Parameter” on page 113 for additional information.
11.4.4
Intraabdominal Pressure (IAP) Digital Tile
11.4.4.1
Abdominal Perfusion Pressure (APP) Digital
The system calculates the APP value by subtracting the Intra-Abdominal Pressure (IAP) from the
Mean Arterial Pressure (MAP).
NOTE:
V Series Operating Instructions
To obtain the MAP digital, the other IBP tile must be configured as an
ART line.
0070-10-0727-02
11 - 9
IBP Digital Tile Layouts
Invasive Blood Pressure (IBP)
NOTE:
11.4.5
11.4.6
To display the APP value in the digital tile, the Display APP button must
configured to On. Refer to “Configuring the IBP Parameter” on page 113 for additional information.
About the IBP Tile
•
The IBP tile displays all blood pressure in units of mmHg with a resolution of 1 mmHg.
•
During cuff inflation or deflation, the cuff pressure replaces the mean value.
•
If the IBP measurement is invalid, “- -” displays in place of digits.
•
An IBP tile displays “XX” in place of numerics when the transducer has not been zeroed.
Message Area
The message area provides information about the current state of the IBP parameter. If there is more
than one message to display, the messages scroll.
11 - 10
MESSAGE*
DETAILS
IBPX Systolic High Alarm Violation (where <X>
is the corresponding channel name)
Indicates that the current value is either equal to or higher
than the set alarm limits.
IBPX Systolic Low Alarm Violation (where <X>
is the corresponding channel name)
Indicates that the current value is either equal to or lower
than the set alarm limits.
IBPX Diastolic High Alarm Violation (where
<X> is the corresponding channel name)
Indicates that the current value is either equal to or higher
than the set alarm limits.
IBPX Diastolic Low Alarm Violation (where <X>
is the corresponding channel name)
Indicates that the current value is either equal to or lower
than the set alarm limits.
IBPX Mean High Alarm Violation (where <X> is
the corresponding channel name)
Indicates that the current value is either equal to or higher
than the set alarm limits.
IBPX Mean Low Alarm Violation (where <X> is
the corresponding channel name)
Indicates that the current value is either equal to or lower
than the set alarm limits.
Zeroing Complete
Indicates that the zeroing request successfully completed.
Unable To Zero
Indicates that the zeroing request did not complete
successfully.
0070-10-0727-02
V Series Operating Instructions
Invasive Blood Pressure (IBP)
11.5
IBP Tile Layouts
IBP Tile Layouts
The IBP parameter is shown in a digital tile and a waveform tile format.
11.5.1
IBP Digital Tile Layout
The IBP digital tile displays:
1.
Tile name
2.
IBP waveform
3.
IBP waveform scale
4.
Unit of measure
5.
PA waveform
1
2
3
4
3
FIGURE 11-7 Example IBP2 Waveform Tile
5
FIGURE 11-8 Example ARTPA Overlapping Waveform Tile
NOTE:
V Series Operating Instructions
Refer to ‘‘Overlapping Waveform’’ on page 3-10 for additional
information.
0070-10-0727-02
11 - 11
Inserting the PA Catheter
11.6
Invasive Blood Pressure (IBP)
Inserting the PA Catheter
NOTE:
One of the IBP channels must be labeled PA to use the PA Insertion
dialog.
1.
Prepare the catheter for insertion into the patient.
2.
Select the Procedures tab from the Navigation Area.
3.
Select the PA Insertion button.
The PA Insertion dialog displays (as shown in FIGURE 11-10).
FIGURE 11-9 Example PA Insertion Dialog
4.
Select the Setup button.
5.
Select the buttons described in TABLE 11-4 to configure the tab.
.
TABLE 11-4
FUNCTION
DESCRIPTION
SETTINGS*
PA Scale
Configures the PA waveform height in
the PA Insertion dialog.
-10 to 10 mmHg, 0 to 20 mmHg, 0 to
40 mmHg, 0 to 60 mmHg, 0 to 80
mmHg, 60 to 140 mmHg, 0 to 160
mmHg, 0 to 225 mmHg, 0 to 320
mmHg
PA Speed
Configures the PA waveform speed in
the PA Insertion dialog.
6.25 mm/sec, 12.5 mm/sec, 25 mm/
sec
*
The factory default configuration settings are in bold.
6.
Continue with catheter installation following hospital protocol.
7.
Use the dialog to help insert the catheter into the patient. The PA Insertion dialog reflects
waveform changes as the PA catheter progresses during the installation procedure.
NOTE:
11 - 12
Use the PA Insertion dialog as an adjunct. It is not meant to replace
proper clinical technique, fluoroscopy, and other methods used to
verify proper insertion criteria.
0070-10-0727-02
V Series Operating Instructions
Invasive Blood Pressure (IBP)
11.7
Pulmonary Artery Wedge Pressure (PAWP)
Pulmonary Artery Wedge Pressure (PAWP)
Pulmonary Artery Wedge Pressure (PAWP) is a pressure measurement derived from a PA catheter
when the PA distal balloon is inflated and the catheter advances and occludes a distal pulmonary
artery. PAWP pressure is a reflection of the pressure in the left ventricle at end-diastole.
NOTE:
11.7.1
One of the channels must be labeled PA to measure PAWP.
Measuring PAWP
NOTE:
To ensure accurate wedge pressure readings, rezero the PA pressure
channel and check the PA catheter for integrity, kinks and/or leaks prior
to measurement.
1.
Select the PA digital or waveform tile.
2.
Select the Zero button.
3.
Select the PAWP button.
The PAWP dialog displays (as shown in FIGURE 11-10).
FIGURE 11-10 Example PAWP Dialog
4.
Inflate balloon, then watch PA waveform for the wedge waveform.
NOTE:
5.
V Series Operating Instructions
Follow manufacturer’s suggested procedures and hospital policy for
PAWP balloon inflation.
Once a satisfactory wedge waveform is detected, press the Measure button to freeze the
waveforms within the PAWP dialog.
0070-10-0727-02
11 - 13
Pulmonary Artery Wedge Pressure (PAWP)
6.
Invasive Blood Pressure (IBP)
Adjust the reference line to the estimated wedge measurement by selecting the
arrow buttons.
11.7.2
7.
Select the Accept button to save the PAWP measurement.
The PAWP value and associated timestamp display in the PA digital tile.
8.
Optional - select Measure to further adjust the reference line.
9.
Select the Done button.
Understanding the PAWP Dialog
•
11.7.3
The PAWP dialog supports an expanded PA waveform and up to three (3) other waveforms
(primary ECG lead, PA, and CO2/Respiration).
•
The waveforms in the PAWP dialog are ordered as follows: ECG lead, ART, PA, and Resp/CO2.
•
All waveforms in the PAWP dialog scroll at the configured PA sweep speed.
•
All waveforms in the PAWP dialog share a common erase bar.
•
The ECG waveform is always positioned in the first waveform position in the PAWP dialog.
•
When the ART waveform is configured to On in the PAWP Setup dialog, and it is active, the ART
waveform displays in the second waveform position in the PAWP dialog.
•
PA is the third waveform in the PAWP dialog.
•
Resp/CO2 is the forth waveform in the PAWP dialog.
•
When currently monitoring CO2, the CO2 waveform is included in the PAWP dialog.
•
In the absence of the CO2 waveform, the Respiration waveform is included in the PAWP dialog.
PAWP Setup Dialog
To change some of the parameters which display in the PAWP dialog, change the PA waveform scale,
or the waveform speed, access the PAWP Setup dialog.
11 - 14
1.
Select the PA digital or waveform tile.
2.
Select the PAWP button.
3.
Select the Setup button.
The PAWP Setup dialog displays (as shown in FIGURE 11-11).
0070-10-0727-02
V Series Operating Instructions
Invasive Blood Pressure (IBP)
Pulmonary Artery Wedge Pressure (PAWP)
FIGURE 11-11 Example PAWP Setup Dialog
Select the buttons described in TABLE 11-5 to configure the tab.
4.
TABLE 11-5
BUTTON
DESCRIPTION / COMMENTS
CHOICES*
PA Scale
Configures the waveform height and width.
-10 to 10 mmHg
0 to 20 mmHg
0 to 40 mmHg
0 to 60 mmHg
0 to 80 mmHg
60 to 140 mmHg
0 to 160 mmHg
0 to 225 mmHg
0 to 320 mmHg
PA Speed
Configures the waveform sweep speed.
6.25 mm/sec
12.5 mm/sec
25 mm/sec
Display ART
Configures whether or not to display the ART
waveform in the PAWP dialog.
On, Off
*
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
5.
V Series Operating Instructions
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
0070-10-0727-02
11 - 15
IBP Troubleshooting
11.8
Invasive Blood Pressure (IBP)
IBP Troubleshooting
The IBP tile message area displays messages indicating the current state of the IBP parameter. If there
is more than one message to display, the messages scroll.
MESSAGE/PROBLEM
Damped invasive waveform
IBP not displayed / no IBP
waveform
Dashes “- -” display in place
of numerics.
REASON
SOLUTION
Air bubbles in tubing.
Eliminate air from tubing.
Kinked catheter.
Change position of catheter, check
patient.
Catheter against wall of blood
vessel.
Check for leaks at connector, flush
catheter.
Blood in tubing.
Pump pressure bag up to 300
mmHg.
Catheter partially occluded with
clot.
Consult physician.
Improper setup.
Check display setup in monitor
setup.
Cable not plugged in.
Check cable.
Transducer not connected.
Check transducer connection.
Stopcock turned improperly.
Check transducer.
Transducer not zeroed.
Check and zero the transducer.
The measured result is invalid or out
of range.
Change to a pulsatile label.
IBP might be set to non-pulsatile
labels like CVP, LA, RA, and ICP.
11 - 16
Abnormally high or low
readings
Transducer too HIGH or to LOW.
Check patient adjust transducer
rezero.
Unable to Zero
Stopcock not open to atmosphere.
Check transducer.
PAWP button disabled
One IBP channel must be labeled PA.
Label an IBP channel as PA.
0070-10-0727-02
V Series Operating Instructions
12.0
Heart Rate (HR)
Introduction .......................................................................................................................................................... 12-2
HR Dialog ................................................................................................................................................................ 12-2
Heart Rate Digital Tile Layout..................................................................................................................... 12-4
HR Troubleshooting ......................................................................................................................................... 12-6
V Series Operating Instructions
0070-10-0727-02
12 - 1
Introduction
12.1
Heart Rate (HR)
Introduction
The chapter describes the heart rate (HR) parameter and the various HR sources available.The HR
sources when configured for the Auto mode are ECG, pulsatile channels of IBP, and SpO2. The V 12/V
21 calculates the high and low HR values based on the HR source.
Patient Sizes
Intended patient types: Adult, Pediatric, Neonatal.
VPS
The VPS module calculates the HR parameter value through an IBP channel, ECG, or SpO2 parameters.
12.2
HR Dialog
The HR dialog (as shown in FIGURE 12-1) contains an Alarm tab and a Setup tab. A description of
each tab follows.
12.2.1
Navigating to the HR Dialog
•
Select the HR digital tile or waveform tile.
OR
1.
Select the Setup tab from the Navigation Area.
2.
Select the Parameters button.
3.
Select the HR button.
The HR dialog displays (as shown in FIGURE 12-1).
FIGURE 12-1 Example HR Dialog (Alarms Tab)
12 - 2
0070-10-0727-02
V Series Operating Instructions
Heart Rate (HR)
12.2.2
HR Dialog
Configuring Heart Rate Alarm Limits
Refer to ‘‘Configuring Alarm Limits’’ on page 8-2 for additional information.
12.2.3
Configuring the Heart Rate Parameter
1.
Select the HR digital tile.
2.
Select the Setup tab (as shown in FIGURE 12-2).
NOTE:
The current parameter setting displays in bold to the right of each
button.
FIGURE 12-2 Example HR Dialog (Setup Tab)
Select the buttons described in TABLE 12-1 to configure the tab.
3.
TABLE 12-1
BUTTON
DESCRIPTION / COMMENTS
CHOICES*
HR Source
Configures the HR source.
Auto, ECG, all available
pulsatile IBP channels, SpO2
NOTE:
*
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
4.
V Series Operating Instructions
The monitor produces an audible systole
beep from the current heart rate source. To
adjust the systole beep volume or to disable
it, refer to ‘‘Audio Levels Dialog’’ on page
2-13.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
0070-10-0727-02
12 - 3
Heart Rate Digital Tile Layout
12.3
Heart Rate (HR)
Heart Rate Digital Tile Layout
The HR digital tile displays:
1.
Tile name
2.
Message area
3.
Units of measure
4.
HR value
5.
HR Source
6.
High and Low alarm limits
7.
HR value (hollow font)
1
2
3
4
6
5
FIGURE 12-3 Example HR Digital Tile
7
FIGURE 12-4 Example HR Digital Tile (during an ESU event)
12.3.1
12.3.2
About the HR Tile
•
The HR tile displays heart rate in units of BPM with a resolution of 1 mmHg.
•
If the measurement is invalid, “- -” displays in place of digits.
•
The HR tile displays the value in a hollow font (as shown in FIGURE 12-4) during an ECG Noise, ESU
event, or when the reliability of the measurement value is compromised.
•
Non-alarming text displays:
•
In the ECG color when the HR source is invalid or the HR source is ECG.
•
In the IBP <channel> color when the HR source is an IBP <channel>.
•
In the SpO2 color when the HR source is SpO2.
•
In the NIBP color when the HR source is NIBP.
HR Alarms
Refer to ‘‘Factory Default Alarm Limits’’ on page 8-4 for additional information.
12 - 4
0070-10-0727-02
V Series Operating Instructions
Heart Rate (HR)
12.3.3
Heart Rate Digital Tile Layout
Message Area
The HR Tile Message Area displays messages indicating the current state of the HR parameter. When a
message is displayed, it overwrites the units of measure. If there is more than one message to display,
the messages scroll.
MESSAGE
DETAILS
HR High Alarm Violation
The HR alarm limit is equal to or exceeds the high HR alarm limit.
HR High Alarm Violation
The HR alarm limit is equal to or exceeds the low HR alarm limit.
ESU
An ESU event was detected and the ECG Respiration is disabled.
ECG Noise
There is noise present on one or more leads.
V Series Operating Instructions
0070-10-0727-02
12 - 5
HR Troubleshooting
12.4
Heart Rate (HR)
HR Troubleshooting
The HR tile message area displays messages indicating the current state of the HR parameter. If there
is more than one message to display, the messages scroll.
12 - 6
MESSAGE/PROBLEM
REASON
SOLUTION
The HR value display in a hollow
font (as shown in FIGURE 4-4).
The measurement value is
compromised by an ECG Noise or
ESU event.
Resolve technical issue.
Dashes “- -” display in place of
numerics.
The measurement is invalid.
Check the patient.
0070-10-0727-02
V Series Operating Instructions
13.0
Temperature (Temp)
Introduction .......................................................................................................................................................... 13-2
Temperature Dialog ......................................................................................................................................... 13-3
Measuring Temperature ................................................................................................................................ 13-5
Temperature Digital Tile Layout................................................................................................................ 13-9
Temperature Troubleshooting .................................................................................................................. 13-11
V Series Operating Instructions
0070-10-0727-02
13 - 1
Introduction
13.1
Temperature (Temp)
Introduction
This chapter describes the Temperature function in detail, including configuring alarm limits,
configuring the temperature, and taking temperature measurements.
The V 12/V 21 temperature measurement function is designed to take a continuous temperature
reading from 400 series or compatible probes.
Temp units of " C" and " F" are available. Adjust the temperature units in the Setup tab.
The V 12/V 21 has three (3) potential temperature measurement sources: the TI, T2, and T Blood. Data
for up to two (2) of these sources may be simultaneously displayed.
Patient Sizes
Intended patient types: Adult, Pediatric, Neonatal (with the exception of TBlood).
VPS
The VPS module supports one (1) Temperature connector (as shown in FIGURE 13-1). Refer to
‘‘Measuring Temperature’’ on page 13-5 for additional information.
Temperature
Connectors
FIGURE 13-1 Example VPS Temp Connectors (Standalone Module on Left, VPS on Right)
Display Setup
To be able to see the Temp values, Temp must be configured to display on the Main Screen. Refer to
‘‘Display Options Dialog’’ on page 3-2 for additional information.
13 - 2
0070-10-0727-02
V Series Operating Instructions
Temperature (Temp)
13.2
Temperature Dialog
Temperature Dialog
The Temperature dialog (as shown in FIGURE 13-2) contains an Alarms tab and a Setup tab. A
description of each tab follows.
13.2.1
Navigating to the Temperature Dialog
•
Select the Temp digital tile.
OR
1.
Select the Setup tab from the Navigation Area.
2.
Select the Parameters button.
3.
Select the Temperature button.
The Temperature dialog displays (as shown in FIGURE 13-2).
FIGURE 13-2 Example Temperature Dialog (Alarms Tab)
13.2.2
Configuring Temperature Alarm Limits
Refer to ‘‘Configuring Alarm Limits’’ on page 8-2 for additional information.
13.2.3
Configuring the Temperature Parameter
1.
Select the Temp digital tile.
2.
Select the Setup tab (as shown in FIGURE 13-3).
NOTE:
V Series Operating Instructions
The current parameter setting displays in bold to the right of the
button.
0070-10-0727-02
13 - 3
Temperature Dialog
Temperature (Temp)
FIGURE 13-3 Example Temperature Dialog (Setup Tab)
Select the buttons described in TABLE 13-1 to configure the tab.
3.
TABLE 13-1
BUTTON
DESCRIPTION / COMMENTS
CHOICES*
T<channel number>Label
Configures the temperature channel
label.
T<channel number> 1,2 or 3,
ESO, NAS, REC, BLA, AXI, SKI.
Color
Configures the temperature
parameter and graphical plot color.
16 distinct colors
Note: Factory default color is
white.
Display Delta
Configures whether delta
temperature displays in the
temperature tile.
On, Off
Units
Configures the temperature unit of
measure.
F°
C°
*
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
4.
13 - 4
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
0070-10-0727-02
V Series Operating Instructions
Temperature (Temp)
13.3
Measuring Temperature
Measuring Temperature
The different temperature probes are described in detail in the following sections.
13.3.1
Temperature Probes
13.3.1.1
Skin Temperature Sensor with 400 Series Thermistor
Description (P/N 0206-03-0112-02)
The Skin Temperature Sensor is designed for placement on the surface of the skin. The skin
temperature sensor consists of a thermistor embedded in an adhesive backed foam disk. One side of
the foam disk is covered by a metallic film. The opposite surface of the foam is coated with a medical
grade hypo-allergenic adhesive suitable for skin application. The hypo-allergenic adhesive holds the
sensor in place. The foam thermally insulates the sensor and the metallic layer reflects external
infrared heat energy thus providing accurate measurement of body temperature.
The temperature transducer is in the form of an electrically insulated 400 series thermistor. The
accuracy of the thermistor is ± 0.2° Celsius in the range of 5° Celsius to 45° Celsius. The assembly is
disposable, single use only, and packaged sterile.
This device is intended for use with electronic temperature monitors accepting 400 series thermistor
sensors or equivalent that are equipped with alarms. To interconnect the probe with the instrument,
use cable part number 040-000091-00.
Electrical leakage current of the device, when used with the monitor and cable, comply with IEC 6011/EN60601-1.
Indications
The Skin Temperature Sensor is indicated for use in the routine monitoring of skin temperature.
Contraindications
The Skin Temperature Sensor may be contraindicated over traumatized areas.
Adverse Reactions
Adverse reactions reported during applications of Skin Temperature Sensors include skin abrasions
and tissue burns due to aberrant electro-cautery current pathways.
Directions For Use And Precautions
1.
Dry skin completely in the area intended for sensor placement.
2.
Remove the protective backing and place the sensor onto the previously dried skin area.
3.
Align the sensor’s connector with the monitor cable’s connector and push firmly to assure full
contact. Forced mating of the connectors without proper alignment may cause damage to the
connectors and interruption in electrical continuity.
V Series Operating Instructions
0070-10-0727-02
13 - 5
Measuring Temperature
13.3.2
Temperature (Temp)
WARNING:
During procedures employing electro-cautery, use currently
acceptable procedures to minimize conditions of the thermistor and
lead wires functioning as an alternate path for radio-frequency current
to return to ground, causing localized tissue burns. Procedures which
may minimize risk of electro-surgical burns are: keep both active and
ground electrodes of the electro-cautery system in close proximity so
that the temperature sensor is outside the radio-frequency current
field. Keep temperature monitor with its associated cables separated
from electro-cautery systems. Unusual, fast artificial variations in
temperature readings may occur with concomitant applications of the
electro-cautery system.
WARNING:
Temperature probes are sterile unless unit container is opened or
damaged.
CAUTION:
Temperature probes are for single use only. Destroy after single use. Do
not re-sterilize. Federal (U.S.A.) law restricts this device to sale by or on
the order of a physician.
Esophageal Stethoscope with 400 Series Thermistor
Temperature Sensor
Description (P/Ns 0206-03-0112-02, 0206-03-0118-02)
The esophageal stethoscope with temperature sensor is a disposable device which provides for
accurate measurement of core body temperature as well as transmission of heart and lung sounds.
Heart and lung sounds are transmitted across a thin cuff wall, through the side and distal openings of
the tube. Made of a special material which optimizes sound transmission and remains both durable
and flexible, the cuff maintains its integrity and prevents secretion from entering the tube. For
connection to any standard ear piece, a male luer adaptor is attached to the proximal end of the
esophageal stethoscope. The stethoscope is 19 inches (48.3cm) long. The tube, the cuff and luer
adaptor are made of lightweight, non-toxic, implant tested material.
The temperature transducer is in the form of an electrically insulated “400” series thermistor, which is
permanently secured within the lumen of the esophageal stethoscope. The thermistor is placed at
the distal end of the tube. The accuracy of the thermistor is ±0.2°C in the range of 5 - 45°C.
The assembly is disposable, single use only, and packaged sterile. It is available in sizes 12 and 18
French.
This device is intended for use with electronic temperature monitors accepting 400 series thermistor
sensors or equivalent that are equipped with alarms. To interconnect the probe with the instrument,
use cable part number 040-000091-00.
Electrical leakage current of the device (sensor and esophageal stethoscope) when used with
monitor and cable, comply with IEC 601-1/EN 60601-1.
Indications
The esophageal stethoscope with temperature sensor is indicated where patient temperature
monitoring is desired along with accurate heart and lung sound monitoring. The sensor is designed
for insertion into the esophagus.
Contraindications
The use of the esophageal stethoscope may be contraindicated in neonates and small infants
undergoing tracheostomy or internal jugular artery catheterization or laser surgical procedures.
13 - 6
0070-10-0727-02
V Series Operating Instructions
Temperature (Temp)
Measuring Temperature
Adverse Reactions
Adverse reactions reported during applications of esophageal stethoscopes with or without
temperature sensors include accidental tracheal or bronchial intubation accompanied with airway
obstruction, esophageal abrasion and or perforation, pharyngeal abrasion and tissue burns due to
aberrant electro-cautery radio frequency current pathways.
Directions for Use and Precautions
13.3.3
1.
If a patient has to be intubated with an endotracheal tube, perform the intubation prior to the
placement of the esophageal stethoscope.
2.
Lubricate the stethoscope prior to the insertion and place the stethoscope in accordance with
currently acceptable medical procedures.
3.
Verify position of the stethoscope by direct laryngoscopy or other acceptable medical
techniques.
4.
Align the sensor’s connector with the monitor cable’s connector and push firmly to assure full
contact. Forced mating of the connectors without proper alignment may cause damage to the
connectors and interruption in electrical continuity.
WARNING:
During procedures employing electro-cautery, use currently
acceptable procedures to minimize conditions of the thermistor and
lead wires functioning as an alternate path for radio-frequency current
to return to ground, causing localized tissue burns. Procedures which
may minimize risk of electro-surgical burns are: keep both active and
ground electrodes of the electro-cautery system in close proximity so
that the temperature sensor is outside the radio-frequency current
field. Keep temperature monitor with its associated cables separated
from electro-cautery systems. Unusual, fast artificial variations in
temperature readings may occur with concomitant applications of the
electro-cautery system.
WARNING:
Temperature probes are sterile unless unit container is opened or
damaged.
CAUTION:
Temperature probes are for single use only. Destroy after single use. Do
not re-sterilize. Federal (U.S.A.) law restricts this device to sale by or on
the order of a physician.
Esophageal/Rectal Temperature Probe with 400 Series
Thermistor
Description (P/Ns 0206-03-0209-02, 0206-03-0212-02)
Hypothermia and hyperthermia are well recognized clinical conditions necessitating temperature
monitoring. The economical and disposable Esophageal/Rectal Temperature Probe is a sensitive and
accurate temperature transducer, to be used clinically where continuous temperature monitoring is
required.
The temperature sensor is in the form of an electrically insulated “400” series thermistor, which is
permanently secured within a PVC tube. The bullet tipped PVC tube provides for atraumatic insertion.
The thermistor is placed at the distal end of the tube. The accuracy of the thermistor is ± 0.2°C in the
range of 5 - 45°C.
The assembly is disposable, single use only, and packaged sterile. It is available in sizes 9 and 12
French.
V Series Operating Instructions
0070-10-0727-02
13 - 7
Measuring Temperature
Temperature (Temp)
This device is intended for use with electronic temperature monitors accepting 400 series thermistor
sensors or equivalent that are equipped with alarms. To interconnect the probe with the instrument,
use cable part number 040-000091-00.
Electrical leakage current of the device (sensor and PVC tube) when used with monitor and cable,
comply with IEC 601-1/EN 60601-1.
Indications
The Esophageal/Rectal Temperature Probe is indicated where continuous patient temperature
monitoring is desired. The sensor is designed for insertion into the esophagus, nasopharynx, or
rectum.
Contraindications
The use of the esophageal/rectal sensor may be contraindicated in neonates and small infants
undergoing tracheostomy or internal jugular artery catheterization and laser surgical procedures.
Adverse Reactions
Adverse reactions reported during applications of these sensors include accidental tracheal or
bronchial intubation accompanied with airway obstruction, esophageal or rectal abrasion and/or
perforation, pharyngeal abrasions and tissue burns due to aberrant electro-cautery radio-frequency
current pathways.
Directions For Use And Precautions
13 - 8
1.
If a patient has to be intubated with an endotracheal tube, perform the intubation prior to
placing the temperature probe into esophagus.
2.
Lubricate the temperature probe prior to insertion and place the probe in accordance with
currently acceptable medical procedures.
3.
Verify position of the probe by acceptable medical procedures.
4.
Align the sensor’s connector with the monitor cable’s connector and push firmly to assure full
contact. Forced mating of the connectors without proper alignment may cause damage to the
connectors and interruption in electrical continuity.
WARNING:
During procedures employing electro-cautery, use currently
acceptable procedures to minimize conditions of the thermistor and
lead wires functioning as an alternate path for radio-frequency current
to return to ground, causing localized tissue burns. Procedures which
may minimize risk of electro-surgical burns are: keep both active and
ground electrodes of the electro-cautery system in close proximity so
that the temperature sensor is outside the radio-frequency current
field. Keep temperature monitor with its associated cables separated
from electro-cautery systems. Unusual, fast artificial variations in
temperature readings may occur with concomitant applications of the
electro-cautery system.
WARNING:
Temperature probes are sterile unless unit container is opened or
damaged.
CAUTION:
Temperature probes are for single use only. Destroy after single use. Do
not re-sterilize. Federal (U.S.A.) law restricts this device to sale by or on
the order of a physician.
0070-10-0727-02
V Series Operating Instructions
Temperature (Temp)
13.4
Temperature Digital Tile Layout
Temperature Digital Tile Layout
The Temperature tile displays:
1.
Temperature name
2.
Tile label
3.
Up to two (2) temperature values
4.
Message area
5.
Unit of measure
6.
High and low alarm limits
7.
Delta value
2
4
3
1
6
5
FIGURE 13-4 Example Digital Temp Tile with a single temperature
4
3
2
1
7
6
5
2
3
FIGURE 13-5 Example Digital Temp Tile with two temperatures and delta
NOTE:
V Series Operating Instructions
Delta Temperature displays if it is enabled and if at least two
temperatures are being monitored. Refer to ‘‘Configuring the
Temperature Parameter’’ on page 13-3 for additional information.
0070-10-0727-02
13 - 9
Temperature Digital Tile Layout
13.4.1
13.4.2
Temperature (Temp)
About the Temperature Tile
•
The Temp tile displays temperature in the configured units of measure, with a resolution of 0.1° C
when the unit of measure is Celsius and 0.1° F when the unit of measure is Fahrenheit.
•
If the Temp measurement is invalid, “- -” displays in place of digits.
•
The temperature tile can support two formats; one for a single temperature display and one for
dual temperature display.
•
The temperature tile automatically reconfigures between the single temperature format and the
dual temperature format as needed when the probes are inserted and removed.
Temperature Alarms
Refer to the ‘‘Temp Tab’’ on page 8-6 for additional information.
13.4.3
Message Area
The message area provides information about the current state of the CO2 parameter. If there is more
than one message to display, the messages scroll.
13 - 10
MESSAGE*
DETAILS
<Temperature Label> High Alarm Violation
Indicates that the current value is either equal to or higher
than the set alarm limits.
<Temperature Label> High Alarm Violation
Indicates that the current value is either equal to or lower
than the set alarm limits.
Delta T High Alarm Violation
Indicates that the current value is either equal to or higher
than the set alarm limits.
0070-10-0727-02
V Series Operating Instructions
Temperature (Temp)
13.5
Temperature Troubleshooting
Temperature Troubleshooting
The Temp tile message area displays messages indicating the current state of the Temp parameter. If
there is more than one message to display, the messages scroll.
MESSAGE/PROBLEM
REASON
SOLUTION
Dashes “- -” display in place
of numerics.
The measurement is invalid.
Check the patient.
Temperature probes not
working
Poor probe contact with body
Check the body surface contact at
the probe tip.
Reposition or apply
thermoconductive gel.
Temperature not displayed
in tile
V Series Operating Instructions
Improper display setup
Check Display Setup and change
as needed.
Cable not plugged in.
Check the cable.
0070-10-0727-02
13 - 11
Temperature Troubleshooting
Temperature (Temp)
This page intentionally left blank.
13 - 12
0070-10-0727-02
V Series Operating Instructions
14.0
Non-Invasive Blood Pressure (NIBP)
Introduction .......................................................................................................................................................... 14-2
NIBP Dialog............................................................................................................................................................ 14-3
Measuring NIBP................................................................................................................................................... 14-5
General NIBP Information............................................................................................................................. 14-8
NIBP Digital Tile Layout .................................................................................................................................. 14-9
NIBP List Tile Layout ......................................................................................................................................... 14-11
NIBP Troubleshooting ..................................................................................................................................... 14-12
V Series Operating Instructions
0070-10-0727-02
14 - 1
Introduction
14.1
Non-Invasive Blood Pressure (NIBP)
Introduction
This chapter describes the Non-Invasive Blood Pressure (NIBP) function in detail including how to
configure NIBP alarm limits, monitor NIBP, and configure the NIBP parameter.
The V 12/V 21 calculates NIBP values using the oscillometric method of noninvasive blood pressure
measurement. The NIBP measurement includes Systolic (Sys), Diastolic (Dia) and Mean Blood
Pressure. These measurements are determined accurate after comparison to auscultatory
measurements per ANSI/AAMI SP10 standard with the fifth Korotkoff sound which is used to
determine diastolic pressure.
The V 12/V 21 measures blood pressure that are equivalent to those obtained by a trained observer
using the cuff/stethoscope auscultation method, within the limits prescribed by the American
National Standard, Electronic or automated sphygmomanometers.
Patient Sizes
Intended patient types: Adult, Pediatric, Neonatal.
VPS Connector
The VPS module supports one (1) NIBP connector (as shown in FIGURE 14-1). Refer to ‘‘Measuring
NIBP’’ on page 14-5 for additional information.
NIBP Connector
FIGURE 14-1 Example Nellcor VPS NIBP Connector
14 - 2
0070-10-0727-02
V Series Operating Instructions
Non-Invasive Blood Pressure (NIBP)
NIBP Dialog
Display Setup
To be able to see the NIBP values, NIBP must be configured to display on the Main Screen. Refer to
‘‘Display Options Dialog’’ on page 3-2 for additional information.
14.2
NIBP Dialog
The NIBP dialog (as shown in FIGURE 14-2) contains an Alarms tab and a Setup tab. A description of
each tab follows.
14.2.1
Navigating to the NIBP Dialog
•
Select the NIBP digital tile.
OR
1.
Select the Setup tab from the Navigation Area.
2.
Select the Parameters button.
3.
Select the NIBP button.
The NIBP dialog displays (as shown in FIGURE 14-2).
FIGURE 14-2 Example NIBP Dialog (Alarms Tab)
14.2.2
Configuring NIBP Alarm Limits
Refer to ‘‘Configuring Alarm Limits’’ on page 8-2 for additional information.
14.2.3
Configuring the NIBP Parameter
1.
Select the NIBP digital tile.
2.
Select the Setup tab (as shown in FIGURE 14-3).
V Series Operating Instructions
0070-10-0727-02
14 - 3
NIBP Dialog
Non-Invasive Blood Pressure (NIBP)
NOTE:
The current parameter setting displays in bold to the right of each
button.
FIGURE 14-3 Example NIBP Dialog (Setup Tab)
Select the buttons described in TABLE 14-1 to configure the tab.
3.
TABLE 14-1
BUTTON
DESCRIPTION / COMMENTS
CHOICES*
Interval
Configures the time separation between NIBP
automatic measurements.
Off, 1 min, 2 min, 3 min, 5 min, 10
min, 15 min, 20 min, 30 min, 1
hour, 2 hour, 4 hours
Color
Configures the NIBP parameter color.
There are 16 different colors
available. The factory default is
orange.
Start Mode
Configures the NIBP measurement mode.
Refer to ‘‘Measurement Types’’ on page 14-5
for additional information.
Interval, Clock·
Start Pressure
Configures the start pressure value for the
NIBP measurement.
Adult: 100 to 280 (180)
Pediatric: 60 to 180 (140)
Neonate: 40 to 120 (100)
Success End Tone
Configures the monitor to sound a distinct
audio tone when it obtains a successful blood
pressure measurement.
On, Off
*
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
4.
14 - 4
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
0070-10-0727-02
V Series Operating Instructions
Non-Invasive Blood Pressure (NIBP)
14.3
14.3.1
Measuring NIBP
Measuring NIBP
NOTE:
Try to measure infants when they are calm. A kicking or crying baby
may disturb or jiggle the cuff, causing noise within the system and
resulting in unstable blood pressure readings. If necessary, hold the
cuffed limb steady, without impeding circulation. Do not hold onto the
cuff and do not pat the cuffed limb to comfort the child.
NOTE:
NIBP cannot be taken under all conditions. Even manual methods,
employing a sphygmomanometer and stethoscope, will not work on
unstable or active patients.
Measurement Types
MEASUREMENT TYPE
DESCRIPTION
Interval
Takes NIBP measurements based on a specified time period (for example,
every 10 minutes, 20 minutes, etc.).
Clock
Synchronizes the NIBP measurement interval with the real time clock. For
example, if you start the BP measurement at 1:05 pm, the next measurement
will be taken at 2:05 pm.
NIBP Stat
Allows continuous measurements for a maximum of five (5) minutes or 10
measurements. In the Stat mode, measurements are taken every two
(2) seconds).
Manual
14.3.2
14.3.3
Allows for an instant NIBP measurement without configuring an interval or
clock setting.
NIBP Cuff Checklist
•
On infants, try the calf. Irritable newborns will react to the cuff pressure but may tolerate the
calf better than the arm. Place the cuff just above the ankle.
•
On infants, place the cuff lightly. If the cuff is too snug, it will not work properly. On infants, you
should be able to easily move the cuff over the limb.
•
To reduce errors, adjust the cuff the cuff so that little or no air is present within the cuff.
•
Ensure that the cuff lies directly against the patient’s skin. No clothing should come between
the patient and the cuff.
•
Do not be place the NIBP cuff on a limb that is being utilized for any other medical procedure.
For example, an IV catheter or an SpO2 sensor.
•
Verify the cuff’s Index line falls between the Range lines.
•
Ensure that the cuff is properly applied to avoid pressure on the limb not falling to zero
between measurements when the cuff is wrapped too tightly.
•
For skin that is fragile (i.e., on pediatrics, geriatrics, etc.), consider using a longer interval
between measurements to decrease the number of cuff inflations over a period of time. In
extreme cases, a thin layer of soft roll or cotton padding may be applied to the limb in order to
cushion the skin when the cuff is inflated. This measure may affect NIBP performance and
should be used with caution.
Measuring NIBP
NOTE:
V Series Operating Instructions
Try using disposable cuffs on infants. Disposable cuffs are more pliant
than reusable ones. They generally fit smaller infants better.
0070-10-0727-02
14 - 5
Measuring NIBP
Non-Invasive Blood Pressure (NIBP)
NOTE:
Select the cuff size based on the limb circumference of the patient. The
design dimensions of the cuffs and their intended uses are based on
recommendations of the American Heart Association.
NOTE:
Replace cuffs that have become brittle as they age.
NOTE:
Ensure that the pressure tubes are not compressed or restricted.
1.
Select an appropriate sized cuff for the patient.
2.
Attach the cuff hose to the NIBP connector on the VPS (as shown in FIGURE 14-1)
NOTE:
3.
Apply the cuff to the patient.
4.
If not already selected, choose the patient size through the Patient Info dialogs.
5.
If needed, change the starting cuff pressure through the NIBP Setup tab.
NOTE:
Refer to TABLE 14-1 on page 14-4 for additional information.
Choose a measurement type.
6.
14.3.4
Ensure that the pressure tubes are not compressed or restricted.
NOTE:
Refer to ‘‘Measurement Types’’ on page 14-5 for additional information.
NOTE:
Inflate the cuff only after proper application to the patient’s limb. Cuff
damage can result if the cuff is left unwrapped and then inflated.
•
The cuff inflates to the selected start pressure, slowly deflates, and collects the data for display.
The cuff pressure displays in place of the Mean digital.
•
If the inflation was inadequate, the NIBP retries a measurement for a maximum of three (3)
times.
•
The patient should remain still. After the pressure drops below the diastolic pressure, the
measurements are displayed.
•
If the End tone is set to On, a tone indicates a successful measurement.
NIBP Interval Measurements
The NIBP Interval mode allows automatic measurements based on an specified time period (for
example, every 10 minutes, 20 minutes).
14.3.5
1.
Follow steps 1- 5 in the ‘‘Measuring NIBP’’ on page 14-5.
2.
Select the Interval button from the Setup tab.
3.
Select an interval period.
4.
Select the Start NIBP button to begin the measurement.
NOTE:
Once selected, the Start NIBP button changes to Stop NIBP.
NOTE:
If an NIBP interval is changed when in the Interval mode, the change
takes effect at the completion of the current interval measurement.
Pausing/Restarting a Clock or Interval NIBP Measurement
To suspend or postpone a scheduled measurement or a cycle already in progress:
14 - 6
•
Select the Stop NIBP button in the NIBP dialog.
•
Select the Stop NIBP button on the Quick Functions tab.
•
Select the Start/Stop NIBP button on the VPS.
0070-10-0727-02
V Series Operating Instructions
Non-Invasive Blood Pressure (NIBP)
Measuring NIBP
NOTE:
Once selected, the Start NIBP button changes to Stop NIBP.
NOTE:
When an interval measurement is stopped, the NIBP status changes to
Idle.
Restarting a Clock or Interval NIBP Measurement Once Paused
Once selecting Stop NIBP, the measurement pauses but the interval or clock configuration remains
intact until the paused mode is exited. To exit the Paused mode, select the Start NIBP button. The
interval or clock measurements resume.
14.3.6
NIBP Stat Measurements
The NIBP Stat mode allows continuous measurements for a maximum of five (5) minutes or 10
measurements. The number of measurements taken is dependent on the cuff pressure. In the Stat
mode, measurements are taken every two (2) seconds).
•
Start an NIBP Stat measurement by doing one of the following:
•
Select the NIBP Stat button in the Quick Functions tab.
•
Select the NIBP Stat button in the NIBP dialog.
NOTE:
14.3.7
If the Stat mode is active, “Intrv: STAT” displays in the NIBP tile.
Stopping a Stat NIBP Measurement
To stop a Stat NIBP measurement cycle before the designated measurement period expires:
•
Select the Stop NIBP button in the NIBP dialog.
•
Select the Stop NIBP button on the Quick Functions tab.
•
Select the Start/Stop NIBP button on the VPS.
NOTE:
V Series Operating Instructions
When the Stat cycle ends, the system returns to its previous
measurement state.
0070-10-0727-02
14 - 7
General NIBP Information
Non-Invasive Blood Pressure (NIBP)
14.4
General NIBP Information
14.4.1
Cuff Inflation Time
If the NIBP does not pressurize the cuff to the target pressure within 60 seconds, the cuff vents to
atmosphere, and the NIBP Message Area alternately a displays a retry message.
14.4.2
NIBP Pressure Limit Fail Safe
If the cuff is over-pressurized, the cuff automatically vents to the atmosphere, and the NIBP message
window alternately displays Cuff Over Pressure and Unable to Measure. The maximum inflation
pressures are:
14 - 8
•
Adult:
330 mmHg
•
Pediatric: 220 mmHg
•
Neonate: 165 mmHg
0070-10-0727-02
V Series Operating Instructions
Non-Invasive Blood Pressure (NIBP)
14.5
NIBP Digital Tile Layout
NIBP Digital Tile Layout
The NIBP digital tile displays:
1.
Tile name
2.
Message area
3.
Systolic value
4.
Diastolic value
5.
Units of measure
6.
Diastolic alarm limits
7.
Mean alarm limits
8.
Mean value/cuff pressure
9.
Elapsed time since last measurement
10. Measurement interval
11. Systolic alarm limits
1
2
3
4
5
11
6
7
10
9
8
FIGURE 14-4 Example NIBP Digital Tile
14.5.1
14.5.2
About the NIBP Tile
•
The NIBP tile displays all blood pressure in units of mmHgwith a resolution of 1 mmHg.
•
During cuff inflation or deflation, the cuff pressure replaces the mean value.
•
If the NIBP measurement is invalid, “- -” displays in place of digits.
•
If the elapsed time of the current measurement meets or exceeds the configured timeout value,
“- -” displays in place of the BP values.
NIBP Alarms
Refer to the ‘‘Pressure Tab’’ on page 8-5 for additional information.
14.5.3
Heart Rate (HR) Measurement
If the HR Source is set to Auto, and no other source for HR is available, the NIBP measures the patient’s
heart rate for Neonate, Pediatric, and Adult sizes using a blood pressure cuff. If the system is unable to
measure heart rate, “- -” displays in place of a numeric.
NOTE:
V Series Operating Instructions
Refer to the Heart Rate (HR) chapter for additional information.
0070-10-0727-02
14 - 9
NIBP Digital Tile Layout
14.5.4
Non-Invasive Blood Pressure (NIBP)
Message Area
The message area provides information about the current state of the NIBP parameter. When a
message is displayed, it overwrites the units of measure. If there is more than one message to display,
the messages scroll.
14 - 10
MESSAGE
DETAILS
NIBP Systolic High Alarm
Violation
Indicates that the current value is either equal to or higher than the set alarm
limits.
NIBP Systolic Low Alarm
Violation
Indicates that the value is either equal to or lower than the set alarm limits.
NIPB Diastolic High Alarm
Violation
Indicates that the value is either equal to or higher than the set alarm limits.
NIPB Diastolic Low Alarm
Violation
Indicates that the value is either equal to or lower than the set alarm limits.
NIPB Mean High Alarm
Violation
Indicates that the value is either equal to or higher than the set alarm limits.
NIPB Mean Low Alarm
Violation
Indicates that the value is either equal to or lower than the set alarm limits.
Measuring
The NIBP measurement is in process once the cuff begins to inflate.
Deflate
The measurement stopped and the cuff deflates.
Retry – Pump Higher
The measurement failed due to a reason other than inadequate cuff inflation
pressure or hardware overpressure, and a retry is being attempted.
Cuff Inflation Pressure Failure;
Retry
The measurement failed because of inadequate cuff inflation pressure and a
retry is being attempted.
Unable to Measure
The system was unsuccessful in capturing the NIBP measurement. This
message times out with the NIBP data and is based on the NIBP timeout.
Measurement Stopped
The measurement ceased before it finished taking the measurement.
Ready to Begin a
Measurement
The monitor is ready to take an NIBP measurement.
Cuff Overpressure
The hardware overpressure limit was exceeded.
Check Calibration
Software detected that the overpressure transducer is out of calibration.
Press Start NIBP to Clear
Overpressure
The NIBP cuff pressure exceeded the maximum pressure allowed for a given
patient size.
Measurement Failed; Retry
The NIBP measurement was unsuccessful and must be retried.
0070-10-0727-02
V Series Operating Instructions
Non-Invasive Blood Pressure (NIBP)
14.6
NIBP List Tile Layout
NIBP List Tile Layout
The NIBP list tile displays the four (4) most recent measurements, with the most recent measurement
at the top of the list.The NIBP list tile displays:
1.
Tile name
2.
Message area
3.
Measurement time
4.
Systolic value
5.
Diastolic value
6.
Mean value
7.
Measurement type
8.
Interval
NOTE:
When the background color of an NIBP value is highlighted (as shown
in 14-5), this indicates that the value violated an alarm threshold
causing an alarm. The color corresponds to the alarm priority.
1
2
3
4
5
6
7
8
2
FIGURE 14-5 Example NIBP List Tile
V Series Operating Instructions
0070-10-0727-02
14 - 11
NIBP Troubleshooting
14.7
Non-Invasive Blood Pressure (NIBP)
NIBP Troubleshooting
The NIBP tile message area displays messages indicating the current state of the NIBP parameter. If
there is more than one message to display, the messages scroll.
ISSUE
REASON
SOLUTION
Dashes “- -” display in place
of numerics.
Measurement is invalid.
Check sensor placement, move as
necessary. Switch limb/notify
physician.
Double beep tone heard
An NIBP Start button is selected
when an NIBP measurement is in
currently in progress.
Complete the current measurement
before selecting the NIBP Start
button.
The NIBP cuff is still deflating when
the NIBP Start button is selected.
Wait for the cuff to deflate before
selecting the NIBP Start button.
Patient movement
Wait until patient is calm or gently
hold limb.
Unable to obtain a BP
Reading too high or too low
14 - 12
Cuff or hose NOT attached / leaking
Check all connections.
HR irregular / arrhythmia present
Check patient and notify physician.
Blood pressure is out of range.
Check patient and verify BP with
manual method.
Improper cuff size / brand
Measure patient limb. Use only
properly sized approved accessories.
Incorrect cuff size
Measure patient limb, use correct
cuff.
Patient movement
Wait until patient is calm or gently
hold limb.
0070-10-0727-02
V Series Operating Instructions
15.0
Pulse Oximetry (SpO2)
Introduction .......................................................................................................................................................... 15-2
SpO2 Dialog .......................................................................................................................................................... 15-3
Navigating to the SpO2 Dialog................................................................................................................. 15-3
Measuring SpO2................................................................................................................................................. 15-7
SpO2 Tile Layouts .............................................................................................................................................. 15-9
Performance Considerations ...................................................................................................................... 15-13
SpO2 Troubleshooting ................................................................................................................................... 15-14
V Series Operating Instructions
0070-10-0727-02
15 - 1
Introduction
15.1
Pulse Oximetry (SpO2)
Introduction
This chapter describes the SpO2 function in detail including monitoring an SpO2 measurement,
configuring alarm limits, waveform color, and waveform speed.
Pulse oximetry is a continuous and non-invasive measurement of the amount of oxygen attached to
the hemoglobin in red blood cells. SpO2 is an estimation of arterial oxygen saturation. The V 12/V 21
comes standard with Nellcor® SpO2 or Masimo SpO2 which measures the SpO2 high and low limits.
Patient Sizes
Intended patient types: Adult, Pediatric, Neonatal.
VPS Connector
The VPS module supports one (1) SpO2 connector. Refer to ‘‘Taking an SpO2 Measurement’’ on page
15-7 for additional information.
SpO2 Connector
FIGURE 15-1 Example Nellcor VPS SpO2 Connector
Display Setup
To be able to see the SpO2 values, SpO2 must be configured to display on the Main Screen. Refer to
‘‘Display Options Dialog’’ on page 3-2 for additional information.
15 - 2
0070-10-0727-02
V Series Operating Instructions
Pulse Oximetry (SpO2)
15.2
SpO2 Dialog
SpO2 Dialog
The SpO2 dialog (as shown in FIGURE 15-2) contains an Alarms tab, Setup tab, and a Waveform tab.
A description of each tab follows.
15.2.1
Navigating to the SpO2 Dialog
•
Select the SpO2 digital or waveform tile.
OR
1.
Select the Setup tab from the Navigation Area.
2.
Select the Parameters button.
3.
Select the SpO2 button.
The SpO2 dialog displays (as shown in FIGURE 15-2).
FIGURE 15-2 Example SpO2 Dialog (Alarms tab)
15.2.2
Configuring SpO2 Alarm Limits
Refer to ‘‘Configuring Alarm Limits’’ on page 8-2 for additional information.
15.2.3
Configuring the SpO2 Parameter Setup
1.
Select the SpO2 digital or waveform tile.
2.
Select the Setup tab (as shown in FIGURE 15-3).
NOTE:
V Series Operating Instructions
The current parameter setting displays in bold to the right of the each
button.
0070-10-0727-02
15 - 3
SpO2 Dialog
Pulse Oximetry (SpO2)
FIGURE 15-3 Example Nellcor SpO2 Dialog (Setup Tab)
3.
Select the buttons described in TABLE 15-1 to configure the tab.
TABLE 15-1
FUNCTION
DESCRIPTION
SETTINGS*
Sensor Off Audio
(Nellcor and Masimo)
Configures whether there will be an
audible tone if there is an SpO2 sensor
off condition.
On, Off
Color
(Nellcor and Masimo)
Configures the SpO2 parameter and
waveform color.
16 distinct colors
Note: Default color is cyan.
Sat-Seconds
(Nellcor only)
Configures the saturation seconds when
using a Nellcor SpO2 module. SatSeconds limit controls the time that
the% SpO2 level may fall below the
alarm limit before an audible alarm
sounds.
Off, 10 seconds, 25 seconds, 50
seconds, and 100 seconds.
Avg. Mode
(Nellcor only)
Configures how quickly the reported
SpO2 value responds to changes in the
patient’s saturation.
Normal, Fast
Display PI (perfusion
index)
(Masimo only)
Configures whether there will be a
perfusion rate displayed in the digital tile.
The perfusion index allows clinicians to
assess the pulse strength at the
monitoring site for optimal sensor
placement.
On, Off
*
15 - 4
The factory default configuration settings are in bold.
0070-10-0727-02
V Series Operating Instructions
Pulse Oximetry (SpO2)
SpO2 Dialog
TABLE 15-1 (Continued)
FUNCTION
DESCRIPTION
SETTINGS*
Sensitivity Mode
(Masimo only)
Choose the sensitivity mode depending
upon signal quality and patient motion.
High, Normal, APOD
High
This mode should be used for the sickest
patients, where obtaining a reading is
most difficult. Maximum Sensitivity is
designed to interpret and display data
for even the weakest of signals. This
mode is recommended during
procedures and when clinician and
patient contact is continuous.
Normal
This mode provides the best
combination of sensitivity and probe off
detection performance. This mode
is recommended for the majority of
patients.
APOD (Adaptive Probe Off Detection)
This mode is the least sensitive in
picking up a reading on patients with
low perfusion but has the best detection
for probe-off conditions. This mode is
useful for patients that are at particular
risk of the sensor becoming detached
(pediatric, combative, etc.)
Post Avg. Time
(Masimo only)
Configures the alarm delay.
2-4 seconds, 4-6 seconds, 8 seconds,
10 seconds, 12 seconds, 16 seconds
Fast Sat
(Masimo only)
Configures whether there will be a
turned on or off. FastSat enables rapid
tracking of arterial oxygen saturation
changes.
On, Off
*
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
4.
15.2.4
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Configuring the SpO2 Waveform
1.
Select the SpO2 digital or waveform tile.
2.
Select the Waveform tab (as shown in FIGURE 15-4).
V Series Operating Instructions
0070-10-0727-02
15 - 5
SpO2 Dialog
Pulse Oximetry (SpO2)
FIGURE 15-4 Example Nellcor SpO2 Dialog (Waveform Tab)
Select the buttons described in TABLE 15-2 to configure the tab.
3.
)
TABLE 15-2
FUNCTION
DESCRIPTION
SETTINGS*
ECG/SpO2 Speed
Configures the SpO2 pleth waveform
and ECG waveform speed.
6.25 mm/sec, 12.5 mm/sec, 25 mm/
sec, 50 mm/sec
Display SIQ
(Masimo only)
Configures whether the SIQ displays in
the SpO2 waveform tile. SIQ measures
the signal quality.
On, Off
*
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
4.
15 - 6
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
0070-10-0727-02
V Series Operating Instructions
Pulse Oximetry (SpO2)
Measuring SpO2
15.3
Measuring SpO2
15.3.1
Taking an SpO2 Measurement
1.
Select the appropriate sensor for the patient.
2.
Attach the SpO2 sensor to the patient’s finger or other appropriate site.
3.
Attach the SpO2 patient cable to the sensor and plug the other end of the patient cable into the
SpO2 connector (as shown in FIGURE 15-1 on page 15-2).
4.
The SpO2 measurement displays when the V 12/V 21 detects that the sensor is connected to
the patient. A pleth waveform displays to the left of the SpO2 digital tile, provided the SpO2
parameter is part of the Display Setup.
CAUTION:
Tissue damage or inaccurate measurements may be caused by incorrect
SpO2 sensor application or use, such as wrapping too tightly, applying
supplemental tape, failing to inspect the sensor site periodically, or
failing to position appropriately. Carefully read the sensor directions
for use, the V 12/V 21 Operating Instructions, and all precautionary
information before use.
CAUTION:
Inaccurate SpO2 measurements may be caused by:
•
Incorrect sensor application or use
•
Significant levels of dysfunctional hemoglobins, (e.g.,
carboxyhemoglobin or methemoglobin)
•
Intra-vascular dyes such as indocyanine green or methylene blue
•
Exposure to excessive illumination such as surgical lamps
(especially ones with a xenon light source), bilirubin lamps,
fluorescent lights, infrared heating lamps, or excessive ambient
light. In such cases, cover the sensor site with opaque material
•
Excessive patient movement
•
Venous pulsations
•
Electro-surgical interference
•
Placement of a sensor on an extremity that has a blood pressure
cuff, arterial catheter, or intra-vascular line
•
Nail polish or fungus
CAUTION:
In certain situations in which perfusion and signal strength are low,
such as in patients with thick or pigmented skin, inaccurately low SpO2
readings will result. Verification of oxygenation should be made,
especially in pre-term infants and patients with chronic lung disease,
before instituting any therapy or intervention.
CAUTION:
Many patients suffer from poor peripheral perfusion due to
hypothermia, hypovolemia, severe vasoconstriction, reduced cardiac
output, etc. These symptoms may cause a loss in vital sign readings.
CAUTION:
Prolonged and continuous monitoring may increase the risk of skin
erosion and pressure necrosis at the site of the sensor. Check the SpO2
sensor site frequently to ensure proper positioning, alignment and skin
integrity at least every eight (8) hours; with the Adult and Pediatric reusable finger sensor, check every four (4) hours; for neonates and
patients of poor perfusion or with skin sensitive to light, check every 2 3 hours; more frequent examinations may be required for different
patients. Change the sensor site if signs of circulatory compromise
occur.
V Series Operating Instructions
0070-10-0727-02
15 - 7
Measuring SpO2
Pulse Oximetry (SpO2)
CAUTION:
15.3.2
When cleaning SpO2 sensors, do not use excessive amounts of liquid.
Wipe the sensor surface with a soft cloth, dampened with cleaning
solution. Do not attempt to sterilize.
Nellcor® SpO2
CAUTION:
When equipped with Nellcor® SpO2, use only Nellcor oxygen
transducers including Nellcor Oxisensor® and OxiMax® patient
dedicated adhesive sensors. Use of other oxygen transducers may
cause improper oximeter performance.
Nellcor Sensors
Nellcor provides a family of sensors suitable for a wide variety of clinical settings and patients.
Specific sensors have been developed for neonates, infants, children, and adults. Durasensor®
and/ OxiMax® oxygen transducers are sterile adhesive sensors with optical components mounted on
adhesive tape. Oxiband® oxygen transducers and the Duraform® oxygen transducer system are
reusable sensors that are applied with disposable adhesive. The Durasensor DS-100A Adult Digit
Oxygen Transducer is a reusable sensor with its optical components mounted in a plastic casing. The
Nellcor RS-10 and Max-Fast® oxygen transducers are adhesive sensors for application on the forehead
or temples.
Packaging of sterile sensors ensure sterile conditions until opened or damaged or until expiration
date is reached.
NOTE:
Consideration should be given to the disposal of packaging waste.
To order all Nellcor accessories and sensors call 1-888-744-1414.
Selecting a Nellcor Sensor
Sensors are designed for specific sites on patients with designated weight ranges. To select the
appropriate sensor, consider the patient’s weight, level of activity, adequacy of perfusion, which
sensor sites are available, whether sterility is required, and the anticipated duration of monitoring.
15.3.3
Masimo SpO2
V 12/V 21 monitors equipped with Masimo SET SpO2 allow the user to adjust sensitivity and SpO2
avg time. Choose the sensitivity mode depending upon signal quality and patient motion. In most
cases, the normal setting is appropriate. If patient motion is limited, use the high sensitivity mode.
Choose the average time based on the a number of seconds.
NOTE:
Refer to TABLE 15-1 on page 15-4.
CAUTION:
When equipped with Masimo SET® SpO2, use only Masimo
SET Oxygen Transducers including Masimo SET LNOP® and
LNCS® Patient Dedicated Adhesive Sensors and Masimo SET
PC Series Patient Cables. Use of other oxygen transducers
may cause improper oximeter performance.
Masimo SET Sensors
Masimo SET provides a family of sensors suitable for a wide variety of clinical settings and patients.
Specific sensors have been developed for neonates, infants, children, and adults. All sensors are
indicated for continuous non-invasive monitoring of arterial oxygen saturation (SpO2) and pulse rate,
all sensors are non-sterile and usable during patient movement.
The Adult Reusable Finger Sensors can also be used for spot check applications if needed. All sensors
are intended for single-patient use only unless indicated as “reusable.”
15 - 8
0070-10-0727-02
V Series Operating Instructions
Pulse Oximetry (SpO2)
15.4
SpO2 Tile Layouts
SpO2 Tile Layouts
The SpO2 parameter is shown in a digital tile and a waveform tile format.
15.4.1
SpO2 Digital Tile Layout
The SpO2 digital tile displays:
1.
Tile name
2.
SpO2 value
3.
SpO2 unit of measure
4.
High and low alarm limits
5.
Message area
6.
PR value
7.
PR unit of measure
8.
Nellcor Sat-Seconds icon (pie-chart)
9.
Masimo perfusion index value (as shown in FIGURE 15-6)
5
1
6
4
7
8
2
3
FIGURE 15-5 Example Nellcor SpO2 Digital Tile
About the Nellcor Sat-Seconds Icon
Sat-seconds is used to control oximetry nuisance alarms.
The display rules of Sat-Seconds icon (as shown in FIGURE 15-5):
•
Displays when the Sat-Seconds setting is activated.
•
Indicates the current Sat-Seconds value beside the icon.
•
Indicates the current status of the alarm graphically within the pie-chart icon.
•
Fills in a clockwise direction when the monitor detects the SpO2 value is outside the set alarm
limits.
•
Empties in a counter-clockwise direction when the SpO2 reading falls within the set alarm limits.
V Series Operating Instructions
0070-10-0727-02
15 - 9
SpO2 Tile Layouts
Pulse Oximetry (SpO2)
About the Masimo Perfusion Index Indicator
9
FIGURE 15-6 Example Masimo SpO2 Digital Tile
15.4.2
15.4.3
•
Displays when the PI setting is activated
•
Indicates the current PI value beside the PI label
•
Displays invalid data as "- -"
•
Displays the PI resolution as 0.01% - 9.99% when 0 < PI < 10 %.
•
Displays the PI resolution as 10.0% - 20.0% when 20% >= PI >= 10 %.
About the SpO2 Tile
•
The SpO2 tile displays in units of % with a resolution of 1%.
•
If the SpO2 measurement or PR is invalid, “- -” displays in place of digits.
•
If the elapsed time of the current measurement meets or exceeds the configured timeout value,
“- -” displays in place of the SpO2 values.
•
The SpO2 PR value display in units of BPM with a resolution of 1 BPM.
SpO2 Alarms
Refer to the ‘‘SpO2/Gases Tab’’ on page 8-8 for additional information.
15.4.4
Message Area
The message area provides information about the current state of the SpO2 parameter. If there is
more than one message to display, the messages scroll.
15 - 10
MESSAGE
DETAILS
SpO2 High Alarm Violation
Indicates that the current value is either equal to or higher than the set alarm
limits.
SpO2 Low Alarm Violation
Indicates that the current value is either equal to or lower than the set alarm
limits.
No Sensor
Indicates that the SpO2 sensor or SpO2 cable was removed or there is no SpO2
sensor present at power up.
Board Failure
Indicates that the SpO2 board malfunctioned.
Interference
Indicates that noise is detected on the pulse signal preventing pulse separation
from the noise.
Pulse Search
Indicates that the hardware settings are being adjusted in order to separate a
pulse waveform.
Sensor Failure
Indicates that the sensor failed.
Sensor Off
Indicates that the sensor is off the patient.
Communication Error
Indicates that the VPS module is having problems communicating with the
SpO2 board.
0070-10-0727-02
V Series Operating Instructions
Pulse Oximetry (SpO2)
SpO2 Tile Layouts
Nellcor Only Messages
MESSAGE
DETAILS
No Pulse
The Nellcor status indicates no detectable pulse is
measured and all other measurement conditions are
normal.
Check Sensor
Indicates that a faulty sensor was detected.
Sat-Seconds
The Nellcor status indicates that a Sat-Seconds alarm is
active. Sat-Seconds limit controls the time that the % SpO2
level may fall below the alarm limit before an audible alarm
sounds.
Motion alarm message
The Nellcor status indicates that a motion is detected.
Masimo Only Messages
MESSAGE
DETAILS
Unrecognized Sensor
Indicates that the Masimo board does not recognize the
sensor.
Too Much Light
Indicates that there is too much ambient light to take a
measurement.
Low Perfusion
Indicates that the patient’s perfusion is low.
Defective Sensor
Indicates that a faulty sensor was detected.
V Series Operating Instructions
0070-10-0727-02
15 - 11
SpO2 Tile Layouts
15.4.5
Pulse Oximetry (SpO2)
SpO2 Waveform Tile Layout
The SpO2 waveform tile displays:
1.
Tile name
2.
Pleth waveform
3.
Signal Index Quality (SIQ)
1
2
FIGURE 15-7 Example Nellcor SpO2 Waveform Tile
3
FIGURE 15-8 Example Masimo SpO2 Waveform Tile (SIQ enabled)
15.4.6
About the SpO2 Waveform Tile
•
Displays in the configured SpO2 color.
•
Provides scrolling, real-time waveform data.
•
Scrolls the waveform in the configured sweep speed.
•
Automatically scales the SpO2 waveform data area to maximize the vertical height of the Pleth
waveform for the data range.
•
If using Masimo SpO2, the Signal Quality Index (SIQ) may display below the waveform if enabled.
NOTE:
15.4.7
Refer to TABLE 15-2 on page 15-6 for additional information.
Message Area
No messages display in the SpO2 waveform tile message area.
15 - 12
0070-10-0727-02
V Series Operating Instructions
Pulse Oximetry (SpO2)
15.5
Performance Considerations
Performance Considerations
To ensure optimal performance, use an appropriate sensor, apply it as directed and observe all
warnings and cautions.
If excessive ambient light is present, cover the sensor site with opaque material. Failure to do so may
result in inaccurate measurements. Light sources that can affect performance include surgical lights,
especially those with a xenon light source, bilirubin lamps, fluorescent lights, infrared heating lamps,
and direct sunlight.
When unable to get a reading, or the reading is inaccurate, consider the following:
•
If your patient is poorly perfused, try applying the sensor to another site - such as a different
finger or toe.
•
Check that the sensor is properly aligned.
•
In electrosurgery, make sure sensor is not too close to ESU devices or cables.
•
Check to make sure the site area is clean/non-greasy. Clean site and sensor if needed.
CAUTION:
A functional tester cannot be used to assess the accuracy of the pulse
oximeter probe or a pulse oximeter monitor.
NOTE:
If the supply mains is interrupted during SpO2 monitoring, the V 12/V
21 switches power to battery backup if at least one battery is installed
and charged. If power has been completely interrupted, SpO2
monitoring continues when the supply mains is restored or a fully
charged battery is installed, and power has been recycled to the
monitor.
V Series Operating Instructions
0070-10-0727-02
15 - 13
SpO2 Troubleshooting
15.6
Pulse Oximetry (SpO2)
SpO2 Troubleshooting
The SpO2 tile message area displays messages indicating the current state of the SpO2 parameter. If
there is more than one message to display, the messages scroll.
ISSUE
REASON
SOLUTION
Dashes “- -” display in place
of numerics.
Measurement is invalid.
Check sensor placement, move as
necessary. Switch limb/notify
physician.
Do not see SpO2 parameter
tiles in display.
Parameter not configured to display.
Refer to ‘‘Display Options Dialog’’ on
page 3-2 for additional information.
Unable to obtain SpO2
reading
Patient has poor perfusion.
Switch limbs/notify physician.
Sensor not on patient.
Reapply sensor.
No SpO2 waveform
Low amplitude SpO2 signal
Dashes “- -” display in place
of numerics.
15 - 14
Cables loose / not connected.
Check connections, switch cable.
Ambient light.
Switch limbs and cover sensor with
opaque material.
Waveform not selected to display.
Refer to ‘‘Display Options Dialog’’ on
page 3-2 for additional information.
Cable or sensor not plugged in.
Check cable and sensor.
SpO2 sensor on same limb as cuff.
Check sensor placement, move as
necessary.
Patient has poor perfusion.
Switch limb/notify physician.
Measurement is invalid.
Check sensor placement, move as
necessary. Switch limb/notify
physician.
0070-10-0727-02
V Series Operating Instructions
16.0
ST
Introduction .......................................................................................................................................................... 16-2
ST Dialog ................................................................................................................................................................. 16-2
ST Tile Layouts...................................................................................................................................................... 16-9
ST Troubleshooting .......................................................................................................................................... 16-13
V Series Operating Instructions
0070-10-0727-02
16 - 1
Introduction
16.1
ST
Introduction
This chapter describes the ST parameter in detail including how to configure ST alarm limits, enable/
disable ST analysis, adjust the ST ISO, J points, and review the ST waveforms for each active ECG lead.
Monitoring ST is optional and needs to be enabled for analysis to begin.
The V 12/V 21 calculates ST values and calls an alarm can be set for either single lead alarm or dual
lead alarm. The ST single lead alarm initiates when one ST lead exceeds the defined alarm
parameters. The ST dual lead alarm initiates when two ST leads exceeds the defined alarm
parameters.
Patient Sizes
Intended patient types: Adult and Pediatric.
VPS
The VPS module supports the ST parameter through the ECG parameter.
Display Setup
To be able to see the ST values, ST must be configured to display on the Main Screen. Refer to ‘‘Display
Options Dialog’’ on page 3-2 for additional information.
16.2
ST Dialog
The ST dialog (as shown in FIGURE 16-1) contains an Alarm tab, Setup tab, Adjust tab, and a Review
tab. A description of each tab follows.
16.2.1
Navigating to the ST Dialog
•
Select the ST tile.
OR
16 - 2
1.
Select the Setup tab from the Navigation Area.
2.
Select the Parameters button.
3.
Select the ST button.
The ST dialog displays (as shown in FIGURE 16-1).
0070-10-0727-02
V Series Operating Instructions
ST
ST Dialog
FIGURE 16-1 Example ST Dialog (Alarms Tab)
16.2.2
Configuring ST Alarms Limits
Refer to ‘‘Configuring Alarm Limits’’ on page 8-2 for additional information.
16.2.3
Configuring the ST Parameter
1.
Select the ST tile.
2.
Select the Setup tab (as shown in FIGURE 16-2).
NOTE:
V Series Operating Instructions
The current parameter setting displays in bold to the right of the each
button.
0070-10-0727-02
16 - 3
ST Dialog
ST
FIGURE 16-2 Example ST Dialog (Setup Tab)
3.
Select the buttons described in TABLE 16-1 to configure the tab.
TABLE 16-1
BUTTON
DESCRIPTION / COMMENTS
CHOICES*
Analysis
Enables or disables ST analysis.
On, Off
ST Alarm Delay
Configures the delay time before calling an ST
alarm.
30 seconds, 45 seconds, 1
minute, 90 seconds, 2 minutes,
and 3 minutes]
ST Mode
Configures whether Current and Reference
digital data display in the ST Real-Time tile, or
if only the Current digital data appears in the
ST Real-Time tile.
Current, Curr.(Ref )
12 Lead View
When using a 12-lead cable type, configures
which of the 12-leads are viewable in the tile.
1-aVF, V1-V6
Show Markers
When displaying the ST Rep Beat tile, this
configures whether or not the ISO, J/ST points
are shown in the tile
On, Off
*
16 - 4
The factory default configuration settings are in bold.
0070-10-0727-02
V Series Operating Instructions
ST
ST Dialog
TABLE 16-1 (Continued)
BUTTON
DESCRIPTION / COMMENTS
CHOICES*
Representative Beat
Display
When using a cable type other than 3-lead,
and using Auto mode, the leads display
based on their deviation. The most deviated
beat displays at the top, followed by second
most deviated in the middle, followed by the
third most deviated at the bottom.
When using the Manual mode, the leads
display according the beat number selected
in the Configure ST Beat Display option. Beat
one displays as the top beat, beat two as the
middle, and beat three at the bottom.
Auto (which includes the 3 most
deviated leads), Manual
NOTE:
Configure ST Beat
Display
*
This button is only enabled when the
Representative Beat Display is set to Manual.
This configures which beats display in the ST
Rep Beat tile.
Varies depending on the current
lead set in use.
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
4.
16.2.4
Switching leadsets
automatically changes back
to the default of Auto.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Adjusting the ISO and J/ST Points
NOTE:
When connected to a central monitoring system (i.e., central station),
adjustments to ISO and J/ST points at the V 12/V 21 bedside monitor
are updated at the central station if ST is enabled. Refer to the central
station operating instructions for additional information.
1.
Select the ST tile.
2.
Select the Adjust tab (as shown in FIGURE 16-3).
NOTE:
The current parameter setting displays in bold to the right of each
button.
NOTE:
When using a cable type other than 3-lead cable, the ST Adjust dialog
displays two (2) valid representative beats as shown in FIGURE 16-3.
NOTE:
When using a 3-lead cable, only one (1) representative beat displays.
V Series Operating Instructions
0070-10-0727-02
16 - 5
ST Dialog
ST
Representative Beat
FIGURE 16-3 Example ST Dialog other than 3-lead (Adjust Tab)
Adjust the parameter using the tab buttons described in TABLE 16-2.
3.
TABLE 16-2
BUTTON
DESCRIPTION / COMMENTS
OPTIONS*
ST Offset
Based on the msec setting selected, moves
the ST point further or closer to the J point in
the ST template.
60/80 msec, 40 msec, 60 msec, 80
msec
ISO, J Adjust
Selecting Auto fixes the ISO and J/ST points.
Selecting Manual allows the clinician to
manually adjust ISO and J/ST points.
Auto, Manual
NOTE:
ISO left arrow
If ISO, J Adjust is set to manual, the button adjusts the ISO reference line to the left.
ISO right arrow
If ISO, J Adjust is set to manual, the button adjusts the ISO reference line right.
J/ST left arrow
If ISO, J Adjust is set to manual, the button adjusts the J and ST reference lines left.
J/ST right arrow
If ISO, J Adjust is set to manual, the button adjusts the J and ST reference lines right.
*
The factory default configuration settings are in bold.
Select Accept or Cancel.
4.
16 - 6
To adjust the ISO, J/ST points manually, the ISO, J Adjust
must be set to Manual.
•
The Accept button saves the settings and closes the dialog.
•
The Cancel button closes the dialog without saving the settings
0070-10-0727-02
V Series Operating Instructions
ST
ST Dialog
16.2.5
Reviewing ST Points
1.
Select the ST tile.
2.
Select the Review tab.
FIGURE 16-4 Example ST Dialog (Review Tab)
Select Accept or Cancel.
3.
16.2.6
•
The Accept button saves the settings and closes the dialog.
•
The Cancel button closes the dialog without saving the settings
ST Relearning
NOTE:
Selecting the Relearn ST button initiates the learning process for ST
analysis.
The V 12/V 21 initiates the learning process for ST or Arrhythmia analysis after one of the following:
•
Unit power-up
•
Return to normal monitoring from Standby mode
•
After enabling ST or Arrhythmia analysis
•
The lead has been changed in ECG 1 waveform (3 lead only)
•
Patient Size is changed
•
After selecting the Relearn button in the ST, ECG, or Arrhythmia tab.
Selecting the Relearn button is recommended after one or more of the following:
V Series Operating Instructions
•
ECG electrodes have been repositioned
•
Eight hours have passed since the last relearn
0070-10-0727-02
16 - 7
ST Dialog
16 - 8
ST
•
After significant changes to the patient QRS complex
•
A clinician has observed clinically questionable arrhythmia calls
•
Initiate a relearn if learning occurred during a leads off condition.
0070-10-0727-02
V Series Operating Instructions
ST
ST Tile Layouts
16.3
ST Tile Layouts
The ST parameter is shown in a digital tile and a ST Rep (Representative) Beat format.
16.3.1
ST Digital Tile Layout
The ST digital tile displays:
1.
Tile name
2.
Message area
3.
Units of measure
4.
Lead identifier
5.
Current and reference values
1
2
3
4
4
5
5
FIGURE 16-5 Example 5-Lead ST Digital Tile
FIGURE 16-6 Example 3-Lead Digital Tile
FIGURE 16-7 Example 6-Lead Digital Tile
FIGURE 16-8 Example 12-Lead Digital Half Tile
FIGURE 16-9 Example 12-Lead Digital Full Tile
V Series Operating Instructions
0070-10-0727-02
16 - 9
ST Tile Layouts
16.3.2
16.3.3
ST
About the ST Tile
•
Displays reference data when configured to include reference data in the Setup tab.
•
Supports 3-lead, 5-lead, 6-lead, and 12-lead ECG configurations.
•
When using a 3-lead set, one of vector I, II, or III display.
•
When using a 5-lead set, vectors I, II, III, aVR, aVL, aVF, and V display in that order.
•
When using a 6-lead set, vectors I, II, III, aVR, aVL, aVF, and Vx, and Vy display in that order.
•
When using a 12-lead set, vectors I, II, III, aVR, aVL, and aVF display, in that order, when configured
to display non-chest leads.
•
When using a 12-lead set, vectors V1, V2, V3, V4, V5, and V6 display, in that order, when configured
to display chest leads.
•
When using a 12-lead set, vectors I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, and V6 display, in that
order, when configured to display in expanded mode.
Message Area
The message area provides information about the current state of the ST parameter. If there is more
than one message to display, the messages scroll.
16 - 10
MESSAGE
DETAILS
ST Single Alarm Violation
Indicates that the current value is either equal to, higher, or
lower than the set alarm limits.
ST Dual Alarm Violation
Indicates that the current value is either equal to, higher, or
lower than the set alarm limits.
0070-10-0727-02
V Series Operating Instructions
ST
ST Tile Layouts
16.3.4
ST Rep Beat Tile
The ST Rep (Representative) Beat tile displays the beats of the most deviated leads or the three
selected leads.
The ST Rep Beat tile displays:
1.
Tile name
2.
Representative beat
3.
Lead identifier
4.
Current and reference values
5.
Unit of measure
6.
Current and reference labels
7.
ST markers (ISO, J/ST)
8.
Scale label
1
2
8
6
5
4
3
FIGURE 16-10 Example ST Rep Tile Layout (without Markers)
7
FIGURE 16-11 Example ST Rep Tile Layout (with Markers)
16.3.5
About the ST Rep Beat Tile
•
The current numerics field indicates the most recent reading for each lead.
•
The reference numerics field indicates the initial reading for each lead.
•
The ST beat layout displays one (1) ST beat for 3-lead cable set.
•
The ST beat layout displays three (3) ST beat for all cable sets excluding 3-lead.
•
When the Representative Beat Display button (in the ST Setup tab) is set to Auto, the left most
beat in the tile is the most deviated lead, with the second most deviated in the middle, followed
by the third most deviated lead to the far right.
V Series Operating Instructions
0070-10-0727-02
16 - 11
ST Tile Layouts
ST
•
16.3.6
When the Representative Beat Display button (in the ST Setup tab) is set to Manual, the left most
beat in the tile is beat 1, followed by beat 2 in the middle, followed by beat 3 to the far right.
ST Alarms
Refer to the ‘‘Factory Default Alarm Limits’’ on page 8-4 for additional information.
16 - 12
0070-10-0727-02
V Series Operating Instructions
ST
ST Troubleshooting
16.4
ST Troubleshooting
The ST tile message area displays messages indicating the current state of the ST parameter. If there is
more than one message to display, the messages scroll.
ISSUE
REASON
SOLUTION
Do not see ST parameter tiles
in display.
Parameter not configured to display.
Refer to ‘‘Display Options Dialog’’ on
page 3-2 for additional information.
Ref (reference) values not
displaying
ST Mode is set to Current.
Change ST Mode from Current to
Curr. (Ref ). Refer to ‘‘Configuring the
ST Parameter’’ on page 16-3 for
additional information.
Display Setup is configured
to display ST no ST values
display in ST tiles.
ST Analysis is disabled.
Enable ST Analysis. Refer to
‘‘Configuring the ST Parameter’’ on
page 16-3 for additional
information.
ISO and J/ST arrow buttons
are disabled in the ST dialog
Adjust tab.
The ISO, J Adjust setting is
configured for Auto.
Change the ISO, J Adjust setting to
Manual. Refer to ‘‘Adjusting the ISO
and J/ST Points’’ on page 16-5 for
additional information.
V Series Operating Instructions
0070-10-0727-02
16 - 13
ST Troubleshooting
ST
This page intentionally left blank.
16 - 14
0070-10-0727-02
V Series Operating Instructions
17.0
CO2 Monitoring (Optional)
Introduction .......................................................................................................................................................... 17-2
CO2 Dialog............................................................................................................................................................. 17-2
CO2 Tile Layouts................................................................................................................................................. 17-9
CO2 Troubleshooting...................................................................................................................................... 17-12
V Series Operating Instructions
0070-10-0727-02
17 - 1
Introduction
17.1
CO2 Monitoring (Optional)
Introduction
This chapter describes the CO2 parameter in detail, including monitoring CO2, configuring alarm
limits, and configuring the CO2 parameter.
The V 12/V 21 displays the ET CO2 numeric, the Insp CO2 numerics, and the CO2 waveform when
the CO2 is being measured.
Patient Sizes
Intended patient types: Adult, Pediatric, Neonatal.
CO2 Module Connector
The VPS module does not include the CO2 parameter. The CO2 parameter is available as a separate
module (as shown in FIGURE 17-1). Refer to ‘‘Taking a CO2 Measurement’’ on page 17-7 for additional
information.
Input Door
CO2 Exhaust
FIGURE 17-1 Example CO2 Module Connector
Display Setup
To be able to see the CO2 values, CO2 must be configured to display on the Main Screen. Refer to
‘‘Display Options Dialog’’ on page 3-2 for additional information.
17.2
CO2 Dialog
The CO2 dialog (as shown in FIGURE 17-2) contains an Alarms tab, Setup tab, and a Waveform tab.
A description of each tab follows.
17.2.1
Navigating to the CO2 Dialog
•
Select the CO2 digital or waveform tile.
OR
17 - 2
1.
Select the Setup tab from the Navigation Area.
2.
Select the Parameters button.
3.
Select the CO2 button.
The CO2 dialog displays (as shown in FIGURE 17-2).
0070-10-0727-02
V Series Operating Instructions
CO2 Monitoring (Optional)
CO2 Dialog
FIGURE 17-2 Example CO2 Dialog (Alarms tab)
17.2.2
Configuring CO2 Alarm Limits
Refer to ‘‘Configuring Alarm Limits’’ on page 8-2 for additional information.
17.2.3
Configuring the CO2 Parameter Setup
1.
Select the CO2 digital or waveform tile.
2.
Select the Setup tab (as shown in FIGURE 17-2).
NOTE:
V Series Operating Instructions
The current parameter setting displays in bold to the right of each
button.
0070-10-0727-02
17 - 3
CO2 Dialog
CO2 Monitoring (Optional)
FIGURE 17-3 Example CO2 Dialog (Setup Tab)
Select the buttons described in TABLE 17-1 to configure the tab.
3.
.
TABLE 17-1
FUNCTION
DESCRIPTION
SETTINGS*
Color
Configures the CO2 parameter and
waveform color.
16 distinct colors
Note: Default color is gray.
Units
Configures the units of measure for the
CO2 parameter.
mmHg, %, kPa
*
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
4.
17.2.4
17 - 4
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Configuring the CO2 Waveform
1.
Select the CO2 digital or waveform tile.
2.
Select the Waveform tab (as shown in FIGURE 17-4).
0070-10-0727-02
V Series Operating Instructions
CO2 Monitoring (Optional)
CO2 Dialog
FIGURE 17-4 Example CO2 Dialog (Waveform Tab)
Select the buttons described in TABLE 17-2 to configure the tab.
3.
TABLE 17-2
FUNCTION
DESCRIPTION
SETTINGS*
Scale
Configures the CO2 waveform size or
height.
0 to 40 mmHg, 0 to 60 mmHg
0 to100 mmHg when CO2 units
configured for mmHg
0% to 5%, 0% to 7.5%, 0% to 10%
when CO2 units configured for%
0 to 5 kPa
0 to 7.5 kPa, 0 to 10 kPa when CO2
units configured for kPa
Speed
*
3.125 mm/sec., 6.25 mm/sec.,
12.5 mm/sec., 25 mm/sec
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
4.
V Series Operating Instructions
Configures the waveform sweep speed.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
0070-10-0727-02
17 - 5
CO2 Dialog
17.2.5
CO2 Monitoring (Optional)
Calibrating the CO2 Module
Calibration is required when it has been more than one (1) year from the time of the last successful
calibration or whenever the readings appear to be in error. The date of the last successful calibration
displays in the CO2 Calibration dialog.
NOTE:
For maximum accuracy during calibration, a 20 minute warm-up time is
recommended.
Tools required:
•
Gas cylinder
•
T-shape connector
•
Tubing
FIGURE 17-5 Example CO2 Dialog (Calibrate Tab)
17 - 6
1.
Select the CO2 digital or waveform tile.
The CO2 dialog displays (as shown in FIGURE 17-5).
2.
Select the Calibrate tab.
3.
Connect the gas cylinder with the tubing using a T-connector (as shown in FIGURE 17-6). Check
the airway ensure there are no leaks.
0070-10-0727-02
V Series Operating Instructions
CO2 Monitoring (Optional)
CO2 Dialog
Open to the Air
Tubing
CO2 Module
Relief Valve
Gas Cylinder
FIGURE 17-6
4.
Open the relief valve to vent calibration gas, (P/N 0075-00-0033-01) and ensure that there is an
excess gas flow through the T-shape connector to air and CO2 reading is displayed during the
calibration.
5.
After the measured CO2 concentration becomes stable, select Start to calibrate the CO2
module, the message Calibrating, continue to apply 5% CO2 appears in the Calibration
dialog. When the calibration completes, the message changes to Calculating, calibration gas can
be removed. Turn off the button on the canister, and remove the connector.
6.
After a moment, the message changes to Calibration Completed Successfully CO2. The date
and time of the successful calibration displays in the Calibration dialog.
NOTE:
Select the Cancel or Accept button.
7.
17.2.6
If no gas is being delivered, or the mixture does not contain 5% CO2,
the message "Calibration error. Caused by no gas or wrong gas
concentration" will appear. In this case, perform another calibration.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Taking a CO2 Measurement
NOTE:
When the caution message Occlusion displays, indicating that the
FilterLine which is attached to the handheld monitor is blocked, the
monitor’s CO2 pump stops pumping the patient’s breath into the
monitor for testing. First disconnect and reconnect the Filterline. If the
message still displays, disconnect and replace the Filterline. Once a
working Filterline is attached to the bedside monitor, the pump
automatically resumes operations.
NOTE:
During nebulization or suction for intubated patients, in order to avoid
moisture buildup and sampling line occlusion, remove the sample line
luer connector from the monitor.
1.
Select the appropriate tubing for the patient.
NOTE:
V Series Operating Instructions
Replace the sampling line according to hospital protocol or when a
blockage is indicated by the device. Excessive patient secretions or a
build-up of liquids in the airway tubing may occlude the sampling line,
requiring more frequent replacement.
0070-10-0727-02
17 - 7
CO2 Dialog
CO2 Monitoring (Optional)
2.
NOTE:
Ensure all tubing connections are secure.
NOTE:
Consideration should be given to the disposal of packaging waste and
calibration gases.
3.
17.2.7
Open CO2 input door on the CO2 module and connect the sensor. Connect the opposite end to
the patient.
After a warm-up period, the CO2 waveform and digital CO2 value display in the CO2 tile.
CO2 Sensors
Microstream-Oridion Medical and miniMediCO2 module Microstream CO2 modules provide Expired
CO2, Inspired CO2 and Respiration Rate monitoring utilizing a small lumen FilterLine®. Microstream
capnography is accomplished via a nasal cannula (non-intubated) or through an adapter set for use
in a breathing circuit (intubated). Microstream and can be used on adult, pediatric and neonatal
patients.
NOTE:
17 - 8
When monitoring an anesthesized patient in an operating room
environment, connection from the exhaust port of the V 12/V 21 to the
hospital's waste gas scavenging system is recommended to prevent
exposure of hospital personnel to the patient's respiratory sample.
0070-10-0727-02
V Series Operating Instructions
CO2 Monitoring (Optional)
17.3
CO2 Tile Layouts
CO2 Tile Layouts
The CO2 parameter is shown in a digital tile and a waveform tile format
17.3.1
CO2 Digital Tile Layout
The CO2 digital tile displays:
1.
Inspired CO2 value
2.
Message area
3.
ET CO2 value
4.
CO2 unit of measure
5.
Resp unit of measure
6.
Resp value
7.
Source
8.
High and low alarm limits
2
3
4
5
6
1
7
8
8
8
FIGURE 17-7 Example CO2 Digital Tile
17.3.2
17.3.3
About the CO2 Digital Tile
•
If a CO2 measurement is invalid, “- -” displays in place of digits.
•
The CO2 tile displays all values in units of mmHg with a resolution of 1 mmHg when displayed in
mmHg.
•
The CO2 tile displays all values in units of percent (%)with a resolution of 0.1% when displayed in
percent.
•
The CO2 tile displays all values in units of kPa with a resolution of 0.1 kPa when displayed in kPa.
CO2 Alarms
Refer to the ‘‘SpO2/Gases Tab’’ on page 8-8 for additional information.
V Series Operating Instructions
0070-10-0727-02
17 - 9
CO2 Tile Layouts
17.3.4
CO2 Monitoring (Optional)
Message Area
The message area provides information about the current state of the CO2 parameter. If there is more
than one message to display, the messages scroll.
MESSAGE*
DETAILS
Inspired CO2 High Alarm Violation
Indicates that the current value is either equal to or higher
than the set alarm limits.
ET CO2 High Alarm Violation
Indicates that the current value is either equal to or higher
than the set alarm limits.
ET CO2 Low Alarm Violation
Indicates that the current value is either equal to or lower
than the set alarm limits.
Resp High Alarm Violation
Indicates that the current value is either equal to or higher
than the set alarm limits.
Resp Low Alarm Violation
Indicates that the current value is either equal to or lower
than the set alarm limits.
Apnea Alarms
Displays during episodes of apnea.
NOTE:
17 - 10
The Apnea alarm takes priority over the Low Respiration alarm.
Filterline Disconnected
Filterline is disconnected from the monitor.
Warming Up
CO2 Operating lamp has not yet reached its operating
temperature.
Auto Zero in Progress
CO2 module is performing zeroing out the values.
CO2 Failure
CO2 subsystem failed.
Check Flow Rate
CO2 flow rate is either low or high.
Occlusion
CO2 hardware indicates the filterline is blocked.
Purge
CO2 detects a fluid obstruction and attempts to purge by
temporarily increasing the flow rate.
CO2 Not Calibrated
CO2 hardware indicates module is not calibrated.
0070-10-0727-02
V Series Operating Instructions
CO2 Monitoring (Optional)
17.3.5
CO2 Tile Layouts
CO2 Waveform Tile Layout
The CO2 waveform tile displays:
1.
Tile name
2.
CO2 waveform
3.
Waveform scale
4.
Unit of measure
1
2
3
4
3
FIGURE 17-8 Example CO2 Waveform Tile
17.3.6
17.3.7
About the CO2 Waveform Tile
•
The CO2 waveform tile displays the waveform and the wave gain setting in the configured CO2
color.
•
Provides a scrolling, real-time waveform and an erase bar to provide a time indicator of oldest and
new data.
•
The CO2 waveform tile rails the top most value when the waveform exceeds the upper scale limit
for real-time waveforms.
•
The CO2 waveform tile rails the bottom most value when the waveform exceeds the lower scale
limit for real-time waveforms.
•
The CO2 waveform tile displays the waveform at the configured waveform sweep speed.
Message Area
No messages display in the CO2 waveform tile message area.
V Series Operating Instructions
0070-10-0727-02
17 - 11
CO2 Troubleshooting
17.4
CO2 Monitoring (Optional)
CO2 Troubleshooting
The CO2 tile message area displays messages indicating the current state of the CO2 parameter. If
there is more than one message to display, the messages scroll.
17 - 12
ISSUE
REASON
SOLUTION
Do not see CO2 parameter
tiles in display.
Parameter not configured to display.
Refer to ‘‘Display Options Dialog’’ on
page 3-2 for additional information.
“- -” displays in place of
numerics.
Measurement is invalid.
Filter may be disconnected. Check
patient.
0070-10-0727-02
V Series Operating Instructions
18.0
Cardiac Output (CO) (Optional)
Introduction .......................................................................................................................................................... 18-2
Cardiac Output Dialog.................................................................................................................................... 18-2
Measuring CO ...................................................................................................................................................... 18-6
CO Digital Tile Layout...................................................................................................................................... 18-9
CO Troubleshooting......................................................................................................................................... 18-11
V Series Operating Instructions
0070-10-0727-02
18 - 1
Introduction
18.1
Cardiac Output (CO) (Optional)
Introduction
This chapter describes the CO parameter in detail including configuring how to configure CO alarm
limits, monitor CO, and configure the CO parameter settings for example, height, weight and auto
start.
Cardiac Output (CO) is the amount of blood ejected from the left ventricle each minute, expressed in
liters per minute (l/min). Cardiac Index (CI) is the Cardiac Output divided by the patient's body surface
area.
Patient Sizes
Intended patient types: Adult and Pediatric. The CO module is not available when the patient size is
configured to Neonate.
CO Module Connector
The VPS module does not include the CO parameter. The CO parameter is available as a separate
module (as shown in FIGURE 18-1). Refer to ‘‘Taking CO Measurements’’ on page 18-6 for additional
information.
CO Connector
FIGURE 18-1 Example CO Module Connector
Display Setup
To be able to see the CO/CI values, CO must be configured to display on the Main Screen. Refer to
‘‘Display Options Dialog’’ on page 3-2 for additional information.
18.2
Cardiac Output Dialog
The Cardiac Output dialog (as shown in FIGURE 18-2) contains an Alarms tab and Setup tab. A
description of each tab follows.
18.2.1
Navigating to the Cardiac Output Dialog
•
Select the CO digital tile.
OR
18 - 2
1.
Select the Setup tab from the Navigation Area.
2.
Select the Parameters button.
3.
Select the CO button.
The Cardiac Output dialog displays (as shown in FIGURE 18-2).
0070-10-0727-02
V Series Operating Instructions
Cardiac Output (CO) (Optional)
Cardiac Output Dialog
FIGURE 18-2 Example Cardiac Output Dialog (Alarms tab)
18.2.2
Configuring TBlood Alarm Limits
There are no alarm limits settings for Cardiac Output. The alarm limits are for blood temperature or T
Blood. Refer to ‘‘Configuring Alarm Limits’’ on page 8-2 for additional information.
18.2.3
Configuring the CO Parameter
1.
Select the CO digital tile.
2.
Select the Setup tab (as shown in FIGURE 18-3).
NOTE:
V Series Operating Instructions
The current parameter setting displays in bold to the right of each
button.
0070-10-0727-02
18 - 3
Cardiac Output Dialog
Cardiac Output (CO) (Optional)
FIGURE 18-3 Example Cardiac Output Dialog (Setup Tab)
3.
Select the buttons described in TABLE 18-1 to configure the tab.
.
TABLE 18-1
FUNCTION
DESCRIPTION
SETTINGS*
Height
Opens the digital keypad to enter the
patient’s height.
None
Weight
Opens the digital keypad to enter the
patient’s weight.
None
NOTE:
Enter the patient’s height and weight to calculate the Cardiac
Index (CI). The cardiac index cannot be calculated without it.
Computational
Constant
Verify the correct computation is used
based on the PA manufacturers
instructions.
Auto Start
When Auto Start is enabled, the monitor
automatically takes the CO
measurement after establishing a
baseline blood temperature. In this
mode, it is not necessary to select the
Start CO button in the CO Run dialog.
0.001 to 1.000 in steps of 0.001
Default: 0.500
On, Off
When Auto Start is disabled, the clinician
must manually select the Start CO
button in the CO Run dialog in order for
the monitor to begin a CO Run.
CO Time
*
18 - 4
Configures the time scale in the CO Run
window.
60 seconds, 30 seconds
The factory default configuration settings are in bold.
0070-10-0727-02
V Series Operating Instructions
Cardiac Output (CO) (Optional)
Cardiac Output Dialog
TABLE 18-1
FUNCTION
DESCRIPTION
SETTINGS*
CO Scale
Configures the temperature scale in the
CO Run window.
0.5 ºC, 1ºC, 2 ºC, 4 ºC
Color
Configures the color of the digital data in
the CO digital tile.
16 distinct colors
Note: Factory default color is yellow.
Ready Tone
Provides an audible indication that the
monitor is ready to begin a CO run. This
allows the clinician to know a CO run can
be started without actively viewing the
monitor.
On, Off
*
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
4.
V Series Operating Instructions
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
0070-10-0727-02
18 - 5
Measuring CO
Cardiac Output (CO) (Optional)
18.3
Measuring CO
18.3.1
Optimizing CO Measurements
18.3.2
1.
From the PA catheter package insert, verify the correct computation constant for the catheter
type, injectate volume, and injectate temperature. Change the computation constant if it is
different than the monitor’s factory default of 0.500.
2.
Verify proper PA catheter positioning.
3.
Purge system of air.
4.
Use correct injectate port.
Auto and Manual CO Measurements
In Auto Start mode (when Auto Start is set to On), the monitor automatically takes the CO
measurement after establishing a baseline blood temperature. In this mode, it is not necessary to
select the Start CO button in the CO Run dialog. After a bolus injection, the V 12/V 21 computes the
CO and is ready to start another bolus injection.
In Manual mode (when Auto Start is set to Off ), the monitor takes the CO measurement after
selecting the Start CO button in the CO Run dialog. After a bolus injection, the V 12/V 21 computes
the CO and is ready to start another bolus injection.
18.3.3
18 - 6
Taking CO Measurements
1.
Connect the CO cable to the CO connector in the CO module.
2.
If not previously done, follow the steps in the ‘‘Configuring the CO Parameter’’ on page 18-3 or
skip to following step.
3.
Select the CO digital tile.
4.
Select the Setup tab.
5.
Select the C.O. Run button.
The Cardiac Output dialog displays.
0070-10-0727-02
V Series Operating Instructions
Cardiac Output (CO) (Optional)
Measuring CO
FIGURE 18-4 Example CO Run dialog
Start the measurement:
6.
•
If Auto Start is set to On, the measurement automatically begins after establishing a baseline
blood temperature.
•
If Auto Start is set to Off, prepare the injectate, then select the Start CO button.
NOTE:
7.
The Start CO button changes to Stop CO once it is selected.
Once injecting the bolus, the CO curve appears, and the CO measurement displays.
NOTE:
If a measurement is compromised, as indicated by an Irregular Curve or
error alert message, the curve displays in red and a red
displays in
the box (as shown in FIGURE 18-4).
8.
Note the injectate temperature and verify that the correct computation constant was selected.
9.
Perform subsequent cardiac output runs as needed.
NOTE:
Any run with an invalid CO value is excluded from the averaged CO
value.
10. Once a sufficient number of CO runs are complete, select the Accept Average button to
calculate the averaged data.
V Series Operating Instructions
0070-10-0727-02
18 - 7
Measuring CO
Cardiac Output (CO) (Optional)
NOTE:
Runs containing green waveform data and a
in the upper right
corner of the run indicate that the measurement was included in the
average. Runs containing red waveform data and a red
in the
upper right corner of the run indicate that the measurement was not
included in the average.
11. Optional - select the Hemo Calculations button to open the Hemodynamics dialog and
perform a calculation.
NOTE:
Refer to ‘‘Hemodynamics Dialog’’ on page 21-2 for additional
information.
12. Select the Done button.
18.3.3.1
18.3.3.2
About the Cardiac Output Dialog
•
The Cardiac Output dialog displays one (1) current run and four (4) historical runs.
•
The averaged CO/CI values are updated as runs are excluded and included.
•
Runs in error are not included in the CO average.
•
Only runs containing valid CO values are included in the average.
•
Once a CO average is accepted, it cannot be edited.
Cardiac Output Dialog Messages
•
There are three types of CO messages: error, alert, and procedural prompts.
•
Error messages and alert message display at the completion of a CO run.
•
Error messages have priority over alert messages.
•
If multiple alert messages occur at the same time, the messages will alternate every two (2)
seconds.
•
Only one procedural prompt displays at a time.
NOTE:
Refer to ‘‘CO Troubleshooting’’ on page 18-11 for assistance in resolving
these issues.
MESSAGE CATEGORY
MESSAGE TYPE
Error
Signal Under Range
Alert
Noisy Baseline
Irregular Curve
Delayed Injection
Injectate Temperature Error
Procedural Prompts
Check Catheter
Injectate Temperature Out of Range
Please Wait
Inject Now
Measuring
Ready
Inject When Ready
18 - 8
0070-10-0727-02
V Series Operating Instructions
Cardiac Output (CO) (Optional)
18.4
CO Digital Tile Layout
CO Digital Tile Layout
The CO digital tile displays:
1.
CO/CI tile label
2.
Message area
3.
CO timestamp
4.
TBlood value
5.
TBlood label
6.
CO value
7.
CI value
8.
Units of measure
1
1
2
7
6
3
8
5
4
FIGURE 18-5 Example CO Digital Tile
18.4.1
About the CO Tile
CO and CI Parameter
•
The CO parameter displays CO in units of L/minwith a resolution of 0.1/min1.
•
The CI parameter displays CI in units of L/min/min2with a resolution of 0.1/min1/min2.
•
If the CO/CI measurement is invalid, “- -” displays in place of digits.
•
The CO tile displays a timestamp.
NOTE:
The timestamp only displays after accepting a CO average.
TBlood Parameter
18.4.2
•
The TBlood parameter displays TBlood in the configured units of measure, with a resolution of
0.1° C when the unit of measure is Celsius and 0.1° F when the unit of measure is Fahrenheit.
•
If the TBlood measurement is invalid, “- -” displays in place of digitals.
CO Alarms
Refer to the ‘‘Temp Tab’’ on page 8-6 for additional information.
V Series Operating Instructions
0070-10-0727-02
18 - 9
CO Digital Tile Layout
18.4.3
Cardiac Output (CO) (Optional)
Message Area
The message area provides information about the current state of the CO function. If there is more
than one message to display, the messages scroll.
18 - 10
MESSAGE
DETAILS
TBlood High Alarm Violation
Indicates that the current value is either equal to or higher
than the set alarm limits.
TBlood Low Alarm Violation
Indicates that the current value is either equal to or lower
than the set alarm limits.
0070-10-0727-02
V Series Operating Instructions
Cardiac Output (CO) (Optional)
18.5
CO Troubleshooting
CO Troubleshooting
The CO tile message area displays messages indicating the current state of the CO parameter. If there
is more than one message to display, the messages scroll.
MESSAGE/PROBLEM
REASON
SOLUTION
Do not see CO
parameter tiles in
display.
Parameter not configured to display.
Refer to ‘‘Display Options Dialog’’
on page 3-2 for additional
information.
CO value higher / lower
than expected
Computation constant incorrect for PA
catheter type, injectate temperature, and
injectate volume.
Check computation constant and
enter correct data.
Catheter may be kinked or not in proper
position.
Notify physician.
No measurement/
Unable to measure
Unstable temperature.
Check injectate temperature.
No temperature or temperature out of
range.
Flush PA catheter.
Time elapsed for measurement.
Discard bolus fluid.
Check patient.
Wait for Ready or Inject when
Ready message to appear.
Rebolus when ready.
CO Signal Under Range
Appears if the CO curve is not sufficient for
a CO calculation or if a curve is not detected
within thirty (30) seconds.
Rebolus if necessary
CO Out of Range
Appears if the CO is out of the measurable
range (0.2 l/min to 20.0 l/min).
Computation constant incorrect for PA
catheter type, injectate temperature, and
injectate volume.
Check computation constant and
enter correct data. Rebolus when
ready.
Irregular curve
Improper injection procedure.
Check hospital policy, inject in a
smooth and fluid bolus.
Catheter may be kinked or not in proper
position.
Notify physician.
Patient movement during injection.
Have patient lay still during bolus
procedure.
Measurement displayed if CO curve has
multiple peaks, failure to return to baseline
or irregularities in curve.
Rebolus when ready
Appears if the time between the start of the
CO measurement and the onset of the
temperature change is more than fifteen
(15) seconds
Rebolus when ready.
Delayed Injection
Ensure that the CO bolus is
initiated within 15 seconds
Check the temperature of the
injectate
Injectate Temp Error
Appears when the temperature of the
injectate is too warm (>27ºC) or the
difference between the injectate and the
blood temperature is <8ºC.
Check injectate fluid, insure fluid is
not under warm lights, near a
warming blanket or another
warm source.
Noisy Baseline
Cardiac Output waveform baseline is
unstable.
Rebolus when ready.
Measuring
Displays once an injection is detected
during the process of a CO run.
V Series Operating Instructions
0070-10-0727-02
18 - 11
CO Troubleshooting
18 - 12
Cardiac Output (CO) (Optional)
MESSAGE/PROBLEM
REASON
SOLUTION
Injectate Temp. Out
of Range
Displays when the temperature of the
injectate is too warm (>27ºC) or the
difference between the injectate and the
blood temperature is <8ºC.
Check injectate fluid, insure fluid is
not under warm lights, near a
warming blanket or over-chilled
in the ice bath.
Inject When Ready
Displays if Auto Start is enabled, stable
temperatures are detected
Bolus when ready.
Ready
Displays if Auto Start is not enabled, and
stable temperatures are detected
Press Start CO when ready.
Inject Now
Displays once Start CO has been pressed,
before bolus is initiated
Bolus when ready.
Please Wait
Displays after fluid bolus is initiated and
Cardiac Output is being calculated
Wait until message disappears
0070-10-0727-02
V Series Operating Instructions
19.0
Reports
Introduction .......................................................................................................................................................... 19-2
Print Setup.............................................................................................................................................................. 19-2
Print Queue............................................................................................................................................................ 19-7
Internal Recorder (Optional) ....................................................................................................................... 19-8
Laser Printer Reports........................................................................................................................................ 19-9
Printing Troubleshooting.............................................................................................................................. 19-44
V Series Operating Instructions
0070-10-0727-02
19 - 1
Introduction
19.1
Reports
Introduction
This chapter describes the V 12/V 21 reports and provides instructions on how to generate them
from the laser printer and thermal printer module.
Patient Sizes
Intended patient types for all these report are Adult, Pediatric, Neonatal except when specified.
19.2
Print Setup
The Print Setup dialog controls which waveforms print in the waveform reports (for example,
Waveform Report, Event Detail Report). It also controls how often a waveform report prints when
configured for interval printing, and whether the report will print to the laser or thermal printer.
FIGURE 19-1 Example Print Setup Dialog
19.2.1
19 - 2
Navigating to the Print Setup Dialog
1.
Select the Print tab from the Navigation Area.
2.
Select the Print Setup button.
The Print Setup dialog displays (as shown in FIGURE 19-1).
0070-10-0727-02
V Series Operating Instructions
Reports
19.2.2
Print Setup
Configuring the Print Setup
1.
Select the Print tab from the Navigation Area.
2.
Select the Print Setup button.
3.
Select the buttons described in TABLE 19-1 to configure the tab.
TABLE 19-1
BUTTON
DESCRIPTION / COMMENTS
CHOICES*
Configure Waveforms
Selects which waveforms print and in which
order the waveforms print in the waveform
reports.
ECG 1, ECG II, ECG III, ECG aVR, ECG
aVF, ECG aVL, ECG V/Vx/V1, ECG
Vy/V2, ECG V3, ECG V4, ECG V5,
ECG V6, SpO2, Resp, CO2, IBP1-8.
Refer to ‘‘Configuring the
Waveforms to Print’’ on page 19-4
for additional information.
Mode
Determines if the reports are printed by a set
interval or by the clock.
Interval, Clock
Interval
Determines how often a waveform report will
automatically be printed.
Off, 30 min, 1hr, 2hrs, 4hrs, 8hrs,
12hrs
NOTE:
*
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
4.
V Series Operating Instructions
The Interval setting does not limit the ability
to print on demand or interfere with the
Print on Alarm feature.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
0070-10-0727-02
19 - 3
Print Setup
19.2.3
Reports
Configuring the Waveforms to Print
1.
Select the Print tab from the Navigation Area.
2.
Select the Print Setup button.
3.
Select the Configure Waveforms button.
The Waveform Configuration dialog displays (as shown in FIGURE 19-2).
FIGURE 19-2 Example Waveform Configuration Dialog
4.
Navigate in this dialog by using the buttons described in TABLE 19-2.
TABLE 19-2
BUTTON
DESCRIPTION
Add
Adds the highlighted parameter(s) to the Selected list (located on the
right side of the dialog).
NOTE:
19 - 4
Multiple parameters may be
highlighted in the list before
selecting the button.
Remove
Removes the highlighted parameter(s) from the Selected list and
moves them to the Choices list.
Remove All
Removes all the selected parameters from the Selected list and moves
them to the Choices list.
Move to Top
Moves the selected parameter to the top position in the Selected list.
Move Up
Moves the selected parameter up one position in the Selected list.
Move Down
Moves a parameter from the Selected list down one position.
0070-10-0727-02
V Series Operating Instructions
Reports
Print Setup
TABLE 19-2
BUTTON
DESCRIPTION
Move to Bottom
Moves the selected parameter to the bottom position in the Selected
list.
Scrolls up the Choices or Selected lists.
Scrolls down the Choices or Selected lists.
Select the Cancel or Accept button to close the Waveform Configuration dialog.
5.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Select the Cancel or Accept button to close the Print Setup dialog.
6.
19.2.4
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Configuring the Print Destination
1.
Select the Print tab from the Navigation Area.
2.
Select the Print Setup button.
3.
Select the Destination tab.
The Destination tab displays (shown in FIGURE 19-3)
FIGURE 19-3 Example Print Setup Dialog (Destination Tab)
V Series Operating Instructions
0070-10-0727-02
19 - 5
Print Setup
Reports
Select the buttons described in TABLE 19-3 to configure the tab.
4.
TABLE 19-3
BUTTON
DESCRIPTION / COMMENTS
CHOICES*
Real-Time
Determines where the waveform and strip
reports print.
Laser, Thermal, or Laser, Thermal
Print On Alarm
Determines where the report prints if the
Print on Alarm option is enabled in the Alarm
Responses tab.
Laser, Thermal, or Laser, Thermal
Other
Determines where the historical reports and
miscellaneous reports for example, Drug
Calculations Report and Hemodynamic
Calculations Report print.
Laser, Thermal, or Laser, Thermal
*
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
5.
19 - 6
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
0070-10-0727-02
V Series Operating Instructions
Reports
19.3
Print Queue
Print Queue
The Print Queue dialog displays all the current print requests. From this dialog, view all print requests
and delete current print requests.
NOTE:
19.3.1
The print queue displays the 10 most recent print requests.
Navigating to the Print Queue Dialog
1.
Select the Print tab from the Navigation Area.
2.
Select the Print Queue button.
The Print Queue dialog displays (as shown in FIGURE 19-4).
NOTE:
At this time, the arrow buttons are disabled.
FIGURE 19-4 Example Print Queue Dialog
19.3.2
Deleting all Print Requests
1.
Select the Print tab from the Navigation Area.
2.
Select the Print Queue button.
NOTE:
The Delete All button is only enabled if there are print requests in the
queue.
3.
Select the Delete All button.
All the print requests are deleted from the queue.
4.
Select the Done button.
V Series Operating Instructions
0070-10-0727-02
19 - 7
Internal Recorder (Optional)
19.4
Reports
Internal Recorder (Optional)
The V 12/V 21 thermal printer is a strip chart recorder with an integral paper spool. The recorder uses
only Mindray thermal paper P/N 0683-00-0422-10 (box of 10) or P/N 0683-00-0422-01 (single roll).
NOTE:
Refer to ‘‘Installing the Thermal Recorder Paper’’ on page 4-20 for
additional information.
NOTE:
All grid patterns and data are printed by the recorder.
The following reports are available from the recorder:
19.4.1
•
ECG Strip
•
List Trend Strip
•
Disclosure Detail Strip
•
Event List Strip
•
Event Detail Strip
•
Graphic Trend Strip
•
Print on Alarm Strip
•
ST Strip
•
Drug Calculation Strip
•
Hemodynamic Calculations Strip
•
Quick Trend Strip
•
CO Strip
•
Continuous ECG Strip
Printing to the Thermal Recorder
Once the print destination is defined, follow the printing directions in the Laser Printer Reports
section to print any (with the exception of the ECG Strip) of the strips to the thermal printer.
NOTE:
19.4.2
Refer to ‘‘Configuring the Print Destination’’ on page 19-5 for additional
information.
Printing an ECG Strip
To print a single strip
•
Press the
button on the thermal recorder to print an ECG strip.
Optional - press the button a second time to stop printing.
To print continuous strips
19 - 8
1.
Select Print from the Navigation Area.
2.
Select the Continuous button.
The strips begin to print to the thermal printer and the Continuous button changes to Abort.
3.
Select the Abort button to stop the printing.
0070-10-0727-02
V Series Operating Instructions
Reports
Laser Printer Reports
19.5
Laser Printer Reports
19.5.1
Waveform Report
NOTE:
Contact your System Administrator to find out where the laser printer is
setup on the network.
NOTE:
This report contains waveforms. To configure which waveforms print in
the report, refer to ‘‘Configuring the Waveforms to Print’’ on page 19-4.
NOTE:
This report may also be printed from the thermal printer. Refer to
‘‘Configuring the Print Destination’’ on page 19-5 for additional
information.
The Waveform Report (as shown in FIGURE 19-5) prints 10 seconds of the configured waveforms plus
all the other parameters being monitored at the time the report was initiated. A marker (shown as a
triangle
) displays above the waveform grid indicating the date and time the data was recorded.
This report includes a header, waveform information, digital parameter values, and a footer.
V Series Operating Instructions
0070-10-0727-02
19 - 9
Laser Printer Reports
Reports
FIGURE 19-5 Example Waveform Report (Laser Printer Output)
19.5.2
Printing a Waveform Report
Select the Strip button in the Navigation Area to print the Waveform Report.
19 - 10
0070-10-0727-02
V Series Operating Instructions
Reports
19.5.3
Laser Printer Reports
12 Lead Report
The 12-lead Report (as shown in FIGURE 19-6) provides 12-leads of ECG data for the
selected patient. This report includes a header, waveform data, and a footer.
FIGURE 19-6 Example 12 Lead Report (Laser Printer Output)
V Series Operating Instructions
0070-10-0727-02
19 - 11
Laser Printer Reports
19.5.4
19 - 12
Reports
Printing the 12 Lead Report
1.
Select the Print tab from the Navigation Area.
2.
Select the Print 12-Lead button.
The report prints.
0070-10-0727-02
V Series Operating Instructions
Reports
19.5.5
Laser Printer Reports
List Trend Report
The Trend List Report (as shown in FIGURE 19-7) shows a patient’s historical trended digital data for a
1, 2, 4, 8, 12 or 24 hour time period. This report includes a header, trend records and a footer.
NOTE:
This report may also be printed from the thermal printer. Refer to
‘‘Configuring the Print Destination’’ on page 19-5 for additional
information.
FIGURE 19-7 Example List Trend Report (Laser Printer Output)
V Series Operating Instructions
0070-10-0727-02
19 - 13
Laser Printer Reports
19.5.6
Reports
Printing the List Trend Report
1.
Select the History button from the Navigation Area.
2.
Select the List Trend tab.
3.
Navigate to the desired time.
4.
Select the Print button.
5.
Select a time interval.
NOTE:
19 - 14
Refer to ‘‘Printing from the Historical Dialogs’’ on page 20-22 for
additional information.
6.
Select the Accept button.
The report prints.
7.
Select the Done button.
0070-10-0727-02
V Series Operating Instructions
Reports
19.5.7
Laser Printer Reports
Disclosure Overview Report
The Disclosure Overview Report (as shown in FIGURE 19-8) prints a maximum of 60 minutes of
compressed ECG data on each page. Each waveform is one (1) minute in length. The heart rate prints
the averaged heart rate for the last second of the strip at the end of the strip. This report includes a
header, disclosure data, and a footer.
FIGURE 19-8 Example Disclosure Overview Report (Laser Printer Output)
V Series Operating Instructions
0070-10-0727-02
19 - 15
Laser Printer Reports
19.5.8
Reports
Printing the Disclosure Overview Report
1.
Select the History button from the Navigation Area.
2.
Select the Full Disclosure tab.
3.
Navigate to the desired time.
4.
Select the Print button.
5.
Select a time interval.
NOTE:
19 - 16
Refer to ‘‘Printing from the Historical Dialogs’’ on page 20-22 for
additional information.
6.
Select the Accept button.
The report prints.
7.
Select the Done button.
0070-10-0727-02
V Series Operating Instructions
Reports
19.5.9
Laser Printer Reports
Disclosure Detail Report
The Disclosure Detail Report (as shown in FIGURE 19-9) shows the detail for the specific area of
disclosure data. A marker (shown as a triangle
) displays above the waveform grid indicating the
date and time the data was recorded. This report includes a header, parameter detail, and a footer.
NOTE:
This report may also be printed from the thermal printer. Refer to
‘‘Configuring the Print Destination’’ on page 19-5 for additional
information.
FIGURE 19-9 Example Disclosure Detail Report (Page 1) (Laser Printer Output)
V Series Operating Instructions
0070-10-0727-02
19 - 17
Laser Printer Reports
Reports
FIGURE 19-10 Example Disclosure Detail Report (Page 2) (Laser Printer Output)
19 - 18
0070-10-0727-02
V Series Operating Instructions
Reports
19.5.10
Laser Printer Reports
Printing the Disclosure Detail Report
NOTE:
This report contains waveforms. To configure which waveforms print in
the report, refer to ‘‘Configuring the Waveforms to Print’’ on page 19-4.
1.
Select the History button from the Navigation Area.
2.
Select the Full Disclosure tab.
3.
Navigate to the desired time.
4.
Select the Views button.
5.
Select Detail.
6.
Select the Print button.
The report prints.
7.
Select the Done button.
V Series Operating Instructions
0070-10-0727-02
19 - 19
Laser Printer Reports
19.5.11
Reports
Event List Report
The Event List Report (as shown in FIGURE 19-11) shows a patient’s historical physiological,
system and technical alarm events for a 1, 2, 4, 8, 12 and 24 hour time period. This report
includes a header, event records, and a footer.
NOTE:
This report may also be printed from the thermal printer. Refer to
‘‘Configuring the Print Destination’’ on page 19-5 for additional
information.
FIGURE 19-11 Example Event List Report (only Page 1 shown) (Laser Printer Output)
19 - 20
0070-10-0727-02
V Series Operating Instructions
Reports
19.5.12
Laser Printer Reports
Printing the Event List Report
1.
Select the History button from the Navigation Area.
2.
Select the Events tab.
3.
Optional - create an event filter.
NOTE:
Refer to ‘‘Applying/Removing an Events Filter’’ on page 20-8 for
additional information.
4.
Select the Print button.
5.
Select a time interval.
NOTE:
Refer to ‘‘Printing from the Historical Dialogs’’ on page 20-22 for
additional information.
6.
Select the Accept button.
The report prints.
7.
Select the Done button.
V Series Operating Instructions
0070-10-0727-02
19 - 21
Laser Printer Reports
19.5.13
Reports
Event Detail Report
The Event Detail In Report (as shown in FIGURE 19-12 and FIGURE 19-13) shows all of a patient’s
historical digital data and 20 seconds of waveform data for a selected event. A marker (shown as a
triangle
) displays above the waveform grid indicating the date and time the data was recorded
This report includes a header, digital data, waveform data, and a footer.
NOTE:
This report may also be printed from the thermal printer. Refer to
‘‘Configuring the Print Destination’’ on page 19-5 for additional
information.
FIGURE 19-12 Example Event Detail Report (Page 1) (Laser Printer Output)
19 - 22
0070-10-0727-02
V Series Operating Instructions
Reports
Laser Printer Reports
FIGURE 19-13 Example Event Detail Report (Page 2) (Laser Printer Output)
V Series Operating Instructions
0070-10-0727-02
19 - 23
Laser Printer Reports
19.5.14
Reports
Printing the Event Detail Report
NOTE:
1.
Select the History button from the Navigation Area.
2.
Select the Events tab.
3.
Navigate to the desired event, then select it.
4.
Select the Views button.
5.
Select Detail.
6.
Select the Print button.
The report print.
7.
Select the Done button.
NOTE:
19 - 24
This report contains waveforms. To configure which waveforms print in
the report, refer to ‘‘Configuring the Waveforms to Print’’ on page 19-4.
Refer to ‘‘Events Tab’’ on page 20-7 for additional information.
0070-10-0727-02
V Series Operating Instructions
Reports
19.5.15
Laser Printer Reports
Graphic Trend Report
The Graphic Trend Report (as shown in FIGURE 19-14) displays the trends in a graphical
format. This report includes a header, digital data, graphic data, and a footer.
NOTE:
This report may also be printed from the thermal printer. Refer to
‘‘Configuring the Print Destination’’ on page 19-5 for additional
information.
FIGURE 19-14 Example Graphic Trend Report (Page 1) (Laser Printer Output)
V Series Operating Instructions
0070-10-0727-02
19 - 25
Laser Printer Reports
Reports
FIGURE 19-15 Example Graphic Trend Report (Page 2) (Laser Printer Output)
19 - 26
0070-10-0727-02
V Series Operating Instructions
Reports
19.5.16
Laser Printer Reports
Printing the Graphic Trend Report
1.
Select the History button from the Navigation Area.
2.
Select the Graphic Trends tab.
3.
Navigate to the desired time.
4.
Select the Print button.
5.
Select a time interval.
NOTE:
Refer to ‘‘Printing from the Historical Dialogs’’ on page 20-22 for
additional information.
6.
Select the Accept button.
The report prints.
7.
Select the Done button.
V Series Operating Instructions
0070-10-0727-02
19 - 27
Laser Printer Reports
19.5.17
Reports
Print On Alarm Report
The Print On Alarm report automatically prints when the parameter’s Print on Alarm alarm response
setting is configured to On. A marker (shown as a triangle
) displays above the waveform grid
indicating the date and time the data was recorded. This report includes a header, waveform data,
and a footer.
NOTE:
Refer to ‘‘Alarm Responses’’ on page 8-10 for additional information.
NOTE:
This report may also be printed from the thermal printer. Refer to
‘‘Configuring the Print Destination’’ on page 19-5 for additional
information.
FIGURE 19-16 Example Print On Alarm Report (Laser Printer Output)
19 - 28
0070-10-0727-02
V Series Operating Instructions
Reports
19.5.18
Laser Printer Reports
Printing the Print on Alarm Report
Refer to ‘‘Understanding Alarm Response Settings’’ on page 8-11 and ‘‘Configuring Alarm Response
Settings’’ on page 8-11 for additional information.
V Series Operating Instructions
0070-10-0727-02
19 - 29
Laser Printer Reports
19.5.19
Reports
ST Report
The ST Report (as shown in FIGURE 19-17 and FIGURE 19-18) includes current and reference digital
values with the associated ST templates. This report includes a header, ST data, and a footer.
NOTE:
This report may also be printed from the thermal printer. Refer to
‘‘Configuring the Print Destination’’ on page 19-5 for additional
information.
FIGURE 19-17 Example ST Report (Page 1) (Laser Printer Output)
19 - 30
0070-10-0727-02
V Series Operating Instructions
Reports
Laser Printer Reports
FIGURE 19-18 Example ST Report (Page 2) (Laser Printer Output)
V Series Operating Instructions
0070-10-0727-02
19 - 31
Laser Printer Reports
19.5.20
Reports
Printing the ST Report
1.
Select the ST tile.
2.
Select the Review tab.
3.
Select the Print button.
The report prints.
OR
1.
Select the Setup tab from the Navigation Area.
2.
Select the Parameters button.
3.
Select the ST button.
4.
Select the Review tab.
5.
Select the Print button.
The report prints.
NOTE:
19 - 32
Refer to ‘‘ST’’ on page 16-1 for additional information.
0070-10-0727-02
V Series Operating Instructions
Reports
19.5.21
Laser Printer Reports
PAWP Report
The PAWP Report (as shown in FIGURE 19-19) includes all the waveforms contained in the
PAWP dialog: ECG, ART2, PA, CO2 plus all the other parameters being monitored during
the PAWP measurement.This report includes a header, PAWP data, and a footer.
FIGURE 19-19 Example PAWP Report (Laser Printer Output)
V Series Operating Instructions
0070-10-0727-02
19 - 33
Laser Printer Reports
19.5.22
Reports
Printing the PAWP Report
1.
Select the PA tile.
2.
Select the PAWP button.
3.
Select the Measure button.
4.
Select Accept PAWP button.
5.
Select the Print PAWP button.
The report prints.
OR
1.
Select the Setup tab from the Navigation Area.
2.
Select the Parameters button.
3.
Select the PA button to display the PA dialog.
4.
Select the PAWP button.
5.
Select Accept PAWP button.
6.
Select the Print PAWP button.
The report prints.
7.
Select the Done button.
NOTE:
19 - 34
Refer to ‘‘Pulmonary Artery Wedge Pressure (PAWP)’’ on page 11-13 for
additional information.
0070-10-0727-02
V Series Operating Instructions
Reports
19.5.23
Laser Printer Reports
Drug Calculations Report
The Drug Calculator Report (as shown in FIGURE 19-20) shows a detailed printout of specific drug
information and drug infusion rates. This report includes a header, drug dosage and drug infusion
rate information, and a footer.
NOTE:
This report may also be printed from the thermal printer. Refer to
‘‘Configuring the Print Destination’’ on page 19-5 for additional
information.
FIGURE 19-20 Example Drug Calculation Report (Laser Printer Output)
V Series Operating Instructions
0070-10-0727-02
19 - 35
Laser Printer Reports
19.5.24
Reports
Printing the Drug Calculations Report
1.
Select the Tools tab from the Navigation Area.
2.
Select the Calculators button.
3.
Select the Drug button.
4.
Select a drug from the Previous Calculations list at the top of the dialog box.
5.
Select the Titration Table tab.
6.
Select the Print button.
The report prints.
NOTE:
7.
Select the Done button.
NOTE:
19 - 36
To enable the Print button, there must be at least one calculation in the
table.
Refer to ‘‘Drug Calculations’’ on page 21-8 for additional information.
0070-10-0727-02
V Series Operating Instructions
Reports
19.5.25
Laser Printer Reports
Hemodynamic Calculation Report
The Hemodynamic Calculations Report (as shown in FIGURE 19-21) prints the a set of values used to
determine the hemodynamic status of the patient. The report includes header information,
hemodyanmic calculations, and a footer.
NOTE:
This report may also be printed from the thermal printer. Refer to
‘‘Configuring the Print Destination’’ on page 19-5 for additional
information.
FIGURE 19-21 Example Hemodynamic Calculations Report (Laser Printer Output)
V Series Operating Instructions
0070-10-0727-02
19 - 37
Laser Printer Reports
19.5.26
Reports
Printing the Hemodynamic Calculation Report
1.
Select the Tools tab from the Navigation Area.
2.
Select the Calculators button.
3.
Select the Hemo Calculations button.
4.
Select the Print button.
The report prints.
NOTE:
19 - 38
To enable the Print button, there must be at least one calculation in the
log.
5.
Select the Done button.
6.
Select the Done button.
0070-10-0727-02
V Series Operating Instructions
Reports
19.5.27
Laser Printer Reports
Quick Trend Report
The Quick Trend Report (as shown in FIGURE 19-22) shows a detailed printout of the Quick
Trends list in the History tab. This report includes a header, quick trend data (HR, SpO2,
NIBP), and a footer.
NOTE:
This report may also be printed from the thermal printer. Refer to
‘‘Configuring the Print Destination’’ on page 19-5 for additional
information.
FIGURE 19-22 Example Quick Trend Report (Laser Printer Output)
V Series Operating Instructions
0070-10-0727-02
19 - 39
Laser Printer Reports
19.5.28
19 - 40
Reports
Printing the Quick Trend Report
1.
Select the History button from the Navigation Area.
By default, the Quick Trends tab is selected.
2.
Select the Print button.
The report prints.
0070-10-0727-02
V Series Operating Instructions
Reports
19.5.29
Laser Printer Reports
System Settings Report
The System Settings Report prints every parameter by patient size. In addition, it prints the unit of
measure, high and low alarm limits, alarm priority, arrhythmia settings, and the alarm response
settings. The report includes a header, system settings information, and a footer.
FIGURE 19-23 Example System Settings Report (Page 1) (Laser Printer Output)
V Series Operating Instructions
0070-10-0727-02
19 - 41
Laser Printer Reports
Reports
FIGURE 19-24 Example System Settings Report (Page 2) (Laser Printer Output)
19 - 42
0070-10-0727-02
V Series Operating Instructions
Reports
19.5.30
Laser Printer Reports
Printing the System Settings Report
1.
Select the Setup tab from the Navigation Area.
2.
Select the System button.
3.
Enter the password.
The System dialog opens.
4.
Select the System tab.
5.
Select the Print System Settings button.
The report prints.
6.
Select the Accept button.
V Series Operating Instructions
0070-10-0727-02
19 - 43
Printing Troubleshooting
19.6
19 - 44
Reports
Printing Troubleshooting
ISSUE
REASON
SOLUTION
Printer overheats
Printer has not had ample time to
recover between print requests.
Do not use printer again until
temperature reduces.
Printer paper jam
Paper is stuck in printer.
Try to clear jam. If unable to clear
jam, contact service personnel.
0070-10-0727-02
V Series Operating Instructions
20.0
History Dialogs
Introduction .......................................................................................................................................................... 20-2
Trends........................................................................................................................................................................ 20-2
Events Tab............................................................................................................................................................... 20-7
Full Disclosure ...................................................................................................................................................... 20-13
History Dialog Common Functions........................................................................................................ 20-16
Historical Events ................................................................................................................................................. 20-25
Troubleshooting................................................................................................................................................. 20-29
V Series Operating Instructions
0070-10-0727-02
20 - 1
Introduction
20.1
History Dialogs
Introduction
The History dialog provides access to a patient’s historical physiological data. The History dialog (as
shown in FIGURE 20-1) contains a Quick Trends tab, List Trends tab, Graphic Trends tab, Events,
and Full Disclosure tab. A description of each tab follows.
Patient Sizes
Intended patient types: Adult, Pediatric, Neonatal.
20.2
Trends
The History dialog contains Quick Trends, List Trends, and Graphic Trends.
20.2.1
Navigating to the Quick Trends Tab
•
Select the History button from the Navigation Area.
The History dialog displays (as shown in FIGURE 20-1) with the Quick Trends tab selected.
FIGURE 20-1 Example History Dialog (Quick Trends Tab)
20.2.2
About Quick Trends
The Quick Trends tab allows the user to view an abbreviated tabular listing of HR, SpO2 and NIBP data
only and includes the date and time the trend recorded. Data will not collect in the Quick Trends list
until an NIBP measurement is taken. Each time an NIBP measurement is taken, the list updates. The
list can only displays a maximum of nine (9) records at one time. Once the tenth NIBP measurement is
taken, the first measurement is removed from the Quick Trends list but not from the List Trends list.
20.2.3
List Trends
The List Trends display allows the user to view a tabular list of stored patient vital signs. Trend data
automatically displays in one minute intervals unless an alternate Trend Display interval is selected.
NOTE:
Refer to ‘‘Configuring a Display Interval’’ on page 20-16 for additional
information.
Selecting the List Trends tab before the first measurement is taken will display an empty list. An NIBP,
CO/CI, or PAWP measurement must be taken before the list will populate. All previously collected
parameter data displays, even if the parameter is not currently being monitored.
20 - 2
0070-10-0727-02
V Series Operating Instructions
History Dialogs
20.2.4
Trends
Navigating to the List Trends Tab
1.
Select the History button from the Navigation Area.
The History dialog displays (as shown in FIGURE 20-1).
2.
Select the List Trends tab (as shown in FIGURE 20-2).
NOTE:
The Display Interval in FIGURE 20-2 is configured for one (1) minute
intervals. Refer to ‘‘Configuring a Display Interval’’ on page 20-16 for
more information.
FIGURE 20-2 Example History Dialog (List Trends Tab)
20.2.5
20.2.6
About the List Trends Tab
•
List Trends displays the time and date on the horizontal axis and it is always visible.
•
List Trends displays the parameter data on the vertical axis and it is always visible.
•
List Trends always displays the Heart Rate (HR) parameter in the top row.
•
List Trends displays the trend records in descending order, beginning with the most recent on the
right side of the grid.
•
List Trends displays any currently monitored parameter or previously monitored parameter that is
configured to display.
Navigating in the List Trends Tab
The dialog navigation buttons are described in TABLE 20-1.
NOTE:
When a navigation button becomes disabled, this indicates that there is
no more data available or the end of the data range was reached.
TABLE 20-1
BUTTON
FUNCTION
Moves the cursor to the oldest record from its current
position.
Moves the cursor one page back from its current position.
V Series Operating Instructions
0070-10-0727-02
20 - 3
Trends
History Dialogs
TABLE 20-1
BUTTON
FUNCTION
Moves the cursor one record back from its current position.
Moves the cursor one record forward from its current
position.
Moves the cursor one page forward from its current
position.
Moves the cursor to the newest record from its current
position.
Previous Event
Moves the cursor to the previous event from its current
position.
Next Event
Moves the cursor to the next event from its current
position.
Moves the cursor up one parameter from it current
position.
Moves the cursor down one parameter from it current
position.
20.2.7
Configuring a List Trends Display Interval
Refer to ‘‘Configuring a Display Interval’’ on page 20-16 for additional information.
20.2.8
Configuring a List Trends Display Group
Refer to ‘‘Configuring a Display Group’’ on page 20-17 for additional information.
20.2.9
Configuring a List Trends Time Search
Refer to ‘‘Configuring a Time Search’’ on page 20-19 for additional information.
20.2.10
Printing from the List Trends Tab
Refer to ‘‘Printing from the Historical Dialogs’’ on page 20-22 for additional information.
20.2.11
Graphic Trends
The Graphic Trend display allows the user to view a graphic summary of stored patient vital signs.
20.2.12
Navigating to the Graphic Trends Tab
1.
Select the History button from the Navigation Area.
2.
Select the Graphic Trends tab (as shown in FIGURE 20-3).
NOTE:
20 - 4
The display interval in FIGURE 20-3 is configured for one (1) hour. Refer
to ‘‘Configuring a Display Interval’’ on page 20-16 for more information.
0070-10-0727-02
V Series Operating Instructions
History Dialogs
Trends
FIGURE 20-3 Example History Dialog (Graphic Trends Tab)
20.2.13
20.2.14
About the Graphic Trends Tab
•
The Graphic Trends area displays a trend digital tile adjacent to each trend graph.
•
The Graphic Trends area always displays the heart rate (HR) as the first trend graph and it is fixed
in the top row position.
•
The Graphic Trends area displays the trend data in the time range specified in the Display Interval.
•
The Graphic Trends provides a trend cursor which moves around the historical data based on
which navigation button is selected.
•
The Graphic Trends area displays the date and time of the trend cursor.
•
The Graphic Trends area displays a blank tile when no trend data is available for the configured
parameter.
•
The Graphic Trends horizontal scale is automatically scaled to present the entire waveform at the
maximum height.
•
The Graphic Trends area displays a vertical event marker line for each historical event. The event
marker line extends from the top of the trend graph to the bottom.
•
The event marker contains the event date and time and the event message.
•
The event marker line displays in the color corresponding to the priority of the event.
•
The event marker lines displays the event with the highest priority when multiple events
occur at the same time.
Viewing Event Detail from Graphic Trends
1.
Select the History button from the Navigation Area.
2.
Select the Graphic Trends tab.
3.
Position the trend cursor on an event by selecting the Previous Event or Next Event buttons.
The cursor advances to the next event. Beside the cursor is an event message tag. For example,
Arrhythmia Relearn.
4.
Select the event message bubble.
The event opens in the Events tab where the event details display.
NOTE:
V Series Operating Instructions
Refer to ‘‘Events Tab’’ on page 20-7 for additional information.
0070-10-0727-02
20 - 5
Trends
20.2.15
History Dialogs
Navigating in the Graphic Trends Tab
The navigation buttons in the Graphic Trends tab are the same as described in the List Trends tab.
Refer to ‘‘Navigating in the List Trends Tab’’ on page 20-3 for additional information.
20.2.16
Configuring a Graphic Trends Display Interval
Refer to ‘‘Configuring a Display Interval’’ on page 20-16 for additional information.
20.2.17
Configuring a Graphic Trends Display Group
Refer to ‘‘Configuring a Display Group’’ on page 20-17 for additional information.
20.2.18
Configuring a Graphic Trends Time Search
Refer to ‘‘Configuring a Time Search’’ on page 20-19 for additional information.
20.2.19
Printing from Graphic Trends
Refer to ‘‘Printing from the Historical Dialogs’’ on page 20-22 for additional information.
20 - 6
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V Series Operating Instructions
History Dialogs
20.3
Events Tab
Events Tab
The Events tab lists all the patient’s events. View events in a list format or a detail format. Both views
are outlined in this section. Events can be physiological indicating that a patient’s physiological alarm
thresholds have been violated or technical indicating that a specific technical issue has occurred.
Some events are saved to the events database.
NOTE:
20.3.1
For a list of the specific events saved to the events database, refer to
‘‘Historical Events’’ on page 20-25.
Navigating to the Events Tab
1.
Select the History button from the Navigation Area.
2.
Select the Event tab.
The Events - List view displays (as shown in FIGURE 20-4).
FIGURE 20-4 Example History Dialog (Events Tab List View)
20.3.2
20.3.3
Events - List View
About the Events - List View Tab
The Events - List View:
•
Displays the total number of events stored in the events database.
•
Displays if an event filter is in place.
•
Displays the date and time for each event record.
•
Displays the cursor location.
•
Displays a minimum of three (3) rows without requiring scrolling.
•
Displays event digital tiles to the right of the grid.The digital tiles correspond to the selected
event.
•
Displays the event waveform above the grid. The waveform corresponds to the selected event.
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20 - 7
Events Tab
20.3.4
History Dialogs
Navigating in the Events - List View
Navigate in this dialog by using the buttons described in TABLE 20-2.
TABLE 20-2
BUTTON
FUNCTION
Moves the cursor to the oldest record from its current
position.
Moves the cursor one page forward from its current
position.
Moves the cursor one record forward from its current
position.
Moves the cursor up one record from it current position.
Moves the cursor one page backward from its current
position.
Moves the cursor to the newest record from its current
position.
20.3.5
Applying/Removing an Events Filter
Use event filters to help focus on a particular event type. Use an event filter based on the event type
and/or the event time range.
To apply an event filter:
1.
Select the History button from the Navigation Area.
2.
Select the Events tab.
3.
Select the Events Filter button to display the Event Filter dialog.
4.
Optional - select the Time Range button to display the Time Range dialog.
5.
Enter a start date and time and end date and time.
6.
Optional - select the Clear Time button to delete the time filter.
7.
Optional - select the event type using the buttons described in TABLE 20-3.
NOTE:
If any of the event filter buttons are disabled, this indicates that there
are no events of that kind currently contained in the Events list.
NOTE:
The arrow beside an event filter button (for example,
)
indicates that there is a submenu with additional choices available.
NOTE:
20 - 8
After selecting an event filter, it displays in the Selected Filters list.
0070-10-0727-02
V Series Operating Instructions
History Dialogs
Events Tab
TABLE 20-3
BUTTON
DESCRIPTION / COMMENTS
Show All
Displays all events.
NOTE:
Physiological
20.3.6
Show All is the default selection. When it is selected, the
button is outlined in red.
Displays all physiological events.
Arrhythmia
Displays all arrhythmia events.
Hemodynamics
Displays all hemodynamic events.
Gases
Displays all gas events.
Archived
Displays all archived events. The Archived button switches between None and
Archived. None indicates that the filter will not include archived events. Archived
indicates that the filter will include archived events.
Pressures
Displays all pressure events.
Technical
Displays all technical events.
8.
Optional - to remove a filter from the Selected Filter list, select the Remove button.
9.
Select the Cancel or Accept button.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Tagging Events in the Events - List View
Tagging is used to delete and print multiple event records.
NOTE:
A maximum of 100 event records can be tagged at one time.
To tag an event:
20.3.7
1.
Select the History button from the Navigation Area.
2.
Select the Events tab.
3.
Select an event record in the list.
4.
Select the Tagged box.
A check mark displays in the Tagged box.
Archiving Events in the Events - List View
Archiving is used to help prevent the accidental deletion of an event. Archived events cannot be
deleted.
NOTE:
A maximum of 100 event records can be archived at one time.
NOTE:
Certain events are automatically archived. Refer to ‘‘Historical Events’’
on page 20-25 for additional information.
To archive an event:
1.
Select the History button from the Navigation Area.
2.
Select the Events tab.
3.
Select an event record in the list.
4.
Select the Archived box.
A check mark displays in the Archived box.
V Series Operating Instructions
0070-10-0727-02
20 - 9
Events Tab
20.3.8
History Dialogs
Changing Leads in the Events - List View
Refer to ‘‘Changing Leads’’ on page 20-20 for additional information.
20.3.9
Creating an Events - List View Time Search
Refer to ‘‘Configuring a Time Search’’ on page 20-19 for additional information.
20.3.10
Deleting Events in the Events - List View
Unarchived single events or multiple events may be deleted from the Events - List View.
To delete a single event from the list:
1.
Select the History button from the Navigation Area.
2.
Select the Events tab.
3.
Select an event record.
4.
Select the Delete Event button.
5.
When the pop-up menu displays, select the Current option.
A message box “Are you sure you want to delete the current event from the list?” displays.
6.
Select the Yes button in the message box.
The event is deleted from the list.
To delete multiple events from the list:
NOTE:
1.
Select the History button from the Navigation Area.
2.
Select the Events tab.
3.
Tag the events in the list.
NOTE:
20.3.11
A maximum of 100 event records can be deleted at one time.
Refer to ‘‘Tagging Events in the Events - List View’’ on page 20-9 for
additional information.
4.
Select the Delete Event button.
5.
When the pop-up menu displays, select the Tagged option.
A message box “Are you sure you want to delete all the tagged events from the list?”
displays.
6.
Select the Yes button in the message box.
The events are deleted from the list.
Configuring Displayed Parameters for the Events - List View
Refer to ‘‘Configuring Displayed Parameters’’ on page 20-22 for additional information.
20.3.12
Printing from the Events - List View
Refer to ‘‘Printing from the Historical Dialogs’’ on page 20-22 for additional information.
20.3.13
Accessing the Events - Detail View
To access the Detail view:
20 - 10
1.
Select the History button from the Navigation Area.
2.
Select the Events tab.
3.
Select a physiological event in the list.
0070-10-0727-02
V Series Operating Instructions
History Dialogs
Events Tab
4.
Select the Views button.
NOTE:
5.
20.3.14
The Views button is only enabled when the cursor is positioned on a
physiological event.
Select the Detail option to display the event in the Detail view.
About the Events - Detail View
The ECG lead displayed in the topmost position is based on the ECG lead configured as the
topmost ECG waveform on the Main Screen at the time the event occurred.
•
NOTE:
Refer to ‘‘Editing a Display Preset’’ on page 3-8 for additional
information.
The Events - Detail View:
20.3.15
•
Displays a minimum of four (4) seconds of waveform data in the window.
•
Indicates if there is a active filter.
•
Indicates if there is a note attached to the event.
Navigating in the Events - Detail View
Navigate in this dialog by using the buttons described in TABLE 20-4.
NOTE:
When a navigation button becomes disabled, this indicates that there is
no more data available or the end of the data range was reached.
TABLE 20-4
BUTTON
FUNCTION
Moves the cursor to the first second in the event from its
current position.
Moves the cursor one page back from its current position.
Moves the cursor one second back from its current
position.
Moves the cursor one second forward from its current
position.
Moves the cursor one page forward from its current
position.
Moves the cursor to the last second in the event from its
current position.
Previous Event
Moves the cursor to the previous event in the list from its
current position.
Next Event
Moves the cursor to the next event in the list from its
current position.
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20 - 11
Events Tab
History Dialogs
TABLE 20-4
BUTTON
FUNCTION
Moves the cursor up one parameter from it current
position.
Moves the cursor down one parameter from it current
position.
20.3.16
Configuring Displayed Parameters for the Events - Detail View
Refer to ‘‘Configuring Displayed Parameters’’ on page 20-22 for additional information.
20.3.17
Printing from the Events - Detail View
Refer to ‘‘Printing from the Historical Dialogs’’ on page 20-22 for additional information.
20 - 12
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V Series Operating Instructions
History Dialogs
20.4
Full Disclosure
Full Disclosure
Full disclosure provides an overview of all the patient’s stored ECG data. View disclosure data in an
overview format or a detail format. A description of both views follows.
20.4.1
Navigating to the Full Disclosure - Overview View
1.
Select the History button from the Navigation Area.
2.
Select the Full Disclosure tab.
The Full Disclosure - Overview View displays (as shown in FIGURE 20-5).
FIGURE 20-5 Example Full Disclosure Tab Overview View
20.4.2
20.4.3
About the Full Disclosure - Overview View
•
The ECG waveform defaults to the topmost ECG waveform in the Main Screen.
•
The Full Disclosure - Overview View:
•
Displays one ECG waveform at a time.
•
Displays one minute of compressed waveform data horizontally.
•
Displays historical events on the waveform at the time of the event.
Navigating in the Full Disclosure - Overview View
The dialog navigation buttons are described in TABLE 20-5.
NOTE:
When a navigation button becomes disabled, this indicates that there is
no more data available or the end of the data range was reached.
TABLE 20-5
BUTTON
FUNCTION
Moves the cursor down to the most current ECG data.
Moves the cursor up to the oldest historical ECG data.
V Series Operating Instructions
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20 - 13
Full Disclosure
History Dialogs
TABLE 20-5
BUTTON
FUNCTION
Moves the cursor backward five (5) seconds.
Moves the cursor forward five (5) seconds.
Previous Event
Moves the cursor to the previous event from its current
position.
Next Event
Moves the cursor to the next event from its current
position.
Moves the cursor up to the next page of historical ECG
data.
Moves the cursor up to the previous row of historical ECG
data.
Moves the cursor down to the next row of historical ECG
data.
Moves the cursor down to the next page of historical ECG
data.
20.4.4
Changing Leads in the Full Disclosure - Overview View
Refer to ‘‘Changing Leads’’ on page 20-20 for additional information.
20.4.5
Creating a Full Disclosure - Overview View Time Search
Refer to ‘‘Configuring a Time Search’’ on page 20-19 for additional information.
20.4.6
Printing from the Full Disclosure - Overview View
Refer to ‘‘Printing from the Historical Dialogs’’ on page 20-22 for additional information.
20.4.7
Accessing the Full Disclosure - Detail View
To access the Detail View:
20.4.8
1.
Select the History button from the Navigation Area.
2.
Select the Full Disclosure tab.
3.
Select the Views button.
4.
Select the Detail option to display the event in the Detail view.
About the Full Disclosure - Detail View
Refer to ‘‘About the Events - Detail View’’ on page 20-11 for additional information.
20.4.9
Navigating in the Full Disclosure- Detail View
The dialog navigation buttons are described in TABLE 20-5.
20 - 14
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V Series Operating Instructions
History Dialogs
Full Disclosure
NOTE:
V Series Operating Instructions
When a navigation button becomes disabled, this indicates that there is
no more data available or the end of the data range was reached.
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20 - 15
History Dialog Common Functions
History Dialogs
20.5
History Dialog Common Functions
20.5.1
Configuring a Display Interval
NOTE:
This option is available in List Trends and the Graphic Trends.
Display intervals allow for the trends to display in a specified time interval. In List Trends if the display
interval is configured for 15 min, the trends display at 11 am, 11:15 am, 11:30, etc.
In Graphic Trends, if the display interval is configured for 1 hour, a total of one hour of graphic trends
data displays in the Graphic Trends display.
Select the Display Interval button from the applicable History dialog tab.
One of the Interval dialogs displays (as shown in FIGURE 20-6 and FIGURE 20-7).
1.
FIGURE 20-6 Example Display Interval
Dialog (List Trends Tab)
Select an interval.
List Trends tab choices are: 1 min, 5 min, 10 min, 15 min, 30 min, 1hr, 2hr. (as shown in
FIGURE 20-6)
Graphic Trends choices are: 1hr, 2hrs, 4hrs, 6hrs, 8hrs, 12hrs (as shown in FIGURE 20-7)
2.
NOTE:
20 - 16
The default display interval displays in bold.
Select the Cancel or Accept button.
3.
4.
FIGURE 20-7 Example Display Interval Dialog
(Graphic Trends Tab)
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Optional - select the Done button to close the History dialog.
0070-10-0727-02
V Series Operating Instructions
History Dialogs
20.5.2
History Dialog Common Functions
Configuring a Display Group
NOTE:
This option is available in List Trends and the Graphic Trends.
Customize the parameters that display in the List Trends and the Graphic Trends by selecting one of
the pre-defined parameter groups in the Display Group dialog.
Select the Display Group button from the applicable History dialog tab.
The Display Group dialog displays (as shown in FIGURE 20-8).
1.
FIGURE 20-8 Example Display Group Dialog
2.
Select one of the parameter groups. The choices are Show All, Cardiac, Hemodynamics,
Pressures, Pulmonary, Neuro, Gases, Temperature, Custom Configuration.
3.
Select the Cancel or Accept button.
4.
20.5.3
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Optional - select the Done button to close the History dialog.
Configuring Custom Configuration Option
NOTE:
This option is available in List Trends and the Graphic Trends.
Create a customized display group by using the Display Groups Custom Configuration option.
1.
Select the Display Group button from the applicable History dialog tab
The Display Group dialog displays (as shown in FIGURE 20-8).
2.
Select the Custom Configuration radio button, then select the Setup button.
The Display Group dialog displays (as shown in FIGURE 20-9).
V Series Operating Instructions
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20 - 17
History Dialog Common Functions
History Dialogs
FIGURE 20-9 Example Display Group (Custom Configuration)
3.
Navigate in this dialog by using the buttons described in TABLE 20-6.
TABLE 20-6
BUTTON
DESCRIPTION
Add All
Adds all the parameters on the left side of dialog to the Selected list
(located on the right side of the dialog).
Add
Adds the highlighted parameter(s) to the Selected list.
NOTE:
Multiple parameters may be selected from the
list.
Remove
Removes the highlighted parameter(s) from the Selected list and
moves them to the Choices list.
Remove All
Removes all the selected parameters from the Selected list and moves
them to the Choices list.
NOTE:
Move to Top
The HR parameter cannot be removed.
Moves the selected parameter to the position below the HR parameter
in the Selected list.
Move Up
Moves the selected parameter up one position in the Selected list.
Move Down
Moves a parameter from the Selected list down one position.
Move to Bottom
Moves the selected parameter to the bottom position in the Selected
list.
Scrolls up the Choices or Selected lists.
Scrolls down the Choices or Selected lists.
20 - 18
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V Series Operating Instructions
History Dialogs
History Dialog Common Functions
Select the Cancel or Accept button to close the Display Group (Custom Configuration Setup)
dialog.
4.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Select the Cancel or Accept button to close the Display Group dialog.
5.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Optional - select the Done button to close the History dialog.
6.
20.5.4
Configuring a Time Search
NOTE:
This option is available in List Trends, Graphic Trends, Events - List view,
and Full Disclosure - Overview view.
Minimize the number of records that display by creating a time filter or search.
Select the Time Search button from the applicable History dialog tab.
The Time Search dialog displays (as shown in FIGURE 20-10).
1.
FIGURE 20-10 Example Time Search Dialog
2.
Use the left and right arrow keys to scroll to the date needed.
3.
Use the up and down arrow keys to scroll to the time needed.
4.
Use the AM/PM button to toggle between AM and PM.
5.
Select the Cancel or Accept button.
6.
V Series Operating Instructions
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Optional - select the Done button to close the History dialog.
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History Dialog Common Functions
20.5.5
History Dialogs
Changing Leads
NOTE:
This option is available in the Events views and the Full Disclosure
views.
The historical tabs display one ECG lead at a time. Any of the leads active during the time of the event
may be viewed.
NOTE:
Refer to the ‘‘Events Tab’’ on page 20-7 and ‘‘Full Disclosure’’ on page
20-13 for additional information.
To view a different lead:
20.5.6
1.
Select the Change Lead button from the applicable History dialog tab.
2.
Select a lead from the list.
The new lead now displays in the top left corner of the data window and the data updates
accordingly to reflect the selected lead.
Adding/Deleting Event Notes
NOTE:
This option is available in the Events views and the Full Disclosure
views.
Clinical notes may be added to or deleted from an event record. The system displays an indication
that a note is attached to the event.
NOTE:
The Notes dialog accepts a total of 80 alphanumeric characters.
To add a note:
Select the
1.
icon from the applicable History dialog view.
The Notes dialog displays.
2.
Select the Edit button to display the keyboard dialog.
3.
Enter the text using the on-line keyboard.
4.
Select the Cancel or Accept button.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Optional - select the Done button to close the History dialog.
5.
To delete a note:
Select the
1.
icon from the applicable History dialog view.
The Notes dialog displays.
2.
Select the Delete button.
3.
Select the Cancel or Accept button.
4.
20 - 20
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Optional - select the Done button to close the History dialog.
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V Series Operating Instructions
History Dialogs
20.5.7
History Dialog Common Functions
Performing ECG Waveform Measurements
NOTE:
This option is available in the Events List - Detail view and the Full
Disclosure - Detail view.
Perform ECG waveform measurements by using the Calipers dialog.
Caliper Vertical Measurements (Timing)
1.
Select the
2.
Select either the PR, QRS, QT, or R to R intervals.
A dashed vertical reference line is placed to the left of the solid vertical reference line.
NOTE:
icon from the applicable History dialog detail view.
Adjustments can be made to both the solid vertical reference line and/
or the vertical dashed reference line. Selecting the interval button a
second time toggles between the two reference lines. When a reference
line is active, it blinks/flashes on the screen.
Adjust the location of the vertical reference line as follows:
3.
•
For coarse adjustments, select the desired location on the touch screen. The reference line will
move to that point.
•
For fine adjustments, use the left/right arrow buttons to position the reference line at the
desired point.
Select the Calculate button once the vertical reference line appears in the desired location. The
measurement populates the text box beside the selected interval.
4.
•
If another vertical measurement is desired, select another interval button.
•
To delete a measurement, select the interval button that needs to be to reset, then select the
Clear button.
Caliper Horizontal Measurements (Amplitude)
1.
Select the
2.
Select the ST interval button.
A dashed horizontal reference line is placed above the solid horizontal reference line.
NOTE:
Adjustments can be made to both the horizontal solid reference line
and/or the horizontal dashed reference line. Selecting the interval
button a second time toggles between the two reference lines. When a
reference line is active, it blinks/flashes on the screen.
Adjust the location of the dashed, horizontal reference line as follows:
3.
•
For coarse adjustments, select the desired location on the touch screen. The reference line will
move to that point.
•
For fine adjustments, use the up/down arrow buttons to position the reference line at the
desired point.
Once the dashed, horizontal reference line appears in the desired location, select the Calculate
button. The measurement populates the text box beside the ST interval.
4.
V Series Operating Instructions
icon from the applicable History dialog detail view.
•
If another horizontal measurement is desired, select another interval button.
•
To delete the ST measurement, select the ST interval button, then select the Clear button.
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History Dialog Common Functions
20.5.8
History Dialogs
Configuring Displayed Parameters
NOTE:
This option is available in the Event views and the Full Disclosure Detail view.
To configure the parameters that display in the Events - List View, Events - Detail view and Full
Disclosure - Detail view use the Setup button.
1.
Select the Setup tab from the applicable History dialog tab.
The History Setup dialog displays.
2.
Select the Configure Parameters button.
The Configure Parameters dialog displays.
3.
Navigate in the dialog by using the buttons described in TABLE 20-7.
TABLE 20-7
BUTTON
DESCRIPTION
Add All
Adds all the parameters to the Selected list (located to the right of the
navigation buttons).
Add
Adds the selected choice to the Selected list (located to the right of
the navigation buttons).
Remove
Removes the selected choice from the Selected list.
Remove All
Removes all the choices from the Selected list and moves them back
to the Choices list (located to the left of the navigation buttons).
Move to Top
Moves the highlighted choice to the top position in the Selected list.
Move Up
Moves the choice in the Selected list up one position.
Move Down
Moves the choice from the Selected list down one position.
Move to Bottom
Moves the cursor up by one in the Selected list.
Select the Cancel or Accept button to close the Configure Parameters dialog.
4.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Select the Cancel or Accept button to close the History Setup dialog.
5.
6.
20.5.9
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Optional - select the Done button to close the History dialog.
Printing from the Historical Dialogs
The Print dialog is available from the all of the historical dialogs. Up to 24 hours of trends, events, and
full disclosure data may be printed, and up to 12 hours of graphic trends data may be printed.
To print the historical data contained in these historical dialogs:
NOTE:
1.
20 - 22
Refer to the ‘‘Reports’’ on page 19-1 for a full description of the reports
and sample reports.
Select the Print button from the applicable History dialog tab.
The Print dialog displays (as shown in FIGURE 20-11 and FIGURE 20-12).
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V Series Operating Instructions
History Dialogs
History Dialog Common Functions
FIGURE 20-11 Example Display Interval
Dialog (Events - List View)
2.
FIGURE 20-12 Example Print Dialog
(Graphic Trends)
Select an interval. The potential choices are Current, 1 hr, 2 hrs, 4 hrs, 8 hrs, 12 hrs, 24 hrs,
Tagged, and Archived. Refer to TABLE 20-8 for additional information.
TABLE 20-8
TIME INTERVAL
PRINTS
Current Page
Only prints the four displayed events in the dialog including the
digital parameter values associated with the events.
Current
Prints the displayed time period of patient data.
1 hr
Prints one hour of patient data, beginning at 1/2 before the
cursor time and printing up to and including the cursor time.
2 hrs
Prints two hours of patient data, beginning at one hour before
the cursor time and printing up to and including the cursor
time.
4 hrs
Prints four hours of patient data, beginning at two hours before
the cursor time and printing up to and including the cursor
time.
8 hrs
Prints eight hours of patient data, beginning at four hours
before the cursor time and printing up to and including the
cursor time.
12 hrs
Prints 12 hours of patient data, beginning at six hours before the
cursor time and printing up to and including the cursor time.
24 hrs
Prints 24 hours of patient data, beginning at 12 hours before the
cursor time and printing up to and including the cursor time.
NOTE:
Tagged
V Series Operating Instructions
Up to 12 hours of Graphic Trends data
may be printed. The 24 hour option
does not exist in Graphic Trends.
Prints all the events with the Tagged check box selected.
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History Dialog Common Functions
History Dialogs
TABLE 20-8
TIME INTERVAL
PRINTS
Archived
Prints all the events with the Archived check box selected.
NOTE:
Select the Cancel or Accept button.
3.
4.
20 - 24
The Tagged and Archived options
are only available when printing
from the Events - List view.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Optional - select the Done button to close the History dialog.
0070-10-0727-02
V Series Operating Instructions
History Dialogs
20.6
Historical Events
Historical Events
TABLE 20-9 lists all the storable events. The events may be physiological, technical, or informational.
The asterisk (*) beside the event message name indicates that the event is automatically archived and
cannot be deleted from the Events database.
TABLE 20-9
PARAMETER
MESSAGE
EVENT/ALARM TYPE
Asystole
Physiological
Ventricular Tacycardia
Physiological
Ventricular Fibrillation
Physiological
Bigeminy
Physiological
Bradycardia
Physiological
Couplet
Physiological
Irregular Heart Rate
Physiological
Multiform PVC
Physiological
Pause
Physiological
Pause Per Minute
Physiological
R-On-T PVC
Physiological
PVCs / Minute Alarm Violation
Physiological
Run
Physiological
Trigeminy
Physiological
Ventricular Rhythm
Physiological
Arrhythmia Learning Started*
Informational
Asystole Configured On*
Informational
Asystole Config Off*
Informational
Ventricular Tacycardia Configured On*
Informational
Ventricular Tacycardia Config Off*
Informational
Ventricular Fibrillation Configured On*
Informational
Ventricular Fibrillation Config Off*
Informational
Learning
Informational
ARRHYTHMIA
*
V Series Operating Instructions
Indicates that event cannot be deleted from the Events database.
0070-10-0727-02
20 - 25
Historical Events
History Dialogs
TABLE 20-9 (Continued)
PARAMETER
MESSAGE
EVENT/ALARM TYPE
<Lead> Off (<Lead> is the corresponding
lead name)
Technical
Leads Off*
Technical
ECG Noise
Technical
HR High Alarm Violation
Physiological
HR High Alarm Violation
Physiological
<Temperature Label> High Alarm Violation
Physiological
ECG
HR
TEMPERATURE
<Temperature Label> High Alarm Violation
Physiological
Delta T High Alarm Violation
Physiological
SPO2
SpO2 High Alarm Violation
Physiological
SpO2 Low Alarm Violation
Physiological
No Sensor
Technical
Sensor Off
Technical
Sat Seconds
Technical
NIBP Systolic High Alarm Violation
Physiological
NIBP
NIBP Systolic Low Alarm Violation
Physiological
NIPB Diastolic High Alarm Violation
Physiological
NIPB Diastolic Low Alarm Violation
Physiological
NIPB Mean High Alarm Violation
Physiological
NIPB Mean Low Alarm Violation
Physiological
IBPX Systolic High Alarm Violation
Physiological
IBPX Systolic Low Alarm Violation
Physiological
IBPX Diastolic High Alarm Violation
Physiological
IBPX Diastolic Low Alarm Violation
Physiological
IBPX Mean High Alarm Violation
Physiological
IBPX Mean Low Alarm Violation
Physiological
Apnea
Physiological
Respiration High Alarm
Physiological
Respiration Low Alarm
Physiological
IBP
RESP
CVA
Apnea Detection*
*
20 - 26
Informational
Indicates that event cannot be deleted from the Events database.
0070-10-0727-02
V Series Operating Instructions
History Dialogs
Historical Events
TABLE 20-9 (Continued)
PARAMETER
MESSAGE
EVENT/ALARM TYPE
ST Single Alarm Violation
Physiological
ST Dual Alarm Violation
Physiological
ST On*
Informational
ST Off*
Informational
ST Learning Started*
Informational
Accept PAWP
Physiological
Inspired CO2 High Alarm
Physiological
ST
PAWP
CO2
End Tidal CO2 High Alarm
Physiological
End Tidal CO2 Low Alarm
Physiological
CO2 Occlusion
Technical
CO2 Failure
Technical
T Blood High Alarm Violation
Physiological
T Blood Low Alarm Violation
Physiological
CO Accepted
Physiological
CCO High Alarm Violation
Physiological
CCO Low Alarm Violation
Physiological
CO
CCO
*
V Series Operating Instructions
CCI High Alarm Violation
Physiological
CCI Low Alarm Violation
Physiological
SVR High Alarm Violation
Physiological
SVR Low Alarm Violation
Physiological
SVRI High Alarm Violation
Physiological
SVRI Low Alarm Violation
Physiological
EDV High Alarm Violation
Physiological
EDV Low Alarm Violation
Physiological
EDVI High Alarm Violation
Physiological
EDVI Low Alarm Violation
Physiological
RVEF High Alarm Violation
Physiological
RVEF Low Alarm Violation
Physiological
SV High Alarm Violation
Physiological
SV Low Alarm Violation
Physiological
SVI High Alarm Violation
Physiological
SVI Low Alarm Violation
Physiological
CCO STAT High Alarm Violation
Physiological
CCO STAT Low Alarm Violation
Physiological
CCI STAT High Alarm Violation
Physiological
Indicates that event cannot be deleted from the Events database.
0070-10-0727-02
20 - 27
Historical Events
History Dialogs
TABLE 20-9 (Continued)
PARAMETER
MESSAGE
EVENT/ALARM TYPE
CCI STAT Low Alarm Violation
Physiological
EDV High Alarm Violation
Physiological
EDV Low Alarm Violation
Physiological
EDVI High Alarm Violation
Physiological
EDVI Low Alarm Violation
Physiological
RVEF STAT High Alarm Violation
Physiological
RVEF STAT Low Alarm Violation
Physiological
SV STAT High Alarm Violation
Physiological
SV STAT Low Alarm Violation
Physiological
SVI STAT High Alarm Violation
Physiological
SVI STAT Low Alarm Violation
Physiological
Check Vigilance
Technical
SVO2
SvO2 High Alarm Violation
Physiological
SvO2 Low Alarm Violation
Physiological
Check Vigilance
Technical
Low Battery
Physiological
MAIN SCREEN
*
20 - 28
Fan Failure
Physiological
Communications Lost
Technical
Indicates that event cannot be deleted from the Events database.
0070-10-0727-02
V Series Operating Instructions
History Dialogs
20.7
Troubleshooting
Troubleshooting
ISSUE*
REASON
SOLUTION
Navigation arrows are not
available
There is no data going in the
direction of the selected arrow.
Check the patient’s admit time or
date.
Already at the top or bottom or far
left or far right of a list.
Quick Trends list is empty
The list does not populate until an
NIBP measurement is taken.
Take an NIBP measurement.
No Further Events
There are no earlier or later event
from where the cursor is currently
positioned.
Select a button to move forward or
backward.
Cannot delete event
Event is archived.
Uncheck the archived checkbox.
Event cannot be deleted.
Certain events cannot be deleted.
Too many archived events!
Attempted to archive more than 100
events.
Only able to archive100 events at
one time. Uncheck some events.
Too many tagged events!
Attempted to tag more than 100
events.
Only able to tag 100 events at one
time. Uncheck some events.
Can not set the Archive
status for this event!
To prevent deleting, the selected
event cannot be unarchived.
No solution required.
*
V Series Operating Instructions
Messages are shown in all bold text.
0070-10-0727-02
20 - 29
Troubleshooting
History Dialogs
This page intentionally left blank.
20 - 30
0070-10-0727-02
V Series Operating Instructions
21.0
Calculators
Hemodynamics Calculations...................................................................................................................... 21-2
Hemodynamics Dialog................................................................................................................................... 21-2
Hemodynamic Calculations Report....................................................................................................... 21-6
Hemodynamic Calculations Troubleshooting................................................................................. 21-7
Drug Calculations .............................................................................................................................................. 21-8
Drug Calculator Dialog................................................................................................................................... 21-8
Drug Calculator Troubleshooting............................................................................................................ 21-17
Standard Calculator.......................................................................................................................................... 21-18
V Series Operating Instructions
0070-10-0727-02
21 - 1
Hemodynamics Calculations
21.1
Calculators
Hemodynamics Calculations
Hemodynamic calculations are a set of values used to determine the hemodynamic status of the
patient. The following values are necessary for these calculations: height, weight, CO, HR, Mean ART,
Mean PA, PAWP and Central Venous Pressure (CVP).
All manually entered values (such as PAWP) are denoted with an asterisk (*).
Patient Sizes
Intended patient types: Adult, Pediatric. The Hemodynamic Calculations are not available when the
patient size is set to Neonate.
VPS
Hemodynamic calculations are part of the V 12/V 21 and do not function as part of the VPS.
21.2
Hemodynamics Dialog
The Hemodynamic dialog (as shown in FIGURE 21-1) contains an Calculator tab and a Log tab. A
description of each tab follows.
21.2.1
Navigating to the Calculator Tab
•
Select the Procedures tab, then select the Hemo Calculations button.
The Hemodynamics dialog displays (as shown in FIGURE 21-1)
OR
1.
Select the Tools tab from the Navigation Area.
2.
Select the Calculators button, then select the Hemo Calculations button.
FIGURE 21-1 Example Hemodynamics Calculator
21 - 2
0070-10-0727-02
V Series Operating Instructions
Calculators
21.2.1.1
Hemodynamics Dialog
Configuring the Calculator Tab
1.
Select the Procedures tab, then select the Hemo Calculations button.
2.
If necessary, select the Calculator tab.
3.
Select the buttons described in TABLE 21-1 to configure the tab.
NOTE:
All manually entered values or edited values are denoted with an
asterisk (*).
TABLE 21-1
BUTTON
DESCRIPTION / COMMENTS
Height
Select to enter or change patient’s height.
Factory default is a blank value.
Weight
Select to enter or change patient’s weight.
Factory default is a blank value.
NOTE:
CO
Height and weight are required to
calculate index values.
Defaults to the current CO value when the Hemodynamic dialog displays, but
the value may be edited.
NOTE:
If the Hemodynamic CO parameter is
manually entered, the CO time is updated
accordingly.
HR
Defaults to the current HR value when the Hemodynamic dialog displays.
Ejection Fraction
Select to enter the ejection fraction parameter value.
Factory default is a blank value.
MAP
Defaults to the current Mean Arterial Pressure (MAP) value when the
Hemodynamic dialog displays. The source of the MAP displays.
ART Diastolic
Defaults to the Diastolic Arterial Pressure (DAP) value when the Hemodynamics
dialog displays.
Mean PA
Defaults to the current mean PA value when the Hemodynamics dialog
displays.
PAWP
Defaults to the PAWP value when the Hemodynamics dialog displays.
NOTE:
CVP
4.
If the Hemodynamic PAWP parameter is
manually entered, the PAWP time is
updated accordingly.
Defaults to the mean CVP value when the Hemodynamics dialog displays.
Select the Calculate button. The formulas found in TABLE 21-2 are used to determine the
hemodynamic calculations:
TABLE 21-2 Hemodynamic Calculations
ABBREVIATION / UNITS
DESCRIPTION
FORMULA
BSA (m2)*
Body Surface Area
Ht0.725(cm) x Wt0.425(kg) x 0.007184
CI (l/min/m2)
Cardiac Index
CO / BSA
SV (ml)/beat
Stroke Volume
(CO / HR) x 1000
SVI (ml/beat/m2)
Stroke Volume Index
SV / BSA
SVR (dyne-sec/cm5)
Systemic Vascular
Resistance
((ART mean-CVP) / CO) x 79.96
SVRI (dyne-sec/cm5/m2)
Systemic Vascular
Resistance Index
SVR x BSA
V Series Operating Instructions
0070-10-0727-02
21 - 3
Hemodynamics Dialog
Calculators
TABLE 21-2 Hemodynamic Calculations
ABBREVIATION / UNITS
DESCRIPTION
FORMULA
PVR (dyne-sec/cm5)
Pulmonary Vascular
Resistance
((PA mean-PAWP) / CO) x 79.96
PVRI (dyne-sec/cm5/m2)
Pulmonary Vascular
Resistance Index
PVR x BSA
LCW (kg-m)
Left Cardiac Work
0.0136 x ART mean x CO
Left Cardiac
Work Index
LCW / BSA
LCWI (kg-m/m
RCW (kg-m)
Right Cardiac Work
0.0136 x PA mean x CO
RCWI (kg-m/m2)
Right Cardiac Work Index
RCW / BSA
LVSW (g-m)/beat
Left Ventricular Stroke Work
SV x (ART mean-PAWP) x 0.0136
LVSWI (g-m/beat/m2)
Left Ventricular Stroke Work
Index
LVSW / BSA
RVSW (g-m)/beat
Right Ventricular Stroke
Work
SV x (PA mean - CVP) x 0.0136
RVSWI (g-m/beat/m2)
Right Ventricular Stroke
Work Index
RVSW / BSA
CoPP (mmHg)
Coronary Artery Perfusion
Pressure
Coronary Perfusion Pressure = Diastolic ART
Blood Pressure - PAWP
EDV (ml)
End-Diastolic Volume
End Diastolic Volume = SV / (EF / 100%)
EDVI (ml/m²)
End-Diastolic Volume Index
End Diastolic Volume Index = EDV / BSA
ESV (ml)
End-Systolic Volume
End Systolic Volume = EDV - SV
ESVI (ml/m²)
End-Systolic Volume - Index
End Systolic Volume Index = ESV / BSA
*
5.
21.2.1.2
21 - 4
2)
Dubois’ equation
Select the Done button to close the Hemodynamics dialog.
About the Calculator Tab
•
The calculator displays the calculated parameters in the following order: BSA, CI, SV, SVI, SVRI, PVR,
PVRI, LCW, LCWI, RCW, RCWI, LVSW, LVSWI, RVSW, RVSWI, CoPP, EDV, EDVI, ESV, ESVI.
•
With the exception of the patient BSA, the calculator indicates when a parameter was manually
entered.
•
The calculator displays the three most recent sets of calculations in a tabular format. Each set
includes a date and timestamp.
•
The most recent data displays in the right most position; followed by the second most recent in
the middle position; ending with the oldest calculations in the far left position.
•
Up and down arrows display beside the table to scroll vertically through the list.
0070-10-0727-02
V Series Operating Instructions
Calculators
21.2.2
21.2.2.1
Hemodynamics Dialog
Navigating to the Log Tab
1.
Select the Procedures tab, then select the Hemo Calculations button.
2.
If necessary, select the Log tab.
3.
Optional - scroll through the list using the following buttons:
•
Select the
arrow key to move up the list.
•
Select the
arrow key to move down the list.
•
Select the
arrow key to move to the oldest set of calculations.
•
Select the
arrow key to move to the newest set of calculations.
4.
Optional - select the Print button to print currently displayed calculations to the default printer.
5.
Select the Done button to close the Hemodynamics dialog.
About the Log Tab
•
The log displays the calculated parameters in the following order: CO, CO Time, CI, HR, MAP, MAP
source, ART Diastolic, Mean PA, PAWP, PAWP Time, CVP, RA, BSA, SV, SVI, SVR, SVRI, PVR, PVRI, LCW,
LCWI, RCW, RCWI, LVSW, LVSWI, RVSW, RVSWI, CoPP, EF, EDV, EDVI, ESV, ESVI.
•
With the exception of the patient BSA, the log indicates when a parameter was manually entered.
•
The log displays the nine most recent sets of calculations in a tabular format. Each set includes a
date and timestamp.
•
The most recent calculations data displays in the right most position.
•
The oldest calculations data displays in the left most position.
V Series Operating Instructions
0070-10-0727-02
21 - 5
Hemodynamic Calculations Report
21.3
Calculators
Hemodynamic Calculations Report
Refer to ‘‘Hemodynamic Calculation Report’’ on page 19-37 for additional information.
21 - 6
0070-10-0727-02
V Series Operating Instructions
Calculators
21.4
Hemodynamic Calculations Troubleshooting
Hemodynamic Calculations Troubleshooting
ISSUE
REASON
SOLUTION
Dashes “- -” display in place
of numerics.
All the required information was not
entered.
Height and weight are required to
calculate indices.
Value out of range
An invalid value was entered in the
keypad.
The acceptable range displays
above the text box. Observe the
range, then enter a value within the
range.
V Series Operating Instructions
0070-10-0727-02
21 - 7
Drug Calculations
21.5
Calculators
Drug Calculations
The V 12/V 21 has the ability to calculate and display IV drug infusion rate and concentration based
upon patient weight and/or drug dosage.
Patient Sizes
Intended patient types: Adult.
VPS
Hemodynamic calculations are part of the V 12/V 21 and do not function as part of the VPS.
21.6
Drug Calculator Dialog
The Drug Calculator dialog (as shown in FIGURE 21-2) contains an Calculator tab and a Titration
Table tab. A description of each tab follows.
21.6.1
Navigating to the Drug Calculator Dialog
1.
Select the Tools tab from the Navigation Area.
2.
Select the Calculators button.
3.
Select the Drug button.
The Drug Calculator dialog displays (as shown in FIGURE 21-2).
FIGURE 21-2 Example Drug Calculator
21 - 8
0070-10-0727-02
V Series Operating Instructions
Calculators
21.6.2
Drug Calculator Dialog
Configuring a Drug Calculation
1.
Select the Tools tab from the Navigation Area.
2.
Select the Calculators button.
3.
Select the Drug button.
4.
Select the buttons described in TABLE 21-3 to configure the tab.
TABLE 21-3
BUTTON
DESCRIPTION / COMMENTS
CHOICES*
Drug Name
Select a drug from the list.
For a full list of drug names, refer
to TABLE 21-4.
Unspecified
Weight Based
Configure whether the drug calculation is
weight based or not.
Note: The weight based choices are only
available after selecting the drug name.
Yes, No
Weight
If the Weight Based button is enabled, enter
the patient’s weight.
Note: Refer to ‘‘Weight Requirements’’ on
page 21-11 for additional information.
N/A
Accepts entered weight in
pounds (lbs) or kilograms (g).
Drug Amount
Enter the drug amount based on hospital’s
formulary.
N/A
Accepts entered drug amounts in
mcg (micrograms), mg
(milligrams), or g (grams) for all
drugs other than Drugs A, B, C,
and D.
Accepts entered drug amounts in
mcg (micrograms), mg
(milligrams), g (grams), units, mU
for Drugs A, B, C, and D.
Solution Vol
Enter the drug amount based on the
hospital’s formulary.
N/A
Accepts entered solution volumes
in mililiters (ml).
Dose
Enter the drug dose.
N/A
Accepts entered dosages in mcg
(micrograms), mg (milligrams), or
g (grams).
Accepts dosage in minutes or
hours.
Infusion Rate
Infusion rate is automatically calculated
based on the dosage.
*
5.
V Series Operating Instructions
The factory default configuration settings are in bold.
Select the Done button.
0070-10-0727-02
21 - 9
Drug Calculator Dialog
21.6.2.1
Calculators
Drug List and Requirements
•
The drug name choices are listed by generic drug name in alphabetical order except for the
generic drugs Drug A, B, C, D which appear last in the list.
•
When Drug A, B, C, D are selected, the drug calculator displays an alphanumeric keyboard to
enter a drug name.
NOTE:
Enter a maximum of 30 characters for the generic drug name.
•
When Milrinone is the chosen drug, the weight-based setting is set to Yes and it cannot be
changed.
•
The default value for the weight based setting is dependent on the drug name.
TABLE 21-4
WEIGHT
BASED
SETTING
DRUG
DOSE
UNITS
DRUG
AMOUNT
SOLUTION
VOLUME
TITRATION
TABLE
INCREMENT
Aminophylline /
Theophylline
Yes
mg
500 mg
500 ml
1
Diltiazem / Cardizem
No
mg
125 mg
125 ml
1
Dobutamine / Dobutrex
Yes
mcg
500 mg
250 ml
1
Dopamine / Inotropin
Yes
mcg
400 mg
250 ml
1
Epinephrine HCL /
Adrenalin
No
mcg
1 mg
250 ml
1
Esmolol HCL / Brevibloc
Yes
mcg
5000 mg
500 ml
1
Fentanyl Citrate /
Sublimaze
Yes
mcg
5 mg
100 ml
1
Heparin Sodium /
Heparin
No
units
12,500
units
250 ml
1
Inamrinone Lactate /
Inocor
Yes
mcg
500 mg
250 ml
1
Insulin, Regular /
Humulin
No
units
100 units
100 ml
1
Isoproterenol HCL /
Isuprel HCL
No
mcg
2 mg
500 ml
1
Labetalol HCL /
Normodyne
No
mg
200 mg
200 ml
1
Lidocaine HCL /
Xylocaine HCL
No
mg
2000 mg
500 ml
1
DRUG NAME/GENERIC
NAME
Lorazepam / Ativan
No
mg
40 mg
500 ml
1
Midazolam HCL / Versed
Yes
mg
125 mg
125 ml
1
Milrinone Lactate /
Primacor
Yes
mcg
20 mg
200 ml
0.125
Nicardipine HCL /
Cardene
No
mg
25 mg
250 ml
1
Nitroglycerin / Tridil
No
mcg
50 mg
250 ml
1
Nitroprusside Sodium /
Nipride
Yes
mcg
50 mg
250 ml
1
* Indicates that the drug amounts are programmable for generic drugs. For all other drugs, units are not programmable.
21 - 10
0070-10-0727-02
V Series Operating Instructions
Calculators
Drug Calculator Dialog
TABLE 21-4
WEIGHT
BASED
SETTING
DRUG
DOSE
UNITS
DRUG
AMOUNT
SOLUTION
VOLUME
TITRATION
TABLE
INCREMENT
Norepinephrine /
Levophed
No
mcg
4 mg
250 ml
1
Phenylephrine /
Neosynephrine
No
mcg
10 mg
250 ml
1
Procainamide HCL /
Pronestyl
No
mg
2000 mg
500 ml
1
DRUG NAME/GENERIC
NAME
Propofol / Diprivan
Yes
mcg
500 mg
50 ml
1
Vasopressin / Pitressin
No
units
250 units
250 ml
1
Drug A
Yes
mcg*
Unspecifie
d
Unspecified
1
Drug B
Yes
mcg*
Unspecifie
d
Unspecified
1
Drug C
Yes
mcg*
Unspecifie
d
Unspecified
1
Drug D
Yes
mcg*
Unspecifie
d
Unspecified
1
* Indicates that the drug amounts are programmable for generic drugs. For all other drugs, units are not programmable.
21.6.2.2
21.6.2.3
Weight Requirements
•
Entering a weight is only permitted when a weight based drug is selected.
•
Entered weights for a specific drug calculation take effect immediately.
•
Weight entered via the drug calculator is saved to the demographic database and remains in the
calculator for the patient until it is changed.
•
The weight originally entered for previous calculations remains persistent even if the weight for
new calculations was changed.
Drug Amount Requirements
•
Entering a drug amount is only permitted after choosing a drug.
•
The default values for the drug amount when Drug A, B, C, or D is chosen drug is Unspecified.
•
The drug calculation software provides an error message when the entered amount is invalid.
•
The default drug amount values for any other drug other than Drug A, B, C, or D is dependent on
the factory defaults. Refer to TABLE 21-4 for a listing of all the factory default settings.
•
When the current drug is Drug A, B, C, or D, the drug calculator allows the drug amount to be
entered.
•
For all drugs other than Drug A, B, C, or D, the values for drug amounts are restricted to units and
mU.
V Series Operating Instructions
0070-10-0727-02
21 - 11
Drug Calculator Dialog
21.6.2.4
21.6.2.5
21.6.2.6
21 - 12
Calculators
Solution Volume Requirements
•
Solution volume only displays after selecting a drug name.
•
Default values for solution volume when Drug A, B, C, or D is chosen drug is Unspecified.
•
The solution volume resets to Unspecified if the drug amount unit family is changed for Drug A, B,
C, or D.
•
The drug calculation software checks for invalid or out of range entries.
•
The default drug values for any other drug other than Drug A, B, C, or D is dependent on the
factory defaults. Refer to TABLE 21-4 for a listing of all the factory default settings.
Non-Weight Based Dose Requirements
•
The dose button is only available when a non-weight based drug is selected.
•
The dose value can either be entered manually or calculated.
•
Enter the dose in dose/minute or dose/hour.
•
The factory default dose time is dose/minute.
•
When the drug amount units are mcg, mg, or g, the drug calculator provides dose units choices
of mcg, mg, and g.
•
When the drug amount units are mU, the drug calculator provides the dose unit choice of mU.
•
The drug calculation software checks for invalid or out of range entries for manually entered
values.
•
The drug calculation software calculates the dose value provided all of the following information
is entered: drug name, drug amount, solution volume, and infusion rate.
•
When calculating the dose, the drug calculation software checks for overflow and underflow and
displays the dose as invalid data in either of these cases.
•
The dose value defaults to Unspecified and remains Unspecified until the value is either
calculated or manually entered.
Weight Based Dose Requirements
•
The dose value can either be entered manually or calculated.
•
A valid weight must exist before the drug calculation software will calculate the dose value.
•
Enter the dose in dose/kg/minute or dose/kg/hour when the chosen drug is anything other than
Milrinone.
•
Enter the dose only in dose/kg/minute when the chosen drug is Milrinone.
•
The drug calculator provides a factory default dose/kg time units to dose/kg/minute.
•
When the drug amount units are mcg, mg, or g, the drug calculator provides dose units choices
of mcg, mg, and g.
•
When the drug amount units are mU, the drug calculator provides the dose unit choice of mU.
•
The drug calculation software checks for invalid or out of range entries for manually entered
values.
•
The drug calculation software calculates the dose value provided all of the following information
is entered: drug name, patient weight, drug units, drug amount, solution volume, and infusion
rate.
•
When calculating the dose/kg, the drug calculation software checks for overflow and underflow
and displays the dose/kg as invalid data in either of these cases.
0070-10-0727-02
V Series Operating Instructions
Calculators
21.6.2.7
21.6.2.8
21.6.3
Drug Calculator Dialog
•
The dose/kg value defaults to Unspecified and remains Unspecified until the value is either
calculated or manually entered.
•
The dose/kg value is reset to Unspecified if the drug amount units unit family is changed to Drug
A, B, C, or D.
Infusion Rate Requirements
•
The infusion rate can either be entered manually or calculated.
•
The drug calculation software checks for invalid or out of range entries for manually entered
values.
•
The drug calculation software calculates the infusion rate provided all of the following
information is available: drug name, patient weight (if chosen drug is weight-based), drug
amount, solution volume, and dosage.
•
When calculating the infusion rate, the drug calculation software checks for overflow and
underflow and displays it as invalid data in either of these cases.
•
The infusion rate defaults to Unspecified.
•
If the drug amount units unit family changes when the drug name selected is Drug A, B, C, or D,
then the infusion rate changes to Unspecified.
Concentration Requirements
•
The unit of measure for concentration will be one of the following depending on the selected
drug dose units: mcg/ml, mg/ml, g/ml, units/ml, or mU/mL.
•
The drug calculation software computes the calculation value provided all of the following
information is available: drug name, drug amount, and solution volume.
•
The concentration value is automatically recalculated if the drug amount or solution volume is
changed.
•
When computing the calculation value, the drug calculation software checks for overflow and
underflow and displays it as invalid data in either of these cases.
•
The concentration value defaults to blank.
•
If the drug amount units unit family changes when the drug name selected is Drug A, B, C, or D,
then the concentration value is blank.
Previous Drug Calculations
Previous drug calculations are stored in the calculator and can be viewed in the calculator and the
titration table.
•
Up to five previous calculations are stored in the drug calculator list.
•
The drug calculation list includes the generic drug name, trade drug name, date of the last
calculation for the drug, and time of the last calculation for the drug.
•
A blue cursor highlights the current drug in the Previous Calculations list.
•
If a drug calculation from the Previous Calculations list is edited, the timestamp and date is
updated.
•
If a calculation for a new drug occurs when the Previous Calculations list is full, the oldest
calculation from the list is automatically removed to accommodate the newer calculation.
•
When the cursor is moved through the Previous Calculations list while viewing the Titration table,
the titration table updates to the selected drug in the list.
V Series Operating Instructions
0070-10-0727-02
21 - 13
Drug Calculator Dialog
21.6.4
21.6.5
Calculators
Deleting a Drug from the Previous Calculations List
1.
Select the Tools tab from the Navigation Area.
2.
Select the Calculators button.
3.
Select the Drug button.
4.
Use the arrow buttons in the Previous Calculations list to highlight the drug.
5.
Select the Delete selected button.
The drug is deleted from the Previous Calculations list.
Navigating to the Drug Titration Table
1.
Select the Tools tab from the Navigation Area.
2.
Select the Calculators button.
3.
Select the Drug button.
4.
Select the Titration Table tab (as shown in FIGURE 21-3).
FIGURE 21-3 Example Titration Table
5.
21 - 14
Select a drug from the Previous Calculations list.
0070-10-0727-02
V Series Operating Instructions
Calculators
Drug Calculator Dialog
6.
Select the buttons described in TABLE 21-5 to configure the tab.
TABLE 21-5
BUTTON
DESCRIPTION / COMMENTS
CHOICES*
Dose Interval
Use to configure the increments by which the
entries in the table dosages are varied.
1, 5, 10, 25, 50, 100, 0.01, 0.05, 0.1,
0.125, 0.2, 0.5
Note: Default dose interval value
is dependent on the selected
drug specified in TABLE 21-3.
Exact Rate
This check box displays the infusion rates as
exact numbers or whole numbers. When
selected, the infusion rates display as exact
numbers.
On, Off
7.
21.6.5.1
Select the Done button.
Titration Table Requirements
•
The titration table entries pair the dose and the infusion rate.
•
The dose and the infusion rate pair that was last entered displays in the 15th position of the table
whenever possible so that all dosages in the table are greater than zero.
•
For each drug, the table may contain up to 30 entries.
•
When the titration table dose interval is 0.125, the precision is 0.001.
•
The titration table infusion rate values are rounded to the nearest whole number when the
infusion rate is configured to use whole numbers.
•
The titration table displays the following header information: drug name (generic and trade
name), patient weight in lbs or kg (if drug is weight-based), drug amount and drug units, solution
volume and solution volume units, concentration and concentration units.
•
The titration table displays a blank field for patient weight when the drug is not weight-based.
V Series Operating Instructions
0070-10-0727-02
21 - 15
Drug Calculations Report
21.7
Calculators
Drug Calculations Report
Refer to ‘‘Drug Calculations Report’’ on page 19-35 for additional information.
21 - 16
0070-10-0727-02
V Series Operating Instructions
Calculators
21.8
Drug Calculator Troubleshooting
Drug Calculator Troubleshooting
ISSUE
REASON
SOLUTION
Drug calculations does not
display in Previous
Calculations list.
Drug is not in viewable area of list.
Use the arrow buttons to scroll up
and down to find the drug.
Previous Calculations list
arrow button are disabled.
All the drug calculations are already
shown in the list.
N/A
No Previous Calculations
Either all the drug calculations were
deleted from the calculator or no
drug calculations exist for the
patient.
If needed, create a drug calculation.
The Delete selected button
is disabled
There are no drugs in the Previous
Calculations list to delete.
N/A
The Print button is disabled
in the Titration table tab
There are no drug calculations.
N/A
V Series Operating Instructions
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21 - 17
Standard Calculator
Calculators
21.9
Standard Calculator
21.9.1
Navigating to the Standard Calculator
1.
Select the Tools tab from the Navigation Area.
2.
Select the Calculators button.
3.
Select the Standard button.
The Calculator dialog displays (as shown in FIGURE 21-4).
FIGURE 21-4 Example Calculator Dialog
21 - 18
4.
Build a condition using the division, multiplication, subtraction, or addition keys, then select
Enter to generate the answer.
5.
Optional - select the Clear button to delete an entry.
6.
Select the Done button to close the dialog.
0070-10-0727-02
V Series Operating Instructions
22.0
Alarm Watch
Alarm Watch ......................................................................................................................................................... 22-2
Alarm Watch Tile ................................................................................................................................................ 22-6
Alarm Watch Notification.............................................................................................................................. 22-6
Alarm Watch Troubleshooting .................................................................................................................. 22-8
V Series Operating Instructions
0070-10-0727-02
22 - 1
Alarm Watch
22.1
Alarm Watch
Alarm Watch
The Alarm Watch feature enables a V Series monitor to be notified of an alarm condition and observe
specified parameters for another networked V Series monitor from a remote location. To view the
locations or beds, configure the alarm watch tile (shown as A-W) to display at the remote site. Up to
16 beds can be viewed from a remote location.
During the initial setup and configuration of the monitor, the System Administrator configures the
default alarm watch locations. During this setup process, the administrator has to decide which
default locations and alarms the monitor will watch. These decisions are usually based on staffing
and/or departmental needs. Once the locations are configured for a monitor, they become the
default watched locations for that monitor and will continue to be watched until the System
Administrator changes them.
Once the A-W tile is configured to display at the remote site, the default locations populate the A-W
icon beside a bed indicates that it was added by the System Administrator.
tile. The
NOTE:
Refer to ‘‘Configuring the Alarm Watch Tab’’ on page 25-11 for
additional information.
Additional locations may also be watched but do not have to be setup by the System Administrator.
These locations are usually for short-term observation and are not saved as part of the departmental
defaults. This chapter describes how to configure these types of locations.
Display Setup
To be able to see all the currently monitored beds, alarm watch must be configured to display on the
Main Screen. Refer to ‘‘Display Options Dialog’’ on page 3-2 for additional information.
NOTE:
22.1.1
The V 12/V 21 also provides a visual notification when a bed is in alarm
even if the tile is not configured to display. Refer to ‘‘Alarm Watch
Notification’’ on page 22-6 for additional information.
Navigating to the Alarm Watch Setup Dialog
•
Select the A-W tile.
OR
•
Select the Tools tab, then select the Alarm Watch button.
The Alarm Watch Setup dialog displays (as shown in FIGURE 22-1).
NOTE:
22 - 2
The beds listed in the Alarm Watch Setup dialog include all the
currently monitored beds.
0070-10-0727-02
V Series Operating Instructions
Alarm Watch
Alarm Watch
FIGURE 22-1 Example Alarm Watch Setup Dialog
22.1.2
Alarm Watch Bed Status Symbols
SYMBOL
DESCRIPTION
Indicates that the location is active on the V Series central network.
Indicates that the location is currently inactive on the V Series central network.
Indicates that the location is locked. Locked locations are setup by the System Administrator
in the System Alarm Watch tab and require a password to modify or remove.
NOTE:
22.1.3
The locked symbol may be combined with the
inactive and/or active symbol. For example, this
symbol
indicates the location is active and
locked.
Adding a Bed
NOTE:
The beds added from this dialog must be on the V Series central
network. Beds added in this dialog are not saved to the default System
Alarm Watch locations. Refer to ‘‘Adding an Alarm Watch Location’’ on
page 25-12 for additional information.
1.
Select the A-W tile.
The Alarm Watch Setup dialog displays.
2.
Select an available position in the Alarm Watch Setup grid.
3.
Select the Add Bed button, then select a bed from the list box.
The bed displays in the Alarm Watch Setup grid.
V Series Operating Instructions
0070-10-0727-02
22 - 3
Alarm Watch
Alarm Watch
NOTE:
Only locations where room/bed information was entered are available
in the list.
NOTE:
The beds are listed alphabetically in the list box.
NOTE:
One monitor can watch a maximum of 16 beds.
Select the Cancel or Accept button.
4.
22.1.4
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Removing a Bed
1.
Select the A-W tile.
The Alarm Watch Setup dialog displays.
2.
Select an unlocked bed in the Alarm Watch Setup grid.
NOTE:
Locked beds (indicated by the
symbol) cannot be removed from the
Alarm Watch Setup grid. Refer to ‘‘Removing Alarms from the Watched
Alarms List’’ on page 22-4 for additional information.
22.1.5
3.
Select the Remove Bed button.
4.
Select the Cancel or Accept button.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Adding Alarms to Watched Alarm List
NOTE:
1.
Select the A-W tile.
The Alarm Watch Setup dialog displays.
2.
Select a bed in the Alarm Watch Setup grid.
3.
Select the Alarms button.
4.
Select an alarm from the Choices list (left side of dialog), then select the Add button.
The alarm moves to the Watched Alarms list (right side of dialog).
5.
Select the Cancel or Accept button.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Select the Cancel or Accept button.
6.
22.1.6
22 - 4
Alarms added in this dialog are not saved to the default System Alarm
Watch locations. Refer to ‘‘Adding Alarms to Watched Alarm List’’ on
page 22-4 for additional information.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Removing Alarms from the Watched Alarms List
1.
Select the A-W tile.
The Alarm Watch Setup dialog displays.
2.
Select a bed in the Alarm Watch Setup grid.
0070-10-0727-02
V Series Operating Instructions
Alarm Watch
Alarm Watch
3.
Select the Alarms button.
4.
Select an unlocked alarm from the Watched Alarm list (right side of dialog), then select the
Remove button.
The alarm is moved back to the Choices list (left side of dialog).
NOTE:
Locked alarms (indicated by the
symbol) cannot be removed from
the Watched Alarm list. Refer to ‘‘Removing an Alarm Watch Location’’
on page 25-12 for additional information.
Select the Cancel or Accept button.
5.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Select the Cancel or Accept button.
6.
V Series Operating Instructions
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
0070-10-0727-02
22 - 5
Alarm Watch Tile
22.2
Alarm Watch
Alarm Watch Tile
The Alarm Watch tile displays:
1.
Tile name
2.
Locked bed
3.
Active, unlocked bed
1
2
3
FIGURE 22-2 Example Alarm Watch Tile (No Beds in Alarm)
22.3
Alarm Watch Notification
When a watched bed is in alarm, it is either displayed in the A-W tile or displayed somewhere on the
Main Screen (as shown in FIGURE 22-5). Both types of alarm notification display the alarm type, flash
in the corresponding alarm priority color, and indicate the alarms location. The V 12/V 21 displays the
three highest priority most recent alarms for the currently monitored beds. When there are more
than three active alarms for the currently monitored beds, the Show All (as shown in FIGURE 22-4)
button displays in the tile indicating that there are more than three beds in alarm.
NOTE:
If the remote monitor is in the Privacy Mode and a watched bed goes
into alarm, the Privacy Mode indicator/alarm light settings of the
remote monitor are observed. Refer to ‘‘Privacy Mode’’ on page 3-12 for
additional information.
NOTE:
If the C.O. Run, PAWP, PA Insertion, Hemo Calculations, Drug
Calculations, or VA Access dialogs is open when a watched bed goes
into alarm, all alarm watch notifications are disabled and the message
“Incoming Alarms Blocked” displays in the A-W tile message area.
A-W Tile Configured
FIGURE 22-3 Example Alarm Watch Tile (One (1) Bed in Alarm)
FIGURE 22-4 Example Alarm Watch Tile (Three (3) or More Beds in Alarm)
22 - 6
0070-10-0727-02
V Series Operating Instructions
Alarm Watch
Alarm Watch Notification
A-W Tile Not-Configured
FIGURE 22-5 Example Alarm Watch Notification Strip (One alarm)
22.3.1
Acknowledging Watched Alarms
To acknowledge a single alarm (where the Show All button is not present):
•
Select the A-W tile or the Alarm Watch Notification Strip (as shown in FIGURE 22-5).
This opens the Remote View dialog and silences all the active alarms for the bed.
NOTE:
Refer to the Remote View chapter for additional information.
To acknowledge an alarm where the Show All button is present:
1.
Select the Show All button.
The Alarm Watch Overview dialog (shown in FIGURE 22-6).
2.
Select the Silence All button to permanently acknowledge all the alarms for the monitored
beds or wait for the dialog to time-out.
FIGURE 22-6 Example All Current Alarms Dialog
NOTE:
V Series Operating Instructions
The Alarm Watch Overview dialog displays the highest priority most
recent alarms for the currently monitored beds.
0070-10-0727-02
22 - 7
Alarm Watch Troubleshooting
22.4
Alarm Watch
Alarm Watch Troubleshooting
The A-W tile area displays messages indicating the current state of the alarm watch beds. If there is
more than one message to display, the messages scroll.
ISSUE
REASON
SOLUTION
Do not see the A-W tile in
display.
Tile not configured to display.
Refer to ‘‘Display Options Dialog’’ on
page 3-2 for additional information.
Cannot remove bed from
Alarm Watch Setup dialog.
Bed is locked and can only be
removed the System Administrator.
Refer to See “Removing a Bed” on
page 22-4. If the bed is locked,
Contact the System Administrator.
See bed at the central station
but do not see in Alarm
Watch Setup dialog.
Only locations where room/bed
information was entered are
available in the list.
Add a room/bed to the location.
Incoming Alarms Blocked
One of the following dialogs is open
at the remote location: C.O. Run,
PAWP, PA Insertion, Hemo
Calculations, Drug Calculations, or
VA Access.
Close the dialogs at the remote
location to unblock alarm watching.
Cannot add any more beds.
The V 12/V 21 can only watch up to
16 beds.
No solution needed.
The system is only watching
lethal alarms.
Only lethal alarms are included in
the Watched Alarms list.
Refer to See “Adding Alarms to
Watched Alarm List” on page 22-4.
AW Comm Lost
Displays when the A-W tile is not
configured for display and there is a
communications loss with the
source monitor.
Contact the System Administrator.
*
22 - 8
Display messages are shown in bold text.
0070-10-0727-02
V Series Operating Instructions
23.0
Remote View
Remote View......................................................................................................................................................... 23-2
Remote View Troubleshooting ................................................................................................................. 23-6
V Series Operating Instructions
0070-10-0727-02
23 - 1
Remote View
23.1
Remote View
Remote View
The Remote View feature allows the simultaneous display of data from two patients on a single
monitor. The monitor where the data originates is defined as the source monitor. The monitor at the
distant location is defined as the remote monitor. When using Remote View, all of the parameters at
the host monitor are still seen but are pushed and compressed to the top portion of the display to
allow room for the Remote View dialog (as shown in FIGURE 23-1).
FIGURE 23-1 Example Remote View Dialog
23.1.1
Remote View Setup
1.
Select the Tools tab, then select the Remote View button.
The Remote View dialog displays.
2.
If the desired location is not already displayed in the Remote View dialog, choose the Select
Location button, then select a location from the listbox.
Data from the selected location displays in the Remote View dialog.
NOTE:
23 - 2
The system automatically remembers and displays the last selected
device in the Remote View dialog unless the Remote View feature is
turned off.
0070-10-0727-02
V Series Operating Instructions
Remote View
23.1.2
Remote View
3.
Optional - select the Select Location button, then choose the Off button to stop viewing the
remote view location.
4.
Optional - select the Done button to close the Remote View dialog.
Configuring the Remote View Display Dialog
Customize the Remote View dialog to view the parameters and waveforms which are especially
useful in managing a patient remotely. The Remote View dialog displays the parameters and
waveforms, including the waveform speed, size, and color based on the configuration settings at the
source monitor, unless they are customized at the remote location to display differently.
NOTE:
Any customizations made in the Remote View dialog are only
temporary. Once the dialog closes or the location is changed, the
settings from the source location are reloaded.
E
FIGURE 23-2 Example Remote View Dialog
1.
Select the Tools tab, then select the Remote View button.
The Remote View dialog displays.
2.
If the desired location is not already displayed Remote View dialog, choose the Select Location
button, then select the desired location from the listbox.
Data from the selected location displays in the Remote View dialog.
3.
Select the Setup button.
The Remote View Display Setup dialog displays.
4.
As the screen message indicates, select an area on the grid to see a list of available parameters.
A list of digital or waveform parameters displays to the right of the grid (as shown in FIGURE 233).
NOTE:
V Series Operating Instructions
The remote monitor can display all data with the exception of the
following: NIBP List tile, ST Beat tile, Time tile, overlapped IBP tiles.
0070-10-0727-02
23 - 3
Remote View
Remote View
FIGURE 23-3 Example Remote View Display Setup Dialog
Select a parameter button.
5.
NOTE:
The arrow beside a parameter button (for example,
)
indicates that there is a submenu with additional choices available.
Select a parameter from the list to add it to the grid.
6.
OR
Select the Off button to leave that portion of the grid empty.
NOTE:
Select the Cancel or Accept button.
7.
8.
23.1.3
23 - 4
The HR parameter tile and the topmost ECG waveform tile cannot be
turned off.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Optional - select the Done button to close the Remote View dialog.
Managing Alarm Delays from the Remote View Monitor
•
The alarm audio enunciation delay at the remote monitor is dependent on the configuration
settings at the source monitor. Acknowledgement of alarms can only occur at the source
monitor. When an alarm is silenced from the remote monitor, the current silence state with a
countdown of the audio resume time displays in the message area (which is above the HR) in the
Remote View dialog and the source monitors message area.
•
Manage alarm silencing by using the buttons described in TABLE 23-1.
0070-10-0727-02
V Series Operating Instructions
Remote View
Remote View
.
TABLE 23-1
BUTTON
DESCRIPTION / COMMENTS
Remote Silence All
Temporarily silences all current and future alarms at the source and remote
locations for two (2) minutes provided the Silence Source setting is turned On. if
the Silence Source setting is turned Off, the silencing of alarms only occurs at the
remote location.
Remote Silence
Temporarily silences all current at the source and remote locations for two (2)
minutes provided the Silence Source setting is turned On. if the Silence Source
setting is turned Off, the silencing of alarms only occurs at the remote location.
NOTE:
*
23.1.4
Refer to ‘‘Configuring the System Tab’’ on
page 25-14 for additional information.
The factory default configuration settings are in bold.
Printing from the Remote View Dialog
Select the Print button to print the Waveform Report from the Remote View dialog.
NOTE:
The settings and the data are derived from the source monitor even
though it is being printed from the remote location.
NOTE:
Refer to the ‘‘Waveform Report’’ on page 19-9 for additional
information.
V Series Operating Instructions
0070-10-0727-02
23 - 5
Remote View Troubleshooting
23.2
Remote View
Remote View Troubleshooting
.
23 - 6
ISSUE
REASON
SOLUTION
Source monitor is not
silencing when Remote
Silence or Remote Silence All
is selected at remote
monitor.
Silence Source is not turned On at
the source monitor.
Turn on Silence Source in the
System tab. Refer to ‘‘Configuring
the System Tab’’ on page 25-14 for
additional information.
No waveforms print on the
Waveform Report.
No waveforms were selected to
print at the source monitor.
Check the Configure Waveform
settings at the source monitor.
0070-10-0727-02
V Series Operating Instructions
24.0
VAccess
Introduction .......................................................................................................................................................... 24-2
V Series Operating Instructions
0070-10-0727-02
24 - 1
Introduction
24.1
VAccess
Introduction
VAccess provides a mechanism to connect to a single remote computer directly from the V 12 or V
21 monitor while still viewing the patient’s vital signs. One monitor can save a maximum of four
VAccess connections.
NOTE:
24.1.1
The VAccess button is only available in the Tools tab if it was enabled in
System Setup. Refer to the System Setup chapter for additional
information.
Navigating to the VAccess Dialog
1.
Select the Tools button from the Navigation Area.
2.
Select the VAccess button.
The VAccess dialog displays (as shown in FIGURE 24-1).
FIGURE 24-1 Example VAccess Dialog
24.1.2
Connecting to a VAccess Location
1.
Select the Tools button from the Navigation Area.
2.
Select the VAccess button.
3.
Select the Select Location button, then select a location from the list.
Within a few moments, the remote desktop loads in window.
NOTE:
24 - 2
If there is no activity at the remote desktop, for example, no one has
logged in to remote desktop, it automatically times out. The Remote
Access Protocol (RDP) Administrator at the site configures this time out.
If there is 10 minutes of inactivity once logged into the remote desktop,
the VAccess application automatically times out. The 10 minute time
out is controlled by the V Series application and is not user
configurable.
4.
Optional - to switch to a different connection, select the Select Location button again and
choose a different location from the list.
5.
When finished with connection, select the Done button.
0070-10-0727-02
V Series Operating Instructions
25.0
System Setup
Introduction .......................................................................................................................................................... 25-2
System Dialog ...................................................................................................................................................... 25-2
Configuration Management....................................................................................................................... 25-16
V Series Operating Instructions
0070-10-0727-02
25 - 1
Introduction
25.1
System Setup
Introduction
The V 12/V 21 System Setup dialog provides access to the system default settings such as date and
time format, parameter timeouts, enabling/disabling lethal alarms, Quick Functions buttons, default
printers, service mode, and password updates. Access to this dialog requires a password.
25.2
System Dialog
The System dialog, located in the Setup tab, (as shown in FIGURE 25-1) contains the following tabs:
•
General
•
Alarms
•
Printer
•
Network
•
Alarm Watch
•
System
A description of each tab follows.
25.2.1
Navigating to the System Dialog
1.
Select the Setup tab from the Navigation Area.
2.
Select the System button.
NOTE:
The
icon in the System button indicates that a password is required
to access the System dialog.
3.
Enter the password.
4.
Select the Accept button.
The System dialog displays (as shown in FIGURE 25-1).
FIGURE 25-1 Example System Dialog (General Tab)
25 - 2
0070-10-0727-02
V Series Operating Instructions
System Setup
25.2.2
System Dialog
Configuring the General Tab
Select the General tab to configure the screen formats, timeouts, display setup, and Quick Functions
buttons. These functions apply to all patient sizes.
1.
Select the Setup tab from the Navigation Area.
2.
Select the System button, enter the password, then select the Accept button.
3.
Select the General tab (as shown in FIGURE 25-1).
NOTE:
The current setting displays beside the tab button.
Select the buttons described in TABLE 25-1 to configure the tab.
4.
TABLE 25-1
BUTTON
DESCRIPTION / COMMENTS
CHOICES*
Date Format
Changes the format in which dates are
displayed in the system.
D/M/Y, Y/M/D, M/D/Y
Time Format
Changes the format in which time is
displayed in the system.
12 Hr, 24 Hr
NIBP Timeout
Determines the time interval at which the
NIBP measurement is automatically removed
from the Main Display.
15 min, 30 min, 45 min, 1 hr
CO\PAWP Timeout
Determines the time interval at which the
CO/PAWP measurement is automatically
removed from the Main Display.
15 min, 30 min, 45 min, 1 hr
Nurse Call
Sends an electronic signal to the Nurse Call
system when an alarm is active.
Off, One-Shot, Continuous
NOTE:
Quick Functions
*
Configures the buttons in the Quick
Functions tab in the Navigation Area.
Refer to the ‘‘Configuring the
Quick Functions Tab’’ on page 253 for additional information.
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
5.
25.2.3
When Nurse Call is configured for Off, the
Alarm Responses dialog does not display the
Nurse Call column.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Configuring the Quick Functions Tab
The Quick Functions tab may be configured to include six (6) predefined keys. These functions apply
to all patient sizes.
To define the Quick Function Keys buttons:
1.
Select the Setup tab from the Navigation Area.
2.
Select the System button, enter the password, then select the Accept button.
By default, the General tab selects.
3.
Select the Quick Functions button.
The Quick Function Keys dialog displays (as shown in FIGURE 25-2).
V Series Operating Instructions
0070-10-0727-02
25 - 3
System Dialog
System Setup
FIGURE 25-2 Example Quick Function Keys Dialog
4.
Select from the available choices listed in TABLE 25-2.
NOTE:
The order of the keys shown in the Quick Function row of the
Navigation Area is dependent on how the keys are ordered in the Quick
Function Keys dialog list box. For example, in FIGURE 25-2, the NIBP
Start/Stop key is listed first and displays as the first button in the Quick
Functions row.
TABLE 25-2
•
NIBP Start/Stop
NOTE:
NIBP Stat
The NIBP Start/Stop and NIBP Stat keys only display in the Navigation
Area provided NIBP or NIBP List is configured to display in the Display
Setup configuration.
•
Zero All IBP
•
View All ECG
•
Lead/Size
•
Standby
•
Print 12-Lead
•
Alarm Responses
•
Transfer/Discharge
•
Arrhythmia
•
Demographics
•
Quick Trends
•
Display Presets
•
List Trends
•
Privacy Mode
•
Relearn Arrhythmia
•
Parameters
•
Relearn ST
•
Hemodynamics
•
ST Review
•
Drug Calculator
•
NIBP Interval
*
25 - 4
•
The factory default configuration settings are in bold.
0070-10-0727-02
V Series Operating Instructions
System Setup
System Dialog
TABLE 25-2
•
C.O. Run
•
ECG Menu
•
PAWP
•
Quick Trends
•
PA Insertion
•
Graphic Trends
•
Alarm Limits
•
Full Disclosure
•
List Trends
•
Events
•
VAccess
*
The factory default configuration settings are in bold.
5.
Use the buttons described in TABLE 25-3 to navigate in this dialog.
TABLE 25-3
BUTTON
DESCRIPTION
Add
Adds the selected choice to the Selected list (located to the right of
the navigation buttons).
Remove
Removes the selected choice from the Selected list.
Remove All
Removes all the choices from the Selected list and moves them back
to the Choices list (located to the left of the navigation buttons).
Move to Top
Moves the highlighted choice to the top position in the Selected list.
Move Up
Moves the choice in the Selected list up one position.
Move Down
Moves the choice from the Selected list down one position.
Move to Bottom
Moves the cursor up by one in the Selected list.
Select the Cancel or Accept button.
6.
V Series Operating Instructions
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
0070-10-0727-02
25 - 5
System Dialog
25.2.4
System Setup
Configuring the Alarms Tab
Select the Alarms tab to configure the alarm silencing, lethal alarms, alarm delays, and other alarm
related settings. Except for the Lethal Alarms and Apnea Detection, which apply to Adult and
Pediatric patient sizes only, the other alarm settings apply to all patient sizes.
To configure the Alarms tab:
1.
Select the Setup tab from the Navigation Area.
2.
Select the System button, enter the password, then select the Accept button.
3.
Select the Alarms tab.
The Alarms tab displays (as shown in FIGURE 25-3).
FIGURE 25-3 Example System Dialog (Alarms Tab)
4.
Select the buttons described in TABLE 25-4 to configure the tab.
TABLE 25-4
BUTTON
DESCRIPTION / COMMENTS
CHOICES*
Silence All
Timeout
Allows an authorized user to choose which
settings are available in the Alarm Setup
dialog Silence All functions. This setting
controls for how long an alarm is muted.
France only:
1,2 min
1, 2, 5 min
1, 2, 5, 10 min
Other countries:
1, 2, 5,10 min, Permanent
1, 2, 5, 10 min
1, 2, 5 min
1,2 min
NOTE:
*
25 - 6
The Silence All configuration applies to all patient
sizes.
The factory default configuration settings are in bold.
0070-10-0727-02
V Series Operating Instructions
System Setup
System Dialog
TABLE 25-4
BUTTON
DESCRIPTION / COMMENTS
CHOICES*
Lethal Alarms
Allows an authorized user to determine
whether or not a user can modify the lethal
arrhythmia settings and decide whether
Asystole, VTach and VFib alarms can be
turned off by the user.
Locked
Unlocked
Apnea Alarms
Allows an authorized user to enable Apnea
alarms at the monitor.
Locked
Unlocked
*
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
5.
25.2.5
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Configuring the Printer Tab
Select the Printer tab to configure up to three (3) laser printers. These functions apply to all patient
sizes.
To configure the Printer tab:
1.
Select the Setup tab from the Navigation Area.
2.
Select the System button, enter the password, then select the Accept button.
3.
Select the Printer tab.
The Printer tab displays (as shown in FIGURE 25-4).
FIGURE 25-4 Example System Dialog (Printer Tab)
V Series Operating Instructions
0070-10-0727-02
25 - 7
System Dialog
System Setup
Select the buttons described in TABLE 25-5 to configure the tab.
4.
TABLE 25-5
BUTTON/
CHECK BOX
DESCRIPTION / COMMENTS
CHOICES*
Printer
Allows an authorized user a means to specify
a name for each laser printer. An example
could be, department name, unit, or nurses
station, etc.
Accepts up to 15 alphanumeric
characters.
Factory defaults to a blank value.
IP Address
Allows an authorized user to specify the laser
printer IP address for each laser printer.
Accepts up to 15 digital
characters.
Factory default 7.7.7.0
*
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
5.
25.2.6
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Configuring the Network Tab
Select the Network tab to define the hospital name, department, indicate if the monitor will be
networked to another monitor or to a central station, and establish VAccess connections. These
functions apply to all patient sizes.
1.
Select the Setup tab from the Navigation Area.
2.
Select the System button, enter the password, then select the Accept button.
3.
Select the Network tab.
The Network tab displays (as shown in FIGURE 25-5).
FIGURE 25-5 Example System Dialog (Network Tab)
25 - 8
0070-10-0727-02
V Series Operating Instructions
System Setup
System Dialog
Select the buttons described in TABLE 25-6 to configure the tab.
4.
TABLE 25-6
BUTTON/
CHECK BOX
DESCRIPTION / COMMENTS
CHOICES*
Hospital
Provides clinician or biomedical engineer a
means to specify the hospital name.
Accepts up to 15 alphanumeric
characters.
Factory defaults to blank.
Department
Provides clinician or biomedical engineer a
means to specify the hospital name.
Accepts up to 15 digital
characters.
Factory defaults to blank.
Wired
Select to enter the IP Address and Subnet
Mask.
Factory default IP address 7.6.6.0.
Factory default Subnet Mask is
255.255.255.0.
VAccess
Select to enable access to a maximum of four
remote computers.
Refer to ‘‘Configuring VAccess’’ on
page 25-9 for additional
information.
*
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
5.
25.2.7
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Configuring VAccess
1.
Select the Setup tab from the Navigation Area.
2.
Select the System button, enter the password, then select the Accept button.
3.
Select the Network tab, then select the VAccess Setup button.
The VAccess Setup dialog displays (as shown in FIGURE 25-6).
.
FIGURE 25-6 Example VAccess Setup Dialog
V Series Operating Instructions
0070-10-0727-02
25 - 9
System Dialog
System Setup
Select the buttons described in TABLE 25-7 to configure the tab.
4.
TABLE 25-7
BUTTON/
CHECK BOX
DESCRIPTION / COMMENTS
CHOICES*
VAccess Enable
Provides clinician or biomedical engineer a
means to specify if the VAccess button is
visible in Tools menu.
Off, Primary
VAccess Size
Provides clinician or biomedical engineer a
means to specify the size of the VAccess
window.
Small, Large
VAccess Address 1- 4
Provides clinician or biomedical engineer a
means to specify the IP address for up to four
remote computers.
The default is blank.
NOTE:
*
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
5.
25.2.8
Enter the VAccess IP address in a X.X.X.X (where X
represents the number) format.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Entering VAccess Addresses
Up to four (4) VAccess IP addresses may be entered into the system.
25.2.9
1.
Select the Setup tab from the Navigation Area.
2.
Select the System button, enter the password, then select the Accept button.
3.
Select the Network tab, then select the VAccess Setup button.
4.
Select one (four buttons are available) of the VAccess Address buttons.
A keyboard displays.
5.
Enter the IP address in a X.X.X.X (where X represents the number) format, then select the
Accept button to close the keyboard dialog.
6.
Select the Cancel or Accept button.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Configuring the Alarm Watch Tab
The Alarm Watch feature allows the simultaneous viewing of selected alarms for up to 16 beds from a
single monitor. The System Administrator can add different locations for each monitor to watch
based on the staffing and/or departmental needs. Default alarm watch locations are managed
through the password protected System Alarm Watch tab. All configured locations are automatically
included in the monitor’s list of watched beds. Any changes made (including the initial
configuration) to the System Alarm Watch settings do not take effect until the patient is either
discharged or the patient size is changed. Any active location on the V Series central network can
be added to the watched list.
25 - 10
0070-10-0727-02
V Series Operating Instructions
System Setup
System Dialog
FIGURE 25-7 Example System Setup (Alarm Watch Tab)
25.2.10
Adding an Alarm Watch Location
1.
Select the Setup tab from the Navigation Area.
2.
Select the System button, enter the password, then select the Accept button.
3.
Select the Alarm Watch tab.
4.
Select the Add Location button, then select a location from the list.
The location displays in the Alarm Watch grid.
NOTE:
Only locations where room/bed information was entered are available
in the list.
NOTE:
Once a location is added to the list, it remains on the list until it is
removed. The locations are listed alphabetically in the list box.
Select the Cancel or Accept button.
5.
25.2.11
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Removing an Alarm Watch Location
NOTE:
Removing alarms from a System alarm watch location effects all the
watched beds.
1.
Select the Setup tab from the Navigation Area.
2.
Select the System button, enter the password, then select the Accept button.
V Series Operating Instructions
0070-10-0727-02
25 - 11
System Dialog
25.2.12
System Setup
3.
Select the Alarm Watch tab.
4.
Select a location from the alarm watch grid.
5.
Select the Remove Location button.
Adding Alarms to a Watched Alarm List
NOTE:
Adding alarms from a System alarm watch location effects all the
watched beds.
1.
Select the Setup tab from the Navigation Area.
2.
Select the System button, enter the password, then select the Accept button.
3.
Select the Alarm Watch tab.
4.
Select the Alarms button.
NOTE:
Asystole, V-Fibrillation, and V-Tachycardia are automatically included
in the watched alarms list. They are indicated by the locked
icon
(meaning they cannot be removed from the list).
Select an alarm from the Choices list (left side of dialog), then select the Add button.
The alarm moves to the Watched Alarms list (right side of dialog).
5.
Select the Cancel or Accept button.
6.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Select the Cancel or Accept button.
7.
25.2.13
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Removing Alarms from the Watch Alarm List
1.
Select the Setup tab from the Navigation Area.
2.
Select the System button, enter the password, then select the Accept button.
3.
Select the Alarm Watch tab.
4.
Select the Alarms button.
5.
Select an unlocked alarm from the Watched Alarms list (right side of dialog), then select the
Remove button.
The alarm moves to the Choice list (left side of dialog).
NOTE:
Asystole, V-Fibrillation, and V-Tachycardia are automatically included
in the watched alarms list. They are indicated by the locked
icon
(meaning they cannot be removed from the list).
Select the Cancel or Accept button.
6.
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Select the Cancel or Accept button.
7.
25 - 12
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
0070-10-0727-02
V Series Operating Instructions
System Setup
25.2.14
System Dialog
Alarm Watch Response
The Alarm Watch Response is Visual/Audio. This settings indicates that when a configured alarm
occurs, a visual indication displays and an audio alarm enunciates.
25.2.15
Configuring the System Tab
Select the System tab to configure the demo mode and service settings. These functions apply to all
patient sizes.
To configure the System tab:
1.
Select the Setup tab from the Navigation Area.
2.
Select the System button, enter the password, then select the Accept button.
3.
Select the System tab.
The System tab displays (as shown in FIGURE 25-8).
FIGURE 25-8 Example System Dialog (System Tab)
4.
Select the buttons described in TABLE 25-8 to configure the tab.
TABLE 25-8
BUTTON/
CHECK BOX
DESCRIPTION / COMMENTS
CHOICES*
Demo Mode
Allows an authorized user to choose a
demonstration mode for in-servicing staff or
testing product features.
Enable, Disable
Demo Scenario
Allows an authorized user various
demonstration scenarios that are intended to
non-clinical conditions.
List all scenarios contained in the
Scenarios folder.
*
V Series Operating Instructions
The factory default configuration settings are in bold.
0070-10-0727-02
25 - 13
System Dialog
System Setup
TABLE 25-8
BUTTON/
CHECK BOX
DESCRIPTION / COMMENTS
CHOICES*
Silence Source
This checkbox is related to the Remote View
feature. When enabled, allows the alarms at
the source location to be silenced by
selecting a button from the remote location.
On, Off
Restore Factory
Defaults
Allows an authorized user to reestablish the
original database power up settings to
factory default values.
N/A
Restart the V 12/V 21 after restoring factory
defaults. The monitor returns to its factory
default state after the restart.
NOTE:
Refer to ‘‘Restore Factory Defaults’’ on page 25-14 for a
list of exceptions.
Change Password
Allows an authorized user to change the
System password.
N/A
Service
Allows an authorized user access to the
password protected Service Diagnostic
mode.
N/A
Export Config
Copies the current settings to the external
drive.
N/A
Import Config
Copies the settings from the external drive to
the V 12/V 21 unit.
N/A
Save Dept. Defaults
Allows an authorized user to save the current
monitor settings for the selected patient size.
N/A
Print System Settings
Prints all the system settings by patient size.
N/A
*
The factory default configuration settings are in bold.
Select the Cancel or Accept button.
5.
25.2.15.1
CAUTION:
•
The Cancel button closes the dialog without saving the settings.
•
The Accept button saves the settings and closes the dialog.
Restore Factory Defaults
The following settings are not affected when the Restore Factory Defaults button is selected because
they are tied to regional settings:
25 - 14
•
Date
•
Time
•
Temperature
•
Language
•
Country
CAUTION:
Restart the V 12/V 21 after restoring factory defaults. The monitor
returns to its factory default state after the restart.
NOTE:
A confirmation message displays prior to restoring the current
database values to the factory default values.
0070-10-0727-02
V Series Operating Instructions
System Setup
25.2.15.2
System Dialog
Change Password
This changes the password to access the System dialog.
NOTE:
25.2.15.3
To change the System password, the current System password is
required.
1.
Select the Setup tab from the Navigation Area.
2.
Select the System button, enter the password, then select the Accept button.
3.
Select the System tab, then select the Change Password button.
The Enter Password keyboard displays.
4.
Enter the current System password, then select the Accept button.
The Create Password keyboard displays.
5.
Enter a new password, then select the Accept button.
The Verify Password keyboard displays.
6.
Enter the new password again, then select the Accept button.
A confirmation box displays.
Import/Export Configuration Settings
Monitor settings may be imported or exported to multiple units provided a storage device is
available.
1.
Select the Setup tab from the Navigation Area.
2.
Select the System button, enter the password, then select the Accept button.
By default, the General tab selects.
3.
Select the System tab.
4.
Insert a storage device into one of the serial ports.
NOTE:
5.
Optional - select the Save Dept. Defaults button before selecting the Export Config button to
save the current department defaults for the selected patient size. If they are not saved, the
factory default settings are exported.
6.
Select the Export Config or the Import Config button.
A message warning not to remove the storage device and a progress bar display.
NOTE:
If the storage device is not found after the Export/Import Config button
is selected, the message “Warning: Please insert a external storage
device.” displays.
The files copy to or from the unit.
The message “Transfer Complete” displays.
7.
NOTE:
25.2.15.4
Refer to ‘‘General Product Description’’ on page 1-1 for serial port
locations.
Imported settings DO NOT effect the current patient. They take effect
once the current patient is discharged and a new admission occurs.
Save Dept. Defaults
The following settings are not affected when the Save Dept. Defaults button is selected because
the setting is intended to be temporary:
V Series Operating Instructions
•
Notch Filter
•
ESU Filter
0070-10-0727-02
25 - 15
Configuration Management
System Setup
NOTE:
25.2.15.5
A confirmation message displays prior to saving the department
default settings as the power up settings.
Print System Settings
Refer to ‘‘System Settings Report’’ on page 19-41 for additional information.
25.3
Configuration Management
If the monitor is inadvertently powered down (due to power failure or battery depletion), monitor
settings are recovered as follows:
25 - 16
•
Restarting the monitor within 60 seconds restores the latest user-settings.
•
Restarting the monitor after 60 but before 120 seconds restores the settings by either the latest
user-settings or the user-saved settings.
•
Restarting the monitor after120 seconds restores the user-saved configurations.
0070-10-0727-02
V Series Operating Instructions
26.0
Product Maintenance
Introduction .......................................................................................................................................................... 26-2
Care and Cleaning of Monitor, Modules and Racks...................................................................... 26-2
Care and Cleaning of SpO2 Sensors ...................................................................................................... 26-3
Care and Cleaning of Reusable Temperature Probes.................................................................. 26-3
Care and Cleaning of Reusable Cuffs .................................................................................................... 26-4
Care and Cleaning of Lead ECG Cables and Wires........................................................................ 26-5
Battery Maintenance ....................................................................................................................................... 26-5
Care of CO2 Module......................................................................................................................................... 26-6
V Series Operating Instructions
0070-10-0727-02
26 - 1
Introduction
26.1
Product Maintenance
Introduction
This section of the manual outlines routine monitor maintenance guidelines.
The V 12/V 21 monitor is designed for stable operation over long periods of time. Under normal
circumstances the monitor should not require technical maintenance beyond that described in this
section. However, routine maintenance, calibration and safety checks are recommended at least once
a year or more often as required by local statutory or hospital administration practice.
26.2
Care and Cleaning of Monitor, Modules and
Racks
NOTE:
Only use the following approved cleaning solutions. The system may
become inoperable or halted because of contamination or damage
caused by use of unapproved cleaning solution.
Clean with a lint-free cloth, moistened with warm water (40°C/104°F maximum) and soap, diluted in
any of the approved cleaning solutions.
•
70% isopropyl alcohol
•
10% sodium hypocholride (bleach) solution
•
Water
•
Virkon
•
Super Sani-cloth (0.5% Quaternary ammonium chloride and 55% Isopropyl alcohol)
Apply cleaning solution to the cloth, not directly onto the monitor. DO NOT apply large amounts of
liquid. DO NOT use abrasive cleaning agents or organic solvents.
Clean any spillage of blood or solutions on the monitor as soon as possible. Dried blood is very
difficult to remove. Use a lint-free absorbent towels for spill cleanups. Dampen the towel with one of
the approved cleaning solutions to aid in cleaning.
To prevent scratches on the screen carefully brush dust and dirt particles with a soft sponge
moistened with cleaning solution or a fine, soft-hair brush. DO NOT use abrasive cleaning materials
such as acetone or trichloroethylene. Remove fingerprints and stains with a liquid lens cleaner and a
soft cloth. DO NOT wipe a dry screen or use alcohol or solvents containing chlorinated hydrocarbon.
Take extra care when cleaning the monitor screen because it is more sensitive to rough cleaning
methods than the housing. Do not permit any liquid to enter the monitor case and avoid pouring it
on the monitor while cleaning. Do no allow water or cleaning solution to enter the measurement
connectors. Wipe around, not over, connector sockets.
After cleaning, dry all areas except the monitor screen with an absorbent paper towel.
26.2.1
Monitor Sterilization
Sterilization is not recommended for this monitor, related products, accessories or supplies unless
otherwise indicated in the Operating Instructions that accompany the accessories or supplies.
26 - 2
0070-10-0727-02
V Series Operating Instructions
Product Maintenance
26.3
Care and Cleaning of SpO2 Sensors
Care and Cleaning of SpO2 Sensors
NOTE:
Refer to the individual instruction sheets that are packaged with each
sensor.
•
Check sensors and cables daily for signs of damage. Replace as required.
•
Clean reusable SpO2 sensors before and after each new patient.
•
Wipe the patient contact area using a soft cloth with mild soap and water solution or isopropyl
alcohol. Hydrogen peroxide can be used to remove dried blood.
•
Allow the sensor to completely dry before using.
CAUTION:
When cleaning SpO2 sensors, do not use excessive amounts of liquid.
Wipe the sensor surface with a soft cloth, dampened with cleaning
solution. Do not attempt to sterilize.
Cleaning and Re-use of a Nellcor® Sensor
Nellcor reusable SpO2 sensors may be reattached to the same patient if the emitter and detector
windows are clear and the adhesive still adheres to the skin. The adhesive can be partially
rejuvenated by wiping with an alcohol wipe and allowing the sensor to thoroughly air dry prior to
replacement on the patient.
Do not immerse any Oxisensor®, OxiMax®, Durasensor®, Oxiband®, or Duraform® oxygen transducers,
the Nellcor® RS-10 or Max-Fast® oxygen transducers, or any Nellcor® adhesive in water or cleaning
solution. Clean Durasensor®, Oxiband®, and Duraform® oxygen transducers, and the Nellcor® RS-10 or
Max-Fast® oxygen transducers by wiping with a disinfectant such as a solution containing 70%
alcohol. Do not sterilize by irradiation, steam, or ethylene oxide. Use a new Oxiband® adhesive wrap or
FORM-A adhesive bandage for each patient. Do not re-sterilize Oxisensor® or OxiMax® oxygen
transducers.
26.4
Care and Cleaning of Reusable Temperature
Probes
NOTE:
Refer to the individual instruction sheets that are packaged with each
temperature probe for additional information.
•
Check temperature probes and cables daily for signs of damage. Replace as required.
•
Clean the probes before and after each new patient.
•
Wipe the patient contact area using a soft cloth with mild soap and water solution or isopropyl
alcohol.
•
Allow the probe to completely dry before using.
V Series Operating Instructions
0070-10-0727-02
26 - 3
Care and Cleaning of Reusable Cuffs
26.5
Care and Cleaning of Reusable Cuffs
NOTE:
26.5.1
Product Maintenance
Accuracy of cuff-pressure transducers/indicators is to be verified at
intervals specified by the manufacturer.
Reusable Cuffs with Bladders
Take out the bladder before cleaning and disinfecting the cuff.
Cleaning
Hand or machine wash the cuff in warm water or with mild detergent. Clean the bladder with a damp
cloth. Air dry the cuff thoroughly after washing.
NOTE:
Machine washing may shorten the service life of the cuff.
Disinfection
Disinfect the cuff with a cloth dampened in 70% isopropanol or with ultraviolet. Also clean the
bladder with ultraviolet.
NOTE:
Prolonged use of disinfectant may cause discoloration of the cuff.
Replace the bladder after cleaning and disinfecting the cuff:
1.
Place the bladder on the top of the cuff (as shown in FIGURE 26-1).
2.
Roll the bladder lengthwise and insert it into the large opening (as shown in
FIGURE 26-1).
3.
Hold the hose and the cuff and shake the complete cuff until the bladder is in position.
4.
Thread the hose from inside the cuff, and out through the small hole under the internal flap.
FIGURE 26-1 Example NIBP Cuff
CAUTION:
26.5.2
Clean and disinfect the cuff according to the instructions.
Do not dry clean the cuff.
Do not press the cuff with a hot iron.
Do not clean with detergent or disinfectant.
Disinfect the bladder with 70% isopropanol or ultraviolet.
Reusable Bladderless Cuffs
Clean cuffs with warm water and a mild detergent. Do not use a detergent containing hand
conditioners, softeners, or fragrances.
26 - 4
0070-10-0727-02
V Series Operating Instructions
Product Maintenance
Care and Cleaning of Lead ECG Cables and Wires
Antimicrobial Definition
Bladderless cuffs are treated with an antimicrobial coating. Antimicrobial technology effectively
controls a broad spectrum of bacteria, fungi, algae and yeasts on a wide variety of treated substrates.
26.6
Care and Cleaning of Lead ECG Cables
and Wires
Use the same approved cleaning solutions outlined in the "Care and Cleaning of Monitor, Modules
and Racks" on page 26-2.
After cleaning, the ECG cables and lead wires should be wiped with water using a clean damp cloth
then dried with a clean dry cloth. The ECG cables and lead wires must be allowed to dry thoroughly
before use.
26.7
NOTE:
ECG cables and lead wires must never be immersed, soaked in any
fluids, and they should not be cleaned with harsh chemicals such as
acetone or non-diluted bleach.
NOTE:
Do not autoclave, radiation or steam sterilize ECG cables or lead wires.
NOTE:
Extended exposure to Ethylene Oxide gas may shorten life of the ECG
cables and lead wires, leading to poor signal quality.
Battery Maintenance
Battery Replacement
1.
Open battery compartment door, on left side of unit, by pressing the finger grip area and sliding
the door to the rear.
2.
Slide the release located at the top of the installed battery. This ejects the battery. Slide out and
remove battery.
3.
Slide in replacement battery until it clicks into place.
4.
Close battery compartment door by sliding the door to the right until it firmly clicks into place.
CAUTION:
Replace Li-Ion batteries with P/N 0146-00-0091-01 ONLY.
NOTE:
Batteries using P/N 0146-00-0069 may fit inside the V 12 monitor but
they will not properly report charging status.
The batteries may be subject to local regulations regarding disposal. At the end of the battery life,
dispose of the batteries in accordance with any local regulations.
NOTE:
V 12 batteries may only be charged within a V 12 monitor. Do not attempt
to use commercial rechargers.
Li-Ion
Storage of the Li-Ion-ion batteries depends on temperature, time period and the degree of cell
charging state. After 6 months of storage at 23oC, fully charged Li-Ion-ion batteries have a retention
capacity of 93%.
Battery Maintenance
The batteries may be subject to local regulations regarding disposal. At the end of the battery life,
dispose of the batteries in accordance with any local regulations.
V Series Operating Instructions
0070-10-0727-02
26 - 5
Care of CO2 Module
Product Maintenance
NOTE:
26.8
V 12 batteries may only be charged within a V 12 monitor. Do not attempt
to use commercial rechargers.
Care of CO2 Module
Refer to "Carbon Dioxide (CO2)" on page 28-37 for additional information.
26 - 6
0070-10-0727-02
V Series Operating Instructions
27.0
Accessories
ECG ............................................................................................................................................................................. 27-2
SpO2 .......................................................................................................................................................................... 27-4
NIBP ............................................................................................................................................................................ 27-5
Temperature.......................................................................................................................................................... 27-7
IBP................................................................................................................................................................................ 27-7
CO2............................................................................................................................................................................. 27-8
CO................................................................................................................................................................................ 27-9
Miscellaneous Accessories........................................................................................................................... 27-10
Mounts & Mounting Accessories............................................................................................................. 27-10
Networking Accessories................................................................................................................................ 27-11
Manuals.................................................................................................................................................................... 27-11
V Series Operating Instructions
0070-10-0727-02
27 - 1
ECG
Accessories
27.1
ECG
27.1.1
ECG Electrodes
27.1.2
27.1.3
PART NUMBER
DESCRIPTION
0681-00-0100-02
Disposable pre-gelled ECG Electrodes (box of 60)
0681-00-0100-01
Disposable pre-gelled ECG Electrodes, 1 case of 600 (10 boxes of 60)
0683-00-0449-01
Dual Snap Electrodes (box of 200)
0681-00-0098-01
Radio Opaque, Neonatal Pre-wired, 3 Lead ECG Electrodes, AAMI, 18" (45.7 cm), box
of 100 packs (each pack contains 3 electrodes)
0681-00-0098-02
Radio Translucent, Neonatal Pre-wired, 3 Lead ECG Electrodes, AAMI, 18" (45.7 cm),
box of 100 Packs (each pack contains 3 electrodes)
ECG Cables
PART NUMBER
DESCRIPTION
0012-00-1745-01
ECG Cable, 3/5 lead, 10’ (3.1 m)
0012-00-1745-02
ECG Cable, 3/5 lead, 20’ (6.1 m)
0012-00-1745-03
ECG Cable, 3/5 lead, ESIS, 10’ (3.1 m)
0012-00-1745-04
ECG Cable, 3/5 lead, ESIS, 20’ (6.1 m)
040-000072-00
Neonatal ECG Patient Cable, 10’ (3.1 m)
0012-00-1746-01
ECG Cable 6 Lead, 10'
0012-00-1746-02
ECG Cable 6 Lead, 20'
0012-00-1746-03
ECG Cable 6 lead, 10', ESIS
0012-00-1746-04
ECG Cable 6 lead, 20', ESIS
ECG Leadsets
PART NUMBER
DESCRIPTION
0012-00-1503-01
ECG Leadwires, 5 lead, Snap, 18" (45.7 cm), AAMI
0012-00-1503-02
ECG Leadwires, 5 lead, Snap, 24" (61.0 cm), AAMI
0012-00-1503-03
ECG Leadwires, 5 lead, Snap, 36" (101.6 cm), AAMI
0012-00-1503-10
ECG Leadwires, 5 lead, Snap, 18" (45.7 cm), IEC
0012-00-1503-11
ECG Leadwires, 5 lead, Snap, 24" (61.0 cm), IEC
0012-00-1503-12
ECG Leadwires, 5 lead, Snap, 36" (101.6 cm), IEC
0012-00-1503-04
ECG Leadwires, 3 lead, Snap, 18" (45.7 cm), AAMI
0012-00-1503-05
ECG Leadwires, 3 lead, Snap, 24" (61.0 cm), AAMI
0012-00-1503-06
ECG Leadwires, 3 lead, Snap, 36" (101.6 cm), AAMI
0012-00-1503-13
ECG Leadwires, 3 lead, Snap, 18" (45.7 cm), IEC
0012-00-1503-14
ECG Leadwires, 3 lead, Snap, 24" (61.0 cm), IEC
0012-00-1503-15
ECG Leadwires, 3 lead, Snap, 36" (101.6 cm), IEC
0012-00-1514-01
ECG Leadwires, 5 lead, Pinch, 18" (45.7 cm), AAMI
0012-00-1514-02
ECG Leadwires, 5 lead, Pinch, 24" (61.0 cm), AAMI
*
27 - 2
Not available for sale in the United States
0070-10-0727-02
V Series Operating Instructions
Accessories
ECG
PART NUMBER
DESCRIPTION
0012-00-1514-03
ECG Leadwires, 5 lead, Pinch, 36" (101.6 cm), AAMI
0012-00-1514-10
ECG Leadwires, 5 lead, Pinch, 18" (45.7 cm), IEC
0012-00-1514-11
ECG Leadwires, 5 lead, Pinch, 24" (61.0 cm), IEC
0012-00-1514-12
ECG Leadwires, 5 lead, Pinch, 36" (101.6 cm), IEC
0012-00-1514-04
ECG Leadwires, 3 lead, Pinch, 18" (45.7 cm), AAMI
0012-00-1514-05
ECG Leadwires, 3 lead, Pinch, 24" (61.0 cm), AAMI
0012-00-1514-06
ECG Leadwires, 3 lead, Pinch, 36" (101.6 cm), AAMI
0012-00-1514-13
ECG Leadwires, 3 lead, Pinch, 18" (45.7 cm), IEC
0012-00-1514-14
ECG Leadwires, 3 lead, Pinch, 24" (61.0 cm), IEC
0012-00-1514-15
ECG Leadwires, 3 lead, Pinch, 36" (101.6 cm), IEC
0012-00-1816-02
ECG Leadwires, 6 lead, Pinch, 24" (61.0 cm), AAMI
0012-00-1816-03
ECG Leadwires, 6 lead, Pinch, 36" (101.6 cm), AAMI
0012-00-1816-12
ECG Leadwires, 6 lead, Pinch, 24" (61.0 cm), IEC
0012-00-1816-13
ECG Leadwires, 6 lead, Pinch, 36" (101.6 cm), IEC
0012-00-1773-02
ECG Leadwires, 6 lead, Snap, 24" (61.0 cm), AAMI
0012-00-1773-03
ECG Leadwires, 6 lead, Snap, 36" (101.6 cm), AAMI
0012-00-1773-12
ECG Leadwires, 6 lead, Snap, 24" (61.0 cm), IEC
0012-00-1773-13
ECG Leadwires, 6 lead, Snap, 36" (101.6 cm), IEC
0012-00-1818-02
5-lead extended leadset snap 24", AAMI
0012-00-1818-03
5-lead extended leadset snap 36", AAMI
0012-00-1818-11
5-lead extended leadset snap 24", IEC
0012-00-1818-12
5-lead extended leadset snap 36", IEC
0012-00-1820-02
5-lead extended leadset pinch 24", AAMI
0012-00-1820-03
5-lead extended leadset pinch 36", AAMI
0012-00-1820-11
5-lead extended leadset pinch 24", IEC
0012-00-1820-12
5-lead extended leadset pinch 36", IEC
0010-10-12304
Adult Electrode (Kendall, package of 10)*
*
V Series Operating Instructions
Not available for sale in the United States
0070-10-0727-02
27 - 3
SpO2
27 - 4
Accessories
27.2
SpO2
27.2.1
Masimo SpO2 Module
PART NUMBER
DESCRIPTION
0020-00-0154
LNCS® Adult/Pediatric starter kit
0020-00-0156
LNCS® Adult/Pediatric disposable starter kit
0020-00-0155
LNCS® Neonatal disposable starter kit
0600-00-0126
LNCS DC-I Adult finger reusable sensor
0600-00-0127
LNCS DC-IP Pediatric finger reusable sensor
0600-00-0121
LNCS ADTX Adult single patient adhesive sensors
0600-00-0122
LNCS PDTX Pediatric single patient adhesive sensors
0600-00-0123
LNCS INF-L Infant single patient adhesive sensors
0600-00-0124
LNCS NEO-L Neonatal single patient adhesive sensors
0600-00-0125
LNCS NEO PT-L Neonatal preterm patient adhesive sensors
0012-00-1652
LNC-4 SpO2 Patient cable
0012-00-1599
LNC-10 SpO2 Patient cable
0012-00-1653
LNC-14 SpO2 Patient cable
0012-00-1651
LNCS to LNOP PC series adapter
0012-00-1656
Masimo SET AC-1 LNCS adapter cable
0600-00-0047
LNOP® DCI-Adult reusable finger sensor
0600-00-0063
LNOP® DCIP-Pediatric/slender digit reusable finger sensor
0600-00-0110
LNOP® TC-I TipClip Ear Sensor
0600-00-0086
Ear Clip
0600-00-0087
Ear Hanger
0600-00-0078
LNOP® YI-Multisite reusable sensor
0600-00-0081
Multisite wrap
0600-00-0083
Multisite wrap, foam
0600-00-0077
LNOP® DCSC-Adult spot check reusable sensor
0012-00-1099-01
PC08-SpO2 cable
0012-00-1099-02
PC12-SpO2 cable
0600-00-0043-01
LNOP® Adt-Adult single patient adhesive sensors
0600-00-0044-01
LNOP® Pdt-Pediatric/slender digit single patient sensors
0600-00-0100
LNOP® II Inf-L-Infant L single patient adhesive sensors
0600-00-0108
Replacement tapes for LNOP® II Inf-L-Infant L single patient
adhesive sensors
0600-00-0045-01
LNOP® Neo-Neonatal Y single patient adhesive sensors-for
patients more than 1 kg. and less than 10 kgs.
0600-00-0065
Adhesive tapes for Neonatal Y single patient adhesive sensors
0600-00-0099
LNOP® II Neo-Neonatal L single patient adhesive sensors-for
patients more than 1 kg. and less than 10 kgs.
0600-00-0096
Adhesive tapes for Neonatal L single patient adhesive sensors
0600-00-0046-01
LNOP® NeoPt-Preterm neonatal Y single patient adhesive sensorsfor patients less than 1 kg.
0600-00-0064
Posey wraps for Preterm neonatal Y single patient adhesive
sensors
0070-10-0727-02
V Series Operating Instructions
Accessories
27.2.2
NIBP
PART NUMBER
DESCRIPTION
0600-00-0098
LNOP® II NeoPt-L-Preterm neonatal L single patient adhesive
sensors-for patients less than 1 kg.
0600-00-0097
Posey wraps for Preterm neonatal L single patient adhesive
sensors
0600-00-0084
Clothing clips
0600-00-0085
Adhesive squares
Nellcor® SpO2 Module
PART NUMBER
DESCRIPTION
0600-00-0051
Reusable Sensor
0012-00-1464
SpO2 cable, DOC-10, OxiMax
0600-00-0103
Disposable Nellcor OxiMax Sensor Kit
9000-10-07308
OXI-P/I reusable sensor, Ped/Inf*
0010-10-12476
Dura-Y Multi-Site sensor, Adu/Ped/Neo/Inf*
0010-10-12202
MAX-A disposable sensor, Adu, >30kg, 24 pcs/box*
0010-10-12203
MAX-P disposable sensor, Ped, 10 to 50kg, 24 pcs/box*
0010-10-12204
MAX-I disposable sensor, Inf, 3 to 20kg, 24 pcs/box*
0010-10-12205
MAX-N disposable sensor, Adu/Neo, >40kg or <3kg, 24 pcs/box*
*
27.3
Not available for sale in the United States
NIBP
PART NUMBER
V Series Operating Instructions
DESCRIPTION
0020-00-0184-01
Reusable NIBP cuffs starter kit
0683-15-0001-01
Reusable NIBP cuff, Child, 10 to 19 cm, quick connect
0683-15-0002-01
Reusable NIBP cuff, Small Adult, 18 to 26 cm, quick connect
0683-15-0003-01
Reusable NIBP cuff, Adult, 25 to 35 cm, quick connect
0683-15-0004-01
Reusable NIBP cuff, Large Adult, 33 to 47 cm, quick connect
0683-15-0005-01
Reusable NIBP cuff, Thigh, 46 to 66 cm, quick connect
0683-15-0007-01
Reusable NIBP Cuff, Adult Long, 27.5 – 36.5 cm, quick connect
0683-15-0006-01
Reusable NIBP Cuff, Large Adult Long, 35.5-46 cm, quick connect
0683-14-0001-01
Disposable NIBP cuff, Child, 10 to 19 cm, quick connect, box of 10
0683-14-0002-01
Disposable NIBP cuff, Small Adult, 18 to 26 cm, quick connect, box of
10
0683-14-0003-01
Disposable NIBP cuff, Adult, 25 to 35 cm, quick connect, box of 10
0683-14-0004-01
Disposable NIBP cuff, Large Adult, 33 to 47 cm, quick connect, box of
10
0683-14-0005-01
Disposable NIBP cuff, Thigh, 46 to 66 cm, quick connect, box of 10
0683-14-0007-01
Disposable NIBP Cuff, Adult Long, 27.5 – 36.5 cm, quick connect
0683-14-0006-01
Disposable NIBP Cuff, Large Adult Long, 35.5 - 46 cm, quick connect,
box of 10
0683-23-0001
Neonatal Size 1: limb circumference 3 – 6 cm, box of 10
0070-10-0727-02
27 - 5
NIBP
27 - 6
Accessories
PART NUMBER
DESCRIPTION
0683-23-0002
Neonatal Size 2: limb circumference 5 – 8 cm, box of 10
0683-23-0003
Neonatal Size 3: limb circumference: 7 – 10 cm, box of 10
0683-23-0004
Neonatal Size 4: limb circumference 9 – 13 cm, box of 10
0683-23-0005
Neonatal Size 5: limb circumference 12 – 17 cm, box of 10
0683-04-0003
NIBP Hose, 5' (1.5 m), Quick Connect to Quick Connect
0683-04-0004
NIBP Hose, 10’ (3.5 m), Quick Connect to Quick Connect
0070-10-0727-02
V Series Operating Instructions
Accessories
Temperature
27.4
Temperature
27.4.1
Disposable 400 Series Temperature Probes
27.5
PART NUMBER
DESCRIPTION
0206-03-0112-02
Esophageal Stethoscope, 400 Series Disposable Temperature Probe, 12 Fr, ES 400-12
0206-03-0118-02
Esophageal Stethoscope, 400 Series Disposable Temperature Probe, 18 Fr, ES 400-18
0206-03-0209-02
Esophageal/Rectal, 400 Series Disposable Temperature Probe, 9 Fr, ER 400-9
0206-03-0212-02
Esophageal/Rectal, 400 Series Disposable Temperature Probe, 12 Fr, ER 400-12
0206-03-0300-02
Skin, 400 Series Disposable Temperature Probe, SK 400
040-000091-00
Reusable Instrument Cable, 400 Series
040-000055-00
5 pin Temp probe, Adult Esophageal/Rectal
040-000057-00
5 pin Temp probe, Adult skin
040-000056-00
5 pin Temp probe, Pediatrics Esophageal/Rectal
040-000058-00
5 pin Temp probe, Pediatrics skin
040-000100-00
5pin Temp adapter cable (Not for Clinical Use)
IBP
PART NUMBER
DESCRIPTION
040-000053-00
IBP Cable, BD P10EZ-1, P23XL-1, DTX/Plus
040-000054-00
IBP cable for Edwards Life Sciences TruWave PX
040-000052-00
IBP cable for Hospira Transpac IV
040-000096-00
IBP cable adapter
6000-10-02107
BD, Disposable pressure Transducer*
0010-10-42638
Abbott, Disposable Transducer*
0010-10-12156
BD, Transducer/manifold mount*
M90-000133---
Abbott, Steady rest for IBP Transducer and Clamp*
M90-000134---
Abbott, Mounting clamp for IBP transducer (Hospira, send with the cable)*
*
V Series Operating Instructions
Not available for sale in the United States
0070-10-0727-02
27 - 7
CO2
Accessories
27.6
CO2
27.6.1
Oridion Microstream CO2 Module
PART NUMBER
DESCRIPTION
0008-00-0332-01
CO2 Exhaust connector assembly
0075-00-0033-01
Calibration gas
0020-00-0188-01
Adult Filterline Kit
0010-10-42560
Oridion FilterLine Set, Adult/Pediatric*
0010-10-42563
Oridion FilterLine Set Adult/Pediatric Long*
0010-10-42561
Oridion FilterLine Humidified Set Adult/Pediatric*
0010-10-42562
Oridion FilterLine Humidified Set Infant/Neonatal*
0010-10-42564
Oridion FilterLine Humidified Set Adult/Pediatric Long*
0010-10-42565
Oridion FilterLine Humidified Set Infant/Neonatal Long*
0010-10-42566
Oridion Smart CapnoLine Plus Adult/Intermediate*
0010-10-42567
Oridion Smart CapnoLine Pediatric*
0010-10-42577
Oridion NIV-Line Adult*
0010-10-42578
Oridion NIV-Line Pediatric*
0010-10-42572
Oridion CapnoLine Humidified Adult*
0010-10-42573
Oridion CapnoLine Humidified Pediatric*
0010-10-42574
Oridion CapnoLine Humidified Infant/Neonatal*
0010-10-42575
Oridion CapnoLine Humidified O2 Adult*
0010-10-42576
Oridion CapnoLine Humidified O2 Pediatric*
0010-10-42568
Oridion Smart CapnoLine Plus O2 Adult/Intermediate*
0010-10-42569
Oridion Smart CapnoLine O2 Pediatric*
0010-10-42570
Oridion Smart CapnoLine Plus O2 Adult/Intermediate Long*
0010-10-42571
Oridion Smart CapnoLine O2 Pediatric Long*
040-000027-00
Oridion CO2 Kit Infant/Neonatal*
040-000027-00
Oridion CO2 Kit Adult/Pediatric*
*
27 - 8
Not available for sale in the United States
0070-10-0727-02
V Series Operating Instructions
Accessories
27.7
CO
CO
PART NUMBER
DESCRIPTION
0012-00-1447-01
Cardiac output cable
0012-00-1519
Cardiac output probes
0012-00-1520
Cardiac output probes (Edward)
6000-10-02079
BD, IT sensor (OHMEDA P /N: SP4042 'BD')*
6000-10-02080
BD, IT sensor housing (OHMEDA P /N: SP5045 'BD')*
6000-10-02081
Medex, 12CC contrl syringe W /1CC Stop W /Rotator*
0010-10-12317
Edward, CO syringe (93610 “EDWARTDS")*
6000-10-02183
Edward, Dilution hose (131HF7 'Edwards' or 'Baxter')*
*
V Series Operating Instructions
Not available for sale in the United States
0070-10-0727-02
27 - 9
Miscellaneous Accessories
27.8
Accessories
Miscellaneous Accessories
PART NUMBER
DESCRIPTION
0146-00-0091-01
Li-Ion-Ion Battery
0012-00-1801-01
Terminated pigtail cable for analog out interface to Maquet
balloon pump
0012-00-1801-02
Unterminated pigtail cable for analog out
0012-00-1277-02
Nurse call cable
0012-25-0001
Power Cord 110 Volt (US market)
0012-25-0002
Power Cord 220 Volt (European Market)
0012-25-0003
Power Cord 240 Volt (UK Market)
0000-10-10903
Power Cord (Indian Market)
509B-10-05996
Power Cord (Chinese Market)
0160-00-0126-01
Color flat panel secondary display
023-000288-00
V Series USB Memory Stick, 8GB
023-000287-00
V Series USB Memory Stick, 16GB (for Service use only)
0012-00-1803-05
Cable, mod bus, powered USB, 4'
0012-00-1803-02
Cable, mod bus, powered USB, 6'
0012-00-1803-03
Cable, mod bus, powered USB, 12'
0012-00-1275-01
Serial Port Cable
023-000248-00
V Series USB Mouse
023-000247-00
V Series USB Keyboard
0000-10-10792
Mouse*
0000-10-11060
Keyboard*
0683-00-0422-02
Chart/thermal paper (box of 10 rolls)
0683-00-0422-01
Chart/thermal paper (single roll)
*
27.9
27 - 10
Not available for sale in the United States
Mounts & Mounting Accessories
PART NUMBER
DESCRIPTION
115-005392-00
Rolling Stand Assembly
115-003088-00
Mounting Bracket for Rolling Stand
115-006911-00
V Series VHM Wall Mount Assembly
045-000295-00
Telescoping Down Post (Future)
045-000305-00
Non-telescoping Down Post
115-006912-00
V Series Modules Rack Wall Mount Assembly
115-005389-00
V Hub Mounting Cleat
115-005387-00
Docking station Mounting Plate
034-000107-00
Adjustable handle (Future)
034-000108-00
VHM Cable Management Clips
034-000109-00
Wall Channel Cover
045-000297-00
V Hub quick release mounting plate
0070-10-0727-02
V Series Operating Instructions
Accessories
27.10
Networking Accessories
Networking Accessories
PART NUMBER
DESCRIPTION
0992-00-0091-07
Laser Printer - HP4015N
0992-00-0085-03
12 Port Hub
0012-00-1274-01
CAT 5 Ethernet Cable, Patch, STP, 6' (1.83m)
0012-00-1274-02
CAT 5 Ethernet Cable, Patch, STP, 25' (7.62m)
0012-00-1274-03
CAT 5 Ethernet Cable, Patch, STP, 50' (15.24m)
0683-00-0503
Paper, laser printer with grid (pkg 500 sheets)
0012-00-1392-05
CAT 5 Ethernet Cable, Crossover, STP, 3’ (0.91 m)
0012-00-1392-06
CAT 5 Ethernet Cable, Crossover, STP, 6’ (1.83 m)
0012-00-1392-07
CAT 5 Ethernet Cable, Crossover, STP, 10’ (3.05 m)
0012-00-1392-08
CAT 5 Ethernet Cable, Crossover, STP, 20’ (6.10 m)
* The Networking Installation charge includes appropriate interface cables, jacks, wall plates, certification and
labor for a certified contractor. Does not include laser printer, hub or comm-ports.
27.11
Manuals
PART NUMBER
DESCRIPTION
0070-CD-0727-02
V 12/V 21 Operators Manual - International English CD
0070-00-0727-02
V 12/V 21 Operators Manual - International English
V Series Operating Instructions
0070-10-0727-02
27 - 11
Manuals
Accessories
This page intentionally left blank.
27 - 12
0070-10-0727-02
V Series Operating Instructions
28.0
Product Specifications
Specifications ....................................................................................................................................................... 28-2
Impedance Respiration.................................................................................................................................. 28-25
Power Specifications........................................................................................................................................ 28-40
Performance Characteristics ....................................................................................................................... 28-41
Safety Designations.......................................................................................................................................... 28-44
Electromagnetic Capability ......................................................................................................................... 28-45
Environmental Conditions ........................................................................................................................... 28-49
Sound........................................................................................................................................................................ 28-49
Communication Protocols ........................................................................................................................... 28-49
Connection to Panorama® Central Station ........................................................................................ 28-49
Operator Position............................................................................................................................................... 28-49
V Series Operating Instructions
0070-10-0727-02
28 - 1
Specifications
Product Specifications
28.1
Specifications
28.1.1
Standards Compliance
The V 12/V 21 Monitor is in compliance with following industry standards.
TABLE 28-1
28 - 2
EN60601-1:1990+A1:1993+A2:1995+A3:1996/
IEC 60601-1:1988 +A1:1991 +A2:1995
Medical electrical Equipment - General Requirements for Safety
UL 60601-1:2003
Medical electrical Equipment - General Requirements for Safety
CAN/CSA-C22.2 NO. 601.1M90: 2005
Medical Electrical Equipment - General Requirements for Safety
EN 60601-1-1:2001/ IEC 60601-1-1:2000
Medical electrical equipment - Part 1-1: General requirements for
safety - Collateral standard: Safety requirements for medical
electrical systems
IEC 60601-1-2:2007/EN 60601-1-2:2007
Medical electrical equipment - Part 1-2: General requirements for
safety - Collateral standard: Electromagnetic compatibility Requirements and tests
IEC 60601-1-4:2000
Medical electrical equipment - Part 1-4: General requirements for
safety - Collateral standard: Programmable electrical medical
systems
IEC62366: 2007
Application of Usability Engineering to medical devices
IEC 60601-1-6:2006
Medical electrical equipment - Part 1-6: General requirements for
safety - Collateral standard: Usability
EN 60601-2-34:2001 / IEC 60601-2-34:2000
Medical electrical equipment - Part 2-34: Particular requirements
for the safety, including essential performance, of invasive blood
pressure monitoring equipment
IEC 60601-1-8:2006/ EN 60601-1-8:2007
Collateral Standard: General requirements, tests and guidance for
alarm systems in medical electrical equipment and medical
electrical systems
EN 60601-2-49:2001 / IEC 60601-2-49:2001
Particular requirements for the safety of multifunction patient
monitoring equipment
IEC 60601-2-27:2005
Medical electrical equipment, Part 2: Particular requirements for
the safety of electrocardiographic monitoring equipment
IEC 60601-2-25:1993/A1:1999
Medical electrical equipment, Part 2: Particular requirements for
the safety of electrocardiographs
EN 60601-2-30:2000 / IEC 60601-2-30:1999
Medical electrical equipment, Part 2: Particular requirements for
the safety, including essential performance, of automatic cycling
non-invasive blood pressure monitoring equipment.
EN 1060-1:1995 + A1:2002
Non-invasive sphygmomanometers - Part 1: General
requirements
ISO 10993-1:2003/EN ISO 10993-1:2009
Biological evaluation of medical devices - Part 1: Evaluation and
testing
EN 980: 2008
Graphical Symbols for Use in the Labeling of Medical Devices
EN 1041:1998
Information supplied by the manufacturer of medical devices
AAMI/ANSI HE74:2001
Human Factors Design Process for Medical Devices
0070-10-0727-02
V Series Operating Instructions
Product Specifications
Specifications
TABLE 28-1 (Continued)
28.1.2
ISO 15223:2000 + A1:2001 + A2:2004
Medical devices - Symbols to be used with medical device labels,
labeling and information to be supplied
ISO 9919:2005/EN ISO 9919:2009
Medical electrical equipment - Particular requirements for the
basic safety and essential performance of pulse oximeter
equipment for medical use
EN 1060-3:1997 + A1:2005
Non-invasive sphygmomanometers - Part 3: Supplementary
requirements for electro-mechanical blood pressure measuring
systems
ANSI/AAMI SP10:2002 + A1:2003 + A2:2006
Manual, electronic or automated sphygmomanometers
EN 12470-4:2000+A1:2009
Performance of electrical thermometers for continuous
measurement
ASTM E1112-00 (2006)
Standard Specification for Electronic Thermometers for
Intermittent Determination of Patient Temperature
EC13: 2002
Cardiac monitors, heart rate meters, and alarms
EC11: 1991/(R) 2001
Diagnostic electrocardiographic devices
EC57:1998/(R)2003
Testing and Reporting Performance Results of Cardiac Rhythm
and ST-Segment Measurement Algorithms
ISO21647:2004+Cor 2005/EN ISO 21647:2009
Medical electrical equipment - Particular requirements for the
basic safety and essential performance of respiratory gas
monitors
EC53:1995/(R)2001
ECG cables and leadwires
V 12 Safety Designations:
TABLE 28-2
V Series Operating Instructions
Type of protection against electric shock:
Class II with internal electric power source. Where the
integrity of the external protective earth (ground) in the
installation or its conductors is in doubt, the equipment shall
be operated from its internal electric power source
(batteries).
Supply Connection:
14.3Amps (max), +15Vdc Input
11.1 VDC Removable Battery
3.7 VDC Internal Backup Battery
Mode of Operation:
Continuous
Protection Against Hazards of Explosion:
Not protected (Ordinary)
Protection Against Ingress of Liquids
Drip-proof (IPX1)
Degree of electrical connection between
equipment and patient
Equipment designed for direct electrical and non-electrical
connection to the patient
Degree of Mobility:
Portable
Maximum Size:
13.7"H x 9.4"W x 7.5"D
Maximum Weight:
8.9 lbs. (without batteries)
Operating Temperature:
+5°C to +40°C
0070-10-0727-02
28 - 3
Specifications
Product Specifications
TABLE 28-2 (Continued)
28.1.3
Operating Humidity:
15% to 95%, non-condensing
Operating Altitude:
1060hPa to 700hPa
Storage Temperature:
-20°C to +60°C
Storage Humidity:
10% to 95%, non-condensing
Storage Altitude:
1060hPa to 570hPa
Controls/Indicators:
1- Touchscreen
1- 12.1" TFT Display
2- Alarm LED
Display
Operates in portrait orientation
Minimum +50/-50 degree horizontal viewing angle
Minimum +45/-45 degree vertical viewing angle
Aspect ratio of 3:4 in portrait mode
Display resolution is 1024 x 768 pixels
Interfaces:
1- Diagnostic Port (DP1)
1- V Dock Interface (D1)
1- V Hub Interface (MR4)
3- Battery Interface (1, 2, 3)
6 - Module bays (M1-M6)
V 21 Safety Designations:
TABLE 28-3
28 - 4
Type of protection against electric shock:
Class II
Supply Connection:
14.3Amps (max), +15Vdc Input
3.7 VDC Internal Backup Battery
Mode of Operation:
Continuous
Protection Against Hazards of Explosion:
Not protected (Ordinary)
Protection Against Ingress of Liquids
Drip-proof (IPX1)
Degree of electrical connection between
equipment and patient
Equipment designed for direct electrical and non-electrical
connection to the patient
Degree of Mobility:
Stationary
Maximum Size:
23"H x 16"W x 9"D
Maximum Weight:
23 lbs.
Operating Temperature:
+5°C to +40°C
Operating Humidity:
15% to 95%, non-condensing
Operating Altitude:
1060hPa to 700hPa
Storage Temperature:
-20°C to +60°C
Storage Humidity:
10% to 95%, non-condensing
Storage Altitude:
1060hPa to 570hPa
0070-10-0727-02
V Series Operating Instructions
Product Specifications
Specifications
TABLE 28-3 (Continued)
28.1.4
Controls/Indicators:
1- Touchscreen
1- 21.3" TFT Display
2- Alarm LED
1 - Touchpad
Display:
Operates in portrait orientation
Minimum +50/-50 degree horizontal viewing angle
Minimum +45/-45 degree vertical viewing angle
Aspect ratio of 3:4 in portrait mode
Display resolution is 1600 x 1200 pixels
Interfaces:
1- Diagnostic Port (DP1)
1- V Dock Interface (D1)
1- V Hub Interface (MR4)
1- AC Present
V Dock Safety Designations:
TABLE 28-4
Type of protection against electric shock:
Class I
Supply Connection (Input):
90Vac min - 264 Vac max
47Hz min, 63 Hz max, Single Phase
Supply Connection (Output):
14.3Amps (max), +15Vdc Output
Mode of Operation:
Continuous
Protection Against Hazards of Explosion:
Not protected (Ordinary)
Protection Against Ingress of Liquids
Drip-proof (IPX1)
Degree of electrical connection between
equipment and patient:
Equipment designed for non-electrical connection to the
patient
Degree of Mobility:
Portable
Maximum Size:
6.2"H x 7.6"W x 9.9"D
Maximum Weight:
3.5 lbs.
Operating Temperature:
+5°C to +40°C
Operating Humidity:
15% to 95%, non-condensing
Operating Altitude:
1060hPa to 700hPa
Storage Temperature:
-20°C to +60°C
Storage Humidity:
10% to 95%, non-condensing
Storage Altitude:
1060hPa to 570hPa
Controls/Indicators:
1- AC Present
1- Battery(ies) Charging
V Series Operating Instructions
0070-10-0727-02
28 - 5
Specifications
Product Specifications
TABLE 28-4 (Continued)
Interfaces:
28.1.5
1 - V Dock Interface (D1)
3 - V Hub Interface (MR1- MR3)
3 - Serial Bus (SB1-SB3)
1 - Nurse Call (NC1)
1 - Video (DV1)
1 - Ethernet (CS1)
1 - AC Inlet
VPS Safety Designations:
TABLE 28-5
28 - 6
Type of protection against electric shock:
Class II
Degree of protection against electric shock:
ECG - Type CF defibrillation protected
IBP - Type CF defibrillation protected
Temperature - Type CF defibrillation protected
NIBP - Type BF defibrillation protected
SpO2-Type BF
Supply Connection:
+12VDC, +5VDC from M1 through M6
Mode of Operation:
Continuous
Protection Against Hazards of Explosion:
Not protected (Ordinary)
Protection Against Ingress of Liquid's
Drip-proof (IPX1)
Degree of electrical connection between equipment
and patient
Equipment designed for direct electrical and nonelectrical connection to the patient
Degree of Mobility:
Portable
Maximum Size:
2.988"H x 6.2"W x 5.5"D
Maximum Weight:
1.93 lbs.
Operating Temperature:
+5°C to +40°C
Operating Humidity:
15% to 95%, non-condensing
Operating Altitude:
1060hPa to 700hPa
Storage Temperature:
-20°C to +60°C.
Storage Humidity:
10% to 95%, non-condensing.
Storage Altitude:
1060hPa to 570hPa
Controls/Indicators:
1- Button, Silence All Alarms
1- Zero All IBPs Button, Start/Stop NIBP
1- LED, Powered and Communicating
Interfaces:
1- Non-Invasive Blood Pressure
1 - Temperature
2- Invasive Blood Pressure
1- ECG
1- Nellcor SpO2 or Masimo SpO2
2 - Analog Output
2 - Mx & My Module Bay Connectors
0070-10-0727-02
V Series Operating Instructions
Product Specifications
28.1.6
Specifications
V Hub Safety Designations:
TABLE 28-6
28.1.7
Type of protection against electric shock:
Class II
Supply Connection:
+12 VDC, +5 VDC from monitor
Mode of Operation:
Continuous
Protection Against Hazards of Explosion:
Not protected (Ordinary)
Protection Against Ingress of Liquids
Drip-proof (IPX1)
Degree of electrical connection between equipment
and patient
Equipment designed for direct electrical and nonelectrical connection to the patient
Degree of Mobility:
Portable
Maximum Size:
10"H x 8"W x 5"D
Maximum Weight:
3.0 lbs
Operating Temperature:
+5°C to +40°C
Operating Humidity:
15% to 95%, non-condensing
Operating Altitude:
1060hPa to 700hPa
Storage Temperature:
-20°C to +60°C
Storage Humidity:
10% to 95%, non-condensing
Storage Altitude:
1060hPa to 570hPa
Controls/Indicators:
1 - Lock control
1 - Indicator light
Interfaces:
1 - V 12/V 21 Connector
12L ECG Safety Designations:
TABLE 28-7
Type of protection against electric shock:
Class II
Degree of protection against electric shock:
ECG- Type CF defibrillation protected
Supply Connection:
+3.3 VDC from VPS
Mode of Operation:
Continuous
Protection Against Hazards of Explosion:
Not protected (Ordinary)
Protection Against Splashing Water:
IPX4
Degree of electrical connection between
equipment and patient
Equipment designed for direct electrical connection to the patient
Degree of Mobility:
Portable
Maximum Size:
1.1"H x 2.6"W x 4.6"D
Maximum Weight:
1.02 lbs.
V Series Operating Instructions
0070-10-0727-02
28 - 7
Specifications
Product Specifications
TABLE 28-7 (Continued)
28.1.8
Operating Temperature:
+5°C to +40°C
Operating Humidity:
15% to 95%, non-condensing
Operating Altitude:
1060hPa to 700hPa
Storage Temperature:
-20°C to +60°C
Storage Humidity:
10% to 95%, non-condensing.
Storage Altitude:
1060hPa to 570hPa
Controls/Indicators:
1- LED, Powered and Communicating
Interfaces:
1- 12 Lead Yoke Cable
1- VPS ECG Interface Cable
CO Module Safety Designations:
TABLE 28-8
28.1.9
Supply Connection:
+12VDC, +5VDC
Protection Against Hazards of Explosion:
Not protected (Ordinary)
Protection Against Ingress of Liquid's
Drip-proof (IPX1)
Degree of electrical connection between
equipment and patient:
Equipment designed for direct electrical connection to the
patient
Degree of Mobility:
Portable
Maximum Size:
0.988"H x 6.2"W x 5.5"D
Maximum Weight:
0.74 lbs.
Operating Temperature:
+5°C to +40°C
Operating Humidity:
15% to 95%, non-condensing
Operating Altitude:
1060hPa to 700hPa
Storage Temperature:
-20°C to +60°C.
Storage Humidity:
10% to 95%, non-condensing.
Storage Altitude:
1060hPa to 570hPa
Controls/Indicators:
1- Button, Start CO Run
1- LED, Powered and Communicating
Interfaces:
1- CO
1 - Module Bay (Mx)
CO2 Module Safety Designations:
TABLE 28-9
28 - 8
Supply Connection:
+12VDC, +5VDC
Protection Against Hazards of Explosion:
Not protected (Ordinary)
0070-10-0727-02
V Series Operating Instructions
Product Specifications
Specifications
TABLE 28-9 (Continued)
28.1.10
Protection Against Ingress of Liquids:
Drip-proof (IPX1)
Degree of electrical connection between
equipment and patient:
Equipment designed for direct electrical connection to the
patient
Degree of Mobility:
Portable
Maximum Size:
1.988"H x 6.2"W x 5.5"D
Maximum Weight:
1.12 lbs.
Operating Temperature:
+5°C to +40°C
Operating Humidity:
15% to 95%, non-condensing
Operating Altitude:
1060hPa to 700hPa
Storage Temperature:
-20°C to +60°C
Storage Humidity:
10% to 95%, non-condensing
Storage Altitude:
1060hPa to 570hPa
Controls/Indicators:
1- LED, Powered and Communicating
Interfaces:
1- CO2 Exhaust
1- CO2
1- Module Bay (Mx)
IBP Module Safety Designations:
TABLE 28-10
Supply Connection:
+12VDC, +5VDC
Protection Against Hazards of Explosion:
Not protected (Ordinary)
Protection Against Ingress of Liquid's
Drip-proof (IPX1)
Degree of electrical connection between
equipment and patient
Equipment designed for direct electrical and non-electrical
connection to the patient
Degree of Mobility:
Portable
Maximum Size:
0.988“H x 6.2”W x 5.5”D
Maximum Weight:
0.75 lbs.
Operating Temperature:
+5°C to +40°C
Operating Humidity:
15% to 95%, non-condensing
Operating Altitude:
1060hPa to 700hPa
Storage Temperature:
-20°C to +60°C
Storage Humidity:
10% to 95%, non-condensing
Storage Altitude:
1060hPa to 570hPa
Controls/Indicators:
1- Button, Zero IBP
1- LED, Powered and Communicating
V Series Operating Instructions
0070-10-0727-02
28 - 9
Specifications
Product Specifications
TABLE 28-10 (Continued)
Interfaces:
28.1.11
2- IBP
1- Module Bay (Mx)
Temp Module Safety Designations:
TABLE 28-11
28.1.12
Supply Connection:
+12VDC, +5VDC
Protection Against Hazards of Explosion:
Not protected (Ordinary)
Protection Against Ingress of Liquids:
Drip-proof (IPX1)
Degree of electrical connection between equipment
and patient:
Equipment designed for direct electrical and non-electrical
connection to the patient
Degree of Mobility:
Portable
Maximum Size:
0.988“H x 6.2”W x 5.5”D
Maximum Weight:
0.75 lbs.
Operating Temperature:
+5°C to +40°C
Operating Humidity:
15% to 95%, non-condensing
Operating Altitude:
1060hPa to 700hPa
Storage Temperature:
-20°C to +60°C
Storage Humidity:
10% to 95%, non-condensing
Storage Altitude:
1060hPa to 570hPa
Controls/Indicators:
1- LED, Powered and Communicating
2- LED, Channel Indicators
Interfaces:
1- Temp
1- Module Bay (Mx)
Recorder Safety Designations:
TABLE 28-12
28 - 10
Supply Connection:
+12VDC, +5VDC
Protection Against Hazards of Explosion:
Not protected (Ordinary)
Protection Against Ingress of Liquids:
Drip-proof (IPX1)
Degree of electrical connection between equipment
and patient:
None
Degree of Mobility:
Portable
Maximum Size:
2.988“H x 6.2”W x 5.5”D
Maximum Weight:
1.12 lbs.
Operating Temperature:
+5°C to +40°C
Operating Humidity:
15% to 95%, non-condensing
0070-10-0727-02
V Series Operating Instructions
Product Specifications
Specifications
TABLE 28-12 (Continued)
Operating Altitude:
1060hPa to 700hPa
Storage Temperature:
-20°C to +60°C
Storage Humidity:
10% to 95%, non-condensing
Storage Altitude:
1060hPa to 570hPa
Controls/Indicators:
1- LED, Powered and Communicating
1- Button, Recorder Door Release
1- Button, Print
Interfaces:
2- Mx & My Module Bay Connectors
28.1.13
VDI Safety Designations:
TABLE 28-13
28.1.14
Supply Connection:
+12VDC, +5VDC
Protection Against Hazards of Explosion:
Not protected (Ordinary)
Protection Against Ingress of Liquids:
Drip-proof (IPX1)
Degree of electrical connection between equipment
and patient:
None
Degree of Mobility:
Portable
Maximum Size:
.988“H x 6.2”W x 5.5”D
Maximum Weight:
.68 lbs.
Operating Temperature:
+5°C to +40°C
Operating Humidity:
15% to 95%, non-condensing
Operating Altitude:
1060hPa to 700hPa
Storage Temperature:
-20°C to +60°C
Storage Humidity:
10% to 95%, non-condensing
Storage Altitude:
1060hPa to 570hPa
Controls/Indicators:
1- LED, Powered and Communicating
Interfaces:
2- Mx & My Module Bay Connectors
Visual and Auditory Alarm Disclosure
V Series Operating Instructions
•
The V 12/V 21 I/O Processor generates a high priority LED alarm.
•
The high priority LED alarm has a flashing frequency of 2 Hz.
•
The high priority LED alarm has a duty cycle of 50%.
•
The V 12/V 21 I/O Processor generates a medium priority LED alarm.
•
The medium priority LED alarm has a flashing frequency of 0.5 Hz.
•
The medium priority LED alarm has a duty cycle of 50%.
0070-10-0727-02
28 - 11
Specifications
Product Specifications
•
The V 12/V 21 I/O Processor generates a low priority LED alarm.
•
The low priority LED alarm is constantly on.
•
The low priority LED alarm has a duty cycle of 100%.
28.1.15
Verifying Alarm Functionality
28.1.15.1
Self-Test of Alarm System
Requirements for alarm sound: adopt low-priority alarm sound of the alarm system. The alarm sound
volume is 5.
Alarms can be verified by creating an alarm condition on the V 12/V 21 and verifying the
corresponding alarm indicators are present on the monitor.
Alarm Delay
•
Apnea Alarm Delay settings are:
Adult/Pediatric: 10/15/20/25/30/35/40/45/50/55 seconds, 1 min
Neonate: 10/15/20 sec
•
ST Alarm Delay settings are:
Adult/Pediatric: 30 seconds/45 seconds/ 1 min/90 seconds/2 min/3 min.
•
Alarm delay settings are:
None/1s/2s/3s/4s/5s/6s/7s/8s.
Audio alarm can be delayed for a predetermined time period, with the exception of Apnea, ST alarm,
lethal Arrhythmia alarms, SpO2 Desat and Insp O2 shortage.
•
28.1.16
When alarm is triggered, the alarm tone will not be presented, but the visual signal will be
presented during delay time.
ECG Performance
V 12/V 21 in conjunction with:
A.
VPS
1.
Lead Definition
TABLE 28-14
2.
ECG TYPE
ACQUIRED LEADS
DISPLAYABLE LEADS
3-Lead ECG
I, II, III
I, II, III (one vector at a time)
5-Lead ECG
I, II, and V (n)
I, II, III, aVR, aVL, aVF, V (n)
6-Lead ECG
I, II, V(n1), and V(n2)
I, II, III, aVR, aVL, aVF, Vx, Vy
3/5/6 Lead ECG Cable Detection
The ECG System automatically detects 3, 5, or 6 leads cable when Mindray auto-detectable cables are
used.
3.
Defibrillator Overload protection
The ECG function is in accordance with the applicable requirements of EN 60601-2-27 and EN 606012-25.
4.
28 - 12
Recovery
0070-10-0727-02
V Series Operating Instructions
Product Specifications
Specifications
ECG System recovers automatically from defibrillator overload as per ANSI/AAMI EC11: 1991/(R) 2001
within 8 seconds. Monitor recovers automatically from defibrillator overload as per ANSI/AAMI EC132002 within 5 seconds.
5.
AC Overload Protection
AC overload protection withstands 60Hz, 1V p-p for 10 seconds in accordance with applicable
requirements of ANSI/AAMI EC13-2002 and ANSI/AAMI EC11: 1991/(R) 2001.
6.
ESU Protection
None.
7.
Electro Surgical Unit Noise Suppression
The peak noise during ESU operation for 3, 5, and 6-Lead ECG System is less than ± 2mV from ECG
baseline when used with Mindray ESU cables.
8.
ESU Withstand
3, 5, and 6-Lead ECG Systems withstand stress from a High Frequency Surgical Unit operating at 300
Watts in cut mode and 100 Watts in coagulate mode.
9.
Input Impedance
Single ended input impedance of ECG System is greater than 2.5M
4.2.9.2 and ANSI/AAMI EC11: 1991/(R) 2001, 3.2.9.
as per ANSI/AAMI EC13-2002,
10. Lead Fault
Lead resistances  51K
in parallel with 0.047μF capacitance unable to cause a lead fault condition.
Differential offsets ±300mV unable to cause a lead fault condition.
11. System Noise
System noise is less than 30 μV p-p, referred to input, through shielded 51K resistors in parallel with
47nF capacitors (ANSI/AAMI EC13-2002, 4.2.9.3 or ANSI/AAMI EC11: 1991/(R) 2001, 3.2.12).
12. Overall System Error
Overall system error is 5% or 40μV, whichever is greater (ANSI/AAMI EC13-2002, 4.2.9.8 or ANSI/AAMI
EC11: 1991/(R) 2001, 3.2.7).
13. Gain Stability
The gain change one minute after energizing does not exceed 0.66 percent per minute. The total
change in one hour does not exceed ± 10 percent of any available fixed gain setting. (ANSI/AAMI
EC13-2002, 4.2.9.5 (d) or ANSI/AAMI EC11: 1991/(R) 2001, 3.2.4.4).
14. Multichannel Crosstalk
Multichannel crosstalk is a maximum of 2%, per (ANSI/AAMI EC13-2002, 4.2.9.4 or ANSI/AAMI EC11:
1991/(R) 2001, 3.2.12.2).
15. Baseline Stability
Baseline stability is as per (ANSI/AAMI EC13-2002, 4.2.9.11 (b) or ANSI/AAMI EC11: 1991/(R) 2001,
3.2.13.2).
16. Frequency Response
TABLE 28-15
ECG Type
3/5/6 Lead ECG
V Series Operating Instructions
Bandwidth (-3db)
Monitor
Diagnostic
ST
0.5 to 40 Hz
0.05 to 150 Hz
0.05 to 40 Hz
0070-10-0727-02
28 - 13
Specifications
Product Specifications
17. Impulse response
Impulse response is as per (ANSI/AAMI EC13-2002, 4.2.9.8 (c) or ANSI/AAMI EC11: 1991/(R) 2001,
3.2.7.2 (a), (b), Method A, D).
18. Notch Filter Selection
ECG System is equipped with 50 Hz or 60 Hz notch filter with option to turn off.
19. CMRR
CMRR is as per (ANSI/AAMI EC13-2002, 4.2.9.10 or ANSI/AAMI EC11: 1991/(R) 2001, 3.2.11). Notch filter
is turned off.
20. Pacer Enhancement
Pacer signals within the range ±2mV and ± 700mV (RTI) amplitude with a maximum rise time of
100usec and with duration in the 0.1ms to 2.0ms range are enhanced on the display when the Pacer
Enhancement Mode is turned ON.
21. Pacer Rejection
Pacer signals from ±2mV to ±700mV (RTI) amplitude and 0.1ms to 2ms in duration, and a maximum
of 100μs rise time are rejected from the display when the Pacer Rejection Mode is ON.
22. ESIS Filtering
An ESU Interference filter provides greater than 90 dB attenuation at 500 kHz. The ESU Filter shall have
the option of being turned off.
23. ESU Noise Detection
An ESU noise declaration is asserted if signals detected as pacers are detected at rate greater than 50
Hz. No noise declaration will be asserted if pacer like signals are detected at rate greater than 10 MHz.
24. ECG Heart Rate Meter
The ECG heart rate meter function is derived from the ECG waveform.
Range:
TABLE 28-16
ECG Source:
Neonatal Range
(BPM)
Pediatric Range:
(BPM)
Adult Range:
(BPM)
3/5/6 Lead ECG
30 to 350
30 to 300
30 to 300
25. Resolution
Resolution is 1 BPM.
26. Accuracy
Accuracy is ± 3 BPM or ± 3% from 30 to 250 BPM, whichever is greater and ± 5% in the 251 to 350
BPM range.
27. Out of Range
For values outside the specified measurement range, the heart rate meter indicates invalid data as
(- -).
28. Trigger Indication
There is an audible beep on every beat captured, if enabled.
29. Trigger Threshold
28 - 14
0070-10-0727-02
V Series Operating Instructions
Product Specifications
Specifications
Heart rate meter does not trigger on signals having a QRS amplitude of less than 0.2 mV, or a duration
of 10 msec or less with an amplitude of 1mv (ANSI/AAMI EC13-2002, 4.2.6.1) in ADULT mode only.
30. Detectable QRS Width
70 to 120 msec, minimum for Adults and 40 to 120 msec, minimum, for Pediatric and Neonate
patients as per ANSI/AAMI EC13-2002, 4.2.6.1
31. 60 Hz Voltage Tolerance
Heart rate meter is able to tolerate 60 Hz sinusoidal voltage less than or equal to 100 μV p-p RTI as per
ANSI/AAMI EC13-2002, 4.2.6.2.
32. Drift Tolerance
Heart rate meter is able to tolerate triangular wave of 0.1 Hz, 4mV p-p RTI superimposed on ECG per
ANSI/AAMI EC13-2002, 4.2.6.3.
33. Time to Alarm for Cardiac Standstill
The time to alarm for a step change in heart rate from 80 BPM to 0 BPM, with lower alarm limit set to
closest to 60 BPM does not exceed 10 seconds as per ANSI/AAMI EC13-2002 Section 4.2.8.4.
34. Time to Alarm for Low Heart Rate
The time to alarm for a step change in heart rate from 80 BPM to 40 BPM, with lower alarm limit set to
closest to 60 BPM, does not exceed 10 seconds as per ANSI/AAMI EC13-2002 Section 4.2.8.5.
35. Time to Alarm for High Heart Rate
The time to alarm for a step change in heart rate from 80 BPM to 120 BPM, with the upper alarm limit
set closest to 100 BPM, does not exceed 10 seconds.
36. Tall T-Wave Rejection
Tall T-wave rejection is as per ANSI/AAMI EC13-2002 Section 4.1.2.1 (c). The heart rate meter rejects all
T-waves with amplitudes less than 120% of a 1mV, 100 msec QRS, and a T wave duration of 180ms
and a Q-T interval of 350 msec.
37. Response Time of Heart Rate Meter to Change in Heart Rate
The response time of the heart rate meter to change in heart rate is less than 10 seconds for step
increase from 80 to 120 BPM and less then 10 seconds for step decrease from 80 to 40 BPM as per
ANSI/AAMI EC13-2002 Section 4.1.2.1 (f ).
38. Time to Alarm for Tachycardia
The alarm response time for tachycardia is less than 10 seconds as per section ANSI/AAMI EC13-2002
Section 4.1.2.1(g).
39. Pacer Rejection
The pacer rejection is in accordance with ANSI/AAMI EC13-2002 Section 4.1.4; the heart rate meter
rejects all pacer pulses of amplitude ± 2.0 mV to ± 700 mV and duration 0.1 msec to 2 msec with no
tail.
When tested in accordance with ANSI/AAMI EC13-2002 Section 4.1.4, the 3/5/6 Lead ECG derived
heart rate meter rejects all pacer pulses ± 2.0 mV to ± 700 mV and duration 0.1 msec to 2 msec with
tails of less than 2 mV and with time constants from 4ms to 100ms.
Pacer pulse detector rejection of fast ECG signals: 50 V/s RTI when measured in accordance with
ANSI/AAMI EC13-2002 Section 4.1.4.3.
40. Heart Rate Average
V Series Operating Instructions
0070-10-0727-02
28 - 15
Specifications
Product Specifications
In compliance with the requirements in Clause 4.1.2.1 d) of ANSI/AAMI EC13-2002, the following
method is used:
The average heart rate is calculated on the basis of the mean RR-interval of the last 16 beats, unless
the heart rate calculated using the last 4 beats is less than or equal to 48, then this rate is used. HR is
updated on the display every second.
41. Response to Irregular Rhythm
In compliance with the requirements in Clause 4.1.2.1 e) of ANSI/AAMI EC13-2002, the indicated heart
rate after 20 seconds of stabilization period is:
Ventricular bigeminy (3a): 80 BPM
Slow alternating ventricular bigeminy (3b): 60 BPM
Rapid alternating ventricular bigeminy (3c): 120 BPM
Bidirectional systoles (3d): 90 BPM
Accuracy for above is ± 3 BPM or ± 3%, whichever is greater.
42. Heart Rate Alarms
The VPS is equipped with High and Low heart rate alarms. Alarms can be triggered when measured
rate is equal to or greater than the alarm setting.
High Alarm Limits:
Adult:
50 to 300 BPM in steps of 1 BPM, default 150 BPM
Note: If country configuration is France, default is 120 BPM
Pediatric:
50 to 300 BPM in steps of 1 BPM, default 180 BPM
Note: If country configuration is France, default is 150 BPM
Neonate:
50 to 350 BPM in steps of 1 BPM, default 200 BPM
Note: If country configuration is France, default is 175 BPM
Low Alarm Limits:
Adult:
25 to 200 BPM in steps of 1 BPM, default 50 BPM
Note: If country configuration is France, default is 30 BPM
Pediatric:
25 to 200 BPM in steps of 1 BPM, default 80 BPM
Note: If country configuration is France, default is 50 BPM
Neonate:
25 to 200 BPM in steps of 1 BPM, default 90 BPM
Note: If country configuration is France, default is 70 BPM
43. ST Segment Analysis Performance Requirements
TABLE 28-17
28 - 16
ENABLING:
ADULT AND PEDIATRIC MODES ONLY
Absolute ST Deviation Range(3/5/6 Lead ECG):
-10.0 mm to + 10.0mm (-1000μV to + 1000μV RTI
Resolution:
0.1 mm (10 μV)
User Selectable ST Measurement Points:
40, 60 or 80 msec after the J point (heart rate
independent) OR 60/80 Heart Rate Dependent
Default ST Measurement Point:
60/80 Heart Rate Dependent.
(80 msec after the J point for heart rates 120 BPM.
60 msec after the J point for heart rates >120 BPM.)
0070-10-0727-02
V Series Operating Instructions
Product Specifications
Specifications
TABLE 28-17 (Continued)
V Series Operating Instructions
ENABLING:
ADULT AND PEDIATRIC MODES ONLY
Default ISO Point:
User Selectable ISO Point
(3/5/6 Lead ECG):
- Located between the P and Q waves.
- User adjustable from "R peak" - 10msec to "R peak" 200 msec in 2 msec increments.
Default J Point:
User Selectable J Point
(3/5/6 Lead ECG):
End of the QRS complex
User adjustable from "R peak" + 10msec to "R peak" +
200 msec in 2 msec increments
Excluded Beats:
Ventricular ectopic beats and ventricular paced beats
are excluded from ST measurements.
Invalid ST: (3/5/6 lead modes):
ST data shall be invalidated under the following
conditions:
If Ventricular Paced Rhythm, Ventricular Rhythm or
Ventricular Tachycardia persists for more than 45
seconds and/or during detected episodes of Asystole
and Ventricular Fibrillation.
Invalid ST deviation data displayed as invalid (- -)
0070-10-0727-02
28 - 17
Specifications
Product Specifications
44. ST deviation Alarms
System is equipped with ST deviation alarms. ST deviation alarms trigger if the measured deviation is
equal to or greater than the alarm setting for the appropriate lead. Single ST & Dual ST deviation
Alarms Limits:
(For Adult, Pediatric))
TABLE 28-18
ST Single Lead High Alarm:
+0.5 to +10.0 mm in steps of 0.1 mm, default: Off
ST Single Lead Low Alarm:
-0.5 to -10.0 mm in steps of 0.1 mm, default: Off
ST Dual Lead High Alarm:
+0.5 to +10.0 mm in steps of 0.1 mm, default: Off
ST Dual Lead Low Alarm:
-0.5 to -10.0 mm in steps of 0.1 mm, default: Off
45. Arrhythmia Analysis
Arrhythmia analysis is disabled in neonatal mode. Non-lethal or all arrhythmia alarms can be disabled.
The ECG module has ability to make following calls as applicable per ECG source:
•
Asystole
•
Bigeminy
•
Bradycardia
•
Couplet
•
Irregular Heart Rate
•
Multiform PVC
•
Pause
•
Pause/Minute
•
R-On-T PVCs
•
PVC s Per Minute
•
Run
•
Trigeminy
•
Ventricular Fibrillation
•
Ventricular Rhythm
•
Ventricular Tachycardia
12L ECG
B.
•
1.
The 12L ECG functions in conjunction with the VPS.
Lead Definition
TABLE 28-19
2.
ECG TYPE
ACQUIRED LEADS
DISPLAYABLE LEADS
12 Lead ECG
I, II, V1, V2, V3, V4, V5, V6
I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6
12 Lead ECG Cable Detection
The ECG System automatically detects 12 Lead cables when Mindray auto-detectable cables are
used.
28 - 18
0070-10-0727-02
V Series Operating Instructions
Product Specifications
Specifications
3.
Defibrillator Overload protection
The ECG function is in accordance with the applicable requirements of EN 60601-2-27 and EN 606012-25.
4.
Recovery
ECG System recovers automatically from defibrillator overload as per ANSI/AAMI EC11: 1991/(R) 2001
within 8 seconds. Monitor recovers automatically from defibrillator overload as per ANSI/AAMI EC132002 within 5 seconds.
5.
AC Overload Protection
AC overload protection withstands 60Hz, 1V p-p for 10 seconds in accordance with applicable
requirements of ANSI/AAMI EC13-2002 and ANSI/AAMI EC11: 1991/(R) 2001.
6.
ESU Protection
The 12 Lead ECG does not provide ESU protection or suppression.
7.
Electro Surgical Unit Noise Suppression
The 12 Lead ECG does not provide ESU protection or suppression.
8.
ESU Withstand
The 12 Lead ECG does not provide ESU protection or suppression.
9.
Input Impedance
Single ended input impedance of ECG System is greater than 2.5M
4.2.9.2 and ANSI/AAMI EC11: 1991/(R) 2001, 3.2.9.
as per ANSI/AAMI EC13-2002,
10. Lead Fault
Lead resistances  51K
in parallel with 0.047μF capacitance unable to cause a lead fault condition.
Differential offsets ±300mV unable to cause a lead fault condition.
11. System Noise
System noise is less than 30 μV p-p, referred to input, through shielded 51K
resistors in parallel
with 47nF capacitors (ANSI/AAMI EC13-2002, 4.2.9.3 or ANSI/AAMI EC11: 1991/(R) 2001, 3.2.12).
12. Overall System Error
Overall system error is 5% or 40μV, whichever is greater (ANSI/AAMI EC13-2002, 4.2.9.8 or ANSI/AAMI
EC11: 1991/(R) 2001, 3.2.7).
13. Gain Stability
The gain change one minute after energizing does not exceed 0.66 percent per minute. The total
change in one hour does not exceed ± 10 percent of any available fixed gain setting. (ANSI/AAMI
EC13-2002, 4.2.9.5 (d) or ANSI/AAMI EC11: 1991/(R) 2001, 3.2.4.4).
14. Multichannel Crosstalk
Multichannel crosstalk is a maximum of 2%, per (ANSI/AAMI EC13-2002, 4.2.9.4 or ANSI/AAMI EC11:
1991/(R) 2001, 3.2.12.2).
15. Baseline Stability
Baseline stability is as per (ANSI/AAMI EC13-2002, 4.2.9.11 (b) or ANSI/AAMI EC11: 1991/(R) 2001,
3.2.13.2).
V Series Operating Instructions
0070-10-0727-02
28 - 19
Specifications
Product Specifications
16. Frequency Response
TABLE 28-20
ECG Type
12 Lead ECG
Bandwidth (-3db)
Monitor
Diagnostic
ST
0.5 to 40 Hz
0.05 to 150 Hz
0.05 to 40 Hz
17. Impulse response
Impulse response is as per (ANSI/AAMI EC13-2002, 4.2.9.8 (c) or ANSI/AAMI EC11: 1991/(R) 2001,
3.2.7.2 (a), (b), Method A, D).
18. Notch Filter Selection
ECG System is equipped with 50 Hz or 60 Hz notch filter with option to turn off.
19. CMMR
CMMR is as per (ANSI/AAMI EC13-2002, 4.2.9.10 or ANSI/AAMI EC11: 1991/(R) 2001, 3.2.11). Notch filter
is turned off.
20. Pacer Enhancement
Pacer signals within the range ±2mV and ± 700mV (RTI) amplitude with a maximum rise time of
100usec and with duration in the 0.1ms to 2.0ms range are enhanced on the display when the Pacer
Enhancement Mode is turned ON.
21. Pacer Rejection
Pacer signals from ±2mV to ±700mV (RTI) amplitude and 0.1ms to 2ms in duration, and a maximum
of 100μs rise time are rejected from the display when the Pacer Rejection Mode is ON.
22. ESIS Filtering
The 12 Lead ECG does not provide ESU protection or suppression.
23. ESU Noise Detection
The 12 Lead ECG does not provide ESU protection or suppression.
24. ECG Heart Rate Meter
The ECG heart rate meter function is derived from the ECG waveform.
Range:
TABLE 28-21
ECG Source:
Neonatal Range
(BPM)
Pediatric Range:
(BPM)
Adult Range:
(BPM)
12 Lead ECG
30 to 300
30 to 300
30 to 350
25. Resolution
Resolution is 1 BPM.
26. Accuracy
Accuracy is ± 3 BPM or ± 3% from 30 to 250 BPM, ± 5% in the 251 to 350 BPM range.
28 - 20
0070-10-0727-02
V Series Operating Instructions
Product Specifications
Specifications
27. Out of Range
For values outside the specified measurement range, the heart rate meter indicates invalid data as
(- -).
28. Trigger Indication
There is an audible beep on every beat captured, if enabled.
29. Trigger Threshold
Heart rate meter does not trigger on signals having a QRS amplitude of 0.2 mV or less, or a duration of
10 msec or less with an amplitude of 1mv (ANSI/AAMI EC13-2002, 4.2.6.1) in ADULT mode only.
30. Detectable QRS Width
70 to 120 msec, minimum for Adults and 40 to 120 msec, minimum, for Pediatric and Neonate
patients as per ANSI/AAMI EC13-2002, 4.2.6.1.
31. 60 Hz Voltage Tolerance
Heart rate meter is able to tolerate 60 Hz sinusoidal voltage less than or equal to 100 μV p-p RTI as per
ANSI/AAMI EC13-2002, 4.2.6.2.
32. Drift Tolerance
Heart rate meter is able to tolerate triangular wave of 0.1 Hz, 4mV p-p RTI superimposed on ECG per
ANSI/AAMI EC13-2002, 4.2.6.3.
33. Time to Alarm for Cardiac Standstill
The time to alarm for a step change in heart rate from 80 BPM to 0 BPM, with lower alarm limit set to
closest to 60 BPM does not exceed 10 seconds as per ANSI/AAMI EC13-2002 Section 4.2.8.4.
34. Time to Alarm for Low Heart Rate
The time to alarm for a step change in heart rate from 80 BPM to 40 BPM, with lower alarm limit set to
closest to 60 BPM, does not exceed 10 seconds as per ANSI/AAMI EC13-2002 Section 4.2.8.5.
35. Time to Alarm for High Heart Rate
The time to alarm for a step change in heart rate from 80 BPM to 120 BPM, with the upper alarm limit
set closest to 100 BPM, does not exceed 10 seconds.
36. Tall T-Wave Rejection
Tall T-wave rejection is as per ANSI/AAMI EC13-2002 Section 4.1.2.1 (c). The heart rate meter rejects all
T-waves with amplitudes less than 120% of a 1mV, 100 msec QRS, and a T wave duration of 180ms
and a Q-T interval of 350 msec.
37. Response Time of Heart Rate Meter to Change in Heart Rate
The response time of the heart rate meter to change in heart rate is less than 10 seconds for step
increase from 80 to 120 BPM and less than 10 seconds for step decrease from 80 to 40 BPM as per
ANSI/AAMI EC13-2002 Section 4.1.2.1 (f ).
38. Time to Alarm for Tachycardia
The alarm response time for tachycardia is less than 10 seconds as per section ANSI/AAMI EC13-2002
Section 4.1.2.1(g).
39. Pacer Rejection
The pacer rejection is in accordance with ANSI/AAMI EC13-2002 Section 4.1.4; the heart rate meter
rejects all pacer pulses of amplitude ± 2.0 mV to ± 700 mV and duration 0.1 msec to 2 msec with no
tail.
V Series Operating Instructions
0070-10-0727-02
28 - 21
Specifications
Product Specifications
When tested in accordance with ANSI/AAMI EC13-2002 Section 4.1.4, the 3/5/6 Lead ECG derived
heart rate meter rejects all pacer pulses ± 2.0 mV to ± 700 mV and duration 0.1 msec to 2 msec with
tails of less than 2 mV and with time constants from 4ms to 100ms.
Pacer pulse detector rejection of fast ECG signals: 50 V/s RTI when measured in accordance with
ANSI/AAMI EC13-2002 Section 4.1.4.3.
40. Heart Rate Average
In compliance with the requirements in Clause 4.1.2.1 d) of ANSI/AAMI EC13-2002, the following
method is used:
The average heart rate is calculated on the basis of the mean RR-interval of the last 16 beats, unless
the heart rate calculated using the last 4 beats is less than or equal to 48, then this rate is used. HR is
updated on the display every second.
41. Response to Irregular Rhythm
In compliance with the requirements in Clause 4.1.2.1 e) of ANSI/AAMI EC13-2002, the indicated heart
rate after 20 seconds of stabilization period is:
Ventricular bigeminy (3a): 80 BPM
Slow alternating ventricular bigeminy (3b): 60 BPM
Rapid alternating ventricular bigeminy (3c): 120 BPM
Bidirectional systoles (3d): 90 BPM
Accuracy for above is ± 3 BPM or ± 3%, whichever is greater.
42. Heart Rate Alarms
The 12L ECG is equipped with High and Low heart rate alarms. Alarms can be triggered when
measured rate is equal to or greater than the alarm setting.
High Alarm Limits:
Adult:
50 to 300 BPM in steps of 1 BPM, default 150 BPM
Note: If country configuration is France, default is 120 BPM
Pediatric:
50 to 300 BPM in steps of 1 BPM, default 180 BPM
Note: If country configuration is France, default is 150 BPM
Neonate:
50 to 350 BPM in steps of 1 BPM, default 200 BPM
Note: If country configuration is France, default is 175 BPM
Low Alarm Limits:
Adult:
25 to 200 BPM in steps of 1 BPM, default 50 BPM
Note: If country configuration is France, default is 30 BPM
Pediatric:
25 to 200 BPM in steps of 1 BPM, default 80 BPM
Note: If country configuration is France, default is 50 BPM
Neonate:
25 to 200 BPM in steps of 1 BPM, default 90 BPM
Note: If country configuration is France, default is 70 BPM
43. ST Segment Analysis Performance Requirements
TABLE 28-22
28 - 22
ENABLING:
ADULT AND PEDIATRIC MODES ONLY.
Absolute ST Deviation Range(12 Lead ECG):
-10.0 mm to + 10.0mm (-1000μV to + 1000μV RTI
0070-10-0727-02
V Series Operating Instructions
Product Specifications
Specifications
TABLE 28-22 (Continued)
ENABLING:
ADULT AND PEDIATRIC MODES ONLY.
Resolution:
0.1 mm (10 μV).
User Selectable ST Measurement Points:
40, 60 or 80 msec after the J point (heart rate
independent) OR 60/80 Heart Rate Dependent.
Default ST Measurement Point:
60/80 Heart Rate Dependent.
(80 msec after the J point for heart rates ±120 BPM.
60 msec after the J point for heart rates >120 BPM.)
Default ISO Point:
User Selectable ISO Point
(12 Lead ECG):
- Located between the P and Q waves.
- User adjustable from "R peak" - 10msec to "R peak" 200msec in 2 msec increments.
Default J Point:
User Selectable J Point
(12 Lead ECG):
End of the QRS complex.
User adjustable from "R peak" + 10msec to "R peak" +
200msec in 2 msec increments.
Excluded Beats:
Ventricular ectopic beats and ventricular paced beats
are excluded from ST measurements.
Invalid ST: (12 Lead modes):
ST data shall be invalidated under the following
conditions:
If Ventricular Paced Rhythm, Ventricular Rhythm or
Ventricular Tachycardia persists for more than 45
seconds and/or during detected episodes of Asystole
and Ventricular Fibrillation.
Invalid ST deviation data displayed as invalid (- -)
44. ST deviation Alarms
System is equipped with ST deviation alarms. ST deviation alarms trigger if the measured deviation is
equal to or greater than the alarm setting for the appropriate lead. Single ST & Dual ST deviation
Alarms Limits:
(For Adult, Pediatric))
TABLE 28-23
V Series Operating Instructions
ST Single Lead High Alarm:
+0.5 to +10.0 mm in steps of 0.1 mm, default: Off
ST Single Lead Low Alarm:
-0.5 to -10.0 mm in steps of 0.1 mm, default: Off
ST Dual Lead High Alarm:
+0.5 to +10.0 mm in steps of 0.1 mm, default: Off
ST Dual Lead Low Alarm:
-0.5 to -10.0 mm in steps of 0.1 mm, default: Off
0070-10-0727-02
28 - 23
Specifications
Product Specifications
45. Arrhythmia Analysis
Arrhythmia analysis is disabled in neonatal mode. Non-lethal or all arrhythmia alarms can be disabled.
The ECG module has ability to make following calls as applicable per ECG source:
28 - 24
•
Asystole
•
Bigeminy
•
Bradycardia
•
Couplet
•
Irregular Heart Rate
•
Multiform PVC
•
Pause
•
Pause/Minute
•
R-On-T PVCs
•
PVC/Minute
•
Run
•
Trigeminy
•
Ventricular Fibrillation
•
Ventricular Rhythm
•
Ventricular Tachycardia
0070-10-0727-02
V Series Operating Instructions
Product Specifications
28.2
Impedance Respiration
Impedance Respiration
V 12/V 21 in conjunction with:
A.
VPS for impedance respiration
1.
Performance:
TABLE 28-24
2.
Sensing Lead:
Lead II or I
Default Sensing Lead:
Lead II
Source:
When using a 3-Lead, 5-Lead, 6-Lead, the respiration system acquires
respiration via the ECG leads.
Range:
ECG Respiration parameter range is 4 RPM to 199 RPM.
Respiration Rate Out of Range:
The respiration rate counter indicates invalid (- -) for values outside
specified range.
Accuracy:
ECG Respiration parameter accuracy is greater of ± 2 RPM or 2% of
the signal value within the range of 4 to 150 RPM. ECG Respiration
parameter accuracy is ± 4% of the signal value within the range of
151 to 199 RPM.
Excitation Frequency:
38.4 kHZ
Excitation Current:
< 384 μA RMS max
Bandwidth:
0.1 Hz to 3 Hz (-3 dB) for adults
0.2 Hz to 3 Hz (-3 dB) for pediatric and neonatal patients
Baseline Impendence Range:
200
High Impedance Indication:
Greater than 2.2 k
User Selectable Scale:
Five (5) gains are provided.
Linear Signal Range:
8
Noise:
Less than 0.05
ECG cable.
Min. Breath Height Detected:
It is function of respiration scale. Waveform needs to be Greater than
0.1
in order for breathes to be accurately detected.
Cardiovascular Artifact Rejection:
Detected by algorithm.
to 2000
at patient with 1k resistor in the ECG cable.
at patient.
p-p minimum.
at 500
patient impedance, using a Mindray
Respiration Alarms
Respiration function includes High and Low respiration rate alarms. Alarms can be triggered when
measured rate is equal to or greater than the alarm setting.
High Alarm Limits:
Adult:
10 to 190 RPM in steps of 1 RPM, default Off
Pediatric:
10 to 190 RPM in steps of 1 RPM, default Off
Neonate:
10 to 190 RPM in steps of 1 RPM, default Off
V Series Operating Instructions
0070-10-0727-02
28 - 25
Impedance Respiration
Product Specifications
Low Alarm Limits:
Adult:
5 to 50 RPM in steps of 1 RPM, default Off
Pediatric:
5 to 50 RPM in steps of 1 RPM, default Off
Neonate:
5 to 50 RPM in steps of 1 RPM, default Off
Apnea Alarm Delay:
Adult:
10 to 60 seconds adjustable in steps of 1 second, default 30 sec
Pediatric:
10 to 20 seconds adjustable in steps of 1 second, default 15 sec
Neonate:
10 to 20 seconds adjustable in steps of 1 second, default 15 sec
V 12/V 21 in conjunction with:
B.
12L ECG for impedance respiration
1.
Performance:
TABLE 28-25
28 - 26
Sensing Lead:
Lead II or I
Default Sensing Lead:
Lead II
Source:
When using a 12 Lead the respiration system acquires respiration via
the ECG leads.
Range:
ECG Respiration parameter range is 4 RPM to 199 RPM.
Respiration Rate Out of Range:
The respiration rate counter indicates invalid (- -) for values outside
specified range.
Accuracy:
ECG Respiration parameter accuracy is greater of ± 2 RPM or 2% of
the signal value within the range of 4 to 150 RPM. ECG Respiration
parameter accuracy is ± 4% of the signal value within the range of
151 to 199 RPM.
Excitation Frequency:
38.4 kHz
Excitation Current:
< 384 μA RMS max
Bandwidth:
0.1 Hz to 3 Hz (-3 dB) for adults
0.2 Hz to 3 Hz (-3 dB) for pediatric and neonatal patients
Baseline Impendence Range:
200
High Impedance Indication:
Greater than 2.2 k
User Selectable Scale:
Five (5) gains are provided.
Linear Signal Range:
8
Noise:
Less than 0.05
ECG cable.
Min. Breath Height Detected:
It is function of respiration scale. Waveform needs to be Greater than
0.1
in order for breathes to be accurately detected.
Cardiovascular Artifact Rejection:
Detected by algorithm.
to 2000
at patient with 1k resistor in the ECG cable.
at patient.
p-p minimum.
0070-10-0727-02
at 500
patient impedance, using a Mindray
V Series Operating Instructions
Product Specifications
Impedance Respiration
2.
Respiration Alarms
Respiration function includes High and Low respiration rate alarms. Alarms can be triggered when
measured rate is equal to or greater than the alarm setting.
High Alarm Limits:
Adult:
10 to 190 RPM in steps of 1 RPM, default Off
Pediatric:
10 to 190 RPM in steps of 1 RPM, default Off
Neonate:
10 to 190 RPM in steps of 1 RPM, default Off
Low Alarm Limits:
Adult:
5 to 50 RPM in steps of 1 RPM, default Off
Pediatric:
5 to 50 RPM in steps of 1 RPM, default Off
Neonate:
5 to 50 RPM in steps of 1 RPM, default Off
Apnea Alarm Delay:
28.2.1
Adult:
10 to 60 seconds adjustable in steps of 1 second, default 30 sec
Pediatric:
10 to 20 seconds adjustable in steps of 1 second, default 15 sec
Neonate:
10 to 20 seconds adjustable in steps of 1 second, default 15 sec
Non-Invasive Blood Pressure (NIBP)
The NIBP function is in accordance with the requirements of EN 60601-2-30, EN 1060-1, EN 1060-3,
and SP 10.
NOTE:
This equipment is suitable for use in the presence of electrosurgery.
V 12/V 21 in conjunction with:
VPS
•
1.
NIBP Maximum Cuff Pressure
TABLE 28-26
2.
MODE
SOFTWARE CONTROL MAXIMUM CUFF
PRESSURE IN MMHG
HARDWARE CONTROL
MAXIMUM CUFF PRESSURE
IN MMHG
Adult
295
330
Pediatric
190
220
Neonate
145
165
NIBP Cuff Inflation
The inflation source is capable of supplying sufficient air to bring a volume of 200 cc to a pressure of
300 mmHg in no more than 10 seconds (Reference ANSI/AAMI SP10-2002). If the cuff is not inflated to
the needed pressure within 60 seconds then the cuff is vented and a retry cycle is initiated up to 3
times.
V Series Operating Instructions
0070-10-0727-02
28 - 27
Impedance Respiration
Product Specifications
3.
NIBP Maximum Leakage
The maximum allowed pressure drop with the bleed valves closed is 1 mmHg in 10 seconds as
measured with a 200 cc volume at differential pressures of 250 mmHg, 150 mmHg and 50 mmHg
(Reference ANSI/AAMI SP10-2002, EN1060-3, 1997).
4.
NIBP Vent Rate
System can vent a volume of 500 cc, from a pressure of 260 mmHg to a pressure of 15 mmHg in a
maximum of 10 seconds. In the Neonate patient mode, system can vent a volume of 100 cc, from a
pressure of 150 mmHg to a pressure of 5 mmHg in less then 5 seconds (Reference: EN1060-3, 1997,
ANSI/AAMI SP10-2002).
5.
NIBP Systolic Pressure
Accuracy:
Mean error ±5 mmHg
Standard Deviation:
less than 8 mmHg
Measurement Range:
Adult Mode: 55 to 235 mmHg
Pediatric Mode: 55 to 160 mmHg
Neonate Mode: 45 to 120 mmHg
Resolution:
1 mmHg
6.
NIBP Systolic Pressure Alarms
NIBP system is equipped with High and Low NIBP rate alarms. Alarms can be triggered when
measured rate is equal to or greater than the alarm setting.
High Alarm Limits:
Adult:
40 to 240 mmHg in steps of 1 mmHg, default: Off
Pediatric:
30 to 140 mmHg in steps of 1 mmHg, default: Off
Neonate:
30 to 100 mmHg in steps of 1 mmHg, default: Off
Low Alarm Limits:
Adult:
30 to 150 mmHg in steps of 1 mmHg, default: Off
Pediatric:
20 to 120 mmHg in steps of 1 mmHg, default: Off
Neonate:
20 to 90 mmHg in steps of 1 mmHg, default: Off
7.
NIBP Diastolic Pressure
Accuracy:
Mean error ±5 mmHg
Standard Deviation:
less than 8 mmHg
Measurement Range: Hg
Adult Mode:30 to 200 mmHg
Pediatric Mode: 30 to 150 mmHg
Neonate Mode:20 to 100 mmHg
Resolution:
1 mmHg
8.
NIBP Diastolic Pressure Alarms
NIBP system is equipped with High and Low NIBP rate alarms. Alarms can be triggered when
measured rate is equal to or greater than the alarm setting.
28 - 28
0070-10-0727-02
V Series Operating Instructions
Product Specifications
Impedance Respiration
High Alarm Limits:
Adult:
40 to 150 mmHg in steps of 1 mmHg, default: Off
Pediatric:
30 to 120 mmHg in steps of 1 mmHg, default: Off
Neonate:
30 to 90 mmHg in steps of 1 mmHg, default: Off
Low Alarm Limits:
Adult:
20 to 140 mmHg in steps of 1 mmHg, default: Off
Pediatric:
20 to 100 mmHg in steps of 1 mmHg, default: Off
Neonate:
10 to 80 mmHg in steps of 1 mmHg, default: Off
NOTE:
9.
Mean Arterial Pressure (MAP) is defined as:
Mean Pressure 1 = Mean Pressure determined from the oscillometric profile
Mean Pressure 2 = (2*diastolic + systolic) / 3
Mean Pressure Displayed = (Mean Pressure 1 + Mean Pressure 2) / 2
NIBP Static Pressure:
Accuracy:
±3 mmHg
Range:
0 to 300 mmHg
10. NIBP Heart Rate:
Accuracy:
Greater of ± 3 BPM or ± 3%
Resolution:
1 BPM
Measurement Range:
Adult Mode:35 to 245 BPM
Pediatric Mode:35 to 245 BPM
Neonate Mode:70 to 245 BPM
Invalid Data:
Invalid NIBP Heart Rate data displayed as (- -).
11. NIBP Start Pressure Settings and Ranges
The Start Pressure is adjustable throughout the following ranges and set to the following defaults:
TABLE 28-27
PATIENT SETTING
START PRESSURE
RANGE
INCREMENT SIZE
DEFAULT SETTING
Adult Mode
100-280 mmHg
1 mmHg
180 mmHg
Pediatric Mode
60-180 mmHg
1 mmHg
140 mmHg
Neonatal Mode
40-120 mmHg
1 mmHg
100 mmHg
V Series Operating Instructions
0070-10-0727-02
28 - 29
Impedance Respiration
Product Specifications
12. NIBP Measurement Cycle
NIBP System has three different modes of measurement:
Manual Mode:
It requires operator to initiate the measurement cycle.
Interval Mode:
In this mode NIBP System follows a configured plan of
automatically initiated measurement cycles. NIBP System supports
Off, 1 min, 2 min, 3 min, 5 min, 10 min, 15 min, 20 min, 30 min, 1 hr,
2 hrs, 4 hrs intervals.
STAT Measurement Mode:
Once STAT mode is selected, NIBP system performs a series of
blood pressure measurements for five (5) minutes or 10
measurements. As soon as a measurement is completed, the next
one starts with pause of 2 seconds between measurements.
(Reference: EN60601-2-30, 2000)
The Maximum Measurement Cycle Duration is 180 sec for Adult and Pediatric patients (Reference:
EN60601-2-30, 2000).
The Maximum Measurement Cycle Duration is 90 sec for Neonatal patients (Reference: EN60601-2-30,
2000).
28.2.2
Invasive Blood Pressure (IBP)
V 12/V 21 in conjunction with:
•
VPS or IBP module
1.
Performance:
Accuracy:
± 2mm Hg or 2% of the signal value which ever is greater
(excluding transducer error).
Resolution:
1 mmHg
2.
IBP Transducer:
Excitation:
5 Volts DC, ±2%
Minimum Load resistance:
300 ohms per transducer.
Transfer Function:
Compatible with 5μV/mmHg/Volt nominal excitation
transducers
Zero Offset Range:
The transducer zero offset range is ± 120 mmHg.
Zero Accuracy:
The zero accuracy is ± 1 mmHg.
Linear Input Range:
-30 to +300 mmHg, after zeroing.
Noise:
<0.5 mmHg RTI, 300
Drift:
<0.15 mmHg per degree Celsius.
Frequency Response:
8Hz ± 1 Hz, 12Hz ± 1 Hz, 16 Hz ± 1 Hz, (-3db Point)
Invalid Data:
Invalid IBP data displayed as (- -).
source impedance.
Transducer not zeroed or
Uncalibrated:
28 - 30
The blood pressure indication is XX when the transducer is not
zeroed or uncalibrated.
0070-10-0727-02
V Series Operating Instructions
Product Specifications
Impedance Respiration
3.
IBP Alarm Limits
IBP system is equipped with High and Low IBP alarms. Alarms can be triggered when measured rate
is equal to or greater than the alarm setting.
Systolic Pressure High Alarm Limits:
Adult:
5 to 300 mmHg in steps of 1 mmHg, default: Off
Pediatric:
5 to 300 mmHg in steps of 1 mmHg, default: Off
Neonate:
5 to 300 mmHg in steps of 1 mmHg, default: Off
Systolic Pressure Low Alarm Limits:
Adult:
0 to 150 mmHg in steps of 1 mmHg, default: Off
Pediatric:
0 to 150 mmHg in steps of 1 mmHg, default: Off
Neonate:
0 to 150 mmHg in steps of 1 mmHg, default: Off
Diastolic Pressure High Alarm Limits:
Adult:
5 to 200 mmHg in steps of 1 mmHg, default: Off
Pediatric:
5 to 200 mmHg in steps of 1 mmHg, default: Off
Neonate:
5 to 200 mmHg in steps of 1 mmHg, default: Off
Diastolic Pressure Low Alarm Limits:
Adult:
0 to 150 mmHg in steps of 1 mmHg, default: Off
Pediatric:
0 to 150 mmHg in steps of 1 mmHg, default: Off
Neonate:
0 to 150 mmHg in steps of 1 mmHg, default: Off
Mean Pressure High Alarm Limits:
Adult:
5 to 200 mmHg in steps of 1 mmHg, default: Off
Pediatric:
5 to 200 mmHg in steps of 1 mmHg, default: Off
Neonate:
5 to 200 mmHg in steps of 1 mmHg, default: Off
Mean Pressure Low Alarm Limits:
Adult:
0 to 150 mmHg in steps of 1 mmHg, default: Off
Pediatric:
0 to 150 mmHg in steps of 1 mmHg, default: Off
Neonate:
0 to 150 mmHg in steps of 1 mmHg, default: Off
V Series Operating Instructions
0070-10-0727-02
28 - 31
Impedance Respiration
Product Specifications
4.
IBP Heart Rate
Range:
Adult Mode:30 to 300 BPM
Pediatric Mode:30 to 300 BPM
Neonate Mode: 30 to 350 BPM
28.2.3
Invalid Data:
Invalid IBP Heart Rate data displayed as (- -).
Resolution:
1 BPM
Accuracy:
± 3 BPM or ± 3% at 30 to 250 BPM
± 5 BPM or ± 5% from 251 to 350 BPM
Temperature
V 12/V 21 in conjunction with:
•
1.
VPS or Temp module
Performance:
Scale:
Selectable, Celsius or Fahrenheit
Range:
15º C to 45º C, inclusive
59º F to 113 F, inclusive
Invalid Data:
Invalid Temperature data displayed as (- -).
Resolution:
0.1º C, 0.1º F
Accuracy:
± 0.1º C (15º C - 45º C), exclusive of probe errors
± 0.2º F (59º F - 113º F), exclusive of probe errors
Accuracy 400 Series Probes:
± 0.1º C (25º C - 45º C)
± 0.2º C (otherwise)
± 0.2º F (77 º F - 113º F)
± 0.4º F (otherwise)
Probe Excitation: 400 series-
<200μA, Thermister to Ground.
Delta Temperature range:
0º C to 10.0º C
0º F to 10.0º F
Delta T Resolution:
0.1º C
0.1º F
2.
Temperature Alarms
The temperature function includes High and Low temperature alarms. Alarms can be triggered when
measured temperature is equal to or greater than the alarm setting.
Temperature High Alarm Limits:
28 - 32
Adult:
25.0º C to 45.0º C in steps of 0.1º C, default Off
77.0º F to 113.0º F in steps of 0.1º F, default Off
Pediatric:
25.0º C to 45.0º C in steps of 0.1º C, default Off
77.0º F to 113.0º F in steps of 0.1º F, default Off
Neonate:
25.0º C to 45.0º C in steps of 0.1º C, default Off
77.0º F to 113.0º F in steps of 0.1º F, default Off
0070-10-0727-02
V Series Operating Instructions
Product Specifications
Impedance Respiration
Temperature Low Alarm Limits:
Adult:
15.0º C to 40.0º C in steps of 0.1º C, default Off
59.0 F to 104.0 F in steps of 0.1 F, default Off
Pediatric:
15.0º C to 40.0º C in steps of 0.1º C, default Off
59.0º F to 104.0º F in steps of 0.1º F, default Off
Neonate:
15.0º C to 40.0º C in steps of 0.1º C, default Off
59.0º F to 104º.0 F in steps of 0.1º F, default Off
Delta Temperature High Alarm Limits:
Adult:
0.0º C to 10.0º C in steps of 0.1º C, default Off
0.0º F to 10.0º F in steps of 0.1º F, default Off
Pediatric:
0.0º C to 10.0º C in steps of 0.1º C, default Off
0.0º F to 10.0º F in steps of 0.1º F, default Off
Neonate:
0.0º C to 10.0º C in steps of 0.1º C, default Off
0.0º F to 10.0º F in steps of 0.1º F, default Off
Delta Temperature Low Alarm Limits:
28.2.4
Adult:
0.0º C to 10.0º C in steps of 0.1º C, default Off
0.0º F to 10.0º F in steps of 0.1º F, default Off
Pediatric:
0.0º C to 10.0º C in steps of 0.1º C, default Off
0.0º F to 10.0º F in steps of 0.1º F, default Off
Neonate:
0.0º C to 10.0º C in steps of 0.1º C, default Off
0.0º F to 10.0º F in steps of 0.1º F, default Off
Pulse Oximetry (SpO2)
V 12/V 21 in conjunction with:
A.
•
VPS with Nellcor or Masimo
SpO2 Alarms
High Alarm Limits:
Adult:
75 to 101% in steps of 1%, default 101%
Pediatric:
75 to 101% in steps of 1%, default 101%
Neonate:
75 to 101% in steps of 1%, default 101%
Low Alarm Limits:
Adult:
70 to 99% in steps of 1%, default 88%
Pediatric:
70 to 99% in steps of 1%, default 90%
Neonate:
70 to 99% in steps of 1%, default 92%
B.
VPS with Nellcor
1.
Nellcor SpO2 Sensor Compatibility
V Series Operating Instructions
•
OxiMax Adhesive Sensors: MAX-A, MAX-AL, MAX -P, MAX-I, MAX-N.
•
OxiMax OxiCliq Sensors: OxiCliq A, OxiCliq P, OxiCliq I, OxiCliq N, OxiCliq Sensor Cable OC-3.
0070-10-0727-02
28 - 33
Impedance Respiration
Product Specifications
•
2.
OxiMax Reusable Sensors: DS-100A, D-YS, D-YSE, D-YSPD, Oxiband OXI-A/N, Oxiband OXI-P/I.
Nellcor SpO2 Saturation Accuracy
SENSOR
ACCURACY
MAX-A, MAX-AL, MAX -P, MAX-I, MAX-N (Adult), MAX-N (Neonate)
70% to 100% ± 2 digits
OxiCliq A, OxiCliq P, OxiCliq I, OxiCliq N(Adult), OxiCliq N (Neonate)
70% to 100% ± 2.5 digits
DS-100A, D-YS (Infant to Adult), OXI-A/N (Adult), OXI-P/I
70% to 100% ± 3 digits
D-YS with D-YSE Ear Clip, D-YS with D-YSPD Spot Clip
70% to 100% ± 3.5 digits
D-YS (Neonate), OXI-A/N (Neonate)
70% to 100% ± 4 digits
•
SpO2 parameter minimum range is 70% to 100%.
•
Invalid SpO2 parameter displayed as (- -).
•
SpO2 parameter display resolution is 1%.
3.
Nellcor SpO2 Performance Requirements
•
Update Rate: Every 2 seconds
NOTE:
The sensor wavelengths are nominal.
•
660 nm for the red LED and 890 nm for the infrared LED.
•
Maximum optical power output for the LEDs is 4 mW.
4.
Nellcor SpO2 Heart Rate
For Adult, Pediatric, and Neonatal:
RANGE
ACCURACY
20 to 249 BPM
±3 BPM
•
SpO2 heart rate resolution is 1BPM.
•
Invalid SpO2 heart rate data displayed as (- -)
5.
Nellcor Sat Seconds
•
Indicates the current status of the alarm graphically within the pie-chart icon.
•
Fills in a clockwise direction when the monitor detects the SpO2 value is outside the set alarm
limits.
•
Empties in a counter-clockwise direction when the SpO2 reading falls within the set alarm limits.
C.
VPS with Masimo
1.
Masimo SpO2 Sensor Compatibility
•
2.
28 - 34
Masimo LNOP series and LNCS series
Masimo SpO2 Saturation Accuracy
SENSOR
ACCURACY
The Pulse Oximetry Parameter accuracy (adult)
Maximum error of 2% with no motion
The Pulse Oximetry Parameter accuracy (adult)
Maximum error of 3% in the presence of
motion with motion resistant sensors.
The Pulse Oximetry Parameter accuracy (pediatric)
Maximum error of 2% with no motion
0070-10-0727-02
V Series Operating Instructions
Product Specifications
Impedance Respiration
SENSOR
ACCURACY
The Pulse Oximetry Parameter accuracy (pediatric)
Maximum error of 3% in the presence of
motion with motion resistant sensors.
The Pulse Oximetry Parameter accuracy (neonatal)
Maximum error of 3% with no motion
The Pulse Oximetry Parameter accuracy (neonatal)
Maximum error of 3% in the presence of
motion with motion resistant sensors.
•
SpO2 parameter minimum range is 70% to 100%.
•
Invalid SpO2 parameter displayed as (- -).
•
SPO2 parameter display resolution is 1%.
3.
Masimo SpO2 Performance Requirements
•
Update Rate: Every 2 seconds
NOTE:
4.
The sensor measurement wavelengths are nominally
•
660 nm for the red LED and 890 nm for the infrared LED.
•
Maximum optical power output for the LEDs is 4 mW.
Masimo SpO2 Heart Rate
For Adult, Pediatric, and Neonatal:
RANGE
ACCURACY
25 to 239 BPM
±3 BPM
•
SpO2 heart rate resolution is 1BPM.
•
Invalid SpO2 heart rate data displayed as (- -).
5.
28.2.5
Masimo Perfusion Index
•
Displays the PI resolution as 0.01% - 9.99% when 0 < PI < 10 %
•
Displays the PI resolution as 10.0% - 20.0% when 20% >= PI >= 10 %
Analog Output
V 12/V 21 in conjunction with:
•
1.
VPS
ECG Interface
Bandwidth (-3 dB referenced to 10 Hz):
0.5 Hz to 100 Hz
Propagation Delay (Delay of QRS complex): Less than 25 msec
Sensitivity:
1 V/mV ±10% (referenced to 10 Hz).
Pacer Displayed with ECG lead:
I,II
Pacer Enhancement:
Pacer is summed at the output when Pacer enhancement mode is
turned ON.
Pacer amplitude signal is a minimum of 2.5v.
Pacer width is10ms, with a 5% tolerance.
Pacer rise and fall times are100 s, maximum.
V Series Operating Instructions
0070-10-0727-02
28 - 35
Impedance Respiration
Product Specifications
2.
Bandwidth (-3 dB referenced to DC):
DC to 15 Hz
Propagation Delay:
Less than 25 msec
Sensitivity:
1 V/100 mmHg ±2%
3.
28.2.6
IBP1 and IBP2 Interface
Defibrillator Sync Interface
Maximum delay between the QRS peak and the rising edge
of the defibrillator sync pulse:
35 msec
Minimum Output Amplitude:
2V into a 5 Kohm load
Output Pulse Width:
2 msec to 7 msec
Thermodultion Cardiac Output (CO)
The V 12/V 21 in conjunction with:
•
1.
Performance:
Range:
0.2 to 20.0 liters/minute
Range for Hospira:
1.0 to 20.0 liters/minute
Range for Edwards Life Science:
1.0 to 20.0 liters/minute
Resolution:
0.1 liters/minute
Accuracy:
5% or 0.2 liters/minute, whichever is greater
Repeatability:
+ 2% or 0.2 liters/minute, whichever is greater as measured by
electronically generated flow curves.
Invalid Data:
Invalid data displayed as (- -)
2.
Blood Temperature Measurement
Range:
17.5 to 43 C (63.5º F to 109.4º F)± 0.2º C (± 0.4º F)
Resolution:
0.1º C (0.1º F)
Accuracy:
± 0.2º C (± 0.4º F)(not including probe error)
Invalid Data:
Invalid data displayed as (--)
T-blood High Alarm:
(For Adult and Pediatric)
35.0º C to 43.0º C in steps of 1º C, default Off
(95.0º F to 110.0º F in steps of 1 F, default Off )
T-blood Low Alarm:
(For Adult and Pediatric)
26.0º C to 38.0º C in steps of 1º C, default Off
(80.0º F to 100.0º F in steps of 1º F, default Off )
3.
28 - 36
CO Module
Injectate Temperature Measurement
Range:
-1.0 to 30.0º C (30.2º F to 86º F)
Resolution:
0.1º C (0.1º F)
Accuracy:
Exclusive of probe errors:± 0.2º C (± 0.4º F)
Invalid Data:
Invalid data displayed as (- -).
0070-10-0727-02
V Series Operating Instructions
Product Specifications
28.2.7
Impedance Respiration
Carbon Dioxide (CO2)
The V 12/V 21 in conjunction with:
•
1.
CO2 Module with Oridion
Performance (at sea level)
CO2 range is 0-99 mmHg, inclusive.
The V 12/V 21 is equipped with automatic barometric pressure compensation.
2.
Accuracy (at sea level)
Accuracy specification of the measured CO2 partial pressure is according to the following table. This
testing is done according to ISO 21647 clauses 51.101.1 and 51.101.2.
Accuracy in the presence of interfering gases:
TABLE 28-28
CO2 PARTIAL PRESSURE AT SEA LEVEL
ACCURACY
0-38 mmHg
± 2 mmHg
39-99 mmHg
± (5% of reading + 0.08% x (reading -39 mmHg))
NOTE:
Accuracy applies for breath rates of up to 80 bpm. For breath rates above 80 bpm,
accuracy is 4 mmHg or ± 12% of reading whichever is greater, for EtCO2 values
exceeding 18 mmHg. This is tested according to and is compliant with ISO 21647.
The accuracy specification is maintained to within 4% of the values indicated inTABLE 28-28 on page
28-37 in the presence of interfering gases according to ISO 21647 clauses 51.101.3 and 101.1. The
accuracy specification is maintained to within 4% of the values indicated in the table above in the
presence of up to 80% Helium with up to 15% oxygen when tested according to the procedures
defined by ISO 21647.
Respiration Rate
Respiration Rate Range:
0 to 150 RPM
Flow Rate:
50 ml/min -7.5 + 15 ml/min, flow measured by volume
Respiration Rate Accuracy:
The respiration rate measurement accuracy is:
0 to 70 RPM
± 1 RPM
71 to 120 RPM
± 2 RPM
121 to 150 RPM
± 3 RPM
Invalid Data:
Invalid data displayed as (--).
CO2 Calibration Interval:
No routine calibration is required.
The module should initially be calibrated after 1200 operating hours,
then once a year or after 4,000 operating hours, whichever comes first.
System Response Time
System Response Time:
The system response time (with a standard-length FilterLine) which
includes the delay time and rise time (10% to 90%) in response to a step
change in the CO2 concentration is 2.9 seconds typical. Rise Time Adult
and Neonatal: 190 mSec max.
Delay Time: 4.9 seconds typical
Initialization Time
V Series Operating Instructions
0070-10-0727-02
28 - 37
Impedance Respiration
Product Specifications
Before the module begins to measure CO2, it completes self-test and initialization procedures
required for proper operation.
CO2 Reporting Resolution
The CO2 reporting resolution is 0.1 mmHg.
Self-Maintenance (SFM) Interval
Self-Maintenance Interval (SFM):
Self-Maintenance (SFM) is performed only during measurement
mode. The module performs one or more of the following:
Ambient pressure measurement
Auto zero (AZ)
Flow test
SFM is triggered:
3.
•
During the first hour after entering measurement mode,
periodically for durations of typically 10 seconds at a rate which
limits the total time consumed by SFMs to less than 2% of the time
in which active measurements are taken. Following the first hour
after entering measurement mode, periodically for durations of
typically 10 seconds at a rate of at most once per hour.
•
If a change of 8 °C from the last AZ is detected.
•
If pressure change of 20 mmHg relative to the last ambient
pressure measurement (less than the purge threshold) for a period
of 30 seconds is detected. The module will be able to detect a real
change in the ambient pressure and a pressure change due to
partial blockage of the FilterLine.
•
The module prevents the triggering of an SFM in the following
situations:
•
In case of purging until the end of this state.
•
During a breath absence period which follows a valid breath.While
waiting a minimum of 20 seconds for host SFM enable command.
(After the 20-second opportunity given to the host to schedule the
SFM passes, the module schedules the SFM according to a priority
determined by current conditions).
CO2 Alarm Limits
The CO2 module function includes High and Low CO2 alarms. Alarms can be triggered when
measured CO2 is equal to or greater than the alarm setting.
ETCO2 High Alarm Limits:
28 - 38
Adult:
20 to 80 mmHg in steps of 1 mmHg, default: 60mmHg
2.0 to 10.0% in steps of 0.1%, default: 10%
2.0 to 10.0 kPa in steps of 0.1 kPa, default: 10 kpa
Pediatric:
20 to 80 mmHg in steps of 1 mmHg, default: 60 mmHg
2.0 to 10.0% in steps of 0.1%, default: 10%
2.0 to 10.0 kPa in steps of 0.1 kPa, default: 10 kPa
Neonate:
20 to 80 mmHg in steps of 1 mmHg, default: 60 mmHg
2.0 to 10.0% in steps of 0.1%, default: 10%
2.0 to 10.0 kPa in steps of 0.1 kPa, default: 10 kPa
0070-10-0727-02
V Series Operating Instructions
Product Specifications
Impedance Respiration
ETCO2 Low Alarm Limits:
Adult:
5 to 50 mmHg in steps of 1 mmHg, default: 15mmHg,
1.0 to 6.0% in steps of 0.1%, default: 2%,
1.0 to 6.0 kPa in steps of 0.1 kPa, default: 2 kPa
Pediatric:
5 to 50 mmHg in steps of 1 mmHg, default: 15 mmHg
1.0 to 6.0% in steps of 0.1%, default: 2%
1.0 to 6.0 kPa in steps of 0.1 kPa, default: 2 kPa
Neonate:
5 to 50 mmHg in steps of 1 mmHg, default: 15 mmHg
1.0 to 6.0% in steps of 0.1%, default: 2%
1.0 to 6.0 kPa in steps of 0.1 kPa, default: 2 kPa
Inspired CO2 High Alarm Limits:
Adult:
5 to 30 mmHg in steps of 1 mmHg, default: 10 mmHg
1.0 to 4.0% in steps of 0.1%, default: 1%
1.0 to 4.0 kPa in steps of 0.1 kPa, default: 0.1 kPa
Pediatric:
5 to 30 mmHg in steps of 1 mmHg, default: 10 mmHg
1.0 to 4.0% in steps of 0.1%, default: 1%
1.0 to 4.0 kPa in steps of 0.1 kPa, default: 0.1 kPa
Neonate:
5 to 30 mmHg in steps of 1 mmHg, default: 10 mmHg
1.0 to 4.0% in steps of 0.1%, default: 1%
1.0 to 4.0 kPa in steps of 0.1 kPa, default: 0.1 kPa
4.
Respiration Alarm Limits
Refer to the alarms section ‘‘Impedance Respiration’’ on page 28-25, which includes apnea alarms.
28.2.8
Drug Calculations
The V 12/V 21 has the ability to calculate and display intravenous (IV) drug infusion rate and
concentration based upon patient weight and drug dosage in Adult mode only. The calculator
calculates the following:
28.2.9
•
Infusion Rate
•
Concentration
•
Titration Table
•
Drug Dosage
•
Review Previously Calculated Drug Calculations
Patient Contacting Materials
Following is a listing of patient contacting components of the V Series monitoring platform and their
respective materials:
PATIENT CONTACTING COMPONENT
Handle
Front Bezel
Rear Housing
All patients contacting materials where found to be in compliance with the applicable parts of ISO
10991:2003, Biological Evaluations of Medical Devices.
V Series Operating Instructions
0070-10-0727-02
28 - 39
Power Specifications
28.3
Product Specifications
Power Specifications
Power Supply Type
•
AC power, battery
•
Whole-system consumption: maximum of 215 W.
AC Mains Power Source
•
AC power: 100~240 Vac, +/-10%
•
Current: 2.4 - 1.0 Amps
•
AC input power frequency: 60 Hz/50 Hz
Internal User-Removable Battery
•
Li-Ion battery (0146-00-0091-01, Mindray)
•
Number of batteries: 3 (maximum)
Li-Ion Battery Index
•
Voltage: 11.1VDC
•
Rated Battery capacity: 4.8 Ah (one battery)
•
Battery run time: >240min (three batteries)
Operating conditions: 25ºC for new fully-charged battery. Equipment configuration: 5-lead ECG,
Impedance Respiration, Temperature, IBP1, IBP2, and NIBP in 15-min Interval mode.
Battery charge time:
28 - 40
•
3.5 hours for 90% charge and 5.5 hours for full charge (equipment powered off )
•
5.5 hours for 90% charge and 8.5 hours for full charge (equipment powered on)
0070-10-0727-02
V Series Operating Instructions
Product Specifications
Performance Characteristics
28.4
Performance Characteristics
28.4.1
ECG Specifications
Regulations
Complies with the following regulations:
•
ANSI/AAMI EC11:1991/(R) 2001
•
EC13:2002*
•
ANSI/AAMI EC57:1998 (R2003)
•
IEC 60601-2-27:2005 / EN60601-2-27:2006
•
IEC 60601-2-25:1993 + A1:1999 / EN60601-2-25:1995 + A1:1999
*
*
28.4.1.1
Accuracy of input signal reproduction: Methods A & D were used, as prescribed in section 3.2.7.2 and 4.2.7.2
of this standard, to establish overall system error and frequency response. Because of the sampling characteristics and the asynchronism between sample rate and signal rate, the V 12/V 21 may produce a noticeable modulating effect from one cycle to the next, particularly in pediatric recordings. * Heart Rate Meter
Accuracy and Response to Irregular Rhythm: Ventricular bigeminy: 80 bpm; Slow alternating ventricular
bigeminy: 60 bpm; Rapid alternating ventricular bigeminy: 120 bpm; Bidirectional systoles: 90 bpm. *
Response time to HR change: From 80 to 120 bpm: less than 11 s; From 80 to 40 bpm: less than 11 s
Time to alarm for tachycardia: <11s (measured in accordance with EC 13 and IEC 60601-2-27)
ECG Function and Specifications
Intelligent Detection of Lead Sets
Automatic detection of 3, 5-lead or 6-lead ECG lead when ECG leads are connected to the patient.
ECG Signal Range
•
± 5mV (peak-to-peak value); the output accuracy of signals complies with 50.102.1 of IEC60601-227:2005.
Calibration Signal
•
1mV (peak-to-peak value)
•
Accuracy: 5% or 40μV, whichever is greater
Detected RTI Range of Measured ECG Signals
•
4.88 uV, ±8 mV when gain is ×0.125, ×0.25, ×0.5, ×1, ×2, ×4.
Input Impedance
•
> 5 M ohms
Pace Pulse Rejection
•
HR calculation rejects pulses with amplitude between ±2mV to ± 700 mV and width between 0.1
msec and 2 msec (no tails).
To enable about 50% pace pulses with fig.5d (EC13, at page 28) waveforms to trigger pace pulse
detector, the minimum input waveform change rate is 50 V/s RTI.
V Series Operating Instructions
0070-10-0727-02
28 - 41
Performance Characteristics
28.4.1.2
Product Specifications
ECG Specifications
Tall T waves Rejection
•
Complies with 4.1.2.1 c of ANSI/AAMI EC13-2002.
HR calculation is not affected for T-waves whose QRS complex is 100ms, QT interval is 350ms, lasting
time is 180ms and amplitude less than 1.2mv.
28.4.2
Temperature Performance Characteristics
The V 12/V 21 is capable of providing temperature measurements from three (3) channels for 400
series probe.
Measuring range: 0 - 50°C (32 -122°F)
Resolution: 0.1°C (0.1°F)
Scale: °C, °F
Tabular Trend: Yes
Graphic Trend: Yes
Clinical Common Range Default of Graphic Trend: 32 - 43°C (90 - 110°F)
400 Series Probes:
Scale: Celsius or Fahrenheit
Range: 59° F to 113° F (15° C to 45° C)
Resolution: 0.1° C (0.1° F)
Accuracy: ± 0.1° C (15° C - 45° C), exclusive of probe errors, ± 0.2° F (59° F - 113° F), exclusive of probe
errors
Accuracy inclusive of 400 Series probes:
± 0.1° C (25° C - 42° C), ± 0.2° C (otherwise),
± 0.2° F (77° F - 108° F), ± 0.4° F (otherwise)
Probe Excitation: < 200 μA, tip to sleeve.
The minimum measuring time required to obtain an accurate reading at the specified body site is
probe-dependent and should be indicated on the probe Instructions For Use.
For each temperature probe, information about the proper environmental conditions of use, storage,
and transport including temperature and humidity should be contained in the probe Instructions For
Use.
28.4.3
Recorder Parameter Specifications
28.4.3.1
Recorder Safety Specifications
The recorder module function is in accordance with the applicable requirements of IEC 60601-2-27
and IEC 60601-2-25.
28.4.3.2
Recorder Performance Specifications
The recorder can print physiological waveforms.
28 - 42
Recorder paper:
50mm wide spooled thermal strip chart paper, minimum 100 ft long,
max diameter 20mm when rolled.
Resolution:
600 dots per 25mm at a print speed of 25mm/s, 400 dots at all other
print speeds
Maximum traces:
3 traces on thermal strip chart paper
Printing speed:
5 printing speeds: 3.125, 6.25, 12.5, 25, and 50mm/sec, each within ±
5%
Paper installation:
Auto feed
0070-10-0727-02
V Series Operating Instructions
Product Specifications
28.4.4
Performance Characteristics
Sensitivity:
± 5% on each trace
Performance:
EC11: 2001, and EC13: 2002
Continuous Cardiac Output (CCO) Performance Characteristics
VDI module has capability to interface with Edwards Life Science Vigilance, Edward Life Science
Vigilance 2, and Edward Life Science Vigileo in Adult and Pediatric Mode.
28.4.4.1
28.4.4.2
28.4.4.3
28.4.4.4
28.4.4.5
Continuous Cardiac Output Performance Requirements
Range:
0.2 liters/minute to 25.0 liters/minute
Resolution:
0.1 liters/minute
Accuracy:
0.2 liters/minute and 5%
Reproducibility:
greater of 0.1 liters/minute and ± 6% (as measured by
electronically generated flow curve)
Continuous Cardiac Index Performance Requirements
Range:
0.2 to 25.0 l/min/m2
Resolution:
0.1 l/min/m2
Real-time SVR Performance Requirements
Range:
0 to 3000 dynes/sec/cm-5
Resolution:
1 dynes/sec/cm-5
SVRI Performance Requirements
Range:
0 to 6000 dynes/sec/m2/cm-5
Resolution:
1 dynes/sec/m2/cm-5
SVO2 Output Performance Requirements
Range:
0 % to 99%
Resolution:
1%
Accuracy:
± 2 % at 30% to 99%
V Series Operating Instructions
0070-10-0727-02
28 - 43
Safety Designations
Product Specifications
28.5
Safety Designations
28.5.1
Safety Classification
V 12 - Portable equipment intended for mobility.
V 21 - Stationary equipment
Type of Protection Against Electric Shock
V 12
Class II equipment.
Where the integrity of the external protective earth conductor arrangement is in doubt, equipment
shall be operated from its internal electrical electric power source (battery).
V 21
Class II equipment.
Degree of Protection Against Electric Shock
•
ECG/RESP/IBP/TEMP: CF, defibrillation-proof
•
SpO2/NIBP/CO2: BF, defibrillation-proof
Protection Against Power Failure
Requirements of ISO21647: 2005: provides the device to prevent AC power from disconnection and
tension of 10 Kg.
If the power supply is restored after interrupted, saved presets, user settings, and patient data
previous to power failure are retained or can be restored with a storage device.
The monitor stores up to 43 hours of trend information (approximately 6000 trend items) when
powered off. The interval for trend data is 1 minute.
If the power failure duration is equal to or greater than 120 seconds, then after recycling power to the
monitor, the user defaults are reloaded.
If the power failure duration is less than 120 seconds, then after recycling power to monitor, the latest
configuration is loaded automatically. These are the settings performed by users before power failure.
In the case of accidental power loss (removal of battery(ies) or AC), the system is equipped with an
internal backup battery which prevents the system from shutting down if power is re-applied within
30 seconds. During the power loss period, the display shuts down and all the monitored parameters
stop monitoring.
If power is restored within 30 seconds, the system re-establish all monitoring and connections that
were available prior to the power loss. If power is not restored within 30 seconds, the system shuts
down.
28 - 44
0070-10-0727-02
V Series Operating Instructions
Product Specifications
Electromagnetic Capability
28.6
Electromagnetic Capability
28.6.1
EMC Safety
The V 12/V 21 monitor needs special precautions regarding EMC and needs to be installed and put
into service according to the EMC information in this Instructions For Use. Portable and mobile RF
communications equipment can affect the V 12/V 21 monitor.
The V 12/V 21 is suitable for use in all establishments other than domestic establishments and those
directly connected to the public low-voltage power supply network that supplies buildings used for
domestic purposes.
Radiated Emission
Complies with the requirements of CISPR 11 (EN 55011:2007) Group 1, Class A.
Immunity Against Radiated Electromagnetic Fields
Complies with the requirements of IEC 61000-4-3:2001: 80 MHz to 2.5 GHz, 3V/m, 80% AM @ 2 Hz or
modulation frequency significant for the equipment under test.
28.6.2
V 12/V 21
The V 12/V 21 meets the requirements of IEC 60601-1-2/EN 60601-1-2.
NOTE:
The V 12/V 21 needs special precautions regarding EMC and needs to
be installed and put into service according to the EMC information
provided below.
NOTE:
Portable and mobile RF communications equipment can affect the V
12/V 21. See tables 28-29 through 28-32 that follow.
TABLE 28-29
GUIDANCE AND DECLARATION - ELECTROMAGNETIC EMISSIONS
The V 12/V 21 is intended for use in the electromagnetic environment specified below. The customer or the
user of the V 12/V 21 should assure that it is used in such an environment.
EMISSIONS
TEST
COMPLIANCE
ELECTROMAGNETIC ENVIRONMENT - GUIDANCE
RF emissions
CISPR 11
Group 1
The V 12/V 21 uses RF energy only for its internal function.
Therefore, its RF emissions are very low and are not likely to
cause any interference in nearby electronic equipment.
RF emissions
CISPR 11
Class A
Harmonic
emissions IEC
61000-3-2
Class A
The V 12/V 21 is suitable for use in all establishments other
than domestic establishments and those directly connected
to the public low-voltage power supply network that supplies
buildings used for domestic purposes
Voltage
fluctuations/
Flicker
emissions IEC
61000-3-3
Complies
V Series Operating Instructions
0070-10-0727-02
28 - 45
Electromagnetic Capability
Product Specifications
TABLE 28-30
GUIDANCE AND DECLARATION - ELECTROMAGNETIC IMMUNITY
The V 12/V 21 is intended for use in the electromagnetic environment specified below. The customer or the
user of the V 12/V 21 should assure that it is used in such an environment.
IEC 60601 TEST
LEVEL
COMPLIANCE
LEVEL
ELECTROMAGNETIC ENVIRONMENT GUIDANCE
Electrostatic
discharge (ESD)
IEC 61000-4-2
±6 kV contact ±8
kV air
±6 kV contact
±8 kV air
Floors should be wood, concrete or
ceramic tile. If floors are covered with
synthetic material, the relative humidity
should be at least 30%.
Electrical fast
transient/burst IEC
61000-4-4
±2 kV for power
supply lines ±1 kV
for input/output
lines
±2 kV for power
supply lines ±1 kV
for input/output
lines
Mains power quality should be that of a
typical commercial or hospital
environment.
Surge
IEC 61000-4-5
±1 kV differential
mode ±2 kV
common mode
±1 kV differential
mode ±2 kV
common mode
Mains power quality should be that of a
typical commercial or hospital
environment.
Voltage dips, short
interruptions and
voltage variations
on power supply
input lines IEC
61000-4-11
<5% UT (>95%
dip in UT ) for 0.5
cycle
<5% UT (>95% dip
in UT ) for 0.5 cycle
Mains power quality should be that of a
typical commercial or hospital
environment. If the user of the V 12/V 21
requires continued operation during
power mains interruptions, it is
recommended that the V 12/V 21 be
powered from an uninterruptible power
supply or a battery.
IMMUNITY TEST
40% UT (60% dip
in UT ) for
5 cycles
70% UT (30% dip
in UT ) for
25 cycles
<5% UT (>95%
dip in UT ) for 5
sec
Power frequency
(50/60 Hz)
magnetic field IEC
61000-4-8
3 A/m
40% UT (60% dip in
UT ) for
5 cycles
70% UT (30% dip in
UT ) for
25 cycles
<5% UT (>95% dip
in UT ) for 5 sec
3 A/m
Power frequency magnetic fields should
be at levels characteristic of a typical
location in a typical commercial or
hospital environment.
UT is the A.C. mains voltage prior to application of the test level.
28 - 46
0070-10-0727-02
V Series Operating Instructions
Product Specifications
Electromagnetic Capability
TABLE 28-31
GUIDANCE AND DECLARATION - ELECTROMAGNETIC IMMUNITY
The V 12/V 21 is intended for use in the electromagnetic environment specified below. The customer or the user
of the V 12/V 21 should assure that it is used in such an environment.
IMMUNITY
TEST
IEC 60601 TEST
LEVEL
COMPLIANCE
LEVEL
ELECTROMAGNETIC ENVIRONMENT GUIDANCE
Portable and mobile RF communications
equipment should be used no closer to any
part of the V 12/V 21, including cables, than
the recommended separation distance
calculated from the equation applicable to
the frequency of the transmitter.
Recommended separation distance
Conducted RF
IEC 61000-4-6
3 Vrms
150 kHz to 80 MHz
3 Vrms
d = 1.2 x
P
Radiated RF IEC
61000-4-3
3 V/m
80 MHz to 2.5 GHz
3 V/m
d = 1.2 x
P
80 MHz to 800 MHz
d = 2.3 x
P
800 MHz to 2.5 GHz
where P is the maximum output power
rating of the transmitter in watts (W)
according to the transmitter manufacturer
and d is the recommended separation
distance in meters (m).
Field strengths from fixed RF transmitters, as
determined by an electromagnetic site
survey,a should be less than the compliance
level in each frequency range.b
Interference may occur in the
vicinity of equipment marked
with the following symbol:
NOTE:
At 80 MHz and 800 MHz, the higher frequency range applies.
NOTE:
These guidelines may not apply in all situations. Electromagnetic
propagation is affected by absorption and reflection from structures,
objects and people.
a
b
V Series Operating Instructions
Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and
land mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy. To assess the electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey should be considered. If the measured field strength in the location in which the V 12/V
21 is used exceeds the applicable RF compliance level above, the V 12/V 21 should be observed to verify normal operation. If abnormal performance is observed, additional measures may be necessary, such as reorienting or relocating the V 12/V 21.
Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.
0070-10-0727-02
28 - 47
Electromagnetic Capability
Product Specifications
TABLE 28-32
RECOMMENDED SEPARATION DISTANCES BETWEEN PORTABLE AND MOBILE RF
COMMUNICATIONS EQUIPMENT AND THE V 12/V 21
The V 12/V 21 is intended for use in an electromagnetic environment in which radiated RF disturbances are
controlled. The customer or the user of the V 12/V 21 can help prevent electromagnetic interference by
maintaining a minimum distance between portable and mobile RF communications equipment (transmitters)
and the V 12/V 21 as recommended below, according to the maximum output power of the communications
equipment.
RATED MAXIMUM OUTPUT
POWER (P)
OF TRANSMITTER
IN WATTS (W)
SEPARATION DISTANCE (d) IN METERS (m) ACCORDING TO
FREQUENCY OF TRANSMITTER
150 kHz to
80 MHz
d = 1.2 x
P
80 MHz to
800 MHz
d = 1.2 x
800 MHz to
2.5 GHz
P
d = 2.3 x
0.01
0.12
0.12
0.23
0.1
0.38
0.38
0.73
1
1.2
1.2
2.3
10
3.8
3.8
7.3
100
12
12
23
P
For transmitters rated at a maximum output power not listed above, the recommended separation distance d
in meters (m) can be determined using the equation applicable to the frequency of the transmitter, where P is
the maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer.
28 - 48
NOTE:
At 80 MHz and 800 MHz, the separation distance for the higher
frequency range applies.
NOTE:
These guidelines may not apply in all situations. Electromagnetic
propagation is affected by absorption and reflection from
structures, objects and people.
0070-10-0727-02
V Series Operating Instructions
Product Specifications
Environmental Conditions
28.7
Environmental Conditions
28.7.1
Power Supply
A power supply from another equipment for equipment in a system shall be specified by the
manufacturer.
28.8
Sound
•
Power-on self test tone
•
Alarm tone
•
•
IEC alarm tone (high, medium, low; complies with the requirements of IEC60601-1-8)
•
Provides 1 to 10 levels of alarm tone adjustment.
•
Sound Pressure Range: 45 to 85 dB
Key-pressing prompt tone
•
•
28.9
Provides hard key tones for informational signals
Systole heartbeat tone/pulse beat tone (Pitch tone)
•
Provides 0 to 10 levels of tone adjustment. "0" stands for no sound.
•
Provides systole sound for technical signals
•
Provides Pitch Tone based on the SpO2 value
Communication Protocols
Alarm Delay Time to Remote Equipment
The alarm delay time from the V 12/V 21 to remote equipment is 2 seconds, measured at the V 12/
V 21 signal output connector.
28.10
Connection to Panorama® Central Station
The V 12/V 21 communicates with the Panorama Central Station via direct hardwire CS1 port. Refer
to the Panorama Operating Instructions Manual for a list of supported parameters.
The V 12/V 21 is capable of transmitting a discharge command to a Panorama Central Station. It is
also capable of bi-directional transmission of patient demographics and patient alarm settings with a
Panorama Central Station.
When Discharge is selected from the Patient Menu and Enable Network is set to “Wired”, the
Panorama discharges the patient.
28.11
Operator Position
The operator of the device should be positioned in front of the V 12/V 21 display at a distance of no
more than 1 meter.
V Series Operating Instructions
0070-10-0727-02
28 - 49
Operator Position
Product Specifications
This page intentionally left blank.
28 - 50
0070-10-0727-02
V Series Operating Instructions
29.0
Glossary
This section provides a glossary of terminology used throughout the V 12/V 21 Operating
Instructions.
•
V Series Operating Instructions
Terms, Acronyms, and Abbreviations
0070-10-0727-02
29 - 1
Terms, Acronyms, and Abbreviations
29.1
Glossary
Terms, Acronyms, and Abbreviations
TERMS
DEFINITIONS
Agent
The gas used to anesthetize a patient during surgery
Arrhythmia
Abnormal ECG rhythms
Bedside Monitor
A monitoring device that has its own user interface and does not
require the Panorama Central Station to be its primary monitoring
source
Heart Rate
Number of heartbeats detected during a one minute time period
Internet Protocol (IP)
TCP/IP is the standard protocol that defines the IP datagram as the
unit of information passed across an Internet. IP provides the basis
for connectionless, best effort packet delivery of services.
Invasive Blood
Pressure (IBP)
Method of obtaining blood pressure using an internal pressure
sensor
Monitoring Device
The instrumentation connected to the patient. The monitoring
device acquires the patient data and then transmits it onto the
network.
Non-Invasive Blood Pressure Method of obtaining blood pressure using an external cuff
(NIBP)
Panorama Central Network
Supports hardwired communication between Panorama Central
Stations and laser printers
Panorama Patient Network
Supports hardwired communication of the real-time patient data
collected by monitoring devices attached to the patient
Panorama Wireless Network Supports wireless communications between the wireless
monitoring devices and the Panorama Server.
29 - 2
PAWP
Pulmonary Artery Wedge Pressure
Persistent
Data or settings maintained and remain available until purposely
edited or deleted
Respiration
Number of breaths during a one minute time period
SpO2
Level of Oxygen Saturation in the blood
ST
The ST portion of the ECG waveform
0070-10-0727-02
V Series Operating Instructions
Glossary
Terms, Acronyms, and Abbreviations
ACRONYMS/ABBREVIATIONS
DEFINITIONS
ADT
Admit Discharge Transfer
AHA
American Heart Association
American Hospital Association
APP
Abdominal Perfusion Pressure
ART
Arterial Pressure
APOD
Adaptive Probe Off Detection
AXI
Axillary
BLA
Bladder
bpm
Beats per minute
BSA
Body Surface Area
C
Current ST
Chest Lead (IEC)
CCO
Continuous Cardiac Output
CCI
Continuous Cardiac Index
CePP
Cerebral Perfusion Pressure
cm
Centimeters
CO
Cardiac Output
CI
Cardiac Index
C-LAN
Panorama Central Network
CO2
Carbon Dioxide
CVA
Cardiovascular Artifact
CVP
Central Venous Pressure
Des
Desoflurane
Oxygen Delivery
DO2
2
-5
dynes/sec/m /cm
Dynes per sec per meter squared per centimeter to the power
of -5
dynes/sec/cm-5
Dynes per sec per centimeter to the power of -5
EDV
End Diastolic Volume
EDVI
End Diastolic Volume Index
ECG
Electrocardiogram
EMC
Electromagnetic Compatibility
Enf
Enflurane
EMR
Electronic Medical Records
ESO
Esophageal
ESV
End Systolic Volume
V Series Operating Instructions
0070-10-0727-02
29 - 3
Terms, Acronyms, and Abbreviations
Glossary
ACRONYMS/ABBREVIATIONS
DEFINITIONS
ESVI
End Systolic Volume Index
ET
End-Tidal when referencing CO2/O2/N2O/Agent parameters
Elapsed Time when referencing NIBP
F
Left Leg when referring to ECG Leads (IEC)
Hal
Haloflurane
HR
Heart Rate
IAP
Intra-abdominal Pressure
IBP
Invasive Blood Pressure
ICP
Intracranial Pressure
IEC
International Electro-Technical Commission
in
Inches
INSP
Inspired
IP
Internet Protocol
ISO
Isoflurane when referencing Agent
Isoelectric when referencing ST monitoring
kg
Kilograms
kPa
Kilopascals Per Atmosphere
L
Left Arm when referring to ECG Leads (IEC)
Liters per minute
l/min
l/min/m
29 - 4
2
Liters per minute per meter squared
LA
Left Arm when referring to ECG Leads (AHA)
lbs
Pounds
LL
Left Leg when referring to ECG Leads (AHA)
LV
Left Ventricle
MAP
Mean Arterial Pressure
MDD
Medical Device Directive
mmHg
Millimeters of Mercury
N
Right Leg when referring to ECG Leads (IEC)
N2O
Nitrous Oxide
NAS
Nasal
NIBP
Non-Invasive Blood Pressure
NSR
Normal Sinus Rhythm
O2
Oxygen
O2EI
Oxygen Extraction
PA
Pulmonary Artery
0070-10-0727-02
V Series Operating Instructions
Glossary
Terms, Acronyms, and Abbreviations
ACRONYMS/ABBREVIATIONS
DEFINITIONS
PI
Perfusion Index
Pleth
Plethysmograph
PVC
Premature Ventricular Contraction
R
Right Arm when referring to ECG Leads (IEC)
Referenced ST
RA
Right Atrium when referring to IBP
Right Arm when referring to ECG Leads (AHA)
REC
Rectal
RESP
Respiration Rate
RL
Right Leg when referring to ECG Leads (AHA)
rpm
Respirations per minute
RVEF
Right Ventricular Ejection Fraction
ScVO2
Central Venous Oxygen Saturation
Sev
Sevoflurane
SKI
Skin
SpO2
Oxygen Saturation
SvO2
Saturated Venous Oxygenation
SV
Stroke Volume
SVI
Stroke Volume Index
SVR
Systemic Vascular Resistance
SVRI
Systemic Vascular Resistance Index
SVV
Stroke Volume Variation
TEMP
Temperature
T Blood
Blood temperature
UA
Umbilical Artery
V
Chest Lead (AHA)
VO2
Oxygen Consumption
V Series Operating Instructions
0070-10-0727-02
29 - 5
0070-10-0727-02
Revision B
September 8, 2011
SHENZHEN MINDRAY BIO-MEDICAL ELECTRONICS CO., LTD.• Mindray Building, Keji 12th Road
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